bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Associated With Maternal and Neonatal Interventions at the Threshold of Viability
Authors: Hajdu Sierra A. , Rossi Robert M. , DeFranco Emily A.
Published: May 2020

OBJECTIVE:

To quantify the influence of maternal sociodemographic, medical, and pregnancy characteristics on decisions to offer or receive antepartum and neonatal interventions with deliveries occurring at 22–23 weeks of gestation.

METHODS:

This is a case–control study of U.S. live births at 22 0/7–23 6/7 weeks of gestation using National Center for Health Statistics vital statistics birth records from 2012 to 2016. We analyzed three outcomes in the treatment of periviable delivery: 1) maternal interventions (cesarean delivery, maternal hospital transfer or antenatal corticosteroid administration), 2) neonatal interventions (neonatal intensive care unit admission, surfactant administration, antibiotic administration, or assisted ventilation), and 3) combined interventions (at least one maternal and at least one neonatal intervention). Logistic regression estimated the influence of characteristics on interventions received.

RESULTS:

Of 19,844,580 U.S. live births from 2012 to 2016, 24,379 (0.12%) occurred at 22–23 weeks of gestation. Of these, 37.5% received maternal interventions, 51.7% received neonatal interventions, and 28.0% received combined interventions. Rates of births receiving at least one intervention were 38.9% and 78.3% for 22 and 23 weeks of gestation, respectively. Preeclampsia was the factor most positively associated with interventions. Other factors positively associated with interventions were increasing maternal age, Medicaid, low educational attainment, multiparity, twin gestation, and infertility treatment. Some factors had opposite influences on maternal compared with neonatal interventions. The presence of birth defects was positively associated with maternal interventions but negatively associated with neonatal interventions, whereas being of black race was negatively associated with maternal interventions but positively associated with neonatal interventions.

CONCLUSION:

Maternal and neonatal interventions occur frequently at the threshold of viability, especially at 23 weeks of gestation where the occurrence of interventions exceeds 50%. This study identifies sociodemographic and medical factors associated with using interventions with periviable deliveries. These data elucidate observed practice patterns in the management of periviable births and may assist providers in the counseling of women at risk of periviable birth.
Association of Antenatal Corticosteroids and Magnesium Sulfate Therapy With Neurodevelopmental Outcome in Extremely Preterm Children
Authors: Gentle Samuel J. , Carlo Waldemar A. , Tan Sylvia , Gargano Marissa , Ambalavanan Namasivayam , Chawla Sanjay , Bell Edward F. , Bann Carla M. , Hintz Susan R. , Heyne Roy J. , Tita Alan , Higgins Rosemary D. ,   for the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Neonatal Research Network
Published: May 2020

OBJECTIVE:

To test the primary hypothesis that extremely preterm children antenatally exposed to both magnesium sulfate and antenatal corticosteroids have a lower rate of severe neurodevelopmental impairment or death compared with those exposed to antenatal corticosteroids alone.

METHODS:

This was a prospective observational study of children born at 22 0/7–26 6/7 weeks of gestation from 2011 to 2014 at Eunice Kennedy Shriver National Institute of Child Health and Human Development Neonatal Research Network hospitals (N=3,093). The primary outcome was severe neurodevelopmental impairment or death at 18–26 months of corrected age follow-up based on exposure to antenatal corticosteroids and magnesium sulfate or antenatal corticosteroids alone. Secondary outcomes included components of severe neurodevelopmental impairment by exposure group and comparisons of severe neurodevelopmental impairment or death between children exposed to both antenatal corticosteroids and magnesium sulfate with those exposed to magnesium sulfate alone or to neither antenatal corticosteroids nor magnesium sulfate. Logistic regression models adjusted for background characteristics.

RESULTS:

Children exposed to both antenatal corticosteroids and magnesium sulfate had a lower rate of severe neurodevelopmental impairment or death (813/2,239, 36.3%) compared with those exposed to antenatal corticosteroids alone (225/508, 44.3%; adjusted odds ratio [aOR] 0.73; 95% CI 0.58–0.91), magnesium sulfate alone (47/89, 53%; aOR 0.49; 95% CI 0.29–0.82), or neither therapy (121/251; 48.2%; aOR 0.66, 95% CI 0.49–0.89). Similarly, children exposed to both antenatal corticosteroids and magnesium sulfate had a lower rate of death compared with either or neither therapy, but the rate of severe neurodevelopmental impairment among survivors did not differ between exposure groups.

CONCLUSION:

In children born between 22 0/7 and 26 6/7 weeks of gestation, exposure to both antenatal corticosteroids and magnesium sulfate was associated with lower rates of severe neurodevelopmental impairment or death and death compared with exposure to antenatal corticosteroids alone.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT00063063.
Coronavirus Disease 2019 (COVID-19) and Pregnancy
Authors: Jago Caitlin Anne , Singh Sukhbir Sony , Moretti Felipe
Published: May 2020

With the current global coronavirus disease 2019 (COVID-19) pandemic, new challenges arise as social distancing and isolation have become the standard for safety. Evidence supports the protective benefits of social connections and support during pregnancy and labor; there are increased maternal, fetal, and pregnancy risks when pregnant and laboring women lack support. As health care professionals take appropriate precautions to protect patients and themselves from infection, there must be a balance to ensure that we do not neglect the importance of social and emotional support during important milestones such as pregnancy and childbirth. Resources are available to help pregnant women, and technology represents an opportunity for innovation in providing care.
A Postpartum Death Due to Coronavirus Disease 2019 (COVID-19) in the United States
Authors: Vallejo Victoria , Ilagan John G.
Published: May 2020

BACKGROUND:

Limited U.S. reports of pregnant women with coronavirus disease 2019 (COVID-19) infection describe a few critical cases and no maternal mortality.

CASE:

A 36-year-old patient at 37 weeks of gestation presented with shortness of breath, fever, cough, and sore throat for 1 week. Within 3 hours of admission, she experienced respiratory distress, required intubation, and underwent cesarean delivery and transfer to the intensive care unit. She subsequently decompensated, with multiorgan failure, sepsis, and cardiopulmonary arrest within 36 hours, despite aggressive supportive care and investigational therapies.

CONCLUSION:

A pregnant patient with COVID-19 infection can experience a rapid onset of critical complications that may prove fatal, despite an indolent presentation. The pathogenesis leading to rapid deterioration is unknown.
Prevalence of primary aldosteronism and association with cardiovascular complications in patients with resistant and refractory hypertension
Authors: Parasiliti-Caprino Mirko , Lopez Chiara , Prencipe Nunzia , Lucatello Barbara , Settanni Fabio , Giraudo Giuseppe , Rossato Denis , Mengozzi Giulio , Ghigo Ezio , Benso Andrea , Maccario Mauro
Published: May 2020

Objectives:

To assess the prevalence of primary aldosteronism and its association with cardiometabolic complications in patients with resistant and refractory hypertension.

Methods:

One hundred and ten consecutive patients with true resistant hypertension [insufficient blood pressure control despite appropriate lifestyle measures and treatment with at least three classes of antihypertensive medication, including a diuretic] and without previous cardiovascular events were screened for secondary hypertension. Refractory hypertension was diagnosed in case of uncontrolled blood pressure despite the use of at least five antihypertensive drugs.

Results:

Primary aldosteronism was diagnosed in 32 cases (29.1%). The multivariate analysis showed that primary aldosteronism is a strong factor positively associated with left ventricular hypertrophy [odds ratio (OR) = 12.98, 95% confidence interval (CI) 3.82–60.88; P < 0.001], microalbuminuria (OR = 3.67, 95% CI 1.44–9.78; P = 0.007), carotid intima–media thickness at least 0.9 mm (OR = 2.69, 95% CI 1.02–7.82; P = 0.037), aortic ectasia (OR = 4.08, 95% CI 1,18–15.04; P = 0.027) and atrial fibrillation (OR 8.80, 95% CI 1.53–73.98; P = 0.022). Moreover, primary aldosteronism was independently associated with the presence of at least one (OR = 8.60, 95% CI 1.73–69.88; P = 0.018) and at least two types of organ damage (OR = 3.08, 95% CI 1.19–8.24; P = 0.022). Thirteen patients (11.8%) were affected by refractory hypertension. This group was characterized by significantly higher values of carotid intima–media thickness, higher rate of aldosterone-producing adenoma and atrial fibrillation, compared with the other individuals with resistant hypertension.

Conclusion:

The current study indicates that primary aldosteronism is a frequent cause of secondary hypertension and cardiovascular complications among patients with resistant and refractory hypertension, suggesting a crucial role of aldosterone in the pathogenesis of severe hypertensive phenotypes and cardiovascular disease.
Symptomatic Infection is Associated with Prolonged Duration of Viral Shedding in Mild Coronavirus Disease 2019: A Retrospective Study of 110 Children in Wuhan
Authors: Lu Yingying , Li Yi , Deng Wenyue , Liu Mingyang , He Yuanzhi , Huang Lingyue , Lv Mengxue , Li Jianxin , Du Hao
Published: May 2020

Background:

Information regarding viral shedding in children with coronavirus disease 2019 (COVID-19) was limited. This study aims to investigate the clinical and laboratory characteristics associated with viral shedding in children with mild COVID-19.

Methods:

The clinical and laboratory information of 110 children with COVID-19 at Wuhan Children’s Hospital, Wuhan, China, from January 30 to March 10, 2020, were analyzed retrospectively.

Results:

The median age was 6 years old. The median period of viral shedding of COVID-19 was 15 days (interquartile range [IQR], 11–20 days) as measured from illness onset to discharge. This period was shorter in asymptomatic patients (26.4%) compared with symptomatic patients (73.6%) (11 days vs. 17 days). Multivariable regression analysis showed increased odds of symptomatic infection was associated with age <6 years (odds ratio [OR] 8.94, 95% confidence interval [CI]: 2.55–31.35; P = 0.001), hypersensitive C-reactive protein >3.0 mg/L (OR 4.89; 95% CI: 1.10–21.75; P = 0.037) and presenting pneumonia in chest radiologic findings (OR 8.45; 95% CI: 2.69–26.61; P < 0.001). Kaplan-Meier analysis displayed symptomatic infection (P < 0.001), fever (P = 0.006), pneumonia (P = 0.003) and lymphocyte counts <2.0 × 109/L (P = 0.008) in children with COVID-19 were associated with prolonged duration of viral shedding in children with COVID-19.

Conclusion:

Prolonged duration of viral shedding in children with COVID-19 was associated with symptomatic infection, fever, pneumonia and lymphocyte count less than 2.0 × 109/L. Monitoring of symptoms could help to know the viral shedding in children with COVID-19.
Effectiveness and agreement of 3 optical biometers in measuring axial length in the eyes of patients with mature cataracts
Authors: Henriquez Maria Alejandra , Zúñiga Raúl , Camino Maythé , Camargo Jorge , Ruiz-Montenegro Katia , Izquierdo Luis
Published: May 2020

Purpose:

To evaluate the effectiveness and agreement of 3 optical biometers in measuring axial length (AL) and biometric parameters in the eyes of patients with mature cataracts.

Setting:

Oftalmosalud Instituto de Ojos, Peru.

Design:

Prospective, comparative study.

Methods:

Eyes with mature cataracts were examined. Three consecutive scans were performed with each device: the IOLMaster 700, the Galilei G6, and the Pentacam AXL. The following parameters were recorded: AL, anterior flat keratometry (K1), steep K (K2), anterior astigmatism, mean K (Km), anterior chamber depth (ACD), central corneal thickness (CCT), and lens thickness. Agreement between devices was assessed using the coefficient of correlation of concordance (CCC).

Results:

Forty-five eyes were included. After 3 attempts, the acquisition success rates in measuring mature cataracts were 84.4% (38/45), 42.2% (19/45), and 37.7% (17/45) for the IOLMaster, the Galilei, and the Pentacam, respectively. Significant differences were found between the Pentacam and the IOLMaster in terms of AL, K2, and CCT. Significant differences were found in terms of K1, K2, Km, ACD, and CCT between the Pentacam and the Galilei; and significant differences were found in AL, K1, Km, and ACD between the Galilei and the IOLMaster (P < .05 all). Good correlations were found between devices (>0.90) in terms of keratometries and AL.

Conclusions:

The IOLMaster 700 had the highest AL acquisition success rate when compared with the Pentacam AXL and Galilei G6. Good agreement between devices was found in terms of AL and K readings.
The Effect of Rehospitalization and Emergency Department Visits on Subsequent Adherence to Weight Telemonitoring
Authors: Haynes Sarah C. , Tancredi Daniel J. , Tong Kathleen , Hoch Jeffrey S. , Ong Michael K. , Ganiats Theodore G. , Evangelista Lorraine S. , Black Jeanne T. , Auerbach Andrew , Romano Patrick S. ,   On behalf of the Better Effectiveness After Transition–Heart Failure (BEAT-HF) Research Group
Published: May 2020

Background

Weight telemonitoring may be an effective way to improve patients' ability to manage heart failure and prevent unnecessary utilization of health services. However, the effectiveness of such interventions is dependent upon patient adherence.

Objective

The purpose of this study was to determine how adherence to weight telemonitoring changes in response to 2 types of events: hospital readmissions and emergency department visits.

Methods

The Better Effectiveness After Transition–Heart Failure trial examined the effectiveness of a remote telemonitoring intervention compared with usual care for patients discharged to home after hospitalization for decompensated heart failure. Participants were followed for 180 days and were instructed to transmit weight readings daily. We used Poisson regression to determine the within-person effects of events on subsequent adherence.

Results

A total of 625 events took place during the study period. Most of these events were rehospitalizations (78.7%). After controlling for the number of previous events and discharge to a skilled nursing facility, the rate for adherence decreased by nearly 20% in the 2 weeks after a hospitalization compared with the 2 weeks before (adjusted rate ratio, 0.81; 95% confidence interval: 0.77–0.86; P < .001).

Conclusions

Experiencing a rehospitalization had the effect of diminishing adherence to daily weighing. Providers using telemonitoring to monitor decompensation and manage medications should take advantage of the potential “teachable moment” during hospitalization to reinforce the importance of adherence.
Hidden blood loss and the risk factors after posterior lumbar fusion surgery
Authors: Lei Fei , Li Zhongyang , He Wen , Tian Xinggui , Zheng Lipeng , Kang Jianping , Feng Daxiong
Published: May 2020

Hidden blood loss (HBL) plays an important role in perioperative rehabilitation of patients underwent posterior lumbar fusion surgery. This study was to calculate the volume of HBL and evaluate the risk factors among patients after posterior lumbar fusion surgery.

A retrospective analysis was made on the clinical data of 143 patients underwent posterior lumbar fusion surgery from March 2017 to December 2017. Recording preoperative and postoperative hematocrit to calculate HBL according to Gross formula and analyzing its related factors including age, sex, height, weight, body mass index (BMI), surgery levels, surgical time, surgery types, duration of symptoms, disorder type, specific gravity of urine (SGU), plasma albumin (ALB), glomerular filtration rate (GFR), glucose (GLU), drainage volume, hypertension. Risk factors were further analyzed by multivariate linear regression analysis and t test.

Eighty-six males and 57 females, mean age 52.7 ± 11.4 years, mean height 162 ± 7.0, mean weight 61.5 ± 9.4, were included in this study. The HBL was 449 ± 191 mL, with a percentage of 44.2% ± 16.6% in the total perioperative blood loss. Multivariate linear regression analysis revealed that patients with higher BMI (P = .026), PLIF procedures (P = .040), and more surgical time (P = .018) had a greater amount of HBL. Whereas age (P = 0.713), sex (P = .276), surgery levels (P = .921), duration of symptoms (P = .801), disorder type (P = .511), SGU (P = .183), ALB (P = .478), GFR (P = .139), GLU (P = .423), hypertension (P = .337) were not statistically significant differences with HBL.

HBL is a large proportion of total blood loss in patients after posterior lumbar fusion surgery. BMI >24 kg/m2, PLIF procedures, and more surgical time are risk factors of HBL. Whereas age, sex, surgery levels, duration of symptoms, disorder type, SGU, ALB, GFR, GLU, hypertension were not associated with HBL.
The Efficacy of PowerPoint-based CBT Delivered Through Email: Breaking the Barriers to Treatment for Generalized Anxiety Disorder
Authors: ALAVI NAZANIN , HIRJI ALYSSA
Published: May 2020

Objective:

A lack of resources and cultural stigma associated with mental health treatment necessitate the development of innovative and economical individualized treatments. This study evaluated the efficacy of delivering computer-based cognitive behavioral therapy (e-CBT) presented through Microsoft PowerPoint and delivered via email in the treatment of generalized anxiety disorder (GAD) to Iranian patients, as a means of overcoming treatment barriers.

Methods:

Participants (N=80) of Iranian descent were recruited through announcements on psychology websites, Iranian organization websites, weblogs, and in flyers. Participants were randomly assigned to either an e-CBT or a control group. The e-CBT group received 12 weekly modules and homework assignments through email, presented using PowerPoint. The control group received no treatment (individuals in the control group were able to pursue another treatment, but would then be excluded from the study although they could continue with the program). All emails were sent by an attending or resident psychiatrist, who also provided feedback on weekly homework via email. The Beck Anxiety Inventory was used to measure levels of anxiety before study onset and changes in levels of anxiety upon completion of the program at 12 weeks, and at 6-month and 1-year follow-up in both groups.

Results:

Beck Anxiety Inventory scores were significantly reduced in the group who received PowerPoint e-CBT modules delivered via email, compared with the control group, following 12 weeks of treatment, and the reductions were maintained at both follow-up points.

Conclusions:

Delivery of PowerPoint e-CBT modules via email was found to be a viable method for delivering CBT to individuals with GAD and a simple method for overcoming language, cultural, and travel barriers to accessing mental health resources. This simplified approach to the individualization and delivery of treatment modules has the potential to improve access to CBT as a treatment option throughout the world.
Group Intervention for Young Adults With Mood and Anxiety Disorders Transitioning to College
Authors: CHUGANI CARLA D. , GOLDSTEIN TINA R. , SALK RACHEL H. , POLING KIM , SAKOLSKY DARA , BRENT DAVID
Published: May 2020

Young adults with chronic mood and anxiety disorders may receive a range of services in pediatric care (eg, psychiatry, therapy) and within the school system (eg, individualized education plans). Such services rely on the involvement of parents or guardians to support youth (eg, attending appointments, administering medications). However, in college, young adults are often on their own and need to assume responsibility for scheduling appointments, obtaining and taking medications, and seeking out additional services (eg, accommodations). Unfortunately, many young adults may not have developed the skills needed to navigate campus and health care systems effectively, which can often lead to dire consequences. Adding to these difficulties are the high rates of depression and suicidal ideation observed in today’s college students. Many students need intermediate levels of care to stay in school successfully, although not all have the maturity and skills to navigate health care without a transition plan. To address the needs of young adults transitioning out of pediatric mental health care, we developed a brief group intervention delivered to young adults and their parents during the 6 months before college or transition to living independently in the community. The transition group program structured sessions focused on scaffolding knowledge about one’s own skills (and deficits) related to independent living, successful transition to college or community, and ability to independently manage a chronic mental health disorder. All young adults and parents reported that they would recommend or strongly recommend the group to a friend, and the majority found the group to be acceptable with regard to length and frequency. For both young adults and parents, the future outlook also improved from pregroup to postgroup.
Leekyejoonella antrihumi gen. nov., sp. nov., a new member of the family Dermacoccaceae isolated from a cave soil
Authors: Lee Soon Dong , Kim In Seop , Schumann Peter , Song Gwanpil
Published: May 2020

A novel Gram-stain-positive, actinobacterial strain, designated C5-26T, was isolated from soil from a natural cave in Jeju, Republic of Korea, and its taxonomic position was investigated using a polyphasic approach. The organism was aerobic, and cells were non-spore-forming, non-motile cocci that occurred singly, in pairs, in triplets, in tetrads, in short chains or in irregular clusters. Colonies of the cells were circular, convex, entire and white. The peptidoglycan type was A4α with an l-Ser–d-Asp interpeptide bridge. The whole-cell sugars comprised glucose, rhamnose, mannose, arabinose, galactose and ribose. The major menaquinone was MK-8(H4). The polar lipids contained diphosphatidylglycerol, phosphatidylglycerol, phosphatidylinositol and an unidentified phospholipid. The major fatty acids were iso-C16 : 0 and iso-C16 : 1 h. The size of the draft genome was 5.32 Mbp with depth of coverage of 161×. The G+C content of the genomic DNA was 67.1 mol%. Phylogenetic analyses based on 16S rRNA gene sequences showed that the novel isolate belonged to the family

Dermacoccaceae

and formed a distinct subcluster at the base of the radiation of the genus

Luteipulveratus

. Highest sequence similarities of the novel isolate were found to the type strains of

Luteipulveratus halotolerans

(96.2 %),

Branchiibius hedensis

(95.4 %),

Luteipulveratus mongoliensis

(95.4 %) and

Branchiibius cervicis

(95.3 %). The whole genome-based phylogeny supported the novelty of the isolate at the genus level in the family

Dermacoccaceae

. On the basis of data from this polyphasic study, strain C5-26T (=KCTC 39632T=DSM 108676T) represents a novel species of a new genus in the family

Dermacoccaceae

, for which the name Leekyejoonella antrihumi gen. nov., sp. nov. is proposed.
Human cytomegalovirus major immediate early transcripts arise predominantly from the canonical major immediate early promoter in reactivating progenitor-derived dendritic cells
Authors: Mason Rebecca , Groves Ian J. , Wills Mark R. , Sinclair John H. , Reeves Matthew B.
Published: May 2020

Human cytomegalovirus latency and reactivation is a major source of morbidity in immune-suppressed patient populations. Lifelong latent infections are established in CD34+progenitor cells in the bone marrow, which are hallmarked by a lack of major lytic gene expression, genome replication and virus production. A number of studies have shown that inhibition of the major immediate early promoter (MIEP) – the promoter that regulates immediate early (IE) gene expression – is important for the establishment of latency and that, by extension, reactivation requires reversal of this repression of the MIEP. The identification of novel promoters (termed ip1 and ip2) downstream of the MIEP that can drive IE gene expression has led to speculation over the precise role of the MIEP in reactivation. In this study we show that IE transcripts arise from both the MIEP and ip2 promoter in the THP1 cell macrophage cell line and also CD14+monocytes stimulated with phorbol ester. In contrast, we show that in in vitro generated dendritic cells or macrophages that support HCMV reactivation IE transcripts arise predominantly from the MIEP and not the intronic promoters. Furthermore, inhibition of histone modifying enzyme activity confirms the view that the MIEP is predominantly regulated by the activity of cellular chromatin. Finally, we observe that ip2-derived IE transcription is cycloheximide-sensitive in reactivating DCs, behaviour consistent with an early gene designation. Taken together, these data argue that MIEP activity is still important for HCMV reactivation but ip2 activity could play cell-type-specific roles in reactivation.
Meningococcal core and accessory phasomes vary by clonal complex
Authors: Wanford Joseph J. , Holmes Jonathan C. , Bayliss Christopher D. , Green Luke R.
Published: May 2020

Neisseria meningitidis

is a Gram-negative human commensal pathogen, with extensive phenotypic plasticity afforded by phase-variable (PV) gene expression. Phase variation is a stochastic switch in gene expression from an ON to an OFF state, mediated by localized hypermutation of simple sequence repeats (SSRs). Circulating

N. meningitidis

clones vary in propensity to cause disease, with some clonal complexes (ccs) classified as hypervirulent and others as carriage-associated. We examined the PV gene repertoires, or phasome, of these lineages in order to determine whether phase variation contributes to disease propensity. We analysed 3328 genomes representative of nine circulating meningococcal ccs with PhasomeIt, a tool that identifies PV genes by the presence of SSRs and homologous gene clusters. The presence, absence and functions of all identified PV gene clusters were confirmed by annotation or blast searches within the

Neisseria

PubMLST database. While no significant differences were detected in the number of PV genes or the core, conserved phasome content between hypervirulent and carriage lineages, individual ccs exhibited major variations in PV gene numbers. Phylogenetic clusters produced by phasome or core genome analyses were similar, indicating co-evolution of PV genes with the core genome. While conservation of PV clusters is high, with 76 % present in all meningococcal isolates, maintenance of an SSR is variable, ranging from conserved in all isolates to present only in a single cc, indicating differing evolutionary trajectories for each lineage. Diverse functional groups of PV genes were present across the meningococcal lineages; however, the majority directly or indirectly influence bacterial surface antigens and could impact on future vaccine development. Finally, we observe that meningococci have open pan phasomes, indicating ongoing evolution of PV gene content and a significant potential for adaptive changes in this clinically relevant genus.
AsnB is responsible for peptidoglycan precursor amidation in Clostridium difficile in the presence of vancomycin
Authors: Ammam Fariza , Patin Delphine , Coullon Héloise , Blanot Didier , Lambert Thierry , Mengin-Lecreulx Dominique , Candela Thomas
Published: May 2020

Clostridium difficile

630 possesses a cryptic but functional gene cluster vanG
Cd homologous to the vanG operon of

Enterococcus faecalis

. Expression of vanG
Cd in the presence of subinhibitory concentrations of vancomycin is accompanied by peptidoglycan amidation on the meso-DAP residue. In this paper, we report the presence of two potential asparagine synthetase genes named asnB and asnB2 in the

C. difficile

genome whose products were potentially involved in this peptidoglycan structure modification. We found that asnB expression was only induced when

C. difficile

was grown in the presence of vancomycin, yet independently from the vanG
Cd resistance and regulation operons. In addition, peptidoglycan precursors were not amidated when asnB was inactivated. No change in vancomycin MIC was observed in the asnB mutant strain. In contrast, overexpression of asnB resulted in the amidation of most of the

C. difficile

peptidoglycan precursors and in a weak increase of vancomycin susceptibility. AsnB activity was confirmed in

E. coli

. In contrast, the expression of the second asparagine synthetase, AsnB2, was not induced in the presence of vancomycin. In summary, our results demonstrate that AsnB is responsible for peptidoglycan amidation of

C. difficile

in the presence of vancomycin.
Clinical characteristics and fecal–oral transmission potential of patients with COVID-19
Authors: Wang Saibin , Tu Junwei , Sheng Yijun
Published: May 2020

Background

A significant proportion of patients with COVID-19 generate negative pharyngeal swab viral nucleic acid test results but test positive using fecal samples. However, fecal–oral transmission of COVID-19 has not been established to date. The purpose of this study was to evaluate the duration of fecal swab positivity in COVID-19 patients after pharyngeal swab nucleic acid test turned negative and to explore its potential for fecal–oral transmission.

Methods

A retrospective analysis of clinical records, laboratory results, and chest computed tomography (CT) findings of 17 COVID-19 patients confirmed by laboratory tests from January 22 to February 7, 2020 at a tertiary hospital was performed. The potential of fecal–oral transmission was assessed by detecting the presence of SARS-CoV-2 nucleic acid in fecal swab samples.

Results

A total of 16 patients (94.1%) had fever; other symptoms included dry cough, dyspnea, nausea, diarrhea, sore throat, fatigue, and muscle pain. Three patients had decreased white blood cell counts, 7 had decreased lymphocyte numbers, and 7 had increased C-reactive protein levels. Fecal samples of 11 patients tested positive for SARS-CoV-2 nucleic acid, of whom the time for the fecal samples to become SARS-CoV-2 nucleic acid-negative was longer in 10 patients than that for pharyngeal swab samples, and only one case exhibited a shorter time for his fecal sample to become SARS-CoV-2 nucleic acid-negative compared to his pharyngeal swab sample. The remaining 6 patients were negative for SARS-CoV-2 nucleic acid in fecal samples.

Conclusion

In COVID-19 patients who tested positive for SARS-CoV-2 nucleic acid in both pharyngeal swab and fecal samples, the time for the fecal samples to become SARS-CoV-2 nucleic acid-negative was generally longer than that in pharyngeal swab samples. However, there is currently no evidence demonstrating that the virus can be transmitted through the fecal–oral route.
Inhibition of the replication of SARS-CoV-2 in human cells by the FDA-approved drug chlorpromazine
Authors: Plaze Marion , Attali David , Prot Matthieu , Petit Anne-Cécile , Blatzer Michael , Vinckier Fabien , Levillayer Laurine , Perin-Dureau Florent , Cachia Arnaud , Friedlander Gérard , Chrétien Fabrice , Simon-Loriere Etienne , Gaillard Raphaël
Published: May 2020

Urgent action is needed to fight the ongoing COVID-19 pandemic by reducing the number of infected people along with the infection contagiousness and severity. Chlorpromazine (CPZ), the prototype of typical antipsychotics from the phenothiazine group, is known to inhibit clathrin-mediated endocytosis and acts as an antiviral, in particular against SARS-CoV-1 and MERS-CoV. In this study, we describe thein vitrotesting of CPZ against a SARS-CoV-2 isolate in monkey and human cells. We evidenced an antiviral activity against SARS-CoV-2 with an IC50 of ∼10μM. Because of its high biodistribution in lung, saliva and brain, such IC50 measuredin vitromay translate to CPZ dosage used in clinical routine. This extrapolation is in line with our observations of a higher prevalence of symptomatic and severe forms of COVID-19 infections among health care professionals compared to patients in psychiatric wards. These preclinical findings support the repurposing of CPZ, a largely used drug with mild side effects, in COVID-19 treatment.
Cryo-Electron Microscopy Visualization of a Large Insertion in the 5S ribosomal RNA of the Extremely Halophilic ArchaeonHalococcus morrhuae
Authors: Tirumalai Madhan R , Kaelber Jason T , Park Donghyun R , Tran Quyen , Fox George E
Published: May 2020

The extreme halophileHalococcus morrhuae(ATCC® 17082) contains a 108-nucleotide insertion in its 5S rRNA. Large rRNA expansions in Archaea are rare. This one almost doubles the length of the 5S rRNA. In order to understand how such an insertion is accommodated in the ribosome, we obtained a cryo-electron microscopy reconstruction of the native large subunit at subnanometer resolution. The insertion site forms a four-way junction that fully preserves the canonical 5S rRNA structure. Moving away from the junction site, the inserted region is conformationally flexible and does not pack tightly against the large subunit.
Coronavirus activates a stem cell-mediated defense mechanism that reactivates dormant tuberculosis: implications in COVID-19 pandemic
Authors: Pathak Lekhika , Gayan Sukanya , Pal Bidisha , Talukdar Joyeeta , Bhuyan Seema , Sandhya Sorra , Yeger Herman , Baishya Debabrat , Das Bikul
Published: May 2020

We postulate that similar to bacteria, adult stem cells may also exhibit an innate defense mechanism to protect their niche. Here, we provide preliminary data on stem cell based innate defense against a mouse model of coronavirus, murine hepatitis virus-1 (MHV-1) infection. In a mouse model of mesenchymal stem cell (MSC) mediatedMycobacterium tuberculosis(Mtb) dormancy, MHV-1 infection in the lung exhibited 20 fold lower viral loads than the healthy control mice, suggesting the potential enhancement of an anti-MHV-1 defense byMtb. This defense mechanism involves thein vivoexpansion and reprogramming of CD271+MSCs in the lung to an enhanced stemness phenotype. The reprogrammed MSCs facilitate the activation of stemness genes, intracellular Mtb replication, and extracellular release ofMtb. The conditioned media of the reprogrammed MSCs exhibit direct anti-viral activity in anin vitromodel of MHV-1 induced toxicity to type II alveolar epithelial cells. Thus, our data suggest that reprogrammed MSCs exert a unique innate defense against MHV-1 by activating dormantMtb.The molecular details of this anti-viral defense mechanism against coronavirus could be further studied to develop a vaccine against COVID-19.
Establishment and maintenance of motor neuron identity via temporal modularity in terminal selector function
Authors: Li Yinan , Osuma Anthony , Correa Edgar , Okebalama Munachiso A. , Dao Pauline , Gaylord Olivia , Aburas Jihad , Islam Priota , Brown André E.X. , Kratsios Paschalis
Published: May 2020

Terminal selectors are transcription factors (TFs) that establish during development and maintain throughout life post-mitotic neuronal identity. We previously showed that UNC-3/Ebf, the terminal selector ofC. eleganscholinergic motor neurons (MNs), acts indirectly to prevent alternative neuronal identities (Feng et al., 2020). Here, we globally identify the direct targets of UNC-3. Unexpectedly, we find that the suite of UNC-3 targets in MNs is modified across different life stages, revealing “temporal modularity” in terminal selector function. In all larval and adult stages examined, UNC-3 is required for continuous expression of various protein classes (e.g., receptors, transporters) critical for MN function. However, only in late larvae and adults, UNC-3 is required to maintain expression of MN-specific TFs. Minimal disruption of UNC-3’s temporal modularity via genome engineering affects locomotion. AnotherC. elegansterminal selector (UNC-30/Pitx) also exhibits temporal modularity, supporting the potential generality of this mechanism for the control of neuronal identity.
Sales order backlog and corporate cash holdings
Authors: Deng Kailing , Nichols Linda , Sun Li
Published: May 2020

Purpose

We examine the impact of sales order backlog (an important leading performance indicator) on corporate cash holdings and the role of corporate governance in the relation between sales order backlog and cash holdings.

Design/methodology/approach

We use the regression analysis to examine our research questions.

Findings

Consistent with the agency motive and the precautionary motive of cash holdings, we document a significant negative relation between order backlog and cash, suggesting that firms with higher order backlog hold less cash. We further examine and find that the relationship between order backlog and cash becomes stronger for firms with stronger corporate governance, highlighting the role of governance in determining the level of corporate cash holdings.

Originality/value

Our study contributes to the accounting literature on sales order backlog and the finance literature on corporate cash holdings. In particular, our study contributes to developing a more comprehensive understanding of the sales order backlog because it is still an under-researched area in accounting. To the best of our knowledge, this study is perhaps the first empirical study that examines the direct link between order backlog and cash.
Reimagining career collections to increase usage and engagement
Authors: Grays Lateka , Tucker James Cory
Published: May 2020

Purpose

The purpose of this study is to describe a case study of building a career collection at an academic library and to assess the use of materials and the services provided to students and the career services office.

Design/methodology/approach

This study reviewed circulation statistics and COUNTER reports to identify usage of career services resources.

Findings

The major findings of this study indicated that items in the print career collection experienced higher circulation rate than items in the circulating collection at Lied Library.

Originality/value

The information and findings of this study can provide a background of services and information on how to build a career collection in an academic library that can be used as an example for other libraries interested in providing career services and/or collections.
Novel green plants extract as corrosion inhibiting coating for steel embedded in concrete
Authors: ElShami Ahmed A. , Bonnet Stéphanie , Makhlouf Mohamed Hussein , Khelidj A. , Leklou N.
Published: May 2020

Purpose

This paper aims to evaluate the ability of Aubepine and Molokhia extract, obtained by cathodic electrochemical treatment (CET), to protect steel rebar against attack by chloride ions in environment of reinforced concrete marine structures. The effect of Aubepine and Molokhia extract was investigated by electrochemical impedance spectroscopy (EIS) and potentiodynamic polarization techniques.

Design/methodology/approach

This experimental work has achieved particularity to compare the behaviour of two types of treatment (carbon steel treated one time by Aubepine extract and one time by Molokhia extract) submitted to the presence and absence of chloride ions.

Findings

The results obtained show that the extract solution of the plant could serve as an effective inhibitor for the corrosion of steel. Inhibition was found to increase with increasing concentration of Molokhia extract and for Aubepine extract maximum concentration is 1 g/L.

Research limitations/implications

Plant extracts and traditional medicinal herbs have become important as an environmentally acceptable, readily available and renewable source for wide range of inhibitors.

Originality/value

Aubepine and Molokhia extract are novel green plants extract as corrosion inhibiting coating for steel embedded in concrete. Aubepine is a genus of trees in the family Rosaceae and Molokhia is the leaves of Corchorus olitorius. Flavonoids content was found in both of Aubepine and Molokhia extract as green inhibitors for corrosion of metals.
Epidemiology and clinical features of emergency department patients with suspected COVID‐19: Initial results from the COVID‐19 Emergency Department Quality Improvement Project (COVED‐1)
Authors: O'Reilly Gerard M , Mitchell Rob D , Rajiv Prithi , Wu Jamin , Brennecke Helen , Brichko Lisa , Noonan Michael P , Hiller Ryan , Mitra Biswadev , Luckhoff Carl , Paton Andrew , Smit De Villiers , Santamaria Mark J , Cameron Peter A
Published: May 2020

Objective

The COVID‐19 Emergency Department (COVED) Quality Improvement Project aims to provide regular and real‐time clinical information to ED clinicians caring for patients with suspected and confirmed COVID‐19. The present study summarises data from the first 2 weeks of the study.

Methods

COVED is an ongoing prospective cohort study that commenced on 1 April 2020. It includes all adult patients presenting to a participating ED who undergo testing for SARS‐CoV‐2. Data are collected prospectively and entered into a bespoke registry. Outcomes include a positive SARS‐CoV‐2 polymerase chain reaction test result and requirement for intensive respiratory support.

Results

In the period 1–14 April 2020, 240 (16%) of 1508 patients presenting to The Alfred Emergency and Trauma Centre met inclusion criteria. Of these, 11 (5%) tested positive for SARS‐CoV‐2. The mean age of patients was 60 years and the commonest symptoms were acute shortness of breath (n = 122 [67%]), cough (n = 108 [56%]) or fever (n = 98 [51%]). Overseas travel or known contact with a confirmed case was reported by 24 (14%) and 16 (10%) patients, respectively. Fever or hypoxia was recorded in 23 (10%) and 11 (5%) patients, respectively. Eleven (5%) patients received mechanical ventilation in the ED, of whom none tested positive for SARS‐CoV‐2.

Conclusions

Among patients presenting to a tertiary ED with suspected COVID‐19, only a small proportion tested positive for SARS‐CoV‐2. Although the low incidence of positive cases currently precludes the development of predictive tools, the COVED Project demonstrates that the rapid establishment of an agile clinical registry for emergency care is feasible.
Naphyrone (naphthylpyrovalerone): Pharmacokinetics, behavioural effects and thermoregulation in Wistar rats
Authors: Pinterova‐Leca Nikola , Horsley Rachel R. , Danda Hynek , Žídková Monika , Lhotková Eva , Šíchová Klára , Štefková Kristýna , Balíková Marie , Kuchař Martin , Páleníček Tomáš
Published: May 2020

Naphthylpyrovalerone (naphyrone) is a pyrovalerone cathinone that potently inhibits monoamine transporters and provides stimulatory‐entactogenic effects. Little is known about the safety of naphyrone or its effects in vivo, and more research is needed to acquire knowledge about its fundamental effects on physiology and behaviour. Our objective was to investigate naphyrone's pharmacokinetics, acute toxicity, hyperthermic potential and stimulatory and psychotomimetic properties in vivo in male Wistar rats. Pharmacokinetics after 1 mg/kg subcutaneous (sc.) naphyrone were measured over 6 h in serum, the brain, liver and lungs. Rectal temperature (degree Celsius) was measured over 10 h in group—versus individually housed rats after 20 mg/kg sc. In the behavioural experiments, 5, 10 or 20 mg/kg of naphyrone was administered 15 or 60 min prior to testing. Stimulation was assessed in the open field, and sensorimotor processing in a prepulse inhibition (PPI) task. Peak concentrations of naphyrone in serum and tissue were reached at 30 min, with a long‐lasting elevation in the brain/serum ratio, consistent with observations of lasting hyperlocomotion in the open field and modest increases in body temperature. Administration of 20 mg/kg transiently enhanced PPI. Naphyrone crosses the blood–brain barrier rapidly and is eliminated slowly, and its long‐lasting effects correspond to its pharmacokinetics. No specific signs of acute toxicity were observed; therefore, clinical care and harm‐reduction guidance should be in line with that available for other stimulants and cathinones.
Outcomes following acute tocolysis prior to emergency caesarean section
Authors: Buckley Victoria A. , Wu Joyce , De Vries Bradley
Published: May 2020

Aim

To determine if a policy recommending administration of terbutaline prior to emergency caesarean section improved arterial umbilical cord pH.

Materials and Methods

This was a prospective audit between February 2018 and June 2019 among women who underwent a category one or two caesarean section. Neonatal cord gas results and perinatal outcomes were compared before and after the introduction of a policy recommending subcutaneous terbutaline prior to emergency caesarean section.

Results

Among 423 women in the pre‐policy change cohort and 253 post‐policy change, there was no difference in arterial cord pH (median pH = 7.24 before the policy and median pH = 7.24 after the policy was introduced, P = 0.88). There was no statistically significant difference in any perinatal outcome, apart from the median arterial cord lactate which was higher in the post‐treatment group (4.2 mmol/L vs 3.9 mmol/L, P = 0.006). Maternal heart rate was higher (median 110 vs 95, P < 0.0001) in the post‐treatment group. Breastfeeding was more common in the post‐treatment group (99% vs 95%, P = 0.005). There was no difference in estimated blood loss or rate of post‐partum haemorrhage. A post hoc analysis according to treatment received, limited to caesarean section when the indication was suspected fetal compromise, demonstrated that among women who received terbutaline the rate of low pH (<7.1) was 3.8% (5/130) when terbutaline was given, compared with 6.6% (18/272) when terbutaline was not given (χ21 = 1.3, P = 0.26).

Conclusion

Changing our labour ward policy to recommending terbutaline prior to all category one and category two caesarean sections did not change arterial cord pH.
The predictive power of macroeconomic uncertainty for commodity futures volatility
Authors: Huang Zhuo , Liang Fang , Tong Chen
Published: May 2020

We investigate whether and to what extent macroeconomic uncertainty predicts the volatility of commodity futures. By examining 26 commodities in six categories, we find that the measure of aggregate macroeconomic uncertainty based on a large dataset has a significant predictive effect for commodity volatility. The predictive relationship holds both in‐sample and out‐of‐sample after controlling for lagged volatility. The extent of the predictability differs by commodity category, with energy, precious metals, and industrial metals futures having the most significant effect. For all commodities, the predictive power of macroeconomic uncertainty is stronger in more recent data and during recessions.