bluuebunny/crossref_metadata_2025 huggingface dataset:
Location-Based Sedentary Time and Physical Activity in People Living With Coronary Artery Disease
Authors: Trecarten Neil , Kirkland Susan , Rainham Daniel , Giacomantonio Nicholas , McGowan Erin , Murnaghan Donna , Reid Robert , King-Shier Kathryn , Spence John C. , Warburton Darren , Rhodes Ryan E. , Blanchard Chris M.
Published: September 2020

Purpose:

Sedentary time (ST) and lack of physical activity increase the risk of adverse outcomes for those living with coronary artery disease (CAD). Little is known about how much ST, light physical activity (LPA), and moderate to vigorous physical activity (MVPA) that CAD participants not attending cardiac rehabilitation engage in, the locations where they engage in these behaviors, and how far from home the locations are.

Methods:

Participants completed a survey and wore an accelerometer and global positioning system receiver for 7 d at baseline and 6 mo later.

Results:

Accelerometer analyses (n = 318) showed that participants averaged 468.4 ± 102.7 of ST, 316.1 ± 86.5 of LPA, and 32.9 ± 28.9 of MVPA min/d at baseline. ST and LPA remained stable at 6 mo, whereas MVPA significantly declined. The global positioning system (GPS) analyses (n = 315) showed that most of participant ST, LPA, and MVPA time was spent at home followed by other residential, retail/hospitality, and work locations at baseline and 6 mo. When not at home, the average distance to a given location ranged from approximately 9 to 18 km.

Conclusions:

Participants with CAD spent the majority of their time being sedentary. Home was the location used the most to engage in ST, LPA, and MVPA. When not home, ST, LPA, and MVPA were distributed across a variety of locations. The average distance from home to a given location suggests that proximity to home may not be a barrier from an intervention perspective.
Influence of cardiovascular risk factors on arterial hypertension and mild cognitive impairment in 4602 participants of the ELITE study
Authors: Schrader Bastian , Schrader Joachim , Elsässer Albrecht , Bünker Anna-Maria , Hillmann Berit , Vaske Bernhard , Haller Hermann , Lüders Stephan
Published: September 2020

Background:

In ELITE (Ernährung, Lebensstil und individuelle Information zur Verhinderung von Herzinfarkt, Schlaganfall und Demenz; german for: Nutrition, Lifestyle and Individual Information for the Prevention of Heart Attack, Stroke and Dementia) data on cardiovascular risk factors, cognitive function and quality of life are prospectively collected, which will be improved through targeted individual information. The aim is to improve the health of the participants and identify the reasons for the lack of implementation.

Methods:

Risk factors of 4602 participants were linked to (controlled) hypertension and mild cognitive impairment (MCI). Blood pressure was measured according to the guidelines and the DEMTECT– test was used to detect MCI.

Results:

The most common risk factor was hypertension (60%). Hypertensive patients were older (56.1 and 44.7 years), had a higher BMI (28 and 24.8 kg/m2), frequently physical inactive (26 and 32.4%), diabetes (9.3 and 1.3%), higher LDL (134.7 and 124.1 mg/dl), higher triglycerides (169.6 and 124.8 mg/dl) and lower HDL (57.9 and 65.5 mg/dl) compared with normotensives (P < 0.001). Controlled hypertensive patients are less common men (46.1 and 52.1%, P < 0.001), have a lower BMI (28.3 and 29.1 kg/m2, P < 0.001), lower LDL (129.0 and 135.6 mg/dl, P = 0.004) and lower triglycerides (162.5 and 182.3 mg/dl, P = 0.001) compared with treated uncontrolled hypertensive patients. Antihypertensives per person (2.015; 2.017) do not differ. The prevalence of MCI is highly significantly associated with the number of risk factors. in participants without risk factors, the prevalence is 3.9%, in participants with 4 risk factors, 16.3%. In hypertensive patients, the frequency is 11.8% compared with 4.8% for normotensives (P < 0.001). The occurrence of MCI depends significantly from age, blood pressure and diabetes

Conclusion:

The frequency of MCI is highly significantly associated with the number of cardiovascular risk factors, regardless of age. The prevalence was particularly high among hypertensive patients, which is not often described. The occurrence of MCI depends significantly from age, blood pressure and diabetes. The metabolic syndrome and lack of exercise complicate blood pressure control.
Immune Reconstitution and Thymic Involution in the Acute and Delayed Hematopoietic Radiation Syndromes
Authors: Wu Tong , Plett P. Artur , Chua Hui Lin , Jacobsen Max , Sandusky George E. , MacVittie Thomas J. , Orschell Christie M.
Published: September 2020

Lymphoid lineage recovery and involution after exposure to potentially lethal doses of ionizing radiation have not been well defined, especially the long-term effects in aged survivors and with regard to male/female differences. To examine these questions, male and female C57BL/6 mice were exposed to lethal radiation at 12 wk of age in a model of the Hematopoietic-Acute Radiation Syndrome, and bone marrow, thymus, spleen, and peripheral blood examined up to 24 mo of age for the lymphopoietic delayed effects of acute radiation exposure. Aged mice showed myeloid skewing and incomplete lymphocyte recovery in all lymphoid tissues. Spleen and peripheral blood both exhibited a monophasic recovery pattern, while thymus demonstrated a biphasic pattern. Naïve T cells in blood and spleen and all subsets of thymocytes were decreased in aged irradiated mice compared to age-matched non-irradiated controls. Of interest, irradiated males experienced significantly improved reconstitution of thymocyte subsets and peripheral blood elements compared to females. Bone marrow from aged irradiated survivors was significantly deficient in the primitive lymphoid-primed multipotent progenitors and common lymphoid progenitors, which were only 8-10% of levels in aged-matched non-irradiated controls. Taken together, these analyses define significant age- and sex-related deficiencies at all levels of lymphopoiesis throughout the lifespan of survivors of the Hematopoietic-Acute Radiation Syndrome and may provide a murine model suitable for assessing the efficacy of potential medical countermeasures and therapeutic strategies to alleviate the severe immune suppression that occurs after radiation exposure.
Identification of a High-risk Subgroup With Malignant Mitral Valve Prolapse Who Are Predisposed to Sudden Cardiac Death: A Review
Authors: Russo Ronald , Maan Abhishek , Apostolidou Eirini , Khorasani-Zadeh Arshia , Byrnes Sean , Chebaya Philip , Beale Robert , Abbasi Mohammad Usama , Beale Charles
Published: September 2020

Mitral valve prolapse (MVP) affects approximately 170 million people worldwide; however, phenotypically, there is a wide variety of heterogeneity. In particular subsets, the incidence of sudden cardiac death is calculated to be 998 per 100,000 person-years, which is significantly increased when compared with the general population of MVP patients. Individuals with high-risk features have been identified as young females with bileaflet MVP and electrocardiogram findings of frequent complex ectopy, ST-T wave changes, and inferior T wave inversions. Supplemental imaging modalities in this subgroup demonstrate redundant leaflets and chordae on 2-dimensional transthoracic echocardiography along with varying severity of mitral annular disjunction. Detailed morphologic assessment by 3-dimensional echocardiography provides a quantitative assessment of annular disjunction along with left ventricular longitudinal and basal circumferential strain patterns. Late gadolinium enhancement on cardiac magnetic resonance imaging identifies diffuse and isolated left ventricle fibrosis involving the fascicles and papillary muscles, which has been visualized in isolation during autopsy. Findings of this review propose that sudden cardiac death as a result of malignant arrhythmias arises from automaticity, complex ectopy, and reentry at the level of the fascicles and papillary muscles. The repetitive mechanical stress provides a nidus for the development of both micro- and macrofibrosis easily identified by late gadolinium enhancement on cardiac magnetic resonance imaging. Escalation to electrophysiology studies and early intervention could provide new targeted lifesaving therapies.
Short- and Long-Term Stability of Plasma Rich in Growth Factors Eye Drops
Authors: Anitua Eduardo , de la Fuente María , Muruzábal Francisco , Merayo-Lloves Jesús
Published: September 2020

Purpose:

To analyze whether plasma rich in growth factors (PRGFs) eye drops preserve their activity and biological properties after storage for 9 and 12 months at −20°C, and at 4°C, and at room temperature (RT) for 3 and 7 days in comparison to fresh samples (t0).

Methods:

PRGF eye drops were obtained from 6 healthy donors. Then, they were stored for 9 and 12 months at −20°C. At each time, different PRGF eye drops samples were thawed and maintained at RT or at 4°C for 3 and 7 days. Platelet-derived growth factor-AB, epidermal growth factor, transforming growth factor-β1, vascular endothelial growth factor, angiopoietin-1, and thrombospondin-1 were analyzed at each time and temperature of storage. In addition, the pH level, the microbial contamination, and the proliferative potential on primary human corneal stromal fibroblasts human keratocytes of each obtained PRGF eye drops were also evaluated.

Results:

All growth factor levels were preserved at each time and storage condition. No differences were observed on the human keratocytes proliferation after treatment with PRGF eye drops at any studied time or temperature. No microbial contamination was observed in any of the PRGF eye drops. Finally, the pH levels increased significantly after 9 and 12 months of storage at −20°C compared with t0.

Conclusions:

PRGF eye drops can be stored for up to 12 months without reduction of the main growth factors and proteins and without any microbial contamination. Furthermore, the biological activity of the PRGF eye drops is maintained after storing for 3 and 7 days at 4°C or at RT.
Longitudinal Epithelial Thickness Profile Changes 18 Months After Photorefractive Keratectomy
Authors: Latifi Golshan , Mohammadi S.Saeed , Davoodabadi Mahmood
Published: September 2020

Purpose:

Long-term evaluation of corneal epithelial thickness (ET) profile changes after photorefractive keratectomy (PRK) using Fourier-domain anterior segment optical coherence tomography.

Methods:

Three hundred twenty-six eyes of 163 patients were included in this prospective observational study. The corneal epithelial map was obtained across a 9-mm diameter area of the cornea before and up to 27 months after surgery. ET was assessed in 25 sectors and 4 annular zones (central 2 mm, paracentral 2–5 mm, midperipheral 5–7 mm, and peripheral 7–9 mm).

Results:

There was a significant reduction in mean ET in all zones 1 month after PRK. Subsequently, ET increased in all annular zones. The change in mean ET became stable in the midperipheral and peripheral zones at 3 to 6 months and in the central zone at 12 months, and it continued to increase in the paracentral zone even after 18 months after surgery. The ET was 3.40 μm and 4.05 μm in the central and paracentral zones at 6 months, respectively. Postoperative spherical equivalent changed significantly only from 1 to 3 months (P < 0.04). There was a significant correlation between postoperative spherical equivalent at month 1 and ET change in the paracentral and midperipheral zones (P < 0.027).

Conclusions:

There is a significant reduction in ET 1 month after myopic PRK with a gradual thickening thereafter until it reaches stability at 12 months in the central zone. However, it continues to change even after 18 months in the paracentral zone. The greatest thickening is in the paracentral zone, followed by the central zone.
Effect of intraoperative mitomycin-C application on epithelial regeneration after transepithelial photorefractive keratectomy
Authors: Lu Nan-Ji , Koppen Carina , Awwad Shady , Aslanides Minas I. , Aslanides Ioannis M. , Chen Shi-Hao
Published: September 2020

Purpose:

To investigate the effect of mitomycin-C (MMC) intraoperative application on postoperative corneal epithelial remodeling, haze incidence, and refractive correction in transepithelial photorefractive keratectomy (transPRK).

Setting:

Eye Hospital of Wenzhou Medical University, Wenzhou, China.

Design:

Prospective randomized controlled study.

Methods:

Eyes that completed all follow-ups were included. Epithelial thickness (ET) map measurement was conducted preoperatively and at 1 week, and at 1 month, 3 months, and 6 months postoperatively, generating ET in central, paracentral, and midperipheral zones. The difference between postoperative and preoperative ET (ΔET) was computed for each zone. During follow-up, haze incidence and visual acuity were assessed and compared between groups.

Results:

A total of 100 eyes completed all follow-up, including 40 eyes treated with MMC in MMC group and 60 eyes in control group without MMC treatment. For ΔET, between-group difference was found in midperipheral (P = .011) zone at 1 week postoperatively and in central (P = .036) and paracentral zones (P = .039) at 1 month postoperatively. Haze incidence was lower in MMC group at 1 week and 1 month postoperatively (P = .035 and .018, respectively). Safety index (postoperative uncorrected distance visual acuity/preoperative corrected distance visual acuity [CDVA]) and efficacy index (postoperative CDVA/preoperative CDVA) were higher in MMC group (P = .012 and P = .036, respectively) at 1 month postoperatively. No difference was found after 3 months postoperatively.

Conclusions:

With a temporary impact on corneal epithelial regeneration and refractive correction, intraoperative MMC application in transPRK decreased the haze incidence but had no effect on epithelial remodeling.
Rethinking the optimal methods for vector analysis of astigmatism
Authors: Koch Douglas D. , Wang Li , Abulafia Adi , Holladay Jack T. , Hill Warren
Published: September 2020

Purpose:

To evaluate the accuracy and usefulness of certain methods of analyzing astigmatic vectors.

Setting:

Cullen Eye Institute, Baylor College of Medicine, Houston, Texas.

Design:

Case samples.

Methods:

Using 2 sample cases for analysis of corneal surgically induced astigmatism and an actual toric intraocular lens (IOL) case, univariate analyses from the ASSORT program were compared to double-angle plots of preoperative and postoperative astigmatism and prediction errors.

Results:

Certain univariate figures for analyzing the 2 sample cases were misleading. For the toric IOL case, some of the key outcome vectors were inaccurate.

Conclusions:

ASSORT's univariate analysis of astigmatic vectors can be unpredictably erroneous and misleading. Recommended vector analyses should include double-angle plots with centroids and confidence ellipses of preoperative and postoperative astigmatism and the prediction errors, along with means and standard deviations of these vector magnitudes.
Effect of topical povidone–iodine 10% plus levofloxacin 0.5% 1 hour before cataract surgery in eliminating perioperative conjunctival flora: randomized clinical trial
Authors: Eslami Jamshid , Rezaei Roghayeh , Jamali Hossein , Sedaghat Ahad , Nowroozzadeh Mohammad Hossein
Published: September 2020

Purpose:

To evaluate the effect of a single administration of topical povidone–iodine (PVI) 10% plus levofloxacin 0.5% at 1 hour before cataract surgery on perioperative elimination rate of conjunctival flora.

Setting:

Poostchi Ophthalmology Research Center, Shiraz, Iran.

Design:

Randomized controlled trial.

Method:

Patients who required cataract surgery were randomly assigned to 1 of 2 groups: intervention (administration of PVI 10% plus levofloxacin 0.5% at 1 hour preoperatively) or control. The patients in both groups received PVI just before the operation. Conjunctival cultures were obtained using thioglycollate broth at 4 timepoints: T1, before intervention; T2, before the second application of PVI; T3, 3 minutes after the second administration of PVI; and T4, just postoperatively.

Results:

The study comprised 142 patients. The comparative rates of positive cultures in the intervention vs control groups were as follows: T1 (70.4% vs 73.2%, P = .709); T2 (15.5% vs 71.8%, P < .001); T3 (7.0% vs 19.7%, P = .027); and T4 (5.6% vs 4.2%, P = .698). Coagulase-negative Staphylococci was the most common isolated microorganism.

Conclusions:

Results showed that a single adjuvant application of PVI 10% plus levofloxacin 0.5% eyedrops at 1 hour before operation leads to a further increase in the rate of sterile conjunctiva just preoperatively.
Micro-RNA-183-5p acts as a potential diagnostic biomarker for atherosclerosis and regulates the growth of vascular smooth muscle cell
Authors: Sun Bin , Shan Zhengkun , Sun Guoyu , Wang Xiaolong
Published: September 2020

Background:

Atherosclerosis (AS) is a multifactorial chronic disease, and vascular smooth muscle cells (VSMCs) play important roles in the pathology of AS. Micro-RNAs regulate multiple cellular biological processes. This study aimed to investigate the clinical value of miR-183-5p in AS patients and further explored the effects of miR-183-5p on the proliferation and migration of VSMCs.

Methods:

Quantitative real-time polymerase chain reaction was used to test the level of miR-183-5p. The diagnostic value of miR-183-5p for AS patients was assessed by a receiver operating characteristic (ROC) analysis. The proliferation and migration of VSMCs were determined via the CCK-8 and Transwell assay.

Results:

MiR-183-5p was highly expressed in AS patients compared with the healthy group. Serum miR-183-5p expression was positively associated with carotid intima-media thickness and C-reactive protein in AS patients. The ROC analysis suggested that miR-183-5p had the quality to be used as a biomarker with high specificity and sensitivity for AS detection. Overexpression of miR-183-5p promoted the proliferation and migration of VSMCs.

Conclusion:

MiR-183-5p is highly expressed in AS patients, which promotes the proliferation and migration of VSMCs. MiR-183-5p may be a key molecular in the diagnosis and treatment of AS in the future.
Hemodilution Increases the Susceptibility of Red Blood Cells to Mechanical Shear Stress During In Vitro Hemolysis Testing
Authors: Sargent Christian R. , Perkins Ina Laura , Kanamarlapudi Venkateswarlu , Moriarty Christopher , Ali Sabrina
Published: September 2020

The American Society for Testing and Materials (ASTM) F1841 standard for the assessment of hemolysis in blood pumps recommends using phosphate-buffered saline (PBS) for hemodilution to standardize hematocrit (HCT). However, PBS increases red blood cell mechanical fragility and hemolysis. Herein, we investigated diluents and dilutions during in vitro testing to reduce hemodilution bias when assessing hemolysis. Bovine blood was diluted with either PBS or PBS + 4/6 g% bovine serum albumin (BSA) to a 70/90% blood dilution, or to an HCT of 30% ± 2%, and pumped with the CentriMag or RotaFlow under hemodynamic conditions. Separately, bovine and human blood were subjected to ventricular assist device–like shear stress using a vortex. Plasma-free hemoglobin levels, normalized milligram index of hemolysis (mgNIH), and protein concentrations were analyzed. Hemolysis depended on the diluent and final blood concentration. Seventy percent of blood diluted with PBS alone caused significantly greater hemolysis than PBS + 4/6 g% BSA. However, at 90% blood, PBS + 4/6 g% BSA caused significantly greater hemolysis than PBS alone. Hence, a positive correlation between mgNIH and hemodilution was observed with PBS and a negative correlation with PBS + 4g% BSA. PBS alone significantly reduced the total protein concentration. Hemodilution with BSA maintains protein concentration within a physiologic range and reduces bias during hemolysis testing at high blood dilutions. Thus, American Society for Testing and Materials standards could consider including BSA as a diluent, when and as required: where large dilution is required (<83%) use PBS + 4 g% BSA, otherwise use PBS alone.
Sleep quality in individuals with short—duration chronic spinal cord injury
Authors: Aydin Tuğba , Öneş Kadriye , Kesiktaş Fatma Nur , Corum Mustafa , Kalaoğlu Eser , Karacan Ilhan
Published: September 2020

The aim of the study is to estimate the association between spinal cord injuries related medical factors and subjective sleep disturbance in individuals with short-duration chronic spinal cord injury. Seventy-nine individuals with traumatic spinal cord injuries were included in our study and evaluated using the Beck Depression Index for severity of depressive symptoms, Short-Form Health Survey for quality of life, Douleur Neuropathique 4 score for neuropathic pain severity, and the Pittsburgh Sleep Quality Index for subjective sleep disturbances in a tertiary rehabilitation center. Associated subjective sleep disturbance factors were predicted using multivariate binary logistic regression analysis. Subjective sleep disturbance frequency was 74.7 %, and significantly higher in individuals with paraplegia (P = 0.025, odds ratio, 9.74, 95% confidence interval, 1.21–78.14). Intermittent nighttime catheterization frequency and neuropathic pain severity levels were significantly higher in individuals with subjective sleep disturbance, and quality of life and depressive symptoms were significantly worse in individuals with subjective sleep disturbance. Poor-sleep quality was associated significantly with shorter spinal cord injury duration. The strongest associated factors for sleep disturbance were paraplegic involvement, severity of depressive symptoms (Beck Depression Index score), and quality of life (Short-Form Health Survey general health perceptions score) (odds ratio: 95% confidence interval, 29.75; 1.66–534.36, 1.47; 1.11–1.95, and 0.91; 0.85–0.97, respectively). Our study suggests that paraplegic involvement, low quality of life, and depressive mood are related to sleep disturbance in individuals with traumatic spinal cord injury.
Polypharmacy After Elective Orthopaedic Surgery
Authors: Pelkowski Jessica N.
Published: September 2020

Polypharmacy is common, especially among older patients. Polypharmacy can lead to adverse patient outcomes and increased healthcare costs. After elective hip or knee arthroplasty, several new medications are prescribed, which can contribute to polypharmacy, although these medications are necessary in the postoperative period. Although some instances of polypharmacy may be appropriate, many are not. Nurse practitioners play a vital role in identifying and preventing inappropriate polypharmacy in the postoperative period and can develop individualized therapy plans for each patient to provide safe medication use in patients. This would be beneficial in the orthopaedic surgery postoperative period because of the introduction of several new medications.
Communication Preferences in Total Joint Arthroplasty
Authors: Groeneveld Bob S. , Dekkers Tessa , Mathijssen Nina M. C. , Vehmeijer Stephan B. W. , Melles Marijke , Goossens Richard H. M.
Published: September 2020

BACKGROUND:

Improving communication and information services for people receiving a total joint (knee or hip) arthroplasty (TJA) depends on the differences in patient communication needs and personal characteristics.

PURPOSE:

The purpose of this study was to further examine individual differences in TJA patient preferences regarding communication and information provision.

METHODS:

Nineteen patients participated in generative research, which meant they actively reflected on their TJA experiences and communication preferences through creative exercises (e.g., collage making). Audio transcripts of their shared reflections were qualitatively analyzed through an inductive approach.

RESULTS:

Some participants wanted detailed health education, others did not. Participants also reported different support needs (e.g., at hospital discharge or during rehabilitation). Moreover, participant preferences for social connections with care providers differed.

CONCLUSIONS:

An individual patient's mindset, his or her social support needs, physical condition, and medical history should guide the provision of tailored services.
Parental Mental Health Care After Their Child’s Pediatric Intensive Care Hospitalization*
Authors: Logan Grace E. , Sahrmann John M. , Gu Hongjie , Hartman Mary E.
Published: September 2020

Objectives:

Post-traumatic stress disorder, depression, and anxiety have all been found in parents of PICU survivors. How these research findings translate to actual use of mental health services by parents remains unknown.

Design:

Retrospective observational cohort study.

Setting:

Insurance claims data from 2006 to 2013 obtained from the IBM MarketScan Commercial Database.

Patients:

Parents of PICU survivors.

Interventions:

We examined rates of: 1) mental health diagnoses, 2) outpatient mental health visits, and 3) prescriptions for antidepressants and anxiolytics among parents, 6 months before and 6 months after their child’s PICU admission, using each parent as their own control.

Measurements and Main Results:

Of the 95,070 parents identified, 9.5% received a new mental health diagnosis in the 6 months after their child’s PICU hospitalization, which represented a 110% increase from pre-PICU rates. A smaller proportion of parents were given new prescriptions for antidepressants (3.4%) and anxiolytics (3.9%) in the 6 months after their child’s PICU hospitalization. Mothers were twice as likely to receive a new mental health diagnosis and be taking a new medication than fathers in the post-PICU period. The parental diagnosis of acute stress disorder or post-traumatic stress disorder increased by 87% from the pre-PICU to the post-PICU period.

Conclusions:

After their child’s PICU hospitalization, the proportion of parents with a new mental health diagnosis nearly doubled. Mothers were at nearly twice the risk of receiving a new mental health diagnosis and receiving a new mental health medication compared with fathers. The proportion of parents receiving mental healthcare is much lower than the proportion reporting mental health symptoms in long-term outcomes studies. Whether this indicates a gap in healthcare delivery for parents with mental health symptoms remains unknown.
Predictors of Mortality and Refracture in Patients Older Than 65 Years With a Proximal Femur Fracture
Authors: Ganhão Sara , Guerra Miguel Gomes , Lucas Raquel , Terroso Georgina , Aguiar Francisca , Costa Lúcia , Vaz Carlos
Published: September 2020

Objectives

To evaluate potential predictors of subsequent fracture and increased mortality in a population 65 years or older who suffered a proximal femur fragility fracture.

Methods

This was a longitudinal study that included patients with a proximal femur fragility fracture, referred from the Orthopedics Inpatient Department to the Rheumatology Department's Fracture Liaison Service, from March 2015 to March 2017.

Results

Five hundred twenty-two patients were included, with a median age (IQR) of 84 years (interquartile range [IQR], 11 years), 79.7% (n = 416) female. Nine percent (n = 47) suffered a new fracture, with a median time to event of 298 days (IQR, 331 days). Cumulative probability without refracture at 12 months was 93% (95% confidence interval [CI], 90.2%–95.0%); 22.8% (n = 119) patients died, with median time to death of 126 days (IQR, 336 days). Cumulative survival probability at 12 months was 81.7 (95% CI, 77.9–84.8). Neurologic disease (hazard ratio [HR], 2.30; 95% CI, 0.97–5.50; p = 0.06) and chronic obstructive pulmonary disease (HR, 3.61; 95% CI, 1.20–10.9; p = 0.022) were both predictors of refracture. Age older than 80 years (HR, 1.54; 95% CI, 0.99–2.38; p = 0.052), higher degree of dependence (HR, 1.24;95% CI, 1.09–1.42; p = 0.001), male sex (HR, 1.55; 95% CI, 1.03–2.33; p = 0.034), femoral neck fracture (HR, 0.45; 95% CI, 0.24–0.88; p = 0.018), Charlson score (HR, 2.08; 95% CI, 1.17–3.69; p = 0.012), heart failure (HR, 2.44; 95% CI, 1.06–5.63; p = 0.037), hip bone mass density (HR, 3.99; 95% CI, 1.19–13.4; p = 0.025), hip T score (HR, 0.64; 95% CI, 0.44–0.93; p = 0.021), and β-crosslaps (HR, 1.98; 95% CI, 1.02–3.84; p = 0.042) all predicted a higher mortality.

Conclusions

Neurologic disease and chronic obstructive pulmonary disease may increase the risk of subsequent fracture after a hip fracture. Male sex, age, autonomy degree, femur bone mass density/T score, fracture type, Charlson score, diabetes mellitus, heart failure, and β-crosslaps had significant impact on survival. The authors highlight β-crosslaps as a potential serological marker of increased mortality in clinical practice.
Facial Reanimation With Free Latissumus Dorsi Muscle Transfer, a Comparative Study Between Lateral and Supine Approach
Authors: Elbatawy Amr M. , Hamdi Abdelnaser , Ouf Mohamed Osama , Zayid Tarek , Ismail Hany , Sholkamy Khallad , Hussin Hazem , Elbanoby Tarek , Ayad Wael M.
Published: September 2020

In this article, the authors present the versatility of the Latissmus dorsi muscle as a donor option in facial reanimation and compare between different approaches in harvesting this muscle.

The study included 24 Latissimus Dorsi (LD) functional muscles were transferred for smile reanimation of complete facial palsy. The patients were classified into 2 groups in which the muscle either harvested with supine or lateral (trans-axillary) approach. Muscle harvesting time, total operating times, blood loss, and bulkiness of the flap were analyzed and compared. The hypoglossal nerve was used in 14 cases, the masseteric nerve in 4 cases, and the lower trunk of the facial nerve was used in 6 cases as adonor nerve. No microvascular complications were observed, hematoma occurred in 2 cases only. No donor site complications in any of the cases.

The trans-axillary approach provides less operative time, blood loss, and donor site morbidity, while the classic approach is easier and has the advantage of skin paddle in complex cases.
Marinomonas profundi sp. nov., isolated from deep seawater of the Mariana Trench
Authors: Li Yi , Sun Xiao-Meng , Li Jian , Song Xiao-Yan , Qin Qi-Long , Su Hai-Nan , Chen Xiu-Lan , Zhang Yu-Zhong , Fan Shou-Jin , Zhang Xi-Ying
Published: September 2020

A Gram-stain-negative, aerobic, polarly flagellated, straight or curved rod-shaped bacterium, designated strain M1K-6T, was isolated from deep seawater samples collected from the Mariana Trench. The strain grew at −4 to 37 °C (optimum, 25–30 °C), at pH 5.5–10.0 (optimum, pH 7.0) and with 0.5–14.0  % (w/v) NaCl (optimum, 2.0 %). It did not reduce nitrate to nitrite nor hydrolyse gelatin or starch. Phylogenetic analysis based on 16S rRNA gene sequences indicated that strain M1K-6Twas affiliated with the genusMarinomonas, sharing 93.1–97.0  % sequence similarity with the type strains of recognizedMarinomonasspecies. The major cellular fatty acids were summed feature 3 (C16 : 1ω6c/C16 : 1ω7c), summed feature 8 (C18 : 1ω7c/C18 : 1ω6c), C16 : 0, C10 : 03-OH and C18 : 0. The predominant respiratory quinone was ubiquinone-8. Polar lipids of strain M1K-6Tincluded phosphatidylethanolamine, phosphatidylglycerol and two unidentified lipids. The genomic G+C content of strain M1K-6Twas 46.0 mol%. Based on data from the present polyphasic study, strain M1K-6Twas considered to represent a novel species within the genusMarinomonas, for which the nameMarinomonas profundisp. nov. is proposed. The type strain is M1K-6T(=KCTC 72501T=MCCC 1K03890T).
A comparative study and application of modified SIR and Logistic models at Municipal Corporation level database of CoViD-19 in India
Authors: Bajaj Naman S. , Pardeshi Sujit S. , Patange Abhishek D. , Khade Hrushikesh S. , Mate K. K.
Published: September 2020

The WHO declared a global pandemic owing to the newfound coronavirus, or Covid-19, in March 2020. The disease quickly spread around the world by contagion, and the lack of an appropriate vaccine has led to limited social activities in every track of life. Several national and state-level studies conducted predict the course of the pandemic using machine learning algorithms, most common being the SIR and the Logistic models. However, it is unclear whether these models work for a controlled community like Municipal Corporation or not. With measures now being employed at Municipal levels in India, it only fits to conduct particular research to examine how these models perform at lower jurisdictions. This study provides concrete evidence to show the superiority of the modified SIR model over the Logistic model based on analysis. The models not only give accurate predictions for up to 14 days but can also be used to define and signify the practicality and effectiveness of the decisions taken by the authorities. This feature of the study allows us to justly say that the government action of Unlock 1.0 was not a wise decision considering the nature of the pandemic. This study hopes to help the authorities to take the proper actions to prevent any further aggravation of the spreading virus. In conclusion, Municipal corporations having control should make use of this study to make decisions and test their effectiveness, and more corporations should be empowered to benefit from this study.
Antibodies to SARS-CoV-2 and risk of future sickness
Authors: Dillner Joakim , Elfström K. Miriam , Blomqvist Jonas , Eklund Carina , Lagheden Camilla , Nordqvist-Kleppe Sara , Hellström Cecilia , Olofsson Jennie , Andersson Eni , Falk August Jernbom , Bergström Sofia , Hultin Emilie , Pin Elisa , Månberg Anna , Nilsson Peter , Hedhammar My , Hober Sophia , Mattsson Johan , Mühr Laila Sara Arroyo , Lundgren Kalle Conneryd
Published: September 2020

Background

The extent that antibodies to SARS-CoV-2 may protect against future virus-associated disease is unknown.

Method

We analyzed 12928 healthy hospital employees for SARS-CoV-2 antibodies and compared results to participant sick leave records (Clinical trial registration: https:ClinicalTrials.govNCT04411576).

Results

Subjects with viral serum antibodies were not at excess risk for future sick leave (Odds Ratio (OR): 0.85 (95% Confidence Interval (CI) (0.85 (0.43-1.68)). By contrast, subjects with antibodies had an excess risk for sick leave in the past weeks (OR: 3.34 (2.98-3.74)).

Conclusion

Presence of viral antibodies marks past disease and protection against excess risk of future disease.
Strict lockdown versus flexible social distance strategy for COVID-19 disease: a cost-effectiveness analysis
Authors: Mol Ben W. , Karnon Jonathan
Published: September 2020

Objectives

To balance the costs and effects comparing a strict lockdown versus a flexible social distancing strategy for societies affected by Coronavirus-19 Disease (COVID-19).

Design

Cost-effectiveness analysis.

Participants

We used societal data and COVID-19 mortality rates from the public domain.

Interventions

The intervention was a strict lockdown strategy that has been followed by Denmark. Reference strategy was flexible social distancing policy as was applied by Sweden. We derived mortality rates from COVID-19 national statistics, assumed the expected life years lost from each COVID-19 death to be 11 years and calculated lost life years until 31stAugust 2020. Expected economic costs were derived from gross domestic productivity (GDP) statistics from each country’s official statistics bureau and forecasted GDP. The incremental financial costs of the strict lockdown were calculated by comparing Sweden with Denmark using externally available market information. Calculations were projected per one million inhabitants. In sensitivity analyses we varied the total cost of the lockdown (range −50% to +100%).

Main outcome measure

Financial costs per life years saved.

Results

In Sweden, the number of people who died with COVID-19 was 577 per million inhabitants, resulting in an estimated 6,350 life years lost per million inhabitants. In Denmark, where a strict lockdown strategy was installed for months, the number of people dying with COVID-19 was on average 111 per million, resulting in an estimated 1,216 life years per million inhabitants lost. The incremental costs of strict lockdown to save one life year was US$ 137,285, and higher in most of the sensitivity analyses.

Conclusions

Comparisons of public health interventions for COVID-19 should take into account life years saved and not only lost lives. Strict lockdown costs more than US$ 130,000 per life year saved. As our all our assumptions were in favour of strict lockdown, a flexible social distancing policy in response to COVID19 is defendable.
COVID-19 Case Age Distribution: Correction for Differential Testing by Age
Authors: Fisman David N. , Greer Amy L. , Hillmer Michael , O’Brien Sheila F. , Drews Steven J. , Tuite Ashleigh R.
Published: September 2020

Background

SARS-CoV-2 is a novel pathogen and is currently the cause of a global pandemic. Despite expected universal susceptibility to a novel pathogen, the pandemic to date has been characterized by higher observed incidence in the oldest individuals and lower incidence in children and adolescents. Differential testing by age group may explain some of these observed differences, but datasets linking case counts to public health testing volumes are uncommon.

Methods

We used data from Ontario, Canada. Case data were obtained from Ontario’s provincial line, while testing data were obtained from an information system with complete SARS-CoV-2 testing data for public, hospital, and private laboratories. Demographic and temporal patterns in reported case incidence, testing rates, and test positivity were explored using negative binomial regression models. Standardized morbidity and testing ratios (SMR, STR), and standardized test positivity (STP) were calculated by dividing age- and sex-specific rates by overall rates; demographic and temporal patterns in standardized ratios were explored using meta-regression. Testing adjusted SMR were estimated using linear regression models.

Results

Observed disease incidence and testing rates were highest in oldest individuals and markedly lower in those aged < 20. Temporal trends in disease incidence and testing were observed, but standardizing morbidity and testing ratios eliminated temporal trends (i.e., relative patterns by age and sex remained identical regardless of epidemic phase). After adjustment for testing frequency, SMR were lowest in children and adults aged 70 and older, approximately the same in adolescents as in the population as a whole and elevated in young adults (aged 20-29 years), providing a markedly different picture of the epidemic than seen with crude SMR or case-based incidence. Test-adjusted SMR were validated using seroprevalence data (Pearson correlation coefficient 0.82, P = 0.04).

Conclusions

Surveillance for SARS-CoV-2 infection is typically performed using only test-positive case data, without adjustment for testing frequency. Older adults are tested more frequently, likely due to increased disease severity, while children are under-tested. Adjustment for testing frequency results in a very different picture of SARS-CoV-2 infection risk by age, one that is consistent with estimates obtained through serological testing.
Decreased inflammatory cytokine production of antigen-specific CD4+T cells in NMDA receptor encephalitis
Authors: Dao Le-Minh , Machule Marie-Luise , Bacher Petra , Hoffmann Julius , Ly Lam-Thanh , Wegner Florian , Scheffold Alexander , Prüss Harald
Published: September 2020

Anti-N-methyl-D-aspartate-receptor (NMDAR) encephalitis is the most common autoimmune encephalitis with psychosis, amnesia, seizures and dyskinesias. The disease is mediated by pathogenic autoantibodies against the NR1 subunit that disrupt NMDAR function. Antibody infusion into mouse brains can recapitulate encephalitis symptoms, while active immunization resulted also in strong T cell infiltration into the hippocampus. However, whether T cells react against NMDAR and their specific contribution to disease development are poorly understood. Here we characterized the ex vivo frequency and phenotype of circulating CD4+ T helper (TH) cells reactive to NR1 protein using antigen-reactive T cell enrichment (ARTE) in 24 patients with NMDAR encephalitis, 13 patients with LGI1 encephalitis and 51 matched controls. Unexpectedly, patients with NMDAR encephalitis had lower frequencies of CD154- expressing NR1-reactive TH cells than healthy controls and produced significantly less inflammatory cytokines. No difference was seen in T cells reactive to the synaptic target LGI1 (Leucine-rich glioma-inactivated 1), ubiquitous Candida antigens or neoantigens, suggesting that the findings are disease-specific and not related to therapeutic immunosuppression. Also, patients with LGI1 encephalitis showed unaltered numbers of LGI1 antigen-reactive T cells. The data reveal disease-specific functional alterations of circulating NMDAR-reactive TH cells in patients with NMDAR encephalitis and challenge the idea that increased pro- inflammatory NMDAR-reactive T cells contribute to disease pathogenesis.
COVID-19 pandemic increased the magnitude of mortality risks associated with cold temperature in Italy: A nationwide time-stratified case-crossover study
Authors: Yu Wenhua , Xu Rongbin , Ye Tingting , Han Chunlei , Li Shanshan , Guo Yuming
Published: September 2020

Backgrounds

The coronavirus disease 2019 (COVID-19) pandemic and some containment measures have changed many people’s lives and behaviours. Whether the pandemic could change the association between cold temperature and mortality remains unknown.

Objectives

We aimed to assess whether the association between cold temperature and all-cause mortality in the pandemic period has changed compared to non-COVID-19 period (2015-2019) in Italy.

Methods

We collected daily all-cause mortality data and meteorological data for 107 Italian provinces from 1, January 2015 to 31, May 2020. A time-stratified case-crossover design with the distributed lag non-linear model was used to examine the association between cold temperature and all-cause mortality during the first three months (from March to May in 2020) of the COVID-19 outbreak and the same months in 2015-2019.

Results

The relative risk (RR) of all-cause mortality at extreme cold temperature (2.5thpercentile of temperature at 3°C)in comparison with the minimum mortality temperature (24 °C) was 4.75 [95% confidence interval (CI): 3.90-5.79] in the pandemic period, which is more than triple higher than RR [1.41 (95%CI: 1.33-1.50)] in the same months during 2015-2019. The shift in cold-mortality association was particularly significant for people aged 65-74 years [RR (95%CI): 5.98 (3.78-9.46) in 2020 versus 1.29 (1.10-1.51) in 2015-2019], 75-84 years [5.25 (3.79-7.26) versus 1.40 (1.25-1.56)], and ≥ 85 years [5.03 (3.90-6.51) versus 1.52 (1.39-1.66)], but not significant for those aged 0-64 years [1.95 (1.17-3.24) versus 1.24 (1.05-1.48)].

Conclusion

The findings suggest that the COVID-19 pandemic enhanced the risk of cold temperature on mortality in Italy, particularly among the elderly people. Further studies are warranted to understand the exact mechanism when detailed data are available.
Knowledge, attitudes and practices associated with the COVID-19 among slum dwellers resided in Dhaka City: A Bangladeshi interview-based survey
Authors: Islam Md. Saiful , Emran Md. Galib Ishraq , Rahman Md. Estiar , Banik Rajon , Sikder Md. Tajuddin , Smith Lee , Hossain Sahadat
Published: September 2020

Background

The emergent COVID-19 has impacted unprecedentedly to all classes of people. Slum-dwellers’ knowledge, attitudes and practices (KAP) towards COVID-19 are currently poorly understood. To investigate the KAP towards COVID-19 among slum dwellers resided in Dhaka City, Bangladesh.

Methods

A cross-sectional offline survey was carried out enrolling 406 slum dwellers (53.2% male; mean age=44.9 years [SD=12.1]; age range=18-85 years) between August and September, 2020. The face to face interview was conducted to collect data from 6 selected slum areas in Dhaka City using convenience sampling. The questionnaire consisted of informed consent along with questions concerning observational checklists, socio-demographics, and KAP.

Results

A sizeable minority were observed without wearing face masks during the survey periods (18.2%) and a vast portion (97.5%) without any hand protection. The mean scores of KAP were 6.1±2.6 (out of 17), 12.3±1.7 (out of 14), and 9.8±1.6 (out of 12), respectively. Moreover, the KAP were strongly and positively correlated with each other.

Conclusions

The findings revealed that the majority of slum dwellers in Bangladesh have limited knowledge of COVID-19. Poor practices (i.e., face mask and hand protection) were directly observed during the survey. The findings suggest the immediate implementation of health education programs and adequate interventions.
Association among income loss, financial strain and depressive symptoms during COVID-19: evidence from two longitudinal studies
Authors: Hertz-Palmor N , Moore TM , Gothelf D , DiDomenico GE , Dekel I , Greenberg DM , Brown LA , Matalon N , Visoki E , White LK , Himes MH , Schwartz-Lifshitz M , Gross R , Gur RC , Gur RE , Pessach IM , Barzilay R
Published: September 2020

Background

The COVID-19 pandemic has major ramifications for global health and the economy, with growing concerns about economic recession and implications for mental health. Here we investigated the associations between COVID-19 pandemic-related income loss with financial strain and mental health trajectories over a 1-month course.

Methods

Two independent studies were conducted in the U.S and in Israel at the beginning of the outbreak (March-April 2020, T1; N = 4 171) and at a 1-month follow-up (T2; N = 1 559). Mixed-effects models were applied to assess associations among COVID-19-related income loss, financial strain, and pandemic-related worries about health, with anxiety and depression, controlling for multiple covariates including pre-COVID-19 income.

Findings

In both studies, income loss and financial strain were associated with greater depressive symptoms at T1, above and beyond T1 anxiety, worries about health, and pre-COVID-19 income. Worsening of income loss was associated with exacerbation of depression at T2 in both studies. Worsening of subjective financial strain was associated with exacerbation of depression at T2 in one study (US).

Interpretation

Income loss and financial strain were uniquely associated with depressive symptoms and the exacerbation of symptoms over time, above and beyond pandemic-related anxiety. Considering the painful dilemma of lockdown versus reopening, with the tradeoff between public health and economic wellbeing, our findings provide evidence that the economic impact of COVID-19 has negative implications for mental health.

Funding

This study was supported by grants from the National Institute of Mental Health, the US-Israel Binational Science Foundation, Foundation Dora and Kirsh Foundation.