bluuebunny/crossref_metadata_2025 huggingface dataset:
Lessons learned from a mandatory Irish Carbapenemase producing Enterobacterales (CPE) contact communication programme at University of Limerick Hospitals Group (ULHG)
Authors: Slevin Barbara , Waldron Ruth , Power Lorraine , Kennedy Sarah , Farah Bushra , Woods Sara , Moloney Alison , Monahan Regina , Powell James , Woodland Edel , Burke Paul , O'Connell Nuala
Published: March 2020

Background: ULHG first detected CPE in 2009. A decision was made at the outset to flag CPE contacts on the surveillance software system (ICNet) rather than write to discharged contacts. CPE was declared a national public health emergency, October 2017. In September 2018, the Irish CPE Expert Group mandated that all hospitals write to CPE contacts, as per open disclosure policy, to inform them of their status. Screening was also offered. An eligible contact was defined as one who did not have 4 negative screens since exposure.

Methods: An ICNet search was conducted to detect all CPE contacts, cross-checking with the national death registry before delineating the number of CPE screens tested via the Laboratory Information System. Processes were put in place to address queries from patients; a generic helpline and a recorded telephone line for clinical concerns or complaints. Screening packs were developed. National template letters were posted to patients, their GPs and consultants.

Results: 2016 CPE contacts were identified from Feb 2009 to Sept 2018. 422 patients contacted the generic helpline; 347 requested call-back from the CPE nursing expert. 115 requested testing packs with 103 delisted as contacts. Patients voiced many concerns including anger for the untimely notification, upset at the potential risk of CPE acquisition and criticism regarding the letter content.

Conclusions: The decision to inform patients is appropriate but it must be timely with access to understandable information and support from a suitably trained professional. The communication programme continues prospectively in the setting of CPE endemicity.
Developing a national indicator of intravenous antibiotic use to support timely review of antibiotics in Scottish hospitals
Authors: Malcolm William , Baxter Linsey , McNicol Megan , Sneddon Jacqueline
Published: March 2020

Background

To address increasing antibiotic use in acute hospitals, the Scottish Antimicrobial Prescribing Group developed a quality improvement (QI) initiative to support reliable review of patients started on intravenous (IV) antibiotics within 72 hours. This will reduce unnecessary continuation of antibiotics, ensure personalised treatment and appropriate IV to oral switch with associated benefits for patients of reduced risk of device related infections and potential for earlier discharge from hospital.

Methods

Using data obtained from the Hospital Medicines Utilisation Database, a national database of secondary care medicines use in Scotland, we examined trends in IV antibiotic use between 2013 and 2017. We then projected the current trend forward to 2021 to inform development of national indicator to optimise IV antibiotic use.

Results

In 2017, IV antibiotics accounted for 32.9% of all antibiotic use in Scottish hospitals. Annual IV antibiotic use (defined daily doses per 1000 population per day) increased by 20.5% between 2013 and 2017. We estimated a further projected increase of 12.5% between 2018 and 2021. To measure the impact of our QI initiative SAPG agreed to employ a national indicator with a target that ‘use of IV antibiotics in hospitals will be no higher in 2021 than it was in 2018’.

Conclusion

This national indicator will evaluate progress with achieving reliable and timely review of IV antibiotic therapy to reduce hospital antibiotic use and contribute to reduction in total antibiotic use in humans which is a key ambition of the UK AMR National Action Plan.
An audit of antimicrobial usage in perioperative period of adult patients undergoing appendectomy
Authors: Modan Huriyah , Hughes Stephen
Published: March 2020

Introduction

Antimicrobials are prescribed at appropriate dose and in a timely fashion, to reduce post-operative infections in adult patients undergoing appendectomy. It is desirable to establish the shortest and most effective prophylaxis. To assess this, we reviewed a sample of adult patients that have appendectomy procedure completed at the CWFT to assess antimicrobial prescribing in line with local prescribing guidelines.

Method

We undertook a retrospective observational study at a central London teaching hospital to investigate antimicrobial prescribing in adult patients undergoing appendectomy between Jan2019 and Jun2019.

Results.

A total of 173 patients [median age 31year] were analysed; 7 and 167 had undergone an elective and urgent appendectomy respectively. 163/173 [94.2%] received antimicrobials peri-operatively. Compliance with local guidelines was 40.5%; a lack of aminoglycoside in combination with beta-lactam was common (58%). 126/173(72.8%) patients received antimicrobials on discharge, median 7.0 days total antimicrobials. Readmission rates within 30 days of surgery were 6.4% but unrelated to antimicrobial prescribing (p=0.8). Enterobacteriaceae was the most commonly identified pathogen (n=45), with high co-amoxiclav resistance reported (31%).

Conclusions

Combination co-amoxiclav plus aminoglycoside is advised peri-operatively for appendectomies yet adherence is poor. Despite local co-amoxiclav resistance, aminoglycosides are often omitted. The number of patients treated with post-op antimicrobials and the duration of therapy is greater than comparable published studies. Lack of standard definitions for complicated appendectomies makes it difficult to identify patients that do benefit from post-operative antimicrobials thus overprescribing occurs. Agreement on the optimum duration of treatment also is unclear and results in likely excessive prescribing.
Demographics of new diagnoses of leprosy in the UK over 23 years: a retrospective study of cases at the Hospital for Tropical Diseases, London
Authors: McIntosh Amy , Checkley Anna , McBride Angela , Walker Steve , Lockwood Diana
Published: March 2020

BACKGROUND: Leprosy is rare in the UK, but migration from endemic countries results in new diagnoses annually. Early recognition, diagnosis and treatment can prevent harmful stigma and disability.

METHODS: We conducted retrospective analysis from a database of new cases of leprosy seen at the Hospital for Tropical Diseases, London from 1995 to 2018. We aimed to identify typical demographics of patients presenting with leprosy and identify causes and consequences of delayed diagnosis.

RESULTS: 157 cases were included. A large proportion were male (67.5%) with a median age of 34 years. Most were non-UK born and migrated in adulthood. 41.3% of cases were acquired in India, Sri Lanka or Bangladesh. Borderline tuberculoid (43.9%) was the most common type, followed by lepromatous leprosy (33.8%). The mean time between arrival in the UK and symptom onset was 5.87 years (SD 10.33). It took over 5 years for 12.8% of patients to be diagnosed. 93.6% of patients completed multidrug treatment following diagnosis.

CONCLUSION: Male predominance and age at diagnosis reflects global epidemiology of leprosy. Patterns of acquisition reflect trends in UK migration from endemic countries. The typical patient presenting to the clinician is a young male who has migrated as an adult and developed symptoms in the years surrounding migration. Many patients may have developed disability before treatment commences as the time to diagnosis can be prolonged. Once diagnosed in the UK, treatment is of high quality, readily available, and effective: earlier recognition by clinicians can prevent disability and reduce the risk of transmission.
In vitro activity of fosfomycin, and synergy in combination, against Gram negative bloodstream infection isolates in a UK hospital
Authors: Suich Joseph , Mawer Damian , Woude Marian Van der , Wearmouth Deborah , Eyre Alison , Burns Phillipa , Smeets Ton , Barlow Gavin
Published: March 2020

Background:Fosfomycin has retained activity against many multi-drug resistant (MDR) Gram-negatives, and may be useful against extended spectrum beta-lactamase (ESBL) producing and carbapenem-resistant Enterobacteriaceae. There are few data from the UK on the susceptibility of invasive Gram-negative isolates to fosfomycin, especially in the era of increasing use of oral fosfomycin for UTIs.

Materials/methods:

1. We evaluated, in 100 consecutive Gram-negative bloodstream infections (BSI), the in-vitro activity of fosfomycin. Disc diffusion and MIC test strip methods applying revised EUCAST guidelines for fosfomycin were used.

2. A secondary objective was testing for synergy in combination with 10 further antibiotics. Isolates were selected if:

a) Fosfomycin resistant

b) AMP-C/ESBL/carbapenemase producers (or carbapenem resistant)

c) ‘MDR’: defined as ‘resistance to ≥3 classes of antibiotics’ (based on prior routine sensitivity testing).

For eligible isolates, MICs were determined individually, and subsequently in combination using the MTS ‘cross’ synergy method.

Results:96/100 isolates were susceptible to fosfomycin by MIC test strip. 30/100 isolates were eligible for synergy testing. Synergy was most commonly detected between fosfomycin and piperacillin/tazobactam (32.1%), ceftazidime/avibactam (30%), and temocillin (28.5%). An additive effect was most commonly detected with aztreonam (85.7%) and meropenem (82.1%), but 100% indifference was found with tigecycline. No antagonism was identified.

Conclusions:Synergistic or additive effects were detected for beta-lactam/fosfomycin combinations in a high proportion of isolates; >80% for all suggesting such combinations should be preferred when using fosfomycin combination therapy. Agents with a different site of antibiotic action, were more likely to result in indifference.
A retrospective audit of microbiological sampling for spondylodiscitis at the Royal Devon and Exeter Hospital (RD&E)
Authors: Powell Matthew , Morgan Marina
Published: March 2020

Introduction

Spondylodiscitis is an increasingly diagnosed condition with significant morbidity and mortality. A key aspect of management is a protracted course of targeted antimicrobial therapy, ideally tailored to the organisms isolated from appropriate microbiological specimens in accordance with Infectious Diseases Society of America (IDSA) guidelines (2015). When consulted regarding possible discitis, we routinely recommend blood cultures and disc biopsy, particularly if blood cultures are negative.

Method

We undertook a retrospective audit of patients presenting over 6 years with a radiological diagnosis of discitis with the primary objective of determining the proportion of patients who had appropriate microbiological investigation either via blood culture or biopsy.

Results

42 patients met the inclusion criteria. Blood cultures were positive with organisms likely to be the causative agent in 50% of patients. Of the 50% of patients with negative blood cultures, 57% went on to have a successful spinal biopsy. Biopsies proved positive in 75% of cases. 8 patients with negative blood cultures did not progress to biopsy at the time of diagnosis and four suffered some degree of harm. One of these patients failed empirical anti-staphylococcal therapy and later required spinal stabilization due to destruction of the spinal disc was proven to have pseudomonas infection at the time of the corrective surgery.

Conclusion

19% of patients with discitis did not have appropriate disc sampling prior to commencement of antibiotic therapy. 50% of these suffered some degree of harm. This strengthens the case for recommending appropriate sampling prior to initiation of therapy, unless absolutely contraindicated.
Sanitisation effects of selected medicinal plant extracts against Escherichia coliO157:H7 and Salmonella enterica subsp.enterica(Serovar Typhi) on Malus pumila Mill. fruit surfaces
Authors: Kasambala Lindsay Mudiwa , Chingwaru Walter
Published: March 2020

Raw fruit and vegetables have become a major risk factor for diarrhoea outbreaks across the world. Salmonella enterica and Shiga toxin-producing Escherichia coli account for 21% and 10% of all diarrhoeal outbreaks around the globe. Despite these statistics, the quantitative risk of consuming RTEFV remains unknown. The potential utility of medicinal plant extracts as disinfectants of RTEFV has remained unexplored. This study sought to assess the efficacy of extracts of Vernonia amygdalina and Ximenia caffra in the removal of Salmonella typhi and E. coli on Malus pumilaMill. fruit surfaces. Two-cm2 square sections of apple epidermal tissues from apples spiked with S. typhi and E. coli were soaked in prepared extracts for 90 minutes. Microbial loads on washed surfaces were determined using conventional agar plate based techniques. Washing of apple surfaces with ethanolic extracts of freshly crushed leaves of X. caffra (X-FLEE) and dry leaves of V. amygdalina (V-DLEE) achieved at least 7 log reductions in counts of E. coli and S. typhi without changes in surface morphology and colour. The selected extracts were shown to be rich in alkaloids, tannins and flavonoids, which are known to harbour antimicrobial activities (inhibitory and cidal effects). Extracts from the selected plants, especially ethanolic extracts of X. caffra and V. amygdalina have potential as sanitisers of apples against diarrhoeagenic E. coli and S. typhi. We therefore recommend the use of ethanol as a solvent of choice in obtaining plant extracts for use-, as well as the use of as well as vinegar, chlorinated water or bicarbonate of soda as sanitisers of fresh apple surfaces.
The Reliability of C-Reactive Protein Levels in Predicting Dengue Severity: A Systematic Review
Authors: Salud Vincci Monique , Reyes Francis Andrew , Ricohermoso Jaymelyn , Rubion Lou Erika , Roman Arthur Dessi
Published: March 2020

Background

Clinical manifestations of dengue vary from mild febrile illnesses to shock and organ failure. However, severe symptoms may not be clinically evident immediately, making it difficult for early detection of patients at risk for poor outcomes. Several biomarkers, particularly C-reactive protein (CRP), were revealed to be highly predictive of dengue hemorrhagic fever/dengue shock syndrome (DHF/DSS). This systematic review aims to determine a relationship between CRP levels and the probability of developing DHF/DSS.

Methods

Multiple electronic databases were searched for English literature from January 2007 to August 2017. Four reviewers independently extracted data from eligible studies using the standardized critical appraisal tool from JBI-MAStARI. Articles that scored six and above were included.

Results

Three cohort and two cross-sectional studies were reviewed. Sample sizes ranged from 70 to 235 participants. The cohort studies measured CRP levels at point of diagnosis, but were re-measured at different time points in the subjects’ admission. However, regardless of the time difference, they all showed that increased CRP levels exhibited a trend towards development of DSS/DHF. The studies also identified a possible “golden period” for measuring CRP levels that can accurately predict development of DHF/DSS. The cross-sectional studies also saw a similar trend, but have measured this in median values of the CRP levels.

Conclusion

This systematic review showed that increased CRP levels appeared to have a trend towards a higher probability of developing DHF/DSS. A larger population and more studies are needed to further establish a statistically significant relationship.
Haemophagocytic lymphohistiocytosis secondary to disseminated adenovirus infection twenty-five years post heart-lung transplant
Authors: Vathenen Ramu , Rokadiya Sakib , Lambourne Jonathan
Published: March 2020

Disseminated adenovirus infection is recognised in transplant patients, often occurring early and associated with a high mortality rate. Treatment options are poorly understood and potentially toxic. Haemophagocytic lymphohistiocytosis (HLH) is a life-threatening hyper-inflammatory response.

A 75-year-old ex-banker presented following a fall, with a 2-week history of fevers, cough and high stoma output after a recent cruise. Past medical history included heart-lung transplant (25 years previously), diverticular disease and diabetes mellitus. Initially, he was febrile and tachycardic and blood tests showed an acute kidney injury (AKI), transaminitis and pancytopenia. Chest radiograph and urinalysis were unremarkable. Initial treatment was with co-amoxiclav and intravenous fluids for neutropenic sepsis. Computerised tomography of thorax and abdomen showed moderate splenomegaly with no lymphadenopathy or pneumonitis.

After 48 hours, he remained febrile with worsening renal and hepatic function. Nasopharyngeal swabs returned positive for adenovirus. Blood cultures were negative with undetectable serum cytomegalovirus (CMV) and Epstein-Barr virus (EBV) DNA.

On day 4 he developed fulminant multi-organ failure. Further investigations were suggestive of HLH. Cidofovir/Brincidofovir were discussed as potential treatments but were difficult to obtain with concern regarding toxicity. On day 6, intravenous immunoglobulins for HLH was commenced. On day 8 he died. Adenovirus was later isolated from urine, stool and serum samples.

Early diagnosis and treatment for infection in immunosuppressed patients is crucial. The 25-year interval between transplant and disseminated adenovirus infection in this case is unprecedented. Difficulty in obtaining adenovirus treatment combined with their toxicity and uncertainty of effectiveness prevented their immediate use in this patient.
Appropriateness of meropenem prescriptions at a large district general hospital, East of England, UK
Authors: Sharma Abhishek , Dhungana Drishya , Vaghela Tejal , Kandil Hala
Published: March 2020

Introduction

Meropenem is a broad spectrum antibiotic used to treat a variety of bacterial infections. There are no clear standards nationally for the use of meropenem. The purpose of this study is to audit the appropriateness of Meropenem prescription at West Hertfordshire NHS trust

METHODOLOGY

Patients started on meropenem were identified via the hospital pharmacy in the period from 1st January 2019 to 31st March 2019. Patients’ clinical notes, drug charts and blood tests were reviewed. Appropriateness of meropenem prescription was judged based on the following: indication, penicillin allergy and its nature, pathogen antibiogram, microbiologists approval, indications for escalation and duration of treatment

RESULTS

forty-eight patients were identified during the study period. The main indications were hospital-acquired/community-acquired pneumonia and UTI. Penicillin allergy was documented in 31%, the nature of allergy was intolerance in 13% and not known in 20%. Of note, in 42% of these, treatment was not pathogen guided. In 45.5% of non-penicillin allergic patients, escalation to meropenem were neither supported by antibiogram nor by microbiologists. The main driver was raised inflammatory markers (62.5%). Of the 37 patients who completed their treatment during the study period, 21.6% had > 7 days with only 50% recommended by Microbiologists.

CONCLUSION:

In third of the patients, meropenem use was driven by penicillin allergy, however the nature of allergy did not justify its use in many of these cases. Lack of microbiology approval, failure to de-escalate and long courses of meropenem were additional areas identified to target in our antimicrobial stewardship programme
Antimicrobial Efficacy Study using a light disinfection device for Health Care-Associated Infections
Authors: AIN Qurat UL , YEUNG King Lun
Published: March 2020

Multidrug-resistant organisms (MDROs) are a global challenge especially in long-term care facilities (LTCFs). Older people are more vulnerable to infection due to the senescence of their immune system, resulting in more frequent and longer hospitalization increased cost of care, hence greater workload. Even in the strict hospital environment, less than half of the environmental surfaces sampled were not properly cleaned and this poses a significant risk of disease transmission.

In this study, new light-based surface disinfection technology can complement existing hospital practices to address an important public health problem. Its strategy is based on high-intensity narrow-wavelength (Hi-NW) light sources for surface decontamination of microorganisms commonly found in health care environments using synergic effects of blue LEDs at 405 & 470 nm and UV LED at 278nm, which were not previously investigated together.

A retrospective review of MDRO records has been conducted throughout the study period. Organisms were identified using special agar media and treatment with Hi-NW prototype was tested in the LTCF surfaces.

The prototype results show 99.9% & 88.9% bactericidal rate against MDROs for 5minutes and 2 minutes exposure time on flat surfaces, respectively. Work is still in progress for the 30-second cycle exposure of prototype.

This discovery will support the use of the device as a high material compatibility technology with hospital items, or in other common areas, such as public areas and homes, where frequently touched surfaces play an important role in disease transmission. There is an utmost need for this tool to prevent the proliferation of MDROs
Low lineage diversity and increased virulence of group C Streptococcus dysgalactiae subsp. equisimilis
Authors: Santos Victor Lima , Silva Ligia Guedes , Martini Caroline Lopes , Anjos Isis Hazelman V. , Maia Mariana Masello , Genteluci Gabrielle L. , Sant’Anna Viviane , Ferreira Ana Maria A. , Couceiro José Nelson S.S. , Figueiredo Agnes Marie Sá , Ferreira-Carvalho Bernadete Teixeira
Published: March 2020

Introduction. In some species, the population structure of pathogenic bacteria is clonal. However, the mechanisms that determine the predominance and persistence of specific bacterial lineages of group C

Streptococcus

remain poorly understood. In Brazil, a previous study revealed the predominance of two main lineages of

Streptococcus dysgalactiae

subsp.

equisimilis

﻿(SDSE).

Aim. The aim of this study was to assess the virulence and fitness advantages that might explain the predominance of these SDSE lineages for a long period of time.

Methodology.
emm typing was determined by DNA sequencing. Adhesion and invasion tests were performed using human bronchial epithelial cells (16HBE14o-). Biofilm formation was tested on glass surfaces and the presence of virulence genes was assessed by PCR. Additionally, virulence was studied using Caenorhabditis elegans models and competitive fitness was analysed in murine models.

Results. The predominant lineages A and B were mostly typed as emm stC839 and stC6979, respectively. Notably, these lineages exhibited a superior ability to adhere and invade airway cells. Furthermore, the dominant lineages were more prone to induce aversive olfactory learning and more likely to kill C. elegans. In the competitive fitness assays, they also showed increased adaptability. Consistent with the increased virulence observed in the ex vivo and in vivo models, the predominant lineages A and B showed a higher number of virulence-associated genes and a superior ability to accumulate biofilm.

Conclusion. These results suggest strongly that this predominance did not occur randomly but rather was due to adaptive mechanisms that culminated in increased colonization and other bacterial properties that might confer increased bacteria–host adaptability to cause disease.
TWIRLS, an automated topic-wise inference method based on massive literature, suggests a possible mechanism via ACE2 for the pathological changes in the human host after coronavirus infection
Authors: Ji Xiaoyang , Zhang Chunming , Zhai Yubo , Zhang Zhonghai , Zhang Chunli , Xue Yiqing , Tan Guangming , Niu Gang
Published: March 2020

Faced with the current large-scale public health emergency, collecting, sorting, and analyzing biomedical information related to the “coronavirus” should be done as quickly as possible to gain a global perspective, which is a basic requirement for strengthening epidemic control capacity. However, for human researchers studying the viruses and the hosts, the vast amount of information available cannot be processed effectively and in a timely manner, particularly when the scientific understanding may be limited, which can further lower the information processing efficiency. We present TWIRLS, a method that can automatically acquire, organize, and classify information. Additionally, independent functional data sources can be added to build an inference system using a machine-based approach, which can provide relevant knowledge to help human researchers quickly establish subject cognition and to make more effective decisions. TWIRLS can automatically analyze more than three million words in more than 14,000 literature articles in only 4 hours. Combining with generalized gene interaction databases creates a data interface that can help researchers to further analyze the information. Using the TWIRLS system, we found that an important regulatory factor angiotensin-converting enzyme 2 (ACE2) may be involved in the host pathological changes on binding to the coronavirus after infection. After triggering functional changes in ACE2/AT2R, an imbalance in the steady-state cytokine regulatory axis involving the Renin-Angiotensin System and IP-10 leads to a cytokine storm.
Clinical significance of IgM and IgG test for diagnosis of highly suspected COVID-19 infection
Authors: Jia Xingwang , Zhang Pengjun , Tian Yaping , Wang Junli , Zeng Huadong , Wang Jun , Liu Jiao , Chen Zeyan , Zhang Lijun , He Haihong , He Kunlun , Liu Yajie
Published: March 2020

Quick, simple and accurate diagnosis of suspected COVID-19 is very important for the screening and therapy of patients. Although several methods were performed in clinical practice, however, the IgM and IgG diagnostic value evaluation was little performed. 57 suspected COVID-19 infection patients were enrolled in our study. 24 patients with positive and 33 patients with negative nucleic acid test. The positive rate of COVID-19 nucleic acid was 42.10%. The positive detection rate of combination of IgM and IgG for patients with COVID-19 negative and positive nucleic acid test was 72.73% and 87.50%. The results were significantly higher than the nucleic acid or IgM, IgG single detection. hsCRP in the COVID-19 nucleic acid negative group showed significantly higher than the positive groups (P=0.0298). AST in the COVID-19 IgM negative group showed significantly lower than the positive groups (P=0.0365). We provided a quick, simple, accurate aided detection method for the suspected patients and on-site screening in close contact with the population.
Closed environments facilitate secondary transmission of coronavirus disease 2019 (COVID-19)
Authors: Nishiura Hiroshi , Oshitani Hitoshi , Kobayashi Tetsuro , Saito Tomoya , Sunagawa Tomimasa , Matsui Tamano , Wakita Takaji ,   MHLW COVID-19 Response Team, Suzuki Motoi
Published: March 2020

Objective

To identify common features of cases with novel coronavirus disease (COVID-19) so as to better understand what factors promote secondary transmission including superspreading events.

Methods

A total of 110 cases were examined among eleven clusters and sporadic cases, and investigated who acquired infection from whom. The clusters included four in Tokyo and one each in Aichi, Fukuoka, Hokkaido, Ishikawa, Kanagawa and Wakayama prefectures. The number of secondary cases generated by each primary case was calculated using contact tracing data.

Results

Of the 110 cases examined, 27 (24.6%) were primary cases who generated secondary cases. The odds that a primary case transmitted COVID-19 in a closed environment was 18.7 times greater compared to an open-air environment (95% confidence interval [CI]: 6.0, 57.9).

Conclusions

It is plausible that closed environments contribute to secondary transmission of COVID-19 and promote superspreading events. Our findings are also consistent with the declining incidence of COVID-19 cases in China, as gathering in closed environments was prohibited in the wake of the rapid spread of the disease.
A simple model to assess Wuhan lock-down effect and region efforts during COVID-19 epidemic in China Mainland
Authors: Yuan Zheming , Xiao Yi , Dai Zhijun , Huang Jianjun , Chen Yuan
Published: March 2020

Since COVID-19 emerged in early December, 2019 in Wuhan and swept across China Mainland, a series of large-scale public health interventions, especially Wuhan lock-down combined with nationwide traffic restrictions and Stay At Home Movement, have been taken by the government to control the epidemic. Based on Baidu Migration data and the confirmed cases data, we identified two key factors affecting the later (e.g February 27, 2020) cumulative confirmed cases in non-Wuhan region (y). One is the sum travelers from Wuhan during January 20 to January 26 (x1), which had higher infected probability but lower transmission ability because the human-to-human transmission risk of COVID-19 was confirmed and announced on January 20. The other is the “seed cases” from Wuhan before January 19, which had higher transmission ability and could be represented with the confirmed cases before January 29 (x2) due to a mean 10-day delay between infection and detection. A simple yet effective regression model then was established as follow: y= 70.0916+0.0054×x1+2.3455×x2 (n = 44, R2 = 0.9330, P<10−7). Even the lock-down date only delay or in advance 3 days, the estimated confirmed cases by February 27 in non-Wuhan region will increase 35.21% or reduce 30.74% - 48.59%. Although the above interventions greatly reduced the human mobility, Wuhan lock-down combined with nationwide traffic restrictions and Stay At Home Movement do have a determining effect on the ongoing spread of COVID-19 across China Mainland. The strategy adopted by China has changed the fast-rising curve of newly diagnosed cases, the international community should learn from lessons of Wuhan and experience from China. Efforts of 29 Provinces and 44 prefecture-level cities against COVID-19 were also assessed preliminarily according to the interpretive model. Big data has played and will continue playing an important role in public health.
Differentiation potential of fish fins –Effective utilization of the fins as food wastes–
Authors: Tsuruwaka Yusuke , Shimada Eriko
Published: March 2020

Fish cells are largely affected by their culture media. Fibroblast-like cells obtained from the fish fins can differentiate to various kinds of cells such as skeletal muscle-like, neurofilaments and adipocytes. Our results suggest that the fins which are usually discarded as food wastes may practically applied to the clean meat technology.
The within-host viral kinetics of SARS-CoV-2
Authors: Li Chentong , Xu Jinhu , Liu Jiawei , Zhou Yicang
Published: March 2020

In this work, we use a within-host viral dynamic model to describe the SARS-CoV-2 kinetics in host. Chest radiograph score data are used to estimate the parameters of that model. Our result shows that the basic reproductive number of SARS-CoV-2 in host growth is around 3.79. Using the same method we also estimate the basic reproductive number of MERS virus is 8.16 which is higher than SARS-CoV-2. The PRCC method is used to analyze the sensitivities of model parameters and the drug effects on virus growth are also implemented to analyze the model.
Inhibition of a cortico-thalamic circuit attenuates cue-induced reinstatement of drug-seeking behavior in “relapse prone” male rats
Authors: Kuhn Brittany N. , Campus Paolo , Klumpner Marin S. , Chang Stephen E. , Iglesias Amanda G. , Flagel Shelly B.
Published: March 2020

Relapse often occurs when individuals are exposed to stimuli or cues previously associated with the drug-taking experience. The ability of drug cues to trigger relapse is believed to be a consequence of incentive salience attribution, a process by which the incentive value of reward is transferred to the reward-paired cue. Sign-tracker (ST) rats that attribute enhanced incentive value to reward cues are more prone to relapse compared to goal-tracker (GT) rats that primarily attribute predictive value to such cues. The neurobiological mechanisms underlying this individual variation in relapse propensity remains largely unexplored. The paraventricular nucleus of the thalamus (PVT) has been identified as a critical node in the regulation of cue-elicited behaviors in STs and GTs, including cue-induced reinstatement of drug-seeking behavior. Here we used a chemogenetic approach to assess whether “top-down” cortical input from the prelimbic cortex (PrL) to the PVT plays a role in mediating individual differences in relapse propensity. Chemogenetic inhibition of the PrL-PVT pathway selectively decreased cue-induced reinstatement of drug-seeking behavior in STs, without affecting behavior in GTs. In contrast, cocaine-primed drug-seeking behavior was not affected in either phenotype. Furthermore, when rats were characterized based on a different behavioral phenotype – locomotor response to novelty – inhibition of the PrL-PVT pathway had no effect on either cue- or drug-induced reinstatement. These results highlight an important role for the PrL-PVT pathway in vulnerability to relapse that is driven by individual differences in the propensity to attribute incentive salience to discrete reward cues.
Canonical Wnt Signaling is Involved in Anterior Regeneration of the AnnelidAeolosoma viride
Authors: Chen Cheng-Yi , Yueh Wei-Ting , Chen Jiun-Hong
Published: March 2020

Annelids are regenerative animals, but the underlying mechanisms await to be discovered. Because Wnt pathway is involved in animal regeneration to varying extents, we usedAeolosoma virideto interrogate whether and how this pathway plays a role in annelid anterior regeneration. We found that the expression ofwnt4,β-cateninand nuclear-localized β-catenin protein were up-regulated during blastemal formation and down-regulated as anterior structures gradually reformed. Consistent with potential Wnt activities in the blastema, treatments with either Wnt pathway activator (azakenpaullone) or inhibitor (XAV939) inhibited head regeneration, which further supports a role of Wnt pathway during anterior regeneration. Detailed tissue-level examines demonstrated that wound closure and blastemal cell proliferation were impaired by over-activating the pathway, and that neuronal and musculature differentiation were affected under Wnt inhibition. Combined, gene expression and chemical inhibitor data suggest the presence of dynamic Wnt activities at different anterior regeneration stages: an initial low activity may be required for wound closure, and the following activation may signal blastemal formation and cell differentiation. In a nutshell, we propose that the canonical Wnt signaling regulates blastemal cellular responses during annelid regeneration.
Effects of weather-related social distancing on city-scale transmission of respiratory viruses
Authors: Jackson Michael L. , Hart Gregory R. , McCulloch Denise J. , Adler Amanda , Brandstetter Elisabeth , Fay Kairsten , Han Peter , Lacombe Kirsten , Lee Jover , Sibley Thomas , Nickerson Deborah A. , Rieder Mark J. , Starita Lea , Englund Janet A. , Bedford Trevor , Chu Helen , Famulare Michael
Published: March 2020

BACKGROUND

Unusually high snowfall in western Washington State in February 2019 led to widespread school and workplace closures. We assessed the impact of social distancing caused by this extreme weather event on the transmission of respiratory viruses.

METHODS

Residual specimens from patients evaluated for acute respiratory illness at hospitals in the Seattle metropolitan area were screened for a panel of respiratory viruses. Transmission models were fit to each virus, with disruption of contact rates and care-seeking informed by data on local traffic volumes and hospital admissions.

RESULTS

Disruption in contact patterns reduced effective contact rates during the intervention period by 16% to 95%, and cumulative disease incidence through the remainder of the season by 3% to 9%. Incidence reductions were greatest for viruses that were peaking when the disruption occurred and least for viruses in early epidemic phase.

CONCLUSION

High-intensity, short-duration social distancing measures may substantially reduce total incidence in a respiratory virus epidemic if implemented near the epidemic peak.

One sentence summary

Disruptions of school and work due to heavy snowfall in the Seattle metro area reduced the total size of respiratory virus epidemics by up to 9%.
Rapid Detection of SARS-CoV-2 Using Reverse transcription RT-LAMP method
Authors: Yang Weihua , Dang Xiaofei , Wang Qingxi , Xu Mingjie , Zhao Qianqian , Zhou Yunying , Zhao Huailong , Wang Li , Xu Yihui , Wang Jun , Han Shuyi , Wang Min , Pei Fenyan , Wan Yunshan
Published: March 2020

Corona Virus Disease 2019 (COVID-19) is a recently emerged life-threatening disease caused by SARS-CoV-2. Real-time fluorescent PCR (RT-PCR) is the clinical standard for SARS-CoV-2 nucleic acid detection. To detect SARS-CoV-2 early and control the disease spreading on time, a faster and more convenient method for SARS-CoV-2 nucleic acid detecting, RT-LAMP method (reverse transcription loop-mediated isothermal amplification) was developed. RNA reverse transcription and nucleic acid amplification were performed in one step at 63 °C isothermal conditions, and the results can be obtained within 30 minutes. ORF1ab gene, E gene and N gene were detected at the same time. ORF1ab gene was very specific and N gene was very sensitivity, so they can guarantee both sensitivity and specificity for SARS-CoV-2. The sensitivity of RT-LAMP assay is similar to RT-PCR, and specificity was 99% as detecting 208 clinical specimens. The RT-LAMP assay reported here has the advantages of rapid amplification, simple operation, and easy detection, which is useful for the rapid and reliable clinical diagnosis of SARS-CoV-2.
Fusion pore expansion and contraction during catecholamine release from endocrine cells
Authors: Jackson M. B. , Hsiao Y.-T. , Chang C.-W.
Published: March 2020

Amperometry recording reveals the exocytosis of catecholamine from individual vesicles as a sequential process, typically beginning slowly with a pre-spike foot, accelerating sharply to initiate a spike, reaching a peak, and then decaying. This complex sequence reflects the interplay between diffusion, flux through a fusion pore, and possibly dissociation from a vesicle’s densecore. In an effort to evaluate the impacts of these factors, a model was developed that combines diffusion with flux through a static pore. This model recapitulated the rapid phases of a spike, but generated relations between spike shape parameters that differed from experimental results. To explore the possibility of fusion pore dynamics, a transformation of amperometry current was introduced that yields fusion pore permeability divided by vesicle volume (g/V). Applying this transform to individual fusion events yielded a highly characteristic time course.g/Vinitially tracks the pre-spike foot and the start of the spike, increasing ∼15-fold to the peak. However, after the spike peaks,g/Vunexpectedly declines and settles to a constant value that indicates the presence of a stable post-spike pore.g/Vof the post-spike pore varies greatly between events, and has an average that is ∼3.5-fold below the peak value and ∼4.5-fold above the pre-spike value. The post-spike pore persists andg/Vremains flat for tens of milliseconds, as long as catecholamine flux can be detected. Applying theg/Vtransform to rare events with two peaks revealed a stepwise increase ing/Vduring the second peak. Theg/Vtransform offers an interpretation of amperometric current in terms of fusion pore dynamics and provides a new framework for analyzing the actions of proteins that alter spike shape. The stable post-spike pore conforms with predictions from lipid bilayer elasticity, and offers an explanation for previous reports of prolonged hormone retention within fusing vesicles.

STATEMENT OF SIGNIFICANCE

Amperometry recordings of catecholamine release from single vesicles reveal a complex waveform with distinct phases. The role of the fusion pore in this waveform is poorly understood. A model based on a static fusion pore fails to recapitulate important aspects of the waveform. A new transform of amperometric current introduced here renders fusion pore permeability in real time. This transform reveals rich dynamic behavior of the fusion pore as catecholamine leaves a vesicle. This analysis shows that fusion pore permeability rapidly increases and then decreases before settling into a stable post-spike configuration.
HCN domain is required for HCN channel expression and couples voltage- and cAMP-dependent gating mechanisms
Authors: Wang Ze-Jun , Blanco Ismary , Hayoz Sebastien , Brelidze Tinatin I.
Published: March 2020

Hyperpolarization-activated cyclic nucleotide-gated (HCN) channels are major regulators of synaptic plasticity, and rhythmic activity in the heart and brain. Opening of HCN channels requires membrane hyperpolarization and is further facilitated by intracellular cyclic nucleotides (cNMPs). In HCN channels, membrane hyperpolarization is sensed by the membrane-spanning voltage sensor domain (VSD) and the cNMP-dependent gating is mediated by the intracellular cyclic nucleotide-binding domain (CNBD) connected to the pore-forming S6 transmembrane domain via the C-linker. Previous functional analysis of HCN channels suggested a direct or allosteric coupling between the voltage- and cNMP-dependent activation mechanisms. However, the specifics of the coupling were unclear. The first cryo-EM structure of an HCN1 channel revealed that a novel structural element, dubbed HCN domain (HCND), forms a direct structural link between the VSD and C-linker/CNBD. In this study, we investigated the functional significance of the HCND. Deletion of the HCND prevented surface expression of HCN2 channels. Based on the HCN1 structure analysis, we identified R237 and G239 residues on the S2 of the VSD that form direct interactions with I135 on the HCND. Disrupting these interactions abolished HCN2 currents. We then identified three residues on the C-linker/CNBD (E478, Q382 and H559) that form direct interactions with residues R154 and S158 on the HCND. Disrupting these interactions affected both voltage- and cAMP-dependent gating of HCN2 channels. These findings indicate that the HCND is necessary for the surface expression of HCN channels, and provides a functional link between the voltage- and cAMP-dependent mechanisms of HCN channel gating.
Cost assessment of multi-tenancy for a 5G broadband network in a dense urban area
Authors: Rendon Schneir Juan , Konstantinou Konstantinos , Bradford Julie , Zimmermann Gerd , Droste Heinz , Canto Palancar Rafael , Ajibulu Ade
Published: March 2020

Purpose

5G systems will enable an improved transmission performance and the delivery of advanced communication services. To meet the expected requirements, operators will need to invest in network modernisation, with the radio access network being the most expensive network component. One possible way for operators to reduce this investment would be via sharing of resources by means of a multi-tenancy concept. This implies that a mobile service provider may use the common infrastructure of one or various infrastructure providers, whereby it provides services to multiple tenants. This paper aims to study the expected cost savings in terms of capital expenditures (CAPEX) and operational expenditures (OPEX) that can be achieved when using a cloudified 5G multi-tenant network.

Design/methodology/approach

A cost model was used. The study period is 2020-2030 and the study area consists of three local districts in central London, UK.

Findings

This paper describes that the total cost reduction achieved when using multi-tenancy for a 5G broadband network in comparison with the case where operators make the investment independently ranges from 5.2% to 15.5%.

Research limitations/implications

Further research is needed to assess the cost implications of network sharing for 5G on a regional or nationwide basis.

Originality/value

Very little quantitative research about the cost implications of network sharing under 5G networks has been published so far. This paper sheds light on the economic benefits of multi-tenancy in a 5G broadband network.
Nonprofit organization fraud reporting: does governance matter?
Authors: Abu Khadra Husam , Delen Dursun
Published: March 2020

Purpose

This paper aims to contribute to the extant literature in this field by examining nonprofit organizations’ fraud reporting compliance using logistic regression and decision tree induction algorithms.

Design/methodology/approach

This study used the data from 428 nonprofit organizations during 2009-2015 period, and analyzed 21 individual measures (obtained from these organizations’ Internal Revenue Service Form990 filings) using logistic regression and decision tree induction algorithms, to study the governance characteristics and fraud reporting.

Findings

The study found evidence that compliance with the law, board of directors’ independence, federal audit and using independent accountants to compile and review financial statements are the most prevailing factors affecting the odds of nonprofit organizations experiencing fraud reported as an asset diversion.

Originality/value

The argument associated with using governance to reduce the chances of fraud has been a popular topic in industry and academia but unfortunately has limited empirical evidence in the literature, especially when it relates to nonprofits. This study contributes to the literature in this respect.
Socioeconomic evaluation of green energy investments
Authors: Skordoulis Michalis , Ntanos Stamatis , Arabatzis Garyfallos
Published: March 2020

Purpose

The purpose of this paper is to explore citizens’ willingness to invest in photovoltaics.

Design/methodology/approach

To meet the aim of the research, a questionnaire survey was conducted in the island of Evia in Greece using the method of random stratified sampling. A total of 366 responses were analyzed using both descriptive and inductive statistics methods, such as principal components analysis, K-means cluster analysis, discriminant analysis and binary logistic regression.

Findings

The research results indicate that 73per cent of the respondents would invest in renewable energy sources, whereas 55per cent of them would specifically invest in photovoltaics. Regarding their views on photovoltaics, three components were extracted; photovoltaics positive effects, facilitations for investments in photovoltaics and photovoltaics’ performance. Area of residence, annual income and the above-mentioned three components of views on photovoltaics were found to be statistically significant for the dichotomous variable of willingness to invest in photovoltaics. Among the examined variables, photovoltaics performance found to contribute the most in increasing respondents’ willingness to invest in photovoltaics.

Originality/value

The study filled the literature gap concerning citizens’ willingness to invest in photovoltaics in Greece. Furthermore, the research results made feasible to understand the factors that can lead in an investment decision for photovoltaics.