bluuebunny/crossref_metadata_2025 huggingface dataset:
Dorsal root ganglion stimulation of injured sensory neurons in rats rapidly eliminates their spontaneous activity and relieves spontaneous pain
Authors: Chao Dongman , Mecca Christina M. , Yu Guoliang , Segel Ian , Gold Michael S. , Hogan Quinn H. , Pan Bin
Published: April 2021

Dorsal root ganglion field stimulation (GFS) relieves evoked and spontaneous neuropathic pain by use-dependent blockade of impulse trains through the sensory neuron T-junction, which becomes complete within less than 1 minute for C-type units, also with partial blockade of Aδ units. We used this tool in the spinal nerve ligation (SNL) rat model to selectively block sensory neuron spontaneous activity (SA) of axotomized neurons at the fifth lumbar (L5) level vs blockade of units at the L4 level that remain uninjured but exposed to inflammation. In vivo dorsal root single-unit recordings after SNL showed increased SA in L5 units but not L4 units. Ganglion field stimulation blocked this SA. Ganglion field stimulation delivered at the L5 dorsal root ganglion blocked mechanical hyperalgesia behavior, mechanical allodynia, and ongoing spontaneous pain indicated by conditioned place preference, whereas GFS at L4 blocked evoked pain behavior but not spontaneous pain. In vivo single-unit recordings of spinal cord dorsal horn (DH) wide-dynamic-range neurons showed elevated SA after SNL, which was reduced by GFS at the L5 level but not by GFS at the L4 level. In addition, L5 GFS, but not L4 GFS, increased mechanical threshold of DH units during cutaneous mechanical stimulation, while L5 GFS exceeded L4 GFS in reducing evoked firing rates. Our results indicate that SA in injured neurons supports increased firing of DH wide-dynamic-range neurons, contributing to hyperalgesia, allodynia, and ongoing pain. Ganglion field stimulation analgesic effects after nerve injury are at least partly attributable to blocking propagation of this SA.
Fecal microbiota profile in patients with inflammatory bowel disease in Taiwan
Authors: Chang Tien-En , Luo Jiing-Chyuan , Yang Ueng-Cheng , Huang Yi-Hsiang , Hou Ming-Chih , Lee Fa-Yauh
Published: April 2021

Background:

Inflammatory bowel disease (IBD) is a chronic inflammatory disease associated with complicated interaction between immune, gut microbiota, and environmental factors in a genetically vulnerable host. Dysbiosis is often seen in patients with IBD. We aimed to investigate the fecal microbiota in patients with IBD and compared them with a control group in Taiwan.

Methods:

In this cross-sectional study, we investigated fecal microbiota in 20 patients with IBD and 48 healthy controls. Fecal samples from both IBD patients and controls were analyzed by the next-generation sequencing method and relevant software.

Results:

The IBD group showed lower bacterial richness and diversity compared with the control group. The principal coordinate analysis also revealed the significant structural differences between the IBD group and the control group. These findings were consistent whether the analysis was based on an operational taxonomic unit or amplicon sequence variant. However, no significant difference was found when comparing the composition of fecal microbiota between ulcerative colitis (UC) and Crohn’s disease (CD). Further analysis showed that Lactobacillus, Enterococcus, and Bifidobacterium were dominant in the IBD group, whereas Faecalibacterium and Subdoligranulum were dominant in the control group at the genus level. When comparing UC, CD, and control group, Lactobacillus, Bifidobacterium, and Enterococcus were identified as dominant genera in the UC group. Fusobacterium and Escherichia_Shigella were dominant in the CD group.

Conclusion:

Compared with the healthy control, the IBD group showed dysbiosis with a significant decrease in both richness and diversity of gut microbiota.
Adherence to healthy lifestyle improved clinical outcomes in coronary artery disease patients after coronary intervention
Authors: Yang Ya-Ling , Leu Hsin-Bang , Yin Wei-Hsian , Tseng Wei-Kung , Wu Yen-Wen , Lin Tsung-Hsien , Yeh Hung-I , Chang Kuan-Cheng , Wang Ji-Hung , Wu Chau-Chung , Chen Jaw-Wen
Published: April 2021

Background:

Lifestyle modification is suggested for patients with coronary artery disease (CAD), but the impact of adherence to a healthy lifestyle remains undetermined. The aim of this study is to investigate the association of adherence to a healthy lifestyle with future outcomes and biochemical markers in CAD patients.

Methods:

The Biosignature CAD study examined 716 CAD patients who underwent a percutaneous coronary intervention (PCI). Information was collected on whether these patients adhered to a healthier lifestyle after PCI, including healthy diet, not smoking, and exercise. The clinical outcomes included major cardiovascular events and unplanned revascularization procedures, hospitalization for refractory or unstable angina, and other causes

Results:

The average follow-up period was 26.8 ± 8.1 months, during which 175 (24.4%) patients experienced at least one event. The combination of healthy lifestyle factors was associated with lower risk, and the maximum risk reduction reached 50% (hazard ratio: 0.50, 95% confidence interval: 0.25-0.99). As the number of healthy lifestyle factors increased, there were decreases in inflammatory markers, C-reactive protein, waist circumference, low-density lipoprotein cholesterol, and the ratio of total cholesterol to high-density lipoprotein (HDL) cholesterol (p < 0.05). The benefits of modifiable healthy lifestyle factors were especially observed in the younger population, males, patients with HDL <40 mg/dL, those with reduced left ventricular ejection fraction, and those receiving statin therapy.

Conclusion:

Adherence to a healthy lifestyle is independently associated with a lower risk of future adverse events in CAD patients and plays an important role in secondary prevention in the era of interventional cardiology.
The Association of Psoriasis and Obesity: Focusing on IL-17A-Related Immunological Mechanisms
Authors: Xu Cheng , Ji Jie , Su Ting , Wang Hong-Wei , Su Zhong-Lan
Published: April 2021

Psoriasis is a chronic, recurrent, inflammatory skin disease that is often accompanied by obesity. An increasing amount of research has elucidated the pathophysiological link between psoriasis and obesity. Since 2005, interleukin (IL)-17-producing T helper 17 cells and their main effector cytokine IL-17A have been considered to play a critical role in the pathogenesis of psoriasis; the marked effect of biotherapies targeting IL-17A on moderate and severe psoriasis has further established its role in psoriasis. Recent studies have found that obesity induces T helper 17 cells to secrete IL-17A and participate in the pathogenesis of psoriasis. IL-17A may be a crucial element in the association between psoriasis and obesity. This review discusses the association between psoriasis and obesity, with a focus on and the implications regarding the need to treat psoriasis.
Effects of Nursing Education Using Films on Perception of Nursing, Satisfaction With Major, and Professional Nursing Values
Authors: PARK Hyangjin , CHO Haeryun
Published: April 2021

Background

Cinenurducation, a film-based approach to nursing education that incorporates student-centered, problem-solving, experiential, and reflective learning strategies, allows students to experience a variety of indirect experiences and improves critical thinking and self-reflection through discussion.

Purpose

The aims of this study were, first, to employ a cinenurducation approach to help instill a proper professional nursing identity in second-year nursing students and, second, to examine the effects of this approach on the perception of nursing, satisfaction with major, and professional nursing values of the participants.

Methods

An experimental, pretest-and-posttest design was used to test the primary variables, including perception of nursing, satisfaction with major, and professional nursing values. The nursing educational program was developed based on the learning concepts of cinenurducation and the core concepts of nursing. The program, which included six films, addressed the following concepts: Me Before You (problem solving and professionalism), Testament of Youth (nursing management and professionalism), Girl, Interrupted (interpersonal skills and nursing knowledge), Hungry Heart (interpersonal skills and problem solving), Iris (nursing knowledge and problem solving), and Chronic (nursing knowledge and cooperation). The experimental group (n = 14) participated in the 8-week educational program, and the control group (n = 15) did not.

Results

Perception of nursing, satisfaction with major, and professional nursing values all improved significantly more in the experimental group than in the control group, with large effects observed.

Conclusions

Cinenurducation is an effective approach to promoting professional nursing identity in nursing students. Educators should incorporate films into nursing education. In addition, nursing education should incorporate a variety of educational materials to provide students with opportunities for reflective learning.
The prevalence of symptomatic uncomplicated diverticular disease could be lower than expected: a single-center colonoscopy-based cohort study
Authors: Tursi Antonio , Elisei Walter , Franceschi Marilisa , Picchio Marcello , Di Mario Francesco , Brandimarte Giovanni
Published: April 2021

Aim

The real prevalence of symptomatic uncomplicated diverticular disease (SUDD) is still unknown. The aim of this study was to assess the prevalence of SUDD, post-diverticulitis SUDD (PD-SUDD) and irritable bowel syndrome (IBS)-like symptoms in a real-life population.

Methods

A cohort of patients, submitted to colonoscopy from 1st January 2012 to 30th April 2018 was revised.

Results

A cohort of 5451 patients with diverticulosis was identified during the study period. Abdominal pain was recorded in 1141 patients (20.93%), diarrhea in 288 (5.28%) and constipation in 536 (9.83%) patients. SUDD was recorded in 371 patients (6.81% of the patients having diverticulosis and 32.51% of the patients experiencing abdominal pain), PD-SUDD was recorded in 103 patients (1.89% of the patients having diverticulosis and 9.03% of the patients experiencing abdominal pain) and IBS-like was recorded in 348 patients (6.38% of the patients having diverticulosis and 30.5% of the patients experiencing abdominal pain). Three hundred and nineteen patients were not part of any of the previous categories (5.85% of the patients having diverticulosis and 27.96% of the patients experiencing abdominal pain). SUDD and PD-SUDD were more frequent in older ages (>60 years), while IBS-like symptoms were more frequent in younger. Nonspecific abdominal pain was equally distributed in through the ages.

Conclusion

The prevalence of SUDD seems to be lower than expected, and most of patients with diverticulosis and abdominal symptoms may suffer from IBS-like or other causes.
Self-Efficacy, Outcome Expectations, Group Social Support, and Adherence to Physical Activity in African American Women
Authors: Garland Meghan , Wilbur JoEllen , Fogg Louis , Halloway Shannon , Braun Lynne , Miller Arlene
Published: April 2021

Background

African American women have lower levels of leisure time physical activity compared to White American women. Interventions to improve physical activity have mixed benefits for African American women, even when guided by theory. Understanding how theoretical constructs used in physical activity interventions relate to changing behavior may provide direction for more successful interventions.

Objective

The study aimed to examine the relationships among social cognitive constructs (self-efficacy, social support from group behavioral meetings, outcome expectations/realizations), and change in physical activity from baseline to 48 weeks in African American women participating in a lifestyle physical activity program.

Methods

A secondary data analysis of longitudinal data using a correlational design was conducted using data from a 48-week physical activity randomized controlled trial (RCT). The RCT included a group behavioral meeting component with one of three telephone intervention conditions (no calls, personal motivation calls, or automated motivational calls) randomly assigned across six community healthcare sites. The participants were 260 sedentary, midlife African American women with no major signs or symptoms of cardiovascular disease who completed baseline and 48-week assessments of the RCT. Measures included self-efficacy for change in overcoming barriers to physical activity at 24 weeks, physical and psychological outcome realizations at 24 weeks, social support from group behavioral meetings at 24 weeks, and physical activity (self-report and device-measured) change from baseline to 48 weeks.

Results

In a hierarchical regression model predicting change in self-reported time spent in weekly moderate–vigorous physical activity at 48 weeks, psychological outcome realizations at 24 weeks were significant positive predictors. In a hierarchical regression model for change in device-measured daily steps at 48 weeks, a self-efficacy change at 24 weeks was a significant positive predictor.

Discussion

Attention should be given to increasing self-efficacy to overcome physical activity barriers and achieve self-identified physical and psychological outcomes in physical activity programs.
Parking Meters to Touch Screens
Authors: Norman Jensine’ , Stowers Jared , Verduzco-Gutierrez Monica
Published: April 2021

Greater than 25% of annual healthcare expenditures in the United States are associated with the medical needs of people with disabilities. People with disabilities often experience inequalities with access to healthcare services, resulting in increased costs of living with disability. The economic burden of living with a disability results in nearly US $400 billion spent annually from combined public and private payor sources. Historically, disparities in health care are associated with intersections between race, culture, and environmental factors. Minority status also plays a significant role in health outcomes, and studies have highlighted the additional burdens faced at the junction of race and disability status. COVID-19 changed the landscape of healthcare delivery in the United States, resulting in a drastic increase in telehealth utilization. Traditional nonmedical barriers to persons with disability, such as unforeseen parking fees, are documented in the literature. However, conditions surrounding access to the necessary technology required to participate in a telehealth-driven medical landscape are less clear. This article addresses the nonmedical barriers and costs associated with living with a disability and discusses potential solutions in the evolving healthcare system.
Decreasing Foot Traffic in the Orthopedic Operating Room: A Narrative Review of the Literature
Authors: Buckner Laura , Lacy Jordan , Young Kasey , Dishman Deniz
Published: April 2021

Introduction

Surgical site infections (SSIs) are implicated in poor outcomes in orthopedic surgical patients. Decreasing foot traffic in orthopedic surgical suites is correlated with the reduction of SSI risk. This review aims to understand the background and significance of the problem, isolate factors contributing to the movement in and out of operating rooms, and identify interventions that decrease traffic in procedure areas.

Methods

A comprehensive search was completed using the databases Embase and Medline (Ovid). A PICOT question was used in the literature search to evaluate the efficacy of a standardized guideline on operating room door opening frequency. The Mixed Methods Appraisal Tool was used to appraise the literature critically, and conventional content analysis methodology identified themes within the publications.

Results

The literature search yielded 18 articles providing 3 different themes of evidence: airborne bacterial counts and their association with foot traffic; specific personnel, namely, nurses demonstrating the greatest amount of foot traffic; and interventions aimed at minimizing this foot traffic.

Conclusions

Implementing multiple evidence-based interventions can decrease foot traffic and reduce the risk of SSIs in orthopedic patients. Further studies are needed to directly link airborne bacterial counts to SSIs, increase the level of evidence, and isolate interventions.
The Perfect Storm: Exam of a Medical Error and Factors Contributing to Its Possible Escalation
Authors: Walters Gerald K.
Published: April 2021

Objective

After an initial medical misadventure, failure of recognition and continuing factors that could perpetuate the error are examined.

Methods

A critical evaluation of the continuum of care after the initial error was conducted through chart review and comparison to published standards.

Results

Analysis of the continuum of care after the original error demonstrated numerous system failures that should have alerted the providers to the initial error.

Discussion

Technology, electronic medical records, lack of critical communications, and short cuts have the potential to not recognize patient care safety issues and potential harm.

Conclusions

Medical errors are multifactorial. Blame casting and accusations are not productive. Critical analysis of systems/processes, current technology, eliminating shortcuts, and critical communications may increase patient safety.
A Collision Intrathyroidal Tumor Causing Primary Hyperparathyroidism
Authors: Foppiani Luca , Sola Simona , Pitto Francesca , Ansaldo Gianluca , Piccardo Arnoldo
Published: April 2021

A 67-year-old man was diagnosed with primary hyperparathyroidism and normofunctioning left nodular goiter. Fine-needle aspiration cytology showed thyroid (Thy) 4 (suspicious of malignancy). After first-line imaging proved negative, integrated 18F-choline PET/4D contrast-enhanced CT revealed uptake by the thyroid nodule and by 3 nodules of the left central compartment. Thyroidectomy and lymphadenectomy were performed. Histopathology revealed a collision tumor (ie, 2 histologically distinct tumors occurring at the same anatomic site) composed of both PTC (papillary thyroid carcinoma) and parathyroid carcinoma within the left thyroid nodule. Lymph nodes showed PTC metastases. Primary hyperparathyroidism and calcium levels normalized, and the patient underwent radioiodine therapy.
Effect of Nasal Soft-Tissue Envelope Thickness on Postoperative Healing Process Following Rhinoplasty
Authors: Erdur Zülküf Burak , Öktem Fatih , Inci Ender , Yener Haydar Murat , Üstündağ Ahmet
Published: April 2021

Objective:

Understanding the postoperative dynamics of the nasal soft-tissue envelope (NSTE) is necessary to obtain the desired cosmetic results after rhinoplasty. This study was conducted to determine the changes of NSTE thickness and its effects on periorbital edema and ecchymosis following rhinoplasty.

Methods:

Thirty-five patients who underwent rhinoplasty were included in the study. Nasal skin and subcutaneous tissue thickness at the tip, supratip, rhinion, and nasion were measured using ultrasonography preoperatively and at the postoperative 3rd and 10th months. Periorbital edema and ecchymosis were evaluated at postoperative days 1, 3, and 7. The patients were categorized as the thick NSTE group (n = 17) and the thin NSTE group (n = 18) according to the preoperative median NSTE thickness.

Results:

In the thin NSTE group, supratip skin, subcutaneous tissue, and total NSTE thickness were lowest on the preoperative day but no statistically significant difference was found for the thick NSTE group. In the thin NSTE group, total NSTE thickness of the rhinion was highest at the postoperative 3rd month, but in the thick NSTE group, there was no statistically significant difference between postoperative 3rd and 10th months. In both groups, total NSTE thickness of the nasion was highest at the postoperative 3rd month and lowest at the postoperative 10th month.

Conclusions:

Supratip fullness occurs more prominent in patients with thin NSTE. Postoperative edema in the rhinion is greater in patients with thin NSTE for the early postoperative period but it lasts longer in patients with thick NSTE. Soft-tissue envelope atrophy at the nasion occurs in both groups in the late postoperative period. Periorbital edema and ecchymosis severity are not affected by NSTE thickness.
Novel Trauma Composite Score is a more reliable predictor of mortality than Injury Severity Score in pediatric trauma
Authors: Keskey Robert C. , Hampton David A. , Biermann Henry , Cirone Justin , Zakrison Tanya L. , Cone Jennifer T. , Wilson Ken L. , Slidell Mark B.
Published: April 2021

BACKGROUND

The equivalent Injury Severity Score (ISS) cutoffs for severe trauma vary between adult (ISS, >16) and pediatric (ISS, >25) trauma. We hypothesized that a novel injury severity prediction model incorporating age and mechanism of injury would outperform standard ISS cutoffs.

METHODS

The 2010 to 2016 National Trauma Data Bank was queried for pediatric trauma patients. Cut point analysis was used to determine the optimal ISS for predicting mortality for age and mechanism of injury. Linear discriminant analysis was implemented to determine prediction accuracy, based on area under the curve (AUC), of ISS cutoff of 25 (ISS, 25), shock index pediatric adjusted (SIPA), an age-adjusted ISS/abbreviated Trauma Composite Score (aTCS), and our novel Trauma Composite Score (TCS) in blunt trauma. The TCS consisted of significant variables (Abbreviated Injury Scale, Glasgow Coma Scale, sex, and SIPA) selected a priori for each age.

RESULTS

There were 109,459 blunt trauma and 9,292 penetrating trauma patients studied. There was a significant difference in ISS (blunt trauma, 9.3 ± 8.0 vs. penetrating trauma, 8.0 ± 8.6; p < 0.01) and mortality (blunt trauma, 0.7% vs. penetrating trauma, 2.7%; p < 0.01). Analysis of the entire cohort revealed an optimal ISS cut point of 25 (AUC, 0.95; sensitivity, 0.86; specificity, 0.95); however, the optimal ISS ranged from 18 to 25 when evaluated by age and mechanism. Linear discriminant analysis model AUCs varied significantly for each injury metric when assessed for blunt trauma and penetrating trauma (penetrating trauma–adjusted ISS, 0.94 ± 0.02 vs. ISS 25, 0.88 ± 0.02 vs. SIPA, 0.62 ± 0.03; p < 0.001; blunt trauma–adjusted ISS, 0.96 ± 0.01 vs. ISS 25, 0.89 ± 0.02 vs. SIPA, 0.70 ± 0.02; p < 0.001). When injury metrics were assessed across age groups in blunt trauma, TCS and aTCS performed the best.

CONCLUSION

Current use of ISS in pediatric trauma may not accurately reflect injury severity. The TCS and aTCS incorporate both age and mechanism and outperform standard metrics in mortality prediction in blunt trauma.

LEVEL OF EVIDENCE

Retrospective review, level IV.
Neuro-Ophthalmic Phenotype of OPA3
Authors: Huna-Baron Ruth , Yahalom Gilad , Anikster Yair , Ben Zeev Bruria , Hoffmann Chen , Hassin-Baer Sharon
Published: April 2021

Background:

Type III 3-methylglutaconic aciduria (OPA 3) is a neuro-ophthalmologic syndrome consisting of early-onset bilateral optic atrophy. Since Costeff described the phenotype of 19 patients in 1989, several reports described approximately 50 patients, but most of them lack details about neuro-ophthalmic phenotype. Our aim was to characterize the clinical neuro-ophthalmic phenotype of this syndrome.

Methods:

Nine patients underwent meticulous visual function history and medical documents' review. Results of best-corrected visual acuity (VA), color vision, visual field (VF), ocular motility, pupillary reaction, slit-lamp, and dilated fundus examinations were recorded. Optical coherence tomography (OCT) was performed whenever possible.

Results::

The average VA was 1.4 ± 0.8 logarithm of the minimum angle of resolution. Poor vision was the presenting symptom in 5 patients. Six patients had decreased VA and variable degrees of optic atrophy. Humphrey VF testing of 7 patients revealed generalized depression in 5 and a cecocentral defect in 2. All patients demonstrated dysmetric saccades. Four patients had strabismus, 3 with exotropia, and one with esotropia. Seven patients had nystagmus. Ocular motility abnormality is possibly the result of cerebellar atrophy that was found in MRI studies of our patients. OCT of the retina was possible in 6 patients and revealed retinal nerve fiber layer (RNFL) thinning as well as average retinal thinning. Three patients, in whom ganglion cell layer–inner plexiform layer (IPL) measurement was possible, also showed diffused thinning.

Conclusions:

This study compiled data regarding neuro-ophthalmic manifestation of OPA 3 Type III patients. Contrary to established literature, poor vision was the presenting symptom in only 50% of our patients. This is the first report of OCT findings in 3MGA patients. The results demonstrated diffused thinning of the RNFL and ganglion cell complex-IPL with correlation to VA, which is in contrast to OPA1 patients in whom the most severe thinning is at the level of the papillomacular bundle. Average retinal thinning was identified at second and third decades of life, possibly resulting from early ganglion cell loss. These results may contribute to visual prognosis, and OCT may help monitor experimental therapies.
Developmental instability and phenotypic evolution in a small and isolated bear population
Authors: Loy A. , Ciucci P. , Guidarelli G. , Roccotelli E. , Colangelo P.
Published: April 2021

We explored fluctuating asymmetry (FA) and morphological integration (MI) in the skull of the small, highly inbred and divergent Apennine bear (Ursus arctos marsicanus), to explore its uniqueness and investigate any potential effects of inbreeding depression. We used 3D geometric morphometrics contrasting Apennine bears with other two large outbred bear populations from Scandinavia and Kamchatka as controls. Shape divergence and variability were explored by a principal component analysis on aligned coordinates of 39 landmarks. Procrustes ANOVA, morphological disparity and the global integration index were used to explore FA, shape variance and MI. By remarking Apennine bears as a highly divergent phenotype, we recorded the highest FA and deviation from self-similarity compared with the other two control populations. We conclude that Apennine bears are likely facing developmental instability as a consequence of inbreeding depression, whereas the divergent trait covariance pattern may represent a potential source of evolutionary novelties. We discuss the implications for the conservation and management of this imperiled taxon.
Photodynamic inactivation of
Lasiodiplodia theobromae
: lighting the way towards an environmentally friendly phytosanitary treatment
Authors: Garcia M. , David B. , Sierra-Garcia I. N. , Faustino M. A. F. , Alves A. , Esteves A. C. , Cunha A.
Published: April 2021

The fungus
Lasiodiplodia theobromae
is one of the main causal agents of trunk canker and dieback of grapevine. The objective of this work was to evaluate the efficiency of photodynamic inactivation (PDI) of
L. theobromae
with synthetic and natural photosensitizers and irradiation with either sunlight or artificial photosynthetically active radiation. Although the growth of the mycelium could not be completely prevented with natural sunlight irradiation, phenothiazine dyes (methylene blue, MB; toluidine blue O, TBO), riboflavin and a cationic porphyrin (Tetra-Py
+
-Me) caused complete inhibition under continuous irradiation with artificial light. Free radicals were the main cytotoxic agents in the PDI with MB, indicating the predominance of the type I mechanism. PDI with MB or Tetra-Py
+
-Me may represent a promising approach for the sanitation of vine material in greenhouse nurseries, in order to reduce the risk of infection upon grafting.
Converting Access Microbiology to an open research platform: focus group and AI review tool research results
Authors: Howat Alexandra M. , Mulhern Alexander , Logan Hilary F. , Redvers-Mutton Gaynor , Routledge Chris , Clark Justin
Published: April 2021

The Microbiology Society will be launching an open research platform in October 2021. Developed using funding from the Wellcome Trust and the Howard Hughes Medical Institute (HHMI), the platform will combine our current sound-science journal, Access Microbiology, with artificial intelligence (AI) review tools and many of the elements of a preprint server. In an effort to improve the rigour, reproducibility and transparency of the academic record, the Access Microbiology platform will host both preprints of articles and their Version of Record (VOR) publications, as well as the reviewer reports, Editor's decision, authors' response to reviewers and the AI review reports. To ensure the platform meets the needs of our community, in February 2020 we conducted focus group meetings with various stakeholders. Using articles previously submitted to Access Microbiology, we undertook testing of a range of potential AI review tools and investigated the technical feasibility and utility of including these tools as part of the platform. In keeping with the open and transparent ethos of the platform, we present here a summary of the focus group feedback and AI review tool testing.
Evaluation of bat adenoviruses suggests co-evolution and host roosting behaviour as drivers for diversity
Authors: Ntumvi Nkom F. , Diffo Joseph Le Doux , Tamoufe Ubald , Ndze Valantine Ngum , Takuo Jean-Michel , Mouiche Moctar M. M. , Nwobegahay Julius , LeBreton Matthew , Gillis Amethyst , Rimoin Anne W. , Schneider Bradley S. , Monagin Corina , McIver David J. , Joly Damien O. , Wolfe Nathan D. , Rubin Edward M. , Lange Christian E.
Published: April 2021

Adenoviruses (AdVs) are diverse pathogens of humans and animals, with several dozen bat AdVs already identified. Considering that over 100 human AdVs are known, and the huge diversity of bat species, many bat AdVs likely remain undiscovered. To learn more about AdV prevalence, diversity and evolution, we sampled and tested bats in Cameroon using several PCR assays for viral and host DNA. AdV DNA was detected in 14 % of the 671 sampled animals belonging to 37 different bat species. There was a correlation between species roosting in larger groups and AdV DNA detection. The detected AdV DNA belonged to between 28 and 44 different, mostly previously unknown, mastadenovirus species. The novel isolates are phylogenetically diverse and while some cluster with known viruses, others appear to form divergent new clusters. The phylogenetic tree of novel and previously known bat AdVs does not mirror that of the various host species, but does contain structures consistent with a degree of virus–host co-evolution. Given that closely related isolates were found in different host species, it seems likely that at least some bat AdVs have jumped species barriers, probably in the more recent past; however, the tree is also consistent with such events having taken place throughout bat AdV evolution. AdV diversity was highest in bat species roosting in large groups. The study significantly increased the diversity of AdVs known to be harboured by bats, and suggests that host behaviours, such as roosting size, may be what limits some AdVs to one species rather than an inability of AdVs to infect other related hosts.
Sero-monitoring of health care workers reveals complex relationships between common coronavirus antibodies and SARS-CoV-2 severity
Authors: Gouma Sigrid , Weirick Madison E. , Bolton Marcus J. , Arevalo Claudia P. , Goodwin Eileen C. , Anderson Elizabeth M. , McAllister Christopher M. , Christensen Shannon R. , Dunbar Debora , Fiore Danielle , Brock Amanda , Weaver JoEllen , Millar John , DerOhannessian Stephanie ,   The UPenn COVID Processing Unit, Frank Ian , Rader Daniel J. , Wherry E. John , Hensley Scott E.
Published: April 2021

Recent common coronavirus (CCV) infections are associated with reduced COVID-19 severity upon SARS-CoV-2 infection, however the immunological mechanisms involved are unknown. We completed serological assays using samples collected from health care workers to identify antibody types associated with SARS-CoV-2 protection and COVID-19 severity. Rare SARS-CoV-2 cross-reactive antibodies elicited by past CCV infections were not associated with protection; however, the duration of symptoms following SARS-CoV-2 infections was significantly reduced in individuals with higher common betacoronavirus (βCoV) antibody titers. Since antibody titers decline over time after CCV infections, individuals in our cohort with higher βCoV antibody titers were more likely recently infected with common βCoVs compared to individuals with lower antibody titers. Therefore, our data suggest that recent βCoV infections potentially limit the severity of SARS-CoV-2 infections through mechanisms that do not involve cross-reactive antibodies. Our data are consistent with the emerging hypothesis that cellular immune responses elicited by recent common βCoV infections transiently reduce disease severity following SARS-CoV-2 infections.
Effect of multiple freeze-thaw cycles on detection of anti-SARS-CoV-2 IgG antibodies
Authors: Shurrab Farah M. , Al-Sadeq Duaa W. , Amanullah Fathima , Younes Salma N. , Al-Jighefee Hadeel , Younes Nadin , Dargham Soha R. , Yassine Hadi M. , Raddad Laith J. Abu , Nasrallah Gheyath K.
Published: April 2021

Several studies have investigated the effect of repeated freeze-thaw (F/T) cycles on RNA detection for SARS-CoV-2. However, no data is available regarding the effect of repeated F/T cycles on SARS-CoV-2 antibody detection in serum. We investigated the effect of multiple F/T cycles on anti-SARS-CoV-2 IgG detection using an ELISA test targeting the nucleocapsid antibodies. Ten positive and one negative SARS-CoV-2 IgG sera from 11 participants, in replicates of five were subjected to a total of 16 F/T cycles and stored at 4°C until tested by ELISA. Statistical analysis was done to test for F/T cycle effect. Non-of the 10 positive sera turned into negative after 16 F/T cycles. There was no significant difference in the OD average reading between the first and last F/T cycles, except for one serum with a minimal decline in the OD. The random-effect linear regression of log (OD) on the number of cycles showed no significant trend with a slope consistent with zero (B=-0.0001; 95% CI −0.0008; 0.0006; p-value=0.781). These results suggest that multiple F/T cycles had no effect on the ability of the ELISA assay to detect the SARS-CoV-2 IgG antibodies.
Association of cerebral small vessel disease burden with brain structure and cognitive and vascular risk trajectories in mid-to-late life
Authors: Jansen Michelle G , Griffanti Ludovica , Mackay Clare E , Anatürk Melis , Melazzini Luca , de Lange Ann-Marie G , Filippini Nicola , Zsoldos Enikő , Wiegertjes Kim , de Leeuw Frank-Erik , Singh-Manoux Archana , Kivimäki Mika , Ebmeier Klaus P , Suri Sana
Published: April 2021

We characterize the associations of total cerebral small vessel disease (SVD) burden with brain structure, trajectories of vascular risk factors, and cognitive functions in mid-to-late life. Participants were 623 community-dwelling adults from the Whitehall II Imaging Sub-study with multi-modal MRI (mean age 69.96 SD=5.18, 79% men). We used linear mixed-effects models to investigate associations of SVD burden with up to 25-year retrospective trajectories of vascular risk and cognitive performance. General linear modelling was used to investigate concurrent associations with grey matter (GM) density and white matter (WM) microstructure, and whether these associations were modified by cognitive status (Montreal Cognitive Assessment, MoCA). Severe SVD burden in older age was associated with higher mean arterial pressure throughout midlife (β=3.36, 95% CI [0.42-6.30]), and faster 25-year cognitive decline in letter fluency (β=-0.07, 95% CI [-0.13–-0.01]), and verbal reasoning (β=-0.05, 95% CI [-0.11–-0.001]). Moreover, SVD burden was related to lower GM volumes in 9.7% of total GM, and widespread WM microstructural decline (FWE-corrected p<0.05). The latter association was most pronounced in individuals with cognitive impairments on MoCA (F3,608=2.14, p=0.007). These findings highlight the importance of managing midlife vascular health to preserve brain structure and cognitive function in old age.
Survival analysis methods for analysis of hospitalization data: Application to COVID-19 patient hospitalization experience
Authors: Rathouz Paul J. , Valencia Victoria , Chang Patrick , Morton David , Yang Haoxiang , Surer Ozge , Fox Spencer , Meyers Lauren Ancel , Matsui Elizabeth C. , Haynes Alex B.
Published: April 2021

During most of 2020, the COVID-19 pandemic gave rise to considerable and growing numbers of hospitalizations across most of the U.S. Typical COVID-19 hospitalization data, including length of stay, intensive care unit (ICU) use, mechanical ventilation (Vent), and in-hospital mortality provide clearly interpretable health care endpoints that can be compared across population strata. They capture the resources consumed for the care of COVID-19 patients, and analysis of these endpoints can be used for resource planning at the local level. Yet, hospitalization data embody novel features that require careful statistical treatment to be useful in this context. Specifically, statistical models must meet three goals: (i) They should mesh with and inform mathematical epidemiologic or agent-based models of the COVID-19 experience in the population. (ii) They need to handle administrative censoring of hospitalization experience when data are extracted and downloaded for a given patient before that patient’s hospitalization experience has terminated. And, (iii) models need to handle risks for competing events, the occurrence of one blocking the possibility of the other(s). For example, live discharge from the hospital “competes with” (i.e., blocks) in-hospital mortality. We have adapted approaches from the survival analysis literature to address these challenges in order to better understand and quantify the population experience in hospital with respect to length of stay, ICU, Vent use and so on. Using hospitalization data from a large U.S. metropolitan region, in this report, we show how standard techniques from survival analysis can be brought to bear to address these challenges and yield interpretable results. In the breakout/discussion, we will discuss formulation, estimation and inference, and interpretation of competing risks models.
Eating Disorders Spectrum during COVID Pandemic: a systematic review
Authors: Miniati Mario , Marzetti Francesca , Palagini Laura , Marazziti Donatella , Orrù Graziella , Conversano Ciro , Gemignani Angelo
Published: April 2021

Background

Several data suggest that COVID-19 pandemic might exacerbate or trigger Eating Disorders (EDs). The aim of this paper was to summarize present literature on COVID pandemic and EDs.

Methods

Literature search, study selection, methods, and quality evaluation were performed following PRISMA Guidelines.

Results

The systematic search permitted the identification of 91 studies; 21 papers were eligible and included in the review. Nine papers (42.9%) evaluated the effect of pandemic and associated protective and risk factors in EDs patients, ten (47.6%) explored the prevalence of disturbed eating behaviours and risk factors for exacerbating EDs in the general population, and the remaining two (9.5%) were qualitative studies describing the impact of lockdown and quarantine on EDs patients.

Their analysis revealed five main findings: 1) changes in physical activities routines were related to a worsening of preoccupation on weight/body shape; 2) food access limitation during pandemic represented a risk factors for both triggering and exacerbating EDs; 3) restriction in healthcare facilities contributed to increase anxiety levels and modifies treatment compliance; 4) social isolation was related to symptoms’ exacerbation in EDs patients who are home-confined with family members; 5) conflicts and difficulties in relationships with ‘no way out’ were maintenance factors for EDs symptoms, especially in adolescents and young adults.

Conclusion

COVID-19 pandemic had a negative impact on EDs that might be triggered or worsened by the exceptional conditions deriving from COVID-19-related stress in predisposed subjects. Patients already affected by EDs experienced a worsening of their clinical conditions and related quality of life.
Increased Transmissibility of SARS-CoV-2 Lineage B.1.1.7 by Age and Viral Load: Evidence from Danish Households
Authors: Lyngse Frederik Plesner , Mølbak Kåre , Skov Robert Leo , Christiansen Lasse Engbo , Mortensen Laust Hvas , Albertsen Mads , Møller Camilla Holten , Krause Tyra Grove , Rasmussen Morten , Michaelsen Thomas Yssing , Voldstedlund Marianne , Fonager Jannik , Steenhard Nina ,   The Danish Covid-19 Genome Consortium, Kirkeby Carsten
Published: April 2021

1

Aim

The aim of this study was to estimate the household transmissibility of SARS-CoV-2 for lineage B.1.1.7 compared with other lineages, by age and viral load. Further-more, we wanted to estimate whether there is a multiplicative or additive effect of the increased transmissibility of B.1.1.7 compared with other lineages.

Background

New lineages of SARS-CoV-2 are of potential concern due to higher transmissibility, risk of severe outcomes, and/or escape from neutralizing antibodies. Lineage B.1.1.7 has been estimated to be more transmissible than other previously known lineages, but the association between transmissibility and risk factors, such as age of primary case and viral load is still unknown.

Methods

We used comprehensive administrative data from Denmark, comprising the full population, all SARS-CoV-2 RT-PCR tests, and all WGS lineage data (January 11 to February 7, 2021), to estimate household transmissibility stratified by lineage B.1.1.7 and other lineages.

Results

We included 5,241 households with primary cases; 808 were infected with SARS-CoV-2 lineage B.1.1.7 and 4,433 were infected with other lineages. The attack rate was 38% in households with a primary case infected with B.1.1.7 and 27% in households with a primary case infected with other lineages. Primary cases infected with B.1.1.7 had an increased transmissibility of 1.5-1.7 times that of primary cases infected with other lineages. The increased transmissibility of B.1.1.7 was multiplicative across age and viral load.

Conclusions

The results found in this study add new knowledge that can be used to mitigate the further spread of SARS-CoV-2 lineage B.1.1.7, which is becoming increasingly widespread in numerous countries. Our results clarify that the transmissibility of B.1.1.7 should be included as a multiplicative effect in mathematical models used as a tool for decision makers. The results may have important public health implications, as household transmission may serve as a bridge between otherwise separate transmission domains, such as schools and physical workplaces, despite implemented non-pharmaceutical interventions.
Genetics and Epigenetics of Aldehyde Dehydrogenase (ALDH2) in Alcohol Related Liver Disease
Authors: Shankarappa Bhagyalakshmi , Mahadevan Jayant , Murthy Pratima , Purushottam Meera , Viswanath Biju , Jain Sanjeev , Devarbhavi Harshad , Mysore Ashok V.
Published: April 2021

Alcohol dependence and cirrhosis are key outcomes of excessive alcohol use. We studied the interaction between genetics and epigenetics at the aldehyde dehydrogenase (ALDH2) locus to understand differences in vulnerability to cirrhosis. Individuals were selected according to ICD 10 criteria for Alcohol dependence with Cirrhosis (AUDC+ve, N=116) and Alcohol dependence but without Cirrhosis; (AUDC-ve, N=123) from the clinical services of Gastroenterology and Psychiatry at the St John’s Medical College Hospital (SJMCH). Fibroscan/sonographic evidence was used to rule out fibrosis for the AUDC-ve group. Genomic DNA from blood was used for genotyping at ALDH2 (rs2238151) locus. A subset of the samples was assessed for DNA methylation (AUDC+ve, N=50; AUDC-ve, N=50) at the LINE-1 and ALDH2 CpG loci by pyrosequencing on a PyroMark Q24.

LINE1 DNA methylation did not differ between the groups. ALDH2 DNA methylation was significantly lower in AUDC+ve group compared to AUDC-ve group (P <0.001). Lower methylation in T-allele carriers compared to T-allele non-carriers of the ALDH2 locus (rs2238151) was observed in AUDC+ve subjects (P=0.009). Compromised methylation in blood DNA at candidate loci, in those with liver disease in the context of prolonged severe alcohol abuse, could be explored as a biomarker for current pathology, and further progression.
Prevalence and Transmission of SARS-CoV-2 in Childcare Facilities: A Longitudinal Study
Authors: Haag Luise , Blankenburg Judith , Unrath Manja , Grabietz Johanna , Kahre Elisabeth , Galow Lukas , Schneider Josephine , Dalpke Alexander H. , Lück Christian , Büttner Leo , Berner Reinhard , Armann Jakob P.
Published: April 2021

Objectives

Previous data indicate that children might play a less crucial role in SARS-CoV-2 transmission than initially assumed. We conducted a study to gain further knowledge on prevalence, transmission and spread of SARS-CoV-2 among preschool children, their parents and caretakers.

Methods

Children, their parents and care givers in 14 childcare facilities in Dresden, Saxony/ Germany were invited to participate in the KiTaCoviDD19-study between July 2020 and January 2021. Seroprevalence of SARS-CoV-2 antibodies was assessed up to 4 times during the study period in all participating adults and personal characteristics as well as epidemiological information of personal SARS-CoV-2 history were obtained. Stool viral shedding of SARS-CoV-2 was analyzed every 2-4 weeks in all participating children.

Results

In total, 318 children, 299 parents and 233 childcare workers were enrolled. The percentage of seropositive adults and SARS-CoV-2 positive detected children rose considerably by January 2021. However, the rate of SARS-CoV-2 positive children was considerably lower than the rate of seropositive adults. Overall, we detected a maximum of three connected cases in children. About 50% of SARS-CoV-2 infections in children could not be connected to a secondary case within our study population.

Conclusion

The study could not provide evidence for a relevant asymptomatic (“silent”) spread of SARS-CoV-2 in childcare facilities, neither in a low nor a high prevalence setting. This finding adds to the evidence that childcare and educational settings do not play a crucial role in driving the SARS-CoV-2 pandemic.

Table of Contents Summary

This longitudinal study among children, parents and childcare workers provides further insight on SARS-CoV-2 prevalence and transmission within childcare facilities.

What’s Known on This Subject

Based on age distribution of SARS-CoV-2 infections and previous data of very limited spread of COVID-19 among primary and secondary schools there is reason to believe that children play a less crucial role in SARS-CoV-2 transmission than initially assumed.

What This Study Adds

Previously published studies focus mainly on SARS-CoV-2 transmission in schools. This longitudinal study provides information on prevalence, transmission and spread of SARS-CoV-2 within childcare facilities during low- and high-prevalence settings.