bluuebunny/crossref_metadata_2025 huggingface dataset:
Intravenous versus topical tranexamic acid in lumbar interbody fusion
Authors: Song Fei , Zheng Zhouhai
Published: June 2020

Background:

Questions still remain about the safest and most effective route of administration for tranexamic acid (TXA) in lumbar interbody fusion. As such, the goal of this randomized clinical trial was to assess the efficacy and safety of topical TXA compared with intravenous TXA in lumbar interbody fusion.

Methods:

This was a prospectively randomized trial that investigated the effectiveness and safety of the intravenous and topical administrations of TXA with regard to lumbar interbody fusion. Approval from Clinical Studies Ethical Committee in our hospital was obtained. The patients were randomized to 1 of 2 treatment options:

Patients, surgeons, anesthesiologists, nurses, and research assistants collecting data were blinded to group allocation. The primary outcome measures were perioperative calculated blood loss, total drain output at 24 hours, and perioperative blood transfusion rate. Secondary outcomes included an analysis of complications, namely symptomatic venous thromboembolism, cerebrovascular accident, and arterio-occlusive events. Data were analyzed using the statistical software package SPSS version 25.0 (Chicago, IL).

Results:

There are several limitations to this study. We did not include a group of patients who did not receive TXA. Another potential limitation is that the study population contains heterogeneity such as varying patient diagnosis and surgical technique/approach. Despite these limitations, the validity of our results should be maintained, as the same methodology was applied to both treatment arms.

Trial registration:

This study protocol was registered in Research Registry (researchregistry5564).
Characteristics and surgical invervention of ovarian torsion in pregnant compared with nonpregnant women
Authors: Wu Wei-Fang , Wang Zhen-Hong , Xiu Ying-Ling , Xie Xi , Pan Mian
Published: June 2020

The aim of our study was to compare the clinical and surgical characteristics of pregnant and nonpregnant women with surgically verified ovarian torsion, as well as the differences among 3 trimesters during pregnancy.

We conducted a retrospective study of patients diagnosed with surgically proven ovarian torsion in our hospital from January 2012 to June 2018. The clinical characteristics, surgical procedure, pathologic outcomes, and trimesters of pregnancy were analyzed.

Thirty-three pregnant and 72 nonpregnant patients diagnosed with surgically proven ovarian torsion were assessed during the study period. The most common presenting symptom in both groups was abdominal pain (90.2% and 99.0%, respectively). The median time from admission to surgery was shorter in pregnant patients than nonpregnant patients (5.3 compared with 47.7 hours, P < .001). Pregnant patients had a higher number of twists than nonpregnant patients (median of 2 compared with 1, P < .01). Benign cyst was the most common cyst causing ovarian torsion in both groups, and luteum cyst was more common in the pregnant group. The mean size of ovarian cyst in pregnant patients was much smaller in the third trimester than the first and the second trimesters (6.6 ± 2.0, 8.4 ± 2.1and 8.1 ± 1.5 cm, respectively; P = .097). Cystectomy performed in the third trimester was more frequent compared with the other 2 trimesters (77.8%, 26.7%, and 22.2%, respectively; P = .021).

Abdominal pain is the most common feature of ovarian torsion. Clinical presentation of ovarian torsion is relatively similar between pregnant and nonpregnant women, and among different trimesters. The tumor size was smaller in the third trimester of pregnancy than the other 2 trimesters of pregnancy. Cystectomy performed in pregnant patients is more during the third trimester compared with the other 2 trimesters.
Traditional Chinese medicine on treating active rheumatoid arthritis
Authors: Zhang Lingyue , Cao Zuoyuan , Yang Yeying , Tan Xinyi , Mao Jianchun , Su Li
Published: June 2020

Background:

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease associated with progressive joint damage and disability. There is a lack of effective methods in the treatment of RA currently. Many clinical trials have proved that traditional Chinese medicine (TCM) has obvious advantages in the treatment of RA. In this systematic review, we intend to evaluate the efficacy and safety of TCM for active RA.

Methods:

We will search PubMed, the Cochrane Library, Embase, Web of Science, the Chinese National Knowledge Infrastructure Database, Wanfang Data, and Chinese Science and Technology Periodical Database. Simultaneously we will retrieval relevant meeting minutes, eligible research reference lists, symposium abstracts, and grey literatures. Included criteria are randomized controlled trials (RCTs) about TCM for active RA to assess its efficacy and safety. We will use the Revman 5.3 and Stata 13.0 software for data synthesis, sensitivity analysis, meta regression, subgroup analysis, and risk of bias assessment. The Grading of Recommendations Assessment, Development, and Evaluation standard will be used to evaluate the quality of evidence.

Results:

This systematic review will provide a synthesis of TCM for patients with active RA from various evaluation aspects including tender joint count, swollen joint count, RF, CRP, ESR, DAS28, TCM syndrome evaluation criteria, and adverse events.

Conclusion:

The systematic review will provide evidence to assess the efficacy and safety of TCM in the treatment of patients with active RA.

PROSPERO registration number:

PROSPERO CRD42019146726
Effect of acupuncture on chronic bronchitis
Authors: Mao Dongdong , Deng Yanli , Zhang Leixiao , Zhao Ying , Li Ying , Wang Fei
Published: June 2020

Introduction:

Chronic bronchitis (CB) is a clinically common and recurrent respiratory disease. However, many trials have shown that acupuncture can effectively treat CB. There is currently no systematic review of this therapy. The plan is to evaluate the effectiveness and safety of this treatment in patients with CB.

Methods and analysis:

This systematic evaluation will entail an electronic and manual search of all acupuncture for CB from inception to December 31, 2020, regardless of the publication status or language. Databases include PubMed, Embase, Springer, Web of Science, the Cochrane Library, the World Health Organization International Clinical Trial Registration Platform, the Chinese Medicine Database, the China National Knowledge Infrastructure, the Chinese Biomedical Literature Database, the China Science Journal Database, and the Wanfang Database. Other sources of information, including bibliographies and meeting minutes for identified publications, will also be searched. A manual search for grey literature, including unpublished conference articles will be performed. Additionally, any clinical randomized controlled trials related to acupuncture for CB, regardless of the publication status and language limitations, will be included in the study. Study selection, data extraction, and research quality assessments will be conducted independently by 2 researchers. The main result was the Change in cystic fibrosis transmembrane conductance regulator function as measured by sweat chloride analysis or treatment effect. Secondary outcomes included Quality of life (eg, SF-36), change in Breathlessness, Cough, and Sputum Scale score, follow-up relapse rate, and adverse events. The system searches for randomized controlled trials of this therapy for CB. Implement the Cochrane RevMan V5.3 bias assessment tool to assess bias risk, data integration risk, meta-analysis risk, and subgroup analysis risk (if conditions are met). Mean difference, standard mean deviation, and binary data will be used to represent continuous results.

Results:

This study will provide a comprehensive review and evaluation of the available evidence for the treatment of CB using this therapy.

Conclusion:

This study will provide new evidence to evaluate the effectiveness and side effects of acupuncture on CB. Because the data are not personalized, no formal ethical approval is required.

PROSPERO registration number:

CRD42020170287
DNA methylation-based diagnostic and prognostic biomarkers of nasopharyngeal carcinoma patients
Authors: Wu Zeng-hong , Zhou Tao , Sun Hai-Ying
Published: June 2020

Nasopharyngeal carcinoma (NPC) is the most common malignant tumor with a remarkable racial and geographical distribution including people in southern China, South East Asia, and the Middle East/North Africa. DNA methylation is an important manifestation of epigenetic modification, has been studied over several decades, and by regulating and controlling the expression of cancer-related genesits, abnormal DNA methylation can influence in a variety of human malignancy tumors.

Until now, there is no analysis focus on differentially methylated, differential expressed genes (MDEGs) study, so we make a joint analysis for both gene methylation profiling microarray and gene expression profiling microarray in NPC. Two gene expression datasets (GSE64634 and GSE12452) and gene methylation profiling data set (GSE62336) were downloaded from GEO and analyzed using the online tool GEO2R to identify MDEGs. Gene ontology (GO) functional analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis of the differentially methylated genes were performed. The STRING database was used to evaluate the interactions of MDEGs and to construct a protein–protein interaction (PPI) network using Cytoscape software. Hub genes were validated with the cBioPortal database.

The overlap among the 3 datasets contained 135 hypermethylation genes and 541 hypomethylation genes between NPC and non-NPC samples. A total of 4 genes (TROAP,PCOLCE2,HOXA4, andC1QB) in Hyper-LGs and 14 genes (DYNC1H1,LNX1,RAB37,ALDH3A1,SLC24A4,CP,CEP250,ANK2,DNAI2,MUC13,ACACB,GABRP,STX7, andTTC9) in Hypo-HGs were identified as hub genes.

The study of DNA methylation and gene expression provides us a strong support as well as new comprehensive information of MDEGs to the revelation of nasopharyngeal carcinomaʼs complex pathogenesis. However, further studies are needed to elucidate the biological function of these genes in NPC in the future.
Effect of Panax ginseng on preventing acute respiratory tract infection
Authors: Zhang Zepeng , Xu Peng , Wang Zhihong , Zhao Daqing , Huang Qingxia , Lu Jing , Sun Liwei , Wang Jian , Li Xiangyan
Published: June 2020

Background:

Acute respiratory tract infection (ARTI) should be deeply concerned all over the world. Panax ginseng (ginseng) as traditional Chinese medicine is widely used in the treatment and health care for respiratory diseases. However, only one similar systematic review based on common cold has been published in 2011. New studies have occurred and a new systematic evaluation which could describe ARTI is needed.

Methods and analysis:

We will search for randomized control trials of ginseng on preventing acute respiratory tract infection in the following 8 databases: Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, AMED (via OVID) and 4 Chinese databases (Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Chinese Science and Technology Periodical Database, and Wan fang Database). The time is limited from the construction of the library to April 2020. The selection of studies, data extraction and quality of assessment will be conducted independently by 2 reviewers. The morbidity of ARTI by assessing self-report, caregiver report or clinical confirmation will be considered as the primary outcome. ARTI-related death among children or adults, other adverse events, absenteeism, laboratory-confirmed infection will be regarded as secondary outcome. All reported side effects and adverse events will be included as safety outcomes. Standard meta-analysis will be performed using Rev Man software V5.3.

Results:

This study will provide a better understanding of the association between P ginseng and ARTI.

Conclusion:

This systematic review may offer stronger evidences for the clinicians to prevent the patients from ARTI and update the former one based on basic diseases and the safety.

PROSPERO registration number:

CRD42020181317.
Infantile hepatic hemangioendothelioma associated with pulmonary artery hypertension and cardiac insufficiency successfully treated with transcatheter arterial embolization and propranolol
Authors: Wang Liang , Song Dan , Wu Changhua , Li Jing , Yin Jie , Guo Lei
Published: June 2020

Introduction:

Infantile hepatic hemangioendothelioma is a type of benign hepatic tumor that occurs in infancy. Many hepatic tumors are diagnosed when screening is done for multiple cutaneous hemangiomas. Hepatic tumors are small multifocal lesions and are mostly asymptomatic. There have been many case reports of asymptomatic infantile hepatic hemangioendothelioma, but few of these have pointed out that hepatic hemangiomas can sometimes be life-threatening due to fatal hepatomegaly complications such as pulmonary artery hypertension or even congestive heart failure. At present, there are no standard protocols for treating infantile hepatic hemangioendothelioma, though most clinicians agree that treatment is unnecessary for multiple small hepatic hemangiomas in asymptomatic patients. Little is known about treatment for cases with life-threatening complications induced by infantile hepatic hemangioendothelioma as there are so few reported cases. Here, we report a special case with hepatomegaly, pulmonary artery hypertension, and cardiac insufficiency induced by infantile hepatic hemangioendothelioma.

Patient concerns:

We present a case with hepatomegaly, pulmonary artery hypertension, and cardiac insufficiency caused by infantile hepatic hemangioendothelioma.

Diagnosis:

Infantile hepatic hemangioendothelioma was diagnosed.

Interventions:

The patient underwent transcatheter arterial embolization and was given propranolol.

Outcomes:

The patient responded well to treatment with transcatheter arterial embolization and propranolol. The patient gained weight steadily, liver volume, and mass size have decreased considerably, echocardiography showed normal pulmonary artery pressure and ejection fraction, and we discovered no serious complications after 1 year of follow-up.

Conclusion:

Transcatheter arterial embolization combined with propranolol is an effective treatment for life-threatening infantile hepatic hemangioendothelioma.
Microendoscopic discectomy versus minimally invasive transforaminal lumbar interbody fusion for lumbar spinal stenosis without spondylolisthesis
Authors: Yi Weihong , Tang Yu , Yang Dazhi , Huang Wenhua , Liu Huan , Sun Ziqi , Yao Yuan , Zhou Yue
Published: June 2020

Micoendoscopic discectomy (MED) and minimally invasive transforaminal lumbar interbody fusion (MIS-TLIF) has become alternatives of the traditional open decompression surgery alone and decompression plus fusion surgery in the treatment of lumbar spinal stenosis (LSS). To date, there is no study focusing on the comparison of clinical outcomes after MED and MIS-TLIF for LSS without spondylolisthesis.

Four hundred ninety-seven patients who underwent MED (236 cases) or MIS-TLIF (261 cases) for LSS without spondylolisthesis were included in this study. Perioperative outcomes (hospital stay, operation time and blood loss), cost, functional scores (Oswestry Disability Index, 12-item short form health survey) with a 24-month follow-up visit, complication and reoperation condition within 24 months after surgery were recorded and assessed.

No significant difference of clinical outcomes over time was observed between these 2 surgical approaches. Compared with MIS-TLIF, MED was associated with greater satisfaction at 1-month time point postoperatively, whereas this effect was equalized at 3-month time point postoperatively. MED brought advantages in shorter hospital stay, shorter operation time, less blood loss, and less cost over MIS-TLIF.

There was no significant difference in 24-month function scores over time between MED group and MIS-TLIF group. Compared with MIS-TLIF, MED could result in a better perioperative effect and less cost.
Geographic risk assessment of COVID-19 transmission using recent data
Authors: Jen Tung-Hui , Chien Tsair-Wei , Yeh Yu-Tsen , Lin Jui-Chung John , Kuo Shu-Chun , Chou Willy
Published: June 2020

Background:

The US Centers for Disease Control and Prevention (CDC) regularly issues “travel health notices” that address disease outbreaks of novel coronavirus disease (COVID)-19 in destinations worldwide. The notices are classified into 3 levels based on the risk posed by the outbreak and what precautions should be in place to prevent spreading. What objectively observed criteria of these COVID-19 situations are required for classification and visualization? This study aimed to visualize the epidemic outbreak and the provisional case fatality rate (CFR) using the Rasch model and Bayes's theorem and developed an algorithm that classifies countries/regions into categories that are then shown on Google Maps.

Methods:

We downloaded daily COVID-19 outbreak numbers for countries/regions from the GitHub website, which contains information on confirmed cases in more than 30 Chinese locations and other countries/regions. The Rasch model was used to estimate the epidemic outbreak for each country/region using data from recent days. All responses were transformed by using the logarithm function. The Bayes's base CFRs were computed for each region. The geographic risk of transmission of the COVID-19 epidemic was thus determined using both magnitudes (i.e., Rasch scores and CFRs) for each country.

Results:

The top 7 countries were Iran, South Korea, Italy, Germany, Spain, China (Hubei), and France, with values of {4.53, 3.47, 3.18, 1.65, 1.34 1.13, 1.06} and {13.69%, 0.91%, 47.71%, 0.23%, 24.44%, 3.56%, and 16.22%} for the outbreak magnitudes and CFRs, respectively. The results were consistent with the US CDC travel advisories of warning level 3 in China, Iran, and most European countries and of level 2 in South Korea on March 16, 2020.

Conclusion:

We created an online algorithm that used the CFRs to display the geographic risks to understand COVID-19 transmission. The app was developed to display which countries had higher travel risks and aid with the understanding of the outbreak situation.
Academic Dishonesty Among Nursing Students
Authors: McClung Emily L. , Gaberson Kathleen B.
Published: June 2020

Background

Much has been explored about academic dishonesty among nursing students.

Problem

Nursing students continue to engage in a variety of dishonest behaviors in the classroom and clinical settings. Concerned faculty members are seeking assistance in understanding the problem and finding suggestions for reducing students' engagement in academically dishonest behaviors.

Approach

Drawing on current literature, we discuss an expanded definition of academic dishonesty, explore motivating factors for students' academic dishonesty, and summarize common ways to reduce students' engagement in academically dishonest behaviors. We also provide guidance for development of policies concerning academic dishonesty.

Conclusions

By cultivating a learning environment that promotes honesty and integrity, rather than waiting until a dishonest act occurs to take action, the likelihood is lower that students will engage in academically dishonest behaviors.
Generation Z Students in the Online Environment
Authors: Chunta Kristy , Shellenbarger Teresa , Chicca Jennifer
Published: June 2020

Background

Student enrollment in online learning is increasing. Generation Z students are now enrolled in higher education, including in online nursing courses. Faculty teaching in the online environment should consider best practices and learner characteristics to address the needs of this student generation.

Problem

Generation Z students prefer independent learning while still being socially connected to peers. Although this generation of students is comfortable with technology, their unique traits may create challenges for nurse educators teaching in online settings.

Approach

This article provides strategies for nurse educators teaching Generation Z students in online learning environments. Ways to foster student engagement, stimulate intellectual development, and build rapport with students, while considering characteristics specific to this generation of learners, are offered.

Conclusion

Online learning continues to develop as a means for educating nursing students. Using strategies for best online teaching practices while considering learner attributes will help students and educators be successful.
Collaborating With Rural Practice Partners to Provide a Primary Care Experience for Prelicensure Nursing Students
Authors: Mennenga Heidi A. , Brown Robin J. , Horsley T. Leann , Abuatiq Alham A. , Plemmons Christina
Published: June 2020

Background

Prelicensure nursing education has generally emphasized acute care; however, as primary care changes in the United States, academia must transform. The national call for transforming primary care requires innovation in the education of prelicensure nursing students.

Problem

To ensure future RNs can function in the primary care setting and assume enhanced roles within the interprofessional team, prelicensure nursing students need to be exposed to primary care. A key barrier to providing this essential education is the lack of partnerships with primary care facilities.

Approach

The purpose of this project was to collaborate with rural practice partners to provide a primary care clinical experience for prelicensure nursing students.

Outcomes

Collaboration between academic-practice partners to develop a clinical experience for prelicensure nursing students allowed exposure to the role of RNs in rural primary care.

Conclusions

By sharing the process for planning the clinical experience, other interested academic institutions may replicate similar opportunities.
When Parents Hit
Authors: Slingsby Brett A. , Moore Jessica L. , Wing Robyn , Brown Linda L.
Published: June 2020

Objectives

No studies have evaluated how training physicians intervene when corporal punishment (CP) is observed in a simulated hospital setting. The pilot study examined physician trainee performance in a simulation where hitting is observed between caregiver and child during a medical visit and to assess physician self-reported experiences, opinions, and comfort when observing CP in a simulation.

Methods

We ran 7 simulations where one pediatric resident, emergency medicine resident, or pediatric emergency medicine fellow participated in the simulation while a group of similar trainees observed. All participants were given a postsurvey, followed by a semistructured debriefing led by a child abuse pediatrician.

Results

Thirty-seven physician trainees participated; 7 engaged in the simulation while 30 observed. The majority (6/7) did not de-escalate the increasingly aggravated parent prior to hitting, 4 of 7 did not recommend that the caregiver refrain from CP, and most (5/7) did not provide education to the parent about more appropriate discipline. The majority (91.4%) believe that a physician should intervene when a parent hits or spanks his/her child in the hospital setting, highlighting the incongruity between this belief and their performance in/knowledge of intervening. All participants stated they would benefit from additional education and training on CP.

Conclusions

The educational experience provided physicians in training with the opportunity to participate in or observe a situation in which CP occurs in the medical setting. The simulation and debriefing were an innovative approach to providing an educational opportunity for physicians to learn from difficult situations and discussions surrounding CP with caregivers.
Pediatric Syncope: A Systematic Review
Authors: Zavala Rennette , Metais Benjamin , Tuckfield Lynnia , DelVecchio Michael , Aronoff Stephen
Published: June 2020

Objectives

The aims of the study were to perform the first systematic review of pediatric syncope etiologies and to determine the most common diagnoses with credible intervals (CredIs).

Methods

Review was performed within Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines and used Embase, Scopus, PubMed, and the Cochrane Controlled Trial databases. The following inclusion criteria for the articles were used: minimum of 10 patients, standard definition of syncope used, subjects who were 21 years or younger, and subjects who were either a consecutive retrospective group or a prospective group. No restrictions were made regarding language of the studies, but an English abstract was required. The following information was collected: purpose of the study, definition of syncope, number of patients, patient age range, inclusion/exclusion criteria, and etiologies of syncope.

Results

Of the 500 articles initially identified, 11 studies met the inclusion criteria and were the basis for this review. Three thousand seven hundred patients were included, ranging in age from 3 months to 21 years. The most common etiologies identified were vasovagal (52.2%; 95% CredI, 50.6–53.9), postural orthostatic tachycardia syndrome (13.1%; 95% CredI, 12.1–14.2), and cardiac causes (4.0%; 95% CredI, 3.39–4.65). A total of 18.3% (95% CredI, 17.0–19.5) of patients were found to have syncope of unknown cause.

Conclusions

Syncope is a common pediatric complaint. Most cases seen are a result of benign causes, with only a small percentage because of serious medical conditions. In addition, most syncopal episodes in the pediatric population are diagnosed clinically or with minimally invasive testing, emphasizing the importance of a detailed history and physical examination.
Advances in Treatment of Follicular Lymphoma
Authors: Luminari Stefano , Trotman Judith , Federico Massimo
Published: June 2020

Follicular lymphoma (FL) is a heterogeneous disease with varying prognosis owing to differences in clinical, laboratory, and disease parameters. Although generally considered incurable, prognosis for early and advanced stage disease has improved because of therapeutic advances, several of which have resulted from elucidation of the biologic and molecular basis of the disease. The choice of treatment for FL is highly dependent on patient and disease characteristics. Several tools are available for risk stratification, although limitations in their routine clinical use exist. For limited disease, treatment options include radiotherapy, rituximab monotherapy or combination regimens, and surveillance. Treatment of advanced disease is often determined by tumor burden, with surveillance or rituximab considered for low tumor burden and chemoimmunotherapy for high tumor burden disease. Treatment for relapsed or refractory disease is influenced by initial first-line therapy and the duration and quality of the response. At present, there is no consensus for treatment of patients with early or multiply-relapsed disease; however, numerous agents, combination regimens, and transplant options have demonstrated efficacy. While the number of therapies available to treat FL has increased together with an improved understanding of the underlying biologic basis of disease, the best approach to select the most appropriate treatment strategy for an individual patient at a particular time continues to be elucidated. This chapter considers prognostic factors and the evolving treatment landscape of FL, including recent and emerging therapies, as well as remaining unmet needs.
Molecular Diagnostics of Non-Hodgkin Lymphoma
Authors: Solomon James P. , Arcila Maria E.
Published: June 2020

Non-Hodgkin lymphoma encompasses a diverse group of B-cell and T-cell neoplasms. Current classification is based on clinical information, histologic assessment, immunophenotypic characteristics, and molecular alterations. A wide range of genetic alterations, including large chromosomal structural rearrangements, aneuploidies, point mutations, and copy number alterations, have been reported across all types of lymphomas. Many of these are now incorporated into the World Health Organization–defined criteria for the diagnostic evaluation of patients with lymphoid proliferations and, therefore, their accurate identification is paramount for diagnosis, subclassification, and selection of treatment. In addition to their value in the diagnostic setting, many alterations that are not routinely evaluated in standard clinical practice may still define specific disease entities as they have important implications in risk stratification, as well as roles in emerging alternate therapies and disease monitoring. Because of the complexity and range of alterations, their accurate and sensitive assessment requires a careful selection of technology. Here, we discuss the most commonly used molecular techniques in current clinical practice and highlight some of the benefits and pitfalls based on the type of alteration.
Intersecting Pandemics: Impact of SARS-CoV-2 (COVID-19) Protective Behaviors on People Living With HIV, Atlanta, Georgia
Authors: Kalichman Seth C. , Eaton Lisa A. , Berman Marcie , Kalichman Moira O. , Katner Harold , Sam Soya S. , Caliendo Angela M.
Published: June 2020

Background:

COVID-19 and its social responses threaten the health of people living with HIV. We conducted a rapid-response interview to assess COVID-19 protective behaviors of people living with HIV and the impact of their responses on HIV-related health care.

Method:

Men and women living with HIV (N = 162) aged 20–37 years participating in a longitudinal study of HIV treatment and care completed routine study measures and an assessment of COVID-19–related experiences.

Results:

At baseline, most participants demonstrated HIV viremia, markers indicative of renal disorders, and biologically confirmed substance use. At follow-up, in the first month of responding to COVID-19, engaging in more social distancing behaviors was related to difficulty accessing food and medications and increased cancelation of health care appointments, both by self and providers. We observed antiretroviral therapy adherence had improved during the initial month of COVID-19 response.

Conclusions:

Factors that may pose added risk for COVID-19 severity were prevalent among people living with HIV, and those with greater risk factors did not practice more COVID-19 protective behaviors. Social distancing and other practices intended to mitigate the spread of COVID-19 interfered with HIV care, and impeded access to food and medications, although an immediate adverse impact on medication adherence was not evident. These results suggest social responses to COVID-19 adversely impacted the health care of people living with HIV, supporting continued monitoring to determine the long-term effects of co-occurring HIV and COVID-19 pandemics.
Role of Serum MRP8/14 in Predicting Response to Methotrexate in Children With Juvenile Idiopathic Arthritis
Authors: Bagri Narendra Kumar , Karmakar Subhradip , Haldar Partha , Lodha Rakesh , Kabra S. K.
Published: June 2020

Objective

Nearly 40% of children with juvenile idiopathic arthritis (JIA) might not respond to first-line disease-modifying antirheumatic drugs (DMARDs) including methotrexate (MTX). Hence, there is a need for a biomarker that can predict MTX response and help in tailoring initial therapy. Our objective was to study the role of serum myeloid-related protein (MRP) 8/14, and other inflammatory cytokines, as predictors of response to MTX among children with JIA.

Methods

We did a longitudinal follow-up study among children diagnosed with JIA at our institute. All MTX-naive children with JIA requiring DMARDs were eligible for this study; those who either took corticosteroids or DMARDs for more than 6 weeks at time of presentation were excluded. The demographic and clinical information was collected using a pretested semistructured questionnaire, and selected biomarkers were collected at baseline and again at 3 months. Response at 3 months was assessed using the American College of Rheumatology (ACR) criteria; responders were children who achieved ACR50, whereas those failing to achieve ACR30 were classified as nonresponders. Multivariate binary logistic regression was done to assess determinants of being a responder.

Results

We enrolled 69 children (36 boys) with JIA, of which 48 (69.5%) were responders. The baseline value of serum MRP8/14 was significantly higher in responders (median, 144.34 [interquartile range, 88.54–188.34] ng/mL) compared with the nonresponders (median, 95.34 [interquartile range, 76.54–130.28] ng/mL), p = 0.047. Being a responder was significantly associated with baseline serum MRP8/14 with adjusted odds ratio of 1.01 (95% confidence interval, 1.00–1.02).

Conclusions

The baseline levels of MRP8/14 were significantly raised in children meeting ACR50 at follow-up and suggest a prognostic value in predicting response to MTX.
Prevalence of Osteopenia in Drug-Naive Patients With Antineutrophil Cytoplasmic Antibody–Associated Vasculitis
Authors: Yoo Byung-Woo , Jung Seung Min , Song Jason Jungsik , Park Yong-Beom , Lee Sang-Won
Published: June 2020

Objectives

To examine the bone mineral density and prevalence of osteoporosis and osteopenia in glucocorticoid- and immunosuppressive drug–naive patients younger than 55 years with antineutrophil cytoplasmic antibody–associated vasculitis (AAV).

Methods

This was a cross-sectional study. We reviewed the medical records of 35 AAV patients and 35 age-, sex-, and body mass index (BMI)–matched control subjects. We collected clinical data such as AAV-related variables and conventional risk factors for osteoporosis and assessed bone mineral density and the prevalence of osteoporosis and osteopenia in both groups. Categorical and continuous variables were compared between the 2 groups using the χ2 or Fisher exact test and Mann-Whitney U test, respectively. Multivariate logistic regression analysis was used to calculate the odds ratio (OR).

Results

There were no statistically significant differences between the demographical data of AAV patients and control subjects. Patients with AAV showed significantly higher frequencies of conventional risk factors for osteoporosis than the control subjects, except for hyperthyroidism. Osteopenia was found more commonly in AAV patients than in control subjects (57.1% vs. 31.4%, p = 0.030). In the univariate logistic regression analysis, BMI (OR, 0.813) and AAV (OR, 2.620) were associated with osteopenia in all participants. In the multivariate analysis, both BMI and AAV were associated with osteopenia, but this was not statistically significant. In contrast, when analyzing AAV patients only, neither conventional risk factors nor AAV-related variables were associated with the prevalence of osteopenia.

Conclusions

Antineutrophil cytoplasmic antibody–associated vasculitis and BMI were both associated with osteopenia.
Circulating Exosomes From Lipopolysaccharide-Induced Ards Mice Trigger Endoplasmic Reticulum Stress in Lung Tissue
Authors: Tang Xumao , Yu Qian , Wen Xiaoting , Qi Di , Peng Jiao , He Jing , Deng Wang , Zhu Tao , Zhao Yan , Wang Daoxin
Published: June 2020

Background:

Acute respiratory distress syndrome (ARDS) is a critical clinical syndrome with high mortality rate, and few effective therapies have been found in the past 50 years, indicating that the pathogenesis of ARDS remains unclear. Exosomes, a novel cross-communication mechanism, are involved in critical diseases. However, the role of circulating exosomes in the development of ARDS remains poorly understood.

Methods:

In the present study, naive mice were treated with circulating exosomes from lipopolysaccharide (LPS)-induced ARDS mice or exosome-depleted serum. Histological lung damage, bronchoalveolar lavage fluid (BALF), and endoplasmic reticulum (ER) stress were measured.

Results:

Increased tumor necrosis factor (TNF)-α, interleukin (IL)-6, total cell counts, polymorphonuclear (PMN) leukocyte proportions and myeloperoxidase (MPO) activity in BALF, and increased wet/dry weight ratios and protein concentrations in BALF were found in mice after exosome injection but not in mice treated with exosome-depleted serum. Furthermore, western blot analysis showed that circulating exosomes from ARDS mice upregulated glucose-regulated protein 78 (GRP78) and C/EBP homologous protein (CHOP) expression and downregulated β-Catenin and VE-cadherin expression in lung tissues.

Conclusions:

Collectively, these data demonstrate that circulating exosomes from LPS-induced ARDS mice trigger ER stress in lung tissue, facilitating the development of ARDS, at least partly by promoting endothelial dysfunction.
Efficacy of Mealtime Interventions for Malnutrition and Oral Intake in Persons With Dementia
Authors: Borders James C. , Blanke Samantha , Johnson Stephen , Gilmore-Bykovskyi Andrea , Rogus-Pulia Nicole
Published: June 2020

Malnutrition and weight loss are highly prevalent in persons with Alzheimer’s disease and related dementias. Oral intake is an important interventional target for addressing these nutritional consequences. However, the efficacy of interventions remains poorly understood as prior syntheses have failed to examine the impact of intervention approaches on malnutrition and hypothesized mechanisms of action in persons with dementia. This review aimed to determine the efficacy of mealtime interventions to improve oral intake and nutritional outcomes in persons with dementia. Four databases yielded 1712 studies, resulting in 32 studies that met inclusion criteria. Studies included education, environmental modifications, feeding, oral supplementation, and other pharmacologic/ecopsychological interventions. While the majority of studies reported statistically significant improvements in at least 1 nutritional outcome, study design and outcome measures were heterogenous with many lacking adequate statistical power or blinding. Collectively, we found moderate evidence to suggest the efficacy of oral supplementation, and preliminary evidence to suggest that feeding interventions, education, and environmental modifications may confer improvements. Findings clarify the state of existing evidence regarding various interventional strategies for improving malnutrition in persons with dementia. While some approaches are promising, adequately powered and rigorously designed multidimensional intervention trials are needed to inform clinical decision-making in real-world contexts.
Harnessing hypoxia as an evolutionary driver of complex multicellularity
Authors: Hammarlund Emma U.
Published: June 2020

Animal tissue requires low-oxygen conditions for its maintenance. The need for low-oxygen conditions contrasts with the idea of an evolutionary leap in animal diversity as a result of expanding oxic conditions. To accommodate tissue renewal at oxic conditions, however, vertebrate animals and vascular plants demonstrate abilities to access hypoxia. Here, I argue that multicellular organisms sustain oxic conditions first after internalizing hypoxic conditions. The ‘harnessing’ of hypoxia has allowed multicellular evolution to leave niches that were stable in terms of oxygen concentrations for those where oxygen fluctuates. Since oxygen fluctuates in most settings on Earth's surface, the ancestral niche would have been a deep marine setting. The hypothesis that ‘large life’ depends on harnessing hypoxia is illustrated in the context of conditions that promote the immature cell phenotype (stemness) in animal physiology and tumour biology and offers one explanation for the general rarity of diverse multicellularity over most of Earth's history.
The rise and early evolution of animals: where do we stand from a trace-fossil perspective?
Authors: Mángano M. Gabriela , Buatois Luis A.
Published: June 2020

The trace-fossil record provides a wealth of information to track the rise and early evolution of animals. It comprises the activity of both hard- and soft-bodied organisms, is continuous through the Ediacaran (635–539 Ma)– Cambrian (539–485 Ma) transition, yields insights into animal behaviour and their role as ecosystem engineers, and allows for a more refined characterization of palaeoenvironmental context. In order to unravel macroevolutionary signals from the trace-fossil record, a variety of approaches is available, including not only estimation of degree of bioturbation, but also analysis of ichnodiversity and ichnodisparity trajectories, and evaluation of the occupation of infaunal ecospace and styles of ecosystem engineering. Analysis of the trace-fossil record demonstrates the presence of motile benthic bilaterians in the Ediacaran, mostly feeding from biofilms. Although Ediacaran trace fossils are simple and emplaced at or immediately below the sediment surface, an increase in ichnofossil complexity, predation pressure, sediment disturbance and penetration depth is apparent during the terminal Ediacaran. Regardless of this increase, a dramatic rise in trace fossil diversity and disparity took place during the earliest Cambrian, underscoring that the novelty of the Fortunian (539–529 Ma) cannot be underestimated. The Fortunian still shows the persistence of an Ediacaran-style matground ecology, but is fundamentally characterized by the appearance of new trace-fossil architectural plans reflecting novel ways of interacting with the substrate. The appearance of Phanerozoic-style benthic ecosystems attests to an increased length and connectivity of the food web and improved efficiency in organic carbon transfer and nutrient recycling. A profound reorganization of the infaunal ecospace is recorded in both high-energy sand-dominated nearshore areas and low-energy mud-dominated offshore environments, during the early Cambrian, starting approximately during Cambrian Age 2 (529–521 Ma), but continuing during the rest of the early Cambrian. A model comprising four evolutionary phases is proposed to synthetize information from the Ediacaran–Cambrian trace-fossil record. The use of a rich ichnological toolbox; critical, systematic and comprehensive evaluation of the Ediacaran–Cambrian trace-fossil record; and high-resolution integration of the ichnological dataset and sedimentological information show that the advent of biogenic mixing was an important factor in fully marine environments at the dawn of the Phanerozoic.
Nucleus preservation in early Ediacaran Weng'an embryo-like fossils, experimental taphonomy of nuclei and implications for reading the eukaryote fossil record
Authors: Sun Weichen , Yin Zongjun , Cunningham John A. , Liu Pengju , Zhu Maoyan , Donoghue Philip C. J.
Published: June 2020

The challenge of identifying fossilized organelles has long hampered attempts to interpret the fossil record of early eukaryote evolution. We explore this challenge through experimental taphonomy of nuclei in a living eukaryote and microscale physical and chemical characterization of putative nuclei in embryo-like fossils from the early Ediacaran Weng'an Biota. The fossil nuclei exhibit diverse preservational modes that differ in shape, presence or absence of an inner body and the chemistry of the associated mineralization. The nuclei are not directly fossilized; rather, they manifest as external moulds. Experimental taphonomy of epidermal cells from the common onion (Allium cepa) demonstrates that nuclei are more decay resistant than their host cells, generally maintaining their physical dimensions for weeks to months post-mortem, though under some experimental conditions they exhibit shrinkage and/or become shrouded in microbial biofilms. The fossil and experimental evidence may be rationalized in a single taphonomic pathway of selective mineralization of the cell cytoplasm, preserving an external mould of the nucleus that is itself resistant to both decay and mineral replication. Combined, our results provide both a secure identification of the Weng'an nuclei as well as the potential of a fossil record of organelles that might help arbitrate in long-standing debates over the relative and absolute timing of the evolutionary assembly of eukaryote-grade cells.
Molecular phylogeny and historical biogeography of andrenine bees (Hymenoptera: Andrenidae)
Authors: Pisanty Gideon , Richter Robin , Martin Teresa , Dettman Jeremy , Cardinal Sophie
Published: June 2020

The mining bee subfamily Andreninae (Hymenoptera: Andrenidae) is a widely distributed and diverse group of ground-nesting solitary bees, including numerous species known as important pollinators. Most of the species diversity of Andreninae is concentrated in the mainly Holarctic genusAndrena, comprising ca. 1500 described species. The subfamily and especially the genus have remained relatively neglected by recent molecular phylogenetic studies, with current classifications relying largely on morphological characters. We sampled ultraconserved element (UCE) sequences from 235 taxa, including all andrenine genera and 98 out of 104 currently recognizedAndrenasubgenera. Using 419,858 aligned nucleotide sites from 1009 UCE loci, we present a comprehensive molecular phylogenetic analysis of the subfamily. Our analysis supports the recognition of seven distinct genera in the Andreninae:Alocandrena, Ancylandrena, Andrena, Cubiandrena, Euherbstia, Megandrena, andOrphana. Within the genusAndrena, present-day subgeneric concepts revealed high degrees of paraphyly and polyphyly, due to heavy morphological character homoplasy, necessitating a thorough, extensive revision of the higher classification of the genus. Our results also show that the MRCA ofAndrena+Cubiandrenadispersed from the New World to the Palaearctic probably during the Eocene– early Oligocene, followed by 10–14 Neogene dispersal events from the Palaearctic to the Nearctic and 1–6 Neogene dispersals back into the Palaearctic, all within the genusAndrena.

Highlights

A phylogeny is presented for the bee subfamily Andreninae based on UCE sequences

The Eastern Mediterranean subgenusCubiandrenais sister to all remainingAndrena

ManyAndrenasubgenera exhibit paraphyly or polyphyly, requiring recircumscription

At least 11 Old World–New World exchange events have occurred withinAndrena
Pooling size sorted malaise trap fractions to maximise taxon recovery with metabarcoding
Authors: Elbrecht Vasco , Bourlat Sarah J. , Hörren Thomas , Lindner Angie , Mordente Adriana , Noll Niklas W. , Sorg Martin , Zizka Vera M.A.
Published: June 2020

Small and rare specimens can remain undetected when metabarcoding bulk samples with a high size heterogeneity of specimens. This is especially critical for malaise trap samples, where most of the biodiversity is often contributed by small specimens. How to size sort and in which proportions to pool these samples has not been widely explored. We set out to find a size sorting strategy that maximizes taxonomic recovery but remains highly scalable and time efficient.

Three 3 malaise trap samples where size sorted into 4 size classes using dry sieving. Each fraction was homogenized and lysed. The corresponding lysates were pooled to simulate samples never sorted, pooled in equal proportions and in 4 different proportions favoring the small size fractions. DNA from the pooled fractions as well as the individual size classes were extracted and metabarcoded using the FwhF2 and Fol-degen-rev primer set. Additionally wet sieving strategies were explored.

The small size fractions harbored the highest diversity, and were best represented when pooling in favor of small specimens. Not size sorting a sample leads to a 45-77% decrease in taxon recovery compared to size sorted samples. A size separation into only 2 fractions (below 4 mm and above) can already double taxon recovery compared to not sorting. However, increasing the sequencing depth 3-4 fold can also increase taxon recovery to comparable levels, but remains biased toward biomass rich taxa in the sample.

We demonstrate that size fractionizing bulk malaise samples can increase taxon recovery. The most practical approach is wet sieving into two size fractions, and proportional pooling of the lysates in favor of the small size fraction (80-90% volume). However, in large projects with time constraints, increasing sequencing depth can also be an alternative solution.