bluuebunny/crossref_metadata_2025 huggingface dataset:
Examining Health and Wealth Correlates of Perceived Financial Vulnerability: A Normative Study
Authors: Lichtenberg Peter A , Paulson Daniel , Han S Duke
Published: September 2020

Background and Objectives

Age-associated financial vulnerability was introduced because it was increasingly recognized that cognitively intact older adults experienced changes that rendered them financially vulnerable. In this study, we attempt to apply the construct of Age-Associated Financial Vulnerability to a measure of Perceived Financial Vulnerability and whether this perceived vulnerability is predicted by risk factors from the 4 categorical domains used to define Age-Associated Financial Vulnerability’s impact.

Research Design and Methods

This study was part of the Health and Retirement Study (HRS) survey in 2018. The survey contained 7 experimental module items of Perceived Financial Vulnerability. One thousand three hundred fourteen participants completed the Perceived Financial Vulnerability measure. The sample was drawn from Waves 13 and 14 of the HRS (2016 and 2018, respectively). The measurement of Perceived Financial Vulnerability was developed on the basis of 7 questions assessing financial awareness and psychological vulnerability items regarding personal finance that were included in the 2018 HRS data collection. Predictors included measures of cognition, function/health, depression, and wealth. Predictor measures from 2016 were regressed on 2018 Perceived Financial Vulnerability scores.

Results

Six items of Perceived Financial Vulnerability had psychometric properties acceptable for a new measure. Responses revealed variability in Perceived Financial Vulnerability. Overall, 18% of variance was accounted for and measures from cognition, depression, assets, and functional abilities were all unique and significant predictors.

Discussion and Implications

This study represents both a conceptual and empirical contribution to our understanding of older adult’s perceptions of financial vulnerability. The high levels of Perceived Financial Vulnerability found in this normative sample underscore the importance of context in understanding people’s economic behaviors. For instance, more than one half of the sample indicated that they wished they had someone to talk to about their finances. This desire to talk with others is normative and yet often underappreciated.
Securing the nation through the politics of sexual violence: tracing resonances between Delhi and Cologne
Authors: Holzberg Billy , Raghavan Priya
Published: September 2020

Postcolonial and black feminist scholars have long cautioned against the dangerous proximity between the politics of sexual violence and the advancement of nationalist and imperial projects. In this article, we uncover what it is in particular about efforts to address sexual violence that makes them so amenable to exclusionary nationalist projects, by attending to the political aftermaths of the rape of Jyoti Singh in Delhi in 2012, and the cases of mass sexual abuse that took place during New Year's Eve in Cologne in 2015. Tracing the nationalist discourses and policies precipitated in their wake, we demonstrate how across both contexts, the response to sexual violence was ultimately to augment the securitizing power and remit of the state—albeit through different mechanisms, and while producing different subjects of/for surveillance, control and regulation. We highlight how in both cases it is through contemporary resonances of a persistent (post)colonial echo—which enmeshes the normative female body with the idea of the nation—that sexual abuse becomes an issue of national security and the politics of sexual violence becomes tethered to exclusionary nationalisms. Revealing the more general, shared, rationalities that bind the nation to the normative female body while attending to the located political reverberations that make this entanglement so affectively potent in the distinct contexts of India and Germany helps distinguish and amplify transnational and intersectional feminist approaches to sexual violence that do not so readily accommodate nationalist ambitions.
What are the endovascular options and outcomes for repair of ascending aortic or aortic arch pathology?
Authors: Sharma Varun J , Prakash Minesh , Lin Zaw , Lo Casey
Published: September 2020

A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was ‘in patients with ascending aortic or aortic arch disease what are the outcomes with endovascular repair in terms of survival, complications and reintervention?’ Altogether 585 papers were found using the reported search, of which 9 represented the best evidence to answer the clinical question. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. We found that the endovascular operative techniques with the greatest evidence were ascending aortic chimney grafts (AACs), branched thoracic endovascular aortic repair (bTEVAR) aortic grafts and fenestrated TEVAR (fTEVAR) aortic grafts. The best evidence available were small case-series or retrospective cohort studies (n < 100), with 1 systematic review, at a short follow-up period (range 0–5 years). Intraoperatively, these techniques have a high technical success rate (84–100%). We found rates of endoleak comparable between AAC (7.4–16%) and bTEVAR/fenestrated TEVAR (11.1–21.4%). Stroke rates are higher in bTEVAR (3.1–42% vs 1–26% in AACs), attributed to more proximal pathology and technically challenging procedures. Following the immediate postoperative period, the 30-day mortality is 0–10.8% and patency is 97–100%. Stroke and reintervention rates remain higher in the bTEVAR group (3.1–42.0% and 0.5–33.3%) compared to the AAC group (1.0–11.1% and 6.7–16.7%). The 3- and 5-year survival ranges from 59% to 90%, but is driven by non-aortic pathology in a high-risk population; 3-year freedom from aortic death is 93–97%. Patency is 97–100% at up to 3 years, conformation and supra-aortic occlusions thereafter remain unknown. We conclude that AACs, bTEVARs and fenestrated TEVARs are safe endovascular options in high-risk elective patients, with results comparable to open or hybrid repair. They remain unverified in acute settings or in patients fit for open intervention.
Midterm varicose vein recurrence rates after endovenous laser ablation: comparison of radial fibre and bare fibre tips
Authors: Abud Burcin , Kunt Ayse Gul
Published: September 2020

OBJECTIVES

We evaluated and compared midterm recurrence results of our patients with great saphenous vein insufficiency who were treated with a 1470-nm diode laser using 2 different types of fibre catheter kits.

METHODS

A total of 61 consecutive patients were treated between 2013 and 2014 with a bare fibre (BF) tip (BF group) and 60 consecutive patients were treated with a radial fibre (RF) tip (RF group) from 2014 to 2016. First-year venous clinical severity scores (VCSSs) were compared with VCSS before endovenous laser ablation and at the first-month follow-up. Patients were examined for recurrence and classified according to the system developed by Stonebridge.

RESULTS

There was no significant difference between the 2 groups in terms of VCSS. Examination with Doppler ultrasonography showed no recurrence in the RF group, whereas recurrences were detected in 6 patients in the BF group, which was statistically significant (P = 0.028). All of the recurrences were type 1b (incompetent tributaries) varicose vein recurrences. The VCSS of the patients with recurrence were the same as the scores of patients without recurrence (0.5 ± 0.55).

CONCLUSIONS

Varicose vein recurrence was more often seen in the BF group than in the RF group. Recanalization-induced and neovascularization-induced recurrences were not found in either group. Saphenofemoral side branch-induced recurrence was more significant in the group treated with the BF tip.
Intrinsic phytase in hybrid rye increases the digestibility of phosphorus in corn and soybean meal in diets fed to growing pigs
Authors: Archs Toledo Joan L , Lee Su A , McGhee Molly L , Mateos Gonzalo G , Stein Hans H
Published: September 2020

An experiment was conducted to test the hypothesis that inclusion of hybrid rye in diets containing corn and soybean meal (SBM) without or with microbial phytase improves the apparent total tract digestibility (ATTD) and the standardized total tract digestibility (STTD) of P because of the intrinsic phytase activity in hybrid rye. Forty-eight growing barrows (initial body weight: 39.5 ± 7.7 kg) were allotted to six diets. A basal diet containing corn and SBM; a rye-based diet; and a diet containing corn, SBM, and rye were formulated. Each diet was formulated without and with microbial phytase (500 units/kg of diet) for a total of six diets. Fecal samples were collected for 4 d following a 5-d adaptation period according to the marker-to-marker procedure. Results indicated that no interactions between diets and concentration of phytase were observed for any of the response criteria measured. The ATTD and STTD of P and the ATTD of Ca differed (P < 0.05) among diets, but regardless of diet, the concentration of P in feces was reduced (P < 0.05) by adding microbial phytase to the diets. As a consequence, microbial phytase increased (P < 0.05) ATTD and STTD of P, and the ATTD of Ca was also increased (P < 0.05) by the use of microbial phytase. Measured values for the ATTD and STTD of P in the diets containing corn, SBM, and hybrid rye without or with phytase were greater (P < 0.05) than values that were predicted based on the ATTD and STTD of P for the corn–SBM and the hybrid rye diet. The observation that STTD predicted from the individual ingredients underestimated the STTD of P in the mixed diet indicates that the intrinsic phytase in hybrid rye resulted in increased digestibility of the P in the corn and SBM included in the corn–SBM–hybrid rye diet. In conclusion, microbial phytase increased the ATTD and STTD of P and the ATTD of Ca regardless of feed ingredients used in diets fed to pigs. In addition, the intrinsic phytase from hybrid rye increased the ATTD and STTD of P in corn and SBM.
Chronotopic information interaction: integrating temporal and spatial structure for historical indexing and interactive search
Authors: Adams Benjamin
Published: September 2020

Domain-based learning and research are important applications driving the development of exploratory search systems. A wealth of historical information about events from around the world resides within documents on the web, yet contemporary search engines do not take advantage of the closely integrated temporal and spatial information found within these web pages for indexing and design of search user interfaces. This gap limits the use of the web as a resource for historical and geohistorical information seeking. In this article, we propose chronotopic information interaction as a new interaction concept for web search that explicitly links temporal and spatial entities to keywords using a space–time grid index and a paired search user interface. The space–time grid index allows different modes of interaction between spatial, temporal, and keyword-based views in the search user interface. We demonstrate the use of the space–time grid index and chronotopic information interaction concept with the development of Pteraform, a prototype of a search engine that enables users to explore information in the English version of Wikipedia through a geohistorical lens.
Expectancy Theory of Motivation and Substance Use Treatment: Implications for Music Therapy
Authors: Yoes Marshall , Silverman Michael J
Published: September 2020

The existing literature indicates that motivation is an important predictor of treatment outcome for people with substance use disorders (SUD). Although researchers have found that music therapy can positively impact motivation for people with SUD, the music therapy and SUD literature base lack a theoretical understanding of motivation. Vroom’s expectancy theory of motivation (ETM) is an established theoretical framework positing that motivation depends on three relationships: expectancy, instrumentality, and valence. These relationships consist of four variables: effort, performance, reward, and preference. Based on these four variables, motivation depends on the expectation that an increase in effort will lead to improved performance, thus leading to a reward aligned with an individual’s preferences. The purpose of this paper is to apply Vroom’s ETM to music therapy and SUD clinical practice and research. We reviewed the existing literature addressing Vroom’s ETM within SUD treatment and created a model to depict how to apply Vroom’s ETM to music therapy clinical practice for people with SUD. Application of Vroom’s ETM may help music therapists understand and augment motivation for people with SUD, potentially leading to relapse prevention and recovery. Implications for clinical practice, limitations, and suggestions for future research are provided.
Regenerated isotropic wood
Authors: Guan Qing-Fang , Han Zi-Meng , Yang Huai-Bin , Ling Zhang-Chi , Yu Shu-Hong
Published: September 2020

Construction of sustainable high-performance structural materials is a core part of the key global sustainability goal. Many efforts have been made in this field; however, challenges remain in terms of lowering costs by using all-green basic building blocks and improving mechanical properties to meet the demand of practical applications. Here, we report a robust and efficient bottom-up strategy with micro/nanoscale structure design to regenerate an isotropic wood from natural wood particles as a high-performance sustainable structural material. Regenerated isotropic wood (RGI-wood) exceeds the limitations of the anisotropic and inconsistent mechanical properties of natural wood, having isotropic flexural strength of ∼170 MPa and flexural modulus of ∼10 GPa. RGI-wood also shows superior water resistance and fire retardancy properties to natural pine wood. Mass production of large sized RGI-wood and functional RGI-wood nanocomposites can also be achieved.
Investigation of the status of Unit 2 nuclear reactor of the Fukushima Daiichi by Cosmic Muon Radiography
Authors: Fujii Hirofumi , Gi Meiki , Hara Kazuhiko , Hashimoto Shugo , Hayashi Kohei , Kakuno Hidekazu , Kodama Hideyo , Mizokami Masato , Mizokami Shinya , Nagamine Kanetada , Sato Kotaro , Sekita Shunsuke , Shirai Hiroshi , Kim Shin-Hong , Sumiyoshi Takayuki , Suzuki Atsuto , Takada Yoshihisa , Takahashi Kazuki , Takahashi Yu , Takasaki Fumihiko , Yamada Daichi , Yamashita Satoru
Published: September 2020

We have investigated the status of the nuclear debris in the Unit-2 Nuclear Reactor of the Fukushima Daiichi Nuclear Power plant by the method called Cosmic Muon Radiography. In this measurement, the muon detector was placed outside of the reactor building, as was the case of the measurement for the Unit-1 Reactor. Compared to the previous measurements, the detector was down-sized, which made it possible for us to locate it closer to the reactor and to investigate the lower part of the fuel loading zone in particular. We identified the inner structures of the reactor such as the containment vessel, pressure vessel and other objects through the thick concrete wall of the reactor building. Furthermore, the observation showed existence of heavy material at the bottom of the pressure vessel, which can be interpreted as the debris of melted nuclear fuel dropped from the loading zone.
Large-scale survey reveals pervasiveness and potential function of endogenous geminiviral sequences in plants
Authors: Sharma Vikas , Lefeuvre Pierre , Roumagnac Philippe , Filloux Denis , Teycheney Pierre-Yves , Martin Darren P , Maumus Florian
Published: September 2020

The family Geminiviridae contains viruses with single-stranded DNA genomes that have been found infecting a wide variety of angiosperm species. The discovery within the last 25 years of endogenous geminivirus-like (EGV) elements within the nuclear genomes of several angiosperms has raised questions relating to the pervasiveness of EGVs and their impacts on host biology. Only a few EGVs have currently been characterized and it remains unclear whether any of these have influenced, or are currently influencing, the evolutionary fitness of their hosts. We therefore undertook a large-scale search for evidence of EGVs within 134 genome and 797 transcriptome sequences of green plant species. We detected homologues of geminivirus replication-associated protein (Rep) genes in forty-two angiosperm species, including two monocots, thirty-nine dicots, and one ANITA-grade basal angiosperm species (Amborella trichopoda). While EGVs were present in the members of many different plant orders, they were particularly common within the large and diverse order, Ericales, with the highest copy numbers of EGVs being found in two varieties of tea plant (Camellia sinensis). Phylogenetic and clustering analyses revealed multiple highly divergent previously unknown geminivirus Rep lineages, two of which occur in C.sinensis alone. We find that some of the Camellia EGVs are likely transcriptionally active, sometimes co-transcribed with the same host genes across several Camellia species. Overall, our analyses expand the known breadths of both geminivirus diversity and geminivirus host ranges, and strengthens support for the hypothesis that EGVs impact the biology of their hosts.
Family Clusters of Shiga Toxin-producing Escherichia coli Infection
Authors: Luini Mario Vittorio , Colombo Rosaria , Dodaro Antonella , Vignati Chiara , Masia Carla , Arghittu Milena , Daprai Laura , Maisano Antonio Marco , Vezzoli Fausto , Bianchini Valentina , Spelta Chiara , Castiglioni Bianca , Bertasi Barbara , Ardissino Gianluigi
Published: September 2020

Background:

The aim of the present work was to investigate family clusters of Shiga toxin-producing Escherichia coli (STEC) infection among the household members of STEC positive patients, identified within a screening program of bloody diarrhea (BD) for STEC in Northern Italy.

Methods:

Stool samples from patients with BD or BD-associated-hemolytic uremic syndrome (HUS) and related households were investigated by molecular and bacteriologic methods to detect and characterize the virulence profile of STEC and Pulsed Field Gel Electrophoresis analysis were done on isolates.

Results:

Thirty-nine cases of STEC infection (isolated BD in 16, BD-associated-HUS in 23) were considered, and a total of 130 stool samples from 1 to 8 households of the index patient were analyzed. The prevalence of positivity was higher in siblings (34.8%, 8/23) than in mothers (20%, 7/35), grandparents (9.5%, 2/21), fathers (8.8%, 3/34) or other households. In 14 clusters (36%), one or more household shared a STEC with the same virulence profile (stx, eae, serogroup) as the index case. In 7 clusters, STEC strains isolated from at least 2 subjects also shared identical Pulsed Field Gel Electrophoresis profile. The frequency of household infection does not appear to be associated to the index case’s illness (HUS or BD), nor with the serotype or with the virulence profile of the involved STEC (stx2 or stx1-stx2).

Conclusions:

Our study shows that STEC infections, most likely related to human-to-human transmission, are common among households of patients with STEC BD or HUS and underlines the importance of extending the epidemiologic investigations to all family members, as the index case may not always be the primary infection in the family.
Acute Ischemic Stroke as a Result of Paradoxical Embolus in a Patient with Renal Cell Carcinoma, Intravenous Tumor Thrombus Extension, and Patent Foramen Ovale
Authors: Gritsch David , Abdallah Amir , Taylor Abigail M. , Mesbah Zhubene , Demaerschalk Bart M.
Published: September 2020

Introduction:

Patent foramen ovale is a common congenital cardiac abnormality. An association with acute ischemic stroke is well described. Extension of renal cell carcinoma (RCC) into the adjacent veins is common. Surgical resection is felt to be an effective approach to treatment, even in the setting of extensive venous involvement.

Case Report:

A 55-year-old woman with recently diagnosed right renal mass and cavoatrial tumor thrombus was transferred to our facility for surgical resection. She subsequently underwent open radical right nephrectomy, regional lymph node dissection, inferior vena cava and right atrial tumor thrombectomy, and resection of the infrahepatic vena cava. An intraoperative transesophageal echocardiogram confirmed the absence of tumor thrombus from the inferior vena cava and right atrium and also identified a patent foramen ovale (PFO). Upon weaning sedation, she was noted to be agitated and have left hemiplegia. Her National Institutes of Health Stroke Scale (NIHSS) was 30 and Glasgow Coma Scale (GCS) 6. The computerized tomography scan of head revealed extensive hypoattenuation right in the middle and left posterior cerebral artery territories. There was associated cerebral edema and 5-mm midline shift. In the setting of devastating neurological injury, her family elected to transition to comfort care and the patient died on the postoperative day 7.

Conclusions:

This is the first reported case of intraoperative paradoxical embolism in the setting of RCC with cavoatrial extension and PFO. The presence of PFO may be a risk factor for severe cerebrovascular complications in the surgical management of RCC with venous involvement.
Two Years of Improved Neurological Function With Nusinersen in a 48-Year-Old Patient With Spinal Muscular Atrophy Type 3
Authors: Shah Jaimin S. , Rubin Devon I. , Dimberg Elliot L. , Owens Christina R. , Gicalone Angelica R. , De Oliveira Gleydiane , Oskarsson Björn E.
Published: September 2020

Introduction:

Nusinersen antisense oligonucleotide infusions have been shown to be effective in the treatment spinal muscular atrophy. The majority of the evidence has been collected in young type 1 and type 2 patients, and evidence of efficacy in adult patients is limited.

Case Report:

A 48-year-old woman with spinal muscular atrophy type 3 who has received the loading dose and 8 maintenance infusions over an 8-month period. Grip and pinch strength, measured by hand-held dynamometry measured at baseline and in 6 to 12 months interval improved over a 24-month period. She also reported multiple other subjective improvements in function.

Conclusions:

This is the first published case of nusinersen in a middle-aged adult with spinal muscular atrophy. Sustained clinically meaningful improvement may be possible with nusinersen initiation in mid adulthood.
Leukoencephalopathy With Brain Stem and Spinal Cord Involvement and Lactate Elevation (LBSL)
Authors: Yazici Gencdal Isil , Dincer Alp , Obuz Oguzhan , Yapici Zuhal
Published: September 2020

Introduction:

Leukoencephalopathy with brain stem and spinal cord involvement and lactate elevation (LBSL) is caused by a recessive mutation in the DARS2 gene and can be recognized by specific magnetic resonance imaging patterns.

Case Report:

A girl who developed leg tremors at age 4 years was diagnosed at age 17 years with LBSL -after evolution of ataxia and sensory loss. Examination at age 29 revealed mild spastic gait, ataxia, and sensory loss, and she did not require assistance to walk.

Conclusion:

This report illustrates the clinical and magnetic resonance imaging characteristics of a slowly progressive long-term course of childhood-onset LBSL.
Acute Flaccid Myelitis in an Adult
Authors: Kazi Stephanie , Lommen Matthew , Persson Justin
Published: September 2020

Introduction:

Acute flaccid myelitis (AFM) is a condition causing acute onset flaccid limb weakness primarily in children. Correlations with specific viral illnesses have been found, however, specific pathogenesis remains unknown.

Case Report:

A 21-year-old female individual presented with progressive weakness provoking multiple falls, severe fatigue, headaches, and body aches after an upper respiratory illness. Deep tendon reflexes were absent, and cerebrospinal fluid analysis was remarkable for lymphocytic pleocytosis and elevated protein. Magnetic resonance imaging revealed T2 hyperintensity extending from C1-T2 predominantly involving the anterior horns. Weakness continued to increase before subtly improving over the course of a 10-day hospital stay. Functional improvements had been achieved by the patient at 1-year follow-up with intensive physical therapy.

Conclusions:

AFM should be included in the differential for the presentation of acute weakness in adults and pediatric patients. As the incidence of AFM continues to rise, awareness of the condition and prompt obtainment of specimens in suspected patients is crucial to aid in the investigation.
Magnetic Resonance Imaging Availability Reduces Computed Tomography Use for Pediatric Appendicitis Diagnosis
Authors: James Natasha C. , Ahmadian Rosstin , Mckee Jason Q. , Sarangarm Dusadee , Bussmann Silas C. , Williamson Susan , Upham Bryan D.
Published: September 2020

Objectives

To determine if introducing magnetic resonance imaging (MRI) as an imaging option for children with suspected appendicitis and an inconclusive ultrasound reduces computed tomography (CT) use.

Methods

This is a retrospective cohort study of patients aged 5 to 18 years who presented to a pediatric emergency department (ED) with suspected appendicitis. Rates of CT use 1 year before and 1 year after MRI availability are compared. Secondary outcomes include missed and negative appendectomies, imaging charges, time to antibiotics and surgery, time to radiology read, ED length of stay, and test characteristics of MRI and CT.

Results

Of the 981 patients screened, 499 patients met inclusion criteria. There was an absolute reduction of CT use of 25% from 38% in year 1 to 13% in year 2 (95% confidence interval, 18% to 33%). Advanced imaging charges were $371 higher in year 2 (MRI) than year 1 (CT), and median time to radiologist reads was longer in MRIs than CTs (129 versus 62 minutes; difference 53 minutes, 95% confidence interval, 23 to 74 minutes). All other secondary outcomes, including ED length of stay and test characteristics, were statistically similar.

Conclusions

Introducing MRI for as an imaging option for children with suspected appendicitis and an inconclusive ultrasound markedly reduced CT use, but did result in a small increase in imaging charges and time to preliminary radiology read.
Measuring Intertrochanteric Fracture Stability with a Novel Strain-Sensing Sliding Hip Screw
Authors: Carrington Nathan T. , Milhouse Paul W. , Behrend Caleb J. , Pace Tom B. , Anker Jeffrey N. , DesJardins John D.
Published: September 2020

Background

Bone healing after internal fixation of intertrochanteric hip fractures is difficult to monitor with radiography, particularly with internal fixation implants such as the sliding hip screw (SHS). In this study, we evaluate a robust, user-friendly device to non-invasively determine the loading on the screw implant. This will allow clinicians to better monitor the status of bone healing and take preventative steps if complications occur.

Methods

A novel strain-sensing sliding hip screw (SS-SHS) was designed and refined using a finite element model of a simple intertrochanteric fracture and a standard SHS implant. The SS-SHS houses an internally fixed indicator rod, whose position relative to the screw body can be viewed on plain film radiographs to measure screw bending. Screw bending was assessed in an intact femur and an unstable A1 intertrochanteric fracture using a finite element computational model and compared with experimental axial loading of a femoral Sawbones composite and human cadaveric femur specimens. Indicator rod position relative to the screw was visually tracked using plain radiographs at each load state.

Results

The indicator rod was found to displace linearly in response to implant strain in the unstable fracture. This movement was consistently visible and measurable using radiography throughout loading cycles across the mechanical and cadaveric fracture models. Sensor movement was not detected in healed fracture models. The slope of the curve was approximately equal in the computations, composite and cadaveric models (0.08 µm/N, 1.0 µm/N, 0.08 µm/N, respectively). The noise level was approximately 25 N in the composite model and 63 N in the cadaveric specimen and this was sufficient to see 1/10thof body weight or more for an 80 kg patient which is likely good enough to track fracture healing.

Conclusions

In current practice, clinicians must carefully monitor their patients for signs of implant failure after surgery. However, by the time signs of failure are apparent, it is often too late to avoid revision surgery. This device enables clinicians to quantitatively track fracture healing, and better communicate the process to the patient. Clinicians can also take preventive measures with at-risk patients before revision surgery is needed, thus reducing mortality risks.

Clinical Relevance

By augmenting an existing SHS system with an indicator rod, crucial information on the status of fracture healing can be ascertained from follow-up radiographs already taken with no additional risk to the patient.
Association between population density and infection rate suggests the importance of social distancing and travel restriction in reducing the COVID-19 pandemic
Authors: Yin Heliang , Sun Tong , Yao Lan , Jiao Yan , Ma Li , Lin Lin , Graff J Carolyn , Aleya Lotfi , Postlethwaite Arnold , Gu Weikuan , Chen Hong
Published: September 2020

Background

Currently, the 2019-nCoV has spread to most countries of the world. Understanding the environmental factors that affect the spread of the disease COVID-19 infection is critical to stop the spread of the disease. The purpose of this study is to investigate whether population density is associated with the infection rate of the COVID-19.

Methods

We collected data from official webpages of cities in China and in the US. The data were uploaded on Excel spreadsheets for statistical analyses. We calculated the morbidity and population density of cities and regions in these two countries. We then examined the relationship between the morbidity and other factors.

Results

Our analysis indicated that the population density in cities in Hubei province where the COVID-19 was severe was associated with a higher percentage of morbidity, with an r value of 0.62. Similarly, in the US, the density of 51 states and territories is also associated with morbidity from COVID-19 with an r value of 0.55. In contrast, as a control group, there is no association between the morbidity and population density in 33 other regions of China, where the COVID-19 epidemic is well under control. Interestingly, our study also indicated that these associations were not influenced by the first case of COVID-19. The rate of morbidity and the number of days from the first case in the US has no association, with an r value of -0.1288.

Conclusions

Population density is positively associated with the percentage of patients with COVID-19 infection in the population. Our data support the importance of such as social distancing and travel restriction in the prevention of COVID-19 spread.
Social capital and psychological distress during Colombian coronavirus disease lockdown
Authors: Caballero-Domínguez Carmen Cecilia , De Luque-Salcedo Jeimmy , Campo-Arias Adalberto
Published: September 2020

Introduction

This study aims to establish the association between low capital social (CS) with some indicators of psychological distress.

Methods

A cross-sectional study was carried out using an online questionnaire that evaluated demographic variables, social capital, coronavirus disease perceived stress, depression risk, insomnia risk, and suicide risk. SC was taken as an independent variable, and symptoms indicating psychological distress was handed as dependent variables. Odds ratios (OR) were established with 95% confidence intervals (CI), using binary logistic regression analysis.

Results

A group of 700 adults participated in the survey; they were aged between 18 and 76 years (M = 37, SD = 13). Low SC was associated with depression risk (OR = 2.00, 95%CI 1.34-2.97), elevated suicide risk (OR = 2.62, 95%CI 1.40-4.91) high perceived stress related to coronavirus disease (OR = 2.08, 95%CI 1.15-3.76), and insomnia risk (OR = 2.42, 95%CI 1.69-3.47).

Conclusions

Low CS was associated with indicators of psychological distress represented in depression risk, elevated suicide risk, high perceived stress related to coronavirus disease and insomnia risk. SC is a community social resource that could help mitigate the impact of the coronavirus disease quarantine amidst the Colombian population’s psychological health. It is necessary to deepen the SC role in psychological well-being during and after the coronavirus disease epidemic.
Strategies for exiting COVID-19 lockdown for workplace and school: a scoping review protocol
Authors: D’Angelo Daniela , Coclite Daniela , Napoletano Antonello , Fauci Alice Josephine , Latina Roberto , Iacorossi Laura , Di Nitto Marco , Iannone Primiano
Published: September 2020

Objective

The main objectives of this review are to summarise the existing literature and to identify strategies for exiting lockdown during the COVID-19 pandemic, with a focus on reopening schools and returning to work.

Introduction

After months of strict quarantine, several countries are planning exit strategies to progressively lift social restrictions without giving rise to an increase in the number of COVID-19 cases. Although several strategies have been studied in terms of how and when to relax such stringent constraints, there is a lack of consensus on the optimal strategy for managing the pandemic beyond lockdown. The risks posed by delaying return to work and school openings are real and sizeable, particularly for relevant working sectors and for students from low-income families

Inclusion criteria

This review will consider studies that focussed on relaxation strategies for lockdown exit among workers and students facing an epidemic /pandemic crisis.

Methods

The searches will be conducted across four databases (MEDLINE, EMBASE, SciSearch, Google Scholar), and the bibliography of all selected studies will be hand-searched. In addition, because the topic is new, relevant literature will be checked using daily, updated COVID-19 collections from NCBI (LitCovid) and MedRxiv servers. Studies published in English, German, Spanish, Italian and French will be included, with no limits on publication dates. This review will consider all study designs, regardless of their rigor. The review method will be based on a two-phase approach: a title and abstract screening, and a full-text review performed by two independent researchers. Data will be summarised and categorised, and results will be presented in a tabular/diagrammatic form.
Efficacy assessment of newly-designed and locally-produced filtering facemasks during the SARS-CoV-2 pandemic
Authors: Boogaard Bob , Tas Ali , Nijssen Joep , Broeren Freek , van der Dobbelsteen John , Verhoeven Vincent , Pluim Jip , Dekker Sing , Snijder Eric , van Hemert Martijn , Herfst Sander
Published: September 2020

The SARS-CoV-2 pandemic resulted in shortages of production and test capacity of FFP2-respirators. Such facemasks are required to be worn by healthcare professionals when performing aerosol-generating procedures on COVID-19 patients. In response to the high demand and short supply, we designed three models of facemasks that are suitable for local production. As these facemasks should meet the requirements of an FFP2-certified facemask, the newly-designed facemasks were tested on the filtration efficiency of the filter material, inward leakage, and breathing resistance with custom-made experimental setups. In these tests, the locally-produced facemasks were benchmarked against a commercial FFP2 facemask. Furthermore, the protective capacity of the facemasks was tested for the first time with coronavirus-loaded aerosols under physiologically relevant conditions. This multidisciplinary effort resulted in the design and production of facemasks that meet the FFP2 requirements, and which can be mass-produced at local production facilities.
The link between vitamin D deficiency and Covid-19 in a large population
Authors: Israel Ariel , Cicurel Assi , Feldhamer Ilan , Dror Yosef , Giveon Shmuel M , Gillis David , Strich David , Lavie Gil
Published: September 2020

BACKGROUND

Recent studies suggest a link between vitamin D deficiency and Covid-19 infection. In our population we observe major differences in Covid-19 incidence in ethnic groups and genders in each group.

METHODS

We carried out a population-based study among 4.6 million members of Clalit Health Services (CHS). We collected results from vitamin D tests performed between 2010 and 2019 and used weighted linear regression to assess the relationship between prevalence of vitamin D deficiency and Covid-19 incidence in 200 localities. Additionally, we matched 52,405 infected patients with 524,050 control individuals of the same sex, age, geographical region and used conditional logistic regression to assess the relationship between baseline vitamin D levels, acquisition of vitamin D supplements in the last 4 months, and positive Covid-19.

RESULTS

We observe a highly significant correlation between prevalence of vitamin D deficiency and Covid-19 incidence, and between female-to-male ratio for severe vitamin D deficiency and female-tomale ratio for Covid-19 incidence in localities (P<0.001). In the matched cohort, we found a significant association between low vitamin D levels and the risk of Covid-19, with the highest risk observed for severe vitamin D deficiency. A significant protective effect was observed for members who acquired liquid vitamin D formulations (drops) in the last 4 months.

CONCLUSION

In this large observational population study, we show a strong association between vitamin D deficiency and Covid-19 occurrence. After adjustment for baseline characteristics and prior vitamin D levels, acquisition of liquid vitamin D formulations is associated with decreased risk for Covid-19 infection.
Trans-ethnic analysis reveals genetic and non-genetic associations with COVID-19 susceptibility and severity
Authors: Shelton Janie F. , Shastri Anjali J. , Ye Chelsea , Weldon Catherine H. , Filshtein-Somnez Teresa , Coker Daniella , Symons Antony , Esparza-Gordillo Jorge ,   Team The 23andMe COVID-19 Team, Aslibekyan Stella , Auton Adam
Published: September 2020

COVID-19 presents with a wide range of severity, from asymptomatic in some individuals to fatal in others. Based on a study of over one million 23andMe research participants, we report genetic and non-genetic associations with testing positive for COVID-19, respiratory symptoms, and hospitalization. Risk factors for hospitalization include advancing age, male sex, elevated body mass index, lower socio-economic status, non-European ancestry, and pre-existing cardio-metabolic and respiratory conditions. Using trans-ethnic genome-wide association studies, we identify a strong association between blood type and COVID-19 diagnosis, as well as a gene-rich locus on chr3p21.31 that is more strongly associated with outcome severity. While non-European ancestry was found to be a significant risk factor for hospitalization after adjusting for socio-demographics and pre-existing health conditions, we did not find evidence that these two primary genetic associations explain differences between populations in terms of risk for severe COVID-19 outcomes.
Sleep quality in the chronic stage of concussion is associated with poorer recovery: A systematic review
Authors: Ludwig Rebecca , Nelson Eryen , Vaduvathiriyan Prasanna , Rippee Michael A. , Siengsukon Catherine
Published: September 2020

Objective

To examine the association between sleep quality during the chronic stage of concussion and post-concussion outcomes.

Literature Survey

Literature searches were performed during July 1st to August 1st, 2019 in selected databases along with searching grey literature. Out of the 733 results, 702 references were reviewed after duplicate removal.

Methodology

Three reviewers independently reviewed and consented on abstracts meeting eligibility criteria (n = 35). The full-text articles were assessed independently by two reviewers. Consensus was achieved, leaving four articles. Relevant data from each study was extracted using a standard data-extraction table. Quality appraisal was conducted to assess potential bias and the quality of articles.

Synthesis

One study included children (18–60 months) and three studies included adolescents and/or adults (ranging 12 years to 35). The association between sleep and cognition (two studies), physical activity (one study), and emotion symptoms (one study) was examined. Sleep quality was associated with decreased cognition and emotional symptoms, but not with meeting physical activity guidelines 6 months post-concussion injury.

Conclusions

The heterogeneity in age of participants and outcomes across studies and limited number of included studies made interpretations difficult. Future studies may consider if addressing sleep quality following concussion will improve outcomes.
Probabilistic inference of the genetic architecture underlying functional enrichment of complex traits
Authors: Patxot Marion , Banos Daniel Trejo , Kousathanas Athanasios , Orliac Etienne J. , Ojavee Sven E. , Moser Gerhard , Holloway Alexander , Sidorenko Julia , Kutalik Zoltan , Mägi Reedik , Visscher Peter M. , Rönnegård Lars , Robinson Matthew R.
Published: September 2020

Due to the complexity of linkage disequilibrium (LD) and gene regulation, understanding the genetic basis of common complex traits remains a major challenge. We develop a Bayesian model (BayesRR-RC) implemented in a hybrid-parallel algorithm that scales to whole-genome sequence data on many hundreds of thousands of individuals, taking 22 seconds per iteration to estimate the inclusion probabilities and effect sizes of 8.4 million markers and 78 SNP-heritability parameters in the UK Biobank. We show in theory and simulation that BayesRR-RC provides robust variance component and enrichment estimates, improved marker discovery and effect estimates over mixed-linear model association approaches, and accurate genomic prediction. Of the genetic variation captured for height, body mass index, cardiovascular disease, and type-2 diabetes in the UK Biobank, only ≤ 10% is attributable to proximal regulatory regions within 10kb upstream of genes, while 12-25% is attributed to coding regions, 32-44% to intronic regions, and 22-28% to distal 10-500kb upstream regions. ≥ 60% of the variance contributed by these exonic, intronic and distal 10-500kb regions is underlain by many thousands of common variants, which on average have larger effect sizes than for other annotation groups. Up to 24% of all cis and coding regions of each chromosome are associated with each trait, with over 3,100 independent exonic and intronic regions and over 5,400 independent regulatory regions having ≥ 95% probability of contributing ≥ 0.001% to the genetic variance of these four traits. Thus, these quantitative and disease traits are truly complex. The BayesRR-RC prior gives robust model performance across the data analysed, providing an alternative to current approaches.
The timing of COVID-19 transmission
Authors: Ferretti Luca , Ledda Alice , Wymant Chris , Zhao Lele , Ledda Virginia , Abeler-Dörner Lucie , Kendall Michelle , Nurtay Anel , Cheng Hao-Yuan , Ng Ta-Chou , Lin Hsien-Ho , Hinch Rob , Masel Joanna , Kilpatrick A. Marm , Fraser Christophe
Published: September 2020

The timing of SARS-CoV-2 transmission is a critical factor to understand the epidemic trajectory and the impact of isolation, contact tracing and other non-pharmaceutical interventions on the spread of COVID-19 epidemics. We examined the distribution of transmission events with respect to exposure and onset of symptoms. We show that for symptomatic individuals, the timing of transmission of SARS-CoV-2 is more strongly linked to the onset of clinical symptoms of COVID-19 than to the time since infection. We found that it was approximately centered and symmetric around the onset of symptoms, with three quarters of events occurring in the window from 2-3 days before to 2-3 days after. However, we caution against overinterpretation of the right tail of the distribution, due to its dependence on behavioural factors and interventions. We also found that the pre-symptomatic infectious period extended further back in time for individuals with longer incubation periods. This strongly suggests that information about when a case was infected should be collected where possible, in order to assess how far into the past their contacts should be traced. Overall, the fraction of transmission from strictly pre-symptomatic infections was high (41%; 95%CI 31-50%), which limits the efficacy of symptom-based interventions, and the large fraction of transmissions (35%; 95%CI 26-45%) that occur on the same day or the day after onset of symptoms underlines the critical importance of individuals distancing themselves from others as soon as they notice any symptoms, even if they are mild. Rapid or at-home testing and contextual risk information would greatly facilitate efficient early isolation.
AN EVALUATION OF EDUCATIONAL INSTITUTIONS REOPENING STRATEGIES FOR IN-PERSON CLASSES SAFELY AMID THE COVID-19 PANDEMIC
Authors: Mukherjee Ujjal Kumar , Bose Subhonmesh , Ivanov Anton , Souyris Sebastian , Seshadri Sridhar , Sridhar Padmavati , Watkins Ronald , Xu Yuqian
Published: September 2020

Can educational institutions open up safely amid COVID-19? We build an epidemiological model to investigate the strategies necessary for institutions to reopen. The four measures that are most relevant for in-person opening are: (i) wide-spread rapid testing, possibly saliva-based, (ii) enforcement of mask wearing, (iii) social distancing, and (iv) contact tracing. We demonstrate that institutions need to test at a relatively high level (e.g., at least once every week) in the initial phases of reopening. Contact tracing is relatively more important when the positivity rate from random testing is relatively low, which is likely during the initial phases. A Bayesian adaptive testing strategy based on positivity rates can help institutions optimally manage the costs and risks of reopening. Finally, we provide empirical estimates of some of the educational institutions opening up experience and comment on mitigation strategies. We also provide an estimate of locational effects of institution on mitigation strategies. This paper contributes to the nascent literature on combating the COVID-19 pandemic and is especially relevant for large-scale organizations. This work is motivated and guided by the SHIELD program of UIUC.
Single-cell analysis of chromatin silencing programs in development and tumor progression
Authors: Wu Steven J. , Furlan Scott N. , Mihalas Anca B. , Kaya-Okur Hatice S. , Feroze Abdullah H. , Emerson Samuel N. , Zheng Ye , Carson Kalee , Cimino Patrick J. , Keene C. Dirk , Sarthy Jay F. , Gottardo Raphael , Ahmad Kami , Henikoff Steven , Patel Anoop P.
Published: September 2020

Single-cell analysis has become a powerful approach for the molecular characterization of complex tissues. Methods for quantifying gene expression1and chromatin accessibility2of single cells are now well-established, but analysis of chromatin regions with specific histone modifications has been technically challenging. Here, we adapt the recently published CUT&Tag method3to scalable single-cell platforms to profile chromatin landscapes in single cells (scCUT&Tag) from complex tissues. We focus on profiling Polycomb Group (PcG) silenced regions marked by H3K27 trimethylation (H3K27me3) in single cells as an orthogonal approach to chromatin accessibility for identifying cell states. We show that scCUT&Tag profiling of H3K27me3 distinguishes cell types in human blood and allows the generation of cell-type-specific PcG landscapes from heterogeneous tissues. Furthermore, we use scCUT&Tag to profile H3K27me3 in a brain tumor patient before and after treatment, identifying cell types in the tumor microenvironment and heterogeneity in PcG activity in the primary sample and after treatment.