bluuebunny/crossref_metadata_2025 huggingface dataset:
Endocapillary Proliferation was Associated with Unfavorable Outcomes in Children with Henoch-Schönlein Purpura Nephritis and IgA Nephropathy
Authors: Chanvitan Supatjaree , Tangnararatchakit Kanchana , Saisawat Pawaree , Chantarogh Songkiat , Worawichawong Suchin , Pirojsakul Kwanchai
Published: July 2020

Introduction: There are limited data on the outcomes in children with Henoch-Schönlein purpura nephritis (HSPN) and IgA nephropathy (IgAN) in limited-resource countries. This study was aimed to evaluate the outcome of HSPN and IgAN and to evaluate the pathological findings associated with unfavorable outcomes.Materials and methods: This was a retrospective study conducted in children (≤18 years) diagnosed with HSPN or IgAN, had estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2 and underwent renal biopsy between year 2002 - 2018 at Ramathibodi Hospital, Bangkok, Thailand. Clinical outcomes were graded according to the outcome classification by Counahan, as follows: favorable [A, normal; B, minor urinary abnormalities (proteinuria < 1 g/1.73 m2/day)]; unfavorable [C, active renal disease (proteinuria > 1 g/1.73 m2/day and/or hypertension); D, renal insufficiency (eGFR < 60 mL/min/1.73 m2 or died)]. Pathologies were graded according to Oxford classification.Results: A total of 47 patients (28 HSPN and 19 IgAN) were included with means of age at 9.4 ± 2.8 vs 11.3 ± 4.3 years, respectively. After a median follow-up time of 50 months, proportions of favorable outcomes in the patients with HSPN and IgAN were 82.1% (23/28) and 89.5% (17/19), respectively (p-value = 0.685). In multivariate analysis, only endocapillary proliferation (E) was associated with unfavorable outcomes in both diseases with the odds ratio (95% CI) of 12.46 (1.36 - 114.51, p-value = 0.026).Conclusion: The clinical outcomes of most patients with HSPN and IgAN were favorable and comparable. Endocapillary proliferation (E) was the only factor associated with poor outcome in both diseases.
Investigation on the influencing factors of mental health of healthcare workers for aid in Hubei during the outbreak of the COVID-19
Authors: Zhou Peng , Du Na , Diao Dongmei , OuYang Yingjie , Pathiranage Heshan Sameera Kankanam
Published: July 2020

Background
The objective of this study is to understand the psychological health status and analyze the related factors of healthcare workers for aid in Hubei during the epidemic. 220 subjects were investigated by Self-Rating Scale of Sleep(SRSS), Generalized Anxiety Scale (GAD-7), and 9-item patient health questionnaire (PHQ-9).
Results
The average SRSS score of all subjects was significantly higher than the national norm (p < 0.001)and the influencing factors were gender, whether the patients died under the charge of nursing/treatment, the history of psychosis and whether their family members were infected with the COVID-19. The average GAD-7 score of all subjects was in a moderate anxiety level, and the main influencing factors were gender, years of work, history of psychosis, self-perceived health statues and whether their family members were infected with the COVID-19. The average PHQ-9 score of all subjects was in mild depression level. The primary influencing factors were whether they nursed/treated severely ill patients during aid in Hubei and whether they had a history of psychosis.
Conclusions
During the outbreak of COVID-19, the symptoms of insomnia and anxiety of the healthcare workers for aid in Hubei were prominent. Moreover, male workers, those whose patients have died during their treatment, with previous anxiety disorders and whose family members infected with COVID-19 were facing more serious problems. Therefore, this special group needs to be strengthened follow-up psychological support individually.
Risk Factors for Urinary Tract Infection (UTI) Among Home Health Care Patients: Analysis Using Routinely Collected Clinical Data
Authors: Woo Kyungmi , Song Jiyoun , McDonald Margaret V. , Topaz Maxim , Shang Jingjing
Published: July 2020

Background: Urinary tract infection (UTI) is a complication often experienced during a home health care (HHC) episode, yet related hospitalization risk factors are unclear. Objectives: This study use multiple data sources to identify risk factors for UTI related hospitalization or emergency department (ED) visits among HHC patients.Method: We performed a multivariable logistic regression to identify risk factors for UTI-related hospitalization or ED visits using merged data from the Outcome and Assessment Information Set, electronic health record from a large HHC agency, and Center for Medicare and Medicaid claims. Results: Of 48,336 cases, 1,689 patients (3.5%) had a UTI-related hospitalization/ED visits. Being a female (OR = 1.31; 95% CI: 1.16–1.46), the presence of a urinary catheter (OR = 5.7; 95% CI: 4.54–7.14), treatment with general antibacterial and antiseptics (OR = 2.75; 95% CI: 1.02–7.38), dependency in instrumental activities of daily living (e.g., meal preparation [OR=1.72; 95% CI: 1.25-2.37]), and no available caregivers (OR = 1.79; 95% CI: 1.2–2.68) increased the odds of a UTI related event among HHC patients. Discussion/conclusion: We identified notable risk factors for UTI related hospitalization/ER visit, filling a knowledge gap on the currently understudied HHC population. Risk factors identified in this study can be used to proactively identify HHC patients at risk for UTI related hospitalization and target them for preventive interventions. Further research is needed in HHC to develop tailored interventions for at-risk patients.
A Clinical Prediction Model for Complicated Appendicitis in Children Younger than Five Years of Age
Authors: Feng Wei , Zhao Xu-Feng , Li Miao-Miao , Cui Hua-Lei
Published: July 2020

Background: No reliably specific method for complicated appendicitis has been identified in children younger than five years of age. This study aimed to analyze the independent factors for complicated appendicitis in children younger than five years of age, develop and validate a prediction model for the differentiation of simple and complicated appendicitis.Methods: A retrospective study of 382 children younger than five years of age with acute appendicitis from January 2007 to December 2016 was conducted with assessments of demographic data, clinical symptoms and signs, and pre-operative laboratory results. According to intraoperative findings and postoperative pathological results, acute appendicitis were divided into simple and complicated appendicitis. Univariate and multivariate analyses were used to screen out the independent factors of complicated appendicitis, and develop a prediction model for complicated appendicitis. Then 156 such patients from January 2017 to December 2019 were collected as validation sample to validate the prediction model. Test performance of the prediction model was compared with the ALVARADO score and Pediatric Appendicitis Score (PAS).Results: Of the 382 patients, 244 (63.9 %) had complicated appendicitis. Age, white blood cell count, and duration of symptoms were the independent factors for complicated appendicitis in children younger than five years of age. The final predication model for complicated appendicitis included factors above. In validation sample, the prediction model exhibited a high degree of discrimination (area under the curve [AUC]: 0.830; 95% confidence interval [CI]: 0.762 - 0.885) corresponding to a optimal cutoff value of 0.62, and outperformed the PAS (AUC: 0.735; 95% CI: 0.658 - 0.802), Alvarado score (AUC: 0.733; 95% CI: 0.657 - 0.801).Conclusion: Younger age, higher white blood cell count, and longer duration of symptoms in children younger than five years of age with acute appendicitis are important predictors for complicated appendicitis. The prediction model is a novel but promising method that aids in the differentiation of acute simple and complicated appendicitis.Trial registration: All procedures performed in studies involving human participants were in accordance with the ethical standards of the Tianjin Children's Hospital institutional research committee (approved number L202001).
Presymptomatic transmission and diverse progression of familial clustering COVID-19 cases in Zhoushan, China
Authors: Liu Miao , Liu Leijie , Li Ping , Ding Yibo , Wu Ting , Tang Weina , Wang Zhongfa , Cao Guangwen
Published: July 2020

Background

Novel coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-caused emerging infectious disease, firstly identified in Wuhan (Hubei, China), is pandemic. However, data concerning presymptomatic SARS-CoV-2 transmission and disease diversity among family members are limited.
Objectives

To investigate the epidemiological and clinical characteristics of presymptomatic transmission-caused familial clustering cases of SARS-CoV-2 infection in Zhoushan island, China.
Methods

All family members were tested for SARS-CoV-2 genomic RNA by quantitative reverse transcription PCR in 3 different samples and serum antibody immunoglobin M (IgM) and IgG against SARS-CoV-2. Exposure identification, laboratory test, and imaging were performed according to the national guideline of COVID-19 (7th edition, China).
Results

Of the 6 cases, index case who ever met his relative with COVID-19 from Xianning, Hubei on January 26–31, 2020, transmitted SARS-CoV-2 to his family members in Zhoushan via visiting family during January 31 and February 3, 2020. The index was identified as common-type COVID-19 on February 6, 2020. All 5 family members were infected with SARS-CoV-2. Of those, a 7-year-old girl was an asymptomatic carrier whereas her grandparents, especially her grandfather, were very sick. Case 6 (grandfather) remained positive for SARS-CoV-2 RNA in his sputum specimen in subsequent 2 months. Case 2 (mother) tested negative for SARS-CoV-2 RNA in all samples but positive for IgM and IgG to SARS-CoV-2 since February 9, 2020.
Conclusions

Presymptomatic transmission of SARS-CoV-2 causes familial cluster of COVID-19. Exposed to the same source of infection, family members present their differences in disease severity and viral clearance.
Syntaxin binding protein 4 as a novel therapeutic target and an effective biomarker for better treatment selection in lung squamous cell carcinoma: A theranostic study
Authors: Bilguun Erkhem-Ochir , Kaira Kyoichi , Kawabata-Iwakawa Reika , Rokudai Susumu , Shimizu Kimihiro , Yokobori Takehiko , Oyama Tetsunari , Shirabe Ken , Nishiyama Masahiko
Published: July 2020

Background
Lung squamous cell carcinoma (LSCC) remains a challenging disease to treat, and further improvements in prognosis are dependent upon the identification of LSCC-specific therapeutic biomarkers and/or targets. We previously found that Syntaxin Binding Protein 4 (STXBP4) plays a crucial role in lesion growth and, therefore, clinical outcomes in LSCC patients through regulation of tumor protein p63 (TP63) ubiquitination.
Methods
To clarify the potential of STXBP4 as a novel therapeutic target and/or a predictive biomarker of therapeutic response, we assessed its prognostic impact of the protein in 144 LSCC patients and examined whether its action pathway is distinct from those of currently used drugs in in vitro experiments including RNA-seq analysis through comparison with the other putative exploratory targets and/or markers.
Results
Kaplan–Meier analysis revealed that, along with ΔNp63 (an isoform of TP63) and vascular endothelial growth factor receptor 2 (VEGFR2), STXBP4 expression signified a worse prognosis in LSCC patients, both in terms of overall survival (OS, P = 0.002) and disease-free survival (DFS, P = 0.041). Multivariate analysis demonstrated STXBP4 to be an independent prognostic factor for poor DFS, while VEGFR2 (P < 0.001) and TP63 (ΔNp63, P < 0.05) were independent prognostic factors for poor OS. The action pathway of STXBP4 on suppression of TP63 (ΔNp63), which results in the and inhibits tumor growth, was unique: Ingenuity pathway analysis using the knowledge database and our RNA-seq analysis in human LSCC cell lines indicated that 35 pathways were activated or inactivated in association with STXBP4, but the action pathway of STXBP4 was distinct from those of other current drug targets: STXBP4, TP63 and KDR (VEGFR2 gene) formed a cluster independent from other target genes of tumor protein p53 (TP53), tubulin beta 3 (TUBB3), stathmin 1 (STMN1) and cluster of differentiation 274 (CD274: programmed cell death 1 ligand 1, PD-L1). STXBP4 itself appeared not to be a potent predictive marker of individual drug response, but we found that TP63, main action target of STXBP4, might be involved in drug resistance mechanisms of LSCC.
Conclusion
STXBP4 could afford a unique therapeutic target and a key to the development of precision medicine for LSCC patients.
LINC00649 Underexpression is an Adverse Prognostic Marker in Acute Myeloid Leukemia
Authors: Guo Chao , Gao Ya-yue , Ju Qian-qian , Zhang Chun-xia , Gong Ming , Li Zhen-ling
Published: July 2020

Background long noncoding RNAs (lncRNA) play a role in leukemogenesis, maintenance, development, and therapeutic resistance of AML. While few studies have focused on the prognostic significance of LINC00649 in AML, which we aim to investigate in this present study.Methods We compared the expression level of LINC00649 between AML patients and healthy controls. The Kaplan-Meier curves of AML patients expressing high versus low level of LINC00649 was performed. The LINC00649 correlated genes/miRNAs/lncRNAs and methylation CpG sites were screened by Pearson correlation analysis with R (version 3.6.0), using TCGA-LAML database. The LINC00649 associated ceRNA network was established using lncBase 2.0 and miRWalk 2.0 online tools, combining results from correlation analysis. Finally, a prediction model was constructed using LASSO-Cox regression.Results LINC00649 was underexpressed in bone marrow of AML group than that in healthy control group. The patients of LINC00649-low group have significantly inferior PFS and OS. A total of 154 mRNAs, 31 miRNAs, 28 lncRNAs and 1590 methylated CpG sites were identified to be significantly correlated with LINC00649. Furthermore, the network of ceRNA was established with 6 miRNAs and 122 mRNAs. The Lasso-Cox model fitted OS/PFS to novel prediction models, which integrated clinical factors, ELN risk stratification, mRNA/miRNA expression and methylation profiles. The analysis of time-dependent ROC for our model showed a superior AUC (AUC = 0.916 at 1 year, AUC = 0.916 at 3 years, and AUC = 0.891 at 5 years).Conclusions Low expression of LINC00649 is an unfavorable prognostic marker for AML patients. The analysis by LASSO-COX regression identified a novel comprehensive model with a superior diagnostic utility, which integrated clinical and genetic variables.
SMAD4 Haploinsufficiency in Small Intestinal Neuroendocrine Tumors
Authors: Hofving Tobias , Elias Erik , Rehammar Anna , Inge Linda , Altiparmak Gülay , persson marta , kristiansson Erik , Johansson Martin E , Nilsson Ola , Arvidsson Yvonne
Published: July 2020

Background Patients with small intestinal neuroendocrine tumors (SINETs) frequently present with lymph node and liver metastases at the time of diagnosis, but the molecular changes that lead to the progression of these tumors are largely unknown. Sequencing studies have only identified recurrent point mutations in a single gene, CDKN1B, with heterozygous mutations in less than 10% of all tumors. Although SINETs are genetically stable tumors with a low frequency of point mutations and indels, they often harbor recurrent hemizygous copy number alterations (CNAs) yet the functional implications of these CNA are unclear.MethodsUtilizing comparative genomic hybridization (CGH) arrays we analyzed the CNA profile of 131 SINETs from 117 patients. Two tumor suppressor genes and corresponding proteins i.e. SMAD4, and CDKN1B, were further characterized using a tissue microarray (TMA) with 846 SINETs. Immunohistochemistry (IHC) was used to quantify protein expression in TMA samples and this was correlated with chromosome number evaluated with fluorescent in-situ hybridization (FISH). Intestinal tissue from a Smad4+/- mouse model was used to detect entero-endocrine cell hyperplasia with IHC.ResultsAnalyzing the CGH arrays we found loss of chromosome 18q and SMAD4 in 71% of SINETs and that focal loss of chromosome 12 affecting the CDKN1B was present in 9.4% of SINETs. No homozygous loss of chromosome 18 was detected. Hemizygous loss of SMAD4, but not CDKN1B, significantly correlated with reduced protein levels but hemizygous loss of SMAD4 did not induce entero-endocrine cell hyperplasia in the Smad4+/- mouse model. Conclusions Hemizygous loss of chromosome 18q and the SMAD4 gene is the most common genetic event in SINETs and our results suggests that this could influence SMAD4 protein expression. Although SMAD4 haploinsufficiency alone did not induce tumor initiation, loss of chromosome 18 could represent an evolutionary advantage in SINETs explaining the high prevalence of this aberration. Functional consequences of reduced SMAD4 protein levels could hypothetically be a potential mechanism as to why loss of chromosome 18 appears to be clonally selected in SINETs.
Impact of COVID-19 on small-scale coastal fisheries of Southeast Sulawesi, Indonesia
Authors: Campbell Stuart , Jakub Raymond , Valdivia Abel , Setiawan Haris , Setiawan Agus , Cox Courtney , Kiyo Askabul , Darman  , Djafar Lely , Rosa Emilio de la , Suherfian Wahid , Yuliani Ade , Kushardanto Hari , Muawanah Umi , Rukma Arwandrija , Alimi Taufiq , Box Stephen
Published: July 2020

Numerous reports suggest that the volume and value of fish catches in fisheries worldwide have declined since the COVID-19 pandemic was declared. To quantify the effects of the pandemic on small scale fisheries in Indonesia we collected catch data across Southeast Sulawesi using a digital data collection system. We show that the number of active fishers and traders declined by more than 60% after the pandemic was announced. While average weight of catch per trip increased across fishers, average price of fish declined. Interviews with 185 fishers and traders revealed that low demand and a decline in price were the primary causes of disruption in their lives. Approximately 75% of fishers are coping by continuing to fish, highlighting that there were few alternative livelihoods available at the time of the interviews. Our results provide key insights into the vulnerability of small-scale fishing communities to impacts of the COVID-19 pandemic.
Can Reasoned Mass Testing Impact on Covid-19 Hard Outcomes in Wide Community Contexts? An Evidence-based Opinion
Authors: Cassone Antonio , Crisanti Andrea
Published: July 2020

We provide data of Covid-19 epidemic in two geographycally contiguous Italian regions, Lombardy and Veneto, which were the first and simultaneously hit by SARS-2-Cov in Italy but showed markedly different disease outcome in terms of case fatality rate, mortality and hospitalization.. We discuss similarities and differences in the regional context and conclude that Covid-19 better outcome in Veneto was due, at least in part, to the adoption of a strategy of active search of asymptomatic SARS-2-CoV infections ( Reasoned Mass Testing;) instead of a strategy strictly based on detection of symptomatic cases.SARS.
Prevalence and predictors of nonalcoholic fatty liver disease in South Asian women with polycystic ovary syndrome
Authors: Shengir Mohamed , Krishnamurthy Srinivasan , Ghali Peter , Deschenes Marc , Wong Philip , Chen Tianyan , Sebastiani Giada
Published: July 2020

Background & Aims: Polycystic ovary disease (PCOS) may be a risk factor for nonalcoholic fatty liver disease (NAFLD) due to common pathogenetic pathways, including insulin resistance and obesity. Both PCOS and NAFLD are more severe in South Asian women. Data on NAFLD in South Asian women with PCOS are lacking.Methods: We investigated prevalence and predictors of NAFLD and liver fibrosis by transient elastography (TE) with associated controlled attenuation parameter (CAP) in PCOS patients from South Asia, through a routine screening program. NAFLD was defined as CAP >288 dB/m. Significant liver fibrosis (stage 2 and higher out of 4) was defined as TE measurement >8.0 kPa. Elevated ALT was defined as ALT >24 IU/L, as per upper limit of normal reported in South Asian women. Hyperandrogenism was defined as free androgen index >5. Predictors of NAFLD were determined by logistic regression analysis.Results: 101 PCOS patients (mean age 36.3 years) with no significant alcohol intake or viral hepatitis were included. Prevalence of NAFLD and significant liver fibrosis was 39.6% and 6.9%, respectively. Elevated ALT was observed in 40.0% and 11.5% of patients with and without NAFLD, respectively. After adjusting for duration of PCOS and insulin resistance measured by HOMA-IR, independent predictors of NAFLD were higher BMI (adjusted odds ratio [aOR] 1.30, 95% CI 1.13-1.52), hyperandrogenism (aOR 5.32, 95% CI 1.56-18.17) and elevated ALT (aOR 3.54, 95% CI 1.10-11.47). Lifetime cardiovascular risk was higher in patients with NAFLD compared to those without NAFLD (0.31+0.11 vs. 0.26+0.13).Conclusions: Despite their young age, NAFLD diagnosed by TE with CAP is a frequent comorbidity in South Asian women with PCOS and is strongly associated with higher BMI and hyperandrogenism. Non-invasive screening strategies could help early diagnosis and initiation of interventions, including counselling on weight loss, cardiovascular risk stratification and linkage to hepatology care where appropriate.
18F-FDG brain PET metabolism in post-SARS-CoV-2 infection: substrate for persistent/delayed disorders?
Authors: Guedj Eric , Million Matthieu , Dudouet Pierre , Tissot-Dupont Hervé , Bregeon Fabienne , Cammilleri Serge , Raoult Didier
Published: July 2020

Purpose: Several brain complications of SARS-CoV-2 infection have been reported. It has been moreover speculated that this neurotropism could potentially cause a delayed outbreak of neuropsychiatric and neurodegenerative diseases of neuroinflammatory origin. A propagation mechanism has been proposed across the cribriform plate of the ethmoid bone, from the nose to the olfactory epithelium, and possibly afterwards to other limbic structures, and deeper parts of the brain including the brainstem. Methods: Review of clinical examination, and whole-brain voxel-based analysis of 18F-FDG PET metabolism in comparison to healthy subjects (p-voxel<0.001, p-cluster<0.05), of two patients with confirmed diagnosis of SARS-CoV-2 pneumonia explored at the post-viral stage of the disease.Results: Hypometabolism of the olfactory/rectus gyrus was found on the two patients, especially one with 4 weeks prolonged anosmia. Additional hypometabolisms were found within bilateral amygdala, hippocampus, cingulate cortex, thalamus, pons and medulla brainstem in the other patient who complained of delayed onset of an atypical painful syndrome.Conclusion: These preliminary findings reinforce the hypotheses of SARS-CoV-2 neurotropism through the olfactory bulb, and the possible extension of this impairment to other limbic structures and to the brainstem. 18F-FDG PET hypometabolism could constitute a cerebral quantitative biomarker of this involvement. Post-viral cohort studies are required to specify the exact relationship between limbic/brainstem hypometabolisms and the possible persistent disorders, especially involving cognitive or emotion disturbances, residual respiratory symptoms or painful complaints.
Correlation Between Foot Posture Index and Radiographic Parameters
Authors: Cho Yun Jae , Lee Jae Hee , Kyung Min Gyu , Shin Min Seok , Park Jay Hoon , Lee Dong Yeon
Published: July 2020

Background: The Foot Posture Index (FPI-6) is a validated and rapid clinical method for evaluating standing foot posture through assessing six individual criteria. Although it has been widely used without radiographic examination, evidences for correlation of FPI-6 with radiographic parameters remain scanty. The objective of this study is to investigate the correlation of FPI-6 with radiographic measurements and to assess the feasibility of FPI-6 for clinical evaluation of standing foot postures. Methods: Sixty patients (M:F,33:27, mean age 62 ) of foot and ankle symptoms and 40 asymptomatic male volunteers (age, 20-28), were included in this study. FPI-6 scores were evaluated by 4 raters and inter-rater reliability of FPI-6 was assessed by intraclass correlation coefficient (ICC). Radiologic measurements including talo-first metatarsal angle (TMA), Meary’s angle (MA), talonavicular coverage angle (TNCA), talocalcaneal angle (TCA), calcaneal pitch angle (CPA), and hindfoot alignment angle (HAA) were measured. For the correlation analysis between FPI-6 and radiographic parameters, statistical analysis was performed using Pearson’s correlation test.Results: Inter-rater reliability was ‘high to excellent’ among raters. However, FPI-6 score was more repeatable in patients group and in more experienced raters. In total group, FPI-6 score was correlated with TNCA, TMA, lateral TCA, MA, and HAA. Especially, TNCA and HAA were more strongly correlated among them. When we analyzed the subdomains of FPI-6, the congruence of the medial longitudinal arch and the prominence in the region of the talonavicular joint were most strong indicators for TNCA and HAA, respectively. Conclusion: This study manifested that not only the feasibility of the FPI-6, but also its correlation to radiographic parameters, is significant for both the patients and the asymptomatic group. We assert that FPI-6 scoring system can be used as a first-line tool for foot posture assessment in clinics without radiographic evaluation if used carefully.
Systematic Review on Wearable Lower-Limb Exoskeletons for Gait Training in Neuromuscular Impairments
Authors: Rodríguez-Fernández Antonio , Lobo-Prat Joan , Font-Llagunes Josep M.
Published: July 2020

Gait disorders can reduce the quality of life for people with neuromuscular impairments. Therefore, walking recovery is one of the main priorities for counteracting sedentary lifestyle, reducing secondary health conditions and restoring legged mobility. At present, wearable powered lower-limb exoskeletons are emerging as a revolutionary technology for robotic gait rehabilitation. This systematic review provides a comprehensive overview on wearable lower-limb exoskeletons for people with neuromuscular impairments, addressing the following three questions: (1) what is the current technological status of wearable lower-limb exoskeletons for gait rehabilitation?, (2) what are the benefits and risks for exoskeleton users?, and (3) what is the current evidence on clinical efficacy for wearable exoskeletons?. We analyzed 87 clinical studies focusing on both device technology (e.g., actuators, sensors, structure) and clinical aspects (e.g., training protocol, outcome measures, patient impairments), and make available the database with all the compiled information. The results of the literature survey reveal that wearable exoskeletons have potential for a number of applications including early rehabilitation, promoting physical exercise, and carrying out daily living activities both at home and the community. Likewise, wearable exoskeletons may improve mobility and independence in non-ambulatory people, and may reduce secondary health conditions related to sedentariness, with all the advantages that this entails. However, the use of this technology is still limited by heavy and bulky devices, which require supervision and the use of walking aids. In addition, evidence supporting their benefits is still limited to short-intervention trials with few participants and diversity among their clinical protocols. Wearable lower-limb exoskeletons for gait rehabilitation are still in their early stages of development and randomized control trials are needed to demonstrate their clinical efficacy.
SPP1 Promotes Schwann Cell Proliferation and Survival through PKCα by Binding with CD44 and αvβ3 after Peripheral Nerve Injury
Authors: Wang Jiang-Bo , Zhang Zhan , Li Jian-Nan , Yang Tuo , Du Shuang , Cao Rang-Juan , Cui Shu-Sen
Published: July 2020

Background: Schwann cells (SCs) play a crucial role in Wallerian degeneration after peripheral nerve injury. The expression of genes in SCs undergo a series of changes, which greatly affect the proliferation and apoptosis of SCs as well as the fate of peripheral nerve regeneration. However, how do these genes regulate the proliferation and apoptosis of SCs remains unclear. Results: SPP1 and PKCα were found upregulated after human median peripheral nerve injury, which promoted SCs proliferation and survival. The promoted proliferation and inhibited apoptosis by SPP1 were blocked after the treatment of PKCα antagonist Gö6976. Whereas, the inhibited proliferation and enhanced apoptosis induced by silence of SPP1 could be rescued by the activation of PKCα, which suggested that SPP1 functioned through PKCα. Moreover, both CD44 and αvβ3 were found expressed in SCs and increased after peripheral nerve injury. Silence of CD44 or β3 alleviated the increased proliferation and inhibited apoptosis induced by recombinant osteopontin, suggesting the function of SPP1 on SCs were dependent on CD44 and β3. Conclusion: These results suggested that SPP1 promoted proliferation and inhibited apoptosis of SCs through PKCα signaling pathway by binding with CD44 and αvβ3. This study provides a potential therapeutic target for improving peripheral nerve recovery.
Perspectives on the Early Quality of Evidence Guiding the Therapeutic Management of SARS CoV-2: A Systematic Literature Review
Authors: Subramanian Kaushik , Nalli Anuradha , Senthil Vinitha , Jain Saurabh , Nayak Aravind , Bhat Amit
Published: July 2020

Background:Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak is a serious health concern. Repurposing of existing drugs indicated for other conditions seems to be the first choice for immediate therapeutic management. The quality of early evidence favoring the different treatment options needs to be apprised for informed decision making. Methods:In this systematic literature review, we apprised the quality of available evidence for different therapeutic options and also the basis for different treatment guidelines. In order to include all studies that are in different stages of publications, we also included studies from the preprint servers, BioRxiv, MedRxiv and published studies from PubMed. Results:We retrieved 5621 articles and included 20 studies for the systematic review. Based on our study, chloroquine/hydroxychloroquine either alone or in combination with azithromycin, remdesivir, corticosteroids, convalescent sera, ritonavir/lopinavir and arbidol were evaluated as therapeutic options. The data from different study designs reveal contradictory findings except for convalescent sera for which the evidence available is only from case series. Based on these early evidence, various national guidelines recommend remdesivir, convalescent sera, corticosteroids, hydroxychloroquine in different sub set of patients. Conclusion:Establishing consensus with respect to the endpoints to be assessed for respiratory viruses may enhance the quality of evidences in case of future pandemics. Further clinical evidence from the ongoing trials may lead to evolution of treatment guidelines with the addition of more therapeutic options.
The interplay between host genetics and the gut microbiome reveals common and distinct microbiome features for human complex diseases
Authors: Xu Fengzhe , Fu Yuanqing , Sun Tingyu , Jiang Zengliang , Miao Zelei , Shuai Menglei , Gou Wanglong , Ling Chuwen , Yang Jian , Wang Jun , Chen Yu-ming , Zheng Ju-Sheng
Published: July 2020

Background There is increasing interest about the interplay between host genetics and gut microbiome on human complex diseases, with prior evidence mainly derived from animal models. In addition, the shared and distinct microbiome features among human complex diseases remain largely unclear.Results The analysis was based on a Chinese population with 1,475 participants. We estimated the SNP-based heritability, which suggested that Desulfovibrionaceae and Odoribacter had significant heritability estimates (0.456 and 0.476, respectively). We performed a microbiome genome-wide association study to identify host genetic variants associated with gut microbiome.We then conducted bi-directional Mendelian randomization analyses to examine the potential causal associations between gut microbiome and human complex diseases. We found that Saccharibacteria (per 1-SD higher in the log-transformed abundance) could potentially decrease the concentration of serum creatinine (Beta: -0.011 [95%CI: -0.019, -0.003], p=0.007) and increase estimated glomerular filtration rate (Beta: 0.012 [95%CI: 0.004, 0.020], p=0.003). On the other hand, atrial fibrillation, chronic kidney disease and prostate cancer, as predicted by the host genetics, had potential causal effect on the abundance of some specific gut microbiota. For example, atrial fibrillation (per log odds) could increase the abundance of Burkholderiales (Beta: 0.079[95%CI: 0.009, 0.150], p=0.027) and Alcaligenaceae (Beta: 0.082[95%CI: 0.012, 0.152], p=0.022), and decrease the abundance of Lachnobacterium (Beta:-0.078[95%CI: -0.148, -0.006], p=0.034), Bacteroides coprophilus (Beta: -0.113[95%CI: -0.184, -0.041], p=0.002), Barnesiellaceae (odds ratio: 0.818[95%CI: 0.686, 0.976], p=0.026), Veillonellaceae undefined (odds ratio: 0.801[95%CI: 0.669, 0.960], p=0.017) as well as Mitsuokella (odds ratio: 0.657[95%CI: 0.496, 0.870], p=0.003). Further disease-microbiome feature analysis suggested that systemic lupus erythematosus and chronic myeloid leukemia shared common gut microbiome features.Conclusions These results suggest that different human complex diseases share common and distinct gut microbiome features, which may help re-shape our understanding about the disease etiology in humans.
State-level impact of social distancing and testing on COVID-19 in the United States
Authors: Chiu Weihsueh A. , Fischer Rebecca , Ndeffo-Mbah Martial L.
Published: July 2020

Social distancing measures have been implemented in the United States (US) since March 2020, to mitigate the spread of SARS-CoV-2, the causative agent of COVID-19. However, by mid-May most states began relaxing these measures to support the resumption of economic activity, even as disease incidence continued to increase in many states. To evaluate the impact of relaxing social distancing restrictions on COVID-19 dynamics and control in the US, we developed a transmission dynamic model and calibrated it to US state-level COVID-19 cases and deaths from March to June 20th, 2020, using Bayesian methods. We used this model to evaluate the impact of reopening, social distancing, testing, contact tracing, and case isolation on the COVID-19 epidemic in each state. We found that using stay-at-home orders, most states were able to curtail their COVID-19 epidemic curve by reducing and achieving an effective reproductive number below 1. But by June 20th, 2020, only 19 states and the District of Columbia were on track to curtail their epidemic curve with a 75% confidence, at current levels of reopening. Of the remaining 31 states, 24 may have to double their current testing and/or contact tracing rate to curtail their epidemic curve, and seven need to further restrict social contact by 25% in addition to doubling their testing and contact tracing rates. When social distancing restrictions are being eased, greater state-level testing and contact tracing capacity remains paramount for mitigating the risk of large-scale increases in cases and deaths.
Differences Between Encoding and Retrieval Failure in Mild Cognitive Impairment: Results from Quantitative Electroencephalography and Magnetic Resonance Volumetry
Authors: Han Su-Hyun , Pyun Jungmin , Yeo Soeun , Kang Dong Won , Jeong Ho Tae , Kang Seung Wan , Kim SangYun , Youn Young Chul
Published: July 2020

Background: Memory impairments in mild cognitive impairment can be classified into encoding (EF) and retrieval (RF) failure. We explored differences between the two using quantitative electroencephalography (qEEG) and magnetic resonance imaging volumetry.Methods: We compared qEEG power spectra and connectivity between 87 participants with EF and 78 with RF, and gray matter (GM) volume differences between participants with mild cognitive impairment and 71 controls. Demographic and cognitive assessment results between groups were compared with Student’s t-tests, and obtained qEEG features were analyzed according to statistically significant differences between the groups using iSyncBrain ™. GM volume changes underlying EF and RF in amnestic mild cognitive impairment were compared on processed magnetic resonance images of cognitively normal subjects using Student’s t-tests, with age and total intracranial volume classified as nuisance covariates. We used a voxel-based morphometry analysis to demonstrate significant atrophic GM areas in the two types of patients with amnestic mild cognitive impairment. Results were considered statistically significant at p < 0.05 and were corrected for family-wise errors to avoid multiple-comparison problems.Results: qEEG showed higher frontal theta and lower beta2 band power and higher theta and lower beta connectivity in patients with EF. GM volume reductions due to EF in the left thalamus and bilateral hippocampi and reductions due to RF in the left thalamus, right superior frontal lobe, right superior temporal lobe, and right middle cingulum were observed. Conclusions: Patients with mild cognitive impairment differ functionally and structurally according to their specific memory impairments. EF findings are more consistent with the prodromal Alzheimer's disease stage than RF findings. Since this study is a cross-sectional study, prospective follow-up studies are needed to investigate whether different types of memory impairments can predict the underlying pathology of amnestic MCI. Additionally, insufficient sample size may lead to ambiguous statistical finidings in direct comparisons, a larger patient cohort could more robustly identify differences in GM volume reductions between the EF and the RF group.
Evolving trajectories of COVID-19 curves in India: Prediction using autoregressive integrated moving average modeling.
Authors: Bhandari Sudhir , Tak Amit , Gupta Jitendra , Patel Bhoopendra , Shukla Jyotsna , Shaktawat Ajit Singh , Singhal Sanjay , Saini Abhishek , Kakkar Shivankan , Dube Amitabh , Dia Sunita , Dia Mahendra , Wehner Todd C
Published: July 2020

The forecasting of Coronavirus Disease-19 (COVID-19) dynamics is a centerpiece in evidence based disease management. Numerous approaches that use mathematical modeling have been used to predict the outcome of the pandemic, including data driven models, empirical and hybrid models. This study was aimed at prediction COVID-19 evolution in India using a model based on autoregressive integrated moving average (ARIMA). Retrieving real time data from the Johns Hopkins dashboard from 11 Mar 2020 to 25 Jun 2020 (N = 107 time points) to fit the model. The ARIMA (1,3,2) and ARIMA (3,3,1) model fit best for cumulative cases and deaths respectively with minimum Akaike Informaton Criteria. The prediction of cumulative cases and deaths for next 10 days from 26 Jun 2020 to 05 Jul 2020 showed a trend toward continuous increment. The predicted root mean square error (PredRMSE) and base root mean square error (BaseRMSE) of ARIMA(1,3,2) model was 21137 and 166330 respectively. Similarly, PredRMSE and BaseRMSE of ARIMA(3,3,1) model was 668.7 and 5431 respectively. We propose that data on COVID-19 be collected continuously, and that forecasting continue in real time. The COVID-19 forecast assist government in resource optimization and evidence based decision making for a subsequent state of affairs.
Are Australian medical interns adequately prepared for the optimal use of personal protective equipment?
Authors: Barratt Ruth
Published: July 2020

BackgroundThe current COVID-19 pandemic has demonstrated that personal protective equipment (PPE) is essential, to prevent the acquisition and transmission of infectious diseases, yet its use is often sub-optimal in the clinical setting. Training and education are important to ensure and sustain the safe and effective use of PPE by medical interns, but current methods are often inadequate in providing the relevant knowledge and skills. The purpose of this study was to explore new graduates’ experiences of the use of PPE and identify opportunities for improvement in medical student education and training programmes, to improve occupational and patient safety. MethodsThis study was undertaken in 2018 in a large tertiary-care teaching hospital in XXXX, Australia, to explore medical interns’ self-reported experiences of PPE use, at the beginning of their first postgraduate year. Focus groups were conducted immediately after theoretical and practical PPE training, during hospital orientation. Transcripts of recorded discussions were analysed, using a thematic approach that drew on the COM-B (capability, opportunity, motivation - behaviour) framework for behaviour. Results 80% of 90 eligible interns participated. Many interns had not previously received formal training in the specific skills required for optimal PPE use and had developed potentially unsafe habits. Their experiences as medical students in clinical areas contrasted sharply with recommended practice taught at hospital orientation and impacted on their ability to cultivate correct PPE use. ConclusionsUndergraduate teaching should be consistent with best practice PPE use, and include practical training that embeds correct and safe practices.
Assessing the Macronutrient Status of Some Selected Soils in Bayelsa State, South-South Nigeria
Authors: Diri Kelvin Harrison , Joseph Tate Oyinbrakemi
Published: July 2020

Fertility status of soils within the south-south region of Nigeria varies both inter and intra states. Therefore, the study investigated the macronutrient status of some selected soils in Bayelsa State. Two farm sites in Opume (OPF) and Amassoma (AMF) with records of long term cultivation were randomly selected and soil samples randomly collected from each locality for physico-chemical analyses. Data collected were subjected to statistical analysis of means and a post hoc regression analysis to determine relationships between soils and analyzed parameters. Results revealed that soils were loam to sandy clay loam and acidic with low pH levels. Exchangeable bases (Ca2+, Mg2+, K+) were low in AMF soils compared to OPF soils except for Na+. Organic carbon and organic matter were moderately low in both soils, however, AMF had lower contents. Total N were found to be critically low (0.03%) in both soils. OPF had higher available phosphorus (5.09 mg/kg) while AMF had higher available Sulphur (6.55 mg/kg). Base saturation was moderate in OPF (50.44 %), however, not significantly different (p<0.05) from AMF. Similarly, Effective Cation Exchange Capacity (ECEC) was low in soils of both localities. Regression analysis showed that pH had significant positive relationships with sand, Org C, Org M, available P, TN, % B.S and the basic cations (r=0.534*, 0.841***, 0.837***, 0.855***, 0.736***, 0.856**) with a negative relationship with Exchangeable acidity and SO42- (r=-0.799** and -0.844***). Org C, Org M and TN had significant negative relationships with silt at both localities (r=-0.592**, -0.592** and -0.491*) respectively. These results indicate clearly that the nutrient status of soils in the study areas are mostly controlled by pH and the textural distribution. It also indicates that improved soil management practices can improve the macronutrient status for increased crop production.
Patterns of Social Reactions to COVID-19 Pandemic; Reasons & Proposed Ways to Overcome
Authors: Ahmed Kaenat
Published: July 2020

This study on the patterns of social reactions to a pandemic has been done amid the spread of COVID-19 globally.  Worldwide, everyone reacts differently to every single situation that takes place, especially those as serious as a pandemic.  Every individual builds a social reaction unique to his/her concerns.  The purpose of this study is to explore the types of reactions people have been showing amid the pandemic from COVID-19, which could help policy makers all over the world to figure out and adapt to the situation according to their own needs and concerns rather than applying a single solution universally.  Due to novelty of the topic, and hence limited availability of formal research, this study mostly relies upon reports in print and electronic media about the emerging situation.  The study suggests that worldwide, there have been four broad categories of social reactions to a pandemic which include fear, panic, indifference and fatalism.  After studying these social reactions, the research comes up with strategies to help resolve these concerns which will eventually help everyone accept the situation and tackle it wisely.
Combining Ability and Heterosis in Diallel Analysis of Maize (Zea mays L.) Lines
Authors: Onejeme Francis Chukwuma , Okporie Emmanuel Ogbonna , Eze Chinedu Emmanuel
Published: July 2020

A sound breeding program for maize improvement is very important to meet the demands of the growing population. Therefore, combining ability and heterosis were studied in a 4 x 4 full diallel cross in maize for growth attributes, yield and its contributing traits. Randomized Complete Block Design (RCBD) with four replicates was used to study the general combining ability of parents, specific combining ability of F1s (including reciprocals) and heterosis of the F1s over commercial check variety on selected agronomic characters. Genotype was highly significant for all the traits studied. The combining abilities (GCA and SCA) and reciprocal mean squares were highly significant for most studied characters. The ratio of GCA/SCA was not less than unity for studied traits excepted for days to anthesis and ear height. The results indicated that the additive genetic effects were more important and played major role in studied traits. Thus, results revealed GCA effects for the parental lines (PL). Where ‘PL2’ was excellent combiner for number of tassels and cob circumference and ‘PL3’ was good combiner for days to silking and grain yield (t.h-1). While ‘PL4’ for short height. Majority of the F1s from the GCA effects showed high SCA effects. This F1 (PL2 x PL3) performed best amongst. However, several reciprocals were not desirable. Heterosis estimation was carried out using a commercial check, Oba super II. When commercial check was used, the percent heterosis especially on grain yield varied from -8.89 to 22.62%. Among the twelve F1s, nine of the crosses exhibited significant positive heterosis for grain yield (t.h-1). Those F1s that showed significant positive and/or negative desirable traits for SCA effects and significant positive heterosis could be used for varietal development in maize breeding. And conservation of those parents that exhibited high GCA effects be considered as well.