bluuebunny/crossref_metadata_2025 huggingface dataset:
Electrically controllable router of interlayer excitons
Authors: Liu Yuanda , Dini Kévin , Tan Qinghai , Liew Timothy , Novoselov Kostya S. , Gao Weibo
Published: October 2020

Electrically controllable excitonic transistor and router based on bilayer WSe
2
have been demonstrated.
Dole effect as a measurement of the low-latitude hydrological cycle over the past 800 ka
Authors: Huang Enqing , Wang Pinxian , Wang Yue , Yan Mi , Tian Jun , Li Shihan , Ma Wentao
Published: October 2020

Changes in the isotope composition of atmospheric O
2
are mainly controlled by rainfall intensity over tropical lands.
Restoration of seagrass habitat leads to rapid recovery of coastal ecosystem services
Authors: Orth Robert J. , Lefcheck Jonathan S. , McGlathery Karen S. , Aoki Lillian , Luckenbach Mark W. , Moore Kenneth A. , Oreska Matthew P. J. , Snyder Richard , Wilcox David J. , Lusk Bo
Published: October 2020

A total of 3612 ha of seagrass habitat was restored to the Virginia coast along with services like blue carbon and fisheries.
Solution NMR readily reveals distinct structural folds and interactions in doubly
13
C- and
19
F-labeled RNAs
Authors: Becette Owen B. , Zong Guanghui , Chen Bin , Taiwo Kehinde M. , Case David A. , Dayie T. Kwaku
Published: October 2020

19
F-
13
C spy couple enables NMR visualization of long-lived signals of large RNA structures, folds, and drug binding pockets.
Propagating bands of plastic deformation in a metal alloy as critical avalanches
Authors: Mäkinen Tero , Karppinen Pasi , Ovaska Markus , Laurson Lasse , Alava Mikko J.
Published: October 2020

Portevin–Le Chatelier deformation bands obey predictions of a simple mean-field model of critical avalanche dynamics.
ICOSL
+
plasmacytoid dendritic cells as inducer of graft-versus-host disease, responsive to a dual ICOS/CD28 antagonist
Authors: Adom Djamilatou , Dillon Stacey R. , Yang Jinfeng , Liu Hao , Ramadan Abdulraouf , Kushekhar Kushi , Hund Samantha , Albright Amanda , Kirksey Maykala , Adeniyan Titilayo , Lewis Katherine E. , Evans Lawrence , Wu Rebecca , Levin Steven D. , Mudri Sherri , Yang Jing , Rickel Erika , Seaberg Michelle , Henderson Katherine , Gudgeon Chelsea J. , Wolfson Martin F. , Swanson Ryan M. , Swiderek Kristine M. , Peng Stanford L. , Hippen Keli L. , Blazar Bruce R. , Paczesny Sophie
Published: October 2020

Intestinal CD146
+
CCR5
+
T cells activated by ICOSL
+
plasmacytoid DCs during acute GVHD can be inhibited by a dual ICOS/CD28 antagonist.
Single-cell transcriptomic architecture of endothelial cells
Authors: Giannarelli Chiara
Published: October 2020

Single-cell transcriptomics reveals organ-specific identities and sex-specific differences of endothelial cells.
New Amides Containing Selenium as Potent Leishmanicidal Agents Targeting Trypanothione Reductase
Authors: Etxebeste-Mitxeltorena Mikel , Plano Daniel , Espuelas Socorro , Moreno Esther , Aydillo Carlos , Jiménez-Ruiz Antonio , Soriano Juan Carlos García , Sanmartín Carmen
Published: October 2020

Two new series of 28 selenocyanate and diselenide derivatives containing amide moieties were designed, synthesized, and evaluated for their leishmanicidal activity against
Leishmania infantum
axenic amastigotes, and selectivity was assessed in human THP-1 cells. Eleven compounds exhibited excellent leishmanicidal activity with EC
50
values lower than the reference drug miltefosine (EC
50
= 2.84 μM). In addition, for six of them the selectivity index ranged from 9 to >1,442, greater than both references used.
Expression of the MexXY Aminoglycoside Efflux Pump and Presence of an Aminoglycoside-Modifying Enzyme in Clinical Pseudomonas aeruginosa Isolates Are Highly Correlated
Authors: Seupt Alexander , Schniederjans Monika , Tomasch Jürgen , Häussler Susanne
Published: October 2020

The impact of MexXY efflux pump expression on aminoglycoside resistance in clinical
Pseudomonas aeruginosa
isolates has been debated. In this study, we found that, in general, elevated
mexXY
gene expression levels in clinical
P. aeruginosa
isolates confer to slight increases in aminoglycoside MIC levels; however, those levels rarely lead to clinically relevant resistance phenotypes. The main driver of resistance in the clinical isolates studied here was the acquisition of aminoglycoside-modifying enzymes (AMEs).
Cyclic-di-GMP Regulates the Quorum-Sensing System and Biocontrol Activity of Pseudomonas fluorescens 2P24 through the RsmA and RsmE Proteins
Authors: Liang Fei , Zhang Bo , Yang Qingqing , Zhang Yang , Zheng Dehong , Zhang Li-qun , Yan Qing , Wu Xiaogang
Published: October 2020

In various bacteria, the bacterial second messenger c-di-GMP influences a wide range of cellular processes. However, the function of c-di-GMP on biocontrol traits in the plant-beneficial rhizobacteria remains largely unclear. The present work shows that the QS system and polyketide antibiotic 2,4-DAPG production are regulated by c-di-GMP through RsmA and RsmE proteins in
P. fluorescens
2P24. The diguanylate cyclases (DGCs) C0J56_12915, C0J56_13325, and C0J56_27925 are especially involved in regulating the biocontrol traits of 2P24. Our work also demonstrated a connection between the Gac/Rsm cascade and the c-di-GMP signaling pathway in
P. fluorescens
.
Zika Virus-Like Particles Bearing a Covalent Dimer of Envelope Protein Protect Mice from Lethal Challenge
Authors: De Lorenzo Giuditta , Tandavanitj Rapeepat , Doig Jennifer , Setthapramote Chayanee , Poggianella Monica , Sanchez-Velazquez Ricardo , Scales Hannah E. , Edgar Julia M. , Kohl Alain , Brewer James , Burrone Oscar R. , Patel Arvind H.
Published: October 2020

Infection with Zika virus (ZIKV) leads to the production by the host of antibodies that target the viral surface envelope (E) protein. A subset of these antibodies can inhibit virus infection, thus making E a suitable candidate for the development of vaccine against the virus. However, the anti-ZIKV E antibodies can cross-react with the E protein of the related dengue virus on account of the high level of similarity exhibited by the two viral proteins. Such a scenario may lead to severe dengue disease. Therefore, the design of a ZIKV vaccine requires particular care. Here, we tested two candidate vaccines containing a recombinant form of the ZIKV E protein that is forced in a covalently stable dimeric conformation (cvD). They were generated with an explicit aim to reduce the exposure of the cross-reactive epitopes. One vaccine is composed of a soluble form of the E protein (sE-cvD), the other is a more complex virus-like particle (VLP-cvD). We used the two candidate vaccines to immunize mice and later infected them with ZIKV. The animals produced a high level of inhibitory antibodies and were protected from the infection. The VLP-cvD was the most effective, and we believe it represents a promising ZIKV vaccine candidate.
Metagenomes from Experimental Hydrologic Manipulation of Restored Coastal Plain Wetland Soils (Tyrell County, North Carolina)
Authors: Peralta Ariane L. , Bledsoe Regina B. , Muscarella Mario E. , Huntemann Marcel , Clum Alicia , Foster Brian , Foster Bryce , Roux Simon , Palaniappan Krishnaveni , Varghese Neha , Mukherjee Supratim , Reddy T. B. K. , Daum Chris , Copeland Alex , Chen I-Min A. , Ivanova Natalia N. , Kyrpides Nikos C. , Glavina del Rio Tijana , Eloe-Fadrosh Emiley A.
Published: October 2020

Hydrologic changes modify microbial community structure and ecosystem functions, especially in wetland systems. Here, we present 24 metagenomes from a coastal freshwater wetland experiment in which we manipulated hydrologic conditions and plant presence. These wetland soil metagenomes will deepen our understanding of how hydrology and vegetation influence microbial functional diversity.
Complete Genome Sequences of Methicillin-Resistant Staphylococcus aureus Strains 110900 and 128254, Two Representatives of the CRISPR-Cas-Carrying Sequence Type 630/
spa
Type t4549 Lineage
Authors: Sieber Raphael N. , Overballe-Petersen Søren , Kaya Hülya , Larsen Anders R. , Petersen Andreas
Published: October 2020

Methicillin-resistant
Staphylococcus aureus
(MRSA) sequence type 630 (ST630) and
spa
type t4549 is an emerging lineage in Nordic countries, and some representatives carry the CRISPR-Cas system. Here, the complete genome sequences of two isolates from this lineage are presented, comprising chromosomes of 2,918,239 and 2,877,083 nucleotides, respectively, and a 2,473-nucleotide plasmid carrying
erm
(C).
Metagenomics of Wastewater Influent from Southern California Wastewater Treatment Facilities in the Era of COVID-19
Authors: Rothman Jason A. , Loveless Theresa B. , Griffith Madison L. , Steele Joshua A. , Griffith John F. , Whiteson Katrine L.
Published: October 2020

Sequencing wastewater may be useful for detecting pathogens and assaying microbial water quality. We concentrated, extracted, and sequenced nucleic acids from 17 composite influent wastewater samples spanning seven southern California wastewater treatment facilities in May 2020. Bacteria were the most proportionally abundant taxonomic group present, followed by viruses and archaea.
Draft Genome Sequence of
Streptomyces
sp. Strain BR123, Endowed with Broad-Spectrum Antimicrobial Potential
Authors: Ashraf Neelma , Bechthold Andreas , Anwar Munir Ahmad , Khaliq Shazia
Published: October 2020

The genome of
Streptomyces
sp. strain BR123, isolated from rhizospheric soil that exhibited promising antimicrobial properties, was sequenced and assembled. Here, we report an 8,157,040-bp genome sequence with a G+C content of 72.63%. This genome sequence enlightens the genes responsible for the production of secondary metabolites and antimicrobial compounds by this strain.
Chronology of terraces in the Rio Grande rift, Socorro basin, New Mexico: Implications for terrace formation
Authors: Sion Brad D. , Phillips Fred M. , Axen Gary J. , Harrison J. Bruce J. , Love David W. , Zimmerer Matthew J.
Published: October 2020

The Rio Grande rift hosts a remarkable record of Quaternary river incision preserved in an alluvial terrace sequence that has been studied for more than a century. However, our understanding of Rio Grande incision history in central New Mexico since the end of basin filling ca. 0.78 Ma remains hampered by poor age control. Robust correlations among Rio Grande terrace sequences in central and southern New Mexico are lacking, making it difficult to address important process-related questions about terrace formation in continental-scale river systems. We present new age controls using a combination of 40Ar/39Ar, 36Cl surface-exposure, and 14C dating techniques from alluvial deposits in the central New Mexico Socorro area to document the late Quaternary incision history of the Rio Grande. These new age controls (1) provide constraints to establish a firm foundation for Socorro basin terrace stratigraphy, (2) allow terrace correlations within the rift basin, and (3) enable testing of alternative models of terrace formation. We identified and mapped a high geomorphic surface interpreted to represent the end of basin filling in the Socorro area and five distinct, post–Santa Fe Group (ca. 0.78 Ma) alloformations and associated geomorphic surfaces using photogrammetric methods, soil characterization, and stratigraphic descriptions. Terrace deposits exhibit tread heights up to 70 m above the valley floor and are 5 to >30 m thick. Their fills generally have pebble-to-cobble bases overlain by fine-to-pebbly sand and local thin silt and clay tops. Alluvial-fan terraces and associated geomorphic surfaces grade to former valley levels defined by axial terrace treads. Carbon-14 ages from detrital charcoal above and below a buried tributary terrace tread show that the most recent aggradation event persisted until ca. 3 ka during the transition from glacial to modern climate conditions. Drill-log data show widespread valley fill ∼30 m thick that began aggrading after glacial retreat in northern New Mexico and southern Colorado (ca. 14 ka). Aggradation during this transition was likely due to hillslope destabilization, increased sediment yield, decreased runoff, and reduced stream competence. Chlorine-36 ages imply similar controls on earlier terraces that have surface ages of ca. 27–29, 64–70, and 135 ka, and suggest net incision during glacial expansions when increased runoff favored down-cutting and bedload mobilization. Our terrace chronology supports existing climate-response models of arid environments and links tributary responses to the axial Rio Grande system throughout the central Rio Grande rift. The terrace chronology also reflects a transition from modest (60 m/m.y.) to rapid (300 m/m.y.) incision between 610 and 135 ka, similar to patterns observed throughout the Rio Grande rift and the western United States in general.
Extraformational sediment recycling on Mars
Authors: Edgett Kenneth S. , Banham Steven G. , Bennett Kristen A. , Edgar Lauren A. , Edwards Christopher S. , Fairén Alberto G. , Fedo Christopher M. , Fey Deirdra M. , Garvin James B. , Grotzinger John P. , Gupta Sanjeev , Henderson Marie J. , House Christopher H. , Mangold Nicolas , McLennan Scott M. , Newsom Horton E. , Rowland Scott K. , Siebach Kirsten L. , Thompson Lucy , VanBommel Scott J. , Wiens Roger C. , Williams Rebecca M.E. , Yingst R. Aileen
Published: October 2020

Extraformational sediment recycling (old sedimentary rock to new sedimentary rock) is a fundamental aspect of Earth’s geological record; tectonism exposes sedimentary rock, whereupon it is weathered and eroded to form new sediment that later becomes lithified. On Mars, tectonism has been minor, but two decades of orbiter instrument–based studies show that some sedimentary rocks previously buried to depths of kilometers have been exposed, by erosion, at the surface. Four locations in Gale crater, explored using the National Aeronautics and Space Administration’s Curiosity rover, exhibit sedimentary lithoclasts in sedimentary rock: At Marias Pass, they are mudstone fragments in sandstone derived from strata below an erosional unconformity; at Bimbe, they are pebble-sized sandstone and, possibly, laminated, intraclast-bearing, chemical (calcium sulfate) sediment fragments in conglomerates; at Cooperstown, they are pebble-sized fragments of sandstone within coarse sandstone; at Dingo Gap, they are cobble-sized, stratified sandstone fragments in conglomerate derived from an immediately underlying sandstone. Mars orbiter images show lithified sediment fans at the termini of canyons that incise sedimentary rock in Gale crater; these, too, consist of recycled, extraformational sediment. The recycled sediments in Gale crater are compositionally immature, indicating the dominance of physical weathering processes during the second known cycle. The observations at Marias Pass indicate that sediment eroded and removed from craters such as Gale crater during the Martian Hesperian Period could have been recycled to form new rock elsewhere. Our results permit prediction that lithified deltaic sediments at the Perseverance (landing in 2021) and Rosalind Franklin (landing in 2023) rover field sites could contain extraformational recycled sediment.
GMDE: Extracting quantitative information from geologic maps
Authors: Allmendinger Richard W.
Published: October 2020

GMDE is a program, available on the desktop for Apple Macintosh, Microsoft Windows, and Linux platforms and in a mobile version for iOS, that enables geologists to extract quantitative structural information from geologic maps and satellite images. The program facilitates the digitizing of strikes and dips or calculating them from three-point problems, calculation of stratigraphic map thickness, determination of piercing points on faults, and the construction of down-plunge projections and vertical cross sections with projected apparent dips, contacts, and cylindrical folds. The program also enables the automatic plotting of planar contacts across topography based on orientation calculated from three clicked points, which can be carried out in the field for immediate hypothesis testing. Error propagation is built into many of the calculations. Maps and satellite images require no projection or datum information, just four points with known latitude and longitude information. Alternatively, the user can enter the map or image in MBTiles format. Users can easily extract X-Y-Z data for any clicked or calculated point or polygon, enabling them to make their own calculations.
Reduced PICU respiratory admissions during COVID-19
Authors: Vásquez-Hoyos Pablo , Diaz-Rubio Franco , Monteverde-Fernandez Nicolas , Jaramillo-Bustamante Juan Camilo , Carvajal Cristobal , Serra Alberto , Karsies Todd , Rotta Alexandre Tellechea , González-Dambrauskas Sebastián
Published: October 2020

Background

The COVID-19 pandemic reached the Southern Hemisphere in the autumn of 2020, thus coinciding with its expected annual viral respiratory season. The potential impact of national strategies aimed at mitigating COVID-19 during the pandemic on the incidence of other critical viral lower respiratory tract infections (LRTIs) in children is unknown.

Methods

We analysed admission data for LRTIs from 22 paediatric intensive care units (PICUs) in four countries, part of a large international Latin American registry of children with acute respiratory failure (Red Colaborativa Pediátrica de Latinoamérica [LARed Network]).

Results

Between January and August, there were 83% fewer PICU admissions for LRTIs in 2020 compared to the 2018/2019 average over the same period. Similar decreases were noted for PICU admissions due to respiratory syncytial virus and influenza (92% and 78%, respectively).

Conclusion

We observed a striking reduction in PICU admissions due to viral LRTIs over winter, during the COVID-19 pandemic in South America.
Prediabetes influences the structure of the macula: thinning of the macula in the Northern Finland Birth Cohort
Authors: Huru JenniMaria , Leiviskä Ilmari , Saarela Ville , Liinamaa M Johanna
Published: October 2020

Background/Aim

The aim of this study was to evaluate the effect of prediabetes and diabetes on macular thickness and retinal vascular calibres in our population-based cohort (Northern Finland Birth Cohort).

Methods

The population of 2005 individuals was divided into diabetes (n=57), prediabetes (n=1638) and normal glucose metabolism (NGM) groups (n=310). Total thickness of the macula was measured using Cirrus HD-OCT 4000. Central retinal arteriolar equivalent (CRAE) and central retinal venular equivalent (CRVE) calibres were measured from the fundus images. The diagnosis of diabetes and prediabetes was made according to WHO 2006 diagnostic standards.

Results

Significant macular thinning was observed in subjects with prediabetes (−2.69 μm (95% CI −4.29 to −1.09), p<0.05 and −0.10 mm3 (95% CI −0.16 to −0.04), p<0.05 for macular cube average thickness and cube volume, respectively) and it was greatest in the pericentral area. Macular cube average thickness and macular cube volume decreased significantly by worsening glucose metabolism. Furthermore, CRAE was decreased by increases in 2-hour post-load glucose, glucose area under the curve and increase in Matsuda index (p<0.001, 0.019 and <0.001, respectively). In mediation analysis, macular thickness had significant average causal mediation effect (ACME) on CRVE and CRAE in subjects with prediabetes.

Conclusion

We detected significant thinning of the macula in subjects with prediabetes. The diameters of retinal arteries were decreased by impaired glucose metabolism. This study provides a new perspective since it revealed that the early and subtle changes caused by prediabetes as macular thinning had significant ACME on retinal vessels, therefore supporting the neurodegenerative theory of diabetes-induced changes in the retina.
Health-related quality of life and its determinants in patients with chronic low back pain at a tertiary hospital in Cameroon: a cross-sectional study
Authors: Aminde Jeannine Anyingu , Aminde Leopold Ndemnge , Bija Marie Doualla , Lekpa Fernando Kemta , Kwedi Felix Mangan , Yenshu Emmanuel Vubo , Chichom Alain Mefire
Published: October 2020

Objective

To evaluate health-related quality of life (HRQoL) and its determinants in chronic low back pain (CLBP) patients in Cameroon.

Design

Observational cross-sectional study.

Setting

Tertiary hospital.

Participants

There were 150 eligible adults with low back pain of at least 12 weeks who provided informed consent. Of these, 136 with complete questionnaires were analysed.

Outcomes

HRQoL was measured using the WHO Quality of Life questionnaire (WHOQOL-BREF). Outcome measures included its four domain (physical health, psychological, social relationships and environmental) scores and two independent scores for overall quality of life (OQOL) and general health satisfaction (GH).

Results

Participants had a median age of 52 years, and median pain duration of 33 (IQR: 69) months. The median OQOL score was 50 (IQR: 25). After multivariable adjustment, tertiary education (β=11.43, 95% CI 3.12 to 19.75), age (β=0.49, 95% CI 0.12 to 0.87) and being a student (β=23.07, 95% CI 0.28 to 45.86) contributed to better OQOL. Age (β=0.57, 95% CI 0.10 to 1.04) and physical-type employment (β=−14.57, 95% CI −25.83 to −3.31) affected GH. Smoking (β=−20.49, 95% CI −35.49 to −5.48) and radiological anomalies (β=−7.57, 95% CI −14.64 to −0.49) affected the physical health domain, while disability (β=−0.67, 95% CI −1.14 to −0.20) and duration of pain (β=−0.13, 95% CI −0.20 to −0.05) affected the psychological domain. Income (β=14.94, 95% CI 4.06 to 25.81) affected the social domain, while education (β=9.96, 95% CI 1.41 to 18.50) and disability (β=−0.75, 95% CI −1.26 to −0.24) affected the environmental domain.

Conclusions

Our findings suggest that CLBP affects HRQoL and multiple socioeconomic and clinical factors influence its impact on different domains of HRQoL. Multipronged management programmes, especially those that reduce disability, could improve HRQoL in patients with CLBP.
Factors associated with non-urgent visits to the emergency department in a tertiary care centre, western Saudi Arabia: cross-sectional study
Authors: Al-Otmy Saja S , Abduljabbar Abeer Z , Al-Raddadi Rajaa M , Farahat Fayssal
Published: October 2020

Objectives

To explore magnitude and factors associated with non-urgent visits to the emergency department (ED) in a tertiary care centre, western Saudi Arabia.

Design

A cross-sectional study.

Setting

ED of a tertiary care hospital in western Saudi Arabia.

Participants

400 patients, both men and women.

Interventions

An interview-based questionnaire was administered to a consecutive sample of patients who visited the ED during morning shifts, where primary healthcare centres (PHCs) and outpatient clinics were available.

Primary outcome measure

ED visits classified as non-urgent versus urgent (excluding life-threatening conditions) based on the Canadian Triage and Acuity Scale (CTAS). Levels IV and V were classified as non-urgent.

Results

Majority of the cases were adult (97.3%) and half of them were women (54.8%). Non-urgent visits represented 78.5% among non-life-threatening cases. One-third of the patients (33.8%) had three visits or more to the ED during the past year. Main reasons for visiting the ED were perception that the condition was urgent (42.0%), easy access (25.5%) and limited resources and services at the PHCs (17.8%). Patients 40–50 years old were more likely to have non-urgent visits (OR=3.21, 95% CI 1.15 to 8.98). However, likelihood of non-urgent visits was significantly lower among patients with cancer (OR=0.37, 95% CI 0.19 to 0.72) and cardiovascular disease (OR=0.43, 95% CI 0.23 to 0.83), and those who live near the hospital (OR=0.49, 95% CI 0.28 to 0.88).

Conclusions

The current study reported overuse of the ED. Enhancement of the primary care services, in concordance with community awareness, is an important component to reduce burden due to non-urgent use of the ED.
Protocol for a scoping review to identify and map intervention components of existing school-based interventions for the promotion of physical activity and cardiorespiratory fitness among school children aged 6–10 years old
Authors: Brandes Berit , Busse Heide , Sell Louisa , Christianson Lara , Brandes Mirko
Published: October 2020

Introduction

Physical inactivity is known as a leading cause of mortality and tracks from childhood to adulthood. Many types of school-based single-component and multicomponent interventions to promote physical activity (PA) have been undertaken and evaluated, with mixed findings overall. Enlarging the intervention areas beyond the school setting is a promising approach. WHO’s Health Promoting School (WHO HPS) framework is a holistic, setting-based approach where health is promoted through the whole school environment with links to other settings such as the home environment and wider community. In this paper, we outline our scoping review protocol to systematically review the published literature from the last 10 years to identify existing school-based interventions to promote PA and cardiorespiratory fitness among children aged 6–10 years old and to map intervention components according to the features of this framework.

Methods and analysis

Arksey and O’Malley’s scoping review methodology framework will guide the conduct of this review. We will search Medline, PsycINFO, Cumulative Index to Nursing and Allied Health Literature, Sports Medicine & Education Index, Education Resources Information Centre and CENTRAL and hand search the reference lists of key studies to identify studies appropriate for inclusion. Any empirical study that evaluated the effectiveness of a school-based intervention promoting PA and/or cardiorespiratory fitness in children aged 6–10 years old will be included. Two reviewers will independently screen all abstracts and full texts for inclusion. One reviewer will extract general information, study characteristics and intervention contents to classify them according to the features of the WHO HPS framework. Results will be synthesised narratively.

Ethics and dissemination

Findings will be disseminated in conference presentations and peer-reviewed publications. A condensed version of the results will be made available for the public. Stakeholder meetings will be arranged to discuss and disseminate the findings.
INtravenous Contrast computed tomography versus native computed tomography in patients with acute Abdomen and impaired Renal functiOn (INCARO): a multicentre, open-label, randomised controlled trial - study protocol
Authors: Räty Panu , Mentula Panu , Lampela Hanna , Nykänen Taina , Helanterä Ilkka , Haapio Mikko , Lehtimäki Tiina , Skrifvars Markus B , Vaara Suvi T , Leppäniemi Ari , Sallinen Ville
Published: October 2020

Introduction

CT is the primary imaging option for acute abdominal pain in adults. Intravenous (IV) contrast media use improves CT quality but may cause post-contrast acute kidney injury (PC-AKI). Retrospective studies show no association between reduced baseline renal function and IV contrast CT, but, to our knowledge, no data from randomised controlled trials exist.

Methods and analysis

The INCARO (INtravenous Contrast computed tomography versus native computed tomography in patients with acute Abdomen and impaired Renal functiOn) trial is a multicentre, open-label, parallel group, superiority, individually randomised controlled trial comparing IV contrast-enhanced CT to native CT in patients requiring emergency abdominal or body CT with impaired renal function defined as an estimated glomerular filtration rate (eGFR) of 15 to 45 mL/min/1.73 m2. The primary outcome is a composite of all-cause mortality or renal replacement therapy (RRT) within 90 days from CT. Secondary outcomes are AKI measured by KDIGO (The Kidney Disease: Improving Global Outcomes) criteria within 72 hours from CT, organ dysfunction defined by mSOFA (modified Sequential Organ Failure Assessment) criteria after 48 hours from CT, alive and hospital-free days within 90 days after CT, and time from imaging to definitive treatment. All-cause mortality, need for RRT and renal transplant in long-term follow-up are also measured. The calculated sample size is 994 patients. Patient recruitment is estimated to take 3 years.

Ethics and dissemination

The Ethics Committee of Helsinki University Hospital approved the study. The findings will be disseminated in peer-reviewed academic journals.

Trial registration number

NCT04196244
Assessing the hospital volume-outcome relationship in surgery: a scoping review protocol
Authors: Levaillant Mathieu , Marcilly Romaric , Levaillant Lucie , Vallet Benoît , Lamer Antoine
Published: October 2020

Introduction

Even if a positive volume-outcome correlation in surgery is mostly admitted in many surgical fields, the various ways to assess this relationship make it difficult for researchers and policymakers to use it. Our aim is therefore to provide an overview of the way hospital volume-outcome relationship was assessed. Through this overview, our goal is to identify potential gaps in the assessment of this relationship, to help researchers who want to pursue work in this field and, ultimately, to help policy makers interpret such analyses.

Methods and analysis

This review will be conducted using the six stages of the scoping review method: identifying the research question, searching for relevant studies, selecting studies, data extraction, collating, summarising and reporting the results and concluding. This review will address all the key questions used to assess the volume-outcome relationship in surgery.

Primary research papers investigating the hospital volume-outcome relationship from 2009 will be included. Studies only looking at surgeons’ volume-outcome relationship or studies were the volume variable is not individualisable will be excluded.

Both MEDLINE and Scopus will be searched along with grey literature. Two researchers will perform all the stages of the review: screen the titles and abstracts, review the full text of selected articles to determine final inclusions and extract the data. The results will be summarised quantitatively using numerical counts.

Ethical considerations and dissemination

Reviews of published articles are considered secondary analysis and do not need ethical approval. The findings will be disseminated through multiple channels like conferences and peer-reviewed journals.
Association of tea consumption and the risk of gastric cancer in Japanese adults: the Japan Collaborative Cohort Study
Authors: Sheerah Haytham , Keyang Liu , Eshak Ehab Salah , Cui Renzhe , Shirai Kokoro , Muraki Isao , Iso Hiroyasu , Tamakoshi Akiko
Published: October 2020

Objective

To examine the possible relationship between tea consumption and risk of gastric cancer (GC) among Japanese men and women included in a large Japanese population-based study titled the Japan Collaborative Cohort (JACC) Study.

Design

Prospective cohort study.

Setting

A population-based cohort included subjects who were recruited from 24 areas of JACC Study, in which data regarding the incidence of cancer were available.

Participants

63 848 participants (26 025 men and 37 823 women), aged 40–79, were included in the analyses and underwent follow-up (median 13.3 years) prospectively in research on cancer incidence.

Primary and secondary outcome measures

The primary outcome variable was the risk of GC according to the frequency intakes of total tea, green tea, black tea and oolong tea. The adjusted HRs for the risk of GC associated with tea consumption were calculated using the Cox proportional hazards model.

Results

1494 cases of GC were detected (960 men and 534 women) during the follow-up period. The multivariable-adjusted HRs for the risk of GC in the highest versus lowest quintiles of total tea intake were 1.05 (0.83–1.33); p trend=0.50 in men, and 0.82 (0.60–1.12); p trend=0.45 in women. There was no association found between the consumption of green tea, black tea or oolong tea with the risk for GC in either gender.

Conclusions

In this large community-based prospective cohort study, tea consumption was not associated with the risk of GC in either gender.
Cohort profile: the eLIXIR Partnership—a maternity–child data linkage for life course research in South London, UK
Authors: Carson Lauren E , Azmi Borscha , Jewell Amelia , Taylor Clare L , Flynn Angela , Gill Carolyn , Broadbent Matthew , Howard Louise , Stewart Robert , Poston Lucilla
Published: October 2020

Purpose

Linked maternity, neonatal and maternal mental health records were created to support research into the early life origins of physical and mental health, in mothers and children. The Early Life Cross Linkage in Research (eLIXIR) Partnership was developed in 2018, generating a repository of real-time, pseudonymised, structured data derived from the electronic health record systems of two acute and one Mental Health Care National Health Service (NHS) Provider in South London. We present early descriptive data for the linkage database and the robust data security and governance structures, and describe the intended expansion of the database from its original development. Additionally, we report details of the accompanying eLIXIR Research Tissue Bank of maternal and neonatal blood samples.

Participants

Descriptive data were generated from the eLIXIR database from 1 October 2018 to 30 June 2019. Over 17 000 electronic patient records were included.

Findings to date

10 207 women accessed antenatal care from the 2 NHS maternity services, with 8405 deliveries (8772 infants). This diverse, inner-city maternity service population was born in over 170 countries with an ethnic profile of 46.1% white, 19.1% black, 7.0% Asian, 4.1% mixed and 4.1% other. Of the 10 207 women, 11.6% had a clinical record in mental health services with 3.0% being treated during their pregnancy. This first data extract included 947 infants treated in the neonatal intensive care unit, of whom 19.1% were postnatal transfers from external healthcare providers.

Future plans

Electronic health records provide potentially transformative information for life course research, integrating physical and mental health disorders and outcomes in routine clinical care. The eLIXIR database will grow by ~14 000 new maternity cases annually, in addition to providing child follow-up data. Additional datasets will supplement the current linkage from other local and national resources, including primary care and hospital inpatient data for mothers and their children.
Appropriate CT cervical spine utilisation in the emergency department
Authors: Baker Mark , Jaeger Cassie , Hafley Carol , Waymack James
Published: October 2020

Introduction

Over 40 000 CT scans are performed in our emergency department (ED) annually and utilisation is over 80% capacity. Improving medical appropriateness of CT scans may reduce total number of scans, time, cost and radiation exposure.

Methods

Lean Six Sigma methodology was used to improve the process. A National Emergency X-Radiography Utilisation Study (NEXUS)-based PowerForm was implemented in the electronic health record and providers were educated on the criteria.

Results

The rate of potentially medically inappropriate CT C-spine scans decreased from 45% (19/42) to 22% (90/403) (two-proportion test, p=0.002). After the intervention, there was no longer a difference between midlevel providers and physicians in the rate of medically inappropriate orders (19% vs 22%) (two-proportion test, p=0.850) compared with that before the intervention (56% vs 31%) (two-proportion test, p<0.01). Overall rates of CT C-spine scans ordered decreased from 69.3 to 62.6/week (t-test, p=0.019).

Conclusion

A validated clinical decision-making tool implemented into the medical record can improve quality of care. This study lays a foundation for other imaging studies with validated support tools with similar potential improvements.
Evaluation of a novel strategy to implement exercise evidence into clinical practice in breast cancer care: protocol for the NEXT-BRCA randomised controlled trial
Authors: Smith-Turchyn Jenna , Mukherjee Som , Richardson Julie , Ball Elizabeth , Bordeleau Louise , Neil-Sztramko Sarah , Levine Oren , Thabane Lehana , Sathiyapalan Arani , Sabiston Catherine
Published: October 2020

Introduction

The burden of breast cancer in Canada is steadily growing. More women are surviving breast cancer, yet, survivors live with side effects for years after treatments have ended. The benefits of exercise for women with breast cancer are well established and include improvement in treatment-related physical and emotional side effects. Despite these benefits, few survivors meet exercise guidelines. Exercise programmes are needed within the cancer institution in Canada to bridge the current knowledge to practice gap. The purpose of this study is to test the effects of a novel implementation strategy that includes institution-based exercise plus self-management (SM) or SM alone versus usual care in improving exercise level, quality of life, aerobic capacity, muscle strength and use of healthcare services over 12 months for women with breast cancer receiving chemotherapy.

Methods and analysis

Participants:Women with stages I–III breast cancer undergoing chemotherapy.Intervention:Group 1: institution-based exercise and SM (8 exercise sessions plus 8 SM modules); Group 2: SM alone; Group 3: usual care.Outcomes:The primary effectiveness outcome is minutes per week of moderate to vigorous physical activity. Secondary outcomes include quality of life, aerobic capacity, muscle strength, and use of healthcare services.Randomisation: Participants will be randomised (1:1:1) to one of the three groups by a blinded statistician and will be stratified based on age of participant (<40, 40–60, and >60 years).Statistical analysis: Outcomes will be measured at baseline, post-intervention, 6-month and 12-month follow-up using an analysis of covariance to test changes between groups over time adjusted for age.

Ethics and Dissemination

This study addresses a long-standing need to help women with breast cancer undergoing chemotherapybecome and staymore active by implementing novel rehabilitation strategies into real-world practice. This is vital in order for this population to minimise the lingering side effects of treatment, improve function and quality of life and prevent cancer recurrence.

Trial registration number

The study protocol (v1: July 2020) has been registered on ClinicalTrials.gov (NCT04109274).
Utilisation of artificial intelligence for the development of an EUS-convolutional neural network model trained to enhance the diagnosis of autoimmune pancreatitis
Authors: Marya Neil B , Powers Patrick D , Chari Suresh T , Gleeson Ferga C , Leggett Cadman L , Abu Dayyeh Barham K , Chandrasekhara Vinay , Iyer Prasad G , Majumder Shounak , Pearson Randall K , Petersen Bret T , Rajan Elizabeth , Sawas Tarek , Storm Andrew C , Vege Santhi S , Chen Shigao , Long Zaiyang , Hough David M , Mara Kristin , Levy Michael J
Published: October 2020

Objective

The diagnosis of autoimmune pancreatitis (AIP) is challenging. Sonographic and cross-sectional imaging findings of AIP closely mimic pancreatic ductal adenocarcinoma (PDAC) and techniques for tissue sampling of AIP are suboptimal. These limitations often result in delayed or failed diagnosis, which negatively impact patient management and outcomes. This study aimed to create an endoscopic ultrasound (EUS)-based convolutional neural network (CNN) model trained to differentiate AIP from PDAC, chronic pancreatitis (CP) and normal pancreas (NP), with sufficient performance to analyse EUS video in real time.

Design

A database of still image and video data obtained from EUS examinations of cases of AIP, PDAC, CP and NP was used to develop a CNN. Occlusion heatmap analysis was used to identify sonographic features the CNN valued when differentiating AIP from PDAC.

Results

From 583 patients (146 AIP, 292 PDAC, 72 CP and 73 NP), a total of 1 174 461 unique EUS images were extracted. For video data, the CNN processed 955 EUS frames per second and was: 99% sensitive, 98% specific for distinguishing AIP from NP; 94% sensitive, 71% specific for distinguishing AIP from CP; 90% sensitive, 93% specific for distinguishing AIP from PDAC; and 90% sensitive, 85% specific for distinguishing AIP from all studied conditions (ie, PDAC, CP and NP).

Conclusion

The developed EUS-CNN model accurately differentiated AIP from PDAC and benign pancreatic conditions, thereby offering the capability of earlier and more accurate diagnosis. Use of this model offers the potential for more timely and appropriate patient care and improved outcome.
More expansive horizons: a review of endovascular therapy for patients with low NIHSS scores
Authors: McCarthy David J , Tonetti Daniel A , Stone Jeremy , Starke Robert M , Narayanan Sandra , Lang Michael J , Jadhav Ashutosh P , Gross Bradley A
Published: October 2020

While the landmark 2015 stroke trials demonstrated that endovascular therapy (EVT) was superior to medical management for the treatment of acute ischemic stroke due to large vessel occlusion, the efficacy of EVT for patients presenting with a low NIHSS score remains undetermined. We conducted a review of the EVT low National Institutes of Health Stroke Scale (NIHSS) stroke literature, identifying 24 quantitative and six qualitative publications. Details of study designs and outcome were extracted and critically discussed.

All identified qualitative studies were retrospective. There was significant study design heterogeneity, with 18 unique study designs between the 24 identified quantitative manuscripts. Study investigations included low NIHSS EVT feasibility (n=6), EVT versus best medical management (BMM; n=10), EVT versus intravenous therapy (IVT, n=3), and low NIHSS score versus high NIHSS score (n=3). From single-arm EVT feasibility studies, the reported ranges of modified Thrombolysis in Cerebral Infarction and symptomatic intracranial hemorrhage were 78–97% and 0–10%, respectively. The EVT versus BMM literature had heterogeneous results with 40% reporting benefit with EVT and 60% reporting neutral findings. None of the studies comparing EVT with IVT reported a difference between the two revascularization therapies. The four identified meta-analyses had incongruent inclusion criteria and conflicting results. Two randomized trials are currently investigating EVT in patients with a low NIHSS score. Selected meta-analyses do suggest a potential benefit of EVT over BMM; however, current and future randomized clinical trials will better elucidate the efficacy of EVT in this patient population.
Changes in selected haematological parameters associated with JAK1/JAK2 inhibition observed in patients with rheumatoid arthritis treated with baricitinib
Authors: Kay Jonathan , Harigai Masayoshi , Rancourt Josh , Dickson Christina , Melby Thomas , Issa Maher , de la Torre Inmaculada , Isaka Yoshitaka , Cardoso Anabela , Saifan Chadi , Keystone Edward C , van Vollenhoven Ronald F , Giles Jon T , Huizinga Tom WJ , Kremer Joel M
Published: October 2020

Objective

To characterise changes in selected haematological parameters following once-daily oral baricitinib dosing.

Methods

Data were pooled from eight randomised clinical trials (four phase 3, three phase 2, one phase 1b) and one long-term extension. Changes in haematological parameters were evaluated up to 128 weeks (N=2387); overall safety of baricitinib was assessed up to 6 years (N=3492).

Results

Mean absolute neutrophil counts decreased (−1.36×109/L) within 1 month, followed by stabilisation within the normal reference range through week 128. The incidence of serious infections was not elevated in patients with neutropenia during the 24-week placebo-controlled period. Mean lymphocyte counts increased (+0.30×109/L) within 1 month, then decreased to baseline (weeks 12–24). Mean platelet counts increased at week 2 (+51×109/L), then decreased towards baseline. Overall, mean haemoglobin concentrations decreased (−0.12 mmol/L), then returned to baseline; however, reduced baseline haemoglobin concentrations observed in the highest baseline high-sensitivity C reactive protein quartile increased over time. Permanent drug discontinuation occurred due to laboratory abnormalities related to neutrophil count in 8 (0.2%), lymphocyte counts in 6 (0.2%), platelet counts in 8 (0.2%), and haemoglobin levels in 16 (0.5%) of all baricitinib-treated patients (N=3492 with 7993 total person-years of exposure).

Conclusions

Moderate decreases in neutrophils were seen during baricitinib treatment; however, serious infection was uncommon in patients with neutropenia. Transient increases were observed in lymphocytes and platelets, which returned to baseline over time. Changes in haemoglobin concentration were generally small. Haematological abnormalities seldom led to drug discontinuation.
Experimental study of an innovative driven and grouted soil nail (x-Nail)
Authors: Bhuiyan Mohammad Zahidul I. , Wang Shanyong , Carter John P.
Published: October 2020

This paper describes an experimental investigation of a newly developed driven and grouted soil nail (x-Nail), which combines the capabilities of a purely frictional driven nail and a compaction-grouted nail. The innovative design allows the x-Nail to be driven into the ground with a latex balloon attached that is subsequently used for compaction grouting. A grout bulb is thus formed at the driven end of the nail to improve its pull-out resistance. For compaction grouting, a special type of additive−mixed cement grout was used in this investigation because of its zero bleeding and high bond strength. A series of pullout model tests was conducted to examine the performance of the x-Nail compared to a purely frictional soil nail. It was found that more than 90% of the pullout force of the x-Nail was resisted by the expanded grout bulb and the end bearing resistance of the grout bulb increased with the increment of the injected grout volumes. The experimental results revealed that the pullout force of the x-Nail increased approximately 1800%, 1550%, 1200%, and 900% compared to the purely frictional soil nail for the injected grout volumes of about 350, 270, 220, and 170 mL, respectively.
Proteomics of host–bacterial interactions: new insights from dual perspectives
Authors: Sukumaran Arjun , Woroszchuk Elizabeth , Ross Taylor , Geddes-McAlister Jennifer
Published: October 2020

Mass-spectrometry (MS)-based proteomics is a powerful and robust platform for studying the interactions between biological systems during health and disease. Bacterial infections represent a significant threat to global health and drive the pursuit of novel therapeutic strategies to combat emerging and resistant pathogens. During infection, the interplay between a host and pathogen determines the ability of the microbe to survive in a hostile environment and promotes an immune response by the host as a protective measure. It is the protein-level changes from either biological system that define the outcome of infection, and MS-based proteomics provides a rapid and effective platform to identify such changes. In particular, proteomics detects alterations in protein abundance, quantifies protein secretion and (or) release, measures an array of post-translational modifications that influence signaling cascades, and profiles protein–protein interactions through protein complex and (or) network formation. Such information provides new insight into the role of known and novel bacterial effectors, as well as the outcome of host cell activation. In this Review, we highlight the diverse applications of MS-based proteomics in profiling the relationship between bacterial pathogens and the host. Our work identifies a plethora of strategies for exploring mechanisms of infection from dual perspectives (i.e., host and pathogen), and we suggest opportunities to extrapolate the current knowledgebase to other biological systems for applications in therapeutic discovery.