bluuebunny/crossref_metadata_2025 huggingface dataset:
Cerebrovascular disease in patients with COVID-19: neuroimaging, histological and clinical description
Authors: Hernández-Fernández Francisco , Sandoval Valencia Hernán , Barbella-Aponte Rosa Angélica , Collado-Jiménez Rosa , Ayo-Martín Óscar , Barrena Cristina , Molina-Nuevo Juan David , García-García Jorge , Lozano-Setién Elena , Alcahut-Rodriguez Cristian , Martínez-Martín Álvaro , Sánchez-López Antonio , Segura Tomás
Published: July 2020

Since the appearance of the first case of coronavirus disease 2019 (COVID-19) a pandemic has emerged affecting millions of individuals worldwide. Although the main clinical manifestations are respiratory, an increase in neurological conditions, specifically acute cerebrovascular disease, has been detected. We present cerebrovascular disease case incidence in hospitalized patients with SARS-CoV-2 infection. Patients were confirmed by microbiological/serological testing, or on chest CT semiology. Available data on co-morbidity, laboratory parameters, treatment administered, neuroimaging, neuropathological studies and clinical evolution during hospitalization, measured by the modified Rankin scale, were analysed. A bivariate study was also designed to identify differences between ischaemic and haemorrhagic subtypes. A statistical model of binary logistic regression and sensitivity analysis was designed to study the influence of independent variables over prognosis. In our centre, there were 1683 admissions of patients with COVID-19 over 50 days, of which 23 (1.4%) developed cerebrovascular disease. Within this group of patients, cerebral and chest CT scans were performed in all cases, and MRI in six (26.1%). Histological samples were obtained in 6/23 cases (two brain biopsies, and four arterial thrombi). Seventeen patients were classified as cerebral ischaemia (73.9%, with two arterial dissections), five as intracerebral haemorrhage (21.7%), and one leukoencephalopathy of posterior reversible encephalopathy type. Haemorrhagic patients had higher ferritin levels at the time of stroke (1554.3 versus 519.2, P = 0.004). Ischaemic strokes were unexpectedly frequent in the vertebrobasilar territory (6/17, 35.3%). In the haemorrhagic group, a characteristic radiological pattern was identified showing subarachnoid haemorrhage, parieto-occipital leukoencephalopathy, microbleeds and single or multiple focal haematomas. Brain biopsies performed showed signs of thrombotic microangiopathy and endothelial injury, with no evidence of vasculitis or necrotizing encephalitis. The functional prognosis during the hospital period was unfavourable in 73.9% (17/23 modified Rankin scale 4–6), and age was the main predictive variable (odds ratio = 1.5; 95% confidence interval 1.012–2.225; P = 0.043). Our series shows cerebrovascular disease incidence of 1.4% in patients with COVID-19 with high morbidity and mortality. We describe pathological and radiological data consistent with thrombotic microangiopathy caused by endotheliopathy with a haemorrhagic predisposition.
Integration of FDG-PET/CT in the Diagnostic Workup for Staphylococcus aureus Bacteremia: A Prospective Interventional Matched-cohort Study
Authors: Ghanem-Zoubi Nesrin , Kagna Olga , Abu-Elhija Jawad , Mustafa-Hellou Mona , Qasum Majd , Keidar Zohar , Paul Mical
Published: July 2020

Background

Staphylococcus aureus bacteremia (SAB) is uniquely characterized by focal pyogenic complications that might not be apparent clinically. We investigated the benefit of adding fluorodeoxyglucose–positron emission tomography/computed tomography (FDG-PET/CT) in the workup of patients with SAB.

Methods

In a matched-cohort study patients with SAB (intervention group) were prospectively recruited to undergo FDG-PET/CT 7–14 days after diagnosis. Treatment was directed by FDG-PET/CT findings. Clinical outcomes were compared with a control group of patients with SAB who had not undergone FDG-PET/CT, matched by age, Charlson score, methicillin susceptibility, and survival duration to FDG-PET/CT. The primary outcome was 90-day mortality. Residual confounding was controlled through regression analyses.

Results

During the study period 149 patients with 151 separate episodes of SAB underwent FDG-PET/CT and were compared with 150 matched patients with 151 SAB episodes. Patients in the intervention group acquired infections more frequently in the community and had less frequently solid malignancies and more frequently high-risk SAB. Ninety-day mortality in the intervention group was significantly lower than in the control group (21/151 [13.9%] vs 43/151 [28.5%], P = .002). The difference remained significant in a subgroup analysis of patients with community-onset infections without malignancy and among patients with low-risk SAB. Controlling for other risk factors for mortality, FDG-PET/CT performance among all patients was independently associated with lower mortality (OR, .39; 95% CI, .18–.84). Patients in the intervention group had longer duration of treatment and more focus control procedures performed compared with the control group.

Conclusions

FDG-PET/CT in patients with SAB seems to improve survival through guidance of treatment duration and co-interventions.
Investigator-initiated Randomized Controlled Trials in Infectious Diseases: Better Value for Money for Registration Trials of New Antimicrobials
Authors: Paul Mical , Harbarth Stephan , Huttner Angela , Thwaites Guy E , Theuretzbacher Ursula , Bonten Marc J M , Leibovici Leonard
Published: July 2020

Randomized controlled trials (RCTs) conducted by the industry are expensive, especially trials conducted for registration of new drugs for multidrug-resistant (MDR) bacteria. Lower-cost investigator-initiated trials have recently been successful in recruiting patients with severe infections caused by MDR bacteria. In this viewpoint, we contrast the aims, methods, and resulting costs of industry-led and investigator-initiated trials and ask whether contemporary registration trial costs are justified. Contract research organizations, delivering and monitoring industry-sponsored trials at a significant cost, have little incentive to make trials more efficient or less expensive. The value of universal monitoring of all trial data is questionable. We propose that clinical trial networks play a more influential role in RCT design and planning, lead adaptive risk-based trial monitoring, and work with the industry to maximize efficient recruitment and lower costs in registration trials for the approval of new antimicrobials.
Single-cell analysis of SARS-CoV-2 receptor ACE2 and spike protein priming expression of proteases in the human heart
Authors: Liu Hanning , Gai Shujie , Wang Xiaoyi , Zeng Juntong , Sun Cheng , Zhao Yan , Zheng Zhe
Published: July 2020

Aims

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) directly binds to ACE2 (angiotensin-converting enzyme 2) to facilitate cellular entry. Compared with the lung or respiratory tract, the human heart exhibits greater ACE2 expression. However, little substantial damage was found in the heart tissue, and no viral particles were observed in the cardiac myocytes. This study aims to analyse ACE2 and SARS-CoV-2 spike (S) protein proteases at the single-cell level, to explore the cardiac involvement in COVID-19 and improve our understanding of the potential cardiovascular implications of COVID-19.

Methods and Results

With meta-analysis, the prevalence of cardiac injury in COVID-19 patients varies from 2% [95% confidence interval (CI) 0–5%, I2 = 0%] in non-ICU patients to 59% (95% CI 48–71%, I2 = 85%) in non-survivors. With public single-cell sequence data analysis, ACE2 expression in the adult human heart is higher than that in the lung (adjusted P < 0.0001). Inversely, the most important S protein cleavage protease TMPRSS2 (transmembrane protease serine protease-2) in the heart exhibits an extremely lower expression than that in the lung (adjusted P < 0.0001), which may restrict entry of SARS-CoV-2 into cardiac cells. Furthermore, we discovered that other S protein proteases, CTSL (cathepsin L) and FURIN (furin, paired basic amino acid cleaving enzyme), were expressed in the adult heart at a similar level to that in the lung, which may compensate for TMPRSS2, mediating cardiac involvement in COVID-19.

Conclusion

Compared with the lung, ACE2 is relatively more highly expressed in the human heart, while the key S protein priming protease, TMPRSS2, is rarely expressed. The low percentage of ACE2+/TMPRSS2+ cells reduced heart vulnerability to SARS-CoV-2 to some degree. CTSL and FURIN may compensate for S protein priming to mediate SARS-CoV-2 infection of the heart.
Smoking May Reduce the Effectiveness of Anti-TNF Therapies to Induce Clinical Response and Remission in Crohn’s Disease: A Systematic Review and Meta-analysis
Authors: Lee Sangmin , Kuenzig M Ellen , Ricciuto Amanda , Zhang Ziyu , Shim Hang Hock , Panaccione Remo , Kaplan Gilaad G , Seow Cynthia H
Published: July 2020

Background and Aims

Cigarette smoking worsens prognosis of Crohn’s disease [CD]. We conducted a systematic review and meta-analysis to examine the association between smoking and induction of clinical response or remission with anti-tumour necrosis factor [TNF] therapy.

Methods

MEDLINE, EMBASE, PubMed, and Cochrane CENTRAL [June 2019] were searched for studies reporting the effect of smoking on short-term clinical response and remission to anti-TNF therapy [≤16 weeks following the first treatment] in patients with CD. Risk ratios [RR] with 95% confidence intervals [CI] were calculated using random-effects models.

Results

Eighteen observational studies and three randomised controlled trials [RCT] were included. Current smokers and non-smokers [never or former] had similar rates of clinical response [observational studies RR: 0.96; 95% CI: 0.88, 1.05; RCTs RR: 1.09; 95% CI: 0.84, 1.41]. When restricted to studies clearly defining the smoking exposure, smokers treated with anti-TNF were less likely to achieve clinical response than non-smokers [smokers defined as having ≥5 cigarettes/day for ≥6 months RR: 0.63; 95% CI: 0.48, 0.83; lifetime never smokers vs ever smokers excluding former smokers RR: 0.81; 95% CI: 0.71, 0.93]. Current smokers were also less likely to achieve clinical remission in observational studies [RR: 0.75; 95% CI: 0.57, 0.98], though this association was not seen in RCTs [RR: 1.04; 95% CI: 0.89, 1.21].

Conclusions

Smoking is significantly associated with a reduction in the ability of infliximab or adalimumab to induce short-term clinical response and remission when pooling studies where smoking status was clearly defined. When patients with CD are treated with highly effective therapy, including anti-TNF agents, concurrent smoking cessation may improve clinical outcomes.
COVID-19 treatment with lopinavir–ritonavir resulting in sick sinus syndrome: a case report
Authors: Wang Laureen Yi-Ting , Ng Gavin Yeow Ping
Published: July 2020

Background

COVID-19 infection is the most serious global public health crisis of the century. With no approved treatments against it, investigational treatments are being used despite limited safety data. Besides being at higher risk of complications of COVID-19 infection, patients with underlying cardiovascular disease are more likely to develop cardiac-related side effects of treatment. We present a case of sinus arrest with junctional escape related to lopinavir–ritonavir.

Case summary

A 67-year-old man, with underlying stable ischaemic heart disease, acquired COVID-19 infection. He had a prolonged duration of fever and cough. He subsequently developed acute respiratory distress and required intensive care unit (ICU) care. Given his severe infection, he was started on lopinavir–ritonavir. Hydroxychloroquine was not used as he had a prolonged QTc interval. During observation in the ICU, the patient developed recurrent episodes of sinus arrest with junctional escape. Initial concerns were of myocarditis, but he had no ST-segment changes on ECG, with mild elevations of highly sensitive troponin I and a normal transthoracic echocardiogram. A multidisciplinary team discussion involving the intensivist, infectious disease physicians, and cardiologist; the decision was made to stop treatment with lopinavir–ritonavir. Within 48 h, the bradyarrhythmia resolved. The patient did not require transvenous and permanent pacemaker insertion.

Conclusion

Current efficacy and safety evidence of lopinavir–ritonavir as a treatment in COVID-19 patients is limited. Although uncommonly reported, those with underlying cardiovascular disease are at increased risk of bradyarrhythmia-related adverse effects of lopinavir–ritonavir. When initiating investigational therapies, especially in patients with cardiovascular conditions, adequate counselling and close monitoring are required.
A practical risk score for early prediction of neurological outcome after out-of-hospital cardiac arrest: MIRACLE2
Authors: Pareek Nilesh , Kordis Peter , Beckley-Hoelscher Nicholas , Pimenta Dominic , Kocjancic Spela Tadel , Jazbec Anja , Nevett Joanne , Fothergill Rachael , Kalra Sundeep , Lockie Tim , Shah Ajay M , Byrne Jonathan , Noc Marko , MacCarthy Philip
Published: July 2020

Aims

The purpose of this study was to develop a practical risk score to predict poor neurological outcome after out-of-hospital cardiac arrest (OOHCA) for use on arrival to a Heart Attack Centre.

Methods and results

From May 2012 to December 2017, 1055 patients had OOHCA in our region, of whom 373 patients were included in the King’s Out of Hospital Cardiac Arrest Registry (KOCAR). We performed prediction modelling with multivariable logistic regression to identify predictors of the primary outcome to derive a risk score. This was externally validated in two independent cohorts comprising 473 patients. The primary endpoint was poor neurological outcome at 6-month follow-up (Cerebral Performance Category 3–5). Seven independent predictors of outcome were identified: missed (unwitnessed) arrest, initial non-shockable rhythm, non-reactivity of pupils, age (60–80 years—1 point; >80 years—3 points), changing intra-arrest rhythms, low pH <7.20, and epinephrine administration (2 points). The MIRACLE2 score had an area under the curve (AUC) of 0.90 in the development and 0.84/0.91 in the validation cohorts. Three risk groups were defined—low risk (MIRACLE2 ≤2—5.6% risk of poor outcome); intermediate risk (MIRACLE2 of 3–4—55.4% of poor outcome); and high risk (MIRACLE2 ≥5—92.3% risk of poor outcome). The MIRACLE2 score had superior discrimination than the OHCA [median AUC 0.83 (0.818–0.840); P < 0.001] and Cardiac Arrest Hospital Prognosis models [median AUC 0.87 (0.860–0.870; P = 0.001] and equivalent performance with the Target Temperature Management score [median AUC 0.88 (0.876–0.887); P = 0.092].

Conclusions

The MIRACLE2 is a practical risk score for early accurate prediction of poor neurological outcome after OOHCA, which has been developed for simplicity of use on admission.
Experience of mobile nursing workforce from Portugal to the NHS in UK: influence of institutions and actors at the system, organization and individual levels
Authors: Leone Claudia , Dussault Gilles , Rafferty Anne Marie , Anderson Janet E
Published: July 2020

In UK, since 2010 shortages of nurses and policy changes led many health service providers to become more active in recruiting nurses from the European Union Member States. This article analyses the experience of Portuguese nurses working in the English NHS considering the individual and organizational factors that affect the quality and duration of nurses’ migration experience, future career plans and expectations. Twenty-seven semi-structured interviews were conducted at the individual, organizational and policy levels in UK with Portuguese nurses and NHS healthcare staff in 2015–16. The results demonstrate that organizational settings, conditions, actors’ attitudes and level of support influence nurses’ level of commitment to their employer and their overall mobility experience. Professional achievements, professional and personal sources of support made these nurses evaluate their overall mobility experience as positive, even overcoming personal challenges such as homesickness. The results reveal that migration is accomplished through constant interaction between institutions and individual actors at different levels. Understanding the influencing factors as well as the complex and dynamic nature of a professional’s decision-making can design more effective retention responses.
Hospital doctors in Ireland and the struggle for work–life balance
Authors: Humphries Niamh , McDermott Aoife M , Creese Jennifer , Matthews Anne , Conway Edel , Byrne John-Paul
Published: July 2020

Ireland has a high rate of doctor emigration. Challenging working conditions and poor work–life balance, particularly in the hospital sector, are often cited as a driver. The aim of this study was to obtain insight into hospital doctors’ experiences of work and of work–life balance. In late 2019, a stratified random sample of hospital doctors participated in an anonymous online survey, distributed via the national Medical Register (overall response rate 20%; n = 1070). This article presents a qualitative analysis of free-text questions relating to working conditions (n = 469) and work–life balance (n = 314). Results show that respondent hospital doctors, at all levels of seniority, were struggling to achieve balance between work and life, with work–life imbalance and work overload being the key issues arising. Work–life imbalance has become normalized within Irish hospital medicine. Drawing on insights from respondent hospital doctors, this study reflects on the sustainability of this way of working for the individual doctors, the medical workforce and the Irish health system. If health workforce planning is about getting the right staff with the right skills in the right place at the right time to deliver care, work–life balance is about maintaining doctor wellbeing and encouraging their retention.
Wild birds as reservoirs for diverse and abundant gamma- and deltacoronaviruses
Authors: Wille Michelle , Holmes Edward C
Published: July 2020

Wild birds interconnect all parts of the globe through annual cycles of migration with little respect for country or continental borders. Although wild birds are reservoir hosts for a high diversity of gamma- and deltacoronaviruses, we have little understanding of the ecology or evolution of any of these viruses. In this review, we use genome sequence and ecological data to disentangle the evolution of coronaviruses in wild birds. Specifically, we explore host range at the levels of viral genus and species, and reveal the multi-host nature of many viral species, albeit with biases to certain types of avian host. We conclude that it is currently challenging to infer viral ecology due to major sampling and technical limitations, and suggest that improved assay performance across the breadth of gamma- and deltacoronaviruses, assay standardization, as well as better sequencing approaches, will improve both the repeatability and interpretation of results. Finally, we discuss cross-species virus transmission across both the wild bird – poultry interface as well as from birds to mammals. Clarifying the ecology and diversity in the wild bird reservoir has important ramifications for our ability to respond to the likely future emergence of coronaviruses in socioeconomically important animal species or human populations.
Conscious Movement Processing, Fall-Related Anxiety, and the Visuomotor Control of Locomotion in Older Adults
Authors: Ellmers Toby J , Cocks Adam J , Kal Elmar C , Young William R
Published: July 2020

Objectives

Older adults anxious about falling will often consciously process walking movements in an attempt to avoid falling. They also fixate their gaze on the present step rather than looking ahead to plan future actions. The present work examined whether conscious movement strategies result in such restricted visual planning.

Methods

A total of 18 community-dwelling older adults (agemean = 71.22; SD = 5.75) walked along a path and stepped into two raised targets. Repeated-measures analyses of variance were used to compare gaze behavior and movement kinematics when participants walked: (a) at baseline (ground level); (b) under conditions designed to induce fall-related anxiety (walkway elevated 0.6 m); and (c) in the absence of anxiety (ground level), but with explicit instructions to consciously process movements.

Results

Participants reported increased conscious movement processing when walking both on the elevated walkway (fall-related anxiety condition) and at ground level when instructed to consciously process gait. During both conditions, participants altered their gaze behavior, visually prioritizing the immediate walkway 1–2 steps ahead (areas needed for the on-line visual control of individual steps) at the expense of previewing distal areas of the walking path required to plan future steps. These alterations were accompanied by significantly slower gait and increased stance durations prior to target steps.

Conclusions

Consciously processing movement (in the relative absence of anxiety) resulted in gaze behavior comparable to that observed during conditions of fall-related anxiety. As anxious participants also self-reported directing greater attention toward movement, this suggests that fall-related anxiety may disrupt the visual control of gait through increased conscious movement processing.
Prisons and COVID-19: A Desperate Call for Gerontological Expertise in Correctional Health Care
Authors: Prost Stephanie Grace , Novisky Meghan A , Rorvig Leah , Zaller Nick , Williams Brie
Published: July 2020

The large and continued growth of the older adult population within U.S. prisons affects not only criminal justice policy and correctional health practice, but also gerontology. Amidst the unfolding COVID-19 crisis, associated knowledge and skills surrounding older adulthood will be critical to assuring the needs of older adults incarcerated in prisons are met during their detention, while undergoing off-site intervention in community settings, and when preparing for release. We outline several key areas for which gerontologists and associated practitioners are especially well suited in the effort to curtail morbidity and mortality driven by the disease caused by the novel coronavirus. Critical gerontological knowledge and skills needed in prison health care include awareness regarding the unusual clinical presentations of COVID-19 among older adults, deconditioning among older adults due to immobility, challenges in prognostication, and advance care planning with older adults. Specific, targeted opportunities for gerontologists are identified to reduce growing risks for older adults incarcerated in prisons.
Fungal Dysbiosis Aggravates Pouchitis in a Rat Model of Ileal Pouch Anal Anastomosis
Authors: Zhu Feng , Feng Dengyu , Ding Chao , Zhang Tenghui , Chen Jianwei , Yu Zeqian , Zhao Lei , Xu Yi , Zhu Weiming , Gong Jianfeng
Published: July 2020

Background

Although the interaction between gut microbiota and pouchitis after ileal pouch anal anastomosis (IPAA) for ulcerative colitis (UC) has been confirmed, evidence of commensal mycobiota in the etiology of pouchitis is still lacking. This study aimed to investigate the role of fungi in the pathogenesis of pouchitis.

Methods

Fecal samples were collected from UC patients with or without pouchitis after IPAA. Experimental pouchitis was induced by 5% dextran sulfate sodium for 7 consecutive days in a rat model of IPAA. Fungal dysbiosis was induced by 0.5% fluconazole (Flu), and commensal fungal recognition through dectin-1 was blocked by 5% laminarin. Fecal fungal composition was analyzed using internal transcribed spacer 2 sequencing. Severity of pouchitis and activation of the CARD9-nuclear factor kappa-B pathway was determined among different groups.

Results

Patients with pouchitis had a lower alpha (α) diversity in mycobiota composition and a higher abundance of Saccharomyces at the genus level compared with those with a normal pouch. In the rat model of pouchitis, Flu treatment decreased fungal burden but induced fungal dysbiosis, characterized by increased α diversity, a decreased relative abundance of Kazachstania, and increased Polythrincium and Saccharomyces. In addition, Flu treatment worsened dextran sulfate sodium pouchitis, as indicated by increased mortality, weight loss, higher histological score, and CD4+ cell infiltration. Laminarin also increased the severity of pouchitis. In the Flu and laminarin groups, the expression of interferon-γ, tumor necrosis factor-α, CARD9, and phosphorylated nuclear factor kappa-B inhibitor alpha was decreased.

Conclusions

Patients with pouchitis had altered fungal composition. Fungal dysbiosis or recognition deficiency by the host may exacerbate experimental pouchitis. Strategies targeting commensal mycobiota may provide therapeutic potential against pouchitis, especially for antibiotic-refractory patients.
Otolith δ18O and microstructure analyses provide further evidence of population structure in sardine Sardinops sagax around South Africa
Authors: Sakamoto Tatsuya , van der Lingen Carl D , Shirai Kotaro , Ishimura Toyoho , Geja Yonela , Peterson James , Komatsu Kosei
Published: July 2020

Sardine Sardinops sagax is an ecologically and economically important Clupeid found off the entire South African coast that includes both coastal upwelling and western boundary current systems. Although the management of the sardine fisheries historically assumed a single, panmictic population, the existence of three, semi-discrete subpopulations has recently been hypothesized. We conducted otolith δ18O and microstructure analyses to investigate nursery habitat temperatures and early life growth rates, respectively, of sardine collected from three biogeographic regions around South Africa’s coast to test that hypothesis. Analyses indicated that for both summer- and winter-captured adults and summer-captured juveniles, fishes from the west coast grew significantly slower in water that was several degrees cooler than those from the south and east coasts. This suggests that mixing of sardines between regions, particularly the west and other coasts, is relatively limited and supports the hypothesis of semi-discrete subpopulations. However, the west-south differences disappeared in the results for winter-captured juveniles, suggesting that differences in early life conditions between regions may change seasonally, and/or that all or most winter-captured juveniles originated from the west coast. Further elucidating the interactions between South African sardine subpopulations and the mechanisms thereof is important for sustainable harvesting of this species.
The surgical management of type IA endoleak after thoracic endovascular aortic repair
Authors: Dun Yaojun , Shi Yi , Guo Hongwei , Liu Yanxiang , Qian Xiangyang , Sun Xiaogang , Yu Cuntao
Published: July 2020

OBJECTIVES

Our goal was to investigate the surgical strategy for type Ia endoleak after thoracic endovascular aortic repair (TEVAR) by reporting our experiences.

METHODS

From November 2012 to September 2019, a total of 23 patients received surgical management for type Ia endoleak after TEVAR.

RESULTS

The operations included total arch replacement with the frozen elephant trunk technique in 15 patients, direct closure of the endoleak in 2 patients, hybrid aortic arch repair in 4 patients, arch debranching with TEVAR in 1 patient and left common carotid artery to left subclavian artery bypass with TEVAR in 1 patient. Among 21 patients with cardiopulmonary bypass (CPB), the mean CPB and aortic cross-clamp times were 146.7 ± 42.2 and 81.0 ± 43.3 min, respectively. The selective cerebral perfusion time was 18.8 ± 8.2 min in 17 patients with hypothermic circulatory arrest. The in-hospital mortality was 8.7% (2/23). Type Ia endoleak was sealed successfully after surgery in 95.5% (21/22) of patients. The follow-up data were available for all 21 survivors. The median follow-up period was 18 months (range 1–84 months). During the follow-up period, a total of 8 patients died or had aortic events, including 5 deaths and 6 aortic events.

CONCLUSIONS

Different surgical strategies could be selected to treat patients with type Ia endoleak after TEVAR, with acceptable early and late outcomes.
COVID-19 in South Korea: epidemiological and spatiotemporal patterns of the spread and the role of aggressive diagnostic tests in the early phase
Authors: Lee Whanhee , Hwang Seung-Sik , Song Insung , Park Chaerin , Kim Honghyok , Song In-Kyung , Choi Hayon Michelle , Prifti Kristi , Kwon Younggyu , Kim Jeongheon , Oh Seuk , Yang Juyeon , Cha Mirae , Kim Yoonhee , Bell Michelle L , Kim Ho
Published: July 2020

Background

South Korea experienced the novel coronavirus disease (COVID-19) outbreak in the early period; thus data from this country could provide significant implications for global mitigation strategies. This study reports how COVID-19 has spread in South Korea and examines the effects of rapid widespread diagnostic testing on the spread of the disease in the early epidemic phase.

Methods

We collected daily data on the number of confirmed cases, tests and deaths due to COVID-19 from 20 January to 13 April 2020. We estimated the spread pattern with a logistic growth model, calculated the daily reproduction number (Rt) and examined the fatality pattern of COVID-19.

Results

From the start date of the epidemic in Korea (18 February 2020), the time to peak and plateau were 15.2 and 25 days, respectively. The initial Rt was 3.9 [95% credible interval (CI) 3.7 to 4.2] and declined to <1 after 2 weeks. The initial epidemic doubling time was 3.8 days (3.4 to 4.2 days). The aggressive testing in the early days of the epidemic was associated with reduction in transmission speed of COVID-19. In addition, as of 13 April, the case fatality rate of COVID-19 in Korea was 2.1%, suggesting a positive effect of the targeted treatment policy for severe patients and medical resources.

Conclusions

Our findings provide important information for establishing and revising action plans based on testing strategies and severe patient care systems, needed to address the unprecedented pandemic.
Channel structure and differential pricing strategies in dual-channel e-retail considering e-platform business models
Authors: Fu Yufang , Gu Bojun , Xie Yuying , Ye Jun , Cao Bin
Published: July 2020

Although online business has been growing for some time, third-party e-platforms and their impact on e-channels are an under-explored area in the literature on dual-channel supply chains. Considering different combinations of open and self-support e-platform, this paper develops dynamic game models in four dual-channel e-retail structures to study pricing strategies and channel preference for manufacturers. The results provide interesting insights. First, a manufacturer’s optimal prices vary in different e-channels. Second, e-retail prices on the self-support e-platform and open e-platform are both affected by the e-platform’s service quality and commission fee. Regardless of the channel structure, a better service quality by one e-platform leads to an increase in its own e-retail prices and forces the competing e-platform to either improve its service quality or take a lower price. Lastly and more importantly, we compare the manufacturer’s pricing strategies and performances in different dual-channel e-retail structures and identify its preferences. Specifically, if the commission fee is dynamic, we find that the manufacturer always prefers to use two e-channels provided by different e-platforms, and at least one of the e-channels is the self-support model, although it is a sub-optimal strategy.
Optimal finite element error estimates for an optimal control problem governed by the wave equation with controls of bounded variation
Authors: Engel Sebastian , Vexler Boris , Trautmann Philip
Published: July 2020

This work discusses the finite element discretization of an optimal control problem for the linear wave equation with time-dependent controls of bounded variation. The main focus lies on the convergence analysis of the discretization method. The state equation is discretized by a space-time finite element method. The controls are not discretized. Under suitable assumptions optimal convergence rates for the error in the state and control variable are proven. Based on a conditional gradient method the solution of the semi-discretized optimal control problem is computed. The theoretical convergence rates are confirmed in a numerical example.
Real Algebraic Curves on Real del Pezzo Surfaces
Authors: Manzaroli Matilde
Published: July 2020

The study of the topology of real algebraic varieties dates back to the work of Harnack, Klein, and Hilbert in the 19th century; in particular, the isotopy-type classification of real algebraic curves in real toric surfaces is a classical subject that has undergone considerable evolution. On the other hand, not much is known for more general ambient surfaces. We take a step forward in the study of topological-type classification of real algebraic curves on non-toric surfaces focusing on real del Pezzo surfaces of degree 1 and 2 with multi-components real part. We use degeneration methods and real enumerative geometry in combination with variations of classical methods to give obstructions to the existence of topological-type classes realized by real algebraic curves and to give constructions of real algebraic curves with prescribed topology.
World Cynipoidea (Hymenoptera): A Key to Higher-Level Groups
Authors: Buffington Matthew L , Forshage Mattias , Liljeblad Johan , Tang Chang-Ti , van Noort Simon
Published: July 2020

While much has been learned regarding the phylogeny and evolution of cynipoid wasps, clearly illustrated diagnostic tools and identification keys have remained stagnant. So too, where keys do exist, they are often to genus or species, and there are no user-friendly keys to groups such as tribes, subfamilies, or families. This state of affairs leaves a knowledge gap for non-specialists and slows future research on the group. To address this, we provide a fully illustrated key to the higher-level groups of world Cynipoidea. We also provide summaries of all higher-level taxa with updated generic lists, biological data, distribution, and literature resources. The dichotomous key presented here is complimented with a multi-entry matrix-based key, created in Lucid, and served on www.waspweb.org with online versions of the dichotomous keys also available.
Swinging Shale: Shale Oil, the Global Oil Market, and the Geopolitics of Oil
Authors: Kim Inwook
Published: July 2020

Is shale oil “revolutionizing” the global oil market and the geopolitics of oil? If so, how? While two aspects of the shale boom—a new source of supply and a cause for the price collapse in 2014–2015—dominate the conventional wisdom, I argue that the most revolutionary change is the least understood aspect of shale oil—shale oil producers’ rise as new swing suppliers due to its unique extraction technique and cost structure. Shale oil producers also differ from traditional swing producers in motives, contexts, and an amount of accessible excess capacity such that while shale oil lowers the medium-term price ceiling, it does not eliminate short-term price volatility. By examining the geopolitics of oil since the advent of shale oil, I analyze how such new market realities have or have not altered the US foreign policy on issues involving possible oil supply disruptions, Saudi Arabia's long-held special status in US grand strategy, rationale for US withdrawal from the Persian Gulf, and the foreign policy of China, the largest oil importer today, and Russia, a major petrostate.
Differential response from selection for high calving ease vs. low birth weight in American Simmental beef cattle
Authors: Saad Hamad M , Thomas Milton G , Speidel Scott E , Peel Richard K , Frasier W Marshall , Enns R Mark
Published: July 2020

Data on calving ease (CE) and birth, weaning weight (WW), and yearling weight (YW) were obtained from the American Simmental Association (ASA) and included pedigree and performance information on 11,640,735 animals. Our objective was to quantify differential response from selection for high CE vs. low birth weight (LBW) in first-calf Simmental heifers. We hypothesized that direct selection for CE should be used as the primary approach to reduce dystocia and mitigate losses in growth-related traits. WW and YW were adjusted to 205 and 365 d of age, respectively. Sire and maternal grandsire (co)variance components for CE, birth weight (BW), and 205-d weaning weight (205-d WW), and sire covariance components for 160-d postweaning gain (160-d gain) were estimated using a sire-maternal grandsire model. Direct and maternal expected progeny differences (EPD) for CE, BW, and 205-d WW and direct EPD for 160-d gain and 365-d yearling weight (365-d YW) for first-calf Simmental heifers population (465,710 animals) were estimated using a threshold-linear multivariate maternal animal model. This population was used to estimate genetic trends and as a selection pool (control) for various selection scenarios. Selection scenarios were high CE (HCE), LBW, the all-purpose selection index (API = −1.8 BW + 1.3 CE + 0.10 WW + 0.20 YW) of the ASA and its two derived subindices: (API1 = 1.3 CE + 0.20 YW) and (API2 = −1.8 BW + 0.20 YW), and lastly Dickerson’s selection index (DSI = −3.2 BW + YW). Data for each selection scenario were created by selecting sires with EPD greater than or equal to the average along with the top 75% of dams. Comparison between selection scenarios involved evaluating the direct and maternal genetic trends from these scenarios. Direct heritabilities for CE, BW, 205-d WW, 160-d gain, and 365-d YW of Simmental cattle were 0.23, 0.52, 0.28, 0.21, and 0.33, respectively. The single trait, HCE, selection scenario, as opposed to LBW, increased the intercept for CE by 57.7% and the slopes (P < 0.001) for BW, 205-d WW, 160-d gain, and 365-d YW by 27.9%, 37.5%, 16%, and 28%, respectively. Comparisons of various selection scenarios revealed that the CE-based selection scenarios (HCE, API, and API1) had a greater response for CE and growth traits.
Effect of phytase on nutrient digestibility and expression of intestinal tight junction and nutrient transporter genes in pigs
Authors: Lu Hang , Shin Sunhye , Kuehn Imke , Bedford Mike , Rodehutscord Markus , Adeola Olayiwola , Ajuwon Kolapo M
Published: July 2020

The study was conducted to determine the effects of high levels of phytase on growth performance, nutrient digestibility, phytate breakdown, and expression of mucosal tight junction and nutrient transporter genes in weanling pigs. A total of 128 barrows were penned in groups of four and used in a randomized completely block design and assigned to four treatments for a 28-d study. A two-phase feeding was implemented (phase 1: day 1 to 14; phase 2: day 15 to 28). The diets differed in dietary calcium (Ca) and phosphorus (P) levels (positive control [PC]: 8.1 to 7.1 g/kg Ca and 6.5 to 6.8 g/kg P; negative control [NC]: 6.6 to 5.5 g/kg Ca and 5.6 to 5.3 g/kg P) from phase 1 to phase 2, respectively. NC diets were supplemented with phytase at 0 (NC), 1,500 (NC + 1,500), or 3,000 (NC + 3,000) phytase units (FTU)/kg. Blood was collected after fasting (day 27) or feeding (day 28) for the measurement of plasma inositol concentrations. On day 28, two pigs per pen were euthanized. Duodenal–jejunal and ileal digesta samples and feces were collected to determine inositol phosphates (InsP3-6) concentrations. Phytase supplementation increased the body weight on days 14 and 28 (P < 0.05). Average daily gain and feed efficiency compared with NC were increased by phytase with the majority of its effect in phase 1 (P < 0.05). The apparent ileal digestibility and apparent total tract digestibility of P were increased in piglets fed phytase-supplemented diets (P < 0.01) compared with NC piglets. Disappearance of InsP6 and total InsP3-6 up to the duodenum–jejunum, ileum, and in feces was increased by both phytase application rates (P < 0.01). Plasma concentrations of myo-inositol were higher (P < 0.001) in the phytase-supplemented diets than PC and NC diets, irrespective of whether pigs were fed or fasted. Expression of claudin 3 was higher in pigs fed both phytase-supplemented diets in the duodenum and jejunum compared with PC and NC. Mucin 2 expression was lower in the ileum of NC + 3,000 fed piglets compared with PC (P < 0.05), whereas expression of GLUT2 (solute carrier family 2-facilitated glucose transporter member 2) was increased (P < 0.05) by the NC + 3,000 treatment in all sections. In summary, high phytase supplementation increased the growth performance of nursery pigs. The increased expression of GLUT2 by phytase may indicate an upregulation of glucose absorption from the intestine by phytase.
Endogenous GHB in Segmented Hair Part I: Inter-individual Variation for Group Comparisons
Authors: Thomas Jennifer L , Strickland Erin C , Lloyd Erin W , Donnelly Christopher C , Rankoth Anusha , Pieczonka Sandra M , Colpoys Caroline , Smith Michael A , LeBeau Marc A , Montgomery Madeline A , Karas Roman P , Peters Eugene M , Miller Mark L
Published: July 2020

While earlier studies have attempted to resolve the challenges encountered when interpreting gamma-hydroxybutyric acid (GHB) concentrations in hair (primarily due to its endogenous presence), few have had large sample sizes. The first objective of this study was to evaluate the inter-individual variation of endogenous GHB concentrations. The second objective, to be detailed in another report, was to assess intra-individual variation and the impact on exogenous GHB discrimination. Over 2,000 hair segments from 141 women and 73 men (all processed hair 3–12 cm long) were analyzed in this study. The raw calculated range of endogenous GHB concentrations was <0.40–5.47 ng/mg with 97.5% of the segmental results calculated less than 2.00 ng/mg. Imputation, assuming a lognormal distribution, was applied to the data to include non-detect (ND) data (<LOQ), which led to an estimated endogenous GHB range of 0.16–5.47 ng/mg. Kruskal–Wallis tests were employed on a segmental basis for group comparisons. This test was applied to the male and female segmental medians and subsequently indicated that these groups were different at the α = 0.05 level of significance. Additionally, female hair samples appeared to have a trend comprising higher endogenous GHB concentrations close to the scalp and a mean net decrease of ~0.2–0.3 ng/mg distally. Male hair samples displayed the opposite trend, with a mean net increase of ~0.5–0.6 ng/mg from the proximal to the distal end of the hair shaft. It was also concluded that differences exist between the median GHB concentrations of the ‘treated’ and ‘untreated’ hair in the female group at the α = 0.05 level of significance. Age groups and races were analyzed, but none of the observed differences in median concentration were significant at α = 0.05. This is the largest endogenous GHB hair population study to date and provides substantial new data on inter-individual variation and chronological trends of GHB concentrations in hair.
Intervention Content and Outcomes of Postdischarge Rehabilitation Programs for Adults Surviving Major Burns: A Systematic Scoping Review
Authors: Bayuo Jonathan , Wong Frances Kam Yuet
Published: July 2020

Improvement in burn care has led to more patients surviving the injury but has also led to more burn survivors requiring rehabilitation for a protracted period after discharge. Thus, this review sought to map the intervention content and outcomes associated with existing postdischarge rehabilitation programs for adults surviving major burns. A systematic scoping review approach was utilized. The Template for Intervention Description and Replication (TIDieR) and core outcome set for adult burn survivors were used to guide data extraction following which a narrative synthesis was undertaken. In all, 23 papers were retained in the review. Following discharge and up to 1 year postburn, the components of the rehabilitation programs comprised of physical, psychological, and social components. Beyond 1 year postburn, the rehabilitation programs demonstrated a preponderance of physical therapies. Support for family members was not highlighted in the included studies. Outcomes of rehabilitation programs up to 1 year postburn covered the seven core outcome domains. Outcomes associated with rehabilitation programs beyond 1 year postburn were, however, limited to the perceived quality of life, neuromuscular, and physical role functioning domains. Although most studies reported statistically significant findings, the outcome measures varied across studies which makes it difficult to draw overarching conclusions. The findings suggest that long-term rehabilitation programs for adult burn survivors are lacking. More robust studies are also needed to examine community participation outcomes associated with burns rehabilitation programs. The nature of burns and its far-reaching consequences suggest a patient- and family-centered approach to rehabilitation.
The density of the Atlantic marsh fiddler crab (Minuca pugnax, Smith, 1870) (Decapoda: Brachyura: Ocypodidae) in its expanded range in the Gulf of Maine, USA
Authors: Martínez-Soto Kayla S , Johnson David S
Published: July 2020

The Atlantic marsh fiddler crab, Minuca pugnax (Smith, 1870), is a climate migrant that recently expanded its range northward into the Gulf of Maine. We tracked the M. pugnax population within the Great Marsh, in northeastern Massachusetts, USA, since it was first detected in 2014 using burrow counts. Because burrow counts can overestimate fiddler-crab density, we used camera traps to determine the relationship between burrow densities and fiddler-crab densities in 2019. The burrow count surveys show a six-fold increase in the density of M. pugnax in the Great Marsh from 2014 to 2019. Results indicates that the fiddler-crab population in the expanded range is established and growing. Based on burrow counts, however, the density of M. pugnax in the expanded range (6 burrows m–2) remains much lower than those found in the historical range (up to 300 burrows m–2). Based on the camera traps, we determined that burrow counts overestimated fiddler-crab densities by 47% in 2019. There was, on average, one crab detected for every two burrows observed. This result suggests that estimates of densities of M. pugnax based on burrow counts should be reduced by half. Minuca pugnax is an ecosystem engineer that can influence saltmarsh functioning and the magnitude of that influence is related to its density. Our results imply that the populations of M. pugnax in the expanded range are currently having minor impacts on marshes relative to larger populations in the historical range, but their impact will increase as the populations grow.
Complex Blends of Synthetic Pheromones are Effective Multi-Species Attractants for Longhorned Beetles (Coleoptera: Cerambycidae)
Authors: Rice Marlin E , Zou Yunfan , Millar Jocelyn G , Hanks Lawrence M
Published: July 2020

The wood-boring larvae of longhorned beetles (Coleoptera: Cerambycidae) can be important pests of woody plants, particularly as invasive species introduced by international commerce. Previous research has revealed that cerambycid species native to different parts of the world often share the same aggregation-sex pheromones and that pheromones of different species can be combined to create multi-species attractants that would be advantageous for surveillance monitoring for a number of species simultaneously. To explore the extent to which these chemicals can be combined into single lures, we developed four different blends of six to eight compounds and tested their effects as attractants for a community of longhorned beetle species in Iowa. The blends included known pheromones of species native to the study site, as well as pheromones identified from cerambycid species native to other parts of the world. The experiment confirmed that several cerambycid species were attracted by specific blends, in accordance with their known pheromone chemistry, and despite the presence of pheromone components of heterospecifics. This finding lends further support to developing multi-component blends that can effectively monitor for new incursions of multiple exotic species concurrently.