bluuebunny/crossref_metadata_2025 huggingface dataset:
Association between intercellular adhesion molecule 1 (ICAM1) polymorphisms and diabetic foot susceptibility
Authors: Cao Xue-Xia , Yang Jin-Kui , Wang Li
Published: March 2020

The objective of the present study was to explore the association between intercellular adhesion molecule 1 (ICAM1) polymorphisms (rs5498 and rs3093030) and diabetic foot (DF) susceptibility in a Chinese Han population.

128 type 2 diabetes mellitus (T2DM) patients with DF, 147 T2DM patients without DF, and 155 healthy individuals were enrolled in this study. ICAM1 polymorphisms were genotyped by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). The genotypes and alleles of the polymorphisms were compared by χ
2 test between the 2 groups. Association between ICAM1 polymorphisms and DF susceptibility was expressed through odds ratio (OR) with corresponding 95% confidence interval (95%CI). Effects of ICAM1 polymorphisms on DF clinical characteristics were analyzed by t test.

GG genotype of rs5498 polymorphism was distinctly correlated with decreased T2DM risk (OR = 0.369, 95%CI = 0.152–0.895) and reduced susceptibility to DF among healthy controls (OR = 0.316, 95%CI = 0.119–0.837). Similar results were discovered between rs5498 G allele and decreased risk of T2DM (OR = 0.676, 95%CI = 0.475–0.963) and DF (OR = 0.656, 95%CI = 0.453–0.950) among healthy controls. Individuals carrying rs3093030 T allele had low susceptibility to DF developed from T2DM (OR = 0.634, 95%CI = 0.412–0.974). DF patients carrying rs5498 AA genotype had significantly higher serum creatinine levels than GG genotype carriers (P = .003).

ICAM1 rs3093030 polymorphism may act as a protective factor against DF developed from T2DM, moreover, rs5498 may be involved in onset of T2DM.

Clinical trial number: ChiCTR-INR-18010231.
SIRT2 expression exhibits potential to serve as a biomarker for disease surveillance and prognosis in the management of cervical cancer patients
Authors: Yang Li-ping , Feng Hai-qin , Ma Jian-cai , Wu Hong , Liu Cai-ru , Hou Jun-de
Published: March 2020

This study aimed to compare the sirtuin 2 (SIRT2) expression between tumor tissue and adjacent tissue, and to investigate the association of tumor SIRT2 expression with clinical characteristics and survival profiles in cervical cancer patients.

One hundred ninety-one cervical cancer patients were reviewed in this retrospective study. All patients underwent surgical resection and had well-preserved tumor tissue and adjacent tissue, which were obtained for SIRT2 expression detection by immunohistochemistry (IHC). Clinical parameters were obtained. Disease free survival (DFS) and overall survival (OS) were calculated.

Both SIRT2 expression by IHC score (P < .001) and the percentage of SIRT2 high expression (defined as IHC score >3) (P < .001) were declined in tumor tissue compared with paired adjacent tissue. In addition, SIRT2 expression in tumor tissue was negatively correlated with tumor size (P = .047), lymph node metastasis (P = .009) and FIGO stage (P = .001). And the DFS (P = .007) as well as OS (P = .008) were better in patients with SIRT2 high expression compared with patents with SIRT2 low expression. Univariate Cox's proportional hazards regression model analyses revealed that high SIRT2 expression in tumor tissue was a predictive factor for more prolonged DFS (P = .009) and OS (P = .011), while multivariate Cox's proportional hazards regression model analysis disclosed that it lacks independent predictive value for DFS (P = .084) or OS (P = .132).

SIRT2 expression exhibits potential to serve as a biomarker for disease surveillance and prognosis in the management of cervical cancer patients.
What is the relevance of an ambulatory quick diagnosis unit or inpatient admission for the diagnosis of pancreatic cancer? A retrospective study of 1004 patients
Authors: Bosch Xavier , Moreno Pedro , Guerra-García Mar , Guasch Neus , López-Soto Alfons
Published: March 2020

Quick diagnosis units (QDU) have become an alternative hospital-based ambulatory medicine strategy to inpatient hospitalization for potentially serious illnesses in Spain. Whether diagnosis of pancreatic cancer is better accomplished by an ambulatory or inpatient approach is unknown. The main objective of this retrospective study was to examine and compare the diagnostic effectiveness of a QDU or inpatient setting in patients with pancreatic cancer.

Patients with a diagnosis of pancreatic adenocarcinoma who had been referred to a university, tertiary hospital-based QDU or hospitalized between 2005 and 2018 were eligible. Presenting symptoms and signs, risk and prognostic factors, and time to diagnosis were compared. The costs incurred during the diagnostic assessment were analyzed with a microcosting method.

A total of 1004 patients (508 QDU patients and 496 inpatients) were eligible. Admitted patients were more likely than QDU patients to have weight loss, asthenia, anorexia, abdominal pain, jaundice, and palpable hepatomegaly. Time to diagnosis of inpatients was similar to that of QDU patients (4.1 [0.8 vs 4.3 [0.6] days; P = .163). Inpatients were more likely than QDU patients to have a tumor on the head of the pancreas, a tumor size >2 cm, a more advanced nodal stage, and a poorer histological differentiation. No differences were observed in the proportion of metastatic and locally advanced disease and surgical resections. Microcosting revealed a cost of €347.76 (48.69) per QDU patient and €634.36 (80.56) per inpatient (P < .001).

Diagnosis of pancreatic cancer is similarly achieved by an inpatient or QDU clinical approach, but the latter seems to be cost-effective. Because the high costs of hospitalization, an ambulatory diagnostic assessment may be preferable in these patients.
Efficacy and safety of Chinese herbal medicine Long Dan Xie Gan Tang in insomnia
Authors: Fan Xu , Su Zhuang , Nie Shichao , Yang Jie , Zhang Xiaoyu , Tan Dongyang , Xie Sihang , Xu Yi , Zhao Yanying , Feng Liu , Gu Mingyi , Sun Xiaomeng
Published: March 2020

Background:

Insomnia is a global public problem, which has a significant negative impact on both physical and mental health, while increasing the economic burden placed on both sufferers and society. Western medicine has a fast treatment on sleep, but it leads to side effects and strong dependence. Long Dan Xie Gan Tang(LDXGT) is a representative Chinese herbal medicine for the treatment of insomnia especially which has a bad-tempered symptom, and its effectiveness and safety has been validated clinically. However, there is yet to be any evidence-based medicine. Therefore, the effectiveness and safety of LDXGT in the treatment of insomnia are studied and systematically evaluated in this study. It will provide a theoretical support for the treatment of insomnia compared to western medicine.

Objective:

The study is purposed to evaluate the effectiveness and safety of LDXGT for the treatment of insomnia.

Methods:

Search was conducted for various databases including Pubmed, Chinese Biomedicine Database(CBM), China National Knowledge Infrastructure (CNKI), Chinese Scientific Journals Database (VIP), and Wan-fang. Randomized-controlled trials (RCTs) were identified for insomnia treatment involving LDXGT and LDXGT combined with ordinary Western medicine. The quality of literature was evaluated by Cochrane assessing tool to reduce the risk of bias. RevMan 5.3 software and STATA 12.0 software were applied to perform the meta-analysis.

Results:

Thirteen studies involving 1181 participants were identified in this systematic review. Few studies described the details of random principle. No placebo was involved in treatment. LDXGT was compared with ordinary Western medicine in 11 trials and with LDXGT combined with conventional Western medicine in 2 trials. The results of our meta-analysis showed the relative benefits in effective rates compared with conventional western medicine. (Odds Ratio [OR]= 4.32, I
2 = 0%,95% confidence interval CI [3.05 to 6.13], P < .00001) and recovery rate was (Odds Ratio [OR] = 2.67, I
2 = 0%,95% confidence interval CI [2.04 to 3.48], P < .00001). In two trials, adverse events were reported, but no serious adverse effects were reported.

Conclusion:

Our systematic evaluation will provide evidence for the clinical effectiveness and safety of LDXGT in the treatment of insomnia, and the side effects of western medicine are addressed. Further trials are necessary to collect the evidence for the use of LDXGT.
Effects of mind-body exercises for osteoporosis in older adults
Authors: Zhang Yonghui , Wang Zhijie , Lu Min , Wang Qichao , Wang Haijiao
Published: March 2020

background:

Osteoporosis is an important cause of bone fractures and even a cause of threaten to the lives of elderly people. Mind-body exercises are beneficial interventions for improving flexibility, controlling body balance, and reducing pain. To assess the effect of mind-body exercise on osteoporosis in aging people, we will perform this systematic review.

Methods:

Randomized controlled trials (RCTs) which carried out about mind-body exercise for osteoporosis will be included. Web of Science, PubMed, Science Direct, Medline, Cochrane Library, China National Knowledge Infrastructure, and Wanfang will be searched from inception to January 2020. The outcomes will include bone mineral density (BMD), bone mineral content (BMC), body balance, function of lower extremity, pain, fearing level, and quality of life. Trial reporting quality will be assessed by 2 reviewers independently and Review Manager 5.3 software will be used for meta-analysis. Trial registration is under PROSPERO (CRD42020165385).

Results:

Based on the current evidence, the potential rank of the efficacy and safety of mind-body exercises for BMD, BMC, body balance, function of lower extremity, pain, fearing level and quality of life will be assessed, and a prioritization regimen will be summarized.

Conclusions:

Evidence from this systematic review could be useful for patients, clinical practitioners, and guideline-makers to select an optimum proposal of mild-body exercises for older adults with osteoporosis.
Study on the risk prediction for cerebral infarction after transient ischemic attack
Authors: Zhang Chenhao , Zang Yanjing , Hu Lei , Song Qin , Zhao Weidong , Zhang Chunliang , Liu Hongshun , Gu Fang
Published: March 2020

Transient ischemic attack (TIA) is often recurrent, and about one-third of patients will progress to cerebral infarction. Rapidly identifying high-risk patients is pivotal to prevent the development of cerebral infarction. Therefore, this study aimed to evaluate the value of ABCD2 score, ABCD2 score combined with magnetic resonance diffusion weighted imaging (DWI) and intracranial arterial magnetic resonance angiography (MRA) in predicting cerebral infarction after 2 to 30 days of transient ischemic attack (TIA).

182 patients with TIA from August 2011 to August 2014 were enrolled as study subjects, and their clinical data, test results of DWI and MRA were collected. The incidence of cerebral infarction was observed at 2 days, 7 days and 30 days after TIA in patients with TIA, through scoring according to the 7-point ABCD2 score method proposed by Johnston. The relationship between ABCD2 score, performances of DWI and MRA and the early incidence of cerebral infarction after TIA was analyzed. The accuracy rating of ABCD2 score and ABCD2 + DWI + MRA score used for predicting the early incidence of cerebral infarction after TIA were compared with each other.

The incidence of cerebral infarction after TIA was 19 cases (10.4%) in 2 days, 42 cases (23.1%) in 7 days, 56 cases (30.8%) in 30 days respectively. For the ABCD2 score of incidence of cerebral infarction 2 to 30 days after TIA, that of those with high risk was higher than that with medium risk, and that with the medium risk was higher than that with low risk (P < .05). The area under the curve of ABCD2 + DWI + MRA score and ABCD2 score predicting the incidence of cerebral infarction was: in 2 days: 0.782 and 0.748, in 7 days: 0.839 and 0.801, in 30 days: 0.780 and 0.757, P < .05.

Compared with ABCD2 score, ABCD2 score combined with DWI and MRA can further improve the accuracy of prediction for cerebral infarction after TIA.
Identification of a robust non-coding RNA signature in diagnosing autism spectrum disorder by cross-validation of microarray data from peripheral blood samples
Authors: Cheng Wei , Zhou Shanhu , Zhou Jinxia , Wang Xijia
Published: March 2020

Novel molecular signatures are needed to improve the early and accurate diagnosis of autism spectrum disorder (ASD), and indicate physicians to provide timely intervention. This study aimed to identify a robust blood non-coding RNA (ncRNA) signature in diagnosing ASD. One hundred eighty six blood samples in the microarray dataset were randomly divided into the training set (n = 112) and validation set (n = 72). Then, the microarray probe expression profile was re-annotated into the expression profile of 4143 ncRNAs though probe sequence mapping. In the training set, least absolute shrinkage and selection operator (LASSO) penalized generalized linear model was adopted to identify the 20-ncRNA signature, and a diagnostic score was calculated for each sample according to the ncRNA expression levels and the model coefficients. The score demonstrated an excellent diagnostic ability for ASD in the training set (area under receiver operating characteristic curve [AUC] = 0.96), validation set (AUC = 0.97) and the overall (AUC = 0.96). Moreover, the blood samples of 23 ASD patients and 23 age- and gender-matched controls were collected as the external validation set, in which the signature also showed a good diagnostic ability for ASD (AUC = 0.96). In subgroup analysis, the signature was also robust when considering the potential confounders of sex, age, and disease subtypes. In comparison with a 55-gene signature deriving from the same dataset, the ncRNA signature showed an obviously better diagnostic ability (AUC: 0.96 vs 0.68, P < .001). In conclusion, this study identified a robust blood ncRNA signature in diagnosing ASD, which might help improve the diagnostic accuracy for ASD in clinical practice.
Second urgent endoscopy within 48-hour benefits cirrhosis patients with acute esophageal variceal bleeding
Authors: Lu Zheng , Sun Xiaotian , Zhang Wenhui , Jin Bo , Han Jingjing , Wang Yanling , Han Jun , Ma Xuemei , Liu Bo , Wu Libing , Wu Qin , Yu Xiaoli , Li Hanwei
Published: March 2020

Urgent endoscopy (UE) is important to the diagnosis and treatment of liver cirrhosis patients with esophageal variceal bleeding (EVB). It was reported that a second-look endoscopy may benefit acute upper gastrointestinal bleeding (UGIB) caused by peptic ulcer, while whether it could improve UGIB caused by liver cirrhosis associated EVB remains unclear. This study aimed to investigate the characteristics of second UE for liver cirrhosis with EVB and further examined the potential prognostic factors.

Patients aged ≥18 years who underwent UE for EVB within 2 hours after the admission were included and divided into scheduled second-look group (n = 245) and uncontrolled bleeding group (n = 352) based on the indications for second UE within 48 hours after initial endoscopy. Demographic and clinical data were collected and analyzed. Univariate and multivariate analysis were used to identify the risk factors for prognosis. The value of different scoring system was compared.

Statistical differences were found on history of bleeding and hepatocellular carcinoma, ascites, endoscopic type of bleeding, between scheduled second-look group and uncontrolled bleeding group. Univariate and multivariate logistic regression analysis confirmed that ascites, hemoglobin <60 g/L, AIMS65 score and failure to identify in initial UE were independent risk factors for bleeding uncontrolled after initial UE, and age, bilirubin level, initial unsatisfactory UE hemostasis, failure to identify bleeding on initial UE and tube/urgent TIPS suggested in initial UE were independent risk factors for 42-day mortality.

A second-look UE could bring benefit for liver cirrhosis patients with EVB without increasing the complication rate.
Translation and validation of the cardiac rehabilitation barriers scale in the Czech Republic (CRBS-CZE)
Authors: Winnige Petr , Batalik Ladislav , Filakova Katerina , Hnatiak Jakub , Dosbaba Filip , Grace Sherry L.
Published: March 2020

Background:

Cardiovascular diseases are highly prevalent and represent leading causes of morbidity worldwide, including in Central Europe. Cardiac rehabilitation (CR) is an effective method of secondary prevention, but utilization is low. Barriers to CR use in the Czech Republic are not well-characterized, and therefore we propose a protocol to translate and validate the cardiac rehabilitation barriers scale (CRBS).

Methods:

In this multi-method study, we translated and cross-culturally validated the CRBS to Czech (CRBS-CZE) first through the following main steps: professional translation, reconciliation/harmonization, and cross-cultural adaptation, and piloting in 50 cardiac patients. A prospective study will be undertaken to psychometrically-validate the CRBS-CZE, where 300 to 600 cardiac inpatients eligible for phase II/outpatient CR will be recruited. Consenting participants will be informed about the CR program and their sociodemographic, clinical characteristics, and the CRBS-CZE administered. Factor analysis will be performed with oblique rotation, factors will be extracted based on eigenvalues, the examination of the scree plot, and factor loadings. The internal reliability of the total scale and subscales will be assessed with Cronbach alpha. Overall CRBS scores will be compared by patient characteristics such as sex, socioeconomic indicators, risk factor burden, and travel time to investigate content validity. Their CR enrollment, adherence (% of 24 prescribed sessions attended), and completion will be tracked. The second administration of CRBS-CZE will be undertaken in patients at 3 weeks after enrollment. To test criterion validity, t tests and Pearson correlation (for adherence) will be used to determine the association of these utilization indicators with CRBS scores.

Results:

The translated version was considered by 2 bilingual CR experts. Some revisions and example additions were made to the items. Upon piloting with patients, some further edits were made. No additional barriers were raised.

Discussion:

Through this study, a reliable and valid means of assessing patient's CR barriers will be established. Results will be used to identify ways to help patients overcome barriers to CR utilization.
Natural history and aggravating factors of sagittal imbalance in marked sagittal deformity compared with mild to moderate sagittal deformity
Authors: Moon Bong Ju , Ryu Dal Sung , Kim Byeongwoo , Ha Yoon , Yoon Seung Hwan , Kim Keung Nyun , Chin Dong Kyu , Lee Jung-Kil
Published: March 2020

Sagittal imbalance is a multifactorial complex deformity that can arise from a variety of causes such as spinal stenosis, sarcopenia, vertebral fracture, and neuromuscular diseases. Furthermore, there is lack of research regarding spinal and general conditions that precede the development of sagittal imbalance. Our aim was to evaluate aggravating factors, such as natural history, for sagittal imbalance in a cohort comprising elderly individuals by conducting various examinations.

We recruited 96 participants who had a sagittal vertical axis (SVA) larger than 50 mm in a sagittal imbalance study. Finally, 69 participants were followed up and enrolled this study after 2 years. We evaluated full spine radiographs, magnetic resonance imaging (MRI), bone mineral density, and health-related quality of life from patients survey and analyzed factors associated with aggravation of sagittal imbalance. Aggravation was defined by an SVA > 30 mm and T1 pelvic angle (T1PA) > 3° in the third year compared to SVA and T1PA values of the first year.

Eighteen participants of the follow-up group had a sagittal imbalance aggravation. According to the deformity severity in the first-year evaluations, the marked deformity group (38 participants) defined as Schwab classification had 11 (28.9%) participants presenting with sagittal imbalance aggravation. These participants had larger mean values of Schwab sagittal modifiers and T1PA compared with the nonaggravation participants. Logistic regression analysis showed a higher pelvic incidence (PI) (OR = 1.201, 95% CI = 1.015–1.422, P = .033) and a small multifidus (MF) volume (OR = 0.991, 95% CI = 0.983–1.000, P = .043) correlated with sagittal imbalance aggravation.

From the follow-up group, 18 (26%) subjects of total 69 participants presented a deteriorated sagittal imbalance. A higher PI and smaller MF volume correlated with the aggravation of sagittal imbalance. We should consider that high PI and small MF volume are associated with aggravation of sagittal imbalance.
Tranexamic acid reduce hidden blood loss in posterior lumbar interbody fusion (PLIF) surgery
Authors: Xu Derong , Chen Xin , Li Zheng , Ren Zhinan , Zhuang Qianyu , Li Shugang
Published: March 2020

Background:

Posterior lumbar interbody fusion (PLIF) surgery is associated with significant blood loss; however, few studies have focused on hidden blood loss (HBL) in PLIF or its regulatory factors. The purpose of this study was to explore the HBL in PLIF surgery as well as the influence of tranexamic acid (TXA) on blood loss in PLIF.

Methods:

We performed a randomized controlled trial (RCT) and recruited patients undergoing PLIF into the study from November 2013 to April 2017. All participants were assigned to one of 2 groups according to a simple equal probability randomization scheme. At the end of PLIF surgery, for patients in the TXA group, the surgical field was immersed in TXA (1 g in 100 mL of saline solution) for 5 min before stitching the wound. For the control group, the surgical field was immersed in the same volume of normal saline.

Results:

In our study, the drainage volume during the first 24 h and the total postoperative drainage volume were significantly lower in patients in the TXA group than in the control group (P = .001). The hematocrit (Hct) of the drainage and calculation of blood contained in the drainage showed similar results. The mean length of hospital stay and rate of blood transfusion in the TXA group were less than those in the control group (P < .05). HBL was responsible for 45.6% of the total blood loss in PLIF, and both of the indicators in the TXA group were much lower than those in the control group.

Conclusions:

PLIF is associated with massive perioperative HBL, but the application of topical TXA leads to less postoperative blood loss including less HBL, a lower blood product transfusion rate, and a shorter hospital stay for PLIF.
Is coffee ground vomiting important? Findings from a large bleeding unit database and outcomes at 30 days
Authors: Schneider James R. , Thomson John M. , Fraser Andrew , Vijayan Balasubramaniam , Bassett Paul , Leeds John S.
Published: March 2020

Objectives:

‘Coffee ground’ vomiting (CGV) has classically been considered a sign of upper gastrointestinal bleeding. There is a paucity of data concerning endoscopic findings and outcomes in patients presenting with CGV. The aim of this study was to analyze endoscopic yield and 30-day outcomes in CGV patients.

Methods:

Analysis was performed over the period 1992–2005 and four groups were identified: CGV alone, hematemesis alone, melena alone, and hematemesis and melena. Endoscopic yield, requirement for blood transfusion, rebleeding, and mortality rate at 30 days were calculated and compared using logistic regression analysis.

Results:

6054 patients (mean age 61.3 years, 3538 male) were included in the study. The hematemesis group was younger compared with the other groups. Therefore, endoscopic yield was adjusted for age and sex. CGV was associated with a significantly lower risk of gastric ulcer, duodenal ulcer, varices, gastric cancer, esophageal cancer, and Mallory–Weiss tears compared with some or all of the other groups. CGV was associated with an increased risk of esophagitis and no source was found. CGV was associated with a lower rate of blood transfusion and rebleeding (all P < 0.0001) but 30-day mortality rates were similar. CGV was less likely to require endoscopic intervention compared with the other groups (all P < 0.001).

Conclusions:

CGV is associated with a lower endoscopic yield, requirement for blood transfusion, rebleeding rate, and potential for intervention compared to those with hematemesis, melena or both. Mortality rates are similar suggesting a nonbleeding cause and therefore questions the role of endoscopy in CGV.
An Evaluation of Nurses' Perception and Confidence After Implementing a Workplace Aggression and Violence Prevention Training Program
Authors: Story Angela R. , Harris Robin , Scott Susan D. , Vogelsmeier Amy
Published: March 2020

Workplace violence is highly prevalent for nurses, often going unreported. Regrettably, the very patients and visitors being cared for often perpetrate the majority of violence. This article's purpose is to describe how an institution implemented a workplace violence prevention training program designed to increase nurses' perception and confidence with aggressive and violent events. Evaluation of this quality improvement program posttraining was positive, suggesting this approach may influence nurses' abilities to prevent and manage these events.
Personalized eHealth Program for Life-style Change: Results From the “Do Cardiac Health Advanced New Generated Ecosystem (Do CHANGE 2)” Randomized Controlled Trial
Authors: Broers Eva R. , Widdershoven Jos , Denollet Johan , Lodder Paul , Kop Willem J. , Wetzels Mart , Ayoola Idowu , Piera-Jimenez Jordi , Habibović Mirela
Published: March 2020

Objective

Unhealthy life-style factors have adverse outcomes in cardiac patients. However, only a minority of patients succeed to change unhealthy habits. Personalization of interventions may result in critical improvements. The current randomized controlled trial provides a proof of concept of the personalized Do Cardiac Health Advanced New Generation Ecosystem (Do CHANGE) 2 intervention and evaluates effects on a) life-style and b) quality of life over time.

Methods

Cardiac patients (n = 150; mean age = 61.97 ± 11.61 years; 28.7% women; heart failure, n = 33; coronary artery disease, n = 50; hypertension, n = 67) recruited from Spain and the Netherlands were randomized to either the “Do CHANGE 2” or “care as usual” group. The Do CHANGE 2 group received ambulatory health-behavior assessment technologies for 6 months combined with a 3-month behavioral intervention program. Linear mixed-model analysis was used to evaluate the intervention effects, and latent class analysis was used for secondary subgroup analysis.

Results

Linear mixed-model analysis showed significant intervention effects for life-style behavior (F
interaction(2,138.5) = 5.97, p = .003), with improvement of life-style behavior in the intervention group. For quality of life, no significant main effect (F(1,138.18) = .58, p = .447) or interaction effect (F(2,133.1) = 0.41, p = .67) was found. Secondary latent class analysis revealed different subgroups of patients per outcome measure. The intervention was experienced as useful and feasible.

Conclusions

The personalized eHealth intervention resulted in significant improvements in life-style. Cardiac patients and health care providers were also willing to engage in this personalized digital behavioral intervention program. Incorporating eHealth life-style programs as part of secondary prevention would be particularly useful when taking into account which patients are most likely to benefit.

Trial Registration:
https://clinicaltrials.gov/ct2/show/NCT03178305.
Lingual Application of Pre-Bent Reconstruction Plate for Segmental Mandibular Defect: Easy and Accurate Method Through the Buccal Drilling Approach Using Computer-Aided Design/Computer-Aided Manufacturing Surgical Guides
Authors: Hwang Bo-Yeon , Lee Jung-Woo
Published: March 2020

To prevent or treat for complications of reconstruction plate, such as metal plate fracture, plate exposure, and formation of skin fistula, the use of reconstruction plates on the mandibular lingual aspect has been introduced. However, this method increases the difficulty of surgery and lengthens the surgery time. In this study, the authors aimed to present a method to apply for reconstruction plates on the lingual side of the mandible to overcome the complications associated with the use of these plates. In the proposed method, the reconstruction plate was bent and fixed by a specially designed screws on a three-dimensional model created through a pre-operative virtual surgical simulation. Next, the model, prebent reconstruction plant, and screw were 3-dimensionally scanned and then superimposed precisely onto the three-dimensional model generated through the virtual surgical simulation. After extracting the three-dimensional path of the screws on the superimposed model, a surgical guide was prepared to drill screw holes in the buccal side of the mandible by transferring the extracted paths. The proposed surgical method using virtual surgical planning and surgical guides makes mandibular lingual application of the prebent reconstruction plates convenient, fast, and precise through drilling in the buccal side of the mandible.
Symbiosis genes show a unique pattern of introgression and selection within a Rhizobium leguminosarum species complex
Authors: Cavassim Maria Izabel A. , Moeskjær Sara , Moslemi Camous , Fields Bryden , Bachmann Asger , Vilhjálmsson Bjarni J. , Schierup Mikkel Heide , W. Young J. Peter , Andersen Stig U.
Published: March 2020

Rhizobia supply legumes with fixed nitrogen using a set of symbiosis genes. These can cross rhizobium species boundaries, but it is unclear how many other genes show similar mobility. Here, we investigate inter-species introgression using de novo assembly of 196

Rhizobium leguminosarum

sv. trifolii genomes. The 196 strains constituted a five-species complex, and we calculated introgression scores based on gene-tree traversal to identify 171 genes that frequently cross species boundaries. Rather than relying on the gene order of a single reference strain, we clustered the introgressing genes into four blocks based on population structure-corrected linkage disequilibrium patterns. The two largest blocks comprised 125 genes and included the symbiosis genes, a smaller block contained 43 mainly chromosomal genes, and the last block consisted of three genes with variable genomic location. All introgression events were likely mediated by conjugation, but only the genes in the symbiosis linkage blocks displayed overrepresentation of distinct, high-frequency haplotypes. The three genes in the last block were core genes essential for symbiosis that had, in some cases, been mobilized on symbiosis plasmids. Inter-species introgression is thus not limited to symbiosis genes and plasmids, but other cases are infrequent and show distinct selection signatures.
Estimation of the final size of the second phase of the coronavirus COVID 19 epidemic by the logistic model
Authors: Batista Milan
Published: March 2020

In the note, the logistic growth regression model is used for the estimation of the final size and its peak time of the coronavirus epidemic in China, South Korea, and the rest of the World.
Time-aggregated mobile phone mobility data are sufficient for modelling influenza spread: the case of Bangladesh
Authors: Engebretsen Solveig , Engø-Monsen Kenth , Aleem Mohammad Abdul , Gurley Emily Suzanne , Frigessi Arnoldo , de Blasio Birgitte Freiesleben
Published: March 2020

Human mobility plays a major role in the spatial dissemination of infectious diseases. We develop a spatio-temporal stochastic model for influenza-like disease spread based on estimates of human mobility. The model is informed by mobile phone mobility data collected in Bangladesh. We compare predictions of models informed by daily mobility data (reference) with that of models informed by time-averaged mobility data, and mobility model approximations. We find that the gravity model overestimates the spatial synchrony, while the radiation model underestimates the spatial synchrony. Using time-averaged mobility resulted in spatial spreading patterns comparable to the daily mobility model. We fit the model to 2014-2017 influenza data from sentinel hospitals in Bangladesh, using a sequential version of Approximate Bayesian Computation. We find a good agreement between our estimated model and the case data. We estimate transmissibility and regional spread of influenza in Bangladesh, which are useful for policy planning. Time-averaged mobility appears to be a good proxy for human mobility when modelling infectious diseases. This motivates a more general use of the time-averaged mobility, with important implications for future studies and outbreak control. Moreover, time-averaged mobility is subject to less privacy concerns than daily mobility, containing less temporal information on individual movements.
Social distance and SARS memory: impact on the public awareness of 2019 novel coronavirus (COVID-19) outbreak
Authors: Chen Haohui , Xu Weipan , Paris Cecile , Reeson Andrew , Li Xun
Published: March 2020

This study examines publicly available online search data in China to investigate the spread of public awareness of the 2019 novel coronavirus (COVID-19) outbreak. We found that cities that suffered from SARS and have greater migration ties to the epicentre, Wuhan, had earlier, stronger and more durable public awareness of the outbreak. Our data indicate that forty-eight such cities developed awareness up to 19 days earlier than 255 comparable cities, giving them an opportunity to better prepare. This study suggests that it is important to consider memory of prior catastrophic events as they will influence the public response to emerging threats.
Antibiotic prescribing for lower UTI in elderly patients in primary care and risk of bloodstream infection: a cohort study using electronic health records
Authors: Shallcross Laura , Rockenschaub Patrick , Blackburn Ruth , Nazareth Irwin , Freemantle Nick , Hayward Andrew
Published: March 2020

Abstract

Background

Research has questioned the safety of delaying or withholding antibiotics for suspected urinary tract infection (UTI) in older patients. We evaluated the association between antibiotic treatment for lower UTI and risk of bloodstream infection (BSI) in adults aged ≥65 years in primary care.

Methods

We analysed primary care records from patients aged ≥65 years in England with community-onset UTI using the Clinical Practice Research Datalink (2007-2015) linked to Hospital Episode Statistics and census data. The primary outcome was BSI within 60 days, comparing patients treated immediately with antibiotics and those not treated immediately.

Findings

147,334 patients were included representing 280,462 episodes of lower UTI. BSI occurred in 0·4% (1,025 / 244,963) of UTI episodes with immediate antibiotics versus 0·6% (228 / 35,499) of episodes without immediate antibiotics. The odds of BSI were equivalent in patients who were not treated with antibiotics immediately and those who were treated on the date of their UTI consultation (adjusted odds ratio aOR 1·13; 95%-CI: 0·97-1·31). However, delaying or withholding antibiotics was associated with increased odds of death in the subsequent 60 days (aOR 1·17; 95% CI: 1·09-1·26).

Interpretation

Evidence on the safety of delaying or withholding antibiotics in older adults with suspected UTI is conflicting. Given the prevalence of asymptomatic bacteriuria in this population, their risk of antibiotic-related side effects, and the public health need to tackle antibiotic resistance, we recommend a trial to address this uncertainty.
Social, behavioural, and cultural factors of HIV in Malawi: a semi-automated systematic review
Authors: Thiabaud Amaury , Triulzi Isotta , Orel Erol , Tal Kali , Keiser Olivia
Published: March 2020

Background

Demographic and socio-behavioural factors are strong drivers of HIV infection rates in sub-Saharan Africa. These factors are often studied in qualitative research but ignored in quantitative analyses. However, they provide an in-depth insight into the local behaviour, and may help to improve HIV prevention.

Methods

To obtain a comprehensive overview of the socio-behavioural factors influencing HIV prevalence and incidence in Malawi, we systematically reviewed the literature. Due to the choice of broad search terms (“HIV AND Malawi”), our preliminary search revealed many thousands of articles. We, therefore, developed a Python tool to automatically extract, process, and categorise open-access articles published from January 1st, 1987 until October 1st, 2019 in Pubmed, Pubmed Central, JSTOR, Paperity, and arXiV databases. We then used a topic modelling algorithm to classify and identify publications of interest.

Results

Our tool extracted 22’709 unique articles; 16’942 could be further processed. After topic modelling, 519 of these were clustered into relevant topics; 20 of which were kept after hand-screening. We retrieved 7 more publications after examining references so that 27 publications were finally included in the review. Reducing the 16’942 articles to 519 potentially relevant ones by using the software took 5 days. Several factors were identified to contribute to the risk of HIV infection, including religion, gender and relationship dynamics, beliefs, and socio-behavioural attitudes.

Conclusions

Our software does not replace traditional systematic reviews, but it returns useful results to broad queries of open-access literature in under a week, without a priori knowledge. This produces a “seed data-set” of relevance which could be further developed. It identified known factors and rare factors that may be specific to Malawi. In the future, we aim to expand the tool by adding more social science databases and applying it to other sub-Saharan African countries.
Immunopathological characteristics of coronavirus disease 2019 cases in Guangzhou, China
Authors: Shi Yaling , Tan Mingkai , Chen Xing , Liu Yanxia , Huang Jide , Ou Jingyi , Deng Xilong
Published: March 2020

Coronavirus disease 2019 (COVID-19) is a respiratory disorder caused by the highly contagious SARS-CoV-2. The immunopathological characteristics of COVID-19 patients, either systemic or local, have not been thoroughly studied. In the present study, we analyzed both the changes in the cellularity of various immune cell types as well as cytokines important for immune reactions and inflammation. Our data indicate that patients with severe COVID-19 exhibited an overall decline of lymphocytes including CD4+ and CD8+ T cells, B cells, and NK cells. The number of immunosuppressive regulatory T cells was moderately increased in patients with mild COVID-19. IL-2, IL-6, and IL-10 were remarkably up-regulated in patients with severe COVID-19. The levels of IL-2 and IL-6 relative to the length of hospital stay underwent a similar “rise-decline”pattern, probably reflecting the therapeutic effect. In conclusion, our study shows that the comprehensive decrease of lymphocytes, and the elevation of IL-2 and IL-6 are reliable indicators of severe COVID-19.
Characterizing HIV and STIs among Transgender Female Sex Workers: A Longitudinal Analysis
Authors: Poteat Tonia , White Rebecca Hamilton , Footer Katherine H.A. , Park Ju Nyeong , Galai Noya , Huettner Steve , Silberzahn Brad E. , Allen Sean T. , Glick Jennifer , Beckham S. Wilson , Gaydos Charlotte A. , Sherman Susan G.
Published: March 2020

Objectives

Though highly vulnerable to HIV and STIs, transgender female sex workers (TFSW) are understudied in the U.S. HIV and STI response. This study examined the correlates of laboratory-confirmed STIs among a cohort of 62 TFSW followed over the course of one year and explored associations between specimen site and self-reported engagement in insertive and receptive anal intercourse.

Methods

Participants completed an interviewer-administered computer assisted personal interview at baseline, 3-, 6-, 9-, and 12-month visits where self-administered anal swabs and urine samples for gonorrhea, chlamydia, and trichomonas were also collected. HIV testing was conducted at baseline, 6-, and 12-month visits.

Results

Baseline HIV prevalence was 40.3% with no HIV seroconversions over follow-up. Baseline prevalence of gonorrhea, chlamydia, and trichomonas was 9.7%, 17.7%, and 14.5%, respectively. In the multivariable regression modeling, recent arrest was significantly associated with testing positive for any STI (aRR 1.77; 95% CI: 1.10-2.84). Insertive anal sex with clients was associated with increased risk of testing positive for an STI via urine specimen (RR 3.48; 95% CI: 1.14-10.62), while receptive anal sex was not significantly associated with specimen site.

Conclusion

Our findings confirm a high prevalence of STIs among TFSW and highlight the importance of addressing structural drivers such as criminal justice involvement as well as the need to ensure screening for STIs at all anatomical sites regardless of self-reported sites of potential exposure. More research is needed to better understand HIV and STI vulnerabilities and appropriate interventions for TFSW in the U.S.

KEY MESSAGES

Transgender female sex workers in the U.S. face substantial vulnerability to HIV and STIs, and interventions to reduce their risk for HIV and STI acquisition are needed.

Engagement with criminal justice significantly increases the risk for STIs among transgender women engaged in street-based sex work, suggesting the need to address factors that lead to disproportionate arrest and incarceration of transgender women.

Screening for STIs among transgender women should include all potential sites of exposure, regardless of reported sexual positioning.
Unprecedented disruptions of lives and work – a survey of the health, distress and life satisfaction of working adults in China one month into the COVID-19 outbreak
Authors: Zhang Stephen X , Wang Yifei , Rauch Andreas , Wei Feng
Published: March 2020

ABSTRACTS

What are the health and wellbeing of people during the COVID-19 outbreak? We aim to assess the health and wellbeing of normal adults living and working after one month of confinement to contain the COVID-19 outbreak in China. On Feb 20–21, 2020, we surveyed 369 adults in 64 cities in China that varied in their rates of confirmed coronavirus cases on their health conditions, distress and life satisfaction. The participants also reported their work status, whether they had chronic health issues, and the number of hours they exercised per day in the past week. 27% of the participants worked at the office, 38% resorted to working from home, and 25% stopped working due to the outbreak. Those who stopped working reported worse mental and physical health conditions as well as distress. The severity of COVID-19 in an individual’s home city predicts their life satisfaction, and this relationship is contingent upon individuals’ existing chronic health issues and their hours of exercise. Our evidence supports the need to pay attention to the health of people who were not affected by the virus epidemiologically, especially for people who stopped working during the outbreak. Our results highlight that physically active people might be more susceptible to wellbeing issues during the lockdown. Policymakers who are considering introducing restrictive measures to contain COVID-19 may benefit from understanding such health and wellbeing implications.
Differential TAM receptor regulation of hepatic physiology and injury
Authors: Zagórska Anna , Través Paqui G. , Jiménez-García Lidia , Strickland Jenna D. , Tapia Francisco J. , Mayoral Rafael , Burrola Patrick , Copple Bryan L. , Lemke Greg
Published: March 2020

The TAM receptor tyrosine kinases (RTK) Mer and Axl have been implicated in liver disease, yet our understanding of their roles in liver homeostasis and injury is limited. We therefore examined the performance of Mer and Axl mutant mice during aging, and in four models of liver injury. We find that Mer and Axl are most prominently expressed in Kupffer and hepatic endothelial cells, and that asAxl-/-Mertk-/-mice normally age, they develop profound liver disease. We further find that Mer signaling is critical to the phagocytosis of apoptotic hepatocytes that are generated during acute hepatic injury, and that Mer and Axl act in concert to inhibit injury-triggered cytokine production. TAM expression in Kupffer cells is crucial for these effects. In contrast, we show that Axl is uniquely important in mitigating liver damage during acute acetaminophen intoxication. Finally, we demonstrate that Axl exacerbates the fibrosis that develops in a model of chronic hepatic injury. These divergent effects have important implications for the design and implementation of TAM-directed therapeutics that target these RTKs in the liver.
The maturity in fetal pigs using a multi-fluid metabolomic approach
Authors: Lefort Gaëlle , Servien Rémi , Quesnel Hélène , Billon Yvon , Canario Laurianne , Iannuccelli Nathalie , Canlet Cécile , Paris Alain , Vialaneix Nathalie , Liaubet Laurence
Published: March 2020

In mammalian species, the first days after birth are an important period for survival and the rates of mortality before weaning are high. In pigs, the perinatal deaths average 20% of the litter, with important economic and societal consequences. Among the factors influencing piglet survival at birth, the maturity is likely to be one of the most important. Maturity can be defined as the outcome of complex mechanisms of intra-uterine development and maturation occurring during the last month of gestation. Here, we provide new insights on maturity by studying the end of gestation at two different stages (three weeks before term and close to term) in two breeds of pigs that strongly differ in terms of neonatal survival. Since metabolomics is a promising approach for phenotype characterization or biomarker discovery, we provide a complete understanding of the metabolome of the fetuses in late gestation in three fluids (plasma, urine, and amniotic fluid). We found that biological processes related to amino acid and carbohy-drate metabolisms are critical for piglet maturity. We also confirmed some previously described metabolites associated with delayed growth (e.g., proline and myo-inositol). Altogether, our study proposes new routes for a better characterization of piglet maturity at birth.
Directed Evolution of Adenine Base Editors with Increased Activity and Therapeutic Application
Authors: Gaudelli Nicole M. , Lam Dieter K. , Rees Holly A. , Solá-Esteves Noris M. , Barrera Luis A , Born David A. , Edwards Aaron , Gehrke Jason M. , Lee Seung-Joo , Liquori Alexander J , Murray Ryan , Packer Michael S. , Rinaldi Conrad , Slaymaker Ian M , Yen Jonathan , Young Lauren E. , Ciaramella Giuseppe
Published: March 2020

The foundational adenine base editors (e.g.ABE7.10) enable programmable C•G to T•A point mutations but editing efficiencies can be low at challenging loci in primary human cells. Here we further evolve ABE7.10 using a library of adenosine deaminase variants to create ABE8s. At NGG PAM sites, ABE8s result in ∼1.5x higher editing at protospacer positions A5-A7 and ∼3.2x higher editing at positions A3-A4 and A8-A10 compared with ABE7.10. Non-NGG PAM variants have a ∼4.2-fold overall higher on-target editing efficiency than ABE7.10. In human CD34+ cells, ABE8 can recreate a natural allele at the promoter of the γ-globin genes HBG1 and HBG2, with up to 60% efficiency, causing persistence of fetal hemoglobin. In primary human T cells, ABE8s achieve 98-99% target modification which is maintained when multiplexed across three loci. Delivered as mRNA, ABE8s induce no significant levels of sgRNA-independent off-target adenine deamination in genomic DNA and very low levels of adenine deamination in cellular mRNA.