bluuebunny/crossref_metadata_2025_split huggingface dataset:
Altered Mental Status Among Febrile Hospitalized HIV-Infected Children Aged 0–59 Months in Mozambique
Authors: Moon Troy D , Maússe Fabião E , Gebretsadik Tebeb , Kenga Darlenne B , Charles Pedro , Agy Mustuafá , Simbine Samuel , Sacarlal Jahit 
Published: June 2020

Abstract

Background
Altered mental status (AMS) is a priority presenting sign that must be assessed in HIV-infected, febrile children, yet diagnosis is difficult in areas with limited diagnostic capacity. Malaria and bacterial meningitis have been reported as the most common causes of AMS in febrile children presenting to the hospital in sub-Saharan Africa. However, in an HIV-infected child, central nervous system manifestations are diverse.

Methods
We conducted a clinical observational study of HIV-infected febrile children, aged 0–59 months, hospitalized in Mozambique and prospectively followed. Within this cohort, a nested study was designed to characterize children admitted with AMS and to assess factors associated with mortality. Univariate and multivariable analysis were performed comparing characteristics of the cohort by AMS status and evaluated demographic and clinical factors by in-hospital mortality outcome.

Results
In total, 727 children were enrolled between April 2016 and February 2019, 16% had AMS at admission. HIV-infected, febrile children, who presented with AMS and who had a diagnosis of bacteremia, had a 4-fold increased relative odds of in-hospital mortality, and children who presented with neurologic symptoms on admission had a roughly 8-fold higher odds of in-hospital mortality relative to children without presenting neurologic findings.

Conclusions
Mozambique has a pressing need to expand local diagnostic capacity. Our results highlight the critical need for clinicians to incorporate a broader differential into their potential causes of AMS, and to develop a Ministry of Health approved diagnostic and management algorithm, which is standardly used, to manage patients for whom reliable and relevant diagnostic services are not available.
Identifying international barriers and facilitators to research utilization
Authors: Younas Ahtisham 
Published: June 2020

Abstract

Purpose:
To define research utilization (RU) and identify barriers and facilitators to RU in nursing practice.

Methods:
An international integrative review of 42 studies was conducted related to barriers and facilitators of RU.

Results:
Following a review of the research that met the inclusion criteria, the author identifies common themes related to the implementation of research into clinical practice and the challenges surrounding RU.

Conclusion:
Despite consistently perceived barriers to research among nurses from different geographic, cultural, and clinical backgrounds, practice changes are typically out of their hands. Further research is necessary to gauge perception among the nursing associations, regulatory bodies, healthcare organizations, policy makers, and managers responsible for implementing these changes.
Randomized Trial Comparing Preliminary Results of Radialization and Centralization Procedures in Bayne Types 3 and 4 Radial Longitudinal Deficiency
Authors: Mittal Samarth , Garg Bhavuk , Mehta Nishank , Kumar Vijay , Kotwal Prakash 
Published: June 2020

Background:
The choice of surgical procedure in severe (Bayne and Klug types 3 and 4) radial longitudinal deficiency (RLD) is contentious. Existing studies have reported varying results with both centralization and radialization procedures. The purpose of this study was to compare the clinical and radiologic outcome of radialization and centralization procedures at a short-to-intermediate–term follow-up for the treatment of types 3 and 4 RLD.

Methods:
Fourteen patients with 17 affected limbs having types 3 or 4 RLD were recruited in this prospective, randomized, controlled trial. After initial application of successive casts for soft tissue distraction, patients were randomized to 2 wrist alignment procedures—centralization and radialization. Clinical and radiologic parameters recorded at stipulated intervals until a final follow-up of 24 months included hand-forearm angle, ulnar bow, forearm length, arm length, total angulation, and range of motion at elbow, wrist, and fingers.

Results:
Centralization was performed in 9 affected limbs, whereas radialization was performed in 8 affected limbs. Nine affected limbs had type 4 RLD, and 8 affected limbs had type 3 RLD. There was no significant difference in the hand-forearm angle in the immediate postoperative period. At 3 months, the radiologic hand-forearm angle increased to 19 degrees in the centralization group, while the radialization group showed an average increase to 4 degrees. This increase in the hand-forearm angle continued at 6-, 12-, and 24-month follow-up assessments. Worsening of the deformity was more in the centralization group, as compared with the radialization group. The forearm length also significantly differed in the 2 groups at 6-, 12-, and 24-month follow-up; however, when adjusted for preoperative lengths, the difference was significant only at 12- and 24-month follow-up.

Conclusions:
At a short-to-intermediate–term follow-up, radialization fares better than centralization in terms of recurrence of deformity and in terms of affecting the forearm length. Longer follow-up with a larger sample size is needed to draw definitive conclusions.

Level of Evidence:
Level I.
Asymmetry of Macular Vessel Density in Bilateral Early Open-angle Glaucoma With Unilateral Central 10-2 Visual Field Loss
Authors: Lu Peng , Xiao Hui , Chen Hailiu , Ye Dan , Huang Jingjing 
Published: June 2020

Précis:
Glaucomatous eyes without detectable 10-2 visual field loss showed significant macular vessel density loss, especially in inferior quadrant of perifoveal area. Macular vessel density loss spatially corresponded with structural and functional damage.

Purpose:
The purpose of this study was to investigate the characteristics, intereye and intraeye asymmetry of macular vessel density assessed by optical coherence tomography (OCT) angiography in bilateral early open-angle glaucoma with unilateral 10-2 visual field loss.

Materials and Methods:
Thirty-two eyes of 16 patients with bilateral early open-angle glaucoma and unilateral 10-2 visual field loss, and 13 eyes of 13 healthy participants were consecutively enrolled. All subjects underwent 30-2, 10-2 visual fields, OCT, and OCT angiography examinations. Intereye differences were compared between the perimetrically affected eye and the unaffected eye in the same patient. Intraeye differences were compared between the affected hemifields and the unaffected hemifields in the same eye with single-hemifield 10-2 visual field loss.

Results:
Macular whole image vessel density of the perimetrically unaffected eyes was lower than the healthy eyes (46.6% vs. 51.1%; P<0.001). Parafoveal vessel density parameters of the perimetrically affected eyes were comparable to the unaffected eyes (all P>0.05). Although inferior perifoveal vessel density of the perimetrically affected eyes was significantly lower than the unaffected eyes (42.2% vs. 46.2%; P=0.007), similar results were found in macular ganglion cell complex. In glaucomatous eyes with single-hemifield loss, perifoveal vessel density and macular ganglion cell complex of the affected hemifields were significantly worse than the unaffected hemifields (43.6% vs. 47.0%, 78.4 μm vs. 89.0 μm; P=0.023 and 0.005; respectively).

Conclusions:
Significant macular microvascular damage was present in glaucomatous eyes without detectable 10-2 visual field damage. The damage of inferior perifoveal vessel density was more significant in early glaucoma. Macular microvascular damage spatially corresponded with functional and structural damage.
The Relationship Between Corneal Hysteresis and Progression of Glaucoma After Trabeculectomy
Authors: Fujino Yuri , Murata Hiroshi , Matsuura Masato , Nakakura Shunsuke , Shoji Nobuyuki , Nakao Yoshitaka , Kiuchi Yoshiaki , Asaoka Ryo 
Published: June 2020

Purpose:
The purpose of this study was to investigate the association of corneal hysteresis (CH) measured with Ocular Response Analyzer on the progression of glaucoma after trabeculectomy.

Materials and Methods:
Twenty-four eyes of 19 patients with primary open-angle glaucoma underwent trabeculectomy. A series of visual fields (Humphery Field Analyzer 24-2 SITA-standard) were measured starting after 6 months after trabeculectomy (4.2±5.0 y, mean±SD). The mean total deviation (mTD) of the 52 test points were calculated. In addition, the mTD was divided into the following areas: central area (within central 10 degrees), superior area and inferior area: mTDcentre, mTDsuperior, and mTDinferior, respectively. The relationship between each area’s progression rate of mTD and the 7 variables of baseline age, central corneal thickness, baseline mTD, mean intraocular pressure (IOP), SD of IOP divided by the mean IOP, the difference between baseline IOP obtained before the initiation of any treatment, mean IOP, and CH were analyzed using the linear mixed model, and the optimal model was selected using the model selection method with the second ordered Akaike Information Criterion.

Results:
In the optimal model for mTD progression rate, only CH was selected with the coefficient of 0.11. The optimal model for the mTDcentre progression rate included mean IOP with the coefficient of −0.043 and CH with the coefficient of 0.12, and that for mTDinferior included only CH with the coefficient of 0.089. There was no variable selected in the optimal model for the mTDsuperior progression rate.

Conclusion:
CH is a useful measure in the management of glaucoma after trabeculectomy.
The Limited Sensitivity of Chest Computed Tomography Relative to Reverse Transcription Polymerase Chain Reaction for Severe Acute Respiratory Syndrome Coronavirus-2 Infection
Authors: Waller Joseph V. , Allen Isabel E. , Lin Keldon K. , Diaz Michael J. , Henry Travis S. , Hope Michael D. 
Published: June 2020

Objectives
Several studies suggest the sensitivity of chest computed tomography (CT) is far greater than that of reverse transcription polymerase chain reaction (RT-PCR) in diagnosing COVID-19 patients, and therefore, CT should be included as a primary diagnostic tool. This systematic review aims to stratify studies as high or low risk of bias to determine the true sensitivity of CT for severe acute respiratory syndrome coronavirus-2 infection according to the unbiased (low risk) studies, a topic of particular importance given the insufficient quantity of RT-PCR kits in many countries. We focus on sensitivity as that is the chief advantage perceived of CT.

Materials and Methods
This systematic review involved searching the PubMed and Google Scholar databases for articles conducted and published between January 1 and April 15, 2020. The quality assessment tool QUADAS-2 was used to stratify studies according to their risk of bias, and exclusion criteria included not providing the information deemed relevant for such a stratification, such as not indicating if the patients were symptomatic or asymptomatic, or identifying the source of the specimen for the reference standard, RT-PCR (eg, nasal, oropharyngeal, etc). Sensitivity values were then extracted, and random effects meta-analyses were performed.

Results
Of 641 search results, 37 studies (n = 9610 patients) were included in the analysis. The mean sensitivity of RT-PCR for COVID-19 reported by the biased studies was 70% (n = 5409/7 studies; 95% confidence interval [CI], 43–97; I
2 = 99.1%), compared with 78% by unbiased studies (n = 534/4 studies; 95% CI, 69–87, I
2 = 89.9%). For chest CT, the mean sensitivity reported by biased studies was 94% (n = 3371 patients/24 studies; 95% CI, 92–96; I
2 = 93.1%), compared with 75% by unbiased studies (n = 957/10 studies; 95% CI, 67–83; I
2 = 89.5%).

Conclusions
The difference between the sensitivities of CT and RT-PCR for severe acute respiratory syndrome coronavirus-2 infection is lower than previously thought, as after stratifying the studies, the true sensitivity for CT based on the unbiased studies is limited.
Prevalence of Burnout Among Cardiothoracic Radiologists
Authors: Eisenberg Ronald L. , Sotman Timothy E. , Czum Julianna M. , Montner Steven M. , Meyer Cristopher A. 
Published: June 2020

Purpose:
Burnout is a psychological syndrome in response to chronic occupational stressors. The prevalence of burnout among medical professionals has been increasing, and recent studies have shown that radiologists are among those affected. We investigated the prevalence of burnout and assessed associated factors among cardiothoracic radiologists.

Materials and Methods:
Society of Thoracic Radiology members were invited to complete an anonymous cross-sectional survey that included an adapted Maslach Burnout Inventory and questions about demographics, work place characteristics, and stressors.

Results:
The survey response rate was 33.1% (290/874). Per-item response rate ranged from 94% to 100% with a median of 99%. The prevalence of emotional exhaustion was 66.8% (186/283), depersonalization was 79% (223/283), and low personal accomplishment was 23% (65/280). There were no statistically significant differences between academic and private practice. There was a trend toward worse burnout in women, but this was not statistically significant. Being in early career (0 to 10 y since fellowship) was associated with low personal accomplishment [odds ratio (OR): 2.07, 95% confidence interval (CI): 1.08-3.99]. Those working fewer than 51 hours per week were significantly less likely to report emotional exhaustion (OR: 0.55, 95% CI: 0.33-0.90). The odds of emotional exhaustion for those producing fewer than 7500 work relative value units per year were approximately half of those exceeding that number (OR: 0.46, 95% CI: 0.22-0.95).

Conclusions:
The prevalence of burnout among cardiothoracic radiologists is comparable to that reported for radiologists in other subspecialties such as musculoskeletal and interventional radiology. High work relative value unit productivity and longer work hours are associated with higher prevalence of burnout.
SVEP1, a novel human coronary artery disease locus, promotes atherosclerosis
Authors: Jung In-Hyuk , Elenbaas Jared S. , Alisio Arturo , Santana Katherine , Young Erica P. , Kang Chul Joo , Kachroo Puja , Lavine Kory J. , Razani Babak , Mecham Robert P. , Stitziel Nathan O. 
Published: June 2020

SummaryA low-frequency variant of SVEP1, an extracellular matrix protein, is associated with risk of coronary disease in humans independent of plasma lipids. Despite a robust statistical association, however, it was unclear if and how SVEP1 might contribute to atherosclerosis. Here, using Mendelian randomization and complementary mouse models, we provide evidence that SVEP1 promotes atherosclerosis in humans and mice. We find that SVEP1 is expressed by vascular smooth muscle cells (VSMCs) within the atherosclerotic plaque. VSMCs also interact with SVEP1, causing proliferation and dysregulation of key differentiation pathways, including integrin and Notch signaling. Fibroblast growth factor receptor transcription increases in VSMCs interacting with SVEP1, and is further increased by the coronary disease-associated SVEP1 variant. These effects ultimately drive inflammation and promote atherosclerosis. Taken together, our results suggest that VSMC-derived SVEP1 is a pro-atherogenic factor, and support the concept that pharmacological inhibition of SVEP1 should protect against atherosclerosis in humans.
Array-based analysis of SARS-CoV-2, other coronaviruses, and influenza antibodies in convalescent COVID-19 patients
Authors: Steiner Daniel J. , Cognetti John S. , Luta Ethan P. , Klose Alanna M. , Bucukovski Joseph , Bryan Michael R. , Schmuke Jon J. , Nguyen-Contant Phuong , Sangster Mark Y. , Topham David J. , Miller Benjamin L. 
Published: June 2020

AbstractDetection of antibodies to upper respiratory pathogens is critical to surveillance, assessment of the immune status of individuals, vaccine development, and basic biology. The urgent need for antibody detection tools has proven particularly acute in the COVID-19 era. We report a multiplex label-free antigen microarray on the Arrayed Imaging Reflectometry (AIR) platform for detection of antibodies to SARS-CoV-2, SARS-CoV-1, MERS, three circulating coronavirus strains (HKU1, 229E, OC43) and three strains of influenza. We find that the array is readily able to distinguish uninfected from convalescent COVID-19 subjects, and provides quantitative information about total Ig, as well as IgG- and IgM-specific responses.
Epithelial Tissues as Active Solids: From Nonlinear Contraction Pulses to Rupture Resistance
Authors: Armon Shahaf , Bull Matthew S. , Moriel Avraham , Aharoni Hillel , Prakash Manu 
Published: June 2020

AbstractEpithelial tissues in many contexts can be viewed as soft active solids. Their active nature is manifested in the ability of individual cells within the tissue to contract and/or remodel their mechanical properties in response to various conditions. Little is known about the emergent properties of such materials. Specifically, how an individual cellular activity gives rise to collective spatiotemporal patterns is not fully understood. Recently we reported the observation of ultrafast contraction pulses in the dorsal epithelium ofT.adhaerensin vivo [1] and speculated these propagate via mechanical fields. Other accumulating evidence suggest mechanics is involved in similar contractile patterns in embryonic development in vivo and in cellular monolayers in vitro. Here we show that a widespread cellular response – activation of contraction in response to stretch – is sufficient to give rise to nonlinear propagating contraction pulses. Using a minimal numerical model and theoretical considerations we show how such mechanical pulses emerge and propagate, spontaneously or in response to external stretch. The model – whose mathematical structure resembles that of reaction-diffusion systems – explains observed phenomena inT. adhaerens(e.g. excitable or spontaneous pulses, pulse interaction) and predicts other phenomena (e.g. symmetric strain profile, “spike trains”). Finally, we show that in response to external tension, such an active two-dimensional sheet lowers and dynamically distributes the strains across its surface, hence facilitating tissue resistance to rupture. Adding a cellular softening-threshold further enhances the tissue resistance to rupture at cell-cell junctions. As cohesion is at the heart of epithelial physiology, our model may be relevant to many other epithelial systems, even if manifested at different time/length scales.SignificanceOur work demonstrates that many observed dynamical phenomena in epithelial tissues can be explained merely by mechanical cell-cell interactions, and do not require chemical diffusion or transport between cells (though chemical activity may participate in relevant intracellular processes). Specifically, we show that single cell extension-induced-contraction (EIC) is sufficient to generate propagating contraction pulses, which also increase the tissue’s resistance to rupture, an essential function of epithelia. Our results may shed light on how epithelial tissues function under challenging physiological conditions, e.g. in lung, gut, vasculature and other biomedical contexts. Our results may also be relevant in the study of early evolution of multicellularity and the nervous-muscular systems. Finally, the work offers guidelines for designing soft synthetic solids with improved mechanical properties.
Thein vitroantiviral activity of the anti-hepatitis C virus (HCV) drugs daclatasvir and sofosbuvir against SARS-CoV-2
Authors: Sacramento Carolina Q. , Fintelman-Rodrigues Natalia , Temerozo Jairo R. , de Paula Dias Da Silva Aline , da Silva Gomes Dias Suelen , dos Santos da Silva Carine , Ferreira André C. , Mattos Mayara , Pão Camila R. R. , de Freitas Caroline S. , Soares Vinicius Cardoso , Hoelz Lucas Villas Bôas , Fernandes Tácio Vinício Amorim , Branco Frederico Silva Castelo , Bastos Mônica Macedo , Boechat Núbia , Saraiva Felipe B. , Ferreira Marcelo Alves , Rajoli Rajith K. R. , Pedrosa Carolina S. G. , Vitória Gabriela , Souza Letícia R. Q. , Goto-Silva Livia , Guimarães Marilia Zaluar , Rehen Stevens K. , Owen Andrew , Bozza Fernando A. , Bou-Habib Dumith Chequer , Bozza Patrícia T. , Souza Thiago Moreno L. 
Published: June 2020

AbstractCurrent approaches of drugs repurposing against 2019 coronavirus disease (COVID-19) have not proven overwhelmingly successful and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic continues to cause major global mortality. Daclatasvir (DCV) and sofosbuvir (SFV) are clinically approved against hepatitis C virus (HCV), with satisfactory safety profile. DCV and SFV target the HCV enzymes NS5A and NS5B, respectively. NS5A is endowed with pleotropic activities, which overlap with several proteins from SARS-CoV-2. HCV NS5B and SARS-CoV-2 nsp12 are RNA polymerases that share homology in the nucleotide uptake channel. We thus tested whether SARS-COV-2 would be susceptible these anti-HCV drugs. DCV consistently inhibited the production of infectious SARS-CoV-2 in Vero cells, in the hepatoma cell line (HuH-7) and in type II pneumocytes (Calu-3), with potencies of 0.8, 0.6 and 1.1 μM, respectively. Although less potent than DCV, SFV and its nucleoside metabolite inhibited replication in Calu-3 cells. Moreover, SFV/DCV combination (1:0.15 ratio) inhibited SARS-CoV-2 with EC50of 0.7:0.1 μM in Calu-3 cells. SFV and DCV prevented virus-induced neuronal apoptosis and release of cytokine storm-related inflammatory mediators, respectively. Both drugs inhibited independent events during RNA synthesis and this was particularly the case for DCV, which also targeted secondary RNA structures in the SARS-CoV-2 genome. Concentrations required for partial DCVin vitroactivity are achieved in plasma at Cmax after administration of the approved dose to humans. Doses higher than those approved may ultimately be required, but these data provide a basis to further explore these agents as COVID-19 antiviral candidates.
Negative density-dependent parasitism in a group-living carnivore
Authors: Albery Gregory F , Newman Chris , Ross Julius Bright , Bansal Shweta , Buesching Christina 
Published: June 2020

AbstractAnimals living at high population densities commonly experience greater exposure to disease, leading to increased parasite burdens. However, social animals can benefit immunologically and hygienically from cooperation, and individuals may alter their socio-spatial behaviour in response to infection, both of which could counteract density-related increases in exposure. Consequently, the costs and benefits of sociality for disease are often uncertain. Here, we use a long-term study of a wild European badger population (Meles meles) to investigate how within-population variation in host density determines infection with multiple parasites. Four out of five parasite taxa exhibited consistent spatial hotspots of infection, which peaked among badgers living in areas of low local population density. Combined movement, survival, spatial, and social network analyses revealed that parasite avoidance was the likely cause of this negative density dependence, with possible roles for localised mortality, encounter-dilution effects, and micronutrient-enhanced immunity. These findings demonstrate that animals can organise their societies in space to minimise parasite infection, with important implications for badger behavioural ecology and for the control of badger-associated diseases.