bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bayesian analysis of the association between effective strategies of multimodal nonpharmacological intervention and characteristics of cognitive function in nursing home residents with cognitive impairment
Authors: Yorozuya Kyosuke , Yamane Shingo , Nobuhisa Misako , Owaki Hiroko , Suzuki Takeaki , Okahara Hikaru , Iwamori Wataru , Hanaoka Hideaki 
Published: September 2020

Abstract
The cognitive function of nursing home (NH) residents with cognitive impairment (CI) tends to decline over time. An effective multimodal non-pharmacological intervention (MNPI) strategy is needed to improve the cognitive function of NH residents with CI.
The aim of this study was to clarify the cognitive function characteristics of NH residents with CI in whom a non-pharmacological intervention (NPI) can be implemented, consisting of MNPI using a Bayesian analysis, and to incorporate suggestions to make the MNPI strategy as effective as possible.
This study had a cross-sectional design. The 61 subjects were selected from the residents of 5 NHs, of whom 90.16% were female, and the mean (standard deviation) age was 87.20 ± 6.90. Analyses were performed using a hierarchical Bayesian model, and the global and specific cognitive functions as assessed by the Japanese version of the Neurobehavioral Cognitive Status Examination were the response variables. Three types of NPI (cognitive enhancement NPI, physical NPI, psychological and psychosocial NPI), and activities of daily living (ADL), as assessed by the Barthel index, were the explanatory variables.
Cognitive enhancement NPI was revealed to have no association with any cognitive function. Physical NPI was negatively associated with orientation [OR 0.31 (95% credible interval (95% CI) –2.33, –0.10)], comprehension [OR 0.16 (95% CI –2.78, –0.95)] and naming [OR 0.49 (95% CI –1.47, –0.02)]. Psychological and psychosocial NPI was positively associated with comprehension [OR 3.67 (95% CI 0.52, 2.13)]. Barthel index was positively associated with total Japanese version of the Neurobehavioral Cognitive Status Examination [OR 1.74 (95% CI 0.08, 2.12)], comprehension [OR 3.49 (95% CI 0.45, 4.67)], repetition [OR 10.07 (95% CI 0.53, 9.01)], naming [OR 2.24 (95% CI 0.07, 3.20)], and calculations [OR 18.82 (95% CI 2.71, 9.40)].
The implementation of MNPI should be preceded by cognitive enhancement NPI and physical NPI. Providing ADL enhancing NPI in response to cognitive improvement may be an effective strategy. Providing cognitive enhancement NPI, physical NPI, psychological, and psychosocial NPI, as well as ADL-enhancing NPI at the same time, is also an effective strategy for subjects with mild dementia who are considered to have relatively high cognitive functions.
Traditional Chinese medicine for mild cognitive impairment
Authors: Wang Haiyan , Yu Haiyang , Song Kai , Xiong Fanjie , Zhang Hong 
Published: September 2020

Abstract

Background:
Mild cognitive impairment (MCI) is an intermediate stage between normal aging and Alzheimer disease, which is the most common form of dementia in the world. In clinical practice, traditional Chinese medicine (TCM) interventions have been administered for MCI, However, there is still uncertain about what strategy of TCM interventions treatment should be preferred in clinical practice. This study aims to evaluate the efficacy and acceptability of different TCM therapies through systematic review and network meta-analysis.

Methods:
According to the strategy, the authors will retrieve a total of 7 electronic databases by August 2020, including PubMed, the Cochrane Library, EMbase, China National Knowledge Infrastructure, China Biological Medicine, Chongqing VIP, and Wan-fang databases. After a series of screening, 2 researchers will use Aggregate Data Drug Information System and Stata software to analyze the data extracted from the randomized controlled trials of TCM therapies for MCI. The primary outcome of this study is the improvement of cognitive function and the secondary outcome is the activities of daily living, clinical efficacy, and adverse events, and the quality of the evidence will be evaluated using the Grading of Recommendations Assessment, Development and Evaluation instrument.

Results:
This study will provide a reliable evidence for the selection of TCM therapies in the treatment of MCI.

Conclusion:
This study will generate evidence for different TCM therapies for MCI and provide a decision-making reference for clinical research.

Ethics and dissemination:
This study does not require ethical approval. The results will be disseminated through a peer-reviewed publication.

OSF registration number:
DOI 10.17605/OSF.IO/JV9KG.
Health Care Transition
Authors: Vittorio Jennifer 
Published: September 2020

ABSTRACTImprovements in pediatric liver transplantation (LT) have led to an increased number of patients reaching young adulthood. Young adult LT recipients transferring from pediatric to adult models of care have increased rates of rejection, graft loss, and medical complications. The goal of a health care transition program is to optimize health and assist youth in reaching their full potential. The means to achieve this goal requires an organized transition process to support youth in acquiring independent health care skills, preparing for an adult model of care, and transferring to new providers without disruption in treatment. This can only be achieved through a multidisciplinary approach to transition planning. This is often a labor and resource‐intensive undertaking, which may not receive the necessary support from local institutions. Widespread implementation requires the assistance and endorsement from governing organizations at the national and international level.
How Much Weight Loss is Required for Cardiovascular Benefits? Insights From a Metabolic Surgery Matched-cohort Study
Authors: Aminian Ali , Zajichek Alexander , Tu Chao , Wolski Kathy E. , Brethauer Stacy A. , Schauer Philip R. , Kattan Michael W. , Nissen Steven E. 
Published: September 2020

Objective:
The aim of this study was to determine the minimum amount of weight loss required to see a reduction in major adverse cardiovascular events (MACE).

Background:
Although obesity is an established risk factor for morbidity and mortality, the minimum amount of weight loss to have a meaningful impact on cardiovascular health and survival is unknown.

Methods:
Patients with obesity (body mass index ≥30 kg/m2) and type 2 diabetes who underwent metabolic surgery in an academic center (1998–2017) were propensity-matched 1:5 to nonsurgical patients who received usual care. The adjusted linear and nonlinear effects of weight loss (achieved in the first 18 months after the index date) were studied to identify cut-offs for the minimum weight loss to achieve decreased risk of all-cause mortality and MACE (composite of all-cause mortality, coronary artery events, cerebrovascular events, heart failure, nephropathy, and atrial fibrillation).

Results:
A total of 7201 patients (1223 surgical and 5978 nonsurgical) with a median follow-up time of 4.9 years (interquartile range, 3.5–7) were included. The positive effect of metabolic surgery was still present after adjusting for weight loss amounts, suggesting that there are weight loss-independent factors contributing to a reduction in risk of MACE and all-cause mortality in the surgical cohort. After considering the weighted estimates from a diverse set of models, the risk of MACE decreases after approximately 10% of weight is lost in the surgical group and approximately 20% in the nonsurgical group. For all-cause mortality, the threshold for benefit appeared to be approximately 5% weight loss after metabolic surgery and 20% in the nonsurgical group.

Conclusions:
This large matched-cohort study identified the minimum weight loss thresholds for reduction in risk of MACE and all-cause mortality in patients with obesity and diabetes. Furthermore, in our analysis, the effect of surgery was still present after accounting for weight loss, which may suggest the presence of weight-independent beneficial effects of metabolic surgery on MACE and survival.
Evaluation of Host Immune Cellular and Extracellular Matrix Responses to Prolapse Mesh With and Without Tension in a Rat Model
Authors: Bickhaus Jennifer A. , Fraser Matthew O. , Weidner Alison C. , Jayes Friederike L. , Amundsen Cindy L. , Gall Ken , Marini Frank C. , Robboy Stanley J. , Siddiqui Nazema Y. 
Published: September 2020

Objectives
We sought to determine whether vaginal host immune cellular and extracellular matrix responses are altered in a rat sacrocolpopexy model when lightweight polypropylene mesh is attached on tension versus without tension.

Methods
We performed hysterectomy and ovariectomy in 32 Sprague-Dawley rats. Animals were assigned to 4 groups (n = 8/group): (1) controls with sham operation only (control), (2) mesh sutured only on the vagina (vaginal mesh), (3) sacrocolpopexy without tension, and (4) sacrocolpopexy with tension. Ninety days later, we excised vagina-mesh complexes. A histomorphologic scoring system of hematoxylin/eosin and Masson trichrome stained slides was used to assess host inflammatory responses. The cellular inflammatory response was further quantified using (1) identification of M1 and M2 macrophage subsets and (2) quantification of proinflammatory and anti-inflammatory cytokines. The extracellular matrix response was evaluated by measuring (1) matrix metalloproteinase-2 and matrix metalloproteinase-9 levels and (2) type I/III collagen.

Results
Histomorphological tissue responses were greater in all groups with mesh compared with sham controls. Both sacrocolpopexy groups had similar scores, but each group scored significantly higher than the vaginal mesh group. Among the 4 groups, there were no statistically significant differences in M1 or M2 macrophage subsets, proinflammatory or anti-inflammatory cytokines, or extracellular matrix remodeling responses.

Conclusions
Attachment of prolapse mesh resulted in an increased histologic inflammatory response independent of tension. Other markers of cellular inflammation and extracellular matrix remodeling showed no differences among experimental groups. Tension on lightweight polypropylene mesh did not significantly alter the host response in this rat sacrocolpopexy model.
The Role of the Emergency Department in Protecting the Hospital as a Critical Infrastructure in the Corona Pandemic Strategies and Experiences of a Rural Sole Acute-Care Clinic
Authors: Kortüm S. , Becker D. , Ott H.-J. , Schlaudt H-P. 
Published: September 2020

AbstractBackgroundThe Klinikum Hochrhein is responsible as a regional sole provider for the acute and emergency medical treatment of more than 170.000 people. Against the background of the pandemic spread of SARS-CoV-2 with expected high patient inflows and at the same time endangering one’s own infrastructure due to intraclinical transmissions, the hospital management defined the maintenance of one’s functionality as a priority protection objective in the pandemic. An essential strategic element was a very short-term restructuring of the Emergency Department with the objectives of reducing the number of cases within the clinic, detecting COVID-19 cases as sensitively as possible and separating the patient pathways at an early stage.MethodsThe present work is a retrospective analysis of the processes and structures established in the Emergency Department between 27 March 2020 and 20 May 2020. In addition, a retrospective descriptive evaluation of the epidemiological and clinical data of the patients is carried out at the time of first contact during the period mentioned above.ResultsAfter establishing a pre-triage with structured algorithms, all confirmed COVID-19 cases were identified before entering the clinic and assigned to an appropriate treatment pathway. Unprotected entry into hospital structures or nosocomial infections were not observed, although almost 35% of patients with confirmed infection were admitted due to other symptom complexes or injuries. 201 inpatient patients were initially isolated without COVID-19 being confirmed. The number of cases in the Emergency Department was 39% lower than the previous year’s period, thus avoiding crowding.DiscussionThe reduction in the number of cases was strategically intended and is primarily the result of a restrictive indication of in-clinical treatment but supported by a decline in emergency consultations that can be noticed anyway. The proportion of false positive triage results is probably dependent on epidemiological activity and was accepted for safety reasons as sufficient resources were available for isolation.ConclusionShort-term organizational, spatial and procedural restructuring of the Emergency Department has enabled the clinic to achieve its goal of managing the pandemic. The algorithms we developed are particularly well suited to guarantee the desired level of safety in the case of a high pre-test probability.
Seroprevalence of the SARS-CoV-2 infection in health workers of the Sanitary Region VIII, at province of Buenos Aires
Authors: Silva Andrea P. , Fernanda Aguirre M. , Ballejo Christian , Jimena Marro M. , Gamarnik Andrea V. , Vargas Gastón , Pifano Marina , Varela Teresa B. , García Enio , Lawrynowicz Alicia EB , Uez Osvaldo C. , Pagano Irene 
Published: September 2020

AbstractIntroductionThe aim of this study was to estimate the seroprevalence of the SARS-CoV-2 infection in health workers of the Sanitary Region VIII, at province of Buenos Aires during June 2020.MethodsA cross-sectional design was used. A probabilistic sampling by two-stage conglomerates was carried out. Data were collected from a self-administered questionnaire and a blood sample for antibody identification. The COVIDAR IgG and IgM test were used. RESULTS: 738 health workers were included; the overall response rate was 73.80%. 71.83% of that were women; age showed a normal distribution. Nurses and doctors accounted for more than half of the staff. 75.86% of people claimed to always use Personal Protective Equipment. 5.61% of people had close contact with a confirmed case of COVID-19. 4.60% of people had previously had a nasopharyngeal swab with a negative result. Five workers had positive IgG for SARS-CoV-2 (four women and one man) with negative IgM. The mean age of the cases was 35 years old; two of them were asymptomatic; neither of them had a swab sample taken. The overall seroprevalence was 0.75%, with no significant differences between strata.DiscussionThe seroprevalence found was low; indicating a large proportion of workers was susceptible to infection. We stress the need to complement passive epidemiological surveillance strategies with serological monitoring in health workers.
Factors associated with the risk of upper respiratory tract bacterial infections among HIV-positive patients
Authors: Skrzat-Klapaczyńska Agata , Paciorek Marcin , Firląg-Burkacka Ewa , Horban Andrzej , Kowalska Justyna D. 
Published: September 2020

AbstractBackgroundThe risk and characteristics of upper respiratory tract (URT) bacterial infections (URT-BI) among HIV (+) patients is understudied. We analyzed factors associated with its occurrence and the spectrum of pathogens among patients routinely followed at the HIV Out-Patient Clinic in Warsaw.MethodsAll symptomatic HIV (+) patients with available URT swab culture were included into analyses. Patients were followed from the day of registration in the clinic until first positive URT swab culture or last clinical visit. Cox proportional hazard models were used to identify factors associated with positive URT swabs culture (those with p<0.1 in univariate included into multivariable).ResultsIn total 474 patients were included into the analyses, 166 with positive URT swab. In general 416 (87.8%) patients were male, 342 (72.1%) were infected through MSM contact, 253 (53.4%) were on antiretroviral therapy. Median follow-up time was 3.4 (1.3-5.7) years, age 35.2 (30.6-42.6) years and CD4+ count 528 (400–685) cells/µl. The most common pathogens were S. aureus (40.4%) and S. pyogenes (13.9%) (Table 1). Patients with URT-BI were more likely to be MSM (68.5% vs 78.9%; p<0.016), have detectable viral load (20.9% vs 12.0%; p<0.0001) and CD4+ cell count <500 cells/µl(55.2% vs 39.0%; p=0.003) (Table 2). In multivariate survival analyses detectable viral load (HR3.13; 95%Cl: 2.34-4.19) and MSM (1.63;1.09-2.42) were increasing, but older age (0.63;0.58-0.69, per 5 years older) and higher CD4+ count (0.90;0.85-0.95, per 100 cells/µl) decreasing the risk of URT-BI (Table 2).ConclusionsURT BI are common among HIV (+) positive patients with high CD4+ count. Similarly to general population most common patogens are S. aureus and S. pyogenes. Risk factors identified in multivariate survival analysis indicate that younger MSM patients with detectable HIV viral load are at highest risk. In clinical practice this group of patients requires special attention.
Capturing biodiversity complexities while accounting for imperfect detection: the application of occupancy-based diversity profiles
Authors: Abrams Jesse F. , Sollmann Rahel , Mitchell Simon L. , Struebig Matthew J. , Wilting Andreas 
Published: September 2020

AbstractMeasuring the multidimensional diversity properties of a community is of great importance for ecologists, conservationists and stakeholders. Diversity profiles, a plotted series of Hill numbers, simultaneously capture all the common diversity indices. However, diversity metrics require information on species abundance. They often rely on raw count data without accounting for imperfect and varying detection, although detectability can vary between species and study sites. Hierarchical occupancy models explicitly account for variation in detectability, and Hill numbers have been expanded to allow estimation based on occupancy probability. But agreement between occupancy and abundance-based diversity profiles has not been investigated.Here, we fit community occupancy models to simulated animal communities to explore how well occupancy-based diversity profiles reflect true abundance-based diversity. Because we expect occupancy-based diversity to be overestimated, we further tested a novel occupancy thresholding approach to reduce potential biases in the estimated diversity profiles. Finally, we use empirical data from a megadiverse bird community to present how the framework can be extended to consider trait or phylogeny-based similarity when calculating diversity profiles.The simulation study showed that occupancy-based diversity profiles produced among-community patterns in diversity similar to true abundance diversity profiles, although within-community diversity was overestimated with the exception of richness. While applying an occupancy threshold reduced this positive bias, this resulted in negative bias in species richness estimates and slightly reduced the ability to reproduce true differences among the simulated communities. Application of our approach to a large bird dataset revealed differential diversity patterns in communities of different habitat types. Accounting for phylogenetic and ecological similarities between species reduced diversity and its variability among habitats.Our framework allows investigating the complexity of diversity for incidence data, while accounting for imperfect and varying detection probabilities, as well as species similarities. Visualizing results in the form of diversity profiles facilitates comparison of diversity between sites or across time. Therefore, our extension to the diversity profile framework will be a useful tool for studying and monitoring biodiversity.
Palm-to-finger cortical functional interactions in primary somatosensory cortex: a 7T fMRI study
Authors: Akselrod Michel , Martuzzi Roberto , van der Zwaag Wietske , Blanke Olaf , Serino Andrea 
Published: September 2020

ABSTRACTMany studies focused on the cortical representations of fingers, while the palm is relatively neglected despite its importance for hand function. Here, we investigated palm representation (PR) and its interactions with finger representations (FRs) in primary somatosensory cortex (S1). Few studies in humans suggested that PR is located medially with respect to FRs in S1, yet to date, no study directly quantified the somatotopic organization of PR and the five FRs. Importantly, the relationship between the somatotopic organization and the cortical functional interactions between PR and FRs remains largely unexplored. Using 7T fMRI, we mapped PR and the five FRs at the single subject level. First, we analyzed the cortical distance between PR and FRs to determine their somatotopic organization. Results show that the PR was located medially with respect to D5. Second, we tested whether the observed cortical distances would predict palm-finger functional interactions. Using three complementary measures of functional interactions (co-activations, pattern similarity and resting-state connectivity), we show that palm-finger functional interactions were not determined by their somatotopic organization, that is, there was no gradient moving from D5 to D1, except for resting-state connectivity, which was predicted by the somatotopy. Instead, we show that the representational geometry of palm-finger functional interactions reflected the physical structure of the hand. Collectively, our findings suggest that the spatial proximity between topographically organized neuronal populations do not necessarily predicts their functional interactions, rather the structure of the sensory space (e.g. the hand shape) better predicts the observed functional interactions.
A shift to shorter cuticular hydrocarbons accompanies sexual isolation amongDrosophila americanagroup populations
Authors: Davis Jeremy S. , Pearcy Matthew J. , Yew Joanne Y. , Moyle Leonie C. 
Published: September 2020

AbstractBecause sensory signals often evolve rapidly, they could be instrumental in the emergence of reproductive isolation between species. However, pinpointing their specific contribution to isolating barriers, and the mechanisms underlying their divergence, remains challenging. Here we demonstrate sexual isolation due to divergence in chemical signals between two populations ofDrosophila americana(SC and NE) and one population ofD. novamexicana, and dissect its underlying phenotypic and genetic mechanisms. Mating trials revealed strong sexual isolation betweenDrosophila novamexicanamales and SCDrosophila americanafemales, as well as more moderate bi-directional isolation betweenD. americanapopulations. Mating behavior data indicates SCD. americanamales have the highest courtship efficiency and, unlike males of the other populations, are accepted by females of all species. Quantification of cuticular hydrocarbon (CHC) profiles—chemosensory signals that are used for species recognition and mate finding inDrosophila—shows that the SCD. americanapopulation differs from the other populations primarily on the basis of compound carbon chain-length. Moreover, manipulation of male CHC composition via heterospecific perfuming—specifically perfumingD. novamexicanamales with SCD. americanamales—abolishes their sexual isolation from theseD. americanafemales. Of a set of candidates, a single gene—elongase CG17821—had patterns of gene expression consistent with a role in CHC differences between species. Sequence comparisons indicate D. novamexicana and our Nebraska (NE)D. americanapopulation share a derived CG17821 truncation mutation that could also contribute to their shared “short” CHC phenotype. Together, these data suggest an evolutionary model for the origin and spread of this allele and its consequences for CHC divergence and sexual isolation in this group.