bluuebunny/crossref_metadata_2025_split huggingface dataset:
Elevation of Liver Fibrosis Index FIB-4 Is Associated With Poor Clinical Outcomes in Patients With COVID-19
Authors: Ibáñez-Samaniego Luis , Bighelli Federico , Usón Clara , Caravaca Celia , Fernández Carrillo Carlos , Romero Miriam , Barreales Mónica , Perelló Christie , Madejón Antonio , Marcos Aránzazu Caballero , Albillos Agustín , Fernández Inmaculada , García-Samaniego Javier , Calleja José Luis , Bañares Rafael 
Published: June 2020

Abstract

Background
COVID-19 is a potentially severe disease caused by the recently described SARS-CoV-2. Whether liver fibrosis might be a relevant player in the natural history of COVID-19 is currently unknown. We aimed to evaluate the association between FIB-4 and the risk of progression to critical illness in middle-aged patients with COVID-19.

Methods
In this multicenter, retrospective study with prospective follow-up of 160 patients aged 35–65 years with COVID-19, FIB-4, clinical, and biochemical variables were collected at baseline. FIB-4 ≥2.67 defined patients with risk for advanced liver fibrosis.

Results
Risk for advanced fibrosis was estimated in 28.1% of patients. Patients with FIB-4 ≥2.67 more frequently required mechanical ventilation (37.8% vs 18.3%; P = .009). In multivariate analysis, FIB-4 ≥2.67 (odds ratio [OR], 3.41; 95% confidence interval [CI], 1.30–8.92), cardiovascular risk factors (OR, 5.05; 95% CI, 1.90–13.39), previous respiratory diseases (OR, 4.54; 95% CI, 1.36–15.10), and C-reactive protein (OR, 1.01; 95% CI, 1.01–1.02) increased significantly the risk of ICU admission. Bootstrap confirmed FIB-4 as an independent risk factor.

Conclusions
In middle-aged patients with COVID-19, FIB-4 may have a prognostic role. The link between liver fibrosis and the natural history of COVID-19 should be evaluated in future studies.
In vitro activity of eravacycline against common ribotypes of Clostridioides difficile
Authors: Bassères Eugénie , Begum Khurshida , Lancaster Chris , Gonzales-Luna Anne J , Carlson Travis J , Miranda Julie , Rashid Tasnuva , Alam M Jahangir , Eyre David W , Wilcox Mark H , Garey Kevin W 
Published: June 2020

Abstract

Background
Eravacycline is a novel synthetic fluorocycline antibacterial approved for complicated intra-abdominal infections.

Objectives
The purpose of this study was to assess the in vitro activities of eravacycline and comparator antibiotics against contemporary clinical isolates of Clostridioides difficile representing common ribotypes, including isolates with decreased susceptibility to metronidazole and vancomycin.

Methods
Clinical C. difficile strains from six common or emerging ribotypes were used to test the in vitro activities of eravacycline and comparator antibiotics (fidaxomicin, vancomycin and metronidazole) by broth microdilution. In addition, MBC experiments, time–kill kinetic studies and WGS experiments were performed.

Results
A total of 234 isolates were tested, including ribotypes RT001 (n = 37), RT002 (n = 41), RT014-020 (n = 39), RT027 (n = 42), RT106 (n = 38) and RT255 (n = 37). MIC50/90 values were lowest for eravacycline (≤0.0078/0.016 mg/L), followed by fidaxomicin (0.016/0.063 mg/L), metronidazole (0.25/1.0 mg/L) and vancomycin (2.0/4.0 mg/L). MBCs were lower for eravacycline compared with vancomycin for all ribotypes tested. Both vancomycin and eravacycline demonstrated bactericidal killing, including for epidemic RT027. The presence of the tetM or tetW resistance genes did not affect the MIC of eravacycline.

Conclusions
This study demonstrated potent in vitro activity of eravacycline against a large collection of clinical C. difficile strains that was not affected by ribotype, susceptibility to vancomycin or the presence of certain tet resistance genes. Further development of eravacycline as an antibiotic to be used in patients with Clostridioides difficile infection is warranted.
Loss of libido in a man with an incidental Leydig cell tumour of the testis: a rare tumour discovered following an isolated common complaint
Authors: Brown Dominic , Tsampoukas Georgios 
Published: June 2020

AbstractLeydig cell tumours (LCTs) are rare testicular stromal neoplasms classically presenting with a painless testicular mass or swelling in adults. Symptoms secondary to hypogonadism may occur resulting from the hormonal activity of these tumours. Loss of libido is described in LCTs in conjunction with other symptoms; however, no case has reported this as the sole presenting feature. We describe the case of a 42-year-old man presenting to his General Practitioner with loss of libido and no other features suspicious of testicular cancer. Ultrasound performed due to an unrelated epididymal cyst detected an incidental mass confirmed as a benign LCT following radical orchidectomy. Biochemical markers remained normal throughout and following treatment his libido returned to normal. This case may serve as a reminder for clinicians to maintain a high index of suspicion for testicular neoplasms in patients with features of hypogonadism in the absence of classical features for testicular cancer.
A Genomic Cluster Containing Novel and Conserved Genes is Associated with Cichlid Fish Dental Developmental Convergence
Authors: Karagic Nidal , Schneider Ralf F , Meyer Axel , Hulsey C Darrin 
Published: June 2020

AbstractThe two toothed jaws of cichlid fishes provide textbook examples of convergent evolution. Tooth phenotypes such as enlarged molar-like teeth used to process hard-shelled mollusks have evolved numerous times independently during cichlid diversification. Although the ecological benefit of molar-like teeth to crush prey is known, it is unclear whether the same molecular mechanisms underlie these convergent traits. To identify genes involved in the evolution and development of enlarged cichlid teeth, we performed RNA-seq on the serially homologous-toothed oral and pharyngeal jaws as well as the fourth toothless gill arch of Astatoreochromis alluaudi. We identified 27 genes that are highly upregulated on both tooth-bearing jaws compared with the toothless gill arch. Most of these genes have never been reported to play a role in tooth formation. Two of these genes (unk, rpfA) are not found in other vertebrate genomes but are present in all cichlid genomes. They also cluster genomically with two other highly expressed tooth genes (odam, scpp5) that exhibit conserved expression during vertebrate odontogenesis. Unk and rpfA were confirmed via in situ hybridization to be expressed in developing teeth of Astatotilapia burtoni. We then examined expression of the cluster’s four genes in six evolutionarily independent and phylogenetically disparate cichlid species pairs each with a large- and a small-toothed species. Odam and unk commonly and scpp5 and rpfA always showed higher expression in larger toothed cichlid jaws. Convergent trophic adaptations across cichlid diversity are associated with the repeated developmental deployment of this genomic cluster containing conserved and novel cichlid-specific genes.
Indication of interference competition between the EU-protected Kerry slug Geomalacus maculosus and the native tree slug Lehmannia marginata in Ireland
Authors: O'Hanlon Aidan , Fahy Ronan , Gormally Michael J 
Published: June 2020

ABSTRACTInterspecific competition plays a major role in organizing biological communities. Competition can involve direct (e.g. aggression) or indirect (e.g. avoidance) interactions, and can influence the behaviour, distribution and fitness of interacting species. Competition appears to be common among marine and terrestrial snail species, but the potential role of interspecific competition in the structure of terrestrial slug communities remains poorly known. This study examined whether competition between two terrestrial slug species, Geomalacus maculosus and Lehmannia marginata, contributes to the abundance of each species in a modified habitat (commercial conifer forest) in Ireland. Geomalacus maculosus is an EU-protected species but was probably an ancient introduction to Ireland, whereas L. marginata is unprotected but is native and widespread. A negative association was observed between the abundances of each species in field plots, sampled fortnightly over a 19-month period. The presence of other slug species and some environmental variables also influenced the abundances of L. marginata and G. maculosus. Behavioural experiments found no evidence of direct aggressive interactions between G. maculosus and L. marginata. However, L. marginata exhibited an aversion to G. maculosus mucus trails, suggesting an indirect mechanism of competition. Conversely, G. maculosus behaviour was not modified by the presence of L. marginata mucus. Results from field and laboratory studies together suggest that both species may compete in modified habitats. To our knowledge, these results provide the first experimental evidence of a negative long-term association between sympatric slugs, and the first evidence that mucus trails can act as a mechanism of interspecific interference competition in slugs.
MicroRNA dilution during oocyte growth disables the microRNA pathway in mammalian oocytes
Authors: Kataruka Shubhangini , Modrak Martin , Kinterova Veronika , Malik Radek , Zeitler Daniela M , Horvat Filip , Kanka Jiri , Meister Gunter , Svoboda Petr 
Published: June 2020

AbstractMicroRNAs (miRNAs) are ubiquitous small RNAs guiding post-transcriptional gene repression in countless biological processes. However, the miRNA pathway in mouse oocytes appears inactive and dispensable for development. We propose that marginalization of the miRNA pathway activity stems from the constraints and adaptations of RNA metabolism elicited by the diluting effects of oocyte growth. We report that miRNAs do not accumulate like mRNAs during the oocyte growth because miRNA turnover has not adapted to it. The most abundant miRNAs total tens of thousands of molecules in growing (∅ 40 μm) and fully grown (∅ 80 μm) oocytes, a number similar to that observed in much smaller fibroblasts. The lack of miRNA accumulation results in a 100-fold lower miRNA concentration in fully grown oocytes than in somatic cells. This brings a knock-down-like effect, where diluted miRNAs engage targets but are not abundant enough for significant repression. Low-miRNA concentrations were observed in rat, hamster, porcine and bovine oocytes, arguing that miRNA inactivity is not mouse-specific but a common mammalian oocyte feature. Injection of 250,000 miRNA molecules was sufficient to restore reporter repression in mouse and porcine oocytes, suggesting that miRNA inactivity comes from low-miRNA abundance and not from some suppressor of the pathway.
Updated Return-to-Play Recommendations for Collision Athletes After Cervical Spine Injury: A Modified Delphi Consensus Study With the Cervical Spine Research Society
Authors: Schroeder Gregory D , Canseco Jose A , Patel Parthik D , Hilibrand Alan S , Kepler Christopher K , Mirkovic Srdjan M , Watkins Robert G , Dossett Andrew , Hecht Andrew C , Vaccaro Alexander R 
Published: June 2020

Abstract

BACKGROUND
Previous studies have attempted to establish return-to-play (RTP) guidelines in collision sport athletes after cervical spine injury; however, recommendations have been limited by scant high-quality evidence and basic consensus survey methodologies.

OBJECTIVE
To create relevant clinical statements regarding management in collision sport athletes after cervical spine injury, and establish consensus RTP recommendations.

METHODS
Following the modified Delphi methodology, a 3 round survey study was conducted with spine surgeons from the Cervical Spine Research Society and National Football League team physicians in order to establish consensus guidelines and develop recommendations for cervical spine injury management in collision sport athletes.

RESULTS
Our study showed strong consensus that asymptomatic athletes without increased magnetic resonance imaging (MRI) T2-signal changes following 1-/2- level anterior cervical discectomy and fusion (ACDF) may RTP, but not after 3-level ACDF (84.4%). Although allowed RTP after 1-/2-level ACDF was noted in various scenarios, the decision was contentious. No consensus RTP for collision athletes after 2-level ACDF was noted. Strong consensus was achieved for RTP in asymptomatic athletes without increased signal changes and spinal canal diameter >10 mm (90.5%), as well as those with resolved MRI signal changes and diameter >13 mm (81.3%). No consensus was achieved in RTP for cases with pseudarthrosis following ACDF. Strong consensus supported a screening MRI before sport participation in athletes with a history of cervical spine injury (78.9%).

CONCLUSION
This study provides modified Delphi process consensus statements regarding cervical spine injury management in collision sport athletes from leading experts in spine surgery, sports injuries, and cervical trauma. Future research should aim to elucidate optimal timelines for RTP, as well as focus on prevention of injuries.
De Novo Shoot Regeneration Controlled by HEN1 and TCP3/4 in Arabidopsis
Authors: Yang Woorim , Choi Myung-Hwan , Noh Bosl , Noh Yoo-Sun 
Published: June 2020

Abstract
Plants have the ability to regenerate whole plant body parts, including shoots and roots, in vitro from callus derived from a variety of tissues. However, the underlying mechanisms for this de novo organogenesis, which is based on the totipotency of callus cells, are poorly understood. Here, we report that a microRNA (miRNA)-mediated posttranscriptional regulation plays an important role in de novo shoot regeneration. We found that mutations in HUA ENHANCER 1 (HEN1), a gene encoding a small RNA methyltransferase, cause cytokinin-related defects in de novo shoot regeneration. A hen1 mutation caused a large reduction in the miRNA319 (miR319) level and a subsequent increase in its known target (TCP3 and TCP4) transcript levels. TCP transcription factors redundantly inhibited shoot regeneration and directly activated the expression of a negative regulator of cytokinin response ARABIDOPSIS THALIANA RESPONSE REGULATOR 16 (ARR16). A tcp4 mutation at least partly rescued the shoot-regeneration defect and derepression of ARR16 in hen1. These findings demonstrate that the miR319-TCP3/4-ARR16 axis controls de novo shoot regeneration by modulating cytokinin responses.
Calling the Police: Dispatchers as Important Interpreters and Manufacturers of Calls for Service Data
Authors: Simpson Rylan 
Published: June 2020

Abstract
Policing has historically been conceptualized as a team sport which requires the work of many to produce the output of one. Although police officers have been the focus of much policing research, it is important to recognize that the work of officers hinges upon the work of dispatchers. As a lifeline for both citizens and police officers, dispatchers play an integral role in ensuring that help is provided where help is required via their management of the emergency (911) telephone and radio system. Despite their importance, however, dispatchers have largely been excluded from mainstream criminological scholarship. Supplemented by a narrative review of the scant literature on the subject of dispatching, this commentary illustrates the important role of dispatchers in policing operations, theorizes the dearth of research regarding dispatchers, and calls for future research to better understand their discretionary and interpretive work. This commentary thus casts light on these highly important but understudied and undertheorized figures in the policing nexus.
Opioid-induced Constipation
Authors: Argoff Charles E. 
Published: June 2020

Objective:The objective of this study was to provide an overview of opioid-induced constipation (OIC) and its influence on disease burden and quality of life (QOL).Methods:This is a narrative review.Results:For many patients, opioid-related side effects, the most common being OIC, have the potential to significantly impair patients’ QOL. Patients with OIC often experience substantial overall burden (ie, increases in anxiety and depression, impairments in activities of daily living, low self-esteem, feelings of embarrassment) and economic burden (ie, higher health care costs, more frequent doctor visits, increased out-of-pocket medication costs), which often causes patients to modify or discontinue opioid treatment despite the analgesic benefits. OIC occurs when opioids bind to peripheral μ-opioid receptors in the gastrointestinal tract. Currently, 4 Food and Drug Administration (FDA)-approved medications are available for OIC, 3 of which are peripherally acting µ-opioid receptor antagonists (PAMORAs). PAMORAs block µ-opioid receptors in the gastrointestinal tract without affecting the central analgesic effects of the opioid and thus provide a targeted approach to OIC management. Two PAMORAs, naldemedine and methylnaltrexone, have shown significant improvements in QOL based on the Patient Assessment of Constipation Symptoms questionnaire relative to placebo. Along with pharmacologic management for OIC, health care providers should institute comprehensive communication strategies with patients to ensure OIC is effectively recognized and managed.Discussion:OIC has both physical and psychological impacts on patients. PAMORAs provide effective relief of OIC while also improving QOL. To augment the pharmacologic management of OIC, proactive counseling approaches between physicians and patients may help relieve some of the patient burden associated with OIC and lead to improved outcomes.
Peripheral vasodilation is reduced during exercise in perimenopausal women with elevated cardiovascular risk
Authors: Gonzales Joaquin U. , Moore David J. , Elavsky Steriani , Proctor David N. 
Published: June 2020

Abstract

Objective:
The menopausal transition has a negative effect on peripheral dilation in response to various stimuli including shear stress and exercise. Whether the presence of elevated traditional cardiovascular disease (CVD) risk factors in women going through menopause exacerbates the adverse effect on peripheral vasodilation is unclear.

Methods:
Forty-four perimenopausal women with relatively low CVD risk were divided into tertiles based on atherosclerotic CVD (ASCVD) 10-year risk scores (lowest: 0.1%-0.5%, middle: 0.6%-0.9%, higher: >1%). Comparisons were made across tertile groups for the femoral artery vascular conductance (FVC) response to single-leg knee extension exercise (0, 5, 10, 15 W) as measured using Doppler ultrasound.

Results:
At higher exercise intensities, FVC was lower in women in the tertile group with the highest ASCVD 10-year risk scores (10 W: 6 ± 2 mL/min/mm Hg, 15 W: 8 ± 3 mL/min/mm Hg) compared to women in the lowest tertile group (10 W: 9 ± 3 mL/min/mm Hg, P = 0.01; 15 W: 12 ± 3 mL/min/mm Hg, P < 0.01) and middle tertile group (10 W: 10 ± 4 mL/min/mm Hg, P < 0.01; 15 W: 12 ± 5 mL/min/mm Hg, P < 0.01). The overall increase in FVC during exercise from 0 to 15 W remained lower (P ≤ 0.01) in women with the highest ASCVD risk scores compared to the other two tertile groups even after adjustment for chronological age, arterial stiffness, and fat-free mass adjusted aerobic fitness level.

Conclusion:
Our results show that the presence of mild differences in ASCVD risk scores may be associated with a blunted active limb blood flow during leg exercise in mid-life women transitioning through menopause.
Comparison of direct oral anticoagulant and vitamin K antagonists on outcomes among elderly and nonelderly trauma patients
Authors: Nishimura Takeshi , Guyette Francis X. , Naito Hiromichi , Nakao Atsunori , Brown Joshua B. , Callaway Clifton W. 
Published: June 2020

BACKGROUND
Direct oral anticoagulants (DOACs) are widely used among patients requiring anticoagulant therapy. These drugs are associated with a lower risk of bleeding than vitamin K antagonists (VKAs). However, the outcomes of elderly trauma patients receiving DOACs are not well known.

METHODS
We reviewed data from trauma patients at our level I trauma center (University of Pittsburgh Medical Center, Presbyterian Hospital) seen from January 2011 to July 2018. We identified trauma patients taking DOACs or VKAs and compared these cohorts using 1:1 propensity score–matching based on patient characteristics, antiplatelet use, comorbidities, and laboratory values. The primary outcome was in-hospital mortality. Secondary outcomes included the proportion of patients discharged to skilled nursing facility/rehabilitation facility discharge or to home, and transfusion volume.

RESULTS
Of 32,272 trauma patients screened, 530 were taking DOACs and 1,702 were taking VKAs. We matched 668 patients in a 1:1 ratio (DOACs group, 334 vs. VKAs group, 334). The DOACs group had similar mortality (4.8% vs. 1.6%; odds ratio (OR), 3.0; 95% confidence interval (CI), 0.31–28.8; p = 0.31) among patients younger than 65 years, but mortality differed (3.0% vs. 6.6%; OR, 0.41; 95% CI, 0.17–0.99; p = 0.048) among patients older than 65 years. The proportion of patients discharged to skilled nursing facility/rehabilitation facility (50.0% vs. 50.6%; OR, 0.98; 95% CI, 0.72–1.32; p = 0.88) and to home (40.4% vs. 38.6%; OR, 1.08; 95% CI, 0.79–1.47; p = 0.64) were similar. Patients in the DOACs group received fewer fresh frozen plasma (p = 0.032), but packed red blood cells (p = 0.86) and prothrombin complex concentrate (p = 0.48) were similar.

CONCLUSION
In this matched cohort of anticoagulated trauma patients, DOACs were associated with the decreased in-hospital mortality and decreased administration of fresh frozen plasma compared with VKAs among trauma patients 65 years or older taking anticoagulant therapy.

LEVEL OF EVIDENCE
Prognostic/Epidemiological, level III.
Covid-19 rapid test by combining a random forest based web system and blood tests
Authors: de Freitas Barbosa Valter Augusto , Gomes Juliana Carneiro , de Santana Maíra Araújo , de Lima Clarisse Lins , Calado Raquel Bezerra , Bertoldo Júnior Claúdio Roberto , de Almeida Albuquerque Jeniffer Emidio , de Souza Rodrigo Gomes , de Araújo Ricardo Juarez Escorel , de Souza Ricardo Emmanuel , dos Santos Wellington Pinheiro 
Published: June 2020

AbstractBackgroundThe disease caused by the new type of coronavirus, the Covid-19, has posed major public health challenges for many countries. With its rapid spread, since the beginning of the outbreak in December 2019, the disease transmitted by SARS-Cov2 has already caused over 400 thousand deaths to date. The diagnosis of the disease has an important role in combating Covid-19.ObjectiveIn this work, we propose a web system, Heg.IA, which seeks to optimize the diagnosis of Covid-19 through the use of artificial intelligence.MethodThe main ideia is that healthcare professionals can insert 41 hematological parameters from common blood tests and arterial gasometry into the system. Then, Heg.IA will provide a diagnostic report. It will indicate if the patient is infected with SARS-Cov2 virus, and also predict the type of hospitalization (regular ward, semi-ICU, or ICU).ResultsWe developed a web system called Heg.IA to support decision-making regarding to diagnosis of Covid-19 and to the indication of hospitalization on regular ward, semi-ICU or ICU. This application is based on decision trees in a Random Forest architecture with 90 trees. The system showed to be highly efficient, with great results for both Covid-19 diagnosis and to recommend hospitalization. For the first scenario we found average results of accuracy of 92.891% ± 0.851, kappa index of 0.858 ± 0.017, sensitivity of 0.936 ± 0.011, precision of 0.923 ± 0.011, specificity of 0.921 ± 0.012 and area under ROC of 0.984 ± 0.003. As for the indication of hospitalization, we achieved excellent performance of accuracies above 99% and more than 0.99 for the other metrics in all situations.ConclusionBy using a computationally simple method, based on the classical decision trees, we were able to achieve high diagnosis performance. Heg.IA system may be a way to overcome the testing unavailability in the context of Covid-19. We also expect the system will provide wide access to Covid-19 effective diagnosis and thereby reach and help saving lives.