bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of 10- versus 14-gauge angiocatheter for treatment of tension pneumothorax and tension-induced pulseless electrical activity with hemorrhagic shock: Bigger is still better
Authors: Norris Emily A. , McEvoy Christian S. , Leatherman Matthew L. , Boboc Michael R. , Fitch Jamie L. , Jensen Shane D. , Polk Travis M. 
Published: May 2020

BACKGROUND
Little is known regarding the effect of hemorrhagic shock on the diagnosis and treatment of tension pneumothorax (tPTX). Recently, the Tactical Combat Casualty Care guidelines included the 10-gauge angiocatheter (10-g AC) as an acceptable alternative to the 14-g AC. This study sought to compare these two devices for decompression of tPTX and rescue from tension-induced pulseless electric activity (tPEA) in the setting of a concomitant 30% estimated blood volume hemorrhage.

METHODS
Following a controlled hemorrhage, carbon dioxide was insufflated into the chest to induce either tPTX or tPEA. Tension pneumothorax was defined as a reduction in cardiac output by 50%, and tPEA was defined as a loss of arterial waveform with mean arterial pressure less than 20 mm Hg. The affected hemithorax was decompressed using a randomized 14-g AC or 10-g AC while a persistent air leak was maintained after decompression. Successful rescue from tPTX was defined as 80% recovery of baseline systolic blood pressure, while successful return of spontaneous circulation following tPEA was defined as a mean arterial pressure greater than 20 mm Hg. Primary outcome was success of device.

RESULTS
Eighty tPTX and 50 tPEA events were conducted in 38 adult Yorkshire swine. There were no significant differences in the baseline characteristics between animals or devices. In the tPTX model, the 10-g AC successfully rescued 90% of events, while 14-g AC rescued 80% of events (p = 0.350). In the tPEA model, the 10-g AC rescued 87% of events while the 14 AC rescued only 48% of events (p = 0.006).

CONCLUSION
The 10-g AC was vastly superior to the 14-g AC for return of spontaneous circulation following tPEA in the setting of 30% hemorrhage. These findings further support the importance of larger caliber devices that facilitate rapid recovery from tPTX, particularly in the setting of polytrauma.

LEVEL OF EVIDENCE
Therapeutic, level II.
Preliminary evidence from a multicenter prospective observational study of the safety and efficacy of chloroquine for the treatment of COVID-19
Authors: Huang Mingxing , Li Man , Xiao Fei , Liang Jiabi , Pang Pengfei , Tang Tiantian , Liu Shaoxuan , Chen Binghui , Shu Jingxian , You Yingying , Li Yang , Tang Meiwen , Zhou Jianhui , Jiang Guanmin , Xiang Jingfen , Hong Wenxin , He Songmei , Wang Zhaoqin , Feng Jianhua , Lin Changqing , Ye Yinong , Wu Zhilong , Li Yaocai , Zhong Bei , Sun Ruilin , Hong Zhongsi , Liu Jing , Chen Huili , Wang Xiaohua , Li Zhonghe , Pei Duanqing , Tian Lin , Xia Jinyu , Jiang Shanping , Zhong Nanshan , Shan Hong 
Published: May 2020

AbstractBackgroundEffective therapies are urgently needed for the SARS-CoV-2 pandemic. Chloroquine has been proved to have antiviral effect against coronavirus in vitro. In this study, we aimed to assess the efficacy and safety of chloroquine with different doses in COVID-19.MethodIn this multicenter prospective observational study, we enrolled patients older than 18 years old with confirmed SARS-CoV-2 infection excluding critical cases from 12 hospitals in Guangdong and Hubei Provinces. Eligible patients received chloroquine phosphate 500mg, orally, once (half dose) or twice (full dose) daily. Patients treated with non-chloroquine therapy were included as historical controls. The primary endpoint is the time to undetectable viral RNA. Secondary outcomes include the proportion of patients with undetectable viral RNA by day 10 and 14, hospitalization time, duration of fever, and adverse events.ResultsA total of 197 patients completed chloroquine treatment, and 176 patients were included as historical controls. The median time to achieve an undetectable viral RNA was shorter in chloroquine than in non-chloroquine (absolute difference in medians −6.0 days; 95% CI −6.0 to −4.0). The duration of fever is shorter in chloroquine (geometric mean ratio 0.6; 95% CI 0.5 to 0.8). No serious adverse events were observed in the chloroquine group. Patients treated with half dose experienced lower rate of adverse events than with full dose.ConclusionsAlthough randomised trials are needed for further evaluation, this study provides evidence for safety and efficacy of chloroquine in COVID-19 and suggests that chloroquine can be a cost-effective therapy for combating 102 the COVID-19 pandemic.
Full-spectrum dynamics of the coronavirus disease outbreak in Wuhan, China: a modeling study of 32,583 laboratory-confirmed cases
Authors: Hao Xingjie , Cheng Shanshan , Wu Degang , Wu Tangchun , Lin Xihong , Wang Chaolong 
Published: May 2020

ABSTRACTVigorous non-pharmaceutical interventions have largely suppressed the COVID-19 outbreak in Wuhan, China. We developed a susceptible-exposed-infectious-recovered model to study the transmission dynamics and evaluate the impact of interventions using 32,583 laboratory-confirmed cases from December 8, 2019 till March 8, 2020, accounting for time-varying ascertainment rates, transmission rates, and population movements. The effective reproductive number R0 dropped from 3.89 (95% credible interval: 3.79-4.00) before intervention to 0.14 (0.11-0.28) after full-scale multi-8 pronged interventions. By projection, the interventions reduced the total infections in Wuhan by 96.5% till March 8. Furthermore, we estimated that 79% (lower bound: 60%) of the total infections were unascertained, potentially including asymptomatic and mild-symptomatic cases. The probability of resurgence was 0.22 and 0.10 based on models with 79% and 60% infections unascertained, respectively, assuming interventions were lifted after a 14-day period of no new ascertained infections. These results provide important implications for continuing surveillance and interventions to eventually contain the outbreak.
Do professional fights go too long?: A video review of concussions and their consequences in professional boxing and MMA matches
Authors: Bernick Charles , Hansen Tucker , Ng Winnie , Williams Vernon , Goodman Margaret , Nalepa Bryce , Shan Guogen , Seifert Tad 
Published: May 2020

AbstractObjectivesDetermine, through video reviews, how often concussions occur in combat sport matches, how well non-medical personnel can be trained to recognize concussions and how often fights are judged to continue too long.MethodsThis is a retrospective video analysis by an 8 person panel of 60 professional fights (30 boxing and 30 mixed martial arts). Through video review, medical and non-medical personnel recorded details about each probable concussion and determined if and when they would have stopped the fight compared to the official stoppage time.ResultsA concussion was recorded in 47/60 fights. The fighter that sustained the first concussion ultimately lost 98% of the time. The physician and non-physician raters had 86% agreement regarding the number of concussions that occurred to each fighter per match. The mean number of concussions per minute of fight time was 0.08 (0.06 for boxers and 0.10 for MMA). When stratifying by outcome of the bout, the mean number of concussion per minute for the winner was 0.01 compared to the loser at 0.15 concussions per minute. The physician raters judged that 24 of the 60 fights (11 boxing [37%]; 13 MMA [43 %]) should have been stopped sooner than what occurred.ConclusionRecognizing that the losing fighter almost always is concussed first and tends to sustain more concussions during the fight, along with the demonstration that non-physician personnel can be taught to recognize concussion, may guide policy changes that improve brain health in combat sports.
Structure of anxiety associated with the COVID-19 pandemic in the Russian-speaking sample: results from on-line survey
Authors: Sorokin M.Yu. , Kasyanov E.D. , Rukavishnikov G.V. , Makarevich O.V. , Neznanov N.G. , Lutova N.B. , Mazo G.E. 
Published: May 2020

AbstractThe COVID-19 pandemic imposed not only serious threats to the physical health of the population, but also provoked a wide range of psychological problems.ObjectiveTo identify the most vulnerable populations during the epidemic period (including individuals with affective disorders) who are most in need of psychological and / or psychiatric help.Material and methodsOn-line survey of 1957 Russian-speaking respondents over 18 years old from March 30 to April 5, 2020. The level of anxiety distress was verified with the psychological stress scale (PSM-25). Stigmatization of individuals experiencing respiratory symptoms was assessed with modified devaluation / discrimination questionnaire (PDD; Cronbach’s α = 0.707).Results99.8% of respondents had variable concerns associated with COVID-19. Their mean scores of psychological stress were increased to moderate levels (104.9 ± 34.4 points), and the stigmatization scores exceeded the value of the whole sample median (19.5 ± 3.4; Me = 19). 35% of respondents had concerns about COVID-19 associated with anxiety distress (Cohen’s d = 0.16–0.39): these were “risk of isolation” and “possible lack of medication for daily use”. The most prone to concerns were respondents’ groups with affective disorders, young people (≤20 years old), unemployed, single, those without higher education and women.ConclusionsLarge sub-cohorts of the Russian-speaking sample need correction of anxiety distress associated with the COVID-19 pandemic. The implementation of such measures should be targeted and oriented in terms of coverage and content to identified vulnerable social groups.
Commercial stocks of SARS-CoV-2 RNA may report low concentration values, leading to artificially increased apparent sensitivity of diagnostic assays
Authors: Jue Erik , Ismagilov Rustem F. 
Published: May 2020

AbstractIn response to the rapidly evolving COVID-19 pandemic, the U.S. Food and Drug Administration (FDA) has rapidly issued 49 emergency use authorizations (EUAs) for SARS-CoV-2 in vitro diagnostic test-kits. A critical metric in the performance evaluation for a diagnostic test kit is the analytical sensitivity, which is measured by the limit of detection (LOD). Commercial RNA stocks with known titers are used to determine LOD. We identified a problem with the titer reported for the commercial stocks when examining the analytical sensitivity of the reverse transcription quantitative PCR (RT-qPCR) protocol that is recommended by the Centers for Disease Control and Prevention (CDC) using plasmid DNA from Integrated DNA Technologies (IDT), synthetic RNA from BEI Resources (BEI), and extracted genomic RNA from BEI. We detected 3/3 positives for reactions containing synthetic RNA at a concentration of 0.1 copies/reaction (based on the supplier’s label concentration). The apparent better-than-single-molecule performance is a statistically highly unlikely event, indicating a potential inaccuracy in the supplier’s quantification of the stock material. Using an ultrasensitive and precise assay, reverse transcription digital PCR (RT-dPCR), we independently quantified concentrations of commercial SARS-CoV-2 plasmid DNA and SARS-CoV-2 RNA stocks. For plasmid DNA, the actual concentration measured by RT-dPCR was 11% of the nominal label concentration. For synthetic RNA, the actual concentration measured by RT-dPCR for one lot was 770% of the label concentration and for a different lot was 57% of the label concentration. For genomic RNA, the concentration measured by RT-dPCR for one lot was 240% of the label concentration and for a different lot it was 300% of the label concentration. This SARS-CoV-2 genomic RNA from BEI Resources has been used in at least 11 approved FDA Emergency Use Authorizations as of April 27, 2020. Such deviations of reported RNA or DNA stock concentrations from true concentrations can result in inaccurate quantification and calculation of LOD. Precise and accurate reporting of DNA and RNA stock concentrations by commercial suppliers will enable accurate quantification of assay performance, which is urgently needed to improve evaluation of different assays by diagnostic developers and regulatory bodies.
Hippocampal Avoidance Whole-brain Radiotherapy in Preservation of Neurocognitive Function for Brain Metastases: A Phase II Blinded Randomized Trial
Authors: Yang Wen-Chi , Chen Ya-Fang , Yang Chi-Cheng , Wu Pei-Fang , Chan Hsing-Min , Chen Jenny Ling-Yu , Chen Guann-Yiing , Cheng Jason Chia-Hsien , Kuo Sung-Hsin , Hsu Feng-Ming 
Published: May 2020

AbstractBackgroundHippocampal avoidance whole-brain radiotherapy (HA-WBRT) shows potential for neurocognitive preservation. This study aimed to evaluate whether HA-WBRT or conformal WBRT is better for preserving neurocognitive function.MethodsThis single-blinded randomized phase II trial enrolled patients with brain metastases and randomly assigned to receive HA-WBRT or conformal WBRT. Primary end point is the decline of Hopkins Verbal Learning Test–Revised (HVLT-R) Delayed Recall at 4 months after treatment. Neurocognitive function tests were analyzed with a mixed effect model. Brain progression free survival (BPFS) and overall survival (OS) were estimated using the Kaplan–Meier method.ResultsPatients were enrolled from March 2015 to December 2018 with a median follow-up of 12.4 months. A total of 70 patients were randomized. No differences in baseline neurocognitive function existed between the two arms. There were no differences in any neurocognitive assessments at four months. At six months, patients receiving HA-WBRT showed favorable perpetuation of HVLT-R total recall (mean difference = 2.60, p = 0.079) and significantly better preservation of the HVLT-R recognition-discrimination index (mean difference = 1.78, p = 0.019) and memory score (mean difference = 4.38, p = 0.020) compared with patients undergoing conformal WBRT. There were no differences in TMT part A, part B, or the COWA test between the two arms at any time point. There were no differences in BPFS or OS between arms as well.ConclusionsPatients receiving HA-WBRT without Memantine showed better preservation in late verbal memory, but not in verbal fluency or executive function.
A cohort of patients with COVID-19 in a major teaching hospital in Europe
Authors: Borobia Alberto M. , Carcas Antonio J. , Arnalich Francisco , Álvarez-Sala Rodolfo , Montserrat Jaime , Quintana Manuel , Figueira Juan Carlos , Santos-Olmo Rosario M. Torres , García-Rodríguez Julio , Martín-Vega Alberto , Buño Antonio , Ramírez Elena , Martínez-Alés Gonzalo , Les Nicolás García-Arenzana , Núñez M. Concepción , Martí-de-Gracia Milagros , Ramos Francisco Moreno , Reinoso-Barbero Francisco , Martin-Quiros Alejandro , Núñez Angélica Rivera , Mingorance Jesús , Segura Carlos J Carpio , Arribas Daniel Prieto , Cuevas Esther Rey , Sánchez Concepción Prados , Rios Juan J. , Hernán Miguel A. , Frías Jesús , Arribas José R ,   for the COVID@HULP Working Group
Published: May 2020

ABSTRACTBACKGROUNDSince the confirmation of the first patient infected with SARS-CoV-2 in Spain in January 2020, the epidemic has grown rapidly, with the greatest impact on the Madrid region. This article describes the first 2226 consecutive adult patients with COVID-19 admitted to the La Paz University Hospital in Madrid.METHODSOur cohort included all consecutively admitted patients who were hospitalized and who had a final outcome (death or discharge) in a 1286-bed hospital of Madrid (Spain) from February 25th (first case admitted) to April 19th, 2020. Data was entered manually into an electronic case report form, which was monitored prior to the analysis.RESULTSWe consecutively included 2226 adult patients admitted to the hospital who either died (460) or were discharged (1766). The patients’ median age was 61 years; 51.8% were women. The most common comorbidity was arterial hypertension (41.3%). The most common symptom on admission were fever (71.2%). The median time from disease onset to hospital admission was 6 days. Overall mortality was 20.7% and was higher in men (26.6% vs 15.1%). Seventy-five patients with a final outcome were transferred to the ICU (3.4%). Most patients admitted to the ICU were men, and the median age was 64 years. Baseline laboratory values on admission were consistent with an impaired immune-inflammatory profile.CONCLUSIONSWe provide a description of the first large cohort of hospitalized patients with COVID-19 in Europe. Advanced age, male gender, the presence of comorbidities and abnormal laboratory values were more common among the patients with fatal outcomes.
Principal component analysis reveals multiple consistent responses to naturalistic stimuli in children and adults
Authors: Di Xin , Biswal Bharat B. 
Published: May 2020

AbstractFunctional MRI (fMRI) study of naturalistic conditions, e.g. movie watching, usually focuses on shared responses across subjects. However, individual differences have been attracting increasing attention in search of group differences or associations with behavioral outcomes. Individual differences are typically studied by directly modeling the pair-wise intersubject correlation matrix or projecting the relations onto a single dimension. We contend that it is critical to examine whether there are one or more consistent responses underlying the whole sample, because multiple components, if exist, may undermine the intersubject relations using the previous methods. We propose to use principal component analysis (PCA) to examine the heterogeneity of brain responses across subjects and project the individual variability into higher dimensions. By analyzing an fMRI dataset of children and adults watching a cartoon movie, we showed evidence of two consistent responses in the supramarginal gyrus and other regions. While the first components in many regions represented a response pattern mostly in older children and adults, the second components mainly represented the younger children. The second components in the supramarginal network resembled a delayed version of the first PCs for 4 seconds (2 TR), indicating slower responses in the younger children than the older children and adults. The analyses highlight the importance of identifying multiple consistent responses in responses to naturalistic stimuli. This PCA-based approach could be complementary to the commonly used intersubject correlation to analyze movie watching data.
Spatiotemporal single-cell RNA sequencing of developing hearts reveals interplay between cellular differentiation and morphogenesis
Authors: Mantri Madhav , Scuderi Gaetano J. , Nassab Roozbeh Abedini , Wang Michael F.Z. , McKellar David , Butcher Jonathan T. , De Vlaminck Iwijn 
Published: May 2020

ABSTRACTSingle-cell RNA sequencing is a powerful tool to study developmental biology but does not preserve spatial information about cellular interactions and tissue morphology. Here, we combined single-cell and spatial transcriptomics with new algorithms for data integration to study the early development of the chicken heart. We collected data from four key ventricular development stages, ranging from the early chamber formation stage to the late four-chambered stage. We created an atlas of the diverse cellular lineages in developing hearts, their spatial organization, and their interactions during development. Spatial mapping of differentiation transitions revealed the intricate interplay between cellular differentiation and morphogenesis in cardiac cellular lineages. Using spatially resolved expression analysis, we identified anatomically restricted gene expression programs. Last, we discovered a stage-dependent role for the small secreted peptide, thymosin beta-4, in the coordination of multi-lineage cellular populations. Overall, our study identifies key stage-specific regulatory programs that govern cardiac development.
Crystallographic and cryogenic electron microscopic structures and enzymatic characterization of sulfur oxygenase reductase fromSulfurisphaera tokodaii
Authors: Sato Yuta , Yabuki Takashi , Adachi Naruhiko , Moriya Toshio , Arakawa Takatoshi , Kawasaki Masato , Yamada Chihaya , Senda Toshiya , Fushinobu Shinya , Wakagi Takayoshi 
Published: May 2020

AbstractSulfur oxygenase reductases (SORs) are present in thermophilic and mesophilic archaea and bacteria, and catalyze oxygen-dependent oxygenation and disproportionation of elemental sulfur. SOR has a hollow, spherical homo-24-mer structure and reactions take place at active sites inside the chamber. The crystal structures of SORs from twoAcidianusspecies have been reported. However, the states of the active site components (mononuclear iron and cysteines) and the entry and exit paths of the substrate and products are still in dispute. Here, we report the biochemical and structural characterizations of SORs from the thermoacidophilic archaeonSulfurisphaera tokodaii(StSOR) and present high-resolution structures determined by X-ray crystallography and cryogenic electron microscopy (cryo-EM). The crystal structure of StSOR was determined at 1.73 Å resolution. At the catalytic center, iron is ligated to His86, His90, Glu114, and two water molecules. Three conserved cysteines in the cavity are located 9.5∼13 Å from the iron and were observed as free thiol forms. A mutational analysis indicated that the iron and one of the cysteines (Cys31) were essential for both activities and the other two cysteines (Cys101 and Cys104) had a supportive role. The cryo-EM structure was determined at 2.24 Å resolution using an instrument operating at 200 kV. The two structures determined by different methodologies showed similar main chain traces, but the maps exhibited different features at catalytically important components. Given the high resolution achieved in this study, StSOR was shown to be a good benchmark sample for cryo-EM measurements.HighlightsSulfur oxygenase reductase (SOR) was biochemically and structurally characterized.High resolution structures of SOR were determined by crystallography and cryo-EM.Twenty-four identical subunits of SOR form a hollow sphere.Catalytic components exhibited different features in the crystal and cryo-EM structures.