bluuebunny/crossref_metadata_2025_split huggingface dataset:
Liver injury in patients with severe acute respiratory syndrome coronavirus-2 infection: a systematic review and meta-analysis
Authors: Labenz Christian , Toenges Gerrit , Wörns Marcus-Alexander , Sprinzl Martin F. , Galle Peter R. , Schattenberg Jörn M. 
Published: August 2020

Objective
Coronavirus disease-19 (COVID-19) infection is a global health threat. To inform the liver community on the potential relevance of COVID-19, we performed a systematic review and meta-analysis of published data on liver injury in patients with COVID-19 infection.

Methods
We searched PubMed and Google Scholar through 22 March according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Pooled data were analyzed by using random-effects meta-analyses.

Results
A total of 14 studies combining data from 2.871 patients were identified. The prevalence of pre-existing liver disease was reported at 3.1%. The pooled prevalence of elevated aspartate aminotransferase (AST) and alanine transaminase (ALT) levels were 26% [95% confidence interval (CI), 20–32%] and 19% (95% CI, 14–26%), respectively. Only two studies reported the prevalence of elevated liver function tests according to normal ward versus ICU and here the frequency of elevated levels of AST was 50% and 62% versus ALT 40.8% and thus quantitatively higher in ICU-treated patients. Mean levels of absolute AST levels were 33 U/L (95% CI, 30.21–36.09), while mean ALT levels were 31 U/L (95% CI, 27.52–34.57). Cholestatic liver function tests were only incompletely reported in 510 patients. Here, mean levels of alkaline phosphatase were 71 U/L across three studies, and mean levels of gamma-glutamyl transferase were 40.6 U/L across four studies.

Conclusions
Emerging data on LFTs in COVID-19 are heterogeneous indicating mild LFTs involvement in every fourth to fifth patients with numerical more prevalent AST over ALT elevations. Prospective studies are needed to define the clinical relevance of liver injury in COVID-19.
Serial measurements of faecal calprotectin may discriminate intestinal tuberculosis and Crohn’s disease in patients started on antitubercular therapy
Authors: Sharma Vishal , Verma Suhang , Kumar-M Praveen , Mandavdhare Harshal S. , Singh Harjeet , Shah Jimil , Kalsi Dimple , Dutta Amitava , Mishra Shubhra , Prasad Kaushal K. , Sharma Arun K. , Dutta Usha 
Published: August 2020

Background
Response to antitubercular therapy (ATT) is often used to differentiate intestinal tuberculosis (ITB) from Crohn’s disease. Role of non-invasive biomarkers to predict mucosal response to ATT is unclear.

Materials and methods
A prospective study to compare faecal calprotectin and serum C-reactive protein (CRP) levels at diagnosis, 2 and 6 months of ATT in patients with suspected ITB started on ATT was done. The patients were eventually divided into two groups: ITB or alternative diagnosis (OTH). Decline of calprotectin and CRP levels was used to compute area under the receiver operating characteristic (AUROC) to predict mucosal healing at 2 months.

Results
Thirty-seven patients (mean age: 34.95 ± 16.35 years, 23 males) were included and 28 (75.67%) were diagnosed as ITB while nine (24.32%) had alternative diagnosis (OTH). The median faecal calprotectin values of ITB and OTH groups at baseline, 2 months and 6 months were 216 and 282 µg/g (P = 0.466), 43 and 216 µg/g (P = 0.003), and 26 and 213 µg/g (P < 0.001), respectively. The median CRP values at baseline, 2 months and 6 months were 18 and 30 mg/L (P = 0.767), 4.7 and 15 mg/L (P = 0.025), and 3 and 10.85 mg/L (P = 0.068), respectively. The AUROC of percent decline in faecal calprotectin and serum CRP at 2 months for mucosal healing were 0.8287 [95% confidence inteval (CI) 0.6472–1] and 0.6018 (95% CI 0.4079–0.7957), respectively.

Conclusion
Faecal calprotectin can help in assessing response to therapy in suspected ITB patients started on empirical ATT.
The effects of diabetes mellitus on clinical outcomes of hospitalized patients with acute diverticulitis
Authors: Jiang Yi , Rodgers Brandon , Damiris Konstantinos , Choi Catherine , Ahlawat Sushil 
Published: August 2020

Objectives
Acute diverticulitis is a common gastrointestinal illness due to diverticular inflammation and focal necrosis. Diabetes mellitus has been reported to influence the outcomes of patients with diverticular disease. Our study aimed to examine the inpatient outcomes and complications of patients with acute diverticulitis and coexisting diabetes mellitus.

Methods
The Nationwide Inpatient Sample was used to identify adult patients in 2014 admitted for acute diverticulitis. Primary outcomes were mortality, length of stay (LOS), and total hospitalization charges. Secondary outcomes were complications of acute diverticulitis and interventions.

Results
In total, 44 330 of patients with acute diverticulitis and diabetes mellitus were included in the analysis. Acute diverticulitis patients with diabetes mellitus had a higher rate of diverticular bleeding (P < 0.0001), but lower rates of abscess (P < 0.0001), obstruction (P < 0.0001) and colectomy (P < 0.0001) when compared to acute diverticulitis patients without diabetes mellitus. Complicated diabetes mellitus was associated with a longer LOS (P = 0.00003) and greater total hospitalization charges (P = 0.0021) compared to uncomplicated diabetes mellitus when coexisting with acute diverticulitis.

Conclusions
Acute diverticulitis with diabetes mellitus is associated with a higher rate of diverticular bleeding, lower rates of abscess, obstruction, and colectomy compared to acute diverticulitis without diabetes mellitus. When coexisting with acute diverticulitis, complicated diabetes mellitus is not associated with higher rates of mortality or diverticulitis-related complications compared to uncomplicated diabetes mellitus.
99mTc-dimercaptosuccinic acid scan versus MRI in pyelonephritis: a meta-analysis
Authors: Sarikaya Ismet , Albatineh Ahmed N. , Sarikaya Ali 
Published: August 2020

Purpose

99mTc-dimercaptosuccinic acid (DMSA) scan is the current gold standard in detecting parenchymal changes, particularly scarring, in pyelonephritis. Recently, magnetic resonance imaging (MRI) is gaining popularity in the diagnosis of pyelonephritis. The aim of this study is to perform a meta-analysis on studies directly comparing MRI to DMSA scan in patients with pyelonephritis.

Materials
Systematic searches of PUBMED and EMBASE databases were performed to extract studies comparing MRI and DMSA scan in patients with pyelonephritis. The relevance of articles was assessed by two authors according to predefined inclusion and exclusion criteria. The pooled estimates of the sensitivities of MRI and DMSA scan were computed using random-effects meta-analysis model following DerSimonian and Laird’s method. Subgroup analysis and publication bias were performed.

Results
Seven studies were included (164 patients). Using random effect model, the pooled estimate of the sensitivities of MRI and DMSA scan were 0.62 (95%CI: 0.44 – 0.77) and 0.59 (95%CI: 0.48 – 0.70), respectively. The pooled estimates of sensitivities of MRI and DMSA scan for acute pyelonephritis were 0.73 (95%CI: 0.49- 0.89) and 0.66 (95%CI: 0.56 – 0.75), respectively, and for scar detection were 0.48 (95%CI: 0.31- 0.66), and 0.50 (95%CI: 0.30 – 0.71), respectively.

Conclusion
The overall sensitivities of MRI and DMSA scan were equivalent in detecting parenchymal changes in pyelonephritis. MRI and DMSA scan appeared to be equivalent to scar detection. In a small number of studies, MRI appeared to be better than the DMSA scan in acute pyelonephritis but this should be further studied in a larger number of patients.
Universal Trauma Screening in an Adult Behavioral Health Setting
Authors: Streb Stephanie , Burda Charon 
Published: August 2020

Purpose/Objectives
The Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (PCL-5) with Criterion A was universally used in admission screening to pilot a trauma-informed care process for quality improvement.

Description of the Project
All adult inpatient behavioral health patients at a Mid-Atlantic county hospital were screened for trauma exposure on admission. Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition with Criterion A was provided to all adults admitted to a 27-bed inpatient behavioral health unit for 8 weeks. Quantitative descriptive statistics were calculated based on self-report PCL-5 scores; qualitative data were gathered from staff and stakeholders.

Outcome
During the pilot period, there was a 49.2% response rate. Fifty respondents (53.8%) screened positive for trauma as recorded on the Criterion A portion. Seventeen (18.3%) were negative for trauma self-report, and 26 (30.0%) did not complete this portion. Fifty-six (60.2%) completed screens scored 33 or greater on the PCL-5 portion. Staff found the timing of administration convenient but expressed concern over emotional cost to patient.

Conclusions
Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition with Criterion A served as guidepost for trauma-informed assessment, treatment, and referrals. Future considerations may include timing of presentation to patient, electronic translation of the tool to facilitate interdisciplinary collaboration, and tracking of screening completion.
Building Evidence-Based Practice Competency Through Interactive Workshops
Authors: O'Shea Debra , Fischer-Cartlidge Erica 
Published: August 2020

Background
Consistent implementation of evidence-based practice (EBP) leads to high-quality care, improved patient outcomes, and reduced costs. Increased job satisfaction, decreased turnover, and increased autonomy are reported when nurses use evidence for practice decisions. It is essential that clinical nurse specialists have strong EBP skills and enculturate these skills into bedside staff.

Project Design and Implementation
Interactive 90-minute workshops were developed to review the steps of EBP. The participants were nurses at the bedside and were encouraged to cultivate a spirit of inquiry.

Outcome Evaluation
Twenty-three workshops were held with 349 participants. Pre and post surveys were used to assess changes in knowledge and self-perceived confidence. A moderate to large effect size was noted in all areas measured. The largest change in knowledge was in correct identification of use of Boolean operators, which showed a 71% improvement. Overall mean knowledge improved by 29%, which was statistically significant (P < .0001).

Implications for Practice
Clinical nurse specialists can enact culture change by understanding the needs of their stakeholders and applying concepts to find creative ways to bring change to staff. This workshop successfully taught EBP concepts and implemented culture change in a way that was low cost and easy to replicate.
Association of chronic spinal pain with diet quality
Authors: Zick Suzanna Maria , Murphy Susan Lynn , Colacino Justin 
Published: August 2020

Abstract

Introduction:
Chronic spinal pain is disabling and has high personal and societal costs. Risk factors include behavioral factors; however, little is known about the role of diet quality and its association with spinal pain. Higher diet quality and consumption of macronutrients that drive higher diet quality were hypothesized to be associated with lower odds of having spinal pain.

Methods:
An analysis of a population-based data set (NHANES cycle 2009–2010) was conducted. Diet quality was calculated using the Healthy Eating Index 2015 (score 0–100). To examine odds of pain related to dietary intake, generalized linear regressions were used adjusting for relevant covariates.

Results:
Of 4123 participants (mean age 43.5 ± 0.44 [SD], 2167 [52.6%] female), 800 (19.4%) reported chronic spinal pain. People with chronic spinal pain consumed similar amounts of calories to those with no spinal pain (2137 ± 44.5 vs 2159.9 ± 27.7), but had significantly poorer diet quality compared to people without spinal pain (51.97 ± 0.65 vs 54.31 ± 0.39, P = 0.007). From multivariate analyses, individuals with diet quality in the highest tertile on Healthy Eating Index-2015 were 24% less likely to report chronic spinal pain relative to those in the lowest tertile. Higher fruit, whole grain, and dairy intake were associated with 20% to 26% lower likelihood (all P for trend <0.028) of chronic spinal pain. Added sugars were associated with 49% increased odds of chronic spinal pain (P for trend = 0.002).

Conclusion:
Although causality cannot be assumed, this study supports continued investigation into the role of nutritional quality as a factor that may impact pain.
Using HIV self-testing to increase the affordability of community-based HIV testing services
Authors: d’Elbée Marc , Makhetha Molemo Charles , Jubilee Makhahliso , Taole Matee , Nkomo Cyril , Machinda Albert , Tlhomola Mphotleng , Sande Linda A. , Gomez Guillen Gabriela B. , Corbett Elizabeth L. , Johnson Cheryl C. , Hatzold Karin , Meyer-Rath Gesine , Terris-Prestholt Fern 
Published: August 2020

Objectives:
This study estimates the costs of community-based HIV testing services (HTS) in Lesotho and assesses the potential efficiency gains achieved by adding HIV self-testing (HIVST) and then self-testing booths.

Design:
Micro-costing analysis using longitudinal data from a real-world intervention.

Methods:
We collected data prospectively on provider's costs and programmatic outcomes over three time periods of approximately 8 months each, between May 2017 and April 2019. The scope of services was extended during each period as follows: HTS only, HTS and HIVST, HTS and HIVST with individual HIVST booths wherein clients were encouraged to self-test on-site followed by on-site confirmative testing for those with reactive self-test. For each implementation period, we estimated the full financial and economic implementation costs, the incremental costs of adding HIVST onto conventional HTS and the cost per HIV positive case identified.

Results:
Costs per HIV-positive case identified increased between period 1 (US$956) and period 2 (US$1249) then dropped in period 3 (US$813). Full versus incremental cost analyses resulted in large differences in the magnitude of costs, attributable to methods rather than resource use: for example, in period 3, the average full and incremental cost estimates for HTS were US$34.3 and US$23.5 per person tested, and for HIVST were US$37.7 and US$14.0 per kit provided, respectively.

Conclusion:
In Lesotho, adding HIVST to community-based HTS improves its overall affordability for HIV-positive case finding. The reporting of both full and incremental cost estimates increase transparency for use in priority setting, budgeting and financial planning for scale-up.
Philtrum Reconstruction Using a Triangular-Frame Conchae Cartilage Graft in Secondary Cleft Lip Deformities
Authors: Wei Jiao , Zhang Jinsong , Herrler Tanja , Zhang Yi , Li Qingfeng , Hua Chenqing , Dai Chuanchang 
Published: August 2020

Background:
The philtrum represents an essential feature in the architecture of the upper lip and over all facial appearance. A missing philtral ridge and dimple after cleft lip repair is associated with aesthetic impairment. The authors therefore developed a novel strategy for philtrum reconstruction using a triangular-frame conchae cartilage. The authors herein describe the surgical procedure and evaluate the postoperative outcomes.

Method:
In this study, 32 patients with a deficiency of the philtrum due to unilateral or bilateral cleft lip underwent reconstructive surgery based on a triangular-frame conchae cartilage graft. Preoperative and postoperative assessment of the convexity of the philtral ridge and dimpling was performed at rest and while puckering by standard patient photography and video technology. Postoperative outcome and complications were recorded during follow-up including a patient satisfaction survey.

Results:
The follow-up period after philtrum reconstruction ranged from 6 months to 5.3 years. Postoperative evaluation showed satisfactory and stable results with an aesthetic philtral ridge and dimpling, even in the long term. The vast majority (31 patients) were satisfied with the postoperative outcome. Complications included acute infection (1 case), temporary stiffness of smile (1 case), and reddening of the scar (1 case). No systemic complications occurred.

Conclusion:
The authors here propose a simple, effective, and reliable surgical technique for secondary philtrum reconstruction in cleft lip deformity patients using a triangular-frame auricular cartilage graft.

Level of Evidence:
4
Anti-pig IgE and IgA Antibodies in Naive Primates and Nonhuman Primates With Pig Xenografts
Authors: Li Qi , Iwase Hayato , Yamamoto Takayuki , Nguyen Huy Quoc , Ayares David , Wang Yi , Cooper David K.C. , Hara Hidetaka 
Published: August 2020

Background.
Natural preformed anti-pig IgM/IgG antibodies in primates play an important role in xenograft rejection. As it is not clear how IgE and IgA engage in the immune system in xenotransplantation, we investigated natural preformed and elicited anti-pig IgE/IgA in naive primates and after xenotransplantation in nonhuman primates.

Methods.
The binding of IgM/IgG/IgE/IgA antibodies to red blood cells (RBCs) from wild-type (WT), α1,3-galactosyltransferase gene-knockout (GTKO), and GTKO/cytidine monophospho-N-acetylneuraminic acid hydroxylase gene-knockout/β-1,4 N-acetylgalactosaminyltransferase 2 gene-knockout (ie, triple-knockout pigs) pigs were measured by flow cytometry in naive human (n = 50) and baboon (n = 14) sera. Antibody binding to WT and GTKO pig RBCs (pRBCs) was also measured in the sera of baboons (nonsensitized n = 7, sensitized n = 2) and rhesus monkeys (nonsensitized n = 2, sensitized n = 11) following WT or GTKO pig organ/tissue xenotransplantation. Deposition of IgM/IgG/IgE/IgA in the grafts was detected by immunohistochemistry.

Results.
The majority of humans had natural preformed IgM/IgG/IgE/IgA to WT and GTKO pRBCs. In contrast, IgM/IgG/IgE/IgA to triple-knockout pRBCs were present at lower levels and frequency (P < 0.01). Baboons also had IgM/IgG/IgE/IgA antibodies against WT pRBCs, but fewer to GTKO and triple-knockout (P < 0.01). After xenotransplantation into nonhuman primates, when IgM/IgG increased, IgE/IgA also increased, but to a lesser extent. In addition to IgM/IgG, IgE or IgA deposition was observed in rejected pig xenografts.

Conclusions.
Primates develop serum anti-pig IgE/IgA antibodies both naturally and during xenograft rejection. The pathophysiological role, if any, of anti-pig IgE/IgA antibodies remains unknown.
The increasing role of muscle MRI to monitor changes over time in untreated and treated muscle diseases
Authors: Nuñez-Peralta Claudia , Alonso-Pérez Jorge , Díaz-Manera Jordi 
Published: August 2020

Purpose of review
This review aims to discuss the recent results of studies published applying quantitative MRI sequences to large cohorts of patients with neuromuscular diseases.

Recent findings
Quantitative MRI sequences are now available to identify and quantify changes in muscle water and fat content. These two components have been associated with acute and chronic injuries, respectively. Studies show that the increase in muscle water is not only reversible if therapies are applied successfully but can also predict fat replacement in neurodegenerative diseases. Muscle fat fraction correlates with muscle function tests and increases gradually over time in parallel with the functional decline of patients with neuromuscular diseases. There are new spectrometry-based sequences to quantify other components, such as glycogen, electrolytes or the pH of the muscle fibre, extending the applicability of MRI to the study of several processes in neuromuscular diseases.

Summary
The latest results obtained from the study of long cohorts of patients with various neuromuscular diseases open the door to the use of this technology in clinical trials, which would make it possible to obtain a new measure for assessing the effectiveness of new treatments. The challenge is currently the popularization of these studies and their application to the monitoring of patients in the daily clinic.
Production of Trimeric SARS-CoV-2 Spike Protein by CHO Cells for Serological COVID-19 Testing
Authors: Johari Yusuf B. , Jaffé Stephen R.P. , Scarrott Joseph M. , Johnson Abayomi O. , Mozzanino Théo , Pohle Thilo H. , Maisuria Sheetal , Bhayat-Cammack Amina , Brown Adam J. , Tee Kang Lan , Jackson Philip J. , Wong Tuck Seng , Dickman Mark J. , Sargur Ravishankar , James David C. 
Published: August 2020

ABSTRACTWe describe scalable and cost-efficient production of full length, His-tagged SARS-CoV-2 spike glycoprotein trimer by CHO cells that can be used to detect SARS-CoV-2 antibodies in patient sera at high specificity and sensitivity. Transient production of spike in both HEK and CHO cells mediated by PEI was increased significantly (up to 10.9-fold) by a reduction in culture temperature to 32°C to permit extended duration cultures. Based on these data GS-CHO pools stably producing spike trimer under the control of a strong synthetic promoter were cultured in hypothermic conditions with combinations of bioactive small molecules to increase yield of purified spike product 4.9-fold to 53 mg/L. Purification of recombinant spike by Nichelate affinity chromatography initially yielded a variety of co-eluting protein impurities identified as host cell derived by mass spectrometry, which were separated from spike trimer using a modified imidazole gradient elution. Purified CHO spike trimer antigen was used in ELISA format to detect IgG antibodies against SARS-CoV-2 in sera from patient cohorts previously tested for viral infection by PCR, including those who had displayed COVID-19 symptoms. The antibody assay, validated to ISO 15189 Medical Laboratories standards, exhibited a specificity of 100% and sensitivity of 92.3%. Our data show that CHO cells are a suitable host for the production of larger quantities of recombinant SARS-CoV-2 trimer which can be used as antigen for mass serological testing.
ApharSeq: An Extraction-free Early-Pooling Protocol for Massively Multiplexed SARS-CoV-2 Detection
Authors: Chappleboim Alon , Joseph-Strauss Daphna , Rahat Ayelet , Sharkia Israa , Adam Miriam , Kitsberg Daniel , Fialkoff Gavriel , Lotem Matan , Gershon Omer , Schmidtner Anna-Kristina , Oiknine-Djian Esther , Klochendler Agnes , Sadeh Ronen , Dor Yuval , Wolf Dana , Habib Naomi , Friedman Nir 
Published: August 2020

AbstractThe global SARS-CoV-2 pandemic created a dire need for viral detection tests worldwide. Most current tests for SARS-CoV-2 are based on RNA extraction followed by quantitative reverse-transcription PCR assays. While automation and improved logistics increased the capacity of these tests, they cannot exceed the lower bound dictated by one extraction and one RT-PCR reaction per sample. Multiplexed next generation sequencing (NGS) assays provide a dramatic increase in throughput, and hold the promise of richer information including viral strains, host immune response, and multiple pathogens.Here, we establish a significant improvement of existing RNA-seq detection protocols. Our workflow, ApharSeq, includes a fast and cheap RNA capture step, that is coupled to barcoding of individual samples, followed by sample-pooling prior to the reverse transcription, PCR and massively parallel sequencing. Thus, only one non-enzymatic step is performed before pooling hundreds of barcoded samples for subsequent steps and further analysis. We characterize the quantitative aspects of the assay by applying ApharSeq to more than 500 clinical samples in a robotic workflow. The assay results are linear, and the empirical limit of detection is found to be Ct 33 (roughly 1000 copies/ml). A single ApharSeq test currently costs under 1.2$, and we estimate costs can further go down 3-10 fold. Similarly, we estimate a labor reduction of 10-100 fold, automated liquid handling of 5-10 fold, and reagent requirement reduction of 20-1000 fold compared to existing testing methods.