bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of chest ultrasound on diagnostic workup in elderly patients with acute respiratory failure in the emergency department: a prospective study
Authors: De Carvalho Hugo , Javaudin François , Le Bastard Quentin , Boureau Anne-Sophie , Montassier Emmanuel , Le Conte Philippe 
Published: June 2020

Diagnostic assessment of acute respiratory failure in elderly patients is often challenging, and initial misdiagnosis is associated with poorer outcomes. Chest ultrasound could help to improve diagnostic performance in this population. The objective of our study was to assess chest ultrasound (i.e. combined cardiac and lung ultrasound) add-on investigation to standard diagnosis approach in elderly patients presenting to the emergency department (ED) with acute respiratory failure.

Methods
We carried out a prospective study performed in our ED, included patients older than 75 years presenting with acute respiratory failure. Noninclusion criteria were documented palliative care or the need for immediate intensive care. After informed consent approval and routine diagnostic procedure (clinical, radiological and laboratory tests), the ED physician established the first diagnosis. Chest ultrasound was then performed, and a second diagnosis was established. An adjudication committee also established a diagnosis. The unweighted Cohen’s kappa (κ) coefficient was used to measure the strength of agreement between routine diagnostic approach, chest ultrasound and adjudication committee diagnosis.

Results
A total of 89 patients were included, mean age 86 ± 5 years old. Concordance was very good (κ = 0.82) between chest ultrasound and adjudication committee diagnostic and moderate (κ = 0.52) between routine diagnostic approach and adjudication committee diagnostic. Cardiogenic pulmonary edema and community-acquired pneumonia were the most frequent diagnoses (48.5 and 27%, respectively). Chest ultrasound had higher sensitivity and specificity for both diagnoses.

Conclusion
In our study, chest ultrasound add-on investigation to standard approach improved diagnosis performance in elderly patients presenting to the ED with acute respiratory failure. Further multicenter randomized trials are warranted to confirm this finding.
Assessment of Tamoxifen-Related Endometrial Changes in Premenopausal Female Patients With Diffusion-Weighted Magnetic Resonance Imaging
Authors: Abdel Razek Ahmed Abdel Khalek , Elkalla Hend M. Hamdey Rashed , Refky Basel , Elsergany Aliaa , Sakrana Amal Abdelsattar , Saleh Gehad , Gadelhak Basma N. 
Published: June 2020

Purpose
To evaluate tamoxifen-related endometrial changes in premenopausal female patients with diffusion-weighted magnetic resonance imaging (DWI).

Methods
This prospective study was performed on 71 premenopausal female patients (mean age, 41 years) who were receiving tamoxifen therapy. All patients underwent magnetic resonance imaging with DWI of the pelvis and hysteroscopic-guided endometrial biopsy. The apparent diffusion coefficient (ADC) values of the endometrial plate were calculated and correlated with pathological results.

Results
The mean ADCs of tamoxifen-related benign endometrial lesions (1.35 ± 0.19 and 1.32 ± 0.13 × 10−3 mm2/s) were significantly higher (P = 0.001) than those of normal endometrial plate (0.95 ± 0.11 and 0.93 ± 0.11 × 10−3 mm2/s) by both reviewers, respectively. The cutoff ADC values used to differentiate tamoxifen-related benign endometrial lesions from normal endometrium were 1.07 and 1.02 × 10−3 mm2/s with areas under the curve of 0.94 and 0.93 and accuracy of 94.4 and 95.8 by both reviewers, respectively. The mean ADC values of endometrial polyp (EP) (1.44 ± 0.19 and 1.42 ± 0.22 × 10−3 mm2/s) were significantly higher (P = 0.001) than those of endometrial hyperplasia (EH) (1.25 ± 0.19 and 1.23 ± 0.19 × 10−3 mm2/s) by both reviewers, respectively. The cutoff ADC values used to differentiate EP from EH were 1.38 × 10−3 and 1.36 × 10−3 mm2/s with areas under the curve of 0.81 and 0.77 and accuracy of 80% and 70% by both reviewers, respectively. There was an insignificant difference in ADC value between typical and atypical EH. The ADC values of endometrial cancer (0.80 and 0.78 × 10−3 mm2/s) were lower than those of tamoxifen-related benign endometrial lesions. The final diagnosis was normal endometrium (n = 36), benign endometrial lesions either EH (n = 17), or EP (n = 16), and endometrial cancer in only 2 patients.

Conclusions
We concluded that DWI helps in detection and characterization of different tamoxifen-related endometrial changes in the premenopausal female patients.
Comparative Study Between Integrated Positron Emission Tomography/Magnetic Resonance and Positron Emission Tomography/Computed Tomography in the T and N Staging of Hypopharyngeal Cancer: An Initial Result
Authors: Huang Caiyun , Song Tianbin , Mukherji Suresh Kumar , Zhang Lingyu , Lu Jie , Chen Xiaohong , Xian Junfang 
Published: June 2020

Objective
To compare the diagnostic accuracy of positron emission tomography/magnetic resonance (PET/MR) versus PET/computed tomography (PET/CT) for T and N staging of hypopharyngeal cancer.

Methods
Integrated PET/MR and PET/CT examinations were performed in 20 patients with hypopharyngeal cancer after same-day single injection. Eleven of 20 patients underwent surgery with histologic findings directly compared with imaging findings. Statistical analysis included Spearman correlation and McNemar test.

Results
Accuracy of PET/MR, PET/CT, and MRI for T staging was 81.8%, 63.6%, and 72.7%, respectively. Sensitivity and specificity for detecting metastatic lymph nodes was 88.2% and 98.2% on PET/MR, 76.5% and 98.3% on PET/CT, and 64.7% and 94.7% on MRI.

Conclusions
The PET/MR and PET/CT provide comparable results for assessing hypopharyngeal carcinoma and detecting metastatic lymph nodes.
Access to Lung Transplantation in the United States: The Potential Impact of Access to a High-volume Center
Authors: Chan Ernest G. , Hayanga J.W. Awori , Tuft Marie , Morrell Matthew R. , Sanchez Pablo G. 
Published: June 2020

Background.
Health disparities plague our healthcare system. Utilizing a novel approach, we sought to assess the effects of geographic disparities on access to lung transplantation (LT) in the United States.

Methods.
A total of 13 743 LT adult recipients in the United Network for Organ Sharing Database were identified between May 2005 and December 2014 with a zip code status. Geographic access was defined by global spherical distance from patient zip code centroid to transplant center. Measures analyzed included the association among socioeconomic status (SES), distance to a transplant center, and center switching behavior.

Results.
Median distance traveled was 62.9 miles. There was an inverse relationship between Diez Roux SES and median distance traveled (90 versus 80.1 versus 60.5 versus 30, P < 0.001). There was no association found between 5-y survival and distance traveled (P = 0.099). However, traveling >158.7 miles was associated with worse survival (hazard ration 1.1; 95% confidence interval, 1.0-1.2; P = 0.005). Over 80% of patients exhibiting center switching were transplanted at a high-volume center than their home institution. Those more likely to switch to a high-volume center were those with an associates/bachelor (P < 0.005) or graduate-level degree (P < 0.05). Recipients with high-volume home institutions had the lowest probability of switching to an alternative center (odds ratio, 0.009; P < 0.001). There was no difference in survival when comparing those transplanted at their home institution versus those who sought transplantation at an alternative institution (55.3% versus 55.0%, P = 0.41).

Conclusions.
Although there was no association among SES, distance traveled, and survival, access to LT services varies among populations in the United States.
Association between methylenetetrahydrofolate reductase gene C677T polymorphism and susceptibility to polycystic ovary syndrome
Authors: Rai Vandana , Kumar Pradeep 
Published: June 2020

AbstractPolycystic ovary syndrome (PCOS) is the most common form of endocrinopathy of women. Several studies have investigated the association of methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism with PCOS risk but the results are contradictory. So, the aim of the present study was to carry out a meta-analysis of a published case control studies to find out exact association between MTHFR gene C677T polymorphism and PCOS susceptibility. Pubmed, Springer link, Science Direct and Google Scholar databases were searched for case-control studies. Odds ratios (ORs) with 95% confidence intervals (CIs) was used as association measure and meta-analysis was performed using MIX and MetaAnalyst programs.Meta-analysis of 24 studies showed strong significant association between C677T polymorphism and PCOS risk (for T vs. C: OR= 1.18, 95% CI=1.01-1.38, p=0.03; for TT vs. CC: OR= 1.37, 95% CI=1.0-1.89, p= 0.045; for TT + CT vs. CC: OR= 1.31, 95% CI= 1.07-1.62, p= 0.008; for CT vs. CC: OR= 1.31, 95% CI= 1.04-1.62, p= 0.01 and for TT vs. CT + CC: OR= 1.10, 95% CI= 0.82-1.47, p= 0.04). In subgroup analysis, MTHFR C677T polymorphism is significantly associated with PCOS risk with Asian individuallas but in Caucasian population MTHFR C677T polymorphism was not significantly associated with PCOS risk. In conclusion, C677T polymorphism is a risk factor for PCOS.
Adaptation of bacteria to glyphosate: a microevolutionary perspective of the enzyme 5-enolpyruvylshikimate-3-phosphate (EPSP) synthase
Authors: Rainio Miia J. , Ruuskanen Suvi , Helander Marjo , Saikkonen Kari , Saloniemi Irma , Puigbò Pere 
Published: June 2020

ABSTRACTGlyphosate is the leading herbicide worldwide, but it also affects prokaryotes because it targets the central enzyme (EPSPS) of the shikimate pathway in the synthesis of the three essential aromatic amino acids in autotrophs. Our results reveal that bacteria easily become resistant to glyphosate through changes in the EPSPS active site. This indicates the importance of examining how glyphosate affects microbe-mediated ecosystem functions and human microbiomes.
Engaging Community Leaders to Identify Community Assets for Emergency Preparedness
Authors: Piltch-Loeb Rachael , Bernard Dottie , Quinones Beatriz , Harriman Nigel , Savoia Elena 
Published: June 2020

AbstractIntroductionPublic health and emergency management agencies play a critical role in addressing the needs of vulnerable populations in preparation for and in response to emergencies. Identifying and leveraging community assets is a way to address such needs. Local knowledge about community assets is a valuable and untapped resource that can be leveraged for disaster response and recovery efforts. This study focuses on the development of a process and tools to engage community leaders in sharing their knowledge about their community characteristics and assets useful for emergency planning.MethodsWe conducted interviews with community leaders across five study sites with the goal of understanding what type of local knowledge community leaders are able to share in regards to emergency preparedness. Interview questions focused on community challenges and assets that could be useful to plan for emergencies. Based on the interviews’ results we developed and tested a mobile application to generate a directory and map of community assets. Subsequently, we hosted five community meetings and two tabletop exercises to gather feedback, from community leaders and preparedness planners, on the utility of the local knowledge data produced and on the use of the mobile application to gather and share such knowledge.ResultsBased on the interviews’ results we identified two main types of local knowledge about community assets for emergency preparedness: communication-based and trust-based local knowledge. Interviews’ data were used to develop a directory of community assets embedded into a mobile application to be used by community leaders to share the location and/or point of access of specific community assets based on their knowledge. Preparedness planners, who tested the application during a tabletop exercise, found it a useful tool to raise awareness about community assets and enhance planning efforts for vulnerable populations.ConclusionCommunity leaders’ engagement in preparedness efforts is important to identify community assets that can be leveraged to address the needs of the most vulnerable segments of a community. The use of a directory of community assets, embedded in a mobile application, can enhance information sharing between community leaders and preparedness planners and facilitate the integration of community assets into preparedness efforts.
SARS-CoV-2 qRT-PCR Ct value distribution in Japan and possible utility of rapid antigen testing kit
Authors: Takeda Yuta , Mori Masatoshi , Omi Kazuya 
Published: June 2020

AbstractThe exact pathology of COVID-19 remains mostly unclear, and accurate epidemiological understanding and rapid testing are crucial to overcome this disease. Several types of nucleic acid tests (NAT) have been used in Japan, but information about the viral RNA load, determined by Ct values, of the patients is limited due to the small number of patients tested in each clinical institution and lack of standardization of the testing kits. We have been performing the qRT-PCR tests established by NIID, and the mean Ct value distribution of 62 cases, which are deemed “first-visit” patients, among the total of 88 positive cases tested in a 4-day window of early April, was 24.9 with SD=5.45. Recently approved antigen testing kits were also used in the same samples (62 positives) along with 100 negative cases, and it revealed the positive predictive value of 80.6% and negative predictive value of 100%, with an overall agreement rate of 92.6%. These results indicate that a certain number of patients with lower Ct values, existed in Japan when SARS-CoV-2 virus started to spread. The newly approved rapid antigen testing kit will be a useful tool to identify such populations rapidly.
Seroprevalence and epidemiological characteristics of immunoglobulin M and G antibodies against SARS-CoV-2 in asymptomatic people in Wuhan, China: a cross-sectional study
Authors: Ling Ruijie , Yu Yihan , He Jiayu , Zhang Jixian , Xu Sha , Sun Renrong , Zhu Wangcai , Chen Mingfeng , Li Tao , Ji Honglong , Wang Huanqiang 
Published: June 2020

AbstractObjectivesPopulation screening for IgG and IgM against SARS-CoV-2 was initiated on March 25 and was open to all residents of Wuhan who were symptom-free. All ages with no fever, headache or other symptoms of COVID-19 among residents in Wuhan were included.MethodsThis study adopted a cross-sectional study. Pearson Chi-square test, T-test, and Mann-Whitney test were used in comparison between different groups. To correct the effects of gender and age, the seroprevalence of IgM positivity, IgG positivity, and IgM and/or IgG positivity were standardized according to the gender and age-specific population of Wuhan in 2017.ResultsThe seroprevalence of IgG and IgM standardized for age and gender in Wuhan showed a downward trend. No significant correlation was observed between the seroprevalence of IgG and the different age groups. The seroprevalence was significantly higher for females than males (x2 =35.702, p < 0.001), with an odds ratio of 1.36 (95% CI: 1.24–1.48). A significant difference was seen in the seroprevalence of IgG among people from different geographic areas and different types of workplaces (respectively, x2 = 42.871, p < 0.001 and x2 = 202.43, p < 0.001). The IgG antibody-positive cases had a greater number of abnormalities in CT imaging than IgG-negative cases (30.7% vs 19.7%).ConclusionsOur work found the reported number of confirmed patients in Wuhan only represents a small proportion of the total number of infections. There was a significant aggregation of asymptomatic infections in individuals from some occupations, and based on CT and laboratory findings, some damage may have occurred in asymptomatic individuals positive for IgG antibody.Strengths and limitations of this studyThis study has the important feature of having been designed as repeated five-day serosurveys, which allowed for the monitoring of seroprevalence progression.This study applied scientific statistical methods accounting for the demographic structure of the general population and imperfect diagnostic tests to estimate seroprevalence in the overall population.This study had selection bias since the analyzed medical records were based on examinees directed by their work units.People under the age of 19 and over age 65 were too few to be fully covered in analyses.
VEGFC induced cell cycle arrest mediates sprouting and differentiation of venous and lymphatic endothelial cells
Authors: Jerafi-Vider Ayelet , Moshe Noga , Hen Gideon , Splittstoesser Daniel , Shin Masahiro , Lawson Nathan , Yaniv Karina 
Published: June 2020

AbstractThe emergence and growth of new vessels requires a tight synchronization between proliferation, differentiation and sprouting, traditionally thought to be controlled by mitogenic signals, especially of the VEGF family. However, how these cues are differentially transduced, by sometimes even neighboring endothelial cells (ECs), remains unclear. Here we identify cell-cycle progression as a new regulator of EC sprouting and differentiation. Using transgenic zebrafish illuminating cell-cycle stages, we show that venous and lymphatic precursors sprout from the Cardinal Vein (CV) exclusively in G0/G1, and reveal that cell-cycle arrest is induced in these ECs by p53 and the CDK-inhibitors p27 and p21. Moreover, we demonstrate thatin vivo, chemical and genetic cell-cycle inhibition, results in massive vascular growth. Mechanistically, we identify the mitogenic VEGFC/VEGFR3/ERK axis as direct inducer of cell-cycle arrest in angiogenic ECs and characterize the cascade of events governing venous vs. lymphatic segregation and sprouting. Overall, our results uncover an unexpected mechanism whereby mitogen-controlled cell-cycle arrest boosts sprouting, raising important questions about the use of cell-cycle inhibitors in pathological angiogenesis and lymphangiogenesis.
Adolescent intermittent ethanol exposure effects on kappa opioid receptor mediated dopamine transmission: Sex and age of exposure matter
Authors: Spodnick Mary B. , Amirault Raymond T. , Towner Trevor T. , Varlinskaya Elena I. , Spear Linda P. , Karkhanis Anushree N. 
Published: June 2020

ABSTRACTUnderage alcohol drinking increases the risk of developing alcohol use disorder (AUD). In rodents, adolescent ethanol exposure augments ethanol consumption and anxiety-like behavior while reducing social interaction. However, the underlying mechanisms driving these adaptations are not understood. The dopamine and kappa opioid receptor (KOR) systems in the nucleus accumbens (NAc) are implicated in affective disorders and AUD, with studies showing augmented KOR function and reduced dopamine transmission in ethanol-dependent adult animals. Thus, this study, we examined the impact of adolescent intermittent ethanol (AIE) exposure on dopamine transmission and KOR function. Rats were exposed to water or ethanol (4 g/kg, intragastrically) every-other-day during early (PD25–45) or late (PD45–65) adolescence. While AIE exposure during early-mid adolescence (early AIE) did not alter dopamine release in male and female rats, AIE exposure during late adolescence (late AIE) resulted in greater dopamine release in males and lower dopamine release in females. To determine the impact of AIE exposure on KOR function, we bath applied cumulative concentrations of KOR agonist, U50,488 (0.01–1.0 μM), and measured its effect on dopamine release. Early AIE exposure potentiated KOR-mediated inhibition of dopamine release in female rats, while late AIE exposure attenuated this effect in male rats. Together these data suggest that AIE-exposure impact on neural processes is dependent on sex and exposure timing. These differences likely arise from differential developmental timing in males and females. This is the first study to show changes in KOR function following AIE exposure.
The impact of the Covid-19 lockdown on the experiences and feeding practices of new mothers in the UK: Preliminary data from the COVID-19 New Mum Study
Authors: Vazquez Adriana , Dib Sarah , Rougeaux Emeline , Wells Jonathan , Fewtrell Mary 
Published: June 2020

AbstractBackgroundThe COVID-19 New Mum Study is recording maternal experiences and infant feeding during the period of UK lockdown. This report from week 1 of the survey aims to (1) provide information relevant for those supporting this population; (2) identify groups currently under-represented in the survey.MethodsWomen living in the UK aged ≥18 years with an infant ≤12 months of age completed an anonymous online survey (https://is.gd/covid19newmumstudy). Information/links are shared via websites, social media and existing contacts.ResultsBetween May 27thand June 3rd2020, 1365 women provided data (94% white, 95% married/with partner, 66% degree/higher qualification, 86% living in house; 1049 (77%) delivered before lockdown (BL) and 316 (23%) during lockdown (DL). Delivery mode, skin-to-skin contact and breastfeeding initiation did not differ between groups. DL women had shorter hospital stays (p<0.001) and 39% reported changes to their birth plan. Reflecting younger infant age, 59% of DL infants were exclusively breast-fed or mixed fed versus 39% of BL (p<0.05). Thirteen % reported a change in feeding; often related to lack of breastfeeding support, especially with practical problems. Important sources of feeding support were the partner (60%), health professional (50%) and online groups (47%). 45% of DL women reported insufficient support with feeding. Among BL women, 57% and 69% reported decreased feeding support and childcare, respectively. 40% BL/45% DL women reported insufficient support with their own health, 8%/9% contacted a mental health professional and 11% reported their mental health was affected. 9% highlighted lack of contact and support from family and distress that they had missed seeing the baby.ConclusionLockdown has had an impact on maternal experiences, resulting in distress for many women. Survey participants are currently not representative of the population; notably, groups at greater risk are under-represented. Increasing the diversity of participants is a priority.Survey fundingNone. All research at Great Ormond Street Hospital NHS Foundation Trust and UCL Great Ormond Street Institute of Child Health is made possible by the NIHR Great Ormond Street Hospital Biomedical Research Centre. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health.