bluuebunny/crossref_metadata_2025_split huggingface dataset:
Initial Naval Training for Medical Officers: successes and opportunities
Authors: Heil K M , Thornback A 
Published: November 2020

AbstractIn 2012, the Initial Officer Training (INT(O)) pipeline for Royal Navy Medical and Dental Officers (RN MODOs) was reorganised to ensure the same key training objectives were met by all Officers in the RN. This modernisation programme was initiated by the Institute of Naval Medicine (INM) and Britannia Royal Naval College (BRNC), to guarantee that MOs possess the leadership and military skills required for service in the Royal Navy.This article describes the course and how it has developed over the seven years since its introduction. It aims to give an understanding of what initial MO training involves, some areas of opportunity, and intends to inform potential RN Medical Service applicants about what they can expect during initial training.
A structured review of literature on body composition profiles in Navy personnel: current practices and considerations for the future
Authors: Havenetidis K , Bissas A 
Published: November 2020

AbstractIntroductionThere is need of a better understanding of body composition profiles in multi-national Navy personnel and their relationship with health and fitness. The aim of this review was to produce a critical assessment of original research addressing body composition in this military branch.MethodsElectronic databases PubMed and SPORTDiscus were searched to identify surveys and randomised clinical trials from journal articles and technical reports investigating body composition profiles on Navy populations.ResultsTwenty-two studies were selected on the basis of stated inclusion criteria for military surveys and randomised clinical trials. Excepting Navy personnel in special operation force units, data indicated that body composition profiles, as determined by Body Mass Index (BMI) and body fat percentage for Navy personnel, were lower compared to respective Army profiles. BMI values increase from shore to ship deployment, with body composition profiles showing less healthy trends for personnel serving on vessels with limited space, whilst special operation forces do not conform to this pattern, constituting a mission-oriented body composition profile.ConclusionsBody composition profiles in multi-national Navy personnel vary in relation to other military branches, geographical locations, specialty and deployment status. There is a need to validate new body composition techniques so recruitment is based on more representative profiles. Finally, the development of fitness interventions for personnel serving on vessels is deemed absolutely necessary in order to counterbalance health and fitness negative adaptations.
3 Commando Brigade - United States Marine Corps medical interoperability
Authors: Andrews S 
Published: November 2020

AbstractThis article describes a study investigating the medical interoperability of 3 Commando Brigade (3 Cdo Bde) with the US Marine Corps (USMC), predominately in the Role 2 and overarching Command and Control domain. This was conducted over two main exercise periods in 2017. The information was gathered through coalition casualty serials, face to face interviews, attendance at US training courses and visits to US facilities.The operational patient care pathways are broadly interoperable. There is no critical factor that would prevent medical interoperability between 3 Cdo Bde and the USMC if medical treatment facilities were required to deploy on imminent operations.
Surgeons in surge — the versatility of the acute care surgeon: outcomes of COVID-19 ICU patients in a community hospital where all ICU patients are managed by surgical intensivists
Authors: Choron Rachel Leah , Butts Christopher A , Bargoud Christopher , Krumrei Nicole , Teichman Amanda L , Schroeder Mary , Bover Manderski Michelle T , To Jennifer , Moffa Salvatore M , Rodricks Michael B , Lissauer Matthew , Gupta Rajan 
Published: November 2020

BackgroundReported characteristics and outcomes of critically ill patients with COVID-19 admitted to the intensive care unit (ICU) are widely disparate with varying mortality rates. No literature describes outcomes in ICU patients with COVID-19 managed by an acute care surgery (ACS) division. Our ACS division manages all ICU patients at a community hospital in New Jersey. When that hospital was overwhelmed and in crisis secondary to COVID-19, we sought to describe outcomes for all patients with COVID-19 admitted to our closed ICU managed by the ACS division.MethodsThis was a prospective case series of the first 120 consecutive patients with COVID-19 admitted on March 14 to May 10, 2020. Final follow-up was May 27, 2020. Patients discharged from the ICU or who died were included. Patients still admitted to the ICU at final follow-up were excluded.ResultsOne hundred and twenty patients were included (median age 64 years (range 25–89), 66.7% men). The most common comorbidities were hypertension (75; 62.5%), obesity (61; 50.8%), and diabetes (50; 41.7%). One hundred and thirteen (94%) developed acute respiratory distress syndrome, 89 (74.2%) had shock, and 76 (63.3%) experienced acute kidney injury. One hundred (83.3%) required invasive mechanical ventilation (IMV). Median ICU length of stay (LOS) was 8.5 days (IQR 9), hospital LOS was 14.5 days (IQR 13). Mortality for all ICU patients with COVID-19 was 53.3% and 62% for IMV patients.ConclusionsThis is the first report of patients with COVID-19 admitted to a community hospital ICU managed by an ACS division who also provided all surge care. Mortality of critically ill patients with COVID-19 admitted to an overwhelmed hospital in crisis may not be as high as initially thought based on prior reports. While COVID-19 is a non-surgical disease, ACS divisions have the capability of successfully caring for both surgical and medical critically ill patients, thus providing versatility in times of crisis.Level of evidenceLevel V.
New‐Onset Atrial Fibrillation After Coronary Artery Bypass Grafting and Long‐Term Outcome: A Population‐Based Nationwide Study From the SWEDEHEART Registry
Authors: Taha Amar , Nielsen Susanne J. , Bergfeldt Lennart , Ahlsson Anders , Friberg Leif , Björck Staffan , Franzén Stefan , Jeppsson Anders 
Published: November 2020

Background
The long‐term impact of new‐onset postoperative atrial fibrillation (POAF) after coronary artery bypass grafting and the benefit of early‐initiated oral anticoagulation (OAC) in patients with POAF are uncertain.

Methods and Results
All patients who underwent coronary artery bypass grafting without preoperative atrial fibrillation in Sweden from 2007 to 2015 were included in a population‐based study using data from 4 national registries: SWEDEHEART (Swedish Web System for Enhancement and Development of Evidence‐based Care in Heart Disease Evaluated According to Recommended Therapies), National Patient Registry, Dispensed Drug Registry, and Cause of Death Registry. POAF was defined as any new‐onset atrial fibrillation during the first 30 postoperative days. Cox regression models (adjusted for age, sex, comorbidity, and medication) were used to assess long‐term outcome in patients with and without POAF, and potential associations between early‐initiated OAC and outcome. In a cohort of 24 523 patients with coronary artery bypass grafting, POAF occurred in 7368 patients (30.0%), and 1770 (24.0%) of them were prescribed OAC within 30 days after surgery. During follow‐up (median 4.5 years, range 0‒9 years), POAF was associated with increased risk of ischemic stroke (adjusted hazard ratio [aHR] 1.18 [95% CI, 1.05‒1.32]), any thromboembolism (ischemic stroke, transient ischemic attack, or peripheral arterial embolism) (aHR 1.16, 1.05‒1.28), heart failure hospitalization (aHR 1.35, 1.21‒1.51), and recurrent atrial fibrillation (aHR 4.16, 3.76‒4.60), but not with all‐cause mortality (aHR 1.08, 0.98‒1.18). Early initiation of OAC was not associated with reduced risk of ischemic stroke or any thromboembolism but with increased risk for major bleeding (aHR 1.40, 1.08‒1.82).

Conclusions
POAF after coronary artery bypass grafting is associated with negative prognostic impact. The role of early OAC therapy remains unclear. Studies aiming at reducing the occurrence of POAF and its consequences are warranted.
Biochemical and genetic analysis of Ecm14, a conserved fungal pseudopeptidase
Authors: McDonald R. Christian , Schott Matthew J. , Idowu Temitope A. , Lyons Peter J. 
Published: November 2020

AbstractBackgroundLike most major enzyme families, the M14 family of metallocarboxypeptidases (MCPs) contains a number of pseudoenzymes predicted to lack enzyme activity and with poorly characterized molecular function. The genome of the yeastSaccharomyces cerevisiaeencodes one member of the M14 MCP family, a pseudoenzyme named Ecm14 proposed to function in the extracellular matrix. In order to better understand the function of such pseudoenzymes, we studied the structure and function of Ecm14 inS. cerevisiae.ResultsA phylogenetic analysis of Ecm14 in fungi found it to be conserved throughout the ascomycete phylum, with a group of related pseudoenzymes found in basidiomycetes. To investigate the structure and function of this conserved protein, His6-tagged Ecm14 was overexpressed in Sf9 cells and purified. The prodomain of Ecm14 was cleaved in vivo and in vitro by endopeptidases, suggesting an activation mechanism; however, no activity was detectable using standard carboxypeptidase substrates. In order to determine the function of Ecm14 using an unbiased screen, we undertook a synthetic lethal assay. Upon screening approximately 27,000 yeast colonies, twenty-two putative synthetic lethal clones were identified. Further analysis showed many to be synthetic lethal with auxotrophic marker genes and requiring multiple mutations, suggesting that there are few, if any, singleS. cerevisiaegenes that present synthetic lethal interactions withecm14Δ.ConclusionsWe show in this study that Ecm14, although lacking detectable enzyme activity, is a conserved carboxypeptidase-like protein that is secreted from cells and is processed to a mature form by the action of an endopeptidase. Our study and datasets from other recent large-scale screens suggest a role for Ecm14 in processes such as vesicle-mediated transport and aggregate invasion, a fungal process that has been selected against in modern laboratory strains ofS. cerevisiae.
A nomogramic model based on clinical and laboratory parameters at admission for predicting the survival of COVID-19 patients
Authors: Ma Xiaojun , Wang Huifang , Huang Junwei , Geng Yan , Jiang Shuqi , Zhou Qiuping , Chen Xuan , Hu Hongping , Li Weifeng , Zhou Chengbin , Gao Xinglin , Peng Na , Deng Yiyu 
Published: November 2020

Abstract
Background
COVID-19 has become a major global threat. The present study aimed to develop a nomogram model to predict the survival of COVID-19 patients based on their clinical and laboratory data at admission.

Methods
COVID-19 patients who were admitted at Hankou Hospital and Huoshenshan Hospital in Wuhan, China from January 12, 2020 to March 20, 2020, whose outcome during the hospitalization was known, were retrospectively reviewed. The categorical variables were compared using Pearson’s χ2-test or Fisher’s exact test, and continuous variables were analyzed using Student’s t-test or Mann Whitney U-test, as appropriate. Then, variables with a P-value of ≤0.1 were included in the log-binomial model, and merely these independent risk factors were used to establish the nomogram model. The discrimination of the nomogram was evaluated using the area under the receiver operating characteristic curve (AUC), and internally verified using the Bootstrap method.

Results
A total of 262 patients (134 surviving and 128 non-surviving patients) were included in the analysis. Seven variables, which included age (relative risk [RR]: 0.905, 95% confidence interval [CI]: 0.868–0.944; P < 0.001), chronic heart disease (CHD, RR: 0.045, 95% CI: 0.0097–0.205; P < 0.001, the percentage of lymphocytes (Lym%, RR: 1.125, 95% CI: 1.041–1.216; P = 0.0029), platelets (RR: 1.008, 95% CI: 1.003–1.012; P = 0.001), C-reaction protein (RR: 0.982, 95% CI: 0.973–0.991; P < 0.001), lactate dehydrogenase (LDH, RR: 0.993, 95% CI: 0.990–0.997; P < 0.001) and D-dimer (RR: 0.734, 95% CI: 0.617–0.879; P < 0.001), were identified as the independent risk factors. The nomogram model based on these factors exhibited a good discrimination, with an AUC of 0.948 (95% CI: 0.923–0.973).

Conclusions
A nomogram based on age, CHD, Lym%, platelets, C-reaction protein, LDH and D-dimer was established to accurately predict the prognosis of COVID-19 patients. This can be used as an alerting tool for clinicians to take early intervention measures, when necessary.
Using optical coherence tomography and intravascular ultrasound imaging to quantify coronary plaque cap thickness and vulnerability: a pilot study
Authors: Lv Rui , Maehara Akiko , Matsumura Mitsuaki , Wang Liang , Wang Qingyu , Zhang Caining , Guo Xiaoya , Samady Habib , Giddens Don P. , Zheng Jie , Mintz Gary S. , Tang Dalin 
Published: November 2020

Abstract
Background
Detecting coronary vulnerable plaques in vivo and assessing their vulnerability have been great challenges for clinicians and the research community. Intravascular ultrasound (IVUS) is commonly used in clinical practice for diagnosis and treatment decisions. However, due to IVUS limited resolution (about 150–200 µm), it is not sufficient to detect vulnerable plaques with a threshold cap thickness of 65 µm. Optical Coherence Tomography (OCT) has a resolution of 15–20 µm and can measure fibrous cap thickness more accurately. The aim of this study was to use OCT as the benchmark to obtain patient-specific coronary plaque cap thickness and evaluate the differences between OCT and IVUS fibrous cap quantifications. A cap index with integer values 0–4 was also introduced as a quantitative measure of plaque vulnerability to study plaque vulnerability.

Methods
Data from 10 patients (mean age: 70.4; m: 6; f: 4) with coronary heart disease who underwent IVUS, OCT, and angiography were collected at Cardiovascular Research Foundation (CRF) using approved protocol with informed consent obtained. 348 slices with lipid core and fibrous caps were selected for study. Convolutional Neural Network (CNN)-based and expert-based data segmentation were performed using established methods previously published. Cap thickness data were extracted to quantify differences between IVUS and OCT measurements.

Results
For the 348 slices analyzed, the mean value difference between OCT and IVUS cap thickness measurements was 1.83% (p = 0.031). However, mean value of point-to-point differences was 35.76%. Comparing minimum cap thickness for each plaque, the mean value of the 20 plaque IVUS-OCT differences was 44.46%, ranging from 2.36% to 91.15%. For cap index values assigned to the 348 slices, the disagreement between OCT and IVUS assignments was 25%. However, for the OCT cap index = 2 and 3 groups, the disagreement rates were 91% and 80%, respectively. Furthermore, the observation of cap index changes from baseline to follow-up indicated that IVUS results differed from OCT by 80%.

Conclusions
These preliminary results demonstrated that there were significant differences between IVUS and OCT plaque cap thickness measurements. Large-scale patient studies are needed to confirm our findings.
COVID-19 vaccine development: What lessons can we learn from TB?
Authors: Safar Hussain A. , Mustafa Abu Salim , McHugh Timothy D. 
Published: November 2020

AbstractAt the time of writing, the SARS-CoV-2 virus has infected more than 49 million people causing more than 1.2 million deaths worldwide since its emergence from Wuhan, China in December 2019. Vaccine development against SARS-CoV-2 has drawn the global attention in order to stop the spread of the virus, with more than 10 vaccines being tested in phase III clinical trials, as of November 2020. However, critical to vaccine development is consideration of the immunological response elicited as well as biological features of the vaccine and both need to be evaluated thoroughly. Tuberculosis is also a major infectious respiratory disease of worldwide prevalence and the vaccine development for tuberculosis has been ongoing for decades. In this review, we highlight some of the common features, challenges and complications in tuberculosis vaccine development, which may also be relevant for, and inform, COVID-19 vaccine development.
Dynamic body-weight support to boost rehabilitation outcomes in patients with non-traumatic spinal cord injury: an observational study
Authors: Huber Justin P. , Sawaki Lumy 
Published: November 2020

AbstractBackgroundDynamic body-weight support (DBWS) may play an important role in rehabilitation outcomes, but the potential benefit among disease-specific populations is unclear. In this study, we hypothesize that overground therapy with DBWS during inpatient rehabilitation yields greater functional improvement than standard-of-care in adults with non-traumatic spinal cord injury (NT-SCI).MethodsThis retrospective cohort study included individuals diagnosed with NT-SCI and undergoing inpatient rehabilitation. All participants were recruited at a freestanding inpatient rehabilitation hospital. Individuals who trained with DBWS for at least three sessions were allocated to the experimental group. Participants in the historical control group received standard-of-care (i.e., no DBWS). The primary outcome was change in the Functional Independence Measure scores (FIMgain).ResultsDuring an inpatient rehabilitation course, participants in the experimental group (n = 11), achieved a mean (SD) FIMgainof 48 (11) points. For the historical control group (n = 11), participants achieved a mean (SD) FIMgainof 36 (12) points. From admission to discharge, both groups demonstrated a statistically significant FIMgain. Between groups analysis revealed no significant difference in FIMgain(p = 0.022; 95% CI 2.0–22) after a post hoc correction for multiple comparisons. In a secondary subscore analysis, the experimental group achieved significantly higher gains in sphincter control (p = 0.011: 95% CI 0.83–5.72) with a large effect size (Cohen’sd1.19). Locomotion subscores were not significantly different (p = 0.026; 95% CI 0.37–5.3) nor were the remaining subscores in self-care, mobility, cognition, and social cognition.ConclusionsThis is the first study to explore the impact of overground therapy with DBWS on inpatient rehabilitation outcomes for persons with NT-SCI. Overground therapy with DBWS appears to significantly improve functional gains in sphincter control compared to the standard-of-care. Gains achieved in locomotion, mobility, cognition, and social cognition did not meet significance. Findings from the present study will benefit from future large prospective and randomized studies.
Mesenchymal stem cells and acellular products attenuate murine induced colitis
Authors: Li Yan , Altemus Jessica , Lightner Amy L. 
Published: November 2020

Abstract
Background
Mesenchymal stem cells (MSCs) are a well-established immunomodulatory agent which can also promote tissue repair and regeneration. Recent studies have demonstrated MSCs as a novel therapeutic for inflammatory bowel disease (IBD), a chronic idiopathic inflammatory disorder of the gastrointestinal tract. However, the precise role of MSCs in regulating immune responses is controversial, and its significance in the pathogenesis remains IBD undefined. In addition, MSCs’ acellular product, extracellular vesicles (EVs), may also play an important role in the armamentarium of therapeutics, but how EVs compare to MSCs remains unknown due to the lack of side-by-side comparative investigation. We herein compared MSCs and MSC-derived EVs for the treatment of IBD using a DSS-induced colitis model.

Methods
A DSS-induced colitis model was used. At day 4, mice received adipose-derived MSCs, MSC-derived EVs, or placebo. Weight loss, stool consistency, and hematochezia was charted. At day 8, murine colons were harvested, histologic analysis performed, and serum/tissue cytokine analysis conducted.

Results
MSCs and EVs demonstrated equivalent immunosuppressive function in DSS-treated mice through decreased colonic lymphocyte infiltration and attenuated disease severity after both MSC and EV treatment. Furthermore, both MSCs and EVs have an equivalent ability to inhibit inflammation in the DSS colitis model by inhibiting JAK, JNK 1/2, and STAT3 signaling.

Conclusions
These results suggest that (i) both MSCs and EVs are effective therapeutic candidates for a DSS-induced mouse colitis model, (ii) MSCs and EVs have similar immunosuppressive and anti-inflammatory functions, and (iii) EVs may present a novel future therapeutic for the treatment of IBD.
Detection of viral RNA fragments in human iPSC cardiomyocytes following treatment with extracellular vesicles from SARS-CoV-2 coding sequence overexpressing lung epithelial cells
Authors: Kwon Youjeong , Nukala Sarath Babu , Srivastava Shubhi , Miyamoto Hiroe , Ismail Nur Izzah , Jousma Jordan , Rehman Jalees , Ong Sang-Bing , Lee Won Hee , Ong Sang-Ging 
Published: November 2020

AbstractCoronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a global pandemic. The prevalence/severity of COVID-19 is higher among patients with cardiovascular risk factors. Despite the expression of angiotensin-converting enzyme 2 (ACE2), a receptor for SARS-CoV-2 infection, in cardiomyocytes, there has been no conclusive evidence of direct viral infection although the presence of viral genome within COVID-19 patients’ hearts has been reported. Here, we overexpressed SARS-CoV-2 genes in A549 lung epithelial cells. We then isolated extracellular vesicles (EVs) and detected the presence of viral RNA within these EVs. We observed that human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) are receptive to these EVs, and viral genes were detectable in the cardiomyocytes. Accordingly, the uptake of viral RNA-harboring EVs led to an upregulation of inflammation-related genes in hiPSC-CMs. Thus, our findings indicate that SARS-CoV-2 RNA containing EVs represents an indirect route of viral RNA entry into cardiomyocytes.