bluuebunny/crossref_metadata_2025_split huggingface dataset:
TP10.2.9The effect of COVID-19 on Breast clinic follow ups – a change in future practice?
Authors: Norman Carol , Ragad Lilia , Nagarajakumar Anupama , Khan Maryam Alam , Uhercik Michal , Kasem Abdul 
Published: October 2021

Abstract

Aims
Prior to March 2020, at Princess Royal University Hospital (PRUH), Kings College NHS Foundation Trust, almost daily face to face benign/malignant breast clinic follow ups occurred. On March 23rd 2020 the UK went into official COVID-19 pandemic lockdown. The effect on elective follow up practice was swift with cancellation, triaging and replacement of face-to-face by telephonic/virtual consultations.
We compared the change of follow up pattern, pre and post COVID-19. Could this effect the future of consultations at PRUH?

Methods
A comparison of all patients attending PRUH breast unit outpatients in January 2020 (preCOVID-19) for follow up, with those attending in April 2020 (postCOVID-19).
Data collection from clinic lists and electronic patient records, with Excel version 16 analysis.

Results
343 patient follow up consultations 01/2020. 53 patient follow up consultations 04/2020.
Malignant cases: January 65%, April 60%
Benign/B3 cases: January 35%, April 20%
Summary follow up types.

Conclusions
Impact of COVID has been widespread in our practice. Our results show a significant reduction in face-to-face appointments, to allow social distancing. Further evaluation of this model will show its sustainability. Patient satisfaction will have to be assessed, with a view to a full move to video/telephone consultation where indicated.
MRI-derived g-ratio and lesion severity in newly diagnosed multiple sclerosis
Authors: York Elizabeth N , Martin Sarah-Jane , Meijboom Rozanna , Thrippleton Michael J , Bastin Mark E , Carter Edwin , Overell James , Connick Peter , Chandran Siddharthan , Waldman Adam D , Hunt David P J ,   Future-MS Consortium, Akula Amit , Artal Javier Carod , Baranzini Sergio , Barret Fiona , Bastin Mark , Batchelor Christine , Beswick Emily , Brown Fraser , Chandran Siddharthan , Chang Jessie , Chen Yingdi , Colville Shuna , Connick Peter , Cranley Denise , Dakin Rachel , Dhillon Baljean , Elliot Elizabeth , Finlayson James , Foley Peter , Glasmacher Stella , Grossart Angus , Haagenrud Haane , Hafezi Katarzyna , Harrison Emily , Harroud Adil , Hathorn Sara , Hopkins Tracey , Hunt David , Hutchinson Aidan , Jayprakash Kiran , Justin Matt , Kampaite Agniete , Kearns Patrick , Kennedy Gwen , Kleynhans Michaela , Kwong Julian Ng Kee , Larraz Juan , Love Kathryn , Lyle Dawn , MacDonald James , MacDougall Niall , Macfarlane Lesley , Maclennan Beverly , Maclean Alan , MacLeod Margaret Ann , Macleod Nicola , Mahad Don , Martin Sarah Jane , McMahon Lynn , Megson Ian , Meijboom Rozanna , Mollison Daisy , Monaghan Mary , Murphy Lee , Murray Katy , Newton Judith , O’Riordan Jonathan , Perry David , Quigley Suzanne , Scotson Adam , Stenson Amy , Thrippleton Michael , Hernandez Maria Valdez , Waldman Adam , Weaver Christine , Webb Stewart , Weller Belinda , Williams Anna , Wiseman Stewart , Wong Charis , Wong Michael , York Elizabeth 
Published: October 2021

AbstractMyelin loss is associated with axonal damage in established multiple sclerosis. This relationship is challenging to study in vivo in early disease. Here, we ask whether myelin loss is associated with axonal damage at diagnosis by combining non-invasive neuroimaging and blood biomarkers. We performed quantitative microstructural MRI and single-molecule ELISA plasma neurofilament measurement in 73 patients with newly diagnosed, immunotherapy naïve relapsing–remitting multiple sclerosis. Myelin integrity was evaluated using aggregate g-ratios, derived from magnetization transfer saturation and neurite orientation dispersion and density imaging diffusion data. We found significantly higher g-ratios within cerebral white matter lesions (suggesting myelin loss) compared with normal-appearing white matter (0.61 versus 0.57, difference 0.036, 95% CI: 0.029–0.043, P &lt; 0.001). Lesion volume (Spearman’s rho rs= 0.38, P &lt; 0.001) and g-ratio (rs= 0.24, P &lt; 0.05) correlated independently with plasma neurofilament. In patients with substantial lesion load (n = 38), those with higher g-ratio (defined as greater than median) were more likely to have abnormally elevated plasma neurofilament than those with normal g-ratio (defined as less than median) [11/23 (48%) versus 2/15 (13%), P &lt; 0.05]. These data suggest that, even at multiple sclerosis diagnosis, reduced myelin integrity is associated with axonal damage. MRI-derived g-ratio may provide useful additional information regarding lesion severity and help to identify individuals with a high degree of axonal damage at disease onset.
Surgical outcomes of two different reconstruction routes for esophagectomy in esophageal cancer patients: a meta-analysis
Authors: Yan Dongqing , Zheng Hongjie , Wang Peijie , Yin Yin , Zhang Qiwei , Zhang Liang , Liang Hongsen , Shi Donglei , Hu Liu , Fan Haiyang , Wang Zhaojun , Zeng FeiFei , Zhang Junhang , Li Yun 
Published: October 2021

Summary
To evaluate the effects of two different reconstruction routes (the posterior mediastinal route (PR) and the retrosternal route (RR)) on the surgical outcomes of patients after esophagectomy for esophageal carcinoma. PubMed, Embase, Web of Science and Scopus were searched from database inception to March 2021. Randomized controlled trials (RCTs) and case–control trials on the surgical outcomes of patients undergoing esophagectomy via one of the two routes were included. RevMan 5.3 software was used for the meta-analysis. In total, 19 studies were included, 8 were RCTs and 11 were case–control studies. The meta-analysis showed that among the case–control trials, the PR had reduced rates of anastomotic leakage [odds ratio (OR) = 0.56, 95% confidence interval (CI) (0.43, 0.74), P &lt; 0.01]. In addition, it had reduced rates of anastomotic stenosis [OR = 0.42, 95% CI (0.30, 0.59), P &lt; 0.01] and pulmonary complications [OR = 0.63, 95% CI (0.47, 0.84), P &lt; 0.01]. However, there was no significant difference in cardiac complications [RCTs, relative risk (RR) = 0.57, 95% CI (0.29, 1.11), P = 0.10; case–control trials, OR = 1.06, 95% CI (0.70, 1.62), P = 0.78] or postoperative mortality [RCTs, RR = 0.47, 95% CI (0.19, 1.16), P = 0.10; case–control trials, OR = 0.68, 95% CI (0.32, 1.44), P = 0.31]. Compared with the RR, the PR had reduced rates of anastomotic leakage, anastomotic stenosis and pulmonary complications.
Heterogeneity in the transcriptional response of the human pathogen Aspergillus fumigatus to the antifungal agent caspofungin
Authors: Colabardini Ana Cristina , Wang Fang , Dong Zhiqiang , Pardeshi Lakhansing , Rocha Marina Campos , Costa Jonas Henrique , dos Reis Thaila Fernanda , Brown Alec , Jaber Qais Z , Fridman Micha , Fill Taicia , Rokas Antonis , Malavazi Iran , Wong Koon Ho , Goldman Gustavo Henrique 
Published: October 2021

Abstract
Aspergillus fumigatus is the main causative agent of invasive pulmonary aspergillosis (IPA), a severe disease that affects immunosuppressed patients worldwide. The fungistatic drug caspofungin (CSP) is the second line of therapy against IPA but has increasingly been used against clinical strains that are resistant to azoles, the first line antifungal therapy. In high concentrations, CSP induces a tolerance phenotype with partial reestablishment of fungal growth called CSP paradoxical effect (CPE), resulting from a change in the composition of the cell wall. An increasing number of studies has shown that different isolates of A. fumigatus exhibit phenotypic heterogeneity, including heterogeneity in their CPE response. To gain insights into the underlying molecular mechanisms of CPE response heterogeneity, we analyzed the transcriptomes of two A. fumigatus reference strains, Af293 and CEA17, exposed to low and high CSP concentrations. We found that there is a core transcriptional response that involves genes related to cell wall remodeling processes, mitochondrial function, transmembrane transport, and amino acid and ergosterol metabolism, and a variable response related to secondary metabolite (SM) biosynthesis and iron homeostasis. Specifically, we show here that the overexpression of a SM pathway that works as an iron chelator extinguishes the CPE in both backgrounds, whereas iron depletion is detrimental for the CPE in Af293 but not in CEA17. We next investigated the function of the transcription factor CrzA, whose deletion was previously shown to result in heterogeneity in the CPE response of the Af293 and CEA17 strains. We found that CrzA constitutively binds to and modulates the expression of several genes related to processes involved in CSP tolerance and that crzA deletion differentially impacts the SM production and growth of Af293 and CEA17. As opposed to the ΔcrzACEA17 mutant, the ΔcrzAAf293 mutant fails to activate cell wall remodeling genes upon CSP exposure, which most likely severely affects its macrostructure and extinguishes its CPE. This study describes how heterogeneity in the response to an antifungal agent between A. fumigatus strains stems from heterogeneity in the function of a transcription factor and its downstream target genes.
Visual Impairment and Risk of Dementia in 2 Population-Based Prospective Cohorts: UK Biobank and EPIC-Norfolk
Authors: Littlejohns Thomas J , Hayat Shabina , Luben Robert , Brayne Carol , Conroy Megan , Foster Paul J , Khawaja Anthony P , Kuźma Elżbieta 
Published: October 2021

Abstract
Visual impairment has emerged as a potential modifiable risk factor for dementia. However, there is a lack of large studies with objective measures of vision and with more than 10 years of follow-up. We investigated whether visual impairment is associated with an increased risk of incident dementia in UK Biobank and European Prospective Investigation into Cancer in Norfolk (EPIC-Norfolk). In both cohorts, visual acuity was measured using a “logarithm of the minimum angle of resolution” (LogMAR) chart and categorized as no (≤0.30 LogMAR), mild (&gt;0.3 to ≤0.50 LogMAR), and moderate to severe (&gt;0.50 LogMAR) impairment. Dementia was ascertained through linkage to electronic medical records. After restricting to those aged ≥60 years, without prevalent dementia and with eye measures available, the analytic samples consisted of 62 206 UK Biobank and 7 337 EPIC-Norfolk participants, respectively. In UK Biobank and EPIC-Norfolk, respectively, 1 113 and 517 participants developed dementia over 11 and 15 years of follow-up. Using multivariable Cox proportional-hazards models, the hazard ratios for mild and moderate to severe visual impairment were 1.26 (95% confidence interval [CI]: 0.92–1.72) and 2.16 (95% CI: 1.37–3.40), in UK Biobank, and 1.05 (95% CI: 0.72–1.53) and 1.93 (95% CI: 1.05–3.56) in EPIC-Norfolk, compared to no visual impairment. When excluding participants censored within 5 years of follow-up or with prevalent poor or fair self-reported health, the direction of the associations remained similar for moderate impairment but was not statistically significant. Our findings suggest visual impairment might be a promising target for dementia prevention; however, the possibility of reverse causation cannot be excluded.
Clinical Study of Mesenchymal Stem/Stromal Cell Therapy for the Treatment of Frailty: A Proposed Experimental Design for Therapeutic and Mechanistic Investigation
Authors: Hoang Duc M , Nguyen Kien T , Hoang Van T , Dao Lan T M , Bui Hang T , Ho Thanh T K , Nguyen Thuy T P , Ngo Anh T L , Nguyen Hoa K , Thanh Liem Nguyen 
Published: October 2021

Abstract
Frailty, a specific condition of increased vulnerability and reduced general health associated with aging in older people, is an emerging problem worldwide with major implications for clinical practice and public health. Recent preclinical and clinical studies have supported the safety of mesenchymal stem/stromal cells (MSCs) in the treatment of frailty. Comprehensive study is needed to assess the interrelationship between the condition of frailty and the effects of MSC-based therapy. This randomized controlled phase I/II trial aims to investigate the safety and potential therapeutic efficacy of the allogeneic administration of umbilical cord-derived MSCs (UC-MSCs) in combination with the standard treatment for frailty in Vietnam. Moreover, this study describes the rationales, study designs, methodologies, and analytical strategies currently employed in stem cell research and clinical studies. The primary outcome measures will include the incidences of prespecified administration-associated adverse events and serious adverse events. The potential efficacy will be evaluated based on improvements in frailty conditions (including those determined through a physical examination, patient-reported outcomes, quality of life, immune markers of frailty, metabolism analysis, and cytokine markers from patient plasma). This clinical trial and stem cell analysis associated with patient sampling at different time points aim to identify and characterize the potential effects of UC-MSCs on improving frailty based on the stem cell quality, cytokine/growth factor secretion profiles of UC-MSCs, cellular senescence, and metabolic analysis of patient CD3+ cells providing fundamental knowledge for designing and implementing research strategies in future studies.
Clinical Trials Registration Number: NCT04919135
Communicative Resilience of First-Generation College Students During the COVID-19 Pandemic
Authors: Scharp Kristina M , Wang Tiffany R , Wolfe Brooke H 
Published: October 2021

AbstractAs U.S. higher education institutions closed their campuses and transitioned to online education due to the high risk for COVID-19 transmission, first-generation college students (FGS) were particularly susceptible to multiple stressors. Findings from a sample of 44 participants reveal seven resilience triggers, four resilience processes, and three relationships between resilience processes and triggers. Based on these findings, we advance the communication theory of resilience by establishing the ways triggers can be structural, emergent, and overlapping and by theorizing resilience processes as both enduring and time-bound/contingent. We also employ a new qualitative method, thematic co-occurrence analysis, to illuminate the relationships between the resilience triggers and processes. Practical applications for higher education administrators, teaching instructors, and student support professionals are described.
Implementing a digital system for contact tracing and case investigation during COVID-19 pandemic in San Francisco: a qualitative study
Authors: Burgess Hailey , Gutierrez-Mock Luis , Ho Yun-Xian , Moghadassi Michelle , Lesh Neal , Krueger Elizabeth , Reid Michael 
Published: October 2021

Abstract
During the COVID-19 pandemic, many health jurisdictions deployed digital informatics systems to support “manual” case investigation and contact tracing (CICT). This case study evaluates the implementation and use of a digital information system through the experiences of CICT workers in the City and County of San Francisco (CCSF). We conducted semi-structured, 90-min interviews with a sample of the CCSF CICT workforce (n = 37). Participants also completed standardized assessments of the digital system using the System Usability Scale (SUS). Qualitative analyses highlighted (1) the importance of digital tools to ensure rapid onboarding and effective data capture in a public health emergency; (2) the use of digital systems to support culturally sensitive care; and (3) the role of digitals tools in building supportive work environments. The mean SUS score was 70/100 (SD = 17), indicating relative ease of use. In summary, the analysis highlights the importance of digital tools to support manual CICT in the COVID-19 response.
Effects of dietary inclusion of Radix Bupleuri extract on the growth performance, and ultrastructural changes and apoptosis of lung epithelial cells in broilers exposed to atmospheric ammonia
Authors: Bai Shiping , Peng Xi , Wu Caimei , Cai Tong , Liu Jiangfeng , Shu Gang 
Published: October 2021

Abstract
To explore whether Radix Bupleuri extract (RBE) could protect lung injury of broilers under ammonia (NH3) exposure, 360 one-d-old male broilers were randomly allocated to four groups of six replicates each in a 2 × 2 factorial design with two diets (the basal diet [control; CON] and the basal diet supplemented with RBE [RB]) and two air conditions (normal condition [&lt;2 ppm of NH3; NOR] and NH3 exposure [70 ppm of NH3; NH70]). The RB diet contained 80 mg saikosaponins/kg diet. On day 7, the lung tissues were collected and the lung epithelial cells (LEC) were isolated. Our experimental results showed that the NH3 exposure decreased body weight gain and feed intake irrespective of dietary treatments during days 1 to 7. However, the RBE addition decreased feed consumption to body weight gain ratio in broilers under NH70 conditions. In the LEC of CON-fed broilers under NH70 conditions, Golgi stacks showed the dilation of cisternaes and reduced secretory vesicles, mitochondria enlarged, the inner membrane of mitochondria became obscure, and the cristae of mitochondria ruptured, whereas only a mild enlargement of Golgi cisternaes and the part rupture of mitochondrial cristaes occurred in the LEC of RB-fed broilers under NH70 conditions. The NH3 exposure increased malondialdehyde (MDA) level, but decreased total antioxidant capacity (T-AOC) in the lungs of CON-fed broilers. However, the RBE addition decreased MDA level and increased T-AOC in the lungs of broilers under NH70 conditions. Simultaneously, the NH3 exposure increased apoptotic rate (AR), mitochondrial membrane potential (MMP), and reactive oxygen species (ROS) level in the isolated LEC of CON-fed broilers. The RBE addition decreased AR, MMP, and ROS in the isolated LEC of broilers under NH70 condition. Besides, the NH3 exposure increased mRNA expression of B-cell lymphoma-2 associated X protein (BAX), caspase-3, and tumor necrosis factor α (TNF-α), but increased interferon γ (IFN-γ) mRNA abundance in the lungs of CON-fed broilers. The RBE supplement decreased mRNA levels of BAX, caspase-3, and TNF-α, but increased IFN-γ, interleukin (IL)-4, and IL-17 mRNA levels in the lungs of broilers under NH70 conditions. These results indicated that dietary RBE addition alleviated NH3 exposure-induced intercellular ultrastructural damage via mitochondrial apoptotic pathway, possibly due to RBE-induced increase of antioxidant capacity and immunomodulatory function in the lungs of broilers under NH3 exposure.
Common Bubble Detection in Large Dimensional Financial Systems
Authors: Chen Ye , Phillips Peter C B , Shi Shuping 
Published: October 2021

Abstract
Price bubbles in multiple assets are sometimes nearly coincident in occurrence. Such near-coincidence is strongly suggestive of co-movement in the associated asset prices and is likely driven by certain factors that are latent in the financial or economic system with common effects across several markets. Can we detect the presence of such common factors at the early stages of their emergence? To answer this question, we build a factor model that includes I(1), mildly explosive, and stationary factors to capture normal, exuberant, and collapsing phases in such phenomena. The I(1) factor models the primary driving force of market fundamentals. The explosive and stationary factors model latent forces that underlie the formation and destruction of asset price bubbles, which typically exist only for subperiods of the sample. The article provides an algorithm for testing the presence of and date-stamping the origination and termination of price bubbles determined by latent factors in a large-dimensional system embodying many markets. Asymptotics of the bubble test statistic are given under the null of no common bubbles and the alternative of a common bubble across these markets. We prove the consistency of a factor bubble detection process for the origination and termination dates of the common bubble. Simulations show good finite sample performance of the testing algorithm in terms of its successful detection rates. Our methods are applied to real estate markets covering eighty-nine major cities in China over the period January 2005 to December 2008. Results suggest the presence of a common bubble episode in what are known as China’s Tier 1 and Tier 2 cities from June 2007 to February 2008. There is also a common bubble episode in Tier 3 cities but of shorter duration.
Lysine biofortification of crops to promote sustained human health in the 21st century
Authors: Yang Qingqing , Zhao Dongsheng , Zhang Chuangquan , Sreenivasulu Nese , Sun Samuel Sai-Ming , Liu Qiaoquan 
Published: October 2021

Abstract
Crop biofortification is pivotal in preventing malnutrition, with lysine considered the main limiting essential amino acid (EAA) required to maintain human health. Lysine deficiency is predominant in developing countries where cereal crops are the staple food, highlighting the need for efforts aimed at enriching the staple diet through lysine biofortification. Successful modification of aspartate kinase (AK) and dihydrodipicolinate synthase (DHDPS) feedback inhibition has been used to enrich lysine in transgenic rice plants without yield penalty, while increases in the lysine content of quality protein maize have been achieved via marker-assisted selection. Here, we reviewed the lysine metabolic pathway and proposed the use of metabolic engineering targets as the preferred option for fortification of lysine in crops. Use of gene editing technologies to translate the findings and engineer lysine catabolism is thus a pioneering step forward.
A systematic review of adaptations and effectiveness of scaled-up nutrition interventions
Authors: Sutherland Rachel L , Jackson Jacklyn K , Lane Cassandra , McCrabb Sam , Nathan Nicole K , Yoong Sze Lin , Lum Melanie , Byaruhanga Judith , McLaughlin Matthew , Brown Alison , Milat Andrew J , Bauman Adrian E , Wolfenden Luke 
Published: October 2021

Abstract

Context
Public health nutrition interventions shown to be effective under optimal research conditions need to be scaled up and implemented in real-world settings.

Objectives
The primary aim for this review was to assess the effectiveness of scaled-up public health nutrition interventions with proven efficacy, as examined in a randomized controlled trial. Secondary objectives were to: 1) determine if the effect size of scaled-up interventions were comparable to the prescale effect, and; 2) identify any adaptations made during the scale-up process.

Data sources
Six electronic databases were searched and field experts contacted.

Study selection
An intervention was considered scaled up if it was delivered on a larger scale than a preceding randomized controlled trial (“prescale”) in which a significant intervention effect (P ≤ 0.05) was reported on a measure of nutrition.

Data extraction
Two reviewers independently performed screening and data extraction. Effect size differences between prescale and scaled-up interventions were quantified. Adaptations to scale-up studies were coded according to the Adaptome model.

Results
Ten scaled-up nutrition interventions were identified. The effect size difference between prescale trials and scaled-up studies ranged from –32.2% to 222% (median, 50%). All studies made adaptations between prescale to scaled-up interventions.

Conclusion
The effects of nutrition interventions implemented at scale typically were half that achieved in prior efficacy trials. Identifying effective scale-up strategies and methods to support retainment of the original prescale effect size is urgently needed to inform public health policy.

Systematic Review Registration
PROSPERO registration no.CRD42020149267.