Publications by authors named "Jianfang Liu"

175 Publications

Prediction of High-Risk Cytogenetic Status in Multiple Myeloma Based on Magnetic Resonance Imaging: Utility of Radiomics and Comparison of Machine Learning Methods.

J Magn Reson Imaging 2021 May 12. Epub 2021 May 12.

Department of Radiology, Peking University Third Hospital, Haidian District, Beijing, People's Republic of China.

Background: Radiomics has shown promising results in the diagnosis, efficacy, and prognostic assessments of multiple myeloma (MM). However, little evidence exists on the utility of radiomics in predicting a high-risk cytogenetic (HRC) status in MM.

Purpose: To develop and test a magnetic resonance imaging (MRI)-based radiomics model for predicting an HRC status in MM patients.

Study Type: Retrospective.

Population: Eighty-nine MM patients (HRC [n: 37] and non-HRC [n: 52]).

Field Strength/sequence: A 3.0 T; fast spin-echo (FSE): T1-weighted image (T1WI) and fat-suppression T2WI (FS-T2WI).

Assessment: Overall, 1409 radiomics features were extracted from each volume of interest drawn by radiologists. Three sequential feature selection steps-variance threshold, SelectKBest, and least absolute shrinkage selection operator-were repeated 10 times with 5-fold cross-validation. Radiomics models were constructed with the top three frequency features of T WI/T WI/two-sequence MRI (T WI and FS-T WI). Radiomics models, clinical data (age and visually assessed MRI pattern), or radiomics combined with clinical data were used with six classifiers to distinguish between HRC and non-HRC statuses. Six classifiers used were support vector machine, random forest, logistic regression (LR), decision tree, k-nearest neighbor, and XGBoost. Model performance was evaluated with area under the curve (AUC) values.

Statistical Tests: Mann-Whitney U-test, Chi-squared test, Z test, and DeLong method.

Results: The LR classifier performed better than the other classifiers based on different data (AUC: 0.65-0.82; P < 0.05). The two-sequence MRI models performed better than the other data models using different classifiers (AUC: 0.68-0.82; P < 0.05). Thus, the LR two-sequence model yielded the best performance (AUC: 0.82 ± 0.02; sensitivity: 84.1%; specificity: 68.1%; accuracy: 74.7%; P < 0.05).

Conclusion: The LR-based machine learning method appears superior to other classifier methods for assessing HRC in MM. Radiomics features based on two-sequence MRI showed good performance in differentiating HRC and non-HRC statuses in MM.

Evidence Level: 3 TECHNICAL EFFICACY: Stage 2.
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http://dx.doi.org/10.1002/jmri.27637DOI Listing
May 2021

Primary care nurse practitioner burnout and perceptions of quality of care.

Nurs Forum 2021 Apr 19. Epub 2021 Apr 19.

Stone Foundation and Elise D. Fish Professor of Nursing, New York, New York, USA.

Background: Burnout threatens patient care and clinicians are experiencing challenges within the practice environment. Little is known about nurse practitioner (NP) perceptions of burnout and its relationship to care quality and practice environment. We investigate the relationship between primary care NP burnout on perceptions of care quality and if the practice environment moderates the relationship between burnout and care quality.

Methods: This is a secondary analysis of cross-sectional survey data from 396 NPs. Burnout and care quality were measured using a single item, but the practice environment was measured using the Nurse Practitioner Primary Care Organizational Climate Questionnaire. Multi-level proportional odds cumulative logit models were built to test for associations between burnout and care quality and for moderation.

Results: Total, 25.3% of NPs reported burnout. Odds of perceiving higher quality of care was 85% less for NPs experiencing burnout compared to those not experiencing burnout. Practice environment did not moderate the relationship between burnout and care quality, but with a one unit increase in the practice environment subscales, the odds of NPs perceiving higher care quality increased anywhere from 3.83 to 7.57 times.

Conclusion: Burnout is related to lower perceptions of care quality but favorable environments were related to higher perceptions of quality.
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http://dx.doi.org/10.1111/nuf.12579DOI Listing
April 2021

Predicting healthcare-associated infections, length of stay, and mortality with the nursing intensity of care index.

Infect Control Hosp Epidemiol 2021 Apr 16:1-8. Epub 2021 Apr 16.

Columbia University School of Nursing, New York, New York.

Objectives: The objectives of this study were (1) to develop and validate a simulation model to estimate daily probabilities of healthcare-associated infections (HAIs), length of stay (LOS), and mortality using time varying patient- and unit-level factors including staffing adequacy and (2) to examine whether HAI incidence varies with staffing adequacy.

Setting: The study was conducted at 2 tertiary- and quaternary-care hospitals, a pediatric acute care hospital, and a community hospital within a single New York City healthcare network.

Patients: All patients discharged from 2012 through 2016 (N = 562,435).

Methods: We developed a non-Markovian simulation to estimate daily conditional probabilities of bloodstream, urinary tract, surgical site, and Clostridioides difficile infection, pneumonia, length of stay, and mortality. Staffing adequacy was modeled based on total nurse staffing (care supply) and the Nursing Intensity of Care Index (care demand). We compared model performance with logistic regression, and we generated case studies to illustrate daily changes in infection risk. We also described infection incidence by unit-level staffing and patient care demand on the day of infection.

Results: Most model estimates fell within 95% confidence intervals of actual outcomes. The predictive power of the simulation model exceeded that of logistic regression (area under the curve [AUC], 0.852 and 0.816, respectively). HAI incidence was greatest when staffing was lowest and nursing care intensity was highest.

Conclusions: This model has potential clinical utility for identifying modifiable conditions in real time, such as low staffing coupled with high care demand.
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http://dx.doi.org/10.1017/ice.2021.114DOI Listing
April 2021

The Association between Obesity and Severity in Patients with Coronavirus Disease 2019: a Retrospective, Single-center Study, Wuhan.

Int J Med Sci 2021 18;18(8):1768-1777. Epub 2021 Feb 18.

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.

In other respiratory infectious diseases, obesity may be associated with a poor outcome. For coronavirus disease 2019 (COVID-19), the association between obesity and severity or prognosis requires further analysis. This was a retrospective, single-center study. Hospitalized patients were recruited in Renmin Hospital of Wuhan University from January 2, 2020 to February 20, 2020. The data of body mass index (BMI) was obtained from follow-up of surviving patients. According to BMI, normal weight was defined as 18.5-23.9 kg/m, overweight as 24.0-27.9 kg/m and obesity as > 28.0 kg/m. A total of 463 patients were enrolled, of which 242 (52.3%) patients were in the normal weight group; 179 (38.7%) were in the overweight group; and 42 (9.1%) were in the obesity group. Compared to the normal group, obese patients were more likely to have a higher heart rate; lower finger oxygen saturation; higher levels of white blood cells, neutrophil counts, basophil counts, intravenous glucose, triacylglycerol, uric acid, alanine aminotransferase, creatine kinase-MB, CD19+ cell counts and percentage; and lower levels of monocyte percentage, high density lipoprotein and CD3+ cell percentage. In addition, the proportions of hypertension (21.5% vs. 42.6%) and severe+critical illness (47.8 vs. 81.0 %) were significantly higher in the obesity group than those in normal group. However, no significant differences were observed between the normal and obesity groups in critical illness, organ damage and defined endpoint (mechanical ventilation or intensive care unit). Multiple logistic regression showed that obesity increased the risk of developing severe+critical illness (Odd ratio 3.586, 95% CI 1.550-8.298, P=0.003) in patients with COVID-19, and did not affect the risk of critical illness, organ damage and endpoints. Overweight did not affect the risk of severity, organ damage or endpoint in patients with COVID-19. Obesity may be a risk factor for developing severity in patients with COVID-19.
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http://dx.doi.org/10.7150/ijms.54655DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7976577PMC
March 2021

The role of interleukin-10 family members in cardiovascular diseases.

Int Immunopharmacol 2021 May 1;94:107475. Epub 2021 Mar 1.

The First Clinical College of Wuhan University, Wuhan, China; Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China. Electronic address:

Interleukin (IL)-10 cytokine family members, including IL-10, IL-19, IL-20, IL-22, IL-24, IL-26 and the distantly related IL-28A, IL-28B, and IL-29, play critical roles in the regulation of inflammation. The occurrence and progression of cardiovascular diseases closely correlate with the regulation of inflammation, which may provide novel strategies for the treatment of cardiovascular diseases. In recent years, studies have focused on the association between the IL-10 cytokine family and the physiological and pathological progression of cardiovascular diseases. The aim of this review is to summarize relevant studies and clarify whether the IL-10 cytokine family contributes to the regulation of cardiovascular diseases.
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http://dx.doi.org/10.1016/j.intimp.2021.107475DOI Listing
May 2021

Primary care Practice Environment and Burnout among Nurse Practitioners.

J Nurse Pract 2021 Feb 11;17(2):157-162. Epub 2021 Jan 11.

630 W. 168th Street, mail code 6; New York, NY 10032.

Poor practice environments contribute to burnout, but favorable environments containing support, resources, autonomy, and optimal relations with colleagues may prevent burnout. Compared to all nurse practitioners (NPs), 69% of these NPs provide primary care to patients, yet it is unknown whether the practice environment is associated with NP burnout. A study to examine environmental factors related to NP burnout was conducted. Overall, 396 NPs completed the survey and 25.3% were burnt-out. Higher scores on the professional visibility, NP-physician relations, NP-administration relations, independent practice and support subscales were associated with 51%, 51%, 58%, and 56% lower risk of NP burnout, respectively.
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http://dx.doi.org/10.1016/j.nurpra.2020.11.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920210PMC
February 2021

Use of multifunctional electronic health records and burnout among primary care nurse practitioners.

J Am Assoc Nurse Pract 2021 Jan 27. Epub 2021 Jan 27.

Columbia University School of Nursing, New York, New York.

Background: Prevalence of electronic health records (EHRs) has significantly increased, and EHRs are a known contributor to clinician burnout. However, it is unknown whether the use of multifunctional EHRs is associated with nurse practitioner (NP) burnout in primary care practices. This is a major gap in the literature because 69% of practicing NPs deliver primary care services to patients.

Purpose: This study aimed to investigate whether the use of multifunctional EHRs is associated with primary care NP burnout.

Method: This study is a secondary analysis of cross-sectional survey data collected from NPs in two states (Pennsylvania and New Jersey). Nurse practitioners completed surveys measuring burnout, use of multifunctional EHRs, demographics, and characteristics of their practice. Use of multifunctional EHRs was operationalized using two items-computerized capabilities and electronic reminder systems. Burnout was measured using a validated, single item asking NPs to self-report their feelings of burnout. A multilevel cox regression model was built to test for associations between the use of multifunctional EHRs and NP burnout.

Results: Of 396 NPs included, 25.3% reported burnout. The use of multifunctional EHRs did not increase primary care NP burnout (risk ratio = 0.30, 95% confidence interval = 0.13-0.71, p = .01).

Implications For Practice: With 25.3% of NPs burned out, it is imperative to reduce NP burnout. However, computerized capabilities and electronic reminder systems did not contribute to feelings of NP burnout. Future research examining other EHR components is needed to understand which features of the EHR contribute to NP burnout.
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http://dx.doi.org/10.1097/JXX.0000000000000533DOI Listing
January 2021

The impact of nurse practitioner and physician assistant workforce supply on Medicaid-related emergency department visits and hospitalizations.

J Am Assoc Nurse Pract 2021 Jan 27. Epub 2021 Jan 27.

Office of Scholarship and Research, Columbia University School of Nursing, New York City, New York Pace University College of Health Professions, New York City, New York Department of Medicine, Columbia University Medical Center, New York City, New York Department of Sociomedical Sciences, Columbia University Mailman School of Public Health, New York City, New York.

Background: New York State (NYS) has approximately 4.7 million Medicaid beneficiaries with 75% having at least one or more chronic conditions. An estimated 10% of Medicaid beneficiaries seek emergency department (ED) services for nonurgent matters. It is unclear if an increased supply of nurse practitioners (NPs) and physician assistants (PAs) impact utilization of ED and subsequent hospitalizations for chronic conditions.

Purpose: To investigate the relationship between NYS workforce supply (physicians, NPs, and PAs) and 1) ED use and 2) in-patient hospitalizations for chronically ill Medicaid beneficiaries.

Methods: A cross-sectional study design was employed by calculating total workforce supply per NYS county and the proportion of physicians, NPs, and PAs per total number of Medicaid beneficiaries. We extracted the frequencies of all NYS Medicaid beneficiary chronic condition-related ED visits and in-patient admissions. Medicaid beneficiaries were considered to have a chronic condition if there was a claim indicating that the beneficiary received a service or treatment for this specific condition. We calculated the proportion of ED visits/beneficiary for each chronic disease category and the proportion of category-specific in-patient hospitalizations per the number of beneficiaries with that diagnosis.

Results: As the NP/beneficiary proportion increased, ED visits for dual and nondual eligible beneficiaries decreased (p = .007; β = -2.218; 95% confidence interval [CI]: -3.79 to -0.644 and p = .04; β = -2.698; 95% CI: -5.268 to -0.127, respectively).

Implications For Practice: Counties with a higher proportion of NPs and PAs had significantly lower numbers of ED visits and hospitalizations for Medicaid beneficiaries.
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http://dx.doi.org/10.1097/JXX.0000000000000542DOI Listing
January 2021

State policy change and organizational response: Expansion of nurse practitioner scope of practice regulations in New York State.

Nurs Outlook 2021 Jan-Feb;69(1):74-83. Epub 2020 Oct 23.

University of Pittsburgh School of Nursing, Pittsburgh, PA.

Background: In January of 2015, New York (NY) implemented a new policy, Nurse Practitioners Modernization Act, which removed the required written practice agreement between physicians and experienced nurse practitioners (NPs).

Purpose: We examined NP work environment in NY before (2012) and after (2018) the implementation of the new policy.

Methods: Cross-sectional survey data on work environments were collected from NPs in NY in 2012 and 2018. Work environment was measured with the Nurse Practitioner Primary Care Organizational Climate Questionnaire. In 2012, 278 and in 2018, 348 NPs completed the tool. Regression analyses were used to examine the relationship between the study year and work environment.

Findings: Controlling for individual and organizational characteristics, NPs reported significantly better work environments in 2018. Positive changes were observed both for experienced and less experienced NPs.

Discussion: Removing state-level policy restrictions on NPs may promote a better work environment within health care organizations.
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http://dx.doi.org/10.1016/j.outlook.2020.08.007DOI Listing
February 2021

Trends in comorbidities among HIV-infected hospital admissions in New York City from 2006-2016.

Clin Infect Dis 2020 Nov 27. Epub 2020 Nov 27.

Columbia University School of Nursing, New York, NY.

Background: Due to the advent and success of antiretroviral therapy (ART), the number of people living and aging with HIV has grown substantially. Although PLHIV are experiencing longer life expectancies, this achievement may be undermined by increasing and disproportionate chronic disease burden among PLHIV.

Methods: This study is a retrospective analysis of adult (≥18 years) inpatient hospital discharges from a large hospital system in the New York City, New York metropolitan area, between January 1st, 2006 and December 31st, 2016. We aimed to investigate 1) changes in the prevalence of Charlson-defined comorbidities among PLHIV hospitalized between 2006 and 2016, and 2) changes in the unadjusted prevalence ratio (PR) of comorbidities in HIV-positive versus HIV-negative admissions over time.

Results: Of 898,139 hospital admissions from 2006-2016, 19,039 (2.1%) were HIV-positive. Across all admissions during the study period, the greatest comorbidity disparities between HIV-positive and HIV-negative admissions were mild liver disease (PR=4.9, 95% CI: [4.8,5.1]), moderate or severe liver disease (PR=2.2 [2.0,2.4]), and chronic pulmonary disease (PR=1.8 [1.8,1.8]).

Conclusions: The prevalence and relative burden of comorbidities among hospitalized PLHIV is changing over time. Careful monitoring and intensive discharge planning may be effective strategies for addressing the evolving health needs of PLHIV.
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http://dx.doi.org/10.1093/cid/ciaa1760DOI Listing
November 2020

Spinal osteoblastoma: a retrospective study of 35 patients' imaging findings with an emphasis on MRI.

Insights Imaging 2020 Nov 23;11(1):122. Epub 2020 Nov 23.

Department of Radiology, Peking University Third Hospital, 49 North Garden Road, Haidian District, Beijing, 100191, People's Republic of China.

Objective: To investigate the values of multimodal imaging approaches in the diagnosis of spinal osteoblastomas with an emphasis on MRI findings.

Materials And Methods: We retrospectively evaluated the imaging findings of 35 patients with spinal osteoblastomas. The imaging methods included radiography, whole-body bone scintigraphy (WBBS), CT and MRI.

Results: Radiography detected 87.1% (27/31) of the lesions; WBBS demonstrated increased radionuclide activity in all the lesions. CT could precisely show and localize all niduses, and calcification was always detected. MRI usually could adequately delineate the niduses of osteoblastomas, especially on T2WI (88.2%; 30/34). 71.9% (23/32) of osteoblastomas were surrounded with moderate or extensive bone marrow edema (BME) with soft tissue edema (STE). STE always extended along the muscle bundle adjacent to the lesion; there was no subcutaneous fat involvement. BME was eccentrically distributed in the vertebral body and spread inward from the sides of the nidus. The extent of BME in the vertebral body tended to be inversely proportional to the distance from the nidus. In addition, rare magnifications of osteoblastoma including multifocal diseases (n = 2), vertebra plana (n = 1) or with aneurysmal bone cysts (n = 6) were also observed in our study.

Conclusions: In patients showing moderate or extensive BME together with STE on MRI, both CT and MRI should be used to confirm nidus presence. The above-mentioned characteristics of edema on MRI of patients with spinal osteoblastoma are helpful in not only localizing the nidus, but also enhancing the diagnostic confidence.
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http://dx.doi.org/10.1186/s13244-020-00934-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7683662PMC
November 2020

Recent progress of antiviral therapy for coronavirus disease 2019.

Eur J Pharmacol 2021 Jan 24;890:173646. Epub 2020 Oct 24.

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, 430060, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China. Electronic address:

The coronavirus disease 2019 (COVID-19) pandemic has become a global public health crisis, for which antiviral treatments are considered mainstream therapeutic approaches. With the development of this pandemic, the number of clinical studies on antiviral therapy, including remdesivir, chloroquine and hydroxychloroquine, lopinavir/ritonavir, ribavirin, arbidol, interferon, favipiravir, oseltamivir, nitazoxanide, nelfinavir, and camostat mesylate, has been increasing. However, the efficacy of these antiviral drugs for COVID-19 remains controversial. In this review, we summarize the recent progress and findings on antiviral therapies, aiming to provide clinical support for the management of COVID-19. In addition, we analyze the causes of controversy in antiviral drug research and discuss the quality of current studies on antiviral treatments. High-quality randomized clinical trials are required to demonstrate the efficacy and safety of antiviral drugs for the treatment of COVID-19.
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http://dx.doi.org/10.1016/j.ejphar.2020.173646DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7584884PMC
January 2021

Elevated Serum Tsukushi Levels in Patients With Hyperthyroidism.

Front Endocrinol (Lausanne) 2020 29;11:580097. Epub 2020 Sep 29.

Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Tsukushi (TSK) is a secreted hepatokine recently identified as playing an important role in modulating glucose and lipid metabolism, and systemic energy homeostasis. However, information is not available regarding the association between circulating TSK and hyperthyroidism in humans. We measured serum TSK levels in 180 patients with hyperthyroidism and 82 healthy controls recruited from the clinic. Of them, 46 hyperthyroid patients received thionamide treatment for 3 months. Hyperthyroid patients had higher levels of circulating TSK than healthy controls [186.67 (133.63-280.59) ng/ml vs. 97.27 (77.87-146.96) ng/ml, < 0.001]. Subjects with higher level of serum free triiodothyronine (T3) and free thyroxine (T4) had higher levels of circulating TSK. In addition, serum TSK levels markedly declined with the improvement of thyroid function after thionamide treatment. In multivariable linear regression analyses, circulating TSK concentrations were significantly associated with serum free T3, free T4, thyroid stimulating hormone, thyrotropin receptor antibody, total cholesterol, low-density lipoprotein cholesterol (LDL-cholesterol), high-density lipoprotein cholesterol (HDL-cholesterol), and basal metabolic rate (all < 0.01), adjusting for age, gender, smoking, and body mass index (BMI). Importantly, circulating TSK was significantly associated with risks of hyperthyroidism in multivariable logistic regression analyses, adjusting for age, gender, smoking, BMI, fasting glucose, LDL-cholesterol, and insulin resistance (HOMA-IR) [OR (95% CI), 1.012(1.005-1.019), = 0.001]. These findings indicate that circulating TSK concentrations are independently associated with hyperthyroidism, suggesting that circulating TSK may be a predictive factor of hyperthyroidism and can be used for therapeutic monitoring.
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http://dx.doi.org/10.3389/fendo.2020.580097DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7553082PMC
September 2020

Clinical Features of COVID-19 Patients with Different Outcomes in Wuhan: A Retrospective Observational Study.

Biomed Res Int 2020 5;2020:2138387. Epub 2020 Oct 5.

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan 430060, China.

Coronavirus disease 2019 (COVID-19) has caused considerable morbidity and mortality worldwide since December 2019. This retrospective study determined the characteristics and prognostic factors of COVID-19 patients, focusing on inpatients who died or were discharged between 30 December 2019 and 29 February 2020 at Renmin Hospital of Wuhan University. Patients' medical histories, comorbidities, symptoms, signs, laboratory findings, computed tomography (CT) findings, and clinical management were recorded. All 293 patients were divided into the nonsurviving ( = 116) and surviving ( = 177) groups. The median age was older in the nonsurviving group than in the surviving group; most patients were older than 65 years in the nonsurviving group. The incidence rates of lymphopenia, neutrophilia, and leukocytosis were significantly higher in the nonsurviving group than in the surviving group. More patients in the nonsurviving group had increased levels of nonspecific infection markers, abnormal liver and kidney function, cardiac injury, and blood coagulation abnormalities on admission. Immune and inflammatory responses were more severely disturbed in the nonsurviving group than in the surviving group. The incidence rates of complications during hospitalization were higher in the nonsurviving group than in the surviving group. Cox regression results also showed that older age, symptoms of dyspnea, comorbidities, and complications were all predictors of death. Close monitoring and timely treatment are needed for high-risk COVID-19 patients.
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http://dx.doi.org/10.1155/2020/2138387DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7537706PMC
October 2020

The Association of Asthma, Sexual Identity, and Inhaled Substance Use among U.S. Adolescents.

Ann Am Thorac Soc 2021 02;18(2):273-280

Office of Scholarship and Research, Columbia University School of Nursing, New York, New York; and.

Minority sexual identity appears to confer asthma risks. Although associations between inhaled substances and asthma are established, these have not been examined among sexual minority youths. Given sexual minority adolescents' disproportionately high rates of substance use, research is needed to fill this important gap. Using a representative sample of adolescents from the United States, we ) examined associations among asthma, sexual identity, and inhaled substance use and tested ) whether sexual identity moderates relationships between asthma and inhaled substance use and ) whether inhaled substance use mediates associations between sexual identity and asthma. Data are from the 2015 and 2017 Youth Risk Behavior Surveillance Survey. Adolescents ( = 30,113) reported if they were ever diagnosed with asthma, current use of cigarettes, cigars and/or cigarillos, marijuana, and electronic vapor products and if they ever used inhalants or synthetic marijuana. We used logistic regression to examine associations between asthma, sexual identity, and inhaled substance use controlling for age, race or ethnicity, and body mass index percentile, stratified by sex. Lesbian, gay, and bisexual respondents had higher relative risks for asthma than heterosexual youth. Sexual minority female youths had significantly higher relative risks than heterosexual female youths for use of every inhaled substance. There were few sexual identity differences in inhaled substance use among male youths. Inhaled substance use was significantly associated with higher risks for asthma. In general, associations between each individual inhaled substance and asthma did not differ between sexual minority and heterosexual youths. However, when all inhaled substances were added into the models concurrently, inhaled substance use appeared to mediate associations with asthma among lesbian and bisexual female youths, and partially mediated these associations among sexual minority male youths. Sexual identity and inhaled substance use appear to play important roles in asthma risk. However, these variables do not fully explain the risk, suggesting that other unmeasured variables (e.g., stress and victimization) may be implicated in risks for both inhaled substance use and asthma. It is important that clinicians providing care to adolescents ask about sexual identity and inhaled substance use. Effective approaches to reducing inhaled substance use among adolescents, especially sexual minorities, are needed.
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http://dx.doi.org/10.1513/AnnalsATS.202001-062OCDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7869781PMC
February 2021

The Development and Preliminary Impact of CAMP Air: A Web-based Asthma Intervention to Improve Asthma Among Adolescents.

Patient Educ Couns 2021 Apr 15;104(4):865-870. Epub 2020 Sep 15.

3C Institute, United States.

Objective: Describe the development and preliminary impact of CAMP Air, a web-based intervention for adolescents with uncontrolled asthma.

Materials And Methods: CAMP Air was developed using an iterative process with input from stakeholders and incorporating usability testing results (n = 14 adolescents). To test CAMP Air's initial impact, 61 adolescents from two New York City public high schools (n = 37) and from clinics, community-based organizations, and third-party recruitment services (i.e., community sample; n = 24) were enrolled in a randomized pilot trial. Participants were randomized to CAMP Air (n = 30) or information-and-referral control intervention (n = 31). A point-person worked with school participants to complete CAMP Air.

Results: CAMP Air participants were satisfied with the intervention and its value for supporting self-management, completing on average 6 of 7 modules. Relative to controls, CAMP Air participants demonstrated significantly improved asthma knowledge, asthma control, night wakening and school absences, and less risk for urgent care visits. Adolescents enrolled in schools completed more modules and had significantly fewer nights woken and school absences than community enrollees.

Conclusion: CAMP Air improves asthma outcomes among adolescents with uncontrolled asthma.

Practice Implications: A web-based intervention CAMP Air is a promising intervention. When a point-person works with adolescents, CAMP Air's access and impact are improved.
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http://dx.doi.org/10.1016/j.pec.2020.09.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7956908PMC
April 2021

The Association Between the Frequency of Interruptions in Antibiotic Exposure and the Risk of Health Care-Associated Infection.

Curr Ther Res Clin Exp 2020 5;93:100600. Epub 2020 Aug 5.

Department of Pediatrics, Columbia University Irving Medical Center, New York, New York.

Background: Although antibiotic use is an established risk factor for health care-associated infection, estimates of the association between infection and antibiotic use vary, depending upon how antibiotic exposure is measured.

Objectives: The purpose of this study was to explore the association between the frequency of interruptions in antibiotic exposure and the risk of health care-associated infection.

Methods: A retrospective chart review cohort study was conducted of all inpatients between 2011and 2016 from a single academic health center who received at least 1 dose of a systemic antibacterial for a cumulative duration of >3 days and ≤30 days. The measures of antibiotic exposure examined were durationcumulative total calendar days of antibiotics therapy-and continuity-the frequency of interruptions in antibiotic exposure that was defined as the number of antibiotic treatment courses.

Results: A total of 52,445/227,967 (23%) patients received antibacterial therapy for >3 days and ≤30 days during their hospitalization. Of these, 1161 out of 52,445 (2.21%) were patients with health care-associated infection. An adjusted multivariable logistic regression analysis revealed that the risk of increased with longer cumulative days (odds ratio = 2.7; comparison of >12 days to ≤5 days) and fewer interruptions of antibiotic treatment (odds ratio = 0.78; comparison of >3 discrete antibiotic treatment courses to 1 course or continuous antibiotic treatment course; all values < 0.05).

Conclusions: For patients who received the same number of cumulative days of therapy, the patients who had more frequently interrupted courses of antibiotic therapy were less likely to experience health care-associated infection. (. 2020; 81:XXX-XXX).
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http://dx.doi.org/10.1016/j.curtheres.2020.100600DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7451585PMC
August 2020

Development and validation of prognostic gene signature for basal-like breast cancer and high-grade serous ovarian cancer.

Breast Cancer Res Treat 2020 Dec 2;184(3):689-698. Epub 2020 Sep 2.

Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA, USA.

Purpose: Molecular similarities have been reported between basal-like breast cancer (BLBC) and high-grade serous ovarian cancer (HGSOC). To date, there have been no prognostic biomarkers that can provide risk stratification and inform treatment decisions for both BLBC and HGSOC. In this study, we developed a molecular signature for risk stratification in BLBC and further validated this signature in HGSOC.

Methods: RNA-seq data was downloaded from The Cancer Genome Atlas (TCGA) project for 190 BLBC and 314 HGSOC patients. Analyses of differentially expressed genes between recurrent vs. non-recurrent cases were performed using different bioinformatics methods. Gene Signature was established using weighted linear combination of gene expression levels. Their prognostic performance was evaluated using survival analysis based on progression-free interval (PFI) and disease-free interval (DFI).

Results: 63 genes were differentially expressed between 18 recurrent and 40 non-recurrent BLBC patients by two different methods. The recurrence index (RI) calculated from this 63-gene signature significantly stratified BLBC patients into two risk groups with 38 and 152 patients in the low-risk (RI-Low) and high-risk (RI-High) groups, respectively (p = 0.0004 and 0.0023 for PFI and DFI, respectively). Similar performance was obtained in the HGSOC cohort (p = 0.0131 and 0.004 for PFI and DFI, respectively). Multivariate Cox regression adjusting for age, grade, and stage showed that the 63-gene signature remained statistically significant in stratifying HGSOC patients (p = 0.0005).

Conclusion: A gene signature was identified to predict recurrence in BLBC and HGSOC patients. With further validation, this signature may provide an additional prognostic tool for clinicians to better manage BLBC, many of which are triple-negative and HGSOC patients who are currently difficult to treat.
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http://dx.doi.org/10.1007/s10549-020-05884-zDOI Listing
December 2020

Genetic Polymorphisms of / in Chronic Obstructive Pulmonary Disease.

COPD 2020 10 5;17(5):595-600. Epub 2020 Aug 5.

Department of General Practice, Hainan Affiliated Hospital of Hainan Medical University, Haikou, Hainan, China.

Chronic obstructive pulmonary disease (COPD) is a high incidence in the elderly and significantly affects the quality of life. and play an important role in tobacco-related diseases and inflammatory reactions. Thus, we aim to investigate the association between / polymorphisms and the risk of COPD. In this study, a total of 821 subjects were recruited which include 313 COPD cases and 508 healthy controls. Seven SNPs of / were selected for genotyping. The odds ratios (ORs) and 95% confidence interval (95% CI) were calculated using logistic regression analysis to evaluate the association between COPD risk and / polymorphisms. Our study showed that A allele of rs9332220 in was associated with reducing COPD risk (OR = 0.64, 95% CI = 0.43-0.94,  = 0.021). And rs111853758 G allele carrier could significantly decrease 0.35-fold COPD risk compared with T allele carrier (OR = 0.65, 95% CI = 0.45-0.96,  = 0.027). Furthermore, sex-based stratification analysis showed that rs9332220 and rs111853758 polymorphisms were associated with the risk of COPD in males. This is the first study to investigate the association between and genetic polymorphisms and COPD risk, which may give a new perspective on the prevention and diagnosis of COPD.
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http://dx.doi.org/10.1080/15412555.2020.1780577DOI Listing
October 2020

Resolvin E1 protects against doxorubicin-induced cardiotoxicity by inhibiting oxidative stress, autophagy and apoptosis by targeting AKT/mTOR signaling.

Biochem Pharmacol 2020 10 1;180:114188. Epub 2020 Aug 1.

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan, China. Electronic address:

Doxorubicin (DOX)-induced cardiotoxicity impairs the quality of life of cancer patients during or after DOX treatment, and it is imperative to explore a novel strategy to address this problem. Resolvin E1 (RvE1) is derived from eicosapentaenoic acid (EPA), which has been reported to exert beneficial effects on DOX-induced oxidative stress in cardiomyocytes. This study was designed to investigate whether RvE1 protects against DOX-induced cardiotoxicity, and the underlying mechanism was explored. DOX (20 mg/kg, one injection, i.p.) was used to induce DOX-induced cardiotoxicity in C57BL/6 mice. At 5 days after DOX administration, the effect of RvE1 was assessed by measuring cardiac function, oxidative stress, autophagy and apoptosis in cardiac tissue. We used an AKT inhibitor and rapamycin to investigate the underlying mechanisms. Our results showed that RvE1 inhibited the DOX-induced decrease in body weight and heart weight, the reduction in left ventricular ejection fraction and fractional shortening, and the increase in lactate dehydrogenase, creatine kinase myocardial bound and cardiomyocyte vacuolization. Compared to the control group, the DOX group exhibited increased oxidative stress, autophagy and apoptosis in cardiac tissue, which were alleviated by treatment with RvE1. The AKT/mTOR signaling pathways were responsible for RvE1-mediated regulation of DOX-induced oxidative stress, autophagy and myocardial apoptosis. In conclusion, RvE1 protected against DOX-induced cardiotoxicity via the regulation of AKT/mTOR signaling.
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http://dx.doi.org/10.1016/j.bcp.2020.114188DOI Listing
October 2020

The effect of CYP3A4 genetic variants on the susceptibility to chronic obstructive pulmonary disease in the Hainan Han population.

Genomics 2020 11 30;112(6):4399-4405. Epub 2020 Jul 30.

Department of General Practice, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan, China. Electronic address:

Purpose: Genetic polymorphisms act a crucial role in chronic obstructive pulmonary disease (COPD) progression. This study aimed to investigate the correlation between CYP3A4 variants and COPD risk.

Methods: We carried out a case-control study of 821 individuals (313 patients and 508 healthy subjects) to identify the correlation of CYP3A4 SNPs with COPD risk in the Hainan Han population. The association was evaluated by Odds ratios (OR) and 95% confidence intervals (CI).

Results: Our study showed that rs4646437 polymorphism was related to a significantly increased susceptibility to COPD (OR 1.45, 95% CI = 1.10-1.90, p = 0.008). Stratified analyses indicated that rs4646437 polymorphism was significantly related to an increased risk of COPD in males (OR 1.95, 95% CI = 1.19-3.20, p = 0.008). However, rs4646440 played a protective role in females (OR 0.54, 95% CI = 0.31-0.93, p = 0.024). Rs4646437 was found to significantly improve the risk of COPD in smokers (OR 1.67, 95% CI = 1.12-2.48, p = 0.011). While rs4646440 had a significantly lower susceptibility to COPD in non-smokers (OR 0.64, 95% CI = 0.45-0.90, p = 0.010). Haplotype analysis revealed that AT haplotype of CYP3A4 was found to increase the risk of COPD in non-smokers (OR 1.71, 95% CI = 1.04-2.82, p = 0.034).

Conclusion: Our result gives a new understanding of the association between CYP3A4 gene and COPD in the Hainan Han population.
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http://dx.doi.org/10.1016/j.ygeno.2020.07.043DOI Listing
November 2020

The expression of interleukin 20 increases in plasma and aortic tissues from patients with acute aortic dissection.

Clin Chim Acta 2020 Nov 28;510:373-380. Epub 2020 Jul 28.

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China; Cardiovascular Research Institute, Wuhan University, Wuhan, China; Hubei Key Laboratory of Cardiology, Wuhan 430060, China. Electronic address:

Objective: Acute aortic dissection (AAD) is the most devasting cardiovascular disease associated with high mortality. The occurrence and progression of AAD can be regulated by inflammatory processes, and further understanding of this inflammatory pathogenesis may improve the treatment of AAD. Interleukin 20 (IL-20), as an inflammatory mediator, has been demonstrated to be associated with several inflammatory diseases. However, the association between IL and 20 and AAD is still unknown.

Methods: Five aortic dissection tissue samples and five control aortic tissue samples were evaluated in our study. The expression of IL-20 and its receptor subunits (IL-20Rα and IL-20Rβ) was detected by immunofluorescence staining. From January 2018 to March 2018, 70 consecutive AAD patients and 25 non-AAD (NAD) patients were enrolled in this study. Diagnosis was based on computed tomography angiography (CTA) results. Blood samples were obtained from the patients on the first day of hospitalization. Plasma IL-20, TNF-α and IL-6 concentrations were evaluated with enzyme-linked immunosorbent assay (ELISA) kits.

Results: The expression levels of IL-20 and its receptor subunits (IL-20Rα and IL-20Rβ) were increased in the sites of arterial wall dissection in the AAD patients. In a separate group, the plasma IL-20, TNF-α and IL-6 concentrations were significantly higher in the AAD patients than in the non-AAD patients. Spearman's correlation analysis showed that plasma IL-20 was positively correlated with plasma TNF-α and IL-6, D-dimer, C-reaction protein (CRP), creatinine, fasting blood glucose, systolic blood pressure (SBP), and diastolic blood pressure (DBP). Multiple linear regression revealed that IL-20, in addition to IL-6, glucose, CRP and D-dimer, was independently associated with the presence of AAD.

Conclusion: IL-20 was closely associated with the presence of AAD. IL-20 may contribute to the inflammatory pathogenesis of AAD.
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http://dx.doi.org/10.1016/j.cca.2020.07.049DOI Listing
November 2020

Elevated circulating Gpnmb levels are associated with hyperthyroidism.

Endocr Connect 2020 Aug;9(8):783-792

Department of Endocrinology and Metabolism, Nanfang Hospital, Southern Medical University, Guangzhou, China.

Background: Glycoprotein non-metastatic protein B (Gpnmb) has been identified as a new cytokine secreted by hepatocyte that plays an important role in balancing lipid homeostasis and development of obesity and metabolic disorders. However, information is not available regarding the association between circulating Gpnmb and hyperthyroid in humans.

Methods: We measured serum Gpnmb in 180 hyperthyroid patients and 82 healthy subjects that were recruited from the clinic. Of them, 46 hyperthyroid patients received thionamide treatment for 3 months.

Results: Hyperthyroid subjects had higher levels of circulating Gpnmb than healthy controls (47.8 ± 10.1 ng/mL vs 31.0 ± 4.9 ng/mL, P < 0.001). Subjects with higher levels of serum free triiodothyronine (T3) and free thyroxine (T4) had higher levels of circulating Gpnmb. After thionamide treatment, levels of circulating Gpnmb in hyperthyroid subjects remarkably declined with significant improvement of thyroid function (P < 0.001). Furthermore, the change of circulating Gpnmb levels was significantly associated with basal metabolic rate (BMR) and thyroid hormones, including free T3 and free T4, adjusting for age, gender, smoking and BMI before thionamide treatment. In multivariable logistic regression analyses, circulating Gpnmb was significantly associated with risks of hyperthyroidism (OR (95% CI): 1.44 (1.20-1.74), P < 0.001), adjusted for age, gender, BMI, fasting glucose, HOMA-IR, LDL-cholesterol, ALT and AST.

Conclusions: These findings indicate that circulating Gpnmb concentrations are independently associated with hyperthyroid, suggesting that circulating Gpnmb may be a predictor of risk for hyperthyroidism and can be used for therapeutic monitoring.
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http://dx.doi.org/10.1530/EC-20-0240DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7487193PMC
August 2020

Resolvin D1 protects against sepsis-induced cardiac injury in mice.

Biofactors 2020 Sep 15;46(5):766-776. Epub 2020 Jul 15.

Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China.

Increased inflammation is the key mechanism that mediates sepsis induced cardiac injury. Resolvin D1 (RvD1), a bioactive lipid mediator synthesized from docosahexaenoic acid, can attenuate the severity of many inflammation-related diseases through anti-inflammatory and pro-resolving properties. However, the protective role of RvD1 in sepsis induced cardiac injury remains unclear. Mice were randomly divided into three groups: the control group, LPS group and RvD1 + LPS group. LPS (10 mg/kg, i.p.) was used to establish a sepsis-induced cardiac injury model. RvD1 (5 ug/kg, i.p.) was injected 30 min before LPS injection. RvD1 treatment significantly attenuated the deteriorated cardiac function and cardiac injury induced by LPS, as evidenced by the improved left ventricular ejection fraction, serum levels of cardiac injury markers and severity of cardiomyocyte apoptosis. In addition, RvD1 treatment significantly attenuated the infiltration of pro-inflammatory M1 macrophages and expression of inflammatory cytokines in the heart. Mechanistically, the attenuated activation of NK-κB and MAPK signaling mediated the anti-inflammatory and antiapoptotic effects of RvD1. In addition, LPS-induced infiltration of neutrophils and M1 macrophages in the spleen was significantly attenuated by the RvD1 treatment. Results of the present study suggest that RvD1 protects the heart against LPS-induced injuries by attenuating the local and systemic inflammatory response, highlighting the therapeutic effects of RvD1 in sepsis-induced cardiac injury.
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http://dx.doi.org/10.1002/biof.1668DOI Listing
September 2020

Can contrast-enhancement computed tomography texture and histogram analyses help to differentiate malignant from benign thyroid nodules?

Jpn J Radiol 2020 Dec 14;38(12):1135-1141. Epub 2020 Jul 14.

Department of Radiology, Peking University Third Hospital, 49 North Garden Rd, Haidian District, Beijing, 100191, People's Republic of China.

Purpose: We aimed to determine the ability of contrast-enhanced computed tomography (CECT) texture and histogram analyses to differentiate between benign and malignant thyroid nodules.

Materials And Methods: The clinical data from 49 patients with 60 thyroid nodules were retrospectively analyzed. Nodules were classified as malignant or benign based on their histological results. Five texture and histogram parameters of thyroid nodules from CECT images, including entropy, mean, standard deviation, skewness, and kurtosis, were compared and analyzed between the two groups. Regions of interest in axial CECT images were delineated manually by two radiologists. Interobserver agreement in texture and histogram parameters between the two radiologists was assessed using the intraclass correlation coefficient (ICC). The Mann-Whitney U test and receiver operating characteristic curve analysis were conducted to estimate the diagnostic capability of texture parameters.

Results: Interobserver reproducibility (ICC = 0.919-0.969) was excellent. Among the 60 nodules, 36 were malignant and 24 were benign. Entropy of malignant thyroid nodules was significantly higher compared with benign thyroid nodules (P = 0.005). A trend toward a higher kurtosis value was observed in malignant thyroid nodules (P = 0.062). When an entropy value of 6.55 was used as a cutoff for differentiating benign from malignant thyroid nodules, the optimal area under the curve, sensitivity, and specificity were 0.716 (0.585-0.847, 95% confidence interval, P = 0.005), 75.0%, and 62.5%, respectively.

Conclusions: CECT texture and histogram analyses can be used to differentiate benign from malignant thyroid nodules.
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http://dx.doi.org/10.1007/s11604-020-01018-zDOI Listing
December 2020

Clinical Features of COVID-19 in Patients With Essential Hypertension and the Impacts of Renin-angiotensin-aldosterone System Inhibitors on the Prognosis of COVID-19 Patients.

Hypertension 2020 09 13;76(3):732-741. Epub 2020 Jul 13.

From the Department of Cardiology (W.P., J.Z., M.W., J.Y., Y.X., Z.W., D.Y., M.Z., Z.L., J.L., J.W.), Renmin Hospital of Wuhan University, China.

Hypertension is one of the most common comorbidities in patients with coronavirus disease 2019 (COVID-19). This study aimed to clarify the impact of hypertension on COVID-19 and investigate whether the prior use of renin-angiotensin-aldosterone system (RAAS) inhibitors affects the prognosis of COVID-19. A total of 996 patients with COVID-19 were enrolled, including 282 patients with hypertension and 714 patients without hypertension. Propensity score-matched analysis (1:1 matching) was used to adjust the imbalanced baseline variables between the 2 groups. Patients with hypertension were further divided into the RAAS inhibitor group (n=41) and non-RAAS inhibitor group (n=241) according to their medication history. The results showed that COVID-19 patients with hypertension had more severe secondary infections, cardiac and renal dysfunction, and depletion of CD8 cells on admission. Patients with hypertension were more likely to have comorbidities and complications and were more likely to be classified as critically ill than those without hypertension. Cox regression analysis revealed that hypertension (hazard ratio, 95% CI, unmatched cohort [1.80, 1.20-2.70]; matched cohort [2.24, 1.36-3.70]) was independently associated with all-cause mortality in patients with COVID-19. In addition, hypertensive patients with a history of RAAS inhibitor treatment had lower levels of C-reactive protein and higher levels of CD4 cells. The mortality of patients in the RAAS inhibitor group (9.8% versus 26.1%) was significantly lower than that of patients in the non-RAAS inhibitor group. In conclusion, hypertension may be an independent risk factor for all-cause mortality in patients with COVID-19. Patients who previously used RAAS inhibitors may have a better prognosis.
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http://dx.doi.org/10.1161/HYPERTENSIONAHA.120.15289DOI Listing
September 2020

Time-dependent changes in the clinical characteristics and prognosis of hospitalized COVID-19 patients in Wuhan, China: A retrospective study.

Clin Chim Acta 2020 Nov 6;510:220-227. Epub 2020 Jul 6.

Department of Cardiology, Renmin Hospital of Wuhan University, China; Cardiovascular Research Institute, Wuhan University, China; Hubei Key Laboratory of Cardiology, China. Electronic address:

Cases of coronavirus disease 2019 (COVID-19) have been breaking out around the world recently. However, the dynamic changes in the clinical symptoms and prognosis of COVID-19 patients remain unknown. According to the onset time of initial clinical symptoms, 843 COVID-19 patients admitted between Jan 22 and Feb 14, 2020 were divided into three groups: group A (Jan 21 to Jan 25, n = 324), group B (Jan 26 to Jan 31, n = 358) and group C (Feb 1 to Feb 10, n = 161). Data on the demographics, symptoms, first laboratory results, treatments and outcomes (within 12 days of hospitalization) were collected. The results showed that the median duration from symptom onset to admission shortened over time (13, 10 and 5 days, respectively, p < 0.05). Fewer patients had fever symptoms and bilateral pneumonia in group C than in the group A and B. Laboratory results showed that white blood cell, neutrophil, and platelet counts, lactic acid and D-dimer levels were lower, while lymphocyte, CD3, and CD8 counts were higher in group C. In addition, group C had more mild-moderate cases and fewer severe cases than the other two groups. More importantly, the incidence of complications (18.5%, 14.2% and 11.2%, respectively, p < 0.05) and all-cause mortality (11.7%, 8.4%, and 5.6%, respectively, p < 0.05) decreased over time. The clinical characteristics and prognosis of COVID-19 patients changed over time. Improved prognosis was found at a later stage.
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http://dx.doi.org/10.1016/j.cca.2020.06.051DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7832796PMC
November 2020

Recombinant tandem epitope vaccination provides cross protection against Actinobacillus pleuropneumoniae challenge in mice.

AMB Express 2020 Jul 8;10(1):123. Epub 2020 Jul 8.

College of Veterinary Medicine/ Key Laboratory of Zoonosis, Institute of Zoonosis, Jilin University, Xi'an Road 5333, Changchun, 130062, Jilin, People's Republic of China.

Actinobacillus pleuropneumoniae (A. pleuropneumoniae/APP) is the pathogen that causes porcine contagious pleuropneumonia. Actinobacillus pleuropneumoniae is divided into 18 serovars, and the cross protection efficacy of epitopes is debatable, which has resulted in the slow development of a vaccine. Consequently, epitope-based vaccines conferring Actinobacillus pleuropneumoniae cross protection have rarely been reported. In this study, B cell epitopes in the head domain of trimeric autotransporter adhesin were predicted, and 6 epitopes were selected. Then, the predicted epitopes (Ba1, Bb5, C1, PH1 and PH2) were connected by linkers to construct a recombinant tandem antigen (rta) gene. The RTA protein encoded by the recombinant rta gene was expressed, and finally the ICR mice were immunized with the RTA protein with or without inactivated Actinobacillus pleuropneumoniae (serovars 1 and 5b) and challenged with Actinobacillus pleuropneumoniae to evaluate the protective effect of the epitope-based vaccine and combined vaccine. The mice in the RTA-immunized group and RTA plus inactivated Actinobacillus pleuropneumoniae vaccine group had a significant improvement in clinical symptoms and a higher level of antibody in the serum than those in the control group. The RTA immune group had a 40% survival rate after Actinobacillus pleuropneumoniae infection, whereas the combination of RTA and inactivated Actinobacillus pleuropneumoniae produced very strong cross immune protection in mice, at least 50% (RTA IB1 + C5) and at most 100% (RTA IB5 + C1), whereas no cross immunoprotection was found in the solo Actinobacillus pleuropneumoniae immune group. Overall, the combination of the RTA protein and inactivated bacteria significantly enhanced the cross protection effects. This implies that RTA protein in combination with a suitable inactivated Actinobacillus pleuropneumoniae strain could be a candidate vaccine for porcine contagious pleuropneumonia.
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http://dx.doi.org/10.1186/s13568-020-01051-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7341470PMC
July 2020

Novel Strategies for Predicting Healthcare-Associated Infections at Admission: Implications for Nursing Care.

Nurs Res 2020 Sep/Oct;69(5):399-403

Philip Zachariah, MD, MSc, is Assistant Professor, Department of Pediatrics, Columbia University Vagelos College of Physicians and Surgeons, New York, New York. Elioth Sanabria, MS, is Graduate Research Assistant, Columbia University Fu Foundation School of Engineering and Applied Sciences, New York, New York. Jianfang Liu, PhD, MAS, is Assistant Professor, Quantitative Research (in Nursing), Columbia University School of Nursing, New York, New York. Bevin Cohen, PhD, MS, MPH, RN, is Associate Research Scientist, Columbia University School of Nursing, New York, New York. David Yao, PhD, is Piyasombatkul Family Professor, Columbia University Fu Foundation, New York, New York. Elaine Larson, PhD, RN, FAAN, CIC, is Professor, Columbia University School of Nursing, New York, New York.

Background: Accurate, real-time models to predict hospital adverse events could facilitate timely and targeted interventions to improve patient outcomes. Advances in computing enable the use of supervised machine learning (SML) techniques to predict hospital-onset infections.

Objectives: The purpose of this study was to trial SML methods to predict urinary tract infections (UTIs) during inpatient hospitalization at the time of admission.

Methods: In a large cohort of adult hospitalizations in three New York City acute care facilities (N = 897,344), we used two SML methods-neural networks and decision trees-to predict having a hospital-onset UTI using data available and accessible on the first day of admission at healthcare facilities in the United States.

Results: Performance for both neural network and decision tree models were superior compared to logistic regression methods. The decision tree model had a higher sensitivity compared to neural network, but a lower specificity.

Discussion: SML methods show potential for automated accurate UTI risk stratification using electronic data routinely available at admission; this could relieve nurses from the burden of having to complete and document additional risk assessment forms in the electronic medical record. Future studies should pilot and test interventions linked to the risk stratification results, such as short nursing educational modules or alerts triggered for high-risk patients.
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http://dx.doi.org/10.1097/NNR.0000000000000449DOI Listing
December 2020

LoTToR: An Algorithm for Missing-Wedge Correction of the Low-Tilt Tomographic 3D Reconstruction of a Single-Molecule Structure.

Sci Rep 2020 06 26;10(1):10489. Epub 2020 Jun 26.

The Molecular Foundry, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA.

A single-molecule three-dimensional (3D) structure is essential for understanding the thermal vibrations and dynamics as well as the conformational changes during the chemical reaction of macromolecules. Individual-particle electron tomography (IPET) is an approach for obtaining a snap-shot 3D structure of an individual macromolecule particle by aligning the tilt series of electron tomographic (ET) images of a targeted particle through a focused iterative 3D reconstruction method. The method can reduce the influence on the 3D reconstruction from large-scale image distortion and deformation. Due to the mechanical tilt limitation, 3D reconstruction often contains missing-wedge artifacts, presented as elongation and an anisotropic resolution. Here, we report a post-processing method to correct the missing-wedge artifact. This low-tilt tomographic reconstruction (LoTToR) method contains a model-free iteration process under a set of constraints in real and reciprocal spaces. A proof of concept is conducted by using the LoTToR on a phantom, i.e., a simulated 3D reconstruction from a low-tilt series of images, including that within a tilt range of ±15°. The method is validated by using both negative-staining (NS) and cryo-electron tomography (cryo-ET) experimental data. A significantly reduced missing-wedge artifact verifies the capability of LoTToR, suggesting a new tool to support the future study of macromolecular dynamics, fluctuation and chemical activity from the viewpoint of single-molecule 3D structure determination.
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http://dx.doi.org/10.1038/s41598-020-66793-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7320192PMC
June 2020