Genescene: Biomedical Text and Data Mining

To access the content of digital texts efficiently, it is necessary to provide more sophisticated access than keyword based searching. GeneScene provides biomedical researchers with research findings and background relations automatically extracted from text and experimental data. These provide a more detailed overview of the information available. The extracted relations were evaluated by qualified researchers and are precise. A qualitative ongoing evaluation of the current online interface indicates that this method to search the literature is more useful and efficient than keyword based searching

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

Impaired Behavioral Pattern Separation in Refractory Temporal Lobe Epilepsy and Mild Cognitive Impairment.

ObjectiveEpisodic memory impairment and hippocampal pathology are hallmark features of both temporal lobe epilepsy (TLE) and amnestic mild cognitive impairment (aMCI). Pattern separation (PS), which enables the distinction between similar but unique experiences, is thought to contribute to successful encoding and retrieval of episodic memories. Impaired PS has been proposed as a potential mechanism underling episodic memory impairment in aMCI, but this association is less established in TLE. In this study, we examined behavioral PS in patients with TLE and explored whether profiles of performance in TLE are similar to aMCI.MethodPatients with TLE, aMCI, and age-matched, healthy controls (HCs) completed a modified recognition task that relies on PS for the discrimination of highly similar lure items, the Mnemonic Similarity Task (MST). Group differences were evaluated and relationships between clinical characteristics, California Verbal Learning Test-Second Edition scores, and MST performance were tested in the TLE group.ResultsPatients with TLE and aMCI demonstrated poorer PS performance relative to the HCs, but performance did not differ between the two patient groups. Neither the side of seizure focus nor having hippocampal sclerosis affected performance in TLE. However, TLE patients with clinically defined memory impairment showed the poorest performance.ConclusionMemory performance on a task that relies on PS was disrupted to a similar extent in TLE and aMCI. The MST could provide a clinically useful tool for measuring hippocampus-dependent memory impairments in TLE and other neurological disorders associated with hippocampal damage

Density, abundance, survival, and ranging patterns of common bottlenose dolphins (Tursiops truncatus) in Mississippi Sound following the Deepwater Horizon oil spill.

After the Deepwater Horizon (DWH) oil spill began in April 2010, studies were initiated on northern Gulf of Mexico common bottlenose dolphins (Tursiops truncatus) in Mississippi Sound (MSS) to determine density, abundance, and survival, during and after the oil spill, and to compare these results to previous research in this region. Seasonal boat-based photo-identification surveys (2010-2012) were conducted in a section of MSS to estimate dolphin density and survival, and satellite-linked telemetry (2013) was used to determine ranging patterns. Telemetry suggested two different ranging patterns in MSS: (1) inshore waters with seasonal movements into mid-MSS, and (2) around the barrier islands exclusively. Based upon these data, dolphin density was estimated in two strata (Inshore and Island) using a spatially-explicit robust-design capture-recapture model. Inshore and Island density varied between 0.77-1.61 dolphins km-2 ([Formula: see text] = 1.42, 95% CI: 1.28-1.53) and 3.32-5.74 dolphins km-2 ([Formula: see text] = 4.43, 95% CI: 2.70-5.63), respectively. The estimated annual survival rate for dolphins with distinctive fins was very low in the year following the spill, 0.73 (95% CI: 0.67-0.78), and consistent with the occurrence of a large scale cetacean unusual mortality event that was in part attributed to the DWH oil spill. Fluctuations in density were not as large or seasonally consistent as previously reported. Total abundance for MSS extrapolated from density results ranged from 4,610 in July 2011 to 3,046 in January 2012 ([Formula: see text] = 3,469, 95% CI: 3,113-3,725)

Overall common bottlenose dolphin abundance and density estimates by stratum in Mississippi Sound from the spatially-explicit robust-design capture-recapture model applied to 2010–2012 photo-identification data.

<p>Overall common bottlenose dolphin abundance and density estimates by stratum in Mississippi Sound from the spatially-explicit robust-design capture-recapture model applied to 2010–2012 photo-identification data.</p

Estimated common bottlenose dolphin density (dolphins km⁻²) and abundance (dolphins) during primary photo-identification capture-recapture periods, and averaged over the study period in Mississippi Sound (MSS).

<p>Estimated common bottlenose dolphin density (dolphins km⁻²) and abundance (dolphins) during primary photo-identification capture-recapture periods, and averaged over the study period in Mississippi Sound (MSS).</p

Sighting frequency of marked individual common bottlenose dolphins from Mississippi Sound photo-identification surveys during 2010–2012.

<p>Sighting frequency of marked individual common bottlenose dolphins from Mississippi Sound photo-identification surveys during 2010–2012.</p

Number of individuals sighted during photo-identification surveys and discovery curve for common bottlenose dolphins in Mississippi Sound during 2010–2012.

<p>Number of individuals sighted during photo-identification surveys and discovery curve for common bottlenose dolphins in Mississippi Sound during 2010–2012.</p

Monthly hot spot number (p < 0.05 and p < 0.01), and hot spot overlap number and percentage between consecutive months at p < 0.05.

<p>Monthly hot spot number (p < 0.05 and p < 0.01), and hot spot overlap number and percentage between consecutive months at p < 0.05.</p