bluuebunny/crossref_metadata_2025 huggingface dataset:
Survey of females at school age group between 10-15 years old to study the prevalence of ovarian cysts among them using pelvic ultrasound
Authors: Abdelhameed A M , Khater N H , Ahmed S A
Published: May 2020

Background

Ovarian cyst is a common gynecological problem.The great majority of ovarian cysts are asymptomatic functional (physiological) cysts with simple appearance and small size. Ultrasonography (US) is the imaging modality of choice in the evaluation of cystic ovarian lesions in adolescent females.

Aim of the Work

To document ovarian cyst frequency and characteristics in females at school age group between 10-15 years old to study the prevalence and characteristics of ovarian cysts among them.

Patient and Methods

Our study was done on 52 girls aged between 10-15 years old presented and referred to our Radio-diagnosis department at Mataria teaching hospital from different outpatient clinics for pelvic US examination in a period of six months from May 2018 to November 2018.

Results

In our study the mean age 12.87±1.79, while age of start of menstruation (menarche) ranged from 10-14 with mean value 11.94±0.88. Regarding their menstrual pattern, girls with regular menstruation were (65.6 %) while those with irregular menstruation were (34.4%). Ovarian cystic lesions were founded in 9 girls (17.3%) while 43girls (82.7%) have normal ovaries. Simple ovarian cyst was the most frequent lesion which was seen in 8 girls(15.4%) followed by hemorrhagic cyst in one girl (1.9%).

Conclusion

Cystic lesions of the ovary are a common gynecological finding. They are very common and mostly benign during adolescence. Many ovarian cysts are asymptomatic and found incidentally on routine pelvic examination.
The validity of Triggering Receptor Expressed on Myeloid Cells (TREM-1) in diagnosis of Spontaneous Bacterial Peritonitis in cirrhotic patients
Authors: Abdelmonsef W , Abdelkader N A , Ismail G A , Elgaafary M M , Abdelrazek Y A
Published: May 2020

Background

Spontaneous bacterial peritonitis (SBP) is a serious complication in cirrhotic patients with ascites. Without early antibiotic treatment, this complication is associated with a 30-50% mortality rate. Recently we have evaluated the validity and utility of ascitic fluid triggering receptors expressed on myeloid cells-1 (TREM-1) levels for the diagnosis of SBP.

Patients and Methods

This was a Prospective case control study conducted on 60 patients with chronic liver disease and ascites divided into two group, group 1 (control) 30 patients without SBP and group 2 (SBP) 30 patients, admitted to the Tropical Medicine Department with ascites due to chronic liver disease. All patients were subjected to full history taking and clinical examination full laboratory investigations including complete blood picture liver and renal profiles, C reactive protein, viral markers, abdominal ultrasound, UGI endoscopy and ascitic fluid sampling for biochemical testing, total and differential cell count, microbiological culture and TREM-1 level.

Results

There was high statistical significant difference between the two groups in the base level of TREM-1 in which the mean was 1280 pg/ml (1136.9) with level range between (580---4500pg/ml) in SBP versus mean 129.9 pg/ml (51.9) with level range between (60-250pg/ml) in the control group. Also there was a statistical significant difference in the level of TREM-1 before and after treatment in the SBP patients in which the mean of TREM-1 before treatment was 1280.6 pg/ml (1136.9) with level range between (580-4500pg/ml) versus mean 376.2 pg/ml (78.4) and level range between (260-560 pg/ml) after the treatment.

Conclusion

our data indicate that the measurement of ascitic fluid TREM-1 is rapid, easy and valid test in the diagnosis and follow up of chronic liver disease patients with SBP.
Evaluation of Intra-Detrusor Injection of Botulinum A Toxin in Neurogenic Bladder in Patients with Multiple Sclerosis
Authors: Mourad M S , Kamal K M , Nada M A , Fahmy A G
Published: May 2020

Background

Early diagnosis and amelioration of lower urinary tract symptoms is a key focus in the management of multiple sclerosis. Untreated LUTS can lead to increased morbidity and mortality, for instance as a result of irreversible changes in the lower urinary tract itself, recurrent UTIs, renal stones, renal function impairment, and lowered HR-QoL.

Aim of the Work

to assess the effects of intradetrusor muscle injection of botulinum A toxin on urgency & urgency urinary incontinence, urodynamic variables, and quality of life in patients with MS and voiding dysfunction.

Patients and Methods

This prospective randomized control study was conducted on 40 patients recruited after signing a formal consent. The patients had been subjected to cystoscopy and intradetrusor injection of 200 U of botulinum A toxin, sparing the trigon, with consent to do CIC if needed. We had compared between the results of urodynamics and patients’ satisfaction before and after botulinum A toxin injection.

Results

The study showed highly statistically significant difference over the periods through UI episodes per week in the study group; In addition to significant reductions in UI, IDCs were absent at week 12 in approximately 65% of patients; and in those patients with an IDC, PdetmaxIDC decreased to levels traditionally considered safe for the upper urinary tract. Improved QOL scores were observed following onabotulinumtoxin A, and the mean change (26.07) was substantially higher than the reported minimally important difference.

Conclusion

in patients with UI in association with MS, the use of intradetrusor onabotulinumtoxinA after failure with antimuscarinics is efficacious and generally well tolerated and represents a valuable development in the management of UI in these patients. Intradetrusor onabotulinumtoxinA produces sustained improvement in symptoms and HR-QoL. Further studies of repeat injections over a longer time frame will be of considerable interest.
The classification of public research organizations: Taxonomical explorations
Authors: Cruz-Castro Laura , Martínez Catalina , Peñasco Cristina , Sanz-Menéndez Luis
Published: May 2020

This article addresses, conceptually and empirically, the classification of public research organizations (PROs) understood as non-university and non-enterprise research-focused organizations that are public by nature or in which the government has an influence. The construction of archetypes of research performing organizations has been a standard method of analysis, as reflected in the Frascati Manual that guides national statistical offices to delineate the perimeter of the institutional sector of PROs. However, this practice has often overlooked the emergence of new types because traditional approaches to classification tend to characterize previously defined mutually exclusive categories, rather than allow evidence to reveal categories ex-post. This gives rise to a number of concerns related to the scientific validity of the classification of entities in the organizational field of research. The present article discusses conceptual and methodological issues associated with different classificatory strategies. It also presents the empirical results of a taxonomical exploration that allows the identification of categories not determined ex-ante. Our empirical strategy consists in applying clustering techniques on a number of organizational dimensions, chosen based on theoretical grounds and proxied by variables determined by data availability. We implement it on a pilot dataset of 197 research-focused organizations from eight different European countries.
Mapping heterogeneity in a research system: The emergence of a ‘hybrid’ organizational field between science and industry
Authors: Giachi Sandro , Fernández-Esquinas Manuel
Published: May 2020

This article analyses the diversification of research systems by focusing on the role of the new population of centres created by universities, public research organizations, and firms for the purpose of knowledge transfer and exchange. It departs from the mix of policies and the structural conditions in Spain which resulted in an organizational field frequently unnoticed in research evaluation exercises. An original methodology combining a map of centres and a survey has been used to observe their profiles, activities, and internal organization. This study highlights the role of hybrid research organizations in the system and the importance of institutionalization processes to shape their portfolio of activities and outcomes. In the conclusions, methodological and practical implications are provided for an understanding of the heterogeneity of research systems as a result of collaboration between academic science and industry.
Mergers and acquisitions in the public research sector. Toward a comprehensive typology
Authors: Heller-Schuh Barbara , Lepori Benedetto , Neuländtner Martina
Published: May 2020

While the literature on firm mergers and acquisitions (M&A) is quite extensive, systematic approaches to analyze mergers in the public research sector are still scarce and focus only on the higher education sector. This article provides, for the first time, systematic empirical evidence on the extent and characteristics of M&A in public-sector research in Europe, by building on a novel dataset comprising demographic events since the year 2000. The goal of this study is to characterize such events in terms of organizations involved, types of events, and regional distribution. We find that M&A constituted a major change process within European public research. Nearly 400 events occurred in Europe between 2000 and 2016 with an increasing trend over time; M&A involved nearly one-fifth of public-sector research organizations and were geographically distributed across two-fifths of all European regions. Demographic events concerned primarily specialist institutions and to a larger extent public research entities and colleges. While the strong involvement of colleges was expected from the literature, for the first time we can show the extensive restructuring which took place in the public research entity sector. On the contrary, well known and prestigious university mergers, largely driven by the quest for international visibility, constituted only 10% of the events. Finally, we identified six broad groups of events characterized in terms of two dimensions, i.e. whether the involved organizations are active on the same or different markets and the extent of overlap between subject offerings.
Cortical Volume Differences in Subjects at Risk for Psychosis Are Driven by Surface Area
Authors: Buechler Roman , Wotruba Diana , Michels Lars , Theodoridou Anastasia , Metzler Sibylle , Walitza Susanne , Hänggi Jürgen , Kollias Spyros , Rössler Wulf , Heekeren Karsten
Published: May 2020

In subjects at risk for psychosis, the studies on gray matter volume (GMV) predominantly reported volume loss compared with healthy controls (CON). However, other important morphological measurements such as cortical surface area (CSA) and cortical thickness (CT) were not systematically compared. So far, samples mostly comprised subjects at genetic risk or at clinical risk fulfilling an ultra-high risk (UHR) criterion. No studies comparing UHR subjects with at-risk subjects showing only basic symptoms (BS) investigated the differences in CSA or CT. Therefore, we aimed to unravel the contribution of the 2 morphometrical measures constituting the cortical volume (CV) and to test whether these groups inhere different morphometric features. We conducted a surface-based morphometric analysis in 34 CON, 46 BS, and 39 UHR to examine between-group differences in CV, CSA, and CT vertex-wise across the whole cortex. Compared with BS and CON, UHR individuals presented increased CV in frontal and parietal regions, which was driven by larger CSA. These groups did not differ in CT. Yet, at-risk subjects who later developed schizophrenia showed thinning in the occipital cortex. Furthermore, BS presented increased CSA compared with CON. Our results suggest that volumetric differences in UHR subjects are driven by CSA while CV loss in converters seems to be based on cortical thinning. We attribute the larger CSA in UHR to aberrant pruning representing a vulnerability to develop psychotic symptoms reflected in different levels of vulnerability for BS and UHR, and cortical thinning to a presumably stress-related cortical decomposition.
The role of 11C-methionine PET in patients with negative diffusion-weighted magnetic resonance imaging: correlation with histology and molecular biomarkers in operated gliomas
Authors: Castello Angelo , Riva Marco , Fernandes Bethania , Bello Lorenzo , Lopci Egesta
Published: May 2020

Objective

To compare 11C-methionine (11C-METH) PET with diffusion-weighted MRI (DWI-MRI) diagnostic accuracy and prognostic value in patients with glioma candidate to neurosurgery.

Methods

We collected and analyzed data from 124 consecutive patients (n = 124) investigated during preoperative work-up. Both visual and semiquantitative parameters were utilized for image analysis. The reference standard was based on histopathology. The median follow-up was 14.3 months.

Results

Overall, 47 high-grade gliomas (HGG) and 77 low-grade gliomas (LGG) were diagnosed. On visual assessment, sensitivity and specificity for differentiating HGG from LGG were 80.8 and 59.7% for DWI-MRI, versus 95.7 and 41.5% for 11C-METH PET, respectively. On semiquantitative analysis, the sensitivity, specificity, and area under the curve were 78.7, 71.4, and 80.4% for SUVmax, 78.7, 70.1, and 81.1% for SUVratio, and 74.5, 61, and 76.7% for MTB (metabolic tumor burden), respectively. In patients with negative DWI-MRI and IDH-wild type, SUVmax and SUVratio were higher compared to IDH-mutated (P = 0.025 and P = 0.01, respectively). In LGG, patients with 1p/19q codeletion showed higher SUVmax (P = 0.044). In all patients with negative DWI-MRI, median PFS was longer for SUVmax <3.9 (median not reached vs 34.2 months, P = 0.004), SUVratio <2.3 (median not reached vs 21.5 months, P < 0.001), and MTB <3.1 (median not reached vs 45.7 months, P = 0.05). In LGG patients with negative DWI-MRI, only SUVratio <2.3 and MTB <3.1 were associated with longer PFS (P = 0.016 and P = 0.024, respectively).

Conclusion:

C-METH PET was found highly sensitive for glioma differentiation and molecular characterization. In DWI-negative patients, PET parameters correlated with molecular profile were associated with clinical outcome.
Oleiliquidispirillum nitrogeniifigens gen. nov., sp. nov., a new member of the family Rhodospirillaceae isolated from oil reservoir water
Authors: Li Fang-Ling , Wang Xiao-Tong , Shan Jian-Jie , Li Shuai , Zhang Ya-Xi , Li Xi-Zhe , Li Dong-An , Li Wen-Jun , Wang Lei
Published: May 2020

A novel Gram-staining-negative, spiral-shaped bacterium, designated strain 64-1T, was isolated from oil reservoir water collected from Liaohe oilfield, north-eastern China. Growth occurred at 15–55 °C and pH 6.0–10.0. The sole respiratory quinone was Q-10. The predominant cellular fatty acids were summed feature 8 (C18 : 1
 ω7c /C18 : 1
 ω6c), C16 : 0 and C19 : 0 cyclo ω8c. The polar lipids consisted of phosphatidylethanolamine (PE), phosphatidylglycerol (PG), phosphatidylcholine (PC), an unidentified aminophospholipid (UAPL), an unidentified aminolipid (UAL) and two unidentified polar lipids (UPL). The genomic DNA G+C content of strain 64-1T was 64.5 mol%. Strain 64-1T shared the highest 16S rRNA gene sequence similarities with

Phaeospirillum chandramohanii

JA145T (92.0 %) and

Telmatospirillum siberiense

26-4b1T (91.8 %). In the phylogenetic trees, the strain constituted a sub-cluster within the family

Rhodospirillaceae

. Based on the results of morphological, physiological, biochemical and phylogenetic analysis, strain 64-1T represents a new species of a novel genus within the family

Rhodospirillaceae

, for which the name Oleiliquidispirillum nitrogeniifigens gen. nov., sp. nov. is proposed. The type strain is 64-1T (=CGMCC 1.16798T=LMG 31399T).
Gimesia chilikensis sp. nov., a haloalkali-tolerant planctomycete isolated from Chilika lagoon and emended description of the genus Gimesia
Authors: Kumar Dhanesh , Gaurav Kumar , PK Sreya , A. Shabbir , Uppada Jagadeeshwari , Ch. Sasikala , Ch.V. Ramana
Published: May 2020

A Gram-stain-negative, aerobic, non-motile, salt- and alkali-tolerant, pear to oval shaped, rosette-forming, white coloured, bacterium, designated as strain JC646T, was isolated from a sediment sample collected from Chilika lagoon, India. Strain JC646T reproduced through budding, grew well at up to pH 9.0 and tolerated up to 7 % NaCl. Strain JC 646T utilized α-d-glucose, fumarate, lactose, sucrose, fructose, d-galactose, mannose, maltose and d-xylose as carbon sources. Peptone, l-isoleucine, l-serine, l-lysine, l-glutamic acid, l-aspartic acid, dl-threonine and l-glycine were used by the strain as nitrogen sources for growth. The respiratory quinone was MK6. Major fatty acids were C16 : 1 ω7c/C16 : 1 ω6c and C16 : 0. The polar lipids of strain JC646T comprised phosphatidyl-dimethylethanolamine, phosphatidylcholine, diphosphatidylglycerol, an unidentified amino lipid and two unidentified lipids. Strain JC646T had highest (97.3 %) 16S rRNA gene sequence identity to the only species of the genus

Gimesia

,

Gimesia maris

DSM 8797T. The genome of strain JC646T was 7.64 Mbp with a DNA G+C content of 53.2 mol%. For the resolution of the phylogenetic congruence of the novel strain, the phylogeny was also reconstructed with the sequences of 92 housekeeping genes. Based on phylogenetic analyses, digital DNA–DNA hybridization (19.0 %), genome average nucleotide identity (74.5 %) and average amino acid identity/percentageof conserved proteins (77 %) results, chemotaxonomic characteristics, and differential physiological properties, strain JC646T is recognized as representing a new species of the genus

Gimesia

, for which we propose the name Gimesia chilikensis sp. nov. The type strain is JC646T (=KCTC 72175T=NBRC 113881T).
Distinguishing between COVID-19 and the common cold in a primary care setting - comparison of patients with positive and negative SARS-CoV-2 PCR results
Authors: Just Johannes , Puth Marie-Therese , Regenold Felix , Weckbecker Klaus , Bleckwenn Markus
Published: May 2020

Background

Combating the COVID-19 pandemic is a major challenge for health systems, citizens and policy makers worldwide. Early detection of affected patients within the large and heterogeneous group of patients with common cold symptoms is an important element of this effort, but often hindered by limited testing resources and the lack of pathognomonic symptoms in COVID-19. Therefore, we aimed to identify predictive risk factors for a positive SARS-CoV-2 PCR (CovPCR) result in a primary care setting.

Method

We performed a multi-center cross-sectional cohort study on predictive clinical characteristics for a positive CovPCR over a period of 4 weeks in primary care patients in Germany.

Findings

In total, 374 patients in 14 primary care centers received CovPCR and were included in this analysis. The median age was 44.0 (IQR: 31.0-59.0) and a fraction of 10.7% (n=40) tested positive for COVID-19. Patients who reported anosmia had a higher odds ratio (OR: 4.54; 95%-CI: 1.51-13.67) for a positive test result while patients with a sore throat had a lower OR (OR: 0.33; 95%-CI: 0.11-0.97). Patients who had a first grade contact with an infected persons and showed symptoms themselves also had an increased OR for positive testing (OR: 5.16; 95% CI: 1.72-15.51). This correlation was also present when they themselves were still asymptomatic (OR: 12.55; 95% CI: 3.97-39.67).

Conclusions

Several anamnestic criteria may be helpful to assess pre-test probability of COVID-19 in patients with common cold symptoms
Estimation of the basic reproduction number, average incubation time, asymptomatic infection rate, and case fatality rate for COVID-19: Meta-analysis and sensitivity analysis
Authors: He Wenqing , Yi Grace Y. , Zhu Yayuan
Published: May 2020

The coronavirus disease 2019 (COVID-19) has been found to be caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, comprehensive knowledge of COVID-19 remains incomplete and many important features are still unknown. This manuscripts conduct a meta-analysis and a sensitivity study to answer the questions: What is the basic reproduction number? How long is the incubation time of the disease on average? What portion of infections are asymptomatic? And ultimately, what is the case fatality rate? Our studies estimate the basic reproduction number to be 3.15 with the 95% interval (2.41, 3.90), the average incubation time to be 5.08 days with the 95% confidence interval (4.77, 5.39) (in day), the asymptomatic infection rate to be 46% with the 95% confidence interval (18.48%, 73.60%), and the case fatality rate to be 2.72% with 95% confidence interval (1.29%, 4.16%) where asymptomatic infections are accounted for.
Global prediction of unreported SARS-CoV2 infection from observed COVID-19 cases
Authors: Chow Carson C. , Chang Joshua C. , Gerkin Richard C. , Vattikuti Shashaank
Published: May 2020

Estimation of infectiousness and fatality of the SARS-CoV-2 virus in the COVID-19 global pandemic is complicated by ascertainment bias resulting from incomplete and non-representative samples of infected individuals. We developed a strategy for overcoming this bias to obtain more plausible estimates of the true values of key epidemiological variables. We fit mechanistic Bayesian latent-variable SIR models to confirmed COVID-19 cases, deaths, and recoveries, for all regions (countries and US states) independently. Bayesian averaging over models, we find that the raw infection incidence rate underestimates the true rate by a factor, the case ascertainment ratio CARt that depends upon region and time. At the regional onset of COVID-19, the predicted global median was 13 infections unreported for each case confirmed (CARt = 0.07 C.I. (0.02, 0.4)). As the infection spread, the median CARt rose to 9 unreported cases for every one diagnosed as of April 15, 2020 (CARt = 0.1 C.I. (0.02, 0.5)). We also estimate that the median global initial reproduction number R0 is 3.3 (C.I (1.5, 8.3)) and the total infection fatality rate near the onset is 0.17% (C.I. (0.05%, 0.9%)). However the time-dependent reproduction number Rt and infection fatality rate as of April 15 were 1.2 (C.I. (0.6, 2.5)) and 0.8% (C.I. (0.2%,4%)), respectively. We find that there is great variability between country- and state-level values. Our estimates are consistent with recent serological estimates of cumulative infections for the state of New York, but inconsistent with claims that very large fractions of the population have already been infected in most other regions. For most regions, our estimates imply a great deal of uncertainty about the current state and trajectory of the epidemic.
Battling the COVID-19 Pandemic: Is Bangladesh Prepared?
Authors: Khan Md Hasinur Rahaman , Howlader Tamanna , Islam Md. Mazharul
Published: May 2020

Following detection of the first few COVID-19 cases in early March, Bangladesh has stepped up its efforts to strengthen capacity of the healthcare system to avert a crisis in the event of a surge in the number of cases. This paper sheds light on the preparedness of the healthcare system by examining the spatial distribution of isolation beds across districts and divisions, forecasting the number of ICU units that may be required in the short term and analyzing the availability of frontline healthcare workers to combat the pandemic. As of May 2, COVID-19 cases have been found in 61 of the 64 districts in Bangladesh with Dhaka District being the epicenter. Seventy-one percent of the cases have been identified in 6 neighboring districts, namely, Dhaka, Narayanganj, Gazipur, Narsingdi, Munsiganj and Kishoreganj, which appear to form a spatial cluster. However, if one takes into account the population at risk, the prevalence appears to be highest in Dhaka, followed by Narayanganj, Gazipur, Kishorganj, Narsingdi and Munshiganj. These regions may therefore be flagged as the COVID-19 hotspots in Bangladesh. Among the eight divisions, prevalence is highest in Dhaka Division followed by Mymensingh. The number of cases per million exceeds the number of available isolation beds per million in the major hotspots indicating that there is a risk of the healthcare system becoming overwhelmed should the number of cases rise. This is especially true for Dhaka Division, where the ratio of COVID-19 patients to doctors appears to be alarmingly high. My-mensingh Division also has a disproportionately small number of doctors relative to the number of COVID-19 patients. Using second order polynomial regression, the analysis predicts that even if all ICU beds are allocated to COVID-19 patients, Bangladesh may run out of ICU beds soon after May 15, 2020. We conclude that in spite of a significant increase in hospital capacity during 2005-15 and a 57 % rise in the number of doctors during the same period, the healthcare system in Bangladesh and Dhaka Division in particular, may not be fully prepared to handle the COVID-19 crisis. Thus, further steps need to be taken to flatten the curve and improve healthcare capacity.
Functional Impacts of Aminoglycoside Treatment on Speech Perception and Extended High-Frequency Hearing Loss in Cystic Fibrosis
Authors: Blankenship Chelsea M. , Hunter Lisa L. , Feeney M. Patrick , Cox Madison , Bittinger Lindsey , Garinis Angie , Lin Li , McPhail Gary , Clancy John P.
Published: May 2020

Purpose

The purpose of this study is to better understand the prevalence of ototoxicity-related hearing loss and its functional impact on communication in a pediatric and young adult cohort with cystic fibrosis (CF) and individuals without CF (controls).

Method

Observational, cross-sectional investigation of hearing function in children, teens, and young adults with CF (n = 57, mean = 15.0 yr.) who received intravenous aminoglycoside antibiotics and age- and gender-matched controls (n = 61, mean = 14.6 yr.). Participants completed standard and extended high frequency audiometry, middle ear measures, speech perception tests, and a hearing and balance questionnaire.

Results

Individuals with CF were 3 to 4 times more likely to report issues with hearing, balance, and tinnitus and performed significantly poorer on speech perception tasks compared to controls. A higher prevalence of hearing loss was observed in individuals with CF (57%) compared to controls (37%). CF and control groups had similar proportions of slight and mild hearing losses, however individuals with CF were 7.6 times more likely to have moderate and greater degrees of hearing loss. Older participants displayed higher average EHF thresholds, with no effect of age on average SF thresholds. Although middle ear dysfunction has not previously been reported to be more prevalent in CF, this study showed that 16% had conductive or mixed hearing loss and higher rates of previous otitis media and pressure equalization (PE) tube surgeries compared to controls.

Conclusions

Individuals with CF have a higher prevalence of conductive, mixed and sensorineural hearing loss, poorer speech-in-noise performance and higher rates of multiple symptoms associated with otologic disorders (tinnitus, hearing difficulty, dizziness, imbalance and otitis media) compared to controls. Accordingly, children with CF should be asked about these symptoms, receive baseline hearing assessment(s) prior to treatment with potentially ototoxic medications, and at regular intervals thereafter in order to provide otologic and audiologic treatment for hearing and ear-related problems to improve communication functioning.
COVID-19: How to Relax Social Distancing If You Must
Authors: Duque Daniel , Morton David Paul , Singh Bismark , Du Zhanwei , Pasco Remy , Meyers Lauren Ancel
Published: May 2020

Following the April 16, 2020 release of the Opening Up America Again guidelines for relaxing COVID-19 social distancing policies, local leaders are concerned about future pandemic waves and lack robust strategies for tracking and suppressing transmission. Here, we present a framework for monitoring COVID-19 hospitalization data to project risks and trigger shelter-in-place orders to prevent overwhelming healthcare surges while minimizing the duration of costly lockdowns. Assuming the relaxation of social distancing increases the risk of infection ten-fold, the optimal strategy for Austin, Texas--the fastest-growing large city in the US--will trigger a total of 135 [90% prediction interval: 126-141] days of sheltering, allow schools to open in the fall, and result in an expected 2929 deaths [90% prediction interval: 2837-3026] by September 2021, which is 29% the annual mortality rate. In the months ahead, policy makers are likely to face difficult choices and the extent of public restraint and cocooning of vulnerable populations may save or cost thousands of lives.
Clinical characteristics of 106 patients with neurological diseases and co-morbid coronavirus disease 2019: a retrospective study
Authors: Yin Rong , Yang ZhiQi , Wei YaXuan , Li YuanMing , Chen Hui , Liu Zhao , Zhao Bo , Ma DanDan , Dan MeiLing , Zhang YingJie , Liu Xuan , Leng HuiCeng , Xiang DaWei
Published: May 2020

Objectives

To describe the clinical characteristics of patients with coronavirus disease 2019 (COVID-19) with co-morbid neurological symptoms.

Design

Retrospective case series.

Setting

Huoshenshan Hospital in Wuhan, China.

Participants

From 4 February to 14 April 2020, 106 patients with neurological diseases were enrolled from all patients in the hospital with confirmed COVID-19 and divided into a severe group and a non-severe group according to their COVID-19 diagnosis.

Main outcome measures

Clinical characteristics, laboratory results, imaging findings, and treatment methods were all retrieved through an electronic medical records system and recorded in spreadsheets.

Results

The mean (standard deviation, SD) age of patients was 72.7 (11.8) years, and 64 patients were male (60.4%). Among patients with co-morbid neurological diseases, 81 had a previous cerebral infarction (76.4%), 20 had dementia (18.9%), 10 had acute cerebral infarction (9.4%), 5 had sequelae of cerebral haemorrhage (4.7%), 4 had intracranial mass lesions (3.8%), 3 had epilepsy (2.8%), 2 had Parkinson’s disease (1.9%), and 1 had myelopathy (0.9%). Fever (n = 62, 58.5%) was the most common symptom. The most common neurological symptoms were myalgia (n = 26, 24.5%), followed by extremity paralysis (n = 20, 18.9%), impaired consciousness (n = 17, 16%), and positive focal neurological signs (n = 42, 39.6%). Eight patients (7.5%) died. There were more patients with altered mental status in the severe group than in the non-severe group (6 [10.2%] vs. 0, P = 0.033). The inflammatory response in the severe group was more significant than that in the non-severe group. There were more patients taking anticoagulant drugs (25 [42.4%] vs. 4 [8.5%], P < 0.001) and sedative drugs (22 [37.3%] vs. 9 [19.1%], P = 0.041) in the severe group than in the non-severe group. Amid all 93 patients with cerebrovascular diseases, only 32 (34.4%) were taking aspirin, 13 (14%) taking clopidogrel, and 33 (35.5%) taking statins.

Conclusions

Patients with COVID-19 with co-morbid neurological diseases had an advanced age, a high rate of severe illness, and a high mortality rate. Among the neurological symptoms, altered mental status was more common in patients with severe COVID-19 with co-morbid neurological diseases.
AN INTERACTIVE COVID-19 MOBILITY IMPACT AND SOCIAL DISTANCING ANALYSIS PLATFORM
Authors: Zhang Lei , Ghader Sepehr , Pack Michael L. , Xiong Chenfeng , Darzi Aref , Yang Mofeng , Sun QianQian , Kabiri AliAkbar , Hu Songhua
Published: May 2020

The research team has utilized privacy-protected mobile device location data, integrated with COVID-19 case data and census population data, to produce a COVID-19 impact analysis platform that can inform users about the effects of COVID-19 spread and government orders on mobility and social distancing. The platform is being updated daily, to continuously inform decision-makers about the impacts of COVID-19 on their communities using an interactive analytical tool. The research team has processed anonymized mobile device location data to identify trips and produced a set of variables including social distancing index, percentage of people staying at home, visits to work and non-work locations, out-of-town trips, and trip distance. The results are aggregated to county and state levels to protect privacy and scaled to the entire population of each county and state. The research team are making their data and findings, which are updated daily and go back to January 1, 2020, for benchmarking, available to the public in order to help public officials make informed decisions. This paper presents a summary of the platform and describes the methodology used to process data and produce the platform metrics.
Effective Heat Inactivation of SARS-CoV-2
Authors: Wang Tony , Lien Christopher , Liu Shufeng , Selveraj Prabhuanand
Published: May 2020

The outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCoV) has quickly turned into a global pandemic. Infectious viruses had been isolated from oro- or naso-pharyngeal swabs, sputum and possibly stool samples of infected individuals. Handling these clinical specimens therefore poses a biosafety risk to both healthcare professionals and laboratory workers. In this study, we aimed to evaluate the stability of SARS-CoV-2 under different heat conditions and report that the virus is stable at 37 C for at least 24 hours. Heating at 56 C for 30 minutes, however, effectively inactivated the virus while preserved the stability of viral RNA in both human sera and sputum samples. These findings provide critical information regarding the biology of the virus as well as a practical way to inactivate infectious virus that is potentially found in clinical specimens.
Diagnostic value of self-report compared with Beck Depression Inventory (BDI-II) in screening of depression
Authors: zarghami Mehran , Taghizadeh Fatemeh , mousazadeh Mahmood
Published: May 2020

Background

Depression is a common cause of mortality and morbidity worldwide. To detect depression, we compared Beck Depression Inventory scoring as a valid tool with participants self-reporting depression.

Methodology

This cross-sectional study aimed to explore the diagnostic values of self-reporting in patients’ with depression comparing to Beck Depression Inventory scoring in Mazandaran Persian cohort study, with a total of 1300 samples. The sample size was determined to include 155 participants through the census method. In order to increase the test power, 310 healthy participants were included in the study through random selection. In order to evaluate the diagnostic value of self-reporting, BDI-II was completed by blind interviewing to the case group as well as to another group who reported that they were not depressed, as control.

Results

Sensitivity, specificity, accuracy, false positive, false negative, positive and negative predictive values of self-reporting was calculated 58.4%, 79.1%,73.4%, 20.8%, 41.6%, 51.8%, and 83.2% for the total population respectively, as well as, sensitivity, specificity, accuracy, positive and negative predictive values of self-report in males were 83.3%, 77.2%, 77.1%, 43.8% and 95.6% and 53.7%, 78.1%, 71.2%, 49.2%, and 81.1% for females, respectively.

Conclusion

The positive predictive value and sensitivity of self-reporting are insufficient in total population and females, and therefore self-reporting cannot detect depressed patients, but regarding to its average positive predictive value, perhaps, it can be used to identify non-depressant individuals.
Early transmission dynamics and control of COVID-19 in a southern hemisphere setting: Lima-Peru, February 29th-March 30th, 2020
Authors: Munayco César V. , Tariq Amna , Soto-Cabezas Gabriela G , Reyes Mary F. , Valle Andree , Rojas-Mezarina Leonardo , Cabezas César , Loayza Manuel ,   Peru COVID-19 working group, Chowell Gerardo
Published: May 2020

The COVID-19 pandemic that emerged in Wuhan China rapidly spread around the world. The daily incidence trend has been rapidly rising in Latin America since March 2020 with the great majority of the cases reported in Brazil (28320) followed by Peru (11475) as of April 15th, 2020. Although Peru implemented social distancing measures soon after the confirmation of its first case on March 6th, 2020, the daily number of new COVID-19 cases continues to increase. We assessed the early COVID-19 transmission dynamics and the effect of social distancing interventions in Lima, Peru.

We estimate the transmission potential of COVID-19, R, during the early phase of the outbreak, from the daily series of imported and autochthonous cases by the date of symptoms onset as of March 30th, 2020. We also assessed the effect of social distancing interventions in Lima by generating short-term forecasts grounded on the early transmission dynamics before interventions were put in place.

Prior to the implementation of the social distancing measures in Lima, we estimated the reproduction number at 2.3 (95% CI: 2.0, 2.5). Our analysis indicates that school closures and other social distancing interventions have helped stem the spread of the virus, with the nearly exponential growth trend shifting to an approximately linear growth trend after the national emergency declaration.

The COVID-19 epidemic in Lima followed an early exponential growth trend, which slowed down and turned into an almost linear growth trend after broad scale social distancing interventions were put in place by the government.

Peru COVID-19 working group
Single-cell Transcriptome Analysis Indicates New Potential Regulation Mechanism of ACE2 and NPs signaling among heart failure patients infected with SARS-CoV-2
Authors: Xu Dachun , Ma Mengqiu , Xu Yanhua , Su Yang , Ong Sang-Bing , Hu Xingdong , Chai Min , Zhao Maojun , Li Hong , Xu Xiaojiang
Published: May 2020

The coronavirus disease 2019 (COVID-19) has resulted in high morbidity and mortality worldwide since December 2019. Recent studies showed that patients with previous heart disease, especially heart failure (HF), whose plasma Natriuretic Peptides (NPs) concentrations are higher, were more susceptible to SARS-CoV-2 infection. In this study, we retrospectively analyzed single-center case series of 91 patients with COVID-19 in China. 46 (50.5%) patients exhibited cardiac dysfunction as indicated by elevated Natriuretic Peptides B (BNP) levels. Moreover, the results indicate that patients with cardiac dysfunction had higher mortality than those without cardiac dysfunction. Nonetheless, it remains unclear as to how the virus infects the heart, especially in HF patients and why a higher level of BNP in the heart dampen inflammation. Angiotensin-converting enzyme 2 (ACE2), the critical host cellular receptor of SARS-CoV-2, expresses in different organs. Still, its cellular distribution in the human heart, especially in patients with HF remains unclear. Thus, we investigated ACE2 gene expression pattern in single-cell RNA sequence (scRNA-seq) data of hearts from normal adults versus patients with HF. Our results indicate that ACE2 is predominantly enriched in cardiomyocytes (CMs), endothelial cells, fibroblasts and smooth muscle cells in normal heart. Not only ACE2+ CMs, but also expression of ACE2 are significantly boosted in CMs of patients with HF. Also, genes related to virus entry, virus replication and suppression of IFN-γ signaling besides ACE2 were up-regulated in HF patient, mainly in CMs, indicating the higher susceptibility to SARS-CoV-2 infection. Interestingly, NPs are significantly up-regulated in ACE2-postive (ACE2+) ventricular myocytes and share the upstream transcription factor. ACE2 and NPs can form a negative feedback loop with protective effects. But it maybe turns into a positive feedback loop by virus and ineffective NPs, which lead to severe prognosis. In summary, the increased expression of ACE2, NPs during HF predisposes to SARS-CoV-2 infection. Modulating the levels of ACE2, NPs therefore may potentially be a novel therapeutic target to prevent the SARS-CoV-2 infection.
Effectiveness of a nutrition education package on glycaemic control among children with type 1 diabetes mellitus aged 3-14 years in Uganda: study protocol for a cluster-randomized trial
Authors: NDAHURA NICHOLAS BARI , MUNGA JUDITH , KIMIYWE JUDITH , MUPERE EZEKIEL
Published: May 2020

Introduction: Inadequate dietary management practices among children with type 1 diabetes mellitus (T1DM) often result in preventable complications, disability, and premature deaths, and yet strict glycaemic control can help reduce the long-term complications. Furthermore, parental caregiving has also been shown to have an impact on glycaemic control and yet often a gap exists between recommended care and provided care, resulting in failure of children with T1DM meeting their treatment targets. In Uganda, no published study has been conducted to find out if nutrition education has an effect on glycaemic control and caregivers level of knowledge on general and diabetes-specific nutrition for children with T1DM.
Methods: The study will be a cluster randomised controlled trial with 10 health facilities randomised to control or intervention at a ratio of 1:1. A total of 100 caregiver-child pairs will be recruited. The participants in the control group will continue to receive routine medical care, while those in the intervention group will receive routine medical care and a nutrition education package. The primary outcome is glycated hemoglobin (HbA1c) values. Secondary outcomes will be caregivers level of knowledge on general and diabetes-specific nutrition knowledge, childrens dietary diversity score and childrens mean intake of energy, protein, and fat.
Discussion: The findings of this study will be used in improving nutrition education in T1DM among children attending diabetes clinics in Uganda.
Trial registration number: The trial is registered with The Pan African Clinical Trials Registry (PACTR201902548129842).
Probable causes and risk factors for positive SARS-CoV-2 test in recovered patients: Evidence from Brunei Darussalam
Authors: Wong Justin , Koh Wee Chian , Momin Riamiza Natalie , Alikhan Mohammad Fathi , Fadillah Noraskhin , Naing Lin
Published: May 2020

We report findings of a national study in Brunei Darussalam indicating that one in five recovered patients subsequently test positive again for SARS-CoV-2 - this risk is nearly three times higher in older patients (age 53 and above) than younger ones (below age 53). Review of clinical and epidemiological records do not support reinfection or reactivation as likely causes of the 're-positive' observation. Instead, prolonged but intermittent viral shedding is the most probable explanation. We discuss the implications of these findings for infection control and clinical practice.
Lockdown exit strategies and risk of a second epidemic peak: a stochastic agent-based model of SARS-CoV-2 epidemic in France
Authors: Hoertel Nicolas , Blachier Martin , Blanco Carlos , Olfson Mark , Massetti Marc , Rico Marina Sánchez , Limosin Frédéric , Leleu Henri
Published: May 2020

Most European countries have responded to the COVID-19 threat by nationwide implementation of barrier measures and lockdown. However, assuming that population immunity will build up through the epidemic, it is likely to rebound once these measures are relaxed, possibly leading to a second or multiple repeated lockdowns. In this report, we present results of epidemiological modelling that has helped inform policy making in France. We used a stochastic agent-based microsimulation model of the COVID-19 epidemic in France, and examined the potential impact of post-quarantine measures, including social distancing, mask-wearing, and shielding of the population the most vulnerable to severe COVID-19 infection, on the disease’s cumulative incidence and mortality, and on ICU-bed occupancy. The model calibrated well and variation of model parameter values had little impact on outcome estimates. While quarantine is effective in containing the viral spread, it would be unlikely to prevent a rebound of the epidemic once lifted, regardless of its duration. Both social distancing and mask-wearing, although effective in slowing the epidemic and in reducing mortality, would also be ineffective in ultimately preventing the overwhelming of ICUs and a second lockdown. However, these measures coupled with shielding of vulnerable people would be associated with better outcomes, including lower cumulative incidence, mortality, and maintaining an adequate number of ICU beds to prevent a second lockdown. Benefits would nonetheless be markedly reduced if these measures were not applied by most people or not maintained for a sufficiently long period, as herd immunity progressively establishes in the less vulnerable population.
RSI model: COVID-19 in Germany Alternating quarantine episodes and normal episodes
Authors: Knoch Carolin , Hartmann Timo , Wildblood Alan
Published: May 2020

This paper was developed in the Civil Systems Engineering Department at the Technical University of Berlin. The background is the spread of COVID-19 pandemic in Germany. Our current situation is a threat from the COVID-19 virus without vaccine and medication. Germany has increased its intensive capacities, intensified research in its analyzes and research projects and is currently testing the influence of various measures on the rate of expansion.

The goal now is to find a strategy that slows the spread so that medical capacities are not overloaded. The approach is to alternate between quarantine and normal episodes and the result is an oscillation in the number of cases between two limits.

The mathematical model is an SRI model that can be used to calculate the development of the case numbers. All uncertain parameters are varied at significant intervals. Influence parameters and control parameters were defined. By adjusting the length of the episode to match the speed of spread of the virus, the gap can be bridged until a vaccine has been developed or sufficient immunity is available in the population. By observing the capacity limits in connection with the number of cases, the need for a new quarantine episode and the possibility of initiating a normal episode can be predetermined. This does not exceed the capacity limit.

In quarantine, contagion within households is limited by the size of the household; only system-critical professions continue to work in public. All others must remain in the homeschooling / home office. In the normal episode, everyone can work, go to school, have social contacts. A solution could be found in all parameter combinations. The ratio of the normal episode duration / quarantine episode lies between 0.3 and 0.95 in the examination area.