bluuebunny/crossref_metadata_2025 huggingface dataset:
The Racialized Glass Escalator and Safety Net: Wages and Job Quality in “Meds and Eds” among Working-Class Men
Authors: Dill Janette , Hodges Melissa J
Published: July 2020

Past research has shown that minority men are more likely than others to enter female-dominated occupations, but less is known about the quality of their jobs in these fields in contrast to other employment options. We use the 2004 and 2008 panels of the Survey of Income and Program Participation (SIPP) to examine whether the female-dominated industries of education and health care produce better job quality in terms of wages, benefits, hours, and job security for working-class men relative to other industries, with emphasis on differences by race-ethnicity. We find that although workers in the education and health care industries fared better during the Great Recession compared to those in other industries, effects for wages, health insurance, hours, and layoff for working-class Men of Color were substantially lower compared to those of White men. We find strong evidence of a racialized glass escalator, but also a racialized safety net in the care sector post-recession: the health care and education industries provide better job quality for White men than for Men of Color, though they are less likely to be in these jobs, and these sectors were more protective of White men as compared to minorities during the recession.
Dropout, response, and abstinence outcomes of a national text-messaging smoking cessation intervention for teens, SmokeFreeTeen
Authors: Chan Charmaine , Kamke Kristyn , Assuah Freda , El-Toukhy Sherine
Published: July 2020

Although text-messaging interventions are effective for smoking cessation, few target teens in the USA and little is known about their effectiveness. The purpose of this manuscript is to examine correlates of dropout, response to smoking status prompts, and abstinence rates among subscribers of SmokeFreeTeen, a free, publicly available text-messaging smoking cessation intervention sponsored by the National Cancer Institute’s SmokeFree.Gov initiative, on quit day through 1 month follow-up. In a sample of teens (N = 2,685), aged 13–19, we examined demographics, smoking frequency, cigarettes smoked per day, prequit intervention time (i.e., maximum of 14 days of prequit day preparation), and number of quit attempts as correlates of response and abstinence rates among program initiators (i.e., participants who reached quit day but dropped out on or before intervention end) and completers (i.e., participants who reached quit day and completed the intervention). We also conducted Cox regression analysis of time from quit day to dropout by daily and nondaily smoking status. Two-thirds (n = 1,733, 64.54%) dropped out before the intervention ended, with dropout rates peaking on quit day (n = 289, 13.10%). Response rate to smoking status prompts remained below 30% throughout the intervention. At intervention end and 1 month follow-up, abstinence was 2.63% and 2.55% among program initiators, whereas abstinence was 6.09% and 6.01% among program completers. Dropout, response, and abstinence rates did not consistently differ by subscriber characteristics. Prequit time was associated with decreased likelihood of dropping out (adjusted hazards ratio: 0.94, confidence interval [CI]: 0.93–0.95), responding to smoking status prompts (adjusted odds ratio [aOR]: 0.94, CI: 0.92–0.96), and being abstinent (aOR: 0.96, CI: 0.93–0.99) on quit day. Two or more quit attempts were associated with increased response (aOR: 1.61, CI: 1.16–2.23) and abstinence (aOR: 1.91, CI: 1.25–2.92) rates on Day 7. In a first assessment of SmokeFreeTeen outcomes, we document high dropouts and low response and abstinence rates. SmokeFreeTeen produced abstinence rates lower than comparable text-messaging interventions targeting teens and young adults. Improving SmokeFreeTeen’s reach, engagement, and effectiveness is needed.
Local public health officials and COVID-19: Evidence from China
Authors: Jiang John (Xuefeng) , Wang Maobin
Published: July 2020

Local public health authorities are at the forefront of fighting COVID-19. They monitor its spread in the local population and advise the local government on whether to close schools and businesses. Examining their role in battling COVID-19 will inform the public how best to prepare for a public health emergency. This study examined whether more competent local public health officials in China are more effective in fighting COVID-19, where competence was measured by the public health officials’ professional background. Only 38% of the heads of the public health departments of Chinese cities have a medical background. Cities with medical professionals as the head of public health departments had lower infection rates and death rates from COVID-19. The results were significant only at the start of the outbreak. Our results suggest that we should staff local public health authorities with competent professionals to better combat a pandemic.
A study of risk analysis and prognosis models for the mortality of sepsis based on real-world data in China
Authors: Lu Yu , Kong Qing , Li Jing , Jiang Tao , Tang Zihui
Published: July 2020

Background

The study aimed to explore the factors associated with the mortality of sepsis and to develop prognosis models for predicting outcomes based on real-world data in China. Methods: Data regarding sepsis patients’ medical records were extracted from the hospital information systems in four hospitals. The data included general information, laboratory tests, score systems, and supportive treatment for sepsis. In total, 507 medical records with complete data were available for data analysis. Multiple variable regression (MR) analysis used to explore associations, and to develop prognosis models

Results

The mortality of sepsis was 0.3124 in the total sample. A univariate analysis indicated 23 variables significantly associated with the mortality of sepsis (p <0.05 for all). The MLR analysis showed independent and significant variables of age, GCS, SOFA, shock, breath rate, TBIL, CHE, BUN, LAC, OI, HCO3-, IMV, and ALB (P <0.05 for all). Prognosis models have a high predictive performance (AUC = 0.885, 95% CI: 0.854–0.917 in model2). Conclusion: The study showed evidence of independent and significant factors associated with the mortality of sepsis, including age, GCS, SOFA, septic shock, breath rate, TBIL, CHE, BUN, LAC, OI, HCO3-, IMV, and ALB. Prognosis models with a high performance were developed. (Trial registration: ClinicalTrials.gov Identifier: NCTNCT03883061 retrospectively registered 19 Mar 2019.)
Paired nasopharyngeal and deep lung testing for SARS-CoV2 reveals a viral gradient in critically ill patients: a multi-centre study
Authors: Hamed Islam , Shaban Nesreen , Nassar Marwan , Cayir Dilek , Love Sam , Curran Martin D , Webb Stephen , Yang Huina , Watson Katherine , Rostron Anthony , Navapurkar Vilas , Mahroof Razeen , Morris Andrew Conway
Published: July 2020

Samples for diagnostic tests for SARS-CoV-2 can be obtained from the upper (nasopharyngeal/oropharyngeal swabs) or lower respiratory tract (sputum or tracheal aspirate or broncho-alveolar lavage - BAL). Data from different testing sites indicates different rates of positivity. Reverse-transcriptase polymerase chain reaction (RT-PCR) allows for semi-quantitative estimates of viral load as time to crossing threshold (Ct) is inversely related to viral load.

Objectives

The objective of our study was to evaluate SARS-CoV2 RNA loads between paired nasopharyngeal (NP) and deep lung (endotracheal aspirate or BAL) samples from critically ill patients.

Methods

SARS-CoV-2 RT-PCR results were retrospectively reviewed for 51 critically ill patients from 5 intensive care units in 3 hospitals ; Addenbrookes Hospital Cambridge (3 units), Royal Papworth Cambridge (1 unit), and Royal Sunderland Hospital (1 unit). At the times when paired NP and deep lung samples were obtained, one patient had been on oxygen only, 6 patients on non-invasive ventilation, 18 patients on ECMO, and 26 patients mechanically ventilated.

Results

Results collected showed significant gradient between NP and deep lung viral loads. Median Ct value was 29 for NP samples and 24 for deep lung samples. Of 51 paired samples, 16 were negative (below limit of detection) on NP swabs but positive (above limit of detection) on deep lung sample, whilst 2 were negative on deep sample but positive on NP (both patients were on ECMO).

Conclusions

It has been suggested that whilst SARS-CoV1 tends to replicate in the lower respiratory tract, SARS-CoV2 replicates more vigorously in the upper respiratory tract. These data challenge that assumption. These data suggest that viral migration to, and proliferation in, the lower respiratory tract may be a key factor in the progression to critical illness and the development of severe acute respiratory syndrome (SARS). Factors which promote this migration should be examined for association with severe COVID-19. From a practical point of view, patients with suspected severe COVID-19 should have virological samples obtained from the lower respiratory tract where-ever possible, as upper respiratory samples have a significant negative rate.
Creating and validating a DNA methylation-based proxy for Interleukin-6
Authors: Stevenson Anna J. , Gadd Danni A. , Hillary Robert F. , McCartney Daniel L. , Campbell Archie , Walker Rosie M. , Evans Kathryn L. , Harris Sarah E. , Spires-Jones Tara L , MacRae Allan F. , Visscher Peter M. , McIntosh Andrew M , Deary Ian J , Marioni Riccardo E
Published: July 2020

Chronic inflammation is a pervasive feature of ageing and may be linked to age-related cognitive decline. However, population studies evaluating its relationship with cognitive functioning have produced heterogeneous results. A potential reason for this is the variability of inflammatory mediators which could lead to misclassifications of individuals’ persisting levels of inflammation. The epigenetic mechanism DNA methylation has shown utility in indexing environmental exposures and could potentially be leveraged to provide proxy signatures of chronic inflammation.

We conducted an elastic net regression of interleukin-6 (IL-6) in a cohort of 895 older adults (mean age: 69 years) to develop a DNA methylation-based predictor. The predictor was tested in an independent cohort (n=7,028 [417 with measured IL-6], mean age: 51 years).We examined the association between the DNA methylation IL-6 score and serum IL-6, its association with age and established correlates of circulating IL-6, and with cognitive ability.

A weighted score from 12 DNA methylation sites optimally predicted IL-6 (independent test set R2=5.1%). In the independent test cohort, both measured IL-6, and the DNA methylation proxy, increased as a function of age (serum IL-6: n=417, β=0.02, SE=0.004 p=1.3×10−7; DNAm IL-6 score: n=7,028, β=0.02, SE=0.0009, p<2 × 10−16). Serum IL-6 was not found to associate with cognitive ability (n=417, β=-0.06, SE=0.05, p=0.19); however, an inverse association was identified between the DNA methylation score and cognitive functioning (n=7,028, β=-0.14, SE=0.02, pFDR=1.5 × 10−14).

These results suggest DNA methylation-based predictors can be used as proxies for inflammatory markers, potentially allowing for reliable insights into the relationship between chronic inflammation and pertinent health outcomes.
The Neurological Symptoms of ‘Long’ COVID-19: A Comparison with other Neurological Conditions and Implications for Healthcare Services
Authors: Wildwing T , Holt N
Published: July 2020

Objective

In response to the rapid spread of COVID-19, this paper provides health professionals with better accessibility to available evidence, summarising findings from a systematic overview of systematic reviews of the neurological symptoms seen in patients with COVID-19. Implications of so-called ‘Long Covid’ on neurological services and primary care and similarities with other neurological disorders are discussed.

Methods

Firstly, a systematic overview of current reviews of neurological symptoms of COVID-19 was conducted. Secondly the implications of these findings are discussed in relation to the potential effect on neurological services and the similarities in the experience of patients with COVID-19 and those with other neurological disorders.

Results

Twenty-nine systematic reviews were identified within seven databases, published between 11thApril 2020 and 27thAugust 2020. The results indicated (so far), that COVID-19 exhibits two types of neurological symptoms; life threatening symptoms such as Guillain Barre Syndrome and encephalitis, and less devastating symptoms such as fatigue and myalgia. These so-called lesser symptoms appear to be emerging as longer-term for some sufferers and have been recently labelled Long Covid. When compared, these Long Covid symptoms are very similar to other neurological conditions such as Chronic Fatigue Syndrome (CFS) and Functional Neurological Disorder (FND).

Conclusions

Implications for neurological healthcare services in the UK may include longer waiting times and a need for more resources (including more qualified health professionals). There is also a possible change-effect on health professionals’ perceptions of other neurological conditions such as CFS and FND. Future research is recommended to explore changes in health professionals’ perceptions of neurological symptoms because of COVID-19.
An Analysis of Outbreak Dynamics and Intervention Effects for COVID-19 Transmission in Europe
Authors: Wang Wei
Published: July 2020

As of March 13, 2020, Europe became the center of COVID-19 pandemic. In order to prevent further spread and slow down the increase in confirmed cases and deaths, many countries in European Union have taken some interventions since mid-March. In this study, a metapopulation model was used to model the outbreak of COVID-19 in Europe and the effectiveness of these interventions were also estimated. The findings suggested that many countries successfully kept the reproduction number Rt less than 1 (e.g., Belgium, Germany, Spain, and France) while other countries exhibited Rt greater than 1 (e.g., United Kingdom, Cyprus). Based on the assumed reopen strategy, this study also revealed that a 2-week delay in response predicted approximately 2,000 deaths and 200,000 cases (daily peak value), while a 3-week delay predicted approximately 5,000 deaths and 600,000 cases (daily peak value). Therefore, a quick response upon signs of a re-emerging pandemic in the world is highly imperative to mitigate potential loss of life and to keep transmission of Covid-19 under control.
Stringent thresholds for SARS-CoV-2 IgG assays result in under-detection of cases reporting loss of taste/smell
Authors: Eyre David W , Lumley Sheila F , O’Donnell Denise , Stoesser Nicole E , Matthews Philippa C , Howarth Alison , Hatch Stephanie B , Marsden Brian D , Cox Stuart , James Tim , Cornall Richard J , Stuart David I , Screaton Gavin , Ebner Daniel , Crook Derrick W , Conlon Christopher P , Jeffery Katie , Walker Timothy M , Peto Timothy EA
Published: July 2020

Thresholds for SARS-CoV-2 antibody assays have typically been determined using samples from symptomatic, often hospitalised, patients. Assay performance following mild/asymptomatic infection is unclear. We assessed IgG responses in asymptomatic healthcare workers with a high pre-test probability of Covid-19, e.g. 807/9292(8.9%) reported loss of smell/taste. The proportion reporting anosmia/ageusia increased at antibody titres below diagnostic thresholds for both an in-house ELISA and the Abbott Architect chemiluminescent microparticle immunoassay (CMIA): 424/903(47%) reported anosmia/ageusia with a positive ELISA, 59/387(13.2%) with high-negative titres, and 324/7943(4.1%) with low-negative results. Adjusting for the proportion of staff reporting anosmia/ageusia suggests the sensitivity of both assays is lower than previously reported: Oxford ELISA 90.8% (95%CI 86.1-92.1%) and Abbott CMIA 80.9% (77.5-84.3%). However, the sensitivity may be lower if some anosmia/ageusia in those with low-negative titres is Covid-19-associated. Samples from individuals with mild/asymptomatic infection should be included in SARS-CoV-2 immunoassay evaluations. Reporting equivocal SARS-CoV-2 antibody results should be considered.
The Global Health Security Index is not predictive of coronavirus pandemic responses among Organization for Economic Cooperation and Development countries
Authors: Abbey E.J. , Khalifa B.A.A. , Oduwole M.O. , Ayeh S.K. , Nudotor R.D , Salia E.L. , Lasisi O. , Bennett S. , Yusuf H.E. , Agwu A.L. , Karakousis P.C.
Published: July 2020

The ongoing COVID-19 pandemic has devastated many countries with ripple effects felt in various sectors of the global economy. In November 2019, the Global Health Security (GHS) Index was released as the first detailed assessment and benchmarking of 195 countries to prevent, detect, and respond to infectious disease threats. This paper presents the first comparison of Organization for Economic Cooperation and Development OECD countries’ performance during the pandemic, with the pre-COVID-19 pandemic preparedness as determined by the GHS Index. Using a rank-based analysis, four indices were compared between select countries, including total cases, total deaths, recovery rate, and total tests performed, all standardized for comparison. Our findings suggest a discrepancy between the GHS index rating and the actual performance of countries during this pandemic, with an overestimation of the preparedness of some countries scoring highly on the GHS index and underestimation of the preparedness of other countries with relatively lower scores on the GHS index.
Impact of Restrictions on Parental Presence in Neonatal Intensive Care Units Related to COVID-19
Authors: Darcy-Mahoney Ashley , White Robert D. , Velasquez Annalyn , Barrett Tyson S. , Clark Reese H. , Ahmad Kaashif A.
Published: July 2020

Objectives

To determine the relationship between the emergence of COVID-19 and neonatal intensive care unit (NICU) family presence as well as how NICU design affects these changes.

Study Design

A cross-sectional survey from April 21 to 30, 2020. We queried sites regarding NICU demographics, NICU restrictions on parental presence, and changes in ancillary staff availability.

Results

Globally, 277 facilities responded to the survey. NICU policies preserving 24/7 parental presence decreased (83% to 53%, p<0.001) and of preserving full parental participation in rounds fell (71% to 32%, p<0.001). Single family room design NICUs best preserved 24/7 parental presence after the emergence of COVID-19 (single family room 65%, hybrid-design 57%, open bay design 45%, p=.018). In all, 120 (43%) NICUs reported reductions in therapy services, lactation medicine, and/or social work support.

Conclusions

Hospital restrictions have significantly limited parental presence for NICU admitted infants, although single family room design may attenuate this effect.
Air pollution, sociodemographic and health conditions effects on COVID-19 mortality in Colombia: an ecological study
Authors: Rodriguez-Villamizar Laura A. , Belalcazar-Ceron Luis Carlos , Fernández-Niño Julián Alfredo , Marín-Pineda Diana Marcela , Rojas-Sánchez Oscar Alberto , Acuña-Merchán Lizbeth Alexandra , Ramirez-Garcia Nathaly , Mangones-Matos Sonia Cecilia , Vargas-Gonzalez Jorge Mario , Herrera-Torres Julián , Agudelo-Castañeda Dayana Milena , Piñeros Jiménez Juan Gabriel , Rojas-Roa Néstor Y. , Herrera-Galindo Victor Mauricio
Published: July 2020

Objective

To determine the association between chronic exposure to fine particulate matter (PM2.5), sociodemographic aspects, and health conditions and COVID-19 mortality in Colombia.

Methods

Ecological study using data at the municipality level, as units of analysis. COVID-19 data were obtained from official reports up to and including July 17th, 2020. PM2.5 long-term exposure was defined as the 2014-2018 average of the estimated concentrations at municipalities obtained from the Copernicus Atmospheric Monitoring Service Reanalysis (CAMSRA) model. We fit a logit-negative binomial hurdle model for the mortality rate adjusting for sociodemographic and health conditions.

Results

Estimated mortality rate ratios (MRR) for long-term average PM2.5 were not statistically significant in either of the two components of the hurdle model (i.e., the likelihood of reporting at least one death or the count of fatal cases). We found that having 10% or more of the population over 65 years of age (MRR=3.91 95%CI 2.24-6.81), the poverty index (MRR=1.03 95%CI 1.01-1.05), and the prevalence of hypertension over 6% (MRR=1.32 95%CI1.03-1.68) are the main factors associated with death rate at the municipality level. Having a higher hospital beds capacity is inversely correlated to mortality.

Conclusions

There was no evidence of an association between long-term exposure to PM2.5 and mortality rate at the municipality level in Colombia. Demographics, health system capacity, and social conditions did have evidence of an ecological effect on COVID-19 mortality.
Weak association of coinfection by SARS-CoV-2 and other respiratory viruses with severe cases and death
Authors: Fernandes-Matano L , Monroy-Muñoz IE , Uribe-Noguez LA , Hernández-Cueto MA , Sarquiz-Martínez B , Pardavé-Alejandre HD , Santos Coy-Arechavaleta A , Alvarado-Yaah JE , Rojas-Mendoza T , Santacruz-Tinoco CE , Grajales-Muñiz C , Borja-Aburto VH , Muñoz-Medina JE
Published: July 2020

Background

SARS-CoV-2 is a novel coronavirus described for the first time in China in December 2019. This virus can cause a disease that ranges in spectrum from asymptomatic to severe respiratory disease with multiorgan failure, and the most severe cases are associated with some comorbidities and patient age. However, there are patients who do not have those risk factors who still develop serious disease.

Methods

In this study, we identified the presence of other respiratory viruses in positive cases of COVID-19 in Mexico to determine if any coinfections were correlated with more severe manifestations of COVID-19. We analysed 103 confirmed cases of COVID-19 using RT-qPCR for the detection of 16 other respiratory viruses.

Results

Of the cases analysed, 14 (13.6%) were cases of coinfection, and 92% of them never required hospitalization, even when comorbidities and advanced age were involved. There weren’t significant differences between the presence of comorbidities and the mean ages of the groups

Conclusions

These results suggest that coinfection is not related to more severe COVID-19 and that, depending on the virus involved, it could even lead to a better prognosis. We believe that our findings may lay the groundwork for new studies aimed at determining the biological mechanism by which this phenomenon occurs and for proposing corresponding strategies to limit the progression to severe cases of COVID-19.

CLINICAL TRIAL REGISTRATION

Not apply
One in seven pathogenic variants can be challenging to detect by NGS: An analysis of 450,000 patients with implications for clinical sensitivity and genetic test implementation
Authors: Lincoln Stephen E. , Hambuch Tina , Zook Justin M. , Bristow Sara L. , Hatchell Kathryn , Truty Rebecca , Kennemer Michael , Shirts Brian H. , Fellowes Andrew , Chowdhury Shimul , Klee Eric W. , Mahamdallie Shazia , Cleveland Megan H. , Vallone Peter M. , Ding Yan , Seal Sheila , DeSilva Wasanthi , Tomson Farol L. , Huang Catherine , Garlick Russell K. , Rahman Nazneen , Salit Marc , Kingsmore Stephen F. , Ferber Matthew J. , Aradhya Swaroop , Nussbaum Robert L.
Published: July 2020

Purpose

To evaluate the impact of technically challenging variants on the implementation, validation, and diagnostic yield of commonly used clinical genetic tests. Such variants include large indels, small CNVs, complex alterations, and variants in low-complexity or segmentally duplicated regions.

Methods

An interlaboratory pilot study used novel synthetic specimens to assess detection of challenging variant types by various NGS-based workflows. One well-performing workflow was further validated and used in clinician-ordered testing of more than 450,000 patients.

Results

In the interlaboratory study, only two of 13 challenging variants were detected by all 10 workflows, and just three workflows detected all 13. Limitations were also observed among 11 less-challenging indels. In clinical testing, 21.6% of patients carried one or more pathogenic variants, of which 13.8% (17,561) were classified as technically challenging. These variants were of diverse types, affecting 556 of 1,217 genes across hereditary cancer, cardiovascular, neurological, pediatric, reproductive carrier screening, and other indicated tests.

Conclusion

The analytic and clinical sensitivity of NGS workflows can vary considerably, particularly for prevalent, technically challenging variants. This can have important implications for the design and validation of tests (by laboratories) and the selection of tests (by clinicians) for a wide range of clinical indications.
Dynamic Analysis on Simultaneous iEEG-MEG Data via Hidden Markov Model
Authors: Zhang Siqi , Cao Chunyan , Quinn Andrew , Vivekananda Umesh , Zhan Shikun , Liu Wei , Sun Bomin , Woolrich Mark , Lu Qing , Litvak Vladimir
Published: July 2020

Background

Intracranial electroencephalography (iEEG) recordings are used for clinical evaluation prior to surgical resection of the focus of epileptic seizures and also provide a window into normal brain function. While these recordings afford detailed information about local brain activity, putting this activity in context and comparing results across patients is challenging. Non-invasive whole-brain Magnetoencephalography (MEG) could help translate iEEG in the context of overall brain activity, and thereby aid group analysis and interpretation.

Methods

Simultaneous MEG-iEEG recordings were performed at rest on 11 patients with epilepsy. Pre-processed MEG sensor data was projected to source space. The time delay embedded hidden Markov model (HMM) technique was applied to find recurrent sub-second patterns of network activity in a completely data-driven way. To relate MEG and iEEG results, correlations were computed between HMM state time courses and iEEG power envelopes in equally spaced frequency bins and presented as correlation spectra for the respective states and iEEG channels.

Results

Five HMM states were inferred from MEG. Two of them corresponded to the left and right temporal activations and had a spectral signature primarily in the theta/alpha frequency band. The majority of iEEG contacts were also located in left and right temporal areas and the theta/alpha power of the local field potentials (LFP) recorded from these contacts correlated with the time course of the HMM state corresponding to the temporal lobe of the respective hemisphere.

Discussion

Our findings are consistent with the fact that most subjects were diagnosed with temporal epilepsy and implanted with temporal electrodes. As the placement of electrodes between patients was inconsistent, their modulation by HMM states could help group the contacts into functional clusters. This is the first time that HMM was applied to simultaneously recorded iEEG-MEG and our pipeline could be used in future similar studies.
SARS-CoV-2 antibodies, serum inflammatory biomarkers and clinical severity of hospitalized COVID-19 Patients
Authors: Gozalbo-Rovira Roberto , Gimenez Estela , Latorre Víctor , Francés-Gómez Clara , Albert Eliseo , Buesa Javier , Marina Alberto , Blasco María Luisa , Signes-Costa Jaime , Rodríguez-Díaz Jesús , Geller Ron , Navarro David
Published: July 2020

Background

The involvement of SARS-CoV-2 antibodies in mediating immunopathogenetic events in COVID-19 patients has been suggested. By using several experimental approaches, we investigated the potential association between SARS-CoV-2 IgGs recognizing the spike (S) protein receptor-binding domain (RBD), neutralizing antibodies (NtAb) targeting S, and COVID-19 severity.

Patients and Methods

This unicenter, retrospective, observational study included 51 hospitalized patients (24 at the intensive care unit; ICU). A total of 93 sera from these patients collected at different time points from the onset of symptoms were analyzed. SARS-CoV-2 RBD IgGs were quantitated by ELISA and NtAb50titers were measured in a GFP reporter-based pseudotyped virus platform. Demographic and clinical data, complete blood counts, as well as serum levels of ferritin, Dimer-D, C reactive protein (CRP), lactose dehydrogenase (LDH), and interleukin-6 (IL-6) were retrieved from clinical charts.

Results

The overall correlation between levels of both antibody measurements was good (Rho=0.79;P=0<0.001). SARS-CoV-2 RBD IgG and NtAb50levels in sera collected up to day 30 after the onset of symptoms were comparable between ICU and non-ICU patients (P=>0.1). The percentage of patients who exhibited high NtAb50titers (≥ 160) was similar (P=0.20) in ICU (79%) and non-ICU (60%) patients. Four ICU patients died; two of these achieved NtAb50titers ≥ 1/160 while the other two exhibited a 1/80 titer. Very weak (Rho=>0.0-<0.2) or weak (Rho=>0.2-<0.4) correlations were observed between anti-RBD IgGs, NtAb50,and serum levels pro-inflammatory biomarkers.

Conclusions

The data presented herein do not support an association between SARS-CoV-2 RBD IgG or NtAb50levels and COVID-19 severity.
THE RELATIONSHIP OF THE FOOT AND ANKLE STRUCTURE WITH OVERUSE INJURIES IN LICENSED FOOTBALLERS, A PROSPECTIVE COHORT
Authors: Sahillioglu Ali , Cerrahoglu Lale
Published: July 2020

The main purpose of this study was to compare the values determined in the clinical examination of the foot and ankle and the plantar pressure measurements of the foot in athletes who developed an overuse-type disability and in athletes who did not develop overuse-type disability, and was to find factors that might predispose to disability, during the one-year follow-up. 100 licensed football players were included in the study. Presence of joint hypermobility, foot posture assessment, ankle and first metatarsophalangeal (MTP) joint range of motion (ROM) measurements, pedobarographic plantar pressure assessment of foot was carried out. Then, the footballers were followed for 12 months for the development of new foot and ankle overuse injuries and the clinical and pedobarographic data of the footballers with at least one injury were compared with the group without injury. We found asymmetric pressure distribution between the preferred and non-preferred foot in the group who had an injury in the pedobarographic static foot plantar pressure measurements(p = .040). When we compared the ROM values of footballers who had an injury and footballers who did not have an injury, we found a significant limitation in the group that suffered an injury, in the ankle eversion, first MTP joint dorsiflexion and ankle plantarflexion degrees(p = .029, p = .023, p=.044, respectively). These findings suggest that impairments in foot plantar pressure distribution and limitations in ankle and foot joint ROM may be risk factors for the development of foot and ankle overuse injury.
Enhancing MR imaging driven Alzheimer’s disease classification performance using generative adversarial learning
Authors: Zhou Xiao , Qiu Shangran , Joshi Prajakta S. , Xue Chonghua , Killiany Ronald J. , Mian Asim , Chin Sang P. , Au Rhoda , Kolachalama Vijaya B. ,   for the Alzheimer’s Disease Neuroimaging Initiative
Published: July 2020

Background

Generative adversarial networks (GAN) can generate images of improved quality but their ability to augment image-based classification tasks is not fully explored.

Purpose

We evaluated if a modified GAN can learn from MRI scans of multiple magnetic field strength to enhance Alzheimer’s disease (AD) classification performance.

Materials and methods

T1-weighted brain MRI scans from 151 participants of the Alzheimer’s Disease Neuroimaging Initiative (ADNI), who underwent both 1.5 Tesla (1.5T) and 3 Tesla imaging at the same time were selected to construct a GAN model. This model was trained along with a three-dimensional fully convolutional network (FCN) using the generated images (1.5T*) as inputs to predict AD status. Quality of the generated images was evaluated using signal to noise ratio (SNR), Blind/Referenceless Image Spatial Quality Evaluator (BRISQUE) and Natural Image Quality Evaluator (NIQE). Data from the Australian Imaging, Biomarker & Lifestyle Flagship Study of Ageing (AIBL, n=107), and the National Alzheimer’s Coordinating Center (NACC, n=565) was used for model validation.

Results

The mean quality of the generated (1.5T*) images was consistently higher than the 1.5T images, as measured using SNR, BRISQUE and NIQE on the validation datasets. The 1.5T*-based FCN classifier performed better than the FCN model trained using the 1.5T scans.

Specifically, the mean area under curve increased from 0.907 to 0.932, from 0.934 to 0.940 and from 0.870 to 0.907 on the ADNI test, AIBL and NACC datasets, respectively.

Conclusion

This study demonstrates that GAN frameworks can be constructed to simultaneously improve image quality and augment classification performance.

Key points

Our proposed generative adversarial network used 1.5 and 3 Tesla MR scans of the brain to generate images of improved quality, as estimated using no-reference image quality algorithms.

Classification models of Alzheimer’s disease risk developed using the generated images had higher classification performance than the models developed using the original 1.5 Tesla scans.
D614G Spike Mutation Increases SARS CoV-2 Susceptibility to Neutralization
Authors: Weissman Drew , Alameh Mohamad-Gabriel , de Silva Thushan , Collini Paul , Hornsby Hailey , Brown Rebecca , LaBranche Celia C. , Edwards Robert J , Sutherland Laura , Santra Sampa , Mansouri Katayoun , Gobeil Sophie , McDanal Charlene , Pardi Norbert , Hengartner Nick , Lin Paulo J.C. , Tam Ying , Shaw Pamela A. , Lewis Mark G. , Boesler Carsten , Şahin Uğur , Acharya Priyamvada , Haynes Barton F. , Korber Bette , Montefiori David C.
Published: July 2020

The SARS-CoV-2 Spike protein acquired a D614G mutation early in the COVID-19 pandemic that appears to confer on the virus greater infectivity and is now the globally dominant form of the virus. Certain of the current vaccines entering phase 3 trials are based on the original D614 form of Spike with the goal of eliciting protective neutralizing antibodies. To determine whether D614G mediates neutralization-escape that could compromise vaccine efficacy, sera from Spike-immunized mice, nonhuman primates and humans were evaluated for neutralization of pseudoviruses bearing either D614 or G614 Spike on their surface. In all cases, the G614 pseudovirus was moderately more susceptible to neutralization. The G614 pseudovirus also was more susceptible to neutralization by monoclonal antibodies against the receptor binding domain and by convalescent sera from people known to be infected with either the D614 or G614 form of the virus. These results indicate that a gain in infectivity provided by D614G came at the cost of making the virus more vulnerable to neutralizing antibodies, and that the mutation is not expected to be an obstacle for current vaccine development.
Evidence for immunity to SARS-CoV-2 from epidemiological data series
Authors: Yubero Pablo , Lavin Alvar A. , Poyatos Juan F.
Published: July 2020

The duration of immunity to SARS-CoV-2 is uncertain. Delineating immune memory typically requires longitudinal serological studies that track antibody prevalence in the same cohort for an extended time. However, this information is needed in faster timescales. Notably, the dynamics of an epidemic where recovered patients become immune for any period should differ significantly from those of one where the recovered promptly become susceptible. Here, we exploit this difference to provide a reliable protocol that can estimate immunity early in an epidemic. We verify this protocol with synthetic data, discuss its limitations, and then apply it to evaluate human immunity to SARS-CoV-2 in mortality data series from New York City. Our results indicate that New York’s mortality figures are incompatible with immunity lasting anything below 105 or above 211 days (90% CI.), and set an example on how to assess immune memory in emerging pandemics before serological studies can be deployed.
Homebound by COVID19: The Benefits and Consequences of Non-Pharmaceutical Intervention Strategies
Authors: Oruc Buse Eylul , Baxter Arden , Keskinocak Pinar , Asplund John , Serban Nicoleta
Published: July 2020

Objectives

To evaluate the tradeoffs between potential benefits (e.g., reduction in infection spread and deaths) of non-pharmaceutical interventions for COVID19 and being homebound (i.e., refraining from community/workplace interactions).

Methods

An agent-based simulation model to project the disease spread and estimate the number of homebound people and person-days under multiple scenarios, including combinations of shelter-in- place, voluntary quarantine, and school closure in Georgia from March 1 to September 1, 2020.

Results

Compared to no intervention, under voluntary quarantine, voluntary quarantine with school closure, and shelter-in-place with school closure scenarios 3.43, 19.8, and 200+ homebound adult-days were required to prevent one infection, with the maximum number of adults homebound on a given day in the range of 121K-268K, 522K-567K, 5,377K-5,380K, respectively.

Conclusions

Voluntary quarantine combined with school closure significantly reduced the number of infections and deaths with a considerably smaller number of homebound person-days compared to shelter-in-place.

Three-question Summary Box

What is the current understanding of this subject?

Recent research has been conducted by various countries and regions on the impact of non-pharmaceutical interventions (NPIs) on reducing the spread of COVID19.

What does this report add to the literature?

Our report assessed which intervention strategies provided the best results in terms of both reducing infection outcomes (cases, deaths, etc.) and minimizing their social and economic effects (e.g., number of people homebound, providing childcare, etc.).

What are the implications for public health practice?

Voluntary quarantine proved to be the most beneficial in terms of reducing infections and deaths compared to the number of people who were homebound.
COVID-19 in-hospital mortality and mode of death in a dynamic and non-restricted tertiary care model in Germany
Authors: Rieg Siegbert , Cube Maja von , Kalbhenn Johannes , Utzolino Stefan , Pernice Katharina , Bechet Lena , Baur Johanna , Lang Corinna N. , Wagner Dirk , Wolkewitz Martin , Kern Winfried V. , Biever Paul
Published: July 2020

Background

Reported mortality of hospitalised COVID-19 patients varies substantially, particularly in critically ill patients. So far COVID-19 in-hospital mortality and modes of death under optimised care conditions have not been systematically studied.

Methods

This retrospective observational monocenter cohort study was performed after implementation of a non-restricted, dynamic tertiary care model at the University Medical Center Freiburg, an experienced ARDS and ECMO referral center. All hospitalised patients with PCR-confirmed SARS-CoV-2 infection were included. The primary endpoint was in-hospital mortality, secondary endpoints included major complications and modes of death. A multistate analysis and a Cox regression analysis for competing risk models were performed. Modes of death were determined by two independent reviewers.

Results

Between February 25, and May 8, 213 patients were included in the analysis. The median age was 65 years, 129 patients (61%) were male. 70 patients (33%) were admitted to the intensive care unit (ICU), of which 57 patients (81%) received mechanical ventilation and 23 patients (33%) extracorporeal membrane-oxygenation (ECMO) support. According to the multistate model the probability to die within 90 days after COVID-19 onset was 24% in the whole cohort. If the levels of care at time of study entry were accounted for, the probabilities to die were 16% if the patient was initially on a regular ward, 47% if in the ICU and 57% if mechanical ventilation was required at study entry. Age ≥65 years and male sex were predictors for in-hospital death. Predominant complications – as judged by two independent reviewers – determining modes of death were multi-organ failure, septic shock and thromboembolic and hemorrhagic complications.

Conclusion

In a dynamic care model COVID-19-related in-hospital mortality remained substantial. In the absence of potent antiviral agents, strategies to alleviate or prevent the identified complications should be investigated. In this context, multistate analyses enable comparison of models-of-care and treatment strategies and allow estimation and allocation of health care resources.

Registration

German Clinical Trials Register (identifier DRKS00021775), retrospectively registered June 10, 2020.
The Optimal Allocation of Covid-19 Vaccines
Authors: Babus Ana , Das Sanmay , Lee SangMok
Published: July 2020

Covid-19 vaccine prioritization is key if the initial supply of the vaccine is limited. A reasonable policy will surely prioritize populations facing high risk of severe illness in high-exposure occupations. The challenge is deciding between high-risk populations in low-exposure occupations and those that are young and healthy but work in high-exposure occupations. We estimate occupation-based infection risks and use age-based infection fatality rates in a model to assign priorities over populations with different occupations and ages. Among others, we find that 50 year-old food-processing workers and 60 year-old financial advisors are equally prioritized. Our model suggests a vaccine distribution that emphasizes age-based mortality risk more than occupation-based exposure risk. Designating some occupations as essential does not affect the optimal vaccine allocation, unless a stay-at-home order is also in effect. Even with vaccines allocated optimally, 1.37% of the employed workforce is still expected to be infected with the virus until the vaccine becomes widely available, provided the vaccine is 50% effective and assuming a supply of 60mil doses.
Decreased incidence, virus transmission capacity, and severity of COVID-19 at altitude on the American continent
Authors: Arias-Reyes Christian , Carvajal-Rodriguez Favio , Poma-Machicao Liliana , Aliaga-Raudan Fernanda , Marques Danuzia A. , DeUrioste Natalia Zubieta , Accinelli Roberto Alfonso , Schneider-Gasser Edith M. , Zubieta-Calleja Gustavo , Dutschmann Mathias , Soliz Jorge
Published: July 2020

The coronavirus disease 2019 (COVID-19) outbreak in North, Central, and South America has become the epicenter of the current pandemic. We have suggested previously that the infection rate of this virus might be lower in people living at high altitude (over 2,500 m) compared to that in the lowlands. Based on data from official sources, we performed a new epidemiological analysis of the development of the pandemic in 23 countries on the American continent as of May 23, 2020. Our results confirm our previous finding, further showing that the incidence of COVID-19 on the American continent decreases significantly starting at 1,000 m above sea level (masl). Moreover, epidemiological modeling indicates that the virus transmission rate capacity is lower in the highlands (>1,000 masl) than in the lowlands (<1,000 masl). Finally, evaluating the differences in the recovery percentage of patients, the death-to-case ratio, and the theoretical fraction of undiagnosed cases, we found that the severity of COVID-19 is also decreased above 1,000 m. We conclude that the impact of the COVID-19 decreases significantly with altitude.

Highlights

There is a negative correlation between altitude and COVID-19 incidence on the American Continent starting from 1,000 m above sea level.

The transmission rate of SARS-CoV-2 is lower in the highlands than in the lowlands.

The severity of COVID-19 decreases significantly with increased altitude.
Neuroanatomic markers of post-traumatic epilepsy based on magnetic resonance imaging and machine learning
Authors: Akrami Haleh , Leahy Richard M. , Irimia Andrei , Kim Paul E. , Heck Christianne N. , Joshi Anand A.
Published: July 2020

Although post-traumatic epilepsy (PTE) is a common complication of traumatic brain injury (TBI), the relationship between these conditions is unclear, early PTE detection and prevention being major unmet clinical challenges. This study aims to identify imaging biomarkers that distinguish PTE and non-PTE subjects among TBI survivors based on a magnetic resonance imaging (MRI) dataset. We performed tensor-based morphometry to analyze brain shape changes associated with TBI and to derive imaging features for statistical group comparison. Additionally, machine learning was used to identify structural anomalies associated with brain lesions. Automatically generated brain lesion maps were used to identify brain regions where lesion load may indicate an increased incidence of PTE. Statistical analysis suggests that lesions in the temporal lobes, cerebellum, and the right occipital lobe are associated with an increased PTE incidence.
Pediatric intensive care unit admissions for COVID-19: insights using state-level data
Authors: Loomba Rohit S. , Villarreal Enrique G. , Farias Juan S. , Bronicki Ronald A. , Flores Saul
Published: July 2020

Introduction

Intensive care has played a pivotal role during the COVID-19 pandemic as many patients developed severe pulmonary complications. The availability of information in pediatric intensive care (PICUs) remains limited. The purpose of this study is to characterize COVID-19 positive admissions (CPAs) in the United States and to determine factors that may impact those admissions.

Materials and Methods

This is a retrospective cohort study using data from the COVID-19 dashboard virtual pediatric system containing information regarding respiratory support and comorbidities for all CPAs between March and April 2020. The state level data contained 13 different factors from population density, comorbid conditions and social distancing score. The absolute CPAs count was converted to frequency using the state’s population. Univariate and multivariate regression analyses were performed to assess the association between CPAs frequency and endpoints.

Results

A total of 205 CPAs were reported by 167 PICUs across 48 states. The estimated CPAs frequency was 2.8 per million children. A total of 3,235 tests were conducted with 6.3% positive tests. Children above 11 years of age comprised 69.7% of the total cohort and 35.1% had moderated or severe comorbidities. The median duration of a CPA was 4.9 days [1.25-12.00 days]. Out of the 1,132 total CPA days, 592 [52.2%] were for mechanical ventilation. The inpatient mortalities were 3 [1.4%]. Multivariate analyses demonstrated an association between CPAs with greater population density [beta-coefficient 0.01, p<0.01] and increased percent of children receiving the influenza vaccination [beta-coefficient 0.17, p=0.01].

Conclusions

Inpatient mortality during PICU CPAs is relatively low at 1.4%. CPA frequency seems to be impacted by population density while characteristics of illness severity appear to be associated with ultraviolet index, temperature, and comorbidities such as Type 1 diabetes. These factors should be included in future studies using patient-level data.