bluuebunny/crossref_metadata_2025 huggingface dataset:
Proposal of Enterococcus xinjiangensis Ren et al. 2020 as a later heterotypic synonym of Enterococcus lactis Morandi et al. 2012
Authors: Li Yu Qin , Gu Chun Tao
Published: February 2021

Enterococcus lactis

was published in the International Journal of Systematic and Evolutionary Microbiology in June 2012.

Enterococcus xinjiangensis

was published in Current Microbiology in 2016 and validated in November 2020. In the present study, the relationship between

E. lactis

and

E. xinjiangensis

was re-evaluated. In the 16S rRNA gene phylogeny,

E. xinjiangensis

was closely related to

E. lactis

and

Enterococcus faecium

. The type strains of

E. xinjiangensis

and

E. lactis

shared 99.8 % 16S rRNA gene sequence similarity, 98.5 % pheS sequence similarity, 99.9 % rpoA sequence similarity, 98.7 % average nucleotide identity (ANI) value and 88.9 % digital DNA–DNA hybridization (dDDH) value, indicating that they represent the same species. Meanwhile, although the type strains of

E. xinjiangensis

and

E. faecium

also shared 99.8 % 16S rRNA gene sequence similarity, 97.1 % pheS sequence similarity and 99.6 % rpoA sequence similarity, 94.7 % ANI and 59.1 % dDDH values indicated that they represent two different species. On the basis of the results present here, we propose

Enterococcus xinjiangensis

Ren et al. 2020 as a later heterotypic synonym of

Enterococcus lactis

Morandi et al. 2012.
Advancing data science in drug development through an innovative computational framework for data sharing and statistical analysis
Authors: Mallon Ann-Marie , Häring Dieter A. , Dahlke Frank , Aarden Piet , Afyouni Soroosh , Delbarre Daniel , El Emam Khaled , Ganjgahi Habib , Gardiner Stephen , Kwok Chun Hei , West Dominique M. , Straiton Ewan , Haemmerle Sibylle , Huffman Adam , Hofmann Tom , Kelly Luke J. , Krusche Peter , Laramee Marie-Claude , Lheritier Karine , Ligozio Greg , Readie Aimee , Santos Luis , Nichols Thomas E. , Branson Janice , Holmes Chris
Published: February 2021

Background

Novartis and the University of Oxford’s Big Data Institute (BDI) have established a research alliance with the aim to improve health care and drug development by making it more efficient and targeted. Using a combination of the latest statistical machine learning technology with an innovative IT platform developed to manage large volumes of anonymised data from numerous data sources and types we plan to identify novel patterns with clinical relevance which cannot be detected by humans alone to identify phenotypes and early predictors of patient disease activity and progression.

Method

The collaboration focuses on highly complex autoimmune diseases and develops a computational framework to assemble a research-ready dataset across numerous modalities. For the Multiple Sclerosis (MS) project, the collaboration has anonymised and integrated phase II to phase IV clinical and imaging trial data from ≈35,000 patients across all clinical phenotypes and collected in more than 2,200 centres worldwide. For the “IL-17” project, the collaboration has anonymised and integrated clinical and imaging data from over 30 phase II and IIICosentyxclinical trials including more than 15,000 patients, suffering from four autoimmune disorders (Psoriasis, Axial Spondyloarthritis, Psoriatic arthritis (PsA) and Rheumatoid arthritis (RA)).

Results

A fundamental component of successful data analysis and the collaborative development of novel machine learning methods on these rich data sets has been the construction of a research informatics framework that can capture the data at regular intervals where images could be anonymised and integrated with the de-identified clinical data, quality controlled and compiled into a research-ready relational database which would then be available to multi-disciplinary analysts. The collaborative development from a group of software developers, data wranglers, statisticians, clinicians, and domain scientists across both organisations has been key. This framework is innovative, as it facilitates collaborative data management and makes a complicated clinical trial data set from a pharmaceutical company available to academic researchers who become associated with the project.

Conclusions

An informatics framework has been developed to capture clinical trial data into a pipeline of anonymisation, quality control, data exploration, and subsequent integration into a database. Establishing this framework has been integral to the development of analytical tools.
Plasma Hydrogen Sulfide Production Capacity is Positively Associated with Post-Operative Survival in Patients Undergoing Surgical Revascularization
Authors: Longchamp Alban , MacArthur Michael R. , Trocha Kaspar , Ganahl Janine , Mann Charlotte G. , Kip Peter , King William W. , Sharma Gaurav , Tao Ming , Mitchell Sarah J. , Ditrói Tamás , Nagy Péter , Ozaki C. Keith , Hine Christopher , Mitchell James R.
Published: February 2021

Objective

Hydrogen sulfide (H2S) is a gaseous signaling molecule and redox factor important for cardiovascular function. Deficiencies in its production or bioavailability are implicated in atherosclerotic disease. However, it is unknown if circulating H2S levels differ between vasculopaths and healthy individuals, and if so, whether H2S measurements can be used to predict surgical outcomes. Here, we examine: 1) Plasma H2S levels in patients undergoing vascular surgery and compare these to healthy controls, and 2) Associations between H2S levels and mortality in surgical revascularization patients.

Approach & Results

Patients undergoing carotid endarterectomy, open lower extremity revascularization or leg amputation were enrolled. Peripheral blood was also collected from a matched cohort of 20 patients without peripheral or coronary artery disease. Plasma H2S production capacity and sulfide concentration were measured using the lead acetate and monobromobimane methods, respectively. Plasma H2S production capacity and plasma sulfide concentrations were reduced in patients with PAD (p<0.001, p=0.013 respectively). Patients that underwent surgical revascularization were divided into high versus low H2S production capacity groups by median split. Patients in the low H2S production group had increased probability of mortality (p=0.003). This association was robust to correction for potentially confounding variables using Cox proportional hazard models.

Conclusions

Circulating H2S levels were lower in patients with atherosclerotic disease. Patients undergoing surgical revascularization with lower H2S production capacity, but not sulfide concentrations, had increased probability of mortality within 36 months post-surgery. This work provides insight on the role H2S plays as a diagnostic and potential therapeutic for cardiovascular disease.

HIGHLIGHTS

Vascular disease patients have higher plasma hydrogen sulfide levels than controls without vascular disease as measured by two distinct methods, the lead acetate hydrogen sulfide release method and the HPLC-based monobromobimane method.

Only the lead acetate hydrogen sulfide release method robustly predicts survival after vascular surgery intervention over 35 months of follow up.

The lead acetate release method measures non-enzymatic hydrogen sulfide release from plasma which requires iron and is catalyzed by vitamin B6.
What is the extent of COVID-19 vaccine hesitancy in Bangladesh? : A cross-sectional rapid national survey
Authors: Ali Mohammad , Hossain Ahmed
Published: February 2021

objectives

To assess COVID-19 vaccine hesitancy in Bangladesh and identify population subgroups with higher odds of vaccine hesitancy.

design

A nationally representative cross-sectional survey was used. Univariate analysis was employed to compute vaccine hesitancy proportions and compare them across groups and multiple logistic regression analyses were performed to compute the adjusted odds ratio.

setting

Bangladesh

participants

A total of 1134 participants from the general population, aged 18 years and above.

outcome measures

Prevalence and predictors of vaccine hesitancy.

results

32.5% of participants showed COVID-19 vaccine hesitancy. Hesitancy was high among respondents who were males, over age 60, unemployed, from low-income families, from central Bangladesh including Dhaka, living in rented houses, tobacco users, politically affiliated, participants who did not believe in the vaccine’s effectiveness for Bangladeshis and those who did not have any physical illnesses in the last year. In the multilevel logistic regression models, respondents who were transgender (AOR= 3.62), married (AOR=1.49), tobacco users (AOR=1.33), those who did not get any physical illnesses in the last year (AOR=1.49), those with political affiliations with opposition parties (AOR= 1.48), those who believed COVID-19 vaccines will not be effective for Bangladeshis (AOR= 3.20), and those who were slightly concerned (AOR = 2.87) or not concerned at all (AOR = 7.45) about themselves or a family member getting infected with COVID-19 in the next one year were significantly associated with vaccine hesitancy (p < 0.05).

conclusions

Given the high prevalence of COVID-19 vaccine hesitancy, it is important to promote evidence-based communication, mass media campaigns, and policy initiatives across Bangladesh to reduce vaccine hesitancy among the Bangladeshi population.

Strengths and Limitations of the study

This study is the first its kind to measure COVID-19 vaccine hesitancy in Bangladesh.

In this study, randomly selected participants were interviewed face to face, enabling a nearly true representative sample of the Bangladeshi general population.

This study identified a wide range of sub-groups of the general population with higher odds of COVID-19 vaccine hesitancy relating to their sociodemographic characteristics in Bangladesh; thus, providing baseline evidence for the low and middle-income and low-resourced countries worldwide.

Traditional media and social media influence on COVID-19 vaccine hesitancy was not measured which is a major limitation of this study.
Multicenter cohort study of children hospitalized with SARS-CoV-2 infection
Authors: Barton Michelle , Papenburg Jesse , Ulloa-Gutierrez Rolando , Brenes-Chacon Helena , Yock-Corrales Adriana , Ivankovich-Escoto Gabriela , Soriano-Fallas Alejandra , Mezerville Marcela Hernandez-de , Bitnun Ari , Morris Shaun K. , Tal Tala El , Yeh E. Ann , Gill Peter , Laxer Ronald M. , Nateghian Alireza , Aski Behzad Haghighi , Manafif Ali , Lefebvre Marie-Astrid , Caya Chelsea , Cooke Suzette , Dewan Tammie , Restivo Lea , Viel-Thériault Isabelle , Trajtman Adriana , Dwilow Rachel , Bullard Jared , Sadarangani Manish , Roberts Ashley , Saux Nicole Le , Bowes Jennifer , Wong Jacqueline K. , Purewal Rupeena , Lautermilch Janell , Leifso Kirk , Foo Cheryl , Newhook Leigh Anne , Bayliss Ann , Petel Dara , Robinson Joan
Published: February 2021

Background

A cohort study was conducted to describe and compare the characteristics of SARS-CoV-2 infection in hospitalized children in three countries.

Methods

This was a retrospective cohort of consecutive children admitted to 15 hospitals (13 in Canada and one each in Iran and Costa Rica) up to November 16, 2020. Cases were included if they had SARS-CoV-2 infection or multi-system inflammatory syndrome in children (MIS-C) with molecular detection of SARS-CoV-2 or positive SARS-CoV-2 serology.

Results

Of 211 included cases (Canada N=95; Costa Rica N=84; Iran N=32), 103 (49%) had a presumptive diagnosis of COVID-19 or MIS-C at admission while 108 (51%) were admitted with other diagnoses. Twenty-one (10%) of 211 met criteria for MIS-C. Eighty-seven (41%) had comorbidities. Children admitted in Canada were older than those admitted to non-Canadian sites (median 4.1 versus 2.2 years; p<0.001) and less likely to require mechanical ventilation (3/95 [3%] versus 15/116 [13%]; p<0.05). Sixty-four of 211 (30%) required supplemental oxygen or intensive care unit (ICU) admission and 4 (1.9%) died. Age < 30 days, admission outside Canada, presence of at least one comorbidity and chest imaging compatible with COVID-19 predicted severe or critical COVID-19 (defined as death or need for supplemental oxygen or ICU admission).

Conclusions

Approximately half of hospitalized children with confirmed SARS-CoV-2 infection or MIS-C were admitted with other suspected diagnoses. Disease severity was higher at non-Canadian sites. Neonates, children with comorbidities and those with chest radiographs compatible with COVID-19 were at increased risk for severe or critical COVID-19.

Main points

Approximately half of hospitalized children with laboratory confirmed MIS-C or SARS-CoV-2 infection were admitted with another primary diagnoses. The severity of disease was higher in the middle income countries (Costa Rica and Iran) than in Canada.
Disorganization of language and working memory systems in frontal versus temporal lobe epilepsy
Authors: Caciagli Lorenzo , Paquola Casey , He Xiaosong , Vollmar Christian , Centeno Maria , Wandschneider Britta , Braun Urs , Trimmel Karin , Vos Sjoerd B. , Sidhu Meneka K. , Thompson Pamela J. , Baxendale Sallie , Winston Gavin P. , Duncan John S. , Bassett Danielle S. , Koepp Matthias J. , Bernhardt Boris C.
Published: February 2021

Cognitive impairment is a common comorbidity of epilepsy, and adversely impacts people with both frontal lobe epilepsy (FLE) and temporal lobe epilepsy (TLE). While the underlying neural substrates in TLE have been extensively investigated, functional imaging studies in FLE are scarce. In this study, we profiled cognitive dysfunction in FLE, and directly compared FLE and TLE patients to establish commonalities and differences. We investigated 172 adult participants (56 with FLE, 64 with TLE, and 52 controls), using neuropsychological tests and four functional MRI tasks probing the neural correlates of expressive language (verbal fluency, verb generation) and working memory (verbal and visuo-spatial). Patient groups were comparable in disease duration and anti-epileptic drug load. We devised a multiscale approach to map the landscape of brain activation and deactivation during cognition, and track reorganization in FLE and TLE. Voxel-based analyses were complemented with profiling of task effects (i) across intrinsic functional systems, and (ii) along the principal functional connectivity gradient, which encodes a continuous transition from lower-level sensory to higher-order transmodal brain areas. We show that cognitive impairment in FLE is associated with reduced activation across attentional and executive systems, and reduced deactivation of the default mode system, indicative of a large-scale disorganization of task-related recruitment. Functional abnormalities in FLE were modulated by disease load. Patterns of dysfunction in FLE were broadly similar to those in TLE, but some traits were syndrome-specific: altered default-mode deactivation was more prominent in FLE, while impaired recruitment of posterior language areas during a task with semantic demands was more marked in TLE. Our study elucidates neural processes underlying language and working memory impairment in FLE, identifies shared and syndrome-specific alterations in the two most common focal epilepsies, and sheds light on system behavior that may be amenable to future remediation strategies.
A Prospective Clinical Evaluation of a Patient Isolation Hood During the COVID-19 Pandemic
Authors: McGain Forbes , Bates Samantha , Lee Jung Hoon , Timms Patrick , Kainer Marion A , French Craig , Monty Jason
Published: February 2021

Background

Healthcare workers have frequently become infected with SARS-CoV-2 whilst treating patients with COVID-19. A variety of novel devices have been proposed to reduce COVID-19 cross contamination.

Objective

To test whether a novel patient isolation hood was safe and comfortable, and could potentially reduce HCW COVID-19 infections.

Methods

Prospective cohort study of 20 patients, entailing staff/patient questionnaires, and safety aspects of prototype isolation hoods.Prospective collection of HCW COVID-19 data.Assessment of the hood’s safety and practicality, and adverse event reporting.

Outcome Measures

Questionnaires’ responses, adverse events reporting, rates of HCW infections during study period (20/6/2020 −21/7/2020).HCW COVID-19 infections reported until last recorded HCW COVID-19 diagnosis (20/6/2020 −27/9/2020).

Results

Of the 60 (of 64) eligible individual staff surveys, 60 favoured isolation hood use.Staff were unanimous in: perceiving the hood as safe (60/60), preferring its use (56/56), and understanding its potential COVID-19 cross-contamination minimisation (60/60). All eight patients who completed the questionnaire thought the isolation hood helped prevent COVID-19 cross-infection, was safe, and comfortable. There were no reported patient safety adverse events. The overall attack COVID-19 attack rate from 20/6/2020-27/9/2020 among registered nurses was 3.4% (102/2994): ICUs 2.2% (3/138), Geriatric wards 13.2% (26/197), and COVID-19 Wards 18.3% (32/175). The COVID-19 attack rate among medical staff was: all junior medical staff 2.1% (24/932), senior medical staff 0.7% (4/607), aged care/rehabilitation 6.7% (2/30), and ICU all medical staff 8.6% (3/35).

Conclusions

The isolation hood was strongly endorsed by staff and patients, and post-study became part of standard ICU therapy. ICU nurse COVID-19 infection rates were low. ICU HCWs feel safer when treating patients with COVID-19 using an isolation hood.
Quantitative fluorescence in situ hybridization (FISH) of magnetically confined bacteria enables rapid determination of early-stage human bacteremia
Authors: Lee Min Seok , Hyun Hwi , Park Inwon , Kim Sungho , Jang Dong-Hyun , Kim Seonghye , Im Jae-Kyeong , Kim Hajin , Lee Jae Hyuk , Kwon Taejoon , Kang Joo H.
Published: February 2021

The current diagnosis of bacteremia mainly uses blood culture, which is insufficient to offer rapid and quantitative determination of pathogens in blood. Here, we report a quantitative and sequential multiplexed fluorescence in situ hybridization in a microfluidic device (µFISH) that enables early and rapid (2-hour) diagnosis of bacteremia without prior blood culture. Mannose-binding lectin-coated magnetic nanoparticles enrich a broad range of pathogens, and µFISH enables identification and quantification of the magnetically confined bacteria. We detect Escherichia coli (E. coli) and measure their relative proportions to universal bacteria levels in the bacteremic blood of a porcine model and human whole blood collected from E. coli-infected patients, which was elusive with the conventional bacteremia diagnosis methods. Thus, µFISH can be used as a versatile tool to rapidly identify pathogens and further assess the number of both culturable and non-culturable bacteria in biological and environmental samples.
Long-term air pollution and other risk factors associated with COVID-19 at the census-tract-level in Colorado
Authors: Berg Kevin , Present Paul Romer , Richardson Kristy
Published: February 2021

An effective response to the COVID-19 pandemic requires identification of the factors that affect the severity and mortality of the disease. Previous nationwide studies have reported links between long-term PM2.5 concentrations and COVID-19 infection and mortality rates. In order to translate these results to the state level, we use Bayesian hierarchical models to explore potential links between long-term PM2.5 concentrations and census tract-level rates of COVID-19 outcomes (infections, hospitalizations, and deaths) in Colorado. We explicitly consider how the uncertainty in PM2.5 estimates affect our results by comparing four different PM2.5 surfaces from academic and governmental organizations. After controlling for 20 census tract level covariates including race/ethnicity, socioeconomic status, social distancing, age demographics, comorbidity rates, meteorology, and testing rate, we find that our results depend heavily on the choice of PM2.5 surface. Using PM2.5 estimates from the United States EPA, we find that a 1 µg/m3 increase in long term PM2.5 is associated with a statistically significant 25% increase in the relative risk of hospitalizations and a 35% increase in mortality. Results for all other surfaces and outcomes were not statistically significant. At the same time, we find a clear association between communities of color and COVID-19 outcomes at the Colorado census-tract level that is minimally affected by the choice of PM2.5 surface. A per-interquartile range (IQR) increase in the percent of non-African American people of color was associated with a 31%, 44%, and 59% increase in the relative risk of infection, hospitalization, and mortality respectively, while a per-IQR increase in the proportion of non-Hispanic African Americans was associated with a 4% and 7% increase in the relative risk of infections and hospitalizations. These results have strong implications for the implementation of an equitable public health response during the crisis and suggest targeted areas for additional air monitoring in Colorado.
Regulatory-approved Deep Learning/Machine Learning-Based Medical Devices in Japan as of 2020: A Systematic Review
Authors: Aisu Nao , Miyake Masahiro , Takeshita Kohei , Akiyama Masato , Kawasaki Ryo , Kashiwagi Kenji , Sakamoto Taiji , Oshika Tetsuro , Tsujikawa Akitaka
Published: February 2021

Machine learning (ML) and deep learning (DL) are changing the world and reshaping the medical field. Thus, we conducted a systematic review to determine the status of regulatory-approved ML/DL-based medical devices in Japan, a leading stakeholder in international regulatory harmonization. Information about the medical devices were obtained from the Japan Association for the Advancement of Medical Equipment search service. The usage of ML/DL methodology in the medical devices was confirmed using public announcements or by contacting the marketing authorization holders via e-mail when the public announcements were insufficient for confirmation. Among the 114,150 medical devices found, 11 were regulatory-approved ML/DL-based Software as a Medical Device (SaMD), with 6 products (54.5%) related to radiology and 5 products (45.5%) related to gastroenterology. The domestic ML/DL-based SaMD were mostly related to health check-ups, which are common in Japan. Our review provides a global overview that can foster international competitiveness and further tailored advancements.
Cytokine status of patients with atherosclerotic injury of carotid arteries
Authors: Danilova M.A. , Baidina T.V.
Published: February 2021

The research was aimed at studying interleukin-6 (IL-6), interleukin-10 (IL-10) and C-reactive protein (CRP) levels in serum of 61 patients suffering from atherosclerotic injury of carotid arteries. The results received by the immunoferment method were compared with ultrasound features of atherosclerotic plaques and morphological peculiarities of their biopsies which were obtained during carotid endarterectomy.

An increased concentration of cytokines under analysis and CRP in serum of patients with atherosclerotic injury of carotid arteries was detected. It was found out that high levels of IL-6 and CRP are associated with progressing atherosclerosis of carotid arteries and its cerebral complications. The research revealed that detection of cytokines and CRP in serum can be used as an additional method to diagnose unstable character of atherosclerotic plaques.
International travel in times of the COVID-19 pandemic: Evidence from German school breaks
Authors: Backhaus Andreas
Published: February 2021

The COVID-19 pandemic has triggered severe global restrictions on international travel with the intention of limiting the spread of SARS-CoV-2 across countries. This paper studies the effects of the partial relaxation of these travel restrictions in Europe during the summer months of 2020. It exploits the staggered start of the summer school breaks across German states as an exogenous shock to the travel opportunities of the population. While the school breaks also increased mobility within Germany, the event study regressions include disaggregated and time-varying controls for domestic mobility and local COVID-19-related restrictions. The resulting intention-to-treat effects of the relaxed travel restrictions show a significant and sizable increase of the COVID-19 incidence in German counties during the later weeks of the school breaks.
Evolutionary trajectories and transmission dynamics of multidrug-resistant Mycobacterium tuberculosis in Tibet, China
Authors: Jiang Qi , Liu Hai-can , Liu Qing-yun , Phelan Jody E. , Shi Li , Gao Min , Zhao Xiu-qin , Wang Jian , Glynn Judith R. , Yang Chong-guang , Takiff Howard E. , Wan Kang-lin , Clark Taane G. , Gao Qian
Published: February 2021

Objective

Tibet has the highest prevalence of both tuberculosis disease and multidrug-resistant tuberculosis (MDR-TB) in China. The circulated Mycobacterium tuberculosis strains from Tibet were sequenced to investigate the underlying drivers for the high burden of MDR-TB.

Methods

Using whole-genome sequencing data of 576 M. tuberculosis strains isolated from consecutive patients in Tibet, we mapped resistance-conferring mutations onto phylogenetic trees to determine their evolution and spread. The impact of drug resistance on bacterial population growth was assessed with a Bayesian (Skyline Plot) analysis. Multivariable logistic regression was used to identify risk factors for the development of rifampicin resistance.

Results

Of the 576 isolates, 284 (49.3%), 280 (48.6%), and 236 (41.0%) were, respectively, genetically resistant to isoniazid, rifampicin, or both (MDR-TB). Among the isoniazid- and rifampicin-resistant strains, the proportions in phylogenetically-inferred clusters were 77.8% (221/284) and 62.1% (174/280), respectively. Nearly half (47.2%, 134/284) of the isoniazid-resistant strains were in six major clades, which contained between 8 and 58 strains with katG S315T, katG S315N, or fabG1 promoter −15 C>T resistance mutations. These major clades exponentially expanded after emerging with isoniazid resistance and stabilized before evolving into MDR-TB twenty years later. Isoniazid-resistant isolates showed an increased risk of accumulating rifampicin resistance compared to isoniazid-susceptible strains, with an adjusted odds ratio of 3.81 (95% confidence interval 2.47-5.95).

Conclusion

Historical expansion of isoniazid-resistant strains and their increased likelihood of acquiring rifampicin resistance both contributed to the high burden of MDR-TB in Tibet, highlighting the need to detect INH-resistant strains promptly and to control their transmission.
Effect of antihypertensive drug treatment on long-term blood pressure reduction: An individual patient-level data meta-analysis of 352,744 Participants from 51 large-scale randomised clinical trials
Authors:   The Blood Pressure Lowering Treatment Trialists’ Collaboration
Published: February 2021

Objectives

Evidence from randomised trials on long-term blood pressure (BP) reduction from pharmacologic treatment is limited. To investigate the effects of antihypertensive drugs on long-term BP change and examine its variation over time and among people with different clinical characteristics

Design

Individual participant-level data meta-analysis

Setting and data source

The Blood Pressure Lowering Treatment Trialists’ Collaboration involving 51 large-scale long-term randomised clinical trials

Participants

352,744 people (42% women) with mean age of 65 years and mean baseline systolic/diastolic BP of 152/87 mmHg, of whom 18% were current smokers, 50% had cardiovascular disease, 29% had diabetes, and 72% were taking antihypertensive treatment at baseline

Intervention

Pharmacological BP-lowering treatment

Outcome

Difference in longitudinal changes in systolic and diastolic BP between randomised treatment arms over an average follow-up of four years

Result

Drugs were effective in lowering BP, with the maximum effect becoming apparent after 12-month follow-up and with gradual attenuation towards later years. Based on measures taken ≥12 months post-randomisation, more intense BP-lowering treatment reduced systolic/diastolic BP (95% confidence interval) by −11.2 (−11.4 to −11.0)/−5.6 (−5.8 to −5.5) mmHg than less intense treatment; active treatment by −5.1 (−5.3 to −5.0)/−2.3 (−2.4 to −2.2) mmHg lower than placebo, and active arm by −1.4 (−1.5 to −1.3)/−0.6 (−0.7 to −0.6) mmHg lower than the control arm for drug class comparison trials. BP reductions were consistently observed across a wide range of baseline BP values and ages, and by sex, history of cardiovascular disease and diabetes, and prior antihypertensive treatment use.

Conclusion

Pharmacological agents were effective in lowering long-term BP among individuals with a wide range of characteristics, but the net between-group reductions were modest, which is partly attributable to the intended trial goals.
Human mobility data from the BBC Pandemic project
Authors: Conlan Andrew JK , Klepac Petra , Kucharski Adam J , Kissler Stephen , Tang Maria L , Fry Hannah , Gog Julia R
Published: February 2021

We present human mobility data for the United Kingdom collected from the “BBC Pandemic”, a public science project linked to the BBC Four television documentary of the same name. Mobile phone GPS trajectories submitted by users and collected over a 24 hour period were aggregated to construct anonymised origin-destination flux matrices at the local administrative district (LAD). We use these data to explore how mobility patterns change with age and employment status - unique stratifications that are not available from other publicly and privately held mobility data sets. We validate the consistency of the aggregated BBC mobility data set against census workflow data and illustrate how the systematic differences in mobility rates with age affect the risk and pattern of transmission between regions with 18-30 year old’s contributing the greatest risk of transmission to adjacent regions, but older 60-100 years playing the most important role in more remote low-density locations.
Rehabilitation clinicians’ perspectives of reactive balance training
Authors: Jagroop David , Houvardas Stephanie , Danells Cynthia J , Kochanowski Jennifer , French Esmé , Salbach Nancy M. , Musselman Kristin , Inness Elizabeth L. , Mansfield Avril
Published: February 2021

Purpose

Reactive balance training (RBT) aims to improve reactive balance control. However, because RBT involves clients losing balance, clinicians may view that it is unsafe or not feasible for some clients. We aimed to explore how clinicians are specifically implementing RBT to treat balance and mobility issues.

Materials and methods

Physiotherapists and kinesiologists across Canada who reported that they include RBT in their practices were invited to complete telephone interviews about their experience with RBT. Interviews were transcribed verbatim, and analysed using a deductive thematic analysis.

Results

Ten participants completed telephone interviews, which lasted between 30-60 minutes. Participants were primarily working in a hospital setting (inpatient rehabilitation (n=3); outpatient rehabilitation (n=2), and were treating those with neurological disorders (n=5). Four main themes were identified: 1) there is variability in RBT approaches; 2) knowledge can be a barrier and facilitator to RBT; 3) reactive balance control is viewed as an advanced skill; and 4) RBT experience builds confidence.

Conclusions

Our findings suggest a need for resources to make clinical implementation of RBT more feasible.
Chronic Kidney Disease in Ecuador: An Epidemiological and Health System Analysis of an Emerging Public Health Crisis
Authors: Torres Irene , Sippy Rachel , Bardosh Kevin Louis , Bhargava Ramya , Lotto-Batista Martín , Bideaux Abigail E. , Garcia-Trabanino Ramon , Goldsmith Amelia , Narsipur Sriram S. , Stewart-Ibarra Anna M.
Published: February 2021

Background

The absence of a chronic kidney disease (CKD) registry in Ecuador makes it difficult to assess the burden of disease, but there is an anticipated increase in the incidence of end-stage kidney disease along with increasing diabetes, hypertension and population age. From 2008, augmented funding for renal replacement treatment expanded dialysis clinics and patient coverage.

Methods

We conducted 73 in-depth interviews with healthcare providers in eight provinces. Findings were analyzed using qualitative methods and triangulated with quantitative data on patients with CKD diagnoses from six national-level databases between 2015 and 2018. We also reviewed grey and scientific literature on CKD and health systems in Ecuador.

Results

Datasets show a total of 17 484 dialysis patients in 2018, or 567 patients per million population (pmp), with an annual cost exceeding 11% of Ecuador’s public health budget. Each year, there were 139—162 pmp new dialysis patients, while doctors report waiting lists. The number of patients on peritoneal dialysis was stable; those on hemodialysis increased over time. Only 13 of 24 provinces have dialysis services, and nephrologists are in major cities, which limits access, delays medical attention, and adds a travel burden on patients. Prevention and screening programs are scarce, while hospitalization is an important reality of CKD patients.

Conclusion

CKD is an emerging public health crisis that has increased dramatically over the last decade in Ecuador and is expected to continue, making coverage for all patients impossible and the current structure, unsustainable. A patient registry would permit to estimate the demand and progression of patients with consideration for comorbidities, requirements and costs, and mortality, and identify where to focus prevention efforts. Health policy should clearly state CKD definitions and required patient data, including cause, disease stage and follow-up statistics. Organized monitoring of patients would benefit from improvements in patient referral.
Follow-up study in the ski-resort Ischgl: Antibody and T cell responses to SARS-CoV-2 persisted for up to 8 months after infection and transmission of virus was low even during the second infection wave in Austria
Authors: Borena Wegene , Bánki Zoltán , Bates Katie , Winner Hannes , Riepler Lydia , Rössler Annika , Pipperger Lisa , Theurl Igor , Falkensammer Barbara , Ulmer Hanno , Walser Andreas , Pichler Daniel , Baumgartner Matthias , Schönherr Sebastian , Forer Lukas , Knabl Ludwig , Würzner Reinhard , Laer Dorothee von , Paetzold Jörg , Kimpel Janine
Published: February 2021

Background

In early March 2020, a SARS-CoV-2 outbreak in the ski resort Ischgl in Austria initiated the spread of SARS-CoV-2 throughout Austria and Northern Europe. In a cross-sectional study, we found that the seroprevalence in the adult population of Ischgl had reached 45% by the end of April. To answer the question of how long immunity persists and what effect this high-level immunity had on virus transmission, we performed a follow-up study in early November, 2020.

Methods

Of the 1259 adults that participated in the baseline study, 801 could be included in the follow-up. The study involved the analysis of binding and neutralizing antibodies and T cell responses. In addition, the incidence of SARS-CoV-2 infections in Ischgl was compared to the incidence in similar municipalities in Tyrol throughout 2020.

Findings

For the 801 individuals that participated in both studies, the seroprevalence declined from 51.4% (95% confidence interval (CI) 47.9 - 54.9) to 45.4% (95% CI 42.0 - 49.0). Median antibody concentrations dropped considerably but antibody avidity increased. T cell responses were analysed in 93 cases, including all 4 formerly seropositive cases that had lost antibodies in all assays, three of which still had detectable T cell memory. In addition, the incidence in the second COVID-19 wave that hit Austria in November 2020, was significantly lower in Ischgl than in comparable municipalities in Tyrol or the rest of Austria.

Interpretation

This study has important implications as it shows that although antibodies to SARS-CoV-2 declined, T and B cell memory can be detected for up to 8 months. Complemented by infection prevention measures a level of around 40-45% immunity in Ischgl significantly reduced local virus transmission during the second wave in Austria in November 2020.

Funding

Funding was provided by the government of Tyrol and the FWF Austrian Science Fund.
The Association of Opioid Use Disorder and COVID-19 in Shahroud, Iran
Authors: Jamali Zhaleh , Emamian Mohammad Hassan , Hashemi Hassan , Fotouh Akbar
Published: February 2021

Background

COVID-19 quickly spread to the world, causing a pandemic. While some studies have found no link between Opioid Use Disorder (OUD) and COVID-19, the role of the opioid on COVID-19 is challenging. The present study aimed to determine the relationship between OUD and COVID-19.

Methods

This was a prospective cohort study. We used data from the third phase of the Shahroud eye cohort study on 4394 participants which started in September 2019 and ended before the COVID-19 epidemic in Shahroud in February 2020. The participants were followed for 10.5 months till November 2020. COVID-19 was detected by RT-PCR on swap samples from the oropharynx and nasopharynx. The incidence of COVID-19 compared in OUD and Non-OUD participants, and relative risk was calculated in Log Binomial Regression model.

Results

Among the 4394 participants with a mean age of 61.1 years, 120 people had OUD. The incidence of COVID-19 in participants with OUD and Non-OUD were 3.3% and 4.5%, respectively. The relative risk of OUD for COVID-19 was 0.75 (95% Confidence intervals: 0.28 – 1.98; P= 0.555).

Conclusions

Opioid use disorder was not associated with COVID-19. The claim that people with OUD are less likely to develop COVID-19 is not supported by this data.
Does advance contact with research participants increase response to questionnaires: A Systematic Review and meta-Analysis
Authors: Woolf Benjamin , Edwards Phil
Published: February 2021

Background

Questionnaires remain one of the most common forms of data collection in epidemiology, psychology and other human-sciences. However, results can be badly affected by non-response. One way to potentially reduce non-response is by sending potential study participants advance communication. The last systematic review to examine the effect of questionnaire pre-notification on response is ten years old, and lacked a risk of bias assessment.

Objectives

Update Edwards et al. (2009) to include 1) recently published studies, 2) an assessment of risk of bias.

Methods

Data sources: Edwards et al. (2009); 13 data-bases; the references in, and citations of included studies. Eligibility criteria: Randomised control trials examining the impact of pre-notification on response. Data extraction: data extraction was done twice by a single unblinded reviewer. Risk of bias was assessed using the Cochrane Risk of Bias tool and funnel plots.

Results

103 trials were included. Over-all pre-notification increased response, OR = 1.38 (95%CI: 1.25-1.53). However, when studies at high or unclear risk of bias were excluded the effect was greatly reduced (OR = 1.11, 95% CI: 1.01-1.21).

Conclusions

The evidence implies that while pre-notification does increase response rates, this may not be of clinical utility.
Antigen production and development of an indirect ELISA based on the nucleocapsid protein to detect human SARS-CoV-2 seroconversion
Authors: Conzentino Marcelo S. , Forchhammer Karl , Souza Emanuel M , Pedrosa Fábio O. , Nogueira Meri B. , Raboni Sônia M. , Rego Fabiane G. M. , Zanette Dalila L. , Aoki Mateus N. , Nardin Jeanine M. , Fornazari Bruna , Morales Hugo M. P. , Celedon Paola A. F. , Lima Carla V. P. , Mattar Sibelle B. , Lin Vanessa H. , Morello Luis G. , Marchini Fabricio K. , Bueno Lucas Bochnia , Reis Rodrigo A. , Huergo Luciano F.
Published: February 2021

Serological assays are important tools to identify previous exposure to SARS-CoV-2, helping to track COVID-19 cases and determine the level of humoral response to SARS-CoV-2 infections and/or immunization to future vaccines. Here the SARS-CoV-2 nucleocapsid protein was expressed in Escherichia coli and purified to homogeneity and high yield using a single chromatography step. The purified SARS-CoV-2 nucleocapsid protein was used to develop an indirect enzyme-linked immunosorbent assay for the identification of human SARS-CoV-2 seroconverts. The assay sensitivity and specificity were determined analyzing sera from 140 PCR-confirmed COVID-19 cases and 210 pre-pandemic controls. The assay operated with 90% sensitivity and 98% specificity; identical accuracies were obtained in head-to-head comparison with a commercial ELISA kit. Antigen coated plates were stable for up to 3 months at 4°C). The ELISA method described is ready to mass production and will be an additional toll to track COVID-19 cases.
Does pre-notification increase questionnaire response rates: a nested randomised control trial
Authors: Woolf Benjamin , Edwards Phil
Published: February 2021

Background

Study results can be badly affected by non-response. One way to potentially reduce non-response is by sending potential study participants advance communication. During the update of a systematic review examining the effect of pre-notification on response rates, a number of study authors needed to be contacted for further information.

Objectives

To conduct an RCT to investigate the effect of pre-notification, nested within the request for further information for a systematic review.

Methods

Study authors included in the systematic review, whose studies were at unclear risk of bias, and who were contactable, were randomly sent or not set a pre-notification email prior to being sent the request for further information email.

Results

At the end of follow up, 14/33 (42.4%) authors in the pre-notification condition had returned responses to the questionnaire, and 18/42 (42.9%). There was not evidence of a difference between these groups.

Conclusions

This study’s results do not support the hypothesis that pre-notification does increase response from participants.
Tissue Stress from Laparoscopic Grasper Use and Bowel Injury in Humans: Establishing Intraoperative Force Boundaries
Authors: Khan Amanda Farah , MacDonald Matthew Kenneth , Streutker Catherine , Rowsell Corwyn , Drake James , Grantcharov Teodor
Published: February 2021

Background

Inappropriate force in laparoscopic surgery can lead to inadvertent tissue injury. It is currently unknown however at what magnitude of compressive stress trauma occurs in gastrointestinal tissues.

Methods

This study included 10 small bowel and 10 colon samples. Each was compressed with pressures ranging from 100 kPa to 600 kPa by a novel device to induce compressive “grasps” to simulate those of a laparoscopic grasper. Experimentation was performed ex-vivo, in-vitro. Grasp conditions of 0 to 600 kPa for a duration of 10 seconds were utilized. Two pathologists who were blinded to all study conditions, performed a histological analysis of the tissues. Patients were eligible if their surgery procured healthy tissue margins for experimentation (a convenience sample). 26 patient samples were procured; six samples were unusable. 10 colon and 10 small bowel samples were tested for a total of 120 experimental cases. No patients withdrew their consent. Two metrics of damage were quantified: an intestinal layer thickness calculation where the serosa layer was measured in the area of compression and compared to a local control and a histological scoring scale for tissue trauma.

Results

Small bowel (10), M:F was 7:3, average age was 54.3 years. Colon (10), M:F was 1:1, average age was 65.2 years. All 20 patients experienced a significant difference (p<0.05) in serosal thickness post-compression at both 500 and 600 kPa for both tissue types. A logistic regression analysis with a sensitivity of 100% and a specificity of 84.6% on a test set of data predicts a safety threshold of 329-330 kPa.

Conclusion

A threshold was discovered that corresponded to both significant serosal thickness change and a positive histological trauma score rating. This “force limit” could be used in novel sensorized laparoscopic tools to avoid intraoperative tissue injury.
Phased implementation of COVID-19 vaccination: rapid assessment of policy adoption, reach and effectiveness to protect the most vulnerable in the US
Authors: Li Yun , Li Moming , Rice Megan , Su Yanfang , Yang Chaowei
Published: February 2021

Objectives

The US and rest of the world have suffered from the COVID-19 pandemic for over a year. The high transmissibility and severity of this virus have provoked governments to adopt a variety of mitigation strategies. Some of these previous measures, such as social distancing and mask mandates, were effective in reducing the case growth rate yet became economically and administratively difficult to enforce as the pandemic continued. In late December 2020, COVID-19 vaccines were first approved in the US and states began a phased implementation of COVID-19 vaccination. However, there is limited quantitative evidence regarding the effectiveness of the phased COVID-19 vaccination. This study aims to provide a rapid assessment of the adoption, reach, and effectiveness of the phased implementation of COVID-19 vaccination.

Methods

We utilize an event-study analysis to evaluate the effect of vaccination on the state-level, daily COVID-19 case growth rate.

Results

Through this analysis, we assert that vaccination is effective in reducing the spread of COVID-19 shortly after the first shots were given. Specifically, the case growth rate declined by 0.124, 0.347, 0.345, 0.464, 0.490, and 0.756 percentage points corresponding to the 1-5, 6-10, 11-15, 16-20, 21-25, and 26 or more day periods after the initial shots.

Conclusions

The findings could be insightful for policymakers as they work to optimize vaccine distribution in later phases, and also for the public as the COVID-19 related health risk is a contentious issue.
Synthesizing evidence regarding community-based volunteer facilitated programs supporting integrated care transitions from hospital to home: A scoping review protocol
Authors: Nelson Michelle L. A. , Armas Alana , Thombs Rachel , Singh Hardeep , Fulton Joseph , Cunningham Heather , Munce Sarah , Hitzig Sander L. , Bettger Janet Prvu
Published: February 2021

Background

Given the risks inherent in care transitions, it is imperative that patients discharged from hospital to home receive the integrated care services necessary to ensure that the transition is successful. Despite efforts by the health care sector to develop health system solutions to improve transitions, problems persist. Research on transitional support has predominantly focused on services delivered by health care professionals; the evidence for services provided by lay navigators or volunteers in supporting people transitioning from hospital to home has not been synthesized to guide practice, policy or future research.

Aim

This is a protocol for a scoping review that will examine the role and contributions of voluntary sector personnel and services to support transitions from hospital to home.

Methods

Using the well-established scoping review methodology outlined by Arksey and O’Malley, a six-stage study is outlined (1) identifying the research question, (2) identifying relevant studies, (3) selecting studies, (4) charting the data, (5) collating, summarizing and reporting the results, and (6) providing consultation. The search strategy, designed by an information scientist, is applied to ten databases reflecting empirical and grey literature sources. A two-stage screening process will be used to determine eligibility of articles. To be included in the review, articles must report on a community-based program that engages volunteers in the provisions of services that support adults transitioning from hospital to home. All articles will be independently assessed for eligibility, and data from eligible articles will be abstracted and charted using a standardized form. Extracted data will be analyzed using narrative and descriptive analyses. Research ethics approval is not required for this scoping review.

Discussion

This scoping review will map the available literature focused on the contributions of voluntary sector personnel and services to support transitions from hospital to home.