bluuebunny/crossref_metadata_2025 huggingface dataset:
Negative Symptoms and Functioning in Youth at Risk of Psychosis: A Systematic Review and Meta-analysis
Authors: Devoe Daniel J. , Braun Amy , Seredynski Thomas , Addington Jean
Published: November 2020

Learning objective

After participating in this activity, learners should be better able to:

• Evaluate the relationship between negative symptoms and functioning in youth at clinical high risk for psychosis.

Aim

Youth at CHR for psychosis often demonstrate significant negative symptoms and poor functioning, though the magnitude and direction of the relationship between the two remains unknown. The objective of this systematic review is to summarize the relationship between negative symptoms and functioning in CHR samples.

Method

Electronic databases CINAHL, EBM, Embase, MEDLINE, and PsycINFO were searched from inception. Studies were selected if they included any study that reported a relationship between negative symptoms and functioning in youth at clinical high risk (CHR). The correlation coefficient r was converted to Cohen’s d, and all random-effects meta-analyses were performed using the transformed values.

Results

Forty-one studies met the inclusion criteria, including a total of 4574 individuals at CHR for psychosis. Negative symptom total scores were significantly associated with poorer global functioning (d, −1.40; 95% CI, −1.82 to −0.98; I2 = 79.4%; p < .001 [9 studies, n = 782]), social functioning (d, −1.10; 95% CI, −1.27 to −0.93; I2 = 10.40%; p < .001 [12 studies, n = 811]), and role functioning (d, −0.96; 95% CI, −1.17 to −0.76; I2 = 41.1%; p < .001 [9 studies, n = 881]). In addition, negative symptoms were consistently associated with poor premorbid functioning. When examining negative symptom domains, avolition, anhedonia, and blunted affect were each significantly and independently associated with poorer social functioning and role functioning. In terms of prediction models, negative symptoms contributed to the prediction of lower functioning across multiple studies.

Conclusion

This meta-analysis demonstrates a strong relationship between negative symptoms and functioning in youth at clinical high risk for psychosis.
Messaging in Biological Psychiatry: Misrepresentations, Their Causes, and Potential Consequences
Authors: Dumas-Mallet Estelle , Gonon Francois
Published: November 2020

Most experts in the field of psychiatry recognize that neuroscience advances have yet to be translated into clinical practice. The main message delivered to laypeople, however, is that mental disorders are brain diseases cured by scientifically designed medications. Here we describe how this misleading message is generated. We summarize the academic studies describing how biomedical observations are often misrepresented in the scientific literature through various forms of data embellishment, publication biases favoring initial and positive studies, improper interpretations, and exaggerated conclusions. These misrepresentations also affect biological psychiatry and are spread through mass media documents. Exacerbated competition, hyperspecialization, and the need to obtain funding for research projects might drive scientists to misrepresent their findings. Moreover, journalists are unaware that initial studies, even when positive and promising, are inherently uncertain. Journalists preferentially cover them and almost never inform the public when those studies are disconfirmed by subsequent research. This explains why reductionist theories about mental health often persist in mass media even though the scientific claims that have been put forward to support them have long been contradicted. These misrepresentations affect the care of patients. Indeed, studies show that a neuro-essentialist conceptualization of mental disorders negatively affects several aspects of stigmatization, reduces the chances of patients’ healing, and overshadows psychotherapeutic and social approaches that have been found effective in alleviating mental suffering. Public information about mental health should avoid these reporting biases and give equal consideration to the biological, psychological, and social aspects of mental health.
Mindfulness and Behavior Change
Authors: Schuman-Olivier Zev , Trombka Marcelo , Lovas David A. , Brewer Judson A. , Vago David R. , Gawande Richa , Dunne Julie P. , Lazar Sara W. , Loucks Eric B. , Fulwiler Carl
Published: November 2020

Initiating and maintaining behavior change is key to the prevention and treatment of most preventable chronic medical and psychiatric illnesses. The cultivation of mindfulness, involving acceptance and nonjudgment of present-moment experience, often results in transformative health behavior change. Neural systems involved in motivation and learning have an important role to play. A theoretical model of mindfulness that integrates these mechanisms with the cognitive, emotional, and self-related processes commonly described, while applying an integrated model to health behavior change, is needed. This integrative review (1) defines mindfulness and describes the mindfulness-based intervention movement, (2) synthesizes the neuroscience of mindfulness and integrates motivation and learning mechanisms within a mindful self-regulation model for understanding the complex effects of mindfulness on behavior change, and (3) synthesizes current clinical research evaluating the effects of mindfulness-based interventions targeting health behaviors relevant to psychiatric care. The review provides insight into the limitations of current research and proposes potential mechanisms to be tested in future research and targeted in clinical practice to enhance the impact of mindfulness on behavior change.
Visual Field Characteristics of Type I Boston Keratoprosthesis Patients Without Glaucoma
Authors: Quercia Andressa Z.F. , Silva Luzia D. , de Oliveira Filipe , Teixeira Sergio H. , de Sousa Luciene B. , de Oliveira Lauro A.
Published: November 2020

Purpose:

To determine visual field findings in Boston type 1-KPro (BI-KPro) patients without glaucoma. Characterize normal threshold values and global indices using standard automated perimetry and characterize visual field amplitude using Goldmann’s manual perimetry.

Methods:

This cross-sectional prospective noninterventional study included patients (n=6 patients, 6 eyes) with BI-KPro who had normal optical coherence tomography and fundoscopic evaluation of the optic disc and retina. None had a previous history of glaucoma. Visual acuity, reliable and reproducible standard automated perimetry (24-2 and 30-2), and manual perimetry examinations were obtained from all patients. Each patient answered the National Eye Institute Visual Function Questionnaire, and the results were correlated with visual field indices.

Results:

The mean visual acuity was 0.35±0.31 logMAR (0.84 to 0.10). All visual fields had good reliability indices. The standard automated perimetry mean deviation values were −7.25±3.63 decibels (dB) and −7.75±3.23 (24-2 and 30-2 values, respectively), whereas pattern SD values were 2.72±0.82 and 3.30±1.13 (24-2 and 30-2, respectively). The manual visual field mean values of the 4 quadrants (superior, temporal, inferior, and nasal), were 39.7±4.5, 61.8±6.2, 54.0±4.3, and 48.2±7.6 degrees, respectively. The authors found a significant correlation between the VFQ-25 indexes of general sight and close-range activities with the values of total deviation at 10 degrees. VFQ-25 peripheral vision indexes also correlated significantly with values of total deviation at 30 degrees (outermost locations in the 30-degree area).

Conclusions:

Patients with BI-KPro presented reliable and reproductive visual field measurements. The authors found a consistent reduction in visual field extension and a global sensitivity reduction in these patients. Despite visual field changes, our patients had a good quality of life scores. Overall, these results could be useful to improve early glaucoma diagnosis and to follow-up BI-KPro patients.
Depression and Medical Treatment Adherence in Mexican Patients With Glaucoma
Authors: Gamiochipi-Arjona Jorge E. , Azses-Halabe Yael , Tolosa-Tort Paulina , Lazcano-Gómez Gabriel , Gonzalez-Salinas Roberto , Turati-Acosta Mauricio , García-Huerta Magdalena , Jiménez-Román Jesús
Published: November 2020

Precis:

The prevalence of depression in Mexican patients with glaucoma is higher than that reported in the general population. Depression prevalence and severity are directly associated with glaucoma severity and lower adherence to medical treatment.

Purpose:

To determine the prevalence of depression in patients with glaucoma and to describe the correlation between the severity of depression, glaucoma, and treatment adherence.

Patients and Methods:

This cross-sectional study included 111 patients with glaucoma who answered the Beck Depression Inventory (BDI)-II and the Morisky-Green questionnaire that evaluated their depression severity and medical treatment adherence. Low treatment adherence was defined as having a score of >2 on the Morisky-Green questionnaire. Analysis of variance, Fisher exact test, and linear regression models were used for statistical analyses. The main outcomes were prevalence of depression, prevalence of depression according to glaucoma damage, and the association between depression severity, medical treatment adherence, and glaucoma damage.

Results:

The average patient age was 67.6±13.8 years. The prevalence of depression was 50.4%. Analysis of variance revealed a statistically significant association between glaucoma severity of the “worse eye” and the BDI raw score. In the “better eye,” there was no statistically significant difference in mean BDI raw scores across glaucoma severity categories. There was a statistically significant association between the presence of depression and the level of treatment adherence after adjusting for age, sex, type of glaucoma, and the glaucoma severity in both eyes. The risk of low treatment adherence in patients with depression was 38 times that of patients with no depression.

Conclusion:

Glaucoma is associated with a prevalence of depression nearly 10 times higher than that in the general population. Glaucoma, depression severity, and lower adherence to medical treatment are associated.
Trauma Versus Nontrauma Intensive Care Unit Nursing: A Workload Comparison
Authors: Youn Seok Hwa , Son Hyun-Sook , Kim JuRyang , Jung Kyoungwon , Moon Jonghwan , Huh Yo , Kim Younghwan
Published: November 2020

Background:

Trauma centers with dedicated trauma intensive care units (TICUs) have recently been developed in South Korea. It is hypothesized that TICU nurse staffing is driven not only by the number of patients but also by the work intensity. This study aims to compare nursing workload characteristics between TICUs and non-TICUs.

Methods:

A 1-year retrospective study was performed in one TICU and five non-TICUs in a single trauma center from September 2014 to August 2015. Demographic data were collected along with nursing workload characteristics using the Workload Management System of Critical Care Nurses (WMSCN) score.

Results:

A total of 332 trauma patients in the TICU and 2,346 nontrauma patients in non-TICUs were studied. TICU patients were younger (49.27 vs. 60.44, p < .001) and more frequently male (75.6% vs. 24.4%, p < .001). The most common admission reasons were motor vehicle crash (38.6%) and cardiovascular conditions (24.9%). Both intensive care unit and hospital length of stay were longer in TICU patients (12.72 vs. 5.43, p < .001; and 35.61 vs. 18.16, p < .001), whereas the mortality rates in the TICU were lower (11.1% vs. 15.1%, p < .001). Total WMSCN scores were significantly higher in the TICU (115.99 vs. 110.19; p < .001).

Conclusions:

This study found that nursing workload or work intensity was significantly higher in the TICU than in non-TICUs. Further multicenter studies using objective medical severity scores are warranted.
Whole Blood Administration: Comparison of In Vitro Platelet Function of Pressure Bag, Pressure Bag With Fluid Warming Device, and Rapid Infuser Methods
Authors: Alley Tiffany , Taylor Gigi , Owens Amy , Goodin James W. , Rasnake Niki , Daley Brian J. , Clark Christopher T.
Published: November 2020

Background:

Use of low-titer group O whole blood for emergent transfusion of patients with unknown blood type became AABB approved in January 2018. Since that time, there is increasing use of whole blood in massive transfusion protocols. Whole blood stored at refrigerator temperature (2–4 °C) contains functional platelets that some research proposes may provide better clot dynamics than standard platelets, which are stored at room temperature (20–24 °C). Conventional teaching does not promote infusion of platelet products with pressure or warming, due to concerns of activation and subsequent inactivity of the infused platelets. Although a few reports found no significant changes in platelet function with warming or pressure during infusion of conventional room-temperature-stored platelets, there is limited data to support use of warming or pressure for infusion of whole blood products containing cold-stored platelets.

Methods:

This study design is to evaluate and compare three commonly used methods of administering blood products in a massive transfusion setting for their potential effects on platelets contained within whole blood units (pressure bag alone, pressure bag with fluid warming line, and rapid infuser).

Results:

Platelet function of 10 units tested pre- and post-infusion by thromboelastography (TEG) and platelet aggregation studies found no significant difference in platelet activity pre- and post-infusion with any of the three methods evaluated.

Conclusions:

This study supports the use of rapid infuser or pressure bag devices (with or without warming) as acceptable for infusion of whole blood products. Infusion of whole blood with warming is preferable to prevent potential transfusion-associated hypothermia.
Relationship of Time of Injury Marijuana Exposure and Traumatic Brain Injury: A Systematic Review
Authors: Elias Dina , Plurad David , Bender Miriam
Published: November 2020

Background:

Traumatic brain injury (TBI) is a significant nursing concern, as it is a leading cause of mortality, morbidity, and disability in the United States. Notably, up to 51% of all TBI patients have substance use exposure at the time of injury. Marijuana remains the most widely used illicit drug in the United States. However, little is known about marijuana exposure and TBI incidence and severity, particularly at the time of injury.

Methods:

A systematic literature review was conducted following PRISMA guidelines in PubMed to determine the relationship between marijuana exposure and TBI severity.

Heterogeneity of study designs, concepts, samples, and variables in included studies precluded a meta-analysis. Hence, a descriptive analysis of findings was conducted.

Results:

The search yielded 939 studies, of which eight met inclusion criteria. Only one study found a connection between positive marijuana toxicology screen and mortality outcomes in TBI patients. There was significant variation in how marijuana exposure was defined, conceptualized, and operationalized in the other studies.

Conclusions:

This review identified the need for larger, better-designed studies to address the significant knowledge gap about the relationship between marijuana use and its influence on TBI. Data and knowledge derived from such studies can help inform policy and aid in the development of nursing interventions that target prevention and increase awareness of TBI risk when under the influence of marijuana.
Development of a Prediction Model for Trauma Registry Chart Abstraction Time
Authors: Evans Kelly Jo , Samanta Damayanti
Published: November 2020

Introduction

A Level I trauma center routinely faced challenges with meeting data submission deadlines and frequently struggled with a backlog of cases that limited opportunities for concurrent performance improvement. To provide a validated algorithm through which registry workload could be evaluated, the study institution designed a scientific model that predicted the amount of time required for chart abstraction on a patient-by-patient basis.

Methods

As part of this quality improvement endeavor, registrars documented the amount of time required to complete each chart. A total of 600 patients' data were included by randomly selecting 150 patients from each of the 4 trauma registrars. Given that no previous study has examined the association of patient-related factors with chart abstraction time, study variables utilized to construct this predictive model were determined by the trauma program manager and the lead trauma registrar.

Results

Multiple linear regression demonstrated that inhospital mortality; transfer from a referring facility; hospital stay; ventilator days; and number of complications, specialty consults, injuries, blood products, and procedures were significant predictors of chart abstraction time. The equation for the regression line for the multivariate regression was as follows: Y = 38.95 + 31.28 × mortality + 15.33 × referring facility + 4.68 × complications+3.55 × hospital stay + 3.33 × consults + 2.83 × diagnoses + 2.00 × ventilator days + 1.78 × blood products + 1.09 × procedures.

Conclusions

The merit of this prediction model is that it is based on patient-related variables and predicts time on a patient-by-patient basis. This innovative tool can be utilized by other trauma centers to evaluate registry productivity and identify opportunities for improvement retrospectively.
Imprinting disorders in humans: a review
Authors: Butler Merlin G.
Published: November 2020

Purpose of review

Mammals have two complete sets of chromosomes, one from each parent with equal autosomal gene expression. Less than one percentage of human genes are imprinted or show expression from only one parent without changing gene structure, usually by DNA methylation, but reversible in gametogenesis. Many imprinted genes affect fetal growth and development accounting for several human disorders reviewed in this report.

Recent findings

Disorders include Prader–Willi and Angelman syndromes, the first examples of imprinting errors in humans, chromosome 15q11.2-q13.3 duplication, Silver–Russell syndrome, Beckwith–Weidemann syndrome, GNAS gene-related inactivation disorders (e.g. Albright hereditary osteodystrophy), uniparental chromosome 14 disomy, chromosome 6q24-related transient neonatal diabetes mellitus, parent of origin effects in 15q11.2 BP1–BP2 deletion (Burnside–Butler) syndrome and 15q11-q13 single gene imprinted disorders.

Periconceptional and intrauterine life can be influenced by environmental factors and nutrition impacting DNA methylation. This process not only alters development of the fetus, but pregnancy complications may result from large fetal size. Epigenetic processes control imprinted gene functions and regulation with susceptibility to diseases as described. A better understanding of these processes will impact on care and treatment of affected individuals.
Male survival advantage on the Baja California peninsula
Authors: Schacht Ryan , Macfarlan Shane J. , Meeks Huong , Cervantes Paola Linette , Morales Fernando
Published: November 2020

A consistent finding from contemporary Western societies is that women outlive men. However, what is unclear is whether sex differences in survival are constant across varying socio-ecological conditions. We test the universality of the female survival advantage with mortality data from a nineteenth century population in the Baja California peninsula of Mexico. When examined simply, we find evidence for a male-biased survival advantage. However, results from Cox regression clearly show the importance of age intervals for variable survival patterns by sex. Our key findings are that males: (i) experience significantly lower mortality risk than females during the ages 15–30 (RR = 0.69), (ii) are at a significantly increased risk of dying in the 61+ category (RR = 1.30) and (iii) do not experience significantly different mortality risk at any other age interval (0–14, 31–45, 46–60). We interpret our results to stem from differing intrinsic and extrinsic risk factors for sex-biased mortality across age intervals, highlighting the relevance of a lifecourse approach to the study of survival advantage. Ultimately, our results make clear the need to more broadly consider variability in mortality risk factors across time and place to allow for a clearer understanding of human survival differences.
Brilliant cresyl blue enhanced optoacoustic imaging enables non-destructive imaging of mammalian ovarian follicles for artificial reproduction
Authors: Dutta Rahul , Mandal Subhamoy , Lin Hsiao-Chun Amy , Raz Tal , Kind Alexander , Schnieke Angelika , Razansky Daniel
Published: November 2020

In the field of reproductive biology, there is a strong need for a suitable tool capable of non-destructive evaluation of oocyte viability and function. We studied the application of brilliant cresyl blue (BCB) as an intra-vital exogenous contrast agent using multispectral optoacoustic tomography (MSOT) for visualization of porcine ovarian follicles. The technique provided excellent molecular sensitivity, enabling the selection of competent oocytes without disrupting the follicles. We further conducted
in vitro
embryo culture, molecular analysis (real-time and reverse transcriptase polymerase chain reaction) and DNA fragmentation analysis to comprehensively establish the safety of BCB-enhanced MSOT imaging in monitoring oocyte viability. Overall, the experimental results suggest that the method offers a significant advance in the use of contrast agents and molecular imaging for reproductive studies. Our technique improves the accurate prediction of ovarian reserve significantly and, once standardized for
in vivo
imaging, could provide an effective tool for clinical infertility management.
Introduction: Diversifying the historiography of bacteriophages
Authors: Sankaran Neeraja
Published: November 2020

The essays in this special issue draw on a bank of diverse primary and secondary sources in different languages, to offer novel perspectives on the different directions that research on or with bacteriophages—bacterial viruses—has evolved over the century since they were first discovered. Looking beyond the established historical accounts of the discovery of the bacteriophages and their role as a tool in founding molecular biology, although these milestones are not ignored, papers in this volume offer insights into other investigative threads and figures that were either previously unknown or under-represented in history. Taken together they show that the bacteriophages have had a far richer and more diverse life in both scientific laboratories and written works than hitherto realized, and that more is yet to come.
Afterword: Phage, history and historiography
Authors: Summers William C.
Published: November 2020

The papers in this special issue all touch on the broad problems of scientific
credit and priority and the historiography of science. My remarks consider the
deeper meaning of ‘discovery’, ‘priority’ and
‘scientific credit’, topics of interest to both the scientist and
the historian, in light of the centenary of d'Herelle's paper and
what became known as the ‘Twort–d'Herelle
controversy’. The seminal analysis of these topics by Thomas Kuhn
provides a starting point for these discussions on what discovery means and how
priority and credit are allocated in light of the fraught concept of
discovery.
Do children learn from their prediction mistakes? A registered report evaluating error-based theories of language acquisition
Authors: Fazekas Judit , Jessop Andrew , Pine Julian , Rowland Caroline
Published: November 2020

Error-based theories of language acquisition suggest that children, like adults, continuously make and evaluate predictions in order to reach an adult-like state of language use. However, while these theories have become extremely influential, their central claim—that unpredictable input leads to higher rates of lasting change in linguistic representations—has scarcely been tested. We designed a prime surprisal-based intervention study to assess this claim. As predicted, both 5- to 6-year-old children (
n
= 72) and adults (
n
= 72) showed a pre- to post-test shift towards producing the dative syntactic structure they were exposed to in surprising sentences. The effect was significant in both age groups together, and in the child group separately when participants with ceiling performance in the pre-test were excluded. Secondary predictions were not upheld: we found no verb-based learning effects and there was only reliable evidence for immediate prime surprisal effects in the adult, but not in the child group. To our knowledge, this is the first published study demonstrating enhanced learning rates for the same syntactic structure when it appeared in surprising as opposed to predictable contexts, thus providing crucial support for error-based theories of language acquisition.
Spatio-temporal development of cuticular ridges on leaf surfaces ofHevea brasiliensisalters insect attachment
Authors: Surapaneni Venkata A. , Bold Georg , Speck Thomas , Thielen Marc
Published: November 2020

Cuticular ridges on plant surfaces can control insect adhesion and wetting behaviour and might also offer stability to underlying cells during growth. The growth of the plant cuticle and its underlying cells possibly results in changes in the morphology of cuticular ridges and may also affect their function. We present spatial and temporal patterns in cuticular ridge development on the leaf surfaces of the model plant,Hevea brasiliensis. We have identified, by confocal laser scanning microscopy of polymer leaf replicas, an acropetally directed progression of ridges during the ontogeny ofHevea brasiliensisleaf surfaces. The use of Colorado potato beetles(Leptinotarsa decemlineata)as a model insect species has shown that the changing dimensions of cuticular ridges on plant leaves during ontogeny have a significant impact on insect traction forces and act as an effective indirect defence mechanism. The traction forces of walking insects are significantly lower on mature leaf surfaces compared with young leaf surfaces. The measured walking traction forces exhibit a strong negative correlation with the dimensions of the cuticular ridges.
Homing behaviour by destructive crown-of-thorns starfish is triggered by local availability of coral prey
Authors: Ling S. D. , Cowan Z.-L. , Boada J. , Flukes E. B. , Pratchett M. S.
Published: November 2020

Corallivorous crown-of-thorns starfishes (
Acanthaster
spp.) can decimate coral assemblages on Indo-Pacific coral reefs during population outbreaks. While initial drivers of population irruptions leading to outbreaks remain largely unknown, subsequent dispersal of outbreaks appears coincident with depletion of coral prey. Here, we used
in situ
time-lapse photography to characterize movement of the Pacific crown-of-thorns starfish (
Acanthaster
cf.
solaris
) in the northern and southern Great Barrier Reef in 2015, during the fourth recorded population outbreak of the starfish, but prior to widespread coral bleaching. Daily tracking of 58 individuals over a total of 1117 h revealed all starfish to move a minimum of 0.52 m, with around half of all tracked starfish showing negligible daily displacement (less than 1 m day
−1
), ranging up to a maximum of 19 m day
−1
. Movement was primarily nocturnal and daily displacement varied spatially with variation in local availability of
Acropora
spp., which is the preferred coral prey. Two distinct behavioural modes emerged: (i) homing movement, whereby tracked paths (as tested against a random-walk-model) involved short displacement distances following distinct ‘outward' movement to
Acropora
prey (typically displaying ‘feeding scars') and ‘homebound' movement to nearby shelter; versus (ii) roaming movement, whereby individuals showed directional movement beyond initial tracking positions without return. Logistic modelling revealed more than half of all tracked starfish demonstrated homing when local abundance (percentage cover) of preferred
Acropora
coral prey was greater than 33%. Our results reveal facultative homing by
Acanthaster
with the prey-dependent behavioural switch to roaming forays providing a mechanism explaining localized aggregations and diffusion of these population irruptions as prey is locally depleted.
Containing pandemics through targeted testing of households
Authors: Voigt André , Martyushenko Nikolay , Karlsen Emil , Hall Martina , Nyhamar Kristen , Omholt Stig William , Almaas Eivind
Published: November 2020

While invasive social distancing measures have proven efficient to control the spread of pandemics in the absence of a vaccine, they carry vast societal costs. Guided by the finding that large households function as hubs for the propagation of COVID-19, we developed a data-driven individual-based epidemiological network-model to assess the intervention efficiency of targeted testing of larger households. For an outbreak with reproductive number R = 1.5, we find that weekly testing of just the 15% largest households is capable of forcing R below unity. For the case of R = 1.2, our results suggest that the same testing regime with the largest 20% of households in an urban area is as effective as imposing strict lockdown measures and will curb the outbreak in a few weeks. Pooled household testing appears to be a powerful alternative to more invasive measures as a localized early response to contain epidemic outbreaks.
The relationship between anxiety, health, and potential stressors among adults in the United States during the COVID-19 pandemic
Authors: Parcesepe Angela M , Robertson McKaylee , Berry Amanda , Maroko Andrew , Zimba Rebecca , Grov Christian , Westmoreland Drew , Kulkarni Sarah , Rane Madhura , Salgado-You William , Mirzayi Chloe , Waldron Levi , Nash Denis
Published: November 2020

Objective

To estimate the prevalence of anxiety symptoms and the association between moderate or severe anxiety symptoms and health and potential stressors among adults in the U.S. during the COVID-19 pandemic

Methods

This analysis includes data from 5,250 adults in the Communities, Households and SARS/CoV-2 Epidemiology (CHASING) COVID Cohort Study surveyed in April 2020. Poisson models were used to estimate the association between moderate or severe anxiety symptoms and health and potential stressors among U.S. adults during the COVID-19 pandemic.

Results

Greater than one-third (35%) of participants reported moderate or severe anxiety symptoms. Having lost income due to COVID-19 (adjusted prevalence ratio [aPR] 1.27 (95% CI 1.16, 1.30), having recent COVID-like symptoms (aPR 1.17 (95% CI 1.05, 1,31), and having been previously diagnosed with depression (aPR 1.49, (95% CI 1.35, 1.64) were positively associated with anxiety symptoms.

Conclusions

Anxiety symptoms were common among adults in the U.S. during the COVID-19 pandemic. Strategies to screen and treat individuals at increased risk of anxiety, such as individuals experiencing financial hardship and individuals with prior diagnoses of depression, should be developed and implemented.
A Cascade of Care for Alcohol Use Disorder: Using 2015-2018 National Survey on Drug Use and Health Data to Identify Gaps in Care
Authors: Mintz Carrie M. , Hartz Sarah M. , Fisher Sherri L. , Ramsey Alex T. , Geng Elvin H. , Grucza Richard A. , Bierut Laura J.
Published: November 2020

Background

Although effective treatments exist, alcohol use disorder (AUD) is undertreated. We used a cascade of care framework to understand gaps in care between diagnosis and treatment for persons with AUD.

Methods

Using 2015-2018 National Survey on Drug Use and Health data, we evaluated the following steps in the cascade of care: 1) prevalence of adults with AUD; 2) proportion of adults who utilized health care in the past 12 months; 3) were screened about alcohol use; 4) received a brief intervention about alcohol misuse; 5) received information about treatment for alcohol misuse; and 6) proportion of persons with AUD who received treatment. Analyses were stratified by AUD severity.

Results

Of the 171,766 persons included in the sample, weighted prevalence of AUD was 7.9% (95% CI 7.7-8.0%). Persons with AUD utilized health care settings at similar rates as those without AUD. Cascades of care showed the majority of individuals with AUD utilized health care and were screened about alcohol use, but the percent who received the subsequent steps of care decreased substantially. For those with severe AUD, 83.5% (CI: 78.3%-88.7%) utilized health care in the past 12 months, 73.5% (CI: 68.1%-78.9%) were screened for alcohol use, 22.7% (CI: 19.4%-26.0%) received a brief intervention, 12.4% (CI: 10%-14.7%) received information about treatment, and 20.5% (CI: 18%-23.1%) were treated for AUD. The greatest decrease in the care continuum occurred from screening to brief intervention and referral to treatment. More persons with severe AUD received treatment than were referred, indicating other pathways to treatment outside of the healthcare system.

Conclusions

Persons with AUD utilize health care at high rates and are frequently screened about alcohol use, but few receive treatment. Health care settings-particularly primary care settings-represent a prime opportunity to implement pharmacologic treatment for AUD to improve outcomes in this high-risk population.
A New Approach to the Dynamic Modeling of an Infectious Disease
Authors: Shayak B , Sharma Mohit M
Published: November 2020

In this work we propose a delay differential equation as a lumped parameter or compartmental infectious disease model featuring high descriptive and predictive capability, extremely high adaptability and low computational requirement. Whereas the model has been developed in the context of COVID-19, it is general enough to be applicable mutatis mutandis to other diseases as well. Our fundamental modeling philosophy consists of a decoupling of public health intervention effects, immune response effects and intrinsic infection properties into separate terms. All parameters in the model are directly related to the disease and its management; we can measure or calculate their values a priori basis our knowledge of the phenomena involved, instead of having to extrapolate them from solution curves. Our model can accurately predict the effects of applying or withdrawing interventions, individually or in combination, and can quickly accommodate any newly released information regarding, for example, the infection properties and the immune response to an emerging infectious disease. After demonstrating that the baseline model can successfully explain the COVID-19 case trajectories observed all over the world, we systematically show how the model can be expanded to account for heterogeneous transmissibility, detailed contact tracing drives, mass testing endeavours and immune responses featuring different combinations of limited-time sterilizing immunity, severity-reducing immunity and antibody dependent enhancement.
Modeling-based UV-C decontamination of N95 masks optimized to avoid undertreatment
Authors: Sears Adam P. , Ohayon Jacques , Shutov Anton D. , Pettigrew Roderic I.
Published: November 2020

As the Coronavirus 2019 pandemic creates worldwide shortages of personal protective equipment, hospitals have increasingly turned to sterilization and re-use protocols, often without significant data supporting the specific methodologies. When using UV-C irradiation, previously shown to be effective for decontaminating hard surfaces, modeling shows the importance of accounting for the porosity and non-uniform curvature of the N95 masks in decontamination procedures. Data shows a standard incident dose of 1 J/cm2 delivered to both front and back surfaces is more than 500x higher than the known kill dose. However, modeling indicates this would undertreat 40% of the mask material due to the curvature, path-length attenuation and scatter. Multidirectional UV-C irradiation employing dose calibrated exposures can adjust for this loss and best decontaminate masks. Such protocols can be rapidly implemented in thousands of hospitals across the world equipped with UV-C irradiation lamps without the need for additional capital equipment purchases.
Literature study on the return on investment concerning the implementation of a computerized clinical decision support in a hospital information system
Authors: Kuotu Gérard Christian , Moukam Lower Bride Barth
Published: November 2020

Background

The objective of this study was to carry out a bibliographic study on the return on investment concerning the implementation of a computerized clinical decision support in a hospital information system.

Methods

A bibliographic search was carried out using the PubMed and Google Scholar bibliographic databases. The articles obtained were selected by combining the elements: outlook, net benefits, comparability, types of costs, discount rate, sensitivity analyzes, and measurement of effectiveness. This enabled us to review 498 articles published during our study period, of which 56 were selected.

Results

The most commonly available tools are return on investment estimation methods. The data in the literature on the return on investment concerning the implementation of clinical decision support, although documented, are quite mixed.

Conclusion

Evaluations such as the econometric approach can be considered to determine if these investments are justified.
Investigating the effects of absolute humidity and human encounters on transmission of COVID-19 in the United States
Authors: Lin Gary , Hamilton Alisa , Gatalo Oliver , Haghpanah Fardad , Igusa Takeru , Klein Eili ,   For the CDC MInD-Healthcare Network
Published: November 2020

Background

Mounting evidence suggests that the primary mode of transmission of SARS-CoV-2 is aerosolized transmission from close contact with infected individuals. Even though transmission is a direct result of human encounters, environmental conditions, such as lower humidity, may enhance aerosolized transmission risks similar to other respiratory viruses such as influenza.

Methods

We utilized dynamic time warping to cluster all 3,137 counties in the United States based on temporal data on absolute humidity from March 10 to September 29, 2020. We then used a multivariate generalized additive model (GAM) combining data on human mobility derived from mobile phone data with humidity data to identify the potential effect of absolute humidity and mobility on new daily cases of COVID-19 while considering the temporal differences between seasons.

Results

The clustering analysis found ten groups of counties with similar humidity levels. We found a significant negative effect between increasing humidity and new cases of COVID-19 in most regions, particularly in the period from March to July. The effect was greater in regions with generally lower humidity in the Western, Midwest, and Northeast regions of the US. In the two regions with the largest effect, a 1 g/m3 increase of absolute humidity resulted in a 0.21 and 0.15 decrease in cases. The effect of mobility on cases was positive and significant across all regions in the July-Sept time period, though the relationship in some regions was more mixed in the March to June period.

Conclusions

We found that increasing humidity played an important role in falling cases in the spring, while increasing mobility in the summer contributed more significantly to increases in the summer. Our findings suggest that, similar to other respiratory viruses, the decreasing humidity in the winter is likely to lead to an increase in COVID-19 cases. Furthermore, the fact that mobility data were positively correlated suggests that efforts to counteract the rise in cases due to falling humidity can be effective in limiting the burden of the pandemic.
SARS-CoV-2 Infection Hospitalization Rate and Infection Fatality Rate among the Non-Congregant Population in Connecticut
Authors: Mahajan Shiwani , Caraballo César , Li Shu-Xia , Dong Claire , Chen Lian , Huston Sara K. , Srinivasan Rajesh , Redlich Carrie A. , Ko Albert I. , Faust Jeremy S. , Forman Howard P. , Krumholz Harlan M.
Published: November 2020

Importance

COVID-19 case fatality and hospitalization rates, calculated using the number of confirmed cases of COVID-19, have been described widely in the literature. However, the number of infections confirmed by testing underestimates the total infections as it is biased based on the availability of testing and because asymptomatic individuals may remain untested. The infection fatality rate (IFR) and infection hospitalization rate (IHR), calculated using the estimated total infections based on a representative sample of a population, is a better metric to assess the actual toll of the disease.

Objective

To determine the IHR and IFR for COVID-19 using the statewide SARS-CoV-2 seroprevalence estimates for the non-congregate population in Connecticut.

Design

Cross-sectional.

Setting

Adults residing in a non-congregate setting in Connecticut between March 1 and June 1, 2020.

Participants

Individuals aged 18 years or above.

Exposure

Estimated number of adults with SARS-CoV-2 antibodies.

Main Outcome and Measures

COVID-19-related hospitalizations and deaths among adults residing in a non-congregate setting in Connecticut between March 1 and June 1, 2020.

Results

Of the 2.8 million individuals residing in the non-congregate settings in Connecticut through June 2020, 113,515 (90% CI 56,758–170,273) individuals had SARS-CoV-2 antibodies. There were a total of 9425 COVID-19-related hospitalizations and 4071 COVID-19-related deaths in Connecticut between March 1 and June 1, 2020, of which 7792 hospitalizations and 1079 deaths occurred among the non-congregate population. The overall COVID-19 IHR and IFR was 6.86% (90% CI, 4.58%–13.72%) and 0.95% (90% CI, 0.63%–1.90%) among the non-congregate population. Older individuals, men, non-Hispanic Black individuals and those belonging to New Haven and Litchfield counties had a higher burden of hospitalization and deaths, compared with younger individuals, women, non-Hispanic White or Hispanic individuals, and those belonging to New London county, respectively.

Conclusion and Relevance

Using representative seroprevalence estimates, the overall COVID-19 IHR and IFR were estimated to be 6.86% and 0.95% among the non-congregate population in Connecticut. Accurate estimation of IHR and IFR among community residents is important to guide public health strategies during an infectious disease outbreak.
Mapping the human helminthiases: a systematic review of geospatial tools in medical parasitology
Authors: Schluth Catherine G. , Standley Claire J. , Bansal Shweta , Carlson Colin J.
Published: November 2020

Helminthiases are a class of neglected tropical diseases that affect at least one billion people worldwide, with a disproportionate impact in resource-poor areas with limited disease surveillance. Geospatial methods can offer valuable insights into the burden of these infections, particularly given that many are subject to strong ecological influences on the environmental, vector-borne, or zoonotic stages of their life cycle. In this study, we screened 6,829 abstracts and analyzed 485 studies that use maps to document, infer, or predict transmission patterns for over 200 species of parasitic worm. We found that quantitative mapping methods are increasingly used in medical parasitology, drawing on One Health surveillance data from the community scale to model geographic distributions and burdens up to the regional or global scale. However, we found that the vast majority of the human helminthiases may be entirely unmapped, with research effort focused disproportionately on a half-dozen infections that are targeted by mass drug administration programs. Entire regions were also surprisingly under-represented in the literature, particularly southern Asia and the Neotropics. We conclude by proposing a shortlist of possible priorities for future research, including several neglected helminthiases with a burden that may be substantially underestimated.
Personalized Prescription of ACEI/ARBs for Hypertensive COVID-19 Patients
Authors: Bertsimas Dimitris , Borenstein Alison , Mingardi Luca , Nohadani Omid , Orfanoudaki Agni , Stellato Bartolomeo , Wiberg Holly , Sarin Pankaj , Varelmann Dirk J. , Estrada Vicente , Macaya Carlos , Núñez Gil Iván J.
Published: November 2020

The COVID-19 pandemic has prompted an international effort to develop and repurpose medications and procedures to effectively combat the disease. Several groups have focused on the potential treatment utility of angiotensin-converting–enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) for hypertensive COVID-19 patients, with inconclusive evidence thus far. We couple electronic medical record (EMR) and registry data of 3,643 patients from Spain, Italy, Germany, Ecuador, and the US with a machine learning framework to personalize the prescription of ACEIs and ARBs to hypertensive COVID-19 patients. Our approach leverages clinical and demographic information to identify hospitalized individuals whose probability of mortality or morbidity can decrease by prescribing this class of drugs. In particular, the algorithm proposes increasing ACEI/ARBs prescriptions for patients with cardiovascular disease and decreasing prescriptions for those with low oxygen saturation at admission. We show that personalized recommendations can improve patient outcomes by 1.0% compared to the standard of care when applied to external populations. We develop an interactive interface for our algorithm, providing physicians with an actionable tool to easily assess treatment alternatives and inform clinical decisions. This work offers the first personalized recommendation system to accurately evaluate the efficacy and risks of prescribing ACEIs and ARBs to hypertensive COVID-19 patients.

Highlights

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This paper introduces a data-driven approach for personalizing the prescription of ACE inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) for hypertensive COVID-19 patients.

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Leveraging an international cohort of more than 3,500 patients, we identify clinical and demographic characteristics that may affect the effectiveness of ACEIs/ARBs for COVID-19 patients, such as low oxygen saturation at admission.

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We developed a user-friendly online application that is available to physicians to facilitate interpretation and communication of the results of the algorithm.
Concentration of the cellular material in the nasopharyngeal swabs increases the clinical sensitivity of SARS-CoV2 RT-PCR
Authors: Kannian Priya , Mahanathi Pasuvaraj , Ashwini Veeraraghavan
Published: November 2020

Severe acute respiratory syndrome - coronavirus 2 (SARS-CoV2) is detected by a highly sensitive molecular method, reverse transcriptase-polymerase chain reaction (RT-PCR) from nasopharyngeal swab (NPS) samples collected in 2-3ml of viral transport medium (VTM). Unlike body fluids, NPS samples are undermined by high variability in the amount of cells that get suspended into the VTM. Hence, the cell density used for RNA extraction becomes an important analytical variable that contributes to the overall sensitivity of the RT-PCR. In this study, we compared the sensitivity of SARS-CoV2 RT-PCR in 50 NPS samples collected from in-patients of the COVID wards using the concentration and direct methods. The concentration method detected the viral RNA in all 50 samples, while the direct method was positive in only 41 (82%) samples (p=0.003). Additionally, the Ct values were lower in the direct method compared to concentration method among the 41 positive samples (p=0.03 for N gene and p=0.04 for RdRp gene). The mean CV% was also ≥10%. Thus, the concentration of the cells prior to RNA extraction drastically improves the sensitivity of detection of SARS-CoV2 in NPS samples.