bluuebunny/crossref_metadata_2025 huggingface dataset:
Results and Impact of Intensive SARS-CoV-2 Testing in a High Volume, Outpatient Radiation Oncology Clinic in a Pandemic Hotspot
Authors: McBride Sean M , Bundick Kimberly , Hubbeling Harper , Freret Morgan , Modlin Leslie A , Kamboj Mini , Cahlon Oren , Gomez Daniel R
Published: August 2020

Background

In an attempt to reduce interruptions in radiation treatment, our department implemented universal SARS-CoV-2 PCR testing during the peak of the New York City COVID-19 epidemic.

Methods

Starting 4/18/20, outpatients coming into the Department of Radiation Oncology for either simulation or brachytherapy were required to undergo PCR testing for SARS-CoV-2. Starting on 5/6/20, patients were offered simultaneous SARS CoV-2 IgG antibody testing.

Results

Between 4/18/20-6/25/20, 1360 patients underwent 1,401 outpatient screening visits (Table 1). Of the patients screened, 411 were screened between 4/18/20 and 5/6/20 (Phase 1) with PCR testing: 13 (3.1%) patients were PCR positive. From 5/7/20 to 6/25/20, 990 patients were scheduled for both PCR and antibody testing (Phase 2), including 41 previously screened in Phase 1. Of those with known antibody status (n=952), 5.5% were seropositive. After 5/21/20, no screened patient (n=605) tested PCR positive. In the month prior to screening (3/17/20-4/19/20), 24 of 625 patients initiating external radiation had treatment interrupted due to COVID-19 infection (3.8%) vs 7 of 600 patients (1.1%) in the month post screening (4/20/20-5/24/20) (p=0.002).

Conclusions

State-wide mitigation efforts, coupled with intensive departmental screening, helped prevent interruptions in radiation during the COVID-19 epidemic that could have compromised treatment efficacy.
Social Network Analysis of COVID-19 Transmission in Karnataka, India
Authors: Saraswathi S. , Mukhopadhyay A. , Shah H. , Ranganath T.S.
Published: August 2020

We used social network analysis (SNA) to study the novel coronavirus (COVID-19) outbreak in Karnataka, India, and assess the potential of SNA as a tool for outbreak monitoring and control. We analyzed contact tracing data of 1147 Covid-19 positive cases (mean age 34.91 years, 61.99% aged 11–40, 742 males), anonymized and made public by the government. We used software tools Cytoscape and Gephi to create SNA graphics and determine network attributes of nodes (cases) and edges (directed links, determined by contact tracing, from source to target patients). Outdegree was 1–47 for 199 (17.35%) nodes, and betweenness 0.5–87 for 89 (7.76%) nodes. Men had higher mean outdegree and women, higher betweenness. Delhi was the exogenous source of 17.44% cases. Bangalore city had the highest caseload in the state (229, 20%), but comparatively low cluster formation. Thirty-four (2.96%) “super-spreaders” (outdegree≥5) caused 60% of the transmissions. Real-time social network visualization can allow healthcare administrators to flag evolving hotspots and pinpoint key actors in transmission. Prioritizing these areas and individuals for rigorous containment could help minimize resource outlay and potentially achieve a significant reduction in COVID-19 transmission.
Progressive changes in glutamate concentration in early stages of schizophrenia: A longitudinal 7-Tesla MRS study
Authors: Jeon Peter , Limongi Roberto , Ford Sabrina , Mackinley Michael , Dempster Kara , Théberge Jean , Palaniyappan Lena
Published: August 2020

Progressive reduction in glutamatergic transmission has been proposed as an important component of the illness trajectory of schizophrenia. Despite its popularity, to date, this notion has not been convincingly tested in patients in early stages schizophrenia. In a longitudinal 7T magnetic resonance spectroscopy (1H-MRS), we quantified glutamate at the dorsal anterior cingulate cortex in 21 participants with a median lifetime antipsychotic exposure of less than 3 days and followed them up after 6 months of treatment. Healthy controls were also scanned at two time points. While patients had significantly lower overall glutamate levels than healthy controls (F(1,27) = 5.23, p = 0.03), we did not observe a progressive change of glutamate concentration in patients (F(1,18) = 0.47, p = 0.50), and the group by time interaction was not significant (F(1,27) = 0.86, p = 0.36). On average, patients with early psychosis receiving treatment showed a 0.02 mM/year increase, while healthy controls showed a 0.06 mM/year reduction of MRS glutamate levels. Bayesian analysis of our observations does not support early, post-onset glutamate loss in schizophrenia. Interestingly, it provides evidence in favour of a lack of progressive glutamate change in our schizophrenia sample – indicating that the glutamatergic level at the onset of illness was the best predictor of the levels 6 months after treatment. A more nuanced view of glutamatergic physiology, linked to early cortical maturation, may be required to understand glutamatergic dynamics in schizophrenia.
The use of an Artificial Neural Network (ANN) in the evaluation of the Extracorporeal Shockwave Lithotripsy (ESWL) as a treatment of choise for urinary lithiasis
Authors: Athanasios Tsitsiflis , Yiannis Kiouvrekis , Georgios Chasiotis , Georgios Perifanos , Stavros Gravas , Ioannis Stefanidis , Vasilios Tzortzis , Anastasios Karatzas
Published: August 2020

Purpose

Artificial Neural Networks (ANNs) are simplified computational models simulating the central nervous system. They are widely applied in medicine, since they substantially increase the sensitivity and specificity of the diagnosis, classification and the prognosis of a medical condition. In this study we constructed an artificial neural network to evaluate several parameters of extracorporeal shockwave lithotripsy (ESWL), such as the outcome and safety of the procedure.

Materials and methods

Patients with urinary lithiasis suitable for ESWL treatment were enrolled. An artificial neural network (ANN) was designed and a unique algorithm was executed with the use of the well-known numerical computing environment, MATLAB. Medical data were collected from all patients and 12 nodes were used as inputs (sex, age, B.M.I. (Body Mass Index), stone location, stone size, comorbidity, previous ESWL sessions, analgesia, number of shockwaves, shockwave intensity, presence of a ureteral stent and hydronephrosis). Conventional statistical analysis was also performed.

Results

716 patients were finally included in our study. Univariate analysis revealed that diabetes and hydronephrosis were positively correlated to the ESWL complications. Regarding efficacy, univariate analysis revealed that stone location, stone size, the number and density of shockwaves delivered and the presence of a stent in the ureter were independent factors of the ESWL outcome. This was further confirmed when adjusted for sex and age in a multivariate analysis.The performance of the ANN (predictive/real values) at the end of the training state reached 98,72%. The four basic ratios (sensitivity, specificity, PPV, NPV) were calculated for both training and evaluation data sets. The performance of the ANN at the end of the evaluation state was 81,43%.

Conclusions

Our ANN achieved high score in predicting the outcome and the side effects of the extracorporeal shockwave lithotripsy treatment for urinary stones. In fact, the accuracy of the network may further improve by using larger sets of data, different architecture in designing the model or using different set of input variables, making ANNs thus, a quite promising instrument for effective, precise and swift medical diagnosis.
Water, Sanitation, Hygiene and Covid-19 pandemic: a global socioeconomic analysis
Authors: Roy Ajishnu , Basu Aman , Pramanick Kousik
Published: August 2020

Socioeconomic achievement of WASH (access to safe water, sanitation and hygiene) services are being acknowledged as anticipatory actors, indispensable in safeguarding health during this Covid-19 pandemic. However, on a global scale, it is currently not clear whether deprivation or non-obtainability of which of the various WASH services are closely related to Covid-19 dynamics and up to which degree. We have analysed data (March - June 2020) related to five Covid-19 indicators for most of the countries in the world with indicators of safe water, sanitation and hygiene to understand this. We have found a strong positive correlation between lesser effects of Covid-19 and better access to safe water, sanitation as well as hygiene throughout this time for most of the indicators. However, some indicators show the opposite nature of the relationship, for which we have given probable explanation accordingly. The hypothesis of an inversely proportional association between Covid-19 and poor WASH facilities on a global scale is confirmed in this study. We propose that this study should be perceived as an expanded comprehensive view on the complexities of WaSH-Covid19 interrelationships, which could help to shape an agenda for research into some unanswered questions.

Highlights

WASH indicators are highly correlated to cumulative indicators of Covid-19.

Trends of this correlation have been changing from March-June, 2020.

Income groups and geographic locations have no distinguishing effects on countries.

Better WASH performance does not always correlate against Covid-19.
Does mother’s pregnancy intention affect child healthcare and growth in India? Evidence from a longitudinal survey
Authors: Chowdhury Poulomi , Garg Mausam Kumar , Sk Md Illias Kanchan
Published: August 2020

Objective

To assess the effect of unintended births on children’s health care and nutritional status.

Design

The study uses cross-sectional prospective design.

Setting

The nationally representative Indian Human Development Survey (IHDS) data of two rounds (i.e. 2004-5, 2011-12) was used in this study. The women data was used to draw representative sample of 7,166, and out of them 3,905 belong to under 5 years of age group.

Statistical Analyses

Secondary analysis, using bivariate and multivariate linear and logistic models was conducted using both rounds of IHDS data. We categorized birth as an unintended birth if mother did not want to have addition child at IHDS-I but gave birth during inter-survey. Furthermore, all births exceeding to the desired number of children reported by mothers in the IHDS-II were also included in unintended births and all other births were considered as intended births. Multivariate logistic regression models were applied to analyse the effect of unintended and intended births on child-immunization and exclusive breastfeeding. While multivariate linear regression models were used to assess the effect of childbearing intention on child nutritional status.

Results

The study shows that by controlling other factors, unintended births were less likely to be exclusively breastfed (OR 0.885, p<0.05) and receive full immunization (OR 0.830, p<0.001). Moreover, children’s poor nutrition was more prevalent among unintended births as they were more likely to be stunting and underweight.

Conclusions

The findings of the study underscore the importance of investments in family planning to reduce the unintended births to improve children’s health and growth.

Strengths and limitations of the study

The findings of this study are from nationally representative sample of 3,905 belong to under 5 years of age group.

Other child development indicators namely cognitive skills and academic performance are not included in this study.

The seven years of duration between the survey period could have changed women’s childbearing intention.
ASSOCIATION BETWEEN ETHNICITY AND SEVERE COVID-19 DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Raharja Antony , Tamara Alice , Kok Li Teng
Published: August 2020

Background

Multiple reports suggest a disproportionate impact of Covid-19 on ethnic minorities. Whether ethnicity is an independent risk factor for severe Covid-19 disease is unclear.

Purpose

Review the association between ethnicity and poor outcomes including all-cause mortality, hospitalisation, critical care admission, respiratory and kidney failure.

Data Sources

MEDLINE, EMBASE, Cochrane COVID-19 Study Register, WHO COVID-19 Global Research Database up to 15/06/2020, and preprint servers. No language restriction.

Study Selection

All studies providing ethnicity-aggregated data on the pre-specified outcomes, except case reports or interventional trials.

Data Extraction

Pairs of investigators independently extracted data, assessed risk of bias using Newcastle-Ottawa scale (NOS), and rated certainty of evidence following GRADE framework.

Data Synthesis

Seventy-two articles (59 cohort studies with 17,950,989 participants; 13 ecological studies; 54 US-based and 15 UK-based; 41 peer-reviewed) were included for systematic review and 45 for meta-analyses. Risk of bias was low, with median NOS 7 of 9 (interquartile range 6-8). In the unadjusted analyses, compared to white ethnicity, all-cause mortality risk was similar in Black (RR:0.96 [95%CI: 0.83-1.08]), Asian (RR:0.99 [0.85-1.16]) but reduced in Hispanic ethnicity (RR:0.69 [0.57-0.84]). Age and sex-adjusted-risks were significantly elevated for Black (HR:1.38 [1.09-1.75]) and Asian (HR:1.42 [1.15-1.75]), but not for Hispanic (RR:1.14 [0.93-1.40]). Further adjusting for comorbidities attenuated these association to non-significance; Black (HR:0.95 [0.72-1.25]); Asian (HR:1.17 [0.84-1.63]); Hispanic (HR:0.94 [0.63-1.44]). Similar results were observed for other outcomes. In subgroup analysis, there was a trend towards greater disparity in outcomes for UK ethnic minorities, especially hospitalisation risk.

Limitations

Paucity of evidence on native ethnic groups, and studies outside the US and UK.

Conclusions

Currently available evidence cannot confirm ethnicity as an independent risk factor for severe Covid-19 illness, but indicates that disparity may be partially attributed to greater burden of comorbidities.

Registration

PROSPERO, CRD42020188421

Funding source

none
Universal screening for SARS-CoV-2 infection among pregnant women at Elmhurst Hospital Center, Queens, New York
Authors: Maru Sheela , Patil Uday , Carroll-Bennett Rachel , Baum Aaron , Bohn-Hemmerdinger Tracy , Ditchik Andrew , Scanlon Michael L , Krishnan Parvathy , Bogaert Kelly , Woodbury Carson , Maru Duncan , Noble Lawrence , Wasserman Randi , Brown Barry , Vreeman Rachel , Masci Joseph
Published: August 2020

Background

Universal screening for SARS-CoV-2 infection on Labor and Delivery (L&D) units is a critical strategy to manage patient and health worker safety, especially in a vulnerable high-prevalence community. We describe the results of a SARS-CoV-2 universal screening program at the L&D Unit at Elmhurst Hospital in Queens, NY, a 545-bed public hospital serving a diverse, largely immigrant and low-income patient population and an epicenter of the global pandemic.

Methods and findings

We conducted a retrospective cross-sectional study. All pregnant women admitted to the L&D Unit of Elmhurst Hospital from March 29, 2020 to April 22, 2020 were included for analysis. The primary outcomes of the study were: (1) SARS-CoV-2 positivity among universally screened pregnant women, stratified by demographic characteristics, maternal comorbidities, and delivery outcomes; and (2) Symptomatic or asymptomatic presentation at the time of testing among SARS-CoV-2 positive women.

A total of 126 obstetric patients were screened for SARS-CoV-2 between March 29 and April 22. Of these, 37% were positive. Of the women who tested positive, 72% were asymptomatic at the time of testing. Patients who tested positive for SARS-CoV-2 were more likely to be of Hispanic ethnicity (unadjusted difference 24.4 percentage points, CI 7.9, 41.0) and report their primary language as Spanish (unadjusted difference 32.9 percentage points, CI 15.8, 49.9) than patients who tested negative.

Conclusions

In this retrospective cross-sectional study of data from a universal SARS-Cov-2 screening program implemented in the L&D unit of a safety-net hospital in Queens, New York, we found over one-third of pregnant women testing positive, the majority of those asymptomatic. The rationale for universal screening at the L&D Unit at Elmhurst Hospital was to ensure safety of patients and staff during an acute surge in SARS-Cov-2 infections through appropriate identification and isolation of pregnant women with positive test results. Women were roomed by their SARS-CoV-2 status given increasing space limitations. In addition, postpartum counseling was tailored to infection status. We quickly established discharge counseling and follow-up protocols tailored to their specific social needs. The experience at Elmhurst Hospital is instructive for other L&D units serving vulnerable populations and for pandemic preparedness.
Testing Healthcare Workers Exposed to COVID19 using Rapid Antigen Detection
Authors: Herrera Victor , Hsu Vincent , Adewale Ademola , Johnson Lee , Hendrix Timothy , Kuhlman Jeffrey , Finkler Neil
Published: August 2020

There is a need to develop safe and cost-effective ways to test healthcare workers for COVID19. Here we describe a rapid antigen testing strategy in a cohort of 497 Healthcare workers exposed to SARS-CoV-2 that can be applied by systems facing a surge of COVID19 cases, increased number of exposures in their workforce and limited RT-PCR availability. Our findings support an expanded use for antigen testing beyond its current indication and highlights the importance of further evaluating this modality for the diagnosis of COVID19 on asymptomatic individuals.
Inherited extremes of aortic diameter confer risk for a specific class of congenital heart disease
Authors: Tcheandjieu Catherine , Zanetti Daniela , Yu Mengyao , Priest James R.
Published: August 2020

Population based studies demonstrate strong familial recurrence of cardiac malformations particularly for individuals affected with a specific class of CHD, left-ventricular outflow tract (LVOT) obstruction. Recently we linked 99 lead variants across 71 loci to diameter of the ascending aorta derived from MRI measurements across multiple ethnicities in the UK Biobank. Using these data we created a polygenic risk score capturing ascending aortic diameter (PRSAoD) Among 2,594 individuals with CHD; a decrease by one standard deviation in PRSAoD was associated with an increased risk of congenital LVOT (OR=1.14[1.03-1.26], p=0.014) but not with other subtypes of CHD. Using Mendelian Randomization we observed strong evidence of a causal effect where inheritance of a smaller diameter of the ascending aorta corresponded to an increase in risk for congenital LVOT (p_IVW = 0.008). Our data may suggest that genetic determinants of a smaller ascending aorta act during early development to disturb blood flow through left-sided structures to increasing the risk of LVOT CHD, which is consistent with experimental evidence and the “no flow, no grow” paradigm in the formation of the left ventricular outflow tract.
Epidemics forecast from SIR-modeling, verification and calculated effects of lockdown and lifting of interventions
Authors: Schlickeiser R. , Kröger M.
Published: August 2020

Due to the current COVID-19 epidemic plague hitting the worldwide population it is of utmost medical, economical and societal interest to gain reliable predictions on the temporal evolution of the spreading of the infectious diseases in human populations. Of particular interest are the daily rates and cumulative number of new infections, as they are monitored in infected societies, and the influence of non-pharmaceutical interventions due to different lockdown measures as well as their subsequent lifting on these infections. Estimating quantitatively the influence of a later lifting of the interventions on the resulting increase in the case numbers is important to discriminate this increase from the onset of a second wave. The recently discovered new analytical solutions of Susceptible-Infectious-Recovered (SIR) model allow for such forecast and the testing of lockdown and lifting interventions as they hold for arbitrary time dependence of the infection rate. Here we present simple analytical approximations for the rate and cumulative number of new infections.
Hospital preparedness in epidemics by using simulation. The case of COVID-19
Authors: Garcia-Vicuña Daniel , Esparza Laida , Mallor Fermin
Published: August 2020

This paper presents a discrete event simulation model to support the decision-making concerned with the short-term planning of the necessary hospital resources, especially Intensive Care Unit (ICU) beds, to face outbreaks, as the SARS-CoV-2. Being used as a short-term forecasting tool, the simulation model requires an accurate representation of the current system state and high fidelity in mimicking the system dynamics from that state. The two main components of the simulation model are the stochastic modeling of the admission of new patients and the patient flow through the hospital facilities. For the patient arrival process, we analyze different models based on growth curves of the twenty most affected countries (until June 15) and propose the use of the Gompertz curve. The length of stay is divided into several stages, each one modeled separately. We analyze the starting of the simulation model, which requires different procedures depending on the information available about the patients currently hospitalized. We also report the use of this simulation model during the COVID-19 outbreak in the Autonomous Community of Navarre, in Spain. Every day, the research team informed the regional logistic team in charge of planning the health resources, who programmed the ward and ICU beds based on the resulting predictions.
Analysing air particle quantity in a dental primary care setting
Authors: Bates A. J. , Bates D. R.
Published: August 2020

Objectives

This study was undertaken to assess the amount of dental aerosol created in a primary care dental surgery.

Methods

Two particle meters were placed a set distances round a volunteer patient whilst undergoing simulated dental treatment using a high speed dental handpiece, and 3-in-1 air/water syringe, moisture control was managed with high volume suction and a saliva ejector. Measurement were taken every thirty seconds with the surgery environment set a neutral ventilation and with the windows open plus fan assistance.

Results

From the cessation of aerosol generation it took between 6 and 19 minutes for the surgery to return to baseline. The ventilated surgery had faster aerosol dispersal, returning to background levels within 5 minutes.

Conclusion

It is concluded for the surgery under investigation the dental aerosol had dissipated after 30 minutes using HVS and optimal surgery.
Efficacy of Tocilizumab in Covid 19: A metanalysis of case series studies
Authors: Hussain Shalam Mohamed , Syeda Ayesha Farhana , Al-Wutayd Osama , Al Nafeesah Abdullah , Alshammari Mohammad , Alnasser Sulaiman , Krishnadas Nandakumar
Published: August 2020

Background

characteristic feature of COVID-19 during its progression in severity is the cytokine storm (via interleukin-6, IL-6) which is responsible for secondary acute respiratory distress syndrome (ARDS) [4]. Tocilizumab has an antagonist effect on the IL-6 receptor. With present review and metanalysis, we intend to update the current status on the clinical efficacy of tocilizumab in the treatment of Covid 19 infections in the published literature of case series.

MATERIALS AND METHODS

The following inclusion criteria were used: (i) case series studies (number of reported patients in each study equal to or greater than ten (ii) use of tocilizumab alone or in combination with standard of care therapy (iii) Covid 19 adult patients (iv) the studies with endpoints on all-cause mortality, need for mechanical ventilation, clinical improvements.

Data synthesis and statistical analysis

Meta-analysis was performed using a random effects model and the DerSimonian and Laird method.

RESULTS

18 were selected for the quantitative analysis (meta-analysis). 14 studies were retrospective and 4 were prospective

Meta-analysis

The mortality rate of COVID-19 patients with tocilizumab was 21% (251/1212) Asymmetric funnel plot in the cylindrical form due to publication bias

In conclusion

the present synthesis provide us useful insights with the other available evidence to refine our strategy and equip ourselves effectively with tocilizumab to defeat COVID 19 to save humanity.

Limitations

The included studies utilized varied doses of tocilizumab (single or double), and duration drug availability issues emerged in some centers, which may have influenced both sample sizes and study designs.

Clinical implications

Incorporated studies without control groups into systematic reviews and quantitative synthesis especially when there are no other studies to consider can provide information for formulating effective treatment strategies for management of COVID 19 infections through the use of tocilizumab.
Antibody prevalence for SARS-CoV-2 following the peak of the pandemic in England: REACT2 study in 100,000 adults
Authors: Ward Helen , Atchison Christina , Whitaker Matthew , Ainslie Kylie EC , Elliott Joshua , Okell Lucy , Redd Rozlyn , Ashby Deborah , Donnelly Christl A , Barclay Wendy , Darzi Ara , Cooke Graham , Riley Steven , Elliott Paul
Published: August 2020

Background

England, UK has experienced a large outbreak of SARS-CoV-2 infection. As in USA and elsewhere, disadvantaged communities have been disproportionately affected.

Methods

National REal-time Assessment of Community Transmission-2 (REACT-2) prevalence study using a self-administered lateral flow immunoassay (LFIA) test for IgG among a random population sample of 100,000 adults over 18 years in England, 20 June to 13 July 2020.

Results

Data were available for 109,076 participants, yielding 5,544 IgG positive results; adjusted (for test performance) and re-weighted (for sampling) prevalence was 6.0% (95% Cl: 5.8, 6.1). Highest prevalence was in London (13.0% [12.3, 13.6]), among people of Black or Asian (mainly South Asian) ethnicity (17.3% [15.8, 19.1] and 11.9% [11.0, 12.8] respectively) and those aged 18-24 years (7.9% [7.3, 8.5]). Adjusted odds ratio for care home workers with client-facing roles was 3.1 (2.5, 3.8) compared with non-essential workers. One third (32.2%, [31.0-33.4]) of antibody positive individuals reported no symptoms. Among symptomatic cases, most (78.8%) reported symptoms during the peak of the epidemic in England in March (31.3%) and April (47.5%) 2020. We estimate that 3.36 million (3.21, 3.51) people have been infected with SARS-CoV-2 in England to end June 2020, with an overall infection fatality ratio (IFR) of 0.90% (0.86, 0.94); age-specific IFR was similar among people of different ethnicities.

Conclusion

The SARS-CoV-2 pandemic in England disproportionately affected ethnic minority groups and health and care home workers. The higher risk of infection in minority ethnic groups may explain their increased risk of hospitalisation and mortality from COVID-19.
Models of Accommodation Deficiency in Presbyopia Patients
Authors: Karkhanis Mohit U. , Banerjee Aishwaryadev , Ghosh Chayanjit , Likhite Rugved , Meyer David , Mastrangelo Carlos H.
Published: August 2020

Structured Abstract

Purpose

We describe new phenomenological illumination-dependent static models of the accommodation deficiency for patients with presbyopia. Such models are suitable for vision restoration with adaptive-optics accommodating eyeglasses and contact lenses.

Methods

Data from fifteen participants over the age of 45 and diagnosed with presbyopia was collected. Participants were asked to wear a pair of mechanically-tunable eyeglasses and clearly identify the optotypes corresponding to the LogMAR 0.0 line on Early Treatment of Diabetic Retinopathy Study (ETDRS) charts, by suitably adjusting the optical powers of the lenses on these tunable eyeglasses for each measurement. Seven ETDRS charts, placed at distances from the patients varying from 4 m through 30 cm, were used under three chart illumination levels (75 lx, 500 lx and 800 lx). The optical power of the lenses in the patient-adjusted tunable eyeglasses was subsequently measured using a Shack-Hartman wavefront sensor for each chart, which provided the accommodation deficiency data of the participants.

Results

The measured accommodation deficiency data from 15 presbyopes was curve-fitted to a model for each patient. The calculated root-mean-square error values for the fitted models ranged between 0.09 D – 0.67 D over a 3.08D accommodation stimulus range.

Conclusions

The data shows that while accommodation deficiency in humans is a function of the stimulus, it is also strongly dependent on the object illumination and age of the patients. The models adequately describe the relation between static accommodation deficiency, accommodation stimulus and object illumination.
Differential DNA methylation landscape in skin fibroblasts from African Americans with systemic sclerosis
Authors: Frost DeAnna Baker , da Silveira Willian , Hazard E. Starr , Atanelishvili Ilia , Wilson Robert C. , Flume Jonathan , Day Kayleigh L. , Oates James C. , Bogatkevich Galina S. , Feghali-Bostwick Carol , Hardiman Gary , Ramos Paula S.
Published: August 2020

Objective

The etiology and reasons underlying the ethnic disparities in systemic sclerosis (SSc) remain unknown. African Americans are disproportionally affected by SSc, yet underrepresented in research. The aim of this study was to comprehensively investigate the association of DNA methylation levels with SSc in dermal fibroblasts from patients of African ancestry.

Methods

Reduced representation bisulfite sequencing (RRBS) was performed on primary cultured dermal fibroblasts from 15 SSc patients and 15 controls of African ancestry, and over 3.8 million CpG sites were tested for differential methylation patterns between cases and controls. Gene set enrichment (GSEA) and gene ontology (GO) analyses were computed to elucidate the underlying biological processes. Quantitative PCR (qPCR) was performed to assess correlations between DNA methylation changes and gene expression levels of top candidate genes.

Results

Skin fibroblasts from African American patients exhibited widespread reduced DNA methylation. Differentially methylated CpG sites were most enriched in introns and intergenic regions, while depleted in 5’ UTR, promoters, and CpG islands. Seventeen genes and eleven promoters showed significant differential methylation, mostly in non-coding RNA genes and pseudogenes. GSEA and GO enrichment analysis revealed enrichment of immune, metabolism, cell development, and cell signaling pathways, including those related to interferon signaling and mesenchymal differentiation. The hypomethylation of DLX5 and TMEM140 was accompanied by these genes’ overexpression, while for the IncRNA MGC12916, it was accompanied by its under-expression in patients.

Conclusion

These data show that differential methylation occurs in dermal fibroblasts from African American patients with SSc and identifies novel coding and non-coding genes.
Alice in Wonderland syndrome (AIWS): A research overview
Authors: Hossain Md Mahbub
Published: August 2020

Background

Alice in Wonderland syndrome (AIWS) is a rare neuropsychiatric condition characterized by distorted visual perceptions, body schema, and experience of time. This bibliometric study aimed to analyze the characteristics of the global research landscape on AIWS.

Methods

Bibliometric data on AIWS related publications published until 2019 were retrieved from the Web of Science database. The data were analyzed using statistical and scientometric tools to evaluate the publication trends, key research domains, top contributing journals, institutions, and countries associated with AIWS-related research.

Results

A total of 125 published items were analyzed with a mean of 3 authors and 8.15 citations per document. Most articles were published after 2008, in medical journals focused on neuropsychiatric sciences, and most institutions affiliated with AIWS research were based on high-income countries. Major research domains associated with AIWS included visual disturbances, body image, migraine, infections, risk factors, and other clinical correlates.

Conclusion

The current research landscape informs a developing trend in AIWS research in selected regions and specialties. Future research should emphasize multidisciplinary and translational investigations through global collaborations to advance the knowledge and practice on AIWS.
The operational impact of deploying SARS-CoV-2 vaccines in countries of the WHO African Region
Authors: Ortiz Justin R. , Robertson Joanie , Hsu Jui-Shan , Yu Stephen L. , Driscoll Amanda J. , Williams Sarah R. , Chen Wilbur H. , Fitzpatrick Meagan C. , Sow Samba , Biellik Robin J. , Okwo-Bele Jean-Marie , Neuzil Kathleen M.
Published: August 2020

Background

After SARS-CoV-2 vaccines become available, they will be deployed to many countries with limited immunization systems.

Methods

We conducted a cold chain capacity assessment of a simulated country in the WHO African Region. We combined region-specific data regarding immunization, population, healthcare workforce, and cold storage capacity (upper and lower range and quartile values for national and subnational levels). We used seasonal influenza vaccines as proxies for SARS-CoV-2 vaccines. We evaluated the increase in vaccine doses to be administered, doses administered per vaccinator, and cold storage volumes for SARS-CoV-2 campaigns targeting risk groups compared to routine immunization baselines.

Findings

Compared to routine immunization, a SARS-CoV-2 vaccination campaign would increase monthly doses administered when targeting risk groups: ≥65 years (29.9%), chronic diseases patients (101.5%), and healthcare workers (1.2%). SARS-CoV-2 vaccination campaigns would increase doses administered per vaccinator for risk groups: ≥65 years (32.5%), chronic diseases patients (110.4%), or healthcare workers (1.4%). Routine vaccine volumes already exceed national level storage capacity for at least 75% of African Region countries, but subnational levels would have sufficient storage capacity for SARS-CoV-2 vaccines in all but the lower 25% of African Region countries.

Interpretation

SARS-CoV-2 vaccination campaigns would substantially increase doses per vaccinator and cold chain capacity requirements over routine immunization baselines. Pandemic vaccination campaigns would add volume to national level stores already at their limits, but substantial capacity exists at subnational levels for SARS-CoV-2 vaccines. Immediate attention to strengthening delivery systems is essential to support pandemic vaccine responses in the African Region.

Funding

None
Predicting the Impact of the COVID-19 Pandemic for the Low- and Middle-Income Countries
Authors: Ding Zhiwei , Sha Feng , Kong Jing , Li Bingyu , Zhang Yi , Yip Paul , Yang Zhouwang
Published: August 2020

This study predicts the maximum hospital demand and number of infections for the LMICs in the first wave of COVID-19 pandemic. The epidemic is estimated to impose health care burden excessively exceeding the current capacity of hospitals in many LMICs, especially in Honduras, Central African Republic and Colombia.
A novel approach for evaluating contact patterns and risk mitigation strategies for COVID-19 in English Primary Schools with application of Structured Expert Judgement
Authors: Sparks R.S.J. , Aspinall W.P. , Brooks-Pollock E. , Cooke R.M. , Danon L. , Barclay J. , Scarrow J.H. , Cox J.H.
Published: August 2020

Background

Contact patterns are the drivers of close-contacts infections, such as COVID-19. In an effort to control COVID-19 transmission in the UK, schools were closed on 23 March 2020. With social distancing in place, Primary Schools were partially re-opened on 1 June 2020, with plans to fully re-open in September 2020. The impact of social distancing and risk mitigation measures on children’s contact patterns is not known.

Methods

We conducted a structured expert elicitation of a sample of Primary Headteachers to quantify contact patterns within schools in pre-COVID-19 times and how these patterns were expected to change upon re-opening. Point estimates with uncertainty were determined by a formal performance-based algorithm. Additionally, we surveyed school Headteachers about risk mitigation strategies and their anticipated effectiveness.

Results

Expert elicitation provides estimates of contact patterns that are consistent with contact surveys. We report mean number of contacts per day for four cohorts within schools along with a range at 90% confidence for the variations of contacts among individuals. Prior to lockdown, we estimate that, mean numbers per day, younger children (Reception and Year 1) made 15 contacts [range 8..35] within school, older children (Year 6) 18 contacts [range 5.. 55], teaching staff 25 contacts [range 4.. 55) and non-classroom staff 11 contacts [range 2.. 27]. Compared to pre-COVID times, after schools re-opened the mean number of contacts were reduced by about 53% for young children, about 62% for older children, about 60% for classroom staff and about 64% for other staff. Contacts between teaching and non-teaching staff reduced by 80%, which is consistent with other independent estimates. The distributions of contacts per person are asymmetric indicating a heavy tail of individuals with high contact numbers.

Conclusions

We interpret the reduction in children’s contacts as a consequence of efforts to reduce mixing with interventions such as forming groups of children (bubbles) who are organized to learn together to limit contacts. Distributions of contacts for children and adults can be used to inform COVID-19 transmission modelling. Our findings suggest that while official DfE guidelines form the basis for risk mitigation in schools, individual schools have adopted their own bespoke strategies, often going beyond the guidelines.
Has COVID-19 Hurt Resident Education? A network-wide resident survey on education and experience during the pandemic
Authors: Ostapenko Alexander , McPeck Samantha , Liechty Shawn , Kleiner Daniel
Published: August 2020

Purpose

As the COVID-19 pandemic continues to evolve, the healthcare system has been forced to adapt in myriad ways. Residents have faced significant changes in work schedules, deployment to COVID-19 units, and alterations to didactics. This study aims to identify the effects of the COVID-19 pandemic on resident perception of their own education within the Nuvance Health Network.

Methods

We conducted an observational study assessing resident perception of changes in education and lifestyle during the COVID-19 pandemic. A survey was developed to assess the quality and quantity of resident education during this time and administered anonymously to all residents within the healthcare network.

Results

Eighty-four (68%) residents responded to the survey from five different specialties, including general surgery, internal medicine, obstetrics and gynecology, pathology, and radiology. The average change in hours per week performing clinical work was −5.6 hours (SD=16.8), in time studying was +0.02 hours (SD=4.6), in weekly didactics was −1.7 hours (SD=3.1), and in attending involvement was −1.2 hours (SD=2.3). Additionally, 32% of residents expressed concern that the pandemic has diminished their preparedness to become an attending, 13% expressed concern about completing graduation requirements, and 3% felt they would need an additional year of training.

Conclusions

During the COVID-19 pandemic thus far, residents perceived that time spent on organized didactics/conferences decreased and that attending physicians are less involved in education. Furthermore, the majority of residents felt that the quality of didactic education diminished as a result of the pandemic. Surprisingly, while many residents expressed concerns about being prepared to become an attending, few were concerned about completing graduation requirements or needing an extra year of education. In light of these findings, it is critical to devote attention to the effects of the pandemic on residents’ professional trajectories and create innovative opportunities for improving education during this challenging time.
Twelve-year changes in protein profiles in patients with and without gastric bypass surgery
Authors: Yousri Noha A. , Engelke Rudolf , Sarwath Hina , McKinlay Rodrick D. , Simper Steven C. , Adams Ted D. , Schmidt Frank , Suhre Karsten , Hunt Steven C.
Published: August 2020

Gastric bypass surgery results in long-term weight loss due to re-routing of the gastro-intestinal anatomy and dietary intake alterations. Studies have examined protein change during rapid weight loss (up to 1 year post-surgery), but whether protein changes are maintained long-term after weight stabilization is unknown. To identify proteins and pathways involved with the long-term beneficial effects of weight loss, abundances of 1297 blood-circulating proteins were measured at baseline, 2 and 12 years after Roux-en-Y gastric bypass surgery. Protein changes were compared between 234 surgery and 144 non-surgery subjects with severe obesity, with discovery and replication subgroups. Seventy-one protein changes were associated with 12-year BMI changes and 58 (7 unique) with surgical status. Protein changes, including ApoM, were most strongly associated with long-term changes in lipids (HDL-C and triglycerides). Inflammation, adipogenesis, cellular signaling, and complement pathways were implicated. Short-term improvements in protein levels were maintained long-term, even after some weight regain.
Sero-prevalence Findings from Metropoles in Pakistan: Implications for Assessing COVID-19 Prevalence and Case-fatality within a Dense, Urban Working Population
Authors: Javed Wajiha , Baqar Jaffer Bin , Abidi Syed Hussain Baqar , Farooq Wajiha
Published: August 2020

Population-level serologic testing has demonstrated groundbreaking results in monitoring the prevalence and case-fatality of COVID-19 within a population. In Pakistan, Getz Pharma conducted a sero-prevalence survey on a sample of 24,210 individuals using the IgG/IgM Test Kit (Colloidal gold) with follow-up and sequential testing after every 15-20 days on a sub-sample. This is the first of its kind, large scale census conducted on a dense, urban, working population in Pakistan. The study results reveal that from 24,210 individuals screened, 17.5% tested positive, with 7% IgM positive, 6.0% IgG positive and 4.5% combined IgM and IgG positive. These findings have been extrapolated to the rest of the urban, adult, working population of Pakistan, and as of 6th July, 2020, 4.11 million people in Pakistan have been infected with COVID-19, which is 17.7 times higher than the current number of 231,818 symptom-based PCR cases reported by the government which exclude asymptomatic cases.
Inequality indices to monitor geographic differences in incidence, mortality and fatality rates over time during the COVID-19 pandemic
Authors: Manz Kirsi , Mansmann Ulrich
Published: August 2020

Background

It is of interest to explore the variability in how the COVID-19 pandemic evolved geographically during the first twelve months. To this end, we apply inequality indices over regions to incidences, infection related mortality, and infection fatality rates. If avoiding of inequality in health is an important political goal, a metric must be implemented to track geographical inequality over time.

Methods

The relative and absolute Gini index as well as the Theil index are used to quantify inequality. Data are taken from international data bases. Absolute counts are transformed to rates adjusted for population size.

Results

Comparing continents, the absolute Gini index shows an unfavorable development in four continents since February 2020. In contrast, the relative Gini as well as the Theil index support the interpretation of less inequality between European countries compared to other continents. Infection fatality rates within the EU as well as within the U.S. express comparable improvement towards more equality (as measured by both Gini indices).

Conclusions

The use of inequality indices to monitor changes in geographic in-equality over time for key health indicators is a valuable tool to inform public health policies. The absolute and relative Gini index behave complementary and should be reported simultaneously in order to gain a meta-perspective on very complex dynamics.
COVID-19 vaccination intention in the UK: Results from the ‘COVID-19 Vaccination Acceptability Study’ (CoVAccS), a nationally representative cross-sectional survey
Authors: Sherman Susan M. , Smith Louise E. , Sim Julius , Amlôt Richard , Cutts Megan , Dasch Hannah , Rubin G James , Sevdalis Nick
Published: August 2020

Aim

To investigate factors associated with intention to be vaccinated against COVID-19.

Methods

Online cross-sectional survey of 1,500 UK adults, recruited from an existing online research panel. Data were collected between 14th and 17th July 2020. We used linear regression analyses to investigate associations between intention to be vaccinated for COVID-19 “when a vaccine becomes available to you” and socio-demographic factors, previous influenza vaccination, general vaccine attitudes and beliefs, attitudes and beliefs about COVID-19, and attitudes and beliefs about a COVID-19 vaccination.

Results

64% of participants reported being likely to be vaccinated against COVID-19; 27% were unsure and 9% reported being unlikely to be vaccinated. Personal and clinical characteristics, previous influenza vaccination, general vaccination beliefs, and beliefs and attitudes about COVID-19 and a COVID-19 vaccination explained 77% of the variance in vaccination intention. Intention to be vaccinated was associated with more positive general COVID-19 vaccination beliefs and attitudes, weaker beliefs that the vaccination would cause side effects or be unsafe, greater perceived information sufficiency to make an informed decision about COVID-19 vaccination, greater perceived risk of COVID-19 to others but not oneself, older age, and having been vaccinated for influenza last winter (2019/20).

Conclusions

Despite uncertainty around the details of a COVID-19 vaccination, most participants reported intending to be vaccinated for COVID-19. Actual uptake will likely be lower. Vaccination intention reflects general vaccine beliefs and attitudes. Campaigns and messaging about a COVID-19 vaccination should emphasize the risk of COVID-19 to others and necessity for everyone to be vaccinated.