bluuebunny/crossref_metadata_2025 huggingface dataset:
Screening diabetes mellitus patients for pulmonary tuberculosis: a multisite study in Indonesia, Peru, Romania and South Africa
Authors: Alisjahbana Bachti , McAllister Susan M , Ugarte-Gil Cesar , Panduru Nicolae Mircea , Ronacher Katharina , Koesoemadinata Raspati C , Zubiate Carlos , Riza Anca Lelia , Malherbe Stephanus T , Kleynhans Leanie , Lopez Sonia , Dockrell Hazel M , Ruslami Rovina , Ioana Mihai , Walzl Gerhard , Pearson Fiona , Critchley Julia A , Moore David A J , van Crevel Reinout , Hill Philip C
Published: October 2020

Background

Diabetes mellitus (DM) patients are three times more likely to develop tuberculosis (TB) than the general population. Active TB screening in people with DM is part of a bidirectional approach. The aim of this study was to conduct pragmatic active TB screening among DM patients in four countries to inform policy.

Methods

DM patients were recruited in Indonesia (n=809), Peru (n=600), Romania (n=603) and South Africa (n=51). TB cases were diagnosed using an algorithm including clinical symptoms and chest X-ray. Presumptive TB patients were examined with sputum smear and culture.

Results

A total of 171 (8.3%) individuals reported ever having had TB (South Africa, 26%; Indonesia, 12%; Peru, 7%; Romania, 4%), 15 of whom were already on TB treatment. Overall, 14 (0.73% [95% confidence interval 0.40 to 1.23]) TB cases were identified from screening. Poor glucose control, smoking, lower body mass index, education and socio-economic status were associated with newly diagnosed/current TB. Thirteen of the 14 TB cases diagnosed from this screening would have been found using a symptom-based approach.

Conclusions

These data support the World Health Organization recommendation for routine symptom-based screening for TB in known DM patients in high TB-burden countries. DM patients with any symptoms consistent with TB should be investigated and diagnostic tools should be easily accessible.
Intimate Association of PRR- and NLR-Mediated Signaling in Plant Immunity
Authors: Lu You , Tsuda Kenichi
Published: October 2020

This article is part of the Top 10 Unanswered Questions in MPMI invited review series.

Plants recognize the presence or invasion of microbes through cell surface-localized pattern recognition receptors (PRRs) and intracellular nucleotide-binding domain leucine-rich repeat receptors (NLRs). Although PRRs and NLRs are activated by ligands located in different subcellular compartments through distinct mechanisms, signals initiated from PRRs and NLRs converge into several common signaling pathways with different dynamics. Increasing evidence suggests that PRR- and NLR-mediated signaling extensively crosstalk and such interaction can greatly influence immune response outcomes. Sophisticated experimental setups enabled dissection of the signaling events downstream of PRRs and NLRs with fine temporal and spatial resolution; however, the molecular links underlying the observed interactions in PRR and NLR signaling remain to be elucidated. In this review, we summarize the latest knowledge about activation and signaling mediated by PRRs and NLRs, deconvolute the intimate association between PRR- and NLR-mediated signaling, and propose hypotheses to guide further research on key topics.

[Formula: see text] Copyright © 2021 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
A Core Outcome Set for Pediatric Critical Care*
Authors: Fink Ericka L , Maddux Aline B. , Pinto Neethi , Sorenson Samuel , Notterman Daniel , Dean J. Michael , Carcillo Joseph A. , Berg Robert A. , Zuppa Athena , Pollack Murray M. , Meert Kathleen L. , Hall Mark W. , Sapru Anil , McQuillen Patrick S. , Mourani Peter M. , Wessel David , Amey Deborah , Argent Andrew , Brunow de Carvalho Werther , Butt Warwick , Choong Karen , Curley Martha A. Q. , del Pilar Arias Lopez Maria , Demirkol Demet , Grosskreuz Ruth , Houtrow Amy J. , Knoester Hennie , Lee Jan Hau , Long Debbie , Manning Joseph C. , Morrow Brenda , Sankar Jhuma , Slomine Beth S. , Smith McKenna , Olson Lenora M. , Watson R. Scott ,   for the Pediatric Outcomes STudies after PICU (POST-PICU) Investigators of the Pediatric Acute Lung Injury and Sepsis Investigators (PALISI) Network and the Eunice Kennedy Shriver National Institute of Child Health and Human Development Collaborative Pediatric Critical Care Research Network (CPCCRN)
Published: October 2020

Objectives:

More children are surviving critical illness but are at risk of residual or new health conditions. An evidence-informed and stakeholder-recommended core outcome set is lacking for pediatric critical care outcomes. Our objective was to create a multinational, multistakeholder-recommended pediatric critical care core outcome set for inclusion in clinical and research programs.

Design:

A two-round modified Delphi electronic survey was conducted with 333 invited research, clinical, and family/advocate stakeholders. Stakeholders completing the first round were invited to participate in the second. Outcomes scoring greater than 69% “critical” and less than 15% “not important” advanced to round 2 with write-in outcomes considered. The Steering Committee held a virtual consensus conference to determine the final components.

Setting:

Multinational survey.

Patients:

Stakeholder participants from six continents representing clinicians, researchers, and family/advocates.

Measurements and Main Results:

Overall response rates were 75% and 82% for each round. Participants voted on seven Global Domains and 45 Specific Outcomes in round 1, and six Global Domains and 30 Specific Outcomes in round 2. Using overall (three stakeholder groups combined) results, consensus was defined as outcomes scoring greater than 90% “critical” and less than 15% “not important” and were included in the final PICU core outcome set: four Global Domains (Cognitive, Emotional, Physical, and Overall Health) and four Specific Outcomes (Child Health-Related Quality of Life, Pain, Survival, and Communication). Families (n = 21) suggested additional critically important outcomes that did not meet consensus, which were included in the PICU core outcome set—extended.

Conclusions:

The PICU core outcome set and PICU core outcome set—extended are multistakeholder-recommended resources for clinical and research programs that seek to improve outcomes for children with critical illness and their families.
Effectiveness of Music to Improve Anxiety in Hemodialysis Patients
Authors: Burrai Francesco , Forton Magavern Emma , Micheluzzi Valentina , Magnaghi Cristiano , Apuzzo Luigi , Brioni Elena
Published: October 2020

Anxiety affects many hemodialysis patients. The response to treatment varies and often requires patients to take therapeutics for long periods; thus, many patients look for complementary approaches. There have been reports of music alleviating anxiety in hemodialysis patients. However, the efficacy of music needs to be evaluated. The objective of this study was to conduct a systematic review and meta-analysis to compare the effects of participation in standard care combined with music with standard care alone. This was a systematic review and meta-analysis of randomized controlled trials to determine the efficacy of music to lower anxiety in hemodialysis patients. Five studies were included in the review (290 patients). Listening to music resulted, on average, in an anxiety reduction that was −0.52 standard deviation units greater (95% confidence interval, −1.02 to −0.03 lower, P = .003) than in the standard care group. No adverse events were identified. All trials contained a risk of bias due to lack of blinding. The heterogeneity showed an I
2 = 75%. The strength of evidence was very low. No adverse events were identified. Few trials were available for inclusion, with small sample sizes and significant heterogeneity. Within these considerable limitations there was a demonstrated decrease in anxiety for hemodialysis patients receiving standard care augmented with music. The effect size was moderate. Results were inconsistent across studies. We are uncertain about the estimate. The likelihood that effect will be substantially different is very high. Further research has a large potential for reducing uncertainty about the effects of the music interventions.
Effects of Acupressure on Preoperative Acute Anxiety in Cesarean Section Under Spinal Anesthesia
Authors: Kanza Gul Derya , Solt Kirca Ayça
Published: October 2020

Anxiety during the preoperative period is a common problem experienced by women who will deliver by cesarean section. The use of nonpharmacological methods to control anxiety in pregnant women has been shown to be more appropriate. This double-blind randomized controlled experimental study was conducted to assess the effect of acupressure on acute anxiety developing before cesarean section under spinal anesthesia. In the present study, 82 pregnant women scheduled for surgery were randomly assigned to the acupressure and control groups including 40 and 42 persons, respectively. Acupressure was applied to HE-7 acupuncture points in the participants in the acupressure (intervention) group for 10 minutes before the surgery. The participants in the control group were subjected to the hospital protocol. Anxiety levels of the participating women were assessed twice preoperatively using the State-Trait Anxiety Inventory. Anxiety scores of the participants in the acupressure group before the procedure (49.13 ± 6.22) were higher than were those of the participants in the control group (41.71 ± 3.26); however, after the procedure, the anxiety scores decreased statistically significantly in the acupressure group (38.30 ± 4.45) compared with the control group (52.48 ± 7.30) (P < .001). Acupressure reduced the preoperative acute anxiety suffered by the participating pregnant women.
Sight-Threatening Thyroid Eye Disease: Role of Diabetes Mellitus and Interaction with Other Risk Factors
Authors: Rath Suryasnata , Pattnaik Monalisha , Tripathy Devjyoti , Mohapatra Samir , Panigrahy Bharat , Ali Mohammad Hasnat
Published: October 2020

Purpose:

The aim of the study was to investigate whether diabetes mellitus (DM) is an independent risk factor in sight-threatening thyroid eye disease (ST-TED) and explore the interaction of DM with other known risk factors in TED.

Methods:

This was a retrospective cohort study and included 202 consecutive TED patients presenting between 2013 and 2019. Data collected included demography, history of smoking, thyroid dysmetabolism, and presence of DM, TED-duration, activity and severity, best-corrected visual acuity (BCVA), and follow-up. Primary outcome measure was development of ST-TED and secondary outcome measures included change in BCVA, activity, and bilateral ST-TED.

Results:

Mean age of the cohort was 52.14 + 9.14 years and 74 (36%) were male. DM was present in 49 (24%) and a positive history of smoking in 65 (32%) TED patients. Cox’s proportional hazards showed the presence of DM (hazard ratio [HR] 2.22; P = 0.02) and a positive history of smoking (HR 3.62; P = 0.003) were significant risk factors for development of ST-TED and dysthyroid optic neuropathy (DON). Older age was a risk factor (HR 1.05; P = 0.02) for DON. DM increased the risk of developing bilateral ST-TED (OR 4.14; P = 0.004). Median follow-up was 4 months (range 0.1–96 months). A linear mixed model to predict longitudinal interaction between risk factors, found TED patients in DM group were likely to have worsening of visual function and a positive history of smoking accentuated this adverse outcome.

Conclusion:

DM and smoking are major independent risk factors predictive of ST-TED. Coexisting DM either singularly or in combination with smoking may predict worsening of visual function in TED patients.
Maternal HIV status skews transcriptomic response in infant cord blood monocytes exposed to Bacillus Calmette--Guerín
Authors: Jones Chloe I. , Rose Suzanne L. , Shutt Ashley , Cairo Cristiana , Bourgeois Natasha M. , Charurat Manhattan , Sodora Donald L. , Wood Matthew P.
Published: October 2020

Objectives:

HIV-exposed uninfected (HEU) infants exhibit altered vaccine responses and an increased mortality compared with HIV-unexposed infants. Here, vaccine responses in HEU and HIV-unexposed cord blood monocytes (CBMs) were assessed following Bacillus Calmette--Guerín (BCG) treatment.

Design:

Innate responses to in-vitro BCG treatment were assessed through transcriptional profiling using CBMs obtained from a Nigerian cohort of HIV-infected and uninfected women.

Methods:

HIV-unexposed (n = 9) and HEU (n = 10) infant CBMs were treated with BCG and transcriptionally profiled with the Nanostring nCounter platform. Differential expression and pathway enrichment analyses were performed, and transcripts were identified with enhanced or dampened BCG responses.

Results:

Following BCG stimulation, several pathways associated with inflammatory gene expression were upregulated irrespective of HIV exposure status. Both HIV-unexposed and HEU monocytes increased expression of several cytokines characteristic of innate BCG responses, including IL1β, TNFα, and IL-6. Using differential expression analysis, we identified genes significantly upregulated in HEU compared with HIV-unexposed monocytes including monocyte chemokine CCL7 and anti-inflammatory cytokine TNFAIP6. In contrast, genes significantly upregulated in HIV-unexposed compared with HEU monocytes include chemokine CCL3 and cytokine IL23A, both of which influence anti-mycobacterial T-cell responses. Finally, two genes, which regulate prostaglandin production, CSF2 and PTGS2, were also more significantly upregulated in the HIV-unexposed cord blood indicating that inflammatory mediators are suppressed in the HEU infants.

Conclusion:

HEU monocytes exhibit altered induction of several key innate immune responses, providing mechanistic insights into dysregulated innate response pathways that can be therapeutically targeted to improve vaccine responses in HEU infants.
Ending an HIV epidemic among persons who inject drugs in a middle-income country: extremely low HIV incidence among persons who inject drugs in Hai Phong, Viet Nam
Authors: Des Jarlais Don C. , Huong Duong Thi , Oanh Khuat Thi Hai , Feelemyer Jonathan P. , Arasteh Kamyar , Khue Pham Minh , Giang Hoang Thi , Thanh Nham Thi Tuyet , Vinh Vu Hai , Le Sao Mai , Vallo Roselyne , Quillet Catherine , Rapoud Delphine , Michel Laurent , Laureillard Didier , Moles Jean Pierre , Nagot Nicolas
Published: October 2020

Objective:

To determine whether it is possible to ‘end an HIV epidemic’ among persons who inject drugs (PWID) in a low/middle income country.

Design:

Serial cross-sectional surveys with a cohort of HIV seronegative participants with 6-month follow-up visits recruited from surveys.

Methods:

Surveys of PWID using respondent driven and snowball sampling were conducted in 2016, 2017, 2018, and 2019 (N = 1383, 1451, 1444, and 1268). HIV recency testing was used to identify possible seroconversions in the window period prior to study entry. Structured interviews covering drug use histories, current drug use, and use of HIV-related services were administered by trained interviewers. Urinalysis was used to confirm current drug use. HIV and hepatitis C virus testing were conducted. Electronic fingerprint readers were used to avoid multiple participation in each survey and to link participants across surveys. A cohort of HIV seronegative participants with 6-month follow-up visits was recruited from the surveys, 480 from 2016, 233 from 2017, and 213 from 2018.

Results:

Participants were predominantly male (95%), mean age approximately 40, all reported injecting heroin, HIV prevalence ranged between 26 and 30%. We had three seroconversions in 1483 person-years at risk (PYAR) in the cohort study, and 0 in 696 PYAR among repeat survey participants, and 0 seroconversions in 1344 PYAR in recency testing. Overall HIV incidence was 0.085/100 PYAR, 95% confidence interval 0.02–0.25/100 PYAR.

Conclusion:

The data from Hai Phong clearly demonstrate that it is possible to achieve very low HIV incidence – ‘end an HIV epidemic’ – among PWID in a middle-income country.
Decision-making regarding condom use among daily and event-driven users of preexposure prophylaxis in the Netherlands
Authors: Zimmermann Hanne M.L. , Jongen Vita W. , Boyd Anders , Hoornenborg Elske , Prins Maria , de Vries Henry J.C. , Schim van der Loeff Maarten F. , Davidovich Udi
Published: October 2020

Objective:

To explore the frequency of and reasons for using condoms among men who have sex with men (MSM) on preexposure prophylaxis (PrEP).

Design:

We analyzed quantitative app-based diary data on daily sexual practices (August 2015–February 2019) and qualitative in-depth interviews among MSM using daily PrEP and event-driven PrEP (edPrEP) in the Amsterdam PrEP demonstration project.

Methods:

Participants could report daily about sex acts, PrEP use and condom use per partner type (steady and casual partners). We examined four strategies of PrEP and condom use: PrEP only, PrEP and condoms, condoms only, and neither strategy. We compared the proportions of sex acts per strategy between PrEP regimens. In 43 in-depth interviews, we explored motives for implementing each strategy.

Results:

Three hundred and fifty-two participants reported 48 949 anal sex acts. PrEP only was the most common strategy employed with any partner type (81%, n = 39 650/48 949) and was motivated by anticipating more pleasurable sex, sexually transmitted infection's perceived curability, and habituation to condomless sex. Combining PrEP and condoms was more often chosen for sex acts with casual partners (18%, n = 6829/37 317) than with steady partners (5%, n = 614/11 632) and was linked to, for example, higher perceived vulnerability for sexually transmitted infections or HIV and avoidance of PrEP disclosure. Condoms only was uncommon but occurred particularly among edPrEP users (4%, n = 379/8695). Applying neither strategy was common among edPrEP users with steady partners (25%, n = 538/2122) and was motivated by low perceived HIV risk.

Conclusion:

Condoms remain a viable option for PrEP users in certain settings. Condoms were applied in higher risk settings, to avoid PrEP disclosure, or as substitute for PrEP, especially among edPrEP users.
Hazardous alcohol use, antiretroviral therapy receipt, and viral suppression in people living with HIV who inject drugs in the United States, India, Russia, and Vietnam
Authors: Wagman Jennifer A. , Wynn Adriane , Matsuzaki Mika , Gnatienko Natalia , Metsch Lisa R. , del Rio Carlos , Feaster Daniel J. , Nance Robin M. , Whitney Bridget M. , Delaney Joseph A.C. , Kahana Shoshana Y. , Crane Heidi M. , Chandler Redonna K. , Elliott Jennifer C. , Altice Frederick , Lucas Gregory M. , Mehta Shruti H. , Hirsch-Moverman Yael , El-Sadr Wafaa M. , Vu Quan , Nguyen Thanh Binh , Springer Sandra A. , Tsui Judith I. , Samet Jeffrey H.
Published: October 2020

Objectives:

In high-income countries, hazardous alcohol use is associated with reduced receipt of antiretroviral therapy (ART) and viral suppression among people living with HIV (PLHIV) who inject drugs. These associations are less understood in lower middle-income countries (LMIC) and upper middle-income countries.

Design:

We examined associations between hazardous alcohol use, ART receipt, and viral suppression among PLHIV who reported current or former injection drug use. Participants were from nine studies in the United States (high-income country), India (LMIC), Russia (upper middle-income country), and Vietnam (LMIC).

Methods:

Hazardous alcohol use was measured via Alcohol Use Disorders Identification Test. Outcomes were HIV viral suppression (viral load of <1000 RNA copies/ml) and self-reported ART receipt. Logistic regression assessed associations between hazardous alcohol use and both outcome variables, controlling for age and sex, among participants with current and former injection drug use.

Results:

Among 2790 participants, 16% were women, mean age was 37.1 ± 9.5 years. Mean Alcohol Use Disorders Identification Test scores were 4.6 ± 8.1 (women) and 6.2 ± 8.3 (men); 42% reported ART receipt; 40% had viral suppression. Hazardous alcohol use was significantly associated with reduced ART receipt in India (adjusted odds ratio = 0.59, 95% confidence interval: 0.45–0.77, P < 0.001); and lower rates of viral suppression in Vietnam (adjusted odds ratio = 0.51, 95% confidence interval: 0.31–0.82, P = 0.006).

Conclusion:

Associations between hazardous alcohol use, ART receipt, and viral suppression varied across settings and were strongest in LMICs. Addressing hazardous alcohol use holds promise for improving HIV continuum of care outcomes among PLHIV who inject drugs. Specific impact and intervention needs may differ by setting.
Risk of smoking-related cancers among women and men living with and without HIV
Authors: Hessol Nancy A. , Barrett Benjamin W. , Margolick Joseph B. , Plankey Michael , Hussain Shehnaz K. , Seaberg Eric C. , Massad L. Stewart
Published: October 2020

Objectives:

We investigated whether the effect of smoking on the incidence of smoking-related cancers differs by HIV-infection status, if sex modifies the impact of risk factors for smoking-related cancers, and the sex-specific attributable risk of smoking on cancer incidence.

Design:

Data from two large prospective studies in the United States were analyzed: 6789 men in the Multicenter AIDS Cohort Study from 1984 through 2018 and 4423 women in the Women's Interagency HIV Study from 1994 through 2018.

Methods:

Incidence rates, relative risks, and adjusted population attributable fractions (PAFs) were calculated for smoking-related cancers.

Results:

During study follow-up, there were 214 incident smoking-related cancers in the men and 192 in the women. The age-adjusted incidence ratess for smoking-related cancers were higher in the women (392/100 000) than for the men (198/100 000; P < 0.01) and higher for people living with HIV (PLWH, 348/100 000) than for those without HIV (162/100 000; P < 0.01). Unadjusted incidence rates in PLWH were higher than in those without HIV when stratifying by cumulative pack-years of smoking (all P values <0.01). In adjusted interaction models, the effects of cumulative pack-years of smoking were significantly stronger in women. The adjusted PAFs for smoking-related cancers were nonsignificantly higher in the women than in the men (39 vs. 28%; P = 0.35).

Conclusion:

HIV looks to be an independent risk factor for smoking-related cancers and women appear to have a greater risk than men. These results highlight the need for interventions to help PLWH, especially women, quit smoking and sustain cessation to reduce their risk of smoking-related cancers.
Impact of a community-wide combination HIV prevention intervention on knowledge of HIV status among adolescents
Authors: Shanaube Kwame , Schaap Ab , Hoddinott Graeme , Mubekapi-Musadaidzwa Constance , Floyd Sian , Bock Peter , Hayes Richard , Fidler Sarah , Ayles Helen
Published: October 2020

Objective:

To determine the impact of a community-wide combination HIV-prevention package (PopART Intervention) that includes universal testing and treatment (UTT) on knowledge of HIV status, among adolescents aged 15--19 years.

Design:

The HPTN 071 (PopART) for Youth (P-ART-Y) study was nested within HPTN 071 (PopART), a three-arm, cluster-randomized trial conducted from 2013 through 2018 in 21 communities in Zambia and South Africa. Communities were randomly assigned to arm A (combination prevention intervention with universal ART), arm B (prevention intervention with ART provided according to local guidelines), or arm C (standard-of-care).

Methods:

Knowledge of HIV status was measured using data collected during the third round of the PopART intervention in arms A and B (October 2016 to December 2017) and by conducting a cross-sectional survey (August to November 2017) in arm C communities to provide comparative data. The survey was conducted among ∼200 randomly selected adolescents in each community. We used linear regression of the 21 community-level values to make comparisons among trial arms.

Results:

Knowledge of HIV status was 78.2% (23 544/30 089) in arm A and 76.0% (24 417/32 148) in arm B communities, compared with 32.9% (698/2120) in arm C communities. Knowledge of HIV status varied by country, triplet, sex, and age. The adjusted mean difference was 42.3% between arm A with arm C, 95% CI 28.1–56.6, P less than 0.001 and 40.4% between arm B with arm C, 95% CI 24.6–56.2, P < 0.001).

Conclusion:

Implementation of a community-wide combination HIV-prevention package that includes UTT substantially enhanced knowledge of HIV status among adolescents.
When fiction becomes fact: exaggerating host manipulation by parasites
Authors: Doherty Jean-François
Published: October 2020

In an era where some find fake news around every corner, the use of sensationalism has inevitably found its way into the scientific literature. This is especially the case for host manipulation by parasites, a phenomenon in which a parasite causes remarkable change in the appearance or behaviour of its host. This concept, which has deservedly garnered popular interest throughout the world in recent years, is nearly 50 years old. In the past two decades, the use of scientific metaphors, including anthropomorphisms and science fiction, to describe host manipulation has become more and more prevalent. It is possible that the repeated use of such catchy, yet misleading words in both the popular media and the scientific literature could unintentionally hamper our understanding of the complexity and extent of host manipulation, ultimately shaping its narrative in part or in full. In this commentary, the impacts of exaggerating host manipulation are brought to light by examining trends in the use of embellishing words. By looking at key examples of exaggerated claims from widely reported host–parasite systems found in the recent scientific literature, it would appear that some of the fiction surrounding host manipulation has since become fact.
Experimental evidence of warming-induced disease emergence and its prediction by a trait-based mechanistic model
Authors: Kirk Devin , Luijckx Pepijn , Jones Natalie , Krichel Leila , Pencer Clara , Molnár Péter , Krkošek Martin
Published: October 2020

Predicting the effects of seasonality and climate change on the emergence and spread of infectious disease remains difficult, in part because of poorly understood connections between warming and the mechanisms driving disease. Trait-based mechanistic models combined with thermal performance curves arising from the metabolic theory of ecology (MTE) have been highlighted as a promising approach going forward; however, this framework has not been tested under controlled experimental conditions that isolate the role of gradual temporal warming on disease dynamics and emergence. Here, we provide experimental evidence that a slowly warming host–parasite system can be pushed through a critical transition into an epidemic state. We then show that a trait-based mechanistic model with MTE functional forms can predict the critical temperature for disease emergence, subsequent disease dynamics through time and final infection prevalence in an experimentally warmed system of
Daphnia
and a microsporidian parasite. Our results serve as a proof of principle that trait-based mechanistic models using MTE subfunctions can predict warming-induced disease emergence in data-rich systems—a critical step towards generalizing the approach to other systems.
Estimating the effect of social inequalities in the mitigation of COVID-19 across communities in Santiago de Chile
Authors: Gozzi Nicolò , Tizzoni Michele , Chinazzi Matteo , Ferres Leo , Vespignani Alessandro , Perra Nicola
Published: October 2020

We study the spatio-temporal spread of SARS-CoV-2 in Santiago de Chile using anonymized mobile phone data from 1.4 million users, 22% of the whole population in the area, characterizing the effects of non-pharmaceutical interventions (NPIs) on the epidemic dynamics. We integrate these data into a mechanistic epidemic model calibrated on surveillance data. As of August 1st 2020, we estimate a detection rate of 102 cases per 1,000 infections (90% CI: [95 - 112 per 1,000]). We show that the introduction of a full lockdown on May 15th, 2020, while causing a modest additional decrease in mobility and contacts with respect to previous NPIs, was decisive in bringing the epidemic under control, highlighting the importance of a timely governmental response to COVID-19 outbreaks. We find that the impact of NPIs on individuals’ mobility correlates with the Human Development Index of comunas in the city. Indeed, more developed and wealthier areas became more isolated after government interventions and experienced a significantly lower burden of the pandemic. The hetero-geneity of COVID-19 impact raises important issues in the implementation of NPIs and highlights the challenges that communities affected by systemic health and social inequalities face adapting their behaviors during an epidemic.
Mitigating the impact of COVID-19 on tuberculosis and HIV services: a cross-sectional survey of 669 health professionals in 64 low and middle-income countries
Authors: Khan Mishal S. , Rego Sonia , Rajal Joaquín Benítez , Bond Virginia , Fatima Razia Kaneez , Isani Afshan Khurshid , Sutherland Jayne , Kranzer Katharina
Published: October 2020

Objective

The experiences of frontline healthcare professionals are essential in identifying strategies to mitigate the disruption to healthcare services caused by the COVID-19 pandemic.

Methods

We conducted a cross-sectional study of TB and HIV professionals in low and middle-income countries (LMIC). Between May 12 and August 6 2020, we collected qualitative and quantitative data using an online survey in 11 languages. We used descriptive statistics and thematic analysis to analyse responses.

Findings

669 respondents from 64 countries completed the survey. Over 40% stated that it was either impossible or much harder for TB and HIV patients to reach healthcare facilities since COVID-19. The most common barriers reported to affect patients were: fear of getting infected with SARS-CoV-2, transport disruptions and movement restrictions. 37% and 28% of responses about TB and HIV stated that healthcare provider access to facilities was also severely impacted. Strategies to address reduced transport needs and costs – including proactive coordination between the health and transport sector and cards that facilitate lower cost or easier travel - were presented in qualitative responses. Access to non-medical support for patients, such as food supplementation or counselling, was severely disrupted according to 36% and 31% of HIV and TB respondents respectively; qualitative data suggested that the need for such services was exacerbated.

Conclusion

Patients and healthcare providers across numerous LMIC faced substantial challenges in accessing healthcare facilities, and non-medical support for patients was particularly impacted. Synthesising recommendations of frontline professionals should be prioritised for informing policymakers and healthcare service delivery organisations.
Rapid and Low-cost Sampling for Detection of Airborne SARS-CoV-2 in Dehumidifier Condensate
Authors: Moitra Parikshit , Alafeef Maha , Dighe Ketan , Ray Priyanka , Chang James , Ramamurthy Sai Sathish , Ge Xudong , Pan Dipanjan , Rao Govind
Published: October 2020

Airborne spread of COVID-19 by infectious aerosol is all but certain. However, easily implemented approaches to assess the actual environmental threat are currently unavailable. We present a simple approach with the potential to rapidly provide information about the prevalence of SARS-CoV-2 in the atmosphere at any location. We used a portable dehumidifier as a readily available and affordable tool to collect airborne virus in the condensate. The dehumidifiers were deployed in selected locations of a hospital ward with patients reporting flu like symptoms which could possibly be due to COVID-19 over three separate periods of one week. Samples were analyzed frequently for both virus envelope protein and SARS-CoV-2 RNA. In several samples across separate deployments, condensate from dehumidifiers tested positive for the presence of SARS-CoV-2 antigens and confirmed using two independent assays. RNA was detected, but not attributable to SARS-CoV-2. Our results point to a facile pool testing method to sample air in any location in the world and assess the presence and concentration of the infectious agent in order to obtain quantitative risk assessment of exposure, designate zones as ‘hot spots’ and minimize the need for individual testing which may often be time consuming, expensive and laborious.
Covid-19 pandemic Analysis using Regression
Authors: Raji P , Deeba Lakshmi GR
Published: October 2020

Covid-19 is a pandemic which has affected all parts of the world. Covid-19 is a pandemic which can be controlled only by maintaining social distancing, proper hygiene, wearing mask, hand sanitation and to a extend by wearing face shield. Even though each state has followed their own ways of controlling the infection, awareness among citizens and behaving as responsible citizens is very important in controlling this disease. Contact tracing plays an important role in controlling this pandemic. This paper deals with the effect of Covid-19 in various states of India and also forecasts its effect using machine learning techniques. Regression analysis like Linear and polynomial have been used for analysis of Covid-19, where Kaggle dataset has been used. This helps in understanding the much-affected states in India and helps to understand the infrastructure requirements to handle this pandemic efficiently.
Estimating the impact of disruptions due to COVID-19 on HIV transmission and control among men who have sex with men in China
Authors: Booton Ross. D. , Fu Gengfeng , MacGregor Louis , Li Jianjun , Ong Jason J. , Tucker Joseph D. , Turner Katy M.E. , Tang Weiming , Vickerman Peter , Mitchell Kate M.
Published: October 2020

Introduction

The COVID-19 pandemic is impacting HIV care globally, with gaps in HIV treatment expected to increase HIV transmission and HIV-related mortality. We estimated how COVID-19-related disruptions could impact HIV transmission and mortality among men who have sex with men (MSM) in four cities in China.

Methods

Regional data from China indicated that the number of MSM undergoing facility-based HIV testing reduced by 59% during the COVID-19 pandemic, alongside reductions in ART initiation (34%), numbers of sexual partners (62%) and consistency of condom use (25%). A deterministic mathematical model of HIV transmission and treatment among MSM in China was used to estimate the impact of these disruptions on the number of new HIV infections and HIV-related deaths. Disruption scenarios were assessed for their individual and combined impact over 1 and 5 years for a 3-, 4- or 6-month disruption period.

Results

Our China model predicted that new HIV infections and HIV-related deaths would be increased most by disruptions to viral suppression, with 25% reductions for a 3-month period increasing HIV infections by 5-14% over 1 year and deaths by 7-12%. Observed reductions in condom use increased HIV infections by 5-14% but had minimal impact (<1%) on deaths. Smaller impacts on infections and deaths (<3%) were seen for disruptions to facility testing and ART initiation, but reduced partner numbers resulted in 11-23% fewer infections and 0.4-1.0% fewer deaths. Longer disruption periods of 4 and 6 months amplified the impact of combined disruption scenarios. When all realistic disruptions were modelled simultaneously, an overall decrease in new HIV infections was always predicted over one year (3-17%), but not over 5 years (1% increase-4% decrease), while deaths mostly increased over one year (1-2%) and 5 years (1.2 increase – 0.3 decrease).

Conclusions

The overall impact of COVID-19 on new HIV infections and HIV-related deaths is dependent on the nature, scale and length of the various disruptions. Resources should be directed to ensuring levels of viral suppression and condom use are maintained to mitigate any adverse effects of COVID-19 related disruption on HIV transmission and control among MSM in China.
Associations between governor political affiliation and COVID-19 cases, deaths, and testing in the United States
Authors: Neelon Brian , Mutiso Fedelis , Mueller Noel T , Pearce John L , Benjamin-Neelon Sara E
Published: October 2020

Introduction

The response to the COVID-19 pandemic became increasingly politicized in the United States (US) and political affiliation of state leaders may contribute to policies affecting the spread of the disease. This study examined differences in COVID-19 infection, death, and testing by governor party affiliation across 50 US states and the District of Columbia.

Methods

A longitudinal analysis was conducted in December 2020 examining COVID-19 incidence, death, testing, and test positivity rates from March 15 through December 15, 2020. A Bayesian negative binomial model was fit to estimate daily risk ratios (RRs) and posterior intervals (PIs) comparing rates by gubernatorial party affiliation. The analyses adjusted for state population density, rurality, census region, age, race, ethnicity, poverty, number of physicians, obesity, cardiovascular disease, asthma, smoking, and presidential voting in 2020.

Results

From March to early June, Republican-led states had lower COVID-19 incidence rates compared to Democratic-led states. On June 3, the association reversed, and Republican-led states had higher incidence (RR=1.10, 95% PI=1.01, 1.18). This trend persisted through early December. For death rates, Republican-led states had lower rates early in the pandemic, but higher rates from July 4 (RR=1.18, 95% PI=1.02, 1.31) through mid-December. Republican-led states had higher test positivity rates starting on May 30 (RR=1.70, 95% PI=1.66, 1.73) and lower testing rates by September 30 (RR=0.95, 95% PI=0.90, 0.98).

Conclusion

Gubernatorial party affiliation may drive policy decisions that impact COVID-19 infections and deaths across the US. Future policy decisions should be guided by public health considerations rather than political ideology.
Predicting dengue in the Philippines using artificial neural network
Authors: Zafra Bryan
Published: October 2020

Dengue fever is an infectious disease caused byFlavivirustransmitted byAedesmosquito. This disease predominantly occurs in the tropical and subtropical regions. With no specific treatment, the most effective way to prevent dengue is vector control. The dependence of Aedes mosquito population on meteorological variables make prediction of dengue infection possible using conventional statistical and epidemiologic models. However, with increasing average global temperature, the predictability of these models may be lessened employing the need for artificial neural network. This study uses artificial neural network to predict dengue incidence in the entire Philippines with humidity, rainfall, and temperature as independent variables. All generated predictive models have mean squared logarithmic error of less than 0.04.
Cardiac Arrhythmias in Patients with COVID-19: A Systematic review and Meta-analysis
Authors: Hamam Omar , Goda Ahmed , Eldalal Moustafa , Ussama Amr , Fahmy Mostafa , Elyamany Karim , Ikram Waleed , Mahdy Ahmed , Bhandari Renu , Elbahnasawy Mohammad A. , Asal Hosam , Egbe Alexander
Published: October 2020

Background: Cardiac arrhythmia cannot be overlooked in patients with coronavirus disease 2019 (COVID-19) as it carries a great influence on the outcomes. Hence, this study aimed to build concrete evidence regarding the incidence of cardiac arrhythmia in patients with COVID-19. Methods: We performed a systematic search for trusted databases/search engines including PubMed, Scopus, Cochrane library and web of science. After screening, the relevant data were extracted and the incidences from the different included studies were pooled for meta-analysis. Results: Nine studies were finally included in our study consisting of 1445 patients. The results of meta-analysis showed that the incidence of arrhythmia in patients with COVID-19 was 19.7% with 95% confidence interval (CI) ranging from 11.7 to 27.6%. There was also a significant heterogeneity (I2 = 94.67%). Conclusion: Cardiac arrhythmias were highly frequent in patients with COVID-19 and observed in 19.7% of them. Appropriate monitoring by electrocardiogram with accurate and early identification of arrhythmias is important for better management and outcomes.
A double-blind sham-controlled phase 1 clinical trial of tDCS of the dorsolateral prefrontal cortex in cocaine inpatients: craving, sleepiness, and contemplation to change
Authors: Gaudreault Pierre-Olivier , Sharma Akarsh , Datta Abhishek , Nakamura-Palacios Ester M. , King Sarah , Malaker Pias , Wagner Ariella , Vasa Devarshi , Parvaz Muhammad A. , Parra Lucas C. , Alia-Klein Nelly , Goldstein Rita Z.
Published: October 2020

Impaired inhibitory control accompanied by enhanced salience attributed to drug-related cues, both dorsolateral prefrontal cortex (dlPFC) functions, are hallmarks of drug addiction, contributing to worse symptomatology including craving. dlPFC modulation with transcranial direct current stimulation (tDCS) showed craving reduction in inpatients with cocaine use disorder (CUD). Our study aimed at assessing feasibility of a longer tDCS protocol in CUD (15 vs. the common five/10 sessions), and replicability of previous results.

In a randomized double-blind sham-controlled protocol, 17 inpatients were assigned to either a real-tDCS (right anodal/left cathodal) or a sham-tDCS condition, for 15 sessions. Primary outcome measures were self-reported craving, anxiety, depression, and quality of life. Secondary measures included sleepiness, readiness to change drug use, and affect. We also assessed cognitive function including impulsivity.

An 82% retention rate demonstrated feasibility. Partially supporting previous results, there was a trend for self-reported craving to decrease in the real-tDCS group more than the sham group, an effect that would reach significance with 15 subjects per group. Quality of life and impulsivity improved over time of treatment in both groups. Significant group × time interactions showed improvements after treatment only in the real-tDCS group for daytime sleepiness and readiness to change drug use. One-month follow-up suggested transient effects of tDCS on sleepiness and craving.

This study suggests that more subjects are needed to show a unique effect of real-tDCS on craving and to examine the duration of effect. Increased vigilance and motivation to change in the real-tDCS group suggest fortification of dlPFC-supported executive functions.
Determinants of Developing Symptomatic Disease in Ethiopian COVID-19 Patients
Authors: Leulseged Tigist W. , Alemahu Degu G. , Hassen Ishmael S. , Maru Endalkachew H. , Zewde Wuletaw C. , Chamesew Nigat W. , Yegile Kalkidan T. , Abebe Daniel S. , Abdi Firaol M. , Menyelshewa Etsegenet Y. , Gerbi Tegenu G. , Hagos Helen T.
Published: October 2020

Background

Studies show that having some symptoms seems to be associated with more severe disease and poor prognosis. Therefore, knowing who is more susceptible to symptomatic COVID-19 disease is important to provide targeted preventive and management practice. The aim of the study was to assess the determinants of having symptomatic disease among COVID-19 patients admitted to Millennium COVID-19 Care Center in Ethiopia.

Methods

A case-control study was conducted from August to September 2020 among a randomly selected 765 COVID-19 patients (372 Asymptomatic and 393 Symptomatic patients). Chi-square test and independent t-test were used to detect the presence of a statistically significant difference in the characteristics of the cases (symptomatic) and controls (asymptomatic), where p-value of <0.05 considered as having a statistically significant difference. Multivariable binary logistic regression was used to assess a statistically significant association between the independent variables and developing symptomatic COVID-19 where Adjusted Odds ratio (AOR), 95% CIs for AOR, and P-values were used for testing significance and interpretation of results.

Results

The result of the multivariable binary logistic regression shows that age group (AOR= 1.818, 95% CI= 1.210, 2.731, p-value=0.004 for 30-39 years; AOR= 1.611, 95% CI= 1.016, 2.554, p-value=0.043 for 40-49 years and AOR= 4.076, 95% CI= 2.582, 6.435, p-value=0.0001 for years and above), sex (AOR= 1.672, 95% CI= 1.216, 2.299, p-value=0.002) and history of diabetes mellitus (AOR= 2.406, 95% CI= 1.384, 4.181, p-value=0.002) were found to be significant factors that determine the development of symptomatic disease in COVID-19 patients.

Conclusions

Developing a symptomatic COVID-19 disease was found to be determined by exposures of old age, male sex, and being diabetic. Therefore, patients with the above factors should be given enough attention in the prevention and management process, including inpatient management, to pick symptoms earlier and to manage accordingly so that these patients can have a favorable treatment outcome.
Investigating the relationship between IGF-I, -II and IGFBP-3 concentrations and later-life cognition and brain volume
Authors: Salzmann Antoine , James Sarah-Naomi , Williams Dylan M. , Richards Marcus , Cadar Dorina , Schott Jonathan M. , Coath William , Sudre Carole H. , Chaturvedi Nishi , Garfield Victoria
Published: October 2020

Background

The insulin/insulin-like signalling (IIS) pathways, including Insulin-like Growth Factors (IGFs), varies with age. However, their association with late-life cognition and neuroimaging parameters is not well characterised.

Methods

Using data from the British 1946 birth cohort we investigated associations of IGF-I, -II and IGFBP-3 (measured at 53 and 60-64 years) with cognitive performance (word learning test (WLT) and visual letter search (VLS) – at 60-64y and 69y) and cognitive state (Addenbrooke’s Cognitive Exam-III (ACE-III) - at 69-71y), and in a proportion, quantified neuroimaging measures (whole brain volume (WBV); white matter hyperintensity volume (WMHV); hippocampal volume (HV)). Regression models included adjustments for demographic, lifestyle and health factors.

Results

Higher IGF-I and IGF-II at 53y was associated with higher ACE-III scores (ß 0.07 95%CI [0.02,0.12]; scoreACE-III 89.48 [88.86,90.1], respectively). IGF-II at age 53y was additionally associated with higher WLT scores (scoreWLT 20 [19.35,20.65]). IGFBP-3 at 60-64y was associated with favourable VLS score at 60-64y and 69y (ß 0.07 [0.01,0.12]; ß 0.07 [0.02,0.12], respectively), higher memory and cognitive state at 69y (ß 0.07 [0.01,0.12]; ß 0.07 [0.01,0.13], respectively) and reduced WMHV (ß -0.1, [-0.21,-0.00]). IGF-I/IGFBP-3 at 60-64y was associated with lower VLS scores at 69y (ß -0.08, [-0.15,-0.02]).

Conclusions

Increased measure in IIS parameters (IGF-I, -II and IGFBP-3) relate to better cognitive state in later life. There were apparent associations with specific cognitive domains (IGF-II relating to memory; IGFBP-3 to memory, processing speed and WMHV; and IGF-I/IGFBP-3 molar ratio with slower processing speed). IGFs and IGFBP-3 are associated with favourable cognitive function outcomes.