bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnosis and Management of Neonatal Herpes Simplex Infection in the Emergency Department
Authors: Ramgopal Sriram , Wilson Paria M. , Florin Todd A. 
Published: April 2020

Abstract
Neonatal herpes simplex virus infection (HSV) is rare in neonates, with an estimated global incidence of 10 per 100,000 live births. Neonatal HSV is challenging to diagnose due to often vague signs and symptoms. Untreated, the mortality of some HSV subtypes exceeds 80%. Overtesting and overtreatment can result in prolonged hospitalizations and expose neonates to medication toxicity. In contrast, prompt evaluation and use of empiric antiviral therapy before the results of definitive testing can improve outcomes for infants with HSV. A wide degree of practice variation exists with respect to testing and treatment for neonatal HSV, and more research is required to safely risk-stratify this population. This review presents the epidemiology, risk factors, presenting features, and emergency department management of neonatal HSV infection.
Venue-Based HIV Testing at Sex Work Hotspots to Reach Adolescent Girls and Young Women Living With HIV: A Cross-sectional Study in Mombasa, Kenya
Authors: Ma Huiting , Wang Linwei , Gichangi Peter , Mochache Vernon , Manguro Griffins , Musyoki Helgar K. , Bhattacharjee Parinita , Cholette François , Sandstrom Paul , Becker Marissa L. , Mishra Sharmistha ,   on behalf of the Transitions Study Team
Published: April 2020

Background:
We estimated the potential number of newly diagnosed HIV infections among adolescent girls and young women (AGYW) using a venue-based approach to HIV testing at sex work hotspots.

Methods:
We used hotspot enumeration and cross-sectional biobehavioral survey data from the 2015 Transition Study of AGYW aged 14–24 years who frequented hotspots in Mombasa, Kenya. We described the HIV cascade among young females who sell sex (YFSS) (N = 408) versus those young females who do not sell sex (YFNS) (N = 891) and triangulated the potential (100% test acceptance and accuracy) and feasible (accounting for test acceptance and sensitivity) number of AGYW that could be newly diagnosed through hotspot-based HIV rapid testing in Mombasa. We identified the profile of AGYW with an HIV in the past year using generalized linear mixed regression models.

Results:
N = 37/365 (10.1%) YFSS and N = 30/828 (3.6%) YFNS were living with HIV, of whom 27.0% (N = 10/37) and 30.0% (N = 9/30) were diagnosed and aware (P = 0.79). Rapid test acceptance was 89.3%, and sensitivity was 80.4%. There were an estimated 15,635 (range: 12,172–19,097) AGYW at hotspots. The potential and feasible number of new diagnosis was 627 (310–1081), and 450 (223–776), respectively. Thus, hotspot-based testing could feasibly reduce the undiagnosed fraction from 71.6% to 20.2%. The profile of AGYW who recently tested was similar among YFSS and YFNS. YFSS were 2-fold more likely to report a recent HIV test after adjusting for other determinants [odds ratio (95% confidence interval): 2.2 (1.5 to 3.1)].

Conclusion:
Reaching AGYW through hotspot-based HIV testing could fill gaps left by traditional, clinic-based HIV testing services.
Into the wild and on to the table: A Western Trauma Association multicenter analysis and comparison of wilderness falls in rock climbers and nonclimbers
Authors: Bernard Matthew , Martin Matthew J. , Corsa Josh , Robinson Bryce , Zeeshan Muhammad , Joseph Bellal , Morris David , Shillinglaw William , Schurr Michael , Smith Terrie , Lara Sabino , Brown Carlos , Harrell Kevin , Maxwell Robert , Berndtson Allison E. , Curry Terry , Kaups Krista , Dirks Rachel , Rott Michael , Schroeppel Thomas , Stillman Zachery , Warriner Zachary , Inaba Kenji , Burlew Clay , Robinson Caitlin , Jackson Rebecca , Dunn Julie , Chapin Trinette , Wilson Alison , Moulton Steve , Phillips Ryan , Shahi Niti , Urban Shane , Velopulos Catherine , Davenport Daniel , C. Bernard Andrew 
Published: April 2020

BACKGROUND
Wilderness activities expose outdoor enthusiasts to austere environments with injury potential, including falls from height. The majority of published data on falls while climbing or hiking are from emergency departments. We sought to more accurately describe the injury pattern of wilderness falls that lead to serious injury requiring trauma center evaluation and to further distinguish climbing as a unique pattern of injury.

METHODS
Data were collected from 17 centers in 11 states on all wilderness falls (fall from cliff: International Classification of Diseases, Ninth Revision, e884.1; International Classification of Diseases, 10th Revision, w15.xx) from 2006 to 2018 as a Western Trauma Association multicenter investigation. Demographics, injury characteristics, and care delivery were analyzed. Comparative analyses were performed for climbing versus nonclimbing mechanisms.

RESULTS
Over the 13-year study period, 1,176 wilderness fall victims were analyzed (301 climbers, 875 nonclimbers). Fall victims were male (76%), young (33 years), and moderately injured (Injury Severity Score, 12.8). Average fall height was 48 ft, and average rescue/transport time was 4 hours. Nineteen percent were intoxicated. The most common injury regions were soft tissue (57%), lower extremity (47%), head (40%), and spine (36%). Nonclimbers had a higher incidence of severe head and facial injuries despite having equivalent overall Injury Severity Score. On multivariate analysis, climbing remained independently associated with increased need for surgery but lower odds of composite intensive care unit admission/death. Contrary to studies of urban falls, height of fall in wilderness falls was not independently associated with mortality or Injury Severity Score.

CONCLUSION
Wilderness falls represent a unique population with distinct patterns of predominantly soft tissue, head, and lower extremity injury. Climbers are younger, usually male, more often discharged home, and require more surgery but less critical care.

LEVEL OF EVIDENCE
Epidemiological, Level IV.
A globally available COVID-19 – Template for clinical imaging studies
Authors: Salg G.A. , Ganten M.K. , Baumhauer M. , Heußel C.P. , Kleesiek J. 
Published: April 2020

AbstractBackgroundThe pandemic spread of COVID-19 has caused worldwide implications on societies and economies. Chest computed tomography (CT) has been found to support both, current diagnostic and disease monitoring. A joint approach to collect, analyze and share clinical and imaging information about COVID-19 in the highest quality possible is urgently needed.MethodsAn evidence-based reporting template was developed for assessing COVID-19 pneumonia using an FDA-approved medical software. The annotation of qualitative and quantitative findings including radiomics features is performed directly on primary imaging data. For data collection, secondary information from the patient history and clinical data such as symptoms and comorbidities are queried.ResultsLicense-royalty free, cloud-based web platform and on-premise deployments are offered. Hospitals can upload, assess, report and if pseudonymized share their COVID-19 cases. The aggregation of radiomics in correlation with rt-PCR, patient history, clinical and radiological findings, systematically documented in a single database, will lead to optimized diagnosis, risk stratification and response evaluation. A customizable analytics dashboard allows the explorative real-time data analysis of imaging features and clinical information.ConclusionsThe COVID-19-Template is based on a systematic, computer-assisted and context-guided approach to collect, analyze and share data. Epidemiological and clinical studies for therapies and vaccine candidates can be implemented in compliance with high data quality, integrity and traceability.An additional explanation video of the COVID-19-Template video is provided via:http://cloud1.mint-medical.de/downloads/player/index.html?v=Covid19StandardizedAssessmentWebHighlightsDynamic evidence-based electronic case report form (eCRF) for COVID-19 including documentation of primary imaging data, secondary clinical data and patient history including radiomics featuresComputer-assisted, context-guided reporting approach based on FDA approved medical product software package available free of chargeData quality, traceability, integrity in open-access web platformCustomizable analytics dashboard for explorative real-time data analysis of imaging features and clinical informationHuman and machine-readable data export for clinical trials
Clinical and epidemiological characteristics of Coronavirus Disease 2019 (COVID-19) patients
Authors: Tan Shing Cheng 
Published: April 2020

SummaryBackgroundNumerous groups have reported the clinical and epidemiological characteristics of Coronavirus Disease 2019 (COVID-19) cases; however, the data remained inconsistent. This paper aimed to pool the available data to provide a more complete picture of the characteristics of COVID-19 patients.MethodsA systematic review and pooled analysis was performed. Eligible studies were identified from database and hand searches up to March 2, 2020. Data on clinical (including laboratory and radiological) and epidemiological (including demographic) characteristics of confirmed COVID-19 cases were extracted and combined by simple pooling.ResultsOf 644 studies identified, 69 studies (involving 48,926 patients) were included in the analysis. The average age of the patients was 49.16 years. A total of 51.46% of the patients were men and 52.32% were non-smokers. Hypertension (50.82%) and diabetes (20.89%) were the most frequent comorbidities observed. The most common symptoms were fever (83.21%), cough (61.74%), and myalgia or fatigue (30.22%). Altered levels of blood and biochemical parameters were observed in a proportion of the patients. Most of the patients (78.50%) had bilateral lung involvements, and 5.86% showed no CT findings indicative of viral pneumonia. Acute respiratory distress syndrome (28.36%), acute cardiac injury (7.89%) and acute kidney injury (7.60%) were the most common complications recorded.ConclusionsClinical and epidemiological characteristics of COVID-19 patients were mostly heterogeneous and non-specific. This is the most comprehensive report of the characteristics of COVID-19 patients to date. The information presented is important for improving our understanding of the spectrum and impact of this novel disease.
Management of rheumatic diseases in the times of COVID-19 pandemic- perspectives of rheumatology practitioners from India
Authors: Gupta Latika , Misra Durga Prasanna , Agarwal Vishwesh , Balan Suma , Agarwal Vikas 
Published: April 2020

AbstractObjectiveThe Coronavirus disease 19 (COVID-19) pandemic has led to widespread concerns about the risk of infection in patients with rheumatic diseases (RD) receiving disease modifying ant-rheumatic drugs (DMARDs) and other immunosuppressants (IS).MethodsA SurveyMonkey® based electronic survey was conducted amongst members of the Indian Rheumatology Association to understand the need for changes in prevailing practices.ResultsOf the 861 invitees, 221 responded. In the wake of the pandemic, 47.5% would reduce biological DMARDs (bDMARDs) while only 12.2% would reduce the use of conventional synthetic DMARDs. 64.2% were likely to defer change in IS, the reluctance being most with rituximab (58.3%) followed by cyclophosphamide (53.3%), anti-tumor necrosis factor alpha agents (52.4%) and Janus kinase inhibitors (34.39%).Hydroxychloroquine was the preferred choice (81.9%) for the treatment of COVID-19 followed by protease inhibitors (22.1%) and intravenous immunoglobulin (8.1%). Chloroquine was less preferred (19%). More than two-thirds (70.5%) believed that COVID-19 might trigger macrophage activation syndrome. Social distancing (98.1%) and hand hygiene (74.6%) were recommended by majority. 62.8% would avoid touch for clinical examination whenever feasible.ConclusionMost rheumatologists perceived the need to change treatment of RDs during the COVID-19 pandemic; reduce immunosuppression and defer the usage of rituximab and bDMARDs.Key messagesWhat is already known about this subject?Patients with rheumatic diseases receiving glucocorticoids, disease modifying ant-rheumatic drugs and other immunosuppressants have increased susceptibility to infections including respiratory tract infectionsWhat does this study add?○There is an urgent need to revise the management of rheumatic diseases as perceived by a large group of practicing rheumatologists in India in the times of the COVID-19 pandemic.○There is reluctance to initiate biological DMARDs (especially Rituximab and anti-TNF agents), tsDMARDs (JAK inhibitors) and cyclophosphamide.○There is an inclination to prescribe hydroxychloroquine (HCQ) even for rheumatic diseases with weak level of evidence.How might this impact on clinical practice?This might identify areas to be addressed in a Delphi exercise to develop expert evidence to guide the management of RDs during the pandemic.
Genomic Analysis of Cardiac Surgery-Associated Mycobacterium chimaera Infections in Italy
Authors: Ghodousi Arash , Borroni Emanuele , Peracchi Marta , Palù Giorgio , Fallico Loredana , Rassu Mario , Manfrin Vinicio , Mantegani Paola , Monzillo Vincenzina , Manganelli Riccardo , Tortoli Enrico , Cirillo Daniela Maria 
Published: April 2020

AbstractOne hundred and twenty-two Mycobacterium chimaera strains isolated in Italy from cardiac surgery-related patients, cardiac surgery-unrelated patients and from heater-cooler units, were submitted to whole-genome sequencing and to subsequent SNP analysis. All but one strains isolated from cardiac surgery-related patients belonged to Subgroup 1.1 (19/23) or Subgroup 1.8 (3/23). Only 28 out of 79 strains isolated from heater-cooler units belonged to groupings other than 1.1 and 1.8. The strains isolated from cardiac surgery-unrelated patients were instead distributed across the phylogenetic tree. Our data, the first on isolates from Italy, are in agreement with a recent large genomic study suggesting a common source, represented by strains belonging to Subgroups 1.1 and 1.8, of cardiac surgery-related Mycobacterium chimaera infections. The strains belonging to groupings other than 1.1 and 1.8 isolated from heather-cooler units evidently resulted from contaminations at hospital level and had no share in the Mycobacterium chimaera outbreak. One Mycobacterium chimaera strain investigated in this study proved distant from every previously known Mycobacterium chimaera Groups (1, 2, 3 and 4) and we propose to assign to a novel group, named” Group 5”.
Reduction in time delay of isolation in COVID-19 cases in South Korea
Authors: Ryu Sukhyun , Jang Cheolsun , Kim Baekjin 
Published: April 2020

AbstractKorean public health authorities raised the public alert to its highest level on February 23, 2020 to mitigate the 2019 novel coronavirus disease epidemic. We have identified that the mean delay from symptom onset to isolation was reduced to one day after raising the alert. Vigilance can reduce this interval.
Toilets dominate environmental detection of SARS-CoV-2 virus in a hospital
Authors: Ding Zhen , Qian Hua , Xu Bin , Huang Ying , Miao Te , Yen Hui-Ling , Xiao Shenglan , Cui Lunbiao , Wu Xiaosong , Shao Wei , Song Yan , Sha Li , Zhou Lian , Xu Yan , Zhu Baoli , Li Yuguo 
Published: April 2020

AbstractBackgroundRespiratory and faecal aerosols play a suspected role in transmitting the SARS-CoV-2 virus. We performed extensive environmental sampling in a dedicated hospital building for Covid-19 patients in both toilet and non-toilet environments, and analysed the associated environmental factors.MethodsWe collected data of the Covid-19 patients. 107 surface samples, 46 air samples, two exhaled condensate samples, and two expired air samples were collected were collected within and beyond the four three-bed isolation rooms. We reviewed the environmental design of the building and the cleaning routines. We conducted field measurement of airflow and CO2 concentrations.FindingsThe 107 surface samples comprised 37 from toilets, 34 from other surfaces in isolation rooms (ventilated at 30-60 L/s), and 36 from other surfaces outside isolation rooms in the hospital. Four of these samples were positive, namely two ward door-handles, one bathroom toilet-seat cover and one bathroom door-handle; and three were weakly positive, namely one bathroom toilet seat, one bathroom washbasin tap lever and one bathroom ceiling-exhaust louvre. One of the 46 air samples was weakly positive, and this was a corridor air sample. The two exhaled condensate samples and the two expired air samples were negative.InterpretationThe faecal-derived aerosols in patients’ toilets contained most of the detected SARS-CoV-2 virus in the hospital, highlighting the importance of surface and hand hygiene for intervention.FundingThe work were partially supported by the National Natural Science Foundation of China (no 41977370), the Research Grants Council of Hong Kong’s (no 17202719) (no C7025-16G), and Scientific Research Fund of Jiangsu Provincial Department of Health (no S21017002).
A computational approach to identify interfering medications on urine drug screening assays without data from confirmatory testing
Authors: Ayala-Lopez Nadia , Aref Layla , Colby Jennifer M. , Hughey Jacob J. 
Published: April 2020

AbstractBackgroundUrine drug screening (UDS) assays can rapidly and sensitively detect drugs of abuse, but can also produce spurious results due to interfering substances. We previously developed an approach to identify interfering medications using electronic health record (EHR) data, but the approach was limited to UDS assays for which presumptive positives were confirmed using more specific methods. Here we adapted the approach to search for medications that cause false positives on UDS assays lacking confirmation data.MethodsFrom our institution’s EHR data, we used our previous dataset of 698,651 UDS and confirmation results. We also collected 211,108 UDS results for acetaminophen, ethanol, and salicylates. Both datasets included individuals’ prior medication exposures. We hypothesized that the odds of a presumptive positive would increase following exposure to an interfering ingredient independently of exposure to the assay’s target drug(s). For a given assay-ingredient pair, we quantified potential interference as an odds ratio from logistic regression. We evaluated interference of selected compounds in spiking experiments.ResultsCompared to the approach requiring confirmation data, our adapted approach showed only modestly diminished ability to detect interfering ingredients. Applying our approach to the new data, three ingredients had a higher odds ratio on the acetaminophen assay than acetaminophen itself did: levodopa, carbidopa, and entacapone. The first two, as well as related compounds methyldopa and alpha-methyldopamine, produced presumptive positives at < 40 μg/mL.ConclusionsOur approach can reveal interfering medications using EHR data from institutions at which UDS results are not routinely confirmed.
Injection Molded Autoclavable, Scalable, Conformable (iMASC) system for aerosol-based protection
Authors: Byrne James D. , Wentworth Adam J. , Chai Peter R. , Huang Hen-Wei , Babaee Sahab , Li Canchen , Becker Sarah L. , Tov Caitlynn , Min Soekkee , Traverso Giovanni 
Published: April 2020

AbstractThere is a dire need for personal protective equipment (PPE) within healthcare settings during the COVID-19 pandemic. In particular, single use disposable N95 face masks have been limited in supply. We have developed an Injection Molded Autoclavable, Scalable, Conformable (iMASC) system for aerosol-based protection. The iMASC system was designed as a reusable liquid silicone rubber mask with disposable N95 filter cartridges that can fit most face sizes and shapes. This system reduced the amount of N95 filter while preserving breathability and fit. Using finite element analysis, we demonstrated mask deformation and reaction forces from facial scans of twenty different wearers. In addition, we validated these findings by successful fit testing in twenty participants in a prospective clinical trial. The iMASC system has the potential to protect our healthcare workers with a reusable N95-comparable face mask that is rapidly scalable.
State-specific Projection of COVID-19 Infection in the United States and Evaluation of Three Major Control Measures
Authors: Chen Shi , Li Qin , Gao Song , Kang Yuhao , Shi Xun 
Published: April 2020

ABSTRACTMost models of the COVID-19 pandemic in the United States do not consider geographic variation and spatial interaction. In this research, we developed a travel-network-based susceptible-exposed-infectious-removed (SEIR) mathematical compartmental model system that characterizes infections by state and incorporates inflows and outflows of interstate travelers. Modeling reveals that curbing interstate travel when the disease is already widespread will make little difference. Meanwhile, increased testing capacity (facilitating early identification of infected people and quick isolation) and strict social-distancing and self-quarantine rules are most effective in abating the outbreak. The modeling has also produced state-specific information. For example, for New York and Michigan, isolation of persons exposed to the virus needs to be imposed within 2 days to prevent a broad outbreak, whereas for other states this period can be 3.6 days. This model could be used to determine resources needed before safely lifting state policies on social distancing.
Susceptible supply limits the role of climate in the COVID-19 pandemic
Authors: Baker Rachel E. , Yang Wenchang , Vecchi Gabriel A. , Metcalf C. Jessica E. , Grenfell Bryan T. 
Published: April 2020

AbstractPreliminary evidence suggests that climate may modulate the transmission of SARS-CoV-2. Yet it remains unclear whether seasonal and geographic variations in climate can substantially alter the pandemic trajectory, given high susceptibility is a core driver. Here, we use a climate-dependent epidemic model to simulate the SARS-CoV-2 pandemic probing different scenarios of climate-dependence based on known coronavirus biology. We find that while variations in humidity may be important for endemic infections, during the pandemic stage of an emerging pathogen such as SARS-CoV-2 climate may drive only modest changes to pandemic size and duration. Our results suggest that, in the absence of effective control measures, significant cases in the coming months are likely to occur in more humid (warmer) climates, irrespective of the climate-dependence of transmission and that summer temperatures will not substantially limit pandemic growth.