bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of Resuscitative Care Provided to an Infant With Abusive Head Trauma in Community Emergency Departments
Authors: Lutfi Riad , Berrens Zachary J. , Ackerman Laurie L. , Montgomery Erin E. , Mustafa Manahil , Kirby Michele L. , Pearson Kellie J. , Abu-Sultaneh Samer , Abulebda Kamal 
Published: November 2020

Objectives
Abusive head trauma (AHT) is a very common and serious form of physical abuse, and a major cause of mortality and morbidity for young children. Early Recognition and supportive care of children with AHT is a common challenge in community emergency department (CEDs). We hypothesized that standardized, in situ simulation can be used to measure and compare the quality of resuscitative measures provided to children with AHT in a diverse set of CEDs.

Methods
This prospective, simulation-based study measured teams' performance across CEDs. The primary outcome was overall adherence to AHT using a 15-item performance assessment checklist based on the number of tasks performed correctly on the checklist.

Results
Fifty-three multiprofessional teams from 18 CEDs participated in the study. Of 270 participants, 20.7% were physicians, 65.2% registered nurses, and 14.1% were other providers. Out of all tasks, assessment of airway/breathing was the most successfully conducted task by 53/53 teams (100%). Although 43/53 teams (81%) verbalized the suspicion for AHT, only 21 (39.6%) of 53 teams used hyperosmolar agent, 4 (7.5%) of 53 teams applied cervical spine collar stabilization, and 6 (11.3%) of 53 teams raised the head of the bed. No significant difference in adherence to the checklist was found in the CEDs with an inpatient pediatric service or these with designated adult trauma centers compared with CEDs without. Community emergency departments closer to the main academic center outperformed CEDs these that are further away.

Conclusions
This study used in situ simulation to describe quality of resuscitative care provided to an infant presenting with AHT across a diverse set of CEDs, revealing variability in the initial recognition and stabilizing efforts and provided and targets for improvement. Future interventions focusing on reducing these gaps could improve the performance of CED providers and lead to improved patient outcomes.
Integrative Analysis of Prognostic Biomarkers for Acute Rejection in Kidney Transplant Recipients
Authors: Cao Yue , Alexander Stephen I. , Chapman Jeremy R. , Craig Jonathan C. , Wong Germaine , Yang Jean Y.H. 
Published: November 2020

Background.
Noninvasive biomarkers may predict adverse events such as acute rejection after kidney transplantation and may be preferable to existing methods because of superior accuracy and convenience. It is uncertain how these biomarkers, often derived from a single study, perform across different cohorts of recipients.

Methods.
Using a cross-validation framework that evaluates the performance of biomarkers, the aim of this study was to devise an integrated gene signature set that predicts acute rejection in kidney transplant recipients. Inclusion criteria were publicly available datasets of gene signatures that reported acute rejection episodes after kidney transplantation. We tested the predictive probability for acute rejection using gene signatures within individual datasets and validated the set using other datasets. Eight eligible studies of 1454 participants, with a total of 512 acute rejections episodes were included.

Results.
All sets of gene signatures had good positive and negative predictive values (79%–96%) for acute rejection within their own cohorts, but the predictability reduced to <50% when tested in other independent datasets. By integrating signature sets with high specificity scores across all studies, a set of 150 genes (included CXCL6, CXCL11, OLFM4, and PSG9) which are known to be associated with immune responses, had reasonable predictive values (varied between 69% and 90%).

Conclusions.
A set of gene signatures for acute rejection derived from a specific cohort of kidney transplant recipients do not appear to provide adequate prediction in an independent cohort of transplant recipients. However, the integration of gene signature sets with high specificity scores may improve the prediction performance of these markers.
Role of ivermectin in the prevention of COVID-19 infection among healthcare workers in India: A matched case-control study
Authors: Behera Priyamadhaba , Patro Binod Kumar , Singh Arvind Kumar , Chandanshive Pradnya Dilip , S.R. Ravi Kumar , Pradhan Somen Kumar , Pentapati Siva Santosh Kumar , Batmanabane Gitanjali , Padhy Biswa Mohan , Bal Shakti , Singh Sudipta Ranjan , Mohanty Rashmi Ranjan 
Published: November 2020

BackgroundIvermectin is one among several potential drugs explored for its therapeutic and preventive role in COVID-19 infection. The study was aimed to explore the association between ivermectin prophylaxis and development of COVID-19 infection among healthcare workers.MethodsA hospital-based matched case-control study was conducted among healthcare workers of AIIMS Bhubaneswar, India, from September to October 2020. Profession, gender, age and date of diagnosis were matched for 186 case-control pairs. Cases and controls were healthcare workers who tested positive and negative, respectively, for COVID-19 by RT-PCR. Exposure was defined as the intake of ivermectin and/or hydroxychloroquine and/or vitamin-C and/or other prophylaxis for COVID-19. Data collection and entry was done in Epicollect5, and analysis was performed using STATA version 13. Conditional logistic regression models were used to describe the associated factors for COVID-19 infection.ResultsIvermectin prophylaxis was taken by 77 controls and 38 cases. Two-dose ivermectin prophylaxis (0.27, 95% CI, 0.15-0.51) was associated with 73% reduction of COVID-19 infection among healthcare workers for the following one month, those who were involved in physical activity (3.06 95% CI, 1.18-7.93) for more than an hour/day were more likely to contract COVID-19 infection. Type of household, COVID duty, single-dose ivermectin prophylaxis, vitamin-C prophylaxis and hydroxychloroquine prophylaxis were not associated with COVID-19 infection.ConclusionTwo-dose ivermectin prophylaxis at a dose of 300 μg/kg with a gap of 72 hours was associated 73% reduction of COVID-19 infection among healthcare workers for the following one-month. Further research is required before its large scale use.
Attitudes and beliefs about family and domestic violence in Australian faith-based communities: A qualitative study
Authors: Truong Mandy , Sharif Mienah , Olsen Anna , Pasalich Dave , Calabria Bianca , Priest Naomi 
Published: November 2020

AbstractFamily and domestic violence (FDV) is a major public health and social issue that is associated with a range of physical, mental and behavioural health outcomes. Religion and faith are powerful and influential in shaping the lives of many individuals and societies, in addition to the social practices, norms and structures that are significant in understanding and responding to FDV. This qualitative study aims to deepen understanding of the influence of religious beliefs and values on attitudes and beliefs of FDV among culturally diverse faith communities in Australia. Interviews and focus groups were conducted with 64 participants from a diverse range of cultural and religious backgrounds which included faith leaders, community members and FDV sector workers. Six main themes were identified describing attitudes, beliefs and knowledge about FDV: 1) Faith and religion do not condone violence; 2) Awareness of FDV is increasing, yet remains often poorly understood; 3) FDV is still a taboo topic; 4) Denial and defensiveness about FDV persist; 5) Patience, endurance and forgiveness is often prioritised over safety; 6) Gender roles and norms founded on religious beliefs and interpretations underpin many FDV understandings and responses. These findings demonstrate the tensions between expressions of faith and attitudes to women and FDV. Further exploration of these issues within specific faith communities, as well as how to support and engage with these communities in increasing understandings of FDV and developing effective responses, is needed in the Australian context.
Infections after routine syndesmotic screw removal – a retrospective quality study
Authors: Øverby Thomas Aleksander , Jakobsen Rune B. 
Published: November 2020

ABSTRACTBackgroundInfections after routine removal of syndesmotic screws are an unwanted complication.MethodsWe included all patients treated with syndesmotic screw with routine removal in a five-year period and extracted information regarding fracture characteristics and patient characteristics. Infections were classified as superficial or deep incisional.Results1246 patients with ankle fractures were treated surgically in the study period. 343 had routine removals of the syndesmotic screw. We identified 6 cases with infection (1.7%) developing after routine syndesmotic screw removal.ConclusionsWe found a low infection rate but when infections did occur, they frequently required surgical revision(s) and long-time antibiotic treatment.
COVID-19 Pandemic Among Immigrant Latinx Farmworker and Non-farmworker Families: A Rural-Urban Comparison of Economic, Educational, Healthcare, and Immigration Concerns
Authors: Quandt Sara A. , LaMonto Natalie J. , Mora Dana C. , Talton Jennifer W. , Laurienti Paul J. , Arcury Thomas A. 
Published: November 2020

AbstractCOVID-19 has highlighted social and health injustices in the US. Structural inequalities have increased the likelihood of immigrants contracting COVID-19, by being essential workers and through poverty that forces this population to continue working. Rural and urban immigrant families may face different concerns. Using a telephone survey in May 2020 of 105 Latinx families in an existing study, quantitative and qualitative data were gathered on work and household economics, childcare and education, healthcare, and community climate. Analyses show that, although rural and urban groups experienced substantial economic effects, impacts were more acute for urban families. Rural workers reported fewer workplace protective measures for COVID-19. For both groups, fear and worry, particularly about finances and children, dominated reports of their situations with numerous reports of experiencing stress and anxiety. The experience of the pandemic is interpreted as an example of contextual vulnerability of a population already experiencing structural violence through social injustice.
Racial and Ethnic Disparities in Health of Adults in the United States: A 20-Year National Health Interview Survey Analysis, 1999-2018
Authors: Mahajan Shiwani , Caraballo César , Lu Yuan , Massey Dorothy , Murugiah Karthik , Annapureddy Amarnath R. , Roy Brita , Riley Carley , Onuma Oyere , Nunez-Smith Marcella , Valero-Elizondo Javier , Forman Howard P. , Nasir Khurram , Herrin Jeph , Krumholz Harlan M. 
Published: November 2020

ABSTRACTImportanceThirty-five years ago, the Heckler Report described health disparities among minority populations in the US. Since then, policies have been implemented to address these disparities. However, a recent evaluation of progress towards improving the health and health equity among US adults is lacking.ObjectivesTo evaluate racial/ethnic disparities in the physical and mental health of US adults over the last 2 decades.DesignCross-sectional.SettingNational Health Interview Survey data, years 1999–2018.ParticipantsAdults aged 18–85 years.ExposureRace/ethnicity subgroups (non-Hispanic White, non-Hispanic Black, non-Hispanic Asian, Hispanic).Main outcome and measuresProportion of adults reporting poor/fair health status, severe psychological distress, functional limitation, and insufficient sleep. We also estimated the gap between non-Hispanic White and the other subgroups for these four outcomes.ResultsWe included 596,355 adults (mean age 46 years, 51.8% women), of which 69.7%, 13.8%, 11.8% and 4.7% identified as non-Hispanic White, Hispanic, non-Hispanic Black, and non-Hispanic Asian, respectively. Between 1999 and 2018, Black individuals fared worse on most measures of health, with 18.7% (95% CI 17.1–20.4) and 41.1% (95% CI 38.7–43.5) reporting poor/fair health and insufficient sleep in 2018 compared with 11.1% (95% CI 10.5– 11.7) and 31.2% (95% CI 30.3–32.1) among White individuals. Notably, between 1999–2018, there was no significant decrease in the gap in poor/fair health status between White individuals and Black (−0.07% per year, 95% CI −0.16–0.01) and Hispanic (−0.03% per year, 95% CI −0.07– 0.02) individuals, and an increase in the gap in sleep between White individuals and Black (+0.2% per year, 95% CI 0.1–0.4) and Hispanic (+0.3% per year, 95% CI 0.1–0.4) individuals. Additionally, there was no significant decrease in adults reporting poor/fair health status and an increase in adults reporting severe psychological distress, functional limitation, and insufficient sleep.Conclusions and RelevanceThe marked racial/ethnic disparities in health of US adults have not improved over the last 20 years. Moreover, the self-perceived health of US adults worsened during this time. These findings highlight the need to re-examine the initiatives seeking to promote health equity and improve health.
Aerosol and bioaerosol particle size and dynamics from defective sanitary plumbing systems
Authors: Gormley Michael , Aspray Thomas J , Kelly David A 
Published: November 2020

AbstractAerosols are readily transported on airstreams through building sanitary plumbing and sewer systems and those containing microbial pathogens (known as bioaerosols) are recognised as contributors to infection spread within buildings. When a defect occurs in the sanitary plumbing system that affects the system integrity, a cross-transmission route is created that can enable the emission of bioaerosols from the system into the building. These emission occurrences are characterised as short-burst events (typically < 1 minute in duration) which makes them difficult to detect and predict. The characterisation of these emission events is the focus of this research.Two methods were used to characterise bioaerosol emission events in a full scale test rig: (i) an Aerodynamic Particle Sizer (APS) for particle size distribution and concentrations; and (ii) a slit-to-agar sampler to enumerate the ingress of a viable tracer microorganism (Pseudomonas putida). The APS data confirmed that most particles (> 99.5%) were <5 μm and were therefore considered aerosols. Particles generated within the sanitary plumbing system as a result of a toilet flush leads to emissions into the building during system defect conditions with an equivalence of someone talking loudly for over 6 and a half minutes. There were no particles detected of a size > 11μm anywhere in the system. Particle count was influenced by flush volume, but it was not possible to determine if there was any direct influence from airflow rate. Typical emissions resulting from a 6 litre flush were in the range of 280 – 400 particles per second at a concentration of typically 9 to 12 number per cm3 and a total particle count in the region of 3,000 to 4,000 particles, whereas the peak emissions from a 1.2 litre flush was 60 - 80 particles per second at a concentration of 2.4 to 3 number per cm3 and a total particle count in the region of 886 to 1045 particles. The reduction in particles is in direct proportion to the reduction in flush volume. The slit-to-agar sampler was able to provide viable time course CFU data and confirmed the origin of the particles to be the tracer microorganism flushed into the system. The time course data also has characteristics consistent with the unsteady nature of a toilet flush.
MODELLING PRESYMPTOMATIC INFECTIOUSNESS IN COVID-19
Authors: Cheng Russell , Dye Christopher , Dagpunar John , Williams Brian 
Published: November 2020

ABSTRACTThis paper considers SEPIR, the extension of an existing parametric SEIR continuous simulation compartment model. Both models can be fitted to real data as they include parameters that can simply be estimated from the data. However SEPIR deploys an additional presymptomatic (also called asymptomatic) infectious stage that is not included in SEIR but which is known to exist in COVID-19. This stage is also parametrised and so can be fitted to data. Both SEPIR and the existing SEIR model assume a homogeneous mixing population, an idealisation that is unrealistic in practice when dynamically varying control strategies are deployed against virus. This means that if either model is to represent more than just a single period in the behaviour of the epidemic, then the parameters of the model will have to be time dependent. This issue is also discussed in this paper.
Development of novel clinical examination scales for the measurement of disease severity in Creutzfeldt-Jakob disease
Authors: Nihat Akin , Mok Tze How , Odd Hans , Thompson Andrew , Caine Diana , McNiven Kirsty , O’Donnell Veronica , Tesfamichael Selam , Rudge Peter , Collinge John , Mead Simon 
Published: November 2020

AbstractObjectiveSporadic Creutzfeldt-Jakob disease (sCJD) causes rapidly-progressive dementia and complex abnormalities of motor systems with striking phenotypic heterogeneity, but no tools are available for the clinician to determine disease severity from bedside cognitive and neurological assessments. We used a robust statistical methodology and routinely-collected examination data to develop and validate short clinical rating scales quantifying longitudinal motor and cognitive dysfunction in sCJD.MethodsWe undertook a retrospective analysis of clinical examination data from the prospective National Prion Monitoring Cohort study, October 2008 – December 2016. Rasch analysis was used to iteratively construct interval scales measuring composite cognitive and motor dysfunction from pooled bedside neurological and cognitive examination tests.A longitudinal clinical examination dataset was constructed from a total of 528 patients with sCJD, comprising 1030 Motor Scale and 757 Cognitive Scale scores, over 130 patient-years of study, and used to demonstrate scale utility.ResultsThe Rasch-derived Motor Scale consists of 8 items, including examination items reliant on pyramidal, extrapyramidal and cerebellar systems. The Cognitive Scale comprises 6 items, and includes measures of executive function, language, visual perception and memory. Both scales are unidimensional, perform consistently regardless of age or gender and have excellent inter-rater reliability. Each scale can be completed in a few minutes at the bedside, as part of a normal neurocognitive examination. Several uses of the scales, in measuring longitudinal change, prognosis, and phenotypic heterogeneity are illustrated.InterpretationThese two novel scales measuring motor and cognitive dysfunction in sCJD should prove useful to objectively measure phenotypic and clinical change in future clinical trials and for patient stratification. This statistical approach can help to overcome obstacles to assessing clinical change in rapidly-progressive, multisystem conditions with limited longitudinal follow-up.
Mobile Monitoring of Mood (MoMo-Mood) Pilot: A Longitudinal, Multi-Sensor Digital Phenotyping Study of Patients with Major Depressive Disorder and Healthy Controls
Authors: Triana Ana María , Martikkala Annasofia , Baryshnikov Ilya , Heikkilä Roope , Alakörkkö Tuomas , Darst Richard K. , Ekelund Jesper , Isometsä Erkki , Aledavood Talayeh 
Published: November 2020

AbstractMental disorders are a major global cause of morbidity and mortality. The surge in adoption of smartphones and other wearable devices has made it possible to use the data generated by them for clinical purposes. In particular, in psychiatry, detailed and high-resolution information on patient’s state, mood, and behavior can significantly improve the assessment, diagnosis and the treatment of patients. However, there is long path to turn the raw data created by these sensors, to information and insights that can be applied in clinical practice.Here, we introduce the MoMo-Mood Pilot: a study created to investigate the feasibility of using smartphones and wearables as data collection tools from subjects suffering from major depressive disorder. We collect data from 14 patients and 22 controls in two phases (active and passive). We demonstrate the feasibility of monitoring patients with several devices over short periods and passively monitoring them over long periods of time with minimal disruption in their daily activities. We identify and describe a series of challenges in this process.The MoMo-Mood pilot study is an encouraging step in the process of determining the effectiveness of using wearables for quantifying the behavior and the state of psychiatric patients with high temporal resolution, which can lead to their potential adoption in clinical practice.
Performance characteristics of a rapid SARS-CoV-2 antigen detection assay at a public plaza testing site in San Francisco
Authors: Pilarowski Genay , Lebel Paul , Sunshine Sara , Liu Jamin , Crawford Emily , Marquez Carina , Rubio Luis , Chamie Gabriel , Martinez Jackie , Peng James , Black Douglas , Wu Wesley , Pak John , Laurie Matthew T. , Jones Diane , Miller Steve , Jacobo Jon , Rojas Susana , Rojas Susy , Nakamura Robert , Tulier-Laiwa Valerie , Petersen Maya , Havlir Diane V. ,   The CLIAHUB Consortium, DeRisi Joseph 
Published: November 2020

ABSTRACTWe evaluated the performance of the Abbott BinaxNOW™ Covid-19 rapid antigen test to detect virus among persons, regardless of symptoms, at a public plaza site of ongoing community transmission. Titration with cultured clinical SARS-CoV-2 yielded a human observable threshold between 1.6×104-4.3×104viral RNA copies (cycle threshold (Ct) of 30.3-28.8 in this assay). Among 878 subjects tested, 3% (26/878) were positive by RT-PCR, of which 15/26 had a Ct<30, indicating high viral load. 40% (6/15) of Ct<30 were asymptomatic. Using this Ct<30 threshold for Binax-CoV2 evaluation, the sensitivity of the Binax-CoV2 was 93.3% (14/15), 95% CI: 68.1-99.8%, and the specificity was 99.9% (855/856), 95% CI: 99.4-99.9%.
Randomized controlled trial of convalescent plasma therapy against standard therapy in patients with severe COVID-19 disease
Authors: AlQahtani Manaf , Abdulrahman Abdulkarim , Almadani Abdulrahman , Alali Salman Yousif , Al Zamrooni Alaa Mahmood , Hejab Amal Hamza , Conroy Ronán M , Wasif Pearl , Atkin Stephen L , Otoom Sameer , Abduljalil Manal 
Published: November 2020

AbstractBackgroundConvalescent plasma (CP) therapy in COVID-19 disease has been suggested to improve clinical outcome in severe disease. This pilot study was designed to inform the design of a definitive phase 3 clinical trial.MethodsThis was a prospective, interventional and randomized open label pilot trial involving 40 patients with COVID-19 who were requiring oxygen therapy and who had radiological evidence of pneumonia. Twenty COVID-19 patients received two 200ml transfusions of convalescent patient CP over 24 hours were compared with 20 patients who received routine care alone. The primary outcome was the requirement for ventilation. The secondary outcomes were white blood cell count, lactate dehydrogenase (LDH), C-reactive protein (CRP), Troponin, Ferritin, D-Dimer, procalcitonin, mortality rate at 28 days.ResultsThe CP group were a higher risk group with higher ferritin levels (p<0.05) though respiratory indices did not differ. The primary outcome measure – ventilation – was required in 6 controls and 4 patients on CP (risk ratio 0.67 95% CI 0.22 – 2.0, p=0.72); mean time on ventilation was 10.5 days in the control against 8.2 days in patients on CP (p=0.81). There were no differences in secondary measures at the end of the study. Two patients died in the control and one patient in the CP arm.ConclusionThere were no significant differences in the primary or secondary outcome measures between CP and standard therapy though fewer patients required ventilation and for a shorter period of time. The study showed that CP therapy appears to be safe and it is feasible to perform a definitive phase 3 clinical trial using this study protocol.