bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing global air pollution: the scope for further policy interventions
Authors: Amann Markus , Kiesewetter Gregor , Schöpp Wolfgang , Klimont Zbigniew , Winiwarter Wilfried , Cofala Janusz , Rafaj Peter , Höglund-Isaksson Lena , Gomez-Sabriana Adriana , Heyes Chris , Purohit Pallav , Borken-Kleefeld Jens , Wagner Fabian , Sander Robert , Fagerli Hilde , Nyiri Agnes , Cozzi Laura , Pavarini Claudia 
Published: September 2020

Over the last decades, energy and pollution control policies combined with structural changes in the economy decoupled emission trends from economic growth, increasingly also in the developing world. It is found that effective implementation of the presently decided national pollution control regulations should allow further economic growth without major deterioration of ambient air quality, but will not be enough to reduce pollution levels in many world regions. A combination of ambitious policies focusing on pollution controls, energy and climate, agricultural production systems and addressing human consumption habits could drastically improve air quality throughout the world. By 2040, mean population exposure to PM2.5 from anthropogenic sources could be reduced by about 75% relative to 2015 and brought well below the WHO guideline in large areas of the world. While the implementation of the proposed technical measures is likely to be technically feasible in the future, the transformative changes of current practices will require strong political will, supported by a full appreciation of the multiple benefits. Improved air quality would avoid a large share of the current 3–9 million cases of premature deaths annually. At the same time, the measures that deliver clean air would also significantly reduce emissions of greenhouse gases and contribute to multiple UN sustainable development goals.
This article is part of a discussion meeting issue ‘Air quality, past present and future’.
Cost-effectiveness of remdesivir and dexamethasone for COVID-19 treatment in South Africa
Authors: Jo Youngji , Jamieson Lise , Edoka Ijeoma , Long Lawrence , Silal Sheetal , Pulliam Juliet R.C. , Moultrie Harry , Sanne Ian , Meyer-Rath Gesine , Nichols Brooke E 
Published: September 2020

AbstractBackgroundSouth Africa recently experienced a first peak in COVID-19 cases and mortality. Dexamethasone and remdesivir both have the potential to reduce COVID-related mortality, but their cost-effectiveness in a resource-limited setting with scant intensive care resources is unknown.MethodsWe projected intensive care unit (ICU) needs and capacity from August 2020 to January 2021 using the South African National COVID-19 Epi Model. We assessed cost-effectiveness of 1) administration of dexamethasone to ventilated patients and remdesivir to non-ventilated patients, 2) dexamethasone alone to both non-ventilated and ventilated patients, 3) remdesivir to non-ventilated patients only, and 4) dexamethasone to ventilated patients only; all relative to a scenario of standard care. We estimated costs from the healthcare system perspective in 2020 USD, deaths averted, and the incremental cost effectiveness ratios of each scenario.ResultsRemdesivir for non-ventilated patients and dexamethasone for ventilated patients was estimated to result in 1,111 deaths averted (assuming a 0-30% efficacy of remdesivir) compared to standard care, and save $11.5 million. The result was driven by the efficacy of the drugs, and the reduction of ICU-time required for patients treated with remdesivir. The scenario of dexamethasone alone to ventilated and non-ventilated patients requires additional $159,000 and averts 1,146 deaths, resulting in $139 per death averted, relative to standard care.ConclusionsThe use of dexamethasone for ventilated and remdesivir for non-ventilated patients is likely to be cost-saving compared to standard care. Given the economic and health benefits of both drugs, efforts to ensure access to these medications is paramount.40-word summary of article’s main pointThe use of remdesivir and dexamethasone for treatment of severe COVID-19 in South Africa is likely to be cost-saving relative to standard care. Enabling access to these medications should be prioritize to improve patient outcomes and reduce total costs.
Self-sampling of capillary blood for serological testing of SARS-CoV-2 by COVID-19 IgG ELISA
Authors: Brown Lottie , Byrne Rachel L , Fraser Alice , Owen Sophie I , Cubas-Atienzar Ana I , Williams Chris , Kay Grant A , Cuevas Luis E , Fitchett Joseph R A , Fletcher Tom , Garrod Gala , Kontogianni Konstantina , Krishna Sanjeev , Menzies Stefanie , Planche Tim , Sainter Chris , Staines Henry M , Turtle Lance , Adams Emily R 
Published: September 2020

AbstractSerological testing is emerging as a powerful tool to progress our understanding of COVID-19 exposure, transmission and immune response. Large-scale testing is limited by the need for in-person blood collection by staff trained in venepuncture. Capillary blood self-sampling and postage to laboratories for analysis could provide a reliable alternative.Two-hundred and nine matched venous and capillary blood samples were obtained from thirty nine participants and analysed using a COVID-19 IgG ELISA to detect antibodies against SARS-CoV-2.Thirty seven out of thirty eight participants were able to self-collect an adequate sample of capillary blood (≥50 μl). Using plasma from venous blood collected in lithium heparin as the reference standard, matched capillary blood samples, collected in lithium heparin-treated tubes and on filter paper as dried blood spots, achieved a Cohen’s kappa coefficient of >0.88 (near-perfect agreement). Storage of capillary blood at room temperature for up to 7 days post sampling did not affect concordance.Our results indicate that capillary blood self-sampling is a reliable and feasible alternative to venepuncture for serological assessment in COVID-19.
An incomplete Circle of Willis is not a risk factor for white matter hyperintensities: The Tromsø Study
Authors: Hindenes Lars B. , Håberg Asta K. , Mathiesen Ellisiv B. , Vangberg Torgil R. 
Published: September 2020

AbstractObjectiveThe Circle of Willis (CoW) is often underdeveloped or incomplete, leading to suboptimal blood supply to the brain. As hypoperfusion is thought to play a role in the aetiology of white matter hyperintensities (WMH), the objective of this study was to assess whether incomplete CoW variants were associated with increased WMH volumes compared to the complete CoW.MethodsIn a cross-sectional population sample of 1864 people (age 40 – 84 years, 46.4% men), we used an automated method to segment WMH using T1-weighted and T2-weighted fluid-attenuated inversion recovery image obtained at 3T. CoW variants were classified from time-of-flight scans, also at 3T. WMH risk factors, including age, sex, smoking and blood pressure, were obtained from questionnaires and clinical examinations. We used linear regression to examine whether people with incomplete CoW variants had greater volumes of deep WMH (DWMH) and periventricular WMH (PWMH) compared to people with the complete CoW, correcting for WMH risk factors.ResultsParticipants with incomplete CoW variants did not have significantly higher DWMH or PWMH volumes than those with complete CoW when accounting for risk factors. Age, pack-years smoking, and systolic blood pressure were risk factors for increased DWMH and PWMH volume. Diabetes was a unique risk factor for increased PWMH volume.ConclusionIncomplete CoW variants do not appear to be risk factors for WMH in the general population.
The Use of Psychoactive Substances in the Context of the Covid-19 Pandemic in Brazil
Authors: Weber César Augusto Trinta , Monteiro Ingridi Teixeira , Gehrke Julia Medeiros , de Souza Wagner Silva 
Published: September 2020

AbstractBackgroundThe protocols for mitigating the transmission of Covid-19 seem to be a trigger for the use of psychoactive substances, as an individual’s adaptive response to support this new way of being in the world. Objective: To investigate the use of psychoactive substances in the context of the Covid-19 pandemic in Brazil. Method: A cross-sectional and prospective observational study, undertaken in a virtual environment. An online survey was developed and employed through Google Forms to collect data. The survey was made available to participants on social networks, Facebook@, Whatsapp@, and Instagram@, linked to the research group, during the period 06/15/2020 to 07/15/2020. 1,145 individuals participated in the research. Results: The average age of the participants was 37 years old. They were mostly female, white, Brazilians, with a higher education level, with occupations in the health field, and had religion. They either maintained their family income or suffered a small income decrease. Moreover, they informed that they were caring for social isolation. The most used substances before and after the beginning of the Covid-19 pandemic were alcohol, tobacco, marijuana, although the use of these substances decreased (P< 0.001). Approximately 32% of the participants started using psychoactive substances in this period. Among them, most individuals started by their own initiative. Conclusions: For a better understanding of the pattern use of psychoactive substances during the Covid-19 pandemic and the adverse effects on human behavior and mental disorders, careful longitudinal studies must be developed, due to the great interest in the knowledge of adaptive responses when people’s lives are at risk.
Low-Cost Differential Pressure Spirometry for Emergency Ventilator Tidal Volume Sensing
Authors: Edmunds Jordan L. , Bustamante Mauricio J. , Piech David K. , Schor Jonathan S. , Raymond Samuel J. , Camarillo David B. , Maharbiz Michel M. 
Published: September 2020

AbstractCOVID-19 has become a significant burden on the healthcare systems in the United States and around the world, with many patients requiring invasive mechanical ventilation (IMV) to survive. Close monitoring of patients is critical, with total volume per breath (tidal volume) being one of the most important data points. However, ventilators are complex and expensive devices, typically in the range of tens of thousands of US dollars, and are challenging to manufacture, typically requiring months. Solutions which could augment the ventilator supply rapidly and at low cost in the United States and elsewhere would be valuable. In this paper, we present a standalone tidal volume measurement system consisting of a D-Lite spirometer, pressure sensor, microcontroller, and tubing with a cost of parts less than $50 USD. We also provide a model to predict the error in tidal volume measurements based on the pressure sensor used and the flow during ventilation. We validate this system and show that the tidal volume accuracy for flows above 10 L/min was within 10%. We envision this system being used to increase the ventilator supply in resource-constrained settings.
Dynamic connectivity predicts acute motor impairment and recovery post-stroke
Authors: Bonkhoff Anna K. , Rehme Anne K. , Hensel Lukas , Tscherpel Caroline , Volz Lukas J. , Espinoza Flor A. , Gazula Harshvardhan , Vergara Victor M. , Fink Gereon R. , Calhoun Vince D. , Rost Natalia S. , Grefkes Christian 
Published: September 2020

AbstractObjectiveThorough assessment of cerebral dysfunction after acute brain lesions is paramount to optimize predicting short- and long-term clinical outcomes. The potential of dynamic resting-state connectivity for prognosticatingmotorrecovery has not been explored so far.MethodsWe built random forest classifier-based prediction models of acute upper limb motor impairment and recovery after stroke. Predictions were based on structural and resting-state fMRI data from 54 ischemic stroke patients scanned within the first days of symptom onset. Functional connectivity was estimated using both a static and dynamic approach. Individual motor performance was phenotyped in the acute phase and six months later.ResultsA model based on the time spent in specific dynamic connectivity configurations achieved the best discrimination between patients with and without motor impairments (out-of-sample area under the curve and 95%-confidence interval (AUC±95%-CI): 0.67±0.01). In contrast, patients with moderate-to-severe impairments could be differentiated from patients with mild deficits using a model based on the variability of dynamic connectivity (AUC±95%-CI: 0.83±0.01). Here, the variability of the connectivity between ipsilesional sensorimotor cortex and putamen discriminated the most between patients. Finally, motor recovery was best predicted by the time spent in specific connectivity configurations (AUC±95%-CI: 0.89±0.01) in combination with the initial motor impairment. Here, better recovery was linked to a shorter time spent in a functionally integrated network configuration in the acute phase post-stroke.InterpretationDynamic connectivity-derived parameters constitute potent predictors of acute motor impairment and post-stroke recovery, which in the future might inform personalized therapy regimens to promote recovery from acute stroke.
40 Hz Auditory Steady-State Responses Predict Transition to Psychosis in Clinical-High-Risk Participants: A MEG Study
Authors: Grent-‘t-Jong Tineke , Gajwani Ruchika , Gross Joachim , Gumley Andrew I. , Krishnadas Rajeev , Lawrie Stephen M. , Schwannauer Matthias , Schultze-Lutter Frauke , Uhlhaas Peter J. 
Published: September 2020

AbstractObjectiveTo examine whether 40-Hz Auditory Steady-State Responses (ASSR) in participants at clinical high-risk for psychosis predict clinical outcomes.MethodIn this study, magnetoencephalography (MEG) data were collected during a 40-Hz ASSR paradigm in 116 participants meeting clinical high-risk (CHR-P) for psychosis criteria, a clinical control group characterized by affective disorders and/or substance abuse (CHR-N: n=38), 32 first-episode psychosis patients (FEP, 14 antipsychotic-naïve), and 49 healthy controls. We examined 40-Hz-ASSR-source-activity in bilateral Heschl’s gyrus, superior temporal gyrus, Rolandic operculum, and the thalamus. Group differences in ASSR amplitudes were tested and correlated with neuropsychological scores, psychosocial functioning, and clinical symptoms. Linear discriminant analyses was used to assess whether 40-Hz-ASSR predicts transition to psychosis and persistence of APS.ResultsCompared to controls, 40-Hz-ASSR responses in CHR-Ps were impaired in right Rolandic operculum (d=0.41) and right thalamus (d=0.43), particularly in those with combined UHR/BS symptoms and CHR-Ps who transitioned to psychosis (n=11). FEP-patients showed significant impairments in the right thalamus (d=0.58), while the CHR-N group was unaffected. Importantly, right thalamus 40-Hz-ASSRs predicted transition to psychosis (transitioned [n=11] vs non-transitioned [n=105]); classification accuracy 73.3%, AUC=0.827), whereas this was not the case for persistent APS (Persistent [n=41] vs non-Persistent [n=37]; classification accuracy 56.4%).ConclusionsThe current study indicates that MEG-recorded 40-Hz-ASSRs constitute a potential biomarker for predicting transition to psychosis in CHR-P participants.
Onset, duration, and persistence of taste and smell changes and other COVID-19 symptoms: longitudinal study in Israeli patients
Authors: Klein Hadar , Asseo Kim , Karni Noam , Benjamini Yuval , Nir-Paz Ran , Muszkat Mordechai , Israel Sarah , Niv Masha Y. 
Published: September 2020

ABSTRACTObjectivesThe multifaceted disease manifestation of COVID-19 requires longitudinal characterization of symptoms, to aid with screening and disease management.MethodsPhone interviews and follow-ups were completed with 112 mild COVID-19 RT-PCR-positive adult patients, over a six weeks period.ResultsMore than one symptom at disease onset was experienced by ∼70 of the patients. Over one third of the patients experienced fever, dry cough, headache, or muscle ache as the first symptom. If fatigue was reported, it was usually the first symptom to appear. Smell and taste changes had occurred 3.9 ± 5.4 and 4.6 ± 5.7 days (mean ± SD) since disease onset and emerged as first symptoms in 15% and 18% of patients, respectively. Fever was the shortest lasting symptom (5.8 ± 8.6 days (mean ± SD), and smell and taste changes were the longest-lasting symptoms (24.3 ± 22.9 days and 19.4 ± 19.1 (mean ± SD), respectively), with longer smell recovery correlated with smell change severity. In one third of patients who reported cough, smell and taste changes, these symptoms persisted after negative RT-PCR tests.ConclusionsEach symptom can occur as first or later, some are more likely to appear as firsts, and typically more than one symptom occurs at disease onset. The severity of olfactory change is associated with its recovery time. Lack of chemosensory recuperation in recovered patients is common. These findings can aid patients through their illness and provide expected recovery patterns.
Equity in Paediatric Emergency Departments during COVID-19
Authors: Thorne Sophie , Bhopal Sunil , Harkensee Christian , Battersby Alex , Brough Anna , Owens Stephen 
Published: September 2020

AbstractChildren’s attendances in paediatric emergency departments have fallen precipitously in North East England and elsewhere in recent months. We analysed data from 3 hospitals to understand which children were not being brought during the COVID-19 ‘lockdown’. In our population there is no evidence of a disproportionate impact on children belonging to vulnerable sociodemographic groups and no obvious change in illness acuity among those children still attending. However we noted a marked reduction in infectious disease presentations which might reflect one positive impact of enhanced social distancing on child health. More granular data describing the ‘collateral damage’ of the COVID-19 pandemic to children’s clinical services are needed to plan for the mitigation of its continuing effects.What is known on this topicPresentations to paediatric emergency departments in Europe and the United States have reduced dramatically during the COVID-19 pandemic ‘lockdown’.What this paper adds boxThis is the first paper to show that reduced attendance was proportionate across different deprivation and ethnicity groups.We show that presentations of children with infectious diseases reduced more than those with other conditions or trauma.There was no change in admission rates, taken as a broad indicator of illness acuity at presentation among the population still attending paediatric emergency departments.
Airway emergency management in a pediatric hospital before and during the COVID-19 pandemic
Authors: Thom Christopher S , Deshmukh Hitesh , Soorikian Leane , Jacobs Ian , Fiadjoe John E , Lioy Janet 
Published: September 2020

AbstractObjectiveChildren’s hospitals frequently care for infants with various life-threatening airway anomalies. Management of these infants can be challenging given unique airway anatomy and potential malformations. Airway emergency management must be immediate and precise, often demanding specialized equipment and/or expertise. We developed a Neonatal-Infant Airway Safety Program to improve medical responses, communication, equipment usage and outcomes for infants requiring emergent airway interventions.Patients and MethodsAll patients admitted to our quaternary neonatal and infant intensive care unit (NICU) from 2008-2019 were included in this study. Our program consisted of a multidisciplinary airway response team, pager system, and emergency equipment cart. Respiratory therapists present at each emergency event recorded specialist response times, equipment utilization, and outcomes. A multidisciplinary oversite committee reviewed each incident.ResultsSince 2008, there were 159 airway emergency events in our NICU (∼12 per year). Mean specialist response times decreased from 5.9±4.9 min (2008-2012, mean±SD) to 4.3±2.2 min (2016-2019, p=0.12), and the number of incidents with response times >5 min decreased from 28.8±17.8% (2008-2012) to 9.3±11.4% (2016-2019, p=0.04 by linear regression). As our program became more standardized, we noted better equipment availability and subspecialist communication. Few emergency situations (n=9, 6%) required operating room management. There were 3 patient deaths (2%).ConclusionsOur airway safety program, including readily available specialists and equipment, facilitated effective resolution of airway emergencies in our NICU and multidisciplinary involvement enabled rapid and effective changes in response to COVID-19 regulations. A similar program could be implemented in other centers.
COVID-19 in Youth Soccer
Authors: Watson Andrew M. , Haraldsdottir Kristin , Biese Kevin , Goodavish Leslie , Stevens Bethany , McGuine Timothy 
Published: September 2020

ABSTRACTPurposeThe purpose of this study was to determine the case and incidence rates of COVID-19 among youth soccer players and evaluate the relationship with background COVID-19 risk and phase of return to play.MethodsSurveys were distributed to soccer clubs throughout the country regarding their phase of return to soccer (individual only, group non-contact, group contact) and date of reinitiation, number of players, cases of COVID-19, and risk reduction procedures that were being implemented. Overall case and incidence rates were compared to national pediatric data and county data from the prior 10 weeks where available. Finally, a negative binomial regression model was developed to predict club COVID-19 cases with local incidence rate and phase of return as covariates and the log of club player-days as an offset.Results129 clubs responded, of whom 124 had reinitiated soccer, representing 91,007 players with a median duration of 73 days (IQR: 53-83 days) since restarting. Of the 119 that had progressed to group activities, 218 cases of COVID-19 were reported among 85,861 players. Youth soccer players had a lower case rate and incidence rate than the national rate for children in the US (254 v. 477 cases per 100,000; IRR = 0.511, 95% CI = [0.40-0.57], p<0.001) and the general population from the counties in which soccer clubs were based where data was available (268 v. 864 cases per 100,000; IRR = 0.202 [0.19-0.21], p<0.001). After adjusting for local COVID-19 incidence, there was no relationship between club COVID-19 incidence and phase of return (non-contact: β=0.35±0.67, p=0.61; contact: β=0.18±0.67, p=0.79). No cases were reported to have resulted in hospitalization or death. 100% of clubs reported having a plan in place to reduce the risk of COVID-19 and utilizing multiple different risk reduction procedures (median 8, IQR 6-10).ConclusionsThe incidence of COVID-19 among youth soccer athletes is relatively low when compared to the background incidence among children in the United States and the local general population. No relationship was identified between club COVID-19 incidence and phase of return to soccer. Youth soccer clubs universally report implementing a number of risk reduction procedures.