bluuebunny/crossref_metadata_2025_split huggingface dataset:
Informal carers and peer support in pulmonary rehabilitation: an underutilized resource?
Authors: Patel Suhani , Man William D.-C. , Roberts Nicola J. 
Published: August 2020

Purpose of review
The aim of this review is to discuss the recent literature relating to the involvement of informal carers and peer support in pulmonary rehabilitation.

Recent findings
Informal carers and peer support have been identified by both patients and healthcare workers as a crucial component in the care of those with chronic respiratory disease at home. Pulmonary rehabilitation, a cornerstone in the management of patients with breathlessness, is limited in its clinical effectiveness by poor referral, uptake and completion rates. Engagement of informal carers and support from peers may help maximize the utilization of pulmonary rehabilitation.

Summary
This review highlights the need for more good-quality randomized controlled trials in identifying suitable interventions that may increase uptake and completion of pulmonary rehabilitation programmes. Qualitative studies have highlighted the potential for informal carers and peer support to play a key role in the design of research programmes, and in the delivery of pulmonary rehabilitation. This needs to be addressed in future research.
Supportive and palliative care for people with chronic respiratory disease and frailty
Authors: Brighton Lisa Jane , Bone Anna E. , Maddocks Matthew 
Published: August 2020

Purpose of review
Frailty is a multidimensional syndrome associated with increased risk of poor outcomes. It is estimated that at least one in five people with chronic respiratory disease is also living with frailty. In this review, we consider recent advances in how frailty can be recognized, and its associated impact on people with chronic respiratory disease. We then discuss advances in supportive and palliative care for those with both chronic respiratory disease and frailty.

Recent findings
The interconnectedness of chronic respiratory disease and frailty is being better understood. An increasing number of factors associated with frailty in respiratory disease have been identified, from increased symptom burden (e.g. breathlessness, fatigue) to increased exacerbations and higher mortality. These contribute to accumulating multidimensional losses in reserve, and unpredictable health. Recent advances in respiratory research, while not always with people with frailty, may inform supportive and palliative care to address frailty in chronic respiratory disease. These include rehabilitation interventions to strengthen reserves, advance care planning interventions to help manage unpredictable trajectories, and integrated models of care (e.g. incorporating respiratory, geriatric, and palliative care) to address multidimensional needs.

Summary
Recent evidence supporting the role of rehabilitation, advance care planning, and early palliative care, may be of benefit to people living with chronic respiratory disease and frailty. Models showing integration across multiple specialities and professionals may have the most potential to meet the multidimensional needs of this group. Future research should develop and test models of care that address frailty and/or explore the role of frailty in triggering integrated multidisciplinary input.
Ecological momentary assessment in eating disorders research: recent findings and promising new directions
Authors: Schaefer Lauren M. , Engel Scott G. , Wonderlich Stephen A. 
Published: August 2020

Purpose of review
Ecological momentary assessment (EMA) is an important tool for clarifying common precipitants and consequences of eating disorder symptoms that might be meaningfully targeted in treatments for these pernicious disorders. This article reviews recent advances in EMA work conducted within clinical eating disorder samples.

Recent findings
Published studies from the past 2.5 years can broadly be categorized as involving functional analysis of eating disorder behaviors, examining hypothesized predictors of eating disorder symptoms, or applying novel approaches to EMA data. Examples of the latter category include the use of latent profile analysis with EMA data, integration of neurocognitive (e.g., ambulatory inhibitory control task) or biological indicators (e.g., fMRI, plasma leptin), and examining changes in associations between momentary variables over time through multiwave EMA data collection.

Summary
EMA studies in eating disorders have advanced significantly in recent years, with findings demonstrating strong support for the emotion regulation function of eating disorder behaviors and momentary predictors of distinct eating disorder symptoms. The use of novel statistical and data collection approaches represent exciting areas of growth, with likely implications for intervention approaches, including those that utilize ambulatory technology to deliver treatment.
Impact of tocilizumab administration on mortality in severe COVID-19
Authors: Tsai Andrew , Diawara Oumou , Nahass Ronald G. , Brunetti Luigi 
Published: August 2020

AbstractPurposeThe novel coronavirus disease 2019 (COVID-19) worldwide pandemic has placed a significant burden on hospitals and healthcare providers. The immune response to this disease is thought to lead to a cytokine storm, which contributes to the severity of illness. There is an urgent need to confirm whether the use of tocilizumab provides a benefit in individuals with COVID-19.MethodsA single-center propensity-score matched cohort study, including all consecutive COVID-19 patients, admitted to the medical center who were either discharged from the medical center or expired between March 1, 2020, and May 5, 2020, was performed. Patients were stratified according to the receipt of tocilizumab for cytokine storm and matched to controls using propensity scores. The primary outcome was in-hospital mortality.ResultsA total of 132 patients were included in the matched dataset (tocilizumab=66; no tocilizumab=66). Approximately 73% of the patients were male. Hypertension (55%), diabetes mellitus (31%), and chronic pulmonary disease (15%) were the most common comorbidities present. There were 18 deaths (27.3%) in the tocilizumab group and 18 deaths (27.3%) in the no tocilizumab group (odds ratio, 1.0; 95% confidence interval, 0.465 – 2.151; p=1.00). Advanced age, history of myocardial infarction, dementia, chronic pulmonary disease, heart failure, and malignancy were significantly more common in patients who died.ConclusionThe current analysis does not support the use of tocilizumab for the management of cytokine storm in patients with COVID-19. Use of this therapeutic agent should be limited to the context of a clinical trial until more evidence is available.
Real-Time Monitoring of COVID-19 in Scotland
Authors: Calder-Gerver Giles David , Mazeri Stella , Haynes Samuel , Simonet Camille Anna , Woolhouse Mark EJ , Brown Helen 
Published: August 2020

AbstractTo manage the public health risk posed by COVID-19 and assess the impact of interventions, policy makers must be able to closely monitor the epidemic’s trajectory. Here we present a simple methodology based on basic surveillance metrics for monitoring the spread of COVID-19 and its burden on health services in Scotland. We illustrate how this has been used throughout the epidemic in Scotland and explore the underlying biases that have affected its interpretation.
Is my Arm moving? Proprioceptive impairment in Developmental Dyslexia
Authors: Julie Laprevotte , Charalambos Papaxanthis , Sophie Saltarelli , Patrick Quercia , Jeremie Gaveau 
Published: August 2020

AbstractDevelopmental Dyslexia is a specific learning disorder causing reading deficits. Although it has long been considered a purely cognitive disorder, mounting evidence revealed that Developmental Dyslexia is associated with sensory impairments. Because these impairments are restrained to vision and hearing – both senses being heavily involved in reading – a large controversy exists regarding their role in the pathophysiology of Developmental Dyslexia. Cognitive theories argue that sensory impairments are caused by the lack of reading practice, and mainly represent an aggravating factor. Sensory theories argue that damaged neural mechanisms cause sensory impairments that, themselves, cause reading disabilities. An important prediction from sensory theories is that sensory troubles should encompass the whole sensory system. Here, we directly tested proprioceptive acuity in dyslexic children and age-matched controls. We used a well-known speed perception task where a robotic manipulandum passively rotates a child’s elbow and the child presses a trigger as soon as he felts the motion. Although dyslexics and controls equally well detected salient stimuli, dyslexics were strongly impaired at detecting weaker stimuli. Furthermore, we found that proprioceptive acuity positively correlated with reading abilities. These results cannot be explained by a lack of reading practice and thus strongly support sensory theories of Developmental Dyslexia.
Projecting hospital resource utilization during a surge using parametric bootstrapping
Authors: Chiang Jeffrey N. , An Ulzee , Kordi Misagh , Jew Brandon , Kravit Clifford , Dunne William J. , Perez Ronald , Parikh Neil R. , Weil Drew , Azar Richard F. , Cherry Robert , Grimley Karen A. , Skootsky Samuel A. , Saigal Christopher E. , Manuel Vladimir , Eskin Eleazar , Halperin Eran 
Published: August 2020

AbstractDuring the initial wave of the COVID-19 pandemic in the United States, hospitals took drastic action to ensure sufficient capacity, including canceling or postponing elective procedures, expanding the number of available intensive care beds and ventilators, and creating regional overflow hospital capacity. However, in most locations the actual number of patients did not reach the projected surge leaving available, unused hospital capacity. As a result, patients may have delayed needed care and hospitals lost substantial revenue.These initial recommendations were made based on observations and worst-case epidemiological projections, which generally assume a fixed proportion of COVID-19 patients will require hospitalization and advanced resources. This assumption has led to an overestimate of resource demand as clinical protocols improve and testing becomes more widely available throughout the course of the pandemic.Here, we present a parametric bootstrap model for forecasting the resource demands of incoming patients in the near term, and apply it to the current pandemic. We validate our approach using observed cases at UCLA Health and simulate the effect of elective procedure cancellation against worst-case pandemic scenarios. Using our approach, we show that it is unnecessary to cancel elective procedures unless the actual capacity of COVID-19 patients approaches the hospital maximum capacity. Instead, we propose a strategy of balancing the resource demands of elective procedures against projected patients by revisiting the projections regularly to maintain operating efficiency. This strategy has been in place at UCLA Health since mid-April.
Visualizing and Assessing US County-Level COVID19 Vulnerability
Authors: Cahill Gina , Kutac Carleigh , Rider Nicholas L. 
Published: August 2020

AbstractObjectiveLike most of the world, the United States’ public health and economy are impacted by the COVID19 pandemic. However, discrete pandemic effects may not be fully realized on the macro-scale. With this perspective, our goal is to visualize spread of the pandemic and measure county-level features which may portend vulnerability.Materials and MethodsWe accessed the New York Times GitHub repository COVID19 data and 2018 US Census data for all US Counties. The disparate datasets were merged and filtered to allow for visualization and assessments about case fatality rate (CFR%) and associated demographic, ethnic and economic features.ResultsOur results suggest that county-level COVID19 fatality rates are related to advanced population age (p <0.001) and less diversity as evidenced by higher proportion of Caucasians in High CFR% counties (p < 0.001). Also, lower CFR% counties had a greater proportion of the population reporting has having 2 or more races (p <0.001). We noted no significant differences between High and Low CFR% counties with respect to mean income or poverty rate.ConclusionsUnique COVID19 impacts are realized at the county level. Use of public datasets, data science skills and information visualization can yield helpful insights to drive understanding about community-level vulnerability.
Estrogen and COVID-19 symptoms: associations in women from the COVID Symptom Study
Authors: Costeira Ricardo , Lee Karla A. , Murray Benjamin , Christiansen Colette , Castillo-Fernandez Juan , Lochlainn Mary Ni , Pujol Joan Capdevila , Macfarlane Heather , Kenny Louise C. , Buchan Iain , Wolf Jonathon , Rymer Janice , Ourselin Sebastien , Steves Claire J. , Spector Timothy D. , Newson Louise R. , Bell Jordana T. 
Published: August 2020

AbstractBackgroundMen and older women have been shown to be at higher risk of adverse COVID-19 outcomes. Animal model studies of SARS-CoV and MERS suggest that the age and sex difference in COVID-19 symptom severity may be due to a protective effect of the female sex hormone estrogen. Females have shown an ability to mount a stronger immune response to a variety of viral infections because of more robust humoral and cellular immune responses.ObjectivesWe sought to determine whether COVID-19 positivity increases in women entering menopause. We also aimed to identify whether premenopausal women taking exogenous hormones in the form of the combined oral contraceptive pill (COCP) and post-menopausal women taking hormone replacement therapy (HRT) have lower predicted rates of COVID-19, using our published symptom-based model.DesignThe COVID Symptom Study developed by King’s College London and Zoe Global Limited was launched in the UK on 24thMarch 2020. It captured self-reported information related to COVID-19 symptoms. Data used for this study included records collected between 7thMay - 15thJune 2020.Main outcome measuresWe investigated links between COVID-19 rates and 1) menopausal status, 2) COCP use and 3) HRT use, using symptom-basedpredictedCOVID-19, tested COVID-19, and disease severity based on requirement for hospital attendance or respiratory support.ParticipantsFemale users of the COVID Symptom Tracker Application in the UK, including 152,637 women for menopause status, 295,689 for COCP use, and 151,193 for HRT use. Analyses were adjusted for age, smoking and BMI.ResultsPost-menopausal women aged 40-60 years had a higher rate ofpredictedCOVID (P=0.003) and a corresponding range of symptoms, with consistent, but not significant trends observed for tested COVID-19 and disease severity. Women aged 18-45 years taking COCP had a significantly lowerpredictedCOVID-19 (P=8.03E-05), with a reduction in hospital attendance (P=0.023). Post-menopausal women using HRT or hormonal therapies did not exhibit consistent associations, including increased rates ofpredictedCOVID-19 (P=2.22E-05) for HRT users alone.ConclusionsOur findings support a protective effect of estrogen on COVID-19, based on positive association betweenpredictedCOVID-19 and menopausal status, and a negative association with COCP use. HRT use was positively associated with COVID-19 symptoms; however, the results should be considered with caution due to lack of data on HRT type, route of administration, duration of treatment, and potential comorbidities.Trial registrationThe App Ethics has been approved by KCL ethics Committee REMAS ID 18210, review reference LRs-19/20-18210
High SARS-CoV-2 seroprevalence in Health Care Workers but relatively low numbers of deaths in urban Malawi
Authors: Chibwana Marah G. , Jere Khuzwayo C. , Kamn’gona Raphael , Mandolo Jonathan , Katunga-Phiri Vincent , Tembo Dumizulu , Mitole Ndaona , Musasa Samantha , Sichone Simon , Lakudzala Agness , Sibale Lusako , Matambo Prisca , Kadwala Innocent , Byrne Rachel L. , Mbewe Alice , Morton Ben , Phiri Chimota , Mallewa Jane , Mwandumba Henry C , Adams Emily R. , Gordon Stephen B. , Jambo Kondwani C. 
Published: August 2020

AbstractBackgroundIn low-income countries, like Malawi, important public health measures including social distancing or a lockdown, have been challenging to implement owing to socioeconomic constraints, leading to predictions that the COVID-19 pandemic would progress rapidly. However, due to limited capacity to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, there are no reliable estimates of the true burden of infection and death. We, therefore, conducted a SARS-CoV-2 serosurvey amongst health care workers (HCW) in Blantyre city to estimate the cumulative incidence of SARS-CoV-2 infection in urban Malawi.MethodsFive hundred otherwise asymptomatic HCWs were recruited from Blantyre City (Malawi) from 22nd May 2020 to 19th June 2020 and serum samples were collected all participants. A commercial ELISA was used to measure SARS-CoV-2 IgG antibodies in serum. We run local negative samples (2018 - 2019) to verify the specificity of the assay. To estimate the seroprevalence of SARS CoV-2 antibodies, we adjusted the proportion of positive results based on local specificity of the assay.ResultsEighty-four participants tested positive for SARS-CoV-2 antibodies. The HCW with a positive SARS-CoV-2 antibody result came from different parts of the city. The adjusted seroprevalence of SARS-CoV-2 antibodies was 12.3% [CI 9.0–15.7]. Using age-stratified infection fatality estimates reported from elsewhere, we found that at the observed adjusted seroprevalence, the number of predicted deaths was 8 times the number of reported deaths.ConclusionThe high seroprevalence of SARS-CoV-2 antibodies among HCW and the discrepancy in the predicted versus reported deaths, suggests that there was early exposure but slow progression of COVID-19 epidemic in urban Malawi. This highlights the urgent need for development of locally parameterised mathematical models to more accurately predict the trajectory of the epidemic in sub-Saharan Africa for better evidence-based policy decisions and public health response planning.
High rate of major drug-drug interactions of lopinavir-ritonavir for COVID-19 treatment
Authors: Macías Juan , Pinilla Ana , Lao-Dominguez Francisco A. , Corma Anaïs , Contreras-Macias Enrique , González-Serna Alejandro , Gutierrez-Pizarraya Antonio , Fernández-Fuertes Marta , Morillo-Verdugo Ramón , Trigo Marta , Real Luis M. , Pineda Juan A. 
Published: August 2020

AbstractThe impact of drug-drug interactions (DDI) between ritonavir-boosted lopinavir (LPV-r) to treat patients with coronavirus disease 2019 (COVID-19) and commonly used drugs in clinical practice is not well-known. Thus, we evaluated the rate and severity of DDI between LPV-r for COVID-19 treatment and concomitant medications. This was a cross-sectional study including all individuals diagnosed of SARS-CoV-2 infection treated with LPV-r and attended at a single center in Southern Spain (March 1st to April 30th, 2020). The frequency [95% confidence interval (95% CI)] of potential and major DDI were calculated. Overall, 469 patients were diagnosed of COVID-19, 125 (27%) of them were prescribed LPV-r. LPV-r had potential DDI with concomitant medications in 97 (78%, 95% CI: 69%-85%) patients, and in 33 (26%, 95% CI: 19%-35%) individuals showed major DDI. Twelve (36%) patients with major DDI and 14 (15%) individuals without major DDI died (p=0.010). After adjustment, only the Charlson index was independently associated with death [adjusted OR (95% CI) for Charlson index ≥5: 85 (10-731), p <0.001]. LPV-r was discontinued due to side effects in 31 (25%) patients. Management by the Infectious Diseases Unit was associated with a lower likelihood of major DDI [adjusted odds ratio (95% CI): 0.14 (0.04-0.53), p=0.003). In conclusion, a high frequency of DDI between LPV-r for treating COVID-19 and concomitant medications was found, including major DDI. Patients with major DDI showed worse outcomes, but this association was explained by the older age and comorbidities. Patients managed by the Infectious Diseases Unit had lower risk of major DDI.
Quantification of the association between predisposing health conditions, demographic, and behavioural factors with hospitalisation, intensive care unit admission, and death from COVID-19: a systematic review and meta-analysis
Authors: Fernandez Villalobos Nathalie Verónica , Ott Jördis Jennifer , Klett-Tammen Carolina Judith , Bockey Annabelle , Vanella Patrizio , Krause Gérard , Lange Berit 
Published: August 2020

AbstractBackgroundComprehensive evidence synthesis on the associations between comorbidities and behavioural factors with hospitalisation, Intensive Care Unit (ICU) admission, and death due to COVID-19 is lacking leading to inconsistent national and international recommendations on who should be targeted for non-pharmaceutical interventions and vaccination strategies.MethodsWe performed a systematic review and meta-analysis on studies and publicly available data to quantify the association between predisposing health conditions, demographics, and behavioural factors with hospitalisation, ICU admission, and death from COVID-19. We provided ranges of reported and calculated effect estimates and pooled relative risks derived from a meta-analysis and meta-regression.Results75 studies were included into qualitative and 74 into quantitative synthesis, with study populations ranging from 19 - 44,672 COVID-19 cases. The risk of dying from COVID-19 was significantly associated with cerebrovascular [pooled RR 2.7 (95% CI 1.7-4.1)] and cardiovascular [RR 3.2 (CI 2.3-4.5)] diseases, hypertension [RR 2.6 (CI 2.0-3.4)], and renal disease [RR 2.5 (CI 1.8-3.4)]. Health care workers had lower risk for death and severe outcomes of disease (RR 0.1 (CI 0.1-0.3). Our meta-regression showed a decrease of the effect of some comorbidities on severity of disease with higher median age of study populations. Associations between comorbidities and hospitalisation and ICU admission were less strong than for death.ConclusionsWe obtained robust estimates on the magnitude of risk for COVID-19 hospitalisation, ICU admission, and death associated with comorbidities, demographic, and behavioural risk factors. We identified and confirmed population groups that are vulnerable and that require targeted prevention approaches.SummaryComorbidities such as cardiovascular disease or hypertension are less strongly associated with hospitalization and ICU admission than with death in COVID-19 patients. Increasing age is associated with a lower effect on comorbidities on disease severity.