bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pregnant Smokers Receiving Opioid Agonist Therapy Have an Elevated Nicotine Metabolite Ratio: A Replication Study
Authors: Kranzler Henry R , Washio Yukiko , Zindel Leah R , Lynch Kevin G , Hand Dennis , Tyndale Rachel F , Oncken Cheryl , Schnoll Robert 
Published: April 2020

Abstract

Introduction
Pregnant women exposed chronically to opioids smoked more cigarettes per day (CPD) and had a higher nicotine metabolite ratio (NMR), 3-hydroxycotinine/cotinine, a biomarker of nicotine metabolism and clearance, than those not receiving opioids. We examined CPD and NMR in a group of pregnant smokers, a quarter of whom were receiving opioid agonist therapy (OAT).

Aims and Methods
Pregnant smokers recruited to participate in a placebo-controlled trial of bupropion for smoking cessation provided a blood sample for measurement of NMR.

Results
Half (52.4%) of the 124 women with NMR data were African American. OAT-treated women (n = 34, 27.4%; 27 receiving methadone and 7 buprenorphine) were more likely to be white (79% vs. 30%, p &lt; .001) and to have a lower mean PHQ-9 total score (2.91 [SD = 2.83] vs. 4.83 [SD = 3.82], p = .007). OAT-treated women reported smoking more CPD (9.50 [SD = 5.26] vs. 7.20 [SD = 3.65], p = .005) and had higher NMR (0.78 [SD = 0.36] vs. 0.56 [SD = 0.25], p = .001) than the non-OAT-treated group. In a linear regression analysis adjusting for race, depression severity, and CPD, NMR was greater in the OAT group (p = .025), among whom the daily methadone-equivalent dosage correlated with NMR (Spearman’s ρ = 0.49, p = .003).

Conclusions
Consistent with the findings of Oncken et al. (2019), we found that OAT smokers smoked more and had higher NMR than non-OAT smokers. As higher NMR is associated with a reduced likelihood of smoking cessation, the effects on NMR of both pregnancy and OAT could contribute to a lower smoking cessation rate in pregnant smokers receiving chronic opioid therapy.

Implications
We replicated the finding that the NMR is significantly greater among pregnant smokers receiving OAT than those not receiving this treatment for opioid use disorder. Furthermore, we found that the dosage of the OAT was significantly associated with the NMR level. These findings may contribute to a poorer response to smoking cessation treatment in pregnant women treated with OAT, particularly those receiving high-dose therapy, and raise the question of whether novel approaches are needed to treat smoking in this subgroup of pregnant smokers.
The Time for Universal Masking of the Public for Coronavirus Disease 2019 Is Now
Authors: Gandhi Monica , Havlir Diane 
Published: April 2020

Abstract
In this perspective, we recommend universal masking of the US public during coronavirus disease 2019 due to the high contagiousness of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), viral shedding of viable SARS-CoV-2 from asymptomatic individuals, and the likely contribution of masking to core distancing public health strategies for curbing transmission.
Navigated Spinal Robotics in Minimally Invasive Spine Surgery, With Preoperative and Intraoperative Workflows: 2-Dimensional Operative Video
Authors: Pham Martin H , Osorio Joseph A , Lehman Ronald A 
Published: April 2020

Abstract
The use of robotic guidance for spinal instrumentation has become promising for its ability to offer the advantages of precision, accuracy, and reproducibility. However, the utilization and adoption of robotic platforms for spine surgery remain limited, especially in comparison to other surgical fields. We present here a case of a 52-yr-old man with a grade 1 L4-5 degenerative spondylolisthesis causing severe claudication and radiculopathy who subsequently underwent a minimally invasive L4-5 transforaminal lumbar interbody fusion with navigated spinal robotic assistance (Mazor X Stealth Edition, Mazor Robotics Ltd, Caesarea, Israel). This platform allows for planning and registration via (1) a preoperative thin-cut computed tomography (CT) scan, or (2) an intraoperative CT “scan-and-plan” method. We show here the preoperative CT method that we use in the majority of our patients. To our knowledge, this is the first video demonstrating the preoperative software and intraoperative surgical registration and instrument workflow of navigated spinal robotic guidance using the Mazor X Stealth Edition for the insertion of pedicle screws in a minimally invasive spine surgery procedure.
There is no identifying information in this video. Patient consent was obtained for the surgical procedure and for publishing of the material included in the video.
High-flow nasal cannula implementation has not reduced intubation rates for bronchiolitis in Canada
Authors: Garland Hilarie , Gunz Anna C , Miller Michael R , Lim Rodrick K 
Published: April 2020

Abstract

Background and Objective
Bronchiolitis is the most common reason for admission to hospital in the first year of life, with increasing hospitalization rates in Canada. Respiratory support with high-flow nasal cannula (HFNC) is being routinely used in paediatric centres, though the evidence of efficacy is continuing to be evaluated. We examined the impact of HFNC on intubation rates, hospital and paediatric critical care unit (PCCU) length of stay (LOS), and PCCU admission rates in paediatric tertiary centres in Canada.

Methods
We conducted a multicentre, interrupted time series analysis to examine intubation rates pre- to postimplementation of HFNC for bronchiolitis. Data were obtained from the Canadian Institute for Health Information database. Paediatric tertiary centres that introduced HFNC between 2009 and 2014 were included, and data were collected from April 2005 to March 2017.

Results
A total of 17,643 patients met inclusion criteria. There was no significant change in intubation rates after the introduction of HFNC. There was a significant increase in PCCU admission, with a decrease in the PCCU LOS following the introduction of HFNC. There was no significant change in average hospital LOS after HFNC was introduced.

Conclusions
This study adds to the evolving evidence showing that overall disease course is not modified by the use of HFNC. The initiation of HFNC in Canadian paediatric centres resulted in no significant change in intubation rates or average LOS in hospital, but had an increase in PCCU admissions. Careful monitoring of new technologies on their clinical impact as well as health care resource utilization is warranted.
Development and initial validation of a composite disease activity score for systemic juvenile idiopathic arthritis
Authors: Tibaldi Jessica , Pistorio Angela , Aldera Elena , Puzone Laura , El Miedany Yasser , Pal Priyankar , Giri Prabhas Prasun , De Hriday , Khubchandani Raju , Chavan Pallavi Pimpale , Vilaiyuk Soamarat , Lerkvaleekul Butsabong , Yamsuwan Jutamas , Sabui Tapas K , Datta Pragati , Pardeo Manuela , Bracaglia Claudia , Sawhney Sujata , Mittal Sumidha , Hassan Waleed A , Elderiny Ghada Farouk , Abu-Zaid Mohammed Hassan , Eissa Mervat , Sztajnbok Flavio , das Neves Sztajnbok Fernanda C , Russo Ricardo , Katsicas María Martha , Cimaz Rolando , Marrani Edoardo , Alexeeva Ekaterina , Dvoryakovskaya Tatyana M , Alsuweiti Motasem O , Alzyoud Ra’ed M , Kostik Mikhail , Chikova Irina , Minoia Francesca , Filocamo Giovanni , Farag Yomna , Lotfy Hala , Nasef Samah Ismail , Al-Mayouf Sulaiman M , Maggio Maria Cristina , Magalhaes Claudia Saad , Gallizzi Romina , Conti Giovanni , Shimizu Masaki , Civino Adele , Felici Enrico , Giancane Gabriella , Ruperto Nicolino , Consolaro Alessandro , Ravelli Angelo 
Published: April 2020

Abstract

Objective
To develop a composite disease activity score for systemic JIA (sJIA) and to provide preliminary evidence of its validity.

Methods
The systemic Juvenile Arthritis Disease Activity Score (sJADAS) was constructed by adding to the four items of the original JADAS a fifth item that aimed to quantify the activity of systemic features. Validation analyses were conducted on patients with definite or probable/possible sJIA enrolled at first visit or at the time of a flare, who had active systemic manifestations, which should include fever. Patients were reassessed 2 weeks to 3 months after baseline. Three versions were examined, including ESR, CRP or no acute-phase reactant.

Results
A total of 163 patients were included at 30 centres in 10 countries. The sJADAS was found to be feasible and to possess face and content validity, good construct validity, satisfactory internal consistency (Cronbach’s alpha 0.64–0.65), fair ability to discriminate between patients with different disease activity states and between those whose parents were satisfied or not satisfied with illness outcome (P &lt; 0.0001 for both), and strong responsiveness to change over time (standardized response mean 2.04–2.58). Overall, these properties were found to be better than those of the original JADAS and of DAS for RA and of Puchot score for adult-onset Still’s disease.

Conclusion
The sJADAS showed good measurement properties and is therefore a valid instrument for the assessment of disease activity in children with sJIA. The performance of the new tool should be further examined in other patient cohorts that are evaluated prospectively.
Analysis of the mutation dynamics of SARS-CoV-2 reveals the spread history and emergence of RBD mutant with lower ACE2 binding affinity
Authors: Jia Yong , Shen Gangxu , Nguyen Stephanie , Zhang Yujuan , Huang Keng-Shiang , Ho Hsing-Ying , Hor Wei-Shio , Yang Chih-Hui , Bruning John B , Li Chengdao , Wang Wei-Lung 
Published: April 2020

SummaryMonitoring the mutation dynamics of SARS-CoV-2 is critical for the development of effective approaches to contain the pathogen. By analyzing 106 SARS-CoV-2 and 39 SARS genome sequences, we provided direct genetic evidence that SARS-CoV-2 has a much lower mutation rate than SARS. Minimum Evolution phylogeny analysis revealed the putative original status of SARS-CoV-2 and the early-stage spread history. The discrepant phylogenies for the spike protein and its receptor binding domain proved a previously reported structural rearrangement prior to the emergence of SARS-CoV-2. Despite that we found the spike glycoprotein of SARS-CoV-2 is particularly more conserved, we identified a receptor binding domain mutation that leads to weaker ACE2 binding capability based on in silico simulation, which concerns a SARS-CoV-2 sample collected on 27thJanuary 2020 from India. This represents the first report of a significant SARS-CoV-2 mutant, and requires attention from researchers working on vaccine development around the world.HighlightsBased on the currently available genome sequence data, we provided direct genetic evidence that the SARS-COV-2 genome has a much lower mutation rate and genetic diversity than SARS during the 2002-2003 outbreak.The spike (S) protein encoding gene of SARS-COV-2 is found relatively more conserved than other protein-encoding genes, which is a good indication for the ongoing antiviral drug and vaccine development.Minimum Evolution phylogeny analysis revealed the putative original status of SARS-CoV-2 and the early-stage spread history.We confirmed a previously reported rearrangement in the S protein arrangement of SARS-COV-2, and propose that this rearrangement should have occurred between human SARS-CoV and a bat SARS-CoV, at a time point much earlier before SARS-COV-2 transmission to human.We provided first evidence that a mutated SARS-COV-2 with reduced human ACE2 receptor binding affinity have emerged in India based on a sample collected on 27th January 2020.
Safety of Focused Ultrasound Neuromodulation in Humans with Temporal Lobe Epilepsy
Authors: Stern John M. , Korb Alexander S. , Spivak Norman M. , Becerra Sergio , Kronemyer David , Khanlou Négar , Reyes Samuel D. , Monti Martin M. , Schnakers Caroline , Walshaw Patricia , Kuhn Taylor P. , Cohen Mark S. , Yong William , Fried Itzhak , Jordan Sheldon E. , Engel Jerome , Schafer Mark E. , Bystritsky Alexander 
Published: April 2020

ABSTRACTObjectiveLow-Intensity Focused Ultrasound Pulsations (LIFUP) is a promising new potential neuromodulation tool. However, the safety of LIFUP neuromodulation has not yet been adequately assessed. Patients with refractory temporal lobe epilepsy electing to undergo an anterior temporal lobe resection present a unique opportunity to evaluate the safety and efficacy of LIFUP neuromodulation. Because the brain tissue in these patients will be removed, histological changes in tissue after LIFUP can be examined. Evidence of effective neuromodulation was assessed using functional MRI and EEG, while further potential safety concerns were assessed using neuropsychological testing.MethodsEEG, functional MRI, and neuropsychology were assessed in six patients before and after focused ultrasound sonication of the temporal lobe at intensities up to 5760 mW/cm2. Using the BrainSonix Pulsar 1002, LIFUP was delivered under MR guidance, using the Siemens Magnetom 3T Prisma scanner. Neuropsychological changes were assessed using various batteries. EEG was recorded using the Electrical Geodesics EGI 256 channel system. Histological changes were assessed using hematoxylin and eosin staining, among others.ResultsLIFUP was not able to modulate the BOLD signal on fMRI in a reliable and consistent manner. The EEG data that was available did not demonstrate a change in activity after LIFUP in all but one subject. Likewise, the neuropsychology testing did not show any statistically significant changes in any test, except for a slight decrease in performance on the one test after LIFUP. Lastly, the histology did not reveal any detectable damage to the tissue, except for one subject for whom the histology findings were inconclusive.SignificanceThe safety in the histology was the primary endpoint, and as such, longer exposure at the highest intensity levels will be administered moving forward.Key PointsLIFUP is a novel brain stimulation technique with not yet fully established safety guidelines.LIFUP was administered to patients electing to undergo resective brain surgery.LIFUP does not appear to cause damage to tissue.Longer exposure times are needed to further show safety at these intensity levels.
Time-Varying COVID-19 Reproduction Number in the United States
Authors: Gunzler Douglas D. , Sehgal Ashwini R. 
Published: April 2020

AbstractThe basic reproduction number is the average number of people to whom an infected person transmits the infection when virtually all individuals in a population are susceptible. We sought to calculate the current reproduction number for COVID-19 for each state in the United States. For the entire United States, the time-varying reproduction number declined from 4.02 to 1.51 between March 17 and April 1, 2020. We also found that the time-varying reproduction number for COVID-19 has declined in most states over the same two week period which suggests that social isolation measures may be having a beneficial effect.
A systematic review protocol for estimation of the prevalence of depression using diagnostic instruments in the elderly population in India, 2000-2019
Authors: Behera Priyamadhaba , Pilania Manju , Yadav Vikas , Bairwa Mohan , Dabar Deepti , Behera Surama Manjari , Poongothai S. , Mohan Viswanathan , Dutt Gupta Shiv 
Published: April 2020

AbstractIntroductionDepression is a common mental disorder in the elderly population, which significantly impacts their quality of life. However, correct estimates of its magnitude are not available in the elderly in India. The present systematic review and meta-analysis would attempt to estimate the prevalence of depression using diagnostic instruments among elderly persons aged 60 years and above.Methods and analysisSearches will be performed in PubMed, Scopus, Embase, Web of Science, CINAHL, and PsycINFO. Community-based cross-sectional and cohort studies (2001 – 9/2019) reporting the prevalence of depression in the elderly; using diagnostic instruments will be included. Studies conducted among chronic disease patients, in-hospital patients, and special groups such as with disaster-stricken populations, and studies reporting the only 1 or 2 subcategories of depression, will be excluded. Disagreements in study selection and data abstraction will be resolved by consensus and arbitration by a third reviewer. AXIS critical appraisal tool will be used for quality assessment of individual studies. Findings of eligible studies will be pooled using fixed-effects or random-effects meta-analysis whichever is appropriate. Heterogeneity between studies will be examined by Cochran’s Q test and quantified by I2statistic. A cumulative meta-analysis will be used to detect temporal trends in the prevalence of depression and the effect of poor-quality studies on the pooled estimate. Publication bias will be assessed by visual inspection of funnel plots and the Egger test.Ethics and disseminationNo ethical approval will be needed because it will be a systematic review. Data from previously published studies will be retrieved and analyzed. Findings will be disseminated through a peer-reviewed publication in a scientific journal and conferences.PROSPEROregistration number CRD42019138453.Strengths and limitations of this studyIt is a first-ever systematic review of depression prevalence in India based on diagnostic instruments only.Meta-analytic techniques such as cumulative meta-analysis, leave-one-out (jack-knife estimation) meta-analysis, and meta-regression will enrich the analysis and provide the estimate of prevalence nearer to the population estimate.A comprehensive synthesis of all available depression prevalence data in India using a standardized risk of bias tool.The protocol adheres to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines.Heterogeneity in methodologies, such as diagnostic criteria, study duration, sampling design, and study locations may limit comparison across studies.
Rapid Utilization of Telehealth in a Comprehensive Cancer Center as a Response to COVID-19
Authors: Lonergan Peter E. , Washington Samuel L. , Branagan Linda , Gleason Nathaniel , Pruthi Raj S. , Carroll Peter R. , Odisho Anobel Y. 
Published: April 2020

AbstractBackgroundThe emergence of the coronavirus disease 2019 (COVID-19) pandemic in March 2020 created unprecedented challenges in the provision of scheduled ambulatory cancer care. As a result, there has been a renewed focus on video consultations as a means to continue ambulatory care.ObjectiveTo analyze the change in video visit volume at the University of California, San Francisco (UCSF) Comprehensive Cancer Center in response to COVID-19 and compare demographics/appointment data from January 1, 2020 and in the 11 weeks after transition to video visits.MethodsPatient demographics and appointment data (dates, visit types, and departments) were abstracted from the Electronic Health Record reporting database. Video visits were performed using a HIPAA-compliant video conferencing platform with a pre-existing workflow.ResultsIn 17 departments and divisions at the UCSF Cancer Center, 2,284 video visits were performed in the 11 weeks before COVID-19 changes with an average (SD) of 208 (75) per week and 12,946 video visits were performed in the 11 week post-COVID-19 period with an average (SD) of 1,177 (120) per week. The proportion of video visits increased from 7-18% to 54-72%, between the pre- and post-COVID-19 periods without any disparity based on race/ethnicity, primary language, or payor.ConclusionsIn a remarkably brief period of time, we rapidly scaled the utilization of telehealth in response to COVID-19 and maintained access to complex oncologic care at a time of social distancing.
Modifying reusable elastomeric respirators to utilise breathing system filters with 3D printed adapters, a safe alternative to N95 during COVID-19
Authors: Liu D.C.Y. , Koo T.H. , Wong J.K.K. , Wong Y.H. , Fung K.S.C. , Chan Y. , Lim H.S. 
Published: April 2020

SummaryThe COVID-19 pandemic has caused a worldwide shortage of personal protective equipment including N95 and FFP3 respirators. Reusable elastomeric respirators are suitable alternatives when used with compatible filters. These filters may be difficult to source and elastomeric respirators are not recommended for surgical use as the exhaled air is not filtered. Breathing system filters are routinely used in anaesthetic circuits to filter virus and bacteria. In this study, we designed 3D printed adapters that allowed elastomeric respirators to utilise breathing system filters and made simple modifications to the respirators to filter exhaled breaths. We then evaluated the performance and safety of our modified elastomeric respirators with quantitative fit tests.We recruited 8 volunteers to perform quantitative fit tests. Fit factors, respiratory rate and end-tidal carbon dioxide were recorded before and after wearing the modified respirators for 1 hour. All 8 volunteers obtained fit factors of 200+, the maximum achievable, for all tests exercises in all fit tests. The mean (range) end-tidal carbon dioxide was 4.5 (3.9-5.5) kPa and 4.6 (range 4.1-5.3) kPa before and after 1 hour of usage. The mean (range) respiratory rate was 16.5 (11-24) min-1and 17.4 (15-22) min-1before and after 1 hour of usage. Four (50%) did not experience any subjective discomfort while 2 (25%) reported pressure on the face, 1 (12.5%) reported exhalation resistance and 1 (12.5%) reported transient dizziness with exertion. Breathing system filters combined with properly fitted reusable elastomeric respirators is a safe alternative to N95 during the COVID-19 pandemic.
Covid-19 clinical data analysis using Ball Mapper
Authors: Dlotko Pawel , Rudkin Simon 
Published: April 2020

AbstractIn this note we provide a result of analysis of blood test data from patients with SARS-Cov-2 using Ball Mapper Algorithm. We observe that patients with the virus and in particularly patients who end up in Intensive Care Unit have quite narrow values of those parameters. Please note that this is a preliminary work and it need to be validated on much larger dataset which we are trying to acquire at the moment.
Hospitalization time and outcome in patients with Coronavirus Disease 2019 (COVID-19): analysis data from China
Authors: Chai Songshan , Xiao Dongdong , Cheng Qikai , Huang Shengzhi , Wang Yihao , Qian Jiajia , Wang Jiajing , Li Junjun , Fu Peng , Wang Qiangping , Rao Jing , Zhao Hongyang , Zhang Fangcheng , Xiong Nanxiang 
Published: April 2020

ABSTRACTObjectiveThe mean hospitalization time and outcome among patients with coronavirus disease 2019 (COVID-19) was estimated with the purpose of providing evidence for decision-making in medical institutions and governments in epidemic areas.MethodThe data of COVID-19 patients in china were collected from the websites of provincial and municipal health commissions. The mean hospitalization time and mortality in the mild or severe patients and the mean time from severe to mild illness were calculated by Gaussian mixture modeling.ResultsThe mean hospitalization time among mild patients in Hubei province, other areas except Hubei province, and the national areas was 20.71± 9.30, 16.86 ± 8.24, and 19.34 ± 9.29 days, respectively. The mean transition time from severe to mild group in the above three areas were 15.00, 17.00, and 14.99 days, respectively. The death rate of mild and severe patients in Hubei province and the national areas were 1.10% and 18.14%, and 1.10% and 17.70%, respectively. Among those patients who died of COVID-19, the mean time from severe transition to death in Hubei province and the national areas was 6.22 ± 5.12 and 6.35 ± 5.27 days, respectively.ConclusionThere were regional differences in the average length of stay between Hubei province and other regions, which may be related to different medical configurations. For those severe patients who died of COVID-19, the average time from hospitalization to death was about one week, and proper and effective treatments in the first week were critical.