bluuebunny/crossref_metadata_2025_split huggingface dataset:
Carer reported experiences: supporting someone with a rare disease
Authors: McMullan Julie , Crowe Ashleen L. , Downes Kirsten , McAneney Helen , McKnight Amy Jayne 
Published: July 2020

BackgroundThe uniqueness and complexity of rare diseases, together with a perceived lack of understanding from health professionals, can make caring for someone with a rare disease extremely challenging. Carers are often forced to become ‘expert’ patients alongside people they care for. Due to the demands placed upon carers it is essential that appropriate support is available for them to ensure they can continue to carry out this vital role. This exploratory study researched challenges carers face when looking after someone with a rare disease and identify how they could be better supported in this role.MethodsTo be eligible to participate, respondents had to be adults caring for someone with a rare disease. Mixed methods were used including an online survey (n=57 respondents) where carers highlighted a need for better support specific to their mental health needs, liaising with health and social care professionals, financial, communication, training and respite options. During a facilitated workshop (n=32 attendees) discussions focused on challenges carers face as well as priorities to better support carer needs in the future.ResultsWhile carers reported several positive aspects of their caring role, the majority of comments highlighted challenges such as sub-optimal interactions with healthcare professionals, insufficient (or absent) emotional, psychological and social support, lack of financial support, and lack of awareness of existing support services.ConclusionIt is important that strategies are put in place to ensure that carers take the time they need to care for themselves and raise awareness of available support options for carers of people with a rare disease(s) from health and social care providers, charities, or support groups.Strengths and limitations of this studyThis study provides insight into current challenges, and some requested solutions, based on reported experiences from carers of people with a rare disease in the UK and Ireland.The use of an online survey promoted flexibility and accessibility for person’s unable to attend the in-person workshopThe facilitated workshop enabled carers to network, discussing challenges and potential solutions with their peers.Responses in this exploratory study are based upon people who were self-motivated to participate.
Diaper need is associated with risk for food insecurity in a statewide sample of WIC participants
Authors: Belarmino Emily H. , Malinowski Amy , Flynn Karen 
Published: July 2020

ABSTRACTDiaper need is a form of material hardship that acutely affects families with young children, is not currently addressed by US antipoverty programs, and has received little public or scientific attention. This study examined the association between diaper need and risk for food insecurity in a statewide sample of participants in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Families enrolled in Vermont WIC in August 2019 were invited to an online survey. Generalized linear models were used to estimate the relationship between risk for food insecurity measured by the Hunger Vital Sign tool and diaper need, with and without adjustment for household factors. Follow-up questions asked those with diaper need what they do when they run out of diapers and those without diaper need how they access enough diapers. Complete data were available for 501 households. Over half (52.3%) were at risk for food insecurity and nearly one-third (32.5%) reported diaper need. The odds of experiencing risk for food insecurity were 3.852 (95% CI=2.557, 5.803) times greater for families with diaper need than for families that had enough diapers. The association persisted with adjustment for location, age of respondent, number of children in diapers, and length of time participating in WIC (adjusted OR=4.036, 95% CI=2.645, 6.160). Strategies to avoid running out of diapers included borrowing, stretching supplies, switching to cloth or underwear, and buying on credit. It is possible that public health interventions that address diaper need may reduce food insecurity in households with children.
Diagnostic value of skin manifestation of SARS-CoV-2 infection
Authors: Bataille V. , Visconti A. , Rossi N. , Murray B. , Bournot A. , Wolf J. , Ourselin S. , Steves C. , Spector T.D. , Falchi M. 
Published: July 2020

AbstractSARS-CoV-2 causes multiple immune-related reactions at various stages of the disease. The wide variety of skin presentations has delayed linking these to the virus. Previous studies had attempted to look at the prevalence and timing of SARS-COV-2 rashes but were based on mostly hospitalized severe cases and had little follow up. Using data collected on a subset of 336,847 eligible UK users of the COVID Symptom Study app, we observed that 8.8% of the swab positive cases (total: 2,021 subjects) reported either a body rash or an acral rash, compared to 5.4% of those with a negative swab test (total: 25,136). Together, these two skin presentations showed an odds ratio (OR) of 1.67 (95% confidence interval [CI]: 1.41-1.96) for being swab positive. Skin rashes were also predictive in the larger untested group of symptomatic app users (N=54,652), as 8.2% of those who had reported at least one classical COVID-19 symptom, i.e., fever, persistent cough, and/or anosmia, also reported a rash. Data from an independent online survey of 11,546 respondents with a rash showed that in 17% of swab positive cases, the rash was the initial presentation. Furthermore, in 21%, the rash was the only clinical sign. Skin rashes cluster with other COVID-19 symptoms, are predictive of a positive swab test and occur in a significant number of cases, either alone or before other classical symptoms. Recognising rashes is important in identifying new and earlier COVID-19 cases.
Addition of Tocilizumab to the standard of care reduces mortality in severe COVID-19: A systematic review and meta-analysis
Authors: Boregowda Umesha , Perisetti Abhilash , Nanjappa Arpitha , Gajendran Mahesh , Goyal Hemant 
Published: July 2020

ABSTRACTIntroductionTocilizumab is an anti-interleukin-6 antibody that has been used for the treatment of severe coronavirus disease 2019 (COVID-19). However, the concrete evidence of its benefit in reducing the mortality in severe COVID-19 is lacking. Therefore, we performed a systematic review and meta-analysis of relevant studies that compared the efficacy of Tocilizumab in severe COVID-19 vs. standard of care alone.MethodsLiterature search for studies that compared ‘Tocilizumab’ and ‘Standard of care’ in the treatment of COVID-19 was done using major online databases from December 2019 to June 14th, 2020. Search words ‘ Tocilizumab,’ ‘anti-interleukin-6 antibody,’ and ‘COVID-19’ or ‘coronavirus 2019’ in various combinations were used. Articles in the form of abstracts, letters without original data, case reports, and reviews were excluded. Data was gathered on an excel sheet, and statistical analysis was performed using Review Manager 5.3.ResultsSixteen studies were eligible from 693 initial studies, including 3,641 patients (64% males). There were thirteen retrospective studies and three prospective studies. There were 2,488 patients in the standard of care group (61.7%) and 1,153 patients (68.7%) in the Tocilizumab group. The death rate in the tocilizumab group, 22.4% (258/1153), was lower than the standard of care group, 26.21% (652/2,488) (Pooled odds ratio 0.57 [95% CI 0.36-0.92] p=0.02). There was a significant heterogeneity (Inconsistency index= 80%) among the included studies.ConclusionThe addition of Tocilizumab to the standard of care might reduce the mortality in severe COVID-19. Larger randomized clinical trials are needed to validate these findings.
In-house modification and improvement of the CDC real-time PCR diagnostic assay for SARS-CoV-2 detection
Authors: Das Srirupa , Dowell-Martino Candice , Arrigo Lisa , Fiedler Paul N. , Lobo Sandra 
Published: July 2020

AbstractThe world is currently facing an unprecedented pandemic caused by the novel coronavirus SARS-CoV-2 (COVID-19) which was first reported in late 2019 by China to the World Health Organization (WHO). The containment strategy for COVID-19, which has non-specific flu-like symptoms and where upwards of 80% of the affected has either mild or no symptoms, is critically centered upon diagnostic testing, tracking and isolation. Thus, the development of specific and sensitive diagnostic tests for COVID-19 is key towards the first successful step of disease management. Public health organizations like the WHO and the US-based Centers for Disease Control and Prevention (CDC) have developed real-time PCR (RT-PCR) based diagnostic tests to aid in the detection of acute infection. In this study we sought to modify the CDC RT-PCR diagnostic assay protocol to increase its sensitivity and to make the assay directly portable to health care providers in a community-based hospital setting. A number of modifications to the original protocol were tested. Increasing the RT-PCR annealing temperature by 7°C to 62°C was associated with the most significant improvement in sensitivity, wherein the cycle-threshold (Ct) value for the N2 assay was reduced by ∼3 units, in effect both reducing the overall number of inconclusive results and yielding N1/N2 assays to have similar Ct values. The limit of detection of the modified assay was also improved (0.86 RNA copies/µl for both nCoV 2019_N1/N2 assays) compared to the CDC RT-PCR diagnostic assay (1 and 3.16 RNA copies/µl for nCoV 2019_N1 and N2 assay, respectively). Using this modification, there was no significant effect on SARS-CoV-2 detection rate when viral RNA extraction was performed either manually or through an automated extraction method. We believe this modified protocol allows for more sensitive detection of the virus which in turn will be useful for pandemic management.
Genetic associations for two biological age measures point to distinct aging phenotypes
Authors: Kuo Chia-Ling , Pilling Luke C. , Liu Zuyun , Atkins Janice L. , Levine Morgan E. 
Published: July 2020

AbstractBiological age measures outperform chronological age in predicting various aging outcomes, yet little is known regarding genetic predisposition. We performed genome-wide association scans of two age-adjusted biological age measures (PhenoAgeAcceleration and BioAgeAcceleration), estimated from clinical biochemistry markers1,2 in European-descent participants from UK Biobank. The strongest signals were found in the APOE gene, tagged by the two major protein-coding SNPs, PhenoAgeAccel—rs429358 (APOE e4 determinant) (p=1.50×10−72); BioAgeAccel—rs7412 (APOE e2 determinant) (p=3.16×10−60). Interestingly, we observed inverse APOE e2 and e4 associations and unique pathway enrichments when comparing the two biological age measures. Genes associated with BioAgeAccel were enriched in lipid related pathways, while genes associated with PhenoAgeAccel showed enrichment for immune system, cell function, and carbohydrate homeostasis pathways, suggesting the two measures capture different aging domains. Our study reaffirms that aging patterns are heterogenous across individuals, and the manner in which a person ages may be partly attributed to genetic predisposition.
Commercial Serology Assays Predict Neutralization Activity Against SARS-CoV-2
Authors: Suhandynata Raymond T. , Hoffman Melissa A. , Huang Deli , Tran Jenny T. , Kelner Michael J. , Reed Sharon L. , McLawhon Ronald W. , Voss James E. , Nemazee David , Fitzgerald Robert L. 
Published: July 2020

AbstractBackgroundCurrently it is unknown whether a positive serology results correlates with protective immunity against SARS-CoV-2. There are also concerns regarding the low positive predictive value of SARS-CoV-2 serology tests, especially when testing populations with low disease prevalence.MethodsA neutralization assay was validated in a set of PCR confirmed positive specimens and in a negative cohort. 9,530 specimens were screened using the Diazyme SARS-CoV-2 IgG serology assay and all positive results (N=164) were reanalyzed using the neutralization assay, the Roche total immunoglobin assay, and the Abbott IgG assay. The relationship between the magnitude of a positive SARS-CoV-2 serology result and the levels of neutralizing antibodies detected was correlated. Neutralizing antibody titers (ID50) were also longitudinally monitored in SARS-CoV-2 PCR confirmed patients.ResultsThe SARS-CoV-2 neutralization assay had a PPA of 96.6% with a SARS-CoV-2 PCR test and a NPA of 98.0% across 100 negative controls. ID50 neutralization titers positively correlated with all three clinical serology platforms. Longitudinal monitoring of hospitalized PCR confirmed COVID-19 patients demonstrates they made high neutralization titers against SARS-CoV-2. PPA between the Diazyme IgG assay alone and the neutralization assay was 50.6%, while combining the Diazyme IgG assay with either the Roche or Abbott platforms increased the PPA to 79.2% and 78.4%, respectively.ConclusionsFor the first time, we demonstrate that three widely available clinical serology assays positively correlate with SARS-CoV-2 neutralization activity observed in COVID-19 patients. When a two-platform screen and confirm approach was used for SARS-CoV-2 serology, nearly 80% of two-platform positive specimens had neutralization titers (ID50 >50).SummaryClinical performance of a SARS-CoV-2 neutralization assay was evaluated using SARS-CoV-2 PCR confirmed patients and SARS-CoV-2 negative individuals. The neutralization assay was compared with results from SARS-CoV-2 positive serology specimens. We demonstrate that positive SARS-CoV-2 serology results correlate with the presence of neutralization activity against SARS-CoV-2. We show a high false positive rate when using a single SARS-CoV-2 serology platform to screen populations with low disease prevalence; and confirm that using a two-platform approach for COVID-19 seropositives greatly improves positive predictive value for neutralization.
Association of Cancer with Risk and Mortality of COVID-19: Results from the UK Biobank
Authors: Shi Zhuqing , Resurreccion W. Kyle , Wang Chi-Hsiung , Wei Jun , Na Rong , Zheng S. Lilly , Billings Liana K. , Helfand Brian T. , Khandekar Janardan , Xu Jianfeng 
Published: July 2020

AbstractAlthough cancer has been associated with COVID-19 risk and mortality in hospital-based studies, few population-based studies have been reported. Utilizing data from the UK Biobank (UKB), a population-based prospective cohort, we formally tested the association of over 44 different types of cancer with COVID-19 infection and mortality among 7,661 subjects who were tested by June 17, 2020. Compared to non-cancer subjects, cancer subjects (N=1,521) had significantly lower overall risk for COVID-19 infection [odds ratio (OR) and 95% confidence interval (CI): 0.79 (0.68-0.92), P=2.60E-03]. However, a trend of higher risk for COVID-19 mortality was found among 256 COVID-19 positive cancer patients, especially for hematologic cancers such as non-Hodgkin lymphoma [3.82 (1.17-12.01), P=0.02]. In cancer patients, while few demographic, lifestyle, genetic and comorbidity factors predicted risk for COVID-19 infection, older age, male sex, heart disease and hypertension significantly predicted COVID-19 mortality. The lower risk for COVID-19 infection is likely due to extra caution in COVID-19 prevention and more testing among cancer patients, an encouraging finding that demonstrates the feasibility of intervention. These results, if confirmed in future releases of UKB data and other independent populations, may provide guidance for COVID-19 prevention and treatment among cancer patients.
Perceived preparedness to respond to the COVID-19 pandemic: A study with healthcare workers in Ghana
Authors: Afulani Patience A. , Gyamerah Akua O. , Aborigo Raymond , Nutor Jerry John , Malechi Hawa , Laar Amos , Sterling Mona , Awoonor-Williams John Koku 
Published: July 2020

AbstractIntroductionHealthcare workers’ (HCWs) preparedness to respond to pandemics is critical to containing disease spread. Low-resource countries, however, experience barriers to preparedness due to limited resources. In Ghana, a country with a constrained healthcare system and high COVID-19 cases, we examined HCWs’ perceived preparedness to respond to COVID-19 and associated factors.Methods472 HCWs completed questions in a cross-sectional self-administered online survey. Perceived preparedness was assessed using a 15-question scale (Cronbach alpha=0.91) and summative scores were created (range=0-45). Higher scores meant greater perceived preparedness. We used linear regression with robust standard errors to examine associations between perceived preparedness and potential predictors.ResultsThe average preparedness score was 24 (SD=8.9); 27.8% of HCWs felt prepared. In multivariate analysis, factors associated with higher perceived preparedness were: training (β=3.35, 95%CI: to 4.69); having adequate PPE (β=2.27, 95%CI: 0.26 to 4.29), an isolation ward (β=2.74, 95%CI: 1.15 to 4.33), and protocols for screening (β=2.76, 95%CI: 0.95 to 4.58); and good perceived communication from management (β=5.37, 95%CI: 4.03 to 7.90). When added to the model, perceived knowledge decreased the effect of training by 28.0%, although training remained significant, suggesting a partial mediating role. Perceived knowledge was associated with a 6-point increase in perceived preparedness score (β=6.04, 95%CI: 4.19 to 7.90).ConclusionHCWs reported low perceived preparedness to respond to COVID-19. Training, clear protocols, PPE availability, isolation wards, and communication play an important role in increasing preparedness. Government stakeholders must institute necessary interventions to increase HCWs’ preparedness to respond to the ongoing pandemic and prepare for future pandemics.Strengths and limitations of this studyThis is one of the few studies globally to empirically examine Healthcare workers’ (HCWs) perceived preparedness to respond to COVID-19, and the first study to do so among HCWs in Ghana and in Africa.We developed a perceived preparedness for COVID-19 scale and conducted psychometric analysis to confirm its validity and reliability; this scale can facilitate similar research in other settings.We show that providers have low perceived preparedness to respond to the COVID-19 pandemic, and that this is associated with a lack of training on COVID-19, PPE, clear protocols, and isolation wards, as well as poor communication from management.The use of an online survey with recruitment via social media may have accounted for a relatively young sample.Findings are based on self-reported data from a cross-sectional survey, thus, there may be social desirability bias and associations described are not causal.
Epidemiological characteristics of COVID-19 patients in Samarinda, East Kalimantan, Indonesia
Authors: Paramita Swandari , Isnuwardana Ronny , Rahmadi Anton , Rafshodia Osa , Kusasih Ismid 
Published: July 2020

AbstractIntroductionCoronavirus Disease (COVID-19) is caused by SARS-CoV-2 infection. Indonesia announced the first COVID-19 case on 2 March 2020. East Kalimantan has been determined as the new capital of Indonesia since 2019. This makes Samarinda as the capital of East Kalimantan has been focused for its capability of handling COVID-19 patients. We report the epidemiological characteristics and immunofluorescence assay results of these patients.MethodsAll patients with positive confirmed COVID-19 by RT-PCR were admitted to hospitals and quarantine center in Samarinda. We retrospectively analyzed data from the daily report of the Samarinda City and East Kalimantan Health Office information system.ResultsBy June 25, 2020, 64 patients had been identified as having positive confirmed COVID-19. The mean age of the patients was 37.3 ± 13.8 years. Most of the patients were men (57 [90.6%] patients). Thirty-nine COVID-19 patients were imported cases with a history of traveling from South Sulawesi. Most of the patients were admitted to the Quarantine Center of Samarinda City. The mean duration from the first hospital admission for isolation to discharge was 25.6 ± 13.1 days. There was only one death case of COVID-19 patients in Samarinda. There were the highest confirmed cases of COVID-19 in Samarinda in early June 2020. There was a declining trend in the age of COVID-19 patients and the duration of isolation time in the hospital.DiscussionImported cases still contributed to the increase of COVID-19 cases in Samarinda. Younger age of COVID-19 patients was more involved in frequent mobility which makes them cause the spread of the disease. Activation of the national reference laboratory for the COVID-19 examination in Samarinda has reduced the length of time patients treated in hospitals.ConclusionThe epidemiological characteristics of COVID-19 patients show the ability of local governments to deal with this pandemic. This can be seen from the low case fatality rate in Samarinda.
Surface area-to-volume ratio, not cellular rigidity, determines red blood cell traversal through small capillaries
Authors: Namvar Arman , Blanch Adam J. , Dixon Matthew W. , Carmo Olivia M. S. , Liu Boyin , Tiash Snigdha , Looker Oliver , Andrew Dean , Chan Li-Jin , Tham Wai-Hong , Lee Peter V. S. , Rajagopal Vijay , Tilley Leann 
Published: July 2020

SummaryThe remarkable deformability of red blood cells (RBCs) depends on the viscoelasticity of the plasma membrane and cell contents and the surface area to volume (SA:V) ratio; however, it remains unclear which of these factors is the key determinant for passage through small capillaries. We used a microfluidic device to examine the traversal of normal, stiffened, swollen, parasitised and immature RBCs. We show that dramatic stiffening of RBCs had no measurable effect on their ability to traverse small channels. By contrast, a moderate decrease in the SA:V ratio had a marked effect on the equivalent cylinder diameter that is traversable by RBCs of similar stiffness. We developed a finite element model that provides a coherent rationale for the experimental observations, based on the nonlinear mechanical behaviour of the RBC membrane skeleton. We conclude that the SA:V ratio should be given more prominence in studies of RBC pathologies.
Single-cell analysis of mosquito hemocytes identifies signatures of immune cell subtypes and cell differentiation
Authors: Kwon Hyeogsun , Mohammed Mubasher , Franzén Oscar , Ankarklev Johan , Smith Ryan C. 
Published: July 2020

AbstractMosquito immune cells, known as hemocytes, are integral to cellular and humoral responses that limit pathogen survival and mediate immune priming. However, without reliable cell markers and genetic tools, studies of mosquito immune cells have been limited to morphological observations, leaving several aspects of their biology uncharacterized. Here, we use single-cell RNA sequencing (scRNA-seq) to characterize mosquito immune cells, demonstrating an increased complexity to previously defined prohemocyte, oenocytoid, and granulocyte subtypes. Through functional assays relying on phagocytosis, phagocyte depletion, and RNA-FISH experiments, we define markers to accurately distinguish immune cell subtypes and provide evidence for immune cell maturation and differentiation. In addition, gene-silencing experiments demonstrate the importance of lozenge in defining the mosquito oenocytoid cell fate. Together, our scRNA-seq analysis provides an important foundation for studies of mosquito immune cell biology and a valuable resource for comparative invertebrate immunology.