bluuebunny/crossref_metadata_2025_split huggingface dataset:
High prevalence of deep venous thrombosis in non-severe COVID-19 patients hospitalized for a neurovascular disease
Authors: Rouyer Olivier , Pierre-Paul Irène Nora , Balde Amadou Talibe , Jupiter Damaris , Bindila Daniela , Geny Bernard , Wolff Valérie 
Published: September 2020

AbstractIntroductionSevere SARS-CoV-2 infection, responsible for COVID-19, is accompanied by venous thromboembolic events particularly in intensive care unit. In non-severe COVID-19 patients affected by neurovascular diseases, the prevalence of deep venous thrombosis (DVT) is unknown. The aim of or study was to report data obtained after systematic Doppler ultrasound scanning (DUS) of lower limbs in such patients.MethodsBetween March 20 and May 2, 2020, consecutive patients with neurovascular diseases with non-severe COVID-19 were investigated with a systematic bedside DUS.ResultsThirteen patients were enrolled including 10 acute ischemic strokes, one transient ischemic attack, one cerebral venous thrombosis and one haemorrhagic stroke. At admission the median National Institute of Health Stroke Scale (NIHSS) was of 6 (IQR, 0–20). We found a prevalence of 38.5% of asymptomatic calves’ DVT (n = 5) during the first week after admission despite thromboprophylaxis. Among them, one patient had a symptomatic pulmonary embolism. Two patients died during hospitalization but the outcome was favourable in the others with a discharge median NIHSS of 1 (IQR, 0–11).Discussion/ConclusionDespite thromboprophylaxis, systematic bedside DUS showed a high prevalence of 38.5% of DVT in non-severe COVID-19 patients with neurovascular diseases. Therefore, we suggest that this non-invasive investigation should be performed in all patients of this category.
Investigating the causal nature of the relationship of subcortical brain volume with smoking and alcohol use
Authors: Logtenberg Emma , Overbeek Martin F , Pasman Joëlle A , Abdellaoui Abdel , Luijten Maartje , van Holst Ruth J , Vink Jacqueline M , Denys Damiaan , Medland Sarah E , Verweij Karin JH , Treur Jorien L 
Published: September 2020

AbstractBackgroundStructural variation in subcortical brain regions has been linked to substance use, including the most prevalent substances nicotine and alcohol. It may be that pre-existing differences in subcortical brain volume affect smoking and alcohol use, but there is also evidence that smoking and alcohol use can lead to structural changes. We assess the causal nature of this complex relationship with bi-directional Mendelian randomization (MR).MethodsMR uses genetic variants predictive of a certain trait (‘exposure’) as instrumental variables to test causal effects on a certain outcome. Due to random assortment at meiosis, genetic variants shouldn’t be associated with confounders, allowing less biased causal inference. We employed summary-level data of the largest available genome-wide association studies of subcortical brain region volumes (nucleus accumbens, amygdala, caudate nucleus, hippocampus, pallidum, putamen, and thalamus; n = 50,290) and smoking and alcohol use (smoking initiation, n = 848,460; cigarettes per day, n = 216,590; smoking cessation, n = 378,249; alcohol drinks per week, n = 630,154; alcohol dependence, n = 46,568). The main analysis, inverse-variance weighted regression, was verified by a wide range of sensitivity methods.ResultsThere was strong evidence that alcohol dependence decreased amygdala and hippocampal volume and that smoking more cigarettes per day decreased hippocampal volume. From subcortical brain volumes to substance use, there was no or weak evidence for causal effects.ConclusionsOur findings suggest that heavy alcohol use and smoking can causally reduce subcortical brain volume. This adds to accumulating evidence that alcohol and smoking affect the brain, and most likely mental health, warranting more recognition in public health efforts.
The role of school reopening in the spread of COVID-19
Authors: Beesley Richard 
Published: September 2020

AbstractMany countries chose to close schools as part of their response to the SARS-CoV2 coronavirus (COVID-19) pandemic. Whilst nations are gradually reopening schools, and many politicians advise that schools remain safe and the risks of increases in the spread of COVID-19 are low, little evidence has been presented to confirm those statements.A review of the numbers of new confirmed COVID-19 cases by country suggests that the reopening of schools is likely to be a driver in the increase of the number of new cases. This is likely exacerbated by accompanying changes and easing of restrictions. However, with the exception of China, notable for its robust test, track, trace, and isolate processes, no other countries that had significant numbers of COVID-19 cases have successfully reopened schools without an increase in cases as a consequence.Whilst reopening of schools following an initial peak and decrease in COVID-19 infections is desirable for a range of reasons, doing so without adequate controls and protections may lead to an exacerbation of spread within the school environment, which could then lead to increased community spread of disease.
Autoimmune and Inflammatory Mechanisms in Cervical Dystonia
Authors: Kilic-Berkmen Gamze , Scorr Laura , Dinasarapu Ashok R. , McKay Lucas , Rosen Ami , Bagchi Pritha , Hanfelt John , McKeon Andrew , Jinnah H. A. 
Published: September 2020

AbstractThere are many causes for cervical dystonia (CD), although most cases are idiopathic and a cause cannot be identified. The observation that 10-15% of cases have an affected family member has pointed to genetic causes, but known genes account for only a small fraction of all cases. The current manuscript describes a series of studies focusing on potential autoimmune or inflammatory mechanisms in CD. First, a case-control survey for 32 autoimmune diseases in 271 subjects with CD confirmed prior anecdotal observations that CD is associated with thyroid disease, which often results from autoimmune mechanisms. Second, unbiased proteomic methods involving a total of 20 subjects with CD, with or without associated thyroid disease, pointed towards a series of overlapping mechanisms relating to the immune system. Third, a multiplex immunoassay focusing on 37 markers associated with neuroinflammation applied to a total of 20 subjects with CD with or without thyroid disease and 20 controls pointed to abnormalities in several specific measures of the immune system. Finally, a broad screening test for neuronal antibodies in a total of 58 subjects with CD did not disclose any specific antibodies. Altogether, the association of CD with thyroid disease and blood-based immune measures point to abnormalities in cell-mediated immunity that may play a pathogenic role for a subgroup of subjects with CD.
Feasibility of Establishing a Return-To-Work Protocol Based on COVID-19 Antibodies Testing
Authors: Okungbowa-Ikponmwosa Jennifer , Mu Yijia , Job Gerard 
Published: September 2020

AbstractIntroductionPrior to the diagnosis of the first SARS-CoV2 patient in Florida, the Miami Dade Fire Rescue developed and implemented its return-to-work protocol based on guidelines from the CDC and Florida Fire Chiefs Association. As of February 17, 2020, all asymptomatic employees exposed to PCR-confirmed positive SARS-CoV2 individuals would be excluded from work for 14 days and report absence of symptoms to a delegated supervisor every 24 hours. We postulated that if COVID-19 transmission rate continues at the current rate in the absence of systemic vaccination strategy for SARS-CoV2, then a safer and more efficient return-to-work policy is needed for exposed first responders who are identified as low-risk for disease transmission.ObjectivesWe sought to establish a safe and shortened return-to-work protocol to maintain our workforce. We evaluated the utility of serological antibody testing in predicting negative seroconversion of first responders at 7 days post low-risk exposure to confirmed COVID-19 individuals.MethodsAll exposed, asymptomatic employees underwent serology testing for SARS-CoV2 one week after the initial exposure. Participants who were serologically negative had follow-up RT-PCR within 24 hours and serology testing 14 days after the initial serological test.ResultsOverall, of the 71 firefighters who have had documented exposures to SARS-CoV2 positive individuals in the fire rescue agency, 41 of 71 had initially negative serology studies. Of the 41 patients with negative serology studies, 20 voluntarily underwent confirmatory PCR testing within one day after serology testing and all 20 participants were negative. Subsequently, out of the 20 participants who underwent serology and PCR testing, 10 participants followed up and underwent repeat serology testing 14 days after exposure and all 10 participants had negative repeat serology tests. The other ten who chose not to retest remained asymptomatic 14 days after exposure.ConclusionsAlthough serology testing has limitations, it correlated with negative prediction of disease in low-risk participants with exposures in this study. Serology testing may offer a feasible, alternative return-to-work strategy for fire agencies.
Immunological characteristics govern the changing severity of COVID-19 during the transition to endemicity
Authors: Lavine Jennie S , Bjornstad Ottar N , Antia Rustom 
Published: September 2020

1AbstractAs prospects for eradicating CoV-2 dwindle, we are faced with the question of how the severity of CoV-2 disease may change in the years ahead. Will CoV-2 continue to be a pathogenic scourge that, like smallpox or measles, can be tamed only by ongoing vaccination, or will it join the ranks of mild endemic human coronaviruses (HCoVs)? Our analysis of immunological and epidemiological data on HCoVs shows that infection-blocking immunity wanes rapidly, but disease-reducing immunity is long-lived. We estimate the relevant parameters and incorporate them into a new epidemiological model framework which separates these different components of immunity. Our model recapitulates both the current severity of CoV-2 and the relatively benign nature of HCoVs; suggesting that once the endemic phase is reached, CoV-2 may be no more virulent than the common cold. The benign outcome at the endemic phase is contingent on the virus causing primary infections in children. We predict a very different outcome were a CoV like MERS (that causes severe disease in children) to become endemic. These results force us to re-evaluate control measures that rely on identifying and isolating symptomatic infections, and reconsider ideas regarding herd immunity and the use of immune individuals as shields to protect vulnerable groups.
Forecasting the outbreak of COVID-19 in Lebanon
Authors: Deeb Omar El , Jalloul Maya 
Published: September 2020

AbstractThis note explores the spread of the Coronavirus disease 2019 (COVID-19) in Lebanon using available data until August 25th, 2020 and forecasts the number of infections until the end of September using four diffierent scenarios for mitigation measures reflected in the reproductive number Rt. Mitigation measures in Lebanon date back to early March soon after the first confirmed cases, and have been gradually lifted as of May. Thereafter, the country has witnessed a slow yet steady increase in the number of cases that has been significantly exacerbated after the explosion at Beirut harbor on August 4. Furthermore, we estimate the daily active cases in need of intensive care compared to the available number of beds and we assess accordingly that this capacity will be exhausted within a short span of time, unless severe measures are imposed.
Switched and unswitched memory B cells detected during SARS-CoV-2 convalescence correlate with limited symptom duration
Authors: Newell Krista L. , Clemmer Deanna C. , Cox Justin B. , Kayode Yetunde I. , Zoccoli-Rodriguez Victoria , Taylor Harry E. , Endy Timothy P. , Wilmore Joel R. , Winslow Gary M. 
Published: September 2020

AbstractSevere acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of the pandemic human respiratory illness COVID-19, is a global health emergency. While severe acute disease has been linked to an expansion of antibody-secreting plasmablasts, we sought to identify B cell responses that correlated with positive clinical outcomes in convalescent patients. We characterized the peripheral blood B cell immunophenotype and plasma antibody responses in 40 recovered non-hospitalized COVID-19 subjects that were enrolled as donors in a convalescent plasma treatment study. We observed a significant negative correlation between the frequency of peripheral blood memory B cells and the duration of symptoms for convalescent subjects. Memory B cell subsets in convalescent subjects were composed of classical CD24+class-switched memory B cells, but also activated CD24-negative and natural unswitched CD27+IgD+IgM+subsets. Memory B cell frequency was significantly correlated with both IgG1 and IgM responses to the SARS-CoV-2 spike protein receptor binding domain (RBD).IgM+memory, but not switched memory, directly correlated with virus-specific antibody responses, and remained stable over time. Our findings suggest that the frequency of memory B cells is a critical indicator of disease resolution, and that IgM+memory B cells play an important role in SARS-CoV-2 immunity.
Public Preferences for Government Response Policies on Outbreak Control
Authors: Ozdemir Semra , Tan Si Ning Germaine , Chaudhry Isha , Maholtra Chetna , Finkelstein Eric Andrew 
Published: September 2020

AbstractObjectivesTo assess the extent to which public support for outbreak containment policies varies with respect to the severity of an infectious disease outbreak.MethodsA web-enabled survey was administered to 1,017 residents of Singapore during the COVID-19 pandemic, and was quota-sampled based on age, gender and ethnicity. A fractional-factorial design was used to create hypothetical outbreak vignettes characterised by morbidity and fatality rates, and local and global spread of an infectious disease. Each respondent was asked to indicate which response policies (among 5 policies restricting local movement and 4 border control policies) they would support in 5 randomly-assigned vignettes. Binomial logistic regressions were used to predict the probabilities of support as a function of outbreak attributes, personal characteristics and perceived policy effectiveness.ResultsLikelihood of support varied across government response policies; however, was generally higher for border control policies compared to internal policies. The fatality rate was the most important factor for internal policies while the degree of global spread was the most important for border control policies. In general, individuals who were less healthy, had higher income and were older were more likely to support these policies. Perceived effectiveness of a policy was a consistent and positive predictor of public support.ConclusionsOur findings suggest that campaigns to promote public support should be designed specifically to each policy and tailored to different segments of the population. They should also be adapted based on the evolving conditions of the outbreak in order to receive continued public support.
Long, thin transmission chains of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) may go undetected for several weeks at low to moderate reproductive numbers: Implications for containment and elimination strategy
Authors: Killeen Gerry F. 
Published: September 2020

SUMMARYEspecially at low to moderate reproductive numbers, the generally mild, non-specific symptomology of Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2) allows long, thin transmission chains to go undetected by passive surveillance over several weeks. This phenomenon has important implications: (1) Surveillance becomes less sensitive and reliable as an indicator of freedom from infection at the low reproductive numbers required to achieve elimination end points, passive surveillance systems may need to document an absence of new cases for at least a month to establish certainty of elimination. (2) Reproductive numbers should be kept as low as possible throughout such follow up periods without confirmed cases, to ensure such long, thin, undetected transmission chains all collapse before restrictions are eased and reproduction numbers are allowed to rebound. (3) While contact tracing systems may be highly effective when applied to large clusters in foci of elevated transmission where wide, rapidly expanding transmission chains are detected within two viral generations, large fractions of community transmission occurring through thinner, more extended transmission chains at lower reproductive numbers are often be too long to trace retrospectively and will be underrepresented in surveillance data. (4) Wherever surveillance systems are weak and/or younger age groups with lower rates of overt symptoms dominate transmission, containment effectiveness of contact tracing and isolation may be more severely limited, even at the higher reproduction numbers associated with larger outbreaks. While, contact tracing and isolation will remain vital for at least partially containing larger outbreaks, containment and elimination of SARS-CoV-2 will have to rely primarily upon the more burdensome and presumptive population-wide prevention measures that have proven so effective thus far against community transmission. Furthermore, these will have to be sustained at a much more stringent level and for longer periods after the last detected case than was necessary for SARS-CoV-1.
Estimating COVID-19 hospital demand using a non-parametric model: a case study in Galicia (Spain)
Authors: López-Cheda Ana , Jácome María-Amalia , Cao Ricardo , De Salazar Pablo M 
Published: September 2020

AbstractUnderstanding the demand for hospital beds for COVID-19 patients is key for decision-making and planning mitigation strategies, as overwhelming healthcare systems has critical consequences for disease mortality. However, accurately mapping the time-to-event of hospital outcomes, such as the length-of-stay in the ICU, requires understanding patient trajectories while adjusting for covariates and observation bias, such as incomplete data. Standard methods, like the Kaplan-Meier estimator, require prior assumptions that are untenable given current knowledge. Using real-time surveillance data from the first weeks of the COVID-19 epidemic in Galicia (Spain), we aimed to model the time-to-event and event probabilities of patients hospitalized, without parametric priors and adjusting for individual covariates. We applied a nonparametric Mixture Cure Model and compared its performance in estimating hospital ward/ICU lengths-of-stay to the performances of commonly used methods to estimate survival. We showed that the proposed model outperformed standard approaches, providing more accurate ICU and hospital ward length-of-stay estimates. Finally, we applied our model estimates to simulate COVID-19 hospital demand using a Monte Carlo algorithm. We provided evidence that adjusting for sex, generally overlooked in prediction models, together with age is key for accurately forecasting ICU occupancy, as well as discharge or death outcomes.
CARE OF PERIPHERAL INTRAVENOUS CATHETERS IN THREE HOSPITALS IN SPAIN: MAPPING CLINICAL OUTCOMES AND IMPLEMENTATION OF CLINICAL PRACTICE GUIDELINES
Authors: Blanco-Mavillard Ian , Parra-García Gaizka , Fernández-Fernández Ismael , Rodríguez-Calero Miguel Ángel , Personat-Labrador Celia , Castro-Sánchez Enrique 
Published: September 2020

AbstractBackgroundPeripheral intravenous catheters (PIVCs) are the most widely used invasive devices worldwide. Up to 42% of PIVCs are prematurely removed during intravenous therapy due to failure. To date, there have been few systematic attempts in European hospitals to measure adherence to recommendations to mitigate PIVC failures.AimTo analyse the clinical outcomes from clinical practice guideline recommendations for PIVC care on different hospital types and environments.MethodsWe conducted an observational study in three hospitals in Spain from December 2017 to April 2018. The adherence to recommendations was monitored via visual inspection in situ evaluations of all PIVCs inserted in adults admitted. Context and clinical characteristics were collected by an evaluation tool, analysing data descriptively.Results646 PIVCs inserted in 624 patients were monitored, which only 52.7% knew about their PIVC. Regarding PIVC insertion, 3.4% (22/646) patients had at least 2 PIVCs simultaneously. The majority of PIVCs were 20G (319/646; 49.4%) and were secured with transparent polyurethane dressing (605/646; 93.7%). Most PIVCs (357/646; 55.3%) had a free insertion site during the visual inspection at first sight. We identified 342/646 (53%) transparent dressings in optimal conditions (clean, dry, and intact dressing). PIVC dressings in medical wards were much more likely to be in intact conditions than those in surgical wards (234/399, 58.7% vs. 108/247, 43.7%). We identified 55/646 (8.5%) PIVCs without infusion in the last 24 hours and 58/646 (9.0%) PIVCs without infusion for more than 24 hours. Regarding PIVC failure, 74 (11.5%) adverse events were identified, all of them reflecting clinical manifestation of phlebitis.ConclusionsOur findings indicate that the clinical outcome indicators from CPG for PIVC care were moderate, highlighting differences between hospital environments and types. Also, we observed that nearly 50% of patients did not know what a PIVC is.
Large Mammals Have More Powerful Antibacterial Defenses Than Expected from Their Metabolic Rates
Authors: Downs Cynthia J. , Schoenle Laura A. , Goolsby Eric W. , Oakey Samantha J. , Ball Ray , Jiang Rays H.Y. , Klasing Kirk C. , Martin Lynn B. 
Published: September 2020

AbstractTerrestrial mammals span 7 orders of magnitude in body size, ranging from the < 2 g pygmy shrew (Suncus etruscus) to the > 3900 kg African elephant (Loxodonta africana). Although body size has profound effects on the behavior, physiology, ecology, and evolution of animals, how investment in immune defenses changes with body size is unknown. Here, we develop a novel 12-point dilution-curve approach to describe and compare antibacterial capacity against 3 bacterial species among >160 terrestrial species of mammals. We show that antibacterial activity in serum across mammals exhibits isometry, but the serum of large mammals is less hospitable to bacteria than would be predicted by their metabolic rates. Specifically, hypometric metabolic rates would predict that a large species should have disproportionately lower antibacterial capacity than small species, but body size is unrelated to killing capacity across species. Scaling of antibacterial immune defenses provides novel perspectives on the ecology of host-pathogen interactions, and on their co-evolutionary dynamics. These results have direct implications for effectively modeling the evolution of immune defenses and identifying potential reservoir hosts of zoonotic pathogens.