bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hydroxychloroquine and Chloroquine in COVID-19
Authors: Mehta Bella , Moezinia Carine J. , Jannat-Khah Deanna , Gibofsky Allan , Tornberg Haley , Pearce-Fisher Diyu , Goodman Susan M. , Salmon Jane E. , Ibrahim Said 
Published: July 2020

Objective
With hydroxychloroquine (HCQ) and chloroquine (CQ) emerging as potential therapies for coronavirus disease 2019 (COVID-19), shortages have been reported. We aimed to understand how rheumatologists, one of the most common prescribers of HCQ/CQ, prescribed these medications to manage COVID-19 and to understand if their patients are affected by shortages.

Methods
Between April 8 and April 27, 2020, an online survey was distributed to a convenience sample of rheumatologists who practice medicine in a diverse range of settings globally, resulting in 506 responses. Adjusted Poisson regression models were calculated.

Results
Only 6% of respondents prescribed HCQ/CQ for COVID-19 prophylaxis, and only 12% for outpatient treatment of COVID-19. Compared to the United States, the likelihood of prescribing HCQ/CQ for prophylaxis was higher in India (adjusted risk ratio [aRR], 6.7; 95% confidence interval [CI], 2.7–16.8; p < 0.001). Further, compared to the United States and those with 1 to 5 years of experience, rheumatologists in Europe (aRR, 2.9; 95% CI, 1.6–5.3; p < 0.001) and those with 10+ years of experience (11–20 years: aRR, 2.5; 95% CI, 1.2–5.3; p = 0.015; 21+ years: aRR = 3.3; 95% CI, 1.4–7.4; p = 0.004) had a higher likelihood of prescribing HCQ/CQ for outpatient treatment. Of note, 71% of all rheumatologists reported that their patients were directly affected by HCQ/CQ shortages.

Conclusion
The results suggest that only a small percentage of rheumatologists are prescribing HCQ/CQ for prophylaxis or outpatient treatment of COVID-19. Medication shortages experienced by large numbers of autoimmune disease patients are concerning and should play a role in decisions, especially given poor efficacy data for HCQ/CQ in COVID-19.
Developing Strategies for Targeted Improvement of Perioperative Education for Postbariatric Surgery Body-Contouring Patients
Authors: Cho Hoyune E. , Huynh Kristine A. , Corriere Matthew A. , Chung Kevin C. , Cederna Paul S. 
Published: July 2020

BackgroundThe quality of perioperative patient education impacts surgical outcomes, patient experiences, and resources needed to address patient concerns and unplanned visits. We examined patient inquiries and education materials to assess the quality of perioperative education and identify areas of targeted improvement for postbariatric surgery body-contouring procedures.MethodsWe examined 100 consecutive postbariatric procedures at an academic center. Themes of patient-generated calls, e-mails, and electronic medical record portal messages during the perioperative period were identified via qualitative analysis. Understandability and actionability of perioperative educational resources were assessed using the Patient Education Materials Assessment Tool (PEMAT).ResultsAmong 212 communications identified, 167 (79%) were postoperative. Common themes were concerns regarding the surgical site (38%), medications (10%), and activity restrictions (10%). One hundred thirty inquiries were resolved through patient re-education (57%), but 36 (16%) required in-person evaluation including 4 unplanned emergency department visits and 3 readmissions for surgical-site concerns. The PEMAT scores for institutional materials were fair for understandability (69%) and actionability (60%). American Society of Plastic Surgeons materials were more understandable (84%) but less actionable (40%).ConclusionsPatient queries can be leveraged as a source of qualitative data to identify gaps in perioperative education. High-yield topics, such as education regarding the surgical site and medications, can be targeted for quality improvement through better communication and potentially reduce the number of unnecessary visits. Using the PEMAT, we also identified how directly the education materials can be revised. Improving perioperative education can promote mutual understanding between patients and surgeons, better outcomes, and efficient resource utilization.
Prevention of Severe Intestinal Barrier Dysfunction Through a Single-Species Probiotics is Associated With the Activation of Microbiome-Mediated Glutamate–Glutamine Biosynthesis
Authors: Leng Yuxin , Jiang Chao , Xing Xiaofang , Tsai Ming-Shian , Snyder Michael , Zhai Aixia , Yao Gaiqi 
Published: July 2020

ABSTRACT

Introduction:
Intra-abdominal hypertension (IAH), the leading complication in the intensive care unit, significantly disturbs the gut microbial composition by decreasing the relative abundance of Lactobacillus and increasing the relative abundance of opportunistic infectious bacteria.

Methods:
To evaluate the preventative effect of Lactobacillus-based probiotics on IAH-induced intestinal barrier damages, a single-species probiotics (L92) and a multispecies probiotics (VSL#3) were introduced orally to Sprague-Dawley rats for 7 days before inducing IAH. The intestinal histology and permeability to macromolecules (fluoresceine isothiocyanate, FITC-dextran, N = 8 for each group), the parameters of immunomodulatory and oxidative responses [monocyte chemotactic protein 1 (MCP-1), interleukin-1β (IL-1β), interleukin-4 (IL-4), interleukin-10 (IL-10), malonaldehyde, glutathione peroxidase (GSH- Px), catalase (CAT), and superoxide dismutase; N = 4 for each group], and the microbiome profiling (N = 4 for each group) were analyzed.

Results:
Seven-day pretreatments of L92 significantly alleviated the IAH-induced increase in intestinal permeability to FITC-dextran and histological damage (P
< 0.0001), accompanied with the suppression of inflammatory and oxidative activation. The increase of MCP-1 and IL-1β was significantly inhibited (P
< 0.05); the anti-inflammatory cytokines, IL-4, and IL-10 were maintained at high levels; and the suppression of CAT (P
<
0.05) was significantly reversed when pretreated with L92. On the contrary, no significant protective effects were observed in the VSL#3-pretreated group. Among the 84 identified species, 260 MetaCyc pathways, and 217 Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways, the protective effects of L92 were correlated with an increased relative abundance of Bacteroides finegoldii, Odoribacter splanchnicus, and the global activation of amino acid biosynthesis pathways, especially the glutamate–glutamine biosynthesis pathway.

Conclusions:
Seven-day pretreatment with a single-species probiotics can prevent IAH-induced severe intestinal barrier dysfunction, potentially through microbial modulation.
Isolated rib cage fractures in the elderly: Do all patients belong to the intensive care unit? A retrospective nationwide analysis
Authors: Naar Leon , El Hechi Majed W. , van Erp Inge A. , Mashbari Hassan Naser A. , Fawley Jason , Parks Jonathan J. , Fagenholz Peter J. , King David R. , Mendoza April E. , Velmahos George C. , Kaafarani Haytham M.A. , Saillant Noelle N. 
Published: July 2020

BACKGROUND
Western Trauma Association guidelines recommend admitting patients 65 years or older with two or more rib fractures diagnosed by chest radiograph to the intensive care unit (ICU). Increased use of computed tomography has led to identification of less severe, “occult” rib fractures. We aimed to evaluate current national trends in disposition of older patients with isolated rib cage fractures and to identify characteristics of patients initially admitted to the ward who failed ward management.

METHODS
A retrospective cohort study of patients 65 years or older with isolated two or more blunt rib cage fractures using the 2010 to 2016 American College of Surgeons Trauma Quality Improvement Program database was performed. Ward failure was defined as patients initially admitted to the ward with subsequent need for unplanned ICU admission or intubation. Multivariable analyses were derived to study the independent predictors of failure of ward management. Propensity score matching sub-analysis was used to assess outcomes in patients admitted to the ward versus ICU.

RESULTS
There were 5,021 patients included in the analysis. Of these patients, 1,406 (28.0%) were admitted to the ICU. On multivariable analysis, age was an independent predictor of ICU admission. Of the 3,577 patients admitted directly to the ward, 38 (1.1%) patients required unplanned intubation or ICU admission. Independent predictors of failure of ward management included chronic renal failure (odds ratio [OR], 7.20; p ≤ 0.001; 95% confidence interval [CI], 2.50–20.76), traumatic pneumothorax (OR, 8.70; p = 0.008; 95% CI, 1.76–42.93), concurrent sternal fracture (OR, 6.52; p ≤ 0.001; 95% CI, 2.53–16.80), drug use disorder (OR, 6.58; p = 0.032; 95% CI, 1.17–36.96), and emergency department oxygen requirement or oxygen saturation less than 95% (OR, 2.38; p = 0.018; 95% CI, 1.16–4.86). Mortality was higher in patients with delayed ICU care versus patients with successful ward disposition (21.1% vs. 0.8%; p < 0.001).

CONCLUSION
Our results suggest that the majority of isolated rib cage fractures in older patients are safely managed on the ward with exceedingly low ward failure rates (1.1%). Patients with failure of ward management have significantly higher mortality, and we have identified predictors of failing the ward.

LEVEL OF EVIDENCE
Therapeutic/Care Management, level IV; Prognostic III.
Sequential 3D OrbiSIMS and LESA-MS/MS-based metabolomics for prediction of brain tumor relapse from sample-limited primary tissue archives
Authors: Meurs Joris , Scurr David J. , Lourdusamy Arockia , Storer Lisa C.D. , Grundy Richard G. , Alexander Morgan R. , Rahman Ruman , Kim Dong-Hyun 
Published: July 2020

ABSTRACTWe present here a novel surface mass spectrometry strategy to perform untargeted metabolite profiling of formalin-fixed paraffin-embedded (FFPE) pediatric ependymoma archives. Sequential Orbitrap secondary ion mass spectrometry (3D OrbiSIMS) and liquid extraction surface analysis-tandem MS (LESA-MS/MS) permitted the detection of 887 metabolites (163 chemical classes) from pediatric ependymoma tumor tissue microarrays (diameter <1 mm; thickness: 4 μm). From these 163 classes, 60 classes were detected with both techniques, whilst LESA-MS/MS and 3D OrbiSIMS individually allowed the detection of another 83 and 20 unique metabolite classes, respectively. Through data fusion and multivariate analysis, we were able to identify key metabolites and corresponding pathways predictive of tumor relapse which were retrospectively confirmed using gene expression analysis with publicly available data. Altogether, this sequential mass spectrometry strategy has shown to be a versatile tool to perform high throughput metabolite profiling on sample-limited tissue archives.Abstract FigureFor Table of Contents Only
Is population anxiety associated with COVID-19 related hospitalizations and deaths? A study protocol
Authors: Feys Frederik , Naser Abdallah 
Published: July 2020

AbstractBACKGROUNDThe nocebo effect is any harmful reaction following a negative suggestion. Anxiety can be seen as a manifestation of a nocebo context. The psychological stress of the COVID-19 pandemic led some people to experience COVID-19 symptoms, which were not actually related to a COVID-19 infection. A fundamental goal during the COVID-19 pandemic is to limit the COVID-19 related demand on healthcare systems and to minimize COVID-19 related deaths. This exploratory study aims to determine to what extent the anxiety in the population is related to the number of covid-19 related hospitalizations and deaths.METHODSWe will quantify the magnitude of the relationship between population anxiety and hospitalizations / deaths. Anxiety will be assessed using the results of the most frequently used anxiety measuring scale. Official websites of governments will be screened to determine hospitalizations and deaths.Studies will be included if they had at least 100 respondents, used a validated anxiety scale, reported on the general population of a country, and were conducted during the Covid-19 pandemic. A search strategy will take into account the limited resources for this study and will be used to search Pubmed, MedRXiv and PsychRXiv. Screening will take place at two levels: abstracts and titles, followed by full text reports. One researcher will extract data which will be double checked by a second researcher.We will perform weighted OLS regression to quantify the relationship of anxiety and covid-19 related hospitalizations / deaths.DISCUSSIONCovid-19 related measures can carry a significant social cost and risk of unwanted effects; it is therefore important to assess the extent to which anxiety in the population is related to covid-19 related hospitalizations or deaths. If anxiety can be properly reduced in the population, health care will be safeguarded. Thus, any strategy that reduces anxiety can then be included in evidence-based decision making.
The properties of hot household hygroscopic materials and their potential use for non-medical facemask decontamination
Authors: Andreola Marie-Line , Becquart Fréderic , Jomaa Wahbi , Verhoeven Paul O. , Baldacchino Gérard , Hemour Simon , consortium D-Mask 
Published: July 2020

AbstractThe wide use of facemasks through the population to prevent SARS-CoV-2 virus transmission, and its resulting mis- or even non-decontamination are challenging the management of the epidemic at a large scale. As a complement to machine-wash that wastes significant amount of water and energy, hot hygroscopic materials could be used to decontaminate non-medical facemasks in household settings. We report the inactivation of a viral load on a facial mask for an exposure of 15 minutes, with the combined effect of heat and humidity under a decaying pattern suggesting straight-forward general public deployment towards a reliable implementation by the population.
A Contact-Explicit Covid-19 Epidemic and Response Assessment Model
Authors: Getz Wayne M. , Vissat Ludovica Luisa , Salter Richard 
Published: July 2020

AbstractWe formulate a refined SEIR epidemic model that explicitly includes a contact class C that either thwarts pathogen invasion and returns to the susceptible class S or progresses successively through latent, asymptomatic, and symptomatic classes L, A, and I. Individuals in both A and I may go directly to an immune class V, and in I to a dead class D. We extend this SCLAIV formulation by including a set of drivers that can be used to develop policy to manage current Covid-19 and similar type disease outbreaks. These drivers include surveillance, social distancing (rate and efficacy), social relaxation, quarantining (linked to contact tracing), patient treatment/isolation and vaccination processes, each of which can be represented by a non-negative constant or an s-shaped switching flow. The latter are defined in terms of onset and switching times, initial and final values, and abruptness of switching. We built a Covid-19NMB-DASA web app to generate both deterministic and stochastic solutions to our SCLAIV and drivers model and use incidence and mortality data to provide both maximum-likelihood estimation (MLE) and Bayesian MCMC fitting of parameters. In the context of South African and English Covid-19 incidence data we demonstrate how to both identify and evaluate the role of drivers in ongoing outbreaks. In particular, we show that early social distancing in South Africa likely averted around 80,000 observed cases (actual number is double if only half the cases are observed) during the months of June and July. We also demonstrated that incidence rates in South Africa will increase to between a conservative estimate of 15 and 30 thousand observed cases per day (at a 50% surveillance level) by the end of August if stronger social distancing measures are not effected during July and August, 2020. On different a note, we show that comparably good local MLE fits of the English data using surveillance, social distancing and social relaxation drivers can represent very different kinds of outbreaks—one with close to 90% and another with under 8% immune individuals. This latter result provides a cautionary tale of why fitting SEIR-like models to incidence or prevalence data can be extremely problematic when not anchored by other critical measures, such as levels of immunity in the population. Our presentation illustrates how our SCLAIV formulation can be used to carry out forensic and scenario analyses of disease outbreaks such as Covid-19 in well defined regions.
Early Repolarization Pattern is Associated with Schizophrenia: A Single Center Experience in Japan
Authors: Kameyama Hiroshi , Sugimoto Kenichi , Inamura Keisuke , Itoh Kyoko , Kodaka Fumitoshi , Matsuda Yuki , Nukariya Kazutaka , Kato Tomohiro , Shigeta Masahiro 
Published: July 2020

AbstractIntroductionRecent studies have shown a high frequency of abnormal electrocardiograms in patients with schizophrenia. The objective of this study was to associate schizophrenia diagnoses with early repolarization patterns in a sample of hospitalized patients from a single hospital in Japan.MethodsWe conducted a retrospective age, sex and coronary risk factors matched case-control study on 85 patients with schizophrenia and 89 controls from medical checkups. First, we compared the presence of early repolarization patterns in both groups. Secondly, we elucidated an association between the presence of an early repolarization pattern and clinical findings in the patients’ groups. We also evaluated J-point elevation patterns.ResultsAs a result, we found that both early repolarization patterns and J-point elevation patterns observed were significantly higher in the schizophrenic group than in the matched control group (early repolarization pattern 23;6 P < 0.001; J-point elevation pattern 34:12; P = 0.001). After multivariable logistic regression among the patients and controls, schizophrenia was the independent predictor for early repolarization pattern (P = 0.001) and J-point elevation (P < 0.001). Among the patients, the independent predictor for early repolarization pattern was psychiatric family history (P = 0.006), while older age (P = 0.038) and psychiatric family history (P = 0.014) were predictors for J-point elevation patterns.ConclusionThese findings suggest that an association between early repolarization pattern or J-point elevation pattern and schizophrenia in a single Japanese center.
Epidemiological aspects of COVID-19 disease in India during nationwide lockdown phase-An empirical data-based analysis and its implications on interrupting the transmission
Authors: Perumal Vanamail 
Published: July 2020

AbstractBackgroundCovid-19 disease is pandemic in more than 85% of the countries in the world, with about 10 million cases and 0.5 million deaths as on July 2, 2020. In India reporting of the first case was on January 30, 2020, and to prevent rapid community spread of the disease nationwide lockdown phase was imposed from March 25- June 1, 2020. Our objective was to assess various epidemiological measures during the lockdown phase.MethodsWe used daily reporting of confirmed cases by the Ministry of Health and Family Welfare, Government of India during the period March 19-June 1, 2020. Using statistical packages STATA and R-packages, we fitted three statistical distributions (Gamma, Weibull and Log-normal) to the daily recorded new cases. We estimated daily incidence rate and death rate per million population, generation time and Basic Reproduction numbers.ResultsDuring the lockdown phase, the daily per cent increase in the cumulative number of cases showed negative exponential growth with 0.022 as an instantaneous rate of decrease. The average incidence rate with a 95% confidence interval (CI) was 1.84 (1.43-2.25). Day specific incidence rate per million (revealed the exponential pattern with 0.069 as the instantaneous rate of increase per day, which accounted for the doubling time of the disease (10 days; 95% CI: 9.25-10.93). Case fatality rate (2.92%; 95% CI: 2.82% −3.02%) and overall death rate was 1.14 (95% CI: 0.87-1.41) per million. were abysmally low. Statistical distribution fitting of new cases found to be satisfactory with Gamma distribution. Basic reproduction numbers 1.83 (95% CI: 1.82-1.83) was less.ConclusionIn India, with a population density of about 450 per Km2, the virulent of COVID-19 transmission was interrupted significantly with 70 days lockdown during the early transmission stage. We observed a considerable decline in all the epidemiological indices compared to the corresponding indices recorded during the same period in the severely affected countries.
Development of a simplein vitroassay to identify and evaluate nucleotide analogs against SARS-CoV-2 RNA-dependent RNA polymerase
Authors: Lu Gaofei , Zhang Xi , Zheng Weinan , Sun Jialei , Hua Lan , Xu Lan , Chu Xin-jie , Ding Sheng , Xiong Wen 
Published: July 2020

AbstractNucleotide analogs targeting viral RNA polymerase have been approved to be an effective strategy for antiviral treatment and are attracting antiviral drugs to combat the current SARS-CoV-2 pandemic. In this report, we develop a robustin vitrononradioactive primer extension assay to evaluate the incorporation efficiency of nucleotide analog by SARS-CoV-2 RNA-dependent RNA polymerase (RdRp) quantitively. Our results show that many nucleotide analogs can be incorporated into RNA by SARS-CoV-2 RdRp, and that the incorporation of some of them leads to chain termination. The discrimination values of nucleotide analog over those of natural nucleotide were measured to evaluate the incorporation efficiency of nucleotide analog by RdRp. We found that the incorporation efficiency of Remdesivir-TP is higher than ATP, and we did not observe chain termination or delayed chain termination caused by single Remdesivir-TP incorporation, while multiple incorporations of Remdesivir-TP caused chain termination in our assay condition. The incorporation efficiency of Ribavirin-TP and Favipiravir-TP is very low either as ATP or GTP analogs, which suggested that mutagenesis may not be the mechanism of action of those two drugs against SARS-CoV-2. Incorporation of Sofosbuvir-TP is also very low suggesting that sofosbuvir may not be very effective in treating SARS-CoV-2 infection. As a comparison, 2’-C-Methyl-GTP can be incorporated into RNA efficiently, and the derivative of 2’-C-Methyl-GTP may have therapeutic application in treating SARS-CoV-2 infection. This report provides a simple screening method that should be useful in evaluating nucleotide-based drugs targeting SARS-CoV-2 RdRp, and for studying the mechanism of action of selected nucleotide analog.
Loss ofNupr1promotes engraftment by tuning the quiescence threshold of hematopoietic stem cell repository via regulating p53-checkpoint pathway
Authors: Wang Tongjie , Xia Chengxiang , Weng Qitong , Wang Kaitao , Dong Yong , Hao Sha , Dong Fang , Liu Xiaofei , Liu Lijuan , Geng Yang , Guan Yuxian , Du Juan , Cheng Tao , Cheng Hui , Wang Jinyong 
Published: July 2020

AbstractHematopoietic stem cells (HSCs) are dominantly quiescent under homeostasis, which is a key mechanism of maintaining the HSC pool for life-long hematopoiesis. Dormant HSCs poise to be immediately activated on urgent conditions and can return to quiescence after regaining homeostasis. To date, the molecular networks of regulating the threshold of HSC dormancy, if exist, remain largely unknown. Here, we unveiled that deletion ofNupr1, a gene preferentially expressed in HSCs, activated the quiescence HSCs under homeostatic status, which conferred engraftment competitive advantage on HSCs without compromising their stemness and multi-lineage differentiation abilities in serial transplantation settings. Following an expansion protocol, theNupr1-/-HSCs proliferate more robustly than their wild type counterpartsin vitro. Nupr1inhibits the expression of p53 and the rescue of which offsets the engraftment advantage. Our data unveil thede novorole ofNupr1as an HSC quiescence-regulator, which provides insights into accelerating the engraftment efficacy of HSC transplantation by targeting the HSC quiescence-controlling network.