bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes among HIV-positive patients hospitalized with COVID-19
Authors: Karmen-Tuohy Savannah , Carlucci Philip M. , Zacharioudakis Ioannis M. , Zervou Fainareti N. , Rebick Gabriel , Klein Elizabeth , Reich Jenna , Jones Simon , Rahimian Joseph 
Published: May 2020

ABSTRACTBackgroundSARS-CoV-2 infection continues to cause significant morbidity and mortality worldwide. Preliminary data on SARS-CoV-2 infection suggests that some immunocompromised hosts experience worse outcomes. We performed a retrospective matched cohort study to characterize outcomes in HIV-positive patients with SARS-CoV-2 infection.MethodsLeveraging data collected from electronic medical records for all patients hospitalized at NYU Langone Health with COVID-19 between March 2, 2020 and April 23, 2020, we matched 21 HIV-positive patients to 42 non-HIV patients using a greedy nearest neighbor algorithm. Admission characteristics, laboratory results, and hospital outcomes were recorded and compared between the two groups.ResultsWhile there was a trend toward increased rates of ICU admission, mechanical ventilation, and mortality in HIV-positive patients, these differences were not statistically significant. Rates for these outcomes in our cohort are similar to those previously published for all patients hospitalized with COVID-19. HIV-positive patients had significantly higher admission and peak CRP values. Other inflammatory markers did not differ significantly between groups, though HIV-positive patients tended to have higher peak values during their clinical course. Three HIV-positive patients had superimposed bacterial pneumonia with positive sputum cultures, and all three patients expired during hospitalization. There was no difference in frequency of thrombotic events or myocardial infarction between these groups.ConclusionThis study provides evidence that HIV coinfection does not significantly impact presentation, hospital course, or outcomes of patients infected with SARS-CoV-2, when compared to matched non-HIV patients. A larger study is required to determine if the trends we observed apply to all HIV-positive patients.
Compassionate drug (mis)use during pandemics: lessons for COVID-19 from 2009
Authors: Rojek Amanda M , Martin Genevieve E , Horby Peter W 
Published: May 2020

AbstractBackgroundNew emerging infections have no known treatment. Assessing potential drugs for safety and efficacy enables clinicians to make evidence-based treatment decisions, and contributes to overall outbreak control. However, it is difficult to launch clinical trials in the unpredictable environment of an outbreak. We conducted a bibliometric systematic review for the 2009 influenza pandemic to determine the speed, and quality of evidence generation for treatments. This informs approaches to high-quality evidence generation in this and future pandemics.MethodsWe searched PubMed for all clinical data (including clinical trial, observational and case series) describing treatment for patients with influenza A(H1N1)pdm09 and ClinicalTrials.gov for research that aimed to enrol patients with the disease.Findings33869 treatment courses for patients hospitalised with A(H1N1)pdm09 were detailed in 160 publications. Most were retrospective observational studies or case series. 592 patients received treatment (or placebo) as participants in a registered interventional clinical trial with results publicly available. None of these registered trial results were available during the timeframe of the pandemic, and the median date of publication was 213 days after the Public Health Emergency of International Concern ended.InterpretationPatients were frequently treated for pandemic influenza with drugs not registered for this indication, but rarely under circumstances of high-quality data capture. The result was a reliance on use under compassionate circumstances, resulting in continued uncertainty regarding the potential benefits and harms of anti-viral treatment. Rapid scaling of clinical trials is critical for generating a quality evidence base during pandemics.FundingWellcome Trust.
Gut microbiota impairs insulin clearance during obesity
Authors: Foley Kevin P. , Zlitni Soumaya , Duggan Brittany M. , Barra Nicole G. , Anhê Fernando F. , Cavallari Joseph F. , Henriksbo Brandyn D. , Chen Cassandra Y. , Huang Michael , Lau Trevor C. , Schertzer Jonathan D. 
Published: May 2020

AbstractHyperinsulinemia can be a cause and consequence of obesity and insulin resistance. Increased insulin secretion and reduced insulin clearance can contribute to hyperinsulinemia. The triggers for changes in insulin clearance during obesity are ill-defined. We found that oral antibiotics mitigated impaired insulin clearance in mice fed a high fat diet (HFD) for 12 weeks or longer. Short-term HFD feeding and aging did not alter insulin clearance in mice. Germ-free mice colonized with microbes from HFD-fed mice had impaired insulin clearance, but not C-peptide clearance, and only after mice were colonized for 6 weeks and then HFD-fed. Five bacterial taxa predicted >90% of the variance in insulin clearance. Our data indicate that gut microbes are an independent and transmissible factor that regulates obesity-induced changes in insulin clearance. A small cluster of microbes may be a target for mitigating defects in insulin clearance and the progression of obesity and Type 2 Diabetes. We propose that a small community in the gut microbiota can impair insulin clearance and increase insulin load and the risk of complications from hyperinsulinemia.
Drive-through testing for SARS-CoV-2 in symptomatic health and social care workers and household members: an observational cohort study in Tayside, Scotland
Authors: Parcell Benjamin , Brechin Kathryn , Allstaff Sarah , Park Meg , Third Wendy , Bean Susan , Hind Chris , Farmer Rajiv , Chalmers James D 
Published: May 2020

AbstractIt has been recognised that health and social care workers (HSCW) experience higher rates of infection with SARS-CoV-2. Widespread testing of HSCWs and their symptomatic household contacts (SHCs) has not been fully implemented in the United Kingdom. We describe the results of a testing programme for HSCWs and SHCs in a single UK region (Tayside, Scotland). The testing service was established 17 th March 2020 as the first in the country, and samples were collected at a drive-through testing hub based at a local community hospital. HSCWs with mild symptoms who were self-isolating and the SHCs of HSCWs who would therefore be absent from work attended for testing. From 17 th March 2020 to 11 th April, 1887 HSCWs and SHCs underwent testing. Clinical information was available for 1727 HSCWs and SHCs. 4/155 (2.6%) child contacts, 73/374 (19.5%) adult contacts and 325/1173 (27.7%) HSCWs tested positive for SARS-CoV-2. 15 of 188 undetermined cases were positive (8.0%). We estimate that testing prevented up to 3634 lost work days from HSCW testing, 2795 from adult SHC testing and 1402 lost work days from child SHC testing. The establishment of this testing programme has assisted the infection prevention and control team in their investigation of transmission and supported adequate staffing in health and social care sectors.
Estimation of the number of general anesthesia cases based on a series of nationwide surveys on Twitter during COVID-19 in Japan: A statistical analysis
Authors: Fujii Yosuke , Daijo Hiroki , Hirota Kiichi 
Published: May 2020

AbstractPurposeThe coronavirus disease (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread to more than 200 other countries. In light of this situation, the Japanese Government declared a state of emergency in seven regions of Japan on April 7, 2020, under the provisions of the law. The medical care delivery system has been under pressure. Although various surgical societies have published guidelines on which to base their surgical decisions, it is not clear how general anesthesia has been performed and will be performed in Japan.MethodsOne of the services provided by Twitter is a voting function—Twitter Polls—through which anonymous surveys can be conducted. We used quadratic programming to analyze the results of a series of 17 surveys on Twitter, over the course of 22 weeks. The analysis focused on solving the mathematical optimizing problem on the status of operating restrictions. Public data provided by the Japanese Government were used to estimate the current changes in the number of general anesthesia performed in Japan.ResultsThe minimum number of general anesthesia per week was estimated at 66.1%, compared to 2015, on April 27, 2020. The time series trend was compatible with the results reported by the Japanese Society of Anesthesiologists.ConclusionThe number of general anesthesia was reduced by up to two-thirds during the COVID-19 pandemic in Japan, and was quantitatively estimated using the Twitter quick questionnaire.
Lactate arterial-central venous gradient among COVID-19 patients in ICU: a potential tool in the clinical practice
Authors: Nardi Giuseppe , Sanson Gianfranco , Tassinari Lucia , Guiotto Giovanna , Potalivo Antonella , Montomoli Jonathan , Schiraldi Fernando 
Published: May 2020

ABSTRACTObjectiveIn physiological conditions arterial blood lactate concentration is equal or lower than central venous. The aim of this study was to explore if the COVID-19 induced lung cells damage was mirrored by an arterial lactatemia higher than the central venous one; then if the administration of immunosuppressant drugs (i.e. canakinumab) could normalize such abnormal lactate a-cv difference.MethodsProspective cohort study started on March 25th 2020 for a duration of 10 days, enrolling 21 patients affected by severe COVID-19 pneumonia undergoing mechanical ventilation consecutively admitted to the ICU of the Rimini Hospital, Italy.Arterial and central venous blood samples were contemporary collected to calculate the difference between arterial and central venous lactate (Delta a-cv lactate) concentration within 24 h from tracheal intubation (T0), and 24 hours after canakinumab administration (T1).ResultsAt the T0 19/21 (90.5%) patients showed a pathologic Delta a-cv lactate (median 0.22 mmol/L; IQR 0.07–0.36), suggesting severe inflammation. In the 13 patients undergoing canakinumab administration, at the T1 Delta a-cv lactate decreased in 92.3% of cases, being the decrease statistically significant (T0: median 0.15, IQR 0.07–0.25 mmol/L; T1: median −0.01, IQR 0.09–0.04 mmol/L; p=0.002).ConclusionA reversed Delta a-cv lactate is likely to be one of the effects of COVID-19 related cytokine storm, that could reflect a derangement in the lung cells mitochondrial metabolism induced by inflammation or other uncoupling mediators. Delta a-cv lactate decrease may reflect the anti-inflammatory activity of canakinumab. Our preliminary findings need to be confirmed by larger outcome studies.
COVID-19 transmission risk factors
Authors: Notari Alessio , Torrieri Giorgio 
Published: May 2020

AbstractWe analyze risk factors correlated with the initial transmission growth rate of the recent COVID-19 pandemic in different countries. The number of cases follows in its early stages an almost exponential expansion; we chose as a starting point in each country the first daydiwith 30 cases and we fitted for 12 days, capturing thus the early exponential growth. We looked then for linear correlations of the exponentsαwith other variables, for a sample of 126 countries. We find a positive correlation,i.e. faster spread of COVID-19, with high confidence level with the following variables, with respectivep-value: low Temperature (4 · 10−7), high ratio of old vs. working-age people (3 · 10−6), life expectancy (8 · 10−6), number of international tourists (1· 10−5), earlier epidemic starting datedi(2· 10−5), high level of physical contact in greeting habits (6 · 10−5), lung cancer prevalence (6 · 10−5), obesity in males (1· 10−4), share of population in urban areas (2· 10−4), cancer prevalence (3· 10−4), alcohol consumption (0.0019), daily smoking prevalence (0.0036), UV index (0.004, 73 countries). We also find a correlation with low Vitamin D serum levels (0.002—0.006), but on a smaller sample, 50 countries, to be confirmed on a larger sample. There is highly significant correlation also with blood types: positive correlation with types RH-(3· 10−5) and A+ (3 ·10−3), negative correlation with B+ (2 ·10−4). We also find positive correlation with moderate confidence level (p-value of 0.02∼ 0.03) with: CO2/SO emissions, type-1 diabetes in children, low vaccination coverage for Tuberculosis (BCG). Several of the above variables are correlated with each other and so they are likely to have common interpretations. We thus performed a Principal Component Analysis, in order to find the significant independent linear combinations of such variables. We also analyzed the possible existence of a bias: countries with low GDP-per capita might have less intense testing and we discuss correlation with the above variables.
A two-wave epidemiological model of COVID-19 outbreaks using MS-Excel®
Authors: De Noni Agenor , da Silva Bernardo Araldi , Dal-Pizzol Felipe , Porto Luismar Marques 
Published: May 2020

AbstractThe emergence of the coronavirus SARS-CoV-2 has raised a global issue and a pandemic disease outbreak, COVID-19, was declared by the World Health Organization on March 12th, 2020. The new virus is rapidly spreading in humans and cases of severe acute respiratory syndromes are being reported worldwide. Health authority advisors and governments from small towns to large countries need to quickly manage and deal with growing epidemiological data on a daily basis. In this work, current available data from reported cases and deaths over time were analyzed and treated. Lethality has been calculated by finding linearization of death cases against reported ones, using a time-delayed data transposition. A two-wave statistical model, 2WM, based on the superposition of normal distributions was used to fit current data and to estimate the evolution of infections and deaths, using Microsoft® Excel. The model showed good agreement even for apparent single wave behavior in some countries and can easily be extended to any number of waves. A gamma distribution was used as a risk function to estimate death probability from patient admission to reported death. Evolution of fatality cases over time can then be estimated from the model with reasonable accuracy. Data from South Korea, China, Australia, Germany, Italy and Spain were used to validate the model. Data from The United States, United Kingdom and Brazil were used to study the epidemiology as the pandemic progresses. Additionally, the 2WM was applied to world data and to the Brazilian state of Santa Catarina. The model was implemented in MS-Excel, a popular and easy to use analytical tool. A template spreadsheet is provided as supplementary material. Constant lethality can be determined from the initial stage of the pandemic wave. Values ranged from 1.7% to 15.3%, depending on the degree of possible sub notification cases. Even for places with low testing, a linear relationship can be found. The two-wave model can be fine-tuned to properly adjust the data. The second wave pattern was estimated according to the first wave parameter. The accuracy for estimating COVID-19 evolution was compared to the classic SIR model with good agreement. According to the model, based on current trends, health protocols and policies, approximately 10,000,000 cases and 860,000 deaths will be recorded worldwide. Approximately 99% of that number would be reached by the end of July 2020 given constant conditions.
Tracking multi-site seizure propagation using ictal high frequency activity
Authors: Tobochnik Steven , Bateman Lisa M. , Akman Cigdem I. , Anbarasan Deepti , Bazil Carl W. , Bell Michelle , Choi Hyunmi , Feldstein Neil A. , Kent Paul F. , McBrian Danielle , McKhann Guy M. , Mendiratta Anil , Pack Alison M. , Sands Tristan T. , Sheth Sameer A. , Srinivasan Shraddha , Schevon Catherine A. 
Published: May 2020

AbstractObjectiveCharacterization of progressive multi-site seizure recruitment using high frequency oscillations.MethodsIctal and interictal high frequency oscillations were identified in a series of 13 patients with 72 seizures recorded by stereotactic depth electrodes, using previously validated methods. Channels with ictal high frequency oscillations were assigned to distinct spatial clusters, and seizure hubs were identified by stereotypically recruited non-overlapping clusters. Clusters were correlated with asynchronous seizure terminations to provide supportive evidence for independent seizure activity at these sites. The spatial overlap of ictal and interictal high frequency oscillations were compared.ResultsIctal high frequency oscillations were detected in 71% of seizures and 10% of implanted contacts, enabling tracking of contiguous and noncontiguous seizure recruitment. Multiple seizure hubs were identified in 54% of cases, including 43% of patients thought preoperatively to have unifocal epilepsy. Noncontiguous recruitment was associated with asynchronous seizure termination (Odds Ratio=10, 95% CI 2.9-41, p<0.001). Interictal high frequency oscillations demonstrated greater spatial overlap with ictal high frequency oscillations in cases with single seizure hubs than in those with multiple hubs (100% vs 66% per patient, p=0.03).SignificanceAnalysis of ictal high frequency oscillations can serve as a useful adjunctive technique to distinguish contiguous seizure spread from propagation to remote seizure sites. This study demonstrated that multiple seizure hubs were commonly identified by spatial clustering of ictal high frequency oscillations, including in cases that were considered unifocal. The distinction between initially activated and delayed seizure hubs was not evident based on interictal high frequency analysis, but may provide important prognostic information.Key Points-Spatial clustering and temporal activation sequences of ictal HFOs were analyzed in a cohort of surgical epilepsy patients.-Ictal HFOs revealed recruitment of multiple noncontiguous seizure hubs during seizure propagation, even in cases thought to be unifocal.-The presence of multiple seizure hubs was associated with asynchronous seizure terminations.-Interictal HFOs showed greater spatial overlap with ictal HFOs in cases with single compared to multiple seizure hubs.
Easing COVID-19 lockdown measures while protecting the older restricts the deaths to the level of the full lockdown
Authors: Fokas A.S. , Cuevas-Maraver J. , Kevrekidis P.G. 
Published: May 2020

ABSTRACTGuided by a rigorous mathematical result, we have earlier introduced a numerical algorithm, which using as input the cumulative number of deaths caused by COVID-19, can estimate the effect of easing of the lockdown conditions. Applying this algorithm to data from Greece, we extend it to the case of two subpopulations, namely, those consisting of individuals below and above 40 years of age. After supplementing the Greek data for deaths with the data for the number of individuals reported to be infected by SARS-CoV-2, we estimated the effect on deaths and infections in the case that the easing of the lockdown measures is different for these two subpopulations. We found that if the lockdown measures are partially eased only for the young subpopulation, then the effect on deaths and infections is small. However, if the easing is substantial for the older population, this effect may be catastrophic.
COVID-19: Predictive Mathematical Models for the Number of Deaths in South Korea, Italy, Spain, France, UK, Germany, and USA
Authors: Fokas Athanasios S. , Dikaios Nikolaos , Kastis George A. 
Published: May 2020

AbstractWe have recently introduced two novel mathematical models for characterizing the dynamics of the cumulative number of individuals in a given country reported to be infected with COVID-19. Here we show that these models can also be used for determining the time-evolution of the associated number of deaths. In particular, using data up to around the time that the rate of deaths reaches a maximum, these models provide estimates for the time that a plateau will be reached signifying that the epidemic is approaching its end, as well as for the cumulative number of deaths at that time. The plateau is defined to occur when the rate of deaths is 5% of the maximum rate. Results are presented for South Korea, Italy, Spain, France, UK, Germany, and USA. The number of COVID-19 deaths in other counties can be analyzed similarly.
Significant Relaxation of SARS-CoV-2-Targeted Non-Pharmaceutical Interventions Will Result in Profound Mortality: A New York State Modelling Study
Authors: Hoffman Benjamin U. 
Published: May 2020

AbstractSevere acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is the most significant global health crisis of the 21st century. The aim of this study was to develop a model to estimate the effect of undocumented infections, seasonal infectivity, immunity, and non-pharmaceutical interventions (NPIs), such as social distancing, on the transmission, morbidity, and mortality of SARS-CoV-2 in New York State (NYS). Simulations revealed dramatic infectivity driven by undocumented infections, and a peak basic reproductive number in NYS of 5.7. NPIs have been effective, and relaxation >50% will result in tens-of-thousands more deaths. Endemic infection is likely to occur in the absence of profound sustained immunity. As a result, until an effective vaccine or other effective pharmaceutical intervention is developed, it will be critical to not reduce NPIs >50% below current levels. This study establishes fundamental characteristics of SARS-CoV-2 transmission, which can help policymakers navigate combating this virus in the coming years.
Modelling safe protocols for reopening schools during the COVID-19 pandemic in France
Authors: Di Domenico Laura , Pullano Giulia , Sabbatini Chiara E. , Boëlle Pierre-Yves , Colizza Vittoria 
Published: May 2020

ABSTRACTAs countries in Europe implement strategies to control COVID-19 pandemic, different options are chosen regarding schools. Through a stochastic age-structured transmission model calibrated to the observed epidemic in Île-de-France in the first wave, we explored scenarios of partial, progressive, or full school reopening. Given the uncertainty on children’s role, we found that reopening schools after lockdown may increase COVID-19 cases, yet protocols exist that maintain the epidemic controlled. Under a scenario with stable epidemic activity if schools were closed, reopening pre-schools and primary schools would lead up to 76% [67, 84]% occupation of ICU beds if no other school level reopened, or if middle and high schools reopened later. Immediately reopening all school levels may overwhelm the ICU system. Priority should be given to pre- and primary schools allowing younger children to resume learning and development, whereas full attendance in middle and high schools is not recommended for stable or increasing epidemic activity. Large-scale test and trace are required to maintain the epidemic under control. Ex-post assessment shows that progressive reopening of schools, limited attendance, and strong adoption of preventive measures contributed to a decreasing epidemic after lifting the first lockdown.