bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Duration of Pain at Baseline Influence Longer-term Clinical Outcomes of Low Back Pain Patients Managed on an Evidence-Based Pathway?
Authors: Jess Mary-Anne , Ryan Cormac , Hamilton Sharon , Wellburn Shaun , Atkinson Greg , Greenough Charles , Peat Glynis , Coxon Andrew , Fatoye Francis , Ferguson Diarmaid , Dickson Alastair , Ridley Helen , Martin Denis 
Published: October 2020

Study Design.
Nonrandomized longitudinal observational study.

Objective.
The aim of this study was to evaluate the association between baseline pain duration and medium-to-long term clinical outcomes, in low back pain (LBP) patients enrolled on the North East of England Regional Back Pain and Radicular Pain Pathway (NERBPP).

Summary of Background Data.
The NERBPP is based upon National Institute for Health and Care Excellence (NICE) guidelines. These guidelines no longer differentiate management of LBP patients based on pain duration. Medium-to-long term data from the NERBPP is lacking.

Methods.
Between May 2015 and December 2019, 786 and 552 LBP patients from the NERBPP returned 6-month and 12-month follow-up outcome measures, respectively. Outcomes included pain (Numerical rating scale), function (Oswestry Disability Index) and quality-of-life (EuroQol five-dimension, five-level questionnaire), analyzed using a series of covariate-adjusted models. Patients were categorized into four groups based upon baseline pain duration: <3 months, ≥3 to <6 months, ≥6 months to <12 months, ≥12 months.

Results.
Patients with <3 months duration demonstrated clinically important improvements on all outcomes, at both follow-ups. The improvements in outcomes from this group were larger than those in the ≥12 month's duration group (P < 0.05), these group differences in change, in some cases surpassed our threshold for clinical relevance. Functional improvements in those with ≥12 month's duration were not clinically relevant at either follow-up. All patients, regardless of baseline pain duration, reported similar levels of readiness to self-manage at the 12-month follow-up.

Conclusion.
Baseline pain duration would appear to be of clinical importance. Patients with shorter baseline pain duration demonstrated better outcomes. Those with ≥12 month's duration of pain may need additional support during their management to achieve clinically relevant functional improvements in the medium-to-long term. These findings raise questions about the decision by NICE to move away from duration of pain to differentiate management of LBP patients.

Level of Evidence: 3
Targeting the Vascular Endothelium in the Treatment of COVID-19
Authors: Suvorava Tatsiana , Kaesemeyer Wayne 
Published: October 2020

Abstract:
The involvement of the vascular endothelium in the complications of coronavirus disease 2019 is now recognized. Chief among these are pulmonary endotheliitis, cytokine storm, endotoxic shock, and cardiovascular collapse. This Perspectives article is focused on therapeutical strategies to reduce the risk of these complications by targeting the vascular endothelium as a part of the overall treatment of coronavirus disease 2019.
Comparison of Visual and Tomographic Outcomes of Epithelium-On and Epithelium-Off Accelerated Corneal Crosslinking: A Longitudinal Study
Authors: Niyazmand Hamed , McKelvie James , Li Ye , McLintock Cameron 
Published: October 2020

Purpose:
To compare the visual and tomographic outcomes of epithelium-on and epithelium-off corneal collagen crosslinking (CXL) in an accelerated protocol in eyes with progressive keratoconus.

Methods:
Sixty-one patients with progressive keratoconus (female patients, n = 30; male patients, n = 31) aged 17 and 48 years (mean age: 25.8 ± 6.2 yrs) were included in this study. Patients underwent either epithelium-off (n = 27) or epithelium-on (n = 34) CXL using an accelerated protocol. Patients with at least 12 months of follow-up were included in the study. Visual and tomographic data from 3, 6, and 12 months after surgery were analyzed.

Results:
There were no differences between the visual and tomographic characteristics of the epithelium-on and epithelium-off groups at baseline (P > 0.05). No significant changes in uncorrected and best spectacles-corrected visual acuity were found at any stage during the first 12 months within either group or between the groups (all P > 0.05). There were no changes in thickness and keratometric parameters at any stage during the first 12 months within either group, or between groups (P > 0.05) except for a transient significant thinning of the central cornea in all groups in the first 3 months which recovered by 6 months. There was no significant difference between groups regarding the number of eyes with progression in the 12 months after treatment (P > 0.05).

Conclusions:
Epithelium-on and epithelium-off CXL in an accelerated protocol provide comparable visual and tomographic outcomes after 1 year in eyes with progressive keratoconus.
Variability in the management and imaging use in paediatric minor head trauma in European emergency departments. A Research in European Pediatric Emergency Medicine study
Authors: Velasco Roberto , Moore Carmel M. , Deiratany Samir , D’Elia Federica , Tourteau Laetitia Bertrand , Zuiani Chiara , Bognar Zsolt , Erdelyi Katalin , Fadgyas Balazs , Fejes Marianna , Teksam Ozlem , Mirzeyev Yalçin , Esmeray Pelin , Fernández Santiago M. , Ricondo Amaia , Da Dalt Liviana , Bressan Silvia , Priante Elena , Snoeck Eveline , Broers Merel , Castman-Berrevoets Coriene E. , Fernandes Ricardo M. , Borges Joana , Obieta Anaida , Alcalde Maider , Piñol Sergio , González Javier , Azzali Annachiara , Gioè Daniela , La Spina Luisa , Bianconi Martina , Arribas Marta , Parri Niccolò 
Published: October 2020

Objective
The objective of the study was to assess the variability in the management of paediatric MHT in European emergency departments (EDs).

Methods
This was a multicentre retrospective study of children ≤18 years old with minor head trauma (MHT) (Glasgow Coma Scale ≥14) who presented to 15 European EDs between 1 January 2013 and 31 December 31. Data on clinical characteristics, imaging tests, and disposition of included patients were collected at each hospital over a 3-year period.

Results
We included 11 212 patients. Skull radiography was performed in 3416 (30.5%) patients, range 0.4–92.3%. A computed tomography (CT) was obtained in 696 (6.2%) patients, range 1.6–42.8%. The rate of admission varied from 0 to 48.2%.

Conclusion
We found great variability in terms of the type of imaging and rate of CT scan obtained. Our study suggests opportunity for improvement in the area of paediatric head injury and the need for targeted individualised ED interventions to improve management of MHT.
Investigation of the Status of Nurses Returning to Work After Recovering From COVID-19 and Influencing Factors
Authors: Zheng Na , Zhang Teng , Liu Yu , Zhu Xiu-qin 
Published: October 2020

Background:
More than 3000 medical personnel in China had been infected with coronavirus disease-2019 (COVID-19). We report on 75 previously infected nurses who returned to work.

Purpose:
The aim was to understand the adaptation status of nurses after recovering from COVID-19 and returning to work.

Methods:
Data were collected online via the Work Adaptation Scale and the Psychological Capital Scale, and the related influencing factors were analyzed.

Results:
The social integration and task mastery scores were highest, and the clear roles and cultural adaptation scores were low. The self-efficacy and hope scores were highest, but the resilience and optimism scores were not high. Psychological capital was positively correlated with work adaptation (P < .01).

Conclusions:
To ensure the quality and safety of nursing care, nurse managers should adopt effective intervention measures to address the physical and mental health of returning nurses and improve their levels of psychological capital and adaptability.
A Mixed-Methods Study of the Experiences and Beliefs of Older People With Complex Health Care Needs About Medication Adherence
Authors: Purvis Sacha , Manias Elizabeth , Redley Bernice 
Published: October 2020

Background:
Medication adherence is seldom examined in older people from diverse ethnic, cultural, and language backgrounds.

Purpose:
The purpose of this study was to explore medication adherence among culturally diverse older people with complex health care needs.

Methods:
Using a mixed-methods design, a consecutive sample of 40 older people living in a culturally diverse, low socioeconomic area completed the Brief Medication Questionnaire; 12 reporting high medication nonadherence were interviewed. Analyses used descriptive statistics and thematic analyses.

Results:
Participants experienced high medication nonadherence (n = 34, 85%), language barriers (n = 15, 37.5%), financial difficulties (n = 24, 60%), and poor understanding of their medications (n = 34, 85%). Medication nonadherence was attributed to finger dexterity (57.5%), poor vision (85%), and memory problems (87.5%). Interviews revealed 5 themes to explain nonadherence: (1) illness beliefs; (2) experiences of the aging process; (3) challenges for non-English-speaking participants; (4) adherence impediments; and (5) therapeutic relationships.

Conclusions:
Vulnerable, older people had high medication nonadherence. Targeted interventions may enhance medication adherence in this group.
COVID-19 and Nurse-Sensitive Indicators
Authors: Stifter Janet , Sermersheim Emily , Ellsworth Mary , Dowding Erin , Day Elizabeth , Silvestri Karen , Margwarth Jessica , Korkmaz Kerem , Walkowiak Nicole , Boudreau Lisa , Hernandez Laura , Harbert Bryce , Ambutas Shirley , Abraham Aney , Shaw Phil 
Published: October 2020

Background:
Nurse-sensitive quality indicators have historically been used as a metric of nursing care quality in health care organizations.

Problem:
At our academic medical center, critically ill COVID-19 patients led to a dramatic change in the organizational standard of care resulting in an increase in nurse-sensitive health care–associated infections.

Approach:
Nursing performance improvement teams provided the structure for development of innovative strategies implemented in real time by our frontline clinicians to address the quality and safety issues found with these elevated health care–associated infections.

Outcomes:
A new COVID-19 CLABSI (central line–associated bloodstream infection) Tip Sheet and a Prone Positioning Kit for HAPI Prevention are strategies developed to address quality of care issues experienced with the COVID-19 patients.

Conclusions:
Deployment of these innovative practice strategies has led to a decline in health care–associated infections and instituted a new care standard for the COVID-19 patients.
Brief Report: Virologic and Immunologic Outcomes for HIV Patients With Coronavirus Disease 2019
Authors: Hu Rong , Yan Han , Liu Manqing , Tang Li , Kong Wenhua , Zhu Zerong , Liu Pan , Bai Wenjuan , Hu Xuejiao , Ding Jie , Wang Xia , Xie Nianhua 
Published: October 2020

Background:
To describe the virologic and immunologic outcomes among people living with HIV (PLHIV) coinfected with SARS-CoV-2.

Setting:
Wuhan, China.

Methods:
Thirty-five coinfected patients were identified by matching the reported cases in National Notifiable Infectious Disease Report system for COVID-19 and HIV in Wuhan by time of April 19, 2020. Questionnaire-based survey and follow-up with blood sample collection were used to obtain characteristics before COVID-19 and after recovery. Nonparametric Mann–Whitney U test, χ2, or Fisher exact test, Mcnemar test, and Wilcoxon test were conducted.

Results:
Twenty of the 35 coinfected patients were identified as asymptomatic/mild/moderate COVID-19 (nonsevere group) and 15 were identified as severe/critical (severe group). The severe and nonsevere group had no differences in demographics, HIV baseline status, the intervals between last tests and follow-up tests for CD4+ cell count and HIV-1 viral load (all P > 0.05). Overall, there was a significantly increased number of coinfected patients with HIV-1 viral load ≥20 copies/mL after recovery (P = 0.008). The median viral load increased significantly after recovery in severe group (P = 0.034), whereas no significant change of HIV-1 viral load was observed in the nonsevere group. Limited change of CD4+ cell count was found (all P > 0.05).

Conclusion:
The coinfection of SARS-CoV-2 may put PLHIV at greater risk for HIV-1 viral rebound especially for severe/critical COVID-19, whereas it had limited impacts on CD4+ cell count. Whether continuous antiretroviral therapy against HIV infection would have significant impacts on CD4+ cell count among PLHIV coinfected with SARS-CoV-2 needs further research.
A Multiplexed, Next Generation Sequencing Platform for High-Throughput Detection of SARS-CoV-2
Authors: Aynaud Marie-Ming , Hernandez J. Javier , Barutcu Seda , Braunschweig Ulrich , Chan Kin , Pearson Joel D. , Trcka Daniel , Prosser Suzanna L. , Kim Jaeyoun , Barrios-Rodiles Miriam , Jen Mark , Song Siyuan , Shen Jess , Bruce Christine , Hazlett Bryn , Poutanen Susan , Attisano Liliana , Bremner Rod , Blencowe Benjamin J. , Mazzulli Tony , Han Hong , Pelletier Laurence , Wrana Jeffrey L. 
Published: October 2020

AbstractPopulation scale sweeps of viral pathogens, such as SARS-CoV-2, that incorporate large numbers of asymptomatic or mild symptom patients present unique challenges for public health agencies trying to manage both travel and local spread. Physical distancing is the current major strategy to suppress spread of the disease, but with enormous socio-economic costs. However, modelling and studies in isolated jurisdictions suggest that active population surveillance through systematic molecular diagnostics, combined with contact tracing and focused quarantining can significantly suppress disease spread1-3 and has significantly impacted disease transmission rates, the number of infected people, and prevented saturation of the healthcare system4-7. However, reliable systems allowing for parallel testing of 10-100,000’s of patients in larger urban environments have not yet been employed. Here we describe “COVID-19 screening using Systematic Parallel Analysis of RNA coupled to Sequencing” (C19-SPAR-Seq), a scalable, multiplexed, readily automated next generation sequencing (NGS) platform8 that is capable of analyzing tens of thousands of COVID-19 patient samples in a single instrument run. To address the strict requirements in clinical diagnostics for control of assay parameters and output, we employed a control-based Precision-Recall and predictive Receiver Operator Characteristics (coPR) analysis to assign run-specific quality control metrics. C19-SPAR-Seq coupled to coPR on a trial cohort of over 600 patients performed with a specificity of 100% and sensitivity of 91% on samples with low viral loads and a sensitivity of > 95% on high viral loads associated with disease onset and peak transmissibility. Our study thus establishes the feasibility of employing C19-SPAR-Seq for the large-scale monitoring of SARS-CoV-2 and other pathogens.
Prediction of Covid-19 Infections Through December 2020 for 10 US States Incorporating Outdoor Temperature and School Re-Opening Effects-September Update
Authors: Newell Ty 
Published: October 2020

AbstractA two‐parameter, human behavior Covid‐19 infection growth model predicts total infections between‐4.2% (overprediction) and 4.5% (underprediction) of actual infections from July 27, 2020 to September 30, 2020 for 10 US States (NY, WA, GA, IL, MN, FL, OH, MI, CA, NC). During that time, total Covid‐19 infections for 9 of the 10 modeled US States grew by 60% (MI) to 95% (MN). Only NY limited Covid‐19 infection growth with an 11% increase from July 27 to September 30, 2020.September is a month with contraposing effects of increased social interaction (eg, physical school openings) and outdoor temperatures decreasing to the 50F (10C) to 70F (21C) range in which outdoor activities and building ventilation are beneficially increased. All State infection predictions except GA, FL and CA predictions through September 30 are bounded by four prediction scenarios (no school with outdoor temperature effect, no school with no outdoor temperature effect, school with temperature effect, school with no temperature effect). GA, FL and CA continued along a path slightly below the linear infection growth boundary separating infection growth and decay, resulting in overprediction of infection growth over the two month simulation period(‐3.1% for GA, ‐1.9% for FL, and ‐4.5% for CA).Three eastern States (NY, NC, and GA) are most accurately represented by models that assume no significant change in social interactions coupled with minor outdoor temperature effects. Four midwestern States (IL, MI, MN, OH) are most accurately modeled with minor outdoor temperature effects due to a delayed decrease in average outdoor temperatures in the Midwest. The remaining three States (WA, FL, and CA) are also in good agreement with the model but with differing weather condition and social interaction impacts.Overall, model predictions continue to support the basic premise that human behavior in the US oscillates across a linear infection growth boundary that divides accelerated infection growth and decaying infection transmission.
Why do per capita COVID-19 Case Rates Differ Between U.S. States?
Authors: Chambless Lloyd 
Published: October 2020

AbstractBackgroundThe popular press has explored the differences among U.S. states in rates of COVID-19 cases, mostly focusing on political party differences, and often mentioning that political party differences in health outcomes are confounded by demographic and socio-economic differences between Democratic areas and Republican areas. The purpose of this paper is to present a thorough analysis of these issues.Design and MethodsState-specific COVID-19 cases per 100,000 people was the main outcome studied, with explanatory variables from Bureau of Census surveys, including percentages of the state population that were Hispanic, black, below poverty level, had at least a bachelor’s degree, or were uninsured, along with median age, median income, population density, and degree of urbanization. We also included political party in power as an explanatory variable in multiple linear regression. The units of analysis in this study are the 50 U.S. states.ResultsAll explanatory variables were at least marginally statistically significantly associated with case rate in univariate regression analysis, except for population density and urbanization. All the census characteristics were at least marginally associated with party in power in one factor analysis of variance, except for percentage black. In a forward stepwise procedure in a multivariable model for case rate, percentages of the state population that were Hispanic or black, median age, median income, population density, and (residual) percentage poverty were retained as statistically significant and explained 62% of the variation between states in case rates. In a model with political party in power included, along with any additional variables that notably affected the adjusted association between party in power and case rate, 69% of the variance between states in case rates was explained, and adjusted case rates per 100,000 people were 2155 for states with Democratic governments, 2269 for states with mixed governments, and 2738 for Republican-led states. These estimates are based on data through October 8, 2020.ConclusionsU.S. state-specific demographic and socio-economic variables are strongly associated with the states’ COVID-19 case rates, so must be considered in analysis of variation in case rates between the states. Adjusting for these factors, states with Democrats as the party in power have lower case rates than Republican-led states.
Diabetic macular thickness diagnostic guideded by optical coherence tomography using artificial intelligence methods: a scoping review protocol
Authors: Brasileiro Fabiana , Bublitz Frederico M. 
Published: October 2020

ABSTRACTIntroductiondiabetic retinopathy remains the mainly cause of blindness worldwide and its diagnoses and assessment is poorer as the countryside the patient is. To minimize de boundaries of health care and improve the accuracy how the treatment is stablished, the artificial intelligence (AI) techniques have been studied years ago using fundus phothographies for instance. This scoping review aims to study these AI techniques applied in Opctical Coherence Tomography (OCT) images.MethodsThis scoping review will follow the methodology framework defined in “Scoping studies: advancing the methodology”. In this methodological framework, six stages are proposed for scoping reviewStudiesidentifying the research question; identifying relevant studies; study selection; charting the data; collating, summarizing, and reporting the results; and consultation. The research questions aim to investigate what are the methods, and techniques used in artificial intelligence due to perfmorm a clinical diagnostic using OCT scanners. The team will focus on the Scopus Document Search e PubMed (Medline). The search query is a combination of terms related to Diabetic Retinopathy AND Artificial Intelligence.Ethics and DisseminationThis is a scoping review study and there is no requirement for ethical approval, as primary data will not be collected. The results from this scoping review will be published in a peer reviewed journal and reported at scientific meetings. We intend to share the results with the Ophthalmologists.ARTICLE SUMMARYStrengths and Limitations of this studyThis protocol uses a comprehensive approach, relating one research question, that will enable the identification of the main gaps and opportunities in the area;
Due to the comprehensiveness of this review protocol, it can serve as the basis for future works, with more specific scope, and the proposal of standards;The investigation of who are the mainly artificial intelligence skills will allow other researchs in this area;The inclusion of aspects of data governance in the protocol will serve as the basis for establishing an assessment model of artificial intelligence and diabetic macular thickness;One weakness of this review protocol was the number of the studies including glaucoma in their criterias.
Echo chambers as early warning signals of widespread vaccine refusal in social-epidemiological networks
Authors: Phillips Brendon , Bauch Chris T. 
Published: October 2020

AbstractSudden shifts in population health and vaccination rates occur as the dynamics of some epidemiological models go through a critical point; literature shows that this is sometimes foreshadowed by early warning signals (EWS). We investigate different structural measures of a network as candidate EWS of infectious disease outbreaks and changes in popular vaccine sentiment. We construct a multiplex disease model coupling infectious disease spread and social contact dynamics. We find that the number and mean size of echo chambers predict transitions in the infection dynamics, as do opinion-based communities. Graph modularity also gives early warnings, though the clustering coefficient shows no significant pre-outbreak changes. Change point tests applied to the EWS show decreasing efficacy as social norms strengthen. Therefore, many measures of social network connectivity can predict approaching critical changes in vaccine uptake and aggregate health, thereby providing valuable tools for improving public health.