bluuebunny/crossref_metadata_2025_split huggingface dataset:
Estimation of salt intake, potassium intake and sodium-to-potassium ratio by 24-hour urinary excretion: an urban rural study in Sri Lanka
Authors: Jayatissa R , Yamori Y , De Silva AH , Mori M , De Silva PC , De Silva KH 
Published: April 2020

AbstractBackgroundSodium intakes of different populations around the world became of interest after a positive correlation was drawn between dietary sodium intake and prevalence of hypertension. Sri Lanka has adopted a salt reduction strategy to combat high blood pressure in the population with escalation of non-communicable diseases.ObjectiveTo measure intake of salt, potassium and sodium/potassium ratio of adults in urban and rural settings.DesignA community based study of 328 adults between 30-59 years, including equal numbers from urban and rural sectors. Weight, height and waist circumference were measured. Blood pressure was measured by a standardized automated measurement system and the mean of two readings was used for analysis. 24-hour urine was collected and measured for creatinine, sodium, potassium levels.ResultsMean daily salt consumption was 8.3g (95%CI:7.9,8.8), which is 1.6 times higher than WHO recommendation. Mean daily potassium intake was 1,265g (95%CI:1191.0,1339.3), which is 2.8 times lower and sodium/potassium ratio was 4.3 (95%CI:4.2,4.5), which is 7 times higher than WHO recommendation. Daily salt consumption was significantly higher in males (9.0g;95%CI:8.3,9.8) than females (7.7g;95%CI:7.2,8.2); rural (8.9g;95%CI:8.2-9.6,) than urban (7.7g;95%CI:7.2,8.3) with increasing body mass index (8.2g;95%CI:6.1,10.2 to 10.0g;95%CI:8.5,11.6). Systolic blood pressure was significantly positively correlated with high BMI and waist circumference.ConclusionsHigh salt consumption, low potassium intake and high sodium/potassium ratio was found in this population. This information can be used to set targets to reduce salt intake in the population. Need to create awareness to enhance the consumption of potassium rich food while reducing salt intake to minimize future NCD burden.
Triad entanglement of estrogen-sulfotransferase (SULT1E1), NFκβ and Nrf-2 confers matrix-metalloprotease (MMP 2/9) action in breast carcinogenesis
Authors: Nazmeen Aarifa , Maiti Sayantani , Maiti Smarajit 
Published: April 2020

ABSTRACTEstrogen (E2) is one of the most important signaling molecules that control cell-differentiation/early-embryogenesis/organogenesis in gender-independent manner. Nevertheless, during adolescence/adulthood it influences female reproductive-functions by delicate cellular proliferative-events via nongenomic (cellular-signaling)/genomic (transcriptional-signaling) pathways to recruit a number of genes/proteins. In case of post-menopausal-women high E2 may initiates tumors in breast/gynaecological-tissues. Impired estrogenic signaling may be the results from abnormal redox-regulations of estrogen-metabolizing-enzyme estrogen-sulfotransferase(SULT1E1), transcriptional-factors NFκβ, Nrf-2 and Matrixmetalloproteases (specially MMP 2/9) in the breast-tumor. Here, tumor and its surrounding tissues were obtained from the district-hospital. Intracellular redox-environment of tumors was screened with some in vitro-studies. RT-PCR for SULT1E1 expression and MMP 2/9-zymogram were conducted in lasoprazole (Nrf-2 inducer) or dexamethasone (SULT1E1 inducer) treted rat liver tissues. Immunohistochemistry was performed to analyze SULT1E1/NFκβ localization and MMP 2/9-zymogram in human breast-cancer versus its surrounding tissues. It can be hypothesized that transcription-factors (NFκβ/Nrf-2) imposes effect on MMPs expressions resulting in significant impacts on metastatic transition of breast-cancer. Breast tumor reveals higher (vs surrounding-tissue) expression/immunolocalization of NFκB/SULT1E1 paralleling to our previous finding of Nrf-2 induction. The relation between Nrf2/NFκB is determined by oxidative-stress and by CBP recruitment of HDAC3. Further, this relation is a determinant of MMP-regulations and SULT1E1-mediated E2 levels. Adaptively, augmented Nrf-2 may induce SULT1E1 resulting in lower active-estrogen. The triad regulations of NFκβ, SULT1E1 and Nrf2 are proposed here to execute MMPs function in the severity of human breast-carcinogenesis. Therapeutically this triad system may be effectively targeted for breast cancer treatment. Further studies are necessary in this regard.
An e-Leadership Training Academy for Practicing Clinicians in Primary Care and Public Health Settings
Authors: Sullivan Erin , Moftah Dena , Mbye PaMalick , Weilnau Taylor , Tobin Jonathan N. 
Published: April 2020

AbstractProblemThere is a lack of leadership training in health care despite it being an essential competency for providers to deliver accessible, high quality healthcare and navigate a continually changing system. The barriers to adding leadership development to the various stages of medical training are numerous. A specific barrier is the lack of access to resources for this training. This group aimed to tackle this barrier within post-graduate medical education and training through their e- Leadership Academy.ApproachThe e-Leadership Academy was developed as a partnership between the Harvard Medical School Center for Primary Care and Clinical Directors Network, Inc. (CDN). The result of the collaboration was a virtual leadership academy, offered over a 10-month period that covered the fundamental concepts and skills for leading within a clinical practice. The audience for this program were clinicians and staff of community health centers and health departments in the United States.OutcomesFor the results of this article, primary outcome analysis was of participant responses to both formative and summative evaluations that took place throughout and at the end of the course. Results were used to assess course quality, participant satisfaction, participant engagement, and provide data about future offerings that would be useful to the target audience.Next StepsThe group proposes future training programs could measure the changes in the behavior of teams and clinical outcomes utilizing expanded evaluations. Proposed plans for expansion of the e- Leadership Academy include developing additional modules and the potential integration of an in- person component.
Spatial scales in human movement between reservoirs of infection
Authors: Hardwick Robert J. , Vegvari Carolin , Collyer Benjamin , Truscott James E. , Anderson Roy M. 
Published: April 2020

AbstractThe life cycle of parasitic organisms that are the cause of much morbidity in humans often depend on reservoirs of infection for transmission into their hosts. Understanding the daily, monthly and yearly movement patterns of individuals between reservoirs is therefore of great importance to implementers of control policies seeking to eliminate various parasitic diseases as a public health problem. This is due to the fact that the underlying spatial extent of the reservoir of infection, which drives transmission, can be strongly affected by inputs from external sources, i.e., individuals who are not spatially attributed to the region defined by the reservoir itself can still migrate and contribute to it. In order to study the importance of these effects, we build and examine a novel theoretical model of human movement between spatially-distributed focal points for infection clustered into regions defined as ‘reservoirs of infection’. Using our model, we vary the spatial scale of human moment defined around focal points and explicitly calculate how varying this definition can influence the temporal stability of the effective transmission dynamics — an effect which should strongly influence how control measures, e.g., mass drug administration (MDA), define evaluation units (EUs). Considering the helminth parasites as our main example, by varying the spatial scale of human movement, we demonstrate that a critical scale exists around infectious focal points at which the migration rate into their associated reservoir can be neglected for practical purposes. This scale varies by species and geographic region, but is generalisable as a concept to infectious reservoirs of varying spatial extents and shapes. Our model is designed to be applicable to a very general pattern of infectious disease transmission modified by the migration of infected individuals between clustered communities. In particular, it may be readily used to study the spatial structure of hosts for macroparasites with temporally stationary distributions of infectious focal point locations over the timescales of interest, which is viable for the soil-transmitted helminths and schistosomes. Additional developments will be necessary to consider diseases with moving reservoirs, such as vector-born filarial worm diseases.
Large-scale implementation of pooled RNA-extraction and RT-PCR for SARS-CoV-2 detection
Authors: Ben-Ami Roni , Klochendler Agnes , Seidel Matan , Sido Tal , Gurel-Gurevich Ori , Yassour Moran , Meshorer Eran , Benedek Gil , Fogel Irit , Oiknine-Djian Esther , Gertler Asaf , Rotstein Zeev , Lavi Bruno , Dor Yuval , Wolf Dana G. , Salton Maayan , Drier Yotam ,   The Hebrew University-Hadassah COVID-19 diagnosis team
Published: April 2020

AbstractTesting for active SARS-CoV-2 infection is a fundamental tool in the public health measures taken to control the COVID-19 pandemic. Due to the overwhelming use of SARS-CoV-2 RT-PCR tests worldwide, availability of test kits has become a major bottleneck. Here we demonstrate pooling strategies to perform RNA extraction and RT-PCR in pools, significantly increasing throughput while maintaining clinical sensitivity. We implemented the method in a routine clinical diagnosis setting of asymptomatic populations, and already tested 5,464 individuals for SARS-CoV-2 using 731 RNA extraction and RT-PCR kits. We identified six SARS-CoV-2 positive patients corresponding to 0.11% of the tested population.
Untargeted metabolomic study of autism in newborn screening samples: a pilot study
Authors: Courraud Julie , Ernst Madeleine , Laursen Susan Svane , Hougaard David M. , Cohen Arieh S. 
Published: April 2020

AbstractBackgroundThe etiopathology of autism spectrum disorder (ASD) is unclear. Main risk factors include both genetic and non-genetic factors, especially prenatal and perinatal events. The Danish Neonatal Screening Biobank in connection with registry data provides unique opportunities to study early signs of disease. Therefore, we aimed to study the metabolomic profiles of dried blood spot (DBS) of newborns later diagnosed with ASD.MethodsFrom the iPsych cohort, we randomly selected 37 subjects born in 2005 and diagnosed with ASD in 2012 (cases) together with 37 matched controls and submitted their biobanked DBS to an LC-MS/MS-based untargeted metabolomics protocol. Raw data were preprocessed using MZmine 2.41.2 and metabolites were subsequently putatively annotated using mzCloud, GNPS feature-based molecular networking and other metabolome mining tools (MolNetEnhancer). Statistical analyses and data visualization included principal coordinates analyses, PERMANOVAs, t-tests, and fold-change analyses.Results4360 mass spectral features were detected, of which 150 could be putatively annotated at a high confidence level. Chemical structure information at a broad level could be retrieved for a total of 1009 metabolites, covering 31 chemical classes including bile acids, various lipids, nucleotides, amino acids, acylcarnitines and steroids. Although the untargeted analysis revealed no clear distinction between cases and controls, 18 compounds repeatedly reported in the ASD literature could be detected in our study and three mass spectral features were found differentially abundant in cases and controls before FDR correction. In addition, our results pinpointed important other factors influencing chemical profiles of newborn DBS samples such as gestational age, age at sampling and month of birth.LimitationsInherent to pilot studies, our sample size was insufficient to reveal metabolic markers of ASD. Nevertheless, we were able to establish an efficient metabolomic data acquisition and analysis pipeline and flag main confounders to be considered in future studies.ConclusionsIn this first untargeted DBS metabolomic study, newborns later diagnosed with ASD did not show a significantly different metabolic profile when compared to controls. Nevertheless, our method covered many metabolites associated with ASD in previous studies, suggesting that biochemical markers of ASD are present at birth and may be monitored during newborn screening.
Holistic AI-Driven Quantification, Staging and Prognosis of COVID-19 Pneumonia
Authors: Chassagnon Guillaume , Paragios Nikos 
Published: April 2020

ABSTRACTImproving screening, discovering therapies, developing a vaccine and performing staging and prognosis are decisive steps in addressing the COVID-19 pandemic. Staging and prognosis are especially crucial for organizational anticipation (intensive-care bed availability, patient management planning) and accelerating drug development; through rapid, reproducible and quantified response-to-treatment assessment. In this letter, we report on an artificial intelligence solution for performing automatic staging and prognosis based on imaging, clinical, comorbidities and biological data. This approach relies on automatic computed tomography (CT)-based disease quantification using deep learning, robust data-driven identification of physiologically-inspired COVID-19 holistic patient profiling, and strong, reproducible staging/outcome prediction with good generalization properties using an ensemble of consensus methods. Highly promising results on multiple independent external evaluation cohorts along with comparisons with expert human readers demonstrate the potentials of our approach. The developed solution offers perspectives for optimal patient management, given the shortage of intensive care beds and ventilators1, 2, along with means to assess patient response to treatment.
Polygenic risk, susceptibility genes, and breast cancer over the life course
Authors: Mars Nina , Widén Elisabeth , Kerminen Sini , Meretoja Tuomo , Pirinen Matti , Palta Priit ,   FinnGen, Palotie Aarno , Kaprio Jaakko , Joensuu Heikki , Daly Mark , Ripatti Samuli 
Published: April 2020

ABSTRACTPolygenic risk scores (PRS) for breast cancer have potential to improve risk prediction, but there is limited information on their clinical applicability. We set out to study how PRS could help in clinical decision making. Among 99,969 women in the FinnGen study with 6,879 breast cancer cases, the PRS was associated not only with breast cancer incidence but also with a range of breast cancer-related endpoints. Women with a breast cancer PRS above the 90th percentile had both higher breast cancer mortality (HR 2.40, 95%CI 1.82-3.17) and higher risk for non-localized disease at diagnosis (HR 2.94, 95%CI 2.63-3.28), compared to those with PRS <80th percentile. The PRS modified the breast cancer risk of two high-impact frameshift risk variants. Women with the c.1592delT variant in PALB2 (242-fold enrichment in Finland, 263 carriers) and an average PRS (20-80th percentile) had a lifetime risk of breast cancer at 58% (95%CI 50-66%), which increased to 85% (70-100%) with a high PRS (>90th percentile), and decreased to 27% (15-39%) with a low PRS (<20th percentile). Similarly, for c.1100delC in CHEK2 (3.7-fold enrichment; 1,543 carriers), the respective lifetime risks were 27% (95%CI 25-30%), 59% (52-67%), and 18% (13-22%). Among breast cancer cases, a PRS >90th percentile was associated with risk of contralateral breast cancer with HR 1.66 (95%CI 1.24-2.22). Finally, the PRS significantly refined the risk assessment of women with first-degree relatives diagnosed with breast cancer, i.e. the combination of high PRS (>90th percentile) and a positive family-history was associated with a 2.33-fold elevated risk (95%CI 1.57-3.46) compared to a positive family history alone. These findings demonstrate opportunities for a comprehensive way of assessing genetic risk in the general population, in breast cancer patients, and in unaffected family members.
Forecasting of COVID-19 Cases and Deaths Using ARIMA Models
Authors: Bayyurt Lutfi , Bayyurt Burcu 
Published: April 2020

ABSTRACTAfter the outbreak of severe acute respiratory syndrome (SARS-2002/2003) and middle east respiratory syndrome (MERS-2012/2014) in the world, new public health crisis, called new coronavirus disease (COVID-19), started in China in December 2019 and has spread all over countries. COVID-19 coronavirus has been global threat of the disease and infected humans rapidly. Control of the pandemi is urgently essential, and science community have continued to research treatment agents. Support therapy and intensive care units in hospitals are also efective to overcome of COVID-19. Statistic forecasting models could aid to healthcare system in preventation of COVID-19. This study aimed to compose of forecasting model that could be practical to predict the spread of COVID-19 in Italy, Spain and Turkey. For this purpose, we performed Auto Regressive Integrated Moving Average (ARIMA) model on the European Centre for Disease Prevention and Control COVID-19 data to predict the number of cases and deaths in COVID-19. According to the our results, while number of cases in Italy and Spain is expected to decrease as of July, in Turkey is expected to decline as of September. The number of deaths in Italy and Spain is expected to be the lowest in July. In Turkey, this number is expected to reach the highest in July. In addition, it is thought that if studies in which the sensitivity and validity of this method are tested with more cases, they will contribute to researchers working in this field.
Quantitative Method for Comparative Assessment of Particle Filtration Efficiency of Fabric Masks as Alternatives to Standard Surgical Masks for PPE
Authors: Mueller Amy V. , Eden Matthew J. , Oakes Jessica M. , Bellini Chiara , Fernandez Loretta A. 
Published: April 2020

SummaryIn response to the COVID-19 pandemic, cloth masks are being used to control the spread of virus, but the efficacy of these loose-fitting masks is not well known. Here, tools and methods typically used to assess tight-fitting respirators were modified to quantify the efficacy of community- and commercially-produced fabric masks as PPE. Two particle counters concurrently sample ambient air and air inside the masks; mask performance is evaluated by mean particle removal efficiency and statistical variability when worn as designed and with a nylon overlayer, to independently assess fit and material. Worn as designed both commercial surgical masks and cloth masks had widely varying effectiveness (53-75% and 28-90% filtration efficiency, respectively). Most surgical-style masks improved with the nylon overlayer, indicating poor fit. This rapid testing method uses widely available hardware, requires only a few calculations from collected data, and provides both a holistic and aspect-wise evaluation of mask performance.
A low-cost multi-patient pressure-controlled ventilation system with individualized parameter settings
Authors: Jardim-Neto Alcendino Cândido , Perlman Carrie E. 
Published: April 2020

AbstractIn a major health crisis, demand for mechanical ventilators may exceed supply. This scenario has led to the idea of connecting ventilation circuits in parallel to ventilate multiple patients simultaneously with the same machine. However, simple parallel connection may be harmful when the patients’ respiratory system mechanics differ. The aim of this work was to develop and test a low-cost, multi-patient, pressure-controlled ventilation system in which parameter settings could be individualized. Two types of circuits were built from polyvinyl chloride plumbing tubes and connectors, with ball valves and water columns used to control pressures. The circuits were connected to test lungs of differing compliances, ventilated in parallel at 20 cycles per minute and assessed for control error, variability and interdependency during peak inspiratory (20 to 35 cmH2O, in 5 cmH2O steps) and positive end-expiratory (5 to 20 to 5 cmH2O, in 5 cmH2O steps) pressure changes in one of the circuits. Results showed control errors lower than 1 cmH2O, a maximum standard deviation in pressure of 1.4 cmH2O and no dependency between the parallel circuits during the pressure maneuvers or a controlled disconnection/reconnection. This pressure-control system might be used to expand a commercial ventilator or, with constant gas inflow and an automated outlet valve, as a stand-alone ventilator with individually-controlled settings for multiple patients. In conclusion, the proposed solution is presented as a potentially reliable strategy for safely individualizing pressure-control parameters in a multi-patient ventilation system during a major health crisis.
Comparison of Four Molecular In Vitro Diagnostic Assays for the Detection of SARS-CoV-2 in Nasopharyngeal Specimens
Authors: Zhen Wei , Manji Ryhana , Smith Elizabeth , Berry Gregory J. 
Published: April 2020

AbstractThe novel human coronavirus SARS-CoV-2 was first discovered in the city of Wuhan, Hubei province, China, causing an outbreak of pneumonia in January 2020. As of April 10, 2020, the virus has rapidly disseminated to over 200 countries and territories, causing more than 1.6 million confirmed cases of COVID-19 and 97,000 deaths worldwide. The clinical presentation of COVID-19 is fairly non-specific, and symptoms overlap with other seasonal respiratory infections concurrently circulating in the population. Further, it is estimated that up to 80% of infected individuals experience mild symptoms or are asymptomatic, confounding efforts to reliably diagnose COVID-19 empirically. To support infection control measures, there is an urgent need for rapid and accurate molecular diagnostics to identify COVID-19 positive patients. In the present study, we have evaluated the analytical sensitivity and clinical performance of four SARS-CoV-2 molecular diagnostic assays granted Emergency Use Authorization by the FDA using nasopharyngeal swabs from symptomatic patients. This information is crucial for both laboratories and clinical teams, as decisions on which testing platform to implement are made.
Surveying Tenants of Permanent Supportive Housing in Skid Row about COVID-19
Authors: Henwood Benjamin F. , Redline Brian , Lahey Jack 
Published: April 2020

AbstractPermanent supportive housing (PSH) enrolls highly vulnerable homeless adults who experience early onset of geriatric conditions and require in-home support. Thus, there is potentially a high risk for COVID-19 within PSH, which may necessitate tenants to take protective measures. This study reports on survey results collected from 532 PSH tenants in Los Angeles, California during the 4th week of March in 2020. Results show that nearly all tenants were aware of COVID-19, and 65% considered it to be a very serious health threat. The latter characteristic was a strong predictor of taking protective measures (i.e., handwashing and social distancing). Tenants in units with shared bathroom facilities had lower odds of social distancing than those in studio apartments. Tenants with mental health diagnoses had lower odds of consistent handwashing. Lack of access to food, hygiene items, and medication delivery were commonly reported barriers to sheltering in place.