bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics and outcomes of adolescents living with perinatally acquired HIV within Southern Africa
Authors: Tsondai Priscilla R. , Braithwaite Kate , Fatti Geoffrey , Bolton Moore Carolyn , Chimbetete Cleophas , Rabie Helena , Phiri Sam , Sawry Shobna , Eley Brian , Hobbins Michael A. , Boulle Andrew , Taghavi Katayoun , Sohn Annette H. , Davies Mary-Ann 
Published: September 2020

Background:
Using data from 15 International epidemiology Databases to Evaluate AIDS in Southern Africa sites, we compared the characteristics and outcomes of adolescents living with perinatally acquired HIV (ALPH).

Methods:
We included ALPH entering care aged less than 13 years with at least one HIV care visit during adolescence (10–19 years). We compared the characteristics and cross-sectional outcomes: transfer out, loss to follow-up (no visit in the 12 months prior to database closure), mortality, and retention between those who entered care aged less than 10 vs. aged 10–13 years; and explored predictors of mortality after age 13 years using Cox Proportional Hazards models.

Results:
Overall, 16 229 (50% female) ALPH who entered HIV care aged less than 10 years and 8897 (54% female) aged 10–13 years were included and followed for 152 574 person-years. During follow-up, 94.1% initiated antiretroviral therapy, with those who entered care aged less than 10 more likely to have initiated antiretroviral therapy [97.9%, 95% confidence interval (CI) 97.6; 98.1%] than those who presented aged 10–13 years (87.3%, 95% CI 86.6; 88.0%). At the end of follow-up, 3% had died (entered care aged <10 vs. 10–13 years; 1.4 vs. 5.1%), 22% were loss to follow-up (16.2 vs. 33.4%), and 59% (66.4 vs. 45.4%) were retained. There was no difference in the risk of dying after the age of 13 years between adolescents entering care aged less than 10 vs. 10–13 years (adjusted hazard ratio 0.72; 95% CI 0.36; 1.42).

Conclusion:
Retention outcomes for ALPH progressively worsened with increasing age, with these outcomes substantially worse among adolescents entering HIV care aged 10–13 vs. less than 10 years.
In Situ Simulation
Authors: Sharara-Chami Rana , Sabouneh Rami , Zeineddine Rida , Banat Rim , Fayad Joe , Lakissian Zavi 
Published: September 2020

Introduction
Working under extreme stress can cause medical professionals to deviate from clinical guidelines even if they know of their existence, let alone in situations such as COVID-19 where guidelines are unclear, fluid, and resources limited. In situ simulation has been proven an effective tool for training medical professionals during previous healthcare crises, eg, Ebola, influenza, as well as for assessing the preparedness of centers by identifying potential latent safety threats. In this article, we describe our ongoing simulation activities to ensure that our staff is best prepared to adapt to the challenges of COVID-19.

Methods
This is a prospective preparedness assessment and training intervention at a tertiary care academic center in Lebanon during the COVID-19 pandemic. In situ simulations followed by debriefing with good judgment occur daily involving native teams of 3 to 5 professionals in the newly established COVID intensive care unit and wards, the adult and pediatric intensive care unit and wards, and the emergency department. The simulations are assessed by the instructor using the Simulation Team Assessment Tool and by the participants using the Simulation Effectiveness Tool. Transcripts of recorded simulation debriefings are analyzed for content for latent safety threats using the SHELL Framework (Software-Hardware-Equipment-Liveware).

Results
In 2 weeks, we conducted 15 simulations with 106 participants and 47 observers. Simulation Team Assessment Tool scores show an overall improvement across the hospital over time [101.5 ± 13 (80–134)]. Participants' feedback on the Simulation Effectiveness Tool has been predominantly positive on the educational and practical benefits of the simulation activity. Data from debriefings and observations demonstrated the following categories of latent safety threats: inadequate preparedness on infection control, uncertainty of guidelines on oxygen supplementation and intubation protocols, lack of leadership and communication, overall panic, and others.

Conclusions
Our single-center preparedness intervention demonstrated multiple latent safety threats in relation to COVID-19, which can be recognized through simulation before translating into actual patient care.
Image-guided Endoscopic Parathyroidectomy Using the Axillo-breast Approach in the Treatment of Primary Hyperparathyroidism
Authors: Elzahaby Islam A. , Abouzid Amr , Saleh Saleh , Shetiwy Mosab 
Published: September 2020

Background:
Focused parathyroidectomy is currently performed using minimal access techniques. Here, we aim to evaluate the outcomes of the axillo-breast totally endoscopic approach (ABTEA) in patients with primary hyperparathyroidism caused by a single parathyroid adenoma.

Patients and Methods:
Ten patients with primary hyperparathyroidism were retrospectively evaluated. In all patients, the presence of a single parathyroid adenoma was confirmed using cervical ultrasonography by an expert radiologist with or without the use of parathyroid scintigraphy. All patients underwent focused parathyroidectomy using ABTEA. Clinicopathologic characteristics, surgical outcomes, biochemical cure rates, and cosmetic outcomes were evaluated.

Results:
The parathyroid adenoma was successfully excised in all patients without significant complications and without conversion to open approach. All patients were cured, with ≥6 months of follow-up. Temporary hoarseness of the voice was observed in 1 case. The mean surgical time was 91±17.61 minutes. The mean blood loss was 20 mL. The postoperative pain scores were satisfactory and 90% of patients were extremely satisfied with the procedure.

Conclusion:
With accurate preoperative sonographic localization of a single parathyroid adenoma, focused parathyroidectomy using ABTEA is a safe and feasible technique even for posteriorly located parathyroid adenomas.
Relationship Between Maternal Age at First Delivery and Subsequent Pelvic Organ Prolapse
Authors: Wang Rui , Tulikangas Paul K. , Tunitsky-Bitton Elena 
Published: September 2020

Objective
To determine the relationship between age at first delivery and subsequent risk of pelvic organ prolapse.

Study Design
We performed a retrospective cross-sectional study using the National Health and Nutrition Examination Survey data from 2005 to 2012. Our primary outcome was self-reported prolapse. Survival analyses and Cox proportional hazard models were used to estimate parous women’s risks of reporting prolapse in terms of time since first delivery, adjusting for parity, body mass index, prior hysterectomy, ethnicity, and education. We performed subgroup analyses on women with at least 1 vaginal delivery and those with only cesarean deliveries.

Results
The survey-weighted prevalence of prolapse was 2.82%. A total of 6203 women, 79% of all parous women surveyed, reported age at first delivery. Kaplan-Meier curves were different for women based on age at first delivery (P = 0.034). For each year increase in age at first delivery, there was a 6% increase in the rate of developing prolapse (adjusted hazard ratio, 1.06; 95% confidence interval, 1.01–1.11; P = 0.011). Compared with a woman who was 20 years at her first delivery, someone who was 30 years had 1.79 times the risk, while at 40 years the risk was 3.21 times. Among women with at least 1 vaginal delivery, the same relationship was found (adjusted hazard ratio, 1.06; 95% confidence interval, 1.01–1.12; P = 0.019). However, this was not significant for women with only cesarean deliveries (P = 0.367).

Conclusions
Older age at the time of first delivery was associated with a higher risk of subsequent prolapse. These results should be interpreted with caution given the limitations of cross-sectional survey data.
On the Role of Artificial Intelligence in Medical Imaging of COVID-19
Authors: Born Jannis , Beymer David , Rajan Deepta , Coy Adam , Mukherjee Vandana V. , Manica Matteo , Prasanna Prasanth , Ballah Deddeh , Guindy Michal , Shaham Dorith , Shah Pallav L. , Karteris Emmanouil , Robertus Jan L. , Gabrani Maria , Rosen-Zvi Michal 
Published: September 2020

AbstractThe global COVID-19 pandemic has accelerated the development of numerous digital technologies in medicine from telemedicine to remote monitoring. Concurrently, the pandemic has resulted in huge pressures on healthcare systems. Medical imaging (MI) from chest radiographs to computed tomography and ultrasound of the thorax have played an important role in the diagnosis and management of the coronavirus infection.We conducted the, to date, largest systematic review of the literature addressing the utility of Artificial Intelligence (AI) in MI for COVID-19 management. Through keyword matching on PubMed and preprint servers, including arXiv, bioRxiv and medRxiv, 463 papers were selected for a meta-analysis, with manual reviews to assess the clinical relevance of AI solutions. Further, we evaluated the maturity of the papers based on five criteria assessing the state of the field: peer-review, patient dataset size and origin, algorithmic complexity, experimental rigor and clinical deployment.In 2020, we identified 4977 papers on MI in COVID-19, of which 872 mentioned the term AI. 2039 papers of the 4977 were specific to imaging modalities with a majority of 83.8% focusing on CT, while 10% involved CXR and 6.2% used LUS. Meanwhile, the AI literature predominantly analyzed CXR data (49.7%), with 38.7% using CT and 1.5% LUS. Only a small portion of the papers were judged as mature (2.7 %). 71.9% of AI papers centered on disease detection.This review evidences a disparity between clinicians and the AI community, both in the focus on imaging modalities and performed tasks. Therefore, in order to develop clinically relevant AI solutions, rigorously validated on large-scale patient data, we foresee a need for improved collaboration between the two communities ensuring optimal outcomes and allocation of resources. AI may aid clinicians and radiologists by providing better tools for localization and quantification of disease features and changes thereof, and, with integration of clinical data, may provide better diagnostic performance and prognostic value.
Caffeine Increases the Reinforcing Efficacy of Alcohol, an Effect that is Independent of Dopamine D2Receptor Function
Authors: Holstein Sarah E. , Barkell Gillian A. , Young Megan R. 
Published: September 2020

AbstractThe rising popularity of alcohol mixed with energy drinks (AmEDs) has become a significant public health concern, with AmED users reporting higher levels of alcohol intake than non-AmED users. One mechanism proposed to explain heightened levels of alcohol intake in AmED users is that the high levels of caffeine found in energy drinks may increase the reinforcing properties of alcohol, an effect which may be dependent on interactions between adenosine signaling pathways and the dopamine D2receptor. Therefore, the purpose of the current study was to confirm whether caffeine increases the reinforcing efficacy of alcohol using both fixed ratio (FR) and progressive ratio (PR) designs, and to investigate a potential role of the dopamine D2receptor in caffeine’s reinforcement-enhancing effects. Male Long Evans rats were trained to self-administer a sweetened alcohol or sucrose solution on an FR2 schedule of reinforcement. Pretreatment with caffeine (5-10 mg/kg) significantly increased operant responding for the sweetened alcohol reinforcer, but not sucrose. PR tests of motivation for alcohol or sucrose likewise confirmed a caffeine-dependent increase in motivation for a sweetened alcohol solution, but not sucrose. However, the D2receptor antagonist eticlopride did not block the reinforcementenhancing effects of caffeine using either an FR or PR schedule of reinforcement. Taken together, these results support the hypothesis that caffeine increases the reinforcing efficacy of alcohol, which may explain caffeine-induced increases in alcohol intake. However, the reinforcement-enhancing effects of caffeine appear to be independent of D2receptor function.
Cuticular Hydrocarbons on Old Museum Specimens of the Spiny Mason Wasp,Odynerus spinipes, (Hymenoptera: Vespidae: Eumeninae) Shed Light on the Distribution and on Regional Frequencies of Distinct Chemotypes
Authors: Moris Victoria C. , Christmann Katharina , Wirtgen Aline , Belokobylskij Sergey A. , Berg Alexander , Liebig Wolf-Harald , Soon Villu , Baur Hannes , Schmitt Thomas , Niehuis Oliver 
Published: September 2020

AbstractThe mason waspOdynerus spinipesshows an exceptional case of intrasexual CHC dimorphism. Females of this species express one of two cuticular hydrocarbon (CHC) profiles (chemotypes) that differ qualitatively and quantitatively from each other. The ratio of the two chemotypes was previously shown to be close to 1:1 at three sites in Southern Germany, which might not be representative given the Palearctic distribution of the species. To infer the frequency of the two chemotypes across the entire distributional range of the species, we analyzed with GC-MS the CHC profiles of 1,042 dry-mounted specimens stored in private and museum collections. We complemented our sampling by including 324 samples collected and preserved specifically for studying their CHCs. We were capable of reliably identifying the chemotypes in 91% of dry-mounted samples, some of which collected almost 200 years ago. We found both chemotypes to occur in the Far East, the presumed glacial refuge of the species, and their frequency to differ considerably between sites and geographic regions. The geographic structure in the chemotype frequencies could be the result of differential selection regimes and/or different dispersal routes during the colonization of the Western Palearctic. The presented data pave the route for disentangling these factors by providing information where to geographically sampleO. spinipesfor population genetic analyses. They also form the much-needed basis for future studies aiming to understand the evolutionary and geographic origin as well as the genetics of the astounding CHC dimorphism thatO. spinipesfemales exhibit.
Healthcare workers in elderly care: a source of silent SARS-CoV-2 transmission?
Authors: Dautzenberg Mirjam , Eikelenboom-Boskamp Andrea , Drabbe Miranda , Janssen Jacqueline , de Jong Ewoud , Weesendorp Eefke , Koopmans Marion , Voss Andreas 
Published: September 2020

ABSTRACTImportanceHealthcare workers (HCWs), including those with mild symptoms, may be an important source of COVID-19 within elderly care.ObjectiveTo gain insight into the spread of SARS-CoV-2 among HCWs working in elderly care settings.DesignCross-sectional study among HCWs working in elderly care in the South-East of the Netherlands, testing for SARS-CoV-2, between March 31 and April 17, 2020.SettingHCWs working in geriatric rehabilitation, somatic and psychogeriatric wards or small-scale living groups and district nursing, with a total of 5245 HCWs within 4 organisations.Participants621 HCWs with mild respiratory symptoms.Main OutcomesNumber of HCWs testing positive for SARS-CoV-2 in pharyngeal swabs, using realtime reverse-transcriptase PCR targeting the SARS-CoV-2 E-gene, N-gene, and RdRP. HCWs filled out a survey to collect information on symptoms and possible sources of infection.Results133/615 (21.6%) HCWs tested positive for SARS-CoV-2, ranging from 15.6 to 44.4% per elderly care organisation, and from 0 to 64.3% per separate location of the organizations, respectively. 74.6% of tested HCWs were nursing staff, 1.7% elderly care physicians, 20.3% other HCWs with patient contact and 3.4% HCWs without patient contact. In the univariate analysis, fever, runny or stuffy nose, anosmia, general malaise, myalgia, headache and ocular pain were associated with SARS-CoV-2 positivity, while gastro-intestinal symptoms and respiratory symptoms, other than runny or stuffy nose were not. Risk factors for SARS-CoV-2 positivity were contact with patients or colleagues with suspected or proven COVID-19. Whole genome sequencing of 22 samples in 2 facilities strongly suggests spread within facilities.Conclusions and RelevanceWe found a high SARS-CoV-2 prevalence among HCWs in nursing homes and district nursing, supporting the hypothesis of undetected spread within elderly care facilities. Structural testing of elderly care HCWs, including track and trace of contacts, should be performed to control this spread, even when only mild symptoms are present.
The Geography of Excess Deaths in England during the Covid-19 pandemic: Longer term impacts and monthly dynamics
Authors: Breen Richard , Ermisch John 
Published: September 2020

AbstractPhysical social interaction relevant to the spread of infectious diseases occurs, by its nature, at a local level. If infection and related mortality are associated with social background, it is therefore natural to study variation in them in relation to the social composition of local areas. The first part of the paper studies the geographical impact of Covid-19 infection on age-standardised sex-specific excess death rates during the peak months of the pandemic so far, March through May 2020. The second part examines monthly mortality dynamics in relation to predictions from a spatial SIR (Susceptible, Infected, Recovered) model of infection introduced by Bisin and Moro (2020). The analysis indicates that during the peak months of the Covid-19 pandemic, a larger non-white population and higher social deprivation in an area were associated with higher excess mortality, particularly among men. Regarding dynamics, higher population density accelerated the growth in mortality during the upsurge in infection and increased its rate of decline after the peak of the epidemic, thereby producing a more peaked mortality profile. There is also evidence of a slower post-peak decline in mortality in more socially deprived areas but a more rapid decline in areas with a larger non-white population.
Influenza may facilitate the spread of SARS-CoV-2
Authors: Domenech de Cellès Matthieu , Casalegno Jean-Sébastien , Lina Bruno , Opatowski Lulla 
Published: September 2020

AbstractAs in past pandemics, co-circulating pathogens may play a role in the epidemiology of coronavirus disease 2019 (COVID-19), caused by the novel severe acute respiratory syndrome coronavirus 2 (SARSCoV-2). Here we hypothesized that influenza interacted with SARS-CoV-2 during the early 2020 epidemic of COVID-19 in Europe. We developed a population-based model of SARS-CoV-2 transmission, combined with mortality incidence data in four European countries, to test a range of assumptions about the impact of influenza. We found consistent evidence for a 2–2.5-fold population-level increase in SARSCoV-2 transmission associated with influenza during the period of co-circulation. These results suggest the need to increase vaccination against influenza, not only to reduce the burden due to influenza viruses, but also to counteract their facilitatory impact on SARS-CoV-2.
Ongoing natural selection drives the evolution of SARS-CoV-2 genomes
Authors: Liu Qi , Zhao Shilei , Hou Yali , Ye Sicheng , Sha Tong , Su Yankai , Zhao Wenming , Bao Yiming , Xue Yongbiao , Chen Hua 
Published: September 2020

AbstractSARS-CoV-2 is a new RNA virus affecting humans and spreads extensively through world populations since its first outbreak in late December, 2019. Whether the transmissibility and pathogenicity of SARS-CoV-2 is actively evolving, and driven by adaptation to the new host and environments is still unknown. Understanding the evolutionary mechanism underlying epidemiological and pathological characteristics of COVID-19 is essential for predicting the epidemic trend, and providing guidance for disease control and treatments. Interrogating 22,078 SARS-CoV-2 genome sequences of 84 countries, we demonstrate with convincing evidence that (i) SARS-CoV-2 genomes are overall conserved under purifying selection. (ii) Ongoing positive selection is actively driving the evolution of specific genes. Notably, genes related to coronavirus infection and host immune system defense are under adaptive evolution while genes related to viral RNA replication, transcription and translation are under purifying selection. A spatial and temporal landscape of 54 critical mutants is constructed based on their divergence among viral haplotype clusters, of which multiple mutants potentially conferring viral transmissibility, infectivity and virulence of SARS-CoV-2 are highlighted.
COVID-19 Belgium: Extended SEIR-QD model with nursing homes and long-term scenarios-based forecasts
Authors: Franco Nicolas 
Published: September 2020

AbstractFollowing the spread of the COVID-19 pandemic and pending the establishment of vaccination campaigns, several non pharmaceutical interventions such as partial and full lockdown, quarantine and measures of physical distancing have been imposed in order to reduce the spread of the disease and to lift the pressure on healthcare system. Mathematical models are important tools for estimating the impact of these interventions, for monitoring the current evolution of the epidemic at a national level and for estimating the potential long-term consequences of relaxation of measures. In this paper, we model the evolution of the COVID-19 epidemic in Belgium with a deterministic age-structured extended compartmental model. Our model takes special consideration for nursing homes which are modelled as separate entities from the general population in order to capture the specific delay and dynamics within these entities. The model integrates social contact data and is fitted on hospitalisations data (admission and discharge), on the daily number of COVID-19 deaths (with a distinction between general population and nursing home related deaths) and results from serological studies, with a sensitivity analysis based on a Bayesian approach. We present the situation as in November 2020 with the estimation of some characteristics of the COVID-19 deduced from the model. We also present several mid-term and long-term projections based on scenarios of reinforcement or relaxation of social contacts for different general sectors, with a lot of uncertainties remaining.
Heterogeneous distribution of mRNAs within flight muscle fibers, and implications for function
Authors: Parekh Aditya , Chakraborty Kunal , Purohit Devam J , Pasha Shaik Naseer , Sowdhamini R. , VijayRaghavan K. , Chaturvedi Dhananjay 
Published: September 2020

AbstractMuscle heterogeneity has been explored in terms of fiber-type distribution, structural organisation, and differences at their junctions with neurons and tendons. We amplify on such observation to additionally suggest that muscle syncytia have nonuniform protein requirements along their length, deployed for developmental and functional uses. An exploration of regionalized proteins or their mRNA across muscle syncytia has not been done. We investigated mRNA localization in regions ofDrosophila melanogasterdorsal longitudinal muscle (DLM) syncytia over their entire transcriptome. Dissection of muscle regions, their RNA-seq and stringent Differential Gene Expression analysis indeed reveals statistically significant regionalization of nearly a hundred mRNA over the length of DLMs. Functions of over half of these genes require experimental verification. A preponderance of mRNA coding for catabolic and proteolytic enzymes is conspicuous among transcripts enriched in the posterior of DLMs. Our findings provide a foundation for exploring molecular processes that contribute to syncytial maturation and muscle homeostasis in a spatially non-homogenous manner.