bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Survival of Critical Care Patients With Coronavirus Disease 2019 in England: A National Cohort Study, March to June 2020*
Authors: Dennis John M. , McGovern Andrew P. , Vollmer Sebastian J. , Mateen Bilal A. 
Published: October 2020

Objectives:
To measure temporal trends in survival over time in people with severe coronavirus disease 2019 requiring critical care (high dependency unit or ICU) management, and to assess whether temporal variation in mortality was explained by changes in patient demographics and comorbidity burden over time.

Design:
Retrospective observational cohort; based on data reported to the COVID-19 Hospitalisation in England Surveillance System. The primary outcome was in-hospital 30-day all-cause mortality. Unadjusted survival was estimated by calendar week of admission, and Cox proportional hazards models were used to estimate adjusted survival, controlling for age, sex, ethnicity, major comorbidities, and geographical region.

Setting:
One hundred eight English critical care units.

Patients:
All adult (18 yr +) coronavirus disease 2019 specific critical care admissions between March 1, 2020, and June 27, 2020.

Interventions:
Not applicable.

Measurements and Main Results:
Twenty-one thousand eighty-two critical care patients (high dependency unit n = 15,367; ICU n = 5,715) were included. Unadjusted survival at 30 days was lowest for people admitted in late March in both high dependency unit (71.6% survival) and ICU (58.0% survival). By the end of June, survival had improved to 92.7% in high dependency unit and 80.4% in ICU. Improvements in survival remained after adjustment for patient characteristics (age, sex, ethnicity, and major comorbidities) and geographical region.

Conclusions:
There has been a substantial improvement in survival amongst people admitted to critical care with coronavirus disease 2019 in England, with markedly higher survival rates in people admitted in May and June compared with those admitted in March and April. Our analysis suggests this improvement is not due to temporal changes in the age, sex, ethnicity, or major comorbidity burden of admitted patients.
A Pilot Program Assessing Bronchoscopy Training and Program Initiation in a Low-income Country
Authors: Siddharthan Trishul , Jackson Peter , Argento A. Christine , Sachdeva Ashutosh , Yarmus Lonny , Alupo Patricia , Kirenga Bruce , Woordria William , Lee Hans J. 
Published: October 2020

Background:
Flexible bronchoscopy is an essential procedure for the evaluation and management of the pulmonary disease. However, this technology and related training is not available in many low-middle income countries (LMICs). We conducted a pilot training program for flexible bronchoscopy in Uganda.

Methods:
A multimodal curriculum was developed with pulmonologists from Uganda and the United States. The training included an online distance learning management system for video content, simulation, just-in-time training, and deliberate practice via clinical proctoring. Procedural standards and a de novo bronchoscopy suite were concurrently developed. Competency was assessed using the Bronchoscopic Skills and Tasks Assessment Tool written examination and the Ontario Bronchoscopy Assessment Tool.

Results:
We trained 3 pulmonary physicians with no prior experience in flexible bronchoscopy. Three bronchoscopies with bronchoalveolar lavage were performed during the training and an additional 11 cases were performed posttraining. All 3 Ugandan physicians had an increase in their written Bronchoscopic Skills and Tasks Assessment Tool and Ontario Bronchoscopy Assessment Tool in the competent range (P<0.05). All bronchoscopies were successfully completed, adequate samples were obtained, and there were no procedure-related complications.

Conclusion:
Bronchoscopy implementation in LMICs is feasible, but requires competency-based training. Further studies are needed to validate this curriculum in LMICs, including the use of this type of curriculum for more complicated bronchoscopic procedures.
Obesity and immune status in children
Authors: Fang Xingyuan , Henao-Mejia Jorge , Henrickson Sarah E. 
Published: October 2020

Purpose of review
Childhood obesity, with persistent chronic inflammation, is a worldwide epidemic. Obesity causes dysregulation throughout the immune system, affecting the balance and levels of cytokines, adipokines, and innate and adaptive immune cells. The present review focuses on the impact of obesity on immune function in children: altering the baseline activation state of immune cells and affecting the ability of the host to combat pathogens and malignancy and respond appropriately to vaccination.

Recent findings
Obesity causes dysregulation of the immune system. Single-cell RNA-sequencing of adipose tissue and resident immune cells is quantifying the impact of obesity on the frequency of immune cell subsets and their states. The system-wide alterations in immune function in obesity are most evident upon perturbation, including the response to infection (e.g. increased risk of severe COVID-19 in the ongoing pandemic), vaccination, and malignancy. However, mechanistic research in pediatric obesity is limited and this impacts our ability to care for these children.

Summary
We must better understand baseline and perturbed immune health in obese children to determine how to account for altered frequency and function of humoral and cellular immune components in acute infection, during vaccine design and when considering therapeutic options for this complex, medically vulnerable group.
Coccygodynia Due to a Sacrococcygeal Anomaly
Authors: García Sánchez Paula , de Ceano Vivas la Calle María , Martín Sánchez Julia , Molina Gutiérrez Miguel Ángel , Pérez Vigara Ana , Martínez Martínez Leopoldo 
Published: October 2020

Abstract
We report a case of an uncommon sacrococcygeal anomaly in a healthy girl initially presenting to the emergency department with coccygodynia and a past history of longstanding constipation. The clinical evolution was satisfactory once the bony anomaly was removed (coccygectomy). This unusual case exemplifies the importance of the medical history and physical examination to make an accurate diagnosis. An inadequate intervention may result in persistent pain, worsening longstanding constipation, and psychosocial and medical consequences.
Diagnosis and Treatment of Headache in a Pediatric Emergency Department
Authors: Costa Francisca M. , Ferreira Inês P. , Mascarenhas Inês F. , Alves Cláudio F. , Bento Vanda A. , Loureiro Helena C. 
Published: October 2020

Objectives
The aims of the study were (1) to analyze the etiology and clinical management of headaches in children in the emergency department and (2) to analyze the treatment used in children diagnosed with headaches and with migraines.

Methods
Retrospective study of all the patients who were admitted to the pediatric emergency department of Hospital Professor Doutor Fernando Fonseca, Lisbon, in 2014, with a chief complaint of headaches or the primary discharge diagnosis was headache/migraine.

Results
Headache related cases represented 3.8% of all the visits, a total of 2354 subjects. The median age was 10 years and 52.6% were female. The most frequent diagnoses were as follow: headaches (21.3%), upper respiratory infections (18.4%), and migraines (6.1%). There were 4 cases of meningitis, 6,5% of all patients underwent computed tomography which was mostly requested in school-age children and adolescents. The average time from the first medical observation until discharge was 85 minutes. Fifty-five percent did not take any pain relief medication, 17.2% took acetaminophen, and 11.1% took ibuprofen. Patients who received ondansetron had less revisits (P = 0.000). Subjects with mild-moderate pain treated with acetaminophen or no medication had more revisits (P = 0.000).

Conclusions
Secondary benign headaches were the most common and very rarely headache as a symptom was associated with life-threatening situations. Antiemetics seem to be efficient ally in the treatment of primary headaches, but it is important to consider alternative pharmacological regimes in patients who present with higher pain scores.
Wheelchair Athlete Concussion Baseline Data
Authors: Harper Michael W. , Lee Jonathan , Sherman Katherine A. , Uihlein Michael Joseph , Lee Kenneth Kyung Keun 
Published: October 2020

ObjectiveThe aim of the study was to investigate whether a disabled athlete’s underlying disability and concussion history impact the score on baseline testing from a disability modified Graded Symptoms Checklist, Standardized Assessment of Concussion, and Wheelchair Error Scoring System.Study DesignThis is a retrospective chart review of the 81 veteran wheelchair sports athletes who had baseline concussion evaluations. Demographic data including qualifying disability for the National Veterans Wheelchair Games, scores from the modified Graded Symptoms Checklist, Standardized Assessment of Concussion, and Wheelchair Error Scoring System were analyzed.ResultsForty-three percent of wheelchair athletes reported a history of a concussion. Individuals with a history of a concussion displayed more symptoms on the modified Graded Symptoms Checklist (38.8vs.24.71,P= 0.0378) as did those who had a qualifying disability in the brain disorder category (54.87vs.amputees 24.07 and spinal cord disorders 24.9,P= 0.0015). There was no difference in Standardized Assessment of Concussion examination or Wheelchair Error Scoring System scores based on concussion history or qualifying disability.ConclusionsBaseline symptom scores from a modified Graded Symptoms Checklist were higher in participants with a history of concussion, independent of their underlying disability, and higher if the athlete’s disability was a brain disorder including multiple sclerosis and cerebral vascular accident. Scores on the Standardized Assessment of Concussion examination and Wheelchair Error Scoring System were not affected by the athlete’s disability or concussion history. Baseline testing is integral for disabled athletes, especially those with underlying brain disorders and history of concussion.
Extending the range of symptoms in a Bayesian Network for the Predictive Diagnosis of COVID-19
Authors: Butcher Rachel , Fenton Norman 
Published: October 2020

AbstractEmerging digital technologies have taken an unprecedented position at the forefront of COVID-19 management. This paper extends a previous Bayesian network designed to predict the probability of COVID-19 infection, based on a patient’s profile. The structure and prior probabilities have been amalgamated from the knowledge of peer-reviewed articles. The network accounts for demographics, behaviours and symptoms, and can mathematically identify multivariate combinations with the highest risk. Potential applications include patient triage in healthcare systems or embedded software for contact-tracing apps. Specifically, this paper extends the set of symptoms that are a marker for COVID-19 infection and the differential diagnosis of other conditions with similar presentations.
Clinical and laboratory characteristics in outpatient diagnosis of COVID-19 in healthcare professionals in Rio de Janeiro, Brazil
Authors: Porto Luís Cristóvão , da Costa Claudia Henrique , Nunes Alessandra Sant’Anna , Bouzas Isabel , Ferreira Tiago C. , Porto Vinicius M. , Secco Danielle A. , Vilas Boas Sandra P. C. , Faria Anamelia C. , Marins Rosangela A. G. , Duarte Cíntia A. , Bittencourt Elizabeth P. , Loureiro Anderson V. , Santos Angela Maria G. , Souza Vania Maria A. , Silva Fernanda H. , Lopes Maria Cristina , Castro Marcelle V. , Silva Areta D. , Vasconcelos Flavia M. , Moreira Diego S. , Motta Juliana P. , Lima Cristiano V. , Menezes Raphaela S. , Brazão Nathalia B. V. , Nogueira Jeane S. , Villela Silva Ana Paula , Brito Ingrid A.A. , Costa Scarlathe B. , Lemes Roberta Mariana R. , dePaula Jessica Isis O. , Bongionanni Giovanna L. , Bezerra Ohana C. L. , Andrade-Neto Valter V. , Morette Leonardo , Barbosa Rafael S. , Sanches Jose Afonso L. , Melo Pedro L. , Freire Sergio M. , Souza Romulo , Gomes Laiz , Felizardo Denize P. , Rodrigues Alexsandre V. , Franco Priscila A. , Miranda Renata , Rufino Rogerio 
Published: October 2020

AbstractAimsThis study aimed to identify the symptoms associated with early stage SARS-CoV-2 (COVID-19) infections in healthcare professionals (HCP) using both clinical and laboratory data.MethodsA total of 1,297 patients, admitted between March 18 and April 8, 2020, were stratified according to their risk of developing COVID-19 using their responses to a questionnaire designed to evaluate symptoms and risk conditions.ResultsAnosmia/hyposmia (p <0.0001), fever (p<0.0001), body pain (p<0.0001), and chills (p=0.001) were all independent predictors for COVID-19, with a 72% estimated probability for detecting COVID-19 in nasopharyngeal swab samples. Leukopenia, relative monocytosis, decreased eosinophil values, CRP, and platelets were also shown to be significant independent predictors for COVID-19.ConclusionsThe significant clinical features for COVID-19 were identified as anosmia, fever, chills, and body pain. Elevated CRP, leukocytes under 5,400 x 109/L, and relative monocytosis (>9%) were common among patients with a confirmed COVID-19 diagnosis. These variables may help, in the absence of RT-PCR tests, to identify possible COVID-19 infections during pandemic outbreaks.SummaryFrom March 19 to April 8 2020, 1,297 patients attended the Polyclinic Piquet Carneiro for COVID-19 detection. Healthcare professional data was analyzed, significant clinical features were anosmia, fever, chills and body pain. Elevated CRP, leukopenia and monocytosis were common in COVID-19.
deMeta: Removing sub-studies from meta-analysis of genome wide association studies (GWAS)
Authors: Sun Jiangming , Wang Yunpeng 
Published: October 2020

ABSTRACTSummaryPost-GWAS studies using the results from large consortium meta-analysis often need to correctly take care of the overlapping sample issue. The gold standard approach for resolving this issue is to reperform the GWAS or meta-analysis excluding the overlapped participants. However, such approach is time-consuming and, sometimes, restricted by the available data.deMetaprovides a user friendly and computationally efficient command-line implementation for removing the effect of a contributing sub-study to a consortium from the meta-analysis results. Only the summary statistics of the meta-analysis the sub-study to be removed are required. In addition,deMetacan generate contrasting Manhattan and quantile-quantile plots for users to visualize the impact of the sub-study on the meta-analysis results.Availability and ImplementationThe python source code, examples and documentations ofdeMetaare publicly available athttps://github.com/Computational-NeuroGenetics/deMeta-beta.Contactjiangming.sun@med.lu.se(J. Sun);yunpeng.wang@psykologi.uio.no(Y. Wang)Supplementary informationNone.
Structure of transmembrane prolyl 4-hydroxylase reveals unique organization of EF and dioxygenase domains
Authors: Myllykoski Matti , Sutinen Aleksi , Koski M. Kristian , Kallio Juha P. , Raasakka Arne , Myllyharju Johanna , Wierenga Rikkert , Koivunen Peppi 
Published: October 2020

AbstractProlyl 4-hydroxylases (P4Hs) catalyze post-translational hydroxylation of peptidyl proline residues. In addition to collagen P4Hs and hypoxia-inducible factor P4Hs, a poorly characterized endoplasmic reticulum (ER)-localized transmembrane prolyl 4-hydroxylase (P4H-TM) is found in animals. P4H-TM variants are associated with the familiar neurological HIDEA syndrome. Here, the 3D structure of the soluble human P4H-TM was solved using X-ray crystallography. The structure revealed an EF-domain with two Ca2+-binding motifs inserted to the catalytic domain. A substrate-binding cavity was formed between the EF-domain and the catalytic domain. The active site contained bound Fe2+and N-oxalylglycine. Comparison to homologous structures complexed with peptide substrates showed that the substrate interacting residues and the lid structure that folds over the substrate are conserved in P4H-TM. Differences to homologs were found in the extensive loop structures that surround the substrate-binding cavity and generate a negative surface charge. Ca2+-binding affinity of P4H-TM was determined to be within the range of physiological Ca2+concentration in the ER. The proximity of the EF-domain to the active site suggests that Ca2+-binding is relevant to the catalytic activity. P4H-TM was found both as a monomer and a dimer in solution, but the monomer-dimer equilibrium was not regulated by Ca2+. The solved 3D structure suggests that the HIDEA variants cause loss of P4H-TM function. In conclusion, P4H-TM shares key structural elements with the known P4Hs while possessing a unique property among the 2-oxoglutarate-dependent dioxygenases having an EF-domain and a catalytic activity potentially regulated by Ca2+.
What do unit root tests tell us about unemployment hysteresis in transition economies?
Authors: Çağlayan Akay Ebru , Oskonbaeva Zamira , Bülbül Hoşeng 
Published: October 2020

PurposeThis study aims to examine the hysteresis hypothesis in unemployment using monthly data from 13 countries in transition.Design/methodology/approachStationarity in the unemployment rate of selected transition economies was analyzed using four different group unit root tests, namely, linear, structural breaks, non-linear and structural breaks and non-linear.FindingsThe empirical results show that the unemployment hysteresis hypothesis is valid for the majority of transition economies, including Bulgaria, Croatia, the Czech Republic, Estonia, Hungary, the Kyrgyz Republic, Latvia, Lithuania, Poland, Romania and Slovenia. However, the results strongly reject the null hypothesis of unemployment hysteresis for the Kazakhstan and the Slovak Republics.Originality/valueThis study revealed that, for countries in transition, advanced unit root tests exhibit greater validity when compared to standard tests
Employment discrimination against gender diverse individuals in Western Australia
Authors: Bates Trudy , Thomas Cati S. , Timming Andrew R. 
Published: October 2020

PurposeThis paper explores employment discrimination against gender diverse job applicants and employees in Western Australia (WA).Design/methodology/approachUsing grounded theory, this study draws on semi-structured interviews with respondents (n = 20) who identified as trans women, trans men, nonbinary or agender. Thematic analysis focused on the multiple dimensions of disadvantage experienced by respondents, including subtle, not so subtle and overt types of employment discrimination.FindingsThe authors’ results point to several reasons why gender diverse individuals (GDIs) may fear the labor market, including difficulties in concealing their stigma and acquiescence to discrimination. On the other hand, our results also point to sources of organizational support, including encouragement from direct line managers and colleagues who are also Allies.Practical implicationsThe results of the research have important implications for sociological frameworks surrounding dramaturgy, stigma, aesthetic labor, organizational silence and social identity. Practical implications for employers, employees, human resource (HR) professionals and trade unions are also articulated.Originality/valueWhereas previous studies have prioritized the discriminatory experiences of GDIs in the US and European labor markets, this study reports on gender diverse voices in WA. Furthermore, recent work on this topic has been experimental and largely quantitative, whereas the present study offers a compelling set of profound narratives, thereby addressing calls for qualitative research that foregrounds the complexities and nuances of lived experience for GDIs and renders their voices heard.
Disrupting rules of emotion in an urban English classroom
Authors: Sosa Teresa , Hall Allison H. , Collins Brian 
Published: October 2020

PurposeThis study aims to focus on the regulation of emotions in critical literacy, its resulting racial oppression and students’ response to emotional control. The authors examine a student discussion of a poem, looking specifically at the affective responses of students’ interactions as these open possibilities for identifying ways that students confront, resist and subvert emotional control. This research question asks how students resisted limited forms of emotion and enabled opportunities for varied affective forms of engagement.Design/methodology/approachIn this analysis, the authors explored both emotions and discourse (broadly defined as languages, actions, embodied acts, etc.) as they construct the flow of activity in this discussion. The authors also looked at past familiar practices that make the present one recognizable and meaningful.FindingsThe findings indicate black students resisted emotion rules by discussing racism, a highly taboo subject in schools. Students also rallied against an interpretation that felt as a distraction, an attempt to negate or shut down the naming and sensing of racism in the poem and in the classroom. Despite the constant regulation of emotions before, during and after the discussion, black youth firmly indicated their right to judge the interpretation that the poem had nothing to do with racism as inadequate and steeped in whiteness.Originality/valueIn schools, critical literacy often fails to attend to how emotions are managed and reflect racial control and dominance. For critical literacy as an anti-oppressive pedagogy to confront the oppressive status quo of schools, it must no longer remain silent or leave unquestioned rules of emotional dispositions that target marginalized students.