bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quantifying and mitigating the impact of the COVID-19 pandemic on outcomes in colorectal cancer
Authors: Sud Amit , Jones Michael , Broggio John , Scott Stephen , Loveday Chey , Torr Bethany , Garrett Alice , Nicol David L. , Jhanji Shaman , Boyce Stephen A. , Williams Matthew , Lyratzopoulos Georgios , Barry Claire , Riboli Elio , Kipps Emma , McFerran Ethna , Lawler Mark , Muller David C. , Abulafi Muti , Houlston Richard , Turnbull Clare 
Published: May 2020

ABSTRACTBackgroundThe COVID-19 pandemic has caused disruption across cancer pathways for diagnosis and treatment. In England, 32% of colorectal cancer (CRC) is diagnosed via urgent symptomatic referral from primary care, the “2-week-wait” (2WW) pathway. Access to routine endoscopy is likely to be a critical bottleneck causing delays in CRC management due to chronic limitation in capacity, acute competition for physician time, and safety concerns.MethodsWe used age-specific, stage-specific 10 year CRC survival for England 2007–2017 and 2WW CRC cases volumes. We used per-day hazard ratios of CRC survival generated from observational studies of CRC diagnosis-to-treatment interval to model the effect of different durations of per-patient delay. We utilised data from a large London observational study of faecal immunochemical testing (FIT) in symptomatic patients to model FIT-triage to mitigate delay to colonoscopy.FindingsModest delays result in significant reduction in survival from CRC with a 4-month delay resulting across age groups in ≥20% reduction in survival in Stage 3 disease and in total over a year, 1,419 attributable deaths across the 11,266 CRC patients diagnosed via the 2WW pathway. FIT triage of >10 ug Hb/g would salvage 1,292/1,419 of the attributable deaths and reduce colonoscopy requirements by >80%. Diagnostic colonoscopy offers net survival in all age groups, providing nosocomial COVID-19 infection rates are kept low (<2·5%).InterpretationTo avoid significant numbers of avoidable deaths from CRC, normal diagnostic and surgical throughput must be maintained. An accrued backlog of cases will present to primary care following release of lockdown, supranormal endoscopy capacity will be required to manage this without undue delays. FIT-triage of symptomatic cases provides a rational approach by which to avoid patient delay and mitigate pressure on capacity in endoscopy. This would also reduce exposure to nosocomial COVID-19 infection, relevant in particular to older patient groups.FundingBreast Cancer Now, Cancer Research UK, Bobby Moore Fund for Cancer Research, National Institute for Health Research (NIHR).
BRAZIL IS PROJECTED TO BE THE NEXT GLOBAL COVID-19 PANDEMIC EPICENTER
Authors: de Lemos Menezes Pedro , Garner David M. , Valenti Vitor E. 
Published: May 2020

ABSTRACTCoronavirus disease 2019 (COVID-19) is a disease triggered by SARS-CoV-2 infection, which is related in the most recent pandemic situation, significantly affecting health and economic systems. In this study we assessed the death rate associated to COVID-19 in Brazil and the United States of America (USA) to estimate the probability of Brazil becoming the next pandemic epicenter. We equated data between Brazil and USA obtained through the Worldometer website (www.worldometer.info). Epidemic curves from Brazil and USA were associated and regression analysis was undertaken to predict the Brazilian death rate regarding COVID-19 in June. In view of data from April 9th 2020, death rates in Brazil follow a similar exponential increase to USA (r=0.999; p<0.001), estimating 64,310 deaths by June 9th 2020. In brief, our results demonstrated that Brazil follows an analogous progression of COVID-19 deaths cases when compared to USA, signifying that Brazil could be the next global epicenter of COVID-19. We highlight public strategies to decrease the COVID-19 outbreak.
A Novel Multi-ventilation Technique to Split Ventilators
Authors: Lee Albert , Umar Soban , Hoftman Nir N. 
Published: May 2020

ABSTRACTBackgroundDespite efforts to initially contain Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV-2), it has spread worldwide and has strained international healthcare systems to the point where advanced respiratory resources and ventilators are depleted. This study aims to explore splitting ventilators, or “multi-ventilation,” as a viable alternative in these demanding times. We investigated whether individualized tidal volume and positive end expiratory pressure (PEEP) delivery is possible to lungs of different compliances that are being simultaneously ventilated from one anesthesia ventilator.MethodsWe performed a controlled experiment in an operating room environment without animal or human participants. Two “test lungs” were connected to distinct modified Y-pieces that were ventilated in parallel from a single anesthesia ventilator.ResultsVentilation can be manipulated to qualitatively deliver individually tailored tidal volumes in the setting of varying PEEP and compliance requirements in pressure control mode.ConclusionsSplitting ventilators, or “multi-ventilation,” is a viable alternative to acute ventilator shortage during a pandemic. Ventilators can be split for individualized tidal volume and positive end-expiratory pressure delivery in multiple subjects of differing compliances and demographics.
A Method to Identify the Missing COVID-19 Cases in the U.S. and Results for mid-April 2020
Authors: Breton Theodore R. 
Published: May 2020

AbstractI use the COVID-19 death rate in South Korea and a method relating the ratio of death rates in a U.S. state to its share of cumulative positive tests to estimate the total cases of COVID-19 in the U.S. and to estimate the extent of infection and the unidentified share of the infected population in each of the lower-48 states and in New York City in mid-April, 2020. I identify a logarithmic relationship between the cumulative death rate in a state and its cumulative positive share of tests. Using this relationship, I find that 4.3-5.4 million people, 1.4-1.7% of the U.S. population, were infected, with rates of infection that ranged from 0.1% in more rural states to 8-10% in New York state and 11-13% in New York City. Only 16-20% of these infected individuals were identified later through testing.
Rapid development of COVID-19 rapid diagnostics for low resource settings: accelerating delivery through transparency, responsiveness, and open collaboration
Authors: Adams Emily R , Augustin Yolanda , Byrne Rachel L , Clark David J , Cocozza Michael , Cubas-Atienzar Ana I , Cuevas Luis E. , Cusinato Martina , Davies Benedict M O , Davis Mark , Davis Paul , Duvoix Annelyse , Eckersley Nicholas M , Edwards Thomas , Fletcher Tom , Fraser Alice J , Garrod Gala , Hadcocks Linda , Hu Qinxue , Johnson Michael , Kay Grant A , Keymer Katherine , Kirwan Daniela , Klekotko Kesja , Lewis Zawditu , Mason Jenifer , Mensah-Kane Josie , Menzies Stefanie , Monahan Irene , Moore Catherine M , Nebe-von-Caron Gerhard , Owen Sophie I , Planche Tim , Sainter Chris , Schouten James , Staines Henry M , Turtle Lance , Williams Chris , Wilkins John , Woolston Kevin , Sall Amadou Alpha , Fitchett Joseph R A , Krishna Sanjeev 
Published: May 2020

SummaryHere we describe an open and transparent consortium for the rapid development of COVID-19 rapid diagnostics tests. We report diagnostic accuracy data on the Mologic manufactured IgG COVID-19 ELISA on known positive serum samples and on a panel of known negative respiratory and viral serum samples pre-December 2019.In January, Mologic, embarked on a product development pathway for COVID-19 diagnostics focusing on ELISA and rapid diagnostic tests (RDTs), with anticipated funding from Wellcome Trust and DFID.834 clinical samples from known COVID-19 patients and hospital negative controls were tested on Mologic’s IgG ELISA. The reported sensitivity on 270 clinical samples from 124 prospectively enrolled patients was 94% (95% CI: 89.60% - 96.81%) on day 10 or more post laboratory diagnosis, and 96% (95% CI: 84.85% - 99.46%) between 14–21 days post symptom onset. A specificity panel comprising 564 samples collected pre-December 2019 were tested to include most common respiratory pathogens, other types of coronavirus, and flaviviruses. Specificity in this panel was 97% (95% CI: 95.65% - 98.50%).This is the first in a series of Mologic products for COVID-19, which will be deployed for COVID-19 diagnosis, contact tracing and sero-epidemiological studies to estimate disease burden and transmission with a focus on ensuring access, affordability, and availability to low-resource settings.
Paucity and disparity of publicly available sex-disaggregated data for the COVID-19 epidemic hamper evidence-based decision-making
Authors: Kocher Kristen , Délot-Vilain Arthur , Spencer D’Andre , LoTempio Jonathan , Délot Emmanuèle C. 
Published: May 2020

ABSTRACTCOVID-19 has joined the long list of human disorders with sexually dimorphic expression. Increased lethality in men was evident in the first large reports from ChinaCDC and WHO-China, and the gender gap appeared even wider in the early Italian outbreak. Newspapers and scientific journals alike have commented on this finding and the preexisting conditions, biological processes, and gender role behavior differences that may underlie it. However, as for other diseases, and in spite of years of advocating for the collection of raw epidemiological data and the analysis of clinical trial data sets by sex, very little appeared to be released about sex differences in characteristics of the epidemics beyond infection and death rates, such as severity of disease, comorbidities, rate of recovery, length of hospital stay, or number of tests for the SARS-CoV-2 coronavirus. These data are critical not only for scientists to understand the pathophysiology of disease, but also to inform decision-making by countries and healthcare systems on how to prioritize testing and best allocate scarce resources and relief funds.Systematic analysis of official websites for the 20 countries and 6 US states reporting the highest number of cases on March 21, 2020, revealed a wide disparity in sex-disaggregated data made available to the public and scholars. Only a handful of the countries reported cases by sex separately. None of the other characteristics, including fatality rates, were stratified by sex at the time. Beyond suboptimal sex disaggregation, our analysis found a paucity of usable raw data sets and a generalized lack of standardization of captured data, making comparisons difficult. A second round of data capture in April found more complete, but even more disparate, information.Our analysis revealed a wide range of sex ratios among confirmed cases, which changed over time. In countries where a male-biased sex ratio was initially reported, the reported proportion of women among cases dramatically increased in under 3 weeks. In contrast, men were consistently over-represented in severe cases, intensive care admissions, and deaths. We also show that the sex ratio varies with age, with a complex pattern, reproduced across the 6 countries for which data were found.Accurate, peer-reviewed, statistical analysis of harmonized, sex-disaggregated data for other characteristics of epidemics, such as availability of testing, suspected source of infection, or comorbidities will be critical to understand where the observed disparities come from and to generate evidence-based recommendations for decision-making by institutions and governments around the world.
THE G-FORCE CONUNDRUM IN PRF GENERATION- MANAGEMENT OF A PROBLEM HIDDEN IN PLAIN SIGHT
Authors: Sneha Kidambi , Ajmera Jhansi Rani , Chandra Rampalli Viswa 
Published: May 2020

ABSTRACTAimA force of 400g at 2700 RPM results in an optimum leucocyte and platelet-rich fibrin (L-PRF). Most of centrifuges with varying characteristics generate a g-force in excess of 700g at 2700 RPM. In this context, the study explores the effect of the original centrifugation protocol and a modified protocol tailor-made to lower the RPM to generate a g-force of ~400g on platelet concentration, clot size and growth factors release in L-PRF prepared in two different commercially available centrifuges.Materials and Methods25 subjects each were assigned to the following groups; R1and R2where L-PRF was obtained from two laboratory swing-out centrifuges (Remi 8C® & Remi C854®, Mumbai, India) respectively. PRF was obtained from each subject within a group using two protocols; Original (O) protocol: conforming to the original centrifugation cycle (2700 RPM for 12 min) and Modified (M) protocol. Clot size, growth factor estimation and platelet counts were measured at 20, 40 and 60 mins from all the L-PRF clots.ResultsAt the third time period (40–60min), there were no significant differences in clot sizes with the original protocol (p=0.09), but a highly significant difference was noticed with the modified protocol in both the centrifuges (p=0.001). Our results showed an increased concentration of VEGF and EGF with modified protocol than with original protocol with both the centrifuges (p=0.001). By the end of second and third time periods, more platelet concentration was observed with modified protocol than with the original protocol in both the centrifuges (p=0.001)ConclusionThis study infers that the centrifuge type and RCF can affect the quality and quantity of cells and growth factors and an optimum relationship between g-force and RPM should be maintained in order to obtain L-PRF with adequate cell viability and optimum growth factor release.
News from the front: Estimation of excess mortality and life expectancy in the major epicenters of the COVID-19 pandemic in Italy
Authors: Ghislandi Simone , Muttarak Raya , Sauerberg Markus , Scotti Benedetta 
Published: May 2020

AbstractExisting studies on the mortality impacts of the COVID-19 pandemic commonly rely on national official reports. However, in a pandemic, deaths from COVID-19 can be miscounted due to under-reporting and inaccurate death registration. Official statistics on COVID-19 mortality are sensitive to classification, estimation and reporting practice which are not consistent across countries. Likewise, the reported mortality is often provided at the national level which results in underestimation of the true scale of the human life impact given that the outbreaks are localised.This study overcomes the problem of under-reporting of COVID-19-related deaths by using all cause daily death registrations data provided by the Italian Statistical Office (ISTAT) from January 1 to April 30, 2020 in comparison with official figures reported by the Civil Protection Department. The study focuses on the five most severely hit provinces in Italy (Bergamo, Brescia, Cremona, Lodi and Piacenza) and Lombardy region. We calculate excess mortality in 2020 compared to the average of the years 2015 to 2019 and estimate life expectancy for the first wave of the epidemic and for the rest of the year 2020. Not only is life expectancy a reliable measure of a country’s health status and development, it also allows us to quantify the impact of COVID-19 on human life.The estimated excess deaths show significantly higher mortality than COVID-19 official mortality statistics, particularly during the peak of the epidemic and amongst people aged 60 years and over. We find that for the first wave of the epidemic, life expectancy in the five provinces reduced by 5.1 to 7.8 and 3.2 to 5.8 years for men and women, respectively. For annual life expectancy for the year 2020, in a scenario with no harvesting effect i.e. mortality rates resume to an average level of the years 2015-2019 after the end of the first epidemic wave, the years of life lost is equivalent to 2 to 3.5 years for men and 1.1. to 2.5 years for women in the five provinces.The COVID-19 pandemic posed a substantial impact on population health in Italy as it represents the largest decline in life expectancy after the 1918 influenza pandemic and the Second World War.
Preliminary Results of Seroprevalence of SARS-CoV-2 at Community Clinics in Tokyo
Authors: Takita Morihito , Matsumura Tomoko , Yamamoto Kana , Yamashita Erika , Hosoda Kazutaka , Hamaki Tamae , Kusumi Eiji 
Published: May 2020

AbstractSerological evaluation with SARS-CoV-2 specific IgG antibody will be an alternative way to know the pandemic of novel coronavirus disease (COVID-19) if the capacity for diagnostic PCR test is limited. The point-of-care test to detect SARS-CoV-2 specific IgG antibody in peripheral blood (n=202) was performed in two community clinics in Tokyo, Japan. The overall positive rate of SRAS-CoV-2 IgG antibody was 5.9% (95% confidence interval[CI]: 3.1-10.1). Higher rate was observed for healthcare workers (n=55, 9.1 [3.0-20.0]). The limitation on antibody tests includes low sensitivity and potent cross-reactivity with the previous coronavirus. Robust healthcare policy to efficiently monitor COVID-19 spread is warranted in Tokyo.
Differential effects of voclosporin and tacrolimus on insulin secretion from human islets
Authors: Kolic Jelena , Beet Leanne , Overby Peter , Cen Haoning Howard , Panzhinskiy Evgeniy , Ure Daren R. , Cross Jennifer L. , Huizinga Robert B. , Johnson James D. 
Published: May 2020

AbstractContextThe incidence of new onset diabetes after transplant (NODAT) has increased over the past decade, likely due to calcineurin inhibitor-based immunosuppressants, including tacrolimus (TAC) and cyclosporin (CsA). Voclosporin (VCS), a next generation calcineurin inhibitor is reported to cause fewer incidences of NODAT but the reason is unclear.ObjectiveWhilst calcineurin signaling plays important roles in pancreatic β-cell survival, proliferation, and function, its effects on human β-cells remain understudied. In particular, we do not understand why some calcineurin inhibitors have more profound effects on the incidence of NODAT.MethodsWe compared the effects of TAC and VCS on the dynamics of insulin secretory function, programmed cell death rate, and the transcriptomic profile of human islets. We studied two clinically relevant doses of TAC (10 ng/ml, 30 ng/ml) and VCS (20 ng/ml, 60 ng/ml), meant to approximate the clinical trough and peak concentrations.ResultsTAC, but not VCS, caused a significant impairment of 15 mM glucose-stimulated and 30 mM KCl-stimulated insulin secretion. This points to molecular defects in the distal stages of exocytosis after voltage-gated Ca2+entry. No significant effects on islet cell survival or total insulin content were identified. RNA sequencing showed that TAC significantly decreased the expression of 17 genes, including direct and indirect regulators of exocytosis (SYT16,TBC1D30,PCK1,SMOC1,SYT5, PDK4, andCREM), whereas VCS has less broad and milder effects on gene expression.ConclusionsClinically relevant doses of TAC, but not VCS, directly inhibit insulin secretion from human islets, likely via transcriptional control of exocytosis machinery.
Geospatial Correlation Between COVID-19 Health Misinformation and Poisoning with Household Cleaners in the Greater Boston Area
Authors: Chary Michael , Overbeek Daniel , Papadimoulis Alexandria , Sheroff Adina , Burns Michele 
Published: May 2020

AbstractObjectiveTo determine the relationship between health misinformation on social media and adverse health outcomes.MethodsWe analyzed 16,729 calls to the Regional Center for Poison Control and Prevention serving Massachusetts and Rhode Island (MARI PCC) and 25,231 tweets discussing treating COVID-19 with house cleaners.ResultsHalf of the spikes in calls to MARI PCC about exposures to cleaners were preceded 2–3 days earlier by tweets advocating ingesting or insufflating bleach to cure COVID-19. The relationship was only statistically significant for tweets in the Greater Boston Area and calls to MARI PCC. [Results of network analysis].ConclusionsHealth misinformation on social media had a spatiotemporally specific relationship with increased calls to Poison Control and referrals to hospitals for cleaner ingestions. The spatiotemporal specificity of our results strengthens our conviction that the increased calls were driven in part by health misinformation on social media.Public Health ImplicationsHealth misinformation can directly lead to secondary harm. Thematically targeted messages at specific loci in the social network may stem this harm.
Group testing for SARS-CoV-2 allows for up to 10-fold efficiency increase across realistic scenarios and testing strategies
Authors: Verdun Claudio M. , Fuchs Tim , Harar Pavol , Elbrächter Dennis , Fischer David S. , Berner Julius , Grohs Philipp , Theis Fabian J. , Krahmer Felix 
Published: May 2020

AbstractWe provide a comparison of general strategies for group testing in view of their application to medical diagnosis in the current COVID-19 pandemic. We find significant efficiency gaps between different group testing strategies in realistic scenarios for SARS-CoV-2 testing, highlighting the need for an informed decision of the pooling protocol depending on estimated prevalence, target specificity, and high- vs. low-risk population. For example, using one of the presented methods, all 1.47 million inhabitants of Munich, Germany, could be tested using only around 141 thousand tests if an infection rate up to 0.4% is assumed. Using 1 million tests, the 6.69 million inhabitants from the city of Rio de Janeiro, Brazil, could be tested as long as the infection rate does not exceed 1%. Altogether this work may help provide a basis for efficient upscaling of current testing procedures, fine grained towards the desired study population, e.g. cross-sectional versus health-care workers and adapted mixtures thereof. For comparative visualization and querying of the precomputed results we provide an interactive web application. The source code for computation is open and freely available.
Humoral immune response and prolonged PCR positivity in a cohort of 1343 SARS-CoV 2 patients in the New York City region
Authors: Wajnberg Ania , Mansour Mayce , Leven Emily , Bouvier Nicole M. , Patel Gopi , Firpo Adolfo , Mendu Rao , Jhang Jeffrey , Arinsburg Suzanne , Gitman Melissa , Houldsworth Jane , Baine Ian , Simon Viviana , Aberg Judith , Krammer Florian , Reich David , Cordon-Cardo Carlos 
Published: May 2020

AbstractBackgroundSevere acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a global pandemic. The percentage of infected individuals who seroconvert is still an open question. In addition, it has been shown in some individuals that viral genome can still be detected at considerable time post symptom resolution. Here we investigated both seroconversion and PCR-positivity in a large cohort of convalescent serum donors in New York City.MethodsIndividuals with confirmed or suspected SARS-CoV-2 infection were screened via PCR for presence of viral genome and via enzyme-linked immunosorbent assay for presence of anti SARS-CoV-2 spike antibodies.ResultsAll but three confirmed SARS-CoV-2 patients seroconverted to the SARS-CoV-2 spike while only 37.4% of suspected SARS-CoV-2 patients seroconverted. PCR-positivity was detected up to 28 days from symptom resolution.ConclusionsHere we show that the vast majority of confirmed COVID19 patients seroconvert, potentially providing immunity to reinfection. We also report that in a large proportion of individuals, viral genome can be detected via PCR in the upper respiratory tract for weeks post symptom resolution, but it is unclear if this signal represents infectious virus.