bluuebunny/crossref_metadata_2025_split huggingface dataset:
Insights into the practical effectiveness of RT-PCR testing for SARS-CoV-2 from serologic data, a cohort study
Authors: Zhang Zhen , Bi Qifang , Fang Shisong , Wei Lan , Wang Xin , He Jianfan , Wu Yongsheng , Liu Xiaojian , Gao Wei , Zhang Renli , Gong Wenfeng , Su Qiru , Azman Andrew S , Lessler Justin , Zou Xuan 
Published: September 2020

AbstractBackgroundVirologic detection of SARS-CoV-2 through Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) has limitations for surveillance. Serologic tests can be an important complementary approach.ObjectiveAssess the practical performance of RT-PCR based surveillance protocols, and the extent of undetected SARS-CoV-2 transmission in Shenzhen, China.DesignCohort study nested in a public health response.SettingShenzhen, China; January-May 2020.Participants880 PCR-negative close-contacts of confirmed COVID-19 cases and 400 residents without known exposure (main analysis). Fifty-seven PCR-positive case contacts (timing analysis).MeasurementsVirological testing by RT-PCR. Measurement of anti-SARS-CoV-2 antibodies in PCR-negative contacts 2-15 weeks after initial testing using total Ab ELISA. Rates of undetected infection, performance of RT-PCR over the course of infection, and characteristics of seropositive but PCR-negative individuals were assessed.ResultsThe adjusted seropositivity rate for total Ab among 880 PCR-negative close-contacts was 4.1% (95%CI, 2.9% to 5.7%), significantly higher than among residents without known exposure to cases (0.0%, 95%CI, 0.0% to 1.0%). PCR-positive cases were 8.0 times (RR; 95% CI, 5.3 to 12.7) more likely to report symptoms than the PCR-negative individuals who were seropositive, but otherwise similar. RT-PCR missed 36% (95%CI, 28% to 44%) of infected close-contacts, and false negative rates appear to be highly dependent on stage of infection.LimitationsNo serological data were available on PCR-positive cases. Sample size was limited, and only 20% of PCR-negative contacts met inclusion criteria.ConclusionEven rigorous RT-PCR testing protocols may miss a significant proportion of infections, perhaps in part due to difficulties timing testing of asymptomatics for optimal sensitivity. Surveillance and control protocols relying on RT-PCR were, nevertheless, able to contain community spread in Shenzhen.Funding sourceBill & Melinda Gates Foundation, Special Foundation of Science and Technology Innovation Strategy of Guangdong Province of China, and Key Project of Shenzhen Science and Technology Innovation Commission, Shenzhen, China
Validating and modeling the impact of high-frequency rapid antigen screening on COVID-19 spread and outcomes
Authors: Nash Beatrice , Badea Anthony , Reddy Ankita , Bosch Miguel , Salcedo Nol , Gomez Adam R. , Versiani Alice , Silva Gislaine Celestino Dutra , dos Santos Thayza Maria Izabel Lopes , Milhim Bruno H. G. A. , Moraes Marilia M , Campos Guilherme Rodrigues Fernandes , Quieroz Flávia , Reis Andreia Francesli Negri , Nogueira Mauricio L. , Naumova Elena N. , Bosch Irene , Herrera Bobby Brooke 
Published: September 2020

AbstractHigh frequency screening of populations has been proposed as a strategy in facilitating control of the COVID-19 pandemic. We use computational modeling, coupled with clinical data from rapid antigen tests, to predict the impact of frequent viral antigen rapid testing on COVID-19 spread and outcomes. Using patient nasal or nasopharyngeal swab specimens, we demonstrate that the sensitivity/specificity of two rapid antigen tests compared to quantitative real-time polymerase chain reaction (qRT-PCR) are 82.0%/100% and 84.7%/85.7%, respectively; moreover, sensitivity correlates directly with viral load. Based on COVID-19 data from three regions in the United States and São José do Rio Preto, Brazil, we show that high frequency, strategic population-wide rapid testing, even at varied accuracy levels, diminishes COVID-19 infections, hospitalizations, and deaths at a fraction of the cost of nucleic acid detection via qRT-PCR. We propose large-scale antigen-based surveillance as a viable strategy to control SARS-CoV-2 spread and to enable societal re-opening.
Erythrocyte sedimentation rate as a new diagnostic biomarker for neuroacanthocytosis syndromes
Authors: Darras Alexis , Peikert Kevin , Rabe Antonia , Yaya François , Simionato Greta , John Thomas , Dasanna Anil Kumar , Buvalyy Semen , Geisel Jürgen , Hermann Andreas , Fedosov Dmitry A. , Danek Adrian , Wagner Christian , Kaestner Lars 
Published: September 2020

ABSTRACTChorea-acanthocytosis (ChAc) and McLeod syndrome (MLS) are the core diseases among the group of rare neurodegenerative disorders that comprise neuroacanthocytosis syndrome (NAS). Both ChAc and MLS patients present with an increased number of irregularly spiky erythrocytes, so-called acanthocytes. The detection of acanthocytes is often a crucial parameter in the diagnosis of NAS. However, this approach is error-prone and not very reliable, typically explaining the misdiagnosis of NAS patients. Based on the standard Westergren method, we show that compared with that in healthy controls, the erythrocyte sedimentation rate (ESR) with a two-hour read-out is significantly prolonged in ChAc and MLS with no overlap. Thus, the ESR is a clear, robust and easily obtained diagnostic marker. Mechanistically, by applying modern colloidal physics, we show that acanthocyte aggregation and plasma fibrinogen levels slow the sedimentation process. Apart from its diagnostic value, ESR may also be the first biomarker for monitoring treatments for NAS patients. Further studies are required to test whether the ESR may also detect other NASs. In addition to medical progress, this study is also a hallmark of the physical view of the erythrocyte sedimentation process by describing anticoagulated blood in stasis as a percolating gel, allowing the application of colloidal physics theory.
Advanced neurological recovery translates into greater long-term functional independence after acute spinal cord injury
Authors: Khosravi-Hashemi Navid , Abel Rainer , Grassner Lukas , Kalke Yorck-Bernhard , Maier Doris , Rupp Rüdiger , Weidner Norbert , Curt Armin , Kramer John K. 
Published: September 2020

ABSTRACTThe absence of effective pharmacological interventions in acute traumatic spinal cord injury is a major problem in its management. A critical barrier in identifying such interventions lies in the vast heterogeneity of recovery profiles, which masks the potential efficacy of treatments in clinical trials. To determine the impact of temporal recovery profiles on long-term functional independence, we used EMSCI (European Multicenter Study about Spinal Cord Injury) data. Total motor scores from the International Standards for the Neurological Classification of Spinal Cord Injury (ISNCSCI) and the Spinal Cord Independence Measure (SCIM) were used to assess neurological and functional outcomes, respectively. We developed a classification method consisting of thresholding and unsupervised machine learning clustering and applied it to the total motor score profiles. Comparing SCIM scores between classes revealed that functional independence is significantly higher among patients displaying advanced neurological recovery profile. Our study suggests that the evaluation of temporal recovery profiles can provide novel insights in spinal cord injury clinical trials.
Integrative Genetics Analysis of Juvenile Idiopathic Arthritis Identifies Novel Loci
Authors: Li Yun R. , Li Jin , Glessner Joseph T. , Yang Jie , March Michael E. , Kao Charlly , Bradfield Jonathan P. , Li Junyi , Mentch Frank D. , Qu Huiqi , Qi Xiaohui , Chang Xiao , Hou Cuiping , Abrams Debra J. , Qiu Haijun , Wei Zhi , Connolly John J. , Wang Fengxiang , Snyder James , Limou Sophie , Flatø Berit , Førr Øystein , Thompson Susan D. , Langefeld Carl D , Glass David N , Becker Mara L. , Perez Elena , Lie Benedicte A. , Punaro Marilynn , Shivers Debra K , Ellis Justine A. , Munro Jane E. , Wise Carol , Sleiman Patrick M.A. , Hakonarson Hakon 
Published: September 2020

AbstractJuvenile Idiopathic Arthritis (JIA) is the most common type of arthritis among children, encompassing a highly heterogeneous group of immune-mediated joint disorders, being classified into seven subtypes based on clinical presentation.To systematically understand the distinct and shared genetic underpinnings of JIA subtypes, we conducted a heterogeneity-sensitive GWAS encompassing a total of 1245 JIA cases classified into 7 subtypes and 9250 controls. In addition to the MHC locus, we uncovered 16 genome-wide significant loci, among which 15 were shared between at least two JIA subtypes, including 11 novel loci. Functional annotation indicates that candidate genes at these loci are expressed in diverse immune cell types. Further, based on the association results, the 7 JIA subtypes were classified into two groups, reflecting their autoimmune vs autoinflammatory nature.Our results suggest a common genetic mechanism underlying these subtypes in spite of their different clinical disease phenotypes, and that there may be drug repositioning opportunities for rare JIA subtypes.
Examination of Isolation Rate in SIQR model for COVID-19 Epidemic
Authors: Hashiguchi Koichi 
Published: September 2020

AbstractNewly proposed SIQR model defines exponent λ of exponential function expressing daily number of isolated persons as linear equation of isolation rate q and social distancing ratio x. In order to dynamically analyze the process of COVID-19 epidemic in seven countries by means of regression analyses of λ, increasing rate of cumulative isolated persons(cases), IRCC, is proposed as practical index for the isolation rate q. IRCC is correlated with q in the form of q=C · IRCC, where C is a normalizing coefficient. At first, C is formulated in two modes, one is simple and the other complex, under the constraint conditions by definition 0≤x, q≤1, which give allowable narrow path of C between upper and lower boundaries. Then, the dynamic locus of q-x relation is analyzed for each of seven countries including Japan and the United States using formulated isolation rate q, and characteristic q-x behavior for each country is derived. At the same time, it is shown that specific path selection of C gives almost same linear loci of q-x relation derived by mathematical sequential method imitating a bipedal walk. In addition, increasing rates of cumulative PCR tests, IRCT, for six countries are discussed in relation with IRCC, and are shown that IRCT contributes to the promotion of the isolation rate via IRCC.
Prognostic accuracy of emergency department triage tools for children with suspected COVID-19: The PRIEST observational cohort study
Authors:   The PRIEST Research Group, Biggs Katie , Thomas Ben , Goodacre Steve , Lee Ellen , Sutton Laura , Bursnall Matthew , Loban Amanda , Waterhouse Simon , Simmonds Richard , Marincowitz Carl , Schutter Jose , Connelly Sarah , Sheldon Elena , Hall Jamie , Young Emma , Bentley Andrew , Challen Kirsty , Fitzimmons Chris , Harris Tim , Lecky Fiona , Lee Andrew , Maconochie Ian , Walter Darren 
Published: September 2020

AbstractObjectivesEmergency department clinicians can use triage tools to predict adverse outcome and support management decisions for children presenting with suspected COVID-19. We aimed to estimate the accuracy of triage tools for predicting severe illness in children presenting to the emergency department (ED) with suspected COVID-19 infection.MethodsWe undertook a mixed prospective and retrospective observational cohort study in 44 EDs across the United Kingdom (UK). We collected data from children attending with suspected COVID-19 between 26 March 2020 and 28 May 2020, and used presenting data to determine the results of assessment using the WHO algorithm, swine flu hospital pathway for children (SFHPC), Paediatric Observation Priority Score (POPS) and Children’s Observation and Severity Tool (COAST). We recorded 30-day outcome data (death or receipt of respiratory, cardiovascular or renal support) to determine prognostic accuracy for adverse outcome.ResultsWe collected data from 1530 children, including 26 (1.7%) with an adverse outcome. C-statistics were 0.80 (95% confidence interval 0.73-0.87) for the WHO algorithm, 0.80 (0.71-0.90) for POPS, 0.76 (0.67-0.85) for COAST, and 0.71 (0.59-0.82) for SFHPC. Using pre-specified thresholds, the WHO algorithm had the highest sensitivity (0.85) and lowest specificity (0.75), but POPS and COAST could optimise sensitivity (0.96 and 0.92 respectively) at the expense of specificity (0.25 and 0.38 respectively) by using a threshold of any score above zero instead of the pre-specified threshold.ConclusionExisting triage tools have good but not excellent prediction for adverse outcome in children with suspected COVID-19. POPS and COAST could achieve an appropriate balance of sensitivity and specificity for supporting decisions to discharge home by considering any score above zero to be positive.RegistrationISRCTN registry, ISRCTN28342533, http://www.isrctn.com/ISRCTN28342533
Analysis of presence and short-term persistence of SARS-CoV-2 neutralizing antibodies in COVID-19 convalescent plasma donors
Authors: Annen Kyle , Morrison Thomas E. , DomBourian Melkon G. , McCarthy Mary K. , Huey Leah , Merkel Patricia , Andersen Gillian , Schwartz Eileen , Knight Vijaya 
Published: September 2020

AbstractIn March 2020, the FDA approved the use of COVID-19 convalescent plasma (CCP) as an investigational new drug for treatment of COVID-19. Since then, collection of CCP from COVID-19 recovered patients has been implemented in several donor centers across the country. Children’s Hospital Colorado rapidly put into practice a CCP collection protocol, necessitating the development and implementation of assays to evaluate SARS-CoV-2 antibodies in CCP units. We evaluated 87 separate units of CCP collected from 36 donors over two to four sequential donations using both antigen- binding assays for SARS-CoV-2 nucleoprotein and spike antigens, and a live virus focus reduction neutralization test (FRNT50). Our data shows that the majority of donors (83%) had a FRNT50 titer of 1:80 or greater, and 61% had a titer ≥ 1:160, which meet the FDA’s criteria for acceptable CCP units. Additionally, our data indicates that analysis of antibodies to a single SARS-CoV-2 antigen is likely to miss a percentage of seroconverters; however, these individuals tend to have neutralizing antibody titers of <1:80. Of note, there was considerable variability in the short term, sustained antibody response, measured by neutralizing antibody titers, among our donor population.
Trends and Patterns of Opioid Epidemic: A Large-Scale Retrospective Study of Hospital Visits with Opioid Poisoning in New York State, 2010-2016
Authors: Chen Xin , Hou Wei , Rashidian Sina , Wang Yu , Zhao Xia , Rosenthal Richard N , Saltz Mary , Saltz Joel H , Schoenfeld Elinor Randi , Leibowitz George Stuart , Wang Fusheng 
Published: September 2020

ABSTRACTIntroductionTo discover trends and patterns of opioid poisoning and the demographic and regional disparities by analyzing large scale patient visits data in New York State (NYS).MethodsDemographic, spatial, temporal and correlation analyses were performed for all OP patients extracted from the New York Statewide Planning and Research Cooperative System (SPARCS) from 2010 to 2016, along with Decennial US Census and American Community Survey zip code level data. The study is based on claims data. 58,481 patients with at least one OP diagnosis and a valid NYS zip code address were included. OP patient counts and rates per 100,000 population; patient level factors (gender, age, race and ethnicity, residential zip code); zip code level social demographic factors. Analyses were completed between 2017 and 2019.ResultsIn this study of 58,481 patients with opioid poisoning (OP) in New York State from 2010 to 2016, the OP rate increased by 364.6%, and by 741.5% for the age group > 65 years. There were wide disparities among groups by race and ethnicity on rates and age distributions of OP. Heroin and non-Heroin based OP rates show distinct temporal trends as well as major geospatial variation.ConclusionsThe findings highlight strong demographic disparity of OP patients, evolving patterns and substantial geospatial variation.
Early elevation of FIB-4 liver fibrosis score is associated with adverse outcomes among patients with COVID-19
Authors: Xiang Fangfei , Sun Jing , Chen Po-Hung , Han Peijin , Zheng Haipeng , Cai Shuijiang , Kirk Gregory D. 
Published: September 2020

ABSTRACTBackgroundLimited prior data suggest that pre-existing liver disease was associated with adverse outcomes among patients with COVID-19. FIB-4 is a noninvasive index of readily available laboratory measurements that represents hepatic fibrosis. The association of FIB-4 with COVID-19 outcomes has not been previously evaluated.MethodsFIB-4 was evaluated at admission in a cohort of 267 patients admitted with early-stage COVID-19 confirmed through RT-PCR. Hazard of ventilator use and of high-flow oxygen was estimated using Cox regression models controlled for covariates. Risk of progress to severe cases and of death/prolonged hospitalization (>30 days) were estimated using logistic regression models controlled for same covariates.ResultsForty-one (15%) patients progressed to severe cases, 36 (14%) required high-flow oxygen support, 10 (4%) required mechanical ventilator support, and 1 died. Patients with high FIB-4 score (>3.25) were more likely to be older with pre-existing conditions. FIB-4 between 1.45-3.25 was associated with over 5-fold (95% CI: 1.2-28) increased hazard of high-flow oxygen use, over 4-fold (95% CI: 1.5-14.6) increased odds of progress to severe stage, and over 3-fold (95% CI: 1.4-7.7) increased odds of death or prolonged hospitalization. FIB-4>3.25 was associated with over 12-fold (95% CI: 2.3-68. 7) increased hazard of high-flow oxygen use and over 11-fold (95% CI: 3.1-45) increased risk of progress to severe disease. All associations were independent of sex, number of comorbidities, and inflammatory markers (D-dimer, C-reactive protein).ConclusionsFIB-4 at early-stage of COVID-19 disease had an independent and dose-dependent association with adverse outcomes during hospitalization. FIB-4 provided significant prognostic value to adverse outcomes among COVID-19 patients.
Exploring the global impact of the COVID-19 pandemic on medical education: an international cross-sectional study of medical learners
Authors: Brown Allison , Kassam Aliya , Paget Mike , Blades Kenneth , Mercia Megan , Kachra Rahim 
Published: September 2020

AbstractTo broadly explore the extent that COVID-19 has initially impacted medical learners around the world and examine global trends and patterns across geographic regions and levels of training, a cross-sectional survey of medical learners was conducted between March 25-June 14th, 2020, shortly after the World Health Organization declared concurrent COVID-19 a pandemic. 6492 medical learners completed the survey from 140 countries, Students were concerned about the quality of their learning, training progression, and milestone fulfillment. Most trainees felt under-utilized and wanted to be engaged clinically in meaningful ways; however, some trainees felt that contributing to healthcare during a pandemic was beyond the scope of a medical learner. Statistically significant differences were detected between levels of training and geographic regions for satisfaction with organizational responses, the impact of COVID-19 on wellness, and state-trait anxiety. Overall, the initial disruption to medical training has been perceived by learners across all levels and geographic regions to have negatively affected their training and well-being, particularly amongst postgraduate trainees. These results provide initial insights into the areas that warrant future research as well as consideration for current and future policy planning, such as the policies for clinical utilization of medical learners during public health emergencies.
Neuropsychiatric symptoms are associated with dementia in Parkinson’s disease but not predictive of it
Authors: Horne Kyla-Louise , MacAskill Michael R. , Myall Daniel J. , Livingston Leslie , Grenfell Sophie , Pascoe Maddie J. , Young Bob , Shoorangiz Reza , Melzer Tracy R. , Pitcher Toni L. , Anderson Tim J. , Dalrymple-Alford John C. 
Published: September 2020

AbstractBackgroundNeuropsychiatric symptoms in Parkinson’s disease (PD) may increase dementia (PDD) risk. The predictive value of these symptoms, however, has not been compared to clinical and demographic predictors of future PDD.Methods325 PD participants completed baseline neuropsychiatric and MDS-Task Force Level II assessments. Of these, 195 non-demented individuals were followed-up over a four-year period to detect conversion to PDD; 51 developed PDD. ROC analysis tested associations between baseline neuropsychiatric symptoms and conversion to PDD. The probability of developing PDD was also modelled as a function of neuropsychiatric inventory (NPI) total score, PD Questionnaire (PDQ) hallucinations, PDQ anxiety and contrasted to cognitive ability, age and motor function. Leave-one-out information criterion was used to evaluate which models provided useful information when predicting future PDD.ResultsThe PDD group experienced greater levels of neuropsychiatric symptoms compared to the PD-MCI and PD-N groups at baseline. Few differences were found between the PD-MCI and PD-N groups. Five neuropsychiatric measures were significantly, but weakly, associated with future PDD. The strongest was NPI total score: AUC=0.66 [0.55-0.76]. There was, however, no evidence that it contained useful out-of-sample predictive information of future PDD (delta ELPD=1.6 (SD 2.4)); Similar results held for PDQ hallucinations and PDQ anxiety. In contrast, cognitive ability (delta ELPD=35 (SD 8)) and age (delta ELPD=11 (SD 5)) provided useful predictive information of future PDD.ConclusionsCognitive ability and age strongly out-performed neuropsychiatric measures as markers of developing PDD within four years. Therefore, neuropsychiatric symptoms do not appear to be useful markers of PDD risk.