bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preferences of Transgender and Gender-Nonconforming Persons in Gender-Confirming Surgical Care
Authors: Margulies Ilana G. , Chuang Carolyn , Travieso Roberto , Zhu Victor , Persing John A. , Steinbacher Derek M. , Zellner Elizabeth G. 
Published: March 2020

Introduction
Increased awareness for transgender and gender-nonconforming individuals may lead to increased demand for surgical interventions in gender-confirming care. However, limited literature exists regarding transgender and gender-nonconforming preferences and experiences with medical or surgical care. The authors aim to characterize the medical and surgical care sought by this population, as well as their surgical preferences, motivations, and barriers to care.

Methods
An online questionnaire about opinions and personal experiences with medical and surgical care during gender transition was publicized via regional online social networking forums in Connecticut and surrounding areas catering to transgender communities.

Results
Responses were received from 313 participants. Participants were 97% male gender at birth and 92% white with an average (SD) age of 51.6 (13.5) years. Fifty-nine percent identified as male-to-female transgender and 20% as gender nonconforming. Respondents were aware of their gender identity at a mean (SD) age of 9.6 (9.0) years, but did not begin transitioning until a mean (SD) age of 38.9 (20.8) years, with gender-nonconforming respondents choosing to transition at a significantly younger age as compared with transgender respondents (29.8 vs 41.4 years; P = 0.0061, unpaired t test). Only 42% of all respondents, with a significantly greater number of transgender as opposed to gender-nonconforming individuals, had previously met with a physician to discuss transitioning (49% vs 21%, P = 0.002, χ2 test). Eight percent of the study population had undergone gender confirmation surgery (GCS), 52% were interested in GCS, and 40% were not interested in GCS. Primary motivation for GCS included discomfort in one's current body (28%), and barriers to GCS included cost (40%) and reactions of family (40%), partners (32%), and friends (25%).

Conclusions
Transgender and gender-nonconforming individuals lack medical support for gender transition, with fewer than half of survey respondents reporting a prior meeting with a physician to discuss transitioning. The reported perspectives offer important insight into transgender preferences that should act as the basis of future efforts to improve the efficacy of gender-confirming care.
Complement as a Major Inducer of Harmful Events in Infectious Sepsis
Authors: Fattahi Fatemeh , Zetoune Firas S. , Ward Peter A. 
Published: March 2020

ABSTRACT
There is abundant evidence that infectious sepsis both in humans and mice with polymicrobial sepsis results in robust activation of complement. Major complement activation products involved in sepsis include C5a anaphylatoxin and its receptors (C5aR1 and C5aR2) and, perhaps, the terminal complement activation product, C5b-9. These products (and others) also cause dysfunction of the innate immune system, with exaggerated early proinflammatory responses, followed by decline of the innate immune system, leading to immunosuppression and multiorgan dysfunction. Generation of C5a during sepsis also leads to activation of neutrophils and macrophages and ultimate appearance of extracellular histones, which have powerful proinflammatory and prothrombotic activities. The distal complement activation product, C5b-9, triggers intracellular Ca2+ fluxes in epithelial and endothelial cells. Histones activate the NLRP3 inflammasome, products of which can damage cells. C5a also activates MAPKs and Akt signaling pathways in cardiomyocytes, causing buildup of [Ca2+]i, defective action potentials and substantial cell dysfunction, resulting in cardiac and other organ dysfunction. Cardiac dysfunction can be quantitated by ECHO-Doppler parameters. In vivo interventions that block these complement-dependent products responsible for organ dysfunction in sepsis reduce the intensity of sepsis. The obvious targets in sepsis are C5a and its receptors, histones, and perhaps the MAPK pathways. Blockade of C5 has been considered in sepsis, but the FDA-approved antibody (eculizumab) is known to compromise defenses against neisseria and pneumonococcal bacteria, and requires immunization before the mAb to C5 can be used clinically. Small molecular blocking agents for C5aRs are currently in development and may be therapeutically effective for treatment of sepsis.
Identifying Septic Shock Populations Benefitting From Polymyxin B Hemoperfusion: A Prospective Cohort Study Incorporating a Restricted Cubic Spline Regression Model
Authors: Nakata Hidekazu , Yamakawa Kazuma , Kabata Daijiro , Umemura Yutaka , Ogura Hiroshi , Gando Satoshi , Shintani Ayumi , Shiraishi Atsushi , Saitoh Daizoh , Fujishima Seitaro , Mayumi Toshihiko , Kushimoto Shigeki , Abe Toshikazu , Shiino Yasukazu , Nakada Taka-aki , Tarui Takehiko , Hifumi Toru , Otomo Yasuhiro , Okamoto Kohji , Kotani Joji , Sakamoto Yuichiro , Sasaki Junichi , Shiraishi Shin-ichiro , Takuma Kiyotsugu , Tsuruta Ryosuke , Hagiwara Akiyoshi , Masuno Tomohiko , Takeyama Naoshi , Yamashita Norio , Ikeda Hiroto , Ueyama Masashi , Fujimi Satoshi 
Published: March 2020

ABSTRACT

Introduction:
Polymyxin B hemoperfusion (PMX-HP) is an adjuvant therapy for sepsis or septic shock that removes circulating endotoxin. However, PMX-HP has seldom achieved expectations in randomized trials targeting nonspecific overall sepsis patients. If used in an optimal population, PMX-HP may be beneficial. This study aimed to identify the optimal population for PMX-HP in patients with septic shock.

Methods:
We used a prospective nationwide cohort targeting consecutive adult patients with severe sepsis (Sepsis-2) in 59 intensive care units in Japan. Associations between PMX-HP therapy and in-hospital mortality were assessed using multivariable Cox proportional hazard regression models. To identify best targets for PMX-HP, we developed a non-linear restricted cubic spline model including two-way interaction term (treatment × Acute Physiology and Chronic Health Evaluation [APACHE] II score/Sequential Organ Failure Assessment [SOFA] score) and three-way interaction term (treatment × age × each score).

Results:
The final study cohort comprised 741 sepsis patients (92 received PMX-HP, 625 did not). Cox proportional hazards regression model adjusted for the covariates suggested no association between PMX-HP therapy and improved mortality overall. Effect modification of PMX-HP by APACHE II score was statistically significant (P for interaction = 0.189) but non-significant for SOFA score (P for interaction = 0.413). Three-way interaction analysis revealed suppressed risk hazard in the PMX-HP group versus control group only in septic shock patients with high age and in the most severe subset of both scores, whereas increased risk hazard was observed in those with high age but in the lower severity subset of both scores.

Conclusions:
Our results suggested that although PMX-HP did not reduce in-hospital mortality among overall septic shock patients, it may benefit a limited population with high age and higher disease severity.
Efficacy and Safety of Tocilizumab in the Treatment of Acute Active Antibody-mediated Rejection in Kidney Transplant Recipients
Authors: Pottebaum April A. , Venkatachalam Karthikeyan , Liu Chang , Brennan Daniel C. , Murad Haris , Malone Andrew F. , Alhamad Tarek 
Published: March 2020

Background.
Antibody-mediated rejection (AMR) continues to have a deleterious impact on kidney allograft survival. Recent evidence supports use of tocilizumab for treatment of chronic active AMR, but it has not been assessed for treatment of acute active AMR.

Methods.
We performed a single-center, observational study of kidney transplant recipients who received at least 1 dose of tocilizumab in addition to conventional therapies for acute active AMR between October 2016 and October 2018 with follow-up through August 2019.

Results.
Seven patients were included. All 7 patients received tocilizumab 8 mg/kg (max dose, 800 mg) monthly. We noted a 50% or greater reduction in immunodominant donor-specific antibodies in 4 of 6 patients. Renal function improved or stabilized in all patients throughout the duration of therapy. One patient developed cytomegalovirus esophagitis and 1 had a potential hypersensitivity reaction. In the extended follow-up, 1 patient had mixed rejection and 2 patients had T-cell–mediated rejection, which occurred 6 to 24 mo after completion of therapy.

Conclusions.
Tocilizumab may be considered as an addition to conventional therapies for treatment of acute active AMR. More studies are needed to determine which patients may benefit from therapy and to examine the appropriate duration of treatment.
Comparative Performance of SARS-CoV-2 Detection Assays using Seven Different Primer/Probe Sets and One Assay Kit
Authors: Casto Amanda M. , Huang Meei-Li , Nalla Arun , Perchetti Garrett , Sampoleo Reigran , Shrestha Lasata , Wei Yulun , Zhu Haiying , Greninger Alexander L. , Jerome Keith R. 
Published: March 2020

AbstractMore than 100,000 people worldwide are known to have been infected with SARS-CoV-2 beginning in December 2019. The virus has now spread to over 93 countries including the United States, with the largest cluster of US cases to date in the Seattle metropolitan area in Washington. Given the rapid increase in the number of local cases, the availability of accurate, high-throughput SARS-CoV-2 testing is vital to efforts to manage the current public health crisis. In the course of optimizing SARS-CoV-2 testing performed by the University of Washington Clinical Virology Lab (UW Virology Lab), we tested assays using seven different primer/probe sets and one assay kit. We found that the most sensitive assays were those the used the E-gene primer/probe set described by Corman et al. (Eurosurveillance 25(3), 2020, https://doi.org/10.2807/1560-7917.ES.2020.25.3.2000045) and the N2 set described by the CDC (Division of Viral Diseases, Centers for Disease Control and Prevention, 2020, https://www.cdc.gov/coronavirus/2019-ncov/downloads/rt-pcr-panel-primer-probes.pdf). All assays tested were found to be highly specific for SARS-CoV-2, with no cross-reactivity with other respiratory viruses observed in our analyses regardless of the primer/probe set or kit used. These results will provide invaluable information to other clinical laboratories who are actively developing SARS-CoV-2 testing protocols at a time when increased testing capacity is urgently needed worldwide.
Assessment of public attention, risk perception, emotional and behavioural responses to the COVID-19 outbreak: social media surveillance in China
Authors: Hou Zhiyuan , Du Fanxing , Jiang Hao , Zhou Xinyu , Lin Leesa 
Published: March 2020

SummaryBackgroundUsing social media surveillance data, this study aimed to assess public attention, risk perception, emotion, and behavioural response to the COVID-19 outbreak in real time.MethodsWe collected data from most popular social medias: Sina Weibo, Baidu search engine, and Ali e-commerce marketplace, from 1 Dec 2019 to 15 Feb 2020. Weibo post counts and Baidu searches were used to generate indices assessing public attention. Public intention and actual adoption of recommended protection measures or panic buying triggered by rumours and misinformation were measured by Baidu and Ali indices. Qualitative Weibo posts were analysed by the Linguistic Inquiry and Word Count text analysis programme to assess public emotion responses to epidemiological events, governments’ announcements, and control measures.FindingsWe identified two missed windows of opportunity for early epidemic control of the COVID-19 outbreak, one in Dec 2019 and the other between 31 Dec and 19 Jan, when public attention was very low despite the emerging outbreak. Delayed release of information ignited negative public emotions. The public responded quickly to government announcements and adopted recommended behaviours according to issued guidelines. We found rumours and misinformation regarding remedies and cures led to panic buying during the outbreak, and timely clarification of rumours effectively reduced irrational behaviour.InterpretationSocial media surveillance can enable timely assessments of public reaction to risk communication and epidemic control measures, and the immediate clarification of rumours. This should be fully incorporated into epidemic preparedness and response systems.FundingNational Natural Science Foundation of China.
CoViD–19: An Automatic, Semiparametric Estimation Method for the Population Infected in Italy
Authors: Fenga Livio 
Published: March 2020

AbstractTo date, official data on the number of people infected with the SARS-CoV-2 - responsible for the CoViD–19 - have been released by the Italian Government just on the basis of a non representative sample of population which tested positive for the swab. However a reliable estimation of the number of infected, including asymptomatic people, turns out to be crucial in the preparation of operational schemes and to estimate the future number of people, who will require, to different extents, medical attentions. In order to overcome the current data shortcoming, this paper proposes a bootstrap–driven, estimation procedure for the number of people infected with the SARS-CoV-2. This method is designed to be robust, automatic and suitable to generate estimations at regional level. Obtained results show that, while official data at March the 12th report 12.839 cases in Italy, people infected wiyh the SARS-CoV-2 could be as high as 105.789.
Blood single cell immune profiling reveals the interferon-MAPK pathway mediated adaptive immune response for COVID-19
Authors: Huang Lulin , Shi Yi , Gong Bo , Jiang Li , Liu Xiaoqi , Yang Jialiang , Tang Juan , You Chunfang , Jiang Qi , Long Bo , Zeng Tao , Luo Mei , Zeng Fanwei , Zeng Fanxin , Wang Shuqiang , Yang Xingxiang , Yang Zhenglin 
Published: March 2020

AbstractThe coronavirus disease 2019 (COVID-19) outbreak is an ongoing global health emergence, but the pathogenesis remains unclear. We revealed blood cell immune response profiles using 5’ mRNA, TCR and BCR V(D)J transcriptome analysis with single-cell resolution. Data from 134,620 PBMCs and 83,387 TCR and 12,601 BCR clones was obtained, and 56 blood cell subtypes and 23 new cell marker genes were identified from 16 participants. The number of specific subtypes of immune cells changed significantly when compared patients with controls. Activation of the interferon-MAPK pathway is the major defense mechanism, but MAPK transcription signaling is inhibited in cured patients. TCR and BCR V(D)J recombination is highly diverse in generating different antibodies against SARS-CoV-2. Therefore, the interferon-MAPK pathway and TCR-and BCR-produced antibodies play important roles in the COVID-19 immune response. Immune deficiency or immune over-response may result in the condition of patients with COVID-19 becoming critical or severe.
The clinical and epidemiological features and hints of 82 confirmed COVID-19 pediatric cases aged 0-16 in Wuhan, China
Authors: Yu Hui , Cai Qinzhen , Dai Xiang , Liu Xiuzhen , Sun Hong 
Published: March 2020

AbstractAlthough COVID-19 pediatric patients just account for 1% of the overall cases, they are nonnegligible invisible infection sources. We quantitatively analyzed the clinical and epidemiological features of 82 confirmed cases aged 0-16 admitted to Wuhan Children’s Hospital, which are expected to shed some lights onto the pediatric diagnosis and therapy.
Coronavirus disease-19: Summary of 2,370 Contact Investigations of the First 30 Cases in the Republic of Korea
Authors:   COVID-19 National Emergency Response Center, Epidemiology and Case Management Team, Korea Centers for Disease Control and Prevention
Published: March 2020

AbstractBetween January 24 and March 10, of a total of 2,370 individuals who had contacted the first 30 cases of COVID-19, 13 were found to have COVID-19, resulting secondary attack rate of 0.55% (95% CI 0.31 – 0.96). Of 119 household contacts, 9 had infections resulting secondary attack rate of 7.56 (95% CI 3.73 – 14.26).
Coronavirus disease-19: The First 7,755 Cases in the Republic of Korea
Authors:   COVID-19 National Emergency Response Center, Epidemiology Center, Epidemiology & and Case management team, Korea Centers for Disease Control and Prevention
Published: March 2020

AbstractWe report the first 7,755 patients with confirmed COVID-19 in Korea as of March 13, 2020. A total of 66 deaths were identified, resulting case fatality proportion of 0.9%. Older people, and those with coexisting medical conditions were at risk for fatal outcomes. The highest number of cases were from Daegu, followed by Gyeongbuk, with elevated age-stratified case fatality. This summary may help to understand the disease dynamics in the early phase of COVID-19 outbreak, therefore, to guide future public health measures.
Effect of large-scale testing platform in prevention and control of the COVID-19 pandemic: an empirical study with a novel numerical model
Authors: Xie Qing , Wang Jing , You Jianling , Zhu Shida , Zhou Rui , Tian Zhijian , Wu Hao , Lin Yang , Chen Wei , Xiao Lan , Jin Xin , Li Jianjuan , Dong Jie , Wu Honglong , Zhang Wei , Li Jing , Xu Xun , Yin Ye , Mu Feng , Chen Weijun , Jian Wang 
Published: March 2020

BackgroundChina adopted an unprecedented province-scale quarantine since January 23rd 2020, after the novel coronavirus (COVID-19) broke out in Wuhan in December 2019. Responding to the challenge of limited testing capacity, large-scale standardized and fully-automated laboratory (Huo-Yan) was built as an ad-hoc measure. There was so far no empirical data or mathematical model to reveal the impact of the testing capacity improvement since the quarantine.MethodsWe integrated public data released by the Health Commission of Hubei Province and Huo-Yan Laboratory testing data into a novel differential model with non-linear transfer coefficients and competitive compartments, to evaluate the trends of suspected cases under different nucleic acid testing capacities.ResultsWithout the establishment of Huo-Yan, the suspected cases would increased by 47% to 33,700, the corresponding cost of the quarantine would be doubled, and the turning point of the increment of suspected cases and the achievement of “daily settlement” (all daily new discovered suspected cases were diagnosed according to the nucleic acid testing results) would be delayed for a whole week and 11 days. If the Huo-Yan Laboratory ran at its full capacity, the number of suspected cases would decrease at least a week earlier, the peak of suspected cases would be reduced by at least 44% and the quarantine cost could be reduced by more than 72%. Ideally, if a daily testing capacity of 10,500 could achieved immediately after the Hubei lockdown, “daily settlement” for all suspected cases would be achieved immediately.ConclusionsLarge-scale and standardized clinical testing platform with nucleic acid testing, high-throughput sequencing and immunoprotein assessment capabilities need to be implemented simultaneously in order to maximize the effect of quarantine and minimize the duration and cost. Such infrastructure like Huo-Yan, is of great significance for the early prevention and control of infectious diseases for both common times and emergencies.
Mechanism of anterior cruciate ligament loading during dynamic motor tasks
Authors: Nasseri Azadeh , Lloyd David G , Bryant Adam L , Headrick Jonathon , Sayer Timothy , Saxby David J 
Published: March 2020

AbstractThis study determined anterior cruciate ligament (ACL) force and its contributors during a standardized drop-land-lateral jump task using a validated computational model. Healthy females (n=24) who were recreationally active performed drop-land-lateral jump and straight run tasks. Three-dimensional whole-body kinematics, ground reaction forces, and muscle activation patterns from eight lower limb muscles were collected concurrently during both tasks, but only the jump was analyzed computationally, with the run included for model calibration. External biomechanics, muscle-tendon unit kinematics, and muscle activation patterns were used to model lower limb muscle and ACL forces. Peak ACL force (2.3±0.5 BW) was observed at 13% of the stance phase during the drop-land-lateral jump task. The ACL force was primarily developed through the sagittal plane, and muscle was the dominant source of ACL loading. The gastrocnemii and quadriceps were main ACL antagonists (i.e., loaders), while hamstrings were the main ACL agonists (i.e., supporters).
Low variability of dynamical functional connectivity in cerebellar networks
Authors: Fernandez-Iriondo Izaro , Jimenez-Marin Antonio , Diez Ibai , Bonifazi Paolo , Swinnen Stephan P. , Muñoz Miguel A. , Cortes Jesus M. 
Published: March 2020

AbstractBrain networks can be defined and explored using different types of connectivity. Here, we studied P=48 healthy participants with neuroimaging state-of-the-art techniques and analyzed the relationship between the actual structural connectivity (SC) networks (between 2514 regions of interest covering the entire brain and brainstem) and the dynamical functional connectivity (DFC) among the same regions. To do so, we focused on a combination of two metrics: the first one measures the degree of SC-DFC similarity –i.e. how much functional correlations can be explained by structural pathways– and the second one, the intrinsic variability of DFC networks across time. Overall, we found that cerebellar networks have smaller DFC variability than other networks in the cerebrum. Moreover, our results clearly evidence the internal structure of the cerebellum, which is divided in two differentiated networks, the posterior and anterior parts, the latter also being connected to the brain stem. The mechanism for keeping the DFC variability low in the posterior part of the cerebellum is consistent with another finding, namely, it exhibits the highest SC-DFC similarity among all other sub-networks, i.e. its structure constrains very strongly its dynamics. On the other hand, the anterior part of the cerebellum, which also exhibits a low level of DFC variability, has the lowest SC-DFC similarity, suggesting very different dynamical mechanisms. It is likely that its connections with the brain stem –which regulates sleep cycles, cardiac and respiratory functioning– might have a critical role in DFC variations in the anterior part. A lot is known about cerebellar networks, such as having extremely rich and complex anatomy and functionality, connecting to the brainstem, and cerebral hemispheres, and participating in a large variety of cognitive functions, such as movement control and coordination, executive function, visual-spatial cognition, language processing, and emotional regulation. However, as far as we know, our findings of low variability in the dynamical functional connectivity of cerebellar networks and its possible relation with the above functions, have not been reported so far. Further research is still needed to shed light on these findings.