bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Implementation Research Logic Model: A Method for Planning, Executing, Reporting, and Synthesizing Implementation Projects
Authors: Smith Justin D. , Li Dennis H. , Rafferty Miriam R. 
Published: April 2020

AbstractBackgroundNumerous models, frameworks, and theories exist for specific aspects of implementation research, including for determinants, strategies, and outcomes. However, implementation research projects often fail to provide a coherent rationale or justification for how these aspects are selected and tested in relation to one another. Despite this need to better specify the conceptual linkages between the core elements involved in projects, few tools or methods have been developed to aid in this task. The Implementation Research Logic Model (IRLM) was created for this purpose and to enhance the rigor and transparency of describing the often-complex processes of improving the adoption of evidence-based practices in healthcare delivery systems.MethodsThe IRLM structure and guiding principles were developed through a series of preliminary activities with multiple investigators representing diverse implementation research projects in terms of contexts, research designs, and implementation strategies being evaluated. The utility of the IRLM was evaluated in the course of a two-day training to over 130 implementation researchers and healthcare delivery system partners.ResultsPreliminary work with the IRLM produced a core structure and multiple variations for common implementation research designs and situations, as well as guiding principles and suggestions for use. Results of the survey indicated high utility of the IRLM for multiple purposes, such as improving rigor and reproducibility of projects; serving as a “roadmap” for how the project is to be carried out; clearly reporting and specifying how the project is to be conducted; and understanding the connections between determinants, strategies, mechanisms, and outcomes for their project.ConclusionsThe IRLM is a semi-structured, principles-guided tool designed to improve the specification, rigor, reproducibility, and testable causal pathways involved in implementation research projects. The IRLM can also aid implementation researchers and implementation partners in the planning and execution of practice change initiatives. Adaptation and refinement of the IRLM is ongoing, as is the development of resources for use and applications to diverse projects, to address the challenges of this complex scientific field.
Systemic analysis of tissue cells potentially vulnerable to SARS-CoV-2 infection by the protein-proofed single-cell RNA profiling of ACE2, TMPRSS2 and Furin proteases
Authors: Zhou Lulin , Niu Zubiao , Jiang Xiaoyi , Zhang Zhengrong , Zheng You , Wang Zhongyi , Zhu Yichao , Gao Lihua , Huang Hongyan , Wang Xiaoning , Sun Qiang 
Published: April 2020

ABSTRACTSingle-cell RNA profiling of ACE2, the SARS-CoV-2 receptor, had proposed multiple tissue cells as the potential targets of SARS-CoV-2, the novel coronavirus causing the COVID-19 pandemic. However, most were not echoed by the patients’ clinical manifestations, largely due to the lack of protein expression information of ACE2 and co-factors. Here, we incorporated the protein information to analyse the expression of ACE2, together with TMPRSS2 and Furin, two proteases assisting SARS-CoV-2 infection, at single cell levelin situ, which we called protein-proofed single-cell RNA (pscRNA) profiling. Systemic analysis across 36 tissues revealed a rank list of candidate cells potentially vulnerable to SARS-CoV-2. The top targets are lung AT2 cells and macrophages, then cardiomyocytes and adrenal gland stromal cells, followed by stromal cells in testis, ovary and thyroid. Whereas, the polarized kidney proximal tubule cells, liver cholangiocytes and intestinal enterocytes are less likely to be the primary SARS-CoV-2 targets as ACE2 localizes at the apical region of cells, where the viruses may not readily reach. Actually, the stomach may constitute a physical barrier against SARS-CoV-2 as the acidic environment in normal stomach (pH < 2.0) could completely inactivate SARS-CoV-2 pseudo-viruses. These findings are in concert with the clinical characteristics of prominent lung symptoms, frequent heart injury, and uncommon intestinal symptoms and acute kidney injury. Together, we provide a comprehensive view on the potential SARS-CoV-2 targets by pscRNA profiling, and propose that, in addition to acute respiratory distress syndrome, attentions should also be paid to the potential injuries in cardiovascular, endocrine and reproductive systems during the treatment of COVID-19 patients.
The unseen and pervasive threat of COVID-19 throughout the US
Authors: Javan Emily , Fox Spencer J. , Meyers Lauren Ancel 
Published: April 2020

AbstractFor each US county, we calculated the probability of an ongoing COVID-19 epidemic that may not yet be apparent. Based on confirmed cases as of April 15, 2020, COVID-19 is likely spreading in 86% of counties containing 97% of US population. Proactive measures before two cases are confirmed are prudent.
Estimation of the percentages of asymptomatic patients and undiagnosed patients of the novel coronavirus (SARS-CoV-2) infection in Hokkaido, Japan by using birth-death process with recursive full tracing
Authors: Tanaka Takuma , Yamaguchi Takayuki , Sakamoto Yohei 
Published: April 2020

AbstractEstimating the percentages of undiagnosed and asymptomatic patients is essential for controlling the outbreak of SARS-CoV-2, and for assessing any strategy for controlling the disease. In this paper, we propose a novel analysis based on the birth-death process with recursive full tracing. We estimated the numbers of undiagnosed symptomatic patients and total infected individuals per diagnosed patient before and after the declaration of the state of emergency in Hokkaido, Japan. The median of the estimated number of undiagnosed symptomatic patients per diagnosed patient decreased from 1.9 to 0.77 after the declaration, and the median of the estimated number of total infected individuals per diagnosed patient decreased from 4.7 to 2.4. We will discuss the limitations and possible expansions of the model.
The effectiveness of non-pharmaceutical interventions in containing epidemics: a rapid review of the literature and quantitative assessment
Authors: Cheatley Jane , Vuik Sabine , Devaux Marion , Scarpetta Stefano , Pearson Mark , Colombo Francesca , Cecchini Michele 
Published: April 2020

AbstractThe number of confirmed COVID-19 cases has rapidly increased since discovery of the disease in December 2019. In the absence of medical countermeasures to stop the spread of the disease (i.e. vaccines), countries have responded by implementing a suite of non-pharmaceutical interventions (NPIs) to contain and mitigate COVID-19. Individual NPIs range in intensity (e.g. from lockdown to public health campaigns on personal hygiene), as does their impact on reducing disease transmission. This study uses a rapid review approach and investigates evidence from previous epidemic outbreaks to provide a quantitative assessment of the effectiveness of key NPIs used by countries to combat the COVID-19 pandemic. Results from the study are designed to help countries enhance their policy response as well as inform transition strategies by identifying which policies should be relaxed and which should not.
Making sense of the Global Coronavirus Data: The role of testing rates in understanding the pandemic and our exit strategy
Authors: Potluri Rahul , Lavu Deepthi 
Published: April 2020

AbstractThe Coronavirus disease 2019(COVID-19) outbreak has caused havoc across the world. Subsequently, research on COVID-19 has focused on number of cases and deaths and predicted projections have focused on these parameters. We propose that the number of tests performed is a very important denominator in understanding the COVID-19 data. We analysed the number of diagnostic tests performed in proportion to the number of cases and subsequently deaths across different countries and projected pandemic outcomes.We obtained real time COVID-19 data from the reference website Worldometer at 0900 BST on Saturday 4th April, 2020 and collated the information obtained on the top 50 countries with the highest number of COVID 19 cases. We analysed this data according to the number of tests performed as the main denominator. Country wise population level pandemic projections were extrapolated utilising three models - 1) inherent case per test and death per test rates at the time of obtaining the data (4/4/2020 0900 BST) for each country; 2) rates adjusted according to the countries who conducted at least 100000 tests and 3) rates adjusted according to South Korea.We showed that testing rates impact on the number of cases and deaths and ultimately on future projections for the pandemic across different countries. We found that countries with the highest testing rates per population have the lowest death rates and give us an early indication of an eventual COVID-19 mortality rate. It is only by continued testing on a large scale that will enable us to know if the increasing number of patients who are seriously unwell in hospitals across the world are the tip of the iceberg or not. Accordingly, obtaining this information through a rapid increase in testing globally is the only way which will enable us to exit the COVID-19 pandemic and reduce economic and social instability.
Characterizing relevant microRNA editing sites in Parkinson’s disease
Authors: Lu Chenyu , Ren Shuchao , Zhao Zhigang , Wu Xingwang , Suo Angbaji , Zhou Nan , Yang Jun , Wu Shuai , Li Tianqing , Peng Chao , Zheng Yun 
Published: April 2020

AbstractMicroRNAs (miRNAs) are extensively edited in human brains. However, the functional relevance of miRNA editome is largely unknown in Parkinson’s disease (PD). By analyzed small RNA sequencing profiles of brain tissues of 43 PD patients and 88 normal controls, we totally identified 421 miRNA editing sites with significantly different editing levels in prefrontal cortices of PD patients (PD-PC). A-to-I edited miR-497-5p has significantly higher expression levels in PD-PC compared to normal controls and directly represses OPA1 and VAPB, which potentially contributes to the progressive neurodegeneration of PD patients. These results provide new insights into mechanistic understanding, novel diagnostic and therapeutic clues of PD.
Hypertension in patients hospitalized with COVID-19 in Wuhan, China: A single-center retrospective observational study
Authors: Zeng Zhenhua , Sha Tong , Zhang Yuan , Wu Feng , Hu Hongbin , Li Haijun , Han Jiafa , Song Wenhong , Huang Qiaobing , Chen Zhongqing 
Published: April 2020

AbstractObjectivesIt is unclear whether patients with hypertension are more likely to be infected with SARS-COV-2 than the general population and whether there is a difference in the severity of COVID-19 pneumonia in patients who have taken ACEI/ARB drugs to lower blood pressure compared to those who have not.MethodsThis observational study included data from all patients with clinically confirmed COVID-19 who were admitted to the Hankou Hospital, Wuhan, China between January 5 and March 8, 2020. Data were extracted from clinical and laboratory records. Follow-up was cutoff on March 8, 2020.ResultsA total of 274 patients, 75 with hypertension and 199 without hypertension, were included in the analysis. Patients with hypertension were older and were more likely to have pre-existing comorbidities, including chronic renal insufficiency, cardiovascular disease, diabetes mellitus, and cerebrovascular disease than patients without hypertension. Moreover, patients with hypertension tended to have higher positive COVID-19 PCR detection rates. Patients with hypertension who had previously taken ACEI/ARB drugs for antihypertensive treatment have an increased tendency to develop severe pneumonia after infection with SARS-COV-2 (P = 0.064).ConclusionsCOVID-19 patients with hypertension were significantly older and were more likely to have underlying comorbidities, including chronic renal insufficiency, cardiovascular disease, diabetes mellitus, and cerebrovascular disease. Patients with hypertension who had taken ACEI/ARB drugs for antihypertensive treatment have an increased tendency to develop severe pneumonia after infection with SARS-COV-2. In future studies, a larger sample size and multi-center clinical data will be needed to support our conclusions.
The need of health policy perspective to protect Healthcare Workers during COVID-19 pandemic. A GRADE rapid review on the N95 respirators effectiveness
Authors: Iannone Primiano , Castellini Greta , Coclite Daniela , Napoletano Antonello , Fauci Alice , Iacorossi Laura , D’Angelo Daniela , Renzi Cristina , La Torre Giuseppe , Mastroianni Claudio M. , Gianola Silvia 
Published: April 2020

AbstractProtecting Health Care Workers (HCWs) during routine care of suspected or confirmed COVID-19 patients is of paramount importance to halt the SARS-CoV-2 (Severe Acute Respiratory Syndrome-Coronavirus-2) pandemic. The WHO, ECDC and CDC have issued conflicting guidelines on the use of respiratory filters (N95) by HCWs. We searched PubMed, Embase and The Cochrane Library from the inception to March 21, 2020 to identify randomized controlled trials (RCTs) comparing N95 respirators versus surgical masks for prevention of COVID-19 or any other respiratory infection among HCWs. The grading of recommendations, assessment, development, and evaluation (GRADE) was used to evaluate the quality of evidence. Four RCTs involving 8736 HCWs were included. We did not find any trial specifically on prevention of COVID-19. However, wearing N95 respirators can prevent 73 more (95% CI 46-91) clinical respiratory infections per 1000 HCWs compared to surgical masks (2 RCTs; 2594 patients; low quality of evidence). A protective effect of N95 respirators in laboratory-confirmed bacterial colonization (RR= 0.41; 95%CI 0.28-0.61) was also found. A trend in favour of N95 respirators was observed in preventing laboratory-confirmed respiratory viral infections, laboratory-confirmed respiratory infection, and influenza like illness. We found no direct high quality evidence on whether N95 respirators are better than surgical masks for HCWs protection from SARS-CoV-2. However, low quality evidence suggests that N95 respirators protect HCWs from clinical respiratory infections. This finding should be contemplated to decide the best strategy to support the resilience of healthcare systems facing the potentially catastrophic SARS-CoV-2 pandemic.
Key to successful treatment of COVID-19: accurate identification of severe risks and early intervention of disease progression
Authors: Chen Meizhu , Tu Changli , Tan Cuiyan , Zheng Xiaobin , Wang Xiaohua , Wu Jian , Huang Yiying , Wang Zhenguo , Yan Yan , Li Zhonghe , Shan Hong , Liu Jing , Huang Jin 
Published: April 2020

AbstractBackgroundCOVID-19 is a new and highly contagious respiratory disease that has caused global spread, high case fatality rate in severe patients, and a huge medical burden due to invasive mechanical ventilation. The current diagnosis and treatment guidelines are still need to be improved, and more excellent clinical experience is needed to provide reference.MethodsWe analyzed and summarized clinical data of 97 confirmed COVID-19 adult patients (including 26 severe cases) admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from January 17, 2020 to March 10, 2020, included laboratory examination results, imaging findings, treatment effect, prognosis, etc, in order to put forward prediction index of severe COVID-19 patients, principles of early intervention and methylprednisolone usages in COVID-19 patients.ResultsHypoxemia, hyperlactic acid, hypoproteinemia, and hypokalemia were prevalent in COVID-19 patients. The significant low lymphocyte count, hypoproteinemia, hypokalemia, the persistent or worsen high CRP, high D-dimer, and high BNP, and the occurrence of hemoptysis and novel coronavirus (SARS-CoV-2) viremia were important indicators for early diagnosis and prediction of severe disease progression.Characteristic images of lung CT had a clear change in COVID-19, Ground-glass opacity (GGO) and high-density linear combinations may indicate different pathological changes. Rapid lobular progression of GGO suggests the possibility of severe disease.Basic principles of early intervention treatment of COVID-19: on the premise of no effective antiviral drugs, treatment is based on supportive and symptomatic therapy (albumin supplementation, supplement of potassium, supplement blood plasma, etc.) in order to maintain the stability of the intracellular environment and adequately reactivate body immunity to clean up SARS-CoV-2.According to severity, oxygenation index, body weight, age, underlying diseases, appropriate amount methylprednisolone application on severe/critical COVID-19 patients on demand, improved blood oxygen and reduced the utilization rate of invasive mechanical ventilation, case fatality rate and medical burden significantly. The most common indications for invasive mechanical ventilation should be strictly control in critical COVID-19 patients.ConclusionsAccurate and timely identification of clinical features in severe risks, and early and appropriate intervention can block disease progression. 2. Appropriate dose of methylprednisolone can effectively avoid invasive mechanical ventilation and reduce case fatality rate in critical COVID-19 patients.
Multi-route respiratory infection: when a transmission route may dominate
Authors: Gao Caroline X. , Li Yuguo , Wei Jianjian , Cotton Sue , Hamilton Matthew , Wang Lei , Cowling Benjamin J. 
Published: April 2020

AbstractThe exact transmission route of many respiratory infectious diseases remains a subject for debate to date. The relative contribution ratio of each transmission route is largely undetermined, which is affected by environmental conditions, human behavior, the host and the microorganism. In this study, a detailed mathematical model is developed to investigate the relative contributions of different transmission routes to a multi-route transmitted respiratory infection. It is illustrated that all transmission routes can dominate the total transmission risk under different scenarios. Influential parameters considered include dose-response rate of different routes, droplet governing size that determines virus content in droplets, exposure distance, and virus dose transported to the hand of infector. Our multi-route transmission model provides a comprehensive but straightforward method to evaluate the transmission efficiency of different transmission routes of respiratory diseases and provides a basis for predicting the impact of individual level intervention methods such as increasing close-contact distance and wearing protective masks. (Word count: 153)HighlightsA multi-route transmission model is developed by considering evaporation and motion of respiratory droplets with the respiratory jet and consequent exposure of the susceptible.We have illustrated that each transmission route may dominate during the influenza transmission, and the influential factors are revealed.The short-range airborne route and infection caused by direct inhalation of medium droplets are highlighted.
Analysing and comparing the COVID-19 data: The closed cases of Hubei and South Korea, the dark March in Europe, the beginning of the outbreak in South America
Authors: De Leo Stefano , Maia Gabriel G. , Solidoro Leonardo 
Published: April 2020

The present work is a statistical analysis of the COVID-19 pandemic. As the number of cases worldwide overtakes one million, data reveals closed outbreaks in Hubei and South Korea, with a new slight increase in the number of infected people in the latter. Both of these countries have reached a plateau in the number of Total Confirmed Cases per Million (TCCpM) residents, suggesting a trend to be followed by other affected regions. Using Hubei’s data as a basis of analysis, we have studied the spreading rate of COVID-19 and modelled the epidemic center for 10 European countries. We have also given the final TCCpM curves for Italy and Lombardia. The introduction of the α-factor allows us to analyse the different stages of the outbreak, compare the European countries amongst each other, and, finally, to confront the initial phase of the disease between Europe and South America.MethodsBy dividing the TCCpM curves in multiple sections spanning short time frames we were able to fit each section to a linear model. By pairing then the angular coefficient (α factor) of each section to the total number of confirmed infections at the center of the corresponding time interval, we have analysed how the spreading rate of Covid-19 changes as more people are infected. Also, by modelling the TCCpM curves with an asymmetrical time integral of a Normal Distribution, we were able to study, by fitting progressively larger data ensembles, how the fitting parameters change as more data becomes available.FindingsThe data analysis shows that the spreading rate of COVID-19 increases similarly for all countries in its early stage, but changes as the number of TCCpM in each country grows. Regarding the modelling of the TCCpM curves, we have found that the fitting parameters oscillate with time before reaching constant values. The estimation of such values allows the determination of better parameters for the model, which in turn leads to more trustworthy forecasts on the pandemic development.InterpretationThe analysis of the oscillating fitting parameters allows an early prediction of the TCC, epidemic center and standard deviation of the outbreak. The α factor and the recovered over confirmed cases ratio can be used to understand the pandemic development in each country and to compare the protective measures taken by local authorities and their impact on the spreading of the disease.FundingCNPq (grant number 2018/303911) and Fapesp (grant numebr 2019/06382-9).
Alternative Qualitative Fit Testing Method for N95 Equivalent Respirators in the Setting of Resource Scarcity at the George Washington University
Authors: Provenzano Destie , Rao Yuan James , Mitic Konstantin , Obaid Sofian N. , Berger Jeffrey , Goyal Sharad , Loew Murray H. 
Published: April 2020

AbstractThe 2019 Novel Coronavirus (COVID-19) has caused an acute shortage of personal protective equipment (PPE) globally as well as shortage in the ability to test PPE such as respirator fit testing. This limits not only the ability to fit PPE to medical practitioners, but also the ability to rapidly prototype and produce alternative sources of PPE as it is difficult to validate fit. At the George Washington University, we evaluated an easily sourced method of qualitative fit testing using a nebulizer or “atomizer” and a sodium saccharin solution in water. If aerosolized saccharin entered candidate masks due to poor fit or inadequate filtration, then a sweet taste was detected in the mouth of the user. This method was tested against previously fit tested Milwaukee N95 and 3D Printed Reusable N95 Respirator as a positive control. A Chinese sourced KN95, cotton cloth material, and surgical mask were tested as other masks of interest. Sensitivity testing was done with no mask prior to fit test. A sweet taste was detected for both the surgical mask and cotton cloth, demonstrating a lack of seal. However, there was no sweet taste detected for the Milwaukee N95, 3D Printed Reusable N95 Respirator, or Chinese KN95. These results demonstrate this could be a valuable methodology for rapid prototyping, evaluation, and validation of fit in a non-clinical environment for use in creation of PPE. This method should be not be used without confirmation in a formal qualitative or quantitative fit test but can be used to preserve those resources until developers are confident that potential new N95 comparable respirators will pass. We strongly suggest validation of masks and respirators with Occupational Safety and Health Administration (OSHA) approved fit testing prior to use in a clinical environment.