bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electromagnetic Navigation Bronchoscopy With Tomosynthesis-based Visualization and Positional Correction
Authors: Pritchett Michael A. , Bhadra Krish , Mattingley Jennifer S. 
Published: May 2020

Background:
Electromagnetic navigation bronchoscopy (ENB) aids in lung lesion biopsy. However, anatomic divergence between the preprocedural computed tomography (CT) and the actual bronchial anatomy during the procedure can limit localization accuracy. An advanced ENB system has been designed to mitigate CT-to-body divergence using a tomosynthesis-based software algorithm that enhances nodule visibility and allows for intraprocedural local registration.

Materials and Methods:
A prospective, 2-center study was conducted in subjects with single peripheral lung lesions ≥10 mm to assess localization accuracy of the superDimension navigation system with fluoroscopic navigation technology. Three-dimensional accuracy was confirmed by cone-beam computed tomography. Complications were assessed through 7 days.

Results:
Fifty subjects were enrolled (25 per site). Lesions were <20 mm in 61.2% (30/49). A bronchus sign was present in 53.1% (26/49). Local registration was completed in 95.9% (47/49). Three-dimensional target overlap (primary endpoint) was achieved in 59.6% (28/47) and 83.0% (39/47) before and after location correction, respectively. Excluding subjects with unevaluable video files, target overlap was achieved 68.3% (28/41) and 95.1% (39/41), respectively. Malignant results were obtained in 53.1% (26/49) by rapid on-site evaluation and 61.2% (30/49) by final pathology of the ENB-aided sample. Diagnostic yield was not evaluated. Procedure-related complications were pneumothorax in 1 subject (no chest tube required) and scant hemoptysis in 3 subjects (no interventions required).

Conclusion:
ENB with tomosynthesis-based fluoroscopic navigation improved the 3-dimensional convergence between the virtual target and actual lung lesion as confirmed by cone-beam computed tomography. Future studies are necessary to understand the impact of this technology on diagnostic yield.
Predicting the CN Lantern Test for Railways with Clinical Color-vision Tests
Authors: Almustanyir Ali , Hovis Jeffery K. 
Published: May 2020

SIGNIFICANCE
This research will help clinicians in advising their color-vision–defective patients regarding their career options.

PURPOSE
In Canadian railways, individuals with a color-vision-defect (CVD) may qualify for positions at shorter sighting distance from signal lights. The railway companies' medical units use the CN Lantern (CNLan) test, and there is little information available as to whether clinical color-vision tests (CCVTs) can predict the CNLan results. This study determines the ability of some CCVTs to predict the CNLan performance to assist clinicians in advising their CVD patients regarding career options.

METHODS
The CNLan viewing distance was varied between 4.6 and 0.57 m using a geometric progression. The CCVTs were the Hardy, Rand, and Rittler; Ishihara; ColorDx pseudoisochromatic plate (PIP); the Rabin Cone Contrast Test; Color Assessment and Diagnosis; Cambridge Color Vision Test; U.S. Air Force Operational Based Vision Assessment Cone Contrast Test; Farnsworth Munsell D15; and ColorDx D15. Fifty-six normal-color-vision and 63 CVD subjects participated in this study.

RESULTS
Failure of either the Farnsworth Munsell D15 or ColorDx D15 essentially guarantees failure on the CNLan at the 4.6-m distance. The agreement values decreased as the viewing distance decreased.

CONCLUSIONS
To counsel patients regarding a career as a locomotive engineer, clinicians should have either the Hardy, Rand, and Rittler or ColorDx PIP and a D15 test. For patients applying for a position in the yard, a mild-to-moderate classification CVD on HRR or ColorDx PIP indicates a high probability of passing CNLan.
Pseudopartial Third Nerve Palsy as the Presenting Sign of Ocular Myasthenia Gravis
Authors: Bertolet Anne N. , Druckenbrod Rachel C. 
Published: May 2020

SIGNIFICANCE
This case emphasizes the high degree of suspicion necessary for a timely diagnosis of myasthenia gravis.

PURPOSE
This report discusses a case of ocular myasthenia gravis presenting as a pseudo–third nerve palsy with ptosis. The pathogenesis, treatment, and management of ocular myasthenia gravis are discussed.

CASE REPORT
A 68-year-old white man presented to our clinic after noticing a new right eyelid droop for several days and experiencing horizontal double vision for the past 3 weeks. A pupil-sparing partial third nerve palsy was diagnosed, and MRI and laboratory work were ordered to assist with diagnosis. Laboratory results demonstrated highly positive acetylcholinesterase antibodies, confirming a diagnosis of ocular myasthenia gravis.

CONCLUSIONS
Myasthenia gravis commonly presents with ocular signs and symptoms. Because ocular myasthenia gravis can mimic other causes of diplopia, heightened awareness and suspicion are necessary to make a timely diagnosis.
Social Integration and Diurnal Cortisol Decline: The Role of Psychosocial and Behavioral Pathways
Authors: Dickman Kristina D. , Thomas Mark C. , Anderson Barbara , Manuck Stephen B. , Kamarck Thomas W. 
Published: May 2020

ABSTRACTObjectiveA growing number of studies have associated various measures of social integration, the diversity of social roles in which one participates, with alterations in hypothalamic-pituitary-adrenocortical (HPA) functioning. The pathways through which social integration may be linked to HPA functioning, however, are as yet unknown. The present study examined whether daily social interactions, affective responses, health behaviors, and personality help explain the association between social integration and diurnal cortisol slope.MethodsA sample of 456 healthy, employed adults (53.9% female, 82.0% white, 72.2% bachelor’s degree or greater, mean age of 42.86 years) completed a 4-day ecological momentary assessment protocol that measured cortisol, social interactions, affect, sleep, and physical activity at frequent intervals throughout the day. Social integration was measured at baseline.ResultsRegression results controlling for age, sex, race, and education indicated that more socially integrated individuals showed steeper cortisol slopes (B= −0.00253,p= .006). Exploratory analyses suggested that the consistency (i.e., reduced variability) in nightly sleep midpoint partially explained this association (B= −0.00042, 95% confidence interval = −0.00095 to −0.00001). Personality, mood, social interaction patterns, and nonsleep health behavior differences did not account for the association between social integration and HPA activity.ConclusionThis study replicates previous findings linking social integration and HPA functioning, and it examines patterns of nightly sleep as possible pathways through which the association may operate. Results have implications for understanding mechanisms for health risk and for development of future interventions.
The Association of Individual Changes in Stressful Life Events and Telomere Length Over Time in Twins 50 Years and Older
Authors: Gerritsen Lotte , Hägg Sara , Reynolds Chandra A. , Pedersen Nancy L. 
Published: May 2020

ABSTRACT

Objective
Exposure to adverse stressors has been associated with shortening of leukocyte telomere length (LTL). The present longitudinal study investigates the time course of exposure to life events and LTL to determine whether increases in exposure to life events are related to subsequent accelerated LTL shortening.

Methods
In the Swedish Adoption/Twin Study of Aging, we assessed late-life stressful events and LTL in 543 individual participants (mean age = 68.4 years, 40% men, including 48 complete monozygotic twin pairs and 167 complete dizygotic twin pairs) in up to five separate measurements over a period of 25 years. LTL was measured using quantitative polymerase chain reaction. Longitudinal analyses were conducted using time-varying mixed modeling, corrected for life-style factors and depressive symptoms.

Results
When adjusting for differences in genetic makeup by looking only in monozygotic twins, we found that an increase in life stressors within an individual was related to decreased LTL over time (B = −0.02; 95% confidence interval = −0.04 to 0.01; p = .002). None of the findings were significant when only looking at dizygotic twins (all, p > .05).

Conclusions
Our findings in an older population show a causal relation between increase in life stress and accelerated LTL shortening by using intraindividual time-varying analysis.
Mind the Gap: Changes in Levator Dimensions After Sacrocolpopexy
Authors: Geynisman-Tan Julia , Kenton Kimberly S. , Brown Oluwateniola , Gillingham Akira , Lewicky-Gaupp Christina , Mueller Margaret G. , Collins Sarah A. 
Published: May 2020

Objective
The aim of the study was to compare levator hiatus (LH) and levator area (LA) on transvaginal 3-dimensional (3D) ultrasound (US) and genital hiatus (GH) size by Pelvic Organ Prolapse Quantification (POP-Q) examination before and after minimally invasive sacrocolpopexy.

Methods
Women with prolapse (POP) beyond the hymen undergoing minimally invasive sacrocolpopexy without concomitant POP repairs completed Pelvic Floor Distress Inventory short form (PFDI), POP-Q, and transvaginal 3D US before and 14 weeks after surgery. Data were analyzed by 2 urogynecologists, blinded to US image sequence and to corresponding POP-Q scores.

Results
Forty-three patients were enrolled; 35 with complete data are included. Patients had a mean ± SD age of 55 ± 11 years. Most were white (89%), vaginally parous (94%), postmenopausal (66%), sexually active (63%), and had stage 3 POP (86%). The majority (89%) had concomitant hysterectomy, and 60% had midurethral slings. At baseline, the mean ± SD PFDI and Prolapse subscale of the Pelvic Floor Distress Inventory scores were 98 ± 50 and 42 ± 22. The median (interquartile range) POP-Q stage decreased after surgery from 3 (3) to 0 (0–1, P < 0.001) and the mean ± SD PFDI scores decreased to 55 ± 42 (P = 0.002). At baseline, the mean ± SD GH and perineal body measurements were 3.5 ± 0.7 and 2.4 ± 0.6 cm. Although the GH size decreased by 0.5 cm after surgery, perineal body was unchanged. Levator hiatus remained unchanged between the baseline and 14-week visits (P = 0.07), whereas LA increased by 0.8 cm2 (P = 0.03). At 14 weeks, the change in LA was not correlated with the change in GH (ρ = −0.2, P = 0.2) or POP stage (ρ = −0.2, P = 0.9).

Conclusions
Restoring the apex with sacrocolpopexy alone reduces GH size on clinical examination; however, it does not impact the size of the underlying LH on US.
On the Generation of Medical Dialogues for COVID-19
Authors: Yang Wenmian , Zeng Guangtao , Tan Bowen , Ju Zeqian , Chakravorty Subrato , He Xuehai , Chen Shu , Yang Xingyi , Wu Qingyang , Yu Zhou , Xing Eric , Xie Pengtao 
Published: May 2020

AbstractUnder the pandemic of COVID-19, people experiencing COVID19-related symptoms or exposed to risk factors have a pressing need to consult doctors. Due to hospital closure, a lot of consulting services have been moved online. Because of the shortage of medical professionals, many people cannot receive online consultations timely. To address this problem, we aim to develop a medical dialogue system that can provide COVID19-related consultations. We collected two dialogue datasets – CovidDialog – (in English and Chinese respectively) containing conversations between doctors and patients about COVID-19. On these two datasets, we train several dialogue generation models based on Transformer, GPT, and BERT-GPT. Since the two COVID-19 dialogue datasets are small in size, which bear high risk of overfitting, we leverage transfer learning to mitigate data deficiency. Specifically, we take the pretrained models of Transformer, GPT, and BERT-GPT on dialog datasets and other large-scale texts, then finetune them on our CovidDialog datasets. Experiments demonstrate that these approaches are promising in generating meaningful medical dialogues about COVID-19. But more advanced approaches are needed to build a fully useful dialogue system that can offer accurate COVID-related consultations. The data and code are available at https://github.com/UCSD-AI4H/COVID-Dialogue
Behaviours and attitudes in response to the COVID-19 pandemic: Insights from a cross-national Facebook survey
Authors: Perrotta Daniela , Grow André , Rampazzo Francesco , Cimentada Jorge , Fava Emanuele Del , Gil-Clavel Sofia , Zagheni Emilio 
Published: May 2020

AbstractIn the absence of medical treatment and vaccination, individual behaviours are key to controlling the spread of COVID-19. We developed a rapid response monitoring system through an online survey (the “COVID-19 Health Behavior Survey”). Participant recruitment takes places continuously via Facebook in eight countries (Belgium, France, Germany, Italy, the Netherlands, Spain, the United Kingdom, the United States). The survey collects key information on people’s health, attitudes, behaviours, and social contacts. In this paper, we present results based on a total of 71,612 completed questionnaires, collected between March 13-April 19, 2020. We find sex-specific patterns, as women show higher threat perceptions, lower confidence in the healthcare system, and a higher likelihood of adopting preventive behaviours. Our findings also show higher awareness and concern among older respondents. Finally, we find spatio-temporal heterogeneity in threat perception, confidence in organisations, and adoption of preventive behaviours.
COVID-19 and Environmental factors. A PRISMA-compliant systematic review
Authors: Chatziprodromidou I. , Apostolou T. , Vantarakis A. 
Published: May 2020

AbstractThe emergence of a novel human coronavirus, SARS-CoV-2, has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described with incubation times between 2-10 days, facilitating its airborne spread via droplets. The impact of environmental factors on the coronavirus disease 2019 (COVID-19) outbreak is under consideration. We therefore reviewed the literature on all available information about the impact of environmental factors on human coronaviruses. Temperature, humidity and other environmental factors have been recorded as environmental drivers of the COVID-19 outbreak in China and in other countries. Higher temperatures might be positive to decrease the COVID-19 incidence. In our review, the analysis of 23 studies show evidence that high temperature and high humidity reduce the COVID-19 transmission. However, further studies concerning other environmental (namely meteorological) factors’ role should be conducted in order to further prove this correlation.As no specific therapies are available for SARS-CoV-2, early containment and prevention of further spread will be crucial to stop the ongoing outbreak and to control this novel infectious thread.
A collaborative online AI engine for CT-based COVID-19 diagnosis
Authors: Xu Yongchao , Ma Liya , Yang Fan , Chen Yanyan , Ma Ke , Yang Jiehua , Yang Xian , Chen Yaobing , Shu Chang , Fan Ziwei , Gan Jiefeng , Zou Xinyu , Huang Renhao , Zhang Changzheng , Liu Xiaowu , Tu Dandan , Xu Chuou , Zhang Wenqing , Yang Dehua , Wang Ming-Wei , Wang Xi , Xie Xiaoliang , Leng Hongxiang , Holalkere Nagaraj , Halin Neil J. , Kamel Ihab Roushdy , Wu Jia , Peng Xuehua , Wang Xiang , Shao Jianbo , Mongkolwat Pattanasak , Zhang Jianjun , Rubin Daniel L. , Wang Guoping , Zheng Chuangsheng , Li Zhen , Bai Xiang , Xia Tian 
Published: May 2020

AbstractArtificial intelligence can potentially provide a substantial role in streamlining chest computed tomography (CT) diagnosis of COVID-19 patients. However, several critical hurdles have impeded the development of robust AI model, which include deficiency, isolation, and heterogeneity of CT data generated from diverse institutions. These bring about lack of generalization of AI model and therefore prevent it from applications in clinical practices. To overcome this, we proposed a federated learning-based Unified CT-COVID AI Diagnostic Initiative (UCADI, http://www.ai-ct-covid.team/), a decentralized architecture where the AI model is distributed to and executed at each host institution with the data sources or client ends for training and inferencing without sharing individual patient data. Specifically, we firstly developed an initial AI CT model based on data collected from three Tongji hospitals in Wuhan. After model evaluation, we found that the initial model can identify COVID from Tongji CT test data at near radiologist-level (97.5% sensitivity) but performed worse when it was tested on COVID cases from Wuhan Union Hospital (72% sensitivity), indicating a lack of model generalization. Next, we used the publicly available UCADI framework to build a federated model which integrated COVID CT cases from the Tongji hospitals and Wuhan Union hospital (WU) without transferring the WU data. The federated model not only performed similarly on Tongji test data but improved the detection sensitivity (98%) on WU test cases. The UCADI framework will allow participants worldwide to use and contribute to the model, to deliver a real-world, globally built and validated clinic CT-COVID AI tool. This effort directly supports the United Nations Sustainable Development Goals’ number 3, Good Health and Well-Being, and allows sharing and transferring of knowledge to fight this devastating disease around the world.
EXCESS MORTALITY FROM COVID-19. WEEKLY EXCESS DEATH RATES BY AGE AND SEX FOR SWEDEN
Authors: Modig Karin , Ebeling Marcus 
Published: May 2020

ABSTRACTObjectivesMortality from Covid-19 is monitored in detail both within as well as between countries with different strategies against the virus. However, death counts and relative risks based on crude numbers can be misleading. Instead, age specific death rates should be used for comparability. Given the difficulty of ascertainment of Covid-19 specific deaths, excess all-cause mortality is currently more appropriate for comparisons. By estimating age- and sex-specific death rates we aim to get more accurate estimates of the excess mortality attributed to Covid-19, as well as the difference between men and women in Sweden.DesignWe make use of Swedish register data about total weekly deaths, total population at risk, and estimate age- and sex-specific weekly death rates for 2020 and the 5 previous years. The data is provided by Statistics Sweden.ResultsFrom the first week of April and onwards, the death rates at all ages above 60 are higher than those in previous years in Sweden. Persons above age 80 are dis-proportionally more affected, and men suffer higher levels of excess mortality than women at all ages with 75% higher death rates for males and 50% higher for females. Current excess mortality corresponds to a decline in remaining life expectancy of 3 years for men and 2 years for women.ConclusionThe Covid-19 pandemic has so far had a clear and consistent effect on total mortality in Sweden, with male death rates being comparably more affected. What consequences the pandemic will eventually have on mortality and life expectancy will depend on the progression of the pandemic, the extent that some of the deaths would have occurred in the absence of the pandemic, only somewhat later, the consequences for other health conditions, as well as the health care sector at large.
Estimating the extent of asymptomatic COVID-19 and its potential for community transmission: systematic review and meta-analysis
Authors: Byambasuren Oyungerel , Cardona Magnolia , Bell Katy , Clark Justin , McLaws Mary-Louise , Glasziou Paul 
Published: May 2020

AbstractBackgroundThe prevalence of true asymptomatic COVID-19 cases is critical to policy makers considering the effectiveness of mitigation measures against the SARS-CoV-2 pandemic. We aimed to synthesize all available research on the asymptomatic rates and transmission rates where possible.MethodsWe searched PubMed, Embase, Cochrane COVID-19 trials, and Europe PMC (which covers pre-print platforms such as MedRxiv). We included primary studies reporting on asymptomatic prevalence where: (a) the sample frame includes at-risk population, and (b) there was sufficiently long follow up to identify pre-symptomatic cases. Meta-analysis used fixed effect and random effects models. We assessed risk of bias by combination of questions adapted from risk of bias tools for prevalence and diagnostic accuracy studies.ResultsWe screened 2,454 articles and included 13 low risk-of-bias studies from seven countries that tested 21,708 at-risk people, of which 663 were positive and 111 were asymptomatic. Diagnosis in all studies was confirmed using a RT-PCR test. The proportion of asymptomatic cases ranged from 4% to 41%. Meta-analysis (fixed effect) found that the proportion of asymptomatic cases was 17% (95% CI: 14% - 20%) overall; higher in aged care 20% (14% - 27%), and lower in non-aged care 16% (13% - 20%). Five studies provided direct evidence of forward transmission of the infection by asymptomatic cases. Overall, there was a 42% lower relative risk of asymptomatic transmission compared to symptomatic transmission (combined Relative Risk: 0.58; 95% CI 0.335-0.994, p=0.047).DiscussionOur estimates of the prevalence of asymptomatic COVID-19 cases and asymptomatic transmission rates are lower than many highly publicized studies, but still sufficient to warrant policy attention. Further robust epidemiological evidence is urgently needed, including in sub-populations such as children, to better understand the importance of asymptomatic cases for driving spread of the pandemic.FundingOB is supported by NHMRC Grant APP1106452. PG is supported by NHMRC Australian Fellowship grant 1080042. KB is supported by NHMRC Investigator grant 1174523. All authors had full access to all data and agreed to final manuscript to be submitted for publication. There was no funding source for this study.
Structure of a proton-powered molecular motor that drives protein transport and gliding motility
Authors: James Rory Hennell , Deme Justin C. , Kjӕr Andreas , Alcock Felicity , Silale Augustinas , Lauber Frédéric , Berks Ben C. , Lea Susan M. 
Published: May 2020

SummaryIon-driven motors are rare in biology. The archetypes of the three classes identified to date are ATP synthase, the bacterial flagellar motor, and a proton-driven motor that powers gliding motility and protein secretion inBacteroidetesbacteria. Whilst the molecular mechanism of ATP synthase is now well understood, structural information is lacking for the other two classes of motor. Here we present the structure of theBacteroidetesgliding motility motor determined by cryo-electron microscopy. The motor is an asymmetric inner membrane protein complex in which the single transmembrane helices of two periplasm-spanning GldM proteins are positioned within a ring of five GldL proteins. Combining mutagenesis and single-molecule tracking, we identify protonatable amino acid residues within the transmembrane domain of the complex that are important for motor function. Our data imply a mechanism in which proton flow leads the periplasm-spanning GldM dimer to rotate with respect to the intra-membrane GldL ring to drive processes at the bacterial outer membrane. This work provides a molecular basis for understanding how the gliding motility motor is able to transduce the energy of the inner membrane protonmotive force across the bacterial cell envelope.