bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Communication in Outpatient Consultations in People With Cirrhosis
Authors: Low Joseph T.S. , Davis Sarah , Greenslade Lynda , Carroll Cathy , Craig Rachel , Wilson Jo , Clancy Jennifer-Louise , Marshall Aileen , Thorburn Douglas , Stone Patrick 
Published: April 2020

Background and Aims:
Liver health professionals have difficulty discussing liver cirrhosis and its prognosis with patients and families. Question Prompt Lists (QPLs), which are evidence-based lists of “recommended questions,” may improve communication but need to be designed specifically for the target population. This study aimed to develop and pilot a QPL for patients with cirrhosis.

Methods:
A mixed-methods design in 3 phases. In phase 1 (item generation), potential questions for inclusion in the QPL were identified from 3 sources—a scoping literature review; an online survey; and interviews with patients, family members, and health professionals. In phase 2 (QPL construction), a multidisciplinary expert panel finalized the selection of questions and the format of the QPL. In phase 3 (pilot study), the QPL was assessed for acceptability and feasibility in a hepatology outpatient clinic population.

Results:
From 258 topics initially identified, 30 questions were included in the first draft of the QPL. After review by a multidisciplinary expert panel including patients, the QPL was reduced to 22 questions. In the pilot study, 133/215 eligible patients consented to participate, although only 67/133 used the QPL in their clinic appointment. Among those who used the QPL, all questions were asked at least once. The most commonly asked question related to life expectancy. Most participants expressed support for the content of the QPL.

Conclusions:
A QPL, suitable for use in patients with liver cirrhosis attending hepatology outpatient clinics, has been developed and piloted. The QPL seems to be feasible to use and acceptable to patients and clinicians. Further work is needed to evaluate its effectiveness and to determine optimum delivery in clinical practice.
Nonbiopsy Approach for Celiac Disease Is Accurate When Using Exact Duodenal Histomorphometry
Authors: Popp Alina , Arvola Taina , Taavela Juha , Kivelä Laura , Ene Adina , Laurila Kaija , Saavalainen Päivi , Mäki Markku , Kurppa Kalle 
Published: April 2020

Goals:
To test the accuracy of serology-based criteria for diagnosing celiac disease utilizing quantitative histomorphometry.

Background:
The revised European pediatric guidelines allow noninvasive celiac disease diagnosis for a subgroup of children. However, in some of the studies on this issue, the positive predictive value (PPV) of serology has remained suboptimal, possibly because of challenges of histopathology as the reference standard.

Study:
Prospectively enrolled children with transglutaminase 2 antibodies (TGA) above the upper limit of normal (ULN) underwent blood sampling and duodenal biopsy in Finland and Romania. Those with TGA ≥10× ULN, positive endomysium antibodies (EmA), and disease-associated genetics were considered to fulfill triple criteria for celiac disease. Initial histopathologic analysis was conducted using grouped classification, whereupon centralized morphometry was performed.

Results:
Altogether 88 (54%) children were triple positive. In local evaluation, 99% of triple-positive children and 73% of children with TGA <10× ULN had celiac disease. These figures increased to 100% and 85% after more precise morphometric analysis. Triple-positive children had more anemia and higher median EmA and liver enzyme values than those with TGA<10× ULN; the groups were comparable in other clinical features and laboratory parameters.

Conclusions:
When applied as recommended, the nonbiopsy strategy had already yielded excellent PPV regardless of the site of diagnosis or clinical presentation in the local analysis. PPV further increased to 100% with standardized duodenal morphometry.
Psychological Distress During Pregnancy
Authors: Spedding Maxine F. , Sorsdahl Katherine , Parry Charles D.H. , Mathews Catherine , Stein Dan J. , Williams Petal Petersen 
Published: April 2020

Abstract
The prevalence and risk factors associated with peripartum psychological distress—a unifying factor among common mental disorders (CMDs)—are not widely understood in underresourced settings. Cross-sectional data were collected from 664 pregnant women who reported for antenatal care at any of one of the 11 midwife and obstetrics units in Cape Town, South Africa. The prevalence of prepartum psychological distress was 38.6%. Associated factors included low socioeconomic status as measured by asset ownership (odds ratio [OR], 1.45; 95% CI, 1.24–1.68), recent physical abuse and/or rape (OR, 1.94; 95% CI, 1.57–2.40), complications during a previous birth (OR, 1.18; 95% CI, 1.01–1.38), and having given birth before (OR, 1.61; 95% CI, 1.21–2.14). The high prevalence of psychological distress is consistent with those found in other South African studies of peripartum CMDs. If effective context-specific interventions are to be appropriately designed, closer investigation of a broader symptomology associated with peripartum CMDs in these settings is warranted.
Evaluation of Intrinsic Hand Musculature Reinnervation following Supercharge End-to-Side Anterior Interosseous–to–Ulnar Motor Nerve Transfer
Authors: Head Linden K. , Zhang Zach Z. , Hicks Katie , Wolff Gerald , Boyd Kirsty U. 
Published: April 2020

Summary:
Supercharge end-to-side anterior interosseous–to–ulnar motor nerve transfer is commonly performed in the authors’ institution to augment intrinsic hand function. Following observations of recovery patterns, the authors hypothesized that despite its more distal innervation, the first dorsal interosseous muscle recovers to a greater extent than the abductor digiti minimi muscle. The objective of this work was to evaluate the clinical and electrodiagnostic pattern of reinnervation of intrinsic hand musculature following supercharge end-to-side anterior interosseous–to–ulnar motor nerve transfer. A retrospective cohort of prospectively collected data included all patients who underwent a supercharge end-to-side anterior interosseous–to–ulnar motor nerve transfer. Two independent reviewers performed data collection. Reinnervation was assessed with two primary outcome measures: (1) clinically, with serial Medical Research Council strength assessments; and (2) electrodiagnostically, with serial motor amplitude measurements. Statistical analysis was performed using nonparametric statistics. Seventeen patients (65 percent male; mean age, 56.9 ± 13.3 years) were included with a mean follow-up of 16.7 ± 8.5 months. Preoperatively, all patients demonstrated clinically significant weakness and electrodiagnostic evidence of denervation. Postoperatively, strength and motor amplitude increased significantly for both the first dorsal interosseous muscle (p = 0.002 and p = 0.016) and the abductor digiti minimi muscle (p = 0.044 and p = 0.015). Despite comparable preoperative strength (p = 0.098), postoperatively, the first dorsal interosseous muscle achieved significantly greater strength when compared to the abductor digiti minimi muscle (p = 0.023). Following supercharge end-to-side anterior interosseous–to–ulnar motor nerve transfer, recovery of intrinsic muscle function differs between the abductor digiti minimi and the first dorsal interosseous muscles, with better recovery observed in the more distally innervated first dorsal interosseous muscle. Further work to elucidate the underlying physiologic and anatomical basis for this discrepancy is indicated.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, IV.
Observable Variations in Human Sex Ratio at Birth
Authors: Long Yanan , Chen Qi , Larsson Henrik , Rzhetsky Andrey 
Published: April 2020

AbstractThe human sex ratio at birth (SRB), defined as the ratio between the number of newborn boys to the total number of newborns, is typically slightly greater than 1/2 (more boys than girls) and tends to vary across different geographical regions and time periods. In this large-scale study, we sought to validate previously-reported associations and test new hypotheses using statistical analysis of two very large datasets incorporating electronic medical records (EMRs). One of the datasets represents over half (∼150 million) of the US population for over 8 years (IBM Watson Health MarketScan insurance claims) while another covers the entire Swedish population (∼9 million) for over 30 years (the Swedish National Patient Register). After testing more than 100 hypotheses, we showed that neither dataset supported models in which the SRB changed seasonally or in response to variations in ambient temperature. However, increased levels of a diverse array of air and water pollutants, were associated with lower SRBs, including increased levels of industrial and agricultural activity, which served as proxies for water pollution. Moreover, some exogenous factors generally considered to be environmental toxins turned out to induce higher SRBs. Finally, we identified new factors with signals for either higher or lower SRBs. In all cases, the effect sizes were modest but highly statistically significant owing to the large sizes of the two datasets. We suggest that while it was unlikely that the associations have arisen from sex-specific selection mechanisms, they are still useful for the purpose of public health surveillance if they can be corroborated by empirical evidences.Author SummaryThe human sex ratio at birth (SRB), usually slightly greater than 1/2, have been reported to vary in response to a wide array of exogenous factors. In the literature, many such factors have been posited to be associated with higher or lower SRBs, but the studies conducted so far have focused on no more than a few factors at a time and used far smaller datasets, thus prone to generating spurious correlations. We performed a series of statistical tests on 2 large, country-wide health datasets representing the United States and Sweden to investigate associations between putative exogenous factors and the SRB, and were able to validate a set of previously-reported associations while also discovering new signals. We propose to interpret these results simply as public health indicators awaiting further empirical confirmation rather than as implicated in (adaptive) sexual selection mechanisms.
When Resources Are Scarce - Feasibility of Emergency Ventilation of Two Patients With One Ventilator
Authors: Reinacher Peter C. , Schlaepfer Thomas E. , Schick Martin A. , Beck Jürgen , Bürkle Hartmut , Schumann Stefan 
Published: April 2020

AbstractA potential shortage of intensive care ventilators has led to the idea to ventilate more than one patient with a single ventilator. Besides other problems, this is associated with the lack of knowledge concerning distribution of tidal volume and the patients’ individual respiratory system mechanics.In this study we used two simple hand-manufactured adaptors to connect physical models of two adult respiratory systems to one ventilator. The artificial lungs were ventilated in the pressure-controlled mode and we investigated if disconnecting one lung from the ventilation circuit for several breaths would allow to determine reliably the other lung’s tidal volume and compliance.Compliances and volumes were measured both with the ventilator and external sensors corresponded well. However, tidal volumes measured via the ventilator were smaller compared to the tidal volumes measured via the external sensors with an absolute error of 5.3 ± 2.5%. The tidal volumes of the individual artificial lungs were distributed in proportion to the compliances and did not differ relevantly when both artificial lungs were connected to when one was disconnected.We conclude that in case of emergency, ventilation of two patients with one ventilator requires two simple hand-crafted tubes as adaptors and available standard breathing circuit components. In such a setting, respiratory system mechanics and tidal volume of each individual patient can be reliably measured during short term clamping of the tracheal tube of the respective other patient.
Household Secondary Attack Rate of COVID-19 and Associated Determinants
Authors: Jing Qin-Long , Liu Ming-Jin , Yuan Jun , Zhang Zhou-Bin , Zhang An-Ran , Dean Natalie E. , Luo Lei , Ma Mengmeng , Longini Ira , Kenah Eben , Lu Ying , Ma Yu , Jalali Neda , Fang Li-Qun , Yang Zhi-Cong , Yang Yang 
Published: April 2020

AbstractBackgroundAs of April 2, 2020, the global reported number of COVID-19 cases has crossed over 1 million with more than 55,000 deaths. The household transmissibility of SARS-CoV-2, the causative pathogen, remains elusive.MethodsBased on a comprehensive contact-tracing dataset from Guangzhou, we estimated both the population-level effective reproductive number and individual-level secondary attack rate (SAR) in the household setting. We assessed age effects on transmissibility and the infectivity of COVID-19 cases during their incubation period.ResultsA total of 195 unrelated clusters with 212 primary cases, 137 nonprimary (secondary or tertiary) cases and 1938 uninfected close contacts were traced. We estimated the household SAR to be 13.8% (95% CI: 11.1-17.0%) if household contacts are defined as all close relatives and 19.3% (95% CI: 15.5-23.9%) if household contacts only include those at the same residential address as the cases, assuming a mean incubation period of 4 days and a maximum infectious period of 13 days. The odds of infection among children (<20 years old) was only 0.26 (95% CI: 0.13-0.54) times of that among the elderly (≥60 years old). There was no gender difference in the risk of infection. COVID-19 cases were at least as infectious during their incubation period as during their illness. On average, a COVID-19 case infected 0.48 (95% CI: 0.39-0.58) close contacts. Had isolation not been implemented, this number increases to 0.62 (95% CI: 0.51-0.75). The effective reproductive number in Guangzhou dropped from above 1 to below 0.5 in about 1 week.ConclusionSARS-CoV-2 is more transmissible in households than SARS-CoV and MERS-CoV, and the elderly ≥60 years old are the most vulnerable to household transmission. Case finding and isolation alone may be inadequate to contain the pandemic and need to be used in conjunction with heightened restriction of human movement as implemented in Guangzhou.
Detection of spreader nodes and ranking of interacting edges in Human-SARS-CoV protein interaction network
Authors: Saha Sovan , Chatterjee Piyali , Basu Subhadip , Nasipuri Mita 
Published: April 2020

AbstractThe entire world has recently witnessed the commencement of coronavirus disease 19 (COVID-19) pandemic. It is caused by a novel coronavirus (n-CoV) generally distinguished as Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). It has exploited human vulnerabilities to coronavirus outbreak. SARS-CoV-2 promotes fatal chronic respiratory disease followed by multiple organ failure which ultimately puts an end to human life. No proven vaccine for n-CoV is available till date in spite of significant research efforts worldwide. International Committee on Taxonomy of Viruses (ICTV) has reached to a consensus that the virus SARS-CoV-2 is highly genetically similar to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) outbreak of 2003. It has been reported that SARS-CoV has ∼89% genetic similarities with n-CoV. With this hypothesis, the current work focuses on the identification of spreader nodes in SARS-CoV protein interaction network. Various network characteristics like edge ratio, neighborhood density and node weight have been explored for defining a new feature spreadability index by virtue of which spreader nodes and edges are identified. The selected top spreader nodes having high spreadability index have been also validated by Susceptible-Infected-Susceptible (SIS) disease model. Initially, the proposed method is applied on a synthetic protein interaction network followed by SARS-CoV-human protein interaction network. Hence, key spreader nodes and edges (ranked edges) are unmasked in SARS-CoV proteins and its connected level 1 and level 2 human proteins. The new network attribute spreadability index along with generated SIS values of selected top spreader nodes when compared with the other network centrality based methodologies like Degree centrality (DC), Closeness centrality (CC), Local average centrality (LAC) and Betweeness centrality (BC) is found to perform relatively better than theexisting-state-of-art.
Challenges in control of COVID-19: short doubling times and long delay to effect of interventions
Authors: Pellis Lorenzo , Scarabel Francesca , Stage Helena B. , Overton Christopher E. , Chappell Lauren H. K. , Lythgoe Katrina A. , Fearon Elizabeth , Bennett Emma , Curran-Sebastian Jacob , Das Rajenki , Fyles Martyn , Lewkowicz Hugo , Pang Xiaoxi , Vekaria Bindu , Webb Luke , House Thomas A. , Hall Ian 
Published: April 2020

AbstractThe unconstrained growth rate of COVID-19 is crucial for measuring the impact of interventions, assessing worst-case scenarios, and calibrating mathematical models for policy planning. However, robust estimates are limited, with scientific focus on the time-insensitive basic reproduction number R0. Using multiple countries, data streams and methods, we consistently estimate that European COVID-19 cases doubled every three days when unconstrained, with the impact of physical distancing interventions typically seen about nine days after implementation, during which time cases grew eight-fold. The combination of fast growth and long detection delays explains the struggle in countries’ response better than large values of R0 alone, and warns against relaxing physical distancing measures too quickly. Testing and tracing are fundamental in shortening such delays, thus preventing cases from escalating unnoticed.
Incidence, clinical outcomes, and transmission dynamics of hospitalized 2019 coronavirus disease among 9,596,321 individuals residing in California and Washington, United States: a prospective cohort study
Authors: Lewnard Joseph A. , Liu Vincent X. , Jackson Michael L. , Schmidt Mark A. , Jewell Britta L. , Flores Jean P. , Jentz Chris , Northrup Graham R. , Mahmud Ayesha , Reingold Arthur L. , Petersen Maya , Jewell Nicholas P. , Young Scott , Bellows Jim 
Published: April 2020

ABSTRACTBackgroundThe United States is now the country reporting the highest number of 2019 coronavirus disease (COVID-19) cases and deaths. However, little is known about the epidemiology and burden of severe COVID-19 to inform planning within healthcare systems and modeling of intervention impact.MethodsWe assessed incidence, duration of hospitalization, and clinical outcomes of acute COVID-19 inpatient admissions in a prospectively-followed cohort of 9,596,321 individuals enrolled in comprehensive, integrated healthcare delivery plans from Kaiser Permanente in California and Washington state. We also estimated the effective reproductive number (RE) describing transmission in the study populations.ResultsData covered 1277 hospitalized patients with laboratory- or clinically-confirmed COVID-19 diagnosis by April 9, 2020. Cumulative incidence of first COVID-19 acute inpatient admission was 10.6-12.4 per 100,000 cohort members across the study regions. Mean censoring-adjusted duration of hospitalization was 10.7 days (2.5-97.5%iles: 0.8-30.1) among survivors and 13.7 days (2.5-97.5%iles: 1.7-34.6) among non-survivors. Among all hospitalized confirmed cases, censoring-adjusted probabilities of ICU admission and mortality were 41.9% (95% confidence interval: 34.1-51.4%) and 17.8% (14.3-22.2%), respectively, and higher among men than women. We estimated RE was 1.43 (1.17-1.73), 2.09 (1.63-2.69), and 1.47 (0.07-2.59) in Northern California, Southern California, and Washington, respectively, for infections acquired March 1, 2020. RE declined to 0.98 (0.76-1.27), 0.89 (0.74-1.06), and 0.92 (0.05-1.55) respectively, for infections acquired March 20, 2020.ConclusionsWe identify high probability of ICU admission, long durations of stay, and considerable mortality risk among hospitalized COVID-19 cases in the western United States. Reductions in RE have occurred in conjunction with implementation of non-pharmaceutical interventions.
Improving COVID-19 Testing Efficiency using Guided Agglomerative Sampling
Authors: Minhas Fayyaz , Grammatopoulos Dimitris , Young Lawrence , Amin Imran , Snead David , Anderson Neil , Ben-Hur Asa , Rajpoot Nasir 
Published: April 2020

AbstractOne of the challenges in the current COVID-19 crisis is the time and cost of performing tests especially for large-scale population surveillance. Since, the probability of testing positive in large population studies is expected to be small (<15%), therefore, most of the test outcomes will be negative. Here, we propose the use of agglomerative sampling which can prune out multiple negative cases in a single test by intelligently combining samples from different individuals. The proposed scheme builds on the assumption that samples from the population may not be independent of each other. Our simulation results show that the proposed sampling strategy can significantly increase testing capacity under resource constraints: on average, a saving of ~40% tests can be expected assuming a positive test probability of 10% across the given samples. The proposed scheme can also be used in conjunction with heuristic or Machine Learning guided clustering for improving the efficiency of large-scale testing further. The code for generating the simulation results for this work is available here:https://github.com/foxtrotmike/AS.
Synaptic learning rules for sequence learning
Authors: Reifenstein Eric T. , Kempter Richard 
Published: April 2020

AbstractRemembering the temporal order of a sequence of events is a task easily performed by humans in everyday life, but the underlying neuronal mechanisms are unclear. This problem is particularly intriguing as human behavior often proceeds on a time scale of seconds, which is in stark contrast to the much faster millisecond time-scale of neuronal processing in our brains. One long-held hypothesis in sequence learning suggests that a particular temporal fine-structure of neuronal activity — termed “phase precession” — enables the compression of slow behavioral sequences down to the fast time scale of the induction of synaptic plasticity. Using mathematical analysis and computer simulations, we find that — for short enough synaptic learning windows — phase precession can improve temporal-order learning tremendously and that the asymmetric part of the synaptic learning window is essential for temporal-order learning. To test these predictions, we suggest experiments that selectively alter phase precession or the learning window and evaluate memory of temporal order.