bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinician Engagement in Quality: A Literature Review
Authors: Dickinson Marie , Duffield Christine , Bichel-Findlay Jen , Travaglia Joanne 
Published: December 2020

Background and Objectives:
Defining quality in the health care context has proven difficult, with many organizations not able to clearly articulate their use of this term in a manner that is easily understood by their clinical staff. This review seeks to investigate the literature to explore clinician engagement in quality including where engagement has been problematic, and if the reasons for this have been identified.

Methods:
An integrative review of the literature was undertaken to determine whether evidence within the literature supports a hypothesis that there is a lack of understanding of and engagement in quality at an organizational level by health professionals. A search of the literature was conducted using EBSCO Academic Complete, CINAHL, and MEDLINE databases.

Results:
This article identified 18 studies where the understanding of quality by clinicians and their level of engagement with the process are investigated. We found that there has been no comprehensive study that explores the development of an agreed-upon definition and measurement of quality or clinician understanding and engagement in quality. The studies conducted have been small and discipline-specific.

Conclusion:
There is a growing body of evidence indicating that clinical and nonclinical staff interpret the meaning of quality and quality improvement differently. Quality and quality improvement are interpreted in relation to the clinician's individual work, professional, and learning and development experience. The literature suggests that clinician interpretation is influenced in part by their own personal beliefs and values, in addition to their interpretation of their individual work/professional responsibilities.
The Stress Concentration and Biomechanical Properties of the Intra-oral Distractors and the Extra-oral Distractors Used in Treatment of Post Ankylosis Facial Asymmetric Patients: A Finite Element Analysis Study
Authors: Elhadidi Yasser Nabil , Askar Mohamed Gamal , El Sayed Abdulmotakaber Galal Abdullatif 
Published: December 2020

Abstract
Assessment of stress and micromotions using finite element analysis along both the intraoral and the extraoral distractors devices used in the mandibular distraction of post temporomandibular joint ankylosis deformed mandible patients. The process of finite element analysis was carried out to assess distraction models. The first model was an extraoral mandibular distraction model and the second model was an intraoral mandibular distraction model. To analyze the stress state, 2 vertical loads were applied on the defective and normal side respectively by a 3D finite element ball model. The intraoral system observed lower stress (4.5 MPa) in the mandibular bone compared to the extra-oral system (11.5 MPa). The results revealed that the intraoral system observed higher stress on the distractor fixing points (392.21 MPa) compared to the extra-oral fixing points (12.62 MPa). The results revealed that the extra-oral system reflected higher displacement on the bone surrounding the screws of about 3720 μm compared to the intraoral system 1414.6 μm. Internal devices give better shielding to the bone and induce fewer stresses over the mandibular, so it is more advisable to be used. The external devices permit greater distraction length because the pins and the distractor main body are subjected to fewer stresses.
Cleft and COVID-19 Pandemic: Controversial Aspects of Social Distancing
Authors: Nabavizadeh Sara Sadat , Nadjmi Nasser , Vardanjani Hossein Molavi 
Published: December 2020

Abstract
In the meantime, as COVID-19 has gone pandemic, social distancing has become inevitable; therefore, most in-person visits have been canceled to minimize the spread of the disease. This will greatly impact cleft palate patients as it will limit their chance to receive timely care and have persistent follow-up, and that could in turn delay its management so significantly that it could cause much more considerable complications. To mitigate the issue, it seems necessary to start integrating modern-day technologies into the everyday practice of physicians and to benefit from the opportunities it provides. Much of medical decision making is cognitive, and telemedicine can provide easy access to specialists who are not immediately available. With wide internet access, this task is more than feasible. Telemedicine and other modern facilities are very promising platforms that could fill the gap that has been made by social distancing. We tried to address some of these issues as well as give recommendations for possible solutions to each of them.
The burden of active infection and anti-SARS-CoV-2 IgG antibodies in the general population: Results from a statewide survey in Karnataka, India
Authors: Babu Giridhara R , Sundaresan Rajesh , Athreya Siva , Akhtar Jawaid , Pandey Pankaj Kumar , Maroor Parimala S , Padma MR , Lalitha R , Shariff Mohammed , Krishnappa Lalitha , Manjunath CN , Sudarshan MK , Gururaj G , Ranganath TS , Kumar Vasanth , Banandur Pradeep , Deepa R , Shiju Shilpa , Lobo Eunice , Satapathy Asish , Alahari Lokesh , Prameela  , Vinitha T , Desai Anita , Ravi V 
Published: December 2020

AbstractBackgroundGlobally, the routinely used case-based reporting and IgG serosurveys underestimate the actual prevalence of COVID-19. Simultaneous estimation of IgG antibodies and active SARS-CoV-2 markers can provide a more accurate estimation.MethodsA cross-sectional survey of 16416 people covering all risk groups was done between 3-16 September 2020 using the state of Karnataka’s infrastructure of 290 hospitals across all 30 districts. All participants were subjected to simultaneous detection of SARS-CoV-2 IgG using a commercial ELISA kit, SARS-CoV-2 antigen using a rapid antigen detection test (RAT), and reverse transcription-polymerase chain reaction (RT-PCR) for RNA detection. Maximum-likelihood estimation was used for joint estimation of the adjusted IgG, active, and total prevalence, while multinomial regression identified predictors.FindingsThe overall adjusted prevalence of COVID-19 in Karnataka was 27 ·3% (95% CI: 25 ·7-28 ·9), including IgG 16 ·4% (95% CI: 15 ·1 - 17 ·7) and active infection 12 ·7% (95% CI: 11 ·5-13 ·9). The case-to-infection ratio was 1:40, and the infection fatality rate was 0 ·05%. Influenza-like symptoms or contact with a COVID-19 positive patient are good predictors of active infection. The RAT kits had higher sensitivity (68%) in symptomatic participants compared to 47% in asymptomatic.InterpretationThis is the first comprehensive survey providing accurate estimates of the COVID-19 burden anywhere in the world. Further, our findings provide a reasonable approximation of population immunity threshold levels. Using the RAT kits and following the syndromic approach can be useful in screening and monitoring COVID-19. Leveraging existing surveillance platforms, coupled with appropriate methods and sampling framework, renders our model replicable in other settings.
A Simplified Bayesian Analysis Method for Vaccine Efficacy
Authors: Graziani Carlo 
Published: December 2020

AbstractWe describe a simplified Bayesian analysis of vaccine trial data, in which a reparametrization of the Poisson likelihood leads to a factorization in which the protective vaccine efficacyVESand the nuisance parameter appear in different factors. As a consequence the posterior density acquires a factorized form, and marginalization over the nuisance parameter is trivial. Estimates ofVESaccordingly become a matter of simple manipulations of one-dimensional posterior probability densities. We demonstrate the method using the publically-released data on the efficacy of three vaccines agains SARS-CoV-2: the final Phase III data from the Pfizer/BioNTech and Moderna mRNA vaccines and the interim data released for the Sputnik V adenovirus-based vaccine.
COVID-19 Rapid Diagnostic test results and their associations with certain factors among the residents of Balochistan
Authors: Larik Ehsan , Arif Muhammad , Saeed Abid , Baig Mirza Amir , Hussain Zakir , Chaudhary Ambreen , Baig Zeeshan Iqbal , Bugti Zubair , Inayat Jan , Muhammad Khair , Abdullah Muhammad , Ahmed Zubair , Qurat-ul-ain  , Kakar Aftab , Sheik Nasir 
Published: December 2020

AbstractBackgroundThis paper analyses any possible association of various factors like gender, last COVID-19 PCR test results, BCG Vaccination, Seasonal Flu vaccination, Occupation and confirmed case contact history with COVID-19 RDT results of the participants. COVID-19 will soon become endemic in Pakistan, the government should adopt COVID-19 RDT kits for trace, test and quarantine activities.MethodologyConsidering the availability of COVI-19 rapid diagnostic kits, 596 individuals all previously COVID-19 PCR tested were made part of this cross sectional study. Simple random sampling was used for the selection of study participants. The whole study was conducted during September and October 2020.ResultsThe major findings of this study is clearly showing that the Positive Likely hood ratio of the COVID-19 RDT Kits (LR+) is well above 1; similarly the Negative Likely hood ratio is approaching 0.On the other hand the Sensitivity and Specificity 80% and 74% respectively. Similarly study found statistically significant association was between RDT out comes and Last PCR Test status, Occupation and Contact with COVID-19 positive individuals. While other variables like Gender, BCG Vaccination and history of seasonal flu vaccinations were found to have no significant associations with COVID-19 RDT Kit out comes.ConclusionBeing the first study of its kind in Pakistan the major findings of this study are almost in line with the set hypothesis and objectives of this study and based on study findings it will be of high value to use COVID-19 RDT kits during mass screening especially during Test, Trace and Quarantine activities.
Why the SARS-CoV-2 antibody test results may be misleading: insights from a longitudinal analysis of COVID-19
Authors: Taubel Jorg , Cole Samuel Thomas , Spencer Christopher S. , Freier Anne , Camilleri Dorothée , Lorch Ulrike 
Published: December 2020

AbstractTo estimate the effectiveness of vaccines in development, a robust mechanism is required to understand immunity, risks of reinfection and measure the immune response to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and how this may change over time. This study is a longitudinal analysis of COVID-19 infection rates using PCR, membrane immunoassay and chemiluminescent microparticle immunoassay (CMIA) diagnostic tests. Our data confirm that antibody levels wane in the three months after symptom onset. Comparison of the three methods used suggests that quantitative CMIA testing may exaggerate numbers of COVID-19 negative individuals.
Sex differences in genetic and environmental influences on frailty and its relation to body mass index and education
Authors: Mak Jonathan K. L. , Reynolds Chandra A. , Hägg Sara , Li Xia , Ericsson Malin , Pedersen Nancy L. , Jylhävä Juulia , Kuja-Halkola Ralf 
Published: December 2020

AbstractBackgroundFrailty is a multifactorial expression of aging influenced by numerous genetic and environmental factors. However, sex differences in how these factors may affect frailty, and the gene-environment interplay among frailty and two of its well-established risk factors, unhealthy body mass index (BMI) and low education, are less clear.MethodsIn a large sample of 42,994 Swedish twins aged 41–99 years, we used structural equation models to estimate the genetic (heritability) and environmental sources of variance in frailty, defined as the Rockwood frailty index (FI), separately in men and women. We also estimated the genetic and environmental contributions to the associations between FI and BMI, and FI and education. Moderation models were fitted to test for gene-environment interaction by levels of BMI and education.ResultsGenetic and individual-specific environmental factors contributed approximately equally to the FI variance. The heritability of FI was slightly higher in women (52%) than in men (45%), yet we found only weak-to-no indication of different sources of genetic variance influencing frailty in men and women. A small-to-moderate genetic overlap between FI and BMI, and a perfect negative correlation of the environmental factors common to twins in a pair between FI and education were observed. Additionally, the heritability of FI was greater at both low and high BMI levels, with similar patterns of moderation in both sexes.ConclusionsIndividual differences in frailty are equally influenced by genetic and individual-specific environmental factors, and different mechanisms seem to underlie the association of frailty with BMI and education.
Geographic variation in work disability burden: Identifying hotspots, coldspots, and associated sociodemographic factors
Authors: Lane Tyler J , Collie Alex 
Published: December 2020

ABSTRACTObjectivesTo identify geographic hotspots and coldspots of work disability burden and associated sociodemographic factors in Australia.MethodsUsing Australian workers’ compensation and census data, we calculated weeks of compensated time off work per 1,000 labour force at Statistical Area Level 4, an indicator of work disability burden. Records included all claims with at least one day of compensated time off work lodged between 2010 and 2015. Work disability burden was z-transformed by state and mapped across Australia. Statistical Areas ≥ 1.5 standard deviations from the state/territory mean were considered hotspots and coldspots. We tested several sociodemographic factors as predictors of work disability burden.ResultsWork disability burden hotspots were concentrated in lower socioeconomic suburbs and exurbs of state capitals, plus several regional areas. Coldspots were primarily in wealthy central urban and suburban areas. Factors associated with greater work disability burden include socioeconomic disadvantage, rurality, lower labour force participation, higher unemployment, and more people with core activity limitations, aged 65+ years, and aged 65+ but fewer foreign-born.ConclusionsWork disability burden is unequally distributed across Australia and strongly influenced by sociodemographic factors. The findings can guide more efficient allocation of resources for primary and secondary work disability prevention and rehabilitation.
Artificial intelligence-enabled analysis of UK and US public attitudes on Facebook and Twitter towards COVID-19 vaccinations
Authors: Hussain Amir , Tahir Ahsen , Hussain Zain , Sheikh Zakariya , Gogate Mandar , Dashtipour Kia , Ali Azhar , Sheikh Aziz 
Published: December 2020

AbstractBackgroundGlobal efforts towards the development and deployment of a vaccine for SARS-CoV-2 are rapidly advancing. We developed and applied an artificial-intelligence (AI)-based approach to analyse social-media public sentiment in the UK and the US towards COVID-19 vaccinations, to understand public attitude and identify topics of concern.MethodsOver 300,000 social-media posts related to COVID-19 vaccinations were extracted, including 23,571 Facebook-posts from the UK and 144,864 from the US, along with 40,268 tweets from the UK and 98,385 from the US respectively, from 1st March - 22nd November 2020. We used natural language processing and deep learning based techniques to predict average sentiments, sentiment trends and topics of discussion. These were analysed longitudinally and geo-spatially, and a manual reading of randomly selected posts around points of interest helped identify underlying themes and validated insights from the analysis.ResultsWe found overall averaged positive, negative and neutral sentiment in the UK to be 58%, 22% and 17%, compared to 56%, 24% and 18% in the US, respectively. Public optimism over vaccine development, effectiveness and trials as well as concerns over safety, economic viability and corporation control were identified. We compared our findings to national surveys in both countries and found them to correlate broadly.ConclusionsAI-enabled social-media analysis should be considered for adoption by institutions and governments, alongside surveys and other conventional methods of assessing public attitude. This could enable real-time assessment, at scale, of public confidence and trust in COVID-19 vaccinations, help address concerns of vaccine-sceptics and develop more effective policies and communication strategies to maximise uptake.
Characterizing the Dynamic of COVID-19 with a New Epidemic Model: Susceptible-Exposed-Symptomatic-Asymptomatic-Active-Removed
Authors: Yi Grace Y , Hu Pingbo , He Wenqing 
Published: December 2020

AbstractThe coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spread stealthily and presented a tremendous threat to the public. It is important to investigate the transmission dynamic of COVID-19 to help understand the impact of the disease on public health and economy. While a number of epidemic models have been available to study infectious diseases, they are in-adequate to describe the dynamic of COVID-19. In this paper, we develop a new epidemic model which utilizes a set of ordinary differential equations with unknown parameters to delineate the transmission process of COVID-19. Different from the traditional epidemic models, this model accounts for asymptomatic infections as well the lag between symptoms onset and the confirmation date of infection. We describe an estimation procedure for the unknown parameters in the proposed model by adapting the iterated filter-ensemble adjustment Kalman filter (IF-EAKF) algorithm to the reported number of confirmed cases. To assess the performance of our proposed model, we examine COVID-19 data in Quebec for the period of April 2, 2020 to May 10, 2020 and carry out sensitivity studies under a variety of assumptions. To reflect the transmission potential of an infected case, we derive the basic reproduction number from the proposed model. The estimated basic reproduction number suggests that the pandemic situation in Quebec for the period of April 2, 2020 to May 10, 2020 is not under control.
SARS-CoV-2 Viral Load in Saliva Rises Gradually and to Moderate Levels in Some Humans
Authors: Winnett Alexander , Cooper Matthew M. , Shelby Natasha , Romano Anna E. , Reyes Jessica A. , Ji Jenny , Porter Michael K. , Savela Emily S. , Barlow Jacob T. , Akana Reid , Tognazzini Colten , Feaster Matthew , Goh Ying-Ying , Ismagilov Rustem F. 
Published: December 2020

AbstractTransmission of SARS-CoV-2 in community settings often occurs before symptom onset, therefore testing strategies that can reliably detect people in the early phase of infection are urgently needed. Early detection of SARS-CoV-2 infection is especially critical to protect vulnerable populations who require frequent interactions with caretakers. Rapid COVID-19 tests have been proposed as an attractive strategy for surveillance, however a limitation of most rapid tests is their low sensitivity. Low-sensitivity tests are comparable to high sensitivity tests in detecting early infections when two assumptions are met: (1) viral load rises quickly (within hours) after infection and (2) viral load reaches and sustains high levels (>105– 106 RNA copies/mL). However, there are no human data testing these assumptions. In this study, we document a case of presymptomatic household transmission from a healthy young adult to a sibling and a parent. Participants prospectively provided twice-daily saliva samples. Samples were analyzed by RT-qPCR and RT-ddPCR and we measured the complete viral load profiles throughout the course of infection of the sibling and parent. This study provides evidence that in at least some human cases of SARS-CoV-2, viral load rises slowly (over days, not hours) and not to such high levels to be detectable reliably by any low-sensitivity test. Additional viral load profiles from different samples types across a broad demographic must be obtained to describe the early phase of infection and determine which testing strategies will be most effective for identifying SARS-CoV-2 infection before transmission can occur.One sentence summaryIn some human infections, SARS-CoV-2 viral load rises slowly (over days) and remains near the limit of detection of rapid, low-sensitivity tests.
Through The Back Door: Expiratory Accumulation Of SARS-Cov-2 In The Olfactory Mucosa As Mechanism For CNS Penetration
Authors: Pipolo Carlotta , Bulfamante Antonio Mario , Schillaci Andrea , Banchetti Jacopo , Castellani Luca , Saibene Alberto Maria , Felisati Giovanni , Quadrio Maurizio 
Published: December 2020

AbstractIntroductionSARS-CoV-2 is a respiratory virus supposed to enter the organism through aerosol or fomite transmission to the nose, eyes and oropharynx. It is responsible for various clinical symptoms, including hyposmia and other neurological ones. Current literature suggests the olfactory mucosa as a port of entry to the CNS, but how the virus reaches the olfactory groove is still unknown. Because the first neurological symptoms of invasion (hyposmia) do not correspond to first signs of infection, the hypothesis of direct contact through airborne droplets during primary infection and therefore during inspiration is not plausible. The aim of this study is to evaluate if a secondary spread to the olfactory groove in a retrograde manner during expiration could be more probable.MethodsFour three-dimensional virtual models were obtained from actual CT scans and used to simulate expiratory droplets. The volume mesh consists of 25 million of cells, the simulated condition is a steady expiration, driving a flow rate of 270 ml/s, for a duration of 0.6 seconds. The droplet diameter is of 5 μm.ResultsThe analysis of the simulations shows the virus to have a high probability to be deployed in the rhinopharynx, on the tail of medium and upper turbinates. The possibility for droplets to access the olfactory mucosa during the expiratory phase is lower than other nasal areas, but consistent.DiscussionThe data obtained from these simulations demonstrates the virus can be deployed in the olfactory groove during expiration. Even if the total amount in a single act is scarce, it must be considered it is repeated tens of thousands of times a day, and the source of contamination continuously acts on a timescale of several days. The present results also imply CNS penetration of SARS-CoV-2 through olfactory mucosa might be considered a complication and, consequently, prevention strategies should be considered in diseased patients.