bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic accuracy of the 4AT for delirium detection: systematic review and meta-analysis
Authors: Tieges Zoë , MacLullich Alasdair M. J. , Anand Atul , Brookes Claire , Cassarino Marica , O’Connor Margaret , Ryan Damien , Saller Thomas , Arora Rakesh C. , Chang Yue , Agarwal Kathryn , Taffet George , Quinn Terence , Shenkin Susan. D. , Galvin Rose 
Published: June 2020

ABSTRACTObjectiveDetection of delirium in hospitalised older adults is recommended in national and international guidelines. The 4 ‘A’s Test (4AT) is a short (<2 min) instrument for delirium detection that is used internationally as a standard tool in clinical practice. We performed a systematic review and meta-analysis of diagnostic test accuracy of the 4AT for delirium detection.MethodsWe searched MEDLINE, EMBASE, PsycINFO, CINAHL,clinicaltrials.govand the Cochrane Central Register of Controlled Trials, from 2011 (year of 4AT release on the websitewww.the4AT.com) until 21 December 2019. Inclusion criteria were: older adults (≥ 65y); diagnostic accuracy study of the 4AT index test when compared to delirium reference standard (standard diagnostic criteria or validated tool). Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled estimates of sensitivity and specificity were generated from a bivariate random effects model.Results17 studies (3702 observations) were included. Settings were acute medicine, surgery, a care home, and the emergency department. Three studies assessed performance of the 4AT in stroke. The overall prevalence of delirium was 24.2% (95% CI 17.8-32.1%; range 10.5-61.9%). The pooled sensitivity was 0.88 (95% CI 0.80-0.93) and the pooled specificity was 0.88 (95% CI 0.82-0.92). Excluding the stroke studies, the pooled sensitivity was 0.86 (95% CI 0.77-0.92) and the pooled specificity was 0.89 (95% CI 0.83-0.93). The methodological quality of studies varied but was moderate to good overall.ConclusionsThe 4AT shows good diagnostic test accuracy for delirium in the 17 available studies. These findings support its use in routine clinical practice in delirium detection.PROSPERO Registration number CRD42019133702.Key pointsThe 4AT is a short delirium assessment tool that is widely used internationally in clinical practice.This systematic review and meta-analysis of diagnostic accuracy studies of the 4AT included 3702 observations in 17 studies from nine countries.Studies recruited from a range of settings including the Emergency Department, and medical, stroke, and surgical wards.The 4AT had a pooled sensitivity of 0.88 and pooled specificity of 0.88.The methodological quality of studies varied but was moderate to good overall.
Assessing the influence of parental anxiety on childhood anxiety during the COVID-19 pandemic in the United Arab Emirates
Authors: Saddik Basema , Hussein Amal , Albanna Ammar , Elbarazi Iffat , Al-Shujairi Arwa , Sharif-Askari Fatemeh Saheb , Temsah Mohamad-Hani , Stip Emmanuel , Hamid Qutayba , Halwani Rabih 
Published: June 2020

AbstractThe COVID-19 pandemic originated in Wuhan, China on December 31st and spread into international borders, leading to a public health crisis and complete shutdown of countries. The strict quarantine measures taken by governments kept a large number of people, around the world, in isolation and affected many aspects of people’s lives. These unprecedented changes triggered a wide variety of psychological problems ranging from panic disorders, anxiety and depression. In this study, we aim to explore anxiety levels among parents, teachers and the general community amid the COVID-19 pandemic in the UAE, as well as identify emotional and anxiety disorders in children. Using a web-based cross-sectional survey we collected data from 2,200 self-selected assessed volunteers. Demographic information, knowledge and beliefs about COVID-19, generalized anxiety disorder (GAD) using the (GAD-7) scale, emotional problems in children using the strengths and difficulties questionnaire (SDQ), worry and fear about COVID-19, coping mechanisms and general health information were collected. The overall prevalence of GAD in the general population was 71% with younger people (59.8%) and females (51.7%) reporting the highest levels of anxiety. Parents who were teachers reported the highest percentage of emotional problems in children (26.7%) compared to parents only (14.6%) or teachers only (4.7%). Multivariate logistic regression for GAD-7 score showed that females, participants who felt public fear was justifiable, persons who worried about COVID-19, persons who intended to take the COVID-19 vaccine and smokers were all associated with anxiety. Multivariate logistic regression for SDQ showed parents who had severe anxiety levels were 7 times more likely to report more emotional problems in their children (OR=7.00, 95% CI, 3.45 to 14.0) than less anxious parents. Findings suggest the urgency of policy makers to develop effective screening and coping strategies for parents and teachers and more specifically for vulnerable children.
Mediation analysis in sibling designs: an application to the effect of prenatal antidepressant exposure on toddler depression mediated by gestational age at birth
Authors: Wood Mollie E. , Eilertsen Espen , Ystrom Eivind , Nordeng Hedvig , Hernandez-Diaz Sonia 
Published: June 2020

AbstractBackgroundMediation analysis requires strong assumptions of no unmeasured confounding. Sibling designs offer a method for controlling confounding shared within families, but no previous research has done mediation analysis using sibling models.MethodsWe demonstrate the validity of the sibling mediation approach using simulation, and show its application using the example of prenatal antidepressant exposure and toddler anxiety and depression, with gestational age at birth as a mediator. We used data from the Norwegian Mother and Child Cohort Study, a cohort comprising 41% of births in Norway between 1999 and 2008 to identify 91,333 pregnancies, of which 25,776 were part of sibling groups.ResultsIn simulations, sibling models were less biased than cohort models in cases where non-shared confounding was weaker than shared confounding, and when stronger non-shared confounding was controlled, but more biased otherwise. In the full cohort, the estimated mean difference in depression/anxiety scale z-scores for natural direct effects (NDE) were 0.31 (95% confidence interval 0.23 to 0.39) and 0.14 (95% CI 0.03 to 0.24), without and with adjustment for non-shared confounders, respectively. The natural indirect effect was 0.01 (95% CI 0.00 to 0.02) after adjustment. Adjustment for shared and non-shared confounding showed similar point estimates with wider confidence intervals (NDE 0.18, 95% CI −0.21 to 0.47; NIE −0.01, 95% CI −0.06 to 0.06).ConclusionsFindings suggest that the modest association between prenatal antidepressant exposure and anxiety/depression is not mediated by gestational age and is likely explained by both shared confounders and non-shared confounders, and chance.
COVID-19 pandemic-related lockdown: response time is more important than its strictness
Authors: Loewenthal Gil , Abadi Shiran , Avram Oren , Halabi Keren , Ecker Noa , Nagar Natan , Mayrose Itay , Pupko Tal 
Published: June 2020

AbstractThe rapid spread of SARS-CoV-2 and its threat to health systems worldwide have led governments to take acute actions to enforce social distancing. Previous studies used complex epidemiological models to quantify the effect of lockdown policies on infection rates. However, these rely on prior assumptions or on official regulations. Here, we use country-specific reports of daily mobility from people cellular usage to model social distancing. Our data-driven model enabled the extraction of mobility characteristics which were crossed with observed mortality rates to show that: (1) the time at which social distancing was initiated is of utmost importance and explains 62% of the number of deaths, while the lockdown strictness or its duration are not as informative; (2) a delay of 7.49 days in initiating social distancing would double the number of deaths; and (3) the expected time from infection to fatality is 25.75 days and significantly varies among countries.
Characterization and Prediction of Clinical Pathways of Vulnerability to Psychosis through Graph Signal Processing
Authors: Sandini Corrado , Zöller Daniela , Schneider Maude , Tarun Anjali , Armando Marco , Nelson Barnaby , Mallawaarachchi Sumudu Rasangi , Amminger G. Paul , Farhall John , Bolt Luke K. , Yuen Hok Pan , Markulev Connie , Schäfer Miriam R. , Mossaheb Nilufar , Schlögelhofer Monika , Smesny Stefan , Hickie Ian B. , Berger Gregor Emanuel , Chen Eric Y.H. , de Haan Lieuwe , Nieman Dorien H. , Nordentoft Merete , Riecher-Rössler Anita , Verma Swapna , Thompson Andrew , Yung Alison Ruth , Allott Kelly A. , McGorry Patrick D. , Van De Ville Dimitri , Eliez Stephan 
Published: June 2020

AbstractThere is a growing recognition that psychiatric symptoms have the potential to causally interact with one another. Particularly in the earliest stages of psychopathology dynamic interactions between symptoms could contribute heterogeneous and cross-diagnostic clinical evolutions. Current clinical approaches attempt to merge clinical manifestations that co-occur across subjects and could therefore significantly hinder our understanding of clinical pathways connecting individual symptoms. Network approaches have the potential to shed light on the complex dynamics of early psychopathology. In the present manuscript we attempt to address 2 main limitations that have in our opinion hindered the application of network approaches in the clinical setting. The first limitation is that network analyses have mostly been applied to cross-sectional data, yielding results that often lack the intuitive interpretability of simpler categorical or dimensional approaches. Here we propose an approach based on multi-layer network analysis that offers an intuitive low-dimensional characterization of longitudinal pathways involved in the evolution of psychopathology, while conserving high-dimensional information on the role of specific symptoms. The second limitation is that network analyses typically characterize symptom connectivity at the level of a population, whereas clinical practice deals with symptom severity at the level of the individual. Here we propose an approach based on graph signal processing that exploits knowledge of network interactions between symptoms to predict longitudinal clinical evolution at the level of the individual. We test our approaches in two independent samples of individuals with genetic and clinical vulnerability for developing psychosis.
An international assessment of the COVID-19 pandemic using ensemble data assimilation
Authors: Evensen Geir , Amezcua Javier , Bocquet Marc , Carrassi Alberto , Farchi Alban , Fowler Alison , Houtekamer Peter L. , Jones Christopher K. , de Moraes Rafael J. , Pulido Manuel , Sampson Christian , Vossepoel Femke C. 
Published: June 2020

AbstractThis work shows how one can use iterative ensemble smoothers to effectively estimate parameters of an SEIR model with age-classes and compartments of sick, hospitalized, and dead. The data conditioned on are the daily numbers of accumulated deaths and the number of hospitalized. Also, it is possible to condition on the number of cases obtained from testing. We start from a wide prior distribution for the model parameters; then, the ensemble conditioning leads to a posterior ensemble of estimated parameters leading to model predictions in close agreement with the observations. The updated ensemble of model simulations have predictive capabilities and include uncertainty estimates. In particular, we estimate the effective reproductive number as a function of time, and we can assess the impact of different intervention measures. By starting from the updated set of model parameters, we can make accurate short-term predictions of the epidemic development given knowledge of the future effective reproductive number. Also, the model system allows for the computation of long-term scenarios of the epidemic under different assumptions. We have applied the model system on data sets from several countries with vastly different developments of the epidemic, and we can accurately model the development of the COVID-19 outbreak in these countries. We realize that more complex models, e.g., with regional compartments, may be desirable, and we suggest that the approach used here should be applicable also for these models.
The global viralization of policies to contain the spreading of the COVID-19 pandemic: analyses of school closures and first reported cases
Authors: Nazif-Muñoz José Ignacio , Peña Sebastián , Oulhote Youssef 
Published: June 2020

AbstractBackgroundWith the exposure to the COVID-19 pandemic, countries swiftly implemented a variety of health policies. In this work we examine how rapid countries responded to this pandemic using two events: the day in which the first case of COVID-19 was reported, and first day in which countries used school closure as one of the measures to avoid outbreaks.MethodsWe compiled information from multiple sources, from December 31st 2019 to June 1st 2020, to trace when 172 countries reported their first COVID-19 case and implemented school closure to contain outbreaks. We applied cross-national Weibull survival analysis to evaluate the global speed of detection of first COVID-19 reported cases and school closure. We also assessed how countries’ health systems, globalization, economic development, political systems, and economic integration to China, Republic of Korea and Italy increased the speed of adoption.ResultsTen days after the World Health Organization (WHO) declared COVID-19 to be an international emergency, countries were 28 (95% CI: 12,77) times more likely to report first COVID-19 cases and 42 (95% CI: 22,90) times more likely to close schools. One standard deviation increase in the epidemic security index rises the rate of report first cases by 37% (Hazard Ratio (HR) 1.37 (95% CI: 1.09,1.72) and delays the adoption for school closures by 36% (HR 0.64 (95% CI:0.50,0.82). One standard deviation increase in the globalization index augments the adoption for school closures by 74% (HR 1.74 (95% CI:1.34,2.24).ConclusionAfter the WHO declared a global emergency, countries were unprecedently acting very rapidly. While countries more globally integrated were swifter in closing schools, countries with better designed health systems to tackle epidemics were slower in adopting it. More studies are needed to assess how the speed of school closures and other policies will affect the development of the pandemic.
They stumble that run fast: the economic and COVID-19 transmission impacts of reopening industries in the US
Authors: Zimmermann Marita , Benefield Amy E , Althouse Benjamin M 
Published: June 2020

AbstractCOVID-19 has laid bare the United States economically and epidemiologically. Decisions must be made as how and when to reopen industries. Here we quantify economic and health risk tradeoffs of reopening by industry for each state in the US. To estimate total economic impact, we summed income loss due to unemployment and profit loss. We assess transmission risk by: (1) workplace size, (2) human interactions, (3) inability to work from home, and (4) industry size. We found that the industry with the highest estimated economic impact from COVID-19 was manufacturing in 40 states; the industry with the largest transmission risk index was accommodation and food services in 41 states, and the industry with the highest economic impact per unit of transmission risk, interpreted as the value of reopening, was manufacturing in 37 states. Researchers and decision makers must work together to consider both health and economics when making tough decisions.O, let us hence; I stand on sudden haste.Wisely and slow; they stumble that run fast.-William Shakespeare, Romeo and Juliet, Act II, scene 3
Comorbidity and Sociodemographic determinants in COVID-19 Mortality in an US Urban Healthcare System
Authors: Wang An-Li , Zhong Xiaobo , Hurd Yasmin L 
Published: June 2020

ABSTRACTBackgroundNew York City is the US epicenter of the coronavirus disease 2019 (COVID-19) pandemic. Early international data indicated that comorbidity contributes significantly to poor prognosis and fatality in patients infected with SARS-CoV-2. It is not known to what degree medical comorbidity and sociodemographic determinants impact COVID-19 mortality in the US.MethodsEvaluation of de-identified electronic health records of 7,592 COVID-19 patients confirmed by SARS-CoV-2 lab tests in New York City. Medical comorbidites and outcome of mortality, and other covariates, including clinical, sociodemographic, and medication measures were assessed by bivariate and multivariate logistic regression models.ResultsOf common comorbid conditions (hypertension, chronic kidney disease, chronic obstructive pulmonary disease, asthma, obesity, diabetes, HIV, cancer), when adjusted for covariates, chronic kidney disease remained significantly associated with increased odds of mortality. Patients who had more than one comorbidities, former smokers, treated with Azithromycin without Hydroxychloroquine, reside within the boroughs of Brooklyn and Queens Higher had higher odds of death.ConclusionsIncreasing numbers of comorbid factors increase COVID-19 mortality, but several clinical and sociodemographic factors can mitigate risk. Continued evaluation of COVID-19 in large diverse populations is important to characterize individuals at risk and improve clinical outcomes.
Estimation of global case fatality rate of coronavirus disease 2019 (COVID-19) using meta-analyses: Comparison between calendar date and days since the outbreak of the first confirmed case
Authors: Ghayda Ramy Abou , Lee Keum Hwa , Han Young Joo , Ryu Seohyun , Hong Sung Hwi , Yoon Sojung , Jeong Gwang Hun , Lee Jinhee , Lee Jun Young , Yang Jae Won , Effenberger Maria , Eisenhut Michael , Kronbichler Andreas , Solmi Marco , Li Han , Jacob Louis , Koyanagi Ai , Radua Joaquim , Shin Jae Il , Smith Lee 
Published: June 2020

AbstractSince the outbreak of the coronavirus disease 2019 (COVID-19) in December of 2019 in China, the estimation of the pandemic’s case fatality rate (CFR) has been the focus and interest of many stakeholders. In this manuscript, we prove that the method of using the cumulative CFR is static and does not reflect the trend according to the daily change per unit of time. A proportion meta-analysis was carried out on CFR in every country reporting COVID-19 cases. Based on the results, we performed a meta-analysis for global COVID-19 CFR. Each analysis was performed on two different calculations of CFR: according to calendar date and according to days since the outbreak of the first confirmed case. We thus explored an innovative and original calculation of CFR concurrently based on the date of the first confirmed case as well as on a daily basis. For the first time, we showed that using meta-analyses, according to calendar date and days since the outbreak of the first confirmed case were different. We propose that CFR according to days since the outbreak of the first confirmed case might be a better predictor of the current CFR of COVID-19 and its kinetics.
The role of social solidarity in the rise and decline of the South Korean student movement in the 1970–1990s
Authors: Park Sung-Lim 
Published: June 2020

PurposeThe purpose of this paper is to identify the cause how the student movement in South Korea enjoyed the golden age in the 1970–1990s and could not be revived since the late 1990s and cannot be played a pivotal role again.Design/methodology/approachThis study adopts historical analysis as primary methodology, traced the historical evolution of South Korean student activism in the 1970–1990s through analyzing secondary Korean literature and newspaper on the particular struggle cases in the period.FindingsSocial solidarity between society and student had played a pivotal role in the South Korean students' long activism in the struggle of the 1970–1990s. In the 1970–1980s, democratic election and constitutional reform set in the main purpose of struggle that attracted wide support from society and enjoyed maintaining a new member supply and their commitment despite authoritarian government's persistent oppression. When the sixth constitution was passed in 1987 with Democratization, the student decided to choose continuing struggle and set social cooperation with North Korea as the new goal, the sensitive issue in South Korea that confronted fierce criticism. Society chose to withdraw their support to the activism in the Yonsei University incident of 1996, rung a knell of long struggle since the 1970s.Originality/valueThe research identified the cause how South Korean students in university could persist long strike without particular internal resource production during three decades and ended the long struggle in the late 1990s; the existence of social solidarity between student and society was the main reason of continued new member supply and their commitment in the battle.
Homo moralis and Homo economicus: scale development and validation of consumers' moral preferences
Authors: Lee Jihyun 
Published: June 2020

PurposeThe purpose of this study is to develop and validate scales measuring two consumer moral preferences: Homo moralis and Homo economicus.Design/methodology/approachThis research includes four sequential studies. Before the first study, items were established through a comprehensive literature review and pre-test. Four studies were then conducted to verify the validity and reliability of the scales following the scale validation methodology suggested by Churchill (1979) and Anand and Kaur (2018). Study 1 employed exploratory factor analysis to extract the underlying factor structure of the scale. This led to a two-factor structure with sufficient evidence of internal reliability. Study 2 and Study 3 were conducted to confirm the reliability and the validity of the scale using confirmatory factor analysis and Cronbach's alpha. The final study established the predictive validity of the scale using a structural equation model.FindingsFinally, seven items were developed measuring consumers' moral preferences for Homo moralis and Homo economicus.Research limitations/implicationsThis research has some limitations that should be addressed in future research. First, the scale was only tested in a Korean context. Second, this study was not conducted in the context of a specific industry.Originality/valueThis study extends the range of research to an empirical field by practically verifying how these two preferences are independent, can be generalized and can influence human behavior. This study empirically demonstrates that the preferences affect human behavior such as purchase intention. This study extends the current knowledge on Homo moralis and Homo economicus by providing a scale for empirical validation of the concepts.