bluuebunny/crossref_metadata_2025_split huggingface dataset:
Willingness to Get a COVID-19 Vaccine and Reasons for Hesitancy Among Medicare Beneficiaries: Results From a National Survey
Authors: Luo Huabin , Qu Haiyan , Basu Rashmita , Rafferty Ann P. , Patil Shivajirao P. , Cummings Doyle M. 
Published: June 2021

Objectives:
To assess (1) the willingness to get a COVID-19 vaccine among Medicare beneficiaries, (2) the associated factors, and (3) the reasons for vaccine hesitancy.

Methods:
Data were taken from the Medicare Current Beneficiary Survey (MCBS) 2020 Fall COVID-19 Supplement, conducted October-November 2020. Willingness to get a COVID-19 vaccine was measured by respondents' answer to whether they would get a COVID-19 vaccine when available. We classified responses of “definitely” and “probably” as “willing to get,” and responses “probably not,” “definitely not,” and “not sure” as “vaccine hesitancy.” Reasons for vaccine hesitancy were assessed by a series of yes/no questions focusing on 10 potential reasons. The analytical sample included 6715 adults 65 years and older. We conducted a logistic regression model to assess demographic factors and other factors associated with the willingness to get a COVID-19 vaccine. All analyses were conducted in Stata 14 and accounted for the complex survey design of MCBS.

Results:
Overall, 61.0% (95% confidence interval [CI], 59.1-63.0) of Medicare beneficiaries would be willing to get a vaccine when available. Among those who were hesitant, more than 40% reported that mistrust of the government and side effects as the main reasons. Logistic regression model results showed that non-Hispanic Blacks (adjusted odds ratio [AOR] = 0.33; 95% CI, 0.24-0.44) and Hispanics (AOR = 0.60; 95% CI, 0.47-0.77) were less willing to get a vaccine than non-Hispanic Whites; beneficiaries with an income of less than $25 000 (AOR = 0.71; 95% CI, 0.62-0.81) were less willing to get the vaccine than those with an income of $25 000 or more; those who did not think that the COVID-19 virus was more contagious (AOR = 0.53; 95% CI, 0.41-0.69) or more deadly (AOR = 0.51; 95% CI, 0.41-0.65) were also less willing to get the vaccine than those who thought that the virus was more contagious or more deadly than the influenza virus.

Conclusions:
The 2020 MCBS survey data showed that close to 40% of Medicare beneficiaries were hesitant about getting a COVID-19 vaccine, and the hesitancy was greater in racial/ethnic minorities. Medicare beneficiaries were concerned about the safety of the vaccine, and some appeared to be misinformed. Evidence-based educational and policy-level interventions need to be implemented to further promote COVID-19 vaccination.
Interrelationships Between Oxidative Stress, Cytokines, and Psychotic Symptoms and Executive Functions in Patients With Chronic Schizophrenia
Authors: Wu Zhi Wei , Yu Hong Hua , Wang Xuan , Guan Heng Yong , Xiu Mei Hong , Zhang Xiang Yang 
Published: June 2021

ABSTRACT

Objective
Accumulating evidence has demonstrated that the pathophysiology of schizophrenia is involved in various abnormalities in oxidative stress markers and cytokines closely related to synaptic plasticity. However, the interactive effects among key cytokines, oxidative stress, and executive dysfunction and symptoms of schizophrenia have not been investigated yet.

Methods
A total of 189 patients with chronic schizophrenia and 60 controls were recruited in the current study. Tumor necrosis factor α (TNF-α), interleukin (IL)-8, IL-6, and IL-2 levels; catalase, glutathione peroxidase, and superoxide dismutase (SOD) activities; and malondialdehyde (MDA) levels were determined in patients and controls. Executive function was evaluated by the Wisconsin card sorting tests, the verbal fluency tests, and the Stroop word-color test. Clinical symptoms were evaluated by the Positive and Negative Syndrome Scale.

Results
Relative to the controls, the patients had lower activities of SOD and glutathione peroxidase and levels of TNF-α, but higher levels of MDA, IL-8, IL-6, and IL-2 (all p values < .05). A significant negative relationship between SOD activity and IL-8 levels was found only in patients (β = −0.44, p = .008). Furthermore, we found that an interactive effect of low TNF-α level and high MDA level was associated with negative symptoms (β = −0.02, p = .01). Moreover, the interactive effects of IL-8 and MDA or IL-8 and SOD were correlated with executive function only in patients (β = 0.23, p = .02; β = 0.09, p = .03).

Conclusions
Our findings suggest that the interrelationships between oxidative stress markers and cytokines occur in schizophrenia patients, which may be the basis of their pathological mechanisms underlying clinical symptoms and cognitive dysfunction.
Technique for Reduced Trocar Decapsulation of a Giant Nonparasitic Splenic Cyst
Authors: Dapri Giovanni , Arts Sophie 
Published: June 2021

Background:
Minimally invasive surgery is adopted for patients presenting benign splenic cysts. Reduced port laparoscopy is an evolution of conventional laparoscopy, which can be applied for splenic cysts as well. In this video, a 3-trocar laparoscopic decapsulation of a giant nonparasitic splenic cyst is reported.

Case Report:
A 16-year-old man, without history of trauma or abdominal surgery, suddenly presented abdominal pain in the left hypochondrium, associated to fever and hyperleukocytosis. A thoracoabdominal computed tomography scan showed a giant cyst of the upper pole of the spleen; serum tumor markers carcinoembryonic antigen and carbohydrate antigen 19-9 were negatives. Any preoperative vaccine was prescribed.

Results:
Operative time was 130 minutes, and operative bleeding 10 mL. No additional trocar or conversion to laparotomy was necessary. Postoperatively, 4 g of paracetamol were used for 2 days, when the patient was discharged. Pathology confirmed the nonparasitic epidermoid splenic cyst. At 18 months, the patient is fine, without symptoms and without disease’s recurrence.

Conclusions:
Decapsulation of a giant nonparasitic splenic cyst is feasible to be performed by 3-trocar laparoscopy. This technique allows to improve the patient’s comfort and the cosmetic results, to reduce the postoperative pain and to finally avoid a preoperative vaccine.
Aberrant cerebral intrinsic activity and cerebro-cerebellar functional connectivity in right temporal lobe epilepsy: a resting-state functional MRI study
Authors: Zhou Xia , Liu Jinping , Zhang Zhao , Qin Lu , Pang Xiaomin , Yu Lu , Zheng Jinou 
Published: June 2021

Objective
Numerous neuroimaging studies have demonstrated that functional brain aberrations are associated with cognitive impairments in temporal lobe epilepsy (TLE). Here, we aimed to investigate the neural substrates of attention deficits by combining assessment of regional intrinsic brain activities with large-scale functional connectivity in patients with right TLE (rTLE).

Methods
Thirty-five patients with rTLE and 33 matched healthy controls were recruited. All participants completed the Attention Network Test (ANT) and resting-sate functional MRI (rs-fMRI) scans. The z-standardized fractional amplitude of the low-frequency fluctuation (zfALFF) approach was applied to evaluate the brain’s intrinsic activity. The cerebral regions with significant zfALFF values were selected as seeds for subsequent functional connectivity analyses. A correlation analysis was performed between functional activity and clinical variables.

Results
Compared with the healthy control group, the patients showed decreased zfALFF in the right inferior temporal gyrus and bilateral superior parietal gyrus, and the right inferior temporal gyrus exhibited increased functional connectivity with the bilateral cerebellum-6/vermis-6 and decreased functional connectivity with right superior frontal gyrus. The ANT indicated that the rTLE group exhibited attention deficits. Furthermore, a positive correlation was found between the zfALFF value of the left superior parietal gyrus and alerting performance, while a negative correlation between the zfALFF value of the right superior parietal gyrus and disease duration.

Conclusion
This study demonstrated aberrant intrinsic cerebral activity and functional connectivity in the whole brain network, which may act as responsible and compensatory factors in attention deficits, especially further profoundly illuminated the compensatory role of cerebellum in patients with rTLE.
The Female Predominant Persistent Immune Dysregulation of the Post COVID Syndrome: A Cohort Study
Authors: Ganesh Ravindra , Grach Stephanie L , Bierle Dennis M. , Salonen Bradley R , Collins Nerissa M , Joshi Avni Y , Boeder Neal , Anstine Christopher V , Mueller Michael R , Wight Elizabeth C , Croghan Ivana T , Badley Andrew D , Carter Rickey E , Hurt Ryan T 
Published: June 2021

AbstractObjectiveTo describe the clinical data from the first 107 patients seen in the Mayo Clinic Post COVID-19 Care Clinic (PCOCC).Patients and MethodsAfter IRB approval, we reviewed the charts of 107 patients seen between January 19, 2021 and April 29, 2021 in the Mayo Clinic Post COVID Care Clinic (PCOCC) in order to describe the first 107 patients treated through the Mayo Clinic PCOCC. Data was abstracted from the electronic medical record into a standardized database to facilitate analysis. Phenotypes of patients seen in the PCOCC clinic were identified by expert review of predominant symptom clusters.ResultsThe majority of patients seen in our clinic were female (75%, 80/107), and the median age at presentation was 47 years (interquartile range [IQR] 37, 55). All had Post Acute Sequelae of SARS-CoV-2 infection (PASC) with six clinical phenotypes being identified – fatigue predominant (n=68), dyspnea predominant (n=23), myalgia predominant (n=6), orthostasis predominant (n=6), chest pain predominant (n=3), and headache predominant (n=1). The fatigue-predominant phenotype was more common in women (84%, p=0.006) and the dyspnea-predominant phenotype was more common in men (52%, p=0.002). IL-6 was elevated in 61% of patients (69% of women, p=0.0046) which was statistically discordant with elevation in CRP and ESR which was identified in 17% and 20% of cases respectively (p<0.001). Four PASC phenotypes (fatigue-predominant, myalgia-predominant, orthostasis predominant, and headache-predominant) were associated with central sensitization (CS), and higher IL-6 levels than those phenotypes not associated with CS (p=0.013). Patients with CS phenotypes after COVID-19 infection (post COVID syndrome) were predominantly female (80%, p=0.0085).ConclusionIn our post COVID clinic, we observed several distinct clinical phenotypes. Fatigue-predominance was the most common presentation and was associated with elevated IL-6 levels and female gender. Dyspnea-predominance was more common in men and was not associated with elevated IL-6 levels. IL-6 levels were significantly elevated in patients with PASC and discordant with ESR and CRP, particularly in those with central sensitization phenotypes.
Clinical validation of colorimetric RT-LAMP, a fast, highly sensitive and specific COVID-19 molecular diagnostic tool that is robust to detect SARS-CoV-2 variants of concern
Authors: Alves Pedro A. , Oliveira de Ellen G. , Franco-Luiz Ana Paula M. , Almeida Letícia T. , Gonçalves Amanda B. , Borges Iara A. , Rocha Flávia de S. , Rocha Raissa P. , Bezerra Matheus F. , Miranda Pâmella , Capanema Flávio D. , Martins Henrique R. , Weber Gerald , Teixeira Santuza M. R. , Wallau Gabriel Luz , do Monte-Neto Rubens L. 
Published: June 2021

AbstractThe COVID-19 pandemics unfolded due to the widespread SARS-CoV-2 transmission reinforced the urgent need for affordable molecular diagnostic alternative methods for massive testing screening. We present the clinical validation of a pH-dependent colorimetric RT-LAMP (reverse transcription loop-mediated isothermal amplification) for SARS-CoV-2 detection. The method revealed a limit of detection of 19.3 ± 2.7 viral genomic copies/μL when using RNA extracted samples obtained from nasopharyngeal swabs collected in guanidine-containing viral transport medium. Typical RT-LAMP reactions were performed at 65 ºC for 30 min. When compared to RT-qPCR, up to Ct value 32, RT-LAMP presented 97% (87.4-99.4% 95% CI) sensitivity and 100% (86.2-100%) specificity for SARS-CoV-2 RNA detection targeting N gene. No cross-reactivity was detected when testing other non-SARS-CoV virus, confirming high specificity. The test is compatible with primary RNA extraction free samples. We also demonstrated that colorimetric RT-LAMP can detect SARS-CoV-2 variants of concern (VOC) and variants of interest (VOI), such as variants occurring in Brazil named P.1, P.2, B.1.1.374 and B.1.1.371. The method meets point-of-care requirements and can be deployed in the field for high-throughput COVID-19 testing campaigns, especially in countries where COVID-19 testing efforts are far from ideal to tackle the pandemics. Although RT-qPCR is considered the gold standard for SARS-CoV-2 RNA detection, it requires expensive equipments, infrastructure and highly trained personnel. In contrast, RT-LAMP emerges as an affordable, inexpensive and simple alternative for SARS-CoV-2 molecular detection that can be applied to massive COVID-19 testing campaigns and save lives.
The Impact of COVID-19 Lockdowns on Mental Health Patient Populations: Evidence from Medical Claims Data
Authors: Ferwana Ibtihal , Varshney Lav R. 
Published: June 2021

AbstractBackgroundSocial distancing policies were enacted during March 2020 to limit the spread of COVID-19. Lockdowns and movement restrictions increased the potential of negative impact on population mental health, in which depression and anxiety symptoms were frequently reported by different population groups during COVID-19 lockdown. However, the causal relationship of mitigation policies on national-wide mental health resource usage is lacking.ObjectiveThis study investigates the effect of COVID-19 mitigation measures on mental health across the United States, on county and state levels. It examines the effect on mental health facility usage and the prevalence of mental illnesses on the total population, different age and gender groups, and patients of selected mental health diagnoses.MethodsWe used large-scale medical claims data for mental health patients dated from September 1, 2019 to December 31, 2020, with publicly available state- and county-specific COVID-19 cases from first case in January to December 31, 2020, and used publicly available lockdown dates for states and counties. We designed a difference-in-differences (DID) model, which infers the causal effect of a policy intervention by comparing pre-policy and post-policy periods in different regions. We mainly focused on two types of social distancing policies, stay-at-home and school closure orders.ResultsBased on common pre-treatment trend assumption of regions, we find that lockdown has significantly and causally increased the usage of mental health in regions with lockdowns in comparison to regions without. In regions with lockdown orders the resource usage increased by 18% compared to 1% decline in regions without a lockdown. Also, female populations have been exposed to a larger lockdown effect on their mental health with 24% increase in regions with lockdowns compared to 3% increase in regions without. While male mental health patients decreased by 5% in regions without lockdowns. Patients diagnosed withpanic disordersandreaction to severe stressboth were significantly exposed to a significant large effect of lockdowns. Also,life management difficultypatients doubled in regions with stay-at-home orders but increased less with school closures. Contrarily,attention-deficit hyperactivitypatients declined in regions without stay-at-home orders. Patients older than 80 used mental health resources less in regions with lockdowns. Adults between (21 – 40) years old were exposed to the greatest lockdown effect with increase between 20% to 30% in regions with lockdown.ConclusionAlthough non-pharmaceutical intervention policies were effective in containing the spread of COVID-19, our results show that mitigation policies led to population-wide increase in mental health patients. Our results suggest the need for greater mental health treatment resources in the face of lockdown policies.
Incidence of chikungunya virus infections among Kenyan children with neurological disease: a prospective cohort study
Authors: Nyamwaya Doris K. , Otiende Mark , Mwango Lilian , Kariuki Symon M. , Otieno Berrick , Omuoyo Donwilliams O. , Githinji George , Kitsao Barnes S. , Karanja Henry K. , Gitonga John N. , de Laurent Zaydah R. , Davies Alun , Mwarumba Salim , Agoti Charles N. , Thumbi Samuel M. , Hamaluba Mainga M. , Newton Charles R. , Bejon Philip , Warimwe George M. 
Published: June 2021

ABSTRACTBackgroundNeurological complications due to chikungunya virus (CHIKV) infection have been described in different parts of the world, with children being disproportionately affected. However, the burden of CHIKV-associated neurological disease in Africa is currently unknown.MethodsWe estimated the incidence of CHIKV infection among children hospitalised with neurological disease in coastal Kenya. We used reverse-transcriptase polymerase chain reaction (RT-PCR) to systematically test for CHIKV in cerebrospinal fluid (CSF) samples from children aged <16 years hospitalised with symptoms of neurological disease at Kilifi County Hospital between January 2014 and December 2018. Clinical records were linked to the Kilifi Health and Demographic Surveillance System and population incidence rates of CHIKV infection estimated.FindingsThere were 18,341 paediatric admissions during the 5-year study period, of which 4,332 (24%) had CSF collected. The most common clinical reasons for CSF collection were impaired consciousness, seizures and coma (47%, 22% and 21% of all collections, respectively). After acute investigations done for immediate clinical care, CSF samples were available for 3,980 admissions, of which 367 (9.2%) were CHIKV RT-PCR positive. The annual incidence of CHIKV-associated neurological disease varied between 13 to 58 episodes per 100,000 person-years among all children <16 years old. Among children aged <5 years, the incidence of CHIKV-associated neurological disease was 77 per 100,000 person-years, compared with 20 per 100,000 for cerebral malaria and 7 per 100,000 for bacterial meningitis during the study period.InterpretationAlthough not previously recognized, CHIKV-associated neurological disease is common in coastal Kenya and a significant public health burden.
Chronic distress in male mice impairs motivation compromising both effort and reward processing with altered anterior insular cortex and basolateral amygdala neural activation
Authors: Cabeza Lidia , Ramadan Bahrie , Cramoisy Stephanie , Houdayer Christophe , Haffen Emmanuel , Risold Pierre-Yves , Fellmann Dominique , Peterschmitt Yvan 
Published: June 2021

AbstractIn humans and mammals, effort-based decision-making for monetary or food rewards paradigms contribute to the study of adaptive goal-directed behaviours acquired through reinforcement learning. Chronic distress modelled by repeated exposure to glucocorticoids in rodents induces suboptimal decision-making under uncertainty by impinging on instrumental acquisition and prompting negative valence behaviours. In order to further disentangle the motivational tenets of adaptive decision-making, this study addressed the consequences of enduring distress on relevant effort and reward processing dimensions. Experimentally, appetitive and consummatory components of motivation were evaluated in adult C57BL/6JRj male mice experiencing chronic distress induced by oral corticosterone (CORT), using multiple complementary discrete behavioural tests. Behavioural data (from Novelty Supressed Feeding, operant effort-based choice, Free Feeding and Sucrose Preference tasks) collectively show that behavioural initiation, effort allocation and hedonic appreciation and valuation are altered in mice exposed to several weeks of oral CORT treatment. Additionally, data analysis from FosB immunohistochemical processing of postmortem brain samples highlight a CORT-dependent dampening of neural activation in the anterior insular cortex (aIC) and basolateral amygdala (BLA), key telencephalic brain regions involved in cue appetitive and consummatory motivational processing. Combined, these results suggest that chronic distress-induced irregular aIC and BLA neural activations with reduced effort production and attenuated reward value processing during reinforcement-based instrumental learning could result in maladaptive decision-making under uncertainty. The current study further illustrates how the stoichiometry of effort and reward processing contributes to dynamically adjust the motivational threshold triggering goal-directed behaviours in versatile environments.
Performance evaluation of virus concentration methods for implementing SARS-CoV-2 wastewater based epidemiology emphasizing quick data turnaround
Authors: Juel Md Ariful Islam , Stark Nicholas , Nicolosi Bridgette , Lontai Jordan , Lambirth Kevin , Schlueter Jessica , Gibas Cynthia , Munir Mariya 
Published: June 2021

AbstractWastewater based epidemiology (WBE) has drawn significant attention as an early warning tool to detect and predict the trajectory of COVID-19 cases in a community, in conjunction with public health data. This means of monitoring for outbreaks has been used at municipal wastewater treatment centers to analyze COVID-19 trends in entire communities, as well as by universities and other community living environments to monitor COVID-19 spread in buildings. Sample concentration is crucial, especially when viral abundance in raw wastewater is below the threshold of detection by RT-qPCR analysis. We evaluated the performance of a rapid ultrafiltration-based virus concentration method using InnovaPrep Concentrating Pipette (CP) Select and compared this to the established electronegative membrane filtration (EMF) method. We evaluated sensitivity of SARS-CoV-2 quantification, surrogate virus recovery rate, and sample processing time. Results suggest that the CP Select concentrator is more efficient at concentrating SARS-CoV-2 from wastewater compared to the EMF method. About 25% of samples that tested negative when concentrated with the EMF method produced a positive signal with the CP Select protocol. Increased recovery of the surrogate virus control using the CP Select confirms this observation. We optimized the CP Select protocol by adding AVL lysis buffer and sonication, to increase the recovery of virus. Sonication increased Bovine Coronavirus (BCoV) recovery by 19%, which seems to compensate for viral loss during centrifugation. Filtration time decreases by approximately 30% when using the CP Select protocol, making this an optimal choice for building surveillance applications where quick turnaround time is necessary.