bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Leading from the front’ implementation strategies increase the success of influenza vaccination drives among healthcare workers: A reanalysis of Systematic Review evidence using Intervention Component Analysis (ICA) and Qualitative Comparative Analysis (QCA)
Authors: Sutcliffe Katy , Kneale Dylan , Thomas James 
Published: February 2021

AbstractBackgroundSeasonal influenza vaccination of healthcare workers (HCW) is widely recommended to protect staff and patients. A previous systematic review examined interventions to encourage uptake finding that hard mandates, such as loss of employment for non-vaccination, were more effective than soft mandates, such as signing a declination form, or other interventions such as incentives. Despite these overarching patterns the authors of the review concluded that ‘substantial heterogeneity’ remained requiring further analysis. This paper reanalyses the evidence using Intervention Component Analysis (ICA) and Qualitative Comparative Analysis (QCA) to examine whether the strategies used to implement interventions explain the residual heterogeneity.MethodsWe used ICA to extract implementation features and trialist’s reflections on what underpinned the success of the intervention they evaluated. The ICA findings then informed and structured two QCA analyses to systematically analyse associations between implementation features and intervention outcomes. Analysis 1 examined hard mandate studies. Analysis 2 examined soft mandates and other interventions.ResultsIn Analysis 1 ICA revealed the significance of ‘leading from the front’ rather than ‘top-down’ implementation of hard mandates. Four key features underpinned this: providing education prior to implementation; two-way engagement so HCW can voice concerns prior to implementation; previous use of other strategies so that institutions ‘don’t-go-in-cold’ with hard-mandates; and support from institutional leadership. QCA revealed that either of two configurations were associated with greater success of hard mandates. The first involves two-way engagement, leadership support and a ‘don’t-go-in-cold’ approach. The second involves leadership support, education and a ‘don’t-go-in-cold’ approach. Reapplying the ‘leading from the front’ theory in Analysis 2 revealed similar patterns.ConclusionsRegardless of intervention type a ‘leading from the front’ approach to implementation will likely enhance intervention success. While the results pertain to flu vaccination among HCWs, the components identified here may be relevant to public health campaigns regarding COVID-19 vaccination.
Impact of a Chlorhexidine Decolonization on the Nasal and Dermal Microbiome of Therapy Dogs Participating in Hospital Animal-Assisted Intervention Programs: A Pilot Study
Authors: Dalton Kathryn R. , Ruble Kathy , Carroll Karen C. , Redding Laurel E. , Chen Allen R. , Grice Elizabeth A. , Morris Daniel O. , Davis Meghan F. 
Published: February 2021

AbstractTherapy animals in hospital animal-assisted intervention programs are an invaluable part of holistic patient care. However, therapy dogs may be exposed to hospital-associated pathogens through these activities. This pilot study sought to examine the effect of topical chlorhexidine application, used as an infection control measure, on the microbial composition of the skin and mucous membranes of therapy dogs. We found that the chlorhexidine decolonization intervention altered microbial alpha diversity and shifted microbial structures in these therapy dogs, and particularly influenced more phylogenetically rare taxa. Specifically, the intervention reduced the abundance of Staphylococcus pseudintermedius, the archetypal canine commensal and a frequent cause of opportunistic infections. However, it did not reduce levels of S. aureus, which is a common hospital-associated pathogen of people. These preliminary findings highlight the importance of considering holistic microbial communities when undertaking infection control strategies, and stress the need for further research to understand the unintended consequences of antiseptic use on therapy dogs.
SARS-CoV-2 genome surveillance in Mainz, Germany, reveals convergent origin of the N501Y spike mutation in a hospital setting
Authors: Lemmermann NA , Lieb B , Laufs T , Renzaho A , Runkel S , Kohnen W , Linke M , Gerber S , Schweiger S , Michel A , Bikar S-E , Plachter B , Hankeln T 
Published: February 2021

AbstractWhile establishing a regional SARS-Cov-2 variant surveillance by genome sequencing, we have identified three infected individuals in a clinical setting (two long-term hospitalized patients and a nurse) that shared the spike N501Y mutation within a genotype background distinct from the current viral variants of concern. We suggest that the adaptive N501Y mutation, known to increase SARS-CoV-2 transmissibility, arose by convergent evolution around December in Mainz, Germany. Hospitalized patients with a compromised immune system may be a potential source of novel viral variants, which calls for monitoring viral evolution by genome sequencing in clinical settings.
Prevalence of dementia in elderly age population of Barangay Bangkal, City
Authors: Jaiswal Vikash , Lourdes Pormento Maria Kezia , Hange Namrata , Ngaba Neguemadji Ngardig , Somagutta Manoj Kumar , Apostol Dy Inna Celina , Savani Saloni , Javed Sana , Nagpal Shavy , Bhatnagar Arushee , Mohit  , Singh Annie , Mukherjee Dattatreya , Paladiya Ruchir , Malanyaon Freda 
Published: February 2021

ABSTRACTBackgroundDementia, a significant cause of disability and dependency among older adults. The growing population of the elderly in the Philippines is expected to increase the prevalence of dementia in the country.PurposeThis study aims to determine the prevalence of dementia in the elderly population of Barangay Bangkal, Makati City.MethodsDescriptive cross-sectional community-based study was conducted to determine the prevalence of dementia in the elderly population of Barangay Bangkal, Makati City, aged 60 years and above over one month from mid-October to mid-November 2019. Data was collected with help of Mini-Mental State Examination – Philippines version (MMSE-P) to determine the cognitive status and diagnose dementia in elderly population.ResultsA total of 266 elderly adults participated in the study. Representatives of the study population were male (59.0%), married (68.0%), with an income of less than 5,000 peso (51.1%), working (64.3%), and with high school education (42.1%). The average age of the study population was 68.02 (+ 6.76) years. The average MMSE score of the participants was 27.05 (+ 3.94). The prevalence of dementia in the sample was 18.8%. Age, income, and level of education were associated with the MMSE score (r□ = - 0.26, n = 266, p < 0.001, r□ = 0.23, n = 266, p < 0.001, and rs = 0.19, n = 266, p = 0.002, respectively). The findings for statistical significance do resonate with clinical significance as evident during administration of MMSE score.ConclusionAdvancing age increases the risk for cognitive decline while higher income and education level prevent or delays the onset of dementia. Collaborative management between the medical education faculty & students, researchers, and local state health officials might address dementia in the region.
Long stability of SARS-CoV-2 RNA in dry and saliva swab samples stored for diagnostics, Denmark
Authors: Alfaro-Núñez Alonzo , Crone Stephanie , Mortensen Shila , Worsøe Rosenstierne Maiken , Fomsgaard Anders , Marving Ellinor , Nielsen Sofie Holdflod , Jørgensen Michelle Grace Pinto , Cohen Arieh S. , Nielsen Claus 
Published: February 2021

AbstractDuring the current COVID-19 pandemic, Danish authorities demand that clinical swab samples must be analysed within 72 hours. This time constraint was adopted to guarantee a quick and efficient response. As today, analysis results are given within 20 hours average fulfilling this demand. However, it is unclear for how long and under which conditions swab specimens can be stored without clinically affecting SARS-CoV-2 RNA stability. This study demonstrates that swabs specimens can be stored at −20°C and +4°C for up to 26 days without affecting RT-qPCR results. However, early detection of asymptomatic cases is important to reduce spreading COVID-19 may be the final consequence not only in Denmark but worldwide.
Assessing the impact of secondary school reopening strategies on within-school COVID-19 transmission and absences: a modelling study
Authors: Leng Trystan , Hill Edward M. , Thompson Robin N. , Tildesley Michael J. , Keeling Matt J. , Dyson Louise 
Published: February 2021

AbstractBackgroundStrategies involving rapid testing have been suggested as a way of reopening schools that minimises absences while controlling transmission. We assess the likely impact of rapid testing strategies using lateral flow tests (LFTs) on infections and absences in secondary schools, compared to a policy of isolating year group bubbles upon a pupil returning a positive polymerase chain reaction (PCR) test.MethodsWe developed an individual-based model of a secondary school formed of exclusive year group bubbles (five year groups, with 200 pupils per year). By simulating infections over the course of a seven-week half-term, we compared the impact of differing strategies on transmission, absences, and testing volume. We also considered the sensitivity of results to underlying model assumptions.FindingsRepeated testing of year-group bubbles following case detection or regular mass-testing strategies result in a modest increase in infections compared to the policy of isolating year-group bubbles, but substantially reduce absences. When combined these two testing strategies can reduce infections to levels lower than would occur under year-group isolation, although such a policy requires a high volume of testing.InterpretationOur results highlight the conflict between the goals of minimising within-school transmission, minimising absences and minimising testing burden. While mass and targeted testing strategies can reduce school transmission and absences, it may lead to a large number of daily tests.
Evaluating COVID-19 reporting data in the context of testing strategies across 31 LMICs
Authors: Van Gordon Mollie M. , McCarthy Kevin A. , Proctor Joshua L. , Hagedorn Brittany L. 
Published: February 2021

Abstract0.1BackgroundCOVID-19 case counts are the predominant measure used to track epidemiological dynamics and inform policy decision-making. Case counts, however, are influenced by testing rates and strategies, which have varied over time and space. A method to consistently interpret COVID-19 case counts in the context of other surveillance data is needed, especially for data-limited settings in low- and middle-income countries (LMICs).0.2MethodsWe leverage statistical analyses to detect changes in COVID-19 surveillance data. We apply the pruned exact linear time change detection method for COVID-19 case counts, number of tests, and test positivity rate over time. With this information, we categorize change points as likely driven by epidemiological dynamics or non-epidemiological influences such as noise.0.3FindingsHigher rates of epidemiological change detection are more associated with open testing policies than with higher testing rates. We quantify alignment of non-pharmaceutical interventions with epidemiological changes. LMICs have the testing capacity to measure prevalence with precision if they use randomized testing. Rwanda stands out as a country with an efficient COVID-19 surveillance system. Sub-national data reveal heterogeneity in epidemiological dynamics and surveillance.0.4InterpretationRelying solely on case counts to interpret pandemic dynamics has important limitations. Normalizing counts by testing rate mitigates some of these limitations, and open testing policy is key to efficient surveillance. Our findings can be leveraged by public health officials to strengthen COVID-19 surveillance and support programmatic decision-making.0.5FundingThis publication is based on models and data analysis performed by the Institute for Disease Modeling at the Bill & Melinda Gates Foundation.Research in ContextEvidence before this studyWe searched for articles on the current practices, challenges, and proposals for COVID-19 surveillance in LMICs. We used Google Scholar with search terms including “COVID surveillance.” Existing studies were found to be qualitative, anecdotal, or highly location-specific.Added value of this studyWe developed a quantitative method that makes use of limited information available from LMICs. Our approach improves interpretation of epidemiological data and enables evaluation of COVID-19 surveillance dynamics across countries.Implications of all the available evidenceOur results demonstrate the importance of open testing for strong surveillance systems, bolstering existing anecdotal evidence. We show strong alignment across LMICs between non-pharmaceutical interventions and epidemiological changes. We demonstrate the importance of considering sub-national heterogeneity of epidemiological dynamics and surveillance.
Implications of climatic and demographic change for seasonal influenza dynamics and evolution
Authors: Baker Rachel E. , Yang Qiqi , Worby Colin J. , Yang Wenchang , Saad-Roy Chadi M. , Viboud Cecile , Shaman Jeffrey , Metcalf C. Jessica E. , Vecchi Gabriel , Grenfell Bryan T. 
Published: February 2021

AbstractSeasonal influenza causes a substantial public health burden, as well as being a key substrate for pandemic emergence. Future climatic and demographic changes may alter both the magnitude, frequency and timing of influenza epidemics and the prospects for pathogen evolution, however, these issues have not been addressed systematically. Here, we use a parsimonious influenza model, grounded in theoretical understanding of the link between climate, demography and transmission to project future changes globally. We find that climate change generally acts to reduce the intensity of influenza epidemics as specific humidity increases. However, this reduction in intensity is accompanied by increased seasonal epidemic persistence with latitude, which may increase suitability for year-round local influenza evolution. Using a range of population growth scenarios, we find that the number of global locations with high evolution suitability may double by 2050. High population growth in tropical Africa could thus make this region a locus of novel strain emergence, shifting the current focus from South East Asia.
The Missing Science: Epidemiological data gaps for COVID-19 policy in the United States
Authors: Bhatia Rajiv , Sledge Isabella , Baral Stefan 
Published: February 2021

AbstractWe report on a scoping study of COVID-19 epidemiological data available for COVID-19 policy and management decisions for U.S. settings. We synthesize current US Centers for Disease and Control and Prevention (CDC) estimates for parameter of infectious transmission, infection severity, and disease burden, and summarize epidemiologic contributions to these parameters published by CDC-affiliated investigators through Oct 30, 2020. Authoritative estimates of most infectious transmission and infection severity parameters exist but rely primarily on data from studies conducted in non-U.S. populations. Estimates of secondary infection risks for household, workplace, school, or other community settings are lacking and estimates of the clinical fraction remain uncertain. The CDC reports multiple disease incidence and prevalence measures at national and state geographies, including some measures disaggregated by age group, race/ethnicity and sex; however, nationally uniform disease burden measures are not available at the sub-state level or for sub-populations defined by exposure setting, limiting opportunities for targeted interventions. CDC-affiliated investigators authored 133 quantitative studies on COVID-19 through Oct 30, 2020; however only 34 employed analytic methods. The remainder were descriptive. Of the 34 analytic studies, eleven reported on risk factors for infection, seven reported on risk factors for severe disease, three on symptomatic infections, three reported secondary infection risks, and four reported on indirect pandemic effects. Gaps remain in the epidemiological data required for an efficient and equitable public health policy response to COVID-19. The existence of these gaps one year after the onset of the COVID-19 pandemic underscores the need for standardizing data collection and research priorities and protocols in the context of a rapidly emerging infectious disease epidemics.
Identification of a rapidly-spreading triple mutant for high-level metabolic insecticide resistance inAnopheles gambiaeprovides a real-time molecular diagnostic for anti-malarial intervention deployment
Authors: Njoroge Harun , van’t Hof Arjen , Oruni Ambrose , Pipini Dimitra , Nagi Sanjay C. , Lynd Amy , Lucas Eric R. , Tomlinson Sean , Grau-Bove Xavi , McDermott Daniel , Wat’senga Francis T. , Manzambi Emile Z. , Agossa Fiacre R. , Mokuba Arlette , Irish Seth , Kabula Bilali , Mbogo Charles , Bargul Joel , Paine Mark J.I. , Weetman David , Donnelly Martin J. 
Published: February 2021

AbstractInsecticide resistance provides both an increasingly pressing threat to the control of vector-borne diseases and insights into the remarkable capacity of natural populations to show rapid evolutionary responses to contemporary selection. Malaria control remains heavily dependent on deployment of pyrethroid insecticides, primarily in long lasting insecticidal nets (LLINs), but resistance in the major malaria vectors has increased over the last 15 years in concert with dramatic expansion of LLIN distributions. Identifying genetic mechanisms underlying high-level resistance in mosquitoes, which may almost entirely overcome pyrethroid efficacy, is crucial for the development and deployment of potentially resistance-breaking tools. Using theAnopheles gambiae1000 genomes (Ag1000g) data we identified a very recent selective sweep in mosquitoes from Uganda which localized to a cluster of cytochrome P450 genes, including some commonly implicated in resistance. Further interrogation revealed a haplotype involving a trio of mutations, a nonsynonymous point mutation inCyp6p4(I236M), an upstream insertion of a partial Zanzibar-like transposable element (TE) and a duplication of theCyp6aa1gene. The mutations appear to have originated recently inAn. gambiaefrom the Kenya-Uganda border region around Lake Victoria, with stepwise replacement of the double-mutant (Zanzibar-like TE andCyp6p4-236M) with the triple-mutant haplotype (includingCyp6aa1duplication), which has spread into the Democratic Republic of Congo and Tanzania. The triple-mutant haplotype is strongly associated with increased expression of genes able to metabolise pyrethroids and is strongly predictive of resistance to pyrethroids most notably deltamethrin, a commonly-used LLIN insecticide. Importantly, there was increased mortality in mosquitoes carrying the triple-mutation when exposed to nets co-treated with the synergist piperonyl butoxide (PBO). Frequencies of the triple-mutant haplotype remain spatially variable within countries, suggesting an effective marker system to guide deployment decisions for limited supplies of PBO-pyrethroid co-treated LLINs across African countries. Duplications of theCyp6aa1gene are common inAn. gambiaeacross Africa and, given the enzymes metabolic activity, are likely to be a useful diagnostic for high levels of pyrethroid resistance.
Effect of ligand sensing on flagellar bundle formation in bacteria
Authors: Agrawal Megha , Chakraborty Soumyadeep , Tirumkudulu Mahesh S. , Venkatesh K.V 
Published: February 2021

AbstractE. coliswims in liquid media by rotating long appendages called flagella. The direction of rotation of each flagellum is governed by a transmembrane rotary nanomotor, which receives signals from ligand-specific receptors. Attractants bias the motor to rotate in CCW direction causing flagella to bundle and provide thrust for locomotion. Recent studies have shown that sensing not only leads to increase in CCW bias but also increases the motor rotation speed due to the recruitment of additional stator units bound to the rotor. Despite the detailed studies on bacterial motility, the effect of ligand sensing on the synchronization of flagellar filaments leading to bundle formation and changes in bundle geometry are not clear. In this work, we performed real-time imaging of the flagellar bundle of swimming cells in metabolising (glucose) and non-metabolisable (2-Deoxy-d-glucose) attractants. We characterized bundles during swimming by measuring visible distal length and the spread of filaments at poles. We show that sensing of attractant by receptor leads to the formation of tight bundles when compared to control buffer. Contrary to previous studies, the swimming speeds were proportional to the bundle tightness with the latter dependent not only on the bias but also on the torque exerted by the motor. We further show that the observed wiggles in the swimming trajectory of cells is directly proportional to the spread angles of bundle and is effected by both motor CCW bias and torque. Mutant cells, which were rendered non-motile due to the absence of the PTS (phosphotransferase system) sugar uptake mechanism, exhibited motility when exposed to the non-metabolisable attractant confirming that mere sensing can induce torque in flagellar motor. These results clarify the role of sensing and metabolism on bundle formation and its impact on the motility of cells.Statement of significancePeritrichously flagellatedE. coliswims away or towards ligands by biasing the direction of rotation of its flagellar motor. Recently, it has been shown that motor speed is also modulated on merely sensing a ligand. How does this impact flagellar bundle formation and swimming behavior? Using real-time imaging, we show that the bundle geometry changes in response to both metabolisable and non-metabolisable ligand. Mere sensing of a ligand temporarily increases the motor torque and CCW bias that causes tight flagellar bundles and leads to smooth swimming trajectories at high speeds. Our result provides strong evidence of a new signalling pathway that controls the flagellar motor speed to enable the bacteria to respond efficiently to changes in its environment.
Polymetallic nodules are essential for food-web integrity of a prospective deep-seabed mining area in Pacific abyssal plains
Authors: Stratmann Tanja , Soetaert Karline , Kersken Daniel , van Oevelen Dick 
Published: February 2021

AbstractPolymetallic nodule fields provide hard substrate for sessile organisms on the abyssal seafloor between 3,000 and 6,000 m water depth. Deep-seabed mining targets these mineral-rich nodules and will likely modify the consumer-resource (trophic) and substrate-providing (non-trophic) interactions within the abyssal food web. However, the importance of nodules and their associated sessile fauna in supporting food-web integrity remains unclear. Here, we use seafloor imagery and published literature to develop highly-resolved trophic and non-trophic interaction webs for the Clarion-Clipperton Fracture Zone (CCZ, central Pacific Ocean) and the Peru Basin (PB, south-east Pacific Ocean) and to assess how nodule removal will modify these networks. The CCZ interaction web included 1,028 compartments connected with 59,793 links and the PB interaction web consisted of 342 compartments and 8,044 links. We show that knock-down effects of nodule removal resulted in a 17.9% (CCZ) to 20.8% (PB) loss of all compartments and 22.8% (PB) to 30.6% (CCZ) loss of network links. Subsequent analysis identified stalked glass sponges living attached to the nodules as key structural species that supported a high diversity of associated fauna. We conclude that polymetallic nodules are critical for food-web integrity and that their absence will likely result in reduced local benthic biodiversity.