bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrent Syncope Caused by a Dural Arteriovenous Fistula
Authors: Sheinberg Dallas L. , Luther Evan , Chen Stephanie , McCarthy David , Starke Robert M. 
Published: March 2021

Background:
Dural arteriovenous fistulas (DAVFs) are pathologic vascular connections that shunt dural arterial flow directly to dural venous drainage. Only a few isolated case reports describe syncope on presentation. We report the first case of DAVF causing recurrent, progressive syncope in an otherwise asymptomatic patient.

Case Report:
A female in her late 20s presented with a 9-year history of syncopal episodes and was found to have a DAVF. Syncopal episodes were exacerbated by positional changes, strenuous activity and emotional stressors. Symptoms occurred upon wakening and lasted for 2 to 3 hours before she was able to regain functionality. Physical examination revealed no abnormalities. Magnetic resonance imaging of the brain showed no irregularities. Magnetic resonance angiography revealed abnormal serpiginous structures in the left jugular foramen which communicated with the ascending pharyngeal branch of the left external carotid artery. Cerebral angiogram disclosed a left jugular bulb DAVF supplied by the left ascending pharyngeal and left occipital arteries. The DAVF was successfully managed by progressive endovascular embolization with coils and Onyx 34. On clinical follow-up evaluation, the patient had no further episodes of dizziness or syncope.

Conclusion:
We present an atypical case of DAVF in a patient presenting with recurrent syncope. Only 4 cases of DAVF causing syncope have been reported, all in combination with other neurological symptoms. In comparison, we report a unique case of DAVF presenting solely with recurrent syncope, a previously undocumented finding in the literature. Our case adds to other reports of nonspecific DAVF presentations and highlights the importance of considering this etiology.
A novel 5E training model and other methods implemented for rapid readiness at an ad-hoc COVID-19 facility in India
Authors: Singh Suhail , Singh Anchit Raj , Pathak Basant , Tilak TVSVGK , Kumar Aparajita , Bhatia IPS , Hasvi Jayraj 
Published: March 2021

AbstractBackgroundA ad-hoc dedicated COVID-19 hospital was setup in New Delhi, India over a span of 12 days. At this time, new teaching modalities were employed to train the staff. This study aims to identify and quantify the effectiveness of these teaching models in terms of learning which was evaluated using case scenarios before and after the teaching session.ObjectivesTo assess education methods and models for training of healthcare workers during rapid deployment at an ad-hoc dedicated COVID-19 hospital.MethodsThe 5E (Engage, Explore, Explain, Elaborate and Evaluate) teaching modality through peer group teaching methods was utilised in the situation. Statistical analysis was done using Mann Whitney U test.ResultsA total of 86 participants (43 doctors and 43 nurses) answered the pre and post test questionnaires. The number of correct responses per question in the pre test (Mean + SD;49.0+ 18.53) vs post test (Mean + SD;54.40+ 15.95) with stratification by the domain of learning was analysed. No significant difference was found in the pre and post test responses.ConclusionFurther studies of this nature will contribute towards assessing efficacy of teaching modalities employed in rapid readiness for future pandemic scenarios.
Proteome profiling of Cryoglobulinemia
Authors: Liu Peng , Wu Jianqiang , Sun Dandan , Qi Zhihong , Qin Xuzhen , Su Wei 
Published: March 2021

ObjectiveTo better understand and identify candidate protein biomarkers of cryoglobulinemia (CGE) from healthy patients or benign brain disease control patients.MethodsThe tandem mass tag (TMT)-labeled quantitative proteomics approach was used to identify differential proteins in the serum proteome of 10 CGE patients and 10 disease control patients with negative cryoglobulin (CG), respectively. GO, KEGG and protein domain enrichment analysis was used for functional annotation of differential proteins. The biomarker candidates were validated by the parallel reaction monitoring (PRM) method in 20 samples (10 CGE patients, 5 healthy control patients, and 5 disease control patients).ResultsA total of 1004 proteins were quantitatively identified. Among these, 62 proteins were upregulated, and 56 proteins were downregulated. 25 candidate biomarkers were validated by PRM. 5 upregulated proteins of A2M, MMP2, VCAM1, MCAM, and PCSK9, and 4 downregulated proteins of C3, IGHG2, PROZ, PPBP were consistent with TMT results. Upregulated proteins mostly related with cholesterol metabolism, while downregulated proteins were associated with immune regulation.ConclusionThis study is the first proteomic study of cryoglobulinemia in China These findings might contribute to the application of proteomics for detecting and monitoring CGE. And our findings indicated cholesterol metabolism accelerates the development of CGE.
Characterizing an epidemiological geography of the United States: influenza as a case study
Authors: Rosensteel Grant E. , Lee Elizabeth C. , Colizza Vittoria , Bansal Shweta 
Published: March 2021

AbstractThe prediction, prevention, and management of infectious diseases in the United States is either geographically homogeneous or is coordinated through ad-hoc administrative regions, ignoring the intense spatio-temporal heterogeneity displayed by most outbreaks. Using influenza as a case study, we characterize a regionalization of the United States. Based on influenza time series constructed from fine-scale insurance claims data from 2002-2009, we apply a complex network approach to characterize regions of the U.S. which experience comparable influenza dynamics. Our results identify three to five epidemiologically distinct regions for each flu season, with all locations within each region experiencing synchronous epidemics, and with an average of a two week delay in peak timing between regions. We find that there is significant heterogeneity across seasons in the identity of the regions and the relative timing across regions, making predictability from one season to the next challenging. Within a given season, however, our approach shows the potential to inform on the shaping of regions over time, to improve resources mobilization and targeted communication. Our epidemiologically-driven regionalization approach could allow for disease monitoring and control based on epidemiological risk rather than geopolitical boundaries, and provides a tractable public health approach to account for vast heterogeneity that exists in respiratory disease dynamics.
Racial and ethnic differences in COVID-19 vaccine hesitancy and uptake
Authors: Nguyen Long H. , Joshi Amit D. , Drew David A. , Merino Jordi , Ma Wenjie , Lo Chun-Han , Kwon Sohee , Wang Kai , Graham Mark S. , Polidori Lorenzo , Menni Cristina , Sudre Carole H. , Anyane-Yeboa Adjoa , Astley Christina M. , Warner Erica T. , Hu Christina Y. , Selvachandran Somesh , Davies Richard , Nash Denis , Franks Paul W. , Wolf Jonathan , Ourselin Sebastien , Steves Claire J. , Spector Tim D. , Chan Andrew T. 
Published: March 2021

BackgroundRacial and ethnic minorities have been disproportionately impacted by COVID-19. In the initial phase of population-based vaccination in the United States (U.S.) and United Kingdom (U.K.), vaccine hesitancy and limited access may result in disparities in uptake.MethodsWe performed a cohort study among U.S. and U.K. participants in the smartphone-based COVID Symptom Study (March 24, 2020-February 16, 2021). We used logistic regression to estimate odds ratios (ORs) of COVID-19 vaccine hesitancy (unsure/not willing) and receipt.ResultsIn the U.S. (n=87,388), compared to White non-Hispanic participants, the multivariable ORs of vaccine hesitancy were 3.15 (95% CI: 2.86 to 3.47) for Black participants, 1.42 (1.28 to 1.58) for Hispanic participants, 1.34 (1.18 to 1.52) for Asian participants, and 2.02 (1.70 to 2.39) for participants reporting more than one race/other. In the U.K. (n=1,254,294), racial and ethnic minorities had similarly elevated hesitancy: compared to White participants, their corresponding ORs were 2.84 (95% CI: 2.69 to 2.99) for Black participants, 1.66 (1.57 to 1.76) for South Asian participants, 1.84 (1.70 to 1.98) for Middle East/East Asian participants, and 1.48 (1.39 to 1.57) for participants reporting more than one race/other. Among U.S. participants, the OR of vaccine receipt was 0.71 (0.64 to 0.79) for Black participants, a disparity that persisted among individuals who specifically endorsed a willingness to obtain a vaccine. In contrast, disparities in uptake were not observed in the U.K.ConclusionsCOVID-19 vaccine hesitancy was greater among racial and ethnic minorities, and Black participants living in the U.S. were less likely to receive a vaccine than White participants. Lower uptake among Black participants in the U.S. during the initial vaccine rollout is attributable to both hesitancy and disparities in access.
COVID-19 International Border Surveillance Cohort Study at Toronto’s Pearson Airport
Authors: Goel Vivek , Bulir David , De Propetis Eric , Jamil Munaza , Rosella Laura , Mertz Dominik , Regehr Cheryl , Smieja Marek 
Published: March 2021

AbstractObjectivesThe primary objective was to estimate the positivity rate of air travelers coming to Toronto, Canada in September and October, 2020, at arrival, day 7 and day 14. Secondary objectives were to estimate degree of risk based on country of origin; to assess knowledge and attitudes towards COVID-19 control measures; and subjective well-being during the quarantine period.DesignProspective cohort of arriving international travelers.SettingToronto Pearson Airport Terminal 1, Toronto, Canada.ParticipantsPassengers arriving on international flights. Inclusion criteria were those aged 18 or older who had a final destination within 100 km of the airport; spoke English or French; and provided consent. Excluded were those taking a connecting flight; who had no internet access; who exhibited symptoms of COVID-19 on arrival; or who were exempted from quarantine.Main outcome measuresPositive for SARS-CoV-2 virus on RT-PCR with self-administered nasal-oral swab, and general well-being using the WHO-5 index.ResultsOf 16,361 passengers enrolled, 248 (1·5%, 95% CI 1.3%,1.5%) tested positive. Of these, 167 (67%) were identified on arrival, 67 (27%) on day 7, and 14 (6%) on day 14. The positivity rate increased from 1% in September to 2% in October. Average well-being score declined from 19.8 (out of a maximum of 25) to 15.5 between arrival and day 7 (p<0.001).ConclusionsA single arrival test will pick up two-thirds of individuals who will become positive, with most of the rest detected on the second test at day 7. These results support strategies identified through mathematical models that a reduced quarantine combined with testing can be as effective as a 14 day quarantine.Article SummaryStrengths and limitations of this studyDecisions regarding border restrictions have been based on trial and error and mathematical models with limited empirical data to support such decision-making.This study assessed the prevalence of SARS-CoV-2 in a cohort of international travellers at arrival, day 7 and 14 of quarantine.It is limited to one airport and there is the potential from bias due to non-participation and loss to follow-up.Self-collected nasal-oral swabs were used which facilitated participation but may have reduced sensitivity.
Predicting COVID-19 related death using the OpenSAFELY platform
Authors:   The OpenSAFELY Collaborative, Williamson Elizabeth J , Tazare John , Bhaskaran Krishnan , McDonald Helen I , Walker Alex J , Tomlinson Laurie , Wing Kevin , Bacon Sebastian , Bates Chris , Curtis Helen J , Forbes Harriet , Minassian Caroline , Morton Caroline E , Nightingale Emily , Mehrkar Amir , Evans Dave , Nicholson Brian D , Leon Dave , Inglesby Peter , MacKenna Brian , Davies Nicholas G , DeVito Nicholas J , Drysdale Henry , Cockburn Jonathan , Hulme Will , Morley Jess , Douglas Ian , Rentsch Christopher T , Mathur Rohini , Wong Angel , Schultze Anna , Croker Richard , Parry John , Hester Frank , Harper Sam , Grieve Richard , Harrison David A , Steyerberg Ewout W. , Eggo Rosalind M , Diaz-Ordaz Karla , Keogh Ruth , Evans Stephen JW , Smeeth Liam , Goldacre Ben 
Published: March 2021

AbstractObjectivesTo compare approaches for obtaining relative and absolute estimates of risk of 28-day COVID-19 mortality for adults in the general population of England in the context of changing levels of circulating infection.DesignThree designs were compared. (A) case-cohort which does not explicitly account for the time-changing prevalence of COVID-19 infection, (B) 28-day landmarking, a series of sequential overlapping sub-studies incorporating time-updating proxy measures of the prevalence of infection, and (C) daily landmarking. Regression models were fitted to predict 28-day COVID-19 mortality.SettingWorking on behalf of NHS England, we used clinical data from adult patients from all regions of England held in the TPP SystmOne electronic health record system, linked to Office for National Statistics (ONS) mortality data, using the OpenSAFELY platform.ParticipantsEligible participants were adults aged 18 or over, registered at a general practice using TPP software on 1stMarch 2020 with recorded sex, postcode and ethnicity. 11,972,947 individuals were included, and 7,999 participants experienced a COVID-19 related death. The study period lasted 100 days, ending 8thJune 2020.PredictorsA range of demographic characteristics and comorbidities were used as potential predictors. Local infection prevalence was estimated with three proxies: modelled based on local prevalence and other key factors; rate of A&E COVID-19 related attendances; and rate of suspected COVID-19 cases in primary care.Main outcome measuresCOVID-19 related death.ResultsAll models discriminated well between patients who did and did not experience COVID-19 related death, with C-statistics ranging from 0.92-0.94. Accurate estimates of absolute risk required data on local infection prevalence, with modelled estimates providing the best performance.ConclusionsReliable estimates of absolute risk need to incorporate changing local prevalence of infection. Simple models can provide very good discrimination and may simplify implementation of risk prediction tools in practice.
Muscle Strength Explains the Protective Effect of Physical Activity against COVID-19 Hospitalization among Adults aged 50 Years and Older
Authors: Maltagliati Silvio , Sieber Stephen , Sarrazin Philippe , Cullati Stéphane , Chalabaev Aïna , Millet Grégoire P. , Boisgontier Matthieu P. , Cheval Boris 
Published: March 2021

AbstractObjectivesPhysical activity has been proposed as a protective factor for COVID-19 hospitalization. However, the mechanisms underlying this association are unclear. Here, we examined the association between physical activity and COVID-19 hospitalization and whether this relationship was explained by other risk factors for severe COVID-19.MethodWe used data from adults aged 50 years and older from the Survey of Health, Ageing and Retirement in Europe. The outcome was self-reported hospitalization due to COVID-19 measured before August 2020. The main exposure was usual physical activity, self-reported between 2004 and 2017. Data were analyzed using logistic regression models.ResultsAmong the 3139 participants included in the study (69.3 ± 8.5 years, 1763 women), 266 were tested positive for COVID-19 and 66 were hospitalized. Results showed that individuals who engaged in physical activity more than once a week had lower odds of COVID-19 hospitalization than individuals who hardly ever or never engaged in physical activity (odds ratios = 0.41, 95% confidence interval = 0.22–0.74, p = .004). This association between physical activity and COVID-19 hospitalization was explained by muscle strength, but not by other risk factors.ConclusionThese findings suggest that, after 50 years of age, engaging in physical activity more than once a week is associated with lower odds of COVID-19 hospitalization. The protective effect of physical activity on COVID-19 hospitalization is explained by muscle strength.
RT-qPCR assay for detection of British (B.1.1.7) and South Africa (B.1.351) variants of SARS-CoV-2
Authors: Yaniv Karin , Ozer Eden , Plotkin Noam , Bhandarkar Nikhil Suresh , Kushmaro Ariel 
Published: March 2021

AbstractLess than a year following the SARS-CoV-2 outbreak, variants of concern have emerged in the form of the British variant B.1.1.7 and the South Africa variant B.1.351. Due to their high infectivity and morbidity, it is crucial to quickly and effectively detect them. Current methods of detection are either time-consuming, expensive or indirect. Here, we report the development of a rapid, cost-effective and direct RT-qPCR method for detection of the two variants of concern. We developed and validate a detection system for the detection of the B.1.1.7 variant and another single detection set for the B.1.351 variant. The developed approach was characterized and tested on wastewater samples and illustrated that all primers and probes were sensitive and specific. The novel system presented here will allow proper response and pandemic containment with regard to these variants. In addition, it may provide a basis for developing tools for the detection of additional variants of concern.
Donor Anti-Spike Immunity is Related to Recipient Recovery and Can Predict the Efficacy of Convalescent Plasma Units
Authors: Janaka Sanath Kumar , Hartman William , Mou Huihui , Farzan Michael , Stramer Susan L. , Goodhue Erin , Weiss John , Evans David , Connor Joseph P. 
Published: March 2021

AbstractBackgroundThe novel coronavirus, SARS-CoV2 that causes COVID-19 has resulted in the death of more than 2.31 million people within the last year and yet no cure exists. Whereas passive immunization with COVID-19 convalescent plasma (CCP) provides a safe and viable option, selection of optimal units for therapy and lack of clear therapeutic benefit from transfusion remain as barriers to the use of CCP.Study design and methodsTo identify plasma that is expected to benefit recipients, we measured anti-SARS-CoV2 antibody levels using clinically available serological assays and correlated with the neutralizing activity of CCP from donors. Neutralizing titer of plasma samples was measured by assaying infectivity of SARS-CoV-2 spike protein pseudotyped retrovirus particles in the presence of dilutions of plasma samples. We also used this assay to identify evidence of passive transfusion of neutralizing activity in CCP recipients.ResultsViral neutralization and anti-spike protein antibodies in 109 samples from 87 plasma donors were highly varied but modestly correlated with each other. Recipients who died of COVID-19 were found to have been transfused with units with lower anti-spike antibody levels and neutralizing activity. Passive transfer of neutralization activity was documented in 62% of antibody naive plasma recipients.ConclusionsSince viral neutralization is the goal of CCP transfusion, our observations not only support the use of anti-spike SARS-CoV2 serology tests to identify beneficial CCP units, but also support the therapeutic value of convalescent plasma with high titers of anti-spike antibodies.
A Multilayer Model for Early Detection of COVID-19
Authors: Shmueli Erez , Mansuri Ronen , Porcilan Matan , Amir Tamar , Yosha Lior , Yechezkel Matan , Patalon Tal , Handelman-Gotlib Sharon , Gazit Sivan , Yamin Dan 
Published: March 2021

ABSTRACTCurrent efforts for COVID-19 screening mainly rely on reported symptoms and potential exposure to infected individuals. Here, we developed a machine-learning model for COVID-19 detection that utilizes four layers of information: 1) sociodemographic characteristics of the tested individual, 2) spatiotemporal patterns of the disease observed near the testing episode, 3) medical condition and general health consumption of the tested individual over the past five years, and 4) information reported by the tested individual during the testing episode. We evaluated our model on 140,682 members of Maccabi Health Services, tested for COVID-19 at least once between February and October 2020. These individuals had 264,516 COVID-19 PCR-tests, out of which 16,512 were found positive. Our multilayer model obtained an area under the curve (AUC) of 81.6% when tested over all individuals, and of 72.8% when tested over individuals who did not report any symptom. Furthermore, considering only information collected before the testing episode – that is, before the individual may had the chance to report on any symptom – our model could reach a considerably high AUC of 79.5%. Namely, most of the value contributed by the testing episode can be gained by earlier information. Our ability to predict early the outcomes of COVID-19 tests is pivotal for breaking transmission chains, and can be utilized for a more efficient testing policy.
Aberrant levels of cortical myelin distinguish individuals with unipolar depression from healthy controls
Authors: Baranger David A.A. , Halchenko Yaroslav O. , Satz Skye , Ragozzino Rachel , Iyengar Satish , Swartz Holly A. , Manelis Anna 
Published: March 2021

ABSTRACTThe association of unipolar depression (UD), relative to healthy controls (HC), with cortical myelin is underexplored, despite growing evidence of associations with white matter tract integrity. We characterized cortical myelin in the 360 Glasser atlas regions using the T1w/T2w ratio in 39 UD and 47 HC participants (ages=19-44, 75% female). A logistic elastic net regularized regression with nested cross-validation and a subsequent linear discriminant analysis conducted on held-out samples were used to select brain regions and classify UD vs. HC. True-label model performance was compared against permuted-label model performance. Cortical myelin distinguished UD from HC with 68% accuracy (p<0.001; sensitivity=63.8%, specificity=71.5%). Brain regions contributing to this classification performance were located in the orbitofrontal cortex, anterior cingulate, extended visual, and auditory cortices, and showed statistically significant decreases and increases in myelin levels in UD vs. HC. The patterns of cortical myelin in these regions may be a biomarker of UD.
Excess deaths reveal the true spatial, temporal, and demographic impact of COVID-19 on mortality in Ecuador
Authors: Cuéllar Leticia , Torres Irene , Romero-Severson Ethan , Mahesh Riya , Ortega Nathaniel , Pungitore Sarah , Hengartner Nicolas , Ke Ruian 
Published: March 2021

AbstractBackgroundIn early 2020, Ecuador reported one of the highest surges of per capita deaths across the globe.MethodsWe collected a comprehensive dataset containing individual death records between 2015 and 2020 from the Ecuadorian National Institute of Statistics and Census and the Ecuadorian Ministry of Government. We computed the number of excess deaths across time, geographical locations and demographic groups using Poisson regression methods.ResultsBetween January 1st and September 23rd, 2020, the number of excess deaths in Ecuador is 36,402 (95% CI: 35,762-36,827) or 208 per 105 population, which is 171% of the expected deaths in that period in a typical year. Only 20% of the excess deaths are attributable to confirmed COVID-19 deaths. Strikingly, in provinces that were most affected by COVID-19, such as Guayas and Santa Elena, the all-cause deaths are more than double the expected number of deaths that would have occurred in a normal year. The extent of excess deaths in men is higher than in women, and the number of excess deaths increases with age. Indigenous populations had the highest level of excess deaths among all ethnic groups.ConclusionsOverall, the exceptionally high level of excess deaths in Ecuador highlights the enormous burden and heterogeneous impact of COVID-19 on mortality especially in older age groups and indigenous populations in Ecuador that was not fully revealed by COVID-19 death counts. Together with the limited testing in Ecuador, our results suggest that the majority of the excess deaths were likely to be undocumented COVID-19 deaths.