bluuebunny/crossref_metadata_2025_split huggingface dataset:
Update on neuroimaging in disorders of consciousness
Authors: Sanz Leandro R.D. , Thibaut Aurore , Edlow Brian L. , Laureys Steven , Gosseries Olivia 
Published: May 2021

Purpose of review
Neuroimaging has acquired a prominent place in the assessment of disorders of consciousness (DoC). Rapidly evolving technologies combined with state-of-the-art data analyses open new horizons to probe brain activity, but selecting appropriate imaging modalities from the plethora of available techniques can be challenging for clinicians. This update reviews selected advances in neuroimaging that demonstrate clinical relevance and translational potential in the assessment of severely brain-injured patients with DoC.

Recent findings
Magnetic resonance imaging and high-density electroencephalography provide measurements of brain connectivity between functional networks, assessments of language function, detection of covert consciousness, and prognostic markers of recovery. Positron emission tomography can identify patients with preserved brain metabolism despite clinical unresponsiveness and can measure glucose consumption rates in targeted brain regions. Transcranial magnetic stimulation and near-infrared spectroscopy are noninvasive and practical tools with promising clinical applications.

Summary
Each neuroimaging technique conveys advantages and pitfalls to assess consciousness. We recommend a multimodal approach in which complementary techniques provide diagnostic and prognostic information about brain function. Patients demonstrating neuroimaging evidence of covert consciousness may benefit from early adapted rehabilitation. Translating methodological advances to clinical care will require the implementation of recently published international guidelines and the integration of neuroimaging techniques into patient-centered decision-making algorithms.
Neuralgic amyotrophy
Authors: IJspeert Jos , Janssen Renske M.J. , van Alfen Nens 
Published: May 2021

Purpose of review
This review focuses on the current insights and developments in neuralgic amyotrophy (NA), an auto-immune multifocal peripheral nervous system disorder that leaves many patients permanently impaired if not recognized and treated properly.

Recent findings
NA is not as rare as previously thought. The phenotype is broad, and recent nerve imaging developments suggest that NA is the most common cause of acute anterior or posterior interosseous nerve palsy. Phrenic nerve involvement occurs in 8% of all NA patients, often with debilitating consequences. Acute phase treatment of NA with steroids or i.v. immunoglobulin may benefit patients. Long-term consequences are the rule, and persisting symptoms are mainly caused by a combination of decreased endurance in the affected nerves and an altered posture and movement pattern, not by the axonal damage itself. Patients benefit from specific rehabilitation treatment. For nerves that do not recover, surgery may be an option.

Summary
NA is not uncommon, and has a long-term impact on patients’ well-being. Early immunomodulating treatment, and identifying phrenic neuropathy or complete nerve paralysis is important for optimal recovery. For persistent symptoms a specific treatment strategy aiming at regaining an energy balance and well-coordinated scapular movement are paramount.
Using a household-structured branching process to analyse contact tracing in the SARS-CoV-2 pandemic
Authors: Fyles Martyn , Fearon Elizabeth , Overton Christopher ,   University of Manchester COVID-19 Modelling Group, Wingfield Tom , Medley Graham F. , Hall Ian , Pellis Lorenzo , House Thomas 
Published: May 2021

We explore strategies of contact tracing, case isolation and quarantine of exposed contacts to control the SARS-CoV-2 epidemic using a branching process model with household structure. This structure reflects higher transmission risks among household members than among non-household members. We explore strategic implementation choices that make use of household structure, and investigate strategies including two-step tracing, backwards tracing, smartphone tracing and tracing upon symptom report rather than test results. The primary model outcome is the effect of contact tracing, in combination with different levels of physical distancing, on the growth rate of the epidemic. Furthermore, we investigate epidemic extinction times to indicate the time period over which interventions must be sustained. We consider effects of non-uptake of isolation/quarantine, non-adherence, and declining recall of contacts over time. Our results find that, compared to self-isolation of cases without contact tracing, a contact tracing strategy designed to take advantage of household structure allows for some relaxation of physical distancing measures but cannot completely control the epidemic absent of other measures. Even assuming no imported cases and sustainment of moderate physical distancing, testing and tracing efforts, the time to bring the epidemic to extinction could be in the order of months to years.
This article is part of the theme issue ‘Modelling that shaped the early COVID-19 pandemic response in the UK’.
Outbreaks in care homes may lead to substantial disease burden if not mitigated
Authors: Hall Ian , Lewkowicz Hugo , Webb Luke , House Thomas , Pellis Lorenzo , Sedgwick James , Gent Nick ,   on behalf of the University of Manchester COVID-19 Modelling Group and the Public Health England Modelling Team
Published: May 2021

The number of COVID-19 outbreaks reported in UK care homes rose rapidly in early March of 2020. Owing to the increased co-morbidities and therefore worse COVID-19 outcomes for care home residents, it is important that we understand this increase and its future implications. We demonstrate the use of an SIS model where each nursing home is an infective unit capable of either being susceptible to an outbreak (S) or in an active outbreak (I). We use a generalized additive model to approximate the trend in growth rate of outbreaks in care homes and find the fit to be improved in a model where the growth rate is proportional to the number of current care home outbreaks compared with a model with a constant growth rate. Using parameters found from the outbreak-dependent growth rate, we predict a 73% prevalence of outbreaks in UK care homes without intervention as a reasonable worst-case planning assumption.
This article is part of the theme issue ‘Modelling that shaped the early COVID-19 pandemic response in the UK’.
Engagement and adherence trade-offs for SARS-CoV-2 contact tracing
Authors: Lucas Tim C. D. , Davis Emma L. , Ayabina Diepreye , Borlase Anna , Crellen Thomas , Pi Li , Medley Graham F. , Yardley Lucy , Klepac Petra , Gog Julia , Déirdre Hollingsworth T. 
Published: May 2021

Contact tracing is an important tool for allowing countries to ease lockdown policies introduced to combat SARS-CoV-2. For contact tracing to be effective, those with symptoms must self-report themselves while their contacts must self-isolate when asked. However, policies such as legal enforcement of self-isolation can create trade-offs by dissuading individuals from self-reporting. We use an existing branching process model to examine which aspects of contact tracing adherence should be prioritized. We consider an inverse relationship between self-isolation adherence and self-reporting engagement, assuming that increasingly strict self-isolation policies will result in fewer individuals self-reporting to the programme. We find that policies which increase the average duration of self-isolation, or that increase the probability that people self-isolate at all, at the expense of reduced self-reporting rate, will not decrease the risk of a large outbreak and may increase the risk, depending on the strength of the trade-off. These results suggest that policies to increase self-isolation adherence should be implemented carefully. Policies that increase self-isolation adherence at the cost of self-reporting rates should be avoided.
This article is part of the theme issue ‘Modelling that shaped the early COVID-19 pandemic response in the UK’.
Clinical Evaluation of In House Produced 3D Printed Nasopharyngeal Swabs for COVID-19 Testing
Authors: Lapierre Simon Grandjean , Bedwani Stéphane , DeBlois François , Fortin Audray , Cuervo Natalia Zamorano , Zerouali Karim , Caron Elise , Potvin Philippe Morency , Gagnon Simon , Nguissan Nakome , Arlotto Pascale , Hardy Isabelle , Boutin Catherine-Audrey , Tremblay Cécile , Coutlée François , Guise Jacques de , Grandvaux Nathalie 
Published: May 2021

Abstract3D printed alternatives to standard flocked swabs were rapidly developed to provide a response to the unprecedented and sudden need for an exponentially growing amounts of diagnostic tools to fight the pandemics of COVID-19. In light of the anticipated shortage, an hospital-based 3D printing platform was implemented in our institution for the production of swabs for nasopharyngeal and oropharyngeal sampling based on the freely available open-sourced design made available to the community by University of South Florida’s Health Radiology and Northwell Health System teams as replacement for locally used commercial swabs. Validation of our 3D printed swabs was performed by a head-to-head diagnostic accuracy study of the 3D printed “Northwell model” with the cobas PCR Media swabs sample kit. We observed an excellent concordance (total agreement 96.8%, Kappa 0.936) in results obtained with the 3D printed and flocked swabs indicating that the in-house 3D printed swab can be used reliably in a context of shortage of flocked swabs. To our knowledge, this is the first study to report on autonomous hospital-based production and clinical validation of 3D printed swabs.
MALDI-ToF Protein Profiling as Potential Rapid Diagnostic Platform for COVID-19
Authors: Chivte Prajkta , LaCasse Zane , Seethi Venkata Devesh R. , Bharti Pratool , Bland Joshua , Kadkol Shrihari S. , Gaillard Elizabeth R. 
Published: May 2021

AbstractMore than a year after the COVID-19 pandemic has been declared, the need still exists for accurate, rapid, inexpensive and non-invasive diagnostic methods that yield high specificity and sensitivity towards the current and newly emerging SARS-CoV-2 strains. Several studies have since established saliva as a more amenable specimen type for early detection of SARS-CoV-2 as compared to nasopharyngeal swabs. Considering the limitations and high demand for COVID-19 testing, we employed MALDI-ToF mass spectrometry for the analysis of 60 gargle samples from human donors and compared the spectra with their COVID-19 status. Several standards including isolated human serum immunoglobulins and controls such as pre-COVID-19 saliva and heat inactivated SARS-CoV-2 virus were simultaneously analyzed to provide a relative view of the saliva and viral proteome as they would appear in this works methodology. Five potential biomarker peaks were established that demonstrated high concordance with COVID-19 positive individuals. Overall, the agreement of these results with RT-qPCR testing on NP swabs was no less than 90% for the studied cohort, which consisted of young and largely asymptomatic student athletes. From a clinical standpoint, the results from this pilot study are promising and suggest that MALDI-ToF can be used to develop a relatively rapid and inexpensive COVID-19 assay.
Risk Factors, Clinical Outcomes and Prognostic Factors of Bacterial Keratitis: The Nottingham Infectious Keratitis Study
Authors: Ting Darren S. J. , Cairns Jessica , Gopal Bhavesh P. , Ho Charlotte Shan , Krstic Lazar , Elsahn Ahmad , Lister Michelle , Said Dalia G. , Dua Harminder S. 
Published: May 2021

ABSTRACTBackground/aimTo examine the risk factors, clinical characteristics, outcomes and prognostic factors of bacterial keratitis (BK) in Nottingham, UK.MethodsThis was a retrospective study of patients who presented to the Queen’s Medical Centre, Nottingham, with suspected BK during 2015-2019. Relevant data, including the demographic factors, risk factors, clinical outcomes, and potential prognostic factors, were analysed.ResultsA total of 283 patients (n=283 eyes) were included; mean age was 54.4±21.0 years and 50.9% were male. Of 283 cases, 128 (45.2%) cases were culture-positive. Relevant risk factors were identified in 96.5% patients, with ocular surface diseases (47.3%), contact lens wear (35.3%) and systemic immunosuppression (18.4%) being the most common factors. Contact lens wear was most commonly associated withP. aeruginosawhereasStaphylococci spp. were most commonly implicated in non-contact lens-related BK cases (p=0.017). At presentation, culture-positive cases were associated with older age, worse presenting corrected-distance-visual-acuity (CDVA), larger epithelial defect and infiltrate, central location and hypopyon (all p<0.01), when compared to culture-negative cases. Hospitalisation was required in 57.2% patients, with a mean length of stay of 8.0±8.3 days. Surgical intervention was required in 16.3% patients. Significant complications such as threatened/actual corneal perforation (8.8%), loss of perception of light vision (3.9%), and evisceration/enucleation (1.4%) were noted. Poor visual outcome (final corrected-distance-visual-acuity of <0.6 logMAR) and delayed corneal healing (>30 days from initial presentation) were significantly affected by age >50 years, infiltrate size >3mm, and reduced presenting vision (all p<0.05).ConclusionBK represents a significant ocular morbidity in the UK. Culture positivity is associated with more severe disease at presentation but has no significant influence on the final outcome. Older age, large infiltrate, and poor presenting vision were predictive of poor visual outcome and delayed corneal healing, highlighting the importance of primary prevention and early intervention for BK.
Pharmacological Management of Acute Spinal Cord Injury: A longitudinal multi-cohort observational study
Authors: Jutzeler Catherine R. , Bourguignon Lucie , Tong Bobo , Ronca Elias , Bailey Eric , Harel Noam Y. , Geisler Fred , Ferguson Adam R. , Kwon Brian K. , Cragg Jacquelyn J. , Grassner Lukas , Kramer John L.K. 
Published: May 2021

ABSTRACTBackgroundNearly every individual sustaining traumatic spinal cord injury receives multiple types and classes of medications to manage a litany of secondary complications. Prior clinical studies and evidence from animal models suggest that several of these medications could enhance or impede endogenous neurological recovery. However, there is a knowledge gap surrounding the spectrum of pharmacologic agents typically administered in the routine management of spinal cord injury.ObjectiveTo systematically determine the types of medications commonly administered, alone or in combination, in the acute to subacute phase of spinal cord injury.MethodsWe conducted an analysis of two largescale cohorts (the Sygen interventional trial and the SCIRehab observational cohort study) to determine what constitutes “ standards of acute pharmacological care” after spinal cord injury. Concomitant medication use, including dosage, timing and reason for administration, was tracked. Descriptive statistics were used to describe the medications administered within the first 60 days after spinal cord injury.ResultsAcross 2040 individuals with spinal cord injury, 775 unique medications were administered within the two months after injury. On average, patients enrolled in the Sygen trial received 9.9 ± 4.9 (range 0-34), 14.3 ± 6.3 (range 1-40), 18.6 ± 8.2 (range 0-58), and 21.5 ± 9.7 (range 0-59) medications within the first 7, 14, 30, and 60 days post-injury, respectively. Patients enrolled in the SCIRehab cohort study received on average 1.7 ± 1.7 (range 0-11), 3.7 ± 3.7 (range 0-24), 8.5 ± 6.3 (range 0-42), and 13.5 ± 8.3 (range 0-52) medications within the first 7, 14, 30, and 60 days post-injury, respectively. Polypharmacy was commonplace (up to 43 medications per day per patient). Approximately 10% of medications were administered acutely as prophylaxis (e.g., against the development of pain or infections).ConclusionsTo our knowledge, this was the first time acute pharmacological practices have been comprehensively examined after spinal cord injury. Our study revealed a high degree of polypharmacy in the acute stages of spinal cord injury, with potential to both positively and negatively impact neurological recovery. This data may provide key insight to achieve better understanding of how the acute pharmacological management of spinal cord injury affects long-term recovery. All results can be interactively explored on theRXSCIweb site (https://jutzelec.shinyapps.io/RxSCI/) and GitHub repository (https://github.com/jutzca/Acute-Pharmacological-Treatment-in-SCI/).
Generic Patient-Reported Outcomes and Outcome Measures: A Systematic Review Study Protocol
Authors: Seidler Yuki , Mosor Erika , Andrews Margaret , Watson Carolina , Bott Nick , Gross Evelyn , Hazelzet Jan A , Omara Maisa , Ritschl Valentin , Stamm Tanja 
Published: May 2021

AbstractBackgroundPatient-reported outcomes (PROs) are an essential part of health outcome measurement and vital to patient-centricity and valued-based care. Several international consortia have developed core outcome sets and many of them include PROs. PROs are measured by patient-reported outcome measures (PROMs). PROs and PROMs can be generic or specific to certain diseases or conditions. While the characteristics of generic PROs and PROMs are well recognised as widely relevant and applicable across different domains, diseases and conditions, there is a lack of knowledge on the types of PROs measured by generic PROMs. We also do not know in which disease areas generic PROs and PROMs are commonly used. To date, there has been no systematic review solely focusing on generic PROMs, what they measure and their areas of application.ObjectivesThis systematic review will identify core PROs measured by generic PROMs used in adult populations and the areas in which they are applied.MethodsWe will conduct a systematic review of reviews. The screening process and the reporting will comply with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) 2020 Statement. We will use four databases, Medline [PubMed], CINHAL [Ebsco], Cochrane [Cochrane Library], and PsycINFO [Ovid], and reports from international consortia. Inclusion criteria are systematic reviews, meta-analysis or patient-reported outcome sets developed by international consortia reporting on generic PROMs in adult populations. Articles primarily focusing on patient-reported experience measures (PREMs), children or adolescents, or those not written in English will be excluded. Risk of bias will be assessed by checking if the included articles comply with established guidelines for systematic reviews such as the PRISMA statement. We will extract generic PROMs and PROs measured by these PROMs, and the areas applied from the selected articles and reports. Extracted data and information will be quantitatively and qualitatively synthesised without statistical interference. The quality of the synthesised evidences will be assessed by clarifying the strengths, limitations and possible biases in our review.
Insulinopathies of the brain? Genetic overlap between somatic insulin-related and neuropsychiatric disorders
Authors: Fanelli Giuseppe , Franke Barbara , De Witte Ward , Ruisch I. Hyun , Haavik Jan , van Gils Veerle , Jansen Willemijn J. , Vos Stephanie J. B. , Lind Lars , Buitelaar Jan K. , Banaschewski Tobias , Dalsgaard Søren , Serretti Alessandro , Mota Nina Roth , Poelmans Geert , Bralten Janita 
Published: May 2021

AbstractThe prevalence of Alzheimer’s disease (AD), autism spectrum disorder (ASD), and obsessive-compulsive disorder (OCD) is higher among patients with somatic insulinopathies, like metabolic syndrome (MetS), obesity, and type 2 diabetes mellitus (T2DM). Dysregulation of insulin signalling has been implicated in these neuropsychiatric disorders, and shared genetic factors might partly underlie these observed comorbidities. We investigated genetic overlap between AD, ASD, and OCD with MetS, obesity, and T2DM by estimating pairwise genetic correlations using the summary statistics of the largest available genome-wide association studies for these diseases. Stratified covariance analyses were performed to investigate the contribution of insulin-related gene-sets. Having tested these hypotheses, novel brain “insulinopathies” were explored by estimating the genetic relationship of six additional neuropsychiatric disorders with nine insulin-related diseases/traits. Significant genetic correlations were found between OCD and MetS (rg=-0.315, p=3.9e-8), OCD and obesity (rg=-0.379, p=3.4e-5), and OCD and T2DM (rg=-0.172, p=3e-4). Stratified analyses showed negative genetic covariances between ASD and MetS/T2DM through gene-sets comprising insulin signalling and/or insulin processing genes, and between AD/OCD and MetS/T2DM through an insulin receptor recycling gene-set (p<6.17e-4). Significant genetic correlations with insulin-related phenotypes were also found for anorexia nervosa, attention-deficit/hyperactivity disorder, major depression, and schizophrenia (p<6.17e-4). Our findings suggest the existence of two clusters of neuropsychiatric disorders, in which the genetics of insulin-related diseases and traits may exert divergent pleiotropic effects. These results represent a starting point for a new research line on “insulinopathies” of the brain, which may support the development of more effective/tolerated treatment strategies for neuropsychiatric disorders.
Risk-Averse Multi-Stage Stochastic Programming to Optimizing Vaccine Allocation and Treatment Logistics for Effective Epidemic Response
Authors: Yin Xuecheng , Büyüktahtakın İ. Esra 
Published: May 2021

AbstractExisting compartmental-logistics models in epidemics control are limited in terms of optimizing the allocation of vaccines and treatment resources under a risk-averse objective. In this paper, we present a data-driven, mean-risk, multi-stage, stochastic epidemics-vaccination-logistics model that evaluates various disease growth scenarios under the Conditional Value-at-Risk (CVaR) risk measure to optimize the distribution of treatment centers, resources, and vaccines, while minimizing the total expected number of infections, deaths, and close contacts of infected people under a limited budget. We integrate a new ring vaccination compartment into a Susceptible-Infected-Treated-Recovered-Funeral-Burial epidemics-logistics model. Our formulation involves uncertainty both in the vaccine supply and the disease transmission rate. Here, we also consider the risk of experiencing scenarios that lead to adverse outcomes in terms of the number of infected and dead people due to the epidemic. Combining the risk-neutral objective with a risk measure allows for a trade-off between the weighted expected impact of the outbreak and the expected risks associated with experiencing extremely disastrous scenarios. We incorporate human mobility into the model and develop a new method to estimate the migration rate between each region when data on migration rates is not available. We apply our multi-stage stochastic mixed-integer programming model to the case of controlling the 2018-2020 Ebola Virus Disease (EVD) in the Democratic Republic of the Congo (DRC) using real data. Our results show that increasing the risk-aversion by emphasizing potentially disastrous outbreak scenarios reduces the expected risk related to adverse scenarios at the price of the increased expected number of infections and deaths over all possible scenarios. We also find that isolating and treating infected individuals are the most efficient ways to slow the transmission of the disease, while vaccination is supplementary to primary interventions on reducing the number of infections. Furthermore, our analysis indicates that vaccine acceptance rates affect the optimal vaccine allocation only at the initial stages of the vaccine rollout under a tight vaccine supply.