bluuebunny/crossref_metadata_2025_split huggingface dataset:
Time Windows Voting Classifier for COVID-19 Mortality Prediction
Authors: Goh Tiong-Thye , Liu MengJun 
Published: July 2021

BackgroundThe ability to predict COVID-19 patients’ level of severity (death or survival) enables clinicians to prioritise treatment. Recently, using three blood biomarkers, an interpretable machine learning model was developed to predict the mortality of COVID-19 patients. The method was reported to be suffering from performance stability because the identified biomarkers are not consistent predictors over an extended duration.MethodsTo sustain performance, the proposed method partitioned data into three different time windows. For each window, an end-classifier, a mid-classifier and a front-classifier were designed respectively using the XGboost single tree approach. These time window classifiers were integrated into a majority vote classifier and tested with an isolated test data set.ResultsThe voting classifier strengthens the overall performance of 90% cumulative accuracy from a 14 days window to a 21 days prediction window.ConclusionsAn additional 7 days of prediction window can have a considerable impact on a patient’s chance of survival. This study validated the feasibility of the time window voting classifier and further support the selection of biomarkers features set for the early prognosis of patients with a higher risk of mortality.
Evaluating Adoption, Impact, and Factors Driving Adoption for TREWS, a Machine Learning-Based Sepsis Alerting System
Authors: Henry Katharine E. , Adams Roy , Parent Cassandra , Sridharan Anirudh , Johnson Lauren , Hager David N. , Cosgrove Sara E. , Markowski Andrew , Klein Eili Y. , Chen Edward S. , Henley Maureen , Miranda Sheila , Houston Katrina , Linton Robert C. , Ahluwalia Anushree R. , Wu Albert W. , Saria Suchi 
Published: July 2021

ABSTRACTMachine learning-based clinical decision support tools for sepsis create opportunities to identify at-risk patients and initiate treatments earlier, critical to improving sepsis outcomes. Increasing use of such systems necessitates quantifying and understanding provider adoption. Using real-time provider interactions with a sepsis early detection tool (Targeted Real-time Early Warning System) deployed at five hospitals over a two-year period (469,419 screened encounters, 9,805 (2.1%) retrospectively-identified sepsis cases), we found high sensitivity (82% of sepsis cases identified), high adoption rates (89% of alerts evaluated by a physician or advanced practice provider and 38% of evaluated alerts confirmed) and an association between use of the tool and earlier treatment of sepsis patients (1.85 (95% CI:1.66-2.00) hour reduction in median time to first antibiotics order). Further, we found that provider-related factors were strongly associated with adoption. Beyond improving system performance, efforts to improve adoption should focus on provider knowledge, experience, and perceptions of the system.
Evaluating the Clinical Feasibility of an Artificial Intelligence-Powered Clinical Decision Support System: A Longitudinal Feasibility Study
Authors: Popescu Christina , Golden Grace , Benrimoh David , Tanguay-Sela Myriam , Slowey Dominique , Lundrigan Eryn , Williams Jérôme , Desormeau Bennet , Kardani Divyesh , Perez Tamara , Rollins Colleen , Israel Sonia , Perlman Kelly , Armstrong Caitrin , Baxter Jacob , Whitmore Kate , Fradette Marie-Jeanne , Felcarek-Hope Kaelan , Soufi Ghassen , Fratila Robert , Mehltretter Joseph , Looper Karl , Steiner Warren , Rej Soham , Karp Jordan F. , Heller Katherine , Parikh Sagar V. , McGuire-Snieckus Rebecca , Ferrari Manuela , Margolese Howard , Turecki Gustavo 
Published: July 2021

AbstractObjectiveWe examine the feasibility of an Artificial Intelligence (AI)-powered clinical decision support system (CDSS), which combines the operationalized 2016 Canadian Network for Mood and Anxiety Treatments guidelines with a neural-network based individualized treatment remission prediction.MethodsDue to COVID-19, the study was adapted to be completed entirely at a distance. Seven physicians recruited outpatients diagnosed with major depressive disorder (MDD) as per DSM-V criteria. Patients completed a minimum of one visit without the CDSS (baseline) and two subsequent visits where the CDSS was used by the physician (visit 1 and 2). The primary outcome of interest was change in session length after CDSS introduction, as a proxy for feasibility. Feasibility and acceptability data were collected through self-report questionnaires and semi-structured interviews.ResultsSeventeen patients enrolled in the study; 14 completed. There was no significant difference between appointment length between visits (introduction of the tool did not increase session length). 92.31% of patients and 71.43% of physicians felt that the tool was easy to use. 61.54% of the patients and 71.43% of the physicians rated that they trusted the CDSS. 46.15% of patients felt that the patient-clinician relationship significantly or somewhat improved, while the other 53.85% felt that it did not change.ConclusionsOur results confirm the primary hypothesis that the integration of the tool does not increase appointment length. Findings suggest the CDSS is easy to use and may have some positive effects on the patient-physician relationship. The CDSS is feasible and ready for effectiveness studies.
Masks in a Post COVID-19 World: A Better Alternative to Curtailing Influenza?
Authors: Froese Henri , Prempeh Angel G. A. 
Published: July 2021

AbstractOver the course of the coronavirus pandemic, it has become apparent that non-pharmaceutical interventions such as masks and social distancing are of great help in mitigating the transmission of airborne infectious diseases. Additionally, data from respiratory specimen analysis from the past year show that current mask mandates established for COVID-19 have inadvertently reduced the rates of other respiratory diseases, including influenza. Thus, the question arises as to whether comparatively mild measures should be kept in place after the pandemic to reduce the impact of influenza. In this study, we employed a series of differential equations to simulate past influenza seasons, assuming people wore face masks. This was achieved by introducing a variable to account for the efficacy and prevalence of masks and then analyzing its impact on influenza transmission rate in an SEIR model fit to the actual past seasons. We then compared influenza rates in this hypothetical scenario with the actual rates over the seasons. Our results show that several combinations of mask efficacy and prevalence can significantly reduce the burden of seasonal influenza. Particularly, our simulations suggest that a minority of individuals wearing masks greatly reduce the number of influenza infections. Considering the efficacy rates of masks and the relatively insignificant monetary cost, we highlight that it may be a viable alternative or complement to influenza vaccinations. We conclude with a brief discussion of our results and other practical aspects
IFIH1 rs1990760 variants, systemic inflammation and outcome in critically-ill COVID-19 patients
Authors: Amado-Rodríguez Laura , del Riego Estefanía Salgado , de Oña Juan Gómez , López-Alonso Inés , Gil-Peña Helena , López-Martínez Cecilia , Martín-Vicente Paula , López-Vázquez Antonio , González-López Adrián , Cuesta-Llavona Elías , Rodríguez-García Raquel , Boga José Antonio , Álvarez-Arguelles Marta Elena , Mayordomo-Colunga Juan , Vidal-Castiñeira José Ramón , Crespo Irene , Fernández Margarita , Criado Loreto , Salvadores Victoria , Jimeno-Demuth Francisco José , Blanch Lluís , Prieto Belén , Fernández-Fernández Alejandra , López-Larrea Carlos , Coto Eliecer , Albaiceta Guillermo M 
Published: July 2021

AbstractRationaleOutcomes in patients with severe SARS-CoV-2 infection (COVID-19) are conditioned by virus clearance and regulation of inflammation. Variants in IFIH1, a gene coding the cytoplasmatic RNA sensor MDA5, regulate the response to viral infections.ObjectiveTo characterize the impact of IFIH1 rs199076 variants on host response and outcomes after severe COVID-19.MethodsPatients admitted to an intensive care unit (ICU) with confirmed COVID-19 were prospectively studied and rs1990760 variants determined. Peripheral blood gene expression, cell populations and immune mediators were measured. Peripheral blood mononuclear cells from healthy volunteers were exposed to an MDA5 agonist and dexamethasone ex-vivo, and changes in gene expression assessed. ICU discharge and hospital death were modelled using rs1990760 variants and dexamethasone as factors in this cohort and in-silico clinical trials.Measurements and Main Results227 patients were studied. Patients with the IFIH1 rs1990760 TT variant showed a lower expression of inflammation-related pathways, an anti-inflammatory cell profile and lower concentrations of pro-inflammatory mediators. Cells with TT variant exposed to a MDA5 agonist showed an increase in IL6 expression after dexamethasone treatment. All patients with the TT variant not treated with steroids (N=14) survived their ICU stay (HR 2.49, 95% confidence interval 1.29–4.79). Patients with a TT variant treated with dexamethasone (N=50) showed an increased hospital mortality (HR 2.19, 95% confidence interval 1.01–4.87) and serum IL-6. In-silico clinical trials supported these findings.ConclusionsCOVID-19 patients with the IFIH1 rs1990760 TT variant show an attenuated inflammatory response and better outcomes. Dexamethasone may reverse this anti-inflammatory phenotype.
Preserved C-reactive protein responses to blood stream infections following tocilizumab treatment for COVID-19
Authors: Wey Emmanuel Q , Bristow Clare , Nandani Aarti , O’Farrell Bryan , Pang Jay , Lanzman Marisa , Yang Shuang , Ho Soo , Mack Damien , Spiro Michael , Balakrishnan Indran , Bhagani Sanjay , Pollara Gabriele 
Published: July 2021

AbstractC-reactive protein (CRP) levels are elevated following bacterial infections but may be attenuated by the IL-6-receptor antagonist tocilizumab. In hospitalised COVID-19 patients, tocilizumab induced a transient (<21 day) fall in CRP but retained CRP responses to nosocomial blood stream infections, and therefore its utility in guiding antibiotic prescribing.
Vaccination willingness for COVID-19 among health care workers in Switzerland
Authors: Zürcher Kathrin , Mugglin Catrina , Egger Matthias , Müller Sandro , Fluri Michael , Bolick Laurence , Piso Rein Jan , Hoffmann Matthias , Fenner Lukas 
Published: July 2021

ABSTRACTAims of the studyVaccination is regarded as the most promising response to the COVID-19 pandemic. We assessed opinions towards COVID-19 vaccination, willingness to be vaccinated, and reasons for vaccination hesitancy among health care workers (HCWs).MethodsWe conducted a cross-sectional, web-based survey among 3,793 HCWs in December 2020 in the Canton of Solothurn, Switzerland, before the start of the national COVID-19 vaccination campaign.ResultsMedian age was 43 years (interquartile range [IQR] 31-53), 2,841 were female (74.9%). 1,511 HCWs (39.8%) reported willingness to accept vaccination, while 1,114 (29.4%) were unsure, and 1,168 (30.8%) would decline vaccination. Among medical doctors, 76.1% were willing, while only 27.8% of nurses expressed willingness. Among 1,168 HCWs who would decline vaccination, 1,073 (91.9%) expressed concerns about vaccine safety and side effects. The willingness of HCWs to be vaccinated was associated with older age (adjusted odds ratio [aOR] 1.97, 95%Cl 1.71-2.27) and having been vaccinated for influenza this year (aOR 2.70, 95%Cl 2.20-3.31). HCWs who reported a lack of confidence in government were less likely to be willing to be vaccinated (aOR 0.58, 95%Cl 0.40-0.84), and women were less willing to be vaccinated than men (OR 0.33 (0.28-0.38).ConclusionLess than half of HCWs reported willingness to be vaccinated before the campaign start, but proportions varied greatly depending on the profession and workplace. Strategies with clear and objective messages that particularly address the concerns of HCWs are needed if their willingness to be vaccinated is to be increased.
Analysis of the association between rs111200466 variants and cervical Cancer susceptibility in Sudanese women
Authors: Andarawi Safaa Othman , Bakheit Sahar 
Published: July 2021

AbstractWorldwide there are more than 273,000 deaths from cervical cancer each year and it accounts for 9% of female cancer deaths. The high-risk variants of human papillomavirus such as HPV 16 and 18 are major etiological agents of cervical cancer. The persistency of infection with HPV may due to inappropriate immune response due to SNPs interfering with the function of particular part of the immune system. Toll-like receptors (TLRs) play an important role in the signaling of many pathogen-related molecules and endogenous proteins associated with immune activation. The –196 to –174del polymorphism affects the TLR2 gene and alters its promoter activity.AimIn this study we investigated the presence and the influence of TLR2 –196 to – 174del polymorphism on the risk of cervical cancer development in Sudanese. The study was performed on 42 patients with cervical cancer and 27 healthy controls. Genotyping of –196 to –174del polymorphism of TLR2 was investigated using allele-specific polymerase chain reaction method in all subjects. We documented the presence of–196 to –174del polymorphism of TLR2 in Sudanese women with allele frequency 37% of control and 34% of patient sample although there was no observed association between this SNP and the risk of cervical cancer (p value. 394).Further studies are needed in a large and ethnically diverse population to determine the impact of the TLR2 polymorphism in the susceptibility of cervical cancer.
Excess years of life lost to COVID-19 and other causes of death by sex, neighbourhood deprivation and region in England & Wales during 2020
Authors: Kontopantelis Evangelos , Mamas Mamas A. , Webb Roger T. , Castro-Avila Ana , Rutter Martin K. , Gale Chris P. , Ashcroft Darren M. , Pierce Matthias , Abel Kathryn M. , Price Gareth , Faivre-Finn Corinne , Van Spall Harriette G.C. , Graham Michelle M. , Morciano Marcello , Martin Glen P. , Sutton Matt , Doran Tim 
Published: July 2021

AbstractBackgroundDeaths in the first year of the COVID-19 pandemic in England & Wales have been shown to be unevenly distributed socioeconomically and geographically. However, the full scale of inequalities may have been underestimated as most measures of excess mortality do not adequately account for varying age profiles of deaths between social groups. We measured years of life lost (YLL) attributable to the pandemic, directly or indirectly, comparing mortality across geographic and socioeconomic groups.MethodsYLL for registered deaths in England & Wales, from 27th December 2014 until 25th December 2020, were calculated using 2019 single year sex-specific life tables for England & Wales. Panel time-series models were used to estimate expected YLL by sex, geographical region, and deprivation quintile between 7th March 2020 and 25th December 2020 by cause: direct deaths (COVID-19 and other respiratory diseases), cardiovascular disease & diabetes, cancer, and other indirect deaths - all other causes). Excess YLL during the pandemic period were calculated by subtracting observed from expected values. Additional analyses focused on excess deaths for region and deprivation strata, by age-group.FindingsBetween 7th March 2020 and 25th December 2020 there were an estimated 763,550 (95% CI: 696,826 to 830,273) excess YLL in England & Wales, equivalent to a 15% (95% CI: 14 to 16) increase in YLL compared to the equivalent time period in 2019. There was a strong deprivation gradient in all-cause excess YLL, with rates per 100,000 population ranging from (916; 95% CI: 820 to 1,012) for the least deprived quintile to (1,645; 95% CI: 1,472 to 1,819) for the most deprived. The differences in excess YLL between deprivation quintiles were greatest in younger age groups; for all-cause deaths, an average of 9.1 years per death (95% CI: 8.2 to 10.0) were lost in the least deprived quintile, compared to 10.8 (95% CI: 10.0 to 11.6) in the most deprived; for COVID-19 and other respiratory deaths, an average of 8.9 years per death (95% CI: 8.7 to 9.1) were lost in the least deprived quintile, compared to 11.2 (95% CI: 11.0 to 11.5) in the most deprived. There was marked variability in both all-cause and direct excess YLL by region, with the highest rates in both in the North West.InterpretationDuring 2020, the first calendar year of the COVID-19 pandemic, longstanding socioeconomic and geographical health inequalities in England & Wales were exacerbated, with the most deprived areas suffering the greatest losses in potential years of life lost.FundingNone
What We Learned from COVID-19: From endotheliitis to treatment
Authors: Dirican Adem , Ildir Selin , Uzar Tugce , Karaman Irem , Ozkaya Sevket 
Published: July 2021

AbstractObjectiveCOVID-19 may yield a variety of clinical pictures, differing from pneumonitis to Acute Respiratory Distress Syndrome (ARDS) along with vascular damage in the lung tissue, named asendotheliitis. To date, no specific treatment strategy was approved by any authority for the prevention or treatment of COVID-19 in terms of endotheliitis-related comorbidities. Here, we present our experience of COVID-19 by evaluating 11,190 COVID-19 patients with the manifestations of endotheliitis in skin, lung, and brain tissues according to the different phases of COVID-19.MethodsAfter a retrospective examination, patients were divided into three groups according to their repercussions of vascular distress, which were represented by radiological, histopathological, and clinical findings. (Group A: no or mild pulmonary involvement, Group B: moderate pulmonary involvement with clinical risk of deterioration, Group C: severe pulmonary involvement and respiratory failure). We presented the characteristics and disease course of seven representative and complicated cases which represents the different phases of the disease, and discussed the treatment strategies in each group. The current pathophysiological mechanisms responsible from SARS-CoV-2 infection, COVID-19 related respiratory failure and current treatment strategies were reviewed and discussed in detail.ResultsAmong 11.190 patients, 9294 patients met the criteria for Group A, and 1376 patients were presented to our clinics with Group B characteristics. Among these patients, 1896 individuals(Group B and Group C) were hospitalized. While 1220 inpatients were hospitalized within the first 10 days after the diagnosis, 676 of them were worsened and hospitalized 10 days after their diagnosis. Among hospitalized patients, 520 of them did not respond to group A and B treatments and developed hypoxemic respiratory failure (Group C) and 146 individuals needed ventilator support and were followed in the intensive care unit, and 43 (2.2%) patients died.ConclusionDistinctive manifestations in each COVID-19 patient, including non-respiratory conditions in the acute phase and the emerging risk of long-lasting complications, suggest that COVID-19 has anendotheliitis-centred thrombo-inflammatory pathophysiology. Endotheliitis can also explain the mechanism behind the respiratory failure in COVID-19, and the difference of COVID-19 related ARDS from ARDS seen in other critical conditions. In addition, use of early corticosteroid in patients with early symptoms and early tocilizumab in ICU helps to reduce mortality and progression of the disease. Endotheliitis-based pathophysiological mechanisms are known to be momentarily changing and difficut to manage due to their risk of sudden aggrevation. Hence, daily evaluation of clinical, laboratory and radiological findings of patients and deciding appropriate pathophysiological treatment would help to reduce the mortality rate of COVID-19.
High mortality of COVID-19 associated mucormycosis in France: a nationwide retrospective study
Authors: Danion François , Letscher-Bru Valérie , Guitard Juliette , Sitbon Karine , Dellière Sarah , Angoulvant Adela , Desoubeaux Guillaume , Botterel Francoise , Bellanger Anne-Pauline , Gargala Gilles , Uhel Fabrice , Bougnoux Marie-Elisabeth , Gerber Victor , Michel Justin , Cornu Marjorie , Bretagne Stéphane , Lanternier Fanny ,   the COVID-Mucor study group
Published: July 2021

AbstractWe studied COVID-19 associated mucormycosis based on 17 cases reported nationwide and assessed the differences with India. They differed by frequencies of diabetes mellitus (47% in France versus 95% in India), hematological malignancies (35% versus 1%), anatomical sites (53% lung versus >80% rhino-orbito-cerebral) and prognosis (>80% mortality versus <50%).
Application of nasal spray containing dimethyl sulfoxide (DMSO) and ethanol during the COVID-19 pandemic may protect healthcare workers: A randomized controlled trials
Authors: Hosseinzadeh Ali , Tavakolian Abbas , Kia Vahid , Ebrahimi Hossein , Sheibani Hossein , Binesh Ehsan , Jafari Reza , Mirrezaie Seyed Mohammad , Jafarisani Moslem , Emamian Mohammad Hassan 
Published: July 2021

AbstractBackgroundCoronavirus pandemic has affected a large population worldwide. Currently, the standard care for individuals who are exposed is supportive care, symptomatic management, and isolation. The aim of our study was to evaluate effects of combined use of ethanol and DMSO as a nasal spray in preventing COVID-19.MethodsWe conducted a randomized controlled trial on volunteer healthcare workers of medical centers that were at the forefront of the fight against COVID-19 in Shahroud, Iran. Two hundred and thirty-two participants were randomly assigned to intervention and control groups to receive DMSO/ethanol or routine care, respectively. The subjects were followed for 4 weeks to determine the incidence of COVID-19 infection in each group based on the RT-qPCR test. Finally, absolute risk difference and relative risk were calculated to evaluate the effect of DMSO in prevent COVID-19.ResultsThe results showed that the incidence of COVID-19 in the control group and intervention group were 0.07 and 0.008, respectively. The relative risk (RR) was 0.12 (0.9-0.02) according to the incidence rate in the two groups.Conclusioncombined application of DMSO and ethanol in healthcare providers can considerably prevent COVID-19.