bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Care Providers in Federally Qualified Health Centers Can Treat Hepatitis C Effectively Without Ongoing Consultative Support From Specialists
Authors: Moore Richard A. , Fried Michael W. , Wright Brad 
Published: June 2021

Background:
Hepatitis C virus (HCV) infection remains underdiagnosed and undertreated, but treatment advances may allow primary care providers to address gaps in care by delivering HCV treatment themselves.

Objective:
The objective of this study was to evaluate results of an HCV treatment program at a federally qualified health center (FQHC) in rural North Carolina and assess the extent to which program success depends upon ongoing consultative support from specialists.

Methods:
In this retrospective cohort study, we used data on 381 FQHC patients internally referred for HCV care from January 2015 to December 2018, with follow-up through December 2019. Using modified Poisson regression analyses we compared outcomes during periods with (2015–2016) and without (2017–2018) consultative support. Outcomes included treatment initiation, completion, and cure. We also modeled the likelihood of keeping the first appointment, but because multiple referral attempts were made among nonresponsive patients throughout the study period, we could not compare this outcome in periods with and without consultative support.

Results:
Of all patients referred for evaluation, 91.3% kept at least 1 appointment, 74.1% initiated treatment, 72% completed treatment, and 68.1% were cured. When comparing periods with and without consultative support, there were no significant differences in treatment initiation ([relative risk (RR): 0.975, 95% confidence interval (CI): 0.871, 1.092], treatment completion (RR: 0.989, 95% CI: 0.953, 1.027), or cure (RR: 0.977, 95% CI: 0.926, 1.031).

Conclusions:
After 2 years of consultative support from specialists, primary care providers at FQHCs can deliver HCV treatment effectively without ongoing support. However, more research is needed to determine whether our findings are generalizable across primary care settings.
Diabetes in chronic pancreatitis: risk factors and natural history
Authors: Goodarzi Mark O. , Petrov Maxim S. , Andersen Dana K. , Hart Phil A. 
Published: June 2021

Purpose of review
The purpose of this review is to delineate risk factors for the development of diabetes in patients with chronic pancreatitis. The natural history including progression to diabetes and complications that develop once diabetes occurs in chronic pancreatitis is also reviewed.

Recent findings
Studies have found that predictors of diabetes in chronic pancreatitis include both risk factors for type 2 diabetes (e.g., obesity, genetic variants) as well as pancreas-specific factors (e.g., pancreatic calcification, exocrine insufficiency). Rates of diabetes in chronic pancreatitis are strongly related to the duration of chronic pancreatitis, reflecting progressive dysfunction and damage to the insulin-secreting beta cells. Patients with diabetes and chronic pancreatitis experience an excess burden of complications, including higher all-cause and cancer-related mortality.

Summary
The high incidence and significant impact of diabetes on the morbidity and mortality of patients with chronic pancreatitis highlights the urgent need for clinically applicable models to predict diabetes in those with chronic pancreatitis, allowing efforts for targeted interventions to prevent diabetes. Research being carried out in the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer holds promise to fulfill these goals.
Equity of access to renal transplantation: a European perspective
Authors: Wu Diana A. , Oniscu Gabriel C. 
Published: June 2021

Purpose of review
Renal transplantation offers the chance for patients with end-stage renal disease (ESRD) to have a significantly longer, healthier and better quality life compared with remaining on dialysis. Inequities have been demonstrated at multiple points in the transplantation pathway. In this review, the factors contributing to inequity in access to renal transplantation will be explored from a European perspective.

Recent findings
Despite improvements in patient assessment and revision of organ-offering schemes, there remain persistent inequities in access to the waiting list, allocation of a deceased donor transplant, receiving a living donor transplant and achieving preemptive transplantation. Older age, lower socioeconomic status and health literacy are key factors that continue to impact equity of access to transplantation.

Summary
A number of modifiable factors have been identified affecting access to transplantation, Increased patient education together with a better access to and promotion of living donation may help address some of these inequities.
Objective Measures of Retinal Image Degradation Due to Refractive Corrections
Authors: Westheimer Gerald 
Published: June 2021

SIGNIFICANCE
There is a need for a measure, as simple and yet as informative as possible, to describe objectively the retinal image quality when a patient views targets at various distances through spectacle, contact, or intraocular corrections with optics more elaborate than single vision.

PURPOSE
The purposes of this study are to examine the current status of quantitative descriptions of retinal image blur and find optimal characterization of image degradation.

METHODS
A variety of indexes of image degradation are computed for a typical eye and polychromatic light, in and out of focus, and as exemplars of sophisticated wave shaping, when the pupil transmission has been modified to a truncated Bessel amplitude function and to a “fractal” phase function.

RESULTS
Figures are shown for the optical transfer, point- and edge-spread functions, and Koenig bar and optotype letter blur for the various imaging and defocus conditions, and the relative values of several blur indexes are compared graphically and in a correlation table.

CONCLUSIONS
No single index captures the many ways in which the image can deviate from the diffraction-limited ideal. Among the incomplete descriptors of image degradation, the light distribution at a sharp edge stands out as optimally informative and economical, and, when condensed to just two values, one representing central image sharpness and the other outlying light spread, allows for a quick survey of the imaging deficit.
ICU Admission in Children With Acute Lymphoblastic Leukemia in Sweden: Prevalence, Outcome, and Risk Factors
Authors: Ranta Susanna , Broman Lars Mikael , Abrahamsson Jonas , Berner Jonas , Fläring Urban , Hed Myrberg Ida , Kalzén Håkan , Karlsson Lene , Mellgren Karin , Nilsson Anna , Norén-Nyström Ulrika , Palle Josefine , von Schewelov Katarina , Svahn Johan E. , Törnudd Lisa , Heyman Mats , Harila-Saari Arja 
Published: June 2021

OBJECTIVES:
Despite progress in the treatment of childhood acute lymphoblastic leukemia, severe complications are common, and the need of supportive care is high. We explored the cumulative prevalence, clinical risk factors, and outcomes of children with acute lymphoblastic leukemia, on first-line leukemia treatment in the ICUs in Sweden.

DESIGN:
A nationwide prospective register and retrospective chart review study.

SETTING:
Children with acute lymphoblastic leukemia were identified, and demographic and clinical data were obtained from the Swedish Childhood Cancer Registry. Data on intensive care were collected from the Swedish Intensive Care Registry. Data on patients with registered ICU admission in the Swedish Childhood Cancer Registry were supplemented through questionnaires to the pediatric oncology centers.

PATIENTS:
All 637 children 0–17.9 years old with acute lymphoblastic leukemia diagnosed between June 2008 and December 2016 in Sweden were included.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Twenty-eight percent of the children (178/637) were admitted to an ICU at least once. The Swedish Intensive Care Registry data were available for 96% of admissions (241/252). An ICU admission was associated with poor overall survival (hazard ratio, 3.25; 95% CI, 1.97–5.36; p ≤ 0.0001). ICU admissions occurred often during early treatment; 48% (85/178) were admitted to the ICU before the end of the first month of acute lymphoblastic leukemia treatment (induction therapy). Children with T-cell acute lymphoblastic leukemia or CNS leukemia had a higher risk of being admitted to the ICU in multivariable analyses, both for early admissions before the end of induction therapy and for all admissions during the study period.

CONCLUSIONS:
The need for intensive care in children with acute lymphoblastic leukemia, especially for children with T cell acute lymphoblastic leukemia and CNS leukemia, is high with most admissions occurring during early treatment.
The Longitudinal Effects of Blood Pressure and Hypertension on Neurocognitive Performance in People Living With HIV
Authors: Guzman Vanessa A. , Cham Heining , Gutierrez Jose , Byrd Desiree , Morris Emily P. , Tureson Kayla , Morgello Susan , Mindt Monica R. ,   for the Manhattan HIV Brain Bank
Published: June 2021

Background:
Hypertension (HTN) and HIV are salient risk factors for cerebral small vessel disease and neurocognitive (NC) impairment, yet the effects of HTN on NC performance in persons living with HIV remain poorly understood. This is the first study to examine the longitudinal associations between blood pressure (BP), HTN, and pulse pressure (PP) with NC performance in persons living with HIV.

Setting:
New York City.

Methods:
Analysis of medical, NC, and virologic data from 485 HIV+ participants was collected by the Manhattan HIV Brain Bank, a prospective, observational, longitudinal study of neuroHIV. A series of multilevel linear growth curve models with random intercepts and slopes were estimated for BP, HTN status, and PP to predict the change in NC performance.

Results:
The baseline prevalence of HTN was 23%. Longitudinal changes in diastolic and systolic pressure were associated with a 10.5-second and 4-second increase in the Grooved Pegboard Test nondominant hand performance, respectively. A longitudinal change in diastolic BP was also associated with a 0.3-point decline in correct categories and 3-point increase in perseverative responses and total errors on the Wisconsin Card Sorting Test. Increasing odds of prevalent and/or incident HTN were associated with a 0.1-point decrease in correct categories and a 0.8-point increase in total errors on the Wisconsin Card Sorting Test. There was no association between PP and NC performance.

Conclusions:
The results indicate linear longitudinal relations for BP and HTN with poorer NC test performance, particularly in psychomotor and executive functions in persons with HIV.
Alexithymia is associated with reduced vitamin D levels, but not polymorphisms of the vitamin D binding-protein gene
Authors: Terock Jan , Hannemann Anke , Weihs Antoine , Janowitz Deborah , Grabe Hans J. 
Published: June 2021

Objective
Alexithymia is a personality trait characterized by difficulties in identifying and describing emotions, which is associated with various psychiatric disorders, including depression and posttraumatic stress disorder (PTSD). Its pathogenesis is incompletely understood but previous studies suggested that genetic as well as metabolic factors, are involved. However, no results on the role of vitamin D and the polymorphisms rs4588 and rs7041 of the vitamin D binding protein (VDBP) have been published so far.

Methods
Serum levels of total 25(OH)D were measured in two general-population samples (total n = 5733) of the Study of Health in Pomerania (SHIP). The Toronto Alexithymia Scale-20 (TAS-20) was applied to measure alexithymia. Study participants were genotyped for rs4588 and rs7041. Linear and logistic regression analyses adjusted for sex, age, waist circumference, physical activity, season and study and, when applicable, for the batch of genotyping and the first three genetic principal components, were performed. In sensitivity analyses, the models were additionally adjusted for depressive symptoms.

Results
25(OH)D levels were negatively associated with TAS-20 scores (β = −0.002; P < 0.001) and alexithymia according to the common cutoff of TAS-20>60 (β = −0.103; P < 0.001). These results remained stable after adjusting for depressive symptoms. The tested genetic polymorphisms were not significantly associated with alexithymia.

Conclusions
Our results suggest that low vitamin D levels may be involved in the pathophysiology of alexithymia. Given that no associations between alexithymia and rs4588 as well as rs7041 were observed, indicates that behavioral or nutritional features of alexithymic subjects could also explain this association.
Seasonal Disease in the United States Has the Hallmarks of an Entrained Circannual Clock
Authors: Schober Andrew F. , Rzhetsky Andrey , Rust Michael J. 
Published: June 2021

AbstractInfectious human diseases are often characterized by seasonal variation in incidence which produces recurring annual peaks with precise timing. Changing weather conditions such as temperature and humidity are known to affect virus transmission, but we consider the possibility that an intrinsic rhythm in susceptibility, entrained to annual cues, also contributes to seasonality. These two mechanisms produce different predictions about how the timing and amplitude of seasonal disease depend on environmental forcing. Using databases of health insurance claims and weather across U.S. counties, we find that the timing of winter-peaking diseases, but not their amplitude, scales with latitude. This latitude scaling is shared across many diagnosis codes involving multiple pathogens. Regression against simple models suggests an underlying limit cycle that, in temperate zones, is entrained to annual changes in irradiance, possibly a human circannual clock.Significance statementPeak timing but not amplitude of seasonal disease scales with latitude, suggesting a circannual rhythm in host susceptibility.
Regular testing of asymptomatic healthcare workers identifies cost-efficient SARS-CoV-2 preventive measures
Authors: Sanchez-Taltavull Daniel , Castelo-Szekely Violeta , Murugan Shaira , Rollenske Tim , Ganal-Vonarburg Stephanie C. , Büchi Isabel , Keogh Adrian , Li Hai , Salm Lilian , Spari Daniel , Yilmaz Bahtiyar , Zimmermann Jakob ,   UVCM-COVID researchers, Gerfin Michael , Roldan Edgar , Beldi Guido 
Published: June 2021

AbstractProtecting healthcare professionals is crucial in maintaining a functioning health-care system. The risk of infection and optimal preventive strategies for health-care workers during the COVID-19 pandemic remain poorly understood. Here we report the results of a weekly testing regime that has been performed since the beginning of the COVID-19 pandemic to identify pre- and asymptomatic healthcare workers. Based on these observations we have developed a mathematical model of SARS-CoV-2 transmission that integrates the sources of infection from inside and outside the hospital. The data were used to study how regular testing and a desynchronisation protocol are effective in preventing transmission of COVID-19 infection at work, and compared both strategies in terms of workforce availability and cost-effectiveness. We showed that case incidence among healthcare workers is higher than would be explained solely by community infection. Furthermore, while testing and desynchronisation protocols are both effective in preventing nosocomial transmission, regular testing maintains work productivity with implementation costs.
Genomic characterization and Epidemiology of an emerging SARS-CoV-2 variant in Delhi, India
Authors: Dhar Mahesh S , Marwal Robin , Radhakrishnan VS , Ponnusamy Kalaiarasan , Jolly Bani , Bhoyar Rahul C. , Sardana Viren , Naushin Salwa , Rophina Mercy , Mellan Thomas A , Mishra Swapnil , Whittaker Charles , Fatihi Saman , Datta Meena , Singh Priyanka , Sharma Uma , Ujjainiya Rajat , Batheja Nitin , Divakar Mohit Kumar , Singh Manoj K , Imran Mohamed , Senthivel Vigneshwar , Maurya Ranjeet , Jha Neha , Mehta Priyanka , Vivekanand A , Sharma Pooja , Arvinden VR , Chaudhary Urmila , Soni Namita , Thukral Lipi , Flaxman Seth , Bhatt Samir , Pandey Rajesh , Dash Debasis , Faruq Mohammed , Lall Hemlata , Gogia Hema , Madan Preeti , Kulkarni Sanket , Chauhan Himanshu , Sengupta Shantanu , Kabra Sandhya ,   The Indian SARS-CoV-2 Genomics Consortium (INSACOG), Gupta Ravindra K. , Singh Sujeet K , Agrawal Anurag , Rakshit Partha 
Published: June 2021

AbstractDelhi, the national capital of India, has experienced multiple SARS-CoV-2 outbreaks in 2020 and reached a population seropositivity of over 50% by 2021. During April 2021, the city became overwhelmed by COVID-19 cases and fatalities, as a new variant B.1.617.2 (Delta) replaced B.1.1.7 (Alpha). A Bayesian model explains the growth advantage of Delta through a combination of increased transmissibility and partial reduction of immunity elicited by prior infection (median estimates; ×1.5-fold, 20% reduction). Seropositivity of an employee and family cohort increased from 42% to 86% between March and July 2021, with 27% reinfections, as judged by increased antibody concentration after previous decline. The likely high transmissibility and partial evasion of immunity by the Delta variant contributed to an overwhelming surge in Delhi.One-Sentence SummaryDelhi experienced an overwhelming surge of COVID-19 cases and fatalities peaking in May 2021 as the highly transmissible and immune evasive Delta variant replaced the Alpha variant.
The INDSCI-SIM model for COVID-19 in India
Authors: Hazra Dhiraj Kumar , Pujari Bhalchandra S. , Shekatkar Snehal M. , Mozaffer Farhina , Sinha Sitabhra , Guttal Vishwesha , Chaudhuri Pinaki , Menon Gautam I. 
Published: June 2021

AbstractEstimating the burden of COVID-19 in India is difficult because the extent to which cases and deaths have been undercounted is hard to assess. The INDSCI-SIM model is a 9-component, age-stratified, contact-structured compartmental model for COVID-19 spread in India. We use INDSCI-SIM, together with Bayesian methods, to obtain optimal fits to reported cases and deaths across the span of the first wave of the Indian pandemic, over the period Jan 30, 2020 to Feb 15, 2021. We account for lock-downs and other non-pharmaceutical interventions, an overall increase in testing as a function of time, the under-counting of cases and deaths, and a range of age-specific infection-fatality ratios. We first use our model to describe data from all individual districts of the state of Karnataka, benchmarking our calculations using data from serological surveys. We then extend this approach to aggregated data for Karnataka state. We model the progress of the pandemic across the cities of Delhi, Mumbai, Pune, Bengaluru and Chennai, and then for India as a whole. We estimate that deaths were undercounted by a factor between 2 and 5 across the span of the first wave, converging on 2.2 as a representative multiplier that accounts for the urban-rural gradient across the country. We also estimate an overall under-counting of cases by a factor of between 20 and 25 towards the end of the first wave. Our estimates of the infection fatality ratio (IFR) are in the range 0.05 - 0.15, broadly consistent with previous estimates but substantially lower than values that have been estimated for other LMIC countries. We find that approximately 40% of India had been infected overall by the end of the first wave, results broadly consistent with those from serosurveys. These results contribute to the understanding of the long-term trajectory of COVID-19 in India.
Does Hemispheric Asymmetry Reduction in Older Adults (HAROLD) in motor cortex reflect compensation?
Authors: Knights Ethan , Morcom Alexa ,   Cam-CAN, Henson Richard N. 
Published: June 2021

AbstractOlder adults tend to display greater brain activation in the non-dominant hemisphere during even basic sensorimotor responses. It is debated whether this Hemispheric Asymmetry Reduction in Older Adults (HAROLD) reflects a compensatory mechanism. Across two independent fMRI experiments involving an adult-lifespan human sample (N = 586 and N = 81; approximately half female) who performed right hand finger responses, we distinguished between these hypotheses using behavioural and multivariate Bayes (MVB) decoding approaches. Standard univariate analyses replicated a HAROLD pattern in motor cortex, but in- and out-of-scanner behavioural results both demonstrated evidence against a compensatory relationship, in that reaction time measures of task performance in older adults did not relate to ipsilateral motor activity. Likewise, MVB showed that this increased ipsilateral activity in older adults did not carry additional information, and if anything, combining ipsilateral with contralateral activity patterns reduced action decoding in older adults (at least in Experiment 1). These results contradict the hypothesis that HAROLD is compensatory, and instead suggest that the age-related, ipsilateral hyper-activation is non-specific, in line with alternative hypotheses about age-related reductions in neural efficiency/differentiation or inter-hemispheric inhibition.Significance StatementA key goal in the cognitive neuroscience of ageing is to provide a mechanistic explanation of how brain-behaviour relationships change with age. One interpretation of the common finding that task-based hemispheric activity becomes more symmetrical in older adults, is that this shift reflects a compensatory mechanism, with the non-dominant hemisphere needing to “help out” with computations normally performed by the dominant hemisphere. Contrary to this view, our behavioural and brain data indicate that the additional activity in ipsilateral motor cortex in older adults is not reflective of better task performance nor better neural representations of finger actions.
Hybridization chain reaction enables a unified approach to multiplexed, quantitative, high-resolution immunohistochemistry and in situ hybridization
Authors: Schwarzkopf Maayan , Liu Mike C. , Schulte Samuel J. , Ives Rachel , Husain N. , Choi Harry M.T. , Pierce Niles A. 
Published: June 2021

ABSTRACTRNA in situ hybridization (RNA-ISH) based on the mechanism of hybridization chain reaction (HCR) enables multiplexed, quantitative, high-resolution RNA imaging in highly autofluorescent samples including whole-mount vertebrate embryos, thick brain slices, and formalin-fixed paraffin-embedded (FFPE) tissue sections. Here, we extend the benefits of 1-step, multiplexed, quantitative, isothermal, enzyme-free HCR signal amplification to immunohistochemistry (IHC), enabling accurate and precise protein relative quantitation with subcellular resolution in an anatomical context. More-over, we provide a unified framework for simultaneous quantitative protein and RNA imaging with 1-step HCR signal amplification performed for all target proteins and RNAs simultaneously.SUMMARYSignal amplification based on the mechanism of hybridization chain reaction enables multiplexed, quantitative, high-resolution imaging of protein and RNA targets in highly autofluorescent tissues.