bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Distraction for Reducing Pain and Distress Associated With Venipuncture in the Pediatric Posttransplant Population
Authors: Grabinski Zoe G. , Boscamp Nicholas S. , Zuckerman Warren A. , Zviti Ronald , O'Brien Ann , Martinez Mercedes , Tsze Daniel S. 
Published: May 2021

Objective
Distraction can reduce pain and distress associated with painful procedures but has never been studied in children with solid organ transplants. We aimed to determine whether there is a difference in pain and distress associated with venipuncture in pediatric posttransplant patients who receive distraction compared with those who do not.

Methods
Randomized controlled trial of children aged 4 to 17 years with solid organ transplants undergoing venipuncture in the outpatient setting. Patients were randomized to receive distraction or no distraction. The primary outcome was the Faces Pain Scale–Revised. Secondary outcomes were the Observational Scale of Behavioral Distress–Revised; Faces, Leg, Activity, Cry, Consolability; and Children's Hospital of Eastern Ontario Pain Scale. Exploratory outcomes included the number of venipuncture attempts, time to successful venipuncture, and satisfaction of phlebotomists and parents.

Results
Median age of the 40 children enrolled was 11.5 years. Type of transplants included the heart (67.5%), kidney (22.5%), liver (7.5%), and more than 1 organ (2.5%). There was no difference between the Faces Pain Scale–Revised scores in distraction and no distraction groups (1.4; 95% confidence interval, 0.9–1.9; and 1.3, 95% confidence interval, 0.5–2.1, respectively). There was also no difference in the Observational Scale of Behavioral Distress–Revised; Faces, Leg, Activity, Cry, Consolability; and Children's Hospital of Eastern Ontario Pain Scale scores, number of venipuncture attempts, or time to successful venipuncture. Phlebotomists were more satisfied with the venipuncture when distraction was implemented.

Conclusions
In children with solid organ transplants, there was no difference in pain and distress associated with venipuncture between those who did and did not receive distraction. There was also no difference in other procedure-related outcomes except for greater phlebotomist satisfaction when distraction was implemented.
Maintenance Strategies for Myeloma
Authors: Nooka Ajay K. , Joseph Nisha S. 
Published: May 2021

Abstract
Over the last decade, several very important prospective randomized controlled trials have confirmed the significant survival benefit conferred by maintenance therapies. Owing to these developments, the role of continued maintenance in the optimal management strategies of newly diagnosed myeloma patients (both transplant-eligible and transplant-ineligible) has been strongly cemented. In dealing with an incurable disease such as myeloma, whether to offer maintenance is no longer as relevant a question as it was before, but which antimyeloma agent or agents to use, as maintenance remains more pertinent today. More importantly, a personalized risk-stratified maintenance approach for an individual patient to yield the best benefit for that specific patient is yet to be uniformly adapted. In this article, we review the available and evolving clinical data leading to our current-day practices, and we make an effort to describe what lies ahead.
Smoldering Myeloma Treatment
Authors: Mejia Saldarriaga Mateo , Rossi Adriana 
Published: May 2021

Abstract
Smoldering multiple myeloma (MM) is a clonal plasma cell disorder characterized by excess marrow involvement and immunoglobulin production. It is the precursor of MM, differing by the lack of end-organ damage. Smoldering MM encompasses a heterogeneous group of patients, with a median risk of progression to active disease of 50% in the first 5 years. Until recently, the standard of care would dictate observation off therapy until the development of end-organ damage. The recognition of high-risk and ultrahigh-risk subgroups of smoldering MM, with more likely evolution to MM, has led to earlier initiation of therapy in the disease course. Ongoing studies to define the ideal timing and patient population are underway, as well as identification of which agents would be of greatest benefit, as the armamentarium for MM continues to grow.
MDRO transmission in acute hospitals during the COVID-19 pandemic
Authors: Sun Jin Louisa , Fisher Dale 
Published: May 2021

Purpose of review
The coronavirus disease (COVID-19) pandemic has resulted in necessary modifications of infection control policies and practices in acute healthcare facilities globally. This is often accompanied by infrastructure modifications, ward redesignations, as well as healthcare staff redeployments and changes to infection prevention and control (IPC) practices. We review the potential for both negative and positive impacts these major changes can have on nosocomial transmission of multidrug-resistant organisms (MDROs).

Recent findings
Healthcare facilities around the world have reported outbreaks of MDROs during the COVID-19 pandemic. In contrast some centres have reported a decrease in baseline rates due to a number of possible factors.

Summary
While implementing crucial preventive measures for COVID-19, is it important to consider any collateral effects of changes in IPC and antimicrobial stewardship program (ASP) practices. The disruption caused to IPC and ASP practices during the pandemic are likely to see a counter intuitive increase in transmission of MDROs.
Evaluating a Convolutional Neural Network Noise Reduction Method When Applied to CT Images Reconstructed Differently Than Training Data
Authors: Huber Nathan R. , Missert Andrew D. , Yu Lifeng , Leng Shuai , McCollough Cynthia H. 
Published: May 2021

Objective
The aim of this study was to evaluate a narrowly trained convolutional neural network (CNN) denoising algorithm when applied to images reconstructed differently than training data set.

Methods
A residual CNN was trained using 10 noise inserted examinations. Training images were reconstructed with 275 mm of field of view (FOV), medium smooth kernel (D30), and 3 mm of thickness. Six examinations were reserved for testing; these were reconstructed with 100 to 450 mm of FOV, smooth to sharp kernels, and 1 to 5 mm of thickness.

Results
When test and training reconstruction settings were not matched, there was either reduced denoising efficiency or resolution degradation. Denoising efficiency was reduced when FOV was decreased or a smoother kernel was used. Resolution loss occurred when the network was applied to an increased FOV, sharper kernel, or decreased image thickness.

Conclusions
The CNN denoising performance was degraded with variations in FOV, kernel, or decreased thickness. Denoising performance was not affected by increased thickness.
Stappia albiluteola sp. nov., isolated from marine sediment
Authors: Jiang Shan , Sun You-Yang , Lian Feng-Bai , Zhang Xiao-Kui , Du Zong-Jun 
Published: May 2021

A Gram-stain negative, rod-shaped, facultatively aerobic, pale-beige-coloured bacterial strain, designated F7233T, was isolated from coastal sediment sampled at Jingzi Bay, Weihai, PR China. Cells of strain F7233T were 0.3–0.4 µm wide, 1.2–1.4 µm wide long, non-spore-forming and motile with one flagellum. Optimum growth occurred at 30 °C, with 1.0 % (w/v) NaCl and at pH 6.5–7.0. Positive for nitrate reduction, hydrolysis of Tweens and oxidase activity. The sole respiratory quinone of strain F7233T was ubiquinone-10 and the predominant cellular fatty acid was summed feature 8 (C18 : 1
ω7c/C18 : 1
ω6c). The major polar lipids were diphosphatidylglycerol, phosphatidylethanolamine, phosphatidylglycerol, phosphatidylcholine and one unidentified aminophospholipid. The G+C content of the chromosomal DNA was 63.3 mol%. Phylogenetic analysis of the 16S rRNA gene sequence revealed that the newly isolate belonged to the genus

Stappia

, with 96.8 % sequence similarity to

Stappia indica

MCCC 1A01226T, 96.1 % similarity to

Stappia stellulata

JCM 20692T and 95.5% similarity to

Stappia taiwanensis

CC-SPIO-10-1T. On the basis of phylogenetic, phenotypic and chemotaxonomic data, it is considered that strain F7233T should represent a novel species within the genus

Stappia

, for which the name Stappia albiluteola sp. nov. is proposed. The type strain is F7233T (=MCCC 1H00419T=KCTC 72859T).
Joint analysis reveals shared autoimmune disease associations and identifies common mechanisms
Authors: Lincoln Matthew R , Connally Noah , Axisa Pierre-Paul , Gasperi Christiane , Mitrovic Mitja , Heel David van , Wijmenga Cisca , Withoff Sebo , Jonkers Iris H , Padyukov Leonid ,   International Multiple Sclerosis Genetics Consortium, Rich Stephen S , Graham Robert R , Gaffney Patrick M , Langefeld Carl D , Hafler David A , Chun Sung , Sunayev Shamil R , Cotsapas Chris 
Published: May 2021

AbstractAutoimmune and inflammatory diseases are polygenic disorders of the immune system. Many genomic loci harbor risk alleles for several diseases, but the limited resolution of genetic mapping prevents determining if the same allele is responsible, indicating a shared underlying mechanism. Using a collection of 129,058 cases and controls across six diseases, we show that ∼40% of overlapping associations are due to the same allele. We improve fine-mapping resolution for shared alleles two-fold by combining cases and controls across diseases, allowing us to identify more eQTLs driven by the shared alleles. The patterns of sharing indicate widespread shared mechanisms, but not a single global autoimmune mechanism. Our approach can be applied to any set of traits, and is particularly valuable as sample collections become depleted.One sentence summaryGenetic mapping in autoimmune diseases increases genetic mapping resolution and reveals shared mechanisms
Target Product Profiles for a Micronutrient Assessment Tool and Associated Blood Collection Device for Use in Population-Based Surveys: An Expert Consensus
Authors: Smith Emily R. , Lee Joanne , Allen Lindsay H. , Boyle David S. , Brindle Eleanor , Craft Neal E. , Dalmiya Nita , Erhardt Juergen , Garrett Dean , Jefferds Maria Elena , Kavishe Festo , Killilea David W. , Kung’u Jaqueline K. , Kurpad Anura , Loechl Cornelia U. , Moore Sophie E. , Namaste Sorrel ML , Pfeiffer Christine M. , Rohner Fabian , Schulze Kerry , Shaheen Nazma , Soofi Sajid , Winichagoon Pattanee , Thomas Bethanie , Osendarp Saskia , Rawat Rahul 
Published: May 2021

AbstractMicronutrient deficiencies are a significant public health problem affecting a large portion of the world’s population. Disproportionately affected populations—infants, young children, adolescents and women of reproductive age including pregnant women — are especially susceptible to the health consequences of insufficient micronutrient intakes. However, assessment of micronutrient deficiencies is not routinely included in population health surveys. This nutrition data gap hampers policy, program, and promotion efforts to prevent and treat micronutrient deficiencies. To address one of the barriers to micronutrient assessment, an expert group created a consensus of a target product profile (TPP) for a micronutrient assessment tool and associated blood collection device for use in population surveys. Experts in laboratory medicine, micronutrient assessment, population-based surveys, and product development reviewed proposed TPP standards and collaboratively established minimum and optimal characteristics. These experts defined the target population as infants and children from 6-59 months, adolescents and women of reproductive age 12-49 years including pregnant women. At minimum, the assessment tool should be a multiplex ELISA formatted for >1 analyte that uses a serum or plasma sample prepared from venous blood obtained by a phlebotomist with a 2-week training. Given the use case was specific for population surveys, experts agreed the minimum tool could be semi-quantitative, with analytical specificity of 99%. The TPP also considers the variable field environments for testing (e.g. storage conditions and time to results). The consensus TPP developed can be used to guide selection of existing technologies into population-based surveys, as well as future investment in product development. Partnerships focused on research and development—including industry, public sector, nonprofit, and academic institutions—can help advance the field and fill the micronutrient data gap.
Patient Characteristics in Cases of Reinfection or Prolonged viral shedding in SARS-CoV-2
Authors: Yoo Richard M. , Romero Roland A. , Mabajen Joseph , Mehrotra Suchit , Kohane Isaac S. , Sheils Natalie E 
Published: May 2021

AbstractImportanceAs testing options increase for COVID-19, their interpretability is challenged by the increasing variety of clinical contexts in which results are obtained. In particular, positive COVID-19 diagnostic (RT-PCR) tests that occur after a patient has seroconverted may be indicative of reinfection. However, in the absence of SARS-CoV-2 sequence data, the possibility of prolonged viral shedding may not be excluded. We highlight a testing pattern that identifies such cases and study its statistical power in identifying potential reinfection. We also study the medical records of patients that matched the pattern.ObjectiveTo describe the frequency and demographic information of people with a testing pattern indicative of SARS-CoV-2 reinfection.DesignWe examined 4.2 million test results from a large national health insurer in the United States. Specifically, we identified the pattern of a positive RT-PCR test followed by a positive IgG test, again followed by a positive RT-PCR.SettingData from outpatient laboratories across the United States was joined with claims data from a single large commercial insurer’s administrative claims database.ParticipantsStudy participants are those whose insurance, either commercial or Medicare, is provided by a single US based insurer.ExposuresPeople who received at least two positive diagnostic tests via RT-PCR for SARS-Cov-2 separated by 42 or more days with at least one serological test (IgG) indicating the presence of antibodies between diagnostic tests.Main Outcomes and MeasuresCount and characteristics of people with the timeline of three tests as described in Exposures.ResultsWe identified 79 patients who had two positive RT-PCR tests separated by more than six weeks, with a positive IgG test in between. These patients tended to be older than those COVID-19 patients without this pattern (median age 56 vs. 42), and they exhibited comorbidities typically attributed to a compromised immune system and heart disease.Conclusions and RelevanceWhile the testing pattern alone was not sufficient to distinguish potential reinfection from prolonged viral shedding, we were able to identify common traits of the patients identified through the pattern.
Body mass index and birth weight improve polygenic risk score for type 2 diabetes
Authors: Moldovan Avigail , Waldman Yedael Y. , Brandes Nadav , Linial Michal 
Published: May 2021

AbstractOne of the major challenges in the post-genomic era is elucidating the genetic basis of human diseases. In recent years, studies have shown that polygenic risk scores (PRS), based on aggregated information from millions of variants across the human genome, can estimate individual risk for common diseases. In practice, the current medical practice still predominantly relies on physiological and clinical indicators to assess personal disease risk. For example, caregivers mark individuals with high body mass index (BMI) as having an increased risk to develop type 2 diabetes (T2D). An important question is whether combining PRS with clinical metrics can increase the power of disease prediction in particular from early life. In this work we examined this question, focusing on T2D. We show that an integrated approach combining adult BMI and PRS achieves considerably better prediction than each of the measures on unrelated Caucasians in the UK Biobank (UKB, n=290,584). Likewise, integrating PRS with self-reports on birth weight (n=172,239) and comparative body size at age ten (n=287,203) also substantially enhance prediction as compared to each of its components. While the integration of PRS with BMI achieved better results as compared to the other measurements, the latter are early-life measurements that can be integrated already at childhood, to allow preemptive intervention for those at high risk to develop T2D. Our integrated approach can be easily generalized to other diseases, with the relevant early-life measurements.
Maliqua: A study within Malakit, a project on malaria and gold miners in French Guiana
Authors: Parent André-Anne , Galindo Muriel Suzanne , Lambert Yann , Douine Maylis 
Published: May 2021

SummaryMalaria is endemic in French Guiana, especially within the gold mining community working illegally. Gold miners travel to remote camps in the forest to carry out their activities, exposing themselves to the presumed contamination area. This paper presents the results of a qualitative case study of the Malakit project, a free distribution of self-diagnosis and self-treatment kits, along with appropriate training/information from health facilitators, at resting sites in Brazil and Suriname on the borders with French Guiana. This study documents how Malakit is part of the care trajectory of gold miners. The data was collected using three methods: 1) on-site observation; 2) semi-structured individual interviews (n=26); 3) semi-structured group interviews (n=2). The results inform us that Malakit responds to the need for treatment and facilitates access to care. Gold miners say they trust the facilitators and receive accurate explanations. The majority of participants find the kit easy to use and to carry and explanations given were sufficient, although some people needed to be reminded how to use it once in the forest. Results remind us that malaria among illegal gold miners in French Guiana is a question of social inequalities in health, where the interaction of the health, social, economic and political contexts of Brazil and French Guiana influence exposure to numerous risk factors. Thus, malaria intervention practices such as Malakit cannot be carried out without considering the complexity generated by social inequalities in health.
THE US MIDLIFE MORTALITY CRISIS CONTINUES: EXCESS CAUSE-SPECIFIC MORTALITY DURING 2020
Authors: Glei Dana A. 
Published: May 2021

ABSTRACTCOVID-19 prematurely ended many lives, particularly among the oldest Americans, but the pandemic also had an indirect effect on health and non-COVID mortality among the working-age population, who suffered the brunt of the economic consequences. This analysis investigates whether monthly excess mortality in the US during 2020 varied by age and cause of death. Based on national-level death counts and population estimates for 1999-2020, negative binomial regression models—fit separately by sex— were used to estimate monthly cause-specific excess mortality by age group during 2020. Among males, 71% non-COVID excess deaths occurred at working ages (25-64), but those ages accounted for only 36% of non-COVID excess deaths in females. The results revealed substantial numbers of excess deaths from external causes (particularly among males), heart disease, diabetes, Alzheimer’s disease (particularly among women), and cerebrovascular disease. For males, the largest share of non-COVID excess deaths resulted from external causes, nearly 80% of which occurred at working ages. Although incorrectly classified COVID-19 deaths may explain some excess non-COVID mortality, misclassification is unlikely to explain the increase in external causes of mortality. Auxiliary analyses suggested that drug-related mortality may be driving the rise in external mortality, but drug overdoses were already increasing for a full year prior to the pandemic. The oldest Americans bore the brunt of COVID-19 mortality, but working-age Americans, particularly men, suffered substantial numbers of excess non-COVID deaths, most commonly from external causes and heart disease.
Reduction in COPD exacerbations during COVID-19: a systematic review and meta-analysis
Authors: Alqahtani Jaber S. , Oyelade Tope , Aldhahir Abdulelah M. , Mendes Renata Gonçalves , Alghamdi Saeed M. , Miravitlles Marc , Mandal Swapna , Hurst John R. 
Published: May 2021

BackgroundReports have suggested a reduction in exacerbations of chronic obstructive pulmonary disease (COPD) during the coronavirus (COVID-19) pandemic, particularly hospital admissions for severe exacerbations. However, the magnitude of this reduction varies between studies.MethodElectronic databases were searched from January 2020 to May 2021. Two independent reviewers screened titles and abstracts and, when necessary, full text to determine if studies met inclusion criteria. A modified version of the Newcastle-Ottawa Scale was used to assess study quality. A narrative summary of eligible studies was synthesised, and meta-analysis was conducted using a random effect model to pool the rate ratio and 95% confidence intervals (95% CI) for hospital admissions. Exacerbation reduction was compared against the COVID-19 Containment and Health Index.ResultsA total of 13 of 745 studies met the inclusion criteria and were included in this review, with data from nine countries. Seven studies could be included in the meta-analysis. The pooled rate ratio of hospital admissions for COPD exacerbations during the pandemic period was 0.50 (95% CI 0.42-0.58). Findings on the rate of community-treated exacerbations were inconclusive. Three studies reported a significant decrease in the incidence of respiratory viral infections compared with the pre-pandemic period. There was not a significant relationship between exacerbation reduction and the COVID-19 Containment and Health Index.ConclusionThere was a 50% reduction in admissions for COPD exacerbations during the COVID-19 pandemic period, associated with a reduction in respiratory viral infections that trigger exacerbations. We provide pooled evidence supporting the potential effectiveness of COVID-19 preventive interventions in reducing the risk of admissions for COPD exacerbations.
Complexities in the role of acetylation dynamics in modifying inducible gene activation parameters
Authors: Carrera Samantha , O’Donnell Amanda , Li Yaoyong , Nowicki-Osuch Karol , Baker Syed Murtuza , Spiller David , Sharrocks Andrew D. 
Published: May 2021

AbstractHigh levels of histone acetylation are associated with the regulatory elements of active genes, suggesting a link between acetylation and gene activation. However, several studies have shown that histone acetylation dynamics rather than hyperacetylation per se are important determinants in gene activation, particularly at inducible genes. We revisited this model, in the context of EGF-inducible gene expression and found that rather than a simple unifying model, there are two broad classes of genes; one in which high lysine acetylation activity is required for efficient gene activation, and a second group where the opposite occurs and high acetylation activity is inhibitory. We examined the latter class in more detail using EGR2 as a model gene and found that lysine acetylation levels are critical for several activation parameters, including the timing of expression onset, and overall amplitudes of the transcriptional response. In contrast, DUSP1 responds in the canonical manner and its transcriptional activity is promoted by acetylation. Single cell approaches demonstrate heterogenous DUSP1 activation kinetics and that acetylation levels influence allele activation frequencies. Our data therefore point to a complex interplay between acetylation dynamics and target gene induction, which cannot simply be explained by a unified response to acetylation activity. Instead, acetylation level thresholds are an important determinant of transcriptional induction dynamics that are sensed in a gene-specific manner.