bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital Length of Stay: A cross-Specialty Analysis and Beta-Geometric Model
Authors: Dehouche Nassim , Viravan Sorawit , Santawat Ubolrat , Torsuwan Nungruethai , Taijan Sakuna , Intharakosum Atthakorn , Sirivatanauksorn Yongyut 
Published: April 2021

AbstractThe typical hospital Length of Stay (LOS) distribution is known to be right-skewed, to considerably vary across Diagnosis Related Groups (DRG), and to contain markedly high values, in significant proportions. These very long stays are often considered outliers, and thin-tailed statistical distributions are assumed. Moreover, modeling is typically performed by Diagnosis Related Group (DRG) and is consequently based on small empirical samples, thus justifying the previous assumption. However, resource consumption and planning occur at the level of medical specialty departments covering multiple DRG, and when considered at this decision-making scale, extreme LOS values represent a significant component of the distribution of LOS (the right tail) that determines many of its statistical properties.Through a study of 46, 364 electronic health records over four medical specialty departments (Pediatrics, Obstetrics/Gynecology, Surgery, and Rehabilitation Medicine) in the largest hospital in Thailand (Siriraj Hospital in Bangkok), we show that the distribution of LOS exhibits a tail behavior that is consistent with a subexponential distribution. We analyze some empirical properties of such a distribution that are of relevance to cost and resource planning, notably the concentration of resource consumption among a minority of admissions/patients, an increasing residual LOS, where the longer a patient has been admitted, the longer they would, counter-intuitively, be expected to remain admitted, and a slow convergence of the Law of Large Numbers, making empirical estimates of moments (e.g. mean, variance) unreliable. Consequently, we propose a novel Beta-Geometric model that shows a good fit with observed data and reproduces these empirical properties of LOS. Finally, we use our findings to make practical recommendations regarding the pricing and management of LOS.
A Single Drop of Fingerstick Blood for Quantitative Antibody Response Evaluation After SARS-CoV-2 Vaccination
Authors: Du Jinwei , Zhang Dayu , May Hannah , Loginova Yulia , Chu Eric , Madej Roberta , Lu Chuanyi M. , Pathakamuri Joseph A. , Kuebler Daniel , Neves Jocelyn V. , Zhang Aiguo , Sha Michael Y. 
Published: April 2021

AbstractAmong several COVID vaccines that have been approved, the Moderna and Pfizer-BioNTech vaccines are mRNA vaccines that are safe and highly effective at preventing COVID-19 illness. Studies have demonstrated that neutralizing antibody responses elicited by these vaccines correlate strongly with antibodies measured by immunoassays such as ELISA. To monitor the antibody level duration of vaccine-induced immune responses in vaccinated population, cost-effective and easily implementable antibody testing methodologies are urgently needed. In this study, we evaluated the feasibility of using a single drop of fingerstick blood collected with flocked swabs for a high-throughput and quantitative anti-SARS-CoV-2 spike (S1) IgG antibody immunoassay. A total of 50 voluntary subjects participated and donated fingerstick blood samples before and after receiving the Moderna mRNA vaccine. Among all individuals tested, no anti-SARS-CoV-2 S1 IgG antibody was detected before vaccination and on day 7 after receiving the first vaccine dose. On day 14 after the first dose, a significant amount of anti-SARS-CoV-2 S1 IgG antibody was detected in all participants’ samples. By the end the third week from the first dose, the median anti-SARS-CoV-2 S1 IgG concentration increased to 44.9 ug/mL. No anti-SARS-CoV-2 nucleocapsid (N) protein IgG antibody was detected in any of the participants during the study period, indicating that the anti-SARS-CoV-2 S1 IgG assay is specific for the mRNA vaccine induced antibodies.Comaprison of venous blood plasma and fingerstick blood for anti-SARS-CoV-2 S1 IgG shown a higher correlation. Furthermore, the fingerstick blood dried swab samples are stable for at least 4 days. In summary, we demonstrated that a single drop of fingerstick blood collected with flocked swab can be used for quantitative detection and monitoring of anti-SARS-CoV-2 spike IgG responses after receiving COVID-19 vaccination. This testing platform does not require venous blood draw and can be easily implemented for large scale antibody testing in vaccinated populations.
Assessing risk perceptions that contribute to tetanus toxoid maternal vaccine hesitancy in Kilifi County, Kenya
Authors: Kiyuka Patience Kerubo , Moindi Rodgers Onsomu , Murunga Nickson , Muinga Naomi , Mutua Meshack Nzesei , Wanjala Stanley , Sandra Sheba , Mumba Noni , Odhiambo Evans Otieno , Mutengu Lillian , Shauri Halimu Suleiman 
Published: April 2021

AbstractVaccination is one of the most effective public health interventions today. However, there is a growing number of people who perceive vaccines as unsafe and unnecessary. Waning vaccine confidence threatens global immunization programmes, contributing to decreased immunization rates and outbreaks of vaccine-preventable diseases. We used a mixed-method approach surveying men and women of reproductive age and Focus Group Discussions with expectant mothers to understand maternal vaccine hesitancy within a rural setting of Kilifi County, Kenya. Of the 104 people surveyed, 70% of the participants were aware of the vaccine that expectant women receive and 26% stating that they know people in their community who have refused or were hesitant to take maternal vaccination. Reasons given for refusals include religion and rumors that have spread in the community that the tetanus toxoid vaccine was a family planning method. Stockout of the vaccine was identified as one of the healthcare factors affecting vaccine uptake. The majority of the respondents (84%) reported that they mainly trust a healthcare worker for vaccination information. Approximately 53% and 23% reported that they strongly agree or agreed, respectively, that vaccines for expectant women should be made compulsory. The availability of safe and effective maternal vaccines will only be beneficial if mothers choose to use them. Dissemination of accurate information and continuous engagement with the community members can build trust and confidence in vaccines.
Use of heated tobacco products may be associated with hypertensive disorders of pregnancy and low birth weight in Japan: An analysis of the JACSIS study
Authors: Zaitsu Masayoshi , Hosokawa Yoshihiko , Okawa Sumiyo , Hori Ai , Kobashi Gen , Tabuchi Takahiro 
Published: April 2021

ABSTRACTBackgroundLittle is known about heated tobacco product (HTP) use in pregnant women and associated maternal and neonatal risks for hypertensive disorders of pregnancy (HDP) and low birth weight (LBW). Thus, this study aimed to assess the status of HTP use among pregnant women in Japan and explore the risk of HDP and LBW associated with HTP use.MethodsUsing data from the Japan “COVID-19 and Society” Internet Survey (JACSIS) study, a web-based nationwide survey, we investigated 558 post-delivery and 365 currently pregnant women in October 2020. We assessed the prevalence of ever HTP smokers (defined as ever experiencing HTP use) in post-delivery and currently pregnant women. Among post-delivery women, we collected the information regarding HDP and LBW based on their Maternal and Child Health Handbooks (maternal and newborn records). In the multivariable regression analysis, we estimated the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of ever HTP smokers for HDP and LBW compared with those of never HTP smokers using logistic regression. A stratified analysis with respect to combustible cigarette smoking (never/ever) was also performed.ResultsThe prevalence of ever HTP use were 11.7% and 12.6% in post-delivery and currently pregnant women, respectively. Among post-delivery women, ever HTP smokers had higher HDP incidence (13.8% vs. 6.5%, P=0.03), with an OR of 2.78 (95% CI 0.84–9.15) and higher LBW incidence (18.5% versus 8.9%, P=0.02), with an elevated OR of 2.08 (95% CI 0.80–5.39). A similar tendency was observed among never and ever combustible cigarette smokers.ConclusionIn Japan, the incidence of HTP use has exceeded 10% among pregnant women, and HTP smoking may be associated with increased maternal and neonatal risks. School-based tobacco prevention and cessation programs should be conducted regardless of product types to prevent life-threatening perinatal complications and deaths.What this paper addsLittle is known about heated tobacco product (HTP) use and associated perinatal risks among pregnant women.In Japan, the prevalence of ever HTP use exceeded 10% among pregnant women.HTP use approximately doubled perinatal risk of hypertensive disorders of pregnancy and low birth weight.When stratified by cigarette smoking status, a similar tendency was observed among never and ever cigarette smokers.
Longitudinal Changes in Functional Connectivity in Antipsychotic-treated and Antipsychotic-naive Patients with First Episode Psychosis
Authors: Chopra Sidhant , Francey Shona M. , O’Donoghue Brian , Sabaroedin Kristina , Arnatkeviciute Aurina , Cropley Vanessa , Nelson Barnaby , Graham Jessica , Baldwin Lara , Tahtalian Steven , Yuen Hok Pan , Allott Kelly , Alvarez-Jimenez Mario , Harrigan Susy , Pantelis Christos , Wood Stephen J , McGorry Patrick , Fornito Alex 
Published: April 2021

AbstractBackgroundAltered functional connectivity (FC) is a common finding in resting-state functional Magnetic Resonance Imaging (rs-fMRI) studies of people with psychosis, yet how FC disturbances evolve in the early stages of illness, and how antipsychotics may influence the temporal evolution of these disturbances, remains unclear. Here, we scanned first episode psychosis (FEP) patients who were and were not exposed to antipsychotic medication during the first six months of illness at baseline, three months, and 12 months, to characterize how FC changes over time and in relation to medication use.MethodsSixty-two antipsychotic-naïve patients with FEP received either an atypical antipsychotic or a placebo pill over a treatment period of 6 months. Both FEP groups received intensive psychosocial therapy. A healthy control group (n=27) was also recruited. A total of 202 rs-fMRI scans were obtained across three timepoints: baseline, 3-months and 12-months. Our primary aim was to differentiate patterns of FC in antipsychotic-treated and antipsychotic-naive patients within the first 3 months of treatment, and to examine associations with clinical and functional outcomes. A secondary aim was to investigate long-term effects at the 12-month timepoint.ResultsAt baseline, FEP patients showed widespread functional dysconnectivity in comparison to controls, with reductions predominantly affecting interactions between the default mode network (DMN), limbic systems, and the rest of the brain. From baseline to 3 months, patients receiving placebo showed increased FC principally within the same systems, and some of these changes correlated with improved clinical outcomes. Antipsychotic exposure was associated with increased FC primarily between the thalamus and the rest of the brain. At the 12-month follow-up, antipsychotic treatment was associated with a prolonged increase of FC primarily in the DMN and limbic systems.Conclusions and RelevanceAntipsychotic-naïve FEP patients show widespread functional dysconnectivity at baseline, followed by an early normalization of DMN and paralimbic dysfunction in patients receiving a psychosocial intervention only. Antipsychotic exposure is associated with distinct FC changes, principally concentrated on thalamo-cortical and limbic networks.
Emergence of the novel SARS-CoV-2 lineage P.4.1 and massive spread of P.2 in South Brazil
Authors: Sant’Anna Fernando Hayashi , Muterle Varela Ana Paula , Prichula Janira , Comerlato Juliana , Comerlato Carolina Baldisserotto , Roglio Vinicius Serafini , Mendes Pereira Gerson Fernando , Moreno Flávia , Seixas Adriana , Márcia Wendland Eliana 
Published: April 2021

ABSTRACTSouth Brazil has been the novel epicenter of Coronavirus Disease 2019 (COVID-19) in 2021, accounting for the greatest number of cumulative cases and deaths (per 100 thousand inhabitants in a week) worldwide. In this study, we analyzed 340 whole genomes of SARS-CoV-2, which were sampled between April and November 2020 in 33 cities in South Brazil. We demonstrated the circulation of two novel emergent lineages, described here as P.4 and P.4.1 (provisionally termed VUI-NP13L), and seven lineages that had already been assigned (B.1.1.33, B.1.1.28, P.2, B.1.91, B.1.1.94, B.1.195 and B.1.212). P.2 and P.4.1 demonstrated massive spread from approximately September/October 2020. Constant and consistent genomic surveillance is crucial to identify newly emerging SARS-CoV-2 lineages in Brazil and to guide decision making in the Brazilian Public Healthcare System.
Polygenic Risk for Schizophrenia, Brain Structure and Environmental Risk in UK Biobank
Authors: Zhu Xingxing , Ward Joey , Cullen Breda , Lyall Donald M. , Strawbridge Rona J. , Lyall Laura M. , Smith Daniel J. 
Published: April 2021

AbstractSchizophrenia is a heritable neurodevelopmental disorder characterized by neuroanatomical changes in the brain but exactly how increased genetic burden for schizophrenia influences brain structure is unknown. Similarly, the impact of environmental risk factors for schizophrenia on brain structure is not fully understood. We investigated how genetic burden for schizophrenia (indexed by a polygenic risk score, PRS-SCZ) was associated with cortical thickness (CT), cortical surface area (SA), cortical volume (CV) and multiple subcortical structures within 18,147 White British ancestry participants from UK Biobank. We also explored whether environmental risk factors for schizophrenia (cannabis use, childhood trauma, low birth weight and Townsend social deprivation index) exacerbated the impact of PRS-SCZ on brain structure. We found that PRS-SCZ was significantly associated with lower CT in the frontal lobe, insula lobe, lateral orbitofrontal cortex, medial orbitofrontal cortex, posterior cingulate cortex and inferior frontal cortex, as well as reduced SA and CV in the supramarginal cortex and superior temporal cortex, but not with differences in subcortical volumes. When models included environmental risk factors as covariates, PRS-SCZ was only associated with lower SA/CV within the supramarginal cortex, superior temporal cortex and inferior frontal cortex. Moreover, no interactions were observed between PRS-SCZ and each of the environmental risk factors on brain structure. Overall, we identified brain structural correlates of PRS-SCZ predominantly within frontal and temporal regions. Some of these associations were independent of environmental risk factors, suggesting that they may represent biomarkers of genetic risk for schizophrenia.
Investigating the use of physical restraint of children in emergency departments: A Scandinavian survey
Authors: Aaberg Lauridsen Julie , Lefort Sønderskov Michele , Hetmann Fredrik , Hamilton Annika , Salmi Heli , Wildgaard Kim 
Published: April 2021

AimThe aim of the study is to describe the current frequency of physical restraint and the use of analgesics and sedatives for treating pediatric pain in emergency departments (EDs) in Scandinavia.MethodsWe performed a nation‐wide electronic survey asking nurses in the emergency departments in Denmark, Norway, and Sweden about their experience treating children in pain.ResultsResponses from 103 Danish, Norwegian and Swedish nurses were included (79% response rate). Physical restraint was reported used at 79% [70.0‐85.9] (N = 78) of the surveyed departments (DK: 96%, NO: 67%, SE: 77%) with two participants reporting daily use of physical restraint. Paracetamol was available at all departments and used most frequently. Sedation was available at 88% [78.8‐92.0] of the departments with midazolam as the most recurrent sedative (83%, [74.8‐89.4]). Seventy‐three percent of respondents reported a need for better treatments. Lack of education was the most frequently reported obstacle for providing both pain treatment (29%) and sedation (43%) followed by lack of guidelines.ConclusionPhysical restraint of children during painful procedures is used in the majority of Scandinavian emergency departments (79%). There appears to be a lack of local guidelines for both pain treatment and sedation.
Vascular inflammation in moderate‐to‐severe atopic dermatitis is associated with enhanced Th2 response
Authors: Villani Axel P. , Pavel Ana B. , Wu Jianni , Fernandes Marie , Maari Catherine , Saint‐Cyr Proulx Etienne , Jack Carolyn , Glickman Jacob , Choi Seulah , He Helen , Ungar Benjamin , Estrada Yeriel , Kameyama Naoya , Zhang Ning , Gonzales Juana , Tardif Jean‐Claude , Krueger James G. , Bissonnette Robert , Guttman‐Yassky Emma 
Published: April 2021

AbstractBackgroundIn atopic dermatitis (AD), some studies have shown an association with increased cardiovascular disease in certain populations. However, other investigations found modest or no association. Despite conflicting results, molecular profiling studies in both AD skin and blood have demonstrated upregulation of atherosclerosis and cardiovascular risk‐related markers. However, the underlying mechanisms connecting AD to vascular inflammation/atherosclerosis are unknown. In this study, we aim to determine factors associated with vascular inflammation/atherosclerosis in AD patients.MethodsWe used 18‐FDG PET‐CT to characterize vascular inflammation in AD patients and healthy subjects. In parallel, we assessed their skin and blood immune profiles to determine AD‐related immune biomarkers associated with vascular inflammation. We also assessed levels of circulating microparticles, which are known to be associated with increased cardiovascular risk.ResultsWe found significant correlations between vascular inflammation and Th2‐related products in skin and blood of AD patients as well as atherosclerosis‐related markers that were modulated by dupilumab. Circulating levels of endothelial microparticles were significantly higher in severe AD patients and tended to correlate with vascular inflammation assessed by PET‐CT.ConclusionVascular inflammation in AD is associated with enhanced Th2 response and clinical severity, which may explain cardiovascular comorbidities observed in select AD populations. Larger prospective studies are needed to further evaluate vascular inflammation and cardiovascular events and mortality in AD patients. Finally, as dupilumab treatment demonstrated significant modulation of atherosclerosis‐related genes in AD patients compared to placebo, these data suggest that modulation of vascular inflammation with systemic treatment should be explored in patients with AD.
Characteristics of tissue–resident ILCs and their potential as therapeutic targets in mucosal and skin inflammatory diseases
Authors: Orimo Keisuke , Tamari Masato , Saito Hirohisa , Matsumoto Kenji , Nakae Susumu , Morita Hideaki 
Published: April 2021

AbstractDiscovery of innate lymphoid cells (ILCs), which are non–T and non–B lymphocytes that have no antigen‐specific receptors, changed the classical concept of the mechanism of allergy, which had been explained mainly as antigen‐specific acquired immunity based on IgE and Th2 cells. The discovery led to dramatic improvement in our understanding of the mechanism of non–IgE‐mediated allergic inflammation. Numerous studies conducted in the past decade have elucidated the characteristics of each ILC subset in various organs and tissues and their ontogeny. We now know that each ILC subset exhibits heterogeneity. Moreover, the functions and activating/suppressing factors of each ILC subset were found to differ among both organs and types of tissue. Therefore, in this review, we summarize our current knowledge of ILCs by focusing on the organ/tissue‐specific features of each subset to understand their roles in various organs. We also discuss ILCs’ involvement in human inflammatory diseases in various organs and potential therapeutic/preventive strategies that target ILCs.
Pharmacist‐led interventions to reduce adverse drug events in older people living in residential aged care facilities: A systematic review
Authors: Ali Sheraz , Salahudeen Mohammed S. , Bereznicki Luke R. E. , Curtain Colin M. 
Published: April 2021

AimsWe aimed to investigate the efficacy and effectiveness of pharmacist‐led interventions to reduce adverse drug events (ADEs) in older people living in residential aged care facilities (RACFs).MethodsWe systematically searched MEDLINE via PubMed, Embase, Cochrane Central Register of Controlled Trials and PsycINFO from their inceptions to July 2020. We investigated experimental study designs that employed a control group, or quasi‐experimental studies conducted in RACFs.ResultsWe screened 3826 records and included 23 studies. We found seven single‐component and 16 multicomponent pharmacist‐led interventions to reduce ADEs in older people living in RACFs. The most frequent single‐component pharmacist‐led intervention was medication review. Medication review and education provision to healthcare professionals were the most common components in many pharmacist‐led multicomponent interventions. Thirteen studies (56%) showed no effect, whereas ten studies (43%) reported significant reductions in ADEs following pharmacist‐led interventions either as a sole intervention or as a part of a multi‐component intervention. Many interventions focused on reducing the incidence of falls (39%).ConclusionsThis systematic review suggests that pharmacist‐led interventions have the potential to reduce the incidence of ADEs in older people living in RACFs. Medication review and educational programmes, particularly academic detailing, either as a single component or as part of multicomponent interventions were the most common approaches to reducing drug‐related harm in older people living in RACFs. The lack of a positive association between interventions and ADE in many studies suggests that targeted and tailored pharmacist‐led interventions are required to reduce ADEs in older people in RACFs.
The wider perspective: cord blood banks and their future prospects
Authors: Querol Sergio , Rubinstein Pablo , Madrigal Alejandro 
Published: April 2021

SummaryOver the past three decades, cord blood transplantation (CBT) has established its role as an alternative allograft stem cell source. But the future of stored CB units should be to extend their use in updated transplant approaches and develop new CB applications. Thus, CBT will require a coordinated, multicentric, review of transplantation methods and an upgrade and realignment of banking resources and operations. Significant improvements have already been proposed to support the clinical perspective including definition of the cellular threshold for engraftment, development of transplantation methods for adult patients, engraftment acceleration with single cell expansion and homing technologies, personalised protocols to improve efficacy, use of adoptive cell therapy to mitigate delayed immune reconstitution, and further enhancement of the graft‐versus‐leukaemia effect using advanced therapies. The role of CB banks in improving transplantation results are also critical by optimizing the collection, processing, storage and characterization of CB units, and improving reproducibility, efficiency and cost of banking. But future developments beyond transplantation are needed. This implies the extension from transplantation banks to banks that support cell therapy, regenerative medicine and specialized transfusion medicine. This new “CB banking 2.0” concept will require promotion of international scientific and technical collaborations between bank specialists, clinical investigators and transplant physicians.