bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence of increasing recorded diagnosis of autism spectrum disorders in Wales, UK – an e-cohort study
Authors: Underwood Jack F G , DelPozo-Banos Marcos , Frizzati Aura , John Ann , Hall Jeremy 
Published: February 2021

AbstractEstimates place the prevalence of autism spectrum disorders (autism) at around 1% in the population. New services for adult diagnosis have been set up in Wales, UK, at a time of rising awareness of the spectrum of autism experiences, however no studies have examined adult autism prevalence in Wales. In this study we use an anonymised e-cohort comprised of healthcare record data to produce all-age estimates of prevalence and incidence of recorded autism for the years 2001-2016. We found the overall prevalence rate of autism in healthcare records was 0.51%. The number of new-recorded cases of autism increased from 0.188 per 1000 person-years in 2001 to 0.644 per 1000 person-years in 2016. The estimate of 0.51% prevalence in the population is lower than suggested by population survey and cohort studies study methodologies, but comparable to other administrative record study estimates. Rates of new incident diagnoses of autism saw a >150% increase in the years 2008-2016, with a trend towards more diagnoses in those over 35 and an eightfold increase in diagnoses in women from 2000-2016. Our study suggests that while the number of people being diagnosed with autism is increasing, many are still unrecognised by healthcare services.Lay AbstractAutism spectrum disorders (autism) are thought to be relatively common, with analyses estimating 1% in the population could meet diagnostic criteria. New services for adult diagnosis have been set up in Wales, UK, however no studies have examined for the proportion of adults with autism in Wales. In this study we take anonymised healthcare record data from more than 3.6 million people to produce a national estimate of recorded autism diagnoses. We found the overall prevalence rate of autism in healthcare records was 0.51%. The number of new-recorded cases of autism increased from 0.188 per 1000 person-years in 2001 to 0.644 per 1000 person-years in 2016. The estimate of 0.51% prevalence in the population is lower than suggested by population survey and cohort studies, but comparable to other administrative records. From 2001-2016 the number of autism services for adults has increased, and autism is more widely known in society, while concurrently in healthcare records there was a >150% increase autism diagnoses in the years 2008-2016. An increasing number of diagnoses were amongst women and those aged over 35. Our study suggests that while the number of people being diagnosed with autism is increasing, many are still unrecognised by healthcare services.
Structural differences between healthy subjects and patients with schizophrenia and schizoaffective disorder: A graph and control theoretical perspective
Authors: Dimulescu Cristiana , Gareayaghi Serdar , Kamp Fabian , Fromm Sophie , Obermayer Klaus , Metzner Christoph 
Published: February 2021

AbstractThe coordinated, dynamical interactions of large-scale networks give rise to cognitive function. Recent advances in network neuroscience have suggested that the anatomical organization of such networks puts a fundamental constraint on the dynamical landscape of the brain. Consequently, changes in large-scale brain activity have been hypothesized to underlie many neurological and psychiatric disorders. Specifically, evidence has emerged that large-scale dysconnectivity might play a crucial role in the pathophysiology of schizophrenia. To investigate potential differences in graph and control theoretic measures between patients with schizophrenia (SCZ), patients with schizoaffective disorder (SCZaff) and matched healthy controls (HC), we use structural MRI data. More specifically, we first calculate seven graph measures of integration, segregation, centrality and resilience and test for group differences. Second, we extend our analysis beyond these traditional measures and employ a simplified noise-free linear discrete-time and time-invariant network model to calculate two complementary measures of controllability. Average controllability identifies brain areas that can guide brain activity into different, easily reachable states with little input energy. Modal controllability on the other hand, characterizes regions that can push the brain into difficult-to-reach states, i.e. states that require substantial input energy. We identified differences in standard network and controllability measures for both patient groups compared to HCs. Specifically, we found a strong reduction of betweenness centrality for both patient groups and a strong reduction in average controllability for the SCZ group again in comparison to the HC group. Our findings of network level deficits might help to explain the many cognitive deficits associated with these disorders.
Assessment of knowledge, attitude and practices among Accredited Social Health Activists (ASHAs) towards COVID-19: a descriptive cross-sectional study in Tripura, India
Authors: Chowdhury Purvita , Baidya Subrata , Paul Debosmita , Debbarma Pinki , Kalita Biraj , Karmakar Sanjoy 
Published: February 2021

AbstractWith the surge in COVID-19 cases, community healthcare workers (CHW) remain pivotal for proper dissemination of awareness of disease transmission and infection control measures among the communities in low- and middle-income countries. In this context, lack of adequate knowledge and appropriate attitude among the CHW can directly influence the COVID-19 management programme. Therefore, the present study was designed to assess the knowledge, attitude and practices towards COVID-19 among the CHW of India known as Accredited Social Health Activists (ASHAs). A descriptive cross-sectional was conducted in the state of Tripura, Northeast India, among ASHAs with 14-, 4- and 3-item self-administered questionnaire for knowledge, attitude and practice. Around 61.2% of participants had the mean correct answer rate and the mean score of knowledge was 8.57± 2.25 (±SD). As per Bloom’s cut-off, it was observed that only 10% of the ASHAs had adequate knowledge, 30.9% showed positive attitude and 88% adhered to the good practices. It was observed that the indigenous ASHAs were 1.79 times more likely to adhere to the good practice of wearing masks during filed visits in the community (OR: 1.791, 95% CI: 1.059-3.028, p=0.030). Multinomial regression analysis showed that practice was significantly associated with fear of getting infected during service and the community’s fearfulness of ASHAs spreading the disease. Urgent addressing of the provisions of support, guidance and training of grassroot level healthcare workers in rural tough terrains can ensure robust output from the existing community healthcare workers in future pandemic-like emergencies.
Harnessing recombinase polymerase amplification for rapid detection of SARS-CoV-2 in resource-limited settings
Authors: Cherkaoui Dounia , Huang Da , Miller Benjamin S. , McKendry Rachel A. 
Published: February 2021

AbstractThe COVID-19 pandemic has challenged testing capacity worldwide. The mass testing needed to stop the spread of the virus requires new molecular diagnostic tests that are faster and with reduced equipment requirement, but as sensitive as the current gold standard protocols based on polymerase chain reaction.We developed a fast (25-35 minutes) molecular test using reverse transcription recombinase polymerase amplification for simultaneous detection of two conserved regions of the virus, targeting the E and RdRP genes. The diagnostic platform offers two complementary detection methods: real-time fluorescence or visual dipstick.The analytical sensitivity of the test by real-time fluorescence was 9.5 (95% CI: 7.0-18) RNA copies per reaction for the E gene and 17 (95% CI: 11-93) RNA copies per reaction for the RdRP gene. The analytical sensitivity for the dipstick readout was 130 (95% CI: 82-500) RNA copies per reaction. The assay showed high specificity with both detection methods when tested against common seasonal coronaviruses, SARS-CoV and MERS-CoV model samples. The dipstick readout demonstrated potential for point-of-care testing, with simple or equipment-free incubation methods and a user-friendly prototype smartphone application was proposed with data capture and connectivity.This ultrasensitive molecular test offers valuable advantages with a swift time-to-result and it requires minimal laboratory equipment compared to current gold standard assays. These features render this diagnostic platform more suitable for decentralised molecular testing.
Estimating the Failure Risk of Quarantine Systems for Preventing COVID-19 Outbreaks in Australia and New Zealand
Authors: Grout Leah , Katar Ameera , Ouakrim Driss Ait , Summers Jennifer A. , Kvalsvig Amanda , Baker Michael G. , Blakely Tony , Wilson Nick 
Published: February 2021

AbstractObjectivesTo identify COVID-19 outbreaks and border control failures associated with quarantine systems in Australia and New Zealand and to estimate the failure risks.Design, setting, participantsObservational epidemiological study of travellers transiting quarantine in Australia and New Zealand up to 15 June 2021.Main outcome measuresThe incidence of COVID-19 related failures arising from quarantine, and the failure risk for those transiting quarantine, estimated both per 100,000 travellers and per 1000 SARS-CoV-2 positive cases.ResultsAustralia and New Zealand had 32 COVID-19 related failures arising from quarantine systems up to 15 June 2021 (22 and 10, respectively). One resultant outbreak involved an estimated 800 deaths and quarantine failures instigated nine lockdowns. The failure risk for those transiting quarantine was estimated at 5.0 failures per 100,000 travellers and 6.1 failures (95%CI: 4.0 to 8.3) per 1000 SARS-CoV-2 positive cases. The latter risk was two-fold higher in New Zealand compared with Australia. The full vaccination of frontline border workers could likely have prevented a number of quarantine system failures.ConclusionsQuarantine system failures can be costly in terms of lives and economic impacts such as lockdowns. Ongoing improvements or alternatives to hotel-based quarantine are required.
Early pandemic molecular diversity of SARS-CoV-2 in children
Authors: Moustafa Ahmed M. , Otto William , Gai Xiaowu , Pandey Utsav , Ryutov Alex , Bootwalla Moiz , Maglinte Dennis T , Shen Lishuang , Ruble David , Ostrow Dejerianne , Gerber Jeffrey S. , Bard Jennifer Dien , Harris Rebecca M. , Planet Paul J. 
Published: February 2021

AbstractBackgroundIn the US, community circulation of the SARS-CoV-2 virus likely began in February 2020 after mostly travel-related cases. Children’s Hospital of Philadelphia began testing on 3/9/2020 for pediatric and adult patients, and for all admitted patients on 4/1/2020, allowing an early glimpse into the local molecular epidemiology of the virus.MethodsWe obtained 169 SARS-CoV-2 samples (83 from patients <21 years old) from March through May and produced whole genome sequences. We used genotyping tools to track variants over time and to test for possible genotype associated clinical presentations and outcomes in children.ResultsOur analysis uncovered 13 major lineages that changed in relative abundance as cases peaked in mid-April in Philadelphia. We detected at least 6 introductions of distinct viral variants into the population. As a group, children had more diverse virus genotypes than the adults tested. No strong differences in clinical variables were associated with genotypes.ConclusionsWhole genome analysis revealed unexpected diversity, and distinct circulating viral variants within the initial peak of cases in Philadelphia. Most introductions appeared to be local from nearby states. Although limited by sample size, we found no evidence that different genotypes had different clinical impacts in children in this study.SummaryUsing sequencing and a novel technique for quantifying SARS-CoV-2 diversity, we investigated 169 SARS-CoV-2 genomes (83 <21 years old). This analysis revealed unexpected diversity especially in children. No clear differences in clinical presentation were associated with the different virus lineages.
Comprehensive lipidomics reveals reduced hepatic lipid turnover in NAFLD during alcohol intoxication
Authors: Israelsen Mads , Kim Min , Suvitaival Tommi , Stæhr Madsen Bjørn , Hansen Camilla Dalby , Torp Nikolaj , Trost Kajetan , Thiele Maja , Hansen Torben , Legido-Quigley Cristina , Krag Aleksander 
Published: February 2021

Background & AimsIn experimental models, alcohol induces acute changes in lipid metabolism that cause hepatocyte lipoapoptosis and inflammation. Here we study human hepatic lipid turnover during controlled alcohol intoxication.MethodsWe studied 39 participants with three distinct hepatic phenotypes: alcohol-related liver disease (ALD), non-alcoholic fatty liver disease (NAFLD), and healthy controls. Alcohol was administrated via nasogastric tube over 30 minutes. Hepatic and systemic venous blood were sampled simultaneously at three time points: baseline, 60 and 180 min after alcohol intervention. Liver biopsies were sampled 240 minutes after alcohol intervention. We used ultra-high-performance liquid chromatograph mass spectrometry to measure levels of more than 250 lipid species from the blood and liver samples.ResultsAfter alcohol intervention, the levels of blood free fatty acid (FFA) and lysophosphatidylcholine (LPC) decreased while triglyceride (TG) increased. FFA was the only lipid class to decrease in NAFLD after alcohol intervention, while LPC and FFA decreased and TG increased after intervention in ALD and healthy controls. Fatty acid chain uptake preference in FFAs and LPCs were oleic acid, linoleic acid, arachidonic acid, and docosahexaenoic acid. Hepatic venous blood FFA and LPC levels were lower when compared to systemic venous blood levels throughout the intervention. After alcohol intoxication, liver lipidome in ALD was similar to that in NAFLD.ConclusionsAlcohol intoxication induces rapid changes in circulating lipids including hepatic turnaround from FFA and LPC, potentially leading to lipoapoptosis and steatohepatitis. TG clearance was suppressed in NAFLD, possibly explaining why alcohol and NAFLD are synergistic risk factors for disease progression. These effects may be central to the pathogenesis of ALD.
Is Google Trends a useful tool for tracking mental and social distress during a public health emergency? A time-series analysis
Authors: Knipe Duleeka , Gunnell David , Evans Hannah , John Ann , Fancourt Daisy 
Published: February 2021

AbstractBackgroundGoogle Trends data are increasingly used by researchers as an indicator of population mental health, but few studies have investigated the validity of this approach.MethodsRelative search volumes (RSV) for the topics depression, anxiety, self-harm, suicide, suicidal ideation, loneliness, and abuse were obtained from Google Trends. We used graphical and time-series approaches to compare daily trends in searches for these topics against population measures of these outcomes recorded using validated scales (PHQ-9; GAD-7; UCLA-3) in a weekly survey (n=∼70,000) of the impact COVID-19 on psychological and social experiences in the UK population (12/03/2020 to 21/08/ 2020).ResultsSelf-reported levels of depression, anxiety, suicidal ideation, self-harm, loneliness and abuse decreased during the period studied. There was no evidence of an association between self-reported anxiety, self-harm, abuse and RSV on Google Trends. Trends in reported depression symptoms and suicidal ideation declined over the study period, whereas Google topic RSV increased (p=0.03 and p=0.04 respectively). There was some evidence that suicidal ideation searches preceded reported self-harm (p=0.05), but graphical evidence suggested this was an inverse association. However, there was statistical and graphical evidence that self-report and Google searches for loneliness (p<0.001) tracked one another.LimitationsNo age/sex breakdown of Google Trends data are available. Survey respondents were not representative of the UK population and no pre-pandemic data were available.ConclusionGoogle Trends data do not appear to be a useful indicator of changing levels of population mental health during a public health emergency, but may have some value as an indicator of loneliness.
Seasonal influenza vaccine hesitancy profiles and determinants among Chinese children’s guardians and the elderly
Authors: Wei Zheng , Sun Xiu , Yang Yingying , Zhan Siyi , Fu Chuanxi 
Published: February 2021

AbstractBackgroundSeasonal influenza imposes a significant clinical and economic burden, yet vaccine coverage remains low in China due to possible influenza vaccine hesitancy (IVH) and practical issues. We sought to investigate IVH and its determinants among children’s guardians and the elderly for better understanding of the situation and for future intervention.MethodsIVH scales for the guardians and elderly were designed. We then performed two cross-sectional studies to identify the profiles and determinants of IVH using stratified cluster random sampling in an eastern China province in 2019.ResultsOf the 1,564 guardians and 522 elders, 43.2% (95% confidence interval: 40.4–46.0%) of guardians and 33.5% of elders (95% confidence interval: 29.5–37.6%) had IVH, whereas 31.3% of the guardians and 5.5% of the elderly had Influenza vaccine demand. The scales were well structured (KMO: 0.736 and 0.682; Cronbach’s α: 0.638 and 0.611). ‘From rural area’ (Odds ratio: 1.36), ‘don’t know government recommendation for flu vaccination’ (1.39), ‘don’t know flu vaccine is vaccinated annually’ (1.93), ‘family members (0.22), friends and neighbors had positive attitude toward flu vaccine’(0.58) were related factors of the guardians’ IVH. ‘Aged 70–79 years’ (0.46), ‘had flu before’ (0.35) and ‘once had been vaccinated’ (0.42) were related to the elderly’s IVH.ConclusionPoor awareness of influenza and vaccination, relatives’ negative/positive attitude, lack of government recommendations, anxiety about vaccine quality, and practical issues such as short supply are related to IVH in China. Precision education aiming hesitancy in wider groups are anticipated to increase vaccine confidence and coverage in influenza-vulnerable groups.
Service user experiences and views regarding telemental health during the COVID-19 pandemic: a co-produced framework analysis
Authors: Vera San Juan Norha , Shah Prisha , Schlief Merle , Appleton Rebecca , Nyikavaranda Patrick , Birken Mary , Foye Una , Lyons Natasha , Rains Luke Sheridan , Dedat Zainab , Lloyd-Evans Brynmor , Needle Justin J , Simpson Alan , Morant Nicola , Johnson Sonia 
Published: February 2021

AbstractBackgroundThe prominence of telemental health, including providing care by video call and telephone, has greatly increased during the COVID-19 pandemic. However, there are clear variations in uptake and acceptability, and concerns that digital exclusion may exacerbate previous inequalities in accessing good quality care. Greater understanding is needed of how service users experience telemental health, and what determines whether they engage and find it acceptable.MethodsWe conducted a collaborative framework analysis of data from semi-structured interviews with a sample of people already experiencing mental health problems prior to the pandemic. Data relevant to participants’ experiences and views regarding telemental health during the pandemic was identified and extracted. Data collection and analysis used a participatory, coproduction approach where lived experience researchers, clinical and academic researchers contributed to all stages of data collection, analysis and interpretation of findings.FindingsParticipants’ experiences and preferences regarding telemental health care were dynamic and varied across time, settings, and individuals. Participants’ preferences were shaped by the reason for contacting providers, their relationship with the care provider, and both parties’ access or acceptability to use remote technology. While face-to-face care tended to be the preferred option, participants identified benefits of remote care including making care more accessible for some populations and improved efficiency for functional appointments such as prescription reviews. Participants highlighted important new challenges around safety and privacy in online settings, and gave examples of good remote care strategies, including scheduling regular phone calls and developing guidelines about how to access remote care tools.DiscussionParticipants in our study and previous literature have highlighted advantages of telemental health care, as well as significant limitations which hinder mental health support and exacerbate inequalities in access to services. Some of these limitations are seen as potentially removable, for example through staff training or better digital access for staff or service users. Others indicate a need to maintain traditional face-to-face contact at least for some appointments. There is a clear need for care to be flexible and individualised to service user circumstances and preferences. Further research is needed on ways of minimising digital exclusion and to support staff in making effective and collaborative use of relevant technologies.
Assessing Age-Specific Vaccination Strategies and Post-Vaccination Reopening Policies for COVID-19 Control Using SEIR Modeling Approach
Authors: Wang Xia , Wu Hulin , Tang Sanyi 
Published: February 2021

AbstractBackgroundAs the availability of COVID-19 vaccines, it is badly needed to develop vaccination guidelines to prioritize the vaccination delivery in order to effectively stop COVID-19 epidemic and minimize the loss.MethodsWe evaluated the effect of age-specific vaccination strategies on the number of infections and deaths using an SEIR model, considering the age structure and social contact patterns for different age groups for each of different countries.ResultsIn general, the vaccination priority should be given to those younger people who are active in social contacts to minimize the number of infections; while the vaccination priority should be given to the elderly to minimize the number of deaths. But this principle may not always apply when the interaction of age structure and age-specific social contact patterns is complicated. Partially reopening schools, workplaces or households, the vaccination priority may need to be adjusted accordingly.ConclusionsPrematurely reopening social contacts could initiate a new outbreak or even a new pandemic out of control if the vaccination rate and the detection rate are not high enough. Our result suggests that it requires at least nine months of vaccination before fully reopening social contacts in order to avoid a new pandemic.