bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Emergency Department Use of Safety-Net Antibiotic Prescriptions for Acute Otitis Media
Authors: Daggett Alicia , Wyly Donna R. , Stewart Tanis , Phillips Patty , Newell Cassandra , Lee Brian R. , Burns Alaina , Sharma Nikita , Shastri Nirav , Rodean Jonathan , El Feghaly Rana E. 
Published: September 2021

Objectives
Acute otitis media (AOM) is the most common reason for pediatric antibiotic prescriptions. The 2013 American Academy of Pediatrics' AOM guidelines recommend observation for nonsevere AOM. Our aim was to increase the percentage safety-net antibiotic prescription (SNAP) offered to patients 6 months of age or older diagnosed with AOM in 2 pediatric emergency departments (EDs) from a baseline of 0.5% to 15% in 20 months.

Methods
This is a quality improvement study at a quaternary pediatric medical center with 2 locations, both with EDs. A random chart review revealed that 27.5% of patients diagnosed with AOM in the ED would qualify for a SNAP, but only 0.5% were offered it. Quality improvement interventions were designed to improve safety-net antibiotic prescribing. Both EDs conducted multiple interventions, including algorithm development, provider education, and electronic medical record aids. The primary outcome measure was the percentage of patients offered a SNAP for AOM.

Results
A total of 8226 children 6 months of age or older were diagnosed with AOM in our 2 EDs during the 20-month intervention period. The percentage offered a SNAP increased at both EDs. One ED had a single shift in the mean to 7.9%, whereas the other had 2 shifts in the mean, an initial shift to 5.1% and a second to 7.3%. Providers consistently used the algorithm and electronic medical record aids.

Conclusions
Safety-net antibiotic prescriptions in conjunction with parent education was effective in reducing the use of immediate antibiotic prescriptions in children with AOM in 2 pediatric EDs. Offering a SNAP can reduce unnecessary use of antibiotics, which in turn may decrease antibiotic-related adverse events and antibiotic resistance.
Point-of-Care Ultrasound Diagnosis of Achilles Tendon Rupture in Pediatric Patients
Authors: Singh Amar , Poteh Ndah , Kim Joshua , Starr Rebecca , Khalil Paul 
Published: September 2021

Abstract
Achilles tendon injuries are common in the adolescent population, particularly in individuals who participate in sports. The diagnosis of Achilles tendon rupture can be missed on clinical examination in 20% to 30% of patients. In the adult literature, there are several case reports describing the diagnosis of Achilles tendon rupture by point-of-care ultrasound POCUS. There is currently no literature examining POCUS for the diagnosis of Achilles tendon rupture in pediatric patients. This case series describes 2 pediatric patients who were diagnosed with Achilles tendon rupture by POCUS.
Gastroesophageal reflux disease is associated with differences in the allograft microbiome, microbial density and inflammation in lung transplantation
Authors: Schneeberger Pierre H.H. , Kevin Zhang Chen Yang , Santilli Jessica , Chen Bo , Xu Wei , Lee Youngho , Wijesinha Zonelle , Reguera-Nuñez Elaine , Yee Noelle , Ahmed Musawir , Boonstra Kristen , Ramendra Rayoun , Frankel Courtney W. , Palmer Scott M. , Todd Jamie L. , Martinu Tereza , Coburn Bryan 
Published: September 2021

AbstractRationaleGastroesophageal reflux disease (GERD) may affect lung allograft inflammation and function through its effects on allograft microbial community composition in lung transplant recipients.ObjectivesOur objective was to compare the allograft microbiota in lung transplant recipients with or without clinically diagnosed GERD in the first post-transplant year, and assess associations between GERD, allograft microbiota, inflammation and acute and chronic lung allograft dysfunction (ALAD/CLAD).Methods268 bronchoalveolar lavage samples were collected from 75 lung transplant recipients at a single transplant centre every 3 months post-transplant for 1 year. Ten transplant recipients from a separate transplant centre provided samples pre/post-anti-reflux Nissen fundoplication surgery. Microbial community composition and density were measured using 16S rRNA gene sequencing and qPCR, respectively and inflammatory markers and bile acids were quantified.Measurements and Main ResultsWe observed three community composition profiles (labelled community state types, CSTs 1-3). Transplant recipients with GERD were more likely to have CST1, characterized by high bacterial density and relative abundance of the oropharyngeal colonizing genera Prevotella and Veillonella. GERD was associated with more frequent transition to CST1. CST1 was associated with lower per-bacteria inflammatory cytokine levels than the pathogen-dominated CST3. Time-dependant models revealed associations between CST3 and development of ALAD/CLAD. Nissen fundoplication decreased bacterial load and pro-inflammatory cytokines.ConclusionGERD was associated with a high bacterial density, Prevotella/Veillonella dominated CST1. CST3, but not CST1 or GERD, was associated with inflammation and early development of ALAD/CLAD. Nissen fundoplication was associated with decreases in microbial density in BALF samples, especially the CST1-specific genus, Prevotella.
Genetic and environmental correlations between complex phenotypes differ by race/ethnicity and sex
Authors: Elgart Michael , Goodman Matthew O. , Isasi Carmen , Chen Han , de Vries Paul S. , Xu Huichun , Manichaikul Ani W , Guo Xiuqing , Franceschini Nora , Psaty Bruce M. , Rich Stephen S. , Rotter Jerome I. , Lloyd-Jones Donald M. , Fornage Myriam , Correa Adolfo , Heard-Costa Nancy L. , Vasan Ramachandran S. , Hernandez Ryan , Kaplan Robert C. , Redline Susan ,   the Trans-Omics for Precision Medicine (TOPMed) Consortium, Sofer Tamar 
Published: September 2021

AbstractWe developed novel closed-form estimators of genetic and environmental correlation coefficients. We applied them to estimate over 4,000 genetic and environmental correlations between multiple phenotypes in a diverse sample from the Trans-Omics in Precision Medicine (TOPMed) program. We found substantial differences in heritabilities, genetic, and environmental correlations of multiple phenotypes and phenotype-pairs between Black, Hispanic/Latino and White populations as well as between sexes. Finally, we quantified genetic and environmental correlations between phenotypic domains, each characterized by multiple phenotypes. Altogether we provide a novel, in-depth framework for examining relations among complex human phenotypes and their determinants.
A simple, sensitive and quantitative FACS-based test for SARS-CoV-2 serology in humans and animals
Authors: Ribes Agnès Maurel , Bessière Pierre , Guéry Jean Charles , Joly Featherstone Eloïse , Bruel Timothée , Robinot Remy , Schwartz Olivier , Volmer Romain , Abravanel Florence , Izopet Jacques , Joly Etienne 
Published: September 2021

AbstractSerological tests are important for understanding the physiopathology and following the evolution of the Covid-19 pandemic. Assays based on flow cytometry (FACS) of tissue culture cells expressing the spike (S) protein of SARS-CoV-2 have repeatedly proven to perform slightly better than the plate-based assays ELISA and CLIA (chemiluminescent immuno-assay), and markedly better than lateral flow immuno-assays (LFIA).Here, we describe an optimized and very simple FACS assay based on staining a mix of two Jurkat cell lines, expressing either high levels of the S protein (Jurkat-S) or a fluorescent protein (Jurkat-R expressing m-Cherry, or Jurkat-G, expressing GFP, which serve as an internal negative control). We show that the Jurkat-S&R-flow test has a much broader dynamic range than a commercial ELISA test and performs at least as well in terms of sensitivity and specificity. Also, it is more sensitive and quantitative than the hemagglutination-based test HAT, which we described recently. The Jurkat-flow test requires only a few microliters of blood; thus, it can be used to quantify various Ig isotypes in capillary blood collected from a finger prick. It can be used also to evaluate serological responses in mice, hamsters, cats and dogs. Whilst the Jurkat-flow test is ill-suited and not intended for clinical use, it offers a very attractive solution for laboratories with access to tissue culture and flow cytometry who want to monitor serological responses in humans or in animals, and how these relate to susceptibility to infection, or re-infection, by the virus, and to protection against Covid-19.NoteThis manuscript has been refereedby Review Commons, and modified thanks to the comments and suggestions from two referees. Those comments, and our replies, are provided at the end of the manuscript’s pdf, and can also be accessed by clicking on the box with a little green number found just above the “Abstract “ tab in the medRXiv window.
Four-week forecasts of COVID-19 epidemic trajectories in South Africa, Chile, Peru and Brazil: a model evaluation
Authors: Delva Wim , Dominic Emanuel M. , Beauclair Roxanne , Ouifki Rachid , Kroon Matthys , Volmink Heinrich , Dorkin Elton 
Published: September 2021

ABSTRACTIntroductionFrom the beginning of the COVID-19 pandemic, epidemiological models have been used in a number of ways to aid governments and organizations in efficient planning of resources and decision making. These models have elucidated important epidemiological transmission parameters, in addition to making short-term projections.MethodsWe constructed a compartmental mathematical model for the transmission, detection and prevention of SARS-CoV-2 infections for regions where Anglo American has mining operations. We fitted the model to publicly available data and used it to make short-term projections. Finally, we evaluated how the model performed by comparing short-term projections to actual confirmed cases, retrospectively.FindingsThe average forecast errors for four-week-ahead projections ranged between 1% and 8% in all the countries and regions considered in this study. All but one region had more than 75% of the true values falling within the range of four-week-ahead projections. The quality of the projections improved with time as expected due to increased historical data.ConclusionOur model produced four-week forecasts with a sufficiently high level of accuracy to guide operational and strategic planning for business continuity and COVID-19 responses in Anglo American mining sites.
Analysis of Respiratory Kinematics: a method to characterize breaths from motion signals
Authors: Ashe William B. , Innis Sarah E. , Shanno Julia N. , Hochheimer Camille J. , Williams Ronald D. , Ratcliffe Sarah J. , Moorman J. Randall , Gadrey Shrirang M. 
Published: September 2021

AbstractRationaleBreathing motion (respiratory kinematics) can be characterized by the interval and depth of each breath, and by magnitude-synchrony relationships between locations. Such characteristics and their breath-by-breath variability might be useful indicators of respiratory health.ObjectivesTo enable breath-by-breath characterization of respiratory kinematics, we developed a method to detect breaths using motion sensor signals.MethodsIn 34 volunteers who underwent maximal exercise testing, we used 8 motion sensors to record upper rib, lower rib and abdominal kinematics at 3 exercise stages (rest, lactate threshold and exhaustion). We recorded volumetric air flow signals using clinical exercise laboratory equipment and synchronized them with kinematic signals. Using instantaneous phase landmarks from the analytic representation of kinematic and flow signals, we identified individual breaths and derived respiratory rate signals at 1Hz. To evaluate the fidelity of kinematics-derived respiratory rate signals, we calculated their cross-correlation with the flow-derived respiratory rate signals. To identify coupling between kinematics and flow, we calculated the Shannon entropy of the relative frequency with which kinematic phase landmarks were distributed over the phase of the flow cycle.Measurements and Main ResultsWe found good agreement in the kinematics-derived and flow-derived respiratory rate signals, with cross-correlation coefficients as high as 0.94. In some individuals, the kinematics and flow were significantly coupled (Shannon entropy < 2) but the relationship varied within (by exercise stage) and between individuals. The final result was that the phase landmarks from the kinematic signal were uniformly distributed over the phase of the air flow signals (Shannon entropy close to the theoretical maximum of 3.32).ConclusionsThe Analysis of Respiratory Kinematics method can yield highly resolved respiratory rate signals by separating individual breaths. This method will facilitate characterization of clinically significant breathing motion patterns on a breath-by-breath basis. The relationship between respiratory kinematics and flow is much more complex than expected, varying between and within individuals.
Relationship between eye movements and freezing of gait during turning in individuals with Parkinson’s disease
Authors: Wang Ying , van Wanrooij Marc M. , Emaus Rowena , Nonneke Jorik , Cohen Michael X , Cockx Helena , Janssen Sabine , Helmich Rick C. , van Wezel Richard 
Published: September 2021

ABSTRACTBackgroundIndividuals with Parkinson’s disease can experience freezing of gait: “a sudden, brief episode of an inability to move their feet despite the intention to walk”. Since turning is the most sensitive condition to provoke freezing-of-gait episodes, and the eyes typically lead turning, we hypothesize that disturbances in saccadic eye movements are related to freezing-of-gait episodes.ObjectivesThis study explores the relationship between freezing-of-gait episodes and saccadic eye movements for gaze shift and gaze stabilization during turning.MethodsWe analyzed 277 freezing-of-gait episodes provoked among 17 individuals with Parkinson’s disease during two conditions: self-selected speed and rapid speed 180-degree turns in alternating directions. Eye movements acquired from electrooculography signals were characterized by the average position of gaze, the amplitude of gaze shifts, and the speed of gaze stabilization. We analyzed these variables before and during freezing-of-gait episodes occurring at the different phase angles of a turn.ResultsSignificant off-track changes of the gaze position were observed almost one 180-degree-turn time before freezing-of-gait episodes. In addition, the speed of gaze stabilization significantly decreased during freezing-of-gait episodes.ConclusionsWe argue that off-track changes of the gaze position could be a predictor of freezing-of-gait episodes due to continued failure in movement-error correction or an insufficient preparation for eye-to-foot coordination during turning. The decline in the speed of gaze stabilization is large during freezing-of- gait episodes given the slowness or stop of body turning. We argue that this could be evidence for a healthy compensatory system in individuals with freezing-of-gait.
Persistence of child marriage in rural Bangladesh and impact on maternal and perinatal health: findings from a health and demographic surveillance system
Authors: Lee Kyu Han , Chowdhury Atique I. , Rahman Qazi S. , Cunningham Solveig A. , Parveen Shahana , Bari Sanwarul , Arifeen Shams E. , Gurley Emily S. 
Published: September 2021

ABSTRACTObjectivesTo describe temporal trends in child marriage between 1990 and 2019 in a rural sub-district of Bangladesh and characterize relationships between age, time to pregnancy, complications during delivery, and perinatal mortality.DesignHealth and demographic surveillance system.SettingBaliakandi sub-district, Bangladesh.Participants56,155 female residents.Main outcome measuresAnnual proportion of marriages to female residents under 18 years of age, time between first marriage and pregnancy, proportion of births with complications during delivery, and odds of perinatal mortality.ResultsBetween 1990 and 2010, the proportion of marriages to female residents under 18 years of age decreased from 71% to 57%. Most notably, marriages to females aged 10 to 12 years dropped from 22% of all marriages to 3%. In 2019, 53% of all marriages were to females under 18 years. The estimated time between first marriage and pregnancy did not differ by female age at marriage. By 365 days after marriage, the cumulative incidence of pregnancy was approximately 50% for each age group. Adolescent girls were more likely to experience complications during delivery with at least one complication reported for 36% of mothers aged 13 to 15 years, 32% of mothers aged 16 to 17 years, and 23% of mothers aged 18 to 34 years (χ2 test, P<0.001). Compared to adults, births among females aged 13 to 15 years were more likely to result in stillbirths (odds ratio 2.23, 95% confidence interval 1.19 to 4.16) and births among females 16-17 years were more likely to result in early neonatal deaths (odds ratio 1.57, 95% confidence interval 1.01 to 2.42).ConclusionsChild marriage persists in Baliakandi. Over half of all marriages were to child brides and only minor reductions were seen over the past decade. Pregnancies were common among adolescent girls with no evidence of delayed pregnancy after marriage. Compared to adults, adolescents were more likely to experience complications during delivery and perinatal death. Preventing child marriage has substantial social and health benefits for girls and, by doing so, will also contribute to Bangladesh’s commitment to reduce child mortality.
Perceptions and experiences of rare diseases among General Practitioners: an exploratory study
Authors: McMullan Julie , Crowe Ashleen L. , McClenaghan Taylor , McAneney Helen , McKnight Amy Jayne 
Published: September 2021

AbstractBackgroundGeneral Practitioners (GPs) play an important role in healthcare delivery for people living with a rare disease and their families. Managing long-term multisystem diseases that often have no cure and sub-optimal treatment options can be extremely challenging.AimTo gain an understanding of GP’s perception and experience of rare diseases.Design and SettingThis is an exploratory study with GPs from Northern Ireland.MethodAn online survey was hosted within SmartSurvey, available for 6 weeks in early 2019, which queried: GPs career to date, interactions with rare disease patients, challenges faced, the exchange of information with patients, priorities for the future, support for such patients and finally training.ResultsSixty-six GPs engaged with the survey with 15 completing the survey. Many frustrations were mentioned by GPs when caring for such patients including finding a diagnosis, lack of specialist services and lack of awareness. Seventy-nine percent of GPs responding did not feel adequately trained to care for patients with a rare disease, while 93% were interested in undertaking training to enable them to improve their care for rare disease patients.ConclusionMore effective and convenient ‘rare disease’ focused training programs would help GPs manage patients with rare diseases. Enabling efficient, effective communication between GPs and individual medical specialists is of paramount importance to give GPs access to information on how to effectively manage patients living with a rare disease. Awareness should be raised for effective support mechanisms such as charities and support groups for rare disease patients.How this fits inMany GPs have reported feeling overwhelmed when caring for rare disease patients. Their lack of knowledge forces them to turn to the internet but finding reliable information is often difficult. This study acknowledges the difficult task GPs face when caring for this population and highlights the need for training development, improved communication, and better awareness.
Distinguishing Incubation and Acute Disease Stages of Mild-to-Moderate COVID-19
Authors: Müller Michael , Volzke Johann , Subin Behnam , Schmidt Christian J. , Geerdes-Fenge Hilte , Reisinger Emil C. , Müller-Hilke Brigitte 
Published: September 2021

AbstractObjectiveWhile numerous studies have already compared the immune responses against SARS-CoV-2 in severely and mild-to-moderately ill COVID-19 patients, longitudinal trajectories are still scarce. We therefore set out to analyze serial blood samples from mild-to-moderately ill patients in order to define the immune landscapes for differently progressed disease stages.MethodsTwenty-two COVID-19 patients were subjected to consecutive venipuncture within seven days after diagnosis or admittance to hospital. Flow cytometry was performed to analyze peripheral blood immune cell compositions and their activation as were plasma levels of cytokines and SARS-CoV-2 specific immunoglobulins. Healthy donors served as controls.ResultsIntegrating the kinetics of plasmablasts and SARS-CoV-2 specific antibodies allowed for the definition of three disease stages of early COVID-19. The incubation phase was characterized by a sharp increase in pro-inflammatory monocytes and terminally differentiated cytotoxic T cells. The latter correlated significantly with elevated concentrations of IP-10. Early acute infection featured a peak in PD-1+ cytotoxic T cells, plasmablasts and increasing titers of virus specific antibodies. During late acute infection, immature neutrophils were enriched whereas all other parameters returned to baseline.ConclusionOur findings will help to define landmarks that are indispensable for the refinement of new anti-viral and anti-inflammatory therapeutics, and may also inform clinicians to optimize treatment and prevent fatal outcome.
Vaccinations or Non-Pharmaceutical Interventions: Safe Reopening of Schools in England
Authors: Cuesta-Lazaro Carolina , Quera-Bofarull Arnau , Aylett-Bullock Joseph , Lawrence Bryan N. , Fong Kevin , Icaza-Lizaola Miguel , Sedgewick Aidan , Truong Henry , Vernon Ian , Williams Julian , Pagel Christina , Krauss Frank 
Published: September 2021

ABSTRACTWith high levels of the Delta variant of COVID-19 circulating in England during September 2021, schools are set to reopen with few school-based non-pharmaceutical interventions (NPIs). In this paper, we present simulation results obtained from the individual-based model, June, for English school opening after a prior vaccination campaign using an optimistic set of assumptions about vaccine efficacy and the likelihood of prior-reinfection. We take a scenario-based approach to modelling potential interventions to assess relative changes rather than real-world forecasts. Specifically, we assess the effects of vaccinating those aged 16-17, those aged 12-17, and not vaccinating children at all relative to only vaccinating the adult population, addressing what might have happened had the UK began teenage vaccinations earlier. Vaccinating children in the 12-15 age group would have had a significant impact on the course of the epidemic, saving thousands of lives overall in these simulations. In the absence of such a vaccination campaign our simulations show there could still be a significant positive impact on the epidemic (fewer cases, fewer deaths) by continuing NPI strategies in schools. Our analysis suggests that the best results in terms of lives saved are likely derived from a combination of the now planned vaccination campaign and NPIs in schools.