bluuebunny/crossref_metadata_2025_split huggingface dataset:
Infection control strategy and primary care assistance in Campania region during the national lockdown due to COVID-19 outbreak: the experience of two tertiary emergency centers
Authors: Mauro Angela , Improda Nicola , Zenzeri Letizia , Valitutti Francesco , Vecchione Erica , Esposito Sara , Tipo Vincenzo 
Published: January 2021

Abstract
Background
COVID-19 pandemic has markedly affected emergency care, due to sudden limitation of health care capacity by general practitioners (GP) and urgent need for infection control strategies. We evaluated the activity of the Emergency Department (ED) during the national lockdown (March 8–April 30), as well as the outcomes of our infection control strategy.

Results
Despite a reduction in access by one fifth, a proportion of febrile patients comparable to 2019 was seen (829/2492, 33.3% vs 4580/13.342, 34.3%, p = 0.3). Diagnostic swab for COVID-19 was performed in 25% of patients, especially in subjects with co-morbidities or multiple access. Six infected cases were identified, all presenting with febrile disease. Only two positive patients fulfilled the criteria for diagnostic swab provided by the Italian Health Authorities, because of close contact with suspected or confirmed cases.
The rate of admission for febrile or respiratory conditions was higher than the same period of 2019 (33.4% vs 25.9%, p < 0.0001). None of the 105 health-care professionals working during the study time lapse exhibited anti-SARS-CoV-2 seroconversion. Among the 589 patients with information available, 54.9% declared no medical consultation at all prior to coming to ED, while only 40 (of which 27 with fever) had been examined by their GP before coming to ED. Nevertheless, 35.6% of the cases were already taking medications. None of the 9 patients requiring intensive care reported recent pediatric consultation, despite symptoms duration up to 30 days.

Conclusion
Our results provide evidence that the reduced capacity of primary care facilities during the national lockdown may have caused a high rate of self-medication as well as a delayed provision of care in some patients. Identification of pediatric patients affected with SARS-CoV-2 infection remains a challenge because of the absence of reliable predictive factors. Finally, the use of specific triage centers, with dedicated pathways to diagnose SARS-CoV-2 infection, trace contacts and allow adequate care after swabs, is effective in preventing spreading of the infection.
Augmentation of EMDR with multifocal transcranial current stimulation (MtCS) in the treatment of fibromyalgia: study protocol of a double-blind randomized controlled exploratory and pragmatic trial
Authors: Gardoki-Souto I. , Martín de la Torre O. , Hogg B. , Redolar-Ripoll D. , Valiente-Gómez A. , Martínez Sadurní L. , Blanch J. M. , Lupo W. , Pérez V. , Radua J. , Amann B. L. , Moreno-Alcázar A. 
Published: January 2021

Abstract
Background
Fibromyalgia (FM) is a generalized, widespread chronic pain disorder affecting 2.7% of the general population. In recent years, different studies have observed a strong association between FM and psychological trauma. Therefore, a trauma-focused psychotherapy, such as eye movement desensitization and reprocessing (EMDR), combined with a non-invasive brain stimulation technique, such as multifocal transcranial current stimulation (MtCS), could be an innovative adjunctive treatment option. This double-blind randomized controlled trial (RCT) analyzes if EMDR therapy is effective in the reduction of pain symptoms in FM patients and if its potential is boosted with the addition of MtCS.

Methods
Forty-five patients with FM and a history of traumatic events will be randomly allocated to Waiting List, EMDR + active-MtCS, or EMDR + sham-MtCS. Therapists and patients will be kept blind to MtCS conditions, and raters will be kept blind to both EMDR and MtCS. All patients will be evaluated at baseline, post-treatment, and follow-up at 6 months after post-treatment. Evaluations will assess the following variables: sociodemographic data, pain, psychological trauma, sleep disturbance, anxiety and affective symptoms, and wellbeing.

Discussion
This study will provide evidence of whether EMDR therapy is effective in reducing pain symptoms in FM patients, and whether the effect of EMDR can be enhanced by MtCS.

Trial registration
ClinicalTrials.gov NCT04084795. Registered on 2 August 2019.
The role of CT imaging for management of COVID-19 in epidemic area: early experience from a University Hospital
Authors: Bollineni Vikram rao , Nieboer Koenraad Hans , Döring Seema , Buls Nico , de Mey Johan 
Published: January 2021

Abstract
Background
To evaluate the clinical value of the chest CT scan compared to the reference standard real-time polymerase chain reaction (RT-PCR) in COVID-19 patients.

Methods
From March 29th to April 15th of 2020, a total of 240 patients with respiratory distress underwent both a low-dose chest CT scan and RT-PCR tests. The performance of chest CT in diagnosing COVID-19 was assessed with reference to the RT-PCR result. Two board-certified radiologists (mean 24 years of experience chest CT), blinded for the RT-PCR result, reviewed all scans and decided positive or negative chest CT findings by consensus.

Results
Out of 240 patients, 60% (144/240) had positive RT-PCR results and 89% (213/240) had a positive chest CT scans. The sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of chest CT in suggesting COVID-19 were 100% (95% CI: 97–100%, 144/240), 28% (95% CI: 19–38%, 27/240), 68% (95% CI: 65–70%) and 100%, respectively. The diagnostic accuracy of the chest CT suggesting COVID-19 was 71% (95% CI: 65–77%). Thirty-three patients with positive chest CT scan and negative RT-PCR test at baseline underwent repeat RT-PCR assay. In this subgroup, 21.2% (7/33) cases became RT-PCR positive.

Conclusion
Chest CT imaging has high sensitivity and high NPV for diagnosing COVID-19 and can be considered as an alternative primary screening tool for COVID-19 in epidemic areas. In addition, a negative RT-PCR test, but positive CT findings can still be suggestive of COVID-19 infection.
Clinical Translation of Cell Therapies in Stroke (CT2S) Checklist—a pragmatic tool to accelerate development of cell therapy products
Authors: Nagpal Anjali , Milton Austin G. , Koblar Simon A. , Hamilton-Bruce M. Anne 
Published: January 2021

Abstract
Background
Cell therapies present an exciting potential but there is a long history of expensive translational failures in stroke research. Researchers engaged in cell therapy research would benefit from a practical framework that can help in planning research and development of investigational cell therapies into viable medical products.

Methods
We developed a checklist using a mixed methodology approach to evaluate the impact of study design, regulatory policy, ethical, and health economic considerations for efficient implementation of early phase cell therapy studies.

Results
The checklist comprises a series of questions arranged under four domains: the first concerns study design such as characterization of target study population, trial design, endpoints and operational fit of dosage, time, and route of administration to target populations. A second domain addresses the data package required for regulatory approval relevant to the intended use (allogeneic/autologous; homologous/non-homologous; nature of cell processing). The third domain comprises patient involvement to ensure relevant data is collected via targeted study design. The final domain requires the team to determine the critical data elements that could be built into study design to enable health economic data collection to be started at an early phase of the study.

Conclusions
The CT2S checklist can help to determine areas of expertise gaps and enable research groups to appropriately allocate resources for capacity building. Use of this checklist will allow identification of key areas where trial planning needs to be optimized, as well as helping to identify resources that need to be secured. The CT2S checklist can also serve as a general cell therapy research decision aid to improve research output and accelerate new cell therapy development.
Increased susceptibility to intensive care unit-acquired pneumonia in severe COVID-19 patients: a multicentre retrospective cohort study
Authors: Llitjos Jean-François , Bredin Swann , Lascarrou Jean-Baptiste , Soumagne Thibaud , Cojocaru Mariana , Leclerc Maxime , Lepetit Arnaud , Gouhier Albin , Charpentier Julien , Piton Gaël , Faron Matthieu , Stoclin Annabelle , Pène Frédéric 
Published: January 2021

Abstract
Background
The aim of this study is to determine whether severe COVID-19 patients harbour a higher risk of ICU-acquired pneumonia.

Methods
This retrospective multicentre cohort study comprised all consecutive patients admitted to seven ICUs for severe COVID-19 pneumonia during the first COVID-19 surge in France. Inclusion criteria were laboratory-confirmed SARS-CoV-2 infection and requirement for invasive mechanical ventilation for 48 h or more. Control groups were two historical cohorts of mechanically ventilated patients admitted to the ICU for bacterial or non-SARS-CoV-2 viral pneumonia. The outcome of interest was the development of ICU-acquired pneumonia. The determinants of ICU-acquired pneumonia were investigated in a multivariate competing risk analysis.

Result
One hundred and seventy-six patients with severe SARS-CoV-2 pneumonia admitted to the ICU between March 1st and 30th June of 2020 were included into the study. Historical control groups comprised 435 patients with bacterial pneumonia and 48 ones with viral pneumonia. ICU-acquired pneumonia occurred in 52% of COVID-19 patients, whereas in 26% and 23% of patients with bacterial or viral pneumonia, respectively (p < 0.001). Times from initiation of mechanical ventilation to ICU-acquired pneumonia were similar across the three groups. In multivariate analysis, the risk of ICU-acquired pneumonia remained independently associated with underlying COVID-19 (SHR = 2.18; 95 CI 1.2–3.98, p = 0.011).

Conclusion
COVID-19 appears an independent risk factor of ICU-acquired pneumonia in mechanically ventilated patients with pneumonia. Whether this is driven by immunomodulatory properties by the SARS-CoV-2 or this is related to particular processes of care remains to be investigated.
A novel exact solution for the fractional Ambartsumian equation
Authors: Ebaid Abdelhalim , Cattani Carlo , Al Juhani Amnah S. , El-Zahar Essam R. 
Published: January 2021

AbstractFractional calculus (FC) is useful in studying physical phenomena with memory effect. In this paper, a fractional form of Ambartsumian equation is considered utilizing the Caputo fractional derivative. The Heaviside expansion formula in classical calculus (CC) is extended/developed in view of FC. Then, the extended Heaviside expansion formula is applied to obtain the exact solution in a simplest form. Several theorems and lemmas are proved to facilitate the evaluation of the inverse Laplace transform of specific expressions in fractional forms. The exact solution is established in terms of a one-parameter Mittag-Leffler function which is provided for the first time for the Ambartsumian equation in FC. The present solution reduces to the corresponding one in the relevant literature as the fractional order tends to one. Moreover, the convergence of the obtained solution is theoretically proved. Comparisons with another approach in the literature are performed. The advantage of the present analysis over the existing one in the relevant literature is discussed and analyzed.
Suffix-based double reader tag movement RFID anti-collision method
Authors: Lv Haochen , Li Xiaowu , Jia Lianyin , Li Runxin , Ding Jiaman , You Jinguo 
Published: January 2021

AbstractAt present, some existing tag anti-collision algorithms are used mostly in scenarios of fixed number of tags and they perform poorly in tag moving scenarios. Therefore, this paper proposes a double reader tag movement RFID anti-collision method based on suffix, and through the cloud platform based on cloud computing, the supply chain data sharing is realized. Tag moving scenarios usually use a single reader. The proposed employs double reader to expand the recognition range and also to prolong the recognition time, but there is the problem of repeated recognition. This article proposes a suffix-based bit-slot ALOHA (SBSA) algorithm, where this problem is solved and the time-slot is reduced. In view of the problem that a large number of tags entering into the recognition area of readers lead to the reduction of the recognition efficiency. This article proposes a suffix-based tag group bit-slot ALOHA (STGBSA) algorithm, tag grouping and tag estimation methods are proposed. Complexity analysis is deployed in this article, from the perspective of the tag loss ratio and identification efficiency, the performances of various anti-collision algorithms are evaluated and compared with those of the existing methods. The simulation results show that the method proposed in this paper is better than the existing methods.
Making the case for strong health information systems during a pandemic and beyond
Authors: Schmidt Andrea E. , Abboud Linda A. , Bogaert Petronille 
Published: January 2021

Abstract
Background
The Sars-CoV-2 pandemic exacerbates existing inequalities across health care systems globally, both within countries and between countries. It also highlights, like no other crisis before, existing weaknesses in health information systems (HIS). This article summarizes these key challenges for HIS in times of a pandemic and beyond, with a focus on European countries. It builds on the experiences of a large consortium representing HIS experts in key positions in national public health or similar institutes across Europe.

Methods
Data were collected in bi-weekly conference calls organized by the InfAct project between February and June 2020. Emerging themes were clustered and analysed around a WHO framework for health information systems (HIS). We analyse strengths of HIS at two levels: (i) dealing with health information directly, and (ii) dealing with other parts of information systems that allow for a holistic assessment of the pandemic (including health-related aspects).

Results
The analysis highlights the need for capacity-building in HIS before a pandemic hits, the relevance of going beyond health information only related to health care but taking a broader perspective (e.g. on vulnerable groups), the need for strong reporting systems on staffing numbers and in primary care. Further, data linkage emerges as a crucial precondition to identify unmet needs for essential health care services in a timely manner. Finally, room for innovation and digitalisation is key to be able to react flexibly in times of crisis. Trust for health information stakeholders is another important factor to create strong HIS.

Conclusions
The strengths and shortcomings of European HIS that have been observed during the COVID-19 crisis highlight the need for strong HIS beyond the crisis. The experiences reported leave as a central message that successful reactions to the pandemic are (also) grounded in strong HIS that ultimately not only benefit the health of the population but also create a number of economic and psycho-social benefits. Strong data reporting schemes may also support fine-tuning of containment measures during a pandemic as well as transition phases.
Soil carbon stock and emission: estimates from three land-use systems in Ghana
Authors: Anokye Joseph , Logah Vincent , Opoku Andrews 
Published: January 2021

Abstract
Background
Land-use systems that sequester carbon and reduce CO2 emissions are key in the global mitigation strategies of climate change. Greenhouse gas emission from agro-ecosystems in sub-Saharan Africa is little studied. Here, we quantified soil carbon stock (SCS) and CO2 emissions from three land-use systems viz. arable land, oil palm plantation and forestland in the semi-deciduous forest zone of Ghana.

Results
Soil organic carbon concentration at the 0–15 cm layer in the forestland was 62 and 23% greater than that in the arable land and palm plantation, respectively. The SCS along the 1.0-m profile was 108.2, 99.0 and 73.5 Mg ha−1 in the forestland, palm plantation and arable land, respectively. Arable land emitted 30–46% more CO2 than palm plantation and forestland. In the dry season, CO2 emissions were respectively 0.93, 0.63 and 0.5 kg ha−1 h−1 from the arable land, palm plantation and forestland. Positive relationships were observed between CO2 emissions and SCS, soil temperature, and moisture. The SCS greatly influenced CO2 emission in the dry season more than in the wet season in the relatively higher carbon-input systems (forestland and palm plantation). Soil temperature accounted for more than 55% of CO2 emissions in both seasons, which has implications in the era of rising global temperatures.

Conclusions
The study provides relevant information on carbon storage abilities of the three land-use types in tropical climate and calls for drastic climate change actions to reduce degradation of forest cover and soil disturbance in agro-ecosystems in sub-Saharan Africa.
Simultaneous detection and ribotyping of Clostridioides difficile, and toxin gene detection directly on fecal samples
Authors: van Rossen Tessel M. , van Prehn Joffrey , Koek Alex , Jonges Marcel , van Houdt Robin , van Mansfeld Rosa , Kuijper Ed J. , Vandenbroucke-Grauls Christina M. J. E. , Budding Andries E. 
Published: January 2021

Abstract
Background
Clostridioides difficile is the most common cause of nosocomial diarrhea. Ribotyping of cultured strains by a PCR-based test is used to study potential transmission between patients. We aimed to develop a rapid test that can be applied directly on fecal samples for simultaneous detection and ribotyping of C. difficile, as well as detection of toxin genes.

Methods
We developed a highly specific and sensitive primer set for simultaneous detection and ribotyping of C. difficile directly on total fecal DNA. Toxin genes were detected with primers adapted from Persson et al. (Clin Microbiol Infect 14(11):1057–1064). Our study set comprised 130 fecal samples: 65 samples with positive qPCR for C. difficile toxin A/B genes and 65 C. difficile qPCR negative samples. PCR products were analyzed by capillary gel electrophoresis.

Results
Ribosomal DNA fragment peak profiles and toxin genes were detected in all 65 C. difficile positive fecal samples and in none of the 65 C. difficile negative samples. The 65 samples were assigned to 27 ribotypes by the Dutch reference laboratory. Our peak profiles corresponded to these ribotypes, except for two samples. During a C. difficile outbreak, patients were correctly allocated to the outbreak-cluster based on the results of direct fecal ribotyping, before C. difficile isolates were cultured and conventionally typed.

Conclusion
C. difficile ribotyping directly on fecal DNA is feasible, with sensitivity and specificity comparable to that of diagnostic toxin gene qPCR and with ribotype assignment similar to that obtained by conventional typing on DNA from cultured isolates. This supports simultaneous diagnosis and typing to recognize an outbreak.
Agricultural community-based impact assessment and farmers’ perception of climate change in selected Ecological Zones in Nigeria
Authors: Oluwatimilehin Isaac Ayo , Ayanlade Ayansina 
Published: January 2021

Abstract
Background
The impacts of climate change are affecting sustenance and livelihood of many rural farmers in Africa. The majority of these farmers have low adaptive capacity. This study investigates climate change impacts, farmers’ perception, adaptation options and barriers to adaptation in three selected ecological zones in Nigeria using three staple crops. Rainfall and temperature data of over 35 years were analysed using ANOVA, Mann Kendall and Sen’s Slope Analysis. Farmers’ perception of climate change and cropping experiences were assessed with the aid of a well-structured questionnaire, semi-structured interview and focus group discussion.

Results
The results of the study revealed high variability in the annual and monthly rainfall and temperature during the study period. The highest annual maximum temperature was recorded in Kwara with Tmax > 32 ℃. Though, there appeared to be spatial and temporal variations in rainfall in the study area, the highest was in Ogun with mean annual rainfall = 1586.9 mm and lowest in Kwara with mean annual rainfall = 1222.6 mm. Generally the Mann Kendall and Sen's slope analysis revealed general increase in the minimum and maximum temperature, while rainfall revealed generally downward trend. The study revealed a difference in farmers’ perception but nearly 74% of farmers perceived that climate is changing, which is affecting their farming activities. Nearly 70% claimed that lack of financial capital is the major barrier to climate change adaptation.

Conclusions
The study concludes that rainfall and temperature variability have significantly impacted cropping and that farmers are aware of long-term changes in temperature and rainfall, but some are unable to identify those changes as climate change. There is a need for affordable and available improved seedlings and variety of crops that can adapt to climate change conditions.
ACE2 Nascence, trafficking, and SARS-CoV-2 pathogenesis: the saga continues
Authors: Badawi Sally , Ali Bassam R. 
Published: January 2021

AbstractWith the emergence of the novel coronavirus SARS-CoV-2 since December 2019, more than 65 million cases have been reported worldwide. This virus has shown high infectivity and severe symptoms in some cases, leading to over 1.5 million deaths globally. Despite the collaborative and concerted research efforts that have been made, no effective medication for COVID-19 (coronavirus disease-2019) is currently available. SARS-CoV-2 uses the angiotensin-converting enzyme 2 (ACE2) as an initial mediator for viral attachment and host cell invasion. ACE2 is widely distributed in the human tissues including the cell surface of lung cells which represent the primary site of the infection. Inhibiting or reducing cell surface availability of ACE2 represents a promising therapy for tackling COVID-19. In this context, most ACE2–based therapeutic strategies have aimed to tackle the virus through the use of angiotensin-converting enzyme (ACE) inhibitors or neutralizing the virus by exogenous administration of ACE2, which does not directly aim to reduce its membrane availability. However, through this review, we present a different perspective focusing on the subcellular localization and trafficking of ACE2. Membrane targeting of ACE2, and shedding and cellular trafficking pathways including the internalization are not well elucidated in literature. Therefore, we hereby present an overview of the fate of newly synthesized ACE2, its post translational modifications, and what is known of its trafficking pathways. In addition, we highlight the possibility that some of the identified ACE2 missense variants might affect its trafficking efficiency and localization and hence may explain some of the observed variable severity of SARS-CoV-2 infections. Moreover, an extensive understanding of these processes is necessarily required to evaluate the potential use of ACE2 as a credible therapeutic target.