bluuebunny/crossref_metadata_2025_split huggingface dataset:
Converging public health crises: substance use during the coronavirus disease 2019 pandemic
Authors: Striley Catherine W. , Hoeflich Carolin C. 
Published: May 2021

Purpose of review
The international, public health crisis caused by the rapid spread of SARS-CoV-2 has resulted in unforeseen medical and psychiatric consequences. We reviewed publications from January 2020 to January 2021, given that earlier documents were not relevant, to review findings on changes in substance use and overdoses during the pandemic. Additionally, this review of the literature also documents advocacy efforts, health service modification and challenges, as well as COVID-related health complications associated with substance use.

Recent findings
Recent work focused on identifying changes in the distribution and use of substances as well as the unique challenges to promoting the health of persons who use substances in the current pandemic. Although COVID-19 has triggered unprecedented innovations in the organizational and public policy, the use of certain substances (alcohol, cannabis, cigarettes, fentanyl, heroin, and opiates) is increasing internationally. Unique associations between substance use and pandemic-related adverse health outcomes were identified. In addition, the pandemic precipitated significant barriers and disruptions to care.

Summary
Given increased overdose rates and infections among people who use drugs, continued surveillance and vigilance are needed to assess changes and reduce use and adverse consequences during the continuing COVID-19 crisis. Changes are urgently needed to reduce adverse health outcomes because of treatment barriers and lack of adequate treatment options. Additionally, integrative approaches are necessary to promote the public health of persons who use substances.
Epidemiological characteristics and incubation period of SARS-CoV-2 during the 2020-2021 winter pandemic wave in north China: an observational study
Authors: Liu Tiantian , Chen Zijian , Xu Jin 
Published: May 2021

AbstractAs the emergence of new variants of SARS-CoV-2 persists across the world, it is of importance to understand the distributional behavior of incubation period of the variants for both medical research and public health policy-making. We collected the published individual level data of 941 patients of the 2020-2021 winter pandemic wave in Hebei province, north China. We computed some epidemiological characteristics of the wave and estimated the distribution of the incubation period. We further assessed the covariate effects of sex, age and living with a case with respect to incubation period by a model. The infection-fatality rate was only 0.1%. The estimated median incubation period was at least 22 days, significantly extended from the estimates (ranging from 4 to 8.5 days) of the previous wave in mainland China and those ever reported elsewhere around the world. The proportion of asymptomatic patients was 90.6%. No significant covariate effect was found. The distribution of incubation period of the new variants showed a clear extension from their early generations.
The SARS-CoV-2 B.1.351/V2 variant is outgrowing the B.1.1.7/V1 variant in French regions in April 2021
Authors: Roquebert Bénédicte , Trombert-Paolantoni Sabine , Haim-Boukobza Stéphanie , Lecorche Emmanuel , Verdurme Laura , Foulongne Vincent , Sofonea Mircea T. , Alizon Samuel 
Published: May 2021

AbstractSARS-CoV-2 variants threaten our ability to control COVID-19 epidemics. We analyzed 36,590 variant-specific RT-PCR tests performed on samples collected between April 12 and May 7, 2021 in France to compare variant spread. Contrarily to January to March 2021, we found that the V2 variant had a significant transmission advantage over V1 in some regions (15.1 to 16.1% in Île-de-France and 16.1 to 18.8% in Hauts-de-France). This shift in transmission advantage is consistent with the immune evasion abilities of V2 and the high levels of immunization in these regions.
Effective clinical caseload management strategies from the perspective of community consultant psychiatrist: Qualitative analysis
Authors: Warikoo Nishchint , Demirdogen Ezgi Sen 
Published: May 2021

AbstractObjectiveThere is a lack of guidance and literature on determining a safe caseload size and how community consultant psychiatrists (CCPs) manage their caseload. This paper therefore aims at exploring effective and safe ways of clinical caseload management by gaining a qualitative understanding of caseload management (CLM) practice of CCPs.DesignCross sectional Qualitative research using semi structured interviews.SettingThe participants were CCPs working in National health service in Hampshire areas of United Kingdom.ParticipantsThe target population comprised 11 CCPs working in the National Health Service (NHS) to get their view on current practice in NHS and compare past and present practices of CLM.Main Outcome MeasuresA qualitative research method was used to explore the topic of CLM by collecting data through observations, interviews, questionnaires and then analysing the data using the coding and emergent themes method.ResultsCaseload size for CCPs was higher than a manageable level and had an impact on their ability to service their other responsibilities such as strategic work; they did not have a shared view on setting a limit to their caseload. Majority of CCPs were not using CLM and did not have enough control on limiting their caseload size. Some CCPs were using time management and audit of caseload as effective CLM strategies. NWW was not being used equitably.ConclusionsAlthough the study represents the perceptions of limited number of CCPs, the findings of this study are unique and an important addition to the slight literature that exists on this topic. The results were in line with existing research that large caseloads can have negative impact on CCPs and their ability to provide effective care to the clients. The key factors determining the caseload size were highlighted. Proactive time management and proactive caseload size management were found to be effective tools for CLM. These supported by job planning meetings, Yearly appraisal, use of electronic data system and New ways of Working could be effective in maintaining a safe caseload size for the provision of safe and effective care. The data from this study can be used for requisite quantitative studies on a larger and statistically significant number of CCPs to find effectiveness of each CLM strategy.
A common allele of HLA mediates asymptomatic SARS-CoV-2 infection
Authors: Augusto Danillo G. , Yusufali Tasneem , Sabatino Joseph J. , Peyser Noah D. , Murdolo Lawton D. , Butcher Xochitl , Murray Victoria , Pae Vivian , Sarvadhavabhatla Sannidhi , Beltran Fiona , Gill Gurjot , Lynch Kara , Yun Cassandra , Maguire Colin , Peluso Michael J. , Hoh Rebecca , Henrich Timothy J. , Deeks Steven G. , Davidson Michelle , Lu Scott , Goldberg Sarah A. , Kelly J. Daniel , Martin Jeffrey N. , Viera-Green Cynthia A. , Spellman Stephen R. , Langton David J. , Lee Sulggi , Marcus Gregory M. , Olgin Jeffrey E. , Pletcher Mark J. , Gras Stephanie , Maiers Martin , Hollenbach Jill A. 
Published: May 2021

AbstractDespite some inconsistent reporting of symptoms, studies have demonstrated that at least 20% of individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) will remain asymptomatic. Although most global efforts have focused on understanding factors underlying severe illness in COVID-19 (coronavirus disease of 2019), the examination of asymptomatic infection provides a unique opportunity to consider early disease and immunologic features promoting rapid viral clearance. Owing to its critical role in the immune response, we postulated that variation in the human leukocyte antigen (HLA) loci may underly processes mediating asymptomatic infection. We enrolled 29,947 individuals registered in the National Marrow Donor Program for whom high-resolution HLA genotyping data were available in the UCSF Citizen Science smartphone-based study designed to track COVID-19 symptoms and outcomes. Our discovery cohort (n=1428) was comprised of unvaccinated, self-identified subjects who reported a positive test result for SARS-CoV-2. We tested for association of five HLA loci (HLA-A, -B, -C, -DRB1, -DQB1) with disease course and identified a strong association of HLA-B*15:01 with asymptomatic infection, and reproduced this association in two independent cohorts. Suggesting that this genetic association is due to pre-existing T-cell immunity, we show that T cells from pre-pandemic individuals carrying HLA-B*15:01 were reactive to the immunodominant SARS-CoV-2 S-derived peptide NQKLIANQF, and 100% of the reactive cells displayed memory phenotype. Finally, we characterize the protein structure of HLA-B*15:01-peptide complexes, demonstrating that the NQKLIANQF peptide from SARS-CoV-2, and the highly homologous NQKLIANAF from seasonal coronaviruses OC43-CoV and HKU1-CoV, share similar ability to be stabilized and presented by HLA-B*15:01, providing the molecular basis for T-cell cross-reactivity and HLA-B*15:01-mediated pre-existing immunity.
KL-MOB: Automated Covid-19 Recognition Using a Novel Approach Based on Image Enhancement and a Modified MobileNet CNN
Authors: Taresh Mundher Mohammed , Zhu Ningbo , Ali Ali Talal Ahmed , Alghaili Mohammed , Hameed Asaad Shakir , Mutar Modhi Lafta 
Published: May 2021

ABSTRACTThe emergence of the novel coronavirus pneumonia (Covid-19) pandemic at the end of 2019 led to chaos worldwide. The world breathed a sigh of relief when some countries announced that they had obtained the appropriate vaccine and gradually began to distribute it. Nevertheless, the emergence of another wave of this disease has returned us to the starting point. At present, early detection of infected cases has been the paramount concern of both specialists and health researchers. This paper aims to detect infected patients through chest x-ray images. The large dataset available online for Covid-19 (COVIDx) was used in this research. The dataset consists of 2,128 x-ray images of Covid-19 cases, 8,066 normal cases, and 5,575 cases of pneumonia. A hybrid algorithm was applied to improve image quality before conducting the neural network training process. This algorithm consisted of combining two different noise reduction filters in the images, followed by a contrast enhancement algorithm. In this paper, for Covid-19 detection, a novel convolution neural network (CNN) architecture, KL-MOB (Covid-19 detection network based on MobileNet structure), was proposed. KL-MOB performance was boosted by adding the Kullback–Leibler (KL) divergence loss function at the end when trained from scratch. The Kullback–Leibler (KL) divergence loss function was adopted as content-based image retrieval and fine-grained classification to improve the quality of image representation. This paper yielded impressive results, overall benchmark accuracy, sensitivity, specificity, and precision of 98.7%, 98.32%, 98.82%, and 98.37%, respectively. The promising results in this research may enable other researchers to develop modern and innovative methods to aid specialists. The tremendous potential of the method proposed in this research can also be utilized to detect Covid-19 quickly and safely in patients throughout the world.
Caesarean birth in public maternities in Argentina: a formative research study on the views of obstetricians, midwives, and trainees
Authors: Perrotta Carla , Romero Mariana , Sguassero Yanina , Straw Cecilia , Gialdini Celina , Righetti Natalia , Beltrán Ana Pilar , Ramos Silvina 
Published: May 2021

AbstractObjectivesTo explore obstetricians, midwives, and trainees’ perceptions of CS determinants in the context of public obstetric care services provision in Argentina. Our hypothesis is that known determinants of CS use may differ in settings with limited access to essential obstetric services.SettingWe conducted a formative research study in nineteen public maternity hospitals in Argentina. An institutional survey assessed the availability of essential obstetric services. Subsequently, we conducted online surveys and semi-structured interviews to assess the opinions of providers on known CS determinants.ResultsObstetric services showed an adequate provision of emergency obstetric care but limited services to support women during birth. Midwives, with some exceptions, are not involved during labour. We received 680 surveys from obstetricians, residents, and midwives (response rate of 63%) and interviewed 26 key informants. Six out of ten providers (411, 61%) indicated that the use of CS is associated with the complexities of our caseload. Limited pain management access was deemed a potential contributing factor for CS in adolescents and first-time mothers. Providers have conflicting views on the adequacy of training to deal with complex or prolonged labour Obstetricians with more than ten years of clinical experience indicated that fear of litigation was also associated with CS. Overall, there is consensus on the need to implement interventions to reduce unnecessary CS.ConclusionsPublic Maternity Hospitals in Argentina have made significant improvements in the provision of emergency services. The environment of service provision does not seem to facilitate the physiological process of vaginal birth. Providers acknowledged some of those challenges.Article SummaryStrengths and limitations of this studyThis study is one of the few studies exploring the perceptions of providers working in low-resourced settings in middle-income countries on the determinants of increasing trends of CS.Large sample and representation of all professionals and obstetric tasks working in low-resourced settings.Cluster analysis allowed to describe the response variability across professional groups in relation to specific CS determinants.The use of Formative Research is a valuable tool to inform the design and implementation of future interventions.Even though the response rate is good (63%) those who did not respond may have different views on the determinants of CS.Some participant hospitals had lower response rate.
Regional distribution of anoxic brain injury after cardiac arrest: clinical and electrographic correlates
Authors: Snider Samuel B. , Fischer David , McKeown Morgan E. , Cohen Alexander L. , Schaper Frederic L.W.V.J. , Amorim Edilberto , Fox Michael D. , Scirica Benjamin , Bevers Matthew B. , Lee Jong W. 
Published: May 2021

AbstractIntroductionDisorders of consciousness, EEG background suppression and epileptic seizures are associated with poor outcome after cardiac arrest. The underlying patterns of anoxic brain injury associated with each remain unknown. Our objective was to identify the distribution of anoxic brain injury after cardiac arrest, as measured with diffusion MRI, and to define the regional correlates of disorders of consciousness, EEG background suppression, and seizures.MethodsWe analyzed patients from a prospectively-maintained, single-center database of unresponsive patients who underwent diffusion-weighted MRI following cardiac arrest (n = 204). We classified each patient based on recovery of consciousness (command-following) before discharge, the most continuous EEG background (burst suppression versus continuous), and the presence or absence of seizures. Anoxic brain injury was measured using the apparent diffusion coefficient (ADC) signal. We identified abnormalities in ADC relative to control subjects without cardiac arrest (n = 48) and used voxel lesion symptom mapping to identify regional associations with disorders of consciousness, EEG background suppression, and seizures. We then used a bootstrapped lasso regression procedure to identify robust, multivariate regional associations with each clinical and EEG variable. Finally, using area under receiver operating characteristic curves, we then compared the classification ability of the strongest regional associations to that of brain-wide summary measures.ResultsCompared to control subjects, cardiac arrest patients demonstrated a reduction in the ADC signal that was most significant in the occipital lobes. Disorders of consciousness were associated with reduced ADC most prominently in the occipital lobes, but also in the basal ganglia, medial thalamus and cerebellar nuclei. Regional injury more accurately classified patients with disorders of consciousness than whole-brain injury. Background suppression mapped to a similar set of brain regions, but regional injury could no better classify patients than whole-brain measures. Seizures were less common in patients with more severe anoxic injury, particularly in those with injury to the lateral temporal white matter.DiscussionAnoxic brain injury was most prevalent in posterior cerebral regions, and this regional pattern of injury was a better predictor of disorders of consciousness than whole-brain injury measures. EEG background suppression lacked a specific regional association, but patients with injury to the temporal lobe were less likely to have seizures. Collectively, our results suggest that the regional pattern of anoxic brain injury is relevant to the clinical and electrographic sequelae of cardiac arrest and may hold importance for prognosis.
SARS-CoV-2 infection risk during delivery of childhood vaccination campaigns: a modelling study
Authors: Procter Simon R , Abbas Kaja , Flasche Stefan , Griffiths Ulla , Hagedorn Brittany , O’Reilly Kathleen M ,   CMMID COVID-19 Working Group, Jit Mark 
Published: May 2021

AbstractBackgroundThe COVID-19 pandemic has disrupted delivery of immunisation services globally. Many countries have postponed vaccination campaigns out of concern about infection risks to staff delivering vaccination, the children being vaccinated and their families. The World Health Organization recommends considering both the benefit of preventive campaigns and the risk of SARS-CoV-2 transmission when making decisions about campaigns during COVID-19 outbreaks, but there has been little quantification of the risks.MethodsWe modelled excess SARS-CoV-2 infection risk to vaccinators, vaccinees and their caregivers resulting from vaccination campaigns delivered during a COVID-19 epidemic. Our model used population age-structure and contact patterns from three exemplar countries (Burkina Faso, Ethiopia, and Brazil). It combined an existing compartmental transmission model of an underlying COVID-19 epidemic with a Reed-Frost model of SARS-CoV-2 infection risk to vaccinators and vaccinees. We explored how excess risk depends on key parameters governing SARS-CoV-2 transmissibility, and aspects of campaign delivery such as campaign duration, number of vaccinations, and effectiveness of personal protective equipment (PPE) and symptomatic screening.ResultsInfection risks differ considerably depending on the circumstances in which vaccination campaigns are conducted. A campaign conducted at the peak of a SARS-CoV-2 epidemic with high prevalence and without special infection mitigation measures could increase absolute infection risk by 32% to 45% for vaccinators, and 0.3% to 0.5% for vaccinees and caregivers. However, these risks could be reduced to 3.6% to 5.3% and 0.1% to 0.2% respectively by use of PPE that reduces transmission by 90% (as might be achieved with N95 respirators or high-quality surgical masks) and symptomatic screening.ConclusionsSARS-CoV-2 infection risks to vaccinators, vaccinees and caregivers during vaccination campaigns can be greatly reduced by adequate PPE, symptomatic screening, and appropriate campaign timing. Our results support the use of adequate risk mitigation measures for vaccination campaigns held during SARS-CoV-2 epidemics, rather than cancelling them entirely.
Symptom profiles and accuracy of clinical definitions for COVID-19 in the community. Results of the Virus Watch community cohort
Authors: Fragaszy Ellen , Shrotri Madhumita , Geismar Cyril , Aryee Anna , Beale Sarah , Braithwaite Isobel , Byrne Thomas , Fong Wing Lam Erica , Gibbs Jo , Hardelid Pia , Kovar Jana , Lampos Vasileios , Nastouli Eleni , Navaratnam Annalan M D , Nguyen Vincent , Patel Parth , Aldridge Robert W , Hayward Andrew 
Published: May 2021

AbstractBackgroundUnderstanding the symptomatology and accuracy of clinical case definitions for COVID-19 in the community is important for the initiation of Test, Trace and Isolate (TTI) and may, in future, be important for early prescription of antivirals.MethodsVirus Watch is a large community cohort with prospective daily recording of a wide range of symptoms and self-reporting of swab results (mainly undertaken through the UK TTI system). We compared frequency, severity, timing, and duration of symptoms in test positive and test negative cases. We compared the test performance of the current UK case definition used by TTI (any one of: new continuous cough, high temperature, or loss of or altered sense of smell or taste) with a wider definition that also included muscle aches, chills, headache, or loss of appetite.FindingsWe included results from 8213 swabbed illnesses, 944 of which tested positive for SARS-CoV-2. All symptoms were more common in test positive than test negative illnesses and symptoms were also more severe and of longer duration. Common symptoms such as cough, headache, fatigue, muscle aches, and loss of appetite occurred early in the course of illness but were also very common in test-negative illnesses. In contrast, high temperature and loss of or altered sense of smell or taste were less frequently identified in swab positive illnesses but were markedly more common than in swab negative illnesses. The current UK definition had a sensitivity and specificity of 81% and 47% respectively for symptomatic COVID-19 compared to 93% and 26% for the broader definition. On average, cases met the broader case definition 0.3 days earlier than the current definition. 1.7-fold more illnesses met the broader definition than the current case definition.InterpretationCOVID-19 is difficult to distinguish from other respiratory infections and common ailments on the basis of symptoms. Broadening the list of symptoms used to encourage engagement with TTI could moderately increase the number of infections identified and shorten delays to isolation, but with a large increase in the number of tests needed and the number of unwell individuals and contacts who are advised to self-isolate whilst awaiting results, and subsequently test negative for SARS-CoV-2.