bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence-Based Clinical Practice Guideline: Reconstruction after Skin Cancer Resection
Authors: Chen Andrew , Albertini John G. , Bordeaux Jeremy S. , Chen Michael W. , Cook Jonathan L. , Davidson Caryn , Donnelly Katelyn C. , Galaria Irfan I. , Hannan Catherine M. , Kantor Jonathan , Kapp Daniel L. , Lawrence Naomi , Lober Clifford W. , Loeding Lauren D. , Miller Alexander , Ness Daniel T. , Neves Rogerio I. , Revenaugh Peter C. , Setabutr Peter , Tholpady Sunil S. , Tollefson Travis T. , Van Beek Marta J. , Weiss Paul R. , Alam Murad 
Published: July 2021

Summary:
A multi-disciplinary work group involving stakeholders from various backgrounds and societies was convened to develop guidelines for the management of reconstruction after skin cancer resection. The goal was to identify areas of common ground and provide evidence-based recommendations to improve patient care. Given the heterogeneity of reconstructive techniques and clinical scenarios, investigation centered around common elements in the process. In some cases, a distinction was made between treatment options in the office-based setting as opposed to those in the facility setting. A systematic literature review was performed, and an established appraisal process was used to rate the quality of relevant scientific research (Grading of Recommendations Assessment, Development, and Evaluation methodology). Final recommendations are related to concepts concerning the timing of reconstruction, management of anticoagulation, use of antibiotics, methods of pain control, and follow-up assessment. At times, there was insufficient evidence to make high-level recommendations. The literature analysis highlights the need for additional methodologically robust studies in this area, to help guide clinical practice.
Early clinical exposure improves medical students’ recognition of the need for professionalism and interprofessional collaboration
Authors: Chang Ching-Chih , Huang Hui-Chun , Lee Wen-Shin , Chuang Chiao-Lin , Huang Ling-Ju , Lu Dai-Yin , Yang Ying-Ying , Hsu Hui-Chi 
Published: July 2021

Background:
Medical students in Taiwan start their clerkship in their fifth year. A lack of early clinical exposure can mean they have a lack of medical professionalism and collaborative practice. This study investigates whether early engagement in hospital-based clinical practice could improve their understanding of these requirements.

Methods:
From 2017 to 2019, a total of 59 medical students at the end of their third year joined a 2-week summer camp at the hospital. Every participant was assigned to work with one patient and they accompanied this patient throughout their hospital course. The students were also asked to interview other medical professionals within the hospital and to write up interview reports. In addition, they had to complete pre- and postcamp questionnaires which included 10 questions to evaluate their recognition of professionalism, doctor–patient relationships, and interprofessional collaboration. Answers to the questions were all rated using a 5-score Likert scale.

Results:
The total postcamp Likert scores were significantly increased after the 2-week training camp compared with the precourse scores (pre- vs postcourse: 44.08 ± 0.45 vs 46.66 ± 0.33, p < 0.001). In addition, the students’ recognition of medical professionalism, the importance of communication with patients, and their respect for other medical professionals were significantly improved after the 2-week training.

Conclusion:
Our data showed that early clinical exposure through a preclerkship summer camp can help medical students improve their recognition of medical professionalism and interprofessional collaboration.
Advanced Trauma Care for Nurses (ATCN): A Single-Center Analysis of Trauma Nurses Knowledge Gaps
Authors: Kaur Shivpreet , Rattan Amulya , Kumar Hemant , Rao Shalinee , Kant Ravi , Misra Mahesh C. 
Published: July 2021

Background:
Trauma is a global cause of death and disability, and trauma systems are not well developed in low- and middle-income countries. Training of nurses in trauma care is of utmost importance to improve the organization and delivery of trauma care.

Objective:
This study aimed to identify common knowledge gaps and develop study aids to improve nurses' performance taking the Advanced Trauma Care for Nurses (ATCN) course.

Methods:
This is a descriptive, single-center study of the multiple-choice final examinations of the ATCN course conducted over 1 year in the All India Institute of Medical Sciences, Rishikesh, Level I trauma center. The questions missed by candidates were compiled, and the wrong options were tabulated. The most commonly missed questions were identified, and the most commonly marked wrong option was analyzed vis-a-vis the correct answer. Each error was classified into either a theoretical error or a practice-based error.

Results:
Ninety-six nurses attended 6 courses from June 2019 to June 2020. Of the theoretical-based questions, the top 3 categories of most missed questions were geriatric trauma (n = 13; 81.2%), massive transfusion (n = 35; 72.9%), and traumatic brain injury (n = 35; 72.9%). Of the practice-based questions, the top 3 categories of most missed questions were dislocated extremity management (n = 54; 79.4%), basic airway (n = 31; 64.5%), and shock management (n = 30; 62.5%).

Conclusions:
Periodic identification and categorization of the ATCN course examination's most frequent knowledge gaps allow instructors to develop teaching aids to enhance instructor teaching and improve trauma nurses' knowledge.
Trauma Takeaways: Reception and Utilization of a Postsimulation Newsletter
Authors: Patel Katie J. , Williamson Kristy , LaMaina Laura , Bullaro Francesca 
Published: July 2021

Background:
Simulation is incorporated into medical education to reinforce practical skills. Instructor methodologies allow for reflective practice through debriefing; however, this is limited to real-time audiences. Few studies have described education via supplemental materials.

Objective:
This educational initiative demonstrates the reception and use of a postsimulation newsletter for both participating and nonparticipating trauma team members.

Methods:
After each case, the Trauma Takeaways newsletter was distributed to all trauma team members at our Level I pediatric trauma center. The newsletter included a brief case summary, objectives, and debrief highlights regarding communication, medical management, and practical logistics. A survey was conducted to assess its utility 6 months after its introduction.

Results:
Of 69 interdisciplinary respondents, 46 reviewed the newsletter. The majority (69%) reported their trauma education is directly from simulation sessions. Thirty-nine percent of respondents found the newsletter most useful as a review when unable to attend, and 35% found it equally useful as compared with being an active participant. The majority of respondents found the newsletter either very helpful or extremely helpful.

Conclusions:
Medical simulation cases traditionally capture a select audience during educational debriefing sessions. However, because the majority of our respondents receive their trauma education from simulation sessions, the need for supplementation is paramount. Our team members found the Takeaways similarly useful both as a direct participant or as an indirect participant as a helpful reference for communication, management, and practical logistics in pediatric trauma care.
Wandering behavior in children with autism spectrum disorder and other developmental disabilities
Authors: T-Pederson Cassandra , Reisert Hailey , Adesman Andrew 
Published: July 2021

Purpose of review
Approximately one in four children with autism spectrum disorder (ASD) ‘elope’ or wander away from supervision each year; however, many caregivers do not receive adequate information on how to address wandering behavior. The purpose of this review is to summarize the available research on elopement frequency, wandering patterns, and interventions to provide pediatricians and other childcare professionals with appropriate strategies to address wandering behavior.

Recent findings
Despite the high prevalence of wandering by children with ASD or other developmental disabilities, there is relatively limited research in this area. Recent research has identified common patterns and factors associated with risk of elopement and elopement frequency.

Summary
Pediatricians should counsel families on the common issues and intervention strategies related to elopement. By increasing awareness of wandering in children with ASD, caregivers can feel better prepared to make informed decisions regarding their child's wellbeing and safety.
Estimating the HIV Effective Reproduction Number in the United States and Evaluating HIV Elimination Strategies
Authors: Chen Yao-Hsuan , Farnham Paul G. , Hicks Katherine A. , Sansom Stephanie L. 
Published: July 2021

Context:
The reproduction number is a fundamental epidemiologic concept used to assess the potential spread of infectious diseases and whether they can be eliminated.

Objective:
We estimated the 2017 United States HIV effective reproduction number, Re, the average number of secondary infections from an infected person in a partially infected population. We analyzed the potential effects on Re of interventions aimed at improving patient flow rates along different stages of the HIV care continuum. We also examined these effects by individual transmission groups.

Design:
We used the HIV Optimization and Prevention Economics (HOPE) model, a compartmental model of disease progression and transmission, and the next-generation matrix method to estimate Re. We then projected the impact of changes in HIV continuum-of-care interventions on the continuum-of-care flow rates and the estimated Re in 2020.

Setting:
United States.

Participants:
The HOPE model simulated the sexually active US population and persons who inject drugs, aged 13 to 64 years, which was stratified into 195 subpopulations by transmission group, sex, race/ethnicity, age, male circumcision status, and HIV risk level.

Main Outcome Measures:
The estimated value of Re in 2017 and changes in Re in 2020 from interventions affecting the continuum-of-care flow rates.

Results:
Our estimated HIV Re in 2017 was 0.92 [0.82, 0.94] (base case [min, max across calibration sets]). Among the interventions considered, the most effective way to reduce Re substantially below 1.0 in 2020 was to maintain viral suppression among those receiving HIV treatment. The greatest impact on Re resulted from changing the flow rates for men who have sex with men (MSM).

Conclusions:
Our results suggest that current prevention and treatment efforts may not be sufficient to move the country toward HIV elimination. Reducing Re to substantially below 1.0 may be achieved by an ongoing focus on early diagnosis, linkage to care, and sustained viral suppression especially for MSM.
Lockdowns exert selection pressure on overdispersion of SARS-CoV-2 variants
Authors: Nielsen Bjarke Frost , Eilersen Andreas , Simonsen Lone , Sneppen Kim 
Published: July 2021

The SARS-CoV-2 ancestral strain has caused pronounced super-spreading events, reflecting a disease characterized by overdispersion, where about 10% of infected people causes 80% of infections. New variants of the disease have different person-to-person variations in viral load, suggesting for example that the Alpha (B.1.1.7) variant is more infectious but relatively less prone to superspreading. Meanwhile, mitigation of the pandemic has focused on limiting social contacts (lockdowns, regulations on gatherings) and decreasing transmission risk through mask wearing and social distancing. Using a mathematical model, we show that the competitive advantage of disease variants may heavily depend on the restrictions imposed. In particular, we find that lockdowns exert an evolutionary pressure which favours variants with lower levels of overdispersion. We find that overdispersion is an evolutionarily unstable trait, with a tendency for more homogeneously spreading variants to eventually dominate.SignificanceOne of the most important and complex properties of viral pathogens is their ability to mutate. The SARS-CoV-2 pandemic has been characterized by overdispersion – a propensity for superspreading, which means that around 10% of those who become infected cause 80% of infections. However, evidence is mounting that this is not a stable property of the virus and that the Alpha variant spreads more homogeneously. We use a mathematical model to show that lockdowns exert a selection pressure, driving the pathogen towards more homogeneous transmission. In general, we highlight the importance of understanding how non-pharmaceutical interventions exert evolutionary pressure on pathogens. Our results imply that overdispersion should be taken into account when assessing the transmissibility of emerging variants.
Angiotensin II receptor I auto-antibodies following SARS-CoV-2 infection
Authors: Harrington Whitney E. , Jiang Yonghou , Duffy Fergal , Hadlock Jennifer , Raappana Andrew , Styrchak Sheila , Beck Ingrid , Chour William , Houck John , Duvvuri Venkata , Yeung Winnie , Haglund Micaela , Wallner Jackson , Wallick Julie A. , Hardy Samantha , Oldroyd Alyssa , Ko Daisy , Gervassi Ana , Murray Kim M. , Kaplan Henry , Aitchison John D. , Heath James R. , Sather D. Noah , Goldman Jason D. , Frenkel Lisa 
Published: July 2021

AbstractBACKGROUNDCoronavirus disease 2019 (COVID-19) is associated with endothelial activation and coagulopathy, which may be related to pre-existing or infection-induced pro-thrombotic autoantibodies such as those targeting angiotensin II type I receptor (AT1R-Ab).METHODSWe compared prevalence and levels of AT1R-Ab in COVID-19 cases with mild or severe disease to age and sex matched negative controls.RESULTSThere were no significant differences between cases and controls. However, there were trends toward a higher proportion with AT1R-Ab positivity among severe cases versus controls (32% vs. 11%, p=0.1) and higher levels in those with mild COVID-19 compared to controls (median 9.5U/mL vs. 5.9U/mL, p=0.06).CONCLUSIONSThese findings suggest that AT1R-Ab are not consistently associated with COVID-19 but do not exclude a contribution to endothelial pathology in a subset of people.
A cross-sectional cohort study of prevalence of antibodies to COVID-19 in Port-au-Prince, Haiti
Authors: DeGennaro Vincent , Schwartz Timothy , Henderson Rebecca , Elie Marie-Carmelle 
Published: July 2021

AbstractIntroAs of January 14, 2021, Haiti has had 10,781 confirmed (first case March 19th) and 45,927 suspected cases of COVID-19, with 240 official deaths.MethodsFrom May until September, 2020, we tested visitors to 20 clinics, for COVID-19 in five neighborhoods of Port-au-Prince as part of a public health effort to determine prevalence of COVID-19 in the general community. In order to estimate changes in number of deaths, the team visited eighteen funeral homes to solicit data on the number of funerals conducted for each month in 2019 and through October 2020. We also sought to evaluate the attitudes of Port-au-Prince citizens towards a generic COVID-19 vaccine in April 2021.ResultsIn May and July 2020, 11.4% and 9.1% of those tested were positive for antibodies to COVID-19, respectively. The number of funerals held in the Port-au-Prince area increased by 69.6.% (CI 95% 56.1-83.1) since the official arrival of COVID-19 on March 19th. We found high rates of vaccine hesitancy with 76% saying they would not take a free COVID-19 vaccine. Further research is needed to validate the findings here, but there are strong suggestions that COVID-19 has had more of an impact than previously reported.‘What is already known on this subject?’Very little is known about the true epidemiology of COVID-19 in Haiti due to lack of testing, stigma, and lack of resources. The Ministry of Health reports Haiti has had 10,781 confirmed (first case March 19th) and 45,927 suspected cases of COVID-19, with 240 official deaths. Most officials accept these numbers as vast underestimates.‘What does this study add?’’This study estimates a prevalence of 10% for COVID-19 antibodies in the population of Port-au-Prince in May to August 2020. Only 19-38% of those surveyed with confirmed antibodies reported experiencing symptoms in the last few months prior to the survey. We found a 69% increase in funerals per month in Port-au-Prince for the first six months post-COVID (March 2020) compared to the 14 months prior.Finally, we found significant vaccine hesitancy with only 24% reporting “Yes” or “Maybe” when asked if they’d take a free of charge vaccine.
Social isolation, loneliness and all-cause dementia: a longitudinal and imaging-genetic study in the UK Biobank cohort
Authors: Shen Chun , Sahakian Barbara J. , Cheng Wei , Kang Jujiao , Dong Guiying , Xie Chao , Zhao Xing-Ming , Feng Jianfeng 
Published: July 2021

AbstractINTRODUCTIONCurrent findings of the relative influence of social isolation and loneliness on dementia are contradictory, and the potential neurobiological mechanisms are unclear.METHODSWe utilized the UK Biobank to investigate the relationships of social isolation and loneliness with dementia (n = 462,619). Neuroanatomical correlates were identified in a subset of participants (n = 32,263). The transcriptomic signatures of related brain changes were characterized by gene enrichment analysis.RESULTSAfter full adjustment, social isolation but not loneliness was associated with dementia (hazard ratio: 1.28, 95% confidence interval: 1.17-1.39). Isolated individuals had reduced gray matter volumes in temporal, frontal, occipital and subcortical regions (e.g., hippocampus and amygdala). Relevant brain changes were spatially correlated with genes involved in mitochondrial dysfunction and oxidative phosphorylation, and down-regulated Alzheimer’s disease-related genes.DISCUSSIONSocial isolation is an independent risk factor for dementia, which could be partly explained by related structural changes coupling with altered molecular functions.
Indirect impact on number of admitted children with COVID-19 in the first three months of emergency use of two vaccines, in Rio de Janeiro, Brazil
Authors: Fonseca CGB , Costa ALTG , Esteves MDM , de Carvalho BRR , Souza CV , Teixeira CH , Araujo da Silva AR 
Published: July 2021

AbstractIntroductionSince January 19, 2021, two vaccines against SARS-COV-2 are available in Brazil for emergency use for selected groups, not including children.AimTo describe indirect impact on the number of hospitalized children with COVID-19 in the first three months after beginning of emergency use of two vaccines.MethodsA retrospective study was conducted in children (0-18 years), admitted in two pediatric hospitals of Rio de Janeiro city, between January and April 2021 with confirmed COVID-19 by reverse transcription polymerase chain reaction or serological tests. Number of cases, clinical signs, symptoms and outcomes were compared with the first wave of disease (April-June 2020). A p value of less than .05 were considered was significant.ResultsThe number of total admitted patients (with all diseases) were 1097 in 2020 period, being 46 (4.2%) of them with confirmed COVID-19, and 2187 in the 2021 period, with 47 (2.1%) cases (p=0.006). Predominant respiratory symptoms were present in 29/46 (63%) as the main presentation in 2020 patients and 37/47 (78.7%) in 2021 children (p=0.09). The main symptoms were fever, cough and dyspnoea in both periods. The median of lenght of stay after diagnosis were 4 days in 2020 and 2021 (p=0.9). Just one patient died in 2021.ConclusionThere was reduction of relative percentage of admitted confirmed pediatric cases in the the first three months of emergency use of two vaccines against SARS-COV-2, but it’s uncertain to atribute this finding to vaccination due to high circulation of the virus in the city.
Simulating the impact of non-pharmaceutical interventions limiting transmission in COVID-19 epidemics using a membrane computing model
Authors: Campos M , Sempere JM , Galán JC , Moya A , Llorens C , de-los-Angeles C , Baquero-Artigao F , Cantón R , Baquero F 
Published: July 2021

AbstractEpidemics caused by microbial organisms are part of the natural phenomena of increasing biological complexity. The heterogeneity and constant variability of hosts, in terms of age, immunological status, family structure, lifestyle, work activities, social and leisure habits, daily division of time, and other demographic characteristics make it extremely difficult to predict the evolution of epidemics. Such prediction is, however, critical for implementing intervention measures in due time and with appropriate intensity. General conclusions should be precluded, given that local parameters dominate the flow of local epidemics. Membrane computing models allows us to reproduce the objects (viruses, hosts) and their interactions (stochastic but also with defined probabilities) with an unprecedented level of detail. Our LOIMOS model helps reproduce the demographics and social aspects of a hypothetical town of 10,320 inhabitants in an average European country where COVID-19 is imported from the outside. The above-mentioned characteristics of hosts and their lifestyle are minutely considered. The dynamics of the epidemics are reproduced and include the effects on viral transmission of innate and acquired immunity at various ages. The model predicts the consequences of delaying the adoption of non-pharmaceutical interventions (between 15 and 45 days after the first reported cases) and the effect of those interventions on infection and mortality rates (reducing transmission by 20%, 50%, and 80%) in immunological response groups. The lockdown for the elderly population as a single intervention appears to be effective. This modelling exercise exemplifies the application of membrane computing for designing appropriate interventions in epidemic situations.
ANTI - SARS-CoV-2 ANTIBODY SCREENING IN HEALTH CARE WORKERS AND ITS CORRELATION WITH CLINICAL PRESENTATION
Authors: Aryal Suraj , Pandit Sanskriti , Pokhrel Sushant , Chhusyabaga Mandira , Bista Pabitra , Bhatt Mahendra Psd. , Subedi Dharma Datta , Rijal Basista Psd. 
Published: July 2021

AbstractBackgroundAntibody titration and the life span of the antibody against SARS-CoV-2 have been found to be determined by the clinical presentation as well. The extent of exposure of health care workers and the general public to SARS-CoV-2 needs to be assessed to monitor the COVID-19 pandemic. Thus, this study is an attempt in assessing the anti-SARs-COV-2 antibody in health care workers.MethodsThis laboratory-based cross-sectional study was performed in Manmohan Memorial Medical College and Teaching Hospital, Kathmandu from November 2020 to January 2021. A total of 185 HCWs were screened for anti-SARS-CoV-2 antibody in the blood serum specimens. A structured questionnaire was administered to collect information from HCWs. Anti-SARS- CoV-2 antibody screening was performed using a lateral flow immunoassay. Data were analyzed according to standard statistical methods using SPSS version 20.ResultsA total of 185 HCWs were participated in the study, among which 41 (22.2%) of them tested positive for anti-SARS-CoV-2 antibody. Among the 41 individuals who tested positive, 37 of them tested positive for IgG only and 4 of them tested positive for both IgM and IgG antibodies. Presence of history of SARS-CoV-2 infection (p<0.001), presence of flu-like symptoms within the last 6 months (p<0.001), and presence of positive contact history (p=0.002) were statistically significant with antibody screening among HCWs.ConclusionThe burden of SARS-CoV-2 infection among healthcare workers seems to be high and HCWs are at risk of acquiring infection in the workplace. Anti-SARS-CoV-2 antibody screening among health care workers is highly recommended in multiple healthcare settings that can help in monitoring transmission dynamics and evaluation of infection control policies.