bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective Clinical, Virologic, and Immunologic Assessment of COVID-19 in Transplant Recipients
Authors: Marinelli Tina , Ferreira Victor H. , Ierullo Matthew , Ku Terrance , Lilly Les , Kim S. Joseph , Schiff Jeffrey , Sidhu Aman , McDonald Michael , Hosseini-Moghaddam Seyed M. , Husain Shahid , Rotstein Coleman , Majchrzak-Kita Beata , Kulasingam Vathany , Humar Atul , Kumar Deepali 
Published: June 2021

Background.
Several studies have described the clinical features of COVID-19 in solid-organ transplant recipients. However, many have been retrospective or limited to more severe cases (hospitalized) and have not routinely included serial virological sampling (especially in outpatients) and immunologic assessment.

Methods.
Transplant patients diagnosed with COVID-19 based on a respiratory sample PCR were prospectively followed up to 90 d. Patients provided consent for convalescent serum samples and serial nasopharyngeal swabs for SARS-CoV-2 antibody (antinucleoprotein and anti-RBD) and viral load, respectively.

Results.
In the 161 SOT recipients diagnosed with COVID-19, the spectrum of disease ranged from asymptomatic infection (4.3%) to hospitalization (60.6%), supplemental oxygen requirement (43.1%), mechanical ventilation (22.7%), and death (15.6%). Increasing age (OR, 1.031; 95% CI, 1.001-1.062; P = 0.046) and ≥2 comorbid conditions (OR, 3.690; 95% CI, 1.418-9.615; P = 0.007) were associated with the need for supplemental oxygen. Allograft rejection was uncommon (3.7%) despite immunosuppression modification. Antibody response at ≥14 d postsymptoms onset was present in 90% (anti-RBD) and 76.7% (anti-NP) with waning of anti-NP titers and stability of anti-RBD over time. Median duration of nasopharyngeal positivity was 10.0 d (IQR, 5.5–18.0) and shedding beyond 30 d was observed in 6.7% of patients. The development of antibody did not have an impact on viral shedding.

Conclusions.
This study demonstrates the spectrum of COVID-19 illness in transplant patients. Risk factors for severe disease are identified. The majority form antibody by 2 wk with differential stability over time. Prolonged viral shedding was observed in a minority of patients. Reduction of immunosuppression was a safe strategy.
Energizing ASTM lap joint fracture standards
Authors: Kendall Kevin 
Published: June 2021

Several ASTM standards on the fracture of glued and welded joints need attention because they do not consider the Griffith energy criterion of cracking which was proposed a century ago. It is almost as if Griffith never existed because the ASTM definition of failure is the stress criterion postulated by Galileo in 1638 in which stress at failure (i.e. strength = force/area) is defined as the determinant of fracture. Irene Martinez Villegas (Villegas, Rans 2021Phil. Trans. R. Soc. A376, 20200296. (doi:10.1098/rsta.2020.0296)) shows in this volume that attempts to use ASTM D5868 to standardize welded composite (carbon fibre reinforced polymer, CFRP) lap joints reveal major problems. First, the test is a low angle bend–peel test; not shear. Second, the energy required to break the joint is not emphasized so that joints may have high strength properties but also low toughness; third, the fracture force is not proportional to the lap joint area so the concept of strength independent of sample size is false; fourth, as the CFRP panels are made thicker, the strength rises at constant overlap area so the strength can be any value you want; fifth, the strength of larger joints goes down; this is the size effect noted in many bend-cracking tests, much as Galileo suggested for bent beam fracture in his famous book ‘the larger the machine, the greater its weakness'. The purpose of this paper is to demonstrate that poor ASTM ‘shear strength’ standards should be replaced by a definition of welded lap joint performance based on Griffith's energy conservation argument in which fracture surface energy is the main parameter resisting failure. The foundation of this Griffith-style lap joint analysis for long cracks goes back to 1975 but has been largely ignored until now because it does not fit the Griffith equation for cracked sheets, has no ‘stress intensity factor’, and travels at constant speed, not accelerating like the standard Griffith tension crack. This study of tensile delamination shows that a long lap crack is not driven by stress near the crack but by changes in stored elastic energy in the stretched strips remote from the crack tip, while strain energy release rate is negative. It would be more appropriate to call this lap failure a tensile delamination crack.This article is part of a discussion meeting issue ‘A cracking approach to inventing new tough materials: fracture stranger than friction’.
A Markov chain-based model for structural vulnerability assessmentof corrosion-damaged reinforced concrete bridges
Authors: Dizaj Ebrahim Afsar , Padgett Jamie E. , Kashani Mohammad M. 
Published: June 2021

The deterioration and cracking of reinforced concrete (RC) bridges due to the chloride-induced corrosion of steel reinforcement is an inherently time-dependent stochastic phenomenon. In the current practice of bridge management systems, however, the determination of the condition states of deteriorated bridges is highly dependent on the opinion of experienced inspectors. Taking such complexity into account, the current paper presents a new stochastic predictive methodology using a non-homogeneous Markov process, which directly relates the visual inspection data (corrosion rate and crack widths) to the structural vulnerability of deteriorated concrete bridges. This methodology predicts the future condition of corrosion-induced damage (concrete cracking) by linking structural vulnerability analysis and a discrete-time Markov chain model. The application of the proposed methodology is demonstrated through a case-study corrosion-damaged RC bridge pier.This article is part of a discussion meeting issue ‘A cracking approach to inventing new tough materials: fracture stranger than friction’.
The dangers of single-lap shear testing in understanding polymer composite welded joints
Authors: Villegas Irene Fernandez , Rans Calvin 
Published: June 2021

Single-lap shear (SLS) joints are straightforward to manufacture. This makes them especially attractive for testing polymer composite welded joints. Owing to local heating, which is characteristic of composite welding processes, the production of more geometrically intricate joints (such as double-lap or scarfed joints) or bigger joints (such as end-notched flexure or double cantilever beam) typically entails significant complexity in the design of the welding process. Testing of SLS joints is also uncomplicated and, even though, owing to mixed-mode loading and uneven stress distribution, it does not provide design values, it is widely acknowledged as a valuable tool for comparison. Even so, comparing different aspects of composite welded joints through their corresponding SLS strength values alone can be deceptive. This paper shows that comparison of different welding processes, adherend materials, process parameters or different types of joining techniques through SLS testing is only meaningful when strength values are combined with knowledge on other aspects of the joints such as joint mesostructure, failure modes and joint mechanics.
This article is part of a discussion meeting issue ‘A cracking approach to inventing new tough materials: fracture stranger than friction’.
The impact of temperature on the transmission potential and virulence of COVID-19 in Tokyo, Japan
Authors: Yamasaki Lisa , Murayama Hiroaki , Hashizume Masahiro 
Published: June 2021

ABSTRACTBackgroundAssessing the impact of temperature on COVID-19 epidemiology is critical for implementing non-pharmaceutical interventions. However, few studies have accounted for the nature of contagious diseases, i.e., their dependent happenings.AimWe aimed to quantify the impact of temperature on the transmissibility and virulence of COVID-19 in Tokyo, Japan. We employed two epidemiological measurements of transmissibility and severity: the effective reproduction number (Rt) and case fatality risk (CFR).MethodsWe used empirical surveillance data and meteorological data in Tokyo to estimate the Rt and time-delay adjusted CFR and to subsequently assess the nonlinear and delay effect of temperature on Rt and time-delay adjusted CFR.ResultsFor Rt at low temperatures, the cumulative relative risk (RR) at first temperature percentile (3.3°C) was 1.3 (95% confidence interval (CI): 1.1-1.7). As for the virulence to humans, moderate cold temperatures were associated with higher CFR, and CFR also increased as the temperature rose. The cumulative RR at the 10th and 99th percentiles of temperature (5.8°C and 30.8°C) for CFR were 3.5 (95%CI: 1.3-10) and 6.4 (95%CI: 4.1-10.1).ConclusionsThis study provided information on the effects of temperature on the COVID-19 epidemiology using Rt and time-delay adjusted CFR. Our results suggest the importance to take precautions to avoid infection in both cold and warm seasons to avoid severe cases of COVID-19. The results and proposed framework will also help in assessing possible seasonal course of COVID-19 in the future.
Observed and self-reported COVID-19 health protection behaviours on a university campus and the impact of a single simple intervention
Authors: Davies Rachel , Weinman John , Rubin G James 
Published: June 2021

AbstractObjectivesHygiene behaviours had been an essential component of attempts to slow the spread of SARS-CoV-2. Most data on adherence to these behaviours is collected via self-reporting, which can differ from observed behaviours. We quantified this discrepancy among a university sample and tested the impact of simple intervention on observed behaviour.Study designCross-sectional questionnaire of behaviour on campus compared to direct observation on one day without, and one day with, additional signage.MethodsWe circulated an email inviting all staff and students at our university to complete a questionnaire asking how often they wear a mark or practice hand hygiene when entering campus buildings, and how often they practiced social distancing within campus buildings. We observed all entrants to the main building on one campus on a baseline day and on a day after installing a large sign reminding people that these behaviours were mandatory.ResultsIn our survey, 172 out of 252 respondents (68%) reported always cleaning their hands, 225 out of 251 (90%) reported always wearing a face covering, and 124 out of 252 (49%) reported always maintaining social distancing. On the baseline day of observation, 50 out of 311 people (16.1%) cleaned their hands and 256 (82.3%) wore a face covering correctly. Out of 119 people whom we could assess, 9 (7%) maintained social distance from others. The signage was associated with significant improvements for cleaning hands (104 / 375 people: 27.7%), wearing a face covering (374 / 375; 99.8%) and maintaining social distance (79 / 144; 54.8%).ConclusionsGreater use of observational methods will provide a more accurate measure of behaviour than the current reliance on self-report and allow interventions to be robustly tested.
Association of opioid use disorder with healthcare utilization and cost in a public health system
Authors: Miron Oren , Barda Noam , Balicer Ran , Kor Ariel , Lev-Ran Shaul 
Published: June 2021

AbstractBackground and objectivesTo quantify the healthcare costs associated with opioid use disorder among members in a public healthcare system, and compare them to healthcare costs in the general population.MethodsRetrospective cohort study in inpatient and outpatient care settings of Israel’s largest public healthcare provider (that covers 4.7 million members).Participants included 1,173 members who had a diagnosis of opioid use disorder in the years between 2013 and 2018. Each patient was matched with 10 controls based on age and sex. The main outcome was monthly healthcare costs.ResultsThe mean monthly healthcare cost of members with opioid use disorder was $1,102 compared to $211 among controls (5.2-fold difference; 95% confidence interval [CI]: 4.6-6.0). After excluding members with heroin related diagnoses before the index date (in order to focus on prescription opioids), this healthcare cost ratio did not substantially change (4.6-fold; 95%-CI: 3.9-5.4). Members with opioid use disorder under the age of 65 years had a cost difference of 6.1-fold (95%-CI: 5.2-7.1), while those 65 years and older experienced cost difference of 3.4-fold (95%-CI: 2.6-4.5). The category with the highest cost for members with opioid use disorder was inpatient services, which was 8.7-fold (95%-CI 7.2-10.4) greater than among controls.ConclusionsHealthcare costs among individuals with opioid use disorder in a public health system were substantially higher than among controls, at least partially attributed to prescription opioid use disorder. Differences were greater among individuals younger than 65 years, highlighting the importance of preventing and treating opioid use disorder among younger adult populations.
BNT162b2 COVID-19 VACCINATION AND ITS EFFECT ON BLOOD PRESSURE
Authors: Tan Toh Leong , Salleh Sharifah Azura , Man Zuraidah Che , Peng Tan Michelle Hwee , Kader Rashid , Jarmin Razman 
Published: June 2021

AbstractThis study aims to explore the trends of systolic blood pressure (SBP), diastolic BP (DBP), mean arterial pressure (MAP) and pulse pressure (PP) before and 15-minutes after two doses of the BNT162b2 vaccine, which were administered 21 days apart. This vaccine safety active surveillance study was carried out on 15th-16th March (first dose) and 5th-6th April 2021 (second dose), in academic hospital.. Vaccinees above 18 years old, SBP, DBP, MAP and PP pre- and 15 minutes post-vaccination for both doses were analysed. Study outcomes were mean of BP, mean of BP changes, and BP trends measurements. A total of 287 vaccinees were included. A quarter (n=72) had decreased DBP ≥ 10mmHg (mean DBP deceased: 15mmHg, 95%CI: 14-17mmHg) after the first dose, and 12.5% post-second dose (mean DBP decreased: 13mmHg, 95%CI: 12-15mmHg). Post-first dose, 28.6% (n= 82) were found to have widened PP > 40mmHg. After the first dose, those who had elevated and decreased SBP ≥ 20mmHg were 5.2% and 4.9%, respectively. Eleven percent (n = 32) had decreased SBP ≥ 20mmHg post-second dose, nevertheless the psychology effect cannot be ruled out. The BNT162b2 vaccine was generally well tolerated. BP changes after vaccination emphasizes the need for monitoring.
Completion of electronic nursing documentation of inpatient admission assessment: insights from Australian metropolitan hospitals
Authors: Shala Danielle Ritz , Jones Aaron , Fairbrother Greg , Tran Duong Thuy 
Published: June 2021

AbstractIntroductionElectronic nursing documentation is an essential aspect of inpatient care and multidisciplinary communication. Analysing data in electronic medical record (eMR) systems can assist in understanding clinical workflows, improving care quality, and promoting efficiency in the healthcare system. This study aims to assess timeliness of completion of an electronic nursing admission assessment form and identify patient and facility factors associated with form completion in three metropolitan hospitals.Materials and MethodsRecords of 37,512 adult inpatient admissions (November 2018-November 2019) were extracted from the hospitals’ eMR system. A dichotomous variable descriptive of completion of the nursing assessment form (Yes/No) was created. Timeliness of form completion was calculated as the interval between date and time of admission and form completion. Univariate and multivariate multilevel logistic regression were used to identify factors associated with form completion.ResultsAn admission assessment form was completed for 78.4% (n=29,421) of inpatient admissions. Of those, 78% (n=22,953) were completed within the first 24 hours of admission, 13.3% (n=3,910) between 24-72 hours from admission, and 8.7% (n=2558) beyond 72 hours from admission. Patient length of hospital stay, admission time, and admitting unit’s nursing hours per patient day were associated with form completion. Patient gender, age, and admitting unit type were not associated with form completion.DiscussionForm completion rate was high, though more emphasis needs to be placed on the importance of timely completion to allow for adequate patient care planning. Staff education, qualitative understanding of delayed form completion, and streamlined guidelines on nursing admission and eMR use are recommended.Statement on conflicts of interestDeclarations of interest: noneSummary TableWhat was already known on the topicElectronic clinical documentation is an essential aspect of inpatient care and multidisciplinary communicationTimely completion of documentation enables prompt team communication and facilitates quality patient care planningAustralian hospitals are moving towards fully adopting eMR-based technologies to manage patient care processes and multidisciplinary communicationWhat this study added to our knowledgeThe timeliness of electronic nursing documentation can be improvedThere are patient- and facility-related factors which influence the completion of electronic nursing formsThe application of advanced modelling techniques to existing eMR data assists in understanding clinician practices, processes and workflows
Sources of variability in methods for processing, storing, and concentrating SARS-CoV-2 in influent from urban wastewater treatment plants
Authors: Steele Joshua A. , Zimmer-Faust Amity G. , Griffith John F. , Weisberg Stephen B. 
Published: June 2021

AbstractThe rapid emergence of wastewater based surveillance has led to a wide array of SARS-CoV-2 RNA quantification methodologies being employed. Here we compare methods to store samples, inactivate viruses, capture/concentrate viruses, and extract/measure viral RNA from primary influent into wastewater facilities. We found that heat inactivation of the viruses led to a 1-3 log10decrease compared to chemical inactivation. Freezing influent prior to concentration caused a 1-4 log10decrease compared to processing fresh samples, but viral capture by membrane adsorption prior to freezing was robust to freeze-thaw variability. Concentration vs. direct extraction, and PCR platform also affected outcome, but by a smaller amount. The choice of nucleocapsid gene target had nearly no effect. Pepper mild-mottle virus was much less sensitive to these methodological differences than was SARS-CoV-2, which challenges its use as a population-level control among studies using different methods. Better characterizing the variability associated with different methodologies, in particular the impact of methods on sensitivity, will aid decision makers in following the effects of vaccination campaigns, early detection of future outbreaks, and potentially monitoring the appearance of SARS-CoV-2 variants in the population.
School teachers’ self-reported fear and risk perception during the COVID-19 pandemic – a nationwide survey in Germany
Authors: Weinert Stefanie , Thronicke Anja , Hinse Maximilian , Schad Friedemann , Matthes Harald 
Published: June 2021

AbstractBackgroundWith COVID-19 cases peaking, COVID-19 vaccination programs starting and health systems reaching their limits in winter 2020/21, schools remained closed in many countries despite ever-recurring debates. To better understand teachers’ fear of infection and risk perception we conducted a survey in Germany.MethodsParticipants were recruited through various associations and invited to take part in a cross-sectional COVID-19 specific online survey. Anonymous demographic and self-reported data were collected from those who gave their informed consent. Descriptive statistical analysis was performed. To evaluate with fear associated factors of contracting SARS-CoV-2, an adjusted multivariable regression analysis was performed.Results6.753 teachers gave their informed consent to answer the online survey. The median age of the teachers was 43 years with 77% being female. Most teachers worked in high schools (29%) and elementary schools (26%). Most participants (73%) feared to contract SARS-CoV-2 at school while 77% intended to be vaccinated against COVID-19. 98% considered students to pose the greatest risk. Multivariable regression analysis revealed that female and younger teachers were significantly more anxious to get infected with SARS-CoV-2 and that the odds teachers were more anxious was 9 times higher for those who favored re-opening of schools the least (p < 0.001).ConclusionsTo the authors’ knowledge, this is the first study to describe teachers fear and risk perception of COVID-19 and their attitude towards vaccinations in a nationwide survey. The anxiety correlates to the COVID-19 protection measures demanded. Teachers’ fear is the driving factor and not a rational logic.
LONG TERM PSYCHOLOGICAL CONSEQUENCES OF STROKE (OX-CHRONIC): A LONGITUDINAL STUDY OF COGNITION IN RELATION TO MOOD AND FATIGUE AFTER STROKE: PROTOCOL
Authors: Demeyere Nele , Williams Owen A , Milosevich Elise , Chiu Evangeline Grace , Drozdowska Bogna , Dillon Avril , Dawes Helen , Thomas Shirley , Kuppuswamy Annapoorna , Pendlebury Sarah T , Quinn Terry 
Published: June 2021

ABSTRACTBackgroundThe long-term psychological consequences of stroke and how cognitive problems change over time after the first-year following stroke remain unclear. Particularly, trajectories of domain-specific and domain-general cognitive functions and how cognition interacts with mood, fatigue, and quality of life are not well described.AimsTo determine the prevalence, trajectories and wider impact of domain specific cognitive impairment in long term stroke survivors, in relation to mood, fatigue, and quality of life.MethodsParticipants who previously took part in the Oxford Cognitive Screening study, completed the 6-month follow up with cognitive, mood, fatigue, and quality of life assessments and agreed to be contacted for future research will be recruited into OX-CHRONIC. The eligible cohort is between 2- and 9-years post stroke. Cognition will be assessed with a detailed neuropsychological battery, alongside questionnaire measures of mood, fatigue, activities of daily life and quality of life measures at two timepoints, one year apart. Additionally, medical records will be accessed to extract further clinical information about the stroke and patients may opt-in to wear an activity monitor for one week to provide fine-grained measures of sleep and activity. The study protocol and study materials were approved by the national ethics committee (REC Ref:19/SC/0520).Planned outputsOX-CHRONIC will provide detailed data on the evolving cognitive profiles of stroke survivors over several years post-stroke. Estimates of long-term prevalence as well as the effect of changes in cognitive profiles on mood, fatigue and quality of life will be examined. This Study is funded by a Priority Programme Grant from the Stroke Association (SA PPA 18/100032).