bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seizure likelihood varies with day-to-day variations in sleep duration in patients with refractory focal epilepsy: A longitudinal EEG investigation
Authors: Dell Katrina L. , Payne Daniel E. , Kremen Vaclav , Maturana Matias I. , Gerla Vaclav , Nejedly Petr , Worrell Gregory A. , Lenka Lhotska , Mivalt Filip , Boston Raymond C. , Brinkmann Benjamin H. , D’Souza Wendyl , Burkitt Anthony N. , Grayden David B. , Kuhlmann Levin , Freestone Dean R. , Cook Mark J. 
Published: May 2021

AbstractBackgroundWhile the effects of prolonged sleep deprivation (≥24 hours) on seizure occurrence has been thoroughly explored, little is known about the effects of day-to-day variations in the duration and quality of sleep on seizure probability. A better understanding of the interaction between sleep and seizures may help to improve seizure management.MethodsTo explore how sleep and epileptic seizures are associated, we analysed continuous intracranial EEG recordings collected from 10 patients with refractory focal epilepsy undergoing ordinary life activities. A total of 4340 days of sleep-wake data were analysed (average 434 days per patient). EEG data were sleep scored using a semi-automated machine learning approach into wake, stages one, two, and three non-rapid eye movement sleep, and rapid eye movement sleep categories.FindingsSeizure probability changes with day-to-day variations in sleep duration. Logistic regression models revealed that an increase in sleep duration, by 1·66 ± 0·52 hours, lowered the odds of seizure by 27% in the following 48 hours. Following a seizure, patients slept for longer durations and if a seizure occurred during sleep, then sleep quality was also reduced with increased time spent aroused from sleep and reduced REM sleep.InterpretationOur results demonstrate that day-to-day deviations from regular sleep duration correlates with changes in seizure probability. Sleeping longer, by 1·66 ± 0·52 hours, may offer protective effects for patients with refractory focal epilepsy, reducing seizure risk. Furthermore, the occurrence of a seizure may disrupt sleep patterns by elongating sleep and, if the seizure occurs during sleep, reducing its quality.FundingAustralian National Health and Medical Research Council, US National Institutes of Health and Czech Technical University in Prague and Epilepsy Foundation of America Innovation Institute
Outbreaks of Covid-19 Variants in Prisons: A Mathematical Modeling Analysis of Vaccination and Re-Opening Policies
Authors: Ryckman Theresa , Chin Elizabeth T. , Prince Lea , Leidner David , Long Elizabeth , Studdert David M. , Salomon Joshua A. , Alarid-Escudero Fernando , Andrews Jason R. , Goldhaber-Fiebert Jeremy D. 
Published: May 2021

ABSTRACTBackgroundResidents of correctional facilities have experienced disproportionately higher rates of SARS-CoV-2 infection and Covid-19-related mortality. To protect against outbreaks, many prisons and jails imposed heavy restrictions on in-person activities, which are now beginning to lift. Uncertainty surrounds the safety of these moves.Methods and FindingsWe obtained system-wide resident-day level data for the California state prison system, the nation’s third largest. We used the data to develop a transmission-dynamic stochastic microsimulation model that projects the impact of various policy scenarios on risks of SARS-CoV-2 infections and related hospitalization among residents after an initial infection is introduced to a prison. The policy scenarios vary according to levels of vaccine coverage, baseline immunity, resumption of activities, and use of non-pharmaceutical interventions (e.g., masking, physical distancing). The analyses were conducted across 5 types of prisons that differed in their residential layouts, security levels, and resident demographics.If a viral variant is introduced into a prison that has resumed pre-2020 contact levels, has moderate vaccine coverage, and has no baseline immunity, 23-74% of residents are expected to be infected over 200 days. High vaccination coverage coupled with use of non-pharmaceutical measures reduces cumulative infections to 2-54% of residents. In prisons consisting mostly of dormitory housing, even with high vaccine coverage and non-pharmaceutical interventions, resumption of in-person activities is associated with substantial risk, unless there is high baseline immunity (e.g., ≥50%) from prior outbreaks. In prisons consisting mostly of cell housing, <10% of residents are expected to become infected, even with no baseline immunity. However, hospitalization risks are substantial in prisons that house medically vulnerable populations, even for prisons consisting mostly of cells. Risks of large outbreaks are substantially higher if there is continued introduction of infections into a prison. Some findings may not be transportable to other carceral settings, and our assumptions regarding viral variants will not be accurate for all variants.ConclusionsBalancing the benefits of resuming normal in-person activities against the risks of Covid-19 outbreaks is a difficult challenge for correctional systems. The policy choices are not strictly binary. To protect against viral variants, prisons should focus on achieving both high vaccine coverage and maintaining widespread use of non-pharmaceutical interventions. With both in place, some prisons, especially those with lower room occupancy that have already had large outbreaks, could safely resume in-person activities, while continuing testing and measures to protect the medically-vulnerable.
Declining Opioid Distribution to US Hospitals
Authors: Eidbo Sarah A. , Kropp Lopez Amalie K. , Hagedorn Joseph D. , Mathew Varkey , Kaufman Daniel E. , McCall Kenneth L. , Piper Brian J. 
Published: May 2021

ABSTRACTThe United States is enduring a preventable opioid crisis, particularly involving a population specifically being treated in a hospital setting. This project analyzed trends in distribution of opioids by hospitals in the United States from 2000 to 2019. Opioids monitored included buprenorphine, codeine, fentanyl, hydrocodone, hydromorphone, meperidine, methadone, morphine, oxycodone, oxymorphone, powdered opium, remifentanil, and tapentadol. The Automation of Reports and Consolidated Orders System (ARCOS) reports controlled substances via the Drug Enforcement Administration (DEA). Data from ARCOS reports 5 and 7 from 2000 to 2019 were utilized for an observational study on hospital opioid distribution in the US. Morphine milligram equivalents (MME) were calculated using oral conversion factors for each opioid. The MME per person per state was calculated to compare data from the peak year, 2012, to data from 2019. Opioid use in the United States peaked in 2012 with a 46.6% decline from 2012 to 2019. Within the US, 25 of 50 states have seen a decrease of 50% or greater. Of the opioid compounds observed, buprenorphine has seen increased (123%) hospital use from 2000 to 2019. All other opioids have been experiencing a slow decline (>40%) in hospital use since that time. This study demonstrated the progress made thus far by hospitals in curbing the US opioid epidemic.
Population behavioural dynamics can mediate the persistence of emerging infectious diseases
Authors: Fair Kathyrn R , Karatayev Vadim A , Anand Madhur , Bauch Chris T 
Published: May 2021

AbstractThe critical community size (CCS) is the minimum closed population size in which a pathogen can persist indefinitely. Below this threshold, stochastic extinction eventually causes pathogen extinction. Here we use a simulation model to explore behaviour-mediated persistence: a novel mechanism by which the population response to the pathogen determines the CCS. We model severe coronavirus 2 (SARS-CoV-2) transmission and non-pharmaceutical interventions (NPIs) in a population where both individuals and government authorities restrict transmission more strongly when SARS-CoV-2 case numbers are higher. This results in a coupled human-environment feedback between disease dynamics and population behaviour. In a parameter regime corresponding to a moderate population response, this feedback allows SARS-CoV-2 to avoid extinction in the trough of pandemic waves. The result is a very low CCS that allows long term pathogen persistence. Hence, an incomplete pandemic response represents a “sour spot” that not only ensures relatively high case incidence and unnecessarily long lockdown, but also promotes long-term persistence of the pathogen by reducing the CCS. Given the worldwide prevalence of small, isolated populations in which a pathogen with low CCS can persist, these results emphasize the need for a global approach to coronavirus disease 2019 (COVID-19) vaccination.
CCR2-dependent monocyte-derived cells restrict SARS-CoV-2 infection
Authors: Vanderheiden Abigail , Thomas Jeronay , Soung Allison L. , Davis-Gardner Meredith E. , Floyd Katharine , Jin Fengzhi , Cowan David A. , Pellegrini Kathryn , Creanga Adrian , Pegu Amarendra , Derrien-Colemyn Alexandrine , Shi Pei-Yong , Grakoui Arash , Klein Robyn S. , Bosinger Steven E. , Kohlmeier Jacob E. , Menachery Vineet D. , Suthar Mehul S. 
Published: May 2021

AbstractSARS-CoV-2 has caused a historic pandemic of respiratory disease (COVID-19) and current evidence suggests severe disease is associated with dysregulated immunity within the respiratory tract. However, the innate immune mechanisms that mediate protection during COVID-19 are not well defined. Here we characterize a mouse model of SARS-CoV-2 infection and find that early CCR2-dependent infiltration of monocytes restricts viral burden in the lung. We find that a recently developed mouse-adapted MA-SARS-CoV-2 strain, as well as the emerging B. 1.351 variant, trigger an inflammatory response in the lung characterized by expression of pro-inflammatory cytokines and interferon-stimulated genes. scRNA-seq analysis of lung homogenates identified a hyper-inflammatory monocyte profile. Using intravital antibody labeling, we demonstrate that MA-SARS-CoV-2 infection leads to increases in circulating monocytes and an influx of CD45+ cells into the lung parenchyma that is dominated by monocyte-derived cells. We utilize this model to demonstrate that mechanistically, CCR2 signaling promotes infiltration of classical monocytes into the lung and expansion of monocyte-derived cells. Parenchymal monocyte-derived cells appear to play a protective role against MA-SARS-CoV-2, as mice lacking CCR2 showed higher viral loads in the lungs, increased lung viral dissemination, and elevated inflammatory cytokine responses. These studies have identified a CCR2-monocyte axis that is critical for promoting viral control and restricting inflammation within the respiratory tract during SARS-CoV-2 infection.
Does the elevated (thrombosis risk of males relative to females help account for the excess male mortality observed in Covid-19? An observational study
Authors: Cohen Kenneth , Anderson David , Ren Sheng , Cook David J. 
Published: May 2021

AbstractObjectivesWe sought to determine whether underlying thrombophilia helps account for excess Covid-19 mortality rates in males relative to females. Specifically, we asked: What is the contribution of thrombophilia to the excess Covid-19 mortality risk among malesãDesignCross-sectional observational study.SettingData were sourced from electronic medical records (EMRs) drawn from over 200 US hospital systems.Participants16,576 patients hospitalized with Covid-19, aged 40 and above.Main outcome measuresThe primary study outcome was Covid-19 mortality. We measured: 1) the mortality rate of male patients relative to female patients, 2) the rate of thrombotic diagnoses occurring during hospitalization for Covid-19 in male and female patients, and 3) the mortality rate when evidence of thrombosis was present. We used hospital EMR data to determine the rates of a thrombotic diagnosis by sex, and D-dimer levels to help identify undiagnosed thrombosis.ResultsThe Covid-19 mortality rate of males was higher than that of females by 16.1%. Males with Covid-19 also had a 25.4% higher rate of receiving a thrombotic diagnosis compared to females with Covid-19. The mortality rate of all patients with a thrombotic diagnosis was 42.4%—a rate over twice that of Covid-19 patients without a thrombotic diagnosis (adjusted OR 2.4 (2.17 to 2.65), p-value < .001). When defining thrombosis as either a documented thrombotic diagnosis or markedly elevated D-dimer levels, over half of the excess mortality in male patients could be explained by thrombophilia.ConclusionsOur findings suggest the higher Covid-19 mortality rate in males may be significantly accounted for by the increased propensity for thrombophilia among males. This thrombotic tendency is additive to the thrombotic risk associated with Covid-19. Understanding the mechanisms that underlie male thrombophilia may allow for the advancement of effective anticoagulation strategies that reduce Covid-19 mortality.Strengths and limitations of this studyTo our knowledge, this population study is the first to provide evidence of a sex-based clinical association that may help explain the excess Covid-19 mortality in males compared to females.This was an observational study using diagnosis codes and natural language processing (NLP) extractions of detailed electronic health record (EHR) data for 16,576 hospitalized patients with Covid-19.We evaluated underlying thrombosis based on both an inpatient thrombotic diagnosis as well as a markedly elevated D-dimer level relative to CRP level.A limitation of this study was that a portion of the estimated excess male mortality was based on the analysis of a subset of 3,442 patients that had serial D-dimer and CRP levels measured in the hospital, and that a potential undercount of these patients was possible due to the use of NLP.
Automated Medical Chart Review for Breast Cancer: A Novel Natural Language Processing Software System
Authors: Chen Yifu , Hao Lucy , Zou Vito Z , Hollander Zsuzsanna , Ng Raymond T , Isaac Kathryn V 
Published: May 2021

AbstractThe incoming health records to the BC Cancer Registry are processed between two to three years behind real-time. In response, we developed a Natural Language Processing (NLP) software to automate the electronic chart review workflow. For the same task that costs hundreds of hours of trained labour, our pipeline extracts data within minutes. During preliminary evaluation, an MD student yielded 93.0% and 98.2% accuracies on a sample of operative and pathology breast cancer documents (for a total number of 2,563 data points processed). In comparison, our prototype achieved 89.6% and 91.4% accuracies, respectively. Future plans include improving the performance of the pipeline and eventually adapt it to accepting a more comprehensive range of electronic health records across cancer types and diseases. In the context of BC’s digital healthcare transformation initiatives, this customized software may provide time and cost savings for both the Registry and cancer researchers.
Clinical evaluation of BD Veritor™ SARS-CoV-2 and Flu A+B Assay for point-of-care (POC) System
Authors: Christensen Katherine , Ren Huimiao , Chen Shirley , Cooper Charles K. , Young Stephen 
Published: May 2021

ABSTRACTDifferential diagnosis of COVID-19 and/or influenza (flu) at point of care is critical for efficient patient management and treatment for either of these diseases. Clinical performance of the BD Veritor™ System for Rapid Detection of SARS-CoV-2 & FluA+B (“Veritor SARS-CoV-2/Flu”) triplex assay was characterized. The performance for SARS-CoV-2 detection was determined using two hundred and ninety-eight (298) specimens from patients reporting COVID-19 symptoms within 7 days from symptom onset (DSO) in comparison with Lyra® SARS-CoV-2 RT-PCR Assay (“Lyra SARS-CoV-2”). The Veritor SARS-CoV-2/Flu Assay met the FDA EUA acceptance criterion with 95% overall agreement for SARS-CoV-2 test when compared to Lyra SARS-CoV-2. The performance for Flu A and Flu B detection was determined using 75 influenza-positive and 40 influenza-negative retrospective specimens in comparison with the previously FDA cleared BD Veritor™ System for Rapid Detection of Flu A+B (“Veritor Flu”). The Veritor SARS-CoV-2/Flu also demonstrated 100% agreement with the Veritor Flu.
Elevated preoperative suPAR is a strong and independent risk marker for postoperative complications in high-risk patients undergoing major non-cardiac surgery (SPARSE)
Authors: Chalkias Athanasios , Laou Eleni , Kolonia Konstantina , Ragias Dimitrios , Angelopoulou Zacharoula , Mitsiouli Eleni , Kallemose Thomas , Smith-Hansen Lars , Eugen-Olsen Jesper , Arnaoutoglou Eleni 
Published: May 2021

ABSTRACTBackgroundPatients undergoing major surgery are often at risk of developing postoperative complications. We investigated whether the inflammatory biomarker suPAR can aid in identifying patients at high risk for postoperative complications, morbidity, and mortality.MethodsIn this prospective observational study (ClinicalTrials.gov identifier: NCT03851965), peripheral venous blood was collected from consecutive adult patients scheduled for major non-cardiac surgery with expected duration ≥2 hours under general anesthesia. Patients fulfilling the following inclusion criteria were included: age ≥18 years and American Society of Anesthesiologists’ physical status I to IV. Plasma suPAR levels were determined using the suPARnostic® quick triage lateral flow assay. The primary endpoint was post-operative complications defined as presence of any complication and/or admission to intensive care unit and/or mortality within the first 90 postoperative days.ResultsPreoperative suPAR had an OR of 1.50 (95%CI 1.24-1.82) for every ng/ml increase (AUC 0.82, 95%CI: 0.72-0.91). When including age, sex, ASA score, CRP, and grouped suPAR in multivariate analysis, patients with suPAR between 5.5 and 10 ng/ml had an OR of 12.7 (CI: 3.6-45.5) and patients with suPAR>10 ng/ml had an OR of 20.7 (CI: 4.5-95.4) compared to patients with suPAR≤5.5 ng/ml, respectively. ROC analysis including age, sex, CRP levels, and ASA score and had an AUC of 0.69 (95%CI: 0.58-0.80). When suPAR was added to this Model, the AUC increased to 0.84 (0.74-0.93) (p=0.009).ConclusionsPreoperative suPAR provided strong and independent predictive value on postoperative complications in high-risk patients undergoing major non-cardiac surgery.
The central nucleus of the amygdala and gustatory cortex assess affective valence during CTA learning and expression in male and female rats
Authors: Bernanke Alyssa , Burnette Elizabeth , Murphy Justine , Hernandez Nathaniel , Zimmerman Sara , David Walker Q. , Wander Rylee , Sette Samantha , Reavis Zackery , Francis Reynold , Armstrong Christopher , Risher Mary-Louise , Kuhn Cynthia 
Published: May 2021

AbstractThis study evaluated behavior (Boost® intake, LiCl-induced behaviors, ultrasonic vocalizations (USVs), task performance) and c-Fos activation during conditioned taste aversion (CTA), the reinforced task (Boost® task) and control task (cage only) to understand how male and female rats balance the relative danger or safety of a stimulus in learning and performing a task. Females drank more Boost® than males but showed similar aversive behaviors after LiCl treatment. Males produced 55 kHz USVs (indicating positive valence) when anticipating Boost® and inhibited these calls after pairing with LiCl. Females produced 55 kHz USVs based on their estrous cycle but were more likely to make 22 kHz USVs than males (indicating negative valence) after pairing with LiCl. c-Fos responses were similar in males and females after Boost® or LiCl. Females engaged the gustatory cortex and ventral tegmental area more than males during the Boost® task and males engaged the amygdala more than females in both the reinforcing and devalued tasks. Network analysis of correlated c-Fos responses across brain regions identified two unique networks characterizing the Boost® and LiCl (CTA) tasks, in both of which the VTA played a central role. RNAscope identified a population of D1-receptor expressing cells in the CeA that responded to Boost® and D2 receptor-expressing cells that responded to LiCl. The present study suggests that males and females differentially process the affective valence of a stimulus to produce the same goal-directed behavior.
The role of elections as drivers of tropical deforestation
Authors: Morpurgo Joeri , Kissling W. Daniel , Tyrrell Peter , Negret Pablo J. , Allan James R. 
Published: May 2021

AbstractTropical forests support immense biodiversity and provide essential ecosystem services for billions of people. Despite this value, tropical deforestation continues at a high rate. Emerging evidence suggests that elections can play an important role in shaping deforestation, for instance by incentivising politicians to allow increased utilisation of tropical forests in return for political support and votes. Nevertheless, the role of elections as a driver of deforestation has not been comprehensively tested at broad geographic scales. Here, we created an annual database from 2001 to 2018 on political elections and forest loss for 55 tropical nations and modelled the effect of elections on deforestation. In total, 1.5 million km2of forest was lost during this time period, and the rate of deforestation increased in 37 (67%) of the analysed countries. Deforestation was significantly lower in years with presidential or lower chamber elections compared to non-election years, which is in contrast to previous local-scale studies. Moreover, deforestation was significantly higher in presidential or lower chamber elections that are competitive (i.e. when the opposition can participate in elections and has a legitimate chance to gain governmental power) compared to uncompetitive elections. Our results document a pervasive loss of tropical forests and suggest that competitive elections are potential drivers of deforestation. We recommned that organisations monitoring election transparency and fairness should also monitor environmental impacts such as forest loss, habitat destruction and resource exploitation. This would benefit the tracking of potential illegal vote buying with natural resources.