bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Middle-Out Perspective – an approach to formalise ‘normal practice’ in public health advocacy
Authors: Mindell Jennifer S , Parag Yael , Bartington Suzanne E. , Stoll Laura , Barlow James , Janda Kathryn B. 
Published: November 2021

AbstractBackgroundThe Middle-Out Perspective (MOP) provides a lens to examine how actors positioned between government (top) and individuals (bottom) act to promote broader societal changes from the middle-out (rather than the top-down or bottom-up). The MOP has been used in recent years in the fields of energy, climate change, and development studies. Public health practitioners involved with advocacy activities and creating alliances to amplify health promotion actions will be familiar with the general MOP concept if not the formal name.MethodsThis paper introduces the MOP conceptual framework and customises it for a public health audience by positioning it among existing concepts and theories for actions within public health. Using two UK case studies (increasing signalised crossing times for pedestrians and the campaign for smoke-free legislation), we illustrate who middle actors are and what they can do to result in better public health outcomes.ResultsThese cases studies show that involving a wider range of middle actors, including those not traditionally involved in improving the public’s health, can broaden the range and reach of organisations and individuals involving in advocating for public health measures. They also demonstrate that middle actors are not neutral. They can be recruited to improve public health outcomes, but they may also be exploited by commercial interests to block healthy policies or even promote a health-diminishing agenda.ConclusionsUsing the MOP as a formal approach can help public health organisations and practitioners consider potential ‘allies’ from outside traditional health-related bodies or professions. Formal mapping can expand the range of who are considered potential middle actors for a particular public health issue. By applying the MOP, public health organisations and staff can enlist the additional leverage that is brought to bear by involving additional middle actors in improving the public’s health.Graphical abstract
First-generation clinical dual-source photon-counting CT: ultra-low dose quantitative spectral imaging
Authors: Liu Leening P. , Shapira Nadav , Sahbaee Pooyan , Schnall Mitchell , Litt Harold I. , Noël Peter B. 
Published: November 2021

AbstractObjectiveEvaluation of quantification capabilities at ultra-low radiation dose levels of a first-generation dual-source Photon-Counting Computed Tomography (PCCT) compared to a dual-source dual-energy CT (DECT) scanner.MethodsA multi-energy CT phantom was imaged with and without extension ring on both scanners over a range of radiation dose levels (CTDIvol 0.4 - 15.0 mGy). Scans were performed in different modes of acquisition for PCCT with 120 kVp and DECT with 70/Sn150 kVp and 100/Sn150 kVp. Various tissue inserts were used to characterize the precision and repeatability of Hounsfield Units (HUs) on virtual mono-energetic images between 40 and 190 keV. Image noise was additionally investigated at ultra-low radiation dose to illustrate PCCT’s ability to remove electronic background noise.ResultsOur results demonstrate high precision of HU measurements for a wide range of inserts and radiation exposure levels with PCCT. We report high performance for both scanners across a wide range of radiation exposure levels with PCCT outperforming at low exposures compared to DECT. PCCT scans at lowest radiation exposures illustrate significant reduction in electronic background noise, with a mean percent reduction of 74% (p-value ∼10−8) compared to the 70/Sn150 kVp and 60% (p-value ∼10−6) compared to the 100/Sn150 kVp.ConclusionsThis paper reports first experiences with a clinical dual-source PCCT scanner with Quantum technology. PCCT provides reliable HUs without disruption from electronic background noise for a wide range of dose values. Diagnostic benefits are not only for quantification at ultra-low-dose but also for imaging of obese patients.Key PointsPCCT scanners with Quantum technology provide precise and reliable quantitative Hounsfield Units at ultra-low-dose levels.Influence of electronic background noise can be removed at ultra-low dose acquisitions with PCCT.Both spectral platforms have high performance along a wide range of radiation exposure levels with PCCT outperforming at low radiation exposures.
COVID-19 Health Care Behaviour in The Gambia: a cross-sectional survey of 205 adults who went through mandatory institutional quarantine
Authors: Johm Penda , Nkereuwem Oluwatosin , Manjang Aji-Matty , Ceesay Omar , Leigh Lamin , Ceesay Amie , Bittaye Mustapha , Roberts Adeyemi , Manjang Buba , Sambou Sana , Sanneh Sainey , Saidy Lamin , Saidy Binta , Kampmann Beate 
Published: November 2021

ABSTRACTBackgroundTo control the spread of the novel Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome novel Coronavirus-2 (SARS-CoV-2), countries around the world subsequently implemented several public health measures, including the adoption of mandatory institutional quarantine for close contacts. This study explored the experiences of individuals who underwent institutional quarantine in The Gambia to inform government measures to increase its effectiveness and reduce its associated negative impacts.MethodsQuestionnaires were administered via mobile phone call with data collectors calling and directly recording participant responses on a tablet in an electronic online form developed in REDCap (Research Electronic Data Capture). The questionnaire contained questions on COVID-19 related knowledge, health care behaviour, attitudes, perceptions and stigma. Data were analysed using STATA v.13 (Stata Corp, College Station, TX, USA).ResultsIn total, 205 adults who observed the mandatory institutional quarantine were interviewed. There was varied knowledge of COVID-19 causes, spread, symptoms, diagnosis, treatment, and severity. Participants believed the purpose of quarantine was monitoring for signs and symptoms of coronavirus disease, testing for SARS-CoV-2, separation from the community, and protection from coronavirus disease. While a majority reported positive experiences while in quarantine, some expressed prominent dissatisfaction related to the essential services and quality of care provided. Different forms of stigma were also experienced before, during and after the quarantine experience.ConclusionThis study provides important information on quarantine experiences in The Gambia during the global COVID-19 pandemic. The Ministry of Health in The Gambia and other countries could improve the experience of quarantined individuals by consistently providing psychosocial support, compensation for loss of earnings, and timely provision of SARS-CoV-2 test results. Furthermore, stigma experiences and practices should be addressed during and after individuals stay in quarantine via the provision of psychosocial support.
Persistent Autoimmune Activation and Proinflammatory State in Post-COVID Syndrome
Authors: Acosta-Ampudia Yeny , Monsalve Diana M , Rojas Manuel , Rodríguez Yhojan , Zapata Elizabeth , Ramírez-Santana Carolina , Anaya Juan-Manuel 
Published: November 2021

AbstractBackgroundThe immunopathological pathways enabling post-COVID syndrome (PCS) development are not entirely known. We underwent a longitudinal analysis of patients with COVID-19 who developed PCS aiming to evaluate the autoimmune and immunological status associated with this condition.MethodsThirty-three patients were included for longitudinal clinical and autoantibody analyses of whom 12 patients were assessed for cytokines and lymphocyte populations. Patients were followed during 7-11 months after acute COVID-19. Autoimmune profile and immunological status were evaluated mainly by enzyme-linked-immunosorbent assays and flow cytometry.ResultsLatent autoimmunity and overt autoimmunity persisted over time. A proinflammatory state was observed in patients with PCS characterized by upregulated IFN-α, TNF-α, G-CSF, IL-17A, IL-6, IL-1β, and IL-13, whereas IP-10 was decreased. In addition, PCS was characterized by increased levels of Th9, CD8+ effector T cells, naive B cells, and CD4+ effector memory T cells. Total levels of IgG S1-SARS-CoV-2 antibodies remained elevated over time.DiscussionThe clinical manifestations of PCS are associated with the persistence of a proinflammatory, and effector phenotype induced by SARS-CoV-2 infection. This long-term persistent immune activation may contribute to the development of latent and overt autoimmunity. Results suggest the need to evaluate the role of immunomodulation in the treatment of PCS.
Prescribing of antibiotics and other drugs to children from birth to age 5 in the United States: an observational study
Authors: Kissler Stephen M. , Wang Bill , Mehrotra Ateev , Barnett Michael , Grad Yonatan H. 
Published: November 2021

AbstractObjectivesTo inform efforts to reduce pediatric antibiotic use, we measured cumulative pediatric prescriptions for antibiotics and non-antibiotics and how this varies across geography and patient subgroups.DesignObservational study.SettingUnited States, 2008-2018.Participants207,814 children under age 5 born in the United States between 2008 and 2013 with private medical insurance coverage.InterventionsNone.Main outcome measuresStudy outcomes included (1) the cumulative number of prescriptions received per child by age 5, (2) the proportion of these prescriptions that were attributable to respiratory infections, (3) the proportion of children who received at least one prescription by age 5, and (4) the fraction of total prescriptions received by the top 20% of prescription recipients.ResultsChildren received a mean of 8.21 (95% confidence interval [CI] (8.19, 8.22)) prescriptions for antibiotics and 9.81 (95% CI 9.80, 9.82) prescriptions for non-antibiotics by age five. Most antibiotic prescriptions (64%, 95% CI 63, 65) and many non-antibiotic prescriptions (25%, 95% CI 24, 26) were associated with outpatient visits for respiratory infections. By age 5, 93.8% (95% CI 93.4, 94.2) of children had received at least one antibiotic prescription while 88.3% (95% CI 87.9, 88.7) had received at least one prescription for a non-antibiotic. The top 20% of antibiotic prescription recipients accounted for 50.6% of all antibiotic prescriptions, and the top 20% of non antibiotic prescription recipients accounted for 64.2% of all non-antibiotic prescriptions. Relative to other regions, the South featured higher prescribing rates and earlier time to first prescription.ConclusionsChildren in the US receive a substantial number of antibiotics and other prescription drugs early in their lives, largely related to respiratory infections.
Healthcare workers’ SARS-CoV-2 infection rates during the second wave of the pandemic: prospective follow-up study
Authors: Würtz Anne Mette , Kinnerup Martin B. , Pugdahl Kirsten , Schlünssen Vivi , Vestergaard Jesper Medom , Nielsen Kent , Cramer Christine , Bonde Jens Peter , Biering Karin , Carstensen Ole , Kærgaard Hansen Karoline , Dalbøge Annett , Flachs Esben Meulengracht , Hansen Mette Lausten , Thulstrup Ane Marie , Würtz Else Toft , Kjærsgaard Mona , Christensen Mette Wulf , Kolstad Henrik Albert 
Published: November 2021

AbstractObjectivesTo assess if healthcare workers during the second wave of the coronavirus disease 2019 (COVID-19) pandemic had increased severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection rates following close contact with patients, co-workers and persons outside work with COVID-19.MethodsA prospective cohort study of 5985 healthcare workers from Denmark were followed November 2020 to April 2021 and provided day-by-day information on COVID-19 contacts. SARS-CoV-2 infection was defined by the first positive polymerase chain reaction (PCR) test ever.Results159 positive and 35 996 negative PCR tests were recorded during 514 165 person-days. The SARS-CoV-2 infection rate following close contact with COVID-19 patients 3-7 days earlier was 153.7 per 100,000 person-days corresponding with an incidence rate ratio (IRR) of 3.17 (40 cases, 95% CI 2.15 - 4.66) compared with no close contact. IRRs following close contact with co-workers and persons outside work with COVID-19 were 2.54 (10 cases, 95% CI 1.30 - 4.96) and 17.79 (35 cases, 95% CI 12.05 - 26.28). The estimates for close contact with COVID-19 patients, co-workers or persons outside work were mutually adjusted.ConclusionsDespite strong focus on preventive measures during the second wave of the pandemic, healthcare workers were still at increased risk of SARS-CoV-2 infection when in close contact with patients with COVID-19. Among all health care workers, the numbers affected due to close patient contact were comparable to the numbers affected following COVID-19 contact outside work.
How many relevant SARS-CoV-2 variants might we expect in the future?
Authors: Littera Roberto , Melis Maurizio 
Published: November 2021

AbstractObjectivesThe emergence of new SARS-CoV-2 variants is a major challenge in the management of Covid-19 pandemic. A crucial issue is to quantify the number of variants which may represent a potential risk for public health in the future.MethodsWe fitted the data on the most relevant SARS-CoV-2 variants recorded by the World Health Organization (WHO). The function exploited for the fit is related to the total number of infected subjects in the world since the start of the epidemic.ResultsWe found that the number of new relevant variants per ten million cases diminished by 30.4% between March 2020 and March 2022 (from 1.25 to 0.87). However, the decrease is now very slow and a further reduction by 10% would happen only for 5.6 billion infections in the world, i.e. ten times the cases from the beginning of the epidemic up to June 2022.ConclusionOur simple mathematical model can provide an estimate of the number of relevant SARS-CoV-2 variants as the cumulative number of cases increases worldwide and may represent a useful tool in planning strategies to effectively contrast the pandemic.
Healthcare workers benefit from second dose of COVID-19 mRNA vaccine: Effects of partial and full vaccination on sick leave duration and symptoms
Authors: Strum Earl , Casagrande Yolee , Newton Kim , Unger Jennifer B. 
Published: November 2021

ABSTRACTImportanceIn addition to morbidity and mortality of individuals, COVID-19 can affect staffing among organizations. It is important to determine whether vaccination can mitigate this burden. Objective: This study examined the association between COVID-19 vaccination status and time until return to work among 952 healthcare workers (HCW) who tested positive for COVID-19.DesignData were collected prospectively between December 2020 and July 2021. HCW who tested positive for COVID-19 completed an initial interview and were followed until they returned to work.SettingAn academic campus in Southern California consisting of two large hospitals and multiple outpatient clinics and other facilities.ParticipantsClinical and nonclinical HCW who tested positive for COVID-19 during the study period (N=952, mean age=39.2 years, 69% female, 45% Hispanic, 14% white, 14% Asian/Pacific Islander, 5% African American, and 21% other race/ethnicity).ExposureCOVID-19 vaccination status (unvaccinated, partially vaccinated, or fully vaccinated)Main Outcome MeasuresDays until return to work, presenting symptomResultsReturn-to-work time for fully vaccinated HCWs (mean=10.9 days) was significantly shorter than that of partially vaccinated HCWs (15.5 days), which in turn was significantly shorter than that of unvaccinated HCWs (18.0 days). Fully vaccinated HCWs also showed milder symptom profiles compared to partially vaccinated and unvaccinated HCWs.Conclusions and RelevanceCOVID-19 vaccination has the potential to prevent long absences from work and the adverse financial, staffing, and managerial consequences of these long absences.KEY POINTSQuestionDo healthcare workers (HCW) who are vaccinated against COVID-19 return to work sooner and experience milder symptoms compared with unvaccinated HCW?FindingsAmong 952 healthcare workers who tested positive for COVID-19 between December 2020 and July 2021, return-to-work time for fully vaccinated HCWs (mean=10.9 days) was significantly shorter than that of partially vaccinated HCWs (15.5 days), which in turn was significantly shorter than that of unvaccinated HCWs (18.0 days). Fully vaccinated HCWs also showed milder symptom profiles compared to partially vaccinated and unvaccinated HCWs.MeaningCOVID-19 vaccination has the potential to prevent long absences from work and the adverse financial, staffing, and managerial consequences of these long absences.
Quantitative Digitography Solves the Remote Measurement Problem in Parkinson’s disease
Authors: Wilkins K.B. , Petrucci M.N. , Kehnemouyi Y. , Velisar A. , Han K. , Orthlieb G. , Trager M.H. , O’Day J.J. , Aditham S. , Bronte-Stewart H.M. 
Published: November 2021

AbstractBackgroundAssessment of motor signs in Parkinson’s disease (PD) has required an in-person examination. However, 50% of people with PD do not have access to a neurologist. Wearable sensors can provide remote measures of some motor signs but require continuous data acquisition for several days. A major unmet need is reliable metrics of all cardinal motor signs, including rigidity, from a simple short active task that can be performed remotely or in the clinic.ObjectiveInvestigate whether thirty seconds of repetitive alternating finger tapping (RAFT) on a portable quantitative digitography (QDG) device, which measures amplitude and timing, produces reliable metrics of all cardinal motor signs in PDMethodsNinety-six individuals with PD and forty-two healthy controls performed a thirty-second QDG-RAFT task and clinical motor assessment. Eighteen individuals were followed longitudinally with repeated assessments for an average of three years and up to six years.ResultsQDG-RAFT metrics differentiated individuals with PD from controls and provided validated metrics for total motor disability (MDS-UPDRS III) and for rigidity, bradykinesia, tremor, gait impairment and freezing of gait (FOG). Additionally, QDG-RAFT tracked disease progression over several years off therapy, and differentiated akinetic rigid from tremor dominant phenotypes, as well as people with from those without FOG.ConclusionsQDG is a reliable technology, which will improve access to care, allows complex remote disease management, and accurate monitoring of disease progression over time in PD. QDG-RAFT also provides the comprehensive PD motor metrics needed for therapeutic trials.
Enoxaparin for thromboprophylaxis in hospitalized COVID-19 patients: comparison of 40 mg o.d.vs40 mg b.i.d. The X-COVID19 Randomized Clinical Trial
Authors: Morici Nuccia , Podda GianMarco , Birocchi Simone , Bonacchini Luca , Merli Marco , Trezzi Michele , Massaini Gianluca , Agostinis Marco , Carioti Giulia , Serino Francesco Saverio , Gazzaniga Gianluca , Barberis Daniela , Antolini Laura , Valsecchi Maria Grazia , Cattaneo Marco 
Published: November 2021

SummaryIt is uncertain whether higher doses of anticoagulants than recommended for thromboprophylaxis are necessary in COVID-19 patients hospitalized in general wards. This is a multicentre, open-label, randomized trial performed in 9 Italian centres, comparing 40 mg b.i.d. vs 40 mg o.d. enoxaparin in COVID-19 patients, between April 30, 2020 and April 25, 2021. Primary efficacy outcome was in-hospital incidence of venous thromboembolism (VTE): asymptomatic or symptomatic proximal deep vein thrombosis (DVT) diagnosed by serial compression ultrasonography (CUS), and/or symptomatic pulmonary embolism (PE) diagnosed by computed tomography angiography (CTA). Secondary endpoints included each individual component of the primary efficacy outcome and a composite of death, VTE, mechanical ventilation, stroke, myocardial infarction, admission to ICU. Safety outcomes included major bleeding. The study was interrupted prematurely due to slow recruitment. We included 183 (96%) of the 189 enrolled patients in the primary analysis (91 in b.i.d., 92 in o.d.). Primary efficacy outcome occurred in 6 patients (6·5%, 0 DVT, 6 PE) in the o.d. group and 0 in the b.id. group (ARR 6·5, 95% CI, 1·5-11·6). Absence of concomitant DVT and imaging characteristics suggest that most pulmonary artery occlusions were actually caused by local thrombi rather than PE. Statistically non-significant differences in secondary and safety endpoints were observed, with two major bleeding events in each arm. In conclusion, no DVT developed in COVID-19 patients hospitalized in general wards, independently of enoxaparin dosing used for thromboprophylaxis. Pulmonary artery occlusions developed only in the o.d. group. Our trial is underpowered and with few events.REGISTRATIONClinicalTrials.govIdentifier:NCT04366960Ethics Commettee approvation number75/2020
Managing electromyogram contamination in scalp recordings: an approach identifying reliable beta and gamma EEG features of psychoses or other disorders
Authors: Pope Kenneth J. , Lewis Trent W. , Fitzgibbon Sean P. , Janani Azin S. , Grummett Tyler S. , Williams Patricia A.H. , Battersby Malcolm , Bastiampillai Tarun , Whitham Emma M. , Willoughby John O. 
Published: November 2021

AbstractObjectiveIn publications on the electroencephalographic (EEG) features of psychoses and other disorders, various methods are utilised to diminish electromyogram (EMG) contamination. The extent of residual EMG contamination using these methods has not been recognised. Here, we seek to emphasise the extent of residual EMG contamination of EEG.MethodsWe compared scalp electrical recordings after applying different EMG-pruning methods with recordings of EMG-free data from 6 fully-paralysed healthy subjects. We calculated the ratio of the power of pruned, normal scalp electrical recordings in the 6 subjects, to the power of unpruned recordings in the same subjects when paralysed. We produced “contamination graphs” for different pruning methods.ResultsEMG contamination exceeds EEG signals progressively more as frequencies exceed 25 Hz and with distance from the vertex. In contrast, Laplacian signals are spared in central scalp areas, even to 100 Hz.ConclusionGiven probable EMG contamination of EEG in psychiatric and other studies, few findings on beta- or gamma-frequency power can be relied upon. Based on the effectiveness of current methods of EEG de-contamination, investigators should be able to re-analyse recorded data, re-evaluate conclusions from high frequency EEG data and be aware of limitations of the methods.