bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antigen Testing for COVID-19 Asymptomatic Screening: Why it Should be Preferred Over PCR Insights From Navy Region Japan’s Experience With a Comprehensive Antigen Testing Strategy
Authors: Mullinax Ross A 
Published: August 2021

ABSTRACT
Polymerase chain reaction (PCR) is commonly used in asymptomatic screening testing, but is suboptimal for this purpose as it will identify many old persistent positives that are no longer infectious. This can result in placement of individuals that are not infectious to others into isolation. This results in substantial adverse impact to military manning and operations, without any benefit to public health. Antigen testing does not have this same drawback. Antigen testing, while less sensitive than PCR, will identify the vast majority of infectious positives, especially those with higher viral loads that are more likely to transmit to others. Importantly, use of antigen testing will also greatly increase the certainty of benefit from isolation, reducing the risk of isolating those individuals who are beyond their infectious period and pose no threat to public health. The literature on this topic is reviewed, with particular focus on studies that perform viral culture in addition to PCR and antigen testing. This allows for determination of sensitivity for infectious virus. Also, Navy Region Japan’s experience with a comprehensive antigen testing strategy is described. The challenges presented by persistent positive PCR test results are examined, as well as the real-world benefits from implementing widespread use of antigen testing.
Cepheid metallicity in the Leavitt law (C-metall) survey – I. HARPS-N@TNG spectroscopy of 47 classical Cepheids and 1 BL Her variables
Authors: Ripepi V , Catanzaro G , Molinaro R , Gatto M , De Somma G , Marconi M , Romaniello M , Leccia S , Musella I , Trentin E , Clementini G , Testa V , Cusano F , Storm J 
Published: August 2021

ABSTRACT
Classical Cepheids (DCEPs) are the most important primary indicators of the extragalactic distance scale. Establishing the dependence on metallicity of their period–luminosity and period–Wesenheit (PLZ/PWZ) relations has deep consequences on the calibration of secondary distance indicators that lead to the final estimate of the Hubble constant (H0). We collected high-resolution spectroscopy for 47 DCEPs plus 1 BL Her variables with HARPS-N@TNG and derived accurate atmospheric parameters, radial velocities, and metal abundances. We measured spectral lines for 29 species and characterized their chemical abundances, finding very good agreement with previous results. We re-determined the ephemerides for the program stars and measured their intensity-averaged magnitudes in the V, I, J, H, Ks bands. We complemented our sample with literature data and used the Gaia Early Data Release 3 (EDR3) to investigate the PLZ/PWZ relations for Galactic DCEPs in a variety of filter combinations. We find that the solution without any metallicity term is ruled out at more than the 5σ level. Our best estimate for the metallicity dependence of the intercept of the PLKs, PWJKs, PWVKs, and PWHVI relations with three parameters is −0.456 ± 0.099, −0.465 ± 0.071, −0.459 ± 0.107, and −0.366 ± 0.089 mag dex−1, respectively. These values are significantly larger than the recent literature. The present data are still inconclusive to establish whether or not also the slope of the relevant relationships depends on metallicity. Applying a correction to the standard zero-point offset of the Gaia parallaxes has the same effect of reducing by ∼22 per cent the size of the metallicity dependence on the intercept of the PLZ/PWZ relations.
Management of Mycobacterium tuberculosis Prosthetic Joint Infection: 2 Cases and Literature Review
Authors: Lo Carson K L , Chen Lina , Varma Sonal , Wood Gavin C A , Grant Jennifer , Wilson Evan W 
Published: August 2021

Abstract
Prosthetic joint infection caused by Mycobacterium tuberculosis (TBPJI) is uncommon but can be encountered in immunocompromised patients or those from tuberculosis-endemic regions. A lack of clinical suspicion and experience with TBPJI often leads to a delay in diagnosis. We report 2 cases of TBPJI in a Hungarian-Canadian and Iranian-Canadian immigrant, respectively. Both were treated with concurrent surgical and medical therapy. We also performed a literature review on TBPJI case reports, outlining their diagnosis and management.
Association Between SARS-CoV-2 Cycle Threshold Values and Clinical Outcomes in Patients With COVID-19: A Systematic Review and Meta-analysis
Authors: Shah Vishal P , Farah Wigdan H , Hill James C , Hassett Leslie C , Binnicker Matthew J , Yao Joseph D , Murad M Hassan 
Published: August 2021

Abstract
Cycle threshold (CT) values are correlated with the amount of viral nucleic acid in a sample and may be obtained from some qualitative real-time polymerase chain reaction tests used for diagnosis of most patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, CT values cannot be directly compared across assays, and they must be interpreted with caution as they are influenced by sample type, timing of sample collection, and assay design. Presently, the correlation between CT values and clinical outcomes is not well understood. We conducted a systematic review and meta-analysis of published studies through April 19, 2021, that reported an association between CT values and hospitalization, disease severity, and mortality in patients ≥18 years old with SARS-CoV-2. A meta-analysis of 7 studies showed no significant difference in mean CT values between hospitalized and nonhospitalized patients. Among hospitalized patients, those with CT values &lt;25 had a high risk of more severe disease and mortality than patients with CT values &gt;30 (odds ratio [OR], 2.31; 95% CI, 1.70 to 3.13; and OR, 2.95; 95% CI, 2.19 to 3.96; respectively). The odds of increased disease severity and mortality were less pronounced in patients with CT values of 25–30 compared with &gt;30.
Diagnosis of Histoplasmosis Using the MVista Histoplasma Galactomannan Antigen Qualitative Lateral Flow–Based Immunoassay: A Multicenter Study
Authors: Abdallah Wassim , Myint Thein , LaRue Richard , Minderman Melissa , Gunn Suphansa , Wheat L Joseph , Hage Chadi A 
Published: August 2021

Abstract

Background
Accurate and timely methods for the diagnosis of histoplasmosis in resource-limited countries are lacking. Histoplasma antigen detection by enzyme immunoassay (EIA) is widely used in the United States (US) but not in resource-limited countries, leading to missed or delayed diagnoses and poor outcomes. Lateral flow assays (LFAs) can be used in this setting.

Methods
Frozen urine specimens were submitted to MiraVista diagnostics for antigen testing from 3 medical centers in endemic areas of the US. They were blinded and tested for the MVista Histoplasma LFA. Patients were classified as controls or cases of histoplasmosis. Cases were divided into proven or probable; pulmonary or disseminated; immunocompetent or immunosuppressed; and mild, moderate, or severe.

Results
Three hundred fifty-two subjects were enrolled, including 66 cases (44 proven, 22 probable) and 286 controls. Most of the cases were immunocompromised (71%), and 46 had disseminated and 20 had pulmonary histoplasmosis. Four cases were mild, 42 moderate, and 20 severe. LFA and EIA were highly concordant (κ = 0.84). Sensitivity and specificity of the LFA were 78.8% and 99.3%, respectively. LFA sensitivity was higher in proven cases (93.2%), patients with disseminated (91.3%), moderate (78.6%), and severe disease (80%), and those with galactomannan levels &gt;1.8 ng/mL (97.8%). Specificity was 99.3% in proven cases, 99.3% in patients with moderate or severe disease, and 96.8% in those with galactomannan levels &gt;1.8 ng/mL. Cross-reactivity was noted with other endemic mycoses.

Conclusions
The MVista Histoplasma LFA meets the need for accurate rapid diagnosis of histoplasmosis in resource-limited countries, especially in patients with high disease burden, potentially reducing morbidity and mortality.
Dark Pool Trading and Information Acquisition
Authors: Brogaard Jonathan , Pan Jing 
Published: August 2021

Abstract
Theory suggests that dark pools may facilitate or discourage information acquisition. We find that more dark pool trading leads to greater information acquisition. We measure information acquisition using stock price dynamics around earnings announcements. To overcome endogeneity concerns, we exploit a large exogenous decrease to dark pool trading that results from the implementation of the Security and Exchange Commission’s (SEC’s) Tick Size Pilot Program. The results cannot be explained by lit venue liquidity, algorithmic trading, or informational efficiency. A battery of additional tests, such as documenting a shift in SEC EDGAR searches, supports the information acquisition interpretation.
The effect of sleep restriction therapy for insomnia on sleep pressure and arousal: a randomized controlled mechanistic trial
Authors: Maurer Leonie F , Espie Colin A , Omlin Ximena , Emsley Richard , Kyle Simon D 
Published: August 2021

AbstractStudy ObjectivesSleep restriction therapy (SRT) effectively treats insomnia but mechanisms are poorly understood. Theoretical models suggest that potentiation of sleep pressure and reduction of arousal are key mechanisms of action. To our knowledge, this has never been directly tested. We designed a randomized controlled trial with embedded mechanistic measurement to investigate if SRT causally modifies multidimensional assessments of sleep pressure and arousal.MethodsParticipants aged 25–55 who met DSM-5 diagnostic criteria for insomnia disorder were randomized to four weeks of SRT or time in bed regularization (TBR), a control intervention that involves prescription of a regular but not reduced time in bed. Sleep pressure was assessed through daily diary appraisal of morning and evening sleepiness, weekly Epworth sleepiness scale (ESS) scores, psychomotor vigilance, and non-rapid eye movement (NREM) delta power (0.75–4.5 Hz) from ambulatory polysomnographic recordings. Arousal was assessed through daily diary appraisal of cognitive arousal, the pre-sleep arousal scale (PSAS), and NREM beta power (15–32 Hz). Outcomes were assessed at baseline (2-week period prior to randomization), during the intervention phase (1–4 weeks post-randomization), and at 12-week follow-up. We performed intention-to-treat analyses using linear mixed models. For continuous daily measures, the treatment period was split into early (weeks 1–2) and late (weeks 3–4) treatment.ResultsFifty-six participants (39 females, mean age = 40.78 ± 9.08) were assigned to SRT (n = 27) or TBR (n = 29). The SRT group showed enhanced sleep pressure relative to TBR, reflected in (1) enhanced sleepiness in the evening during early (d = 1.17) and late treatment (d = 0.92), and in the morning during early treatment (d = 0.47); (2) higher daytime sleepiness on the ESS at weeks-1 and -2 (d = 0.54, d = 0.45); and (3) reduced psychomotor vigilance at week-1 (d = 0.34). The SRT group also showed reduced arousal relative to TBR, reflected in lower levels of daily-monitored cognitive arousal during early treatment (d = 0.53) and decreased PSAS total score at week-4 and week-12 (ds ≥ 0.39). Power spectral analysis of all night NREM sleep revealed an increase in relative, but not absolute, EEG delta power at week-1 and week-4 (ds ≥ 0.52) and a decrease of relative EEG beta power at week-4 (d = 0.11).ConclusionFor the first time, we show that SRT increases sleep pressure and decreases arousal during acute implementation, providing support for mechanism-of-action.
Insomnia predicts treatment engagement and symptom change: a secondary analysis of a web-based CBT intervention for veterans with PTSD symptoms and hazardous alcohol use
Authors: Buckheit Katherine A , Nolan Jon , Possemato Kyle , Maisto Stephen , Rosenblum Andrew , Acosta Michelle , Marsch Lisa A 
Published: August 2021

Abstract
Posttraumatic Stress Disorder (PTSD) and hazardous drinking are highly comorbid, and often more severe than PTSD or hazardous drinking alone. Integrated, web-based interventions for PTSD/hazardous drinking may increase access to care, but have demonstrated equivocal results in reducing PTSD and hazardous drinking. One factor that may explain treatment engagement and symptom change is the presence of insomnia symptoms. The current study conducted secondary data analysis of a randomized controlled trial of an integrated web-based intervention for PTSD symptoms and hazardous drinking to examine insomnia symptoms as predictors of PTSD symptoms, alcohol use, and treatment engagement. In the parent study, 162 veterans in primary care reporting PTSD symptoms and hazardous drinking were randomized to receive either the intervention or treatment as usual. The current study examined insomnia among veterans who received the intervention (n = 81). Regression models tested baseline insomnia symptoms as predictors of treatment engagement, follow-up PTSD symptoms, and alcohol use. Hierarchical regression models tested change in insomnia during treatment as a predictor of follow-up PTSD symptoms and alcohol use. Results showed baseline insomnia predicted treatment engagement and follow-up drinking days, but not PTSD symptoms or heavy drinking days. Although overall change in insomnia was small, it predicted follow-up PTSD and heavy drinking days, but not drinking days. Results are consistent with previous research highlighting the importance of identifying and treating insomnia in the course of integrated treatment for PTSD/hazardous drinking. Future research should investigate how to best integrate insomnia, PTSD, and/or hazardous drinking interventions to maximize treatment engagement.
The central role of Italy in the spatial spread of USUTU virus in Europe
Authors: Zecchin B , Fusaro A , Milani A , Schivo A , Ravagnan S , Ormelli S , Mavian C , Michelutti A , Toniolo F , Barzon L , Monne I , Capelli G 
Published: August 2021

Abstract
USUTU virus (USUV) is an arbovirus maintained in the environment through a bird–mosquito enzootic cycle. Previous surveillance plans highlighted the endemicity of USUV in North-eastern Italy. In this work, we sequenced 138 new USUV full genomes from mosquito pools (Culex pipiens) and wild birds collected in North-eastern Italy and we investigated the evolutionary processes (phylogenetic analysis, selection pressure and evolutionary time-scale analysis) and spatial spread of USUV strains circulating in the European context and in Italy, with a particular focus on North-eastern Italy. Our results confirmed the circulation of viruses belonging to four different lineages in Italy (EU1, EU2, EU3 and EU4), with the newly sequenced viruses from the North-eastern regions, Veneto and Friuli Venezia Giulia, belonging to the EU2 lineage and clustering into two different sub-lineages, EU2-A and EU2-B. Specific mutations characterize each European lineage and geographic location seem to have shaped their phylogenetic structure. By investigating the spatial spread in Europe, we were able to show that Italy acted mainly as donor of USUV to neighbouring countries. At a national level, we identified two geographical clusters mainly circulating in Northern and North-western Italy, spreading both northward and southward. Our analyses provide important information on the spatial and evolutionary dynamics of USUTU virus that can help to improve surveillance plans and control strategies for this virus of increasing concern for human health.
Comparison of Chloroprocaine Versus Lidocaine With Epinephrine, Sodium Bicarbonate, and Fentanyl for Epidural Extension Anesthesia in Elective Cesarean Delivery: A Randomized, Triple-blind, Noninferiority Study
Authors: Sharawi N. , Bansal P. , Williams M. , Spencer H. , Mhyre J.M. 
Published: August 2021

(Anesth Analg. 2021;132:666–675)
To facilitate intrapartum cesarean delivery anesthesia, patients with ongoing neuraxial labor analgesia receive a more potent local anesthetic through the epidural catheter to establish surgical anesthesia. When this technique is successful, patients can forego other neuraxial or general anesthesia for cesarean delivery. The study institution uses 2 anesthetic solutions for epidural extension anesthesia: 3% chloroprocaine (CP), or a mixture of 2% lidocaine, epinephrine, sodium bicarbonate, and fentanyl (LEBF). Since the mixture takes time to prepare, CP is used for unanticipated emergencies on labor and delivery. This randomized, triple-blind, noninferiority study aimed to compare the surgical anesthesia onset times of CP and LEBF for epidural extension anesthesia for cesarean delivery.
New Persistent Opioid Use After Acute Opioid Prescribing in Pregnancy: A Nationwide Analysis
Authors: Peahl A.F. , Morgan D.M. , Dalton V.K. , Zivin K. , Lai Y.L. , Hu H.M. , Langen E. , Low L.K. , Brummett C.M. , Waljee J.F. , Bauer M.E. 
Published: August 2021

(Am J Obstet Gynecol. 2020;223:566.e1–566.e13)
Reduction of opioid prescription following delivery has become a priority nationwide. Independent of mode of delivery, postpartum opioid exposure has been linked to new persistent use after delivery. This retrospective cohort study assessed rates of opioid prescription during pregnancy to understand the impact on long-term opioid use, including new persistent opioid use (NPOU) and long-term opioid use after delivery.
Maternal Mortality in the United States: Research Gaps, Opportunities, and Priorities
Authors: Chinn J.J. , Eisenberg E. , Dickerson S.A. , King R.B. , Chakhtoura N. , Lim I.A.L. , Grantz K.L. , Lamar C. , Bianchi D.W. 
Published: August 2021

(Am J Obstet Gynecol. 2020;223:568.e1–568.e5)
There has been a rise of pregnancy-related mortality in the United States between 1987 and 2016, with an increase from 7.2 to 16.9 maternal deaths per 100,000 live births. Of these maternal deaths, racial disparities exist. Non-Hispanic black women experience .3 times the number of maternal deaths as non-Hispanic white women. In addition, more than half of the annual maternal deaths within the United States are attributed to preventable causes. As research is an essential component of discovering causes and reversing the rise of maternal morbidity rates, the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) convened 2 workshops in 2019 to identify research gaps, examine current science, and focus on research priorities for this topic.
Effect of Inadequate Sleep on Clinician Performance
Authors: Saadat H. 
Published: August 2021

(Anesth Analg. 2021;132:1338–1343)
Sleep deprivation (SD) can have adverse effects on cognitive function and decision-making, and lead to motor vehicle accidents and devastating health and environmental disasters. Sleep occurs in 4 stages in cycles lasting 90 to 120 minutes. Most adults need 7 to 9 hours per night. There are a number of sleep disturbances and disorders, including insomnias, excessive somnolence (DOES), and parasomnias. SD is categorized into long-term SD (>45 h), short-term SD (≤45 h), and partial SD (<7 h/24 h).
The Effect of the No Pain Labor and Delivery–Global Health Initiative on Cesarean Delivery and Neonatal Outcomes in China: An Interrupted Time-series Analysis
Authors: Drzymalski D.M. , Guo J.-C. , Qi X.-Q. , Tsen L.C. , Sun Y. , Ouanes J.-P.P. , Xia Y. , Gao W.D. , Ruthazer R. , Hu F. , Hu L.-Q. 
Published: August 2021

(Anesth Analg. 2021;132:698–706)
The proportion of births by cesarean delivery (CD) has been increasing in China, to an average of 34.6% in 2014, ranging from 4% to 62.5% across provinces. CD is associated with maternal and neonatal risks, and the Chinese government has begun initiatives to lower the rate of CD. The No Pain Labor and Delivery–Global Health Initiative (NPLD-GHI) conducts week-long training programs using an interdisciplinary team to teach advances of obstetrics, neonatology, and anesthesiology, aiming to help lower the rate of CD and improve outcomes. This study examined the effects of the NPLD-GHI program in a large hospital in a rural province, primarily focusing on the rate of CD.
The Effects of Nitroglycerin on the Oxytocin Dose-response Profile in Oxytocin-desensitized and Naive Human Myometrium: An In Vitro Study
Authors: Jayasooriya G.S. , Carvalho J.C.A. , Luca A. , Balki M. 
Published: August 2021

(Anesth Analg. 2021;132:231–239)
During delivery, nitroglycerin is used clinically to reduce uterine tone, in situations such as uterine hyperstimulation or difficult fetal extraction. Oxytocin (OT) is an uterotonic used to induce contractions and after delivery to prevent postpartum hemorrhage. OT exposure in myometrium can cause desensitization of OT receptors. A previous study by Lau et al1 found OT can achieve satisfactory uterine tone following the use of nitroglycerin myometrium in vitro, but it is not clear if the use of nitroglycerin affects the dose needed to reestablish uterine tone. This in vitro study investigates whether nitroglycerin alters the OT dose-response in OT-desensitized and OT-naive tissues.
Adaptation of an Obstetric Anesthesia Service for the Severe Acute Respiratory Syndrome Coronavirus-2 Pandemic: Description of Checklists, Workflows, and Development Tools
Authors: Li Y. , Ciampa E.J. , Zucco L. , Levy N. , Colella M. , Golen T. , Shainker S.A. , Lunderberg J.M. , Ramachandran S.K. , Hess P.E. 
Published: August 2021

(Anesth Analg. 2021;132:31–37)
Health care workers have a significant risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure and infection. Current guidelines detailing the management of patients with confirmed or suspected SARS-CoV-2 infection do not adequately address preparations aimed at mitigating SARS-CoV-2 infection risks associated with procedures specific to obstetric anesthesia. There is a need for workflows and checklists that maintain safety, provide effective care for patients with or without SARS-CoV-2 infection, and reduce waste during labor analgesia, cesarean neuraxial anesthesia, general anesthesia, and situations such as conversion of labor analgesia to cesarean anesthesia. This report discusses the COVID response workflows developed by the Beth Israel Deaconess Medical Center in Boston.
Good at Heart: Developing a Tertiary Perinatal Cardiac Service; the First Eight Years of Experience
Authors: Heland S. , de Chellis A. , Rieder W. , Sleeman M. , Johns J. , Lancefield T. , Robinson A. , Fung A. , Walker S. 
Published: August 2021

(Aust N Z J Obstet Gynaecol. 2020;60:760–765)
Improved obstetric care in high income countries has reduced overall maternal mortality and morbidity, but an increasing trend of cardiac disease contribution to adverse maternal outcomes has emerged. In developed countries, cardiac disease is now the most common cause of indirect maternal death. In 2009, Mercy Hospital for Women created a multidisciplinary perinatal cardiac service to improve outcomes in parturients with congenital and acquired cardiac disease. This study describes outcomes after the first 8 years of that service and summarizes potential needs of tertiary care related to the significant risks that maternal heart disease poses to fetal and maternal well-being.
European Minimum Standards for Obstetric Analgesia and Anaesthesia Departments: An Experts’ Consensus
Authors: Guasch E. , Brogly N. , Mercier F.J. , Ioscovich A. , Weiniger C.F. , Lucas N. , Chassard D. , Kranke P. , Whitaker D. , Geldner G. , Sabelnikovs O. , de Robertis E. 
Published: August 2021

(Eur J Anaesthesiol. 2020;37:1115–1125)
Currently, no minimum standards of anesthesia care for obstetric patients have been defined in Europe or the European Union. Moreover, obstetric anesthesia standards vary widely within and between countries. Providing recommendations for obstetric anesthesia care helps improve maternal safety and quality care across Europe.