bluuebunny/crossref_metadata_2025_split huggingface dataset:
Rolling With the Punches: A National Electronic Injury Surveillance System Database Study of Craniofacial Injuries in Boxing
Authors: Wolfe Erin M. , Pierrot Randall G. , Slavin Benjamin R. , Plotsker Ethan L. , Samaha Georges J. , Gishen Kriya , Thaller Seth R. 
Published: March 2021

Introduction:
Boxing is a popular combat sport in which competitors may sustain high impact blows to the face. For this reason, they are at high risk for craniofacial injuries; however, data on facial injuries specific to boxing remains sparse. Studies on safety measures, such as headgear, to prevent such injuries in boxing have been inconclusive. Boxing is popular with a wide audience. However, there is no consensus on safety measures across different populations involved in boxing due to lack of data. The objective of this study is to characterize the demography and incidence of injury types of patients presenting to emergency departments with boxing-related craniofacial injuries on a national scale in order to facilitate the establishment of evidence-based safety guidelines for prevention of boxing-related injuries.

Methods:
The National Electronic Injury Surveillance System database was searched for boxing-related craniofacial injuries from the last 10 years (2010–2019). Injuries involving boxing were isolated and organized into 5-year age groups. Information on demographics and injury type was extracted from the National Electronic Injury Surveillance System database. Statistical analysis was performed between different age and gender groups.

Results:
A total of 749 boxing-related craniofacial injuries treated in US emergency departments between 2010 and 2019 were recorded. The 19 to 34-year-old age group had the highest number of cases (54%), followed by the 12 to 18-year-old age group (31%). The most common injury types within both of these age groups were concussions and lacerations. This difference was found to be significant when compared to other craniofacial injury types (P < 0.05). The majority of athletes in these age groups were male (93% and 91%, respectively). Analysis of sex differences demonstrated concussions were more common in females compared to other injury types, whereas lacerations in males were more common compared to other injury types; these differences were found to be significant (P < 0.05).

Conclusions:
The high incidence of boxing-related craniofacial injuries such as concussions and lacerations incurred in young adults (19–34 years) and adolescents (12–18 years) indicate that protective measures such as community-based safety interventions and revised guidelines for protective equipment may be indicated in these groups to protect against craniofacial injuries such as lacerations and concussions. Further studies are required to develop algorithms for management of boxing-related craniofacial injuries and to evaluate the safety and efficacy of protective equipment such as boxing headgear on concussions.
The Full Spectrum of COVID-19 Development and Recovery Among Kidney Transplant Recipients
Authors: Cristelli Marina P. , Viana Laila A. , Dantas Marcus T.C. , Martins Suelen B.S. , Fernandes Ruan , Nakamura Monica R. , Santos Daniel W.C.L. , Taddeo Julia B. , Azevedo Vega F. , Foresto Renato D. , Tedesco-Silva Helio , Medina-Pestana Jose 
Published: March 2021

Background.
Coronavirus disease 2019 (COVID-19) fatality rate is high among kidney transplant recipients. Among survivors, kidney outcomes, seroconversion, and persistence of viral shedding are unexplored.

Methods.
Single-center prospective cohort study including data from kidney transplant recipients with confirmed COVID-19 between March 20, 2020 and July 31, 2020. Outcomes were adjudicated until August 31, 2020 or the date of death.

Results.
There were 491 patients with COVID-19 among the 11 875 recipients in follow-up. The majority were middle aged with ≥1 comorbidities. Thirty-one percent were treated at home, and 69% required hospitalization. Among the hospitalized, 61% needed intensive care, 75% presented allograft dysfunction, and 46% needed dialysis. The overall 28-day fatality rate was 22% and among hospitalized patients it was 41%. Age (odds ratio, 3.08; 95% confidence interval, 1.86-5.09), diabetes mellitus (odds ratio, 1.69; 95% confidence interval, 1.06-2.72), and cardiac disease (odds ratio, 2.00; 95% confidence interval, 1.09-3.68) were independent factors for death. Among the 351 survivors, 19% sustained renal graft dysfunction, and there were 13 (4%) graft losses. Biopsy (n = 20) findings were diverse but decisive to guide treatment and estimate prognosis. Seroconversion was observed in 79% of the survivors and was associated with disease severity. Persistence of viral shedding was observed in 21% of the patients without detectable clinical implications.

Conclusions.
This prospective cohort analysis confirms the high 28-day fatality rate of COVID-19, associated primarily with age and comorbidities. The high incidence of allograft dysfunction was associated with a wide range of specific histologic lesions and high rates of sequelae and graft loss. Seroconversion was high and the persistence of viral shedding deserves further studies.
The Magnitude and Functionality of SARS-CoV-2 Reactive Cellular and Humoral Immunity in Transplant Population Is Similar to the General Population Despite Immunosuppression
Authors: Thieme Constantin J. , Anft Moritz , Paniskaki Krystallenia , Blazquez-Navarro Arturo , Doevelaar Adrian , Seibert Felix S. , Hoelzer Bodo , Justine Konik Margarethe , Meister Toni L. , Pfaender Stephanie , Steinmann Eike , Moritz Berger Marc , Brenner Thorsten , Kölsch Uwe , Dolff Sebastian , Roch Toralf , Witzke Oliver , Schenker Peter , Viebahn Richard , Stervbo Ulrik , Westhoff Timm H. , Babel Nina 
Published: March 2021

Background.
The ability of transplant (Tx) patients to generate a protective antiviral response under immunosuppression is pivotal in COVID-19 infection. However, analysis of immunity against SARS-CoV-2 is currently lacking.

Methods.
Here, we analyzed T cell immunity directed against SARS-CoV-2 spike-, membrane-, and nucleocapsid-protein by flow cytometry and spike-specific neutralizing antibodies in 10 Tx in comparison to 26 nonimmunosuppressed (non-Tx) COVID-19 patients.

Results.
Tx patients (7 renal, 1 lung, and 2 combined pancreas-kidney Txs) were recruited in this study during the acute phase of COVID-19 with a median time after SARS-CoV-2-positivity of 3 and 4 d for non-Tx and Tx patients, respectively. Despite immunosuppression, we detected antiviral CD4+ T cell-response in 90% of Tx patients. SARS-CoV-2–reactive CD4+ T cells produced multiple proinflammatory cytokines, indicating their potential protective capacity. Neutralizing antibody titers did not differ between groups. SARS-CoV-2–reactive CD8+ T cells targeting membrane- and spike-protein were lower in Tx patients, albeit without statistical significance. However, frequencies of anti-nucleocapsid–protein-reactive, and anti-SARS-CoV-2 polyfunctional CD8+ T cells, were similar between patient cohorts. Tx patients showed features of a prematurely aged adaptive immune system, but equal frequencies of SARS-CoV-2–reactive memory T cells.

Conclusions.
In conclusion, a polyfunctional T cell immunity directed against SARS-CoV-2 proteins as well as neutralizing antibodies can be generated in Tx patients despite immunosuppression. In comparison to nonimmunosuppressed patients, no differences in humoral and cellular antiviral-immunity were found. Our data presenting the ability to generate SARS-CoV-2–specific immunity in immunosuppressed patients have implications for the handling of SARS-CoV-2–infected Tx patients and raise hopes for effective vaccination in this cohort.
Common Data Elements, Scalable Data Management Infrastructure and Analytics Workflows for Large-scale Neuroimaging Studies
Authors: Kuplicki Rayus , Touthang James , Zoubi Obada Al , Mayeli Ahmad , Misaki Masaya ,   NeuroMAP-Investigators, Aupperle Robin L , Teague T. Kent , McKinney Brett A. , Paulus Martin , Bodurka Jerzy 
Published: March 2021

1.AbstractNeuroscience studies require considerable bioinformatic support and expertise. Numerous high-dimensional and multimodal datasets must be preprocessed and integrated to create robust and reproducible analysis pipelines. We describe a common data elements and scalable data management infrastructure that allows multiple analytics workflows to facilitate preprocessing, analysis and sharing of large-scale multi-level data. The process uses the Brain Imaging Data Structure (BIDS) format and supports MRI, fMRI, EEG, clinical and laboratory data. The infrastructure provides support for other datasets such as Fitbit and flexibility for developers to customize the integration of new types of data. Exemplar results from 200+ participants and 11 different pipelines demonstrate the utility of the infrastructure.
Post-stroke reorganization of transient brain activity characterizes deficits and recovery of cognitive functions
Authors: Pirondini Elvira , Kinany Nawal , Le Sueur Cécile , Griffis Joseph C. , Shulman Gordon L. , Corbetta Maurizio , Van De Ville Dimitri 
Published: March 2021

AbstractFunctional magnetic resonance imaging (fMRI) has been widely employed to study stroke pathophysiology. In particular, analyses of fMRI signals at rest were directed at quantifying the impact of stroke on spatial features of brain networks. However, brain networks have intrinsic time features that were, so far, disregarded in these analyses. In consequence, standard fMRI analysis failed to capture temporal imbalance resulting from stroke lesions, hence restricting their ability to reveal the interdependent pathological changes in structural and temporal network features following stroke. Here, we longitudinally analyzed hemodynamic-informed transient activity in a large cohort of stroke patients (n = 103) to assess spatial and temporal changes of brain networks after stroke. While large-scale spatial patterns of these networks were preserved after stroke, their durations were altered, with stroke subjects exhibiting a varied pattern of longer and shorter network activations compared to healthy individuals. These temporal alterations were associated with white matter damage and were behavior-specific. Specifically, restoration of healthy brain dynamics paralleled recovery of cognitive functions, but was not significantly correlated to motor recovery. These findings underscore the critical importance of network temporal properties in dissecting the pathophysiology of brain changes after stroke, thus shedding new light on the clinical potential of time-resolved methods for fMRI analysis.Significance StatementUnderstanding the pathophysiology of a disorder is pivotal to design effective treatment. In this regard, recent advances in stroke research settled a new clinical concept:connectional diaschisis, which suggested that post-stroke impairments arise from both focal structural changes (tied to the injury) and widespread alterations in functional connectivity. fMRI time-resolved methods consider structural and temporal properties of brain networks as interdependent features. They are, thus, better suited to capture the intertwine between structural and functional changes. Here we leveraged a dynamic functional connectivity framework based on the clustering of hemodynamic-informed transients in a large and heterogeneous stroke population assessed longitudinally. We showed that lesions led to an unbalance in the brain dynamics that was associated with white matter fibers disruption and was restored as deficits recovered. Our work showed the potential of a time-resolved method to reveal clinically relevant dynamics of large-scale brain networks.
COVID-19 collateral damage: psychological distress and behavioral changes among older adults during the first outbreak in Stockholm, Sweden
Authors: Beridze Giorgi , Triolo Federico , Grande Giulia , Fratiglioni Laura , Calderón-Larrañaga Amaia 
Published: March 2021

ABSTRACTIntroductionDuring the first wave of the COVID-19 pandemic, Swedish public health authorities provided recommendations for 70+ year old people. They were strongly encouraged to self-isolate but remain physically active in a safe manner. This study aimed to explore the indirect, negative effects of COVID-19 restrictions (collateral damage) by exploring to what extent adherence to such recommendations might have impacted the lives and health of older adults living in central Stockholm.MethodsAn ad-hoc phone questionnaire was administered by trained staff between May and June 2020 to a random sample of older adults 68+ years old (n=1231), who had attended the regular follow-up assessment of the longitudinal Swedish National study on Aging and Care in Kungsholmen (SNAC-K) during 2016-2019. We explored three dimensions of collateral damage, namely psychological distress (feelings of worry, stress and loneliness), reductions in social and physical activities, and reductions in medical and social care use. Logistic regression models were used to test the association between age, sex, education and living arrangement, and the risk of collateral damage.ResultsVast majority of participants adhered to the recommendations, with over three quarters practicing self-isolation (n=928). Half of the sample reported psychological distress, 55.3% reported reductions in social or physical activity, and 11.3% reported decreased medical or social care use. Over three quarters of participants were affected by at least one of the three collateral damage dimensions. Female sex was the strongest sociodemographic predictor of individual as well as co-occurring dimensions of collateral damage.ConclusionCOVID-19 and its restrictions during the first half of 2020 have had a negative effect on the health and lives of a majority of elderly living in central Stockholm. Women were at a particularly higher risk of these negative consequences. We emphasize the need for predefined, evidence-based interventions to address these negative consequences.STRENGTHS AND LIMITATIONS OF THIS STUDYThis study uses a large sample of older adults from a well-characterized population-based study (SNAC-K)Several dimensions of the indirect, negative effects (collateral damage) of the COVID-19 pandemic are explored in this studyAs Sweden’s response to COVID-19 differed from most countries, this study provides a unique opportunity of comparison with other settingsThe cross-sectional design of this study does not allow to establish temporality between the onset of the pandemic and studied outcomesThe results of this study may not be generalisable to the entire elderly population in Sweden as participants are from an urban, affluent area in Stockholm
Assessing the utility of lymphocyte count to diagnose COVID-19
Authors: Fralick Michael , Bogler Orly , Tamming Daniel , Lapointe-Shaw Lauren , Kwan Janice , Tang Terence , Rawal Shail , Liu Jessica , Razak Farad , Verma Amol A 
Published: March 2021

ABSTRACTBackgroundCOronaVirus Disease 2019 (COVID-19) can be challenging to diagnose, because symptoms are non-specific, clinical presentations are heterogeneous, and false negative tests can occur. Our objective was to assess the utility of lymphocyte count to differentiate COVID-19 from influenza or community-acquired pneumonia (CAP).MethodsWe conducted a cohort study of adults hospitalized with COVID-19 or another respiratory infection (i.e., influenza, CAP) at seven hospitals in Ontario, Canada.The first available lymphocyte count during the hospitalization was used. Standard test characteristics for lymphocyte count (×109/L) were calculated (i.e., sensitivity, specificity, area under the receiver operating curve [AUC]). All analyses were conducting using R.ResultsThere were 869 hospitalizations for COVID-19, 669 for influenza, and 3009 for CAP. The mean age across the three groups was 67 and patients with pneumonia were older than those with influenza or COVID19, and approximately 46% were woman. The median lymphocyte count was nearly identical for the three groups of patients: 1.0 ×109/L (interquartile range [IQR]:0.7,2.0) for COVID-19, 0.9 ×109/L (IQR 0.6,1.0) for influenza, and 1.0 ×109/L (IQR 0.6,2.0) for CAP. At a lymphocyte threshold of less than 2.0 ×109/L, the sensitivity was 87% and the specificity was approximately 10%. As the lymphocyte threshold increased, the sensitivity of diagnosing COVID-19 increased while the specificity decreased. The AUC for lymphocyte count was approximately 50%.InterpretationLymphocyte count has poor diagnostic discrimination to differentiate between COVID-19 and other respiratory illnesses. The lymphopenia we consistently observed across the three illnesses in our study may reflect a non-specific sign of illness severity. However, lymphocyte count above 2.0 ×109/L may be useful in ruling out COVID-19 (sensitivity = 87%).
Importation, circulation, and emergence of variants of SARS-CoV-2 in the South Indian State of Karnataka
Authors: Pattabiraman Chitra , Prasad Pramada , George Anson K , Sreenivas Darshan , Rasheed Risha , Reddy Nakka Vijay Kiran , Desai Anita , Vasanthapuram Ravi 
Published: March 2021

ABSTRACTAs the pandemic of COVID-19 caused by the coronavirus SARS-CoV-2 continues, the selection of genomic variants which can influence how the pandemic progresses is of growing concern. Of particular concern, are those variants that carry mutations/amino acid changes conferring higher transmission, more severe disease, re-infection, and immune escape. These can broadly be classified as Variants of Concern (VOCs). VOCs have been reported from several parts of the world- UK (lineage B.1.1.7), South Africa (lineage B.1.351) and, Brazil (lineage P.1/B.1.1.28). The conditions that contribute to the emergence of VOCs are not well understood. International travel remains an important means of spread. To track importation, spread, and the emergence of variants locally; we sequenced whole genomes of SARS-CoV-2 from international travellers (n=75) entering Karnataka, a state in South India, between Dec 22, 2020- Jan 31, 2021, and from positive cases in the city of Bengaluru (n=108), between Nov 22, 2020- Jan 22, 2021. The resulting 176 SARS-CoV-2 genomes could be classified into 34 lineages, that were either imported (73/176) or circulating (103/176) in this time period. The lineage B.1.1.7 (a.k.a the UK variant) was the major lineage imported into the state (24/73, 32.9%), followed by B.1.36 (20/73, 27.4%) and B.1 (14/73, 19.2%). We identified B.1.36 (45/103; 43.7%), B.1 (26/103; 25.2%), B.1.1.74 (5/103; 4.9%) and B.1.468 (4/103; 3.9%) as the major variants circulating in Bengaluru city. A distinct clade within the B.1.36 lineage was associated with a local outbreak. Analysis of the complete genomes predicted multiple amino acid replacements in the Spike protein. In total, we identified nine amino acid changes (singly or in pairs) in the Receptor Binding Domain of the Spike protein. Of these, the amino acid replacement N440K was found in 37/65 (56.92%) sequences in the B.1.36 lineage. The E484K amino acid change which is present in both VOCs, B.1.351 and P.1/B.1.1.28, was found in a single circulating virus in the B.1.36 lineage. This study highlights the introduction of VOCs by travel and the local circulation of viruses with amino acid replacements in the Spike protein. These were spread across lineages, suggesting that multiple paths can lead to the emergence of VOCs, this, in turn, highlights the need to sequence and limit outbreaks of SARS-CoV-2 locally. Our data support the use of concentrated and continued genomic surveillance of SARS-CoV-2 to direct public health measures, suggest revisions to vaccines, and serve as an early warning system to prepare for a surge in COVID-19 cases.
Pulmonary Fibrosis after COVID-19 is Associated with Severity of Illness and Blood Leukocyte Telomere Length
Authors: McGroder Claire F. , Zhang David , Choudhury Mohammad A. , Salvatore Mary M. , D’Souza Belinda M. , Hoffman Eric A. , Wei Ying , Baldwin Matthew R. , Garcia Christine Kim 
Published: March 2021

ABSTRACTThe risk factors for development of fibrotic interstitial lung abnormalities (ILA) after severe COVID-19 are incompletely described and the extent to which CT findings correlate with symptoms and physical function after hospitalization remain unclear. At 4 months after hospitalization, fibrotic ILA was more common in those who underwent mechanical ventilation (72%) than in those who did not (20%). We demonstrate that severity of initial illness, duration of mechanical ventilation, lactate dehydrogenase on admission, and leukocyte telomere length are independent risk factors for fibrotic ILA. These fibrotic changes correlate with lung function, cough and measures of frailty, but not with dyspnea.
Oral health inequality in people with severe mental illness: a cross-sectional study using National Health and Nutrition Examination Survey 1999-2016
Authors: Kang Jing , Wu Jianhua , Aggarwal Vishal , Shiers David , Doran Tim , Palmier-Claus Jasper 
Published: March 2021

AbstractOBJECTIVETo explore whether people with severe mental illness (SMI) experience worse oral health compared to the general population, and the risk factors for poor oral health in people with SMI.METHODThis study used cross-sectional data from the National Health and Nutrition Examination Survey (1999-2016) including on self-rated oral health, ache in mouth, tooth loss, periodontitis stage, and number of decayed, missing, and filled teeth. Candidate risk factors for poor oral health included demographic characteristics, lifestyle factors, physical health comorbidities, and dental hygiene behaviours. The authors used ordinal logistic regression and zero-inflated negative binomial models to explore predictors of oral health outcomes.RESULTS53,348 cases were included in the analysis, including 718 people with SMI. In the fully adjusted model, people with SMI were more likely to suffer from tooth loss (OR 1.40, 95% CI: 1.12-1.75). In people with SMI, the risk factors identified for poor oral health outcomes were older age, white ethnicity, lower income, smoking history, and diabetes. Engaging in physical activity and daily use of dental floss were associated with better oral health outcomes.CONCLUSIONSPeople with SMI experience higher rates of tooth loss than the general population, and certain subgroups are particularly at risk. Having a healthy lifestyle such as performing regular physical exercise and flossing may lower the risk of poor oral health. These findings suggest opportunities for targeted prevention and early intervention strategies to mitigate adverse oral health outcomes.Significant outcomes (x3)People with severe mental illness were at 40% higher risk of tooth loss when compared to the general population.Older adults, smokers and people with diabetes were at particularly high risk of poor oral health.Physical exercise and daily use of dental floss were associated with better oral health outcomes.Limitations (x3)The number of cases with data on periodontal disease was limited.The study was cross-sectional so causation could not be inferred.The analysis used prescriptions of antipsychotic and mood stabilising medication as a proxy measure of severe mental illness, as clinical diagnoses were not available in the dataset.Data availability statementThe NHANES 1999-2016 data is available at CDC website: https://www.cdc.gov/nchs/nhanes/index.htm, and is accessible and free to download for everyone.