bluuebunny/crossref_metadata_2025_split huggingface dataset:
Performance of Unobserved Self-Collected Nasal Swabs for Detection of SARS-CoV-2 by RT-PCR Utilizing a Remote Specimen Collection Strategy
Authors: Kagan Ron M , Rogers Amy A , Borillo Gwynngelle A , Clarke Nigel J , Marlowe Elizabeth M 
Published: January 2021

Abstract

Background
The use of a remote specimen collection strategy employing a kit designed for unobserved self-collection for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription polymerase chain reaction (RT-PCR) can decrease the use of personal protective equipment (PPE) and exposure risk. To assess the impact of unobserved specimen self-collection on test performance, we examined results from a SARS-CoV-2 qualitative RT-PCR test for self-collected specimens from participants in a return-to-work screening program and assessed the impact of a pooled testing strategy in this cohort.

Methods
Self-collected anterior nasal swabs from employee return-to-work programs were tested using the Quest Diagnostics Emergency Use Authorization SARS-CoV-2 RT-PCR. The cycle threshold (Ct) values for the N1 and N3 N-gene targets and a human RNase P (RP) gene control target were tabulated. For comparison, we utilized Ct values from a cohort of health care provider–collected specimens from patients with and without coronavirus disease 2019 symptoms.

Results
Among 47 923 participants, 1.8% were positive. RP failed to amplify for 13/115 435 (0.011%) specimens. The median (interquartile range) Cts were 32.7 (25.0–35.7) for N1 and 31.3 (23.8–34.2) for N3. Median Ct values in the self-collected cohort were significantly higher than those of symptomatic but not asymptomatic patients. Based on Ct values, pooled testing with 4 specimens would have yielded inconclusive results in 67/1268 (5.2%) specimens but only a single false-negative result.

Conclusions
Unobserved self-collection of nasal swabs provides adequate sampling for SARS-CoV-2 RT-PCR testing. These findings alleviate concerns of increased false negatives in this context. Specimen pooling could be used for this population, as the likelihood of false-negative results is very low when using a sensitive, dual-target methodology.
What Do Dreams Do?
Authors: Llewellyn Sue 
Published: January 2021

Abstract
What is a dream? It’s a complex, non-obvious pattern derived from your experience. But you haven’t actually experienced it. Strange. Revealing complex, hidden patterns makes dreams odd. Dreams associate elements of different experiences to make something new: a pattern you didn’t know was there until you dreamt it. Patterns are discernible forms in the way something happens or is done. Some patterns are easy to spot, being certain and obvious: night follows day. Patterns in human/animal experiences are less obvious because, first, the patterned elements appear at different times or places and, second, the pattern exhibits tendencies not certainties. Spotting such patterns depends on non-obvious associations. If prompted with ‘sea’, while awake, your logical brain makes obvious associations, ‘beach’ or ‘boat’, with a seaside pattern i.e. beach-boat-seaside. But after awakening from dreaming, when your brain is still tuned to non-obvious associations, ‘sick’ may come to mind. A less obvious element of sea experiences. You tend to seasickness when it’s rough. But you also get sick if you eat shellfish, have a migraine, or travel in cars—but only if you read. Sea–rough–car–read–shellfish–migraine. Visualizing these non-obvious associations between elements of different experiences becomes dream-like. Dreaming brains evolved to identify non-obvious associations. Across evolutionary time, you didn’t want to get sick. Survival depended on being well enough to anticipate the non-obvious patterns of predators and human competitors, while securing access to food and water. Making associations drives many, if not all, brain functions. Dream associations support memory, emotional stability, creativity, unconscious decision-making, and prediction, while also contributing to mental illness. This book explains how.
Eleven biosynthetic genes explain the majority of natural variation in carotenoid levels in maize grain
Authors: Diepenbrock Christine H , Ilut Daniel C , Magallanes-Lundback Maria , Kandianis Catherine B , Lipka Alexander E , Bradbury Peter J , Holland James B , Hamilton John P , Wooldridge Edmund , Vaillancourt Brieanne , Góngora-Castillo Elsa , Wallace Jason G , Cepela Jason , Mateos-Hernandez Maria , Owens Brenda F , Tiede Tyler , Buckler Edward S , Rocheford Torbert , Buell C Robin , Gore Michael A , DellaPenna Dean 
Published: January 2021

AbstractVitamin A deficiency remains prevalent in parts of Asia, Latin America, and sub-Saharan Africa where maize (Zea mays) is a food staple. Extensive natural variation exists for carotenoids in maize grain. Here, to understand its genetic basis, we conducted a joint linkage and genome-wide association study of the US maize nested association mapping panel. Eleven of the 44 detected quantitative trait loci (QTL) were resolved to individual genes. Six of these were correlated expression and effect QTL (ceeQTL), showing strong correlations between RNA-seq expression abundances and QTL allelic effect estimates across six stages of grain development. These six ceeQTL also had the largest percentage of phenotypic variance explained, and in major part comprised the three to five loci capturing the bulk of genetic variation for each trait. Most of these ceeQTL had strongly correlated QTL allelic effect estimates across multiple traits. These findings provide an in-depth genome-level understanding of the genetic and molecular control of carotenoids in plants. In addition, these findings provide a roadmap to accelerate breeding for provitamin A and other priority carotenoid traits in maize grain that should be readily extendable to other cereals.
Pain and Poverty: Disparities by Poverty Level in the Experience of Pain-Related Interference
Authors: Keralis Jessica M 
Published: January 2021

Abstract

Objective
To assess the relationship between poverty and pain-related interference.

Subjects
Data on a sample of 108,259 adults aged 18 and older from the Household Component of the Medical Expenditure Panel Survey (MEPS) from 2013 to 2017 were analyzed.

Methods
I assess the odds of reporting any pain-related interference, as well as increasing levels of pain-related interference, using binary and ordinal logistic regression, respectively.

Results
After controlling for covariates, the analysis showed a significant association between poverty and pain-related interference, with more severe levels of poverty associated with increased odds of reporting any pain-related interference as well as increased levels of pain-related interference. However, Hispanics were less likely to report any pain-related interference overall, and more severe levels of poverty were associated with decreased odds of reporting pain among Hispanics.

Conclusions
Policy makers should regard poverty as a social determinant of health, taking poverty and socioeconomic status into consideration when designing health policies.
Do You Know that I Know that You Know…? Higher-Order Beliefs in Survey Data
Authors: Coibion Olivier , Gorodnichenko Yuriy , Kumar Saten , Ryngaert Jane 
Published: January 2021

AbstractWe implement a new survey of firms, focusing on their higher-order macroeconomic expectations. The survey provides a novel set of stylized facts regarding the relationship between first-order and higher-order expectations of economic agents, including how they adjust their beliefs in response to a variety of information treatments. We show how these facts can be used to calibrate key parameters of noisy-information models with infinite regress as well as to test predictions made by this class of models. We also consider a range of extensions to the basic noisy-information model that can potentially better reconcile theory and empirics. Although some extensions like level-k thinking are unsuccessful, incorporating heterogeneous long-run priors can address the empirical shortcomings of the basic noisy-information model.
The value of telephone consultations during COVID-19 pandemic. An observational study
Authors: Martos-Pérez F , Martín-Escalante M D , Olalla-Sierra J , Prada-Pardal J L , García-de-Lucas M D , González-Vega R , Jiménez-Puente A , García-Alegría J 
Published: January 2021

Summary

Background
Many Spanish hospitals converted scheduled in-person visits to telephone visits during the COVID-19 lockdown. There is scarce information about the performance of those visits.

Aim
To compare telephone visits during the COVID-19 lockdown period with previous in-person visits.

Design
Retrospective descriptive study.

Methods
Telephone visits from 15 March to 31 May 2020 were compared with in-person visits during the same period in 2019.

Main measures
The proportions of both groups were compared in term of failure to contact patient, requested diagnostic tests/referrals, discharges, admissions and emergency visits within 30–60 days. A sample of patients, and all participating physicians completed surveys. Z-score test was used (statistical significance P&lt;0.05).

Results
A total of 5602 telephone visits were conducted. In comparison to in-person visits, telephone visits showed higher rates of visit compliance (95.9% vs. 85.2%, P&lt;0.001) and discharges (22.12% vs. 11.82%; P&lt;0.001), and lower number of ancillary tests and referrals. During the 30- and 60-day periods following the telephone visit, a reduction of 52% and 47% in the combined number of emergency department visits and hospital admissions was observed compared to in-person visits (P&lt;0.01). Of the 120 patients surveyed, 95% were satisfied/very satisfied with the telephone visits. Of the 26 physicians, 84.6% considered telephone visits were useful to prioritize patients.

Conclusions
During health emergencies, previously scheduled outpatient in-person visits can be converted to telephone visits, reducing absenteeism, increasing the rate of discharges and reducing ancillary tests and referrals without increasing the rate of hospital admissions or emergency department visits.
Patient perceptions of health-related quality of life in giant cell arteritis: international development of a disease-specific patient-reported outcome measure
Authors: Robson Joanna C , Almeida Celia , Dawson Jill , Bromhead Alison , Dures Emma , Guly Catherine , Hoon Elizabeth , Mackie Sarah , Ndosi Mwidimi , Pauling John , Hill Catherine 
Published: January 2021

Abstract

Objectives
GCA is a large vessel vasculitis (LVV) presenting with headache, jaw claudication, musculoskeletal and visual involvement. Current treatment is glucocorticoids and anti-IL-6 tocilizumab in refractory disease. The objective of this study was to explore the impact of GCA and its treatment on people’s health-related quality of life (HRQoL), to inform the development of a disease-specific patient-reported outcome measure (PROM) for use in clinical trials and practice.

Methods
Participants from the UK and Australia, with biopsy- or imaging-confirmed GCA, were interviewed to identify salient aspects of HRQoL in relation to GCA and its treatment. Purposive sampling included a range of demographic and disease features (cranial, LVV-GCA and visual involvement). Inductive analysis identified individual themes of importance, then domains. Candidate questionnaire items were developed from the individual themes, refined by piloting, cognitive interviews and a linguistic translatability assessment.

Results
Thirty-six interviews were conducted to saturation with participants with GCA from the UK (25) and Australia (11). Mean age was 74 years, 23 (63.9%) were female, 13 (36.1%) had visual loss and 5 (13.9%) had LVV-GCA. Thirty-nine individual themes within five domains were identified: physical symptoms; activity of daily living and function; participation; psychological impact; and impact on sense of self and perception of health. Sixty-nine candidate items were developed from individual themes; piloting and refinement resulted in a 40-item draft questionnaire.

Conclusion
This international qualitative study underpins the development of candidate items for a disease-specific PROM for GCA. The draft questionnaire is now ready for psychometric testing.
Heart rate variability during wakefulness as a marker of obstructive sleep apnea severity
Authors: Qin Hua , Keenan Brendan T , Mazzotti Diego R , Vaquerizo-Villar Fernando , Kraemer Jan F , Wessel Niels , Tufik Sergio , Bittencourt Lia , Cistulli Peter A , de Chazal Philip , Sutherland Kate , Singh Bhajan , Pack Allan I , Chen Ning-Hung , Fietze Ingo , Gislason Thorarinn , Holfinger Steven , Magalang Ulysses J , Penzel Thomas 
Published: January 2021

Abstract

Study Objectives
Patients with obstructive sleep apnea (OSA) exhibit heterogeneous heart rate variability (HRV) during wakefulness and sleep. We investigated the influence of OSA severity on HRV parameters during wakefulness in a large international clinical sample.

Methods
1247 subjects (426 without OSA and 821 patients with OSA) were enrolled from the Sleep Apnea Global Interdisciplinary Consortium. HRV parameters were calculated during a 5-minute wakefulness period with spontaneous breathing prior to the sleep study, using time-domain, frequency-domain and nonlinear methods. Differences in HRV were evaluated among groups using analysis of covariance, controlling for relevant covariates.

Results
Patients with OSA showed significantly lower time-domain variations and less complexity of heartbeats compared to individuals without OSA. Those with severe OSA had remarkably reduced HRV compared to all other groups. Compared to non-OSA patients, those with severe OSA had lower HRV based on SDNN (adjusted mean: 37.4 vs. 46.2 ms; p &lt; 0.0001), RMSSD (21.5 vs. 27.9 ms; p &lt; 0.0001), ShanEn (1.83 vs. 2.01; p &lt; 0.0001), and Forbword (36.7 vs. 33.0; p = 0.0001). While no differences were found in frequency-domain measures overall, among obese patients there was a shift to sympathetic dominance in severe OSA, with a higher LF/HF ratio compared to obese non-OSA patients (4.2 vs. 2.7; p = 0.009).

Conclusions
Time-domain and nonlinear HRV measures during wakefulness are associated with OSA severity, with severe patients having remarkably reduced and less complex HRV. Frequency-domain measures show a shift to sympathetic dominance only in obese OSA patients. Thus, HRV during wakefulness could provide additional information about cardiovascular physiology in OSA patients.

Clinical Trial Information:
A Prospective Observational Cohort to Study the Genetics of Obstructive Sleep Apnea and Associated Co-Morbidities (German Clinical Trials Register - DKRS, DRKS00003966) https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00003966
The assessment of parents’ knowledge, attitudes and concerns about febrile seizures in children at tertiary hospitals in Rwanda—a descriptive study
Authors: Hakizimana, MBBS, MMed Onesphore , Kalimba, MBBS, MMed Edgar , Arnold, MD Linda , Cartledge, MBChB Peter 
Published: January 2021

Abstract

Background
Febrile seizures (FSs) are the most common seizure disorder in childhood. No previous research has been performed to assess caregiver attitudes, knowledge and concerns of FSs in Rwanda or East Africa.

Objectives
This study sought to assess knowledge, attitudes and concerns regarding FS among caregivers of children presenting to tertiary hospitals in Rwanda using a previously validated questionnaire. The secondary objective was to assess the reliability of a translated version of the Huang Febrile Seizures Questionnaire (HFSQ).

Methods
A multi-centre observational study was conducted at four tertiary teaching hospitals in Rwanda. The admitting doctor determined that children met the definition of FSs. A translated version, of a validated questionnaire, the HFSQ, employing yes/no and five-point Likert questions, was used for this study, after minor adjustments.

Results
Eighty-six caregivers were recruited. Caregivers had low levels of pre-existing knowledge regarding FSs. The most significant caregiver concern was that ‘siblings will have FSs too’(mean = 3.62 ± 0.7). Caregivers felt that children with FSs do not need more attention and care and that FSs can be outgrown (mean = 3.4 ± 1.0).

Discussion
The findings support the need for locally relevant educational materials to be shared with caregivers after a FS event. The HFSQ is a good quality tool for assessing parental knowledge and concerns and has the potential to be used in clinical practice as a benchmarking tool for education.
Case Management on the Front Lines of COVID-19
Authors: Baker Michelle , Nelson Sheila , Krsnak Jean 
Published: January 2021

Purpose:
Since the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the disease known as COVID-19, case management has emerged as a critical intervention in the treatment of cases, particularly for patients with severe symptoms and medical complications. In addition, case managers have been on the front lines of the response across the health care spectrum to reduce risks of contagion, including among health care workers. The purpose of this article is to discuss the case management response, highlighting the importance of individual care plans to provide access to the right care and treatment at the right time to address both the consequences of the disease and patient comorbidities.

Primary Practice Settings:
The COVID-19 response spans the full continuum of health and human services, including acute care, subacute care, workers' compensation (especially catastrophic case management), home health, primary care, and community-based care.

Implications for Case Management Practice:
From the earliest days of the pandemic, case managers have assumed an important role on the front lines of the medical response to COVID-19, ensuring that procedures are in place for managing a range of patients: those who were symptomatic but able to self-isolate and care for themselves at home; those who had serious symptoms and needed to be hospitalized; and those who were asymptomatic and needed to be educated about the importance of self-isolating. Across the care spectrum, individualized responses to the clinical and psychosocial needs of patients with COVID-19 in acute care, subacute care, home health, and other outpatient settings have been guided by the well-established case management process of screening, assessing, planning, implementing, following up, transitioning, and evaluating. In addition, professional case managers are guided by values such as advocacy, ensuring access to the right care and treatment at the right time; autonomy, respecting the right to self-determination; and justice, promoting fairness and equity in access to resources and treatment. The value of justice also addresses the sobering reality that people from racial and ethnic minority groups are at an increased risk of getting sick and dying from COVID-19. Going forward, case management will continue to play a major role in supporting patients with COVID-19, in both inpatient and outpatient settings, with telephonic follow-up and greater use of telehealth.
Cognitive Errors in Pediatric Emergency Medicine
Authors: Scarfone Richard J. , Nagler Joshua 
Published: January 2021

Abstract
Fundamental to the practice of pediatric emergency medicine is making timely and accurate diagnoses. However, studies have shown errors in this process are common. A number of factors in the emergency department environment as well as identifiable errant patterns of thinking can contribute to such challenges. Cognitive psychologists have described 2 types of thinking: system 1 (fast) relies primarily on intuition and pattern recognition, whereas system 2 (slow) is more deliberative and analytical. Reviewing how these 2 styles of thinking are applied in clinical practice provides a framework for understanding specific cognitive errors. This article uses illustrative examples to introduce many of these common errors, providing context for how and why they occur. In addition, a practical approach to reducing the risk of such errors is offered.
Distinctive features of SARS-CoV-2-specific T cells predict recovery from severe COVID-19
Authors: Neidleman Jason , Luo Xiaoyu , George Ashley F. , McGregor Matthew , Yang Junkai , Yun Cassandra , Murray Victoria , Gill Gurjot , Greene Warner C. , Vasquez Joshua , Lee Sulggi , Ghosn Eliver , Lynch Kara , Roan Nadia R. 
Published: January 2021

SUMMARYAlthough T cells are likely players in SARS-CoV-2 immunity, little is known about the phenotypic features of SARS-CoV-2-specific T cells associated with recovery from severe COVID-19. We analyzed T cells from longitudinal specimens of 34 COVID-19 patients with severities ranging from mild (outpatient) to critical culminating in death. Relative to patients that succumbed, individuals that recovered from severe COVID-19 harbored elevated and increasing numbers of SARS-CoV-2-specific T cells capable of homeostatic proliferation. In contrast, fatal COVID-19 displayed elevated numbers of SARS-CoV-2-specific regulatory T cells and a time-dependent escalation in activated bystander CXCR4+ T cells. Together with the demonstration of increased proportions of inflammatory CXCR4+ T cells in the lungs of severe COVID-19 patients, these results support a model whereby lung-homing T cells activated through bystander effects contribute to immunopathology, while a robust, non-suppressive SARS-CoV-2-specific T cell response limits pathogenesis and promotes recovery from severe COVID-19.Graphical AbstractHIGHLIGHTSDysfunctional spike-specific T cells are characteristic of severe COVID-19Spike-specific CD127+ Th1 cells are increased in survivors of severe COVID-19Spike-specific Tregs and IL6+ CD8+ T cells are increased in fatal COVID-19Escalation of activated lung-homing CXCR4+ T cells associates with fatal COVID-19BRIEF SUMMARYBy conducting CyTOF on total and SARS-CoV-2-specific T cells from longitudinal specimens spanning the entire spectrum of COVID-19 diseases, Neidleman et al. demonstrate that spike-specific Th1 cells capable of IL7-dependent homeostatic proliferation predict survival from severe COVID-19, while Tregs and IL6+ CD8+ T cells recognizing spike predict fatal outcome. Fatal COVID-19 is characterized by escalating activation of bystander CXCR4+ T cells in the lungs. Boosting SARS-CoV-2-specific CD4+ T effector responses while diminishing CXCR4-mediated homing may help recovery from severe disease.