bluuebunny/crossref_metadata_2025_split huggingface dataset:
Representation of Black patients in heart failure clinical trials
Authors: Azam Tariq U. , Colvin Monica M. 
Published: April 2021

Purpose of review
Black patients with heart failure in the United States are underrepresented in clinical trials relative to their overrepresentation in the heart failure population and in adverse heart failure outcomes. We aim to evaluate historical trends in this space and highlight recent developments.

Recent findings
Multiple landmark heart failure trials published since 2019 have underrepresented Black patients, though several discussed this lack of representation as limitations. A review of large heart failure clinical trials from 2001 to 2016 found persistent underrepresentation of Black patients without significant change over time. Trials enrolling from North America exclusively had more proportional representation, enrolling an average of 31.6% Black participants.

Summary
There is a shrinking proportion of Black patients in pivotal heart failure trials despite a higher prevalence of disease and associated adverse outcomes. There is increasing awareness of these disparities within the heart failure community, potentially leading to improved representation in future studies.
Can Use of Default Dispensing Quantities in Electronic Medical Record Lower Opioid Prescribing?
Authors: Chua Wee-Jhong , Groenewald Cornelius B. , Varakitsomboon Shing , Harris Jacob , Faino Anna V. , Quan Linda , Walco Gary A. , Sousa Ted C. 
Published: April 2021

Objectives
Leftover opioids can contribute to misuse and abuse. Recommended dosing quantities in the electronic medical record can guide prescribing patterns. We hypothesized that decreasing the default from 30 doses to 12 doses would decrease the overall number of opioids prescribed without increasing second opioid prescriptions or additional health utilization.

Methods
We performed a single-center retrospective study of children with forearm and elbow fractures who presented to the emergency department for evaluation and subsequent orthopedic follow-up between January 15, and September 19, 2017. The default dispensing quantity was decreased on June 1, 2016 from 30 doses to 12 doses. Patients were categorized to preintervention and postintervention groups. We compared the number of opioids prescribed, second opioid prescriptions, emergency department visits, and pain-related telephone calls and orthopedic visits with χ2 and logistic regression analyses.

Results
There were 1107 patients included. Rates of opioid prescribing were similar preintervention and postintervention (61% vs 56%, P = 0.13). After the change to the default quantity, the median number of doses decreased from 18 to 12 doses, with opioid prescriptions of 30 or more doses dropping from 35% to 11%. No significant association was found between preintervention versus postintervention, opioid prescription at discharge, and having 1 or more pain-related or unexpected follow-up visits.

Conclusions
Lowering the default dispensing quantity of opioids in the electronic medical record decreases the number of opioids prescribed without increasing second prescriptions or additional health care utilization. These findings suggest that a further reduction in the number of opioids prescribed for upper-extremity fractures may be possible.
Determining the cutoff points of the 5C scale for assessment of COVID-19 vaccines psychological antecedents among the Arab population: A multinational study
Authors: Ghazy Ramy Mohamed , ElHafeez Samar Abd , Shaaban Ramy , Elbarazi Iffat , Kheirallah Khalid A. , Abdou Marwa Shawky , Ramadan Ahmed 
Published: April 2021

AbstractBackgroundOne of the newly faced challenges during the COVID-19 is vaccine hesitancy (VH). The validated 5C scale, that assesses five psychological antecedents of vaccination, could be effective in exploring COVID-19 VH. This study aimed to determine a statistically valid cutoff points for the 5C sub-scales among the Arab population.MethodsA cross-sectional study was conducted among 446 subjects from three Arab countries (Egypt, United Arab Emirates UAE, and Jordan). Information regarding sociodemographics, clinical history, COVID-19 infection and vaccination history, and 5C scale were collected online. The 5C scores were analyzed to define the cutoff points using the receiver operating characteristic curve (ROC) and to verify the capability of the questionnaire to differentiate whether responders are hesitant or non-hesitant to accept vaccination. ROC curve analysis was conducted setting for previous vaccine administration as a response, with the predictors being the main five domains of the 5C questionnaire. The mean score of each sub-scale was compared with COVID-19 vaccine intakeResultsThe mean age of the studied population was 37±11, 42.9% were males, 44.8% from Egypt, 21.1% from Jordan, and 33.6% from UAE. Statistically significant differences between vaccinated and unvaccinated participants, respectively, weredetetd in the median score of confidence [6.0(1.3) versus 4.7(2.0)], complacency [(2.7(2.0) versus 3.0(2.0), constraints [1.7(1.7) versus 3.7(2.3)], and collective responsibility [6.7(1.7) versus 5.7(1.7)]. The area under the curve of the five scales was 0.72, 0.60, 0.76, 0.66, 0.66 for confidence, complacency, constraints, calculation, and collective responsibility at cutoff values of 5.7, 4.7, 6.0, 6.3, and 6.2, respectively.Conclusionthe Arabic validated version of the 5C scale has a good discriminatory power to predict COVID-19 vaccines antecedent.
Tobacco Smoking and Associated Factors among In-school Adolescents in Vietnam in 2013, 2019
Authors: Van Minh Hoang , Long Khuong Quynh , Van Vuong Do , Hung Nguyen Manh , Park Kidong , Takeuchi Momoe , Kashiwabara Mina , Lam Nguyen Tuan , Quynh Nga Pham Thi , Anh Le Phuong , Van Tuan Le , Bao Tran Quoc , Minh Anh Le Duong , Tuyet Hanh Tran Thi 
Published: April 2021

AbstractTobacco smoking is one of the most dangerous risk behaviors, leading to many adverse human health consequences. The aims of this study is to estimate the prevalence of tobacco smoking and related factor among adolescents aged 13–17 years in Vietnam. The data were from two rounds of the Vietnam Global School-based Student Health Survey (GSHS) that is the nationally representative survey conducted in 2013 and 2019. The logistic regressions were carried out to identify factors associated with tobacco smoking among study participants. We found the prevalence of current smoking (water pipe and cigarettes) reduced significantly from 5.4% (95% CI: 4.0–7.2) in 2013 to 2.8% (95% CI: 2.2–3.6) in 2019. In 2019, 2.6% of students used electronic cigarette products in the last 30 days. Factors associated with higher odds of current smoking status included study year, gender, parental monitoring, loneliness, suicide attempt, sexual intercourse, truancy, alcohol drinking. Similar patterns were found in e-cigarette use. Smoking among adolescents in Vietnam reduced between 2013 and 2019. Further follow-up studies are needed to confirm the causal factors of the reduction and e-cigarettes use.
Clinical Evidence for Improved Outcomes with Histamine Antagonists and Aspirin in 22,560 COVID-19 Patients
Authors: Mura Cameron , Preissner Saskia , Nahles Susanne , Heiland Max , Bourne Philip E. , Preissner Robert 
Published: April 2021

AbstractCOVID-19 has spurred much interest in the therapeutic potential of repurposed drugs. A family of acid-reducing drugs, known as histamine H2receptor antagonists (H2RA), competitively bind the H2R and block its stimulation by histamine; examples of such drugs are famotidine (e.g., Pepcid) and ranitidine (e.g., Zantac). A dense web of functionalities between histamine and H2RAs, on the one hand, and downstream cellular pathways, on the other hand, links disparate physiological pathways in gastrointestinal contexts (e.g., acid reduction) to the dysregulated inflammatory cas-cades (cytokine storm) underlying the pathophysiology of COVID-19. Is famotidine beneficial in treating COVID-19? This question remains unresolved, though not for lack of effort: over 10 studies have examined the potential therapeutic value of famotidine in COVID-19, but have found conflicting results (pro-famotidine, anti-famotidine, and neutral). Given the contradictory reports, we have undertaken the new analysis reported herein. Notably, studies published thus far rest upon substantially smaller datasets than drawn upon in the present work. We analyzed a cohort of 22,560 COVID-19 patients taking H1/H2receptor antagonists, focusing on 1,379 severe cases requiring respiratory support. We analyzed outcomes for treatment with the H1RAs loratadine (e.g., Claritin) and cetirizine (e.g., Zyrtec), the H2RA famotidine, aspirin, and a famotidine & aspirin combination. For cases that reached the point of respiratory support, we found a significantly reduced fatality risk for famotidine treatment. We did not detect a benefit from dual-histamine receptor blockade (concurrently targeting H1and H2receptors). Notably, famotidine combined with aspirin did exhibit a significant synergistic survival benefit (odds ratio of 0.55). The relative risk for death decreased by 32.5%--an immense benefit, given the more than 2.6 million COVID-19-related deaths thus far. We found lower levels of serum markers for severe disease (e.g., C-reactive protein) in famotidine users, consistent with prior findings by others and with a role for famotidine in attenuating cytokine release. The large, international, multi-center retrospective study reported here, sampling over 250,000 COVID-19 cases, hopefully helps clarify the possible value of clinically-approved histamine antagonists such as famotidine. Given these findings, alongside the cost-effectiveness and mild side-effects of popular drugs like famotidine and aspirin, we suggest that further prospective clinical trials, perhaps utilizing the aspirin combination reported here, are advisable.
Multiverse to inform neurological research: an example using recovery outcome of neglect
Authors: Moore Margaret J , Demeyere Nele 
Published: April 2021

AbstractObjectiveMultiverse analysis provides an ideal tool for understanding how inherent, yet ultimately arbitrary methodological choices impact the conclusions of individual studies. With this investigation we aimed to demonstrate the utility of multiverse analysis for evaluating generalisability and identifying potential sources of bias within studies employing neurological populations.MethodMultiverse analysis was used to evaluate the robustness of the relationship between post-stroke visuospatial neglect and poor long term recovery outcome within a sample of 1113 (age =72.5, 45.1% female) stroke survivors. A total of 25,600 t-test comparisons were run across 400 different patient groups defined using various combinations of valid inclusion criteria based on lesion location, stroke type, assessment time, neglect impairment definition, and scoring criteria across 16 standardised outcome measures.ResultsOverall, 33.9% of conducted comparisons yielded significant results. 99.9% of these significant results fell below the null specification curve, indicating a highly robust relationship between neglect and poor recovery outcome. However, the strength of this effect was not constant across all comparison groups. Comparisons which included <100 participants, pre-selected patients based on lesion type, or failed to account for allocentric neglect impairment were found to yield average effect sizes which differed substantially. Similarly, average effect sizes differed across various outcome measures with the strongest average effect in comparisons involving an activities of daily living measure and the weakest in comparisons employing a depression subscale.ConclusionsThis investigation demonstrates the utility of multiverse analysis techniques for evaluating effect robustness and identifying potential sources of bias within neurological research.
Clinical efficacy of Early Administration of Convalescent Plasma among COVID-19 Cases in Egypt
Authors: Asem Noha , Massoud Hossam Hosny , Serag Ihab , Hassany Mohamed , ElAssal Gehan , Abdelbary Akram , Mohsen Marwa , Baki Amin Abdel , Zaky Samy , Amin Wagdy , Kamal Ehab , Ibrahem Hamdy , Abdel Mohsen Ahmed Said , Ali Mohamed Ahmed , Elgendy Nancy , Elbadry Mohamed , Ahmed Salwa Hassan , shenouda Ahmed Naguib Nassif , Fathy Mohamed Abdelhamed , Zaid Hala 
Published: April 2021

AbstractImportanceEarly and effective treatment of COVID-19 is vital for control of SARS-CoV-2 infectionObjectivesThe primary objective of the study was to assess the degree of clinical improvement in severe and critically ill COVID-19 patients, treated early with early CPT.DesignsAn interventional, single-arm, non-randomized clinical trial conducted in Egypt from April 15 to July 21, 2020.SettingsThis was a multi-centre study conducted in 3 hospitals in Egypt.Participantsa total of 94 COVID-19 laboratory-confirmed patients using qRT-PCR were enrolled in the study.InterventionAll patients were administered with two plasma units (each unit is 200cc). The volume of donated plasma was 800cc.Main Outcome and MeasuresPrimary measure was the degree of clinical improvement among the COVID-19 patients who received CPT within seven daysResultsA total of 94 patients were enrolled who received CPT either within seven days or after seven days of hospitalization. 82 were severely ill, 12 were critically ill. The average age remained 58 years (±SD 15.1 years). Male were 69% and 49% patients got cured while 51% died with CFR 51%. 75% deaths were above 45years of age. The symptoms were dyspnoea (55%), fever (52%), cough (46%), and loss of taste and smell (21%), and cyanosis (15%). The most common co-morbidities among the <40 years remained Diabetes Mellitus (21%) and Asthma (14%). Among 40-60 years Hypertension (56%), Diabetes Mellitus (39%) and among >60 years age group Hypertension (57%) and Chronic Heart Disease (24%) were reported. CPT within seven days remained significant as compared with the CPT after seven days with the number of days to cure (p=0.007) and ICU stay (P=0.008) among severely ill cured cases.Conclusion and RelevanceAmong patients with COVID-19 and severe or critical illness, the use of CPT along with routine standard therapy resulted in a statistically significant improvement when administered within seven days of hospital admission. However, plasma transfusion, irrespective of days to transfusion may not help treat critically ill patients. The overall mean time to cure in severely ill patients was 15 days if CPT provided within seven days with 65% cure rate.Trial RegistrationClinical Intervention identifier: MOHP_COVID-19_Ver1.1
A phenotypic spectrum of autism is attributable to the combined effects of rare variants, polygenic risk and sex
Authors: Antaki D , Maihofer A , Klein M , Guevara J , Grove J , Carey Caitlin , Hong O , Arranz MJ , Hervas A , Corsello C , Muotri AR , Iakoucheva LM , Courchesne E , Pierce K , Gleeson JG , Robinson E , Nievergelt CM , Sebat J 
Published: April 2021

AbstractThe genetic etiology of autism spectrum disorder (ASD) is multifactorial with contributions from rare variants, polygenic risk, and sex. How combinations of factors determine risk for ASD is unclear. In 11,313 ASD families (N = 37,375 subjects), we investigated the effects rare and polygenic risk individually and in combination. We show that genetic liability for ASD differs by sex, with females having a greater polygenic load, and males having a lower liability threshold as evident by a negative correlation of rare and polygenic risk. Multiple genetic factors were associated with differing sets of behavioral traits with effects that differed by sex. Furthermore, the correlation of parental age with genetic risk for ASD was attributable tode novomutations and sex-biased effects of inherited risk in parents. Our results demonstrate that a phenotypic spectrum of ASD is attributable to the relative loadings and gene-by-sex effects of rare and common variation.
Visuomotor brain network activation and functional connectivity among individuals with autism spectrum disorder
Authors: Lepping Rebecca J. , McKinney Walker S. , Magnon Grant C. , Keedy Sarah K. , Wang Zheng , Coombes Stephen A. , Vaillancourt David E. , Sweeney John A. , Mosconi Matthew W. 
Published: April 2021

ABSTRACTSensorimotor abnormalities are common in autism spectrum disorder (ASD) and predictive of functional outcomes, though their neural underpinnings remain poorly understood. Using functional magnetic resonance imaging (fMRI), we examined both brain activation and functional connectivity during visuomotor behavior in 27 individuals with ASD and 30 typically developing (TD) controls (ages 9-35 years). Participants maintained a constant grip force while receiving visual feedback at three different visual gain levels. Relative to controls, ASD participants showed increased force variability, especially at high gain, and reduced entropy. Brain activation was greater in individuals with ASD than controls in supplementary motor area, bilateral superior parietal lobules, and left middle frontal gyrus at high gain. During motor action, functional connectivity was reduced between parietal-premotor and parietal-putamen in individuals with ASD compared to controls. Individuals with ASD also showed greater age-associated increases in functional connectivity between cerebellum and visual, motor, and prefrontal cortical areas relative to controls. These results indicate that visuomotor deficits in ASD are associated with atypical activation and functional connectivity of posterior parietal, premotor, and striatal circuits involved in translating sensory feedback information into precision motor behaviors, and that functional connectivity of cerebellar-cortical sensorimotor and non-sensorimotor networks show delayed maturation.HIGHLIGHTSIndividuals with ASD show impaired precision manual force control, especially when visual feedback is magnifiedVisuomotor deficits in ASD are associated with increased activity in frontal and parietal cortex and reduced parietal-frontal and parietal-putamen functional connectivityVisuomotor-dependent functional connectivity of cerebellum with visual, motor, and prefrontal cortices shows atypical age-associated trajectories in ASD
SARS-CoV-2 Detection in the Nasopharyngeal Swabs and Saliva of College Students using RT-qPCR and RT-LAMP
Authors: Bikos D. A. , Hwang C. , Brileya K. A. , Parker A. , Loveday E. K. , Rodriguez M. , Thornton I. , LeFevre T. , Wilking J. N. , Dills M. , Walk S. T. , Adams A. K. , Plowright R. K. , Hoegh A. B. , Carter J. R. , Morrow J. , Taylor M. P. , Keil D. E. , Fields M. W. , Chang C. B. 
Published: April 2021

AbstractBackgroundDiagnostic testing can identify outbreaks and inform preventive strategies for slowing the spread of SARS-CoV-2, the virus that causes Covid-19. The “gold standard” method for detection of SARS-CoV-2 is reverse transcription quantitative polymerase chain reaction (RT-qPCR) performed on samples collected using nasopharyngeal (NP) swabs. While NP RT-qPCR achieves high sensitivity, it requires trained personnel to administer and suffers from lengthy time-to-result. Instead, rapid saliva-based reverse transcription loop-mediated amplification (RT-LAMP) screening methods may offer advantages in sample collection and speed.MethodsRegardless of symptomatic presentation, a total of 233 individuals were tested for SARS-CoV-2 using NP RT-qPCR, alongside saliva-based RT-qPCR (SalivirDetect) and RT-LAMP (SLAMP), a simple and rapid fluorometric RT-LAMP assay performed directly on heat-inactivated saliva without any additional treatments or RNA extraction. SLAMP is conducted in triplicate and takes 45 min. Samples found negative using both saliva-based methods but positive under CDC NP RT-qPCR above the saliva method LoD were excluded from evaluation, suggesting significant differences in viral titer between sampling sites. Individuals who consumed potential inhibitors in the form of food, drink, and oral health products within 30 min of sampling were identified using a self-reported questionnaire.ResultsOf the 233 NP RT-qPCR tests, 58 were positive and 175 were negative. Comparatively, SLAMP resulted in 95% sensitivity and 98% specificity and SalivirDetect 97% sensitivity and 98% specificity. Prior consumption had no measurable effect on test outcomes, except for drinking, which lowered Ct values in saliva.ConclusionsSLAMP requires less technician and instrument time than CDC-approved NP RT-qPCR and demonstrates that saliva-based RT-LAMP can enable frequent and rapid identification of pre-symptomatic and asymptomatic SARS-CoV-2 infections with high sensitivity and specificity.
Genomic epidemiology of SARS-CoV-2 transmission lineages in Ecuador
Authors: Gutierrez Bernardo , Márquez Sully , Prado-Vivar Belén , Becerra-Wong Mónica , Guadalupe Juan José , da Silva Candido Darlan , Fernandez-Cadena Juan Carlos , Morey-Leon Gabriel , Armas-Gonzalez Rubén , Andrade-Molina Derly Madeleiny , Bruno Alfredo , de Mora Domenica , Olmedo Maritza , Portugal Denisse , Gonzalez Manuel , Orlando Alberto , Drexler Jan Felix , Moreira-Soto Andres , Sander Anna-Lena , Brünink Sebastian , Kühne Arne , Patiño Leandro , Carrazco-Montalvo Andrés , Mestanza Orson , Zurita Jeannete , Sevillano Gabriela , du Plessis Louis , McCrone John T. , Coloma Josefina , Trueba Gabriel , Barragán Verónica , Rojas-Silva Patricio , Grunauer Michelle , Kraemer Moritz U.G. , Faria Nuno R. , Escalera-Zamudio Marina , Pybus Oliver G. , Cárdenas Paúl 
Published: April 2021

AbstractCharacterisation of SARS-CoV-2 genetic diversity through space and time can reveal trends in virus importation and domestic circulation, and permit the exploration of questions regarding the early transmission dynamics. Here we present a detailed description of SARS-CoV-2 genomic epidemiology in Ecuador, one of the hardest hit countries during the early stages of the COVID-19 pandemic. We generate and analyse 160 whole genome sequences sampled from all provinces of Ecuador in 2020. Molecular clock and phylgeographic analysis of these sequences in the context of global SARS-CoV-2 diversity enable us to identify and characterise individual transmission lineages within Ecuador, explore their spatiotemporal distributions, and consider their introduction and domestic circulation. Our results reveal a pattern of multiple international importations across the country, with apparent differences between key provinces. Transmission lineages were mostly introduced before the implementation of non-pharmaceutical interventions (NPIs), with differential degrees of persistence and national dissemination.