bluuebunny/crossref_metadata_2025_split huggingface dataset:
A comparative analysis of the health, financial, equity, and cost-effectiveness impacts of maxillofacial surgery in Guinea
Authors: Hamer Mirjam , Alcorn Dennis , Diallo Ibrahima , Bah Fatoumata B.Y , Conde Alhassane , Traoré Lancinè , Millimounou Etienne , Peacock Chelsea , Glasgo Chris , Linz Peter E. , Shrime Mark , Diallo Oumar Raphiou 
Published: March 2021

AbstractBackgroundNon-governmental organizations (NGOs) play a substantive role in the delivery of surgical services in in low- and middle-income countries (LMICs).Assessment of their outcomes, especially as they relate to outcomes of surgery done in country, remains limited.MethodsA prospective analysis of maxillofacial surgery in Guinea. Outcomes of interest were changes in patient health, subjective well-being, and financial status; hardship financing and catastrophic expenditure; equitable distribution of surgical access; and cost-effectiveness.ResultsWe followed 569 patients requiring maxillofacial surgery in Conakry, Guinea, 114 of whom got care at local university hospitals, and 455 of whom got their care with Mercy Ships, a surgical NGO. Patients were followed for between three months (local) and one year (NGO). All patients reported significant improvement in objective and subjective measures of health and in financial status. Approximately half had to borrow and sell to get care, with NGO patients borrowing less, on average. However, NGO patients faced more risk of catastrophic expenditure (41.2% vs. 28.1%, p < 0.001). NGO patients were significantly poorer, whether financial status was measured by asset wealth or monthly income (p < 0.001). Finally, surgical care by the NGO was cost effective.ConclusionsIn a prospective analysis of surgical patients in an LMIC, we find that surgery improves health and financial well-being. NGOs may be able to reach patients who would not be able to get care through their local system; however, this comes at a cost of increased initial financial risk. Finally, NGO-based surgical care is cost-effective.
Remote Assessment of Cognition in Kids and Adolescents with Daytime Sleepiness: A pilot study of feasibility and reliability
Authors: Worhach Jennifer , Boduch Madeline , Zhang Bo , Maski Kiran 
Published: March 2021

AbstractIn this pilot study, we assessed the reliability of cognitive testing for kids and adolescents ages 8-19 years of age with narcolepsy or subjective daytime sleepiness compared to healthy controls. Forty-six participants took part in the study (n=18 with narcolepsy type 1, n=6 with subjective daytime sleepiness, and n= 22 healthy controls recruited from the community). Participants completed verbal (vocabulary testing) and non-verbal intelligence quotient (IQ) tasks (block design, matrix reasoning) from the Weschler Abbreviated Scale of Intelligence-Second Edition (WASI-II) in-person or remotely in their home through a HIPAA compliant telehealth web platform with conditions counterbalanced. We found that vocabulary T-scores showed good reliability with intraclass correlation coefficient (ICC) of 0.76 (95% CI: 0.64, 0.85) between remote and in-person testing conditions. Matrix Reasoning T-scores showed moderate reliability (ICC 0.69, 95% CI: 0.68, 0.90) and Block Design T-scores was poor between testing conditions. Bland-Altman plots showed outliers on vocabulary and matrix reasoning tasks performed better on remote assessments. Overall, the results of this pilot study support the feasibility and reliability of verbal and non-verbal IQ scores collected by telehealth. Use of telehealth to collect verbal and non-verbal IQ scores may offer a means to acquire cognitive data for pediatric sleep research through the COVID-19 pandemic and beyond.
Individual social contact data reflected SARS-CoV-2 transmission dynamics during the first wave in Germany better than population mobility data – an analysis based on the COVIMOD study
Authors: Tomori Damilola Victoria , Rübsamen Nicole , Berger Tom , Scholz Stefan , Walde Jasmin , Wittenberg Ian , Lange Berit , Mikolajczyk Rafael , Jaeger Veronika K , Karch André 
Published: March 2021

AbstractBackgroundThe effect of contact reduction measures on infectious disease transmission can only be assessed indirectly and with considerable delay. However, individual social contact data and population mobility data can offer near real-time proxy information.AimTo compare social contact data and population mobility data with respect to their ability to predict transmission dynamics during the first wave of the SARS-CoV-2 pandemic in Germany.MethodsWe quantified the change in social contact patterns derived from self-reported contact survey data collected by the German COVIMOD study from 04/2020-06/2020 (compared to the pre-pandemic period), and estimated the percentage mean reduction in the effective reproduction number R(t) over time. We compared these results to the ones based on R(t) estimates from open-source mobility data and to R(t) values provided by the German Public Health Institute.ResultsWe observed the largest reduction in social contacts (90%, compared to pre-pandemic data) in late April corresponding to the strictest contacts reduction measures. Thereafter, the reduction in contacts dropped continuously to a minimum of 73% in late June. R(t) estimates based on social contacts underestimated measured R(t) values slightly in the time of strictest contact reduction measures but predicted R(t) well thereafter. R(t) estimates based on mobility data overestimated R(t) considerably throughout the study.ConclusionsR(t) prediction accuracy based on contact survey data was superior to the one based on population mobility data, indicating that measuring changes in mobility alone is not sufficient for understanding changes in transmission dynamics triggered by public health measures.
A cost-effectiveness analysis of front-line treatment strategies in early stage follicular lymphoma
Authors: Tobin Joshua W.D. , Crothers Anna , Ma Ti Eric , Mollee Peter , Gandhi Maher K. , Scuffham Paul , Hapgood Greg 
Published: March 2021

AbstractRecent data suggests the use of radiotherapy alone (RT) in Early-Stage Follicular Lymphoma is declining. Cost-effectiveness analysis of treatments has not been performed. We constructed a partitioning model (15-year horizon) to compare RT, combined-modality therapy (CMT) and immunochemotherapy with rituximab maintenance (ICT+RM) from a PET-staged cohort from the Australian Lymphoma Alliance. Lifetime direct health care costs, quality-adjusted life-years (QALYs) and incremental cost-effectiveness ratios (ICERs) were calculated. AUD $75,000 was defined as the willingness-to-pay threshold (WTP). The direct healthcare costs were: RT $12,791, CMT $29,391 and ICT+RM $42,644. Compared with RT, CMT demonstrated minimal improvement in QALYs (+0.01) and an ICER well above the WTP threshold ($1,535,488). Compared with RT, ICT+RM demonstrated an improvement in QALYs (+0.41) with an ICER of $73,319. Modelling a 25% cost reduction with a rituximab biosimilar led to further ICER reductions with ICT+RM ($52,476). ICT+RM is cost-effective in early stage FL from the Australian taxpayer perspective.
Investigating the evolution of undergraduate medical students’ perception and performance in relation to an innovative curriculum-based research module: a convergent mixed methods study launching the 8A-Model
Authors: Otaki Farah , AlHashmi Deena , Khamis Amar Hassan , Azar Aida Joseph 
Published: March 2021

AbstractEmbedding an experiential research curriculum into medical programs is still not widely adopted. This study investigated, using convergent mixed methods design, the journey of medical students in relation to a research module. The students’ perception of the experience was qualitatively explored using thematic analysis. The students’ performance data were quantitatively analyzed using multi-repeated ANOVA.The exploration generated four themes: 1-Attend-Acquire, 2-Accumulate-Assimilate, 3-Apply-Appreciate, and 4-Articulate-Affect. Quantitatively, two distinct clusters of mean Grade Point Average were revealed (p<0.01). Joint display analysis enabled integrating the qualitative and quantitative findings, generating the 8A-Model. The students start appreciating the experience upon conducting their research.
Pooling-in-a-pod: A Strategy for COVID-19 Testing to Facilitate Safe Return to School
Authors: Berke Ethan M. , Newman Lori M. , Jemsby Suzanna , Hyde Bethany , Bhalla Natasha , Sheils Natalie E. , Oomman Nandini , Reppas John , Verma Prateek , Cangelosi Gerard A. 
Published: March 2021

ABSTRACTThe COVID-19 pandemic prompted widespread primary and secondary school closures. Routine testing of asymptomatic students and staff, as part of a comprehensive program, can help schools open safely. “Pooling-in-a-pod” is a public health surveillance strategy whereby testing cohorts (pods) are based on social relationships and physical proximity. Pooled testing provides one laboratory result for the entire pod, rather than separate results for each individual. Pooling-in-a-pod allowed for weekly on-site point-of-care testing of all staff and students at an independent preschool to grade 12 school in Washington, D.C. Staff and older students self-collected anterior nares samples, and trained staff collected samples from younger students. Overall, 12,885 samples were tested in 1,737 pools for 863 students and 264 staff between November 30, 2020, and April 30, 2021. The average pool size was 7.4 people. Sample collection to pool result time averaged 40 minutes. Direct testing cost per person per week was $$24.24, including swabs. Four surveillance test pools were positive. During the study period, daily new cases in Washington, D.C., ranged from 10 to 46 per 100,000 population. A post-launch survey found most parents (90.3%), students (93.4%), and staff (98.8%) were willing to participate in pooled testing with confirmatory tests for positive pool members. The school reported a 73.4% decrease in virtual learning after program initiation. Pooling-in-a-pod is a feasible and cost-effective surveillance strategy that was acceptable to staff and families and may be appropriate for some schools. School officials and policymakers can leverage this strategy to facilitate safe, sustainable, in-person schooling.
Slow Motion Analysis of Repetitive Tapping (SMART) test: measuring bradykinesia in recently diagnosed Parkinson’s disease and idiopathic anosmia
Authors: Simonet C. , Galmes MA. , Lambert C. , Rees RN. , Haque T. , Bestwick JP. , Lees AJ. , Schrag A. , Noyce AJ. 
Published: March 2021

ABSTRACTBackgroundBradykinesia is the defining motor feature of Parkinson’s disease (PD). There are limitations to its assessment using standard clinical rating scales, especially in the early stages of PD when a floor effect may be observed.ObjectivesTo develop a quantitative method to track repetitive finger tapping movements and to compare people in the early stages of PD, healthy controls, and individuals with idiopathic anosmia.MethodsThis was a cross-sectional study of 99 participants (early-stage PD=26, controls=64, idiopathic anosmia=9). For each participant, repetitive finger tapping was recorded over 20 seconds using a smartphone at 240 frames per second. Three parameters were extracted from videos: amplitude between fingers, frequency (number of taps per second), and velocity (distance travelled per second). Clinical assessment was based on the motor section of MDS-UPDRS.ResultsPeople in the early stage of PD performed the task with slower velocity (p<0.001) and with greater decrement in frequency than controls (p=0.003). The combination of slower velocity and greater decrement in frequency obtained the best accuracy to separate early-stage PD from controls based on metric thresholds alone (AUC = 0.88). Individuals with anosmia exhibited slower velocity (p=0.001) and smaller amplitude (p<0.001) compared with controls.ConclusionsWe present a new simple method to detect early motor dysfunction in PD. Mean tap velocity appeared to be the best parameter to differentiate patients with PD from controls. Patients with anosmia also showed detectable differences in motor performance compared with controls which may be important indication of the prodromal phase of PD.
SARS-CoV-2 new infections among health care workers after the first dose of the BNT162b2 mRNA Covid-19 Vaccine
Authors: Guijarro Carlos , Galán Isabel , MartÍnez-Ponce Diana , Pérez-Fernández Elia , Goyanes Maria José , Castilla Virgilio , Velasco MarÍa 
Published: March 2021

AbstractObjectivesTo evaluate the effect of mRNA SARS-Cov-2 vaccination on the incidence of new SARS-CoV-2 infections in health care workers (HCW).MethodsThe evolution of the incident rate of microbiologically confirmed SARS-CoV-2 infection in a cohort of 2590 HCW after BNT162b2 mRNA SARS-CoV-2 vaccination, as compared to the rate in the community (n=170513) was evaluated by mixed Poisson regression modelsResultsA total of 1820 HCW (70,3% of total) received the first dose of the BNT162b2 mRNA vaccine between January 10-16, 2021), and 296 (11,4%) the following week. All of them completed vaccination 3 weeks later. Incidence rates of SARS-CoV-2 infection after the first dose of mRNA SARS-CoV-2 vaccine declined by 71% (Incidence Rate Ratio (IRR) 0.286, 95% confidence interval (CI) 0.174-0.468, p< 0.001) and by 97% (IRR 0.03 95% CI 0.013-0.068, p<0.001) after the second dose as compared to the perivaccine time. SARS-CoV-2 incidence rates in the community (with a negligible vaccination rate) had a much lower decline: 2% (IRR 0.984; 95% CI 0.943-1.028; p = 0.47) and 61% (IRR 0.390, 95% CI 0.375-0.406; p<.001) for equivalent periods. Adjusting for the decline in the community, the reduction in the incident rates among HCW were 73% (IRR 0.272; 95% CI 0.164-0.451 p<0.001) after the first dose of the vaccine and 92 % (IRR 0.176, 95% CI 0.033-0.174; p<0.001) after the second dose.ConclusionsmRNA SARS-CoV-2 vaccination is associated with a dramatic decline in new SARS-CoV-2 infection among HCW, even before the administration of the second dose of the vaccine.
Antibody response to first and second dose of BNT162b2 in a cohort of characterized healthcare workers
Authors: Padoan Andrea , Dall’Olmo Luigi , Rocca Foscarina della , Barbaro Francesco , Cosma Chiara , Basso Daniela , Cattelan Annamaria , Cianci Vito , Plebani Mario 
Published: March 2021

AbstractBackgroundVaccine-induced population immunity is a key global strategy to control coronavirus disease 2019 (COVID-19). The rapid implementation and availability of several COVID-19 vaccines is now a global health-care priority but more information about humoral responses to single- and double-dose vaccine is neededMethods163 health care workers (HCW) of the Padua University Hospitals, who underwent a complete vaccination campaign with BNT162b2 vaccine were asked to collect serum samples at 12 (t12) and 28 (t28) days after the first inoculum to allow the measurement of SARS-CoV-2 Antibodies (Ab) using chemiluminescent assays against the spike (S) protein and the Receptor Binding Domain (RBD) of the virus, respectively.ResultsSignificant differences were found at t12 for infection-naïve and subjects with previous-natural infection who present higher values of specific antibodies, while no significant differences have been found between t12 and t28. No statistically significant difference was found between male and female, while lower Ab levels have been observed in subjects older than 60 years at t12 but not at t28.ConclusionsOur study confirms observed differences in vaccine responses between infection-naïve and subjects with previous natural infection at t12 but not for a longer time. The influence of sex and age deserves further studies, even if the relationship with age seems particularly significant.
The interplay of policy, behavior, and socioeconomic conditions in early COVID-19 epidemiology in Georgia
Authors: Harris Mallory J. , Tessier-Lavigne Ella , Mordecai Erin A. 
Published: March 2021

AbstractTo investigate the impact of local public health orders, behavior, and population factors on early epidemic dynamics, we investigated variation among counties in the U.S. state of Georgia. We conducted regressions to identify predictors of (1) local public health orders, (2) mobility as a proxy for behavior, and (3) epidemiological outcomes (i.e., cases and deaths). We used an event study to determine whether social distancing and shelter-in-place orders caused a change in mobility.Counties at greater risk for large early outbreaks (i.e., larger populations and earlier first cases) were more likely to introduce local public health orders. Social distancing orders gradually reduced mobility by 19% ten days after their introduction, and lower mobility was associated with fewer cases and deaths. Air pollution and population size were predictors of cases and deaths, while larger elderly or Black population were predictors of lower mobility and greater cases, suggesting self-protective behavior in vulnerable populations. Early epidemiological outcomes reflected responses to policy orders and existing health and socioeconomic disparities related to disease vulnerability and ability to socially distance. Teasing apart the impact of behavior changes and population factors is difficult because the epidemic is embedded in a complex social system with multiple potential feedbacks.
Trajectories of imitation skills in preschoolers with Autism Spectrum Disorders
Authors: Pittet Irène , Kojovic Nada , Franchini Martina , Schaer Marie 
Published: March 2021

AbstractImitation skills play a crucial role in social cognitive development from early childhood. Many studies have shown a deficit in imitation skills in children with Autism Spectrum Disorders (ASD). Little is known about the development of imitation behaviors in children with ASD. This study aims to measure the trajectories of early imitation skills in preschoolers with ASD and how these skills impact other areas of early development. For this purpose, we assessed imitation, language and cognition skills in 177 children with ASD and 43 typically developing children (TD) aged 2 to 5 years old, 126 of which were followed longitudinally, yielding a total of 396 time-points. Our results confirmed the presence of an early imitation deficit in toddlers with ASD compared to TD children. The study of the trajectories showed that these difficulties were marked at the age of two years, and gradually decreased until the age of 5 years old. Imitation skills were strongly linked with cognitive, language skills and level of symptoms in our ASD group at baseline. Moreover, the imitation skills at baseline were predictive of the language gains a year later in our ASD group. Using a data-driven clustering method, we delineated different developmental trajectories of imitation skills within the ASD group. The clinical implications of the findings are discussed, particularly the impact of an early imitation deficit on other areas of competence of the young child.
SARS-CoV-2 Antibody persistence in COVID-19 convalescent plasma donors
Authors: Di Germanio Clara , Simmons Graham , Kelly Kathleen , Martinelli Rachel , Darst Orsolya , Azimpouran Mahzad , Stone Mars , Hazegh Kelsey , Grebe Eduard , Zhang Shuting , Ma Peijun , Orzechowski Marek , Gomez James E , Livny Jonathan , Hung Deborah T. , Vassallo Ralph , Busch Michael P. , Dumont Larry J. 
Published: March 2021

ABSTRACTBackgroundAntibody response duration following SARS-CoV-2 infection tends to be variable and depends on severity of disease and method of detection.Study design and methodsCOVID-19 convalescent plasma (CCP) from 18 donors was collected longitudinally for a maximum of 63 - 129 days following resolution of symptoms. All the samples were initially screened by the Ortho Total Ig test to confirm positivity and subsequently tested with 7 additional direct sandwich or indirect binding assays (Ortho, Roche, Abbott, Broad Institute) directed against a variety of antigen targets (S1, RBD, and NC), along with 2 neutralization assays (Broad Institute live virus PRNT and Vitalant Research Institute Pseudovirus RVPN).ResultsThe direct detection assays (Ortho Total Ig total and Roche Total Ig) showed increasing levels of antibodies over the time period, in contrast to the indirect IgG assays that showed a decline.Neutralization assays also demonstrated declining responses; the VRI RVPN pseudovirus had a greater rate of decline than the Broad PRNT live virus assay.DiscussionThese data show that in addition to variable individual responses and associations with disease severity, the detection assay chosen contributes to the heterogeneous results in antibody stability over time. Depending on the scope of the research, one assay may be preferable over another. For serosurveillance studies, direct, double Ag-sandwich assays appear to be the best choice due to their stability; in particular, algorithms that include both S1 and NC based assays can help reduce the rate of false-positivity and discriminate between natural infection and vaccine-derived seroreactivity.
Evaluation of Clinical Threshold Policies for Cataract Surgery and the Regional Variation in Rates of Surgery
Authors: Lisle J. , Ansari N. , Jabir M. 
Published: March 2021

AbstractBackground/AimsTo characterise the national patterns in rates of cataract surgery across England, review clinical thresholds against NICE guidance, and determine how far variable access to cataract surgery is attributable to regional variation in policy stringency and social deprivation.Methods127 Clinical Commissioning Groups (“CCGs”) provided cataract surgery data and threshold policies in response to a Freedom of Information request. Local cataract surgery rates were grouped by threshold stringency and analysed on an age group-corrected basis. ANOVA testing was used to assess effect of policy stringency on regional rates of cataract surgery.ResultsIn England, rates of cataract surgery vary threefold across CCGs, from 1,980 to 6,427 per 100,000 population over 60, with a standard deviation (784.76) of 22% of the mean value, 3,598. Threshold policies vary across CCGs: 33 had no policy, 45 utilised policies accessible on the basis of Quality of Life (“QoL”) impact, and 39, against NICE guidance, required a Visual Acuity (“VA”) threshold be exceeded. Rates of surgery by CCG were negatively correlated with restrictiveness of policy (η2=0.18, p<0.01), and positively correlated with the Index of Multiple Deprivation (IMD), (r2□=□0.11, p<0.01). Prior approval processes are not significantly associated with reduced rates of surgery.ConclusionOver two-thirds of CCGs continue to use threshold-based policies for access to cataract surgery, with one-third doing so solely on the basis of VA requirements, despite NICE guidance to the contrary. For NHS operations, variation in policy restrictiveness accounts for more of the variation in surgery rates than socioeconomic deprivation.
Comparison of cough particle exposure for indoor commercial and aircraft cabin spaces
Authors: Davis Angela C. , Menard Danny J. , Clark Andrew D. , Cummins Joshua J. , Olson Nels A. 
Published: March 2021

AbstractTo compare the transport of respiratory pathogens, computational fluid dynamics (CFD) simulations were performed to track particles released by coughing from a passenger on a Boeing 737 aircraft, and by a person in a comparable indoor commercial space. Simulation data were post-processed to calculate the amounts of particles inhaled by nearby persons in both environments. The effects of different airflow rates, placement of air inlets, positioning and distances between index (coughing) and susceptible (inhaling) persons were also analyzed. The removal of airborne particles from the indoor environment, due ventilation and deposition onto surfaces, was compared to that of an aircraft cabin. In an aircraft cabin 80% of the particles were removed 5 to 12 times faster than in the indoor commercial space; ultimately resulting in 7 times less particulate mass inhaled in the aircraft cabin.