bluuebunny/crossref_metadata_2025_split huggingface dataset:
Healthcare resource utilization and costs associated with COVID-19 among pediatrics managed in the community or hospital setting in England: a population-based cohort study
Authors: Yang Jingyan , Andersen Kathleen M. , Rai Kiran K. , Tritton Theo , Mugwagwa Tendai , Tsang Carmen , Reimbaeva Maya , McGrath Leah J. , Payne Poppy , Backhouse Bethany , Mendes Diana , Butfield Rebecca , Wood Robert , Nguyen Jennifer L. 
Published: August 2023

ABSTRACTBackgroundAlthough COVID-19 morbidity is significantly lower in pediatrics than in adults, the risk of severe COVID-19 may still pose substantial healthcare resource burden. This study aimed to describe healthcare resource utilization (HCRU) and costs associated with COVID-19 in pediatrics aged 1-17 years in England.MethodsA population-based retrospective cohort study of pediatrics with COVID-19 using Clinical Practice Research Datalink (CPRD Aurum) primary care data and, where available, linked Hospital Episode Statistics Admitted Patient Care (HES APC) secondary care data. HCRU and associated costs to the National Health Service (NHS) were stratified by age, risk of severe COVID-19, and immunocompromized status, separately for those with and without hospitalization records (hospitalized cohort: COVID-19 diagnosis August 2020-March 2021; primary care cohort: COVID-19 diagnosis August 2020-January 2022).ResultsThis study included 564,644 patients in the primary care cohort and 60 in the hospitalized cohort. Primary care consultations were more common in those aged 1-4 years (face-to-face: 4.3%; telephone: 6.0%) compared to those aged 5-11 (2.0%; 2.1%) and 12-17 years (2.2%; 2.5%). In the hospitalized cohort, mean [SD] length of stay was longer (5.0 [5.8] days) among those aged 12-17 years (n=24) than those aged 1-4 (n=15; 1.8 [0.9] days) and 5-11 years (n=21; 2.8 [2.1] days).ConclusionsMost pediatrics diagnosed with COVID-19 were managed in the community. However, hospitalizations were an important driver of HCRU and costs, particularly for those aged 12-17 years. Our results may help optimize the management and resource allocation of COVID-19 in this population.
Validation of the LINEAR deflation algorithm of the Midmark IQvitals Zone Vital Signs Monitor: improving patient comfort from quicker BP acquisition
Authors: Alpert Bruce S. 
Published: August 2023

AbstractObjectivesTo assess the accuracy of the Midmark IQvitals®Zone™ wireless vital signs monitor LINEAR deflation algorithm to the requirements of the ANSI/AAMI/ISO 81060-2 Standard and the British Hypertension Society (BHS) Protocol.MethodsThe Standard and BHS testing each call for ≥ 85 subjects with requirements for gender, blood pressure (BP), and arm circumference. The testers performing auscultation were blinded. Statistical calculations as per requirements were performed.ResultsThe mean ± SD for the 81060-2 Criterion 1 were 1.98 ± 6.90 mmHg for systolic and 0.54 ± 5.79 mmHg for diastolic BP. The Criterion 2 SD values were 5.60 mmHg for systolic and 5.26 mmHg for diastolic BP. All of these values passed the Standard requirements. The overall BHS rating was AA.ConclusionsThe Midmark LINEAR algorithm is validated based on the results. Use of the algorithm results in shorter cuff deflation times, thus improving patient comfort. The LINEAR algorithm has multiple features to improve BP measurement accuracy in critical patient populations.
Systematic Review and Meta-Analysis Protocol of the Efficacy and Safety of COVID-19 Drug Candidates Targeting Host Enzymes Involved in Immune Response
Authors: Mushebenge Aganze Gloire-Aimé , Ugbaja Samuel Chima , Mbatha Nonkululeko Avril , Riziki Manimani Ghislain , Muzumbukilwa Tambwe Willy , kadima Mukanda Gedeon , Kumalo Hezekiel M. 
Published: August 2023

ABSTRACTIntroductionCOVID-19 is a rapidly spreading infectious disease caused by the SARS-CoV-2 virus. Although several therapeutic interventions have been developed, the mortality rate of the disease remains high, and effective treatment options are urgently needed. Host-directed therapies targeting enzymes involved in the immune response represent a promising strategy for the development of novel therapeutics against COVID-19. This study aims to conduct a systematic review and meta-analysis of the literature to evaluate the potential of drug candidates targeting host enzymes involved in the immune response for the treatment of COVID-19.Methods and analysisWe will conduct a systematic search of electronic databases including PubMed, Embase, and Cochrane Library, as well as preprint servers and clinical trial registries for relevant studies. We will include randomized controlled trials, observational studies, and preclinical studies evaluating the efficacy of drug candidates targeting host enzymes involved in the immune response in COVID-19. Two reviewers will independently screen articles, extract data, and assess study quality. The primary outcome will be the effect of drug candidates on mortality, while secondary outcomes will include time to recovery, adverse events, and changes in immune markers. A meta-analysis will be performed to estimate pooled effect sizes of the interventions, and a narrative synthesis will be conducted for studies that are not amenable to quantitative analysis. This study will provide a comprehensive evaluation of the potential of host-directed therapies targeting enzymes involved in the immune response for the treatment of COVID-19. The results of this study may guide the development of novel therapeutics against COVID-19 and inform clinical practice.Ethics and disseminationThis study will review published data, and thus it is unnecessary to obtain ethical approval. The findings of this systematic review will be published in a peer-reviewed journal.PROSPERO registration numberCRD42023415110.
Assessing the role of rare pathogenic variants in heart failure progression by exome sequencing in 8,089 patients
Authors: Chazara Olympe , Dubé Marie-Pierre , Wang Quanli , Middleton Lawrence , Vitsios Dimitrios , Walentinsson Anna , Wang Qing-Dong , Hansson Kenny M. , Granger Christopher B. , Kjekshus John , Haefliger Carolina , Tardif Jean-Claude , Paul Dirk S. , Carss Keren 
Published: August 2023

AbstractMost therapeutic development is targeted at slowing disease progression, often long after the initiating events of disease incidence. Heart failure is a chronic, life-threatening disease and the most common reason for hospital admission in people over 65 years of age. Genetic factors that influence heart failure progression have not yet been identified. We performed an exome-wide association study in 8,089 patients with heart failure across two clinical trials, CHARM and CORONA, and one population-based cohort, the UK Biobank. We assessed the genetic determinants of the outcomes ‘time to cardiovascular death’ and ‘time to cardiovascular death and/or hospitalisation’, identifying seven independent exome-wide-significant associated genes,FAM221A,CUTC,IFIT5,STIMATE,TAS2R20,CALB2andBLK. Leveraging public genomic data resources, transcriptomic and pathway analyses, as well as a machine-learning approach, we annotated and prioritised the identified genes for further target validation experiments. Together, these findings advance our understanding of the molecular underpinnings of heart failure progression and reveal putative new candidate therapeutic targets.
Ezetimibe and Atherosclerotic Cardiovascular Disease: A Systematic Review and Meta-Analyses
Authors: Omidi Fatemeh , Rahmannia Maryam , Mohammadsharifi Parsa , Nasiri Mohammad Javad , Sarmastzadeh Tala 
Published: August 2023

AbstractIntroductionIndividuals diagnosed with atherosclerotic cardiovascular disease (ASCVD), particularly those who have experienced acute coronary syndrome (ACS) within the past year, are at a heightened risk of recurrent cardiovascular events. Lowering low-density lipoprotein cholesterol (LDL-C) levels has been proven effective in reducing this risk. However, there is a lack of a comprehensive meta-analysis investigating the LDL-C-lowering effectiveness and coronary atherosclerotic plaque compositions of Ezetimibe. This study aims to address this gap in knowledge.MethodsWe conducted a systematic review of randomized controlled trials that evaluated the LDL-C-lowering efficacy and coronary atherosclerotic plaques efficacy of ezetimibe in patients with ASCVD. We searched relevant databases, including MEDLINE, EMBASE, and the Cochrane Central Register of Controlled Trials, for publications from database inception until Jul 2023. Meta-analyses were performed to assess the LDL-C-lowering and coronary atherosclerotic plaques efficacy of ezetimibe in the overall ASCVD population.ResultsThe meta-analysis included a total of 20 eligible studies. Our findings revealed that combination therapy of ezetimibe with statins resulted in a more substantial absolute reduction in LDL-C compared to statin monotherapy (mean difference of (−14.06 mg/dL; 95% confidence interval [CI] −18.0 to −10.0; p = 0.0001) after 6-12 months of treatment (or at a time point nearest to 6 -12months). Moreover, the subgroups analysis indicates that the intervention measures were effective in reducing the volume of fibro-fatty plaque (FFP) when compared to the control group [weighted mean difference (WMD) = -1.01, 95% confidence interval (CI) (-3.6 and 1.6), and p = 0.003], necrotic core (NC) volume [WMD =-5.41, 95% CI(-13.3 and 2.5), and p = 0.35], and change dense calcification (change DC) volume [WMD =-1.14, 95% CI (- 1.4 and – 0.8), and p = 0.62] between the treatment group and the control group.ConclusionsOur study indicates that the addition of ezetimibe to statin therapy results in a modest yet significant further reduction in LDL-C compared to statin monotherapy. Ezetimibe led to a significant reduction in FFP volume; however, there were no statistically significant differences observed for NC, or change DC volumes.
Qualitative description of interpersonal HIV stigma and motivations for HIV testing among gays, bisexuals, and men who have sex with men in Ghana’s slums - BSGH-005
Authors: Abu-Ba’are Gamji Rabiu , Zigah Edem Yaw , Shamrock Osman Wumpini , Ogunbajo Adedotun , Dakpui Henry Delali , Agbemedu George Rudolph Kofi , Boyd Donte , Ezechie Oliver , Nelson LaRon , Torpey Kwasi 
Published: August 2023

AbstractDespite significant progress in Ghana’s HIV response, disparities in HIV prevalence persist among different populations. Gays, bisexuals, and other men who have sex with men (GBMSM) in the country remain vulnerable to HIV infection due to high levels of stigma and discrimination, limited access to healthcare services, and low HIV knowledge levels. While limited studies focus on HIV prevention and care in the Ghanaian GBMSM context, we did not find studies on GBMSM in slums. We, therefore, explored stigma and motivations of HIV testing among GBMSM in slums. In collaboration with our community partners, we recruited and conducted face-to-face interviews among 12 GBMSM from slums in Accra and Kumasi, Ghana. Our multiple-reviewer summative content analysis identified the following: under HIV stigma, we identified two categories, avoidance of GBMSM living with HIV and fear of testing positive for HIV. Under motivations for HIV testing, we identified three categories; HIV vulnerability, sexual health decision making, and positive messaging about HIV. Our findings provide valuable insights into stigma and motivations for HIV testing among GBMSM in Ghanaian slums. They also highlight the importance of targeted HIV education interventions to empower GBMSM to take responsibility for their sexual health and address the unique challenges they face accessing HIV testing services.
SARS-CoV-2 live virus culture and sample freeze-thaw stability
Authors: Kanki Phyllis J. , Hamel Donald J. , Riedel Stefan , Dutta Sanjucta , Cheng Annie , Chang Charlotte A. , Arnaout Ramy , Kirby James E. 
Published: August 2023

AbstractThe COVID-19 pandemic has presented unique diagnostic challenges including the need to store and test large number of samples for clinical and research studies. While SARS CoV-2 diagnosis relies on RT-qPCR and antigen testing, live virus culture remains an important surrogate for viral “infectiousness”, as we previously described in “SARS-CoV-2 Antigen Tests Predict Infectivity Based on Viral Culture: Comparison of Antigen, PCR Viral Load and Viral Culture Testing on a Large Sample Cohort” (Clin Microbiol Infect, 2022,PMC9293398). Live virus isolation and characterization has also been important to the SARS CoV-2 research community, to assess viral fitness, cellular tropism, and live virus neutralization, particularly with the emergence of new variants. Many clinical and research studies make use of samples that are frozen in transport media and investigated at later dates. The effect of freezing on RT-qPCR results is well established. However, the effect of freeze-thaw on viral viability has not been. Here, we therefore examined the effect of freeze-thaw on viral culture isolation from a large number of clinical samples that were split, and then cultured either fresh or after being frozen for 7 or 17-18 days. Samples represented the range of viral loads (genome copies/mL) observed in our patient population. We found that freeze-thaw did not significantly affect viral culture isolation. Therefore, the ability to assess infectiousness of samples previously frozen in transport medium appears to be maintained.
An example of too much too soon? A retrospective review of Caesarean Sections performed in the first stage of labour in Kenya
Authors: Allott Helen , Dickinson Fiona , Karangau Stephen , Oduor Michael , Shaaban Nassir , Ogoti Evans , Sawe Sheila , Ochola Ephraim , Ameh Charles 
Published: August 2023

AbstractObjectiveIn Kenya, decisions to perform CS are frequently made by unsupported non-specialist doctors, sometimes resulting in sub-optimal decision-making and inappropriate surgery. This study assesses decision-making in CS performed in the first stage of labour by a retrospective case review.MethodsA panel of expert obstetricians reviewed case-notes randomly selected from a series obtained from seven Kenyan referral hospitals, then discussed in pairs and as a group where opinions differed.ResultsOf the 87 case-notes reviewed consensus was achieved in 94.3% cases. In 41.3% cases, CS was considered appropriate by all assessors, including 8.9% cases where the CS was necessary but performed too late. The decision to delivery interval was 2 hours or longer in 65.8% cases, including 18 cases done for non-reassuring fetal status. In 10.3% it was considered that further reassessment should have occurred.In 9.2% the reviewers concluded that the CS was done too soon and alternative measures could have been taken. Insufficient information was available in the records to make a full assessment in 21.8% of cases and in 11.5% the CS was considered to be inappropriate.ConclusionsThis review suggests a need for improved support for decision-making, improved record-keeping and more timely surgery when indicated.SynopsisAt least 11.5% of Caesarean Sections in the first stage of labour could be avoided if decision-makers had access to support from more experienced practitioners.
Detection of autoantibodies against the acetylcholine receptor, evaluation of commercially available methodologies: fixed Cell-Based Assay, Radioimmunoprecipitation Assay and Enzyme-Linked Immunosorbent Assay
Authors: Diogenes Larissa , Dellavance Alessandra , Baldo Danielle Cristiane , Gozzi-Silva Sarah Cristina , Gomes Kethellen , Prado Monica Simon , Andrade Luis Eduardo C. , Keppeke Gerson Dierley 
Published: August 2023

AbstractIntroductionMyasthenia Gravis (MG) is an autoimmune disease resulting from the action of pathogenic autoantibodies (AAbs) directed against nicotinic acetylcholine receptors (AChR), which interfere with communication between the neurotransmitter acetylcholine and its receptor on the muscle fiber. The detection of anti-AChR using Radio Immuno Precipitation Assay (RIPA) has 100% specificity for the diagnosis of MG, however RIPA has high execution and interpretation complexity and requires radioactive materials, which restrict their use to specialized laboratories.ObjectiveWe compared the performance of the gold standard RIPA with different non-RIPA anti-AChR immunoassays, including a cell-based assay (CBA) and two solid-phase ELISA kits.Results145 samples were included with medical indication for anti-AChR testing. By the RIPA method, 63 were negative (RIPA-Neg <0.02 nmol/L), 17 were classified as Borderline(≥0.02 – 1 nmol/L), and 65 were positive (RIPA-Pos >1 nmol/L). The competitive ELISA yielded a poor performance with low Kappa agreement with RIPA (0.210). The indirect ELISA yielded a substantial Kappa agreement (Kappa=0.652), with ∼70% sensitivity and ∼96% specificity, compared to RIPA. In a semiquantitative analysis, there was a good Spearman correlation between the indirect ELISA and RIPA levels (r=0.845). The best performance was observed with the CBA that uses fixed cells expressing clustered AChR as antigenic substrate. There was an almost perfect agreement with RIPA (Kappa = 0.969), with ∼97% sensitivity and 100% specificity. However, in theBorderlinegroup, only 5 (∼30%) were positive using the CBA method, suggesting a slightly lower sensitivity for the CBA.ConclusionFor detection of anti-AChR reactivity, the indirect immunofluorescence assay yielded a very good analytical performance taking RIPA as the reference method, with potential to replace the RIPA in the clinical laboratory. ELISA could be an option to estimate anti-AChR AAb levels after confirming positivity by the CBA.
Flexible and Highly-Efficient Feature Perception for Molecular Traits Prediction via Self-interactive Deep Learning
Authors: Hu Yang , Sirinukunwattana Korsuk , Li Bin , Gaitskell Kezia , Bonnaffé Willem , Wojciechowska Marta , Wood Ruby , Alham Nasullah Khalid , Malacrino Stefano , Woodcock Dan , Verrill Clare , Ahmed Ahmed , Rittscher Jens 
Published: August 2023

ABSTRACTPredicting disease-related molecular traits from histomorphology brings great opportunities for precision medicine. Despite the rich information present in histopathological images, extracting fine-grained molecular features from standard whole slide images (WSI) is non-trivial. The task is further complicated by the lack of annotations for subtyping and contextual histomorphological features that might span multiple scales. This work proposes a novel multiple-instance learning (MIL) framework capable of WSI-based cancer morpho-molecular subtyping across scales. Our method, debuting as Inter-MIL, follows a weakly-supervised scheme. It enables the training of the patch-level encoder for WSI in a task-aware optimisation procedure, a step normally improbable in most existing MIL-based WSI analysis frameworks. We demonstrate that optimising the patch-level encoder is crucial to achieving high-quality fine-grained and tissue-level subtyping results and offers a significant improvement over task-agnostic encoders. Our approach deploys a pseudo-label propagation strategy to update the patch encoder iteratively, allowing discriminative subtype features to be learned. This mechanism also empowers extracting fine-grained attention within image tiles (the small patches), a task largely ignored in most existing weakly supervised-based frameworks. With Inter-MIL, we carried out four challenging cancer molecular subtyping tasks in the context of ovarian, colorectal, lung, and breast cancer. Extensive evaluation results show that Inter-MIL is a robust framework for cancer morpho-molecular subtyping with superior performance compared to several recently proposed methods, even in data-limited scenarios where the number of available training slides is less than 100. The iterative optimisation mechanism of Inter-MIL significantly improves the quality of the image features learned by the patch embedded and generally directs the attention map to areas that better align with experts’ interpretation, leading to the identification of more reliable histopathology biomarkers.
Semi-Quantitative Group Testing for Efficient and Accurate qPCR Screening of Pathogens with a Wide Range of Loads
Authors: Nambiar Ananthan , Pan Chao , Rana Vishal , Cheraghchi Mahdi , Ribeiro João , Maslov Sergei , Milenkovic Olgica 
Published: August 2023

SUMMARYPathogenic infections pose a significant threat to global health, affecting millions of people every year and presenting substantial challenges to healthcare systems worldwide. Efficient and timely testing plays a critical role in disease control and transmission prevention. Group testing is a well-established method for reducing the number of tests needed to screen large populations when the disease prevalence is low. However, it does not fully utilize the quantitative information provided by qPCR methods, nor is it able to accommodate a wide range of pathogen loads. To address these issues, we introduce a novel adaptive semi-quantitative group testing (SQGT) scheme to efficiently screen populations via two-stage qPCR testing. The SQGT method quantizes cycle threshold (Ct) values into multiple bins, leveraging the information from the first stage of screening to improve the detection sensitivity. DynamicCtthreshold adjustments mitigate dilution effects and enhance test accuracy. Comparisons with traditional binary outcome GT methods show that SQGT reduces the number of tests by 24% while maintaining a negligible false negative rate.
There’s an App for That: Exploring the Market for Contraceptive Fertility Tracking Apps in the Philippines
Authors: Danna K , Harris DM , Rothschild CW , Brogaard B , LaCroix E , Paudel M 
Published: August 2023

AbstractFor generations, women have relied on fertility awareness methods (FAM) to plan and prevent pregnancy; for over a decade, many have been aided by digital tools to do so. New Contraceptive Fertility Tracking Apps (CFTAs)--that are backed by clinical efficacy trials to support their effectiveness as contraception--have the potential to enhance method choice and offer users a unique contraceptive option, but there is little evidence to inform the decisions around expanding access, particularly in low-and middle-income countries (LMICs). We conducted a mixed methods study with quantitative online surveys (n=1600) and qualitative components (n=36) to explore the potential appeal of and demand for a hypothetical CFTA in one such market, the Philippines. Interest in using a CFTA was high among our internet-engaged, urban study population, with 83.9% “definitely” or “probably” interested in using. Across demographic profiles, respondents perceived the appeal of the method as “natural” and “convenient.” A majority were willing to pay for the method, though notably at a price (5.20 USD) below that of currently available CFTAs. We explore various factors to be considered before bringing a method like this to new markets, including equity constraints and the prevalence of other period-tracking apps not intended as contraception.