bluuebunny/crossref_metadata_2025_split huggingface dataset:
Misdiagnosis of Pediatric Concussions in the Emergency Department
Authors: Wazir Adonis , Tamim Hani , Wakil Cynthia , Sawaya Rasha Dorothy 
Published: April 2022

ObjectiveWe aimed to determine the rate and predictors of correctly diagnosed concussions in the pediatric emergency department and to describe the characteristics, presentation, and management of concussions in children presenting for minor head injury.MethodsWe included 186 patients aged 5 to 18 years presenting within 24 hours of minor head injuries and met our diagnostic criteria for concussion. We compared patients correctly diagnosed with a concussion with those who were not. Our main outcome was the rate and predictors of misdiagnoses.ResultsOf the patients, 5.4% were correctly diagnosed. Amnesia was the only variable associated with correct diagnoses (40.0% vs 10.2%,P= 0.02). The most common mechanism of injury was fall (8.4%); the most frequent symptoms were nausea/vomiting (42.5%), and 48.4% had a brain computed tomography scan done.ConclusionsThe high rate of concussion misdiagnosis puts into question the usability of current concussion guidelines, their accuracy, and barriers to translation into clinical practice.
Diagnostic Value of Lactate Dehydrogenase and Uric Acid as Screening Tools for Malignancies in Children
Authors: Oriaifo Irene A. , Gerard James M. , Thomas Scott M. 
Published: April 2022

ObjectiveThe aim of this study was to determine the diagnostic value of lactate dehydrogenase (LDH) and uric acid (UA) in children undergoing evaluation for possible malignancies.MethodsThis was a retrospective chart review of patients aged 0 to 18 years presenting to an urban, tertiary care, pediatric hospital between July 1, 2011, and July 1, 2016. Patients were included if they had an LDH and/or UA level drawn, and they were excluded if they had a known cancer diagnosis. Sensitivity, specificity, and receiver operating characteristic curves were calculated for each biomarker.ResultsSix hundred five subjects were included in this study; 579 and 384 subjects had LDH and UA levels drawn, respectively; 15.7% had a final diagnosis of malignancy (49 leukemia, 46 nonleukemia).ConclusionThe specificities of both biomarkers for all types of malignancies were lower than their respective sensitivities. Comparing leukemic versus nonleukemic malignancies, the areas under the curve were 0.848 and 0.719, respectively, for LDH and 0.681 and 0.555, respectively, for UA.
Multicolor Imaging of Optic Disc Drusen
Authors: Yan Yan , Pugazhendhi Sangeethabalasri , Beres Shannon J , Liao Yaping Joyce 
Published: April 2022

Abstract:
Optic disc drusen (ODD) are calcified deposits at the anterior optic nerve that are often detectable by ophthalmic imaging, including optical coherence tomography and fundus autofluorescence imaging. Multicolor (MC) imaging is a novel modality that captures reflectance of blue, green, and near-infrared laser lights with confocal scanning laser ophthalmoscopy to rapidly acquire high-resolution reflectance images of the optic disc and retina. Here, we show an eye with 3 MC imaging features of ODD, including prominent green hyperreflectance of the optic disc, green sheathing of the papillary and peripapillary vasculature (arterioles > venules), and presence of orange superficial ODD. MC imaging can provide rapid high-resolution assessment of eyes with optic nerve head elevation to help distinguish pseudopapilledema vs papilledema in children and adults without dilation, and future large studies incorporating MC imaging will help determine its contribution in the diagnosis and monitoring of ODD and assessment of other causes of optic nerve head elevation.
Partial ORF1ab Gene Target Failure with Omicron BA.2.12.1
Authors: Rodino Kyle G. , Peaper David R. , Kelly Brendan J. , Bushman Frederic , Marques Andrew , Adhikari Hriju , Tu Zheng Jin , Rolon Rebecca Marrero , Westblade Lars F. , Green Daniel A. , Berry Gregory J. , Wu Fann , Annavajhala Medini K. , Uhlemann Anne-Catrin , Parikh Bijal A. , McMillen Tracy , Jani Krupa , Babady N. Esther , Hahn Anne M. , Koch Robert T. , Grubaugh Nathan D. ,   Yale SARS-CoV-2 Genomic Surveillance Initiative, Rhoads Daniel D. 
Published: April 2022

AbstractMutations in the viral genome of SARS-CoV-2 can impact the performance of molecular diagnostic assays. In some cases, such as S gene target failure, the impact can serve as a unique indicator of a particular SARS-CoV-2 variant and provide a method for rapid detection. Here we describe partial ORF1ab gene target failure (pOGTF) on the cobas® SARS-CoV-2 assays, defined by a ≥2 thermocycles delay in detection of the ORF1ab gene compared to the E gene. We demonstrate that pOGTF is 97% sensitive and 99% specific for SARS-CoV-2 lineage BA.2.12.1, an emerging variant in the United States with spike L452Q and S704L mutations that may impact transmission, infectivity, and/or immune evasion. Increasing rates of pOGTF closely mirrored rates of BA.2.12.1 sequences uploaded to public databases, and, importantly increasing local rates of pOGTF also mirrored increasing overall test positivity. Use of pOGTF as a proxy for BA.2.12.1 provides faster tracking of the variant than whole-genome sequencing and can benefit laboratories without sequencing capabilities.
Human Germline Heterozygous Gain-of-Function STAT6 Variants Cause Severe Allergic Disease
Authors: Sharma Mehul , Lu Henry Y. , Vaseghi-Shanjani Maryam , Del Bel Kate L. , Fornes Oriol , van der Lee Robin , Richmond Phillip A. , Lin Susan , Dalmann Joshua , Lee Jessica J. , Matthews Allison , Blanchard-Rohner Géraldine , van Karnebeek Clara D M , Bedford H. Melanie , Wasserman Wyeth W. , Seear Michael , McKinnon Margaret L. , Ahmed Hanan , Turvey Stuart E. 
Published: April 2022

ABSTRACTSTAT6 (Signal transducer and activator of transcription 6) is a transcription factor that plays a central role in the pathophysiology of allergic inflammation. STAT6 mediates the biological effects of IL-4, a cytokine necessary for type 2 differentiation of T cells and B cell survival, proliferation and class switching to IgE. We have identificated two unrelated patients with a phenotype notable for their early-life onset of profound allergic immune dysregulation, widespread treatment-resistant atopic dermatitis, hypereosinophilia with esosinophilic esophagitis, elevated serum IgE, IgE-mediated food allergies, and vascular anomalies of the brain. Both patients harbored heterozygous de novo missense variants in the DNA binding domain of STAT6 (c.1144G>C, p.E382Q; and c.1256A>G, p.D419G). Functional studies established that both variants caused a gain-of-function (GOF) phenotype associated with enhanced phosphorylation and transcriptional activity of STAT6, in addition to increased transcript abundance of known STAT6 target genes and other genes implicated in allergic disease. JAK inhibitors decreased the enhanced STAT6 responses associated with both these STAT6 GOF variants. This study identifies heterozygous GOF variants in STAT6 as a novel autosomal dominant allergic disorder. We anticipate that our discovery of the first humans with germline STAT6 GOF variants will facilitate the recognition of more affected individuals and the full definition of this new primary atopic disorder.
The Helping Older People Engage (HOPE) Study: Protocol & COVID Modifications for a Randomized Trial
Authors: Van Orden Kimberly A. , Conwell Yeates , Chapman Benjamin P. , Buttaccio April , VanBergen Alexandra , Beckwith Ellen , Santee Angela , Rowe Jody , Palumbos Deborah , Williams Geoffrey , Messing Susan , Sörensen Silvia , Tu Xin 
Published: April 2022

AbstractObjectivesEvidence-based strategies to reduce loneliness in later life are needed because loneliness impacts all domains of health, functioning, and quality of life. Volunteering is a promising strategy, as a large literature of observational studies documents associations between volunteering and better health and well-being. However, relatively few studies have used randomized controlled trials (RCTs) to examine benefits of volunteering, and none have examined loneliness. The primary objective of the Helping Older People Engage (HOPE) study is to examine the social-emotional benefits of a social volunteering program for lonely older adults. This manuscript describes the rationale and design of the trial.DesignRandomized controlled trial examining an existing community volunteering program available nationwide. We are randomly assigning adults aged 60 or older (up to 300) who report loneliness to 12 months of either AmeriCorps Seniors volunteering program or an active control (self-guided life review). Co-primary outcomes are assessed via self-report—loneliness (UCLA Loneliness Scale) and quality of life (WHOQOL-Bref). This trial is registered at clinicaltrials.gov (NCT03343483)SettingLifespan of Greater Rochester, a non-medical, community-based aging services agency (volunteering) and participants’ homes (control).ParticipantsAdult ages ≥60 years who endorsed feelings of loneliness (score of 6 or greater on the 3-item UCLA Loneliness Scale).InterventionThe interventions are 12-months of volunteer service with the AmeriCorps Seniors program or self-guided life review writing (active control).MeasurementsData were collected at baseline, 3-, 6-, and 12-months (loneliness) and baseline and 12-months (quality of life).TimelineEnrollment for this trial is underway and expected to finish by May 2022, with completion of follow-up assessments through April, 2023, and completion of primary outcomes soon thereafter.
Factors affecting oral health problems among school children in Kaski District, Nepal
Authors: Chapain Kamal Prasad , Rampal Krishna Gopal , Pokhrel Kalpana Gaulee , Adhikari Chiranjivi , Hamal Deependra , Pokhrel Khem Narayan 
Published: April 2022

AbstractIntroductionSchool children have a high prevalence of oral health problems in Nepal. Socio-demographic factors such as gender, parents’ socioeconomic status, and individual awareness of oral health may have an influence on the occurrence of oral health problems. However, little evidence is available about the oral health problems and their associated factors among school children. Therefore, this study aimed to assess the factors associated with oral health problems among school children in Nepal.MethodologyA cross-sectional study was conducted among school children of grade 7 in 12 schools of Kaski district, Gandaki Province, Nepal. The schools were randomly chosen from urban and semi-urban areas in the district. A total of 669 students participated in the study. Data were collected using a set of questionnaires covering dental health knowledge, socio-demographic characteristics, oral health condition and practices. The factors of poor oral health condition and practices were examined using t-test, one-way Anova, and multiple linear regression.ResultsSchool children who visited health institutions for oral health services and those with parents having higher level education had higher dental health knowledge scores. Total decayed score was higher among those who did not have knowledge that fluoride prevents decay compared to those who had knowledge about it (Have knowledge about fluoride prevents decay: Mean=1.21 (SD=1.54) Vs No knowledge: mean=2.13 (SD=2.13). Females were more likely to have higher DMFT score compared to males (β-coefficient=0.43, 95% CI=0.13, 0.73, P value=0.005) and increase in knowledge score was associated a with a decrease in DMFT score (β-coefficient=-0.09, 95% CI= -0.20, -0.10, P value=0.047).ConclusionThis study found that gender, knowledge score, and parent’s socioeconomic status were the major factors contributing to higher DMFT scores. School children should be provided with regular oral health counseling and promotion activities in schools and oral health screening in schools.
Predictors of Survival among 6-59 Months Old Children with Severe Acute Malnutrition: A Retrospective Cohort
Authors: Abate Mohammed , Gebre Abel , Bekele Bisrat Tamene , Dinkashe Fantaye Teka 
Published: April 2022

AbstractBackgroundUndernutrition among children is a significant contributor to the global disease burden and a leading cause of child mortality. Ethiopia, home to more than 16 million children under 5 years old, is one of the countries that have high levels of wasting. The aim of this study was to assess survival status and predictors of mortality among children with severe acute malnutrition admitted to Dubti Zonal Referral hospital from January 1/2017 to September 30/2019.MethodsFacility-based retrospective cohort was conducted among 331 severely acutely malnourished children. Data were collected from SAM management registration, individual patient cards and multi-charts admitted from January 1/2017 to September 30/2019. Cox-regression was used to characterize survival within the cohort and to estimate the effect of specific variables while controlling for potential confounders. The hazard ratio was used as a measure of the outcome. P-value less than 0.05 was considered statistically significant to identify independent predictors in multivariable analysis.ResultThe median age of study participants was 18 months and males were 187(56%). About half of 160 (48.3%) respondents were with co-morbidities during admission: diarrhea (44%) and pneumonia (26%) were the major co-morbidities. From a total of 331 SAM children, 255(77%) were recovered, 34(10%) died, and 40(12%) have defaulted from treatment. The main risk factors for earlier death of severely malnourished children were rural residence (AHR=1.6, 95% CI= 0.745-3.493), being on IV Infusion (AHR=2.5, 95% CI= 1.12-4.18), anemia during admission (AHR= 6.27, 95% CI =2.41-16.36) & pneumonia (AHR=0.27, 95% CI = 0.11-0.68)ConclusionsThe death rate was 10% which is close to the minimum SPHERE standard & national management protocol for SAM. Predictors for earlier hospital deaths were rural residence, IV infusion, Anemia, and Pneumonia.
Effects of boosted mRNA and adenoviral-vectored vaccines on immune responses to omicron BA.1 and BA.2 following the heterologous CoronaVac/AZD1222 vaccination
Authors: Suntronwong Nungruthai , Kanokudom Sitthichai , Auphimai Chompoonut , Assawakosri Suvichada , Thongmee Thanunrat , Vichaiwattana Preeyaporn , Duangchinda Thaneeya , Chantima Warangkana , Pakchotanon Pattarakul , Chansaenroj Jira , Puenpa Jiratchaya , Nilyanimit Pornjarim , Srimuan Donchida , Thatsanatorn Thaksaporn , Sudhinaraset Natthinee , Wanlapakorn Nasamon , Poovorawan Yong 
Published: April 2022

AbstractBackgroundThe coronavirus 2019 omicron variant has surged rapidly and raises concerns about immune evasion because it harbors mutations even in individuals with complete vaccination. Here, we examine the capability of the booster vaccination to induce neutralizing antibodies (NAbs) against omicron (BA.1 and BA.2) and T-cell responses.MethodsA total of 167 participants primed with heterologous CoronaVac/AZD1222 were enrolled to receive AZD1222, BNT162b2, or mRNA-1273 as a booster dose. Reactogenicity was recorded. Binding antibody, neutralizing antibody (NAb) titers against omicron BA.1 and BA.2, and total interferon gamma (IFN-γ) post-booster responses were measured.ResultsA substantial loss in neutralizing potency to omicron variant was found at 4 to 5 months after receiving the heterologous CoronaVac/AZD1222. Following booster vaccination, a significant increase in binding antibodies and neutralizing activities toward delta and omicron variants was observed. Neutralization to omicron BA.1 and BA.2 were comparable, showing the highest titers after boosted mRNA-1273 followed by BNT162b2 and AZD1222. Notably, boosted individuals with mRNA vaccines could induce T cell response. Reactogenicity was mild to moderate without serious adverse events.ConclusionsOur findings highlight that the booster vaccination could overcome immunity wanes and provide adequate NAbs coverage against omicron BA.1 and BA.2.
If Research is Not the Evidence, What is it? Egyptian Physicians’ Explanations of the Lack of Research Citations in their Health Vlogs
Authors: Atef Noha 
Published: April 2022

AbstractDoctor-influencers have the knowledge needed to understand scientific research, and they have the social media popularity to share it with large audiences. In this article, I explore the treatment of evidence in vlogs by Egyptian doctor-influencers: how they present it and what they use instead of it. I answer the following questions: 1) How do doctor-influencers present evidence on social media? 2) If evidence is not the research, then what is it? The data was collected through in-depth interviews with 12 Egyptian doctor-influencers from different specializations; two focus groups; and a critical discourse analysis of 48 of the influencers’ most popular and most engaging videos. I found that the doctor-influencers cited academic research only in the videos about medical controversies, new treatments, misinformation, or common medical mistakes. In most of their videos, the Egyptian doctor-influencers scarcely referred to medical research. This is because they believe that their audiences would not understand evidence due to their low educational attainment, weak research skills, and the language barrier (as most medical research is published in English rather than Arabic). These findings highlight the challenges of communicating science in societies with a low level of education. In these settings, communicators may need to move beyond mediating research studies on social media and instead focus on simplifying, translating, and connecting evidence-based information to the cultural context.
Trends in non-COVID-19 hospitalizations prior to and during the COVID-19 pandemic period, United States, 2017 – 2021
Authors: Cassell Kelsie , Zipfel Casey M , Bansal Shweta , Weinberger Daniel M. 
Published: April 2022

AbstractCOVID-19 pandemic-related shifts in healthcare utilization, in combination with trends in non-COVID-19 disease transmission and NPI use, had clear impacts on infectious and chronic disease hospitalization rates. Using a national healthcare billing database (C19RDB), we estimated the monthly incidence rate ratio of hospitalizations between March 2020 and June 2021 according to 19 ICD-10 diagnostic chapters and 189 subchapters. The majority of hospitalization causes showed an immediate decline in incidence during March 2020. Hospitalizations for diagnoses such as reproductive neoplasms, hypertension, and diabetes returned to pre-pandemic norms in incidence during late 2020 and early 2021, while others, like those for infectious respiratory disease, never returned to pre-pandemic norms. These results are crucial for contextualizing future research, particularly time series analyses, utilizing surveillance and hospitalization data for non-COVID-19 disease. Our assessment of subchapter level primary hospitalization codes offers new insight into trends among less frequent causes of hospitalization during the COVID-19 pandemic.
Factors Influencing Health Impacts among Smartphone Users in New Normal Situation: A Case Study among University Students in Thailand
Authors: Siriwong Wattasit , Frost Eric G. , Wilaiwan Wachiraporn 
Published: April 2022

AbstractBackgroundNowadays, smartphone users are increasing across the world. Smartphones have become a necessary thing in people’s life. Using smartphones have both benefits and health effects. Therefore, this study mainly aims to develop an appropriate mobile application to be the tool for health effects and finding factors associated with a health risk from smartphone usage.MethodsThis study was a cross-sectional descriptive study. The data was conducted in Thailand. The sample size was 500 university students. The Smartphone U Health mobile application was developed and shown in the Play Store and App Store. The self-administration was used for data collection throughout the Smart U Health. Data were entered and analyzed with licensed SPSS version 22.ResultsThe participants, including 328 females (65.6%) and 172 males (34.4%) with an average age was 20.3±1.5 years old. The average period of using smartphones was 7.9±2.0 years. The average time spent was 8.6±3.4 hours/day. The primary physical, mental, and social health effects from smartphone usage over three months were eye pain (93.8%), feeling bored (90.4%), the participants had a communication problem with other people (84.0%), respectively. In the multivariate analysis, the significant factors associated with a health risk from smartphone usage were faculty, income, using smartphones in the classroom, experience of resting their eyes before continuing. Moreover, knowledge and practice levels were significantly associated with health risk levels from smartphone usage.ConclusionOveruse of smartphones had many health effects. The Smart U Health mobile application might be the appropriate tool to assess smartphone users’ health risk levels. In the future, it may consider an intervention study to reduce health risks from smartphone usage.
Does greater longevity come with lower life disparity in India? A comparative study between Kerala and Delhi
Authors: Akhtar Saddaf Naaz , Anson Jon 
Published: April 2022

AbstractBackgroundLife expectancy and life disparity are two important measures for determining society’s health condition. Over last decades, Indian life expectancy has increased, reaching 69.4 years in 2018, with highest life expectancies being registered in Kerala and Delhi, with 75.3 years for both-sexes. Delhi has overtaken Kerala and is now top-ranking state in life expectancy. However, whether Delhi also has a lower disparity than Kerala is still unknown.ObjectivesTo assess age-at death distributions, trends in life expectancy and life disparity for Delhi and Kerala from 2010-2018; to assess patterns of life disparity and their relation to rising longevity; to show that, despite having similar life expectancies, life disparity varies between Delhi and Kerala.MethodsAbridged-life table from Sample Registration System from 2010-18 for Kerala and Delhi. Decomposition approach is performed to calculate age-specific contribution to changes in life expectancy and life disparity for each population.ResultsKerala showed inverse relationship between life expectancy and life disparity but not Delhi. Despite having a better Delhi’s life expectancy than Kerala during the study period, Delhi’s life disparity is still higher than Kerala’s. Disparities in life expectancy and life disparity between the two groups are closely related to their differences in age-specific mortality.ConclusionsGiven the ongoing demographic transition in India and spatial variations in it, this study is a welcome contribution to our understanding of India’s mortality decline. Our study has revealed that the life disparity in Delhi is higher than that in Kerala. This is because infant mortality in Delhi is higher than in Kerala whereas old age mortality is higher in Kerala than in Delhi.ContributionBeneficial in allocating healthcare resources to minimize both infants and old deaths and to attain equality in longevity and health.