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Differentiating patients admitted primarily due to coronavirus disease 2019 (COVID-19) from those admitted with incidentally detected severe acute respiratory syndrome corona-virus type 2 (SARS-CoV-2) at hospital admission: A cohort analysis of German hospital records
- Ralf Strobl, Martin Misailovski, Sabine Blaschke, Milena Berens, Andreas Beste, Manuel Krone, Michael Eisenmann, Sina Ebert, Anna Hoehn, Juliane Mees, Martin Kaase, Dhia J. Chackalackal, Daniela Koller, Julia Chrampanis, Jana-Michelle Kosub, Nikita Srivastava, Fady Albashiti, Uwe Groß, Andreas Fischer, Eva Grill, Simone Scheithauer
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- Journal:
- Infection Control & Hospital Epidemiology / Volume 45 / Issue 6 / June 2024
- Published online by Cambridge University Press:
- 14 February 2024, pp. 746-753
- Print publication:
- June 2024
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Objective:
The number of hospitalized patients with severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) does not differentiate between patients admitted due to coronavirus disease 2019 (COVID-19) (ie, primary cases) and incidental SARS-CoV-2 infection (ie, incidental cases). We developed an adaptable method to distinguish primary cases from incidental cases upon hospital admission.
Design:Retrospective cohort study.
Setting:Data were obtained from 3 German tertiary-care hospitals.
Patients:The study included patients of all ages who tested positive for SARS-CoV-2 by a standard quantitative reverse-transcription polymerase chain reaction (RT-PCR) assay upon admission between January and June 2022.
Methods:We present 2 distinct models: (1) a point-of-care model that can be used shortly after admission based on a limited range of parameters and (2) a more extended point-of-care model based on parameters that are available within the first 24–48 hours after admission. We used regression and tree-based classification models with internal and external validation.
Results:In total, 1,150 patients were included (mean age, 49.5±28.5 years; 46% female; 40% primary cases). Both point-of-care models showed good discrimination with area under the curve (AUC) values of 0.80 and 0.87, respectively. As main predictors, we used admission diagnosis codes (ICD-10-GM), ward of admission, and for the extended model, we included viral load, need for oxygen, leucocyte count, and C-reactive protein.
Conclusions:We propose 2 predictive algorithms based on routine clinical data that differentiate primary COVID-19 from incidental SARS-CoV-2 infection. These algorithms can provide a precise surveillance tool that can contribute to pandemic preparedness. They can easily be modified to be used in future pandemic, epidemic, and endemic situations all over the world.
Assessment of perinatal anxiety: diagnostic accuracy of five measures
- Susan Ayers, Rose Coates, Andrea Sinesi, Helen Cheyne, Margaret Maxwell, Catherine Best, Stacey McNicol, Louise R. Williams, Nazihah Uddin, Una Hutton, Grace Howard, Judy Shakespeare, James J. Walker, Fiona Alderdice, Julie Jomeen, the MAP Study Team
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- Journal:
- The British Journal of Psychiatry / Volume 224 / Issue 4 / April 2024
- Published online by Cambridge University Press:
- 25 January 2024, pp. 132-138
- Print publication:
- April 2024
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Background
Anxiety in pregnancy and after giving birth (the perinatal period) is highly prevalent but under-recognised. Robust methods of assessing perinatal anxiety are essential for services to identify and treat women appropriately.
AimsTo determine which assessment measures are most psychometrically robust and effective at identifying women with perinatal anxiety (primary objective) and depression (secondary objective).
MethodWe conducted a prospective longitudinal cohort study of 2243 women who completed five measures of anxiety and depression (Generalized Anxiety Disorder scale (GAD) two- and seven-item versions; Whooley questions; Clinical Outcomes in Routine Evaluation (CORE-10); and Stirling Antenatal Anxiety Scale (SAAS)) during pregnancy (15 weeks, 22 weeks and 31 weeks) and after birth (6 weeks). To assess diagnostic accuracy a sample of 403 participants completed modules of the Mini-International Neuropsychiatric Interview (MINI).
ResultsThe best diagnostic accuracy for anxiety was shown by the CORE-10 and SAAS. The best diagnostic accuracy for depression was shown by the CORE-10, SAAS and Whooley questions, although the SAAS had lower specificity. The same cut-off scores for each measure were optimal for identifying anxiety or depression (SAAS ≥9; CORE-10 ≥9; Whooley ≥1). All measures were psychometrically robust, with good internal consistency, convergent validity and unidimensional factor structure.
ConclusionsThis study identified robust and effective methods of assessing perinatal anxiety and depression. We recommend using the CORE-10 or SAAS to assess perinatal anxiety and the CORE-10 or Whooley questions to assess depression. The GAD-2 and GAD-7 did not perform as well as other measures and optimal cut-offs were lower than currently recommended.
4481 Better Together Harrisburg: Community-Driven Research Day
- Andrea Murray, Martha Wadsworth, Jennifer Kraschnewski, Kathleen Best, Carmen Henry-Harris
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- Journal:
- Journal of Clinical and Translational Science / Volume 4 / Issue s1 / June 2020
- Published online by Cambridge University Press:
- 29 July 2020, pp. 81-82
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OBJECTIVES/GOALS: The overall goal of the Community-Engaged Research Core, supported by the Penn State Clinical and Translational Science Institute, is to invest in opportunities that promote collaboration between researchers and communities. Research in which community members are participating in the research process will more likely lead to reducing health disparities when compared to more traditional approaches. This abstract describes a community research day that brought researchers and community-based organizational leaders together to discuss critical areas of research. We aim to highlight a successful approach for how to work with a community, particularly one that has been distrustful of research, to facilitate and support collaborations between academic researchers and community-based organizational leaders (CBOs). Community-based organizational leaders are often the most knowledgeable individuals when it comes to identifying and discerning the needs and research priorities of their communities and they are generally in the best positions to help build greater trust between academic researchers and communities. METHODS/STUDY POPULATION: A Community Research Day Steering Committee was formed in the spring of 2018 and consisted of 10 community-based organizational leaders from Harrisburg, Pennsylvania, two Penn State University staff, and one Penn State University faculty member. The Steering Committee’s purpose was to design, plan, and execute an event (Better Together: Community Driven Awareness) in which community-organizational leaders and faculty researchers came together to discuss possible research collaborations to improve community health. The Steering Committee participated in bi-monthly planning meetings leading up to the event, Better Together: Community-Driven Awareness. During these planning meetings, members determined that mental health and nutrition were two critical areas deserving of more attention from research within their geographical community. Organizations were asked to identify sub-categories within mental health and nutrition that they saw as most relevant to their communities. The sub-categories that they selected became the theme topics for round table discussions at the main event. This information was also used to determine which academic researchers to invite to the event, based on scientific expertise. In addition to selecting these topics for table discussions, the Steering Committee provided advice on the agenda and program materials. The agenda for Better Together: Community-Driven Awareness featured a presentation from a successful collaboration between a faculty member and a community-based organization whose project was centered around suicide prevention in the school system. After the presentation, researchers and CBOs sat at round tables for facilitated discussions about their table’s theme. The facilitated discussions fostered new relationships and led to collaborations outside of the event. Following the round-table discussions, there was a presentation about funding and next steps. Lastly, feedback forms were given to each attendee to assess their experience of the event and to better understand what to improve upon for the future. RESULTS/ANTICIPATED RESULTS: Following the Community-Driven Awareness event, the Community-Engaged Research Core at Penn State released a call for proposals for planning grants to be awarded to faculty/community-based organization teams. These grants were intended to build capacity for externally-funded research that seeks to address important community-identified research questions. The internal grants support meetings to discuss mutual interests, develop research questions, identify leaders, conduct literature reviews, and collect pilot data. A team must have included, at a minimum, one Penn State faculty researcher and one community-based organizational leader as co-principal investigators. In the proposal, the team was asked to describe its preliminary research question, the work to be accomplished during the planning period, anticipated outcome(s) and deliverables, and preliminary ideas for seeking future external funding. A two-page narrative briefly described how the team members’ expertise/experience/constituencies would address the specified research question. In addition, the team provided a budget and budget justification. Planning grants ranged from $500-$5,000. Funds were allocated for a 6-12 month period. After the call was sent out, seven proposals were submitted and three were selected for external funding. Proposal topics included: * Exploring the Mechanism of Engagement in HIV Testing, Prevention, and Care Among African American and Hispanic/Latino Men who Have Sex with Men * Educator Translation of a Universal Social-Emotional Learning Program in School Practice * Growing Nutritious Communities: Gardening to increase access to and knowledge about fresh fruits and vegetables among residents in South Harrisburg, Hall Manor community. DISCUSSION/SIGNIFICANCE OF IMPACT: There are several academic institutions that have implemented similar events whose goal is to bring together academic researchers and community-based organizational leaders. To our knowledge, this is one of a few examples of an event that was developed from the ground up by a committee comprised mostly of community organization leaders. The community leaders guided the decisions made in all phases of the event design from determining the research themes to providing input on program materials. Additionally, our Steering Committee garnered the interest and attendance from over 20 community participating organizations, which attests to their commitment and dedication to seeing this event through from beginning to end. The feedback received from the event was overwhelmingly positive. Both academic researchers and community-based organizational leaders expressed their appreciation for an event that brought both parties together in a space where they felt comfortable to share ideas and knowledge. When asked how we could improve this event in the future, most attendees shared that they wanted more time and more opportunities to connect. One limitation of the event noted by attendees was that attendees were not able to sign up for the round table discussions themselves but were placed strategically at them by our Steering Committee. Therefore, at our next event, attendees will be able to select their tables and determine which themed topic they prefer to participate in. Lastly, we are considering how to best summarize the ideas that are generated from these round table discussions in a way that can be shared with the larger group and in a way that might foster collaborations outside of the event.
2′Halo-ATP and -GTP analogues: Rational phasing tools for protein crystallography
- MATHIAS GRUEN, CHRISTIAN BECKER, ANDREA BESTE, JOCHEN REINSTEIN, AXEL J. SCHEIDIG, ROGER S. GOODY
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- Journal:
- Protein Science / Volume 8 / Issue 11 / November 1999
- Published online by Cambridge University Press:
- 01 November 1999, pp. 2524-2528
- Print publication:
- November 1999
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The solution of the crystallographic macromolecular phase problem requires incorporation of heavy atoms into protein crystals. Several 2′-halogenated nucleotides have been reported as potential universal phasing tools for nucleotide binding proteins. However, only limited data are available dealing with the effect of 2′-substitution on recognition by the protein. We have determined equilibrium dissociation constants of 2′-halogenated ATP analogues for the ATP binding proteins UMP/CMP kinase and the molecular chaperone DnaK. Whereas the affinities to UMP/CMP kinase are of the same order of magnitude as for unsubstituted ATP, the affinities to DnaK are drastically decreased to undetectable levels. For 2′-halogenated GTP analogues, the kinetics of interaction were determined for the small GTPases p21ras(Y32W) (fluorescent mutant) and Rab5. The rates of association were found to be within about one order of magnitude of those for the nonsubstituted nucleotides, whereas the rates of dissociation were accelerated by factors of ∼100 (p21ras) or ∼105 (Rab5), and the resulting equilibrium dissociation constants are in the nm or μM range, respectively. The data demonstrate that 2′halo-ATP and -GTP are substrates or ligands for all proteins tested except the chaperone DnaK. Due to the very high affinities of a large number of GTP binding proteins to guanine nucleotides, even a 105-fold decrease in affinity as observed for Rab5 places the equilibrium dissociation constant in the μM range, so that they are still well suited for crystallization of the G-protein:nucleotide complex.