Studying the Long-term Impact of COVID-19 in Kids (SLICK). Healthcare use and costs in children and young people following community-acquired SARS-CoV-2 infection: protocol for an observational study using linked primary and secondary routinely collected healthcare data from England, Scotland and Wales.

INTRODUCTION: SARS-CoV-2 infection rarely causes hospitalisation in children and young people (CYP), but mild or asymptomatic infections are common. Persistent symptoms following infection have been reported in CYP but subsequent healthcare use is unclear. We aim to describe healthcare use in CYP following community-acquired SARS-CoV-2 infection and identify those at risk of ongoing healthcare needs. METHODS AND ANALYSIS: We will use anonymised individual-level, population-scale national data linking demographics, comorbidities, primary and secondary care use and mortality between 1 January 2019 and 1 May 2022. SARS-CoV-2 test data will be linked from 1 January 2020 to 1 May 2022. Analyses will use Trusted Research Environments: OpenSAFELY in England, Secure Anonymised Information Linkage (SAIL) Databank in Wales and Early Pandemic Evaluation and Enhanced Surveillance of COVID-19 in Scotland (EAVE-II). CYP aged ≥4 and <18 years who underwent SARS-CoV-2 reverse transcription PCR (RT-PCR) testing between 1 January 2020 and 1 May 2021 and those untested CYP will be examined.The primary outcome measure is cumulative healthcare cost over 12 months following SARS-CoV-2 testing, stratified into primary or secondary care, and physical or mental healthcare. We will estimate the burden of healthcare use attributable to SARS-CoV-2 infections in the 12 months after testing using a matched cohort study of RT-PCR positive, negative or untested CYP matched on testing date, with adjustment for confounders. We will identify factors associated with higher healthcare needs in the 12 months following SARS-CoV-2 infection using an unmatched cohort of RT-PCR positive CYP. Multivariable logistic regression and machine learning approaches will identify risk factors for high healthcare use and characterise patterns of healthcare use post infection. ETHICS AND DISSEMINATION: This study was approved by the South-Central Oxford C Health Research Authority Ethics Committee (13/SC/0149). Findings will be preprinted and published in peer-reviewed journals. Analysis code and code lists will be available through public GitHub repositories and OpenCodelists with meta-data via HDR-UK Innovation Gateway.

Functional connectivity dynamics among cortical neurons: a dependence analysis.

This paper quantifies and comparatively validates functional connectivity between neurons by measuring the statistical dependence between their firing rates. Based on statistical analysis of the pairwise functional connectivity, we estimate, exclusively from neural data, the neural assembly functional connectivity given a behavior task, which provides a quantifiable representation of the dynamic nature during the behavioral task. Because of the time scale of behavior (100-1000 ms), a statistical method that yields robust estimators for this small sample size is desirable. In this work, the temporal resolutions of four estimators of functional connectivity are compared on both simulated data and real neural ensemble recordings. The comparison highlights how the properties and assumptions of statistical-based and phase-based metrics affect the interpretation of connectivity. Simulation results show that mean square contingency (MSC) and mutual information (MI) create more robust quantification of functional connectivity under identical conditions than cross correlation (CC) and phase synchronization (PhS) when the sample size is 1 s. The results of the simulated analysis are extended to real neuronal recordings to assess the functional connectivity in monkey's cortex corresponding to three movement states in a food reaching task and construct the assembly graph given a movement state and the activation degree of a state-related assembly over time using the statistical test exclusively from neural data dependencies. The activation degree of a given state-related assembly reaches the peak repeatedly when the specific movement states occur, which also reveals the network of interactions among the neurons are key for the operation of a specific behavior.