bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cross-country analysis of higher education institutions’ efficiency: The role of strategic positioning
Authors: Agasisti Tommaso , Berbegal-Mirabent Jasmina 
Published: September 2020

AbstractUniversities are highly heterogeneous institutions and this diversity needs to be acknowledged when assessing their performance. Using an unbalanced panel that covers a 3-year period (2011–3) with 761 observations coming from 307 universities located in 8 European countries, this study examines the extent to which strategic choices regarding international positioning and scope determine how efficient universities are in the allocation of their internal resources. Three main groups of universities are identified, according to their internationalisation and scope: world-class, flagship, and regional. Next, we model universities’ objective function as a mix of teaching, research, and third mission endeavours, and calculate efficiency scores. A meta-frontier analysis based on data envelopment analysis is used. This approach allows comparing efficiency frontiers across groups and relative to a common frontier. Policy implications within and between groups are discussed.
Close Relationships in Close Elections
Authors: Lee Byungkyu 
Published: September 2020

Abstract
Close elections are rare, but most Americans have experienced a close election at least once in their lifetime. How does intense politicization in close elections affect our close relationships? Using four national egocentric network surveys during the 1992, 2000, 2008, and 2016 election cycles, I find that close elections are associated with a modest decrease in network isolation in Americans’ political discussion networks. While Americans are more politically engaged in close elections, they also are less likely to be exposed to political dissent and more likely to deactivate their kinship ties to discuss politics. I further investigate a potential mechanism, the extent of political advertising, and show that cross-cutting exposure is more likely to disappear in states with more political ads air. To examine the behavioral consequence of close elections within American families, I revisit large-scale cell phone location data during the Thanksgiving holiday in 2016. I find that Americans are less likely to travel following close elections, and that families comprised of members with strong, opposing political views are more likely to shorten their Thanksgiving dinner. These results illuminate a process in which politicization may “close off” strong-tied relationships in the aftermath of close elections.
Preferences for Tobacco Cessation Information and Support During Covid-19
Authors: Pettigrew Simone , Jun Min , Roberts Ian , Bullen Chris , Nallaiah Kellie , Rodgers Anthony 
Published: September 2020

Objective:
To identify how best to provide smoking cessation advice and support during the Covid-19 pandemic. Preferences were assessed in relation to: (i) specific forms of tobacco cessation support (eg, nicotine replacement therapy (NRT) and various counseling formats); (ii) information sources (eg, government officials, doctors); and (iii) channels via which to receive relevant information (eg, television, social media).

Methods:
An online survey was administered to adults who smoke tobacco in Australia (n = 604) and the UK (n = 600). Descriptive analyses were conducted to identify levels of interest in cessation support and information provision. Differences in responses according to demographic characteristics and smoking history were assessed.

Results:
Around half of the respondents were interested in receiving personal counseling and/or participating in a text support program over the next month. By far the most popular delivery mechanism for personal counseling was email. Three-quarters of the sample expressed an interest in receiving free, home-delivered NRT. The most popular information sources nominated by respondents seeking more information about smokers’ Covid-related risks were government departments and their doctor/general practitioner. Television and online news sources were the most preferred information dissemination channels.

Conclusions:
The substantial levels of interest expressed in accessing various forms of cessation assistance within the next month suggest that Covid-19 may be increasing receptiveness to quitting. The strong interest in free, home-delivered NRT indicates that this may be a useful mechanism for facilitating quit attempts during the pandemic.
The NADase enzyme CD38: an emerging pharmacological target for systemic sclerosis, systemic lupus erythematosus and rheumatoid arthritis
Authors: Peclat Thais Ribeiro , Shi Bo , Varga John , Chini Eduardo Nunes 
Published: September 2020

Purpose of review
Here we review recent literature on the emerging role of nicotinamide adenine dinucleotide (NAD+) metabolism and its dysfunction via the enzyme CD38 in the pathogenesis of rheumatologic diseases. We evaluate the potential of targeting CD38 to ameliorate NAD+-related metabolic imbalance and tissue dysfunction in the treatment of systemic sclerosis (SSc), systemic lupus erythematous (SLE), and rheumatoid arthritis (RA).

Recent findings
In this review, we will discuss emerging basic, preclinical, and human data that point to the novel role of CD38 in dysregulated NAD+-homeostasis in SSc, SLE, and RA. In particular, recent studies implicate increased activity of CD38, one of the main enzymes in NAD+ catabolism, in the pathogenesis of persistent systemic fibrosis in SSc, and increased susceptibility of SLE patients to infections. We will also discuss recent studies that demonstrate that a cytotoxic CD38 antibody can promote clearance of plasma cells involved in the generation of RA antibodies.

Summary
Recent studies identify potential therapeutic approaches for boosting NAD+ to treat rheumatologic diseases including SSc, RA, and SLE, with particular attention to inhibition of CD38 enzymatic activity as a target. Key future directions in the field include the determination of the cell-type specificity and role of CD38 enzymatic activity versus CD38 structural roles in human diseases, as well as the indicators and potential side effects of CD38-targeted treatments.
Cytokines and inflammatory mediators as promising markers of polymyositis/dermatomyositis
Authors: Cerezo Lucie Andrés , Vencovský Jiří , Šenolt Ladislav 
Published: September 2020

Purpose of review
Idiopathic inflammatory myopathies (IIMs), known also as myositis, represent challenging group of heterogeneous muscle disorders characterized by symmetric proximal muscle weakness and evidence of muscle inflammation. The purpose of this review is to provide important updates on cytokines and inflammatory mediators related to myositis.

Recent findings
In the past 5 years, multiple studies brought a fresh insight into the pathogenesis of myositis by introducing new factors or further characterizing the role of the well established mediators in myositis. Among the mediators reviewed in this article, special attention was paid to interferons, C-X-C motif chemokine ligand 10, interleukin-18 and the IL23/Th17 axis. Some of the recent work has also focused on the nontraditional cytokines, such as adipokines, myokines, S100 proteins, High Mobility Group Box 1 or B-cell activating factor and on several anti-inflammatory mediators. Moreover, microRNAs and their potential to reflect the disease activity or to regulate the inflammatory processes in myositis have recently been subject of intensive investigation. Some of the above-mentioned mediators have been proposed as promising clinical biomarkers or therapeutic targets for myositis.

Summary
Several recent studies contributed to a better understanding of the pathogenesis of myositis and highlighted the clinical significance of certain inflammatory mediators. Application of these new findings may help to develop innovative approaches for patients’ phenotyping, disease activity monitoring and potentially novel therapies.
Cardiac involvement in inflammatory myopathies and inherited muscle diseases
Authors: Lilleker James B. , Roberts Mark , Diederichsen Louise 
Published: September 2020

Purpose of review
To examine recent developments relating to cardiac involvement in the adult idiopathic inflammatory myopathies (IIM) and those inherited muscle diseases which may present in adulthood and mimic IIM.

Recent findings
Cardiac involvement is a common feature of IIM and inherited muscle diseases. Frequency according to disease subtype varies, with serotype having particular influence in IIM, and genotype in the inherited muscle diseases. Innovative techniques for examining cardiac function have been investigated further, including speckle-tracking echocardiography and cardiac magnetic resonance tomography. The present work has highlighted a likely underestimate of the burden of cardiac disease to date. The complex relationship between IIM, atherosclerosis, and traditional cardiovascular risk factors has been further elucidated. Consensus recommendations for managing patients with inherited muscle diseases and prominent cardiac involvement have been recently published. In addition to supportive care, disease modifying treatments are increasingly becoming available for inherited muscle diseases which may also improve cardiac outcomes.

Summary
Cardiac involvement is associated with significant morbidity and mortality. We suggest having a low threshold for considering the possibility of cardiac involvement in all patients with muscle disease.
Does Pulmonary Aspergillosis Complicate Coronavirus Disease 2019?
Authors: Beer Karlyn D. , Jackson Brendan R. , Chiller Tom , Verweij Paul E. , Van de Veerdonk Frank L. , Wauters Joost 
Published: September 2020

Objectives:

Aspergillus coinfection in coronavirus disease 2019 patients has rarely been described but may be occurring among coronavirus disease 2019 patients admitted to ICUs. Previous reports of viral coinfections with Aspergillus, including influenza-associated pulmonary aspergillosis, suggest that coronavirus disease 2019–associated aspergillosis is plausible. This report aims to summarize what is known about coronavirus disease 2019 complicated by Aspergillus, introduces coronavirus disease 2019–associated pulmonary aspergillosis as a possible clinical entity, and describes reasons clinical suspicion of Aspergillus is warranted in the critical care setting.

Data Sources:
We summarize the available evidence suggesting the existence of Aspergillus coinfection among severe coronavirus disease 2019 patients. This includes published coronavirus disease 2019 patient case series, a case description, and a review of potential biologic mechanisms.

Study Selection:
Reports of coronavirus disease 2019 patient attributes were selected if they included clinical, microbiologic, or radiologic signs of invasive fungal infection.

Data Extraction:
Data included in summary tables were identified through a literature search for coronavirus disease 2019–associated pulmonary aspergillosis.

Data Synthesis:
We present descriptive data extracted from coronavirus disease 2019–associated pulmonary aspergillosis case series current at the time of article submission.

Discussion:
Pulmonary aspergillosis is known to occur among influenza patients requiring intensive care and is associated with increased mortality. If Aspergillus coinfections are occurring among coronavirus disease 2019 patients, early clinical suspicion and testing are needed to understand the epidemiology of these infections and prevent associated mortality. As the coronavirus disease 2019 pandemic unfolds, reports on the existence of this coinfection are needed, and opportunities to contribute cases of Aspergillus coinfection among coronavirus disease 2019 patients to an ongoing registry are described.
Dexmedetomidine-Associated Hyperpyrexia in Three Critically Ill Patients With Coronavirus Disease 2019
Authors: Czepiel Kathryn S. , Lucas Alexandra T. , Whalen Michael J. , Mojica James E. 
Published: September 2020

Objectives:
To present three patients with severe coronavirus disease 2019 infection who developed life-threatening hyperpyrexia while being treated with dexmedetomidine for sedation.

Data Sources:
Clinical records.

Study Selection:
Case report.

Data Extraction:
Relevant clinical information.

Data Synthesis:
We describe three patients, a 60-year-old female, 43-year-old female, and 46-year-old male, who were hospitalized in surge ICUs during the coronavirus disease 2019 pandemic in the early spring of 2020. All developed hyperpyrexia, defined as a temperature above 41.1°C, following an increase in dexmedetomidine dosing to above 1.5 µg/kg/hr. Fevers resolved following discontinuation of dexmedetomidine.

Conclusions:
While the exact mechanism of hyperpyrexia remains unclear, findings in this study suggest that high doses of dexmedetomidine infusion are associated with hyperpyrexia in a seemingly dose-dependent fashion in critically ill patients with coronavirus disease 2019. Coronavirus disease 2019 infection causes a hyperinflammatory state characterized by pro-inflammatory cytokine dysregulation. Dexmedetomidine, a centrally acting alpha-2 agonist, may alter hypothalamic temperature regulation through disturbances in neurotransmitter expression and metabolism. We postulate that the use of high-dose dexmedetomidine in a hyperinflammatory state may increase the risk of developing hyperpyrexia in this severe disease state.
Disseminated Multifocal Intracerebral Bleeding Events in Three Coronavirus Disease 2019 Patients on Extracorporeal Membrane Oxygenation As Rescue Therapy
Authors: Bihlmaier Karl , Coras Roland , Willam Carsten , Grampp Steffen , Jabari Samir , Eichhorn Philip , Haller Florian , Kuramatsu Joji , Schwab Stefan , Castellanos Ixchel , Birkholz Torsten , Schüttler Jürgen , Altmeppen Jürgen , Schiffer Mario , Herbst Larissa 
Published: September 2020

Objectives:
To describe three coronavirus disease 2019 patients suffering from acute respiratory distress syndrome under venovenous extracorporeal membrane oxygenation therapy and tight anticoagulation monitoring presenting a novel pattern of multifocal brain hemorrhage in various degrees in all cerebral and cerebellar lobes.

Design:
Clinical observation of three patients. Post mortem examinations.

Setting:
Two ICUs at the University Hospital Erlangen.

Patients:
Three patients (medium age 56.6 yr, two male with hypertension and diabetes, one female with no medical history) developed severe acute respiratory distress syndrome on the basis of a severe acute respiratory syndrome coronavirus 2 infection. All required mechanical ventilation and venovenous extracorporeal membrane oxygenation support.

Interventions:
Clinical observation, CT, data extraction from electronic medical records, and post mortem examinations.

Main Results:
We report on an unusual multifocal bleeding pattern in the white matter in three cases with severe acute respiratory distress syndrome due to coronavirus disease 2019 undergoing venovenous extracorporeal membrane oxygenation therapy. Bleeding pattern with consecutive herniation was found in CT scans as well as in neuropathologic post mortem examinations. Frequency for this unusual brain hemorrhage in coronavirus disease 2019 patients with extracorporeal membrane oxygenation therapy at our hospital is currently 50%, whereas bleeding events in extracorporeal membrane oxygenation patients generally occur at 10–15%.

Conclusions:
Multifocality and high frequency of the unusual white matter hemorrhage pattern suggest a coherence to coronavirus disease 2019. Neuropathological analyses showed circumscribed thrombotic cerebrovascular occlusions, which eventually led to microvascular and later on macrovascular disseminated bleeding events. However, signs of cerebrovascular inflammation could not be detected. Polymerase chain reaction analyses of brain tissue or cerebrospinal fluid remained negative. Increased susceptibility for fatal bleeding events should be taken into consideration in terms of systemic anticoagulation strategies in coronavirus disease 2019.
Temperature Trajectory Subphenotypes Correlate With Immune Responses in Patients With Sepsis
Authors: Bhavani Sivasubramanium V. , Wolfe Krysta S. , Hrusch Cara L. , Greenberg Jared A. , Krishack Paulette A. , Lin Julie , Lecompte-Osorio Paola , Carey Kyle A. , Kress John P. , Coopersmith Craig M. , Sperling Anne I. , Verhoef Philip A. , Churpek Matthew M. , Patel Bhakti K. 
Published: September 2020

Objectives:
We recently found that distinct body temperature trajectories of infected patients correlated with survival. Understanding the relationship between the temperature trajectories and the host immune response to infection could allow us to immunophenotype patients at the bedside using temperature. The objective was to identify whether temperature trajectories have consistent associations with specific cytokine responses in two distinct cohorts of infected patients.

Design:
Prospective observational study.

Setting:
Large academic medical center between 2013 and 2019.

Subjects:
Two cohorts of infected patients: 1) patients in the ICU with septic shock and 2) hospitalized patients with Staphylococcus aureus bacteremia.

Interventions:
Clinical data (including body temperature) and plasma cytokine concentrations were measured. Patients were classified into four temperature trajectory subphenotypes using their temperature measurements in the first 72 hours from the onset of infection. Log-transformed cytokine levels were standardized to the mean and compared with the subphenotypes in both cohorts.

Measurements and Main Results:
The cohorts consisted of 120 patients with septic shock (cohort 1) and 88 patients with S. aureus bacteremia (cohort 2). Patients from both cohorts were classified into one of four previously validated temperature subphenotypes: “hyperthermic, slow resolvers” (n = 19 cohort 1; n = 13 cohort 2), “hyperthermic, fast resolvers” (n = 18 C1; n = 24 C2), “normothermic” (n = 54 C1; n = 31 C2), and “hypothermic” (n = 29 C1; n = 20 C2). Both “hyperthermic, slow resolvers” and “hyperthermic, fast resolvers” had high levels of G-CSF, CCL2, and interleukin-10 compared with the “hypothermic” group when controlling for cohort and timing of cytokine measurement (p < 0.05). In contrast to the “hyperthermic, slow resolvers,” the “hyperthermic, fast resolvers” showed significant decreases in the levels of several cytokines over a 24-hour period, including interleukin-1RA, interleukin-6, interleukin-8, G-CSF, and M-CSF (p < 0.001).

Conclusions:
Temperature trajectory subphenotypes are associated with consistent cytokine profiles in two distinct cohorts of infected patients. These subphenotypes could play a role in the bedside identification of cytokine profiles in patients with sepsis.
Urinary neprilysin for early detection of acute kidney injury after cardiac surgery
Authors: Bernardi Martin H. , Wagner Ludwig , Ryz Sylvia , Puchinger Juergen , Nixdorf Larissa , Edlinger-Stanger Maximilian , Geilen Johannes , Kainz Matthias , Hiesmayr Michael J. , Lassnigg Andrea 
Published: September 2020

BACKGROUND
Acute kidney injury (AKI) predicts adverse outcomes after cardiac surgery. The accuracy of using changes in serum creatinine for diagnosis and grading of AKI is limited in the peri-operative cardiac surgical setting and AKI may be underdiagnosed due to haemodilution from cardiopulmonary bypass priming and the need for intra-operative and postoperative volume resuscitation.

OBJECTIVES
To determine whether the urinary biomarker neprilysin can be used as a marker for the early detection of AKI after cardiac surgery.

DESIGN
Prospective, observational cohort study.

SETTING
Austrian tertiary referral centre.

PATIENTS
96 Patients undergoing elective cardiac surgery with cardiopulmonary bypass.

MAIN OUTCOME MEASURES
Differences and discriminatory power of neprilysin levels early after cardiac surgery and on postoperative day 1 between patients with or without AKI, as defined by the Kidney Disease Improving Global Outcomes Group.

RESULTS
AKI was found in 27% (n=26). The median neprilysin levels on postoperative day 1 were significantly higher in the AKI than in the non-AKI group, 4.0 [interquartile range (IQR): 2 to 6.25] vs. 2.0 ng ml−1 [IQR: 1.0 to 4.5], P = 0.0246, respectively. In addition, the median neprilysin levels at the end of surgery were significantly different between both groups, 5.0 [IQR: 2.0 to 9.0] vs. 2.0 ng ml−1 [IQR: 1.0 to 4.0], P = 0.0055, respectively. The discriminatory power of neprilysin for detecting early AKI corresponded to an area under the curve of 0.77 (95% confidence interval, 0.65 to 0.90).

CONCLUSION
Urinary neprilysin has potential as a biomarker for the early detection of AKI after cardiac surgery and has comparable discriminatory power to recently studied AKI biomarkers.

TRIAL REGISTRATION
The trial was registered at ClinicalTrials.gov (NCT03854825, https://clinicaltrials.gov/ct2/show/NCT03854825).
Effect of Intraocular Pressure on Aerosol Density Generated by Noncontact Tonometer Measurement
Authors: Tang Yuan , Li Chunchun , Chen Yanyan , Chen Zhangyan , Zhang Peihua , Wang Aisun , Huang Xiaoqiong , Qu Jia , Li Mengchen , Ma Siwen , Vasudevan Balamurali 
Published: September 2020

Precis:
Aerosols generated by a noncontact tonometer (NCT) were quantified. There was a positive correlation between aerosols and intraocular pressure (IOP), and the concentration of aerosols beside the air jet port was the highest.

Purpose:
To investigate the effects of IOP on the aerosol density generated during the use of an NCT and provide references and suggestions for daily protection of ophthalmic medical staff during the coronavirus disease-19 (COVID-19) outbreak.

Objective and Methods:
This cross-sectional clinical trial included 214 eyes of 140 patients from a hospital in Wenzhou city, Zhejiang Province. All subjects’ IOPs were measured by an NCT (39 eyes with low IOP, 90 eyes with normal IOP, 37 eyes with moderately high IOP, and 48 eyes with very high IOP) between March 7 and June 17, 2020. The density of particulate matter (PM) 2.5 and PM10 generated during the process of IOP measurement with an NCT was analyzed. IOP values were recorded simultaneously. The aerosols generated during different IOP measurements were plotted in scatter plots.

Results:
PM2.5 was generated more at the air jet port of the tonometer during the process of IOP measurement (H=2.731, P=0.019). Larger quantities of PM2.5 and PM10 were generated when the IOP was higher, and these differences were statistically significant (PM2.5: H=119.476, P<0.001; PM10: H=160.801, P<0.001). Linear correlation analysis with one variable demonstrated that IOP had significantly positive correlations with PM2.5 (r=0.756, P<0.001) and PM10 (r=0.864, P<0.001).

Conclusions:
Aerosols can be generated while using an NCT to measure IOP, and aerosols and IOP are positively correlated. Patients with moderately high IOP or very high IOP tend to generate more aerosols during the IOP measurement. The concentration of aerosols beside the air jet port was the highest.