bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk of major cardiovascular and cerebrovascular complications after elective surgery in patients with sleep-disordered breathing
Authors: Chaudhry Rabail , Suen Colin , Mubashir Talha , Wong Jean , Ryan Clodagh M. , Mokhlesi Babak , Chung Frances 
Published: July 2020

BACKGROUND
There is limited and conflicting data on whether sleep-disordered breathing (SDB) is associated with postoperative major cardiovascular and cerebrovascular events (MACCE), and mortality.

OBJECTIVES
To determine whether SDB is associated with increased risks of MACCE, mortality and length of hospital stay.

DESIGN
Retrospective cohort analysis from the Nationwide Inpatient Sample.

SETTING
Adults who underwent elective abdominal, orthopaedic, prostatic, gynaecological, thoracic, transplant, vascular or cardiac surgery in the United States of America between 2011 and 2014.

PATIENTS
The study cohort included 1813 974 surgical patients, of whom 185 615 (10.2%) had SDB. Emergency or urgent surgical procedures were excluded.

MAIN OUTCOME MEASURES
The incidences of MACCE, respiratory and vascular complications, in-hospital mortality and mean length of hospital stay were stratified by SDB. Linear and logistic regression models were constructed to determine the independent association between SDB and outcomes of interest.

RESULTS
The incidences of MACCE [25.3 vs. 19.8%, odds ratio (OR) 1.20, P < 0.001] and respiratory complications (11.75 vs. 8.0%, OR 1.43, P < 0.001) were significantly higher in patients with SDB than in those without SDB. SDB was associated with higher rates of atrial fibrillation (14.7 vs. 10.8%, P < 0.001), other arrhythmias (6.0 vs. 5.4%, P < 0.001) and congestive heart failure (9.8 vs. 7.1%, P < 0.001). SDB patients had a lower rate of myocardial infarction (3.1 vs. 3.4%, OR 0.69, P < 0.001), lower mortality (0.6 vs. 1.3%, P < 0.001) and shorter length of hospital stay (4.8 vs. 5.2 days, P < 0.001).

CONCLUSION
SDB was associated with increased risks of MACCE, and respiratory and vascular complications, but had a lower incidence of in-hospital mortality and shorter length of hospital stay.
Scleral Suture Fixation of Dislocated Posterior Chamber Intraocular Lens: Modification for Tapered Haptics
Authors: Echegaray Jose J. , Smiddy William E. 
Published: July 2020

Purpose:
To present a surgical modification to a previously published technique that allows repositioning and scleral fixation of one-piece acrylic intraocular lenses with tapered haptics.

Methods:
A retrospective review of three consecutive cases.

Results:
Our technique modification enables repositioning using scleral suture fixation of one-piece intraocular lenses with tapered haptics by looping the haptic at its proximal, notched junction to the optic with the polypropylene suture. The suture knot is internalized which effectively suspends the intraocular lens and allows for better adjustment of the intraocular lens centration. Two cases were endocapsular dislocations; the third case was dislocated extracapsularly due through a posterior capsule rupture. All showed adequate lens centration at 3 months of follow-up. One case had suffered a vitreous hemorrhage a month postoperatively that is clearing.

Conclusion:
Repositioning using scleral fixation of one-piece intraocular lenses with tapered haptics is possible with a minor technique modification. This offers an alternative to intraocular lens exchange.
Associations Between Complementary and Alternative Medicine and Health Care Expenditures Among Adults With Chronic Back Pain
Authors: Olaisen R. Henry 
Published: July 2020

Background:
Although complementary and alternative medicine (CAM) has been associated with reduced morbidity among adults with chronic back pain, less is known about the association between CAM use and health care expenditures.

Objectives:
The objective of this study was to first estimate health care expenditures of adult CAM users and nonusers with chronic back pain and then assess CAM’s influence on health care expenditures.

Research Design:
This was an ambidirectional cohort study.

Data:
Linked National Health Interview Survey (2012) and Medical Expenditure Panel Survey (2013–2014).

Measures:
CAM use was defined as 3 or more visits to a practitioner in the 12 months before the National Health Interview Survey interview. Covariates included age, sex, race-ethnicity, and body mass index. The outcome was annual health care expenditures (overall and within 8 categories, including office-based visits and prescription medication).

Analyses:
Survey-weighted, covariate adjusted predicted marginal means models were applied to quantify health care expenditures. Survey-weighted, covariate adjusted linear and logistic regression models were used to investigate CAM’s influence on expenditures, and the Z mediation test statistic was applied to quantify the independent effects of CAM.

Results:
Overall, health care expenditures were significantly lower among CAM users with chronic back pain compared with non-CAM users for both 2013 and 2014: $8402 versus $9851 for 2013; $7748 versus $10,227 in 2014, annual differences of −$1499 (95% confidence interval: −$1701 to −$1197) and −$2479 (95% confidence interval: −$2696 to −$2262), respectively (P<0.001). Adult CAM users also had significantly lower prescription medication as well as outpatient expenses (P<0.001). CAM use was identified as a partial mediator to health care expenditures.

Conclusion:
CAM use is associated with lower overall health care expenditures, driven primarily by lower prescription and outpatient expenditures, among adults with chronic back pain in the United States.
Did the Affordable Care Act Decrease Veteran Enrollment in the Veterans Health Administration?
Authors: Silva Abigail , Tarlov Elizabeth , Gonzalez Beverly , Smith Bridget M. , French Dustin D. , Hogan Timothy P. , Jordan Neil , Huo Zhiping , Martinez Rachael N. , Ippolito Dolores , Stroupe Kevin T. 
Published: July 2020

Background:
Provisions of the Affordable Care Act (ACA) provided nonelderly individuals, including Veterans, with additional health care coverage options. This may impact enrollment for health care through the Veterans Health Administration (VHA). National enrollment data was used to: (1) compare characteristics of enrollees at 3 time points in relation to the implementation of ACA insurance provisions (2012); and (2) examine enrollment trends.

Methods:
The study population included a 10% sample of Veterans under age 65 who were VHA enrollees between January 2012 and September 2015. Demographic and baseline characteristics were compared between 3 enrollment groups: pre-2012, pre-ACA (2012–2013), and post-ACA (2014–2015). Using an interrupted time series approach, we employed pooled logistic regression to assess trends in new VHA enrollment, overall, and by select enrollee characteristics.

Results:
A total of 429,833 enrollees were identified. Compared with pre-ACA enrollees, post-ACA enrollees were more likely to be older, have a service-connected disability, live further away from a VHA medical center, but less likely to use primary care within 6 months. The post-ACA quarterly trend in the odds of being a new enrollee was 3% lower (95% confidence interval: 0.96, 0.98) as compared with the pre-ACA trend. This decline was consistent across sex, geography, (all but 1) priority group, and state Medicaid-expansion subgroups.

Conclusions:
The ACA appears to have contributed to a decline in new VHA enrollment. In addition, the profile of newer enrollees differs from that of pre-ACA enrollees. The VHA must continue to monitor trends in demand in order to continue delivering high-quality, efficient care.
Emergency Medicaid Acquisition Through the Affordable Care Act
Authors: Tran Linda D. , Knowlton Lisa M. , Wagner Todd H. 
Published: July 2020

Background:
Hospital Presumptive Eligibility (HPE) is a national policy stemming from the Affordable Care Act that allows qualified hospitals, working with state officials, to enroll eligible patients for temporary Medicaid coverage. Although all states are required to operate an HPE program, hospital participation is elective and variable. It is unclear which hospitals choose to participate in HPE and how participation affects hospital utilization and revenue.

Objective:
We examined hospital factors associated with HPE participation in the state of California and assessed pre and post changes in hospital revenue and utilization for HPE and non-HPE hospitals.

Research Design:
We performed a logistic regression to identify hospital attributes associated with HPE participation. We then used a difference in differences methodology with a hospital fixed effect to test whether HPE enrollment was associated with changes in annual revenues by payer source, uncompensated care costs, outpatient visits, and/or discharges.

Results:
Three quarters (76%) of qualified hospitals elected to participate in HPE by the end of 2018. Hospitals with 100 or more beds had over 10 times greater odds of participating in HPE compared with smaller hospitals. Hospitals that did not provide outpatient care were significantly less likely to participate. Among hospitals included in trend analyses, enrollment in HPE was associated with increased annual net patient Medicaid revenue and decreased uncompensated care charges. We predicted that HPE enrollment was associated with an average of 9.7% (95% confidence interval: 3.4%–16.4%) increase in annual net patient Medicaid revenue. As of 2018, ∼33,000 adults and children were enrolled in California’s HPE program per month.

Conclusion:
Hospital enrollment in the HPE program shifted costs from uncompensated care to Medicaid.
Use of sleeve gastrectomy in adolescents and young adults with severe obesity
Authors: Singhal Vibha , Youssef Soundos , Misra Madhusmita 
Published: July 2020

Purpose of review
The prevalence of pediatric obesity and its associated complications is increasing around the world. Treatment of obesity is challenging and metabolic and bariatric surgery (MBS) is currently the most effective treatment for this condition. At this time, vertical sleeve gastrectomy (VSG) is the most commonly performed bariatric procedure in adolescents. However, knowledge regarding the efficacy, safety, and durability of VSG in adolescents is still evolving. This review summarizes the most recent updates in the field of MBS particularly VSG in adolescents.

Recent findings
MBS is recommended to treat moderate to severe obesity, especially when complicated by comorbidities. The use of VSG for weight loss is increasing among adolescents and produces similar weight loss at five years in both adolescents and adults. The physiologic mechanisms causing weight loss after VSG are multifactorial and still being investigated. The complication rate after VSG ranges between 0 and 17.5%.

Summary
VSG appears to be a well-tolerated and effective procedure in adolescents. However, it continues to be underutilized despite the increasing prevalence of moderate to severe obesity in adolescents. It is thus important to educate providers regarding its benefits and safety profile.
Split ventilation with pressure regulators for patient-specific tidal volumes
Authors: “Ram” Srinivasan Lakshminarayan , Rishel Chris A. , Larson Barrett J. , Yoo Juhwan , Shelton Ned M. 
Published: July 2020

AbstractAs a measure of last resort during the COVID-19 pandemic, single mechanical ventilators have been repurposed to support multiple patients. In existing split-ventilator configurations using FDA-approved tubing adaptors, each patient receives the same inspiratory pressure, requiring careful matching of patients to avoid barotrauma. Progression of disease may cause tidal volumes to diverge from desired targets, and routine interventions (eg. suctioning) in one patient may adversely affect other patients. To overcome these limitations, we demonstrate a split-ventilator configuration that enables individualized patient management by incorporating a commonly available pressure regulator used for gas appliances. We validate this method by achieving various combinations of tidal volume in each of two synthetic lungs using a standard ventilator machine in combination with two gas flow analyzers. With further safety testing and instrumentation, pressure regulators may represent a viable path to substantially augment the capacity for ventilation in resource-constrained settings.
CGMTSA: An R package for continuous glucose monitoring time series data analysis
Authors: Shao Jian , Xu Tao , Zhou Kaixin 
Published: July 2020

AbstractThe R package CGMTSA was developed to facilitate investigations that examine the continuous glucose monitoring (CGM) data as a time series. Accordingly, novel time series functions were introduced to: 1) enable more accurate missing data imputation and outlier identification; 2) calculate recommended CGM metrics as well as key time series parameters; 3) plot interactive and 3D graphs that allow direct visualizations of temporal CGM data and time series model optimization. The software was designed to accommodate all popular CGM devices and support all common data processing steps.
Early defects in lysosomal storage diseases disrupt excitatory synaptic transmission
Authors: Pará de Aragão Camila de Britto , Bruno Luigi , Bose Poulomee , Pan Xuefang , Han Chanshuai , McPherson Peter S. , Freemantle Erika , Lacaille Jean-Claude , Bonneil Éric , Thibault Pierre , O’Leary Claire , Bigger Brian , Morales Carlos R. , DiCristo Graziella , Pshezhetsky Alexey V. 
Published: July 2020

AbstractAt least two thirds of patients affected with lysosomal storage disorders (LSD) exhibit neurological symptoms. For mucopolysaccharidosis type IIIC (MPS IIIC, Sanfilippo disease type C) caused by mutations in theHGSNATgene and lysosomal storage of heparan sulfate the major burden is progressive and severe neuropsychiatric problems, mental retardation, and dementia though to be mainly mediated by neurodegeneration. HGSNAT knockout mice match human clinical phenotype and develop hyperactivity followed by memory impairment and death.In order to understand whether early clinical symptoms in MPS IIIC mice occurring before the onset of massive neurodegeneration are caused by neuronal dysfunction we studied synaptic transmission and morphology in cultured hippocampal and CA1 pyramidal neurons of MPSIIIC mice. Synaptic spines were also studied in other mouse LSD models and postsynaptic densities in post-mortem cortices of human neurological MPS patients.Cultured hippocampal and CA1 pyramidal neurons of MPS IIIC mice showed a drastic decrease or abnormal distribution of multiple pre- and postsynaptic proteins that could be rescued in vitro and in vivo by virus-mediated gene correction. Dendritic spine densities were immature in cultured hippocampal MPS IIIC mouse neurons and reduced in pyramidal neurons of mouse models of MPS IIIC and other (Tay-Sachs, sialidosis) LSD starting from postnatal day 10. MPS IIIC neurons presented alterations in frequency and amplitude of miniature excitatory and inhibitory postsynaptic currents, sparse synaptic vesicles, reduced postsynaptic densities, disorganised microtubule network and partially impaired axonal transport of synaptic proteins. Postsynaptic densities were also reduced in post-mortem cotrees of human MPS I, II, IIIA, C and D patients suggesting that the pathology is common for these neurological LSD.Together, our results demonstrate that lysosomal storage causes alterations in synaptic structure and abnormalities in neurotransmission originating from disrupted vesicular transport and preceding the first cognitive symptoms and suggest drugs known to affect synaptic transmission can be potentially applied to treat behavioral and cognitive defects in neurological LSD patients.
Identification of potent and safe antiviral therapeutic candidates against SARS-CoV-2
Authors: Xiao Xia , Wang Conghui , Chang De , Wang Ying , Dong Xiaojing , Jiao Tao , Zhao Zhendong , Ren Lili , Dela Cruz Charles S , Sharma Lokesh , Lei Xiaobo , Wang Jianwei 
Published: July 2020

AbstractCOVID-19 pandemic has infected millions of people with mortality exceeding 300,000. There is an urgent need to find therapeutic agents that can help clear the virus to prevent the severe disease and death. Identifying effective and safer drugs can provide with more options to treat the COVID-19 infections either alone or in combination. Here we performed a high throughput screen of approximately 1700 US FDA approved compounds to identify novel therapeutic agents that can effectively inhibit replication of coronaviruses including SARS-CoV-2. Our two-step screen first used a human coronavirus strain OC43 to identify compounds with anti-coronaviral activities. The effective compounds were then screened for their effectiveness in inhibiting SARS-CoV-2. These screens have identified 24 anti-SARS-CoV-2 drugs including previously reported compounds such as hydroxychloroquine, amlodipine, arbidol hydrochloride, tilorone 2HCl, dronedarone hydrochloride, and merfloquine hydrochloride. Five of the newly identified drugs had a safety index (cytotoxic/effective concentration) of >600, indicating wide therapeutic window compared to hydroxychloroquine which had safety index of 22 in similar experiments. Mechanistically, five of the effective compounds were found to block SARS-CoV-2 S protein-mediated cell fusion. These FDA approved compounds can provide much needed therapeutic options that we urgently need in the midst of the pandemic.
cAMP bursts control T cell directionality by actin cytoskeleton remodeling
Authors: Simao Morgane , Régnier Fabienne , Taheraly Sarah , Fraisse Achille , Tacine Rachida , Fraudeau Marie , Benabid Adam , Feuillet Vincent , Lambert Mireille , Delon Jérôme , Randriamampita Clotilde 
Published: July 2020

AbstractT lymphocyte migration is an essential step to mounting an efficient immune response. The rapid and random motility of these cells which favors their sentinel role is conditioned by chemokines as well as by the physical environment. Morphological changes, underlaid by dynamic actin cytoskeleton remodeling, are observed throughout migration but especially when the cell modifies its trajectory. Using dynamic cell imaging, we investigated the signaling pathways involved in T cell directionality control. We monitored cAMP variation concomitantly with actin distribution upon T lymphocyte migration and highlighted the fact that spontaneous bursts in cAMP starting from the leading edge, are sufficient to promote stable actin redistribution triggering trajectory modification.
Effect of expression of human glucosylceramidase 2 isoforms on lipid profiles in COS-7 cells
Authors: Jatooratthawichot Peeranat , Talabnin Chutima , Ngiwsara Lukana , Rustam Yepy Hardi , Svasti Jisnuson , Reid Gavin E. , Cairns James R. Ketudat 
Published: July 2020

AbstractGlucosylceramide (GlcCer) is a major membrane lipid and the precursor of gangliosides. It is continuously formed and degraded in glycosphingolipid metabolism. GlcCer is mainly degraded by two enzymes, lysosomal acid β-glucosidase (GBA) and nonlysosomal β-glucosidase (GBA2). Deficiencies of GBA and GBA2 affect glycosphingolipid metabolism, resulting in neurological diseases, such as Gaucher Disease and Hereditary Spastic Paraplegia. To understand which GBA2 isoforms are active and how they affect glycosphingolipid levels in cells, we expressed nine human GBA2 isoforms in COS-7 cells, confirmed their expression by qRT-PCR and western blotting, and assayed their activity to hydrolyze 4-methylumbelliferyl-β-D-glucopyranoside (4MUG) in cell extracts. Human GBA2 isoform 1 showed high activity, while the other isoforms had activity similar to the background. Comparison of sphingolipid levels by ultra-high resolution/ accurate mass spectrometry (UHRAMS) analysis showed that isoform 1 overexpression increased ceramide and decreased hexosylceramide levels compared to control and other isoforms. Comparison of ratios of glucosylceramides to the corresponding ceramides in the extracts indicated that GBA2 isoform 1 has broad specificity for the lipid component of glucosylceramide. These studies suggest that only one GBA2 isoform 1 is active and affects sphingolipid levels in the cell, acting on glucosylceramides with a wide range of lipid components. Our study provides new insights into how increased breakdown of GlcCer affects cellular lipid metabolic networks.
Astrocytes express DMT1 and transferrin receptors, which transport iron thus activating Ca2+signalling: possible role in neuroprotection against iron overload?
Authors: Xia Maosheng , Guan Wenzheng , Ji Ming , Li Shuai , Li Zexiong , Chen Beina , Zhang Manman , Liang Shanshan , Chen Binjie , Gong Wenliang , Dong Chengyi , Wen Gehua , Zhan Xiaoni , Zhang Dianjun , Li Xinyu , Verkhratsky Alexei , Li Baoman 
Published: July 2020

ABSTRACTIron is the fundamental element for numerous physiological functions. Reduced ferrous (Fe2+) and oxidized ferric (Fe3+) are the two ionized iron states in the living organisms. In the cell membrane, divalent metal ion transporter 1 (DMT1) is responsible for cellular uptake of Fe2+, whereas transferrin receptors (TFR) carry transferrin (TF)-bound Fe3+. In this study we performed, for the first time, detailed analysis of the action of Fe ions on cytoplasmic free calcium ion concentration ([Ca2+]i) in astrocytes. Using qPCR and immunocytochemistry we identified DMT1 and TFR in astrocytes in primary cultures, in acutely isolated astrocytes and in brain tissue preparations;in situboth DMT1 and TFR are concentrated in astroglial perivascular endfeet. Administration of Fe2+or Fe3+in low μM concentrations evoked Ca2+signals in astrocytesin vitroand invivo. Iron ions triggered increase in [Ca2+]iby acting through two distinct molecular cascades. Uptake of Fe2+by DMT1 inhibited astroglial Na+-K+-ATPase (NKA), which led to an elevation in cytoplasmic Na+concentration (as measured by SBFI probe), thus reversing Na+/Ca2+exchanger (NCX) thereby generating Ca2+influx. Uptake of Fe3+by TF-TFR stimulated phospholipase C to produce inositol 1,4,5-trisphosphate (InsP3), thus trigering InsP3receptor-mediated Ca2+release from the endoplasmic reticulum. Iron-induced Ca2+signals promote astroglial release of arachidonic acid and prostaglandin E2 cytokines by activating cytosolic phospholipase A2 (cPLA2) and NF-κB signalling cascade. In summary, these findings reveal new mechanisms of iron-induced astrocytic signalling operational in conditions of iron overload, in response to which astrocytes actively accumulate excessive iron and activate neuroprotective pathways.