bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful Discharge to Community Gap of FFS Medicare Beneficiaries With and Without ADRD Narrowed
Authors: Bardenheier Barbara H. , Rahman Momotazur , Kosar Cyrus , Werner Rachel M. , Mor Vincent 
Published: December 2020

Background/ObjectivesWe sought to compare the post‐acute and long‐term care experience of Medicare beneficiaries with and without Alzheimer Disease and Related Dementias (ADRD), and whether differences changed from January 1, 2007 to September 30, 2015.DesignRetrospective cross‐sectional trend study using Medicare claims linked to the Centers for Medicare & Medicaid Services' (CMS) Minimum Data Set.SettingCMS‐certified skilled nursing facilities (skilled nursing facility (SNF), n = 17,043).ParticipantsFee‐for‐service Medicare beneficiaries aged ≥66 years (n = 6,614,939) discharged from a hospital to a SNF who had not lived in a nursing home during the year before hospitalization.MeasurementsADRD was defined by the Chronic Condition Data Warehouse. Outcome measures included: (1) successful discharge defined as being in SNF less than 90 days, then discharged back to the community, alive without subsequent inpatient health care for 30 continuous days; (2) became long‐stay resident in SNF; (3) death in SNF within 90 days; (4) hospital readmission within 30 days of entering SNF; and (5) transferred to another nursing home within 30 days of entering SNF.ResultsSuccessful discharge of beneficiaries with ADRD increased from 43.4% in 2007 to 53.9% in 2015 (average annual percent change (AAPC) = 2.1 (95% CI = 2.0–2.2)); those without ADRD also increased (from 59.1% to 63.6%, AAPC = 0.9 (95% CI = 0.7–1.1)) but not as fast as those with ADRD (P < .01). The proportion of all beneficiaries who became long‐stay or were readmitted to the hospital decreased (P < .05). The proportion with ADRD who became long‐stay was nearly three times higher than those without throughout the study (15.0% vs 5.5% in 2007; 11.3% vs 4.3% in 2015).ConclusionThough disparity in ADRD in becoming long‐stay residents remains, the increase in successful discharges among those with ADRD also stresses the increasing importance of community as a care setting for adults with ADRD.
Two cases of cryptococcus gattii infection in the rhesus macaque (Macaca Mulatta)
Authors: Johnson Amanda L. , Lewis Anne D. 
Published: December 2020

AbstractCryptococcus gattii was diagnosed in two female indoor‐housed rhesus macaques. Gross and histopathologic findings included an isolated pulmonary cryptococcoma in a non‐SIV‐infected macaque and disseminated disease centered on the lungs of an SIV‐infected macaque. Fungal yeast were positive with special stains, and the diagnoses were confirmed with a lateral flow assay and PCR.
Nicotinamide ameliorates energy deficiency and improves retinal function in Cav‐1‐/‐ mice
Authors: Tang Yizhen , Fang Wangyi , Xiao Zebin , Song Maomao , Zhuang Dongli , Han Binze , Wu Jihong , Sun Xinghuai 
Published: December 2020

AbstractCaveolin‐1(Cav‐1) is involved in lipid metabolism and energy homeostasis, which is important for the energetically demanding retina. Although retinal function deficits were noted in Cav‐1 knockout (Cav‐1‐/‐) mice, the underlying causes remain largely unknown. Here, we investigate if the disruption in energy homeostasis presents a potential mechanism for retinal function deficits in Cav‐1‐/‐ retina and if it can be ameliorated by nicotinamide (NAM). In this study, NAM was administrated orally for 2 weeks in Cav‐1‐/‐ mice before experiments. Oxidative lipidomics was conducted to detect the oxylipin changes, the retinal energy flux was measured by seahorse assay, and the retinal function was assessed by electroretinogram (ERG). Cav‐1 deficiency induced the dysregulation of oxidative lipidomics and reduction in energy consumption/production in the retina by decreasing Na+/K+‐ATPase, oxidative phosphorylation CII, cytochrome c, and oxygen consumption rate (OCR). A decrease in Sirt1 was also detected. Therapeutic administration of NAM significantly increased Sirt1 expression and improved energy deficiency by increasing Na+/K+‐ATPase, cytochrome c, and OCR. The dysregulation of oxidative lipidomics was partially recovered, and the retinal function was improved as assessed by ERG compared to Cav‐1‐/‐ mice. Our study demonstrated the dysregulation of oxidative lipidomics in Cav‐1‐/‐ retina and established a link between energy deficiency and retinal function deficits in Cav‐1‐/‐ mice. Administration of NAM ameliorated energy deficiency, increased the expression of Sirt1, and improved retinal function, which presents a potential therapeutic strategy for Cav‐1 deficiency‐induced retinal function deficits.
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The variability in location of the most prominent points on the posterior torso of those without abnormal surface topography, those with Adolescent Idiopathic Scoliosis and those with Scheuermann's Kyphosis: a seven year longitudinal analysis
Authors: Gardner Adrian , Berryman Fiona , Sur Hartej , Pynsent Paul 
Published: December 2020

AbstractThe correction of adolescent scoliosis involves the recreation of torso symmetry. A symmetrical torso has equivalent areas of shape on either side of the midline. The posterior torso has two areas of prominence, known as the ‘most prominent points’ on either side of the midline which can be used as reference points to measure symmetry of the posterior torso. This study used the three‐dimensional (3D) coordinates of the most prominent points, measured using ISIS2 surface topography and standardised by torso size, in children without abnormal surface topography, with adolescent idiopathic scoliosis (AIS) (right thoracic curves) and with Scheuermann's kyphosis (SK). The purpose was to demonstrate the variability of the position of the points in these three groups. The variability of the 3D coordinates was calculated for each group (mean, standard deviation and range in millimetres) and the standardised data were illustrated using 3D 95% confidence interval ellipsoids. In those without deformity, the position of the left and right point was mirrored with little difference. The AIS group showed a difference between the left and right points, with the right becoming further from the midline and more prominent than the left but with the left becoming more superior than the right. For the SK cohort, both left and right points moved inwards towards the midline and became more prominent. Linear mixed effect modelling was used to examine the contribution of age, kyphosis and scoliosis to the position of the most prominent points. In the cohort without abnormal surface topography, the x parameter increases with the covariates of age and kyphosis, with the covariate of age likely reflecting torso growth. The left side becomes more prominent and inferior compared to the right. In the AIS cohort, age follows the cohort without abnormal surface topography. This is added to by the scoliosis which is observed to make the right side more lateral, less inferior and more prominent, whereas the left becomes more medial, less inferior and less prominent. Kyphosis in the AIS cohort leads to the right point becoming more lateral, less inferior and less prominent whereas in the left becomes more lateral, more inferior and more prominent. In the SK cohort, the effects of the covariates of age and kyphosis are not clear reflecting the small number of cases with more than one surface topography image over time.
Assessing the Effectiveness of Cancer Screening Interventions Targeting Appalachian Populations: A Systematic Review
Authors: Robertson Nicole M. , Hudson Lauren , Attia Suzanna Labib , Porterfield J. Zachary , Vanderford Nathan L. 
Published: December 2020

AbstractPurposeAppalachian residents have higher cancer prevalence and invasive cancer incidence in almost all cancer types relative to non‐Appalachian residents. Public health interventions have been carried out to increase preventive cancer screening participation. However, no studies have evaluated the effectiveness of existing interventions targeting cancer screening uptake in this high‐risk population. The main objective of this study is to assess the effectiveness of interventions aimed at increasing uptake and/or continuing participation in screened cancers (breast, cervical, colorectal, lung, and prostate) in Appalachia.MethodsWe conducted a systematic review of electronic databases and gray literature using a combination of MeSH and free‐text search terms related to breast, cervical, colorectal, lung, and prostate cancer; mass screening; health promotion; and Appalachia. We identified 3,014 articles of which 15 articles were included. We assessed methodological quality using validated tools and analyzed findings using narrative synthesis.FindingsFifteen studies reported uptake and/or continued participation in screening interventions; these focused on cervical (n = 7), colorectal (n = 5), breast (n = 2), and lung (n = 1) cancers in Appalachia. Interventions included diverse components: mass media campaigns, community outreach events, community health workers, interpersonal counseling, and educational materials. We found that multi‐strategy interventions had higher screening uptake relative to interventions employing 1 intervention strategy. Studies that targeted noncompliant populations and leveraged existing community‐based organization partnerships had a substantial increase in screening participation versus others.ConclusionsThere is an urgent need for further research and implementation of effective cancer prevention and screening interventions to reduce disparities in cancer morbidity and mortality in Appalachian populations.
Treatment for chronic hepatitis E virus infection: A systematic review and meta‐analysis
Authors: Gorris Myrte , van der Lecq Bernice M. , van Erpecum Karel J. , de Bruijne Joep 
Published: December 2020

AbstractHepatitis E virus infection can cause chronic hepatitis in immunocompromised patients with significant chance of progressive fibrosis and possibly cirrhosis. The aim of this systematic review was to summarize the efficacy and safety of the various treatment options for chronic hepatitis E. We performed a systematic literature search. The primary outcome measure was a sustained virological response (SVR). Secondary end points were rapid virological response (RVR), relapse rates, side effects and adverse events. Forty‐four articles were included with a total of 582 patients. Reduction of immunosuppressive medication induced viral clearance in 55/174 (32%) of the patients. Meta‐analysis of 395 patients showed a pooled SVR rate of 78% (95‐CI 72%–84%) after ribavirin treatment. Twenty‐five per cent of the patients obtained a RVR, whereas a relapse occurred in 18% of the patients. Anaemia during treatment led to dose reduction, use of erythropoietin and/or blood transfusion in 37% of the patients. A second treatment attempt with ribavirin led to a SVR in 39/51 (76%) of the patients. Pegylated interferon‐alpha was administered to 13 patients and SVR was obtained in 85%. Two patients (15%) suffered from acute transplant rejection during treatment with interferon. In conclusion, reduction of immunosuppressive medication and treatment with ribavirin is safe, generally well tolerated and induced viral clearance in 32% and 78% of patients, respectively. Therefore, ribavirin should be considered as first treatment step for chronic hepatitis E. Treatment with pegylated interferon‐alpha increases the risk of transplant rejection and should therefore be administered with great caution.
Hepatitis E‐Associated Hospitalizations in the United States: 2010–2015 and 2015–2017
Authors: Wasuwanich Paul , Ingviya Thammasin , Thawillarp Supharerk , Teshale Eyasu H. , Kamili Saleem , Crino Jude P. , Scheimann Ann O. , Argani Cynthia , Karnsakul Wikrom 
Published: December 2020

AbstractHepatitis E is considered rare in the United States (US) despite its widespread occurrence in Asian and African countries. The objective of this study was to describe the characteristics of hepatitis E‐related pregnancies and acute‐on‐chronic liver failure and analyse trends for hepatitis E diagnosis among hospitalized patients in the US. We examined data from the 2010–2017 National Inpatient Sample from Healthcare Cost and Utilization Project to determine mortality, morbidity, pregnancy diagnoses, chronic liver disease diagnoses, and other conditions during hospitalization. Data were extracted for hospitalizations with hepatitis E as defined by ICD‐9 codes 070.43 and 070.53 and ICD‐10 code B17.2. Of 208,462,242 hospitalizations from 2010–2015, we identified 960 hepatitis E hospitalizations. The hospitalization rate of hepatitis E was 3.7 per 10 million in 2010 and 6.4 per 10 million in 2015 (β = 0.60, p = 0.011). From 2015 to 2017, the hospitalization appeared to increase with slope (β) of 0.50. Among those hospitalizations, 34 (4%) died and 85 (9%) had acute‐on‐chronic liver failure. Ninety‐five (10%) had a diagnosis of pregnancy, there were no reports of maternal or foetus/neonate deaths, but there was a high proportion of adverse events for both during hospitalization. Having a chronic liver disease was associated with hepatic coma diagnosis (OR = 10.94, p = 0.002). Although the hospitalization rate of hepatitis E in the US is low, it appears to be increasing over time. Further studies are necessary in order to conclude a causal association of hepatitis E with adverse events and mortalities in pregnancy and chronic liver disease in the US.
Entrustment decisions and the clinical team: A case study of early clinical students
Authors: Pinilla Severin , Kyrou Alexandra , Maissen Norina , Klöppel Stefan , Strik Werner , Nissen Christoph , Huwendiek Sören 
Published: December 2020

AbstractPurposeClinical learning contexts influence how medical students engage with entrustment decisions. However, it is unclear how students and health care team members perceive the entrustment decision process. This study explored which factors students and team members consider relevant to entrustment decisions in early clinical rotations.MethodsThe authors conducted a case study at an academic teaching hospital, interviewing 28 medical students and four health care team members during the clerkship year. Within a social constructivist epistemology, we explored students’ and health care team members’ perceptions of ad hoc entrustment decisions using semi‐structured interviews. Transcripts from the interviews and notes from feedback rounds with students were used for analysis.ResultsMedical students in their core clerkship year perceived clinical residents as critical educational gatekeepers and key facilitators of entrustment decisions. Another important theme emerged around students’ motivation, initiative and willingness to engage with the health care team and patients. Students actively engaged in trust formation processes with different health care team members. The entrustment decision process was perceived as multilateral and dynamic, involving all health care team members and patients. Multiple entrusting supervisors for clerkship students, including nurses and psychologists, emerged from our interview data. They assumed an active role in negotiating entrustment decisions both with and for clerkship students, either facilitating or hindering opportunities. The entrustment decisions emerged as a result of a multifaceted supervisor network interaction.ConclusionsSupervising residents’ ability to integrate students into clinical teams seems to be a critical factor in facilitating entrustment opportunities for clinical activities. Students’ active management of informal supervisor networks of health care team members and these team members’ willingness to assume responsibility for the students’ education emerged as relevant aspects for ad hoc entrustment. Our data suggest that supervision from different health professionals is beneficial for clinical education of medical students and merits further exploration.
Hop stunt viroid: A polyphagous pathogenic RNA that has shed light on viroid–host interactions
Authors: Marquez‐Molins Joan , Gomez Gustavo , Pallas Vicente 
Published: December 2020

AbstractTaxonomyHop stunt viroid (HSVd) is the type species of the genus Hostuviroid (family Pospiviroidae). The other species of this genus is Dahlia latent viroid, which presents an identical central conserved region (CCR) but lacks other structural hallmarks present in Hop stunt viroid. HSVd replication occurs in the nucleus through an asymmetric rolling‐circle model as in the other members of the family Pospiviroidae, which also includes the genera Pospiviroid, Cocadviroid, Apscaviroid, and Coleoviroid.Physical propertiesHop stunt viroid consists of a single‐stranded, circular RNA of 295–303 nucleotides depending on isolates and sequence variants. The most stable secondary structure is a rod‐like or quasi‐rod‐like conformation with two characteristic domains: a CCR and a terminal conserved hairpin similar to that of cocadviroids. HSVd lacks a terminal conserved region.Hosts and symptomsHSVd infects a very broad range of natural hosts and has been reported to be the causal agent of five different diseases (citrus cachexia, cucumber pale fruit, peach and plum apple apricot distortion, and hop stunt). It is distributed worldwide.TransmissionHSVd is transmitted mechanically and by seed.
The not‐so‐rare absent RAIR: Internal anal sphincter achalasia in a review of 1072 children with constipation undergoing high‐resolution anorectal manometry
Authors: Baaleman Desiree F. , Malamisura Monica , Benninga Marc A. , Bali Neetu , Vaz Karla H. , Yacob Desale , Di Lorenzo Carlo , Lu Peter L. 
Published: December 2020

AbstractBackgroundOur objective is to describe the prevalence of patients with internal anal sphincter achalasia (IASA) without Hirschsprung disease (HD) among children undergoing anorectal manometry (ARM) and their clinical characteristics.MethodsWe performed a retrospective review of high‐resolution ARM studies performed at our institution and identified patients with an absent rectoanal inhibitory reflex (RAIR). Clinical presentation, medical history, treatment outcomes, and results of ARM and other diagnostic tests were collected. We compared data between IASA patients, HD patients, and a matched control group of patients with functional constipation (FC).Key resultsWe reviewed 1,072 ARMs and identified 109 patients with an absent RAIR, of whom 28 were diagnosed with IASA. Compared to patients with FC, patients with IASA had an earlier onset of symptoms and were more likely to have abnormal contrast enema studies. Compared to patients with HD, patients with IASA were more likely to have had a normal timing of meconium passage, a later onset of symptoms, and were diagnosed at an older age. At the latest follow‐up, the majority of patients diagnosed with IASA (54%) were only using oral laxatives. Over half of patients with IASA had been treated with anal sphincter botulinum toxin injection, and 55% reported a positive response.Conclusions and InferencesPatients diagnosed with IASA may represent a more severe patient population compared to patients with FC, but have a later onset of symptoms compared to patients with HD. They may require different treatments for their constipation and deserve further study.
Thiamine deficiency disorders: a clinical perspective
Authors: Smith Taryn J. , Johnson Casey R. , Koshy Roshine , Hess Sonja Y. , Qureshi Umar A. , Mynak Mimi Lhamu , Fischer Philip R. 
Published: December 2020

AbstractThiamine is an essential water‐soluble vitamin that plays an important role in energy metabolism. Thiamine deficiency presents many challenges to clinicians, in part due to the broad clinical spectrum, referred to as thiamine deficiency disorders (TDDs), affecting the metabolic, neurologic, cardiovascular, respiratory, gastrointestinal, and musculoskeletal systems. Concurrent illnesses and overlapping signs and symptoms with other disorders can further complicate this. As such, TDDs are frequently misdiagnosed and treatment opportunities missed, with fatal consequences or permanent neurologic sequelae. In the absence of specific diagnostic tests, a low threshold of clinical suspicion and early therapeutic thiamine is currently the best approach. Even in severe cases, rapid clinical improvement can occur within hours or days, with neurological involvement possibly requiring higher doses and a longer recovery time. Active research aims to help better identify patients with thiamine‐responsive disorders and future research is needed to determine effective dosing regimens for the various clinical presentations of TDDs. Understanding the clinical diagnosis and global burden of thiamine deficiency will help to implement national surveillance and population‐level prevention programs, with education to sensitize clinicians to TDDs. With concerted effort, the morbidity and mortality related to thiamine deficiency can be reduced.
Trends in mortality rates for oral and oropharyngeal cancer in Spain, 1979–2018
Authors: Duran‐Romero Antonio Jose , Infante‐Cossio Pedro , Pereyra‐Rodriguez Jose‐Juan 
Published: December 2020

AbstractObjectiveTo analyse mortality rate trends in Spain for oral cavity and oropharyngeal cancer (OCOPC) from 1979 to 2018, evaluating differences between oral cavity cancer (OCC) and oropharyngeal cancer (OPC).Materials and MethodsDeath certificates and mid‐year population data were collected from the Spanish National Statistics Institute. Age‐standardized mortality rates were calculated using the direct method. Joinpoint regressions were used to identify significant changes in mortality trends. Independent effects of age, period and cohort (APC) were estimated.ResultsA total of 52,057 deaths were registered from OCOPC, 38,988 from OCC and 13,069 from OPC between 1979 and 2018. While OCC mortality rates declined, OCOPC rates increased slightly and OPC significantly. OCC and OPC mortality reached their highest values between 1979 and 1992, when OCC rates began to decrease in males and OPC levelled off until 2018. Lip cancer suffered the highest drop. APC models showed a mortality increase in males and females from 40 to 45 and 50 to 55 years of age, respectively.ConclusionsFavourable OCC mortality trends was plausibly influenced by decreased tobacco/alcohol consumption, while OPC rise was probably associated with increased human papillomavirus infection. The importance of closely monitoring these cancers by age group, sex and location, and continuing with preventive measures against known risk factors, is highlighted.