bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends of shoulder instability surgery in Finland: a nationwide register study
Authors: Joukainen Antti , Mattila Ville M , Lepola Vesa , Lehtinen Janne , Kukkonen Juha , Paloneva Juha 
Published: October 2020

ObjectiveRate of shoulder instability surgery (SIS) has increased in different specific populations. We analysed nationwide trend of SIS in adults in Finland between 1997 and 2014.DesignA retrospective register study.SettingNational Hospital Discharge Register of Finland.ParticipantsA total of 22 550 adult patients with SIS in Finland (1997–2014).Primary and secondary outcome measuresAnalysis included appropriate diagnosis (International Classification of Diseases 10) and procedure coding combinations applicable for SIS. The primary outcome variable was the incidence of SIS per 100 000 person-years, and the secondary outcomes were the study year, sex, age groups (18–29, 30–49 and over 50 years of age) and the type of hospital (public or private).ResultsThe overall nationwide rate of SIS in adults increased 177% between 1997 and 2014 in Finland. The rate was the lowest (13/100 000 person-years) in 1997, and the peak rate (40/100 000 person-years) was noted in 2007. The increase in rate was rapid between 1997 and 2007, after which the rate became stable. During the study period, the highest increases were noted in the young adults age group (270%), and especially in the middle-aged group who were operated on in private hospitals (930%).ConclusionsThe rate of SIS increased almost threefold in Finland from 1997 to 2014. The increase was most significant in young and middle-aged adults (18–50 years), in men, and in private hospitals.
Longitudinal, multidisciplinary, resident-driven intervention to increase immunisation rates for Medicaid, low-income and uninsured patients
Authors: Cantu Cynthia , Koch Kristopher , Cancino Ramon S 
Published: October 2020

IntroductionMore payers are closely linking reimbursement to high-value care outcomes such as immunisation rates. Despite this, there remain high rates of pneumonia and influenza-related hospitalisations generating hospital expenditures as high as $11 000 per hospitalisation. Vaccinating the public is an integral part of preventing poor health and utilisation outcomes and is particularly relevant to high-risk patients. As part of a multidisciplinary effort between family and internal medicine residency programmes, our goal was to improve vaccination rates to an average of 76% of eligible Medicaid, low-income and uninsured (MLIU) patients at an academic primary care practice.MethodsThe quality improvement project was completed over 3 months by three primary care resident groups. The setting was a suburban academic primary care practice and eligible patients were 18 years of age or older. Our aim was to increase immunisation rates of pneumococcal, influenza, varicella, herpes zoster virus and tetanus and diphtheria vaccination. There were 1690 patients eligible for the vaccination composite metric. Data were derived from the electronic health record and administrative data.InterventionsCohort 1 developed an initial intervention that consisted of a vaccine questionnaire for patients to complete while in the waiting room. Cohort 2 modified questionnaire after reviewing results from initial intervention. Cohort 3 recommended elimination of questionnaire and implementation of a bundled intervention approach.ResultsThere were minimal improvements in patient immunisation rates after using a patient-directed paper questionnaire. After implementation of multiple interventions via an improvement bundle, there were improvements in immunisation rates which were sustained and the result of special cause variation.ConclusionA key to improving immunisation rates for MLIU patients in this clinic was developing relationships with faculty and staff stakeholders. We received feedback from all the medical staff and then applied it to the interventions and made an impact in the average of vaccinations.
Effects of night surgery on postoperative mortality and morbidity: a multicentre cohort study
Authors: Althoff Friederike C , Wachtendorf Luca J , Rostin Paul , Santer Peter , Schaefer Maximilian S , Xu Xinling , Grabitz Stephanie D , Chitilian Hovig , Houle Timothy T , Brat Gabriel A , Akeju Oluwaseun , Eikermann Matthias 
Published: October 2020

BackgroundSurgery at night (incision time 17:00 to 07:00 hours) may lead to increased postoperative mortality and morbidity. Mechanisms explaining this association remain unclear.MethodsWe conducted a multicentre retrospective cohort study of adult patients undergoing non-cardiac surgery with general anaesthesia at two major, competing tertiary care hospital networks. In primary analysis, we imputed missing data and determined whether exposure to night surgery affects 30-day mortality using a mixed-effects model with individual anaesthesia and surgical providers as random effects. Secondary outcomes were 30-day morbidity and the mediating effect of blood transfusion rates and provider handovers on the effect of night surgery on outcomes. We further tested for effect modification by surgical setting.ResultsAmong 350 235 participants in the primary imputed cohort, the mortality rate was 0.9% (n=2804/322 327) after day and 3.4% (n=940/27 908) after night surgery. Night surgery was associated with an increased risk of mortality (ORadj1.26, 95% CI 1.15 to 1.38, p<0.001). In secondary analyses, night surgery was associated with increased morbidity (ORadj1.41, 95% CI 1.33 to 1.48, p<0.001). The proportion of patients receiving intraoperative blood transfusion and anaesthesia handovers were higher during night-time, mediating 9.4% (95% CI 4.7% to 14.2%, p<0.001) of the effect of night surgery on 30-day mortality and 8.4% (95% CI 6.7% to 10.1%, p<0.001) of its effect on morbidity. The primary association was modified by the surgical setting (p-for-interaction<0.001), towards a greater effect in patients undergoing ambulatory/same-day surgery (ORadj1.81, 95% CI 1.39 to 2.35) compared with inpatients (ORadj1.17, 95% CI 1.02 to 1.34).ConclusionsNight surgery was associated with an increased risk of postoperative mortality and morbidity. The effect was independent of case acuity and was mediated by potentially preventable factors: higher blood transfusion rates and more frequent provider handovers.
Prevalence of pulmonary hypertension in adults after atrial switch and role of ventricular filling pressures
Authors: Miranda William R , Jain C Charles , Connolly Heidi M , DuBrock Hilary M , Cetta Frank , Egbe Alexander C , Hagler Donald J 
Published: October 2020

ObjectiveTo assess the prevalence of elevated systemic right ventricular (sRV) end-diastolic pressure and pulmonary arterial hypertension in adults with transposition of the great arteries (TGA) who have undergone atrial switch operation.MethodsForty-two adults (aged ≥18 years) with complete TGA and atrial switch palliation undergoing cardiac catheterisation between 2004 and 2018 at Mayo Clinic, MN, were identified. Clinical, echocardiographic and invasive haemodynamic data were abstracted from the medical charts and procedure logs.ResultsMean age was 37.6±7.9 years; 28 were male (67%). The Mustard operation was performed in 91% of individuals. Mean estimated sRV ejection fraction by echocardiography was 33.3%±10.9% and ≥moderate tricuspid (systemic atrioventricular valve) regurgitation was present in 15 patients (36%). Mean sRV end-diastolic pressure was 13.2±5.4 mm Hg. An sRV end-diastolic pressure >15 mm Hg was present in 35% of individuals whereas a pulmonary artery wedge pressure (PAWP) >15 mm Hg was seen in 59%. Mean pulmonary artery pressure ≥25 mm Hg was seen in 47.5% of patients with PAWP being >15 mm Hg in all but one patient.ConclusionIn adults after atrial switch, elevated sRV end-diastolic pressure was present in only one-third of patients whereas increased PAWP was seen in almost 60%. These findings are most likely related to a combination of decreased pulmonary atrial (functional left atrium) compliance and, in a subset of patients, pulmonary venous baffle obstruction. Elevation in pulmonary pressures was highly prevalent with concomitant elevation in PAWP being present in essentially all patients.
Strength of the naked singularity in critical collapse
Authors: Guo Jun-Qi , Zhang Lin , Chen Yuewen , Joshi Pankaj S. , Zhang Hongsheng 
Published: October 2020

AbstractThe critical collapse of a scalar field is a threshold solution of black hole formation, in which a naked singularity arises. We study here the curvature strength of this singularity using a numerical ansatz. The behavior of the Jacobi volume forms is examined along a non-spacelike geodesic in the limit of approach to the singularity. These are seen to be vanishing, thus showing that all physical objects will be crushed to zero size near the singularity. Consequently, although the critical collapse is considered to be a fine-tuning problem, the naked singularity forming is gravitationally strong. This implies that the spacetime cannot be extended beyond the singularity, thus making the singularity genuine and physically interesting. These results imply that the nature of critical collapse may need to be examined and explored further.
Lefschetz thimbles and quantum phases in zero-dimensional bosonic models
Authors: Bharathkumar R. , Joseph Anosh 
Published: October 2020

AbstractIn this paper, by analyzing the underlyingLefschetz-thimble structure, we investigate quantum phases (or quantum critical points) in zero-dimensional scalar field theories with complex actions. Using first principles, we derive the thimble equations of these models for various values of the coupling parameters. In the thimble decomposition of complex path integrals, determination of the so-called intersection numbers appears as an important ingredient. In this paper, we obtain the analytic expressions for the combined intersection number of thimbles and anti-thimbles of these zero-dimensional theories. We also derive the conditional expressions involving relations among the coupling parameters of the model, that would help us predict quantum phase transitions in these systems. We see that the underlying thimble structure undergoes a drastic change when the system passes through such a phase transition.
Dark photon dark matter and fast radio bursts
Authors: Landim Ricardo G. 
Published: October 2020

AbstractThe nature of dark matter (DM) is still a mystery that may indicate the necessity for extensions of the Standard Model (SM). Light dark photons (DP) may comprise partially or entirely the observed DM density and existing limits for the DP DM parameter space arise from several cosmological and astrophysical sources. In the present work we investigate DP DM using cosmic transients, specifically fast radio bursts (FRBs). The observed time delay of radio photons with different energies have been used to constrain the photon mass or the Weak Equivalence Principle, for example. Due to the mixing between the visible and the DP, the time delay of photons from these cosmic transients, caused by free electrons in the intergalactic medium, can change and impact those constraints from FRBs. We use five detected FRBs and two associations of FRBs with gamma-ray bursts to investigate the correspondent variation on the time delay caused by the presence of DP DM. The result is virtually independent of the FRB used and this variation is very small, considering the still allowed DP DM parameter space, not jeopardizing current bounds on other contributions of the observed time delay.
Resolving Hubble tension with the Milne model
Authors: Vishwakarma Ram Gopal 
Published: October 2020

The recent measurements of the Hubble constant based on the standard [Formula: see text]CDM cosmology reveal an underlying disagreement between the early-Universe estimates and the late-time measurements. Moreover, as these measurements improve, the discrepancy not only persists but becomes even more significant and harder to ignore. The present situation places the standard cosmology in jeopardy and provides a tantalizing hint that the problem results from some new physics beyond the [Formula: see text]CDM model. It is shown that a nonconventional theory — the Milne model — which introduces a different evolution dynamics for the Universe, alleviates the Hubble tension significantly. Moreover, the model also averts some long-standing problems of the standard cosmology, for instance, the problems related with the cosmological constant, the horizon, the flatness, the Big Bang singularity, the age of the Universe and the nonconservation of energy.
Locally finite complexes, modules and generalized information systems
Authors: Chiaselotti G. , Infusino F. 
Published: October 2020

Simplicial complexes (here briefly complexes) are set systems on an arbitrary set which are object of study in many areas of both mathematics and theoretical computer science. Usually, they are investigated over finite sets. However, in general, when we consider an arbitrary set [Formula: see text] (not necessarily finite) and a complex [Formula: see text] on [Formula: see text], the most natural property related to finiteness is the following: for any subset [Formula: see text] of [Formula: see text], if [Formula: see text] for all finite subsets [Formula: see text] of [Formula: see text], then [Formula: see text]. We call locally finite any complex [Formula: see text] having such a property. Bearing in mind some motivations and constructions derived from the analysis of information systems in rough set theory, in this paper we associate with any locally finite complex [Formula: see text] a corresponding pre-closure operator [Formula: see text] and, through it, we establish several properties of [Formula: see text]. Next, we investigate the main features of the specific sub-class of locally finite complexes [Formula: see text] for which [Formula: see text] is a closure operator. We call these complexes closable and exhibit a particular family of closable locally finite complexes using left-modules on rings with identity. Finally, we establish a representation result according to which we can associate a pairing structure with any closable locally finite complex.
An Enhanced Sentiment Analysis Framework Based on Pre-Trained Word Embedding
Authors: Mohamed Ensaf Hussein , Moussa Mohammed ElSaid , Haggag Mohamed Hassan 
Published: October 2020

Sentiment analysis (SA) is a technique that lets people in different fields such as business, economy, research, government, and politics to know about people’s opinions, which greatly affects the process of decision-making. SA techniques are classified into: lexicon-based techniques, machine learning techniques, and a hybrid between both approaches. Each approach has its limitations and drawbacks, the machine learning approach depends on manual feature extraction, lexicon-based approach relies on sentiment lexicons that are usually unscalable, unreliable, and manually annotated by human experts. Nowadays, word-embedding techniques have been commonly used in SA classification. Currently, Word2Vec and GloVe are some of the most accurate and usable word embedding techniques, which can transform words into meaningful semantic vectors. However, these techniques ignore sentiment information of texts and require a huge corpus of texts for training and generating accurate vectors, which are used as inputs of deep learning models. In this paper, we propose an enhanced ensemble classifier framework. Our framework is based on our previously published lexicon-based method, bag-of-words, and pre-trained word embedding, first the sentence is preprocessed by removing stop-words, POS tagging, stemming and lemmatization, shortening exaggerated word. Second, the processed sentence is passed to three modules, our previous lexicon-based method (Sum Votes), bag-of-words module and semantic module (Word2Vec and Glove) and produced feature vectors. Finally, the previous features vectors are fed into 11 different classifiers. The proposed framework is tested and evaluated over four datasets with five different lexicons, the experiment results show that our proposed model outperforms the previous lexicon based and the machine learning methods individually.
CD19-specific CAR T Cells that Express a PD-1/CD28 Chimeric Switch-Receptor are Effective in Patients with PD-L1–positive B-Cell Lymphoma
Authors: Liu Hui , Lei Wen , Zhang Chaoting , Yang Chunmei , Wei Juying , Guo Qunyi , Guo Xiaojun , Chen Zhilu , Lu Ying , Young Ken H. , Lu Zheming , Qian Wenbin 
Published: October 2020

Abstract

Purpose:
CD19-specific chimeric antigen receptor (CAR) T-cell therapy is effective against refractory or relapsed (R/R) B-cell lymphoma, but the efficacy is hindered by the existence of PD-1/PD-L1 pathway.

Patients and Methods:
Here, we generated a novel anti-CD19 CAR-expressing PD-1/CD28 chimeric switch-receptor (CD19-PD-1/CD28-CAR). We then conducted a phase Ib study to evaluate safety and efficacy of CD19-PD-1/CD28-CAR T cells in the treatment of PD-L1+ B-cell lymphoma.

Results:
We found that CD19-PD-1/CD28-CAR T cells had superior T-cell proliferation, cytokine production, and sequentially capability of killing PD-L1+ B-cell lymphoma cells in vitro and in vivo relative to the prototype, CD19-CAR T cells. Among 17 adult patients with R/R lymphoma who received the CAR T therapy, 10 patients had objective response (58.8%), including seven patients with complete remission (41.2%). At a median follow-up 15 months, median overall survival for all patients was not reached. Remarkably, no severe neurologic toxicity or cytokine release syndrome was observed.

Conclusions:
This first-in-human study demonstrates the tolerability, safety, and encouraging efficacy of CD19-PD-1/CD28-CART in PD-L1+ large B-cell lymphoma.
Effect of Germline Mutations in Homologous Recombination Repair Genes on Overall Survival of Patients with Pancreatic Adenocarcinoma
Authors: Yadav Siddhartha , Kasi Pashtoon M. , Bamlet William R. , Ho Thanh P. , Polley Eric C. , Hu Chunling , Hart Steven N. , Rabe Kari G. , Boddicker Nicholas J. , Gnanaolivu Rohan D. , Lee Kun Y. , Lindstrom Tricia H. , Petersen Gloria M. , Couch Fergus J. , McWilliams Robert R. 
Published: October 2020

AbstractPurpose:To compare the clinical characteristics and overall survival (OS) of germline mutation carriers in homologous recombination repair (HRR) genes and noncarriers with pancreatic ductal adenocarcinoma (PDAC).Experimental Design:Germline DNA from 3,078 patients with PDAC enrolled in a prospective registry at Mayo Clinic between 2000 and 2017 was analyzed for mutations in 37 cancer predisposition genes. Characteristics and OS of patients with mutations in eight genes (ATM, BARD1, BRCA1, BRCA2, BRIP1, PALB2, RAD51C, and RAD51D) involved in HRR were compared with patients testing negative for mutations in all 37 genes.Results:The 175 HRR mutation carriers and 2,730 noncarriers in the study had a median duration of follow-up of 9.9 years. HRR mutation carriers were younger (median age at diagnosis: 63 vs. 66 years, P &lt; 0.001) and more likely to have metastatic disease at diagnosis (46% vs. 36%, P = 0.004). In a multivariable model adjusting for sex, age at diagnosis, and tumor staging, patients with germline HRR mutations had a significantly longer OS compared with noncarriers [HR, 0.83; 95% confidence interval (CI), 0.70–0.97; P = 0.02]. Further gene-level analysis demonstrated that germline ATM mutation carriers had longer OS compared with patients without germline mutations in any of the 37 genes (HR, 0.72; 95% CI, 0.55–0.94; P = 0.01).Conclusions:This study demonstrates that germline mutation carrier status in PDAC is associated with longer OS compared with noncarriers. Further research into tumor biology and response to platinum-based chemotherapy in germline mutation carriers with PDAC are needed to better understand the association with longer OS.
Malignant Arrhythmias in Patients With COVID-19
Authors: Turagam Mohit K. , Musikantow Daniel , Goldman Martin E. , Bassily-Marcus Adel , Chu Edward , Shivamurthy Poojita , Lampert Joshua , Kawamura Iwanari , Bokhari Mahmoud , Whang William , Bier Benjamin Aaron , Malick Waqas , Hashemi Helen , Miller Marc A. , Choudry Subbarao , Pumill Christopher , Ruiz-Maya Tania , Hadley Michael , Giustino Gennaro , Koruth Jacob S. , Langan Noelle , Sofi Aamir , Dukkipati Srinivas R. , Halperin Jonathan L. , Fuster Valentin , Kohli-Seth Roopa , Reddy Vivek Y. 
Published: October 2020

Background:
Patients with coronavirus disease 2019 (COVID-19) who develop cardiac injury are reported to experience higher rates of malignant cardiac arrhythmias. However, little is known about these arrhythmias—their frequency, the underlying mechanisms, and their impact on mortality.

Methods:
We extracted data from a registry (NCT04358029) regarding consecutive inpatients with confirmed COVID-19 who were receiving continuous telemetric ECG monitoring and had a definitive disposition of hospital discharge or death. Between patients who died versus discharged, we compared a primary composite end point of cardiac arrest from ventricular tachycardia/fibrillation or bradyarrhythmias such as atrioventricular block.

Results:

Among 800 patients with COVID-19 at Mount Sinai Hospital with definitive dispositions, 140 patients had telemetric monitoring, and either died (52) or were discharged (88). The median (interquartile range) age was 61 years (48–74); 73% men; and ethnicity was White in 34%. Comorbidities included hypertension in 61%, coronary artery disease in 25%, ventricular arrhythmia history in 1.4%, and no significant comorbidities in 16%. Compared with discharged patients, those who died had elevated peak troponin I levels (0.27 versus 0.02 ng/mL) and more primary end point events (17% versus 4%,
P
=0.01)—a difference driven by tachyarrhythmias. Fatal tachyarrhythmias invariably occurred in the presence of severe metabolic imbalance, while atrioventricular block was largely an independent primary event.

Conclusions:
Hospitalized patients with COVID-19 who die experience malignant cardiac arrhythmias more often than those surviving to discharge. However, these events represent a minority of cardiovascular deaths, and ventricular tachyarrhythmias are mainly associated with severe metabolic derangement.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT04358029.