bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Comparison of US Clinical Laboratory Chlamydia and Gonorrhea Testing Practices Before and After the 2014 Centers for Disease Control and Prevention Testing Recommendations
Authors: Davis Alissa , Gaynor Anne 
Published: September 2020

Background
Adherence to recommended laboratory testing practices is crucial for sexually transmitted infection prevention and control. The objective of this article is to compare Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) testing practices of US clinical laboratories in 2013 before the updated 2014 Centers for Disease Control and Prevention recommendations and in 2015 after the updated recommendations.

Methods
A total of 236 clinical laboratories participated in surveys about their 2013 and 2015 CT and NG testing practices, including questions on specimen types collected and assays used.

Results
There was an increase of 5 laboratories offering CT nucleic acid amplification testing (NAAT) from 2013 to 2015 and an increase of 5 laboratories offering NG NAAT. There was a net increase of 3 laboratories accepting urine for CT and NG NAAT, the preferred specimen type for male individuals. There was not a net increase in the total number of laboratories accepting vaginal swabs for CT NAAT (n = 89 in 2013 and 2015), the preferred specimen type for female individuals, but there was an increase of 3 laboratories accepting vaginal swabs for NG NAAT. The number of laboratories performing NG susceptibility testing decreased from 100 in 2013 to 89 in 2015 (χ2 = 1.07, P > 0.10).

Conclusions
There were no major changes in testing practices in the 2-year period from 2013 to 2015. However, there were some small shifts, including increases in the use of NAATs, acceptance of Centers for Disease Control and Prevention–preferred specimen types for CT/NG, and changes in usage of assays by manufacturer.
High-Risk Opioid Prescribing Trends: Prescription Drug Monitoring Program Data From 2010 to 2018
Authors: Ball Sarah J. , Simpson Kit , Zhang Jingwen , Marsden Justin , Heidari Khosrow , Moran William P. , Mauldin Patrick D. , McCauley Jenna L. 
Published: September 2020

Objective:
Deaths due to opioids have continued to increase in South Carolina, with 816 opioid-involved overdose deaths reported in 2018, a 9% increase from the prior year. The objective of the current study is to examine longitudinal trends (quarter [Q] 1 2010 through Q4 2018) of opioid prescribing volume and high-risk opioid prescribing behaviors in South Carolina using comprehensive dispensing data available in the South Carolina Prescription Drug Monitoring Program (SC PDMP).

Design:
Retrospective analyses of SC PDMP data were performed using general linear models to assess quarterly time trends and change in rate of each outcome Q1 2010 through Q4 2018.

Participants:
Opioid analgesic prescription fills from SC state residents between Q1 2010 and Q4 2018.

Main Outcome Measures:
High-risk prescribing behaviors included (1) opioid prescribing rate; (2) percentage of patients receiving opioids dispensed 90 or more average morphine milligram equivalents daily; (3) percentage of opioid prescribed days with overlapping opioid and benzodiazepine prescriptions; (4) rate per 100 000 residents of multiple provider episodes; and (5) percentage of patients prescribed extended release opioids who were opioid naive.

Results:
A total of 33 027 461 opioid prescriptions were filled by SC state residents within the time period of Q1 2010 through Q4 2018. A 41% decrease in the quarterly prescribing rate of opioids occurred from Q1 2010 to Q4 2018. The decrease in overall opioid prescribing was mirrored by significant decreases in all 4 high-risk prescribing behaviors.

Conclusion:
PDMPs may represent the most complete data regarding the dispensing of opioid prescriptions and as such be valuable tools to inform and monitor the supply of licit opioids. Our results indicate that public health policy, legislative action, and multiple clinical interventions aimed at reducing high rates of opioid prescribing across the health care ecosystem appear to be succeeding in the state of South Carolina.
The Cost of Providing the Foundational Public Health Services in Ohio
Authors: Singh Simone R. , Leider Jonathon P. , Orcena Jason E. 
Published: September 2020

Objectives:
To examine levels of expenditure and needed investment in public health at the local level in the state of Ohio pre–COVID-19.

Design:
Using detailed financial reporting from fiscal year (FY) 2018 from Ohio's local health departments (LHDs), we characterize spending by Foundational Public Health Services (FPHS). We also constructed estimates of the gap in public health spending in the state using self-reported gaps in service provision and a microsimulation approach. Data were collected between January and June 2019 and analyzed between June and September 2019.

Participants:
Eighty-four of the 113 LHDs in the state of Ohio covering a population of almost 9 million Ohioans.

Results:
In FY2018, Ohio LHDs spent an average of $37 per capita on protecting and promoting the public's health. Approximately one-third of this investment supported the Foundational Areas (communicable disease control; chronic disease and injury prevention; environmental public health; maternal, child, and family health; and access to and linkages with health care). Another third supported the Foundational Capabilities, that is, the crosscutting skills and capacities needed to support all LHD activities. The remaining third supported programs and activities that are responsive to local needs and vary from community to community. To fully meet identified LHD needs in the state pre–COVID-19, Ohio would require an additional annual investment of $20 per capita on top of the current $37 spent per capita, or approximately $240 million for the state.

Conclusions:
A better understanding of the cost and value of public health services can educate policy makers so that they can make informed trade-offs when balancing health care, public health, and social services investments. The current environment of COVID-19 may dramatically increase need, making understanding and growing public health investment critical.
Revealing the Unequal Burden of COVID-19 by Income, Race/Ethnicity, and Household Crowding: US County Versus Zip Code Analyses
Authors: Chen Jarvis T. , Krieger Nancy 
Published: September 2020

Objective:
To overcome the absence of national, state, and local public health data on the unequal economic and social burden of COVID-19 in the United States.

Design:
We analyze US county COVID-19 deaths and confirmed COVID-19 cases and positive COVID-19 tests in Illinois and New York City zip codes by area percent poverty, percent crowding, percent population of color, and the Index of Concentration at the Extremes.

Setting:
US counties and zip codes in Illinois and New York City, as of May 5, 2020.

Main Outcome Measures:
Rates, rate differences, and rate ratios of COVID-19 mortality, confirmed cases, and positive tests by category of county and zip code–level area-based socioeconomic measures.

Results:
As of May 5, 2020, the COVID-19 death rate per 100 000 person-years equaled the following: 143.2 (95% confidence interval [CI]: 140.9, 145.5) vs 83.3 (95% CI: 78.3, 88.4) in high versus low poverty counties (≥20% vs <5% of persons below poverty); 124.4 (95% CI: 122.7, 126.0) versus 48.2 (95% CI: 47.2, 49.2) in counties in the top versus bottom quintile for household crowding; and 127.7 (95% CI: 126.0, 129.4) versus 25.9 (95% CI: 25.1, 26.6) for counties in the top versus bottom quintile for the percentage of persons who are people of color. Socioeconomic gradients in Illinois confirmed cases and New York City positive tests by zip code–level area-based socioeconomic measures were also observed.

Conclusions:
Stark social inequities exist in the United States for COVID-19 outcomes. We recommend that public health departments use these straightforward cost-effective methods to report on social inequities in COVID-19 outcomes to provide an evidence base for policy and resource allocation.
Acute Postoperative Complications in Prepectoral versus Subpectoral Reconstruction following Nipple-Sparing Mastectomy
Authors: Avila Azalia , Bartholomew Alex J. , Sosin Michael , Deldar Romina , Griffith Kayla F. , Willey Shawna C. , Song David H. , Fan Kenneth L. , Tousimis Eleni A. 
Published: September 2020

Background:
Nipple-sparing mastectomy is associated with improved aesthetics and oncologic safety. Recently, there has been a resurgence in prepectoral reconstruction. Because of limited data comparing complication rates on patients undergoing prepectoral breast reconstruction, this study compared 30-day postoperative complications by plane of prosthetic placement.

Methods:
A retrospective review was conducted on all consecutive patients undergoing nipple-sparing mastectomy with implant-based reconstruction with either prepectoral or subpectoral placement from 2014 to 2018. The primary outcome was a composite, acute 30-day postoperative complication, including nipple-areola complex necrosis, mastectomy flap necrosis, wound dehiscence, infection, hematoma, and seroma. Secondary outcomes included nipple loss and rates of unintended reoperations. Univariate and mixed effects multivariate logistic regression were used to compare outcomes.

Results:
A total of 228 patients and 405 breasts were included in the final cohort, with 202 in the subpectoral cohort and 203 in the prepectoral cohort. The overall complication rate was 7.65 percent, with no significant difference between subpectoral and prepectoral cohorts (9.41 percent versus 5.91 percent, respectively; p = 0.148). Prepectoral reconstruction was associated with significantly reduced ischemic complications, including nipple loss because of necrosis (2.97 percent versus 0.49 percent, respectively; p = 0.015) and mastectomy flap necrosis (5.45 percent versus 0 percent; p = 0.003). There were no significant differences in rates of infection, hematoma, seroma, or implant loss/exchange.

Conclusions:
Prepectoral reconstruction is associated with similar overall 30-day postoperative complications and reoperations compared to traditional subpectoral implants. However, prepectoral reconstruction was associated with significantly decreased ischemic complications, including mastectomy flap necrosis and nipple-areola complex loss because of necrosis.

Clinical Question/Level of Evidence:
Therapeutic, III.
Evaluating a Multimodal Clinical Anesthesia Course Integrated Into an Existing Veterinary Curriculum
Authors: Noyes Julie A. , Keegan Robert D. , Carbonneau Kira J. , Lepiz Mauricio L. , Rankin David C. , Matthew Susan M. 
Published: September 2020

Introduction
This study evaluated a multimodal, simulation-based course in veterinary anesthesia integrated into an existing veterinary curriculum.

Methods
A simulation-based, multimodal training course in clinical anesthesia was evaluated using outcomes from multiple levels of the Kirkpatrick Model of Training Evaluation. Cognitive and affective outcomes were evaluated before and after instruction. Head-mounted cameras were used to record clinical performance during students' first live patient anesthesia experience in the curriculum.

Results
Pretest-posttest analysis of cognitive and affective outcomes for course participants revealed significant increases in knowledge and self-efficacy. Course participants received higher ratings on clinical task performance and professional skills (ie, communication and collaboration) compared with a matched control group when evaluated by blinded, external raters using a standardized rubric.

Conclusions
These findings indicate that implementing a multimodal anesthesia simulation-based course directly into the curriculum can enhance cognitive and affective outcomes and prepare students for subsequent anesthesia-related patient care experiences.
Technical Report and Surgical Outcomes of Needlescopic Totally Extraperitoneal Inguinal Hernia Repair: A Single-center, Retrospective Cohort Study
Authors: Kojima Shigehiro , Kikukawa Rina , Sakamoto Tsuguo 
Published: September 2020

Background:
Technical difficulties in totally extraperitoneal inguinal hernia repair (TEP) may be strongly associated with poor operability in a limited operative field. Needlescopic instruments could be helpful in a limited space, and the aim of this study was to evaluate the clinical efficacy of needlescopic TEP.

Materials and Methods:
The study population constituted 150 consecutive patients undergoing needlescopic TEP, and we compared these patients with 151 consecutive patients who underwent conventional TEP regarding patients’ demographic features and operative outcomes. Inclusion criteria were: (1) being treated by an experienced surgeon and (2) replying to our questionnaire regarding postoperative outcomes.

Results:
The mean skin opening to closing times for unilateral and bilateral repairs were, respectively, 95.3±30.1 and 130.2±48.7 minutes for conventional TEP and 75.7±24.5 and 114.5±46.3 minutes for needlescopic TEP. The difference for unilateral repairs between the 2 surgical groups was significant (P=0.01). Conversion rates, postoperative hospital stays, and perioperative morbidity rates showed no significant differences between the 2 groups.

Conclusions:
Needlescopic TEP is a useful procedure that decreases operative duration with no significant differences in perioperative morbidity compared with conventional TEP.
Skeletal ageing in Virunga mountain gorillas
Authors: Ruff Christopher B. , Junno Juho-Antti , Eckardt Winnie , Gilardi Kirsten , Mudakikwa Antoine , McFarlin Shannon C. 
Published: September 2020

Bone loss and heightened fracture risk are common conditions associated with ageing in modern human populations and have been attributed to both hormonal and other metabolic and behavioural changes. To what extent these age-related trends are specific to modern humans or generally characteristic of natural populations of other taxa is not clear. In this study, we use computed tomography to examine age changes in long bone and vertebral structural properties of 34 wild-adult Virunga mountain gorillas (Gorilla beringei beringei) whose skeletons were recovered from natural accumulations. Chronological ages were known or estimated from sample-specific dental wear formulae and ranged between 11 and 43 years. Gorillas show some of the same characteristics of skeletal ageing as modern humans, including endosteal and some periosteal expansion. However, unlike in humans, there is no decline in cortical or trabecular bone density, or in combined geometric-density measures of strength, nor do females show accelerated bone loss later in life. We attribute these differences to the lack of an extended post-reproductive period in gorillas, which provides protection against bone resorption. Increases in age-related fractures (osteoporosis) in modern humans may be a combined effect of an extended lifespan and lower activity levels earlier in life.This article is part of the theme issue ‘Evolution of the primate ageing process'.
Evaluating the impact of physical frailty during ageing in wild chimpanzees (
Pan troglodytes schweinfurthii
)
Authors: Thompson Melissa Emery , Machanda Zarin P. , Fox Stephanie A. , Sabbi Kris H. , Otali Emily , Thompson González Nicole , Muller Martin N. , Wrangham Richard W. 
Published: September 2020

While declining physical performance is an expected consequence of ageing, human clinical research has placed increasing emphasis on physical frailty as a predictor of death and disability in the elderly. We examined non-invasive measures approximating frailty in a richly sampled longitudinal dataset on wild chimpanzees. Using urinary creatinine to assess lean body mass, we found moderate but significant declines in physical condition with age in both sexes. While older chimpanzees spent less of their day in the trees and feeding, they did not alter activity budgets with respect to travel or resting. There was little evidence that declining lean body mass had negative consequences independent of age. Old chimpanzees with poor lean body mass rested more often but did not otherwise differ in activity. Males, but not females, in poor condition were more likely to exhibit respiratory illness. Poor muscle mass was associated acutely with death in males, but it did not predict future mortality in either sex. While there may be some reasons to suspect biological differences in the susceptibility to frailty in chimpanzees versus humans, our data are consistent with recent reports from humans that lean, physically active individuals can successfully combat frailty.
This article is part of the theme issue ‘Evolution of the primate ageing process’.
Costs of reproduction and ageing in the human female
Authors: Jasienska Grazyna 
Published: September 2020

Evolutionary theories of ageing point to reproduction as a significant factor to consider when asking why ageing occurs and why there is inter-individual variation in its progression. Reproduction in human females is costly, in terms of energy, nutrients and metabolic adjustments. Thus, it is expected that women who experienced high reproductive effort resulting from multiple reproductive events will age faster. However, the evidence for long-term negative effects of reproduction is not conclusive. The lack of understanding of whether there are trade-offs between reproduction and ageing in women is partly due to methodological challenges. The costs of reproduction are often calculated based only on parity, while other elements contributing to these costs (e.g. breastfeeding, timing of reproduction) are neglected, which may significantly underestimate the total costs and obscure the all-important inter-individual variation in such costs. Costs must be evaluated in relation to individual characteristics, including developmental conditions, nutritional status and social support that a mother receives during reproduction. Furthermore, ageing and health must be assessed based on comprehensive markers rather than arbitrarily assembled variables. Finally, longitudinal rather than cross-sectional studies and new statistical approaches are needed to reveal how much of a decline in health and progressing ageing can actually be attributed to past reproductive processes.This article is part of the theme issue ‘Evolution of the primate ageing process'.
Wild flies hedge their thermal preference bets in response to seasonal fluctuations
Authors: Akhund-Zade Jamilla , Yoon Denise , Bangerter Alyssa , Polizos Nikolaos , Campbell Matthew , Soloshenko Anna , Zhang Thomas , Wice Eric , Albright Ashley , Narayanan Aditi , Schmidt Paul , Saltz Julia , Ayroles Julien , Klein Mason , Bergland Alan , de Bivort Benjamin 
Published: September 2020

AbstractFluctuating environmental pressures can challenge organisms by repeatedly shifting the optimum phenotype. Two contrasting evolutionary strategies to cope with these fluctuations are 1) evolution of the mean phenotype to follow the optimum (adaptive tracking) or 2) diversifying phenotypes so that at least some individuals have high fitness in the current fluctuation (bet-hedging). Bet-hedging could underlie stable differences in the behavior of individuals that are present even when genotype and environment are held constant. Instead of being simply ‘noise,’ behavioral variation across individuals may reflect an evolutionary strategy of phenotype diversification. Using geographically diverse wild-derived fly strains and high-throughput assays of individual preference, we tested whether thermal preference variation inDrosophila melanogastercould reflect a bet-hedging strategy. We also looked for evidence that populations from different regions differentially adopt bet-hedging or adaptive-tracking strategies. Computational modeling predicted regional differences in the relative advantage of bet-hedging, and we found patterns consistent with that in regional variation in thermal preference heritability. In addition, we found that temporal patterns in mean preference support bet-hedging predictions and that there is a genetic basis for thermal preference variability. Our empirical results point to bet-hedging in thermal preference as a potentially important evolutionary strategy in wild populations.
Diversity Across the Pancreatic Ductal Adenocarcinoma Disease Spectrum Revealed by Network-Anchored Functional Genomics
Authors: Rose Johnathon L. , Srinivasan Sanjana , Yao Wantong , Seth Sahil , Peoples Michael , Machado Annette , Li Chieh-Yuan , Ho I-Lin , Lee Jaewon J. , Guerrero Paola A. , Kim Eiru , Syed Mustafa , Daniele Joseph R. , Deem Angela , Kim Michael , Bristow Christopher A. , Koay Eugene J. , Genovese Giannicola , Viale Andrea , Heffernan Timothy P. , Maitra Anirban , Hart Traver , Carugo Alessandro , Draetta Giulio F. 
Published: September 2020

ABSTRACTCancers are highly complex ecosystems composed of molecularly distinct sub-populations of tumor cells, each exhibiting a unique spectrum of genetic features and phenotypes, and embedded within a complex organ context. To substantially improve clinical outcomes, there is a need to comprehensively define inter- and intra-tumor phenotypic diversity, as well as to understand the genetic dependencies that underlie discrete molecular subpopulations. To this end, we integrated CRISPR-based co-dependency annotations with a tissue-specific co-expression network developed from patient-derived models to establish CoDEX, a framework to quantitatively associate gene-cluster patterns with genetic vulnerabilities in pancreatic ductal adenocarcinoma (PDAC). Using CoDEX, we defined multiple prominent anticorrelated gene-cluster signatures and specific pathway dependencies, both across genetically distinct PDAC models and intratumorally at the single-cell level. Of these, one differential signature recapitulated the characteristics of classical and basal-like PDAC molecular subtypes on a continuous scale. Anchoring genetic dependencies identified through functional genomics within the gene-cluster signature defined fundamental vulnerabilities associated with transcriptomic signatures of PDAC subtypes. Subtype-associated dependencies were validated by feature-barcoded CRISPR knockout of prioritized basal-like-associated genetic vulnerabilities (SMAD4,ILK, andZEB1) followed by scRNAseq in multiple PDAC models. Silencing of these genes resulted in a significant and directional clonal shift toward the classical-like signature of more indolent tumors. These results validate CoDEX as a novel, quantitative approach to identify specific genetic dependencies within defined molecular contexts that may guide clinical positioning of targeted therapeutics.