bluuebunny/crossref_metadata_2025_split huggingface dataset:
A combined approach to correct posterior left ventricular aneurysm, aortic stenosis and coronary artery disease
Authors: Patel Akshay J , Mohamed Saifullah , Iqbal Yassir , Kar Ashok , Soppa Gopal 
Published: August 2020

Abstract
Ischaemic heart disease and aortic stenosis are potentially life-threatening conditions. A post-infarct left ventricular aneurysm, when combined with the above, is particularly hazardous. We present a case where all three conditions occurred simultaneously and describe the surgical approach undertaken to attempt correction. The patient underwent aneurysmectomy together with aortic valve replacement and two-vessel coronary artery bypass grafting. The aneurysm was excised with direct linear closure of the walls using a Teflon-buttressed interrupted mattress suture technique. Post-operatively, ventricular systolic function was good (LVEF 40%) together with a well-seated aortic valve showing no paravalvular leaks. This case highlights the importance of meticulous removal of thrombus from the aneurysm and everting the edges thereby eliminating a thrombogenic surface and the risk of embolic stroke. The restorative procedure itself serves to underline the importance of ventricular shape in the effective functioning of the myocardium for sustaining an adequate stroke volume with normalized physiology.
Tracking the spread of COVID-19 in India via social networks in the early phase of the pandemic
Authors: Azad Sarita , Devi Sushma 
Published: August 2020

Abstract

Background
The coronavirus pandemic (COVID-19) has spread worldwide via international travel. This study traced its diffusion from the global to national level and identified a few superspreaders that played a central role in the transmission of this disease in India.

Data and methods
We used the travel history of infected patients from 30 January to 6 April 6 2020 as the primary data source. A total of 1386 cases were assessed, of which 373 were international and 1013 were national contacts. The networks were generated in Gephi software (version 0.9.2).

Results
The maximum numbers of connections were established from Dubai (degree 144) and the UK (degree 64). Dubai’s eigenvector centrality was the highest that made it the most influential node. The statistical metrics calculated from the data revealed that Dubai and the UK played a crucial role in spreading the disease in Indian states and were the primary sources of COVID-19 importations into India. Based on the modularity class, different clusters were shown to form across Indian states, which demonstrated the formation of a multi-layered social network structure. A significant increase in confirmed cases was reported in states like Tamil Nadu, Delhi and Andhra Pradesh during the first phase of the nationwide lockdown, which spanned from 25 March to 14 April 2020. This was primarily attributed to a gathering at the Delhi Religious Conference known as Tabliqui Jamaat.

Conclusions
COVID-19 got induced into Indian states mainly due to International travels with the very first patient travelling from Wuhan, China. Subsequently, the contacts of positive cases were located, and a significant spread was identified in states like Gujarat, Rajasthan, Maharashtra, Kerala and Karnataka. The COVID-19’s spread in phase one was traced using the travelling history of the patients, and it was found that most of the transmissions were local.
Galaxy–group (halo) alignments from SDSS DR7 and the ELUCID simulation
Authors: Zhang Youcai , Yang Xiaohu , Guo Hong 
Published: August 2020

ABSTRACT
Based on galaxies from the Sloan Digital Sky Survey (SDSS) and subhaloes in the corresponding reconstructed region from the constrained simulation of ELUCID, we study the alignment of central galaxies relative to their host groups in the group catalogue, as well as the alignment relative to the corresponding subhaloes in the ELUCID simulation. Galaxies in observation are matched to dark matter subhaloes in the ELUCID simulation using a novel neighborhood abundance matching method. In observation, the major axes of galaxies are found to be preferentially aligned to the major axes of their host groups. There is a colour dependence of galaxy–group alignment that red centrals have a stronger alignment along the major axes of their host groups than blue centrals. Combining galaxies in observation and subhaloes in the ELUCID simulation, we also find that central galaxies have their major axes to be aligned to the major axes of their corresponding subhaloes in the ELUCID simulation. We find that the galaxy–group and galaxy–subhalo alignment signals are stronger for galaxies in more massive haloes. We find that the alignments between main subhaloes and the SDSS-matched subhalo systems in simulation are slightly stronger than the galaxy–group alignments in observation.
Monophyletic Origin and Divergent Evolution of Animal Telomerase RNA
Authors: Logeswaran Dhenugen , Li Yang , Podlevsky Joshua D , Chen Julian J -L 
Published: August 2020

Abstract
Telomerase RNA (TR) is a noncoding RNA essential for the function of telomerase ribonucleoprotein. TRs from vertebrates, fungi, ciliates, and plants exhibit extreme diversity in size, sequence, secondary structure, and biogenesis pathway. However, the evolutionary pathways leading to such unusual diversity among eukaryotic kingdoms remain elusive. Within the metazoan kingdom, the study of TR has been limited to vertebrates and echinoderms. To understand the origin and evolution of TR across the animal kingdom, we employed a phylogeny-guided, structure-based bioinformatics approach to identify 82 novel TRs from eight previously unexplored metazoan phyla, including the basal-branching sponges. Synthetic TRs from two representative species, a hemichordate and a mollusk, reconstitute active telomerase in vitro with their corresponding telomerase reverse transcriptase components, confirming that they are authentic TRs. Comparative analysis shows that three functional domains, template-pseudoknot (T-PK), CR4/5, and box H/ACA, are conserved between vertebrate and the basal metazoan lineages, indicating a monophyletic origin of the animal TRs with a snoRNA-related biogenesis mechanism. Nonetheless, TRs along separate animal lineages evolved with divergent structural elements in the T-PK and CR4/5 domains. For example, TRs from echinoderms and protostomes lack the canonical CR4/5 and have independently evolved functionally equivalent domains with different secondary structures. In the T-PK domain, a P1.1 stem common in most metazoan clades defines the template boundary, which is replaced by a P1-defined boundary in vertebrates. This study provides unprecedented insight into the divergent evolution of detailed TR secondary structures across broad metazoan lineages, revealing ancestral and later-diversified elements.
Acute Pancreatitis as the Initial Manifestation in 2 Cases of COVID-19 in Wuhan, China
Authors: Wang Kaige , Luo Jianfei , Tan Fen , Liu Jiasheng , Ni Zhong , Liu Dan , Tian Panwen , Li Weimin 
Published: August 2020

Abstract
Clinical data on coronavirus disease 2019 (COVID-19) with pancreatic injury are extremely limited. An acute manifestation of acute pancreatitis in COVID-19 has not been reported. We describe here 2 cases of COVID-19 with acute pancreatitis as the initial manifestation in Wuhan, China. Patient 1 died despite maximal mechanical ventilatory support and circulation support, while patient 2 was finally discharged after showing significant improvement. Low T cells in peripheral blood may indicate a poor outcome.
Four Challenges Associated With Current Mathematical Modeling Paradigm of Infectious Diseases and Call for a Shift
Authors: Chen Shi , Robinson Patrick , Janies Daniel , Dulin Michael 
Published: August 2020

Abstract
Mathematical models are critical tools to characterize COVID-19 dynamics and take action accordingly. We identified 4 major challenges associated with the current modeling paradigm (SEIR) that hinder the efforts to accurately characterize the emerging COVID-19 and future epidemics. These challenges included (1) lack of consistent definition of “case”; (2) discrepancy between patient-level clinical insights and population-level modeling efforts; (3) lack of adequate inclusion of individual behavioral and social influence; and (4) allowing little flexibility of including new evidence and insights when our knowledge evolved rapidly during the pandemic. Therefore, these challenges made the current SEIR modeling paradigm less practical to handle the complex COVID-19 and future pandemics. Novel and more reliable data sources and alternative modeling paradigms are needed to address these issues.
Marginalization or Incorporation? Welfare Receipt and Political Participation among Young Adults
Authors: Sugie Naomi F , Conner Emma 
Published: August 2020

Abstract
Prior scholarship finds that participation in means-tested welfare programs, including cash assistance and food stamps, deters political participation among groups that are already politically and socioeconomically marginalized. We revisit these findings within a contemporary context using nationally representative data, along with fixed-effects models that adjust for time-stable unobserved and time-varying observed characteristics. In contrast to prior research, we find little evidence that cash assistance is related to participation. However, food stamps—a benefits program that has undergone substantial changes in recent years—is positively associated with being registered to vote. Moreover, food stamps has countervailing associations with voting—e.g., marginalizing and incorporating—that depend on a person’s attention to politics. Together, these findings revise our understanding of how welfare influences political inequalities and advances policy feedback scholarship by identifying heterogeneity by political attentiveness as a focus of future inquiry.
Integrating behavioral health and primary care: a qualitative analysis of financial barriers and solutions
Authors: Shmerling Alison C , Gold Stephanie B , Gilchrist Emma C , Miller Benjamin F 
Published: August 2020

Abstract
The objective of this study was to characterize financial barriers and solutions for the integration of behavioral health in primary care at the practice and system levels.
Semi-structured interviews were conducted March–August of 2015 with 77 key informants. Initially a broad thematic coding approach was used, and data coded as “financing” was further analyzed in ATLAS.ti using an inductive thematic approach by three coders. Themes identified included the following: fragmentation of payment and inadequate investment limit movement toward integration; the evidence base for integration is not well known and requires appropriately structured further study; fee-for-service limits the movement to integration—an alternative payment system is needed; there are financial considerations beyond specific models of payment, including incentivizing innovation, prevention, and practice transformation support; stakeholders need to be engaged and aligned to support this process. There was consensus that the current fragmented, fee-for-service system with inadequate baseline reimbursement significantly hinders progression toward integrated behavioral health and primary care. Funding is needed both to support integrated care and to facilitate the transition to a new model. Multiple suggestions were offered regarding interim solutions to move toward an integrated model and ultimately global payment. Payment, in terms of both adequate amount and model, is a significant obstacle to integrating behavioral health and primary care. Future policy efforts must focus on ensuring stakeholder collaboration, multi-payer alignment, increasing investment in behavioral health and primary care, and moving away from fee-for-service toward a global and value-based payment model.
Lessons learned from service design of a trial of a digital mental health service: Informing implementation in primary care clinics
Authors: Graham Andrea K , Greene Carolyn J , Powell Thomas , Lieponis Pauli , Lunsford Amanda , Peralta Chris D , Orr L Casey , Kaiser Susan M , Alam Nameyeh , Berhane Helom , Kalan Ozan , Mohr David C 
Published: August 2020

AbstractImplementing a digital mental health service in primary care requires integration into clinic workflow. However, without adequate attention to service design, including designing referral pathways to identify and engage patients, implementation will fail. This article reports results from our efforts designing referral pathways for a randomized clinical trial evaluating a digital service for depression and anxiety delivered through primary care clinics. We utilized three referral pathways: direct to consumer (e.g., digital and print media, registry emails), provider referral (i.e., electronic health record [EHR] order and provider recommendation), and other approaches (e.g., presentations, word of mouth). Over the 5-month enrollment, 313 individuals completed the screen and reported how they learned about the study. Penetration was 13%, and direct to consumer techniques, most commonly email, had the highest yield. Providers only referred 16 patients through the EHR, half of whom initiated the screen. There were no differences in referral pathway based on participants’ age, depression severity, or anxiety severity at screening. Ongoing discussions with providers revealed that the technologic implementation and workflow design may not have been optimal to fully affect the EHR-based referral process, which potentially limited patient access. Results highlight the importance of designing and evaluating referral pathways within service implementation, which is important for guiding the implementation of digital services into practice. Doing so can ensure that sustained implementation is not left to post-evaluation bridge-building. Future efforts should assess these and other referral pathways implemented in clinical practice outside of a research trial.
Behavioral health policy for improving population health and wellbeing: opportunities for investment in evidence-based policymaking
Authors: Crowley Max , Green Lawrie , Scott Taylor , Long Elizabeth 
Published: August 2020

Abstract
The high cost of behavioral health problems across the population continues to highlight the need to integrate high-quality behavioral interventions across a variety of service settings. To successfully achieve such a system-wide transformation will require supporting federal policies that invest in sustainable high-quality services. To support these efforts we provide a mixed-method study of all federal mental health legislation over the last three decades. Results indicate that mental and behavioral health policies have grown. Further, specific characteristics that comprise bills that are successfully enacted into law are identified. Finally, opportunities for the field to engage with policymakers to support widespread integration of behavioral health services are offered.
Phylogeny, taxonomic reassessment and ‘ecomorph’ relationship of theOrientallactaga sibiricacomplex (Rodentia: Dipodidae: Allactaginae)
Authors: Cheng Jilong , Xia Lin , Feijó Anderson , Shenbrot Georgy I , Wen Zhixin , Ge Deyan , Lu Liang , Yang Qisen 
Published: August 2020

AbstractThe ecological gradient–morphological variation (‘ecomorph’) relationship has long interested ecologists and evolutionary biologists, but it is applied far less frequently than genetic differentiation in cryptic species detection and species identification. With integrative methods, we revise taxonomic uncertainties in the Orientallactaga sibirica complex (OSC), with 298 sequence specimens and 469 voucher specimens from 138 localities covering nearly the entire distribution of the OSC. Phylogenetic relationships are assessed by Bayesian inference and maximum likelihood using two mitochondrial and nine nuclear genes. We use species-delimitation approaches to divide and validate the ‘candidate species’. We evaluate correlations between ecological divergence and phylogenetic splits, and visualize geographical patterns of morphological variation. The OSC is divided into four phylogenetic groups, the Ognevi, Altay, Bogda and Sibirica groups, and the OSC exhibits a significant ecomorph relationship and ecological divergence pattern. Morphological variations not only follow the general regularity under a large gradient of ecological factors, but are also closely related to the local environment/habitat. We suggest considering the comprehensive ecomorph relationship to identify species. Molecular analyses reveal that the OSC more easily forms deeply divergent lineages in the foothills and this differentiation depth may be related to mountain system size.
Righting the Autonomy-Supervision Pendulum: Understanding the Impact of Independent Rounds on Medical Students, Residents, and Faculty
Authors: Moriarty Jessica A. , Vellanki Srisindu , Trope Lee A. , Hilgenberg Sarah L. , Blankenburg Rebecca L. 
Published: August 2020

Purpose
To explore trainee and faculty perspectives on an independent rounding intervention on general pediatrics wards at 2 institutions.

Method
In July 2018, the authors introduced independent rounds 1 to 2 times a week at 2 training sites. In this qualitative study, the authors conducted semistructured focus groups with a purposive sample of junior trainees (clerkship medical students and postgraduate year [PGY] 1 residents), senior trainees (PGY-2 and PGY 3–5 residents), and hospital medicine faculty between October 2018 and May 2019. Focus groups were audio-recorded, transcribed verbatim, and analyzed for themes using the constant comparative approach associated with grounded theory.

Results
Focus groups included 27 junior trainees, 20 senior trainees, and 18 faculty. Six themes emerged: (1) Independent rounds contributed to all trainees’ development; (2) Senior residents described increased motivation to take full ownership of their patients and educational needs of the team; (3) Faculty expressed concerns about decreased opportunities for teaching and feedback; however, all trainees reported unique learning from having faculty both present and absent from rounds; (4) No significant patient safety events were reported; (5) All participants identified communication and patient progression concerns; and (6) A tension emerged between decreased faculty and enhanced trainee career satisfaction. Participants identified solutions to identified barriers to further improve this educational intervention.

Conclusions
As a result of independent rounding, trainees described increased motivation to take ownership of their patients and team. Both rounding experiences contributed to their development as physicians in different ways. Further studies should explore patient and caregiver perspectives and concerns about communication and patient care progression when designing future interventions to promote resident autonomy.
The Evolution of Assessment: Thinking Longitudinally and Developmentally
Authors: Holmboe Eric S. , Yamazaki Kenji , Hamstra Stanley J. 
Published: August 2020

Becoming a physician or other health care professional is a complex and intensely developmental process occurring over a prolonged period of time. The learning path for each medical student, resident, and fellow varies due to different individual learner abilities and curricular designs, clinical contexts, and assessments used by the training program. The slow and uneven evolution to outcomes-based medical education is partly the result of inadequate approaches to programmatic assessment that do not fully address all essential core competencies needed for practice or account for the developmental nature of training. Too many assessments in medical education still focus on single point-in-time performance or function as indirect proxies for actual performance in clinical care for patients and families.
Milestones are a modest first step of providing predictive, longitudinal data on a national scale. Longitudinal Milestones data can facilitate the continuous improvement efforts of programs in assessment. However, Milestone judgments are only as good as the assessment data and group processes that inform them. Programmatic assessment should be longitudinally focused and provide all learners with comprehensive and actionable data to guide their professional development and support creation of meaningful individualized action plans. Efforts are urgently needed to rebalance programmatic assessment away from an overreliance on assessment proxies toward more effectively using developmentally focused work-based assessments, routinely incorporate clinical performance and patient experience data, and partner with learners through iterative coproduced assessment activities.
Double standard: why electrocardiogram is standard care while electroencephalogram is not?
Authors: Li Yun , Bohringer Christian , Liu Hong 
Published: August 2020

Purpose of review
Major adverse cardiovascular and cerebrovascular events (MACCE) significantly affect the surgical outcomes. Electrocardiogram (ECG) has been a standard intraoperative monitor for 30 years. Electroencephalogram (EEG) can provide valuable information about the anesthetized state and guide anesthesia management during surgery. Whether EEG should be a standard intraoperative monitor is discussed in this review.

Recent findings
Deep anesthesia has been associated with postoperative delirium, especially in elderly patients. Intraoperative EEG monitoring has been demonstrated to reduce total anesthesia drug use during general anesthesia and postoperative delirium.

Summary
Unlike ECG monitoring, the EEG under general anesthesia has not been designated as a standard monitor by anesthesiologist societies around the world. The processed EEG technology has been commercially available for more than 25 years and EEG technology has significantly facilitated its intraoperative use. It is time to consider EEG as a standard anesthesia monitor during surgery.
Sutureless and Equipment-Free Technique for Contact Lens Viewing System During Vitreoretinal Surgery
Authors: Silpa-Archa Sukhum 
Published: August 2020

Purpose:
To report a sutureless and equipment-free technique for contact lens wide-angle viewing system during vitreoretinal surgery.

Methods:
A step-by-step procedure and a surgical video using this technique were proposed.

Results:
This technique needs only three-finger control of contact lens either by the left hand (for the right-handed surgeon) or right hand (for the left-handed surgeon). The contact lens is not fixed to the environment (lid speculums, cannulas, corneoscleral limbus); therefore, it allows the surgeon to move and tilt the contact lens freely while keeping a clear view of the retina.

Conclusion:
The sutureless and equipment-free technique for contact lens viewing system during vitreoretinal surgery has been tried and tested, and it is practical and effective in the real world.