bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sleep Duration and Health Care Expenditures in the United States
Authors: Jasani Foram S. , Seixas Azizi A. , Madondo Kumbirai , Li Yan , Jean-Louis Girardin , Pagán José A. 
Published: August 2020

Objective:
To estimate the average incremental health care expenditures associated with habitual long and short duration of sleep as compared with healthy/average sleep duration.

Data Source:
Medical Expenditure Panel Survey data (2012; N=6476) linked to the 2010–2011 National Health Interview Survey.

Study Design:
Annual differences in health care expenditures are estimated for habitual long and short duration sleepers as compared with average duration sleepers using 2-part logit generalized linear regression models.

Principal Findings:
Habitual short duration sleepers reported an additional $1400 in total unadjusted health care expenditures compared to people with average sleep duration (P<0.01). After adjusting for demographics, socioeconomic factors, and health behavior factors, this difference remained significant with an additional $1278 in total health care expenditures over average duration sleepers (P<0.05). Long duration sleepers reported even higher, $2994 additional health care expenditures over average duration sleepers. This difference in health care expenditures remained significantly high ($1500, P<0.01) in the adjusted model. Expenditure differences are more pronounced for inpatient hospitalization, office expenses, prescription expenses, and home health care expenditures.

Conclusions:
Habitual short and long sleep duration is associated with higher health care expenditures, which is consistent with the association between unhealthy sleep duration and poorer health outcomes.
Participating in Complementary and Integrative Health Approaches Is Associated With Veterans’ Patient-reported Outcomes Over Time
Authors: Elwy A. Rani , Taylor Stephanie L. , Zhao Shibei , McGowan Michael , Plumb Dorothy N. , Westleigh Wendy , Gaj Lauren , Yan Grace W. , Bokhour Barbara G. 
Published: August 2020

Background:
Veterans Affairs is dedicated to providing a Whole Health approach to care, including offering complementary and integrative health (CIH) approaches to Veterans.

Objective:
The objective of this study was to examine the association of CIH participation with Veterans’ patient-reported outcomes over time.

Research Design:
A survey of patient-reported outcomes at 5 timepoints: baseline, 2, 4, 6, and 12 months.

Subjects:
Veterans participating in any type of CIH approach at 2 Veterans Affairs medical centers.

Measures:
Mixed hierarchical models with repeated variables were used to test the hypothesis that participating in any CIH approach would be associated with Veterans’ overall physical/mental health [Patient-Reported Outcomes Measurement Information System 28 (PROMIS 28)], pain intensity, perceived stress (Perceived Stress Scale-4), and engagement in their care (Patient Activation Measure-13), controlling for age, male sex, site, participation in other CIH approaches, and surveys completed.

Results:
We received 401 surveys from 119 Veterans (72% male, age range: 29–85 y) across all timepoints. Yoga participation was related to decreases in perceived stress (P<0.001), while tai chi participation was associated with improvements in overall PROMIS 28 physical and mental health functioning (P<0.02). Specific types of CIH were associated with significant improvements in PROMIS 28 subscales: meditation participation with physical functioning at 2, 6, and 12 months; tai chi participation with anxiety at 2 and 6 months, and ability to participate in social role activities at 2 months. No CIH approach was associated with Veterans’ pain or engagement in their care.

Conclusion:
As specific CIH approaches are associated with improvements in patient-reported outcomes, clinicians, Veterans, and family members may use this information in discussions of nonpharmacological options to address health and well-being.
The Association Between Hospital Characteristics and Emergency Medical Treatment and Labor Act Citation Events
Authors: Terp Sophie , Seabury Seth A. , Axeen Sarah , Pines Jesse M. , Lam Chun Nok , Arientyl Vanessa , Menchine Michael 
Published: August 2020

Objectives:
The Emergency Medical Treatment and Labor Act (EMTALA) is a federal law enacted in 1986 prohibiting patient dumping (refusing or transferring patients with emergency medical conditions without appropriate stabilization), and discrimination based upon ability to pay. We evaluate hospital-level features associated with citation for EMTALA violation.

Materials and Methods:
A retrospective analysis of observational data on EMTALA enforcement (2005–2013). Regression analysis evaluates the association between facility-level features and odds of EMTALA citation by hospital-year.

Results:
Among 4916 EMTALA-obligated hospitals there were 1925 EMTALA citation events at 1413 facilities between 2005 and 2013, with 4.3% of hospitals cited per year. In adjusted analyses, increased odds of EMTALA citations were found at hospitals that were: for-profit [odds ratio (OR): 1.61; 95% confidence interval (CI): 1.32–1.96], in metropolitan areas (OR: 1.32; 95% CI: 1.11–1.57); that admitted a higher proportion of Medicaid patients (OR: 1.01; 95% CI: 1.0–1.01); and were in the top quartiles of hospital size (OR: 1.48; 95% CI: 1.10–1.99) and emergency department (ED) volume (OR: 1.56; 95% CI: 1.14–2.12). Predicted probability of repeat EMTALA citation in the year following initial citation was 17% among for-profit and 11% among other hospital types. Among citation events for patients presenting to the same hospital’s ED, there were 1.30 EMTALA citation events per million ED visits, with 1.04 at private not-for-profit, 1.47 at government-owned, and 2.46 at for-profit hospitals.

Conclusions:
For-profit ownership is associated with increased odds of EMTALA citations after adjusting for other characteristics. Efforts to improve EMTALA might be considered to protect access to emergency care for vulnerable populations, particularly at large, urban, for-profit hospitals admitting high proportions of Medicaid patients.
National Health Care Expenditures Associated With Disability
Authors: Khavjou Olga A. , Anderson Wayne L. , Honeycutt Amanda A. , Bates Laurel G. , Razzaghi Hilda , Hollis NaTasha D. , Grosse Scott D. 
Published: August 2020

Background:
In 2003, national disability–associated health care expenditures (DAHE) were $398 billion. Updated estimates will improve our understanding of current DAHE.

Objective:
The objective of this study was to estimate national DAHE for the US adult population and analyze spending by insurance and service categories and to assess changes in spending over the past decade.

Research Design:
Data from the 2013–2015 Medical Expenditure Panel Survey were used to estimate DAHE for noninstitutionalized adults. These estimates were reconciled with National Health Expenditure Accounts (NHEA) data and adjusted to 2017 medical prices. Expenditures for institutionalized adults were added from NHEA data.

Measures:
National DAHE in total, by insurance and service categories, and percentage of total expenditures associated with disability.

Results:
DAHE in 2015 were $868 billion (at 2017 prices), representing 36% of total national health care spending (up from 27% in 2003). DAHE per person with disability increased from $13,395 in 2003 to $17,431 in 2015, whereas nondisability per-person spending remained constant (about $6700). Public insurers paid 69% of DAHE. Medicare paid the largest portion ($324.7 billion), and Medicaid DAHE were $277.2 billion. More than half (54%) of all Medicare expenditures and 72% of all Medicaid expenditures were associated with disability.

Conclusions:
The share of health care expenditures associated with disability has increased substantially over the past decade. The high proportion of DAHE paid by public insurers reinforces the importance of public programs designed to improve health care for people with disabilities and emphasizes the need for evaluating programs and health services available to this vulnerable population.
A Brief Report on an 8-Week Course of Mindfulness-based Care for Chronic Pain in the Treatment of Veterans With Back Pain
Authors: Eaton Erica , Swearingen Hannah R. , Zand Vakili Amin , Jones Stephanie R. , Greenberg Benjamin D. 
Published: August 2020

Background:
Chronic pain and associated symptoms are debilitating for veterans. Medical costs of treatments are high and current treatment options, most notably with opioid medications, have been associated with significant risk. Mindfulness-based interventions appear promising for chronic pain, but require additional testing in veteran care settings.

Objective:
This project was designed to test the feasibility of engaging and retaining veterans with chronic lower back pain in a new mindfulness protocol tailored for veterans, mindfulness-based care for chronic pain (MBCP). Clinical outcomes were also assessed.

Design:
An open pilot trial of an 8-week MBCP course that included meditation, gentle yoga, and psychoeducation.

Subjects:
Twenty-two veterans (mean age=49.77; 18% women) were recruited from a VA Medical Center in the Northeastern US. After screening for inclusion/exclusion criteria, 20 were eligible at baseline.

Measures:
Veterans were assessed at baseline and postintervention for functional impairment, pain intensity and bothersomeness, depression, and mindfulness.

Results:
The average number of sessions completed was 5; only 4 (20%) attended all sessions. Eleven of the 20 participants (55%) attended 5 or more sessions and had complete preintervention and postintervention visits. Five of the 11 had a clinically meaningful decrease in pain intensity and in depressive symptoms, while 6 of 11 had a meaningful decrease in pain bothersomeness and functional impairment.

Conclusions:
It was challenging to enroll and retain participants in this study, even with our intervention designed for veterans. We discuss possible adaptations and refinements in MBCP for veterans with chronic pain to enhance feasibility and improve upon these interventions.
Role of the Immune System and the Circadian Rhythm in the Pathogenesis of Chronic Pancreatitis
Authors: Kessler Asa , Weksler-Zangen Sarah , Ilan Yaron 
Published: August 2020

Abstract
Pancreatitis, in both acute and chronic forms, poses a major therapeutic challenge and is associated with great morbidity and several complications. The nature of pancreatic injury in chronic pancreatitis (CP) and the wide range of causative processes that lead to CP have made effective therapy a true unmet need. Multiple physiological, genetic, environmental, and behavioral factors contribute to the development of CP. As a result, several fields of research are aimed at identifying and addressing the factors that contribute to pancreatic injury. In this article, we review the current understanding of the pathogenesis and natural history of CP. We focus on the autonomous nervous system, immune system, and role of a chronobiological therapeutic approach to alleviate symptoms and prevent or reverse pancreatic injury associated with CP. We aim to demonstrate that individualizing chronopharmacological treatments for CP is a promising direction for future treatment using immune, nervous, and circadian systems.
Bone Mineral Metabolism During Chemotherapy in Childhood Acute Lymphoblastic Leukemia
Authors: Maddheshiya Sonal , Singh Surya K. , Kumar Ishan , Aggarwal Priyanka , Gupta Vineeta 
Published: August 2020

Objective:
The aim of this study was to evaluate levels of vitamin D, bone mineral density (BMD), and radiograph features at diagnosis and after 6 months of chemotherapy in patients with acute lymphoblastic leukemia (ALL). Vitamin D levels were also correlated with BMD and radiograph features.

Materials and Methods:
25-Hydroxy vitamin D [25(OH)D] levels, BMD, and radiograph features were assessed in 50 newly diagnosed patients of ALL in the age group of 2 to 14 years. A total of 30 age-matched and sex-matched children were recruited as controls. Vitamin D deficiency was defined as 25(OH)D <10 ng/mL, Vitamin D insufficiency as 10 to 29 ng/mL, and Vitamin D sufficiency as ≥30 ng/mL. Enzyme immunoassay (EIA) was used for the quantitative measurement of 25(OH)D levels in plasma and a LUNAR DPX NT bone densitometer was used for the assessment of BMD.

Results:
The mean age of the patients was 6.3 years, with a male:female ratio of 1.38:1. The mean 25(OH)D levels were 31.90±16.90 ng/mL in patients at diagnosis against 41.63±20.50 ng/mL in controls (P=0.02). Levels were 18.50±11.10 ng/mL postchemotherapy (P=0.00). Female sex was a risk factor for deficient 25(OH)D levels. There was a significant decrease in BMD postchemotherapy in the age groups of 5 to 10 and above 10 years at the femoral neck. Osteopenic changes were observed in more number of patients after 6 months of chemotherapy. There was a significant correlation between vitamin D levels, BMD, and osteopenic changes.

Conclusions:
Vitamin D deficiency was common among ALL patients, which worsened after chemotherapy. This had a significant correlation with BMD and osteopenic changes in radiograph.
Incidence Rates of Interstitial Lung Disease Events in Tofacitinib-Treated Rheumatoid Arthritis Patients
Authors: Citera Gustavo , Mysler Eduardo , Madariaga Hugo , Cardiel Mario H. , Castañeda Oswaldo , Fischer Aryeh , Richette Pascal , Chartrand Sandra , Park Jin Kyun , Strengholt Sander , Rivas Jose L. , Thorat Amit V. , Girard Tanya , Kwok Kenneth , Wang Lisy , Ponce de Leon Dario 
Published: August 2020

Background/Objective
Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). Interstitial lung disease (ILD) is an extra-articular manifestation of RA. We investigated incidence rates of ILD in patients with RA, receiving tofacitinib 5 or 10 mg twice daily, and identified potential risk factors for ILD.

Methods
This post hoc analysis comprised a pooled analysis of patients receiving tofacitinib 5 or 10 mg twice daily or placebo from 2 phase (P)1, 10 P2, 6 P3, 1 P3b/4, and 2 long-term extension studies. Interstitial lung disease events were adjudicated as “probable” (supportive clinical evidence) or “possible” (no supportive clinical evidence) compatible adverse events. Incidence rates (patients with events per 100 patient-years) were calculated for ILD events.

Results
Of 7061 patients (patient-years of exposure = 23,393.7), 42 (0.6%) had an ILD event; median time to ILD event was 1144 days. Incidence rates for ILD with both tofacitinib doses were 0.18 per 100 patient-years. Incidence rates generally remained stable over time. There were 17 of 42 serious adverse events (40.5%) of ILD; for all ILD events (serious and nonserious), 35 of 42 events (83.3%) were mild to moderate in severity. A multivariable Cox regression analysis identified age 65 years or older (hazard ratio 2.43 [95% confidence interval, 1.13–5.21]), current smokers (2.89 [1.33–6.26]), and Disease Activity Score in 28 joints–erythrocyte sedimentation rate score (1.30 [1.04–1.61]) as significant risk factors for ILD events.

Conclusions
Across P1/2/3/4/long-term extension studies, incidence rates for ILD events were 0.18 following tofacitinib treatment, and ILD events were associated with known risk factors for ILD in RA.
Covid19data.website
Authors: Malouche Dhafer 
Published: August 2020

Covid19data.website Project is a website that contains more than 250 Dashboards about the COVID-19 Toll areas affected by the virus. You can follow-up every day using this website the number of COVID-19 cases, deaths, active cases, the shares by 1 Million population, the mortality rate, the active rate in every country, continent, and territory and all States in the United States. Unlike the other websites, you can also follow-up an estimation of the reproduction number in the previous sixteen days. These statistics tell you how many secondary infections are likely to occur in a specific area.Furthermore, I provide a classification algorithm of the countries and the affected areas. It’s based on the observation during the previous 14 days of six criteria. A global score is then computed, allowing to evaluate the COVID-19 safeness toll of each area.
Cell-Cell Adhesion During Nephron Development Is Driven by Wnt/PCP Formin Daam1
Authors: Krneta-Stankic Vanja , Corkins Mark , Paulucci-Holthauzen Adriana , Kloc Malgorzata , Gladden Andrew , Miller Rachel 
Published: August 2020

SUMMARYE-cadherin junctions facilitate the assembly and disassembly of cell-cell contacts that drive development and homeostasis of epithelial tissues. The stability of E-cadherin-based junctions highly depends on their attachment to the actin cytoskeleton, but little is known about how the assembly of junctional actin filaments is regulated. Formins are a conserved group of proteins responsible for the formation and elongation of filamentous actin (F-actin). In this study, usingXenopusembryonic kidney and Madin-Darby canine kidney (MDCK) cells, we investigate the role of the Wnt/ planar cell polarity (PCP) formin protein Daam1 (Dishevelled-associated activator of morphogenesis 1) in regulating E-cadherin based intercellular adhesion. Using live imaging we show that Daam1 localizes to newly formed cell-cell contacts in the developing nephron. Furthermore, analyses of junctional F-actin upon Daam1 depletion indicate a decrease in microfilament localization and their slowed turnover. We also show that Daam1 is necessary for efficient and timely localization of junctional E-cadherin, which is mediated by Daam1’s formin homology domain 2 (FH2). Finally, we establish that Daam1 signaling is essential for promoting organized movement of renal cells. This study demonstrates that Daam1 formin junctional activity is critical for epithelial tissue organization.
Comparing Lifeact and Phalloidin for Super-resolution Imaging of Actin in Fixed Cells
Authors: Mazloom-Farsibaf Hanieh , Farzam Farzin , Fazel Mohamadreza , Wester Michael J. , Meddens Marjolein B. M. , Lidke Keith A. 
Published: August 2020

AbstractVisualizing actin filaments in fixed cells is of great interest for a variety of topics in cell biology such as cell division, cell movement, and cell signaling. We investigated the possibility of replacing phalloidin, the standard reagent for super-resolution imaging of F-actin in fixed cells, with the actin binding peptide ‘lifeact’. We compared the labels for use in single molecule based super-resolution microscopy, where AlexaFluor 647 labeled phalloidin was used in a (d)STORM modality and Atto 655 labeled lifeact was used in a single molecule imaging, reversible binding modality. We found that imaging with lifeact had a comparable resolution in reconstructed images and provided several advantages over phalloidin including lower costs, the ability to image multiple regions of interest on a coverslip without degradation, simplified sequential super-resolution imaging, and more continuous labeling of thin filaments.
Integrated environmental and genomic analysis reveals the drivers of local adaptation in African indigenous chickens
Authors: Gheyas Almas A. , Trujillo Adriana Vallejo , Kebede Adebabay , Lozano-Jaramillo Maria , Dessie Tadelle , Smith Jacqueline , Hanotte Olivier 
Published: August 2020

AbstractElucidating the genetic basis of environmental adaptation in indigenous livestock populations has important implications for sustainable breeding improvement. It requires a detailed untangling of relevant environmental pressures and fine resolution detection of genomic signatures of selection associated with these environmental parameters. Here, we uniquely employed an integrative approach, combining Ecological Niche Modelling (ENM) with (i) genome-wide analyses of positive signatures of selection (SSA) and (ii) genotype-environment association (GEA) analyses to unravel the environmental adaptation of Ethiopian indigenous chickens. We first examined 34 agro-ecological and climatic variables and identified six main environmental selection drivers (one temperature - strongly correlated to elevation, three precipitation, and two soil/land variables). We then performed genomic analyses using high-density SNP data from whole-genome sequencing of 245 Ethiopian chickens from 25 different populations. Environmental genomic association analyses (SSA and GEA) identify a few strongly supported selected genomic regions, often with clusters of candidate genes, related to altitude-induced stresses (hypoxia, thrombosis, and cold temperatures), water scarcity, and the challenges of scavenging feeding behaviour. These analyses support a predominantly oligogenic control of environmental adaptation and possible regulation by one or few genetic elements only. Our study shows that the pre-identification of the key environmental drivers of adaptation, followed by a detailed genomic investigation of the associated genetic mechanisms provides a powerful new approach for elucidating the effect of natural selection in domestic animals. These results represent new landmarks to inform sustainable poultry breeding improvement.
A small molecule screen identified N-Acetyl-L-cysteine for promotingex vivogrowth of single circulating tumor cells
Authors: Teng Teng , Kamal Mohamed , Iriondo Oihana , Amzaleg Yonatan , Luo Chunqiao , Thomas Amal , Lee Grace , Nguyen John D. , Smith Andrew , Sposto Richard , Yu Min 
Published: August 2020

AbstractCirculating tumor cells (CTCs) can be isolated via a minimally invasive blood draw and are considered a “liquid biopsy” of their originating solid tumors. CTCs contain a small subset of metastatic precursors that can form metastases in secondary organs, and provide a resource to identify mechanisms underlying metastasis-initiating properties. Despite technological advancements that allow for highly sensitive approaches of detection and isolation, CTCs are very rare and often present as single cells, posing an extreme challenge forex vivoexpansion after isolation. Here, using previously established patient-derived CTC lines, we performed a small molecule drug screening to identify compounds that can improveex vivoculture efficiency for single CTCs. We found that N-acetylcysteine (NAC) and other antioxidants can promoteex vivoexpansion of single CTCs, by reducing oxidative and other stress particularly at the initial stage of single cell expansion. RNA-seq analysis of growing clones and non-growing clones confirmed the effect by NAC, but also indicate that NAC-induced decrease in oxidative stress is insufficient for promoting proliferation of a subset of cells with heterogeneous quiescent and senescent features. Despite the challenge in expanding all CTCs, NAC treatment lead to establishment of single CTC clones that have similar tumorigenic features, which will facilitate future functional analyses.