bluuebunny/crossref_metadata_2025_split huggingface dataset:
Low-residue versus clear liquid diet before colonoscopy
Authors: Chen Engeng , Chen Li , Wang Fei , Zhang Wei , Cai Xianlei , Cao Gaoyang 
Published: December 2020

Abstract
Great value in the early identification and treatment of adenomatous polyps or early canceration using colonoscopy has been recognized. A clear colonoscopic vision brought by good intestinal preparation will become crucial. Several studies have completed using the low-residue diet (LRD) versus a clear liquid diet (CLD) the day before colonoscopy that presenting contradictory results. Therefore, a more comprehensive and updated meta-analysis is needed to summarize the findings on the effects of LRD and CLD on intestinal preparation and the quality of coloscopy.
The comprehensive search was performed in PubMed/MEDLINE, Scopus, Cochrane databases (February 2020). LRD vs CLD before colonoscopy were included in this study. Mantel-Haenszel or DerSimonian and Laird models with the relative risk (RR) to evaluate differences in intestinal preparation, tolerance, readiness to repeat preparation, detected of a polyp, and overall adverse reactions.
Total 16 studies (N = 3413) were eligible. Patients with LRD compared with CLD indicated significantly better of tolerability (RR 0.92;95% CI,0.85–0.99; P < .05) and willingness to repeat intestinal preparation (RR 0.86; 95% CI 0.79–0.93; P < .05), but no differences with adequate intestinal preparations, detected polyp or overall adverse reactions (all P > .05).
Patients with LRD the day before colonoscopy show better tolerance and willingness to repeat intestinal preparation, and no difference with adequate intestinal preparations compared with CLD, but the recommended level of evidence is weak. However, in terms of the detection rate of intestinal adenomas, the LRD group is not weaker than the CLD group, for its evidence level is high, and can significantly reduce the hunger experience of patients.
The Cost of Implementing and Sustaining the COMprehensive Post-Acute Stroke Services Model
Authors: Bayliss William S. , Bushnell Cheryl D. , Halladay Jacqueline R. , Duncan Pamela W. , Freburger Janet K. , Kucharska-Newton Anna M. , Trogdon Justin G. 
Published: December 2020

Background:
The COMprehensive Post-Acute Stroke Services (COMPASS) model, a transitional care intervention for stroke patients discharged home, was tested against status quo postacute stroke care in a cluster-randomized trial in 40 hospitals in North Carolina. This study examined the hospital-level costs associated with implementing and sustaining COMPASS.

Methods:
Using an activity-based costing survey, we estimated hospital-level resource costs spent on COMPASS-related activities during approximately 1 year. We identified hospitals that were actively engaged in COMPASS during the year before the survey and collected resource cost estimates from 22 hospitals. We used median wage data from the Bureau of Labor Statistics and COMPASS enrollment data to estimate the hospital-level costs per COMPASS enrollee.

Results:
Between November 2017 and March 2019, 1582 patients received the COMPASS intervention across the 22 hospitals included in this analysis. Average annual hospital-level COMPASS costs were $2861 per patient (25th percentile: $735; 75th percentile: $3,475). Having 10% higher stroke patient volume was associated with 5.1% lower COMPASS costs per patient (P=0.016). About half (N=10) of hospitals reported postacute clinic visits as their highest-cost activity, while a third (N=7) reported case ascertainment (ie, identifying eligible patients) as their highest-cost activity.

Conclusions:
We found that the costs of implementing COMPASS varied across hospitals. On average, hospitals with higher stroke volume and higher enrollment reported lower costs per patient. Based on average costs of COMPASS and readmissions for stroke patients, COMPASS could lower net costs if the model is able to prevent about 6 readmissions per year.
Association of Mandatory Bundled Payments for Joint Replacement With Postacute Care Outcomes Among Medicare and Medicaid Dual Eligible Patients
Authors: Li Yue , Ying Meiling , Cai Xueya , Thirukumaran Caroline P. 
Published: December 2020

Importance:
The Medicare comprehensive care for joint replacement (CJR) model, a mandatory bundled payment program started in April 2016 for hospitals in randomly selected metropolitan statistical areas (MSAs), may help reduce postacute care (PAC) use and episode costs, but its impact on disparities between Medicaid and non-Medicaid beneficiaries is unknown.

Objective:
To determine effects of the CJR program on differences (or disparities) in PAC use and outcomes by Medicare-Medicaid dual eligibility status.

Design, Setting, and Participants:
Observational cohort study of 2013–2017, based on difference-in-differences (DID) analyses on Medicare data for 1,239,452 Medicare-only patients, 57,452 dual eligibles with full Medicaid benefits, and 50,189 dual eligibles with partial Medicaid benefits who underwent hip or knee surgery in hospitals of 75 CJR MSAs and 121 control MSAs.

Main Outcome Measures:
Risk-adjusted differences in rates of institutional PAC [skilled nursing facility (SNF), inpatient rehabilitation, or long-term hospital care] use and readmissions; and for the subgroup of patients discharged to SNF, risk-adjusted differences in SNF length of stay, payments, and quality measured by star ratings, rate of successful discharge to community, and rate of transition to long-stay nursing home resident.

Results:
The CJR program was associated with reduced institutional PAC use and readmissions for patients in all 3 groups. For example, it was associated with reductions in 90-day readmission rate by 1.8 percentage point [DID estimate=−1.8; 95% confidence interval (CI), −2.6 to −0.9; P<0.001] for Medicare-only patients, by 1.6 percentage points (DID estimate=−1.6; 95% CI, −3.1 to −0.1; P=0.04) for full-benefit dual eligibles, and by 2.0 percentage points (DID estimate=−2.0; 95% CI, −3.6 to −0.4; P=0.01) for partial-benefit dual eligibles. These CJR-associated effects did not differ between dual eligibles (differences in above DID estimates=0.2; 95% CI, −1.4 to 1.7; P=0.81 for full-benefit patients; and −0.3; 95% CI, −1.9 to 1.3; P=0.74 for partial-benefit patients) and Medicare-only patients. Among patients discharged to SNF, the CJR program showed no effect on successful community discharge, transition to long-term care, or their persistent disparities.

Conclusions:
The CJR program did not help reduce persistent disparities in readmissions or SNF-specific outcomes related to Medicare-Medicaid dual eligibility, likely due to its lack of financial incentives for reduced disparities and improved SNF outcomes.
Association Between State Policies on Improving Opioid Prescribing in 2 States and Opioid Overdose Rates Among Reproductive-aged Women
Authors: Ji Xu , Haight Sarah C. , Ko Jean Y. , Cox Shanna , Barfield Wanda D. , Zhang Kun , Guy Gery P. , Li Rui 
Published: December 2020

Background:
The opioid overdose epidemic has been declared a public health emergency. Women are more likely than men to be prescribed opioid medications. Some states have adopted policies to improve opioid prescribing, including prescription drug monitoring programs (PDMPs) and pain clinic laws.

Objective:
Among reproductive-aged women, we examined the association of mandatory use laws for PDMPs in Kentucky (concurrent with a pain clinic law) and New York with overdose involving prescription opioids or heroin and opioid use disorder (OUD).

Study Design, Subjects, and Outcome Measures:
We conducted interrupted time series analyses estimating outcome changes after policy implementation in Kentucky and New York, compared with geographically close states without these policies (comparison states), using 2010–2014 State Inpatient and State Emergency Department Databases. Outcomes included rates of inpatient discharges and emergency department visits for overdoses involving prescription opioids or heroin and OUD among reproductive-aged women.

Results:
Relative to comparison states, following Kentucky’s policy change, we found an immediate postpolicy decrease and a decreasing trend in the rate of overdoses involving prescription opioids, an immediate postpolicy increase in the rate of overdoses involving heroin, and a decreasing trend in the OUD rate (P<0.01); New York’s policy change was not associated with the assessed outcomes.

Conclusions:
PDMPs and pain clinic laws, such as those implemented in Kentucky, may be promising strategies to reduce the adverse impacts of high-risk opioid prescribing among reproductive-aged women. As states continue efforts to improve inappropriate opioid prescribing, similar strategies as those adopted in Kentucky merit consideration.
How to Identify Team-based Primary Care in the United States Using Medicare Data
Authors: Kuo Yong-Fang , Lin Yu-Li , Jupiter Daniel 
Published: December 2020

Background:
Studying team-based primary care using 100% national outpatient Medicare data is not feasible, due to limitations in the availability of this dataset to researchers.

Methods:
We assessed whether analyses using different sets of Medicare data can produce results similar to those from analyses using 100% data from an entire state, in identifying primary care teams through social network analysis. First, we used data from 100% Medicare beneficiaries, restricted to those within a primary care services area (PCSA), to identify primary care teams. Second, we used data from a 20% sample of Medicare beneficiaries and defined shared care by 2 providers using 2 different cutoffs for the minimum required number of shared patients, to identify primary care teams.

Results:
The team practices identified with social network analysis using the 20% sample and a cutoff of 6 patients shared between 2 primary care providers had good agreement with team practices identified using statewide data (F measure: 90.9%). Use of 100% data within a small area geographic boundary, such as PCSAs, had an F measure of 83.4%. The percent of practices identified from these datasets that coincided with practices identified from statewide data were 86% versus 100%, respectively.

Conclusions:
Depending on specific study purposes, researchers could use either 100% data from Medicare beneficiaries in randomly selected PCSAs, or data from a 20% national sample of Medicare beneficiaries to study team-based primary care in the United States.
Parent Perspectives on Information-seeking, Trustworthiness, and Decision-making in High-risk Neuroblastoma
Authors: Brown Katherine , Benjaminy Shelly , Illes Judy , Deyell Rebecca J. 
Published: December 2020

Background:
This study explores how parents of children with high-risk neuroblastoma incorporate information from multiple sources into treatment decision-making for their children as they evaluate the trustworthiness of the sources.

Methods:
Following ethics board approval, parents of children with high-risk neuroblastoma were recruited through purposive sampling from a tertiary care pediatric oncology program in Vancouver, BC, Canada. Participants completed an in-depth, semistructured interview with a study member. The qualitative descriptive methodology was utilized to code interview transcripts and identify emergent themes.

Results:
Nine parents of children with high-risk neuroblastoma during upfront therapy (n=4) or treatment of refractory disease (n=5) were included. Despite almost universal access of web-based information, parents acknowledged distrust in the reliability and consistency of these sources. Open communication between parents and physicians about sources of information outside the clinic and access to regulated, accurate information is highly valued. The impact on the quality of life and the costs, both financial and personal, of travel are key factors in decision-making.

Discussion:
Health care providers shoulder an immense responsibility to augment and contextualize information available about high-risk neuroblastoma for parents to maximize benefit in decision-making. Health care providers should guide access to accurate, evidence-based resources that can be monitored and continuously updated.
Hypoglycemia in a Pediatric Emergency Department
Authors: Papini Laura , Piga Simone , Dionisi-Vici Carlo , Parisi Pasquale , Ciofi degli Atti Marta Luisa , Marcias Michela , Garrone Stefano , Scialanga Barbara , Taurisano Roberta , Reale Antonino , Villa Maria Pia , Raucci Umberto 
Published: December 2020

Objectives
This study aimed to establish the rate, etiology, and short-term outcome of hypoglycemia in infants and children accessing an emergency department of a tertiary care pediatric hospital.

Methods
The study was retrospectively conducted on the clinical records of children with hypoglycemia aged 15 days to 17 years who were admitted consecutively to the emergency department during a 6-year period for various clinical conditions. Hypoglycemia was defined as a venous plasma glucose level lower than 45 mg/dL.

Results
Hypoglycemia was detected in 402 patients (female-to-male ratio, 1.26; mean age, 2.6 ± 1.8 years), with a rate of 0.99 per 1000 children. Plasma glucose levels ranged from 3 to 45 (mean, 37.48 ± 7.44) mg/dL. Hypoglycemia was associated with gastroenteritis or other infectious diseases causing protracted fasting in 86.32% of cases, whereas hypoglycemia related to a different etiology (HDE) was observed in 13.68% of hypoglycemic children. Most HDE patients had a final diagnosis of ketotic hypoglycemia, whereas metabolic defects were a rare (1.49%) but nonnegligible etiologic cause. A severe triage code was more frequent in the HDE group (P < 0.001). Factors significantly and independently associated with HDE were impaired level of consciousness, assessed with the AVPU scale (A, alert; V, responding to verbal; P, responding to pain; U, unresponsive; adjusted odds ratio, 2.50; P = 0.025) and clinical onset within 12 hours (adjusted odds ratio, 3.98; P < 0.001).

Conclusions
In a nonnegligible number of critically ill children, hypoglycemia can be detected. In a minority of cases, hypoglycemia was due to metabolic disorders that should be suspected on the basis of the severity of hypoglycemia, and the recent onset and the presence of neuroglycopenic symptoms.
Persistent Primitive Olfactory Artery: Three Cases
Authors: Pendharkar Hima , Bhattacharya Kajari , Yadav Nishtha , Jabeen Shumyla 
Published: December 2020

Abstract
The persistent primitive olfactory artery is a very rare arterial variant with a little over a score of cases reported in literature so far. We present 3 cases illustrating this entity, which were incidentally diagnosed while imaging for other indications.
The Efficacy of Liposomal Bupivacaine on Postoperative Pain Following Abdominal Wall Reconstruction
Authors: Fafaj Aldo , Krpata David M. , Petro Clayton C. , Prabhu Ajita S. , Rosenblatt Steven , Tastaldi Luciano , Alkhatib Hemasat , Tu Chao , Zolin Samuel J. , Thomas Jonah D. , Costanzo Adele M. , Rosen Michael J. 
Published: December 2020

Objective:To study the efficacy of liposomal bupivacaine on postoperative opioid requirement and pain following abdominal wall reconstruction.Summary Background Data:Despite the widespread use of liposomal bupivacaine in transversus abdominis plane block, there is inadequate evidence demonstrating its efficacy in open abdominal wall reconstruction. We hypothesized that liposomal bupivacaine plane block would result in decreased opioid requirements compared with placebo in the first 72 hours after surgery.Methods:This was a single-center double-blind, placebo-controlled prospective study conducted between July 2018 and November 2019. Adult patients (at least 18 yrs of age) undergoing open, elective, ventral hernia repairs with mesh placed in the retromuscular position were enrolled. Patients were randomized to surgeon-performed transversus abdominis plane block with liposomal bupivacaine, simple bupivacaine, or normal saline (placebo). The main outcome was opioid requirements in the first 72 hours after surgery. Secondary outcomes included total inpatient opioid use, pain scores determined using a 100 mm visual analog scale, length of hospital stay, and patientreported quality of life.Results:Of the 164 patients who were included in the analysis, 57 patients received liposomal bupivacaine, 55 patients received simple bupivacaine, and 52 received placebo. There were no differences in the total opioid used in the first 72 hours after surgery as measured by morphine milligram equivalents when liposomal bupivacaine was compared with simple bupivacaine and placebo (325 ± 225 vs 350 ± 284 vs 310 ± 272, respectively,P= 0.725). Similarly, there were no differences in total inpatient opioid use, pain scores, length of stay, and patient-reported quality of life.Conclusions:There are no apparent clinical benefits to using liposomal bupivacaine transversus abdominis plane block when compared with simple bupivacaine and placebo for open abdominal wall reconstruction.
Perturbation of amygdala-cortical projections reduces ensemble coherence of palatability coding in gustatory cortex
Authors: Lin Jian-You , Mukherjee Narendra , Bernstein Max J. , Katz Donald B. 
Published: December 2020

ABSTRACTTaste palatability is centrally involved in consumption decisions—we ingest foods that taste good and reject those that don’t. Gustatory cortex (GC) and basolateral amygdala (BLA) almost certainly work together to mediate palatability-driven behavior, but the precise nature of their interplay during taste decision-making is still unknown. To probe this issue, we discretely perturbed (with optogenetics) activity in BLA→GC axons during taste deliveries. This perturbation strongly altered GC taste responses, but while the perturbation itself was tonic (2s), the alterations were not—changes preferentially aligned with the onset times of previously-described taste response epochs, and reduced evidence of palatability-related activity in the “late-epoch” of the responses without reducing the amount of taste identity information available in the “middle epoch.” Finally, BLA→GC perturbations changed behavior-linked taste response dynamics themselves, distinctively diminishing the abruptness of ensemble transitions into the late epoch. These results suggest that BLA “organizes” behavior-related GC taste dynamics.
Osteoprotegerin is elevated in pulmonary fibrosis and associates with IPF progression
Authors: Habibie H. , Putri Kurnia S.S. , Boorsma Carian E. , Brass David M. , Heukels Peter , Wijsenbeek Marlies , Kool Mirjam , van den Berge Maarten , Borghuis Theo , Brandsma Corry-Anke , Gan C Tji , Olinga Peter , Timens Wim , Kahn Nicolas , Kreuter Michael , Burgess Janette K. , Melgert Barbro N. 
Published: December 2020

ABSTRACTOsteoprotegerin (OPG), a decoy receptor for receptor activator of NF-kB ligand (RANKL), is used as a biomarker for assessing severity of liver fibrosis. However, its expression and role in pulmonary fibrosis are unknown. We hypothesized that OPG also has a role in pulmonary fibrosis.Human and mouse control and fibrotic lung tissue were used to examine OPG expression, and mouse precision-cut lung slices to study OPG regulation in pulmonary fibrosis. Serum from idiopathic pulmonary fibrosis (IPF) patients and controls was analysed to investigate whether OPG levels correlate with disease status as measured by lung function.OPG-protein levels were significantly higher in mouse and human fibrotic lung tissue compared to control. OPG-mRNA and protein production were induced in mouse precision-cut-lung slices upon TGFβ stimulation and could be inhibited with galunisertib, a TGFβ receptor kinase inhibitor. OPG-protein levels in fibrotic mouse lung tissue correlated with degree of fibrosis. Isolated lung fibroblasts from IPF patients had higher OPG-protein levels than control fibroblasts. Serum OPG levels in IPF patients, at first presentation, negatively correlated with diffusing capacity to carbon monoxide. Finally, serum OPG levels higher than 1234 pg/ml at first presentation were associated with progression of disease in IPF patients.In conclusion, OPG is produced in lung tissue, associates with fibrosis, and may be a potential prognostic biomarker for IPF disease progression. Validation in a larger cohort is warranted to further explore the role of OPG in pulmonary fibrosis and its potential for assessing the prognosis of fibrotic lung disease in individual patients.Take home messageOsteoprotegerin is present in fibrotic lung tissue and high serum levels correlate with low lung function and IPF disease progression in this small study, indicating osteoprotegerin may have value as a biomarker to predict IPF progression
Vectorized Capsid Rendering in the Browser with Capsid.js
Authors: Negrón Daniel Antonio 
Published: December 2020

AbstractMotivationFew online services exist for rendering high-quality viral capsid figures compatible with common productivity software to develop effective infographics in the field of virology.ResultsThe capsid.js library renders class I viral capsids within an online application that parameterizes style options, perspectives, and lattice patterns with SVG export.AvailabilityThis project is actively developed on GitHub (https://github.com/dnanto/capsid), distributed under the MIT License, hosted on GitHub Pages, and runs on modern browsers (https://dnanto.github.io/capsid/capsid.html).Supplementary informationSupplementary data are available on GitHub.
Ultra-high field (7T) functional magnetic resonance imaging in amyotrophic lateral sclerosis: a pilot study
Authors: Barry Robert L. , Babu Suma , Anteraper Sheeba Arnold , Triantafyllou Christina , Keil Boris , Rowe Olivia E. , Rangaprakash D. , Paganoni Sabrina , Lawson Robert , Dheel Christina , Cernasov Paul M. , Rosen Bruce R. , Ratai Eva-Maria , Atassi Nazem 
Published: December 2020

AbstractAmyotrophic lateral sclerosis (ALS) is a neurodegenerative disease of the central nervous system that results in a progressive loss of motor function and ultimately death. It is critical, yet also challenging, to develop non-invasive biomarkers to identify, localize, measure and/or track biological mechanisms implicated in ALS. Such biomarkers may also provide clues to identify potential molecular targets for future therapeutic trials. Herein we report on a pilot study involving twelve participants with ALS and nine age-matched healthy controls who underwent high-resolution resting state functional magnetic resonance imaging at an ultra-high field of 7 Tesla. A group-level whole-brain analysis revealed a disruption in long-range functional connectivity between the superior sensorimotor cortex (in the precentral gyrus) and bilateral cerebellar lobule VI.Post hocanalyses using atlas-derived left and right cerebellar lobule VI revealed decreased functional connectivity in ALS participants that predominantly mapped to bilateral postcentral and precentral gyri. Cerebellar lobule VI is a transition zone between anterior motor networks and posterior non-motor networks in the cerebellum, and is associated with a wide range of key functions including complex motor and cognitive processing tasks. Our observation of the involvement of cerebellar lobule VI adds to the growing number of studies implicating the cerebellum in ALS. Future avenues of scientific investigation should consider how high-resolution imaging at 7T may be leveraged to visualize differences in functional connectivity disturbances in various genotypes and phenotypes of ALS along the ALS-frontotemporal dementia spectrum.