bluuebunny/crossref_metadata_2025_split huggingface dataset:
Biological versus mechanical aortic valve replacement in non-elderly patients: a single-centre analysis of clinical outcomes and quality of life
Authors: Stocco Fabio , Fabozzo Assunta , Bagozzi Lorenzo , Cavalli Chiara , Tarzia Vincenzo , D’Onofrio Augusto , Lorenzoni Giulia , Chiminazzo Valentina , Gregori Dario , Gerosa Gino 
Published: November 2020

AbstractOBJECTIVESThe aim of this study was to evaluate short- and long-term clinical outcomes, including the perceived health-related quality of life, in patients younger than 65 years having undergone aortic valve replacement either with biological or mechanical valve prostheses.METHODSBetween 2002 and 2013, 242 consecutive patients &lt;65 years of age underwent isolated aortic valve replacement at our institution, either with biological (n = 134, 55.4%) or mechanical (n = 108, 44.6%) prostheses. Survival, health-related quality of life, short- and long-term clinical outcomes and echocardiographic data were analysed with a retrospective, single-centre study. Propensity matching was performed.RESULTSNo significant difference in survival was found between the 2 groups (mechanical versus biological: 100% vs 96.6% at 1 year, 98.2% vs 93.1% at 5 years and 92.3% vs 83.4% at 10 years after surgery, P = 0.091). For all the interviewed patients (n = 161, 66.5%), perceived quality of life at the latest follow-up was excellent. Need for reoperation was higher in the bioprosthetic group (8% vs 0%, P = 0.995), whereas the rate of major bleedings was higher in the mechanical valve group (3% vs 20%, P = 0.094). The mean and maximum transvalvular pressure gradients were 20.5 ± 9.7 and 37.4 ± 17.5 mmHg in the biological group and 14.8 ± 4.8 and 26.6 ± 9.2 mmHg in the mechanical group (P = 0.014).CONCLUSIONSNo significant differences were found between biological and mechanical valves in terms of patients’ survival, clinical outcomes and quality of life. Mean and maximum transvalvular pressure gradients were significantly higher in the biological group. The majority of patients would opt for the same prosthesis type, if asked to choose again.
Correlation Between Early Plasma Interleukin 37 Responses With Low Inflammatory Cytokine Levels and Benign Clinical Outcomes in Severe Acute Respiratory Syndrome Coronavirus 2 Infection
Authors: Li Ang , Ling Yun , Song Zhigang , Cheng Xiaobo , Ding Longfei , Jiang Rendi , Fu Weihui , Liu Yan , Hu Huiliang , Yuan Songhua , Chen Jian , Zhu Cuisong , Fan Jun , Wang Jing , Jin Yanling , Zhang Miaomiao , Zhu Lingyan , Sun Peng , Zhang Linxia , Qin Ran , Zhang Wei , Qiu Chenli , Shen Yinzhong , Zhang Lin , Shi Zhengli , Zhao Chen , Zhu Tongyu , Lu Hongzhou , Zhang Xiaoyan , Xu Jianqing 
Published: November 2020

Abstract

Background
The immune protective mechanisms during severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection remain to be deciphered for the development of an effective intervention approach.

Methods
We examined early responses of interleukin 37 (IL-37), a powerful anti-inflammatory cytokine, in 254 SARS-CoV-2–infected patients before any clinical intervention and determined its correlation with clinical prognosis.

Results
Our results demonstrated that SARS-CoV-2 infection causes elevation of plasma IL-37. Higher early IL-37 responses were correlated with earlier viral RNA negative conversion, chest computed tomographic improvement, and cough relief, consequently resulted in earlier hospital discharge. Further assays showed that higher IL-37 was associated with lower interleukin 6 and interleukin 8 (IL-8) and higher interferon α responses and facilitated biochemical homeostasis. Low IL-37 responses predicted severe clinical prognosis in combination with IL-8 and C-reactive protein. In addition, we observed that IL-37 administration was able to attenuate lung inflammation and alleviate respiratory tissue damage in human angiotensin-converting enzyme 2–transgenic mice infected with SARS-CoV-2.

Conclusions
Overall, we found that IL-37 plays a protective role by antagonizing inflammatory responses while retaining type I interferon, thereby maintaining the functionalities of vital organs. IL-37, IL-8, and C-reactive protein might be formulated as a precise prediction model for screening severe clinical cases and have good value in clinical practice.
Impact of inclusion rates of crossbred phenotypes and genotypes in nucleus selection programs
Authors: See Garrett M , Mote Benny E , Spangler Matthew L 
Published: November 2020

Abstract
Numerous methods have been suggested to incorporate crossbred (CB) phenotypes and genotypes into swine selection programs, yet little research has focused on the implicit trade-off decisions between generating data at the nucleus or commercial level. The aim of this study was to investigate the impact of altering the proportion of purebred (PB) and CB phenotypes and genotypes in genetic evaluations on the response to selection of CB performance. Assuming CB and PB performance with moderate heritabilities (h2=0.4), a three-breed swine crossbreeding scheme was simulated and selection was practiced for six generations, where the goal was to increase CB performance. Phenotypes, genotypes, and pedigrees for three PB breeds (25 and 175 mating males and females for each breed, respectively), F1 crosses (400 mating females), and terminal cross progeny (2,500) were simulated. The genome consisted of 18 chromosomes with 1,800 quantitative trait loci and 72k single nucleotide polymorphism (SNP) markers. Selection was performed in PB breeds using estimated breeding value for each phenotyping/genotyping strategy. Strategies investigated were: 1) increasing the proportion of CB with genotypes, phenotypes, and sire pedigree relationships, 2) decreasing the proportion of PB phenotypes and genotypes, and 3) altering the genetic correlation between PB and CB performance (rpc). Each unique rpc scenario and data collection strategy was replicated 10 times. Results showed that including CB data improved the CB performance regardless of rpc or data collection strategy compared with when no CB data were included. Compared with using only PB information, including 10% of CB progeny per generation with sire pedigrees and phenotypes increased the response in CB phenotype by 134%, 55%, 33%, 23%, and 21% when rpc was 0.1, 0.3, 0.5, 0.7, and 0.9, respectively. When the same 10% of CB progeny were also genotyped, CB performance increased by 243%, 54%, 38%, 23%, and 20% when the rpc was 0.1, 0.3, 0.5, 0.7, and 0.9, respectively, compared with when no CB data were utilized. Minimal change was observed in the average CB phenotype when PB phenotypes were included or proportionally removed when CB were genotyped. Removal of both PB phenotypes and genotypes when CB were genotyped greatly reduced the response in CB performance. In practice, the optimal inclusion rate of CB and PB data depends upon the genetic correlation between CB and PB animals and the expense of additional CB data collection compared with the economic benefit associated with increased CB performance.
Field Competitiveness of Aedes albopictus (Diptera: Culicidae) Irradiated Males in Pilot Sterile Insect Technique Trials in Northern Italy
Authors: Bellini Romeo , Carrieri Marco , Balestrino Fabrizio , Puggioli Arianna , Malfacini Marco , Bouyer Jeremy 
Published: November 2020

Abstract
Vector-borne diseases account for 17% of infectious diseases, leading to more than one million deaths each year. Mosquitoes are responsible for 90% of the casualties and alternative control methods to insecticides are urgently needed, especially against Aedes vectors. Aedes albopictus is a particularly important species, causing major public health problems because it is a vector of several arboviruses and has a strong invasive behavior. Various genetic control methods have been proposed to be integrated into the management strategies of Aedes species, among which the sterile insect technique (SIT), which proved efficient against various insect pests and vectors. However, the ability of released irradiated sterile male mosquitoes to compete with their wild counterparts and induce sterility in wild females, which is critical to the success of this strategy, remained poorly defined. Here, we assessed the field competitiveness of Ae. albopictus irradiated male using data from eight release trials implemented in Northern Italy for 3 yr. Sterile males were capable of inducing a good level of sterility in the wild female population, however, with high variability in time and space. The field competitiveness of the released males was strongly negatively correlated with the ratio of sterile to wild males. This should be taken into consideration when designing future programs to suppress field populations of Aedes mosquitoes.
HMGA2-induced epithelial–mesenchymal transition is reversed by let-7d in intrauterine adhesions
Authors: Song Minmin , Cao Chenrui , Zhou Zhenhua , Yao Simin , Jiang Peipei , Wang Huiyan , Zhao Guangfeng , Hu Yali 
Published: November 2020

Abstract
Intrauterine adhesions (IUAs), the leading cause of uterine infertility, are characterized by endometrial fibrosis. The management of IUA is challenging because the pathogenesis of the disease largely unknown. In this study, we demonstrate that the mRNA and protein levels of high mobility group AT-hook 2 (HMGA2) were increased by nearly 3-fold (P &lt; 0.0001) and 5-fold (P = 0.0095) in the endometrial epithelial cells (EECs) of IUA patients (n = 18) compared to controls. In vivo and in vitro models of endometrial fibrosis also confirmed the overexpression of HMGA2 in EECs. In vitro cell experiments indicated that overexpression of HMGA2 promoted the epithelial–mesenchymal transition (EMT) while knockdown of HMGA2 reversed transforming growth factor-β-induced EMT. A dual luciferase assay confirmed let-7d microRNA downregulated HMGA2 and repressed the pro-EMT effect of HMGA2 in vitro and in vivo. Therefore, our data reveal that HMGA2 promotes IUA formation and suggest that let-7d can depress HMGA2 and may be a clinical targeting strategy in IUA.
UPLC-MS based plasma metabolomics and lipidomics reveal alterations associated with IgG4-related disease
Authors: Gong Yiyi , Zhang Panpan , Liu Zheng , Li Jieqiong , Lu Hui , Wang Yujie , Qiu Bintao , Wang Mu , Fei Yunyun , Chen Hua , Peng Linyi , Li Jing , Zhou Jiaxin , Shi Qun , Zhang Xuan , Shen Min , Zeng Xiaofeng , Zhang Fengchun , Zhang Wen 
Published: November 2020

AbstractObjectiveThe pathogenesis of IgG4-related disease (IgG4-RD) remains unclear. Metabolomic profiling of IgG4-RD patients offers an opportunity to identify novel pathophysiological targets and biomarkers. This study aims to identify potential plasma biomarkers associated with IgG4-RD.MethodsThirty newly diagnosed IgG4-RD patients, age-matched healthy controls and post-treated IgG4-RD patients were enrolled. Patients’ clinical data, laboratory parameters and plasma were collected. Plasma was measured for ultraperformance liquid chromatography-tandem mass spectrometry based metabolomics and lipidomics profiling. Multivariate and univariate statistical analyses were conducted to identify potential biomarkers. The receiver operating characteristic and the correlations between biomarkers and clinical parameters were investigated.ResultsThe plasma metabolites are altered among healthy controls, newly diagnosed IgG4-RD and post-treated IgG4-RD groups. Of the identified features, eight metabolites were significantly perturbed in the IgG4-RD group, including glyceric acid 1,3-biphosphate (1,3-BPG), uridine triphosphate (UTP), uridine diphosphate glucose (UDP-Glc) or uridine diphosphate galactose (UDP-Gal), lysophospholipids, linoleic acid derivatives and ceramides. Receiver operating characteristic analysis indicated that UTP, UDP-Glc/UDP-Gal and LysoPC (18:1) had high sensitivity and specificity in diagnosis of IgG4-RD. A Pearson correlation analysis showed that 1,3-BPG and UTP were strongly correlated with clinical parameters.ConclusionIgG4-RD patients have a unique plasma metabolomic profile compared with healthy controls. Our study suggested that metabolomic profiling may provide important insights into pathophysiology and testable biomarkers for diagnosis of IgG4-RD.
Age-related Changes in T1 and C7 Slope and the Correlation Between Them in More Than 300 Asymptomatic Subjects
Authors: Inoue Taro , Ando Kei , Kobayashi Kazuyoshi , Nakashima Hiroaki , Ito Keigo , Katayama Yoshito , Machino Masaaki , Kanbara Shunsuke , Ito Sadayuki , Yamaguchi Hidetoshi , Koshimizu Hiroyuki , Segi Naoki , Kato Fumihiko , Imagama Shiro 
Published: November 2020

Study Design.
A cross-sectional analysis using T1 slope (T1S) and C7 slope (C7S) in asymptomatic individuals.

Objective.
The aim of this study was to identify normative values, ranges of motion (ROMs), age-related changes in T1S and C7S, and correlation between the two slopes.

Summary of Background Data.
Few studies have reported age-related changes in the T1S and C7S angles. Additionally, studies investigating the effects of cervical position on these slopes are limited.

Methods.
A total of 388 asymptomatic subjects (162 males and 226 females) for whom T1S measurement was performed on radiographs were enrolled in the study. The T1S and C7S angles were measured using neutral radiography of the cervical spine. ROMs were assessed by measuring the difference in alignment in the neutral position, flexion, and extension.

Results.
The mean C7S and T1S angles were 19.6° (22.2° in males, 17.9° in females) and 24.0° (26.7° in men and 22.1° in women), respectively. The T1S angle was significantly greater than the C7S angle. Both the C7S and T1S angles significantly increased with age. The flexion ROM of C7S was higher than that of T1S, whereas no significant difference was detected between the extension ROMs of the two slopes. The flexion ROMs of the two slopes did not change, whereas the extension ROMs significantly increased with age. A significant positive correlation was observed between the C7S and T1S angles (r

2
= 0.75).

Conclusion.
The normative values and age-related changes in C7S and T1S were analyzed. Both the C7S and T1S angles increased with age. The C7S angle was strongly correlated with the T1S angle, suggesting that C7S can substitute T1S on radiographic images.

Level of Evidence: 3
Association between physician practice Medicaid acceptance and employing nurse practitioners and physician assistants
Authors: Barnes Hilary , Richards Michael R. , Martsolf Grant R. , Nikpay Sayeh S. , McHugh Matthew D. 
Published: November 2020

Background
Access to care is often a challenge for Medicaid beneficiaries due to low practice participation. As demand increases, practices will likely look for ways to see Medicaid patients while keeping costs low. Employing nurse practitioners (NPs) and physician assistants (PAs) is one low-cost and effective means to achieve this. However, there are no longitudinal studies examining the relationship between practice Medicaid acceptance and NP/PA employment.

Purpose
The purpose of this study was to examine the association of practice Medicaid acceptance with NP/PA employment over time.

Methods
Using SK&A data (2009–2015), we constructed a panel of 102,453 unique physician practices to assess for changes in Medicaid acceptance after newly employing NPs and PAs. We employed practice-level fixed effects linear regressions.

Results
Our results showed that, among practices employing both NPs and PAs, there was a roughly 2% increase in the likelihood of Medicaid participation over time. When stratifying our sample by practice size and specialty, the positive correlation localized to small primary care and medical practices. When both NPs and PAs were present, small primary care practices had a 3.3% increase and small medical practices had a 6.9% increase in the likelihood of accepting Medicaid.

Conclusion
NP and PA employment was positively associated with increases in Medicaid participation.

Practice Implications
As more individuals gain coverage under Medicaid, organizations will need to decide how to adapt to greater patient demand. Our results suggest that hiring NPs and PAs may be a potential lower cost strategy to accommodate new Medicaid patients.
Hospice inpatient services provision, utilization, and financial performance
Authors: He Mengying , O’Connor Stephen J. , Qu Haiyan , Menachemi Nir , Shewchuk Richard M. 
Published: November 2020

Background
Hospice performance is an overlooked area in the health care field due to the difficulty of measuring quality of care and the infrequent quality inspection. Based on the daily reimbursement mechanism for different levels of hospice care, inpatient services provision could influence both hospice-level length of stay (LOS) and financial performance.

Purpose
The objective of this study was to explore the relationship between hospice inpatient services provision and hospice utilization and financial performance.

Methodology/Approach
A longitudinal secondary data set (2009–2013) was merged from three sources: (a) Hospice Cost Reports from the Centers for Medicare & Medicaid Services, (b) the Provider of Services files, and (c) the Area Health Resources Files. The dependent variable in this study was hospice average LOS and financial performance measured by total operating margin (TOM) and return on assets. The independent variable was hospice inpatient services’ offering. Mixed-effects regression models were used in the multivariate regression analyses.

Results
When comparing to hospices not providing inpatient services, offering inpatient services by staff was negatively related to average LOS (b = −0.063, p < .05) and TOM (b = −0.022, p < .05). The combination method with providing inpatient services by staff and under arrangement was negatively associated with return on assets (b = −0.073, p < .05).

Conclusion
Hospice inpatient services provision was associated with average LOS and financial performance.

Practice Implications
Offering the inpatient services to patients by staff decreased average LOS and TOM. Hospice agencies may seek strategies to maintain their financial sustainability through outsourcing.
CONCOMITANT PYOGENIC LIVER AND INTRAOCULAR ABSCESSES IN KLEBSIELLA ENDOGENOUS ENDOPHTHALMITIS: CASE REPORT AND REVIEW OF LITERATURE
Authors: Fan Kenneth C. , Patel Nimesh A. , Sengillo Jesse D. , Hudson Julia L. , Davis Janet L. 
Published: November 2020

Purpose:
To describe a rare presentation of Klebsiella pneumoniae endogenous endophthalmitis with concurrent intraocular and liver abscesses.

Methods:
Case Report.

Results:
A middle-aged man presented with a red and painful eye with a preceding febrile gastrointestinal illness. Examination and work-up revealed concomitant intraocular and liver abscesses that were treated by pars plana vitrectomy, drainage of subretinal abscess, inpatient admission, and systemic antibiotics. The patient ultimately underwent enucleation of the eye because of persistent pain and poor visual prognosis.

Conclusion:

Klebsiella pneumoniae endogenous endophthalmitis is a rare and potentially devastating disease that requires high clinical suspicion and early diagnosis. Practitioners should consider systemic etiologies and communicate guarded prognoses in this serious systemic disease.
Fatal SARS-CoV-2 Inflammatory Syndrome and Myocarditis in an Adolescent: A Case Report
Authors: Beaudry Jeanette T. , Dietrick Barbara , Lammert Dawn B. , Constas Alexander , McCaw Julia , Hammond John , Buendia Matthew , Stein Julie E. , Pekosz Andrew , Schuette Jennifer , Mostafa Heba H. , Hooper Jody E. , Bernier Meghan , Agwu Allison , Feldman Leonard S. 
Published: November 2020

Background:
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), an entity in children initially characterized by milder case presentations and better prognoses as compared with adults. Recent reports, however, raise concern for a new hyperinflammatory entity in a subset of pediatric COVID-19 patients.

Methods:
We report a fatal case of confirmed COVID-19 with hyperinflammatory features concerning for both multi-inflammatory syndrome in children (MIS-C) and primary COVID-19.

Results:
This case highlights the ambiguity in distinguishing between these two entities in a subset of pediatric patients with COVID-19-related disease and the rapid decompensation these patients may experience.

Conclusions:
Appropriate clinical suspicion is necessary for both acute disease and MIS-C. SARS-CoV-2 serologic tests obtained early in the diagnostic process may help to narrow down the differential but does not distinguish between acute COVID-19 and MIS-C. Better understanding of the hyperinflammatory changes associated with MIS-C and acute COVID-19 in children will help delineate the roles for therapies, particularly if there is a hybrid phenotype occurring in adolescents.
Determination of Pressure Injury Prevalance and Risk Factors in Children
Authors: Akpolat Refiye , Aslan Fatma Eti , Şişman Hamide , Alptekin Dudu , Akil Yasemin 
Published: November 2020

Aim
Pressure injury is a serious health problem not only among adults but also among children. However, anatomical and physiological differences of the children may affect the prevalence of pressure injury. The current study aimed at determining the prevalence of pressure injuries and its risk factors for use in designing prevention programs.

Method
This was a 1-day in-depth assessment of all children who were hospitalized at a tertiary center in Turkey. Included were children who were admitted without pressure injuries. Observation and face-to-face interviews were undertaken to assess each child for the presence or absence of pressure injury using an Individual Characteristics Form, the Braden Scale, and the Braden Q Scale for Predicting Pressure Injury Risk. In addition, each child was assessed with the Glasgow Coma Scale and given a nutritional assessment.

Findings
Pressure injury had developed in 17 of the 143 patients (12%). For these children, average age was 66.2 ± 616 months, mean body weight was 19.7 ± 16.5 kg and most of them were determined as underweight according to a body mass index of 70.6% (12 children). Male gender was identified in 64.7% (11 children). Among the children in whom pressure injury developed, it was seen that average hemoglobin value was 9.5 ± 1.6 g/dl and average albumin value was 2.7 ± 0.2 g/dl. It was found out that mean Glasgow Coma Scale score was 10.7 ± 4.6 and mean Braden Risk Score was 15.3 ± 5.2, which indicates moderate risk. Furthermore, 58.8% of the children were treated in the intensive care unit; 52.9% of the children (nine children) had neurological problems, whereas 70.6% of them (12 children) had chronic medical problems. It was discovered that the rate of the patients whose pressure injury was Grade 1 was 47.1% (eight children).

Conclusion
In the current study, prevalence of pressure injury was 12%. Most of the children in whom pressure injuries developed had low body mass index and albumin values and neurological and chronic diseases, showing that these children were under risk for pressure injuries. The results obtained from the current study will be evaluated as evidence to prevent and treat pressure injuries at the institution where the study was done.