bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health status, care needs, and assessment for beneficiaries with or without dementia in a public long-term care insurance pilot in Guangzhou, China
Authors: Wu Jialan , Chen Siman , Wen Huangliang , Yi Yayan , Liao Xiaoyan 
Published: December 2020

Abstract
Background
Chinese government launched a pilot study on public long-term care insurance (LTCI) recently. Guangzhou is one of the fifteen pilot cities, officially started providing LTCI in August 2017. An in-depth analysis of experimental data from the pilot city may provide suggestions for developing a fair and effective LTCI system. This study aimed to evaluate the LTCI pilot by exploring the characteristics and care needs of claimants, and performance of the assessment tool.

Methods
A retrospective cross-sectional study in which claims data between July 2018 and March 2019 in the Guangzhou pilot was analyzed. LTCI claimants during the study period were included. The care needs were determined based on claimants’ physical function assessed by the Barthel Index and their medical conditions. Rasch analysis was used to explore the performance of the Barthel Index.

Results
Among 4810 claimants included, 4582 (95.3%) obtained LTCI benefits. Of these beneficiaries, 4357 (95.1%) were ≧ 60 years old, and 791 (17.3%) had dementia. Among 228 (4.7%) unsuccessful claimants, 22 (0.5%) had dementia. The prevalence of stroke was high in beneficiaries with (38.1%) or without dementia (56.6%), as well as in unsuccessful claimants with (40.9%) or without dementia (52.4%). Beneficiaries without dementia needed more support for basic activities of daily living and nursing care than those with dementia, while beneficiaries with dementia were more likely to be institutionalized. Five (22.7%) unsuccessful claimants with dementia and 48 (23.3%) unsuccessful claimants without dementia were disabled in at least two basic self-care activities. Regarding Barthel Index, Rasch analysis showed threshold disordering in “mobility” and “climbing stairs”, and the narrow interval was observed between all the adjacent categories of the ten items (< 1.4 logits).

Conclusions
Stroke and dementia were two common reasons for needing long-term care in LTCI claimants. The Barthel Index is not suitable for assessing and dividing LTCI claimants, because of inappropriate items and narrow category responses. A comprehensive assessment and grading system is required, together with needs-led care services. The eligibility should be expanded gradually based on balance finance solutions.
Sleep disturbances and the speed of multimorbidity development in old age: results from a longitudinal population-based study
Authors: Sindi Shireen , Pérez Laura Monica , Vetrano Davide L. , Triolo Federico , Kåreholt Ingemar , Sjöberg Linnea , Darin-Mattsson Alexander , Kivipelto Miia , Inzitari Marco , Calderón-Larrañaga Amaia 
Published: December 2020

Abstract
Background
Sleep disturbances are prevalent among older adults and are associated with various individual diseases. The aim of this study was to investigate whether sleep disturbances are associated with the speed of multimorbidity development among older adults.

Methods
Data were gathered from the Swedish National study of Aging and Care in Kungsholmen (SNAC-K), an ongoing population-based study of subjects aged 60+ (N = 3363). The study included a subsample (n = 1189) without multimorbidity at baseline (< 2 chronic diseases). Baseline sleep disturbances were derived from the Comprehensive Psychiatric Rating Scale and categorized as none, mild, and moderate–severe. The number of chronic conditions throughout the 9-year follow-up was obtained from clinical examinations. Linear mixed models were used to study the association between sleep disturbances and the speed of chronic disease accumulation, adjusting for sex, age, education, physical activity, smoking, alcohol consumption, depression, pain, and psychotropic drug use. We repeated the analyses including only cardiovascular, neuropsychiatric, or musculoskeletal diseases as the outcome.

Results
Moderate–severe sleep disturbances were associated with a higher speed of chronic disease accumulation (ß/year = 0.142, p = 0.008), regardless of potential confounders. Significant positive associations were also found between moderate–severe sleep disturbances and neuropsychiatric (ß/year = 0.041, p = 0.016) and musculoskeletal (ß/year = 0.038, p = 0.025) disease accumulation, but not with cardiovascular diseases. Results remained stable when participants with baseline dementia, cognitive impairment, or depression were excluded.

Conclusion
The finding that sleep disturbances are associated with faster chronic disease accumulation points towards the importance of early detection and treatment of sleep disturbances as a possible strategy to reduce chronic multimorbidity among older adults.
A descriptive study of allergen-specific IgE serological tests for canine atopic dermatitis in Thailand
Authors: Chermprapai Suttiwee , Thengchaisri Naris 
Published: December 2020

AbstractBackgroundThis study describes the usefulness of allergen-specific Immunoglobulin E (IgE) serology (ASIS) for identifying allergens in dogs with atopic dermatitis. ASIS tests were conducted in 23 dogs diagnosed with atopic dermatitis for indoor allergens (yeast and mites), outdoor allergens (grass pollen, weed pollen, and tree pollen), and fleas. The relationship among positive ASIS tests were determined using Pearson’s correlation coefficient (r).ResultsOf the atopic dogs, 26.09%, 4.35%, and 47.83% had positive ASIS tests for only indoor allergens, only outdoor allergens, and both indoor and outdoor allergens, respectively. The prevalence of positive ASIS tests was highest for mites (69.57%) and did not differ between indoor and outdoor allergens by age, breed, or sex. The prevalence of positive ASIS tests for indoor allergens during the rainy season (84.21%) was significantly higher than during winter (25.00%,P-value = 0.030). The correlation coefficient of the ASIS results among the outdoor allergens indicated a strong correlation between grass and tree pollen (r = 0.840,P-value < 0.01), grass and weed pollen (r = 0.812,P-value < 0.01), and tree and weed pollen (r = 0.714,P-value < 0.01). The correlation coefficient of the ASIS results ofD. farinaeindicated a strong correlation withA. siro(r = 0.951,P-value < 0.01) and a moderate correlation withB. tropicalis(r = 0.656,P-value < 0.01) andT. putrescentie(r = 0.672,P-value < 0.01).ConclusionsASIS tests are useful in screening for multiple allergens in dogs with atopic dermatitis. Dust mites are an important source of indoor allergens and may be responsible for a higher titer of IgE antibodies against indoor allergens during the rainy season.
How should we monitor the cardiovascular benefit of sodium–glucose cotransporter 2 inhibition?
Authors: Tanaka Atsushi , Node Koichi 
Published: December 2020

AbstractSodium–glucose cotransporter 2 (SGLT2) inhibitors are increasingly prescribed for the treatment of patients with type 2 diabetes to reduce the risk of cardiovascular events, including heart failure (HF). The mechanisms by which SGLT2 inhibitors reduce such risk are likely to be independent of diabetes status and improvement of glycemic control. In this commentary, based on recent mediation analyses of cardiovascular outcome trials with SGLT2 inhibitors, we discuss the prognostic role of a well-known HF-related biomarker, amino-terminal pro-B-type natriuretic peptide (NT-proBNP), in patients receiving SGLT2 inhibitors. Interestingly, the NT-proBNP concentration had a relatively small impact on the SGLT2 inhibitor-associated benefit on HF events, suggesting a limited value in measuring NT-proBNP concentrations to monitor effects on cardiovascular outcomes after initiation of SGLT2 inhibitor therapy. Instead, clinical factors, such as body weight and volume status, were prognostic for cardiovascular outcomes. As shown in some biomarker studies, short-term SGLT2 inhibitor treatment significantly improved volume and HF-related health status, despite the absence of a significant change in NT-proBNP concentration. Given the early and continuous risk reduction in HF events seen in the cardiovascular outcome trials with SGLT2 inhibitors, changes in these fundamental clinical parameters after initiation of SGLT2 inhibitor therapy, independent of NT-proBNP, could be more prognostic and could represent key determinants to identify responders or non-responders to SGLT2 inhibitors for cardiovascular outcomes. Thus, this commentary highlights the clinical importance of establishing how clinicians should monitor patients initiating SGLT2 inhibitor therapy to predict the expected cardiovascular benefit. Further detailed investigations and discussion to better understand this ‘‘black box’’ are urgently warranted.
The invasion depth measurement of bladder cancer using T2-weighted magnetic resonance imaging
Authors: Liu Yang , Zheng Haojie , Xu Xiaopan , Zhang Xi , Du Peng , Liang Jimin , Lu Hongbing 
Published: December 2020

Abstract
Background
Invasion depth is an important index for staging and clinical treatment strategy of bladder cancer (BCa). The aim of this study was to investigate the feasibility of segmenting the BCa region from bladder wall region on MRI, and quantitatively measuring the invasion depth of the tumor mass in bladder lumen for further clinical decision-making. This retrospective study involved 20 eligible patients with postoperatively pathologically confirmed BCa. It was conducted in the following steps: (1) a total of 1159 features were extracted from each voxel of both the certain cancerous and wall tissues with the T2-weighted (T2W) MRI data; (2) the support vector machine (SVM)-based recursive feature elimination (RFE) method was implemented to first select an optimal feature subset, and then develop the classification model for the precise separation of the cancerous regions; (3) after excluding the cancerous region from the bladder wall, the three-dimensional bladder wall thickness (BWT) was calculated using Laplacian method, and the invasion depth of BCa was eventually defined by the subtraction of the mean BWT excluding the cancerous region and the minimum BWT of the cancerous region.

Results
The segmented results showed a promising accuracy, with the mean Dice similarity coefficient of 0.921. The “soft boundary” defined by the voxels with the probabilities between 0.1 and 0.9 could demonstrate the overlapped region of cancerous and wall tissues. The invasion depth calculated from proposed segmentation method was compared with that from manual segmentation, with a mean difference of 0.277 mm.

Conclusion
The proposed strategy could accurately segment the BCa region, and, as the first attempt, realize the quantitative measurement of BCa invasion depth.
Synergistic health effects of air pollution, temperature, and pollen exposure: a systematic review of epidemiological evidence
Authors: Anenberg Susan C. , Haines Shannon , Wang Elizabeth , Nassikas Nicholas , Kinney Patrick L. 
Published: December 2020

Abstract
Background
Exposure to heat, air pollution, and pollen are associated with health outcomes, including cardiovascular and respiratory disease. Studies assessing the health impacts of climate change have considered increased exposure to these risk factors separately, though they may be increasing simultaneously for some populations and may act synergistically on health.
Our objective is to systematically review epidemiological evidence for interactive effects of multiple exposures to heat, air pollution, and pollen on human health.

Methods
We systematically searched electronic literature databases (last search, April 29, 2019) for studies reporting quantitative measurements of associations between at least two of the exposures and mortality from any cause and cardiovascular and respiratory morbidity and mortality specifically. Following the Navigation Guide systematic review methodology, we evaluated the risk of bias of individual studies and the overall quality and strength of evidence.

Results
We found 56 studies that met the inclusion criteria. Of these, six measured air pollution, heat, and pollen; 39 measured air pollution and heat; 10 measured air pollution and pollen; and one measured heat and pollen. Nearly all studies were at risk of bias from exposure assessment error. However, consistent exposure-response across studies led us to conclude that there is overall moderate quality and sufficient evidence for synergistic effects of heat and air pollution. We concluded that there is overall low quality and limited evidence for synergistic effects from simultaneous exposure to (1) air pollution, pollen, and heat; and (2) air pollution and pollen. With only one study, we were unable to assess the evidence for synergistic effects of heat and pollen.

Conclusions
If synergistic effects between heat and air pollution are confirmed with additional research, the health impacts from climate change-driven increases in air pollution and heat exposure may be larger than previously estimated in studies that consider these risk factors individually.
The associations between p,p’-DDE levels and plasma levels of lipoproteins and their subclasses in an elderly population determined by analysis of lipoprotein content
Authors: Jugan Juliann , Lind P. Monica , Salihovic Samira , Stubleski Jordan , Kärrman Anna , Lind Lars , La Merrill Michele A. 
Published: December 2020

Abstract
Background
Lipoproteins at aberrant levels are known to play a role in cardiovascular disease. The metabolite of the insecticide dichlorodiphenyltrichloroethane (DDT), p,p’-dichlorodiphenyldichloroethylene (p,p’-DDE), physically associates with lipids and accumulates in adipose tissue. Little is known about which lipoproteins associate with p,p’-DDE. An association between p,p’-DDE exposure and altered levels of circulating lipids was assessed in a large human cohort using a detailed analysis of lipoprotein content.

Methods
Plasma samples were collected from the subset of 75-year old Swedes in the Prospective Investigation of the Vasculature of Uppsala Seniors (PIVUS) cohort who were not prescribed lipid lowering medication (n = 571). p,p’-DDE concentrations in plasma were measured using high-throughput solid phase extraction and gas chromatography-high resolution mass spectrometry. Analysis of plasma lipoprotein content was performed with nuclear magnetic resonance spectroscopy.

Results
Detectable levels of p,p’-DDE were found in the plasma samples of all subjects. Elevated p,p’-DDE levels were associated with increased concentrations of lipoproteins of all diameters, with the exception of high density lipoprotein (HDL) of diameters between 14.3 nm–10.9 nm. Of the lipoprotein constituents, triglycerides were most uniformly associated with elevated p,p’-DDE across lipoproteins. p,p’-DDE was furthermore associated with apolipoprotein B, but not apolipoprotein A1.

Conclusions
The positive associations observed between each lipoprotein class and elevated p,p’-DDE support previous data suggesting that p,p’-DDE interacts with lipoproteins within plasma. It is speculated that both physio-chemical and biological mechanisms may explain why p,p’-DDE does not uniformly associate with lipids across lipoproteins.
Respiratory microbiome profiles differ by recent hospitalization and nursing home residence in patients on mechanical ventilation
Authors: Baek Min-gyung , Woo Seong Ji , Kim Nam Eun , Baek Chaeyun , Won Sungho , Kim Youngmi , Lee Jae Jun , Yi Hana , Hong Ji Young 
Published: December 2020

AbstractBackgroundHealthcare-associated pneumonia (HCAP) is a heterogeneous disease. We redefined nursing-home- and hospital-associated infections (NHAI) group by revising existing HCAP risk factors. The NHAI group comprised nursing home residents with a poor functional status, or recent (past 90 days) hospitalization or recent (past 180 days) antibiotic therapy. Our aim was to determine whether respiratory microbiota profiles are related to newly defined NHAI group in critically ill patients on mechanical ventilation.MethodsThe 180 endotracheal aspirates (ETAs) from 60 mechanically ventilated ICU patients (NHAI group, n = 24; non-NHAI group, n = 36) were prospectively collected on days 1, 3 and 7 in a university hospital. The bacterial community profiles of the ETAs were explored by 16S rRNA gene sequencing. A phylogenetic-tree-based microbiome association test (TMAT), generalized linear mixed models (GLMMs), the Wilcoxon test and the reference frame method were used to analyze the association between microbiome abundance and disease phenotype.ResultsThe relative abundance of the genusCorynebacteriumwas significantly higher in the pneumonia than in the non-pneumonia group. The microbiome analysis revealed significantly lower α-diversity in the NHAI group than in the non-NHAI group. In the analysis of β-diversity, the structure of the microbiome also differed significantly between the two groups (weighted UniFrac distance, Adonis,p < 0.001). The abundance ofCorynebacteriumwas significantly higher, and the relative abundances ofGranulicatella, Staphylococcus, StreptococcusandVeillonellawere significantly lower, in the NHAI group than in the non-NHAI group.ConclusionsThe microbiota signature of the ETAs distinguished between patients with and without risk factors for NHAI. The lung microbiome may serve as a therapeutic target for NHAI group.
Risk factors for severe COVID-19 in middle-aged patients without comorbidities: a multicentre retrospective study
Authors: Wang Peng , Sha Jing , Meng Mei , Wang Cuiyan , Yao Qingchun , Zhang Zhongfa , Sun Wenqing , Wang Xingguang , Qie Guoqiang , Bai Xue , Liu Keke , Chu Yufeng 
Published: December 2020

AbstractBackgroundInformation regarding characteristics and risk factors of COVID-19 amongst middle-aged (40–59 years) patients without comorbidities is scarce.MethodsWe therefore conducted this multicentre retrospective study and collected data of middle-aged COVID-19 patients without comorbidities at admission from three designated hospitals in China.ResultsAmong 119 middle-aged patients without comorbidities, 18 (15.1%) developed into severe illness and 5 (3.9%) died in hospital. ARDS (26, 21.8%) and elevated D-dimer (36, 31.3%) were the most common complications, while other organ complications were relatively rare. Multivariable regression showed increasing odds of severe illness associated with neutrophil to lymphocyte ratio (NLR, OR, 11.238; 95% CI 1.110–1.382; p < 0.001) and D-dimer greater than 1 µg/ml (OR, 16.079; 95% CI 3.162–81.775; p = 0.001) on admission. The AUCs for the NLR, D-dimer greater than 1 µg/ml and combined NLR and D-dimer index were 0.862 (95% CI, 0.751–0.973), 0.800 (95% CI 0.684–0.915) and 0.916 (95% CI, 0.855–0.977), respectively. SOFA yielded an AUC of 0.750 (95% CI 0.602–0.987). There was significant difference in the AUC between SOFA and combined index(z = 2.574, p = 0.010).ConclusionsMore attention should be paid to the monitoring and early treatment of respiratory and coagulation abnormalities in middle-aged COVID-19 patients without comorbidities. In addition, the combined NLR and D-dimer higher than 1 μg/ml index might be a potential and reliable predictor for the incidence of severe illness in this specific patient with COVID-19, which could guide clinicians on early classification and management of patients, thereby relieving the shortage of medical resource. However, it is warranted to validate the reliability of the predictor in larger sample COVID-19 patients.
Analysis of ALS-related proteins during herpes simplex virus-2 latent infection
Authors: Cabrera Jorge Rubén , Rodríguez-Izquierdo Ignacio , Jiménez José Luis , Muñoz-Fernández María Ángeles 
Published: December 2020

AbstractBackgroundGenetics have provided hints on potential molecular pathways involved in neurodegenerative diseases (NDD). However, the number of cases caused exclusively by genetic alterations is low, suggesting an important contribution of environmental factors to NDDs. Among these factors, viruses like herpes simplex viruses (HSV-2), capable of establishing lifelong infections within the nervous system (NS), are being proposed to have a role in NDDs. Despite promising data, there is a significant lack of knowledge on this and an urgent need for more research.MethodsWe have set up a mouse model to study HSV latency and its associated neuroinflammation in the spinal cord. The goal of this model was to observe neuroinflammatory changes caused by HSV latent infections, and if those changes were similar to alterations observed in the spinal cord of amyotrophic lateral sclerosis (ALS) patients.ResultsIn infected spinal cords, we have observed a strong leukocyte infiltration and a severe alteration of microglia close to motor neurons. We have also analyzed ALS-related proteins: we have not found changes in TDP-43 and Fus in neurons, but interestingly, we have found decreased protein levels of C9orf72, of which coding gene is severely altered in some familial forms of ALS and is critical for microglia homeostasis.ConclusionsLatent infection of HSV in the spinal cord showed altered microglia and leukocyte infiltration. These inflammatory features resembled to those observed in the spinal cord of ALS patients. No changes mimicking ALS neuropathology, such as TDP-43 cytoplasmic inclusions, were found in infected spinal cords, but a decrease in protein levels of C9orf72 was observed. Then, further studies should be required to determine whether HSV-2 has a role in ALS.
Hemagglutinin stalk-based monoclonal antibody elicits broadly reactivity against group 1 influenza A virus
Authors: Huang Jingjin , Huang Nan , Fan Menglu , Zhao Lingcai , Luo Yan , Ding Pingyun , Tian Miao , Liu Qingzheng , Guo Yanna , Zhao Jinhua , Zheng Yiqing , Zhang Haitao , Ping Jihui 
Published: December 2020

Abstract
Background
Influenza virus remains a continuous and severe threat to public health worldwide, and its prevention and treatment have always been a major international issue. Because of its ability to evade immune surveillance through rapid antigenic drift and antigenic shift, broad-spectrum vaccines seem increasingly important.

Methods
A mAb named 3C12 from an immortalized hybrid cell was generated via immunizing mice with HA2 protein from A/chicken/Anhui/BRI99/2016 (AH/BRI99/16, H9N2) generated by prokaryotic expression. Then, its broad-spectrum activity was analyzed by WB and IFA. Next, the minimal linear epitope was identified via analyzing the reaction of a series of HA truncations with 3C12. Finally, the protective effects of 3C12 were evaluated in vitro and in vivo infection experiments.

Results
The mAb could react with the viruses of subtypes H1, H2, H5, H8, H9, H12, H13, H16, and HA protein of H18 in group 1, but failed to react with viruses in group 2. The minimal linear epitope targeted by the mAb was 433NAELLVL439 in full length of HA and localized in the C-helix region of HA2 (residue 95-101, HA2 numbering). What’s more, the mAb 3C12 inhibited H1, H2, H5, H8, H9, H12, H13 and H16 virus-replication in vitro and also has shown effectiveness in preventing and treating disease in mice challenged with lethal dose of AH/BRI99/16 (H9N2) virus in vivo. These results suggested that the broadly reactive anti-HA stem mAb 3C12 exhibited prophylactic and therapeutic efficacy.

Conclusions
Here, we have demonstrated that the linear epitope identified in this study could be a novel target for developing broad-spectrum influenza diagnostics or vaccine design, and the HA2-based monoclonal antibody is indeed a promising strategy for broad-spectrum protection against seasonal and pandemic influenza viruses.