bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in Hospital Mortality for Uninsured Rural and Urban Populations, 2012‐2016
Authors: Elson Lauren E. , Luke Alina A. , Barker Abigail R. , McBride Timothy D. , Joynt Maddox Karen E. 
Published: May 2020

AbstractPurposeRural‐urban health disparities have received increasing scrutiny as rural individuals continue to have worse health outcomes. However, little is known about how insurance status contributes to urban‐rural disparities. This study characterizes how rural uninsured patients compare to the urban uninsured, determines whether rurality among the uninsured is associated with worse clinical outcomes, and examines how clinical outcomes based on rurality have changed over time.MethodsWe conducted a retrospective cohort study of the 2012‐2016 National Inpatient Sample hospital discharge data including 1,478,613 uninsured patients, of which 233,816 were rural. Admissions were broken into 6 rurality categories. Logistic regression models were used to determine the independent association between rurality and hospital mortality.FindingsDemographic and clinical characteristics differed significantly between rural and urban uninsured patients: rural patients were more often white, lived in places with lower median household income, and were more often admitted electively and transferred. Rurality was associated with significantly higher in‐hospital mortality rates (1.44% vs 1.89%, OR 1.32, P < .001). This association strengthened after adjusting for medical comorbidities and hospital characteristics. Further, disparities between urban and rural mortality were found to be growing, with the gap almost doubling between 2012 and 2016.ConclusionsRural and urban uninsured patients differed significantly, specifically in terms of race and median income. Among the uninsured, rurality was associated with higher in‐hospital mortality, and the gap between urban and rural in‐hospital mortality was widening. Our findings suggest the rural uninsured are a vulnerable population in need of informed, tailored policies to reduce these disparities.
Veterans Affairs and Rural Community Providers’ Perspectives on Interorganizational Care Coordination: A Qualitative Analysis
Authors: Miller Christopher , Gurewich Deborah , Garvin Lynn , Pugatch Marianne , Koppelman Elisa , Pendergast Jacquelyn , Harrington Katharine , Clark Jack A. 
Published: May 2020

AbstractObjectiveTo investigate challenges in care coordination between US Department of Veterans Affairs (VA) clinics and community providers serving rural veterans.MethodsWe completed qualitative interviews in 2017‐2018 with a geographically diverse sample of 57 VA and community staff. Interviews were audio‐recorded and transcribed verbatim. We used Rapid Qualitative Inquiry (RQI) to guide analyses.ResultsResults suggested 5 pivotal domains related to interorganizational care coordination at these sites: organizational mechanisms; organizational culture; relational coordination; contextual factors; and the role of the third party administrators charged with management of scheduling and reimbursement of community services through recent legislation. Across these domains, strategies to bridge gaps between organizations (eg, contracts with third party administrators, development of VA‐based community care offices, provision of boundary‐spanning staff) at times exacerbated coordination challenges.ConclusionsSteps taken to improve interorganizational care coordination between VA and community clinics may inadvertently complicate an already complex process. Our findings emphasize the importance of attending to key contextual barriers in coordinating care for rural veterans, and they illustrate the value of fundamental structural and relational approaches to enhancing such care coordination.
SARS‐CoV‐2 and human milk: What is the evidence?
Authors: Lackey Kimberly A. , Pace Ryan M. , Williams Janet E. , Bode Lars , Donovan Sharon M. , Järvinen Kirsi M. , Seppo Antti E. , Raiten Daniel J. , Meehan Courtney L. , McGuire Mark A. , McGuire Michelle K. 
Published: May 2020

AbstractThe novel coronavirus SARS‐CoV‐2 has emerged as one of the most compelling and concerning public health challenges of our time. To address the myriad issues generated by this pandemic, an interdisciplinary breadth of research, clinical and public health communities has rapidly engaged to collectively find answers and solutions. One area of active inquiry is understanding the mode(s) of SARS‐CoV‐2 transmission. Although respiratory droplets are a known mechanism of transmission, other mechanisms are likely. Of particular importance to global health is the possibility of vertical transmission from infected mothers to infants through breastfeeding or consumption of human milk. However, there is limited published literature related to vertical transmission of any human coronaviruses (including SARS‐CoV‐2) via human milk and/or breastfeeding. Results of the literature search reported here (finalized on 17 April 2020) revealed a single study providing some evidence of vertical transmission of human coronavirus 229E; a single study evaluating presence of SARS‐CoV in human milk (it was negative); and no published data on MERS‐CoV and human milk. We identified 13 studies reporting human milk tested for SARS‐CoV‐2; one study (a non‐peer‐reviewed preprint) detected the virus in one milk sample, and another study detected SARS‐CoV‐2 specific IgG in milk. Importantly, none of the studies on coronaviruses and human milk report validation of their collection and analytical methods for use in human milk. These reports are evaluated here, and their implications related to the possibility of vertical transmission of coronaviruses (in particular, SARS‐CoV‐2) during breastfeeding are discussed.
Counterproductive Altruism: The Other Heavy Tail
Authors: Kokotajlo Daniel , Oprea Alexandra 
Published: May 2020

AbstractFirst, we argue that the appeal of effective altruism (henceforth, EA) depends significantly on a certain empirical premise we call the Heavy Tail Hypothesis (HTH), which characterizes the probability distribution of opportunities for doing good. Roughly, the HTH implies that the best causes, interventions, or charities produce orders of magnitude greater good than the average ones, constituting a substantial portion of the total amount of good caused by altruistic interventions. Next, we canvass arguments EAs have given for the existence of a positive (or “right”) heavy tail and argue that they can also apply in support of a negative (or “left”) heavy tail where counterproductive interventions do orders of magnitude more harm than ineffective or moderately harmful ones. Incorporating the other heavy tail of the distribution has important implications for the core activities of EA: effectiveness research, cause prioritization, and the assessment of altruistic interventions. It also informs the debate surrounding the institutional critique of EA.
Social Equity and COVID‐19: The Case of African Americans
Authors: Wright James E. , Merritt Cullen C. 
Published: May 2020

AbstractEmerging statistics demonstrate that COVID‐19 disproportionately affects African Americans. The effects of COVID‐19 for this population are inextricably linked to areas of systemic oppression and disenfranchisement, which are exacerbated by COVID‐19: (1) health care inequality; (2) segregation, overall health, and food insecurity; (3) underrepresentation in government and the medical profession; and (4) inequalities in participatory democracy and public engagement. Following a discussion of these issues, this essay shares early and preliminary lessons and strategies on how public administration scholars and practitioners can lead in crafting equitable responses to this global pandemic to uplift the African American community.
Vicarious ostracism and control in young children
Authors: Marinović Vesna , Träuble Birgit 
Published: May 2020

AbstractAfter observing ostracism or social exclusion, older children, adolescents and adults report decreased satisfaction of the need for control. Attempting to regain control can motivate aggression in ostracized adults. Research has shown that the onset of ostracism’s harmful effects on children’s behavior is at preschool age. We investigated whether preschoolers would exert more control after witnessing ostracism. A sample of 53 children (Mage = 5 years, 5 months) first watched priming videos either showing ostracism or not. Subsequently, they participated in two ball games. In both of the games (order counterbalanced), children could control the flow of a ball’s motion, either live between two people (i.e., social control) or between two bars on a laptop screen (i.e., non‐social control). Overall, children understood social exclusion when it was displayed in the videos. We found an effect of observed ostracism only on social control. Four‐ to five‐year‐old boys who witnessed ostracism stopped a ball game between two persons longer than boys who did not witness ostracism. Our results suggest that observing social exclusion elevates young boys’ need for control over a social situation. Girls showed a different pattern but their responses did not differ significantly between ostracism and non‐ostracism conditions.
Rapid‐cycle deliberate practice: death notification
Authors: Ahmed Rami , Weaver Lindsay , Falvo Lauren , Bona Anna , Poore Julie , Schroedle Karen , Cooper Dylan , Sarmiento Elisa , Hughes Mary , Hobgood Cherri 
Published: May 2020

SummaryBackgroundDeath notification can be challenging for emergency medicine physicians, who have no prior established relationship with the patient or their families. The GRIEV_ING death notification curriculum was developed to facilitate the delivery of the bad news of a patient's death and has been shown to improve learners’ confidence and competence in death notification. Rapid‐cycle deliberate practice (RCDP), a facilitator‐guided, within‐event debriefing technique, has demonstrated an improvement in learners’ skills in a safe learning environment. The aim of this study was to identify whether the use of this technique is an effective method of teaching the GRIEV_ING curriculum, as demonstrated by learners’ improved confidence, cognitive knowledge and performance.Rapid‐cycle deliberate practice (RCDP), a facilitator‐guided within‐event, debriefing technique, has demonstrated an improvement in learners’ skills in a safe learning environmentMethodsA 4‐hour pilot curriculum was developed to educate and assess residents on the delivery of death notification. The curriculum consisted of a pre‐intervention evaluation, the intervention phase, and a post‐intervention evaluation. The cognitive test, critical action checklist, and self‐efficacy/confidence surveys were identical for both pre‐ and post‐intervention evaluations. A Wilcoxon rank‐sum test was used to evaluate differences in scores between pre‐ and post‐intervention groups.ResultsTwenty‐two emergency medicine residents participated in the study. We observed an increase in median self‐efficacy scores (4.0 [4.0–5.0], p ≤ 0.0001), multiple‐choice GRIEV_ING scores (90.0 [80.0–90.0], p ≤ 0.0001) and performance scores for death notification (48.5 [47.0–53.0], p = 0.0303).DiscussionThe RCDP approach was found to be an effective method to train emergency medicine residents in the delivery of the GRIEV_ING death notification curriculum. This approach is actionable with few resources except for content experts trained in RCDP methodology and the application of the GRIEV_ING mnemonic.
Geochronology of calcite‐filled joints, southeast Canada: Insight into Late Cretaceous deformation of eastern North America
Authors: Spalding Jennifer , Schneider David A. , Brown Julie 
Published: May 2020

AbstractResolving the timing of brittle tectonism is a challenge. We examined intra‐cratonic Middle Ordovician limestone bedrock that overlies Mesoproterozoic crystalline basement, which are both cut by ENE‐WSW trending fault zones that have historic M4‐5 earthquakes along their trace. Calcite‐filled mode I joints are ubiquitous within the strata, and are parallel to the modern stress field. Calcite δ18O and δ13C values are analogous to the bulk composition of Middle Ordovician limestones, and suggest vein formation from a source dominated by connate fluids of the host rock. U‐Pb geochronology of six calcite veins sealing ENE‐WSW oriented joints produced similar Cretaceous dates and were regressed together yielding a date of 96.8 ± 1.1 Ma (MSWD: 2.9). A Cenomanian age is consistent with the most recent reorientation of North America's compressive stress field, which is attributed to a change in spreading direction along the northern Mid‐Atlantic Ridge and is linked to a global plate reorganization event at ca. 105–100 Ma. These results suggest that the most recent redistribution of lateral stress was not a passive event, and generated brittle deformation and fluid flow at least 500 km inland of North America's Atlantic passive margin.
Acute respiratory failure among lung transplant adults requiring intensive care: Changing spectrum of causative organisms and impact of procalcitonin test in the diagnostic workup
Authors: Tejada Sofia , Campogiani Laura , Mazo Cristopher , Romero Anabel , Peña Yolanda , Pont Teresa , Gómez Aroa , Román Antonio , Rello Jordi 
Published: May 2020

AbstractBackgroundThe aim was to identify the causing organisms and assess the association of procalcitonin (PCT) with bacterial pneumonia within 24 hours of intensive care unit admission (ICU‐A) among lung transplant (LT) adult recipients.MethodsSecondary analysis from a prospective cohort study. All LT adults admitted to ICU for acute respiratory failure (ARF) over 5 years were included. Patients were followed until hospital discharge or death.ResultsFifty‐eight consecutive LT patients were enrolled. The most important cause of ICU‐A due to ARF was pneumonia 29 (50%) followed by acute rejection 3 (5.2%) and bronchiolitis obliterans syndrome exacerbation 3 (5.2%). Microorganisms were isolated from 22/29 cases with pneumonia (75.9%): 17 (77.2%) bacterial, 4 (18.2%) viral, 1 (4.5%) Aspergillus fumigates, with Pseudomonas aeruginosa being the most common cause (45.5%) of pneumonia, with 10 patients presenting chronic colonization by P aeruginosa. Median [Interquartile range (IQR)] PCT levels within 24 hours after admission were higher in pneumonia (1.5 µg/L; IQR:0.3‐22.0), than in non‐pneumonia cases (0.2 µg/L; IQR:0.1‐0.7) (P = .019) and PCT levels within 24 hours helped to discriminate bacterial pneumonia (8.2 µg/L; IQR:0.2‐43.0) from viral pneumonia and non‐pneumonia cases (0.2 µg/L; IQR:0.1‐0.7). The overall negative predictive value for bacterial pneumonia was 85.1%, increasing to 91.6% among episodes after 6 months of LT.ConclusionsCauses of severe pneumonia in LT are changing, with predominant role of P aeruginosa and respiratory viruses. PCT ≤ 0.5 μg/L within 24 hours helps to exclude bacterial pneumonia diagnosis in LT adults requiring ICU‐A. A negative PCT test allows antimicrobial de‐escalation and requires an alternative diagnostic to bacterial pneumonia.
Evaluation of vitreous degeneration as a potential risk factor for retinal detachment after phacoemulsification in dogs
Authors: West Michael C. , Sila Gwen H. , Aquino Susette M. , Rose Michelle D. 
Published: May 2020

AbstractPurposeTo evaluate vitreous degeneration as a potential risk factor for retinal detachment in dogs after phacoemulsification.MethodsMedical records for dogs with preoperative ocular ultrasound and phacoemulsification between September 28, 2006, and August 2, 2016, were reviewed. Ultrasound images were reviewed by two observers independently, and vitreous echogenicity was graded using an established scale. The following factors were compared between eyes with and without retinal detachment: signalment, operated eye, cataract stage at the time of surgery, and presence or absence of the following: lens‐induced uveitis (LIU), glaucoma, anterior vitreous presentation, lens subluxation, history of prophylactic retinopexy, diabetes mellitus, operating surgeon, concurrent prophylactic retinopexy, posterior capsular tear, phacoemulsification duration, use of automated anterior vitrectomy, placement of an artificial intraocular lens, and intraocular lens type (polymethyl methacrylate or acrylic foldable). Total follow‐up time was recorded. Presence and time from surgery to onset of complications were recorded. Retinal detachment was diagnosed based on observation via indirect ophthalmoscopy or ocular ultrasound.ResultsEvaluation for association between vitreous degeneration and retinal detachment included 290 eyes of 180 dogs. There was no statistically significant correlation between vitreous degeneration and postoperative retinal detachment. Retinal detachment was observed in 17 of 290 eyes (5.9%). Vitreous degeneration was marked as present by at least one observer in 189 of 290 eyes (65%).ConclusionsUltrasonically identifiable vitreous degeneration does not correlate with increased risk of retinal detachment following phacoemulsification.
Efficient removal of heavy metal ions from the water of oil‐rich regions using layered metal‐phosphate incorporated activated carbon nanocomposite
Authors: Esmaeili Bidhendi Mehdi , Abedynia Sara , Mirzaei Seyed Saber , Gabris Mohammad Ali , Rashidi Nodeh Hamid , Sereshti Hassan 
Published: May 2020

AbstractIn this study, a metal‐phosphate layered/activated carbon (KMSP@AC) composed of potassium (K), manganese (Mn), tin (Sn) and phosphorous (P) was prepared by the solvothermal method. The proposed nanocomposite was used as an effective adsorbent to remove Cd(II), Co(II), Ni(II), Pb(II) and V(III) from water samples in oil‐rich areas prior to ICP‐OES analysis. The KMSP@AC was fully characterized using FTIR, SEM and EDX. Factors influencing the removal process (pH, adsorbent dosage, initial concentration and contact time) were studied and optimized. The experimental process was evaluated with kinetic and isotherm models. The adsorption isotherm investigation showed that the adsorption followed the monolayer Langmuir isotherm model with the maximum adsorption capacities of 25 mg/g (Cd2+), 31 mg/g (Co2+), 49 mg/g (Ni3+), 91 mg/g (Pb2+) and 141 mg/g (V3+). The kinetic studies indicated that the pseudo‐second‐order model is well‐fitted to the process with an appropriate correlation coefficient (R2 > 0.99) at an equilibrium time of 120 min. The adsorption of metal ions on the surface of the adsorbent was mainly a physisorption process through electrostatic interactions.
Evaluation of the genotoxicity of mineral water in polyethylene terephthalate bottles exposed to solar radiation and temperature at variable timescale
Authors: Alemu Abenet , Haddis Getahun Alemayehu 
Published: May 2020

AbstractMost bottling companies in Ethiopia use polyethylene terephthalate bottles to package. However, less attention is given to toxic chemicals that could migrate from packaging material into the water. This study aims to assess leaching and toxicological conditions in PET bottled water due to prolonged storage and exposure to direct sunlight. Allium cepa test was used to determine mitotic index (MI) and chromosomal aberrations (CAs). One‐way analysis of variance (ANOVA) and Dunnet’s multiple comparison test were used. P < 0.05 considered statistically significant. The higher chromosomal aberrations and the lowest mitotic index were significantly observed at high temperature (35Â°C) for one month at P < 0.000. The lower mitotic index was correlated with growth cycle disturbance leading to cell growth reduction. Further investigation is recommended to describe the mechanism and rate of migration of chemicals from water samples supplied in PET bottle.
Optimization of immobilization process and survival study of microbial sensing strains used for aromatic hydrocarbon detection in industrial wastewater
Authors: Patel Rushika , Mukherjee Anwesha , Zaveri Purvi , Mehta Krupa , Aswani Himani , Munshi Nasreen S. 
Published: May 2020

AbstractA variety of biosensing strains for monitoring of aromatic hydrocarbon pollutants have been developed but only a few have been applied to the field due to their lower survival rate and susceptibility to toxic pollutants. Immobilization is one of the solutions to protect strain from toxic pollutants. Synthetic and natural matrices were screened for the immobilization of three strains, which were able to detect one‐, two‐ and three‐ring aromatic hydrocarbon compounds. Agarose and calcium alginate were found to be the best matrices for strain immobilization. The survival rate of immobilized strains was determined by the colony‐forming unit (CFU) count at regular intervals till it reaches to the non‐detectable level. The stability of immobilized biosensing strains was found to be 12–15 days in the industrial wastewater. Hence vector from strains was transformed into wastewater isolate Pseudomonas citronellolis. Immobilized Pseudomonas citronellolis was stable for 66 days in industrial wastewater. Immobilized strains may be applied to design automated biosensor for the online monitoring of pollutants.
Greater exercise tolerance in COPD during acute interval, compared to equivalent constant‐load, cycle exercise: physiological mechanisms
Authors: Louvaris Zafeiris , Chynkiamis Nikolaos , Spetsioti Stavroula , Asimakos Andreas , Zakynthinos Spyros , Wagner Peter D. , Vogiatzis Ioannis 
Published: May 2020

Key points
Exercise intolerance is common in chronic obstructive pulmonary disease (COPD) patients.
In patients with COPD, we compared an interval exercise (IE) protocol (alternating 30 s at 100% peak work rate (WRpeak) with 30 s at 50% WRpeak) with moderate‐intensity constant‐load exercise (CLE) at 75% WRpeak, which yielded the same work rate. Exercise endurance time and total work output were almost twice as high for IE than CLE.
At exercise isotime (when work completed was the same between IE and CLE), IE was associated with less dynamic hyperinflation, lower blood lactate concentration, and greater respiratory and locomotor muscle oxygenation, but there were no differences in ventilation or cardiac output.
However, at the limit of tolerance for each modality, dynamic hyperinflation was not different between IE and CLE, while blood lactate remained lower and muscle oxygenation higher with IE.
Taken together, these findings suggest that dynamic hyperinflation and not muscle‐based factors dictate the limits of tolerance in these COPD patients.
AbstractThe relative importance of ventilatory, circulatory and peripheral muscle factors in determining tolerance to exercise in patients with chronic obstructive pulmonary disease (COPD) is not known. In 12 COPD patients (forced expiratory volume in one second: 58 ± 17%pred.) we measured ventilation, cardiac output, dynamic hyperinflation, local muscle oxygenation, blood lactate and time to exhaustion during (a) interval exercise (IE) consisting of 30 s at 100% peak work rate alternating with 30 s at 50%, and (b) constant‐load exercise (CLE) at 75% peak work rate, designed to produce the same average work rate. Exercise time was substantially longer during IE than CLE (19.5 ± 4.8 versus 11.4 ± 2.1 min, p = 0.0001). Total work output was therefore greater during IE than CLE (81.3 ± 27.7 versus 48.9 ± 23.8 kJ, p = 0.0001). Dynamic hyperinflation (assessed by changes from baseline in inspiratory capacity, ΔIC) was less during IE than CLE at CLE exhaustion time (isotime, p = 0.009), but was similar at exhaustion (ΔICCLE: ‐0.38 ± 0.10 versus ΔICIE: ‐0.33 ± 0.12 l, p = 0.102). In contrast, at isotime, minute ventilation, cardiac output and systemic oxygen delivery did not differ between protocols (P > 0.05). At exhaustion in both protocols, the vastus lateralis and intercostal muscle oxygen saturation were higher in IE than CLE (p = 0.014 and p = 0.0002, respectively) and blood lactate concentrations were lower (4.9 ± 2.4 mmol l‐1 versus 6.4 ± 2.2 mmol l‐1, p = 0.039). These results suggest that (1) exercise tolerance with COPD is limited by dynamic hyperinflation; and (2) cyclically lower (50%) effort intervals in IE help to preserve muscle oxygenation and reduce metabolic acidosis compared with CLE at the same average work rate; but these factors do not appear to determine time to exhaustion.