bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community Care Facility—A Novel Concept to Deal With the COVID-19 Pandemic: A Singaporean Institutionʼs Experience
Authors: Goei Anne 
Published: September 2020

Context:
The coronavirus disease 2019 (COVID-19) pandemic has placed a strain on health care systems worldwide. Many hospitals experienced severe bed shortages; some had to turn patients away. In Singapore, the widespread outbreak, especially among the dormitory-based population, created a pressing need for alternative care sites.

Program:
The first massive-scale community care facility (CCF) was started in Singapore to address the pandemic. It served as a low-acuity primary care center that could isolate and treat COVID-19–positive patients with mild disease. This allowed decompression of the patient load in hospitals, ensuring that those with more severe disease could receive timely medical attention.

Implementation:
Various groups from the private and public sectors, including health care, construction, security, hotel management, and project coordination, were involved in the setup and operations of the CCF. A large exhibition center was converted into the care facility and segregated into zones to reduce cross-contamination. State-of-the-art technological infrastructure for health management was used. Several paraclinical services were made available.

Evaluation:
The CCF was a timely and robust response that fulfilled several crucial functions, including cohort isolation, triage, basic medical care, and timely reviews and escalation of patients. It placed a unique focus on promoting patient ownership, responsibility, and mental well-being. It was largely successful, with a low hospital transfer rate of 0.37%.

Discussion:
The success of the CCF could be attributed to the use of a facility of opportunity, strong interorganizational and cross-sector cooperation, an integrated and robust clinical system, and clear communication channels. It allows for efficient resource utilization and is valuable in future pandemics with similar disease characteristics.
Modeling Tissue Expansion with Isogeometric Analysis: Skin Growth and Tissue Level Changes in the Porcine Model
Authors: Janes Lindsay E. , Ledwon Joanna K. , Vaca Elbert E. , Turin Sergey Y. , Lee Taeksang , Tepole Adrian B. , Bae Hanah , Gosain Arun K. 
Published: September 2020

Background:
Tissue expansion relies on the ability of skin to grow in response to sustained mechanical strain. This study focuses on correlation of cellular and histologic changes with skin growth and deformation during tissue expansion.

Methods:
Tissue expanders were placed underneath the skin of five Yucatan minipigs and inflated with one fill of 60 cc of saline 1 hour, 24 hours, 3 days, and 7 days before the animals were killed, or two fills of either 30 cc or 60 cc at 10 and 3 days or 14 and 7 days before the animals were killed. Skin biopsy specimens and three-dimensional photographs were used to calculate skin growth and stretch according to the authors’ novel finite element analysis model.

Results:
The mitotic index of keratinocytes in the basal layer increased 1 hour after stimulus was applied (4 percent) (p = 0.022), peaked at approximately day 3 (26 percent) (p < 0.0001), and tapered by day 7 (12.5 percent) (p = 0.012) after tissue expansion. The authors demonstrated that it is the volume per fill rather than the total volume in the expander that scales the magnitude of response. Lastly, the authors demonstrated that the ratio of deformation attributable to growth versus stretch (Fgrowth/Fstretch) after 60 cc of tissue expansion fill was 1.03 at 1 hour, 0.82 at 1 day, 0.85 at day 3, and 0.95 at 7 days.

Conclusions:
Peak cell proliferation occurred 3 days after tissue expansion fill and is scaled in response to stimulus magnitude. The growth component of deformation equilibrates to the stretch component at day 7, as cell proliferation has started to translate to skin growth.
Ambulatory Access: Improving Scheduling Increases Patient Satisfaction and Revenue
Authors: Volk Angela S. , Davis Matthew J. , Abu-Ghname Amjed , Warfield Rachel G. , Ibrahim Ramzey , Karon Grace , Hollier Larry H. 
Published: September 2020

Background:
Even before seeing a physician, patients must first gain access to the hospital system. At large hospitals with high patient volumes, access to specialty care can pose a particular challenge. This study examines the effects of specific initiatives to increase clinic capacity, appointment use, and ease of scheduling on both patient satisfaction and hospital revenue.

Methods:
In 2017, a task force at a large, multidisciplinary pediatric hospital instituted a number of initiatives to increase patient access to ambulatory specialty clinics. Clinic sessions were standardized to a 4-hour template, and unscheduled, “held” appointment slots were required to be made available (“flipped”) 72 hours before the appointment. A patient-centered electronic scheduling platform was also implemented. Patient satisfaction was assessed using Press Ganey scores. Revenue estimates were calculated for increases in “new” and “return” patient appointments.

Results:
Total new appointment slots increased by over 44 percent, with over 53,000 appointments added annually. The number of held appointment slots declined by 93 percent. A total of 17,996 annual appointments were added in surgical subspecialties, and an additional 14,756 more surgical appointments were completed. Over 2000 appointments were scheduled by means of the online patient portal. Press Ganey “ease-of-scheduling” scores increased from 57 percent to 72 percent over the intervention period. Hospitalwide, these initiatives generated an estimated $8.3 million in revenue opportunity.

Conclusion:
Standardizing clinic sessions and optimizing clinic availability generates new appointment opportunities, improves patient experience, and increases hospital revenue.
Exercise and the Risk of Mild Cognitive Impairment
Authors: Hughes Tiffany F. , Liu Anran , Jacobsen Erin , Rosano Caterina , Berman Sarah B. , Chang Chung-Chou H. , Ganguli Mary 
Published: September 2020

Introduction:
Although exercise is associated with a lower risk for mild cognitive impairment (MCI), it is unclear whether its protective effect depends on the presence or absence of vascular factors.

Methods:
In an exploratory study of data from a population-based cohort, 1254 participants aged 65+ years were followed for 10 years for incident MCI. The main effect of baseline total minutes of exercise per week (0 vs. 1 to 149 vs. 150+), and its interaction with several vascular factors, on risk for incident MCI was examined using Cox proportional hazards regression models, adjusting for demographics.

Results:
Compared with no exercise, 1 to 149 minutes [hazard ratio (HR)=0.90; 95% confidence interval (95% CI), 0.69-1.16] and 150 or more minutes per week (HR=0.84; 95% CI, 0.66-1.07) of exercise lowered risk for incident MCI in a dose-dependent manner. The majority of interactions were not statistically significant, but risk reduction effect sizes of <0.75 suggested that exercise may have stronger effects among those without high cholesterol, never smoking, and not currently consuming alcohol; also, those with arrhythmia, coronary artery disease, and heart failure. Overall, there was a pattern of exercise being associated with lower MCI risk among those without vascular factors.

Conclusions:
Spending more time engaging in exercise each week may offer protection against MCI in late life, with some variation among those with different vascular conditions and risk factors. Our findings may help target subgroups for exercise recommendations and interventions, and also generate hypotheses to test regarding underlying mechanisms.
Androgen Deprivation Therapy Use and Risk of Mild Cognitive Impairment in Prostate Cancer Patients
Authors: Alonso-Quiñones Hector , Stish Bradley J. , Aakre Jeremiah A. , Hagen Clinton E. , Petersen Ronald C. , Mielke Michelle M. 
Published: September 2020

Introduction:
We examined the association between androgen deprivation therapy (ADT) use and the risk of mild cognitive impairment (MCI) among prostate cancer patients.

Methods:
We included 241 cognitively unimpaired men, aged 70 to 90, with a history of prostate cancer before enrollment in the population-based Mayo Clinic Study of Aging. Using the Rochester Epidemiology Project medical records-linkage system, ADT use and length of exposure were abstracted. Follow-up visits occurred every 15 months and MCI diagnoses were made based on clinical consensus. Cox proportional hazards models, with age as the timescale, were used to examine the association between ADT use (yes/no) and length of exposure with the risk of MCI adjusting for education, apolipoprotein E, depression, and the Charlson Index score.

Results:
There was no association between any ADT use (27.8% of participants) and the risk of MCI in the multivariable model [hazard ratio (HR), 1.25; 95% confidence interval (CI), 0.75-2.10]. Although not significant, there was an ADT dose-response relationship for risk of MCI: <5 years versus no use (HR, 1.08; 95% CI, 0.60-1.96) and ≥5 years versus not use (HR, 1.89; 95% CI, 0.83-4.27).

Conclusion:
ADT use among prostate cancer patients was not associated with an increased risk of developing MCI.
Telehealth, Telemedicine, and Related Technologic Platforms
Authors: Mahoney Mary F. 
Published: September 2020

BACKGROUND:Providing health care at a distance has evolved over the past decades, resulting in a myriad of terms and styles of care delivery. Telehealth is defined as any health care service delivered at a distance. Nursing services have been delivered by a wide range of specialty nurses for many years using various technological formats. Clinical experience suggests that few WOC nurses had extensively adopted these technologies and principles into their practice as recently as 2019. However, the COVID-19 pandemic of 2020 has forced both administrators and clinicians to rapidly adapt or introduce telemedicine technologies to deliver specialty care including WOC nurse services.CASES:Three WOC nurses were chosen to describe the use of telehealth technologies to illustrate opportunities for WOC nurses to integrate telehealth nursing into a health care setting. Two adapted telehealth technology into their practice before the pandemic, and one started telehealth practice as a means to provide care after the onset of the pandemic. Disadvantages and advantages are discussed to provide further information regarding WOC patient care using these technologies.CONCLUSION:The pandemic crisis has accelerated the need for health care to reimagine the delivery of care to patients. Telehealth technologies and principles have emerged as essential for WOC nurses to deliver safe and effective care.
Genetic correlation and causal relationships between cardio-metabolic traits and Lung function Impairment
Authors: Wielscher Matthias , Amaral Andre F.S. , van der Plaat Diana , Wain Louise V. , Sebert Sylvain , Mosen-Ansorena David , Auvinen Juha , Herzig Karl-Heinz , Dehghan Abbas , Jarvis Debbie L , Jarvelin Marjo-Riitta 
Published: September 2020

AbstractBackgroundAssociations of low lung function with features of poor cardio-metabolic health have been reported. It is, however, unclear whether these co-morbidities reflect causal associations, shared genetic heritability or are confounded by environmental factors.MethodsWe performed three analyses: 1) cardio-metabolic health to lung function association tests in NFBC1966, 2) cross trait LD score regression to compare genetic backgrounds and 3) Mendelian Randomization (MR) analysis to assess the causal effect of cardio-metabolic traits and disease on lung function, and vice versa (bidirectional MR). Genetic associations were obtained from UK Biobank data or published large-scale genome-wide association studies (N > 82,000).ResultsWe observed negative genetic correlation between lung function and cardio-metabolic traits and diseases. In Mendelian Randomisation analysis (MR) we found associations between Type 2 Diabetes instruments and FVC as well as FEV1/FVC. BMI instruments were associated to all lung function traits and CRP instruments to FVC. These genetic association provide evidence for a causal effect of cardio-metabolic traits on lung function. Multivariable MR suggested independence of these causal effects from other tested cardio-metabolic traits and diseases. Analysis of lung function specific SNPs revealed a potential causal effect of FEV1/FVC on blood pressure.ConclusionsThe present study overcomes many limitations of observational studies by using Mendelian Randomisation. We provide evidence for an independent causal effect of T2D, CRP and BMI on lung function with some of the T2D effect on lung function being mediated by CRP. Furthermore, this analysis suggests a potential causal effect of FEV1/FVC on blood pressure. Our detailed analysis of the interplay between cardio-metabolic traits and impaired lung function provides the opportunity to improve the quality of existing intervention strategies.
Comparison of COVID-19 outcomes among shielded and non-shielded populations: A general population cohort study of 1.3 million
Authors: Jani Bhautesh D , Ho Frederick K , Lowe David J , MacBride-Stewart Sean , Mair Frances S , Pell Jill P 
Published: September 2020

AbstractBackgroundShielding (extended self-isolation) of people judged, a priori, to be at high-risk from COVID-19 has been used by some countries to protect the individuals and reduce demand on health services. It is unclear how well this strategy works in either regard.MethodsA general population study was conducted using linked primary care, prescribing, laboratory, hospital and death records up to end of May 2020. Poisson regression models and population attributable fractions were used to compare COVID-19 outcomes by overall risk category, and individual risk criteria: confirmed infection, hospitalisation, intensive care unit (ICU) admission, population mortality and case-fatality.ResultsOf the 1.3 million population, 32,533 (2.47%) had been advised to shield, a further 347,374 (26.41%) were classified as moderate risk. Testing for COVID-19 was more common in the shielded (6.75%) and moderate (1.99%) than low (0.72%) risk categories. Referent to low-risk, the shielded group had higher risk of confirmed infection (RR 7.91, 95% 7.01-8.92), case-fatality (RR 5.19, 95% CI 4.12-6.53) and population mortality (RR 48.64, 95% 37.23-63.56). The moderate risk had intermediate risk of confirmed infection (RR 4.11, 95% CI 3.82-4.42) and population mortality (RR 26.10, 95% CI 20.89-32.60), but had comparable case-fatality (RR 5.13, 95% CI 4.24-6.21) to the shielded, and accounted for a higher proportion of deaths (PAF 75.27% vs 13.38%). Age ≥70 years made the largest contribution to deaths (49.53%) and was associated with an 8-fold risk of infection, 7-fold case-fatality and 74-fold mortality.ConclusionsShielding has not been effective at preventing deaths in those with highest risk. To be effective as a population strategy, shielding criteria would need to be widely expanded to include other criteria, such as the elderly.
COMPARATIVE ANALYSIS OF COVID-19 MORTALITY IN BRAZIL, RIO DE JANEIRO, CAMPOS DOS GOYTACAZES, MACAÉ, CABO FRIO AND RIO DAS OSTRAS1
Authors: Guimarães Antonio C. C. , Coelho Karla Santa Cruz , da Cruz Kathleen Tereza , de Oliveira Souza Bárbara Soares , de Almeida Janimayri Forastieri , Coelho Gustavo Fialho , Ferreira Gabriella Ramos Lacerda 
Published: September 2020

AbstractObjectiveTo analyze quantitatively and comparatively the deaths by COVID-19 of the four largest municipalities in the North of Rio de Janeiro and Baixada Litorânea of Rio de Janeiro, within the national context.MethodsWe used data from the Civil Registry and demographic information to elaborate a general picture of the pandemic up to the 31st epidemiological week in several aspects: evolution, scope, age, sex, race and impact on other causes of death.ResultsWe characterized the evolution of the pandemic. We found an exponential dependence on the mortality rate by age and a higher lethality in the male population. We determined that COVID-19 represents an important fraction of the causes of death in 2020, being associated with a significant excess of deaths in relation to 2019 and also with the change in mortality patterns due to other causes.ConclusionMortality is an effective and powerful indicator for understanding the infection and its pandemic, and it must be taken into account during the construction of public policies to deal with it.
Comprehensive characterization of protein-protein interaction network perturbations by human disease mutations
Authors: Cheng Feixiong , Zhao Junfei , Wang Yang , Lu Weiqiang , Liu Zehui , Zhou Yadi , Martin William , Wang Ruisheng , Huang Jin , Hao Tong , Yue Hong , Ma Jing , Hou Yuan , Castrillon Jessica , Fang Jiansong , Lathia Justin D. , Keri Ruth A. , Lightstone Felice C. , Antman Elliott Marshall , Rabadan Raul , Hill David E. , Eng Charis , Vidal Marc , Loscalzo Joseph 
Published: September 2020

AbstractTechnological and computational advances in genomics and interactomics have made it possible to identify rapidly how disease mutations perturb interaction networks within human cells. In this study, we investigate at large-scale the effects of network perturbations caused by disease mutations within the human three-dimensional (3D), structurally-resolved macromolecular interactome. We show that disease-associated germline mutations are significantly enriched in sequences encoding protein-protein interfaces compared to mutations identified in healthy subjects from the 1000 Genomes and ExAC projects; these interface mutations correspond to protein-protein interaction (PPI)-perturbing alleles including p.Ser127Arg in PCSK9 at the PCSK9-LDLR interface. In addition, somatic missense mutations are significantly enriched in PPI interfaces compared to non-interfaces in 10,861 human exomes across 33 cancer subtypes/types from The Cancer Genome Atlas. Using a binomial statistical model, we computationally identified 470 PPIs harboring a statistically significant excess number of missense mutations at protein-protein interfaces (termed putative oncoPPIs) in pan-cancer analysis. We demonstrate that the oncoPPIs, including histone H4 complex in individual cancer types, are highly correlated with patient survival and drug resistance/sensitivity in human cancer cell lines and patient-derived xenografts. We experimentally validate the network effects of 13 oncoPPIs using a systematic binary interaction assay. We further showed that ALOX5 p.Met146Lys at the ALOX5-MAD1L1 interface and RXRA p.Ser427Phe at the RXRA-PPARG interface promote significant tumor cell growth using cell line-based functional assays, providing a functional proof-of-concept. In summary, if broadly applied, this human 3D interactome network analysis offers a powerful tool for prioritizing alleles with mutations altering PPIs that may contribute to the pathobiology of human diseases, and may offer disease-specific targets for genotype-informed therapeutic discovery.
Belief states and categorical-choice biases determine reward-based learning under perceptual uncertainty
Authors: Bruckner Rasmus , Heekeren Hauke R. , Ostwald Dirk 
Published: September 2020

AbstractIn natural settings, learning and decision making often takes place under considerable perceptual uncertainty. Here we investigate the computational principles that govern reward-based learning and decision making under perceptual uncertainty about environmental states. Based on an integrated perceptual and economic decision-making task where unobservable states governed the reward contingencies, we analyzed behavioral data of 52 human participants. We formalized perceptual uncertainty with a belief state that expresses the probability of task states based on sensory information. Using several Bayesian and Q-learning agent models, we examined to which degree belief states and categorical-choice biases determine human learning and decision making under perceptual uncertainty. We found that both factors influenced participants’ behavior, which was similarly captured in Bayesian-inference and Q-learning models. Therefore, humans dynamically combine uncertain perceptual and reward information during learning and decision making, but categorical choices substantially modulate this integration. The results suggest that categorical commitments to the most likely state of the environment may generally give rise to categorical biases on learning under uncertainty.
Investigating the effect of biomass fuel use and Kitchen location on Maternal Report of Birth size: A Cross-Sectional Analysis of 2016 Ethiopian Demographic Health Survey data
Authors: Kanno Girum Gebremeskel , Anbesse Adane Tesfaye , Shaka Mohammed Feyisso , Legesse Miheret Tesfu , Andarge Sewitemariam Desalegn 
Published: September 2020

AbstractHousehold air pollution from the use of biomass fuels has been associated with low birth weight in many developing countries. We investigated the effect of indoor air pollution from biomass fuel use and kitchen location on maternal reports of birth size in newborn children in Ethiopia using secondary cross-sectional data from Ethiopian Demographic Health Survey conducted in 2016. Birth weight from child health card and/or mothers’ recall was the dependent dichotomous variable. Fuel type was classified as high pollution fuels, and low pollution fuels. Hierarchical logistic regression was used to assess the effect of fuel type on birth weight. The prevalence of low birth weight was 25.9% and the use of biomass fuels was significantly associated with higher odds of having low birth weight baby in the bivariate analysis, after controlling for child and maternal factors. In the final model, the association turned insignificant with AOR, 1.3 (95% 0.9, 1.9). The kitchen location, Gender of the baby, Mother’s Anemia Status, Maternal Chat chewing, and wealth Index were significant factors in the final model. The use of biomass fuels and kitchen location were associated with reduced child size at birth. Further observational studies should investigate this association using more direct methods.Practical ImplicationsThe findings from this study have important implication at national level for policy makers. Ethiopia is a country with a huge proportion of the population depends on biomass fuels for cooking. Despite the progress made to reduce the burden of maternal and infant mortality and morbidity in the pre SDG era, LBW is still one of the challenges that need to be addressed. Identifying the link between biomass fuel use and kitchen location with low birth weight can help the efforts to revise, amend or implement programs that help achieve the SDG goal six, by engaging the energy and health sectors together.