bluuebunny/crossref_metadata_2025_split huggingface dataset:
Compartmentalized evolution of hepatitis B virus contributes differently to the prognosis of hepatocellular carcinoma
Authors: Yin Jianhua , Chen Xi , Li Nan , Han Xuewen , Liu Wenbin , Pu Rui , Wu Ting , Ding Yibo , Zhang Hongwei , Zhao Jun , Han Xue , Wang Hongyang , Cheng Shuqun , Cao Guangwen 
Published: November 2020

AbstractSerum hepatitis B virus (HBV) mutations can predict hepatocellular carcinoma (HCC) occurrence. We aimed to clarify if HBV evolves synchronously in the sera, adjacent liver and tumors and predict HCC prognosis equally. A total of 203 HBV-positive HCC patients with radical hepatectomy in Shanghai, China, during 2011–15 were enrolled in this prospective study. Quasispecies complexity (QC) in HBV core promoter region was assessed using clone-based sequencing. We performed RNA sequencing on tumors and paired adjacent tissues of another 15 HCC patients and analyzed it with three public data sets containing 127 samples. HBV QC was positively correlated to APOBEC3s’ expression level (r = 0.28, P &lt; 0.001), higher in the adjacent tissues than in the tumors (P = 6.50e-3), and higher in early tumors than in advanced tumors (P = 0.039). The evolutionary distance between the sera-derived HBV strains and the tumor-derived ones was significantly longer than that between the sera-derived ones and the adjacent tissue-derived ones (P &lt; 0.001). Multivariate Cox regression analyses indicated that high HBV QC in the sera predicted an unfavorable overall survival (P = 0.002) and recurrence-free survival (RFS; P = 0.004) in HCC, whereas, in the tumors, it predicted a favorable RFS (P &lt; 0.001). APOBECs-related HBV mutations, including G1764A, were more frequent in the sera than in the adjacent tissues. High-frequent A1762T/G1764A in the sera predicted an unfavorable RFS (P &lt; 0.001), whereas, in the tumors, it predicted a favorable RFS (P = 0.035). In conclusion, HBV evolves more advanced in the sera than in the tumors. HBV QC and A1762T/G1764A in the sera and tumors have contrary prognostic effects in HCC.
Comparative effectiveness of bisoprolol and carvedilol among patients receiving maintenance hemodialysis
Authors: Wu Ping-Hsun , Lin Yi-Ting , Liu Jia-Sin , Tsai Yi-Chun , Kuo Mei-Chuan , Chiu Yi-Wen , Hwang Shang-Jyh , Carrero Juan-Jesus 
Published: November 2020

Abstract

Background
Despite widespread use, there is no trial evidence to inform β-blocker’s (BB) relative safety and efficacy among patients undergoing hemodialysis (HD). We herein compare health outcomes associated with carvedilol or bisoprolol use, the most commonly prescribed BBs in these patients.

Methods
We created a cohort study of 9305 HD patients who initiated bisoprolol and 11 171 HD patients who initiated carvedilol treatment between 2004 and 2011. We compared the risk of all-cause mortality and major adverse cardiovascular events (MACEs) between carvedilol and bisoprolol users during a 2-year follow-up.

Results
Bisoprolol initiators were younger, had shorter dialysis vintage, were women, had common comorbidities of hypertension and hyperlipidemia and were receiving statins and antiplatelets, but they had less heart failure and digoxin prescriptions than carvedilol initiators. During our observations, 1555 deaths and 5167 MACEs were recorded. In the multivariable-adjusted Cox model, bisoprolol initiation was associated with a lower all-cause mortality {hazard ratio [HR] 0.66 [95% confidence interval (CI) 0.60–0.73]} compared with carvedilol initiation. After accounting for the competing risk of death, bisoprolol use (versus carvedilol) was associated with a lower risk of MACEs [HR 0.85 (95% CI 0.80–0.91)] and attributed to a lower risk of heart failure [HR 0.83 (95% CI 0.77–0.91)] and ischemic stroke [HR 0.84 (95% CI 0.72–0.97)], but not to differences in the risk of acute myocardial infarction [HR 1.03 (95% CI 0.93–1.15)]. Results were confirmed in propensity score matching analyses, stratified analyses and analyses that considered prescribed dosages or censored patients discontinuing or switching BBs.

Conclusions
Relative to carvedilol, bisoprolol initiation by HD patients was associated with a lower 2-year risk of death and MACEs, mainly attributed to lower heart failure and ischemic stroke risk.
Association Between Brain Volumes and Patterns of Physical Activity in Community-Dwelling Older Adults
Authors: Wanigatunga Amal A , Wang Hang , An Yang , Simonsick Eleanor M , Tian Qu , Davatzikos Christos , Urbanek Jacek K , Zipunnikov Vadim , Spira Adam P , Ferrucci Luigi , Resnick Susan M , Schrack Jennifer A 
Published: November 2020

Abstract

Background
Larger brain volumes are often associated with more free-living physical activity (PA) in cognitively normal older adults. Yet, whether greater brain volumes are associated with more favorable (less fragmented) PA patterns, and whether this association is stronger than with total PA, remains unknown.

Methods
Brain magnetic resonance imaging and wrist-worn accelerometer data were collected in 301 participants (mean age = 77 [SD = 7] years, 59% women) enrolled in the Baltimore Longitudinal Study of Aging. Linear regression models were fit to examine whether brain volumes (cc) were cross-sectionally associated with: (a) total daily PA minutes and (b) activity fragmentation (mean number of PA bouts / total PA minutes × 100). Sensitivity analyses were conducted by adjusting for counterpart PA variables (eg, fragmentation covariate included in the PA minutes model).

Results
Greater white matter volumes in the parietal and temporal lobes were associated with higher daily PA minutes (2.6 [SE = 1.0] and 3.8 [0.9] min/day, respectively; p &lt; .009 for both) after adjusting for demographics, behavioral factors, medical conditions, gait speed, apolipoprotein E e4 status, and intracranial volume. Greater temporal white matter volume was associated with lower fragmentation (−0.16% [0.05], p = .003). In sensitivity analyses, observed associations between brain volumes and daily PA minutes remained significant while associations with fragmentation no longer remained significant.

Conclusions
Our results suggest white matter brain structure in cognitively normal older adults is associated with the total amount of PA and, to a lesser extent, the PA accumulation patterns. More work is needed to elucidate the longitudinal relationship between brain structure and function and PA patterns with aging.
Age at Immigration and Depression: The Mediating Role of Contemporary Relationships With Adult Children Among Older Immigrants
Authors: Jang Heejung , Pilkauskas Natasha V , Tang Fenyan 
Published: November 2020

Abstract

Objectives
For the growing population of older immigrants in the United States, both age at immigration and familial relationships are important factors affecting psychological well-being. This study explores how age at immigration and contemporary relationships with adult children combine to explain older immigrants’ depressive symptoms.

Method
This study uses 2014 Health and Retirement Study data from a sample of 759 immigrants aged 65 and older who have at least one adult child aged 21 or older. A series of ordinary least squares regressions and mediational analyses were conducted.

Results
Findings indicate that structural solidarity significantly mediates the association between age at immigration and depressive symptoms. Specifically, immigrating in later life was associated with a lower level of depressive symptoms through its relationship with structural solidarity. In addition, giving monetary support to children and providing care for grandchildren may alleviate depressive symptoms for older immigrants.

Discussion
This study suggests that relationships with adult children may differ with age at immigration. The types of support that older immigrants provide to their adult children may be crucial because such support may instill a sense of obligation and reciprocity that may be beneficial to the psychological well-being of older immigrants.
A reference guide to rapidly implementing an institutional dashboard for resource allocation and oversight during COVID-19 pandemic surge
Authors: Jawa Randeep S , Tharakan Mathew A , Tsai Chaowei , Garcia Victor L , Vosswinkel James A , Rutigliano Daniel N , Rubano Jerry A ,   Stony Brook Medicine Enterprise Analytics Team
Published: November 2020

Abstract

Objectives
We develop a dashboard that leverages electronic health record (EHR) data to monitor intensive care unit patient status and ventilator utilization in the setting of the COVID-19 pandemic.

Materials and methods
Data visualization software is used to display information from critical care data mart that extracts information from the EHR. A multidisciplinary collaborative led the development.

Results
The dashboard displays institution-level ventilator utilization details, as well as patient-level details such as ventilator settings, organ-system specific parameters, laboratory values, and infusions.

Discussion
Components of the dashboard were selected to facilitate the determination of resources and simultaneous assessment of multiple patients. Abnormal values are color coded. An overall illness assessment score is tracked daily to capture illness severity over time.

Conclusion
This reference guide shares the architecture and sample reusable code to implement a robust, flexible, and scalable dashboard for monitoring ventilator utilization and illness severity in intensive care unit ventilated patients.
A Simple and High-Throughput LC–MS-MS Method for Simultaneous Measurement of Nicotine, Cotinine, 3-OH Cotinine, Nornicotine and Anabasine in Urine and Its Application in the General Korean Population
Authors: Oh Jongwon , Park Min-Seung , Chun Mi-Ryung , Hwang Jung Hye , Lee Jin-Young , Jee Jae Hwan , Lee Soo-Youn 
Published: November 2020

AbstractMeasuring nicotine metabolites is the most objective method for identifying smoke exposure. Liquid chromatography--tandem mass spectrometry (LC–MS-MS) can measure multiple metabolites and is sensitive enough to detect low concentrations of metabolites. Therefore, we developed a simple and high-throughput method for measuring nicotine, cotinine, trans-3ʹ-hydroxycotinine (3-OH cotinine), nornicotine and anabasine for population-based studies using LC–MS-MS. Each 30 µL of urine sample was diluted with 90 µL of acetonitrile containing five deuterated internal standards. Chromatographic separation used a C18 column, and LC–MS-MS analysis was performed with a multiple reaction monitoring mode. The chromatographic run time for each sample was 6.5 min. The method was validated by evaluating selectivity, interference, limit of detection, lower limit of quantification, precision, accuracy, linearity, extraction recovery, matrix effect and carryover according to guidelines. Our methods required a short preparation time (∼20 min) while simultaneously measuring five markers for smoking status. No endogenous or exogenous interference was found. Our method showed excellent precision and accuracy: within-run coefficient of variation (CV) 2.9–9.4%, between-run CV 4.8–8.7% and bias −10.1 to 5.3%. Linear dynamic ranges were 1–10,000 ng/mL for nicotine, nornicotine and anabasine; 2–5,000 ng/mL for cotinine and 5–15,000 ng/mL for 3-OH cotinine. Extraction recovery was consistent (87–109%) across concentrations. No significant matrix effect or carryover was observed. The validated method was applied to 849 urine samples. In samples from the 125 current smokers, nicotine, cotinine, 3-OH cotinine, nornicotine and anabasine were detected in 97.6, 99.2, 98.4, 96.8 and 87.2%, respectively. No markers were detected in 93.9% of 609 nonsmokers. The overlapping detection of multiple markers made it possible to identify the smoking status even in current smokers with a low concentration of cotinine. Our LC–MS-MS method using a simple sample preparation technique is sensitive and effective for screening of smoking status in the general population.
Effect of Drug Disposal Kits and Fact Sheets on Elimination of Leftover Prescription Opioids: The DISPOSE Multi-Arm Randomized Controlled Trial
Authors: Bicket Mark C , Fu Denise , Swarthout Meghan D , White Elizabeth , Nesbit Suzanne A , Monitto Constance L 
Published: November 2020

Abstract

Objective
To determine how passively providing informational handouts and/or drug disposal kits affects rates of leftover prescription opioid disposal.

Design
A multi-arm parallel-group randomized controlled trial with masked outcome assessment and computer-guided randomization.

Setting
Johns Hopkins Health System outpatient pharmacies.

Subjects
Individuals who filled ≥1 short-term prescription for an immediate-release opioid for themselves or a family member.

Methods
In June 2019, 499 individuals were randomized to receive an informational handout detailing U.S. Food and Drug Administration–recommended ways to properly dispose of leftover opioids (n = 188), the informational handout and a drug disposal kit with instructions on its use (n = 170), or no intervention (n = 141) at prescription pickup. Subjects were subsequently contacted by telephone, and outcomes were assessed by a standardized survey. The primary outcome was the use of a safe opioid disposal method.

Results
By 6 weeks after prescription pickup, 227 eligible individuals reported they had stopped taking prescription opioids to treat pain and had leftover medication. No difference in safe disposal was observed between the non-intervention group (10% [6/63]) and the group that received disposal kits (14% [10/73]) (risk ratio = 1.44; 95% confidence interval: 0.55 to 3.74) or the group that received a fact sheet (11% [10/91]) (risk ratio = 1.15; 95% confidence interval: 0.44 to 3.01).

Conclusions
These findings suggest that passive provision of a drug disposal kit at prescription pickup did not increase rates of leftover opioid disposal when compared with provision of a fact sheet alone or no intervention. Active interventions may deserve further investigation.
In Vitro Characterization of Pressure Redistribution Among Commercially Available Wound Dressings
Authors: Niezgoda Jeffrey A , Niezgoda Jonathan A , Gopalakrishnan Sandeep 
Published: November 2020

ABSTRACT

OBJECTIVE
Recent clinical evidence has suggested that certain wound dressings may play a significant role in protocols to prevent or reduce pressure injury (PI) in patients at risk by modifying the pressure, friction, and shear forces that can contribute to PI. The aim of this study was to investigate the pressure reduction properties of commercially available wound dressings in vitro.

METHODS
Using a standardized protocol (1.7 kg, 7.5-cm sphere), testing was performed in a controlled environment by the same clinician using a pressure mapping device (XSENSOR LX205; XSENSOR Technology Corporation, Calgary, Alberta, Canada) to measure and compare the pressure mitigation properties in a variety of wound dressings.

RESULTS
A total of 13 different commercially available dressings were tested in triplicate for changes in pressure redistribution as compared with the control. One dressing demonstrated the greatest reduction of pressure forces (OxyBand PR; 50.33 ± 1.45 mm Hg) compared with the control (302.7 ± 0.33 mm Hg) and the greatest surface area of all the study dressings tested. There was a negative correlation (R
2 = 0.73) between the average pressure distribution of a wound dressing and its contact area. Further, the peak pressure for OxyBand PR (P ≤ .05) was significantly different from all other tested dressings.

CONCLUSIONS
One dressing (OxyBand PR) provided superior pressure redistribution and significantly reduced peak pressure in this study when compared with currently available standard foam and silicone dressings that are marketed for the purpose of PI prevention.
Joint Initiative Between Infectious Diseases and Podiatry in Outpatient Settings Improves Outcomes and Adherence to Treatment
Authors: Fukuta Yuriko , Fijalkowski Danny R. , Fujii Tomoko 
Published: November 2020

ABSTRACT

BACKGROUND
A joint infectious disease-podiatry clinic (JIDPC) in which an infectious diseases physician and a podiatrist see patients with diabetic foot infections together once a week was initiated in January 2017. This study was designed to investigate if the JIDPC can improve patient adherence and reduce recurrent infections.

METHODS
A retrospective analysis of patients with diabetic foot infection admitted to Wheeling Hospital from March 2013 to December 2018 was performed. Initially, the patients were followed by infectious diseases and podiatry in their clinics separately (preintervention group). Beginning January 2017, they were followed together at the JIDPC (postintervention group). Recurrent infection, mortality, and loss to follow-up were compared using logistic regression models.

RESULTS
Surgeries were performed in 52.5% of preintervention group participants (n = 99) and 81.9% of postintervention group participants (n = 55; P < .001). The preintervention group was more likely to be lost to follow-up (30.3% vs 9.1%; odds ratio [OR], 4.35 [confidence interval (CI), 1.58–11.99]), but the association was attenuated with further adjustment for surgery (OR 3.35 [CI, 1.17–9.62]). The risk of infection recurrence in 6 months was significantly higher in the preintervention group (36.1% vs 20.8%; OR, 2.16 [CI, 0.99–4.71]), but with further adjustment for surgery, this was not significant (P = .067; OR, 2.17 [CI, 0.95–4.94]). Mortality and 90-day readmission were not significantly different.

CONCLUSIONS
Implementation of JIDPCs may decrease the incidence of recurrent infections among patients with diabetic foot infections.
Does Faculty Experience Count? A Quantitative Analysis of Evidence-Based Testing Practices in Baccalaureate Nursing Education
Authors: Moore Wendy L. 
Published: November 2020

Abstract

AIM
This study explored evidence-based testing practices of nurse faculty teaching in baccalaureate programs.

BACKGROUND
Faculty-developed examinations are important for determining progression in nursing programs. Little is known about faculty who implement such practices most often.

METHOD
A causal comparative study with a convenience sample of 177 was used to answer the research question. Participants were grouped according to level of teaching experience based on Benner’s novice to expert theory. Individual/group means were calculated for the best practices in test development survey; one-way analysis of variance was used to identify significant differences between groups.

RESULTS
Expert faculty had higher overall mean scores than the other four groups, with significantly higher scores than both the advanced beginner (p = .007) and proficient (p = .020) groups.

CONCLUSION
Faculty with more experience seem to implement evidence-based testing practices most often. This information can be used to guide faculty development and peer-mentoring initiatives within nursing programs.
Emerging Characteristics of Isotonitazene-Involved Overdose Deaths: A Case-Control Study
Authors: Shover Chelsea L. , Falasinnu Titilola O. , Freedman Rohan B. , Humphreys Keith 
Published: November 2020

Objectives:
Case reports of fatal overdoses involving the novel synthetic opioid isotonitazene have prompted the U.S. Drug Enforcement Administration to consider an emergency scheduling of the drug in June 2020. We aimed to epidemiologically characterize deaths involving isotonitazene.

Methods:
We conducted a case control study using publicly available mortality records from January 1, 2020 to July 31, 2020 in Cook County, IL and Milwaukee County, WI. Cases (all deaths involving isotonitazene) and controls (all deaths involving other synthetic opioids) were compared on demographic characteristics, number of substances involved in fatal overdose, and co-involvement of other substances.

Results:
We identified 40 fatal overdoses involving isotonitazene and 981 fatal overdoses involving other synthetic opioids. Isotonitazene deaths involved a significantly greater number of substances, and were significantly more likely to involve the designer benzodiazepine flualprazolam.

Discussion:
Isotonitazene was involved in a substantial minority of synthetic opioid overdose deaths in the first 7 months of 2020. Future studies characterizing its prevalence in other markets are warranted. Emergence of highly potent novel synthetic opioids underscore the need for comprehensive health services for people with opioid use disorder.
The Effect of Perioperative Lidocaine Infusion on Postoperative Pain and Postsurgical Recovery Parameters in Gynecologic Cancer Surgery
Authors: Kutay Yazici Kübra , Kaya Menşure , Aksu Büşra , Ünver Süheyla 
Published: November 2020

Objectives:
The primary objective of this prospective nonblinded randomized study was to investigate the effect of perioperative systemic lidocaine infusion on pain control after major gynecologic oncology surgery. Patient-reported outcomes, postoperative recovery parameters, and complications were secondary endpoints of the study.

Materials and Methods:
Seventy-five patients with American Society of Anesthesiologists I-III were divided into 3 groups based on perioperative analgesia methods—(1) opioid group: patient-controlled analgesia (PCA) with morphine; (2) lidocaine group: perioperative intravenous lidocaine infusion, plus PCA with morphine; and (3) the epidural group: PCA with bupivacaine. The Visual Analog Scale (VAS) was recorded postoperatively. In addition, nausea-vomiting, time to first oral intake, time to first ambulation, time to first flatus, and length of hospital stay were recorded.

Results:
VAS scores (rest) at 24 hours and VAS scores (cough) at 12 and 24 hours were significantly lower in the epidural group than in the opioid group (P<0.05). VAS scores were found to be similar between the lidocaine and epidural group. The nausea-vomiting incidence was lower in the lidocaine group than in the opioid group (P˂0.05). Compared with the other 2 groups, the first flatus time was shorter in the lidocaine group (P<0.05).

Discussion:
Perioperative lidocaine infusion is effective as epidural analgesia, which is often advocated as the gold-standard analgesic technique for abdominal surgery and is superior to the others in terms of time to first flatus and the incidence of nausea-vomiting.