bluuebunny/crossref_metadata_2025_split huggingface dataset:
Racial/Ethnic Disparities in Health Care Setting Choice for Adults Seeking Severe Acute Respiratory Syndrome Coronavirus 2 Testing
Authors: Sparling Alica , Walls Morgan , Mayfield Carlene A. , Priem Jennifer S. , Durham Jason , Hetherington Timothy , Taylor Yhenneko J. 
Published: November 2021

Objectives:
Equitable access to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) testing is important for reducing disparities. We sought to examine differences in the health care setting choice for SARS-CoV-2 testing by race/ethnicity and insurance. Options included traditional health care settings and mobile testing units (MTUs) targeting communities experiencing disproportionately high coronavirus disease 2019 (COVID-19) rates.

Methods:
We conducted a retrospective, observational study among patients in a large health system in the Southeastern US. Descriptive statistics and multinomial logistic regression analyses were employed to evaluate associations between patient characteristics and health care setting choice for SARS-CoV-2 testing, defined as: (1) outpatient (OP) care; (2) emergency department (ED); (3) urgent care (UC); and (4) MTUs. Patient characteristics included race/ethnicity, insurance, and the existence of an established relationship with the health care system.

Results:
Our analytic sample included 105,386 adult patients tested for SARS-CoV-2. Overall, 55% of patients sought care at OP, 24% at ED, 12% at UC, and 9% at MTU. The sample was 58% White, 24% Black, 11% Hispanic, and 8% other race/ethnicity. Black patients had a higher likelihood of getting tested through the ED compared with White patients. Hispanic patients had the highest likelihood of testing at MTUs. Patients without a primary care provider had a higher relative risk of being tested through the ED and MTUs versus OP.

Conclusions:
Disparities by race/ethnicity were present in health care setting choice for SARS-CoV-2 testing. Health care systems may consider implementing mobile care delivery models to reach vulnerable populations. Our findings support the need for systemic change to increase primary care and health care access beyond short-term pandemic solutions.
Decreased Racial and Ethnic Disparities in Emergency Department Wait Time in the United States
Authors: Abdulai Abubakar-Sadiq B. , Mukhtar Fahad , Ehrlich Michael 
Published: November 2021

Background:
Previous data over an extended period indicated that Black and Hispanic patients waited significantly longer than their White counterparts to see a qualified practitioner in US emergency departments (EDs).

Objective:
The objective of this study was to assess recent trends and sources of racial and ethnic disparities in patient wait time to see a qualified practitioner in US EDs.

Data Sources:
Publicly available ED subsample of the National Hospital Ambulatory Medical Care Survey (NHAMCS), 2003–2017.

Research Design:
A retrospective cross-sectional analysis of a nationally representative sample of visits to US EDs from 2003 to 2017. Joinpoint statistical analysis and survey-weighted regression were used to assess changes in ED wait time by race/ethnic group over time.

Principal Findings:
For non-Hispanic White patients, median ED wait time increased annually by 1.3 minutes from 2003 through 2008, decreased by 3.0 minutes from 2008 through 2012, and decreased by 1.7 minutes from 2012 to 2017. For non-Hispanic Black patients, median wait time increased annually by 2.0 minutes from 2003 through 2008, decreased by 3.8 minutes from 2008 through 2015, and remained fairly unchanged from 2015 through 2017. For Hispanic patients, the trend in median wait time remained statistically unchanged from 2003 through 2009. It decreased by annually by 4.7 minutes from 2009 to 2012 and by 1.5 minutes from 2012 through 2017. By the end of 2017, median ED wait time decreased to under 20 minutes across all 3 groups.

Conclusions:
Over time, ED wait times decreased to under 20 minutes across all racial and ethnic groups between 2003 and 2017. Observed disparities were largely the result of where minority populations accessed care and disappeared over time.
Family Practices in Transforming Clinical Practice Initiative Showed No Changes in Medicare Costs or Utilization
Authors: Dai Mingliang , Chung Yoonkyung , Peterson Lars E. , Petterson Stephen , Phillips Robert L. 
Published: November 2021

Background:
The Centers for Medicare and Medicaid Services proposed that the Transforming Clinical Practice Initiative (TCPI) would improve health outcomes for patients, reduce utilization of institutional services, and generate significant savings for payers by the end of September 2019.

Objective:
The objective of this study was to investigate whether participation in TCPI’s Practice Transformation Networks (PTNs) was associated with improved cost and utilization outcomes for Medicare patients of family medicine–based practices in the first 2 years, that is, 2016–2017, of the Initiative.

Study Design:
A quasi-experimental design with a longitudinal cohort of family medicine–based practices and a propensity-matched comparison sample.

Subjects:
A total of 761 PTN practices and 3451 non-PTN practices.

Measures:
To measure practice-level patient outcomes, we attributed patients to practice based on the plurality of office visits. We obtained Medicare claims from 2011 to 2017 to assess PTN participation effects for Medicare Part A and B costs, hospital admission, and emergency department visit rates using a Difference-in-Differences design, adjusting for baseline characteristics.

Results:
The differences in Medicare Part A and B costs (−1.71%, P=0.25), annual rates of hospitalization (−0.59%, P=0.12) and emergency department visit (−0.29%, P=0.46) were not significantly lower among PTN practices (N=761) than among propensity score–matched non-PTN practices (N=3541).

Conclusions:
TCPI’s transforming efforts, such as the outcomes examined in the study, might need a longer time frame to manifest and require evaluation after the full 4-year participation period. The indistinguishable effect of PTN participation may also be attributed to the fact that non-PTN practices might have participated in other initiatives that changed their care and curbed health care utilization and costs consequently.
Postmortem Interval Estimation With Corneal Endothelial Cell Density
Authors: Özsoy Sait , Kaya Burak , Balandiz Hüseyin , Akyol Mesut , Özge Gökhan , Özmen Mehmet Cüneyt , Uysal Betül Seher 
Published: November 2021

Objectives
In the neonatal period, healthy people have the highest corneal endothelial cell density (CECD) (5000–7000 cells/mm2). Corneal endothelial cell density declines with age in adults (2500–3000 cells/mm2) and continues to decline in the postmortem period. We measured CECD in cases with different postmortem interval (PMI) and investigated its association with PMI.

Methods
A total of 555 corneas harvested from 285 cases with a known time of death were examined using a specular microscope.

Results
Postmortem corneal removal time ranged between 10 and 1395 minutes. The CECD averages were 2653 for right cornea and 2678 cells/mm2 for left cornea. An inverse but nonlinear relationship was found between age and CECD. In both men and women, there was an inverse and weak correlation between age and CECD (ρ = −0.282; P < 0.001; ρ = −0.264; P < 0.001, respectively). There was no significant relationship between postmortem corneal removal time and CECD (ρ = 0.049; P = 0.421; ρ = 0.011; P = 0.855 for right and left corneas, respectively). The highest decline in time dependent CECD was detected between the 480th and 540th minutes at −7.2%.

Conclusions
We found no significant decrease in CECD numbers according to PMI or cause of death. Experimental studies on cases with known and standardized antemortem CECD values will provide essential results in estimating PMI.
Global Positioning System Activity Profile in Male Para Footballers With Cerebral Palsy
Authors: Goh Alvin M. , Ma’ayah Fadi , Harms Craig A. , Newton Robert U. , Drinkwater Eric J. 
Published: November 2021

Objective
The aim of the study was to compare training and match loads for cerebral palsy football athletes in a state-level development program to assess the specificity of training for competition in the para sport.

Design
Time-motion analysis and heart-rate monitoring were applied during 20 training sessions of the Western Australia CP Football 2017 training season and seven competition matches of the 2017 Australian National Championships. The study used an observational study design with between-subjects and within-subjects comparisons of training and match loads.

Results
There were no significant differences between training and match loads in players’ measurements of speed components and heart rates, with two exceptions: higher match distance covered in very high speed (g = 0.33) and time in heart rate zone 1 (<75% heart rate max, g = 0.45) and less time in heart rate zone 2 (g = 0.42).

Conclusions
Our results indicate that the athletes were conditioned to perform at similar intensities implemented during training, as demonstrated by the consistency between competition and training data in total distance, relative speed zones, and relative heart rate zones. Coaches should apply this knowledge in the programming of training volume and intensities to obtain peak match fitness and specifically prepare athletes for competition in cerebral palsy football.
Anxiety enhances pain in a model of osteoarthritis and is associated with altered endogenous opioid function and reduced opioid analgesia
Authors: Lillywhite Amanda , Woodhams Stephen G. , Gonçalves Sara V. , Watson David J.G. , Li Li , Burston James J. , Gowler Peter R.W. , Canals Meritxell , Walsh David A. , Hathway Gareth J. , Chapman Victoria 
Published: November 2021

Abstract

Introduction:
Negative affect, including anxiety and depression, is prevalent in chronic pain states such as osteoarthritis (OA) and associated with greater use of opioid analgesics, potentially contributing to present and future opioid crises.

Objectives:
We tested the hypothesis that the interaction between anxiety, chronic pain, and opioid use results from altered endogenous opioid function.

Methods:
A genetic model of negative affect, the Wistar–Kyoto (WKY) rat, was combined with intra-articular injection of monosodium iodoacetate (MIA; 1 mg) to mimic clinical presentation. Effects of systemic morphine (0.5–3.5 mg·kg−1) on pain behaviour and spinal nociceptive neuronal activity were compared in WKY and normo-anxiety Wistar rats 3 weeks after MIA injection. Endogenous opioid function was probed by the blockade of opioid receptors (0.1–1 mg·kg−1 systemic naloxone), quantification of plasma β-endorphin, and expression and phosphorylation of spinal mu-opioid receptor (MOR).

Results:
Monosodium iodoacetate–treated WKY rats had enhanced OA-like pain, blunted morphine-induced analgesia, and greater mechanical hypersensitivity following systemic naloxone, compared with Wistar rats, and elevated plasma β-endorphin levels compared with saline-treated WKY controls. Increased MOR phosphorylation at the master site (serine residue 375) in the spinal cord dorsal horn of WKY rats with OA-like pain (P = 0.0312) indicated greater MOR desensitization.

Conclusions:
Reduced clinical analgesic efficacy of morphine was recapitulated in a model of high anxiety and OA-like pain, in which endogenous opioid tone was altered, and MOR function attenuated, in the absence of previous exogenous opioid ligand exposure. These findings shed new light on the mechanisms underlying the increased opioid analgesic use in high anxiety patients with chronic pain.
Scarring Caused by the Percutaneous Approach to Fractures of the Orbit and Orbital Rim
Authors: Kashiyama Kazuya , Yano Hiroki , Imamura Yoshinobu , Iwao Atsuhiko , Higashi Akihito , Moriuti Yuki , Ashizuka Shoko , Adachi Yurie , Koga Kazufumi , Hirano Akiyoshi , Tanaka Katsumi 
Published: November 2021

Abstract
Percutaneous and transconjunctival approaches are commonly used for fractures of the orbit and orbital rim. However, it leaves visible scarring on the face. Although previous studies reported scarring from the percutaneous approach, few reported the degree of such scarring. The authors examined the degree of scarring associated with percutaneous approaches to fractures of the orbit and orbital rim in the Japanese population. The authors reviewed photographs of patients who were treated surgically for fractures of the orbital floor, medial orbital wall, or zygomatic bone via percutaneous approaches to examine the presence of scarring and deformation. In 36% of all patients, the observers were unable to determine the side on which the surgery was performed. Furthermore, the site of scarring was identified accurately in only 20.6% of the cases in which observers were able to identify the surgical side. The authors’ study demonstrated that the subciliary approach left minimal scarring under the eyelashes. On the other hand, the medial canthal approach left depressed and wide scarring, whereas pigmentation was apparent in patients who underwent surgery via the lateral eyebrow approach. Similarly, pigmentation under the eyelashes and at the site of secondary incision was common after the subciliary approach.
A Comparison of Dexmedetomidine and Propofol on Emergence Delirium in Children Undergoing Cleft Palate Surgery With Sevoflurane-Based Anesthesia
Authors: Huang Lili , Wang Li , Peng Wei , Qin Chuanqi 
Published: November 2021

Abstract
Emergence delirium is a common complication after sevoflurane-anesthesia and have a serious impact on children undergoing cleft palate surgery. The aim of this study was to compare the effect of propofol and dexmedetomidine on emergence delirium in children. Ninety children aged 8 to 24 months, underwent cleft palate repair, were enrolled in the study. Children were randomly assigned to 3 groups after the induction: Group C (intravenous infusion 0.9% saline), Group P (intravenous infusion 2 mg/kg/hour propofol), and Group D (intravenous infusion 0.5 μg/kg/hour dexmedetomidine). Emergence delirium was diagnosed using the pediatric anesthesia emergence delirium scale and pain using the face, legs, activity, cry, consolability scale. Heart rate, mean arterial pressure, respiratory recovery time, extubation time, post anesthesia care unit observation time, and adverse events were also evaluated. A total of 86 patients were analyzed. The incidence of emergence delirium was 20.1% in group D, 58.6% in group P and 85.7% in group C (P < 0.05). A lower face, legs, activity, cry, consolability score was seen in group D than in group P and group C (3.9 + 1.1 versus 6.1 ± 0.9 and 7.1 ± 1.0, P < 0.05). The value of heart rate and mean arterial pressure during emergence in group P and group C were significantly higher than that in group D (All P < 0.05). These findings suggest that dexmedetomidine as a sedative, analgesic, and sympatholytic agent was superior to propofol in reducing the incidence of emergence delirium in children undergoing cleft palates surgery with sevoflurane-based anesthesia.
Antiepileptics in Electroconvulsive Therapy
Authors: Cinderella Margaret A. , Nichols Nona A. , Munjal Sahil , Yan Jason , Kimball James N. , Gligorovic Predrag 
Published: November 2021

Abstract
Although prior conventional wisdom strongly recommended complete discontinuation of medications increasing the seizure threshold before electroconvulsive therapy (ECT), more recent literature suggests that anticonvulsants should be considered a relative rather than an absolute contraindication to proceeding with therapy. Most literature regarding the use of use antiepileptic drugs in ECT focuses on antiepileptic mood stabilizers with which most psychiatrists are familiar. However, there is considerably less information available about the use of newer antiepileptics in conjunction with ECT, which may be prescribed to a patient with epilepsy or off-label for psychiatric reasons.
In this article, we provide a mechanism-based review of recent available literature concerning the use of antiepileptics during ECT and discuss which medications have the most robust evidence supporting their continued use in select patients. Finally, we highlight important considerations for psychiatrists when deciding how to proceed with patients on antiepileptics who require ECT.
Neural reinstatement tracks attentional selection of object features in working memory
Authors: Printzlau Frida A. B. , Myers Nicholas E. , Manohar Sanjay G. , Stokes Mark G. 
Published: November 2021

ABSTRACTAttention can be allocated in working memory (WM) to select and privilege relevant content. It is unclear whether attention selects individual features or whole objects in WM. Here, we used behavioural measures, eye-tracking and electroencephalography (EEG) to test the hypothesis that attention spreads between an object’s features in WM. Twenty-six participants completed a WM task that asked them to recall the angle of one of two oriented, coloured bars after a delay while EEG and eye-tracking data was collected. During the delay, an orthogonal ‘incidental task’ cued the colour of one item for a match/mismatch judgement. On congruent trials (50%), the cued item was probed for subsequent orientation recall; on incongruent trials (50%), the other memory item was probed. As predicted, selecting the colour of an object in WM brought other features of the cued object into an attended state as revealed by EEG decoding, oscillatory α-power, gaze bias and improved orientation recall performance. Together, the results show that attentional selection spreads between an object’s features in WM, consistent with object-based attentional selection. Analyses of neural processing at recall revealed that the selected object was automatically compared with the probe, whether it was the target for recall or not. This provides a potential mechanism for the observed benefits of non-predictive cueing in WM, where a selected item is prioritised for subsequent decision-making.
Autoantibodies Detected in MIS-C Patients due to Administration of Intravenous Immunoglobulin
Authors: Burbelo Peter D. , Castagnoli Riccardo , Shimizu Chisato , Delmonte Ottavia M. , Dobbs Kerry , Discepolo Valentina , Vecchio Andrea Lo , Guarino Alfredo , Licciardi Francesco , Ramenghi Ugo , Rey Emma , Vial Maria Cecilia , Marseglia Gian Luigi , Licari Amelia , Montagna Daniela , Rossi Camillo , Montealegre Sanchez Gina A. , Barron Karyl , Warner Blake M. , Chiorini John A. , Espinosa Yazmin , Noguera Loreani , Dropulic Lesia , Truong Meng , Gerstbacher Dana , Mató Sayonara , Kanegaye John , Tremoulet Adriana H. ,   Pediatric Emergency Medicine Kawasaki Group, Eisenstein Eli M. , Su Helen C. , Imberti Luisa , Poli Maria Cecilia , Burns Jane C. , Notarangelo Luigi D. , Cohen Jeffrey I. 
Published: November 2021

AbstractThe autoantibody profile associated with known autoimmune diseases in patients with COVID-19 or multisystem inflammatory syndrome in children (MIS-C) remains poorly defined. Here we show that adults with COVID-19 had a moderate prevalence of autoantibodies against the lung antigen KCNRG, and SLE-associated Smith autoantigen. Children with COVID-19 rarely had autoantibodies; one of 59 children had GAD65 autoantibodies associated with acute insulin-dependent diabetes. While autoantibodies associated with SLE/Sjögren’s syndrome (Ro52, Ro60, and La) and/or autoimmune gastritis (gastric ATPase) were detected in 74% (40/54) of MIS-C patients, further analysis of these patients and of children with Kawasaki disease (KD), showed that the administration of intravenous immunoglobulin(IVIG) was largely responsible for detection of these autoantibodies in both groups of patients. Monitoringin vivodecay of the autoantibodies in MIS-C children showed that the IVIG-derived Ro52, Ro60, and La autoantibodies declined to undetectable levels by 45-60 days, but gastric ATPase autoantibodies declined more slowly requiring >100 days until undetectable. Together these findings demonstrate that administration of high-dose IVIG is responsible for the detection of several autoantibodies in MIS-C and KD. Further studies are needed to investigate autoantibody production in MIS-C patients, independently from IVIG administration.
Likelihood based Mendelian randomization analysis with automated instrument selection and horizontal pleiotropic modeling
Authors: Yuan Zhongshang , Liu Lu , Guo Ping , Yan Ran , Xue Fuzhong , Zhou Xiang 
Published: November 2021

AbstractMendelian randomization (MR) is a common tool for identifying causal risk factors underlying diseases. Here, we present a method, MRAID, for effective MR analysis. MRAID borrows ideas from fine mapping analysis to model an initial set of candidate SNPs that are in potentially high linkage disequilibrium with each other and automatically selects among them the suitable instruments for causal inference. MRAID also explicitly models both uncorrelated and correlated horizontal pleiotropic effects that are widespread for complex trait analysis. MRAID achieves both tasks through a joint likelihood framework and relies on a scalable sampling-based algorithm to compute calibratedp-values. Comprehensive and realistic simulations show MRAID can provide calibrated type I error control, reduce false positives, while being more powerful than existing approaches. We illustrate the benefits of MRAID for an MR screening analysis across 645 trait pairs in UK Biobank, identifying multiple lifestyle causal risk factors of cardiovascular disease-related traits.
Human studies of mitochondrial biology demonstrate an overall lack of binary sex differences: A multivariate meta-analysis
Authors: Junker Alex , Wang Jennifer , Gouspillou Gilles , Ehinger Johannes K. , Elmér Eskil , Sjövall Fredrik , Fisher-Wellman Kelsey , Darrell Neufer P. , Molina Anthony J.A. , Ferrucci Luigi , Picard Martin 
Published: November 2021

AbstractMitochondria are maternally inherited organelles that play critical tissue-specific roles, including hormone synthesis and energy production, that influence development, health, and aging. However, whether mitochondria from women and men exhibit consistent biological differences remains unclear, representing a major gap in biomedical knowledge. This meta-analysis systematically examined 4 domains and 6 subdomains of mitochondrial biology (total 39 measures), including mitochondrial content, respiratory capacity, reactive oxygen species (ROS) production, morphometry, and mitochondrial DNA copy number. Standardized effect sizes (Hedge’s g) of sex differences were computed for each measure using data in 2,258 participants (51.5% women) from 50 studies. Only two measures demonstrated aggregate binary sex differences: higher mitochondrial content in women (g = 0.20, χ2p = 0.01), and higher ROS production in skeletal muscle in men (g = 0.49, χ2p < 0.0001). differences showed weak to Sex no correlation with age or BMI. Studies with small sample sizes tended to overestimate effect sizes (r = -0.17, p < 0.001), and sex differences varied by tissue examined. Our findings point to a wide variability of findings in the literature concerning possible binary sex differences in mitochondrial biology. Studies specifically designed to capture sex- and gender-related differences in mitochondrial biology are needed, including detailed considerations of physical activity and sex hormones.