bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparative analysis of developmental profile between normal and severe acute malnourished under-five children in Pakistan: a multicentre cross-sectional study
Authors: Saleem Javeria , Zakar Rubeena , Mushtaq Faisal , Bukhari Gul Mehar Javaid , Fischer Florian 
Published: August 2021

ObjectivesThis study aims to compare the developmental profile of severe acute malnourished (SAM) and normal under-five children and to find sociodemographic determinants accountable for their developmental disabilities.SettingWe conducted a multi-centre cross-sectional study in three basic health units and one rural health centre in Pakistan.Participants200 children (SAM and healthy) aged 6–59 months.Primary and secondary measuresWe screened for nutritional status and clinical complications. Children underwent for developmental assessment by Denver Development Screening Tool II. A pretested structured questionnaire on sociodemographic characteristics and nutrition was used for collecting data about determinants of developmental delay.ResultsWe observed statistically significant differences in anthropometric measurements among SAM compared with normal nourished in weight, height, mid-upper arm circumference and weight-for-height z-scores. SAM serves as a significant risk factors (p<0.001) for delayed personal or social development (69% vs 11%; OR (95% CI)=18.01 (8.45 to 38.37)), delayed fine motor development (39% vs 8%; OR (95% CI)=7.35 (3.22 to 16.81)), delayed language development (32% vs 8%; OR (95% CI)=5.41 (2.35 to 12.48)), delayed gross motor development (34% vs 10%; OR (95% CI)=4.64 (2.14 to 10.05)) and delayed global development (66% vs 20%; OR (95% CI)=7.77 (4.09 to 14.74)). Applying logistic regression, personal or social development (p<0.001) and language development (p<0.05), under-five siblings was a risk factor, while among gross motor development, mother’s educational status (p<0.05) was a significant risk factor for developmental delay.ConclusionsOur analysis indicates that children with malnutrition have a high frequency of developmental delays. Missing maternal education and a higher number of under-five siblings are also potential risk factors for developmental delay.
Protocol for a mixed-method cohort study investigating the prevalence and impact of obsessive–compulsive disorder (OCD) in chronic pain rehabilitation
Authors: Sloley Chad , Shipton Edward A , Bell Caroline , Williman Jonathan 
Published: August 2021

IntroductionWhile there is considerable and growing research in the individual fields of obsessive–compulsive disorder (OCD) and chronic pain, focused research into their potential association remains limited. By exploring this potential association, better theoretical understanding of and better therapeutic approaches to chronic pain management could be developed. The study’s aim is to explore the prevalence and impact of obsessions–compulsions on the experience and rehabilitation of chronic pain among individuals attending different branches of a New Zealand pain service.Methods and analysisThis is a cohort study using well-validated questionnaires and semistructured interviews. Participants will be recruited through community pain services from a private rehabilitation-focused company with branches across New Zealand. Participants will complete an OCD screening measure (Obsessive–Compulsive Inventory-Revised (OCI-R)). These results will be used to compare results from the specialist pain services benchmarking electronic Persistent Pain Outcomes Collaboration measure sets, at both participant intake and completion of each Pain Service Programme. Prevalence rates of OCD caseness from the OCI-R will be estimated with 95% CI. Generalised linear regression models will be used to explore differences in pain baseline and outcome factors between those with high and low obsessive–compulsive symptoms. Semistructured interviews, assessed through interpretative phenomenological analysis (IPA), will be used to provide information on lived experiences of individuals with comorbid chronic pain and OCD. This will be supported through the administration of an Obsessive Beliefs Questionnaire 44.Ethics and disseminationEthical approval has been obtained from the Health and Disability Ethics Committee (HDEC20/CEN/82). Study results will be disseminated at professional conferences and in peer-reviewed journals. A lay summary of findings will be provided to requesting participants or through attendance at a local hui (gathering).Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12621000758808).
Hide and seek: molecular barcoding clarifies the distribution of two cryptic duckweed species across Alberta
Authors: Senevirathna Kanishka M. , Crisfield Varina E. , Burg Theresa M. , Laird Robert A. 
Published: August 2021

Regional and global biodiversity may be underestimated due to the presence of cryptic species: species that are morphologically similar, but genetically distinct. Here, we focus on two cryptic duckweed species, Lemna minor L. and Lemna turionifera Landolt, which have overlapping geographic ranges and are easily mistaken for one another. We developed species-specific primers based on DNA barcoding sequences to facilitate the rapid identification of these two monomorphic duckweeds, allowing us to investigate their presence and distribution in Alberta, Canada. While current reports indicate the presence of L. turionifera (and the morphologically distinct Lemna trisulca L.) in Alberta, our data indicate that L. minor is also present, predominantly in the southern part of the province. Thus, this paper (i) contributes to the accuracy and completeness of a regional flora, and (ii) provides useful and flexible tools for the rapid molecular identification of cryptic Lemna species, which are of wide interest in diverse fields such as biotechnology, toxicology, bioremediation, and ecology.
Putting human behavior predictability in context
Authors: Zhang Wanyi , Shen Qiang , Teso Stefano , Lepri Bruno , Passerini Andrea , Bison Ivano , Giunchiglia Fausto 
Published: August 2021

AbstractVarious studies have investigated the predictability of different aspects of human behavior such as mobility patterns, social interactions, and shopping and online behaviors. However, the existing researches have been often limited to a single or to the combination of few behavioral dimensions, and they have adopted the perspective of an outside observer who is unaware of the motivations behind the specific behaviors or activities of a given individual. The key assumption of this work is that human behavior is deliberated based on an individual’s own perception of the situation that s/he is in, and that therefore it should also be studied under the same perspective. Taking inspiration from works in ubiquitous and context-aware computing, we investigate the role played by four contextual dimensions (or modalities), namely time, location, activity being carried out, and social ties, on the predictability of individuals’ behaviors, using a month of collected mobile phone sensor readings and self-reported annotations about these contextual modalities from more than two hundred study participants. Our analysis shows that any target modality (e.g. location) becomes substantially more predictable when information about the other modalities (time, activity, social ties) is made available. Multi-modality turns out to be in some sense fundamental, as some values (e.g. specific activities like “shopping”) are nearly impossible to guess correctly unless the other modalities are known. Subjectivity also has a substantial impact on predictability. A location recognition experiment suggests that subjective location annotations convey more information about activity and social ties than objective information derived from GPS measurements. We conclude the paper by analyzing how the identified contextual modalities allow to compute the diversity of personal behavior, where we show that individuals are more easily identified by rarer, rather than frequent, context annotations. These results offer support in favor of developing innovative computational models of human behaviors enriched by a characterization of the context of a given behavior.
Highly magmatic break-up LIP centres: revisiting the East Greenland volcanic rifted margin
Authors: Klausen Martin B. 
Published: August 2021

Abstract
The decompressional release of magma at continental triple-rift break-up, large igneous province (LIP) centres, above mantle plume stems, results in highly magmatic settings. As a particularly well-exposed example, it is proposed that the East Greenland coastal dyke swarm preserves a structural record of how dyke dilations v. tectonic extension increased upon approaching its Kangerlussuaq triple rift centre. Such more magmatic break-up is reflected by how abruptly its volcanic rifted margin transitions into 100% dykes, and, in this case, up to 100 km further inland than its geophysically determined continent–ocean boundary. Correspondingly high magma flux through an igneous Kap Edward Holm centre sustained the lateral injection of up to 150 km-long dykes, evidenced by increased cut-off dyke thicknesses, below which there is an anomalously low abundance of thinner dykes, that conform to the cube root of their thermal arrest distance. Only the thickest and, thereby, longest dyke injections linked up with a more southerly located igneous Imilik centre of an en echelon offset dyke swarm, the complex transition into which is also addressed. This highly magmatic central plumbing system is further compared to similar volcanic zones across Iceland and other post-Paleozoic break-up LIPs in order to contextualize its importance.
Cell-Intrinsic Mechanisms of Drug Tolerance to Systemic Therapies in Cancer
Authors: Leonce Camille , Saintigny Pierre , Ortiz-Cuaran Sandra 
Published: August 2021

Abstract

In patients with cancer with metastatic disease, the rate of complete tumor response to systemic therapies is low, and residual lesions persist in the majority of patients due to early molecular adaptation in cancer cells. A growing body of evidence suggests that a subpopulation of drug-tolerant persister cells—a reversible phenotype characterized by reduced drug sensitivity and decreased cell proliferation—maintains residual disease and may serve as a reservoir for resistant phenotypes. The survival of these residual tumor cells can be caused by reactivation of specific signaling pathways, phenotypic plasticity (i.e., transdifferentiation), epigenetic or metabolic reprogramming, downregulation of apoptosis as well as transcriptional remodeling. In this review, we discuss the molecular mechanisms that enable adaptive survival in drug-tolerant cells. We describe the main characteristics and dynamic nature of this persistent state, and highlight the current therapeutic strategies that may be used to interfere with the establishment of drug-tolerant cells, as an alternative to improve objective response to systemic therapies and delay the emergence of resistance to improve long-term survival.
SHP2 Potentiates the Oncogenic Activity of β-Catenin to Promote Triple-Negative Breast Cancer
Authors: Martin Elisha , Agazie Yehenew M. 
Published: August 2021

Abstract

Previous studies have reported dysregulated cytoplasmic and nuclear expression of the β-catenin protein in triple-negative breast cancer (TNBC) in the absence of Wnt signaling pathway dysregulation. However, the mechanism that sustains β-catenin protein dysregulation independent of Wnt signaling is not understood. In this study, we show that Src homology phosphotyrosyl phosphatase 2 (SHP2) is essential for β-catenin protein stability and for sustaining the cytoplasmic and nuclear pools in TNBC cells. The first evidence for this possibility came from immunofluorescence (IF) and immunoblotting (IB) studies that showed that inhibition of SHP2 induces E-cadherin expression and depletion of cytoplasmic and nuclear β-catenin, which in turn confers adherence junction mediated cell–cell adhesion. We further show that SHP2 promotes β-catenin protein stability by mediating the inactivation of GSK3β through its positive effect on Akt and ERK1/2 activation, which was confirmed by direct pharmacologic inhibition of the PI3K-Akt and the MEK-ERK signaling pathway. Finally, we show that SHP2-stabilized β-catenin contributes to TNBC cell growth, transformation, cancer stem cell (CSC) properties, and tumorigenesis and metastasis. Overall, the findings in this report show that SHP2 mediates β-catenin protein stability to promote TNBC.

Implications:
Data presented in this article demonstrates that SHP2 positively regulates β-catenin protein stability, which in turn promotes triple-negative breast cancer (TNBC) cell transformation, tumorigenesis, and metastasis.
Impact of Flow on Prosthesis-Patient Mismatch Following Transcatheter and Surgical Aortic Valve Replacement
Authors: Abbas Amr E. , Ternacle Julien , Pibarot Philippe , Xu Ke , Alu Maria , Rogers Erin , Hahn Rebecca T. , Leon Martin , Thourani Vinod H. 
Published: August 2021

Background:

Severe prosthesis-patient mismatch (PPM) is diagnosed by an indexed effective orifice area <0.65 cm
2
/m
2
, which is derived from stroke volume index. We examined the impact of flow, determined by stroke volume index, on severe PPM following transcatheter aortic valve replacement (TAVR) and surgical aortic valve replacement (SAVR).

Methods:
We included SAVR patients from the PARTNER 2A trial (Placement of Aortic Transcatheter Valve 2A) and TAVR patients from the PARTNER 2 S3i (Placement of Aortic Transcatheter Valve 2 S3i) registry. The primary end point was the separate analysis of all-cause death, cardiac death, and rehospitalization at 5 years. Following TAVR and SAVR, we compared the primary end points between severe versus no-severe PPM in all patients, in low flow (LF), and in normal flow. Multivariable analysis was performed to determine variables associated with the end points.

Results:

Nine hundred fifty-four TAVR and 726 SAVR patients with PPM and flow data were included. Severe PPM following TAVR was significantly lower compared with SAVR in all patients (9% versus 28%,
P
<0.0001), in normal flow (5% versus 8%,
P
=0.04), and in LF (20% versus 42%,
P
<0.0001). Severe PPM was associated with rehospitalization following TAVR (odds ratio, 1.52 [95% CI, 1.01–2.29],
P
=0.0456) and SAVR (odds ratio, 1.51 [95% CI, 1.06–2.16],
P
=0.0237). Severe PPM in LF was independently associated with cardiac death following TAVR (odds ratio, 1.85 [95% CI, 1.06–3.23],
P
=0.0308). Following SAVR, severe PPM in LF and low ejection fraction was associated with increased cardiac death (35.26% versus 12.51%,
P
=0.01) and rehospitalization (37.59% versus 15.46%,
P
=0.006) compared with severe PPM in LF and preserved ejection fraction, respectively. Severe PPM in normal flow was not associated with clinical outcomes despite higher gradients and smaller valves compared with severe PPM in LF.

Conclusions:
Severe PPM is more common following SAVR compared with TAVR. Regardless of the implanted valve size or gradient, severe PPM impacts mortality only in patients with LF following TAVR and LF and low ejection fraction following SAVR. Severe PPM in normal flow is not associated with poor outcomes.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifiers: NCT01314313 and NCT02687035.
Scope and Social Determinants of Food Insecurity Among Adults With Atherosclerotic Cardiovascular Disease in the United States
Authors: Mahajan Shiwani , Grandhi Gowtham R. , Valero‐Elizondo Javier , Mszar Reed , Khera Rohan , Acquah Isaac , Yahya Tamer , Virani Salim S. , Blankstein Ron , Blaha Michael J. , Cainzos‐Achirica Miguel , Nasir Khurram 
Published: August 2021

Background
Atherosclerotic cardiovascular disease (ASCVD) results in high out‐of‐pocket healthcare expenditures predisposing to food insecurity. However, the burden and determinants of food insecurity in this population are unknown.

Methods and Results

Using 2013 to 2018 National Health Interview Survey data, we evaluated the prevalence and sociodemographic determinants of food insecurity among adults with ASCVD in the United States. ASCVD was defined as self‐reported diagnosis of coronary heart disease or stroke. Food security was measured using the 10‐item US Adult Food Security Survey Module. Of the 190 113 study participants aged 18 years or older, 18 442 (adjusted prevalence 8.2%) had ASCVD, representing ≈20 million US adults annually. Among adults with ASCVD, 2968 or 14.6% (weighted ≈2.9 million US adults annually) reported food insecurity compared with 9.1% among those without ASCVD (
P
<0.001). Individuals with ASCVD who were younger (odds ratio [OR], 4.0 [95% CI, 2.8–5.8]), women (OR, 1.2 [1.0–1.3]), non‐Hispanic Black (OR, 2.3 [1.9–2.8]), or Hispanic (OR, 1.6 [1.2–2.0]), had private (OR, 1.8 [1.4–2.3]) or no insurance (OR, 2.3 [1.7–3.1]), were divorced/widowed/separated (OR, 1.2 [1.0–1.4]), and had low family income (OR, 4.7 [4.0–5.6]) were more likely to be food insecure. Among those with ASCVD and 6 of these high‐risk characteristics, 53.7% reported food insecurity and they had 36‐times (OR, 36.2 [22.6–57.9]) higher odds of being food insecure compared with those with ≤1 high‐risk characteristic.

Conclusion
About 1 in 7 US adults with ASCVD experience food insecurity, with more than 1 in 2 adults reporting food insecurity among the most vulnerable sociodemographic subgroups. There is an urgent need to address the barriers related to food security in this population.
Fibroblast Growth Factor 23 and Incident Cardiovascular Disease and Mortality in Middle‐Aged Adults
Authors: Paul Shejuti , Wong Mandy , Akhabue Ehimare , Mehta Rupal C. , Kramer Holly , Isakova Tamara , Carnethon Mercedes R. , Wolf Myles , Gutiérrez Orlando M. 
Published: August 2021

Background
Higher circulating fibroblast growth factor 23 (FGF23) associates with greater risk of cardiovascular disease (CVD) and mortality in older adults. The association of FGF23 with cardiovascular outcomes in younger populations has been incompletely explored.

Methods and Results
We measured C‐terminal FGF23 (cFGF23) and intact FGF23 (iFGF23) in 3151 middle‐aged adults (mean age, 45±4) who participated in the year 20 examination of the CARDIA (Coronary Artery Risk Development in Young Adults) study. We used separate Cox proportional hazards models to examine the associations of cFGF23 and iFGF23 with incident CVD and mortality, adjusting models sequentially for sociodemographic, clinical, and laboratory factors. A total of 157 incident CVD events and 135 deaths occurred over a median 7.6 years of follow‐up (interquartile range, 4.1–9.9). In fully adjusted models, there were no statistically significant associations of FGF23 with incident CVD events (hazard ratio per doubling of cFGF23: 1.14, 95%CI 0.97,1.34; iFGF23: 0.76, 95%CI 0.57,1.02) or all‐cause mortality (hazard ratio per doubling of cFGF23, 1.17; 95% CI, 1.00–1.38; iFGF23, 0.86; 95% CI, 0.64–1.17). In analyses stratified by CVD subtypes, higher cFGF23 was associated with greater risk of heart failure hospitalization (hazard ratio per doubling of cFGF23, 1.52; 95% CI, 1.18–1.96) but not coronary heart disease or stroke, whereas iFGF23 was not associated with CVD subtypes in any model.

Conclusions
In middle‐aged adults with few comorbidities, higher cFGF23 and iFGF23 were not independently associated with greater risk of CVD events or death. Higher cFGF23 was independently associated with greater risk of heart failure hospitalization.
Association Between 2010 Medicare Reform and Inpatient Rehabilitation Access in People With Intracerebral Hemorrhage
Authors: Ifejika Nneka L. , Vahidy Farhaan S. , Reeves Mathew , Xian Ying , Liang Li , Matsouaka Roland , Fonarow Gregg C. , Grotta James C. 
Published: August 2021

Background
Evidence suggests intracerebral hemorrhage survivors have earlier recovery compared with ischemic stroke survivors. The Centers for Medicare and Medicaid Services prospective payment system instituted documentation rules for inpatient rehabilitation facilities (IRFs) in 2010, with the goal of optimizing patient selection. We investigated whether these requirements limited IRF and increased skilled nursing facility (SNF) use compared with home discharge.

Methods and Results
Intracerebral hemorrhage discharges to IRF, SNF, or home were estimated using GWTG (Get With The Guidelines) Stroke registry data between January 1, 2008, and December 31, 2015 (n=265 444). Binary hierarchical models determined associations between the 2010 Rule and discharge setting; subgroup analyses evaluated age, geographic region, and hospital type. From January 1, 2008, to December 31, 2009, 45.5% of patients with intracerebral hemorrhage had home discharge, 22.2% went to SNF, and 32.3% went to IRF. After January 1, 2010, there was a 1.06% absolute increase in home discharge, a 0.46% increase in SNF, and a 1.52% decline in IRF. The adjusted odds of IRF versus home discharge decreased 3% after 2010 (adjusted odds ratio [aOR], 0.97; 95% CI, 0.95–1.00). Lower odds of IRF versus home discharge were observed in people aged <65 years (aOR, 0.92; 95% CI, 0.89–0.96), Western states (aOR, 0.89; 95% CI, 0.84–0.95), and nonteaching hospitals (aOR, 0.90; 95% CI, 0.86–0.95). Adjusted odds of SNF versus home discharge increased 14% after 2010 (aOR, 1.14; 95% CI, 1.11–1.18); there were significant associations in all age groups, the Northeast, the South, the Midwest, and teaching hospitals.

Conclusions
The Centers for Medicare and Medicaid Services 2010 IRF prospective payment system Rule resulted in fewer discharges to IRF and more discharges to SNF in patients with intracerebral hemorrhage. Health policy changes potentially affect access to intensive postacute rehabilitation.
Association Between Diagnosis Code Expansion and Changes in 30‐Day Risk‐Adjusted Outcomes for Cardiovascular Diseases
Authors: Gilstrap Lauren , Wadhera Rishi K. , Austin Andrea M. , Kearing Stephen , Joynt Maddox Karen E. , Yeh Robert W. 
Published: August 2021

BACKGROUND
In January 2011, Centers for Medicare and Medicaid Services expanded the number of inpatient diagnosis codes from 9 to 25, which may influence comorbidity counts and risk‐adjusted outcome rates for studies spanning January 2011. This study examines the association between (1) limiting versus not limiting diagnosis codes after 2011, (2) using inpatient‐only versus inpatient and outpatient data, and (3) using logistic regression versus the Centers for Medicare and Medicaid Services risk‐standardized methodology and changes in risk‐adjusted outcomes.

METHODS AND RESULTS

Using 100% Medicare inpatient and outpatient files between January 2009 and December 2013, we created 2 cohorts of fee‐for‐service beneficiaries aged ≥65 years. The acute myocardial infarction cohort and the heart failure cohort had 578 728 and 1 595 069 hospitalizations, respectively. We calculate comorbidities using (1) inpatient‐only limited diagnoses, (2) inpatient‐only unlimited diagnoses, (3) inpatient and outpatient limited diagnoses, and (4) inpatient and outpatient unlimited diagnoses. Across both cohorts,
International Classification of Diseases, Ninth Revision
(
ICD‐9
) diagnoses and hierarchical condition categories increased after 2011. When outpatient data were included, there were no significant differences in risk‐adjusted readmission rates using logistic regression or the Centers for Medicare and Medicaid Services risk standardization. A difference‐in‐differences analysis of risk‐adjusted readmission trends before versus after 2011 found that no significant differences between limited and unlimited models for either cohort.

CONCLUSIONS
For studies that span 2011, researchers should consider limiting the number of inpatient diagnosis codes to 9 and/or including outpatient data to minimize the impact of the code expansion on comorbidity counts. However, the 2011 code expansion does not appear to significantly affect risk‐adjusted readmission rate estimates using either logistic or risk‐standardization models or when using or excluding outpatient data.