bluuebunny/crossref_metadata_2025_split huggingface dataset:
Super fragmented: a nationally representative cross-sectional study exploring the fragmentation of inpatient care among super-utilizers
Authors: Kaltenborn Zach , Paul Koushik , Kirsch Jonathan D , Aylward Michael , Rogers Elizabeth A. , Rhodes Michael T. , Usher Michael G. 
Published: April 2021

Abstract
Background
Super-utilizers with 4 or more admissions per year frequently receive low-quality care and disproportionately contribute to healthcare costs. Inpatient care fragmentation (admission to multiple different hospitals) in this population has not been well described.

Objective
To determine the prevalence of super-utilizers who receive fragmented care across different hospitals and to describe associated risks, costs, and health outcomes.

Research design
We analyzed inpatient data from the Health Care Utilization Project’s State Inpatient and Emergency Department database from 6 states from 2013. After identifying hospital super-utilizers, we stratified by the number of different hospitals visited in a 1-year period. We determined how patient demographics, costs, and outcomes varied by degree of fragmentation. We then examined how fragmentation would influence a hospital’s ability to identify super-utilizers.

Subjects
Adult patients with 4 or more inpatient stays in 1 year.

Measures
Patient demographics, cost, 1-year hospital reported mortality, and probability that a single hospital could correctly identify a patient as a super-utilizer.

Results
Of the 167,515 hospital super-utilizers, 97,404 (58.1%) visited more than 1 hospital in a 1-year period. Fragmentation was more likely among younger, non-white, low-income, under-insured patients, in population-dense areas. Patients with fragmentation were more likely to be admitted for chronic disease management, psychiatric illness, and substance abuse. Inpatient fragmentation was associated with higher yearly costs and lower likelihood of being identified as a super-utilizer.

Conclusions
Inpatient care fragmentation is common among super-utilizers, disproportionately affects vulnerable populations. It is associated with high yearly costs and a decreased probability of correctly identifying super-utilizers.
Comprehensive tumor molecular profile analysis in clinical practice
Authors: Özdoğan Mustafa , Papadopoulou Eirini , Tsoulos Nikolaos , Tsantikidi Aikaterini , Mariatou Vasiliki-Metaxa , Tsaousis Georgios , Kapeni Evgenia , Bourkoula Evgenia , Fotiou Dimitrios , Kapetsis Georgios , Boukovinas Ioannis , Touroutoglou Nikolaos , Fassas Athanasios , Adamidis Achilleas , Kosmidis Paraskevas , Trafalis Dimitrios , Galani Eleni , Lypas George , Orhan Bülent , Tansan Sualp , Özatlı Tahsin , Kırca Onder , Çakır Okan , Nasioulas George 
Published: April 2021

Abstract
Background
Tumor molecular profile analysis by Next Generation Sequencing technology is currently widely applied in clinical practice and has enabled the detection of predictive biomarkers of response to targeted treatment. In parallel with targeted therapies, immunotherapies are also evolving, revolutionizing cancer therapy, with Programmed Death-ligand 1 (PD-L1), Microsatellite instability (MSI), and Tumor Mutational Burden (TMB) analysis being the biomarkers employed most commonly.

Methods
In the present study, tumor molecular profile analysis was performed using a 161 gene NGS panel, containing the majority of clinically significant genes for cancer treatment selection. A variety of tumor types have been analyzed, including aggressive and hard to treat cancers such as pancreatic cancer. Besides, the clinical utility of immunotherapy biomarkers (TMB, MSI, PD-L1), was also studied.

Results
Molecular profile analysis was conducted in 610 cancer patients, while in 393 of them a at least one biomarker for immunotherapy response was requested. An actionable alteration was detected in 77.87% of the patients. 54.75% of them received information related to on-label or off-label treatment (Tiers 1A.1, 1A.2, 2B, and 2C.1) and 21.31% received a variant that could be used for clinical trial inclusion. The addition to immunotherapy biomarker to targeted biomarkers’ analysis in 191 cases increased the number of patients with an on-label treatment recommendation by 22.92%, while an option for on-label or off-label treatment was provided in 71.35% of the cases.

Conclusions
Tumor molecular profile analysis using NGS is a first-tier method for a variety of tumor types and provides important information for decision making in the treatment of cancer patients. Importantly, simultaneous analysis for targeted therapy and immunotherapy biomarkers could lead to better tumor characterization and offer actionable information in the majority of patients. Furthermore, our data suggest that one in two patients may be eligible for on-label ICI treatment based on biomarker analysis. However, appropriate interpretation of results from such analysis is essential for implementation in clinical practice and accurate refinement of treatment strategy.
Testing configurations of attractive toxic sugar bait (ATSB) stations in Mali, West Africa, for improving the control of malaria parasite transmission by vector mosquitoes and minimizing their effect on non-target insects
Authors: Diarra Rabiatou A. , Traore Mohamed M. , Junnila Amy , Traore Sekou F. , Doumbia Seydou , Revay Edita E. , Kravchenko Vasiliy D. , Schlein Yosef , Arheart Kristopher L. , Gergely Petrányi , Hausmann Axel , Beck Robert , Xue Rui-De , Prozorov Alex M. , Kone Aboubakr S. , Majambere Silas , Vontas John , Beier John C. , Müller Günter C. 
Published: April 2021

Abstract
Background
Application methods of |Attractive Toxic Sugar Baits (ATSB) need to be improved for wide-scale use, and effects on non-target organisms (NTOs) must be assessed. The goals of this study were to determine, at the village level, the effect of different configurations of bait stations to (1) achieve < 25% Anopheles mosquito vector daily feeding rate for both males and females and (2) minimize the effect on non-target organisms.

Methods
Dye was added to Attractive Sugar Bait Stations (without toxin) to mark mosquitoes feeding on the baits, and CDC UV light traps were used to monitor for marked mosquitoes. An array of different traps were used to catch dye marked NTOs, indicating feeding on the ASB. Stations were hung on homes (1, 2, or 3 per home to optimize density) at different heights (1.0 m or 1.8 m above the ground). Eight villages were chosen as for the experiments.

Results
The use of one ASB station per house did not mark enough mosquitoes. Use of two and three stations per house gave feeding rates above the 25% goal. There was no statistical difference in the percentage of marked mosquitoes between two and three stations, however, the catches using two and three bait stations were both significantly higher than using one. There was no difference in An. gambiae s.l. feeding when stations were hung at 1.0 and 1.8 m. At 1.8 m stations sustained less accidental damage. ASB stations 1.8 m above ground were fed on by three of seven monitored insect orders. The monitored orders were: Hymenoptera, Lepidoptera, Coleoptera, Diptera, Hemiptera, Neuroptera and Orthoptera. Using one or two stations significantly reduced percentage of bait-fed NTOs compared to three stations which had the highest feeding rates. Percentages were as follows: 6.84 ± 2.03% Brachycera followed by wasps (Hymenoptera: Vespidae) 5.32 ± 2.27%, and Rhopalocera 2.22 ± 1.79%. Hanging the optimal number of stations per house for catching mosquitoes (two) at 1.8 m above ground, limited the groups of non-targets to Brachycera, Chironomidae, Noctuoidea, Rhopalocera, parasitic wasps and wasps (Hymenoptera). Feeding at 1.8 m only occurred when stations were damaged.

Conclusions
The goal of marking quarter of the total Anopheles population per day was obtained using 2 bait stations at 1.8 m height above the ground. This configuration also had minimal effects on non-target insects.
Lysophosphatidic acid (LPA)-antibody (504B3) engagement detected by interferometry identifies off-target binding
Authors: Ray Manisha , Kihara Yasuyuki , Bornhop Darryl J. , Chun Jerold 
Published: April 2021

Abstract
Background
Lysophosphatidic acid (LPA) is a bioactive lysophospholipid that acts through its six cognate G protein-coupled receptors. As a family, lysophospholipids have already produced medicines (e.g., sphingosine 1-phosphate) as is being pursued for LPA through the use of specific antibodies that reduce ligand availability.

Methods
The binding properties of a commercially available, reportedly specific, monoclonal LPA antibody named 504B3 that is related to the clinical candidate Lpathomab/LT3015 were reexamined using a free solution assay (FSA) measured in a compensated interferometric reader (CIR).

Results
Measurement of 504B3 binding properties with an FSA-CIR approach revealed similar binding affinities for 504B3 against LPA as well as the non-LPA lipids, phosphatidic acid (PA) and lysophosphatidylcholine (LPC).

Conclusions
Antibody binding specificity and sensitivity, particularly involving lipid ligands, can be assessed in solution and without labels using FSA-CIR. These findings could affect interpretations of both current and past basic and clinical studies employing 504B3 and related anti-LPA antibodies.
Effect of endoscopic resection on short-term surgical outcomes of subsequent laparoscopic gastrectomy: a meta-analysis
Authors: Peng Dong , Cheng Yu-Xi , Liao Gang 
Published: April 2021

Abstract
Background
Endoscopic resection (ER) might affect subsequent laparoscopic gastrectomy (LG) because of the electrical coagulation, but the effect remains controversial. The purpose of this meta-analysis was to analyze the effect of ER on the short-term surgical outcomes of subsequent LG.

Materials and methods
The PubMed, EMBASE, and Cochrane Library databases were searched to find eligible studies published from inception to March 21, 2021. Short-term surgical outcomes were compared between the ER-LG group and the LG-only group. The registration ID of this current meta-analysis on PROSPERO is CRD42021238031.

Results
Nine studies involving 3611 patients were included in this meta-analysis. The LG-only group had a higher T stage (T1-T2: OR=2.42, 95% CI=1.09 to 5.34, P=0.03; T3-T4: OR=0.41, 95% CI=0.19 to 0.91, P=0.03) than the ER-LG group. The ER-LG group showed a shorter operation time than the LG-only group (MD=−5.98, 95% CI=−10.99 to −0.97, P=0.02). However, no difference was found in operation time after subgroup analysis of propensity score matching studies. No significant difference was found in intraoperative blood loss, time to first oral feeding, or postoperative hospital stay between the ER-LG group and the LG-only group. And no significance was found in overall complications (OR=1.16, 95% CI=0.89 to 1.50, P=0.27), complications of grade ≥ II (OR=1.11, 95% CI=0.71 to 1.73, P=0.64), complications of grade ≥ III b (OR=1.47, 95% CI=0.49 to 4.43, P=0.49) between the ER-LG group and the LG-only group.

Conclusions
ER did not affect subsequent LG in terms of short-term outcomes, and the ER-LG group might have a shorter operation time than the LG-only group.
The study of screw placement parameters for Ogawa type I acromial fractures by 3D simulation
Authors: Zhang Wei , Sun Zhongye , Li Weiyan , Yan Jun , Han Liren , Han Shizhang , Yang Xiaofei , Zhao Bei 
Published: April 2021

AbstractBackgroundAcromial fractures are rare and there is no consensus on fixation, but an increasing number of studies have reported using two screws to fix Ogawa type I acromial fractures. The objective of this study was to obtain the ideal length, diameter, insertion point, and angle of the screw using a novel 3D simulation.MethodsThe scapular CT data of 100 individuals were obtained to reconstruct 3D models. The transparency of the 3D model was then downgraded along the axial perspective (the view perpendicular to the cross section of the acromion axis) to find the maximum translucent area. Two virtual screws were placed at the anterior edge of the acromion until they penetrated the posterior cortical bon. The largest diameters and lengths of the screw were measured, and the direction and insertion point of the screw were observed.ResultsThe mean maximum lengths of the medial and lateral screws were 43.33 ± 6.17 mm and 39.23 ± 6.01 mm, respectively. The mean maximum diameters of the medial and lateral screws were 4.71 ± 1.23 mm and 4.97 ± 1.07 mm, respectively. Differences in screw length, diameter, and insertion point between males and females were found. The differences in screw angle between sexes were not statistically significant.ConclusionsBased on a 3D model test, we recommend the size, entry points, and angles of screws for Ogawa type I acromial fractures, providing valuable guidance for clinical work. More accurate screw parameters can be obtained preoperatively by establishing an individualized 3D model.
Early detection of osteoarthritis in the rat with an antibody specific to type II collagen modified by reactive oxygen species
Authors: Gigout Anne , Harazin Donata , Topping Louise M. , Merciris Didier , Lindemann Sven , Brenneis Christian , Nissim Ahuva 
Published: April 2021

Abstract
Background
Osteoarthritis (OA) is a disease of the whole joint, with articular cartilage breakdown as a major characteristic. Inflammatory mediators, proteases, and oxidants produced by chondrocytes are known to be responsible for driving cartilage degradation. Nevertheless, the early pathogenic events are still unclear. To investigate this, we employed an antibody that is specific to oxidative post-translationally modified collagen type II (anti-oxPTM-CII) to detect early cartilage pathogenic changes in two rat models of OA.

Methods
The animals underwent surgery for destabilization of the medial meniscus (DMM) and were sacrificed after 3, 5, 7, 14, and 28 days. Alternatively, anterior cruciate ligament transection with partial meniscectomy (ACLT+pMx) was performed and animals were sacrificed after 1, 3, 5, 7, and 14 days. Joints were stained with toluidine blue and saffron du Gatinais for histological scoring, anti-oxPTM-CII, and anti-collagen type X antibodies (anti-CX).

Results
We observed positive oxPTM-CII staining as early as 1 or 3 days after ACLT+pMx or DMM surgeries, respectively, before overt cartilage lesions were visible. oxPTM-CII was located mostly in the deep zone of the medial tibial cartilage, in the pericellular and territorial matrix of hypertrophic chondrocytes, and co-localized with CX staining. Staining was weak or absent for the lateral compartment or the contralateral knees except at later time points.

Conclusion
The results demonstrate that oxidant production and chondrocyte hypertrophy occur very early in the onset of OA, possibly initiating the pathogenic events of OA. We propose to use anti-oxPTM-CII as an early biomarker for OA ahead of radiographic changes.
An association between visceral or subcutaneous fat accumulation and diabetes mellitus among Japanese subjects
Authors: Yokokawa Hirohide , Fukuda Hiroshi , Saita Mizue , Goto Kento , Kaku Tengen , Miyagami Taiju , Takahashi Yuichi , Hamada Chieko , Hisaoka Teruhiko , Naito Toshio 
Published: April 2021

Abstract
Background
The impact of subcutaneous fat accumulation remains controversial. This study assessed the association between visceral or subcutaneous fat area (VFA and SFA, respectively) and diabetes mellitus (DM) among Japanese subjects.

Methods

This was a cross-sectional study involving 1907 eligible participants (men, 1050; women, 857) who participated in a voluntary health check-up conducted at Juntendo University Hospital from January 2017 to December 2018, in Tokyo, Japan. Associations between VFA or SFA quartiles and DM were identified using adjusted odds ratios (AORs) and 95% confidence intervals (CIs) with multivariable logistic regression analysis adjusted for confounders. Receiver operating characteristic (ROC) curve analysis was used to assess appropriate cut-off values of VFA or SFA.

Results
Multivariate analyses showed that Q4 (≥ 125 cm2) of VFA was significantly positively associated with DM compared to Q1 (< 65 cm2) (AOR = 1.94, 95% CI 1.02–3.71), whereas there was no association between SFA and DM in men. Among women, Q4 (≥ 85 cm2) of VFA was significantly positively associated with DM compared to Q1 (< 30 cm2) (Q4, AOR = 6.15, 95% CI 1.65–22.99). Also, Q3 and Q4 (≥ 135 cm2) of SFA were significantly positively associated with DM compared to Q1 (< 90 cm2) (Q3, AOR = 5.64, 95% CI 1.21–26.25; Q4, AOR = 7.81, 95% CI 1.71–35.65). The appropriate cut-off value of VFA in men was 101.5 cm2. Those of VFA and SFA in women were 72.5 cm2 and 165.3 cm2, respectively.

Conclusions
Our results suggest the importance of considering SFA as well as VFA, especially in women, for primary and secondary prevention of DM.
Patterns of rapid weight loss in elite sambo athletes
Authors: Drid Patrik , Figlioli Flavia , Lakicevic Nemanja , Gentile Ambra , Stajer Valdemar , Raskovic Bojan , Vojvodic Nina , Roklicer Roberto , Trivic Tatjana , Tabakov Sergey , Eliseev Sergey , Bianco Antonino 
Published: April 2021

Abstract
Background
Rapid weight loss (RWL) is commonly practiced in combat sports. Both magnitude and methods used to induce RWL are largely similar among combat sports, but currently, there is no data on RWL methodology used by sambo athletes. Therefore, the aim of this study was to determine RWL procedures sambo athletes apply to lose weight rapidly.

Methods
The sample consisted of 199 participants, of which 132 males and 67 females who participated in the World Sambo Championship 2020 held in Novi Sad, Serbia. Each participant received RWL questionnaire that was available in multiple languages, and every participant was instructed how to fill it out.

Results
Almost 87% of sambo participants declared to have intentionally cut their weight prior to the competition, whereby 5.27 kg (SD: ±7.57) was lost. Gradual dieting, sauna use and skipping meals were the most dominant methods used to reduce weight prior to competition while more extreme methods of RWL such as the use of laxatives, diuretics, diet pills and vomiting were also implemented but by much smaller fragment of the participants involved.

Conclusions
Findings from our study largely match with previously conducted RWL studies in terms of prevalence, magnitude and methods used by combat sport athletes, especially in judo and wrestling. Knowing the hazardous consequences of RWL, alternative methods of sustainable weight loss should be considered.
Complex endovascular repair of type B aortic dissection and predicting left arm ischemia: a case report
Authors: Kim Kevin G , Grieff Anthony N , Rahimi Saum 
Published: April 2021

Abstract
Background
Thoracic endovascular aortic repair (TEVAR) is the gold standard for surgical management of descending thoracic aortic pathology. Depending on the anatomy, TEVAR often requires deployment across the origin of the left subclavian artery (LSA) to obtain a proximal seal, thus potentially compromising perfusion to the left upper extremity (LUE). However, in most patients this is generally well tolerated without revascularization due to collateralization from the left vertebral artery (LVA).

Case presentation
We present a complex 59-year-old Caucasian patient case of TEVAR with a history of prior arch debranching and intraoperative LSA coverage requiring subsequent LSA embolization and emergency take-back for left carotid–subclavian bypass.

Conclusion
The purpose of this case report is to highlight an often overlooked anatomic LVA variant and an atypical, delayed presentation of acute LUE limb ischemia.
The preconditioning of lithium promotes mesenchymal stem cell-based therapy for the degenerated intervertebral disc via upregulating cellular ROS
Authors: Zhu Zemin , Xing Hongyuan , Tang Ruofu , Qian Shengjun , He Shaoqi , Hu Qiang , Zhang Ning 
Published: April 2021

Abstract
Adipose-derived stem cell (ADSC) is one of the most widely used candidate cell for intervertebral disc (IVD) degeneration-related disease. However, the poor survival and low differentiation efficacy in stressed host microenvironment limit the therapeutic effects of ADSC-based therapy. The preconditioning has been found effective to boost the proliferation and the functioning of stem cells in varying pathological condition. Lithium is a common anti-depression drug and has been proved effective to enhance stem cell functioning. In this study, the effects of preconditioning using LiCl on the cellular behavior of ADSC was investigated, and specially in a degenerative IVD-like condition.

Method
The cellular toxicity on rat ADSC was assessed by detecting lactate dehydrogenase (LDH) production after treatment with a varying concentration of lithium chloride (LiCl). The proliferative capacity of ADSC was determined by detecting Ki67 expression and the relative cell number of ADSC. Then, the preconditioned ADSC was challenged by a degenerative IVD-like condition. And the cell viability as well as the nucleus pulpous (NP) cell differentiation efficacy of preconditioned ADSC was evaluated by detecting the major marker expression and extracellular matrix (ECM) deposit. The therapeutic effects of preconditioned ADSC were evaluated using an IVD degeneration rat model, and the NP morphology and ECM content were assessed.

Results
A concentration range of 1–10 mmol/L of LiCl was applied in the following study, since a higher concentration of LiCl causes a major cell death (about 40%). The relative cell number was similar between preconditioned groups and the control group after preconditioning. The Ki67 expression was elevated after preconditioning. Consistently, the preconditioned ADSC showed stronger proliferation capacity. Besides, the preconditioned groups exhibit higher expression of NP markers than the control group after NP cell induction. Moreover, the preconditioning of LiCl reduced the cell death and promoted ECM deposits, when challenged with a degenerative IVD-like culture. Mechanically, the preconditioning of LiCl induced an increased cellular reactive oxidative species (ROS) level and activation of ERK1/2, which was found closely related to the enhanced cell survival and ECM deposits after preconditioning. The treatment with preconditioned ADSC showed better therapeutic effects than control ADSC transplantation, with better NP preservation and ECM deposits.

Conclusion
These results suggest that the preconditioning with a medium level of LiCl boosts the cell proliferation and differentiation efficacy under a normal or hostile culture condition via the activation of cellular ROS/ERK axis. It is a promising pre-treatment of ADSC to promote the cell functioning and the following regenerative capacity, with superior therapeutic effects than untreated ADSC transplantation.