bluuebunny/crossref_metadata_2025_split huggingface dataset:
Spinal abscess in a patient with undiagnosed Gerbode defect: a case report
Authors: Liao Yuen Wei , Ensam Bode , Kodamanchile Aaditya , Duckett Simon 
Published: September 2021

Abstract

Background
Gerbode defect (GD) is a rare cardiac defect in which an abnormal communication occurs between the left ventricle and right atrium. The aetiology is usually congenital but acquired defects can occur.

Case summary
We report on a 47-year-old male with atrioventricular block prior to decompression of an epidural abscess extending from the skull base to the 7th thoracic vertebrae. Following positive blood cultures for Staphylococcus aureus, a transoesophageal echocardiogram performed revealed a small GD with associated endocarditis. In our case, the defect was small and there was no evidence of heart failure, there was little guidance or literature available on how to best manage our patient. A multidisciplinary decision was taken to treat the endocarditis medically and to not close the defect in the acute setting. He recovered well and did not suffer any further cardiac complications. A repeat transthoracic echocardiogram did not reveal any evidence of endocarditis.

Conclusion
Gerbode defects are rare but have been known to increase the risk of developing endocarditis. It is important to have a high clinical suspicion of endocarditis in patients with evidence of conduction disorders and systemic infection.
Variation among human populations in endometriosis and PCOS A test of the inverse comorbidity model
Authors: Crespi Bernard 
Published: September 2021

AbstractEvidence linking endometriosis to low prenatal testosterone, and evidence that risk of polycystic ovary syndrome (PCOS) is associated with high prenatal testosterone, have motivated the hypothesis that endometriosis and PCOS exhibit inverse comorbidity. The inverse comorbidity hypothesis predicts that populations exhibiting higher prevalence of one disorder should show lower prevalence of the other. To test this prediction, data were compiled from the literature on the prevalence of endometriosis and PCOS, levels of serum testosterone in women during pregnancy and digit ratios as indicators of prenatal testosterone, in relation to variation in inferred or observed population ancestries. Published studies indicate that rates of endometriosis are highest in women from Asian populations, intermediate in women from European populations and lowest in women from African populations (i.e. with inferred or observed African ancestry); by contrast, rates of PCOS show evidence of being lowest in Asian women, intermediate in Europeans and highest in individuals from African populations. Women from African populations also show higher serum testosterone during pregnancy (which may increase PCOS risk, and decrease endometriosis risk, in daughters), and higher prenatal testosterone (as indicated by digit ratios), than European women. These results are subject to caveats involving ascertainment biases, socioeconomic, cultural and historical effects on diagnoses, data quality, uncertainties regarding the genetic and environmental bases of population differences and population variation in the causes and symptoms of PCOS and endometriosis. Despite such reservations, the findings provide convergent, preliminary support for the inverse comorbidity model, and they should motivate further tests of its predictions.Lay Summary: Given that endometriosis risk and risk of polycystic ovary syndrome show evidence of having genetically, developmentally, and physiologically opposite causes, they should also show opposite patterns of prevalence within populations: where one is more common, the other should be more rare. This hypothesis is supported by data from studies of variation among populations in rates of endometriosis and PCOS and studies of variation among populations in levels of prenatal testosterone, which mediaterisks of both conditions.
Glycosylated apolipoprotein J in cardiac ischaemia: molecular processing and circulating levels in patients with acute ischaemic events
Authors: Cubedo Judit , Padró Teresa , Vilahur Gemma , Crea Filippo , Storey Robert F , Lopez Sendon Jose Luis , Kaski Juan Carlos , Sionis Alessandro , Sans-Rosello Jordi , Fernández-Peregrina Estefanía , Gallinat Alex , Badimon Lina 
Published: September 2021

Abstract

Aim
Using proteomics, we previously found that serum levels of glycosylated (Glyc) forms of apolipoprotein J (ApoJ), a cytoprotective and anti-oxidant protein, decrease in the early phase of acute myocardial infarction (AMI). We aimed to investigate: (i) ApoJ-Glyc intracellular distribution and secretion during ischaemia; (ii) the early changes in circulating ApoJ-Glyc during AMI; and (iii) associations between ApoJ-Glyc and residual ischaemic risk post-AMI.

Methods and results
Glycosylated apolipoprotein J was investigated in: (i) cells from different organ/tissue origin; (ii) a pig model of AMI; (iii) de novo AMI patients (n = 38) at admission within the first 6 h of chest pain onset and without troponin T elevation at presentation (early AMI); (iv) ST-elevation myocardial infarction patients (n = 212) who were followed up for 6 months; and (v) a control group without any overt cardiovascular disease (n = 144). Inducing simulated ischaemia in isolated cardiac cells resulted in an increased intracellular accumulation of non-glycosylated ApoJ forms. A significant decrease in ApoJ-Glyc circulating levels was seen 15 min after ischaemia onset in pigs. Glycosylated apolipoprotein J levels showed a 45% decrease in early AMI patients compared with non-ischaemic patients (P &lt; 0.0001), discriminating the presence of the ischaemic event (area under the curve: 0.934; P &lt; 0.0001). ST-elevation myocardial infarction patients with lower ApoJ-Glyc levels at admission showed a higher rate of recurrent ischaemic events and mortality after 6-month follow-up (P = 0.008).

Conclusions
These results indicate that ischaemia induces an intracellular accumulation of non-glycosylated ApoJ and a reduction in ApoJ-Glyc secretion. Glycosylated apolipoprotein J circulating levels are reduced very early after ischaemia onset. Its continuous decrease indicates a worsening in the evolution of the cardiac event, likely identifying patients with sustained ischaemia after AMI.
Leonurine protects against influenza A virus infection-induced pneumonia in mice
Authors: Qiu Li-Nan , Tan Ya-Rong , Luo Yu-Ju , Chen Xiao-Juan 
Published: September 2021

ABSTRACTInfluenza A virus (H1N1), a swine-origin influenza A virus, causes seasonal epidemics that result in severe illnesses and deaths. Leonurine has been reported to function as an anti-inflammatory agent with protective effects on nervous, urinary and cardiovascular systems. However, the therapeutic effects of leonurine on the pneumonia caused by H1N1 infection remain unclear. Hematoxylin and eosin staining was performed to evaluate the lung injuries of mice infected by H1N1. The amount of immune cells was analyzed by flow cytometry. Enzyme-linked immunosorbent assay was used to evaluate the alteration of multiple cytokines in lung tissues. Real-time quantitative polymerase chain reaction assay was performed to investigate the ribonucleic acid (RNA) levels of certain genes. The protein levels in toll-like receptor 4/nuclear factor kappa-light-chain-enhancer of activated B cells (TLR4/NF-κB) signaling were estimated by western blot assay. Leonurine treatment significantly inhibited the mortality caused by H1N1 infection. Leonurine treatment (60 mg/kg) alleviated the lung injuries caused by virus infection. The inflammatory cell accumulation and cytokine expression were inhibited by the leonurine administration. Leonurine inhibited the mRNA expression of pro-inflammatory cytokines in the lung homogenates at day 5 postinfection. Leonurine regulated the TLR4/NF-κB signaling in the lung homogenates of H1N1-infected mice at day 5 postinfection. Leonurine protects against H1N1 infection-induced pneumonia in mice.
Ethical considerations of preconception and prenatal gene modification in the embryo and fetus
Authors: Mattar Citra Nurfarah Zaini , Labude Markus Klaus , Lee Timothy Nicholas , Lai Poh San 
Published: September 2021

ABSTRACTThe National Academies of Sciences and Medicine 2020 consensus statement advocates the reinstatement of research in preconception heritable human genome editing (HHGE), despite the ethical concerns that have been voiced about interventions in the germline, and outlines criteria for its eventual clinical application to address monogenic disorders. However, the statement does not give adequate consideration to alternative technologies. Importantly, it omits comparison to fetal gene therapy (FGT), which involves gene modification applied prenatally to the developing fetus and which is better researched and less ethically contentious. While both technologies are applicable to the same monogenic diseases causing significant prenatal or early childhood morbidity, the benefits and risks of HHGE are distinct from FGT though there are important overlaps. FGT has the current advantage of a wealth of robust preclinical data, while HHGE is nascent technology and its feasibility for specific diseases still requires scientific proof. The ethical concerns surrounding each are unique and deserving of further discussion, as there are compelling arguments supporting research and eventual clinical translation of both technologies. In this Opinion, we consider HHGE and FGT through technical and ethical lenses, applying common ethical principles to provide a sense of their feasibility and acceptability. Currently, FGT is in a more advanced position for clinical translation and may be less ethically contentious than HHGE, so it deserves to be considered as an alternative therapy in further discussions on HHGE implementation.
Expanding Contributions of Monogenic Very Early Onset Inflammatory Bowel Disease
Authors: Ouahed Jodie 
Published: September 2021

Abstract
Currently over 70 genes known to be causative in very early onset inflammatory bowel disease (VEOIBD) have been identified. In the current issue of Inflammatory Bowel Diseases, 2 articles describing monogenetic forms of VEOIBD are highlighted. One describes a patient with life-threatening VEOIBD and a mutation in ITGA6, illustrating the importance of the epithelial barrier in maintaining mucosal homeostasis. The other describes the presentation and management of 10 patients with VEOIBD secondary to damaging mutations in MVK, resulting in mevalonate kinase deficiency. Though most monogenic causes of VEOIBD remain “private,” understanding the different categories of pathways affected in children with VEOIBD is critical and has already resulted in invaluable insight in the management of patients with VEOIBD and may hold strong implications for the care of IBD overall.
Viral RNA and Infectious Influenza Virus on Mobile Phones of Patients With Influenza in Hong Kong and the United States
Authors: Xiao Jingyi , Bueno de Mesquita P Jacob , Leung Nancy H L , Adenaiye Oluwasanmi , Tai Sheldon , Frieman Matthew B , Hong Filbert , Chu Daniel K W , Ip Dennis K M , Cowling Benjamin J , Milton Donald K 
Published: September 2021

Abstract
Mobile phones are among the most highly touched personal objects. As part of a broader study on the contribution of fomites to influenza transmission, between 2017 and 2019, we swabbed mobile phones from 138 patients with influenza in 2 locations. Influenza viral RNA detection rates were 23% (23 of 99 phones) and 36% (14 of 39) in Hong Kong and Maryland, respectively. In Hong Kong, infectious influenza virus was recovered from 3 of 23 mobile phones which had influenza viral RNA detected. Mobile phone influenza contamination was positively associated with upper respiratory tract viral load and negatively associated with age. Cleaning personal objects of patients with influenza should be recommended, and individuals should avoid sharing objects with these patients.
Mathematical Modeling of Endemic Cholera Transmission
Authors: Chao Dennis L 
Published: September 2021

Abstract
Mathematical modeling can be used to project the impact of mass vaccination on cholera transmission. Here, we discuss 2 examples for which indirect protection from mass vaccination needs to be considered. In the first, we show that nonvaccinees can be protected by mass vaccination campaigns. This additional benefit of indirect protection improves the cost-effectiveness of mass vaccination. In the second, we model the use of mass vaccination to eliminate cholera. In this case, a high population level of immunity, including contributions from infection and vaccination, is required to reach the “herd immunity” threshold needed to stop transmission and achieve elimination.
The effectiveness of Check of Medication Appropriateness for antimicrobial stewardship: an interrupted time series analysis
Authors: Quintens Charlotte , Peetermans Willy E , Lagrou Katrien , Declercq Peter , Schuermans Annette , Debaveye Yves , Van den Bosch Bart , Spriet Isabel 
Published: September 2021

Abstract

Objectives
Inappropriate prescribing of antimicrobials in hospitals contributes to the emergence of resistance and adverse drug events. To support antimicrobial stewardship (AMS), clinical decision rules focusing on antimicrobial therapy were implemented in the ‘Check of Medication Appropriateness’ (CMA). The CMA is a hospital-wide pharmacist-led medication review service consisting of a clinical rule-based screening for potentially inappropriate prescriptions (PIPs). We aimed to investigate the impact of the CMA on antimicrobial prescribing.

Methods
An interrupted time series study was performed at the University Hospitals Leuven. The pre-implementation cohort was exposed to standard-of-care AMS. Afterwards, an AMS-focused CMA comprising 41 specific clinical rules, targeting six AMS objectives, was implemented in the post-implementation period. A regression model was used to assess the impact of the intervention on the number of AMS-related residual PIPs between both periods. The total number of recommendations and acceptance rate was recorded for the 2 year post-implementation period.

Results
Pre-implementation, a median proportion of 75% (range: 33%–100%) residual PIPs per day was observed. After the CMA intervention, the proportion was reduced to 8% (range: 0%–33%) per day. Use of clinical rules resulted in an immediate relative reduction of 86.70% (P &lt; 0.0001) in AMS-related residual PIPs. No significant underlying time trends were observed during the study period. Post-implementation, 2790 recommendations were provided of which 81.32% were accepted.

Conclusions
We proved that the CMA approach reduced the number of AMS-related residual PIPs in a highly significant and sustained manner, with the potential to further expand the service to other AMS objectives.
Understanding antibiotic use: practices, structures and networks
Authors: Tompson A C , Manderson L , Chandler C I R 
Published: September 2021

AbstractIn this article, we consider how social sciences can help us to understand the rising use of antibiotics globally. Drawing on ethnography as a way to research how we are in the world, we explore scholarship that situates antibiotic use in relation to interactions of pathogens, humans, animals and the environment in the context of globalization, changes in agriculture and urbanization. We group this research into three areas: practices, structures and networks. Much of the public health and related social research concerning antimicrobial resistance has focused on antibiotic use as a practice, with research characterizing how antibiotics are used by patients, farmers, fishermen, drug sellers, clinicians and others. Researchers have also positioned antibiotic use as emergent of political-economic structures, shedding light on how working and living conditions, quality of care, hygiene and sanitation foster reliance on antibiotics. A growing body of research sees antibiotics as embedded in networks that, in addition to social and institutional networks, comprise physical, technical and historical connections such as guidelines, supply chains and reporting systems. Taken together, this research emphasizes the multiple ways that antibiotics have become built into daily life. Wider issues, which may be invisible without explication through ethnographic approaches, need to be considered when addressing antibiotic use. Adopting the complementary vantage points of practices, networks and structures can support the diversification of our responses to AMR.
Improving suicide risk prediction via targeted data fusion: proof of concept using medical claims data
Authors: Xu Wanwan , Su Chang , Li Yan , Rogers Steven , Wang Fei , Chen Kun , Aseltine Robert 
Published: September 2021

Abstract

Objective
Reducing suicidal behavior among patients in the healthcare system requires accurate and explainable predictive models of suicide risk across diverse healthcare settings.

Materials and Methods
We proposed a general targeted fusion learning framework that can be used to build a tailored risk prediction model for any specific healthcare setting, drawing on information fusion from a separate more comprehensive dataset with indirect sample linkage through patient similarities. As a proof of concept, we predicted suicide-related hospitalizations for pediatric patients in a limited statewide Hospital Inpatient Discharge Dataset (HIDD) fused with a more comprehensive medical All-Payer Claims Database (APCD) from Connecticut.

Results
We built a suicide risk prediction model for the source data (APCD) and calculated patient risk scores. Patient similarity scores between patients in the source and target (HIDD) datasets using their demographic characteristics and diagnosis codes were assessed. A fused risk score was generated for each patient in the target dataset using our proposed targeted fusion framework. With this model, the averaged sensitivities at 90% and 95% specificity improved by 67% and 171%, and the positive predictive values for the combined fusion model improved 64% and 135% compared to the conventional model.

Discussion and Conclusions
We proposed a general targeted fusion learning framework that can be used to build a tailored predictive model for any specific healthcare setting. Results from this study suggest we can improve the performance of predictive models in specific target settings without complete integration of the raw records from external data sources.
Understanding Factors in Burn Patient Follow-up
Authors: Solomon Eve A , Phelan Elizabeth , Tumbaga Lilia G , Karashchuk Irina P , Greenhalgh David G , Sen Soman , Palmieri Tina L , Romanowski Kathleen S 
Published: September 2021

Abstract
Follow-up rates are concerningly low among burn-injured patients. This study investigates the factors associated with low follow-up rates and missed appointments. We hypothesize that patients who are homeless, use illicit substances, and have psychiatric comorbidities will have lower rates of follow-up and more missed appointments. Data from a discharge-planning survey of 281 burn-injured patients discharged from September 2019 to July 2020 were analyzed and matched with patients’ electronic medical records for a retrospective chart review. Data collected included general demographics, burn characteristics, hospitalization details, follow-up visits, missed appointments, homeless status, substance use, major psychiatric illness, and survey responses. Data analysis used chi-square, Fisher’s exact test, Student’s t-test, Wilcoxon rank sum test, and multivariate regression analysis. Overall, 37% of patients had no follow-up in clinic and 46% had one or more missed appointment. On multivariate regression analysis, homeless patients were more likely to never follow-up, odds ratio (OR) = 0.23 (95% confidence interval [CI] = 0.11–0.49), as were patients who anticipated experiencing transportation difficulties, OR = 0.28 (95% CI = 0.15–0.50). Homeless patients were more likely to have missed appointments, OR = 0.23 (95% CI = 0.1–0.54). On univariate analysis, patients with one or more documented major psychiatric illness had lower follow-up rates, with 50.62% having no follow-up (P &lt; .01). Among patients who responded to the survey that they were current drug users, 52% had no follow-up as compared to 28% of patients who responded that they did not use drugs (P &lt; .01).
Re-domestication of Internet Technologies: Digital Exclusion or Digital Choice?
Authors: Grošelj Darja 
Published: September 2021

Abstract
Internet access is now characterized by multi-device, mobile, and ubiquitous access. We explore the changing nature of internet access by focusing on social practices that shape the position and role of internet technologies in everyday internet use. Drawing on the domestication framework, the study uses data from qualitative interviews with UK internet users to explore how technologies are re-domesticated. Three practices encompassing how internet users develop and maintain internet access were identified: spotlighting, distributing, and making do. In addition, orientation, understanding, play, and communication internet dependencies were examined to determine how individuals relate to internet technologies. The practices of re-domestication reflect differences in the role that internet technologies play in individuals’ daily lives, and differences in the availability of offline resources. The study contributes to our understanding of the mechanisms underlying the development and maintenance of internet access, depending on whether access arrangements are shaped by digital exclusion or choice.
Carbon Border Adjustment Measures: A Straightforward Multi-Purpose Climate Change Instrument?
Authors: Pirlot Alice 
Published: September 2021

Abstract
Carbon border adjustment measures (CBAMs) are instruments that can be used to mitigate climate change, but also have a positive impact on trade, climate leadership and even public finance. In this article, I challenge the view that they can serve as straightforward multi-purpose instruments. In a first step, I analyse each of the purposes that can be achieved through CBAMs and explain their underlying differences. In a second step, I discuss their legal design and explain how CBAMs’ design features affect the types of purposes that they can achieve. I apply this two-step analytical framework to the European Union context, where a proposal for a regulation establishing a CBAM has been published by the European Commission in July 2021. I demonstrate that the design of the EU CBAM is inconsistent with the Commission’s main objectives of promoting fair competition and climate mitigation in line with the Paris Agreement. The EU CBAM proposal is primarily an instrument of climate leadership.