bluuebunny/crossref_metadata_2025_split huggingface dataset:
The potential effectiveness of the WHO International Health Regulations capacity requirements on control of the COVID-19 pandemic: a cross-sectional study of 114 countries
Authors: Wong Martin CS , Huang Junjie , Wong Sunny H , Yuen-Chun Teoh Jeremy 
Published: February 2021

Objectives We examined if the WHO International Health Regulations (IHR) capacities were associated with better COVID-19 pandemic control. Design Observational study. Setting Population-based study of 114 countries. Participants General population. Main outcome measures For each country, we extracted: (1) the maximum rate of COVID-19 incidence increase per 100,000 population over any 5-day moving average period since the first 100 confirmed cases; (2) the maximum 14-day cumulative incidence rate since the first case; (3) the incidence and mortality within 30 days since the first case and first COVID-19-related death, respectively. We retrieved the 13 country-specific International Health Regulations capacities and constructed linear regression models to examine whether these capacities were associated with COVID-19 incidence and mortality, controlling for the Human Development Index, Gross Domestic Product, the population density, the Global Health Security index, prior exposure to SARS/MERS and Stringency Index. Results Countries with higher International Health Regulations score were significantly more likely to have lower incidence (β coefficient −24, 95% CI −35 to −13) and mortality (β coefficient −1.7, 95% CI −2.5 to −1.0) per 100,000 population within 30 days since the first COVID-19 diagnosis. A similar association was found for the other incidence outcomes. Analysis using different regression models controlling for various confounders showed a similarly significant association. Conclusions The International Health Regulations score was significantly associated with reduction in rate of incidence and mortality of COVID-19. These findings inform design of pandemic control strategies, and validated the International Health Regulations capacities as important metrics for countries that warrant evaluation and improvement of their health security capabilities.
Aerosol Generation During Myringotomy With Tympanostomy Tube Insertion: Implications for Otolaryngology in the COVID‐19 Era
Authors: Campiti Vincent J. , Ye Michael J. , Sharma Dhruv , Matt Bruce H. , Mitchell Ryan M. , Ting Jonathan Y. , Illing Elisa A. , Park Jae Hong , Burgin Sarah J. 
Published: February 2021

The risk of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) transmission to health care workers during myringotomy and tympanostomy tube (MT) insertion is unknown. To determine the need for enhanced precautions to prevent potential spread via aerosolized particles, we used an optical particle sizer to measure aerosol generation intraoperatively during a case series of MT insertion. We also discuss our institutional experience with safe pandemic‐era perioperative practices. There was no measured increase in aerosol particle number during the procedure at a distance of 30 cm from the external auditory canal. These initial data are reassuring regarding the risk of SARS‐CoV‐2 transmission to the operating room team due to aerosol generation, but further study is necessary before making definitive recommendations.
White matter network damage mediates association between cerebrovascular disease and cognition
Authors: Hilal Saima , Liu Siwei , Wong Tien Yin , Vrooman Henri , Cheng Ching-Yu , Venketasubramanian Narayanaswamy , Chen Christopher LH , Zhou Juan Helen 
Published: February 2021

To determine whether white matter network disruption mediates the association between MRI markers of cerebrovascular disease (CeVD) and cognitive impairment. Participants (n = 253, aged ≥60 years) from the Epidemiology of Dementia in Singapore study underwent neuropsychological assessments and MRI. CeVD markers were defined as lacunes, white matter hyperintensities (WMH), microbleeds, cortical microinfarcts, cortical infarcts and intracranial stenosis (ICS). White matter microstructure damage was measured as fractional anisotropy and mean diffusivity by tract based spatial statistics from diffusion tensor imaging. Cognitive function was summarized as domain-specific Z-scores. Lacunar counts, WMH volume and ICS were associated with worse performance in executive function, attention, language, verbal and visual memory. These three CeVD markers were also associated with white matter microstructural damage in the projection, commissural, association, and limbic fibers. Path analyses showed that lacunar counts, higher WMH volume and ICS were associated with executive and verbal memory impairment via white matter disruption in commissural fibers whereas impairment in the attention, visual memory and language were mediated through projection fibers. Our study shows that the abnormalities in white matter connectivity may underlie the relationship between CeVD and cognition. Further longitudinal studies are needed to understand the cause-effect relationship between CeVD, white matter damage and cognition.
Cerebral blood volume Alberta Stroke Program Early Computed Tomography Score predicts intracranial hemorrhage after thrombectomy in patients with acute ischemic stroke in an extended time window
Authors: Cao Yue-Zhou , Zhao Lin-Bo , Jia Zhen-Yu , Liu Qiang-Hui , Xu Xiao-Quan , Shi Hai-Bin , Liu Sheng 
Published: February 2021

Background Higher baseline Alberta Stroke Program Early Computed Tomography Score (ASPECTS) was associated with a lower probability of hemorrhagic transformation in patients with acute ischemic stroke (AIS). Purpose To investigate the predictive value of cerebral blood volume (CBV)-ASPECTS of intracranial hemorrhage (ICH) in AIS treated with thrombectomy selected by computed tomographic perfusion (CTP) in an extended time window. Material and Methods A total of 91 consecutive patients with AIS with large vessel occlusion in the anterior circulation after thrombectomy in an extended time window were enrolled between January 2018 and September 2019. ICH was diagnosed according to Heidelberg Bleeding Classification. CBV-ASPECTS was assessed by evaluating each ASPECTS region for relatively low CBV value compared with the mirror region in the contralateral hemisphere. Demographic characteristics, clinical data, CBV-ASPECTS, and procedure process and results were compared between patients with ICH and those without. Results ICH occurred in 31/91 (34.1%) patients with AIS. Symptomatic ICH (sICH) was observed in 4 (4.4%) patients, while asymptomatic ICH (aICH) was seen in 27 (29.7%). In univariate analysis, both ICH and aICH were associated with high admission NIHSS score ( P<0.001 and P<0.001, respectively), more passes of retriever ( P = 0.007 and P = 0.019, respectively), low NCCT-ASPECTS ( P = 0.013 and P = 0.034, respectively), and low CBV-ASPECTS ( P < 0.001 and P < 0.001, respectively). After multivariable analysis, low CBV-ASPECTS remained an independent predictor of ICH (odds ratio [OR] 0.521, 95% confidence interval [CI] 0.371–0.732, P < 0.001) and aICH (OR 0.532, 95% CI 0.376–0.752, P < 0.001), respectively. Conclusion Low CBV-ASPECTS independently predicts ICH in patients with AIS treated with thrombectomy selected by CTP in an extended time window.
Effect of nutritional risk on cognitive function in patients with chronic obstructive pulmonary disease
Authors: Huang Yiben , Ma Jiedong , Jiang Bingqian , Yang Naiping , Fu Fangyi , Chen Xianjing , Liu Chunyan , Miao Xiaqi , Mao Huanhuan , Zheng Rongrong , Wang Jianing , Ding Keke , Zhang Xiaodiao 
Published: February 2021

Objective We aimed to clarify the cognitive function of patients with chronic obstructive pulmonary disease (COPD) and different nutritional status. Methods Among 95 patients with COPD in this retrospective study, we administered the Nutritional Risk Screening 2002 (NRS 2002) and Mini-Mental State Examination (MMSE). We recorded patients’ clinical characteristics, comorbidities, and laboratory measurements. According to NRS 2002 scores, patients were divided into two groups: no nutritional risk with NRS 2002 < 3 ( n = 54) and nutritional risk, with NRS 2002 ≥ 3 ( n = 41). Results We found a negative correlation between NRS 2002 and MMSE scores in participants with COPD ( r = −0.313). Patients with nutritional risk were more likely to be cognitively impaired than those with no nutritional risk. Multivariate logistic regression analysis indicated that malnutrition was an independent risk factor for cognitive impairment, after adjusting for confounders (odds ratio [OR] = 4.120, 95% confidence interval [CI]: 1.072–15.837). We found a similar association between NRS 2002 and MMSE scores at 90-day follow-up using a Pearson’s correlation test ( r = −0.493) and logistic regression analysis (OR = 7.333, 95% CI: 1.114–48.264). Conclusions Patients with COPD at nutritional risk are more likely to have cognitive impairment.
Modeling Student Effort: Flat Tires and Dead Batteries
Authors: Lewer Joshua J. , Corbett Colin , Marcum Tanya M. , Highfill Jannett 
Published: February 2021

This article develops a student effort model that considers several uncertainties students face: the chance of missing an exam as well as the uncertainty associated with translating knowledge into an exam grade. The model suggests that student effort increases when makeup exams are offered and when grading protocols are adopted that reduce knowledge-to-grade frictions; effects on student utility depend on time endowments, and leisure preferences. JEL Classifications: A20, D81, I21
Externalizing Risk Pathways for Adolescent Substance Use and Its Developmental Onset: A Canadian Birth Cohort Study: Trajectoires de comportements extériorisés et le risque pour l’initiation et l’usage de substances des adolescents : Une étude de cohorte de naissance canadienne
Authors: Cox Sylvia Maria Leonarda , Castellanos-Ryan Natalie , Parent Sophie , Benkelfat Chawki , Vitaro Frank , Pihl Robert O. , Boivin Michel , Tremblay Richard E. , Leyton Marco , Séguin Jean Richard 
Published: February 2021

Objective: Only a minority of drug and alcohol users develops a substance use disorder. Previous studies suggest that this differential vulnerability commonly reflects a developmental trajectory characterized by diverse externalizing behaviors. In this study, we examined the relation between child and adolescent externalizing behaviors and adolescent substance use in a prospectively followed Canadian birth cohort, accounting for the temporal sequence of a wide variety of contributing factors. Methods: Two hundred and forty-two adolescents followed since birth (date range: 1996 to 2012) were assessed on externalizing behavior (age 17 months to 16 years), alcohol and cannabis use at age 16, age of alcohol use onset, family history of substance use problems, family functioning (age 11 to 15), sensation seeking (age 16), prenatal substance exposure, socioeconomic status (age 1 to 9), and sex. Results: Age of alcohol use onset was predicted by a family history of substance use problems, externalizing traits from ages 6 to 10 and 11 to 16, sensation seeking at age 16, prenatal alcohol and tobacco exposure and family functioning at ages 11 to 15. High frequencies of alcohol and cannabis use at age 16 were both predicted by externalizing traits from ages 11 to 16, a family history of substance use problems and sensation seeking after controlling for other individual, environmental and familial variables. The association between familial substance use problems and substance use during adolescence was partially mediated by externalizing traits from age 11 to 16. Conclusions: The present findings provide prospective evidence for a developmental risk pathway for adolescent substance use, potentially identifying those who could benefit from early interventions.
Safety analysis of percutaneous needle electrolysis: a study of needle composition, morphology, and electrical resistance
Authors: Margalef Ramón , Bosque Marc , Minaya-Muñoz Francisco , Valera-Garrido Fermín , Santafe Manel M 
Published: February 2021

Background: Percutaneous needle electrolysis (PNE) consists of a galvanic current combined with the insertion of a solid needle into the tissues of the musculoskeletal system. The application of a galvanic current through a needle can alter the morphology and composition during treatment application. This procedure may also provoke a localized temperature increase. Aim: The aim was to evaluate the safety of the PNE procedure by analyzing possible alterations of the needles employed. Methods: Physio Invasiva® and AguPunt EPI® brand needles, commonly used for the application of this technique, were analyzed in response to three different treatment protocols. Temperature changes were evaluated with the needles immersed in a test tube containing Ringer’s solution, and electrical resistance was evaluated with a multimeter. The morphology of the needles, pre- and post-treatment, was examined with a scanning electron microscope (FEI Quanta 600), and the composition of the needles was evaluated using RX diffusion with Oxford Instruments software. Results: Ringer’s solution contained in the test tubes examined did not present temperature changes. No changes were observed in the needles under investigation with respect to electrical resistance, morphology, or composition with a protocol applying 3-mA intensity for 3 s and three applications. However, important morphological alterations were observed that affected needle composition after 50 applications (at 3 mA for 3 s). Conclusion: PNE, applied according to conventional protocols, appeared to be safe and athermal, and did not provoke a loss of metal particles or modify the morphology of the needles used when studied in vitro.
Development and characterization of sodium alginate/poly(sodium 4-styrenesulfonate) composite films for release behavior of ciprofloxacin hydrogen chloride monohydrate
Authors: Sarwar M Sohail , Ghaffar Abdul , Huang Qingrong 
Published: February 2021

Biopolymers, in particular polysaccharides, have attracted considerable interest in the field of drug delivery due to their biodegradable and biocompatible nature. This study is focused on the preparation and characterization of drug delivery devices based on sodium alginate (SA) composite films with poly(sodium 4-styrenesulfonate) (PSS). The prepared composite films were characterized for the determination of physiochemical properties, molecular interactions, and drug release behavior. The possible intermolecular hydrogen bonding between SA and PSS was determined by ATR-FTIR spectroscopy. Surface characterization was done using AFM. Polymeric films consisted of pristine SA and PSS exhibited relatively uniform and flat surfaces. However, the composite films showed phase separation that became more prominent as the concentration of PSS in the composite films was increased up to 40% (w/w). The contact angle (CA) values, using deionized water as a function of time (s), were ranging from 74° to 90°, and a decrease in CA (64° to 76°) was recorded for each composite film till 40 s. These CA values revealed that all the composite films were hydrophobic. It was observed that as the concentration of PSS in the films increased, hydrophobicity slightly varied as compared to the blank films of SA and PSS. Maximum CA (89°) was shown by a composite film having SA/PSS (90/10). Ciprofloxacin hydrochloride monohydrate (CPX), a model drug, loaded in a suitable composite film (cross-linked with 0.3 M CaCl2 solution) and drug release was evaluated in pH 1.2 simulated gastric fluid (SGF) and pH 7.4 phosphate buffer saline (PBS) solution. In SGF, around 90% of the model drug was released in 110 min that was approximately 77% in the case of PBS. Therefore, it was concluded that a sustained drug release behavior was exhibited in SGF as compared to PBS solution. These results suggest that these films are a promising and may potentially be subjected to study further their drug delivery behavior in applications like wound dressing. [Formula: see text]
Advance Care Planning—Complex and Working: Longitudinal Trajectory of Congruence in End-of-Life Treatment Preferences: An RCT
Authors: Lyon Maureen E. , Caceres Sarah , Scott Rachel K. , Benator Debra , Briggs Linda , Greenberg Isabella , D’Angelo Lawrence J. , Cheng Yao I. , Wang Jichuan ,   for the Palliative Care Consortium
Published: February 2021

Context: The effect of advance care planning (ACP) interventions on the trajectory of end-of-life treatment preference congruence between patients and surrogate decision-makers is unstudied. Objective: To identify unobserved distinctive patterns of congruence trajectories and examine how the typology of outcome development differed between ACP and controls. Methods: Multisite, assessor-blinded, intent-to-treat, randomized clinical trial enrolled participants between October 2013 to March 2017 from 5 hospital-based HIV clinics. Persons living with HIV(PLWH)/surrogate dyads were randomized to 2 weekly 60-minute sessions: ACP (1) ACP facilitated conversation, (2) advance directive completion; or Control (1) Developmental/relationship history, (2) Nutrition/Exercise. Growth Mixed Modeling was used for 18-month post-intervention analysis. Findings: 223 dyads (N = 449 participants) were enrolled. PLWH were 56% male, aged 22 to 77 years, and 86% African American. Surrogates were 56% female, aged 18 to 82 years, and 84% African American. Two latent classes (High vs. Low) of congruence growth trajectory were identified. ACP influenced the trajectory of outcome growth (congruence in all 5 AIDS related situations) by latent class. ACP dyads had a significantly higher probability of being in the High Congruence latent class compared to controls (52%, 75/144 dyads versus 27%, 17/62 dyads, p = 0.001). The probabilities of perfect congruence diminished at 3-months post-intervention but was then sustained. ACP had a significant effect (β = 1.92, p = 0.006, OR = 7.10, 95%C.I.: 1.729, 26.897) on the odds of being in the High Congruence class. Conclusion: ACP had a significant effect on the trajectory of congruence growth over time. ACP dyads had 7 times the odds of congruence, compared to controls. Three-months post-intervention is optimal for booster sessions.
Intelligibility in 3-Year-Olds With Cleft Lip and/or Palate Using the Intelligibility in Context Scale: Findings from the Cleft Collective Cohort Study
Authors: Seifert Miriam , Davies Amy , Harding Sam , McLeod Sharynne , Wren Yvonne 
Published: February 2021

Objective: To provide comparison data on the Intelligibility in Context Scale (ICS) for a sample of 3-year-old English-speaking children born with any cleft type. Design: Questionnaire data from the Cleft Collective Cohort Study were used. Descriptive and inferential statistics were carried out to determine difference according to children’s cleft type and syndromic status. Participants: A total of 412 children born with cleft lip and/or palate whose mothers had completed the ICS when their child was 3 years old. Main Outcome Measure(s): Mothers’ rating of their children’s intelligibility using the ICS. Results: The average ICS score for the total sample was 3.75 ( sometimes-usually intelligible; standard deviation [SD] = 0.76, 95% CIs = 3.68-3.83) of a possible score of 5 ( always intelligible). Children’s speech was reported to be most intelligible to their mothers (mean = 4.33, SD = 0.61, 95% CIs = 4.27-4.39) and least intelligible to strangers (mean = 3.36, SD = 1.00, 95% CIs = 3.26-3.45). There was strong evidence ( P < .001) for a difference in intelligibility between children with cleft lip only (n = 104, mean = 4.13, SD = 0.62, 95% CIs = 4.01-4.25) and children with any form of cleft palate (n = 308, mean = 3.63, SD = 0.76, 95% CIs = 3.52-3.71). Children born with cleft palate with or without cleft lip and an identified syndrome were rated as less intelligible (n = 63, mean = 3.28, SD = 0.85, 95% CIs = 3.06-3.49) compared to children who did not have a syndrome (n = 245, mean = 3.72, SD = 0.71, 95% CIs = 3.63-3.81). Conclusions: These results provide preliminary comparative data for clinical services using the outcome measures recommended by the International Consortium for Health Outcomes Measurement.
Nucleolin Improves Heart Function During Recovery From Myocardial Infarction by Modulating Macrophage Polarization
Authors: Tang Yuting , Lin Xiaofang , Chen Cheng , Tong Zhongyi , Sun Hui , Li Yuanbin , Liang Pengfei , Jiang Bimei 
Published: February 2021

Background: Nucleolin has multiple functions within cell survival and proliferation pathways. Our previous studies have revealed that nucleolin can significantly reduce myocardial ischemia-reperfusion injury by promoting myocardial angiogenesis and reducing myocardial apoptosis. In this study, we attempted to determine the role of nucleolin in myocardial infarction (MI) injury recovery and the underlying mechanism. Methods: Male BALB/c mice aged 6–8 weeks were used to set up MI models by ligating the left anterior descending coronary artery. Nucleolin expression in the heart was downregulated by intramyocardial injection of a lentiviral vector expressing nucleolin-specific small interfering RNA. Macrophage infiltration and polarization were measured by real-time polymerase chain reaction, flow cytometry, and immunofluorescence. Cytokines were detected by enzyme-linked immunosorbent assay. Results: Nucleolin expression in myocardium after MI induction decreased a lot at early phase and elevated at late phase. Nucleolin knockdown impaired heart systolic and diastolic functions and decreased the survival rate after MI. Macrophage infiltration increased in the myocardium after MI. Most macrophages belonged to the M1 phenotype at early phase (2 days) and the M2 phenotype increased greatly at late phase after MI. Nucleolin knockdown in the myocardium led to a decrease in M2 macrophage polarization with no effect on macrophage infiltration after MI. Furthermore, Notch3 and STAT6, key regulators of M2 macrophage polarization, were upregulated by nucleolin in RAW 264.7 macrophages. Conclusions: Lack of nucleolin impaired heart function during recovery after MI by reducing M2 macrophage polarization. This finding probably points to a new therapeutic option for ischemic heart disease.