bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community Urgent Care Use Following Implementation of the Veterans Affairs Maintaining Internal Systems and Strengthening Integrated Outside Networks Act
Authors: Vashi Anita A. , Urech Tracy , Wu Siqi , Boothroyd Derek , Mehta Paril , Dalton Aaron L. , Brill Elizabeth , Kessler Chad , Asch Steven M. 
Published: May 2021

Background:
Effective June 6, 2019, Veterans Affairs (VA) began offering a new urgent care (UC) benefit that provides eligible Veterans with greater choice and access to care for the treatment of minor injuries and illnesses in their local communities.

Objectives:
The aim was to describe trends in UC use, identify predictors of UC benefit use, and understand the factors associated with community UC use versus VA emergency department (ED) or urgent care center (UCC) use.

Study Design:
Using VA administrative data, this was a retrospective cross-sectional study of Veterans that were enrolled in VA in FY19. Veterans were classified into 3 groups: UC benefit users, benefit non-users, and VA ED/UCC users.

Methods:
We used summary statistics to compare population characteristics across user groups. To determine whether predisposing, enabling, and need factors predicted UC benefit use and setting choice (community UCC vs. VA ED/UCC), 2 logistic regression models were fitted to assess odds of UC use.

Results:
From June 6, 2019 through February 29, 2020, 138,305 Veterans made 175,821 community UC visits. The majority of visits were made by White males who were not subject to co-pays. The average cost to VA for UC visits was $132 (SD=$135). Upper respiratory infections were the most common reason for UC use. Being younger, female, and living farther from a VA ED/UCC was associated with greater UC benefit use compared with both benefit non-users and VA ED/UCC users.

Conclusions:
The new benefit expands Veteran access to UC services for low-acuity conditions.
National Media Coverage of the Veterans Affairs Waitlist Scandal
Authors: Jones Audrey L. , Fine Michael J. , Taber Peter A. , Hausmann Leslie R.M. , Burkitt Kelly H. , Stone Roslyn A. , Zickmund Susan L. 
Published: May 2021

Background:
On April 23, 2014, US media outlets broadcast reports of excessive wait times and “secret” waitlists at some Veterans Affairs (VA) hospitals, precipitating legislation to increase Veterans’ access to private sector health care.

Objective:
The aims were to assess changes in Veterans’ distrust in the VA health care system before and after the media coverage and explore sex and racial/ethnic differences in the temporal patterns.

Methods:
Veterans completed semistructured interviews on health care satisfaction from June 2013 to January 2015, including a validated scale of health system distrust (range: 1–5). We used linear splines with knots at 90-day intervals to assess changes in distrust before and after April 23, 2014 (“day 0”) in linear mixed models. To explore sex and racial/ethnic differences in temporal patterns, we stratified models by sex and tested for interactions of race/ethnicity with time.

Results:
For women (n=600), distrust scores (mean=2.09) increased by 0.45 in days 0–90 (P<0.01), then decreased by 0.45 in days 90–180 (P<0.01). Among men (n=575), distrust scores (mean=2.05) increased by 0.18 in days 0–90 (P=0.059). Distrust levels were significantly higher for Black versus White women (time adjusted mean difference=0.21) and for Black and Hispanic versus White men (differences=0.26 and 0.18). However, the temporal patterns did not vary by race/ethnicity for women or men (interaction P=0.85 and 0.21, respectively).

Conclusions:
Health system distrust increased in women following media coverage of VA access problems and was higher in Black/Hispanic versus White Veterans at all time periods. Such perceptions could influence Veteran decisions to seek health care in the community rather than VA.
Prognostic Value of Coronary Artery Disease–Reporting and Data System Score for Major Adverse Cardiac Events in Patients Attending the Emergency Department With Acute Chest Pain
Authors: Park Jiwoo , Hur Jin , Han Kyunghwa , Im Dong Jin , Lee Kye Ho , Suh Young Joo , Hong Yoo Jin , Lee Hye-Jeong , Kim Young Jin , Choi Byoung Wook 
Published: May 2021

Objective
This study aimed to compare the prognostic performance of Coronary Artery Disease (CAD)–Reporting and Data System (CAD-RADS) score with those of clinical risk factors and the extent of CAD classification for predicting major adverse cardiac events in emergency department patients.

Methods
A total of 779 patients with acute chest pain at low to intermediate risk for CAD underwent cardiac computed tomography angiography. The primary end point was early and late major adverse cardiac events. We developed the following models: model 1, clinical risk factors; model 2, clinical risk factors and CAD-RADS scores; model 3, clinical risk factors and extent of CAD.

Results
The C-statistics revealed that both CAD-RADS score and CAD extent improved risk stratification over the clinical risk factors (C-index for early events: C-index: 0.901 vs 0.814 and 0.911 vs 0.814; C-index for late events: 0.897 vs 0.808 and 0.905 vs 0.808; all P < 0.05).

Conclusions
The CAD-RADS score had additional risk prediction benefits over clinical risk factors for emergency department patients.
Computed Tomography Imaging Findings for Predicting Histological Subtypes and Clinical Outcomes in Patients With Head and Neck Nodal Involvement of Diffuse Large B-Cell Lymphoma and Follicular Lymphoma
Authors: Imada Hiroki , Kato Hiroki , Ando Tomohiro , Matsuo Masayuki 
Published: May 2021

Objective
This study aimed to assess computed tomography (CT) imaging findings for predicting the histological subtypes and clinical outcomes in patients with head and neck nodal involvement of diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL).

Methods
This retrospective study included 64 patients with histologically confirmed head and neck nodal lymphoma (43 with DLBCL and 21 with FL) who underwent pretreatment CT examinations. The CT imaging findings were retrospectively assessed and compared according to the 2 pathologies and their clinical outcomes.

Results
Multiplicity (86% vs 57%, P < 0.05), necrosis (44% vs 5%, P < 0.01), ill-demarcated margin (33% vs 0%, P < 0.01), and surrounding fat stranding (56% vs 14%, P < 0.01) were significantly more frequent in DLBCLs than in FLs. Multivariate logistic regression analysis revealed that necrosis was a significant factor for predicting the diagnosis of DLBCL (P < 0.01). Multiplicity (100% vs 67%, P < 0.01), bilaterality (44% vs 13%, P < 0.05), and surrounding fat stranding (69% vs 28%, P < 0.01) were significantly more frequent in the poor outcome group than in the good outcome group. Multivariate logistic regression analysis revealed that bilaterality and surrounding fat stranding were significant factors for predicting poor outcomes (P < 0.05).

Conclusions
In patients with head and neck nodal lymphoma, necrosis was useful for predicting the diagnosis of DLBCL, whereas bilaterality and surrounding fat stranding were useful for predicting poor outcomes.
Prediction of Patient Height and Weight With a 3-Dimensional Camera
Authors: Dane Bari , Singh Vivek , Nazarian Matthew , O'Donnell Thomas , Liu Shu , Kapoor Ankur , Megibow Alec 
Published: May 2021

Objective
The aim of this study was to determine accuracy of height and weight prediction by a 3-dimensional (3D) camera.

Methods
A total of 453 patients whose computed tomography imaging used a 3D camera from December 19, 2018 to March 19, 2019 were retrospectively identified. An image of each patient was taken before the computed tomography by a 3D camera mounted to the ceiling. Using infrared imaging and machine learning algorithms, patient height and weight were estimated from this 3D camera image. A total of 363 images were used for training. The test set consisted of 90 images. The height and weight estimates were compared with true height and weight to determine absolute and percent error. A value of P < 0.05 indicated statistical significance.

Results
There was 2.0% (SD, 1.4) error in height estimation by the 3D camera, corresponding to 3.35 cm (SD, 2.39) absolute deviation (P = 1, n = 86). Weight estimation error was 5.1% (SD, 4.3), corresponding to 3.99 kg (SD, 3.11) absolute error (P = 0.74, n = 90).

Conclusion
Pictures obtained from a 3D camera can accurately predict patient height and weight.
Current Status of Radiomics and Deep Learning in Liver Imaging
Authors: Chu Linda C. , Park Seyoun , Kawamoto Satomi , Yuille Alan L. , Hruban Ralph H. , Fishman Elliot K. 
Published: May 2021

Abstract
Artificial intelligence is poised to revolutionize medical image. It takes advantage of the high-dimensional quantitative features present in medical images that may not be fully appreciated by humans. Artificial intelligence has the potential to facilitate automatic organ segmentation, disease detection and characterization, and prediction of disease recurrence. This article reviews the current status of artificial intelligence in liver imaging and reviews the opportunities and challenges in clinical implementation.
Reinfection by the SARS-CoV-2 Gamma variant in blood donors in Manaus, Brazil
Authors: Prete Carlos A. , Buss Lewis F. , Buccheri Renata , Abrahim Claudia M. M. , Salomon Tassila , Crispim Myuki A. E. , Oikawa Marcio K. , Grebe Eduard , da Costa Allyson G. , Fraiji Nelson A. , Carvalho Maria do P. S. S. , Whittaker Charles , Alexander Neal , Faria Nuno R. , Dye Christopher , Nascimento Vítor H. , Busch Michael P. , Sabino Ester C. 
Published: May 2021

AbstractBackgroundThe city of Manaus, north Brazil, was stricken by a second epidemic wave of SARS-CoV-2 despite high seroprevalence estimates, coinciding with the emergence of the Gamma (P.1) variant. Reinfections were postulated as a partial explanation for the second surge. However, accurate calculation of reinfection rates is difficult when stringent criteria as two time-separated RT-PCR tests and/or genome sequencing are required. To estimate the proportion of reinfections caused by the Gamma variant during the second wave in Manaus and the protection conferred by previous infection, we analyzed a cohort of repeat blood donors to identify anti-SARS-CoV-2 antibody boosting as a means to infer reinfection.MethodsWe tested serial blood samples from unvaccinated repeat blood donors in Manaus for the presence of anti-SARS-CoV-2 IgG antibody. Donors were required to have three or more donations and at least one donation during each epidemic wave. Donors were tested with two assays that display waning in early convalescence, enabling the detection of reinfection-induced boosting. The serial samples were used to divide donors into six groups defined based on the inferred sequence of infection and reinfection with non-Gamma and Gamma variants.ResultsFrom 3,655 repeat blood donors, 238 met all inclusion criteria, and 223 had enough residual sample volume to perform both serological assays. Using a strict serological definition of reinfection, we found 13.6% (95% CI 7.0% - 24.5%) of all presumed Gamma infections that were observed in 2021 were reinfections. If we also include cases of probable or possible reinfections, these percentages increase respectively to 22.7% (95% CI 14.3% - 34.2%) and 39.3% (95% CI 29.5% - 50.0%). Previous infection conferred a protection against reinfection of 85.3% (95% CI 71.3% - 92.7%), decreasing to respectively 72.5% (95% CI 54.7% - 83.6%) and 39.5% (95% CI 14.1% - 57.8%) if probable and possible reinfections are included.ConclusionsReinfection due to Gamma is common and may play a significant role in epidemics where Gamma is prevalent, highlighting the continued threat variants of concern pose even to settings previously hit by substantial epidemics.
Temporal changes in the risk of superspreading events of coronavirus disease 2019
Authors: Lim Jun-Sik , Noh Eunbi , Shim Eunha , Ryu Sukhyun 
Published: May 2021

ABSTRACTIn order to identify the temporal change in the possible risk of superspreading events (SSE), we estimated the overdispersion parameter in two different periods of COVID-19 pandemic. We identified the possible risk of SSE was reduced 34% during the second epidemic period in South Korea.
Identifying risk factors for COVID-19 severity and mortality in the UK Biobank
Authors: Madakkatel Iqbal , King Catherine , Zhou Ang , Mulugeta Anwar , Lumsden Amanda , McDonnell Mark , Hyppönen Elina 
Published: May 2021

AbstractSevere acute respiratory syndrome coronavirus has infected over 114 million people worldwide as of March 2021, with worldwide mortality rates ranging between 1-10%. We use information on up to 421,111 UK Biobank participants to identify possible predictors for long-term susceptibility to severe COVID-19 infection (N=1,088) and mortality (N=376). We include 36,168 predictors in our analyses and use a gradient boosting decision tree (GBDT) algorithm and feature attribution based on Shapley values, together with traditional epidemiological approaches to identify possible risk factors. Our analyses show associations between socio-demographic factors (e.g. age, sex, ethnicity, education, material deprivation, accommodation type) and lifestyle indicators (e.g. smoking, physical activity, walking pace, tea intake, and dietary changes) with risk of developing severe COVID-19 symptoms. Blood (cystatin C, C-reactive protein, gamma glutamyl transferase and alkaline phosphatase) and urine (microalbuminuria) biomarkers measured more than 10 years earlier predicted severe COVID-19. We also confirm increased risks for several pre-existing disease outcomes (e.g. lung diseases, type 2 diabetes, hypertension, circulatory diseases, anemia, and mental disorders). Analyses on mortality were possible within a sub-group testing positive for COVID-19 infection (N=1,953) with our analyses confirming association between age, smoking status, and prior primary diagnosis of urinary tract infection.SUMMARYOur hypothesis-free approach combining machine learning with traditional epidemiological methods finds a number of risk factors (sociodemographic, lifestyle, and psychosocial factors, biomarkers, disease outcomes and treatments) associated with developing severe COVID-19 symptoms and COVID-19 mortality.
The global rarity of intact coastal regions
Authors: Williams Brooke A , Watson James E M , Beyer Hawthorne L , Klein Carissa J , Montgomery Jamie , Runting Rebecca K , Roberson Leslie A , Halpern Benjamin S , Grantham Hedley S , Kuempel Caitlin D. , Frazier Melanie , Venter Oscar , Wenger Amelia 
Published: May 2021

AbstractManagement of the land-sea interface is considered essential for global conservation and sustainability objectives, as coastal regions maintain natural processes that support biodiversity and the livelihood of billions of people. However, assessments of coastal regions have focused on either strictly the terrestrial or marine realm, and as a consequence, we still have a poor understanding of the overall state of Earth’s coastal regions. Here, by integrating the terrestrial human footprint and marine cumulative human impact maps, we provide a global assessment of the anthropogenic pressures affecting coastal areas. Just 15.5% of coastal areas globally can be considered having low anthropogenic pressure, mostly found in Canada, Russia, and Greenland. Conversely, 47.9% of coastal regions are heavily impacted by humanity with most countries (84.1%) having >50% of their coastal regions degraded. Nearly half (43.3%) of protected areas across coastal regions are exposed to high human pressures. In order to meet global sustainability objectives, we identify those nations that must undertake greater actions to preserve and restore coastal regions so as to ensure global sustainable development objectives can be met.
Autophagy gene-dependent intracellular immunity triggered by interferon-γ
Authors: McAllaster Michael R. , Bhushan Jaya , Balce Dale R. , Orvedahl Anthony , Park Arnold , Hwang Seungmin , Sullender Meagan E. , Sibley L. David , Virgin Herbert W. 
Published: May 2021

AbstractGenes required for the lysosomal degradation pathway of autophagy play key roles in topologically distinct cellular processes with significant physiologic importance. One of the first-described of theseATGgene-dependent processes is the requirement for a subset ofATGgenes in interferon-γ (IFNγ)-induced inhibition of norovirus andToxoplasma gondiireplication. Herein we identified new genes that are required for or that negatively regulate this immune mechanism. Enzymes involved in the conjugation of UFM1 to target proteins including UFC1 and UBA5, negatively regulated IFNγ-induced inhibition of norovirus replication via effects ofErn1. IFNγ-induced inhibition of norovirus replication requiredWipi2bandAtg9a, but notBecn1(encoding Beclin1),Atg14, orSqstm1. The phosphatidylinositol-3-phosphate and ATG16L1 binding domains of WIPI2B were required for IFNγ-induced inhibition of norovirus replication. BothWIPI2andSQSTM1were required for IFNγ-induced inhibition ofToxoplasma gondiireplication in HeLa cells. These studies further delineate the mechanisms of a programmable form of cytokine-induced intracellular immunity that relies on an expanding cassette of essentialATGgenes to restrict the growth of phylogenetically diverse pathogens.ImportanceInterferon-γ is a critical mediator of cell-intrinsic immunity to intracellular pathogens. Understanding the complex cellular mechanisms supporting robust interferon-γ-induced host defenses could aid in developing new therapeutics to treat infections. Here, we examined the impact of autophagy in the interferon-γ induced host response. We demonstrate that CRISPR-Cas9 screens specifically targeting the autophagy pathway uncover a role for WIPI2 in IFNγ-induced inhibition ofNorovirusreplication in mouse cells and IFNγ mediated restriction of theToxoplasma gondiiparasitophorous vacuole in human cells. Furthermore, we found perturbation of UFMylation pathway components led to more robust IFNγ-induced inhibition ofNorovirusdue to ER stressin vitro. Enhancing or inhibiting these dynamic cellular components could serve as a strategy to weaken intracellular pathogens and maintain an effective immune response.
Characteristics of SARS-CoV-2 Positive Individuals in California From Two Periods During Notable Decline in Incident Infection
Authors: Allan-Blitz Lao-Tzu , Turner Isaac , Hertlein Fred , Klausner Jeffrey D. 
Published: May 2021

AbstractDespite declining SARS-CoV-2 incidence, continued epidemic monitoring is warranted. We collected SARS-CoV-2 test results from 150 drive-through testing centers across California from two observation periods: February 23rd-March 3rd 2021 and April 15th-April 30th 2021. We assessed SARS-CoV-2 positivity, stratified by Hispanic heritage among sociodemographic characteristics and potential exposures. We analyzed 114,789 test results (5.1% and 2.6% positive during the respective observation periods). Nearly half of all positive tests were among testers reporting a recent exposure (48.8% and 45.3% during the respective observation periods). Those findings may provide insight into evolving local transmission dynamics and support targeted public health strategies.
COVID-19: A comparative study of severity of patients hospitalized during the first and the second wave in South Africa
Authors: Maslo Caroline , Messina Angeliki , Laubscher Anchen , Toubkin Mande , Sitharam Liza , Feldman Charles , Richards Guy A 
Published: May 2021

AbstractBackgroundSouth Africa has experienced two waves of COVID-19 infections, the second of which was inter alia attributed to the emergence of a novel SARS-CoV2 variant, 501Y.V2. This variant possibly has increased virulence and may be associated with increased mortality. The objective of this study was to determine if patients admitted in the second wave had more severe illness and higher mortality than those admitted in the first.MethodsWe analysed and compared the characteristics, biological severity markers, treatments, level of care and outcomes of patients hospitalised in a private hospital in the Eastern Cape Province, South Africa.ResultsCompared to the first wave, patients admitted in the second were older and less likely to have co-morbidities. In contrast, the D-dimer and interleukin-6 (IL-6) levels were significantly higher. Despite this, significantly less patients were admitted to ICU and/or were mechanically ventilated. The total length of hospital stay was identical in both groups. Whereas the overall mortality was not significantly higher during the second wave, the ICU mortality was. Those that died in the second wave were older than those in the first wave. Multivariable logistic regression showed that being admitted during the second wave was an independent risk factor for mortality.ConclusionThis study appears to confirm previous reports that the 501Y.V2 variant is possibly more virulent as indicated by the higher levels of D-dimer and IL-6, the slight increase in mortality of hospitalised patients and the higher ICU mortality in the second wave.
Restoring persistent accessibility to memories after sleep deprivation-induced amnesia
Authors: Bolsius Youri G. , Heckman Pim R.A. , Raven Frank , Meijer Elroy L. , Kas Martien J.H. , Ramirez Steve , Meerlo Peter , Havekes Robbert 
Published: May 2021

SummaryIt is well established that sleep deprivation after learning impairs hippocampal memory processes and causes amnesia. It is unknown, however, whether it leads to the actual loss of information or merely suppresses the retrievability of this information stored under suboptimal conditions. Here, we reveal that hippocampal memories formed under sleep deprivation conditions can be successfully retrieved multiple days following training using optogenetic memory engram activation or treatment with the clinically-approved phosphodiesterase 4 (PDE4) inhibitor roflumilast. Moreover, when optogenetic memory engram activation and roflumilast treatment were combined two days following training and subsequent sleep deprivation, it resulted in a more persistent memory trace that allowed for natural (i.e., manipulation free) retrieval several days later. Our studies in mice demonstrate that sleep deprivation does not necessarily cause memory loss, but instead leads to the suboptimal storage of information that is difficult to retrieve. We also provide proof of principle that these suboptimally stored memories can be made accessible again far beyond the learning episode and that the clinically-approved PDE4 inhibitor roflumilast may be used to successfully retrieve information thought to be lost.