bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physician awareness, preparedness, and opinions toward consumer‐initiated genetic testing in Thailand: Views from a changing landscape
Authors: Kittikoon Siraphob , Pithukpakorn Manop , Pramyothin Pornpoj 
Published: May 2021

AbstractConsumer‐initiated genetic tests have captured public interest in recent years, including in low‐to‐middle‐income countries (LMICs) such as Thailand. Due to limited resources and personnel, physicians will most likely bear the burden of increasing service needs from the public as consumer‐initiated genetic tests become popularized. The primary objective of this study was to describe (a) awareness, (b) preparedness to provide counseling about the consumer‐initiated genetic test, and (c) opinions on the usefulness of consumer‐initiated genetic tests among physicians at an academic hospital in Bangkok, Thailand. The secondary objective was to describe factors that were associated with the awareness, preparedness, and opinion of the participants. Paper questionnaires were sent out to participants which included internal medicine residents, fellows, and faculty staff members. The questionnaires assessed awareness, preparedness to discuss consumer‐initiated genetic test results, and opinion on the usefulness of consumer‐initiated genetic tests and included both closed‐ and open‐ended questions. Responses were anonymous. Among 308 participants, there were 223 (72.4%) residents, 14 (4.5%) fellows, and 71 (23.1%) staff members. Only 15% of participants were aware of consumer‐initiated genetic tests, mostly from the internet, and only 7% were prepared to provide counseling regarding consumer‐initiated genetic tests. However, 60% agreed that consumer‐initiated genetic tests may be clinically useful. Many participants, including trainees, expressed concerns about the interpretation of consumer‐initiated genetic test results, application into clinical practice, appropriate counseling, and patient referral to geneticists. Multivariate logistic regression revealed that years of work experience was independently associated with awareness of consumer‐initiated genetic tests, while male gender and less work experience were independently associated with favorable opinion toward the usefulness of consumer‐initiated genetic tests. Our results pointed to an urgent need for genetic counselors in Thailand. Also, physicians, particularly trainees, need appropriate training to prepare them for a rapidly evolving environment where consumer‐initiated genetic tests become commonplace.
IgG4‐related sclerosing cholangitis may be a risk factor for cancer
Authors: Kurita Yusuke , Fujita Yuji , Sekino Yusuke , Watanabe Seitaro , Iwasaki Akito , Kagawa Koichi , Tanida Emiko , Yagi Shin , Hasegawa Sho , Sato Takamitsu , Hosono Kunihiro , Kato Shingo , Kobayashi Noritoshi , Ichikawa Yasushi , Endo Itaru , Nakajima Atsushi , Kubota Kensuke 
Published: May 2021

AbstractBackground/PurposeThe relationship between autoimmune pancreatitis (AIP) and malignancy has been reported. However, the potential risk for cancer in patients with immunoglobulin 4 (IgG4)‐related sclerosing cholangitis (IgG4‐SC) is unclear. The present study aimed to evaluate the incidence of cancer in IgG4‐SC patients.MethodsWe retrospectively collected clinical data for 121 patients diagnosed with IgG4‐SC from 7 hospitals. We calculated the standardized incidence ratio (SIR) of cancer in IgG4‐SC patients based on the national cancer rates. The SIR of the period after the diagnosis of IgG4‐SC were calculated.ResultsThe mean follow‐up period was 6.4 years, with 121 IgG4‐SC patients. During the follow‐up period, 26 patients had cancer, and 29 cancers were diagnosed. The SIR of cancer after the diagnosis of IgG4‐SC was 1.90 (95% confidence interval [CI] 1.67‐2.21). The SIR of pancreatic and bile duct cancer was 10.30 and 8.88, respectively. The SIR of cancer in <1 year, 1‐5 years, and >5 years after diagnosis of IgG4‐SC were 2.58, 1.01, and 2.44, respectively.ConclusionsIgG4‐SC patients have a high risk of cancer including pancreatic and bile duct cancer. The risk of cancer was high less <1 year and >5 years after diagnosis of IgG4‐SC. Therefore, IgG4‐SC patients may require careful long‐term follow‐up.
Investigation of mass‐scale drift effects in the milli‐mass range: Influence on high mass resolution mode multicollector‐inductively coupled plasma mass spectrometer isotope ratio measurements
Authors: Pramann Axel , Noordmann Janine , Rienitz Olaf 
Published: May 2021

AbstractThe consequences, possible origins, and prevention of mass‐scale drifts in the high mass resolution mode (HR, M/ΔM ≈ 8000) under constant conditions were investigated and simulated in case of a multicollector‐inductively coupled plasma mass spectrometer (MC‐ICP‐MS) using silicon enriched in 28Si as the main element in this survey. A drifting mass scale strongly impairs the precise and accurate determination of isotope ratios, depending especially on the peak/plateau width. For example, 29Si+ in Si highly enriched in 28Si has an extremely small mass plateau width of ΔM ≤ 4 × 10−3 u, compare ΔM(56Fe+) ≈ 18 × 10−3 u, which is to our knowledge one of the smallest plateaus routinely investigated in isotope ratio measurements, thus requiring extreme stability. During warm‐up of the double‐focusing sector field mass spectrometer, a mass drift up to ΔM/Δt ≥ 0.006 u/hr has been observed. Long‐term studies on mass scale stability and simulations concerning fluctuations of the magnetic field B, acceleration voltage Uacc and ESA voltage UESA are reported. A change of one of these quantities of 0.01% induces changes of the mass scale of 6 × 10−3 u, 3 × 10−3u, and 1 × 10−3 u in the case of B, Uacc, and UESA, respectively. After identifying electrical charging/discharging effects in the mass spectrometer affecting the mass scale stability, the instrument was completely dismantled and carefully reinstalled. Additional stability tests using silicon, strontium, and lead finally yielded a mass drift of ΔM/Δt ≤ 0.001 u/8 h in the case of silicon. This enhanced stability guarantees measurements of isotope ratios on smallest plateaus with lowest uncertainty. The importance of a stable mass scale is pointed out and the relevant quantities of a typical magnetic sector field mass spectrometer are discussed.
SARS‐CoV‐2 antibodies: IgA correlates with severity of disease in early COVID‐19 infection
Authors: Zervou Fainareti N. , Louie Ping , Stachel Anna , Zacharioudakis Ioannis M. , Ortiz‐Mendez Yadira , Thomas Kristen , Aguero‐Rosenfeld Maria E. 
Published: May 2021

AbstractTiming of detection of immunoglobulin G (IgG), immunoglobulin A (IgA), and immunoglobulin M (IgM) antibodies against severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), and their use to support the diagnosis are of increasing interest. We used the Gold Standard Diagnostics ELISA to evaluate the kinetics of SARS‐CoV‐2 IgG, IgA, and IgM antibodies in sera of 82 hospitalized patients with polymerase chain reaction (PCR)‐confirmed coronavirus disease 2019 (COVID‐19). Serum samples were collected 1–59 days post‐onset of symptoms (PoS) and we examined the association of age, sex, disease severity, and symptoms' duration with antibody levels. We also tested sera of 100 ambulatory hospital employees with PCR‐confirmed COVID‐19 and samples collected during convalescence, 35–57 days PoS. All but four of the admitted patients (95.1%) developed antibodies to SARS‐CoV‐2. Antibodies were detected within 7 days PoS; IgA in 60.0%, IgM in 53.3%, and IgG in 46.7% of samples. IgG positivity increased to 100% on Day 21. We did not observe significant differences in the rate of antibody development in regard to age and sex. IgA levels were highest in patients with a severe and critical illness. In multiple regression analyses, only IgA levels were statistically significantly correlated with critical disease (p = .05) regardless of age, sex, and duration of symptoms. Among 100 ambulatory hospital employees who had antibody testing after 4 weeks PoS only 10% had positive IgA antibodies. The most frequently isolated isotype in sera of employees after 30 days PoS was IgG (88%). IgA was the predominant immunoglobulin in early disease and correlated independently with a critical illness. IgG antibodies remained detectable in almost 90% of samples collected up to two months after infection.
Substantial decrease in concurrent meteorological droughts and consecutive cold events in Huai River Basin, China
Authors: Zhang Yuqing , Yang Xiuqin , Chen Changchun 
Published: May 2021

AbstractConcurrent meteorological droughts and consecutive cold events can significantly impact local ecosystems, socio‐economies, and human health. The respective characteristics of droughts and cold extremes have been extensively studied, however, their concurrent extremes have received very little attention. In this study, we used the Huai River Basin as a case to build a magnitude index of concurrent meteorological droughts and consecutive cold events (CDCMI) based on daily minimum temperature data and a 1‐month standardized precipitation evapotranspiration index (SPEI) from 1961 to 2018. Results show that the magnitude of meteorological droughts increased over the observation period, while consecutive cold events significantly decreased. CDCMI showed a significant downward trend at a rate of −0.14 per decade. Large differences were observed between 1990–2018 and 1961–1989—especially in the southern parts of the basin (around −50%). The frequency of mild and moderate concurrent meteorological droughts and consecutive cold events showed no significant upward or downward trends, but severe and extreme concurrent events showed pronounced decreasing trends at rates of −0.03 events/decade and − 0.036 events/decade, respectively. Under the same return period, high CDCMI values are present in the southeastern part of the basin, indicating that the concurrent events in this region are more serious. When CDCMI = 1.79 (extreme grade), the return period in the southeastern part of the basin (5–10 years) is much lower than that in the northwestern part of the basin (>100 years), indicating that this part is harmed to a greater extent by the concurrent extremes than elsewhere in the basin. The spatial pattern of maximum CDCMI again indicates that the southeastern part of the basin is at a high risk for concurrent events. The proposed magnitude index may be a useful tool for analysing concurrent (compound) droughts and cold events as well as their potential impacts.
Effects of ultrasound pretreatment on the drying kinetics, water status and distribution in scallop adductors during heat pump drying
Authors: Zhu Zhizhuang , Zhao Ya , Zhang Yuexiang , Wu Xiaotian , Liu Jing , Shi Qilong , Fang Zhongxiang 
Published: May 2021

AbstractBACKGROUNDA material's physical and chemical properties during drying are influenced by water status and distribution. However, merely overall water removal is reported in many investigations, which hinders clarification of the drying mechanism. Therefore, the effects of ultrasound (US) pretreatment (0 W, CK; 90 W, US‐90; 180 W, US‐180) on the drying kinetics and quality of heat pump drying (HPD) scallop adductors was performed based on low‐field nuclear magnetic resonance (LF‐NMR).RESULTSCompared with CK, effective moisture diffusion coefficient was increased by 12.43% and 23.35% for US‐90 and US‐180, respectively. The Weibull model satisfactorily described the drying characteristics with a high r2 (> 0.998), low rmse (< 0.0120) and χ2 (< 0.00008). LF‐NMR revealed that the immobilized water was predominant in scallop adductors. As drying proceeded, the relaxation time of free and immobilized water was decreased sharply, whereas the relaxation time of bound water scarcely changed. The time required to reduce approximately two‐fifths of the original peak area of immobilized water was 720, 630 and 540 min for CK, US‐90 and US‐180, respectively. The amplitude of immobilized water was decreased and bound water increased significantly, although free water was kept constant (ranging 1–2%). US pretreatment reduced total color difference and hardness, but enhanced the toughness of dried scallop adductors. However, US had no significant influence on the product rehydration rate and shrinkage rate.CONCLUSIONLF‐NMR was successfully employed to evaluate the drying degree of scallop adductors. US facilitated the conversion of immobilized water to free water and, consequently, promoted water removal during HPD. © 2021 Society of Chemical Industry.
Territorial pressure and tourism contribution to GDP: The case of Italian regions
Authors: Canale Rosaria Rita , De Siano Rita 
Published: May 2021

AbstractThis article focuses on long‐run co‐movement between tourists' arrivals and per capita income with the aim of evaluating, through a macroeconomic perspective, whether its excessive increase can be detrimental to economic development. To this aim, GDP per capita in Italian NUTS2 regions is connected, through a dynamic panel cointegrating technique, to arrivals and to a measure of touristic congestion (tourism territorial pressure index). Results show that tourism contributes to the increase of per capita GDP. However, when accounting for the congestion effect, the relation appears to be nonlinear, revealing a detrimental effect on growth driven by an excessive tourism pressure on territories.
The Diagnostic Contribution of Systematic Lung Ultrasonography in Patients Admitted to a Conventional Pulmonology Hospitalization Unit
Authors: Ramos‐Hernández Cristina , Botana‐Rial Maribel , Mouronte‐Roibas Cecilia , Núñez‐Fernández Marta , González‐Montaos Almudena , Caldera‐Díaz Adriana Carolina , Ruano‐Raviña Alberto , Fernández‐Villar Alberto 
Published: May 2021

ObjectiveAlthough the evidence to date remains limited, we hypothesized that performing protocolized lung ultrasound (LUS) in patients, admitted to a conventional pulmonology hospitalization unit, could improve diagnostic precision. The main objectives of this study were to evaluate the diagnostic contribution and changes in the treatments administered after performing a protocolized LUS in patients hospitalized in a Pulmonology Department ward.MethodologyThis was a prospective, observational study, which included patients admitted from the Emergency Department to a conventional Pulmonology Department hospitalization unit, after first being evaluated by a pulmonologist. LUS was performed within the first 48 hours of admission. The diagnosis at the time of discharge was used as the reference diagnosis.ResultsA total of 180 patients were included in this study. The admitting diagnoses were the decompensation of an underlying obstructive disease in 60 patients (33.3%), respiratory infection in 93 (51.7%), pulmonary thromboembolism (PE) in 9 (5%), exacerbation of an interstitial lung disease in 14 (7.8%), and other causes in 4 cases (2.2%). Ultrasonography provided new information, unsuspected at the patient's admission, in 117 (65%) of the patients by capturing images suggestive of infection in 63 patients (35%), 1 new case of ILD, 23 (12.7%) cases of cardiogenic edema, and pleural pathology in 19 (10.5%), as well as two tumors and indirect data related to a PE. The use of LUS resulted in the decision to change the already established treatment in 17.2% of the cases.ConclusionsLUS provided additive information in more than half of patients that ended up reclassifying or potentially changing diagnosis or treatment. Thus, including LUS in management algorithms could reduce the need for other complementary tests or unnecessary treatments.
Evidence for Above Cuff Vocalization in Patients With a Tracheostomy: A Systematic Review
Authors: Mills Claire S. , Michou Emilia , King Natalie , Bellamy Mark C. , Siddle Heidi J. , Brennan Cathy A. , Bojke Chris 
Published: May 2021

Objectives/HypothesisTo determine how above cuff vocalization (ACV) is implemented in clinical practice, to identify what evidence exists on the effectiveness and safety of ACV, and to evaluate the acceptability of ACV.Study DesignSystematic review.MethodsA literature search was conducted in eight databases (MEDLINE, Embase, AMED, CINAHL, Cochrane Library, PsycINFO, Scopus, and Web of Science) in May 2019 and updated in June 2020. Two reviewers independently screened, selected, and extracted data. Study quality was appraised using the Joanna Briggs Institute Critical Appraisal Tools and a narrative synthesis was conducted. Systematic review registration number: CRD42019133942.ResultsThe searches identified 1327 records. The 13 eligible studies included four case studies, three case series, four observational studies without a control group, one quasi‐experimental study, and one randomized controlled trial. Study quality was low, with most studies having high risk of bias. There was a high level of heterogeneity in study design and outcome measures used. Detailed information on ACV application and dose‐delivered was lacking in 12 studies. Positive effects were reported for communication (n = 7), swallowing (n = 4), cough response (n = 2), and quality‐of‐life (n = 2), but with inconsistent use of objective outcome measures. There is limited quantitative or qualitative evidence for acceptability. Adverse events and complications were reported in nine studies, and four highlighted the importance of involving an experienced speech and language therapist.ConclusionsThere is limited evidence for the acceptability, effectiveness, safety, or optimal implementation of ACV. The evidence is insufficient to provide recommendations regarding optimal intervention delivery. Future research should ensure detailed recording of ACV delivery and utilize a core outcome set. Laryngoscope, 132:600–611, 2022
A field guide to U.S. healthcare reform: The evolution to value‐based healthcare
Authors: Harrill Willard C. , Melon David E. 
Published: May 2021

AbstractObjectiveA consolidated state‐of‐the‐art review of U.S. healthcare reform efforts that documents the evolution towards value‐based healthcare (VBH) is lacking in peer‐review literature. This field guide attempts to clarify working definitions and conceptual boundaries within the lexicon of U.S. healthcare reform efforts that predated and have common thematic perspectives within the evolving VBH reform paradigm.Data SourcesPubmed/MEDLINE/Google search.Review MethodsPubmed/MEDLINE/Google search was performed during August 1, 2020‐January14, 2021 for U.S. healthcare reform terms, legislative and government agency publications. Those citing relevant legislative, regulatory, philosophical and technological advancements integral to the development and function of VBH were catalogued according to the targeted stakeholders and evolving reform strategy or technology.ConclusionsEight healthcare reform paradigms were identified as influential precursors to VBH: Patient‐Centered Care Model, Patient‐Centered Medical Home, Population Health, Personalized Medicine, P4 Medicine, Precision Medicine, Managed Care, and Accountable Care. Several of these models have similar nomenclature and, confusingly, many have multiple interpretations of the terms used to describe these models. However, consistent stakeholders identified within these paradigms are key to VBH; notably the patient, the physician and the payer (the “Big 3”). Demonstrable healthcare spending reductions have been best achieved when the Big 3 stakeholder interests are aligned within healthcare reform legislation. The definition of “Value” within each reform model was found to be based upon the perspective of the targeted stakeholder. Within VBH, the perspectives of the Big 3 stakeholders form a multidimensional meaning of “Value” that can be represented by the equation Value = Patient Experience Management3.
Fecal pellet production by mesozooplankton in the subarctic Northeast Pacific Ocean
Authors: Stamieszkin Karen , Steinberg Deborah K. , Maas Amy E. 
Published: May 2021

AbstractMesozooplankton fecal pellets sinking from the sea‐surface constitute an important component of the biological carbon pump, which is variable in part due to differences in zooplankton community composition on various scales. Particulate organic carbon production as fecal pellets by the entire mesozooplankton community has, until now, not been directly measured. We measured fecal pellet carbon (FPC) production rates of the mesozooplankton community separated into five size classes (0.2 to > 5.0 mm), and rates of key taxa, in the upper 100 m of the subarctic Northeast Pacific Ocean, August–September, 2018. We scaled up FPC production rates to total FPC production in the epipelagic zone, which was 2.8‐fold higher at night than day due to diel vertical migration. Despite its lower total biomass, the smallest size class (0.2–0.5 mm) contributed more FPC than other size classes (up to 81.6%), due to high weight‐specific FPC production rates (3.0 μgFPC mgDW−1 h−1). The pelagic tunicate Salpa aspera had the highest individual FPC production rate (7.5 μgFPC ind−1 h−1) and when present, contributed most to community FPC production (up to 82.3%). While the large copepod Neocalanus cristatus dominated the 2.0–5.0 mm fraction (up to ~ 100% by biomass), its FPC production rate was low (0.4 μgFPC mgDW−1 h−1), likely due to minimal feeding and gut shrinkage preceding diapause. Comparison of FPC production with export recorded in sediment traps suggests high attenuation of smaller pellet classes in the epipelagic (86%). Our results provide direct measurements of mesozooplankton FPC production in a “low‐production, low‐export” region.
Comparing Prochlorococcus temperature niches in the lab and across ocean basins
Authors: Smith Alaina N. , Hennon Gwenn M. M. , Zinser Erik R. , Calfee Benjamin C. , Chandler Jeremy W. , Barton Andrew D. 
Published: May 2021

AbstractNiche theory suggests that the realized niche occupied by an organism in the field is a subset of the fundamental niche space of the organism, absent additional biotic and abiotic factors. Though often assumed, this discrepancy is rarely tested for specific organisms, and could act as a source of error in model predictions of biogeographical shifts resulting from temperature change which assume niche theory constraints. Here, we quantify the difference between fundamental and realized temperature niches for four dominant ecotypes of Prochlorococcus, including eMED4, eMIT9312, eMIT9313, and eNATL2A, and ask whether the realized temperature niches of each ecotype vary across ocean basins. The realized niches for the four ecotypes are, on average, 3.84°C ± 1.18°C colder (mean ± SD across all ocean basins and ecotypes) and 2.15°C ± 1.89°C wider than the lab‐measured fundamental niches. When divided into four ocean regions—North Atlantic, South Atlantic, North Pacific, and South Pacific—we find that the realized temperature niche optimum for a given ecotype compared to the fundamental temperature niche optimum differs across regions by as much as 7.93°C, while the niche width can differ by up to 9.48°C. Colder and wider realized niches may be a result of the metabolic risk associated with living in variable environments when the mean temperature is too close to the optimal temperature for growth or due to physical processes such as dispersal. The strong differences in temperature niches across ocean basins suggest that unresolved genetic diversity within ecotypes, local adaptation, and variable interactive ecological and environmental factors are likely to be important in shaping Prochlorococcus realized temperature niches.