bluuebunny/crossref_metadata_2025_split huggingface dataset:
Apical amplification—a cellular mechanism of conscious perception?
Authors: Marvan Tomáš , Polák Michal , Bachmann Talis , Phillips William A 
Published: October 2021

AbstractWe present a theoretical view of the cellular foundations for network-level processes involved in producing our conscious experience. Inputs to apical synapses in layer 1 of a large subset of neocortical cells are summed at an integration zone near the top of their apical trunk. These inputs come from diverse sources and provide a context within which the transmission of information abstracted from sensory input to their basal and perisomatic synapses can be amplified when relevant. We argue that apical amplification enables conscious perceptual experience and makes it more flexible, and thus more adaptive, by being sensitive to context. Apical amplification provides a possible mechanism for recurrent processing theory that avoids strong loops. It makes the broadcasting hypothesized by global neuronal workspace theories feasible while preserving the distinct contributions of the individual cells receiving the broadcast. It also provides mechanisms that contribute to the holistic aspects of integrated information theory. As apical amplification is highly dependent on cholinergic, aminergic, and other neuromodulators, it relates the specific contents of conscious experience to global mental states and to fluctuations in arousal when awake. We conclude that apical dendrites provide a cellular mechanism for the context-sensitive selective amplification that is a cardinal prerequisite of conscious perception.
Needs of Children and Families during Spring 2020 COVID-19 School Closures: Findings from a National Survey
Authors: Watson Kate R , Astor Ron Avi , Benbenishty Rami , Capp Gordon , Kelly Michael S 
Published: October 2021

Abstract
Despite extensive reports during the COVID-19 pandemic of the academic challenges facing students, and the effects of online learning on academic achievements, we have little information regarding the needs and difficulties of K–12 students and their families from a social work perspective. The present article shares findings from a nationwide survey of 1,275 school social workers (SSWs) reporting on their clients—schools, children, and families—during the spring 2020 COVID-19 school closures. SSWs indicated that the children and families they served had significant unmet basic needs, including for food, healthcare, and housing. Poverty and mental health compounded pandemic difficulties, which were associated with the sociodemographic makeup of schools. Student engagement in social work services during the closures was significantly lower than prepandemic levels, generally due to unmet material needs. Several policy and practice implications arise from these findings, including a need for additional services for students and families, a plan to address structural inequities in our schools and communities, coordinated outreach to reengage missing students, and recognition of the strong work being done by school staff coupled with a need for additional supports and resources to combat persistent inequality.
Nucleotide Substitutions during Speciation may Explain Substitution Rate Variation
Authors: Janzen Thijs , Bokma Folmer , Etienne Rampal S 
Published: October 2021

Abstract
Although molecular mechanisms associated with the generation of mutations are highly conserved across taxa, there is widespread variation in mutation rates between evolutionary lineages. When phylogenies are reconstructed based on nucleotide sequences, such variation is typically accounted for by the assumption of a relaxed molecular clock, which is a statistical distribution of mutation rates without much underlying biological mechanism. Here, we propose that variation in accumulated mutations may be partly explained by an elevated mutation rate during speciation. Using simulations, we show how shifting mutations from branches to speciation events impacts inference of branching times in phylogenetic reconstruction. Furthermore, the resulting nucleotide alignments are better described by a relaxed than by a strict molecular clock. Thus, elevated mutation rates during speciation potentially explain part of the variation in substitution rates that is observed across the tree of life. [Molecular clock; phylogenetic reconstruction; speciation; substitution rate variation.]
Assessment of bovine respiratory disease progression in calves challenged with bovine herpesvirus 1 and Mannheimia haemolytica using point-of-care and laboratory-based blood leukocyte differential assays
Authors: Baruch Joaquin , Cernicchiaro Natalia , Cull Charley A , Lechtenberg Kelly F , Nickell Jason S , Renter David G 
Published: October 2021

Abstract
Blood leukocyte differentials can be useful for understanding changes associated with bovine respiratory disease (BRD) progression. By improving turnaround time, point-of-care leukocyte differential assays (PCLD) may provide logistical advantages to laboratory-based assays. Our objective was to assess BRD progression in steers challenged with bovine herpesvirus 1 and Mannheimia haemolytica using point-of-care and laboratory-based blood leukocyte differentials. Thirty Holstein steers (average body weight of 211 kg + 2.4 kg) were inoculated intranasally on day 0 with bovine herpesvirus 1 and intrabronchially on day 6 with Mannheimia haemolytica. Blood leukocytes differentials were measured using both assays from study days 0 to 13. Linear mixed models were fitted to evaluate the associations between: (1) the type of assay (laboratory-based or PCLD) with respect to leukocyte, lymphocyte, and neutrophil concentrations; (2) study day with cell concentrations; and (3) cell concentrations with lung consolidation measured at necropsy. Point-of-care leukocyte, lymphocyte, and neutrophil concentrations were significantly associated (P &lt; 0.05) with the respective cell concentrations obtained from the laboratory-based leukocyte differential. Cell concentrations reported by both assays differed significantly (P &lt; 0.05) over time, indicating shifts from healthy to viral and bacterial disease states. Lymphocyte concentrations, lymphocyte/neutrophil ratios obtained from both assays, and band neutrophil concentrations from the laboratory-based assay were significantly associated (P &lt; 0.05) with lung consolidation, enhancing assessments of disease severity. The PCLD may be a useful alternative to assess BRD progression when laboratory-based leukocyte differentials are impractical.
Question Prompt List as a Communication Tool for Adults With Gastroesophageal Reflux Disease
Authors: Kamal Afrin , Achkar Edgar , Carlson Dustin , Clarke John , Fass Ronnie , Gyawali Chandra Prakash , Katzka David A. , Patel Dhyanesh , Penagini Roberto , Rezaie Ali , Roman Sabine , Savarino Edoardo , Shaheen Nicholas J. , Triadafilopoulos George 
Published: October 2021

Background:
Question prompt lists (QPLs) are structured sets of disease-specific questions intended for patient use, enhancing the patient-physician communication by encouraging patients to ask relevant questions during a consultation. Recently, a preliminary 78 question gastroesophageal reflux disease (GERD) specific QPL was created by 12 esophageal experts through a modified Delphi (RAND/University of California, Los Angeles) technique. Patients’ perspectives and opinions on each question, however, had not been accounted for in the preliminary expert’ version.

Aim:
The aim was to modify a preliminary experts’ QPL, specific to adults with GERD, following patient perspectives and opinions.

Methods:
A preliminary GERD QPL was modified through patient input and opinions. Thirty-eight patients with a clinical diagnosis of GERD followed at Stanford University Esophageal Clinic between January and November 2019 were consented to modify the preliminary 78 question expert QPL version. After receiving the QPL in Qualtrics (Provo, UT) by a direct e-mail invitation, patients independently rated questions on a 5-point Likert scale, where 1=“should not be included,” 2=“unimportant,” 3=“don’t know/depends,” 4=“important,” and 5=“essential.” Questions were accepted for inclusion in the QPL with an a priori interagreement of 80% ranking in the range of 4 to 5. At the end, patients were encouraged to propose additional questions to incorporate into the QPL by open-endedly asking “Are there questions we didn’t ask, that you think we should?”

Results:
Twenty-three patients with GERD (19 female, median age 64) fully participated and modified the existing QPL (60.5%). Of the 78 questions from the preliminary GERD QPL, 66 questions (84.6%) were accepted for inclusion. The question with the highest agreement among patients rating a question as essential consisted of “what habits, food, and drinks do I have to avoid?” (82.6%). Questions eliminated because of disagreement included “What is the natural history of GERD,” “Do I have a high chance to die from my Barrett’s?,” and “Why are you prescribing an antidepressant to treat my GERD?” Nine patients suggested additional questions totaling to 16 separate questions, including “What type of surgeries are there to help GERD?,” “What stage is my GERD?,” “What are the odds/percentage of getting cancer from GERD?” Incorporating the suggested questions, the final GERD QPL—created by esophageal experts and modified by patients—consisted of 82 questions.

Conclusion:
Esophageal experts and GERD patients have a high level of agreement on important questions, though there is some variation in perspective. Future studies can simplify this list and measure the impact of a shared GERD QPL on patients’ decisional conflict and perceived involvement in care.
The Attitude of Practitioners Towards Endoscopic Sleeve Gastroplasty
Authors: Badurdeen Dilhana , Farha Jad , Fayad Lea , Abbarh Shahem , Singh Gagandeep , Jovani Manol , Hedjoudje Abdellah , Adam Atif , Alqahtani Aayed , Neto Manoel G. , Kumbhari Vivek 
Published: October 2021

Background and Aim:
Despite widespread adoption and encouraging results seen over the last 5 years, no consensus exists regarding the endoscopic sleeve gastroplasty (ESG) technique, training, or preprocedure and postprocedure management of the patient. The aim of our survey was to assess practice trends and preferences of bariatric endoscopists with respect to ESG.

Methods:
Using a digital platform, we conducted a worldwide survey by emailing a link with an electronic questionnaire to 1200 bariatric endoscopists trained to perform endoscopic suturing using the Apollo Overstitch suturing device (Apollo Endosurgery).

Results:
We received 221 responses that were included in the analysis. Fifty-one responders (36.4%) required 1 to 10 procedures, and 37 (26.4%) needed 11 to 20 procedures to become proficient at ESG. Ninety-six (68.6%) stated that lower body mass index thresholds should be adopted for Asian and Arab patients. There was no consensus on the ideal number of sutures, with 45 (32.1%), 42 (30%), 36 (25.7%), 13 (9.3%), and 4 (2.9%) recommending 4 to 6, 5 to 7, 6 to 8, 7 to 9, and 8 to 12 sutures, respectively. The primary barriers to establishing an endobariatric program were the inability to establish a cash pay model, 77 (95.1%); lack of institutional support, 61 (75.3%); and difficulty in establishing an ambulatory surgical center/hospital to perform ESG, 73 (90.1%).

Conclusions:
ESG practice trends remain heterogenous among practitioners in regard to indication, technique, and preprocedure and postprocedure management. Specific ESG guidelines are warranted, and this survey will assist in providing the framework for these guidelines to be written.
Bleeding From Band Ligation–induced Ulcers Following the Treatment of Esophageal Varices
Authors: Hu Zixuan , Liu Shaojun , Liu Tao , Zhu Wei , Li Jiake 
Published: October 2021

Goal:
Our study aimed to explore the incidence of bleeding from ulcers due to premature band slippage and to identify possible associated factors.

Background:
Band ligation (BL) plays a vital role in treating esophageal varices; however, the procedure carries a considerable risk of band slippage, variceal site ulcer formation, and posttreatment bleeding.

Materials and Methods:
We retrospectively reviewed the records of patients with esophageal varices who underwent endoscopic hemostasis by BL at our institution between 2015 and 2020. We statistically compared the patients with post-BL ulcer bleeding and those without (controls). The outcome variable was the development of BL-induced ulcer bleeding. The patients’ demographics, clinical, and laboratory parameters, and BL procedure parameters were independent variables. Univariate followed by a multivariate logistic regression were performed to identify possible associated factors from the odds ratio (OR).

Results:
Of the 4579 eligible patients, 388 (8.5%) presented with post-BL ulcer bleeding. The presence of high-risk stigmata indicated a 1.271 times higher risk of bleeding [95% confidence interval (CI):1.018-1.587], and a greater number of varices was associated with an increased risk of post-BL ulcer bleeding [OR=1.184 (95% CI: 1.073-1.307)]. Conversely, the use of fewer bands per variceal site was associated with fewer bleeding incidents [OR=1.308 (95% CI: 1.090-1.569)]. Univariate analysis identified proton pump inhibitor as protective [OR=0.770 (95% CI: 0.603-0.983)]; however, the difference was not significant after multivariate analysis [OR=1.283 (95% CI: 1.003-1.640)].

Conclusions:
The overall incidence of post-BL ulcer bleeding was 8.5%. The presence of high-risk stigmata, higher number of varices, and bands per variceal site were associated with an increased risk of post-BL bleeding. The effect of adjuvant proton pump inhibitors was not statistically significant.
The Pandemic Within the Pandemic
Authors: Sohal Aalam , Khalid Sameeha , Green Victoria , Gulati Alakh , Roytman Marina 
Published: October 2021

Background and Aim:
The third leading preventable cause of death in the United States is excessive alcohol consumption. Our study sought to assess the impact of the coronavirus disease 2019 (COVID-19) on hospitalizations for alcohol-related hepatitis at a community hospital system. We hypothesized an increase in cases of alcohol-related hepatitis requiring inpatient management, mirroring the strain on economic and societal norms imposed by the COVID-19 pandemic.

Approach/Results:
We performed a retrospective chart review to study the incidence of alcohol-related hepatitis in patients presenting to 3 community hospitals in Fresno, California, before and during the COVID-19. Data including patient demographics, markers of disease severity, and clinical course were extracted from electronic medical records for 329 patients included in the study. There was a 51% increase in the overall incidence of alcohol-related hepatitis requiring hospitalization between 2019 and 2020 (P=0.003) and 69% increase (P<0.001) after implementation of the stay-at-home orders. In addition, 94% (P=0.028) increase in rehospitalizations was noted in 2020 (P=0.028), a 100% increase in patients under the age of 40 (P=0.0028), as well as a trend towards a 125% increase (P=0.06) of female patients admitted with this diagnosis during the COVID-19 pandemic.

Conclusions:
Our study revealed drastic increases in severe alcohol-related hepatitis requiring inpatient management, specifically in patients under the age of 40 and in women during the COVID-19 pandemic. Given the high morbidity and mortality associated with severe alcohol-related hepatitis, these findings have far-reaching and lasting implications for our already strained health care system extending beyond the COVID-19 pandemic timeframe. Urgent public health interventions are needed to combat the rising misuse of alcohol and its consequences.
Quality and Safety in Healthcare, Part XCI
Authors: Harolds Jay A. 
Published: October 2021

Abstract
Lean thinking refers to the thought processes utilizing the main characteristics of Lean to improve processes, reduce waste, and increase value to the customer. Lean thinking can be used to improve health care organizations using such tools as the A3 form, root-cause analysis, value stream maps, Gemba walks, kaizen events, and defining standard work. Examples are given about how Lean thinking improved scheduling and productivity, as well as better compliance regarding core measures and adherence to best practices. Lean thinking examples are also given which resulted in less need for space, inventory, and personnel, and a decrease in hospital-acquired infections.
Presacral Benign Schwannoma Mimics Malignancy on 18F-FDG and 68Ga-FAPI PET/CT
Authors: Zhu Yahua , Wu Junhao , Wang Yingwei , Geng Jun , Zhang Chunyin 
Published: October 2021

Abstract
We present findings of FDG PET/CT and FAPI PET/CT in a 55-year-old woman with a history of black stools and low-back pain. Pelvic CT detected a giant presacral mass that was suspected to be malignant. 18F-FDG and 68Ga-FAPI PET/CT showed that the mass had intense activity. Pathological examination confirmed the mass as a benign schwannoma.
Incidence of SARS-CoV-2 infection in a cohort of workers from the University of Porto
Authors: Costa Joana Pinto , Meireles Paula , Rodrigues Pedro N. S. , Barros Henrique 
Published: October 2021

AbstractBackgroundRepeated serosurveys in the same population provide more accurate estimates of the frequency of SARS-CoV-2 infection and more comparable data than notified cases. We aimed to estimate the incidence of SARS-CoV-2 infection, identify associated risk factors, and assess time trends in the ratio of serological/molecular diagnosis in a cohort of university workers.MethodsParticipants had a serological rapid test for SARS-CoV-2 Immunoglobulins M and G, and completed a questionnaire, in May-July 2020 (n=3628) and November 2020–January 2021 (n=2661); 1960 participated in both evaluations and provided data to compute the incidence proportion and the incident rate. Crude and adjusted incidence rate ratios (aIRR) and 95% confidence intervals (CI) were computed using generalised linear models with Poisson regression.ResultsThe incidence rate was 1.8/100 person-month (95%CI 1.6-2.1), and the 6 months’ cumulative incidence was 10.7%. The serological/molecular diagnosis ratio was 10:1 in the first evaluation and 3:1 in the second. Considering newly identified seropositive cases at the first (n=69) and second evaluation (n=202), 29.0% and 9.4% never reported symptoms, respectively, 14.5% and 33.3% reported contact with a confirmed case and 82.6%, and 46.0% never had a molecular test. Males (aIRR: 0.59; 95%CI: 0.42-0.83) and “high-skilled white-collar” workers (aIRR: 0.73, 95%CI: 0.52-1.02) had lower incidence of infection.ConclusionUniversity workers presented a high SARS-CoV-2 incidence while restrictive measures were in place. The time decrease in the proportion of undiagnosed cases reflected the increased access to testing, but opportunities continued to be missed, even in the presence of COVID-19 like symptoms.What is already known on this subjectThe median ratio of seroprevalence to the corresponding cumulative incidence is 18, however, there is great variability between studies.Seroprevalence studies are essential to estimate the true burden of the infection.Few cohort studies focused on essential non-healthcare workers, such as university workers.What this study addsThis longitudinal seroprevalence study among university workers found a SARS-CoV-2-specific IgM or IgG incidence rate of 1.8/100 person-month, and a 6 months’ cumulative incidence of 10.7%.The undiagnosed fraction was 3:1 in the second evaluation, representing a decrease from a 10:1 in the first evaluation in the same population showing that a gap to test-trace-isolate remained in this highly educated working population.Seropositive participants were mostly pauci- or symptomatic with no known contact with a COVID-19 confirmed case; “high-skilled white-collar” workers were at lower risk of being an incident seropositive case.
Estimating COVID-19 Hospitalizations in the United States with surveillance data using a Bayesian Hierarchical model
Authors: Couture A , Iuliano AD , Chang HH , Patel NN , Gilmer M , Steele M , Havers FP , Whitaker M , Reed C 
Published: October 2021

ABSTRACTIntroductionIn the United States, COVID-19 is a nationally notifiable disease, cases and hospitalizations are reported to the CDC by states. Identifying and reporting every case from every facility in the United States may not be feasible in the long term. Creating sustainable methods for estimating burden of COVID-19 from established sentinel surveillance systems is becoming more important. We aimed to provide a method leveraging surveillance data to create a long-term solution to estimate monthly rates of hospitalizations for COVID-19.MethodsWe estimated monthly hospitalization rates for COVID-19 from May 2020 through April 2021 for the 50 states using surveillance data from COVID-19-Associated Hospitalization Surveillance Network (COVID-NET) and a Bayesian hierarchical model for extrapolation. We created a model for six age groups (0-17, 18-49, 50-64, 65-74, 75-84, and ≥85 years), separately. We identified covariates from multiple data sources that varied by age, state, and/or month, and performed covariate selection for each age group based on two methods, Least Absolute Shrinkage and Selection Operator (LASSO) and Spike and Slab selection methods. We validated our method by checking sensitivity of model estimates to covariate selection and model extrapolation as well as comparing our results to external data.ResultsWe estimated 3,569,500 (90% Credible Interval:3,238,000 – 3,934,700) hospitalizations for a cumulative incidence of 1,089.8 (988.6 – 1,201.3) hospitalizations per 100,000 population with COVID-19 in the United States from May 2020 through April 2021. Cumulative incidence varied from 352 – 1,821per 100,000 between states. The age group with the highest cumulative incidence was aged ≥85 years (5,583.1; 5,061.0 – 6,157.5). The monthly hospitalization rate was highest in December (183.8; 154.5 – 218.0). Our monthly estimates by state showed variations in magnitudes of peak rates, number of peaks and timing of peaks between states.ConclusionsOur novel approach to estimate COVID-19 hospitalizations has potential to provide sustainable estimates for monitoring COVID-19 burden, as well as a flexible framework leveraging surveillance data.
Predicting sensitivity and resilience to modifiable risk factors for cardiometabolic morbidity and mortality
Authors: Pomares-Millan Hugo , Atabaki-Pasdar Naemieh , Johansson Ingegerd , Poveda Alaitz , Franks Paul W. 
Published: October 2021

AbstractBackgroundLifestyle exposures play a major role in the development of disease, yet people vary in their susceptibility. A critical step towards precision medicine is identifying individuals who are resilient or sensitive to the environment, and, assess whether the allocation to these predicted groups are more or less likely to develop cardiometabolic disease.MethodsWe have used repeated data from the VHU study (n=35440) to identify sensitive and resilient individuals using prediction intervals at the 5thand 95thquantile. Three exposure susceptibility groups were derived per cardiometabolic score using quantile regression forests in the training dataset; next, in the validation dataset, we assessed the different risks of the groups using Cox proportional hazard models for CVD and diabetes.ResultsThe results of our study suggest that, after ∼10 y of follow-up, individuals with sensitivity to the environmental exposures associated with systolic and diastolic blood pressure, blood lipids, and glucose were at higher risk of developing cardiometabolic disease. Moreover, when hazards were pooled with the replication cohort, for those individuals sensitive to the exposures associated with blood pressure traits, the hazards remained significant.ConclusionsIdentifying individuals who are predicted to be sensitive are at higher risk of developing disease, this population may be a clinical target for prevention or early intervention and public health strategies.