bluuebunny/crossref_metadata_2025_split huggingface dataset:
National Institute of Nursing Research Grant Funding Recipients: Hispanic and Nurses of Color Are Lagging
Authors: Kippenbrock Thomas , Emory Jan 
Published: March 2021

Introduction: National Institute of Health (NIH) stated in their strategic plan that a diverse research workforce is an important goal for the advancement of health care science; however, there is little evidence to show funding goes to National Institute of Nursing Research (NINR) minority nurse scientists. The study’s aim was to determine NINR grant recipients’ race/ethnicity, gender, and licensed nurse status. Methods: A descriptive research design was used with NIH providing NINR award recipients’ names and employing organizations. An online survey with questions about their gender, race, ethnicity, and being a licensed nurse was sent to 619 award recipients. Results: Survey responses were collected from 135 NINR recipients receiving awards. Almost 50% NINR grant recipients were non-nurses. With licensed nurse recipients, White female was the dominate race and gender. Hispanic licensed nurses were 6.8% of the NINR grant recipients over the 3-year period. In addition, Asians and Blacks were the lowest race categories at 4.1% award percentage over the 3-year period. Conclusions: NIH strategic plan is for a diverse research workforce in order to advance health care science. NINR must lead the efforts to grow a diverse nursing workforce including Hispanic and underrepresented nurses in order to successfully compete in NINR grants and funding.
Malpractice Litigation in Hand Surgery: A Comprehensive Nationwide Analysis
Authors: Umpierrez Erica , Ohliger Erin , Scollan Joseph P. , Styron Joseph F. 
Published: March 2021

Background: The circumstances surrounding claims against hand surgeons have not been elucidated in the literature. The purpose of this study was to analyze trends in malpractice litigation regarding hand surgery through a nationwide legal database. Methods: The Westlaw legal research database was queried for verdicts and settlements between 1985 and 2017 for hand surgery–related malpractice cases. Cases were included if the hand surgeon was sued for malpractice. Procedure type and complications and/or adverse events that resulted in litigation were recorded. Patient characteristics, state, date of case, case outcomes, and indemnity payment were also noted. All dollar amounts were adjusted to 2017 values using the Consumer Price Index. Results: In all, 171 cases (35 states) were included. The most frequently litigated surgeries were carpal tunnel releases followed by fracture treatment. Nerve injury was the predominant cause of litigation. The median nerve was predominantly injured, followed by the ulnar and radial nerves. In fracture surgery, malunion was the predominant cause, followed by weakness, nerve injury, and infection. In total, 72.5% of cases yielded verdicts in favor of the defense, 21.6% favored the plaintiff, and 5.9% were settled. Indemnity varied between $7800 and $8.99 million, averaging $570,397 for cases when the jury ruled in favor of the plaintiffs. Settled cases averaged $1,140,527. Conclusions: Malpractice litigation has substantial financial implications on surgeons and the health care system. Litigation arises most commonly from routine procedures (carpal tunnel release and fracture fixation) rather than complex surgical cases, potentially due to the high variability in operating surgeon subspecialization, with discrepant training.
Disparities in Telemedicine Use for Subspecialty Diabetes Care During COVID-19 Shelter-In-Place Orders
Authors: Haynes Sarah C. , Kompala Tejaswi , Neinstein Aaron , Rosenthal Jennifer , Crossen Stephanie 
Published: March 2021

Background: During the COVID-19 pandemic, telemedicine use rapidly and dramatically increased for management of diabetes mellitus. It is unknown whether access to telemedicine care has been equitable during this time. This study aimed to identify patient-level factors associated with adoption of telemedicine for subspecialty diabetes care during the pandemic. Methods: We conducted an explanatory sequential mixed-methods study using data from a single academic medical center. We used multivariate logistic regression to explore associations between telemedicine use and demographic factors for patients receiving subspecialty diabetes care between March 19 and June 30, 2020. We then surveyed a sample of patients who received in-person care to understand why these patients did not use telemedicine. Results: Among 1292 patients who received subspecialty diabetes care during the study period, those over age 65 were less likely to use telemedicine (OR: 0.34, 95% CI: 0.22-0.52, P < .001), as were patients with a primary language other than English (OR: 0.53, 95% CI: 0.31-0.91, P = .02), and patients with public insurance (OR: 0.64, 95% CI: 0.49-0.84, P = .001). Perceived quality of care and technological barriers were the most common reasons cited for choosing in-person care during the pandemic. Conclusions: Our findings suggest that, amidst the COVID-19 pandemic, there have been disparities in telemedicine use by age, language, and insurance for patients with diabetes mellitus. We anticipate telemedicine will continue to be an important care modality for chronic conditions in the years ahead. Significant work must therefore be done to ensure that telemedicine services do not introduce or widen population health disparities.
N-Acetylcysteine Interference with a Glucose Dehydrogenase Linked Glucose Meter
Authors: Lyon Martha E. , Lyon Andrew W. 
Published: March 2021

Background: Our objective was to determine the effect of therapeutic concentrations of N-acetylcysteine, following intravenous infusion, on the measurement of blood glucose using a Roche Diagnostics glucose dehydrogenase-linked glucose meter compared to hospital laboratory methods. Methods: N-acetylcysteine was added to aliquots of blood, with glucose promptly measured by the glucose meter, blood gas analyzer (glucose oxidase comparative method) and following centrifugation, plasma glucose measured with a hexokinase spectrophotometric comparative method. Glucose results were evaluated with linear regression and Bland Altman plots. Results: In the presence of NAC, at concentrations greater than 5 mg/dL (0.31 mmol/L), positively biased glucose meter results were compared to the clinical laboratory results. Multivariate linear regression revealed that NAC-mediated meter results are influenced by NAC and glucose concentrations. Conclusions: The addition of therapeutic concentrations of NAC to blood produces statistically significant positive biases when measured with the glucose dehydrogenase linked glucose meter device.
Gallbladder adenoma in a domestic shorthair cat
Authors: Broadbridge Catherine , Taylor Samantha S , Renfrew Helen , Gemignani Francesco , Livet Veronique , Vicek Tom , Dobromylskyj Melanie 
Published: March 2021

Case summary A 13-year-old neutered female domestic shorthair rescue cat presented asymptomatically with raised hepatic enzymes following a routine pre-anaesthetic blood test. Cholangitis was suspected, and supportive treatment with 2 weeks of amoxicillin–clavulanic acid and 4 weeks of ursodeoxycholic acid and S-adenosylmethionine was trialled, with no improvement in biochemistry parameters. Clinicopathological investigations also revealed a markedly raised total bilirubin and abnormal bile acid stimulation test. Abdominal ultrasonography revealed pathological changes in the gallbladder, hepatomegaly with increased echogenicity and markedly thickened common bile duct walls. An exploratory laparotomy was performed revealing a grossly abnormal gallbladder with a small rupture at the dorsal fundus, which was managed via cholecystectomy. Pancreatic and hepatic biopsies were collected concurrently. Histopathology from the submitted samples revealed a gallbladder adenoma, chronic neutrophilic cholangitis and nodular hyperplasia of the pancreas. Culture of the gallbladder bile was negative but may be attributable to the initial treatment with antibiosis. At the time of writing, 5 months postoperatively, the cat had recovered well and remained asymptomatic and clinically healthy, but hepatic enzymes and bilirubin were only mildly reduced from the preoperative levels, despite the cat remaining clinically normal. Relevance and novel information To our knowledge, this is the first case of a gallbladder adenoma confirmed histopathologically in a feline patient. Our findings suggest that although gallbladder neoplasia is rare in cats, this benign tumour should be considered a differential diagnosis.
Leg length discrepancy, overgrowth, and associated risk factors after a pediatric tibial shaft fracture
Authors: Choi Woo Young , Park Moon Seok , Lee Kyoung Min , Choi Kug Jin , Jung Hyon Soo , Sung Ki Hyuk 
Published: March 2021

Abstract
Background
This study was performed to investigate leg length discrepancy (LLD), overgrowth, and associated risk factors after pediatric tibial shaft fractures.

Materials and methods
This study included 103 patients younger than 14 years of age (mean age 7.1 years; 75 boys, 28 girls) with unilateral tibial shaft fracture and a minimum follow-up of 24 months. LLD was calculated as the difference between the lengths of the injured and uninjured limbs. Overgrowth was calculated by adding the fracture site shortening from the LLD. Risk factors were assessed in patients with LLD < 1 cm and ≥ 1 cm and overgrowth < 1 cm and ≥ 1 cm.

Results
Casting and titanium elastic nailing (TEN) were performed on 64 and 39 patients, respectively. The mean LLD and overgrowth were 5.6 and 6.4 mm, respectively. There were significant differences in sex (p = 0.018), age (p = 0.041), fibular involvement (p = 0.005), injury mechanism (p = 0.006), and treatment methods (p < 0.001) between patients with LLDs < 1 cm and ≥ 1 cm. There were significant differences in sex (p = 0.029), fibular involvement (p = 0.002), injury mechanism (p = 0.008), and treatment methods (p < 0.001) between patients with overgrowth < 1 cm and ≥ 1 cm. Sex and treatment methods were risk factors associated with LLD ≥ 1 cm and overgrowth ≥ 1 cm following pediatric tibial shaft fracture. The boys had a 7.4-fold higher risk of LLD ≥ 1 cm and 5.4-fold higher risk of overgrowth ≥ 1 cm than the girls. Patients who underwent TEN had a 4.3-fold higher risk of LLD ≥ 1 cm and 4.8-fold higher risk of overgrowth ≥ 1 cm than those treated by casting.

Conclusions
Patients undergoing TEN showed greater LLD and overgrowth than those undergoing casting, with boys showing greater LLD and overgrowth than girls. Surgeons should consider the possibility of LLD and overgrowth after pediatric tibial shaft fractures, especially when performing TEN for boys.

Level of evidence
Level III
Neonatal mortality among neonates admitted to NICU of Hiwot Fana specialized university hospital, eastern Ethiopia, 2020: a cross-sectional study design
Authors: Eyeberu Addis , Shore Hirpo , Getachew Tamirat , Atnafe Genanaw , Dheresa Merga 
Published: March 2021

Abstract
Background
In Ethiopia, neonatal mortality is unacceptably high. Despite many efforts made by the government and other partners to reduce neonatal mortality; it has been increasing since 2014. Factors associated with neonatal mortality were explained by different researchers indifferently. There is no clear evidence to identify the magnitude of neonatal mortality and associated factors in the study area. The study aimed to assess the magnitude and factors associated with neonatal mortality.

Methods

Facility-based cross-sectional study was conducted among 834 randomly selected neonates. The study was conducted from February 20 to March 21, 2020. Data were extracted from medical records using a checklist adapted from the World Health Organization, and neonatal registration book. The data were inserted into Epi-data version 3.1 and then exported into SPSS window version 20 for analysis. Bivariate and multivariate analyses were employed to identify the association between independent variables and the outcome variable.

Results
Magnitude of neonatal mortality was 14.4% (95% CI:11.9,16.7). Being neonates of mothers whose pregnancy was complicated with antepartum hemorrhage [AOR = 4.13, 95%CI: (1.92,8.85)], born from mothers with current pregnancy complicated with pregnancy-induced hypertension [AOR = 4.41, 95%CI: (1.97,9.86)], neonates of mothers with multiple pregnancy [AOR = 2.87, 95% CI (1.08,7.61)], neonates delivered at the health center [AOR = 5.05, 95%CI: (1.72,14.79)], low birth weight [AOR = 4.01, 95%CI (1.30,12.33)], having perinatal asphyxia [AOR =3.85, 95%CI: (1.83,8.10)], and having early-onset neonatal sepsis [AOR = 3.93, 95%CI: (1.84,8.41)] were factors significantly associated with neonatal mortality.

Conclusion
The proportion of neonatal mortality was relatively in line with other studies but still needs attention. Antepartum hemorrhage, Pregnancy-induced hypertension, place of delivery, low birth weight, having perinatal asphyxia, and having neonatal sepsis were independent factors. The hospital, and health care workers should give attention to neonates admitted to intensive care units by strengthening the quality of care given at neonatal intensive care unit like infection prevention and strengthening early detection and treatment of health problems during Antenatal care visit.
Are lifestyle factors significantly associated with self-rated health among Japanese female healthcare students?
Authors: Ohtsuki Makoto , Wakasugi Yusuke , Narukawa Takuhiro , Uehara Shunsuke , Ohkubo Takeshi 
Published: March 2021

Abstract
Background
Self-rated health (SRH), a subjective perception of an individual’s overall health, is widely used in public health assessment. The transition from adolescence to young adulthood is a critical period involving substantial changes in lifestyle and dietary habits. Therefore, it is important to understand SRH among young Japanese females. The present study aimed to investigate the relationships between SRH among female healthcare students and their lifestyle factors, such as living status (living with others or living alone), smoking habit, alcohol consumption, frequency of breakfast consumption (FBC), physical activity, insomnia, and physique recognition.

Methods
A cross-sectional survey was conducted on 1101 female healthcare students in Japan. The body mass index was calculated from the body height and weight using data from periodic health examinations. Self-reported sociodemographic, lifestyle or dietary habits, physical activity, and SRH were used through a self-administered questionnaire. Participants were classified as having either good SRH (excellent, very good, or good) or impaired SRH (fair or poor). Multivariate logistic regression analysis was performed to investigate the independent relationships between SRH and lifestyle factors.

Results
A total of 11.4% participants demonstrated impaired SRH. Multivariate logistic regression analysis showed that the University of California Los Angeles activity score, Athens Insomnia Scale, and physique recognition were associated with SRH.

Conclusions
It was suggested that public health activities that consider physical activity, sleep, and physique recognition may help maintain and improve SRH in female university students in Japan.
Simplified plasmid cloning with a universal MCS design and bacterial in vivo assembly
Authors: Chen Fan , Li Yi-ya , Yu Yan-li , Dai Jie , Huang Jin-ling , Lin Jie 
Published: March 2021

Abstract
Background
The ability to clone DNA sequences quickly and precisely into plasmids is essential for molecular biology studies. The recent development of seamless cloning technologies has made significant improvements in plasmid construction, but simple and reliable tools are always desirable for time- and labor-saving purposes.

Results
We developed and standardized a plasmid cloning protocol based on a universal MCS (Multiple Cloning Site) design and bacterial in vivo assembly. With this method, the vector is linearized first by PCR (Polymerase Chain Reaction) or restriction digestion. Then a small amount (10 ~ 20 ng) of this linear vector can be mixed with a PCR-amplified insert (5× molar ratio against vector) and transformed directly into competent E. coli cells to obtain the desired clones through in vivo assembly. Since we used a 36-bp universal MCS as the homologous linker, any PCR-amplified insert with ~ 15 bp compatible termini can be cloned into the vector with high fidelity and efficiency. Thus, the need for redesigning insert-amplifying primers according to various vector sequences and the following PCR procedures was eliminated.

Conclusions
Our protocol significantly reduced hands-on time for preparing transformation reactions, had excellent reliability, and was confirmed to be a rapid and versatile plasmid cloning technique. The protocol contains mostly mixing steps, making it an extremely automation-friendly and promising tool in modern biology studies.
A multilevel mixed-effects regression analysis of the association between hospital, community and state regulatory factors, and family income eligibility limits for free and discounted care among U.S. not-for-profit, 501(c)(3), hospitals, 2010 to 2017
Authors: Mose Jason N. 
Published: March 2021

Abstract
Background
Not-for-profit hospitals are facing an uncertain financial future, especially following the COVID-19 pandemic. Nevertheless, they are legally obligated to provide free and discounted health care services to communities. This study investigates the hospital, community, and state regulatory factors and whether these factors are associated with family income eligibility levels for free and discounted care.

Methods
Data were sourced from Internal Revenue Service Form 990, several data files from the Centers for Medicare and Medicaid, demographic and community factors from the Census Bureau, supplemental files from The Hilltop Institute, Community Benefit Insight, and Kaiser Family Foundation. The study employs multilevel mixed-effects linear and ordered logit regressions to estimate the association between the hospital, community, state policies, and the hospital’s family income eligibility limit for free and discounted care.

Results
A plurality of hospitals (49.96%) offered a medium level of family income eligibility limit (160–200% of the federal poverty level (FPL)) for free care. In comparison, about 53% (52.94%) offered a low level (0–300 of FPL) eligibility limit for discounted care. Holding all else equal, hospitals designated as critical access, safety net, those in rural areas or located in disadvantaged areas were associated with an increased probability of offering low eligibility limits for free and discounted care. Hospitals in a joint venture, located in highly concentrated markets or states with minimum community benefits requirements, were associated with an increased probability of offering high eligibility limits.

Conclusion
State and community factors appear to be associated with the eligibility level for free and discounted care. Hospitals serving low-income or rural communities seem to offer the least relief. The federal and state policymakers might need to consider relief to these hospitals with a requirement for them to provide a specific set of minimum community benefits.
A follow-up study shows that recovered patients with re-positive PCR test in Wuhan may not be infectious
Authors: Wu Xiaomin , Wang Zengmiao , He Zhenyu , Li Yapin , Wu Yating , Wang Huaiji , Liu Yonghong , Hao Fanghua , Tian Huaiyu 
Published: March 2021

Abstract
Background
Previous studies showed that recovered coronavirus disease 2019 (COVID-19) patients can have a subsequent positive polymerase chain reaction (PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) after they are discharged from the hospital. Understanding the epidemiological characteristics of recovered COVID-19 patients who have a re-positive test is vital for preventing a second wave of COVID-19.

Methods
This retrospective study analyzed the epidemiological and clinical features of 20,280 COVID-19 patients from multiple centers in Wuhan who had a positive PCR test between December 31, 2019, and August 4, 2020. The RT-PCR test results for 4079 individuals who had close contact with the re-positive cases were also obtained.

Results
In total, 2466 (12.16%) of the 20,280 patients had a re-positive SARS-CoV-2 PCR test after they were discharged from the hospital, and 4079 individuals had close contact with members of this patient group. All of these 4079 individuals had a negative SARS-CoV-2 PCR test.

Conclusions
This retrospective study in Wuhan analyzed the basic characteristics of recovered COVID-19 patients with re-positive PCR test and found that these cases may not be infectious.
Clinical and immunological effects of mRNA vaccines in malignant diseases
Authors: Heine Annkristin , Juranek Stefan , Brossart Peter 
Published: March 2021

AbstractIn vitro-transcribed messenger RNA-based therapeutics represent a relatively novel and highly efficient class of drugs. Several recently published studies emphasize the potential efficacy of mRNA vaccines in treating different types of malignant and infectious diseases where conventional vaccine strategies and platforms fail to elicit protective immune responses. mRNA vaccines have lately raised high interest as potent vaccines against SARS-CoV2. Direct application of mRNA or its electroporation into dendritic cells was shown to induce polyclonal CD4+ and CD8+ mediated antigen-specific T cell responses as well as the production of protective antibodies with the ability to eliminate transformed or infected cells. More importantly, the vaccine composition may include two or more mRNAs coding for different proteins or long peptides. This enables the induction of polyclonal immune responses against a broad variety of epitopes within the encoded antigens that are presented on various MHC complexes, thus avoiding the restriction to a certain HLA molecule or possible immune escape due to antigen-loss. The development and design of mRNA therapies was recently boosted by several critical innovations including the development of technologies for the production and delivery of high quality and stable mRNA. Several technical obstacles such as stability, delivery and immunogenicity were addressed in the past and gradually solved in the recent years.This review will summarize the most recent technological developments and application of mRNA vaccines in clinical trials and discusses the results, challenges and future directions with a special focus on the induced innate and adaptive immune responses.