bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is relational continuity of care as important to people as policy makers think? Preferences for continuity of care in primary care
Authors: Norwood Patricia , Correia Isabel , Heidenreich Sebastian , Veiga Paula , Watson Verity 
Published: February 2021

Abstract

Background
In 2005, the Portuguese government launched a Primary Care reform that aimed to reinforce continuity of care. After a promising start, the reform is still incomplete and continuity has been compromised by the lack of General Practice doctors.

Objective
This study evaluates public preferences for relational continuity of care alongside other attributes of Primary Care services in Portugal.

Methods
We use a discrete choice experiment (DCE) to evaluate preferences and estimate the population’s willingness to pay (WTP) for Primary Care attributes. We use a sequential, mixed-methods approach to develop a D-efficient fractional factorial design for the DCE. Five attributes were included in the DCE and there were 32 DCE choice sets. The data collection was conducted in 2014 and the final sample had 517 respondents. A random parameters multinomial logit was used to analyse the data.

Results
We find that respondents value relational continuity of care, but that the current focus of the Portuguese NHS on relational continuity at the expense of other attributes is too simplistic.

Conclusions
Relational continuity should be part of a broader policy that emphasizes person-centred care and considers the preferences of patients for Primary Care attributes.
In silico identification of key regulators instigating the pre-meiotic phase during respiration in Saccharomyces cerevisiae
Authors: Das Deepyaman , Sarkar Hironmoy , Podder Soumita 
Published: February 2021

ABSTRACT
Like higher eukaryotes, diploid MATa/MATα budding yeasts can undergo both mitosis and meiosis. Although the potential reason for their phase switching is elucidated by two consecutive processes, i.e. transition from fermentation (mitotic growth) to respiration in glucose-deficient media and then complete shift to meiotic phase in combined nitrogen- and glucose-starved media, the genomic interactions and regulatory cascade operating this drive remain elusive. Here, we aim to explore the regulatory cross-talk that mediates the phase transition. We have hypothesized that pre-growth in glucose-starved condition (yeast extract–peptone–acetate media) not only causes switch from fermentation to respiration but also prepares them for meiosis via a myriad of signaling events regulated by transcription factors (TFs). We have identified 23 putative TFs from integrated protein–protein interaction and gene regulatory network that were reconstructed from predicted and experimentally validated data. A total of six TFs (Xbp1p, Abf1p, Cbf1p, Ste12p, Reb1p and Gcn4p) are found to be highly connected in the network and involved in the cross-talk between respiration and cellular preparation for meiosis. We have identified Abf1p and Adr1p as the master regulators of the integrated network. This study in yeast will help to decipher the pre-meiotic initiation that occurs in higher eukaryotes.
Multifrequency inversion of global ambient seismic sources
Authors: Ermert L A , Sager K , Nissen-Meyer T , Fichtner A 
Published: February 2021

SUMMARYWe develop and apply a method to constrain the space- and frequency-dependent location of ambient noise sources. This is based on ambient noise cross-correlation inversion using numerical wavefield simulations, which honour 3-D crustal and mantle structure, ocean loading and finite-frequency effects. In the frequency range from 3 to 20 mHz, our results constrain the global source distribution of the Earth’s hum, averaged over the Southern Hemisphere winter season of 9 yr. During Southern Hemisphere winter, the dominant sources are largely confined to the Southern Hemisphere, the most prominent exception being the Izu-Bonin-Mariana arc, which is the most active source region between 12 and 20 mHz. Generally, strong hum sources seem to be associated with either coastlines or bathymetric highs. In contrast, deep ocean basins are devoid of hum sources. While being based on the relatively small number of STS-1 broad-band stations that have been recording continuously from 2004 to 2013, our results demonstrate the practical feasibility of a frequency-dependent noise source inversion that accounts for the complexities of 3-D wave propagation. It may thereby improve full-waveform ambient noise inversions and our understanding of the physics of noise generation.
Deciphering the structural attributes of protein–heparan sulfate interactions using chemo-enzymatic approaches and NMR spectroscopy
Authors: Préchoux Aurélie , Simorre Jean-Pierre , Lortat-Jacob Hugues , Laguri Cédric 
Published: February 2021

Abstract
Heparan sulfates (HS) is a polysaccharide found at the cell surface, where it mediates interactions with hundreds of proteins and regulates major pathophysiological processes. HS is highly heterogeneous and structurally complex and examples that define their structure–activity relationships remain limited. Here, in order to characterize a protein–HS interface and define the corresponding saccharide-binding domain, we present a chemo-enzymatic approach that generates 13C-labeled HS-based oligosaccharide structures. Nuclear magnetic resonance (NMR) spectroscopy, which efficiently discriminates between important or redundant chemical groups in the oligosaccharides, is employed to characterize these molecules alone and in interaction with proteins. Using chemokines as model system, docking based on NMR data on both proteins and oligosaccharides enable the identification of the structural determinant involved in the complex. This study shows that both the position of the sulfo groups along the chain and their mode of presentation, rather than their overall number, are key determinant and further points out the usefulness of these 13C-labeled oligosaccharides in obtaining detailed structural information on HS–protein complexes.
Who will drop out of voluntary social health insurance? Evidence from the New Cooperative Medical Scheme in China
Authors: Xu Mingming , Yang Wei 
Published: February 2021

AbstractAlthough public voluntary health insurance (VHI) has been adopted in many low- and middle-income countries to improve access to care for the population, a common issue with VHI is its high dropout rate. Using the New Cooperative Medical Scheme (NCMS)—a public VHI in China—as a case study, this article employs a fixed-effects negative binomial regression model combining the difference-in-difference-in-differences approach and multivariate distance matching to examine the factors associated with dropping out and the impact of dropout on outpatient care utilization among middle-aged and older people in rural China. Drawing data from the China Health and Retirement Longitudinal Study, our results showed that healthy people, vulnerable people and people who use less healthcare tended to drop out. Dropout had a significant negative impact on outpatient care utilization, especially for those with worse health statuses and those living in poorer provinces. We also found that the impact of dropout on outpatient utilization was more pronounced at secondary and tertiary hospitals than at primary care clinics. We urge policymakers to rethink the design of the NCMS by waiving premiums for the most vulnerable people.
The Highland Society of London, material culture and the development of Scottish military identity, 1798–1817
Authors: Watt Patrick 
Published: February 2021

Abstract
The image of the Highland soldier as a brave, loyal warrior was central to nineteenth-century notions of Scottish national identity. This article uses material culture evidence alongside traditional archival sources to provide an interdisciplinary explanation of how the military dimension of Scottish identity was shaped in the early nineteenth century. It finds that it was the responses of the Highland Society of London to Scottish battlefield valour – rather than the actions themselves – that created the enduring popular perception of the Highland soldier as a desirable national symbol and as an icon of empire.
Integrative analyses of scRNA-seq and scATAC-seq reveal CXCL14 as a key regulator of lymph node metastasis in breast cancer
Authors: Xu Kun , Zhang Wenwen , Wang Cong , Hu Longfei , Wang Runtian , Wang Cenzhu , Tang Lin , Zhou Guohua , Zou Bingjie , Xie Hui , Tang Jinhai , Guan Xiaoxiang 
Published: February 2021

Abstract
The potentially different genetics and epigenetics in the primary tumors and metastases affect the efficacy of treatment in breast cancer patients. Nevertheless, the cellular and molecular mechanisms of breast cancer lymph node metastasis still remain elusive. Here, we employed single-cell RNA sequencing to acquire the transcriptomic profiles of individual cells from primary tumors, negative lymph nodes (NLs) and positive lymph nodes (PLs). We also performed a single-cell assay for transposase-accessible chromatin (ATAC) sequencing (scATAC-seq) of the positive and NL samples to get the chromatin accessibility profile. We identified a novel cell subpopulation with an abnormally high expression level of CXCL14 in the PL of breast cancer patients. Cell trajectory analysis also revealed that CXCL14 was increased expressed in the late pseudo-time. Moreover, based on a tissue microarray of 55 patients and the Oncomine database, we validated that CXCL14 expression was significantly higher in breast cancer patients with lymph node metastasis. Furthermore, scATAC-seq identified several transcription factors that may be potential regulation factors for the lymph node metastasis of breast cancer. Thus, our findings will improve our current understanding of the mechanism for lymph node metastasis, and they are potentially valuable in providing novel prognosis markers for the lymphatic metastasis of breast cancer.
Blood metal levels after minimally invasive repair of pectus excavatum
Authors: Torre Michele , Genova Gaia Luca , Calevo Maria Grazia , Wong Michela , Raso Maria , Barco Sebastiano , Di Gaudio Francesca , Cangemi Giuliana 
Published: February 2021

Abstract

OBJECTIVES
Minimally invasive repair of pectus excavatum (MIRPE) is the most popular surgical approach for paediatric patients with pectus excavatum. A substernal stainless still bar is inserted and left in place for 3 years and then removed. Our goal was to investigate blood metal levels after MIRPE and to correlate them with surgical details, such as the numbers of bars and stabilizers and the length of time the bar was in place.

METHODS
Blood levels of iron, chromium, manganese, molybdenum and nickel were analysed in 130 teenagers (108 boys and 22 girls) who had MIRPE using inductively coupled plasma mass spectrometry. A total of 62 patients were operated on using MIRPE (study group) and 68 patients were evaluated at implant time (control group). Differences between the numbers of bars implanted and the presence or absence of stabilizers were also considered.

RESULTS
Significant increases in the levels of abnormal chromium were found in patients in the study group compared with the controls (P = 0.02). When we compared the group of patients with 2 or more bars with the group with 1 bar, the percentage of patients with a value above the threshold increased by 29 (P = 0.05). A significant increase in chromium levels was observed in patients with stabilizers (P = 0.03). Above-threshold levels of molybdenum were found in 5.1% of patients in the control group, but the number was not statistically significant (P = 0.09).

CONCLUSIONS
We demonstrated that stainless steel devices used in MIRPE can elevate blood metal levels in paediatric patients. Moreover, we demonstrated that the use of metal stabilizers is associated with higher metal levels, probably due to increased dispersion.
Etiology and Diagnosis of Pelvic Inflammatory Disease: Looking Beyond Gonorrhea and Chlamydia
Authors: Mitchell Caroline M , Anyalechi Gloria E , Cohen Craig R , Haggerty Catherine L , Manhart Lisa E , Hillier Sharon L 
Published: February 2021

AbstractPelvic inflammatory disease (PID) is a clinical syndrome that has been associated with a wide range of potential causal pathogens. Three broad groups of organisms have been isolated from the genital tract of people with PID: sexually transmitted organisms such as Neisseria gonorrhoeae, Chlamydia trachomatis, Mycoplasma genitalium, and Trichomonas vaginalis; bacterial vaginosis (BV)-associated species and genera such as Atopobium vaginae, Sneathia, and Megasphaera; and genera and species usually associated with the gastrointestinal or respiratory tracts such as Bacteroides, Escherichia coli, Streptococcus, or Haemophilus influenza. Although PID is often considered to be synonymous with gonorrhea or chlamydia, these pathogens are found in only one quarter to one third of people with PID, suggesting that broader screening and diagnostic and treatment strategies need to be considered to reduce the burden of PID and its associated sequelae.
Long-Term Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Infectiousness Among Three Immunocompromised Patients: From Prolonged Viral Shedding to SARS-CoV-2 Superinfection
Authors: Tarhini Hassan , Recoing Amélie , Bridier-nahmias Antoine , Rahi Mayda , Lambert Céleste , Martres Pascale , Lucet Jean-Christophe , Rioux Christophe , Bouzid Donia , Lebourgeois Samuel , Descamps Diane , Yazdanpanah Yazdan , Le Hingrat Quentin , Lescure François-Xavier , Visseaux Benoit 
Published: February 2021

Abstract

Background
Guidelines for stopping coronavirus disease 2019 patient isolation are mainly symptom-based, with isolation for 10 to 20 days depending on their condition.

Methods
In this study, we describe 3 deeply immunocompromised patients, each with different clinical evolutions. We observed (1) the patients’ epidemiological, clinical, and serological data, (2) infectiousness using viral culture, and (3) viral mutations accumulated over time.

Results
Asymptomatic carriage, symptom resolution, or superinfection with a second severe acute respiratory syndrome coronavirus 2 strain were observed, all leading to prolonged infectious viral shedding for several months.

Conclusions
Understanding underlying mechanisms and frequency of prolonged infectiousness is crucial to adapt current guidelines and strengthen the use of systematic polymerase chain reaction testing before stopping isolation in immunocompromised populations.
Tenofovir disoproxil fumarate and emtricitabine maintenance strategy in virologically controlled adults with low HIV-1 DNA: 48 week results from a randomized, open-label, non-inferiority trial
Authors: Prazuck Thierry , Verdon Renaud , Le Moal Gwenaël , Ajana Faïza , Bernard Louis , Sunder Simon , Roncato-Saberan Mariam , Ponscarme Diane , Etienne Manuel , Viard Jean-Paul , Pasdeloup Thierry , Darasteanu Iuliana , Pialoux Gilles , de la Blanchardière Arnaud , Avettand-Fènoël Véronique , Parienti Jean-Jacques , Hocqueloux Laurent ,   the TRULIGHT Study Team, Fourmy Adeline , Mureau Elody , Juteau Nathalie , Giraudeau Bruno , Dargere Sylvie , Michon Jocelyn , Baldoli Aurélie 
Published: February 2021

Abstract

Objectives
Low HIV reservoirs may be associated with viral suppression under a lower number of antiretroviral drugs. We investigated tenofovir disoproxil fumarate/emtricitabine as a maintenance strategy in people living with HIV (PLHIV) with low HIV-DNA.

Methods
TRULIGHT (NCT02302547) was a multicentre, open-label, randomized trial comparing a simplification to tenofovir disoproxil fumarate/emtricitabine versus a triple regimen continuation (tenofovir disoproxil fumarate/emtricitabine with a third agent, control arm) in virologically suppressed adults with HIV-DNA &lt;2.7 log10 copies/106 PBMCs and no prior virological failure (VF). The primary endpoint (non-inferiority margin 12%) was the percentage of participants with a plasma viral load (pVL) &lt;50 copies/mL in ITT (Snapshot approach) and PP analyses at Week 48 (W48).

Results
Of the 326 participants screened, 223 (68%) were randomized to the tenofovir disoproxil fumarate/emtricitabine arm (n = 113) or control arm (n = 110). At W48, the tenofovir disoproxil fumarate/emtricitabine and control arms maintained a pVL &lt; 50 copies/mL in 100/113 (88.5%) and 100/110 (90.9%) participants, respectively (ITT difference 2.4%, 95% CI –5.9 to 10.7; PP difference 3.4%, 95% CI –4.2 to 11.0). Six VFs occurred in the tenofovir disoproxil fumarate/emtricitabine arm (two with emerging mutations M184V and K65R) versus two in the control arm (ITT difference 3.5%, 95% CI –1.9 to 9.4). All VFs were resuppressed after treatment modification.

Conclusions
Although non-inferiority was shown, simplification to tenofovir disoproxil fumarate/emtricitabine should not be used for most PLHIV because of a low risk of VF with resistance.
A landscape survey of planned SMART/HL7 bulk FHIR data access API implementations and tools
Authors: Jones James , Gottlieb Daniel , Mandel Joshua C , Ignatov Vladimir , Ellis Alyssa , Kubick Wayne , Mandl Kenneth D 
Published: February 2021

Abstract
The Office of National Coordinator for Health Information Technology final rule implementing the interoperability and information blocking provisions of the 21st Century Cures Act requires support for two SMART (Substitutable Medical Applications, Reusable Technologies) application programming interfaces (APIs) and instantiates Health Level Seven International (HL7) Fast Healthcare Interoperability Resources (FHIR) as a lingua franca for health data. We sought to assess the current state and near-term plans for the SMART/HL7 Bulk FHIR Access API implementation across organizations including electronic health record vendors, cloud vendors, public health contractors, research institutions, payors, FHIR tooling developers, and other purveyors of health information technology platforms. We learned that many organizations not required through regulation to use standardized bulk data are rapidly implementing the API for a wide array of use cases. This may portend an unprecedented level of standardized population-level health data exchange that will support an apps and analytics ecosystem. Feedback from early adopters on the API’s limitations and unsolved problems in the space of population health are highlighted.
Terbinafine-Induced Acute Generalized Exanthematous Pustulosis
Authors: Correia Bernardo , Costa Joana , Egipto Paula , Reis Pedro 
Published: February 2021

Abstract
Severe cutaneous adverse drug reactions are uncommon but potentially critical clinical situations demanding prompt diagnosis and treatment. We report a rare and severe case of terbinafine-induced acute generalized pustulosis. The patient was directly referred to a Burn Unit where she underwent diagnostic confirmation, systemic supportive care, and wound care treatments. Clinical and histopathological differential diagnosis of severe cutaneous adverse drug reactions is fundamental due to their significantly different management and prognosis.
Vision and Ocular Surface Salvage in Extreme Postburn Cicatricial Ectropion With Infectious Exposure Keratitis
Authors: Behera Geeta , Sangaraju Suneel , Meethale Thiruvoth Friji , Kasturi Nirupama , Babu Krishna Ramesh 
Published: February 2021

Abstract
Prevention and early management of postburn cicatricial ectropion is the best strategy to avoid ocular complications, with poor visual prognosis in extreme cases. A 51-year-old man presented with diminution of vision and absolute inability to close both eyes, 3 months after thermal burn injuries to face, upper limbs, and trunk. His best corrected visual acuity (BCVA) was 1/60 in BE. He had bilateral extremely severe ectropion involving both upper and lower lids with complete inability to close the eyes. The ensuing exposure keratitis developed secondary infection by Methicillin-resistant Staphylococcus aureus (MRSA) in the right eye and multidrug-resistant Pseudomonas aeruginosa in the left eye. His extreme ectropion prevented infection healing, so its release and full-thickness skin grafting was done when partial resolution of infection was noted. After 3 months, he had moderate residual ectropion in BE; vascularized corneal scar in the inferior part of the right eye (BCVA:20/40) and adherent leucoma in left eye (BCVA:HM). Prioritizing ectropion surgery in our extreme case for infection control, facilitated corneal healing. Our case highlights the extreme consequences of not taking preventive measures or of managing incident ectropion following thermal injury to the face.
Revocation of an EUTM: the relevant time for determining the five-year period of non-use is the filing date of the counterclaim
Authors: Bergazov Marie-Sophie , Basire Yann 
Published: February 2021

Abstract
Court of Justice of the European Union, Husqvarna AB v Lidl Digital International GmbH & Co. KG, C-607/19, 17 December 2020 ECLI:EU:C:2020:1044
In case of a counterclaim for revocation of an EU trade mark, the relevant date for assessing the five-year period of use is the date on which the counterclaim was filed.
Medical Financial Hardship in Survivors of Adolescent and Young Adult Cancer in the United States
Authors: Lu Amy D , Zheng Zhiyuan , Han Xuesong , Qi Ruowen , Zhao Jingxuan , Yabroff K Robin , Nathan Paul C 
Published: February 2021

Abstract

Background
Cancer and its treatment can result in lifelong medical financial hardship, which we aimed to describe among adult survivors of adolescent and young adult (AYA) cancers in the United States.

Methods
We identified adult (aged ≥18 years) survivors of AYA cancers (diagnosed ages 15-39 years) and adults without a cancer history from the 2010-2018 National Health Interview Surveys. Proportions of respondents reporting measures in different hardship domains (material [eg, problems paying bills], psychological [eg, distress], and behavioral [eg, forgoing care due to cost]) were compared between groups using multivariable logistic regression models and hardship intensity (cooccurrence of hardship domains) using ordinal logistic regression. Cost-related changes in prescription medication use were assessed separately.

Results
A total of 2588 AYA cancer survivors (median = 31 [interquartile range = 26-35] years at diagnosis; 75.0% more than 6 years and 50.0% more than 16 years since diagnosis) and 256 964 adults without a cancer history were identified. Survivors were more likely to report at least 1 hardship measure in material (36.7% vs 27.7%, P &lt; .001) and behavioral (28.4% vs 21.2%, P &lt; .001) domains, hardship in all 3 domains (13.1% vs 8.7%, P &lt; .001), and at least 1 cost-related prescription medication nonadherence (13.7% vs 10.3%, P = .001) behavior.

Conclusions
Adult survivors of AYA cancers are more likely to experience medical financial hardship across multiple domains compared with adults without a cancer history. Health-care providers must recognize this inequity and its impact on survivors’ health, and multifaceted interventions are necessary to address underlying causes.