bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of affiliation network membership on hospital quality and financial performance
Authors: Jin Bonnie , Nembhard Ingrid M. 
Published: September 2021

AbstractObjectiveTo examine the effects of hospital membership in affiliation networks—franchise‐like networks sponsored by high‐quality health systems in which affiliate hospitals pay an annual fee for access to sponsor's operational and clinical resources—on clinical quality, patient experience ratings, and financial performance of affiliates and their competitors.Data sourcesNetwork membership data from press releases and websites of four sponsors (Mayo Clinic, Cleveland Clinic, MD Anderson, Memorial Sloan Kettering), American Hospital Association's Annual Survey, Centers for Medicare & Medicaid Services' Hospital Compare, and Healthcare Cost Report Information System, all for 2005–2016.Study designWe used a quasi‐experimental design and estimated hospital‐level regressions with hospital‐fixed effects. Dependent variables were measures of clinical quality, patient experience, and financial performance. Independent variables included an indicator for affiliate versus nonaffiliate and fixed effects for hospital characteristics and year. To analyze effects on competitors, we repeated analyses by comparing hospitals in the same county as an affiliate to nonaffiliated, noncompetitor hospitals.Data collectionMembership was obtained through press releases and network websites then linked across datasets by name and Medicare's identification number.Principal findingsAcross networks, affiliates (N = 199) experienced insignificant clinical quality changes but increased net income by $38,500 and operating margin by 6.6% (p values = 0.01–0.08) compared to nonaffiliates. Multispecialty affiliates improved on no measures. Cancer‐specific affiliates improved their net income ($96,900) and operating margin (3.6%; p‐values < 0.05). Affiliates' competitors experienced mixed changes in clinical measures relative to hospitals without affiliates in market (p‐value < 0.05) but no financial effects. Affiliation was not associated with patient experience ratings for affiliates nor competitors.ConclusionsDespite quality‐focused missions, affiliation networks are not guaranteed to improve public measures of quality in affiliated hospitals, although hospitals in these communities improve financially. Future research should assess the conditions and mechanisms by which affiliation improves quality consistently and which forms of quality.
Risk of bird electrocution in power lines: a framework for prioritizing species and areas for conservation and impact mitigation
Authors: Biasotto L. D. , Moreira F. , Bencke G. A. , D’Amico M. , Kindel A. , Ascensão F. 
Published: September 2021

AbstractElectrocution on power lines is an important human‐related cause of bird mortality and an important conservation issue worldwide. Besides impacts on bird populations, electrocutions cause power outages, resulting in damage to power line network integrity. However, there is a general lack of knowledge on the risk of bird electrocution, especially in developing countries. Generating information over large scales without resorting to local mortality data can be useful for the development of regional management strategies, particularly in countries where electrocution is poorly documented. Here, we developed a framework to model the risk of bird electrocution as an interaction between the species‐specific exposure to power lines (pole density within a species distribution range) and susceptibility (morphological and behavioral traits associated with electrocution hazards). We applied this framework to Brazil, identifying 283 species that face a risk of electrocution, of which 38 were classified as higher risk, mostly raptors (76%). The Pantanal (a large wetland biome) concentrates the greatest cumulative susceptibility due to the high number of species vulnerable to electrocution (i.e. large species using power lines for perching or nesting), while the Atlantic Forest region has a higher risk for electrocution, due to the spatial overlap between the presence of vulnerable species and high exposure to power lines. Furthermore, our study identified spatial patterns of bird electrocution, highlighting priority areas for electrocution susceptibility and electrocution risk to be further investigated, and where measures to mitigate bird electrocutions should be applied on new and existing power lines. Our framework allows a preliminary assessment aimed at identifying areas of higher risk of electrocution, to highlight species vulnerable to this threat and to improve power line routing. This approach can be replicated to other understudied areas of the world where the same information is available.
Use of maximum entropy (Maxent) niche modelling to predict the occurrence of threatened freshwater species in a biodiversity hotspot of Zimbabwe
Authors: Mafuwe Kudzai , Broadley Sheila , Moyo Sydney 
Published: September 2021

AbstractGlobally, freshwater species are under threat from human mediated stressors. Therefore, there is an urgent need for methods to estimate population and species occurrences for conservation purposes. Here, we used a predictive species distribution model to determine the occurrence of three endangered species (Amietia inyangae, Chlorolestes elegans and Strongylopus rhodesianus) in Southern Africa (Eastern Highlands of Zimbabwe). The study revealed that the probability of occurrences for the three species increase with an increase in elevation and annual precipitation and decrease with an increase in annual mean temperature. Our results indicated that the highest probability of occurrences for A. inyange, C. elegans and S. rhodesianus is in the Nyanga, Stapleford and Chimanimani highland areas, with some probabilities of occurrence falling outside protected areas. Our findings suggest that the areas covered by protected areas may need to be revaluated. Our findings will be useful for managing threatened species.
Birth order and socioeconomic disadvantage predict behavioural and emotional problems at age 3 years
Authors: Hjern Anders , Bergström Malin , Fransson Emma , Lindfors Anncharlotte , Bergqvist Kersti 
Published: September 2021

AbstractAimThe aim of this study was to describe sociodemographic and family predictors for behavioural and emotional problems in pre‐schoolers.MethodsThis was a cross‐sectional study including 30,795 children in the Stockholm region whose parents had completed the Strength and Difficulties Questionnaire (SDQ) prior to a routine visit to a well‐baby clinic at age 3 years. Multivariate logistic regression was used to analyse predictors for having a high total SDQ difficulties score.ResultsYoung parental age and a low level of parental education predicted high total SDQ score in a stepwise pattern. Being a first‐born child was associated with a high SDQ score with an adjusted odds ratio of 2.10 (95% C.I. 1.84–2.41), compared with having older siblings. A sole physical custody arrangement predicted a high total SDQ score after parental separation. The percentage of children with a high total SDQ score increased with the Care Need Index (CNI) of the well‐baby clinic.ConclusionsThis study identified socioeconomic disadvantage and being the first‐born child as the main predictors of poor mental health at age 3 years. Well‐baby clinics with socioeconomically disadvantaged catchment areas should be provided with adequate resources and methods for equitable prevention.
The mechanism of Epimedin B in treating osteoporosis as revealed by RNA sequencing‐based analysis
Authors: Diao Xinyue , Wang Liwen , Zhou Yating , Bi Yanan , Zhou Kun , Song Lei 
Published: September 2021

AbstractWith the ageing of populations, the management of osteoporosis is a priority of society in general. Epimedin B, a major ingredient of Herba Epimedii, which has the advantages of high content and hypotoxicity has been proved to be effective in preventing osteoporosis in vitro. However, the efficacy and mechanism of Epimedin B on osteoporosis in vivo have not been well elucidated yet. This study aimed to investigate the effects and the potential mechanisms of 8‐week repeated oral administration of Epimedin B (10 and 20 mg/kg/day) on a mouse osteoporosis model. Effects of Epimedin B were evaluated by examinations of serum bone turnover markers, bone mineral density, bone microstructure parameters and histopathological section. Epimedin B significantly rose N‐terminal propeptide of type I procollagen (P1NP) and dropped C‐telopeptide of type I collagen (CTX1). Connectivity density (Conn.D) increased significantly while structure model index (DA) decreased significantly after treated by Epimedin B. Meanwhile, Epimedin B administration significantly increased the number of trabecular bones while significantly decreased the gap between them. Overall, Epimedin B showed beneficial effects on osteoporosis. Furthermore, RNA sequencing‐based analysis revealed 5 significantly down‐regulated transcripts and 107 significantly up‐regulated transcripts between the Epimedin B administration group and the model group. These transcripts were mapped to 15 pathways by KEGG enrichment analysis, of which PI3K‐Akt signalling pathway, MAPK signalling pathway and PPAR signalling pathway were most connected to osteoporosis. To conclude, Epimedin B is effective in treating osteoporosis in mice via regulating PI3K‐Akt, MAPK and PPAR signalling pathway.
Decreased incidence of cesarean surgical site infection rate with hospital‐wide perioperative bundle
Authors: Sood Neha , Lee Rachel E. , To Justin K. , Cervellione Kelly L. , Smilios Maria DeMarinis , Chun Hajoon , Ngai Ivan M. 
Published: September 2021

AbstractBackgroundReduction in the incidence of surgical site infection (SSI) serves as a measure of patient safety and quality improvement. Cesarean birth (CB) accounts for 31.9% of all childbirths in the United States. However, our understanding of SSI prevention bundles predominantly stems from gynecological and colorectal surgeries. This study aimed to determine the efficacy of a standardized perioperative bundle designed to reduce SSI in CBs.MethodsAll CB patients at Flushing Hospital Medical Center from 2017 to 2019 were included in a retrospective analysis. Patients were divided into three groups based on the timing of intervention: prebundle/control, transition, and postbundle. Baseline demographics and clinical characteristics were summarized using descriptive statistics. Multiple logistic regression was performed to determine the association between bundle group and SSI, considering variables different between groups at baseline (P < 0.10).ResultsTwo thousand eight hundred and seventy‐five CBs were performed: 1086 in prebundle, 812 in transition, and 977 in postbundle phase. In the prebundle phase, 25 CBs (2.3%) were complicated by SSIs; in the transition phase, 10 (1.2%) had SSIs; and in the postbundle phase, 7 (0.7%; P = 0.009) had SSIs. In a logistic regression model, only use of the CB bundle (OR 0.26 [95% CI 0.07‐0.94]; P = 0.04), rupture of membranes (0.29 [0.09‐0.87]; P = 0.03), and operating room time (1.02 [1.01‐1.04]; P = 0.01) were significant in prediction of SSI. SSI postbundle was significantly reduced from prebundle (0.04).ConclusionsThus, introduction of a hospital‐wide perioperative bundle significantly reduced SSI rates, and should be developed as a mainstay of CB surgical care.
Adoptive immunotherapy with double‐bright (CD56bright/CD16bright) expanded natural killer cells in patients with relapsed or refractory acute myeloid leukaemia: a proof‐of‐concept study
Authors: Silla Lucia , Valim Vanessa , Pezzi Annelise , da Silva Maria , Wilke Ianae , Nobrega Juliana , Vargas Alini , Amorin Bruna , Correa Bruna , Zambonato Bruna , Scherer Fernanda , Merzoni Joice , Sekine Leo , Huls Helen , Cooper Laurence J. , Paz Alessandra , Lee Dean A. 
Published: September 2021

SummaryPatients with acute myeloid leukaemia (AML) have a five‐year survival rate of 28·7%. Natural killer (NK)‐cell have anti‐leukaemic activity. Here, we report on a series of 13 patients with high‐risk R/R AML, treated with repeated infusions of double‐bright (CD56bright/CD16bright) expanded NK cells at an academic centre in Brazil. NK cells from HLA‐haploidentical donors were expanded using K562 feeder cells, modified to express membrane‐bound interleukin‐21. Patients received FLAG, after which cryopreserved NK cells were thawed and infused thrice weekly for six infusions in three dose cohorts (106–107 cells/kg/infusion). Primary objectives were safety and feasibility. Secondary endpoints included overall response (OR) and complete response (CR) rates at 28–30 days after the first infusion. Patients received a median of five prior lines of therapy, seven with intermediate or adverse cytogenetics, three with concurrent central nervous system (CNS) leukaemia, and one with concurrent CNS mycetoma. No dose‐limiting toxicities, infusion‐related fever, or cytokine release syndrome were observed. An OR of 78·6% and CR of 50·0% were observed, including responses in three patients with CNS disease and clearance of a CNS mycetoma. Multiple infusions of expanded, cryopreserved NK cells were safely administered after intensive chemotherapy in high‐risk patients with R/R AML and demonstrated encouraging outcomes.
Adjuvant therapy in patients with sarcomatoid renal cell carcinoma: post hoc analysis from Eastern Cooperative Oncology Group‐American College of Radiology Imaging Network (ECOG‐ACRIN) E2805
Authors: Karam Jose A. , Puligandla Maneka , Flaherty Keith T. , Uzzo Robert G. , Matin Surena F. , Pins Michael R. , Wood Christopher G. , Kane Christopher , Jewett Michael A. S. , Kim Se Eun , Dutcher Janice P. , DiPaola Robert S. , Haas Naomi B. 
Published: September 2021

ObjectivesTo study the effects of adjuvant therapy in patients with sarcomatoid renal cell carcinoma (sRCC) enrolled in the randomised phase III clinical trial E2805.Patients and MethodsThe original trial (E2805) was a randomised, double‐blinded phase III clinical trial comparing outcomes in 1943 patients with RCC accrued between 2006 and 2010 and treated with up to 1 year of adjuvant placebo, sunitinib, or sorafenib. The present study analyses the cohort of patients with sRCC that participated in E2805.ResultsA total of 171 patients (8.8%) had sarcomatoid features. Of these, 52 patients received sunitinib, 58 received sorafenib, and 61 received placebo. Most patients were pT3–4 (71.1%, 63.7%, and 70.5%, respectively); 17.3%, 19.0%, and 27.9% had pathologically positive lymph nodes; and 59.6%, 62.1%, and 62.3% of the patients were University of California Los Angeles (UCLA) Integrated Staging System (UISS) very‐high risk. In 49% of patients with subsequent development of metastatic disease, recurrence occurred in the lung, followed by 30% in the lymph nodes, and 13% in the liver. There was a high local recurrence rate in the renal bed (16%, 29%, and 18%, respectively). The 5‐year disease‐free survival (DFS) rates were 33.6%, 36.0%, and 27.8%, for sunitinib, sorafenib and placebo, respectively (hazard ratio [HR] 0.74, 95% confidence interval [CI] 0.45–1.20 for sunitinib vs placebo, and HR 0.82, 95% CI 0.53–1.28 for sorafenib vs placebo).ConclusionsAdjuvant therapy with sunitinib or sorafenib did not show an improvement in DFS or OS in patients with sRCC.
Outcomes of freehand transperineal prostate biopsy with omission of antibiotic prophylaxis
Authors: Setia Shaan A. , Smith John , Cendo Demetri , Yoder Johnathan , Gorin Michael A. , Allaway Matthew J. , Vourganti Srinivas 
Published: September 2021

ObjectiveTo assess the utility of antimicrobial prophylaxis when performing freehand systematic transperineal (TP) biopsy.Patients and MethodsFrom January 2012 to February 2020, freehand TP prostate biopsy via angiocatheters or the PrecisionPoint Transperineal Access System was performed on consecutive men with clinical suspicion of prostate cancer (PCa) or confirmed PCa. Biopsies were performed by a single urologist (developer of the PrecisionPoint system). Clinical data were collected retrospectively. Pre‐procedural antibiotics were given to all patients up until 6 September 2016. After this date, antibiotics were omitted from those without risk factors (chronic catherization, concurrent endoscopic procedure, history of sepsis after transrectal [TR] biopsy, history of TR biopsy within the last year, prosthetic joints/heart valves). Patients were assessed 1 week after biopsy for symptoms, emergency department visits, and hospital admissions. Patients who received antimicrobial prophylaxis were compared with those who did not, and infectious complications were analysed. Additionally, oncological outcomes were reported.ResultsA total of 988 biopsies (median prostate‐specific antigen level 7.7 ng/mL) were included in the analysis on 756 patients. Prophylaxis was given in 538 of the biopsies (54.4%) and in 450 (48.6%) it was not. There was a statistical difference in median age (67 vs 69 years; P < 0.001), abnormal digital rectal examination (13% vs 5%; P < 0.001), and history of multiparametic magnetic resonance imaging (15% vs 31%; P < 0.001) between the prophylaxis and no‐prophylaxis cohorts, respectively. There were no documented complications in those who received antibiotics. Within the no‐prophylaxis cohort, there were three (0.66%) complications (P = 0.09). Two patients (0.44%) had urinary tract infections and one patient (0.22%) experienced post‐procedural urinary retention. No patient required hospital admission or an emergency department visit. Clinically significant cancer was detected in 152 (40.0%) and 64 patients (39.0%) on initial biopsy and prior negative biopsy, respectively.ConclusionsThese data suggest that antimicrobial prophylaxis may be safely omitted in selected patients when using the freehand TP approach.
Odorant‐binding proteins of mammals
Authors: Pelosi Paolo , Knoll Wolfgang 
Published: September 2021

ABSTRACTOdorant‐binding proteins (OBPs) of vertebrates belong to the lipocalin superfamily and perform a dual function: solubilizing and ferrying volatile pheromones to the olfactory receptors, and complexing the same molecules in specialized glands and assisting their release into the environment. Within vertebrates, to date they have been reported only in mammals, apart from two studies on amphibians. Based on the small number of OBPs expressed in each species, on their sites of production outside the olfactory area and their presence in biological fluids known to be pheromone carriers, such as urine, saliva and sexual secretions, we conclude that OBPs of mammals are specifically dedicated to pheromonal communication. This assumption is further supported by the observation that some OBPs present in biological secretions are endowed with their own pheromonal activity, adding renewed interest to these proteins. Another novel piece of evidence is the recent discovery that glycosylation and phosphorylation can modulate the binding activity of these proteins, improving their affinity to pheromones and narrowing their specificity. A comparison with insects and other arthropods shows a completely different scenario. While mammalian OBPs are specifically tuned to pheromones, those of insects, which are completely different in sequence and structure, include carriers for general odorants in addition to those dedicated to pheromones. Additionally, whereas mammals adopted a single family of carrier proteins for chemical communication, insects and other arthropods are endowed with several families of semiochemical‐binding proteins. Here, we review the literature on the structural and functional properties of vertebrate OBPs, summarize the most interesting new findings and suggest possible exciting future developments.
Effects of the COVID‐19 pandemic on caregiver mental health and the child caregiving environment in a low‐resource, rural context
Authors: Pitchik Helen O. , Tofail Fahmida , Akter Fahmida , Sultana Jesmin , Shoab AKM , Huda Tarique M. N. , Forsyth Jenna E. , Kaushal Natasha , Jahir Tania , Yeasmin Farzana , Khan Rizwana , Das Jyoti B. , Khobair Hossain Md. , Hasan Md. Rezaul , Rahman Mahbubur , Winch Peter J. , Luby Stephen P. , Fernald Lia C. H. 
Published: September 2021

AbstractEarly child development has been influenced directly and indirectly by the COVID‐19 pandemic, and these effects are exacerbated in contexts of poverty. This study estimates effects of the pandemic and subsequent population lockdowns on mental health, caregiving practices, and freedom of movement among female caregivers of children 6–27 months (50% female), in rural Bangladesh. A cohort (N = 517) was assessed before and during the pandemic (May–June, 2019 and July–September, 2020). Caregivers who experienced more food insecurity and financial loss during the pandemic reported larger increases in depressive symptoms (0.26 SD, 95% CI 0.08–0.44; 0.21 SD, 0.04–0.40) compared to less affected caregivers. Stimulating caregiving and freedom of movement results were inconsistent. Increases in depressive symptoms during the pandemic may have consequences for child development.
Diagnostic yield of genetic testing in 324 infants with hypotonia
Authors: Sharma Sonal , Repnikova Elena , Noel‐MacDonnell Janelle R. , LePichon Jean‐Baptiste 
Published: September 2021

AbstractThis retrospective cohort study was designed to determine the yield of genetic tests in hypotonic infants and develop a diagnostic algorithm. Out of 496 patients identified by International Classification of Diseases (ICD) 9/10 coding, 324 patients met the inclusion criteria. Diagnostic yields were 32% for karyotype, 19% for microarray, 30% for targeted genetic tests, 38% for gene panels, and 31% for exome sequencing. In addition, we considered the diagnostic contribution of ancillary tests, including neuroimaging, metabolic tests, and so forth. The combination of microarray and exome sequencing gave the highest diagnostic yield. None of the other tests added significant value in arriving at a diagnosis. Based on these results we propose that the vast majority of infants with congenital hypotonia should start with a microarray and proceed with exome sequencing, with the notable exception of infants with clearly syndromic features in whom karyotyping or targeted testing may be more appropriate.
Disruption of rack1 suppresses SHH‐type medulloblastoma formation in mice
Authors: Liu Fengjiao , Shao Jingyuan , Yang Haihong , Yang Guochao , Zhu Qian , Wu Yan , Zhu Lingling , Wu Haitao 
Published: September 2021

AbstractIntroductionMedulloblastoma (MB) is a malignant pediatric brain tumor that arises in the cerebellar granular neurons. Sonic Hedgehog subtype of MB (SHH‐MB) is one of the major subtypes of MB in the clinic. However, the molecular mechanisms underlying MB tumorigenesis are still not fully understood.AimsOur previous work demonstrated that the receptor for activated C kinase 1 (Rack1) is essential for SHH signaling activation in granule neuron progenitors (GNPs) during cerebellar development. To investigate the potential role of Rack1 in MB development, human MB tissue array and SHH‐MB genetic mouse model were used to study the expression of function of Rack1 in MB pathogenesis.ResultsWe found that the expression of Rack1 was significantly upregulated in the majority of human cerebellar MB tumors. Genetic ablation of Rack1 expression in SHH‐MB tumor mice could significantly inhibit MB proliferation, reduce the tumor size, and prolong the survival of tumor rescue mice. Interestingly, neither apoptosis nor autophagy levels were affected in Rack1‐deletion rescue mice compared to WT mice, but the expression of Gli1 and HDAC2 was significantly decreased suggesting the inactivation of SHH signaling pathway in rescue mice.ConclusionOur results demonstrated that Rack1 may serve as a potential candidate for the diagnostic marker and therapeutic target of MB, including SHH‐MB.