bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predicting readmission and death after hospital discharge: a comparison of conventional frailty measurement with an electronic health record-based score
Authors: Tew Yong Yong , Chan Juen Hao , Keeling Polly , Shenkin Susan D , MacLullich Alasdair , Mills Nicholas L , Denvir Martin A , Anand Atul 
Published: February 2021

Abstract

Background
frailty measurement may identify patients at risk of decline after hospital discharge, but many measures require specialist review and/or additional testing.

Objective
to compare validated frailty tools with routine electronic health record (EHR) data at hospital discharge, for associations with readmission or death.

Design
observational cohort study.

Setting
hospital ward.

Subjects
consented cardiology inpatients ≥70 years old within 24 hours of discharge.

Methods
patients underwent Fried, Short Physical Performance Battery (SPPB), PRISMA-7 and Clinical Frailty Scale (CFS) assessments. An EHR risk score was derived from the proportion of 31 possible frailty markers present. Electronic follow-up was completed for a primary outcome of 90-day readmission or death. Secondary outcomes were mortality and days alive at home (‘home time’) at 12 months.

Results
in total, 186 patients were included (79 ± 6 years old, 64% males). The primary outcome occurred in 55 (30%) patients. Fried (hazard ratio [HR] 1.47 per standard deviation [SD] increase, 95% confidence interval [CI] 1.18–1.81, P &lt; 0.001), CFS (HR 1.24 per SD increase, 95% CI 1.01–1.51, P = 0.04) and EHR risk scores (HR 1.35 per SD increase, 95% CI 1.02–1.78, P = 0.04) were independently associated with the primary outcome after adjustment for age, sex and co-morbidity, but the SPPB and PRISMA-7 were not. The EHR risk score was independently associated with mortality and home time at 12 months.

Conclusions
frailty measurement at hospital discharge identifies patients at risk of poorer outcomes. An EHR-based risk score appeared equivalent to validated frailty tools and may be automated to screen patients at scale, but this requires further validation.
A clinical focus on the use of extended-duration thromboprophylaxis in medically ill patients
Authors: Snoga Jenna L , Benitez Rebekah M , Kim Subin , Creager Olivia , Lusk Kathleen A 
Published: February 2021

Abstract

Purpose
This review describes and analyzes literature to provide recommendations for use of extended-duration thromboprophylaxis (EDT) in medically ill patients.

Summary
Guidelines recommend pharmacologic thromboprophylaxis for patients at increased thrombosis risk during hospitalization and recommend against extending thromboprophylaxis beyond hospitalization. Despite these recommendations, observational data demonstrate that venous thromboembolism (VTE) risk persists following hospital discharge. A MEDLINE literature search was performed to identify original research evaluating the safety and efficacy of EDT. Eight meta-analyses and 5 randomized controlled trials—each varying in the agents studied (enoxaparin, rivaroxaban, apixaban, and betrixaban)—were selected for inclusion. Collectively, the evaluated data demonstrates that EDT reduces the incidence of VTE at the expense of increasing the risk of major bleeding and without providing mortality reduction. Variations in enrollment criteria, differences in EDT strategies, and uncertainty regarding proper patient selection limit the applicability of EDT in practice. Rivaroxaban and betrixaban gained Food and Drug Administration (FDA) approval on the basis of results of the APEX and MARINER trials and a post hoc analysis of the MAGELLEN trial results. Although a number of agents are FDA approved for use in EDT, clinicians must carefully weigh the risks vs benefits of EDT with these agents until studies demonstrate a more favorable risk-benefit profile.

Conclusion
Evidence to support EDT in medically ill patients is inconclusive and has highlighted the need for an individualized approach. The reviewed evidence supports guideline recommendations from both the American College of Chest Physicians and the American Society of Hematology that recommend against routine use of EDT in the majority of medically ill patients. Future studies are needed to optimize the risk-benefit profile of EDT and to ensure proper patient selection.
Anatomical patterns of condensed tannin in fine roots of tree species from a cool-temperate forest
Authors: Endo Izuki , Kobatake Miwa , Tanikawa Natsuko , Nakaji Tatsuro , Ohashi Mizue , Makita Naoki 
Published: February 2021

AbstractBackground and AimsCondensed tannin (CT) is an important compound in plant biological structural defence and for tolerance of herbivory and environmental stress. However, little is known of the role and location of CT within the fine roots of woody plants. To understand the role of CT in fine roots across diverse species of woody dicot, we evaluated the localization of CT that accumulated in root tissue, and examined its relationships with the stele and cortex tissue in cross-sections of roots in 20 tree species forming different microbial symbiotic groups (ectomycorrhiza and arbuscular mycorrhiza).MethodsIn a cool-temperate forest in Japan, cross-sections of sampled roots in different branching order classes, namely, first order, second to third order, fourth order, and higher than fourth order (higher order), were measured in terms of the length-based ratios of stele diameter and cortex thickness to root diameter. All root samples were then stained with ρ-dimethylaminocinnamaldehyde solution and we determined the ratio of localized CT accumulation area to the root cross-section area (CT ratio).Key ResultsStele ratio tended to increase with increasing root order, whereas cortex ratio either remained unchanged or decreased with increasing order in all species. The CT ratio was significantly positively correlated to the stele ratio and negatively correlated to the cortex ratio in second- to fourth-order roots across species during the shift from primary to secondary root growth. Ectomycorrhiza-associated species mostly had a higher stele ratio and lower cortex ratio than arbuscular mycorrhiza-associated species across root orders. Compared with arbuscular mycorrhiza species, there was greater accumulation of CT in response to changes in the root order of ectomycorrhiza species.ConclusionsDifferent development patterns of the stele, cortex and CT accumulation along the transition from root tip to secondary roots could be distinguished between different mycorrhizal associations. The CT in tissues in different mycorrhizal associations could help with root protection in specific branching orders during shifts in stele and cortex development before and during cork layer formation.
An Innovative Approach for Facial Rejuvenation and Contouring Injections in Asian Patients
Authors: Cui Haiyan , Zhao Haiguang , Xu Haisong , Wang Guobao , Tan Linlin 
Published: February 2021

Abstract

An increasing number of Asian people are seeking nonsurgical facial aesthetic treatments. Ethnic Asians differ from Western populations in both facial appearance and baseline structural facial anatomy. And there is a lack of clinical instruction to doctors who provide facial aesthetic treatment for Asian patients. The authors proposed the “未来 Future Codes” design in Chinese calligraphy describing the art of facial injection in Asians to help doctors perform well. “未来” are pictograph of 2 Chinese characters, translated into English as “Future,” which represent beautiful meanings and vividly describe the procedure and operating area of the design methods. The concept encompasses a systematic overall design for the art of facial injection in Asians, and these procedures are easy to learn and perform safely. This is the first systematic solution available in the clinic that can be used to design facial aesthetics and rejuvenation in Asians through Eastern philosophy and culture.

Level of Evidence: 5
Insight into the collagen-degrading activity of a serine protease in the latex of Ficus carica cultivar Masui Dauphine
Authors: Nishimura Kosaku , Higashiya Keisuke , Ueshima Naoki , Kojima Kenji , Takita Teisuke , Abe Tatsuya , Takahashi Toru , Yasukawa Kiyoshi 
Published: February 2021

ABSTRACT
Ficus carica produces, in addition to the cysteine protease ficin, a serine protease. Earlier study on a serine protease from F. carica cultivar Brown Turkey showed that it specifically degraded collagen. In this study, we characterized the collagenolytic activity of a serine protease in the latex of F. carica cultivar Masui Dauphine. The serine protease degraded denatured, but not undenatured, acid-solubilized type I collagen. It also degraded bovine serum albumin, while the collagenase from Clostridium histolyticum did not. These results indicated that the serine protease in Masui Dauphine is not collagen-specific. The protease was purified to homogeneity by two-dimensional gel electrophoresis, and its partial amino acid sequence was determined by liquid chromatography-tandem mass spectrometry. BLAST searches against the Viridiplantae (green plants) genome database revealed that the serine protease was a subtilisin-like protease. Our results contrast with the results of the earlier study stating that the serine protease from F. carica is collagen-specific.
CD38+CD27–TNF-α + on Mtb-specific CD4+ T Cells Is a Robust Biomarker for Tuberculosis Diagnosis
Authors: Acharya Muthya Pragun , Pradeep Sai Pallavi , Murthy Venkataramappa Srinivasa , Chikkannaiah Panduranga , Kambar Vivekanand , Narayanashetty Satyanarayana , Burugina Nagaraja Sharath , Gangadhar Niveditha , Yoganand Raksha , Satchidanandam Vijaya 
Published: February 2021

Abstract

Background
Early and accurate diagnosis followed by timely treatment are the key prerequisites to fight tuberculosis (TB) and reduce its global burden. Despite scientific advances, the rapid and correct diagnosis of both pulmonary and extrapulmonary tuberculosis remains a challenge because of traditional reliance on detection of the elusive bacilli. Mycobacterium tuberculosis (Mtb)-specific host immune activation and cytokine production have shown significant promise as alternative means of detecting and distinguishing active disease from latent infection. We queried the diagnostic ability of phenotypic markers on Mtb-specific cytokine-producing immune cell subsets for identifying active TB.

Methods
Subjects belonging to the following groups were recruited: pulmonary and extrapulmonary TB, latent TB, cured TB, sick controls, and healthy controls. Polychromatic flow cytometry was used to identify host immune biomarkers in an exploratory cohort comprising 56 subjects using peripheral blood mononuclear cells. Clinical performance of the identified biomarker was evaluated using whole blood in a blinded validation cohort comprising 165 individuals.

Results
Cytokine secreting frequencies of Mtb-specific cluster of differentiation 4-positive (CD4+) T cells with CD38+CD27– phenotype clearly distinguished infected individuals with active tuberculosis from those without disease. Tumor necrosis factor-α (TNF-α) secretion from CD38+CD27–CD4+ T cells upon stimulation with ESAT6/CFP10 peptides had the best diagnostic accuracy at a cutoff of 9.91% (exploratory: 96.67% specificity, 88.46% sensitivity; validation: 96.15% specificity, 90.16% sensitivity). Additionally, this subset differentiated treatment-naive patients with TB from individuals cured of TB following completion of anti-TB therapy.

Conclusions
Mtb-specific CD38+CD27–TNF-α +CD4+ T-cell subset is a robust biomarker both for diagnosing TB and assessing cure.
Reliability and repeatability of a smartphone-based 6-min walk test as a patient-centred outcome measure
Authors: Mak Jonathan , Rens Neil , Savage Dasha , Nielsen-Bowles Helle , Triggs Doran , Talgo Julia , Gandhi Neil , Gutierrez Sebastian , Gutierrez Santiago , Aalami Oliver 
Published: February 2021

Abstract

Aims
The 6-min-walk test (6MWT) is a validated proxy for frailty and a predictor of clinical outcomes, yet is not widely used due to implementation challenges. This comparative effectiveness study assesses the reliability and repeatability of a home-based 6MWT compared to in-clinic 6MWTs in patients with cardiovascular disease.

Methods and results
One hundred and ten (110) patients scheduled for cardiac or vascular surgery were enrolled during a study period from June 2018 to December 2019 at the Palo Alto VA Hospital. Subjects were provided with an Apple iPhone 7 and Apple Watch Series 3 loaded with the VascTrac research study application and performed a supervised in-clinic 6MWT during enrolment, at 2 weeks, 1, 3, and 6 months post-operatively. Subjects also received notifications to perform at-home smartphone-based 6MWTs once a week for a duration of 6 months. Test–retest reliability of in-clinic measurements and at-home measurements was assessed with an industry standard Cronbach’s alpha reliability test. Test–retest reliability for in-clinic ground truth 6MWT steps vs. in-clinic iPhone 6MWT steps was 0·99, showing high reliability between the two tested measurements. When comparing for in-clinic ground truth 6MWT steps vs. neighbouring at-home iPhone 6MWT steps, reliability was 0·74.

Conclusion
Running the test–reliability test on both measurements shows that an iPhone 6MWT test is reliable compared to an in-clinic ground truth measurement in patients with cardiovascular disease.
Casting Doubt: Image Concerns and the Communication of Social Impact
Authors: Foerster Manuel , van der Weele Joël J 
Published: February 2021

AbstractWe investigate strategic communication about the social impact of costly prosocial actions. A ‘sender’ with noisy information about impact sends a cheap-talk message to a ‘receiver’, upon which both agents choose whether to act. In the presence of social preferences and image concerns, the sender trades off persuasion, exaggerating impact to induce receiver action, and justification, downplaying impact to cast doubt on the effectiveness of action and excuse her own passivity. In an experiment on charitable giving we find evidence for both motives. In line with our theory and a justification motive, increasing image concerns reduces communication of positive impact.
Tricuspid valve detachment for ventricular septal defect closure in infants &lt;5 kg: should we be hesitant?
Authors: Lee Jae Hong , Cho Sungkyu , Kwak Jae Gun , Kwon Hye Won , Kwak Yujin , Min Jooncheol , Kim Woong-Han , Lee Jeong Ryul 
Published: February 2021

Abstract

OBJECTIVES
We compared the clinical outcomes between tricuspid valve detachment (TVD) and non-TVD for ventricular septal defect (VSD) closure in infants &lt;5 kg.

METHODS
From January 2004 to April 2020, 462 infants &lt;5 kg with VSD without more complex intracardiac lesions and who had undergone VSD closure through the trans-atrial approach were enrolled. Propensity score-matching analysis was performed. Clinical outcomes were compared between the paired TVD group (group D) and paired non-TVD group (group N).

RESULTS
The median age and body weight at operation were 1.9 months [interquartile range(IQR), 1.4–2.5] and 4.2 kg (IQR, 3.7–4.6). The median follow-up duration was 83.4 months (IQR, 43.5–130.4). After matching, 44 pairs were extracted from each group. There were no significant differences in all-cause mortality (P = 0.176), reoperation (P = 0.172), postoperative morbidities, including residual VSD, aortic regurgitation, atrioventricular block and significant tricuspid regurgitation (TR) (P = 0.346) between group D and group N. However, group D showed significantly less TR progression during follow-up (P = 0.019).

CONCLUSIONS
In infants &lt;5 kg, TVD can be a reasonable and valid option for successful VSD closure without morbidities, including TR progression if the indication exists.
Cardiac paraganglioma: stent in right coronary artery prior to surgery resection
Authors: Martinez Lopez Daniel , Goicolea Ruigomez Javier , Martín López Carlos Esteban , Forteza Gil Alberto 
Published: February 2021

Abstract
Cardiac paragangliomas are extremely rare. Sometimes surgical resection is a challenge owing to the proximity of vital structures and coronary arteries involvement. We report a case of a 34-year-old man with cardiac paragangliomas located between right atrium and right ventricle with a feeding blood supply from collaterals of the right coronary artery. In this case, we implanted a covered single stent (PK Papyrus®) in the right coronary artery with the objective of embolizing collateral branches and to reinforce the coronary artery wall. Although tumour mass was not reduced, vascularization was minimized, and this hybrid strategy made the surgery easier and safer.
Transcriptional response of Candida albicans to Pseudomonas aeruginosa in a polymicrobial biofilm
Authors: Fourie Ruan , Cason Errol D , Albertyn Jacobus , Pohl Carolina H 
Published: February 2021

Abstract
Candida albicans is frequently co-isolated with the Gram-negative bacterium, Pseudomonas aeruginosa. In vitro, the interaction is complex, with both species influencing each other. Not only does the bacterium kill hyphal cells of C. albicans through physical interaction, it also affects C. albicans biofilm formation and morphogenesis, through various secreted factors and cell wall components. The present study sought to expand the current knowledge regarding the interaction between C. albicans and P. aeruginosa, using transcriptome analyses of early static biofilms. Under these conditions, a total of 2,537 open reading frames (approximately 40% of the C. albicans transcriptome) was differentially regulated in the presence of P. aeruginosa. Upon deeper analyses it became evident that the response of C. albicans toward P. aeruginosa was dominated by a response to hypoxia, and included those associated with stress as well as iron and zinc homeostasis. These conditions may also lead to the observed differential regulation of genes associated with cell membrane synthesis, morphology, biofilm formation and phenotypic switching. Thus, C. albicans in polymicrobial biofilms with P. aeruginosa have unique transcriptional profiles that may influence commensalism as well as pathogenesis.
Mutation in Eftud2 causes craniofacial defects in mice via mis-splicing of Mdm2 and increased P53
Authors: Beauchamp Marie-Claude , Djedid Anissa , Bareke Eric , Merkuri Fjodor , Aber Rachel , Tam Annie S , Lines Matthew A , Boycott Kym M , Stirling Peter C , Fish Jennifer L , Majewski Jacek , Jerome-Majewska Loydie A 
Published: February 2021

Abstract
EFTUD2 is mutated in patients with mandibulofacial dysostosis with microcephaly (MFDM). We generated a mutant mouse line with conditional mutation in Eftud2 and used Wnt1-Cre2 to delete it in neural crest cells. Homozygous deletion of Eftud2 causes brain and craniofacial malformations, affecting the same precursors as in MFDM patients. RNAseq analysis of embryonic heads revealed a significant increase in exon skipping and increased levels of an alternatively spliced Mdm2 transcript lacking exon 3. Exon skipping in Mdm2 was also increased in O9-1 mouse neural crest cells after siRNA knock-down of Eftud2 and in MFDM patient cells. Moreover, we found increased nuclear P53, higher expression of P53-target genes and increased cell death. Finally, overactivation of the P53 pathway in Eftud2 knockdown cells was attenuated by overexpression of non-spliced Mdm2, and craniofacial development was improved when Eftud2-mutant embryos were treated with Pifithrin-α, an inhibitor of P53. Thus, our work indicates that the P53-pathway can be targeted to prevent craniofacial abnormalities and shows a previously unknown role for alternative splicing of Mdm2 in the etiology of MFDM.
Finiteness of ℚ-Fano Compactifications of Semisimple Groups with Kähler–Einstein Metrics
Authors: Li Yan , Li Zhenye 
Published: February 2021

Abstract
Let $G$ be a complex semisimple group. In this note, we give a method to classify $\mathbb Q$-Fano compactifications of $G$. We will prove that there are only finitely many $\mathbb Q$-Fano $G$-compactifications that admit (singular) Kähler–Einstein metrics. As an application, this improves a former result in [ 19].
Rethinking disease eradication: putting countries first
Authors: Gebre Teshome 
Published: February 2021

AbstractThere have been various infectious disease eradication programs implemented in various parts of the world with varying degrees of success since the early 1900s. Of all those programs, the one that achieved monumental success was the Smallpox Eradication Program (SEP). Most of the global health leaders and authorities that came up with the new idea of disease eradication in the 1980s tried to design and shape the new programs based on their experience in the SEP. The SEP had a very effective tool, vaccine, that did not require a cold chain system, and a relatively simple way of administration. The total cost of the eradication program was about US$300 million and the entire campaign took about 10 y. However, the Guinea worm and polio eradication programs that followed in the footsteps of SEP attained varying levels of success, consuming a huge amount of resources and taking a much longer time (&gt;30 y each). This paper reviews the factors that played major roles in hindering the attainment of eradication goals and outlines possible recommendations for the way forward. Among other things, this paper strongly emphasizes that endemic countries should take the lead in all matters pertaining to making decisions for disease elimination and/or eradication initiatives and that ‘elimination as a public health problem’ is the preferred option rather than going for complete eradication at the expense of other health programs and thereby contributing to weakening of already fragile health systems, mainly in Africa.
Two New Species of Sucking Lice (Psocodea: Phthiraptera: Hoplopleuridae) from Chestnut Mice, Pseudomys gracilicaudatus and Pseudomys nanus (Rodentia: Muridae), in Australia
Authors: Wang Wei , Durden Lance A , Shao Renfu 
Published: February 2021

Abstract
We describe two new species of sucking lice in the genus Hoplopleura Enderlein, 1904 (Psocodea: Phthiraptera: Hoplopleuridae) from Australia: Hoplopleura gracilicaudatusa n. sp. from the eastern chestnut mouse Pseudomys gracilicaudatus (Gould) (Rodentia: Muridae), and Hoplopleura nanusa n. sp. from the western chestnut mouse Pseudomys nanus (Gould) (Rodentia: Muridae). Pseudomys Gray is the most speciose genus of rodents endemic to Australia with 24 species; however, only two Pseudomys species have been reported previously to be hosts of sucking lice. The description of the new species in the present study doubles the number of sucking louse species known to parasitize Pseudomys mice and increases the total number of sucking louse species known from endemic Australian rodents from 21 to 23. Pseudomys gracilicaudatus and P. nanus are closely related murines that diverged ~1 MYA with distinct and widely separated extant geographic distributions. The two new Hoplopleura species described in the present study share some morphological characters and likely co-evolved and co-speciated with their chestnut mouse hosts.