bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Affordable Care Act and Health Care Access and Utilization Among White, Asian, and Latino Immigrants in California
Authors: Chu Jun , Ortega Alexander N. , Park Sungchul , Vargas-Bustamante Arturo , Roby Dylan H. 
Published: June 2021

Objective:
The objective of this study was to examine changes in health care access and utilization for White, Asian, and Latino immigrants associated with the implementation of the Patient Protection and Affordable Care Act (ACA) in California.

Study Design:
Using the 2011–2013 and 2015–2017 California Health Interview Survey, we examined changes in 2 health care access and 2 utilization measures among 3 immigrant racial/ethnic groups. We estimated the unadjusted and adjusted percentage point changes in the pre-ACA and post-ACA periods. Adjusted estimates were obtained using linear probability models controlling for predisposing, enabling, and need factors.

Results:
After the ACA was nationally implemented in 2014, rates of insurance increased for non-Latino (NL) White, NL Asian, and Latino immigrant groups in California. Latino immigrants had the largest increase in insurance coverage (14.3 percentage points), followed by NL Asian immigrants (9.9 percentage points) and NL White immigrants (9.2 percentage points). Despite benefitting from the largest increase in insurance coverage, the proportion of insured Latino immigrants was still lower than that of NL White and NL Asian immigrants. Latino immigrants reported a small but significant decrease in the usual source of care (−2.8 percentage points) and an increase in emergency department utilization (2.9 percentage points) after the ACA. No significant changes were found after the ACA in health care access and utilization among NL White and NL Asian immigrants.

Conclusions:
Insurance coverage increased significantly for these 3 immigrant groups after the ACA. While Latino immigrants had the largest gain in insurance coverage, the proportion of Latino immigrants with insurance remained the lowest among the 3 immigrant racial/ethnic groups.
Baseline 18F-FDG PET textural features as predictors of response to chemotherapy in diffuse large B-cell lymphoma
Authors: Coskun Nazim , Okudan Berna , Uncu Dogan , Kitapci Mehmet Tevfik 
Published: June 2021

Purpose
We sought to investigate the performance of radiomics analysis on baseline 18F-FDG PET/CT for predicting response to first-line chemotherapy in diffuse large B-cell lymphoma (DLBCL).

Material and methods
Forty-five patients who received first-line rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R-CHOP) chemotherapy for DLBCL were included in the study. Radiomics features and standard uptake value (SUV)-based measurements were extracted from baseline PET images for a total of 147 lesions. The selection of the most relevant features was made using the recursive feature elimination algorithm. A machine-learning model was trained using the logistic regression classifier with cross-validation to predict treatment response. The independent predictors of incomplete response were evaluated with multivariable regression analysis.

Results
A total of 14 textural features were selected by the recursive elimination algorithm, achieving a feature-to-lesion ratio of 1:10. The accuracy and area under the receiver operating characteristic curve of the model for predicting incomplete response were 0.87 and 0.81, respectively. Multivariable analysis revealed that SUVmax and gray level co-occurrence matrix dissimilarity were independent predictors of lesions with incomplete response to first-line R-CHOP chemotherapy.

Conclusion
Increased textural heterogeneity in baseline PET images was found to be associated with incomplete response in DLBCL.
The set point: weight destiny established before adulthood?
Authors: Rose Kelsey L. , Evans E. Whitney , Sonneville Kendrin R. , Richmond Tracy 
Published: June 2021

Purpose of review
Although the set point is one of the best understood weight defense mechanisms, how and when a set point is established and what causes its disruption are not well understood. The purpose of this review is to address these gaps in the literature by exploring studies on the establishment of the set point theory and the underlying metabolic processes that support its existence.

Recent findings
Research suggests that weight loss achieved through restricted energy intake and increased energy expenditure is difficult to maintain and is often followed by greater weight gain over time. It is hypothesized that such weight gain is driven by an individual's set point, a weight range in which the body seeks to remain by adjusting metabolism (e.g. by moderating energy expenditure based on energy intake in times of diet or energy fluctuation). Similar to adults, weight loss in adolescence results in decreased resting metabolic rate (RMR), and that the RMR remains suppressed even with weight restoration.

Summary
Recommending weight loss in youth results in metabolic adaptations to restore weight and weight inclusive approaches may be more appropriate to protect their health and wellbeing.
Mycobacterium tuberculosis in solid organ transplant donors and recipients
Authors: Malinis Maricar , Koff Alan 
Published: June 2021

Purpose of review
Due to impaired immune response, solid organ transplant (SOT) recipients are susceptible to tuberculosis (TB) and its subsequent morbidity and mortality. Current prevention strategies, diagnostic and treatment approach to TB infection in donors and recipients were reviewed in this article.

Recent findings
Screening of latent tuberculosis infection (LTBI) in donors and recipients is the cornerstone of TB-preventive strategy in recipients and requires an assessment of TB risk factors, TB-specific immunity testing, and radiographic evaluation. Interferon-gamma release assay has superseded the tuberculin skin test in LTBI evaluation despite its recognized limitations. LTBI treatment should be offered to transplant candidates and living donors before transplantation and donation, respectively. Diagnosis of TB disease can be challenging because of nonspecific clinical presentation in the recipient and is limited by the sensitivity of current diagnostics. The approach to LTBI and TB disease treatment is similar to the general population, but can be challenging because of potential drug interactions and toxicities.

Summary
The appropriate evaluation of donors and recipients for TB can mitigate posttransplant TB disease. Current approaches to diagnosis and treatment parallels that of immunocompetent hosts. Future research evaluating existing and novel diagnostics and treatment in transplant recipients is needed.
Normative Data for Nonstrabismic Binocular Vision Parameters in African Schoolchildren
Authors: Darko-Takyi Charles , Moodley Vanessa R. , Boadi-Kusi Samuel B. 
Published: June 2021

SIGNIFICANCE
With reported population differences in parameters of nonstrabismic binocular vision, the present study investigated and reports normative data among a sample of African children.

PURPOSE
This study aimed to determine expected binocular visual function data among schoolchildren in the Central Region of Ghana.

METHODS
The study used a prospective cross-sectional design and used a multistage cluster sampling approach. Eligible normal participants selected through the administration of Convergence Insufficiency Symptom Survey questionnaire (score <16) and preliminary vision screening underwent comprehensive binocular vision testing. Only data for participants who expressed no difficulty with the specific procedures were analyzed.

RESULTS
A total of 1261 normal participants (11 to 17 years [mean, 14.75 ± 1.530 years]) were selected for comprehensive binocular vision testing in the normative data study. The means with ±1 standard deviation for normative data for the nonstrabismic binocular vision parameters include the following: accommodative target near point of convergence (NPC) break (6.10 ± 1.67 cm), NPC recovery (8.17 ± 1.67 cm), fixation light with red-green anaglyph (RG NPC) break (8.51 ± 2.43 cm), RG NPC recovery (10.95 ± 2.60 cm), cover test distance phoria (0.12 ± 0.79 exophoria), cover test near phoria (2.1 ± 2.3 exophoria), modified Thorington test near phoria (1.9 ± 2.5 exophoria), negative relative accommodation (+2.54 ± 0.75 D), positive relative accommodation (−2.58 ± 0.81 D), and the accommodative convergence over accommodation ratio (2.80 ± 1.07:1). Age (in years)-predicted normal linear regression equations for NPC break (5.13 + 0.07 × age), RG NPC break (10.00 − 0.10 × age), RG NPC recovery (12.83 − 0.13 × age), positive relative accommodation (2.05 + 0.04 × age), and the gradient accommodative convergence over accommodation ratio (3.97 − 0.08 × age) serve as a guide.

CONCLUSIONS
The study provides expected data that optometrists may use with similar aged Black African populations.
Community Assessment for Public Health Emergency Response (CASPER) Following Hurricane Michael, Bay and Gulf Counties, Florida, 2019
Authors: Rodriguez Edda , Duclos Chris , Joiner Jessica , Jordan Melissa , Reid Keshia , Kintziger Kristina W 
Published: June 2021

Context:
On October 10, 2018, Hurricane Michael made landfall near Mexico Beach, Florida, as one of the strongest storms on record to hit the US mainland. Hurricane Michael brought strong winds, heavy rain, and life-threatening storm surge, causing extensive damage across the Florida Panhandle.

Objectives:
To assess community preparedness and effects experienced by Panhandle residents, including structural and economic losses, injury and illness, health care access, and suicide risk and ideation in the counties most severely impacted by Hurricane Michael.

Design:
The Florida Department of Health conducted a Community Assessment for Public Health Emergency Response (CASPER) in October and November 2019, a year after Hurricane Michael made landfall. CASPER is a 2-stage cluster sampling method designed to provide household-level information about a community's needs in a timely, inexpensive, and representative manner.

Setting:
A total of 30 clusters were randomly selected from Bay and Gulf Counties, Florida.

Participants:
In total, 178 face-to-face interviews were completed with adult residents 18 years or older.

Main Outcome Measures:
Hurricane-related impacts, including structural and economic losses, injury and illness, health care access; and mental health.

Results:
Almost half of respondents did not evacuate despite mandatory evacuation orders. Most houses (78.1%) received some damage, with more than half still not repaired 1 year later. Access to emergency supply kits, water, nonperishable foods, medications, and health care was common, though many reported needing supplies not included in their kit. Less than half reported having working household carbon monoxide detectors. Injuries and illnesses associated with the hurricane were uncommon; however, anxiety, depression, and insomnia were reported as occurring or worsening by more than one-third of respondents posthurricane.

Conclusions:
Increased education and communication regarding hurricane preparedness and recovery, which include clearer messaging on evacuation, improving emergency supply kits, importance of carbon monoxide detectors, and proper generator use, could enhance the safety of the community.
Everyday Discrimination and Mental Stress–Induced Myocardial Ischemia
Authors: McKinnon Izraelle I. , Shah Amit J. , Lima Bruno , Moazzami Kasra , Young An , Sullivan Samaah , Almuwaqqat Zakaria , Garcia Mariana , Elon Lisa , Bremner J. Douglas , Raggi Paolo , Quyyumi Arshed A. , Vaccarino Viola , Lewis Tené T. 
Published: June 2021

ABSTRACT

Objective
Mental stress–induced myocardial ischemia (MSIMI), a transient myocardial ischemic response to mental stress, is associated with poorer outcomes among patients with coronary heart disease and is more likely to occur among women. However, predictors of MSIMI are not well explored. The current study investigated the association between experiences of everyday discrimination and MSIMI among patients with recent myocardial ischemia and contrasted the results with conventional stress–induced myocardial ischemia (CSIMI). We examined sex differences in associations.

Methods
We studied 295 post-MI patients (145 women, 150 men). Provocation of myocardial ischemia with mental stress (speech task) and conventional stress (exercise or pharmacologic) was assessed by myocardial perfusion imaging. Frequency of exposure to everyday discrimination was assessed via questionnaire using the Everyday Discrimination Scale (EDS).

Results
The mean age was 51 years in both women and men, and the EDS score ranged from 10 to 38 (mean [standard deviation] = 17 [6] years). After multivariable analysis, each standard deviation increase in the EDS score (more frequent exposure) was associated with an increased odds of MSIMI (odds ratio [OR] = 1.57 [1.10–2.23]). The EDS score was not associated with CSIMI (OR = 0.86 [0.64–1.17]). Women demonstrated a twofold increase (OR = 1.96 [1.13–3.38], p = .02) in the adjusted odds of MSIMI, with each standard deviation increase in the EDS score compared with a 1.4-fold increase (OR = 1.40 [0.80–2.44], p = .24) among men; however, interaction was not statistically significant.

Conclusions
Among post-MI patients, everyday discrimination was positively associated with occurrence of MSIMI, but not with CSIMI; associations were more pronounced among women.
The impact of COVID-19 infection on outcomes after injury in a state trauma system
Authors: Kaufman Elinore J. , Ong Adrian W. , Cipolle Mark D. , Whitehorn Gregory , Ratnasekera Asanthi , Stawicki Stanislaw P. , Martin Niels D. 
Published: June 2021

BACKGROUND
The COVID-19 pandemic reshaped the health care system in 2020. COVID-19 infection has been associated with poor outcomes after orthopedic surgery and elective, general surgery, but the impact of COVID-19 on outcomes after trauma is unknown.

METHODS
We conducted a retrospective cohort study of patients admitted to Pennsylvania trauma centers from March 21 to July 31, 2020. The exposure of interest was COVID-19 (COV+) and the primary outcome was inpatient mortality. Secondary outcomes were length of stay and complications. We compared demographic and injury characteristics between positive, negative, and not-tested patients. We used multivariable regression with coarsened exact matching to estimate the impact of COV+ on outcomes.

RESULTS
Of 15,550 included patients, 8,170 (52.5%) were tested for COVID-19 and 219 (2.7%) were positive (COV+). Compared with COVID-19–negative (COV−) patients, COV+ patients were similar in terms of age and sex, but were less often white (53.5% vs. 74.7%, p < 0.0001), and more often uninsured (10.1 vs. 5.6%, p = 0.002). Injury severity was similar, but firearm injuries accounted for 11.9% of COV+ patients versus 5.1% of COV− patients (p < 0.001). Unadjusted mortality for COV+ was double that of COV− patients (9.1% vs. 4.7%, p < 0.0001) and length of stay was longer (median, 5 vs. 4 days; p < 0.001). Using coarsened exact matching, COV+ patients had an increased risk of death (odds ratio [OR], 6.05; 95% confidence interval [CI], 2.29–15.99), any complication (OR, 1.85; 95% CI, 1.08–3.16), and pulmonary complications (OR, 5.79; 95% CI, 2.02–16.54) compared with COV− patients.

CONCLUSION
Patients with concomitant traumatic injury and COVID-19 infection have elevated risks of morbidity and mortality. Trauma centers must incorporate an understanding of these risks into patient and family counseling and resource allocation during this pandemic.

LEVEL OF EVIDENCE
Level II, Prognostic Study.
Rapid and sustained decline in CXCL-10 (IP-10) annotates clinical outcomes following TNF-α antagonist therapy in hospitalized patients with severe and critical COVID-19 respiratory failure
Authors: Hachem Hilal , Godara Amandeep , Schroeder Courtney , Fein Daniel , Mann Hashim , Lawlor Christian , Marshall Jill , Klein Andreas , Poutsiaka Debra , Breeze Janis L. , Joshi Raghav , Mathew Paul 
Published: June 2021

BackgroundA feed-forward pathological signaling loop generated by TNFα and IFN-γ in inflamed lung tissue, driving CXCL-10 (IP-10) and CXCL-9 chemokine-mediated activated T-cell and monocyte/macrophage tissue recruitment, may define, sustain and amplify the inflammatory biology of lethal COVID-19 respiratory failure.MethodsTo assess TNFα-antagonist therapy, 18 hospitalized adults with hypoxic respiratory failure and COVID-19 pneumonia received single-dose infliximab-abda therapy 5mg/kg intravenously between April and December 2020. The primary endpoint was time to increase in oxygen saturation to fraction of inspired oxygen ratio (SpO2/FiO2) by ≥ 50 compared to baseline and sustained for 48 hours. Secondary endpoints included 28-day mortality, dynamic cytokine profiles (Human Cytokine 48-Plex Discovery Assay, Eve Technologies), secondary infections, duration of supplemental oxygen support and hospitalization.FindingsPatients were predominantly in critical respiratory failure (15/18, 83%), male (14/18, 78%), above 60 years (median 63 yrs, range 31-80), race-ethnic minorities (13/18, 72%), lymphopenic (13/18, 72%), steroid-treated (17/18, 94%), with a median ferritin of 1953ng/ml. Sixteen patients (89%) met the primary endpoint within a median of 4 days, 15/18 (83%) recovered from respiratory failure, and 14/18 (78%) were discharged in a median of 8 days and were alive at 28-day follow-up. Deaths among three patients ≥ 65yrs age with pre-existing lung disease or multiple comorbidities were attributed to secondary lung infection. Mean plasma IP-10 levels declined sharply from 9183 pg/ml to 483 pg/ml at Day 3 and further to 146 pg/ml at Day 14/discharge. Significant declines in IFN-γ, TNFα, IL-27, CRP and ferritin were specifically observed at Day 3 whereas other cytokines were unmodified. IL-6 levels declined sharply among patients with baseline levels >10 pg/ml. Among 13 lymphopenic patients, six (46%) had resolution of lymphopenia by day 3, and 11 by day 14. CXCR3-ligand (IP-10 and CXCL-9) declines were strongly correlated among patients with lymphopenia reversal (Day 3, Pearson r: 0.98, p-value: 0.0006).InterpretationConsistent with a pathophysiological role of TNFα, the clinical and cytokine data indicate that infliximab-abda may rapidly abrogate pathological inflammatory signaling to facilitate clinical recovery in severe and critical COVID-19. Randomized studies are required to formally assess mortality outcomes. Funding: National Center for Advancing Translational Sciences
Job stress and loneliness among remote workers
Authors: Miyake Fuyu , Odgerel Chimed-Ochir , Hino Ayako , Ikegami Kazunori , Nagata Tomohisa , Tateishi Seiichiro , Tsuji Mayumi , Matsuda Shinya , Ishimaru Tomohiro 
Published: June 2021

AbstractBackgroundTo prevent the spread of coronavirus disease 2019 (COVID-19), physical distancing and isolation are crucial strategies in society. However, this response to the pandemic promotes loneliness. Previous studies have reported an increase in loneliness since the outbreak of COVID-19, but there is little evidence on the relationship between job stress and loneliness among remote workers.AimsTo assess the relationship between job stress and loneliness among remote workers.MethodsThis study is a part of nation-wide cross-sectional online survey evaluating the impact of the COVID-19 pandemic in Japan. A total of 27,036 full-time workers completed the self-administrated questionnaire in December 2020. We extracted data on 4,052 desk workers who indicated that they were doing remote work. Loneliness was assessed using a single question and job stress was measured using the Job Content Questionnaire. Multiple logistic regression was performed.ResultsFrequency of remote work was moderately associated with loneliness (adjusted odds ratio [AOR] = 1.60, 95% confidence interval [CI]: 1.04–2.46, P = 0.033). Participants who reported of having a low level of co-worker or supervisor support had greater odds of feeling lonely than those who were highly supported (co-worker support: AOR = 4.06, 95% CI: 2.82–5.84, P <0.001; supervisor support: AOR = 2.49, 95% CI: 1.79–3.47, P <0.001).ConclusionsCo-worker support and supervisor support were strongly associated with loneliness, whereas frequency of remote work was moderately associated with feeling lonely. Support from co-workers and supervisors may be crucial factors to prevent loneliness caused by remote work.
Head, facial and neck cooling as per-cooling modalities to improve exercise performance in the heat: A narrative review and practical applications
Authors: Cao Yinhang , Lei Tze-Huan , Wang Faming , Yang Bin 
Published: June 2021

ABSTRACTIt has been well established that athletic performance is greatly affected by environmental heat. Numerous studies have attempted to find reliable cooling strategies to improve athletic performance while exercising in the heat. Whole-body pre-cooling has been found to enhance endurance performance in both dry and humid heat. Nevertheless, positive physiological alternations induced by pre-cooling gradually disappear during exercise. Hence, there is a great need to find effective per-cooling strategies to improve athletic performance in the heat. Unfortunately, it’s impractical to adopt pre-cooling approaches as a per-cooling modality to improve athletic performance due to inherent issues of practicality. Thus, a narrative review was conducted to examine the impact of head, neck and facial cooling on athletic performance in the heat. Based on current evidences, head, neck and facial cooling could greatly decrease local skin temperature at those areas where cooling was applied and thereby, local perceptual sensations were greatly enhanced. Neck cooling during exercise is found effective to improve athletic performance for both endurance and team sports athletes in the heat. Besides, neck cooling is preferred over the head, facial & combined head/facial & neck cooling for both endurance and team sport athletes in the heat from a practical application viewpoint. Research is lacking on the systematically selection of per-cooling modalities to improve athletic performance based on environmental conditions and nature of the sports activity. In addition, powerful but portable head, neck and facial cooling systems are urgently required to help athletes improving performance in the heat.Key pointsNeck cooling during exercise is effective to enhance endurance performance for endurance athletes in the heat.Neck cooling during exercise could improve repeated sprint performance for team sport athletes in the heat.Head, neck & facial cooling could largely reduce local skin temperature and thereby improving local perceptual responses.Neck cooling is preferred over the head, facial & combined head/facial & neck cooling for both endurance and team sport athletes.It’s challenging to adopt facial or head cooling to cool athletes during exercise due to inherent issues of practicality.