bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multivariable Cost Frontiers—Qualitative Financial Analyses Using Operational Metrics From the Implementation of a Surgery Fellowship
Authors: Tan Derek W. , Pandit Jaideep J. , Hudson Mark E. , Steinthorsson Georg , Tsai Mitchell H. 
Published: December 2021

Objective:
We expand the application of cost frontiers and introduce a novel approach using qualitative multivariable financial analyses.

Summary Background Data:
With the creation of a 5 + 2-year fellowship program in July 2016, the Division of Vascular Surgery at the University of Vermont Medical Center altered the underlying operational structure of its inpatient services.

Method:
Using WiseOR (Palo Alto, CA), a web-based OR management data system, we extracted the operating room metrics before and after August 1, 2016 service for each 4-week period spanning from September 2015 to July 2017. The cost per minute modeled after Childers et al’s inpatient OR cost guidelines was multiplied by the after-hours utilization to determine variable cost. Zones with corresponding cutoffs were used to graphically represent cost efficiency trends.

Results:
Caseload/FTE for attending surgeons increased from 11.54 cases per month to 13.02 cases per month (P = 0.0771). Monthly variable costs/FTE increased from $540.2 to $1873 (P = 0.0138). Monthly revenue/FTE increased from $61,505 to $70,277 (P = 0.2639). Adjusted monthly reve-nue/FTE increased from $60,965 to $68,403 (P = 0.3374). Average monthly percent of adjusted revenue/FTE lost to variable costs increased from 0.85% to 2.77% (P = 0.0078). Adjusted monthly revenue/case/FTE remained the same from $5309 to $5319 (P = 0.9889).

Conclusion:
In summary, we demonstrate that multivariable cost (or performance) frontiers can track a net increase in profitability associated with fellowship implementation despite diminishing returns at higher caseloads.
Auxiliary Liver Transplantation for Cirrhosis: From APOLT to RAPID
Authors: Lim Chetana , Turco Celia , Balci Deniz , Savier Eric , Goumard Claire , Perdigao Fabiano , Rousseau Geraldine , Soubrane Olivier , Scatton Olivier 
Published: December 2021

Objective:
To survey the available literature regarding the use of auxiliary liver transplantation (ALT) in the setting of cirrhosis.

Summary of background:
ALT is a type of liver transplantation (LT) procedure in which part of the cirrhotic liver is resected and part of the liver graft is transplanted. The cirrhotic liver left in situ acts as an auxiliary liver until the graft has reached sufficient volume. Recently, a 2-stage concept named RAPID (Resection and Partial Liver segment 2/3 transplantation with Delayed total hepatectomy) was developed, which combines hypertrophy of the small graft followed by delayed removal of the native liver.

Methods:
A scoping review of the literature on ALT for cirrhosis was performed, focusing on the historical background of RAPID and the status of RAPID for this indication. The new comprehensive nomenclature for hepatectomy (“New World” terminology) was used in this review.

Results:
A total of 72 cirrhotic patients underwent ALT [heterotopic (n = 34), orthotopic (Auxiliary partial orthotopic liver transplantation, n = 34 including 5 followed by resection of the native liver at the second stage) and RAPID (n = 4)]. Among the 9 2-stage LTs (APOLT, n = 5; RAPID, n = 4), portal blood flow modulation was performed in 6 patients by deportalization of the native liver (n = 4), portosystemic shunt creation (n = 1), splenic artery ligation (n = 3) or splenectomy (n = 1). The delay between the first and second stages ranged from 18 to 90 days. This procedure led to an increase in the graft-to-recipient weight ratio between 33% and 156%. Eight patients were alive at the last follow-up.

Conclusions:
Two-stage LT and, more recently, the RAPID procedure are viable options for increasing the number of transplantations for cirrhotic patients by using small grafts.
Using the Comprehensive Complication Index to Rethink the ISGLS Criteria for Post-hepatectomy Liver Failure in an International Cohort of Major Hepatectomies
Authors: Calthorpe Lucia , Rashidian Nikdokht , Cacciaguerra Andrea Benedetti , Conroy Patricia C. , Hibi Taizo , Hilal Mohammad Abu , Hoffman Daniel , Park Keon Min , Wang Jaeyun , Adam Mohamed Abdelgadir , Alseidi Adnan ,   International Post-Hepatectomy Liver Failure Study Group
Published: December 2021

Objective:
To compare different criteria for post-hepatectomy liver failure (PHLF) and evaluate the association between International Study Group of Liver Surgery (ISGLS) PHLF and the Comprehensive Complication Index (CCI)” and 90-day mortality.

Summary of Background Data:
PHLF is a serious complication following hepatic resection. Multiple criteria have been developed to characterize PHLF.

Methods:
Adults who underwent major hepatectomies at twelve international centers (2010–2020) were included. We identified patients who met criteria for PHLF based on three definitions: 1) ISGLS, 2) Balzan (INR > 1.7 and bilirubin > 2.92mg/dL) or 3) Mullen (peak bilirubin >7mg/dL). We compared the 90-day mortality and major morbidity predicted by each definition. We then used logistic regression to determine the odds of CCI>40 and 90-day mortality associated with ISGLS grades.

Results:
Among 1646 included patients, 19 (1.1%) met Balzan, 68 (4.1%) met Mullen, and 444 (27.0%) met ISGLS criteria for PHLF. Of the three definitions, the ISGLS criteria best predicted 90-day mortality (AUC = 0.72; sensitivity 69.4%). Patients with ISGLS grades B&C were at increased odds of CCI > 40 (grade B OR 4.0; 95% CI: 2.2–7.2; grade C OR 137.0; 95% CI: 59.2–317.4). Patients with ISGLS grade C were at increased odds of 90-day mortality (OR 113.6; 95% CI: 55.6–232.1). Grade A was not associated with CCI> 40 or 90-day mortality.

Conclusions:
In this diverse international cohort of major hepatectomies, ISGLS grade A was not associated with 90-day mortality or high CCI, calling into question the current classification of patients in this group as having clinically significant PHLF.
COVID-19 amplified racial disparities in the U.S. criminal legal system
Authors: Klein Brennan , Brandon Ogbunugafor C. , Schafer Benjamin J. , Bhadricha Zarana , Kori Preeti , Sheldon Jim , Kaza Nitish , Sharma Arush , Wang Emily A. , Eliassi-Rad Tina , Scarpino Samuel V. , Hinton Elizabeth 
Published: December 2021

AbstractThe criminal legal system in the United States drives an incarceration rate that is the highest on the planet, with disparities by class and race among its signature features [1–3]. During the first year of the COVID-19 pandemic, the number of incarcerated people in the U.S. decreased by at least 17%—the largest, fastest reduction in prison population in American history [4]. In this study, we ask how this reduction influenced the racial com-position of U.S. prisons, and consider possible mechanisms for these dynamics. Using an original dataset curated from public sources on prison demographics across all 50 states and the District of Columbia, we show that incarcerated white people benefited disproportionately from the decrease in the U.S. prison population, and that the fraction of incarcerated Black and Latino people sharply increased. This pattern of increased racial disparity exists across prison systems in nearly every state and reverses a decades-long trend before 2020 and the onset of COVID-19, when the proportion of incarcerated white people was increasing amid declining numbers of incarcerated Black people [5]. Although a variety of factors underlie these trends, we find that racial inequities in average sentence length are a major contributor. Ultimately, this study reveals how disruptions caused by COVID-19 exacer-bated racial inequalities in the criminal legal system, and highlights key forces that sustain mass incarceration.
The role of sub-genomic RNA in discordant results from RT-PCR tests for COVID-19
Authors: Toppings Noah B. , Oberding Lisa K. , Lin Yi-Chan , Evans David , Pillai Dylan R. 
Published: December 2021

AbstractReverse transcription-PCR (RT-PCR) is the standard method of diagnosing COVID-19. An inconclusive test result occurs when one RT-PCR target is positive for SARS-CoV-2 and one RT-PCR target is negative within the same sample. An inconclusive result generally requires retesting. One reason why a sample may yield an inconclusive result is that one target is at a higher concentration than another target. It was hypothesized that concentration differences across targets may be due to the transcription of sub-genomic RNA, as this would result in an increase in the concentration of gene targets near the 3’ end of the SARS-CoV-2 genome. A panel of six digital droplet (dd)PCR assays was designed to quantitate the ORF1, E-gene, and N-gene of SARS-CoV-2. This panel was used to quantify viral cultures of SARS-CoV-2 that were harvested during the eclipse phase and at peak infectivity in such a way as to maximize gene-to-gene copy ratios. Eleven clinical nasopharyngeal swabs were also tested with this panel. In culture, infected cells showed higher N-gene/ORF1 copy ratios than culture supernatants. Both the highest specific infectivity (copies/pfu) and the highest differences between gene targets were observed at 6 hours post-infection (eclipse phase) in infected cells. The same trends in the relative abundance of copies across different targets observed in infected cells was observed in clinical samples, though trends were more pronounced in infected cells. This study showed that a greater copy number of N-gene relative to E-gene and ORF1 transcripts could potentially explain inconclusive results for some RT-PCR tests on low viral load samples. The use of N-gene RT-PCR target(s) as opposed to ORF1 targets for routine testing is supported by this data.Author SummaryThis paper provides insight into a drawback of the standard method of testing for COVID-19 (RT-PCR). The results presented here propose an explanation for why inconclusive results sometimes occur with this method. These results can aid microbiologists in the interpretation of inconclusive test results. These results can also aid in decisions about which COVID-19 test a laboratory should use, as there are a plethora of options available. This is important because this standard testing method will remain a critical tool – globally – for managing the COVID-19 pandemic and any future viral pandemics and epidemics. Thus, it is important to investigate every facet of the testing method. The findings presented here are applicable to any virus which makes sub-genomic transcripts as part of its life cycle. Trends observed in viral cultures are presented alongside the same trends observed in clinical samples. Unlike similar papers in the field, this paper did not strive to develop a new methodology or tool.
A systematic literature review of individual-level psychological and behavioral responses to the health information of COVID-19 from social media and legacy media
Authors: Zhai Wei , Bian Jian , Zhang Jing , Bai Xueyin 
Published: December 2021

AbstractCovid-19 has been recognized as a terrifying global health threat since its detection, with far-reaching consequences that are unprecedented in the modern era. Since the outbreak of the pandemic, social media and legacy media have collectively delivered health information related to COVID-19 to the public as a catalyst to community perception of risk. However, the existing literature exhibits different viewpoints toward the role of social media and legacy media in disseminating health information of COVID-19. In this regard, this article conducted a systematic literature review to provide an overview of the current state of research concerning individuals-level psychological and behavioral response to COVID-19 related information from different sources, as well as presents the challenges and future research directions.
The Influence of Age, Sex, and Socioeconomic Status on Glycemic Control Among People with Type 1 and Type 2 Diabetes in Canada: A Patient-Led Longitudinal Retrospective Cohort Study
Authors: Mousavi Seyedmostafa , Greenberg Dana , Ndjaboué Ruth , Greiver Michelle , Drescher Olivia , Dansokho Selma Chipenda , Boutin Denis , Chouinard Jean-Marc , Dostie Sylvie , Fenton Robert , Greenberg Marley , McGavock Jon , Najam Adhiyat , Rekik Monia , Weisz Tom , Willison Donald J. , Durand Audrey , Witteman Holly O. 
Published: December 2021

AbstractBackgroundClinical guidelines for most adults with diabetes recommend maintaining hemoglobin A1c (HbA1c) ≤7.0% (<53 mmol/mol) to avoid microvascular and macrovascular complications. People with diabetes of different ages, sexes, and socioeconomic statuses may differ in their ease of attaining this goal. As a team of people with diabetes, researchers, and health professionals, we aimed to explore patterns in HbA1c results among people with type 1 or type 2 diabetes in Canada. Our research question was identified by people living with diabetes.MethodsWe used generalized estimating equations to analyze the effects of age, sex and socioeconomic status in 947,543 HbA1c results measured from 2010 to 2019 among 90,770 people living with type 1 or 2 diabetes in Canada. People living with diabetes reviewed and interpreted the results.ResultsHbA1c results at or below 7.0% represented 30.5% (male people living with type 1 diabetes), 21.0% (female people living with type 1 diabetes), 55.0% (male people living with type 2 diabetes) and 59.0% (female people living with type 2 diabetes) of results in each subcategory. We observed higher HbA1c values during adolescence and, for people living with type 2 diabetes, among people living in lower income areas. Among those with type 1 diabetes, female people tended to have lower HbA1c than male people during childbearing years but higher HbA1c than male people during menopausal years. Team members living with diabetes confirmed that the patterns we observed reflected their own life courses and suggested these results be communicated to health professionals and other stakeholders to improve treatment for people living with diabetes.InterpretationA substantial proportion of people with diabetes in Canada are insufficiently supported to maintain guideline-recommended glycemic control goals. Blood sugar management goals may be particularly challenging for people who are going through adolescence, menopause, or living with fewer financial resources. Health professionals should be aware of the challenging nature of glycemic management and policymakers in Canada should provide more support for people with diabetes to live healthy lives.
Antibodies targeting merozoites induce natural killer cell degranulation and interferon gamma secretion and are associated with immunity against malaria
Authors: Odera Dennis O. , Tuju James , Mwai Kennedy , Nkumama Irene N. , Fürle Kristin , Chege Timothy , Kimathi Rinter , Diel Stefan , Musasia Fauzia K. , Rosenkranz Micha , Njuguna Patricia , Hamaluba Mainga , Kapulu Melissa C. , Frank Roland , Osier Faith H. A. ,   CHMI-SIKA Study Team
Published: December 2021

AbstractNatural killer cells are potent immune effectors that can be activated via antibody mediated Fc receptor engagement. Using multiparameter flow cytometry, we found that natural killer (NK) cells degranulate and release IFNγ upon stimulation with antibody-opsonized Plasmodium falciparum merozoites. Antibody-dependent NK activity (Ab-NK) was largely strain-transcending and enhanced the inhibition of invasion into erythrocytes. Ab-NK was associated with the successful control of parasitemia following experimental malaria challenge in African adults. In an independent cohort study in children, Ab-NK increased with age, was boosted by concurrent falciparum infections and associated with a lower risk of clinical episodes of malaria. Nine of 14 vaccine candidates tested induced Ab-NK including some less well-studied antigens - P41, P113, MSP11, RHOPH3, and Pf_11363200. These data highlight an important role for ab-NK in immunity against malaria and provide a new mechanism for the evaluation of vaccine candidatesOne Sentence SummaryAntibody-dependent natural killer activation is induced by merozoites and associated with immunity against malaria
The association between midwifery staffing levels and the experiences of mothers on postnatal wards: cross sectional analysis of routine data
Authors: Turner Lesley , Culliford David , Ball Jane , Kitson-Reynolds Ellen , Griffiths Peter 
Published: December 2021

AbstractBackgroundWomen have consistently reported lower satisfaction with postnatal care compared with antenatal and labour care. The aim of this research was to examine whether women’s experience of inpatient postnatal care in England is associated with variation in midwifery staffing levels.MethodsAnalysis of data from the National Maternity Survey in 2018 including 17,611 women from 129 organisations. This was linked to hospital midwifery staffing numbers from the National Health Service (NHS) Workforce Statistics and the number of births from Hospital Episode Statistics. A two-level logistic regression model was created to examine the association of midwifery staffing levels and experiences in post-natal care.ResultsThe median full time equivalent midwives per 100 births was 3.55 (interquartile range 3.26 to 3.78). Higher staffing levels were associated with less likelihood of women reporting delay in discharge (adjusted odds ratio [aOR] 0.849, 95% CI 0.753 to 0.959, p=0.008), increased chances of women reporting that staff always helped in a reasonable time aOR1.200 (95% CI 1.052, 1.369, p=0.007) and that they always had the information or explanations they needed aOR 1.150 (95% CI 1.040, 1.271, p=0.006). Women were more likely to report being treated with kindness and understanding with higher staffing, but the difference was small and not statistically significant aOR 1.059 (0.949, 1.181, p=0.306).ConclusionsNegative experiences for women on postnatal wards were more likely to occur in trusts with fewer midwives. Low staffing could be contributing to discharge delays and lack of support and information, which may in turn have implications for longer term outcomes for maternal and infant wellbeing.ExplanationWhile we recognise that not all gestational parents identify as women; this term was chosen as it has been used in the data source which was accessed for this study and represents most people having maternities.Statement of significance (problem)Women report negative experiences of postnatal care compared with antenatal care and birth. There is a recognised shortage of midwives in maternity services, and this may be impacting on the quality of postnatal care.What is already known?There is evidence that midwifery staffing levels are associated with birth outcomes but little empirical evidence on the impact of midwifery staffing levels in postnatal careWhat this paper adds?This analysis of survey data supports previous findings that increased midwifery staffing is associated with benefits. This is the first study to examine the effects of staffing on women’s experience of postnatal care.
Discovery and synthesis of hydroxy-L-proline based blockers of the neutral amino acid transporters SLC1A4 (ASCT1) and SLC1A5 (ASCT2)
Authors: Lyda Brent R. , Leary Gregory P. , Farnsworth Jill , Silvius Derek , Seaver Benjamin , Esslinger C. Sean , Natale Nicholas R. , Kavanaugh Michael P. 
Published: December 2021

AbstractThe conformationally restricted heterocycle hydroxy-L-proline is a versatile scaffold for the synthesis of diverse multi-functionalized pyrrolidines for probing the ligand binding sites of biological targets. With the goal to develop new inhibitors of the widely expressed amino acid transporters SLC1A4 and SLC1A5 (also known as ASCT1 and ASCT2), we synthesized and functionally screened a series of hydroxy-L-proline derivatives or ‘prolinols’ using electrophysiological and radio-labeled uptake assays on amino acid transporters from the SLC1, SLC7, and SLC38 solute carrier families. We identified a number of synthetic prolinols that act as selective high-affinity inhibitors of the SLC1 functional subfamily comprising the neutral amino acid transporters SLC1A4 and SLC1A5. The active and inactive prolinols were computationally docked into a threaded homology model and analyzed with respect to predicted molecular orientation and observed pharmacological activity. The series of hydroxy-L-proline derivatives identified here represents a new class of potential agents to pharmacologically modulate SLC1A4 and SLC1A5, amino acid exchangers that play important roles in a wide range of physiological and pathophysiological processes.
Using polyacrylamide hydrogels to model physiological aortic stiffness reveals that microtubules are critical regulators of isolated smooth muscle cell morphology and contractility
Authors: Ahmed Sultan , Johnson Robert. T. , Solanki Reesha , Afewerki Teclino , Wostear Finn , Warren Derek T. 
Published: December 2021

AbstractVascular smooth muscle cells (VSMCs) are the predominant cell type in the medial layer of the aortic wall and normally exist in a quiescent, contractile phenotype where actomyosin-derived contractile forces maintain vascular tone. However, VSMCs are not terminally differentiated and can dedifferentiate into a proliferative, synthetic phenotype. Actomyosin force generation is essential for the function of both phenotypes. Whilst much is already known about the mechanisms of VSMC actomyosin force generation, existing assays are either low throughput and time consuming, or qualitative and inconsistent. In this study, we use polyacrylamide hydrogels, tuned to mimic the physiological stiffness of the aortic wall, in a VSMC contractility assay. Isolated VSMC area decreases following stimulation with the contractile agonists angiotensin II or carbachol. Importantly, the angiotensin II induced reduction in cell area correlated with increased traction stress generation. Inhibition of actomyosin activity using blebbistatin or Y-27632 prevented angiotensin II mediated changes in VSMC morphology, suggesting that changes in VSMC morphology and actomyosin activity are core components of the contractile response. Furthermore, we show that microtubule stability is an essential regulator of isolated VSMC contractility. Treatment with either colchicine or paclitaxel uncoupled the morphological and/or traction stress responses of angiotensin II stimulated VSMCs. Our findings support the tensegrity model and we demonstrate that microtubules act to balance the actomyosin-derived traction stress generation and regulate the morphological responses of VSMCs.