bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isolated tricuspid valve surgery: first outcomes report according to a novel clinical and functional staging of tricuspid regurgitation
Authors: Sala Alessandra , Lorusso Roberto , Bargagna Marta , Ascione Guido , Ruggeri Stefania , Meneghin Roberta , Schiavi Davide , Buzzatti Nicola , Trumello Cinzia , Monaco Fabrizio , Agricola Eustachio , Alfieri Ottavio , Castiglioni Alessandro , De Bonis Michele 
Published: May 2021

Abstract

OBJECTIVES
The goal of this study was to assess the applicability of a novel classification of patients with tricuspid regurgitation based on 5 stages and to evaluate outcomes following isolated surgical treatment.

METHODS
All patients treated with isolated tricuspid valve repair or tricuspid valve replacement (TVR) from March 1997 to January 2020 at a single institution were retrospectively reviewed. Patients were divided according to a novel clinical-functional classification, based on the degree of regurgitation together with symptoms, right ventricular size and function and medical therapy. A total of 195 patients were treated; however, 23/195 were excluded due to lack of sufficient preoperative data.

RESULTS
A total of 172 patients were considered; of these, 129 (75%) underwent TVR and 43 (25%) had tricuspid valve repair. The distribution of patients showed that 46.5% of patients who underwent tricuspid valve repair were in stage 2, whereas 51.9% who underwent TVR were in stage 3. TVR patients were in more advanced stages of the disease, with dilated right ventricles, more pronounced symptoms and development of organ damage. Hospital mortality was 5.8%, in particular 0% in stages 2 and 3 and 15.3% in stages 4 and 5 (P &lt; 0.001). Both intensive care unit and hospital stays were significantly longer in more advanced stages (P &lt; 0.001). Patients in stages 4 and 5 developed more postoperative complications, such as acute kidney injury (3.7–10% in stages 2 and 3 vs 44–100% in stages 4 and 5; P &lt; 0.001) and low cardiac output syndrome (15–50% in stages 2 and 3 vs 71–100% in stages 4 and 5; P &lt; 0.001).

CONCLUSIONS
Patients in more advanced stages had higher hospital mortality and longer hospitalizations. Timely referral is associated with lower mortality, short postoperative course and mostly valve repair.
Age Discrimination in the Context of Motivation and Healthy Aging
Authors: Rothermund Klaus , Klusmann Verena , Zacher Hannes 
Published: May 2021

AbstractAge discrimination can undermine older people’s motivation to stay engaged with their lives and poses a major challenge to healthy aging. In this article, we review research on age discrimination in different life domains, including health and work. Motivation and health constitute potential antecedents as well as outcomes of age discrimination, with reduced motivation and impaired health increasing the likelihood of becoming a victim of age discrimination, but also resulting from age discrimination. Furthermore, high levels of motivation and health can also serve as buffers against the negative effects of age discrimination. Based on our literature review, we discuss possible strategies aimed at reducing age discrimination. Understanding and combating age discrimination can foster older people’s motivation to participate in meaningful activities and promote healthy aging.
Correlates of Memory and Executive Function in Middle-Aged and Older Adults in the CLSA: A Minority Stress Approach
Authors: Stinchcombe Arne , Hammond Nicole G 
Published: May 2021

Abstract

Objectives
Maintaining cognitive function is an important component of healthy aging. There is increasing recognition that extraneous factors expedite the typical cognitive aging process. Risk factors for cognitive decline cluster around inequalities and disproportionally affect minority and vulnerable groups. Taking a minority stress approach, we examined the relationship between proxy measures of minority stress and cognitive health in a large sample of Canadians aged 45–85 years.

Methods
Data were drawn from the baseline of the Canadian Longitudinal Study on Aging, a prospective cohort study. Memory (n = 36,849) and executive function (n = 36,266) were assessed using standardized assessment tools. We ran multiple linear regression models with memory and executive function as the outcomes. Explanatory variables included known correlates of cognitive health (i.e., demographic, health, and cognitive reserve) and proxy measures of minority stress (i.e., sexual orientation, race, and perceived social standing).

Results
Results were consistent with existing evidence showing that demographic and health variables were associated with cognitive performance. Modifiable health variables, walking, and fruit/vegetable consumption were associated with better cognitive performance, as were cognitive reserve and social support measures. Within the models, racial minority status was consistently associated with lower cognitive performance. As one’s perceived social standing within their own community increased, so too did cognitive function.

Discussion
These findings identify factors that may put people at risk for cognitive decline. There is a need to support the cognitive health of racialized Canadians and members of other disadvantaged groups, while promoting health equity.
The consideration of rights in the Israeli Counter-Terrorism Law
Authors: Margalit Lila 
Published: May 2021

Abstract
What can we realistically expect from pre-enactment rights engagement, particularly in sensitive areas like counterterrorism, which pit “our” security against “their” rights? This article seeks to contribute to the ongoing scholarly effort to explore this question, through an in-depth case study of the Israeli Counter-Terrorism Law, adopted by the Knesset in 2016. The case study reveals a complex picture. On the one hand, the unrushed and depoliticized nature of deliberations on the Counter-Terrorism Law contributed to a parliamentary process that, while not challenging the government’s core policy agenda, did force it to justify and refine the specific, worthy purposes of particular provisions, to agree to some narrow-tailoring, and to improve certain procedural safeguards. These parliamentary processes were facilitated primarily by the institution of the Knesset committee legal advisor, whose non-partisan, independent status and wide-ranging advisory functions position them to facilitate informed rights-based deliberations in the absence of a formalized vetting process. At the same time, the case study reveals significant constraints on the potential for deliberative rights engagement, which are particularly salient in the field of counterterrorism, including the information gap—the fact that the government possesses a near monopoly on the factual expertise and information necessary to effectively evaluate counterterrorism policy, and the problem of voice—the fact that those whose rights are most likely to be curtailed by counterterrorism measures are underrepresented in the process. Relatedly, it demonstrates the importance of including in the process actors who are institutionally motivated to be skeptical of government discretion and who take seriously the risk of erroneous or abusive use of power.
Genetic Variants and Immune Responses in a Cohort of Patients With Varicella Zoster Virus Encephalitis
Authors: Thomsen Michelle M , Tyrberg Tobias , Skaalum Kristoffer , Carter-Timofte Madalina , Freytag Mette R , Norberg Peter , Helleberg Marie , Storgaard Merete , Nielsen Henrik , Bodilsen Jacob , Grahn Anna , Mogensen Trine H 
Published: May 2021

Abstract

Background
Infection with varicella zoster virus (VZV) may involve different central nervous system (CNS) manifestations, including meningitis, encephalitis, and vasculitis. In cases in which otherwise healthy individuals are affected, an inborn error of immunity may underlie increased susceptibility or severity of infection.

Methods
We collected a cohort of 17 adults who experienced VZV encephalitis and performed whole exome sequencing. Patient peripheral blood mononuclear cells were infected with VZV, and innate antiviral interferon (IFN) and cytokine responses as well as viral replication were evaluated. Data were analyzed by Mann-Whitney U test.

Results
We identified a total of 21 different potentially disease-causing variants in a total of 13 of the 17 patients included. These gene variants were within 2 major functional clusters: (1) innate viral sensors and immune pathways and (2) autophagy pathways. Antiviral IFN and cytokine responses were abnormal in the majority of patients, whereas viral replication was increased in only 2 of 17 patients.

Conclusions
This study identifies a list of variants of pathogenic potential, which may serve as a platform for generating hypotheses for future studies addressing genetic and immunological factors associated with susceptibility to VZV encephalitis. These data, taken together, suggest that disturbances in innate sensing and autophagy pathways may predispose to VZV encephalitis.
Informatics-enabled citizen science to advance health equity
Authors: Valdez Rupa S , Detmer Don E , Bourne Philip , Kim Katherine K , Austin Robin , McCollister Anna , Rogers Courtney C , Waters-Wicks Karen C 
Published: May 2021

Abstract
The COVID-19 pandemic has once again highlighted the ubiquity and persistence of health inequities along with our inability to respond to them in a timely and effective manner. There is an opportunity to address the limitations of our current approaches through new models of informatics-enabled research and clinical practice that shift the norm from small- to large-scale patient engagement. We propose augmenting our approach to address health inequities through informatics-enabled citizen science, challenging the types of questions being asked, prioritized, and acted upon. We envision this democratization of informatics that builds upon the inclusive tradition of community-based participatory research (CBPR) as a logical and transformative step toward improving individual, community, and population health in a way that deeply reflects the needs of historically marginalized populations.
Real-time electronic health record mortality prediction during the COVID-19 pandemic: a prospective cohort study
Authors: Sottile Peter D , Albers David , DeWitt Peter E , Russell Seth , Stroh J N , Kao David P , Adrian Bonnie , Levine Matthew E , Mooney Ryan , Larchick Lenny , Kutner Jean S , Wynia Matthew K , Glasheen Jeffrey J , Bennett Tellen D 
Published: May 2021

Abstract

Objective
To rapidly develop, validate, and implement a novel real-time mortality score for the COVID-19 pandemic that improves upon sequential organ failure assessment (SOFA) for decision support for a Crisis Standards of Care team.

Materials and Methods
We developed, verified, and deployed a stacked generalization model to predict mortality using data available in the electronic health record (EHR) by combining 5 previously validated scores and additional novel variables reported to be associated with COVID-19-specific mortality. We verified the model with prospectively collected data from 12 hospitals in Colorado between March 2020 and July 2020. We compared the area under the receiver operator curve (AUROC) for the new model to the SOFA score and the Charlson Comorbidity Index.

Results
The prospective cohort included 27 296 encounters, of which 1358 (5.0%) were positive for SARS-CoV-2, 4494 (16.5%) required intensive care unit care, 1480 (5.4%) required mechanical ventilation, and 717 (2.6%) ended in death. The Charlson Comorbidity Index and SOFA scores predicted mortality with an AUROC of 0.72 and 0.90, respectively. Our novel score predicted mortality with AUROC 0.94. In the subset of patients with COVID-19, the stacked model predicted mortality with AUROC 0.90, whereas SOFA had AUROC of 0.85.

Discussion
Stacked regression allows a flexible, updatable, live-implementable, ethically defensible predictive analytics tool for decision support that begins with validated models and includes only novel information that improves prediction.

Conclusion
We developed and validated an accurate in-hospital mortality prediction score in a live EHR for automatic and continuous calculation using a novel model that improved upon SOFA.
Effects of protein supplementation to steers consuming low-quality forages on greenhouse gas emissions
Authors: Shreck Adam L , Zeltwanger Joshua M , Bailey Eric A , Jennings Jenny S , Meyer Beverly E , Cole Noel Andy 
Published: May 2021

Abstract
Providing supplements that enhance the efficiency of feed utilization can reduce methane (CH4) emissions from ruminants. Protein supplementation is widely used to increase intake and digestion of low-quality forages, yet little is known about its impact on CH4 emissions. British-cross steers (n = 23; initial body weight [BW] = 344 ± 33.9 kg) were used in a three-period crossover design to evaluate the effect of protein supplementation to beef cattle consuming low-quality forage on ruminal CH4, metabolic carbon dioxide (CO2) emissions, forage intake, and ruminal fermentation. Steers individually had ad libitum access to low-quality bluestem hay (4.6% crude protein [CP]) and were provided supplemental protein based on (dry matter basis): cottonseed meal (CSM; 0.29% of BW daily; 391 g/d CP), dried distillers grains with solubles (DDGS; 0.41% of BW daily 563 g/d CP), or none (CON). Urea was added to DDGS to match rumen degradable protein provided by CSM. Ruminal CH4 and metabolic CO2 fluxes were obtained 2.4 ± 0.4 times per steer daily using an automated open-circuit gas quantification system (GreenFeed emission monitoring system; C-Lock Inc., Rapid City, SD). Forage intake increased (P &lt; 0.01) with protein supplementation; however, no difference in forage intake (P = 0.14) was observed between CSM and DDGS treatments. Flux of CO2 (g/d) was greater (P &lt; 0.01) for steers fed CSM and DDGS than for steers fed CON. Steers supplemented with CSM had greater (P &lt; 0.01) CH4 emissions (211 g/d) than DDGS (197 g/d) both of which were greater (P &lt; 0.01) than CON (175 g/d). Methane emissions as a proportion of gross energy intake (GEI) were lowest (P &lt; 0.01) for DDGS (7.66%), intermediate for CSM (8.46%) steers, and greatest for CON (10.53%). Steers fed DDGS also had the lowest (P &lt; 0.01) ruminal acetate:propionate ratio (3.60), whereas CSM (4.89) was intermediate, and CON (5.64) steers were greatest. This study suggests that the common practice of supplementing protein to cattle consuming low-quality forage decreases greenhouse gas emissions per unit of GEI.
Face Transplants: An International History
Authors: Alberti Fay Bound , Hoyle Victoria 
Published: May 2021

Face transplants have attracted global media and public attention since the 1990s. The first recipient, Isabelle Dinoire, found herself at the centre of a dramatic episode of surgical innovation after her transplant was announced in November 2005. Subsequently 47 transplants have been conducted worldwide (including two retransplants) up to August 2020, and these have been accompanied by extensive news coverage. Hundreds of papers on the medical, physical, psychological, and ethical implications of the procedure have been published in the scientific literature, disproportionate to the incidence of the procedure. Face transplants have also featured in films, television, and fiction, indicating an appetite for interrogating the social and interpersonal implications of facial difference. However, the history of facial transplantation has largely been unexplored.
This article provides the first international history of the global development and implementation of facial transplantation. Using published medical literature, media coverage, and oral history interviews with key participants as source material, it situates the experimental transplant in national, institutional, and professional contexts. It argues that charting the history of face transplants over a 30 year period from initial discussions in 1991 to the present provides a valuable case study through which to consider surgical cultures and discourses of medical innovation in the twenty-first century.
Rear drop: a new radiographic landmark for estimation of pelvic tilt on pelvis AP radiographs
Authors: Atilla Halis Atil , Raju Sivashanmugam , Akdogan Mutlu , Ozturk Alper , Bilgetekin Yenel Gurkan , Kose Ozkan 
Published: May 2021

Abstract
Estimation of pelvic tilt on anteroposterior (AP) pelvis radiograph is often done by indirect methods based on the midline pelvic landmarks. The purpose of this cadaveric study is to describe a new radiographic landmark and reference measurements to estimate the coronal tilt of the pelvis, independent of the midline references. The new radiologic reference is called ‘rear drop’, and its anatomic location is described with the cadaveric pelvis AP radiographs in various pelvic inclination. The parameters derived from the new reference were used to assess the pelvic tilt, and the results were compared with the previously established method using ‘sacrococcygeal joint to symphysis distance’ (SCSD). The shape of the new figure is used to determine the position of the pelvis, and its relationship with the previously described acetabular retroversion indicators was statistically analyzed. The new reference figure corresponds to the posteroinferior edge of the horseshoe shape of the acetabular margin. The newly derived reference parameters, rear to tear distance and rear to tear angle, changes with pelvic tilt and are strongly correlated with SCSD. The shape of the rear drop changes with the changing pelvic tilt and correlates statistically with the previously described acetabular retroversion indicators. Rear drop and its derivative measurements can be used as a reliable and reproducible indicator to estimate the coronal pelvic tilt, free of midline reference points. This new reference will be a base for future clinical studies on pelvic tilt, rotation and their application in intraoperative hip fluoroscopy.
Getting to the root of belowground high temperature responses in plants
Authors: Fonseca de Lima Cassio Flavio , Kleine-Vehn Jürgen , De Smet Ive , Feraru Elena 
Published: May 2021

Abstract
The environment is continually challenging plants, and in response they use various coping strategies, such as adaptation of their growth. Thermomorphogenesis is a specific growth adaptation that promotes organ growth in response to moderately high temperature. This would eventually enable plants to cool down by dissipating heat. Although well understood for shoot organs, the thermomorphogenesis response in roots has only recently received increased research attention. Accordingly, in the past few years, the hormonal responses and underlying molecular players important for root thermomorphogenesis have been revealed. Other responses triggered by high temperature in the root encompass modifications of overall root architecture and interactions with the soil environment, with consequences for the whole plant. Here, we review scientific knowledge and highlight current understanding of root responses to moderately high and extreme temperature.
A Fluorescence-Based Quantitative Analysis for Total Bilirubin in Blood and Urine
Authors: Tien Tai Tran , Adachi Yasushi , Taketani Shigeru 
Published: May 2021

Abstract

Background
Bilirubin is a catabolic product of heme metabolism that circulates in the bloodstream in its unconjugated or glucuronide-conjugated form. Because the accumulation of bilirubin in the blood is a common symptom of liver diseases, its measurement in plasma (serum) is important for the diagnosis of these diseases.

Method
We developed a method to assess total bilirubin levels in serum and urine, using the fluorescent protein UnaG and β-glucuronidase.

Results
Our results indicate good correlation in serum total bilirubin levels between UnaG and the conventional bilirubin oxidase (BOD) methods. We found low levels of conjugated and unconjugated bilirubin in the urine of healthy subject individuals. Urinary bilirubin levels were elevated in patients with liver or bile duct diseases. A simple spot test of bilirubin using serum and urine showed a strong signal in patients with liver diseases.

Conclusion
The proposed method to assess bilirubin levels in serum and urine will contribute to the accurate diagnosis of health conditions such as jaundice, anemia, and liver disease.
EDTA-Induced Pseudothrombocytopenia up to 9 Months after Initial COVID-19 Infection Associated with Persistent Anti-SARS-CoV-2 IgM/IgG Seropositivity
Authors: Bereczki Dániel , Nagy Béla , Kerényi Adrienne , Nagy Gábor , Szarka Krisztina , Kristóf Katalin , Szalay Balázs , Vásárhelyi Barna , Bhattoa Harjit P , Kappelmayer János 
Published: May 2021

Abstract
Platelets have a role in vascular complications of COVID-19-related viral coagulopathy. Although immune-induced thrombocytopenia has been described mostly in moderate-to-severe COVID-19, the prognostic role of platelet count in COVID-19 is still controversial. Pseudothrombocytopenia has been reported to represent COVID-19-associated coagulopathy in critical illness, and transient EDTA-dependent pseudothrombocytopenia lasting less than 3 weeks was described in a patient with severe acute COVID-19 pneumonia. In our case study, EDTA-induced pseudothrombocytopenia was still present at 9 months after an initial SARS-CoV-2 virus infection in an apparently recovered 60 year old man. The persistence of antinucleocapside and antispike antibodies 9 months after the initial infection suggests that EDTA-induced pseudothrombocytopenia may be related to anti-SARS-CoV-2 IgG or IgM antibodies. We should acknowledge the possibility that pseudothrombocytopenia may also appear in some patients after seroconversion after the launch of large-scale vaccination programs.
The morphology of star-forming gas and its alignment with galaxies and dark matter haloes in the EAGLE simulations
Authors: Hill Alexander D , Crain Robert A , Kwan Juliana , McCarthy Ian G 
Published: May 2021

ABSTRACT
We present measurements of the morphology of star-forming gas in galaxies from the EAGLE simulations, and its alignment relative to stars and dark matter (DM). Imaging of such gas in the radio continuum enables weak lensing experiments that complement traditional optical approaches. Star-forming gas is typically more flattened than the stars and DM within halo centres, particularly for present-day structures of total mass $\sim 10^{12-12.5}\, {\rm M}_\odot$, which preferentially host star-forming galaxies with rotationally supported stellar discs. Such systems have oblate, spheroidal star-forming gas distributions, but in both less- and more-massive subhaloes the distributions tend to be prolate, and its morphology correlates positively and significantly with that of its host galaxy’s stars, both in terms of sphericity and triaxiality. The minor axis of star-forming gas most commonly aligns with the minor axis of its host subhalo’s central DM distribution, but this alignment is often poor in subhaloes with a prolate DM distribution. Star-forming gas aligns with the DM at the centre of its parent subhalo less strongly than is the case for stars, but its morphological minor axis aligns closely with its kinematic axis, affording a route to observational identification of the unsheared morphological axis. The projected ellipticities of star-forming gas in EAGLE are consistent with shapes inferred from high-fidelity radio continuum images, and they exhibit greater shape noise than is the case for images of the stars, owing to the greater characteristic flattening of star-forming gas with respect to stars.