bluuebunny/crossref_metadata_2025_split huggingface dataset:
Age-Related Differences of Rumination on the Loneliness–Depression Relationship: Evidence From a Population-Representative Cohort
Authors: Tong Horace , Hou Wai Kai , Liang Li , Li Tsz Wai , Liu Huinan , Lee Tatia M C 
Published: September 2021

AbstractBackground and ObjectivesThis study examined the association of loneliness with depressive symptoms across various age groups. Loneliness is a significant risk factor for precipitating depressive symptoms. Rumination, a mechanism that underpins depression, can become intense when a person feels lonely. In addition, age is a major factor associated with changes in mental and physical health. Thus, the importance of rumination and age in moderating the loneliness–depression link were investigated.Research Design and MethodsThis cross-sectional study was conducted during the acute phase of the coronavirus disease 2019 pandemic in Hong Kong (February 27 to March 17, 2020). A population-representative sample of 1,972 people (1,107 females; 18–92 years of age) was recruited and interviewed via telephone through random digit dialing. This sample included 394 younger adults (18–30 years), 1,106 middle-aged adults (31–64 years), and 472 older adults (65 years or above). Respondents reported depressive symptoms, subjective loneliness, state rumination, and sociodemographic factors.ResultsLoneliness and rumination were positively associated with depressive symptoms, and they significantly interacted in predicting cognitive-affective symptoms. Further analysis of age showed that the interaction was significant only in middle-aged adults and older adults. Both rumination and age interacted with loneliness, respectively, in predicting cognitive-affective symptoms.Discussion and ImplicationsThese findings indicate that the strength of the association between loneliness and the cognitive-affective symptoms of depression depends on rumination levels and age. An intervention to regulate rumination offers a feasible direction for health care and social care aimed at improving older adults’ mental health.
Negative Perception of Aging Is Associated With Frailty Transitions Within a Cohort of Sexual Minority Men
Authors: Nieves-Lugo Karen , Ware Deanna , Althoff Keri , Brennan-Ing Mark , Meanley Steven , Brown Andre L , Haberlen Sabina A , Masters Mary , Egan James E , Friedman Mackey R , Plankey Michael 
Published: September 2021

Abstract

Background and Objectives
Older people have an increased risk of developing frailty, an age-related clinical syndrome associated with worse health outcomes. This study examined the effect of self-perception of aging (ie, age discrepancy—individuals feel younger/older than their chronological age and aging satisfaction) on frailty transitions.

Research Design and Methods
We use longitudinal data from 549 HIV−/499 HIV+ sexual minority men aged 50 years or older enrolled in the Multicenter AIDS Cohort Study. To test the association of self-perception of aging on transitions between states of frailty (nonfrail/frail), defined using Fried Frailty Phenotype, a multinomial modeling was used.

Results
With remaining nonfrail as the referent group, participants reporting low aging satisfaction (vs moderate aging satisfaction) had increased odds of transitioning from nonfrail to frail (odds ratio [OR]: 2.72; 95% confidence interval [CI]: 1.56–4.74), frail to nonfrail (OR: 3.40; 95% CI: 1.62–7.12), or remaining frail (frail to frail; OR: 6.64; 95% CI: 3.88–11.38). Participants reporting older subjective age (vs no age discrepancy) had increased odds of transitioning from nonfrail to frail (OR: 2.50; 95% CI: 1.11–5.64), frail to nonfrail (OR: 4.47; 95% CI: 1.85–10.81), or remaining frail (frail to frail; OR: 5.68; 95% CI: 3.06–10.56). High aging satisfaction and younger subjective age were not statistically associated with frailty transitions.

Discussion and Implications
Our findings show that negative self-perception of aging (ie, older subjective age and low aging satisfaction) is associated with frailty transitions (nonfrail to frail, frail to nonfrail, and frail to frail) when compared to remaining nonfrail.
Tissue heterogeneity is prevalent in gene expression studies
Authors: Sturm Gregor , List Markus , Zhang Jitao David 
Published: September 2021

Abstract
Lack of reproducibility in gene expression studies is a serious issue being actively addressed by the biomedical research community. Besides established factors such as batch effects and incorrect sample annotations, we recently reported tissue heterogeneity, a consequence of unintended profiling of cells of other origins than the tissue of interest, as a source of variance. Although tissue heterogeneity exacerbates irreproducibility, its prevalence in gene expression data remains unknown. Here, we systematically analyse 2 667 publicly available gene expression datasets covering 76 576 samples. Using two independent data compendia and a reproducible, open-source software pipeline, we find a prevalence of tissue heterogeneity in gene expression data that affects between 1 and 40% of the samples, depending on the tissue type. We discover both cases of severe heterogeneity, which may be caused by mistakes in annotation or sample handling, and cases of moderate heterogeneity, which are likely caused by tissue infiltration or sample contamination. Our analysis establishes tissue heterogeneity as a widespread phenomenon in publicly available gene expression datasets, which constitutes an important source of variance that should not be ignored. Consequently, we advocate the application of quality-control methods such as BioQC to detect tissue heterogeneity prior to mining or analysing gene expression data.
Regulatory Forbearance in the U.S. Insurance Industry: The Effects of Removing Capital Requirements for an Asset Class
Authors: Becker Bo , Opp Marcus M , Saidi Farzad 
Published: September 2021

Abstract
We analyze the effects of a reform of capital regulation for U.S. insurance companies in 2009. The reform eliminates capital buffers against unexpected losses associated with portfolio holdings of MBS, but not for other fixed-income assets. After the reform, insurance companies are much more likely to retain downgraded MBS compared to other downgraded assets. This pattern is more pronounced for financially constrained insurers. Exploiting discontinuities in the reform’s implementation, we can identify the relevance of the capital requirements channel. We also document that the insurance industry crowds outs other investors in the new issuance of (high-yield) MBS.
Authors have furnished an Internet Appendix, which is available on the Oxford University Press Web site next to the link to the final published paper online.
Pilot evaluation of a personalized commercial program on weight loss, health outcomes, and quality of life
Authors: Hales Sarah B , Schulte Erica M , Turner Tonya F , Malcolm Robert , Wojtanowski Alexis C , Rethorst Chad , Pinto Angela M , Foster Gary D , O’Neil Patrick M 
Published: September 2021

Abstract
WW is a validated behavioral weight management program that encourages healthy habits. WW developed a method of personalizing the SmartPoints® budget depending on dietary and lifestyle preferences, and participants were placed into one of three plans as a pilot evaluation of this new program. In this 6-month, single-arm pilot study, participants attended weekly workshops and used an app to monitor eating and physical activity. Baseline and 6-month assessments included weight, waist circumference, blood pressure, energy intake, cravings, happiness, health-related quality of life, hunger, and fullness. Of 145 adults assessed at baseline, 126 (87%) provided follow-up data. Pre–post changes showed significant reductions in body weight (7.39% ± 5.93%), calories consumed (24.79% ± 32.35%) and significant improvements in cravings, happiness, all SF-36 scales and hunger but not in fullness. Greater % weight loss was related to greater improvements in happiness (r = .38, p &lt; .001), general health perceptions (r = .29, p = .001), and health change (r = .31, p = .001), and greater reduction in role limitations due to personal or emotional problems (r = .24, p = .01). Greater % reduction in caloric intake was associated with greater reductions in cravings (r = .23, p = .01), as well as with greater improvements in happiness (r = .23, p = .01), physical functioning (r = .23, p = .01), and general health perceptions (r = .23, p = .01). Participants in this modified program achieved significant weight loss, regardless of dietary plan, as well as improvements in a variety of other physical and psychological constructs. Those who achieved greater reductions in weight also reported greater improvements in cravings, happiness and some quality of life measures.
Selective Anterior Fusion Surgery Does Not Influence Global Spinal Sagittal Alignment in Lenke Type 5 Adolescent Idiopathic Scoliosis Patients
Authors: Okubo Toshiki , Konomi Tsunehiko , Yanai Yoshihide , Furukawa Mitsuru , Fujiyoshi Kanehiro , Yamane Junichi , Asazuma Takashi , Yato Yoshiyuki 
Published: September 2021

Study Design.
Retrospective comparative study.

Objective.
The aim of this study was to evaluate the changes in global spinal sagittal alignment (GSSA) following selective anterior spinal fusion (ASF) in patients with Lenke type 5 adolescent idiopathic scoliosis (AIS).

Summary of Background Data.
Few studies have assessed the changes in postoperative GSSA, including cervical, thoracic, and lumbosacral sagittal alignment in AIS patients with major thoracolumbar/lumbar (TL/L) curve who underwent selective ASF.

Methods.
Fifty-two patients with Lenke type 5 AIS (two males and 50 females, mean age at surgery of 16.4 ± 3.1 years) were included in this study. The average final follow-up was 8.3 ± 3.1 years after surgery. The variations of outcome variables were analyzed in various spinal sagittal profiles using radiographic outcomes (pre-operation, immediate post-operation, and final follow-up). The clinical outcomes at the final follow-up were assessed using Scoliosis Research Society (SRS)-22 and Oswestry Disability Index (ODI) questionnaires.

Results.
The mean Cobb angle of the main TL/L and minor thoracic curve was significantly improved after selective ASF, which was maintained up to the final follow-up. However, in all cases, the various sagittal parameters examined (sagittal vertical axis [SVA], C2–7 SVA, C2–7 lordosis, T1 slope, thoracic kyphosis, T10-L2 kyphosis, lumbar lordosis, pelvic incidence, pelvic tilt, and sacral slope), did not significantly change in the immediate postoperative period, and all GSSA parameters were maintained up to the final follow-up. Furthermore, the magnitude of coronal curve correction and fused levels did not affect each GSSA parameter postoperatively. During the period up to the final follow-up, no significant clinical symptoms were observed. The final SRS-22 global score was 4.5 ± 0.3, and ODI scored 0.8 ± 2.4.

Conclusion.
Selective ASF did not influence various GSSA parameters postoperatively and could maintain excellent correction for coronal deformity with satisfactory final functional and clinical outcomes confirmed by long-term follow-up.

Level of Evidence: 4
Initial Choice of Spinal Manipulation Reduces Escalation of Care for Chronic Low Back Pain Among Older Medicare Beneficiaries
Authors: Whedon James M. , Kizhakkeveettil Anupama , Toler Andrew WJ. , Bezdjian Serena , Rossi Daniel , Uptmor Sarah , MacKenzie Todd A. , Lurie Jon D. , Hurwitz Eric L. , Coulter Ian , Haldeman Scott 
Published: September 2021

Study Design.
We combined elements of cohort and crossover-cohort design.

Objective.
The objective of this study was to compare longterm outcomes for spinal manipulative therapy (SMT) and opioid analgesic therapy (OAT) regarding escalation of care for patients with chronic low back pain (cLBP).

Summary of Background Data.
Current evidence-based guidelines for clinical management of cLBP include both OAT and SMT. For long-term care of older adults, the efficiency and value of continuing either OAT or SMT are uncertain.

Methods.
We examined Medicare claims data spanning a five-year period. We included older Medicare beneficiaries with an episode of cLBP beginning in 2013. All patients were continuously enrolled under Medicare Parts A, B, and D. We analyzed the cumulative frequency of encounters indicative of an escalation of care for cLBP, including hospitalizations, emergency department visits, advanced diagnostic imaging, specialist visits, lumbosacral surgery, interventional pain medicine techniques, and encounters for potential complications of cLBP.

Results.
SMT was associated with lower rates of escalation of care as compared to OAT. The adjusted rate of escalated care encounters was approximately 2.5 times higher for initial choice of OAT vs. initial choice of SMT (with weighted propensity scoring: rate ratio 2.67, 95% confidence interval 2.64–2.69, P < .0001).

Conclusion.
Among older Medicare beneficiaries who initiated long-term care for cLBP with opioid analgesic therapy, the adjusted rate of escalated care encounters was significantly higher as compared to those who initiated care with spinal manipulative therapy.

Level of Evidence: 3
Audit and Comparison Between Radiographic Markers of Gaze Direction Using EOS Imaging – An Essential Step to Streamline Existing Methods
Authors: Hey Hwee Weng Dennis , Lim Joel Xue Yi , Tan Chuen Seng , Liu Gabriel Ka Po , Wong Hee Kit 
Published: September 2021

Study Design.
Retrospective cohort study on prospectively implemented EOS protocol.

Objective.
This study aims to audit and compare existing radiological definitions of gaze direction—chin brow vertical angle (CBVA), McGregor slope (McGS), slope of line of sight (SLS), orbital-internal occipital protuberance (OIOP) slope angle, and Tangent to the hard palate (THP) in a neutral, healthy, and asymptomatic cohort.

Summary of Background Data.
The ability to accurately define direction of gaze is the first step when striving for horizontal gaze restoration in any affected individual with rigid sagittal deformity. Yet, the radiological definition of gaze direction remains poorly standardized.

Methods.
Hundred healthy subjects who could achieve horizontal gaze underwent whole-body standing EOS radiographs taken under a strictly standardized protocol. Radiographic measurements of global spinal sagittal parameters and surrogate measures of horizontal gaze were analyzed and compared.

Results.
The mean age was 45 ± 15.9 years, with a balanced male-to-female-ratio. Their C7 SVA was −7.7 mm ± 24.8 mm, PI was 51.0o ± 11.4o, PI-LL was −0.9o ± 13.0o and T1-slope was 21.2o ± 9.2o. Measured horizontal gaze parameters were as follows: CBVA (1.07o ± 5.48o), McGS (−3.23o ± 5.63o), SLS (0.45o ± 5.34o), OIOP (5.03o ± 4.66o), THP (-0.17o ± 6.27o). CBVA correlated strongly with McGS (r = 0.679, P < 0.001), SLS (r = 0.592, P < 0.001), OIOP (r = 0.697, P < 0.001), and THP (r = −0.504, P < 0.001). OIOP had the lowest variance amongst all parameters and showed less variability compared to CBVA (SD 4.66 Var 21.69 vs. SD 5.48 Var 30.08, P = .012). Multivariate analysis showed that C2-7 angle was the only parameter found to be associated with OIOP values (P = 0.006).

Conclusion.
OIOP is the least variable, and most robust radiological method in determining gaze direction. It uses easily recognizable anatomical landmarks and an angular criterion, which makes it advantageous both with x-rays or slot scanners.

Level of Evidence: 3
Emotional Intelligence and Role-Modeling Nursing's Soft Skills
Authors: Kaiafas Kristen N. 
Published: September 2021

ABSTRACT:
Developing and enhancing emotional intelligence in nursing students is a necessary element of nursing education. Various evidence-based strategies to cultivate emotional intelligence characteristics, such as self-reflection, self-awareness, problem-solving, and interprofessional collaboration in nursing students, are described along with the value of role-modeling Christian qualities that promote empathy and compassion in nursing graduates.
Faith Community Nursing
Authors: Long Elizabeth M. 
Published: September 2021

ABSTRACT:
The number of older adults worldwide is growing; the incidence of social isolation and loneliness among this population is also increasing. Social isolation and loneliness can have significant physical, mental, and spiritual impacts. Faith community nurses are in an optimal position to identify and intervene to help faith communities reduce the social isolation and loneliness among community-dwelling older adults. Risk factors and tools to identify both circumstances are discussed along with interventions and a case study.
Arterial stiffness and age moderate the association between physical activity and global cognition in older adults
Authors: Noriega de la Colina Adrián , Badji Atef , Lamarre-Cliche Maxime , Bherer Louis , Girouard Hélène , Kaushal Navin 
Published: September 2021

Background:
Evidence supports that time spent on physical activity has beneficial effects on cognition in older adults. Nevertheless, whether these beneficial effects are still present at the intersection of different levels of arterial stiffness and age is uncertain.

Methods:
One hundred and ten healthy older adults aged 60–75 years were examined for arterial stiffness [carotid–femoral pulse wave velocity (cf-PWV)], global cognition (composite score of Montreal Cognitive Assessment, and Mini-Mental State Examination), and self-reported physical activity (PACED diary). Using PROCESS macro for SPSS, we evaluated if cf-PWV (moderator 1), and age (moderator 2) moderate the relationship between physical activity (X) and global cognition (Y). The threshold for high stiffness was set at 8.5 m/s based on previous studies that reported this cut-off as more appropriate for classifying cerebrovascular risk groups.

Results:
Physical activity had a positive effect on cognition in young-elderly adults (<68.5 years) with a cf-PWV of at least 8.5 m/s (β = 0.48, SE = 0.193, P = 0.014, 95% CI = 0.100--0.868) and in elderly adults (≥68.5 years) with a cf-PWV of less than 8.5 m/s (β = 0.56, SE = 0.230, P = 0.017, 95% CI = 0.104–1.018). This was not the case in elderly adults with a cf-PWV of at least 8.5 m/s (β = 0.00, SE = 0.193, P = 0.998, 95% CI = −0.362 to 361), or in young-elderly adults with a cf-PWV of less than 8.5 m/s (β = 0.16, SE = 0.247, P = 0.501, 95% CI = −0.326 to 656).

Conclusion:
The interaction between arterial stiffness and age moderated the effect of physical activity on global cognition. Time spent on physical activity alone might not be sufficient to achieve cognitive benefit over a specific threshold of arterial stiffness and age.
Common Differential Diagnostic Issues in Soft Tissue Pathology
Authors: Behtaj Mohadese , Hakim Muhammad Omar , Velez Torres Jaylou , Rosenberg Andrew E. , Montgomery Elizabeth Anne 
Published: September 2021

Abstract
In this review, we discuss 4 differential diagnostic considerations that commonly arise in soft tissue pathology, namely, separating myxoid liposarcoma from myxofibrosarcoma, nodular fasciitis from a host of spindle cell sarcoma types, fibrous histiocytoma from dermatofibrosarcoma protuberans, and atypical lipomatous tumor from several nonneoplastic congeners. These topics were chosen as means to highlight several areas of soft tissue pathology, focusing on some of the most common issues in soft tissue pathology.
Malignant Diffuse Tenosynovial Giant Cell Tumor: Case Report and Review of the Literature
Authors: MacMahon Aoife , Chaudhry Yash , James Aaron W. , McCarthy Edward M. , Llosa Nicolas J. , Ahlawat Shivani , Morris Carol D. 
Published: September 2021

Abstract
Diffuse-type tenosynovial giant cell tumor (TGCT) is a neoplasm that exhibits infiltrative growth, tends to recur locally, and is often located within a joint. We describe a challenging diagnosis and clinical course of a 14-year-old girl with malignant diffuse TGCT, highlighting the difficulty of acquiring a representative biopsy. The patient presented with a painful foot mass, which was diagnosed initially through open biopsy as chronic osteomyelitis. Because her pain persisted, additional open biopsies were performed 1 and 2.5 years after the initial biopsy, which also showed features of benign TGCT. At age 16 years, she underwent marginal resection but developed local recurrence with metastatic disease 1 year later. Core needle biopsy of the foot mass again confirmed diffuse TGCT and showed no evidence of atypical or malignant features. Malignant features were confirmed only through excisional biopsy of chest wall metastasis. The patient started chemotherapy and underwent below-the-knee amputation at age 17 years. Amputation specimen showed malignant diffuse TGCT. She died of disease progression approximately 1 year later. Metastasis of diffuse TGCT with benign histology is challenging to diagnose. Previous studies have also found that benign diffuse TGCT can transform into an aggressive, malignant tumor. This case highlights that biopsy sampling can be challenging in histologically heterogeneous tumors. Initial evaluation by a multidisciplinary team, as well as image-guided biopsy techniques, may increase diagnostic accuracy of the biopsy.
Pandemic Autopsy Biosafety Considerations
Authors: Brooks Erin G. 
Published: September 2021

Abstract
At autopsy, prosectors have always risked exposure to a wide array of infectious agents. With the recent advent of the SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) pandemic, such exposure concerns have increased dramatically. Careful assessment of facility infrastructure and appropriate biosafety training, however, can minimize risks and allow for safe autopsy performance. As with other disease outbreaks, the living have much to learn from the dead. To date, autopsy studies have been critical in elucidating the mechanisms by which COVID-19 (coronavirus disease 2019) may critically compromise not only pulmonary but also cerebral, cardiac, and renal function. Much remains unknown, though, and further tissue-based research is called for. The following review is intended to detail best practices and principles for autopsy biosafety, with a focus on issues specific to the current pandemic.
SARS-CoV-2–Associated Myocarditis at Autopsy
Authors: Singh Ravi B. , Jung Geunyoung , Brooks Erin G. 
Published: September 2021

Abstract
The COVID-19 pandemic has been a major cause of mortality worldwide. While respiratory pathology seems to be the major mechanism of disease, cardiovascular pathology has increasingly been reported to play a role in adverse outcomes. A variety of different cardiovascular histopathologies have been reported at postmortem examination including myocarditis. Because of limited autopsy numbers and lack of standardized reporting of such cases, however, the prevalence of COVID-19 (2019 coronavirus disease)–associated myocarditis is unknown. The current autopsy case report illustrates how COVID-19 pulmonary pathology can be accompanied by right ventricular myocarditis. The discussion reviews the pathophysiology of myocarditis, as well as diagnostic strategies, adding to the growing body of literature describing myocarditis in association with COVID-19 disease.