bluuebunny/crossref_metadata_2025_split huggingface dataset:
Shifting Health Care Use from Hospitalisations and Surgeries to Outpatient Visits in Children with Inflammatory Bowel Disease: A Population-based Cohort Study from Ontario, Canada
Authors: Dheri Aman K , Kuenzig M Ellen , Mack David R , Murthy Sanjay K , Kaplan Gilaad G , Donelle Jessy , Smith Glenys , Benchimol Eric I 
Published: May 2021

Abstract

Background
Modern, specialised care for children with inflammatory bowel disease [IBD] may have resulted in changes in health services use. We report trends over time in health services utilisation and surgery for children with IBD and children without IBD.

Methods
Children aged &lt;18 years, diagnosed with IBD between 1994 and 2013 [n = 5518] and followed until 2015 in Ontario, Canada, were identified from health administrative data and matched to children without IBD on age, sex, rural/urban household, and income [n = 26,677]. We report the annual percentage change [APC] with 95% confidence intervals [CI] in the rate of outpatient visits, emergency department [ED] visits, and hospitalisations, using negative binomial regression for events within 5 years from the diagnosis/index date. We used Cox proportional hazards regression models to report APC in hazards of intestinal resection [Crohn’s disease; CD] and colectomy [ulcerative colitis; UC].

Results
IBD-specific hospitalisation rates decreased by 2.5% [95% CI 1.8–3.2%] annually, and all-cause hospitalisation rates in children without IBD decreased by 4.3% [95% CI 3.5–5.1%] annually. Intestinal resection risk in CD decreased by 6.0% [95% CI 4.6–7.3%] annually and colectomy risk in UC decreased by 3.0% [95% CI 0.7–5.2%] annually. In contrast, IBD-specific outpatient visit rates increased after 2005 by 4.0% [95% CI 3.1–4.9%] annually. Similar trends in outpatient visits were not observed in children without IBD.

Conclusions
Hospitalisations and surgeries decreased over time while outpatient visits increased after 2005. Decreasing hospitalisations were mirrored in children without IBD, likely resulting from a combination of changes in disease management and health system factors.
Enhancing long-term learner engagement through project-based learning
Authors: Aubrey Scott 
Published: May 2021

Abstract
This paper reports on the implementation of a language learning project in a Japanese EFL classroom in which the trigger, or motivational energy for involvement, came from interacting with English-speaking international students. The project provided a context to investigate the trajectory of one group’s (three learners) sustained engagement across three tasks that formed the subgoals of the project. Data sources include learner diaries, engagement questionnaires, and transcripts of task conversations, which together were used to describe the level of engagement for each learner at key times throughout the project. The findings indicate that engagement is sustained by certain flow-like conditions during tasks (i.e., control, interest, challenge-skill balance), group cohesion among project members, and a growing focus on the long-term goal of the project. The results highlight project design features that teachers should consider when implementing projects with the purpose of engaging students.
Macroecological diversification and convergence in a clade of keystone symbionts
Authors: Nelsen Matthew P , Leavitt Steven D , Heller Kathleen , Muggia Lucia , Lumbsch H Thorsten 
Published: May 2021

ABSTRACTLichens are classic models of symbiosis, and one of the most frequent nutritional modes among fungi. The ecologically and geographically widespread lichen-forming algal (LFA) genus Trebouxia is one of the best-studied groups of LFA and associates with over 7000 fungal species. Despite its importance, little is known about its diversification. We synthesized twenty years of publicly available data by characterizing the ecological preferences of this group and testing for time-variant shifts in climatic regimes over a distribution of trees. We found evidence for limited shifts among regimes, but that disparate lineages convergently evolved similar ecological tolerances. Early Trebouxia lineages were largely forest specialists or habitat generalists that occupied a regime whose extant members occur in moderate climates. Trebouxia then convergently diversified in non-forested habitats and expanded into regimes whose modern representatives occupy wet-warm and cool-dry climates. We rejected models in which climatic diversification slowed through time, suggesting climatic diversification is inconsistent with that expected under an adaptive radiation. In addition, we found that climatic and vegetative regime shifts broadly coincided with the evolution of biomes and associated or similar taxa. Together, our work illustrates how this keystone symbiont from an iconic symbiosis evolved to occupy diverse habitats across the globe.
Armand-Marc comte de Montmorin, the French monarchy and the Revolution in 1792
Authors: Rothaus Barry 
Published: May 2021

Abstract
Armand-Marc comte de Montmorin (1746-1792) was the last foreign minister (1787-1789) of the old regime and the first of the constitutional monarchy (1789-1791). Descended from a prominent Auvergnat aristocratic family, he held a very close relationship with the dauphin who became king in 1774. Montmorin’s diplomatic career began with royal support, first as minister to Treves (1775-1778), then as ambassador to Madrid (1778-1784). In 1787, Louis XVI named him to head the foreign ministry as successor to the comte de Vergennes. The outbreak of revolution led to his involvement in domestic affairs. He dedicated his life after 1789 to saving the Crown, urging the royal couple to adopt the newly emerging constitution. Montmorin resigned his office in October 1791; thereafter, he was engaged in various conspiracies. In August 1792, following the overthrow of the monarchy, the Legislative Assembly arrested, tried and convicted him of treason. Held in l’Abbaye prison, he was one of those massacred on September 2. His late career provides a unique window into the chaos and confusion of the early Revolution
Reexamining the Classification of Older Adults With Diabetes by Comorbidities and Exploring Relationships With Frailty, Disability, and 5-year Mortality
Authors: Leung Vania , Wroblewski Kristen , Schumm L Philip , Huisingh-Scheetz Megan , Huang Elbert S 
Published: May 2021

Abstract

Background
Limited research has been conducted to risk stratify older adults with diabetes. Our objective was to reexamine the 2005–2006 classification systems in participants who are now 5 years older.

Methods
We examined a subsample of 884 community-residing older adults with the diagnosis of diabetes from the National Social Life, Health, and Aging Project. The primary objective was to utilize a latent class analysis (LCA) to fit a model to 11 comorbidities, comparing the 2010–2011 LCA model to that of 2005–2006. The secondary objective was to evaluate the association of the identified classes with frailty, disability, and 5-year mortality.

Results
Both 2005–2006 LCA and the 2010–2011 LCA model fit 3 similar comorbidity profiles: Class 1 with the lowest rates of nearly all comorbidities, Class 2 had highest rates of obesity, hypertension, arthritis, and incontinence, and Class 3 had the higher rates of myocardial infarctions, congestive heart failure, and stroke. When compared to the healthier Class 1 (class probability = 0.67), participants with a comorbidity profile with more prevalent cardiovascular conditions (Class 3; 0.09) were at higher risk of frailty and mortality, but not disability; whereas participants with a comorbidity profile with more prevalent geriatric syndrome conditions (Class 2; 0.24) were at higher risk of frailty and disability, but not mortality.

Conclusions
We reconfirmed 3 latent classes with distinct comorbidity profiles among older adults with diabetes. However, the complex relationships between comorbidity classes with frailty, disability, and mortality will likely require revision of the current rationale for stratified goal setting and treatment selection.
Association of Hearing Impairment With Higher-Level Physical Functioning and Walking Endurance: Results From the Baltimore Longitudinal Study of Aging
Authors: Martinez-Amezcua Pablo , Kuo Pei-Lun , Reed Nicholas S , Simonsick Eleanor M , Agrawal Yuri , Lin Frank R , Deal Jennifer A , Ferrucci Luigi , Schrack Jennifer A 
Published: May 2021

Abstract

Background
Although hearing impairment (HI) is linked to poorer physical functioning, the longitudinal associations between HI and higher-level functional measures are unclear.

Method
Data are from the Baltimore Longitudinal Study of Aging (2012–2019). Using pure-tone audiometry, we categorized hearing into normal, mild, and moderate or greater HI. Physical function was assessed with the expanded Short Physical Performance Battery (eSPPB) and walking endurance with time to walk 400 m. Multivariable and mixed-effects linear models tested the hypotheses that participants with HI, at baseline, have poorer physical performance and walking endurance, and faster decline over time (up to 6 measurements). In a subset (n = 526), we further adjusted for vestibular function. Among participants with HI, we evaluated the differences in eSPPB scores and walking endurance between hearing aid users and nonusers.

Results
Of 831 participants, 26% had mild, and 17% moderate or greater HI. After adjustment for demographics and medical history, moderate or greater impairment versus normal hearing was associated with poorer function (0.17 [95% CI: 0.09, 0.26] lower eSPPB score, and 13.3 [95% CI: 3.31, 23.4] seconds slower 400-m walk time) and faster decline in these parameters over 6 years. Adjustment for vestibular function did not attenuate these associations. Hearing aid users walked 400 m 24 seconds faster than nonusers (p = .001).

Conclusion
Moderate or greater HI is associated with poorer initial and greater decline in higher-level physical performance. The observation that hearing aid users had better walking endurance suggests that screening for and treatment of HI may delay or slow progression of hearing-related functional decline.
Liver health events: an indigenous community-led model to enhance HCV screening and linkage to care
Authors: Pandey Mamata , Konrad Stephanie , Reed Noreen , Ahenakew Vanessa , Isbister Patricia , Isbister Tanys , Gallagher Lesley , Campbell Trisha , Skinner Stuart 
Published: May 2021

Summary
Despite high prevalence of hepatitis C virus (HCV), linkage to care and treatment for Indigenous people is low. In an Indigenous community in Saskatchewan, Canada a retrospective review identified 200 individuals (∼12% prevalence) had HCV antibodies though majority lacked ribonucleic acid (RNA) testing, and few received treatment despite availability of an effective cure. Following Indigenous oral traditions, focus group discussions were held with key community members and leadership. Participants emphasized the need for a community-based screening and treatment programme. A team of community members, peers and healthcare professionals developed a streamlined screening pathway termed ‘liver health event’ (LHE) to reduce stigma, reach undiagnosed, re-engage previously diagnosed, and ensure rapid linkage to care/treatment. LHEs began December 2016. Statistics were tracked for each event. As of July 2019, there were 10 LHEs with 540 participants, 227 hepatitis C tests and 346 FibroScans completed. This represented 294 unique individuals, of which 64.3% were tested, and of those, 40.8% were Ab positive. Among those positive for antibodies, 41.7% had active hepatitis C infections, and among these, 90% were linked to care, and 14 new positive individuals were identified. Following the success of LHEs, these were adapted and implemented in 10 other communities in this region, resulting in 17 additional LHEs. This intervention is reaching the undiagnosed and linking clients to care through a low-barrier and de-stigmatizing approach. It has facilitated collaboration, knowledge exchange and mentorship between Indigenous communities, significantly impacting health outcomes of Indigenous people in this region.
Practice-guided public health philosophy
Authors: Folker Anna Paldam , Lauridsen Sigurd , Andersen Martin , Kongsholm Nana Cecilie , Varga Somogy 
Published: May 2021

Summary
Although highly relevant, philosophical theory and philosophical competences are rarely integrated in empirical public health research. We suggest a variant of applied philosophy that is valuable for the development and improvement of public health research. We call it practice-guided public health philosophy because: (i) research questions derive from public health challenges, i.e. real-life concerns that relate to the prevention of disease or the promotion of health and well-being, (ii) the ultimate test of success lies within an empirical framework aiming to improve public health practices and (iii) philosophers collaborate very closely with different kinds of empirical researchers in the different stages of the research process. Using examples from current public health projects at the National Institute of Public Health at the University of Southern Denmark, we outline three paradigmatic cases of practice-guided public health philosophy: (i) by using philosophy as an idea generator of empirical research, (ii) by using philosophy as a frame of reference for interpreting ethnographic data and (iii) by using philosophy as an explanatory resource for discussing survey and register data.
Measured versus predicted postoperative pulmonary function at repeated times up to 1 year after lobectomy
Authors: Shibazaki Takamasa , Mori Shohei , Harada Eriko , Shigemori Rintaro , Kato Daiki , Matsudaira Hideki , Hirano Jun , Ohtsuka Takashi 
Published: May 2021

Abstract

OBJECTIVES
Postoperative pulmonary function is difficult to predict accurately, because it changes from the time of the operation and is also affected by various factors. The objective of this study was to assess the accuracy of predicted postoperative forced expiratory volume in 1 s (FEV1) at different postoperative times after lobectomy.

METHODS
This retrospective study enrolled 104 patients who underwent lobectomy by video-assisted thoracic surgery. Pulmonary function tests were performed preoperatively and postoperatively at 3, 6 and 12 months. We investigated time-dependent changes in FEV1. In addition, the ratio of measured to predicted postoperative FEV1 calculated by the subsegmental method was evaluated to identify the factors associated with variations in postoperative FEV1.

RESULTS
Compared with the predicted postoperative FEV1, the measured postoperative FEV1 was 8% higher at 3 months, 11% higher at 6 months and 13% higher at 12 months. The measured postoperative FEV1 significantly increased from 3 to 6 months (P = 0.002) and from 6 to 12 months (P = 0.015) after lobectomy resected lobe, smoking history and body mass index were significant factors associated with the ratio of measured to predicted postoperative FEV1 at 12 months (P &lt; 0.001, P = 0.036 and P = 0.025, respectively).

CONCLUSIONS
Postoperative FEV1 increased up to 12 months after lobectomy by video-assisted thoracic surgery. The predicted postoperative pulmonary function was underestimated after 3 months, particularly after lower lobectomy.
Comparing outcomes in patients with end-stage chronic obstructive pulmonary disease: single versus bilateral lung transplants
Authors: Mutyala Sudeep , Kashem M Abul , Kanaparthi Jay , Sunagawa Gengo , Suryapalam Manish , Leotta Eros , Minakata Kenji , Brann Stacey , Shigemura Norihisa , Toyoda Yoshiya 
Published: May 2021

Abstract

OBJECTIVES
Debate continues on whether a bilateral (BLT) or a single lung transplantation (SLT) is preferred for patients with end-stage chronic obstructive pulmonary disease (COPD). The purpose of this study is to examine the interplay between patient age and transplant type on survival outcomes.

METHODS
We performed a retrospective study of lung transplants for COPD at our centre from February 2012 to March 2020 (n = 186). Demographics and clinical parameters were compared between patients based on their age (≤65 vs &gt;65 years old) and type of transplant (single vs bilateral). Cox proportional hazards regression was also performed. P-values &lt;0.05 were considered significant.

RESULTS
Of the 186 patients with COPD who received lung transplants, 71 (38.2%) received BLTs and 115 (61.8%) received SLTs. There was no significant difference in survival outcomes when looking at patients with single versus BLTs (P = 0.870). There was also no difference in survival between the 2 age groups ≤65 versus &gt; 65 years (P = 0.723). The Cox model itself also did not show a statistically significant improvement in survival outcomes (P = 0.126).

CONCLUSIONS
Lung transplant outcomes in patients with end-stage COPD demonstrated non-inferior results in patients with an SLT compared to patients with a BLT. When we compared the age groups, neither transplant type showed superior survival benefits, suggesting there may be some utility in an SLT in younger recipients.
Anti–PD-L1 Therapy Does Not Improve Survival in a Murine Model of Lethal Staphylococcus aureus Pneumonia
Authors: Curran Colleen S , Busch Lindsay M , Li Yan , Xizhong Cui , Sun Junfeng , Eichacker Peter Q , Torabi-Parizi Parizad 
Published: May 2021

Abstract

Background
Staphylococcus aureus (SA) bacterial pneumonia is a common cause of sepsis in intensive care units. Immune checkpoint inhibitors (CPIs) that target programmed cell death protein 1 (PD-1) and its ligand (PD-L1) have been proposed for the treatment of sepsis. However, in our systematic review of sepsis preclinical models, none of the models examined CPIs in pneumonia.

Methods
Mice were inoculated intratracheally with vehicle control, low dose (LD)- or high dose (HD)-SA. Immune cell recruitment and checkpoint molecule expression were examined at 4, 24, and 48 hours after infection. Infected animals, treated with control or anti–PD-L1 antibodies, were assessed for survival, bacterial burden, lung immunophenotypes, and mediator production.

Results
LD-SA and HD-SA produced lethality of 15% and 70%, respectively, by 168 hours. At 24 hours, LD-infected animals exhibited increased lung monocyte PD-L1 expression (P = .0002) but lower bacterial counts (P = .0002) compared with HD animals. By 48 hours, either infection induced lung neutrophil and macrophage PD-L1 expression (P &lt; .0001). Anti–PD-L1 treatment at the time of infection and at 24 hours following infection with low to high doses of SA reduced PD-L1 detection but did not affect survival or bacterial clearance.

Conclusions
Anti–PD-L1 therapy did not alter survival in this pneumonia model. Preclinical studies of additional common pathogens and septic foci are needed.
Peripheral Plasmodium falciparum Infection in Early Pregnancy Is Associated With Increased Maternal Microchimerism in the Offspring
Authors: Simon Neta , Shallat Jaclyn , Houck John , Jagannathan Prasanna , Prahl Mary , Muhindo Mary K , Kakuru Abel , Olwoch Peter , Feeney Margaret E , Harrington Whitney E 
Published: May 2021

Abstract

Background
Placental malaria has been associated with increased cord blood maternal microchimerism (MMc), which in turn may affect susceptibility to malaria in the offspring. We sought to determine the impact of maternal peripheral Plasmodium falciparum parasitemia during pregnancy on MMc and to determine whether maternal cells expand during primary parasitemia in the offspring.

Methods
We conducted a nested cohort study of maternal-infant pairs from a prior pregnancy malaria chemoprevention study. Maternal microchimerism was measured by quantitative polymerase chain reaction targeting a maternal-specific marker in genomic DNA from cord blood, first P falciparum parasitemia, and preparasitemia. Logistic and negative binomial regression were used to assess the impact of maternal peripheral parasitemia, symptomatic malaria, and placental malaria on cord blood MMc. Generalized estimating equations were used to assess predictors of MMc during infancy.

Results
Early maternal parasitemia was associated with increased detection of cord blood MMc (adjusted odds ratio = 3.91, P = .03), whereas late parasitemia, symptomatic malaria, and placental malaria were not. The first parasitemia episode in the infant was not associated with increased MMc relative to preparasitemia.

Conclusions
Maternal parasitemia early in pregnancy may increase the amount of MMc acquired by the fetus. Future work should investigate the impact of this MMc on immune responses in the offspring.
The Logic of Ceasefires in Civil War
Authors: Clayton Govinda , Sticher Valerie 
Published: May 2021

AbstractCeasefires play a role in almost all civil war peace processes. Yet existing studies undertheorize the ways in which different logics drive the design of ceasefire agreements, and the effect this has on violence suspension. Building on bargaining theory and existing ceasefire literature, we identify different bargaining problems conflict parties face over the course of a conflict, and three classes of ceasefire design they use to address these problems. We argue that the effect of ceasefires is driven both by these underlying logics and by the provisions they contain. Building on the PA-X data to capture the provisions included within all written civil war ceasefires between 1990 and 2019, and using Uppsala Conflict Data Program georeferenced event data, we estimate models of ceasefire survival, with conflict deaths as the main measure of whether a ceasefire remains in place. We find that definitive ceasefires (i.e., agreements with demobilization and incompatibility provisions), followed by preliminary ceasefires (i.e., agreements with compliance mechanisms), are associated with longer periods of violence suspension than cessation of hostilities agreements that lack such provisions. We discuss the implications of our results for conflict parties and third parties seeking to facilitate the transition from war to peace.
Seeing in Mirrors
Authors: Voltolini Alberto 
Published: May 2021

Abstract
Notwithstanding Plato’s venerable opinion, many people nowadays claim either that mirrors are not pictures, or that, if they are such, they are just transparent pictures in Kendall Walton’s sense of a particular kind of picture (causally based representations, Peircean indexes, namely, natural signs, which are grasped by means of a perceptual experience of transparency—seeing-through—that lets one literally see the object perceived through the picture). In this article, however, I want to argue that mirrors are bona fide pictures. For they are grasped via what, as I assume in the article, makes a picture a picture, that is, a representation with a figurative value, namely, a depiction; namely, a certain seeing-in experience. This is the sui generis perceptual experience that Richard Wollheim originally appealed to. Once this experience is suitably reconceived, one can show how it successfully applies to mirrors as well, in order to prove that they are bona fide pictures. From an aesthetical point of view, this is an important result. For it shows that the class of pictures is broader than what people nowadays think and is closer to the original intuition sustaining Plato’s opinion.