bluuebunny/crossref_metadata_2025_split huggingface dataset:
The ongoing impact of COVID-19 on adult cardiac surgery and suggestions for safe continuation throughout the pandemic: a review of expert opinions
Authors: Kirkley Kirstie , Benedetto Umberto , Caputo Massimo , Angelini Gianni D , Vohra Hunaid A 
Published: May 2021

Objectives: To establish the impact of the COVID-19 pandemic on adult cardiac surgery by reviewing current data and use this to establish methods for safely continuing to carry out surgery. Methods: Conduction of a literature search via PubMed using the search terms: ‘(adult cardiac OR cardiothoracic OR surgery OR minimally invasive OR sternotomy OR hemi-sternotomy OR aortic valve OR mitral valve OR elective OR emergency) AND (COVID-19 or coronavirus OR SARS-CoV-2 OR 2019-nCoV OR 2019 novel coronavirus OR pandemic)’. Thirty-two articles were selected. Results: Cardiac surgery patients have an increased risk of complications from COVID-19 and require vital finite resources such as intensive care beds, also required by COVID-19 patients. Thus reducing their admission and potential hospital-acquired infection with COVID-19 is paramount. During the peak, only emergencies such as acute aortic dissections were treated, triaging patients according to surgical priority and cancelling all elective procedures. Screening and 2-week quarantine prior to admission were essential changes, alongside additional levels of PPE. Focus was on reducing length of stay and switching to day-cases to reduce post-operative transmission risk, whilst several hospitals adopted ‘hot’ and ‘cold’ operating theatres for covid-confirmed and covid-negative patients. Conclusions: This paper suggests a ‘CARDIO’ approach for reintroducing elective procedures: ‘Care, Assess, Re-Evaluate, Develop, Implement, Overcome’; prioritising the mental and physical health of the workforce, learning from and sharing experiences and objectively prioritising patients to improve case load.
Factors Associated With Mental Health Service Use Among Black, Latinx, and Asian Older Adults in Community-Based Organizations
Authors: Zhang Liao , O’Malley Isabel , Cruz-Gonzalez Mario , Sánchez González Mayra L. , Alegría Margarita 
Published: May 2021

Objective: Older adults of color face systemic obstacles in seeking mental health care. Unaddressed late-life mental health issues can challenge independent living and increase disability and mortality risk. This study examined factors associated with mental health service use among community-dwelling older adults. Method: This cross-sectional analysis used data from the Positive Minds-Strong Bodies trial ( N= 1,013). Results: Higher anxiety, depressive, and posttraumatic stress disorder (PTSD) symptoms increased odds of service use (odds ratio [OR] = 1.05–2.11). Asian and Latinx, but not Black, older adults had lower odds of service use than Whites (OR = 0.15–0.35). Yet Asian and Latinx older adults with higher anxiety and depression symptoms and Asians with at least one PTSD symptom had higher odds of service use than Whites with the same symptomatology (OR = 1.16–2.88). Conclusion: White older adults might be more likely to seek mental health care at lower levels of need, while Asian and Latinx older adults might seek services when they perceive greater need.
Effect of raw and encapsulated policosanol on lipid profiles, blood biochemistry, activity, energy expenditure and macronutrient metabolism of adult cats
Authors: Templeman James R , Hogan Kylie , Blanchard Alexandra , Marinangeli Christopher PF , Camara Alexandra , Verbrugghe Adronie , Shoveller Anna K 
Published: May 2021

Objectives The objective of this study was to verify the safety of policosanol supplementation for domestic cats. The effects of raw and encapsulated policosanol were compared with positive (L-carnitine) and negative (no supplementation) controls on outcomes of complete blood count, serum biochemistry, energy expenditure, respiratory quotient and physical activity in healthy young adult cats. Methods The study was a replicated 4 × 4 complete Latin square design. Eight cats (four castrated males, four spayed females; mean age 3.0 ± 1.0 years; mean weight 4.36 ± 1.08 kg; mean body condition score 5.4 ± 1.4) were blocked by sex and body weight then randomized to treatment groups: raw policosanol (10 mg/kg body weight), encapsulated policosanol (50 mg/kg body weight), L-carnitine (200 mg/kg body weight) or no supplementation. Treatments were supplemented to a basal diet for 28 days with a 1-week washout between periods. Food was distributed equally between two offerings to ensure complete supplement consumption (first offering) and measure consumption time (second offering). Blood collection (lipid profile, complete blood count, serum biochemistry) and indirect calorimetry (energy expenditure, respiratory quotient) were conducted at days 0, 14 and 28 of each period. Activity monitors were worn 7 days prior to indirect calorimetry and blood collection. Data were analyzed using a repeated measures mixed model (SAS, v.9.4). Results Food intake and body weight were similar among treatments. There was no effect of treatment on lipid profile, serum biochemistry, activity, energy expenditure or respiratory quotient ( P >0.05); however, time to consume a second meal was greatest in cats fed raw policosanol ( P <0.05). Conclusions and relevance These data suggest that policosanol is safe for feline consumption. Further studies with cats demonstrating cardiometabolic risk factors are warranted to confirm whether policosanol therapy is an efficacious treatment for hyperlipidemia and obesity.
Viscoelastic-assisted inverted cover and free ILM flap techniques
Authors: Romano Mario R , Borgia Alfredo , Raimondi Raffaele 
Published: May 2021

Summary statement: Surgical technique: an innovative way of using cohesive viscoelastic to stabilize the ILM flap during the cover inverted-flap and free-flap procedures. Summary statement: Surgical technique: an innovative way of using cohesive viscoelastic to stabilize the ILM flap during the covering step in the inverted-flap and free-flap procedures.
Leptomeningeal enhancement on post-contrast FLAIR images for early diagnosis of Susac syndrome
Authors: Bellanger Guillaume , Biotti Damien , Adam Gilles , Darcourt Jean , Roques Margaux , Patsoura Sofia , Savatovsky Julien , Obadia Michael , Menjot de Champfleur Nicolas , Charif Mahmoud , Labauge Pierre , Cotton Francois , Durand Dubief Françoise , Tourdias Thomas , Dulau Cecile , Kremer Stéphane , De Sèze Jérôme , Ciron Jonathan , Varenne Fanny , Viguier Alain , Lerebours Fleur , Larrue Vincent , Cognard Christophe , Bonneville Fabrice 
Published: May 2021

Background: Leptomeningeal enhancement (LME) is a key feature of Susac syndrome (SuS) but is only occasionally depicted on post-contrast T1-weighted images (T1-WI). Objective: As post-contrast fluid-attenuated inversion recovery (FLAIR) may be more sensitive, our aim was to assess LME in SuS on this sequence. Methods: From 2010 to 2020, 20 patients with definite SuS diagnosis were retrospectively enrolled in this multicentre study. Two radiologists independently assessed the number of LME on post-contrast FLAIR and T1-WI acquisitions performed before any treatment. A chi-square test was used to compare both sequences and the interrater agreement was calculated. Results: Thirty-five magnetic resonance imagings (MRIs) were performed before treatment, including 19 post-contrast FLAIR images in 17 patients and 25 post-contrast T1-WI in 19 patients. In terms of patients, LME was observed on all post-contrast FLAIR, contrary to post-contrast T1-WI (17/17 (100%) vs. 15/19 (79%), p < 0.05). In terms of sequences, LME was observed on all post-contrast FLAIR, contrary to post-contrast T1-WI (19/19 (100%) vs. 16/25 (64%), p < 0.005). LME was disseminated at both supratentorial (19/19) and infratentorial (18/19) levels on post-contrast FLAIR, contrary to post-contrast T1-WI (3/25 and 9/25, respectively). Interrater agreement was excellent for post-contrast FLAIR (κ = 0.95) but only moderate for post-contrast T1-WI (κ = 0.61). Conclusion: LME was always observed and easily visible on post-contrast FLAIR images prior to SuS treatment. In association with other MRI features, it is highly indicative of SuS.
Transcriptome analysis of ovary tissues from low- and high-yielding Changshun green-shell laying hens
Authors: Mu Ren , Yu Yi-yin , Gegen Tuya , Wen Di , Wang Fen , Chen Zhi , Xu Wen-bin 
Published: May 2021

Abstract
Background
Changshun green-shell laying hens are unique to Guizhou Province, China, and have high egg quality. Improving egg production performance has become an important breeding task, and in recent years, the development of high-throughput sequencing technology provides a fast and exact method for genetic selection. Therefore, we aimed to use this technology to analyze the differences between the ovarian mRNA transcriptome of low and high-yield Changshun green-shell layer hens, identify critical pathways and candidate genes involved in controlling the egg production rate, and provide basic data for layer breeding.

Results
The egg production rates of the low egg production group (LP) and the high egg production group (HP) were 68.00 ± 5.56 % and 93.67 ± 7.09 %, with significant differences between the groups (p < 0.01). Moreover, the egg weight, shell thickness, strength and layer weight of the LP were significantly greater than those of the HP (p < 0.05). More than 41 million clean reads per sample were obtained, and more than 90 % of the clean reads were mapped to the Gallus gallus genome. Further analysis identified 142 differentially expressed genes (DEGs), and among them, 55 were upregulated and 87 were downregulated in the ovaries. KEGG pathway enrichment analysis identified 9 significantly enriched pathways, with the neuroactive ligand-receptor interaction pathway being the most enriched. GO enrichment analysis indicated that the GO term transmembrane receptor protein tyrosine kinase activity, and the DEGs identified in this GO term, including PRLR, NRP1, IL15, BANK1, NTRK1, CCK, and HGF may be associated with crucial roles in the regulation of egg production.

Conclusions
The above-mentioned DEGs may be relevant for the molecular breeding of Changshun green-shell laying hens. Moreover, enrichment analysis indicated that the neuroactive ligand-receptor interaction pathway and receptor protein tyrosine kinases may play crucial roles in the regulation of ovarian function and egg production.
Association of gestational diabetes mellitus with changes in gut microbiota composition at the species level
Authors: Chen Fang , Gan Yu , Li Yingtao , He Wenzhi , Wu Weizhen , Wang Kejian , Li Qing 
Published: May 2021

Abstract
Background
Gestational diabetes mellitus (GDM), a common endocrine disorder with rising prevalence in pregnancy, has been reported to be associated with alteration of gut microbiota in recent years. However, the role of gut microbiome in GDM physiopathology remains unclear. This pilot study aims to characterize the alteration of gut microbiota in GDM on species-level resolution and evaluate the relationship with occurrence of GDM.

Methods
An analysis based on 16S rRNA microarray was performed on fecal samples obtained from 30 women with GDM and 28 healthy pregnant women.

Results
We found 54 and 141 differentially abundant taxa between GDM and control group at the genus and the species level respectively. Among GDM patients, Peptostreptococcus anaerobius was inversely correlated with fasting glucose while certain species (e.g., Aureimonas altamirensis, Kosakonia cowanii) were positively correlated with fasting glucose.

Conclusions
This study suggests that there are large amounts of differentially abundant taxa between GDM and control group at the genus and the species level. Some of these taxa were correlated with blood glucose level and might be used as biomarkers for diagnoses and therapeutic targets for probiotics or synbiotics.
The relationship of coffee consumption and CVD risk factors in elderly patients with T2DM
Authors: Ghavami Hossein Sayed , Khoshtinat Mehran , Sadeghi-Farah Sepehr , Kalimani Arman Bayati , Ferrie Suzie , Faraji Hossein 
Published: May 2021

Abstract
Objective
Clinical studies suggest increasing prevalence of cardiovascular disease (CVD) risk factors and diabetes among the elderly. Meanwhile, some food compounds, such as coffee, can also have beneficial effects on CVD risk factors. The aim of the present study was to examine the relationship between coffee consumption and CVD risk factors in the elderly with type 2 diabetes mellitus (T2DM).

Methods
This cross-sectional study was performed during 2017 on 300 elderly people above 60 years of age with T2DM in Isfahan, Iran. Dietary assessment was performed using a food frequency questionnaire. Coffee consumption was classified into three groups including < 1, 1–3, and > 3 cups/day. Partial correlation test was used to investigate the relationship between CVD risk factors and usual coffee consumption.

Results
The mean age and body mass index of participants were 70.04 ± 4.87 years and 24.74 ± 3.34 kg/m2 respectively. Coffee consumption had a significant inverse relationship with fasting plasma glucose (FPG) and diastolic blood pressure (DBP) in the elderly with T2DM (r: − 0.117, 0.134; p: 0.046, 0.022). Triglyceride (TG) and high-density lipoprotein cholesterol (HDL-C) had a significant positive relationship with coffee consumption levels (r: 0.636, 0.128; p: 0.028, 0.029). These results were obtained after controlling for potential confounders.

Conclusion
Increasing coffee consumption was linked to improved status of some CVD risk factors including FPG, HDL-C, and DBP in the elderly with T2DM. Nevertheless, increasing coffee consumption was also associated with higher TG level and had no significant effect on other risk factors. Further studies are required to confirm these results.
Lymphocyte subset analysis to evaluate the prognosis of HIV-negative patients with pneumocystis pneumonia
Authors: Jin Fan , Xie Jing , Wang Huan-ling 
Published: May 2021

AbstractObjectivesWe analysed the peripheral blood lymphocyte subsets of human immunodeficiency virus (HIV)-negative patients infected with pneumocystis pneumonia (PCP) to determine the relationships between the levels of different types of lymphocytes and the prognosis of patients.MethodsWe retrospectively reviewed HIV-negative patients with PCP diagnosed in our department. All the eligible patients underwent lymphocyte subset analysis on admission.ResultsA total of 88 HIV-negative PCP patients were enrolled in the study. In univariate analyses, low CD4+ T cell count, low CD8+ T cell count, and low natural killer cell (NK cell) count were associated with higher in-hospital mortality. CD8+ T cell count ≤300/μL was found to be an independent risk factor for poor prognosis in multivariate logistical regression analysis (p = 0.015, OR = 11.526, 95% CI = 1.597–83.158). Although low CD4+ T cell and NK cell counts were not independent risk factors, the mortality rates of PCP patients decreased as the CD4+ T cell and NK cell counts increased.ConclusionThe immune process ofPneumocystis jiroveciiinfection is complex but important. We propose that lymphocyte subsets could give clinicians a better understanding of patient immune status, helping with the early identification of potentially lethal infections and treatment decision making, such as adjusting the immunosuppressive regimen and choosing an appropriate patient monitoring level.
“Part of getting to where we are is because we have been open to change” integrating community health workers on care teams at ten Ryan White HIV/AIDS program recipient sites
Authors: Sprague Martinez Linda , Davoust Melissa , Rajabiun Serena , Baughman Allyson , Bachman Sara S. , Bowers-Sword Rachel , Campos Rojo Maria , Sullivan Marena , Drainoni Mari-Lynn 
Published: May 2021

Abstract
Background
Community Health Workers (CHWs) have long been integrated in the delivery of HIV care in middle- and low-income countries. However, less is known about CHW integration into HIV care teams in the United States (US). To date, US-based CHW integration studies have studies explored integration in the context of primary care and patient-centered medical homes.
There is a need for research related to strategies that promote the successful integration of CHWs into HIV care delivery systems. In 2016, the Health Resources and Services Administration HIV/AIDS Bureau launched a three-year initiative to provide training, technical assistance and evaluation for Ryan White HIV/AIDS Program (RWHAP) recipient sites to integrate CHWs into their multidisciplinary care teams, and in turn strengthen their capacity to reach communities of color and reduce HIV inequities.

Methods
Ten RWHAP sites were selected from across eight states. The multi-site program evaluation included a process evaluation guided by RE-AIM to understand how the organizations integrated CHWs into their care teams. Site team members participated in group interviews to walk-the-process during early implementation and following the program period. Directed content analysis was employed to examine program implementation. Codes developed using implementation strategies outlined in the Expert Recommendations for Implementing Change project were applied to group interviews (n = 20).

Findings
Implementation strategies most frequently described by sites were associated with organizational-level adaptations in order to integrate the CHW into the HIV care team. These included revising, defining, and differentiating professional roles and changing organizational policies. Strategies used for implementation, such as network weaving, supervision, and promoting adaptability, were second most commonly cited strategies, followed by training and Technical Assistance strategies.

Conclusions
Wrapped up in the implementation experience of the sites there were some underlying issues that pose challenges for healthcare organizations. Organizational policies and the ability to adapt proved significant in facilitating CHW program implementation. The integration of the CHWs in the delivery of HIV care requires clearly distinguishing their role from the roles of other members of the healthcare delivery team.
Cervico-thoracic pain and associated impairments in air force personnel: a cross-sectional study
Authors: Tegern Matthias , Aasa Ulrika , Larsson Helena 
Published: May 2021

Abstract
Background
Pain and impaired function in the cervical region are common in Air Force personnel (AFP), but evidence is limited regarding the thoracic region. This cross-sectional cohort study examined associations between cervico-thoracic pain and physical performance among Swedish AFP and explored possible differences and similarities in test performance between fighter pilots (FP), helicopter pilots (HP) and rear crew (RC).

Methods
AFP (n = 73) from one airbase performed eight tests of movement control of the spine, active cervical range of motion (ROM) in all six directions and isometric strength and endurance of the cervical flexors and extensors. The association between test performance and cervico-thoracic pain (based on the ‘Musculoskeletal screening protocol’ questionnaire) were analysed in a multiple binary logistic regression model.

Results
For AFP with cervico-thoracic pain (30%), movement control was impaired in the ‘neck flexion test’ (OR [95%CI] =3.61 [1.06–12.34]) and the ‘forward lean test’ (OR [95%CI] =3.43[1.04–11.37]), together with reduced flexion ROM (OR [95%CI] =0.93 [0.87–0.99]). Test performance was in general similar between the three groups, but FP and HP could control the ‘forward lean test’ to a significantly higher degree than RC (p = 0.000). Further, FP showed significantly greater ROM in lateral flexion to the right compared to HP and RC (mean: 40.3°, 36.2° and 33.4°, respectively, p = 0.000), and they showed higher, although not significant, flexor strength than RC (p = 0.026).

Conclusions
The impaired function associated with cervico-thoracic pain highlights the need for a deeper understanding of such relationships when designing tools to systematically optimize the physical performance and prevent pain among AFP. Studies with a longitudinal design are warranted to examine any causative associations between pain and impairments.
A physician assistant entry-level doctoral degree: more harm than good?
Authors: Kulo Violet , Fleming Shani , Gordes Karen L. , Jun Hyun-Jin , Cawley James F. , Kayingo Gerald 
Published: May 2021

Abstract
Background
As most health professions in the United States have adopted clinical or practice doctorates, there has been an ongoing debate on whether physician assistants (PAs) should transition from a master’s to a doctorate as the terminal degree. The authors examined perceived risks, benefits and impact of transitioning to an entry-level PA doctoral degree.

Methods
A multi-prong, mixed-methods approach was used that included a literature review and collecting quantitative and qualitative data using a survey and interviews. Bivariate analysis and binomial logistic regression were performed to evaluate relationships between perceptions/perspectives on an entry-level PA doctoral degree and the anticipated impact of it causing more harm than good to the PA profession. Deductive content analysis was used to analyze the qualitative data.

Results
Of 636 PA clinicians and students (46% response rate), 457 (72%) disagreed that an entry-level PA doctoral degree should be required. More than half of the respondents (54%) agreed that it should be offered but not required and 380 respondents (60%) agreed that an entry-level doctoral degree would cause more harm than good. Race, educational attainment, occupation, and length of practice as a PA were significantly associated with having a perception of causing more harm. There was strong positive association between the perception of a doctoral degree causing more harm with expectations of having a negative impact on the availability of clinical training sites (OR = 4.39, p < .05). The most commonly cited benefits were parity with other professions and competitive advantage, whereas the perceived risks were increased cost for education, decreased diversity in the profession, and negative impact on the PA/physician relationship.

Conclusions
The major takeaway of our study was that perceived benefits and risks are strongly influenced by the lens of the stakeholder. While the majority of PAs and students appear to be not in favor mainly due to the potential harm, the proportion of those in favor is not insignificant and their views should not be ignored. Addressing concerns with key stakeholders could help the PA profession to transition to a doctoral degree with minimal adverse impact.