bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Shared Decision Making For Asian American Pacific Islander Sexual and Gender Minorities
Authors: Bi Stephanie , Gunter Kathryn E. , López Fanny Y. , Anam Seeba , Tan Judy Y. , Polin Danielle J. , Jia Justin L. , Xu Lucy J. , Laiteerapong Neda , Pho Mai T. , Kim Karen E. , Chin Marshall H. 
Published: September 2019

Background:
Asian American Pacific Islander (AAPI) sexual and gender minorities (SGM) face unique challenges in mental health and accessing high-quality health care.

Objective:
The objective of this study was to identify barriers and facilitators for shared decision making (SDM) between AAPI SGM and providers, especially surrounding mental health.

Research Design:
Interviews, focus groups, and surveys.

Subjects:
AAPI SGM interviewees in Chicago (n=20) and San Francisco (n=20). Two focus groups (n=10) in San Francisco.

Measures:
Participants were asked open-ended questions about their health care experiences and how their identities impacted these encounters. Follow-up probes explored SDM and mental health. Participants were also surveyed about attitudes towards SGM disclosure and preferences about providers. Transcripts were analyzed for themes and a conceptual model was developed.

Results:
Our conceptual model elucidates the patient, provider, and encounter-centered factors that feed into SDM for AAPI SGM. Some participants shared the stigma of SGM identities and mental health in their AAPI families. Their AAPI and SGM identities were intertwined in affecting mental health. Some providers inappropriately controlled the visibility of the patient’s identities, ignoring or overemphasizing them. Participants varied on whether they preferred a provider of the same race, and how prominently their AAPI and/or SGM identities affected SDM.

Conclusions:
Providers should understand identity-specific challenges for AAPI SGM to engage in SDM. Providers should self-educate about AAPI and SGM history and intracommunity heterogeneity before the encounter, create a safe environment conducive to patient disclosure of SGM identity, and ask questions about patient priorities for the visit, pronouns, and mental health.
Modeling the Health and Budgetary Impacts of a Team-based Hypertension Care Intervention That Includes Pharmacists
Authors: Overwyk Katherine J. , Dehmer Steven P. , Roy Kakoli , Maciosek Michael V. , Hong Yuling , Baker-Goering Madeleine M. , Loustalot Fleetwood , Singleton Christa-Marie , Ritchey Matthew D. 
Published: September 2019

Objective:
The objective of this study was to assess the potential health and budgetary impacts of implementing a pharmacist-involved team-based hypertension management model in the United States.

Research Design:
In 2017, we evaluated a pharmacist-involved team-based care intervention among 3 targeted groups using a microsimulation model designed to estimate cardiovascular event incidence and associated health care spending in a cross-section of individuals representative of the US population: implementing it among patients with: (1) newly diagnosed hypertension; (2) persistently (≥1 year) uncontrolled blood pressure (BP); or (3) treated, yet persistently uncontrolled BP—and report outcomes over 5 and 20 years. We describe the spending thresholds for each intervention strategy to achieve budget neutrality in 5 years from a payer’s perspective.

Results:
Offering this intervention could prevent 22.9–36.8 million person-years of uncontrolled BP and 77,200–230,900 heart attacks and strokes in 5 years (83.8–174.8 million and 393,200–922,900 in 20 years, respectively). Health and economic benefits strongly favored groups 2 and 3. Assuming an intervention cost of $525 per enrollee, the intervention generates 5-year budgetary cost-savings only for Medicare among groups 2 and 3. To achieve budget neutrality in 5 years across all groups, intervention costs per person need to be around $35 for Medicaid, $180 for private insurance, and $335 for Medicare enrollees.

Conclusions:
Adopting a pharmacist-involved team-based hypertension model could substantially improve BP control and cardiovascular outcomes in the United States. Net cost-savings among groups 2 and 3 make a compelling case for Medicare, but favorable economics may also be possible for private insurers, particularly if innovations could moderately lower the cost of delivering an effective intervention.
Symbolic transfer entropy reveals the age structure of pandemic influenza transmission from high-volume influenza-like illness data
Authors: Kissler Stephen M , Viboud Cécile , Grenfell Bryan T , Gog Julia R 
Published: September 2019

AbstractExisting methods to infer the relative roles of age groups in epidemic transmission can normally only accommodate a few age classes, and/or require data that are highly specific for the disease being studied. Here, symbolic transfer entropy (STE), a measure developed to identify asymmetric transfer of information between stochastic processes, is presented as a way to determine which age groups drive an epidemic. STE provides a ranking of which age groups dominate transmission, rather than a reconstruction of the explicit between-age-group transmission matrix. Using simulations, we establish that STE can identify which age groups dominate transmission, even when there are differences in reporting rates between age groups and even if the data is noisy. Then, the pairwise STE is calculated between time series of influenza-like illness for 12 age groups in 884 US cities during the autumn of 2009. Elevated STE from 5-19 year-olds indicates that school-aged children were the most important transmitters of infection during the autumn wave of the 2009 pandemic in the US. The results may be partially confounded by higher rates of physician-seeking behaviour in children compared to adults, but it is unlikely that differences in reporting rates can explain the observed differences in STE.
Improving personalized prediction of cancer prognoses with clonal evolution models
Authors: Tao Yifeng , Rajaraman Ashok , Cui Xiaoyue , Cui Ziyi , Eaton Jesse , Kim Hannah , Ma Jian , Schwartz Russell 
Published: September 2019

AbstractCancer occurs via an accumulation of somatic genomic alterations in a process of clonal evolution. There has been intensive study of potential causal mutations driving cancer development and progression. However, much recent evidence suggests that tumor evolution is normally driven by a variety of mechanisms of somatic hypermutability, known as mutator phenotypes, which act in different combinations or degrees in different cancers. Here we explore the question of how and to which degree different mutator phenotypes act in a cancer predict its future progression. We develop a computational paradigm using evolutionary tree inference (tumor phylogeny) algorithms to derive features quantifying single-tumor mutational preferences, followed by a machine learning frame-work to identify key features predictive of progression. We build phylogenies tracing the evolution of subclones of cells in tumor tissues using a variety of somatic genomic alterations, including single nucleotide variations, copy number alterations, and structural variations. We demonstrate that mutation preference features derived from the phylogenies are predictive of clinical outcomes of cancer progression – overall survival and disease-free survival – based on the analyses on breast invasive carcinoma, lung adenocarcinoma, and lung squamous cell carcinoma. We further show that mutational phenotypes have predictive power even after accounting for traditional clinical and driver-centric predictors of progression. These results confirm the power of mutational phenotypes as an independent class of predictive biomarkers and suggest a strategy for enhancing the predictive power of conventional clinical or driver-centric genomic features.
Mesoamerica is a cradle and the Atlantic Forest is a museum of Neotropical butterfly diversity: Insights from the evolution and biogeography of Brassolini (Lepidoptera: Nymphalidae)
Authors: Matos-Maraví Pável , Wahlberg Niklas , Freitas André V. L. , DeVries Phil , Antonelli Alexandre , Penz Carla M. 
Published: September 2019

ABSTRACTRegional species diversity is ultimately explained by speciation, extinction, and dispersal. Here we estimate dispersal and speciation rates of Neotropical butterflies to propose an explanation for their distribution and diversity of extant species. We focus on the tribe Brassolini (owl butterflies and allies): a Neotropical group that comprises 17 genera and 108 species, most of them endemic to rainforest biomes. We infer a robust species tree using the multispecies coalescent framework and a dataset including molecular and morphological characters. This formed the basis for three changes in Brassolini classification: 1) Naropina, SYN. NOV. is subsumed within Brassolina; 2)Aponarope, SYN. NOV. is subsumed withinNarope; 3)Selenophanes orgetorix, COMB. NOV. is reassigned fromCatoblepiatoSelenophanes. By applying biogeographical stochastic mapping, we found contrasting species diversification and dispersal dynamics across rainforest biomes, which might be partly explained by the geological and environmental history of each bioregion. Our results reveal a mosaic of biome-specific evolutionary histories within the Neotropics, where butterfly species have diversified rapidly (cradles: Mesoamerica), have accumulated gradually (museums: Atlantic Forest), or have alternately diversified and accumulated (Amazonia). Our study contributes evidence from a major butterfly lineage that the Neotropics are a museum and cradle of species diversity.
Broadening the ecology of fear: non-lethal effects arise from diverse responses to predation and parasitism
Authors: Daversa D.R. , Hechinger R.F. , Madin E. , Fenton A. , Dell A.I. , Ritchie E. , Rohr J. , Rudolf V.H.W. 
Published: September 2019

AbstractThe ecology of fear demonstrates how prey responses to avoid predation cause non-lethal effects at all ecological scales. Parasites also elicit defensive responses in hosts with associated non-lethal effects, which raises the longstanding, yet unresolved question of how non-lethal effects of parasites compare with those of predators. We developed a framework for systematically answering this question for all types of predator and parasite systems. Our framework predicts that trait responses and their non-lethal effects should be strongest from predators and parasites that do not kill individuals to feed on them, but which nevertheless damage fitness. Analysing trait response data on amphibians, which have been well-studied for this area of research, showed that individuals generally responded more directly to short-term predation risks than to parasitism. Apart from studies using amphibians, there have been few direct comparisons of responses to predation and parasitism, and none have incorporated responses to micropredators, parasitoids, or parasitic castrators, or examined their long-term consequences. Addressing these and other data gaps highlighted by our general framework can advance the field toward understanding how non-lethal effects shape real food webs, which contain multiple predator and parasite species.
DMSO potentiates the suppressive effect of dronabinol, a cannabinoid, on sleep apnea and REM sleep
Authors: Calik Michael W. , Carley David W. 
Published: September 2019

AbstractPurposeDimethyl sulfoxide (DMSO) is an amphipathic molecule with innate biological activity that also is used to dissolve both polar and nonpolar compounds in preclinical and clinical studies. Recent investigations of dronabinol, a cannabinoid, dissolved in DMSO demonstrated decreased sleep apnea frequency and time spent in REM sleep in rats. Here, we tested the effects of dronabinol dissolved in 25% DMSO (diluted in phosphate-buffered saline) to rule out potentiating effects of DMSO.MethodsSprague-Dawley rats were anesthetized and implanted with bilateral stainless steel screws into the skull for electroencephalogram recording and bilateral wire electrodes into the nuchal muscles for electromyogram recording. Each animal was recorded by polysomnography. The study was a fully nested, repeated measures crossover design, such that each rat was recorded following each of 8 intraperitoneal injections separated by three days: vehicle (25% DMSO/PBS); vehicle and CB1 antagonist (AM 251); vehicle and CB2 antagonist (AM 630); vehicle and CB1/CB2 antagonist; dronabinol (CB1/CB2 agonist); dronabinol and CB1 antagonist; dronabinol and CB2 antagonist; and dronabinol and CB1/CB2 antagonist. Sleep was manually scored into NREM and REM stages, and apneas were quantified.ResultsDronabinol dissolved in 25% DMSO did not suppress apnea or modify sleep efficiency compared to vehicle controls, in contrast to previously published results. However, dronabinol did suppress REM sleep, which is in line with previously published results.ConclusionsDronabinol in 25% DMSO partially potentiated dronabinol’s effects, suggesting a concomitant biological effect of DMSO on breathing during sleep.
Pupil diameter tracks statistical structure in the environment
Authors: Schwiedrzik Caspar M. , Sudmann Sandrin S. 
Published: September 2019

SummaryPupil diameter determines how much light hits the retina, and thus, how much information is available for visual processing. This is regulated by a brainstem reflex pathway. Here, we investigate whether this pathway is under the control of internal models about the environment. If so, this would allow adjusting pupil dynamics to environmental statistics, and hence optimize information transmission. We manipulate environmental temporal statistics by presenting sequences of images that contain internal temporal structure to humans and macaque monkeys. We then measure whether the pupil tracks this structure not only at the rate that immediately arises from variations in luminance, but also at the rate of higher order statistics that are not available from luminance information alone. We find entrainment to environmental statistics in both species during the image sequences. Furthermore, pupil entrainment predicts later performance in an offline task that taps into the same internal models. Thus, the dynamics of the pupil are under control of internal models which adaptively match pupil diameter to the temporal structure of the environment, in line with an active sensing account.
Rheumatoid arthritis patients express a skewed repertoire of polyclonal, hypomutated B-cell receptors
Authors: Cowan Graeme J.M. , Miles Katherine , Capitani Lorenzo , Giguere Sophie S.B. , Johnsson Hanna , Goodyear Carl , McInnes Iain B. ,   Scottish Early Rheumatoid Arthritis Inception cohort Investigators, Breusch Steffen , Gray David , Gray Mohini 
Published: September 2019

AbstractObjectivesThe success of B cell depletion therapy in rheumatoid arthritis (RA) therapy testifies to their importance in disease pathogenesis, but the precise B cells mediating this are unclear. For example, it is unknown if RA patients predominantly express a limited number of circulating clonally expanded populations of B cells with highly mutated B cell antigen receptors (BCRs) that would constitute a shared antigen driven response.MethodsTo address this, we have undertaken the largest study to date utilising next generation sequencing (NGS), to identify the full length of the peripheral blood BCR sequences from the antigen-binding heavy chain. Between 25,000 to 200,000 BCR sequences per patient were analysed from 127 newly diagnosed RA patients, 16 heathy controls, 16 RA patients with established disease and 8 paired blood and synovial samples. This was complemented with B cell subset analysis from an additional 64 RA patients and 22 healthy controls.ResultsRA patients expressed a significantly higher percentage of circulating poorly mutated polyclonal IgG+vevariable heavy (IgG-Vh) BCR sequences, both at the time of diagnosis and following treatment. These sequences resided predominantly within TNF-alpha secreting IgG+veCD27−veB cells, that were expanded in RA peripheral blood and enriched in the rheumatoid synovium. Surprisingly, peripheral and synovial B cell repertoires of RA patients are quite distinct, sharing very few IgG sequences.ConclusionsThis is the first report to conclusively establish that a substantial component of the peripheral B cell repertoire in RA consists of polyclonal hypomutated IgG+veBCRs that may play a critical role in driving an autoimmune mediated inflammation.
Structural changes in the gut microbiome of short-term and long-term medical workers compared to normal controls
Authors: Zheng Ning , Li Shenghui , Dong Bo , Sun Wen , Li Huairui , Zhang Yongli , Li Peng , Fang Zhiwei , Chen Changming , Han Xiuyan , Li Bo , Zhang Siyi , Xu Miao , Zhang Guixin , Xin Yi , Ma Yufang , Wan Xianyao , Yan Qiulong 
Published: September 2019

ABSTRACTObjectiveHospital environment has been implicated in enrichment and exchange of pathogens and antibiotic resistances, but its potential in shaping the symbiotic microbial community of the hospital staff is unclear. This study was designed to evaluate the alteration of gut microbiome in medical workers compared to non-medical controls.DesignProspective cross-sectional cohort study.SettingIntensive care unit (ICU) and other departments from a center in northeast China.Subjects175 healthy medical workers (1-3 months short-term workers, n = 80; >1 year long-term workers, n = 95) and 80 healthy normal controls.InterventionsNone.Measurements and Main ResultsFecal samples of all subjects were analyzed using the 16S rRNA gene sequencing. Medical workers exhibited remarkable deviation in gut microbial within-sample diversity and enterotypes stratification, and shift in overall microbial structure. Short-term workers were significantly more abundant in taxa including Lactobacillus, Butyrivibrio, Clostridiaceae_Clostridium, Ruminococcus, Dialister, Bifidobacterium, Odoribacter and Desulfovibrio, and with lower abundances of Bacteroides and Blautia compared with the controls. While long-term workers were enriched in taxa including Dialister, Veillonella, Clostridiaceae_Clostridium, Bilophila, Desulfovibrio, Pseudomonas and Akkermansia, with lower abundances of Bacteroides and Coprococcus compared with the controls. In addition, medical worker’s working years (short-term vs. long-term), hospital department (resident doctor vs. nursing staff) and work position (ICU vs. not-ICU) revealed considerable effects on their gut microbiome. Moreover, by analyzing the environmental samples (n = 9) around the inpatient wards and the hospital, we showed that the gut microbiota of medical workers was closer to environmental microbiota than that of the normal controls, probably in correlation to lasting exposure to the pathogenic taxa (e.g. Pseudomonas) in health workers.ConclusionsOur findings demonstrated structural changes in the gut microbial community of the medical workers. Further studies are proposed for investigating the potentially physiological influence of the altered gut microbiome in medical participants.IMPORTANCEIn this study, we for the first time focused on the influence of hospital environmental factors on gut microbiota of medical workers. The significance of our study is not limited to revealing the remodeling effect of the hospital environment on the gut microbiota of medical workers. Based on these, we also propose targeted and operational recommendations that can promote the health of hospital staff.
Microstructure Diffusion Scalar Measures from Reduced MRI Acquisitions
Authors: Aja-Fernández Santiago , de Luis-García Rodrigo , Afzali Maryam , Molendowska Malwina , Pieciak Tomasz , Tristán-Vega Antonio 
Published: September 2019

AbstractIn diffusion MRI, the Ensemble Average diffusion Propagator (EAP) provides relevant microstructural information and meaningful descriptive maps of the white matter previously obscured by traditional techniques like the Diffusion Tensor. The direct estimation of the EAP, however, requires a dense sampling of the Cartesian q-space. Due to the huge amount of samples needed for an accurate reconstruction, more efficient alternative techniques have been proposed in the last decade. Even so, all of them imply acquiring a large number of diffusion gradients with different b-values. In order to use the EAP in practical studies, scalar measures must be directly derived, being the most common the return-to-origin probability (RTOP) and the return-to-plane and return-to-axis probabilities (RTPP, RTAP).In this work, we propose the so-called “Apparent Measures Using Reduced Acquisitions” (AMURA) to drastically reduce the number of samples needed for the estimation of diffusion properties. AMURA avoids the calculation of the whole EAP by assuming the diffusion anisotropy is roughly independent from the radial direction. With such an assumption, and as opposed to common multi-shell procedures based on iterative optimization, we achieve closed-form expressions for the measures using information from one single shell. This way, the new methodology remains compatible with standard acquisition protocols commonly used for HARDI (based on just one b-value). We report extensive results showing the potential of AMURA to reveal microstructural properties of the tissues compared to state of the art EAP estimators, and is well above that of Diffusion Tensor techniques. At the same time, the closed forms provided for RTOP, RTPP, and RTAP-like magnitudes make AMURA both computationally efficient and robust.
Not so dry after all – DRY mutants of the AT1A receptor and H1 receptor can induce G protein-dependent signaling
Authors: Pietraszewska-Bogiel A , Joosen L , Goedhart J 
Published: September 2019

ABSTRACTGPCRs are seven transmembrane spanning receptors that regulate a wide array of intracellular signaling cascades in response to various stimuli. To do so, they couple to different heterotrimeric G proteins and adaptor proteins, including arrestins. Importantly, arrestins were shown to regulate GPCR signaling through G proteins, as well as promote G protein-independent signaling events. Several research groups have reported successful isolation of exclusively G protein-dependent and arrestin-dependent signaling downstream of GPCR activation using biased agonists or receptor mutants incapable of coupling to either arrestins or G proteins. In the latter category, the DRY mutant of the angiotensin II type 1 receptor was extensively used to characterize functional selectivity downstream of AT1AR. In an attempt to understand histamine 1 receptor signaling, we characterized the signaling capacity of the H1R DRY mutant in a panel of dynamic, live cell biosensor assays, including arrestin recruitment, heterotrimeric G-protein activation, Ca2+ signaling, protein kinase C activity, GTP binding of RhoA, and activation of ERK1/2. Here we show that both H1R DRY mutant and the AT1AR DRY mutant (used as a reference) are capable of efficient activation of G protein-mediated signaling. Therefore, contrary to common belief, they do not constitute suitable tools for dissection of arrestin-mediated, G protein-independent signaling downstream of these receptors.