bluuebunny/crossref_metadata_2025_split huggingface dataset:
What Factors Influence Reimbursement for 1 to 2 Level Anterior Cervical Discectomy and Fusion Procedures?
Authors: Virk Sohrab S. , Phillips Frank M. , Moffatt-Bruce Susan D. , Khan Safdar N. 
Published: June 2018

Study Design.
Retrospective review.

Objective.
To determine reimbursement associated with an anterior cervical discectomy and fusion (ACDF) and the demographic factors influencing reimbursement for an ACDF.

Summary of Background Data.
ACDF has been shown to be a cost-effective procedure. However, there has been minimal analysis of factors influencing reimbursement for this procedure.

Methods.
Clinical and financial data were retrospectively reviewed for 176 patients undergoing an ACDF procedure in 2013 and 2014. Patients were included if they had primary ACDF and excluded if they were treated for a traumatic cervical spine fracture, infection, failed primary procedure, front/back procedure, or total disc replacement procedure. Clinical factors analyzed included number of levels fused, surgical time, length of stay in the hospital, estimated blood loss, implant type, Charleson Comorbidity Index (CCI), and preoperative diagnosis. Payer type and reimbursement associated with physician and hospital fees were collected for each patient. A multiple linear regression model determined the factors influencing reimbursement data using a backward conditional stepwise methodology. Variables were only included in multivariate analysis if there was a significant (P < 0.05) impact on reimbursement within univariate analysis.

Results.
One hundred and twenty-eight patients met inclusion criteria. The average reimbursement per patient was $24,622 (+/- standard deviation of 14,616). The only significant factors influencing reimbursement was payer type (P < 0.001) and length of hospital stay (P < 0.001). These two independent multivariate determinants of reimbursement only accounted for 18.6% of reimbursement variability.

Conclusion.
There is substantial variability in reimbursement for ACDF procedures. Multivariate analysis indicates that payer type and length of hospital stay significantly influence reimbursement. Our model, however, only explained a small proportion of reimbursement variability indicating that factors outside our analysis may significantly affect hospital reimbursement.

Level of Evidence: 3
Characteristics, Therapeutic Needs, and Scope of Patients With a Continuous-Flow Left Ventricular Device Entering Cardiac Rehabilitation
Authors: Hildebrandt Anke , Willemsen Detlev , Reiss Nils , Bartsch Petra , Schmidt Thomas , Bjarnason-Wehrens Birna 
Published: June 2018

Background:
With an increasing number of left ventricular assist devices (LVADs) being implanted, the need for adequate cardiac rehabilitation (CR) regimens meeting the special needs of these patients arises. Only a few studies have reported experience gained on this topic. Structured CR strategies are poorly implemented. The aim was to evaluate the characteristics, therapeutic needs, and scope of LVAD patients at admission to CR within a greater cohort in order to identify their special CR needs.

Methods:
Retrospective single-center study; 69 LVAD patients (50.7 ± 13.6 y; 59 male; 48 HVAD; 21 HeartMate II) who completed first inpatient CR were included. Patient records were used to document relevant medical information (including the results of a 6-min walk test and a maximal isometric strength test for quadriceps femoral muscles in both legs) and the International Classification of Functioning, Disability and Health for classification of health and health-related domains.

Results:
Patient characteristics demonstrated a heterogeneous group: CR was started 44 ± 38.6 d after implantation; CR duration was 28 ± 9.7 d. Despite similar etiology, physical and psychological condition was diverse, although, overall a high degree of impairment was present, especially in the body function (79.7%) and activity and participation (95.7%) domains. The results demonstrated the need for a highly individualized approach in the somatic and also in the education, psychosocial, and social therapeutic regimes.

Conclusion:
The results demonstrate a heterogeneous group with a high level of impairment and special needs in many CR domains. The development and evaluation of a special highly individualized approach of CR, which meets the special needs of these patients, is needed.
Evaluation of Long-Term Silicone Hydrogel Use on Ocular Surface Inflammation and Tear Function in Patients With and Without Meibomian Gland Dysfunction
Authors: Yucekul Burcu , Mocan Mehmet C. , Kocabeyoglu Sibel , Tan Cagman , Irkec Murat 
Published: June 2018

Objectives:
To determine whether silicone hydrogel (SH) contact lens (CL) use, with or without meibomian gland dysfunction (MGD), promotes ocular surface inflammation.

Methods:
Subjects wearing SH-CL for at least 6 months who also had coexisting MGD (group 1, n=20), SH-CL users who did not have MGD (group 2, n=20), patients who had MGD but did not use CL (group 3, n=20), and healthy CL-naive individuals with no known systemic or ocular diseases (group 4, n=20) were included in this cross-sectional, single-center study. All subjects underwent tear function tests consisting of tear break-up time (tBUT), ocular surface staining, Schirmer test, and the Ocular Surface Disease Index (OSDI) questionnaire, as well as determination of tear IL-1RA, IL-1β, IL-2, IL-2R, IL-4, IL-5, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-15, IL-17, IFN-α, IFN-γ, TNF-α, granulocyte-macrophage colony-stimulating factor, IP-10, monokine induced by gamma interferon, RANTES, eotaxin, MIP-1α, MIP-1β, and MCP-1 levels using Luminex multicytokine immunobead assay. Intergroup comparisons were made using one-way analysis of variance or Kruskal–Wallis test.

Results:
The tBUT was lower (P=0.048) and ocular surface staining (P=0.032) as well as OSDI scores (P=0.001) were higher in group 1 but not in groups 2 or 3 when compared with those in the control group. Tear cytokine levels were similar across all groups. None of the tear cytokine levels were elevated in CL wearers (groups 1 and 2) or those with MGD (groups 1 and 3) as compared to those in control subjects.

Conclusion:
Silicone hydrogel contact lens use with concomitant MGD is not associated with cytokine-driven ocular surface inflammation but may impact tear function leading to dry eye symptoms.
Sway Balance Mobile Application: Reliability, Acclimation, and Baseline Administration
Authors: Mummareddy Nishit , Brett Benjamin L. , Yengo-Kahn Aaron M. , Solomon Gary S. , Zuckerman Scott L. 
Published: June 2018

Objectives:To describe historic baseline session administration practices, to assess the utility of a practice trial (an acclimation trial) before the official balance session, and to examine the within-session reliability of the Sway Balance Mobile Application (SBMA).Design:Retrospective observational study.Setting:Middle schools, high schools, and colleges across the United States.Participants:More than 17 000 student-athletes were included in the Sway Medical database with 7968 individuals meeting this study's inclusion criteria.Independent Variables:The Sway Medical database included the following subject characteristics for each student-athlete: age, sex, weight, and height.Main Outcome Measures:Balance assessment score generated by the SBMA.Results:Variable administration practices with significant differences between baseline session averages across methods were found. Individuals who performed an acclimation trial had a significantly higher baseline session average than those who did not. Within-session reliability estimates were in the low to adequate range (r = 0.53-0.78), with higher estimates found for 2 consecutive baseline tests (r = 0.75-0.78).Conclusions:For maximum clinical utility, a standardized protocol for postural control baseline acquisition is necessary. Acclimation trial should be administered before a baseline session to minimize variability, especially with only 1 to 2 baseline tests. The highest reliability was observed across 2 consecutive baseline tests within the same baseline session. We suggest obtaining baseline balance measurements with an acclimation trial followed by a baseline session with 2 baseline tests. Prospective studies are required for validation.
Comparative Effectiveness and Safety of Radiofrequency Ablation Versus Argon Plasma Coagulation for Treatment of Gastric Antral Vascular Ectasia
Authors: McCarty Thomas R. , Rustagi Tarun 
Published: June 2018

Background and Aims:
Although argon plasma coagulation (APC) is the current standard endoscopic treatment for gastric antral vascular ectasia (GAVE), radiofrequency ablation (RFA) has emerged as an attractive alternative. The aim of this study was to perform a systematic review and meta-analysis to evaluate the comparative effectiveness and safety of RFA and APC in the treatment of GAVE.

Materials and Methods:
Searches of PubMed, EMBASE, Web of Science, and Cochrane Library databases along with major gastroenterology annual meetings were performed through March 2017. Measured outcomes for comparative effectiveness and safety including improvement in hemoglobin levels, transfusion dependence, number of treatment sessions, complications, follow-up, and author-reported endoscopic success were compared among RFA and APC studies.

Results:
In total, 24 studies (n=508) involving APC and 9 studies (n=104) on RFA were included. Mean age of patients included was comparable in both groups (65.33±7.80 y for APC vs. 66.96±6.23 y for RFA; P=0.98). Pooled mean follow-up was significantly longer for APC compared with RFA (19.52±13.11 vs. 7.43±3.72 mo; P<0.001). In total, 47% of RFA patients were refractory to previous treatment with APC. RFA required fewer mean treatment sessions compared with APC (2.10 vs. 3.39, respectively; P<0.001). RFA resulted in fewer and less severe complications as compared with APC (1.92% vs. 5.12%, respectively; P<0.001). Although the reported endoscopic success was better with RFA compared with APC (97% vs. 66%; P<0.001), the posttreatment pooled hemoglobin increase and reduction in transfusion dependence was higher for APC compared with RFA [weighted mean difference 3.10 g/dL (95% confidence interval, 2.92-3.28) vs. 1.95 g/dL (95% confidence interval, 1.62-2.26); P<0.001; and 88% vs. 66%; P<0.001, for APC and RFA, respectively].

Conclusions:
There is limited long-term data on RFA for GAVE; however, available evidence suggests RFA has a comparable efficacy and tolerability compared with APC. In addition, RFA seems to be effective for APC-refractory GAVE patients. Future controlled trials are needed to directly compare treatment efficacy, long-term durability, safety, and cost-effectiveness between these interventions.
Physical Activity and Skipping Breakfast Have Independent Effects on Body Fatness Among Adolescents
Authors: Cayres Suziane U. , Urban Jacqueline B. , Fernandes Rômulo A. 
Published: June 2018

ABSTRACTObjective:We analyzed the longitudinal relationship between breakfast intake and adiposity among adolescents, and the possible mediation role of physical activity on this phenomenon.Methods:We conducted the longitudinal study composed of 86 adolescents (11–14 years old), absence of any known chronic diseases and no regular medicine use that returned the formal consent and assent both signed. Breakfast intake was reported through face‐to‐face interviews. Adiposity was assessed using a densitometry scanner. Physical activity was estimated through step counts performed using pedometers. Biological maturation was estimated through the maturity level. Student t test for independent samples was used to compare adolescents who were “nonskipping breakfast” and “skipping breakfast,” whereas the relationship between adiposity, physical activity, and skipping breakfast was assessed using Pearson correlation. Structural equation model was created to identify the mediation role of physical activity on the relationship between nonskipping breakfast and adiposity.Results:After 12 months, adolescents who had consumed breakfast regularly presented decreased trunk fatness (−3.5% [95% confidence interval (CI): −6.9 to −0.2]) and body fatness (−2.3% [95% CI: −3.9 to −0.7]) compared with their counterparts. Physical activity had an inverse relationship with trunk fatness (r = −0.270 [95% CI: −0.457 to −0.060]). Nonskipping breakfast was, however, not significantly related to trunk fatness; however, physical activity seems to reduce trunk fatness in our sample (r = −0.281; 95% CI: −0.479 to −0.083).Conclusions:Adolescents who ate breakfast regularly presented lower body fatness independent of physical activity, whereas trunk fatness decreased in adolescents who improved physical activity.
Psychosocial Factors and Preterm Birth Among Black Mothers and Fathers
Authors: Giurgescu Carmen , Misra Dawn P. 
Published: June 2018

Abstract

Objective:
Black women are more likely to live in disadvantaged neighborhoods and experience racial discrimination and psychological stress compared with White women. These factors have been related to preterm birth (PTB). However, research is limited on the associations of disadvantaged neighborhoods, racial discrimination, and psychological stress among expectant Black fathers and PTB. This review focuses on what is known about psychosocial factors in relation to PTB among Black parents.

Methods:
The Scopus database was used to search for studies using keywords of adverse childhood experiences, neighborhood environment, racial discrimination, psychological stress, depressive symptoms/depression, coping, locus of control, social support, and mother–father relationship. Each of these keywords was combined with the term preterm birth. This review focused on the associations of these psychosocial factors collected during the prenatal period and risk for PTB. However, due to lack of data for some of these factors during the prenatal period, studies conducted in the immediate period after birth were included. The focus of this review was on research conducted with Black expectant fathers given the limited data on the association between paternal psychosocial factors and PTB. This review only highlights studies that examined the associations of maternal psychosocial factors and PTB. It does not present a comprehensive review of studies on maternal factors given the extent of the studies that examined these associations.

Results:
Pregnant Black women are more likely to report living in disadvantaged neighborhoods; experiencing racial discrimination, psychological stress, and depressive symptoms; using avoidance coping; and reporting lower levels of social support compared with White women. Limited data suggest that Black expectant fathers experience higher rates of everyday unfair treatment because of race/ethnicity compared with White fathers. Research suggests that these psychosocial factors have been related to PTB among pregnant Black women; however, research is limited on examining these associations among expectant Black fathers.

Clinical Implications:
Maternal–child nurses are in the position to assess these psychosocial factors among expectant parents. Nurses should also assess risk factors for PTB for both expectant parents and provide support to couples who are at risk for PTB.
Recent advances in headache neuroimaging
Authors: Messina Roberta , Filippi Massimo , Goadsby Peter J. 
Published: June 2018

Purpose of review
Primary headaches, such as migraine and cluster headache, are one of the most common and disabling neurological diseases worldwide. Neuroimaging studies have changed the way we understand these diseases and have enriched our knowledge of the mechanisms of actions of currently available therapies.

Recent findings
The present review highlights the major findings reported in migraine and cluster headache neuroimaging over the last year. Widespread structural and functional abnormalities in cortical and subcortical areas involved in multisensory, including pain, processing have been shown in migraine and cluster headache patients during different phases of the disease. Beyond the involvement of single brain areas, dysfunctional brain networks contribute to their pathophysiology. New central mechanisms of action of headache preventive treatments have also been explored.

Summary
A better understanding of migraine and cluster headache biology has paved the way for the development of new improved treatments for both these conditions. Although significant advances have been made over the last year, there are still many unsolved questions to address.
Harnessing formal concepts of biological mechanism to analyze human disease
Authors: Darden Lindley , Kundu Kunal , Pal Lipika R. , Moult John 
Published: June 2018

ABSTRACTMechanism is a widely used concept in biology: in 2017 more than 10% of PubMed abstracts used the term. Thus, searching for and reasoning about mechanisms is fundamental to much of biomedical research, but until now there has been almost no computational infrastructure for this purpose. Recent work in the philosophy of science has explored the central role that the search for mechanistic accounts of biological phenomena plays in biomedical research, providing a conceptual basis for representing and analyzing biological mechanism. The foundational categories for components of mechanisms - entities and activities - guide the development of general, abstract types of biological mechanism parts. Building on that analysis, we have developed a formal framework for describing and representing biological mechanism, MecCog, and applied it to describing mechanisms underlying human genetic disease. Mechanisms are depicted using a graphical notation. Key features are assignment of mechanism components to stages of biological organization and classes; visual representation of uncertainty, ignorance, and ambiguity; and tight integration with literature sources. The MecCog framework facilitates analysis of many aspects of disease mechanism, including the prioritization of future experiments, probing of gene-drug and gene-environment interactions, identification of possible new drug targets, personalized drug choice, analysis of non-linear interactions between relevant genetic loci, and classification of disease based on mechanism.
Non-synonymous to synonymous substitutions suggest that orthologs tend to keep their functions, while paralogs are a source of functional novelty
Authors: Escorcia-Rodríguez Juan M. , Esposito Mario , Freyre-González Julio A. , Moreno-Hagelsieb Gabriel 
Published: June 2018

ABSTRACTOrthologs diverge after lineage separation events and paralogs after gene duplications. Thus, orthologs are expected to remain more functionally coherent across lineages, while paralogs have been proposed as a source of new functions. Because protein functional divergence follows from non-synonymous substitutions, we performed an analysis based on the ratio of non-synonymous to synonymous substitutions (dN/dS), as proxy for functional divergence. We used five working definitions of orthology, including reciprocal best hits (RBH), among other definitions based on network analyses and clustering. The results showed that orthologs, by all definitions tested, had values of dN/dS noticeably lower than those of paralogs, suggesting that, as a group, orthologs tend to be more functionally stable than paralogs. The differences in dN/dS ratios remained suggesting the functional stability of orthologs after eliminating gene comparisons with potential problems, such as genes with high codon usage biases, low coverage of either of the aligned sequences, or sequences with very high similarities. Separation by percent identity of the encoded proteins showed that the differences between the dN/dS ratios of orthologs and paralogs were more evident at high sequence identity, less so as identity dropped. While the last results partially explained the differences between dN/dS ratios of the two groups as being related to differences in protein identity, they also suggested that paralogs undergo functional divergence relatively early after duplication. Our analyses indicate that choosing orthologs as probably functionally coherent remains the right approach in comparative genomics.
ΦCrAss001, a member of the most abundant bacteriophage family in the human gut, infects Bacteroides
Authors: Shkoporov Andrey N. , Khokhlova Ekaterina V. , Fitzgerald C. Brian , Stockdale Stephen R. , Draper Lorraine A. , Ross R. Paul , Hill Colin 
Published: June 2018

AbstractΦCrAss001, isolated from human faecal material, is the first member of the extensive crAssphage family to be grown in pure culture. The bacteriophage infects the human gut symbiont Bacteroides intestinalis, confirming in silico predictions of the likely host. Genome analysis demonstrated that the phage DNA is 102 kb in size, has an unusual genome organisation and does not possess any obvious genes for lysogeny. In addition, electron microscopy confirms that φcrAss001 has a podovirus-like morphology. Despite the absence of lysogeny genes, φcrAss001 replicates in a way that does not disrupt proliferation of the host bacterium and is able to maintain itself in continuous host culture.
Concurrent Spatiotemporal Daily Land Use Regression Modeling and Missing Data Imputation of Fine Particulate Matter Using Distributed Space Time Expectation Maximization
Authors: Taghavi-Shahri Seyed Mahmood , Fassò Alessandro , Mahaki Behzad , Amini Heresh 
Published: June 2018

AbstractGraphical AbstractLand use regression (LUR) has been widely applied in epidemiologic research for exposure assessment. In this study, for the first time, we aimed to develop a spatiotemporal LUR model using Distributed Space Time Expectation Maximization (D-STEM). This spatiotemporal LUR model examined with daily particulate matter ≤ 2.5 μm (PM2.5) within the megacity of Tehran, capital of Iran. Moreover, D-STEM missing data imputation was compared with mean substitution in each monitoring station, as it is equivalent to ignoring of missing data, which is common in LUR studies that employ regulatory monitoring stations’ data. The amount of missing data was 28% of the total number of observations, in Tehran in 2015. The annual mean of PM2.5 concentrations was 33 μg/m3. Spatiotemporal R-squared of the D-STEM final daily LUR model was 78%, and leave-one-out cross-validation (LOOCV) R-squared was 66%. Spatial R-squared and LOOCV R-squared were 89% and 72%, respectively. Temporal R-squared and LOOCV R-squared were 99.5% and 99.3%, respectively. Mean absolute error decreased 26% in imputation of missing data by using the D-STEM final LUR model instead of mean substitution. This study reveals competence of the D-STEM software in spatiotemporal missing data imputation, estimation of temporal trend, and mapping of small scale (20 × 20 meters) within-city spatial variations, in the LUR context. The estimated PM2.5 concentrations maps could be used in future studies on short- and/or long-term health effects. Overall, we suggest using D-STEM capabilities in increasing LUR studies that employ data of regulatory network monitoring stations.Highlights-First Land Use Regression using D-STEM, a recently introduced statistical software-Assess D-STEM in spatiotemporal modeling, mapping, and missing data imputation-Estimate high resolution (20×20 m) daily maps for exposure assessment in a megacity-Provide both short- and long-term exposure assessment for epidemiological studies