bluuebunny/crossref_metadata_2025_split huggingface dataset:
What publicly available quality metrics do hip and knee arthroplasty patients care about most when selecting a hospital in Maryland: a discrete choice experiment
Authors: O’Hara Lyndsay M , Caturegli Ilaria , O’Hara Nathan N , O’Toole Robert V , Dalury David F , Harris Anthony D , Manson Theodore T 
Published: May 2019

ObjectiveTo quantify which publicly reported hospital quality metrics have the greatest impact on a patient’s simulated hospital selection for hip or knee arthroplasty.DesignDiscrete choice experiment.SettingTwo university-affiliated orthopaedic clinics in the greater Baltimore area, Maryland, USA.ParticipantsOne hundred and twenty-eight patients who were candidates for total hip or knee arthroplasty.Primary and secondary outcome measuresThe effect and magnitude of acceptable trade-offs between publicly reported hospital quality parameters on patients’ decision-making strategies using a Hierarchical Bayes model.ResultsPublicly reported information on patient perceptions of attention to alleviation of postoperative pain had the most influence on simulated hospital choice (20.7%), followed by methicillin-resistantStaphylococcus aureus(MRSA) rates (18.8%). The understandability of the discharge instructions was deemed the least important attribute with a relative importance of 6.9%. Stratification of these results by insurance status and duration of pain prior to surgery revealed that patient demographics and clinical presentation affect the decision-making paradigm.ConclusionsPublicly available information regarding hospital performance is of interest to hip and knee arthroplasty patients. Patients are willing to accept suboptimal understanding of discharge instructions, lower hospital ratings and suboptimal cleanliness in exchange for better postoperative pain management, lower MRSA rates, and lower complication rates.
Prevalence, clustering and sociodemographic distributions of non-communicable disease risk factors in Nepalese adolescents: secondary analysis of a nationwide school survey
Authors: Dhungana Raja Ram , Bista Bihungum , Pandey Achyut Raj , de Courten Maximilian 
Published: May 2019

ObjectivesTo assess the prevalence, clustering and sociodemographic distribution of non-communicable disease (NCD) risk factors in adolescents in Nepal.DesignData originated from Global School Based Student Health Survey, Nepal conducted in 2015–2016.SettingThe study sites were the secondary schools in Nepal; 74 schools were selected based on the probability proportional to school enrolment size throughout Nepal.Participants5795 school-going children aged 13–17 years were included in the study.Primary outcomesNCD risk factors: smoking, alcohol consumption, insufficient fruit and vegetable intake, insufficient physical activity and overweight/obesity were the primary outcomes. Sociodemographic distributions of the combined and individual NCD risk factors were determined by Poisson regression analysis.ResultsFindings revealed the prevalence of smoking (6.04%; CI 4.62 to 7.88), alcohol consumption (5.29%; CI 4.03 to 6.92), insufficient fruit and vegetable intake (95.33%; CI 93.89 to 96.45), insufficiently physical activity (84.77%; CI 81.04 to 87.88) and overweight/obesity (6.66%; CI 4.65 to 9.45). One or more risk factors were present in 99.6%, ≥2 were in 83% and ≥3 were in 11.2%. Risk factors were more likely to cluster in male, 17 years of age and grade 7. Prevalence of smoking (adjusted prevalence ratio (aPR)=2.38; CI 1.6 to 3.51) and alcohol consumption (aPR=1.81; CI 1.29 to 2.53) was significantly high in male, and in 16 and 17 years of age. Prevalence of insufficient physical activity and overweight/obesity was significantly lower in higher grades.ConclusionInsufficient fruit and vegetable intake and insufficient physical activity were highly prevalent in the populations studied. Risk factors were disproportionately distributed and clustered in particular gender, age and grade. The study population requires an age and gender specific preventive public health intervention.
Quality of care in large Chinese hospitals: an observational study
Authors: Jian Weiyan , Figueroa Jose , Woskie Liana , Yao Xi , Zhou Yuqi , Li Zhengxiang , Li Changan , Yao Li , Yip Winnie C 
Published: May 2019

ObjectiveTo empirically assess the quality of hospital care in China and trends over a 5-year period during which the government significantly increased its investment in healthcare.DesignRetrospective, observational study comparing hospital quality between two periods: October 2012–March 2013 and October 2017–March 2018.Setting1–2 of the most reputable large tertiary hospitals in each of the 25 provinces in Mainland China (total of 33).ParticipantsAdults 18 years or older admitted with acute myocardial infarction (AMI) (n = 7031), cerebral ischaemic stroke (n = 12 008), chronic obstructive pulmonary disease (COPD) (n = 11 836) and bacterial pneumonia (n = 4263).Main outcome measuresProcess-based quality measures, including seven AMI measures, three stroke measures, four COPD measures and six pneumonia measures.ResultsIn 2012/2013, Chinese hospitals had variable performance on AMI measures, including prescribing aspirin on arrival (80.7%), and discharging patients on aspirin (79.2%), β-blockers (60.8%) or statins (75.8%). This was similar for stroke cases and pneumonia cases. Smoking cessation advice was given at high rates across conditions though rates of influenza/pneumococcal vaccines were performed <1%. In 2017/2018, Chinese hospitals experienced no differences across most quality measures. Performance declined for two measures: aspirin on arrival for AMI cases and blood cultures before antibiotics for pneumonia cases. Performance increased for two measures: percutaneous coronary intervention within 90 min in ST segment elevation myocardial infarction cases (66.6% vs 80.1%, p<0.001) and statins at discharge for stroke cases (64.7% vs 78.7%, p<0.001). Compared with US hospitals, Chinese hospitals underperformed across most measures.ConclusionsChinese hospitals had low and variable performances across most quality measures for common medical conditions. Quality of care generally does not appear to be improving post national health reform. The Chinese government should include quality of care improvement in its health reform priorities to ensure patients receive appropriate and effective care.
Social well-being of Iranian retired men of the armed forces and their wives
Authors: Farokhnezhad Afshar Pouya , Foroughan M , Pirooz F , Ajri M 
Published: May 2019

BackgroundSocial well-being is a major component of health, which was somehow neglected until the last few decades. The aim of this study was to determine the state of social well-being of Iranian retired men of the armed forces and their wives in the metropolis of Tehran.MethodsThis is a cross-sectional study which was conducted in Tehran, capital of Iran, in 2016. Three hundred retired men of the armed forces and their wives were selected by random sampling. We used the Social Well-Being Scale to collect data. We assessed its internal consistency and validity with Cronbach’s alpha and exploratory factor analysis before using it. We used SPSS V.24 software to analyse the data via χ2, Pearson’s correlation, t-test and analysis of variance.ResultsThe mean age was 66.39±6.98 years; 60% were male. The findings revealed that retired men of the armed forces and their wives report a relatively modest degree of well-being. Social well-being of the participants was significantly related to their marital status (p=0.03), education (p=0.03), employment status (p<0.01), housing status (p<0.01), financial status (p<0.01) and health status (p<0.01).ConclusionThe social well-being of retired men of the armed forces and their wives was moderate and was not different from each other, and it was related to housing ownership, employment, self-rated socioeconomic condition, education, good health and married status.
Association between ICAM-1 level and diabetic retinopathy: a review and meta-analysis
Authors: Yao Yang , Du Junhui , Li Rong , Zhao Lei , Luo Na , Zhai Jing Ya , Long Lihui 
Published: May 2019

AbstractElevated levels of proinflammatory markers are evident in patients with diabetic retinopathy (DR) and are associated with disease progression and prognosis. Intercellular adhesion molecule-1 (ICAM-1) is involved in inflammation and acts as a local intensifying signal in the pathological processes associated with chronic eye inflammation. The aim of this systematic review and meta-analysis was to investigate the relationship between ICAM-1 level and DR. Online electronic databases were searched to retrieve all relevant articles published before December 2017. The standard mean difference (SMD) and their 95% CI were included and then pooled with a random effects model. Subgroup analysis and metaregression analysis were applied to explore the sources of heterogeneity, and publication bias was calculated to assess the quality of pooled studies. A total of 11 articles, containing 428 patients with DR and 789 healthy controls, were included in this meta-analysis. The results indicated a significant increase in ICAM-1 level in the DR group compared with the control group (SMD: 1.20, 95%CI 0.83 to 1.57, p&lt;0.001). Subgroup analyses and metaregression analysis indicated that publication year, region, study method, diabetes mellitus type, Newcastle-Ottawa Scale and sample size were not the potential sources of heterogeneity. The results of this current meta-analysis indicated that the increased level of ICAM-1 generally exists in the patients with DR and it may associated with the severity of DR. However, large-scale and high-quality studies are required to confirm this finding in the future.
Modulation of Target Antigen Density Improves CAR T-cell Functionality and Persistence
Authors: Ramakrishna Sneha , Highfill Steven L. , Walsh Zachary , Nguyen Sang M. , Lei Haiyan , Shern Jack F. , Qin Haiying , Kraft Ira L. , Stetler-Stevenson Maryalice , Yuan Constance M. , Hwang Jennifer D. , Feng Yang , Zhu Zhongyu , Dimitrov Dimiter , Shah Nirali N. , Fry Terry J. 
Published: May 2019

AbstractPurpose:Chimeric antigen receptor T-cell (CART) therapy targeting CD22 induces remission in 70% of patients with relapsed/refractory acute lymphoblastic leukemia (ALL). However, the majority of post-CD22 CART remissions are short and associated with reduction in CD22 expression. We evaluate the implications of low antigen density on the activity of CD22 CART and propose mechanisms to overcome antigen escape.Experimental Design:Using ALL cell lines with variable CD22 expression, we evaluate the cytokine profile, cytotoxicity, and in vivo CART functionality in the setting of low CD22 expression. We develop a high-affinity CD22 chimeric antigen receptor (CAR) as an approach to improve CAR sensitivity. We also assess Bryostatin1, a therapeutically relevant agent, to upregulate CD22 and improve CAR functionality.Results:We demonstrate that low CD22 expression negatively impacts in vitro and in vivo CD22 CART functionality and impairs in vivo CART persistence. Moreover, low antigen expression on leukemic cells increases naïve phenotype of persisting CART. Increasing CAR affinity does not improve response to low-antigen leukemia. Bryostatin1 upregulates CD22 on leukemia and lymphoma cell lines for 1 week following single-dose exposure, and improves CART functionality and in vivo persistence. While Bryostatin1 attenuates IFNγ production by CART, overall in vitro and in vivo CART cytotoxicity is not adversely affected. Finally, administration of Bryostain1 with CD22 CAR results in longer duration of in vivo response.Conclusions:We demonstrate that target antigen modulation is a promising strategy to improve CD22 CAR efficacy and remission durability in patients with leukemia and lymphoma.See related commentary by Guedan and Delgado, p. 5188
Targeting IDH1 as a Prosenescent Therapy in High-grade Serous Ovarian Cancer
Authors: Dahl Erika S. , Buj Raquel , Leon Kelly E. , Newell Jordan M. , Imamura Yuka , Bitler Benjamin G. , Snyder Nathaniel W. , Aird Katherine M. 
Published: May 2019

Abstract

Epithelial ovarian cancer (EOC) is the deadliest gynecologic cancer. High-grade serous carcinoma (HGSC) is the most frequently diagnosed and lethal histosubtype of EOC. A significant proportion of patients with HGSC relapse with chemoresistant disease. Therefore, there is an urgent need for novel therapeutic strategies for HGSC. Metabolic reprogramming is a hallmark of cancer cells, and targeting metabolism for cancer therapy may be beneficial. Here, we found that in comparison with normal fallopian tube epithelial cells, HGSC cells preferentially utilize glucose in the TCA cycle and not for aerobic glycolysis. This correlated with universally increased TCA cycle enzyme expression in HGSC cells under adherent conditions. HGSC disseminates as tumor cell spheroids within the peritoneal cavity. We found that wild-type isocitrate dehydrogenase I (IDH1) is the only TCA cycle enzyme upregulated in both adherent and spheroid conditions and is associated with reduced progression-free survival. IDH1 protein expression is also increased in patients with primary HGSC tumors. Pharmacologic inhibition or knockdown of IDH1 decreased proliferation of multiple HGSC cell lines by inducing senescence. Mechanistically, suppression of IDH1 increased the repressive histone mark H3K9me2 at multiple E2F target gene loci, which led to decreased expression of these genes. Altogether, these data suggest that increased IDH1 activity is an important metabolic adaptation in HGSC and that targeting wild-type IDH1 in HGSC alters the repressive histone epigenetic landscape to induce senescence.

Implications:
Inhibition of IDH1 may act as a novel therapeutic approach to alter both the metabolism and epigenetics of HGSC as a prosenescent therapy.
Distribution, threats and conservation of the White-collared Kite (Leptodon forbesi, Accipitridae), the most threatened raptor in the Neotropics
Authors: Pereira Glauco Alves , Araújo Helder Farias Pereira de , Azevedo Júnior Severino Mendes de , Angelieri Cíntia Camila Silva , Silveira Luís Fábio 
Published: May 2019

The White-collared Kite (Leptodon forbesi) is an endemic and threatened raptor of the Brazilian Atlantic Forest. Here we present the known records of the species, describe the vegetation types where it was found and show Ecological Niche Models generated using Maxent algorithm. Most of the presence data were recorded in open ombrophilous forest and seasonal semideciduous forest in the states of Alagoas and Pernambuco. Maxent model had a good performance (AUC = 0.982 ± 0.004 SD), showing higher suitability for the species from Paraíba to Alagoas states. Maxent average model revealed a distribution range of 20,344 km² and an area of occupancy of 1,636.89 km². The most suitable areas for the species are those near watercourses and streams. We suggest the creation of protected areas, including private ones, and possible restoration actions to connect the most suitable forest fragments, along with the captive breeding, as the most appropriate strategies for the conservation of the White-collared Kite.
Proteomic Bioprofiles and Mechanistic Pathways of Progression to Heart Failure
Authors: Ferreira João Pedro , Verdonschot Job , Collier Timothy , Wang Ping , Pizard Anne , Bär Christian , Björkman Jens , Boccanelli Alessandro , Butler Javed , Clark Andrew , Cleland John G. , Delles Christian , Diez Javier , Girerd Nicolas , González Arantxa , Hazebroek Mark , Huby Anne-Cécile , Jukema Wouter , Latini Roberto , Leenders Joost , Levy Daniel , Mebazaa Alexandre , Mischak Harald , Pinet Florence , Rossignol Patrick , Sattar Naveed , Sever Peter , Staessen Jan A. , Thum Thomas , Vodovar Nicolas , Zhang Zhen-Yu , Heymans Stephane , Zannad Faiez 
Published: May 2019

Background
Identifying the mechanistic pathways potentially associated with incident heart failure (HF) may provide a basis for novel preventive strategies.

Methods and Results
To identify proteomic biomarkers and the potential underlying mechanistic pathways that may be associated with incident HF defined as the first hospitalization for HF, a nested-matched case-control design was used with cases (incident HF) and controls (without HF) selected from 3 cohorts (>20 000 individuals). Controls were matched on cohort, follow-up time, age, and sex. Two independent sample sets (a discovery set with 286 cases and 591 controls and a replication set with 276 cases and 280 controls) were used to discover and replicate the findings. Two hundred fifty-two circulating proteins in the plasma were studied. Adjusting for the matching variables age, sex, and follow-up time (and correcting for multiplicity of tests), 89 proteins were found to be associated with incident HF in the discovery phase, of which 38 were also associated with incident HF in the replication phase. These 38 proteins pointed to 4 main network clusters underlying incident HF: (1) inflammation and apoptosis, indicated by the expression of the TNF (tumor necrosis factor)-family members; (2) extracellular matrix remodeling, angiogenesis and growth, indicated by the expression of proteins associated with collagen metabolism, endothelial function, and vascular homeostasis; (3) blood pressure regulation, indicated by the expression of natriuretic peptides and proteins related to the renin-angiotensin-aldosterone system; and (4) metabolism, associated with cholesterol and atherosclerosis.

Conclusions
Clusters of biomarkers associated with mechanistic pathways leading to HF were identified linking inflammation, apoptosis, vascular function, matrix remodeling, blood pressure control, and metabolism. These findings provide important insight on the pathophysiological mechanisms leading to HF.

Clinical Trial Registration:

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02556450.
Intensive Continuous Positive Airway Pressure Adherence Program During Stroke Rehabilitation
Authors: Khot Sandeep , Barnett Heather , Davis Arielle , Siv Jenny , Crane Deborah , Kunze Allison , Li Lue Denise , Bunnell Aaron , McCann Barbara , Bombardier Charles , Longstreth W.T. , Watson Nathaniel , Billings Martha 
Published: May 2019

Background and Purpose—
Continuous positive airway pressure (CPAP) for the treatment of obstructive sleep apnea may improve stroke recovery, but adherence is poor. We assessed the effectiveness of an intensive CPAP adherence program during and after inpatient stroke rehabilitation on 3-month adherence and stroke recovery.

Methods—
In a single-arm study, 90 stroke rehabilitation patients were enrolled into an intensive CPAP adherence program. CPAP was continued after a run-in among qualifying patients with evidence of obstructive sleep apnea. The primary outcome was CPAP adherence, defined as ≥4 hours of use on ≥70% of days, over 3 months.

Results—

A total of 62 patients qualified for continued CPAP and 52 of these were willing to continue CPAP after discharge from rehabilitation. At 3 months, the average daily CPAP use was 4.7 hours (SD 2.6), and 32/52 (62%) patients were adherent. Factors significantly associated with adherence included more severe stroke, aphasia, and white race. Compared with nonadherent patients, adherent patients experienced greater improvements in the cognitive component of the Functional Independence Measure (
P
=0.02) and in the National Institutes of Health Stroke Scale (
P
=0.03).

Conclusions—
This intensive CPAP adherence program initiated during stroke rehabilitation can lead to CPAP adherence in the majority of patients with evidence of obstructive sleep apnea, including those with more severe stroke and aphasia, and may promote recovery.

Clinical Trial Registration—

URL:
https://www.clinicaltrials.gov
. Unique identifier: NCT02809430.
Diurnal Variations in the First 24/7 Mobile Stroke Unit
Authors: Zaidat Osama O. , Changal Khalid H. , Sultan-Qurraie Ali , de Havenon Adam , Calderon Victoria J. , Goins-Whitmore Julie , Patterson Mary S. , Lin Eugene 
Published: May 2019

Background and Purpose—
Mobile Stroke Units (MSUs) provide innovative prehospital stroke care but their 24/7 operation has not been studied. Our study investigates 24/7 MSU diurnal variations related to transport frequency, patient characteristics, and stroke treatments.

Methods—
We compared transportation frequency, demographics, thrombolytic and mechanical thrombectomy administration, and treatment metrics across 8-hour shifts (morning, evening, and nocturnal) from our 24/7 MSU in Northwest Ohio prospective database.

Results—

One hundred ninety-five patients were transported by the MSU. Most transports occurred during the morning shift (52.3%) followed by evening shift (35.8%) and nocturnal shift (11.9%;
P
trend
<0.001). Twenty-three patients (11.9%) received intravenous thrombolytic in the MSU, most frequently in the morning shift (56.5%). No cases of mechanical thrombectomy were performed on MSU patients in the nocturnal shift.

Conclusions—
Morning and evening shifts account for the majority of our MSU transports (88.1%) and therapeutic interventions. Understanding temporal variations in a resource-intensive MSU is critical to its worldwide implementation.
Saudi Primary Education and the Formation of Modern Wahhabism
Authors: Samin Nadav 
Published: May 2019

AbstractThe development of modern primary education in Saudi Arabia transformed Wah­habism in subtle yet significant ways. The art of instructing six- and seven-year-old children in the finer points of Wahhābī theology and law, as occurred in the new Saudi primary schools from 1929, may appear as the authentic continuation of a tradition within a modern institutional framework. Yet in point of fact, this foregrounding of theology constituted a departure from traditional Wahhābī pedagogy, and from precolonial Muslim learning conventions more generally. In response to the encroachment of non-Wahhābī personnel and systems of knowledge into their traditional domain, this paper argues, the Najdī ʿulamāʾ reframed modern education as a theological challenge, one similar to the challenge presented by bedouin and other non-Wahhābī Muslims.
Separating Dynamic and Thermodynamic Impacts of Climate Change on Daytime Convective Development over Land
Authors: Grabowski Wojciech W. , Prein Andreas F. 
Published: May 2019

AbstractClimate change affects the dynamics and thermodynamics of moist convection. Changes in the dynamics concern, for instance, an increase of convection strength due to increases of convective available potential energy (CAPE). Thermodynamics involve increases in water vapor that the warmer atmosphere can hold and convection can work with. Small-scale simulations are conducted to separate these two components for daytime development of unorganized convection over land. The simulations apply a novel modeling technique referred to as the piggybacking (or master–slave) approach and consider the global climate model (GCM)-predicted change of atmospheric temperature and moisture profiles in the Amazon region at the end of the century under a business-as-usual scenario. The simulations show that the dynamic impact dominates because changes in cloudiness and rainfall come from cloud dynamics considerations, such as the change in CAPE and convective inhibition (CIN) combined with the impact of environmental relative humidity (RH) on deep convection. The small RH reduction between the current and future climate significantly affects the mean surface rain accumulation as it changes from a small reduction to a small increase when the RH decrease is eliminated. The thermodynamic impact on cloudiness and precipitation is generally small, with the extreme rainfall intensifying much less than expected from an atmospheric moisture increase. These results are discussed in the context of previous studies concerning climate change–induced modifications of moist convection. Future research directions applying the piggybacking method are discussed.