bluuebunny/crossref_metadata_2025_split huggingface dataset:
Misidentification of Dementia in Medicare Claims and Related Costs
Authors: Zhu Carolyn W. , Ornstein Katherine A. , Cosentino Stephanie , Gu Yian , Andrews Howard , Stern Yaakov 
Published: October 2018

ObjectivesTo examine how misidentification of dementia affects estimation of Medicare costs in a largely minority cohort of participants for whom accurate in‐person diagnoses are available.DesignProspective cohort study.SettingWashington Heights‐Inwood Columbia Aging Project, a multiethnic, population‐based, prospective study of cognitive aging of Medicare beneficiaries aged 65 and older.ParticipantsIndividuals clinically diagnosed with dementia (n=495) and individuals clinically diagnosed without dementia (n=1,701).MeasurementsMedicare claims‐identified dementia was defined according to the presence of any International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes for Alzheimer's disease and related dementias in all available claims during the study period. Participant characteristics associated with claims misidentification of dementia were estimated using logistic regression. Effects of dementia misidentification on Medicare expenditures were estimated using generalized linear models.ResultsMedicare claims correctly identified 250 of the 495 (51%) dementia cases and 1,565 of the 1,701 (92%) nondementia cases. Sensitivity of claims‐identified dementia was 0.51, and specificity was 0.92. Average annual Medicare expenditures were $14,721 for a beneficiary with a clinical diagnosis of dementia, and $18,208 for a beneficiary with claim‐identified dementia, suggesting an overestimation of $3,487 per person per year when Medicare claims were used to identify dementia. Total annual expenditures for all beneficiaries with claims‐identified dementia were $258,707 lower than that for all those who were clinically diagnosed, suggesting an overall underestimation of total Medicare expenditures if Medicare claims were used to identify dementia. Different types of misidentification have different effects on dementia‐related cost estimates. Average annual expenditures per person were highest for false positives.ConclusionMisidentification of dementia in Medicare claims is common. Using claims to identify dementia may result in significantly biased estimates of the cost of dementia. J Am Geriatr Soc 67:269–276, 2019.
The blocking of kappa‐opioid receptor reverses the changes in dorsolateral striatum dopamine dynamics during the amphetamine sensitization
Authors: Azocar Victor Hugo , Sepúlveda Gladys , Ruiz Catalina , Aguilera Consuelo , Andrés Maria Estela , Fuentealba José Antonio 
Published: October 2018

AbstractKappa‐opioid receptors (KOR) control dopamine (DA) levels in the striatum and contribute significantly to the progression of drug addiction. Repeated exposure to psychostimulants has been associated with up‐regulated KOR activity and increased DA levels in dorsal striatum. However, it has not been tested if both processes are linked. In this work, we studied if a mechanism mediated by KOR is contributing to the increase in DA levels in the dorsolateral striatum (DLS) after amphetamine (AMPH) sensitization. The AMPH sensitization was assessed after single or repeated once‐a‐day AMPH injections (1 mg/kg). Only repeated AMPH exposure produced a significant locomotor sensitization. No‐net flux microdialysis was used to assess basal DA dialysate, DA extracellular concentration (Cext), and DA uptake in DLS of anesthetized rats. The role of KOR on DA dynamics in DLS was evaluated by local perfusion (250 μM) and systemic administration (10 mg/kg) of the KOR antagonist nor‐binaltorphimine. A significant decrease in DA Cext is observed in the DLS after an AMPH challenge in rats exposed to a single dose of AMPH. The decrease in DA Cext was associated with both a decreased basal DA dialysate and an increased DA uptake. Conversely, the expression of AMPH sensitization was accompanied by a significant increase in DA Cext associated with an increased basal DA dialysate and an attenuation in DA uptake. Both local and systemic administration of nor‐binaltorphimine reversed changes in DLS after AMPH pre‐treatment. These findings indicate that endogenous KOR system tunes DLS DA dynamics during the progression to AMPH sensitization.
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Response of broiler chickens reared at high density to dietary supplementation with licorice extract and probiotic
Authors: Rashidi Neda , Ghorbani Mohammad Reza , Tatar Ahmad , Salari Somayyeh 
Published: October 2018

AbstractThis study evaluated the effects of licorice extract and probiotic on performance, excreta characteristics and welfare‐related parameters of broiler chickens reared in high stocking density. Three hundred and thirty‐six 1‐day old broiler chicks (Ross 308) were used in a completely randomized design with five treatments and four replicates for 42 days. Treatments were as follows: (a) positive control (PC, 12 chicks/m2); (b) negative control (NC, 18 chicks/m2); (c) NC + 500 ppm licorice extract (LE); (d) NC + 200 ppm probiotic (P); (e) NC + ppm LE + ppm P. Body weight gain (BWG) was affected negatively by increased density in the growing period (p < 0.05). At high density, BWG was increased in the growing and whole period by adding LE and P separately and in combination (p < 0.01). Feed conversion ratio (FCR) was not affected by stocking density. Excreta weight (g/bird) and dry matter (DM, %) were reduced by increasing density (p < 0.01). Use of feed additives at high stocking density had no significant effect on excreta weight, but DM content of excreta was higher in NC + LE + P than NC. Gait problems and footpad and hock burns were increased by increased stocking density, but were not altered by feed additives. In conclusion, licorice extract and probiotic improved BWG of broilers reared at high stocking density; however, these birds had some disorders in footpad, hock and walking ability.
Tolerance to climate change of the clonally reproducing endemic Baltic seaweed, Fucus radicans: is phenotypic plasticity enough?
Authors: Rugiu Luca , Manninen Iita , Rothäusler Eva , Jormalainen Veijo 
Published: October 2018

To predict the effects of climate change, we first need information on both the current tolerance ranges of species and their future adaptive potential. Adaptive responses may originate either in genetic variation or in phenotypic plasticity, but the relative importance of these factors is poorly understood. Here, we tested the tolerance of Fucus radicans to the combination of hyposalinity and warming projected by climate models for 2070–2099. We measured the growth and survival responses of thalli in both current and future conditions, focusing on variations in tolerance among and within different clonal lineages. Survival was 32% lower in future than in current conditions, but the weight and length of the thalli which survived was respectively 267% and 178% higher when exposed to future conditions. The relatively high tolerance to the future conditions suggests that F. radicans is likely to persist in its current distributional range, which is limited to the Gulf of Bothia and Estonian coast in the Baltic Sea. Furthermore, this species may be able to expand its distribution southward and replace its congener F. vesiculosus, which, in previous studies, has not tolerated the future conditions as well. In addition, we discovered variation in tolerance to future conditions within one of the clonal lineages, which have been hitherto presumed to lack adaptive variation. The discovery of intra‐clonal phenotypic plasticity means that this alga has the potential for adaptive responses to climate change, which may be the key to the future persistence of F. radicans in the Baltic Sea.
Patterns of mutation within an emerging endemic lineage of HEV‐3a
Authors: Zhu Yuan O. , Aw Pauline , Aung Myo Myint , Lee Hong Kai , Hibberd Martin , Lee Guan Huei 
Published: October 2018

SummaryThe hepatitis E virus can cause chronic infections in immuno‐suppressed patients, and cases have been on the rise globally. Viral mutations during such infections are difficult to characterize. We deep‐sequenced viral populations from 15 immunocompromised patients with chronic HEV to identify the viral lineage and describe viral mutational hotspots within and across patients. A total of 21 viral RNA samples were collected between 2012 and 2017 from a single hospital in Singapore. Sequences covering a total of 3894 bp of the HEV genome were obtained. Phylogenetic analyses identified all sequences as belonging to the HEV‐3a sub‐clade and clearly indicate a unique local lineage. Deep sequencing reveals variable viral population complexity during infections. Comparisons of viral samples from the same patients spaced 2‐19 months apart revealed rapid nucleotide replacements in the dominant viral sequence in both ribavirin treated and treatment‐naive patients. Mutational hotspots were identified within ORF3 and the PCP/HVR domain of ORF1.
Modelling the decline and future of hepatitis A transmission in Australia
Authors: Jayasundara Duleepa , Hui Ben B. , Regan David G. , Heywood Anita E. , MacIntyre C. Raina , Wood James G. 
Published: October 2018

SummaryHepatitis A incidence has declined in most countries through a combination of prevention measures, augmented through the use of a highly effective vaccine. In Australia, the proportion of the population susceptible to hepatitis A infection has declined over time due to high rates of opportunistic vaccination as well as the sustained inflow of seropositive immigrants from high‐endemicity countries. These factors have contributed to a rapid decline in incidence. An age‐structured hepatitis A transmission model incorporating demographic changes was fitted to seroprevalence and disease notification data and used to project incidence trends and transmission potential for hepatitis A in the general population. Robustness of findings was assessed through worst‐case scenarios regarding vaccine uptake, migration and the duration of immunity. The decline in age‐specific seroprevalence until the introduction of hepatitis A vaccine in 1994 was well explained through a declining basic reproduction number (R0) that remained >1. Accounting for existing immunity, we estimated that the effective reproduction number (Reff) <1 in the general population of Australia since the early 1990s, declining more rapidly after the introduction of the hepatitis A vaccine. Future projections under a variety of scenarios support Reff remaining <1 with continued low incidence in the general population. In conclusion, our results suggest that sustained endemic transmission in the general Australian population is no longer possible although risks of sporadic outbreaks remain. This suggests potential for local elimination of hepatitis A infection in Australia, provided that elimination criteria can be defined and satisfied in risk groups. The methodology used here to investigate elimination potential can easily be replicated in settings such as in the USA where sequential seroprevalence studies are supported by routine notification data.
Improving hepatitis C direct‐acting antiviral access and uptake: A role for patient‐reported outcomes and lived experience
Authors: Goutzamanis Stelliana , Doyle Joseph , Higgs Peter , Hellard Margaret 
Published: October 2018

SummaryHepatitis C virus contributes to substantial and growing mortality and morbidity. Fortunately, the advent of highly effective interferon‐free direct‐acting antiviral (DAA) medications and new diagnostic tests has the potential to dramatically alter the epidemiologic trajectory of hepatitis C, particularly for “hard‐to‐reach” populations. Treatment advances and cure will also likely alter the individual experience of living with hepatitis C. However, it is not yet known in what capacity. This paper provides an overview of the population‐level impact of DAA treatment, highlighting the need to further our understanding of the impact of treatment on behaviour, health and wellbeing through lived experience and more sensitive patient‐reported outcome measures.
A retrospective study of 157 hospitalized cats with pancreatitis in a tertiary care center: Clinical, imaging and laboratory findings, potential prognostic markers and outcome
Authors: Nivy Ran , Kaplanov Alina , Kuzi Sharon , Mazaki‐Tovi Michal , Yas Einat , Segev Gilad , Ben‐Oz Jennifer , Lavy Eran , Aroch Itamar 
Published: October 2018

BackgroundPancreatitis in cats (FP) has been increasingly diagnosed in recent years, but clinical studies of large numbers of affected cats are scarce.ObjectivesTo describe a large cohort of cats with FP requiring hospitalization.AnimalsOne hundred and fifty‐seven client‐owned cats.MethodsRetrospective study, including cats diagnosed with pancreatitis based on sonographic evidence, positive SNAP feline pancreatic lipase immunoreactivity test results, increased 1,2‐o‐dilauryl‐rac‐glycerol‐glutaric Acid‐(6′‐methylresorufin ester)‐lipase activity, histopathology, or some combination of these.ResultsOne‐hundred and twenty‐two cats (77.7%) survived to discharge.Median time from onset of clinical signs to presentation was longer (P= .003) in nonsurvivors. Causes of FP included recent general anesthesia, trauma, hemodynamic compromise, and organophosphate intoxication, but most cases (86.6%) were idiopathic. Ultrasonographic findings consistent with pancreatitis were documented in 134 cats, including pancreatomegaly (81.3%), decreased (31.3%), or increased (14.9%) pancreatic echogenicity, extra‐hepatic biliary tract dilatation (24%), and increased peri‐pancreatic echogenicity (13%). Lethargy (P= .003), pleural effusion (P= .003), hypoglycemia (P= .007), ionized hypocalcemia (P= .016), azotemia (P= .014), parenteral nutrition administration (P= .013), and persistent anorexia during hospitalization (P= .001) were more frequent in nonsurvivors, whereas antibiotics were more frequently administered to survivors (P= .023). Nevertheless, when Bonferroni's correction for multiple comparisons was applied, none of the variables was statistically significant.Conclusions and Clinical ImportancePreviously unreported, clinically relevant, potential prognostic factors, including hypoglycemia, azotemia, parenteral nutrition, and withholding antibacterial treatment were identified in this exploratory study. These preliminary results should be examined further in confirmatory studies.
Comparison of intestinal expression of the apical sodium‐dependent bile acid transporter between dogs with and without chronic inflammatory enteropathy
Authors: Giaretta Paula R. , Rech Raquel R. , Guard Blake C. , Blake Amanda B. , Blick Anna K. , Steiner Jörg M. , Lidbury Jonathan A. , Cook Audrey K. , Hanifeh Mohsen , Spillmann Thomas , Kilpinen Susanne , Syrjä Pernilla , Suchodolski Jan S. 
Published: October 2018

BackgroundIntestinal absorption of bile acids is mediated by the apical sodium‐dependent bile acid transporter (ASBT). Fecal bile acid dysmetabolism has been reported in dogs with chronic inflammatory enteropathy (CIE).ObjectiveCharacterization of ASBT distribution along the intestinal tract of control dogs and comparison to dogs with CIE.AnimalsTwenty‐four dogs with CIE and 11 control dogs.MethodsThe ASBT mRNA and protein expression were assessed using RNA in situ hybridization and immunohistochemistry, respectively. The concentrations of fecal bile acids were measured by gas chromatography‐mass spectrometry. The fecal microbiota dysbiosis index was assessed with a quantitative polymerase chain reaction panel.ResultsIn control dogs, ASBT mRNA expression was observed in enterocytes in all analyzed intestinal segments, with highest expression in the ileum. The ASBT protein expression was restricted to enterocytes in the ileum, cecum, and colon. Dogs with CIE had significantly decreased expression of ASBT protein in the ileum (P = .001), which was negatively correlated with histopathological score (ρ = −0.40; Pcorr = .049). Additionally, dogs with CIE had a significantly increased percentage of primary bile acids in feces compared to controls (P = .04). The fecal dysbiosis index was significantly higher in dogs with CIE than in control dogs (P = .01).Conclusions and Clinical ImportanceThese findings indicate that ileal protein expression of ASBT is downregulated in dogs with CIE. This change may be linked to the inflammatory process, intestinal dysbiosis, and fecal bile acid dysmetabolism observed in these patients.
Retrospective growth analysis of the dwarf shrub Cassiope tetragona allows local estimation of vascular plant productivity in high arctic Svalbard
Authors: Milner Jos M. , Stien Audun , van der Wal René 
Published: October 2018

AbstractQuestionVascular plant productivity of arctic tundra has often been viewed as varying little between years and thus being largely insensitive to the high inter‐annual variation in summer weather conditions. Yet, remote‐sensing data and retrospective growth analyses of the circumpolar dwarf shrub, Cassiope tetragona, commonly show considerable between‐year variability in plant growth in response to variation in summer temperature. Given that both Cassiope growth and vascular plant biomass production share a common environmental driver, summer temperature, we would expect positive co‐variation between them. Here we investigate whether this is indeed the case and if so over what spatial scale.LocationNordenskiöldland, high arctic Svalbard.MethodsWe brought dendroecology and plot‐based field estimation methodologies together in an empirical study using retrospective analysis of Cassiope growth and annual estimation of above‐ground vegetation biomass production to investigate their temporal and spatial co‐variation and sensitivity to summer weather conditions.ResultsDespite substantial small‐scale heterogeneity, we found spatial co‐variation in Cassiope growth patterns, which weakened as distance between sampling sites increased from 0 to 25 km. Furthermore, we found a strong positive correlation between annual estimates of above‐ground live vascular plant biomass and Cassiope shoot growth over a 12‐year period at a local scale. The correlation declined with distance, likely due to increasing differences in local weather conditions.ConclusionsWe demonstrate that Cassiope growth can be used as a proxy for above‐ground tundra vegetation productivity at the local scale. Our findings suggest that Arctic plant productivity is as sensitive to between‐year variation in summer temperature as the well‐established growth response of Cassiope. This challenges the view that tundra plant productivity varies little between years and provides a mechanistic understanding that helps reconcile field‐ and satellite‐based annual estimation methods.
Can community health workers manage uncomplicated severe acute malnutrition? A review of operational experiences in delivering severe acute malnutrition treatment through community health platforms
Authors: López‐Ejeda Noemí , Charle Cuellar Pilar , Vargas Antonio , Guerrero Saul 
Published: October 2018

AbstractCommunity health workers (CHWs) play an important role in the detection and referral of children with severe acute malnutrition (SAM) in many countries. However, distance to health facilities remains a significant obstacle for caregivers to attend treatment services, resulting in SAM treatment coverage rates below 40% in most areas of intervention. The inclusion of SAM treatment into the current curative tasks of CHWs has been proposed as an approach to increase coverage. A literature review of operational experiences was conducted to identify opportunities and challenges associated with this model. A total of 18 studies providing evidence on coverage, clinical outcomes, quality of care, and/or cost‐effectiveness were identified. The studies demonstrate that CHWs can identify and treat uncomplicated cases of SAM, achieving cure rates above the minimum standards and reducing default rates to less than 8%. Although the evidence is limited, these findings suggest that early detection and treatment in the community can increase coverage of SAM in a cost‐effective manner. Adequate training and close supervision were found to be essential to ensure high‐quality performance of CHWs. Motivation through financial compensation and other incentives, which improve their social recognition, was also found to be an important factor contributing to high‐quality performance. Another common challenge affecting performance is insufficient stock of key commodities (i.e., ready‐to‐use therapeutic food). The review of the evidence ultimately demonstrates that the successful delivery of SAM treatment via CHWs will require adaptations in nutrition and health policy and practice.
Nutritional status as a central determinant of child mortality in sub‐Saharan Africa: A quantitative conceptual framework
Authors: Ricci Cristian , Carboo Janet , Asare Hannah , Smuts Cornelius M. , Dolman Robin , Lombard Martani 
Published: October 2018

AbstractChild mortality is a major public health problem in sub‐Saharan Africa and is influenced by nutritional status. A conceptual framework was proposed to explain factors related to undernutrition. Previously proposed conceptual frameworks for undernutrition do not consider child mortality and describe factors related to undernutrition from a qualitative viewpoint only. A structural equation modelling approach was applied to the data from World Bank and FAO databases collected from over 37 sub‐Saharan countries from 2000 to the most recent update. Ten food groups, exclusive breastfeeding, poverty and illiteracy rates, and environmental hygiene were investigated in relation to underweight, stunting, low birthweight, and child mortality. Standardized beta coefficient was reported, and graphical models were used to depict the relations among factors related to under‐five mortality in sub‐Saharan Africa. Child mortality in sub‐Saharan Africa ranged between 76 and 127 × 1,000. In the same period, low birthweight rate was about 14%. Poverty and illiteracy are confirmed to affect health resources, which in turn influenced nutritional status and child mortality. Among nutritional factors, exclusive breastfeeding had a greater influence than food availability. Low birthweight, more than underweight and stunting, influenced child mortality.Structural equation modelling is a suitable way to disentangle the complex quantitative framework among factors determining child mortality in sub‐Saharan Africa. Acting on poverty at the base appear to be the more effective strategy along with improvement of breastfeeding practice and improvement of hygiene conditions.
DdcA antagonizes a bacterial DNA damage checkpoint
Authors: Burby Peter E. , Simmons Zackary W. , Simmons Lyle A. 
Published: October 2018

SummaryBacteria coordinate DNA replication and cell division, ensuring a complete set of genetic material is passed onto the next generation. When bacteria encounter DNA damage, a cell cycle checkpoint is activated by expressing a cell division inhibitor. The prevailing model is that activation of the DNA damage response and protease‐mediated degradation of the inhibitor is sufficient to regulate the checkpoint process. Our recent genome‐wide screens identified the gene ddcA as critical for surviving exposure to DNA damage. Similar to the checkpoint recovery proteases, the DNA damage sensitivity resulting from ddcA deletion depends on the checkpoint enforcement protein YneA. Using several genetic approaches, we show that DdcA function is distinct from the checkpoint recovery process. Deletion of ddcA resulted in sensitivity to yneA overexpression independent of YneA protein levels and stability, further supporting the conclusion that DdcA regulates YneA independent of proteolysis. Using a functional GFP‐YneA fusion we found that DdcA prevents YneA‐dependent cell elongation independent of YneA localization. Together, our results suggest that DdcA acts by helping to set a threshold of YneA required to establish the cell cycle checkpoint, uncovering a new regulatory step controlling activation of the DNA damage checkpoint in Bacillus subtilis.