bluuebunny/crossref_metadata_2025_split huggingface dataset:
2244 Effect of long-term care insurance in a pilot city of China: health benefits among 12,930 disabled older adults
Authors: Zeng L , Zhong Y , Chen Y , Zhou M , Zhao S , Wu J , Dong B , Dou Q 
Published: August 2024

Abstract

Introduction
The surge of disabled older people has brought enormous burdens to society. The aim of this study was to examine the impact of long-term care insurance (LTCI) implementation on mortality and changes in physical ability among disabled older adults.

Methods
This was a prospective observational study based on data from the government led LTCI program in a pilot city of China from 2017 to 2021. Administrative data included the application survey of activities of daily living (ADL), the baseline characteristics and all-cause mortality. Return visit surveys of ADL were conducted between August 2021 and December 2021. A regression discontinuity model was used to analyse the impact of LTCI on mortality. Results: A total of 12,930 individuals older than 65 years were included in this study, and 10,572 individuals were identified with severe disability and participated in the LTCI program.

Results
LTCI implementation significantly reduced mortality by 5.10% (95% CI, −9.30% to −0.90%) and extended the survival time by 33.74 days (95% CI, 13.501 to 53.970). The ADL scores of the LTCI group dropped by 2.5 points on average, while the ADL scores of those did not participate in LTCI dropped by 25.0 points. The heterogeneity analysis revealed that the impact of LTCI on mortality reduction was more significant among females, individuals of lower age, those who were married, cared for by family members, and who lived in districts with rich care resources.

Conclusions
LTCI implementation had a favourable impact on the mortality and physical ability of participants. This research marks the first comprehensive exploration of the potential health benefits associated with the implementation of LTCI, providing valuable perspectives that can inform policy making and enhance the development of robust long-term care systems in developing countries.
A/the Common Good
Authors: Burbidge Dominic 
Published: August 2024

Abstract
The emerging school of “common good constitutionalism” takes a classical natural law approach of identifying the central case of law and constitutionalism, recognizing that a state may make positive law in part based on circumstance, convenience, or a need for social coordination. While law under the classical approach is rooted in realizing the common good of the complete community, this ideal does not dictate all of law’s specifics. Nevertheless, there is a difficulty within the emerging school of common good constitutionalism in the way it seeks to respect the diversity of constitutional orders while retaining a single reference point of the common good. Adrian Vermeule and others appeal to positive law as the determinatio through which public authorities make concrete the state’s pursuit of the common good. But there is often a gulf between common good principles and the determinatio of law. The move from principles to the legitimacy or justness of positive law lies, for Vermeule, in joining-up the central case method of natural law with a singular notion of the common good. The article criticizes this reliance, arguing that the central case method cannot be used to determine law in the sense of the determinatio of positive law. In his articulation of central case methodology, John Finnis is, by contrast, careful to leave space for varieties of coordination and forms of justice, such that the central case method plays a limited role in establishing what counts as common goods. Rather, the central case method identifies what law is. The same delicacy is present in Aquinas, who does not in fact define law as an ordinance of reason for the common good in the way that common good constitutionalists so far would like it to mean, because there are no articles in Latin grammar. In this regard, common good constitutionalism’s mistake is unfortunately in keeping with the majority of jurisprudence, which commits the logical fallacy that an internally consistent account of law is externally authoritative—in other words, that harmony in the way in which laws and legal principles relate to themselves can act as a basis to the body politic’s prioritization of some goods over others.
Pseudobulk with proper offsets has the same statistical properties as generalized linear mixed models in single-cell case-control studies
Authors: Lee Hanbin , Han Buhm 
Published: August 2024

Abstract

Motivation
Generalized linear mixed models (GLMMs), such as the negative-binomial or Poisson linear mixed model, are widely applied to single-cell RNA sequencing data to compare transcript expression between different conditions determined at the subject level. However, the model is computationally intensive, and its relative statistical performance to pseudobulk approaches is poorly understood.

Results
We propose offset-pseudobulk as a lightweight alternative to GLMMs. We prove that a count-based pseudobulk equipped with a proper offset variable has the same statistical properties as GLMMs in terms of both point estimates and standard errors. We confirm our findings using simulations based on real data. Offset-pseudobulk is substantially faster (&gt;×10) and numerically more stable than GLMMs.

Availability and implementation
Offset pseudobulk can be easily implemented in any generalized linear model software by tweaking a few options. The codes can be found at https://github.com/hanbin973/pseudobulk_is_mm.
594 - United States prevalence of atopic dermatitis in adults and pediatrics by race and ethnicity
Authors: Alexis Andrew , Nelson Dave , Heath Candrice , Burge Russel , Mitchell Beth , Cohee Andrea , Pierce Evangeline , Atwater Amber Reck , Chovatiya Raj 
Published: August 2024

Abstract

Background/Purpose
To address issues regarding health disparities and differential access to health care in diverse racial and ethnic populations, many of whom are part of underserved communities, current and robust data on atopic dermatitis (AD) prevalence by race/ethnicity are needed. Whereas data on pediatric prevalence of atopic dermatitis in diverse race/ethnicity populations have been reported, there are limited epidemiologic data on adult populations with AD.

Methods
Analyses were conducted using cross-sectional data from the 2021 National Health Interview Survey. Weighted overall frequencies of subject reports of diagnosed AD or eczema were estimated by race/ethnicity. Adjusted odds ratios were estimated to compare prevalence rates between subgroups. Corresponding population denominators for use in estimating prevalence rates were obtained from the US Census Bureau (2020 Census Demographic Profile). Prevalence is reported as percentage (standard error). Pediatric data was also analyzed for the presentation.

Results
Overall US prevalence of AD in adults ages 18-64 was 7.6% (0.2) and age 65+ was 6.1% (0.3), with a weighted US estimate of 15.3 and 3.2 million respectively. Race/ethnicity prevalence rates for all adults were Black/African American 8.5% (0.6), White 7.7% (0.2), Asian 6.5% (0.7), American Indian/Alaskan Native 4.9% (2.1), and Hispanic 4.8% (0.4). The odds ratio for Hispanic vs Non-Hispanic White was 0.6 (95%CI 0.5-0.7; p&lt;0.0001).

Conclusions
Total US prevalence of AD in all adults is approximately 18 million. Hispanic adults have a lower prevalence AD than all other adult groups. Additional studies are needed to understand sociodemographic variations in AD prevalence.
633 - Physician-assessed effectiveness and safety in adolescent and adult atopic dermatitis patients treated with dupilumab: real-world insights one year into the GLOBOSTAD multinational prospective observational study
Authors: Ferrucci Silvia M , Calzavara-Pinton Piergiacomo , Karlova Iva , Lapeere Hilde , Holzer Gregor , Al-Ahmad Mona , Chu Chia-Yu , Wu Jiangming , Ardeleanu Marius , Bosman Kwinten 
Published: August 2024

Abstract

Introduction
Dupilumab demonstrated robust efficacy in patients with moderate-to-severe atopic dermatitis (AD) in randomized controlled trials. Long-term effectiveness of dupilumab in real-world AD treatment is one of the main objectives of the ongoing GLOBOSTAD study.

Objective
To report dupilumab effectiveness, through physician-assessed AD clinical tools that measure disease severity over time, and a summary of adverse events in patients one year after initiating treatment.

Methods
The GLOBOSTAD five-year, multinational, prospective, observational study (NCT03992417) enrolled patients aged ≥12 years with moderate-to-severe AD. Patients received dupilumab based on country-specific prescribing information. Assessments were performed at baseline, 3 months (M; ±1M), 6M (±2M), and 12M (±2M). Data are reported as observed for enrollment/safety (N = 955; data cutoff: March 2023) and follow-up (N = 903) populations.

Results
758/863/705 patients completed ≥1 follow-up assessment at 3M/6M/12M, respectively. During the study, mean (SD) eczema area and severity index (EASI; &gt;21 = severe; ≤7 = mild/no disease) score rapidly improved from 25.1 (12.8) at baseline to 6.1 (8.0) at 3M, and was sustained until the end of observation period [12M; 4.2 (8.4)]. Similarly, scoring of atopic dermatitis (SCORAD; &gt;50 = severe; &lt;25 = mild/no disease) score improved from 59.3 (16.6) at baseline to 25.3 (16.4) at 3M, further improving to [17.6 (13.0)] at 12M. Adverse events considered related to dupilumab by the investigator were reported in 187 (19.6%) patients. Adverse events leading to permanent dupilumab discontinuation were reported in 23 (2.4%) patients.

Conclusion
In a real-world scenario, clinical AD assessments rapidly improved upon initiating dupilumab treatment, and were sustained through the end of the one-year observation period. Safety data were consistent with previous studies.
639 - Efficacy and safety of once-daily roflumilast cream 0.05% in pediatric patients 2 to 5 years of age with mild to moderate atopic dermatitis (INTEGUMENT-PED): a phase 3 randomized controlled trial
Authors: Eichenfield Lawrence , Browning John , Funk Tracy , Gonzalez Mercedes E , Hebert Adelaide A , Lee Mark , Prajapati Vimal H , Serrao Rocco , Swanson Lisa , Higham Robert , Berk David 
Published: August 2024

Abstract

Background
Roflumilast is a highly potent phosphodiesterase 4 inhibitor under investigation as a non-steroidal, once-daily cream for atopic dermatitis (AD).

Methods
INTEGUMENT-PED (NCT04845620) was a Phase 3 parallel-group, double-blind, vehicle-controlled trial. Children aged 2 to 5 years with mild to moderate AD were treated with roflumilast cream 0.05% (n=437) or vehicle (n=215) once-daily for 4 weeks. The primary efficacy endpoint was validated Investigator Global Assessment-Atopic Dermatitis (vIGA-AD) Success (defined as a score of 0 [clear] or 1 [almost clear] with 2-grade improvement from baseline) at Week 4. Secondary endpoints included 75% improvement in Eczema Area and Severity Index (EASI-75). Worst-Itch-Numeric Rating Score (WI-NRS) Success (≥4-point improvement in patients with baseline ≥4), safety, and tolerability were also assessed.

Results
At Week 4, significantly more roflumilast-treated than vehicle-treated patients achieved vIGA-AD Success (25.4% vs 10.7%; P&lt;0.0001), EASI-75 (39.4% vs 20.6%; P&lt;0.0001), and WI-NRS Success (35.3% vs 18.0%; nominal P=0.0002). Improvement in pruritus was observed by 24 hours after first application (nominal P=0.0014 versus vehicle). Incidence of treatment-emergent adverse events (AEs) was low in both arms, with 98.9% assessed as mild to moderate. AEs occurring in &gt;2% of patients and greater in the roflumilast-treated group were upper respiratory tract infection, diarrhea, and vomiting. For local tolerability, &gt;92% of roflumilast-treated patients reported no or mild sensation across arms at any timepoint.

Conclusion
In this phase 3 trial, once-daily roflumilast cream 0.05% improved AD in pediatric patients (2 to 5 years of age), while demonstrating favorable safety and tolerability.
651 - Improvement of the head and neck regions with continuous tralokinumab treatment for up to 4 years in adults with moderate-to-severe atopic dermatitis
Authors: Chovatiya Raj , Wollenberg Andreas , Ribero Simone , Saeki Hidehisa , Øland Christian B , Steffensen Louise A , Tindberg Ann-Marie , Thyssen Jacob P , Blauvelt Andrew 
Published: August 2024

Abstract

Introduction/Background
Atopic dermatitis (AD) is a chronic, inflammatory disease that can affect multiple regions of the body, but can be particularly burdensome on exposed areas of skin, such as the head and neck (H&N).Tralokinumab, a high-affinity monoclonal antibody that specifically neutralizes interleukin-13, is approved in multiple countries for adults with moderate-to-severe AD. Phase 3 trials showed tralokinumab provided significant improvements in AD severity and was well-tolerated up to 52 weeks of treatment. The ongoing open-label, 5-year extension trial, ECZTEND (NCT03587805), assesses the safety and efficacy of tralokinumab after the completion of parent trials (PT).

Objective
To assess tralokinumab efficacy in the H&N region.

Methods
This post hoc analysis included adult patients with moderate-to-severe AD initially randomized to tralokinumab 300mg Q2W in the phase 3 PTs ECZTRA 1 (NCT03131648) or ECZTRA 2 (NCT03160885). Patients on active tralokinumab treatment were followed for up to 52 weeks in PTs and for up to 152 weeks in ECZTEND as of data cutoff April 30, 2022. Patients re-randomized to placebo at Week (Wk) 16 were not included beyond that timepoint. For this analysis, overall EASI and H&N regional EASI (H&N EASI) were evaluated. H&N EASI (0-7.2) was calculated based on the severity of erythema, induration/papulation, excoriation, lichenification and area of involvement. All data were analyzed and presented as observed.

Results
At baseline, 87.8% (1047/1192) of patients had H&N involvement (H&N EASI&gt;1), and 49.9% (591/1192) of patients exhibited severe AD (IGA 4). Baseline median H&N EASI for the pooled PTs was 3.0 (IQR 1.8; 4.5). In the pooled PTs, 48.2% (542/1125) and 71.2% (558/784) of patients achieved H&N EASI≤1, at Wk16 and Wk52, respectively. After 3 years additional treatment (Wk152 in ECZTEND), the proportion of patients with H&N EASI≤1 was 87.2% (232/266) and the median H&N EASI was 0.2 (IQR 0.0; 0.5). In the subgroup of patients (n=301) with severe AD (IGA 4) and high H&N involvement (H&N EASI≥4), median H&N EASI improved from 5.4 at baseline to 2.4 and 0.8 at Wk16 and Wk52, respectively, and 0.4 at Wk152. Improvements in H&N region were comparable to overall EASI improvement.

Conclusions
Tralokinumab provided sustained improvements in the H&N regions in patients with moderate-to-severe AD for up to 4 years. Sustained improvements were also seen in patients with severe disease and substantial H&N involvement at baseline.
731 - Quality of life in atopic dermatitis: the patient perspective
Authors: Jiminez Victoria , Crawford Michaela , Mayo Tiffany 
Published: August 2024

Abstract

Introduction
Atopic Dermatitis (AD) is a cutaneous disease affecting all ages and demographics. Even in an era of biological treatments, many patients continue to struggle with disease factors that influence their overall quality of life.

Objectives
This study aims to highlight perceived influential factors related to QOL in atopic dermatitis from patient-reported experiences.

Methods
This study is an IRB-approved cross-sectional survey of patients with a diagnosis of atopic dermatitis at a single academic institution. The survey was conducted via phone calls. Patients were asked to self-report information related to their diagnosis, comorbidities, residential community, and factors that contribute to quality of life. Statistical analysis was performed with SPSS.

Results
Sixty-four patients agreed to participate in the survey, with a response rate of 78%. Responders were mostly female (55%) with a mean age of 41 and were racially diverse (White/Caucasian) 48%, Black or African American 36%, and Asian or Asian American 16%). Self-reported disease severity was labeled as mild (17%), moderate (33%), or severe (50%). Many patients had psychiatric comorbidities (anxiety 39%, depression 22%). Subjective feelings of being less attractive or less confident due to AD were significant on logistic regression in those with severe disease (p=0.048, OR 2.78, CI (1.0-7.6) and female gender (p=0.007). The severe group also reported experiencing prior judgment or discrimination (63%) and felt their work or school performance had been affected by their AD (47%), more commonly in males (p=0.026). Differences in race were not significant. Most patients reported itch as being the most bothersome symptom (66%). When asked to choose the top factors contributing to their quality of life related to their AD, symptom burden was the most common (88%) followed by time spent obtaining medical care (45%), and treatment regimen difficulty (39%). More than one in every ten patients (16%) reported that their life goals or dreams had been affected by their disease.

Conclusion
The psychosocial implications of atopic dermatitis remain a significant barrier to patient-perceived quality of life. While symptomatic management remains a large proponent of barriers to QOL improvement, perceived stigmatization anecdotally affects those with AD to a significant degree. Further studies and interventions are needed to discern specific areas of improvement for QOL in atopic dermatitis.
Cortical CD200–CD200R and CD47–SIRPα expression is associated with multiple sclerosis pathology
Authors: van den Bosch Aletta M R , Wever Dennis , Schonewille Pleun , Schuller Sabine L , Smolders Joost , Hamann Jörg , Huitinga Inge 
Published: August 2024

Abstract
Control of microglia activity through CD200–CD200R and CD47–SIRPα interactions has been implicated in brain homeostasis. Here, we assessed CD200, CD47, CD200R and SIRPα expression with qPCR and immunohistochemistry in multiple sclerosis (MS) normal-appearing cortical grey matter (NAGM), normal-appearing white matter (NAWM), cortical grey matter (GM) lesions and perilesional GM, and compared this to control GM and white matter (WM), to investigate possible altered control of microglia in MS. In MS NAGM, CD200 expression is lower compared with control GM, specifically in cortical layers 1 and 2, and CD200 expression in NAGM negatively correlates with the cortical lesion rate. Interestingly, NAGM and NAWM CD200 expression is positively correlated, and NAGM CD200 expression negatively correlates with the proportion of active and mixed WM lesions. In GM lesions, CD200 and CD47 expressions are lower compared with NAGM and perilesional GM. CD200R expression is lower in MS NAGM, whereas SIRPα was increased in and around GM lesions. Taken together, our data indicate that CD200 and CD47 play a role in GM MS lesion formation and progression, respectively, and that targeting CD200 pathways may offer therapeutic avenues to mitigate MS pathology in both WM and GM.
Gastric preconditioning via percutaneous angioembolization before esophagectomy in patients at high risk for esophageal leak
Authors: Bevers Kaitlin C , Sewell Marisa , Bott Matthew J , Sihag Smita , Park Bernard J , Ridouani Fourat , Muñoz Fernando Gómez , Santos Ernesto , Molena Daniela 
Published: August 2024

Summary
Anastomotic leaks and stenoses remain critical complications in esophagectomy and are related to conduit perfusion. Surgical gastric preconditioning has been described but requires additional surgery and creates scar tissue, potentially hindering future operation. We sought to evaluate the feasibility and safety of percutaneous gastric preconditioning by angioembolization to improve perfusion of gastric conduits before esophagectomy in a high-risk patient cohort. Patients pending an esophagectomy for cancer and deemed to be high risk for anastomotic complications underwent preconditioning by image-guided angioembolization. Preconditioning was performed on an outpatient basis by means of superselective embolization of the left gastric and short gastric arteries. Intraoperative conduit perfusion evaluation with indocyanine green and postoperative surgical outcomes was reviewed. Seventeen patients underwent gastric preconditioning, with no complications observed. Thirteen of the 17 patients ultimately underwent esophagectomy; the remaining four patients were not candidates for an operation. Patients proceeded to surgery a median of 23 days (interquartile range, 21–27 days) after preconditioning. The intraoperative indocyanine green perfusion of all conduits was appropriate, with no tip demarcation and with a median time to dye uptake of 20s (interquartile range, 15–20s). There were no anastomotic stenoses or leaks noted within the series. Gastric conduit preconditioning by percutaneous angioembolization of the left gastric and short gastric arteries can be performed safely and without operative delay in high-risk patients. Further evaluation of preconditioning for conduit optimization is warranted to limit the critical complications of anastomotic leak and stenosis in esophagectomy.
Alterations in left atrial and left ventricular coupling in mixed aortic valve disease
Authors: Sooriyakanthan Maala , Graham Fraser J , Ho Natalie , Leong-Poi Howard , Tsang Wendy 
Published: August 2024

Abstract

Aims
To characterize left atrial (LA) and left ventricular (LV) function and atrioventricular (AV) coupling in patients with moderate mixed aortic valve disease (MMAVD) against those with isolated moderate or severe aortic valve disease and controls.

Methods and results
Retrospective LA and LV peak longitudinal strain (LS) analysis were performed on 260 patients [46 MMAVD, 81 moderate aortic stenosis (AS), 50 severe AS, 48 moderate aortic regurgitation (AR), and 35 severe AR] and 66 controls. Peak LV and LA LS and AV coupling, assessed by combined peak LA and LV strain, was compared between the groups. Analysis of variance and two-sided t-tests were used, and a P-value of &lt;0.01 was considered significant. LV strain was significantly lower in those with MMAVD compared with controls and those with moderate or severe isolated AR but comparable to those with moderate or severe AS (−17.1 ± 1.1% MMAVD vs. −17.7 ± 1.5% moderate AS, P = 0.02, vs. −17.0 ± 1.5% severe AS, P = 0.74). AV coupling was significantly lower in those with MMAVD compared with controls and those with moderate AS or AR but comparable to those with severe AS or AR (47.1 ± 6.8% MMAVD vs. 45.1 ± 5.6% severe AS, P = 0.13, vs. 50.4 ± 9% severe AR, P = 0.07).

Conclusion
Impairments in AV coupling are comparable for patients with MMAVD and those with severe isolated AS or AR. Impairments in LV GLS in MMAVD mirror those found in severe AS. These findings suggest that haemodynamic consequences and adverse remodelling are similar for patients with MMAVD and isolated severe disease.