bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Patient Sorting in Avoidable Hospital Stays in Medicare Advantage vs Traditional Medicare
Authors: Xu Jianhui (Frank) , Anderson Kelly E. , Liu Angela , Miller Brian J. , Polsky Daniel 
Published: November 2023

ImportanceUnlike traditional Medicare (TM), Medicare Advantage (MA) plans limit in-network care to a specific network of Medicare clinicians. MA plans thus play a role in sorting patients to a subset of clinicians. It is unknown whether the performance of physicians who treat MA and TM beneficiaries is different.ObjectiveTo examine whether avoidable hospital stay differences between MA and TM can be explained by the primary care clinicians who treat MA and TM beneficiaries.Design, Setting, and ParticipantsThis was a cross-sectional study of a nationally representative sample of MA and TM beneficiaries in 2019 with any of 5 chronic ambulatory care–sensitive conditions (ACSCs). The relative risk (RR) of avoidable hospital stays in MA compared with TM was estimated with inverse probability of treatment-weighted Poisson regression, both without and with clinician fixed effects. The degree to which the estimated MA vs TM difference could be explained by patient sorting was calculated by comparing the 2 RR estimates. Data were analyzed between February 2022 and April 2023.ExposureEnrollment in MA.Main Outcome and MeasuresWhether a beneficiary had avoidable hospital stays in 2019 due to any of the ACSCs. Avoidable hospital stays included both hospitalizations and observation stays.ResultsThe study sample comprised 1 323 481 MA beneficiaries (mean [SD] age, 75.4 [7.0] years; 56.9% women; 69.3% White) and 1 965 863 TM beneficiaries (mean [SD] age, 75.9 [7.4] years; 57.1% women; 82.5% White). When controlling for the primary care clinician, the RR of avoidable hospital stays in MA vs TM changed by 2.6 percentage points (95% CI, 1.72-3.50; P &amp;lt; .001), suggesting that compared with TM beneficiaries, MA beneficiaries saw clinicians with lower rates of avoidable hospital stays. This effect size was statistically significant to explain the 2% lower rate of avoidable hospital stays in MA than in TM.Conclusions and RelevanceIn this cross-sectional study of MA and TM beneficiaries, the lower rate of avoidable hospital stays among MA beneficiaries than TM beneficiaries was attributable to MA beneficiaries visiting clinicians with lower rates of avoidable hospital stays. The patient sorting that occurs in MA plays a critical role in the lower rates of avoidable hospital stays compared with TM.
mRNA SARS-CoV-2 Vaccination Before vs During Pregnancy and Omicron Infection Among Infants
Authors: Goh Orlanda , Pang Deanette , Tan Janice , Lye David , Chong Chia Yin , Ong Benjamin , Tan Kelvin Bryan , Yung Chee Fu 
Published: November 2023

ImportanceInfants younger than 6 months are at risk of severe SARS-CoV-2 infection. Data are lacking on the optimum timing for maternal vaccination and estimated effectiveness against Omicron variants, including XBB, for infants.ObjectiveTo investigate maternal vaccination against Omicron variants, including XBB, and the association of vaccination timing during pregnancy vs prior to pregnancy and risks of SARS-CoV-2 infection among infants aged 6 months or younger.Design, Setting, and ParticipantsThis population-based cohort study was conducted between January 1, 2022, and March 31, 2023. Singapore’s national dataset was used to study infants born at greater than 32 weeks’ gestation between January 1, 2022, and September 30, 2022. The study included infants whose parents had a confirmed SARS-CoV-2 infection from the date of birth up to 6 months of age. Of 21 609 infants born during this period, 7292 (33.7%) had at least 1 parent infected with SARS-CoV-2 before the age of 7 months. Statistical analysis was performed from April to July 2023.ExposureInfants’ mothers were unvaccinated, vaccinated prior to pregnancy, or vaccinated with a messenger RNA (mRNA) SARS-CoV-2 vaccine during pregnancy.Main Outcome and MeasureInfants were considered infected if they had a positive polymerase chain reaction test.ResultsAmong 7292 infants included in this study, 4522 (62.0%) had mothers who were Chinese, 527 (7.2%) had mothers who were Indian, 2007 (27.5%) had mothers who were Malay, and 236 (3.2%) had mothers who were other ethnicity; 6809 infants (93.4%) were born at full term, and 1272 infants (17.4%) were infected during the study period. There were 7120 infants (97.6%) born to mothers who had been fully vaccinated or boosted as of 14 days prior to delivery. The crude incidence rate was 174.3 per 100 000 person-days among infants born to mothers who were unvaccinated, 122.2 per 100 000 person-days among infants born to mothers who were vaccinated before pregnancy, and 128.5 per 100 000 person-days among infants born to mothers who were vaccinated during pregnancy. The estimated vaccine effectiveness (VE) was 41.5% (95% CI, 22.8% to 55.7%) among infants born to mothers vaccinated during pregnancy. Infants of mothers who received vaccination prior to pregnancy did not have a lower risk for infection (estimated VE, 15.4% [95% CI, −17.6% to 39.1%]). A lower risk for Omicron XBB infection was only observed among mothers vaccinated with the third (booster) dose antenatally (estimated VE, 76.7% [95% CI, 12.8% to 93.8%]).Conclusions and RelevanceIn this population-based cohort study, maternal mRNA vaccination was associated with a lower risk of Omicron SARS-CoV-2 infection among infants up to 6 months of age only if the vaccine was given during the antenatal period. These findings suggest that mRNA vaccination during pregnancy may be needed for lower risk of SARS-CoV-2 infection among newborns.
Posttreatment Surveillance Imaging After Radiation for Head and Neck Cancer
Authors: Chen Allen M. , Harris Jeremy P. , Gan Meng , Nabar Rupali , Tjoa Tjoson , Haidar Yarah M. , Truong Annie , Chow Daniel S. , Armstrong William B. 
Published: November 2023

ImportanceThe role of surveillance imaging after treatment for head and neck cancer is controversial and evidence to support decision-making is limited.ObjectiveTo determine the use of surveillance imaging in asymptomatic patients with head and neck cancer in remission after completion of chemoradiation.Design, Setting, and ParticipantsThis was a retrospective, comparative effectiveness research review of adult patients who had achieved a complete metabolic response to initial treatment for head and neck cancer as defined by having an unequivocally negative positron emission tomography (PET) scan using the PET response criteria in solid tumors (PERCIST) scale within the first 6 months of completing therapy. The medical records of 501 consecutive patients who completed definitive radiation therapy (with or without chemotherapy) for newly diagnosed squamous cell carcinoma of the head and neck between January 2014 and June 2022 were reviewed.ExposureSurveillance imaging was defined as the acquisition of a PET with computed tomography (CT), magnetic resonance imaging (MRI), or CT of the head and neck region in the absence of any clinically suspicious symptoms and/or examination findings. For remaining patients, subsequent surveillance after the achievement of a complete metabolic response to initial therapy was performed on an observational basis in the setting of routine follow-up using history-taking and physical examination, including endoscopy. This expectant approach led to imaging only in the presence of clinically suspicious symptoms and/or physical examination findings.Main Outcome and MeasuresLocal-regional control, overall survival, and progression-free survival based on assignment to either the surveillance imaging or expectant management cohort.ResultsThis study included 340 patients (mean [SD] age, 59 [10] years; 201 males [59%]; 88 Latino patients [26%]; 145 White patients [43%]) who achieved a complete metabolic response during this period. There was no difference in 3-year local-regional control, overall survival, progression-free survival, or freedom from distant metastasis between patients treated with surveillance imaging vs those treated expectantly.Conclusions and RelevanceIn this comparative effectiveness research, imaging-based surveillance failed to improve outcomes compared with expectant management for patients who were seemingly in remission after completion of primary radiation therapy for head and neck cancer.
A Biomimetic Structural Material with Adjustable Mechanical Property for Bone Tissue Engineering
Authors: Kong Deyin , Wang Qing , Huang Jiangeng , Zhang Zhihui , Wang Xiebin , Han Qing , Shi Yanbin 
Published: November 2023

AbstractThe development of cellular materials with adjustable mechanical properties, total porosity (Tp), and elastic modulus (E) similar to those of natural bone are eternal pursuits in the field of bone implants. Designing and manufacturing an implant that fulfills all these requirements is a challenging task. In this study, inspired by the trabecular structure of natural bone and developed a biomimetic structural material. Laser powder bed fusion (L‐PBF) is utilized to create the biomimetic structural material. Comprehensive valuations of both the natural trabecular bone and biomimetic structural material are conducted using micro‐CT scanning, nanoindentation testing, finite element (FE) analysis, and compression testing. The results demonstrate that the mechanical properties of the developed biomimetic structural material have excellent controllability. The rod‐plate‐like trabecular (RPT) biomimetic structural material exhibited significantly superior mechanical load‐bearing performance compared to the natural bone trabeculae while maintaining the natural bone's Tp (83.1%) and E (798.1 MPa). The biomimetic structural material effectively balances the combination of strength and E, providing a design template for the next generation of medical implants. It has great potential as a bone repair material for clinical applications, and its adjustable mechanical properties also make it highly promising in the field of tissue engineering.
Strain as a Global Factor in Stabilizing the Ferroelectric Properties of ZrO2
Authors: Xu Bohan , Lomenzo Patrick D. , Kersch Alfred , Schenk Tony , Richter Claudia , Fancher Chris M. , Starschich Sergej , Berg Fenja , Reinig Peter , Holsgrove Kristina M. , Kiguchi Takanori , Mikolajick Thomas , Boettger Ulrich , Schroeder Uwe 
Published: November 2023

AbstractSince the discovery of ferroelectricity in doped HfO2and ZrO2thin films over a decade ago, fluorite‐structured ferroelectric thin films have attracted much research attention due to their excellent scalability and complementary metal‐oxide semiconductor compatibility compared to conventional perovskite ferroelectric materials. Although various factors influencing the formation of the ferroelectric properties are identified, a clear understanding of the causes of the phase formation have been difficult to determine. In this work, ZrO2films deposited by atomic layer deposition and chemical solution deposition have resulted in films with completely different structural properties. Regardless of these differences, a general relationship between strain and phase formation is established, leading to a more unified understanding of ferroelectric phase formation in undoped ZrO2films, which can be applied to other fluorite‐structured films.
Stem Cells Expansion Vector via Bioadhesive Porous Microspheres for Accelerating Articular Cartilage Regeneration
Authors: Bai Lang , Han Qibin , Han Zeyu , Zhang Xiaoyu , Zhao Jingwen , Ruan Huitong , Wang Junliang , Lin Feng , Cui Wenguo , Yang Xing , Hao Yuefeng 
Published: November 2023

AbstractStem cell tissue engineering is a potential treatment for osteoarthritis. However, the number of stem cells that can be delivered, loss of stem cells during injection, and migration ability of stem cells limit applications of traditional stem cell tissue engineering. Herein, kartogenin (KGN)‐loaded poly(lactic‐co‐glycolic acid) (PLGA) porous microspheres is first engineered via emulsification, and then anchored with chitosan through the amidation reaction to develop a new porous microsphere (PLGA‐CS@KGN) as a stem cell expansion vector. Following 3D co‐culture of the PLGA‐CS@KGN carrier with mesenchymal stem cells (MSCs), the delivery system is injected into the capsule cavity in situ. In vivo and in vitro experiments show that PLGA‐CS microspheres have a high cell‐carrying capacity up to 1 × 104 mm−3 and provide effective protection of MSCs to promote their controlled release in the osteoarthritis microenvironment. Simultaneously, KGN loaded inside the microspheres effectively cooperated with PLGA‐CS to induce MSCs to differentiate into chondrocytes. Overall, these findings indicate that PLGA‐CS@KGN microspheres held high cell‐loading ability, adapt to the migration and expansion of cells, and promote MSCs to express markers associated with cartilage repair. Thus, PLGA‐CS@KGN can be used as a potential stem cell carrier for enhancing stem cell therapy in osteoarthritis treatment.
Sprayable Multifunctional Black Phosphorus Hydrogel with On‐Demand Removability for Joint Skin Wound Healing
Authors: Ding Xiaoya , Yu Yunru , Fan Lu , Li Wenzhao , Bian Feika , Wang Jinglin , Zhao Yuanjin 
Published: November 2023

AbstractWound healing remains a critical challenge in regenerative engineering. Great efforts are devoted to develop functional patches for wound healing. Herein, a novel sprayable black phosphorus (BP)‐based multifunctional hydrogel with on‐demand removability is presented as a joints’ skin wound dressing. The hydrogel is facilely prepared by mixing dopamine‐modified oxidized hyaluronic acid, cyanoacetategroup‐functionalized dextran containing black phosphorus, and the catalyst histidine. The catechol‐containing dopamine can not only enhance tissue adhesiveness, but also endow the hydrogel with antioxidant capacity. In addition, benefiting from the photothermal conversion ability of the BP and thermally reversible performance of the formed C═C double bonds between aldehyde groups and cyanoacetate groups, the resulting hydrogel displays excellent antibacterial performance and on‐demand dissolving ability under NIR irradiation. Moreover, by loading vascular endothelial growth factor into the hydrogel, the promoted migration and angiogenesis effects of endothelial cells can also be achieved. Based on these features, it is demonstrated that such sprayable BP hydrogels can effectively facilitate joint wounds healing by accelerating angiogenesis, alleviating inflammation, and improving wound microenvironment. Thus, it is believed that this NIR‐responsive removable BP hydrogel dressing will put forward an innovative concept in designing wound dressings.
An Efficient and Stable Lithium‐Oxygen Battery Based on Metal‐Organic Framework Separator Operating at 160 °C
Authors: Qiu Qianyuan , Yuan Jiashu , Li Gen , Pan Zheng‐ze , Yao Penghui , Zhao Yicheng , Zhang Cuijuan , Li Yongdan 
Published: November 2023

AbstractA lithium oxygen battery (LOB) with molten salt electrolyte operating at elevated temperature has aroused great interest because it enables fast reaction kinetics. However, there is still a lack of open literature on the separator (membrane) of this kind of LOB. Metal‐organic framework (MOF) materials are widely used as components of separators in many kinds of energy storage devices, due to their regular crystalline and well‐defined pore structures. In this work, a MOF material, zirconium (II) 1,4‐benzenedicarboxylate after lithiation (UiO‐66‐SO3Li) with a narrow pore size (6 Å), is used as a key component of the separator for LOB operating at elevated temperature. A “rolling dough” method is adopted to prepare the separator, which achieves 100% material utilization. The LOB with this membrane operates at 160 °C and delivers a specific capacity of 5.1 mAh cm−2 with an overpotential as low as 40 mV at 0.1 mA cm−2 and a prolonged cycle life, 180 cycles with a high coulombic efficiency of 99.9% at 0.5 mA cm−2. This MOF‐based membrane provides efficient Li+ transfer and restricts discharge product migration during battery operation, which is promising for the development of LOB in large‐scale practical applications.
Fabrication and Characterization of a Thermoelectric Generator with High Aspect Ratio Thermolegs for Electrically Active Implants
Authors: Rao Yongchen , Xu Chu , Voss Matthias , Ying Pingjun , Reith Heiko , Nielsch Kornelius , Bechtold Tamara , Hohlfeld Dennis 
Published: November 2023

Implantable thermoelectric generators hold significant promise as an alternative or supplementary energy source for implantable medical devices, but their performance is constrained by spatial limitations within implants and relies heavily on design optimization. In this study, an optimized thermoelectric generator featuring high aspect ratio thermolegs (0.5 × 0.5 × 4 mm3) is presented, which achieves a remarkable power output of 110 µW with a simulated temperature difference (3 K) in an implantation scenario. This achievement is realized through the use of a removable assembly rig during the soldering process, streamlining the fabrication process. Furthermore, the integration of a boost converter within the thermoelectric generator results in a voltage output of 2.5 V, addressing the voltage requirements of active implants. These findings highlight the potential that implantable thermoelectric generators can be used as a reliable, quiet and self‐sufficient power source for implantable medical devices.
Fabrication of Plastic Optics from Chalcogenide Hybrid Inorganic/Organic Polymers for Infrared Thermal Imaging
Authors: Molineux Jake , Lee Taeheon , Kim Kyung Jo , Kang Kyung‐Seok , Lyons Nicholas P. , Nishant Abhinav , Kleine Tristan S. , Durfee Sam W. , Pyun Jeffrey , Norwood Robert A. 
Published: November 2023

AbstractThe development of infrared (IR) plastic optics for infrared thermal imaging, particularly, in the long‐wave IR (LWIR) spectrum (7–14 µm) is an area of growing technological interest due to the potential advantages associated with plastic optics (e.g., moldability and low cost). The development of a new class of optical polymers, chalcogenide‐based inorganic/organic hybrid polymers (CHIPs) derived from the inverse vulcanization of elemental sulfur, has enabled significant improvements in IR transparency due to reduction of IR absorbing organic comonomer units. The vast majority of effort has focused on new chalcogenide hybrid polymer synthesis and optical property improvements (e.g., refractive index, Abbe number, and LWIR transmission); however, fabrication and IR imaging methodology to prepare optical components has not been demonstrated, which remains critical to develop viable IR plastic optics. A new methodology is reported to fabricate optical components and evaluate LWIR imaging performance of this emerging class of optical polymers. New diffractive flat optics with a Fresnel lens design for these materials have been developed, along with a basic LWIR imaging system to evaluate CHIPs for LWIR imaging. This system‐based approach enables correspondence of copolymer structure‐property correlations with LWIR imaging performance, along with demonstration of room temperature LWIR imaging.
Magnetic Mesoporous Janus Microrollers for Combined Chemo‐ and Photothermal Ablation Therapy
Authors: Aybar Tural Gulsen , Bozuyuk Ugur , Dogan Nihal Olcay , Alapan Yunus , Akolpoglu Mukrime Birgul , Aghakhani Amirreza , Lazovic Jelena , Ozer Ozgen , Sitti Metin 
Published: November 2023

AbstractMobile microrobots have been proposed as a promising approach to overcome the limitations of traditional drug/gene delivery systems. Magnetically actuated surface rolling microrobots, or magnetic surface microrollers, have shown potential for navigation in physiologically relevant environments due to their robust locomotion characteristics. Although much is known about their locomotion abilities in various environments, the full extent of their potential in medical applications has yet to be fully explored. Here, the potential of surface microrollers for combined chemo‐ and photothermal ablation therapy under medical imaging modalities is demonstrated. The surface microrollers are half‐coated with magnetic material, allowing for photothermal heating and magnetic locomotion, and loaded with a biopharmaceutics classification system (BCS) class IV anti‐cancer drug, Docetaxel (DTX), for combined therapy. Synergistic action of on‐demand photothermal ablation and the controlled release of DTX result in the efficient elimination of cancer cells. Furthermore, microrollers can be detected ex vivo with magnetic resonance imaging (MRI) and photoacoustic imaging (PA), highlighting the potential of surface microrollers for future targeted medical applications.
Inhibition of CARM1‐Mediated Methylation of ACSL4 Promotes Ferroptosis in Colorectal Cancer
Authors: Feng Shengjie , Rao Zejun , Zhang Jiakun , She Xiaowei , Chen Yaqi , Wan Kairui , Li Haijie , Zhao Chongchong , Feng Yongdong , Wang Guihua , Hu Junbo , Luo Xuelai 
Published: November 2023

AbstractFerroptosis, which is caused by iron‐dependent accumulation of lipid peroxides, is an emerging form of regulated cell death and is considered a potential target for cancer therapy. However, the regulatory mechanisms underlying ferroptosis remain unclear. This study defines a distinctive role of ferroptosis. Inhibition of CARM1 can increase the sensitivity of tumor cells to ferroptosis inducers in vitro and in vivo. Mechanistically, it is found that ACSL4 is methylated by CARM1 at arginine 339 (R339). Furthermore, ACSL4 R339 methylation promotes RNF25 binding to ACSL4, which contributes to the ubiquitylation of ACSL4. The blockade of CARM1 facilitates ferroptosis and effectively enhances ferroptosis‐associated cancer immunotherapy. Overall, this study demonstrates that CARM1 is a critical contributor to ferroptosis resistance and highlights CARM1 as a candidate therapeutic target for improving the effects of ferroptosis‐based antitumor therapy.
Engineering Heterogeneous Tumor Models for Biomedical Applications
Authors: Wu Zhuhao , Huang Danqing , Wang Jinglin , Zhao Yuanjin , Sun Weijian , Shen Xian 
Published: November 2023

AbstractTumor tissue engineering holds great promise for replicating the physiological and behavioral characteristics of tumors in vitro. Advances in this field have led to new opportunities for studying the tumor microenvironment and exploring potential anti‐cancer therapeutics. However, the main obstacle to the widespread adoption of tumor models is the poor understanding and insufficient reconstruction of tumor heterogeneity. In this review, the current progress of engineering heterogeneous tumor models is discussed. First, the major components of tumor heterogeneity are summarized, which encompasses various signaling pathways, cell proliferations, and spatial configurations. Then, contemporary approaches are elucidated in tumor engineering that are guided by fundamental principles of tumor biology, and the potential of a bottom‐up approach in tumor engineering is highlighted. Additionally, the characterization approaches and biomedical applications of tumor models are discussed, emphasizing the significant role of engineered tumor models in scientific research and clinical trials. Lastly, the challenges of heterogeneous tumor models in promoting oncology research and tumor therapy are described and key directions for future research are provided.