bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mandated checkups, knowledge of own health status, and chronic care utilization: The effect of HIV medical evaluation mandates on healthcare quality and expenditure in a US‐single payer system
Authors: Topal Senay , Richard Patrick , Young John , Ganesan Anuradha , Gleeson Todd , Blaylock Jason , Okulicz Jason F. , Chu Xiuping , Agan Brian K. 
Published: September 2023

AbstractIn an effort to improve military readiness, in 2014 the US Air Force reduced the frequency of mandated HIV medical evaluation visits from every 6 months to every 12 months. We employ this natural experiment using data for 2676 active‐duty Military Health System beneficiaries living with HIV with a difference‐in‐differences empirical strategy using the Army, Navy, and Marines as a control group to estimate the causal effect of reducing the frequency of mandated evaluation visits on the quality and cost of medical care for active‐duty military members living with HIV. We find that reducing the frequency of mandated HIV medical evaluation visits reduced the likelihood of regular HIV visits by 23 percentage points but did not affect the likelihood of receiving other preventive care, adhering to HIV therapy, or maintaining viral testing and suppression. The study finds evidence that the recommended level of regular HIV visits may be higher than necessary. The reduction in regular HIV visits was not associated with a similar reduction in the studied quality of care measures, therefore, the effect of alleviating the mandate was overall positive in terms of reducing healthcare utilization without adversely affecting preventive care, HIV therapy, or viral testing and suppression.
Optoα1AR activation in astrocytes modulates basal hippocampal synaptic excitation and inhibition in a stimulation‐specific manner
Authors: Courtney Connor D. , Sobieski Courtney , Ramakrishnan Charu , Ingram Robbie J. , Wojnowski Natalia M. , DeFazio R. Anthony , Deisseroth Karl , Christian‐Hinman Catherine A. 
Published: September 2023

AbstractAstrocytes play active roles at synapses and can monitor, respond, and adapt to local synaptic activity. While there is abundant evidence that astrocytes modulate excitatory transmission in the hippocampus, evidence for astrocytic modulation of hippocampal synaptic inhibition remains more limited. Furthermore, to better investigate roles for astrocytes in modulating synaptic transmission, more tools that can selectively activate native G protein signaling pathways in astrocytes with both spatial and temporal precision are needed. Here, we utilized AAV8‐GFAP‐Optoα1AR‐eYFP (Optoα1AR), a viral vector that enables activation of Gq signaling in astrocytes via light‐sensitive α1‐adrenergic receptors. To determine if stimulating astrocytic Optoα1AR modulates hippocampal synaptic transmission, recordings were made in CA1 pyramidal cells with surrounding astrocytes expressing Optoα1AR, channelrhodopsin (ChR2), or GFP. Both high‐frequency (20 Hz, 45‐ms light pulses, 5 mW, 5 min) and low‐frequency (0.5 Hz, 1‐s pulses at increasing 1, 5, and 10 mW intensities, 90 s per intensity) blue light stimulation were tested. 20 Hz Optoα1AR stimulation increased both inhibitory and excitatory postsynaptic current (IPSC and EPSC) frequency, and the effect on miniature IPSCs (mIPSCs) was largely reversible within 20 min. However, low‐frequency stimulation of Optoα1AR did not modulate either IPSCs or EPSCs, suggesting that astrocytic Gq‐dependent modulation of basal synaptic transmission in the hippocampus is stimulation‐dependent. By contrast, low‐frequency stimulation of astrocytic ChR2 was effective in increasing both synaptic excitation and inhibition. Together, these data demonstrate that Optoα1AR activation in astrocytes changes basal GABAergic and glutamatergic transmission, but only following high‐frequency stimulation, highlighting the importance of temporal dynamics when using optical tools to manipulate astrocyte function.
The Honeysuckle and the Bindweed Revisited: Synthesis and Stereochemistry of Extended Helical Structures from Coordination Complexes
Authors: Downward Alan M. , Granelli Matteo , Besnard Celine , Guénée Laure , Williams Alan F. 
Published: September 2023

AbstractWe report structural studies of a chiral tridentate ligand which forms helical cubanes with cobalt(II) and manganese(II). A quadruple helicate with (P)‐chirality is obtained using a (S)‐ligand with cobalt(II) but the ligand binds manganese(II) in one of two possible orientations and either (P)‐ or (M)‐quadruple helicates may be observed for a given ligand enantiomer. The helicates may be linked into extended structures by p‐nitrobenzoate capping ligands which show stacking interactions with neighbouring complexes. With cobalt(II) we find an extended helical structure with (M)‐chirality linking helicates which themselves have (P)‐chirality. With manganese(II) we observe a remarkable structure with extended (M)‐helices coexisting with extended (P)‐helices.
Leukopenia and leukocytosis as strong predictors of COVID‐19 severity: A cross‐sectional study of the hematologic abnormalities and COVID‐19 severity in hospitalized patients
Authors: Sharafi Fateme , Jafarzadeh Esfehani Reza , Moodi Ghalibaf AmirAli , Jarahi Lida , Shamshirian Ali , Mozdourian Mahnaz 
Published: September 2023

AbstractBackground and AimsPredicting severe disease is important in provocative decision‐making for the management of patients with the coronavirus disease 2019 (COVID‐19); However, there are still some controversies about the COVID‐19's severity predicting factors. This study aimed to investigate the relationships between clinical and laboratory findings regarding COVID‐19's severity in patients admitted to a tertiary hospital in Mashhad, Iran.MethodsA cross‐sectional study was conducted on patients with documented COVID‐19 infection based on the reverse transcription‐polymerase chain reaction test. Clinical symptoms, vital signs, and medical history of the patients were recorded from their medical records. Laboratory findings and computed tomography (CT) study findings were documented. Disease severity was defined based on CT scan findings.ResultsA total of 564 patients (58.8 ± 16.8 years old) were evaluated. The frequency of severe disease was 70.4%. There was a significant difference in heart rate (p = 0.0001), fever (p = 0.002), dyspnea (p = 0.0001), chest pain (p = 0.0001), diarrhea (p = 0.021), arthralgia (p = 0.0001), and chills (p = 0.044) as well as lymphopenia (p = 0.014), white blood cell count (p = 0.001), neutrophil count (p < 0.0001), lymphocyte count (p < 0.0001), and prothrombin time (p = 0.001) between disease severity groups. Predictors of severe COVID‐19 were pulse rate (crude odds ratio [cOR] = 1.014, 95% confidence interval [CI] for cOR: 1.001, 1.027) and leukopenia (cOR = 3.910, 95% CI for cOR: 1.294, 11.809). Predictors for critical COVID‐19 were pulse rate (cOR = 1.075, 95% CI for cOR: 1.046, 1.104), fever (cOR = 2.516, 95%CI for cOR: 1.020, 6.203), dyspnea (cOR = 4.190, 95% CI for cOR: 1.227, 14.306), and leukocytosis (cOR = 3.866, 95% CI for cOR: 1.815, 8.236).ConclusionsLeukopenia and leukocytosis have the strongest correlation with the COVID‐19 severity. These findings could be a valuable guild for clinicians in COVID‐19 patient management in the inpatient setting.
Histomic and transcriptomic features of MRI‐visible and invisible clinically significant prostate cancers are associated with prognosis
Authors: Lehto Timo‐Pekka K. , Pylväläinen Juho , Sandeman Kevin , Kenttämies Anu , Nordling Stig , Mills Ian G. , Tang Jing , Mirtti Tuomas , Rannikko Antti 
Published: September 2023

AbstractMagnetic resonance imaging (MRI) is increasingly used to triage patients for prostate biopsy. However, 9% to 24% of clinically significant (cs) prostate cancers (PCas) are not visible in MRI. We aimed to identify histomic and transcriptomic determinants of MRI visibility and their association to metastasis, and PCa‐specific death (PCSD). We studied 45 radical prostatectomy‐treated patients with csPCa (grade group [GG]2‐3), including 30 with MRI‐visible and 15 with MRI‐invisible lesions, and 18 men without PCa. First, histological composition was quantified. Next, transcriptomic profiling was performed using NanoString technology. MRI visibility‐associated differentially expressed genes (DEGs) and Reactome pathways were identified. MRI visibility was classified using publicly available genes in MSK‐IMPACT and Decipher, Oncotype DX, and Prolaris. Finally, DEGs and clinical parameters were used to classify metastasis and PCSD in an external cohort, which included 76 patients with metastatic GG2‐4 PCa, and 84 baseline‐matched controls without progression. Luminal area was lower in MRI‐visible than invisible lesions and low luminal area was associated with short metastasis‐free and PCa‐specific survival. We identified 67 DEGs, eight of which were associated with survival. Cell division, inflammation and transcriptional regulation pathways were upregulated in MRI‐visible csPCas. Genes in Decipher, Oncotype DX and MSK‐IMPACT performed well in classifying MRI visibility (AUC = 0.86‐0.94). DEGs improved classification of metastasis (AUC = 0.69) and PCSD (AUC = 0.68) over clinical parameters. Our data reveals that MRI‐visible csPCas harbor more aggressive histomic and transcriptomic features than MRI‐invisible csPCas. Thus, targeted biopsy of visible lesions may be sufficient for risk stratification in patients with a positive MRI.
Influenza Vaccination and Warfarin Anticoagulation: A Comparison of Subcutaneous and Intramuscular Routes of Administration in Elderly Men
Authors: Delafuente Jeffrey C. , Davis Judith A. , Meuleman John R. , Jones Ronald A. 
Published: September 2023

Study Objectives. To determine if subcutaneous administration of influenza vaccine is as immunogenic as the intramuscular route, and to evaluate the frequency of local adverse events associated with both routes in elderly anticoagulated men.Design. Single‐blind, prospective study of consecutively enrolled subjects.Setting. Ambulatory clinic at a university‐affiliated Veterans Affairs medical center.Patients. Twenty‐six men age 60 years or older, receiving therapeutic dosages of warfarin.Interventions. Subjects were randomized to receive either intramuscular or subcutaneous injection of a standard trivalent influenza vaccine.Measurements and Main Results. Serum antibody titers to the vaccine's components were measured at baseline, and 6 weeks and 4 months after vaccination. Both routes of administration induced comparable serum antibody titers. There were no differences in adverse events at administration sites between routes of administration.Conclusions. Elderly individuals are able to mount an immune response to influenza vaccine and produce antibody concentrations deemed protective. The routes of administration are similarly effective at inducing an immune response. The intramuscular route in anticoagulated elderly men does not commonly result in local bleeding complications.
Bioavailability of Phenytoin Acid and Phenytoin Sodium with Enteral Feedings
Authors: Doak Karen K. , Haas Curtis E. , Dunnigan Karin J. , Reiss Robert A. , Reiser Janet R. , Huntress Jeff , Altavela Jeanette L. 
Published: September 2023

Study Objective. To compare the absolute bioavailability of phenytoin (PHT) sodium solution and PHT acid suspension in healthy volunteers receiving continuously infused enteral feedings.Design. Randomized, open‐label, single‐dose, three‐period crossover study.Setting. University clinical research center.Subjects. Ten healthy volunteers age 23–43 years.Interventions. The three phases of the study were separated by at least 7 days. During phase A, subjects received PHT sodium 435 mg intravenously over 30 minutes. During phases B and C, subjects had a nasogastric feeding tube placed through which PHT acid suspension 400 mg and PHT sodium solution 435 mg were administered, respectively. For phases B and C, continuous enteral feedings were given by feeding tube for 14 hours before and after the PHT dose. Blood samples were collected over 72 hours after each PHT dose, and the serum was analyzed for PHT.Measurements and Main Results. The rate and extent of PHT absorption and PHT pharmacokinetics were determined using an empirical quadratic function of time method. Bioavailability, rate of absorption, maximum concentration (Cmax), and time to maximum concentration (Tmax) were compared for the two enteral doses by paired Student's t test. There were no significant differences in bioavailability for PHT acid suspension and PHT sodium solution (0.88 ± 0.15 vs 0.91 ± 0.7, p=0.57, 90% CI −0.14–0.071). The Cmax was greater (7.4 ± 0.9 mg/L vs 5.5 ± 1.7 mg/L, p=0.019) and Tmax was less (2.5 ± 3.8 vs. 14.8 ± 11.2 hrs, p=0.004) for the sodium solution. The time to 50% fractional absorption (0.33 ± 0.08 vs 3.2 ± 2.4 hrs, p=0.004) and 90% fractional absorption (7.9 ± 6.2 vs 22.3 ± 17.2 hrs, p=0.021) was also significantly shorter for the sodium solution.Conclusion. The absolute bioavailability of the two dosage forms of PHT administered with concomitant enteral feedings were not significantly different, however, the absorption patterns were significantly different, with the sodium solution being more rapidly absorbed.
AOMadillo: A program for fitting angular overlap model parameters
Authors: Buchhorn Moritz , Krewald Vera 
Published: September 2023

AbstractThe angular overlap model (AOM) is an established parameterization scheme within ligand field theory (LFT). In principle, its application is fairly straightforward, but can be tedious and involve a trial‐and‐error approach to identify and judge the best set of parameters. With the availability of quantum chemical methods to predict d‐d transitions in transition metal complexes, a rich source of computational spectroscopic data with unambiguous assignments to electronic states is available. Herein, we present AOMadillo, a software package that is designed to interface the output of ab initio LFT calculations from the ORCA suite of programs and performs a least‐squares fit for a chosen AOM parameterization. Many steps of the AOM parameterization are automated, so that scans of geometric parameters and evaluations of sets of similar complexes are convenient. The fitting routine is highly configurable, allowing the efficient evaluation of different parameter sets.
Ap4s1 truncation leads to axonal defects in a zebrafish model of spastic paraplegia 52
Authors: Li Yiduo , Zhang Cuizhen , Peng Gang 
Published: September 2023

AbstractBiallelic mutations in AP4S1, the σ4 subunit of the adaptor protein complex 4 (AP‐4), lead to autosomal recessive spastic paraplegia 52 (SPG52). It is a subtype of AP‐4‐associated hereditary spastic paraplegia (AP‐4‐HSP), a complex childhood‐onset neurogenetic disease characterized by progressive spastic paraplegia of the lower limbs. This disease has so far lacked effective treatment, in part due to a lack of suitable animal models. Here, we used CRISPR/Cas9 technology to generate a truncation mutation in the ap4s1 gene in zebrafish. The ap4s1 truncation led to motor impairment, delayed neurodevelopment, and distal axonal degeneration. This animal model is useful for further research into AP‐4 and AP‐4‐HSP.
A health systems assessment of genetic counseling in cardiovascular care in a large health system: Adherence to genetics recommendations in the Military Health System
Authors: Hellwig Lydia D. , Banaag Amanda , Olsen Cara , Turner Clesson , Haigney Mark , Koehlmoos Tracey 
Published: September 2023

AbstractGenetic counseling and genetic testing are important tools for diagnosis, screening, and employment of effective medical management strategies for hereditary cardiovascular diseases. Despite widespread recognition of the benefits of genetic counseling and testing in cardiovascular care, little is published regarding their use in large healthcare systems. We conducted a retrospective cross‐sectional study using administrative claims data in the US Military Health System to assess the state of recommended genomic counseling in clinical cardiovascular care. Logistic regression models were used to examine associations of genetic counseling among beneficiaries with hereditary cardiovascular conditions. Approximately 0.44% of beneficiaries in fiscal year 2018 had a diagnosis of a hereditary cardiovascular condition. Among the 23,364 patients with a diagnosis of hereditary cardiovascular disease, only 175 (0.75%) had documented genetic counseling and 196 (0.84%) had documented genetic testing. Genetic counseling did not differ by race, sex, service, or diagnosis. Age group, Active Duty status, rank as a proxy for socioeconomic status, and geographic location contributed significantly to the likelihood of receiving genetic counseling. These findings suggest that genetic counseling is underutilized in clinical cardiovascular care in the Military Health System and may be more broadly, despite expert consensus recommendations for its use and potential life‐saving benefits. Unlike previous studies in the US civilian health sector, there did not appear to be disparities in genetic counseling by race or sex in the Military Health System. Strategies to improve care for cardiovascular disease should address the underutilization of recommended genetics evaluations for heritable diagnoses and the challenges of assessing use in large health systems studies.
Congruence of cycle lengths and chromatic number
Authors: Cordero‐Michel Narda , Galeana‐Sánchez Hortensia 
Published: September 2023

AbstractIn this paper we obtain the following upper bound for the chromatic number of a graph : Let be a connected graph with at least one cycle and an integer, with . If is the length of a longest cycle in whose length is congruent to 1 modulo , and is the length of a shortest cycle in whose length is congruent to 1 modulo , then . This generalizes a theorem by Diwan et al. Moreover, we give a polynomial time algorithm to get a proper coloring with such number of colors. Additionally, we give other upper bounds for the chromatic number of a graph, in terms of its cycle lengths. We also give a method to obtain the minimum , for which a graph satisfies the hypotheses of the following two outstanding theorems: (1) Let be a graph, if for some positive integer with contains no cycle of length 1 modulo , then is ‐colorable, Tuza; (2) Let be a graph, if contains no cycle of length modulo for some integers and with and , then is ‐colorable if and ‐colorable otherwise, Chen et al. So we get the best bound that each one of these two results allows.
Telehealth effectiveness for pre‐exposure prophylaxis delivery in Brazilian public services: the Combine! Study
Authors: Grangeiro Alexandre , Santos Lorruan Alves do , Estevam Denize Lotufo , Munhoz Rosemeire , Arruda Érico , de Moraes Renata Amaral , de Quadros Winkler Lisiane , Neves Lis Aparecida de Souza , Santos Juliane Cardoso Villela , Kruppa Mariele , Zucchi Eliana Miura , Escuder Maria Mercedes , Leal Andréa Fachel , Koyama Mitti Ayako Hara , Peres Maria Fernanda Tourinho , Couto Marcia Thereza , Neto José Eluf ,   The Combine! Research Group
Published: September 2023

AbstractIntroductionPre‐exposure prophylaxis (PrEP) delivery based on user needs can enhance PrEP access and impact. We examined whether telehealth for daily oral PrEP delivery could change the indicators of care related to prophylactic use in five Brazilian public HIV clinics (testing centres, outpatient clinics and infectious disease hospitals).MethodsBetween July 2019 and December 2020, clients on PrEP for at least 6 months could transition to telehealth or stay with in‐person follow‐up. Clients were clinically monitored until June 2021. A desktop or mobile application was developed, comprising three asynchronous consultations and one annual in‐person consultation visit. Predictors influencing telehealth preference and care outcomes were examined. The analysis encompassed intent‐to‐treat (first choice) and adjustments for sexual practices, schooling, age, duration of PrEP use and PrEP status during the choice period.ResultsOf 470 users, 52% chose telehealth, with the adjusted odds ratio (aOR) increasing over time for PrEP use (aOR for 25–months of use: 4.90; 95% CI: 1.32–18.25), having discontinued PrEP at the time of the choice (aOR: 2.91; 95% CI: 1.40–6.06) and having health insurance (aOR: 1.91; 95% CI: 1.24–2.94) and decreasing for those who reported higher‐risk behaviour (aOR for unprotected anal sex: 0.51; 95% CI: 0.29–0.88). After an average follow‐up period of 1.6 years (95% CI: 1.5–1.7), the risk of discontinuing PrEP (not having the medication for more than 90 days) was 34% lower with telehealth (adjusted hazard ratio: 0.66; 95% CI: 0.45–0.97). When adjusted by mixed linear regression, no differences in adherence (measured by mean medication possession rate) were found between in‐person and telehealth (p = 0.486) or at pre‐ and post‐telehealth follow‐ups (p = 0.245). Sexually transmitted infections increased between the pre‐follow‐up and post‐follow‐up choices and were not associated with in‐person or telehealth (p = 0.528). No HIV infections were observed.ConclusionsOur findings indicate that telehealth for PrEP delivery can enhance service rationalization and reinforce the prevention cascade. This approach reduces prophylaxis interruptions and is mainly preferred by individuals with lower demands for healthcare services.
Prisoners' reasons for denial of guilt for their alleged crimes during interrogation and factors related to their denial
Authors: Wachi Taeko , Yokota Kaeko , Otsuka Yusuke , Hirama Kazuki , Watanabe Kazumi , Koyama Hiroki , Takamiya Eisuke , Suzuki Nozomu , Inozume Yusuke 
Published: September 2023

AbstractThis study investigated predictive factors of prisoners' denial of guilt for their alleged crimes during interrogation. We administered a self‐reported questionnaire to new male prisoners who were convicted of theft and/or fraud and had denied the crime during interrogation. First, we analysed the reasons for their denial and identified factors of Anxiety and Refusal. Next, we investigated which interrogator's behaviour the prisoners believed had influenced their denial and identified three factors: Persuasion, Non‐Presentation of Evidence, and Confrontation. Finally, we examined whether the prisoners' denial at the conclusion of interrogation would be predicted by these factors, specifically in terms of the prisoners' reasons for denial, the interrogator's behaviour and the characteristics of the prisoners and their crimes. The results revealed that marital status, and Anxiety and Non‐Presentation of Evidence were predictive of denial at the conclusion of interrogation. Interrogators need to consider these factors when interviewing denying suspects.