bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does the Ranking Matter? A Retrospective Cohort Study Investigating the Impact of the 2018 CANMAT and ISBD Guidelines for the Management of Patients with Bipolar Disorder Treatment Recommendations for Acute Mania on Rehospitalization Rates
Authors: Gomes Fabiano A. , Dumay Henrique , Fagen Julia , Palma Natalie , Milev Roumen , Brietzke Elisa 
Published: February 2023

Objective There is limited data about the impact of mood disorders treatment guidelines on clinical outcomes. The objective of this study was to investigate the impact of prescribers’ adherence to the 2018 Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) treatment guidelines recommendations on the readmission rates of patients hospitalized for mania. Method A retrospective cohort of all individuals admitted due to acute mania to Kingston General Hospital, Kingston, ON, from January 2018 to July 2021 was included in this study. Patient variables and data regarding index admission and subsequent hospitalizations were extracted from medical records up to December 31, 2021. Treatment regimens were classified as first-line, second-line, noncompliant, or no treatment. We explored the associations between treatment regimens and the risk of readmissions using univariate, multivariate, and survival analysis. Results We identified 211 hospitalizations related to 165 patients. The mean time-to-readmission was 211.8 days (standard deviation [SD]  =  247.1); the 30-day rehospitalization rate was 13.7%, and any rehospitalization rate was 40.3%. Compared to no treatment, only first-line treatments were associated with a statistically significant decreased risk of 30-day readmission (odds ratio [OR] = 0.209; 95% CI, 0.058 to 0.670). The risk of any readmission was reduced by first-line (OR = 0.387; 95% CI, 0.173 to 0.848) and noncompliant regimens (OR = 0.414; 95% CI, 0.174 to 0.982) compared to no treatment. On survival analysis, no treatment group was associated with shorter time-to-readmission (log-rank test, p  =  0.014) and increased risk of readmission (hazard ratio = 2.27; 95% CI, 1.30 to 3.96) when compared to first-line medications. Conclusions Treatment with first-line medications was associated with lower 30-day rehospitalization rates and longer time-to-readmission. Physicians’ adherence to treatments with higher-ranked evidence for efficacy, safety, and tolerability may improve bipolar disorder outcomes.
Sodium-Glucose Cotransporter 2 Inhibitors Among Heart Failure With Mildly Reduced and Preserved Ejection Fraction
Authors: Cheng Judy W. M. , Colucci Vincent , Kalus James S. , Spinler Sarah A. 
Published: February 2023

Objective: Results from large placebo-controlled randomized trials in patients with heart failure with mid-range ejection fraction (HFmrEF) and HF with preserved EF (HFpEF) have become available recently. This article discusses results of these clinical trials. Data Sources: Peer-reviewed articles were identified from MEDLINE (1966 to December 31, 2022) using search terms dapagliflozin, empagliflozin, SGLT-2Is, HFmrEF, and HFpEF. Study Selection and Data Extraction: Eight completed, pertinent clinical trials were included. Data Synthesis: EMPEROR-Preserved, and DELIVER demonstrated that empagliflozin and dapagliflozin reduce CV death and heart failure hospitalization (HHF) in patients with HFmrEF and HFpEF, with/without diabetes when added to a standard heart failure (HF) regimen. The benefit is primarily due to reduction in HHF. Additional data from post hoc analyses of trials of dapagliflozin, ertugliflozin, and sotagliflozin suggest that these benefits may be a class effect. Benefits appear greatest in patients with left ventricular ejection fraction 41% up to about 65%. Relevance to Patient Care and Clinical Practice: While many pharmacologic treatments have been proven to reduce mortality and improve cardiovascular (CV) outcomes in people with HFmrEF and HF with reduced EF (HFrEF), there are few therapy which improve CV outcome in people with HFpEF. SGLT-2I become one of the first class of pharmacologic agent that can be used to reduce HHF and CV mortality. Conclusion: Studies showed that empagliflozin and dapagliflozin reduce the combined risk of CV death or HHF in patients with HFmrEF and HFpEF when added to a standard HF regimen. Given that benefit has now been demonstrated across the spectrum of HF, SGLT-2Is should be considered one of the standard HF pharmacotherapy.
Tracking a Fatal Disease: Lower Limb Gas Gangrene's Mortality-Related Factors
Authors: Mahjoubi Mohamed Farès , Rezgui Bochra , Maatouk Mohamed , Essid Nada , Karoui Yasser , Kandara Hajer , Moussa Mounir Ben 
Published: February 2023

Introduction Because of its rarity compared to dry and wet gangrene of the lower limb, the gaseous form has often been considered as the most severe form of gangrenous disease. We aimed to report clinical, paraclinical, and therapeutic features, and to identify mortality risk factors of gas gangrene of the lower limb. Patients and Methods We conducted a one-center case series retrospective study over a period of 13 years from January 2006 to December 2018. Results A total of 19 patients were included: 12 men, 7 women. Mean age was 59.3  ±  11.3 years. There were 17 diabetic patients and one patient was on radio-chemotherapy for lower rectal cancer. Septic shock was initially present in 4 cases. Hyperleukocytosis was noted in 17 patients. C-reactive protein was elevated in 11 patients. All patients were put on antibiotics then operated on. A total of 8 patients died postoperatively (42%) in an average time of 9.6 days after surgery. On univariate analysis, factors associated with mortality were: Septic shock on admission (p  =  0.02); local signs limited to foot (p  =  0.05) or extended above the knee (p  =  0.02); leukocytosis (p  =  0.005); glycemia level (p  =  0.02); antibiotic therapy duration (p  =  0.04); antibiotic association of Penicillin G, metronidazole, and gentamicin (p  =  0.02); amputation procedure solely (p  =  0.04) or debridement procedure without amputation (p  =  0.05); intraoperative transfusion (p  =  0.006); and hospital stay (p  =  0.01). Conclusion Identifying gas gangrene mortality factors is fundamental to standardize management. Our study was able to build on the small size of our series, but further prospective and large-scale studies are required.
Treatment of stent rupture after endovascular treatment of superior mesenteric aneurysm with open surgery
Authors: He Yiwei , Zhang Jun , Li Gangzhi , Zhou Haining 
Published: February 2023

Background The progress of visceral artery aneurysms (VAAs) after the endovascular repair of artery aneurysms is often accompanies by the potential risks of stent fracture. The clinical reported cases of VAAs stent fractures with stent displacement were extremely rare but severe complication, particularly for the superior mesenteric artery aneurysm (SMAA). Method We here reported a 62-year-old female patient with recurrent symptoms of SMAA 2 years after the successful endovascular repair using coil embolization and two partial overlapping stent-grafts in SMAA. The open surgery was performed instead of secondary endovascular intervention. Result and conclusion The patient experienced a good recovery. As one of the complications after endovascular repair, stent fracture maybe more dangerous than SMAA itself, the stent fracture after endovascular repair treated by open surgery with satisfactory results is alternative and feasible.
Patient and provider perspectives on barriers and facilitators to reproductive healthcare access for women experiencing homelessness with substance use disorders in San Francisco
Authors: Schmidt Christina N , Wingo Erin E , Newmann Sara J , Borne Deborah E , Shapiro Brad J , Seidman Dominika L 
Published: February 2023

Background: Women experiencing homelessness with substance use disorders face unique and intersecting barriers to realizing their reproductive goals. Objective: This study explored the reproductive aspirations of this population, as well as the barriers to accessing reproductive services from the perspectives of affected individuals, and the healthcare providers who serve them. Design: This mixed-methods study included surveys and interviews with women experiencing homelessness with substance use disorders and healthcare providers. Methods: We conducted surveys and semi-structured interviews with women recruited from opiate treatment programs and homeless encampments in San Francisco, California in 2018. We also conducted interviews and focus groups with healthcare providers in reproductive health and substance use treatment settings. Interviews were recorded, transcribed, and coded. Descriptive statistics of survey results were performed. Results: Twenty-eight women completed surveys, 96% of whom reported current substance use. Ten women participated in interviews. One-third (9/28) reported desiring pregnancy in the next year; over half (16/28) reported they would be somewhat or very happy to learn they were pregnant. A majority used no contraception at last intercourse (14/28). Twenty-six healthcare providers participated in interviews (n = 15) and focus groups (n = 2). Patients and providers identified similar barriers to care access, including discrimination, logistical and financial challenges, and delayed pregnancy awareness. While providers proposed solutions focused on overcoming logistical challenges, patients emphasized the importance of transforming the healthcare environment to treat patients affected by substance use and homelessness with dignity and respect. Conclusion: Women experiencing homelessness with substance use disorders face intersecting and compounding barriers to accessing reproductive health services. For patients, the impact of stigma and bias on treatment experiences are particularly salient, in contrast to logistical barriers emphasized by providers. Improving access will require structural and individual-level solutions to address stigma and create person-centered, trauma-informed, and respectful care environments.
Healthcare use and medical cost before and after diagnosis of nontuberculous mycobacterial infection in Korea: the National Health Insurance Service-National Sample Cohort Study
Authors: Lee Seung Won , Chang Shihwan , Park Youngmok , Kim Sol , Sohn Hojoon , Kang Young Ae 
Published: February 2023

Background and objective: The global prevalence and incidence of nontuberculous mycobacterial (NTM) infections are increasing; however, population-level data on healthcare use and medical costs for people with NTM infections are limited. Thus, we investigated the rates of healthcare use and medical costs of people with NTM infections in South Korea using the National Health Insurance Service-National Sample Cohort from 2002 to 2015. Methods: In this cohort study, people with and without NTM infection aged 20–89 years were matched 1 to 4 by sex, age, Charlson comorbidity index, and year of diagnosis. The overall and annual average healthcare use and medical costs were calculated. In addition, trends in healthcare use and medical costs for each of the 3 years before and after NTM diagnosis were investigated for people diagnosed with NTM infection. Results: A total of 798 individuals (336 men and 462 women) diagnosed with NTM infection and 3192 controls were included in the study. NTM-infected patients had significantly higher rates of healthcare use and medical costs than those in the control group ( p < 0.05). NTM-infected patients showed 1.5 times the medical cost and 4.5 times the respiratory disease cost of the control group. People diagnosed with NTM infection incurred the highest medical costs in the 6 months before diagnosis. Conclusion: NTM infection increases the economic burden on Korean adults. Appropriate diagnostic tests and treatment plans for NTM infections are needed to reduce the burden of the disease caused by such infection.
Treadmill Exercise Suppresses Histological Progression of Disuse Atrophy in Articular Cartilage in Rat Knee Joints during Hindlimb Suspension
Authors: Takahashi Ikufumi , Matsuzaki Taro , Kuroki Hiroshi , Hoso Masahiro 
Published: February 2023

ObjectiveThe purpose of this study was to determine the preventive effects of treadmill exercise or physiological loading on disuse atrophy in the rat knee joint cartilage and bone during hindlimb suspension.DesignTwenty male rats were divided into 4 experimental groups, including the control, hindlimb suspension, physiological loading, and treadmill walking groups. Histological changes in the articular cartilage and bone of the tibia were histomorphometrically and immunohistochemically evaluated 4 weeks after the intervention.ResultsCompared with the control group, the hindlimb suspension group showed thinning of cartilage thickness, decreased matrix staining, and decreased proportion of noncalcified layers. Cartilage thinning, decreased matrix staining, and decreased noncalcified layers were suppressed in the treadmill walking group. The physiological loading group exhibited no significant suppression of cartilage thinning or decreased noncalcified layers, but the decreased matrix staining was significantly suppressed. No significant prevention of bone mass loss or changes in subchondral bone thickness were detected after physiological loading or treadmill walking.ConclusionDisuse atrophy of the articular cartilage caused by unloading conditions could be prevented by treadmill walking in rat knee joints.
Observational Analysis of a Generalized, Health Plan-led Community Health Worker Intervention in Medicaid
Authors: Gordon Aliza S. , Oakes Allison H. , Allender Rebeca , Vang Lucida , Hennemann Beau , Chi Winnie C. 
Published: February 2023

Introduction/Objectives: In 2018, a Medicaid managed care plan launched a new community health worker (CHW) initiative in several counties within a state, designed to improve the health and quality of life of members who could benefit from additional services. The CHW program involved telephonic and face-to-face visits from CHWs who provided support, empowerment, and education to members, while identifying and addressing health and social issues. The primary objective of this study was to evaluate the impact of a generalized (not disease-specific), health plan-led CHW program on overall healthcare use and spending. Methods: This retrospective cohort study used data from adult members who received the CHW intervention (N = 538 participants) compared to those who were identified for participation but were unable to be reached (N = 435 nonparticipants). Outcomes measures included healthcare utilization, including scheduled and emergency inpatient admissions, emergency department (ED) visits, and outpatient visits; and healthcare spending. The follow-up period for all outcome measures was 6 months. Using generalized linear models, 6-month change scores were regressed on baseline characteristics to adjust for between-group differences (eg, age, sex, comorbidities) and an indicator for group. Results: Program participants experienced a greater increase in outpatient evaluation and management visits (0.09 per member per month [PMPM]) than the comparison group during the first 6 months of the program. This greater increase was observed across in-person (0.07 PMPM), telehealth (0.03 PMPM), and primary care (0.06 PMPM) visits. There was no observed difference in inpatient admissions, ED utilization or allowed medical spending and pharmacy spending. Conclusions: A health plan-led CHW program successfully increased multiple forms of outpatient utilization in a historically disadvantaged population of patients. Health plans may be particularly well positioned to finance, sustain, and scale programs that address social drivers of health.
SMEs filing for bankruptcy in Spain: The best of luck!
Authors: Sánchez-Vidal F Javier , García Marí José Horacio , Madrid-Guijarro Antonia 
Published: February 2023

The aim of this work is to analyze the factors that help companies avoid liquidation following the spirit of the Spanish insolvency law. This work focuses on the phase starting when companies file for bankruptcy and ending with the completion of the common phase. We apply the agency theory to explain how insolvency administrators and court characteristics influence the outcome of the bankruptcy process (liquidation or reorganization). We analyze unique accounting data from 2,627 companies that filed for bankruptcy during the period 2008–2014. The findings reveal the significant roles played by the liquidation trustee, Big 4 administrators, and higher remunerations, along with the type of court in charge. Processes are more likely to result in reorganization if they are handled by specialized courts, managed by the Big 4, and if the insolvency administrator has longer experience in bankruptcy filing and receives a higher remuneration. These findings have important implications for all the agents involved. It is necessary to rationalize the filing process, foment better training for insolvency administrators, provide courts with more funds, and create more specialized courts. The principal contribution of this article is to examine the role played by insolvency administrators and the courts, and their influence on the outcome of the insolvency process. JEL CLASSIFICATION C35; D21; D22; G33; G38
Conservatively transmitted alleles of key agronomic genes provide insights into the genetic basis of founder parents in bread wheat (Triticum aestivum L.)
Authors: Li Chang , Zhuang Lei , Li Tian , Hou Jian , Liu Hongxia , Jian Chao , Li Huifang , Zhao Jing , Liu Yunchuan , Xi Wei , Hao Pingan , Liu Shujuan , Si Xuemei , Wang Xiaolu , Zhang Xueyong , Hao Chenyang 
Published: February 2023

Abstract
Background
Founder parents play extremely important roles in wheat breeding. Studies into the genetic basis of founder parents and the transmission rules of favorable alleles are of great significance in improving agronomically important traits in wheat.

Results
Here, a total of 366 founder parents, widely grown cultivars, and derivatives of four representative founder parents were genotyped based on efficient kompetitive allele-specific PCR (KASP) markers in 87 agronomically important genes controlling yield, quality, adaptability, and stress resistance. Genetic composition analysis of founder parents and widely grown cultivars showed a consistently high frequency of favorable alleles for yield-related genes. This analysis further showed that other alleles favorable for resistance, strong gluten, dwarf size, and early heading date were also subject to selective pressure over time. By comparing the transmission of alleles from four representative founder parents to their derivatives during different breeding periods, it was found that the genetic composition of the representative founder parents was optimized as breeding progressed over time, with the number and types of favorable alleles carried gradually increasing and becoming enriched. There are still a large number of favorable alleles in wheat founder parents that have not been fully utilized in breeding selection. Eighty-seven agronomically important genes were used to construct an enrichment map that shows favorable alleles of four founder parents, providing an important theoretical foundation for future identification of candidate wheat founder parents.

Conclusions
These results reveal the genetic basis of founder parents and allele transmission for 87 agronomically important genes and shed light on breeding strategies for the next generation of elite founder parents in wheat.
The Integrated Electronic Health System in Iranian health centers: benefits and challenges
Authors: Kalkhajeh Sasan Ghorbani , Aghajari Azam , Dindamal Behnaz , Shahvali-Kuhshuri Zohreh , Faraji-Khiavi Farzad 
Published: February 2023

Abstract
Background
Electronic Health Records (EHRs) were introduced to all Iranian medical universities in 2015 with the launch of Integrated Electronic Health System (which is known as SIB: a Persian backronym in Persian meaning apple), and a number of studies were conducted on SIB. However, most of these studies did not consider the benefits and challenges of adopting SIB in Iran. Therefore, the present study aimed to identify the benefits and challenges of SIB in health centers of Khuzestan Province, Iran.

Methods
This was a qualitative study using qualitative conventional content analysis conducted on 6 experts and 24 users of SIB in six health centers of three cities in Khuzestan province, Iran. The participants were selected using a purposeful sampling method. Maximum variation was considered in selecting the group of users, and snowball sampling was used in the group of experts. Data collection tool was semi-structured interview. Data analysis was performed using thematic analysis.

Results
Overall, 42 components (24 for benefits and 18 for challenges) were extracted from the interviews. Common sub-themes and themes were identified for challenges and benefits. The components formed 12 sub-themes, and they were placed in 3 main themes, namely structure, process and outcome. 1) Structure included four sub-themes of Financial resources, Human resources, Facilities, and Access to the Internet; 2) Process involved three sub-themes of Training, Providing services, and Time and workload; and 3) Outcome incorporated five sub-themes of Quality of health services, Access, Safety and personal distance, Screening and evaluation, and Research.

Conclusions
In the present study, the benefits and challenges of adopting SIB were examined in three themes: structure, process, and outcome. Most of the identified benefits were related to the theme of outcome, and most of the identified challenges were related to the theme of structure. Based on the identified factors, by strengthening the benefits of SIB and also trying to eliminate or reduce its challenges, it is possible to institutionalize and use it more effectively in order to solve health problems.
A comprehensive computational analysis to explore the importance of SIGLECs in HCC biology
Authors: Yao Senbang , Chen Wenjun , Chen Tingting , Zuo He , Bi Ziran , Zhang Xiuqing , Pang Lulian , Jing Yanyan , Yin Xiangxiang , Cheng Huaidong 
Published: February 2023

Abstract
Background
Hepatocellular carcinoma (HCC) is an aggressive, malignant cancer with a complex pathogenesis. However, effective therapeutic targets and prognostic biomarkers are limited. Sorafenib provides delaying cancer progression and survival improvement in advanced HCC. But despite 10 years of research on the clinical application of sorafenib, predictive markers for its therapeutic effect are lacking.

Methods
The clinical significance and molecular functions of SIGLEC family members were assessed by a comprehensive bioinformatic analysis. The datasets included in this study (ICGC-LIRI-JP, GSE22058 and GSE14520) are mainly based on patients with HBV infections or HBV-related liver cirrhosis. The TCGA, GEO, and HCCDB databases were used to explore the expression of SIGLEC family genes in HCC. The Kaplan–Meier Plotter database was used to evaluate relationships between the expression levels of SIGLEC family genes and prognosis. Associations between differentially expressed genes in the SIGLEC family and tumour-associated immune cells were evaluated using TIMER.

Results
The mRNA levels of most SIGLEC family genes were significantly lower in HCC than in normal tissues. Low protein and mRNA expression levels of SIGLECs were strongly correlated with tumour grade and clinical cancer stage in patients with HCC. Tumour-related SIGLEC family genes were associated with tumour immune infiltrating cells. High SIGLEC expression was significantly related to a better prognosis in patients with advanced HCC treated with sorafenib.

Conclusions
SIGLEC family genes have potential prognostic value in HCC and may contribute to the regulation of cancer progression and immune cell infiltration. More importantly, our results revealed that SIGLEC family gene expression may be used as a prognostic marker for HCC patients treated with sorafenib.