bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of the American Rescue Plan Act on racial equity in health insurance coverage
Authors: Katsikas Aina , Mukhopadhyay Sankar 
Published: May 2023

AbstractObjectiveTo evaluate the effects on racial disparities in health insurance coverage from the changes in the Premium Tax Credit (PTC) implemented in March 2021 as part of the American Rescue Plan Act (ARPA).Data Sources and Study SettingWe use nationally representative individual‐level data from the Household Pulse Survey (HPS), which provides demographic, economic, and health insurance information for United States residents during the period April 2020–August 2022.Study DesignWhile the PTC changes applied to all states, the 14 states that did not expand Medicaid received substantially more benefits than the expansion states since they had more uninsured individuals eligible for the PTC than the expansion states. In our analysis, the treatment (control) group includes all Medicaid nonexpansion (expansion) states. We use a difference‐in‐difference regression analysis to estimate the increase in the probability of insurance coverage after the expansion of the PTC. Furthermore, we conduct sensitivity and heterogeneity analyses.Data Collection/Extraction MethodsWe focus on survey respondents ages 18–64.Principal FindingsThe expanded PTC increased the probability of an individual having coverage through the Health Insurance Exchange (HIX) in a nonexpansion state by 0.95 (95% CI: 0.6136, 1.2900), 1.75 (95% CI: 1.1795, 2.3291), and 1.75 (95% CI: 1.1815, 2.3269) percentage points among White, Black, and Hispanic respondents, respectively. It also increased overall health insurance coverage among all groups.ConclusionsThe expanded PTC boosted HIX and overall health insurance coverage and reduced racial disparities.
Implementation of an integrated emergency department acute atrial fibrillation pathway safely reduces cardioversions and hospitalisations: A comparative pre–post study
Authors: Addy Kaleb , Joyce Laura R , Al‐Busaidi Ibrahim S , Pickering John W , Troughton Richard , Than Martin 
Published: May 2023

AbstractObjectiveAtrial fibrillation/flutter (AF/AFL) accounts for high rates of ED presentations and hospital admissions. There is increasing evidence to suggest that delaying cardioversion for acute uncomplicated AF is safe, and that many patients will spontaneously revert to sinus rhythm (SR). We conducted a before‐and‐after evaluation of AF/AFL management after a change in ED pathway using a conservative ‘rate‐and‐wait’ approach, incorporating next working day outpatient clinic follow‐up and delayed cardioversion if required.MethodsWe performed a before‐and‐after retrospective cohort study examining outcomes for patients who presented to the ED in Christchurch, New Zealand, with acute uncomplicated AF/AFL in the 1‐year period before and after the implementation of a new conservative management pathway.ResultsA total of 360 patients were included in the study (182 ‘Pre‐pathway’ vs 178 ‘Post‐Pathway’). Compared to the pre‐pathway cohort, those managed under the new pathway had an 81.2% reduction in ED cardioversions (n = 32 vs n = 6), and 50.7% reduction in all cardioversions (n = 65 vs n = 32). There was a 31.6% reduction in admissions from ED (n = 54 vs n = 79). ED length of stay (3.9 h vs 3.8 h, net difference −0.1 h, 95% confidence interval [CI] −0.6 to 0.3), 1‐year ED AF representation (32.4% vs 26.4%, net difference −6.0% [95% CI −16.0% to 3.9%]), 1‐year ED ischaemic stroke presentation (2.2% in both groups) and 7‐day all‐cause mortality rates (hazard ratio 1.05 [95% CI 0.6 to 1.9]) were all similar.ConclusionsUsing a conservative ‘rate‐and‐wait’ strategy with early follow‐up for patients presenting to ED with AF/AFL can safely reduce unnecessary cardioversions and avoidable hospitalisations.
Research in interventional oncology: How sound is the evidence base?
Authors: Kaufmann Nathalie C , Zeka Bleranda , Pereira Philippe L 
Published: May 2023

AbstractIntroductionInterventional oncology (IO) is an essential component of cancer care, which has gained substantial recognition in recent years. The aim of this review is to evaluate the level of evidence supporting IO and its inclusion in cancer treatment guidelines.MethodsA literature search of the PubMed database was performed to identify publication numbers and types for IO treatments published between 2012 and 2022. Selected cancer treatment guidelines and recommendations were reviewed for their inclusion of IO treatments.ResultsWith 68%, the majority of studies on IO treatments are case reports while randomised controlled trials (RCTs) amount only to 7% of studies. Despite this, IO studies have generated sufficient data to support the inclusion of IO treatments in cancer treatment guidelines and recommendations. This was frequently based on large prospective patient cohorts that corresponded to 24% (20% non‐randomised studies and 4% observational studies) of all analysed studies rather than RCTs.ConclusionThe level of evidence underpinning IO, as well as inclusion of IO in treatment guidelines and recommendations have increased substantially in recent years, indicating the growing importance and acceptance of IO in cancer care. The difficulty in conducting RCTs in IO is mitigated by the observation that they are not necessary to achieve guideline‐inclusion. Nevertheless, it is crucial to conduct well‐designed research projects to further consolidate the position of IO in the field of oncology. This will ensure that IO continues to evolve and meet the needs of cancer patients worldwide.
2015/16 El Niño increased water demand and pushed plants from a Mesic tropical montane grassland beyond their hydraulic safety limits
Authors: Matos Ilaíne Silveira , Rifai Sami W. , Rosado Bruno H. P. 
Published: May 2023

AbstractIn 2015/16, a strong El Niño event caused anomalously high temperatures and reduced precipitation resulting in Pantropical drought‐induced diebacks and wildfires. Although many studies have documented the El Niño impacts on tropical forests, little we know about its effects on tropical grasslands. Here, we investigated plant drought responses during and after the 2015/16 El Niño event (Jun 2016 to Aug 2017) in 12 species with contrasting drought strategies (tolerance, avoidance and escape) in a Brazilian tropical montane grassland. We tested if (1) the El Niño event induced meteorological drought anomalies, (2) the atmospheric and/or soil drought led to plant water stress and (3) plants showed signs of drought recovery. In contrast to other tropical areas, we found that the 2015/16 El Niño event did not strongly affect precipitation in our study site. However, it increased air temperature and vapour pressure deficit, thus pushing all grassland species, even the most drought‐tolerant ones, beyond their hydraulic safety margins during the dry season. Most species showed signs of drought recovery, returning to positive hydraulic margins in the wet season after the El Niño. However, the finding that all evaluated species, regardless of their drought‐response strategy, are already operating close to their hydraulic safe thresholds for stomatal closure and turgor loss suggests that this cool–humid tropical montane grassland is especially vulnerable to meteorological extremes exacerbated by the additive effects of El Niño and climate change.
Modelling of fossil and contemporary data suggest the Broad‐toothed rat (Mastacomys fuscus) currently occupies a small part of its available climatic niche: Implications of paleontological data for conservation of a threatened species
Authors: McDowell Matthew C. , Morris Shane D. , Johnson Christopher N. , Martin Brianna , Brook Barry W. 
Published: May 2023

AbstractWe use fossil, sub‐fossil and contemporary records of the Broad‐toothed rat, Mastacomys fuscus, to model changes in its range over the last 21 thousand years. Mastacomys fuscus was exposed to, and flourished in, a much broader range of environmental conditions in the recent past than it occupies today. It also currently occupies a much smaller range than it did in the Late Pleistocene. Apart from a weak response to sea‐level rise in the Holocene, the decline of M. fuscus does not correlate with known climate change. Instead, the contraction of the species' distribution on mainland Australia to high‐elevation areas occurred recently and rapidly. Small changes in the 1000 year BP and present‐day projected distributions imply some contraction of the area of suitable climate to higher elevations of the mainland subspecies M. f. mordicus, up to 2200 m above sea level. However, M. f. mordicus also persists near sea level at Cape Otway (southwestern Victoria) and from sea level to 1500 m above sea level at Barrington Tops (eastern New South Wales, Australia). This suggests suitable habitat may still exist in coastal Victoria and the central Tablelands/Blue Mountains areas. This research highlights the importance and value of using sub‐fossil data to understand changes in the distribution and niche occupation of threatened species as the basis for conservation planning.
Potentially inappropriate medications and potential prescribing omissions in hospitalised older adults in New Zealand: A retrospective study
Authors: Mohammed Mohammed A. , Chan Amy Hai Yan , Chan Stephanie , Ungureanu Bianca , Seo Hakmi , Ong Patrick , Morrison Caitlyn , Martini Nataly 
Published: May 2023

AbstractObjectiveMedication errors can have detrimental effects on patient outcomes, yet there are limited data on the prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) among older adult inpatients in New Zealand (NZ). This study investigated exposure to PIMs and PPOs in older adults in a New Zealand hospital.MethodsElectronic medical records of 846 older adults (≥ 65 years) discharged from the Auckland District Health Board between June 2020 and May 2021 were retrospectively reviewed to extract data on sociodemographic, medication and diagnostic information. STOPP/START version 2 was used to evaluate PIMs and PPOs on admission and discharge.ResultsThe mean age was 77.47 ± 8.12 years, and 51% were female. On admission, 48% had ≥1 PIMs and 40% had ≥1 PPOs. On discharge, 45% had ≥1 PIMs and 40% had ≥1 PPOs. Increasing age (adjusted odds ratio [AOR] = 1.02, 95% CI [confidence interval] 1.01, 1.04), number of medicines (AOR = 1.23, CI 1.17, 1.29) and 28‐day admission history (AOR = 1.58, CI 1.15, 2.18) were associated with higher odds of PIMs use on admission. At discharge, the number of medicines (AOR = 1.19, CI 1.13, 1.25) and history of readmission (AOR = 1.47, CI 1.08, 2.02) were associated with higher odds of PIMs. Female patients had higher odds of PPOs both on admission (AOR = 1.35, CI 1.02, 1.78) and discharge (AOR = 1.34, CI 1.01, 1.78). Māori, Asian and Pacific patients were more likely to have prescribing omissions compared to NZ Europeans.ConclusionsPrescribing omissions and inappropriate medications were common in older inpatients. There were differences observed between different ethnic groups, with NZ Europeans having fewer omissions than other ethnic groups. These findings highlight key opportunities for health‐care providers to improve medication use in older adults in NZ.
Predictors of successful salvage microdissection testicular sperm extraction (mTESE) after failed initial TESE in patients with non‐obstructive azoospermia: A systematic review and meta‐analysis
Authors: Zhang Feng , Dai Mengyang , Yang Xinyuan , Cheng Yumeng , Ye Lijun , Huang Wensi , Chen Xi , Yin Tailang , Sha Yanwei 
Published: May 2023

AbstractBackgroundThere has been no systematic review and meta‐analysis to analyze and summarize the predictive factors of successful sperm extraction in salvage microdissection testicular sperm extraction.ObjectivesWe aimed to investigate the factors predicting the result of salvage microdissection testicular sperm extraction in patients with non‐obstructive azoospermia who failed the initial microdissection testicular sperm extraction or conventional testicular sperm extraction.Materials and methodsWe conducted a systematic literature search in PubMed, Web of Science, EMBASE, and the Cochrane Library for literature that described the characteristics of patients with non‐obstructive azoospermia who underwent salvage microdissection testicular sperm extraction after failing the initial microdissection testicular sperm extraction or conventional testicular sperm extraction published prior to June 2022.ResultsThis meta‑analysis included four retrospective studies with 332 patients with non‐obstructive azoospermia who underwent a failed initial microdissection testicular sperm extraction and three retrospective studies with 177 non‐obstructive azoospermia patients who underwent a failed conventional testicular sperm extraction. The results were as follows: among non‐obstructive azoospermia patients whose first surgery was microdissection testicular sperm extraction, younger patients (standard mean difference: −0.28, 95% confidence interval [CI]: −0.55 to −0.01) and those with smaller bilateral testicular volume (standard mean difference: −0.55, 95% CI: −0.95 to −0.15), lower levels of follicle‐stimulating hormone (standard mean difference: −0.86, 95% CI: −1.18 to −0.54) and luteinizing hormone (standard mean difference: −0.68, 95% CI: −1.16 to −0.19), and whose testicular histological type was hypospermatogenesis (odds ratio: 3.52, 95% CI: 1.30–9.53) were more likely to retrieve spermatozoa successfully, while patients with Sertoli‐cell‐only syndrome (odds ratio: 0.41, 95% CI: 0.24–0.73) were more likely to fail again in salvage microdissection testicular sperm extraction. Additionally, in patients who underwent salvage microdissection testicular sperm extraction after a failed initial conventional testicular sperm extraction, those with testicular histological type of hypospermatogenesis (odds ratio: 30.35, 95% CI: 8.27–111.34) were more likely to be successful, while those with maturation arrest (odds ratio: 0.39, 95% CI: 0.18–0.83) rarely benefited.ConclusionWe found that age, testicular volume, follicle‐stimulating hormone, luteinizing hormone, hypospermatogenesis, Sertoli‐cell‐only syndrome, and maturation arrest were valuable predictors of salvage microdissection testicular sperm extraction, which will assist andrologists in clinical decision‐making and minimize unnecessary injury to patients.
Gestational diabetes mellitus and time in active labor: A population‐based cohort study
Authors: Nevander Sofia , Carlhäll Sara , Källén Karin , Lilliecreutz Caroline , Blomberg Marie 
Published: May 2023

AbstractIntroductionWomen with gestational diabetes mellitus (GDM) have higher rates of adverse perinatal outcomes compared with women without GDM, including an increased risk for having labor induced and for cesarean section. The findings from previous studies analyzing duration of labor in women with GDM are contradictory.The aim of the study was to evaluate the impact of GDM on time in spontaneous and induced active labor.Material and methodsThis was a population‐based cohort study including 247 524 primiparous women who gave birth to a singleton fetus with cephalic presentation, ≥34+0 (completed gestational weeks + additional days) between January 2014 and May 2020 in Sweden. Data was obtained from the Swedish Pregnancy Register. Time in active labor was compared between women with GDM and without GDM with a spontaneous labor onset or induction of labor using Kaplan Meier survival analysis and Cox regression analysis.ResultsWomen with GDM had significantly longer time in active labor, both with a spontaneous onset and induction of labor compared to women without GDM. Women with GDM had a decreased chance of vaginal delivery at a certain time‐point compared to women without GDM, with adjusted hazard ratio of 0.92 (0.88–0.96) and 0.83 (0.76–0.90) for those with spontaneous onset and induction of labor, respectively. Women with GDM had increased risk for time in active labor ≥12 h both in spontaneous labor onset (adjusted odds ratio 1.14 [1.04–1.25]) and in induction of labor (adjusted odds ratio 1.55 [1.28–1.87]).ConclusionsWomen with GDM seem to spend a longer time in active labor, both in spontaneous and induced active labor compared to women without GDM. To be able to individualize care intrapartum, there is a need for more studies demonstrating the impact of hyperglycemia during pregnancy on outcomes during childbirth.
Extracorporeal CPR after the INCEPTION trial: No one steps twice into the same river
Authors: Scquizzato Tommaso , Yannopoulos Demetris , Bělohlávek Jan , Taccone Fabio S. , Lorusso Roberto , Scandroglio Anna Mara , Landoni Giovanni , Swol Justyna 
Published: May 2023

AbstractThe use of veno‐arterial extracorporeal membrane oxygenation as extracorporeal cardiopulmonary resuscitation in patients suffering out‐of‐hospital cardiac arrest, largely increased in the last decade despite evidence supporting this practice being limited to non‐randomized studies. However, between 2020 and 2023, four randomized studies were published comparing extracorporeal cardiopulmonary resuscitation to conventional cardiopulmonary resuscitation with controversial findings that triggered great debates. In this controversy, we discuss merits and pitfalls, and provide a critical interpretation of the available evidence from randomized trials on the use of extracorporeal cardiopulmonary resuscitation, with a particular focus on the recent multi‐center INCEPTION trial.
Outcomes of penile sarcomatoid squamous cell carcinoma from a single tertiary referral centre: a matched cohort study
Authors: Pang Karl H. , Girling Benedict , Osinibi Elizabeth , Sawhney Paramvir , Haider Aiman , Freeman Alex , Hadway Paul , Nigam Raj , Rees Rowland , Mitra Anita , Muneer Asif , Alifrangis Constantine , Alnajjar Hussain M. 
Published: May 2023

ObjectiveTo report the oncological survival outcomes of men with penile sarcomatoid squamous cell carcinoma (sSCC).Patients and MethodsA retrospective analysis of men with penile sSCC diagnosed between January 2010 and January 2020 in a single centre was conducted. Disease‐specific (DSS), recurrence‐free (RFS) and metastasis‐free (MFS) survival were evaluated. Outcomes were compared with a non‐sarcomatoid penile SCC cohort matched to age, type of surgery and tumour stage. Kaplan–Meier plots were used to estimate survival outcomes.ResultsIn all, 1286 men were diagnosed with penile SCC during the study period and of these 38 (3%) men had sSCC. The median (interquartile range) age and follow‐up was 70 (57–81) years and 16 (7–44) months, respectively. Operations performed included: circumcision, one (2.6%); wide local excision, four (10.5%); glansectomy, 11 (29%); partial penectomy, 10 (26%); subtotal/total penectomy, 12 (32%). The Kaplan–Meier estimated 12‐, 24‐ and 36‐month DSS was 62% (vs non‐sarcomatoid, 67%), 43% (vs non‐sarcomatoid, 67%) and 36% (vs non‐sarcomatoid, 67%), respectively (P = 0.03). The Kaplan–Meier estimated 12‐ and 24‐month RFS was 47% (vs non‐sarcomatoid, 60%) and 28% (vs non‐sarcomatoid, 55%), respectively (P = 0.01). The MFS was 52% (vs non‐sarcomatoid, 62%) at 12 months and 37% (vs non‐sarcomatoid, 57%) at 24 months (P = 0.04).ConclusionsSarcomatoid differentiation was associated with a lower DSS, RFS and MFS. Due to the rarity of its incidence and aggressiveness, expert histological review and multidisciplinary management is required in a specialist penile cancer centre.
Identification and characterization of the new generation soluble guanylate cyclase stimulator BAY‐747 designed for the treatment of resistant hypertension
Authors: Wunder Frank , Stasch Johannes‐Peter , Knorr Andreas , Mondritzki Thomas , Brockschnieder Damian , Becker‐Pelster Eva‐Maria , Sandner Peter , Tinel Hanna , Redlich Gorden , Hartung Ingo V. , Vakalopoulos Alexandros , Follmann Markus 
Published: May 2023

AbstractBackground and PurposeFirst‐generation soluble guanylate cyclase (sGC) stimulators have shown clinical benefit in pulmonary hypertension (riociguat) and chronic heart failure (vericiguat). However, given the broad therapeutic opportunities for sGC stimulators, tailored molecules for distinct indications are required.Experimental ApproachWe report the high‐throughput screening (HTS)‐based discovery of a second generation of sGC stimulators from a novel imidazo[1,2‐a]pyridine lead series. An intense medicinal chemistry programme resulted in the discovery of the sGC stimulator BAY 1165747 (BAY‐747). The pharmacokinetic profile of BAY‐747 was determined in different species, and it was broadly characterized in pharmacological model systems relevant for vasodilatation and hypertension.Key ResultsBAY‐747 is a highly potent sGC stimulator in vitro. In addition, BAY‐747 showed an excellent pharmacokinetic profile with long half‐life and low peak‐to‐trough ratio. BAY‐747 was investigated in experimental in vivo models of malignant and resistant hypertension (rHT). In spontaneously hypertensive (SH) rats, BAY‐747 caused a dose‐related and long‐lasting decrease in mean arterial blood pressure (MAP). Oral treatment over 12 days resulted in a persistent decrease. BAY‐747 provided additional benefit when dosed on top of losartan, amlodipine or spironolactone and even on top of triple combinations of frequently used antihypertensive drugs. In a new canine model of rHT, BAY‐747 caused a dose‐related and long‐lasting (>6 h) MAP decrease.Conclusion and ImplicationsBAY‐747 is a potent, orally available sGC stimulator. BAY‐747 shows long‐acting pharmacodynamic effects with a very low peak‐to‐trough ratio. BAY‐747 could be a treatment alternative for patients with hypertension, especially those not responding to standard‐of‐care therapy.
Exhaustivity and Anti‐Exhaustivity in the RSA Framework: Testing the Effect of Prior Beliefs
Authors: Cremers Alexandre , Wilcox Ethan G. , Spector Benjamin 
Published: May 2023

AbstractDuring communication, the interpretation of utterances is sensitive to a listener's probabilistic prior beliefs. In this paper, we focus on the influence of prior beliefs on so‐called exhaustivity interpretations, whereby a sentence such as Mary came is understood to mean that only Mary came. Two theoretical origins for exhaustivity effects have been proposed in the previous literature. On the one hand are perspectives that view these inferences as the result of a purely pragmatic process (as in the classical Gricean view, and more recent Bayesian approaches); on the other hand are proposals that treat them as the result of an encapsulated semantic mechanism (Chierchia, Fox & Spector 2012). We gain traction on adjudicating between these two approaches with new theoretical and experimental evidence, focusing on the behavior of different models for exhaustivity effects, all of which fit under the Rational Speech Act modeling framework (RSA, Frank & Goodman, 2012). Some (but not all!) of these models include an encapsulated semantic mechanism. Theoretically, we demonstrate that many RSA models predict not only exhaustivity, but also anti‐exhaustivity, whereby “Mary came” would convey that Mary and someone else came. We evaluate these models against data obtained in a new study which tested the effects of prior beliefs on both production and comprehension, improving on previous empirical work. We find that the models which have the best fit to human behavior include an encapsulated exhaustivity mechanism. We conclude that, on the one hand, in the division of labor between semantics and pragmatics, semantics plays a larger role than is often thought, but, on the other hand, the tradeoff between informativity and cost which characterizes all RSA models does play a central role for genuine pragmatic effects.