bluuebunny/crossref_metadata_2025_split huggingface dataset:
Magnitude and determinants of inpatient health expenditure among the elderly in India
Authors: Chatterjee Chandrima , Chandra Nayak Narayan , Mahakud Jitendra 
Published: December 2021

AbstractAs India is experiencing both the epidemiological and demographic transition, the grey population is expected to incur huge expenditure on health care, especially hospitalization expenditure, in the coming decades. The present study, thus, examines the magnitude of different types of inpatient health expenditure (medical, non‐medical, total and out‐of‐pocket expenditure) and factors affecting them among the Indian elderly, using a health expenditure model empirically tested by the World Health Organization. Data were drawn from the 75th Round of the Health Survey conducted by the National Sample Survey Office, Government of India. In addition to basic descriptive statistics, the study employs a two‐stage least square and a generalized linear model with log‐link and gamma distribution to conduct the econometric analysis. The study finds that higher income, education, and household size, diseases like cancer, treatment involving surgery, poor physical mobility, and the elderly opting for packages involve higher inpatient health spending, while both private and social health insurance tends to reduce the same. So, a thrust on insurance‐financed health systems may reduce health spending among the elderly. In this context, the study suggests that a disease‐specific policy is required for the elderly along with ensuring state‐of‐the‐art treatment facilities for them in public hospitals for critical ailments.
A case of novel coronavirus disease after combination therapy with nivolumab and ipilimumab for metastatic renal cell carcinoma
Authors: Kijima Yu , Shimizu Tomokazu , Kato Shinya , Sekido Eri , Kano Kana , Toguchi Makoto , Horiuchi Toshihide , Toma Hiroshi , Iida Shoichi , Takagi Toshio 
Published: December 2021

IntroductionWe present a case of novel coronavirus disease‐2019 that underwent combination therapy with nivolumab and ipilimumab for metastatic renal cell carcinoma.Case presentationA 50‐year‐old man complained of anorexia and weight loss. Contrast‐enhanced computed tomography revealed a solid mass of 57 mm in diameter with cysts in the right kidney, along with liver, lung, and multiple bone metastases. Computed tomography‐guided biopsy of the right kidney was performed, and a diagnosis of clear cell renal cell carcinoma was made. Three weeks after nivolumab and ipilimumab administration, the patient contracted coronavirus disease‐2019. Anticoagulation therapy (dalteparin) was administered for 4 days once infection was confirmed, after which dexamethasone was administered for 10 days. The patient survived without experiencing worsened respiratory symptoms.ConclusionWe administered nivolumab and ipilimumab combination therapy as treatment for metastatic renal cell carcinoma. No side effects or immune‐related adverse events were observed for a short time.
Efficacy of a university offered mindfulness training on perceived stress
Authors: Miller Madison K. , Finkel Jonah P. , Marcus Becca Nimmer , Burgin Elizabeth , Prosek Elizabeth A. , Crace R. Kelly , Bravo Adrian J. 
Published: December 2021

AbstractThe present study examined the efficacy of a 4‐week mindfulness training program offered on a university campus focused on reducing college students’ (n = 38) perceived stress. Results showed a significant reduction in perceived stress levels throughout the duration of the study. These findings provide preliminary support for the implementation of broad mindfulness‐based training in reducing psychological distress among college students. Further controlled research is needed to determine the effects of such trainings in university settings.
The role of blood lnc‐ZFAS1 in acute ischemic stroke: correlation with neurological impairment, inflammation, and survival profiles
Authors: Wang Gang , Zhou Ying , Zhong Tingting , Song Aixia , Xue Qian 
Published: December 2021

AbstractBackgroundLong non‐coding RNA zinc finger antisense 1 (lnc‐ZFAS1) has been reported to inhibit neuronal damage in acute ischemic stroke (AIS). However, the role of lnc‐ZFAS1 in AIS patients remains unclear. Therefore, we assessed the relationship of lnc‐ZFAS1 with neurological impairment, inflammation, and prognosis in AIS patients.MethodsTotally, 241 AIS patients and 120 controls were enrolled. lnc‐ZFAS1 in peripheral blood mononuclear cells was evaluated using reverse transcription‐quantitative polymerase chain reaction. Besides, a 3‐year follow‐up was conducted to assess recurrence‐free survival (RFS) and overall survival (OS) in AIS patients.Resultslnc‐ZFAS1 was reduced in AIS patients compared to that in controls (Z = −10.693, p < 0.001). In AIS patients, lnc‐ZFAS1 was negatively correlated with National Institutes of Health Stroke Scale score (rs = −0.335, p < 0.001), C‐reactive protein (rs = −0.284, p < 0.001), tumor necrosis factor‐alpha (rs = −0.293, p < 0.001), interleukin‐1β (rs = −0.149, p = 0.021), and interleukin‐6 (rs = −0.161, p = 0.012), but not underlying diseases (all p > 0.05). Besides, lnc‐ZFAS1 was divided into high and low levels based on the median expression in AIS patients. Indeed, high lnc‐ZFAS1 predicted better RFS (χ2 = 6.222, p = 0.013); the 1‐year, 2‐year, and 3‐year RFS rates were 94.2%, 88.3%, and 85.5%, respectively, in patients with high lnc‐ZFAS1, then 87.5%, 79.2%, and 71.6%, respectively, in those with low lnc‐ZFAS1. However, lnc‐ZFAS1 was not correlated with OS (χ2 = 1.404, p = 0.236); the 1‐year, 2‐year, and 3‐year OS rates were 98.3%, 95.8%, and 94.0%, respectively, in patients with high lnc‐ZFAS1, then 96.7%, 93.9%, and 89.6%, respectively, in those with low lnc‐ZFAS1.ConclusionLower lnc‐ZFAS1 expression is connected with increased neurological impairment and inflammation as well as worse RFS in AIS patients.
Predictive Value of C‐Reactive Protein and Albumin for Temporal Within‐Individual Pharmacokinetic Variability of Voriconazole in Pediatric Patients Undergoing Hematopoietic Cell Transplantation
Authors: Takahashi Takuto , Jaber Mutaz M. , Smith Angela R. , Jacobson Pamala A. , Fisher James , Kirstein Mark N. 
Published: December 2021

AbstractVoriconazole is a widely used antifungal agent in immunocompromised patients, but its utility is limited by its variable exposure and narrow therapeutic index. Population pharmacokinetic (PK) models have been used to characterize voriconazole PK and derive individualized dosing regimens. However, determinants of temporal within‐patient variability of voriconazole PK were not well established. We aimed to characterize temporal variability of voriconazole PK within individuals and identify predictive clinical factors. This study was conducted as a part of a single‐institution, phase I study of intravenous voriconazole in children undergoing hematopoietic cell transplantation (NCT02227797). We analyzed voriconazole PK study data collected at week 1 and again at week 2 after the start of voriconazole therapy in 59 pediatric patients undergoing HCT (age <21 years). Population PK analysis using nonlinear mixed effect modeling was performed to analyze temporal within‐individual variability of voriconazole PK by incorporating a between‐occasion variability term in the model. A 2‐compartment linear elimination model incorporating body weight and cytochrome P450 2C19 phenotype described the data. The ratio of individual voriconazole clearance between weeks 1 and 2 ranged from 0.11 to 3.3 (−9.1 to +3.3‐fold change). Incorporation of covariate effects by serum C‐reactive protein and albumin levels decreased between‐occasion variability of clearance as compared to the model without them (coefficient of variation, 41.2% and 59.5%, respectively) and improved the model fit (P < .05). As significant covariates on voriconazole PK, C‐reactive protein and albumin concentrations may potentially serve as useful biomarkers as part of therapeutic drug monitoring.
Neutrophil‐to‐lymphocyte ratio is associated with carotid intraplaque neovascularization in asymptomatic carotid stenosis patients
Authors: Lyu Qi , Liu Zehao , Zhu Zewen , Yin Ming 
Published: December 2021

AbstractBackground and PurposeNeutrophil‐to‐lymphocyte ratio (NLR) has been suggested as an available systemic inflammatory biomarker. This study aims to evaluate whether intraplaque neovascularization assessed by contrast‐enhanced ultrasound (CEUS) is associated with NLR in asymptomatic carotid stenosis patients.Materials and MethodsOne hundred and forty‐four asymptomatic patients with carotid luminal stenosis >30% were assessed using contrast‐enhanced ultrasound imaging. The contrast enhancement within the plaque was classified on a visual semiquantitative grading scale. The data collected included the patient's risk factors, laboratory results, cardiovascular disease history, and drug use history. Univariate and multivariate analyses were assessed to identify independent factors related to intraplaque neovascularization with adjustment for potential confounders.ResultsPatients with CEUS grade 2 plaques had a higher level of LDL‐C (p < .001), neutrophil count (p < .001), and blood glucose (p = .005), but lower level of lymphocyte count (p = .021). The presence of grade 2 plaques was significantly associated with high NLR values (OR 1.21, 95% CI 1.03–1.43, p = .017). Patients were divided into four groups according to the quartile of NLR values. Compared to the patients in the first quartile of NLR (<1.73), the patients in the fourth NLR quartile (≥3.38) were characterized by the most prevalence of CEUS grade 2 plaques (OR 4.55, 95% CI 1.69–12.25, p = .003). Multivariate logistic regression analysis after adjusting various variables demonstrated NLR remained an independent risk factor for the presence of CEUS grade 2 plaques.ConclusionIntraplaque neovascularization is significantly associated with NLR in asymptomatic carotid stenosis patients.
The impact of dental curriculum format on student performance on the national board dental examination
Authors: Yang Sireen , Edwards Paul C. , Zahl David , John Vanchit , Bhamidipalli Surya S. , Eckert George J. , Stewart Kelton T. 
Published: December 2021

AbstractPurpose/ObjectiveThe effectiveness of different curriculum types has long been debated by dental educators aiming to provide the best education possible to their students. This study aimed to evaluate the effect of curriculum type (hybrid problem‐based learning [PBL] vs. traditional) on National Board Dental Examination (NBDE) part I and II pass ratesMethodsA retrospective cohort study was conducted with a hybrid PBL cohort and traditional cohort. NBDE part I and II pass rates for the two cohorts were acquired, along with demographic and scholastic variables. Pass rates, scholastic variables, and demographic variables were compared using two‐sample t‐tests and chi‐square tests. Associations of the variables with pass rates were analyzed using logistic regression. Significance was set at 5%ResultsNo significant differences in pass rates for NBDE part I and II were observed between the cohorts. Cumulative dental school grade point average (GPA) was found to be an independent predictor of success for NBDE part I (odds ratio (OR): 1.40, 1.24–1.59 for 0.1 point intervals) and II (OR: 1.34, 1.18–1.52 for 0.1 point intervals), (p < 0.01). DAT biology sub‐score was found to be predictive of success for NBDE part I (OR: 1.58, 1.14–2.19), (p = 0.01)ConclusionsNo significant difference in NBDE part I and II pass rates between the cohorts was found. Dental school GPA was the most predictive variable for success on NBDE part I and II. These findings may be helpful considerations as institutions assess the structure of their school curricula.
Strong chromatic index and Hadwiger number
Authors: van Batenburg Wouter Cames , de Joannis de Verclos Rémi , Kang Ross J. , Pirot François 
Published: December 2021

AbstractWe investigate the effect of a fixed forbidden clique minor upon the strong chromatic index, both in multigraphs and in simple graphs. We conjecture for each that any ‐minor‐free multigraph of maximum degree has strong chromatic index at most . We present a construction certifying that if true the conjecture is asymptotically sharp as . In support of the conjecture, we show it in the case and prove the statement for strong clique number in place of strong chromatic index. By contrast, we make a basic observation that for ‐minor‐free simple graphs, the problem of strong edge‐colouring is “between” Hadwiger's Conjecture and its fractional relaxation. For , we also show that ‐minor‐free multigraphs of edge‐diameter at most 2 have strong clique number at most .
Mutational spectrum and prognosis in Chinese patients with prefibrotic primary myelofibrosis
Authors: Cheng Chi‐Keung , Lai Jennifer W. Y. , Yung Yuk‐Lin , Chan Hoi‐Yun , Wong Raymond S. M. , Chan Natalie P. H. , Cheung Joyce S. , Luo Xi , Pitts Herbert‐Augustus , Ng Margaret H. L. 
Published: December 2021

AbstractPrefibrotic primary myelofibrosis (Pre‐PMF) has been classified as a separate entity of myeloproliferative neoplasms (MPNs). Pre‐PMF is clinically heterogeneous but a specific prognostic model is lacking. Gene mutations have emerged as useful tools for stratification of myelofibrosis patients. However, there have been limited studies comprehensively investigating the mutational spectrum and its clinicopathological significance in pre‐PMF subjects. In this study, we addressed these issues by profiling the mutation status of 141 genes in 172 Chinese MPN patients including 72 pre‐PMF cases. Our findings corroborated the clinical/molecular distinctiveness of pre‐PMF and suggested a refined risk classification strategy for this entity.
Identifying unreported links between ClinicalTrials.gov trial registrations and their published results
Authors: Liu Shifeng , Bourgeois Florence T. , Dunn Adam G. 
Published: December 2021

AbstractA substantial proportion of trial registrations are not linked to corresponding published articles, limiting analyses and new tools. Our aim was to develop a method for finding articles reporting the results of trials that are registered on ClinicalTrials.gov when they do not include metadata links. We used a set of 27,280 trial registration and article pairs to train and evaluate methods for identifying missing links in both directions—from articles to registrations and from registrations to articles. We trained a classifier with six distance metrics as feature representations to rank the correct article or registration, using recall@K to evaluate performance and compare to baseline methods. When identifying links from registrations to published articles, the classifier ranked the correct article first (recall@1) among 378,048 articles in 80.8% of evaluation cases and 34.9% in the baseline method. Recall@10 was 85.1% compared to 60.7% in the baseline. When predicting links from articles to registrations, recall@1 was 83.4% for the classifier and 39.8% in the baseline. Recall@10 was 89.5% compared to 65.8% in the baseline. The proposed method improves on our baseline document similarity method to be feasible for identifying missing links in practice. Given a ClinicalTrials.gov registration, a user checking 10 ranked articles can expect to identify the matching article in at least 85% of cases, if the trial has been published. The proposed method can be used to improve the coupling of ClinicalTrials.gov and PubMed, with applications related to automating systematic review and evidence synthesis processes.
A Combination of Contrast‐Enhanced Ultrasound and Thyroglobulin Level in Fine‐Needle Aspirates Improves Diagnostic Accuracy for Metastatic Lymph Nodes of Papillary Thyroid Carcinoma
Authors: Liu Naxiang , Tang Lina , Chen Yijie , Wang Yaoqin , Huang Weiqin , Du Zhongshi , Shen Youhong , Wu Zhougui , He Tongmei , Su Guangjian , Xie Wenting , Chen Yunchao 
Published: December 2021

ObjectiveTo evaluate the diagnostic performance of contrast‐enhanced ultrasound (CEUS) combined with thyroglobulin (Tg) levels in fine‐needle aspirates (FNA) washout fluid (FNA‐Tg) in diagnosing cervical lymph node (LN) metastasis in papillary thyroid cancer (PTC) patients.MethodsData from 190 LNs in 167 patients suspected of metastasis from the US between November 2018 and September 2020 were included. All subjects underwent FNA, CEUS, and FNA‐Tg examinations. The final outcomes were confirmed by histopathological or cytological examination or follow‐up imaging. Data were analyzed using the Wilcoxon rank‐sum or chi‐squared test. The diagnostic efficacy of FNA, CEUS, and FNA‐Tg in diagnosing LNs was compared.ResultsA cutoff value of 6.15 ng/ml (AUC 0.925, 95% confidence interval (CI) 0.885–0.966) successfully identified metastatic LNs. FNA missed 58 LN metastases, of these, 94.8% (55/58) were correctly diagnosed using the combination of CEUS and FNA‐Tg. FNA‐Tg showed higher sensitivity (90.2%), NPV (86.1%) and accuracy (88.9%) than either FNA (48.2, 57.4 and 69.5%, respectively) or CEUS (82.1, 67.7 and 70.5%, respectively) alone. The combination of CEUS, FNA and FNA‐Tg resulted in maximal sensitivity (100%) and NPV (100%) but reduced specificity (51.3%) and overall diagnostic accuracy (80.0%). After adding FNA‐Tg to discordant samples between CEUS and FNA, 81.9% of LNs (77/94) were correctly diagnosed.ConclusionsThe combination of FNA, FNA‐Tg and CEUS was found to be a promising imaging tool in detecting metastatic LNs in PTC patients.
Neutrophil cytosolic factor 2 (NCF2) gene polymorphism is associated with juvenile‐onset systemic lupus erythematosus, but probably not with other autoimmune rheumatic diseases in children
Authors: Bakutenko Ivan Y. , Haurylchyk Irena D. , Nikitchenko Natalia V. , Sechko Elena V. , Kozyro Inna A. , Tchitchko Alexei M. , Batyan Galina M. , Sukalo Alexander V. , Ryabokon Nadezhda I. 
Published: December 2021

AbstractBackgroundGenetic variations of neutrophil cytosolic factor 2 (NCF2), a subunit of NADPH oxidase, are usually associated with chronic granulomatous disease, and their relationship with autoimmune disorders through the defective NADPH oxidase function during phagocytosis is suggested. Our study aimed to explore whether there is an association between the non‐synonymous single nucleotide polymorphism in the NCF2 gene (rs17849502, NC_000001.11:g.183563445G>T) and the development of juvenile autoimmune rheumatic diseases.MethodsIn order to test this hypothesis, we conducted a pilot case–control study. In total, 709 children and adolescents, all Belarusians, were involved in the study including patients with juvenile‐onset systemic lupus erythematosus (JSLE), juvenile idiopathic arthritis (JIA), Kawasaki disease (KD), and subjects without autoimmune and inflammatory diseases as the clinical control, as well as health newborns as the population control. Real‐time polymerase chain reaction was used for genotyping.ResultsThe minor T allele of NCF2 occurred most frequently in patients with JSLE (OR = 2.60, 95% CI = 1.18–5.73, p = 0.023 as compared to the clinical control). In groups with JIA and KD, its frequency did not differ from the control. The TT genotype was only observed in 5.7% of patients with JSLE (p = 0.007), but not in other groups.ConclusionTherefore, our study suggested that NCF2 rs17849502 polymorphism is a potential genetic risk factor for JSLE, while it is probably not for such autoimmune rheumatic diseases as JIA or KD.
A simple configuration of beam steering substrate integrated waveguide aperture antenna loaded with metamaterials
Authors: Cai Yang , Li Sen , Wu Tao , Cao Yufan 
Published: December 2021

AbstractThis letter presents a novel broadband substrate integrated waveguide aperture antenna with simple structure and beam steering performance. By using the left‐hand and band gap characteristics of the mushroom‐shaped metamaterials, the main beam of the substrate‐integrated waveguide aperture antenna can be easily switched between the back‐fire and boresight directions. Above all, the beam scanning characteristic does not depend on three‐dimensional structures or complex loaded structures, therefore it is a promising technology for designing planar two dimensional beam steering array. Experimental results indicate that the impedance bandwidth of the antenna covers the frequency range from 13.3 to 16.7 GHz and the relative bandwidth is 22.7%. The accordance between the simulated and measured E‐plane radiation pattern of the antenna at three representative frequencies verifies the beam steering capability of the proposed antenna.
Virtual injections using 4D flow MRI with displacement corrections and constrained probabilistic streamlines
Authors: Roberts Grant S. , Loecher Michael W. , Spahic Alma , Johnson Kevin M. , Turski Patrick A. , Eisenmenger Laura B. , Wieben Oliver 
Published: December 2021

AbstractPurposeStreamlines from 4D‐flow MRI have been used clinically for intracranial blood‐flow tracking. However, deterministic and stochastic errors degrade streamline quality. The purpose of this study is to integrate displacement corrections, probabilistic streamlines, and novel fluid constraints to improve selective blood‐flow tracking and emulate “virtual bolus injections.”MethodsBoth displacement artifacts (deterministic) and velocity noise (stochastic) inherently occur during phase‐contrast MRI acquisitions. Here, two displacement correction methods, single‐step and iterative, were tested in silico with simulated displacements and were compared with ground‐truth velocity fields. Next, the effects of combining displacement corrections and constrained probabilistic streamlines were performed in 10 healthy volunteers using time‐averaged 4D‐flow data. Measures of streamline length and depth into vasculature were then compared with streamlines generated with no corrections and displacement correction alone using one‐way repeated‐measures analysis of variance and Friedman’s tests. Finally, virtual injections with improved streamlines were generated for three intracranial pathology cases.ResultsIterative displacement correction outperformed the single‐step method in silico. In volunteers, the combination of displacement corrections and constrained probabilistic streamlines allowed for significant improvements in streamline length and increased the number of streamlines entering the circle of Willis relative to streamlines with no corrections and displacement correction alone. In the pathology cases, virtual injections with improved streamlines were qualitatively similar to dynamic arterial spin labeling images and allowed for forward/reverse selective flow tracking to characterize cerebrovascular malformations.ConclusionVirtual injections with improved streamlines from 4D‐flow MRI allow for flexible, robust, intracranial flow tracking.