bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variations among Electronic Health Record and Physiologic Streaming Vital Signs for Use in Predictive Algorithms in Pediatric Severe Sepsis
Authors: Dziorny Adam C. , Lindell Robert B. , Fitzgerald Julie C. , Bonafide Christopher P. 
Published: September 2022

Abstract
Objective This study sought to describe the similarities and differences among physiologic streaming vital signs (PSVSs) and electronic health record (EHR)-documented vital signs (EVSs) in pediatric sepsis.
Methods In this retrospective cohort study, we identified sepsis patients admitted to the pediatric intensive care unit. We compared PSVS and EVS measures of heart rate (HR), respiratory rate, oxyhemoglobin saturation, and blood pressure (BP) across domains of completeness, concordance, plausibility, and currency.
Results We report 1,095 epochs comprising vital sign data from 541 unique patients. While counts of PSVS measurements per epoch were substantially higher, increased missingness was observed compared with EVS. Concordance was highest among HR and lowest among BP measurements, with bias present in all measures. Percent of time above or below defined plausibility cutoffs significantly differed by measure. All EVS measures demonstrated a mean delay from time recorded at the patient to EHR entry.
Conclusion We measured differences between vital sign sources across all data domains. Bias direction differed by measure, possibly related to bedside monitor measurement artifact. Plausibility differences may reflect the more granular nature of PSVS which can be critical in illness detection. Delays in EVS measure currency may impact real-time decision support systems. Technical limitations increased missingness in PSVS measures and reflect the importance of systems monitoring for data continuity. Both PSVS and EVS have advantages and disadvantages that must be weighed when making use of vital signs in decision support systems or as covariates in retrospective analyses.
COVID-19 and the Electronic Health Record: Tool Design and Evolution at the U.S. Pandemic Epicenter
Authors: Tsega Surafel , Vijayaraghavan Mahima , Chronister Marianne , Srinivas Sindhu , Bassily-Marcus Adel , Gumprecht Jeffrey , Shetreat-Klein Avniel , Darrow Bruce , Craven Catherine K. 
Published: September 2022

Abstract
Objective We detail inpatient electronic health record (EHR) system tools created at Mount Sinai Health System for the clinical management of patients with coronavirus disease 2019 (COVID-19) during the early pandemic months in the U.S. epicenter, New York City. We discuss how we revised these tools to create a robust Care pathway, unlike other tools reported, that helped providers care for these patients as guidelines evolved.
Methods Mount Sinai Health System launched a Command Center on March 8, 2020. The Chief Medical Information Officer launched a workgroup of clinical informaticists and Epic analysts tasked with rapidly creating COVID-19-related EHR tools for the inpatient setting.
Results Initial EHR tools focused on inpatient order sets for care standardization and resource utilization. In preparation for a fall 2020-winter 2021 surge, we created a clinician-facing, integrated Care pathway incorporating additional Epic System-specific tools: a Care Path, a dedicated Navigator, Summary and Timeline Reports, and SmartTexts.
Discussion Initial tools offered standard functionality but included complex decision-making support to account for the lack of COVID-19 clinical knowledge, operational challenges during a dramatic patient surge, and resource limitations. We revised content and built a more comprehensive Care pathway that provided real-time clinical data along with treatment recommendations as knowledge evolved, e.g., convalescent plasma.
Conclusion We have provided a framework that can inform future informaticists in developing EHR tools during an evolving pandemic.
Heat-processed bovine blood–rumen digesta meal and vegetable oil concentrate as partial replacement for soybean meal in broiler finisher diet
Authors: Diarra Siaka S. , Vi Samuela , Seuseu Faasoa , Molimau-Iosefa Tulia 
Published: September 2022

Context Blood and rumen contents, which are currently considered wastes in many abattoirs, could be valuable ingredients in poultry feeding; however, several factors including high fibre and low energy may limit their dietary inclusion. There is need for more research on feed processing and diet formulation to maximise utilisation of these by-products in poultry feeding. Aim We investigated the effect on broiler finisher performance of feeding bovine blood, rumen digesta and vegetable oil concentrate as a partial replacement for soybean meal. Methods Three isonitrogenous and isocaloric diets were formulated: a control diet based on maize and soybean meal, and two test diets. In the test diets, heat-processed blood–rumen digesta meal and vegetable oil concentrate replaced 50% of the soybean meal, with and without exogenous enzymes. Diets were allocated to five replicate pens containing six Ross broilers aged 21 days in a completely randomised design for a period of 21 days. Key results Results showed no treatment effect (P > 0.05) on average daily feed intake but birds fed the test diets gained more weight (P < 0.05) and converted their feed more efficiently (P < 0.05) than the control group. Enzyme supplementation had no additional effect (P > 0.05) on growth performance. There were no dietary effects (P > 0.05) on relative weights of carcass and gut segments. Feed cost of liveweight gain and carcass weight was reduced (P < 0.05) on the test diets. Conclusion Heat-processed blood–rumen digesta meal and vegetable oil concentrate can replace up to 50% of soybean meal in broiler fishier diets. At this level of replacement, enzyme supplementation is not required. Implications The use of blood and rumen content in poultry diets has cost and environmental benefits.
Can decreased cost-sharing reduce the vulnerability of sick families to poverty? An analysis of the multi-level social health insurance scheme in China
Authors: Dong Shiju , Fu Wenhao , Yu Zexuan , Li Jiajia 
Published: September 2022

Abstract
In recent years, China has been increasing social health insurance benefits to alleviate poverty due to illness. In 2015, China introduced the Critical Illness Insurance for patients with high out-of-pocket expenses as supplementary to the social health insurance, which categorized patients with different medical expenses into different cost-sharing policies. We conducted a survey on households with high-cost patients in rural Shandong in 2019 and employed the instrumental variables estimation approach to determine how different cost-sharing measures affect households’ poverty vulnerability. We found that cost-sharing reduction significantly decreases the vulnerability of sick families to poverty. Moreover, we found that the positive effect is attributed to a reduction in health burden and household livelihood capital shocks. The vulnerability to poverty is still exceptionally high owing to the heavy health burden in rural China and other developing countries. The results of our study provide insights into poverty alleviation by improving social health insurance in developing economies.
The Threshold for Stacked Triangulations
Authors: Lubetzky Eyal , Peled Yuval 
Published: September 2022

Abstract
A stacked triangulation of a $d$-simplex $\mathbf {o}=\{1,\ldots ,d+1\}$ ($d\geq 2$) is a triangulation obtained by repeatedly subdividing a $d$-simplex into $d+1$ new ones via a new vertex (the case $d=2$ is known as an Appolonian network). We study the occurrence of such a triangulation in the Linial–Meshulam model, that is, for which $p$ does the random simplicial complex $Y\sim {\mathcal {Y}}_d(n,p)$ contain the faces of a stacked triangulation of the $d$-simplex $\mathbf {o}$, with its internal vertices labeled in $[n]$. In the language of bootstrap percolation in hypergraphs, it pertains to the threshold for $K_{d+2}^{d+1}$, the $(d+1)$-uniform clique on $d+2$ vertices. Our main result identifies this threshold for every $d\geq 2$, showing it is asymptotically $(\alpha _d n)^{-1/d}$, where $\alpha _d$ is the growth rate of the Fuss–Catalan numbers of order $d$. The proof hinges on a second moment argument in the supercritical regime and on Kalai’s algebraic shifting in the subcritical regime.
Comprehensive coverage of particle acceleration and kinetic feedback from the stellar mass black hole V404 Cygni
Authors: Fender R P , Mooley K P , Motta S E , Bright J S , Williams D R A , Rushton A P , Beswick R J , Miller-Jones J C A , Kimura M , Isogai K , Kato T 
Published: September 2022

ABSTRACT
We present analysis of comprehensive radio observations of the black hole V404 Cyg during its 2015 outburst. These data represent the best ever coverage of jet production and particle acceleration from any black hole. We report for the first time a clear and near-linear flux–rms correlation in the radio flux densities. Investigation of individual flares reveals in nearly all cases the peak corresponds to the transition from optically thick to thin to synchrotron emission, but an extended phase of particle acceleration is required in contrast to simple impulsive injection models. The largest radio flare is preceded by a phase of optical oscillations and followed one day later by a smaller but optically thin flare, likely due to ejecta interacting with the interstellar medium. Comparing the radio emission to contemporaneous X-ray and optical data, we find that the X-ray and radio measurements are correlated on all time-scales from seconds to one day. Correlation with the optical flux densities is weak at short time-scales, but becomes significant on time-scales greater than a few hours. We evaluate the physical conditions (size, magnetic field, and internal energy) associated with 86 individual radio flares, which in turn allows us to place a lower limit on the kinetic feedback over the 15 d of intense activity. If this energy was deposited locally to the source, as implied by the failure to detect jets on angular scales larger than milliarcsec, then we predict that a nova-like shell could have been formed.
A new window to tidal asteroseismology: non-linearly excited stellar eigenmodes and the period spacing pattern in KOI-54
Authors: Guo Zhao , Ogilvie Gordon I , Li Gang , Townsend Richard H D , Sun Meng 
Published: September 2022

ABSTRACT
We revisit the tidally excited oscillations (TEOs) in the A-type main-sequence eccentric binary KOI-54, the prototype of heartbeat stars. Although the linear tidal response of the star is a series of orbital-harmonic frequencies which are not stellar eigenfrequencies, we show that the non-linearly excited non-orbital-harmonic TEOs are eigenmodes. By carefully choosing the modes which satisfy the mode-coupling selection rules, a period spacing (ΔP) pattern of quadrupole gravity modes (ΔP ≈ 2520–2535 s) can be discerned in the Fourier spectrum, with a detection significance level of $99.9{{\ \rm per\ cent}}$. The inferred period spacing value agrees remarkably well with the theoretical l = 2, m = 0 g modes from a stellar model with the measured mass, radius, and effective temperature. We also find that the two largest-amplitude TEOs at N = 90, 91 harmonics are very close to resonance with l = 2, m = 0 eigenmodes, and likely come from different stars. Previous works on tidal oscillations primarily focus on the modelling of TEO amplitudes and phases, the high sensitivity of TEO amplitude to the frequency detuning (tidal forcing frequency minus the closest stellar eigenfrequency) requires extremely dense grids of stellar models and prevents us from constraining the stellar physical parameters easily. This work, however, opens the window of real tidal asteroseismology by using the eigenfrequencies of the star inferred from the non-linear TEOs and possibly very-close-to-resonance linear TEOs. Our seismic modelling of these identified eigen g-modes shows that the best-matching stellar models have (M ≈ 2.20, 2.35 M⊙) and super-solar metallicity, in good agreement with previous measurements.
Withdrawal of MTX in rheumatoid arthritis patients on bDMARD/tsDMARD plus methotrexate at target: a systematic review and meta-analysis
Authors: Wang Xiangpeng , Tang Ziyi , Huang Tianwen , Hu Huifang , Zhao Yaxi , Liu Yi 
Published: September 2022

AbstractObjectivesTo evaluate the effect of MTX withdrawal on disease activity and remission rate in patients at target after treatment with biologic DMARDs (bDMARDs)/targeted synthetic DMARDs (tsDMARDs) plus MTX.Material and methodsWe searched the PubMed, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) databases for all randomized controlled trials (RCTs) on MTX withdrawal in patients with RA at target after combination therapy from inception to 7 March 2022 in order to extract data, including: the change from withdrawal in DAS28 at the endpoint; proportion of low disease activity (LDA) assessed by DAS28, Simplified Disease Activity Index (SDAI) or Clinical Disease Activity Index (CDAI); proportion of remission assessed by DAS28, SDAI CDAI or ACR/EULAR Boolean remission. The Cochrane Q test and I2 test were used to assess heterogeneity, and random-effects models were used for data synthesis. This study is registered with PROSPERO (CRD42022303891).ResultsSix articles were included for qualitative and quantitative analysis, all of which were noninferior RCTs involving 1430 patients (734 in the withdrawal group and 696 in the continuation group). Compared with continuing combination therapy, tapering off or discontinuing MTX increased DAS28 by 0.20 (95% CI 0.09, 0.32, I2 = 0%) and decreased the percentage of patients with LDA assessed by DAS28 to &lt;3.2 [risk ratio (RR) 0.88 (0.80, 0.97), I2 = 0%]. However, MTX withdrawal did not decrease remission rates assessed by DAS28, SDAI, CDAI or ACR/EULAR Boolean remission [RR 0.90 (0.81, 1.01), 0.93 (0.77, 1.11), 0.90 (0.74, 1.11), 0.95 (0.70, 1.29), respectively].ConclusionsWithdrawing MTX slightly increases the RA disease activity in patients treated at target with bDMARDs/tsDMARDs plus MTX and has limited effects for patients with deep remission.
Omicron detection with large language models and YouTube audio data
Authors: Anibal James T. , Landa Adam J. , Hang Nguyen T. T. , Song Miranda J. , Peltekian Alec K. , Shin Ashley , Huth Hannah B. , Hazen Lindsey A. , Christou Anna S. , Rivera Jocelyne , Morhard Robert A. , Bagci Ulas , Li Ming , Bensoussan Yael , Clifton David A. , Wood Bradford J. 
Published: September 2022

AbstractPublicly available audio data presents a unique opportunity for the development of digital health technologies with large language models (LLMs). In this study, YouTube was mined to collect audio data from individuals with self-declared positive COVID-19 tests as well as those with other upper respiratory infections (URI) and healthy subjects discussing a diverse range of topics. The resulting dataset was transcribed with the Whisper model and used to assess the capacity of LLMs for detecting self-reported COVID-19 cases and performing variant classification. Following prompt optimization, LLMs achieved accuracies of 0.89, 0.97, respectively, in the tasks of identifying self-reported COVID-19 cases and other respiratory illnesses. The model also obtained a mean accuracy of 0.77 at identifying the variant of self-reported COVID-19 cases using only symptoms and other health-related factors described in the YouTube videos. In comparison with past studies, which used scripted, standardized voice samples to capture biomarkers, this study focused on extracting meaningful information from public online audio data. This work introduced novel design paradigms for pandemic management tools, showing the potential of audio data in clinical and public health applications.
Brain-Derived Neurotrophic Factor (BDNF) Epigenomic Modifications and Brain-Related Phenotypes in Humans: A Systematic Review
Authors: Treble-Barna Amery , Heinsberg Lacey W. , Stec Zachary , Breazeale Stephen , Davis Tara S. , Kesbhat Aboli A. , Chattopadhyay Ansuman , VonVille Helena M. , Ketchum Andrea M. , Yeates Keith Owen , Kochanek Patrick M. , Weeks Daniel E. , Conley Yvette P. 
Published: September 2022

AbstractEpigenomic modifications of the brain-derived neurotrophic factor (BDNF) gene have been postulated to underlie the pathogenesis of neurodevelopmental, psychiatric, and neurological conditions. This systematic review summarizes current evidence investigating the association of BDNF epigenomic modifications (DNA methylation, non-coding RNA, histone modifications) with brain-related phenotypes in humans. A novel contribution is our creation of an open access web-based application, the BDNF DNA Methylation Map, to interactively visualize specific positions of CpG sites investigated across all studies for which relevant data were available. Our literature search of four databases through September 27, 2021 returned 1,701 articles, of which 153 met inclusion criteria. Our review revealed exceptional heterogeneity in methodological approaches, hindering the identification of clear patterns of robust and/or replicated results. We summarize key findings and provide recommendations for future epigenomic research. The existing literature appears to remain in its infancy and requires additional rigorous research to fulfill its potential to explain BDNF-linked risk for brain-related conditions and improve our understanding of the molecular mechanisms underlying their pathogenesis.Highlights153 articles examined BDNF epigenomic modifications and brain-related phenotypesNovel BDNF DNA Methylation Map allows users to interactively visualize CpGsBDNF epigenomics lack robust/replicated results due to methodological heterogeneity
Psychotropic drugs in Portugal from 2016 to 2019: a nationwide pharmacoepidemiological profile
Authors: Madeira Luís , Queiroz Guilherme , Henriques Rui 
Published: September 2022

AbstractBackgroundThe prescription of psychotropic medication is rising in Europe along the last decade. Exploring consumption patterns in pre-pandemic times in Portugal, as well as relevant socio-demographic determinants, can help establish comparisons with worldwide patterns and support public health policies for mental health.MethodsDescriptive, non-comparative cohort study, comprising full nationwide drug prescription records in Portugal along antidepressant, antipsychotic, and anxiolytic classes. Statistical analysis of prescription and consumption patterns according to reference dosages and guided by several criteria, including active substance, demographics, geography, associated medical specialty, and incurred costs.ResultsAn increase of 29.6% and 34.7% in the consumption of antipsychotics and antidepressants between 2016 and 2019 is highlighted, reasonably accompanied by an increase of 37M Eur in total expenditure (>20M Eur in public copay) for these classes of drugs. Disparities in sociodemographic and geographical incidence are identified. Amongst other pivotal results, we further observed that 64% of psychotropic drug prescriptions are undertaken by general practitioners, while only 21% undertaken by neurological and psychiatric specialties.ConclusionNationwide patterns of psychotropic drug prescription in Portugal reveal notable trends and determinants, establishing a reference point for cross-regional studies and being currently assessed at a national level to establish psychosocial initiatives and guidelines for the clinical practice and medical training.NoveltyTo our knowledge, first Portuguese psychopharmacoepidemiological study assessing: 1) economic correlates; 2) prescription patterns by medical specialty; 3) adherence rates and geographical determinants; 4) consumption patterns by active substance; and 5) systematic trends for the pre-pandemic period.
Long-Term Opioid Use and Emotional, Cognitive, and Sensorimotor Function in Chronic Back Pain
Authors: Rached Gaelle , Vigotsky Andrew D. , Branco Paulo , Jabakhanji Rami , Schnitzer Thomas J. , Vania Apkarian A. , Baliki Marwan N. 
Published: September 2022

AbstractThis study examines cognitive, emotional, sensory, and motor function in patients with chronic back pain (CBP) with and without long-term opioid exposure (CBP+O vs. CBP−O) and the influence of race and sex on these outcomes. We recruited 64 CBP+O (mean 7.4 years of opioid use) and 64 matched CBP−O. We collected pain intensity, pain duration, NIH Toolbox outcomes, and measures of opioid use: dosage, duration, blood levels, and withdrawal symptoms. We compared both groups to a normative sample, examined sex and race influences separately, and related CBP+O’s NIH Toolbox outcomes to their opioid use measures.CBP+O reported greater pain interference and poorer emotional function. Sex moderated opioid exposure’s effects on cognitive performance and social satisfaction, while race moderated motor dexterity and taste outcomes. In CBP+O, 1) opioid dosage was associated with cognitive speed and sensory performance; 2) blood levels of opioids corresponded with poorer attention, motor endurance, and more severe stress and negative affect; 3) opioid use duration was related to improved working memory; while 4) higher withdrawal symptoms were associated with poorer cognitive performance, worsened negative emotions, and decreased grip strength.The study demonstrates both positive and negative outcomes associated with long-term opioid use in CBP, highlighting the need to consider sex- and race-related factors when assessing function in this population.
The autism-associated Meis2 gene is necessary for cardiac baroreflex regulation in mice
Authors: Roussel J , Larcher R , Sicard P , Bideaux P , Richard S , Marmigère F , Thireau J 
Published: September 2022

AbstractRecent understanding of Autism Spectrum Disorder (ASD) showed that peripheral primary mechanosensitive neurons involved in touch sensation and central neurons affected in ASD share transcriptional regulators. Mutant mice for ASD-associated transcription factors exhibit impaired primary tactile perception, and restoring those genes specifically in primary sensory neurons rescue some of the anxiety-like behavior and social interaction defects.Interestingly, peripheral mechanosensitive sensory neurons also project to internal organs including the cardio-vascular system, and an imbalance of the cardio-vascular sympatho-vagal regulation is evidenced in ASD and intellectual disability. ASD patients have decreased vagal tone, suggesting dysfunction of sensory neurons involved in cardio-vascular sensing.In light of our previous finding that the ASD-associated Meis2 gene is necessary for normal touch neurons development and function, we investigated here if its inactivation in mouse peripheral sensory neurons also affects cardio-vascular sympatho-vagal regulation and baroreflex. Combining echocardiography, pharmacological challenge, blood pressure monitoring and heart rate variability analysis, we found that Meis2 mutant mice exhibited a blunted vagal response independently of any apparent cardiac malformation. These results suggest that defects in primary sensory neurons with mechanosensitive identity could participate in the imbalanced cardio-vascular sympatho-vagal tone found in ASD patients, reinforcing current hypotheses on the role of primary sensory neurons in the etiology of ASD.