bluuebunny/crossref_metadata_2025_split huggingface dataset:
Design principles for final answer assessment in linear algebra: implications for digital testing
Authors: Veale Alisa J , Craig Tracy S 
Published: February 2022

Abstract
Digital testing, such as multiple-choice questions and final answer items, offers many advantages in higher educational assessment practices. Well-designed digital grading is more reliable and faster than hand grading and is scalable to larger classes. The validity of digital grading is open to criticism, particularly in mathematics where much of mathematics is based on processes and reasoning and not on the final answer achieved. At a technical university in the Netherlands, we have been increasing our use of digital short answer testing in calculus and linear algebra for service mathematics. To assess the validity of this mode of assessment, we graded a linear algebra test in two ways: short answer grading (where answers were considered either correct or incorrect) and the so-called ‘hypothetical grading’, where we assigned a grade based on the fully worked solution. Certain types of items proved to be more suitable for short answer (and hence digital) testing than others. We concluded our analysis with a set of design principles for digital or short answer testing in linear algebra.
Unsuccessful mid-term results for distal humeral hemiepiphysiodesis to treat cubitus varus deformity in young children
Authors: Soldado Francisco , Diaz-Gallardo Paula , Cherqaoui Abdelmounim , Nguyen Trong-Quynh , Romero-Larrauri Pablo , Knorr Jorge 
Published: February 2022

Cubitus varus is the most common complication following a pediatric humeral supracondylar fracture. No reports are available on the result of hemiepiphysiodesis to correct this deformity.
We report the use of a transphyseal crossed cannulated screw (Metaizeau technique) in five very young children (mean 3 years and 7 months). No correction was observed after a mean of 3 years and 10 months of follow-up. The low growing capacity of the distal humeral physis makes corrective osteotomy the procedure of choice for cubitus varus deformity correction in children.
Insurance Type is Associated with Baseline Patient-Reported Outcome Measures in Patients with Lumbar Stenosis
Authors: Crawford Alexander M. , Xiong Grace X. , Lightsey Harry M. , Goh Brian C. , Smith Jeremy T. , Hershman Stuart H. , Schoenfeld Andrew J. , Simpson Andrew K. 
Published: February 2022

Study Design.
Retrospective cohort study.

Objective.
To determine if insurance type is associated with differences in baseline patient-reported outcome measures (PROMs) among patients with lumbar spinal stenosis (LSS).

Summary of Background Data.
PROMs are increasingly used as means to convey value. Prior research suggests that sociodemographic factors, including insurance type may influence these metrics, with patients who are more socioeconomi-cally disadvantaged reporting poorer baseline PROMs. Nonetheless, this association is yet to be evaluated among patients with spinal stenosis.

Methods.
Six-hundred-eight patients with LSS were identified within a major academic health system. Their baseline Patient-Reported Outcomes Measurement Information System for physical function, pain, anxiety and depression, and visual analogue scale for low back and leg pain were analyzed. Wilcoxon rank-sum testing and chi-squared testing were utilized for descriptive nonadjusted comparisons. Negative binomial regression modeling was performed with PROMs considered as dependent variables, insurance type as the primary predictor, and all other factors (e.g., Charlson Comorbidity Index, age, gender, race, ethnicity, language spoken, and median geospatial household income) considered as covariates.

Results.
The mean age of the cohort was 62.6 ± 14years with a female majority (50.7%). Patients with Medicaid insurance were younger, more likely to be Hispanic, and less likely to be English-speaking than those with commercial insurance or Medicare. Overall, patients with Medicaid insurance were found to have worse baseline PROMs across almost all domains, with the worst performance in Patient-Reported Outcomes Measurement Information System 10 physical global (incidence rate ration 0.88, 95% confidence interval 0.82–0.95) and mental function (incidence rate ration 0.85, 95% confidence interval 0.80–0.92).

Conclusion.
LSS patients insured through Medicaid have systematically worse baseline PROMs across almost all domains as compared to those with commercial insurance and Medicare, even after adjusting for confounders. These findings have broad ranging implications for research and healthcare policy, especially when using PROMs as measures of value.
The value of bioactive adrenomedullin and dipeptidyl peptidase 3 to predict short-term unfavourable outcomes after cardiac surgery
Authors: van Lier Dirk , Beunders Remi , Kox Matthijs , Pickkers Peter 
Published: February 2022

BACKGROUND
Adrenomedullin (ADM) is a key regulator of endothelial barrier function and vascular tone. Dipeptidyl peptidase 3 (DPP3) is a protease involved in the degradation of several cardiovascular mediators. Increased levels of bioactive ADM (bio-ADM) and circulating DPP3 (cDPP3) were found to predict short-term outcome in cardiogenic shock patients.

OBJECTIVES
To investigate the unknown temporal profiles of bio-ADM and cDPP3 and their association with short-term outcome following cardiac surgery.

DESIGN
Prospective observational study of 203 adult cardiac surgery patients admitted to the intensive care unit (ICU) postoperatively. Plasma bio-ADM and cDPP3 levels were measured at ICU admission (day 1) and on days 2 and 3.

MAIN OUTCOME MEASURES
Biomarker prediction of prolonged vasopressor dependency (>3 days), acute kidney injury (AKI) and prolonged ICU length of stay (ICU-LOS) (>3 days).

RESULTS
bio-ADM and cDPP3 levels displayed distinct temporal profiles following cardiac surgery. cDPP3 levels were highest on day 1 and strongly correlated with surgical complexity and duration but subsequently normalised on day 2 in most patients. In contrast, bio-ADM levels on day 1 were within the normal range but subsequently increased. Day 2 bio-ADM levels were strongly associated with study outcomes: the area under the receiver-operating curves (AUROC) were 0.82 (95% CI, 0.72 to 0.92) for prolonged vasopressor dependency, 0.87 (0.81 to 0.92) for AKI and 0.82 (0.75 to 0.90) for prolonged ICU-LOS (all P < 0.0001). cDPP3 levels on day 2 also predicted these outcomes, albeit to a lesser extent, with AUROCs of 0.73 (95% CI, 0.64 to 0.81) for prolonged vasopressor dependency, 0.69 (0.61 to 0.77) for AKI and 0.70 (0.62 to 0.79) for prolonged ICU-LOS (all P < 0.0001).

CONCLUSION
Following cardiac surgery, increased bio-ADM levels are strongly associated with unfavourable short-term outcomes, whereas cDPP3 levels are mainly related to surgery complexity and duration. On the basis of these findings, ADM-modulating therapies may have beneficial effects in cardiac surgery patients whereas DPP3-targeted therapies should be reserved for patient categories with higher baseline disease severity.
Evaluation of a nurse practitioner–led transitional care program: The effects on 30-day Medicare readmission rates and patient satisfaction scores
Authors: Sherlock Patrick J. 
Published: February 2022

Background:
Data suggest that nurse practitioner (NP)-led transitional care models can reduce 30-day readmission rates. It remains unclear if transitional care has any impact on Press Ganey's Hospital Consumer Assessment of Health Provider and Systems (HCAHPS) patient satisfaction scores.

Local Problem:
A transitional care encounter program (TCEP) was designed and implemented by an NP at an internal medicine private practice in response to an increase in Medicare 30-day readmission rates and lower HCAHPS results. A program evaluation was carried out to determine any impact on 30-day readmissions and HCAHPS.

Methods:
The evaluator used CDC's Framework for Program Evaluation in Public Health for program evaluation. Quantitative retrospective data collection of Medicare 30-day readmission rates was obtained and compared preimplementation/postimplementation. HCAHPS results were collected from the data analytics department at Methodist Health System and compared preimplementation/postimplementation.

Interventions:
All Medicare patients followed by the private practice discharged from hospital to home had a TCEP visit within 7 days of discharge. The NP extensively reviewed the hospital records, medication reconciliation, education about current medications, diagnoses, and treatment plan with the patient.

Results:
Readmission rates and HCAHPS are tracked by physician name at discharge. The TCEP resulted in a 2.1% reduction in Medicare 30-day readmission rate. Physician A pre-/post-HCAHPS score was 74% increased to 81.3%. Physician B pre-/post-HCAHPS score was 75.8% increased to 78.6%.

Conclusion:
The TCEP model became an integral part of the clinic's daily operations. Transitional care has potential for decreasing Medicare 30-day readmission rate and improving HCAHPS.
Prediction of risk for bleeding, myocardial infarction and mortality after percutaneous coronary intervention in patients with acute coronary syndromes
Authors: Ndrepepa Gjin , Neumann Franz-Josef , Menichelli Maurizio , Richardt Gert , Cassese Salvatore , Xhepa Erion , Kufner Sebastian , Lahu Shqipdona , Aytekin Alp , Sager Hendrik B. , Joner Michael , Ibrahim Tareq , Müller Arne , Fusaro Massimiliano , Hapfelmeier Alexander , Laugwitz Karl-Ludwig , Schunkert Heribert , Kastrati Adnan , Kasel Markus 
Published: February 2022

Background
Whether bleeding and myocardial infarction (MI) improve the performance of risk prediction models for mortality in patients with acute coronary syndromes (ACS) treated with percutaneous coronary intervention (PCI) remains unknown.

Methods
This study included 3377 patients with ACS who underwent PCI in the setting of the ISAR-REACT 5 trial. Patients with bleeding, MI or those dying at 1 year after PCI were characterized in terms of baseline characteristics, risk estimates and C-statistic of the risk prediction models for these outcomes.

Results
Major bleeding (Bleeding Academic Research Consortium types 3–5), MI and mortality occurred in 195 patients (5.8%), 143 patients (4.3%) and 143 patients (4.3%), respectively. After adjustment, bleeding [hazard ratio = 5.08; 95% confidence interval (CI), 3.03–8.53; P < 0.001] and MI [hazard ratio = 5.90; 95% CI, (3.00–11.65); P < 0.001) remained independently associated with the risk for 1-year mortality. The C-statistic (with 95% CI) of the model for bleeding, MI and mortality was, 0.755 (0.722–0.786), 0.752 (0.717–0.789) and 0.868 (0.837–0.896), respectively. The inclusion of bleeding [C-statistic: 0.892 (0.867–0.913); delta C-statistic 0.024 (−0.014 to 0.065); P = 0.200] or MI [C-statistic: 0.878 (0.851–0.903); delta C-statistic 0.011 (−0.030 to 0.053); P = 0.635] in the risk prediction models for mortality alongside baseline demographical and clinical variables did not improve prediction for mortality.

Conclusions
In patients with ACS treated with PCI, mortality is the most accurately predicted outcome. Bleeding and MI did not improve risk discrimination for mortality when added in the risk prediction models for mortality suggesting that these outcomes do not provide incremental prognostic information on top of baseline demographical and clinical data.
Resting-state functional connectivity patterns are associated with worst pain duration in community-dwelling older adults
Authors: Valdes-Hernandez Pedro A. , Montesino-Goicolea Soamy , Hoyos Lorraine , Porges Eric C. , Huo Zhiguang , Ebner Natalie C. , Woods Adam J. , Cohen Ronald , Riley Joseph L. , Fillingim Roger B. , Cruz-Almeida Yenisel 
Published: February 2022

Abstract

Introduction:
An individual's chronic pain history is associated with brain morphometric alterations; but little is known about the association between pain history and brain function.

Objectives:
This cross-sectional study aimed at determining how worst musculoskeletal pain intensity (WPINT) moderated the association between worst musculoskeletal pain duration (WPDUR) and brain resting-state magnetic resonance imaging functional connectivity (RSFC) in community-dwelling older adults (60–94 years, 75% females, 97% right-handed).

Methods:
Resting-state magnetic resonance imaging functional connectivity between region of interests was linearly regressed on WPDUR and WPINT. Predictions were compared with a control group's average RSFC (61–85 years, 47% females, 95% right-handed).

Results:
Three significant patterns emerged: (1) the positive association between WPDUR and RSFC between the medial prefrontal cortex, in the anterior salience network (SN), and bilateral lateral Brodmann area 6, in the visuospatial network (VSN), in participants with more severe chronic pain, resulting in abnormally lower RSFC for shorter WPDUR; (2) the negative association between WPDUR and RSFC between right VSN occipitotemporal cortex (lateral BA37 and visual V5) and bilateral VSN lateral Brodmann area 6, independently of WPINT, resulting in abnormally higher and lower RSFC for shorter and longer WPDUR, respectively; and (3) the positive association between WPDUR and the left hemisphere's salience network-default mode network connectivity (between the hippocampus and both dorsal insula and ventral or opercular BA44), independently of WPINT, resulting in abnormally higher RSFC for longer WPDUR.

Conclusion:
Musculoskeletal effects on brain functional networks of general healthy individuals could accumulate until being observable at older ages. Results invite to examinations of these effects' impact on function and memory.
Failed Breast Conservation Therapy Predicts Higher Frequency of Revision Surgery following Mastectomy with Reconstruction
Authors: Rochlin Danielle H. , Sheckter Clifford C. , Momeni Arash 
Published: February 2022

Background:
Breast conservation therapy remains the gold standard for women with localized breast cancer; however, some women may eventually undergo mastectomy with reconstruction. Little is understood regarding the risks of failed breast conservation therapy as they relate to postmastectomy reconstruction and whether this affects outcomes.

Methods:
Patients undergoing breast reconstruction were extracted from the IBM MarketScan Commercial Database from 2007 to 2016. Frequency of lumpectomy and radiation therapy were determined per reconstructive patient. Outcomes included inpatient complications and frequency of revision procedures. Regression models were adjusted for age, obesity, timing of reconstruction, and Elixhauser Comorbidity Index.

Results:
Six thousand two hundred eighty-eight of 52,826 (11.9 percent) women underwent one or more breast mass excisions before mastectomy with reconstruction. Of those, the mean number of excisions per woman was 1.67 ± 0.90. There were 3334 lumpectomy patients (53.0 percent) who completed radiation therapy. The mean number of revisions with breast conservation therapy was 1.5 versus 1.3 in the general cohort. On multivariable analysis, excision of breast mass alone was not associated with increased odds of inpatient complications (OR, 1.07; p = 0.363), nor was radiation therapy (OR, 0.89; p = 0.153). However, radiation therapy with or without excision of breast mass before mastectomy was a significant predictor of more frequent revision operations (p = 0.032). Excision of breast mass alone was not associated with an increased frequency of revision (p = 0.173).

Conclusions:
History of radiation therapy in the setting of failed breast conservation therapy resulting in mastectomy with reconstruction was associated with an increased risk for revision. Patients should be counseled accordingly before breast conservation therapy in the event they may eventually undergo mastectomy with reconstruction.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, III.
Sudden unexpected death in epilepsy
Authors: Friedman Daniel 
Published: February 2022

Purpose of review
Sudden unexpected death in epilepsy (SUDEP) is a major contributor to premature mortality in people with epilepsy. This review provides an update on recent findings on the epidemiology of SUDEP, clinical risk factors and potential mechanisms.

Recent findings
The overall risk rate of SUDEP is approximately 1 per 1000 patients per year in the general epilepsy population and that children and older adults have a similar incidence. Generalized convulsive seizures (GCS), perhaps through their effects on brainstem cardiopulmonary networks, can cause significant postictal respiratory and autonomic dysfunction though other mechanisms likely exist as well. Work in animal models of SUDEP has identified multiple neurotransmitter systems, which may be future targets for pharmacological intervention. There are also chronic functional and structural changes in autonomic function in patients who subsequently die from SUDEP suggesting that some SUDEP risk is dynamic. Modifiable risks for SUDEP include GCS seizure frequency, medication adherence and nighttime supervision.

Summary
Current knowledge of SUDEP risk factors has identified multiple targets for SUDEP prevention today as we await more specific therapeutic targets that are emerging from translational research studies.
Implementing an evidence-based structured education and management program in an inpatient adult oncology setting to improve patients’ pain control
Authors: Tien Jeraine J.N. , Tan Hui Ching , Chua Chue Teng , Lee Yee Mei , Tho Poh Chi 
Published: February 2022

ABSTRACT

Background and aims:
Cancer-related pain is prevalent across the cancer trajectory, and is probably one of the most feared of all cancer symptoms for patients and their families. Although there were guidelines and framework regarding the management of cancer pain, pain control among patients remain suboptimal. This best practice implementation project aimed to improve patients’ perception on cancer pain management and pain control through implementing structured patient and family education and patient information leaflet (PIL) on managing cancer pain.

Methods:
The current implementation project conducted in an adult oncology inpatient unit utilized the JBI Practical Application of Clinical Evidence System and Getting Research into Practice module for promoting evidence-based health care.

Results:
A comparison between the preimplementation and postimplementation findings showed significant improvements for both audit criteria outcomes. The percentage of patients receiving verbal education rose from 0 to 69%, whereas the percentage of patients receiving PIL increased 0–100%. Patient compliance to analgesic regime increased from 0 to 100%. There was a significant improvement in patients’ pain levels (P < 0.001), with majority rate having none-mild pain post intervention.

Conclusion:
A structured educational program on cancer-related pain improved patients’ knowledge on cancer-related pain management and pain control. Despite the remarkable increase in the compliance rate, further interventions may still be required to achieve 100% compliance. Continuous audits will be held to guide follow-up interventions to ensure compliance and sustention of the project.
Visible blue light inactivates SARS-CoV-2 variants and inhibits Delta replication in differentiated human airway epithelia
Authors: Kocher Jacob , Arwood Leslee , Roberts Rachel C. , Henson Ibrahim , Annas Abigail , Emerson David , Stasko Nathan , Fulcher M. Leslie , Brotton Marisa , Randell Scott H. , Cockrell Adam S. 
Published: February 2022

AbstractThe emergence of SARS-CoV-2 variants that evade host immune responses has prolonged the COVID-19 pandemic. Thus, the development of an efficacious, variant-agnostic therapeutic for the treatment of early SARS-CoV-2 infection would help reduce global health and economic burdens. Visible light therapy has the potential to fill these gaps. In this study, visible blue light centered around 425 nm efficiently inactivated SARS-CoV-2 variants in cell-free suspensions and in a translationally relevant well-differentiated tissue model of the human large airway. Specifically, 425 nm light inactivated cell-free SARS-CoV-2 variants Alpha, Beta, Delta, Gamma, Lambda, and Omicron by up to 99.99% in a dose-dependent manner, while the monoclonal antibody bamlanivimab did not neutralize the Beta, Delta, and Gamma variants. Further, we observed that 425 nm light reduced virus binding to host ACE-2 receptor and limited viral entry to host cells in vitro. Further, the twice daily administration of 32 J/cm2 of 425 nm light for three days reduced infectious SARS-CoV-2 Beta and Delta variants by >99.99% in human airway models when dosing began during the early stages of infection. In more established infections, logarithmic reductions of infectious Beta and Delta titers were observed using the same dosing regimen. Finally, we demonstrated that the 425 nm dosing regimen was well-tolerated by the large airway tissue model. Our results indicate that blue light therapy has the potential to lead to a well-tolerated and variant-agnostic countermeasure against COVID-19.
Analysis of receptors responsible for the dysfunction of the human immune system by different viral infections
Authors: Ivanov Sergey M. , Tarasova Olga A. , Poroikov Vladimir V. 
Published: February 2022

AbstractThere are difficulties in creating direct anti-viral drugs for all viruses, including new, suddenly arising infections, such as COVID-19. Therefore, pathogenetic therapy is often used to treat severe viral infections. Despite significant distinctions in the etiopathogenesis of viral diseases, they are often associated with the substantial dysfunction of the immune system. To identify shared mechanisms of immune dysfunction during infection by nine different viruses (cytomegalovirus, Ebstein-Barr virus, human T-cell leukemia virus type 1, Hepatitis B and C viruses, human immunodeficiency virus, Dengue virus, SARS-CoV, and SARS-CoV-2), we applied analysis of corresponding transcription profiles from peripheral blood mononuclear cells (PBMC). As a result, we revealed common pathways, cellular processes, and master regulators for studied viral infections. We found that all nine viral infections cause immune activation, exhaustion, cell proliferation disruption, and increased susceptibility to apoptosis. An application of network analysis allowed us to identify receptors of PBMC that are the proteins at the top of signaling pathways, which may be responsible for the observed transcription changes. The identified relationships between some of them and virus-induced immune disfunction are new, with little or no information in the literature, e.g., receptors for autocrine motility factor, insulin, prolactin, angiotensin II, and immunoglobulin epsilon.
Fecal immunoglobulin A (IgA) and its subclasses in systemic lupus erythematosus patients are nuclear antigen reactive and this feature correlates with gut permeability marker levels
Authors: Gudi Radhika , Kamen Diane , Vasu Chenthamarakshan 
Published: February 2022

AbstractSystemic lupus erythematosus (SLE) is characterized by the production of anti-nuclear autoantibodies. Here, for the first time, we show that the abundances of gut permeability marker Zonulin and IgA1- and IgA2-subclasses are significantly higher in the fecal samples of SLE patients compared to HCs. Importantly, IgA-total, IgA1- and IgA2-subclasses from SLE patients showed higher nAg reactivity titers. Notably, we found that not only the nuclear antigen (nAg) reactive fecal IgA1:IgA2 ratio is higher in SLE patients, but also the abundance and nAg reactivity of fecal IgA and subclasses, IgA1 particularly, correlate with the fecal levels of Zonulin, which is produced primarily in the small intestine. These observations suggest that higher amounts of nAg-reactive IgA are produced, particularly, in the proximal gut as indicated by higher IgA1:IgA2 abundance and nAg reactivity ratios and correlation of these features with the Zonulin levels.