bluuebunny/crossref_metadata_2025_split huggingface dataset:
The association between comorbidities and disease activity in patients with rheumatoid arthritis: a multicenter, cross-sectional cohort study in Japan with the highest proportion of elderly individuals
Authors: Miura Takanori , Miyakoshi Naohisa , Kashiwagura Takeshi , Tsuchie Hiroyuki , Sugimura Yusuke , Shimada Yoichi 
Published: February 2022

Abstract
Background
This study aimed to assess the association of disease activity with the presence of comorbidities in patients with rheumatoid arthritis, using the Akita Orthopedic Group on Rheumatoid Arthritis (AORA) registry, a multicenter, cross-sectional registry in Japan with the highest proportion of elderly people. We included 1838 patients (mean age: 66.4 years old) who visited our affiliated institutions between April 2018 and March 2019. The patients were divided into two groups based on the disease activity in 28 joints based on the erythrocyte sedimentation rate (DAS28-ESR) into the remission or low disease activity group (L group) and the moderate or high disease activity group (H group). Patient demographics and comorbidities in the two groups were compared.

Results
The most common comorbidity was hypertension (33.7%), followed by renal disease (25.2%), respiratory disease (12.2%), diabetes mellitus (8.1%), cardiovascular disease (8.0%), malignancies (5.7%), and cerebrovascular disease (4.7%). The H group was older (p<0.0001); had a higher prevalence of hypertension (p<0.0001), diabetes (p=0.0011), respiratory disease (p<0.0001), cerebrovascular disease (p<0.0001), and cardiovascular disease (p=0.0030); and was less likely to use anti-rheumatic drugs. The prevalence of comorbidities other than renal disease and malignant tumor was higher in the H group. Multivariate logistic regression analysis showed that female sex (p=0.0054), advanced Steinbrocker class (p<0.0001), high anti-citrullinated protein antibody levels (p=0.0211), high prednisolone dose (p<0.0001), and absence of biologics’ or JAK inhibitors’ use (p<0.0001) were risk factors for high disease activity, and shorter treatment period was a low-risk factor for high disease activity (p=0.0041). Among comorbidities, the presence of cerebrovascular disease (p=0.0334) was the only independent risk factor for high disease activity.

Conclusions
In our registry study with a high proportion of elderly RA patients, cerebrovascular disease was associated with high disease activity in patients with RA. Therefore, when treating elderly patients with RA, we need to pay careful attention to cerebrovascular disease, and treatment should be aimed at achieving adequate control of RA.
Microplastics: a multidimensional contaminant requires a multidimensional framework for assessing risk
Authors: Bucci Kennedy , Rochman Chelsea M. 
Published: February 2022

AbstractThe global ubiquity and demonstrated toxicity of microplastics has led governments around the world to express the need for a risk assessment on microplastics. To conduct a risk assessment, scientists often draw upon frameworks from other contaminants, however we argue that microplastics are a unique pollutant and thus require a unique framework. Microplastics are a multidimensional contaminant, differing in size, shape, polymer type, and chemical cocktail. Each of these dimensions may influence the toxicity of the particle. Furthermore, microplastic pollution exists as a complex and dynamic mixture of particles, that varies over temporal and spatial scales. Thus, we propose a multidimensional risk framework for microplastics that incorporates, rather than simplifies, the multidimensionality of the contaminant as well as the contaminant mixture. With this framework, we can calculate a particle-specific hazard value that describes the potential for a single particle to cause harm based on its chemical and physical properties. The particle-specific hazard values can then be combined based on the number and type of particles in an environmental sample to inform the overall hazard value of the sample. The risk of the sample can then be calculated, which is dependent on the overall hazard value and the concentration of particles in the sample. Risk values among samples in the environment can be compared to illustrate differences among locations or seasons, or can be placed in a management framework with thresholds to guide regulatory decisions. To demonstrate the utility of our proposed framework, we perform a case study using data from San Francisco Bay. Our proposed framework is just that, and requires new research for application. To strengthen the ability of this framework to accurately predict risk, we propose a testing scheme that prioritizes strategic experimental designs that will increase our understanding of how each dimension of microplastics affect the toxicity (or hazard value) of a particle.
Predictor factors for non-invasive mechanical ventilation failure in severe COVID-19 patients in the intensive care unit: a single-center retrospective study
Authors: Romanelli Antonio , Toigo Pietro , Scarpati Giuliana , Caccavale Angela , Lauro Gianluigi , Baldassarre Daniela , Oliva Filomena , Lacava Graziella , Pascale Gabriele , Piazza Ornella 
Published: February 2022

Abstract
Background
During the COVID-19 pandemia, non-invasive mechanical ventilation (NIV) has been largely applied. Few data are available about predictors of NIV failure in critical COVID-19 patients admitted to ICU. The aim of this study is to analyze clinical and laboratory features able to predict non-invasive ventilation success in avoiding endotracheal intubation.

Methods
A retrospective observational study was performed in our COVID-19 ICU during a 6-month period. Demographic, clinical, laboratory, imaging, and outcome data were extracted from electronic and paper medical records and anonymously collected.

Results
Eighty-two severe COVID-19 patients were supported by NIV at ICU admission. The median PaO2/FiO2 ratio was 125 [98.5–177.7]. NIV failed in 44 cases (53%). Patients who experienced NIV failure had a higher Charlson Comorbidity Index (median value 4) compared to those who were dismissed without endotracheal intubation (median 2, p < 0.0001). At Cox regression analysis, the Charlson Comorbidity Index represented a predictive factor related to NIV failure. PaO2/FiO2, CPK, INR, and AT III at ICU admission showed a significant relationship with the outcome, when single variables were adjusted for the Charlson Comorbidity Index.

Conclusion
The Charlson Comorbidity Index may be helpful to stratify patients’ risk of NIV failure in a severe COVID-19 population; even if this study, retrospective design does not allow definitive conclusions.
Financial Hardship in Patients With Head and Neck Cancer
Authors: Mott Nicole M. , Mierzwa Michelle L. , Casper Keith A. , Shah Jennifer L. , Mallen-St Clair Jon , Ho Allen S. , Zumsteg Zachary S. , Prince Mark E.P. , Dossett Lesly A. , Chen Michelle M. 
Published: February 2022

PURPOSE: Financial hardship is a growing concern for patients with cancer. Patients with head and neck cancer (HNC) are particularly vulnerable, given that a third leave the workforce following treatment. The goal of our study was to characterize financial hardship in the psychologic response (response to increased expenses) and coping behaviors (behaviors patients adopt to manage their care in the setting of increased expenses) domains in patients with HNC compared with patients with other cancers. METHODS: This was a retrospective cohort study of nationally representative public survey data from 2013 to 2018 in the National Health Interviews Survey, an annual cross-sectional household survey. We included respondents age ≥ 18 years who reported a diagnosis of cancer and identified a subset of patients with HNC. Our main outcomes were financial hardship in the psychologic response and coping behaviors domains. RESULTS: Our sample included a weighted population of 357,052 patients with HNC and 21.4 million patients with other cancers. Compared with patients with other cancers, patients with HNC reported greater levels of coping behaviors hardship (31% v 23%, P = .015), but similar levels of psychologic financial hardship (73% v 72%, P = .787). Medicaid or uninsured patients more often reported coping behaviors hardship. On multivariable analysis, HNC (odds ratio, 1.51; 95% CI, 1.01 to 2.24) was independently associated with coping behaviors hardship. CONCLUSION: To our knowledge, this is the first study to evaluate financial hardship in patients with HNC compared with patients with other cancers that includes Medicaid and uninsured patients, who are more often to have financial hardship. Patients with HNC have greater levels of hardship in the coping behaviors domain compared with patients with other cancers, but similar levels in the psychologic response domain.
Acceleration of wound healing by topical application of gel formulation of Barringtonia racemosa (L.) Spreng kernel extract
Authors: Sitohang Nur A. , Putra Effendy D. L. , Kamil Hajjul , Musman Musri 
Published: February 2022

Background: Phytomedicines are gaining a spotlight in wound management, where much research has suggested the wound healing potential of Barringtonia racemosa. The objective of this study was to investigate the effectiveness of B. racemosa kernel extract in accelerating wound healing process in animal models. Methods: B. racemosa kernel was extracted using ethanol:water (7:3) solvent and was then used as a bioactive ingredient in a Carbopol 940-based gel formulation in four different concentrations (1, 3, 5 and 7 ppm). A 3 cm diameter wound was made in the dorsal area of Rattus norvegicus rat and wound healing process was assessed up to 12 days using DESIGN (Depth, Exudate, Size of Inflammation/Infection, Granulation tissue, and Necrotic tissue) scoring system. Results: Our data suggested that the DESIGN scores were significantly different among concentration groups after the 3rd day onward suggesting B. racemosa extract accelerated the wound healing process. Rats treated with gel formulation containing 7 ppm of B. racemosa kernel extract had faster wound healing than that treated with topical Metcovazin. Conclusion: B. racemosa kernel extract was effective in accelerating wound healing on rats. Further study is warranted to purify the bioactive component and the action mechanism in wound healing process.
A close-up of the use of weblogs and blogging buddies: A case study in Malaysia
Authors: Chua Yong Eng , Kaur Bhar Sareen 
Published: February 2022

Background – Peer review or evaluation has been seen as a promising approach in helping students to learn from one another instead of relying solely on their overwhelmed teachers for feedback on their written work. However, there have been mixed reviews on the effectiveness of this method. This study aims to examine the effects of peer review on blogging buddies’ writing performance as well as to suggest the groundwork needed for an effective way to pair the blogging buddies to ensure that the peers can bilaterally benefit each other. Methods – A qualitative case study was conducted on eight students from a private university in Malaysia. The writing scores for three different essays (pre and post peer review) were tracked to observe its effects on the respective blogging buddies’ writing performance. Results – The findings have shown that the students’ proficiency levels played an important part in pairing the students as it impacted their writing performance and the effectiveness of the peer review activity. Poor proficiency students who were paired with average proficiency students seemed to make the greatest progress and were the most prominent beneficiaries. Even though these average students benefited from being a reviewer; this pairing was a disadvantage when they reposted their essays after peer review. For high proficiency students who were paired together, they recorded either an increased score or a same score in their post-peer writing. Conclusions – This study has shown that for peer review via weblogs to be effectively implemented in writing classes, proper groundwork needs to be laid for instructors to ensure that adequate training is provided, the peers are properly paired, and sufficient support is provided to these blogging buddies.
Lessons learned and lessons missed: impact of the coronavirus disease 2019 (COVID-19) pandemic on all-cause mortality in 40 industrialised countries and US states prior to mass vaccination
Authors: Kontis Vasilis , Bennett James E. , Parks Robbie M. , Rashid Theo , Pearson-Stuttard Jonathan , Asaria Perviz , Zhou Bin , Guillot Michel , Mathers Colin D. , Khang Young-Ho , McKee Martin , Ezzati Majid 
Published: February 2022

Background: Industrialised countries had varied responses to the COVID-19 pandemic, which may lead to different death tolls from COVID-19 and other diseases. Methods: We applied an ensemble of 16 Bayesian probabilistic models to vital statistics data to estimate the number of weekly deaths if the pandemic had not occurred for 40 industrialised countries and US states from mid-February 2020 through mid-February 2021. We subtracted these estimates from the actual number of deaths to calculate the impacts of the pandemic on all-cause mortality. Results: Over this year, there were 1,410,300 (95% credible interval 1,267,600-1,579,200) excess deaths in these countries, equivalent to a 15% (14-17) increase, and 141 (127-158) additional deaths per 100,000 people. In Iceland, Australia and New Zealand, mortality was lower than would be expected in the absence of the pandemic, while South Korea and Norway experienced no detectable change. The USA, Czechia, Slovakia and Poland experienced >20% higher mortality. Within the USA, Hawaii experienced no detectable change in mortality and Maine a 5% increase, contrasting with New Jersey, Arizona, Mississippi, Texas, California, Louisiana and New York which experienced >25% higher mortality. Mid-February to the end of May 2020 accounted for over half of excess deaths in Scotland, Spain, England and Wales, Canada, Sweden, Belgium, the Netherlands and Cyprus, whereas mid-September 2020 to mid-February 2021 accounted for >90% of excess deaths in Bulgaria, Croatia, Czechia, Hungary, Latvia, Montenegro, Poland, Slovakia and Slovenia. In USA, excess deaths in the northeast were driven mainly by the first wave, in southern and southwestern states by the summer wave, and in the northern plains by the post-September period. Conclusions: Prior to widespread vaccine-acquired immunity, minimising the overall death toll of the pandemic requires policies and non-pharmaceutical interventions that delay and reduce infections, effective treatments for infected patients, and mechanisms to continue routine health care.
Drivers of Resistance in Uganda and Malawi (DRUM): a protocol for the evaluation of One-Health drivers of Extended Spectrum Beta Lactamase (ESBL) resistance in Low-Middle Income Countries (LMICs)
Authors: Cocker Derek , Sammarro Melodie , Chidziwisano Kondwani , Elviss Nicola , Jacob Shevin T. , Kajumbula Henry , Mugisha Lawrence , Musoke David , Musicha Patrick , Roberts Adam P. , Rowlingson Barry , Singer Andrew C. , Byrne Rachel L. , Edwards Thomas , Lester Rebecca , Wilson Catherine N. , Hollihead Beth , Thomson Nicholas , Jewell Christopher P. , Morse Tracy , Feasey Nicholas A. 
Published: February 2022

In sub-Saharan Africa (sSA), there is high morbidity and mortality from severe bacterial infection and this is compounded by antimicrobial resistance, in particular, resistance to 3rd-generation cephalosporins. This resistance is typically mediated by extended-spectrum beta lactamases (ESBLs). To interrupt ESBL transmission it will be important to investigate how human behaviour, water, sanitation, and hygiene (WASH) practices, environmental contamination, and antibiotic usage in both urban and rural settings interact to contribute to transmission of ESBL E. coli and ESBL K. pneumoniae between humans, animals, and the environment. Here we present the protocol for the Drivers of Resistance in Uganda and Malawi (DRUM) Consortium, in which we will collect demographic, geospatial, clinical, animal husbandry and WASH data from a total of 400 households in Uganda and Malawi. Longitudinal human, animal and environmental sampling at each household will be used to isolate ESBL E. coli and ESBL K. pneumoniae. This will be complimented by a Risks, Attitudes, Norms, Abilities and Self-Regulation (RANAS) survey and structured observations to understand the contextual and psychosocial drivers of regional WASH practices. Bacterial isolates and plate sweeps will be further characterised using a mixture of short-,long-read and metagenomic whole-genome sequencing. These datasets will be integrated into agent-based models to describe the transmission of EBSL resistance in Uganda and Malawi and allow us to inform the design of interventions for interrupting transmission of ESBL-bacteria.
Improving Patient Transfer Protocols for Regional Stroke Networks
Authors: Ardestani-Jaafari Amir , Kucukyazici Beste 
Published: February 2022

Currently, stroke patients are transported to the nearest stroke center, following specific protocols. Yet, these protocols do not consider many factors, including the spatial variation in population density, the stroke’s severity, the time since stroke onset, and the congestion level at the receiving stroke center. We develop an analytical framework that enriches the stroke transport decision-making process by incorporating these factors. Our research contributes to the literature of stroke care systems by (i) developing the first analytical framework to determine the optimal primary hospital destination in a regional stroke network and (ii) comparing the impact of incorporating prehospital triaging on health outcomes. To this end, we develop an efficient reformulation for allocation problems with stochastic demand and multiserver system under congestion. We derive data-driven outcome prediction models embedded in mixed integer second-order cone programming formulation. Our framework is applied to two real-life cases: Montreal and Quebec City Stroke Networks. We show that adopting a triage strategy could lead to significantly improved health outcomes, where the magnitude of these improvements varies with the networks’ sizes and congestion levels. In the Montreal case, our proposed policy may increase the ratio of patients for therapeutic intervention eligibility by 12.5% while improving by 69% the number of patients with more than two days of emergency department boarding delays. Our results reveal that it is important to consider the network’s characteristics in making a decision for or against implementing a prehospital triage strategy. Finally, we propose a heuristic policy that provides a promising performance while also being easy to implement.This paper was accepted by Stefan Scholtes, healthcare management.
A Practical Approach for Estimating Influent-Effluent Mass Flow Differences in Dairy Manure-Based Anaerobic Co-Digestion Systems
Authors: Labatut Rodrigo A. , Morris James W. , Gooch Curt A. 
Published: February 2022

HighlightsThree rigorous, methods for estimating influent-effluent mass flow differences due to biogas generation in manure-based anaerobic co-digestion systems are presented.The methods developed reveal that influent-effluent mass flow differences are driven by waste biochemical conversion - biogas water vapor content is insignificant.A simple, input-based method produced comparable results to two, more complex, output-based methods, when tested using 12 months of data collected from three dairy-based anaerobic co-digestion systems.Abstract.During co-digestion of dairy manure and off-farm organic waste in farm anaerobic co-digestion (AcoD) systems, the process’s conversion of biodegradable organics to biogas reduces the volumetric mass (or mass-volume) of the effluent discharged compared to the mass-volume fed. In this study, we present three methods for estimating the mass-flow difference between influent and effluent due to conversion to biogas based on widely accepted, rigorously applied, biological and engineering principles. Monthly operating data from three full-scale AcoD systems, operated under different conditions for a full year were used to compare results using the three calculation methods. Results revealed that the predictions of influent mass flow loss obtained using a simplified input-based method primarily based on influent volumetric flow rates and biodegradability data were in good agreement with those obtained using more accurate, real-time data, namely methane concentration and biogas production. For AcoD systems adding off-site wastes at around 30% or less of the total influent volatile solids (VS), the estimated reduction in effluent flow was in the range of 3% or less. In one case, for VS additions up to approximately 60% of the AcoD system’s influent load, the reduction was 12%. Accepted fundamental water vapor relationships were also applied to biogas generation. Biogas water vapor loses were estimated to comprise approximately 0.2% of the total biogas mass-volume typically produced. Since in most anaerobic digestion systems, biogas condensate water is returned to the influent, this insignificant amount may be ignored. Keywords: Anaerobic, Biogas, Co-digestion, Dairy manure, Digestion, Food waste, Volume-mass flow conversion.
Influence of Hot-water Treatment on the Trypsin Inhibitor Activity Reduction of Sweet Potatoes
Authors: Huang Che-Lun , Lai Yung-Chang , Lien Ching-Yi , Liao Wayne C. 
Published: February 2022

HighlightsSweet potatoes designated for animals contains higher trypsin inhibitor activity.The trypsin inhibitor activity of sweet potatoes was reduced by hot-water treatment.The optimal conditions of hot-water treatment were determined to be 95°C and 14 min.Sweet potato extracts are reversible competitive trypsin inhibitors.ABSTRACT.Sweet potatoes are a good food source, but they contain trypsin inhibitors, which reduce the protein utilization rate in animals. This study analyzed the trypsin inhibitor activity of ten sweet potato varieties. Most of the sweet potatoes designated for animals exhibited high trypsin inhibitor activity. The trypsin activities of TNG57 and TNG10, the most popular sweet potato varieties in Taiwan, were 51.5% and 77.1%, respectively. However, the trypsin inhibitor activity of these fresh sweet potatoes was successfully reduced by hot-water treatment. The influence of hot-water temperature and treatment time was analyzed by response surface methodology (RSM). From the RSM regression models, the optimal conditions of hot-water treatment were determined to be 95°C and 14 min. The kinetic parameters (Km and Vmax) of sweet potato extracts were determined from a Lineweaver-Burke plot. The inhibitor in sweet potato extracts was classified as reversible competitive. Keywords: Hot-water treatment, Sweet potato, Trypsin inhibitor, Response surface methodology.