bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new method for screening acute/chronic lymphocytic leukemia: dual-label time-resolved fluorescence immunoassay
Authors: Zhang Zhen , Zhang Jintao , Dai Shanshan , Xu Hang 
Published: September 2022

Abstract
Background
Lymphocytic leukemia (LL) is a primary malignant tumor of hematopoietic tissue, which seriously affects the health of children and the elderly. The study aims to establish a new detection method for screening acute/chronic LL using time-resolved fluorescence immunoassay (TRFIA) via quantitative detection of S100 calcium binding protein A8 (S100A8) and leucine-rich alpha-2-glycoprotein 1 (LRG1) in serum.

Methods
Here a sandwich TRFIA was optimized and established: Anti-S100A8/LRG1 caputre antibodies immobilized on 96-well plates captured S100A8/LRG1, and then banded together with the anti-S100A8/LRG1 detection antibodies labeled with Europium(III) (Eu3+)/samarium(III) (Sm3+) chelates. Finally time resolved fluorometry measured the fluorescence intensity.

Results
The sensitivity of S100A8 was 1.15 ng/mL(LogY = 3.4027 + 0.4091 × LogX, R2 = 0.9828, P < 0.001, dynamic range: 2.1–10,000 ng/mL), and 3.2 ng/mL for LRG1 (LogY = 3.3009 + 0.4082 × LogX, R2 = 0.9748, P < 0.001, dynamic range: 4.0–10,000 ng/mL). The intra-assay and inter-assay CVs were low, ranging from 5.75% to 8.23% for S100A8 and 5.30% to 9.45% for LRG1 with high specificity and affinity in serum samples. Bland–Altman plots indicated TRFIA and ELISA kits have good agreement in clinical serum samples. Additionally, the cutoff values for S100A8 and LRG1 were 1849.18 ng/mL and 588.08 ng/mL, respectively.

Conclusion
The present TRFIA method could be used for the quantitative detection of S100A8 and LRG1 in serum, and it has high sensitivity, accuracy and specificity. Clinically, this TRFIA method could be suitable for screening of LL via the quantitative detection of S100A8 and LRG1.
The association of gender with receptive and distributive needle sharing among individuals who inject drugs
Authors: Rich Katherine M. , Zubiago Julia , Murphy Meghan , Guardado Rubeen , Wurcel Alysse G. 
Published: September 2022

Abstract
Background
Injection drug use and needle sharing remains a public health concern due to the associated risk of HIV, HCV and skin and soft tissue infections. Studies have shown gendered differences in the risk environment of injection drug use, but data are currently limited to smaller urban cohorts.

Methods
To assess the relationship between gender and needle sharing, we analyzed publicly available data from the 2010–2019 National Survey on Drug Use and Health (NSDUH) datasets. Chi-square tests were conducted for descriptive analyses and multivariable logistic regression models were built adjusting for survey year, age, HIV status, and needle source.

Results
Among the entire sample, 19.8% reported receptive needle sharing, 18.8% reported distributive sharing of their last needle, and 37.0% reported reuse of their own needle during last injection. In comparison with men, women had 34% increased odds (OR 1.34, 95% CI 1.11–1.55) of receptive needle sharing and 67% increased odds (OR 1.67, 95% CI 1.41–1.98) of distributive needle sharing. Reuse of one's own needle did not differ by gender.

Conclusions
In this nationally representative sample, we found that women are more likely in comparison with men to share needles both through receptive and distributive means. Expansion of interventions, including syringe service programs, to increase access to sterile injection equipment is of great importance.
NPWT resource use compared with standard moist wound care in diabetic foot wounds: DiaFu randomized clinical trial results
Authors: Seidel Dörthe , Lefering Rolf ,   DiaFu study group
Published: September 2022

AbstractBackgroundDiabetic foot ulcers not only have a negative impact on patient mortality, morbidity and quality of life, but also require high resource utilization to achieve complete wound healing. The aim of this evaluation was to compare resource utilization of negative pressure wound therapy (NPWT) and standard moist wound care (SMWC) for diabetic foot wounds after amputation, surgical debridement or wound cleansing.MethodsThe multicenter clinical DiaFu study enrolled 368 adults with diabetic foot ulcers between December 23, 2011 and October 21, 2014. Patients were randomly assigned to NPWT and SMWC. Evaluation of direct resource use comprised inpatient and outpatient treatment time, and personnel and material for wound treatment within 16 weeks. This resource use analysis was primarily based on the per protocol population (NPWT 44; SMWC 110).ResultsTreatment duration was 16 days shorter with NPWT (mean (SD) 82.8 (31.6), SMWC 98.8 (24.6); U test, p = 0.001) with 14.9 days shorter outpatient treatment (mean (SD) NPWT 68.3 (31.1), SMWC 83.2 (29.7)). The number of dressing changes per study participant was lower with NPWT (mean (SD) 35.1 (18.6), SMWC (42.9 (21.4); U test, p = 0.067). Time per dressing change was significantly lower with SMWC (mean (SD) 19.7 (12.8), NPWT (16.5 (8.2) minutes; U test, p < < 0.0001). Time for surgical debridements per study participant was 23.3 minutes shorter with NPWT (mean (SD) 20.5 (20.5), SMWC (43.8 (46.7); U test, p = 0.395).ConclusionsResource use was lower for NPWT, which may be an efficient treatment alternative to SMWC for diabetic foot wounds, to be demonstrated in subsequent cost analyses.Trial registrationclinicaltrials.govNCT01480362 on November 28, 2011
Identification of DNA methylation-regulated genes as potential biomarkers for coronary heart disease via machine learning in the Framingham Heart Study
Authors: Zhang Xiaokang , Wang Chen , He Dingdong , Cheng Yating , Yu Li , Qi Daoxi , Li Boyu , Zheng Fang 
Published: September 2022

Abstract
Background
DNA methylation-regulated genes have been demonstrated as the crucial participants in the occurrence of coronary heart disease (CHD). The machine learning based on DNA methylation-regulated genes has tremendous potential for mining non-invasive predictive biomarkers and exploring underlying new mechanisms of CHD.

Results
First, the 2085 age-gender-matched individuals in Framingham Heart Study (FHS) were randomly divided into training set and validation set. We then integrated methylome and transcriptome data of peripheral blood leukocytes (PBLs) from the training set to probe into the methylation and expression patterns of CHD-related genes. A total of five hub DNA methylation-regulated genes were identified in CHD through dimensionality reduction, including ATG7, BACH2, CDKN1B, DHCR24 and MPO. Subsequently, methylation and expression features of the hub DNA methylation-regulated genes were used to construct machine learning models for CHD prediction by LightGBM, XGBoost and Random Forest. The optimal model established by LightGBM exhibited favorable predictive capacity, whose AUC, sensitivity, and specificity were 0.834, 0.672, 0.864 in the validation set, respectively. Furthermore, the methylation and expression statuses of the hub genes were verified in monocytes using methylation microarray and transcriptome sequencing. The methylation statuses of ATG7, DHCR24 and MPO and the expression statuses of ATG7, BACH2 and DHCR24 in monocytes of our study population were consistent with those in PBLs from FHS.

Conclusions
We identified five DNA methylation-regulated genes based on a predictive model for CHD using machine learning, which may clue the new epigenetic mechanism for CHD.
Missed urethral duplication associated with hypospadias, post-hypospadias repair urethral stenosis, and recurrent urinary tract infections in an adult: a case report
Authors: Hosseini Jalil , Abouei Saeid , Mirjalili Alimohammad 
Published: September 2022

Abstract
Background
Duplication of urethra is a very rare congenital disorder. Several types of this anomaly have been reported around the world, and are also discussed in this report. However, the mechanism of this anomaly is still unclear.

Case
A 45-year-old Persian man with a complaint of recurrent urinary tract infection was referred to our clinic. He had a history of repairing penoscrotal hypospadias in childhood along with obstructive and irritating symptoms in adolescence. On his last voiding cystourethrogram and retrograde urethrogram, stenosis was observed in the proximal bulbar urethra along with a double urethra in the dorsal region of the main urethra. The double urethra was removed with operation, and he was followed for 1 month after surgery. He had no complaints of recurrence or urinary incontinence.

Conclusions
This report shows the different classification systems, types of double urethra, and approach and management, which mainly involves surgery; however, surgical management should be done according to the anatomical findings of the abnormality.
Prevalence and associated factors of sleep deprivation among Haramaya University students, Ethiopia, 2021: cross-sectional study
Authors: Lankrew Ayalew Tadele , Wale Belete Gelaw , Haile Kirubel Eshetu 
Published: September 2022

Abstract
Background
Sleep deprivation is the lack of sleep that is associated with an increased risk of cardiovascular illness, diabetes, obesity, cognitive impairment, vehicle accidents, and workplace accidents, as well as being a direct source of daily dysfunction. Despite the fact that some studies have been undertaken, there is a shortage of data on the incidence of sleep deprivation and associated factors among university students in Africa, particularly in Ethiopia, where the study area is located. As a result, the purpose of this study was to determine the incidence of sleep deprivation and its associated factors among Haramaya University students in Eastern Ethiopia.

Methods
A cross-sectional study design was employed among Haramaya University students. A total of 624 students participated in this study. A multistage sampling technique was used to select the participants. A pretested structured self-administered questionnaire was used to collect data. Using Epi Data Version 3.1, the data was checked, coded, entered, and cleaned before being exported to SPSS Version 20 for analysis. Bivariate and multivariate logistic regression analysis was undertaken. For statistical significance, P ≤ 0.001 was used as the cutoff point.

Results
In this study, 586 study participants were participated, with a response rate of 96.2%. Among participants, the majority of 324(55.3%) were males, and the majority of 311(53.1%) were in the age range of 17–20 years with a median age of 19. Most of the study participants were single 561(95.7%). The overall prevalence of sleep deprivation was 68.4% (95% CI: 64.8–72.4). Coffee/tea drinkers (AOR = 2.83, 95% CI:1.17–6.86), Khat chewers (AOR = 2.33, 95%CI: 1.20–4.50), participants with stress (AOR = 3.49,95% CI: 1.22–9.95), participants exposed to moderate stage of anxiety (AOR = 2.87,95% CI:1.14–7.18), and being in the third and fourth study years (AOR = 0.33,95% CI:0.13–0.85) were significantly associated factors with sleep deprivation.

Conclusion
The prevalence of sleep deprivation was found to be high in this study. Coffee/tea users, khat chewers, being stressed, exposed to moderate levels of anxiety, and being in the third and fourth study years were all found to be significantly associated with sleep deprivation.
Factors influencing prescribing by critical care physicians to heart failure patients in Egypt: a cross-sectional survey
Authors: Hadidi Seif El , Bazan Naglaa Samir , Byrne Stephen , Darweesh Ebtissam , Bermingham Margaret 
Published: September 2022

Abstract
Background
Heart failure (HF) guideline-led prescribing improves patient outcomes; however, little is known about the factors influencing guideline-led prescribing in critical care settings. This study used a cross-sectional survey to assess the factors that influence physicians when prescribing to heart failure patients in a critical care setting in Egypt.

Results
The response rate was 54.8%. The international HF guidelines were the primary source of prescribing information for 84.2% of respondents. Staff were more familiar with the latest guideline recommendations than associate staff (86.7% vs 36.8%, p = 0.012) and considered patient’s perspectives more often (86.7% vs 26.3%, p = 0.036). Renal function was the clinical factor that most frequently influenced the prescribing of loop diuretics or renin–angiotensin–aldosterone system inhibitors. Pulmonary function influenced beta-blockers prescription. The most frequently cited barrier to guideline-led prescribing was the absence of locally drafted guidelines. A majority of prescribers agreed that implementation of clinical pharmacy services, physician education and electronic reminders may improve the implementation of guideline-led prescribing.

Conclusions
Although experienced physicians are familiar with and use international guidelines, physicians would welcome local guidance on HF prescribing and greater clinical pharmacist input.
Association of area-level mortgage discrimination and guideline-concordant non–small cell lung cancer care in the United States.
Authors: Fan Qinjin , Hussaini S. M. Qasim , Pollack Craig Evan , Yabroff K. Robin Robin , Nogueira Leticia M 
Published: September 2022

3 Background: Disparities in receipt of care for non-small cell lung cancer (NSCLC) are well described. Discriminatory mortgage lending, which limits access to home ownership in specific neighborhoods overall and disproportionately for racialized groups, is a marker of systemic racism and lower levels of neighborhood investment. This may, in turn, decrease access to high quality care. We used the mortgage denial rate as a measure of housing discrimination and investigated its association with guideline-concordant NSCLC care. Methods: Mortgage denial rates were estimated at the zip code tabulation areas (ZCTAs) level using the Home Mortgage Disclosure Act (HMDA) database (2014-2019). Mortgage denial rates represent the proportion of denied home loans to total loans and were categorized into quartiles. Individuals ≥ 18 years diagnosed with NSCLC 2014-2019 were identified from the National Cancer Database and combined with HMDA. Multivariable logistic regression models examined associations between mortgage discrimination and receipt of guideline-concordant care, including surgery, chemotherapy, and chemoradiation. A multivariable Cox proportional hazard model examined the association between mortgage discrimination and time to chemotherapy initiation. Results: Cohort included 450,614 patients newly diagnosed with NSCLC resided in 33,120 ZCTAs. Individuals residing in ZCTAs with higher mortgage denial rates were more likely to be aged 45-64 years, male, non-Hispanic White, with private health insurance coverage and income < $40,000/year. 69% of all patients received guideline-concordant care. Likelihood of guideline-concordant care was lower in neighborhoods with higher mortgage denial rates, adjusting for age and sex (Table). This disparity was present in all care subgroups. Time to chemotherapy initiation was longer for patients in neighborhoods with higher mortgage denial rates. Conclusions: Mortgage discrimination is adversely associated with receipt of guideline-concordant NSCLC care. Our examination of institutional practices leading to barriers in access to resources highlights the critical need to understand the pathways through which area-level mortgage denials impact receipt of equitable cancer care.[Table: see text]
Impact of proposed 2022 changes to the Merit-Based Incentive Payment System (MIPS) on oncologist performance and reimbursement.
Authors: Patel Vishal R. , Gupta Arjun , Hussaini S. M. Qasim 
Published: September 2022

6 Background: In 2017, the Centers for Medicare & Medicaid Services (CMS) executed a landmark bipartisan legislation aimed at gradually shifting American healthcare from a fee-for-service model to a value-based system. The resulting payment model, MIPS, uses cost and quality metrics to assign clinicians an overall MIPS score, where higher scores correspond to greater payments for practices. In 2018, cost metrics contributed only 10% of this composite score, while quality metrics contributed 50%. Beginning with 2022, the cost and quality categories will be equally weighted (30% each) to encourage clinicians to reduce healthcare costs. As the cost of cancer care is disproportionately high, we investigated the implications of the updated scoring on reimbursements for oncologists and other providers participating in MIPS. Methods: We included physicians participating in the 2018 MIPS Performance Year files. We categorized hematological-, medical, radiation, gynecological, and surgical oncologists as oncologists and delineated those with National Cancer Institute-designated Cancer Center (NCICC)-affiliation. We excluded individuals who were exempt from reporting cost scores due to their MIPS-filing method. We calculated the projected 2022 MIPS composite scores (range, 0-100) by multiplying the 2022 weights by the 2018 component scores. We compared the change in composite MIPS score and the corresponding negative payment adjustments due to reweighing across specialties. Clopper–Pearson 95% confidence intervals were reported. Results: The cohort included 168,659 physicians, of which 163,150 (97%) were non-oncologists and 5,509 (3%) were oncologists. Of oncologists, 1,757 (32%) were at a NCICC. Cost scores (higher is better) for each group were as follows: non-oncologists, 75.2; all oncologists, 65.5; NCICC oncologists, 57.1. Reweighing the 2018 MIPS composite scores with the updated 2022 cost/quality weights resulted in a mean 1.7-point decrease (88.7 to 87) for non-oncologists, a 3.8-point decrease (89.7 to 85.9) for all oncologists, and a 5.2-point decrease (89.2 to 84) for NCICC oncologists. Following the reweighing, the proportion of non-oncologists incurring penalties will increase by 12.8% (95% CI, 12.7%–12.9%); all oncologists by 14.3% (95% CI, 13.2%–15.4%); and NCICC oncologists by 20% (95% CI, 18.1%–21.9%). Conclusions: Beginning with 2022 performance year, federally mandated reweighing of MIPS cost metrics will result in a disproportionate increase in oncologists receiving negative payment adjustments. With a majority Medicare population with new cancer diagnoses, higher patient complexity, and declining operating margins at many oncologic practices, we highlight striking upcoming changes that may inform further optimization of MIPS cost metrics by CMS to ensure oncologists providing high quality care are not penalized.
Using real-world data to quantify chemotherapy waste at Mayo Clinic.
Authors: Soefje Scott A. , Irvine Clayton , Tucker Calvin E. , Shah Vishal S. 
Published: September 2022

8 Background: At Mayo Clinic, the implementation of an automated chemotherapy dose rounding program has resulted in significant cost savings when doses are rounded down to a vial size, however, the cost burden from drug waste continues to be a significant issue when rounding to a vial size is not within our 10% rounding allowance. The mismatch between drug doses and the marketed vial sizes, along with the limitations to the use of single dose vials is a recognized problem, resulting in billions of dollars of wasted drugs in the United States.The goal of our study was to quantify the cost of the wasted amount of chemotherapy and biologic drugs after the implementation of an automated dose rounding program. Methods: Using the electronic health record (EHR), data was collected for biologic and oncolytic agents administered from 1/1/2019 through 12/31/2021. Drugs with waste documented during preparation and that were administered to cancer patients were selected for analysis. The % of doses with waste documented was calculated based upon the total number of all doses given. The total cost of the drug administered along with the cost of the amount of drug wasted were calculated based upon costs listed in the EHR at the time of administration. Results: For the 3-year period, 446,832 doses were dispensed with 47,626 (10.7%) of those doses having waste documented. The total cost of the drugs with documented waste was $114,323,203 with 21.9% ($25,086,608) accounting sole for wasted drug. Five drugs accounted for 59% of the total cost of the drug waste (Table). When examining individual drugs with a high % of doses with documented waste, methoxsalen, epirubicin, eribulin, topotecan, & bortezomib each had > 70% of doses with a documented wasted amount. Conclusions: Despite having an aggressive institutional dose rounding policy, drug waste still results in considerable and significant costs to the Mayo Clinic System. Our data likely underestimates the total cost of drugs waste given that waste documentation requires manual entry into the EHR at the time of preparation. Our results support the need to create and develop solutions that could lead to reduced waste costs which include re-examining the weight based dosing of drugs, mandating pharmaceutical companies to have vial sizes that more appropriately meet the range of standard dosing, developing more multi-dose vials that can be shared across multiple patients, utilizing closed-system transfer devices to extend beyond-use-dating time, or requiring pharmaceutical companies to reimburse payers and patients for the cost of the amount wasted. Drug waste is still a considerable issue and one that needs to be addressed at a policy level.[Table: see text]