bluuebunny/crossref_metadata_2025_split huggingface dataset:
The increasing proportion of adult discharges at children's hospitals, 2004–2019
Authors: Allen Anna Q. , Hall Matt , Goodman Denise M. , McCoy Elisha , Winer Jeffrey C. , Kleinman Michael S. 
Published: September 2022

AbstractSignificant medical advances now enable individuals with pediatric illnesses to survive into adulthood. Finding medical homes for these individuals often remains challenging. We utilized the Pediatric Health Information System to measure the variation in and growth of admissions to children's hospitals, stratified by age and payor from 2004 to 2019. We identified 8,097,081 patient encounters from 30 hospitals. Compared to children, adults discharged at children's hospitals are more likely to have a complex chronic condition, have a higher median cost, and have a longer median length of stay. Hospital‐level adult discharges ranged from 1.9% to 10.1% (median 4.1%; interquartile range: 2.8%–5.4%). Significantly higher increases were seen in each adult age subgroup (18–20, 21–25, and >25 years old) compared to the pediatric age group (p < .001). The number of adults discharged from children's hospitals is increasing faster than children, impacting children's hospitals and the populations they serve.
The bystander effect: Impact of rural hospital closures on the operations and financial well‐being of surrounding healthcare institutions
Authors: Ramedani Shayann , George Daniel R. , Leslie Douglas L. , Kraschnewski Jennifer 
Published: September 2022

AbstractIntroductionThere is presently a rural hospital shortage in the United States with 180 closures since 2005 and hundreds of institutions in financial peril. Although the hospital closure phenomenon is well‐established, less is known about the spillover impact on the operations and financial wellbeing of surrounding hospitals. This preliminary study quantified how discrete rural hospital closures impact institutions in their regional proximity, finding a significant increase in inpatient admissions and emergency department visits for these “bystander hospitals”.MethodsUsing a repository of rural hospital closures collected by the UNC Sheps Center for Health Services Research, we identified closures over the past 15 years. Criteria for inclusion were hospitals that had been fully closed between 2005–2016 and with >25‐bed capacity. We then designated surrounding hospitals within a 30‐mile radius of each closed hospital as “bystander hospitals.” We examined the average rate‐of‐change for inpatient admissions and emergency department visits in surrounding hospitals both two years before and after relevant hospital closures.ResultsWe identified 53 hospital closures and 93 bystander hospitals meeting our criteria during the study period. With respect to geographic distribution, 66% of closures were in the Southern US, including 21% in Appalachia. Average emergency department visits increased by 3.59% two years prior to a hospital's closure; however, at two years post‐closure the average rate of increase rose to 10.22% (F (4,47) = 2.77, p = 0.0375). Average bystander hospital admissions fell by 5.73% in the two years preceding the hospital closure but increased 1.17% in the two years after (F (4,46) = 3.05, p = 0.0259).ConclusionThese findings predict a daunting future for rural healthcare. While previous literature has described the acute effects hospital closures have on communities, this study suggests a significant spillover effect on hospitals within the geographic region and a cyclical process at play in the rural healthcare sector. In the absence of significant public health assistance in regions affected by closures, poor health outcomes, including “diseases of despair,” are likely to continue proliferating, disproportionately affecting the most vulnerable. In the COVID‐19 era, it will be especially necessary to focus on hospital closures given increased risk of maintaining solvency due to delayed and deferred care atop already tight margins.
Clinical outcomes and economic burden of seasonal influenza and other respiratory virus infections in hospitalized adults
Authors: Bolek Hatice , Ozisik Lale , Caliskan Zafer , Tanriover Mine Durusu 
Published: September 2022

AbstractThe cost of influenza and other respiratory virus infections should be determined to analyze the real burden of these diseases. We aimed to investigate the clinical outcomes and cost of illness due to respiratory virus infections in hospitalized adult patients. Hospitalized patients who had nasal swab sampling for a suspected viral infection between August 1, 2018 to March 31, 2019 were included. Outcome variables were oxygen requirement, mechanical ventilation need, intensive care unit admission, and cost. At least one viral pathogen was detected in 125 (47.7%) of 262 patients who were included in the study. Fifty‐five (20.9%) of the patients were infected with influenza. Influenza‐positive patients had higher rates for respiratory support, intensive care unit admission, and mortality compared to all other patients. The average cost of hospitalization per person was 2879.76 USD in the influenza‐negative group, while the same cost was 3274.03 USD in the influenza‐positive group. Although all of the vaccinated influenza‐positive patients needed oxygen support, neither of them required invasive mechanical ventilation or intensive care unit admission. The average hospitalization cost per person was 779.70 USD in the vaccinated group compared to 3762.01 USD in the unvaccinated group. Disease‐related direct cost of influenza in the community was estimated as 22 776 075.61 USD in the 18−65 years of age group and 15 756 120.02 USD in the 65 years of age and over group per year. Influenza, compared to other respiratory virus infections, can lead to untoward clinical outcomes and mortality as well as higher direct medical costs in adults.
Periodontitis prevalence and severity in inflammatory bowel disease: A case–control study
Authors: Baima Giacomo , Muwalla Mamdouh , Testa Giulia , Mazza Francesca , Bebars Ahmad , Perotto Stefano , Vernero Marta , Massano Alessandro , Romano Federica , Ribaldone Davide Giuseppe , Aimetti Mario 
Published: September 2022

AbstractBackgroundRecent evidence is supporting the notion of a microbiological and immunological continuum on the gum–gut axis in health and disease. Therefore, the purpose of this study was to assess the prevalence and risk indicators of periodontitis in patients with Crohn's disease (CD) or ulcerative colitis (UC) compared to age‐ and sex‐matched controls without inflammatory bowel disease (IBD).MethodsA total of 180 IBD (117 CD, 60 UC, 3 IBD‐unclassified) and 180 healthy controls were compared for their periodontitis diagnosis (Centers for Disease Control and Prevention/American Academy of Periodontology [CDC/AAP] case definition) and full‐mouth periodontal parameters. In addition, explorative logistic regression models were performed.ResultsSignificantly more patients with IBD had moderate/severe periodontitis (85.6% vs. 65.6%, p < 0.001) and severe periodontitis (36.7% vs. 25.6%, p < 0.001) than controls. Differences were higher in the 35–50 and 51–65 age groups, without significant changes between CD and UC. IBD subjects presented chances ∼3.5 higher of having moderate/severe periodontitis (p < 0.001). Significant variables associated with periodontitis in the whole sample were older age, presence of IBD, and higher full‐mouth plaque scores, whereas in the IBD group they were male sex, IBD‐associated surgery, and IBD duration and localization (pancolitis). Positive risk indicators for IBD were periodontitis severity and higher bleeding scores, while smoking was negatively associated with UC.ConclusionsRelevant associations between IBD and periodontitis were found, being modified by CD and UC clinical characteristics. Preventive and therapeutic strategies involving the gum–gut axis should be enforced in IBD patients.
Impact of etiology leading to abdominoperineal resection with anterolateral thigh flap reconstruction: A retrospective cohort study
Authors: Meuli Joachim N. , Hubner Martin , Martineau Jérôme , Oranges Carlo M. , Guillier David , Raffoul Wassim , di Summa Pietro G. 
Published: September 2022

AbstractBackgroundLarge and deep perineal defects following abdominal perineal resection (APR) are a challenge for reconstructive surgeons. Even if generally performed for oncological reasons, APR can be indicated as well in extended infection‐related debridement for Hidradenitis suppurativa, Fournier's gangrene, or Crohn's disease. We aimed to compare the outcomes of two groups of patients with different indications for APR (infectious vs. oncological) after pedicled anterolateral thigh (ALT) flap coverageResultsForty‐four consecutive pedicled ALT flap used for coverage after APR in 40 patients were analyzed. 26 patients (65%) underwent APR for oncological reasons and 14 patients (35%) for infectious reasons. The overall postoperative complications rate was significantly higher for infectious cases (76.5% vs. 40.7%, p = 0.0304). Major complications occurred in 52.9% of infectious cases versus 11.1% of oncological cases (p = 0.0045). Obesity and infectious etiology were independent risk factors for overall and major complications, respectively.ConclusionPatients undergoing APR for acute or chronic infections had significantly more overall and major complications than patients having oncological APR. Modified care might be considered, especially in obese patients, in terms of surgical debridement, antibiotic treatment modalities, and postoperative management.
Outcomes of elective cancer surgery in COVID‐19 survivors: An observational study
Authors: Ranganathan Priya , Salunke Bindiya , Wajekar Anjana , Siddique Aafreen , Daruwalla Kaizeen , Chawathey Shreyas , Niyogi Devayani , Nayak Prakash , Divatia Jigeeshu 
Published: September 2022

AbstractBackground and ObjectivesGuidelines recommend deferral of elective surgery after COVID‐19. Delays in cancer surgeries may affect outcomes. We examined perioperative outcomes of elective cancer surgery in COVID‐19 survivors. The primary objective was 30‐day all‐cause postoperative mortality. The secondary objectives were 30‐day morbidity, and its association with COVID‐19 severity, and duration between COVID‐19 and surgery.MethodsWe collected data on age, gender, comorbidities, COVID‐19 severity, preoperative investigations, surgery performed, and intra and postoperative outcomes in COVID‐19 survivors who underwent elective cancer surgery at a tertiary‐referral cancer center.ResultsThree hundred and forty‐eight COVID‐19 survivors presented for elective cancer surgery. Of these, 332/348 (95%) patients had mild COVID‐19 and 311 (89%) patients underwent surgery. Among patients with repeat investigations, computerized tomography scan of the thorax showed the maximum new abnormalities (30/157, 19%). The 30‐day all‐cause mortality was 0.03% (1/311) and 30‐day morbidity was 17% (54/311). On multivariable analysis, moderate versus mild COVID‐19 (odds ratio [OR]: 1.95; 95% confidence interval [CI]: 0.52–7.30; p = 0.32) and surgery within 7 weeks of COVID‐19 (OR: 0.61; 95% CI: 0.33–1.11; p = 0.10) were not associated with postoperative morbidity.ConclusionsIn patients who recover from mild to moderate COVID‐19, elective cancer surgery can proceed safely even within 7 weeks. Additional preoperative tests may not be indicated in these patients.
Quantification of Vocal Fold Atrophy in Age‐Related and Parkinson's Disease‐Related Vocal Atrophy
Authors: Baertsch Hans C. , Bhatt Neel K. , Giliberto John P. , Dixon Connor , Merati Albert L. , Sauder Cara 
Published: September 2022

ObjectiveVocal fold atrophy (VFA) is associated with aging and Parkinson's disease (PD). Clinical diagnosis of VFA depends on several visual‐perceptual laryngostroboscopy findings that are inherently subjective. The purpose of this study was to use quantitative measurements to; (1) examine the relationships between VFA and dysphonia severity and (2) evaluate differences in VFA in patients with age‐related VFA versus PD.MethodsThirty‐six patients >60 years of age with VFA were included in this retrospective cohort study. Demographic information, medical history, Consensus Auditory‐Perceptual Evaluation of Voice (CAPE‐V), Voice Handicap Index‐10 (VHI‐10), and still images from the stroboscopic exam were obtained. Image J™ was used to measure VFA, including bowing index (BI), normalized glottal gap area, and normalized mucosal wave amplitude. Pearson's correlation was used to evaluate the relationship between VFA, CAPE‐V, and VHI‐10. t‐Tests and multivariate linear regression were used to compare VFA measures by dysphonia severity (CAPE‐V <30 vs. >30) and diagnosis (age‐related vocal atrophy [ARVA] and PD).ResultsBI was positively correlated with CAPE‐V. Patients with CAPE‐V >30 had a significantly larger BI compared to those with CAPE‐V <30. Patients with PD had significantly larger BI than those with ARVA. Diagnosis of PD also predicted a larger BI after controlling for age and CAPE‐V.ConclusionQuantitative measures supported an association between bowing severity and dysphonia severity in patients with PD and ARVA. A PD diagnosis significantly predicted more severe BI. These findings demonstrate the potential utility of BI. Quantitative VFA measures might also provide insight into the mechanisms of ARVA and dysphonia.Level of Evidence3 Laryngoscope, 133:1462–1469, 2023
Composite Multicellular Spheroids Containing Fibers with Pores and Epigallocatechin Gallate (EGCG) Coating on the Surface for Enhanced Proliferation of Stem Cells
Authors: Lee Sangmin , Choi Soomi , Byun Hayeon , Lee Jinkyu , Kwon Hyunseok , Shin Heungsoo 
Published: September 2022

AbstractMulticellular spheroids are formed by strong cell–cell and cell‐extracellular matrix interactions and are widely utilized in tissue engineering for therapeutic treatments or ex vivo tissue modeling. However, diffusion of oxygen into the spheroid gradually decreases, forming a necrotic core. In this study, polycaprolactone (PCL) fibers with pores and epigallocatechin gallate (EGCG) coating on their surface to provide a structural framework within the spheroids and investigated their ability to mitigate diffusional limitation and control over the proliferation of human adipose‐derived stem cells (hADSCs) is engineered. The DNA content of composite spheroids prepared from fibers and hADSCs decreased in unadjusted cells (1224 ± 134 ng), in those with fibers with a smooth surface (SF) (1447 ± 331 ng), and in those EGCG‐coated with SF (E‐SF) (1437 ± 289 ng). Cells with fibers with pores on the surface (PF) (2020 ± 32 ng) and those with EGCG‐coated PF (E‐PF) (1911 ± 80 ng) increased after 7 days of culture, with a significantly greater number of proliferating cells (29 ± 8% and 30 ± 8%, respectively). These results indicate that physical modification through the formation of pores on the fiber surface alleviates diffusion limitation of composite spheroids, playing a dominant role over chemical modification.
Recent advances in dopamine D2 receptor ligands in the treatment of neuropsychiatric disorders
Authors: Juza Radomir , Musilek Kamil , Mezeiova Eva , Soukup Ondrej , Korabecny Jan 
Published: September 2022

AbstractDopamine is a biologically active amine synthesized in the central and peripheral nervous system. This biogenic monoamine acts by activating five types of dopamine receptors (D1–5Rs), which belong to the G protein‐coupled receptor family. Antagonists and partial agonists of D2Rs are used to treat schizophrenia, Parkinson's disease, depression, and anxiety. The typical pharmacophore with high D2R affinity comprises four main areas, namely aromatic moiety, cyclic amine, central linker and aromatic/heteroaromatic lipophilic fragment. From the literature reviewed herein, we can conclude that 4‐(2,3‐dichlorophenyl), 4‐(2‐methoxyphenyl)‐, 4‐(benzo[b]thiophen‐4‐yl)‐1‐substituted piperazine, and 4‐(6‐fluorobenzo[d]isoxazol‐3‐yl)piperidine moieties are critical for high D2R affinity. Four to six atoms chains are optimal for D2R affinity with 4‐butoxyl as the most pronounced one. The bicyclic aromatic/heteroaromatic systems are most frequently occurring as lipophilic appendages to retain high D2R affinity. In this review, we provide a thorough overview of the therapeutic potential of D2R modulators in the treatment of the aforementioned disorders. In addition, this review summarizes current knowledge about these diseases, with a focus on the dopaminergic pathway underlying these pathologies. Major attention is paid to the structure, function, and pharmacology of novel D2R ligands, which have been developed in the last decade (2010–2021), and belong to the 1,4‐disubstituted aromatic cyclic amine group. Due to the abundance of data, allosteric D2R ligands and D2R modulators from patents are not discussed in this review.
The piperazine pyrophosphate intumescent flame retardant of polypropylene composites prepared by selective laser sintering
Authors: Zhao Tianyu , Wu Wei , Hu Huanbo , Rui Zhengguo , Zhang Xiyun , Li Jianshuo 
Published: September 2022

AbstractA highly flame‐retardant PP composite powder suitable for selective laser sintering (SLS) was prepared successfully by mechanical blending, which was composed of pure PP, piperazine pyrophosphate (PPAP), melamine polyphosphate (MPP), and triazine‐based charring‐foaming agent (CFA). The results showed that the flowability of PP composite powder decreased by about 40% and the DSC data indicated the sintering window decreased by about 2°C. Although the flame retardants influenced the processing of SLS, the PP composite powder was still able to be used for printing. The LOI value of PP composites prepared by SLS was 29.2% and the UL‐94 grade was V‐0 rating at the filler loading (16wt% PPAP, 4wt% MPP, 4wt% CFA). The cone calorimeter testing (CCT) data represented that the heat and smoke release significantly decreased. The synergistic effect among flame retardants promoted high‐quality char layers, which is favorable for improving the flame retardancy and thermal stability of PP composites by the test of TGA, SEM, Raman spectra, and FT‐IR. However, the flame retardancy and mechanical properties of PP composites made by SLS were both in varying degrees of decline compared to the ones made by thermo‐compression (TC) because of the higher porosity. An air duct with complex structures was prepared by SLS at last.
Spray deposition of sustainable plant based graphene in thermosetting carbon fiber laminates for mechanical, thermal, and electrical properties
Authors: Mulqueen Daniel W. , Sattar Siavash , Le Thienan , Kravchenko Oleksandr G. 
Published: September 2022

AbstractGraphene has generated substantial interest as a filler due to its exceptional strength, flexibility, and conductivity but faces obstacles in supply and implementation. A renewable, plant‐based graphene nanoparticle (pGNP) presents a more accessible filler with the same properties as mineral graphenes. In this study, we examine the effects of pGNP, which was sprayed on a carbon fiber/epoxy prepreg at loadings from 1.1 to 4.2 g/m2. The study considered the mechanical, thermal, and electrical properties of pGNP‐composite. An even particle dispersion was achieved using a spray application of pGNP in a water/alcohol suspension with the addition of surfactants and dispersion aides. Results show that pGNP addition increases flexural modulus 15%, flexural strength 17%, interlaminar shear strength 17%, and mode I fracture toughness by 146%, as well as increases electrical conductivity 294% and thermal conductivity 24%, with these improvements observed at 1.1–2.3 g/m2 spray loadings.
Physically active undergraduates perform better on executive‐related oculomotor control: Evidence from the antisaccade task and pupillometry
Authors: Zhou Junyi , Zhuang Wenjie 
Published: September 2022

AbstractPrevious studies have shown that exercise can improve executive function in young and older adults. However, it remains controversial whether a sufficient amount of physical activity leads to higher‐level executive function. To examine the effect of physical activity on executive function, we used eye‐tracking technology and the antisaccade task in 41 young undergraduates with various levels of physical activity. Moreover, we also investigated their differences in cognitive ability by examining their pupil size during the antisaccade task. Eye‐tracking results showed that physically active individuals showed shorter saccade latency and higher accuracy in the antisaccade task than their physically inactive counterparts. Furthermore, the former showed larger pupil size during the preparatory period of antisaccade. These findings suggest that individuals with higher‐level physical activity have higher‐level executive function. The larger pupil sizes of physically active individuals may imply that their locus coeruleus‐norepinephrine system and executive‐related prefrontal cortex are more active, which contributes to their higher‐level cognitive ability.
Factors involved in the decision to decline prenatal screening with noninvasive prenatal testing (NIPT)
Authors: van Prooyen Schuurman Lisanne , van der Meij Karuna , van Ravesteyn Nicolien , Crombag Neeltje , Gitsels‐van der Wal Janneke , Kooij Caroline , Martin Linda , Peters Ingrid , Polak Marike , van Vliet‐Lachotzki Elsbeth , Galjaard Robert‐Jan , Henneman Lidewij ,   Dutch NIPT Consortium
Published: September 2022

AbstractObjectiveTo investigate factors involved in the decision to decline prenatal screening with noninvasive prenatal testing (NIPT).MethodA questionnaire study was conducted among 219 pregnant women in the Netherlands who had declined prenatal screening with NIPT (TRIDENT‐2 study). Respondents were selectively recruited from three hospitals and 19 midwifery practices, primarily located in or near socioeconomically disadvantaged neighborhoods. 44.3% of the respondents were of non‐Western ethnic origin and 64.4% were religious.ResultsMost respondents (77.2%) found the decision to decline NIPT easy to make, and 59.8% had already made the decision before information about NIPT was offered. These respondents were more often religious, multigravida, and had adequate health literacy. The main reasons to decline NIPT were “I would never terminate my pregnancy” (57.1%) and “every child is welcome” (56.2%). For 16.9% of respondents, the out‐of‐pocket costs (175 euros) played a role in the decision, and the women in this group were more often nonreligious, primigravida, and had inadequate health literacy.ConclusionThe primary factors involved in the decision to decline NIPT were related to personal values and beliefs, consistent with autonomous choice. Out‐of‐pocket costs of NIPT hinder equal access for some pregnant women.