syedzayyan/paper_mill_benchmark huggingface dataset:
The economic impact of infection requiring hospitalization on venous leg ulcers.

To determine the impact of infection (inf) on medical resource utilization (mru) and cost of care in patients with venous leg ulcers (vlu).Methods we performed a retrospective case-control study of 78 patients followed for a minimum of 12 months with c6vlus treated by vascular surgeons, at our wound center.To eliminate minor episodes of inf or incorrectly diagnosed episodes, only patients who had an inpatient admission specifically for inf comprised the inf group, whereas all other admissions were excluded for this group.Mru was defined as the number of clinic visits, visiting nurse association (vna) visits, and inpatient admissions.The actual cost for treatment was determined using financial data provided by both the hospital and physician organization billing units.The total cost over the 1-year follow-up period comprised individual cost centers: inpatient and outpatient facility fees, physician fees, and visiting nurse services.Mean mru and cost data were compared using the two-sample t-test between inf and non-inf.Results of the 78 patients with c6vlu, 9 (11.5%) had at least one inpatient admission for inf related to their vlu in the 1-year treatment period, with an additional five recurrent admissions for a total of 14 admissions, whereas 69 non-inf had three non-inf-related admissions.There was no difference between inf and non-inf for usual risk factors, but inf had a greater proportion of congestive heart failure (44%; 13%, p < .02).Regarding mru, both the number of outpatient wound center visits (inf 16.89 ± 6.41; non-inf 9.46 ± 7.7, p = .008) and vna blocks (inf 3.89 ± 2.93; non-inf 1.94 ± 2.24, p < .02) were greater for inf.Total costs for inf ($27,408 ± $10,859) were threefold higher than those for non-inf ($11,088 ± $9343, p < .0001) and subsequent vna costs were doubled for inf ($9956 ± $4657) vs non-inf ($4657 ± $5486, p = .01).Conclusions infs in patients with vlu led to an overall increase in mru and cost of care, with the inf cohort requiring more inpatient admissions, outpatient visits, and vna services than non-inf.Given the major impact inf has on cost and mru, better treatment modalities that prevent inf as well as identifying risk factors for inf in patients with vlu are needed.

Journal: Journal of vascular surgery. Venous and lymphatic disorders (2022)
Publication types: Journal Article
Analysis of Clinical Parameters, Drug Consumption and Use of Health Resources in a Southern European Population with Alcohol Abuse Disorder during COVID-19 Pandemic.

The disruption in healthcare attention to people with alcohol dependence, along with psychological decompensation as a consequence of lockdown derived from the covid-19 pandemic could have a negative impact on people who suffer from alcohol abuse disorder.Observational real world data pre-post study included 9966 men aged >16 years registered as having the diagnosis of alcohol abuse disorder in the electronic medical records (emr) of the aragon regional health service (spain).Clinical (glutamate-oxaloacetate -got-, glutamate pyruvate -gpt-, creatinine, glomerular filtration, systolic blood pressure -sbp-, diastolic blood pressure -dbp-, total cholesterol, ldl, hdl, triglycerides, and body mass index -bmi-), pharmacological (dose per inhabitant per day, dhd, of drugs used in addictive disorders, benzodiazepines and antidepressants) and health resource use variables (primary and specialized care) were considered.A student'st-test for matched samples was performed to analyze the changes in clinical variables between alcohol abuse disorder patients with and without covid-19.Only creatinine and ldl showed a significant but clinically irrelevant change six months after the end of the strict lockdown.The total number of dhds for all drugs included in the study (except for benzodiazepines), decreased.In the same way, the use of health services by these patients also decreased.The impact of covid-19 among this group of patients has been moderate.The reorganization of health and social services after the declaration of the state of alarm in our country made possible the maintenance of care for this vulnerable population.

Journal: International journal of environmental research and public health (2022)
Publication types: Journal Article;Observational Study
Designing for flexibility in hybrid care services: lessons learned from a pilot in an internal medicine unit.

Digital transformation in healthcare during the covid-19 pandemic led to the development of new hybrid models integrating physical and virtual care.The ability to provide remote care by telemedicine technologies and the need to better manage and control hospitals' occupancy accelerated growth in hospital-at-home programs.The sheba medical center restructured to create sheba beyond as the first virtual hospital in israel.These transformations enabled them to deliver hybrid services in their internal medicine unit by managing inpatient hospital-care with remote home-care based on the patients' medical condition.The hybrid services evolved to integrate care pathways multiplied by the mode of delivery-physical (in person) or virtual (technology enabled)-and the location of care-at the hospital or the patient home.The study examines this home hospitalization program pilot for internal medicine at sheba medical center (mc).The research is based on qualitative semi-structured interviews with sheba beyond management, medical staff from the hospital and the health maintenance organization (hmo), architects, information technology (it), telemedicine and medtech organizations.We investigated the implications of the development of hybrid services for the future design of the physical built-environment and the virtual technological platform.Our findings highlight the importance of designing for flexibility in the development of hybrid care services, while leveraging synergies across the built environment and digital platforms to support future models of care.In addition to exploring the potential for scalability in accelerating the flexibility of the healthcare system, we also highlight current barriers in professional, management, logistic and economic healthcare models.

Journal: Frontiers in medical technology (2023)
Publication types: Journal Article
Comparison of Clinical Outcomes of Lower Extremity Burns in Diabetic and Nondiabetic Patients: A Retrospective Analysis.

Diabetes mellitus is an increasingly prevalent chronic disease that leads to long-term health consequences.Some long-term clinical sequelae of diabetes include coronary artery disease, peripheral vascular disease, peripheral neuropathy, and impaired wound healing.These can increase hospital stay and complications such as wound infections and amputations among patients with lower extremity burns.A retrospective analysis was performed of all isolated lower extremity burns from a single tertiary burn care center from 2006 to 2017.Patients were stratified by diabetic status and the incidence of lower extremity amputations was the primary outcome.Multivariable regression was used to model the association between diabetes and amputations, adjusting for patient and injury characteristics.A total of 198 patients were identified as meeting inclusion criteria, 160 were nondiabetic and 38 were diabetic.Age was significantly different between nondiabetic and diabetic patients; mean age was 46 ± 18 vs 62 ± 17 years (p < .0001).Length of stay was also significantly different, median length of stay was 11 (interquartile range 7-15) vs 18 (interquartile range 12-24; p < .001), with diabetic patients staying longer.There was a significantly greater proportion of diabetic patients that had an amputation (control 4% vs diabetic 29%; p < .0001).After adjustment for patient and injury characteristics, there was a significant association between diabetes and amputation (p = .002).Among patients with isolated lower extremity burns, those with a preexisting condition of diabetes had a longer hospitalization and increased amputations, despite similar size of burn.Diabetes is an important risk factor to acknowledge in patients with these injuries to optimize care.

Journal: Journal of burn care & research : official publication of the American Burn Association (2022)
Publication types: Comparative Study;Journal Article
Solution NMR backbone assignments of the N-terminal Zα-linker-Zβ segment from Homo sapiens ADAR1p150.

Adenosine-to-inosine (a-to-i) editing of a subset of rnas in a eukaryotic cell is required in order to avoid triggering the innate immune system.Editing is carried out by adar1, which exists as short (p110) and long (p150) isoforms.Adar1p150 is mostly cytoplasmic, possesses a z-rna binding domain (zα), and is only expressed during the innate immune response.A structurally homologous domain to zα, the zβ domain, is separated by a long linker from zα on the n-terminus of adar1 but its function remains unknown.Zβ does not bind to rna in isolation, yet the binding kinetics of the segment encompassing zα, zβ and the 95-residue linker between the two domains (zα-zβ) are markedly different compared to zα alone.Here we present the solution nmr backbone assignment of zα-zβ from h.Sapiens adar1.The predicted secondary structure of zα-zβ based on chemical shifts is in agreement with previously determined structures of zα and zβ in isolation, and indicates that the linker is intrinsically disordered.Comparison of the chemical shifts between the individual zα and zβ domains to the full zα-zβ construct suggests that zβ may interact with the linker, the function of which is currently unknown.

Journal: Biomolecular NMR assignments (2021)
Publication types: Journal Article;Research Support, N.I.H., Extramural;Research Support, U.S. Gov't, Non-P.H.S.
Major Climate risks and Adaptation Strategies of Smallholder Farmers in Coastal Bangladesh.

Rural households in south asia's coastal deltas face numerous livelihood challenges, including risks posed by climatic variability and extreme weather events.This study examines major climate risks, farmers' adaptation strategies, and the factors affecting the choice of those strategies using data collected from 630 households in southwestern coastal bangladesh.Farmers identified cyclones, excessive rain and flooding, and salinity as direct climate risks.Increased crop diseases/pests and livestock diseases were perceived as indirect risks resulting from climatic variability.Farmers used multiple adaptation strategies against those risks such as modifications in farm management, use of savings and borrowing funds from family and neighbors, and periodically reducing household food consumption.Off-farm employment and seeking assistance from governmental as well as non-governmental organizations (ngos) were also common adaptation strategies.The results show that male-headed households are more likely to change farming practices and reduce consumption compared with female-headed households that conversely tended to take assistance from ngos as an adaptation strategy.Ownership of land and livestock, as well as farmers' prior exposure to climate change and educational training, also had a significant effect on the choice of adaptation strategy.Therefore, development interventions and policies that aimed at improving resource endowment and training to farmers on climatic risks and their adaptation strategies can help minimize the impact of climatic risks.

Journal: Environmental management (2020)
Publication types: Journal Article;Research Support, Non-U.S. Gov't;Research Support, U.S. Gov't, Non-P.H.S.
Mental Health Diagnoses and Symptoms in Preschool and School Age Youth Presenting to Insomnia Evaluation: Prevalence and Associations with Sleep Disruption.

/background: sleep problems and emotional and behavioral difficulties are highly correlated in community samples of youth and in youth presenting to mental health treatment.However, fewer studies have characterized the associations between sleep and psychopathology symptoms in youth presenting to pediatric sleep clinics.This retrospective, cross-sectional study examined the prevalence of psychopathology symptoms and their associations with sleep disruption in youth presenting to a behavioral sleep medicine clinic.participants: participants were 373 preschoolers (1.5 to 5 years old) and 300 school age youth (6 to 10 years old) presenting to a pediatric behavioral sleep medicine clinic with a primary insomnia diagnosis.methods: as a part of routine clinical care, parents completed a battery of pre-evaluation measures assessing insomnia severity, sleep disturbance, history of mental health diagnosis, and psychopathology symptoms.results: both preschool and school age youth had high rates of parent-reported mental health diagnoses (35% and 74%, respectively) and clinically elevated psychopathology symptoms (69% of preschoolers and 77% of school age youth) at initial insomnia evaluation.These symptoms were significantly associated with sleep disruption, with adhd and affective problems most consistently associated with sleep problems in preschoolers and symptoms of anxiety, affective, and behavioral problems most consistently associated with sleep problems in school age youth.conclusions: psychopathology symptoms should be regularly assessed in youth presenting to behavioral sleep medicine clinics.Further, the role of psychopathology should be considered in insomnia conceptualization and treatment and, when appropriate, psychopathology symptoms should be targeted in treatment or appropriate referrals should be made.

Journal: Behavioral sleep medicine (2019)
Publication types: Journal Article;Research Support, N.I.H., Extramural
Persistent Lung Injury and Prothrombotic State in Long COVID.

Lung injury may persist during the recovery period of covid-19 as shown through imaging, six-minute walk, and lung function tests.The pathophysiological mechanisms leading to long covid have not been adequately explained.Our aim is to investigate the basis of pulmonary susceptibility during sequelae and the possibility that prothrombotic states may influence long-term pulmonary symptoms of covid-19.The patient's lungs remain vulnerable during the recovery stage due to persistent shedding of the virus, the inflammatory environment, the prothrombotic state, and injury and subsequent repair of the blood-air barrier.The transformation of inflammation to proliferation and fibrosis, hypoxia-involved vascular remodeling, vascular endothelial cell damage, phosphatidylserine-involved hypercoagulability, and continuous changes in serological markers all contribute to post-discharge lung injury.Considering the important role of microthrombus and arteriovenous thrombus in the process of pulmonary functional lesions to organic lesions, we further study the possibility that prothrombotic states, including pulmonary vascular endothelial cell activation and hypercoagulability, may affect long-term pulmonary symptoms in long covid.Early use of combined anticoagulant and antiplatelet therapy is a promising approach to reduce the incidence of pulmonary sequelae.Essentially, early treatment can block the occurrence of thrombotic events.Because impeded pulmonary circulation causes large pressure imbalances over the alveolar membrane leading to the infiltration of plasma into the alveolar cavity, inhibition of thrombotic events can prevent pulmonary hypertension, formation of lung hyaline membranes, and lung consolidation.

Journal: Frontiers in immunology (2022)
Publication types: Journal Article;Review
Impact of secondary mitral regurgitation on survival in atrial and ventricular dysfunction.

Natural history of atrial and ventricular secondary mitral regurgitation (smr) is poorly understood.We compared the impact of the degree of smr on survival between atrial and ventricular dysfunction.Methods we conducted a retrospective cohort study of patients who underwent echocardiography in a healthcare network between 2013-2018.We compared the survival of patients with atrial and ventricular dysfunction, using propensity scores developed from differences in patient demographics and comorbidities within smr severity strata (none, mild, moderate or severe).We fitted cox proportional hazards models to estimate the risk-adjusted hazards of death across different severities of smr between patients with atrial and ventricular dysfunction.Results of 11,987 patients included (median age 69 years [iqr 58-80]; 46% women), 6,254 (52%) had isolated atrial dysfunction, and 5,733 (48%) had ventricular dysfunction.3,522 patients were matched from each arm using coarsened exact matching.Hazard of death in atrial dysfunction without smr was comparable to ventricular dysfunction without smr (hr 1.1, 95% ci 0.9-1.3).Using ventricular dysfunction without smr as reference, hazards of death remained higher in ventricular dysfunction than in atrial dysfunction across increasing severities of smr: mild smr (hr 2.1, 95% ci 1.8-2.4 in ventricular dysfunction versus hr 1.7, 95%ci 1.5-2.0 in atrial dysfunction) and moderate/severe smr (hr 2.8, 95%ci 2.4-3.4 versus hr 2.4, 95%ci 2.0-2.9).Conclusions smr across all severities were associated with better survival in atrial dysfunction than in ventricular dysfunction, though the magnitude of the diminishing survival were similar between atrial and ventricular dysfunction in increasing severity of smrs.

Journal: PloS one (2022)
Publication types: Journal Article;Research Support, N.I.H., Extramural
Novel ITS1 Fungal Primers for Characterization of the Mycobiome.

Studies of the human microbiome frequently omit characterization of fungal communities (the mycobiome), which limits our ability to investigate how fungal communities influence human health.The internal transcribed spacer 1 (its1) region of the eukaryotic ribosomal cluster has features allowing for wide taxonomic coverage and has been recognized as a suitable barcode region for species-level identification of fungal organisms.We developed custom its1 primer sets using iterative alignment refinement.Primer performance was evaluated usingin silicotesting and experimental testing of fungal cultures and human samples.Using an expanded novel reference database, sis (18s-its1-5.8s), the newly designed primers showed an averagein silicotaxonomic coverage of 79.9% ± 7.1% compared to a coverage of 44.6% ± 13.2% using previously published primers (p= 0.05).The newly described primer sets recovered an average of 21,830 ± 225 fungal reads from fungal isolate culture samples, whereas the previously published primers had an average of 3,305 ± 1,621 reads (p= 0.03).Of note was an increase in the taxonomic coverage of the candidagenus, which went from a mean coverage of 59.5% ± 13% to 100.0% ± 0.0% (p= 0.0015) comparing the previously described primers to the new primers, respectively.The newly developed its1 primer sets significantly improve general taxonomic coverage of fungal communities infecting humans and increased read depth by an order of magnitude over the best-performing published primer set tested.The overall best-performing primer pair in terms of taxonomic coverage and read recovery, its1-30f/its1-217r, will aid in advancing research in the area of the human mycobiome.importancethe mycobiome constitutes all the fungal organisms within an environment or biological niche.The fungi are eukaryotes, are extremely heterogeneous, and include yeasts and molds that colonize humans as part of the microbiome.In addition, fungi can also infect humans and cause disease.Characterization of the bacterial component of the microbiome was revolutionized by 16s r rna gene fragment amplification, next-generation sequencing technologies, and bioinformatics pipelines.Characterization of the mycobiome has often not been included in microbiome studies because of limitations in amplification systems.This report revisited the selection of pcr primers that amplify the fungal its1 region.We have identified primers with superior identification of fungi present in the database.We have compared the new primer sets against those previously used in the literature and show a significant improvement in read count and taxon identification.These primers should facilitate the study of fungi in human physiology and disease states.

Journal: mSphere (2017)
Publication types: Journal Article
Low-Dose Acetylsalicylic Acid Treatment in Non-Skull-Base Meningiomas: Impact on Tumor Proliferation and Seizure Burden.

Mib-1 index is an important predictor of meningioma progression and was found to be correlated with cox-2 expression.However, the impact of low-dose acetylsalicylic acid (asa) on mib-1 index and clinical symptoms is unclear.Between 2009 and 2022, 710 patients with clinical data, tumor-imaging data, inflammatory laboratory (plasma fibrinogen, serum c-reactive protein) data, and neuropathological reports underwent surgery for primary cranial who grade 1 and 2 meningioma.Asa intake was found to be significantly associated with a low mib-1 labeling index in female patients ≥ 60 years.Multivariable analysis demonstrated that female patients ≥ 60 years with a non-skull-base meningioma taking asa had a significantly lower mib-1 index (or: 2.6, 95%: 1.0-6.6,p= 0.04).Furthermore, the intake of asa was independently associated with a reduced burden of symptomatic epilepsy at presentation in non-skull-base meningiomas in both genders (or: 3.8, 95%ci: 1.3-10.6,p= 0.03).Asa intake might have an anti-proliferative effect in the subgroup of elderly female patients with non-skull-base meningiomas.Furthermore, anti-inflammatory therapy seems to reduce the burden of symptomatic epilepsy in non-skull-base meningiomas.Further research is needed to investigate the role of anti-inflammatory therapy in non-skull-base meningiomas.

Journal: Cancers (2022)
Publication types: Journal Article