bluuebunny/crossref_metadata_2025 huggingface dataset:
A personal touch in text messaging can improve microloan repayment
Authors: Karlan Dean , Morten Melanie , Zinman onathan
Published: September 2023

Because payment delays and defaults significantly affect both lenders and borrowers in fragile economies, strategies to improve timely loan repayment are needed to help make credit markets work smoothly. We worked with two microlenders to test the impact of randomly assigned text message reminders for loan repayments in the Philippines. Messages improved repayment only when they included the account officer's name and only for clients serviced by the account officer previously. These results highlight the potential and limits of communication technology for improving loan repayment rates. They also suggest that personal connections between borrowers and bank employees can be harnessed to help overcome market failures.
Blinding prosecutors to defendants’ race: A policy proposal to reduce unconscious bias in the criminal justice system
Authors: Sah Sunita , Robertson Christopher T. , Baughman Shima B.
Published: September 2023

Racial minorities are disproportionately imprisoned in the United States. This disparity is unlikely to be due solely to differences in criminal behavior. Behavioral science research has documented that prosecutors harbor unconscious racial biases. These unconscious biases play a role whenever prosecutors exercise their broad discretion, such as in choosing what crimes to charge and when negotiating plea bargains. To reduce this risk of unconscious racial bias, we propose a policy change: Prosecutors should be blinded to the race of criminal defendants wherever feasible. This could be accomplished by removing information identifying or suggesting the defendant's race from police dossiers shared with prosecutors and by avoiding mentions of race in conversations between prosecutors and defense attorneys. Race is almost always irrelevant to the merits of a criminal prosecution; it should be omitted from the proceedings whenever possible for the sake of justice.
Evidence for the Benefits of State Prekindergarten Programs: Myth & Misrepresentation
Authors: Farran Dale C. , Lipsey Mark W.
Published: September 2023

In 2014, New York City launched the historic Pre-K for All program, which massively expanded early education for children in the city. The state followed suit with a budgetary pledge of some $1.5 billion over 5 years to implement full-day universal prekindergarten (pre-K) statewide. Many other states have implemented or expanded state-funded pre-K programs in the last decade, encouraged by claims about expected benefits. However, there is remarkably little scientifically rigorous evidence for these benefits. Claims of pre-K success rely largely on small, experimental, model programs run 50 or more years ago—programs that bear little resemblance to current pre-K implementations. Evidence for program effectiveness is crucial given the current interest in and expansion of state-funded pre-K programs. This review of the evidence raises serious questions about the presumed benefits of state pre-K programs.
Identity Traps: How to Think about Race & Policing
Authors: Goff Phillip Atiba
Published: September 2023

Since the summer of 2014, Americans have seen more videos of violent interactions between police and non-Whites than ever before. While the interpretation of some specific incidents remains contentious and data on police use of force are scant, there is evidence that racial disparities in policing exist even when considering racial disparities in crime. The traditional civil rights model of institutional reform assumes that racial bigotry is the primary cause of these disparities; it attempts to address problems through adversarial litigation, protest, and education. This article offers an expansion of that model–one based on insights from behavioral science—that facilitates a less adversarial approach to reform and allows one to be agnostic about the role of racial bigotry. The new behavioral insights model focuses on identifying the contexts—called identity traps—that can escalate negative interactions between police and communities, as well as ways to interrupt them.
Increasing Benefits & Reducing Social Costs of Technological Innovations
Authors: Van de Ven Andrew , Adner Ron , Barley Stephen , Dougherty Deborah , Fountain Jane , Hargadon Andrew , Kamlet Mark , Karlin Beth , Schilling Melissa
Published: September 2023

Technological innovation is a double-edged sword. It can help solve major problems, such as how to treat cancer, and can be an engine of economic growth, but it can also cost jobs, such as when automation replaces people Both aspects raise issues that have major but so far little-recognized policy implications. One such issue is that new technologies are now taking the place not just of routinized jobs but of more complex positions. Another is that many government policies meant to foster needed innovation are based on an outmoded understanding of how innovation occurs and thus are not as effective as they could be. As behavioral scientists who study technology and innovation, we offer insights into addressing both issues.
Applying Population Health Science Principles to Guide Behavioral Health Policy Setting
Authors: Ettman Catherine , Abdalla Salma M. , Galea Sandro
Published: September 2023

Many behaviors, such as smoking and overeating, strongly affect a population's health. Further, social, physical, and economic contexts—for example, housing, transportation, education, and employment—shape health-related behaviors. To improve a population's health, policies must include actions that alter elements of these larger contexts. But the elements are vast and complex, and resources are limited. How can policymakers determine the right priorities to focus on? Building on the emerging field of population health science, we suggest four principles to guide priority setting: view population health as a continuum, focus on affecting ubiquitous influences on health, consider the trade-offs between efficiency and equity, and evaluate return on investment. This proposal offers a novel approach to setting policy for improving health behaviors.
The Ubiquity of Data & Communication: A Double-Edged Sword for Disparities
Authors: Califf Robert M.
Published: September 2023

The fourth industrial revolution, in which most information is stored in digital form, is characterized by connectivity and communication among people and groups via, for instance, cell phones and smart watches. The amount of information now generated about people's health-related activities is multiple log orders more voluminous and complex than the data currently captured in the electronic health record from patient interactions with clinicians. Despite the data's complexity, it is now possible for health care administrators, policymakers, and clinical researchers to develop—and then test—data-informed interventions that could reduce health disparities. For example, programs initiated by a county government and a major medical system have, respectively, improved asthma management and reduced lead exposure in their localities. Use of big data can be a double-edged sword, however. The technology that allows for high-end use of data also opens the way to increasing disparities, as could happen, for instance, if geospatial information were used to locate clinics in places that optimize profit rather than meet health needs. Efforts are underway to limit this risk.
Article Commentary: The need for intersectional practices in addressing workplace diversity
Authors: McCluney Courtney L.
Published: September 2023

In “Designing More Effective Practices for Reducing Workplace Inequality,” Quinetta Roberson, Eden King, and Mikki Hebl suggest robust strategies for addressing inequality.1 They also list unanswered questions, such as whether any practices improve employment opportunities across all demographic groups or contexts. I see one potential answer: that organizational leaders and researchers look to intersectionality as a framework for addressing inequalities that occur inside and outside of organizations.23

An intersectionality framework considers the effects of belonging to multiple social groups simultaneously—for instance, the ways that being both Black and a woman can undercut opportunities beyond the independent ways that being Black or being a woman can. The failure to recognize how diversity policies affect people who belong to multiple disadvantaged groups will perpetuate inequalities rather than eliminate them.
Low voice pitch in orally delivered recommendations can increase compliance with hand sanitizer use among young adults
Authors: Chan Eugene
Published: September 2023

Oral communications delivered in a low voice pitch are more persuasive and perceived as more pleasant and truthful than are communications delivered in a high pitch. The research reported in this article explored whether young adults’ compliance with an orally delivered recommendation to use hand sanitizer, an action thought to limit the spread of COVID-19 and other infectious diseases, would increase when the message was delivered in a low versus a high voice pitch. In an experiment involving 478 university students in Australia, a public health announcement delivered in a low voice pitch, compared with one delivered in a high voice pitch, increased participants’ sense of power, which increased their perceived behavioral control over their physical health and, in turn, increased their likelihood of using hand sanitizer. Because voice pitch is an aspect of health communications that can be modified easily at a low cost, the findings suggest a simple approach that public health and policy officials can adopt to improve hand hygiene in a population of people who spend a lot of time in close proximity and who should therefore practice hand hygiene routinely to protect themselves and others from infection.
Softening the blow: Incorporating employee perceptions of justice into best practices for layoffs during the COVID-19 pandemic
Authors: Bilotta Isabel , Cheng Shannon K. , Ng Linnea C. , Corrington Abby R. , Watson Ivy , King Eden B. , Hebl Mikki R.
Published: September 2023

COVID-19 has led to staggering numbers of people being laid off or furloughed. The way these decisions are communicated to employees can critically affect how workers receive and process the news. Specifically, if employees perceive layoff decisions as unfair, both those who are let go and those who remain may suffer untoward mental and physical effects from the layoffs, and these effects, in turn, can have negative consequences for the organization (such as reputational damage). In this article, we draw on prior research into perceptions of justice—including distributive justice (focused on how resources and burdens are allocated), procedural justice (focused on how decisions are made and implemented), and interactional justice (focused on how decisions are communicated) — to offer behaviorally based policy recommendations that organizational leaders and managers can apply to buffer some of the negative effects that layoff decisions can have on both employees and organizations.
Gender differences in preventing the spread of coronavirus
Authors: Okten Irmak Olcaysoy , Gollwitzer Anton , Oettingen Gabriele
Published: September 2023

Social distancing, handwashing, and mask wearing are key to preventing the spread of COVID-19. However, people vary in the degree to which they follow these practices. Previous findings have indicated that women adhere more to preventive health practices than men do. We examined whether this pattern held true for the COVID-19 pandemic by comparing women and men in three studies. In Study 1, women reported a greater degree of social distancing and handwashing. In Study 2, conducted in three different states in the northeastern United States, a greater percentage of women wore masks in public. In Study 3, anonymous county-level GPS data collected from approximately 15 million smartphones per day between March 9 and May 29, 2020, indicated that counties with a greater percentage of women exhibited greater social distancing. These data suggest that during pandemics, policymakers may benefit from disseminating preventive health messages that are purposely tuned to motivate adherence by men.
Combining a Lottery Incentive with Protection against Losing the Lottery Improves Exercise Adherence
Authors: Meeker Daniella , Knight Tara , Childress Patra , Aliyev Elmar R. , Doctor Jason N.
Published: September 2023

Two common incentives for participating in exercise programs are cash rewards for meeting goals and the loss of deposited money when goals are missed. Direct cash rewards lead to higher enrollment, but the risk of losing money is a stronger motivator for sticking with a program. We conducted an experiment using loss protection to leverage the power of both approaches. Participants were offered two exercise classes a week for 12 weeks. Anyone who attended the first weekly class received a chance to play a lottery that was very likely to pay a cash reward, but they also faced a low risk of not winning any money. Participants in the loss-protection group could insure against the loss by also attending the second class of the week. Participants in the control group could earn the equivalent money by likewise attending the second class, but the incentive was a straight reward for class participation (a flat payment), not as loss protection. For any weekly pattern of attendance, expected earnings were the same in both groups. We randomly assigned 153 participants to either the loss-protection or the control group. The loss-protection framing resulted in greater exercise class attendance, suggesting that the approach could enhance the outcomes of reward-based programs without increasing program costs.
How to Encourage Pro-Environmental Behaviors without Crowding Out Public Support for Climate Policies
Authors: Raimi Kaitlin T.
Published: September 2023

Utilities, governmental agencies, and nonprofit organizations all use interventions meant to spur the public to act in ways that reduce greenhouse gas emissions, such as by turning down the heat in the winter and limiting beef consumption. Yet critics contend that these interventions promote relatively trivial behaviors while reducing the perceived need to support regulations that would have much more of an effect but might require, say, increased taxes or effort. In other words, promoting behavioral interventions can crowd out the public's support for climate policies. But this undesirable consequence is avoidable. In this article, I propose evidence-based guidelines, which I collectively call the SESH formula, for implementing climate-related behavioral interventions that avoid crowding out support for effective policies. They hold that interventions should (a) push for specific high-impact behaviors, (b) accurately convey the behaviors’ effectiveness, (c) promote behaviors that are similar to (that is, are clearly related to) desirable policies, and (d) frame the desired behaviors as steps toward a higher goal—in this case, climate-change mitigation. I review the evidence for each SESH guideline and identify areas for future research into behavioral interventions that will complement, rather than undermine, climate-change policies.
Venezuela: Escaping the Resource Curse
Authors: Mondal Rima , Bahl Shweta
Published: September 2023

As Juan Guaido inherited a debt and poverty-stricken economy characterized by hyperinflation as an ‘interim President’, the fear of his removal and dissolution of the Government engulfed him. He was worried about rising inflation, mismanagement of natural assets, rising fiscal debt, unemployment and poverty. He knew that the socialist policies adopted under the leadership of Chavez and Maduro had benefitted the citizens only for a brief period but had been the primary reason for the economy’s slowdown in the last decade. The economy underwent long periods of hyperinflation amounting to 130,060%, which has rarely been observed in any country worldwide ( Exhibit 1 , Exhibit 3 ). Venezuela is a classic case of a ‘petrostate’ exhibiting the characteristics of a ‘resource curse’. The expansionary fiscal policies, a large share of the government sector, subsidies, price controls, a ban on the private sector and erratic monetary policies contributed to the economic and political crisis. Juan knew the economy was bleeding, and almost seven million Venezuelans still fell into extreme poverty. He thought adopting a contractionary fiscal policy would increase unemployment, and many more would fall under the poverty line. On the other hand, expansionary monetary policy will further increase inflationary pressure. While sitting in his office, Juan thought, ‘Shall I go for a stringent tax policy to increase the government revenue or adopt the dollar as an official currency for curbing inflation?’
Moisture content estimation of green softwood logs of three species based on measurements of flexural vibration
Authors: Fukui Toshiyuki , Yanase Yoshiyuki , Fujii Yoshihisa
Published: September 2023

The moisture contents of sugi (Cryptomeria japonica), todomatsu (Abies sachalinensis) and hinoki (Chamaecyparis obtusa) logs were estimated using a method of moisture content estimation proposed in our previous study. In the course of estimation, it was revealed that the regression line of the correlation between specific dynamic Young’s modulus (E/ρ) and tangent loss (tan δ) of green wood was different from that of moisture-conditioned wood and showed species dependency, both of which are not previously reported. Regression lines at the fiber saturation point (FSP) were constructed for each species by measuring E/ρ and tan δ from the flexural vibration of green small specimens and correcting the E/ρ values at their own moisture contents into E/ρ values at the FSP. The correlation of green wood in this study was different from that reported in previous studies of moisture-conditioned wood near the FSP. The correlations of sugi and hinoki were similar, whereas those of sugi and todomatsu were different despite no previous report of species dependency in air-dried wood. The moisture contents 86 logs (not those used to prepare small specimens) were estimated using regression lines of each species. The standard deviation of the difference between the estimated moisture content and the measured moisture content was 15.7%. A systematic error of 25.9% in moisture content was attributed to the different methods of specimen support used for small specimens and logs.
Ocular sarcoidosis in adults and children: update on clinical manifestation and diagnosis
Authors: Bazewicz Magdalena , Heissigerova Jarmila , Pavesio Carlos , Willermain François , Skrzypecki Janusz
Published: September 2023

Sarcoidosis-associated uveitis, is the predominant ocular sarcoidosis presentation, which affects both adults and children. For adults, international ocular sarcoidosis criteria (IWOS) and sarcoidosis-associated uveitis criteria (SUN) are defined. However, for children they are not yet established internationally. Due to the specificity of pediatric manifestations of sarcoidosis, this task is even more challenging. In children, sarcoidosis is subdivided into Blau syndrome and early-onset sarcoidosis (BS/EOS) affecting younger children (< 5 years) and the one affecting older children with clinical presentation resembling adults. Differential diagnosis, clinical work-up as well as diagnostic criteria should be adapted to each age group. In this article, we review the clinical manifestation of sarcoidosis-associated uveitis in adults and children and the sensitivity and specificity of various ocular sarcoidosis diagnostic modalities, including chest X-ray and CT, FDG PET-CT, gallium-67 scintigraphy, bronchoalveolar lavage fluid, genetic testing for NOD2 mutations and serum biomarkers, such as ACE, lysozyme and IL2R.
Genetic analysis of geometric morphometric 3D visuals of French jumping horses
Authors: Ricard Anne , Crevier-Denoix Nathalie , Pourcelot Philippe , Crichan Harmony , Sabbagh Margot , Dumont-Saint-Priest Bernard , Danvy Sophie
Published: September 2023

Background

For centuries, morphology has been the most commonly selected trait in horses. A 3D video recording enabled us to obtain the coordinates of 43 anatomical landmarks of 2089 jumping horses. Generalized Procrustes analysis provided centered and scaled coordinates that were independent of volume, i.e., centroid size. Genetic analysis of these coordinates (mixed model; 17,994 horses in the pedigree) allowed us to estimate a variance–covariance matrix. New phenotypes were then defined: the “summarized shapes”. They were obtained by linear combinations of Procrustes coordinates with, as coefficients, the eigenvectors of the genetic variance–covariance matrix. These new phenotypes were used in genome-wide association analyses (GWAS) and multitrait genetic analysis that included judges’ scores and competition results of the horses.

Results

We defined ten shapes that represented 86% of the variance, with heritabilities ranging from 0.14 to 0.42. Only one of the shapes was found to be genetically correlated with competition success (rg = − 0.12, standard error = 0.07). Positive and negative genetic correlations between judges’ scores and shapes were found. This means that the breeding objective defined by judges involves improvement of anatomical parts of the body that are negatively correlated with each other. Known single nucleotide polymorphisms (SNPs) on chromosomes 1 and 3 for height at withers were significant for centroid size but not for any of the shapes. As these SNPs were not associated with the shape that distinguished rectangular horses from square horses (with height at withers greater than body length), we hypothesize that these SNPs play a role in the overall development of horses, i.e. in height, width, and length but not in height at withers when standardized to unit centroid size. Several other SNPs were found significant for other shapes.

Conclusions

The main application of 3D morphometric analysis is the ability to define the estimated breeding value (EBV) of a sire based on the shape of its potential progeny, which is easier for breeders to visualize in a single synthetic image than a full description based on linear profiling. However, the acceptance of these new phenotypes by breeders and the complex nature of summarized shapes may be challenging. Due to the low genetic correlations of the summarized shapes with jumping performance, the methodology did not allow indirect performance selection criteria to be defined.
Automatic segmentation of large-scale CT image datasets for detailed body composition analysis
Authors: Ahmad Nouman , Strand Robin , Sparresäter Björn , Tarai Sambit , Lundström Elin , Bergström Göran , Ahlström Håkan , Kullberg Joel
Published: September 2023

Background

Body composition (BC) is an important factor in determining the risk of type 2-diabetes and cardiovascular disease. Computed tomography (CT) is a useful imaging technique for studying BC, however manual segmentation of CT images is time-consuming and subjective. The purpose of this study is to develop and evaluate fully automated segmentation techniques applicable to a 3-slice CT imaging protocol, consisting of single slices at the level of the liver, abdomen, and thigh, allowing detailed analysis of numerous tissues and organs.

Methods

The study used more than 4000 CT subjects acquired from the large-scale SCAPIS and IGT cohort to train and evaluate four convolutional neural network based architectures: ResUNET, UNET++, Ghost-UNET, and the proposed Ghost-UNET++. The segmentation techniques were developed and evaluated for automated segmentation of the liver, spleen, skeletal muscle, bone marrow, cortical bone, and various adipose tissue depots, including visceral (VAT), intraperitoneal (IPAT), retroperitoneal (RPAT), subcutaneous (SAT), deep (DSAT), and superficial SAT (SSAT), as well as intermuscular adipose tissue (IMAT). The models were trained and validated for each target using tenfold cross-validation and test sets.

Results

The Dice scores on cross validation in SCAPIS were: ResUNET 0.964 (0.909–0.996), UNET++ 0.981 (0.927–0.996), Ghost-UNET 0.961 (0.904–0.991), and Ghost-UNET++ 0.968 (0.910–0.994). All four models showed relatively strong results, however UNET++ had the best performance overall. Ghost-UNET++ performed competitively compared to UNET++ and showed a more computationally efficient approach.

Conclusion

Fully automated segmentation techniques can be successfully applied to a 3-slice CT imaging protocol to analyze multiple tissues and organs related to BC. The overall best performance was achieved by UNET++, against which Ghost-UNET++ showed competitive results based on a more computationally efficient approach. The use of fully automated segmentation methods can reduce analysis time and provide objective results in large-scale studies of BC.
Fine-Scale analysis of both wild and cultivated horned galls provides insight into their quality differentiation
Authors: Tian Xufang , Sang Ziyang , Lan Zhaohui , Liu Wei , Feng Ying , Hu Juan , Chen Faju , Liu Yifei
Published: September 2023

Background

Galla chinensis is a traditional Chinese medicine (TCM) produced due to the interaction between the Fordinae aphids and the Rhus plant species. Horned galls with high tannin content are the most widely cultivated gall type, and Wufeng county of Hubei province in China is the center of cultivation. However, long-term artificial cultivation and domestication of horned galls to meet the increasing production demand have led to quality degradation. Understanding the reasons underlying quality degradation is urgent for horned gall production and application. The present study used a combination of metabolic, genetic, and ecological analyses to investigate the quality and genetic differentiation of the horned galls under long-term domestication as well as the potential relationships between them.

Results

Analysis of gallic acid content and other three phenotypic traits (fresh weight, gall size, and wall thickness) revealed quality differentiation of horned galls collected from five locations in Wufeng, in which the cultivated samples from Wang Jiaping (WJP) showed the highest degradation. Genetic differentiation between the cultivated and wild Rhus chinensis trees in WJP, and between WJP and the other populations was detected based on SSR molecular markers, however, no significant difference in genetic structure was seen for the aphid populations. Among the various ecological factors examined, temperature was identified as the primary one affecting the quality of horned galls.

Conclusions

Both genetic and ecological factors caused quality differentiation of horned galls. The collection of diverse germplasm of host trees and aphids will help reduce the quality degradation of horned galls in Wufeng.
Modelling of intensive care unit (ICU) length of stay as a quality measure: a problematic exercise
Authors: Moran John L. , Duke Graeme J. , Santamaria John D. , Linden Ariel ,   the Australian & New Zealand Intensive Care Society (ANZICS) Centre for Outcomes & Resource Evaluation (CORE), Pilcher David , Secombe Paul , Litton Ed , Carr Craig , Millar Johnny , Henson Tamishta , Huckson Sue , Chavan Shaila , Hogan Jennifer
Published: September 2023

Background

Intensive care unit (ICU) length of stay (LOS) and the risk adjusted equivalent (RALOS) have been used as quality metrics. The latter measures entail either ratio or difference formulations or ICU random effects (RE), which have not been previously compared.

Methods

From calendar year 2016 data of an adult ICU registry-database (Australia & New Zealand Intensive Care Society (ANZICS) CORE), LOS predictive models were established using linear (LMM) and generalised linear (GLMM) mixed models. Model fixed effects quality-metric formulations were estimated as RALOSR for LMM (geometric mean derived from log(ICU LOS)) and GLMM (day) and observed minus expected ICU LOS (OMELOS from GLMM). Metric confidence intervals (95%CI) were estimated by bootstrapping; random effects (RE) were predicted for LMM and GLMM. Forest-plot displays of ranked quality-metric point-estimates (95%CI) were generated for ICU hospital classifications (metropolitan, private, rural/regional, and tertiary). Robust rank confidence sets (point estimate and 95%CI), both marginal (pertaining to a singular ICU) and simultaneous (pertaining to all ICU differences), were established.

Results

The ICU cohort was of 94,361 patients from 125 ICUs (metropolitan 16.9%, private 32.8%, rural/regional 6.4%, tertiary 43.8%). Age (mean, SD) was 61.7 (17.5) years; 58.3% were male; APACHE III severity-of-illness score 54.6 (25.7); ICU annual patient volume 1192 (702) and ICU LOS 3.2 (4.9). There was no concordance of ICU ranked model predictions, GLMM versus LMM, nor for the quality metrics used, RALOSR, OMELOS and site-specific RE for each of the ICU hospital classifications. Furthermore, there was no concordance between ICU ranking confidence sets, marginal and simultaneous for models or quality metrics.

Conclusions

Inference regarding adjusted ICU LOS was dependent upon the statistical estimator and the quality index used to quantify any LOS differences across ICUs. That is, there was no “one best model”; thus, ICU “performance” is determined by model choice and any rankings thereupon should be circumspect.
Patient-stimulated fall prevention screening in primary care: analysis of provider coding changes
Authors: Moran Ryan
Published: September 2023

Background

The Centers for Disease Control and Prevention (CDC) has developed an evidenced based clinical screening tool, Stopping Elderly Accidents, Deaths & Injuries (STEADI) but penetration into routine clinical practice has been slow. To increase screening for falls and fall risk in an internal medicine primary care practice, a patient-centered screening program was integrated into a busy academic clinic.

Methods

Over a three month period, Patients were invited to self-screen via a large poster in the waiting room, and complete a STEADI Staying Independent questionnaire, and discuss findings with their healthcare provider. Fall Prevention Booklets were made readily available in clinic exam rooms. Questionnaires and fall prevention booklets, were uniquely numbered, and Epic Slicer-Dicer reports were utilized to evaluate falls screening-related ICD-10 codes determined a priori. Generalized linear modeling calculated difference-in-difference compared with other clinics without this program for rates of coding for fall-related diagnosis codes.

Results

In three months, 255 questionnaires were taken; only 5 (2%) were returned for later review. 110 booklets were disseminated from clinic exam rooms. The absolute difference-in-difference in ICD-10 coding was 0.7% compared to other clinics in the same practice, and year before. Generalized linear modeling showed a 4.7% increased impact in screening-related ICD-10 codes, which was statistically significant (P =  < .0001) without reported disruption to clinical workflows.

Conclusion

There are indicators that patient-centered selective screening at a busy academic practice may have resulted in an increase in falls-related ICD-10 coding. Clinical integration of this program was well received.
Novel model based on ultrasound predict axillary lymph node metastasis in breast cancer
Authors: Zheng Biyu , Chen Qingshuang
Published: September 2023

Background

Whether there is axillary lymph node metastasis is crucial for formulating the treatment plan for breast cancer. Currently, invasive methods are still used for preoperative evaluation of lymph nodes. If non-invasive preoperative evaluation can be achieved, it will effectively improve the treatment plan.

Objective

Constructed a predict model based on ultrasound examination, which forest axillary lymph node metastasis in breast cancer, and validated this model.

Method

Patients admitted to Xiamen First Hospital from April 2018 to August 2021 with complete case data were included in this study. Patients who had undergone breast cancer resection and axillary lymph node dissection or sentinel lymph node biopsy were divided into a training and validation cohort in a 7:3 ratio. In the training cohort, patients were divided into metastatic and non-metastatic groups based on whether axillary lymph nodes had metastasis. The parameters of the two groups were compared, and statistically significant parameters were included in multivariate analysis. Then, a Nomogram model was constructed, named Lymph metastasis predict model (LMPM). Calibration curves, receiver operating curve (ROC), and decision curve analysis (DCA) were plotted between the training and validation cohort, calculate the risk score of each patient, identify the optimal cutoff value, and test the predictive efficacy of LMPM.

Result

Two hundred seventy-three patients were enrolled in final study, the average age 49.7 ± 8.7, training cohort included 191 patients, the diameter of breast cancer, the lymph node peak systolic flow velocity (LNPS) and the cortex area hilum ratio (CH) of lymph node were exist significant difference in metastatic and non-metastatic group. Multivariate analysis showed cancer diameter, LNPS and CH included in LMPM, the cutoff value was 95, the calibration curve, ROC, DCA in training and validation cohort show satisfactory result.

Conclusion

The predict model-LMPM, can predict axillary lymph node metastasis in breast cancer, which is useful for developing personalized treatment plans. However, further validation of the model is required by incorporating a larger number of patients.
Cancer incidence in Khyber Pakhtunkhwa, Pakistan, 2020
Authors: Badar Farhana , Sohaib Muhammad , Mahmood Shahid , Chughtai Omar Rasheed , Sultan Faisal , Yusuf Muhammed Aasim
Published: September 2023

Background

To present the population-based cancer statistics for Khyber Pakhtunkhwa (KP), Pakistan, an incidence study was conducted at the Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore, Pakistan, in 2023.

Methods

Records from various centres on new cancers diagnosed among residents of KP between January and December 2020 were gathered. Both active and passive methods of data collection were applied, and the information was saved in a central repository at SKMCH&RC. The incidence rates were computed by age group and sex and presented per 100,000 population.

Results

Among children (0–14 years), the Age-Standardised Incidence Rate (ASIR) was 4.0 in girls and 6.1 in boys, and haematologic malignancies were more prevalent; in adolescents (15–19 years), the ASIR was 7.7 in females, 9.4 in males, and bone tumours, haematologic malignancies, and neurological cancers were prominent; in adult females (> / = 20 years), the ASIR was 84.9, and cancers of the breast, digestive system, and reproductive organs were predominant; and adult males, the ASIR was 73.0, and cancers of the gastrointestinal tract, lip/oral cavity/pharynx, prostate, and Non-Hodgkin Lymphoma (NHL) were common.

Conclusions

It is crucial to investigate the aetiology of these diseases at the community level because dietary elements, infectious diseases, and tobacco use all appear to be significant contributors. Prospective studies could play a key role in highlighting the factors linked to these diseases. Therefore, cancer registration must continue in conjunction with the exploration of risk factors.
Medico-economic impact of thoracoscopy versus thoracotomy in lung cancer: multicentre randomised controlled trial (Lungsco01)
Authors: Soilly Anne-Laure , Aho Glélé Ludwig Serge , Bernard Alain , Abou Hanna Halim , Filaire Marc , Magdaleinat Pierre , Marty-Ané Charles , Tronc François , Grima Renaud , Baste Jean-Marc , Thomas Pascal-Alexandre , Richard De Latour Bertrand , Pforr Arnaud , Pagès Pierre-Benoît
Published: September 2023

Background

Lungsco01 is the first study assessing the real benefits and the medico-economic impact of video-thoracoscopy versus open thoracotomy for non-small cell lung cancer in the French context.

Methods

Two hundred and fifty nine adult patients from 10 French centres were randomised in this prospective multicentre randomised controlled trial, between July 29, 2016, and November 24, 2020. Survival from surgical intervention to day 30 and later was compared with the log-rank test. Total quality-adjusted-life-years (QALYs) were calculated using the EQ-5D-3L®. For medico-economic analyses at 30 days and at 3 months after surgery, resources consumed were valorised (€ 2018) from a hospital perspective. First, since mortality was infrequent and not different between the two arms, cost-minimisation analyses were performed considering only the cost differential. Second, based on complete cases on QALYs, cost-utility analyses were performed taking into account cost and QALY differential. Acceptability curves and the 95% confidence intervals for the incremental ratios were then obtained using the non-parametric bootstrap method (10,000 replications). Sensitivity analyses were performed using multiple imputations with the chained equation method.

Results

The average cumulative costs of thoracotomy were lower than those of video-thoracoscopy at 30 days (€9,730 (SD = 3,597) vs. €11,290 (SD = 4,729)) and at 3 months (€9,863 (SD = 3,508) vs. €11,912 (SD = 5,159)). In the cost-utility analyses, the incremental cost-utility ratio was €19,162 per additional QALY gained at 30 days (€36,733 at 3 months). The acceptability curve revealed a 64% probability of efficiency at 30 days for video-thoracoscopy, at a widely-accepted willingness-to-pay threshold of €25,000 (34% at 3 months). Ratios increased after multiple imputations, implying a higher cost for video-thoracoscopy for an additional QALY gain (ratios: €26,015 at 30 days, €42,779 at 3 months).

Conclusions

Given our results, the economic efficiency of video-thoracoscopy at 30 days remains fragile at a willingness-to-pay threshold of €25,000/QALY. The economic efficiency is not established beyond that time horizon. The acceptability curves given will allow decision-makers to judge the probability of efficiency of this technology at other willingness-to-pay thresholds.

Trial registration

NCT02502318.
Effect of perioperative goal-directed fluid therapy on postoperative complications after thoracic surgery with one-lung ventilation: a systematic review and meta-analysis
Authors: Li Xuan , Zhang Qinyu , Zhu Yuyang , Yang Yihan , Xu Wenxia , Zhao Yufei , Liu Yuan , Xue Wenqiang , Fang Yu , Huang Jie
Published: September 2023

Background

An understanding of the impact of goal-directed fluid therapy (GDFT) on the outcomes of patients undergoing one-lung ventilation (OLV) for thoracic surgery remains incomplete and controversial. This meta-analysis aimed to assess the effect of GDFT compared to other fluid therapy strategies on the incidence of postoperative complications in patients with OLV.

Methods

The Embase, Cochrane Library, Web of Science, and MEDLINE via PubMed databases were searched from their inception to November 30, 2022. Forest plots were constructed to present the results of the meta-analysis. The quality of the included studies was evaluated using the Cochrane Collaboration tool and Risk Of Bias In Non-Randomized Study of Interventions (ROBINS-I). The primary outcome was the incidence of postoperative complications. Secondary outcomes were the length of hospital stay, PaO2/FiO2 ratio, total fluid infusion, inflammatory factors (TNF-α, IL-6), and postoperative bowel function recovery time.

Results

A total of 1318 patients from 11 studies were included in this review. The GDFT group had a lower incidence of postoperative complications [odds ratio (OR), 0.47; 95% confidence interval (95% CI), 0.29–0.75; P = 0.002; I2, 67%], postoperative pulmonary complications (OR 0.48, 95% CI 0.27–0.83; P = 0.009), and postoperative anastomotic leakage (OR 0.51, 95% CI 0.27–0.97; P = 0.04). The GDFT strategy reduces total fluid infusion.

Conclusions

GDFT is associated with lower postoperative complications and better survival outcomes after thoracic surgery for OLV.
Management strategy and outcomes of sacrococcygeal teratoma — an Egyptian multicenter experience
Authors: Elgendy Ahmed , AbouZeid Amr Abdelhamid , El-Debeiky Mohamed , Mostafa Mahmoud , Takrouney Mohammed Hamada , Abouheba Mohamed , Khairi Ahmed , Shehata Sameh , Shehata Sherif M.
Published: September 2023

Objectives

Nationwide criteria regarding patients with sacrococcygeal teratoma (SCT) are still lacking in Egypt. We aimed to present a multicenter study regarding the management and outcomes of this tumor to evaluate our national treatment strategy.

Methods

A retrospective analysis including all patients with SCT who were managed at four major Egyptian centers between 2013 and 2023. Clinical data, surgical approaches, and short- and long-term outcomes were discussed.

Results

The study included 95 patients (74 were females). Antenatal diagnosis was reported in 25% of patients. Seventy-one patients (74.7%) were classified as Altman type I/II. Surgery was performed via a perineal approach in 75 patients, whereas the remaining 20 underwent a combined abdominoperineal approach. Vertical elliptical incision with midline closure was conducted in 51.5% of patients, followed by classic or modified chevron incisions. Benign mature teratoma was detected in 82% of patients. At a median follow-up of 57 months, eight patients (8.5%) had relapsed. The 5-year overall survival (OS) and event-free survival (EFS) of all patients were 94% and 91%, respectively. In the after-care monitoring, 19 patients (20%) had urinary or bowel dysfunctions. Nine of them were managed using medications. Clean intermittent catheterization was practiced in another five patients. The remaining five underwent further surgical interventions.

Conclusion

Favorable outcomes were achieved in our country during the last decade. Diverse perineal incisions were performed for resection, and vertical elliptical with midline closure was the commonest. During follow-up, 20% of patients developed urological or bowel dysfunctions that required medical and surgical treatment modalities to improve their quality of life.
Longitudinal trajectories of atherogenic index of plasma and risks of cardiovascular diseases: results from the Korean genome and epidemiology study
Authors: Chun Dong-Wook , Lee Yae-Ji , Lee Jun-Hyuk , Lee Ji-Won
Published: September 2023

Background

Although the atherogenic index of plasma (AIP) based on a single measurement is a known risk factor for cardiovascular disease (CVD), little is known about whether changes in AIP over time are related to incident CVD. We aimed to determine whether AIP trajectory, which reflects homogenous AIP trends for a particular period, is associated with CVD risk.

Methods

Data from 5,843 participants of the Korean Genome and Epidemiology Study (KoGES) were analyzed. The KoGES had been conducted biennially from the baseline survey (2001–2002) to the eighth follow-up survey (2017–2018). The research design specifies the exposure period from baseline to the third follow-up, designates the latent period at the fourth follow-up, and establishes the event accrual period from the fifth to the eighth follow-up. During the exposure period, we identified two trajectories: a decreasing (n = 3,036) and an increasing group (n = 2,807) using latent variable mixture modeling. Information on CVD was collected initially through the self-reporting, followed by in depth person-to-person interview conducted by a well-trained examiner. During the event accrual period, the cumulative incidence rates of CVD between the two AIP trajectory groups were estimated using Kaplan–Meier analysis with the log-rank test. Multiple Cox proportional hazard models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs).

Results

The increasing AIP trajectory group had a significantly higher cumulative incidence rate of CVD than the decreasing AIP trajectory group. Compared to the decreasing AIP trajectory group, the increasing AIP trajectory group had a higher risk of incident CVD (HR: 1.31, 95% CI: 1.02–1.69) after adjusting for confounders.

Conclusions

The risk of incident CVD increased when the AIP level showed an increasing trend and remained high over a long period. This suggests that checking and managing the trajectory of the AIP can be a preventive strategy for incident CVD.
Early identification of lung cancer patients with venous thromboembolism: development and validation of a risk prediction model
Authors: Di Wenjuan , Xu Haotian , Ling Chunhua , Xue Ting
Published: September 2023

Introduction

Venous thromboembolism(VTE) is a leading cause of death in patients with lung cancer. Furthermore, hospitalization of patients with advanced lung cancer for VTE treatment represents a major economic burden on the national public health resources. Therefore, we performed this prospective study to identify clinical biomarkers for the early identification of VTE in lung cancer patients.

Methods

This prospective study enrolled 158 patients with confirmed lung cancer, including 27 who were diagnosed with VTE within six months of the follow-up after lung cancer diagnosis. Multivariate logistic regression analysis was used to evaluate the diagnostic performancese of all the relevant clinical features and laboratory indicators in identifying lung cancer patients with a higher risk of VTE. A novel risk prediction model was constructed consisting of five clinical variables with the best diagnostic performances and was validated using the receiver operation characteristic(ROC) curves. The diagnostic performances of the new risk prediction model was also compared with the Khorana risk score (KRS) and the Padua risk score (PRS).

Results

The VTE group of lung cancer patients (n = 27) showed significantly higher serum levels of fibrin degradation products (FDP), D-dimer, thrombomodulin (TM), thrombin-antithrombin-complex (TAT), α2-plasmin inhibitor-plasmin Complex (PIC), and tissue plasminogen activator-plasminogen activator inhibitor complex (t-PAIC) compared to those in the non-VTE group (n = 131). ROC curve analyses showed that the diagnostic efficacy of the new VTE risk prediction model with TM ≥ 9.75 TU/ml, TAT ≥ 2.25ng/ml, t-PAIC ≥ 7.35ng/ml, history of VTE, and ECOG PS score ≥ 2 was superior than the KRS and the PRS in the early identification of lung cancer patients with a higher risk of VTE.

Conclusions

The new risk prediction model showed significantly high diagnostic efficacy in the early identification of lung cancer patients with a high risk of VTE. The diagnostic efficacy of the new risk prediction model was higher than the KRS and the PRS in this cohort of lung cancer patients.