bluuebunny/crossref_metadata_2025 huggingface dataset:
Bloco no poder, participação política e política educacional em São Gonçalo-RJ no contexto de bolsonarismo
Authors: De Oliveira Rafael Bastos Costa
Published: September 2022

Este ensaio trata da atualidade do bloco no poder, no município de São Gonçalo-RJ, tendo como foco a análise dos espaços de participação política e construção de políticas educacionais, a partir do contexto do bolsonarismo, em vigor a nível nacional e local.   As disputas de frações de classes e as lutas populares são destacas. Dados sobre projetos de lei relativos à mudança do plano de carreira da educação; a descrição das sessões da Câmara Municipal;  atividades do Conselho Municipal de Educação de São Gonçalo; a eleição de 2018; a eleição municipal de 2020 e o tipo de condensação de relações de forças no Estado são contemplados. A investigação se deu por meio de observações participativas, interpelando a categoria participação política,  à luz da teoria do Estado de Nicos Poulantzas. As constatações principais indicam que este tipo de bolsonarismo tem uma hegemonia significativa e que a análise da política educacional ajuda a entender as tensões nevrálgicas.
Pengaruh Kombinasi Ekstrak Daun Pare (Momordica charantia L.) dan Kunyit (Curcuma longa) Terhadap Kadar Kreatinin Pada Tikus (Rattus norvegicus) yang Diinduksi CCl4
Authors: Ramadhan Suchin , Ramadhan Achmad , Laenggeng Abd Hakim , Kundera I Nengah
Published: September 2022

Daun pare dan kunyit mengandung seyawa-seyawa kimia seperti flavonoid dan kurkumin yang berperan sebagai antioksidan. Penelitian ini bertujuan untuk mendeskripsikan pengaruh pemberian kombinasi ekstrak daun pare (Momordica charantia L.) dan kunyit (Curcuma longa) terhadap penurunan kadar kreatinin darah tikus (Rattus norvegicus) yang diinduksi dengan karbon tetraklorida (CCl4) dan pemanfaatan nya sebagai media pembelajaran. Penelitian menggunakan eksperimen laboratorium dengan pola rancangan acak lengkap (RAL). Sebanyak 18 ekor tikus jantan diberi perlakuan. Kelompok (Kn) merupakan kelompok tanpa perlakuan, (K-) hanya diinduksi CCl4 secara per oral, (P1) diberi kombinasi ekstrak daun pare dan kunyit konsentrasi 10%, (P2) diberi kombinasi ekstrak daun pare dan kunyit konsentrasi 20%, (P3) diberi kombinasi ekstrak daun pare dan kunyit konsentrasi 40%, dan (P4) diberi kombinasi ekstrak daun pare dan kunyit konsentrasi 80%. Data dianalisis dengan ANAVA menggunakan program STAT-27. Hasil penelitian menunjukkan bahwa terdapat pengaruh yang signifikan pemberian kombinasi ekstrak daun pare dan kunyit terhadap penurunan kadar kreatinin pada tikus. Konsentrasi kombinasi ekstrak daun pare dan kunyit yang optimal menurunkan kadar kreatinin pada tikus yang diinduksi CCl4 yaitu pada konsentrasi 80%. Dan hasil penelitian ini layak digunakan sebagai media pembelajaran dalam bentuk poster.
Pengaruh Serbuk Karet dari Ban Bekas sebagai Bahan Tambah Aspal Pen 60/70 pada Karakteristik Campuran Aspal Porus yang Menggunakan Agregat dari Loli Kota Palu
Authors: Mashuri M.
Published: September 2022

The use of waste crumb rubber tire as an additive in asphalt has been widely practiced in several countries in the world, which aims to improve the characteristics of asphalt mixtures such as porous asphalt. The purpose of this study was to determine the effect of used waste tire rubber powder as an additive in asphalt on the characteristics of porous asphalt mixture using aggregate from stone crusher machine in Loli, Palu city, Central Sulawesi Province. This research was conducted at the Transportation and Highway Laboratory, Tadulako University.This research used several percentages of used waste crumb rubber tire as follows: 0.025%, 0.050%, 0.075%, 0.10% of the aggregate weight in the mixtures (1200 grams). Aggregate composition determination in mixture using Method by sieve.  Optimum Asphalt Content determination using Marshall Method. The results of this research found that the Stability and density value of the mixtures tend to increase at the content of 0.025% - 0,075% used waste crumb rubber tire. The results also found that the maximum stability and maximum density were reached at the Optimum Asphalt Content and the used waste crumb rubber tires content were 0.58% and 0.075%.
Spatio-temporal analysis of built-up area and land surface temperature in Surakarta using Landsat imageries
Authors: Fikriyah Vidya Nahdiyatul , Danardono Danardono , Sunariya Muhammad Iqbal Taufiqurrahman , Cholil Munawar , Hafid Tegar Abdul , Ismail Muhammad Islam
Published: September 2022

The need for built-up areas continues to increase, along with the increasing population in the city of Surakarta and its surrounding. This condition affects the land surface temperature which then leads to the change in climatic conditions. The availability of land for settlement and surface temperature will affect the comfort level of living in a city. For this reason, this study aims to map the distribution of built-up area and the surface temperature of Surakarta city and discusses the relationship between these two aspects spatially and temporally. The data used are Landsat imageries recorded in 2000, 2013, and 2019. The built-up area was identified using Normalized Difference Built-Up Index (NDBI), while the temperature data was obtained through thermal band processing using Land Surface Temperature (LST) method. The results showed that during the period of the study, the built-up area and the surface temperature in Surakarta and its surroundings increased, especially in the eastern and southern parts of Surakarta. The results also showed that there is a positive correlation between the built-up index and its surface temperature.
Unity formulas for the coupling constants and the dimensionless physical constants
Authors: Pellis Stergios
Published: September 2022

In this paper in an elegant way will be presented the unity
formulas for the coupling constants and the dimensionless physical
constants. We reached the conclusion of the  simple unification of the
fundamental interactions. We will find the formulas for the
Gravitational constant. It will be presented that the gravitational
fine-structure constant is a simple analogy between atomic physics and
cosmology. We will find the expression that connects the gravitational
fine-structure constant with the four coupling constants. Perhaps the
gravitational fine-structure constant is the coupling constant for the
fifth force. Also will be presented the simple unification of atomic
physics and cosmology. We will find the formulas for the cosmological
constant. This article will be followed by the energy wave theory and
the fractal space-time theory.
Characterizations and representations of Hilbert-Schmidt frames in Hilbert spaces
Authors: Fu Yan-Ling , Zhang Wei
Published: September 2022

Hilbert-Schmidt frame(HS-frame) is essentially an operator-valued frame,
it is more general than g-frames, and thus, covers some generalizations
of frames. This paper addresses the Hilbert-Schmidt frames theory for
Hilbert spaces. We first introduce the notion of HS-preframe operator,
and characterize the HS-frames, Parseval HS-frames, HS-Riesz bases,
HS-orthonormal bases and dual HS-frames in terms of HS-preframe
operators. In particular, we characterize the dual HS-frames in a
constructive way, that is, the algebraic formulae for all dual HS-frames
of a given HS-frame are given. Then we discuss the sum of HS-frames
through the properties of HS-preframe operators. Finally, we present the
representations of HS-frames in terms of linear combinations of simpler
ones such as HS-orthonormal bases, HS-Riesz bases and Parseval
HS-frames, especially an HS-frame can be represented as a linear
combination of two HS-orthonormal bases if and only if it is an HS-Riesz
basis.
Potential for significant precipitation cycling by forest-floor litter and deadwood
Authors: Floriancic Marius G. , Allen Scott , Meier Raphael , Truniger Lucas , Kirchner James , Molnar Peter
Published: September 2022

The forest-floor litter layer can retain substantial volumes of water,
thus affecting evaporation and soil-moisture dynamics. However, litter
layer wetting/drying dynamics are often overlooked when estimating
forest water budgets. Here we present field and laboratory experiments
characterizing water cycling in the forest-floor litter layer, and
outline its implications for subcanopy microclimatic conditions and for
estimates of transpiration and recharge. Storage capacities of spruce
needle litter and beech broadleaf litter averaged 3.1 mm and 1.9 mm
respectively, with drainage/evaporation timescales exceeding 2 days.
Litter-removal experiments showed that litter reduced soil water
recharge, reduced soil evaporation rates, and insulated against ground
heat fluxes that impacted snowmelt. Deadwood stored ~0.7
mm of water, increasing with more advanced states of decomposition, and
retained water for >7 days. Observed daily cycles in
deadwood weight revealed decreasing water storage during daytime as
evaporation progressed and increasing storage at night from condensation
or absorption. Water evaporating from the forest-floor litter layer
modulates the subcanopy microclimate by increasing humidity, decreasing
temperature and reducing VPD. Despite the relatively small litter
storage capacity (<3.1 mm in comparison to ~10
mm for typical forest soil rooting zones) the litter
layer alone retained and cycled 18% of annual precipitation, or 1/3 of
annual evapotranspiration. These results suggest that overlooking litter
interception may lead to substantial overestimates of recharge and
transpiration in many forest ecosystems.
The impact of corporate governance characteristics on companies’ financial performance: Evidence from Romania
Authors: Mititean Pompei
Published: September 2022

This paper assesses the possibility of a relationship between corporate
governance mechanisms, as independent variables, and firm performance
measures, as dependent variables. The data was taken from the annual reports
of a sample of 66 companies listed on Bucharest Stock Exchange in Premium
and Standard categories during the period 2016-2020. The SPSS statistical
program was used to run the multivariate linear regression model on the
selected sample. Additional variables were used to control for leverage and
size. The results of the study are mixed. Board size, board gender, and
board meetings have a positive impact on a firm?s performance, measured by
both return on assets (ROA) and return on equity (ROE). CEO duality has a
positive and significant impact on a firm?s performance measured by ROA,
while a negative and insignificant correlation was founded for ROE. Board
independence has a negative and insignificant association with both firm
performance measures. The results obtained can help companies to manage
their corporate governance.
Norval Hawkins: Ford Accountant and Salesman Extraordinaire
Authors: Lazdowski Yvette J. , Persson Martin E.
Published: September 2022

This article investigates the life and career of Norval Hawkins (1867–1936), a successful accountant at Ford Motor Company and acclaimed author of salesmanship books. He was, however a convicted felon in a Standard Oil embezzlement scheme. The early years of Ford enjoyed phenomenal growth, especially after introduction of the Model T in 1908. Oversight of accounting and sales remained under James Couzens, from the company's inception in 1903, but less is known about the role of accountant and salesman Norval Hawkins, whose contributions included cost and branch accounting systems and a unique dealership structure. Beyond his accounting and sales skills, Hawkins created a popular house publication, the Ford Times, to influence salespeople, customers, and dealers. Ultimately, his style and success irritated founder Henry Ford, and Hawkins was abruptly ousted. Primary archival material from The Henry Ford was retrieved to provide information on Hawkins' years at Ford from 1907 to 1919.

JEL Classifications: M41; M42; M48.
Household tenure and its associations with multiple long-term conditions amongst working age adults: a cross-sectional analysis using primary care and local government data linked at individual and household levels.
Authors: Ingram Elizabeth , Gomes Manuel , Hogarth Sue , McDonald Helen , Osborn David , Sheringham Jessica
Published: September 2022

ObjectivesWe quantified associations between household tenure – whether someone privately or socially rents their property, or owner occupies – and prevalence of multiple long-term conditions (MLTCs) amongst working age adults. We also assessed whether the success of data linkages conducted to enable this study introduced potential selection biases.
ApproachThis cross-sectional study used the 2019/20 wave of an innovative dataset linking health and local government data at individual and household levels for residents of an East London borough. To assess potential biases, we calculated standardised differences in variables for matched and unmatched primary care records. Our primary outcome was basic MLTCs, defined as two or more long-term conditions from a list of 38. Two further definitions of MLTCs were operationalised. Multilevel logistic regression was used to explore associations for working age adults (16-64 years, inclusive). Interaction terms were used to evaluate potential interactions between tenure and other household factors.
ResultsStandardised differences in selected health variables for matched and unmatched primary care records were <0.2, indicating selection biases were not introduced due to data linkage success. For participants with successfully linked records, prevalence of basic MLTCs was 18.0%. After adjusting for various sociodemographic, health and socioeconomic variables, odds of basic MLTCs were 36% higher for working age social housing tenants (OR 1.36; 95% CI 1.30-1.42) and 19% lower for private renters (OR 0.81, 95% CI 0.77-0.84) when compared to owner-occupiers. These results were largely consistent across different definitions of MLTCs. Other household-level variables - household benefits receipt, occupancy, and household type – were important modifying factors, with associations between tenure and MLTCs greater for individuals in single adult households and households in receipt of benefits.
ConclusionThis study demonstrates that primary care and local government data can be linked without introducing selection biases in key health variables and analysed to reveal important insights. We found evidence that household tenure is associated with MLTCs prevalence, emphasising the importance of understanding and addressing household-level social determinants of health.
Mental disorders and their impact on academic performance in Australia: a matched population-based cohort study.
Authors: Mitchell Rebecca , McMaugh Anne , Schniering Carolyn , Cameron Cate , Lystad Reidar , Badgery-Parker Tim , Nielssen Olav
Published: September 2022

ObjectivesTo compare scholastic performance and high school completion of young people hospitalised with a mental disorder compared to young people not hospitalised for a mental disorder by sex.
ApproachA population-based matched case-comparison cohort study of young people aged ≤18 years hospitalised for a mental disorder during 2005-2018 in New South Wales, Australia using linked birth, health, education and mortality records. The comparison cohort was matched on age, sex and residential postcode. Generalised linear mixed modelling examined risk of school performance below the national minimum standard (NMS) and generalised linear regression examined risk of not completing high school for young people with a mental disorder compared to matched peers.
ResultsYoung males with a mental disorder had over a 1.7 times higher risk of not achieving the NMS for numeracy (ARR: 1.71; 95%CI 1.35-2.15) and reading (ARR: 1.99; 95%CI 1.80-2.20) compared to matched peers. Young females with a mental disorder had around 1.5 times higher risk of not achieving the NMS for numeracy (ARR: 1.50; 95%CI 1.14-1.96) compared to matched peers. Both young males and females with a disorder had around a three times higher risk of not completing high school compared to peers. Young males with multiple disorders had up to a six-fold increased risk and young females with multiple disorders had up to an eight-fold increased risk of not completing high school compared to peers.
ConclusionsEarly recognition and support could improve school performance and educational outcomes for young people who were hospitalised with a mental disorder. This support should be provided in conjunction with access to mental health services and school involvement and assistance.
Collaborating with patient and public members in developing the COVID - Curated and open analysis and research platform (CO-CONNECT).
Authors: Jackson Tracy , McMaugh Anne , Chuter Antony , Cursino Marialuisa , Sheikh Aziz
Published: September 2022

ObjectivesWe aimed to support the work of CO-CONNECT by meaningfully involving patient and public members across all project work packages.  In addition, we aimed to ensure that the team members and outputs are connected to public perspectives and that public voices are adequately represented and embedded throughout CO-CONNECT.
ApproachWe have two public members on our leadership team who co-lead our Patient and Public Involvement and Engagement (PPIE) work stream with support from academics.  They convened a “Public User Group” (PUG) of five public members from across the United Kingdom who regularly contribute to all aspects of CO-CONNECT.  Our PPIE work was co-produced with our public members and a PPIE strategy was developed to ensure meaningful involvement throughout CO-CONNECT.  At the beginning of the project, we developed an information pack for our public members to provide insight into CO-CONNECT and the importance of their role.
ResultsTo ensure complete transparency with the public, our PUG members attend and actively contribute to all team meetings within CO-CONNECT.  This provides opportunities for public voices to be heard and acted upon in relation to questions about the use of, and access to, healthcare data in healthcare research.  PUG members have contributed to the development of the CO-CONNECT website including providing information for biographies to increase public awareness of the involvement of public members in CO-CONNECT.  They have written blogs and been interviewed for newsletter articles on the important of public involvement in research.  Together we have created videos discussing their experience of being involved with CO-CONNECT and created a set of “Frequently Asked Questions” to provide more information about CO-CONNECT for the public-facing website.
ConclusionThe PPIE work within CO-CONNECT has created an innovative approach to ensuring public voices are heard and acted upon within data linkage networks.  This model has the potential to be used in future projects to ensure inclusive and meaningful involvement of patient and public members in healthcare research.
Data on Patient Record Trajectory for Linkage (DataPRinT Linkage).
Authors: Kalia Sumeet , Greiver Michelle , Sullivan Frank , Pow Conrad , Sheikh Aziz
Published: September 2022

The linkage of Electronic Medical Records, Administrative and other data sources is highly valuable for research and health system monitoring. Once linked, combined resources can be analyzed to provide the answers to a variety of health questions that otherwise could not be answered. However, legislative and administrative barriers, including lengthy processes for data sharing agreements, may preclude timely linkage which is a key requirement during pandemics.
ObjectiveTo develop a method using a patient’s health trajectory to probabilistically link primary care Electronic Medical Record (EMR) data with administrative and other data, without the need to transfer large datasets or identifiable information. To determine the legislative feasibility, accuracy and validity of this linkage process.
Study DesignIdentify data strings that do not directly identify patients and could be used as unique linkage variables. The data strings, which we are calling dataprints, are sufficiently similar over time in different databases. One example in Ontario, Canada, is the pattern of submitted health claims. For every patient seen by a family physician, there exists a unique pattern of dates/billing codes/diagnoses over time. These unique patterns are reasonably similar in EMR and administrative datasets. We will apply an algorithm which turns the string in the selected dataprints to an irreversibly hashed code for each person. The hashed code and no additional information will be provided by both data controllers to a trusted-third party who will determine which records match and send a mapping table to both. This enables analyses to be run in parallel, without divulging any direct person identifiers.
DatasetIndividuals contained in the University of Toronto Practice Based Research Network (UTOPIAN).
Outcome MeasuresLinkage quality will be assessed by the number of true matches and represented by sensitivity, specificity and positive and negative predictive values.
ResultsThe method will be evaluated against a validated, deterministically linked reference standard at North York General Hospital using de-identified EMR and hospital data. Results will inform processes to enable analyses across datasets while adhering to privacy legislation.
Identifying prenuptial births from family pedigrees using record linkage.
Authors: Kirelle Nishadi , Christen Peter , Garrett Eilidh
Published: September 2022

ObjectivesDemographers are interested in the degree to which marriage is driven by prenuptial pregnancy within particular communities. To help answer this question, we present a novel method which links marriage certificates to birth certificates, where the birth-mother is the marriage-bride, considering only births which occur in the first seven months after a marriage.
ApproachTo identify prenuptial births we employed an unsupervised graph-based record linkage method to link birth and marriage certificates. We first extracted related groups of individuals: babies and their parents from birth certificates, and brides, grooms, and their parents from marriage certificates. To link births with marriages, we employed techniques to address challenges such as changing attribute values over time (such as names and addresses), the ambiguity of attribute values giving priority to rare names over common names, and different relationships encountered at different points in time (by applying temporal constraints). Based on the obtained links we then extracted prenuptial births.
ResultsUsing two Scottish data sets containing a total of 38,451 births and 8,667 marriage certificates from the period 1861 to 1901 and employing different linkage thresholds we identified between 853 and 945 first birth-marriage links in the smaller (rural) data set, and between 2,165 and 2,232 links in the larger (urban) data set. In the rural data set, between 16.9% and 17.7% of these links were with birth less than 8 months after marriage (i.e. prenuptial births), where the corresponding ground truth contained 17.6% prenuptial births. For the urban data set, we identified between 51.3% and 51.4% prenuptial births. Our results show clear differences between rural and urban prenuptial pregnancies in 19th Century Scotland.
ConclusionWe have presented an unsupervised graph-based record linkage method that compares attribute values of individuals and their relationships to link records based on the ambiguity of attribute values, attribute value changes, and temporal constraints. This linking process helps us to identify prenuptial births to help us understand the degree to which marriages may have been driven by pregnancy.
Using cross-sector data linkage to track patient journeys across health and social care.
Authors: Grimm Fiona , Lewer Dan , Craig John , Rogans-Watson Rafi , Shand Jenny
Published: September 2022

ObjectivesOlder people and people with complex needs often require both health and social care services, but there is limited insight into individual journeys across these services. To help inform joint health and social care planning, we aimed to assess the relationship between hospital admissions and domiciliary care receipt.
ApproachWe used an individually linked dataset of primary care activity, hospital admissions and local authority-held social care records for adults living in Barking and Dagenham, a borough in London, England, on 1 April 2018, and followed them up until 31 March 2020. The outcome was initiation of a new domiciliary care package. We estimated the rate of hospital-associated care package initiation, and of care packages unrelated to hospital admissions. We also described the characteristics of hospital admissions that preceded domiciliary care and examined which primary diagnoses codes were associated with receiving domiciliary care after discharge.
ResultsIn our cohort, 1.4 of participants had a domiciliary care package during a median follow-up of 1.87 years. One in three domiciliary care packages were initiated during a hospital stay or within 7 days of discharge. The rate of new domiciliary care packages was 120 times greater (95% CI 110-130) during or after a hospital stay than at other times, and this association was present for all age groups. Primary admission reasons accounting for the largest number of domiciliary care packages were hip fracture, pneumonia, urinary tract infection, septicaemia, and exacerbations of long-term conditions (COPD and heart failure). Admission reasons with the greatest likelihood of a subsequent domiciliary care package were fractures and strokes.
ConclusionHospitals are a major referral route into domiciliary care. While new and acute illnesses account for many domiciliary care packages, exacerbations of long-term conditions and age- and frailty-related conditions are also an important driver. National-level linked datasets are needed for a better understanding of the relationship between health and social care receipt.
Understanding household health through data linkage.
Authors: Stafford Mai , Deeny Sarah , Marszalek Kathryn , Shand Jenny
Published: September 2022

ObjectivesHousehold factors can affect the level and type of health and social care a person with long-term conditions needs. Information on household composition and health needs within households is not easily available in routine health records but linked data from health providers and local government can address this gap.
ApproachIndividual-level linked data from local government services, health providers and health commissioners in Barking and Dagenham was used. This provided sociodemographic, health and household information alongside activity data for five care settings (primary care, hospital, community, inpatient and outpatient mental health services, and social care). We identified 9222 residents aged 50+ living in two-person households between April 2016 and March 2018. Their long-term conditions were counted using primary care data. Annualised use and cost of care services were compared for households with one versus both residents having two or more long-term conditions (known as “multimorbidity”).
ResultsOver 45% of multimorbid people in two-person households were co-resident with another multimorbid person. This percentage was higher in the most deprived areas. In households where both residents were multimorbid, each resident had higher use of some types of care. After adjustment for age, gender and area deprivation, those co-resident with another multimorbid person were 1.14 (95% CI 1.00, 1.30) times as likely to have any community care activity and 1.24 (95% CI 0.99,1.54) times as likely to have any mental health care activity compared to those co-resident with a healthy person. They had more primary care visits (8.5 (95% CI 8.2,8.8) vs 7.9 (95% CI 7.7,8.2)) and higher primary care costs. Outpatient care and elective admissions did not differ between these groups.
ConclusionsCare use for people with multimorbidity depends on the health of others in their household. Use of household health data could inform local planning for health and other community services. Its use for delivering individual or household level care could be explored, if acceptable to patients. Future research could examine larger households.
Bias in exposure-outcome associations when using left truncated birth datasets.
Authors: Dunne Jennifer , Tessema Gizachew , Pereira Gavin
Published: September 2022

ObjectivesRestriction to the analysis of births that survive past a specified gestational age (typically 20 weeks gestation) can lead to biased exposure-outcome associations. The objective is to estimate the influence of bias resulting from using a left truncated dataset to ascertain exposure-outcome associations in perinatal studies.
ApproachWe simulated the magnitude of bias under a collider-stratification mechanism for the association between the exposure of advancing maternal age (≥ 35 years) and the outcome of stillbirth. This bias occurs when the cause of restriction (early pregnancy loss) is influenced by both the exposure and unmeasured factors that also affect the outcome. Simulation parameters were based on an original birth cohort from Western Australia and a range of plausible values for the prevalence of early pregnancy loss (< 20 gestational weeks), an unmeasured factor U and the odds ratios for the selection effects. Selection effects included the effects of maternal age on early pregnancy loss, U on early pregnancy loss, and U on stillbirth. We then compared the simulated scenarios with the results from the original cohort in which bias was unadjusted.
ResultsWe found the overall magnitude of bias to be minimal in the association between advancing maternal age and stillbirth. The findings indicate that the stronger the effect of the unmeasured U on early pregnancy loss and stillbirth, the greater the departure from the null. When we compared the simulated model with the results of the original cohort, we found evidence of marginal downward bias which was most prominent for women aged 40+ years.
DiscussionOur simulations demonstrated a marginal downward bias in the association between advancing maternal age and stillbirth. We recommend that future studies should quantify the extent of such bias when using left truncated birth datasets to determine exposure-outcome associations.
The COVID - Curated and Open aNalysis aNd rEsearCh plaTform (CO-CONNECT).
Authors: Jefferson Emily , Sheik Aziz , Hopkins Susan , Quinlan Philip
Published: September 2022

ObjectivesCO-CONNECT is making UK COVID-19 data Findable, Accessible, Interoperable and Reusable (FAIR) through a federated platform, which supports secure, anonymised research at scale and pace. This interdisciplinary project, spanning 22 organisations, is connecting data from >50 large research cohorts and data collected through routine healthcare provision across the UK.
ApproachAcross the UK, data has been collected that can help us answer key questions about COVID-19. As the data are in many places with many different processes it is difficult and complex for public health groups, researchers, policymakers, and government to find and access lots of high-quality data quickly and efficiently to make decisions. In collaboration with Health Data Research UK, CO-CONNECT is streamlining processes of accessing data for research.
Results1) Discovering data and meta-analysis: CO-CONNECT enables researchers to determine how many people meet their research criteria within the various datasets across the UK through the Health Data Research Innovation Gateway Cohort Discovery tool e.g. “How many people in each dataset have had a PCR test which was positive and were under the age of 40?” Only summary level, anonymous data are provided so researchers can answer such questions rapidly without requiring multiple data governance permissions and directly contacting each data source. The tool also supports aggregate level meta-analysis of the data.
2) Detailed analysis: With data governance approvals, researchers can analyse detailed level, standardised, linked, pseudonymised data in a Trusted Research Environment. The common format reduces the effort on each research project, supporting rapid research.
ConclusionProviding data in this de-identifiable, safe way enables rapid, robust research e.g., COVID-19 results from a test centre can be linked to hospital records along with prescriptions from pharmacies enabling researchers to understand whether people with different existing health conditions are more or less susceptible to COVID-19. If you want to know more visit https://co-connect.ac.uk.
Potentially non-beneficial interventions in the last 100 days of life of patients with cancer: A population-based retrospective cohort study.
Authors: Webber Colleen , Hafid Abe , Gayowsky Anastasia , Howard Michelle , Tanuseputro Peter , Jones Aaron , Scott Mary , Hsu Amy , Downar James , Manuel Doug , Conen Katrin , Isenberg Sarina
Published: September 2022

ObjectivesThe objective of this study was to describe the receipt of potentially non-beneficial interventions in the last 100 days of life of cancer patients and to examine variations in these interventions according to patient characteristics and cancer site.
ApproachWe conducted a population-based retrospective cohort study of all adults age 18+ who died of cancer in Ontario, Canada between January 1, 2013 and December 31, 2017 using linked administrative health data held at ICES. Potentially non-beneficial interventions were captured via hospital discharge records and included chemotherapy, major surgery, intensive care unit admission, cardiopulmonary resuscitation, defibrillation, dialysis, percutaneous coronary intervention, mechanical ventilation, feeding tube placement, blood transfusion and bronchoscopy. We used bivariate analyses and multivariable Poisson regression to examine associations between the receipt of interventions and decedent age, sex, rurality, area-level income, and cancer site.
ResultsAmong the 125,755 decedents, the most common intervention was blood transfusion (18.1%) and major surgery (12.8%); 23.8% received no interventions, while 14% of decedents received 3+ interventions. Lower intervention rates were observed in older patients (adjusted rate ratio (RR) 0.46, 95% confidence interval (CI) 0.44-0.49 for age 95+ vs. 19-44), females (RR 0.93, 95% CI 0.92-0.94), and individuals living in higher income areas (RR 0.96, 95% CI 0.95-0.98 for highest vs. lowest income quintile). Higher intervention rates were observed in rural patients (RR 1.13, 95% CI 1.11-1.14). Patients with pancreatic cancer had the highest intervention rate (RR 1.13, 95% CI 1.10-1.16), while breast cancer patients had the lowest intervention rate (RR 0.86, 95% CI 0.84-0.89) compared to colorectal cancer patients.
ConclusionPotentially non-beneficial interventions were common in the last 100 days of life of patients with cancer. Variations in interventions across patient demographics and cancer site may reflect differences in healthcare access, end-of-life care preferences, patients’ prognostic awareness, and disease factors.
Biases arising from using linked administrative data for research: A conceptual framework from registration to analysis.
Authors: Shaw Richard , Harron Katie , Pescarini Julia , Júnior Elzo , Siroky Andressa , Campbell Desmond , Dundas Ruth , Ichihara Maria Yury , Barreto Mauricio , Katikireddi Vittal
Published: September 2022

ObjectivesAdministrative data are primarily collected for operational processes and these processes can lead to sources of bias that may not be adequately considered by researchers. We provide a framework to help understand how biases might arise from using linked administrative data, and hopefully aid future study designs.
ApproachWe developed the conceptual framework based on the team’s experiences with the 100 Million Brazilian Cohort (100MCohort) which contains records of more than 131 million people whose families applied for social assistance between 2001 and 2018, linked to other administrative data sources. We provide examples from the 100MCohort of where and how in the linkage process different forms of bias could arise. We make recommendations on how biases might be addressed using commonly available external data.
ResultsThe conceptual framework covers the whole data generating process from people and events occurring in the population through to deriving variables for analysis. The framework comprises three distinct stages: 1) Recording and registration of events in administrative systems such as Brazil’s Mortality Information System (SIM) and the Hospital Information System (SIH); 2) Linkage of different data sources, for example using exact matching via the Social Identification Number (NIS) in Brazil’s CadÚnico database or linkage algorithms; 3) Cleaning and coding data used both for analysis and linkage. The biases arising from linkage can be better understood by applying theory and making additional metadata available.
ConclusionMaximising the potential of administrative data for research requires a better understanding of how biases arise. This is best achieved by considering the entire data generating process, and better communication among all those involved in the data collection and linkage processes.
Understanding how cancer survivors’ needs and experiences after treatment impact their health care utilization: a survey-administrative health data linkage study.
Authors: Urquhart Robin , Kendell Cynthia , Kaal Julia , Vickery Jessica , Lethbridge Lynn
Published: September 2022

ObjectivesTo link population-based survey data to routinely collected administrative health data to enable investigation of how cancer survivors' ongoing physical, emotional, and practical needs and experiences after completing cancer treatment impact their healthcare utilization, including discharge from oncology to primary care.
ApproachThe "Cancer Transitions Survey" is a population-based survey examining survivors' experiences and needs after completing cancer treatment. The survey was administered by the Nova Scotia Cancer Registry (NSCR) as part of a national study, the largest of its kind in Canada. Respondents included Nova Scotian survivors of breast, melanoma, colorectal, prostate, hematologic, and young adult cancers who were 1-3 years after treatment. Survey responses were linked to cancer registry, physicians' claims, hospitalization, and ambulatory care data. The data linkage provided a full four years of healthcare utilization data for each cancer survivor, beginning one year after their cancer diagnosis.
Results1557 survivors responded to the survey and subsequently had their data linked. Collectively, breast, colorectal, and prostate cancer survivors represented 78.5% of survey respondents. Most respondents (65.3%) were 65 years of age or older and 69.8% had an existing co-morbid condition. Regression analyses are now being conducted to investigate whether the type and magnitude of post-treatment care needs, and the interventions (services and supports) received, impact health care utilization in the survivorship period, including discharge to primary care.
ConclusionThis study represents a unique opportunity to link data unavailable in administrative health data: namely, self-reported needs and use of non-physician services and supports (e.g., support groups, counselling). As such, this dataset permits investigation of healthcare utilization and patterns of care that cannot be accomplished using administrative health data alone.
How can we measure the developmental impacts of the COVID-19 pandemic on young children?
Authors: Nelson Amy Hawn , Berkowitz Emily
Published: September 2022

Objectives
• Present a conceptual data model for understanding the impacts of COVID on children 0-5
• Outline administrative datasets with relevant indicators that are commonly collected, integrated at the individual level, and include relevant 2-generation linkages
• Provide specific considerations for research using the conceptual model
ApproachThis session presents findings from a paper that was collaboratively generated by a workgroup of five integrated administrative data systems (IDS) in communities across the US with expansive data holdings in early education. Contributors have decades of experience in utilizing administrative data for social policy planning and analysis. We started with a thorough literature review, used a national survey data of IDS data holdings collected in 2020, and co-created a conceptual data model for administrative data reuse based upon current practices. Specific care was taken to include community-level changes and adult factors that serve as mediators for children’s outcomes.
ResultsThe COVID-19 pandemic made its mark on the entire world, yet little is known about children, aged 0-5, whose lives have been exponentially affected. This conceptual data model presents five developmental resilience pathways (i.e. early learning, safe and nurturing families, health, housing, and financial/employment) that include direct and indirect influencers related to COVID-19 impacts, and the contexts and community supports that can affect child-level outcomes. We then overview commonly available administrative datasets with relevant indicators to be linked at the individual and household level, with discussion of data specific considerations (e.g. access, insufficiency, availability, quality, and linkage). The US response creates a natural experiment of policy and implementation decisions across boundaries, and while US-centric, this approach could be applied internationally.
ConclusionThe development and use of IDS for research has great potential to inform solutions to our most pressing social problems. Cross-site research studies and maintaining sustainable capacities for long-term research is paramount to understanding the implications of response interventions and to study impacts on child development over time.
Pre-pregnancy maternal cardiovascular diseases and risk of offspring’s neurodevelopmental disorders: a population-based cohort study.
Authors: Hossin M. Zakir , McKay Kyla A , Fernández de La Cruz Lorena , Sandström Anna , Razaz Neda
Published: September 2022

ObjectiveMaternal exposure to cardiovascular disease (CVD) is associated with adverse maternal and neonatal health outcomes. However, its association with offspring’s long-term neurodevelopmental disorders (NDDs) is not yet known. We aimed to investigate the association between maternal pre-existing CVDs and children’s NDDs.
ApproachThis nationwide cohort study included 2.7 million live singleton births recorded in the Swedish Medical Birth Register between 1990 and 2019. Information on maternal pre-pregnancy CVDs was extracted from the National Patient Register, including diagnosis of cerebrovascular disease, heart failure, arrhythmia, valvular and congenital heart diseases. Registered diagnoses of offspring NDDs included Attention-Deficit/Hyperactivity Disorder (ADHD), Autism Spectrum Disorder (ASD), and intellectual disability. Cox proportional hazards models were fitted to estimate Hazard Ratios (HRs) and 95% Confidence Intervals (CIs) for the associations. All estimates were adjusted for offspring’s age at diagnosis, sex, calendar period, and maternal characteristics including age at birth, parity, education, country of birth, cohabitation status, smoking, psychiatric illness, pre-gestational diabetes, and hypertension.
ResultsThe overall prevalence of maternal CVDs was 0.8% between 1990 and 2019. A total of 141 651 individuals (5.2%) received a diagnosis of ADHD, 64 691 (2.4%) of ASD, and 22 913 (0.9%) received a diagnosis of intellectual disability. The adjusted analyses showed that offspring of mothers with CVD had 16% higher rate of ADHD (HR 1.16; 95% CI: 1.09-1.24) and 12% higher rate of ASD (HR 1.12; 95% CI: 1.02-1.23), compared with offspring of mothers without CVD. Specifically, maternal heart failure was associated with 1.93-fold increased HR of ASD (95% CI: 1.21-3.08), maternal arrhythmia with 14% increased rate of ADHD (95% CI: 1.04-1.24), and maternal cerebrovascular disease was associated with 30% elevated rate of ASD (95% CI: 1.07-1.59) and 17% elevated rate of ADHD (95% CI: 1.02-1.36). No association was found between maternal CVDs and intellectual disability.
ConclusionMaternal CVD before pregnancy may be a risk factor for offspring’s ADHD and ASD, with varied risks by CVD subtypes. The mechanisms behind the associations warrant further investigations.
Risk of a major adverse cardiovascular event (MACE) following first-ever hospitalisation for acute gout: a Western Australian population-level linked data study.
Authors: Lopez Derrick , Preen David , Raymond Warren , Inderjeeth Charles , Murray Kevin , Nossent Hans , Dwivedi Girish , Keen Helen
Published: September 2022

ObjectivesCardiovascular disease is the largest contributor of increased mortality in patients with gout.  Acute inflammation as seen with gout attacks may have a mechanistic role in developing Major Adverse Cardiovascular Events (MACE).  We examined the temporal relationship between admission to hospital with acute gout and MACE.
ApproachLinked inpatient and mortality data from the Western Australian Rheumatic Disease Epidemiology Registry were used.  We identified patients with an incident acute gout (index) hospitalisation and admission or death records due to MACE (composite of acute coronary syndrome, stroke, heart failure, cardiovascular death).  The risk of MACE during the index post-discharge period (1-30 days after index admission) and control period (365 days prior to index admission and 365 days post-discharge) was determined using a self-controlled case-series (SCCS) design.  Conditional fixed-effects Poisson regression was used to obtain incidence rate ratios (IRR).  Sensitivity analyses were performed excluding deaths and 180-day events.
ResultsWe identified 962 patients (mean age=76.2 years [SD=12.2]; 66.8% male) with incident acute gout admission and documented MACE during the control and/or index post-discharge periods.   917 (95.3%) patients experienced MACE during the control period and 114 (11.9%) during the index post-discharge period.  The rate of MACE during the control and post-discharge periods were 0.84 and 1.44 events per person-year, respectively, with an IRR=1.67 (95% CI: 1.38-2.02) for the post-discharge period compared with the control period from regression analysis.  Sensitivity analyses excluding deaths and 180-day events were IRR=1.68 (95% CI=1.29-2.20) and IRR=1.66 (95% CI=1.34-2.07) respectively.
ConclusionOur self-controlled case-series study using linked administrative data found an increased risk of MACE during the 30 days after discharge for index gout hospitalisation.  This suggests a temporal association between acute inflammation and MACE.