bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unmet Social Needs and No-Show Visits in Primary Care in a US Northeastern Urban Health System, 2018–2019
Authors: Fiori Kevin P. , Heller Caroline G. , Rehm Colin D. , Parsons Amanda , Flattau Anna , Braganza Sandra , Lue Kelly , Lauria Molly , Racine Andrew 
Published: July 2020

Objectives. To characterize the association between social needs prevalence and no-show proportion and variation in these associations among specific social needs. Methods. In this study, we used results from a 10-item social needs screener conducted across 19 primary care practices in a large urban health system in Bronx County, New York, between April 2018 and July 2019. We estimated the association between unmet needs and 2-year history of missed appointments from 41 637 patients by using negative binomial regression models. Results. The overall no-show appointment proportion was 26.6%. Adjusted models suggest that patients with 1 or more social needs had a significantly higher no-show proportion (31.5%) than those without any social needs (26.3%), representing an 19.8% increase (P < .001). We observed a positive trend (P < .001) between the number of reported social needs and the no-show proportion—26.3% for those with no needs, 30.0% for 1 need, 32.1% for 2 needs, and 33.8% for 3 or more needs. The strongest association was for those with health care transportation need as compared with those without (36.0% vs 26.9%). Conclusions. We found unmet social needs to have a significant association with missed primary care appointments with potential implications on cost, quality, and access for health systems.
Integration of Health and Social Services at the Systems Level: A Framework for Addressing Funding and Jurisdictional Silos
Authors: McCullough J. Mac , Leider Jonathon P. , Phillips Megan A. 
Published: July 2020

Objectives. To examine spending and resource allocation decision-making to address health and social service integration challenges within and between governments. Methods. We performed a mixed methods case study to examine the integration of health and social services in a large US metropolitan area, including a city and a county government. Analyses incorporated annual budget data from the city and the county from 2009 to 2018 and semistructured interviews with 41 key leaders, including directors, deputies, or finance officers from all health care–, health-, or social service–oriented city and county agencies; lead budget and finance managers; and city and county executive offices. Results. Participants viewed public health and social services as qualitatively important, although together these constituted only $157 or $1250 total per capita spending in 2018, and per capita public health spending has declined since 2009. Funding streams can be siloed and budget approaches can facilitate or impede service integration. Conclusions. Health and social services should be integrated through greater attention to the budgetary, jurisdictional, and programmatic realities of health and social service agencies and to the budget models used for driving the systems-level pursuit of population health.
Late Neogene–Quaternary Planktic Foraminiferal Biostratigraphy and Biochronology from ODP Site 807A, Ontong Java Plateau, Western Equatorial Pacific
Authors: Kaushik Tushar , Singh Ashutosh Kumar , Sinha Devesh Kumar 
Published: July 2020

ABSTRACTA biostratigraphic and biochronological study from the late Neogene–Quaternary section of Ocean Drilling Program (ODP) Site 807A, located on the Ontong Java Plateau, western equatorial Pacific, revealed 50 planktic foraminiferal events, enabling the identification of eight late Neogene–Quaternary biozones, from the Globorotalia plesiotumida Interval Zone to the Globorotalia truncatulinoides Interval Zone. A significant faunal turnover (17 events) from late Pliocene identified in cores 7 and 8, between 70 and 55 meters below seafloor (mbsf), and spanning 0.67 million years (Myr). This noteworthy turnover may be the result of a shift in oceanographic conditions pertaining to the closure of the Indo–Pacific Seaway, followed by the Northern Hemisphere Glaciation. This study provides a high resolution biostratigraphic and biochronological framework for ODP Site 807A that will aid in correlation and timing the various paleoceanographic changes over the last 6 million years in the western equatorial Pacific.
Feasibility of Using Infant Testing during Immunization to Estimate HIV Mother-to-Child-Transmission Rates in Zambia
Authors: Simbaya Joseph , Funjika Patricia , Moonga Arthur , Mwale John , Kankasa Chipepo 
Published: July 2020

Abstract
Background : This study piloted the feasibility of infant testing in immunization services as a strategy for estimating MTCT rates among the population of HIV exposed infants in Zambia. Methods : The study recruited a cross-sectional sample of 8,042 caregiver-baby pairs in 38 high volume immunization sites in 7 towns across 3 provinces of Zambia. All mothers who brought their children below the age of one year for immunization at the study facilities were invited to participate in the study. All consenting mothers were interviewed and blood drawn from their babies for; rapid HIV antibody test to determine exposure and DNA PCR test for samples of all HIV-exposed babies to determine HIV infection. Results : Of 8,042 recruited caregiver-baby pairs, 1,409 (17.5 %) babies were HIV-exposed. Approximately 90.2 percent of all mothers of HIV exposed infants reported that they attended ANC visits more than two times and facility based deliveries stood at 91.6 percent. Exclusive breastfeeding among HIV exposed infants reduced with increase in age of infant; it was highest at 6 weeks (82.2 %) followed by 10 weeks (74.0 %) and 14 weeks (58.2 %) . MTCT rates were relatively lower than what was reported before at 4.7 percent among Penta 1 seekers, 2.8 percent among Penta 2 seekers, 2.1 percent among Penta 3 seekers and 5.0 percent among Measles vaccination seekers. The overall MTCT rate stood at 3.8 percent. About 48.1 percent of HIV positive babies were male compared to 51.9 percent females. Babies of mothers below the age of 25 years accounted almost half (51.9 %) of all HIV infected babies in the study. Reported exclusive breastfeeding among HIV positive babies was 77.8 percent for Penta 1 seekers, 75.0 percent for Penta 2 seekers and 100 percent for Penta 3 seekers. Conclusion: The study succeeded in estimating MTCT rates using infant testing in immunization services, demonstrating that it is feasible to use routine infant testing in immunization services as a strategy for estimating MTCT rates among the population of HIV-exposed infants in countries with high HIV burden and immunization coverage.
Deletion of pgi gene in E. coli increases tolerance to furfural and 5-hydroxymethyl furfural in media containing glucose-xylose mixture
Authors: Jilani Syed Bilal , Dev Chandra , Eqbal Danish , Jawed Kamran , Prasad Rajendra , Yazdani Syed Shams 
Published: July 2020

Abstract
Background: Furfural and 5-hydroxymethyl furfural (5-HMF) are key furan inhibitors that are generated due to breakdown of lignocellulosic sugars at high temperature and acidic treatment conditions. Both furfural and 5-HMF act in a synergistic manner to inhibit microbial metabolism and resistance to both is a desirable characteristic for efficient conversion of lignocellulosic carbon to ethanol. Genetic manipulations targeted toward increasing cellular NADPH pools have successfully imparted tolerance against furfural and 5-HMF. In present study, deletion of pgi gene as a strategy to augment carbon flow through pentose phosphate pathway (PPP) was studied in ethanologenic Escherichia coli strain SSK101 to impart tolerance towards either furfural or 5-HMFor both inhibitors together.Results: A key gene of EMP pathway, pgi, was deleted in an ethanologenic E. coli strain SSK42 to yield strain SSK101. In presence of 1 g/L furfural in minimal AM1 media, the rate of biomass formation for strain SSK101 was up to 1.9-fold higher as compared to parent SSK42 strain, and it was able to clear furfural in half the time. Tolerance to inhibitor was associated with glucose as carbon source and not xylose, and the tolerance advantage of SSK101 was neutralized in LB media. Bioreactor studies were performed under binary stress of furfural and 5-HMF (1 g/L each) and different glucose concentrations in a glucose-xylose mixture with final sugar concentration of 5.5%, mimicking major components of dilute acid treated biomass hydrolysate. In the mixture having 6 g/L and 12 g/L glucose, SSK101 strain produced ~18 g/L and 20 g/L ethanol, respectively. Interestingly, the maximum ethanol productivity was better at lower glucose load with 0.46 g/(L.h) between 96-120 h, as compared to higher glucose load where it was 0.33 g/(L.h) between 144-168 h. Importantly, parent strain SSK42 did not exhibit significant metabolic activity under similar conditions of inhibitor load and sugar concentration.Conclusions: E. coli strain SSK101 with pgi deletion had enhanced tolerance against both furfural and 5-HMF, which was associated with presence of glucose in media. Strain SSK101 also had improved fermentation characteristics under both hyperosmotic as well as binary stress of furfural and 5-HMF in media containing glucose-xylose mixture.
Influence of diabetes on short-term outcome after major hepatectomy – an underestimated risk?
Authors: Fischer Alexander , Fuchs Juri , Stravodimos Christos , Hinz Ulf , Billeter Adrian , Büchler Markus W. , Mehrabi Arianeb , Hoffmann Katrin 
Published: July 2020

Abstract
Background: Patient-related risk factors such as diabetes mellitus and obesity are increasing in western countries. At the same time the indications for liver resection in both benign and malignant diseases have been significantly extended in recent years. Major liver resection is performed more frequently in a patient population of old age, comorbidity and high rates of neoadjuvant chemotherapy. The aim of this study was to evaluate whether diabetes mellitus, obesity and overweight are risk factors for the short-term post-operative outcome after major liver resection.Methods: Four hundred seventeen major liver resections (≥3 segments) were selected from a prospective database. Exclusion criteria were prior liver resection in patient’s history and synchronous major intra-abdominal procedures. Overweight was defined as BMI ≥ 25 kg/m² and < 30 kg/m² and obesity as BMI ≥ 30 kg/m². Primary end point was 90-day mortality and logistic regression was used for multivariate analysis. Secondary end points included morbidity, complications according to Clavien-Dindo classification, unplanned readmission, bile leakage, and liver failure. Morbidity was defined as occurrence of a post-operative complication during hospital stay or within 90 days postoperatively.Results: Fifty-nine patients had diabetes mellitus (14.1%), 48 were obese (11.6%) and 147 were overweight (35.5%). There were no statistically significant differences in mortality rates between the groups. In the multivariate analysis, diabetes was an independent predictor of morbidity (OR = 2.44, p = 0.02), Clavien-Dindo grade IV complications (OR = 3.6, p = 0.004), unplanned readmission (OR = 2.44, p = 0.04) and bile leakage (OR = 2.06, p = 0.046). Obese and overweight patients did not have an impaired post-operative outcome compared patients with normal weight. Conclusions: Diabetes has direct influence on the short-term postoperative outcome with an increased risk of morbidity but not mortality. Preoperative identification of high-risk patients will potentially decrease complication rates and allow for individual patient counseling as part of a shared decision-making process. For obese and overweight patients, major liver resection is a safe procedure.
IRLnc: A novel functional noncoding RNA contributes to intramuscular fat deposition
Authors: Wang Ligang , Zhou Zhong-Yin , Zhang Tian , Zhang Longchao , Hou Xinhua , Yan Hua , Wang Lixian 
Published: July 2020

Abstract
Background Intramuscular fat (IMF) is associated with meat quality and insulin resistance in animals. Research on genetic mechanism of IMF decomposition has positive meaning to pork quality and diseases such as obesity and type 2 diabetes treatment. In this study, an IMF trait segregation population was used to perform RNA sequencing and to analyze the joint or independent effects of genes and long intergenic non-coding RNAs (lincRNAs) on IMF. Results A total of 26 genes including 6 LincRNA genes show significantly different expression between high- and low-IMF pigs. Interesting, one lincRNA gene, named IMF related LincRNA (IRLnc) not only has a 292-nt conserved region in 100 vertebrates but also has conserved up and down stream genes (<10 kb) in pig and humans. Real-time quantitative polymerase chain reaction (RT-qPCR) validation study indicated that nuclear receptor subfamily 4 group A member 3 (NR4A3) which located at the downstream of IRLnc has similar expression pattern with IRLnc. RNAi-mediated loss of function screens identified that IRLnc silencing could inhibit both of the RNA and protein expression of NR4A3. And the in-situ hybridization co-expression experiment indicates that IRLnc may directly binding to NR4A3. As the NR4A3 could regulate the catecholamine catabolism, which could affect insulin sensitivity, we inferred that IRLnc influence IMF decomposition by regulating the expression of NR4A3.Conclusions In conclusion, a novel functional noncoding variation named IRLnc have been found contribute to IMF by regulating the expression of NR4A3. These finding suggest novel mechanistic approach for treatment of insulin resistance in human beings and meat quality improvement in animal.
Effect of different bonding techniques on marginal adaptation of Harmonize composite resin at different storage times.
Authors: Alagha Ebaa Ibrahim 
Published: July 2020

Abstract
Background
This study evaluated the effect of different bonding techniques on marginal adaptation of Harmonize composite resin at different storage times.
Methods
Hundred twenty upper premolars were divided into two main groups (n = 60) according to the type of the adhesive system used (self-etch adhesive system or total etch adhesive system). Each group was further divided into three subgroups (20 teeth each) according to the storage times into one day, three months and six months. Standardized Class II cavities were prepared and restored with Harmonize composite incrementally. Teeth were stored in distilled water at room temperature. After each storage time, teeth were sectioned buccolingually into two halves and examined under digital stereomicroscope for the purpose of gap formation detection and scanning electron microscope examination was done to evaluate resin-dentin interfaces. The recorded values were tabulated and statistically analyzed. Regression model using three-way Analysis of Variance (ANOVA) was used for testing significance of the effect of adhesive system, storage period and their interactions on the mean gap area. Tukey’s post-hoc test was used for pair-wise comparisons between the groups when ANOVA test is significant. The significance level was set at P ≤ 0.05.
Results
Self-etch adhesive system showed statistically significant higher mean gap area than Total-etch adhesive system at the occlusal and cervical margins. Six months period showed the statistically significant highest mean gap area. There was no statistically significant difference between 1 day and 3 months periods; both showed the statistically significant lowest mean gap area values respectively at the occlusal and cervical margins.
Conclusions
Total-etch adhesive system enhances the marginal adaptation when compared to self-etch adhesive system and the storage period of composite resin in water has adverse effect on the marginal adaptation to all groups with time.
An Internet Investigation of Mental Health Status of 1144 Different Status Identities in South China during Outbreak of COVID-19
Authors: Luo Qianyi , Deng Shaomin , Wu Kai , Wu Zhiyao , Mai Weiyang , Ning Yuping , He Hongbo , Zhang Shuangchun , Wang Dexian , Peng Hongjun 
Published: July 2020

Abstract
Background At the end of 2019, the Coronavirus disease 2019 (COVID-19), with highly infectious, transmits rapidly. So it has caused people panic to a certain degree. Methods This cross-sectional study performed via an online survey run from January 30 to March 30, 2020. 1144 people in South China (287 of level 1 population, 121 of level 2 population, 160 of level 3 population, 576 of level 4 population ) were investigated. GAD-7 scale, PHQ-9 scale, and PSS-10 scale were used to evaluate the mental health status of different populations. Results Among 1144 subjects, the average GAD-7 score was 4(1,8), the average PHQ-9 score was 4(1,9), and the average PSS-10 score was 16(11,19). There were statistically significant differences in the scores of GAD-7 (H = 15.235, P <0.01), PHQ-9 (H = 9.265, P = 0.026), and PSS-10 (H = 8.435, P = 0.049) among different levels of population. In the score of GAD-7: The anxiety degree of the level 1 population is higher than that of the level 2 population and the level 4 population. The difference between the two pairs is statistically significant (Z = -2.932, -4.012, -2.949, P <0.005). There are significant differences in items of“becoming easily annoyed or irritable”, "seemingly terrible things will happen"(Z = -3.399 ~ -2.055, P <0.005); Score of PHQ-9: The depression degree of the level 1 population and the level 2 population is higher than that of the level 4 population, and the difference between the two pairs is statistically significant (Z = -3.38, -2.682, P <0.005). There are significant differences in items of "difficult to fall asleep or not awake", "feeling depressed" and other related items (Z = -2.885 ~ -2.003, P <0.005); Score of PSS-10: The stress degree of the level 3 population is higher than that of the level 1 population and the level 4 population (Z = -3.693 ~ -2.702, P <0.005). There are significant differences in items of "feel confident", "life are as expected", "the ability to control anger", "the things are all under control" and other related items (Z = -4.782 ~ -2.102, P <0.005). Conclusion There are differences in the effects of COVID-19 on the mental health of people with different identities. Appropriate psychological interventions should be provided for different populations in combination with their mental health status.
How Professionals Tinker With Ethical Tensions Collectively When Fostering Service User Autonomy: An Ethnographic Study In Long-term Care
Authors: Heerings Marjolijn , Bovenkamp Hester van de , Cardol Mieke , Bal Roland 
Published: July 2020

Abstract
Background: The value of patient autonomy has become central in healthcare. However, care practices involve a plurality of possibly conflicting values. These values often transgress the borders of the individual professional-client relationship as they involve family members, other professionals and community organizations. Good care should acknowledge this complexity, which requires a collective handling of the tensions between values. To better understand this process, we draw on Mol (2008, 2010) by developing the notion of collective tinkering. Methods: Through ethnographic study in two teams in community housing services for people with intellectual disability and serious mental illness, we analyze how professionals tinker collectively. This research design enables in-depth analysis of care practices as they unfold in their situated context. Data were gathered by means of participant observation, interviews and focus groups with professionals, service users, peer support workers and family members. Results: Collective tinkering is analyzed 1) within teams of professionals working together with family members; 2) between professionals from different organizations providing care for the same client; and 3) in organizing practices for a collective of clients. Collective tinkering involves assembling values into a care practice, attentively experimenting with these care practices and adjusting care accordingly within a collective of those involved in care for a particular client or collective of clients. When collective tinkering does not occur, the stakeholders excluded from the tinkering (e.g. clients or family members) may experience poor quality of care.Conclusion: Collective tinkering differs from ‘individual’ tinkering between professionals and clients in several ways. First, by including stakeholders involved with the client, collective tinkering adds values and ontologies important in dealing with the situation and aids the creative process of inventing and experimenting with the care practices that assemble these values. Second, collective tinkering needs organizational structures beyond direct professional-client contacts. Structures that provide the time and space for the wider collective involved in care to come together, reflect and co-design care practices. The results also show that collective tinkering runs the risk of excluding clients in negotiating value tensions. Including clients should be carefully considered when structuring collective tinkering.
Supracondylar Fractures: A retrospective chart review comparing infection rate, antibiotic use, surgical time and cost of full surgical preparation and draping vs “semi-sterile” technique
Authors: Laxdal Ian , Stockwell Kevin , Xu Mark , Tan Jon , McRae Sheila , Jellicoe Paul 
Published: July 2020

Abstract
Background: Semi-sterile and full preparation and draping techniques are commonly used in closed reduction percutaneous pinning (CRPP) of supracondylar fractures. Debate exists whether full preparation and draping is safer than semi-sterile technique in regards to infection risk and the utility of pre-operative antibiotics. This study is a comparison of infection rates, pre-operative antibiotic administration, cost and surgical time between techniques.Methods: A retrospective chart review of 336 pediatric patients with supracondylar fractures repaired with CRPP at our institution was completed between January 2014 and April 2018, 168 per technique. Infection rates, pre-operative antibiotic administration, preparation-to-incision time and cost in semi-sterile draping versus full preparation and draping techniques were compared. Results: Of the 336 patients, 1/168(0.1%) in the full preparation and draping group developed an infection compared to 0/168(0%) patients in the semi-sterile group. Pre-operative antibiotics (Cefazolin) were administered to 76/168(23%) patients in the full preparation and draping group and 0/168(0%) in the semi-sterile group. The infection found received pre-operative antibiotics. Mean preparation-to-incision time for the semi-sterile group was 2.4±2.0 minutes and the full preparation and draping group was 9.9 ±4.2 minutes(p <0.001). Surgical supply cost was $80.72 [CDN] and 108.24$ [CDN], respectively, for the semi-sterile and full preparation and draping groups. Conclusion: Risk of infection using a semi-sterile draping technique was safe and comparable to a full preparation and draping technique when used in CRPP of supracondylar fractures. The administration of pre-operative antibiotics does not appear to make a difference in infection rates. Semi-sterile operative technique is cost effective and has decreased preparation-to-incision time.