bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness of the Da Qing diabetes prevention program: A modelling study
Authors: Hu Wanxia , Xu Wenhua , Si Lei , Wang Cuilian , Jiang Qicheng , Wang Lidan , Cutler Henry 
Published: December 2020

Objective
The Da Qing Diabetes Prevention program (DQDP) was a randomized lifestyle modification intervention conducted in 1986 for the prevention and control of type 2 diabetes in individuals with impaired glucose tolerance. The current study estimated long-term cost-effectiveness of the program based on the health utilities from the Chinese population.

Methods
A Markov Monte Carlo model was developed to estimate the impact of the intervention from the healthcare system perspective. The analysis was run over 30-year and lifetime periods and costs were estimated respectively as health management service costs. Baseline characteristics and intervention effects were assessed from the DQDP. Utilities and costs were generated from relevant literature. The outcome measures were program cost per quality-adjusted life-years (QALYs) gained and incremental cost-effectiveness ratio (ICER) of the intervention. Sensitivity analyses and threshold analyses were performed.

Results
Using a 30-year horizon, the intervention strategy was cost-saving and was associated with better health outcomes (increase of 0.74 QALYs per intervention participant). Using a lifetime horizon, the intervention strategy was cost-saving and was associated with additional 1.44 QALYs. Sensitivity analyses showed that the overall ICER was most strongly influenced by the hazard ratio of cardiovascular disease event.

Conclusions
The Da Qing lifestyle intervention in a Chinese population with impaired glucose tolerance is likely to translate into substantial economic value. It is cost-saving over a 30-year time and lifetime frame.
Point-of-care characterization and risk-based management of oral lesions in primary dental clinics: A simulation model
Authors: Kang Stella K. , Mali Rahul D. , Braithwaite R. Scott , Kerr Alexander R. , McDevitt John 
Published: December 2020

Objectives
Oral potentially malignant disorders (OPMDs) encompass histologically benign, dysplastic, and cancerous lesions that are often indistinguishable by appearance and inconsistently managed. We assessed the potential impact of test-and-treat pathways enabled by a point-of-care test for OPMD characterization.

Materials and methods
We constructed a decision-analytic model to compare life expectancy of test-treat strategies for 60-year-old patients with OPMDs in the primary dental setting, based on a trial for a point-of-care cytopathology tool (POCOCT). Eight strategies of OPMD detection and evaluation were compared, involving deferred evaluation (no further characterization), prompt OPMD characterization using POCOCT measurements, or the commonly recommended usual care strategy of routine referral for scalpel biopsy. POCOCT pathways differed in threshold for additional intervention, including surgery for any dysplasia or malignancy, or for only moderate or severe dysplasia or cancer. Strategies with initial referral for biopsy also reflected varied treatment thresholds in current practice between surgery and surveillance of mild dysplasia. Sensitivity analysis was performed to assess the impact of variation in parameter values on model results.

Results
Requisite referral for scalpel biopsy offered the highest life expectancy of 20.92 life-years compared with deferred evaluation (+0.30 life-years), though this outcome was driven by baseline assumptions of limited patient adherence to surveillance using POCOCT. POCOCT characterization and surveillance offered only 0.02 life-years less than the most biopsy-intensive strategy, while resulting in 27% fewer biopsies. When the probability of adherence to surveillance and confirmatory biopsy was ≥ 0.88, or when metastasis rates were lower than reported, POCOCT characterization extended life-years (+0.04 life-years) than prompt specialist referral.

Conclusion
Risk-based OPMD management through point-of-care cytology may offer a reasonable alternative to routine referral for specialist evaluation and scalpel biopsy, with far fewer biopsies. In patients who adhere to surveillance protocols, POCOCT surveillance may extend life expectancy beyond biopsy and follow up visual-tactile inspection.
Long-term effects of severe acute malnutrition during childhood on adult cognitive, academic and behavioural development in African fragile countries: The Lwiro cohort study in Democratic Republic of the Congo
Authors: Mwene-Batu Pacifique , Bisimwa Ghislain , Baguma Marius , Chabwine Joelle , Bapolisi Achille , Chimanuka Christine , Molima Christian , Dramaix Michèle , Kashama Nicolas , Macq Jean , Donnen Philippe 
Published: December 2020

Introduction
Little is known about the outcomes of subjects with a history of severe acute malnutrition (SAM). We therefore sought to explore the long-term effects of SAM during childhood on human capital in adulthood in terms of education, cognition, self-esteem and health-related disabilities in daily living.

Methodology
We traced 524 adults (median age of 22) in the eastern Democratic Republic of the Congo, who were treated for SAM during childhood at Lwiro hospital between 1988 and 2007 (median age 41 months). We compared them with 407 community controls of comparable age and sex. Our outcomes of interest were education, cognitive function [assessed using the Mini Mental State Examination (MMSE) for literate participants, or its modified version created by Ertan et al. (MMSE-I) for uneducated participants], self-esteem (measured using the Rosenberg Self-Esteem Scale) and health-related social and functional disabilities measured using the World Health Organization Disability Assessment Schedule (WHODAS). For comparison, we used the Chi-squared test along with the Student’s t-test for the proportions and means respectively.

Results
Compared with the community controls, malnutrition survivors had a lower probability of attaining a high level of education (p < 0.001), of reporting a high academic performance (p = 0.014) or of having high self-esteem (p = 0.003). In addition, malnutrition survivors had an overall mean score in the cognitive test that was lower compared with the community controls [25.6 compared with 27.8, p = 0.001 (MMSE) and 22.8 compared with 26.3, p < 0.001(MMSE-I)] and a lower proportion of subjects with a normal result in this test (78.0% compared with 90.1%, p < 0.001). Lastly, in terms of health-related disabilities, unlike the community controls, malnutrition survivors had less social disability (p = 0.034), but no difference was observed as regards activities of daily living (p = 0.322).

Conclusion
SAM during childhood exposes survivors to low human capital as regards education, cognition and behaviour in adulthood. Policy-deciders seeking to promote economic growth and to address various psychological and medico-social disorders must take into consideration the fact that appropriate investment in child health as regards SAM is an essential means to achieve this.
Comparison study of the axial length measured using the new swept-source optical coherence tomography ANTERION and the partial coherence interferometry IOL Master
Authors: Kim Kook Young , Choi Gon Soo , Kang Min Seok , Kim Ungsoo Samuel 
Published: December 2020

Purpose
To compare a biometer using swept-source optical coherence tomography (SS-OCT) with a partial coherence interferometry (PCI)-based biometer in measurements of two ocular biometry parameters, i.e., the axial length and anterior cornea curvature.

Methods
We compared the two biometers SS-OCT (ANTERION, Heidelberg Engineering Inc., Heidelberg, Germany) and PCI (IOL Master, Carl Zeiss Meditec, Jena, Germany) in terms of the axial length (AL) and corneal curvature (K) measurements of 175 eyes. Paired t-tests were used to compare the two biometers. Agreement between the biometers was evaluated using the Bland–Altman method.

Results
The mean age was 36.0 ± 25.6 years (range: 5 to 85 years). The mean axial length was 24.42 ± 0.13 mm for SS-OCT and 24.45 ± 0.14 mm for PCI. The mean corneal curvature was significantly different between the two biometry in flat K (K1) but not in steep K (K2). The limit of agreement was -0.15 to 0.21 in the axial length, -1.18 to 0.83 in K1, and -1.06 to 0.95 in K2. All above ocular biometric measurements between SS-OCT and PCI correlated significantly (Pearson's correlation, p<0.001).

Conclusions
The axial length measured using SS-OCT is useful in clinical practice. It shows a good correlation and agreement with that measured using PCI. However, the axial length and corneal curvature measured using SS-OCT cannot be used interchangeably with that measured using PCI in clinical practice.
Evaluation of a novel metric for personalized opioid prescribing after hospitalization
Authors: Iverson Nicholas R. , Lau Catherine Y. , Abe-Jones Yumiko , Fang Margaret C. , Kangelaris Kirsten N. , Prasad Priya , Shah Sachin J. , Najafi Nader 
Published: December 2020

Background
The duration of an opioid prescribed at hospital discharge does not intrinsically account for opioid needs during a hospitalization. This discrepancy may lead to patients receiving much larger supplies of opioids on discharge than they truly require.

Objective
Assess a novel discharge opioid supply metric that adjusts for opioid use during hospitalization, compared to the conventional discharge prescription signature.

Design, setting, & participants
Retrospective study using electronic health record data from June 2012 to November 2018 of adults who received opioids while hospitalized and after discharge from a single academic medical center.

Measures & analysis
We ascertained inpatient opioids received and milligrams of opioids supplied after discharge, then determined days of opioids supplied after discharge by the conventional prescription signature opioid-days (“conventional days”) and novel hospital-adjusted opioid-days (“adjusted days”) metrics. We calculated descriptive statistics, within-subject difference between measurements, and fold difference between measures. We used multiple linear regression to determine patient-level predictors associated with high difference in days prescribed between measures.

Results
The adjusted days metric demonstrates a 2.4 day median increase in prescription duration as compared to the conventional days metric (9.4 vs. 7.0 days; P<0.001). 95% of all adjusted days measurements fall within a 0.19 to 6.90-fold difference as compared to conventional days measurements, with a maximum absolute difference of 640 days. Receiving a liquid opioid prescription accounted for an increased prescription duration of 135.6% by the adjusted days metric (95% CI 39.1–299.0%; P = 0.001). Of patients who were not on opioids prior to admission and required opioids during hospitalization but not in the last 24 hours, 325 (8.6%) were discharged with an opioid prescription.

Conclusions
The adjusted days metric, based on inpatient opioid use, demonstrates that patients are often prescribed a supply lasting longer than the prescription signature suggests, though with marked variability for some patients that suggests potential under-prescribing as well. Adjusted days is more patient-centered, reflecting the reality of how patients will take their prescription rather than providers’ intended prescription duration.
Psychosocial impact of skin diseases: A population-based study
Authors: Yew Yik Weng , Kuan Amanda Hui Yu , Ge Lixia , Yap Chun Wei , Heng Bee Hoon 
Published: December 2020

BackgroundWhile it is well established that skin disease places significant psychosocial burden on a patient’s wellbeing, its effects have rarely been examined in Asian populations.ObjectiveEvaluate the psychosocial burden of skin disease among community-dwelling adults in Singapore.MethodsThis cross-sectional study included 1510 participants interviewed on their history of thirteen skin diseases. The Patient Health Questionnaire (PHQ-9), Lubben Social Network Scale-6 (LSNS-6), University of California Los Angeles (UCLA) Loneliness Scale, and European Quality of Life-5 Dimensions- 5 Level (EQ-5D-5L) were used as measures for depressive symptoms, social isolation, loneliness and quality of life respectively. Multiple linear regression analysis was used to examine the association of skin diseases with each of the four measured outcomes.ResultsParticipants with skin diseases reported significantly higher PHQ-9 and UCLA Loneliness scale scores, and lower LSNS-6 and EQ-5D-5L scores when compared to their healthy counterparts. The presence of skin disease was positively associated with depressive symptoms (B = 0.40, SE = 0.11), and negatively associated with quality of life (B = -0.03, SE = 0.01). As disease severity was not evaluated in this study, we were unable to ascertain the associations between disease severity and measured outcomes.ConclusionParticipants with skin diseases were more likely to have depressive symptoms, social isolation, loneliness and lower quality of life. Unemployed, single and elderly patients were at higher risk of developing depressive symptoms. More emphasis should be placed on the psychosocial aspect of care to reduce the burden of skin disease. Some considerations include monitoring patients for mood-related changes and implementing early psychosocial interventions.
Lack of elevated pre-ART elastase-ANCA levels in patients developing TB-IRIS
Authors: Goovaerts Odin , Massinga-Loembé Marguerite , Ondoa Pascale , Ceulemans Ann , Worodria William , Mayanja-Kizza Harriet , Colebunders Robert , Kestens Luc ,   the TB-IRIS Study Group
Published: December 2020

Background
Tuberculosis-associated immune reconstitution inflammatory syndrome (TB-IRIS) in HIV-TB co-infected patients receiving antiretroviral therapy (ART) has been linked to neutrophil activation. Anti-neutrophil cytoplasmic antibodies (ANCAs) are also associated with neutrophil activation. Since ANCAs are reportedly skewed in TB and HIV infections, we investigated plasma levels of 7 ANCAs in TB-IRIS patients.

Methods
We retrospectively compared 17 HIV-TB patients who developed TB-IRIS with controls of similar CD4 count, age and gender who did not (HIV+TB+ n = 17), HIV-infected patients without TB (HIV+TB-, n = 17) and 10 HIV-negative (HIV-TB-) controls. Frozen plasma was collected before ART, at 3 and 9 months of ART, and examined by ELISA for levels of 7 ANCAs directed against; Proteinase 3 (PR3), Myeloperoxidase (MPO), Permeability-increasing protein (BPI), Elastase, Cathepsin, Lysozyme, and Lactoferrin.

Results
Compared to HIV+TB+ controls, pre-ART anti-elastase levels were lower in TB-IRIS patients (p = 0.026) and HIV-TB- controls (p = 0.044), whereas other ANCAs did not show significant differences between groups at any time point. A significant decrease over time could be observed in TB-IRIS patients during ART for anti -PR3 (p = 0.027), -lysozyme (p = 0.011), and -lactoferrin (p = 0.019). Conversely, HIV+TB+ controls showed a significant decrease over time for anti -MPO (p = 0.002), -lyzosyme (p = 0.002) and -elastase (p < 0.001).

Conclusion
The lack of elevated anti-elastase levels in TB-IRIS patients as opposed to HIV+TB+ controls correspond to previous findings of lowered immune capacity in patients that will develop TB-IRIS. This may suggest a specific role for anti-elastase, elastase or even matrix-metalloproteinases in TB-IRIS. The precise dynamics of neutrophil activation in HIV-TB merits further investigation and could provide more insight in the early mechanisms leading up to TB-IRIS.
Colóquio e Exposição: "Santos Rocha, Arqueologia e Territórios da Figueira da Foz".
Authors: Penajoia Marco 
Published: December 2020

Esta notícia aborda o Colóquio e a Exposição denominado: “Santos Rocha, arqueologia e territórios da Figueira da Foz”. Este evento visou a sensibilização para a arqueologia e para o património arqueológico da Figueira da Foz.
Partidos políticos e opinião pública
Authors: Lucas Patrícia Gomes 
Published: December 2020

Durante a segunda metade do século XIX o Partido Regenerador foi um elemento fundamental da política portuguesa, com intervenção governativa e parlamentar significativa. Neste artigo debruçamo-nos sobre o aparelho partidário e a imprensa afecta ao Partido Regenerador, elaborando um estudo de caso da relação dos Regeneradores com a opinião pública. Recorremos ainda aos sistemas de informação geográfica, obtendo uma representação gráfica da dispersão do partido no território nacional, que contribui para a sua análise espacial.
Procura-se, assim, perceber se existia uma rede de centros locais, e se estes tinham uma acção sólida na mobilização de apoios para o partido; e se os jornais oficiais do Partido Regenerador obedeciam a uma estratégia coerente da parte da liderança partidária. Argumentamos ainda, recorrendo a documentação inédita, que a relevância deste tipo de meios de comunicação com o eleitorado foi enfraquecida face ao uso recorrente e eficácia do caciquismo na política portuguesa.
EFEKTIVITAS DOSIS KARBON TETRAKLORIDA (CCl4) TERHADAP TIKUS (Rattus norvegicus L.) SEBAGAI HEWAN MODEL FIBROSIS HATI
Authors: Fahrudin Fahri , Ningsih Sri , Wardhana Hajar Indra , Haribowo Dinda Rama , Hamida Fathin 
Published: December 2020

Liver damage can produce fibrosis condition both acute and chronic. Development of liver fibrosis in animal models is valuable information in order to gain new entities for treatment. The aim of this study is to get an optimal condition of CCl4 induction for achieving animal models of liver fibrosis. CCl4 diluted in coconut oil was administrated orally for 6 consecutive weeks. Total 25 male rats were divided into 5 treatment groups, namely, P1 was a normal group (without CCl4). P2 (CCl4 40%), 1 ml/kg bw 3 times a week. P3 (CCl4 40%), 0.5 ml/kg bw 3 times a week, P4 (CCl4 10%) 1 ml/kg bw 3 times a week, and P5 (CCl4 10%) 1 ml/kg bw twice a week. The analyzed parameters were the activity of liver enzymes, macro and microscopic liver damage, and the percentage of rat deaths. The results of this study indicated an increase in liver enzymes in all treatments which was higher than P1 (P<0.05). Analysis of liver histopathology exhibeted the same result. However, if viewed the percentage of rat deaths, P5 demonstrated the lowest compared to all treatment groups. It could be concluded that the administration of CCl4 (10%) was able to create an animal model of liver fibrosis optimally.
Data in practice: A participatory approach to understanding pre-service teachers’ perspectives
Authors: Prestigiacomo Rita , Hunter Jane , Knight Simon , Martinez-Maldonado Roberto , Lockyer Lori 
Published: December 2020

Data about learning can support teachers in their decision-making processes as they design tasks aimed at improving student educational outcomes. However, to achieve systemic impact, a deeper understanding of teachers’ perspectives on, and expectations for, data as evidence is required. It is critical to understand how teachers’ actions align with emerging learning analytics technologies, including the practices of pre-service teachers who are developing their perspectives on data use in classroom in their initial teacher education programme. This may lead to an integration gap in which technology and data literacy align poorly with expectations of the role of data and enabling technologies. This paper describes two participatory workshops that provide examples of the value of human-centred approaches to understand teachers’ perspectives on, and expectations for, data as evidence. These workshops focus on the design of pre-service teachers enrolled in teacher education programmes (N = 21) at two Australian universities. The approach points to the significance of (a) pre-service teachers’ intentions to track their students’ dispositions to learning and their ability to learn effectively, (b) the materiality of learning analytics as an enabling technology and (c) the alignment of learning analytics with learning design, including the human-centred, ethical and inclusive use of educational data in the teaching practice.

Implications for practice or policy:

Pre-service teachers ought to be given opportunities to engage and understand more about learning design, learning analytics and the use of data in classrooms.
Professional experience placements for pre-service teachers should include participatory data sessions or learning design workshops.
Teacher education academics in universities must be provided with ongoing professional development to support their preparation work of pre-service teachers’ data literacy, learning analytics and the increasing presence of data.
Baltic-Black Sea Region as a Resilient Region: Political and Security Aspects
Authors: Gladysh Marianna , Krayevska Oksana , Holovko-Havrysheva Oksana 
Published: December 2020

The conceptual bases of resilience in modern political science are analyzed, including the key conceptual approaches that are used in academic studies for understanding the policy of resilience, characterizing the reaction of subjects to stress or threat of any kind and origin. The concept of resilience is applied to analyze the cooperation among the Baltic-Black Sea countries as a regional interaction model which should be formed in order to reduce or avoid security crises.
The Baltic-Black Sea countries have developed and formed strong ties in different dimen­sions among one another, opening an opportunity for intellectual adventures in the area of the conceptualization of their interaction modes under the regional cooperation frameworks. Based upon the analyzed doctrinal views and available documentary backgrounds on resilience in the UN and the EU, the possible visions and scenarios for the creation of the Baltic-Black Sea region as a resilient one are given. The existing and potential obstacles to cooperation in the region are highlighted. The main threats and challenges for the Baltic-Black Sea region at present are investigated.
Selling Insecurity via Twitter: Ukrainian President’s Posts and Modern Political Discourse
Authors: Steblyna Nataliia 
Published: December 2020

In modern political discourse, the topics of foreign aggression and insecurity are strongly influencing voter perceptions. In the unpredictable and polarizing environment of Twitter, references to crisis events may be used without justification. The character of tweeting during the peak phase of a crisis may differ, and it is possible to identify such differences analyzingthe tweets.
To compare the pre-election period with the period of foreign aggression, and to study the manner of tweeting of a political leader, the Twitter account of the fifth Ukrainian president Petro Poroshenko was observed between November 2018 (Azov crisis) and July 2019 (early presidential election). A total of 2,519 tweets were content-analyzed (the character of references to Russian aggression, newsbreaks, intensity, language justification were studied).
Tweeting during the Azov crisis was an everyday activity with a large number of tweets over a long period. Pre-election tweeting included commenting on specially created events (commemorations, celebrations) with a large number of mentions for short periods of time and constant online presence with a small number of tweets posted even without a special occasion.
Approximately one out of three tweets was written without reference to any newsbreak. Among the most popular newsbreaks, traditional subjects dominated (meetings, signings of laws etc.). Thus, the term “aggression” was mainly exploited during specially created events after the crisis.
Additionally, the stylistic features (authentic language, amateurism, unpredictability, breaking rules, incivility and impoliteness) that are widespread across social networks arenot typical of Poroshenko. A “polarization” of the political discourse, however, emerges. It is possible to observe it especially before the second round of elections, when the polls were predicting victory to Poroshenko’s opponent.