bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-Reported Conversion Efforts and Suicidality Among US LGBTQ Youths and Young Adults, 2018
Authors: Green Amy E. , Price-Feeney Myeshia , Dorison Samuel H. , Pick Casey J. 
Published: June 2020

Objectives. To explore associations between undergoing sexual orientation or gender identity conversion efforts (SOGICE) and suicidality among young LGBTQ (lesbian, gay, bisexual, transgender, and queer or questioning) individuals. Methods. Data were derived from a 2018 online cross-sectional study of young LGBTQ individuals (13–24 years of age) residing in the United States. Multivariate logistic regression was used to determine the relative odds of suicidality among young LGBTQ individuals who experienced SOGICE (in comparison with those who did not) after adjustment for age, race/ethnicity, geography, parents’ use of religion to say negative things about being LGBTQ, sexual orientation, gender identity, discrimination because of sexual orientation or gender identity, and physical threats or harm because of sexual orientation or gender identity. Results. Relative to young people who had not experienced SOGICE, those who reported undergoing SOGICE were more than twice as likely to report having attempted suicide and having multiple suicide attempts. Conclusions. The elevated odds of suicidality observed among young LGBTQ individuals exposed to SOGICE underscore the detrimental effects of this unethical practice in a population that already experiences significantly greater risks for suicidality.
Management of Subtrochanteric Femoral Fracture Nonunions
Authors: DeRogatis Michael J. , Kanakamedala Ajay C. , Egol Kenneth A. 
Published: June 2020

» Compared with other proximal femoral fractures, subtrochanteric fractures are at a higher risk for nonunion because of the high deforming forces in this region, the associated increased risk of malreduction, and the risk of poor bone healing secondary to bisphosphonate use frequently associated with these fractures.» Further understanding of nonunion of subtrochanteric fractures is of increasing importance given the rise in incidence of subtrochanteric hip fractures.» Surgeons should be aware of risk factors for nonunion and techniques for prevention as well as surgical management and complications associated with surgical implantation devices.» Surgeons should also consider using adjuncts including bone-grafting and biologic agents.
Integrated Analysis of Tracer and Pressure-Interference Tests To Identify Well Interference
Authors: Kumar Ashish , Seth Puneet , Shrivastava Kaustubh , Manchanda Ripudaman , Sharma Mukul M. 
Published: June 2020

SummaryIn ultralow-permeability reservoirs, communication between wells through connected fractures can be observed through tracer and pressure-interference tests. Understanding the connectivity between fractured horizontal wells in a multiwell pad is important for infill well drilling and parent-child well interactions. Interwell tracer and pressure-interference tests involve two or more fractured horizontal wells and provide information about hydraulic-fracture connectivity between the wells. In this work, we present an integrated approach based on the analysis of tracer and pressure interference data to obtain the degree of interference between fractured horizontal wells in a multiwell pad.We analyze well interference using tracer (chemical tracer and radioactive proppant tracer) and pressure data in an 11-well pad in the Permian Basin. Changes in pressure and tracer concentration in the monitor wells were used to identify and evaluate interference between the source and monitor wells. Extremely low tracer recovery and weak pressure response signify the absence of connected fractures and suggest that interference through matrix alone is insignificant. Combined tracer and pressure-interference data suggest connected fracture pathways between the communicating wells. The degree of interference can be estimated in terms of pressure response times and tracer recovery. An effective reservoir model was used to simulate pressure interference between wells during production. Simulation results indicate that well interference observed during production is primarily because of hydraulically connected fractures.Combined tracer and pressure-interference analysis provides a unique tool for understanding the time-dependent connectivity between communicating wells, which can be useful for optimizing infill well drilling, well spacing, and fracture sizing in future treatment designs.
Transcriptome analysis reveals a molecular understanding of nicotinamide and butyrate sodium on meat quality of broilers under high stocking density
Authors: Wu Yuqin , Wang Youli , Yin Dafei , Mahmood Tahir , Yuan Jianmin 
Published: June 2020

Abstract
Background: In recent years, increased attention has been focused on breast muscle yield and meat quality in poultry production. Supplementation with nicotinamide and butyrate sodium can improve the meat quality of broilers. However, the potential molecular mechanism is not clear yet. This study was designed to investigate the effects of supplementation with a combination of nicotinamide and butyrate sodium on breast muscle transcriptome of broilers under high stocking density. A total of 300 21-d-old Cobb broilers were randomly allocated into 3 groups based on stocking density: low stocking density control group (L; 14 birds/m2), high stocking density control group (H; 18 birds/m2), and high stocking density group provided with a combination of 50 mg/kg nicotinamide and 500 mg/kg butyrate sodium (COMB; 18 birds/m2), raised to 42 days of age. Results: The H group significantly increased cooking losses, pH decline and activity of lactate dehydrogenase in breast muscle when compared with the L group. COMB showed a significant decrease in these indices by comparison with the H group (P < 0.05). The transcriptome results showed that key genes involved in glycolysis, proteolysis and immune stress were up-regulated whereas those relating to muscle development, cell adhesion, cell matrix and collagen were down-regulated in the H group as compared to the L group. In contrast, genes related to muscle development, hyaluronic acid, mitochondrial function, and redox pathways were up-regulated while those associated with inflammatory response, acid metabolism, lipid metabolism, and glycolysis pathway were down-regulated in the COMB group when compared with the H group. Conclusions: The combination of nicotinamide and butyrate sodium may improve muscle quality by enhancing mitochondrial function and antioxidant capacity, inhibiting inflammatory response and glycolysis, and promoting muscle development and hyaluronic acid synthesis.
Mitochondrial DNA copy number in cervical exfoliated cells and risk of cervical cancer among HPV-positive women
Authors: Sun Wei , Qin Xueyun , Zhou Jing , Xu Mingjing , Lyu Zhangyan , Li Xin , Zhang Kai , Dai Min , Li Ni , Hang Dong 
Published: June 2020

Abstract
Background Although human papillomavirus (HPV) infection has been recognized as the cause of cervical cancer in over 99% of cases, only a minority of HPV-infected women develop this malignancy. Emerging evidence suggests that alterations of mitochondrial DNA copy number (mtCN) may contribute to carcinogenesis. However, the relationship between mtCN and cervical cancer remains unknown.Methods In this case-control study, we included 591 cervical cancer cases and 373 cancer-free controls, all of whom were infected with high-risk HPV. Relative mtCN in cervical cancer exfoliated cells was measured by qRT-PCR assays, and logistic regression analysis was performed to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Interaction between mtCN and HPV types was assessed by using the Wald test in logistic regression models.Results HPV16, 18, 52, and 58 were the most common types in both case and control groups. Median mtCN in cases was significantly higher than that in controls (1.63 vs. 1.23, P = 0.03). After adjustment for age and HPV types, the highest quartile of mtCN was associated with increased odds of having cervical cancer (OR = 1.77, 95% CI = 1.19, 2.62; P < 0.01), as compared to the lowest quartile. A dose-response effect of mtCN on cervical cancer was also observed (Ptrend < 0.001). The interaction between mtCN and HPV types was statistically nonsignificant.Conclusions In women who test HPV positive, the increase of mtCN in cervical exfoliated cells is associated with cervical cancer. This suggests a potential role of mtCN in cervical carcinogenesis.
Synergy of policies to strengthen primary care: evidence from a national repeated cross-sectional study
Authors: Jin Yinzi , Xu Jin , Zhu Weiming , Zhang Yaoguang , Xu Ling , Meng Qingyue 
Published: June 2020

Abstract
Background: People bypass primary healthcare (PHC) institutions to seek expensive healthcare at high-level hospitals, leading to escalating medical costs and inefficient use of resources. In 2009, China launched nationwide synergic policies on primary care strengthening, to tackle access to healthcare and financial protection. This study aimed to assess the impact of the two policy areas, health insurance and health workforce, on healthcare seeking behavior.Methods: Drawing on national survey data before (2008) and after (2013) the policies, we linked individual-level data on healthcare-seeking behavior with county-level data on health workforce and health insurance. We constructed a multilevel zero-inflated negative binomial regression to examine the impacts of average reimbursement rate (ARR) of health insurance and the density of registered physicians on outpatient/inpatient visits, and multilevel multinomial logistic regression for the impacts on choice of outpatient/inpatient care providers. Results: Although the increase in health insurance ARR and physician density have positive impacts on individuals’ healthcare use, their impacts might be weakened during 2008 and 2013, and the negative impacts of investment of those in PHC institutions on likelihood of visiting hospitals was larger. The negative impacts of ARR at PHC institutions on likelihood of visiting county-, municipal- and higher-level hospitals in 2013 was 28 percentage points, 66 percentage points and 33 percentage points larger than these in 2008.Conclusions: Primary care strengthening requires synergic policies. Effective mechanisms for coordination across multisectoral actions are necessities for deepening those policies to ensure efficient delivery of healthcare without experiencing financial risks.
A cross-sectional study of Swiss ambulatory care services use by multimorbid patients in primary care in the light of the Andersen model
Authors: Messi Mia , Mueller Yolanda , Haller Dagmar M. , Zeller Andreas , Neuner-Jehle Stefan , Streit Sven , Burnand Bernard , Herzig Lilli 
Published: June 2020

Abstract
Background: Multimorbidity is frequently encountered in primary care and is associated with increasing use of healthcare services. The Andersen Behavioral Model of Health Services Use is a multilevel framework classifying societal, contextual, and individual characteristics about the use of healthcare services into three categories: 1. predisposing factors, 2. enabling factors, and 3. need factors. The present study aimed to explore multimorbid patients' use of ambulatory healthcare in terms of homecare and other allied health services, visits to GPs, and number of specialists involved. A secondary aim was to apply Andersen's model to explore factors associated with this use. Method: In a cross-sectional study, 100 Swiss GPs enrolled up to 10 multimorbid patients each. After descriptive analyses, we tested the associations of each determinant and outcome variable of healthcare use, according to the Andersen model: predisposing factors (patient's demographics), enabling factors (health literacy (HLS-EU-Q6), deprivation (DipCare)), and need factors (patient's quality of life (EQ-5D-3L), treatment burden (TBQ), severity index (CIRS), number of chronic conditions, and of medications). Logistic regressions (dichotomous variables) and negative binomial regressions (count variables) were calculated to identify predictors of multimorbid patients' healthcare use.Results: Analyses included 843 multimorbid patients; mean age 73.0 (SD 12.0), 28–98 years old; 48.3% men; 15.1% (127/843) used homecare. Social deprivation (OR 0.75, 95%CI 0.62–0.89) and absence of an informal caregiver (OR 0.50, 95%CI 0.28–0.88) were related to less homecare services use. The use of other allied health services (34.9% (294/843)) was associated with experiencing pain (OR 2.49, 95%CI 1.59–3.90). The number of contacts with a GP (median 11 (IQR 7-16)) was, among other factors, related to the absence of an informal caregiver (IRR 0.90, 95%CI 0.83–0.98). The number of specialists involved (mean 1.9 (SD 1.4)) was linked to the treatment burden (IRR 1.06, 95%CI 1.02–1.10).Conclusion: Multimorbid patients in primary care reported high use of ambulatory healthcare services variably associated with the Andersen model's factors: healthcare use was associated with objective medical needs but also with contextual or individual predisposing or enabling factors. These findings emphasize the importance of adapting care coordination to individual patient profiles.
Engagement Complications of Adolescents with Borderline Personality Disorder: Navigating Through a Zone of Turbulence
Authors: Desrosiers Lyne , St-Jean Micheline , Laporte Lise , Lord Marie-Michèle 
Published: June 2020

Abstract
Objective: Premature treatment discontinuation is a widespread phenomenon in child and adolescent mental health services that impacts treatment benefits and costs of care. Adolescents with borderline personality disorder (BPD) are heavy users of health care services and notoriously difficult to engage in treatment. However, there is hardly any data regarding this phenomenon with these youths. Considering that BPD treatment is associated with intense and chaotic therapeutic processes, exploring barriers emerging in the course of treatment could be relevant. Thus, conceptualizing treatment dropout as a process evolving from engagement to progressive disengagement, and ultimately to dropout, could highlight the mechanisms involved. The aim of this study was to describe the process of treatment disengagement and identify warning signs that foreshadow dropouts of adolescents with BPD. Method: A constructivist grounded theory method was used. This method has been favoured based on the assumption that the behaviours and decisions leading to disengagement may be better informed by the subjective experience of treatment. Thirty-three interviews were conducted to document 11 treatment trajectories with 3 groups of informants (9 adolescents with BPD 13-17 of age, 11 parents, and 13 clinicians). Results: Well before dropout occurs, different phenomena identified as “engagement complications” characterize the disengagement process. These unfold according to a three-step sequence starting with negative emotions associated with the appropriateness of treatment, the therapeutic relationship or the vicissitudes of treatment. These emotions will then generate treatment interfering attitudes that eventually evolve into openly disengaged behaviours. These complications, which may sometimes go unnoticed, punctuate the progression from treatment engagement to disengagement leading the way towards the development of a “zone of turbulence” which creates a vulnerable and unstable therapeutic process presenting risk for late dropout. Conclusion: Engagement of adolescents with BPD is neither static nor certain, but on the contrary, subject to their fluctuating perceptions. Therefore, it can never be taken for granted. Clinicians must constantly pay attention to emergent signs of engagement complications. Maintaining the engagement of adolescents with BPD should be a therapeutic objective akin to reducing symptomatology or improving psychosocial functioning, and should therefore be given the same attention.
Doubly robust estimator of risk in the presence of censoring dependent on time-varying covariates: application to a primary prevention trial for coronary events with pravastatin
Authors: Kawahara Takuya , Shinozaki Tomohiro , Matsuyama Yutaka 
Published: June 2020

Abstract
Background: In the presence of dependent censoring even after stratification of baseline covariates, the Kaplan–Meier estimator provides an inconsistent estimate of risk. To account for dependent censoring, time-varying covariates can be used along with two statistical methods: the inverse probability of censoring weighted (IPCW) Kaplan–Meier estimator and the parametric g-formula estimator. The consistency of the IPCW Kaplan–Meier estimator depends on the correctness of the model specification of censoring hazard, whereas that of the parametric g-formula estimator depends on the correctness of the models for event hazard and time-varying covariates. Methods: We combined the IPCW Kaplan–Meier estimator and the parametric g-formula estimator into a doubly robust estimator that can adjust for dependent censoring. The estimator is theoretically more robust to model misspecification than the IPCW Kaplan–Meier estimator and the parametric g-formula estimator. We conducted simulation studies with a time-varying covariate that affected both time-to-event and censoring under correct and incorrect models for censoring, event, and time-varying covariates. We applied our proposed estimator to a large clinical trial data with censoring before the end of follow-up.Results: Simulation studies demonstrated that our proposed estimator is doubly robust, namely it is consistent if either the model for the IPCW Kaplan–Meier estimator or the models for the parametric g-formula estimator, but not necessarily both, is correctly specified. Simulation studies and data application demonstrated that our estimator can be more efficient than the IPCW Kaplan–Meier estimator.Conclusions: The proposed estimator is useful for estimation of risk if censoring is affected by time-varying risk factors.
Distributed causality in resting-state network connectivity in the acute and remitting phases of RRMS
Authors: Wu Lin , Huang Muhua , Zhou Fuqing , Zeng Xianjun , Gong Honghan 
Published: June 2020

Abstract
Background: Although previous studies have shown that intranetwork abnormalities in brain functional networks are correlated with clinical/cognitive impairment in multiple sclerosis (MS), there is little information regarding the pattern of causal interactions among cognition-related resting-state networks (RSNs) in different disease stages of relapsing-remitting MS (RRMS) patients. We hypothesized that abnormalities of causal interactions among RSNs occurred in RRMS patients in the acute and remitting phases.Patients and methods: Seventeen patients in the acute phases of RRMS, 24 patients in the remitting phases of RRMS, and 23 appropriately matched healthy controls participated in this study. First, we used group independent component analysis to extract the time courses of the spatially independent components from all the subjects. Then, the Granger causality test was used to investigate the causal relationships among RSNs in the spectral domain and to identify correlations with clinical indices . Results: Compared with the patients in the acute phase of RRMS, patients in the remitting phase of RRMS showed a significantly lower expanded disability status scale, modified fatigue impact scale scores, and significantly higher paced auditory serial addition test (PASAT) scores. Compared with healthy subjects, during the acute phase, RRMS patients had significantly increased driving connectivity from the right executive control network (rECN) to the anterior salience network (aSN), and the causal coefficient was negatively correlated with the PASAT score. During the remitting phase, RRMS patients had significantly increased driving connectivity from the rECN to the aSN and from the rECN to the visuospatial network. Conclusion: Together with the disease duration (mean disease duration < 5 years) and relatively better clinical scores than those in the acute phase, abnormal connections, such as the information flow from the rECN to the aSN and the rECN to the visuospatial network, might provide adaptive compensation in the remitting phase of RRMS.
Uptake and predictors of direct-acting antiviral treatment for hepatitis C among people receiving opioid agonist therapy in Sweden and Norway: a drug utilization study from 2014 to 2017
Authors: Aas Christer F. , Vold Jørn Henrik , Skurtveit Svetlana , Odsbu Ingvild , Chalabianloo Fatemeh , Lim Aaron G. , Johansson Kjell Arne , Fadnes Lars Thore 
Published: June 2020

Abstract
Background: Treatment with direct-acting antiviral agents (DAAs) offers an opportunity to eliminate hepatitis C virus (HCV) endemic among people who inject drugs (PWID) and people enrolled in opioid agonist therapy (OAT) programs. The objective of this study was to estimate and to compare HCV treatment uptake after the introduction of DAAs among patients receiving OAT in Sweden and Norway. We also aimed to evaluate predictors of DAAs treatment among OAT patients in both countries.Methods: This observational study was conducted with data from The Swedish Prescribed Drug Register and The Norwegian Prescription Database. We studied dispensed medications to calculate HCV treatment among OAT patients from 2014 to 2017 in Sweden and Norway. HCV prevalence was estimated from primary and secondary sources. Dispensations of medicines from different therapeutic areas, which served as proxy for co-morbidities in 2017, were conditionally adjusted for age, gender, and OAT medications. Logistic regression was used to evaluate these parameters. Results: In total 3,529 individuals were identified with dispensed OAT in the Swedish cohort and 7,739 individuals in the Norwegian cohort. HCV treatment was utilized by 407 persons in Sweden and 920 in Norway during the study period. Annual HCV and DAA treatment uptake increased in both countries. The estimated cumulative HCV treatment uptake at the end of 2017 was 31% in Norway and 28% in Sweden. DAA treatment was associated with increased age (aOR 1.8; 95% CI 1.0-3.2) and the dispensation of drugs used for diabetes (aOR 3.2; 95% CI 1.8-5.7) in Sweden. In Norway, lipid modifying agents and antibacterials were associated with decreased odds (aOR 0.4; 95%CI 0.2-0.9, aOR 0.8; 95%CI 0.6-1.0).Conclusions: An increase in DAA treatment and HCV treatment uptake was observed among Swedish and Norwegian OAT patients whilst introducing new direct-acting antiviral treatment regimens. However, more than two thirds of the OAT population in Norway and Sweden were untreated at the beginning of 2018. A further scale-up is crucial in order to control and eliminate the HCV endemic among OAT patients.