bluuebunny/crossref_metadata_2025_split huggingface dataset:
Equity of Access to Emergency Medical Services Utilization by Elderly Koreans
Authors: PARK JUMOON , Sohn Aeree 
Published: January 2020

Abstract
Background Elderly adults are the demographic most likely to utilize emergency medical services (EMS). To allow for better management of EMS needs and planning, we must better understand the users’ needs and break down the differences in how the various demographic subgroups of the population utilize the offered services. This study examines the extent to which equity in the use of EMS have been achieved for elderly Koreans.Methods Using both descriptive and logistic regression analyses, this paper analyses the 2014 Korean Health Panel Survey data (n=3,175). Results It was found that certain predisposing factors such as sex, education, and marital status were significant predictors of EMS utilization. However, differences in need do not fully account for the original differences observed between subgroups of elderly Koreans. While health status and chronic disease were important predictors of elderly Koreans using EMS, income and place of residence did not account for the subgroup differences. Nonetheless, income and place of residence remain particularly important predictors of EMS utilization for the elderly. Conclusions The main predictors of EMS utilization by elderly Koreans include the presence of chronic disease and overall health status. Notably, though annual household income and place of residence were tested, they seem to have minimal impact on the utilization of EMS by elderly Koreans compared to factors that indicated health status and needs. In addition, the existing EMS system seems to compel certain subgroups of older Koreans (i.e., men, well-educated, married, high family income and/or people living in capital areas) to be less likely to use EMS. These predictors must be considered when modifying the EMS system to more efficiently and effectively manage already limited healthcare resources.
WITHDRAWN: Experience and reflections of using individual work histories and events of public sector doctors to unpack Human Resource Management policies and systems: Job histories as powerful method in Human Resource for Health research
Authors: Purohit Bhaskar , Hill Peter Stuart 
Published: January 2020

Abstract
Background and methods: There is limited use of job histories in Human Resource for Health (HRH) research. This paper presents authors’ reflections of using job histories in HRH related research. In particular paper discusses how these can be useful method specifically to examine the implementation fidelity for health policy analysis of HRH and the strengths and limitations of this approach. Methods: The context of this exploration is a multiple case study research project examining the implementation of HRH policies in public health sector in two Indian States—Sikkim and Rajasthan. As the doctors were the main subjects of the study, semi-structured interviews were conducted with 33 doctors to understand their experiences and interactions with the health department in relation to four key HRH management functions: recruitment, initial posting, transfer and promotions. The interview process revealed construction of work life related chronology by the doctors as a means of structuring their responses. This emerging pattern was adapted for the subsequent interviews to formalise it in form of job histories. Key findings and reflection: Job histories constructed from the interviews gave rich descriptive accounts of doctors’ experiences with the HRM systems, and also unravelled how HRM policies and systems operate, specifically in relation to adherence and dosage aspects of implementation fidelity, represented as narrative and quantitative accounts. For instance, job histories clearly allude non-adherence to posting rules and norms. Similarly, examination of the dosage aspect suggests variable application of HRH related policies and practices, delivered inconsistently across the doctors (applied to some and not to others or not applied consistently to the same doctor across his/her work career) or not applied as often as required. The organic and fluid nature of the job histories grounded in the qualitative data presents itself as a very powerful case in narrating rich job related stories and experiences of doctors. Additionally, it offers the flexibility to collect data in a more structured way potentially demonstrating useful chronological patterns and offering valuable insights into attempts to unravel the complexities and conflicts and in unpacking the rich individual experience, conflicts and tensions that public sector rural doctors confront in interacting with HRM policies and systems. Job histories can serve as a useful method for data collection in the area of Health Policy and Systems Research implementation, especially in relation to HRH.
Young Medical Doctors’ Perspectives on Professionalism: A Qualitative Study Conducted in Public Hospitals in Pakistan
Authors: Jalil Aisha , Mehmood Qaisar Khali , Fischer Florian 
Published: January 2020

Abstract
Background: Professionalism is amongst the major dimensions indicating the competence of medical doctors. A decline in professionalism affects the overall outcome of healthcare services. This study explores the patterns of declining professionalism among young medical doctors in Pakistan.Methods: A qualitative study based on in-depth interviews was conducted with 60 young medical doctors aged less than 40 years who were employed at various levels from house officer to consultant specialist in public tertiary hospitals in Pakistan. The respondents were identified through a multistage maximum heterogeneity sampling strategy. A semi-structured interview guide was developed based on a previous extensive literature review. Written consent was obtained from the hospitals and study participants. Thematic content analysis was applied to analyse the data. Results: The data analysis revealed a rigidity of opinions, inflexibility blocking the acceptance of contrasting perspectives, and perceived superiority over all other professions and over patients. The belief that patients know nothing was common among all participants. Similarly, doctors believed that there is no need to include a professionalism and humanity course in the medical school curriculum. The majority of respondents thought that social science topics are irrelevant to medicine and are common-sense things that they already know. The doctors recognised high professionalism in themselves, while reporting unprofessional behaviour demonstrated by their colleagues. The reported characteristics include using social media applications during duty hours, ridiculing patients, substance use such as cigarettes in the office, referrals of complicated cases to other hospitals, freeing up beds before holidays and inappropriate salaries. Conclusions: It seems that professionalism has declined among young doctors, and this should be immediately addressed by policymakers. The lack of training about ethics and healthcare service delivery, and a lack of performance monitoring and evaluation mechanisms at public hospitals are the major factors contributing to declining professionalism. There is a need to revisit the curriculum taught to medical students in order to strengthen professionalism.
Evaluating the Impact of Social Deprivation on Press Ganey® Outpatient Medical Practice Survey Scores
Authors: Stephens Andrew R , Potter Jared W , Tyser Andrew R , Kazmers Nikolas H 
Published: January 2020

Abstract
Background Social deprivation has been shown to affect access to health care services, and influences outcomes for a variety of physical and psychological conditions. However, the impact on patient satisfaction remains less clear. The objective of this study was to determine if social deprivation is an independent predictor of patient satisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey (PGOMPS).Methods We retrospectively reviewed unique new adult patient (≥18 years of age) seen at a tertiary academic hospital and rural/urban outreach hospitals/clinics between January 2014 and December 2017. Satisfaction was defined a priori as achieving a score above the 33rd percentile. The 2015 Area Deprivation Index (ADI) was used to determine social deprivation (lower score signifies less social deprivation). Univariate and multivariable binary logistic regression were used to determine the impact of ADI on PGOMPS total and provider sub-scores while controlling for variables previously shown to impact scores (wait time, patient age, sex, race, specialty type, provider type, and insurance status).Results Univariate analysis of PGOMPS total scores revealed a 4% decrease in odds of patient satisfaction per decile increase in ADI (p < 0.001). Patients within the most deprived quartile were significantly less likely to report satisfaction compared to the least deprived quartile (OR 0.79, p < 0.001). Multivariable analysis revealed that the odds of achieving satisfaction decreased 2% for each decile increase in ADI on the Total Score (p < 0.001), independent of other variables previously shown to impact scores. For PGOMPS Provider Sub-Score, univariate analysis showed that patients in the lowest ADI quartile were significantly less likely be satisfied, as compared to the least deprived quartile (OR 0.77; 95% CI 0.70 to 0.86; p < 0.001). A 5% decrease in a patient being satisfied was observed for each decile increase in ADI (OR 0.95; 95% CI 0.94 to 0.96; p < 0.001).Conclusions Social deprivation was an independent predictor of outpatient visit dissatisfaction, as measured by the Press Ganey® Outpatient Medical Practice Survey. These results necessitate consideration when developing health care delivery policies that serve to minimize inequalities between patients of differing socioeconomic groups.Registration None
Pulmonary cavitation in patients with thyroid cancer receiving antiangiogenic agents
Authors: Datar Saumil , Cabanillas Maria , Dadu Ramona , Ost David , Grosu Horiana 
Published: January 2020

Abstract
Background: Thyroid malignancies are among the most common endocrine cancers worldwide. Owing to the angiogenic nature of these malignancies, tyrosine kinase inhibitors (TKIs) are an attractive potential treatment. However, TKIs have been associated with an increased risk of tumor cavitation, in turn linked to poor outcomes, in patients with malignancies in the lungs, where thyroid cancer commonly metastasizes. Method: We performed a retrospective cohort study of patients with thyroid cancer and evidence of metastatic disease to the lung who were treated with multi-targeted antiangiogenic TKIs. The primary objective of this study was to determine the incidence of pulmonary cavitation. The secondary objective was to evaluate the effect of pulmonary cavitation on survival. Results: Of the 83 patients analyzed, 10 developed cavitation of pulmonary nodules during treatment. Of these 83 patients, two patient had to stop the treatment due to pneumothorax. Additionally, cavitation did not demonstrate any significant effect on survival. Conclusion: In patients with thyroid cancer and evidence of metastatic disease to the chest, the use of multi-targeted TKIs does not significantly increase the risk of cavitation or pneumothorax requiring termination of treatment in this patient population, however the small sample is a strong limitation of our study.
Mechanism of Overcoming Oxaliplatin Resistance Using HT29 Subcloning
Authors: Lee Jisu , KIM MI YOON , Yang Woomi , Kim Il-woung , Park Seung-Kiel , Park Jong-Il 
Published: January 2020

Abstract
Background: Cancer cells are different from normal healthy cells even though they reside within the same tissue and adapt to others. This intra-tumoral heterogeneity is the reason for chemo-resistance, and the emergence of one or more clones, which are resistant to chemotherapeutic drugs, causing clonal outgrowth to form recurrent cancer mass. The need for personalized chemotherapy is increasing because of the tumor heterogeneity and diverse mechanism of chemotherapy resistance. The recent accumulation of extensive evidence for the existence of cancer stem cells strengthens the cancer stem cell hypothesis for chemotherapy resistance and relapse. The development of a primary culture of cancer cells is essential for functional analysis like the sensitivity of chemotherapeutic drugs and the evaluation of the characteristics of cancer stem cells. Methods: We used a clonal cylinder to establish sub-clones originated from a single cell. Twenty-two sub-clones were successfully established, and eleven clones were selected according to their growth rate and analyzed. The sub-clones with low expression of BRAF, MEK2, and ERK, but not EGFR or KRAS, showed a correlation with the doubling time. We grouped the sub-clones as the fast-growing group and the slow-growing group of the HT29 cell line. Three out of five slow-growing sub-clones showed resistance to oxaliplatin treatment. All oxaliplatin-resistant sub-clones overexpressed ABCC2, and no relevance was found with ABCB1 and ABCG2. Active efflux of the drug by ABCC2, but not by ABCB1 or ABCG2, was confirmed with the inhibitor study using each specific inhibitor. The viability of resistant sub-clones decreased after the MK571 treatment, but other clones were not responsive. CD44 expression in oxaliplatin-resistant sub-clones was higher than that of sensitive clones. Conclusions: This study provides definite evidence of heterogeneity using a cancer cell line. Based on our studies, it appears that intra-tumoral heterogeneity of human cancer tissue is responsible for the development of chemotherapy resistance in cancer. These sub-clones are an excellent model for testing efficacy of anti-cancer drug candidates for advanced cancer therapy. The experimental design and concept of this study could be applied to personalized chemotherapy.
Ammonium recovery from process water of digested sludge dewatering by membrane contactors
Authors: Richter L. , Wichern M. , Grömping M. , Robecke U. , Haberkamp J. 
Published: January 2020

Abstract
Membrane contactors are a promising alternative for nitrogen removal and recovery from process water compared to other physicochemical and biological sidestream treatment processes. Münster wastewater treatment plant (WWTP) is the first municipal WWTP in Germany operating a full-scale membrane contactor system to improve the nitrogen elimination and recovery efficiency. Factors influencing the operation and membrane performance are investigated in an accompanying research project. Additional operational aspects of the applied membrane modules are investigated in detail using a bench-scale membrane contactor. First results of the full-scale application demonstrate a high nitrogen removal efficiency of &gt;95%.
La estructura y la jefatura de los hogares de la frontera norte en la última década
Authors: Vargas Valle Eunice D. , Navarro Ornelas Ana María 
Published: January 2020

El objetivo de este trabajo es describir las tendencias en la estructura y la jefatura femenina de los hogares de la frontera norte de México entre 2000 y 2010, así como los cambios en los perfiles demográficos de los hogares por tipo de estructura y jefatura de los hogares. Se registraron tres tendencias relevantes: el aumento de los hogares unipersonales, la ligera disminución de los hogares extensos y el incremento de los hogares de jefatura femenina. Estas tendencias apuntan hacia la intersección de complejos procesos estructurales y coyunturales. Por un lado, el proceso de envejecimiento de la población sigue en marcha y los procesos culturales ligados al valor por la autonomía individual versus el altruismo familiar siguen evidenciándose en el aumento de hombres solos y jefas de hogar. Por otro lado, procesos coyunturales tales como las crisis económicas y las políticas migratorias y de seguridad de Estados Unidos han repercutido en la reducción de la inmigración interna a la frontera y el alza de la migración de retorno de Estados Unidos, factores que a su vez han alterado las estructuras de los hogares fronterizos.
Turismo residencial y migración de jubilados extranjeros en México: un estudio de caso sobre sus implicaciones ambientales y de servicios en Baja California Sur
Authors: Casas-Beltrán Diego Armando , Beltrán-Morales Luis Felipe , Castellanos Aradit , Solís-Cámara Aurora Breceda 
Published: January 2020

La migración de jubilados extranjeros en México ha aumentado, especialmente en Los Cabos, donde los asentamientos tipo tráiler se incrementan y se desplazan a zonas rurales costeras de alto valor ecológico, con el desconocimiento de las implicaciones ambientales.El objetivo de este trabajo es contribuir al conocimiento de este tipo de asentamientos, documentando mediante un caso de estudio las características de su comunidad así como sus implicaciones ambientales y de dotación de servicios públicos. Concluimos que la localidad se convertirá en un sitio de retiro en corto plazo, pues si bien no presenta altas densidades, sus implicaciones ambientales son significativas y de una cobertura amplia. Su demanda actual de servicios es mínima, pero puede producir conflictos a futuro, especialmente con el agua
Análisis de las estrategias de mitigación y adaptación del sector transporte en la ciudad de Mexicali
Authors: Melero Hernández Argelia , Quintero Núñez Margarito , Galindo Duarte Moisés 
Published: January 2020

El objetivo de este artículo es desarrollar un análisis de las estrategias de mitigación y adaptación del sector transporte en la ciudad de Mexicali, Baja California, México. Basado en la metodología de los Programas de Acción ante el Cambio Climático (PACC), se analiza el inventario de emisiones de Mexicali y se da a conocer un diagnóstico. Una vez analizada la situación actual, se estudian las estrategias de mitigación, como el sistema de transporte colectivo (BRT, por sus siglas en inglés), la verificación vehicular, nuevas leyes de importación, la producción de biocombustibles, la promoción de uso de vehículos de menores emisiones y la planeación urbana. En materia de adaptación se estudia el reciclado de vehículos en Mexicali y el uso de transporte no motorizado como alternativa de movilidad sustentable.
Human Resources Management For Teleworkers
Authors: Özcan Demet 
Published: January 2020

The objective of this paper is to explore the
suggestions and expectations of telecommuters and non-telecommuters for human
resources management and other leaders.
Analysing data from 21 in-depth qualitative interviews according to
grounded theory, 2 main themes are identified as: expectations before the
initiation of telecommuting and expectations after the initiation of
telecommuting. Respondents’ intimate and detailed descriptions of their
expectations as telecommuters are coded under the main themes and the
conceptual model is developed and suggestions are presented. The findings of
the study are expected to be a guide for human resources management to apply
successful teleworking programs and to give a deep understanding of the
experiences, challenges and needs of telecommuters so as to give feedback about
what to do and how to do the implementions both before and after the adoption
of this new way of working.
Emerging Potential of Naturally Occurring Autophagy Modulators Against Neurodegeneration
Authors: Rahman Md. Ataur , Rahman Md Rezanur , Zaman Toyfiquz , Uddin Md. Sahab , Islam Rokibul , Abdel-Daim Mohamed M. , Rhim Hyewhon 
Published: January 2020

Background:
Naturally-occurring products derived from living organisms have been shown to modulate
various pharmacological and biological activities. Natural products protect against various diseases, which
could be used for therapeutic assistance. Autophagy, a lysosome-mediated self-digestion pathway, has been implicated
in a range of pathophysiological conditions and has recently gained attention for its role in several neurodegenerative
diseases.

Methods:
In this current review, we emphasized the recent progress made in our understanding of the molecular
mechanism of autophagy in different cellular and mouse models using naturally-occurring autophagy modulators
for the management of several neurodegenerative diseases.

Results:
Accumulating evidence has revealed that a wide variety of natural compounds such as alkaloids, polyphenols,
terpenoids, xanthonoids, flavonoids, lignans, disaccharides, glycolipoproteins, and saponins are involved
in the modulation of the autophagy signaling pathway. These natural products have been used to treat various
neurodegenerative diseases such as Alzheimer’s disease, Parkinson’s disease, Huntington’s disease, Amyotrophic
lateral sclerosis, spinocerebellar ataxia, neuroblastoma, and glioblastoma. Although a number of synthetic autophagy
regulators have been recognized as encouraging neurodegenerative therapeutic candidates, natural autophagy-
regulating compounds have been of further interest as potential disease therapeutics, as they cause insignificant
side effects.

Conclusion:
Existing in vitro and in vivo data are promising and highlight that naturally-occurring autophagyregulating
compounds play an important role in the prevention and treatment of neurodegenerative disorders.
Role of Dietary Antioxidants in Neurodegenerative Diseases: Where are We Standing?
Authors: Bakir Sena , Catalkaya Gizem , Ceylan Fatma D. , Khan Haroon , Guldiken Burcu , Capanoglu Esra , Kamal Mohammad A. 
Published: January 2020

:
This review presents the potential effects of dietary antioxidants on neurodegenerative diseases. The
relationship between autoimmunity and antioxidants, and their preventive effect on neurodegenerative diseases
are evaluated. The driven factors of neurodegeneration and the potential effects of natural antioxidants are summarized
for Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, spongiform encephalopathy,
Huntington’s disease, and amyotrophic lateral sclerosis. The effect of oxidative stress on neurodegenerative diseases
and regulative effect of antioxidants on oxidative balance is discussed. This review provides beneficial
information for the possible cure of neurodegenerative diseases with dietary intake of antioxidants.