bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of drug compliance on health care costs in newly-diagnosed dementia: a nation-wide analysis
Authors: Oh S T , Han K T , Choi W J , Park J 
Published: November 2019

Abstract

Background
The cost-effectiveness of both cholinesterase inhibitors and memantine by delaying nursing home placement has been supported by numerous studies. The importance of sustained pharmacological treatment in dementia has been relatively less recognized by public health policies compared to early diagnosis. We investigated the effect of the drug (donepezil, rivastigmine, galantamine, and memantine) compliance on the health care costs in newly-diagnosed dementia.

Methods
National Health Insurance Service (NHIS) database which covers the entire population of South Korea was used for analysis. Health care expenditure of patients newly-diagnosed with dementia in between 2012 and 2014 was investigated for 3 to 5 years. For drug compliance, we used Medication Possession Ratio (MPR) that indicates the percentage of time a patient has access to medication. Multivariate linear regression analysis including generalized estimated equation and gamma distribution was used for statistical analysis.

Results
We identified 252,594 patients who were both prescribed with cognitive enhancers and newly diagnosed with dementia. When initial MPR increased 20%, total health care costs decreased 8.4% (RR = 0.916, 95%; CI 0.914 to 0.916). Same relationship was shown with medical costs related to dementia, admission to a general hospital, and emergency room visits. When MPR increased 20% compared to the previous year, the total health care costs, admission to a general hospital, emergency room visits, and admission to a nursing hospital decreased.

Conclusions
This population-based retrospective cohort study provides evidence that patients newly-diagnosed with dementia who showed higher initial drug compliance or maintained antidementia drugs (Cholinesterase inhibitors and memantine) would benefit in total health-care costs.

Key messages
Public health care policies should not only focus on early diagnosis in dementia, but also recognize the importance of adherence to cognitive enhancers. To maximize the positive pharmacoeconomic effect of early diagnosis of dementia, it is important to sustain adequate drug compliance to cognitive enhancers.
Anaemia under-reporting in a hospital setting in Italy
Authors: Lucaroni F , Morciano L , Morucci L , Duggento A , Cerone G , Ambrosone C , Palombi L 
Published: November 2019

Abstract

Background
Anaemia is a common occurrence in the general population, affecting nearly one in three people worldwide, with peaks in the elderly and those with chronic diseases or micronutrient deficiency.
If recognised, anaemia can often be treated through micronutrient administration, thus an early recognition of the disorder has a significant return in terms of Public Health and of investment.

Methods
Hospitalisation records from a large sample of ordinary admissions over a year (2016) were retrospectively analysed, in order to assess the impact of hospital stay on anaemia prevalence, defined according to WHO criteria. Prevalence was estimated by both haemoglobin levels and anaemia-related description codes (ICD9CM) at discharge.
Furthermore, the main diagnoses associated with loss of haemoglobin were investigated, using binary logistic regression.

Results
Over the 15,624 ordinary admissions, we found the prevalence rate of anaemia was 47.2% at hospital admission, increasing to 63.9% at discharge.
During hospital stay, a mean reduction of 0.323 g/dl (SD ± 1.39) haemoglobin was recorded, in particular those with neurological, circulatory, and haematological diseases (p &lt; 0.001). By comparing the two diagnostic criteria, a great under-reporting occurred in 85.3% patients with haemoglobin levels predictive for anaemia at hospital discharge.

Conclusions
Our results highlight the importance of correctly identifying anaemia in the hospital setting as a main Public Health concern. Since haemoglobin loss is recorded during hospital stay, we propose measuring haemoglobin levels not only at admission, but also at discharge, and to enhance proper ICD9CM code inclusion in discharge records. The achievement of both these good practices would have a double effect: to properly inform all the stakeholders and to allow more than half hospital patients, those with haemoglobin levels predictive for anaemia but without specific ICD9CM code at discharge, to be cured in the proper setting.

Key messages
Anaemia often remained misidentified during hospitalisation, thus inducing a decrease in mean inpatients haemoglobin levels and a consequent increase of anaemia prevalence at discharge. Despite this worsening during hospital stay, a significant underreporting was recorded: 85.3% patients with Hb levels predictive for anaemia at hospital discharge had no specific ICD9CM code.
Avoidable hospitalization in Milan’s metropolitan area: inequalities and comparison with OECD cities
Authors: Pongiglione B , Torbica A , Gusmano M 
Published: November 2019

Abstract

Background
The largest cities on the world face the unprecedented challenge of meeting the needs of a population that lives longer, has declining birthrates, and is altering the demographic profile on which social welfare programs have long been premised. This work is part of an international project aimed at comparing health and social care systems in megacities worldwide. We study access to healthcare in the metropolitan area of Milan to quantify avoidable hospital care and social inequalities within this world city, and compare Milan with other OECD megacities.

Methods
Two sources of data are combined: individual-level hospital discharge data to measure hospitalization for ambulatory-care sensitive conditions (ACSC), and municipality-level data collected from the national office for statistics. First, we performed an ecological analysis using a linear model for ACSC hospitalization rates to detect the risk factors in the municipality where the patient resides. Then, to identify both individual and area-level variations in population health, we use multilevel logistic regression model.

Results
Age-adjusted ACSC hospitalization rates continuously declined from 2005 to 2016, from 16% to 10.7%. Municipality-level risk factors include proportion of residents aged 65+ and proportion of foreigner residents. The individual-level predictors of ACSC hospitalization include being male, being single, having co-morbidities and low education. This association is only modestly attenuated when patient’s area-level characteristics are accounted.

Conclusions
We observed declining trends in ACSC hospitalizations and identified some patient’s as well as area-level characteristics related to avoidable hospitalization. Understanding whether ACSC hospitalization has dropped due to improvements in population health and access to healthcare or as part of the overall reduction in hospitalization rates needs to be further explored.

Key messages
Effective primary care can reduce hospitalization for preventable and chronic conditions. This work identifies individual and ecological factors related to avoidable hospitalization in urban settings. Policies to improve access to healthcare, tackle inequalities and reduce hospitalization costs may be more effective if targeted on individuals considering and the environment in which they live.
Genetic Support for Longevity-Enhancing Drug Targets: Issues, Preliminary Data, and Future Directions
Authors: McCorrison Jamison , Girke Thomas , Goetz Laura H , Miller Richard A , Schork Nicholas J 
Published: November 2019

Abstract
Interventions meant to promote longevity and healthy aging have often been designed or observed to modulate very specific gene or protein targets. If there are naturally occurring genetic variants in such a target that affect longevity as well as the molecular function of that target (eg, the variants influence the expression of the target, acting as “expression quantitative trait loci” or “eQTLs”), this could support a causal relationship between the pharmacologic modulation of the target and longevity and thereby validate the target at some level. We considered the gene targets of many pharmacologic interventions hypothesized to enhance human longevity and explored how many variants there are in those targets that affect gene function (eg, as expression quantitative trait loci). We also determined whether variants in genes associated with longevity-related phenotypes affect gene function or are in linkage disequilibrium with variants that do, and whether pharmacologic studies point to compounds exhibiting activity against those genes. Our results are somewhat ambiguous, suggesting that integrating genetic association study results with functional genomic and pharmacologic studies is necessary to shed light on genetically mediated targets for longevity-enhancing drugs. Such integration will require more sophisticated data sets, phenotypic definitions, and bioinformatics approaches to be useful.
A Comparison of Variances in Age Cohorts to Understand Longevity in African Americans
Authors: Whitfield Keith E , Forrester Sarah , Thorpe Roland J 
Published: November 2019

Abstract

Background
African American life expectancy at age 65 is about 2 years less than that of Caucasians, but by age 85, African Americans may have a longevity advantage. One possible explanation for this cross-over effect is that African Americans who make it to the oldest ages have done so by handling stressful contextual and health disadvantages. The purpose of this study was to examine possible within group cohort differences that lead to exceptional longevity among older African Americans.

Methods
Data came from three cohorts of older African Americans: the Carolina African American Twin Study of Aging (CAATSA), the Baltimore Study of Black Aging-Patterns of Cognitive Aging (BSBA-PCA), and the Study of Longevity and Stress in African American Families (SOLSAA). Of the 533 participants, we compared two age cohorts (60–79 and 80+) with an average age of 73.2 (SD = 8.33) and 26.3% are men. Variables included measures of stress, depression, coping, cognition, and health indicators.

Results
The variance for depression and average peak expiratory flow (APEF) was significantly larger for the older cohort but after controlling for demographic factors, the measure of depressive symptoms was not. The Alpha Span test showed a significant difference with the older cohort having larger variances after controlling for demographic factors.

Conclusions
The findings suggest that there are changes in the characteristics of who makes it to later life, but counter to our hypothesis, there was greater variability in the oldest group relative to the younger.
Accelerating the Search for Interventions Aimed at Expanding the Health Span in Humans: The Role of Epidemiology
Authors: Newman Anne B , Kritchevsky Stephen B , Guralnik Jack M , Cummings Steven R , Salive Marcel , Kuchel George A , Schrack Jennifer , Morris Martha Clare , Weir David , Baccarelli Andrea , Murabito Joanne M , Ben-Shlomo Yoav , Espeland Mark A , Kirkland James , Melzer David , Ferrucci Luigi 
Published: November 2019

Abstract

Background
Extensive work in basic and clinical science suggests that biological mechanisms of aging are causally related to the development of disease and disability in late life. Modulation of the biological mechanisms of aging can extend both life span and health span in animal models, but translation to humans has been slow.

Methods
Summary of workshop proceedings from the 2018–2019 Epidemiology of Aging Workshop hosted by the Intramural Research Program at the National Institute on Aging.

Results
Epidemiologic studies play a vital role to progress in this field, particularly in evaluating new risk factors and measures of biologic aging that may influence health span, as well as developing relevant outcome measures that are robust and relevant for older individuals.

Conclusions
Appropriately designed epidemiological studies are needed to identify targets for intervention and to inform study design and sample size estimates for future clinical trials designed to promote health span.
Temporal changes in the growth of a crustacean species, Portunus armatus, in a temperate marine embayment: evidence of density dependence
Authors: Marks Rachel , Hesp S Alex , Johnston Danielle , Denham Ainslie , Loneragan Neil 
Published: November 2019

AbstractGrowth is a key attribute influencing population dynamics and fishery production, and understanding factors that affect the growth of individuals in a population is essential in fisheries science and management. This study analyses 18 years of fishery-independent trawl data to determine the relationships among temperature, density, primary productivity and growth of the blue swimmer crab, Portunus armatus, in a temperate marine embayment. Growth was modelled using mixture distribution analyses and cohort-specific seasonal growth curves to estimate the size of crabs at the age of 0.5 and 1.5 years. Growth was highly seasonal, with size-at-age increasing during the austral summer periods and slowing/ceasing during the cooler winter months. The results from the mixture models were used to estimate the mean size of the 0.5- and 1.5-year-old crabs in each year. Linear models showed that the mean size of adult P. armatus at 1.5 years was negatively related to the density of juvenile (0.5 year) crabs in the previous year (i.e. the same cohort) and chlorophyll a concentrations in this year. Increased chlorophyll a levels may increase the survival of larval and megalopal P. armatus, leading to density-dependent effects such as increased competition among juveniles for food and spatial resources, and ultimately, reduced growth.
The Predominance of Strain Replacement Among Enterobacteriaceae Pairs With Emerging Carbapenem Resistance During Hospitalization
Authors: Ding Baixing , Shen Zhen , Qin Xiaohua , Yang Yang , Xu Xiaogang , Guo Qinglan , Hu Fupin , Wang Minggui 
Published: November 2019

Abstract
Isolates of Enterobacteriaceae collected from the same patient can lose carbapenem susceptibility during antimicrobial therapy, but little attention has been given to how this conversion takes place. In the current study, we retrospectively analyzed microbiological and clinical data from patients with enterobacterial infections at a tertiary hospital in Shanghai, China. After screening 4795 patients and 7120 Enterobacteriaceae isolates over the 3-year study period, we found the change from carbapenem susceptible to carbapenem resistant in 41 pairs of isolates, of which 35 pairs (85.4%) were K. pneumoniae and 25 (61.0%) were from the same anatomic sites. Thirty-six isolate pairs showed different pulsed-field gel electrophoresis patterns between the carbapenem-susceptible and the corresponding resistant strain, and 5 pairs displayed identical pulsed-field gel electrophoresis patterns. Thirty-three (91.7%) of the 36 pairs of Enterobacteriaceae isolates were carbapenem-resistant K. pneumoniae with blaKPC-2, and 28 pairs (90.3%) of K. pneumoniae isolates had different sequence types (STs), with ST11 the most common ST found in carbapenem-resistant K. pneumoniae isolates. Forty of the 41 patients had received antimicrobial therapy such as carbapenems, cephalosporins, and fluoroquinolones, before the isolation of carbapenem-resistant Enterobacteriaceae. These results demonstrated that strain replacement is the main cause of emerging carbapenem resistance in Enterobacteriaceae during hospitalization. The loss of carbapenem susceptibility was not mainly due to in vivo development of carbapenem resistance.
A combined strategy of feature selection and machine learning to identify predictors of prediabetes
Authors: De Silva Kushan , Jönsson Daniel , Demmer Ryan T 
Published: November 2019

AbstractObjectiveTo identify predictors of prediabetes using feature selection and machine learning on a nationally representative sample of the US population.Materials and MethodsWe analyzed n = 6346 men and women enrolled in the National Health and Nutrition Examination Survey 2013–2014. Prediabetes was defined using American Diabetes Association guidelines. The sample was randomly partitioned to training (n = 3174) and internal validation (n = 3172) sets. Feature selection algorithms were run on training data containing 156 preselected exposure variables. Four machine learning algorithms were applied on 46 exposure variables in original and resampled training datasets built using 4 resampling methods. Predictive models were tested on internal validation data (n = 3172) and external validation data (n = 3000) prepared from National Health and Nutrition Examination Survey 2011–2012. Model performance was evaluated using area under the receiver operating characteristic curve (AUROC). Predictors were assessed by odds ratios in logistic models and variable importance in others. The Centers for Disease Control (CDC) prediabetes screening tool was the benchmark to compare model performance.ResultsPrediabetes prevalence was 23.43%. The CDC prediabetes screening tool produced 64.40% AUROC. Seven optimal (≥ 70% AUROC) models identified 25 predictors including 4 potentially novel associations; 20 by both logistic and other nonlinear/ensemble models and 5 solely by the latter. All optimal models outperformed the CDC prediabetes screening tool (P &lt; 0.05).DiscussionCombined use of feature selection and machine learning increased predictive performance outperforming the recommended screening tool. A range of predictors of prediabetes was identified.ConclusionThis work demonstrated the value of combining feature selection with machine learning to identify a wide range of predictors that could enhance prediabetes prediction and clinical decision-making.
Analysis for Alpha-Pyrrolidinovalerophenone and Its 2-Oxo-PVP Metabolite in Plasma by Liquid Chromatography–Tandem Mass Spectrometry
Authors: Andrenyak David M , Moody David E , Crites Jonathan M , Baumann Michael H 
Published: November 2019

Abstract
Alpha-pyrrolidinovalerophenone (alpha-PVP), a novel psychoactive substance, has widespread recreational use. This with interest in its pharmacological effects creates a need for methods that measure alpha-PVP concentrations. We therefore developed an LC–MS-MS method that can quantitate alpha-PVP and 2-oxo-PVP in rat plasma using a 0.1-mL sample volume. Addition of internal standards (2.5 ng/mL alpha-PVP-d8/2-oxo-PVP-d6) was followed by liquid–liquid extraction with 1-chlorobutane:acetonitrile (4:1), evaporation and reconstitution with 0.1% formic acid. Extracts were analyzed by LC–MS-MS using an Agilent 1100 HPLC and a Thermo Scientific TSQ Quantum Access MS-MS, with a YMC ODS-AQ, 50 mm × 2 mm, 3 μm column. The mobile phase was 0.1% formic acid:acetonitrile gradient at a 0.2-mL/minute flow rate with positive ion electrospray. SRM was used for the analysis with transitions: alpha-PVP, 232 → 91; alpha-PVP-d8, 240 → 91; 2-oxo-PVP, 246 → 91; 2-oxo-PVP-d6, 252 → 91. Alpha-PVP and 2-oxo-PVP eluted at 6.4 and 8.9 min. Calibrators range from 0.25 to 500 ng/mL. Accuracy and precision evaluated quality control samples prepared at 0.75, 10 and 400 ng/mL. The intra-assay evaluation also included the 0.25-ng/mL LOQs prepared in six different blank plasma sources. The intra-assay accuracy ranged from 88.9 to 117.8% of the target, and the intra-assay precision ranged from 0.9 to 16.0%. The inter-assay accuracy ranged from 98.7 to 110.7% of the target, and the inter-assay precision ranged from 4.5 to 12.0%. Extraction recovery was at least 52% for alpha-PVP and 67% for 2-oxo-PVP. Ionization recoveries were at least 64% for alpha-PVP and 82% for 2-oxo-PVP. These losses did not adversely affect assay performance. Alpha-PVP and 2-oxo-PVP controls were stable at room temperature for up to 24 h and frozen for at least 36 days. Alpha-PVP and 2-oxo-PVP were also stable in processed samples (extracts) stored at room temperature for at least 24 days. The procedure was used to analyze rat plasma samples from a pharmacokinetic study.
Metabolomics Profiling and AKR Characterization During Paurometabolous Development of Corythucha ciliata (Hemiptera: Tingidae)
Authors: Li Du , Dewer Youssef , Qu Cheng , Li Fengqi , Luo Chen 
Published: November 2019

AbstractThe sycamore lace bug, Corythucha ciliata (Say) is an invasive pest infesting trees of the genus Platanus. Both adults and nymphs damage the foliage of sycamore trees. Nymphs cannot survive in low temperatures; however, the sycamore lace bug overwinters as adults. In this study, we analyzed the metabolite profiles of this pest to determine significantly regulated metabolites during paurometabolous development from nymphs to adults. The identification of metabolites is essential to convert analytical data into meaningful biological knowledge. A total of 62 metabolites were identified using GC-MS. Among them, 29 different metabolites showed differences in content among nymphs, adult females (AF), and adult males (AM). Five of the 29 metabolites, including caffeic acid, D-glucose, D-mannose, glycerol and aminooxyacetic acid, were significantly increased and nine of them were significantly decreased during the developmental stages from nymph to adult. In addition, we identified three novel aldo-keto reductase (AKR) genes that may play a significant role in the control of glycerol biosynthesis. Moreover, the characteristics and expression levels of these genes were analyzed. This study will provide us with the necessary information to improve our understanding of the changes in metabolites in C. ciliata during paurometabolous development.
Mother, wife, or worker: Life course and motivations of remarried Mainland Chinese immigrant women in Hong Kong
Authors: To Clara Wai-Chun 
Published: November 2019

AbstractStudies on international marriage examining the motives in women’s marriage and migration decisions have indicated the limitations of the distinction between categories of migrants for marriage and migrant workers. Gender ideologies and immigration policies have accounted for women’s diverse motivations of transnational marriage; however, studies have focused on women in their first marriage, leaving those of remarried women, whose marital and migration decisions are often linked to the welfare and life trajectories of their children underexamined. Systematic investigations of institutional factors other than immigration policies in both receiving and sending countries, particularly post-Socialist societies, that affect their marital and migration decisions, remain limited. This article highlights the significance of life course, families, and gendered institutions in understanding the migratory flows of remarried immigrant wives. Based on in-depth interviews with remarried Mainland Chinese women in Hong Kong, the study argues that the effects of the labour market, local patriarchy, kinship system, and migration control mechanisms in post-Socialist China and Hong Kong on their remarital decisions vary depending on women’s life courses. Their decisions are embedded in their most salient family relationships, particularly young and adolescent biological children, which are interconnected within specific socio-historical contexts. The study contributes to research on gender and migration by demonstrating the heterogeneity of marriage migrants who are not merely wives or workers but also mothers of diverse life courses and the differential effects of gendered institutions on their remarital and migration decisions.