bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of a financial incentive scheme for dementia care by dementia specialist teams in acute‐care hospitals: A difference‐in‐differences analysis of a nationwide retrospective cohort study in Japan
Authors: Morita Kojiro , Fukahori Hiroki , Ogawara Hirofumi , Iwagami Masao , Matsui Hiroki , Okura Toru , Itoh Sakiko , Fushimi Kiyohide , Yasunaga Hideo 
Published: March 2021

AbstractObjectivesThe quality of care for dementia in acute‐care settings has been criticised. In 2016, the Japanese universal health insurance system introduced a financial incentive scheme for dementia care by dementia specialist teams in acute‐care hospitals. This study aimed to investigate the effectiveness of this financial incentive scheme on short‐term outcomes (in‐hospital mortality and 30‐day readmission).Design and MethodsUsing a Japanese nationwide inpatient database, we identified older adult patients with moderate‐to‐severe dementia admitted for pneumonia, heart failure, cerebral infarction, urinary tract infection, intracranial injury or hip fracture from April 2014 to March 2018. We selected 180 propensity score‐matched pairs of hospitals that adopted (n = 180 of 185) and that did not adopt (n = 180 of 744) the financial incentive scheme. We then conducted a patient‐level difference‐in‐differences analysis. In a sensitivity analysis, we restricted the postintervention group to patients who actually received dementia care.ResultsThere was no association between a hospital's adoption of the incentive scheme and in‐hospital mortality (adjusted odds ratio [aOR]: 0.97; 95% confidence interval [CI]: 0.88–1.06; p = 0.48) or 30‐day readmission (aOR: 1.04; 95% CI: 0.95–1.14; p = 0.37). Only 29% of patients in hospitals adopting the scheme actually received dementia care. The sensitivity analysis showed that receiving dementia care was associated with decreased in‐hospital mortality.ConclusionsThe financial incentive scheme to enhance dementia care by dementia specialist teams in Japan may not be working effectively, but the results do suggest that individual dementia care was associated with decreased in‐hospital mortality.
Cost sharing and the demand for health services in a regulated market
Authors: Serna Natalia 
Published: March 2021

AbstractThis paper measures consumer responsiveness to cost sharing in healthcare using a regression discontinuity design. I use a novel and detailed claims‐level dataset from the Colombian healthcare market, where the government exogenously determines a tier system for coinsurance rates and copays based on the enrollee's monthly income. I find that patients exposed to higher coinsurance rates demand fewer services relative to patients facing lower cost sharing. This reduction holds for both discretionary and preventive services. Lower utilization translates into lower costs, despite evidence that patients facing higher prices do not substitute away from more expensive providers.
‘We are not aware of notification of tuberculosis’: A mixed‐methods study among private practitioners from western India
Authors: Rupani Mihir P. , Shah Chinmay J. , Dave Jigna D. , Trivedi Atul V. , Mehta Kedar G. 
Published: March 2021

AbstractBackgroundImplementing the Standards for tuberculosis care in India (STCI) guidelines in the private sector is vital. This study attempted to estimate the knowledge and practices regarding STCI guidelines among private practitioners and to explore the reasons and solutions for low tuberculosis (TB) notification rates.MethodsWe conducted a cross‐sectional study for assessing the knowledge and practices of the STCI guidelines among 100 full‐time allopathic private practitioners in Bhavnagar (in western part of India) from September 2018 to January 2019. Knowledge and practice were categorised as good or poor by assigning scores to the responses to a questionnaire based on the STCI guidelines. It was followed by two focus group discussions to explore the reasons and solutions for low notification rates of TB as perceived by private practitioners.ResultsAmong the 100 private practitioners, 55% had good knowledge, and 41% had good practice regarding the STCI guidelines; 69% knew about the gazette notification of mandatory notification of TB, and 58% were notifying TB cases to the government. Lack of awareness about the process as well as incentives for notification, time constraints and infrequent visits by health workers were the main reasons perceived by private practitioners for not notifying TB cases to the government. The critical solutions suggested by them were creating awareness regarding the notification process as well as incentives, increasing health worker visits and use of social media for notification.ConclusionOnly about half of private practitioners follow the STCI guidelines for TB care, and the notification rates are low in our setting. Regular sensitisation programs need to be arranged for private practitioners to create awareness on TB notification.
A comparison of brief and extended session duration functional analyses
Authors: Griffith Lee S. , Roscoe Eileen M. , Cornaglia R. Benjamin 
Published: March 2021

Many behavior analysts do not conduct a functional analysis (FA) prior to treatment in a clinical setting (e.g., Roscoe et al., 2015). When asked for an explanation, respondents commonly report that an FA is too time consuming. One way to address this perceived constraint is to evaluate the utility of an abbreviated FA with 5‐min session durations. In the current study, 2 independent FAs, 1 with 5‐min sessions and 1 with 10‐min sessions, were conducted for the problem behavior of 5 individuals diagnosed with autism spectrum disorder (ASD). For all participants, the 5‐ and 10‐min session duration FAs yielded the same identified function of problem behavior: escape from demands. A brief differential reinforcement of alternative behavior (DRA) analysis was subsequently conducted and found to be effective at decreasing problem behavior and increasing an appropriate communication response across participants. These findings demonstrate the utility of conducting an FA using briefer session durations followed by a brief DRA analysis.
A novel synthesis of substituted 3‐amino and 3‐thio pyrimido[5,4‐e]‐1,2,4‐triazine‐5,7(1H,6H)‐diones
Authors: Xu Hao , Powelson Ian A. , Jin Yafei , Showalter Hollis D. 
Published: March 2021

AbstractFervenulin is a natural product that has been extensively studied due to its molecular features and breadth of biological activities. Published studies have reported the generation of numerous analogues of the bicyclic pyrimidotriazinodione core. One underrepresented subclass are compounds with electron releasing atoms bonded directly to the C‐3 position. We report an efficient and straightforward synthesis of compounds with substituted amino and thio functionality attached to the C‐3 position. These are derived from a common 3‐chloro precursor that is made in six steps in 15.8% overall yield from a starting chlorouracil. Our methodology should be applicable to the synthesis of C‐3 ether congeners also, and through previously described chemistry be expandable to incorporating diversity at the N‐6 position of the pyrimidotriazinodione core. The chemistry reported herein expands possibilities for the generation of diverse libraries of substituted pyrimidotriazinediones for future studies.
FW‐EM‐based approach for scalable small‐signal modeling of GaN HEMT with consideration of temperature‐dependent resistances
Authors: Tang Xianli , Yang Taojun , Jia Yonghao , Xu Yuehang 
Published: March 2021

AbstractIn this paper, the full‐wave electromagnetic (FW‐EM) simulation approach for scalable small‐signal modeling of the GaN HEMT device is proposed. The scalable rules are deduced from the extracted parasitic parameters, which is according to a step‐by‐step parameter extraction method. Moreover, the accuracy is enhanced by considering the temperature‐dependent resistance (TDR) Rs and Rd, which are calculated by combining a universal thermal resistance model and the Rs and Rd under the pinch‐off condition. In the end, a set of GaN HEMT with a gate length of 0.25 μm is used for validation, and the experimental results show that good agreements have been achieved between the measured and the simulated scattering (S) parameters.
Impact of central venous catheter repair in pediatric intestinal failure
Authors: Santhana Velarchana , Davis Mary Beth , Rahhal Riad 
Published: March 2021

AbstractObjectivesPatients with intestinal failure (IF) require long‐term parenteral nutrition through central venous catheters (CVCs). When damaged, catheter replacement or repair is considered. Limited literature exists on repair outcomes in this population. We aimed to assess the impact of repair on durability of exiting CVCs and infection rates.MethodsThis was a retrospective cohort study of pediatric IF patients with tunneled silicone CVCs over 10 years. Outcomes were evaluated by assessing CVC longevity, repair success, replacement, and postrepair infection rates.ResultsOne hundred thirty‐eight repairs and 45 replacements were conducted in 37 patients with repair and replacement rates of 4.7 and 1.5 per 1000 catheter days, respectively. Twenty patients (54%) required ≥1 repair. For CVCs requiring repair, median CVC durability without and with repairs were at 123 and 391 days, respectively (P < .0001). Overall repair success rate was 96% with significantly lower success in the emergency department at 81% (P = .007). The 7‐day postrepair infection rate was 2.2% without specific risk factors identified. Most repairs (76%) were performed by the Pediatric Gastroenterology division. Variability in practice was noted among services, including frequency of periprocedural antibiotic use and performance of temporary repairs before permanent repairs. A gradual increase in CVC repair rate was noted over time.ConclusionsOur study showed that CVC repair is effective in prolonging CVC durability in pediatric IF patients without increasing infection rates. Incorporating a temporary repair as a step before permanent repair may offer a route to address potential intraluminal thrombosis before permanent repair.
Efficacy of a Y‐Design Silastic Elastomer Intrauterine Device as a Horse Contraceptive
Authors: Holyoak G. Reed , Lyman Candace C. , Wang Shuodao , Germaine Stephen S. , Anderson Cory O. , Baldrighi Julia M. , Vemula Neha , Rezabek Grant B. , Kane Albert J. 
Published: March 2021

ABSTRACTTo successfully manage population growth rates of free‐roaming horses (Equus ferus caballus), an effective, long‐acting contraceptive could be beneficial. We evaluated the efficacy and safety of an intrauterine device (IUD) in a breeding trial using seasonal pasture assemblages of 2 males individually pastured in large enclosures (~81 ha) each with 10 females per male. The study took place at a large animal research facility at Oklahoma State University in Stillwater, Oklahoma, USA. Specific objectives of the study were to evaluate the effectiveness of IUDs in preventing pregnancy over 20.5 months with return to fertility assessed over the subsequent 6 months and to evaluate potential effects of this IUD on ovarian function and uterine health (e.g., endometrial inflammation, infection, fibrosis). We developed a Y‐design IUD, made of silastic elastomer, and set the desired retention rate at 75%. After procurement of endometrial biopsies, we inserted IUDs into the uteri of 20 females and examined them via transrectal ultrasound every 2 weeks for detection of the device and assessment of uterine health. After 20.5 months we removed the remaining 15 IUDs, obtained a second endometrial biopsy for comparision, and returned the females to their respective males for continued breeding in efforts to assess uterine return to health as indicated by pregnancy rates. The Y‐design IUD met the 75% retention rate goal, with 100% contraception in females that retained the device; 12 of 20 treated females became pregnant (i.e. returned to fertility) after removal of the IUD. Based on these results, we conclude that the Y‐design IUD is a safe and effective device to control fertility in free‐roaming horses. © 2021 The Wildlife Society.
The Effect of Sea Level Rise on Dabbling Duck Energetic Carrying Capacity
Authors: Livolsi Mark C. , Williams Christopher K. , Coluccy John M. , Dibona Matthew T. 
Published: March 2021

ABSTRACTWaterfowl migrating and overwintering in the Atlantic Flyway depend on adequate availability of wetland plant communities to survive winter and fuel reproduction in the subsequent breeding season. Energetics models are the primary tool employed by conservation planners to estimate energetic carrying capacity based on energy supply and demand in different wetlands to assist with effective habitat conservation. Coastal impoundments have been used to provide a consistent, annual source of energy for migrating and wintering waterfowl. But few studies have attempted to comprehensively assess the relative value of managed coastal impoundments compared with unmanaged tidal salt marshes to wintering waterfowl in the Mid‐Atlantic region with further consideration to the effect of sea level rise changing availability. We estimated biomass and energy of preferred foods for 5 dabbling duck species in 7 impoundments and 3 tidal salt marshes over winter by collecting soil core (n = 1,364), nekton (n = 426), and salt marsh snail (Melampus spp.; n = 87) samples in October, January, and April 2011–2013. Food‐energy density was greater in freshwater impoundments for nearly all dabbling ducks (range = 183,344–562,089 kcal/ha), and typically greater in brackish impoundments (range = 169,665–357,160 kcal/ha) than most tidal salt marsh communities (range = 55,693–361,429 kcal/ha), whereas mudflat (range = 96,223–137,473 kcal/ha) and subtidal (range = 55,693–136,326 kcal/ha) communities typically contained the least energy. Extrapolating to the state level, we estimated 7.60 × 109–1.14 × 1010 kcal available within a 16‐km buffer from the Delaware Bayshore, depending on species. Combining estimates for daily energy expenditure and food energy, we estimated 2.86 × 107–7.06 × 107 duck energy days currently available to dabbling ducks over winter. We estimated that in the next century, dabbling duck carrying capacities are likely to decrease under all but the most conservative sea level rise scenarios because of the gradual replacement of land‐cover types that provide high energy density (i.e., low marsh, high marsh communities) with those that provide low energy density (i.e., subtidal, mudflat communities). Coastal impoundments in Delaware, USA, will provide increasingly important habitat for wintering dabbling ducks in the coming decades provided they are properly maintained and retain their current energetic density because they will contain a growing proportion of the available duck energy days on the landscape. Our research will assist managers in meeting target population goals for dabbling ducks in Delaware and the Mid‐Atlantic region by highlighting key differences in the function and value of various wetlands. © 2021 The Wildlife Society.
Effects of Ti addition on microstructure and the associated corrosion behavior of a 22Cr‐5Ni duplex stainless steel
Authors: Zhang Jiantao , Hu Xiaojun , Chou Kuochih 
Published: March 2021

AbstractThe effects of Ti addition on microstructure and the associated electrochemical properties of 22Cr‐5Ni duplex stainless steel were evaluated using X‐ray diffraction, X‐ray electron probe microanalysis, electron backscattered diffraction, scanning Kelvin probe force microscopy, scanning electron microscopy–energy‐dispersive X‐ray spectroscopy, electrochemical techniques, and X‐ray photoelectron spectroscopy. The results indicated that the addition of a minor amount of Ti refined the grains, improved the pitting potential, and lowered passive current densities remarkably. However, excessive content could cause an imbalance of phase proportion of ferrite and austenite phases and precipitation of the coarse TiN particles. The films on the base and Ti‐containing alloy have a similar chemical composition, but the addition of Ti enriched the chromium in the passive film. In particular, the ratio of Cr2O3 and Mo6+ increased, which helped to form a comparatively homogeneous and stable passive film on the duplex stainless steel.
A blended transient/quasistatic Lagrangian framework for salt tectonics simulations with stabilized tetrahedral finite elements
Authors: Scovazzi Guglielmo , Colomés Oriol , Abboud Nabil , Veveakis Manolis , del Castillo Enrique M. , Valiveti Dakshina , Huang Hao 
Published: March 2021

AbstractWe propose a Lagrangian solid mechanics framework for the simulation of salt tectonics and other large‐deformation geomechanics problems at the basin scale. Our approach relies on general elastic‐viscoplastic constitutive models to characterize the deformation of geologic strata, in contrast with the majority of published works on the subject, which utilize nonlinear Stokes flow models. By means of multiscale asymptotics, we also show that the inertia term in the momentum balance equation can be safely neglected, if the goal is to track the Earth's crust deformation over long periods of time. Our time integration strategy is a blended transient/quasistatic approach, in that it consists of a constitutive stress update, subject to the constraint that the stresses must satisfy static equilibrium. In addition, we use stabilized finite element methods specifically built for triangular and tetrahedral grids, which can also perform well under incompressibility constraints. Our approach offers computational geologists the following advantages: (1) improved flexibility in the choice of subsurface constitutive models with respect to the nonlinear Stokes flow; (2) improved efficiency over transient dynamics algorithms used in this context in the past, which are forced to resolve seismic events over geologic time scales; and (3) improved robustness in large strain computations over quadrilateral/hexahedral finite elements. We demonstrate the performance of the proposed approach with simulations of passive diapirism.
High‐order hybridizable discontinuous Galerkin formulation with fully implicit temporal schemes for the simulation of two‐phase flow through porous media
Authors: Costa‐Solé Albert , Ruiz‐Gironés Eloi , Sarrate Josep 
Published: March 2021

AbstractWe present a memory‐efficient high‐order hybridizable discontinuous Galerkin (HDG) formulation coupled with high‐order fully implicit Runge‐Kutta schemes for immiscible and incompressible two‐phase flow through porous media. To obtain the same high‐order accuracy in space and time, we propose using high‐order temporal schemes that allow using large time steps. Therefore, we require unconditionally stable temporal schemes for any combination of element size, polynomial degree, and time step. Specifically, we use the Radau IIA and Gauss‐Legendre schemes, which are unconditionally stable, achieve high‐order accuracy with few stages, and do not suffer order reduction in this problem. To reduce the memory footprint of coupling these spatial and temporal high‐order schemes, we rewrite the nonlinear system. In this way, we achieve a better sparsity pattern of the Jacobian matrix and less coupling between stages. Furthermore, we propose a fix‐point iterative method to further reduce the memory consumption. The saturation solution may present sharp fronts. Thus, the high‐order approximation may contain spurious oscillations. To reduce them, we introduce artificial viscosity. We detect the elements with high‐oscillations using a computationally efficient shock sensor obtained from the saturation solution and the post‐processed saturation of HDG. Finally, we present several examples to assess the capabilities of our formulation.
Threshold for defining fever varies with age, especially in children: A multi‐site diagnostic accuracy study
Authors: Kasbekar Rajesh , Naz Aftab , Marcos Lorenzo , Liu Yingjie , Hendrickson Kristine , Gorsich James C. , Baun Matt 
Published: March 2021

AbstractAimThe American Academy of Pediatrics and the European Centre for Pediatric and Adolescent Medicine guideline define fever as a temperature >38.0°C for all ages and recommend use of rectal thermometers in children <3 years. Based on new literature, this definition of fever using a fixed threshold of 38.0°C needs to be re‐examined.DesignA multi‐site diagnostic accuracy study was conducted to compare an “age‐based” threshold model with a “fixed” threshold over 38.0°C on a total of 894 patients of which 373 were ill.MethodsThe “age‐based” and “fixed” threshold fever determinations were then compared to a clinical categorization (“well” or “ill”) conducted by a clinician through a comprehensive examination.ResultsThe sensitivity and accuracy for the age‐based thresholds were found to be superior to the fixed thresholds in all ages and current ear thermometers were found equivalent to rectal thermometers in infants <6 months.
Assessing stable validity and reliability of the Japanese version of the individualized supported employment fidelity scale: A replication
Authors: Yamaguchi Sosei , Sato Sayaka , Ojio Yasutaka , Shiozawa Takuma , Matsunaga Asami , Taneda Ayano , Sawada Utako , Yoshida Koji , Fujii Chiyo 
Published: March 2021

AbstractBackgroundThe Japanese version of the individualized Supported Employment Fidelity scale (JiSEF) was developed by modifying the 25‐item Individual Placement and Support Fidelity Scale (IPS‐25). While a preliminary study partly confirmed the concurrent validity with vocational outcomes, this replication study aimed to examine the stability of the concurrent validity and the inter‐rater reliability of the JiSEF and to test its convergent validity with IPS‐25.MethodsFidelity assessments were conducted in 2016 (n = 17), 2017 (n = 13), and 2018 (n = 18) to examine the employment rate and the fidelity scores at the agency level. We also evaluated the fidelity scores for the IPS‐25 in 2018. We examined the associations between the fidelity scale scores and vocational outcomes for the concurrent validity and between the fidelity scales for convergent validity. The inter‐rater reliability was examined in the 2016 and 2017 assessments.ResultsHigh intraclass correlation coefficients (0.93 in 2016 and 0.92 in 2017) were obtained for the inter‐rater reliability. The JiSEF score in each year was associated with the agency employment rate (r = 0.710, P = 0.001 in 2016; r = 0.722, P = 0.005 in 2017; and r = 0.665, P = 0.003 in 2018). A supplementary longitudinal data analysis also confirmed the association between the JiSEF score and the employment outcomes. Additionally, the JiSEF was significantly correlated with the IPS‐25 (r = 0.760, P < 0.001).ConclusionsThis study stably replicated good inter‐rater reliability and concurrent validity of the JiSEF. Additionally, the convergent validity was confirmed. Further studies with large samples are needed to confirm these findings.