bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can health service equity alleviate the health expenditure poverty of Chinese patients? Evidence from the CFPS and China health statistics yearbook
Authors: Tang Shaoliang , Yao Ling , Ye Chaoyu , Li Zhengjun , Yuan Jing , Tang Kean , Qian David 
Published: July 2021

AbstractObjectivesTo comprehend the relationship between various indicators of health service equity and patients’ health expenditure poverty in different regions of China, identify areas where equity in health service is lacking and provide ideas for improving patients’ health expenditure poverty.MethodData from China Family Panel Studies (CFPS) in 2018 and the HFGT index formula were used to calculate the health expenditure poverty index of each province. Moreover, Global Moran’s I and Local Moran’s I test are applied to measure whether there is spatial aggregation of health expenditure poverty. Finally, an elastic net regression model is established to analyze the impact of health service equity on health expenditure poverty, with the breadth of health expenditure poverty as the dependent variable and health service equity as the independent variable.ResultsIn the developed eastern provinces of China, the breadth of health expenditure poverty is relatively low. There is a significant positive spatial agglomeration. “Primary medical and health institutions per 1,000 population”, “rural doctors and health workers per 1,000 population”, “beds in primary medical institutions per 1,000 population”, “proportion of government health expenditure” and “number of times to participate in medical insurance (be aided) per 1,000 population” have a positive impact on health expenditure poverty. “Number of health examinations per capita” and “total health expenditure per capita” have a negative impact on health expenditure poverty. Both effects passed the significance test.ConclusionTo enhance the fairness of health resource allocation in China and to alleviate health expenditure poverty, China should rationally plan the allocation of health resources at the grassroots level, strengthen the implementation of hierarchical diagnosis and treatment and encourage the investment in business medical insurance industry. Meanwhile, it is necessary to increase the intensity of medical assistance and enrich financing methods. All medical expenses of the poorest should be covered by the government.
Short term physician visits and medication prescriptions for allergic disease associated with seasonal tree, grass, and weed pollen exposure across the United States
Authors: Saha Shubhayu , Vaidyanathan Ambarish , Lo Fiona , Brown Claudia , Hess Jeremy J. 
Published: July 2021

Abstract
Background
While year-round exposure to pollen is linked to a large burden of allergic diseases, location-specific risk information on pollen types and allergy outcomes are limited. We characterize the relationship between acute exposure to tree, grass and weed pollen taxa and two allergy outcomes (allergic rhinitis physician visit and prescription allergy medication fill) across 28 metropolitan statistical areas (MSA) in the United States.

Methods
We obtained daily pollen data from National Allergy Bureau (NAB) monitors at these 28 MSAs for 2008–2015. We revised the NAB guidelines to classify taxa-specific pollen severity each day. Daily information on allergic rhinitis and prescribed allergy medications for individuals with employer-based health insurance from the IBM MarketScan Research database for these MSAs. We combined the daily pollen and health data for each MSA into a longitudinal dataset. We conducted a MSA-specific conditional quasi-Poisson regression analysis to assess how different levels of pollen concentration impact the health outcomes, controlling for local air pollution, meteorology and Influenza-like illness (ILI). We used a random effects meta-analysis to produce an overall risk estimate for each pollen type and health outcome.

Results
The seasonal distribution of pollen taxa and associated health impacts varied across the MSAs. Relative risk of allergic rhinitis visits increased as concentrations increased for all pollen types; relative risk of medication fills increased for tree and weed pollen only. We observed an increase in health risk even on days with moderate levels of pollen concentration. 7-day average concentration of pollen had stronger association with the health outcomes compared to the same-day measure. Controlling for air pollution and ILI had little impact on effect estimates.

Conclusion
This analysis expands the catalogue of associations between different pollen taxa and allergy-related outcomes across multiple MSAs. The effect estimates we present can be used to project the burden of allergic disease in specific locations in the future as well inform patients with allergies on impending pollen exposure.
An integrated primary care workforce planning toolkit at the regional level (part 1): qualitative tools compiled for decision-makers in Toronto, Canada
Authors: Chamberland-Rowe Caroline , Simkin Sarah , Bourgeault Ivy Lynn 
Published: July 2021

Abstract
Background
A regional health authority in Toronto, Canada, identified health workforce planning as an essential input to the implementation of their comprehensive Primary Care Strategy. The goal of this project was to develop an evidence-informed toolkit for integrated, multi-professional, needs-based primary care workforce planning for the region. This article presents the qualitative workforce planning processes included in the toolkit.

Methods
To inform the workforce planning process, we undertook a targeted review of the health workforce planning literature and an assessment of existing planning models. We assessed models based on their alignment with the core needs and key challenges of the health authority: multi-professional, population needs-based, accommodating short-term planning horizons and multiple planning scales, and addressing key challenges including population mobility and changing provider practice patterns. We also assessed the strength of evidence surrounding the models’ performance and acceptability.

Results
We developed a fit-for-purpose health workforce planning toolkit, integrating elements from existing models and embedding key features that address the region’s specific planning needs and objectives. The toolkit outlines qualitative workforce planning processes, including scenario generation tools that provide opportunities for patient and provider engagement. Tools include STEEPLED Analysis, SWOT Analysis, an adaptation of Porter’s Five Forces Framework, and Causal Loop Diagrams. These planning processes enable the selection of policy interventions that are robust to uncertainty and that are appropriate and acceptable at the regional level.

Conclusions
The qualitative inputs that inform health workforce planning processes are often overlooked, but they represent an essential part of an evidence-informed toolkit to support integrated, multi-professional, needs-based primary care workforce planning.
Rethinking approaches of science, technology, and innovation in healthcare during the COVID-19 pandemic: the challenge of translating knowledge infrastructures to public needs
Authors: da Silva Renan Gonçalves Leonel , Chammas Roger , Novaes Hillegonda Maria Dutilh 
Published: July 2021

AbstractThe coronavirus disease 2019 (COVID-19) outbreak made it clear that despite the potential of science, technology, and innovation (ST&I) to positively impact healthcare systems worldwide, as shown by the rapid development of SARS-CoV-2 test diagnostics and new mRNA vaccines, healthcare stakeholders have faced significant challenges in responding to the crisis through well-integrated ST&I-oriented health initiatives and policies. Therefore, the pandemic has mobilized experts, industry, and governments to evaluate alternative trajectories to promote a more efficient dialogue between ST&I and public health. This article presents a critical thinking about the contemporary asymmetries in the technical and political infrastructures available for particular approaches in ST&I in health, such as precision medicine, and for public health systems worldwide, uncovering a persistent gap in the translation of knowledge and technologies to adequately coordinated responses to the pandemic. We stimulate the understanding of this process as a matter of translation between platforms of knowledge and policy rationales shaped by different institutionalized frames of organizational practices and agendas. We draw attention to the need to strengthen governance tools for the promotion of ST&I as a strategic component of the post-pandemic agenda in public health, to prepare societies to respond efficiently to future emergencies.
The informed road map to prevention of Alzheimer Disease: A call to arms
Authors: McDade Eric , Llibre-Guerra Jorge J. , Holtzman David M. , Morris John C. , Bateman Randall J. 
Published: July 2021

AbstractAlzheimer disease (AD) prevention trials hold the promise to delay or prevent cognitive decline and dementia onset by intervening before significant neuronal damage occurs. In recent years, the first AD prevention trials have launched and are yielding important findings on the biology of targeting asymptomatic AD pathology. However, there are limitations that impact the design of these prevention trials, including the translation of animal models that recapitulate key stages and multiple pathological aspects of the human disease, missing target validation in asymptomatic disease, uncertain causality of the association of pathophysiologic changes with cognitive and clinical symptoms, and limited biomarker validation for novel targets. The field is accelerating advancements in key areas including the development of highly specific and quantitative biomarker measures for AD pathology, increasing our understanding of the course and relationship of amyloid and tau pathology in asymptomatic through symptomatic stages, and the development of powerful interventions that can slow or reverse AD amyloid pathology. We review the current status of prevention trials and propose key areas of needed research as a call to basic and translational scientists to accelerate AD prevention. Specifically, we review (1) sporadic and dominantly inherited primary and secondary AD prevention trials, (2) proposed targets, mechanisms, and drugs including the amyloid, tau, and inflammatory pathways and combination treatments, (3) the need for more appropriate prevention animal models and experiments, and (4) biomarkers and outcome measures needed to design human asymptomatic prevention trials. We conclude with actions needed to effectively move prevention targets and trials forward.
Ethics in extracorporeal life support: a narrative review
Authors: Schou Alexandra , Mølgaard Jesper , Andersen Lars Willy , Holm Søren , Sørensen Marc 
Published: July 2021

AbstractDuring 50 years of extracorporeal life support (ECLS), this highly invasive technology has left a considerable imprint on modern medicine, and it still confronts researchers, clinicians and policymakers with multifarious ethical challenges. After half a century of academic discussion about the ethics of ECLS, it seems appropriate to review the state of the argument and the trends in it. Through a comprehensive literature search on PubMed, we identified three ethical discourses: (1) trials and evidence accompanying the use of ECLS, (2) ECLS allocation, decision-making and limiting care, and (3) death on ECLS and ECLS in organ donation. All included articles were carefully reviewed, arguments extracted and grouped into the three discourses. This article provides a narrative synthesis of these arguments, evaluates the opportunities for mediation and substantiates the necessity of a shared decision-making approach at the limits of medical care.
Recruiting ‘hard to reach’ parents for health promotion research: experiences from a qualitative study
Authors: Tully Louise , Spyreli Eleni , Allen-Walker Virginia , Matvienko-Sikar Karen , McHugh Sheena , Woodside Jayne , McKinley Michelle C. , Kearney Patricia M. , Dean Moira , Hayes Catherine , Heary Caroline , Kelly Colette 
Published: July 2021

AbstractObjectiveMarginalised populations are less likely to take part in health research, and are sometimes considered ‘easy to ignore’. We aimed to describe our approach and results of recruiting parents who experience disadvantage, for focus groups exploring infant feeding on the island of Ireland. Upon receiving ethical approval, we implemented recruitment strategies that included building rapport with community organisations through existing networks, targeting specific organisations with information about our aims, and utilising social media groups for parents.ResultsWe approached 74 organisations of which 17 helped with recruitment. We recruited 86 parents/carers (one male) for 19 focus groups (15 urban/4 rural). Seventy two percent met at the eligibility criteria. Most participants were recruited through organisations (91%), and the remainder on social media (9%). Recruitment barriers included multiple steps, research fatigue, or uncertainty around expectations. Factors such as building rapport, simplifying the recruitment process and being flexible with procedures were facilitators. Despite comprehensive, multi-pronged approaches, the most marginalised parents may not have been reached. Further alternative recruitment strategies are required for recruiting fathers, rural populations, or those without the capacity or opportunity to engage with local services.
Large-scale lipidomic profiling identifies novel potential biomarkers for prion diseases and highlights lipid raft-related pathways
Authors: Kim Yong-Chan , Lee Junbeom , Lee Dae-Weon , Jeong Byung-Hoon 
Published: July 2021

AbstractPrion diseases are transmissible spongiform encephalopathies induced by the abnormally-folded prion protein (PrPSc), which is derived from the normal prion protein (PrPC). Previous studies have reported that lipid rafts play a pivotal role in the conversion of PrPC into PrPSc, and several therapeutic strategies targeting lipids have led to prolonged survival times in prion diseases. In addition, phosphatidylethanolamine, a glycerophospholipid member, accelerated prion disease progression. Although several studies have shown that prion diseases are significantly associated with lipids, lipidomic analyses of prion diseases have not been reported thus far. We intraperitoneally injected phosphate-buffered saline (PBS) or ME7 mouse prions into mice and sacrificed them at different time points (3 and 7 months) post-injection. To detect PrPSc in the mouse brain, we carried out western blotting analysis of the left hemisphere of the brain. To identify potential novel lipid biomarkers, we performed lipid extraction on the right hemisphere of the brain and liquid chromatography mass spectrometry (LC/MS) to analyze the lipidomic profiling between non-infected mice and prion-infected mice. Finally, we analyzed the altered lipid-related pathways by a lipid pathway enrichment analysis (LIPEA). We identified a total of 43 and 75 novel potential biomarkers at 3 and 7 months in prion-infected mice compared to non-infected mice, respectively. Among these novel potential biomarkers, approximately 75% of total lipids are glycerophospholipids. In addition, altered lipids between the non-infected and prion-infected mice were related to sphingolipid, glycerophospholipid and glycosylphosphatidylinositol (GPI)-anchor-related pathways. In the present study, we found novel potential biomarkers and therapeutic targets of prion disease. To the best of our knowledge, this study reports the first large-scale lipidomic profiling in prion diseases.
rpoS-mutation variants are selected in Pseudomonas aeruginosa biofilms under imipenem pressure
Authors: Duan Xiangke , Pan Yanrong , Cai Zhao , Liu Yumei , Zhang Yingdan , Liu Moxiao , Liu Yang , Wang Ke , Zhang Lianhui , Yang Liang 
Published: July 2021

Abstract
Background
Pseudomonas aeruginosa is a notorious opportunistic pathogen causing various types of biofilm-related infections. Biofilm formation is a unique microbial strategy that allows P. aeruginosa to survive adverse conditions such as antibiotic treatment and human immune clearance.

Results
In this study, we experimentally evolved P. aeruginosa PAO1 biofilms for cyclic treatment in the presence of high dose of imipenem, and enriched hyperbiofilm mutants within six cycles in two independent lineages. The competition assay showed that the evolved hyperbiofilm mutants can outcompete the ancestral strain within biofilms but not in planktonic cultures. Whole-genome sequencing analysis revealed the hyperbiofilm phenotype is caused by point mutations in rpoS gene in all independently evolved mutants and the same mutation was found in P. aeruginosa clinical isolates. We further showed that mutation in rpoS gene increased the intracellular c-di-GMP level by turning on the expression of the diguanylate cyclases. Mutation in rpoS increased pyocyanin production and virulence in hyperbiofilm variants.

Conclusion
Here, our study revealed that antibiotic treatment of biofilm-related P. aeruginosa infections might induce a hyperbiofilm phenotype via rpoS mutation, which might partially explain antimicrobial treatment failure of many P. aeruginosa biofilm-related infections.
Malaria: elimination tale from Yunnan Province of China and new challenges for reintroduction
Authors: Yang Heng-Lin , Baloch Zulqarnain , Xu Jian-Wei , Sun Xiao-Dong , Lin Zu-Rui , Zhou Yao-Wu , Zhao Xiao-Tao , Lv Quan , Xu Shi-Yuan , Ding Chun-Li , Chen Qi-Yan , Tian Peng , Dung Kai-Xia , Xia Xue-Shan , Zhou Hong-Ning 
Published: July 2021

Abstract
Background
Eradication of infectious disease is the sanctified public health and sustainable development goal around the world.

Main body
Three antimalarial barriers were developed to control imported malarial cases, and an effective surveillance strategy known as the “1–3–7 approach” was developed to eliminate malaria from the Chinese population. From 2011 to 2019, 5254 confirmed malaria cases were reported and treated in Yunnan Province, China. Among them, 4566 cases were imported from other countries, and 688 cases were indigenous from 2011 to 2016. Since 2017, no new local malarial case has been reported in China. Thus, malaria has been completely eliminated in Yunnan Province. However, malaria is detected in overseas travellers on a regular basis, such as visitors from neighbouring Myanmar.

Conclusion
Hence, the strategies should be further strengthened to maintain a robust public health infrastructure for disease surveillance and vector control programs in border areas. Such programs should be supported technically and financially by the government to avert the possibility of a malarial resurgence in Yunnan Province.

Graphic Abstract
Chew and spit (CHSP) in bariatric patients: a case series
Authors: Aouad Phillip , Stedal Kristin , Walø-Syversen Gro , Hay Phillipa , Lindvall Dahlgren Camilla 
Published: July 2021

Abstract
Background
Studies into the disordered eating behaviour of chew and spit have alluded to several cohorts more likely to engage in the behaviour, one such group being bariatric surgery candidates and patients. Weight-loss surgery candidates have received little to no attention regarding engaging in chew and spit behaviour. Changes in pre- and post- surgery eating pathology related to chew and spit behaviour has yet to be explored and described in academic literature.

Case presentation
The current study reports on three cases of individual women, aged 30, 35, and 62 respectively, who indicated engagement in chew and spit. All three cases underwent bariatric surgery (two underwent gastric bypass, one underwent vertical sleeve gastrectomy). Eating pathology—including chew and spit behaviour, anxiety and depression, and adherence to the Norwegian nutritional guidelines were examined pre-operatively and post-operatively (one and two-year follow-up). At baseline (pre-surgery), two participants reported that they engaged in chew and spit, compared to one patient post-surgery. All three cases reported that they, to at least some extent, adhered to dietary guidelines post-surgery. Subjective bingeing frequency appeared to be relatively low for all three cases, further declining in frequency at one-year follow-up. At baseline, one participant reported clinically significant depression and anxiety, with no clinically significant depression or anxiety reported at follow-ups in participants that chew and spit.

Conclusions
The current study provides a starting point for the exploration of chew and spit as a pathological symptom of disordered eating in bariatric patients. It highlights the need to further explore chew and spit before and after weight-loss surgery.
Downstream effects of polypathology on neurodegeneration of medial temporal lobe subregions
Authors: Wisse L. E. M. , Ravikumar S. , Ittyerah R. , Lim S. , Lane J. , Bedard M. L. , Xie L. , Das S. R. , Schuck T. , Grossman M. , Lee E. B. , Tisdall M. D. , Prabhakaran K. , Detre J. A. , Mizsei G. , Trojanowski J. Q. , Artacho-Pérula E. , de Iñiguez de Onzono Martin M. M. , M. Arroyo-Jiménez M. , Muñoz Lopez M. , Molina Romero F. J. , P. Marcos Rabal M. , Cebada Sánchez S. , Delgado González J. C. , de la Rosa Prieto C. , Córcoles Parada M. , Wolk D. A. , Irwin D. J. , Insausti R. , Yushkevich P. A. 
Published: July 2021

AbstractThe medial temporal lobe (MTL) is a nidus for neurodegenerative pathologies and therefore an important region in which to study polypathology. We investigated associations between neurodegenerative pathologies and the thickness of different MTL subregions measured using high-resolution post-mortem MRI. Tau, TAR DNA-binding protein 43 (TDP-43), amyloid-β and α-synuclein pathology were rated on a scale of 0 (absent)—3 (severe) in the hippocampus and entorhinal cortex (ERC) of 58 individuals with and without neurodegenerative diseases (median age 75.0 years, 60.3% male). Thickness measurements in ERC, Brodmann Area (BA) 35 and 36, parahippocampal cortex, subiculum, cornu ammonis (CA)1 and the stratum radiatum lacunosum moleculare (SRLM) were derived from 0.2 × 0.2 × 0.2 mm3 post-mortem MRI scans of excised MTL specimens from the contralateral hemisphere using a semi-automated approach. Spearman’s rank correlations were performed between neurodegenerative pathologies and thickness, correcting for age, sex and hemisphere, including all four proteinopathies in the model. We found significant associations of (1) TDP-43 with thickness in all subregions (r =  − 0.27 to r =  − 0.46), and (2) tau with BA35 (r =  − 0.31) and SRLM thickness (r =  − 0.33). In amyloid-β and TDP-43 negative cases, we found strong significant associations of tau with ERC (r =  − 0.40), BA35 (r =  − 0.55), subiculum (r =  − 0.42) and CA1 thickness (r =  − 0.47). This unique dataset shows widespread MTL atrophy in relation to TDP-43 pathology and atrophy in regions affected early in Braak stageing and tau pathology. Moreover, the strong association of tau with thickness in early Braak regions in the absence of amyloid-β suggests a role of Primary Age-Related Tauopathy in neurodegeneration.