bluuebunny/crossref_metadata_2025_split huggingface dataset:
Examining area-level variation in service organisation and delivery across the breadth of primary healthcare. Usefulness of measures constructed from routine data
Authors: Butler D. C. , Jorm L. R. , Larkins S. , Humphreys J. , Desborough J. , Korda K. J. 
Published: December 2021

Background
Australia has a universal healthcare system, yet organisation and delivery of primary healthcare (PHC) services varies across local areas. Understanding the nature and extent of this variation is essential to improve quality of care and health equity, but this has been hampered by a lack of suitable measures across the breadth of effective PHC systems. Using a suite of measures constructed at the area-level, this study explored their application in assessing area-level variation in PHC organisation and delivery.

Methods
Routinely collected data from New South Wales, Australia were used to construct 13 small area-level measures of PHC service organisation and delivery that best approximated access (availability, affordability, accommodation) comprehensiveness and coordination. Regression analyses and pairwise Pearson’s correlations were used to examine variation by area, and by remoteness and area disadvantage.

Results
PHC service delivery varied geographically at the small-area level–within cities and more remote locations. Areas in major cities were more accessible (all measures), while in remote areas, services were more comprehensive and coordinated. In disadvantaged areas of major cities, there were fewer GPs (most disadvantaged quintile 0.9[SD 0.1] vs least 1.0[SD 0.2]), services were more affordable (97.4%[1.6] bulk-billed vs 75.7[11.3]), a greater proportion were after-hours (10.3%[3.0] vs 6.2[2.9]) and for chronic disease care (28%[3.4] vs 17.6[8.0]) but fewer for preventive care (50.7%[3.8] had cervical screening vs 62.5[4.9]). Patterns were similar in regional locations, other than disadvantaged areas had less after-hours care (1.3%[0.7] vs 6.1%[3.9]). Measures were positively correlated, except GP supply and affordability in major cities (-0.41, p < .01).

Implications
Application of constructed measures revealed inequity in PHC service delivery amenable to policy intervention. Initiatives should consider the maldistribution of GPs not only by remoteness but also by area disadvantage. Avenues for improvement in disadvantaged areas include preventative care across all regions and after-hours care in regional locations.
Maternal satisfaction with intrapartum care and associated factors among postpartum women at public hospitals of North Shoa Zone Ethiopia
Authors: Silesh Mulualem , Lemma Tesfanesh 
Published: December 2021

Background
Maternal satisfaction is an essential indicator of the quality and the efficiency of the health care systems. At a time when efforts are being made globally to reduce maternal and neonatal mortality and morbidity, assessing maternal satisfaction is essential. There is a dearth of studies on maternal satisfaction with intrapartum care, particularly in the study area. This study aimed to assess maternal satisfaction with intrapartum care and associated factors among postpartum women at public hospitals of North Shoa Zone Ethiopia.

Methods
A facility-based cross-sectional study with a systematic random sampling technique was conducted from May1-30/ 2020. Data were entered into EpiData version 4.6 and analyzed using a statistical package for the social sciences version 25. Bivariate and multivariable logistic regression were employed. In multivariable logistic regression analysis, level of statistical significance was declared at variables with p < 0.05 and the strength of the association was measured by an adjusted odds ratio and 95% confidence interval.

Result
Of the total 394 participants, 111 (28.2%) [95% CI: 23.9, 32.5] of postpartum women were satisfied with the intrapartum care. Place of residence [AOR: 1.934; 95% CI (1.183, 3.162)], planned status of the pregnancy [AOR: 2.245; 95% CI, (1.212, 4.158)], number of antenatal care visit [AOR: 2.389; 95% (1.437, 3.974)] and duration of labour [AOR: 2.463; 95% (1.378, 4.402)] were factors significantly associated with maternal satisfaction with intrapartum care.

Conclusion
The proportion of maternal satisfaction with intrapartum care was low. Therefore, designing strategies to enhance maternal satisfaction by strengthening adherence to antenatal care visits, provision of family planning to prevent unplanned pregnancy, and strict utilization of partograph to prevent prolonged labour and childbirth-related complications are crucial.
Improving oral health in people with severe mental illness (SMI): A systematic review
Authors: Macnamara Alexandra , Mishu Masuma Pervin , Faisal Mehreen Riaz , Islam Mohammed , Peckham Emily 
Published: December 2021

Background
Those with severe mental illness (SMI) are at greater risk of having poor oral health, which can have an impact on daily activities such as eating, socialising and working. There is currently a lack of evidence to suggest which oral health interventions are effective for improving oral health outcomes for people with SMI.

Aims
This systematic review aims to examine the effectiveness of oral health interventions in improving oral health outcomes for those with SMI.

Methods
The review protocol was registered with PROSPERO (ID CRD42020187663). Medline, EMBASE, PsycINFO, AMED, HMIC, CINAHL, Scopus and the Cochrane Library were searched for studies, along with conference proceedings and grey literature sources. Titles and abstracts were dual screened by two reviewers. Two reviewers also independently performed full text screening, data extraction and risk of bias assessments. Due to heterogeneity between studies, a narrative synthesis was undertaken.

Results
In total, 1462 abstracts from the database search and three abstracts from grey literature sources were identified. Following screening, 12 studies were included in the review. Five broad categories of intervention were identified: dental education, motivational interviewing, dental checklist, dietary change and incentives. Despite statistically significant changes in plaque indices and oral health behaviours as a result of interventions using dental education, motivational interviewing and incentives, it is unclear if these changes are clinically significant.

Conclusion
Although some positive results in this review demonstrate that dental education shows promise as an intervention for those with SMI, the quality of evidence was graded as very low to moderate quality. Further research is in this area is required to provide more conclusive evidence.
P014 Postoperative Recurrence in Crohn’s Disease Patients Treated with Adalimumab versus Infliximab: A Systematic Review and Meta-Analysis
Authors: Frankl Luke , Tarakji Ahmad , Akiyama Shintaro , Hennawi Hussam , Levy Alexander , Hamdeh Shadi 
Published: December 2021

BACKGROUND:
Up to 80% of patients with Crohn’s disease (CD) undergo intestinal resection at one point. However, the risk of post-operative recurrence (POR) increases with time, with half of these patients developing recurrence at five years after surgery. Treatment with anti-tumor necrosis factor (anti-TNF) agents has been shown to decrease the risk of clinical and endoscopic recurrence post-operatively. This meta-analysis aims to compare the rate of the two mostly commonly used anti-TNF agents (infliximab (IFX) and adalimumab (ADA)) and their efficacy in maintaining clinical and endoscopic remission in CD patients who were treated with adalimumab versus infliximab after surgery.

METHODS:
A comprehensive search of Medline, EMBASE, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and Scopus was conducted from each database’s inception to May 29th 2021. Comparative studies assessing the efficacy and safety of infliximab and adalimumab for postoperative CD patients were included. Primary outcomes included postoperative clinical and endoscopic remission. Secondary outcome was the risk of adverse events due to anti-TNF agents. Pooled event rates were calculated per person-year of follow-up.

RESULTS:
Four studies with total of 361 CD patients were included in the final analysis. Our meta-analysis showed no statistically significant difference in maintaining clinical and endoscopic remission rates between patients treated with infliximab and those with adalimumab (Pooled incidence rate ratio of 0.75 (95% CI 0.43–1.3), and 0.94 (95% CI 0.71–1.2), respectively) (Figure 1A, 2A). There were low to moderate heterogeneities (I2 = 57.1% for clinical remission and I2 = 0% for endoscopic remission). The funnel plot in each analysis indicated no publication bias, which was supported by Begg’s and Egger’s tests (Figure 1B, 2B). There was also no significant difference in the risk of adverse events between the two groups (RR= 0.56, 95% CI 0.068–4.5) (Figure 3).

CONCLUSION:
Our meta-analysis demonstrated comparable efficacy of infliximab and adalimumab in maintaining post-operative clinical and endoscopic remission in Crohn’s disease, with similar rates of adverse events. Our meta-analysis was limited by the small number of total studies and patients included and the lack of randomized controlled trials.
P022 Biologic Therapy and Therapeutic Drug Monitoring in Patients With Inflammatory Bowel Disease and Primary Sclerosing Cholangitis
Authors: Jain Varun , Behm Brian , Figueroa Esteban 
Published: December 2021

BACKGROUND:
Primary sclerosing cholangitis (PSC) is associated with inflammatory bowel disease (IBD). Patients with concomitant PSC-IBD are at higher risk for IBD-related complications including dysplasia and malignancy, however the typical clinical IBD course is less severe. The aim of this study was to identify the prevalence of biologic use and therapeutic drug monitoring (TDM) in a cohort of PSC-IBD patients.

METHODS:
Retrospective analysis of patients with PSC-IBD on biologic therapy who underwent TDM from Jan. 2018 to Aug. 2020 at the University of Virginia. Demographic data including age, disease duration, and comorbidities were recorded. IBD categorizations were recorded according to the Montreal Classification. Treatment outcomes including therapy changes after TDM were obtained.

RESULTS:
A total of 157 patients with PSC-IBD were identified. Of these, 29 patients (19%) were treated with biologic therapy during the study period. 13 patients underwent reactive TDM due to primary or secondary loss of response and one patient underwent proactive TDM during the study period. Median duration of IBD in this group was 9 years, and the median duration of concomitant PSC-IBD was 5.8 years. 20 TDM tests were obtained in these 14 total patients. Sub-therapeutic drug levels were found in 12 tests among 8 patients, and 3 showed detectable anti-drug antibodies. 8 showed appropriate trough levels. TDM resulted in a change to IBD therapy (i.e., dose escalation, change in biologic therapy used, or addition of IBD medication) in 17 out of 20 tests.

CONCLUSION:
Herein we describe epidemiologic data of biologic use in PSC-IBD patients at an academic center. PSC-IBD classically follows a less severe clinical presentation and course. However, our study demonstrates that a subset of PSC-IBD patients exist which require biologic therapy and follow a more refractory clinical trajectory. In this subset, TDM showed a high incidence of sub-therapeutic trough levels and anti-drug antibodies, leading to a change in therapy in 85% of TDM instances. Larger studies are recommended to better understand this unique subset of PSC-IBD patients.
P044 A Profile of New Start IBD Patients on Multiple Advanced/Biologic Therapies
Authors: John Eric 
Published: December 2021

BACKGROUND:
After analyzing patient chart data from nearly 1,000 recently-initiated biologic/JAK inhibitor inflammatory bowel disease (IBD) patients, it was discovered that 6% are treated with multiple advanced/biologic therapies. This analysis sought to profile those new start patients on a multi-biologic/JAK inhibitor regimen against those treated with a single advanced therapy to determine the type of patient who is typically initiated on more than one advanced/biologic therapy, and why the combination is necessary.

METHODS:
An independent market analytics firm collaborated with US gastroenterologists (n=197) to conduct a retrospective chart review of patients with inflammatory bowel disease (IBD) (n=999) who were started on a biologic agent for the first time. Gastroenterologists submitted patient-level data via a HIPAA-compliant audit form which included both clinical and non-clinical data. The data were collected and analyzed in April-June 2021.

RESULTS:
7% of ulcerative colitis (UC) and 5% of Crohn’s disease (CD) patients are currently treated with more than one biologic/JAK inhibitor. The most common therapy used in combination with another for UC is adalimumab (36%), followed by infliximab brand (18%), and ustekinumab (18%). For CD, the most common combinations involve infliximab brand (35%), followed by vedolizumab (22%), and ustekinumab (13%). The necessity for multiple biologic therapy is clarified when reviewing the IBD patients' comorbidities and medical history. The prevalence of ulcerative proctitis (34% vs. 11%) and gastroduodenal CD (43% vs. 4%) among multi-biologic/JAK inhibitor patients is higher than among those treated with one biologic/JAK inhibitor. Additionally, multi-biologic/JAK inhibitor patients have an increased prevalence of recent bowel perforation (16% vs. 1%) and surgical bowel re-section (10% vs. 3%) compared to those treated with just one advanced therapy. Due to this more severe disease profile, patients treated with more than one advanced/biologic therapy are more likely to report severe impairment in work performance (48% vs. 34%), chronic fatigue comorbidity (23% vs. 5%), more frequent ER visits per year (average= 2.3 vs. 1.1), and more frequent hospitalizations per year (2.0 vs. 0.6).

CONCLUSION:
A profile of new start biologic IBD patients ideal for concomitant advanced therapy emerged when reviewing almost 1,000 physician-reported patient records. These patients are more likely to have had gastroduodenal Crohn’s disease and or recent bowel perforation or re-section. These patients are more likely to report impaired work performance, chronic fatigue, more frequent ER visits and more frequent hospitalizations.
P073 Diagnostic Outcome of Patients With Non-Specific Colitis
Authors: Guzmán-Cárcamo Ana , Navarro Gerrard Christian , Severino Ferreras Indhira , López Goméz Jesús , Cortes Espinosa Tomas , Ramos Gómez Mayra , Paredes Amenabar Carlos , Navarro-Gerrard Megan 
Published: December 2021

BACKGROUND:
Colitis describes inflammation in the colon and is classified into defined diseases: Inflammatory bowel disease (IBD), Microscopic colitis, Ischemic colitis and Infectious colitis. The clinical significance of non-specific colitis is unclear as there are limited analysis which report the issue. Notteghem et al. (1993) showed that of 104 patients with non-specific colitis, 52.3% had another episode of symptoms within 3 years. Of these patients 54% were diagnosed with ulcerative colitis, 33% with Crohn's disease, and 13% remained unclassified, suggesting that non-specific colitis could be undiagnosed IBD. The objective of this analysis is to determine the clinical course of non-specific colitis through colonoscopy and histologic findings.

METHODS:
Retrospective observational study with patients underwent colonoscopies during the period from 2009 to 2019, whose biopsies were reported as non-specific colitis.

RESULTS:
24 patients (18 women and 6 men) with non-specific colitis undergoing follow-up by the Gastroenterology outpatient clinic were included. The most frequent indications for colonoscopy were abdominal pain (43.7%), blood in stools (26.8%), diarrhea (21.6%) and anemia (7.9%). The mean age was 56.5 years. During follow-up, patients had at least 2 colonoscopies and 4 biopsies per colonic segment. In the male population ascending colon cancer was later diagnosed in 16.7%, another 16.7% were diagnosed with nonspecific chronic ulcerative colitis, 33.3% with eosinophilic colitis, and the rest of the patients were diagnosed with non-specific colitis. From the female group, 5.6% had lymphocytic colitis, 5.6% eosinophilic colitis, 5.6% collagenous colitis, 5.6% Crohn's disease, 5.6% mixed irritable bowel syndrome, and the rest of the patients (72%) had biopsy report of non-specific colitis.

CONCLUSIONS:
All patients with a histopathological diagnosis of non-specific colitis underwent a second colonoscopy with biopsy, which resulted in a definitive diagnosis of Crohn's disease in 5.6% of women and Ulcerative Colitis in 16.7% of men. This study comes to show that there is an important subgroup of patients who are underdiagnosed. We suggest that patients with non-specific colitis reported on a histopathology report must continue their follow-up by a specialized ward.
El discurso de las proclamas militares de los golpes de Estado en la Argentina: un análisis estratégico
Authors: Menéndez Salvio Martín 
Published: December 2021

Nos proponemos analizar estratégicamente una serie discursiva compuesta por las proclamas militares de los golpes de estado que durante el siglo XX en la República Argentina. La reconstrucción de estos dispositivos estratégicos explica el funcionamiento discursivo y permite justificar la interpretación que se hace de los discursos que forman la serie. La serie está formada por los siguientes discursos: el del 6 de septiembre de 1930 discurso inaugural del discurso de golpe de estado, la proclama del 4 de junio de 1943 hecha por el Grupo de Oficiales Unidos (GOU), el del 16 de septiembre de 1955 (Revolución Libertadora), el del 28 de junio de 1966 (Revolución Argentina) y el del 24 de marzo de 1976 (Proceso de Reorganización Nacional). Analizaremos la estrategia Justificar la ruptura del orden constitucional a partir de tres movimientos centrales que la conforman: i) Ubicación del sujeto discursivo; ii) Uso de la paradoja o contradicción explícita y, iii) Invocación.
Restriction for general linear groups: The local non-tempered Gan–Gross–Prasad conjecture (non-Archimedean case)
Authors: Chan Kei Yuen 
Published: December 2021

Abstract
We prove a local Gan–Gross–Prasad conjecture on predicting the branching law for the non-tempered representations of general linear groups in the case of non-Archimedean fields. We also generalize to Bessel and Fourier–Jacobi models and study a possible generalization to Ext-branching laws.
Finanzwende und Zivilgesellschaft
Authors: Hülsdünker Timo , Hoffart Franziska M. 
Published: December 2021

Zusammenfassung
Obwohl ein breiter wissenschaftlicher Konsens bezüglich des anthropogenen Klimawandels besteht und seine Folgen immer stärker erforscht und spürbar sind, verschärft sich die Klima- und Biodiversitätskrise zusehends. In diesem Artikel erläutern wir, wieso es ein neues Wirtschaftsnarrativ für die Bekämpfung der Klima- und Biodiversitätskrise braucht, was eine Finanzwende zur Folge hat und warum diese nur gesamtgesellschaftlich gelingen kann. Zudem diskutieren wir die Grundlage und Herausforderungen, die durch die nachhaltige Transformation für Unternehmen entstehen, und geben konkrete Impulse für 1,5-Grad-kompatible Finanzinstitute. Es wird deutlich, dass Finanzinstitute eine zentrale Rolle in der sozial-ökologischen Transformation zu einer lebenswerten 1,5-Grad-kompatiblen Zukunft spielen und Geld als gesellschaftliches Gestaltungsmittel eine positive Wirkung entfalten kann, wenn es zweck- und nicht zielorientiert eingesetzt wird.
Whistleblowing im Finanzsektor: eine Zwischenbilanz mit Ausblick
Authors: Oelrich Sebastian 
Published: December 2021

Zusammenfassung
Dieser Artikel thematisiert Whistleblowing als ein wichtiges Instrument einer transparenten und fairen Finanzwirtschaft. Dabei werden bereits bestehende Mechanismen und Regelungen zum internen und externen Whistleblowing in Deutschland insbesondere im Finanzsektor hervorgehoben und mit anderen Bereichen und Ländern verglichen. Es werden zudem Limitationen und Best Practices sowie die Auswirkung der aktuellen europäischen Richtlinie zum Hinweisgeberschutz diskutiert. Die Arbeit schließt mit einem Ausblick sowie Forderungen zur Ausweitung und Ergänzung bestehender Whistleblowing-Regelungen, durch die der Finanzplatz Deutschland gestärkt werden kann.
Effect of Auraptene on angiogenesis in Xenograft model of breast cancer
Authors: Shiran Mohammad Reza , Mahmoudian Elham , Ajami Abolghasem , Hosseini Seyed Mostafa , Khojasteh Ayjamal , Rashidi Mohsen , Maroufi Nazila Fathi 
Published: December 2021

Abstract

Objectives
Angiogenesis is the most important challenge in breast cancer treatment. Recently, scientists become interesting in rare natural products and intensive researches was performed to identify their pharmacological profile. Auraptene shows helpful effects such as cancer chemo-preventive, anti-inflammatory, anti-oxidant, immuno-modulatory. In this regard, we investigated the anti-angiogenesis effect of Auraptene in in-vitro and in-vivo model of breast cancer.

Methods
In this study, 4T, MDA-MB-231 and HUVEC cell lines were used. The proliferation study was done by MTT assay. For tube formation assay, 250 matrigel, 1 × 104 HUVEC treated with Auraptene, 20 ng/mL EGF, 20 ng/mL bFGF and 20 ng/mL VEGF were used. Gene expression of important gene related to angiogenesis in animal model of breast cancer was investigated by Real-time PCR. Protein expression of VCAM-1 and TNFR-1 gene related to angiogenesis in animal model of breast cancer was investigated by western-blot.

Results
Auraptene treatment led to reduction in cell viability of MDA-MB-231 in a concentration-dependent manner. Also, we observed change in the number of tubes or branches formed by cells incubated with 40 and 80 μM Auraptene. Auraptene effect the gene expression of important gene related to angiogenesis (VEGF, VEGFR2, COX2, IFNɣ). Moreover, the western blot data exhibited that Auraptene effect the protein expression of VCAM-1 and TNFR-1.

Conclusions
Overall, this study shows that Auraptene significantly suppressed angiogenesis via down-regulation of VEGF, VEGFR2, VCAM-1, TNFR-1, COX-2 and up-regulation of IFNγ.