bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research on Current Curative Expenditure and Influencing Factors Among Cardiovascular and Cerebrovascular Diseases Based on “System of Health Accounts 2011”
Authors: Zhang Liwen , Li Xiaoju , Mao Lu , Yang Jielin 
Published: September 2021

Abstract
Background: This study aims to research the total current curative expenditure (CCE) of cardiovascular and cerebrovascular diseases (CVDs) and their influencing factors in Xinjiang, China. Methods: Through multistage stratified cluster sampling, the sample information of patients with CVDs in Xinjiang, in 2017, was collected. Under the framework of “System of Health Accounts 2011,” the top-down allocation method was used to calculate the CCE of CVDs. Multiple linear regression was used to analyze the influencing factors. Results: The CCE of CVDs in Xinjiang was 10.574 billion yuan; 86.81% of the CCE was spent in hospitals, of which 67.22% went to general hospitals. Coronary heart disease, hypertension, and cerebral infarction were the top three diseases among the treatment cost of CVDs, accounting for 74.20% of the total treatment cost. The CCE of older adults aged 65 years and above accounted for 43.51%. The main factors affecting the hospitalization cost were length of stay, grade of the medical institution, operation, age, payment method, and gender. Conclusions: CVDs consume numerous health funds in Xinjiang; prevention and control work focus on older adults. Further, the flow of treatment cost institutions is unreasonable; thus, the role of primary medical institutions in the prevention and treatment of chronic diseases should be strengthened. Reducing the length of hospital stay can effectively control the CCE.
Scaling-up From Leaf to Whole-plant Level for Water Use Efficiency Estimates Based on Stomatal and Mesophyll Behavior
Authors: Zhang Yonge , Jia Guodong , Lihua Chen , Yu Xinxiao 
Published: September 2021

Abstract
AimsPrediction of whole-plant short-term water use efficiency (WUEs,P) is essential to indicate plant performance and facilitates comparison across different temporal and spatial scales. Here, the isotope model for WUEs,P was scaled-up from the leaf to the whole-plant level.MethodsFor WUEs,P modelling, leaf gas exchange information, plant respiration and “unproductive” water loss were taken into account. Specifically, in shaping the expression of the WUEs,P, we emphasized the role of both stomatal (gsw) and mesophyll conductance (gm). ResultsThe verification showed that estimates of gsw from the coupled photosynthesis (Pn,L)-gsw model accounting for the effect of soil water stress slightly outperformed the model neglecting the soil water status effect, and the established coupled Pn,L-gm model proved more effective in the estimation of gm than the previously proposed model. Introducing the two diffusion control functions into the whole-plant model, the developed model for WUEs,P effectively captured its response pattern to different CO2 concentration (Ca) and soil water content (SWC) conditions. ConclusionsOverall, this study confirmed that accurate estimation of WUEs,P requires an improved predictive accuracy of gsw and gm. These results have important implications for predicting how plants respond to climate change.
Job Satisfaction Among Syrian Healthcare Workers in Refugee Health Centers in Turkey
Authors: Zikusooka Monica , Elci Omur Cinar , Özdemir Habibe 
Published: September 2021

Abstract
Background: Achieving universal health coverage is subject to the availability, accessibility, acceptability and quality of health workers. Countries that host refugees and migrants, like Turkey, must strengthen the capacity of their health systems to increase access to services, especially for refugees and migrants. The Turkish Ministry of Health adapted Syrian refugee healthcare workers in the healthcare services to boost Syrian refugees' access to healthcare. This study aimed to assess job satisfaction and the factors influencing job satisfaction among refugee physicians and nurses working in Refugee Health Centers (RHCs) in Turkey.Methods: A self-administered, cross-sectional survey targeted all Syrian physicians and nurses working in RHCs across Turkey. The short-form Minnesota Satisfaction Questionnaire(MSQ) was used to assess job satisfaction. In total, 555 nurse/midwives and 336 physicians responded, yielding a total response rate of 56.5%. Descriptive analyses and linear regression tests were conducted to determine the level of job satisfaction and to analyze determinant factors. Results: Nurses/midwives reported the highest level of general job satisfaction, followed by specialist physicians and general physicians. Physicians who had worked as specialists in Syria but were now working as general physicians in Turkey had the lowest job satisfaction levels. Multiple regression analysis showed that professional status in Turkey, income, teamwork and team management were significantly associated with job satisfaction.Conclusions: To maintain a high level of job satisfaction in refugee healthcare workers, human resources management should consider matching job placements with training specialization and support good leadership and good teamwork. Remuneration that accounts for the cost of living and non-financial incentives could also play a significant role in job satisfaction.
Use, Usability, And Impact of A Tool To Support Conversations About End-of-Life Preferences In Residential Elder Care – A Qualitative Study of Staff Experiences
Authors: Johansson Therese , Tishelman Carol , Eriksson Lars E. , Cohen Joachim , Goliath Ida 
Published: September 2021

Abstract
Background: If EOL care is to be person-centred and value-concordant, proactive conversations about individual preferences between residents, relatives, and staff are required. Nevertheless, the prevalence of conversations about preferences for EOL care is still low in residential care homes (RCHs), often relating to staff’s perceived lack of skills and confidence. Conversation tools may be useful to support staff in facilitating EOL conversations, but often focus more on documenting treatment priorities than on exploring underlying values and reasoning for preferences. In this study, we use the DöBra cards, the Swedish version of the GoWish cards, to support discussions about EOL care values and preferences in RCHs, and explore staff perspectives on use, usability, and impact. Methods: This qualitative study was based on data generated from two participatory action research processes in which RCH staff tested and evaluated use of DöBra cards in EOL conversations. Data comprise 6 interviews and 8 group meetings with a total of 13 participants from 7 elder care facilities. Qualitative content analysis was performed to identify key concepts in relation to use, usability, and impact of the DöBra cards with residents and/or relatives.Results: Based on participants’ experiences of using the DöBra cards as an EOL conversation tool in RCHs, we identified three main categories in relation to its usefulness. Outcomes of using the cards (1) included the outlining of content of conversations and supporting connection and development of rapport. Perceived impact (2) related to enabling openings for future communication and aligning care goals between stakeholders. Use and usability of the cards (3) were influenced by supporting and limiting factors on the personal and contextual level.Conclusions: This study demonstrates how the DöBra cards was found to be useful by staff for facilitating conversations about EOL values, influencing both the content of discussion and interactions between those present. The tool encouraged reflection and interaction, which staff perceived as potentially helpful in building preparedness for future care-decision making. The combination of providing a shared framework and being adaptable in use appeared to be key features for the DöBra cards usability in the RCH setting.
Technical Efficiency of Kenyan Smallholder Dairy Farmers in Different Agro-ecological Regions
Authors: Ngeno Vincent , Chumo Chepchumba 
Published: September 2021

Abstract
We employ stochastic meta-frontier and region-specific frontiers based on the “true” random effect framework to examine technical efficiencies, technology gaps and meta-frontier technical efficiency of Kenyan smallholder dairy farmers in different agro-ecological zones. The empirical analysis is based on comprehensive three-wave household level panel data from across three agro-ecological zones in Kenya. Results show variations in efficiency measures and that smallholder milk production is characterized by increasing returns scale across all agro-ecological zones. The results indicate that the milk output of smallholder dairy farmers from all the agro-ecological zones lags behind their potential with the technology available and the prevailing enviromnetal conditions in their agro-ecological zones. We also, find that there exists a significant technology gap in dairy production across the agro-ecological zones in Kenya. These findings generate important policy implication for achieving increased technical efficiency and reduce the technology gap in smallholder dairy production.
Effect of Changes in Dietary Net Energy Concentration on Growth Performance, Fat Deposition, Skatole Production, and Intestinal Morphology in Immunocastrated Male Pigs
Authors: Lukač Nina Batorek , Čandek-Potokar Marjeta , Škrlep Martin , Kubale Valentina , Labussière Etienne 
Published: September 2021

Abstract
Background: Nutritional requirements of heavy immunocastrated pigs (IM) and thus the appropriate feeding strategies have not been determined. Methods: The effects of a reduced net energy (NE) diet, achieved by including up to 10% dietary fiber were studied in 41 IM pigs fed ad libitum with an extended period between immunization and slaughter (i.e. 8 weeks). Traits assessed included growth performance (before and after immunization at 112 days of age), fat deposition, intestinal skatole and indole production, intestinal morphology, and cell proliferation. Results: From 84 days of age, IM pigs were fed diets with low, medium, or high NE content (LNE, MNE, and HNE diets; with 8.5, 9.3, and 10.0 MJ NE/kg). There was no effect (P > 0.10) of feed NE concentration on average daily gain or the ratio of BW gain to NE intake in any of the periods studied. However, in the period from 143 to 170 days of age, there was a tendency for a higher NE intake (P = 0.08) in pigs fed the HNE diet along with higher (P < 0.01) backfat gain. Dietary treatment affected carcass composition as lower backfat thickness (P = 0.01) and lower area of fat over the longissimus muscle (P = 0.05) were observed in LNE and MNE pigs. In addition, higher lean meat content (P = 0.04) was observed in LNE pigs. Reducing the NE of the diet with fiber addition resulted in lower indole production in the ascending colon (P < 0.01), and higher skatole production (P < 0.01) in the cecum. Greater villi area, width, height and perimeter, crypt depth, and thickness of the intestinal mucosa in the jejunum, ileum, ascending colon, and descending colon were found for the LNE group (P < 0.01) than for the HNE group, while the MNE group was intermediate. Cell proliferation was not affected by dietary treatment (P > 0.05). Conclusion: The present results show that despite improved absorptive capacity (indicated by histomorphological changes in the intestinal mucosa), a reduction in dietary NE concentration reduces lipid deposition, without affecting performance or energy efficiency in IM pigs.
Reef Larval Recruitment in Response to Seascape Dynamics in the SW Atlantic
Authors: Mazzuco Ana Carolina Azevedo , Bernardino Angelo Fraga 
Published: September 2021

Abstract
Advances in satellite observation have improved our capacity to track changes in the ocean and seascapes with numerous ecological and conservation applications, but yet under explored for coastal ecology. In this study, we assessed dynamics in the Seascape Pelagic Habitat Classification, a satellite remote-sensing product developed by NOAA to monitor biodiversity globally, and invertebrate larval recruitment in order to identify and predict changes in coastal benthic assemblages at tropical reefs in the SW Atlantic. Our results revealed that pelagic Seascapes correlated with monthly and seasonal variations in recruitment rates and assemblage composition. Recruitment was strongly influenced by subtropical Seascapes and was reduced during warm, blooms, and high-nutrient waters, likely to affect reef communities in the long term. Modeling indicate that Seascapes may be more efficient than temperature in predicting benthic larval dynamics. Based on historical Seascape patterns, we identified seven events that may have impacted benthic recruitment in this region in the last decades, which not surprisingly, coincided with consistent global heatwaves. These findings provide new insights into the application of novel satellite remote-sensing Seascape categorizations in benthic ecology and evidenced how reef larval supply in the SW Atlantic could be impacted by recent and future ocean changes.
Predicting the Perception of Dental Pain Based on Pain Anxiety, Dental Anxiety and Mental Pain in an Iranian Sample: Emphasizing the Type of Patient Complaint
Authors: taheri Amir abbas , parvizifard Ali akbar , Reisi Sajjad Raeesi , Jafari Mahsa , heshmati Khatereh , Foroughi Aliakbar , Eivazi Masoome 
Published: September 2021

Abstract
Background: dental pain is one of the most common complaints related to dentistry services. Studies indicate that in addition to the damage to the nerves of teeth, psychological factors affect the perception of pain. This study aims to investigate the psychological factors which influence precepting tooth pain. Moreover, another purpose of the current study is to investigate the impact of some services such as tooth restoration and a root canal on the psychological variables. Methods: The research design was a cross-sectional study by convenience sampling method. The participants were 328 patients who consulted the dentistry clinics in Kermanshah city in 2020-20201. The used instruments for this study were the Questionnaires of Pain Anxiety (PASS-20), Dental Anxiety (DAI), Mental Pain (OMMP), and Pain Perception (SF-MPQ-2). Finally, the data after being collected were entered into SPSS version 24 and were analyzed using multiple regression analysis. Results: According to the results of the Pearson correlation coefficient, precepting pain had a significant relationship (P=.001) with dental anxiety (r=0.38), pain anxiety (r=0.45), and mental pain (r=0.25). Based on the results of simultaneous multiple regression analysis (Enter), dental anxiety variables (β =.266), pain anxiety (β =.356), and mental pain (β =.139) were the significant predictors of precepting pain (P<0.05). Moreover, in terms of dental anxiety, there was a significant difference between the patients who consult dentistry clinics for root canal services and those whose purposes were receiving other services (P<.001). Conclusion: According to the findings of this study, it can be concluded that psychological factors such as dental anxiety, pain anxiety, and mental pain affect precepting dental pain. Further, the kind of received services influences the psychological factors related to dentistry services.
Hyperacute Carotid Artery Occlusion with Insufficient Collateral Flow: A Case Report Illustrating a Largely Ignored Life-Threatening Traumatic Cerebrovascular Injury
Authors: Yang Pengfei , Tang Haishuang , Li He , Zhao Kaijun , Zhang Hongjian , Zhao Rui , Li Qiang , Xu Yi , Huang Qinghai , Liu Jianmin 
Published: September 2021

Abstract
Background: Traumatic cerebrovascular injuries (TCI) are rare diseases, with the incidence of 0.18%-1.5% among trauma patients. Among TCI, ischemic TCI is more likely to be ignored when compared with hemorrhagic TCI. However severe ischemic TCI such as acute total occlusion of carotid artery may also be life-threatening especially when without sufficient collateral flow.Case presentation: We report an 18-year-old male patient in cardiopulmonary arrest was transported to our hospital 13 minutes after falling from a 60-feet tall building. After physical examination, an acute right internal carotid arteries (ICA) occlusion was suspected and be further confirmed by digital subtraction angiography (DSA) examination. Subsequent angiograms showed bilateral traumatic dissections of the ICA with complete occlusion of the right ICA just distal to the carotid bifurcation, and severe narrowing of the left ICA. Two covered stents were implanted to reconstruct bilateral ICAs followed by proximal occlusion of ruptured ECA branches using coils. The patient’s blood pressure gradually improved after the procedure. Dual antiplatelet therapy was initiated on the second day. Six-month Follow-up CTAs indicated that bilateral ICAs were well reconstructed, and the patient had a mRS score of 1 at six-month follow-up. Conclusion: TCI may achieve very good clinical outcome if they were diagnosed and properly treated via timely endovascular intervention.
Generation and characterisation of isolated attosecond pulses at 100 kHz repetition rate
Authors: Witting Tobias , Osolodkov Mikhail , Schell Felix , Morales Felipe , Patchkovskii Serguei , Šušnjar Peter Peter , Cavalcante Fabio , Menoni Carmen , Schulz Claus , Furch Federico , Vrakking Marc 
Published: September 2021

Abstract
The generation of coherent light pulses in the extreme ultraviolet
(XUV) spectral region with attosecond pulse durations constitutes the
foundation of the field of attosecond science [1]. Twenty years
after the first demonstration of isolated attosecond pulses [2], they
continue to be a unique tool enabling the observation and control of
electron dynamics in atoms, molecules and solids [3, 4]. It has long
been identified that an increase in the repetition rate of attosecond
light sources is necessary for many applications in atomic and
molecular physics [5, 6], surface science [7], and imaging
[8]. Although high harmonic generation (HHG) at repetition rates
exceeding 100 kHz, showing a continuum in the cut-off region of the
XUV spectrum was already demonstrated in 2013 [9], the number of
photons per pulse was insufficient to perform pulse characterisation
via attosecond streaking [10], let alone to perform a pump-probe
experiment. Here we report on the generation and full characterisation
of XUV attosecond pulses via HHG driven by near-single-cycle pulses at
a repetition rate of 100 kHz. The high number of 106 XUV photons per
pulse on target enables attosecond electron streaking experiments
through which the XUV pulses are determined to consist of a dominant
single attosecond pulse. These results open the door for attosecond
pump-probe spectroscopy studies at a repetition rate one or two
orders of magnitude above current implementations.
Efficient 3-hydroxypropionic acid Production by Acetobacter sp. CIP 58.66 through a Feeding Strategy based on pH Control
Authors: DE FOUCHÉCOUR Florence , LEMARCHAND Anaïs , SPINNLER Henry-Éric , SAULOU-BÉRION Claire 
Published: September 2021

Abstract
Acetic acid bacteria (AAB) can selectively oxidize diols into their corresponding hydroxyacids. Notably, they can convert 1,3-propanediol (1,3-PDO) into 3-hydroxypropionic acid (3-HP), which is a promising building-block. Until now, 3-HP production with AAB is carried out in batch and using resting cells at high cell densities (up to 10 g L− 1 of cell dry weight). This approach is likely limited by detrimental accumulation of the intermediate 3-hydroxypropanal (3-HPA). Herein, we investigate an alternative implementation that allows highly efficient 3-HP production with lower cell densities of growing cells and that prevents 3-HPA accumulation. First, growth and 3-HP production of Acetobacter sp. CIP 58.66 were characterized with 1,3-PDO or glycerol as growth substrate. The strain was then implemented in a bioreactor, during a sequential process where it was first cultivated on glycerol, then the precursor 1,3-PDO was continuously supplied at a varying rate, easily controlled by the pH control. Different pH set points were tested (5.0, 4.5, and 4.0). This approach used the natural resistance of acetic acid bacteria to acidic conditions. Surprisingly, when pH was controlled at 5.0, the performances achieved in terms of titer (69.76 g3 − HP L− 1), mean productivity (2.80 g3 − HP L− 1 h− 1), and molar yield (1.02 mol3 − HP mol− 11,3−PDO) were comparable to results obtained with genetically improved strains at neutral pH. The present results were obtained with comparatively lower cell densities (from 0.88 to 2.08 g L− 1) than previously reported. This feeding strategy could be well-suited for future scale-up, since lower cell densities imply lower process costs and energy needs.
Exploring Polygenic Contributors to Subgroups of Comorbid Conditions in Atism Spectrum Disorder
Authors: Klein Louis , D'Urso Shannon , Eapen Valsamma , Hwang Liang-Dar , Lin Ping-I 
Published: September 2021

Abstract
Background: Individuals with autism spectrum disorder (ASD) have heterogeneous comorbid conditions. This study examined whether comorbid conditions in ASD are associated with polygenic risk scores (PRS) of ASD or PRS of comorbid conditions in non-ASD specific populations. Genome-wide single nucleotide polymorphism (SNP) data were obtained from 1,386 patients with ASD from the Autism Genetic Resource Exchange (AGRE) study. After excluding individuals with missing clinical information concerning comorbid conditions, a total of 707 patients were included in the study.

Methods: A total of 18 subgroups of comorbid conditions (’topics’) were identified using a machine learning algorithm, topic modeling. PRS for ASD were computed using a genome-wide association meta-analysis of 18,381 cases and 27,969 controls.

Results: From these 18 topics, Topic 6 (over-represented by allergies) ( p = 1.72x10 − 3 ) and Topic 17 (over-represented by sensory processing issues such as low pain tolerance) ( p = .037) were associated with PRS of ASD. For associated topics, we further assessed their associations with PRS of their corresponding comorbid conditions based on non-ASD specific populations. However, these two topics were not associated with the PRS of allergies and chronic pain disorder, respectively.

Limitations: Characteristics of the present AGRE sample and those samples used in the original GWAS for ASD, allergies, and chronic pain disorder, may differ due to significant clinical heterogeneity that exists in the ASD population. Additionally, the AGRE sample may be underpowered and therefore insensitive to weak PRS associations due to low relatively small sample size.

Conclusions: Findings imply that susceptibility genes of ASD may contribute more to the occurrence of allergies and sensory processing issues in individuals with ASD, compared with the susceptibility genes for their corresponding phenotypes. Since these comorbid conditions (i.e., allergies and pain sensation issues) cannot be attributable to the corresponding comorbidity-specific biological factors in non-ASD individuals, clinical management for these comorbid conditions may still depend on treatments for core symptoms of ASD.