bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of Growth in Prescription Drug Spending Using 2010–2019 Health Insurance Claims Data
Authors: Lee HyeYeong , Park Dahye , Kim Dong-Sook 
Published: May 2021

Background: Despite policies to manage prescription drug spending and ensure accessibility, prescription drug spending has continued to increase in South Korea. Using nationwide claims data, this study analyzed trends in total pharmaceutical expenditures and pharmaceutical expenditures by drug classification.Methods: We conducted a retrospective population-based study using the Korean National Health Insurance claims database from January 2010 through December 2019. Pharmaceuticals were categorized as new drugs, continued drugs, and abandoned drugs. Prescription drug spending was calculated using the components of price and quantity for individual products in successive two-year periods, to obviate the need to consider changes over time.Results: Total pharmaceutical expenditures increased by 54.2% from 2010 to 2019 (from USD 11.3 billion to USD 17.4 billion). The average annual growth rate was 4.9% overall (the 4% rate for continued drugs was decomposed into −3.5% for the price of drugs, 8.0% for the quantity of drugs, and −0.5% for mixed effects, a measure of changes in drug treatment patterns). The trends were generally consistent. Particularly sharp increases in expenditures were found for groups L (antineoplastic and immunomodulating agents), C (cardiovascular system drugs), and A (alimentary tract and metabolism drugs).Conclusions: Since increased prescription drug spending was primarily driven by an increase in the quantity of drugs used, consumer-focused policies to reduce drug use are necessary.
Acute Stress Response Profiles in Health Workers Facing SARS-CoV-2
Authors: Moderato Luca , Lazzeroni Davide , Oppo Annalisa , Dell’Orco Francesco , Moderato Paolo , Presti Giovambattista 
Published: May 2021

ObjectiveThe study is an explorative investigation aimed to assess the differences in acute stress response patterns of health workers facing coronavirus disease 2019 (COVID-19) during Italy’s first lockdown.MethodsA cross-sectional investigation using convenience sampling method was conducted in Italy during April 2020. Eight hundred fifty-eight health workers participated in the research filling out self-report measures including Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder (GAD-7), Insomnia Severity Index (ISI), and Impact of Event Scale–Revised (IES-R).ResultsModerate/severe depression was found in 28.9% (95% CI, 25.8–32.04), moderate/severe anxiety in 55.4% (95% CI, 51.9–58.8), insomnia in 15% (95% CI, 12.5–17.5), and distress in 52.5% (95% CI, 48.5%–56.6) of participants. The 3% of health workers reported frequent suicidal thoughts. Female sex, working for &gt;15 h/week in a COVID-19 unit, and living apart from family were associated with a significantly higher risk of distress, anxiety, insomnia, depression, and functional impairment. Four profiles were identified on the basis of psychopathological measures: Profile_0 included 44% (N= 270); Profile_1, 25.6% (N= 157); Profile_2, 19.1% (N= 117); and Profile_3, 11.3% (N= 69) of participants. Results showed a significant effect for Profiles X IES-R (η2= 0.079;f= 0.29), indicating that in all profiles, except for Profile_0, avoidance scale is lower than hyperarousal and intrusion symptoms scales of the IES-R. This characteristic could be a probable index of the control exerted by the responders to not fly away from their job.ConclusionThe identification of specific profiles could help psychiatrists and emergency psychologists to build specific interventions in terms of both primary and secondary prevention to face future waves of the COVID-19 outbreak.
Effects of Training Programs on Decision-Making in Youth Team Sports Players: A Systematic Review and Meta-Analysis
Authors: Silva Ana Filipa , Ramirez-Campillo Rodrigo , Sarmento Hugo , Afonso José , Clemente Filipe Manuel 
Published: May 2021

BackgroundThe use of dedicated training programs for improving decision-making (DM) in team sports players has grown in the last several years. Approaches such as imagery training, video-based training, or game-based drills are some of the interventions used in youth players in order to improve DM. However, no systematic reviews or meta-analyses have been conducted to summarize the main evidence regarding the effects of these programs on the players and identify the magnitude of the effects compared to control groups.ObjectiveThis systematic review (with meta-analysis) was conducted to assess the effects of training programs on the DM of youth team sports players.Data SourcesThe data sources utilized were PubMed, PsycINFO, Scopus, SPORTDiscus, and Web of Science.Study eligibility criteriaThe criteria included the following: (i) youth (≤ 18 years old) team sports players with no restriction on sex or competitive level; (ii) players subjected to training programs to develop DM; (iii) control groups; (iv) pre–post outcomes related to tactical behavior, technical execution, reaction, and decision time; and (v) controlled trials.ResultsThe database search initially identified 2497 titles. From these, six articles were eligible for the systematic review and meta-analysis. The results showed a significant beneficial effect of DM interventions on tactical behavior (ES = 1.12;p= 0.035;I2= 80.0%; Egger’s testp= 0.066), whereas no significant effect of DM interventions on technical execution was found (ES = 0.74;p= 0.180;I2= 69.1%; Egger’s testp= 0.873).ConclusionThe DM interventions were significantly effective in improving tactical behavior in youth team sports players independently from the number of sessions to which players were exposed. In addition, DM interventions were significantly effective in improving technical execution. However, the results should be carefully interpreted due to the heterogeneity of the articles’ overall methodological quality. Future DM interventions should consider using combined approaches that allow players to develop both tactical behavior and technical execution.
Detecting Suicide and Self-Harm Discussions Among Opioid Substance Users on Instagram Using Machine Learning
Authors: Purushothaman Vidya , Li Jiawei , Mackey Tim K. 
Published: May 2021

Background: Suicide and substance use disorder (SUD) pose serious public health challenges among young adults in the United States. Increasing social media use among these populations can be leveraged as an alternative method to detect characteristics of suicide-related topics and behavior among substance users.Objective: To detect and characterize suicide and self-harm related conversations co-occurring with SUD posts and comments on the popular social media platform Instagram.Methods: This study used big data and machine learning approaches to collect and classify Instagram posts containing 632 controlled substance-related hashtags. Posts were first classified for online drug diversion topics and then filtered to detect suicide and mental health discussions. Posts and comments were then manually annotated for SUD and mental health co-occurring themes. Associations between these characteristics were tested using the Chi-square test.Results: We detected 719 Instagram posts/comments that included user-generated discussions about suicide, substance use and/or mental health. Posts self-reporting SUD and mental health topics were also more likely to discuss suicide compared to those that did not discuss SUD and mental health topics, respectively (p &lt; 0.001). Major themes observed included concurrent discussions of suicide ideation and attempts and low self-esteem.Conclusions: Our study results provide preliminary evidence of social media discussions about suicide and mental health among those with SUD. This co-occurrence represents a key health risk factor on a platform heavily utilized by young adults. Further studies are required to analyze specific patterns of suicide and self-harm ideations for the purposes of designing future suicide prevention campaigns through digital channels.
Performing Through Privatization: An Ecological Natural Experiment of the Impact of the Swedish Free Choice Reform on Ambulatory Care Sensitive Conditions
Authors: Mosquera Paola A. , San Sebastian Miguel , Burström Bo , Hurtig Anna-Karin , Gustafsson Per E. 
Published: May 2021

Background: In 2010, Sweden opened up for establishment of privately owned primary health care providers, as part of a national Free Choice in Primary Health Care reform. The reform has been highly debated, and evidence on its effects is scarce. The present study therefore sought to evaluate whether the reform have impacted on primary health care service performance.Methods: This ecological register-based study used a natural experimental approach through an interrupted time series design. Data comprised the total adult population of the 21 counties of Sweden 2001–2009 (pre-intervention period) and 2010–2016 (post-intervention period). Hospitalizations and emergency department visits for ambulatory care sensitive conditions (ACSC) were used as indicators of primary health care performance. Segmented regression analysis was used to assess the effects of the reform, in Sweden as a whole, as well as compared between counties grouped by (i) change in private provision pre- to post reform; (ii) the timing of the implementation; and (iii) sustained presence of private providers both pre- and post-reform.Results: The results suggest that, following the introduction of the reform in Sweden as a whole, the trends in total hospitalizations rates were slowed down by 1.0% albeit acute emergency visits increased 1.1% more rapidly after the introduction of the reform. However, we found no evidence of more beneficial effects in counties where the reform had been implemented more ambitiously, specifically those with a larger increase in private primary care providers, or where the reform was introduced early and thus had longer time effects to emerge. Lastly, counties with a sustained high presence of private primary care providers displayed the least favorable development when it comes to ACSC.Conclusion: Taken together, the present study does not support that the Swedish Free Choice reform has improved performance of the primary care delivery system in Sweden, and suggests that high degree of private provision may involve worse performance and higher care burden for specialized health care. Further evaluations of the consequences of the reform are dire needed to provide a comprehensive picture of its intended and unintended impact on health care provision, delivery and results.
Normal Gestational Weight Gain Protects From Large-for-Gestational-Age Birth Among Women With Obesity and Gestational Diabetes
Authors: Mustaniemi Sanna , Nikkinen Hilkka , Bloigu Aini , Pouta Anneli , Kaaja Risto , Eriksson Johan G. , Laivuori Hannele , Gissler Mika , Kajantie Eero , Vääräsmäki Marja 
Published: May 2021

Background: Pre-pregnancy obesity, excess gestational weight gain (GWG), and gestational diabetes (GDM) increase fetal growth. Our aim was to assess whether normal GWG is associated with lower risk for a large-for-gestational-age (LGA; over the 90th percentile of birth weight for sex and gestational age) infant and lower birth weight standard deviation (SD) score in the presence of GDM and maternal obesity.Methods: This multicenter case-control study is part of the Finnish Gestational Diabetes (FinnGeDi) Study and includes singleton pregnancies of 1,055 women with GDM and 1,032 non-diabetic controls. Women were divided into 12 subgroups according to their GDM status, pre-pregnancy body mass index (BMI; kg/m2), and GWG. Non-diabetic women with normal BMI and normal GWG (according to Institute of Medicine recommendations) served as a reference group.Results: The prevalence of LGA birth was 12.2% among women with GDM and 6.2% among non-diabetic women (p &lt; 0.001). Among all women, normal GWG was associated with lower odds of LGA [odds ratio (OR) 0.57, 95% CI: 0.41–0.78]. Among women with both obesity and GDM, the odds for giving birth to a LGA infant was 2.25-fold (95% CI: 1.04–4.85) among those with normal GWG and 7.63-fold (95% CI: 4.25–13.7) among those with excess GWG compared with the reference group. Compared with excess GWG, normal GWG was associated with 0.71 SD (95% CI: 0.47–0.97) lower birth weight SD score among women with GDM and obesity. Newborns of normal weight women with GDM and normal GWG had 0.28 SD (95% CI: 0.05–0.51) lower birth weight SD scores compared with their counterparts with excess GWG. In addition, in the group of normal weight non-diabetic women, normal GWG was associated with 0.46 SD (95% CI: 0.30–0.61) lower birth weight SD scores compared with excess GWG.Conclusion: GDM, obesity, and excess GWG are associated with higher risk for LGA infants. Interventions aiming at normal GWG have the potential to lower LGA rate and birth weight SD scores even when GDM and obesity are present.
Relato de caso - suspeita de endocardite infecciosa em gato doméstico / Case report - suspicious endocarditis in a domestic cat
Authors: Klaumann Matheus Bruno Spaller , Dittrich Gustavo , Da Motta Diogo Ferreira 
Published: May 2021

A endocardite infecciosa (E.I) é uma enfermidade rara em felinos, sendo a sua frequência de 0,006% a 0,018% apresentando alta morbidade e mortalidade. Esta cardiopatia é caracterizada pela colonização de patógenos sobre o endocárdio, especialmente bactérias Gram positivas, com a bacteremia sendo seu principal fator etiológico. Os sinais clínicos são inespecíficos, o que dificulta o diagnóstico antemortem. O tratamento tem como objetivo a eliminação do agente, bem como a resolução das complicações secundárias ao quando infeccioso. Um animal da espécie felina foi encaminhado para o atendimento veterinário com histórico de apatia, anorexia, dispneia e emagrecimento progressivo. O exame físico revelou taquicardia e taquipneia, mucosas hipocoradas, hipotermia. A auscultação revelou abafamento de sons pulmonares e presença de sopro diastólico. Os exames laboratoriais demonstraram leucocitose por neutrofilia, azotemia e anemia. A ecocardiografia revelou a presença de uma estrutura hiperecóica homogênia aderida sobre os folhetos da valva aórtica com consequente insuficiência valvar, insuficiência valvar mitral, hipertrofia excêntrica do ventrículo esquerdo e aumento atrial esquerdo. O ultrassom abdominal evidenciou hepatoesplenomegalia e nefropatia, com a radiografia torácica sugerindo broncopatia, asma felina, efusão pleural e broncopneumonia. Apesar das alterações ecocardiográficas fortemente sugestivas de endocardite infecciosa, bem como os achados laboratoriais, estes critérios não foram suficientes para definir o diagnóstico.
Characterization of NEOSOLS through a pluviometric gradient in brazilian Semiarid / NEOSSOLOS Regolíticos em um gradiente pluviométrico no Semiárido brasileiro
Authors: Saraiva Sebastiana Maely , Fraga Vânia da Silva , Filho José Coelho de Araújo , Dos Santos Roseilton Fernandes , Dias Bruno de Oliveira , Felix Evaldo dos Santos , De Sousa João Ítalo , Carneiro Kalline Almeida Alves 
Published: May 2021

There is still little information about Neossolos Regoliticos ( Neosols) , therefore, generating information about fertility, genesis and mineralogy is important to define the proper use and management. The work aimed to characterize morphologically, physically, chemically and mineralogically three Neossolos Regoliticos (Neosols) along a pluviometric gradient (400 mm; 400 and 600; 600 mm). For this purpose, trenches were opened, where the description and collection of soil samples proceeded. It was not possible to notice rainfall interference in the differentiation of horizons and depth of soils. However, increased clay contents from very dry soil to the sub-humid zone, showing the influence to rainfall that is also reflected in the natural fertility of Neossolos Regoliticos (Neosols)
Inovação com tecnologias híbridas nafta / etanol estudo de casos / Innovation with hybrid tecnologies naphta / ethanol cases
Authors: Bôto Rivaldo Souza 
Published: May 2021

Os processos petroquímicos tradicionais a partir da nafta possuem pouca perspectiva para a descoberta de novos produtos ou para melhorias no desempenho operacional. Por outro lado, os processos na indústria alcoolquímica direcionados para a produção de hidrocarbonetos, ou outros derivados do petróleo a partir do etanol, apresentam sempre custos mais elevados do que os obtidos com uso da nafta, devido a necessidade de processos adicionais e à perda da eficiência atômica.Nos processos petroquímicos, normalmente é exigido o grau polímero para as matérias primas, porque outros hidrocarbonetos, principalmente aqueles de cadeia insaturada, são impurezas para os catalisadores ocasionando aumento do seu consumo e interferindo nas características do produto final. O grau polímero é caracterizado pela exigência de uma pureza acima de 99,9%, sendo considerado grau químico uma matéria prima com pureza apenas acima de 95,0%. Apesar da pequena diferença, o consumo de energia para passar do grau químico para o grau polímero é significativamente elevado, impactando nos custos de produção. Esse trabalho se refere a dois estudos de casos de tecnologias híbridas nafta/etanol utilizando matérias primas com grau químico. O primeiro estudo de caso mostra a vantagem de impureza alcoolquímica na produção de um produto tradicionalmente de origem petroquímicos. O segundo estudo de caso mostra a vantagem de impureza petroquímica na produção de um produto tradicionalmente de origem alcoolquímica.
Contexto y generalidades de la enseñanza del Canto como Licenciatura en tiempos de COVID-19
Authors: Caignet Solanve 
Published: May 2021

Objectives:
-	Contextualization of vocal education in virtual form in the situation of the pandemic.
-	Description of the teaching experience in the face of the new circumstances of online vocal education
-	Analyze the points of view of some students of the Bachelor of Singing on distance education.
Methodology: The methodology used is qualitative exploratory with field research under a non-probabilistic sample obtained by consensus of the seven participants in the survey, as well as an observational follow-up based on the empirical in virtual teaching of the subject of Bachelor-level Singing.
Contribution:
-	Conceptual revision of the virtual treatment in the musical-vocal area.
-	Definition of antecedents to formulate a future suitable didactic strategy.
-	Pre-design of an academic route that contributes to a better performance for virtual classes in the vocal area.
Core depth determination of a slightly buried Si-wire waveguide with a reduced bend loss
Authors: Aso Tatsuya , Ishiguro Takehiro , Yamauchi Junji , Nakano Hisamatsu 
Published: May 2021

Abstract
The effects of adjusting the distance between a core and an air-cladding interface on the propagation properties are investigated in a bent Si-wire waveguide. The eigenmode analysis is carried out using the imaginary-distance beam-propagation method based on Yee’s mesh in the cylindrical co-ordinate system. The pure bend loss (PBL) is evaluated as a function of core depth for several core aspect ratios. Since a waveguide bend causes polarization coupling, the polarization crosstalk (PCT) is also evaluated by the propagation analysis with the aid of the FDTD method. It is found that a core depth with a minimized PBL exists for the TM mode when the air-cladding interface is placed at the position where the field amplitude decays to approximately 5% of its peak, with a PCT being less than −30 dB.
HUBUNGAN ANTARA KETEBALAN LEMAK, KEBUGARAN JASMANI DAN KESEIMBANGAN DENGAN HASIL BELAJAR TOLAK PELURU STUDI KORELASI PADA SISWA KELAS XI SMA NEGERI 2 SUKATANI
Authors: Purbangkara Tedi 
Published: May 2021

Tujuan penelitian ini adalah untuk mengetahui (1) hubungan ketebalan lemak (X1) dengan hasil belajar tolak peluru (Y), (2) kebugaran jasmani (X2) dengan hasil belajar tolak peluru (Y), (3) hubungan keseimbangan (X3) dengan hasil belajar tolak peluru (Y), (4) hubungan ketebalan lemak (X1), keseimbangan (X3), kebugaran jasmani(X2), secara bersama-sama dengan hasil belajar tolak peluru (Y). Metode yang digunakan adalah metode korelasi yang menggunakan perhitungan product moment. Sample berjumlah 60 orang seluruh siswa laki-laki tingkat SMA. Instrumen penelitian yang digunakan adalah (1) ketebalan lemak dengan menggunakan skinfold caliper, (2) kebugaran jasmani menggunakan tes (TKJI), (3) keseimbangan dengan menggunakan instrument keseimbangan yang sudah divalidasi sebelumnya, (4) hasil belajar tolak peluru dengan menggunakan test hasil total dari proses gerakan. Hasil pengujian hipotesis pertama terdapat hubungan yang positif antara ketebalan lemak (X1) dengan hasil belajar tolak peluru dengan nilai koefisien korelasi sebesar 0.879*, kedua terdapat hubungan antara kebugaran jasmani (X2) dengan hasil belajar tolak peluru yang memiliki nilai koefisien korelasi sebesar 0.893*, ketiga terdapat hubungan antara keseimbangan (X3) dengan hasil belajar tolak peluru (Y) yang memiliki nilai sebesar 0.847*, keempat terdapat hubungan antara ketebalan lemak (X1) , keseimbangan (X3), kebugaran jasmani (X2), secara bersama-sama dengan hasil belajar tolak peluru (Y). Jadi dapat disimpulkan bahwa ketebalan lemak, kebugaran jasmani, dan keseimbangan memiliki hubungan yang signifikan dengan hasil belajar tolak peluru.Kata kunci : Ketebalan lemak, Kebugaran jasmani, Keseimbangan, dan Hasil Belajar Tolak Peluru.
Ocena zdrowotności materiału nasiennego traw w zależności od wybranych zapraw nasiennych
Authors: Wiewióra Barbara , Bronisz Dagmara 
Published: May 2021

Celem pracy było określenie wpływu wybranych zapraw nasiennych na zdrowotność nasion traw: kostrzewy łąkowej i życicy trwałej z trzech kolejnych lat zbioru, otrzymanych od hodowców. Materiał do badań stanowiły nasiona czterech odmian kostrzewy łąkowej (Festuca pratesis) i czterech odmian życicy trwałej (Lolium perenne). Badano materiał siewny traktowany czterema zaprawami: dwie biologiczne Bioczos (ekstakt z czosnku) i Polyversum (oospory grzyba Pythium oligandrum) i dwie chemiczne Maxim (substancja aktywna: fludioksonil) i Vitavax (substancja aktywna: karboksyna i tiuram) oraz nasiona niezaprawiane, powierzchniowo odkażone podchlorynem sodu. Nasiona badanych gatunków i odmian były licznie zasiedlone przez grzyby zarówno saprotroficzne: Alternaria alternata, Aureobasidium pullulans, Epicoccum purpurascens i Penicillium spp. jak i patogeny: Fusarium spp. oraz Drechslera spp. i Bipolaris sorokiniana. Stwierdzono, że zastosowanie zapraw chemicznych, zwłaszcza użycie zaprawy Vitavax wpływa pozytywnie na poprawę zdrowotności wyrażoną liczbą kolonii grzybowych, w tym głównych patogenów. Nie obserwowano jednak znaczącej poprawy zdolności kiełkowania badanych nasion.
Sytuacja przemysłu nasiennego i hodowli roślin na Świecie i w Unii Europejskiej
Authors: Chomontowski Chrystian , Podlaski Sławomir 
Published: May 2021

Postęp naukowy w hodowli roślin oraz globalizacja produkcji nasiennej wpłynęły na gwałtowne zwiększenie wielkości handlu nasionami. Nasiona, obok pestycydów charakteryzują się w największym stopniu globalnym charakterem. W ostatnich latach obserwujemy postępującą koncentrację i monopolizację przemysłu nasiennego. „Wielka czwórka” firm nasiennych może decydować o losach światowej produkcji rolnej. W świecie w sektorze publicznym maleją nakłady na dział R&D, rosną natomiast w sektorze prywatnym. Przemysł nasienny, obok farmaceutycznego jest najbardziej innowacyjnym sektorem gospodarczym. Średnie nakłady na prace B&R wynoszą 17% obrotu rocznie. Niektóre kraje europejskie (Dania, Holandia) uczyniły z przemysłu nasiennego narodową specjalizację.