bluuebunny/crossref_metadata_2025_split huggingface dataset:
PP439 Data Driven Subgroups Of Patients With Type 1 Diabetes Based On Health Technology For Insulin Delivery
Authors: Simón Francisco Javier Somolinos , Sáez Gema García , Galisteo Jose Tapia , Pérez Maria Elena Hernando 
Published: December 2021

IntroductionPatients with type 1 diabetes (T1D) require the administration of insulin to maintain glycemic control. Currently, two modes of subcutaneous insulin delivery have gained wider acceptance: multiple daily injections (MDI) and continuous subcutaneous insulin infusion (CSII). Randomized controlled trials have shown that CSII is associated with a slightly lower glycated hemoglobin (HbA1c) level when compared with MDI.The case study on diabetes by the H2020 Next Generation Health Technology Assessment project aims to link evidence from randomized controlled trials to real-world data to estimate the impact of health technology on specific subgroups of patients, as a first step in building prediction models to personalize treatment strategies. This work aims to assess whether patients with T1D can be stratified according to the use of health technology for insulin delivery and associated glycemic control from real-world data.MethodsWe used a longitudinal prospective data repository of T1D patients from 83 clinics in the United States (T1D exchange). A data-driven two-step clustering analysis was done on adult individuals (n = 8,034) with more than five years of disease duration. Clusters were based on body mass index (BMI), sex, age at diagnosis, diabetes duration, HbA1c level, and insulin delivery method. The optimal number of clusters was estimated based on silhouette width.ResultsWe identified the following four clusters of T1D patients characterized by differences in gender and insulin delivery method: men and women with insulin injections or pens and men and women with CSII. Individuals that used CSII had lower HbA1c levels, a higher BMI, and longer diabetes duration than those using Injections or pens.ConclusionsThis preliminary work identified subgroups of T1D patients linked to insulin delivery methods. Future research includes the study of complications associated with different clusters and additional data sources. While the data were sourced from the T1D Exchange, the analyses, content, and conclusions presented have not been reviewed or approved by the T1D Exchange.
PP447 Informing The Development And Evaluation Of An Evidence-Based Service Delivery Model For Mental Health Patients With Complex Needs
Authors: Saini Pooja , Martin Antony , McIntyre Jason C. , Sambrook Laura , Roks Hana , Burton Sam , Balmer Anna , Shetty Amrith , Nathan Rajan 
Published: December 2021

IntroductionMental health services for adults have been developed to provide community-based interventions. There is a recognized unmet need in some of the most complex patients that may not be adequately met by existing mental health services provision. Research is warranted to consider the best model of service delivery for this group of service users. The aims of this research were to examine the profile and history of service users defined as having complex needs as well as their service use and associated costs in the Cheshire and Wirral Partnership NHS Foundation Trust (CWP).MethodsA diverse group of stakeholders were invited to provide feedback on the content and design of the proforma for data collection from the medical records of service users. The rationale of the data collection was described to ensure relevant patient-level cost information was collected to identify and quantify the relevant resources consumed, to inform the evaluation of direct medical costs, direct non-medical costs, and indirect costs for each patient. The proforma was designed to also permit comparisons of clinical and service use outcomes for evaluation of patient health and non-health outcomes associated with alternative care pathways.ResultsStakeholder feedback comprised representatives from the CWP, patients, commissioners, the Local Authority, and housing. Relevant data for extraction from patient medical records were identified and a proforma was developed. The following items were identified for inclusion: baseline demographic data, service user data (family background, contact with the criminal justice system, social history), and clinical data (diagnosis, treatment, hospital visits, and other health service use).ConclusionsA proforma was developed with diverse stakeholder involvement to inform data collection on the resource use and cost impact associated with alternative care pathways in the National Health Service and other sectors of the economy. Based on the proforma developed and data extracted, an exploration of patient health and non-health outcomes associated with alternative care pathways will be conducted to inform service evaluation and to promote patient centric care.
PP451 Does NICE Reimburse Oncology Treatments Meeting End-Of-Life Criteria More Often Than Treatments That Do Not?
Authors: Manchanda Prachi , Mark Karen , Rubinstein Judith 
Published: December 2021

IntroductionThe National Institute of Health and Care Excellence (NICE) issued a supplementary advice in 2009 stating that treatments for patients with short life expectancies (<24 months) can exceed the cost-effectiveness threshold of GBP30,000 (EUR34,668) per additional quality-adjusted life-year (QALY), as long as the treatment is indicated for small patient populations and there is sufficient evidence that it extends life (≥ three months), compared with current National Health Service (NHS) treatments. This study investigated how often NICE reimburses treatments that meet end-of-life (EOL) criteria.MethodsHealth technology assessments (HTAs) conducted by NICE from 2009 to 2020 were reviewed for approved oncology drugs. Terminated appraisals were excluded. Data regarding EOL criteria in these submissions were then gathered. The HTA decisions were divided into the following categories: EOL criteria met; EOL criteria not met; and EOL criteria not applicable. A chi-square analysis was performed.ResultsA total of 316 reviews were assessed in the final sample, of which 71 percent (n = 223) of decisions were positive. Out of the positive decisions, 43 percent (n = 96), 25 percent (n = 55), and 32 percent (n = 72) of decisions were in the EOL criteria met, EOL criteria not met, and EOL criteria not applicable groups, respectively. The chi-square analysis showed a significant correlation between HTA decisions and EOL criteria (p = 0.0008). These results were consistent when the “EOL criteria not applicable” group was excluded (p = 0.001). When the analysis was performed between the “EOL criteria met” and “EOL criteria not met”, along with “EOL criteria not applicable” groups, it showed a possible correlation (p = 0.05).ConclusionsThis study showed that in oncology, NICE reimburses treatments that meet EOL criteria more often than treatments that attempt, but fail, to meet the EOL criteria.
Real-world monitoring progress towards the elimination of hepatitis C virus in Australia using sentinel surveillance of primary care clinics; an ecological study of hepatitis C virus antibody tests from 2009 to 2019
Authors: Wilkinson Anna Lee , Pedrana Alisa , Traeger Michael W. , Asselin Jason , El-Hayek Carol , Nguyen Long , Polkinghorne Victoria , Doyle Joseph S. , Thompson Alexander J. , Howell Jessica , Scott Nick , Dimech Wayne , Guy Rebecca , Hellard Margaret , Stoové Mark 
Published: December 2021

Abstract
To achieve the elimination of the hepatitis C virus (HCV), sustained and sufficient levels of HCV testing is critical. The purpose of this study was to assess trends in testing and evaluate the effectiveness of strategies to diagnose people living with HCV. Data were from 12 primary care clinics in Victoria, Australia, that provide targeted services to people who inject drugs (PWID), alongside general health care. This ecological study spanned 2009–2019 and included analyses of trends in annual numbers of HCV antibody tests among individuals with no previous positive HCV antibody test recorded and annual test yield (positive HCV antibody tests/all HCV antibody tests). Generalised linear models estimated the association between count outcomes (HCV antibody tests and positive HCV antibody tests) and time, and χ2 test assessed the trend in test yield. A total of 44 889 HCV antibody tests were conducted 2009–2019; test numbers increased 6% annually on average [95% confidence interval (CI) 4–9]. Test yield declined from 2009 (21%) to 2019 (9%) (χ2P = <0.01). In more recent years (2013–2019) annual test yield remained relatively stable. Modest increases in HCV antibody testing and stable but high test yield within clinics delivering services to PWID highlights testing strategies are resulting in people are being diagnosed however further increases in the testing of people at risk of HCV or living with HCV may be needed to reach Australia's HCV elimination goals.
External compression of left main bronchus by a large patent ductus arteriosus: a case report
Authors: Yücel Semih Murat , Demirel Berat Dilek , Çetin Eda Beykoz , Şahin İrfan Oğuz 
Published: December 2021

AbstractIn neonates and infants, the trachea and main bronchus may be compressed by adjacent cardiovascular structures. Compression of the main bronchi by the patent ductus arteriosus is rare and causes a variety of respiratory problems. Surgical closure of the patent ductus arteriosus that compresses the main bronchus as soon as possible is an effective treatment option. Rapid clinical recovery is expected after surgical closure of the patent ductus arteriosus. We present a case of patent ductus arteriosus which caused obstruction of the left main bronchus.
Why US Democracy Trumps Populism: Comparative Lessons Reconsidered
Authors: Weyland Kurt 
Published: December 2021

ABSTRACTMatias López and Juan Luna (2021) challenged my comparative analysis of populism’s threat to democracy, its reliance on institutional factors (coupled with conjunctural opportunities), and especially the inference about US democracy’s immunity to populist suffocation. However, their emphasis on structuralist and culturalist factors, which would suggest the vulnerability of the United States, is strikingly selective, theoretically unconvincing, and empirically problematic. López and Luna’s methodological improvement of my analysis does not alter the substantive findings or overturn my sanguine inference about US democracy’s likely resilience. Only their further modifications yield more pessimistic scenarios, but those adjustments stand on shaky theoretical and empirical ground. Indeed, the experiences of 2020–2021 corroborate my theory and its comparative lessons. The US institutional framework held firm and foiled the insistent attempts of President Trump and his most fervent followers to perpetuate the US populist in power. Consequently, US democracy continues to appear quite safe from populist strangulation.
Making reform and stability compatible with each other: elite redeployment in Meiji Japan
Authors: Yamada Makio 
Published: December 2021

AbstractNineteenth-century Japan remains a void in the literature on institutions and growth. Developmental institutions evolved in Japan after the Meiji Restoration despite the absence of political participation. Authoritarian change agents usually face a trade-off between reform and stability: they have coercive power to remove underproductive institutions, but at the risk of inviting instability, as politically influential deprivileged elites may engage in counteraction to recover what they perceive as their entitlement. Many authoritarian regimes, thus, coopt elites by allowing them access to rent, but such buying-off inevitably compromises institutional improvement. How did Meiji Japan overcome this dilemma and liberate major fiscal and administrative spaces for productive players who generate wealth and increase the size of the economic pie for society? This article presents a model that it calls ‘elite redeployment’ to answer this puzzle. In lieu of elite bargains in participatory polities in Europe, the revolutionary authoritarian regime in Japan coercively deprivileged traditional elites and redeployed those with financial or human capital among them in productive institutions. By doing so, the Japanese authoritarian change agents dismantled the incumbent institutions in an irreversible manner and swiftly built new institutions such as modern administrative, educational, financial, and commercial sectors, while maintaining stability.
Intermittent Intense Thermocline Shear Associated With Wind‐Forced Near‐Inertial Internal Waves in a Summer Stratified Temperate Shelf Sea
Authors: Yang Wei , Wei Hao , Liu Zhiyu , Li Guangxue 
Published: December 2021

AbstractThermocline shear (i.e., velocity shear in the thermocline) lies at the heart of stratified shelf sea systems, regulating the vertical mixing and transport of mass and biogeochemical constituents. Based on year‐long moored ADCP measurements in the southern Yellow Sea (YS), the baroclinic kinetic energy and thermocline shear are investigated in this study. The rotary spectra analysis of the velocity measurements and numerical simulations with the slab model demonstrate that the wind‐forced near‐inertial internal waves (NIWs) contribute most of the baroclinic kinetic energy (50%) and thermocline shear (55%) in this stratified temperate shelf sea. The NIWs are mostly in the first two modes and are frequently generated during the warm season, associated with the presence of strong stratification and disturbances from extratropical cyclones. Most interestingly, the observed thermocline shear shows intermittent enhanced near‐inertial shear in the YS for the first time. Further analysis reveals that the thermocline shear is in the form of a clockwise rotating vector with the shear maxima (hereafter the shear spike) occurring at an angle of ∼90° to the right of the wind vector. These shear spikes, which prevail in warm seasons, are further demonstrated to be related to the wind‐shear‐alignment mechanism through comparing with a theoretical shear production model. Given the prevalence of shear spikes in warm seasons, this process is believed to have important implications in inducing thermocline mixing, which may further modulate nutrients cycling and help the maintenance of primary productivity in seasonally stratified shelf seas.
The Possible Role of Turbopause on Sporadic‐E Layer Formation at Middle and Low Latitudes
Authors: Tang Qiong , Zhou Chen , Liu Huixin , Liu Yi , Zhao Jiaqi , Yu Zhibin , Zhao Zhengyu , Feng Xueshang 
Published: December 2021

AbstractIn this paper, we examine the mechanism of middle‐ and low‐latitude sporadic‐E (Es) layer formation. Observations of ionosondes and meteor radars at stations of different latitudes show that Es layer also formed at low‐altitude nonwindshear points, which is distinct from prototypical windshear theory. The theoretical modeling results show that metallic ions can effectively accumulate by the combined effect of the zonal and meridional winds in the mesosphere and the lower thermosphere region. Numerical simulation results also demonstrate that metallic ions can accumulate without wind shear at lower height (90–105 km) as a consequence of the MLT winds leading to the ion drifting downward. We suggest that the turbopause at 90–105 km plays an important role in forming low‐altitude Es layer in the middle‐ and low‐latitude regions.
Unexpected scaffold rearrangement product of pirenzepine found in commercial samples
Authors: Ozenil Marius , Skos Lukas , Roller Alexander , Gajic Natalie , Holzer Wolfgang , Spreitzer Helmut , Platzer-Ozenil Sonja , Vraka Chrysoula , Hacker Marcus , Wadsak Wolfgang , Pichler Verena 
Published: December 2021

AbstractPharmacovigilance aims at a better understanding of the molecular events triggered by medications to prevent adverse effects, which despite significant advances in our analytical repertoire plague the use of drugs until today. In this study, we find that clinically prescribed and commercially available pirenzepine may not be the correct compound. Pirenzepine can undergo an unexpected scaffold rearrangement from the pharmaceutical active ingredient (API) to a previously uncharacterized benzimidazole. The rearrangement occurs under highly acidic conditions, which were believed to favour the dihydrochloride formation of pirenzepine. The rearranged products of pirenzepine and the structurally related telenzepine have significantly decreased affinity for the muscarinic acetylcholine receptor, the pharmacological target of these compounds. Fortunately, in situ rearrangement after oral application is no safety issue, as we show that reaction kinetics in gastric acid prevent rearrangement. The research community should consider appropriate measures to perform reliable receiving inspections in the commercial supply of well described and frequently used chemicals, in particular if experiments yield unexpected results.
A multiethnic association analysis of hyperuricaemia with cardiovascular risk in rural and urban areas in Chinese adults
Authors: Liu Leilei , Lei Juan , Zhang Linyuan , Ma Nana , Xu Zixuan , Peng Lian , Nie Chan , Zhong Jianqin , Zhang Xiao , Hong Feng 
Published: December 2021

AbstractComprehensive research on rural–urban disparities in the association of hyperuricaemia (HUA) with cardiovascular disease (CVD) in China, especially among minority groups, is limited. We explored the HUA-CVD relationship between rural and urban areas within ethnic Chinese groups. We included Dong, Miao, and Bouyei adults in Southwest China from the China Multi-Ethnic Cohort Study. Multivariable logistic regression models were used to assess the relationship between HUA and CVD in both residences. We performed stratified analyses by sex and age. The study population included 16,618 people (37.48% Dong, 30.00% Miao, and 32.52% Bouyei) without a reduced estimated glomerular filtration rate. We identified 476 (188 Dong, 119 Miao, and 169 Bouyei) and 175 (62 Dong, 77 Miao, and 36 Bouyei) CVD cases in rural and urban areas. Compared to urban residents, an at least 49% increased CVD risk (adjusted OR 1.49, 95%CI 1.06–2.08 for the Dong ethnic group; 1.55, 1.07–2.25 for the Bouyei ethnic group) and a 1.65-fold elevated coronary heart disease risk (1.65, 1.03–2.64) related to HUA was present in rural residents. Moreover, HUA was positively associated with increased risk of CVD and coronary heart disease in rural women (2.05, 1.26–3.31; 2.11, 1.19–3.75) and rural older adults (1.83, 1.22–2.75; 2.32, 1.39–3.87) among the Bouyei ethnic group, respectively. We found rural elderly individuals with HUA among the Dong ethnic group had a 52% elevated risk of CVD (1.52, 1.05–2.21); furthermore, an at least 79% increased risk of stroke related to HUA was observed in women (2.24, 1.09–4.62) and elderly people (1.79, 1.02–3.13) in rural areas among the Dong ethnic group. But a positive association was not found among the Miao ethnic group. Screening early-onset HUA patients may be helpful for the control and prevention of CVD in rural residents, especially for women and older adults living in a rural community, among the Dong and Bouyei ethnic groups in China.
Inhibitory effect of a gel paste containing surface pre-reacted glass-ionomer (S-PRG) filler on the cariogenicity of Streptococcus mutans
Authors: Nomura Ryota , Kitamura Takahiro , Matayoshi Saaya , Ohata Jumpei , Suehiro Yuto , Iwashita Naoki , Okawa Rena , Nakano Kazuhiko 
Published: December 2021

AbstractSurface pre-reacted glass-ionomer (S-PRG) filler is a bioactive functional glass that releases six different ions. Although several dental materials containing S-PRG filler have been developed, few self-care products containing S-PRG filler have been reported. We investigated the inhibitory effects of PRG gel paste containing S-PRG filler on Streptococcus mutans, a major pathogen of dental caries. PRG gel paste inhibited bacterial growth of S. mutans in a concentration-dependent manner, and all S. mutans were killed in the presence of ≥ 1% PRG gel paste. Additionally, it was difficult for S. mutans to synthesize insoluble glucan from sucrose in the presence of 0.1% PRG gel paste. A biofilm formation model was prepared in which slices of bovine enamel were infected with S. mutans after treatment with or without PRG gel paste. Biofilm formation was inhibited significantly more on the enamel treated with PRG gel paste than on enamel without PRG gel paste (P < 0.001). The inhibitory effects on bacterial growth and biofilm formation were more prominent with PRG gel paste than with S-PRG-free gel paste, suggesting that PRG gel paste may be effective as a self-care product to prevent dental caries induced by S. mutans.
Test–Retest Reliability of the Listening Self-Efficacy Questionnaire
Authors: Oliva Allison , Riska Kristal M. , Smith Sherri L. 
Published: December 2021

Purpose:
The purpose of this study was to determine the test–retest reliability and the minimum detectable change (MDC) scores of the Listening Self-Efficacy Questionnaire (LSEQ).

Method:
A total of 77 older adults who were experienced hearing aid users were administered the LSEQ in pen–paper format on two separate occasions. They were provided the first copy of the LSEQ in the clinic to take home to complete. Those participants who completed and returned the first copy of the questionnaire were then mailed a second copy of the LSEQ to complete and return approximately 2 weeks later. The mean subscale and total scale scores from the two administrations were compared using intraclass correlation coefficients (ICCs) to determine test–retest reliability of the measure. The MDC scores, or the minimum difference between scores to demonstrate a real change in self-efficacy levels, were also calculated for each subscale and the total scale.

Results:
The ICCs ranged from 0.786 to 0.920 for the subscale and total scale scores. The MDC scores for the subscale and total scale ranged from 14.3% to 19.1%.

Conclusions:
The results of this study indicate that the LSEQ has moderate to excellent test–retest reliability. The MDC scores demonstrate that the LSEQ has the potential to detect true changes in listening self-efficacy in older patients with hearing loss who use hearing aids. The LSEQ may aid clinicians in understanding listening self-efficacy in their patients and how their self-efficacy levels change with amplification.