bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical characteristics and risk factors of fatal patients with COVID-19: a retrospective cohort study in Wuhan, China
Authors: Jin Meng , Lu Zequn , Zhang Xu , Wang Yanan , Wang Jing , Cai Yimin , Tian Kunming , Xiong Zezhong , Zhong Qiang , Ran Xiao , Yang Chunguang , Zeng Xing , Wang Lu , Li Yao , Zhang Shanshan , Dong Tianyi , Yue Xinying , Li Heng , Liu Bo , Chen Xin , Cui Hongyuan , Qi Jirong , Fan Haining , Li Haixia , Yang Xiang-Ping , Hu Zhiquan , Wang Shaogang , Xiao Jun , Wang Ying , Tian Jianbo , Wang Zhihua 
Published: September 2021

Abstract
Background
The coronavirus disease 2019 (COVID-19) has caused a global pandemic, resulting in considerable mortality. The risk factors, clinical treatments, especially comprehensive risk models for COVID-19 death are urgently warranted.

Methods
In this retrospective study, 281 non-survivors and 712 survivors with propensity score matching by age, sex, and comorbidities were enrolled from January 13, 2020 to March 31, 2020.

Results
Higher SOFA, qSOFA, APACHE II and SIRS scores, hypoxia, elevated inflammatory cytokines, multi-organ dysfunction, decreased immune cell subsets, and complications were significantly associated with the higher COVID-19 death risk. In addition to traditional predictors for death risk, including APACHE II (AUC = 0.83), SIRS (AUC = 0.75), SOFA (AUC = 0.70) and qSOFA scores (AUC = 0.61), another four prediction models that included immune cells subsets (AUC = 0.90), multiple organ damage biomarkers (AUC = 0.89), complications (AUC = 0.88) and inflammatory-related indexes (AUC = 0.75) were established. Additionally, the predictive accuracy of combining these risk factors (AUC = 0.950) was also significantly higher than that of each risk group alone, which was significant for early clinical management for COVID-19.

Conclusions
The potential risk factors could help to predict the clinical prognosis of COVID-19 patients at an early stage. The combined model might be more suitable for the death risk evaluation of COVID-19.
Exploring the relationship between mobility and COVID− 19 infection rates for the second peak in the United States using phase-wise association
Authors: Gottumukkala Raju , Katragadda Satya , Bhupatiraju Ravi Teja , Kamal Azmyin Md. , Raghavan Vijay , Chu Henry , Kolluru Ramesh , Ashkar Ziad 
Published: September 2021

AbstractHuman mobility plays an important role in the dynamics of infectious disease spread. Evidence from the initial nationwide lockdowns for COVID− 19 indicates that restricting human mobility is an effective strategy to contain the spread. While a direct correlation was observed early on, it is not known how mobility impacted COVID− 19 infection growth rates once lockdowns are lifted, primarily due to modulation by other factors such as face masks, social distancing, and the non-linear patterns of both mobility and infection growth. This paper introduces a piece-wise approach to better explore the phase-wise association between state-level COVID− 19 incidence data and anonymized mobile phone data for various states in the United States. Prior literature analyzed the linear correlation between mobility and the number of cases during the early stages of the pandemic. However, it is important to capture the non-linear dynamics of case growth and mobility to be usable for both tracking and forecasting COVID− 19 infections, which is accomplished by the piece-wise approach. The associations between mobility and case growth rate varied widely for various phases of the epidemic curve when the stay-at-home orders were lifted. The mobility growth patterns had a strong positive association of 0.7 with the growth in the number of cases, with a lag of 5 to 7 weeks, for the fast-growth phase of the pandemic, for only 20 states that had a peak between July 1st and September 30, 2020. Overall though, mobility cannot be used to predict the rise in the number of cases after initial lockdowns have been lifted. Our analysis explores the gradual diminishing value of mobility associations in the later stage of the outbreak. Our analysis indicates that the relationship between mobility and the increase in the number of cases, once lockdowns have been lifted, is tenuous at best and there is no strong relationship between these signals. But we identify the remnants of the last associations in specific phases of the growth curve.
Beyond the “information deficit model” - understanding vaccine-hesitant attitudes of midwives in Austria: a qualitative study
Authors: Lehner Lisa , Gribi Janna , Hoffmann Kathryn , Paul Katharina T. , Kutalek Ruth 
Published: September 2021

Abstract
Background
Healthcare workers are considered key stakeholders in efforts to address vaccine hesitancy. Midwives’ influence in advising expectant parents on early-childhood vaccinations is unquestioned, yet they remain an understudied group. The literature on midwives’ attitudes towards vaccinations is also inconclusive. We therefore conducted an explorative qualitative study on midwives’ vaccine-hesitant attitudes towards MMR (measles-mumps-rubella) vaccinations in Austria.

Methods
We conducted 12 in-depth interviews on their knowledge, concerns, and beliefs with midwives who self-identified as hesitant or resistant towards early-childhood MMR vaccinations. We analyzed the data using a grounded theory approach to distill common themes and meanings.

Results
Healthcare workers’ stewardship to address vaccine hesitancy is commonly framed in terms of the “information deficit model”: disseminate the right information and remedy publics’ information deficits. Our findings suggest that this approach is too simplistic: Midwives’ professional self-understanding, their notions of “good care” and “good parenthood” inflect how they engage with vaccine information and how they address it to their clients. Midwives’ model of care prioritized good counseling rather than sharing scientific information in a “right the wrong”-manner. They saw themselves as critical consumers of that information and as promoting “empowered patients” who were free, and affluent enough, to make their own choices about vaccinations. In so doing, they also often promoted traditional notions of motherhood.

Conclusions
Research shows that, for parents, vaccine decision-making builds on trust and dialogue with healthcare professionals and is more than a technical issue. In order to foster these interactions, understanding healthcare professionals’ means of engaging with information is key to understanding how they engage with their constituents. Healthcare workers are more than neutral resources; their daily praxis influenced by their professional standing in the healthcare system. Similarly, healthcare professionals’ views on vaccinations cannot be remedied with more information either. Building better and more diverse curricula for different groups of healthcare workers must attend to their respective roles, ethics of care, and professional beliefs. Taken together, better models for addressing vaccine hesitancy can only be developed by espousing a multi-faceted view of decision-making processes and interactions of healthcare workers with constituents.
Knowledge and awareness of dental implants among Syrian refugees: a cross sectional study in Zaatari camp
Authors: Salim Nesreen A. , Meyad Fatima Hafedh , Al-Abdallah Mariam Mohammad , Abu-Awwad Motasum , Satterthwaite Julian D. 
Published: September 2021

Abstract
Background
The popularity of implant dentistry is increasing dramatically, but the success of implant treatment depends on a patient’s knowledge and expectations.

Methods
This study aimed to assess dental implant knowledge among refugees as a treatment option (n = 565), using face-to-face interviews. The frequency distribution of the responses in general and according to age, gender and education was calculated.

Results
81.8% of the interviewees had missing teeth, however, only 26.2% replaced them. 16.6% of participants had never/hardly heard about implants. Females who never heard of implants were more than males (P < 0.001). 51.3% of participants described dental implants as a screw, and only 35.4% knew implants were placed in jawbones. 6.2% of respondents reported that implants required more care than a natural teeth, with 47.6% believing that diseases affect implant success. Friends were the main source of information (61.4%). Highly educated participants showed higher knowledge about implants.

Conclusions
The surveyed sample revealed limited knowledge about dental implants with high cost being a major obstacle, warranting more strategies to increase awareness and to make implants more affordable for this population.
Effects of nanomicelle curcumin capsules on prevention and treatment of oral mucosits in patients under chemotherapy with or without head and neck radiotherapy: a randomized clinical trial
Authors: Kia Seyed Javad , Basirat Maryam , Saedi Hamid Saeidi , Arab Seyed Ali 
Published: September 2021

Abstract
Background
One of the most prevalent complications of chemotherapy and radiotherapy is oral mucositis (OM) and manifests as erythema and ulceration. Curcumin is one of the components of turmeric and possesses anti-inflammatory and anti-oxidative features. Some of studies have proved the effectiveness of Curcumin in OM. This study aimed to investigate the effects of nanomicelle Curcumin on OM related chemotherapy and head and neck radiotherapy.

Methods
In this clinical trial study, 50 patients underwent chemotherapy with or without head and neck radiotherapy were divided into study and control group. The study group was received Curcumin nanomicelle capsules 80 mg twice a day and the control group took placebo two times a day for 7 weeks and the severity and pain of OM was measured.

Results
Oral mucositis severity in control group in the first (P = 0.010), fourth (P = 0.022) and seventh (P < 0.001) weeks were significantly more than the study group. Pain grade in study group was lower than control group only in the seventh week. (P = 0.001) Additionally, NRS incremental gradient in control group was more than study group. OM severity in patients who underwent only chemotherapy in the control group were significantly more than the study group in all weeks. In patients who were under chemotherapy and head and neck radiotherapy, OM in control group was significantly more intense than the study group only in the fourth and seventh weeks.

Conclusions
Nabomicelle Curcumin capsules is effective on prevention and treatment of head and neck radiotherapy and especially chemotherapy induced OM.

Trial registration
Registered 12 February 2019 at Iranian Registry of Clinical Trials (IRCT). IRCT code: IRCT20100101002950N6. https://en.irct.ir/trial/36665. GUMS ethical code: IR.Gums.Rec.1397.296.
How can we improve patients’ access to new drugs under uncertainties? : South Korea’s experience with risk sharing arrangements
Authors: Lee Boram , Bae Eun-Young , Bae SeungJin , Choi Hyun-Jin , Son Kyung-Bok , Lee Young-Sil , Jang Suhyun , Lee Tae-Jin 
Published: September 2021

Abstract
Background
New drugs including cancer drugs and orphan drugs are becoming increasingly more expensive. Risk sharing arrangements (RSAs) could manage the risk based on both financial impact and the health outcome of new drugs if reimbursed. To improve patients’ access to new drugs under uncertainties, many developed countries have adopted RSAs. In this study, we aimed to understand the effects of RSAs in South Korea on patients’ access.

Methods
We reviewed current status of RSA drugs in South Korea. The number of appraisals and time gap between market approval and reimbursement per RSA drug were considered to quantify improvement of patients’ access as they showed how rapidly decisions on reimbursement of RSA drugs were derived. Then, we applied a comparative analysis to determine whether the RSA drugs in South Korea were reimbursed in the UK, Italy, and Australia. Most data for this study were obtained from websites of the governmental department/agencies responsible for appraisal of drug reimbursement in each country. And literatures related to RSAs were investigated as well.

Results
The eligibility for Korean RSAs had two key components - drugs for cancer and rare diseases and not having other alternative treatments. As of the first half of 2019, there were 39 RSA drugs reimbursed in South Korea, the majority of which were financial-based schemes. Refund and expenditure cap were the representative types (89.7%). After introduction of RSAs, the time gap and number of appraisals were decreased. Based on the indications of RSA drugs, the level of drug coverage in South Korea was found lower than Italy, similar to the UK, and higher than Australia.

Conclusions
RSAs in South Korea significantly enhanced patients’ access to new drugs and led to the alleviation of patients’ out-of-pocket expenses. The drug coverage of South Korea had a level comparable to that of other countries. This study provides implications for countries that have a dual mission of containing pharmaceutical expenditure and improving access to new drugs.
Qualitative analysis of Iranian sixth five-year economic, social, and cultural development plan from universal health coverage perspective
Authors: Mahdavi Mahdi , Sajadi Haniye Sadat 
Published: September 2021

AbstractBackgroundThis research analyzed the Sixth Five-Year Economic, Social, and Cultural Development Plan of the Islamic Republic of Iran (6NPD) to shed light on how the plan addresses the Universal Health Coverage (UHC).MethodsThis research was a qualitative study. We systematically analyzed ‘Secs. 14 -Health, Insurance, Health & Women, and Family’ in the 6NPD. Through a content analysis, we converted this section into meaning units and coded them. Coding was guided through the conceptual framework ‘Six Building Blocks of Health System’ and the key principles of UHC.ResultsSix themes and twenty-one subthemes were identified. The subthemes offinancinginclude a fair and secured process of resource pooling, payment methods, revenue generation for the health sector, and a definition of a basic benefits package. The subthemes ofgovernance and leadershipconsist of social insurance policies’ integration, compliance of providers, a designation of the Ministry of Health and Medical Education (MoHME) as the regulator and the steward of health resources, a payer-provider split, and stakeholders’ participation. The subthemesof health workforceemphasizes balancing the quality and quantity of the health workforce with populations’ health needs and the health system’s requirements. The subthemes ofhealth information systems consist of the electronic health records for Iranians, information systems for organization and delivery functions, and information systems for the financing function. The subthemes of theorganization and deliveryconsider improving effectiveness and efficiency of healthcare delivery, strengthening the family physician program and referral system, and extending the pre-hospital emergency system. Lastly,access to medicinefocuses on the design and implementation of an essential drug list and drug systems for approving the coverage and provision of generic medicine.ConclusionsThe 6NPD introduced policies for strengthening the 6 building blocks of the health system. It introduced policies to improve financing particularly resource pooling and the sustainability of financial resources. As mandated by 6NPD, centering the health system’s governance/leadership in MoHME may exacerbate the existing conflict of interests and provoke various arguments, which impede the enforcement of rules and regulation. The 6NPD is a step forward in terms of improving financial protection, yet several other policies need to be made to adequately meet the requirement of UHC regarding equity and effective coverage.
Exosomal circRNAs: new players in colorectal cancer
Authors: Vakhshiteh Faezeh , Hassani Shokoufeh , Momenifar Navid , Pakdaman Fatemeh 
Published: September 2021

AbstractColorectal cancer (CRC) is one of the most malignant cancer types, characterized by elevated mortality rate and treatment resistance. Despite the progress achieved in the explanation of the molecular basis of the disease as well as introducing potential biomarkers in the clinical practice, further investigation is essential to identify innovative molecules that contribute to colorectal carcinogenesis. Circular RNAs (circRNAs) are a novel and unexplored RNA type, associated with various human pathological conditions. Recently, circRNAs have been identified to be enriched and stable in exosomes and can exert their functions when exosomes reach neighboring or distant cells. Increasing evidence indicates that these so called exosomal circRNAs (exo-circRNAs) act as signaling molecules to regulate cancer proliferation, metastasis, and sensitivity to radio- and chemotherapy. This review aims to discuss the latest progress in exo-circRNAs studies in CRC with an emphasis on their potential as promising diagnostic molecular markers and therapeutic targets.
PREparedness, REsponse and SySTemic transformation (PRE-RE-SyST): a model for disability-inclusive pandemic responses and systemic disparities reduction derived from a scoping review and thematic analysis
Authors: Jesus Tiago S. , Kamalakannan Sureshkumar , Bhattacharjya Sutanuka , Bogdanova Yelena , Arango-Lasprilla Juan Carlos , Bentley Jacob , Landry Michel D. , Papadimitriou Christina ,   Refugee Empowerment Task Force and International Networking Group of the American Congress of Rehabilitation Medicine
Published: September 2021

Abstract
Background
People with disabilities (PwD) have been facing multiple health, social, and economic disparities during the COVID-19 pandemic, stemming from structural disparities experienced for long time. This paper aims to present the PREparedness, RESponse and SySTemic transformation (PRE-RE-SyST): a model for a disability-inclusive pandemic responses and systematic disparities reduction.

Methods
Scoping review with a thematic analysis was conducted on the literature published up to mid-September 2020, equating to the initial stages of the COVID-19 pandemic. Seven scientific databases and three preprint databases were searched to identify empirical or perspective papers addressing health and socio-economic disparities experienced by PwD as well as reporting actions to address them. Snowballing searches and experts’ consultation were also conducted. Two independent reviewers made eligibility decisions and performed data extractions on any action or recommended action to address disparities. A thematic analysis was then used for the model construction, informed by a systems-thinking approach (i.e., the Iceberg Model).

Results
From 1027 unique references, 84 were included in the final analysis. The PRE-RE-SyST model articulates a four-level strategic action to: 1) Respond to prevent or reduce disability disparities during a pandemic crisis; 2) Prepare ahead for pandemic and other crises responses; 3) Design systems and policies for a structural disability-inclusiveness; and 4) Transform society’s cultural assumptions about disability. ‘Simple rules’ and literature-based examples on how these strategies can be deployed are provided.

Conclusion
The PRE-RE-SyST model articulates main strategies, ‘simple rules’ and possible means whereby public health authorities, policy-makers, and other stakeholders can address disability disparities in pandemic crises, and beyond. Beyond immediate pandemic responses, disability-inclusiveness is needed to develop everyday equity-oriented policies and practices that can transform societies towards greater resiliency, as a whole, to pandemic and other health and social emergencies.
Gender, health and ageing in Fiji: a mixed methods analysis
Authors: Dodd Rebecca , Shanthosh Janani , Lung Thomas , Robaigau Aporosa , Perman Mai Ling , Rafai Eric , Poulos Roslyn , Zwi Anthony B. , John Renu , Palagyi Anna 
Published: September 2021

Abstract
Background
Women are disadvantaged by ageing: older women are more likely than older men to suffer from ill-health, have less access to health care and suffer discrimination within the health care system. Globally, there is a dearth of health research on gender and ageing with substantial knowledge gaps in low and middle-income country contexts. Part of a wider investigation on health and ageing in Fiji, our objective was to identify and describe gendered differences in healthy ageing in this Pacific Island context. We believe this to be the first such study in the Pacific region.

Methods
Applying a health systems lens, we used a mixed-methods approach, encompassing analysis of cause of death data; focus group discussion to gather community and family attitudes to health services; and policy analysis, and then used data triangulation techniques to draw out key themes and insights.

Results
We found that gender affects health outcomes among older persons, attitudes towards and experience of healthy ageing, and an older person’s access to and use of health services. We also found that while Fiji’s policy response to ageing has recognised the importance of gender, to-date there has been limited action to address gender differences. Gender (as oppose to sex differences) has direct and indirect implications for the health of older Fijians, while gendered inequalities and patriarchal norms appear to affect both men and women’s experience of ageing and the health system response. Further, gender and age discrimination may be intersecting, intensifying their separate effects.

Conclusion
This study demonstrates the feasibility and importance of applying a gender lens to the study of healthy ageing. Our findings from Fiji may be relevant to other island nations in the south Pacific which share similar challenges of population ageing, a constrained health budget and geographically-dispersed populations. The data triangulation methodology may be considered an efficient and insightful way to examine gendered responses to healthy ageing elsewhere.