bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of a health system payment and quality improvement programme for tonsillectomy in Ontario, Canada: an interrupted time series analysis
Authors: Mahant Sanjay , Guan Jun , Zhang Jessie , Gandhi Sima , Propst Evan Jon , Guttmann Astrid 
Published: July 2021

BackgroundTonsillectomy is among the most common and cumulatively expensive surgical procedures in children, with known variations in quality of care. However, evidence on health system interventions to improve quality of care is limited. The Quality-Based Procedures (QBP) programme in Ontario, Canada, introduced fixed episode hospital payment per tonsillectomy and disseminated a perioperative care pathway. We determined the association of this payment and quality improvement programme with tonsillectomy quality of care.MethodsInterrupted time series analysis of children undergoing elective tonsillectomy at community and children’s hospitals in Ontario in the QBP period (1 April 2014 to 31 December 2018) and the pre-QBP period (1 January 2009 to 31 January 2014) using health administrative data. We compared the age-standardised and sex-standardised rates for all-cause tonsillectomy-related revisits within 30 days, opioid prescription fills within 30 days and index tonsillectomy inpatient admission.Results111 411 children underwent tonsillectomy: 51 967 in the QBP period and 59 444 in the pre-QBP period (annual median number of hospitals, 86 (range 77–93)). Following QBP programme implementation, revisit rates decreased for all-cause tonsillectomy-related revisits (0.48 to −0.18 revisits per 1000 tonsillectomies per month; difference −0.66 revisits per 1000 tonsillectomies per month (95% CI −0.97 to −0.34); p<0.0001). Codeine prescription fill rate continued to decrease but at a slower rate (−4.81 to −0.11 prescriptions per 1000 tonsillectomies per month; difference 4.69 (95% CI 3.60 to 5.79) prescriptions per 1000 tonsillectomies per month; p<0.0001). The index tonsillectomy inpatient admission rate decreased (1.12 to 0.23 admissions per 1000 tonsillectomies per month; difference −0.89 (95% CI −1.33 to −0.44) admissions per 1000 tonsillectomies per month; p<0.0001).ConclusionsThe payment and quality improvement programme was associated with several improvements in quality of care. These findings may inform jurisdictions planning health system interventions to improve quality of care for tonsillectomy and other paediatric procedures.
Low Corticosterone Response to Stress in a Perimenopausal Rat Model Is Associated with the Hypoactivation of PaMP Region of the Paraventricular Nucleus and Can Be Corrected by Exogenous Progesterone Supplementation
Authors: Rodrigues-Santos Isabelle , Kalil-Cutti Bruna , Anselmo-Franci Janete Aparecida 
Published: July 2021

<b><i>Introduction:</i></b> The transition to menopause is characterized by mood, behavioral and metabolic changes. However, little is known about the changes in adrenal response to stress. <b><i>Aims:</i></b> The aim of the study was to evaluate, in an animal model of perimenopause induced by 4-vinylcyclohexene diepoxide (VCD), (1) the endocrine and neuronal stress system activity in response to acute restraint stress and (2) the effect of hormonal therapy in this response. <b><i>Methods:</i></b> Prepubertal female Wistar rats received daily injections (s.c) of oil or VCD (160 mg/kg) for 15 days. On 56th–66th days after treatment onset, the groups to be stressed received s.c implants containing placebo (PL), 17β-estradiol (E2), progesterone (P4), or E2P4. At 80 ± 5 days after VCD/oil injections, stress was applied for 30 min. Blood samples were collected immediately after and 60 min after the end of stress session from the tail tip followed by transcardial perfusion with PFA 4% for the assessment of c-Fos expression in the medial and posterior parvocellular (PaMP and PaPo) subdivisions of the paraventricular nucleus (PVN) and c-Fos/tyrosine hydroxylase in the locus coeruleus (LC) using immunohistochemistry. Control groups were not stressed nor received hormone therapy. <b><i>Results:</i></b> While basal corticosterone levels were similar between VCD-periestropausal and control rats, the secretion in response to stress in the VCD group was lower. This effect was prevented by P4 therapy. Inversely, basal levels of P4 were lower in VCD-periestropausal rats than in the controls, and no differences were found in response to stress between the groups. As expected, 30-min restraint stress increased c-Fos immunoreactivity in all brain areas studied in both control and VCD-periestropausal rats. However, the c-Fos increase in the PaMP region was attenuated. In all areas examined, there were no significant differences in the number of c-Fos-positive neurons across hormonal therapies. <b><i>Discussion/Conclusion:</i></b> This is the first study to demonstrate in a perimenopausal rat model that reproductive aging is accompanied by inadequate secretion of corticosterone in response to acute stress in association with the hypoactivation of the PaMP region of the PVN, while adrenal P4 response is preserved. Moreover, P4 therapy was shown to attenuate the effects of progressive ovarian failure on adrenal functioning during stress.
Avoidable Hospitalization for Heart Failure Among a Cohort of 18- to 64-Year-Old Italian Citizens and Immigrants: Results From the Italian Network for Longitudinal Metropolitan Studies
Authors: Dalla Zuanna Teresa , Cacciani Laura , Barbieri Giulia , Batzella Erich , Tona Francesco , Ferracin Elisa , Spadea Teresa , Di Girolamo Chiara , Caranci Nicola , Petrelli Alessio , Marino Claudia , Canova Cristina 
Published: July 2021

Background:
Heart failure (HF) represents a severe public health burden. In Europe, differences in hospitalizations for HF have been found between immigrants and native individuals, with inconsistent results. Immigrants face many barriers in their access to health services, and their needs may be poorly met. We aimed to compare the rates of avoidable hospitalization for HF among immigrants and native individuals in Italy.

Methods:
All 18- to 64-year-old residents of Turin, Venice, Reggio Emilia, Modena, Bologna, and Rome between January 1, 2001 and December 31, 2013 were included in this multicenter open-cohort study. Immigrants from high migratory pressure countries (divided by area of origin) were compared with Italian citizens. Age-, sex-, and calendar year-adjusted hospitalization rate ratios and the 95% CIs of avoidable hospitalization for HF by citizenship were estimated using negative binomial regression models. The hospitalization rate ratios were summarized using a random effects meta-analysis. Additionally, we tested the contribution of socioeconomic status to these disparities.

Results:
Of the 4 470 702 subjects included, 15.8% were immigrants from high migratory pressure countries. Overall, immigrants showed a nonsignificant increased risk of avoidable hospitalization for HF (hospitalization rate ratio, 1.26 [95% CI, 0.97–1.68]). Risks were higher for immigrants from Sub-Saharan Africa and for males from Northern Africa and Central-Eastern Europe than for their Italian citizen counterparts. Risks were attenuated adjusting for socioeconomic status, although they remained consistent with nonadjusted results.

Conclusions:
Adult immigrants from different geographic macroareas had higher risks of avoidable hospitalization for HF than Italian citizens. Possible explanations might be higher risk factors among immigrants and reduced access to primary health care services.
Observational case study of a persistent cold pool and gap flow in the Columbia River Basin
Authors: Adler Bianca , Wilczak James M. , Bianco Laura , Djalalova Irina , Duncan James B. , Turner David D. 
Published: July 2021

AbstractPersistent cold pools form as layers of cold stagnant air within topographical depressions mainly during wintertime when the near-surface air cools and/or the air aloft warms and daytime surface heating is insufficient to mix out the stable layer. An area often affected by persistent cold pools is the Columbia River Basin in the Pacific Northwest, when a high-pressure system east of the Cascade Range promotes radiative cooling and easterly flow. The only major outflow for the easterly flow is through the narrow Columbia River Gorge which cuts through the north-south oriented Cascade Range and often experiences very strong gap flows. Observations collected during the Second Wind Forecast Improvement Project (WFIP2) are used to study a persistent cold pool in the Columbia River Basin between 10-19 Jan 2017 which was associated with a strong gap flow. We used data from various remote sensing and in situ instruments and a optimal estimation physical retrieval to obtain thermodynamic profiles to address the temporal and spatial characteristics of the cold pool and gap flow and to investigate the physical processes involved during formation, maintenance and decay. While large-scale temperature advection occurred during all phases, we found that the cold pool vertical structure was modulated by the existence of low-level clouds and that turbulent shear-induced mixing and downslope wind storms likely played a role during its decay.
A Moments View of Climatology and Variability of the Asian Summer Monsoon Anticyclone
Authors: Manney Gloria L. , Santee Michelle L. , Lawrence Zachary D. , Wargan Krzysztof , Schwartz Michael J. 
Published: July 2021

AbstractA comprehensive investigation of the climatology of and interannual variability and trends in the Asian summer monsoon anticyclone (ASMA) is presented, based on a novel area and moments analysis. Moments include centroid location, aspect ratio, angle, and “excess kurtosis” (measuring how far the shape is from elliptical) for an equivalent ellipse with the same area as the ASMA. Key results are robust among the three modern reanalyses studied. The climatological ASMA is nearly elliptical, with its major axis aligned along its centroid latitude and a typical aspect ratio of ~5–8. The ASMA centroid shifts northward with height, northward and westward during development, and in the opposite direction as it weakens. New evidence finding no obvious climatological bimodality in the ASMA reinforces similar suggestions from previous studies using modern reanalyses. Most trends in ASMA moments are not statistically significant. ASMA area and duration, however, increased significantly during 1979–2018; the 1958–2018 record analyzed for one reanalysis suggests that these trends may have accelerated in recent decades. ASMA centroid latitude is significantly positively (negatively) correlated with subtropical jet-core latitude (altitude), and significantly negatively correlated with concurrent ENSO; these results are consistent with and extend previous work relating monsoon intensity, ENSO, and jet shifts. ASMA area is significantly positively correlated with the multivariate ENSO index 2 months previously. These results improve our understanding of the ASMA using consistently defined diagnostics of its size, geometry, interannual variability, and trends that have not previously been analyzed.
The Origin and Fate of Subantarctic Mode Water in the Southern Ocean
Authors: Li Zhi , England Matthew H. , Groeskamp Sjoerd , Cerovečki Ivana , Luo Yiyong 
Published: July 2021

AbstractSubantarctic Mode Water (SAMW) forms in deep mixed layers just north of the Antarctic Circumpolar Current in winter, playing a fundamental role in the ocean uptake of heat and carbon. Using a gridded Argo product and the ERA-Interim reanalysis for years 2004-2018, the seasonal evolution of the SAMW volume is analyzed using both a kinematic estimate of the subduction rate and a thermodynamic estimate of the air-sea formation rate. The seasonal SAMW volume changes are separately estimated within the monthly mixed layer and in the interior below it. We find that the variability of SAMW volume is dominated by changes in SAMW volume in the mixed layer. The seasonal variability of SAMW volume in the mixed layer is governed by formation due to air-sea buoyancy fluxes (45%, lasting from July to August), entrainment (35%), and northward Ekman transport across the Subantarctic Front (10%). The interior SAMW formation is entirely controlled by exchanges between the mixed layer and the interior (i.e. instantaneous subduction), which occurs mainly during August-October. The annual mean subduction estimate from a Lagrangian approach shows strong regional variability with hotspots of large SAMW subduction. The SAMW subduction hotspots are consistent with the distribution and export pathways of SAMW over the central and eastern parts of the south Indian and Pacific Oceans. Hotspots in the south Indian Ocean produce strong subduction of 8 and 9 Sv for the light and southeast Indian SAMW, respectively, while SAMW subduction of 6 and 4 Sv occurs for the central and southeast Pacific SAMW, respectively.
Transition from Fog to Stratus over the Northwest Pacific Ocean: Large-eddy Simulation
Authors: Yang Liu , Liu Jing-Wu , Xie Shang-Ping , Shen Samuel S. P. 
Published: July 2021

AbstractOver the midlatitude northwest Pacific Ocean, summer fog frequents the Kuroshio-Oyashio front as a result of the warm advection by the prevailing southerly to southwesterly winds, and stratus clouds are prevalent downstream of the fog regime in the subpolar northwest Pacific. The present study tracks a boundary-layer air column along a typical northeastward trajectory along which fog on the sea surface temperature (SST) front makes its transition to stratus clouds. A turbulence-closure large-eddy simulation model can capture the evolution of the air column forced by the time-varying SST along the trajectory. Results show that the surface cooling effects across the SST front and the longwave radiative cooling (LRC) at the cloud top dominate the evolution of the boundary layer and the related turbulent processes. The sharp SST decrease across the SST front cools the surface layer, leading to condensation through shear-induced turbulence. Once the fog forms, the LRC at the fog top cools the boundary layer strongly through thermal turbulent mixing. The buoyancy-induced turbulence near the fog top entrains the warm and dry air from the free atmosphere into the boundary layer, reducing surface humidity and ultimately lifting the cloud base away from the sea surface to form stratus clouds. Sensitivity simulations also suggest that neither the latent heat flux from ocean nor and the diurnal solar variation is essential for the summer fog-to-stratus transition over the northwestern Pacific.
Effects of Urban Particulate Matter on the Olfactory System in a Mouse Model
Authors: Kim Boo-Young , Park Ju Y. , Cho Kwang J. , Bae Jung H. 
Published: July 2021

Background Exposure to urban particulate matter (UPM) is linked to the aggravation of various health problems. Although the nasal cavity is the first barrier to encounter UPM, there is a lack of studies on the impact of UPM on the olfactory area. The purpose of this study was to investigate the cytotoxic effects of UPM on mouse olfactory epithelium, the underlying pathophysiology involved, and changes in cytokine levels. Methods Mice were divided into 4 groups: control, 400UPM (administered 400 µg UPM daily; standard reference material 1649b; average particle diameter 10.5 μm) 1week, 400UPM 2weeks, and recovery 1week after 400UPM 2weeks (n = 10, 6, 6, and 6, respectively). Olfactory function was evaluated by conducting a food-finding test once a week. The olfactory neuroepithelium was harvested for histologic examination, gene ontology, quantitative real-time polymerase chain reaction, and western blotting. Results Compared to those in the control group, olfactory marker protein, olfactory receptor 1507, adenylyl cyclase 3, and GNAL mRNA levels were lower and S-100, 2′,3′-cyclic nucleotide 30-phosphodiesterase, nerve growth factor receptor-associated protein, brain-derived neurotrophic factor, and tachykinin receptor mRNA levels were higher in the 400UPM group olfactory neuroepithelium. There were no significant differences in neuroepithelial inflammatory marker levels between the 400UPM and saline group. Conclusions UPM decreased olfactory function and might have cytotoxic effects on the olfactory epithelium. Olfactory ensheathing cells and trigeminal nerve might be related to the regeneration of the olfactory epithelium after olfactory destruction associated with UPM.
Multi-omics profiling predicts allograft function after lung transplantation
Authors: Watzenboeck Martin L. , Gorki Anna-Dorothea , Quattrone Federica , Gawish Riem , Schwarz Stefan , Lambers Christopher , Jaksch Peter , Lakovits Karin , Zahalka Sophie , Rahimi Nina , Starkl Philipp , Symmank Dörte , Artner Tyler , Pattaroni Céline , Fortelny Nikolaus , Klavins Kristaps , Frommlet Florian , Marsland Benjamin J. , Hoetzenecker Konrad , Widder Stefanie , Knapp Sylvia 
Published: July 2021

RationaleLung transplantation is the ultimate treatment option for patients with end-stage respiratory diseases but bears the highest mortality rate among all solid organ transplantations due to chronic lung allograft dysfunction (CLAD). The mechanisms leading to CLAD remain elusive due to an insufficient understanding of the complex post-transplant adaptation processes.ObjectivesTo better understand these lung adaptation processes after transplantation and to investigate their association with future changes in allograft function.MethodsWe performed an exploratory cohort study of bronchoalveolar lavage samples from 78 lung recipients and donors. We analysed the alveolar microbiome using 16S rRNA sequencing, the cellular composition using flow cytometry, as well as metabolome and lipidome profiling.Measurements and main resultsWe established distinct temporal dynamics for each of the analysed data sets. Comparing matched donor and recipient samples, we revealed that recipient-specific as well as environmental factors, rather than the donor microbiome, shape the long-term lung microbiome. We further discovered that the abundance of certain bacterial strains correlated with underlying lung diseases even after transplantation. A decline in forced expiratory volume during the first second (FEV1) is a major characteristic of lung allograft dysfunction in transplant recipients. By using a machine learning approach, we could accurately predict future changes in FEV1from our multi-omics data, whereby microbial profiles showed a particularly high predictive power.ConclusionBronchoalveolar microbiome, cellular composition, metabolome and lipidome show specific temporal dynamics after lung transplantation. The lung microbiome can predict future changes in lung function with high precision.
Evaluating the relationship between citation set size, team size and screening methods used in systematic reviews: a cross-sectional study
Authors: O’Hearn Katie , MacDonald Cameron , Tsampalieros Anne , Kadota Leo , Sandarage Ryan , Jayawarden Supun Kotteduwa , Datko Michele , Reynolds John M. , Bui Thanh , Sultan Shagufta , Sampson Margaret , Pratt Misty , Barrowman Nick , Nama Nassr , Page Matthew , McNally James Dayre 
Published: July 2021

Abstract
Background
Standard practice for conducting systematic reviews (SRs) is time consuming and involves the study team screening hundreds or thousands of citations. As the volume of medical literature grows, the citation set sizes and corresponding screening efforts increase. While larger team size and alternate screening methods have the potential to reduce workload and decrease SR completion times, it is unknown whether investigators adapt team size or methods in response to citation set sizes. Using a cross-sectional design, we sought to understand how citation set size impacts (1) the total number of authors or individuals contributing to screening and (2) screening methods.

Methods
MEDLINE was searched in April 2019 for SRs on any health topic. A total of 1880 unique publications were identified and sorted into five citation set size categories (after deduplication): < 1,000, 1,001–2,500, 2,501–5,000, 5,001–10,000, and > 10,000. A random sample of 259 SRs were selected (~ 50 per category) for data extraction and analysis.

Results
With the exception of the pairwise t test comparing the under 1000 and over 10,000 categories (median 5 vs. 6, p = 0.049) no statistically significant relationship was evident between author number and citation set size. While visual inspection was suggestive, statistical testing did not consistently identify a relationship between citation set size and number of screeners (title-abstract, full text) or data extractors. However, logistic regression identified investigators were significantly more likely to deviate from gold-standard screening methods (i.e. independent duplicate screening) with larger citation sets. For every doubling of citation size, the odds of using gold-standard screening decreased by 15 and 20% at title-abstract and full text review, respectively. Finally, few SRs reported using crowdsourcing (n = 2) or computer-assisted screening (n = 1).

Conclusions
Large citation set sizes present a challenge to SR teams, especially when faced with time-sensitive health policy questions. Our study suggests that with increasing citation set size, authors are less likely to adhere to gold-standard screening methods. It is possible that adjunct screening methods, such as crowdsourcing (large team) and computer-assisted technologies, may provide a viable solution for authors to complete their SRs in a timely manner.
Determinants of neonatal mortality among newborns admitted in neonatal intensive care unit at Dilla University Referral Hospital in Gedeo Zone, Southern, Ethiopia: unmatched case control study
Authors: Adem Atnafu , Dache Azmach , Dona Aregahegn 
Published: July 2021

Abstract
Background
Around two and half million neonatal mortality occurred in 2017, especially in developing countries. This study was conducted to determine the determinants of neonatal mortality among newborns admitted in the neonatal intensive care unit at Dilla University Referral Hospital in Gedeo Zone, Southern Ethiopia.

Methods
An unmatched case-control study was conducted from February, 24 to March 6, 2020 at Dilla University Referral Hospital in Gedeo Zone Southern Ethiopia. A total of 304 neonates (76 cases and 228 controls) were involved. Neonates registered as died were considered as cases and neonates registered as improved were considered as controls. Data were extracted by pretested checklists from medical records of neonates admitted during the last one year period. Data was entered into EpiData3.1, and analyzed by statistical package for social science software Version 22.Bivariate and multivariate logistic regressions were used to identify determinants associated with neonatal mortality. Finally, AORs at 95 % CI and P-values < 0.05 were used to declare statistical significance.

Results
In this study, a total of 304 cases were assessed with 100 % reviewed rate. It was found that referrals from other health facilities, [AORs = 2.43, 95 % CI (1.14, 5.22)], gestational age < 37 weeks,[AORs = 2.50, 95 % CI (1.12, 5.58)], the weight of newborn < 2500 g, [AORs = 2.44, 95 % CI (1.13, 5.28)], neonates positive for sepsis, [AORs = 2.45, 95 % CI (1.11, 5.41)]and neonates who not breastfed within first hour after delivery,[AORs = 5.24, 95 % CI (2.42, 11.37)] were statistically significant determinants to neonatal mortality.

Conclusions
This study suggests that referral, gestational age, weight of newborn, sepsis and breastfeeding were significant determinants to neonatal mortality. This study shows that neonatal intensive care unit service should be strengthened in Dilla University Referral Hospital; targeting neonate aged below 28 days. Most of these determinants may be prevented and minimized by strengthening referral linkage, improving intrapartum and postpartum care.