bluuebunny/crossref_metadata_2025_split huggingface dataset:
Informing Policy from Prices: An Overview of California Nursing Homes
Authors: El Hajj Karen 
Published: November 2021

Introduction: The rising cost of healthcare along with the aging demographic requires the attention of policy makers. The United States’ nursing home industry is costly to older adults, requiring many to resort to government funded Medicare to offset these costs. This study aims to understand determinants of nursing home prices in the state of California. Variables included in the analysis are selected based on previous literature on the costs of nursing homes in the US.
Methods: The data were analyzed using a multi-variable regression analysis. The analysis sample included 1,121 nursing homes across California, using facility level and governmental data that is publically available for the years of 2016-2017. Data collected included financial indicators (net income), ownership (for-profit, non-profit) represented as a dummy variable, occupancy rates, reimbursement rates (Medicare & Medicaid), staffing, quality and competition variables such as nursing homes per county.
Results: The regression analysis indicated that ownership type (for-profit), competition and occupancy rates have a negative significant effect on nursing home prices. Whereas, reimbursement rates of both Medicare and Medicaid, home income and staffing levels have a positive significant effect, driving further nursing home prices.
Conclusion: The study aimed to understand the relevant variables that influence nursing home prices in the state of Califronia. The regression analysis yielded significant results for various factors including reimbursement rates, occupancy rates and the number of nursing homes per county. However, a notable limitation to the study is the inability to generalize these factors to the rest of the US due to state specific health policies. Determinants such as reimbursement rates and nursing homes per county vary by governmental decisions, therefore, a comprehensive policy tool could be designed to alter nursing home costs through state health policies.
Reliability of Donor Lung Sampling in Lung Transplantation
Authors: Chao Bonnie T , Sage Andrew T , Cypel Marcelo , Liu Mingyao , Yeung Jonathan , Bai Xiaohui , Van Raemdonck Dirk , Ceulemans Laurens , Neyrinck Arne , Verleden Stijn , Keshavjee Shaf 
Published: November 2021

Introduction: Ex vivo lung perfusion (EVLP) is a normothermic platform used to assess donor lungs. Many have studied biomarkers in lung injury, but it is unclear whether samples taken from one location are representative of the organ. Our objective was to investigate the uniformity of cytokine expression in tissue biopsies and in EVLP perfusates from various locations.
Methods: In the tissue study, eight donor lungs were partitioned from apex to base. In each lung, three biopsies were taken from the third, sixth, and ninth slices, while two were taken from the lingula and an injury site. In the perfusate study, four samples were taken from four lobes in eight donors during EVLP. Expressions of IL-6, IL-8, IL-10, and IL-1β were measured using qPCR and ELISA.
Results: In the tissue study, the mean intra-biopsy equal-variance F-value was 0.53. The median intra-biopsy coefficient of variation (CV) was 18%. In donors without gross focal injury, the mean comparisons of biopsies in each donor showed that the three consistent slices showed no differences and had a CV of 20%, which was similar to the intra-biopsy CV (p=0.80). Both the lingula and injury biopsies demonstrated larger differences from the rest. The median intra-lung CV of perfusates from different lobes was 4.9%.
Conclusion: Intra-biopsy variances were consistent across biopsies. Lungs without gross focal injury demonstrated more consistent gene expression. The lingula is not a representative site due to high signal variability. The consistent measurements in EVLP perfusates provided a uniform picture of the inflammation.
Current diesel engine exhaust exposure in the Ontario construction industry
Authors: Ziembicki Stephanie , Kirkham Tracy L , Demers Paul A. , Peters Cheryl E. , Gorman-Ng Melanie , Davies Hugh W. , Tenkate Thomas , Kalenge Sheila , Blagrove-Hall Nicola , Jardine Kate , Arrandale Victoria H. 
Published: November 2021

Introduction: Diesel engine exhaust (DEE) is a known carcinogen and a common occupational exposure in Canada, particularly within construction. The use of diesel-powered equipment in the construction industry is widespread, but little is known about DEE exposures and occupational disease in this work setting. The objective of this study was to characterize and identify key determinants of DEE exposure at construction sites in Ontario.
Methods: Diesel particulate matter (DPM) measurements were taken from workers employed on seven infrastructure construction worksites in Ontario. Full-shift personal air samples were collected from workers using a constant-flow pump and SKC aluminum cyclone with 37-mm quartz fibre filters in an open-faced cassette. Samples were analyzed for elemental carbon (EC), a surrogate of DEE exposure, following NIOSH method 5040. Exposures were compared to recommended health-based limits, including the Dutch Expert Committee on Occupational Safety (DECOS) limit (1.03µg/m3 respirable EC) and the Finnish Institute of Occupational Health (FIOH) recommendation (5µg/m3 respirable EC). A determinants of exposure model was constructed.
Results: In total, 126 DPM samples were collected, ranging from <0.47-52.58µg/m3 with a geometric mean (GM) of 4.23µg/m3 (geometric standard deviation (GSD)=3.05). Overall, 44.8% of samples exceeded the FIOH limit, mostly within underground worksites (93.5%), and 88.8% exceeded the DECOS limit. Underground workers (GM=13.20µg/m3, GSD=1.83) had exposures approximately 4-times higher than below grade workers (GM=3.56µg/m3, GSD=1.94) and 9-times higher than aboveground workers (GM=1.49µg/m3, GSD=1.75). Work grade, enclosed cabs, and seasonality were identified as the major determinants of exposure.
Conclusions: This study provides a better understanding of current DPM exposure in Canadian construction. Most exposures were above recommended health-based limits, signifying a need to further reduce DPM levels in construction. These results can inform a hazard reduction strategy including a new occupational exposure limit and targeted intervention/control measures to reduce DPM exposure and the burden of occupational cancer.
O perfil clínico e o manejo terapêutico da síndrome HELLP: revisão integrativa
Authors: Alves Ana Klara Rodrigues , Silva Barbara Beatriz Lira da , Alves Francisco Robson de Oliveira , Silva Larissa dos Santos , Machado Lívia Filomena Castelo Branco , Pinho Alvaro Martins , Franklin Fábio Landel Alysson Araújo , Ibiapina Maria de Lourdes Pereira , Noronha Francisco Matheus Carvalho , Almeida Lia Moreira de Vasconcelos , Gonçalves Savir Igor de Oliveira , Medeiros Amanda Milhomem , Fortes Neto Noé Araujo , Bucar Luiza Emiliana Queiroz , Rodrigues Iluska Guimarães 
Published: November 2021

O presente estudo tem como objetivo descrever o perfil clínico e o manejo terapêutico da síndrome HELLP. O estudo utilizou como método a revisão integrativa da literatura, realizado por meio de uma busca na base de dados Pubmed usando os cruzamentos os descritores em inglês “HELLP syndrome”, “complications”. Para a avaliação do problema de pesquisa e sua estratificação foi utilizada a estratégia PVO. A estratégia supracitada permitiu formular a seguinte questão norteadora: Quais são as manifestações clínicas da síndrome HELLP e como funciona o manejo terapêutico? A fisiopatologia da doença ainda não é conhecida. No entanto, acredita-se que seja causada por insuficiência placentária e disfunção endotelial generalizada. A apresentação vaga é comum; hipertensão e proteinúria que caracterizam a pré-eclâmpsia geralmente estão ausentes quando a síndrome HELLP se apresenta. Pode-se apresentar com sinais e sintomas inespecíficos, nenhum dos quais são diagnósticos e sendo na maioria dos casos assintomáticos, mas tendo como sintomas a hiperreflexia persistente, dor de cabeça, confusão, dor abdominal, náuseas e vômitos. O diagnóstico incorreto e o reconhecimento tardio da síndrome HELLP são comuns devido à apresentação vaga e variável. Quando a síndrome HELLP é identificada, o parto é necessário para evitar desfechos maternos e neonatais catastróficos. A identificação dos parâmetros basais preditivos da evolução da doença é, portanto, de grande importância para definir qual abordagem obstétrica deve ser priorizada.
Six-Month Effectiveness of Advanced vs. Standard Hybrid Closed-Loop System in Children and Adolescents With Type 1 Diabetes Mellitus
Authors: Tornese Gianluca , Buzzurro Francesca , Carletti Claudia , Faleschini Elena , Barbi Egidio 
Published: November 2021

IntroductionThe purpose of this study was to assess the effectiveness of advanced- (a-HCL) vs. standard-hybrid closed-loop (s-HCL) systems use up to 6 months of treatment in a real-world setting of children and adolescents with T1DM.MethodsWe retrospectively evaluated all T1DM pediatric users of MiniMed™ 670G system (s-HCL) and 780G system (a-HCL). HbA1c and BMI were collected at baseline and three and six months after HCL start. Data on glycemic control were extracted from reports generated with CareLink™ Personal Software in Manual Mode, at HCL start, after one, three, and six months after HCL beginning.ResultsThe study included 44 individuals with a median age of 13.3 years (range 2- 21 years), 20 on s-HCL, and 24 on a-HCL. a-HCL users had a significantly lower HbA1c compared to s-HCL after six months of HCL use (7.1 vs. 7.7%). Significant differences in HbA1c between a-HCL and s-HCL users were found in children aged 7-14 years (7.1 vs. 7.7% after six months) and in those with a worse (HbA1c &gt;8%) glycemic control at the beginning (7.1 vs. 8.1% after six months). No significant changes in HbA1c were found in a-HCL users that previously used a s-HCL system. Nevertheless, only the use of a-HCL significantly predicted a lower HbA1c after six months. All sensor-specific measures of glycemic control improved from Manual to Auto mode, in both s-HCL and a-HCL, without increasing time spent in hypoglycemia. However, the percentage of individuals with TIR&gt;70% increased significantly in a-HCL users, who attained this target earlier and more stably: younger age, a higher rate of auto-correction, and a lower amount of CHO inserted predicted a TIR&gt;70%. BMI SDS did not significantly change throughout the study period.ConclusionThis real-world study suggests that effectiveness might be greater in a-HCL than in s-HCL, with significant changes in HbA1c, and reaching earlier and more stably the target of TIR &gt;70%, without increasing hypoglycemia or BMI. At the same time, previous users of s-HCL systems did not show any further improvement with a-HCL. Children under the age of 14 years of age, not represented in previous studies, seem to benefit the most from a-HCL pumps as well as individuals with the worst glycemic control.
Gluten-free Diet Reduces the Risk of Irritable Bowel Syndrome: A Mendelian Randomization Analysis
Authors: Sun Yuhao , Chen Xuejie , Wang Shuyang , Deng Minzi , Xie Ying , Wang Xiaoyan , Chen Jie , Hesketh Therese 
Published: November 2021

Background: Whether a gluten-free diet (GFD) is a cause of irritable bowel syndrome (IBS) remains controversial. We aim at exploring the causal relationship between gluten intake and IBS within Mendelian randomization (MR) design.Methods: We conducted a two-sample MR and selected single-nucleotide polymorphisms (SNPs) associated with GFD as instrumental variables (IVs). SNPs and genetic associations with GFD and IBS were obtained from the latest genome-wide association studies (GWAS) in Europeans (GFD: cases: 1,376; controls: 63,573; IBS: cases:1,121; controls: 360,073). We performed inverse variance weighting (IVW) as the primary method with several sensitivity analyses like MR-Egger and MR-PRESSO for quality control. The above analyses were re-run using another large dataset of IBS, as well as changing the p-value threshold when screening IVs, to verify the stability of the results.Results: The final estimate indicated significant causal association [per one copy of effect allele predicted log odds ratio (OR) change in GFD intake: OR = 0.97, 95% confidence interval (CI) 0.96 to 0.99, p &lt; 0.01] without heterogeneity statistically (Q = 2.48, p = 0.78) nor horizontal pleiotropy biasing the causality (p = 0.92). Consistent results were found in validation analyses. Results of MR Steiger directionality test indicated the accuracy of our estimate of the causal direction (Steiger p &lt; 0.001).Conclusion: GFD might be a protective factor of IBS. Therefore, we suggest taking a diet of lower gluten intake into account in IBS prevention and clinical practice.
Similarity and Potential Relation Between Periimplantitis and Rheumatoid Arthritis on Transcriptomic Level: Results of a Bioinformatics Study
Authors: Li Shiyi , Zhou Changqing , Xu Yongqian , Wang Yujia , Li Lijiao , Pelekos George , Ziebolz Dirk , Schmalz Gerhard , Qin Zeman 
Published: November 2021

BackgroundThis bioinformatics study aimed to reveal potential cross-talk genes, related pathways, and transcription factors between periimplantitis and rheumatoid arthritis (RA).MethodsThe datasets GSE33774 (seven periimplantitis and eight control samples) and GSE106090 (six periimplantitis and six control samples) were included from the National Center for Biotechnology Information (NCBI) Gene Expression Omnibus (GEO). A differential expression analysis (p &lt; 0.05 and |logFC (fold change)| ≥ 1) and a functional enrichment analysis (p &lt; 0.05) were performed. Based on this, a protein–protein interaction (PPI) network was constructed by Cytoscape. RA-related genes were extracted from DisGeNET database, and an overlap between periimplantitis-related genes and these RA-related genes was examined to identify potential cross-talk genes. Gene expression was merged between two datasets, and feature selection was performed by Recursive Feature Elimination (RFE) algorithm. For the feature selection cross-talk genes, support vector machine (SVM) models were constructed. The expression of these feature genes was determined from GSE93272 for RA. Finally, a network including cross-talk genes, related pathways, and transcription factors was constructed.ResultsPeriimplantitis datasets included 138 common differentially expressed genes (DEGs) including 101 up- and 37 downregulated DEGs. The PPI interwork of periimplantitis comprised 1,818 nodes and 2,517 edges. The RFE method selected six features, i.e., MERTK, CD14, MAPT, CCR1, C3AR1, and FCGR2B, which had the highest prediction. Out of these feature genes, CD14 and FCGR2B were most highly expressed in periimplantitis and RA. The final activated pathway–gene network contained 181 nodes and 360 edges. Nuclear factor (NF) kappa B signaling pathway and osteoclast differentiation were identified as potentially relevant pathways.ConclusionsThis current study revealed FCGR2B and CD14 as the most relevant potential cross-talk genes between RA and periimplantitis, which suggests a similarity between RA and periimplantitis and can serve as a theoretical basis for future research.
Risk Stratification for Organ/Space Surgical Site Infection in Advanced Digestive System Cancer
Authors: Sun Chen , Gao Hui , Zhang Yuelun , Pei Lijian , Huang Yuguang 
Published: November 2021

BackgroundOrgan/space surgical site infection (organ/space SSI) is a serious postoperative complication, closely related to a poor prognosis. Few studies have attempted to stratify the risk of organ/space SSI for patients with advanced digestive system cancer. This study aimed to identify a simple risk stratification for these patients based on perioperative factors.MethodsThe study was based on two randomized controlled trials (RCT) (NCT02715076, ChiCTR-IPR-17011099), including 839 patients undergoing elective radical resection of advanced digestive system cancer. The primary outcome was organ/space SSI within 30 days after surgery. Multivariable logistic regression model was used to identify risk factors. The risk of organ/space SSI stratified over those risk factors was compared using chi-square tests and the relative risk (RR) was estimated.ResultsAmong the 839 patients, 51 developed organ/space SSI (6.1%) within 30 days after surgery. According to the multivariable logistic regression model, 3 procedure types, including gastrectomy (OR=8.22, 95% CI: 2.71-24.87, P&lt;0.001), colorectal resection (OR=8.65, 95% CI: 3.13-23.85, P&lt;0.001) and pancreatoduodenectomy (OR=7.72, 95% CI: 2.95-20.21, P&lt;0.001), as well as anaesthesia time &gt; 4 h (OR=2.38, 95% CI: 1.08-5.27, P=0.032) and prolonged ICU stay (OR=4.10, 95% CI: 1.67-10.10, P=0.002), were risk factors for postoperative organ/space SSI. The number of risk factors was significantly associated with an increased risk of organ/space SSI (P&lt;0.001), which was 2.8% in patients with 0-1 risk factor (RR=0.20, 95% CI: 0.11-0.35), 13.0% in patients with 2 risk factors (RR=3.64, 95% CI: 2.14-6.20) and 35.7% in patients with 3 risk factors (RR=6.41, 95% CI: 3.01-13.65).ConclusionThis study is a preliminary exploratory and provides a simple risk stratification to identify the risk of postoperative organ/space SSI for patients with advanced digestive system cancer. Further research is needed to validate and generalize the results in a wider population.Clinical Trial RegistrationClinicalTrials.gov, identifier NCT02715076; Chinese Clinical Trial Registry [https://www.chictr.org.cn/enindex.aspx], identifier ChiCTR-IPR-17011099.
Trends and clinical characteristics of COVID-19 vaccine recipients: a federated analysis of 57.9 million patients' primary care records in situ using OpenSAFELY
Authors: Curtis Helen J , Inglesby Peter , Morton Caroline E , MacKenna Brian , Green Amelia , Hulme William , Walker Alex J , Morley Jessica , Mehrkar Amir , Bacon Seb , Hickman George , Bates Chris , Croker Richard , Evans David , Ward Tom , Cockburn Jonathan , Davy Simon , Bhaskaran Krishnan , Schultze Anna , Rentsch Christopher T , Williamson Elizabeth J , Rowan Anna , Fisher Louis , McDonald Helen I , Tomlinson Laurie , Mathur Rohini , Drysdale Henry , Eggo Rosalind M , Wing Kevin , Wong Angel YS , Forbes Harriet , Parry John , Hester Frank , Harper Sam , O’Hanlon Shaun , Eavis Alex , Jarvis Richard , Avramov Dima , Griffiths Paul , Fowles Aaron , Parkes Nasreen , Douglas Ian J , Evans Stephen JW , Smeeth Liam , Goldacre Ben ,   (The OpenSAFELY Collaborative)
Published: November 2021

BackgroundOn 8 December 2020 NHS England administered the first COVID-19 vaccination.AimTo describe trends and variation in vaccine coverage in different clinical and demographic groups in the first 100 days of the vaccine rollout.Design and settingWith the approval of NHS England, a cohort study was conducted of 57.9 million patient records in general practice in England, in situ and within the infrastructure of the electronic health record software vendors EMIS and TPP using OpenSAFELY.MethodVaccine coverage across various subgroups of Joint Committee on Vaccination and Immunisation (JCVI) priority cohorts is described.ResultsA total of 20 852 692 patients (36.0%) received a vaccine between 8 December 2020 and 17 March 2021. Of patients aged ≥80 years not in a care home (JCVI group 2) 94.7% received a vaccine, but with substantial variation by ethnicity (White 96.2%, Black 68.3%) and deprivation (least deprived 96.6%, most deprived 90.7%). Patients with pre-existing medical conditions were more likely to be vaccinated with two exceptions: severe mental illness (89.5%) and learning disability (91.4%). There were 275 205 vaccine recipients who were identified as care home residents (JCVI group 1; 91.2% coverage). By 17 March, 1 257 914 (6.0%) recipients had a second dose.ConclusionThe NHS rapidly delivered mass vaccination. In this study a data-monitoring framework was deployed using publicly auditable methods and a secure in situ processing model, using linked but pseudonymised patient-level NHS data for 57.9 million patients. Targeted activity may be needed to address lower vaccination coverage observed among certain key groups.
Роль наукових підходів щодо дослідження механізмів забезпечення виконавської дисципліни публічними службовцями
Authors: Larina N. B.  , Yashutin I. M.  
Published: November 2021

У статті здійснено аналіз теоретичних підходів до визначення поняття та механізмів забезпечення виконавської дисципліни в органах публічної служби, акцентовано увагу на необхідності проведення системного, комплексного підходів щодо дослідження форм, методів стану виконавської дисципліни публічних службовців, що допоможе розкрити основні напрями підвищення рівня виконавської дисципліни на публічній службі.
Запропоновано узагальнити та адаптувати досвід країн Європейського співтовариства щодо підвищення рівня виконавської дисципліни до української дійсності шляхом запровадження інноваційних механізмів забезпечення виконавської дисципліни в органах публічної служби, що позитивно вплине на подальший професійний розвиток публічних службовців органів влади в Україні.
Доцільність дослідження теоретичних підходів щодо розуміння понять та механізмів забезпечення виконавської дисципліни в органах публічної служби обумовлюється важливістю розвитку належного демократичного врядування в Україні. Це сприятиме підвищенню репутації публічної служби в органах влади, зростанню іміджу публічного службовця, формуванню якісно нової системи публічної служби в Україні
Наукові підходи до понять “публічна служба”, “виконавська дисципліна”, “публічне управління” відображають нові, сучасні тенденції становлення наукового дискурсу з цієї проблематики у галузі знань 28 “Публічне управління та адміністрування” й водночас можуть стати платформою для подальших висновків щодо напрямків зростання ефективності виконавської дисципліни в органах публічної служби.
Зазначені чинники зумовлюють необхідність ретельного аналізу теоретичних підходів до розуміння понять, що використовується в досліджені, формулювання власної інтерпретації понятійного поля та механізмів забезпечення виконавської дисципліни в органах публічної служби в Україні.
KEWENANGAN PT. PELINDO IV TARAKAN TERHADAP HAK ATAS TANAH DAERAH LINGKUNGAN KERJA PELABUHAN
Authors: Kurniawan Endy 
Published: November 2021

Abstract The title of the research is to " LAW REVIEW THE LAND ENVIRONMENT WORKING OF PORT AREAS (DLKr) PT. PELINDO IV OF TARAKAN. The purpose of this research is to analyze the authority of PT PELINDO IV Tarakan as holders of land rights in the form of Rights Management (HPL) the land environment working of port areas. In addition, the study also to analyze the land of rights can be given to the people on ) the land environment working of port areas or coastal region. This Research to use normative legal method to study with the type of normative juridical. As for the approach used in this study is the statute approach and conceptual approach. Sources of legal materials used are primary, secondary and tertiary legal material. Legal materials collection techniques used this study to collect and analyze the Regulation in relating to the legal issues raised, as well as collecting the conceptual framework and legal theory to be the basis of analyzing the legal issues studied. PT. PELINDO IV of Tarakan has the authority to the land environment working of port areas with Right to used (HPL) contained in the Joint Decree of the Minister of Home Affair and Minister of Transportation Number 31 of 1992 K.M Number 9 of 1992 concerning frontier Work Environment Ports. In the fourth dictum of the Joint Decree of the Minister of Home Affair and Minister of Transportation, PT. PELINDO IV of Tarakan required to complete the land registration process in the Land Office in accordance with applicable regulations. Until now PT. Pelindo IV Tarakan not enroll all of the land which they are entitled and limitations affect the authority of PT. Pelindo IV Tarakan on the overall the land environment working of port areas. Keynote : Land Law, HPL, Law Review