bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality and Cost of Care by Hospital Teaching Status: What Are the Differences?
Authors: SLOAN FRANK A. 
Published: March 2021

Policy Points
In two respects, quality of care tends to be higher at major teaching hospitals: process of care and long‐term survival of cancer patients following initial diagnosis. There is also evidence that short‐term (30‐day) mortality is lower on average at such hospitals, although the quality of evidence is somewhat lower.
Quality of care is mulitdimensional. Empirical evidence by teaching status on dimensions other than survival is mixed.
Higher Medicare payments for care provided by major teaching hospitals are partially offset by lower payments to nonhospital providers. Nevertheless, the payment differences between major teaching and nonteaching hospitals for hospital stays, especially for complex cases, potentially increase prices other insurers pay for hospital care.
ContextThe relative performance of teaching hospitals has been discussed for decades. For private and public insurers with provider networks, an issue is whether having a major teaching hospital in the network is a “must.” For traditional fee‐for‐service Medicare, there is an issue of adequacy of payment of hospitals with various attributes, including graduate medical education (GME) provision. Much empirical evidence on relative quality and cost has been published. This paper aims to (1) evaluate empirical evidence on relative quality and cost of teaching hospitals and (2) assess what the findings indicate for public and private insurer policy.MethodsComplementary approaches were used to select studies for review. (1) Relevant studies highly cited in Web of Science were selected. (2) This search led to studies cited by these studies as well as studies that cited these studies. (3) Several literature reviews were helpful in locating pertinent studies. Some policy‐oriented papers were found in Google under topics to which the policy applied. (4) Several papers were added based on suggestions of reviewers.FindingsQuality of care as measured in process of care studies and in longitudinal studies of long‐term survival of cancer patients tends to be higher at major teaching hospitals. Evidence on survival at 30 days post admission for common conditions and procedures also tends to favor such hospitals. Findings on other dimensions of relative quality are mixed. Hospitals with a substantial commitment to graduate medical education, major teaching hospitals, are about 10% to 20% more costly than nonteaching hospitals. Private insurers pay a differential to major teaching hospitals at this range's lower end. Inclusive of subsidies, Medicare pays major teaching hospitals substantially more than 20% extra, especially for complex surgical procedures.ConclusionsBased on the evidence on quality, there is reason for patients to be willing to pay more for inclusion of major teaching hospitals in private insurer networks at least for some services. Medicare payment for GME has long been a controversial policy issue. The actual indirect cost of GME is likely to be far less than the amount Medicare is currently paying hospitals.
Why France Spends Less Than the United States on Drugs: A Comparative Study of Drug Pricing and Pricing Regulation
Authors: RAIMOND VÉRONIQUE C. , FELDMAN WILLIAM B. , ROME BENJAMIN N. , KESSELHEIM AARON S. 
Published: March 2021

Policy Points
Spending on prescription drugs is much higher per capita in the United States than in most other industrialized nations, including France.
Lower prescription drug spending in France is due to different approaches to managing drug prices, volume of prescribing, and global health budgets.
Linking a drug's price to value both at the launch of the drug and over its lifetime is key to controlling spending. Regulations on prescription volume and global spending complement the interventions on prices.
If the United States adopted the French approach to regulating drug pricing, Medicare could potentially save billions of dollars annually on prescription drug spending.
ContextPrescription drug spending per capita in the United States is higher than in most other industrialized countries. Policymakers seeking to lower drug spending often suggest benchmarking prices against other countries, including France, which spends half as much as the United States per capita on prescription drugs. Because differences in drug prices may result from how markets are organized in each nation, we sought to directly compare drug prices and pricing regulations between the United States and France.MethodsFor the six brand‐name drugs with the highest gross expenditures in Medicare Part D in 2017, we compared the price dynamics in France and the United States between 2010 and 2018 and analyzed associations between price changes in each country and key regulatory events. We also comprehensively reviewed US and French laws and regulations related to drug pricing.FindingsPrices for the six drugs studied were higher in the United States than in France. In 2018, if Medicare had paid French prices for the brand‐name drugs in our cohort, the agency would have saved $5.1 billion. We identified 12 factors that explain why the United States spends more than France on drugs, including variations in unit prices and the volume of prescriptions, driven by use of health technology assessment and value‐based pricing in France.ConclusionsKey drivers of lower drug spending in France compared to the United States are that the French government regulates drug prices when products are launched and prohibits substantial price increases after launch. The regulation of prescription drugs in France is governed by rules that can inform discussions of US prescription drug policy and potential Medicare price negotiations.
Are forensic scientists too risk averse?
Authors: Mannering Willa M. , Vogelsang Macgregor D. , Busey Thomas A. , Mannering Fred L. 
Published: March 2021

AbstractFingerprint examiners maintain decision thresholds that represent the amount of evidence required for an identification or exclusion conclusion. As measured by error rate studies (Proc Natl Acad Sci USA. 2011;108(19):7733–8), these decision thresholds currently exhibit a preference for preventing erroneous identification errors at the expense of preventing erroneous exclusion errors. The goal of this study is to measure the decision thresholds for both fingerprint examiners and members of the general public, to determine whether examiners are more risk averse than potential jury members. To externally measure these decision thresholds, subjects manipulated decision criteria in a web‐based visualization that reflects the trade‐offs between erroneous identification decisions and erroneous exclusion decisions. Data from fingerprint examiners and the general public were compared to determine whether both groups have similar values as expressed by the placement of the decision criteria. The results of this study show that fingerprint examiners are more risk averse than members of the general public, although they align with error rate studies of fingerprint examiners. Demographic data demonstrate those factors that may contribute to differences in decision criterion placement, both between the two groups and between individuals within a group. The experimental methods provide a rich framework for measuring, interpreting, and responding to the values of society as applied to forensic decision‐making.
COVID‐19: emergence and mutational diversification of SARS‐CoV‐2
Authors: Brüssow Harald 
Published: March 2021

SummaryThe origin of the SARS‐CoV‐2 virus is not yet defined, but a viral zoonosis from bats – with or without an alternative animal as an intermediate host – is still the most likely hypothesis. The intensive virological and epidemiological research combined with massive sequencing efforts of whole viral genomes allowed an unprecedented analysis of an unfolding pandemic at the level of viral evolution with the documentation of extinction events, prevalence increases and rise to dominance for different viral lineages that provide not only fundamental insights into mechanisms of viral evolution, but influence also public health measures to contain the virus.
Evaluating the strength of spinal and proximal girdle muscles in patients with axial spondyloarthritis: Correlation with activity, disability, and functionality
Authors: Yurdakul Ozan Volkan , Ince Ozlenen Eylul , Bagcier Fatih , Kara Mert , Kultur Esra , Aydin Teoman 
Published: March 2021

AbstractAimTo compare the muscle strength of muscle groups in axial spondyloarthritis (axSpA) patients with the muscle powers of healthy volunteers and to examine the relationship of muscle strengths with disease activity, functionality, and disability.MethodOne hundred males (50 axSpA, 50 healthy) were included in the study. Bath Disease Activity Index (BASDAI), Functional Index (BASFI), and Health Assessment Questionnaire‐Disability Index (HAQ‐DI) scores were recorded. The maximum (max) and mean cervical flexion, extension, lateral flexion (CF, CE, CLF), truncal flexion, extension (TF, TE), root joint flexion, extension, abduction, internal and external rotation (SF, SE, SAB, SIR and SER for the shoulder; HF, HE, HAB, HIR and HER for the hip) muscle strengths of the patients in both groups were measured by a handheld dynamometer. Total muscle strength (CT, TT, ST, HT) was found according to the sum of the max and mean values for each region.ResultsAll muscle strengths were lower in the axSpA group compared to the healthy volunteers. The symptom duration was found to have a weak‐moderate negative correlation with CT, TT, ST, HT and all individual muscle strengths except for the TE, CF, HIR, and HER. BASDAI and HAQ‐DI had weak‐moderate negative correlations with HIR and HER. BASFI had a weak‐moderate negative correlation with cervical measurements, TE, TF, SF, SER, SIR, and hip measurements.ConclusionAll muscle strengths were lower in patients compared to healthy volunteers. Strengthening specific muscle groups for the desired goal can be a reasonable strategy. The study is prospectively registered and available at www.clinicaltrials.gov (NCT04435860).
classecol: Classifiers to understand public opinions of nature
Authors: Johnson Thomas F. , Kent Hebe , Hill Bethan M. , Dunn Georgia , Dommett Leonie , Penwill Natasha , Francis Tom , González‐Suárez Manuela 
Published: March 2021

Abstract

Human perceptions of nature, once the domain of the social sciences, are now an important part of environmental research. However, the data and tools to tackle this research are lacking or are difficult to apply.

Here, we present a collection of text classifier models to identify text relevant to the broad topics of hunting and nature, describing whether opinions are pro‐ or against‐hunting, or show interest, concern or dislike of nature. The methods also include a biographical classification—describing whether the author of the text is a person, nature expert, nature organisation or ‘Other’. The classifiers were developed using an extensive social media dataset, and are designed to support qualitative analysis of big data (especially from Twitter).

The classifiers accurately identified biographies, text related to hunting and nature and the stance towards hunting and nature (weighted F‐scores: 0.79–0.99; 1 indicates perfect accuracy).

These classifiers, alongside an array of other text processing and analysis functions, are presented in the form of an R package classecol. classecol also acts as a proof of concept that nature‐related text classifiers can be developed with high accuracy.
Children of Asian ethnicity in Australia have higher risk of food allergy and early‐onset eczema than those in Singapore
Authors: Suaini Noor H. A. , Loo Evelyn Xiu‐Ling , Peters Rachel L. , Yap Gaik Chin , Allen Katrina J. , Van Bever Hugo , Martino David J. , Goh Anne Eng Neo , Dharmage Shyamali C. , Colega Marjorelee T. , Chong Mary Foong Fong , Ponsonby Anne‐Louise , Tan Kok Hian , Tang Mimi L. K. , Godfrey Keith M. , Lee Bee Wah , Shek Lynette Pei‐Chi , Koplin Jennifer J. , Tham Elizabeth Huiwen 
Published: March 2021

AbstractBackgroundIn Western countries, Asian children have higher food allergy risk than Caucasian children. The early‐life environmental exposures for this discrepancy are unclear. We aimed to compare prevalence of food allergy and associated risk factors between Asian children in Singapore and Australia.MethodsWe studied children in the Growing Up in Singapore Towards healthy Outcomes (GUSTO) birth cohort (n = 878) and children of Asian ancestry in the HealthNuts cohort (n = 314). Food allergy was defined as a positive SPT ≥3 mm to egg or peanut AND either a convincing history of IgE‐mediated reaction at 18 months (GUSTO) or a positive oral food challenge at 14‐18 months (HealthNuts). Eczema was defined as parent‐reported doctor diagnosis.ResultsFood allergy prevalence was 1.1% in Singapore and 15.0% in Australia (P<0.001). Egg introduction was more often delayed (>10 months) in Singapore (63.5%) than Australia (16.3%; P<0.001). Prevalence of early‐onset eczema (<6 months) was lower in Singapore (8.4%) than Australia (30.5%) (P<0.001). Children with early‐onset eczema were more likely to have food allergy than those without eczema in Australia [aOR 5.11 (2.34‐11.14); P<0.001] and Singapore [aOR4.00 (0.62‐25.8); P = 0.145].ConclusionsAmong Asian children, prevalence of early‐onset eczema and food allergy was higher in Australia than Singapore. Further research with larger sample sizes and harmonized definitions of food allergy between cohorts is required to confirm and extend these findings. Research on environmental factors influencing eczema onset in Australia and Singapore may aid understanding of food allergy pathogenesis in different parts of the world.
Trends and outcomes in Australian carotid artery revascularization surgery: 2010–2017
Authors: Murtidjaja Michelle , Stathis Alexandra O. , Thomas Shannon D. , Beiles Charles Barry , Mwipatayi Bibombe Patrice , Katib Nedal , Varcoe Ramon L. 
Published: March 2021

AbstractBackgroundCarotid endarterectomy (CEA) and carotid artery stenting (CAS) reduce the risk of stroke in patients with severe carotid stenosis. The aim was to compare contemporary treatment trends and outcomes after CEA and CAS between states of Australia.MethodsA retrospective analysis was conducted on data from the Australasian Vascular Audit between 2010 and 2017. The primary endpoint was perioperative stroke or death (S/D). We also analysed stroke and death independently and revascularization rates per 100 000 population.ResultsA total of 15 413 patients underwent carotid revascularization (CEA 14 070; CAS 1343). S/D rates were similar for CEA and CAS (1.9% versus 1.8%; P = 0.37; symptomatic 2.1% versus 2.3%; P = 0.12; asymptomatic 1.5% versus 1.1%; P = 0.67). Patients ≥80 years (2.7% versus 1.7%; P = 0.01), those who had shunts (2.2% versus 1.7%; P = 0.03) or surgery in teaching hospitals (2.6% versus 1.4%; P = 0.02) had higher rates of S/D after CEA. Patients whose proceduralist used a cerebral protection device had lower S/D rates after CAS for symptomatic disease (4.8% versus 2.2%; P = 0.03). There was a wide variation in practice between states, where CAS as a proportion of total carotid procedures ranged from 0% to 17%, and a wide variation in outcomes, with rates of S/D varying between 1.4–6.6% for CEA and 0–6.7% after CAS.ConclusionOutcomes after CAS are equivalent to CEA when performed by vascular surgeons, however significant variation exists for both choice of revascularization procedure and perioperative outcomes between states. Further investigation is needed to determine whether clinical care pathways should be revised to achieve consistency and quality of outcomes.
Carceral Geographies from Inside Prison Gates: The Micro‐Politics of Everyday Racialisation
Authors: Bloch Stefano , Olivares‐Pelayo Enrique Alan 
Published: March 2021

AbstractAddressing a need for carceral geographical research conducted from inside prison gates, we discuss the spatial context in which racialisation occurs, including its relationship to the performance of prison “politics”. We argue that the convoluted and contentious racial categorisation of prison inmates that begins with “racial priming” and results in “racial sorting” possesses a spatial logic derived from institutional partitioning and street‐level cordoning of individual and group identities. We reveal how racialisation is relied upon through both a self‐segregation and institutional classification system at the micro scale. Based on autoethnographic reflection as formerly jailed and incarcerated individuals, and through a reading of sociological, criminological, and geographical literatures, we argue that the logic of everyday micro‐scale racial identity formation has more to do with location, gang alliances, antagonisms, and the necessary navigating of prison “politics” and protocol than with conceptualisations of “race” engendered by racial capitalism and enforced by the racial state.
How reliable are surgeon‐reported data? A comparison of the British Association of Urological Surgeons radical prostatectomy audit with the National Prostate Cancer Audit Hospital Episode Statistics‐linked database
Authors: Aning Jonathan J. , Parry Matthew G. , van der Meulen Jan , Fowler Sarah , Payne Heather , McGrath John S. , Challacombe Ben , Clarke Noel W. ,   the BAUS Section of Oncology, the National Prostate Cancer Audit
Published: March 2021

ObjectivesTo evaluate the accuracy and completeness of surgeon‐reported radical prostatectomy outcome data across a national health system by comparison with a national dataset gathered independently from clinicians directly involved in patient care.Patients and MethodsData submitted by surgeons to the British Association of Urological Surgeons (BAUS) radical prostatectomy audit for all men undergoing radical prostatectomy between 2015 and 2016 were assessed by cross linkage to the National Prostate Cancer Audit (NPCA) database. Specific data items collected in both databases were selected for comparison analysis. Data completeness and agreement were assessed by percentages and Cohen’s kappa statistic.ResultsData from 4707 men in the BAUS and NPCA databases were matched for comparison. Compared with the NPCA, dataset completeness was higher in the BAUS dataset for type of nerve‐sparing procedure (92% vs 42%) and postoperative margin status (89% vs 48%) but lower for readmission (87% vs 100%) and Charlson score (80% vs 100%). For all other variables assessed completeness was comparable. Agreement and data reliability were high for most variables. However, despite good agreement, the inter‐cohort reliability was poor for readmission, M stage and Charlson score (κ < 0.30).ConclusionsFor the first time in urology we show that surgeon‐reported data from the BAUS radical prostatectomy audit can reliably be used to benchmark peri‐operative radical prostatectomy outcomes. For comorbidity data, to assist with risk analysis, and longer‐term outcomes, NPCA routinely collected data provide a more comprehensive source.
Impact of menopausal hormone therapy on colorectal cancer risk—A systematic review
Authors: Nakhostin Livia , Stadler Aurelia , Stute Petra 
Published: March 2021

AbstractColorectal cancer (CRC) is the second most frequently diagnosed cancer in females worldwide. Menopausal hormone therapy (MHT) has been proposed as a potential protective factor for the development of CRC. Yet, the available evidence is controversial. Thus, we aimed at summarizing the current evidence on the effect of MHT on CRC through a systematic review. A systematic literature search identified 1001 potentially relevant articles, out of which 57 original studies and nine meta‐analyses were deemed eligible for the final synthesis. The evidence synthesis showed the following: (1) MHT showed a heterogeneity in findings for CRC risk with a slight tendency to a neutral or protective effect; (2) MHT effect was either neutral or protective on colorectal adenoma; (3) MHT had no impact on tumour grade, subsite and histologic types; (4) MHT was not associated with CRC mortality; and (5) MHT showed heterogeneous effects on CRC stage and invasiveness, respectively. In summary, despite some evidence pointing towards a protective effect of MHT on CRC, MHT is currently not recommended for primary CRC prevention by international guidelines due to several important, potentially harmful effects.
Constructs of childhood, generation and heroism in editorials on young people's climate change activism: Their mobilisation and effects
Authors: Raby Rebecca , Sheppard Lindsay C. 
Published: March 2021

AbstractWe analyse the effects of constructions and mobilisations of childhood, generation and girl heroism in 30 Canadian editorials written in response to 2019 climate change protests. We discuss how the editorials strategically position—and sometimes dismiss—young activists through discourses of childhood innocence, becoming and social participation. Second, we focus on how the editorials mobilise generation to emphasise either generational division or cross‐generational solidarity. Finally, we problematise the editorials' concentration on individualised girl heroism. We thus contextualise and deconstruct truth statements around age, generation and heroism, emphasising instead their effects and the potential for certain narratives to better recognise the diversity and solidarity in climate change activism.
The species awareness index as a conservation culturomics metric for public biodiversity awareness
Authors: Millard Joseph W. , Gregory Richard D. , Jones Kate E. , Freeman Robin 
Published: March 2021

AbstractAlthough threats to global biodiversity are well known, slowing current rates of biodiversity loss remains a challenge. The Aichi targets set out 20 goals on which the international community should act to alleviate biodiversity decline, 1 of which (Target 1) aims to raise public awareness of the importance of biodiversity. Although conventional indicators for Target 1 are of low spatial and temporal coverage, conservation culturomics metrics show how biodiversity awareness can be quantified at the global scale. Following methods used for the Living Planet Index, we devised a species awareness index (SAI) to measure change in species awareness based on Wikipedia views. We calculated this index at the page level for 41,197 species listed by the International Union for Conservation of Nature (IUCN) across 10 Wikipedia languages and >2 billion views from 1 July 2015 to 30 March 2020. Bootstrapped indices for the page‐level SAI showed that overall awareness of biodiversity increased marginally over time, although there were differences among taxonomic classes and languages. Among taxonomic classes, overall awareness increased fastest for reptiles and slowest for amphibians. Among languages, overall species awareness increased fastest for Japanese and slowest for Chinese and German users. Although awareness of species as a whole increased and was significantly higher for traded species, from January 2016 through January 2020, change in awareness appeared not to be strongly related to whether the species is traded or is a pollinator. As a data source for public biodiversity awareness, the SAI could be integrated into the Conservation International Biodiversity Engagement Indicator.