bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does rehabilitation setting influence risk of institutionalization? A register-based study of hip fracture patients in Oslo, Norway
Authors: Fosse Rina Moe , Ambugo Eliva Atieno , Moger Tron Anders , Hagen Terje P. , Tjerbo Trond 
Published: July 2021

Abstract
Background
Reducing the economic impact of hip fractures (HF) is a global issue. Some efforts aimed at curtailing costs associated with HF include rehabilitating patients within primary care. Little, however, is known about how different rehabilitation settings within primary care influence patients’ subsequent risk of institutionalization for long-term care (LTC). This study examines the association between rehabilitation setting (outside an institution versus short-term rehabilitation stay in an institution, both during 30 days post-discharge for HF) and risk of institutionalization in a nursing home (at 6–12 months from the index admission).

Methods
Data were for 612 HF incidents across 611 patients aged 50 years and older, who were hospitalized between 2008 and 2013 in Oslo, Norway, and who lived at home prior to the incidence. We used logistic regression to examine the effect of rehabilitation setting on risk of institutionalization, and adjusted for patients’ age, gender, health characteristics, functional level, use of healthcare services, and socioeconomic characteristics. The models also included fixed-effects for Oslo’s boroughs to control for supply-side and unobserved effects.

Results
The sample of HF patients had a mean age of 82.4 years, and 78.9 % were women. Within 30 days after hospital discharge, 49.0 % of patients received rehabilitation outside an institution, while the remaining 51.0 % received a short-term rehabilitation stay in an institution. Receiving rehabilitation outside an institution was associated with a 58 % lower odds (OR = 0.42, 95 % CI = 0.23–0.76) of living in a nursing home at 6–12 months after the index admission. The patients who were admitted to a nursing home for LTC were older, more dependent on help with their memory, and had a substantially greater increase in the use of municipal healthcare services after the HF.

Conclusions
The setting in which HF patients receive rehabilitation is associated with their likelihood of institutionalization. In the current study, patients who received rehabilitation outside of an institution were less likely to be admitted to a nursing home for LTC, compared to those who received a short-term rehabilitation stay in an institution. These results suggest that providing rehabilitation at home may be favorable in terms of reducing risk of institutionalization for HF patients.
Early whole blood transcriptional responses to radiation-attenuated Plasmodium falciparum sporozoite vaccination in malaria naïve and malaria pre-exposed adult volunteers
Authors: Duffy Fergal J. , Du Ying , Carnes Jason , Epstein Judith E. , Hoffman Stephen L. , Abdulla Salim , Jongo Said , Mpina Maxmillian , Daubenberger Claudia , Aitchison John D. , Stuart Ken 
Published: July 2021

Abstract
Background
Vaccination with radiation-attenuated Plasmodium falciparum sporozoites is known to induce protective immunity. However, the mechanisms underlying this protection remain unclear. In this work, two recent radiation-attenuated sporozoite vaccination studies were used to identify potential transcriptional correlates of vaccination-induced protection.

Methods
Longitudinal whole blood RNAseq transcriptome responses to immunization with radiation-attenuated P. falciparum sporozoites were analysed and compared across malaria-naïve adult participants (IMRAS) and malaria-experienced adult participants (BSPZV1). Parasite dose and method of delivery differed between trials, and immunization regimens were designed to achieve incomplete protective efficacy. Observed protective efficacy was 55% in IMRAS and 20% in BSPZV1. Study vaccine dosings were chosen to elicit both protected and non-protected subjects, so that protection-associated responses could be identified.

Results
Analysis of comparable time points up to 1 week after the first vaccination revealed a shared cross-study transcriptional response programme, despite large differences in number and magnitude of differentially expressed genes between trials. A time-dependent regulatory programme of coherent blood transcriptional modular responses was observed, involving induction of inflammatory responses 1–3 days post-vaccination, with cell cycle responses apparent by day 7 in protected individuals from both trials. Additionally, strongly increased induction of inflammation and interferon-associated responses was seen in non-protected IMRAS participants. All individuals, except for non-protected BSPZV1 participants, showed robust upregulation of cell-cycle associated transcriptional responses post vaccination.

Conclusions
In summary, despite stark differences between the two studies, including route of vaccination and status of malaria exposure, responses were identified that were associated with protection after PfRAS vaccination. These comprised a moderate early interferon response peaking 2 days post vaccination, followed by a later proliferative cell cycle response steadily increasing over the first 7 days post vaccination. Non-protection is associated with deviations from this model, observed in this study with over-induction of early interferon responses in IMRAS and failure to mount a cell cycle response in BSPZV1.
Improvement of skin lesions in corticosteroid withdrawal-associated severe eczema by multicomponent traditional Chinese medicine therapy
Authors: Uzun Serife , Wang Zixi , McKnight Tory A. , Ehrlich Paul , Thanik Erin , Nowak-Wegrzyn Anna , Yang Nan , Li Xiu-Min 
Published: July 2021

Abstract
Rationale
We recently showed that multicomponent traditional Chinese medicine (TCM) therapy had steroid-sparing effects in moderate-to-severe eczema. We sought to evaluate TCM effects in severe eczema in a 7-year-old male with refractory disease and corticosteroid withdrawal syndrome.

Methods
Prior to referral, the patient had been treated since infancy with increasingly intensive standard of care, including high-dose topical and systemic corticosteroid and antibiotic therapy and was unable to tolerate further steroid treatment. The patient was administered a combination of oral and topical TCM for 17 months following discontinuation of his steroid regimen. His overall medical condition was assessed by SCORAD criteria and laboratory evaluations of serum IgE, absolute eosinophil count, and liver and kidney function tests.

Results
The patient showed rapid improvement of clinical measures of disease after starting TCM therapy, with marked improvement of sleep quality within the first week, complete resolution of itching, oozing, and erythema at 2 weeks, and a 79% and 99% decrease in his SCORAD values after one month and 3–6 months of TCM, respectively. Serum total IgE decreased by 75% (from 19,000 to 4630 (kIU/L), and absolute eosinophil counts decreased by 60% (from 1000 to 427 cells/μL) after 12 months of treatment. The patient did not require oral or topical steroids during the 17-month trial of TCM. TCM was tapered without complications. His dermatologic manifestations continued to be well-controlled 3 months after discontinuation.

Conclusion
This case study suggests TCM should be further evaluated in controlled clinical studies of patients with severe, refractory eczema and steroid withdrawal syndrome.
Iatrogenic fracture during shoulder dislocation reduction: characteristics, management and outcomes
Authors: Pan Xiaohui , Yao Yong , Yan Hongyong , Wang Jun , Dai Lei , Qu Xincong , Fang Zuyi , Feng Feng , Zhou Yan 
Published: July 2021

Abstract
Background
Shoulder dislocation and the cases of iatrogenic fractures during manual reduction are becoming increasingly common. The aim of this study was to investigate the characteristics, management, and patient outcomes of iatrogenic proximal humeral fracture during the manual reduction of shoulder dislocation.

Methods
A retrospective and multi-center study was performed to identify all patients presenting with shoulder dislocation from January 2010 to January 2020. The sex and age of patients, associated injuries, first-time or habitual shoulder dislocation, type of anesthesia, time from injury to revision surgery, and functional outcomes were analyzed.

Results
A total of 359 patients with a mean age of 62.1 ± 7.3 years (range 29–86 years) were included. Twenty-one patients (female/male ratio 17:4) with an average age of 66.3 ± 9.7 years (range 48–86 years) were identified with a post-reduction iatrogenic fracture. Female cases with greater tuberosity fractures (GTF) were more likely than male cases to have iatrogenic fractures during reduction (P = 0.035). Women aged 60 years or older experienced more iatrogenic fractures during manual reduction (P = 0.026). Closed reduction under conscious sedation was more likely than that under general anesthesia to have iatrogenic fractures (P = 0.000). A total of 21 patients underwent open reduction and internal fixation (ORIF) when iatrogenic fractures occurred. The mean follow-up period was 19.7 ± 6.7 months (range 12–36 months). The mean Neer scores were 80.5 ± 7.6 (range 62–93), and the mean visual analog score (VAS) was 3.3 ± 1.5 (range 1–6). Significant differences were observed in the Neer score and VAS with the time (more or less 8 h) from injury to revision surgery (P < 0.05).

Conclusion
A high risk of iatrogenic proximal humeral fracture is present in shoulder dislocation with GTF in senile females without general anesthesia. ORIF performed in a timely manner may help improve functional outcomes in the case of iatrogenic injury.
Family member incarceration and coping strategies during the COVID-19 pandemic
Authors: Testa Alexander , Fahmy Chantal 
Published: July 2021

Abstract
Background
The disproportionately high rate of incarceration and COVID-19 cases during the summer of 2020 in the United States contributed to a set of circumstances that has produced considerable public health concerns as correctional facilities have emerged as significant COVID-19 hot spots. During the COVID-19 pandemic, having a family member incarcerated can be an especially stressful experience. This study assesses how concern about an incarcerated family member contracting COVID-19 impacts diverse coping strategies.

Results
Data are from a survey of individuals who have a family member incarcerated in Texas (N = 365). Ordinary least squares regression is used to examine the association between concern about an incarcerated family member contracting COVID-19 and coping strategies. Findings demonstrate that higher levels of concern for an incarcerated person’s wellbeing during the COVID-19 pandemic is associated with dysfunctional coping mechanisms, but not adaptive or functional coping strategies.

Conclusions
Results suggest appropriate systemic responses by correctional administrations and public health practices can help mitigate dysfunctional coping mechanisms by family members during infectious disease outbreaks in correctional facilities.
Health professionals’ perception of pharmaceuticals procurement performance in public health facilities in Southwestern Ethiopia
Authors: Negera Gotuma , Merga Hailu , Gudeta Tadesse 
Published: July 2021

Abstract
Background
Pharmaceutical’s procurement is a core component of logistics management, and has a significant influence on product availability, and total supply chain costs. In Ethiopia, there are few studies on this topic where almost all of them were from suppliers’ perspectives and entirely quantitative. This study, therefore, aimed to assess health professionals’ perceptions about pharmaceuticals procurement performance in public health facilities in southwest Ethiopia.

Methods
A facility-based cross-sectional study complemented with a qualitative method was conducted from March 20 and April 30, 2019. We collected the quantitative data through self-administered structured questionnaires from pharmacy staff and document review using checklists. EpiData version 3.1 and SPSS version 20 were used for data entry and analysis, respectively. Descriptive statistics were done for quantitative data. Qualitative data were gathered through face-to-face in-depth interviews and analyzed using thematic analysis technique.

Results
Regarding respondents’ perception of accountability in pharmaceutical procurement, 110 (57.9%) agreed or strongly agreed that their facilities adopt and use standard treatment guidelines and facility-specific medicine lists. Concerning competitiveness, 139 (62.6%) of the participants either disagreed or strongly disagreed that their facilities used formal suppliers’ qualifications based on service reliability and financial capacity. Regarding efficiency, 146 (76.8%) disagreed or strongly disagreed that their facilities develop a mechanism for prompt, reliable payment to lower medicine prices. The qualitative analysis identified staff workforce and competency, budget shortages, suppliers’ uncertainty, and pharmaceutical non-availability as challenges for procurement management performance.

Conclusion
The results indicated that participants perceived procurement performance of their facilities as poor. Therefore, staff development, fundraising options, monitoring and evaluation, coordination and collaboration can improve procurement practice and performance.
Is oxygen therapy beneficial for normoxemic patients with acute heart failure? A propensity score matched study
Authors: Yu Yue , Yao Ren-Qi , Zhang Yu-Feng , Wang Su-Yu , Xi Wang , Wang Jun-Nan , Huang Xiao-Yi , Yao Yong-Ming , Wang Zhi-Nong 
Published: July 2021

Abstract
Background
The clinical efficiency of routine oxygen therapy is uncertain in patients with acute heart failure (AHF) who do not have hypoxemia. The aim of this study was to investigate the association between oxygen therapy and clinical outcomes in normoxemic patients hospitalized with AHF using real-world data.

Methods
Normoxemic patients diagnosed with AHF on ICU admission from the electronic ICU (eICU) Collaborative Research Database were included in the current study, in which the study population was divided into the oxygen therapy group and the ambient-air group. Propensity score matching (PSM) was applied to create a balanced covariate distribution between patients receiving supplemental oxygen and those exposed to ambient air. Linear regression and logistic regression models were performed to assess the associations between oxygen therapy and length of stay (LOS), and all-cause in-hospital as well as ICU mortality rates, respectively. A series of sensitivity and subgroup analyses were conducted to further validate the robustness of our findings.

Results
A total of 2922 normoxemic patients with AHF were finally included in the analysis. Overall, 42.1% (1230/2922) patients were exposed to oxygen therapy, and 57.9% (1692/2922) patients did not receive oxygen therapy (defined as the ambient-air group). After PSM analysis, 1122 pairs of patients were matched: each patient receiving oxygen therapy was matched with a patient without receiving supplemental oxygen. The multivariable logistic model showed that there was no significant interaction between the ambient air and oxygen group for all-cause in-hospital mortality [odds ratio (OR) 1.30; 95% confidence interval (CI) 0.92–1.82; P = 0.138] or ICU mortality (OR 1.39; 95% CI 0.83–2.32; P = 0.206) in the post-PSM cohorts. In addition, linear regression analysis revealed that oxygen therapy was associated with prolonged ICU LOS (OR 1.11; 95% CI 1.06–1.15; P <  0.001) and hospital LOS (OR 1.06; 95% CI 1.01–1.10; P = 0.009) after PSM. Furthermore, the absence of an effect of supplemental oxygen on mortality was consistent in all subgroups.

Conclusion
Routine use of supplemental oxygen in AHF patients without hypoxemia was not found to reduce all-cause in-hospital mortality or ICU mortality.
Characterization of multi-scale ionospheric irregularities using ground-based and space-based GNSS observations
Authors: Peng YuXiang , Scales Wayne A , Hartinger Michael D , Xu Zhonghua , Coyle Shane 
Published: July 2021

AbstractIonospheric irregularities can adversely affect the performance of Global Navigation Satellite System (GNSS). However, this opens the possibility of using GNSS as an effective ionospheric remote sensing tool. Despite ionospheric monitoring has been undertaken for decades, these irregularities in multiple spatial and temporal scales are still not fully understood. This paper reviews Virginia Tech’s recent studies on multi-scale ionospheric irregularities using ground-based and space-based GNSS observations. First, the relevant background of ionospheric irregularities and their impact on GNSS signals is reviewed. Next, three topics of ground-based observations of ionospheric irregularities for which GNSS and other ground-based techniques are used simultaneously are reviewed. Both passive and active measurements in high-latitude regions are covered. Modelling and observations in mid-latitude regions are considered as well. Emphasis is placed on the increased capability of assessing the multi-scale nature of ionospheric irregularities using other traditional techniques (e.g., radar, magnetometer, high frequency receivers) as well as GNSS observations (e.g., Total-Electron-Content or TEC, scintillation). Besides ground-based observations, recent advances in GNSS space-based ionospheric measurements are briefly reviewed. Finally, a new space-based ionospheric observation technique using GNSS-based spacecraft formation flying and a differential TEC method is demonstrated using the newly developed Virginia Tech Formation Flying Testbed (VTFFTB). Based on multi-constellation multi-band GNSS, the VTFFTB has been developed into a hardware-in-the-loop simulation testbed with external high-fidelity global ionospheric model(s) for 3-satellite formation flying, which can potentially be used for new multi-scale ionospheric measurement mission design.
Characteristics of colistin-resistant Escherichia coli from pig farms in Central China
Authors: Peng Zhong , Zhang Xiaoxue , Li Xiaosong , Hu Zizhe , Li Zugang , Jia Chaoying , Dai Menghong , Tan Chen , Chen Huanchun , Wang Xiangru 
Published: July 2021

AbstractThe emergence and dissemination of colistin resistance in Enterobacteriaceae mediated by plasmid-borne mcr genes in recent years now pose a threat to public health. In this study, we isolated and characterized colistin-resistant and/or mcr-positive E. coli from pig farms in Central China. Between 2018 and 2019, 594 samples were collected and recovered 445 E. coli isolates. Among them, 33 with colistin resistance phenotypes and 37 that were positive for mcr genes were identified, including 34 positive for mcr-1, one positive for mcr-3, and two positive for both mcr-1 and mcr-3. An insertion of nine bases (“CTGGATACG”) into mcr-1 in four mcr-positive isolates led to gene dysfunction, and therefore did not confer the colistin resistance phenotype. Antimicrobial susceptibility testing revealed that 37 mcr-positive isolates showed severe drug resistance profiles, as 50% of them were resistant to 20 types of antibiotics. Multilocus sequence typing revealed a heterogeneous group of sequence types in mcr-positive isolates, among which ST10 (5/37), ST156 (5/37), and ST617 (4/37) were the predominant types. Plasmid conjugation assays showed that mcr-carrying plasmids of 25 mcr-positive isolates were conjugated with E. coli recipient, with conjugation frequencies ranging from 1.7 × 10-6 to 4.1 × 10-3 per recipient. Conjugation of these mcr genes conferred a colistin resistance phenotype upon the recipient bacterium. PCR typing of plasmids harbored in the 25 transconjugants determined six types of plasmid replicons, including IncX4 (14/25), FrepB (4/25), IncI2 (3/25), IncHI2 (2/25), FIB (1/25), and IncI1 (1/25). This study contributes to the current understanding of antibiotic resistance and molecular characteristics of colistin-resistant E. coli in pig farms.
Potential Winners and Losers: Understanding How the Oncology Care Model May Differentially Affect Hospitals
Authors: Segel Joel E. , Schaefer Eric W. , Zaorsky Nicholas G. , Hollenbeak Christopher S. , Ramian Haleh , Raman Jay D. 
Published: July 2021

PURPOSE: With the introduction of the Oncology Care Model and plans for the transition to Oncology Care First, alternative payment models (APMs) are an increasingly important piece of the oncology care landscape. Evidence is mixed on the Oncology Care Model's impact on utilization and costs, but as policymakers consider expansion of similar models, it is critical to understand the characteristics of hospitals that may be differentially affected. METHODS: We used 2007-2016 SEER-Medicare data to identify patients with breast and prostate cancer receiving chemotherapy, endocrine therapy (breast), or androgen deprivation therapy (prostate). For each hospital, we calculated 6-month expected mortality, emergency department (ED) visits, inpatient admissions, and costs, all commonly collected APM outcomes. After calculating observed-to-expected rates for each outcome by hospital, we estimated the association between observed-to-expected rates and characteristics of each hospital to understand hospital characteristics that might be associated with higher- or lower-than-expected rates of each outcome. RESULTS: Hospitals with > 15% rural patients had significantly higher-than-expected mortality (0.31 points higher, P < .001) and ED visit rates (0.10 points higher, P = .029) as well as significantly lower costs (0.06 points lower, P = .004). Hospitals unaffiliated with a medical school also experienced significantly higher-than-expected mortality and ED visits. Hospitals eligible for disproportionate share hospital payment experienced significantly higher ED visits but lower costs. For-profit hospitals experienced higher-than-expected mortality. CONCLUSION: Rural hospitals and those unaffiliated with a medical school may require special consideration as APMs expand in oncology care. Designated cancer centers and larger hospitals may be advantaged.
Thin Film Properties of Thermally Stable Protic Ionic Liquids
Authors: Kondo Hirofumi , Iimura Ken-ichi 
Published: July 2021

Abstract
Ionic liquids (ILs) have aroused particular interest as potential lubricants because their thermal stabilities are quite superior to those of conventional lubricants, however, their thin film properties have not been investigated very much. Newly synthesized diazabicycloundecenium (DBU) and imidazolium (IM) sulfonates were evaluated as a potential molecularly thin film lubricant for carbon-coated media. The ILs have steady low friction coefficients even after a heat treatment at 250 °C at which those of the conventional lubricant, Z-DOL, steeply increased. A systematic analysis of the thin films was performed using FTIR-RAS and their thermal degradation kinetics were examined. The thermal degradation process of the IL thin films could be described by a zero-order kinetics mechanism. The calculated activation energies show that the ILs physiosorb on the surface and the thermal stabilities of the IL films are significantly lower than that of the bulk. The FTIR measurements indicated two friction reduction regimes for the ILs; i.e., the perfluoroalkylsulfonate molecules, which seem to be a thermally decomposed product from the IL molecules, still remained and oriented parallel to the surface in the temperature range of 200 °C or higher and reduced the friction.