bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring effectiveness of different health financing mechanisms in Nigeria; what needs to change and how can it happen?
Authors: Onwujekwe Obinna , Ezumah Nkoli , Mbachu Chinyere , Obi Felix , Ichoku Hyacinth , Uzochukwu Benjamin , Wang Hong 
Published: September 2019

Abstract

Background
Various attempts to examine health financing mechanisms in Nigeria highlight the fact that there is no single mechanism that fits all contexts and people. This paper sets out findings of an in-depth assessment of different health financing mechanisms in Nigeria.

Methods
The study was undertaken in the Federal Capital territory of Nigeria and two States (Niger and Kaduna). Data were collected through review of government documents, and in-depth interviews of purposively selected respondents. Data analysis was guided by a conceptual framework which draws from various approaches for assessing health financing mechanisms. Data was examined for current practices, what needs to change and how the change can happen.

Results
Health financing mechanisms in Nigeria do not operate optimally. Allocation and use of resources are neither evidence-based nor results-driven. Resources are not allocated equitably or in a manner that minimizes wastage and improves efficiency. None of the mechanisms effectively protects individuals/households from catastrophic health expenditure. Issues with social health insurance cut across legal frameworks and use of Health Maintenance Organisations (HMOs) as purchasers. The concomitant effect is that attainment of Universal Health Coverage is greatly compromised. In order to improve efficiency of health financing mechanisms, government needs to allocate more funds for purchasing health services; this spending must be based on evidence (strategic), and appropriately tracked. The legislation that established National Health Insurance Scheme should be amended such that social health insurance becomes mandatory for all citizens. Implementation of the latter should be complemented by revision of benefit package, strict oversight and regulation of HMOs.

Conclusion
In order to improve health financing in the country, legal and regulatory frameworks need to be revised. Efficient utilization of resources could be improved through strategic purchasing arrangements and strict oversight.
Immunosenescence and human vaccine immune responses
Authors: Crooke Stephen N. , Ovsyannikova Inna G. , Poland Gregory A. , Kennedy Richard B. 
Published: September 2019

Abstract
The age-related dysregulation and decline of the immune system—collectively termed “immunosenescence”—has been generally associated with an increased susceptibility to infectious pathogens and poor vaccine responses in older adults. While numerous studies have reported on the clinical outcomes of infected or vaccinated individuals, our understanding of the mechanisms governing the onset of immunosenescence and its effects on adaptive immunity remains incomplete. Age-dependent differences in T and B lymphocyte populations and functions have been well-defined, yet studies that demonstrate direct associations between immune cell function and clinical outcomes in older individuals are lacking. Despite these knowledge gaps, research has progressed in the development of vaccine and adjuvant formulations tailored for older adults in order to boost protective immunity and overcome immunosenescence. In this review, we will discuss the development of vaccines for older adults in light of our current understanding—or lack thereof—of the aging immune system. We highlight the functional changes that are known to occur in the adaptive immune system with age, followed by a discussion of current, clinically relevant pathogens that disproportionately affect older adults and are the central focus of vaccine research efforts for the aging population. We conclude with an outlook on personalized vaccine development for older adults and areas in need of further study in order to improve our fundamental understanding of adaptive immunosenescence.
Serum fibroblast growth factor 19 and endogenous islet beta cell function in type 2 diabetic patients
Authors: Tang Meng-jie , Su Jian‑bin , Xu Tian-li , Wang Xue‑qin , Zhang Dong-mei , Wang Xiao-hua 
Published: September 2019

Abstract

Background
Fibroblast growth factor 19 (FGF19) takes part in maintaining the balance of glycolipids and may be involved in regulating the secretory activity of islet beta cells in patients with type 2 diabetes. This study aimed to evaluate the relationship between the levels of serum FGF19 and endogenous islet beta cell function in type 2 diabetic patients.

Methods
Samples were obtained from 271 subjects: 85 drug-naïve type 2 diabetes participants exclusively on lifestyle intervention (N-DM group), 122 type 2 diabetes subjects previously used medications (DM group) and 64 normal controls (NC group). Serum FGF19 concentrations were measured by ELISA. The insulin sensitivity (MI), insulin secretion (AUCins/AUCglu) and insulin secretion-sensitivity index-2 (ISSI-2) were also measured in the N-DM and DM.

Results
Serum FGF19 levels decreased, in order, from the NC group [median (interquartile range), 245.03 (126.23–317.43) pg/mL] to the N-DM group [170.05 (89.01–244.70) pg/mL] and, finally, to the DM group [142.25 (55.55–187.58) pg/mL] (p for trend < 0.05). Among subjects in the DM group, there was a positive trend in the serum FGF19 concentration; plasma insulin levels at 60 min, 120 min (INS60, INS120, respectively); and area under the insulin curve (AUCins) at two points (r = 0.214, p = 0.025; r = 0.189, p = 0.048; r = 0.188, p = 0.049). However, the differences were no longer observed among the N-DM subjects. Simultaneously, the ISSI-2 was closely related to the serum FGF19 levels (r = 0.297, p = 0.002) among DM subjects. Furthermore, after adjusting for age, sex, duration, therapy and other clinical factors via multiple logistic regression analysis, ISSI-2 was a key independent factor in the levels of FGF19 (β = 0.281, t = 2.557, p = 0.013).

Conclusions
The serum FGF19 level has a close relation with endogenous beta cell function among DM subjects, as assessed by the ISSI-2. As ISSI-2 is higher in N-DM group, FGF19 may be a main protector in dysfunction of beta cell.
RNA-seq data of Ganoderma boninense at axenic culture condition and under in planta pathogen-oil palm (Elaeis guineensis Jacq.) interaction
Authors: Wong Mui Yun , Govender Nisha T. , Ong Chia Sui 
Published: September 2019

Abstract

Objective
Basal stem rot disease causes severe economic losses to oil palm production in South-east Asia and little is known on the pathogenicity of the pathogen, the basidiomyceteous Ganoderma boninense. Our data presented here aims to identify both the house-keeping and pathogenicity genes of G. boninense using Illumina sequencing reads.

Description
The hemibiotroph G. boninense establishes via root contact during early stage of colonization and subsequently kills the host tissue as the disease progresses. Information on the pathogenicity factors/genes that causes BSR remain poorly understood. In addition, the molecular expressions corresponding to G. boninense growth and pathogenicity are not reported. Here, six transcriptome datasets of G. boninense from two contrasting conditions (three biological replicates per condition) are presented. The first datasets, collected from a 7-day-old axenic condition provide an insight onto genes responsible for sustenance, growth and development of G. boninense while datasets of the infecting G. boninense collected from oil palm-G. boninense pathosystem (in planta condition) at 1 month post-inoculation offer a comprehensive avenue to understand G. boninense pathogenesis and infection especially in regard to molecular mechanisms and pathways. Raw sequences deposited in Sequence Read Archive (SRA) are available at NCBI SRA portal with PRJNA514399, bioproject ID.
Study on coloring method of airport flight-gate allocation problem
Authors: Li Hongyan , Ding Xianfeng , Lin Jiang , Zhou Jingyu 
Published: September 2019

Abstract
With the development of economy, more and more people travel by plane. Many airports have added satellite halls to relieve the pressure of insufficient boarding gates in airport terminals. However, the addition of satellite halls will have a certain impact on connecting flights of transit passengers and increase the difficulty of reasonable allocation of flight and gate in airports. Based on the requirements and data of question F of the 2018 postgraduate mathematical contest in modeling, this paper studies the flight-gate allocation of additional satellite halls at airports. Firstly, match the seven types of flights with the ten types of gates. Secondly, considering the number of gates used and the least number of flights not allocated to the gate, and adding the two factors of the overall tension of passengers and the minimum number of passengers who failed to transfer, the multi-objective 0–1 programming model was established. Determine the weight vector $w=(0.112,0.097,0.496,0.395)$
w
=
(
0.112
,
0.097
,
0.496
,
0.395
)
of objective function by entropy value method based on personal preference, then the multi-objective 0–1 programming model is transformed into single-objective 0–1 programming model. Finally, a graph coloring algorithm based on parameter adjustment is used to solve the transformed model. The concept of time slice was used to determine the set of time conflicts of flight slots, and the vertex sequences were colored by applying the principle of “first come first serve”. Applying the model and algorithm proposed in this paper, it can be obtained that the average value of the overall tension degree of passengers minimized in question F is 35.179%, the number of flights successfully allocated to the gate maximized is 262, and the number of gates used is minimized to be 60. The corresponding flight-gate difficulty allocation weight is $\alpha =0.32$
α
=
0.32
and $\beta =0.40$
β
=
0.40
, and the proportion of flights successfully assigned to the gate is 86.469%. The number of passengers who failed to transfer was 642, with a failure rate of 23.337%.
Adherence to antihypertensive medication in Russia: a scoping review of studies on levels, determinants and intervention strategies published between 2000 and 2017
Authors: Bochkareva Elena Viktorovna , Butina Ekaterina Kronidovna , Kim Irina Vitalievna , Kontsevaya Anna Vasilievna , Drapkina Oxana Mikhailovna , Leon David , McKee Martin 
Published: September 2019

AbstractBackgroundArterial hypertension (HT) is common in the Russian adult population, with half of affected individuals inadequately controlled. Low adherence to medication seems likely to be a factor. We report a scoping review of studies on adherence to antihypertensive therapy (AHT) in Russia to determine the extent of research undertaken, the frequency of adherence among adults diagnosed with HT, methodologies used in the studies, and their ability to describe determinants of adherence.MethodsA scoping review of published studies that have assessed adherence to AHT in Russian HT patients searched the main Russian and international electronic databases eLIBRARY.ru, Russian Medicine, Embase, MEDLINE for full-text reports published in the Russian language between 2000 and 2017. The last search was on November 28, 2017. Among 520 reports identified, 31 were included in the review.ResultsEighteen studies assessed adherence using the 4-item Morisky Medication Adherence Scale (MMAS-4); others used bespoke questionnaires or pill counts. 25 studies assessed levels of adherence, 11 examined its determinants, and 18 examined intervention strategies. The proportion of “adherent” patients varied from 11 to 44% using the MMAS-4, from 23 to 74% when using bespoke questionnaires, and from 5 to 43% when using pill counts. Adherence was associated with sociodemographic factors, access to free drugs provided through the Medicine Assistance Scheme (MAS), use of home blood pressure (BP) monitoring, anxiety, and comorbidity. There was no evidence that adherence was associated with income or physical activity. Evidence of an association between MAS, grade of HT, or experience of hypertensive crisis was inconclusive. Various methods to improve adherence were studied including patient education (improved from 1.8 to 3.9 points,p = 0.0002 or 2.80 to 3.79 points,p < 0.0001 measured by the MMAS-4), telephone reminders (p < 0.0001), training in home BP monitoring (p < 0.05), and use of fixed-dose combinations (p < 0.05).ConclusionsThe main determinants of adherence to AHT are sociodemographic characteristics, the severity of HT, and presence of comorbidity. Patient education and use of fixed-dose combinations of drugs were identified as most important for improving adherence. Most studies assessing adherence use self-reported methods so there is a need for greater use of objective methods.Trial registrationThis scoping review has not been registered.
Antibiotic prescribing in general medical and surgical specialties: a prospective cohort study
Authors: Charani E. , de Barra E. , Rawson T. M. , Gill D. , Gilchrist M. , Naylor N. R. , Holmes A. H. 
Published: September 2019

Abstract

Background
Qualitative work has described the differences in prescribing practice across medical and surgical specialties. This study aimed to understand if specialty impacts quantitative measures of prescribing practice.

Methods
We prospectively analysed the antibiotic prescribing across general medical and surgical teams for acutely admitted patients. Over a 12-month period (June 2016 – May 2017) 659 patients (362 medical, 297 surgical) were followed for the duration of their hospital stay. Antibiotic prescribing across these cohorts was assessed using Chi-squared or Wilcoxon rank-sum, depending on normality of data. The t-test was used to compare age and length of stay. A logistic regression model was used to predict escalation of antibiotic therapy.

Results
Surgical patients were younger (p < 0.001) with lower Charlson Comorbidity Index scores (p < 0.001). Antibiotics were prescribed for 45% (162/362) medical and 55% (164/297) surgical patients. Microbiological results were available for 26% (42/164) medical and 29% (48/162) surgical patients, of which 55% (23/42) and 48% (23/48) were positive respectively. There was no difference in the spectrum of antibiotics prescribed between surgery and medicine (p = 0.507). In surgery antibiotics were 1) prescribed more frequently (p = 0.001); 2) for longer (p = 0.016); 3) more likely to be escalated (p = 0.004); 4) less likely to be compliant with local policy (p < 0.001) than medicine.

Conclusions
Across both specialties, microbiology investigation results are not adequately used to diagnose infections and optimise their management. There is significant variation in antibiotic decision-making (including escalation patterns) between general surgical and medical teams. Antibiotic stewardship interventions targeting surgical specialties need to go beyond surgical prophylaxis. It is critical to focus on of review the patients initiated on therapeutic antibiotics in surgical specialties to ensure that escalation and continuation of therapy is justified.
Competition and bank profitability
Authors: Yuanita Nuraini 
Published: September 2019

Abstract
By issuing Indonesian Banking Architecture in 2004, the central bank of Indonesia has encouraged banking sector to consolidate. The aim of merger among others is to increase bank economies of scale. This study tries to look at the impact of merger bank on the bank performance by implementing structure conduct and performance hypothesis. Merger bank affects market structure. According to structure conduct and performance hypothesis, market structure affects bank behavior as well as bank performance. The result of this study suggests that an increase in market concentration causes a decrease in price. It shows that merger increase economies of scale so that bank can offer lower price. A decrease in price brings down bank profitability. Concentration ratio also can be used as competition measurement. It is known as a structural measure of competition. Using the structural measure, a lower competition that is shown by higher concentration ratio is associated with lower profitability. This research also analyses the relationship between competition and bank profitability using Lerner index as a non-structural measure of competition. The non-structural measure of competition shows that lower competition is associated with higher profitability. Hence, the structural measure of competition creates different result from the non-structural measure of competition.
A comprehensive assessment of demographic, environmental, and host genetic associations with gut microbiome diversity in healthy individuals
Authors:   The Milieu Intérieur Consortium, Scepanovic Petar , Hodel Flavia , Mondot Stanislas , Partula Valentin , Byrd Allyson , Hammer Christian , Alanio Cécile , Bergstedt Jacob , Patin Etienne , Touvier Mathilde , Lantz Olivier , Albert Matthew L. , Duffy Darragh , Quintana-Murci Lluis , Fellay Jacques 
Published: September 2019

Abstract

Background
The gut microbiome is an important determinant of human health. Its composition has been shown to be influenced by multiple environmental factors and likely by host genetic variation. In the framework of the Milieu Intérieur Consortium, a total of 1000 healthy individuals of western European ancestry, with a 1:1 sex ratio and evenly stratified across five decades of life (age 20–69), were recruited. We generated 16S ribosomal RNA profiles from stool samples for 858 participants. We investigated genetic and non-genetic factors that contribute to individual differences in fecal microbiome composition.

Results
Among 110 demographic, clinical, and environmental factors, 11 were identified as significantly correlated with α-diversity, ß-diversity, or abundance of specific microbial communities in multivariable models. Age and blood alanine aminotransferase levels showed the strongest associations with microbiome diversity. In total, all non-genetic factors explained 16.4% of the variance. We then searched for associations between > 5 million single nucleotide polymorphisms and the same indicators of fecal microbiome diversity, including the significant non-genetic factors as covariates. No genome-wide significant associations were identified after correction for multiple testing. A small fraction of previously reported associations between human genetic variants and specific taxa could be replicated in our cohort, while no replication was observed for any of the diversity metrics.

Conclusion
In a well-characterized cohort of healthy individuals, we identified several non-genetic variables associated with fecal microbiome diversity. In contrast, host genetics only had a negligible influence. Demographic and environmental factors are thus the main contributors to fecal microbiome composition in healthy individuals.

Trial registration
ClinicalTrials.gov identifier NCT01699893
Process evaluation of text-based support for fathers during the transition to fatherhood (SMS4dads): mechanisms of impact
Authors: Fletcher Richard , Knight Tess , Macdonald Jacqui A. , StGeorge Jennifer 
Published: September 2019

Abstract

Background
There is growing evidence for the value of technology-based programs to support fathers to make positive transitions across the perinatal period. However, past research has focused on program outcomes with little attention to the mechanisms of impact. Knowledge of why a program works increases potential for replication across contexts.

Methods
Participants were 40 Australian fathers enrolled in the SMS4dads text-based perinatal support program (Mean age 35.11 (5.87). From a starting point between 16 weeks gestation and 12 weeks postpartum, they were sent a maximum of 184 text messages. An inductive approach was used to analyse post-program semi-structured interviews. The aim was to identify mechanisms of impact aligned to previously identified program outcomes, which were that SMS4dads: 1) is helpful/useful; 2) lessens a sense of isolation; 3) promotes the father-infant relationship; and 4) supports the father-partner relationship.

Results
We identified two types of mechanisms: four were structural within the program messages and five were psychological within the participant. The structural mechanisms included: syncing information to needs; normalisation; prompts to interact; and, the provision of a safety net. The psychological mechanisms were: increase in knowledge; feelings of confidence; ability to cope; role orientation; and, the feeling of being connected. These mechanisms interacted with each other to produce the pre-identified program outcomes.

Conclusions
If the current findings are generalisable then, future mobile health program design and evaluation would benefit from explicit consideration to how both program components and individual cognitive and behavioural processes combine to elicit targeted outcomes.
A probabilistic geologic model of the Krafla geothermal system constrained by gravimetric data
Authors: Scott Samuel W. , Covell Cari , Júlíusson Egill , Valfells Águst , Newson Juliet , Hrafnkelsson Birgir , Pálsson Halldór , Gudjónsdóttir María 
Published: September 2019

AbstractThe quantitative connections between subsurface geologic structure and measured geophysical data allow 3D geologic models to be tested against measurements and geophysical anomalies to be interpreted in terms of geologic structure. Using a Bayesian framework, geophysical inversions are constrained by prior information in the form of a reference geologic model and probability density functions (pdfs) describing petrophysical properties of the different lithologic units. However, it is challenging to select the probabilistic weights and the structure of the prior model in such a way that the inversion process retains relevant geologic insights from the prior while also exploring the full range of plausible subsurface models. In this study, we investigate how the uncertainty of the prior (expressed using probabilistic constraints on commonality and shape) controls the inferred lithologic and mass density structure obtained by probabilistic inversion of gravimetric data measured at the Krafla geothermal system. We combine a reference prior geologic model with statistics for rock properties (grain density and porosity) in a Bayesian inference framework implemented in the GeoModeller software package. Posterior probability distributions for the inferred lithologic structure, mass density distribution, and uncertainty quantification metrics depend on the assumed geologic constraints and measurement error. As the uncertainty of the reference prior geologic model increases, the posterior lithologic structure deviates from the reference prior model in areas where it may be most likely to be inconsistent with the observed gravity data and may need to be revised. In Krafla, the strength of the gravity field reflects variations in the thickness of hyaloclastite and the depth to high-density basement intrusions. Moreover, the posterior results suggest that a WNW–ESE-oriented gravity low that transects the caldera may be associated with a zone of low hyaloclastite density. This study underscores the importance of reliable prior constraints on lithologic structure and rock properties during Bayesian geophysical inversion.