bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Behavioral Healthcare Access Disparities by Training Providers in Disadvantaged Communities — Evidence of Strategy Effectiveness
Authors: Neikrug Ariel B. , Cho Shreya S. , Nguyen Ethan S. , Stehli Annamarie , Huo Shutong , Garcia Careesa , Au Stephanie , Masoumirad Mandana , Cant Wendy , Le-Bucklin Khanh-Van , Gagliardi Jane P. , Xiong Glen L. , McCarron Robert M. 
Published: October 2024

Abstract

Background
Inadequate access to behavioral health services disproportionately impacts marginalized populations who live in disadvantaged areas. To reduce this gap, programs dedicated to optimizing behavioral health education and training must focus their efforts to enroll providers who practice in these disadvantaged areas.

Objective
The Train New Trainers (TNT) fellowship program aims to enhance behavioral health knowledge, skills, and attitudes of primary care providers (PCPs) who deliver care in disadvantaged communities. We evaluate the effectiveness of the TNT recruitment strategy and the use of scholarships for targeting and recruiting PCPs who practice in disadvantaged communities.

Design
Observational study.

Participants
TNT fellows from 2016 to 2023.

Main Measures
State/federal classifications of medically underserved counties were used to establish scholarship criteria. Area Deprivation Index (ADI) was utilized to provide criterion validity for the use of state/federal criteria in the recruitment strategy, and to evaluate the effectiveness of the program in successfully recruiting PCPs practicing in disadvantaged communities.

Key Results
Practice location data were available for 347 fellows, 88.8% of whom received scholarships. Of the 347 practices, 300 (86.5%) primarily served communities meeting at least one state or federal criterion for medical shortage areas and/or underserved areas. According to ADI scores, 32.3% of practices served areas classified in the highest ADI (ADI decile 9 or 10), with a progressive increase in the proportion of fellows practicing in underserved areas each year; in 2023, 89.9% of practices met federal shortage criteria and 40.5% served areas with the highest deciles of ADI.

Conclusions
The TNT program strategy for recruiting PCPs from high medical need geographical areas is associated with bringing primary care psychiatry education to areas considered underserved and disadvantaged. Equipping PCPs practicing in underserved areas with enhanced knowledge and skills in behavioral medicine has the potential to significantly improve the existing access gap in disadvantaged communities.
Adult Mental Health Associated with Adverse and Positive Childhood Experiences Among 1st and 2nd Generation Asian Americans
Authors: Jang Jihoon , Gonzales Gilbert 
Published: October 2024

Abstract

Background
Adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) impact adult health. However, differences in ACEs, PCEs, and mental health have not been extensively studied among Asian Americans.

Objective
To examine the association between childhood experiences and adult mental health in first and second generation Asian Americans.

Design
This study used data from the 2021-2022 California Health Interview Survey (CHIS), an address-based sampling of noninstitutionalized Californians conducted online or by phone.

Participants
Asian American respondents aged 18-65 years.

Exposure
Fifteen different ACEs and seven different PCEs.

Main Measures
Adjusted prevalence ratios (aPR) of severe psychological distress for each generation. Survey weights were applied to all analyses for population-based representation.

Key Results
5,744 Asian Americans (48.0% male, 16.4% aged 18-25) were included in the current study. We found that second generation Asian Americans experienced a greater prevalence of ACEs (65.4% reported ≥1 ACE vs 47.5% in first generation Asian Americans) and lower prevalence of PCEs (32.1% reported ≤2 PCEs vs 22.6% in first generation Asian Americans). Second generation Asian Americans were more likely to report ≥4 ACEs (aPR, 1.46; 95% CI, 1.13 to 1.88) and ≤2 PCEs (aPR, 1.51; 95% CI, 1.29 to 1.78) relative to first generation Asian Americans. Second generation Asian Americans with ≥4 ACEs or ≤2 PCEs were more likely to report severe psychological distress (aPR, 2.54; 95% CI, 1.55 to 4.17 and aPR, 1.48; 95% CI, 1.03 to 2.13, respectively) relative to first generation Asian Americans. When examining ACEs and PCEs individually, domestic, physical, and verbal abuse; divorce; racism; and lacking support systems were significantly associated with severe psychological distress in second generation Asian Americans.

Conclusions
Second generation Asian Americans are more likely to experience more ACEs, fewer PCEs, and poorer mental health as a result. Our study indicates that physicians should screen for childhood experiences and leverage trauma-informed care among Asian American subpopulations.
The Magidor iteration and restrictions of ultrapowers to the ground model
Authors: Kaplan Eyal 
Published: October 2024

Abstract
We study the Magidor iteration of Prikry forcings below a measurable limit of measurables κ. We first characterize all the normal measures κ carries in the generic extension, building on and extending the main result of [1]. Then, for every such normal measure, we prove that the restriction of its ultrapower, from the generic extension to the ground model, is an iterated ultrapower of V by normal measures. This is done without core model theoretic assumptions; GCH≤κ
in the ground model suffices.
The Permissibility of Biased AI in a Biased World: An Ethical Analysis of AI for Screening and Referrals for Diabetic Retinopathy in Singapore
Authors: Muyskens Kathryn , Ballantyne Angela , Savulescu Julian , Nasir Harisan Unais , Muralidharan Anantharaman 
Published: October 2024

Abstract
A significant and important ethical tension in resource allocation and public health ethics is between utility and equity. We explore this tension between utility and equity in the context of health AI through an examination of a diagnostic AI screening tool for diabetic retinopathy developed by a team of researchers at Duke-NUS in Singapore. While this tool was found to be effective, it was not equally effective across every ethnic group in Singapore, being less effective for the minority Malay population than for the Chinese majority. We discuss the problematic normative nature of bias in health AI and explore the ways in which bias can interact with various forms of social inequalities. From there, we examine the specifics of the diabetic retinopathy case and weigh up specific trade-offs between utility and equity. Ultimately, we conclude that it is ethically permissible to prioritise utility over equity where certain criteria hold. Given that any medical AI is more likely than not to have lingering bias due to bias in the training data that may reflect other social inequalities, we argue that it is permissible to implement an AI tool with residual bias where: (1) its introduction reduces the influence of biases (even if overall inequality is worsened), and/or (2) where the utility gained is significant enough and shared across groups (even if unevenly).
Novel insights into PLMN-13PT ceramics: impact of spark plasma sintering on compositional and dielectric properties
Authors: Londoño Fernando , do Nascimento William Junior , Viana Diego Seiti Fukano , Eiras Jose Antonio , Garcia Ducinei 
Published: October 2024

AbstractThis study investigates the effects of Spark Plasma Sintering (SPS) on the physical, structural, microstructural, dielectric, and optical properties of on 87[Pb(1−y)Laₓ(Mg1/3Nb2/3)O3]-13PbTiO3, (PLMN-13PT) ceramics. The primary objective was to evaluate how SPS influences the densification, grain growth, and compositional variations of these ceramics, which are critical for electronic device applications. The results demonstrate that SPS effectively achieves high relative density while suppressing grain growth, leading to a more homogeneous microstructure. However, the rapid densification process also induces compositional variations that significantly impact the dielectric properties, including the reduction of undesirable phases like pyrochlore, which are detrimental to performance. These findings highlight the potential of SPS for optimizing PLMN-13PT ceramics, enhancing their suitability for the miniaturization of multifunctional electronic devices.
Soot formation and laminar combustion characteristics of anisole: ReaxFF MD simulation and kinetic analysis
Authors: Dong Wenlong , Hong Run , Yao Jinfang , Wang Dongyang , Yan Liang , Qiu Bingbing , Chu Huaqiang 
Published: October 2024

AbstractThe application of biomass energy is one of the important ways to achieve carbon neutrality and deal with global warming. The study on the combustion mechanism of anisole, an oxygen-containing fuel, is helpful for biofuel large-scale application. In this study, the soot formation and laminar combustion characteristics of anisole were analyzed by reactive force field molecular dynamics (ReaxFF MD) and kinetic simulation, respectively. ReaxFF MD simulation studies had shown that soot formation of anisole combustion occurred in three stages, stage 1 (0–1 ns), stage 2 (1–2.5 ns), stage 3 (2.5–6 ns). The three stages represented the pyrolysis of the fuel, the developmental stage of the soot, and the graphitization stage of the soot, respectively. During the combustion of anisole, primary mechanisms for the soot formation were as follows: H-abstraction-C2H2-addition, carbon-addition-hydrogen-addition, internal ring formation and long carbon chain link. The formation of soot graphitization exhibited different morphologically behaviors: from flakes to onions to spheres with fewer branched chains. From the study of the laminar combustion characteristics of anisole, it can be found that the laminar burning velocities increased along with the increase of temperature, while the opposite trend was shown along with the increase of pressure. The sensitivity coefficient of naphthalene, the main soot precursor, revealed that the main promotional reactions for soot formation were R5 (O2 + H <  =  > O + OH), R36 (CO + OH <  =  > CO2 + H).
Quality attributes and antioxidant activity of stirred yoghurt fortified with some nano-fruit waste powders
Authors: Taha Soad H. , Elshaghabee Fouad M. F. , Ameen Mostafa A. 
Published: October 2024

AbstractAgro-industrial wastes have emerged as a significant source of bioactive compounds. Therefore, this study was conducted to evaluate the feasibility of using nano-powders of some fruit wastes, namely; apricot (Prunus sp.) and peach (Prunus persica L. Batsch) kernels, watermelon (Citrullus lanatus) rind and banana (Musa spp.) peel as functional ingredients (0.5%) in stirred yoghurt, as well as their effect on the antioxidant activity, quality characteristics, viability of yoghurt starter culture and sensory attributes. Results revealed that the fortification process significantly (P < 0.05) elevated the total solids, fat, protein and ash contents, especially with apricot and peach kernels (AK and PK), which distinctly increased fat by average values of 3.46 and 3.40%, and protein by 3.70 and 3.68% during storage compared to control (3.12 and 3.57%), respectively. The addition of watermelon rind (WMR) increased the titratable acidity (0.97%) and viscosity (463.59 cP) with a significant reduction of syneresis (16.38%), increased the total viable count of starter culture, acetaldehyde and diacetyl contents (167.10 and 18.82 mg/100 g) in yoghurt, followed by banana peel (BP). Stirred yoghurt fortified with BP nano-powder had the highest total phenolic content (20.96 mg gallic acid/g) and DPPH scavenging activity (31.93%) as average values during storage compared to the other nano-fruit wastes. Sensory attributes of stirred yoghurt were improved with the addition of WMR and BP during storage periods, compared to those fortified with AK and PK. All the nano-powders of the studied fruit wastes constitute excellent raw materials for the development of novel functional stirred yoghurt.
Emergence of carbapenemase-producing Enterobacterales (CPE) in patients with severe COVID-19 infection and successful control in intensive care
Authors: Longhitano Anthony , Campbell Duncan , Mothobi Nomvuyo , McKenzie Alison , Bartolo Caroline , Saha Sajal , Sherry Norelle , Athan Eugene 
Published: October 2024

Abstract

Objective:
We aim to highlight the risks of acquiring carbapenemase-producing Enterobacterales (CPE) resistance genes in patients with severe coronavirus disease 2019 (COVID-19) in intensive care.

Design:
Outbreak analysis to assess for a transmission risk area (TRA) conducted after identification of potential CPE outbreak within shared room spaces in intensive care.

Setting:
Analysis conducted within a 24-bed single-room model intensive-care department within a level-3 tertiary center public hospital in regional Victoria, Australia.

Patients:
3 patients, with severe COVID-19 admitted to intensive care over a 3-month period with shared room spaces requiring prolonged mechanical ventilation and broad-spectrum antimicrobials, identified and were managed for CPE isolated from sputum. Overlap carbapenemase genes were identified among different organisms raising suspicion of transmitted resistance genes. A subsequent case managed for severe community-acquired pneumonia isolated CPE 3 months beyond these cases.

Methods:
Outbreak analysis via weekly cross-sectional point prevalence screening of fecal samples or rectal swabs for CPE from patients admitted to the intensive-care department over a 4-week period.

Results:
34 patients were included in the analysis with 51 tests for CPE screening conducted. No further cases of CPE were identified. Statewide Infection Surveillance team and the Department of Health and Human Services did not find the cases to derive from a TRA. No further action including environmental screening was indicated.

Conclusions:
These cases highlight the independent acquisition of CPE genes in patients with severe COVID-19 and antimicrobial selective pressures resulting in significant morbidity and mortality. Increasing awareness, robust antimicrobial stewardship, and infection prevention measures could reduce pressures driving CPE resistance mutations and the risk of CPE transmission.
A quasi-experimental analysis comparing antimicrobial usage on COVID-19 and non-COVID-19 wards
Authors: Doyle Daniel , Dalton Bruce , Zhang Zuying , Sabuda Deana , Rajakumar Irina , Rennert-May Elissa , Leal Jenine , Conly John M. 
Published: October 2024

Abstract

Objective:
To describe antimicrobial usage (AMU) trends before and during the coronavirus disease 2019 (COVID-19) pandemic, between COVID-19 and non-COVID-19 wards, and if there was any association with a COVID-19 order set.

Design:
Quasi-experimental retrospective interrupted time series analysis of AMU rates with a contemporaneous comparison of COVID-19 versus non-COVID-19 control wards. Analysis using incidence rate ratios (IRR) was conducted using a Poisson regression generalized linear model.

Setting:
Five COVID-19 and 4 comparable non-COVID-19 wards and 6 intensive care units (ICUs) at 4 hospitals during pandemic waves 1–4.

Participants:
All inpatients receiving systemic antimicrobials.

Intervention:
The COVID-19 checkbox antimicrobial order set was implemented in March 2020, to be used only if considered clinically indicated with modification in August 2021.

Main Outcome(s) and Measure(s):
The primary outcome was a change in AMU rates (defined daily dose per 100 patient days per month) comparing pre- versus peri-pandemic periods and COVID-19 versus control non-COVID-19 wards. Secondary outcomes included antifungal usage rate in ICUs and assessing AMUs following implementation and modification of a COVID-19 order set.

Results:
Significantly greater rates of AMU (IRR[95%CI]) were observed on COVID-19 wards versus non-COVID-19 wards during waves 1–4 for all systemic antimicrobials (1.76[1.71–1.81], 1.10[1.07–1.13], 1.48[1.43–1.53], and 1.06[1.03–1.09]); for azithromycin (11.76[9.80–14.23], 10.96[9.49–12.74], 12.41[10.73–14.45], and 4.88[4.31–5.55]); and for ceftriaxone (2.39[2.16–2.65], 3.64[3.29–4.03], 2.94[2.67–3.23], and 1.62[1.49–1.76]).

Conclusions:
We observed significantly increased AMU rates of all systemic agents during the first 4 waves of the pandemic and on COVID-19 wards compared with control wards for azithromycin and ceftriaxone. These agents saw a twofold reduction following order-set removal, suggesting that the clinical decision-support tool order set, as utilized, had influenced prescribing behavior.
Valuing life
Authors: Slovic Paul 
Published: October 2024

Abstract
The heart of prospect theory is the value function, proposing that the carriers of value are positive or negative changes from a reference point. Daniel Kahneman observed that if prospect theory had a flag, the value function would be drawn on it. The function is nonlinear, reflecting diminishing sensitivity to magnitude. When describing how human lives are valued, the function exposes profound incoherence. An individual life is highly valued and thus vigorously protected if it is the only life at risk. But that life loses its value when it is one of many endangered by a larger tragedy. Beyond this insensitivity, the function may actually decline when many lives at risk become mere numbers. The more who die, the less we care. Implications of this deadly ‘arithmetic of compassion’ for understanding and managing the risk from nuclear weapons are briefly discussed.
Impact of neonatal sepsis on serum selenium levels: Evidence of decreased selenium in sepsis-affected neonates
Authors: Saadat Seyed Hossein , Goodarzi Rakhshaneh , Elahi Zeynab , Ameri Aref 
Published: October 2024

Abstract

Introduction:
Essential trace elements and micronutrients are critical in eliciting an effective immune response to combat sepsis, with selenium being particularly noteworthy. The objective of this investigation is to analyze and the levels of serum selenium in neonates within sepsis and control groups.

Methodology:
In 2023, a case–control study was carried out involving 66 hospitalized infants – 33 diagnosed with sepsis forming the case group and 33 free from sepsis constituting the control group – along with their mothers, at Children’s and Shariati Hospitals in Bandar Abbas. The serum selenium concentrations (expressed in micrograms per deciliter) were quantified utilizing atomic absorption spectrometry. Subsequently, the data were processed and analyzed using IBM SPSS statistical software, version 22.

Results:
The average serum selenium level in neonates with sepsis (42.06 ± 20.40 µg/dL) was notably lower compared to the control group (55.61 ± 20.33 µg/dL), a difference that was statistically significant (p-value = 0.009). The levels of serum selenium were comparable between neonates and mothers across both study groups.

Conclusion:
The findings of this research indicate that selenium levels in the sepsis group were reduced compared to the control group, despite similar selenium levels in the mothers and neonates in both groups, suggesting that sepsis could be associated with a decrease in selenium levels.
Accelerating evidence generation: Addressing critical challenges and charting a path forward
Authors: Rim Jeeyon G. , Jackman Jennifer G. , Hornik Christoph P. , Rutter Joni L. , Warraich Haider , Wittes Janet , Fleisher Lee , Anderson Brian S. , Krofah Ester , Kinter Elizabeth , Locke Trevan , Kehoe Lindsay , Abbasi Ali , Marston Hilary , Meeker-O’Connell Ann , Weber Wendy , Wang Tracy , Hernandez Adrian F. , Landray Martin , Palmer Scott M. 
Published: October 2024

Abstract
Efficient evidence generation to assess the clinical and economic impact of medical therapies is critical amid rising healthcare costs and aging populations. However, drug development and clinical trials remain far too expensive and inefficient for all stakeholders. On October 25–26, 2023, the Duke Clinical Research Institute brought together leaders from academia, industry, government agencies, patient advocacy, and nonprofit organizations to explore how different entities and influencers in drug development and healthcare can realign incentive structures to efficiently accelerate evidence generation that addresses the highest public health needs. Prominent themes surfaced, including competing research priorities and incentives, inadequate representation of patient population in clinical trials, opportunities to better leverage existing technology and infrastructure in trial design, and a need for heightened transparency and accountability in research practices. The group determined that together these elements contribute to an inefficient and costly clinical research enterprise, amplifying disparities in population health and sustaining gaps in evidence that impede advancements in equitable healthcare delivery and outcomes. The goal of addressing the identified challenges is to ultimately make clinical trials faster, more inclusive, and more efficient across diverse communities and settings.
Challenges and Resilience in the Lives of Refugees Now Residing in the United States: A Health and Well-Being Perspective
Authors: Rizek Jamla , Taubman Cara B , Issa Fadi 
Published: October 2024

Abstract

Objective
This article explores the health-related challenges for refugees now residing in the United States and highlights strategies for building resilience in this vulnerable population.

Methods
This is a descriptive study identifying six common challenges refugees face when relocating from their country to another country.

Results
Refugees in the United States face many challenges, including language barriers, access to quality education, discrimination based on cultural and religious differences, and inadequate healthcare access. Child refugees, constituting a significant portion of the refugee population, face distinct challenges compared to adults. Many refugees grapple with psychological trauma and access to proper healthcare.

Conclusion
Refugees face many challenges when transitioning to a new country, including losing community, familial support, safety, and cultural norms. To address these challenges in the United States, advocates, and public health advisors must actively engage with refugees to assess their needs and build resilient communities. Proactive outreach tailored to refugees’ vulnerabilities is crucial to ensuring their well-being and successful integration into their new homes.
Preparing for Nuclear Disaster: A Structured Equation Model by Health Professionals
Authors: Redfield-Shakoor Linda J 
Published: October 2024

Abstract

The potential for a radiological disaster from natural environmental causes, human error, aging nuclear power plants, buried radioactive waste, regular ground transport of radioactive materials, a shared international border, and the threat of radiological terrorism make the Western New York region vulnerable for a radiation emergency. A global threat from Russia and intentional uses of nuclear weapons by non-state approved users, such as North Korea, raise public awareness. Limited importance has been given to educating medical providers and emergency planners with radiological knowledge and preparation.

Objective
The goal of this study was to understand the relationships of the peerception of risk, emergency self-efficacy and willingness to respond to a radiation emergency among health professionals.

Method
Two hundred sixty-nine (269) medical and health practitioners were selected for a purposive, convenience sample in an eight-county region of Western New York. Participants identified the need for improved knowledge and preparation for the management of a radiation emergency.

Results
Statistical findings using the author created Structural Equation Model (SEM) revealed a goodness of fit for perception of risk as a strong predictor of willingness to respond to a radiation emergency.

Conclusion
The SEM study names the variables that influence training for global nuclear realities.