bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extreme Temperatures, Birth Outcomes, and Social Inequalities: Evidence from South China
Authors: Wang Meng , Huang Cheng , Zhao Qingguo 
Published: May 2024

Abstract
The impacts of climate change on health are a critical public health issue, but the association between extreme temperatures and birth outcomes remains poorly understood. This paper links over 1 million birth records from Dongguan, China, between 2004 and 2013, to meteorological data. We investigate the relationship between extreme temperatures and birth outcomes and explore the heterogeneity among different demographic and socioeconomic factors, including maternal migrant status, education level, and mode of delivery. We find that one percentage increase in the number of days exposed to extreme heat during pregnancy is associated with a reduction in birth weight of 2.31 g and a 2% increase in odds of low birth weight (LBW), while exposure to extreme cold temperatures is associated with a reduction in birth weight (0.66 g) and an increase in the risk of LBW (1%). The association between extreme high temperatures and adverse birth outcomes is stronger for groups with disadvantaged social status. Specifically, the migrant group (for extreme heat exposure, local residents, −0.37 g; intraprovincial migrants, −2.75 g; out-of-province migrants, −2.49 g), the less-educated group (for extreme heat exposure, middle school or below, −2.47 g; high school or above, −1.66 g), and the group with vaginal birth [for extreme heat exposure, cesarean sections (C-sections), −1.56 g; vaginal birth, −2.62 g] are more sensitive to extreme weather conditions. Our study provides further evidence about the association of extreme temperatures with birth outcomes and for vulnerable groups of pregnant women.
Development and Validation of Hospital Mental Health Screen to Detect Psychiatric Morbidity in Medically Ill Patients in India
Authors: Sutar Roshan , Lahiri Anuja , Ali Rashida , Solanki Vindhya , Majumdar Anindo , Sharma Manoj , Chaturvedi Santosh 
Published: May 2024

Background: Psychiatric morbidities often go unnoticed in medically ill patients. It is essential to screen patients with medical morbidity so that they can be referred to psychiatrists for early interventions in general hospitals in India. There is a potential lacuna in terms of the availability of a scale that can aptly identify psychiatric symptoms in medically ill patients beyond depression or anxiety, especially in low-resource settings like India. Aim: The aim was to detect psychiatric morbidity in medically ill patients in India. Methodology: Items were generated using deductive and inductive approaches. Item-Content Validity Index (I-CVI) and Scale-Content Validity Index/Universal Agreement (S-CVI/UA) were computed by involving eight subject matter specialists. The tool was circulated to 397 medically ill patients for computing The exploratory factor analysis (EFA). Domain-wise reliability using Cronbach’s alpha was calculated for six factors. The concurrent criterion validity of the Hospital Mental Health Screen (HMHS) tool was calculated by the receiver operating curve (ROC) against the gold standard of any psychiatric morbidity diagnosed by two psychiatrists in 397 medically ill patients. We used IBM SPSS version 23. Results: Initially, 34 items were generated. At the I-CVI threshold of 79%, seven items were discarded. The S-CVI/UA of the scale was 85.1%. The Kaiser–Meier–Olkin Measure of Sampling Adequacy (KMO MSA) was found to be 0.916. At a factor loading threshold of 0.4 and an eigenvalue above 1, a six-factor structure was extracted using principal component analysis and varimax rotation. Domain-wise reliability was computed, which was between 0.657 and 0.840. The final tool consisted of 27 Likert items (0 = never to 4 = always). Using the ROC curve at the 19.5 threshold, 91.4% of the positive outcomes were correctly classified and 9.5% of the adverse outcomes were expected to be incorrectly identified by the HMHS screening tool. Conclusion: HMHS is a valid and reliable tool with good screening properties, designed especially for the Indian setting. This scale can assist in identifying psychiatric morbidity in medically ill patients in low-resource settings. There is further scope for performing confirmatory factor analysis (CFA) to reinforce the factor structure of HMHS.
Investigating the Anti-adipogenic Potential of Xanthium strumarium Linn. Leaves Fractions: HPTLC-MS Characterization, Enzymatic Analysis, and 3T3-L1 Adipocyte Differentiation Assay in Oxidative Stress-modulated Adipogenesis Cascade
Authors: Nayak Nikita , Pattnaik Ashok 
Published: May 2024

Background Molecular pathogenesis of obesity is initiated by cellular oxidative stress along with increased adipogenesis. For the search of better alternatives of synthetic molecules in terms of their adverse events, naturally, existing compounds are now a research focus. In this context, Xanthium strumarium ( X. strumarium) Linn. exhibited anti-diabetic activities and proved to have efficacy in neutralizing very near pathological targets to obesity. Purpose This study is aimed toward bioactivity-guided fraction isolation of methanolic leaves extract, where bioactivity refers to anti-adipogenesis and antioxidant efficacy in in vitro enzymatic and three-day transfer, inoculum 3×105 cells (3T3-L1) adipocyte differentiation assay. Materials and Methods Collection and drying of the raw leaves followed by cold extraction in methanol and flash chromatography for bioactive fraction isolation. 3T3-L1 cell line was utilized for adipocyte differentiation assay of those and on the other hand in vitro pancreatic lipase, α-glucosidase, and α-amylase enzymatic assays were analyzed. Based on exhibited activities, selected fractions are further characterized by high-performance thin-layer chromatography-mass spectrometry (HPTLC-MS). Results The most active fractions from these assays underwent characterization via HPTLC-MS. Fractions 2 and 3 exhibited potent activities in all enzymatic assays (α-glucosidase IC50: 2.48 ± 0.015, 2.84 ± 0.030 µg/mL; α-amylase IC50: 1.98 ± 0.050, 1.79 ± 0.045 µg/mL; pancreatic lipase IC50: 3.16 ± 0.030, 3.18 ± 0.040 µg/mL) and displayed significant inhibition of adipocyte differentiation in 3T3-L1 cell line. These fractions further identified through HPTLC-MS, contained compounds like β-sitosterol and quercetin, affirming their potential bioactivity. Conclusion The study underscores the potential of X. strumarium Linn. fractions as promising natural alternatives for combating obesity-related pathways, highlighting their significance in developing future anti-obesity therapeutics.
Canadian Undergraduate Perspectives on Medical Assistance in Dying for Mental Illness: Does Psychiatric Illness Type, Age, and Exposure to Information Influence Acceptance of MAiD?
Authors: Harper Lori , Tomaras Christina A. , Powell Russell A. , Reddon John R. , Hawrelak Erin 
Published: May 2024

Background and Objectives In 2027, Canadians whose only medical condition is an untreatable mental illness and who otherwise meet all eligibility criteria will be able to request Medical Assistance in Dying (MAiD). This study investigates the attitudes of undergraduate students towards widening the scope of MAiD for physical illness for certain psychiatric conditions. We were interested in understanding if age, information, and type of mental illness influenced undergraduates’ acceptance or rejection of MAiD for mental illness (MAiD-MI). Method 413 undergraduate students participated in this study which examined the factors that correlate with the acceptance or rejection of MAiD-MI. Four scenarios were presented in which age (older or younger) and illness type (depression or schizophrenia) were manipulated. Demographic questions and measures assessing personality, religion, and attitudes towards euthanasia were administered. Questions assessing participants’ general understanding of MAiD and their life experiences with death and suicide were also asked. Results Most of the participants accepted MAiD-MI for both depression and schizophrenia. As hypothesized, support for MAiD-MI was higher for patients with schizophrenia than for depression. Also as hypothesized, support was higher for older patients than for younger patients. Variables such as religion, personality and political affiliation were also associated with acceptance or rejection of MAiD-MI. Finally, consistent with our hypotheses, participants’ understanding of MAiD and experiences with death and suicide was predictive of support for MAiD-MI.
Cytauxzoonosis in Indiana, USA: a case series of cats infected with Cytauxzoon felis (2018–2022)
Authors: Reichard Mason V , Cotey Stacy R , Dangoudoubiyam Sriveny , Weerarathne Pabasara , Tussey Kenneth , Wilkes Rebecca P , Miller Craig A , Mehringer Lori , Burcham Grant N 
Published: May 2024

Case series summary This case series describes six cases involving seven cats naturally infected with Cytauxzoon felis in Indiana, USA. Medical records were retrospectively reviewed and all available information on signalment, history, clinical and diagnostic findings, treatment, outcome and pathology was reported. Cats infected with C felis were domestic shorthairs, were aged between 2 and 9 years and all but one of the cats were male. The seven infected cats originated from five counties in southwestern Indiana. Six of seven cats were found to have acute cytauxzoonosis based on clinical signs, gross pathologic lesions, observation of C felis in tissues and/or detection of C felis DNA. One cat was identified as a subclinical survivor cat with no known clinical history of cytauxzoonosis. Relevance and novel information The reported cases are the first confirmed reports of acute and chronic cytauxzoonosis in cats from Indiana and document an expansion in the range of C felis. Veterinary practitioners in Indiana should consider infection with C felis as a differential diagnosis for cats that present with fever, inappetence, lethargy, depression, dehydration, dyspnea, hemolytic crisis, anorexia or icterus. Administration of approved acaricides to cats currently offers the best protection and control against C felis infection.
Subsidies to Higher Education and Income-Tax Progression
Authors: Barbaro Salvatore 
Published: May 2024

The impact of fiscal activity on human-capital formation has often been analyzed with regard to the expenditure side of the budget; i.e., the subsidization of (higher) education. However, recent contributions have increasingly focused on the effect of taxation on human-capital formation. Less attention has been given to the simultaneous effect of both subsidization and taxation. as subsidies to higher education may offset the distortionary effect of taxation, this paper aims to analyze the amount of subsidization that is necessary to counteract the discouraging effect of various kinds of income-tax progression on human-capital accumulation. An important policy advice derived from the analysis is that a country's educational policies should be evaluated, not just by the levels of educational spending, but also by the level and structure of taxation. The framework we use to illustrate our point is a two-period cohort model with heterogeneous agents, who endogenously decide on higher education with respect to taxation and subsidization. in this framework, we also demonstrate that subsidies may fail to offset existing tax distortions, limiting the optimistic view of some previous literature. in particular, we show that a second-best subsidy rate must be lower than unity. Otherwise an optimal subsidy rate leads to the problem of overeducation.
Inhibiting Institutional Inertia: Squaring Iron Triangles While Reforming Welfare
Authors: Reksulak Michael 
Published: May 2024

The enduring slogan preceding the passage of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) was “to end welfare as we know it.” Common political wisdom is that, measured in caseload numbers and by welfare-to-work efforts, the reform was an unmitigated success. This paper takes a look into what Blank (2002) calls the “black box” of policy adjustments at the level of the welfare managers and the frontline bureaucracy. An analysis of their incentive structure reveals explanations of how the institutional resistance to change was defused. It also implies a specific policy toolbox for situations in which the reduction of the bureaucracy itself is part of the objective of welfare reform. A combination of block-grants, devolution to the smallest feasible structural level and vigorous competition by private sector providers would ensure a higher likelihood of success under this scenario. Power has only one duty—to secure the social welfare of the People. (Benjamin Disraeli (1804–1881), British statesman)1 Welfare is hated by those who administer it, mistrusted by those who pay for it and held in contempt by those who receive it. (Peter C. Goldmark Jr, NY State Budget Director, as quoted in the New York Times, 24 May 1977)2
The Intersection of Flexible Budgeting and Cutback Management: Factors Affecting the Responses of Selected States to Recent Economic Recessions
Authors: Klase Kenneth A. 
Published: May 2024

One important dimension of flexible budgeting involves the ability of a government to deal with adversity. This study examines adversity in the form of economic downturns and their impact on state budgets. It focuses on the role that economic shocks play in the application of flexible budgeting approaches in selected states. Eight contiguous states in the Mid-Atlantic and East Central regions of the U.S. are the focus of this study: Delaware, Maryland, New Jersey, North Carolina, Ohio, Pennsylvania, Virginia, and West Virginia. These states represent a broad sample of diverse states, almost all of which previously had significant budget deficits in the recession of the early 2000s. The research compares the responses of the selected states to the recession in the early 2000's with responses to the recession which started in 2007. Utilizing an historical analysis of responses by the states, the proposed research examines what those responses were and how they differ between the two recessions. It further evaluates to what degree the severity of the recession played a role in the nature of the responses. This comparative analysis of the responses of the selected states to the two recessionary periods provides a basis for examining what factors affected their responses. Responses by states to adverse economic conditions have been described as involving the application of a range of possible cutback management approaches. This study examines what aspects of the budget environment in the selected states contributes to their ability to undertake particular cutback management measures. It considers what attributes enabled states to have sufficient flexibility to respond to the recessionary impacts. It also examines the degree to which flexibility in response is affected by the severity of the recession.
Does Bankruptcy Really Matter? The Solvency of Municipal Governments in the Chicago Metropolitan Region
Authors: Hendrick Rebecca , Crosby Andrew 
Published: May 2024

As specified by Chapter 9 of the U.S. Bankruptcy Code, local governments that are granted bankruptcy protection must be insolvent, but not all insolvent local governments file for bankruptcy. Almost half of the local governments in the US are not permitted by state law to file for bankruptcy, and many governments with authorization to file may not pursue it because its outcomes are uncertain and often undesirable for both the government and creditors. Thus, one should study insolvent governments more generally rather than only bankrupt governments to obtain an accurate and complete understanding of the fiscal crises that produce bankruptcies. This paper examines different dimensions of solvency for 265 municipal governments in suburban Chicago from 1998 to 2010 to determine the relationship between the dimensions and the likelihood of insolvency among these governments. We find that these indices are related but there is also much variation in the joint distributions of the dimensions, suggesting that Chapter 9 as currently structured has critical flaws in its narrow definition of solvency. We use this variation to deduce the likely causes of poor financial condition in the governments at the extremes of the joint distributions and suggest future avenues of study. A version of this paper was presented at the annual conference of the Association for Budgeting and Financial Management, Washington, DC, October 3–5, 2013.
Longitudinal clinical decision support for assessing decisions over time: State-of-the-art and future directions
Authors: Loftus Tyler J , Balch Jeremy A , Marquard Jenna L , Ray Jessica M , Alper Brian S , Ojha Neeraj , Bihorac Azra , Melton-Meaux Genevieve , Khanna Gopal , Tignanelli Christopher J 
Published: May 2024

Objective Patients and clinicians rarely experience healthcare decisions as snapshots in time, but clinical decision support (CDS) systems often represent decisions as snapshots. This scoping review systematically maps challenges and facilitators to longitudinal CDS that are applied at two or more timepoints for the same decision made by the same patient or clinician. Methods We searched Embase, PubMed, and Medline databases for articles describing development, validation, or implementation of patient- or clinician-facing longitudinal CDS. Validated quality assessment tools were used for article selection. Challenges and facilitators to longitudinal CDS are reported according to PRISMA-ScR guidelines. Results Eight articles met inclusion criteria; each article described a unique CDS. None used entirely automated data entry, none used living guidelines for updating the evidence base or knowledge engine as new evidence emerged during the longitudinal study, and one included formal readiness for change assessments. Seven of eight CDS were implemented and evaluated prospectively. Challenges were primarily related to suboptimal study design (with unique challenges for each study) or user interface. Facilitators included use of randomized trial designs for prospective enrollment, increased CDS uptake during longitudinal exposure, and machine-learning applications that are tailored to the CDS use case. Conclusions Despite the intuitive advantages of representing healthcare decisions longitudinally, peer-reviewed literature on longitudinal CDS is sparse. Existing reports suggest opportunities to incorporate longitudinal CDS frameworks, automated data entry, living guidelines, and user readiness assessments. Generating best practice guidelines for longitudinal CDS would require a greater depth and breadth of published work and expert opinion.
Team-Based Approach to Successful Annual Wellness Visits
Authors: Passmore Rachael C. , Iqbal Asif , Rader Taylor L. , Ashley Kelly , Canoy Illies Allie J. , Madden Kathleen A. , Walter Jennifer L. , Crockett Eric D. , Stroebel Robert J. 
Published: May 2024

Objective: The purpose of this study was to implement a 2-phase approach to rapidly increase the number of annual wellness visits (AWVs) and build a sustainable model at 3 study units (Mayo Clinic in Rochester, Minnesota, and clinics in 2 regions of Mayo Clinic Health System), which collectively serve approximately 80 000 patients who qualify for an AWV annually. Methods: In the rapid improvement phase, beginning in July 2022, goals at the facilities were reoriented to prioritize AWVs, educate staff on existing AWV resources, and create low-effort workflows so that AWVs could be incorporated into existing patient appointments. Staff at all 3 study units worked independently and iterated quickly. In the second phase, all study units collaborated to design and implement a best-practice solution while they leveraged the engagement and lessons learned from the first phase and invested in additional system elements and change management to codify long-term success. Results: The number of AWVs completed monthly increased in each study unit. In the rapid improvement phase, the number of AWVs increased but then plateaued (or decreased at some study units). In April 2023, the final scheduled outreach automation and visit tools were implemented, and the number of AWVs was sustained or increased, while outreach and scheduling times were decreased. The number of completed AWVs increased from 1148 across all study units in the first 6 months of 2022 to 14 061 during the first 6 months of 2023. Conclusions: The lessons learned from this project can be applied to other health systems that want to provide more patients with AWVs while improving operational efficiency. The keys are to have a clear vision of a successful outcome, engage all stakeholders, and iterate quickly to find what works best for the organization.
The impact of nurse empowerment program on patient safety culture in general public hospital in Indonesia
Authors: Suryani Lilis , Letchmi Santhna , Said Faridah Binti Moch 
Published: May 2024

Background Patient safety is crucial to health-care quality and is one of the major parameters monitored by all health-care organizations around the world. Nurses play a critical role in improving the quality of care and patient safety because of their intensity in caring patients and families. Objectives This study aimed to determine the impact of nurse empowerment program on patient safety culture in general public hospital in Indonesia. Methods This study was designed as a quasi-experimental design in Indonesia. This program was conducted for three months with a five-day workshop (4 h for each day), followed by hanging up posters and handing out informative pamphlets to the experimental group's nurses and supervisors at their place of work in three common place that visited by nurses such as changing room, nurse station and near toilet. Results In the intervention group, patient safety culture practice score was significantly increased from 3.11(standard deviation [SD] = 1.43) before intervention to 4.89 (SD = 1.33) after three-month intervention (T2), with the t was 5.78, and p = .001. While in the control group, no significant increased score of patient safety culture practice before intervention and after three months intervention (3.05 ± 1.49 vs. 3.09 ± 1.25, t = 0.76, p = .516). Conclusion The implementation of this innovative empowerment program, which included nurses and supervisors, resulted in an increase in patient safety culture scores as well as growth in domain score. Therefore, this program can be used to advance these critical facets of patient safety culture, which are currently underdeveloped.