bluuebunny/crossref_metadata_2025_split huggingface dataset:
Investigation of geographic disparities of diabetes-related hospitalizations in Florida using flexible spatial scan statistics: An ecological study
Authors: Lord Jennifer , Odoi Agricola 
Published: June 2024

Background
Hospitalizations due to diabetes complications are potentially preventable with effective management of the condition in the outpatient setting. Diabetes-related hospitalization (DRH) rates can provide valuable information about access, utilization, and efficacy of healthcare services. However, little is known about the local geographic distribution of DRH rates in Florida. Therefore, the objectives of this study were to investigate the geographic distribution of DRH rates at the ZIP code tabulation area (ZCTA) level in Florida, identify significant local clusters of high hospitalization rates, and describe characteristics of ZCTAs within the observed spatial clusters.

Methods
Hospital discharge data from 2016 to 2019 were obtained from the Florida Agency for Health Care Administration through a Data Use Agreement with the Florida Department of Health. Raw and spatial empirical Bayes smoothed DRH rates were computed at the ZCTA level. High-rate DRH clusters were identified using Tango’s flexible spatial scan statistic. Choropleth maps were used to display smoothed DRH rates and significant high-rate spatial clusters. Demographic, socioeconomic, and healthcare-related characteristics of cluster and non-cluster ZCTAs were compared using the Wilcoxon rank sum test for continuous variables and Chi-square test for categorical variables.

Results
There was a total of 554,133 diabetes-related hospitalizations during the study period. The statewide DRH rate was 8.5 per 1,000 person-years, but smoothed rates at the ZCTA level ranged from 0 to 101.9. A total of 24 significant high-rate spatial clusters were identified. High-rate clusters had a higher percentage of rural ZCTAs (60.9%) than non-cluster ZCTAs (41.8%). The median percent of non-Hispanic Black residents was significantly (p < 0.0001) higher in cluster ZCTAs than in non-cluster ZCTAs. Populations of cluster ZCTAs also had significantly (p < 0.0001) lower median income and educational attainment, and higher levels of unemployment and poverty compared to the rest of the state. In addition, median percent of the population with health insurance coverage and number of primary care physicians per capita were significantly (p < 0.0001) lower in cluster ZCTAs than in non-cluster ZCTAs.

Conclusions
This study identified geographic disparities of DRH rates at the ZCTA level in Florida. The identification of high-rate DRH clusters provides useful information to guide resource allocation such that communities with the highest burdens are prioritized to reduce the observed disparities. Future research will investigate determinants of hospitalization rates to inform public health planning, resource allocation and interventions.
Process evaluation of a data-driven quality improvement program within a cluster randomised controlled trial to improve coronary heart disease management in Australian primary care
Authors: Hafiz Nashid , Hyun Karice , Tu Qiang , Knight Andrew , Hespe Charlotte , Chow Clara K. , Briffa Tom , Gallagher Robyn , Reid Christopher M. , Hare David L. , Zwar Nicholas , Woodward Mark , Jan Stephen , Atkins Emily R. , Laba Tracey-Lea , Halcomb Elizabeth , Johnson Tracey , Manandi Deborah , Usherwood Tim , Redfern Julie 
Published: June 2024

Background
This study evaluates primary care practices’ engagement with various features of a quality improvement (QI) intervention for patients with coronary heart disease (CHD) in four Australian states.

Methods
Twenty-seven practices participated in the QI intervention from November 2019 –November 2020. A combination of surveys, semi-structured interviews and other materials within the QUality improvement in primary care to prevent hospitalisations and improve Effectiveness and efficiency of care for people Living with heart disease (QUEL) study were used in the process evaluation. Data were summarised using descriptive statistical and thematic analyses for 26 practices.

Results
Sixty-four practice team members and Primary Health Networks staff provided feedback, and nine of the 63 participants participated in the interviews. Seventy-eight percent (40/54) were either general practitioners or practice managers. Although 69% of the practices self-reported improvement in their management of heart disease, engagement with the intervention varied. Forty-two percent (11/26) of the practices attended five or more learning workshops, 69% (18/26) used Plan-Do-Study-Act cycles, and the median (Interquartile intervals) visits per practice to the online SharePoint site were 170 (146–252) visits. Qualitative data identified learning workshops and monthly feedback reports as the key features of the intervention.

Conclusion
Practice engagement in a multi-featured data-driven QI intervention was common, with learning workshops and monthly feedback reports identified as the most useful features. A better understanding of these features will help influence future implementation of similar interventions.

Trial registration
Australian New Zealand Clinical Trials Registry (ANZCTR) number ACTRN12619001790134.
Prediction of pharmaceutical and non-pharmaceutical expenditures associated with Diabetes Mellitus type II based on clinical risk
Authors: Gonzalez-Rodriguez Javier-Leonardo , Franco Carlos , Pinzón-Espitia Olga , Caballer Vicent , Alfonso-Lizarazo Edgar , Augusto Vincent 
Published: June 2024

Objective
To assess the effectiveness of different machine learning models in estimating the pharmaceutical and non-pharmaceutical expenditures associated with Diabetes Mellitus type II diagnosis, based on the clinical risk index determined by the analysis of comorbidities.

Materials and methods
In this cross-sectional study, we have used data from 11,028 anonymized records of patients admitted to a high-complexity hospital in Bogota, Colombia between 2017–2019 with a primary diagnosis of Diabetes. These cases were classified according to Charlson’s comorbidity index in several risk categories. The main variables analyzed in this study are hospitalization costs (which include pharmaceutical and non-pharmaceutical expenditures), age, gender, length of stay, medicines and services consumed, and comorbidities assessed by the Charlson’s index. The model’s dependent variable is expenditure (composed of pharmaceutical and non-pharmaceutical expenditures). Based on these variables, different machine learning models (Multivariate linear regression, Lasso model, and Neural Networks) were used to estimate the pharmaceutical and non-pharmaceutical expenditures associated with the clinical risk classification. To evaluate the performance of these models, different metrics were used: Mean Absolute Percentage Error (MAPE), Mean Squared Error (MSE), Root Mean Squared Error (RMSE), Mean Absolute Error (MAE), and Coefficient of Determination (R2).

Results
The results indicate that the Neural Networks model performed better in terms of accuracy in predicting pharmaceutical and non-pharmaceutical expenditures considering the clinical risk based on Charlson’s comorbidity index. A deeper understanding and experimentation with Neural Networks can improve these preliminary results, therefore we can also conclude that the main variables used and those that were proposed can be used as predictors for the medical expenditures of patients with diabetes type-II.

Conclusions
With the increase of technology elements and tools, it is possible to build models that allow decision-makers in hospitals to improve the resource planning process given the accuracy obtained with the different models tested.
Systematic review and meta-analysis: Evaluating the influence of intrahepatic cholestasis of pregnancy on obstetric and neonatal outcomes
Authors: Huang Xuexia , Gu Huifeng , Shen Pinghua , Zhang Xiaoxing , Fei Anping 
Published: June 2024

Background
Intrahepatic cholestasis of pregnancy (ICP) is a serious liver conditions that negatively impacts obstetric and neonatal outcomes. Elevated levels of bile acid, particularly glycine conjugate, may compromise blood flow and cause functional hypoxia-ischemia.

Aims
This meta-analysis aims to assess the association between ICP and key pregnancy outcomes including emergency caesarian sections (C-sections), preeclampsia, hemorrhage, preterm birth, small for gestational age, admission rate to neonatal intensive care union (NICU), gestational age, and stillbirth.

Materials and methods
Literature search across five databases (PubMed, Embase, Web of Science) was done to detect relevant studies published up until June 2023. Meta-analysis of the identified studies was done using a random-effects model, and the results presented as Odds ratio (OR).

Results
A literature search identified 662 studies. Of them, 21 met the inclusion criteria. There was a significant association between ICP and odds of C-section (OR: 1.42, p <0.001), preeclampsia (OR: 2.64, p <0.001), NICU admission (OR: 2.1, p <0.001), and pre-term birth (OR: 2.64, p <0.001). ICP was not associated with postpartum hemmorhage (OR: 1.31, p = 0.13), small for gestational age (OR: 0.87, p = 0.07), stillbirth (OR: 1.49, p = 0.29).

Conclusions
Our results confirm the adverse effects of ICP on co-existing pregnancy complications, obstetric and neonatal outcomes. ICP in associated with severe complications including increased rates of preeclampsia, emergency C-sections, preterm births, l gestational periods and higher rates of NICU admissions. These results may assist healthcare professionals in formulating comprehensive care guidelines for expectant mothers and newborns.
Young People, Radical Democracy And Community Development, Janet Batsleer, Harriet Rowley and Demet Lüküslü (eds) (2022)
Authors: Moxon Dan 
Published: June 2024

Review of: Young People, Radical Democracy And Community Development, Janet Batsleer, Harriet Rowley and Demet Lüküslü (eds) (2022)
Bristol: Policy Press, 256 pp.,
ISBN 978-1-44736-276-0, h/bk, £85
The mineralogy and textural characteristics of a section of Gondo Well, Niger Delta, Nigeria.
Authors: Ekhalekha Raphael 
Published: June 2024

The sands of the Agbada Formation were studied to deduce their mineralogy, tectonic provenance, and textural and reservoir characteristics. The study is based on 40 DITCH CUTTING SAMPLES retrieved from a section of a Gondo well in the Niger Delta Basin. Thin sections were prepared from the samples taken at inconsistent intervals (feet) from the core samples of the well. The study, which was based on quantitative analysis of the detrital minerals, shows that the clastic sediments (mostly sand and tiny sandstones) are predominantly made up of quartz, with the minor occurrence of a variety of feldspar and rock fragments, as revealed in the modal analysis of the results. Among the detrital framework, quartz constitutes about 50%, feldspar 22%, and lithic fragments 29%. The dominance of quartz grains with few feldspars and generally medium- to fine-grain, poorly to moderately sorted sand suggests matured sediments. The QFL (Quartz-feldspar-lithic fragments) ternary diagrams indicate that the sandstones were derived from recycled or quartzose source rocks. This possibly revealed that most of the sandstones might have been derived from the weathering and erosion of igneous and metamorphic rocks. Few polycrystalline quartz occur, which suggests that the sands of the Agbada Formation are just being subjected to diagenesis. Additionally, the information deduced from the provenance chart suggests that the majority of the sediments come from an arid environment, which is practically demonstrated by the present-day linkage of the River Niger with the Futajalon highland, a semi-arid region. Based on the few clay minerals and the textural characteristics of the sediments, it can be concluded that the well has a fair reservoir quality that will not significantly favor hydrocarbon exploration.
Keywords: Petrographic Analysis, Provenance, Reservoir Characteristics, Agbada Formation.
Ultra-Processed Food Consumption and Gastrointestinal Cancer Risk: A Systematic Review and Meta-Analysis
Authors: Meine Gilmara Coelho , Picon Rafael Veiga , Espírito Santo Paula Arruda , Sander Guilherme Becker 
Published: June 2024

INTRODUCTION:
Ultra-processed food (UPF) intake has been associated with a higher risk of obesity, hypertension, type 2 diabetes, and cardiovascular diseases. The initial data on the relationship between UPF consumption and cancer risk were derived from retrospective observational studies with conflicting results. This systematic review and meta-analysis of prospective cohort studies aimed to investigate the association between UPF consumption and gastrointestinal cancer risk.

METHODS:
PubMed, Embase, and Cochrane databases were searched for prospective cohort studies that compared the highest vs the lowest level of UPF consumption according to NOVA food classification and reported the risk of gastrointestinal cancers by subsite. The association with cancer was quantified as hazard ratios (HR) using a random-effects model.

RESULTS:
Five prospective cohort studies were included in this review comprising 1,128,243 participants (241,201 participants in the highest and 223,366 in the lowest levels of UPF consumption). The mean follow-up ranged from 5.4 to 28 years. The highest UPF consumption was significantly associated with an increased risk of colorectal cancer (HR 1.11; 95% confidence interval [CI] 1.03–1.21; P = 0.01; I
2 = 31%), colon cancer (HR 1.12; 95% CI 1.02–1.23; P = 0.02; I
2 = 0%), and non–cardia gastric cancer (HR 1.43; 95% CI 1.02–2.00; P = 0.04; I
2 = 0%) compared with the lowest UPF intake. However, no association was found between high UPF consumption and hepatocellular, esophageal, pancreatic, gastric cardia, and rectal cancer.

DISCUSSION:
The highest level of UPF consumption was significantly associated with colorectal and non–cardia gastric cancer.
Groundwater quality and health risk assessment of nitrate and fluoride in Al Qaseem area, Saudi Arabia
Authors: Alharbi Talal , El-Sorogy Abdelbaset S. 
Published: June 2024

Abstract
Groundwater serves as the lifeline in arid regions, where aquifer overuse and climatic factors can substantially degrade its quality, posing significant challenges. The current study examines the drinking water quality in the Al Qaseem area and assesses the potential health risks from nitrate (

NO

3

−

{\text{NO}}_{3}^{-}

) and fluoride (F−) exposure to infants, children, and adults. This evaluation employs parameters such as the daily water intake, hazard quotient, and non-carcinogenic hazard index. Groundwater samples from 38 wells and boreholes were analyzed for major cations and anions. The water quality index and multivariate tools were utilized. The average concentrations of

SO

4

2
−

{\text{SO}}_{4}^{2-}

, Cl–, Ca+, Na+, Mg2+, and K+ exceeded acceptable limits. Among the 38 samples, 8 were unsuitable for drinking, with 5 categorized as very poor quality, 10 as poor, 14 as good, and 1 as excellent. Nitrate levels ranged from 1.30 to 108.00 mg/L, with a mean of 36.56 mg/L. Three wells exceeded World Health Organization (WHO) guidelines (50.00 mg/L). Fluoride ranged from 0.10 to 0.98 mg/L, with a mean of 0.71 mg/L and none surpassing WHO recommendations (1.5 mg/L). The HI values for adults, children, and infants were 0.993, 2.606, and 2.78, respectively. About 57.89% of the water samples exceeded the safety level of 1 for adults and 94.73% for both children and infants. Thus, the groundwater in the study area may pose non-carcinogenic health risks to infants, children, and adults when used as drinking water.
Risk-stratified analysis of sex risk behaviors and correlates among school-going adolescents in Argentina: insights from a national survey
Authors: Dadras Omid , El Saaidi Christina 
Published: June 2024

Abstract

Objectives
This study was conducted to address a critical gap in understanding adolescent sexual health risks in Argentina, a country that has undergone substantial socio-economic changes that made significant strides in education and healthcare.

Methods
A secondary data analysis of the 2018 Argentina Global School-based Student Health Survey was performed. In this study, 23,262 sexually active adolescents were categorized into four risk groups based on the predicted granular risk: number of sexual partners and condom use in their last sexual encounter.

Results
Males and older adolescents were more prone to high-risk sexual behaviors. Additionally, key psychosocial factors such as loneliness, anxiety, experiences of violence, and school absenteeism were significantly associated with high-risk sexual behaviors. Early alcohol use and recent experiences of hunger were also identified as strong predictors of heightened sexual risk behaviors. Conversely, positive parental engagement and awareness exhibited protective factors.

Conclusions
These findings highlight the necessity for policy interventions that focus on mental health support, parental involvement, and awareness of adolescent issues and activities.
Gender Communication Differences on a Pediatric Provider Listserv
Authors: Allan Jessica M. , Black Erik , Lemieux Nina , Gilliam Courtney A. , Yardley Jeremy , Kim Juliann L. , Ganem Jorge , Black Nicole Paradise , Schroeder Alan R. , Ralston Shawn , Fromme H. Barrett 
Published: June 2024

BACKGROUND AND OBJECTIVES
Gender-based communication differences are described in educational online communities, but have not been rigorously evaluated in medical online communities. Understanding gender differences in communication may provide insight into gender disparities in the medical profession. Our objective was to describe gender differences in post frequency, content, and language styles on the American Academy of Pediatrics Section on Hospital Medicine (SOHM) listserv.

METHODS
Posts were obtained from publicly available SOHM listserv archives. The first month of every quarter of 2019 and 2020 were reviewed. Two reviewers assigned a post topic (clinical, research, etc) and format (question vs statement) to all deidentified original posts (K = 1.0 topic, 0.89 format). Six trained reviewers assigned language styles (intraclass coefficient = 0.73, indicating good agreement).

RESULTS
We analyzed 1592 posts: 287 original posts and 1305 responses. Frequency: Women authored 50% of posts. The 9 most frequent posters (7 men, 2 women) accounted for 19.5% of posts. Content: Men’s posts had more words than women’s (132.51 vs 112.3, P ≤ .01). Men were more likely to post about health policy and research (P &lt; .001). Men were more likely to post statements compared with women (39% vs 21%, P &lt; .001). Style: Men’s posts were more likely to be coded adversarial (12.3% vs 5.5%, P &lt; .001) authoritative (12.2% vs 6.5%, P &lt; .001) or self-amplifying (6.5% vs 3.6%, P &lt; .001).

CONCLUSIONS
Women contribute disproportionately fewer posts to the American Academy of Pediatrics SOHM listserv compared with their percentage in the subspecialty. We noted significant gender differences in language style and content, which may impact career development and online community inclusion.
Radical and incremental innovations performance in Eastern European SMEs: An empirical study of developed and emerging economies
Authors: Sufyan Ali , Asad Arif Ibne , Novák Petr 
Published: June 2024

Assessing the effectiveness of radical and incremental innovation in SMEs in Eastern European countries is a significant issue in regional economics. In contrast, radical innovation entails the creation of wholly novel goods or organization processes that establish new markets. Progressive enhancements to current goods and processes are referred to as incremental innovation. This study explains the influence of incremental and radical innovation on performance of small and medium-sized enterprises in Eastern Europe. Employing EUROSTAT data from 2012 to 2021 using regression analysis and a graphical model, we examined basic, radical, and incremental innovation and total researcher performance in SMEs, which could enormously affect business performance in Eastern European countries. Our findings indicated that radical, incremental innovation and total research are all favourably related to the performance of SMEs and an approach to studying various innovations and their impact on SMEs. The particular performance effects of radical and incremental innovations in Eastern European SMEs might vary considerably. To give more specific knowledge and suggestions for SMEs, empirical investigations and comprehensive research are required. Our results can contribute to SMEs both theoretically and practically, providing fresh theoretical perspectives for scholars and helpful management consequences for administrators of SMEs in developing countries.
Inscriptions in stone, literacy in question: The confusion between <b> and <v> in inscriptions from Roman Africa
Authors: Tamponi Lucia 
Published: June 2024

AbstractIn this paper, a quantitative and qualitative analysis is conducted on the <b>/<v> alternations found in the epigraphic texts from three representative subsets of Roman African inscriptions from both urban centres and more peripheral areas (1st century BCE – 7th century CE). The distribution of the confusion has been related to the dating and provenance place of the inscriptions and the level of literacy of those involved in their crafting. The results show a difference in the distribution of <b>/<v> confusions in the three areas examined, with a higher incidence in later inscriptions from Sabratha. Thus, it is discussed whether the different distribution of the <b>/<v> confusions observed in the different regions might be a cue for internal diatopic variation.
Analysis of The Integrity of Attitudes, Behavior, Openness and Honesty of Captured Fisheries Enterprises for The Conservation of Fish and Marine Resources
Authors: Noordin Rumaizah Mohd , Istiqomah Titis , Ferdian Muh. Agus , Farida Siti 
Published: June 2024

Integrity of attitude, behavior, openness and honesty are important things that capture fisheries business actors must have. Deviations in integrity are allegedly equivalent to criminal acts of corruption because they have the potential to cause very large losses to the state, which are difficult to detect and the value of the losses. In addition, failure to fulfill integrity has a huge potential for loss of sustainability of fisheries resources in the long term, and is difficult to recover. The research aims to examine the relationship between the integrity of capture fisheries business actors and efforts to preserve fish and marine resources. Descriptive research using a literature study approach combined with a limited discussion process with aquatic resource management experts in order tomaintain the sustainability of fish population dynamics due to capture fisheries exploration. The research results show that the integrity component which concerns attitudes, behavior, openness and honesty of capture fisheries business actors is an absolute thing that must be implemented and developed. Potential state losses worth billions of rupiah accompanied by massive damage to marine resources can be avoided if capture fisheries business actors carry out exploration properly and report their activities honestly and openly to the competent government authorities as a control over resource sustainability.