bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing the price levels of medical service and influential factors: evidence from China
Authors: Lin Yanxian , Li Luo , Liu Bao 
Published: January 2024

Abstract
Background
Medical service prices play a crucial role in cost containment in China. This study aimed to assess the change in medical service price levels at the macro level and the relationship with relevant macroeconomic factors.

Methods
Data from the 2022 China Statistics Yearbook, the 2022 China Health Statistics Yearbook, and the 2020 China National Health Accounts Report were used. Time trends of health price levels, utilization, and health expenditure were examined. A time-series regression model was employed to measure the impact of service utilization and medical service prices on total medical service expenditure growth from 2000 to 2021. The Johansen cointegration test was conducted to test the cointegrating relationship between medical service price levels and total medical service expenditure, average wage of employees and CPI. The Granger causality test was performed to observe the direction of causality.

Results
Descriptive analyses showed consistent growth in utilization and medical service price levels from 2000 to 2021. The time-series model indicated that medical service expenditure was influenced by the rise in inpatient admissions and price levels of medical service and medicine. The Johansen cointegration test identified a long-term equilibrium relationship between medical service price levels and total medical service expenditure, average wage and CPI. The change in medical service price levels was the Granger cause of the change in medical service expenditure, but it had no impact on average wage and CPI. However, the change in medical service price levels was influenced by these three macroeconomic factors.

Conclusions
The growth of medical service expenditure in China was driven by inpatient use and price level. There was a long-term equilibrium relationship between medical service price levels and relevant macroeconomic factors. However, medical service price levels only affected medical service expenditure and have no impact on average wage and CPI. It is necessary to improve the value transmission mechanism of medical service prices.
The clinical characteristics of non-cystic fibrosis bronchiectasis patients with positive serum tumor markers: a retrospective study
Authors: Wang Xiaoyue , Wang Juan , He Siqi , Li Jing , Chen Xiaoting , Ma Tianyuan , Liu Lu , Zhang Lei , Bu Xiaoning 
Published: January 2024

Abstract
Background
Serum tumor markers (STM), extensively used for the diagnosis, monitoring and prognostic assessment of tumors, can be increased in some non-malignant lung diseases. To date, there is a paucity of studies regarding the clinical characteristics of non-cystic fibrosis bronchiectasis patients with positive STMs.

Objective
To investigate the clinical characteristics and indicators of bronchiectasis with positive STMs.

Methods
The clinical data of 377 bronchiectasis patients was retrospectively collected from January 2017 to December 2019 from Beijing Chaoyang Hospital. Patients were divided into the STM negative group, the single STM positive group and the ≥2 STMs positive group according to the number of the positive STMs. The clinical characteristics are described and compared separately. The multivariate logistic regression analysis model was used to investigate the indicators regarding positive STMs.

Results
Patients in the ≥2 STMs positive group were older (P = 0.015), had higher mMRC scores (P < 0.001) and developed higher fever (P = 0.027). Additionally, these patients also had lower Albumin/Globulin Ratio (A/G), albumin (ALB), prealbumin (PAB) (P < 0.001, P < 0.001, P < 0.001, respectively) and higher CRP, ESR and Fbg (P < 0.001, P < 0.001 and P < 0.001, respectively). Age (OR 1.022, 95%CI 1.003–1.042; P = 0.026) and the number of affected lobes (OR 1.443, 95%CI 1.233–1.690; P < 0.001) were independently associated with one and ≥ 2 positive STMs in bronchiectasis patients.

Conclusion
The ≥2 positive STMs are associated with a higher inflammation status and severer radiologic manifestations in bronchiectasis patients.
The association between admission mean corpuscular volume and preoperative deep venous thrombosis in geriatrics hip fracture: a retrospective study
Authors: Xu Shuai-Liang , Li Kun , Cao Wen-Wen , Chen Shao-Hua , Ren Shang-Bo , Zhang Bin-Fei , Zhang Yu-Min 
Published: January 2024

Abstract
Objective
This study evaluated the association between admission MCV and preoperative deep vein thrombosis (DVT) in geriatric hip fractures.

Methods
Older adult patients with hip fractures were screened between January 2015 and September 2019. The demographic and clinical characteristics of the patients were collected at the largest trauma center in northwest China. MCV was measured at admission and converted into a categorical variable according to the quartile. Multivariate binary logistic regression and generalized additive model were used to identify the linear and nonlinear association between MCV and preoperative DVT. Analyses were performed using EmpowerStats and the R software.

Results
A total of 1840 patients who met the criteria were finally enrolled and divided into four groups according to their MCV levels. The mean MCV was 93.82 ± 6.49 (80.96 to 105.91 fL), and 587 patients (31.9%) were diagnosed with preoperative DVT. When MCV was a continuous variable, the incidence of preoperative DVT increased with mean corpuscular volume. In the fully adjusted model, admission MCV was positively correlated with the incidence of preoperative DVT (OR: 1.03; 95% CI: 1.01–1.05; P = 0.0013). After excluding the effect of other factors, each additional 1fL of MCV increased the prevalence of preoperative DVT by 1.03 times as a continuous variable.

Conclusion
MCV was linearly associated with preoperative DVT in geriatric patients with hip fractures and could be considered a predictor of DVT risk. The MCV may contribute to risk assessment and preventing adverse outcomes in the elderly.

Study registration
This study is registered on the website of the Chinese Clinical Trial Registry (ChiCTR: ChiCTR2200057323).
A novel device to assess the oxygen saturation and congestion status of the gastric conduit in thoracic esophagectomy
Authors: Fujita Takeo , Shigeno Takashi , Kajiyama Daisuke , Sato Kazuma , Fujiwara Naoto , Daiko Hiroyuki 
Published: January 2024

Abstract
Background
In thoracic esophagectomy, anastomotic leakage is one of the most important surgical complications. Indocyanine green (ICG) is the most widely used method to assess tissue blood flow; however, this technique has been pointed out to have disadvantages such as difficulty in evaluating the degree of congestion, lack of objectivity in evaluating the degree of staining, and bias easily caused by ICG injection, camera distance, and other factors.
Evaluating tissue oxygen saturation (StO2) overcomes these disadvantages and can be performed easily and repeatedly. It is also possible to measure objective values including the degree of congestion. We evaluate novel imaging technology to assess tissue oxygen saturation (StO2) in the gastric conduit during thoracic esophagectomy.

Methods
Fifty patients were enrolled, with seven excluded due to intraoperative findings, leaving 43 for analysis. These patients underwent thoracic esophagectomy for esophageal cancer. The device was used intraoperatively to evaluate tissue oxygen saturation (StO2) and total hemoglobin index (T-HbI), which guided the optimal site for gastric tube anastomosis. The efficacies of StO2 and T-HbI in relation to short-term outcomes were analyzed.

Results
StO2, indicating blood supply to the gastric tube, remained stable beyond the right gastroepiploic artery (RGEA) end but significantly decreased distally to the demarcation line (p <  0.05). T-HbI, indicative of congestion, significantly decreased past the RGEA (p <  0.05). Three patients experienced anastomotic leakage. These patients exhibited significantly lower StO2 (p <  0.01) and higher T-HbI (p <  0.01) at both the RGEA end and the demarcation line. Furthermore, the anastomotic site, usually within 3 cm of the RGEA’s anorectal side, also showed significantly lower StO2 (p <  0.01) and higher T-HbI (p <  0.01) in patients with anastomotic leakage.

Conclusions
The novel device provides real-time, objective evaluations of blood flow and congestion in the gastric tube. It proves useful for safer reconstruction during thoracic esophagectomy, particularly by identifying optimal anastomosis sites and predicting potential anastomotic leakage.
A cross-sectional study: correlation of forehead morphology and dentoskeletal malocclusion in Chinese people
Authors: Zheng Xiuyun , Ding Siqi , Mei Qin , Wu Chuan , Zhang Qunyan , Fu Chunfeng , Han Quancheng , Jin Shiyu , Yu Ruiqi , Yu Muchen , Ye Zixian , Shen Jun , Xu Jianguang , Liu Xiaoyu , Wu Tingting 
Published: January 2024

Abstract
Background
The lateral profile is an important indicator of facial attractiveness. This study explored the general characteristics of the forehead profile and protrusion, and their relationship with related factors in structure and development.

Methods
Four hundred fourteen Chinese participants in the Yangtze River Delta region were involved. Including 206 males (17.15 ± 7.68 years old) and 208 females (18.35 ± 8.06 years old); 94 children (8.54 ± 2.21 years old, ranging from 4 to 12 years old), 166 adolescents (14.83 ± 1.50 years old, ranging from 13 to 17 years old), and 154 adults (25.52 ± 4.89, 18 years or older). The frontal section of the forehead was used to explore its shape. The straight distance between the vertical line of the FH plane through the nasal root point and its parallel line, which is tangential to the forehead, indicates the forehead prominence. Frontal sinus width was measured using the method described by Mahmood.

Results
The general shape of the forehead was straight and slightly bulged near the eyebrow arch in males but rounder in females. The average forehead protrusion in males was higher than that in females in adults. Significant differences in forehead protrusion between the dentoskeletal classifications and growth phases were notable. Frontal protrusion significantly correlated with frontal sinus depth, especially in males, adults, Class I, and those whose convex points were located in the lower section of the forehead.

Conclusions
Age, race, and sex affect the forehead protrusion and frontal sinus width. Forehead protrusion may be an indicator of dentoskeletal deformities in the early stage. And dentoskeletal deformities may impair the correlation between the frontal sinuses and forehead protrusion during development.

Trial registration
This retrospective, cross-sectional study was reviewed and approved by the Research Ethical Committee (T2020008), and registered at ClinicalTrial.gov with an identified number (ChiCTR2100041913).
Radiographic grid for locating foreign bodies in maxillofacial emergency trauma
Authors: Zhang Ziqi , Yang Mingliang , Zhang Ran 
Published: January 2024

Abstract
Objectives
The accurate localization of the foreign bodies (FBs) is essential. This work presents a new noninvasive technique for subcutaneous metallic FBs under a radiographic grid, a system that simplifies the localization of facial FBs removal using a grid with embedded reference points.

Methods
This work designed a retrospective study to evaluate the effect of a radiographic grid on FBs removal surgery. All patients who met the inclusion criteria and attended the Hospital of Stomatology of China Medical University from January 2022 to June 2023 were enrolled and randomly divided into grid and non-grid groups. The assessment of facial swelling, the primary indicator, was conducted on days 2 and 7 post-surgery. The variables were analyzed using the Student t test and a repeated-measures general linear model.

Results
The study sample consisted of 20 patients, with 14 males (70%) and 6 females (30%), who had an average age of 30.30 ± 5.38. The average time of operation was 1.85 ± 0.66 h (range 0.7 to 3.2). In the present cases in this report, of the 20 patients’ FBs, 14 were metal, 5 were glass, and 1 was residual root. And the FBs were surgically removed with no postoperative complications. Through comparison, it was found that the degree of swelling on day 2 postoperatively was significantly different between the grid group and the non-grid group (P < 0.05).

Conclusions
This study demonstrates that a radiographic grid with mark points is a more efficient approach compared with traditional methods for FBs removal, and this surgical method is more accurate, fast and noninvasive.
Enhancing self-care education amongst medical students: a systematic scoping review
Authors: Wan Darius Wei Jun , Goh Laura Shih Hui , Teo Mac Yu Kai , Loh Celestine Jia Ling , Yak Gerald Hng Kai , Lee Joanna Jing Hui , Ravindran Nila , Abdul Rahman Nur Diana , Chiam Min , Ong Eng Koon , Somasundaram Nagavalli , Lim Ying Yin , Phua Gillian Li Gek , Krishna Lalit Kumar Radha 
Published: January 2024

AbstractBackgroundReports of emotional, existential and moral distress amongst medical students witnessing death and suffering of patients during their clinical postings have raised awareness on the need for better psycho-emotional support during medical school. Furthermore, the stress experienced by medical students stemming from the rigours of their academic curriculum underlines the need for greater awareness on mental health issues and better self-care practices across medical training. With such programmes lacking in most medical schools, we propose a systematic scoping review (SSR) to map and address our research question, “what is known about self-care education interventions amongst medical students?”.MethodsWe adopted the Systematic Evidence-Based Approach to guide a systematic scoping review (SSR in SEBA) of relevant articles published between 1st January 2000 and 30th June 2023 in PubMed, Embase, PsycINFO, ERIC, Google Scholar, and Scopus databases. The included articles were independently and concurrently thematically and content analysed, with complementary categories and themes combined using the Jigsaw Approach. The domains created from the Funnelling Process framed the discussion.ResultsA total of 6128 abstracts were identified, 429 full-text articles evaluated, and 147 articles included. The 6 domains identified were definition, topics, pedagogy, influences, outcomes and assessment. Most interventions were promising, though peer-led mindfulness-based interventions showed most promise in enhancing engagement, positively impacting personal wellbeing, and improving patient care. Overall, however, self-care education was poorly recognized, adopted and integrated into curricula.ConclusionGreater dedicated time and conducive practice environments within medical school curricula is required to enhance medical student wellbeing. Host organizations must ensure faculty are appropriately selected to instil the importance of self-care, be trained to assess and personalize self-care interventions and provide longitudinal assessment and support. Further study into assessing self-care capabilities is required.
The residency levels' effect on pediatric dental rehabilitation operation time
Authors: Baakdah Raniah , Al-kharouby Shahad , Al-Sharif Shrouq , Al-Nakhli Rabab , Al-Sulami Yara , Al-Qarni Raghad , Al-Hindi Mohammed Yasir 
Published: January 2024

Abstract
Background
Postgraduate pediatric dental residents' competency, to perform dental rehabilitation procedures under General anesthesia (GA), at different levels of training is challenging for operation time control. An adequate operation time (OT) for children decreases morbidity risk and improves hospital time utilization efficiency. The aim of the study is to assess the effect of pediatric dental resident training level on OT for pediatric dental rehabilitation procedures under GA at King Abdulaziz Medical City (KAMC).

Methods
A cross-sectional study included pediatric dental rehabilitation performed under GA by pediatric dental residents at (KAMC) -Jeddah from October/2015 to September/2022. The primary outcome was OT, and the predictive variable was resident training levels. A linear regression analysis was used to compare OT between procedures performed by junior (years 1–2) or senior (years 3–4) trainees, adjusting for patient and operative factors.

Results
One thousand seven pediatric dental rehabilitation cases were performed under GA by junior (13) and senior (31) residents. The univariant analysis indicated that OT for senior residents was significantly longer (13 min) than for junior residents. However, the linear regression analysis showed that senior residents had a significantly shorter OT when considering the more dental procedures performed per case under GA than junior residents. Senior residents took significantly more radiographs and performed more primary pulp therapies and multi-surface anterior colored restorations under GA than junior residents.

Conclusions
The OT for pediatric dental rehabilitation procedures under GA is associated with resident training level. The total OT was significantly longer based on procedure number, type, and resident level. The study indicated that senior residents could manage more complex cases in a shorter time. The finding emphasizes the importance of assigning GA cases to residents based on their level and the case's complexity. Additionally, it helps standardize the resident privileges under GA and understand the impact of residency training on hospital efficiency.
Understanding health care pathways of patients with sepsis: protocol of a mixed-methods analysis of health care utilization, experiences, and needs of patients with and after sepsis
Authors: Fleischmann-Struzek Carolin , Rose Norman , Ditscheid Bianka , Draeger Lea , Dröge Patrik , Freytag Antje , Goldhahn Ludwig , Kannengießer Lena , Kimmig Aurelia , Matthäus-Krämer Claudia , Ruhnke Thomas , Reinhart Konrad , Schlattmann Peter , Schmidt Konrad , Storch Josephine , Ulbrich Ruben , Ullmann Susanne , Wedekind Lisa , Swart Enno 
Published: January 2024

Abstract
Background
Sepsis is associated with about 20% of deaths worldwide. It often presents with non-specific initial symptoms, making its emergency treatment an interdisciplinary and cross-sectoral challenge. Three in four sepsis survivors suffers from new cognitive, psychological, or physical sequelae for which specific treatment concepts are scarce. The AVENIR project aims to improve the understanding of patient pathways, and subjective care experiences and needs along the entire healthcare pathway before, with and after sepsis. Based on this, concrete recommendations for the organization of care and patient information materials will be developed with close patient participation.

Methods
Mixed-methods study including (1) analysis of anonymized nationwide health claims data from Germany, (2) linkage of health claims data with patient care reports (PCR) of emergency medical services from study regions in two federal states within Germany, and (3) qualitative exploration of the patient, relative, and care provider perspective on sepsis care. In (1), we analyze inpatient and outpatient health care utilization until 30 days pre-sepsis; clinical sepsis care including intra- and inter-hospital transfers; and rehabilitation, inpatient and outpatient aftercare of sepsis survivors as well as costs for health care utilization until 24 months post-sepsis. We attempt to identify survivor classes with similar health care utilization by Latent Class Analyses. In (2), PCR are linked with health claims data to establish a comprehensive database outlining care pathways for sepsis patients from pre-hospital to follow-up. We investigate e.g., whether correct initial assessment is associated with acute (e.g., same-day lethality) and long-term (e.g., new need for care, long-term mortality) outcomes of patients. We compare the performance of sepsis-specific screening tools such as qSOFA, NEWS-2 or PRESEP in the pre-clinical setting. In (3), semi-structured interviews as well as synchronous and asynchronous online focus groups are conducted and analyzed using qualitative content analyses techniques.

Discussion
The results of the AVENIR study will contribute to a deeper understanding of sepsis care pathways in Germany. They may serve as a base for improvements and innovations in sepsis care, that in the long-term can contribute to reduce the personal, medical, and societal burden of sepsis and its sepsis sequelae.

Trial registration
Registered at German Clinical Trial Register (ID: DRKS00031302, date of registration: 5th May 2023).
Experience of copy number variation sequencing applied in spontaneous abortion
Authors: Dai Yi-Fang , Wu Xiao-Qing , Huang Hai-Long , He Shu-Qiong , Guo Dan-Hua , Li Ying , Lin Na , Xu Liang-Pu 
Published: January 2024

Abstract
Purpose
We evaluated the value of copy number variation sequencing (CNV-seq) and quantitative fluorescence (QF)-PCR for analyzing chromosomal abnormalities (CA) in spontaneous abortion specimens.

Methods
A total of 650 products of conception (POCs) were collected from spontaneous abortion between April 2018 and May 2020. CNV-seq and QF-PCR were performed to determine the characteristics and frequencies of copy number variants (CNVs) with clinical significance. The clinical features of the patients were recorded.

Results
Clinically significant chromosomal abnormalities were identified in 355 (54.6%) POCs, of which 217 (33.4%) were autosomal trisomies, 42(6.5%) were chromosomal monosomies and 40 (6.2%) were pathogenic CNVs (pCNVs). Chromosomal trisomy occurs mainly on chromosomes 15, 16, 18, 21and 22. Monosomy X was not associated with the maternal or gestational age. The frequency of chromosomal abnormalities in miscarriages from women with a normal live birth history was 55.3%; it was 54.4% from women without a normal live birth history (P > 0.05). There were no significant differences among women without, with 1, and with ≥ 2 previous miscarriages regarding the rate of chromosomal abnormalities (P > 0.05); CNVs were less frequently detected in women with advanced maternal age than in women aged ≤ 29 and 30–34 years (P < 0.05).

Conclusion
Chromosomal abnormalities are the most common cause of pregnancy loss, and maternal and gestational ages are strongly associated with fetal autosomal trisomy aberrations. Embryo chromosomal examination is recommended regardless of the gestational age, modes of conception or previous abortion status.