bluuebunny/crossref_metadata_2025_split huggingface dataset:
Social Care Responses to Children who Experience Criminal Exploitation and Violence: The Conditions for a Welfare Response
Authors: Lloyd Jenny , Manister Molly , Wroe Lauren 
Published: June 2023

Abstract
This article explores social care responses to children experiencing criminal exploitation and violence. The article draws on data from two children’s social care departments in England applying a Contextual Safeguarding framework to extra-familial harm. Using evidence from interviews, focus groups, meeting observations and two peer assessments, the article explores factors that facilitate welfare approaches when children commit crimes and those conditions that undermine welfare approaches. The findings outline five conditions which facilitate or inhibit welfare responses including: whether legal rights promote the best interests of the child, if harm reduction prioritises a child’s needs, if language is underpinned by caring intention, the extent that systems harm is recognised and addressed and how practitioners gain knowledge of young people. The discussion introduces a welfare framework for social workers to define and describe what the conditions for welfare responses can constitute.
Efficacy and safety of MAS825 (anti-IL-1β/IL-18) in COVID-19 patients with pneumonia and impaired respiratory function
Authors: Hakim Alex D , Awili Mustafa , O’Neal Hollis R , Siddiqi Omar , Jaffrani Naseem , Lee Richard , Overcash Jeffrey S , Chauffe Ann , Hammond Terese C , Patel Bela , Waters Michael , Criner Gerard J , Pachori Alok , Junge Guido , Levitch Rafael , Watts Jen , Koo Philip , Sengupta Tirtha , Yu Lili , Kiffe Michael , Pinck Anne , Stein Richard R , Bendrick-Peart Jamie , Jenkins Janet , Rowlands Marianna , Waldron-Lynch Frank , Matthews Jesse 
Published: June 2023

Abstract
MAS825, a bispecific IL-1β/IL-18 monoclonal antibody, could improve clinical outcomes in COVID-19 pneumonia by reducing inflammasome-mediated inflammation. Hospitalized non-ventilated patients with COVID-19 pneumonia (n = 138) were randomized (1:1) to receive MAS825 (10 mg/kg single i.v.) or placebo in addition to standard of care (SoC). The primary endpoint was the composite Acute Physiology and Chronic Health Evaluation II (APACHE II) score on Day 15 or on the day of discharge (whichever was earlier) with worst-case imputation for death. Other study endpoints included safety, C-reactive protein (CRP), SARS-CoV-2 presence, and inflammatory markers. On Day 15, the APACHE II score was 14.5 ± 1.87 and 13.5 ± 1.8 in the MAS825 and placebo groups, respectively (P = 0.33). MAS825 + SoC led to 33% relative reduction in intensive care unit (ICU) admissions, ~1 day reduction in ICU stay, reduction in mean duration of oxygen support (13.5 versus 14.3 days), and earlier clearance of virus on Day 15 versus placebo + SoC group. On Day 15, compared with placebo group, patients treated with MAS825 + SoC showed a 51% decrease in CRP levels, 42% lower IL-6 levels, 19% decrease in neutrophil levels, and 16% lower interferon-γ levels, indicative of IL-1β and IL-18 pathway engagement. MAS825 + SoC did not improve APACHE II score in hospitalized patients with severe COVID-19 pneumonia; however, it inhibited relevant clinical and inflammatory pathway biomarkers and resulted in faster virus clearance versus placebo + SoC. MAS825 used in conjunction with SoC was well tolerated. None of the adverse events (AEs) or serious AEs were treatment-related.
A body composition model with multiple storage compartments for polar bears (Ursus maritimus)
Authors: Penk Stephanie R , Sadana Pranav , Archer Louise C , Pagano Anthony M , Cattet Marc R L , Lunn Nicholas J , Thiemann Gregory W , Molnár Péter K 
Published: June 2023

Abstract
Climate warming is rapidly altering Arctic ecosystems. Polar bears (Ursus maritimus) need sea ice as a platform from which to hunt seals, but increased sea-ice loss is lengthening periods when bears are without access to primary hunting habitat. During periods of food scarcity, survival depends on the energy that a bear has stored in body reserves, termed storage energy, making this a key metric in predictive models assessing climate change impacts on polar bears. Here, we developed a body composition model for polar bears that estimates storage energy while accounting for changes in storage tissue composition. We used data of dissected polar bears (n = 31) to link routinely collected field measures of total body mass and straight-line body length to the body composition of individual bears, described in terms of structural mass and two storage compartments, adipose and muscle. We then estimated the masses of metabolizable proteins and lipids within these storage compartments, giving total storage energy. We tested this multi-storage model by using it to predict changes in the lipid stores from an independent dataset of wild polar bears (n = 36) that were recaptured 8–200 days later. Using length and mass measurements, our model successfully predicted direct measurements of lipid changes via isotopic dilutions (root mean squared error of 14.5 kg). Separating storage into two compartments, and allowing the molecular composition of storage to vary, provides new avenues for quantifying energy stores of individuals across their life cycle. The multi-storage body composition model thus provides a basis for further exploring energetic costs of physiological processes that contribute to individual survival and reproductive success. Given bioenergetic models are increasingly used as a tool to predict individual fitness and population dynamics, our approach for estimating individual energy stores could be applicable to a wide range of species.
Influence of cusp morphology and sex on quantitative valve composition in severe aortic stenosis
Authors: Patel Kush P , Lin Andrew , Kumar Niraj , Esposito Giulia , Grodecki Kajetan , Lloyd Guy , Mathur Anthony , Baumbach Andreas , Mullen Michael J , Williams Michelle C , Newby David E , Treibel Thomas A , Dweck Marc R , Dey Damini 
Published: June 2023

Abstract

Aims
Aortic stenosis is characterized by fibrosis and calcification of the valve, with a higher proportion of fibrosis observed in women. Stenotic bicuspid aortic valves progress more rapidly than tricuspid valves, which may also influence the relative composition of the valve. We aimed to investigate the influence of cusp morphology on quantitative aortic valve composition quantified from contrast-enhanced computed tomography angiography in severe aortic stenosis.

Methods and results
Patients undergoing transcatheter aortic valve implantation with bicuspid and tricuspid valves were propensity matched 1:1 by age, sex, and comorbidities. Computed tomography angiograms were analysed using semi-automated software to quantify the fibrotic and calcific scores (volume/valve annular area) and the fibro-calcific ratio (fibrotic score/calcific score). The study population (n = 140) was elderly (76 ± 10 years, 62% male) and had a peak aortic jet velocity of 4.1 ± 0.7 m/s. Compared with those with tricuspid valves (n = 70), patients with bicuspid valves (n = 70) had higher fibrotic scores [204 (interquartile range 118–267) vs. 144 (99–208) mm3/cm2, P = 0.006] with similar calcific scores (P = 0.614). Women had greater fibrotic scores than men in bicuspid [224 (181–307) vs. 169 (109–247) mm3/cm2, P = 0.042] but not tricuspid valves (P = 0.232). Men had greater calcific scores than women in both bicuspid [203 (124–355) vs. 130 (70–182) mm3/cm2, P = 0.008] and tricuspid [177 (136–249) vs. 100 (62–150) mm3/cm2, P = 0.004] valves. Among both valve types, women had a greater fibro-calcific ratio compared with men [tricuspid 1.86 (0.94–2.56) vs. 0.86 (0.54–1.24), P = 0.001 and bicuspid 1.78 (1.21–2.90) vs. 0.74 (0.44–1.53), P = 0.001].

Conclusions
In severe aortic stenosis, bicuspid valves have proportionately more fibrosis than tricuspid valves, especially in women.
The relevance of competing risk adjustment in cardiovascular risk prediction models for clinical practice
Authors: Hageman Steven H J , Dorresteijn Jannick A N , Pennells Lisa , van Smeden Maarten , Bots Michiel L , Di Angelantonio Emanuele , Visseren Frank L J 
Published: June 2023

Abstract

Background
Many models developed for predicting the risk of cardiovascular disease (CVD) are adjusted for the competing risk of non-CVD mortality, which has been suggested to reduce potential overestimation of cumulative incidence in populations where the risk of competing events is high. The objective was to evaluate and illustrate the clinical impact of competing risk adjustment when deriving a CVD prediction model in a high-risk population.

Methods and results
Individuals with established atherosclerotic CVD were included from the Utrecht Cardiovascular Cohort—Secondary Manifestations of ARTerial disease (UCC-SMART). In 8355 individuals, followed for a median of 8.2 years (IQR 4.2–12.5), two similar prediction models for the estimation of 10-year residual CVD risk were derived: with competing risk adjustment using a Fine and Gray model and without competing risk adjustment using a Cox proportional hazards model. On average, predictions were higher from the Cox model. The Cox model predictions overestimated the cumulative incidence [predicted–observed ratio 1.14 (95% CI 1.09–1.20)], which was most apparent in the highest risk quartiles and in older persons. Discrimination of both models was similar. When determining treatment eligibility on thresholds of predicted risks, more individuals would be treated based on the Cox model predictions. If, for example, individuals with a predicted risk &gt; 20% were considered eligible for treatment, 34% of the population would be treated according to the Fine and Gray model predictions and 44% according to the Cox model predictions.

Interpretation
Individual predictions from the model unadjusted for competing risks were higher, reflecting the different interpretations of both models. For models aiming to accurately predict absolute risks, especially in high-risk populations, competing risk adjustment must be considered.
Transient cardiac electrophysiological changes in a rat model of subarachnoid haemorrhage: a brain–heart interaction
Authors: Chen Mingxian , Wang Zhuo , Lai Xin , Wang Songyun , Wu Zhihong , Liu Qiming , Zhou Shenghua 
Published: June 2023

Abstract

Aims
Subarachnoid haemorrhage (SAH) is one of the causes of sudden cardiac death (SCD). However, the time course of ventricular arrhythmias and potential mechanisms responsible for this effect after SAH remain unknown.

Objective
This study aims to investigate the effect of SAH on ventricular electrophysiological changes and its potential mechanisms in long-term phase.

Methods and results
We examined the ventricular electrophysiological remodelling and potential mechanisms in a Sprague Dawley rat model of SAH at six time points (baseline, and Days 1, 3, 7, 14 and 28) and explored the potential mechanisms. We measured the ventricular effective refractory period (ERP), ventricular fibrillation threshold (VFT) and left stellate ganglion (LSG) activity at different time points before and after SAH. We also detected neuropeptide Y (NPY) levels in plasma and myocardial tissues by enzyme-linked immunosorbent assay, and quantified NPY 1 receptor (NPY1R) protein and mRNA expression levels by western blotting and quantitative real-time reverse transcription-polymerase chain reaction, respectively. Subarachnoid haemorrhage gradually prolonged QTc intervals, shortened ventricular ERP and reduced VFT during the acute phase, peaking at Day 3. However, no significant changes were observed from Days 14 to 28 compared to Day 0. Subarachnoid haemorrhage gradually increased LSG activity, increased NPY concentrations and up-regulated NPY1R expression in the acute phase of SAH, peaking at Day 3. However, no significant variations were found from Days 14 to 28 compared to Day 0.

Conclusion
Subarachnoid haemorrhage increases the transient susceptibility of VAs in the acute phase, and the underlying mechanisms for this response included increased sympathetic activity and up-regulated NPY1R expression.
A PacBio Hi-Fi Genome Assembly of the Painter’s Mussel Unio pictorum (Linnaeus, 1758)
Authors: Gomes-dos-Santos André , Froufe Elsa , Machado André M , Lajtner Jasna , Černecký Ján , C. Castro L Filipe , Lopes Lima Manuel 
Published: June 2023

Abstract
The highly diverse group of freshwater mussels from order Unionida is found in the world’s freshwater systems due to several fascinating evolutionary adaptations, including “parental care,” and most notably, an obligatory parasitic phase in their early life cycle, called glochidia, which infests and uses fish for nutrition and dispersal. Freshwater mussels play essential ecological roles in freshwater habitats, including water filtration, sediment bioturbation, and nutrient cycling. However, these species are also highly threatened, being one of the faunal groups with the highest recorded extinction rate in the wild. Genomics methods have an incredible potential to promote biodiversity conservation, allowing the characterization of population health, identification of adaptive genetic elements, delineation of conservation units, and providing a framework for predictive assessments of the impact of anthropogenic threats and climate change. Unfortunately, only six freshwater mussel species have had their whole genomes sequenced to date, and only two of these are European species. Here, we present the first genome assembly of the Painter’s Mussel, Unio pictorum (Linnaeus, 1758), the type species representative of the order and the most widespread species of the genus in Europe. We used long-read PacBio Hi-Fi sequencing reads to produce a highly contiguous assembly that will pave the way for the study of European freshwater mussels in the Genome Era.
Most Americans support minimizing administrative burdens for Medicaid recipients as the public health emergency ends
Authors: Haeder Simon F , Moynihan Donald P 
Published: June 2023

AbstractDuring the coronavirus disease 2019 (COVID-19) public health emergency (PHE), states were barred from disenrolling anyone from Medicaid unless the beneficiary asked to be disenrolled, moved out of state, or died. Coverage increased, but as the PHE ends an estimated 7 million eligible Americans are expected to lose insurance due to difficulty navigating the renewal process. The end of the PHE therefore offers state policymakers a chance to reassess the value of such administrative burdens as a variety of policy tools are available to mitigate these losses. We inform this discussion via a national survey that captures public preferences around administrative burdens in public health insurance. We find strong public support for burden-reduction techniques that minimize coverage losses such as using administrative data to shift burdens onto the state and better outreach and communication, with an average of 74% of respondents supporting each policy tool. This support holds across the ideological spectrum and demographic groups, but it is stronger among liberals than conservatives, for those with more direct experience of burdens, those who struggle with such burdens, and for those with lower racial prejudice.
Why is it so hard for academic medical centers to succeed in value-based care?
Authors: Kocher Bob , Wachter Robert M 
Published: June 2023

Abstract
Academic medical centers (AMCs) excel in many ways, but struggle to succeed at delivering cost-effective care in value-based payment models. To the extent these payment models become more widespread, or mandatory, this could be a giant risk to the future success of AMCs. Many attributes of AMCs that have served them well in a fee-for-service payment system may hinder the transformation needed to succeed in value-based care. Much of the underperformance of AMCs may be explained by two core competencies that AMCs lack: the limited ability to redesign clinical workflows and inability to change their economic relationships with their own specialists and primary care providers. These limitations, in turn, flow from a combination of electronic medical record systems that lock-in existing practice patterns, compensation systems that reward volume over value, organizational structures that make it very hard to drive clinicians to change, workforces with too many specialists, and complex accounting systems. To preserve current margins in value-based care, AMCs need to reduce their cost structures and gain new skills in primary and preventive care. Alternative, AMCs may choose to eschew value-based care and raise their prices for fee-for-service to offset declines in patient volume.
Role of independent versus chain pharmacies in providing pharmacy access: a nationwide, individual-level geographic information systems analysis
Authors: Hernandez Inmaculada , Tang Shangbin , Morales Jasmine , Gabriel Nico , Patel Nimish , Mathis Walter S , Guo Jingchuan , Berenbrok Lucas A 
Published: June 2023

Abstract
Pharmacy accessibility is critical for equity in medication access and is jeopardized by pharmacy closures, which disproportionately affect independent pharmacies. We conducted a geographic information systems analysis to quantify how many individuals across the United States do not have optimal pharmacy access or solely rely on independent pharmacies for access. We generated service areas of pharmacies using OpenStreetMap data. For each individual in a 30% random sample of the 2020 RTI International US Household Synthetic Population (N = 90 778 132), we defined optimal pharmacy access as having a driving distance to the closest pharmacy ≤2 miles in urban counties, ≤5 miles in suburban counties, and ≤10 miles in rural counties. Individuals were then categorized according to their access to chain and independent pharmacies. Five percent of the sample or ∼15.1 million individuals nationwide relied on independent pharmacies for optimal access. Individuals relying on independent pharmacies for optimal access were more likely to live in rural areas, be sixty-five years or older, and belong to low-income households. Another 19.5% of individuals in the sample did not have optimal pharmacy access, which corresponds to 59.0 million individuals nationwide. Our findings demonstrate that independent pharmacies play a critical role in ensuring equity in pharmacy access.
Perspectives of private payers on multicancer early-detection tests: informing research, implementation, and policy
Authors: Trosman Julia R , Weldon Christine B , Kurian Allison W , Pasquinelli Mary M , Kircher Sheetal M , Martin Nikki , Douglas Michael P , Phillips Kathryn A 
Published: June 2023

Abstract
Emerging blood-based multicancer early-detection (MCED) tests may redefine cancer screening, reduce mortality, and address health disparities if their benefit is demonstrated. U.S. payers’ coverage policies will impact MCED test adoption and access; thus, their perspectives must be understood. We examined views, coverage barriers, and evidentiary needs for MCED from 19 private payers collectively covering 150 000 000 enrollees. Most saw an MCED test's potential merit for cancers without current screening (84%), but fewer saw its merit for cancers with existing screening (37%). The largest coverage barriers were inclusion of cancers without demonstrated benefits of early diagnosis (73%), a high false-negative rate (53%), and lack of care protocols for MCED–detected but unconfirmed cancers (53%). The majority (58%) would not require mortality evidence and would accept surrogate endpoints. Most payers (64%) would accept rigorous real-world evidence in the absence of a large randomized controlled trial. The majority (74%) did not expect MCED to reduce disparities due to potential harm from overtreatment resulting from an MCED and barriers to downstream care. Payers’ perspectives and evidentiary needs may inform MCED test developers, researchers producing evidence, and health systems framing MCED screening programs. Private payers should be stakeholders of a national MCED policy and equity agenda.
Measuring private equity penetration and consolidation in emergency medicine and anesthesiology
Authors: Adler Loren , Milhaupt Conrad , Valdez Samuel 
Published: June 2023

Abstract
Private equity–backed staffing companies in anesthesia and emergency medicine, as well as those owned by publicly traded companies, gained notoriety for driving surprise billing—a practice where patients unexpectedly treated by an out-of-network provider can be billed for the difference between the provider's charge and what their insurer pays. Yet, little is known about the evolution of private equity and publicly traded company investment in these specialties. In this study, we construct a novel dataset identifying the ownership structure of anesthesia and emergency medicine physician groups to document trends in consolidation and the growing role of private equity and publicly traded companies. From 2009 to 2019, we found substantial increases in local market concentration in each specialty and that physician groups owned by private equity or publicly traded companies grew from 3.2% and 8.6% of the national anesthesia and emergency medicine markets, respectively, to 18.8% and 22.0%.
Introducing the inaugural issue of Health Affairs Scholar: Emerging and Global Health Policy (HAS)
Authors: Phillips Kathryn A 
Published: June 2023

Abstract
We are delighted to introduce readers to the inaugural issue of Health Affairs Scholar: Emerging and Global Health Policy (HAS). HAS is the new fully open access companion journal to Health Affairs. Building on Health Affairs’ reputation as the leading journal of health policy thought and research, HAS serves as an additional forum for high-quality, peer-reviewed work from researchers worldwide. The journal fills a gap by focusing on both health policy and emerging issues that are historically less often addressed in “legacy” health policy journals. HAS will elevate emerging new research and policy analysis on healthcare technology, business models, and innovation; population health; global health policy; and important intersecting topics with health, such as the impact of climate change. The journal will also cover core health policy topics of healthcare costs, access to care, quality, and equity.
Geographic distribution of general industry payments to advanced-practice clinicians
Authors: Sun Qiwei Wilton , Cavallo Joseph J , Forman Howard P 
Published: June 2023

Abstract
Following the recent expansion of the Open Payments program to include advanced-practice clinicians (APCs) as covered recipients, we characterized the geographical distribution of general industry payments to nurse practitioners and physician assistants using the Open Payments database. The number and dollar value of payments, as well as the average and median payment amount earned per provider, varied by state. However, a significantly higher proportion of APCs received payments in states with more restrictive scope-of-practice laws. Understanding how and why payments to APCs vary by state can elucidate how industry–APC relationships are related to changing scope-of-practice and state-specific transparency/disclosure laws, informing future legislation.
Health research in academic health systems: time for a new model
Authors: Collard Harold R , Hooper Sarah , Spetz Joanne 
Published: June 2023

Abstract
Research, along with patient care and education, is a core element of the academic health system's tripartite mission; it is essential to the academic health system's societal commitment to advancing the public's health. Research at academic health systems in the United States is increasingly resource-constrained and, in important ways, the underlying financial model supporting it has reached a point of unsustainability. This commentary reviews the roles that health research at academic health systems plays in society, describes the ways in which the current model of health research is under strain, and proposes an evolved model and series of organizational and operational steps to consider in moving health research forward.