bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital Reimbursement in the Presence of Cherry Picking and Upcoding
Authors: Savva Nicos , Debo Laurens , Shumsky Robert A. 
Published: May 2023

Hospitals throughout the developed world are reimbursed based on diagnosis-related groups (DRGs). Under this scheme, patients are divided into clinically meaningful groups, and hospitals receive a fixed fee per patient episode tied to the patient DRG. The fee is based on the average cost of providing care to patients who belong to the same DRG across all hospitals. This scheme, sometimes referred to as “yardstick competition,” provides incentives for cost reduction, as no hospital wants to operate at a higher cost than average, and can be implemented using accounting data alone. Nevertheless, if costs within a DRG are heterogeneous, this scheme may give rise to cherry-picking incentives, where providers “drop” patients who are more expensive to treat than average. To address this problem, regulators have tried to reduce within-DRG cost heterogeneity by expanding the number of DRG classes. In this paper, we show that even if cost heterogeneity is eliminated, such expansion will fail to completely eliminate patient cherry picking. In equilibrium, the market will bifurcate into two groups, one of which will continue to cherry-pick patients and underinvest in cost reduction, whereas the other group treats all patients. Furthermore, we show that DRG expansion is particularly problematic if hospitals are also able to “upcode” patients, that is, intentionally assign patients to a more resource-intensive DRG than needed to increase income. Upcoding increases within-DRG cost heterogeneity and amplifies cherry-picking incentives. We examine potential solutions involving yardstick competition based on input statistics. This paper was accepted by Carri Chan, healthcare management. Supplemental Material: The online appendices are available at https://doi.org/10.1287/mnsc.2023.4752 .
Influence via Ethos: On the Persuasive Power of Reputation in Deliberation Online
Authors: Manzoor Emaad , Chen George H. , Lee Dokyun , Smith Michael D. 
Published: May 2023

Deliberation among individuals online plays a key role in shaping the opinions that drive votes, purchases, donations, and other critical offline behavior. Yet, the determinants of opinion change via persuasion in deliberation online remain largely unexplored. Our research examines the persuasive power of ethos—an individual’s “reputation”—using a seven-year panel of over a million debates from an argumentation platform containing explicit indicators of successful persuasion. We identify the causal effect of reputation on persuasion by constructing an instrument for reputation from a measure of past debate competition and by controlling for unstructured argument text using neural models of language in the double machine-learning framework. We find that an individual’s reputation significantly impacts their persuasion rate above and beyond the validity, strength, and presentation of their arguments. In our setting, we find that having 10 additional reputation points causes a 31% increase in the probability of successful persuasion over the platform average. We also find that the impact of reputation is moderated by characteristics of the argument content, in a manner consistent with heuristic information processing under cognitive overload. We discuss managerial implications for platforms that facilitate deliberative decision making for public and private organizations online.This paper was accepted by Anandhi Bharadwaj, information systems.Funding: This research was supported in part by the University of Wisconsin Madison Office of the Vice Chancellor for Research and Graduate Education with funding from the Wisconsin Alumni Research Foundation, and by the Carnegie Mellon University Graduate Student Assembly and Provost’s Office. Computing support was provided in part by the Social Science Computing Cooperative at the University of Wisconsin Madison.Supplemental Material: Data and the online appendix is available at https://doi.org/10.1287/mnsc.2023.4762 .
Stigma by Association: The Unintended Interpersonal Consequences of Associating Oneself with an Abusive Supervisor
Authors: Yan Liuxin , Yam Kai Chi 
Published: May 2023

Extant abusive supervision research has predominantly studied its prevalence and destructive effects through the lens of victims, potential victims, or third-party observers who witness such mistreatments. In the present research, we examine a neglected group of individuals—employees who are able to develop high-quality relationships and are closely associated with their abusive supervisors. Drawing insights from the stigma-by-association literature, we conceptualize abusive supervision as a unique form of moral stigma that might result in unintended spillover effects. Specifically, we found that observers tend to perceive employees who are closely associated with an abusive supervisor to be less moral and trustworthy for seemingly sharing a similar set of unethical values and beliefs, even though this might not necessarily be true in reality. As a downstream consequence, these employees are subject to unintended interpersonal backlashes (i.e., withdrawal from helping behaviors) imposed by their fellow coworkers. Furthermore, we investigate the moderating role of voluntary motive attribution, revealing that those who were attributed to voluntarily associate themselves with abusive supervisors received the highest levels of interpersonal backlashes. Results from one pilot study, one multiwave survey study (Study 2), and three preregistered experiments (Studies 1, 3, 4) supported our full theoretical model. Our research adds new insights to the abusive supervision literature by introducing a new unintended consequence on a previously overlooked group of employees who are presumed to be shielded from the negative impact of abusive supervision. Funding: This work was supported by the Singapore Ministry of Education [Grant R-317-000-164-115]. Supplemental Material: The e-companion is available at https://doi.org/10.1287/orsc.2023.1678 .
How paramedics apply the spinal immobilisation algorithm in trauma patients
Authors: Tinker Claire , Boswell Graham , Foster John 
Published: May 2023

Background: Validated criteria are included in the algorithm used in the UK prehospital setting to safely reduce the number of traumatically injured patients requiring full spinal immobilisation. The criteria improve the sensitivity in selecting patients with spinal injuries but evidence how UK ambulance clinicians apply them is sparse. Aims: This study aimed to identify the knowledge levels and the use of the spinal immobilisation algorithm by ambulance clinicians. Methods: A quantitative survey used a convenience sample of all frontline clinicians in London Ambulance Service NHS Trust. Findings: The algorithm is not routinely used when assessing traumatically injured patients at risk of spinal injury; recognition of the algorithm inclusion criteria is poor, especially regarding patients under the influence of drugs or alcohol. There is a belief that too many patients are immobilised unnecessarily. Conclusion: Research is required on how ambulance clinicians use checklists and paramedic education on spinal immobilisation rules requires review.
Outcomes of remote versus face-to-face ear, nose and throat outpatient consultation on patient pathways
Authors: Gupta T , Bhutta MF 
Published: May 2023

Introduction Remote consultation has potential benefits in increasing patient pathway efficiency and has been found to reduce costs and carbon emissions. Previous studies of remote consultation in ear, nose and throat (ENT) practice have reported mixed results and used relatively small sample sizes. The aim of this article is to study the impact of remote telephone consultation on ENT clinic outcomes and pathway efficiency, compared with in-person review, within new and follow-up patient cohorts and subspeciality, where previous studies demonstrate mixed and inconclusive results. Methods This was a comparison of remote clinic appointment outcomes over a 2-month period from a single ENT referral centre (426) with an equivalent data set of face-to-face clinic appointments over a similar time frame (1,533). Statistical analysis included chi-squared test for clinic outcomes and two-sample t-squared test for mean hand-off between both cohorts (p < 0.05). Results For new referrals, remote consultation was associated with statistically significantly greater rates of follow-up (p < 0.00001), investigation (p = 0.00251) and hand-off (p < 0.00013) than patients seen face-to-face – particularly where presenting with head and neck symptoms. For follow-up patients, remote consultation had similar rates of investigation (p = 0.11071) or further follow-up (p = 0.08) and mean hand-off (p < 0.11764) to those seen face-to-face. Conclusions Remote consultation in ENT could become the norm for follow-up patients, but should be used with caution in the initial consultation of new patients.
Gastric outlet obstruction secondary to a wandering spleen: systematic review and surgical management of a case
Authors: Moore E , O’Brien JW , Merali N , Farkas N , Madhavan A , Abbassi-Ghadi N , Preston S , Singh P 
Published: May 2023

Introduction A wandering spleen occurs when laxity or absence of the suspensory ligaments allows migration throughout the abdomen. Gastric outlet obstruction resulting from this abnormality is rare. We present a systematic literature search and a case that was managed successfully with surgical intervention at our centre. Methods A systematic search of the PubMed, Embase™, Medline® and Google Scholar™ databases was carried out employing the combined search terms “gastric outlet obstruction” AND “wandering spleen”. Six results were included for final analysis. Results All six search results described a single case each. Patients underwent surgical management (open or laparoscopic) after initial investigation utilising a range of modalities. There were no mortalities reported at 90 days. The single case we present was complicated by gastric perforation; the patient made a successful recovery following open splenopexy and stapled wedge resection of the stomach. Conclusions A wandering spleen is a rare diagnosis and there are only six reported cases of gastric outlet obstruction secondary to a wandering spleen in the literature. None report associated gastric perforation. There are a variety of presenting symptoms, intraoperative findings and operative techniques used to address the gastrosplenic abnormality. The case reported by our centre adds to this limited evidence base and demonstrates a successful outcome from definitive surgical management. We highlight the need to seek early gastro-oesophageal expertise if any gastric pathology is found together with anatomical abnormality of the spleen.
Indeterminate thyroid nodules (Thy3): malignancy rate and characteristics in a study of 118 patients
Authors: Dimitriadis PA , Moinie A , Michaels J , Bance R , Vijendren A , Mochloulis G 
Published: May 2023

Introduction Thyroid nodules are common, and the combined use of ultrasound and fine needle aspiration cytology provides useful information on their malignancy risk. The Thy reporting system is widely used in the United Kingdom, with malignancy rates for Thy3 cytology being quoted between 5% and 30%. This study aims to establish the risk of thyroid cancer in operated patients with Thy3 cytology and correlate it with patient demographics and nodule size. Methods This is a retrospective observational study of all thyroidectomies that took place in a single institution over a 3-year period (2019–2022). Those with a preoperative cytology of Thy3 were analysed further and in particular, nodule size, final histology and patients’ demographics were documented. Results Some 260 thyroidectomies were performed during the study period. Of these, 118 patients had Thy3 cytology. In the Thy3a group (n = 70), the malignancy rate was 27.1%. The average age of those with thyroid cancer was 51.4 vs 51.2 years for those with benign disease. The nodule size was under 40mm for both groups (36mm vs 39.7mm). In the Thy3f group (n = 48), the malignancy rate was 43.8%. The average age of those with thyroid cancer was 53.5 vs 56.2 years for those with benign disease. The nodule size was similar (24.5mm vs 27.6mm). Conclusions In this study, one in three patients with Thy3 cytology was diagnosed with thyroid cancer. We urge local units to analyse their data, to aid patients’ informed decision-making. Within the subgroups, there was no significant difference in average nodule size or patients’ age.
Hospital dentists seeking to attend the ATLS® course: like pulling teeth?
Authors: MacKenzie-Gureje Anthony 
Published: May 2023

The Advanced Trauma Life Support® (ATLS®) course was first run in the US in 1978 and in the decades since, it has been disseminated and taught all over the world. In the UK, it has become an integral component of surgical training for many specialties including oral and maxillofacial surgery (OMFS), and it is considered an extremely useful adjunct to clinical practice. OMFS requires independent practitioners to be qualified in both medicine and dentistry. The training pathway has multiple entry routes, with some trainees first qualifying in medicine before doing dentistry and vice versa. While the ATLS® steering group has expanded the eligibility criteria to include many types of advanced practitioners, there remain some caveats to the inclusion of hospital dentists. The default position is that they are instead subject to individual review by the chair of the ATLS® steering group if they wish to apply for the ATLS® course. This inevitably brings their competence into question even though they often routinely work with dental or OMFS trauma. This paper highlights a possible perception among some hospital dentists of ineligibility to participate and perceived inequity in accessing the course. Furthermore, there is a mild but nevertheless apparent discrepancy between wording from the ATLS® steering group and guidance from the British Association of Oral and Maxillofacial Surgeons, and the General Dental Council. In order to remedy these issues, it is proposed that there should be joint or concordant, explicit, published guidance from these institutions regarding the participation of non-medically trained OMFS trainees and other hospital dentists on the ATLS® course.
Consent for the paediatric patient
Authors: Jones Andrew , Hyde James , Lee Sharon , Albadri Sondos , Gartshore Laura 
Published: May 2023

Introduction Obtaining valid consent is a fundamental process in dentistry. Written consent must be obtained where treatment involves conscious sedation or general anaesthesia. For children, consent may be provided by a person with parental responsibility (PR). Methods A retrospective evaluation was completed of 160 children over 2 UK hospital sites with paediatric services. Cases involving conscious sedation or general anaesthesia for dental treatment were selected. Data were obtained to establish whether it was documented that the correct person had provided consent for a child and whether all possible individuals with PR for the child were identified at the initial visit. UK national legislation and guidance was reviewed, from which a PR form (to determine PR status for a child) was created and implemented. A second evaluation was subsequently completed, again with 160 children. Results Combined data from both sites confirmed documentation of an appropriate person providing consent in 127 cases (79%) in the first evaluation. This improved to 155 cases (97%) following implementation of the PR form. All possible individuals who had PR for the child were identified at the initial visit in 35 cases (22%). This improved to 139 cases (87%) following the introduction of the PR form. Conclusions Use of a PR form improved documentation regarding valid consent for children.
Methyl Ferulate Induced Conformational Changes of DeOxyHbS: Implication on Sickle Erythrocyte Polymerization
Authors: Ijoma Ikechukwu Kingsley , Ajiwe Vincent Egbulefu 
Published: May 2023

<p class="10-OS-Abstract">Sickle cell disease (SCD) is a molecular disease caused by substituting glutamic acid with valine at the β-6 position of the hemoglobin, leading to the polymerization of erythrocytes that contain the hemoglobin afterward leads to severe clinical consequences. Polymerization of sickle hemoglobin occurs only in the deoxygenated form i.e only sickle deoxyhemoglobin (DeOxyHbS) polymerizes. SCD is predominant in children living in Africa, especially in West Africa. Therefore, molecular docking and molecular dynamic simulation studies were carried out on methyl ferulate isolated from <em>Ficus thonningii</em> leaves, a known antisickling plant used in Eastern Nigeria to manage SCD. The Harborne procedure was used for extraction, whereas the combination of column chromatography and flash chromatography was used for the isolation and purification of active principles of the leaves extract. The structure of methyl ferulate was determined based on nuclear magnetic resonance (NMR) analysis. A binding affinity of -5.8 kcal/mol indicated that methyl ferulate binds to DeOxyHbS and could interfere with the processes that trigger sickle hemoglobin polymerization <em>in vitro</em>. The observed variations in perturbation of both DeOxyHbS and FTH3-DeOxyHbS complex root mean square deviation (RMSD), the radius of gyration (R<sub>gyr</sub>), solvent accessible surface area (SASA), potential energy (PE), and Van der Waal’s (VDW) interactions were obtained from the molecular dynamic simulation studies of the binding site amino acid residue performed at 500 ps and suggest that in silico methyl ferulate binds with amino acid residues reported being involved in sickle hemoglobin polymerization and thus may possess antisickling potentials in vitro.</p>
Fast and practical method for underwater stereo vision calibration based on ray-tracing
Authors: Liu Wenqi , Zhang Zhen , Gu Yonggang , Zhai Chao 
Published: May 2023

The perspective camera model has difficulty handling refracted light in the underwater environment. To achieve accurate and convenient calibration in large underwater scenes, we propose a method based on the underwater refractive camera model in this paper. First, the initial values of the refraction parameters are solved using refraction coplanarity constraints. Then the initial values are optimized nonlinearly using co-point constraints, which simplifies the optimization process of existing methods. In the field of view of 200mm×200mm, the experiment results show that the reconstruction accuracy of the proposed method can reach below 0.02 mm, and it is equally effective in the case of sparse calibration.
Impact of atorvastatin reload on the prevention of contrast-induced nephropathy in patients on chronic statin therapy: A prospective randomized trial
Authors: Hammami Rania , Masmoudi Omar , Jdidi Jihen , Turki Mouna , Charfi Rim , Ben Mrad Imtinene , Bahloul Amine , Ellouze Tarek , Gargouri Rania , Kammoun Samir , Charfeddine Selma , Ayedi Fatma , Abid Leila 
Published: May 2023

Background
This trial aimed to assess the efficacy of Atorvastatin reloading on the prevention of Contrast-induced nephropathy (CIN) in patients pre-treated with this statin and undergoing coronary catheterization.

Methods
This was a prospective randomized controlled study including patients on chronic atorvastatin therapy. We randomly assigned the population to the Atorvastatin Reloading group (AR group), by reloading patients with 80 mg of atorvastatin one day before and three days after the coronary procedure, and the Non-Reloading group (NR group), including patients who received their usual dose without a reloading dose. The primary endpoints were the incidence of cystatin (Cys)-based CIN and Creatinine (Scr)-based CIN. The secondary endpoints consisted of the changes in renal biomarkers (Δ biomarkers) defined as the difference between the follow-up level and the baseline level.

Results
Our population was assigned to the AR group (n = 56 patients) and NR group (n = 54 patients). The baseline characteristics of the 2 groups were similar. Serum creatinine (SCr)-based CIN occurred in 11.1% in the NR group, and in 8.9% in the AR group without any significant difference. Cys-based CIN occurred in 37% in the NR group and 26.8% in the AR group without any significant difference. The subgroup analysis showed that high dose reloading had significantly reduced the CYC-based CIN risk in patients with type 2 diabetes (43.5% vs 18.8%, RR = 0.43. CI 95% [0.18–0.99])). The comparison of “Δ Cystatin” and Δ eGFR between the AR and NR groups didn’t show any significant difference. However, cystatin C had significantly increased between baseline and at 24 hours in the NR group (0.96 vs 1.05, p = 0.001), but not in the AR group (0.94 vs 1.03, p = 0.206).

Conclusions
Our study did not find a benefit of systematic atorvastatin reloading in patients on chronic atorvastatin therapy in preventing CIN. However, it suggested that this strategy could reduce the risk of CyC-based CIN in diabetic type 2 patients.
Validation of an omega-3 substrate challenge absorption test as an indicator of global fat lipolysis
Authors: Freedman Steven D. , Zaworski Kamil , Pierzynowska Kateryna , Pierzynowski Stefan , Gallotto Robert , Sathe Meghana , Borowitz Drucy S. 
Published: May 2023

Introduction
The coefficient of fat absorption (CFA) quantifies fat that remains in stool after digestion and is not a direct measure of lipolysis. CFA has been used to assess treatment of pancreatic insufficiency but does not correlate with pancreatic enzyme replacement therapy dose. We explored use of an omega-3 substrate absorption challenge test as a sensitive test of lipolysis and absorption.

Methods
We studied a novel microbially-derived lipase (SNSP003) employing an established surgical model commonly used to study the uptake of macronutrients, the exocrine pancreatic insufficient pig. Pigs were fed a high-fat diet and given a standardized omega-3 substrate challenge to test the effect of lipolysis on its absorption. Blood was drawn at 0, 1, 2, 4, 6, 8, 12, and 24 hours following the substrate challenge and was analyzed for omega-3 and total fat levels (c14:c24). SNSP003 was also compard to porcine pancrelipase.

Results
The absorption of omega-3 fats was significantly increased following administration of 40, 80 and 120 mg SNSP003 lipase by 51% (p = 0.02), 89%, (p = 0.001) and 64% (p = 0.01), respectively, compared to that observed when no lipase was administered to the pigs, with Tmax at 4 hours. The two highest SNSP003 doses were compared to porcine pancrelipase and no significant differences were observed. Both doses increased plasma total fatty acids (141% for the 80 mg dose (p = 0.001) and 133% for the 120 mg dose (p = 0.006), compared to no lipase) and no significant differences were observed between the SNSP003 lipase doses and porcine pancrelipase.

Conclusion
The omega-3 substrate absorption challenge test differentiates among different doses of a novel microbially-derived lipase and correlates with global fat lipolysis and absorption in exocrine pancreatic insufficient pigs. No significant differences were observed between the two highest novel lipase doses and porcine pancrelipase. Studies in humans should be designed to support the evidence presented here that suggests the omega-3 substrate absorption challenge test has advantages over the coefficient of fat absorption test to study lipase activity.