bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pandemic telehealth flexibilities for buprenorphine treatment: a synthesis of evidence and policy implications for expanding opioid use disorder care in the United States
Authors: Krawczyk Noa , Rivera Bianca D , King Carla , Dooling Bridget C E 
Published: June 2023

Abstract
Buprenorphine is a highly effective treatment for opioid use disorder (OUD) and a critical tool for addressing the worsening US overdose crisis. However, multiple barriers to treatment—including stringent federal regulations—have historically made this medication hard to reach for many who need it. In 2020, under the COVID-19 public health emergency, federal regulators substantially changed access to buprenorphine by allowing prescribers to initiate patients on buprenorphine via telehealth without first evaluating them in person. As the public health emergency has been set to expire in May of 2023, Congress and federal agencies can leverage extensive evidence from studies conducted during the wake of the pandemic to make evidence-based decisions on the regulation of buprenorphine going forward. To aid policy makers, this narrative review synthesizes and interprets peer-reviewed research on the effect of buprenorphine flexibilities on the uptake and implementation of telehealth, and its impact on OUD patient and prescriber experiences, access to treatment, and health outcomes. Overall, our review finds that many prescribers and patients took advantage of telehealth, including the audio-only option, with a wide range of benefits and few downsides. As a result, federal regulators—including agencies and Congress—should continue nonrestricted use of telehealth for buprenorphine initiation.
The Cost of Emergency Care For Children Across Differing Levels of Emergency Department Pediatric Readiness
Authors: Newgard Craig D , Smith McKenna , Lin Amber , McConnell K John , Remick Katherine E , Burd Randall S , Marin Jennifer R , Mann N Clay , Gausche-Hill Marianne , Hewes Hilary A , Child Angela , Lang Benjamin , Foster Ashley A , Maughan Brandon , Goldhaber-Fiebert Jeremy D ,   Pediatric Readiness Study Group
Published: June 2023

Abstract

Background and Objective
High ED pediatric readiness is associated with improved survival in children, but the cost is unknown. We evaluated the costs of emergency care for children across quartiles of ED pediatric readiness.

Methods
This was a retrospective cohort study of children 0 to 17 years receiving emergency services in 747 EDs in 9 states from 1/1/2012 through 12/31/2017. We measured ED pediatric readiness using the weighted Pediatric Readiness Score (wPRS, range 0-100). The primary outcome was the total cost of acute care (ED and inpatient) in 2022 dollars, adjusted for ED case mix and hospital characteristics.

Results
15,138,599 children received emergency services, including 27.6% with injuries and 72.4% with medical illness. The average adjusted per-patient cost by quartile of ED pediatric readiness ranged from $991 (quartile 1) to $1,064 (quartile 4) for injured children and $1,104 to $1,217 for medical children. The resulting cost differences were $72 (95% CI -$6 to $151) and $113 (95% CI $20 to $206), respectively.

Conclusions
Receiving emergency care in high-readiness EDs was not associated with marked increases in the cost of delivering services.
Critical gaps in understanding firearm suicide in Hispanic communities: demographics, mental health, and access to care
Authors: Goldstein Evan V , Brenes Francisco , Wilson Fernando A 
Published: June 2023

Abstract
Suicide rates increased by 26.7% among Hispanics from 2015 to 2020, driven at least in part by highly lethal firearm suicide deaths. However, there are critical gaps in characterizing firearm suicide risks and prevention opportunities in Hispanic communities. We examined Hispanic adult firearm suicide decedents reported through the National Violent Death Reporting System from 2013–2019, focusing on demographic characteristics, firearm choices, suicidal thoughts/behaviors, mental health, and mental health treatment, compared with non-Hispanic adult firearm suicide decedents. Only 13.8% of Hispanic firearm suicide decedents were known to be undergoing treatment for a mental health or substance use problem prior to death, compared to 18.8% of non-Hispanic firearm suicide decedents. On average, Hispanic firearm suicide decedents were significantly less likely than non-Hispanic firearm suicide decedents known to have been treated for a mental health or substance use problem. These results may underscore the critical need for public health agencies and policymakers to promote initiatives integrating mental health screening into medical care, reducing mental health stigma among Hispanics, and expanding mental health treatment capacity in Hispanic communities.
Patient-centered inpatient psychiatry is associated with outcomes, ownership, and national quality measures
Authors: Shields Morgan C , Hollander Mara A G , Busch Alisa B , Kantawala Zohra , Rosenthal Meredith B 
Published: June 2023

AbstractFollowing discharge from inpatient psychiatry, patients experience elevated suicide risk, unplanned readmission, and lack of outpatient follow-up visits. These negative outcomes might relate to patient-centered care (PCC) experiences while hospitalized. We surveyed 739 former patients of inpatient psychiatric settings to understand the relationship between PCC and changes in patients’ trust, willingness to engage in care, and self-reported 30-day follow-up visits. We also linked PCC measures to facility-level quality measures in the Inpatient Psychiatric Facility Quality Reporting program. Relative to patients discharged from facilities in the top quartile of PCC, those discharged from facilities in the bottom quartile were more likely to experience reduced trust (predicted probability [PP] = 0.77 vs 0.46; P &lt; .001), reduced willingness to go to the hospital voluntarily (PP = 0.99 vs 0.01; P &lt; .001), and a lower likelihood of a 30-day follow-up (PP = 0.71 vs 0.92; P &lt; .001). PCC was lower among patients discharged from for-profits, was positively associated with facility-level quality measures of 7- and 30-day follow-up and medication continuation, and was inversely associated with restraint use. Findings underscore the need to introduce systematic measurement and improvement of PCC in this setting.
Recent modifications to the US methadone treatment system are a Band-Aid—not a solution—to the nation's broken opioid use disorder treatment system
Authors: Krawczyk Noa , Joudrey Paul J , Simon Rachel , Russel Danielle M , Frank David 
Published: June 2023

Abstract
For 5 decades, US federal regulations have segregated methadone treatment for opioid use disorder from the rest of the health care system, confining its availability to specialty treatment programs that are highly regulated. These regulations have led to severe shortages in the availability of methadone and grave underutilization of this lifesaving medication despite a worsening overdose crisis. In this commentary, we discuss current barriers to methadone in the US opioid treatment system and how recent changes to federal regulations fall short of the reforms needed to significantly expand access to this treatment. Instead, we propose the urgent need to expand methadone to mainstream health care settings by allowing for office-based prescribing and pharmacy dispensing of methadone, the norm in many other developed countries.
Trends in the level and composition of supplemental benefits in Medicare Advantage
Authors: McCormack Grace , Trish Erin 
Published: June 2023

Abstract
Medicare Advantage (MA) plans that bid below benchmarks (or bidding targets) receive a portion of that difference as rebates, which they then must return to beneficiaries through supplemental benefits or reduced premiums or cost-sharing. Using Centers for Medicare & Medicaid Services data, we evaluate the growth in rebates and concomitant changes in supplemental benefit composition among health maintenance organizations (HMOs) and local preferred provider organizations (PPOs) from 2011 through 2022. Average rebates grew considerably, particularly after 2015 and among PPOs. Alongside this rebate growth, the share of enrollees in plans offering dental, vision, and hearing benefits also increased, with nearly universal coverage of these benefits among both HMOs and PPOs by 2022. Medicare Advantage plans also increasingly reduced beneficiary Part D premium obligations, while increasing beneficiary financial exposure in the form of higher Part D deductibles, medical out-of-pocket maximums, and cost-sharing for inpatient stays. These findings are particularly relevant as policymakers debate the merits of various reforms to MA payment policy.
Understanding categories of postpartum care use among privately insured patients in the United States: a cluster-analytic approach
Authors: Interrante Julia D , Carroll Caitlin , Kozhimannil Katy B 
Published: June 2023

Abstract
The postpartum period is critical for the health and well-being of birthing people, yet little is known about the range of health care services and supports needed during this time. Maternity care patients are often targeted for clinical interventions based on “low risk” or “high risk” designations, but dichotomized measures can be imprecise and may not reflect meaningful groups for understanding needed postpartum care. Using claims data from privately insured patients with childbirths between 2016 and 2018, this study identifies categories and predictors of postpartum care utilization, including the use of maternal care and other, nonmaternal, care (eg, respiratory, digestive). We then compare identified utilization-based categories with typical high- and low-risk designations. Among 269 992 patients, 5 categories were identified: (1) low use (55% of births); (2) moderate maternal care use, low other care use (25%); (3) moderate maternal, high other (8%); (4) high maternal, moderate other (7%); and (5) high maternal, high other (5%). Utilization-based categories were better at differentiating postpartum care use and were more consistent across patient profiles, compared with high- and low-risk dichotomies. Identifying categories of postpartum care need beyond a simple risk dichotomy is warranted and can assist in maternal health services research, policymaking, and clinical practice.
Nursing homes underreport antipsychotic use but overreport diagnoses qualifying for appropriate use
Authors: Chen Amanda C , Grabowski David C 
Published: June 2023

Abstract
Antipsychotic drug use in US nursing homes remains a priority concern, but less is understood about the characteristics associated with reporting. Using linked Medicare claims and Minimum Data Set (MDS) assessments for long-stay nursing home residents from January 2018 to December 2019, we assessed the consistency of antipsychotic drug reporting and diagnosis of conditions (schizophrenia, Tourette's syndrome, and Huntington's disease) that qualify as appropriate drug use across data sources by calculating reporting rates in facility-reported MDS and Medicare claims. The antipsychotic reporting outcome is conditional on claims reporting while the condition reporting outcomes are conditional on MDS reporting. We found underreporting (87% reporting rate) in facility-reported antipsychotic use versus Medicare claims. In contrast, we found overreporting of the qualifying conditions with several facility-reported diagnoses unsupported by a corresponding claims diagnosis. Only 54.8% of schizophrenia, 46.5% of Tourette's syndrome, and 72.4% of Huntington's disease diagnoses reported in the MDS had a claims diagnosis. There was also variation in reporting odds for antipsychotic drug use by dual-eligibility status and race, with higher odds for dual-eligible and lower odds for Black residents. These findings suggest that CMS should continue investigating the source of reporting discrepancies in antipsychotic drug use and qualifying diagnoses.
An ethylene-induced NAC transcription factor acts as a multiple abiotic stress responsor in conifer
Authors: Han Fangxu , Wang Peiyi , Chen Xi , Zhao Huanhuan , Zhu Qianya , Song Yitong , Nie Yumeng , Li Yue , Guo Meina , Niu Shihui 
Published: June 2023

Abstract
The proper response to various abiotic stresses is essential for plants' survival to overcome their sessile nature, especially for perennial trees with very long-life cycles. However, in conifers, the molecular mechanisms that coordinate multiple abiotic stress responses remain elusive. Here, the transcriptome response to various abiotic stresses like salt, cold, drought, heat shock and osmotic were systematically detected in Pinus tabuliformis (P. tabuliformis) seedlings. We found that four transcription factors were commonly induced by all tested stress treatments, while PtNAC3 and PtZFP30 were highly up-regulated and co-expressed. Unexpectedly, the exogenous hormone treatment assays and the content of the endogenous hormone indicates that the upregulation of PtNAC3 and PtZFP30 are mediated by ethylene. Time-course assay showed that the treatment by ethylene immediate precursor, 1-aminocyclopropane-1-carboxylic acid (ACC), activated the expression of PtNAC3 and PtZFP30 within 8 hours. We further confirm that the PtNAC3 can directly bind to the PtZFP30 promoter region and form a cascade. Overexpression of PtNAC3 enhanced unified abiotic stress tolerance without growth penalty in transgenic Arabidopsis and promoted reproductive success under abiotic stress by shortening the lifespan, suggesting it has great potential as a biological tool applied to plant breeding for abiotic stress tolerance. This study provides novel insights into the hub nodes of the abiotic stresses response network as well as the environmental adaptation mechanism in conifers, and provides a potential biofortification tool to enhance plant unified abiotic stress tolerance.
Nodal discrete duality numerical scheme for nonlinear diffusion problems on general meshes
Authors: Andreianov Boris , Houssaine Quenjel El 
Published: June 2023

Abstract
Discrete duality finite volume (DDFV) schemes are known for their ability to approximate nonlinear and linear anisotropic diffusion operators on general meshes, but they possess several drawbacks. The most important drawback of DDFV is the simultaneous use of the cell and the node unknowns. We propose a discretization approach that incorporates DDFV ideas and the associated analysis techniques, but allows for a rapid elimination of the cell unknowns. Further, unlike the DDFV scheme, the new ‘Nodal Discrete Duality’ (NDD) scheme does not require specific adaptation in presence of discontinuities of the diffusion tensor along cell boundaries. We describe in detail the 2D NDD framework and its two 3D variants, focusing on the consistency properties of the discrete gradient and discrete divergence operators and on the key structural property of discrete duality. For the 2D scheme, convergence analysis is carried out and a series of numerical tests are provided for a large family of nonlinear anisotropic elliptic problems with zero Dirichlet boundary condition.
Biohybrid Adsorbent for the Preconcentration of Lead and Its Determination in Fruit Juices by Electrothermal Atomic Absorption Spectrometry
Authors: Quintas Pamela Y , Agostini Elizabeth , Wevar Oller Ana L , Escudero Leticia B 
Published: June 2023

Abstract

Background
Fruit juices are one of the most non-alcoholic beverages consumed in the world. Essential elements and other nutrients present in fruit juices play an important role in human well-being. However, fruit juices may also contain potentially toxic elements at trace levels, causing health risks.

Objective
The objective of this work was to develop an analytical methodology based on the preconcentration of lead using a new biodegradable hybrid material (BHM) composed of Rhodococcus erythropolis AW3 bacteria and Brassica napus hairy roots.

Methods
The BHM was implemented in an online solid-phase extraction (SPE) system for the determination of lead in fruit juices by electrothermal atomic absorption spectrometry (ETAAS).

Results
Effects of critical parameters on lead retention were studied. Under optimal experimental conditions, extraction efficiency higher than 99.9% and an enrichment factor of 62.5 were achieved. The dynamic capacity of the BHM was 36 mg/g, which favored the reuse of the column for at least eight biosorption−desorption cycles. The LOD and LOQ for preconcentration of 5 mL of sample were 5.0 and 16.5 ng/L lead, respectively. The RSD was 4.8% (at 1 µg/L lead and n = 10).

Conclusion
The developed method was suitable for application to lead determination in different types of fruit juice.

Highlights
A novel microextraction procedure based on the use of a biohybrid adsorbent. Highly sensitive determination of Pb at trace levels. Analysis of Pb in fruit juices samples. An eco-friendly microextraction technique for Pb determination.
Combining network pharmacology and in vitro and in vivo experiments to study the mechanism of Keluoxin in the treatment of radiation nephropathy
Authors: Deng Lin , Wang Shaoqing , Leng Xingli , Yao Peng , Li Cuicui , Zheng Yang 
Published: June 2023

Abstract
Radiation nephropathy refers to kidney damage caused by radiation therapy for malignant tumours. Currently, the pathogenesis is unclear and there is a lack of effective treatment methods. With the development of traditional Chinese medicine, the role of traditional Chinese medicine in the protection of radiation nephropathy is receiving increasing attention. Therefore, in this study, we used X-ray intraperitoneal irradiation to construct a mouse model of radiation nephropathy and studied the protective effect of traditional Chinese medicine Keluoxin on radiation nephropathy. We first analysed the potential targets and pathways of Keluoxin in the treatment of radiation nephropathy using network pharmacology methods, combined with in vitro and in vivo experimental verification, to study its potential mechanism. By searching the database, 136 components of Keluoxin were identified. A total of 333 intersectional targets related to radiation nephropathy were obtained. Among them, key targets include IL-6, TNF-α, HIF-1α, STAT1, STAT3, JAK1, JAK2, etc. In in vivo and in vitro experiments, we found that as the irradiation dose increased and time prolonged, kidney damage in mice gradually worsened in a time-dependent and dose-dependent manner. As the irradiation dose increases, the expression of pro-inflammatory factors Il-6, TNF-α, TGF-β increased. Compared with the irradiation group, the intervention of Keluoxin can reduce kidney damage caused by X-ray irradiation and reduce the expression of IL-6, TNF-α, TGF-β, STAT1, STAT3, JAK1, JAK2, etc. These results indicated that Keluoxin can alleviate kidney damage caused by X-ray irradiation, possibly by regulating the JAK/STAT signalling pathway, reducing inflammation levels and oxidative stress damage.
Robotic transposition and ureteroureterostomy of type 1 retrocaval ureter
Authors: Maestroni Umberto , Dinale Francesco , Ziglioli Francesco , Bocchialini Tommaso , Guarino Giulio G , Campobasso Davide 
Published: June 2023

Abstract
Retrocaval ureter (RCU) is a rare malformation of the inferior vena cava. We report a case of a 60-years-old female presented with right flank pain and computed tomography scan diagnosis of (RCU). She underwent robotic transposition and ureteroureterostomy of RCU. No complications were recorded. After 1 year of follow-up the patient remains asymptomatic and without signs of obstruction. Robotic repair of RCU with preservation of the retrocaval segment is a safe procedure with the advantages of the vision and dexterity in dissection and suturing.
Hematogenous prosthetic knee joint infection with Klebsiella pneumoniae caused by asymptomatic gallbladder abscess: a case report and literature review
Authors: Omichi Yasuyuki , Hamada Daisuke , Okada Ryo , Wada Keizo , Tamaki Yasuaki , Yamada Shinichiro , Goto Tomohiro , Sairyo Koichi 
Published: June 2023

Abstract
Klebsiella pneumoniae has the ability to form biofilm; therefore, the treatment of prosthetic joint infection involving K. pneumoniae is often challenging. This report describes the first case of acute hematogenous prosthetic knee joint infection with K. pneumoniae that occurred as a result of an asymptomatic gallbladder abscess. The patient was a 78-year-old man who underwent bilateral total knee arthroplasty 6 years ago. He had pain and swelling in his right knee. The synovial fluid culture of the right knee revealed K. pneumoniae and prosthetic joint infection was diagnosed. Computed tomography revealed a gallbladder abscess in the absence of right upper abdominal pain. The patient underwent simultaneous debridement of the knee and open cholecystectomy. The treatment was successful and the prosthesis was retained. In cases of hematogenous prosthetic joint infection with K. pneumoniae, other sources of infection should be suspected and investigated regardless of whether they are symptomatic.
Individual realities and legal responsibilities: a study of non-resident parents who dispute child maintenance obligations in Swedish administrative courts, 2014–2019
Authors: Finnström Johanna 
Published: June 2023

Abstract
This study is the first large-scale empirical account of child maintenance non-compliance in Sweden. The scheme explored is the guaranteed support system, i.e. when liable parents do not comply with their formal maintenance obligations as determined by the Swedish Social Insurance Agency (SSIA). The objective is to map out and describe the overall reasons why parents do not pay, as well as to explain why parents’ perceptions of their maintenance obligations diverge from those of the SSIA officials. To this end, the study utilises both quantitative descriptive analysis and qualitative thematic text analysis. The data were built on a unique body of material comprising over 700 court cases where liable parents disputed their maintenance obligations in Sweden’s 12 administrative courts, during 2014–2019. The quantitative results show that claiming economic inability and regular involvement in the care of children are the two most common arguments for non-payment. The qualitative analysis further suggests that the administrative tools and legal assessments designed to calculate payments to aid parents are in reality creating barriers, uncertainty, and distrust in the process. Consequently, the rules designed to protect children in lone-parent households are a factor contributing to non-payment by the other parent. The article concludes with reflections and public policy implications.