bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lean healthcare applied systematically in a medium-sized medical clinic hospitalization
Authors: Martins Drei Samuel , Sérgio de Arruda Ignácio Paulo 
Published: April 2022

PurposeThe objective of this paper is to propose a systematic application of Lean Healthcare in the hospitalization activity in the medical clinic entry process.Design/methodology/approachThe methodology used is established in three stages: the first aims to map the process in which the focus activity is inserted, using lean tools, as well as integrating the employees involved in the application. The second is the proposal to apply the systematic, together with the employees, using the A3 tool step by step. Finally, the third stage confirms the applied systematic, collecting the results and analyzing the initial situation with those reached.FindingsAs a result, improvements were made in the medical clinic entry process, such as reduced waiting time for patients, at approximately 53.8%, with a decrease in the standard deviation of the times – of approximately 79.14%, and displacement of those involved, of 72%, in addition to eliminating unnecessary activities for the process. Furthermore, the empirical results on the efficiency of this systemic application in medical clinic enable the replication of this proposal, generating a systematic.Research limitations/implicationsDespite establishing a systematic proposal with real results, it is focused on only one application, due to time limitations, may generate a subjective evaluation of the systematic. Thus, for future research, it is recommended to expand this systemic application in other activities of different processes.Practical implicationsThe practical implications of this paper are precisely related to the data obtained with the application made, developing a Lean Healthcare systematic not previously seen, which is strategic, systemic and has a roadmap to assist in its application and, in addition, brings with it practical results that prove their efficiency.Social implicationsThe social implications of this paper are presented in its empirical results, considering that the study hospital serves, in addition to its host city, 28 other smaller municipalities around it, improving the flow of processes, ensuring better management of the clinic doctor. In addition, the results can assist the processes flow of other medical clinics in hospitals around the world, especially at critical moments, such as pandemics or epidemics.Originality/valueDue to the positive results obtained in the systematic application, this paper fills a gap identified in the literature, proposing a systematic application of Lean Healthcare that is systemic and strategic, in addition to including a roadmap and analysis of data applied in a medium-sized Brazilian hospital, presenting positive practical results exposed in the paper.
Relational capital in referrer networks of medical specialists in office settings
Authors: Pflugfelder Nina Sophie , Ng Frank 
Published: April 2022

PurposeThe purpose of this article is to explore the association of the Relational Capital (RC) embedded in a medical specialist’s social–professional network with the specialist’s economic performance based on social network analysis (SNA).Design/methodology/approachUsing health insurance claims data regarding ∼108,000 physicians treating ∼72,000,000 patients, social–professional networks (patient-sharing-networks (PSNs)) of ∼26,000 medical specialists were simulated. To explore the correlation of the network's characteristics (degree centrality, density, relative betweenness centrality and referrer concentration) with economic performance, ordinary-least-squares (OLS)-regression models were estimated for ten common specialties (gynecology, internal medicine, orthopedics, ophthalmology, otolaryngology, dermatology, urology, neurology, radiology and rehabilitative medicine).FindingsThe study confirms the applicability and strong explanatory power of SNA metrics for RC measurement in ambulatory healthcare. Degree centrality and relative betweenness centrality correlate positively with economic performance, whereas density and referrer concentration exhibit negative coefficients. These results confirm the argument that RC has a strong association with the economic performance of medical specialists.Originality/valueThe study pioneers SNA for RC measurement in healthcare. It is among the first publications on specialists' PSNs. Questions for future research are proposed.
Masculine Old Women or Feminine Old Men? Rethinking Gender and the Ageing Body in Early Modern English Medicine
Authors: Bolissian Amie 
Published: April 2022

AbstractThis article challenges the almost universal historiographical claim that women's bodies were thought to become increasingly masculine as they aged in early modern English medicine, especially after menopause. It is not surprising that this ‘masculinisation hypothesis’ has endured with very little critical appraisal, as there have been few in‐depth studies into medical conceptions of ageing womanhood. Drawing on c.140 English vernacular medical and popular health texts published between 1570 and 1730, this article interrogates and refutes key claims for the corporeal ‘manliness’ of old women. Instead, it argues that while medicine undoubtedly depicted old women and men as growing closer in bodily constitution as they aged, this generic ageing constitution had more ‘feminine’ corporeal attributes than ‘masculine’. Exploring references to ‘effeminated’ old men within medical books, it then questions the impact of these medical gender associations within wider cultural contexts.
Induction immunotherapy followed by surgery for hilar unicentric Castleman disease
Authors: Shoji Fumihiro , Takase Ken , Kozuma Yuka , Yamazaki Koji , Kawauchi Shigeto , Takeo Sadanori 
Published: April 2022

AbstractCastleman disease is a rare disease borne of a B cell lymphoproliferative disorder of uncertain cause. Standard therapy for the unicentric type of Castleman disease localized as a single mass or single lymph‐node station is surgical extirpation. Nevertheless, in the thoracic cavity, unresectable cases or cases of incomplete extirpation of the tumor without lung scarring owing to tumor size/location have been noted. In such cases, lung resection (e.g., lobectomy, pneumonectomy) or additional therapy (immunotherapy, chemotherapy, radiotherapy) after resection is required. However, few instances of patients receiving induction immunotherapy or chemotherapy followed by surgery have been reported. Here, we describe a 21‐year‐old woman with unicentric Castleman disease originating from the left hilum. The tumor seemed to involve/be in contact with the pulmonary vein and bronchus. Tumor location indicated that initial resection was necessary to sacrifice upper and lower pulmonary lobes. To avoid these pulmonary resections, induction therapy followed by surgery was selected. Induction therapy using rituximab was very efficacious. Resection after induction therapy was completed only by tumor extirpation, and resulted in preservation of pulmonary function. Thoracic surgeons might consider induction therapy followed by resection if the tumor is resectable UCAD, but initial resection is needed and sacrifices a large amount of pulmonary function.
Prediction of response to radiotherapy in locally advanced carcinoma cervix using multiparametric MRI: A prospective, single‐center, longitudinal study
Authors: Verma Ashish , Kumar Ishan , Patel Deepak Singh , Ranjan Ritika , Singh Munendra , Pradhan Satyajeet , Shukla Ram Chandra 
Published: April 2022

AbstractPurposeTo evaluate the possible role of a multiparametric magnetic resonance imaging (MRI) and semiquantitative fusion map for the prediction of response to radiotherapy in carcinoma cervix.MethodsThis was a prospective, single‐center, longitudinal observational study performed on patients with locally advanced carcinoma cervix. Relative blood flow (rBF), relative blood volume (rBV), and apparent diffusion coefficient (ADC) values were obtained before and after the onset of radiotherapy. rBV, rBF, and ADC values were used to generate a semiquantitative pharmacokinetic model map to identify any hypoxic component of the tumor. The subjects were retrospectively classified as responders and nonresponders based on response to treatment. Prospective prediction of response status was done using pretreatment multiparametric MRI parameters (rBF, rBV, and ADC) and semiquantitative parametric map.ResultsIn 32 patients (29 with parametrial involvement and 15 with lymphadenopathy), pretreatment ADC of the primary tumor was the most accurate measure for predicting response to treatment as well as for treatment‐induced fractional volume reduction. Although rBV and rBF were insignificant metrics in isolation for predicting response status, a combination with ADC in the form of parametric map had a sensitivity of 86.4% and 77.2%, specificity of 70% and 70%, positive predictive value of 86.4% and 85%, and negative predictive value 70% and 59% respectively by two independent observers.ConclusionADC is the most accurate measure for predicting the response to treatment. A manual parametric map generated by an off‐line fusion of the above map with those generated by pharmacokinetic modeling of perfusion‐weighted MRI may be a useful tool for the prediction of response to radiotherapy.
Pharmacogenetics may explain part of the interindividual variability of dobutamine pharmacodynamics in neonates
Authors: Hallik Maarja , Soeorg Hiie , Kahre Tiina , Murumets Ülle , Ilmoja Mari‐Liis , Kipper Karin , Metsvaht Tuuli 
Published: April 2022

AimsTo determine whether the known single nucleotide polymorphisms in adrenoreceptor associated genes affect the haemodynamic response to dobutamine in critically ill neonates.MethodsAlleles in the known genetic single nucleotide polymorphisms in β1‐ and β2‐adrenoceptor (AR) genes and Gs protein α‐subunit gene (GNAS) possibly affecting inotropic effect were identified in patients of neonatal dobutamine pharmacokinetic‐pharmacodynamic study. Linear mixed‐effect models were used to describe the effect of genetic polymorphisms to heart rate (HR), left ventricular output (LVO) and right ventricular output (RVO) during dobutamine treatment.ResultsTwenty‐six neonates (5 term, 21 preterm) were studied. Dobutamine plasma concentration and exposure time respective HR (adjusted to gestational age) is dependent on β1‐AR Arg389Gly polymorphism so that in G/G (Gly) homozygotes and G/C heterozygotes dobutamine increases HR more than in C/C (Arg) homozygotes, with parameter estimate (95% CI) of 38.3 (15.8–60.7) beats/min per AUC of 100 μg L−1 h, P = .0008. LVO (adjusted to antenatal glucocorticoid administration and illness severity) and RVO (adjusted to gestational age and illness severity) is dependent on GNAS c.393C > T polymorphism so that in T/T homozygotes and C/T heterozygotes but not in C/C homozygotes LVO and RVO increase with dobutamine treatment, 24.5 (6.2–42.9) mL kg−1 min−1 per AUC of 100 μg L−1 h, P = .0095 and 33.2 (12.1–54.3) mL kg−1 min−1 per AUC of 100 μg L−1 h, P = .0025, respectively.ConclusionIn critically ill neonates, β1‐AR Arg389Gly and GNAS c.393C > T polymorphisms may play a role in the haemodynamic response to dobutamine during the first hours and days of life.
SHP2/SPI1axis promotes glycolysis and the inflammatory response of macrophages in Helicobacter pylori‐induced pediatric gastritis
Authors: Li Chuanying , Lu Changyun , Gong Liangju , Liu Jia , Kan Chen , Zheng Hong , Wang Siying 
Published: April 2022

AbstractBackgroundMacrophages, as innate immune cells, were reported to participate in the pathogenesis of Helicobacter pylori (H. pylori)‐induced gastritis. However, the role and mechanism of macrophage dysfunction in H. pylori‐associated pediatric gastritis remain unclear.Materials and MethodsAn RNA‐sequencing assay was used to examine the differential gene expression in normal gastric antrum, non‐H. pylori‐infected tissue, and H. pylori‐infected pediatric gastritis tissue. qPCR assays were applied to verify the expression of target genes. HE staining was performed to identify the occurrence of inflammation in the normal gastric antrum, non‐H. pylori‐infected tissue, and H. pylori‐infected pediatric gastritis tissue. Western blotting was used to measure the expression of SHP2 in pediatric gastritis tissue. The metabolic profile of macrophages was determined via Seahorse metabolic analysis. Flow cytometry analysis was used to examine the level of reactive oxygen species (ROS).ResultsWe found that H. pylori ‐infected gastritis tissue exhibited many differentially expressed genes (DEGs) compared to gastritis tissue without H. pylori infection. Moreover, H. pylori ‐infected gastritis tissue showed many DEGs annotated with an overactive immune response. We identified that tyrosine‐protein phosphatase nonreceptor type 11 (PTPN11), which encodes SHP2, was significantly increased in macrophages of H. pylori ‐infected gastritis tissue. Furthermore, we revealed that SHP2 could activate the glycolytic function of macrophages to promote H. pylori ‐induced inflammation. The transcription factor SPI1 , as the downstream molecule of SHP2, could be responsible for the regulation of metabolism‐associated gene expression and inflammation.ConclusionOur study illustrated the molecular landscape of H. pylori‐infected gastritis tissue in children and suggested that the SHP2/SPI1axis could be a novel therapeutic target in H. pylori‐induced pediatric gastritis.
Role conflict, role ambiguity, and depressive symptoms: The moderating effects of job autonomy among social workers in China
Authors: Zhang Nannan , Li Xin , He Xuesong 
Published: April 2022

AbstractThis article aimed to determine the association between role stress and depressive symptoms, as well as the moderating role of job autonomy on the role stress‐depressive symptoms relationship. The data came from the China Social Work Longitudinal Study. Depressive symptoms were measured with Center for Epidemiologic Studies Depression scale. Role stress was assessed using two standardized scales of role conflict and role ambiguity. Job autonomy was assessed with a measure derived from the Job Content Questionnaire. We found that role conflict and role ambiguity were positively associated with depressive symptoms, while job autonomy was negatively associated with depressive symptoms. In addition, job autonomy was found to act as a moderator against the detrimental effect of role ambiguity on depressive symptoms. Our findings suggest that measures focusing on improving job autonomy and decreasing role stress are necessary to improve social workers’ psychological well‐being.
Global financial crisis versus COVID‐19: Evidence from sentiment analysis
Authors: Maghyereh Aktham , Abdoh Hussein 
Published: April 2022

AbstractThis study examines the relationship between sentiment and the realized volatility of returns for different asset classes (stocks, bonds, foreign currency, and commodities). Specifically, we aim to answer two key questions: first, how does sentiment relate to volatility during crises (mainly during the global financial crisis [GFC] and the COVID‐19 pandemic)? Second, can sentiment be used to forecast volatility during crises? Using two nonparametric methods, mutual information and transfer entropy, we find that information sharing and transfer increased during the pandemic. We also find that sentiment information transfer to the volatility of assets differed between the GFC and the COVID‐19 crisis. Since sentiment can reduce uncertainty around the realized variance of assets, we investigate the forecasting ability of sentiment during crises. We find that sentiment has a greater predictive power on realized volatility during crises, with a differential impact on volatility depending on the asset class. Our findings carry important implications for hedging, risk management and building models to predict variance during crises.
Combined evaluation of Fibrosis‐4 index and fatty liver for stratifying the risk for diabetes mellitus
Authors: Todo Yasuhiko , Miyake Teruki , Furukawa Shinya , Matsuura Bunzo , Ishihara Toru , Miyazaki Masumi , Shiomi Akihito , Nakaguchi Hironobu , Kanzaki Sayaka , Yamamoto Yasunori , Koizumi Yohei , Yoshida Osamu , Tokumoto Yoshio , Hirooka Masashi , Takeshita Eiji , Kumagi Teru , Ikeda Yoshio , Abe Masanori , Iwata Takeru , Hiasa Yoichi 
Published: April 2022

AbstractAims/IntroductionTo investigate whether the Fibrosis‐4 index can help stratify the risk of diabetes mellitus in patients with fatty liver disease.Materials and MethodsBased on fatty liver disease and Fibrosis‐4 index (cut‐off value 1.3), we retrospectively divided 9,449 individuals, who underwent at least two annual health checkups, into four groups stratified by sex: normal; high Fibrosis‐4 index without fatty liver disease; low Fibrosis‐4 index with fatty liver disease; and high Fibrosis‐4 index with fatty liver disease.ResultsOnset rates for diabetes mellitus in the normal, high Fibrosis‐4 index without fatty liver disease, low Fibrosis‐4 index with fatty liver disease and high Fibrosis‐4 index with fatty liver disease groups were 1.6%, 4.3%, 6.8% and 10.2%, respectively, in men, and 0.6%, 0.9%, 5.3% and 7.0%, respectively, in women. Compared with the normal group, the high Fibrosis‐4 index without fatty liver disease, low Fibrosis‐4 index with fatty liver disease and high Fibrosis‐4 index with fatty liver disease groups were at a significant risk for diabetes mellitus onset in both male and female participants. Furthermore, in both sexes, high Fibrosis‐4 index with fatty liver disease remained a significant risk factor on multivariate analysis (high fibrosis‐4 index with fatty liver disease group: adjusted hazard ratio 4.03, 95% confidence interval 2.19–7.42 [men] and adjusted hazard ratio 6.40, 95% confidence interval 1.77–23.14 [women]).ConclusionsIndividuals with fatty liver disease and high Fibrosis‐4 index had a higher risk of diabetes mellitus onset. Therefore, Fibrosis‐4 index can help stratify the risk of diabetes mellitus in patients with fatty liver disease and identify patients requiring intervention.
Emigration State: Race, Citizenship and Settler Imperialism in Modern British History, c. 1850–1972
Authors: Foks Freddy 
Published: April 2022

AbstractWhat role did migration play in the making of modern Britain? We now have a good sense of how ethnicity, class, religion and gender structured immigrants' experience and what impact they had on Britain's culture, society and economy. But as Nancy Green pointed out almost two decades ago, scholars of migration must focus on exit as well as entry. Such a call to study ‘the politics of exit’ is especially apposite in the case of the UK. For in every decade between 1850 and 1980 (with the exception of the 1930s), the UK experienced net emigration year on year. This article analyses this outflow of migrants to reveal a new vision of the UK as an ‘emigration state’. The article employs this concept to make a new argument about the formation of migration policy in the UK and offers a revised account of the geographical boundaries of the modern British state.
The adoption of care policies in Costa Rica: A multiple streams approach
Authors: Leon‐Espinoza Diana 
Published: April 2022

AbstractThis study explains the adoption of the National Childcare and Development Network in Costa Rica using John Kingdon's multiple streams approach. Traditionally, the literature on social policies argues that in the presence of socioeconomic transformations and pressures from women's movements and from left or center‐left governments, the adoption of care policies is more likely to happen. Yet, Costa Rica adopted its care policy during a fiscal crisis, with a lack of demands for care policies from the women's movement, and with a right‐wing party in government. Drawing data from documents and semistructured interviews, this article demonstrates the applicability of the multiple streams approach to understand care policy‐making processes in developing countries. The study finds that the multiple streams approach effectively explains the adoption of the policy as the product of top‐down decisions from the national women's agency that constructs the problem, a close‐knit policy design led by technocrats and bureaucrats, and the politicization of care policies to gain electoral support.
Experimental sexual selection reveals rapid evolutionary divergence in sex‐specific transcriptomes and their interactions following mating
Authors: Veltsos Paris , Porcelli Damiano , Fang Yongxiang , Cossins Andrew R. , Ritchie Michael G. , Snook Rhonda R. 
Published: April 2022

AbstractPost copulatory interactions between the sexes in internally fertilizing species elicits both sexual conflict and sexual selection. Macroevolutionary and comparative studies have linked these processes to rapid transcriptomic evolution in sex‐specific tissues and substantial transcriptomic post mating responses in females, patterns of which are altered when mating between reproductively isolated species. Here, we tested multiple predictions arising from sexual selection and conflict theory about the evolution of sex‐specific and tissue‐specific gene expression and the post mating response at the microevolutionary level. Following over 150 generations of experimental evolution under either reduced (enforced monogamy) or elevated (polyandry) sexual selection in Drosophila pseudoobscura, we found a substantial effect of sexual selection treatment on transcriptomic divergence in virgin male and female reproductive tissues (testes, male accessory glands, the female reproductive tract and ovaries). Sexual selection treatment also had a dominant effect on the post mating response, particularly in the female reproductive tract – the main arena for sexual conflict – compared to ovaries. This effect was asymmetric with monandry females typically showing more post mating responses than polyandry females, with enriched gene functions varying across treatments. The evolutionary history of the male partner had a larger effect on the post mating response of monandry females, but females from both sexual selection treatments showed unique patterns of gene expression and gene function when mating with males from the alternate treatment. Our microevolutionary results mostly confirm comparative macroevolutionary predictions on the role of sexual selection on transcriptomic divergence and altered gene regulation arising from divergent coevolutionary trajectories between sexual selection treatments.