bluuebunny/crossref_metadata_2025_split huggingface dataset:
Financial Policy for Promoting Equality Education in Rural Areas: Two Key Policy Implementation in China
Authors: Li Jian 
Published: November 2022

Abstract
Educational equity is an important value pursuit of educational development in various countries, and fiscal policy is an important part of public policy to realize educational equity. To realize educational equity, China’s more important fiscal policies include transfer payment system and the policy of “two exemptions and one subsidy”. In addition, the reform of the division of financial authority and expenditure responsibility between the central and local governments in the field of education is also one of the priorities of the fiscal policy for educational equity.
Adherence to Tympanostomy Tube Clinical Practice Guidelines in an Advanced Practice Provider Clinic
Authors: Sim Edward S. , Belsky Michael A. , Konanur Anisha , Yan Annie , Shaffer Amber D. , Williams Kathryn , Martsolf Grant R. , Chi David H. , Jabbour Noel 
Published: November 2022

Objective: We compared adherence rates by attending otolaryngologists (OTOs) and advanced practice providers (APPs) to the 2013 American Academy of Otolaryngology—Head and Neck Surgery Foundation clinical practice guideline (CPG) for children with recurrent acute otitis media (RAOM) undergoing bilateral myringotomy and tympanostomy tube placement (BMT). Methods: Patients aged 6 months to 12 years old undergoing BMT for RAOM who had a pre-operative visit with an independent APP or OTO were reviewed. Patients satisfied CPG criteria if middle ear effusion was identified at the pre-operative visit (pre-op) or if they did not have effusion but met exception criteria based on their risk for developmental difficulties and contraindications to medical therapy. Adherence rates between APPs and OTOs were compared. Agreement between pre-op and time-of-surgery middle ear effusion identification was assessed. Results: Nine hundred twenty-three patients were included. Six hundred one patients were seen by OTOs and 322 by APPs. Middle ear effusion was identified at pre-op in 84% of APP patients and in 76% of OTO patients ( P = .005). Eight percent of APP patients and 11% of OTO patients met exception criteria ( P = .138). Overall, 87% of OTO patients and 92% of APP patients met either CPG or exception criteria for BMT ( P = .037). A logistic regression model demonstrated that pre-op provider type did not significantly impact rates of agreement between pre-op visit and time-of-surgery middle ear effusion identification. Conclusions: Independent APP-led clinics can reliably and effectively deliver evidence-based care for prevalent conditions such as RAOM at similar rates of adherence to CPGs as OTOs.
Mental Disorders Among Mothers of Children Born Preterm: A Population-Based Cohort Study in Canada
Authors: Louis Deepak , Akil Hammam , Bolton James M. , Bacchini Fabiana , Netzel Karen , Oberoi Sapna , Pylypjuk Christy , Flaten Lisa , Cheung Kristene , Lix Lisa M. , Ruth Chelsea , Garland Allan 
Published: November 2022

Background Our aim was to examine the association between preterm delivery and incident maternal mental disorders using a population-based cohort of mothers in Canada. Methods Retrospective matched cohort study using Manitoba Centre for Health Policy (MCHP) administrative data in Manitoba. Mothers who delivered preterm babies (<37 weeks gestational age) between 1998 and 2013 were matched 1:5 to mothers of term babies using socio-demographic variables. Primary outcome was any incident mental disorder within 5 years of delivery defined as any of (a) mood and anxiety disorders, (b) psychotic disorders, (c) substance use disorders, and (d) suicide or suicide attempts. Multivariable Poisson regression model was used to estimate the 5-year adjusted incidence rate ratios (IRRs). Results Mothers of preterm children ( N   =   5,361) had similar incidence rates of any mental disorder (17.4% vs. 16.6%, IRR   =   0.99, 95% CI, 0.91 to 1.07) compared to mothers of term children ( N   =   24,932). Mothers of term children had a higher rate of any mental disorder in the first year while mothers of preterm children had higher rates from 2 to 5 years. Being the mother of a child born <28 week (IRR   =   1.5, 95% CI, 1.14 to 2.04), but not 28–33 weeks (IRR   =   1.03, 95% CI, 0.86 to 1.19) or 34–36 weeks (IRR   =   0.96, 95% CI, 0.88 to 1.05), was associated with any mental disorder. Interpretation Mothers of preterm and term children had similar rates of incident mental disorders within 5-years post-delivery. Extreme prematurity was a risk factor for any mental disorder. Targeted screening and support of this latter group may be beneficial.
Optimization of mechanical and thermal expansion properties of resin mineral composites for ultra-precision machine tools
Authors: Long Yunfang , Zhang Yi , Hu Xiangyi , Zhang Qinhe , Zhang Jianhua 
Published: November 2022

Resin mineral composite (RMC), composed of granite aggregate, fly ash, epoxy resin, etc., has been widely noticed in the field of ultra-precision machining by its excellent vibration damping performance. However, RMC’s application is limited by its low mechanical strength. In this paper, two aggregate gradation schemes, containing fractal aggregate gradation (FAG) and coarse aggregate broken gradation (CABG), are designed before researching the effects of aggregate gradation schemes, maximum aggregate size, resin dosage, vibration time, and defoaming agent dosage on the mechanical properties, porosity, and coefficient of thermal expansion (CTE) of the RMC. Shown by the experimental results, CABG has a better performance than FAG both on their mechanical properties, porosity, and thermal expansion properties. FAG and CABG’s compressive strength and elastic modulus reach their maximum values at the resin dosages of 10 wt% and 9 wt%, respectively. Their optimal vibration times are 40 min and 30 min, and optimal defoaming agent dosages are 1.5 wt% and 1.0 wt%, respectively. With the optimal preparation process, 100°C RMC’s compressive strength and elastic modulus increase by 23.8% and 8.6%, respectively, and its CTE decreases by 58.4%. By this research, the resin dosage, vibration time, and RMC’s manufacturing cost would be effectively reduced, thus improving RMC’s application in ultra-precision machine tools.
HIV care cascade for women living with HIV in the Greater Toronto Area versus the rest of Ontario and Canada
Authors: Medeiros Priscilla , Warren Laura , Kazemi Mina , Massaquoi Notisha , Smith Stephanie , Tharao Wangari , Serghides Lena , Logie Carmen H , Kroch Abigail , Burchell Ann N , de Pokomandy Alexandra , Kaida Angela , Loutfy Mona ,   On behalf of the CHIWOS Research Team
Published: November 2022

Background The Greater Toronto Area (GTA) is home to 39% of Canada’s population living with HIV. To identify gaps in access and engagement in care and treatment, we assessed the care cascade of women living with HIV (WLWH) in the GTA versus the rest of Ontario and Canada (in this case: Quebec and British Columbia). Methods We analyzed 2013–2015 self-reported baseline data from the Canadian HIV Women’s Sexual and Reproductive Health Cohort Study for six care cascade stages: linked to care, retained in care, initiated antiretroviral therapy (ART), currently on ART, ART adherence (≥90%), and undetectable (<50 copies/mL). Multivariable logistic regression was used to reveal associations with being undetectable. Results Comparing the GTA to the rest of Ontario and Canada, respectively: 96%, 98%, 100% were linked to care; 92%, 94%, 98% retained in care; 72%, 89%, 96% initiated ART; 67%, 81%, 90% were currently using ART; 53%, 66%, 77% were adherent; 59%, 69%, 81% were undetectable. Factors associated with viral suppression in the multivariable model included: living outside of the GTA (Ontario: aOR = 1.72, 95% CI: 1.09–2.72; Canada: aOR = 2.42, 95% CI: 1.62–3.62), non-Canadian citizenship (landed immigrant/permanent resident: aOR = 3.23, 95% CI: 1.66–6.26; refugee/protected person/other status: aOR = 4.77, 95% CI: 1.96–11.64), completed high school (aOR = 1.77, 95% CI: 1.15–2.73), stable housing (aOR = 2.13, 95% CI: 1.33–3.39), income of ≥$20,000 (aOR = 1.52, 95% CI: 1.00–2.31), HIV diagnosis <6 years (6–14 years: aOR = 1.75, 95% CI: 1.16–2.63; >14 years: aOR = 1.87, 95% CI: 1.19–2.96), and higher resilience (aOR = 1.02, 95% CI: 1.00–1.04). Conclusion WLWH living in the GTA had lower rates of viral suppression compared to the rest of Ontario and Canada even after adjustment of age, ethnicity, and HIV diagnosis duration. High-impact programming for WLWH in the GTA to improve HIV outcomes are greatly needed.
Bridging the labour market skills gap to tackle youth unemployment in South Africa
Authors: Habiyaremye Alexis , Habanabakize Thomas , Nwosu Chijioke 
Published: November 2022

AbstractSouth Africa has one of the world’s highest youth unemployment rates despite a high demand for skilled labour, because employability remains severely hampered by a persistent vertical skills mismatch. The flagship upskilling programme deployed by the government to enhance job readiness and enterprise development capabilities among rural youth has, however, shown mixed results. The slow uptakes of alumni calls into question the adequacy of the programme’s skills composition in resolving the labour market mismatch. Using the Outcome Mapping approach and probit estimation on self-reported skills improvements among programme participants, this study finds perceived improvements in non-technical skills to be associated with a higher likelihood of success in comparison to technical skills, both in securing a stable job and in launching a viable enterprise after completion of the programme. These findings confirm the growing importance of ‘soft skills’ in bolstering employability when jobs are scarce. They suggest the need for a stronger emphasis on this set of skills in upskilling programmes aimed to address unemployment challenges.
Risk factors for elective and urgent open conversion after EVAR—a retrospective observational study
Authors: Haidar Haidar , Kapahnke Sebastian , Frese Jan P , Omran Safwan , Mueller Verena , Hinterseher Irene , Sommerfeld Manuela , Kaschina Elena , Konietschke Frank , Greiner Andreas , Buerger Matthias 
Published: November 2022

Background Endovascular aortic aneurysm repair (EVAR) has become the standard procedure for treating infrarenal abdominal aortic aneurysms (AAA). Various associated complications can lead to open conversion (OC). Thorough follow-up after the procedure is mandatory for the early detection of complications. Persisting perfusion of the aneurysm, a so-called endoleak (EL), paired with structural instability because of aortic wall atrophy and impaired cell functionality induced by EVAR, results in a high risk for aortic rupture. Purpose The goal of this study was to detect the risk factors for elective and urgent OC as a result of EVAR-induced pathophysiological changes inside the aortic wall. Research Design Retrospective data analysis was performed on all open aortic repairs from January 2016 to December 2020. Data Collection and Analysis Fifty patients were identified as treated by OC for failure of an infrarenal EVAR. The patients were divided into two subgroups, here depending on the urgency of surgery. Statistical analysis of patient characteristics and outcomes was performed. Results The most common indications for OC were various types of EL (74%), resulting in an aortic rupture in 15 patients. Patients with insufficient or absent follow-up were treated more frequently in an emergency setting (16% vs. 63%). The mortality rate was higher in cases of emergency OC (3% vs. 26%). Conclusions Particularly in cases of insufficient or absent follow-up, complications such as EL pose an enormous risk for fatal aortic rupture.
Using machine learning to predict help-seeking among 2016–2018 Pregnancy Risk Assessment Monitoring System participants with postpartum depression symptoms
Authors: Fischbein Rebecca , Cook Heather L , Baughman Kristin , Díaz Sebastián R 
Published: November 2022

Background: Despite the importance of early identification and treatment, postpartum depression often remains largely undiagnosed with unreported symptoms. While research has identified several factors as prompting help-seeking for postpartum depression symptoms, no research has examined help-seeking for postpartum depression using data from a multi-state/jurisdictional survey analyzed with machine learning techniques. Objectives: This study examines help-seeking among people with postpartum depression symptoms using and demonstrating the utility of machine learning techniques. Methods: Data from the 2016–2018 Pregnancy Risk Assessment Monitoring System, a cross-sectional survey matched with birth certificate data, were used. Six US states/jurisdictions included the outcome help-seeking for postpartum depression symptoms and were used in the analysis. An ensemble method, “Super Learner,” was used to identify the best combination of algorithms and most important variables that predict help-seeking among 1920 recently pregnant people who screen positive for postpartum depression symptoms. Results: The Super Learner predicted well and had an area under the receiver operating curve of 87.95%. It outperformed the highest weighted algorithms which were conditional random forest and stochastic gradient boosting. The following variables were consistently among the top 10 most important variables across the algorithms for predicting increased help-seeking: participants who reported having been diagnosed with postpartum depression, having depression during pregnancy, living in particular US states, being a White compared to Black or Asian American individual, and having a higher maternal body mass index at the time of the survey. Conclusion: These results show the utility of using ensemble machine learning techniques to examine complex topics like help-seeking. Healthcare providers should consider the factors identified in this study when screening and conducting outreach and follow-up for postpartum depression symptoms.
Non-contrast CT markers of intracerebral hemorrhage expansion: The influence of onset-to-CT time
Authors: Morotti Andrea , Li Qi , Mazzoleni Valentina , Nawabi Jawed , Schlunk Frieder , Mazzacane Federico , Busto Giorgio , Scola Elisa , Brancaleoni Laura , Giacomozzi Sebastiano , Simonetti Luigi , Laudisi Michele , Cavallini Anna , Zini Andrea , Casetta Ilaria , Fainardi Enrico , Dowlatshahi Dar , Padovani Alessandro , Arba Francesco 
Published: November 2022

Background: Hematoma expansion (HE) is an appealing therapeutic target in intracerebral hemorrhage (ICH) and non-contrast computed tomography (NCCT) features are promising predictors of HE. Aims: We investigated whether onset-to-CT time influences the diagnostic performance of NCCT markers for HE. Methods: Retrospective multicentre analysis of patients with primary ICH. The following NCCT markers were analyzed: hypodensities, heterogeneous density, blend sign, and irregular shape. HE was defined as growth ⩾6 mL and/or ⩾33%. We calculated the sensitivity, specificity, positive, and negative predictive values (PPVs and NPVs) of NCCT markers for HE, stratified by onset-to-CT time (<2 h, 2–4 h, 4–6 h, >6 h). Results: We included 1135 patients (median age 69, 53% males), of whom 307 (27%) experienced HE. Overall hypodensities had the highest sensitivity (0.68) and blend sign the highest specificity (0.87) for HE. Hypodensities were more common and had higher sensitivity (0.80) in patients with imaging within 2 h. The same result was observed for heterogeneous density, whereas irregular shape had a similar prevalence across time strata and higher sensitivity (0.79) beyond 6 h from onset. The frequency of blend sign increased with longer onset-to-CT time, whereas its specificity declined after 6 h from onset. Conclusion: The diagnostic performance of NCCT markers is influenced by imaging time. Hypodensities identified four out of five patients with HE within 2 h from onset, whereas irregular shape performed better in late presenters. Our findings may improve the use of NCCT markers in future studies and trials targeting HE.
Longitudinal Digital Glucometric Benchmarking to Evaluate the Impact of Institutional Diabetes Care Initiatives in Adults With Diabetes Mellitus Over the 2016-2020 Period
Authors: Barmanray Rahul D , Kyi Mervyn , Colman Peter G. , Fourlanos Spiros 
Published: November 2022

Background: While glucometric benchmarking has been used to compare glucose management between institutions, the value of longitudinal intra-institution benchmarking to assess quality improvement changes is not established. Methods: A prospective six-month observational study (October 2019–March 2020 inclusive) of inpatients with diabetes or newly detected hyperglycemia admitted to eight medical and surgical wards at the Royal Melbourne Hospital. Networked blood glucose (BG) meters were used to collect capillary BG levels. Outcomes were measures of glycemic control assessed by mean and threshold glucometric measures and comparison with published glucometric benchmarks. Intra-institution comparison was over the 2016-2020 period. Results: In all, 620 admissions (588 unique individuals) met the inclusion criteria, contributing 15 164 BG results over 4023 admission-days. Compared with the 2016 cohort from the same institution, there was increased BG testing (3.8 [SD = 2.2) vs 3.3 [SD = 1.7] BG measurements per patient-day, P < .001), lower mean patient-day mean glucose (PDMG; 8.9 mmol/L [SD = 3.2] vs 9.5 mmol/L [SD = 3.3], P < .001), and reduced mean and threshold measures of hyperglycemia ( P < .001 for all). Comparison with institutions across the United States revealed lower incidence of mean PDMG >13.9 or >16.7 mmol/L, and reduced hypoglycemia (<3.9, <2.8, and <2.2 mmol/L), when compared with published benchmarks from an earlier period (2009-2014). Conclusions: Comprehensive digital-based glucometric benchmarking confirmed institutional quality improvement changes were followed by reduced hyperglycemia and hypoglycemia in a five-year comparison. Longitudinal glucometric benchmarking enables evaluation and validation of changes to institutional diabetes care management practices.
Bacterial uropathogens, their associated factors, and antimicrobial susceptibility pattern among adult diabetic patients in two health centers at Kombolcha town, Northeastern Ethiopia
Authors: Oumer Ousman , Metaferia Yeshi , Gebretsadik Daniel 
Published: November 2022

Objective: Urinary tract infection has catastrophic health outcome among diabetes mellitus patients. This study was conducted to investigate prevalence of bacterial uropathogens, their antibiogram, and associated factors among diabetes mellitus patients in Kombolcha town. Method: Cross-sectional study was done from February to April 2020. A total of 282 study participants were involved and simple random technique was applied for enrollment of subjects. Well-constructed and pre-tested questionnaire was utilized to collect the data. Five to ten milliliters of mid-stream urine specimen was collected for microbiological data. Each sample was inoculated into cystine lactose electrolyte deficient medium, incubated overnight in aerobic atmosphere at 37°C for 24 h and finally biochemical tests were carried out. According to Kirby–Bauer disk diffusion method, the antimicrobial susceptibilities pattern of the bacteria was performed on Mueller–Hinton Agar. The data were analyzed with Statistical Package for Social Sciences version 23. Descriptive statistics, bi-variable, and multivariable logistic regression analyses were performed. For statistical significance association, p value ⩽ 0.05 with a 95% confidence interval was considered Results: The general prevalence of urinary tract infection among study participants was 20.2% (57/282). Being female and having merchant occupation had a statistically significant association. Gram-negative bacteria accounted for 70.2% (40/57) and the leading isolate was Escherichia coli, followed by Klebsiella pneumoniae and Coagulase negative Staphylococcus. About 57.5% gram-negative and 35.3% gram-positive bacteria showed multidrug resistance. Conclusion: The general prevalence of significant bacteriuria was found to be consistent with similar studies conducted in different areas. The higher multidrug resistance rate was observed for the isolated bacteria. Health-care professionals should give due attention and follow rational antibiotic prescription practices to treat these infections.
Validation of the SMH Equations for the Estimation of the Total Body Water Volume in Hemodialysis Patients
Authors: Noori Nazanin , Sharma Parpia Arti , Wald Ron , Goldstein Marc B. 
Published: November 2022

Background: Online dialysis clearance monitors typically provide an accurate value for Kt. A value for V (total body water [TBW]) is required to calculate Kt/V, the measure of the adequacy of the delivered dialysis in hemodialysis (HD) patients. Using bioimpedance spectroscopy (BIS), we previously developed 2 sex-specific equations for the estimation of the TBW, which we have chosen to name the St Michael’s Hospital (SMH) equations. Objective: The objective of this study was to validate the SMH equations in a second distinct population of patients. Design: Cross-sectional study. Setting: Single center hemodialysis unit at St Michael’s Hospital, a tertiary care teaching hospital, in Toronto, Canada. Patients: Eighty-one adult HD patients who had been receiving conventional maintenance HD for at least 3 months. Measurements: Anthropometric measurements including weight, height, and waist circumference were collected. TBW was measured by BIS using the Body Composition Monitor (Fresenius Medical Care, Bad Homburg, Germany). Methods: The Bland-Altman method to calculate the bias and limits of agreement and the difference plot analysis were used to evaluate the difference between the BIS-TBW and the TBW derived from our equations (SMH equation) in this validation cohort. Results: The TBW values based on our equations had a high correlation with BIS-TBW (correlation coefficients = 0.93, P values < .01, bias = 1.8 [95% CI: 1-2.6] liter). Application of SMH equations closely predicted Kt/V, based on BIS value, in all categories of waist circumference. Limitations: Small sample size, single-center, not including peritoneal dialysis patients. A larger and more heterogeneous sample with more patients at the extremes of body mass index would allow for more detailed sub-group analyses in different races and different anthropometric categories to better understand the performance of these equations in discrete sub-groups of patients. Conclusions: In maintenance HD patients, our previously derived equations to estimate the TBW using weight and waist circumference appear to be valid in a distinct patient population. Given the centrality of TBW to the calculation of small molecule clearance, the SMH equations may enhance the measurement of dialysis adequacy and inform practice.