bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Ambiguous Impact of Performance Measurement on Service Quality
Authors: Tøssebro Jan , Mjøen Odd Morten , Bruteig Rebekka 
Published: May 2022

BackgroundPerformance measurement is growing in importance as a management tool in services for disabled people.AimThe aim of this article is to add to the existing literature by exploring (a) the motivation for the introduction of such measurements, (b) the reasoning behind the choice of current indicators, and (c) the impact of performance measurements on service delivery.Methods(1) A study of documents (national and, if available, also local) on the motivation for, choice of, and implementation of quality measurements, and (2) interviews with top and middle managers in community services for people with intellectual disabilities or mental health difficulties.ResultsA varied set of motivations have been identified, including the intention to introduce a more facts-based and transparent governance, the need for information that supports the management of scarce resources, and as a tool in the development of service quality for users. The motivation appears to be dependent on level of government, and the attitude among service unit managers tends to be ambivalent; they want performance measurements but cannot see how to measure the important aspects of service quality. The choice of actual indicators is subject to a process bias; that is, one measures what is easily available in administrative systems. The results concerning impact on services are less clear and also context dependent. We have identified usage in the search for cost-cutting possibilities, defense against critique, and that reporting runs the risk of reinforcing routinization of services.DiscussionThe possible impact on services is discussed. Layers of ambiguity are outlined, as measurements can be tools both for quality development and in the defense of current services against “unrealistic demands” from the media or stakeholders. The measurements tend to be used more as sources of governance information than tools for quality development.ConclusionThe impact of quality measurement is rather ambiguous. On the one hand, it functions as a tool for budget control, whereas on the other hand, unit managers call for better measurement of user outcomes and expect that such measurement can balance the current preoccupation with input indicators, such as expenditures.
Purified PTEN-Long Induces Liver Cancer Cells to Undergo Autophagy and Apoptosis
Authors: Tan Lin , Xu Zeping , Mao Qiqi , Zhou Shaocheng , Zhu Jie , Zhang Xie , Li Hong 
Published: May 2022

BackgroundPTEN-Long is a translational variant of phosphatase and tensin homolog deleted on chromosome 10 (PTEN). This tumor suppressor is frequently lost or mutated and even it has been shown as the determinant in several human tumors. Therefore, we will determine the significant roles of PTEN-Long in the development of liver cancer.MethodsIn the present study, we characterized the antitumor effects of PTEN-Long and PTEN in proliferation, migration of HepG2 cells, apoptosis and autophagy in liver cancer cells. To extends, we have also measured the effects of purified PTEN and PTEN-Long in the above index of HepG2 cells.ResultsPTEN and PTEN-Long were ectopic-expressed in HepG2 cells, and their phenotypic effects were recorded. As expected, there was less expression of PTEN-Long and PTEN in liver cancer samples than in paired normal tissues. Ectopic expression of PTEN-Long or PTEN significantly decreased the proliferation and migration of HepG2 cells and increased apoptosis. PTEN ectopic-expression increased the number of GFP-/RFP+-LC3 puncta and levels of beclin-1 and LC3BII/LC3BI, suggesting autophagy induction. Purified PTEN-Long freely entered cells, decreased proliferation, and increased autophagy and apoptosis, while purified PTEN did not.ConclusionsOur results identify an antitumor function of purified PTEN-Long and suggest its potential utility for liver cancer treatment.
Impact of Time of Surgery on the Outcome after Surgical Stabilization of Rib Fractures in Severely Injured Patients with Severe Chest Trauma—A Matched-Pairs Analysis of the German Trauma Registry
Authors: Becker L. , Schulz-Drost S. , Spering C. , Franke A. , Dudda M. , Kamp O. , Lefering R. , Matthes G. , Bieler D. ,   on behalf of the Committee on Emergency Medicine, Intensive Care and Trauma Management (Sektion NIS) of the German Trauma Society (DGU)
Published: May 2022

PurposeIn severely injured patients with multiple rib fractures, the beneficial effect of surgical stabilization is still unknown. The existing literature shows divergent results, and the indication and especially the right timing of an operation are the subject of a broad discussion. The aim of this study was to determine the influence of the time point of surgical stabilization of rib fractures (SSRF) on the outcome in a multicenter database with special regard to the duration of ventilation, intensive care, and overall hospital stay.MethodsData from the TraumaRegister DGU collected between 2010 and 2019 were used to evaluate patients above 16 years of age with severe rib fractures [Abbreviated Injury Score (AIS)  ≥ 3] who received an SSRF in a matched-pairs analysis. In this matched-pairs analysis, we compared the effects of an early SSRF within 48 h after initial trauma vs. late SSRF 3–10 days after trauma.ResultsAfter the selection process, we were able to find 142 matched pairs for further evaluation. Early SSRF was associated with a significantly shorter length of stay in the intensive care unit (16.2 days vs. 12.7 days, p = 0.020), and the overall hospital stay (28.5 days vs. 23.4 days, p = 0.005) was significantly longer in the group with late SSRF. Concerning the days on mechanical ventilation, we were able to demonstrate a trend for an approximately 1.5 day shorter ventilation time for patients after early SSRF, although this difference was not statistically significant (p = 0.226).ConclusionsWe were able to determine the significant beneficial effects of early SSRF resulting in a shorter intensive care unit stay and a shorter length of stay in hospital and additionally a trend to a shorter time on mechanical ventilation.
RETRACTED: Longitude Variation of the microRNA-497/FGF-23 Axis during Treatment and Its Linkage with Neoadjuvant/Adjuvant Trastuzumab-Induced Cardiotoxicity in HER2-Positive Breast Cancer Patients
Authors: Liu Hui , Hu Xiaoyan , Wang Lingyun , Du Tao , Feng Jing , Li Ming , Liu Lei , Liu Xiaofang 
Published: May 2022

PurposeMicroRNA-497 (miR-497) is previously reported to target fibroblast growth factor 23 (FGF-23) and regulates cardiac injury, while their value in predicting drug-induced cardiotoxicity is not reported. Thus, the current study aimed to investigate the correlation of miR-497/FGF-23 with neoadjuvant/adjuvant trastuzumab-induced cardiotoxicity in human epidermal growth factor receptor 2 (HER2)-positive breast cancer patients.MethodsA total of 97 HER2-positive surgical breast cancer patients who received neoadjuvant/adjuvant trastuzumab contained regimens were enrolled; then, their peripheral blood mononuclear cells (PBMC) and serum were collected at baseline, after neoadjuvant treatment, at 3 months (M3), 6 months (M6), 9 months (M9), and 12 months (M12) after surgery. The PBMC was used for miR-497 measurements, and the serum was used for FGF-23 measurements. The cardiotoxicity events and incidence were recorded.ResultsA total of 24 (24.7%) patients occurred cardiotoxicity during the treatment period. MiR-497 decreased from baseline (median: 0.955) to M12 after surgery (median: 0.602) (p &lt; 0.001), while FGF-23 increased from baseline (median: 0.390 ng/mL) to M12 after surgery (median: 0.566 ng/mL) (p &lt; 0.001); besides, the miR-497/FGF-23 axis greatly reduced from baseline (median: 2.545) to M12 after surgery (median: 1.222) (p &lt; 0.001). At most time points, miR-497 was negatively related to FGF-23 (all p &lt; 0.05). Notably, the miR-497/FGF-23 axis at all time points (including baseline, postneoadjuvant treatment, M3, M6, M9, and M12) was related to a lower risk of cardiotoxicity (all p &lt; 0.05). Furthermore, the miR-497/FGF-23 axis was also positively correlated with the left ventricular ejection fraction (LVEF) at all time points (all p &lt; 0.01).ConclusionThe MiR-497/FGF-23 axis serves as a potential indicator predicting trastuzumab-induced cardiotoxicity in HER2-positive breast cancer patients.
Prediction of Long-Term Survival Outcome by Lymph Node Ratio in Patients of Parotid Gland Cancer: A Retrospective study
Authors: Jiang Wen-Mei , Xu Jian-Feng , Chen Jun , Li Guo-Li , Gao Yun-Fei , Zhang Quan , Chen Yan-Feng 
Published: May 2022

BackgroundLymph node ratio (LNR) has been reported to reliably predict cancer-specific survival (CSS) in parotid gland cancer (PGC). Our study was designed to validate the significance of LNR in patients with PGC.MethodsPatients diagnosed with stage I–IV PGC were enrolled from Surveillance Epidemiology and End Results database (SEER, N = 3529), which is the training group, and Sun Yat-sen University Cancer Center database (SYSUCC, N = 99), the validation group. We used X-tile software to choose the optimal cutoff value of LNR; then, univariable and multivariable analyses were performed, assessing the association between LNR and CSS.ResultsThe optimal cutoff value of LNR was 0.32 by X-tile based on 3529 patients from SEER. Cox proportional hazard regression analysis revealed better CSS for patients with LNR ≤ 0.32 (adjusted hazard ratio [HR] 1.612, 95% confidence interval [95% CI] 1.286–2.019; p &lt; 0.001) compared with patients with LNR &gt; 0.32 in SEER. In the SYSUCC cohort, patients with LNR ≤ 0.32 also had better CSS over patients with LNR &gt; 0.32 (p &lt; 0.001). In N2 and N3 stage groups, patients with LNR ≤ 0.32 had superior CSS outcomes over those with the LNR &gt; 0.32 group, but this benefit was absent in the N1 stage group.ConclusionsIn conclusion, the lymph node ratio turned out to be an independent prognostic factor for cancer-specific survival of PGC in this study. This valuable information could help clinicians to evaluate the prognosis of PGC and suggest that adequate lymph node dissection is necessary.
A Cross-National Comparison on Life Expectancy of Non-Hispanic White Americans
Authors: Xie Lingling , Xiang Defang , He Haijun , Zhai Tiemin , Mao Zongfu , Liang Xiaohui 
Published: May 2022

Objectives: Taking the life expectancy (LE) of Non-Hispanic White (NHW) Americans as an example to provide potential references for improving LE globally.Methods: We collected complete data from the United States (US) CDC, Office for National Statistics in the United Kingdom (UK), and the OECD publications, and described LE changes of NHW Americans by cross-national comparison and Arriaga’s method.Results: LE of NHW Americans was not as optimistic as European countries from 2006 to 2018. The LE annual average growth rate was 0.04% for NHW Americans, 0.19% for the UK population, and the median of 25 countries was 0.24%. Compared with the other age groups, the age group 30–34 revealed an inferior impact on the LE of NHW people, of which accidents and intentional self-harm were likely to be the top two direct causes.Conclusion: Finding out the direct causes that affect the LE growth in different age groups is conducive to making a targeted intervention or solving the LE growth bottleneck.
COVID-19 Impacts Across Multiple Life Domains of Vulnerable Socio-Demographic Groups Including Migrants: A Descriptive Cross-Sectional Study
Authors: Chilunga Felix P. , Coyer Liza , Collard Didier , Leenstra Tjalling , Galenkamp Henrike , Agyemang Charles , Prins Maria , Stronks Karien 
Published: May 2022

Objectives: We assessed the impacts of COVID-19 on multiple life domains across socio-demographic groups in Netherlands.Methods: After the first COVID-19 wave, we distributed online questionnaires among 13,031 participants of the multi-ethnic HELIUS cohort. Questionnaires contained questions on changes in income status, healthy behaviors, mental health, and access to non-COVID-19 health care. We then calculated differences in adjusted proportions of participants that reported negative changes across multiple life domains by migration background, age, sex, education, and occupation.Results: 4,450 individuals (35%) responded, of which 4,294 were included. Older populations and men seemed to be less vulnerable to negative changes in multiple life domains during the COVID-19 pandemic as compared to the pre-pandemic period, while populations with a migration background and lower education/occupation groups seemed to be more vulnerable to negative changes.Conclusion: Not all populations vulnerable to SARS-CoV-2 infection and mortality are also more vulnerable to COVID-19 impacts across multiple other life domains. Targeted interventions are needed in socio-demographic groups that are most impacted by COVID-19 in various life domains to prevent a further increase of their already increased risk of chronic diseases after the pandemic.
Women Who Sell Sex in Eastern and Southern Africa: A Scoping Review of Non-Barrier Contraception, Pregnancy and Abortion
Authors: Macleod Catriona Ida , Reynolds John Hunter , Delate Richard 
Published: May 2022

Objectives: There is a need to hone reproductive health (RH) services for women who sell sex (WSS). The aim of this review was to collate findings on non-barrier contraception, pregnancies, and abortion amongst WSS in Eastern and Southern African (ESA).Methods: A scoping review methodology was employed. Inclusion criteria were: 1) empirical papers from 2) ESA, 3) published since 2010, and 4) addressing WSS in relation to 5) the identified RH issues.Results: Reports of rates of non-barrier contraceptive usage varied from 15% to 76%, of unintended pregnancy from 24% to 91%, and of abortion from 11% to 48%. Cross-cutting factors were alcohol use, violence, health systems problems, and socio-economic issues. Pregnancy desire was associated with having a non-paying partner. Barriers to accessing, and delaying, antenatal care were reported as common. Targeted programmes were reported as promoting RH amongst WSS.Conclusion: Programmes should be contextually relevant, based on local patterns, individual, interpersonal and systemic barriers. Targeted approaches should be implemented in conjunction with improvement of public health services. Linked HIV and RH services, and community empowerment approaches are recommended.
Whole-Exome Sequencing Could Distinguish Primary Pulmonary Squamous Cell Carcinoma From Lung Metastases in Individuals With Cervical Squamous Cell Carcinoma
Authors: Li Lihong , Song Qianqian , Cao Dandan , Jiao Yuchen , Yuan Guangwen , Song Yan 
Published: May 2022

Aims: Metastatic cervical carcinoma is hard to cure using traditional treatment and new therapeutic approaches are needed. However, the process of clonal evolution and the molecular alterations that contribute to tumor progression from primary to metastatic carcinoma remain unclear. It is currently difficult to distinguish between the primary pulmonary squamous cell carcinoma (PPSCC) and metastatic cervical squamous cell carcinoma (CSCC).Methods: Paired primary CSCC and lung/lymph nodes metastatic lesions from eight patients were analyzed by whole-exome sequencing (WES). WES data of matched specimens and normal samples were aligned to the human reference genome and analyzed to identify somatic mutations in primary and metastatic lesions.Results: A total of 1,254 somatic variants were identified. All the primary lesions and metastatic lesions shared mutations, the percentage of shared mutations between primary lesions and corresponding metastatic lesions varied significantly, ranging from 6% to 70%. In other words, all the metastatic lesions are clonally related to primary lesions, confirming WES could prove they are metastatic from the cervix but not PPSCC. We tried to apply a gene panel to help distinguish PPSCC and metastatic CSCC but failed because the mutations were widely distributed in CSCC. Interestingly, lymph nodes metastasis (LNM) harbored fewer cancer driver mutations than primary CSCC specimens with a significant difference. Besides this, there was no significant difference in somatic mutations and copy number variation (CNV) between primary and metastatic CSCC.Conclusion: Our data demonstrate that WES is an additional helpful tool in distinguishing PPSCC and metastatic CSCC, especially for certain difficult cases.
An Experimental Investigation of Thermal Runaway and Gas Release of NMC Lithium-Ion Pouch Batteries Depending on the State of Charge Level
Authors: Amano Kofi Owusu Ansah , Hahn Sarah-K. , Tschirschwitz Rico , Rappsilber Tim , Krause Ulrich 
Published: May 2022

In this study, 19 experiments were conducted with 25 pouch cells of NMC cathode to investigate thermal runaway and the release of gases from lithium-ion batteries (LIBs). Single cells, double cells, and a four-cell battery stack were forced to undergo thermal runaway inside an air-tight reactor vessel with a volume of 100 dm3. The study involved two series of tests with two types of ignition sources. In the Series 1 tests, a heating plug was used to initiate thermal runaway in LIBs in the ranges of 80–89% and 90–100% SOC. In the Series 2 tests, a heating plate was used to trigger thermal runaway in LIBs in the ranges of 30–50%, 80–89%, and 90–100% SOC. Thermal runaway started at an onset temperature of 344 ± 5 K and 345 K for the Series 1 tests and from 393 ± 36 K to 487 ± 10 K for the Series 2 tests. Peak reaction temperatures ranged between 642 K and 1184 K, while the maximum pressures observed were between 1.2 bar and 7.28 bar. Thermal runaway induced explosion of the cells and lead to a rate of temperature increase greater than 10 K/s. The amounts of gases released from the LIBs were calculated from pressures and temperatures measured in the reactor. Then, the gas composition was analyzed using a Fourier transform infrared (FTIR) spectrometer. The highest gaseous production was achieved at a range of 90–100% SOC and higher battery capacities 72 L, 1.8 L/Ah (Series 1, battery stack) and 103 L, 3.2 L/Ah (Series 2, 32 Ah cell)). Among the gases analyzed, the concentration of gaseous emissions such as C2H4, CH4, and C2H6 increased at a higher cell capacity in both series of tests. The study results revealed characteristic variations of thermal behavior with respect to the type of ignition source used.
Urinary Sulfate, Kidney Failure, and Death in CKD: The African American Study of Kidney Disease and Hypertension
Authors: Azim Aniqa , Murray Jennifer , Beddhu Srinivasan , Raphael Kalani L. 
Published: May 2022

Key Points

Higher urine sulfate levels were associated with more favorable outcomes in Blacks with kidney disease attributed to hypertension.These findings are independent of dietary protein intake, suggesting that sulfate has an effect on health above and beyond protein intake.

Background
Sulfur is an important mineral element whose principal source is animal protein. Animal protein contributes to the daily acid load, which is associated with poor outcomes in individuals with chronic kidney disease (CKD). We hypothesized that higher urinary sulfate, as a reflection of the daily acid load, is associated with a greater risk of death and CKD progression.

Methods
Urinary sulfate was measured in 1057 African American Study of Kidney Disease and Hypertension (AASK) participants at baseline. Participants were categorized by tertiles of daily sulfate excretion. The longitudinal outcome of interest was the composite of death, dialysis, or 50% reduction in measured glomerular filtration rate (GFR). Multivariable adjusted Cox regression models were fit to relate the composite outcome to daily sulfate excretion using the lowest tertile as the reference.

Results
Participants in the highest urinary sulfate tertile were more likely to be men and have a higher body mass index, protein intake, measured GFR, and urinary ammonium and phosphate excretion, and lower urinary protein/creatinine. Compared with those in the lowest tertile of sulfate, those in the highest tertile had a 44% lower hazard (95% CI, 0.37 to 0.84), and those in the middle tertile had a 27% lower hazard (95% CI, 0.55 to 0.96) of death, dialysis, or 50% reduction in measured GFR during follow-up after adjusting for demographics, GFR, protein intake, and other potential confounders. Protein intake was not associated with risk of these events.

Conclusions
Higher urinary sulfate excretion is associated with more favorable outcomes in Blacks who have CKD attributed to hypertension.
Levels of Lead in Residential Drinking Water and Iron Deficiency among Patients with End Stage Kidney Disease
Authors: Danziger John , Mukamal Kenneth J. 
Published: May 2022

Key Points

Low levels of drinking water lead contamination are associated with an increased risk of iron deficiency among those with kidney disease.Black people seem particularly susceptible to the association of lead contamination and iron deficiency.

Background
Although those with kidney disease may have heightened susceptibility to heavy metal toxicity, whether low levels of drinking water lead contamination have clinical consequence is unknown.

Methods
Given that lead toxicity is known to associate with iron deficiency, we merged data from the Environmental Protection Agency (EPA) Safe Drinking Water Information and United States Renal Data Systems to examine whether municipal 90th percentile drinking water lead levels associate with iron deficiency among incident dialysis patients. Iron deficiency was defined across thresholds of transferrin saturation (<10% and 20%) and ferritin (<100 and <200 ng/ml), and simultaneous transferrin saturation <20% and ferritin <200 ng/ml, all obtained within 30 days of dialysis initiation. The average 90th percentile of drinking water lead samples per patient city of residence over a 5-year period before dialysis initiation was examined at the <1 μg/L level of detection, and at the 25th, 50th, and 100th percentile of the EPA’s actionable level (15 μg/L).

Results
Among 143,754 incident ESKD patients, those in cities with drinking water lead contamination had 1.06 (95% CI, 1.03 to 1.09), 1.06 (95% CI, 1.02 to 1.10), and 1.07 (95% CI, 1.03 to 1.11) higher adjusted odds of a transferrin saturation <20%, ferritin <200 ng/ml, and simultaneous transferrin saturation <20% and ferritin <200 ng/ml, respectively. These associations were apparent across the range of lead levels found commonly in the United States and were significantly greater among Black patients (multiplicative interaction P values between lead and race <0.05).

Conclusions
Even exposure to low levels of lead contamination, as commonly found in US drinking water, may have adverse hematologic consequence in patients with advanced kidney disease. These associations are particularly evident among Black people and, although consistent with other environmental injustices facing minorities in the United States, might reflect a greater susceptibility to lead intoxication.