bluuebunny/crossref_metadata_2025_split huggingface dataset:
The development of a visual dashboard report to assess physician assistant and nurse practitioner financial and clinical productivity
Authors: Kidd Vasco Deon , Liu Joe Haoming , Reamer-Yu Andy , Wang Joann Hao , Deng Mei 
Published: July 2022

AbstractThe evolving COVID-19 pandemic has unevenly affected academic medical centers (AMCs), which are experiencing resource-constraints and liquidity challenges while at the same time facing high pressures to improve patient access and clinical outcomes. Technological advancements in the field of data analytics can enable AMCs to achieve operational efficiencies and improve bottom-line expectations. While there are vetted analytical tools available to track physician productivity, there is a significant paucity of analytical instruments described in the literature to adequately track clinical and financial productivity of physician assistants (PAs) and nurse practitioners (NPs) employed at AMCs. Moreover, there is no general guidance on the development of a dashboard to track PA/NP clinical and financial productivity at the individual, department, or enterprise level. At our institution, there was insufficient tracking of PA/NP productivity across many clinical areas within the enterprise. Thus, the aim of the project is to leverage our institution’s existing visualization tools coupled with the right analytics to track PA/NP productivity trends using a dashboard report.MethodsWe created an intuitive and customizable highly visual clinical/financial analytical dashboard to track productivity of PAs/NPs employed at our AMC.ResultsThe APP financial and clinical dashboard is organized into two main components. The volume-based key performance indicators (KPIs) included work relative value units (wRVUs), gross charges, collections (payments), and payer-mix. The session utilization (KPIs) included (e.g., new versus return patient ratios, encounter type, visit volume, and visits per session by provider). After successful piloting, the dashboard was deployed across multiple specialty areas and results showed improved data transparency and reliable tracking of PAs/NPs productivity across the enterprise. The dashboard analytics were also helpful in assessing PA/NP recruitment requests, independent practice sessions, and performance expectations.ConclusionTo our knowledge, this is the first paper to highlight steps AMCs can take in developing, validating, and deploying a financial/clinical dashboard specific to PAs/NPs. However, empirical research is needed to assess the impact of qualitative and quantitative dashboards on provider engagement, revenue, and quality of care.
Role of matrix metalloprotease-2 and MMP-9 in experimental lung fibrosis in mice
Authors: Bormann Tina , Maus Regina , Stolper Jennifer , Tort Tarrés Meritxell , Brandenberger Christina , Wedekind Dirk , Jonigk Danny , Welte Tobias , Gauldie Jack , Kolb Martin , Maus Ulrich A. 
Published: July 2022

Abstract
Background
Idiopathic pulmonary fibrosis (IPF) is a diffuse parenchymal lung disease characterized by exuberant deposition of extracellular matrix (ECM) proteins in the lung interstitium, which contributes to substantial morbidity and mortality in IPF patients. Matrix metalloproteinases (MMPs) are a large family of zinc-dependent endopeptidases, many of which have been implicated in the regulation of ECM degradation in lung fibrosis. However, the roles of MMP-2 and -9 (also termed gelatinases A and B) have not yet been explored in lung fibrosis in detail.

Methods
AdTGF-β1 was applied via orotracheal routes to the lungs of WT, MMP-2 KO, MMP-9 KO and MMP-2/-9 dKO mice on day 0 to induce lung fibrosis. Using hydroxyproline assay, FlexiVent based lung function measurement, histopathology, western blot and ELISA techniques, we analyzed MMP-2 and MMP-9 levels in BAL fluid and lung, collagen contents in lung and lung function in mice on day 14 and 21 post-treatment.

Result
IPF lung homogenates exhibited significantly increased levels of MMP-2 and MMP-9, relative to disease controls. Enzymatically active MMP-2 and MMP-9 was increased in lungs of mice exposed to adenoviral TGF-β1, suggesting a role for these metalloproteinases in lung fibrogenesis. However, we found that neither MMP-2 or MMP-9 nor combined MMP-2/-9 deletion had any effect on experimental lung fibrosis in mice.

Conclusion
Together, our data strongly suggest that both gelatinases MMP-2 and MMP-9 play only a subordinate role in experimental lung fibrosis in mice.
Mannose-binding lectin does not explain the dismal prognosis after an acute coronary event in dysglycaemic patients. A report from the GAMI cohort
Authors: Meziani Sara , Ferrannini Giulia , Bjerre Mette , Hansen Troels K. , Ritsinger Viveca , Norhammar Anna , Gyberg Viveca , Näsman Per , Rydén Lars , Mellbin Linda G. 
Published: July 2022

Abstract
Background
Mannose binding lectin (MBL) has been suggested to be associated with an impaired cardiovascular prognosis in dysglycaemic conditions, but results are still contrasting.
Our aims are (i) to examine whether MBL levels differ between patients with an acute myocardial infarction (MI) and healthy controls and between subgroups with different glucose tolerance status, and (ii) to investigate the relation between MBL and future cardiovascular events.

Methods
MBL levels were assessed at discharge and after 3 months in 161 AMI patients without any previously known glucose perturbations and in 183 age- and gender-matched controls from the Glucose metabolism in patients with Acute Myocardial Infarction (GAMI) study. Participants were classified as having dysglycaemia, i.e. type 2 diabetes or impaired glucose tolerance, or not by an oral glucose tolerance test. The primary outcome was a composite of cardiovascular events comprising cardiovascular death, AMI, stroke or severe heart failure during 11 years of follow-up. Total and cardiovascular mortality served as secondary outcomes.

Results
At hospital discharge patients had higher MBL levels (median 1246 μg/L) than three months later (median 575 μg/L; p < 0.01), the latter did not significantly differ from those in the controls (801 μg/L; p = 0.47). MBL levels were not affected by dysglycaemia either in patients or controls. Independent of glycaemic state, increasing MBL levels did not predict any of the studied outcomes in patients. In unadjusted analyses increasing MBL levels predicted cardiovascular events (hazard ratio HR: 1.67, 95% confidence interval CI 1.06–2.64) and total mortality (HR 1.53, 95% CI 1.12–2.10) in the control group. However, this did not remain in adjusted analyses.

Conclusions
Patients had higher MBL levels than controls during the hospital phase of AMI, supporting the assumption that elevated MBL reflects acute stress. MBL was not found to be independently associated with cardiovascular prognosis in patients with AMI regardless of glucose state.
Triglyceride-glucose index linked to all-cause mortality in critically ill patients: a cohort of 3026 patients
Authors: Liao Ying , Zhang Rongting , Shi Shanshan , Zhao Yukun , He Yibo , Liao Lihua , Lin Xueqin , Guo Qian , Wang Yani , Chen Liling , Li Weiguo , Li Shihai , Chen Kaihong , Fang Yong 
Published: July 2022

Abstract
Background
Triglyceride-glucose (TyG) index as a reliable surrogate of insulin resistance (IR) has been shown to be related to adverse clinical outcomes in patients with acute coronary syndrome, heart failure, ischemic stroke and so on. However, the relationship between TyG index and all-cause mortality in intensive care unit (ICU) patients remains unknown. The purpose of this study was to investigate the correlation between TyG index and all-cause mortality to evaluate the impact of IR on the prognosis of this population.

Methods
This was a retrospective observational study that included 3026 patients who had an initial triglyceride and glucose data on the first day of ICU admission, and all data were extracted from the Medical Information Mart for Intensive Care III (MIMIC-III) database. These patients were grouped into quartiles (Q1–Q4) according to TyG index. The Kaplan–Meier analysis was used to compare all-cause mortality among the above four groups. Cox proportional hazards analyses were performed to examine the association between TyG index and all-cause mortality.

Results
During 10.46 years of follow-up, 1148 (37.9%) patients died, of which 350 (11.6%) occurred during the hospital stay and 258 (8.5%) occurred during the ICU stay. Kaplan–Meier analysis showed that the risk of all-cause mortality was significantly higher in patients with higher TyG index (log-rank P = 0.021). Multivariable Cox proportional hazards analyses showed that the TyG index was an independent risk predictor of ICU death (HR: 1.72, 95% CI 1.18–2.52, P = 0.005) and hospital death (HR: 2.19, 95% CI 1.59–3.03, P < 0.001), and each 1-unit increased in the TyG index, a 1.19-fold increase in the risk of death during the hospital stay.

Conclusions
TyG index is strongly related to the all-cause mortality increasing in critically ill patients. This finding indicates that the TyG index might be useful in identifying people at high risk of ICU death and hospital death.
“Raising the curtain on the equality theatre”: a study of recruitment to first healthcare job post-qualification in the UK National Health Service
Authors: Hammond John , Davies Nigel , Morrow Elizabeth , Ross Fiona , Vandrevala Tushna , Harris Ruth 
Published: July 2022

AbstractBackgroundUK equality law and National Health Service (NHS) policy requires racial equality in job appointments and career opportunities. However, recent national workforce race equality standard (WRES) data show that nearly all NHS organisations in the UK are failing to appoint ethnically diverse candidates with equivalent training and qualifications as their white counterparts. This is problematic because workforce diversity is associated with improved patient outcomes and other benefits for staff and organisations.AimTo better understand the reasons behind underrepresentation of ethnically diverse candidates in first NHS healthcare jobs post-qualification and to identify any structural or systemic barriers to employment for such groups.MethodsThe study was informed by critical theory and the authors’ interdisciplinary perspectives as educators and researchers in the healthcare professions. Data collected from semi-structured face-to-face interviews with 12 nurse and physiotherapy recruiting managers from two NHS trusts in London were analysed using a healthcare workforce equity and diversity conceptual lens we developed from the literature. Using this lens, we devised questions to examine six dimensions of equity and diversity in the interview data from recruiting managers.ResultsRecruiting managers said they valued the benefits of an ethnically diverse workforce for patients and their unit/organisation. However, their adherence to organisational policies for recruitment and selection, which emphasise objectivity and standardisation, acted as constraints to recognising ethnicity as an important issue in recruitment and workforce diversity. Some recruiting managers sense that there are barriers for ethnically diverse candidates but lacked information about workforce diversity, systems for monitoring recruitment, or ways to engage with staff or candidates to talk about these issues. Without this information there was no apparent problem or reason to try alternative approaches.ConclusionThese accounts from 12 recruiting managers give a ‘backstage’ view into the reasons behind ethnic inequalities in recruitment to first healthcare job in the UK NHS. Adherence to recruitment and selection policies, which aim to support equality through standardisation and anonymisation, appear to be limiting workforce diversity and creating barriers for ethnically diverse candidates to attain the jobs that they are trained and qualified for. The Healthcare Workforce Equity + Diversity Lens we have developed can help to ‘raise the curtain on the equality theatre’ and inform more inclusive approaches to recruitment such as contextualised recruitment or effective allyship between employers and universities.
Accessing Antenatal Care (ANC) services during the COVID-19 first wave: insights into decision-making in rural India
Authors: Bankar Shweta , Ghosh Deepika 
Published: July 2022

Abstract
Background
Antenatal care (ANC) services are a prime focus of the Government of India's National Health Mission (NHM), of which a key pillar is the promotion of maternal and child health. To ensure uninterrupted service delivery at the last mile, a cadre of Frontline Health Workers (FLHWs) has been appointed and health centres established at the village level. However, the onset of the COVID-19 pandemic and the nationwide lockdown from late March to June 2020 impacted pregnant women's access to institutional antenatal care services.

Methods
Using a qualitative research design, data was collected through 12 in-depth interviews (IDIs) with pregnant women and 17 IDIs with frontline health workers in the selected six districts under study. The narratives were analysed using inductive coding in Atlas.ti.

Results
During the first wave of the COVID-19 pandemic, pregnant women, most of whom belonged to poor and marginalised groups, were left with limited access to health centres and FLHWs. Respondents from the study areas of rural Jharkhand, Madhya Pradesh and Uttar Pradesh extensively reported concerns stemming from the lockdown that influenced their decision to access ANC services. These included anxieties around meeting their families' daily needs due to a loss of livelihood (in particular, abject food insecurity), inability to access healthcare, and a sense of mistrust in public health systems and functionaries. All of these, coupled with the real threat to health posed by COVID-19, disrupted their plans for pregnancy and delivery, further compunding the risk to their health and wellbeing.

Conclusion
This study identified several social, behavioural and structural facets of the communities that contributed to the confusion, anxiety and helplessness experienced during the COVID-19 first wave by both groups, viz. pregnant women and FLHWs. In planning and implementing initiaves to ensure the delivery and uptake of ANC services in this and similar contexts during times of crisis, these facets must be considered.
Disrespect and abuse during labour and birth amongst 12,239 women in the Netherlands: a national survey
Authors: van der Pijl Marit S. G. , Verhoeven Corine J. M. , Verweij Rachel , van der Linden Tineke , Kingma Elselijn , Hollander Martine H. , de Jonge Ank 
Published: July 2022

AbstractBackgroundWomen experience disrespect and abuse during labour and birth all over the world. While the gravity of many forms of disrespect and abuse is evident, some of its more subtle forms may not always be experienced as upsetting by women. This study examines (1) how often women experience disrespect and abuse during labour and birth in the Netherlands and (2) how frequently they consider such experiences upsetting. We also examine (3) which respondent characteristics (age, ethnicity, educational level and parity) are associated with those experiences of disrespect and abuse that are upsetting, and (4) the associations between upsetting experiences of disrespect and abuse, and women’s labour and birth experiences.MethodsWomen who gave birth up to five years ago were recruited through social media platforms to participate in an online survey. The survey consisted of 37 questions about experiences of disrespect and abuse divided into seven categories, dichotomised in (1) not experienced, or experienced but not considered upsetting (2) experienced and considered upsetting. A multivariable logistic regression analysis was performed to examine associated characteristics with upsetting experiences of disrespect and abuse. A Chi-square test was used to investigate the association between upsetting experiences of disrespect and abuse and overall birth experience.Results13,359 respondents started the questionnaire, of whom 12,239 met the inclusion and exclusion criteria. Disrespect and abuse in terms of ‘lack of choices’ (39.8%) was reported most, followed by ‘lack of communication’ (29.9%), ‘lack of support’ (21.3%) and ‘harsh or rough treatment/physical violence’ (21.1%). Large variation was found in how frequently certain types of disrespect and abuse were considered upsetting, with 36.3% of women experiencing at least one situation of disrespect and abuse as upsetting. Primiparity and a migrant background were risk factors for experiencing upsetting disrespect and abuse in all categories. Experiencing more categories of upsetting disrespect and abuse was found to be associated with a more negative birth experience.ConclusionsDisrespectful and abusive experiences during labour and birth are reported regularly in the Netherlands, and are often (but not always) experienced as upsetting. This emphasizes an urgent need to implement respectful maternity care, even in high income countries.
Axenfeld–Rieger syndrome: orthopedic and orthodontic management in a pediatric patient: a case report
Authors: Cazzolla Angela Pia , Testa Nunzio Francesco , Spirito Francesca , Di Cosola Michele , Campobasso Alessandra , Crincoli Vito , Ballini Andrea , Cantore Stefania , Ciavarella Domenico , Lo Muzio Lorenzo , Dioguardi Mario 
Published: July 2022

AbstractAxenfeld–Rieger Syndrome (ARS) is a rare autosomal dominant genetic disease with considerable expressive variability, characterized by ocular and non-ocular manifestations, cardiovascular, mild craniofacial abnormalities and dental malformations. Current data report an incidence of Xenfeld-Rieger syndrome in the population of 1: 200,000.The case described is that of a 14-year-old female patient whose ARS is suspected and investigated following a dental specialist visit for orthodontic reasons, acquired the patient’s family and clinical data following a medical approach multidisciplinary, we proceed to the orthodontic involved the use of the Rapid Palatal Expander (RPE) and a fixed orthodontic treatment.The aim of this study is to report the case of the orthopaedic and orthodontic treatment in a patient affected by ARS and with facial dysmorphism and teeth anomalies associated to ocular anomalies.
Cord blood antimicrobial peptide LL37 levels in preterm neonates and association with preterm complications
Authors: Ren Zhuxiao , Mo Wenhui , Yang Liling , Wang Jianlan , Zhang Qi , Zhong Zhicheng , Wei Wei , Liu Zhipeng , Wu Zhiping , Yao Yao , Yang Jie 
Published: July 2022

Abstract
Background
Cathelicidin/LL-37 plays a significant role in the human immune defense reaction. Preterm human immature organs being exposed to inflammation-induced injury was the critical denominator leading to the common preterm associated complications. Previous study showed LL37 concentration in preterm neonates was lower in tracheal aspirates and breast milk as compared to term infants. An adults study showed decreased LL-37 levels was a risk factor for patients in developing severe chronic obstructive pulmonary disease (COPD). However, little is known about the regulation of human cord blood LL37 in preterm neonates and the association with preterm complications. This study was designed to investigate the concentration of LL37 in cord blood of preterm infants and correlation with preterm complications.

Methods
Singleton infants born in June 2017 to August 2021 in the study hospital were enrolled. Maternal and neonatal clinical characteristics were collected. LL37 levels, pro-inflammatory factor interleukin-6 (IL-6) and tumor necrosis factor-a (TNF-a) in cord blood and LL37 levels in serum 48–72 hours after birth were measured by enzyme-linked immunosorbent assay. The serum level of LL37 in preterm and term neonates were compared, the perinatal factors possibly affecting the LL37 levels were investigated and the relationship between LL37 level and preterm outcomes were analyzed.

Results
Cord blood LL37 levels in preterm infants were lower than that in term neonates. Cord blood LL37 level was positively correlated with gestational age in preterm. Prenatal steroid administration in preterm neonates decreased cord blood LL37 level. LL37 level was obviously lower in patients with bronchopulmonary dysplasia (BPD). Multiple line regression analysis showed higher LL37 level in cord blood was an independent protective factor for BPD. The concentration of pro-inflammatory factor IL-6 was negatively correlated with LL37.

Conclusion
Cord blood LL37 levels increased during gestation and decreased after perinatal steroid usage. Very preterm infants who displayed higher cord blood LL37 level had reduced risk of developing BPD. Regulation of pro-inflammatory cytokine IL-6 may be associated with the protective effect of LL37 on BPD.
The global prevalence of autism spectrum disorder: a comprehensive systematic review and meta-analysis
Authors: Salari Nader , Rasoulpoor Shabnam , Rasoulpoor Shna , Shohaimi Shamarina , Jafarpour Sima , Abdoli Nasrin , Khaledi-Paveh Behnam , Mohammadi Masoud 
Published: July 2022

Abstract
Background
Autism spectrum disorder (ASD) is one of the serious developmental disorders that is usually diagnosed below the age of three years. Although the severity of the disease’s symptoms varies from patient to patient, the ability to communicate with others is affected in all forms of ASD. This study aimed to determine the prevalence of ASD in high-risk groups by continent.

Methods
The present study was conducted by systematic review and meta-analysis from 2008 to July 2021. Databases such as Science Direct, PubMed, Scopus, SID, Magiran, Web of Science (WoS), and Google Scholar from 2008 to July 2021 were searched to find related studies. Data were analysed using Comprehensive Meta-Analysis software (Version 2).

Results
A total of 74 studies with 30,212,757 participants were included in this study. The prevalence of ASD in the world was 0.6% (95% confidence interval: 0.4–1%). Subgroup analyses indicated that the prevalence of ASD in Asia, America, Europe, Africa and Australia was 0.4% (95% CI: 0.1–1), 1% (95% CI: 0.8–1.1), 0.5% (95% CI: 0.2–1), 1% (95% CI: 0.3–3.1), 1.7% (95% CI: 0.5–6.1) respectively.

Conclusion
ASD imposes a heavy health burden on communities around the world. Early detection of ASD can reduce the incidence of developmental disorders and improve patients’ communication skills. Therefore, health policymakers need to be aware of the prevalence and increasing trend of ASD to implement appropriate planning and interventions to reduce its consequences.