bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opioid prescribing in general practice: an Australian cross-sectional survey
Authors: Reid Sharon , Day Carolyn , White Natalie , Harrison Christopher , Haber Paul , Bayram Clare 
Published: July 2022

Abstract
Background
Prescribed opioid doses > 100 mg oral morphine equivalent (OME) and/or co-prescribing of sedating psychoactive medications increase the risk of unintentional fatal overdose. We describe general practice encounters where opioids are prescribed and examine high-risk opioid prescribing.

Methods
The 2006–2016 BEACH study data, a rolling national cross-sectional survey of randomly selected GPs, was analysed.

Results
Opioid prescribing increased 2006–2007 to 2015–2016, however, this plateaued across the latter half-decade. From 2012–2016 3,897 GPs recorded 389,700 encounters and at least one opioid was prescribed at 5.2%. Opioid encounters more likely involved males, those 45–64 years, concession card holders and the socioeconomically disadvantaged. GPs more likely to prescribe opioids were 55 years or older, male, Australian graduates, and in regional and remote areas. The most common problems managed with opioids involved chronic non-cancer pain. One-in-ten opioid prescribing episodes involved high-risk doses and 11% involved co-prescription of sedating psychoactive medications. Over one-third of GPs provided other (non-pharmacological) interventions at encounters with opioid prescriptions.

Conclusions
Only 5% of GP encounters involved an opioid prescription. Of concern, were: prescribing for chronic non-cancer pain, potentially high-risk opioid encounters where > 100 OME daily dose was prescribed, and/or there was co-prescription of sedating psychoactive medication. However, approximately one-in-three opioid prescribing encounters involved non-pharmacological interventions.
Interleukin-8 produced from cancer-associated fibroblasts suppresses proliferation of the OCUCh-LM1 cancer cell line
Authors: Tanaka Ryota , Kimura Kenjiro , Eguchi Shimpei , Ohira Go , Tanaka Shogo , Amano Ryosuke , Tanaka Hiroaki , Yashiro Masakazu , Ohira Masaichi , Kubo Shoji 
Published: July 2022

Abstract
Background
Cancer-associated fibroblasts (CAFs) play an important role in cancer growth by interacting with cancer cells, but their effects differ depending on the type of cancer. This study investigated the role of CAFs in biliary tract cancers (BTCs), compared with pancreatic ductal adenocarcinoma (PDAC) as a comparison cohort.

Methods
We retrospectively evaluated alpha-smooth muscle actin (αSMA) expression in CAFs from 114 cases of PDAC and 154 cases of BTCs who underwent surgical treatment at our institution from 1996 to 2017. CAFs were isolated from resected specimens of BTC and PDAC, and tested for the effects of their supernatants and cytokines on cancer cell proliferation.

Results
PDAC patients with positive αSMA expression showed significantly shorter overall survival and recurrence-free survival than αSMA-negative patients (p = 0.003, p = 0.009, respectively). BTC patients with positive αSMA expression showed better recurrence-free survival than αSMA-negative patients (p = 0.03). CAF-conditioned medium suppressed the proliferation of cancer cells for only OCUCh-LM1 cells and not PDAC cells. Blockage of Interleukin-8 (IL-8) or its receptor C-X-C motif chemokine receptor 2 (CXCR2) by antibodies canceled the suppressive effect of the IL-8.

Conclusions
CAFs are a good prognostic factor in BTC, but not for PDAC. Moreover, CAF-produced Interleukin-8 suppresses the proliferation of OCUCh-LM1 cell lines.
Enhanced magnetic resonance imaging manifestations of paediatric intervertebral disc calcification combined with ossification of the posterior longitudinal ligament: case report and literature review
Authors: Chang Cancan , Zhu Juan , Li Hongyi , Yang Qing 
Published: July 2022

Abstract
Background
Since the first description of paediatric intervertebral disc calcification (IDC) by Báron in 1924, only approximately 400 cases have been reported in the literature. Paediatric IDC combined with ossification of the posterior longitudinal ligament (OPLL) is an even rarer condition, with only 8 cases described in detail to date. In this paper, we present a review of the disease characteristics described in the relevant English language literature and discuss the possible mechanisms of lesion enhancement in contrast-enhanced magnetic resonance imaging (MRI).

Case presentation
In May 2020, a 6-year-old Han nationality girl presented with the chief complaint of neck pain that had lasted for a week. She did not report a history of trauma or a past illness. On admission, there was no personal and family history, congenital diseases, or non-specific infections such as tuberculosis, among others. Further physical examination revealed that the movement of her cervical spine was limited. Computed tomography (CT) and MRI revealed ossification of the intervertebral discs and posterior longitudinal ligament (PLL) at the C4/5 levels and an absence of obvious spinal cord compression. When contrast-enhanced MRI was performed, significant enhancement was observed in the intervertebral discs and PLL at the C4/5 level. We adopted a non-interventional approach and performed an imaging re-examination 8 months later. Both the plain and contrast-enhanced MRI scans indicated swelling in the C4/5 intervertebral discs and disappearance of the previously observed enhancement in the nucleus pulposus (NP) and PLL at the corresponding levels; CT examination revealed that the ossified lesions had been completely resorbed.

Conclusion
Obvious lesion enhancement in contrast-enhanced MRI is an extremely rare manifestation of paediatric IDC combined with OPLL. However, the exact mechanisms of this phenomenon remain unclear. We surmise that it may be caused by a series of biophysical changes related to vertebral endplate injury and repair, but further research will be required for in-depth investigation.
Unemployment, homelessness, and other societal outcomes in patients with schizophrenia: a real-world retrospective cohort study of the United States Veterans Health Administration database
Authors: Lin Dee , Kim Hyunchung , Wada Keiko , Aboumrad Maya , Powell Ethan , Zwain Gabrielle , Benson Carmela , Near Aimee M. 
Published: July 2022

Abstract
Background
The burden associated with schizophrenia is substantial. Impacts on the individual, healthcare system, and society may be particularly striking within the veteran population due to the presence of physical and mental health comorbidities. Disease burden is also influenced by a complex interplay between social determinants of health and health disparities. The objective of the current study was to compare non-healthcare societal outcomes between veterans with and without schizophrenia in the United States Veterans Health Administration (VHA).

Methods
A retrospective cohort study was conducted using the VHA database (01/2013–09/2019; study period). Veterans with schizophrenia (≥2 diagnoses of ICD-9295.xx, ICD-10 F20.x, F21, and/or F25.x during the study period) were identified; the index date was the earliest observed schizophrenia diagnosis. Veterans with schizophrenia were propensity score-matched to those without schizophrenia using baseline characteristics. A 12-month baseline and variable follow-up period were applied. The frequency of unemployment, divorce, incarceration, premature death, and homelessness were compared between the matched cohorts using standardized mean difference (SMD). Risk of unemployment and homelessness were estimated using logistic regression models.

Results
A total of 102,207 veterans remained in each cohort after matching (91% male; 61% White [per AMA]; median age, 59 years). Among veterans with schizophrenia, 42% had a substance use disorder and 30% had mental health-related comorbidities, compared with 25 and 15%, respectively, of veterans without schizophrenia. Veterans with schizophrenia were more likely to experience unemployment (69% vs. 41%; SMD: 0.81), divorce (35% vs. 28%; SMD: 0.67), homelessness (28% vs. 7%; SMD: 0.57), incarceration (0.4% vs. 0.1%; SMD: 0.47), and premature death (14% vs. 12%; SMD < 0.1) than veterans without schizophrenia. After further adjustments, the risk of unemployment and of homelessness were 5.4 and 4.5 times higher among veterans with versus without schizophrenia. Other predictors of unemployment included Black [per AMA] race and history of substance use disorder; for homelessness, younger age (18–34 years) and history of mental health-related comorbidities were additional predictors.

Conclusion
A greater likelihood of adverse societal outcomes was observed among veterans with versus without schizophrenia. Given their elevated risk for unemployment and homelessness, veterans with schizophrenia should be a focus of targeted, multifactorial interventions to reduce disease burden.
Community prescribing trends and prevalence in the last year of life, for people who die from cancer
Authors: Mills Sarah E. E. , Buchanan Deans , Donnan Peter T. , Smith Blair H. 
Published: July 2022

Abstract
Background
People who die from cancer (‘cancer decedents’) may latterly experience unpleasant and distressing symptoms. Prescribing medication for pain and symptom control is essential for good-quality palliative care; however, such provision is variable, difficult to quantify and poorly characterised in current literature. This study aims to characterise trends in prescribing analgesia, non-analgesic palliative care medication and non-palliative medications, to cancer decedents, in their last year of life, and to assess any associations with demographic or clinical factors.

Methods
This descriptive study, analysed all 181,247 prescriptions issued to a study population of 2443 cancer decedents in Tayside, Scotland (2013–2015), in the last year of life, linking prescribing data to demographic, and cancer registry datasets using the unique patient-identifying Community Health Index (CHI) number. Anonymised linked data were analysed in Safe Haven using chi-squared test for trend, binary logistic regression and Poisson regression in SPSSv25.

Results
In their last year of life, three in four cancer decedents were prescribed strong opioids. Two-thirds of those prescribed opioids were also prescribed laxatives and/or anti-emetics. Only four in ten cancer decedents were prescribed all medications in the ‘Just in Case’ medication categories and only one in ten was prescribed breakthrough analgesia in the last year of life. The number of prescriptions for analgesia and palliative care drugs increased in the last 12 weeks of life. The number of prescriptions for non-palliative care medications, including anti-hypertensives, statins and bone protection, decreased over the last year, but was still substantial. Cancer decedents who were female, younger, or had lung cancer were more likely to be prescribed strong opioids; however, male cancer decedents had higher odds of being prescribed breakthrough analgesia. Cancer decedents who had late diagnoses had lower odds of being prescribed strong opioids.

Conclusions
A substantial proportion of cancer decedents were not prescribed strong opioids, breakthrough medication, or medication to alleviate common palliative care symptoms (including ‘Just in Case’ medication). Many patients continued to be prescribed non-palliative care medications in their last days and weeks of life. Age, gender, cancer type and timing of diagnosis affected patients’ odds of being prescribed analgesic and non-analgesic palliative care medication.
Using community-engaged methods to develop a study protocol for a cost analysis of a multi-site patient navigation intervention for breast cancer care
Authors: Rajabiun Serena , Xiao Victoria , Bak Sharon , Robbins Charlotte , Casanova Nicole , Cabral Howard J. , Lemon Stephenie C. , Haas Jennifer S. , Freund Karen M. , Battaglia Tracy ,   TRIP Consortium, James Ted A. , Ohrenberger Ellen , Ross Jo Ellen , Magrini Leo , Gershman Susan T. , Kennedy Mark , Levine Anne , Warner Erica T. , Clark Cheryl R. , Adams William G. , Bak Sharon , Battaglia Tracy A. , Debrito Janice , Finn Katie , Gunn Christine , Hernandez Jackeline , Ko Naomi Y. , Maschke Ariel , Mullikin Katelyn , Robbins Charlotte , Shanahan Christopher W. , Xiao Victoria , Cabral Howard J. , Chen Clara , Finney Carolyn , Lloyd-Travaglini Christine , Contreras Magnolia , Loo Stephanie , Freedman Rachel A. , White Karen Burns , Murphy Anne Marie , Moy Beverly , Haas Jennifer S. , Marotta Caylin , Oravcova-Mejia Mira , Percac-Lima Sanja , Wint Amy J. , Freund Karen M. , Harvey William F. , LeClair Amy M. , Parsons Susan K. , Tsering Dolma , Wang Feng Qing , Rajabiun Serena , Lemon Stephenie C. 
Published: July 2022

AbstractBackgroundPatient navigation is an evidence-based intervention for reducing delays in oncology care among underserved populations. In order to address the financial sustainability of this intervention, information is needed on the cost of implementing patient navigation in diverse healthcare settings. Because patient navigation programs and care settings are highly variable, this paucity of cost data creates difficulties in identifying best practices and decisions about the feasibility of implementing navigation programs within a health care system. One barrier to collecting these cost data is the lack of assessment tools available to support patient navigation programs. These tools must be relevant to the wide variety of navigation activities that exist in health care settings, and be flexible enough to collect cost data important to stakeholders in fee-for-service and value-based care environments.Methods and resultsWe present a novel approach and methods for assessing the cost of a patient navigation program implemented across six hospital systems to enhance timely entry and uptake of breast cancer care and treatment. These methods and tools were developed in partnership with breast oncology patient navigators and supervisors using principles of stakeholder engagement, with the goal of increasing usability and feasibility in the field.ConclusionsThis methodology can be used to strengthen cost analysis and assessment tools for other navigation programs for improving care and treatment for patients with chronic conditions.Trial registrationNCT03514433
Global core indicators for measuring WHO’s paediatric quality-of-care standards in health facilities: development and expert consensus
Authors: Muzigaba Moise , Chitashvili Tamar , Choudhury Allysha , Were Wilson M. , Diaz Theresa , Strong Kathleen L. , Jackson Debra , Requejo Jennifer , Detjen Anne , Sacks Emma 
Published: July 2022

Abstract
Background
There are currently no global recommendations on a parsimonious and robust set of indicators that can be measured routinely or periodically to monitor quality of hospital care for children and young adolescents. We describe a systematic methodology used to prioritize and define a core set of such indicators and their metadata for progress tracking, accountability, learning and improvement, at facility, (sub) national, national, and global levels.

Methods
We used a deductive methodology which involved the use of the World Health Organization Standards for improving the quality-of-care for children and young adolescents in health facilities as the organizing framework for indicator development. The entire process involved 9 complementary steps which included: a rapid literature review of available evidence, the application of a peer-reviewed systematic algorithm for indicator systematization and prioritization, and multiple iterative expert consultations to establish consensus on the proposed indicators and their metadata.

Results
We derived a robust set of 25 core indicators and their metadata, representing all 8 World Health Organization quality standards, 40 quality statements and 520 quality measures. Most of these indicators are process-related (64%) and 20% are outcome/impact indicators. A large proportion (84%) of indicators were proposed for measurement at both outpatient and inpatient levels. By virtue of being a parsimonious set and given the stringent criteria for prioritizing indicators with “quality measurement” attributes, the recommended set is not evenly distributed across the 8 quality standards.

Conclusions
To support ongoing global and national initiatives around paediatric quality-of-care programming at country level, the recommended indicators can be adopted using a tiered approach that considers indicator measurability in the short-, medium-, and long-terms, within the context of the country’s health information system readiness and maturity. However, there is a need for further research to assess the feasibility of implementing these indicators across contexts, and the need for their validation for global common reporting.
Factors affecting the healthcare utilization from Shasthyo Suroksha Karmasuchi scheme among the below-poverty-line population in one subdistrict in Bangladesh: a cross sectional study
Authors: Hasan Md. Zahid , Ahmed Mohammad Wahid , Mehdi Gazi Golam , Khan Jahangir A. M. , Islam Ziaul , Chowdhury Mahbub Elahi , Ahmed Sayem 
Published: July 2022

Abstract
Background
Financing healthcare through out-of-pocket (OOP) payment is a major barrier in accessing healthcare for the poor people. The Health Economics Unit (HEU) of the Ministry of Health and Family Welfare of the government of Bangladesh has developed Shasthyo Suroksha Karmasuchi (SSK), a health protection scheme, with the aim of reducing OOP expenditure and improving access of the below-poverty-line (BPL) population to healthcare. The scheme started piloting in 2016 at Kalihati sub-district of Tangail District. Our objective was to assess healthcare utilization by the enrolled BPL population and to identify the factors those influencing their utilization of the scheme.

Method
A cross-sectional household survey was conducted from July to September 2018 in the piloting sub-district. A total of 806 households were surveyed using a semi-structured questionnaire. Information on illness and sources of healthcare service were captured for the last 90 days before the survey. Multiple logistic regression models were applied to determine the factors related to utilization of healthcare from the SSK scheme and other medically trained providers (MTPs) by the SSK members for both inpatient and outpatient care.

Result
A total of 781 (24.6%) people reported of suffering from illness of which 639 (81.8%) sought healthcare from any sources. About 8.0% (51 out of 639) of them sought healthcare from SSK scheme and 28.2% from other MTPs within 90 days preceding the survey. Households with knowledge about SSK scheme were more likely to utilize healthcare from the scheme and less likely to utilize healthcare from other MTPs. Non-BPL status and suffering from an accident/injury were significantly positively associated with utilization of healthcare from SSK scheme.

Conclusion
Among the BPL population, healthcare utilization from the SSK scheme was very low compared to that of other MTPs. Effective strategies should be in place for improving knowledge of BPL population on SSK scheme and the benefits package of the scheme should be updated as per the need of the target population. Such initiative can be instrumental in increasing utilization of the scheme and ultimately will reduce the barriers of OOP payment among BPL population for accessing healthcare.
Uveitis associated with juvenile arthritis: a continued cohort study 40 years after uveitis onset
Authors: Skarin Angelika , Berthold Elisabet , Rauer Ola , Bengtsson-Stigmar Elisabeth 
Published: July 2022

AbstractBackgroundA third follow-up study, mean 40.7 years after uveitis onset, of a cohort originally consisting of 55 Swedish patients with uveitis associated with juvenile arthritis.MethodA retrospective study of the patients’ ophthalmic medical records. The results were compared to those of the same cohort previously studied at mean 7.2 and 24.0 years after uveitis onset. In the present follow-up study, 30 of the original 55 patients consented to participate. Of these, 26 had ophthalmic medical records that were reviewed.ResultsIn the 30 participants, active uveitis was seen in 43.4%, cataracts in 66.6% and glaucoma in 40.0%. When comparing data from previous follow-ups of the same cohort, a total of 61.8% were reported to have had cataracts at any of the three follow-ups, 29.0% had glaucoma or ocular hypertension and 12.7% had severe visual impairment in both eyes. At mean 40.7 years after uveitis onset 20% of patients in the original uveitis cohort were deceased. In 4 of the 11 deceased individuals, rheumatic disease was stated as the main cause of death, and in 3 it was considered a contributory factor in the patients deaths.ConclusionsUveitis associated with juvenile arthritis can be active into midlife and possibly longer. Ocular complications and visual loss increased up to 40 years after uveitis diagnosis. The mortality rate of this cohort was higher than that of a corresponding Swedish population. Lifelong ophthalmic check-ups are probably necessary for patients diagnosed with this type of uveitis.
Ovulation patterns affect the offspring sex ratios and change with the women’s age
Authors: Fukuda Misao , Fukuda Kiyomi , Mason Shawn , Tatsumi Kenichi , Shimizu Takashi , Akahori Taiichiro , Matsumoto Tsunekazu , Tahara Masahiro , Andersen Claus Yding 
Published: July 2022

Abstract
Background
The aim of this study was to evaluate whether women’s ages at conception and the ratio of male to female infants are associated with various ovulation patterns.

Methods
An observational clinical study was conducted in private OB/GYN clinics. Infertile women with regular menstrual cycles receiving intrauterine insemination (IUI) and/or in-vitro fertilization (IVF) had their ovulation patterns monitored in three consecutive spontaneous cycles receiving infertility treatment in the third cycle. Ovulation patterns were also observed in women with slight ovulation disorders during IUI and/or IVF in clomiphene citrate stimulated cycles. All the pregnant women’s ages at conception and their respective offspring sex ratios were compared to various ovulation patterns. Statistical evaluation was performed using ANOVA, unpaired t test, χ2 test or Fisher’s exact test, heterogeneity χ2 test, odds ratios at 95% confidence intervals and logistic regression.

Results
Contralateral ovulation (i.e. ovulation jumping from ovary to the other) was more often observed in relatively younger women, who showed a higher probability of having a boy than after ipsilateral ovulation. There was a significantly higher frequency of boys being conceived following three consecutive ovulations with a left–left–right (LLR) ovulation pattern, while three ovulations from the left ovary (LLL) were associated with a higher frequency of girls. We also found two consecutive menstrual cycles the left–right (LR) ovulation pattern showed a similar significant difference compared to the left-left (LL) ovulation. Both the infertile and infertile + fertile women groups showing right-sided ovulation, regardless of age, showed significantly higher offspring sex ratio compared to left-sided ovulation, which was not observed in the group of fertile women alone.

Conclusions
LLR, LR and contralateral ovulation happens more often in younger women and favors male offspring in infertile women. Right-sided ovulation favors male offspring in infertile and infertile + fertile women, which was not observed in the group of fertile women.