bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fear and the Safety Net: Evidence from Secure Communities
Authors: Alsan Marcella , Yang Crystal S. 
Published: September 2022

Abstract
We study the effects of Secure Communities, an immigration enforcement program that dramatically increased interior removals of Hispanic noncitizens from the United States, on participation in means-tested social insurance programs among co-ethnic citizens. Exploiting county-level variation in the roll-out of enforcement together with its ethnic specificity, we find that Hispanic-headed citizen households significantly reduced their participation in two large federal safety net programs. Our results are most consistent with network effects that propagate fear through minority communities rather than stigma or lack of benefit information.
Licensing Life-Saving Drugs for Developing Countries: Evidence from the Medicines Patent Pool
Authors: Galasso Alberto , Schankerman Mark 
Published: September 2022

Abstract
We study the effects of the Medicines Patent Pool (MPP)—an institution that pools patents across geographical markets—on the licensing and adoption of life-saving drugs in low- and middle-income countries. We show the presence of an immediate and large increase in licensing when a patent is included in the MPP. We also show evidence that the pool increases actual entry and volume of sales, but these impacts are much smaller than on licensing, which is due to the geographic bundling of licenses. The paper highlights the potential of pools in promoting diffusion of biomedical innovation in developing countries.
North Atlantic Tropical Cyclone Outer Size and Structure Remain Unchanged by the Late Twenty-First Century
Authors: Schenkel Benjamin A. , Chavas Daniel , Lin Ning , Knutson Thomas , Vecchi Gabriel , Brammer Alan 
Published: September 2022

Abstract
There is a lack of consensus on whether North Atlantic tropical cyclone (TC) outer size and structure (i.e., change in outer winds with increasing radius from the TC) will differ by the late twenty-first century. Hence, this work seeks to examine whether North Atlantic TC outer wind field size and structure will change by the late twenty-first century using multiple simulations under CMIP3 SRES A1B and CMIP5 RCP4.5 scenarios. Specifically, our analysis examines data from the GFDL High-Resolution Forecast-Oriented Low Ocean Resolution model (HiFLOR) and two versions of the GFDL hurricane model downscaling climate model output. Our results show that projected North Atlantic TC outer size and structure remain unchanged by the late twenty-first century within nearly all HiFLOR and GFDL hurricane model simulations. Moreover, no significant regional outer size differences exist in the North Atlantic within most HiFLOR and GFDL hurricane model simulations. No changes between the control and late-twenty-first-century simulations exist over the storm life cycle in nearly all simulations. For the simulation that shows significant decreases in TC outer size, the changes are attributed to reductions in storm lifetime and outer size growth rates. The absence of differences in outer size among most simulations is consistent with the process that controls the theoretical upper bound of storm size (i.e., Rhines scaling), which is thermodynamically invariant. However, the lack of complete consensus among simulations for many of these conclusions suggests nontrivial uncertainty in our results.
Pedagogical models: Can they make a difference to girls’ in-class physical activity?
Authors: Oliveros María , Fernandez-Rio Javier 
Published: September 2022

Background: Research has shown the positive connections between physical activity and health, and physical education has been shown to influence the motivation to participate in physical activities. Student-centred pedagogical models encouraging active learning may be capable of bringing about changes in girls’ physical activity. Objective: The aim of the study was to investigate whether a hybrid pedagogical model could make a difference to adolescent girls’ in-class physical activity levels. Design, setting and method: Sixty-six students aged 13–17 years participated in the study from two Year 9 and two Year 11 classes in three different high schools. All classes experienced the same 12-session hybrid sports education-tactical games learning unit. To objectively measure students’ physical activity, participants wore accelerometers. Results and conclusion: The overall results showed that students spent 39.74% of the class in moderate-to-vigorous physical activity (MVPA), but girls showed statistically significantly lower scores. While in the role of judge/referee (27.34% of the class), students showed significantly higher levels of sedentary physical activity. Finally, year 11 students showed higher MVPA than Year 9 students. In conclusion, hybrid pedagogical models, per se, may not help girls achieve MVPA scores similar to those of boys. Teachers need to identify the barriers and make necessary changes to achieve this goal. Some ideas for doing so are discussed in the paper.
Multimodal Intervention Assessing the Appropriateness of Acid Suppression Therapy is Associated With Reduced Prescriptions at the Time of Discharge for Hospitalized Inpatients
Authors: Zhang Jenny , Crossley Brian , Sun Alexander , Palchaudhuri Sonali , Pahwa Amit , O’Rourke Paul , Ahmed Nazeer , Pherson Emily 
Published: September 2022

Background: Acid suppression therapy (AST), including proton pump inhibitors and histamine 2 receptor antagonists, are an overused class of medications. When used inappropriately, AST leads to polypharmacy, increased healthcare costs, and possible negative health consequences. Objective: To assess whether an intervention including prescriber education combined with a pharmacist-driven protocol was effective in reducing the percentage of patients who were discharged with inappropriate AST. Methods: This was a prospective pre-post study of adult patients who were prescribed AST before or during their admission to an internal medicine teaching service. All internal medicine resident physicians received education on appropriate AST prescribing. During the 4-week intervention period, dedicated pharmacists assessed the appropriateness of AST and made recommendations regarding deprescribing if no appropriate indication was identified. Results: During the study period, there were 14 166 admissions during which patients were prescribed AST. Out of the 1143 admissions during the intervention period, appropriateness of AST was assessed by a pharmacist for 163 patients. AST was determined to be inappropriate for 52.8% (n = 86) of patients and discontinuation or de-escalate of therapy occurred in 79.1% (n = 68) of these cases. The percentage of patients discharged on AST decreased from 42.5% before the intervention to 39.9% after the intervention ( P = .007). Conclusion: This study suggests that a multimodal deprescribing intervention reduced prescriptions for AST without an appropriate indication at the time of discharge. To increase the efficiency of the pharmacist assessment several workflow improvements were identified. Further study is necessary to understand the long-term outcomes of this intervention.
Educational Leadership as Accompaniment: From Managing to Cultivating Youth Activism
Authors: Chang Ethan , Gamez Rebeca 
Published: September 2022

Background/Context: Youth activism, the broad-based leadership among young people who seek to challenge and build alternatives to oppressive social systems, has spread across the nation and globe. Yet youth activism is often hemmed in at school gates, particularly by school leaders charged with maintaining efficient school environments. Focus of Study: This article explores the roles and responsibilities of educational leaders committed to justice and asks: What does it mean to lead schools in times of (re)surgent youth activism? Research Design: To address this urgent question, we conducted an interdisciplinary review of youth participation in social movements that spans the fields of civic engagement, learning sciences, and social movement studies. Findings: We argue that youth activism offers profound sites of consequential learning, generative insights for organizational redesign, and imaginative visions for school and societal transformation. Based on these contributions, we offer the notion of educational leadership as accompaniment: a participatory praxis of leadership reflection and action that foregrounds an ethic of listening, attends to dominant forms of exclusion, and stands in solidarity with youth and their struggles for a more dignified and just world. Conclusions/Recommendations: Leadership as accompaniment challenges the deeply rooted managerial imperative in school administration scholarship and deepens opportunities for realizing existing leadership principles, such as those evident in the Professional Standards for Educational Leaders (PSEL). We conclude by discussing the social and material risks impacting those who exercise leadership as accompaniment, and consider what responsibilities such risks demand of education researchers.
A nomogram to predict nosocomial infection in patients on venoarterial extracorporeal membrane oxygenation after cardiac surgery
Authors: Li Xiyuan , Wang Liangshan , Li Chenglong , Wang Xiaomeng , Hao Xing , Du Zhongtao , Xie Haixiu , Yang Feng , Wang Hong , Hou Xiaotong 
Published: September 2022

Introduction After cardiac surgery, patients on venoarterial extracorporeal membrane oxygenation (VA-ECMO) have a higher risk of nosocomial infection in the intensive care unit (ICU). We aimed to establish an intuitive nomogram to predict the probability of nosocomial infection in patients on VA-ECMO after cardiac surgery. Methods We included patients on VA-ECMO after cardiac surgery between January 2011 and December 2020 at a single center. We developed a nomogram based on independent predictors identified using univariate and multivariate logistic regression analyses. We selected the optimal model and assessed its performance through internal validation and decision-curve analyses. Results Overall, 503 patients were included; 363 and 140 patients were randomly divided into development and validation sets, respectively. Independent predictors derived from the development set to predict nosocomial infection included older age, white blood cell (WBC) count abnormality, ECMO environment in the ICU, and mechanical ventilation (MV) duration, which were entered into the model to create the nomogram. The model showed good discrimination, with areas under the curve (95% confidence interval) of 0.743 (0.692–0.794) in the development set and 0.732 (0.643–0.820) in the validation set. The optimal cutoff probability of the model was 0.457 in the development set (sensitivity, 0.683; specificity, 0.719). The model showed qualified calibration in both the development and validation sets (Hosmer–Lemeshow test, p > .05). The threshold probabilities ranged from 0.20 to 0.70. Conclusions For adult patients receiving VA-ECMO treatment after cardiac surgery, a nomogram-monitoring tool could be used in clinical practice to identify patients with high-risk nosocomial infections and provide an early warning.
Factors associated with hospitalisations of patients with chronic heart failure approaching the end of life: A systematic review
Authors: Zehnder Aina R , Pedrosa Carrasco Anna J , Etkind Simon N 
Published: September 2022

Background: Heart failure has high mortality and is linked to substantial burden for patients, carers and health care systems. Patients with chronic heart failure frequently experience recurrent hospitalisations peaking at the end of life, but most prefer to avoid hospital. The drivers of hospitalisations are not well understood. Aim: We aimed to synthesise the evidence on factors associated with all-cause and heart failure hospitalisations of patients with advanced chronic heart failure. Design: Systematic review of studies quantitatively evaluating factors associated with all-cause or heart failure hospitalisations in adult patients with advanced chronic heart failure. Data sources: Five electronic databases were searched from inception to September 2020. Additionally, searches for grey literature, citation searching and hand-searching were performed. We assessed the quality of individual studies using the QualSyst tool. Strength of evidence was determined weighing number, quality and consistency of studies. Findings are reported narratively as pooling was not deemed feasible. Results: In 54 articles, 68 individual, illness-level, service-level and environmental factors were identified. We found high/moderate strength evidence for specialist palliative or hospice care being associated with reduced risk of all-cause and heart failure hospitalisations, respectively. Based on high strength evidence, we further identified black/non-white ethnicity as a risk factor for all-cause hospitalisations. Conclusion: Efforts to integrate hospice and specialist palliative services into care may reduce avoidable hospitalisations in advanced heart failure. Inequalities in end-of-life care in terms of race/ethnicity should be addressed. Further research should investigate the causality of the relationships identified here.
Ultrasonographic and strain elastographic features of epidermal cyst according to body location
Authors: Ahn Do Yeon , Park Hee Jin , Kim Ji Na , Kim Myung Sub , Kang Chang Ho 
Published: September 2022

Background There are not many studies on the differences of ultrasound (US) findings between epidermal cysts (ECs) located in the trunk and those in the extremities. Purpose To compare the sonographic findings of ECs according to location in the body (trunk vs. extremity) and evaluated the feasibility of strain elastography (SE). Material and Methods This is a retrospective study of 76 patients with surgically confirmed non-ruptured EC who underwent US including SE. The US analyses included size, shape, ratio of depth to length (DLR), involvement of more than half the dermis, “submarine sign,” and SE characters of each lesion. SE findings were assigned into four grades based on elasticity. Results The submarine sign was more significantly observed in ECs located in the trunk versus extremities ( P value = 0.004 and 0.035, respectively). Truncal lesions were significantly more likely to possess an ovoid shape ( P < 0.05) and exhibited higher DLR ( P < 0.05). There were more cases with low elasticity according to SE (grade 3 or 4) compared to high elasticity (grade 1 or 2). However, we did not observe significant differences between the two locations ( P > 0.05). More-than-half signs also did not exhibit a significant difference ( P > 0.05). Conclusion The submarine sign, ovoid shape, and tall lesions (higher DLR) are common in the trunk. However, the degree of elasticity and number of more-than-half signs did not differ between the two groups.
Fibrinogen like protein-1 knockdown suppresses the proliferation and metastasis of TU-686 cells and sensitizes laryngeal cancer to LAG-3 blockade
Authors: Huang Jiameng , Huang Qiang , Xue Jiyao , Liu Huiqin , Guo Yang , Chen Hui , Zhou Liang 
Published: September 2022

Objective To detect the expression of fibrinogen like protein-1 (FGL-1) in laryngeal cancer and evaluate its effect on tumor proliferation, metastasis, and antitumor immunity. Methods ELISA and immunohistochemistry were performed to detect FGL-1 expression in laryngeal cancer. The effects of FGL-1 knockdown on the proliferation, cell cycle progression, apoptosis, migration, and invasion of laryngeal cancer cells were evaluated by the CCK-8, colony formation, flow cytometry, Transwell migration, and western blot assays. We detected changes in tumorigenesis and drug response in vivo following FGL-1 knockdown as well as the effects of anti-LAG3 immunotherapy. Immunohistochemistry was performed to determine CD8 and LAG-3 expression in mouse tumor tissues. Results FGL-1 was highly expressed in the plasma and tumor tissues of laryngeal cancer patients. FGL-1 knockdown suppressed the proliferation of TU-686 cells and inhibited the migration and invasion of laryngeal cancer by blocking epithelial-to-mesenchymal transition. Moreover, silencing FGL-1 inhibited tumorigenicity in vivo and synergized with anti-LAG3 immunotherapy. Conclusions We confirmed the high expression of FGL-1 in laryngeal cancer and identified FGL-1 as a potential marker for immunotherapy in laryngeal cancer.
Prevalence of Current PTSD Symptoms Among a Sample of Black Individuals Aged 15 to 40 in Canada: The Major Role of Everyday Racial Discrimination, Racial Microaggresions, and Internalized Racism
Authors: Cénat Jude Mary , Dalexis Rose Darly , Darius Wina Paul , Kogan Cary S. , Guerrier Mireille 
Published: September 2022

Objective Most Black individuals in Canada report having experienced racial discrimination. Although previous studies have shown that there is a strong relationship between racial discrimination and posttraumatic stress disorder (PTSD), no studies in Canada have documented this association among Black individuals. The present study documents (1) the prevalence of PTSD among Black individuals using data from the Black Communities Mental Health project and (2) risk factors associated with PTSD, including racial microaggressions, everyday racial discrimination, and internalized racism. Method A total of 860 participants (75.6% of women) aged 15 to 40 years old ( M = 24.96, SD = 6.29) completed questionnaires assessing PTSD, experience of traumatic events, racial microaggressions, everyday racial discrimination, and internalized racism. Results Findings showed that 95.1% of participants reported exposure to at least one traumatic event during their lifetime. In total, 67.11% of participants reported probable PTSD with no significant difference between men and women (68.2% and 67.8%, χ2 = 0.132, p = 0.72). Participants born in Canada were more likely to experience significant PTSD symptoms, compared to those born abroad (70.92% and 53.14% , χ2 = 19.69, p < 0.001). A multivariable linear regression model of PTSD symptoms was computed using sociodemographic variables and exposure to traumatic events as independent variables, which explained 25.9% of the variance. In addition to these variables, a second model included racial microaggressions, everyday racial microaggressions, and internalized racism, which explained 51.8% of the variance. The model showed that traumatic events ( b = 0.6; p = 0.02), racial microaggressions ( b = 0.5; p < 0.001), everyday discrimination ( b = 0.2; p = 0.03) and internalized racism ( b = 0.5; p < 0.001) were positively associated with PTSD symptoms. Conclusions This article highlights the detrimental consequences of racial discrimination against Black people in Canada. Prevention and mental health programs aimed at mitigating its consequences on the lives of Black people and other racialized populations must be implemented.
Associations Between Copays, Coverage Limits for Naloxone, and Prescribing in Medicaid
Authors: Messinger John C , Kesselheim Aaron S , Vine Seanna M , Fischer Michael A , Barenie Rachel E 
Published: September 2022

Aims: To describe naloxone dispensing in Medicaid fee-for-service (FFS) and examine relationships between copays and coverage limits for naloxone and its dispensing rates. Methods: Cross-sectional study using Medicaid FFS State Drug Utilization Data to quantify the use of naloxone in 2018. The primary outcomes of this study were the proportion of naloxone prescriptions relative to all prescriptions and all opioid prescriptions dispensed in each state. We obtained drug benefit design information from the Medicaid Behavioral Health Services Database. The primary analysis examined the influence of copays (yes/no), copay amounts, and coverage limits on medication dispensing using simple linear regression, excluding states with no measurable use or less than 5% Medicaid FFS. Results: We found substantial variability across 50 states and DC in the proportion of prescriptions dispensed for Narcan and generic naloxone. We found a positive relationship between copay and copay amount and dispensing of generic naloxone. However, a sensitivity analysis including the broadest possible cohort of states failed to confirm this relationship. We found no other relationships between copays or coverage limits and dispensing of any naloxone formulation. Conclusions: Substantial variation exists between the rates of naloxone dispensing across the US for Medicaid patients, but we did not find a meaningful relationship between plan design and dispensing. Whether drug benefit designs in Medicaid influence naloxone use requires further evaluation to avoid limiting access to this life-saving medication.
Cultivating a Healthier Policy Landscape: The Building Healthy Communities Initiative
Authors: Sims Juliet , Baird Rob , Aboelata Manal J. , Mittermaier Sarah 
Published: September 2022

Objective To identify effective methods for local public health departments to secure policy and systems changes that will achieve health equity and improve health outcomes across diverse populations. Methods We reviewed 220 documents from a philanthropic initiative that funded collaborative efforts to improve conditions for health and equity in 14 California communities from 2010 to 2020. We examined the role of factors associated with movement-building approaches—such as organizing, base-building, investing in organizational capacity, and forming alliances—in securing policy and systems changes that foster more equitable community conditions. Results All 14 sites made progress in implementing policies and systems to improve the social determinants of health, including neighborhood conditions and the built environment, health care access, social and community context, economic stability, and education access. All 14 also shifted processes to be more inclusive of and responsive to community members, who in turn gained capacity to advocate for change and build collective power. Conclusion Local public health leaders can make progress toward health equity by drawing on movement-building approaches to change policies and systems that affect social determinants of health.