bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of Life (QoL) and Psychological Distress among Congestive Heart Failure Patients: A Prospective Observational Study from Pakistan
Authors: Shahzad Rana Umar , Malik Madeeha , Hussain Azhar , Hashmi Ayisha 
Published: October 2022

Introduction: Congestive Heart failure (CHF) is a cardiovascular disease harming the physical, social, psychological, emotional, and well-being status of an individual. The interference due to symptoms and signs of heart failure affects QoL (QoL) and leads to depression among the majority of the patients.
Objective: To assess the QoL and depression among CHF patients in Pakistan.
Methodology: A descriptive cross-sectional study design was used to assess the QoLand depression among CHF patients in Pakistan. The study population included CHF patients greater than 18 years old, both genders visiting public and private Health Care Facilities located in twin cities of Pakistan. QoL was assessed by using SF 36 and KCCQ while HADS (hospital anxiety and depression scale) was used to evaluate the Depression among 382 CHF patients selected using the convenience sampling technique. Data was entered in SPSS version 21 and statistically analyzed.
Results: The results highlighted that use of SF-36 showed the lowest scores for QoL in the domain of role physical (8.82, ± 8.23) followed by the domain of role emotional (10.17, ± 8.6) whereas the highest scores were observed in the domain of mental health (67.26, ± 15.67). On the other hand, the results reported that the use of KCCQ-12 highlighted that the lowest scores for QoL were observed in all the domains of QoL i.e. physical limitations (39.98, ± 31.93), symptoms (73.42, ± 27.94), social limitations (43.21, ± 27.78) and QoL (43.32, ± 23.38).
Conclusion: The current study concluded that CHF patients had poor QoL and severe depression. Several domains of QoL among CHF patients were compromised including physical limitations, emotional limitations, social functioning, and pain. For the general symptoms scale, shortness of breath and limitation in sleeping posture are the most commonly affected leading to compromised quality of life. Interventions must be designed with a focus on patient counseling tailored to the needs for improving QoL and minimizing depression.
A Study on Policy Related to Teacher Retention in the Rural Primary Schools of Chhukha, Bhutan
Authors: Tshering . , Phuntsho Dawa 
Published: October 2022

Teachers’ attrition rate keeps rising every year and has been observed that mostly teachers from rural and remote parts of the country choose to resign voluntarily or go on long term leave. Teacher’s attrition rate in 2018 is 4.4% and it has risen up to 5.2% in 2019 which is a serious concern to be looked at. Recruitment and retention of teachers in the remote and rural schools remains a significant challenge in low-income countries, including Bhutan, hampering the educational delivery services to the rural population and slows the progress of achieving Sustainable Development Goals.
For delivering quality educational services to the people and improving their outcomes, motivated teachers must be available at the right time and place. The purpose of this study is to determine the factors affecting teacher retention in the rural areas of Chhukha District based on policy and practice. A total of five domains were assessed regarding financial matters, career matters, personal and family matters, working and living conditions, and policy matters. In the past decade, there have been worrying signs that the intellectual quality of teachers is declining. Teachers who are already in schools and are highly qualified may be able to offset this trend if they are retained.
In order to better understand the key factors influencing rural schools' appeal and retention of teachers, this study was conducted. A satisfaction survey was also conducted to determine if their current place of employment offered them the policies, facilities, services, and support that they were seeking. In order to attract or retain teachers in remote and rural schools, the study findings, recommendations, and appropriate strategies were provided to relevant stakeholders for intervention. Therefore, more motivated teachers are available in remote Bhutanese regions. Consequently, teaching services will be of a higher quality. Gross National Happiness can ultimately be achieved by achieving this goal.
Association Between State Regulations Supportive of Third-party Services and Likelihood of Assisted Living Residents in the US Dying in Place
Authors: Belanger Emmanuelle , Rosendaal Nicole , Wang Xiao (Joyce) , Teno Joan M. , Dosa David M. , Gozalo Pedro L. , Carder Paula , Thomas Kali S. 
Published: October 2022

ImportanceOlder adults are increasingly residing in assisted living residences during their last year of life. The regulations guiding these residential care settings differ between and within the states in the US, resulting in diverse policies that may support residents who wish to die in place.ObjectiveTo examine the association between state regulations and the likelihood of assisted living residents dying in place. The study hypothesis was that regulations supporting third-party services, such as hospice, increase the likelihood of assisted living residents dying in place.Design, Setting, and ParticipantsThis retrospective cohort study combined data about assisted living residences in the US from state registries with an inventory of state regulations and administrative claims data. The study participants comprised 168 526 decedents who were Medicare beneficiaries, resided in 8315 large, assisted living residences (with ≥25 beds) across 301 hospital referral regions during the last 12 months of their lives, and died between 2017 and 2019. Descriptive analyses were performed at the state level, and 3-level multilevel models were estimated to examine the association between supportive third-party regulations and dying in place in assisted living residences. The data were analyzed from September 2021 to August 2022.ExposuresSupportive (vs “silent,” ie, not explicitly mentioned in regulatory texts) state regulations regarding hospice care, private care aides, and home health services, as applicable to licensed/registered assisted living residences across the US.Main Outcomes and MeasuresPresence in assisted living residences on the date of death.ResultsThe median (IQR) age of the 168 526 decedents included in the study was 90 (84-94) years. Of these, 110 143 (65.4%) were female and 158 491 (94.0%) were non-Hispanic White. Substantial variation in the percentage of assisted living residents dying in place was evident across states, from 18.0% (New York) to 73.7% (Utah). Supportive hospice and home health regulations were associated with a higher odds of residents dying in place (adjusted odds ratio [AOR], 1.38; 95% CI, 1.24-1.54; P &amp;lt; .001; and AOR, 1.21; 95% CI, 1.10-1.34; P &amp;lt; .001, respectively). In addition, hospice regulations remained significant in fully adjusted models (AOR, 1.46; 95% CI, 1.25-1.71).Conclusions and RelevanceThe findings of this cohort study suggest that a higher percentage of assisted living residents died in place in US states with regulations supportive of third-party services. In addition, assisted living residents in licensed settings with regulations supportive of hospice regulations were especially likely to die in place.
Comparison of Health Care Utilization by Medicare Advantage and Traditional Medicare Beneficiaries With Complex Care Needs
Authors: Drzayich Antol Dana , Schwartz Richard , Caplan Ariel , Casebeer Adrianne , Erwin C. Jo , Shrank William H. , Powers Brian W. 
Published: October 2022

ImportanceMedicare beneficiaries with co-occurring chronic conditions and complex care needs experience high rates of acute care utilization and poor outcomes. These patterns are well described among traditional Medicare (TM) beneficiaries, but less is known about outcomes among Medicare Advantage (MA) beneficiaries. Compared with TM, MA plans have additional levers to potentially address beneficiary needs, such as network design, care management, supplemental benefits, and value-based contracting.ObjectiveTo compare health care utilization for MA and TM beneficiaries with complex care needs.Design, Setting, and ParticipantsThis cross-sectional study analyzed beneficiaries enrolled in MA and TM using claims data from a large, national MA insurer and a random 5% sample of TM beneficiaries. Beneficiaries were segmented into the following cohorts: frail elderly, major complex chronic, and minor complex chronic. Regression models estimated the association between MA enrollment and health care utilization in 2018, using inverse probability of treatment weighting to balance the MA and TM cohorts on observable characteristics. The study period was January 1, 2017, through December 31, 2018. All analyses were conducted from December 2020 to August 2022.ExposuresEnrollment in MA vs TM.Main Outcomes and MeasuresHospital stays (inpatient admissions and observation stays), emergency department (ED) visits, and 30-day readmissions.ResultsAmong a study population of 1 844 326 Medicare beneficiaries (mean [SD] age, 75.6 [7.1] years; 1 021 479 [55.4%] women; 1 524 458 [82.7%] White; 223 377 [12.1%] with Medicare-Medicaid dual eligibility), 1 177 896 (63.9%) were enrolled in MA and 666 430 (36.1%) in TM. Beneficiary distribution across cohorts was as follows: frail elderly, 116 047 with MA (10.0% of the MA sample) and 104 036 with TM (15.6% of the TM sample); major complex chronic, 320 954 (27.2%) and 158 811 (23.8%), respectively; and minor complex chronic, 740 895 (62.9%) and 403 583 (60.6%), respectively. Beneficiaries enrolled in MA had lower rates of hospital stays, ED visits, and 30-day readmissions. The largest relative differences were observed for hospital stays, which ranged from −9.3% (95% CI, −10.9% to −7.7%) for the frail elderly cohort to −11.9% (95% CI, −13.2% to −10.7%) for the major complex chronic cohort.Conclusions and RelevanceIn this cross-sectional study of Medicare beneficiaries with complex care needs, those enrolled in MA had lower rates of hospital stays, ED visits, and 30-day readmissions than similar beneficiaries enrolled in TM, suggesting that managed care activities in MA may influence the nature and quality of care provided to these beneficiaries.
The impact of reminders on implementation intention: A randomized controlled trial
Authors: Messmer Léonie , Fenouillet Fabien , Legrand Eve 
Published: October 2022

AbstractImplementation intentions are self‐regulatory strategies that increase the probability that desired goals will be achieved. While their effectiveness in the short term is well established in the literature, the long‐term effects are not. The present study, which was conducted in France during the COVID‐19 lockdown, aimed to test whether reminders could support the effects of forming implementation intentions over time. It proposed to help people adopt a new behavior: to set themselves three daily goals for four weeks and send the results to a dedicated website. A total of 118 participants (from an initial sample of 194) sent their three daily goals at least once and constituted our final sample. A 2 (implementation intention: with vs. without), ×2 (reminders: with vs. without), and ×4 (week: 1–4) repeated measures ANOVA was conducted. The results showed significant main effects for all three factors, from small to medium to large. However, no significant interaction emerged. Hence, text message reminders did not seem to intensify the effect of forming implementation intentions.
3D‐Printed Periodic Hierarchical Porous rGO/Ti3C2Tx Architectures Induced Uniform Lithium Deposition for Li Metal Anodes
Authors: Shi Haiting , Pei Mengfan , Wang Shuo , Yao Fengting , Xia Yuanhua , Xu Zhiwei , Liu Shengkai , Shao Ruiqi , Wang Wei , Liang Shuaitong 
Published: October 2022

AbstractNonuniform Li+ flux and lithiophilic sites cause uneven lithium deposition, which impedes the application of lithium metal batteries. Herein, a reduced graphene oxide (rGO)/Ti3C2Tx lattice with periodic printed holes is fabricated by 3D printing. Mesoporous structures formed by regularly assembled nanosheets provide abundant lithiophilic sites. The Li+ flux is regulated by the periodic printed holes prepared by 3D printing. The deposition of lithium is homogenized by the synergistic effect of uniform Li+ flux and abundant lithiophilic sites. The resultant 3D‐printed Li anode has excellent cycling stability up to 3000 h and a high average Coulombic efficiency of 98% after a long lifespan of ≈1000 h. Our work highlights the effect of the correlation between macroscopic and microscopic pores formed by 3D printing on inhibiting lithium dendrites, providing a novel pathway for highly 3D‐printed stable lithium metal anode.
Single‐catalyst reactions from depolymerization to repolymerization: Transformation of polyethylene terephthalate to polyisocyanurate foam with deep eutectic solvents
Authors: Lee Pyung Soo , Jung Simon MoonGeun 
Published: October 2022

AbstractPolyisocyanurate (PIR) has been used as a flame retardant insulation material because of its improved thermal insulation and flame‐retarding effects due to its cyclic structure with an isocyanate trimer group. When a deep eutectic solvent (DES) is used as a catalyst, PET glycolysis produces bis(2‐ hydroxyethyl terephthalate) (BHET) and its derivatives. These recycled polyols react with isocyanate to form PIR foam (PIRF) in the presence of a physical blowing agent. DES‐based glycolysis is a low‐energy process with a relatively low temperature and short reaction time. In this study, a potassium‐based DES system was applied for the sequential depolymerization and repolymerization of waste PET into PIRFs. Potassium‐based DESs were used as hydrogen bond acceptors (HBAs), and ethylene glycol (EG), glycerol, and urea were used as hydrogen bond donors (HBDs). The PIRF was obtained through one‐pot depolymerization and repolymerization with a single‐catalyst DES system. All DES catalyst systems effectively decomposed PET; the PET conversion efficiency reached 95% after 2 h reaction. The recycled PIR was more thermally stable (approximately 26.9% limiting oxygen index (LOI) and approximately 68.8 W/g heat release rate (HRR)). This paper presents an environmentally friendly and robust upcycling process for the transformation of waste PET into PIRF.
Impact of warm sea surface temperature over a Kuroshio large meander on extreme heavy rainfall caused by an extratropical cyclone
Authors: Tochimoto Eigo , Iizuka Satoshi 
Published: October 2022

AbstractOn 12–13 April 2020, an extreme heavy rainfall event associated with an extratropical cyclone occurred over the eastern coastal region of the Kii Peninsula, Japan, when unusual warm sea surface temperature anomalies (SSTAs) over a Kuroshio large meander (KLM) was observed. Here, we carry out numerical experiments to examine the impact of the unusual SSTAs on this heavy rainfall event. The unusual warm SSTAs enhanced the low‐level moisture that was transported toward the coastal region by the cyclone, resulting in an increase in precipitation. In particular, the maximum 3‐hour precipitation is most affected by SSTAs compared with the maximum 1‐hour and 24‐hour precipitation. These findings suggest that the heat and moisture supply from the unusually warm SSTAs over the KLM affected the heavy rainfall event.
Potential use of multikinase inhibitors in immunosuppressed patients with malignancies including thyroid cancer
Authors: Basté Rotllan Neus 
Published: October 2022

AbstractIn this article, we focus on a variety of immunosuppression scenarios and whether multikinase inhibitors, as systemic therapy for advanced thyroid carcinoma (TC), could be useful for the treatment of immunocompromised patients with TC. Lenvatinib and sorafenib, among other MKIs, have become the standard of care for advanced TC based on their efficacy data and despite their adverse effects. Currently, published data on MKIs in immunosuppressed patients are scarce. Secondary malignancies can arise in immunosuppressed patients who have undergone solid organ transplantation, human immunodeficiency virus–infected patients, and hematopoietic stem cell transplant recipients. This review will explore different immunosuppression settings, the risk of secondary malignancies in immunosuppressed patients, and the special characteristics of this population. Some considerations regarding anticancer treatment in immunosuppressed patients with advanced malignancies are reviewed.
Use of multikinase inhibitors/lenvatinib concomitant with locoregional therapies for the treatment of radioiodine‐refractory differentiated thyroid cancer
Authors: Berciano‐Guerrero Miguel‐Ángel 
Published: October 2022

AbstractLocoregional recurrence of differentiated thyroid cancer (DTC) occurs in 20% of thyroid cancer patients. Currently, there are many strategies for management of locoregional recurrence of DTC that lead to local control of the disease. The introduction of lenvatinib into the therapeutic armamentarium provides a new option for the treatment of radioiodine‐refractory DTC (RR‐DTC). However, results for simultaneous treatment with lenvatinib and locoregional therapies are unknown in patients with RR‐DTC. This paper reviews the current status of this approach and gives recommendations on the management of lenvatinib during concomitant locoregional procedures.
Use of multikinase inhibitors/lenvatinib in patients with high cardiovascular risk/vasculopathy and radioiodine refractory‐differentiated thyroid cancer
Authors: Jimenez‐Fonseca Paula 
Published: October 2022

AbstractAntiangiogenic tyrosine kinase inhibitors are the treatment of choice in radioiodine refractory‐differentiated thyroid cancer (RR‐DTC). Nevertheless, these therapies present class toxicities that may impact their feasibility and patient's quality of life. Their mechanism of action explains the high prevalence of hypertension associated with their use, which reaches 68% with lenvatinib. Moreover, up to 85% of patients treated in the SELECT clinical trial were receiving baseline antihypertensive treatment. These data support the need for prevention, detection, and early management of hypertension. Prevention can be accomplished by controlling cardiovascular risk factors (hypertension, diabetes, obesity, and dyslipidemia) and those associated with lifestyle (smoking, harmful alcohol consumption, and physical inactivity) and electrolyte disorders. It is necessary to achieve stabilization of cardiovascular diseases. Detection involves baseline measurement and monitoring of blood pressure and cardiac function. Treatment requires optimization of baseline blood pressure and early initiation of antihypertensive agents.
Bifidobacterium breve predicts the efficacy of anti‐PD‐1 immunotherapy combined with chemotherapy in Chinese NSCLC patients
Authors: Zhao Honghui , Li Dan , Liu Jiayin , Zhou Xinliang , Han Jing , Wang Long , Fan Zhisong , Feng Li , Zuo Jing , Wang Yudong 
Published: October 2022

AbstractBackground and PurposeGut microbes play an important role in the occurrence of lung cancer, immunotherapy, and chemotherapy. In this study, we analyzed the characteristics of gut microbes in patients with lung cancer and investigated the effect of gut microbes on anti‐PD‐1 therapy combined with chemotherapy.MethodsFecal samples from 21 non‐small cell lung cancer (NSCLC) patients and 22 healthy volunteers who were treated in the Fourth Hospital of Hebei Medical University from 2019 to 2021 were collected. DNA was extracted from all samples, and the V3‐V4 region of the bacterial 16S rRNA gene was PCR‐amplified using the Illumina sequencing platform, and R language was used for data analysis.ResultsThere were significant differences in the Beta diversity and metabolic pathways of gut microbes between NSCLC patients and healthy individuals (p < 0.05). Bifidobacterium, Escherichia, and Sarterella were significantly enriched in patients with clinical benefit response (p < 0.05), and these three bacteria had certain predictive value for clinical benefit. Patients with Bifidobacterium breve had significantly longer median progression‐free survival (mPFS) compared with patients with no detectable Bifidobacterium breve feces at baseline (106 days vs. NR, p < 0.001). Multivariate COX analysis showed that the presence of B.breve was an independent good prognostic factor affecting the PFS of patients receiving combination therapy (p < 0.05).ConclusionThe clinical efficacy of anti‐PD‐1 therapy combined with chemotherapy in Chinese advanced NSCLC patients is closely related to the gut microbiota, and Bifidobacterium breve may be a potential biomarker to predict the efficacy of immune‐combined chemotherapy.
Reflections on dilemmas of presidents and trustees
Authors: Boggs George R. 
Published: October 2022

AbstractAccording to John Carver (1990), no single relationship in an organization is as important as that between the board and its chief executive officer. That relationship, well‐conceived, can set the stage for effective governance and leadership. However, the line between governance and administration in community colleges is not always as clear as the experts define it, and this lack of clarity sometimes leads to significant issues for boards and their CEOs. This chapter relates some cases, based upon observations of the author, on the types of dilemmas that occur in the real world and how trustees and CEOs have dealt with them. The lessons learned from these examples can serve to strengthen the relationship between CEOs and boards and inform the important work they do.
Rogue trustees and malice in wonderland
Authors: Cloud Robert C. 
Published: October 2022

AbstractEffective governance requires high levels of trust and mutual respect among trustees who must commit to serving as stewards of the college's resources. This chapter describes rogue trustees, their tactics, and their negative impact on the governing process and college culture. The chapter includes strategies to mitigate the disruptive and counter‐productive conduct of rogues and concludes with practical advice for presidents and responsible board members dealing with recalcitrant trustees.
Addressing workforce needs and educational opportunity through board action
Authors: D'Amico Mark M. , Turk Jonathan M. , Hancock Anthony , Miller Michael T. 
Published: October 2022

AbstractBoards of trustees provide the policy, strategy, and accountability that set the direction for community colleges, all while being accountable to the states, regions, districts, and local areas they serve. One of those particular mission areas of community colleges is the preparation of the workforce to meet the needs of local economies and the simultaneous offering of relevant education that helps individuals achieve social and economic mobility. A critical component of that is to provide educational opportunities that allow individuals to continue to build on levels of education so that there are no “dead ends” as they progress through their careers. In this chapter, we discuss how Boards can embrace the TECH (transparency, equity, career, holistic) approach when governing colleges that address workforce needs and advance educational opportunities.
Colchicine poisoning treated with hemoperfusion and hemodialysis: A case report
Authors: Ramezani Maral , Mostafazadeh Babak , Rahimi Mitra , Evini Peyman Erfan Talab , Shadnia Shahin 
Published: October 2022

AbstractThis case report described an improved case of colchicine poisoning using hemoperfusion and hemodialysis.