bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reference interval of antithrombin, protein C, and protein S activities in healthy adults in Iran, the effect of age, sex, oral contraceptive intake, and menopause
Authors: Tabibian Shadi , Khoshmirsafa Majid , Paridar Mostafa , Motevalian Abbas , Shekarabi Mahdi , Safa Majid 
Published: February 2022

AbstractBackgroundAntithrombin (AT), protein C (PC), and protein S (PS) are natural anticoagulant proteins that deficiency in each of them is associated with an increased risk of venous thromboembolism.The overlapping of plasma levels of AT, PC, and PS between healthy individuals and heterozygote carriers poses significant challenges in precise diagnosis. This study aimed to evaluate the effect of most influencing variables on plasma levels of these proteins and propose specific reference intervals to improve the interpretation of the laboratory results.MethodsThis study was conducted on 1464 individuals who were referred to Massoud medical laboratory, Tehran, Iran, from 2019 to 2020. AT and PC were measured through chromogenic assay and PS plasma level with the clot‐based assay. A multivariable linear regression model was performed to evaluate the effect of sex, age, oral contraceptive (OCP) intake, and menopause state. Normal deviate z value was used for different subgroups to justify the need for a separate reference interval.Results1200 verified healthy individuals (434 males and 766 females), aged between 18 and 69 years were included in the study. The mean ± SD age of the participants was 39.78 ± 11.79 years. The age‐related effects for AT were found in men. In females, increasing age was associated with a rise in AT, PC, and PS plasma levels. No sex difference was found in AT plasma level. OCP‐taking is associated with a decrease in AT and an increase in PC plasma levels.ConclusionThis is the largest study ever conducted on healthy individuals in the Iranian population, using specific reference interval results in accurate diagnosis of true AT, PC, and PS deficiency.
Barriers to prescribing proprotein convertase subtilisin‐kexin type 9 inhibitors after coronary revascularisation
Authors: Nguy Jenny , Hitchen Sarah A. , Lan Nick S. R. , Dwivedi Girish , Larbalestier Robert , Yeap Bu B. , Fegan P. Gerry 
Published: February 2022

AbstractBackgroundGuidelines advocate for intensive lipid‐lowering in patients with atherosclerotic cardiovascular disease (ASCVD). In May 2020, evolocumab, a proprotein convertase subtilisin‐kexin type 9 (PCSK9) inhibitor, became government subsidised in Australia for patients with ASCVD requiring further low‐density lipoprotein cholesterol (LDL‐C) lowering.AimTo identify barriers to prescribing PCSK9 inhibitors in hospitalised patients with ASCVD.MethodsA retrospective 3‐month, single‐site, observational analysis was conducted in consecutive patients undergoing percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery. Lipid‐lowering therapy prescriptions, including PSCK9 inhibitors, were assessed using electronic medical records, compared against the Australian Pharmaceutical Benefits eligibility criteria, and barriers to PCSK9 inhibitor use identified.ResultsOf 331 patients, 244 (73.7%) underwent PCI and 87 (26.3%) underwent CABG surgery. A lipid profile during or within 8 weeks of admission was measured for 202 (82.8%) patients undergoing PCI and 59 (67.8%) undergoing CABG surgery. In patients taking high‐intensity statins on admission (n = 109), LDL‐C ≥1.4, ≥1.8 and >2.6mmol/L was seen in 64 (58.7%), 44 (40.4%) and 19 (17.4%) patients respectively. High‐intensity statin prescribing at discharge was high (>80%); however, ezetimibe was initiated in zero patients with LDL‐C ≥1.4 mmol/L. There was variable advice given by clinicians for LDL‐C targets. No patients met the criteria for subsidised PSCK9 inhibitor therapy, largely due to lack of qualifying lipid levels following combined statin and ezetimibe therapy.ConclusionPrescribing of non‐statin LDL‐C‐lowering therapies remains low in patients with ASCVD. Underprescribing of ezetimibe and suboptimal lipid testing rates are barriers to accessing subsidised PCSK9i therapy using current Australian eligibility criteria.
Circulating vitamin C and D concentrations and risk of dental caries and periodontitis: A Mendelian randomization study
Authors: Hu Zhao , Zhou Feixiang , Xu Huilan 
Published: February 2022

AbstractAimThis Mendelian randomization (MR) study was performed to explore the causal relationship among circulating vitamin C and D levels, dental caries, and periodontitis.Materials and MethodsMR analyses were conducted with the inverse variance weighted (IVW) method, weighted median, MR‐Egger approaches, and MR‐robust adjusted profile score method to assess the causal relationships between circulating vitamin C and D concentrations and dental caries, the number of remaining natural permanent teeth in the mouth (N teeth), and periodontitis.ResultsWe found potential causal association of circulating vitamin D concentrations with N teeth (β = 0.085; 95% confidence interval: 0.019 to 0.150; p = .012) based on the IVW method. No significant causal relationship between circulating vitamin D levels and dental caries and periodontitis was observed. Similarly, no evidence supported a causal relationship between circulating vitamin C concentrations and the risk of dental caries, N teeth, and periodontitis.ConclusionsThere is no obvious evidence suggesting a causal relationship among circulating vitamin D, dental caries, and periodontitis, drawing into question the mechanism for any association with N teeth. Additionally, there is insufficient power to detect small effects in vitamin C levels and caries and periodontitis.
Beavers and flood alleviation: Human perspectives from downstream communities
Authors: Auster Roger E. , Barr Stewart W. , Brazier Richard E. 
Published: February 2022

AbstractNatural flood management (NFM) methods work with natural processes to reduce flood risk, while often providing additional benefits such as water quality improvement or habitat provision. Increasingly, the activity of an animal—beavers—is recognised to potentially provide flow attenuation, along with multiple benefits for the environment and society, but there can also be associated challenges. We use Q‐Methodology to elicit and understand human perspectives of beavers and their potential role in flood management among communities living downstream of beavers at three sites in England (Cornwall, Yorkshire and the Forest of Dean). This is the first time a study has focused on downstream communities as the primary stakeholders. We identify diverse perspectives that exhibit a range of value judgements. We suggest a catchment‐based approach to beaver management and public engagement may facilitate deeper recognition of contextual perspectives in decision‐making and enable knowledge dissemination with communities. Further, we examine the relationship between beavers and other NFM methods through these perspectives. In doing so we identify features that relate to the unique element of relying on the natural behaviour of beavers for flood management, rather than human flood managers being the primary decision‐makers.
Facility characteristics and costs associated with meeting proposed minimum staffing levels in skilled nursing facilities
Authors: Hawk Terry , White Elizabeth M. , Bishnoi Courtney , Schwartz Lindsay B. , Baier Rosa R. , Gifford David R. 
Published: February 2022

AbstractBackgroundFederal minimum nurse staffing levels for skilled nursing facilities (SNFs) were proposed in 2019 U.S. Congressional bills. We estimated costs and personnel needed to meet the proposed staffing levels, and examined characteristics of SNFs not meeting these thresholds.MethodsThis was a cross‐sectional analysis of 2019Q4 payroll data, the Hospital Wage Index, and other administrative data for 14,964 Medicare and Medicaid‐certified SNFs. We examined characteristics of SNFs not meeting proposed minimum thresholds: 4.1 total nursing hours per resident day (HPRD); 0.75 registered nurse (RN) HPRD; 0.54 licensed practical nurse (LPN) HPRD; and 2.81 certified nursing assistant (CNA) HPRD. For SNFs falling below the thresholds, we calculated the additional HPRD needed, along with the associated full‐time equivalent (FTE) personnel and salary costs.ResultsIn 2019, 25.0% of SNFs met the minimum 4.1 total nursing HPRD, while 31.0%, 84.5%, and 10.7% met the RN, LPN, and CNA thresholds, respectively. Only 5.0% met all four categories. In adjusted analyses, factors most strongly associated with SNFs not meeting the proposed minimums were: higher Medicaid census, larger bed size, for‐profit ownership, higher county SNF competition; and, for RNs specifically, higher community poverty and lower Medicare census. Rural SNFs were less likely to meet all categories and this was explained primarily by county SNF competition. We estimate that achieving the proposed federal minimums across SNFs nationwide would require an estimated additional 35,804 RN, 3509 LPN, and 116,929 CNA FTEs at $7.25 billion annually in salary costs based on current wage rates and prepandemic resident census levels.ConclusionsAchieving proposed minimum nurse staffing levels in SNFs will require substantial financial investment in the workforce and targeted support of low‐resource facilities. Extensive recruitment and retention efforts are needed to overcome supply constraints, particularly in the aftermath of the COVID‐19 pandemic.
Payment System Externalities
Authors: PARLOUR CHRISTINE A. , RAJAN UDAY , WALDEN JOHAN 
Published: February 2022

ABSTRACTWe examine how the payment processing role of banks affects their lending activity. In our model, banks operate in separate zones, and issue claims to entrepreneurs who purchase some inputs outside their own zone. Settling bank claims across zones incurs a cost. In equilibrium, a liquidity externality arises when zones are sufficiently different in their outsourcing propensities—a bank may restrict its own lending because it needs to hold liquidity against claims issued by another bank. Our work highlights that the disparate motives for interbank borrowing (investing in productive projects and managing liquidity) can have different effects on efficiency.
Cheilitis Glandularis: A clinicopathologic study with emphasis on etiopathogenesis
Authors: Piperi Evangelia , Georgaki Maria , Andreou Anastasia , Pettas Efstathios , Tziveleka Styliani , Nikitakis Nikolaos G. 
Published: February 2022

AbstractObjectivesCheilitis Glandularis (CG) is an uncommon entity of obscure etiology. A cases series is presented with emphasis on etiopathogenesis.Materials and MethodsFourteen CG cases were analyzed according to their demographic and clinicopathologic characteristics.ResultsThe mean age of the patients with CG was 68.1 years, while a male‐to‐female ratio of 1.8:1 was observed. One or more potential causative factors were identified for each patient, including long‐term smoking (9 cases), xerostomia (4 cases), cosmetic filler injections (2 cases), and actinic cheilitis (1 case). The lesions were located on the lips, buccal mucosa, or both in 7, 2, and 5 cases, respectively. Multiple submucosal nodules with dilated ductal orifices and mucous or purulent discharge were observed in all cases. Histopathologically, ductal ectasia with metaplasia, intraductal mucin, and chronic or mixed inflammation were noted, as well as pools of hyaluronic acid in 2 cases with a history of cosmetic filler injections.ConclusionsCG etiopathogenesis is probably multifactorial. Reduced salivary flow rate and increased viscosity of saliva, potentially caused by long‐term smoking, diabetes mellitus, and drug‐induced xerostomia, may participate in the initial pathogenesis, while local irritants, for example, poor oral hygiene and local trauma, may further contribute to the development and aggravation of the condition.
How lay theories of prejudice shape prejudice confrontations: Examining beliefs about prejudice prevalence, origins, and controllability
Authors: Chaney Kimberly E. , Wedell Emma 
Published: February 2022

AbstractThe formative framework in prejudice confrontations research has focused on the utility of confrontations to activate one's self‐regulation strategies to interrupt unintentional prejudice, discrimination, and stereotyping. As this framework remains dominant in the literature, little research has examined everyday people's theories about prejudice that diverge from this framework and accounted for these theories in investigating confrontation rates and outcomes. In this paper, we review key lay theories of prejudice and discuss the ways in which they may influence prejudice confrontations. First, we summarize lay theories regarding the prevalence, origins, and controllability of prejudice. Next, we consider how lay theories of prejudice may factor into the circumstances under which people confront prejudice, goals that people may hold when confronting, and outcomes of confronting for confronters and perpetrators. Throughout, we highlight fundamental research questions and hypotheses that integrate lay theories of prejudice and prejudice confrontations. We propose that better understanding lay theories of prejudice and how they influence prejudice confrontations may help to advance translational and theoretical research in social psychology.
Indirect effects of the early phase of the COVID-19 pandemic on the coverage of essential maternal and newborn health services in a rural subdistrict in Bangladesh: results from a cross-sectional household survey
Authors: Mhajabin Shema , Hossain Aniqa Tasnim , Nusrat Nowrin , Jabeen Sabrina , Ameen Shafiqul , Banik Goutom , Tahsina Tazeen , Ahmed Anisuddin , Sadeq-ur Rahman Qazi , Gurley Emily S , Bari Sanwarul , Chowdhury Atique Iqbal , Arifeen Shams El , Mehta Rajesh , Rahman Ahmed Ehsanur 
Published: February 2022

ObjectiveThis paper presents the effect of the early phase of COVID-19 on the coverage of essential maternal and newborn health (MNH) services in a rural subdistrict of Bangladesh.DesignCross-sectional household survey with random sampling.SettingBaliakandi subdistrict, Rajbari district, Bangladesh.ParticipantsData were collected from women who were on the third trimester of pregnancy during the early phase of the pandemic (111) and pre-pandemic periods (115) to measure antenatal care (ANC) service coverage. To measure birth, postnatal care (PNC) and essential newborn care (ENC), data were collected from women who had a history of delivery during the early phase of the pandemic (163) and pre-pandemic periods (166).ExposureEarly phase of the pandemic included a strict national lockdown between April and June 2020, and pre-pandemic was defined as August–October 2019.Outcome of interestChanges in the coverage of selected MNH services (ANC, birth, PNC, ENC) during the early phase of COVID-19 pandemic compared with the pre-pandemic period, estimated by two-sample proportion tests.FindingsAmong women who were on the third trimester of pregnancy during the early phase of the pandemic period, 77% (95% CI: 70% to 85%) received at least one ANC from a medically trained provider (MTP) during the third trimester, compared with 83% (95% CI: 76% to 90%) during the pre-pandemic period (p=0.33). Among women who gave birth during the early phase of the pandemic period, 72% (95% CI: 66% to 79%) were attended by an MTP, compared with 63% (95% CI: 56% to 71%) during the pre-pandemic period (p=0.08). Early initiation of breast feeding was practised among 38% (95% CI: 31% to 46%) of the babies born during the early phase of the pandemic period. It was 37% (95% CI: 29% to 44%) during the pre-pandemic period (p=0.81). The coverage of ANC, birth, PNC and ENC did not differ by months of pandemic and pre-pandemic periods; only the coverage of at least one ANC from an MTP significantly differed among the women who were 7 months pregnant during the early phase of the pandemic (35%, 95% CI: 26% to 44%) and pre-pandemic (49%, 95% CI: 39% to 58%) (p=0.04).ConclusionThe effect of the early phase of the pandemic including lockdown on the selected MNH service coverage was null in the study area. The nature of the lockdown, the availability and accessibility of private sector health services in that area, and the combating strategies at the rural level made it possible for the women to avail the required MNH services.
Introducing NICE guidelines for intravenous fluid therapy into a district general hospital
Authors: McDougall Marcia , Guthrie Bruce , Doyle Arthur , Timmins Alan , Bateson Meghan , Ridley Emily , Drummond Gordon , Vadiveloo Thenmalar 
Published: February 2022

BackgroundNational Institute for Health and Care Excellence (NICE) guidelines on intravenous fluid prescribing for adults in hospital, issued in 2013, advised less use of 0.9% sodium chloride than current practice, provided a logical system for prescribing and suggested further study of electrolyte abnormalities.AimsTo describe the steps taken to establish and monitor guideline introduction and to assess effects on clinical biochemistry results, in a general hospital setting.MethodsWe used established principles of change to modify education, teaching, record keeping and audit throughout the hospital, changed the availability of intravenous fluid preparations in the wards and monitored the use of intravenous fluids. We anonymously linked local clinical chemistry records to nationally available patient records (NHS Scotland SMR01). We chose specified medical emergencies, and major emergency and elective general and orthopaedic surgery, where management would require intravenous fluids, for a two-phase cross-sectional study between 2007 and 2017, spanning the change in prescribing. Primary outcomes were abnormal bicarbonate, sodium, potassium and incidence of acute kidney injury (AKI), and secondary outcomes were mortality and length of stay.ResultsOver the study period, sodium chloride 0.9% use decreased by 75%, and overall intravenous fluid use decreased from 0.65 to 0.40 L/occupied bed day. The incidence of acidosis decreased from 7.4% to 4.8% of all admissions (difference −2.7%, 95% CI −2.1 to −3.0). No important changes in other electrolytes were noted; in particular, plasma sodium values showed no adverse effects. Stage 1 AKI increased from 6.7% to 9.0% (difference 2.3%, 95% CI 1.6 to 3.0), but other causes for this cannot be excluded. Mortality and length of stay showed no adverse effects.Conclusions and implicationsEffective implementation of the guidelines required substantial time, effort and resource. NICE suggestions of fluid types for maintenance appear appropriate, but prescribed volumes continue to require careful clinical judgement.
Development of Nightingale Frontline: a leadership support service for nurses and midwives during the COVID-19 crisis
Authors: Bond Carmel , Stacey Gemma , Matheson Joanne , Westwood Greta 
Published: February 2022

BackgroundAs COVID-19 hit the UK, it was apparent that frontline healthcare workers would be faced with challenges they had never encountered before. The longer-term leadership support needs of nurses and midwives were considered central to how they would psychologically emerge from the COVID-19 response. In response, a national leadership support service for nurse and midwife leadersat all levels, was rapidly established.MethodsA collaborative approach was used, drawing from an established community of healthcare leadership development consultants and senior healthcare leaders. Practical plans for how the service would run were formulated via online meetings, held between February and March 2020. An internal questionnaire was distributed to attendees, requesting demographic data and feedback to capture the perceived impact of the service on leadership.ResultsOverall, confidence in leadership ability/skills increased after attending the service; 68.8% of those who completed post-attendance questionnaires reported having learnt new leadership skills and a motivation to facilitate co-consulting sessions for their teams. The service was positively appraised and there were reports of a degree of influence on leadership, and improved confidence after attending.ConclusionLeadership and well-being support provided by an independent and external organisation can offer a unique and safe forum for reflection and for healthcare leaders to decompress. This requires a sustainable investment to mitigate the predicted impact of the pandemic.
Oceanward rift migration during formation of Santos–Benguela ultra-wide rifted margins
Authors: Araujo Mario Neto , Pérez-Gussinyé Marta , Muldashev Iskander 
Published: February 2022

Abstract
This paper presents the time and space evolution of crustal deformation and their respective sedimentary infill of the 600 km wide, asymmetric conjugate rifted margin of the Santos–Benguela basins. Based on a geoseismic transect obtained with interpretation of long-offset seismic reflection and tied by wells, we interpret six main synrift unconformities, corresponding to different deformation phases processed from the Valanganian to Early Albian. Confined by these unconformities, sedimentary growths with progressively young relative ages towards the boundary with the oceanic crust are interpreted as evidence of oceanward rift migration. The combination of this information with crustal structure derived from long-offset seismic reflection illuminating the deep crust of the Santos–Benguela conjugate margins, resulted in a complete view of sedimentary infill, internal compartments, and crustal structure. These data were used to guide a dynamic model of rifting resulting in a simulated lithospheric section.
We show that the margin architecture can be explained by the combination of an early, protracted phase of distributed deformation, followed by basinward rift migration. Distributed deformation lasted from the Valanginian to Early Aptian (135–117 Ma), initiating with isolated lakes that later coalesced into a wide basin-scale lake (>450 km). From the Mid Aptian to Early Albian (117–110 Ma), rift migration formed the main structural compartments and unconformities, as well as the distal hinge zones we observe today in the seismic lines. During this time, the inner proximal margins were left behind to thermally subside, whereas outer proximal and distal margins were tectonically active. Coexistence of these two processes explains the enigmatic simultaneous formation of proximal sag-like geometries, with late synrift accumulation of a salt layer up to 3 km thick, with tectonically active faults in the distal margin, promoting crestal block uplift that could explain the deposition of Late Aptian, shallow water, pre-salt carbonate rocks.