bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trajectories of medical care expenditure in the last year of life and long-term care utilization in frail older adults: a retrospective cohort study
Authors: Kono Ayumi , Yoshiyuki Noriko , Ishihara Takuma , Fukushima Naomi , Miura Takeshi , Kaneko Katsunori 
Published: February 2022

Abstract
Background: Medical care and long-term care utilization in the last year of life of frail older adults could be a key indicator of their quality of life.This study aimed to identify the medical care expenditure trajectories in the last year of life of frail older adults and to investigate the association beween medical care expenditu and long-term care utilization in each trajectory.Methods: The population-based retrospective cohort study of three municipalities in Japan included 405 decedents (median age at death, 85 years; 189 women [46.7%]) from a cohort of 1,658 frail older adults aged ≥65 years who were newly certified as support level in the long-term care insurance program from April 2012 to March 2013. This study used long-term care and medical insurance claim data from April 2012 to March 2017. Primary outcome was medical care expenditure over the 12 months preceding death. Group-based trajectory modeling was conducted to identify the medical care expenditure trajectories and a mixed-effect model were employed to examine the association between long-term care utilization and medical care expenditure in each trajectory. Results: Participants were stratified into four groups based on medical care expenditure trajectories over the 12 months preceding death as follows: rising (n=159, 39.3%), persistently high (n=143, 35.3%), minimal (n=56, 13.8%), and descending (n=47, 11.6%) groups. The mixed-effects model revealed that home-based long-term care utilization increased medical care expenditure in the descending trajectory (coefficient, 1.48; 95% confidence interval [CI], 1.35–1.62). Facility-based long-term care utilization reduced medical care expenditure in the rising trajectory (coefficient, 0.59; 95% CI, 0.50–0.69). Both home-based (coefficient, 0.92; 95% CI, 0.85–0.99) and facility-based (coefficient; 0.53; 95% CI, 0.41–0.63) long-term care utilization reduced medical care expenditure in the persistently high trajectory. Conclusions: Four medical care expenditure trajectories in the last year of life of frail older adults were characterized according to long-term care utilization. These findings may facilitate the integration of medical and long-term care models at the end of life in frail older adults.
Robust synchronization motion tracking control for a two-slider system restrained by a flexible beam
Authors: Dou Haibin 
Published: February 2022

Abstract
This paper addresses the robust sync tracking control problem for a two-slider system where the motion of two sliders is restrained by a flexible beam. The system models are given at first. In the proposed models the dynamics of actuators are also considered. With employment of the models a novel variable gain sliding mode interval observer is proposed to estimate the external disturbances while reducing the system chattering caused by the conservative fixed gain. Then a tracking controller and an output restriction boundary controller for two sliders are designed. The tracking controller is used to tracking the desired trajectory and the output restriction boundary controller is used to restrict the deformation of the beam. The whole systems with the proposed controller are proved to be asymptotically stable by using traditional backstepping technology. Finally, numerical simulations illustrate that the proposed method are more effective compared with the existing method.
The Association of Trefoil Factors with Gastric Cancer and Premalignant Lesions: A4 Cross-Sectional Population-Based Cohort Study
Authors: Zan Xiangyi , Zhou Yongning 
Published: February 2022

Abstract
Background: A lack of research on the association of trefoil factors (TFFs) with gastriccancer (GC) and premalignant lesions (PMLs) in the general populations is an importantobstacle to the application of TFFs for GC screening. We aimed to analyze the associationof TFFs with GC and PMLs in a general population.Methods: We evaluated 3,986 adults residing in Wuwei, China. We collected baselinecharacteristics and GC risk factors, including TFFs, endoscopic diagnosis, and pathologicalinformation. Three logistic regression models were generated to analyze the associationbetween TFFs and GC, as well as PMLs. Adjusted odds ratio (OR) and 95% confidenceintervals (95% CI) were calculated to determine the strength of association.Results: Compared with pepsinogen (PG) and anti-Helicobacter pylori immunoglobulin Gantibody (Hp-IgG), TFFs had significant association with GC and PMLs after adjusting forbiomarkers and risk factors (P < 0.05). The ORs [95% CI] for TFF1 (1.67 [1.27–2.20]),TFF2 (2.66 [2.01–3.51]), and TFF3 (1.32 [1.00–1.74]) were larger than the ORs for PGI(0.79 [0.61–1.03]), PGI/II (1.00 [0.76–1.31]) and Hp-IgG (0.99 [0.73–1.35]) in the GCgroup. In intestinal metaplasia (IM) group, not only the TFF3 serum level was the highest,but also the OR (1.92 [1.64–2.25]) was the highest.Conclusions: Trefoil factor were associated with risk of GC and PMLs.Impact: Serum TFFs can improve the screening of high-risk populations for GC.
First report on Listeria monocytogenes detection in ready-to-eat chicken products in Bangladesh: A glimpse into their antibiotic resistance and virulence genes.
Authors: Shourav Abiral Hasib , Salma Khandokar Padmanon , Ahmed Sangita , Khan Anisur Rahman 
Published: February 2022

Abstract
Background: Ready-to-eat (RTE) meat products are food items that are growing in popularity in Bangladesh. Albeit documented with alarming prevalence of pathogenic multidrug-resistant Listeria species in these food items worldwide, studies from the perspective of Bangladesh are absent. This study was devised with an aim to detect pathogenic Listeria monocytogenes in some of the most popular RTE meat products in Dhaka, Bangladesh. Methods: Thirty-nine such samples were investigated using biochemical tests and the Polymerase Chain Reaction (PCR) analysis. The samples were RTE food products randomly collected from various departmental stores in Dhaka, Bangladesh. Following confirmatory tests and detection of Listeria species, the isolates were subjected to the Kirby-Bauer disc diffusion test to investigate their antibiotic-susceptibility patterns agains some of the most commonly used antibiotics to treat listeriosis – the infection caused my Listeria. Results: Five Listeria species were detected using the biochemical and PCR tests. This constituted an overall prevalence rate of 12.8% (n = 39). Four out of the five Listeria species were concluded to be L. monocytogenes, while the remaining one was a L. innocua isolate. PCR analysis revealed all four of the L. monocytogenes isolates to have the virulence genes hlyA, plcB and actA, although no polymorphism was detected for these genes. Despite the presence of these pathogenic genes, antibiotic susceptibility tests showed promising results as some of the most commonly used drugs against listeriosis were highly effective against the isolates. Conclusion: Despite the fact that the isolates showed little to no antibiotic resistances against the antibiotics used in the study, the presence of three virulence genes in all four L. monocytogenes isolates is still a cause for concern. Even more so, the prevalence of these pathogenic strains in a food item that is increasing in popularity in a country like Bangladesh, where awareness and surveillance against listeriosis is limited, can have dire consequences should an outbreak occurs.
Genomic analyses identify signaling pathways and biological processes in small and large melanoma
Authors: Qian Zhiwen , Chang Tingxiang , Zhang Tingting , Gu Hanming , Wang Jing 
Published: February 2022

Abstract
Melanoma is a skin malignancy that involves different signaling pathways with different sizes and phenotypes. However, the mechanism and function of small and large melanoma are unknown. Here, the aim of this study is to identify the functional molecules and signaling pathways by analyzing the RNA-seq data. The GSE164357 was created by the Illumina MouseWG-6 v2.0 expression bead chip. The KEGG and GO analyses indicated that Antigen processing and presentation and Phagosome are the main processes between the large and small melanoma. Moreover, we identified ten interactive molecules including STAT1, TTN, CALR, ACTA1, FN1, TNNT3, MYL1, TNNI2, RHOA, and TCAP. Therefore, our study may help to further understand the mechanism of melanoma.
Bacterial Brain Abscess Early Treated with Oral Antibiotics in A Case Series of Immunocompetent Adult Patients: Could This Be A Feasible Therapy?
Authors: Dentale Nicola , Coladonato Simona , Zaghi Irene , Spinardi Luca , De Martino Sara Rosa Maria , Viale Pierluigi 
Published: February 2022

Abstract
BACKGROUND.
We report the preliminary observation of community acquired brain abscess in immunocompetent adult patients early treated with high penetrating oral antibiotics, even without microbiological isolation, that showed good outcome.
METHODS.
A retrospective analysis of eight patients being managed for brain abscess who underwent early oral antimicrobial therapy is reported. Data collected of age, sex, co-morbidity, risk factors, diameter of the abscess, microbiological findings, management of therapy, focusing on its early shift to oral regimen and outcome after one year of follow-up.
RESULTS.
Two of eight patients, with a mean age of 59,3 years, required neurosurgery, in 3 case we found positive microbiological samples. The medium length from initial i.v. therapy to per os regimen was 7,7 and the medial length of the complete course of therapy was 58 days. Most of them received the same empiric antimicrobial therapy with levofloxacin and linezolid, because of their high oral bioavailability and optimal penetration into brain barrier. All the patients had clinical improvement and showed no signs of persistent cerebral abscess at one year of follow-up.
CONCLUSIONS.
Cerebral abscess is a significant cause of morbidity and mortality, nevertheless, in selected cases, it can be treated with antimicrobial therapy per os, even in case of negative microbiological samples. Oral antimicrobial therapy could be non inferior to intravenous antibiotic therapy, moreover it has advantages reducing time of hospital stay and improving quality of life and patient compliance to long period of antimicrobial treatment.
The clinical prediction factors for non-culprit lesion progression in patients with acute ST elevation myocardial infarction after primary percutaneous coronary intervention
Authors: wang jian , Yan Cheng-ying 
Published: February 2022

Abstract
Background
To investigate the relationship between the clinical features and progression of non-culprit lesions in patients with ST-elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PPCI).
Methods
A total of 480 patients (57.1 ± 9.2 y) with STEMI who underwent PPCI between January 2016 and December 2017 in Beijing Anzhen Hospital were enrolled in this study. All patients underwent PPCI as a treatment for culprit lesions. Clinical and angiographic follow-up were performed for 12 months. All patients were divided into a non-culprit lesions (NCL) progression group (205 cases) and a control group (275 cases) based on angiographic follow-up outcomes at 12 months. The clinical and angiographic features were analyzed.
Results
Body mass index (BMI), serum creatinine (Scr), fasting blood glucose (FBG), glycated serum albumin, glycated hemoglobin and homocysteine levels in the NCL progression group were significantly higher than those in the control group (P<0.05). A logistic regression analysis showed that FBG (odds ratio = 1.274, 95% confidence interval: 1.077–1.505, P=0.005) and Scr (odds ratio = 1.020, 95% confidence interval: 1.002–1.038, P=0.027) were independent predictors of NCL progression. A partial correlation analysis showed that FBG was positively correlated with NCL progression (r = 0.231, P=0.001). A receiver operating characteristic curve showed that the boundary point of FBG to predict NCL progression was 5.715 mmol/L, and the sensitivity was 74.4% and the specificity was 46.4%.
Conclusions
FBG is a valuable predictor for NCL progression in patients with STEMI after PPCI.
Calculation of the optimal number of nurses based on nursing intensity by patient classification groups in general units in South Korea: A cross-sectional study
Authors: Ko Yukyung , Park Bohyun 
Published: February 2022

Abstract
Background: Calculating the accurate number of nursing personnel based on a patient classification system that clearly reflects the nursing needs of patients is a problem directly related to the nursing unit’s budget management, productivity, etc. This study aimed to calculate the total daily nursing workload and the optimal number of nurses per general unit based on the nursing intensity and direct nursing time per inpatient through patient classification.Methods: Three units at one general hospital were investigated. To calculate nursing intensity, patient classification according to nursing needs was performed for over 10 days in each unit in September 2018. The direct and non-direct nursing time and nursing intensity scores were analyzed using descriptive statistics (e.g. frequency, percentage, and average) generated using Microsoft Excel.Results: For the internal medicine unit, the average direct nursing time per patient was 1.0, 1.5, 2.2, and 2.9 hours for Groups 1, 2, 3 and 4, respectively. For the surgical unit, the average direct nursing time per patient was 0.9, 1.4, 2.1, and 2.6 hours for Groups 1, 2, 3, and 4, respectively. For the comprehensive nursing care unit, the average direct nursing time per patient was 0.8, 1.2, 1.7, and 2.2 hours for Groups 1, 2, 3, and 4. The optimal number of nurses was 25 in the internal medicine unit, 37 in the surgical unit, and 22 in the comprehensive nursing unit. There was a shortage of five nurses in the internal medicine unit and nine in the surgical unit.Conclusion: Based on the nursing time according to patient classification groups, this study confirmed that the optimal number of nurses cannot be secured and that the nursing intensity is very high. This study’s results suggest that long-term efforts, such as improving the nursing environment, should be made to secure an optimal number of nurses in various hospital nursing units.
Nutrition in the Nursing Home: Expectation vs Reality
Authors: Garg Anu , Szymanski Kate , Merugu Ganesh 
Published: February 2022

Abstract
Background: Determine the nutritional value of the food provided to the average patient in the nursing home and compare to the guidelines for the age matched community dwelling individual. Methods: We obtained weekly meal plans. Nutritional value of each meal was calculated from the USDA food composition database with reference to the supply company. The 3 nursing homes ranged in ownership and in star rating and averaged 120 beds per facility. Food companies were comparable. Results: Patients received 1.58 cups of vegetables with a standard deviation (SD) of 0.31 daily. 1.26 cups of fruit (SD of 0.08) and 0.79 cups of dairy (SD 0.26) daily. Average of 5,308mg of sodium (SD 770.4) daily. 474.08 mg of added sugar (SD 137.88) daily. Saturated fats were 10.86% (SD 0.01) of the calories. Conclusions: Intake of fruits, dairy and vegetables was below recommended levels. Calories and sodium were above recommended values. Added sugar and saturated fats were within recommendations. Several changes can be made to improve nutrition in the nursing home to bring the nutrition closer to expectations in the average community dwelling adult values. We recommend further study concerning interventions.
Varus and steep medial posterior tibial slope are risk factors for degenerative medial meniscus lesions
Authors: Xu Tao , Xu Liuhai , Li Xinzhi , Zhou You 
Published: February 2022

Abstract
Degenerative medial meniscus lesions(DMMLs) is different from other meniscus injuries, which have a high incidence and easy to miss diagnosis in the middle-aged and elderly. The present study was designed to identify the risk factors for DMMLs among an Asian sample. The experimental group included 121 patients（ones partly confirmed during arthroscopic surgery) with DMMLs and the control group included 51 patients with no pathological changes identified by using 3.0-T magnetic resonance imaging (MRI) from January 2017 to January 2021 were analyzed retrospectively. By full-length anteroposterior radiographs of lower limbs in weight-bearing position of the two groups, the Hip-Knee-Ankle (HKA) angle in the coronal plane and the Medial Posterior Tibial Slope(MPTS) in the sagittal plane were measured by the MRI T1 sequence of the knee. The potential risk factors of DMMLs were analyzed by multivariate logistic regression. The independent variables included gender, age, body mass index (BMI), occupational kneeling, Kellgren-Lawrence (K-L) grade, HKA, and MPTS. T-test analysis between the Experimental Group and the Control Group showed statistically significant differences in age (t=10.718, p<0.001), BMI (t=7.300, p<0.001), HKA (t=8.677, p<0.001), and MPTS (t=5.025, p<0.001). Chi-square test analysis between the two groups showed no statistically significant differences in gender (t=0.183, p=0.669) and occupational kneeling (t=0.339, p=0.560). Non-parametric analysis showed statistically significant differences in K-L (z=5.857, p<0.001) between the two groups. Logistic regression analysis showed that age, BMI, HKA, and MPTS were risk factors for DMMLs among the above-mentioned variables with statistically significant differences. Varus, steep MPTS, advancing age and obesity were risk factors for DMMLs.
The Effect of a Mobile-learning Curriculum on Improving Compliance to Quality Management Guidelines for HIV Rapid Testing Services in Rural Primary Healthcare Clinics, KwaZulu-natal, South Africa: a Quasi-experimental Study
Authors: Chamane Nkosinothando , Ogunsakin Ropo Ebenezer , Tivani P. Phosa Mashamba-Thompson Prof 
Published: February 2022

Abstract
Background: Despite significant achievements made towards HIV testing, linkage to antiretroviral therapy treatment and viral load suppression, the Sub-Saharan region of Africa continues to be reported to have the highest prevalence of HIV/AIDS, with over 26 million people living with the disease. In light of the added burden on already overwhelmed health systems due to the Covid-19 pandemic, maintaining the reliability and accuracy of point-of-care diagnostics (POC) results is crucial to ensure the sustainability of quality service delivery. The integration of technology-based interventions into nurse education curricula is growing, to help prepare students for the current practice environment which requires access to large amounts of information. The aim of this study was to determine the effect of a Mobile Learning (mLearning) Curriculum on improving the quality of HIV rapid testing services in rural clinics of KwaZulu-Natal (KZN), South Africa.Methods: To achieve the aim of this study, pre-test and post-test audits were conducted in a quasi-experimental design. Eleven clinics of KZN, with the highest availability and usage of POC diagnostics were selected from a cross-sectional study survey to constitute the sample of this study. The World Health Organization On-site Monitoring Checklist-Assessment of Quality System was adapted and used as an audit tool to evaluate four key quality components. The effect of the mLearning curriculum on HIV testing quality improvement was determined through statistically comparing pre-audit and post-audit results. The independent samples t-test and the Levene’s test were employed to evaluate the equality of measured variables for the two groups. The relationships between variables were estimated using the Pearson pair wise correlation coefficient (p) and correlations were reported as significant at p < 0.05.Findings: A total of 11 clinics was audited at the pretest and 7 clinics were audited post-piloting of the mLearning curriculum. The estimated level of compliance of the participating clinics to quality HIV rapid testing guidelines ranged between poor and moderate quality. The mLearning curriculum was shown to have no statistically significant effect on the quality of POC diagnostic services provided in rural clinics of KZN.Conclusion: The mLearning curriculum was shown to have no statistically significant effect on the quality of HIV rapid testing services provided in participating clinics; however, multiple barriers to the full adoption of the piloted curriculum were identified. The provision of reliable technology devices and improved internet connection were recommended to enhance the adoption of technology-based interventions necessary to improve access to relevant learning material and updated information.
Socioeconomic Status and Metabolic Syndrome in Southwest Iran: Results from Hoveyzeh Cohort Study(HCS)
Authors: Saki Nader , Hashemi Seyed Jalal , Hosseini Seyed Ahmad , Rahimi Zahra , Rahim Fakher , Cheraghian Bahman 
Published: February 2022

Abstract
Background: Socioeconomic status (SES) strongly predicts morbidity and premature mortality, especially for non-communicable diseases (NCDs). However, the effect of these factors on Metabolic Syndrome (MetS) is not clear yet. This study was conducted to assess the relationship between socioeconomic indicators and MetS.Methods: In this prospective cohort study, 10009 people aged 35-70 years enrolled from May 2016 to August 2018. The MetS was defined according to The Standard National Cholesterol Education Program (NCEP) - adult treatment panel III (ATP III) or NCEP-ATP III criteria. Demographics and socioeconomic data were gathered face to face by trained interviews. Also, lab, anthropometrics, and blood pressure measurements were assayed for participants. Logistic regression was used to estimate the association between SES and MetS, adjusted for the potential confounding factors. Results: The overall prevalence of MetS in the participants was 39.1%. The crude odds ratios were statistically significant for all the assessed variables (p<0.05). After adjustment for age, sex, physical activity, smoking, and alcohol use as potential confounders, the results indicated significant direct independent associations between skill level (p=0.006) and Townsend index (p=0.002) with MetS. In contrast, no significant associations were seen between educational level and wealth status with MetS. Conclusion: The results of our study showed that SES is related to MetS. Among four assessed SES indicators, skilled levels and Townsend score had a stronger association with MetS. We recommend considering people's SES when interventional programs are planned and conducted on MetS in similar communities.