bluuebunny/crossref_metadata_2025_split huggingface dataset:
Socioeconomic and geographic differences in ablation of atrial fibrillation in Norway - a national cohort study
Authors: Olsen Frank , Uleberg Bård , Jacobsen Bjarne K. , Heuch Ivar , Tande Pål M. , Bugge Einar , Balteskard Lise 
Published: February 2022

Abstract
Background
The aim of this study was to analyse whether there are patient related or geographic differences in the use of catheter ablation among atrial fibrillation patients in Norway.

Methods
National population-based data on individual level of all Norwegians aged 25 to 75 diagnosed with atrial fibrillation from 2008 to 2017 were used to study the proportion treated with catheter ablation. Survival analysis, by Cox regression with attained age as time scale, separately by gender, was applied to examine the associations between ablation probability and educational level, income level, place of residence, and follow-up time.

Results
Substantial socioeconomic and geographic variation was documented. Atrial fibrillation patients with high level of education and high income were more frequently treated with ablation, and the education effect increased with increasing age. Patients living in the referral area of St. Olavs Hospital Trust had around three times as high ablation rates as patients living in the referral area of Finnmark Hospital Trust.

Conclusions
Differences in health literacy, patient preference and demands are probably important causes of socioeconomic variation, and studies on how socioeconomic status influences the choice of treatment are warranted. Some of the geographic variation may reflect differences in ablation capacity. However, geographic variation related to differences in clinical practice and provider preferences implies a need for clearer guidelines, both at the specialist level and at the referring level.
Teachers’ working time as a risk factor for their mental health - findings from a cross-sectional study at German upper-level secondary schools
Authors: Kreuzfeld Steffi , Felsing Christoph , Seibt Reingard 
Published: February 2022

AbstractBackgroundThe work of teachers has changed due to an increase in the range of tasks. However, there is a lack of current information on working hours, task distribution and the possible health effects.MethodsFor the first time for Germany as a whole, a cross-sectional survey determined how long teachers at upper-level secondary schools work per week, what influences their working hours and how different recording methods affect the total working hours. To this end, 6,109 full-time teachers estimated their working hours based on twelve categories and then documented these daily over 4 weeks. Afterwards, the effects of long working hours on teachers' ability to recover and emotional exhaustion were analysed.ResultsThe article shows the large interindividual variance in the working hours of teachers and a significant influence of sex, age, and subject profile. Self-reported working hours varied substantially by method used to record working time with work time reported via daily diaries totaling 2 h per week more than hours recorded by a single estimation.A substantial proportion of the teachers (36%) work longer per week than European guidelines allow (> 48 h); 15% work even more than 55 h per week. Teachers who work more than 45 h per week suffer more often from inability to recover (46%) and emotional exhaustion (32%) than teachers who work less than 40 h per week (26% and 22% respectively).ConclusionsTaking professional experience and teaching subjects into account could in future contribute to a fairer distribution of workload among teachers. This could protect individual teachers from long working hours, ensure sufficient recovery and also reduce the risk of emotional exhaustion. In order to identify teachers whose health is at risk at an early stage, voluntary preventive care offers would be considerably helpful.
Prevalence of overweight, obesity and central obesity and factors associated with BMI in indigenous yaqui people: a probabilistic cross-sectional survey
Authors: Serna-Gutiérrez Araceli , Castro-Juarez Alejandro Arturo , Romero-Martínez Martín , Alemán-Mateo Heliodoro , Díaz-Zavala Rolando Giovanni , Quihui-Cota Luis , Álvarez-Hernández Gerardo , Gallegos-Aguilar Ana Cristina , Esparza-Romero Julián 
Published: February 2022

Abstract
Background
The Yaquis are an Indigenous group who inhabit in the state of Sonora in northwestern Mexico. This group has experienced changes in their lifestyle, moving from a traditional lifestyle to a more modern one, resulting in an increase of obesity and its comorbidities. However, few studies have been done in this group. The aim of this study was to determine the prevalence of overweight, obesity and central obesity and to identify the factors associated with body mass index (BMI) in a representative sample of Indigenous Yaqui people from Sonora, Mexico.

Methods
A cross-sectional survey with multistage sampling was conducted among adults (N = 351) with residence in Yaqui traditional villages (Vícam, Pótam, Loma de Guamúchil, Loma de Bácum, Tórim, Ráhum, Huiribis or Belem). Anthropometric measurements were taken to diagnose overweight, obesity and central obesity. Food frequency and physical activity (PA) questionnaires designed for the Yaqui population were applied, as well as sociodemographic and clinical history questionnaires. The factors associated with BMI were assessed using multiple linear regression considering the complex design of the sampling.

Results
The prevalence of overweight, obesity and central obesity in the population were 36.5%, 35.0% and 76.0%, respectively. Having higher values of the modernization index (β = 0.20, p = 0.049) was associated with a higher BMI, while having a higher consumption of a “prudent” dietary pattern (traditional dishes, fruits, vegetables and low-fat dairy) (β = -0.58, p = 0.009) and performing a greater number of hours per week of vigorous PA (β = -0.14, p = 0.017) were associated with a lower BMI.

Conclusions
The prevalence of the studied abnormalities is high. The evidence presented in this study suggests that interventions are needed and more research is required to determine the appropriate components of such interventions, in order to meet the needs of the Yaqui people.
Managing prior approval for site-of-service referrals: an algorithmic approach
Authors: Dada Maqbool , Mundly Vishal , Chambers Chester G. , Alamdar Yazdi Mohammad Ali , Ha Changhun , Toporcer Sonia E. , Zhou Yi , Gan Yunong , Xing Zhihua , Mooney Mark , Smith Ernest , Kumian Edward , Williams Kayode A. 
Published: February 2022

Abstract
Objectives
Many payers and health care providers are either currently using or considering use of prior authorization schemes to redirect patient care away from hospital outpatient departments toward free-standing ambulatory surgical centers owing to the payment differential between these facilities. In this work we work with a medium size payer to develop and lay out a process for analysis of claims data that allows payers to conservatively estimate potential savings from such policies based on their specific case mix and provider network.

Study Design
We analyzed payment information for a medium-sized managed care organization to identify movable cases that can reduce costs, estimate potential savings, and recommend implementation policy alternatives.

Methods
We analyze payment data, including all professional and institutional fees over a 15-month period. A rules-based algorithm was developed to identify episodes of care with at least one alternate site for each episode, and potential savings from a site-of-service policy.

Results
Data on 64,884 episodes of care were identified as possible instances that could be subject to the policy. Of those, 7,679 were found to be attractive candidates for movement. Total projected savings was approximately $8.2 million, or over $1,000 per case.

Conclusions
Instituting a site-of-service policy can produce meaningful savings for small and medium payers. Tailoring the policy to the specific patient and provider population can increase the efficacy of such policies in comparison to policies previously established by other payers.
Impact of the bidirectional relationship between communication and cognitive efficacy on orthopedic patient adherence behavior
Authors: Chang Dong-Shang , Chen Wil-Lie , Wang Rouwen 
Published: February 2022

Abstract
Background
There is growing interest in patient autonomy, and communication between physicians and patients has become the essential cornerstone for improving the quality of healthcare services. Previous research has concentrated on the direct effect of physician-patient communication on service outcomes. In the present study, we examined the influence among constructs in the service process and the impact on healthcare outcomes. The present study used behavioral theory to expand the process aspect of the Donabedian healthcare service quality structure-process-outcome model to examine the impact of cognitive changes and communication feedback on patients’ adherence behavior. In addition, the moderating effect of hospital facility levels is examined.

Methods
A conceptual model was developed and tested using a questionnaire administered to patients in eight hospitals. A total of 397 respondents returned usable surveys, with a response rate of 92.11%. Structural equation modeling was used to analyze the data in two steps that involved a measurement model and a structural model. The former was applied to estimate the Cronbach’s alphas, intercorrelations of factors, and descriptive statistics; the latter was used to test the hypothesized relationships of the constructs.

Results
The results identified three mediators of the healthcare process within the healthcare services framework: physician-patient communication, cognitive efficacy, and adherence behavior. Physician-patient communication influenced cognitive efficacy (β = 0.16, p < 0.001), and cognitive efficacy influenced physician-patient communication (β = 0.18, p < 0.001). The effect of this bidirectional relationship on adherence behavior was positive (β = 0.38, p < 0.001). The healthcare structure influenced healthcare outcomes via these three healthcare process constructs. The adherence behavior of patients who were treated in the medical center has greater influences by the structure and physician-patient communication than it was treated in the regional hospitals.

Conclusions
This study revealed a complex pattern in relationships among process constructs for healthcare services. The findings of this study acknowledge the important potential interrelationships among the healthcare service constructs to improve the quality of healthcare outcomes.

Trial registration
CRREC104107. Date: 22/01/2016. Prospectively Registered.
Difference in drug cost between private and public drug plans in Quebec, Canada
Authors: M. Chamoun , A. Forget , I. Chabot , M. Schnitzer , L. Blais 
Published: February 2022

Abstract
Background
We expect a difference in drug cost between private drug plans and the Public Drug Plan (PDP) because the dispensing fee is fixed and regulated by the PDP for publicly insured patients, whereas it is determined freely by the pharmacy owner for privately insured patients. This study compared the drug cost of Quebec residents covered by private drug plans with those covered by PDP.

Methods
We used a sample of prescriptions filled between 1 January 2015 and 23 May 2019 selected from reMed, a database of Quebecers’ drug claims. We created strata of prescriptions filled by privately insured patients and matched them with strata of prescriptions filled by publicly insured patients based on the Drug Identification Number, quantity dispensed, number of days of supply, pharmacy identifier, and a date corresponding to the publication of List of Medications of Régie de l’Assurance Maladie du Québec. The differences in drug cost between private plans and the PDP were analyzed with linear regression models using prescription strata as the unit of analysis.

Results
Based on 38 896 prescription strata, we observed that privately insured patients payed $9·35 (95% confidence interval [CI]: 5·58; 13·01) more on average per drug prescription than publicly insured patients, representing a difference of 17·6%.

Conclusions
This study showed that, on average, drug cost is substantially higher for privately insured Quebecers. Knowing that adherence to treatment is affected by drug cost, these results will help public health authorities to make informed decisions about drug policies.
O-GlcNAc transferase couples MRE11 to transcriptionally active chromatin to suppress DNA damage
Authors: Gondane Aishwarya , Girmay Samuel , Helevä Alma , Pallasaho Satu , Loda Massimo , Itkonen Harri M. 
Published: February 2022

Abstract
Background
Transcription, metabolism and DNA damage response are tightly regulated to preserve the genomic integrity, and O-GlcNAc transferase (OGT) is positioned to connect the three. Prostate cancer is the most common cancer in men, and androgen-ablation therapy halts disease progression. However, a significant number of prostate cancer patients develop resistance against anti-androgens, and this incurable disease is termed castration-resistant prostate cancer (CRPC). We have shown that combined inhibition of OGT and the transcription elongation kinase CDK9 induce CRPC-selective anti-proliferative effects. Here, we explain the functional basis for these combinatorial effects.

Methods
We used comprehensive mass spectrometry profiling of short-term CDK9 inhibitor effects on O-GlcNAcylated proteins in an isogenic cell line system that models transition from PC to CRPC. In addition, we used both ChIP-seq and RNA-seq profiling, and pulldown experiments in multiple CRPC models. Finally, we validated our findings in prostate cancer patient samples.

Results
Inhibition of CDK9 results in an OGT-dependent remodeling of the proteome in prostate cancer cells. More specifically, the activity of the DNA damage repair protein MRE11 is regulated in response to CDK9 inhibition in an OGT-dependent manner. MRE11 is enriched at the O-GlcNAc-marked loci. CDK9 inhibition does not decrease the expression of mRNAs whose genes are bound by both O-GlcNAc and MRE11. Combined inhibition of CDK9 and OGT or MRE11 further decreases RNA polymerase II activity, induces DNA damage signaling, and blocks the survival of prostate cancer cells. These effects are seen in CRPC cells but not in normal prostate cells. Mechanistically, OGT activity is required for MRE11 chromatin-loading in cells treated with CDK9 inhibitor. Finally, we show that MRE11 and O-GlcNAc are enriched at the prostate cancer-specific small nucleotide polymorphic sites, and the loss of MRE11 activity results in a hyper-mutator phenotype in patient tumors.

Conclusions
Both OGT and MRE11 are essential for the repair of CDK9 inhibitor-induced DNA damage. Our study raises the possibility of targeting CDK9 to elicit DNA damage in CRPC setting as an adjuvant to other treatments.

Graphical Abstract
Quantitative assessment the longitudinal changes of pulmonary vascular counts in chronic obstructive pulmonary disease
Authors: Park Sang Won , Lim Myoung-Nam , Kim Woo Jin , Bak So Hyeon 
Published: February 2022

Abstract
Background
Chest computed tomography (CT) is a widely used method to assess morphological and dynamic abnormalities in chronic obstructive pulmonary disease (COPD). The small pulmonary vascular cross-section (CSA), quantitatively extracted from volumetric CT, is a reliable indicator for predicting pulmonary vascular changes. CSA is associated with the severity of symptoms, pulmonary function tests (PFT) and emphysema and in COPD patients the severity increases over time. We analyzed the correlation longitudinal changes in pulmonary vascular parameters with clinical parameters in COPD patients.

Materials and methods
A total of 288 subjects with COPD were investigated during follow up period up to 6 years. CT images were classified into five subtypes from normal to severe emphysema according to percentage of low-attenuation areas less than -950 and -856 Hounsfield units (HU) on inspiratory and expiratory CT (LAA-950, LAA-856exp). Total number of vessels (Ntotal) and total number of vessels with area less than 5 mm2 (N<5 mm) per 1 cm2 of lung surface area (LSA) were measured at 6 mm from the pleural surface.

Results
Ntotal/LSA and N<5 mm/LSA changed from 1.16 ± 0.27 to 0.87 ± 0.2 and from 1.02 ± 0.22 to 0.78 ± 0.22, respectively, during Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage progression. Both parameters changed from normal to severe emphysema according to CT subtype from 1.39 ± 0.21 to 0.74 ± 0.17 and from 1.18 ± 0.19 to 0.67 ± 0.15, respectively. LAA-950 and LAA-856exp were negatively correlated with Ntotal/LSA (r = − 0.738, − 0.529) and N<5 mm /LSA (r = − 0.729, -− .497). On the other hand, pulmonary function test (PFT) results showed a weak correlation with Ntotal/LSA and N<5 mm/LSA (r = 0.205, 0.210). The depth in CT subtypes for longitudinal change both Ntotal/LSA and N<5 mm/LSA was (− 0.032, − 0.023) and (− 0.027) in normal and SAD, respectively.

Conclusions
Quantitative computed tomography features faithfully reflected pulmonary vessel alterations, showing in particular that pulmonary vascular alteration started.
“I got to catch my own baby”: a qualitative study of out of hospital birth
Authors: Sperlich Mickey , Gabriel Cynthia 
Published: February 2022

AbstractBackgroundAbout 1.6% of planned births in the United States occur out of hospitals. Studies indicate that planned out-of-hospital birth (OOHB) is safe and satisfying for women; however, there is great variation among ethnic groups, and Black women are underrepresented. A recent phenomenon is the choice to have an unassisted birth (UAB) with no midwife or other professional maternity care attendant. The purpose of this study is to fill a gap in understanding reasons for choosing OOHB or UAB for two clinically important sub-groups of women: Black women, and women who have experienced childhood physical or sexual abuse.MethodsThis study recruited 18 women who had an OOHB or UAB and who identified as either Black or survivors of trauma to participate in in-depth qualitative interviews concerning their choice to give birth out of hospital. A grounded theory approach was utilized that involved a discursive process of data collection, coding textual passages to identify focused themes, memo writing to document analytic decision-making, and eventual conceptual modeling.ResultsAll 18 participants endorsed a history of trauma. Focused coding to identify inherent concepts led to the emergence of a theoretical model of the arc of decision-making around choice of place of birth and birth attendant, or lack thereof. Women may choose OOHB or UAB because of a previous trauma, or because they feel discriminated against by healthcare professionals, either because of skin color, age, pregnancy, weight, or some other health condition. Women may choose OOHB or UAB because it affords more control during the process of giving birth.ConclusionPrevious trauma and experiences of discrimination were influential factors for women in the study sample in their choice of birthplace setting and choice of provider. These findings can inform clinical understanding for birth professionals, including doctors, midwives, doulas, nurses, social workers, and psychologists, and contributes more broadly to the national conversation about birth choices in the USA.
The impact of COVID-related perceived stress and social support on generalized anxiety and major depressive disorders: moderating effects of pre-pandemic mental disorders
Authors: Monistrol-Mula Anna , Felez-Nobrega Mireia , Domènech-Abella Joan , Mortier Philippe , Cristóbal-Narváez Paula , Vilagut Gemma , Olaya Beatriz , Ferrer Montse , Gabarrell-Pascuet Aina , Alonso Jordi , Haro Josep Maria 
Published: February 2022

Abstract
Background
We assessed the moderating effect of pre-pandemic mental disorders on the association of COVID-related perceived stress and social support with mental health.

Methods
A nationally representative sample of 3500 Spanish adults was interviewed in June 2020 (mean age 49.25 years, ± 15.64; 51.50% females). Mental health included Generalized Anxiety Disorders (GAD; GAD-7, cut-off point of ≥ 10), Major Depressive Disorders (MDD; PHQ-8, cut-off point of ≥ 10) and the comorbid form (those screening positive for GAD and MDD). COVID-related stress was assessed using an adapted version of the Peri Life Events Scale, and social support using the Oslo Social Support Scale. Logistic regression models were used to assess if COVID-related stress and social support were related to mental health outcomes and interactions were conducted to examine whether these relationships differed according to the presence of pre-pandemic mental disorders.

Results
Higher COVID-related stress was associated with a higher risk of lower mental health. The association between COVID-related stress with GAD and MDD was significantly moderated by pre-pandemic mental disorders, except for comorbid GAD + MDD. Higher levels of social support were linked to better mental health. Only the association between social support and GAD was significantly moderated by pre-pandemic mental disorders. That is, for those without pre-pandemic mental disorders, higher levels of social support decreased the odds of GAD, while minor decreases were observed in those with pre-pandemic mental disorders.

Conclusions
The impact of COVID-related stress and social support on specific indicators of mental health may vary depending on the existence of a previous mental disorder.