bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between service scope of primary care facilities and prevalence of high-cost population: a retrospective study in rural Guizhou, China
Authors: Li Zhong , Li Yixun , Ding Ziqin , Tao Yunxi , Zhang Liang , He Ruibo 
Published: November 2022

Abstract
Background
High-cost (HC) patients, defined as the small percentage of the population that accounts for a high proportion of health care expenditures, are a concern worldwide. Previous studies have found that the occurrence of HC population is partially preventable by providing a greater scope of primary health care services. However, no study has examined the association between the service scope of primary care facilities and the prevalence of HC populations. Therefore, this study aimed to investigate the association between the service scope of primary care facilities (PCFs) and the prevalence of HC populations within the same communities.

Methods
A multistage, stratified, clustered sampling method was used to identify the service scope of PCFs as of 2017 in rural Guizhou, China. The claims data of 299,633 patients were obtained from the local information system of the New Rural Cooperation Medical Scheme. Patients were sorted by per capita inpatient medical expenditures in descending order, and the top 1%, top 5% and top 10% of patients who had incurred the highest costs were defined as the HC population. Logistic regression models were used to assess the association between the service scope of PCFs and the prevalence of the HC population.

Results
Compared with those in the 95% of the sample deemed as the general population, those in the top 5% of the sample deemed as the HC population were more likely to be over the age of 30 (P <  0.001), to be female (P = 0.014) and to be referred to high-level hospitals (P <  0.001). After controlling for other covariates, patients who lived in the communities serviced by the PCFs with the smallest service scope were more likely to be in the top 1%, top 5% and top 10% of the HC population.

Conclusion
A greater PCF service scope was associated with a reduction in the prevalence of the HC population, which would mean that providing a broader PCF service scope could reduce some preventable costs, thus reducing the prevalence of the HC population. Future policy efforts should focus on expanding the service scope of primary care providers to achieve better patient outcomes.
Effect of a multimodal non-pharmacological intervention on older people with dementia: a single-case experimental design study
Authors: Yorozuya Kyosuke , Tsubouchi Yoshihito , Kubo Yuta , Asaoka Yoshihiro , Hayashi Hiroyuki , Fujita Takashi , Hanaoka Hideaki 
Published: November 2022

Abstract
Background
Older people with dementia (PWD) in nursing homes (NHs) tend to have decreased cognitive function, which may cause behavioral and psychological symptoms of dementia (BPSDs) and hinder activities of daily living (ADLs). Therefore, taking measures against the cognitive decline of PWD in NH and, in turn, the decline of BPSDs and ADLs is crucial. The purpose of this study was to test whether a multimodal non-pharmacological intervention (MNPI) is effective in maintaining and improving global cognitive function, BPSDs, and ADLs in PWD in NHs.

Methods
An intervention study using a single-case AB design was conducted in three subjects in NHs. During the non-intervention phase, participants underwent follow-up assessments, and during the intervention phase, they participated in an MNPI. The ABC Dementia Scale (which concurrently assesses ADLs [“A”], BPSDs [“B”], and cognitive function [“C”]) was used for the assessment.

Results
One of the three patients showed improvement in dementia severity, global cognitive function, ADLs, and BPSDs. However, the other two participants showed no improvement following the MNPI, although the possibility of a maintenance effect remained.

Conclusion
Although there is room for improvement of the MNPI, it may be effective in maintaining and improving cognitive function, ADLs, and BPSD, in PWD in NHs.

Trial registration
The University Hospital Medical Information Network Clinical Trials Registry (http://www.umin.ac.jp/, No. UMIN000045858, registration date: November 1, 2021).
Barefoot walking is more stable in the gait of balance recovery in older adults
Authors: Ren Xiping , Kebbach Maeruan , Bruhn Sven , Yang Qining , Lin Huijie , Bader Rainer , Tischer Thomas , Lutter Christoph 
Published: November 2022

Abstract
Background
Perturbation-based balance training on a treadmill is an emerging method of gait stability training with a characteristic task nature that has had positive and sustained effects on balance recovery strategies and fall reduction. Little is known about the effects produced by shod and barefoot walking. We aimed to investigate which is more appropriate, shod or barefoot walking, for perturbation-based balance training in older adults.

Methods
Fourteen healthy older adults (age: 68.29 ± 3.41 years; body height: 1.76 ± 0.10 m; body mass: 81.14 ± 14.52 kg) performed normal and trip-like perturbed walking trials, shod and barefoot, on a treadmill of the Gait Real-time Analysis Interactive Lab. The marker trajectories data were processed by Human Body Model software embedded in the Gait Offline Analysis Tool. The outcomes of stride length variability, stride time variability, step width variability, and swing time variability were computed and statistically analyzed by a two-way repeated-measures analysis of variance (ANOVA) based on gait pattern (normal gait versus perturbed recovery gait) and footwear condition (shod versus barefoot).

Results
Footwear condition effect (p = 0.0310) and gait pattern by footwear condition interaction effect (p = 0.0055) were only observed in swing time variability. Gait pattern effects were detected in all four outcomes of gait variability.

Conclusions
Swing time variability, independent of gait speed, could be a valid indicator to differentiate between footwear conditions. The lower swing time variability in perturbed recovery gait suggests that barefoot walking may be superior to shod walking for perturbation-based balance training in older adults.
Monitoring the progress towards the elimination of hepatitis B and C in Sweden: estimation of core indicators for 2015 and 2018
Authors: Colombe Soledad , Axelsson Maria , Aleman Soo , Duberg Ann-Sofi , Lundberg Ederth Josefine , Dahl Viktor 
Published: November 2022

Abstract
Introduction
To monitor Sweden’s progress towards the WHO goal of eliminating viral hepatitis, we estimated the prevalence, notification rate, and liver-related morbidity and mortality for diagnosed hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in 2015 and 2018.

Methods
We identified cases of hepatitis B and C within the National System for Notifiable Diseases and obtained data on treatment and whether the case was deceased or not. We calculated prevalence, notification rates per 100,000, and proportion of newly diagnosed cases of hepatitis with liver disease at the time of diagnosis, and proportion of all deceased cases who died from liver disease. We calculated Poisson 95% confidence intervals (CIs) around the notification rates and Wilson 95% CIs around prevalence and mortality estimates.

Results
In 2015 and 2018, the prevalence of diagnosed HBV infections was 0.20% [95% CI: 0.19–0.20] and 0.21% [0.20–0.21]. Notification rates per 100,000 for HBV infections were 13.02 [12.32–13.76] and 7.71 [7.18–8.27]. HBV liver-related morbidity was 2.65% [1.90–3.68] and 2.16% [1.35–3.43]. HBV liver-related mortality was 20.00% [14.81–26.44] and 17.95% [13.20–23.94]. In 2015 and 2018, the prevalence of diagnosed HCV-infections was 0.24% [0.24–0.25] and 0.18% [0.18–0.19]. Notification rates per 100,000 for HCV infections were 15.92 [15.14–16.73] and 13.05 [12.36–13.77]. HCV liver–related morbidity was 8.14% [6.89–9.60] and 3.90% [2.99–5.08]. HCV liver–related mortality was 27.08% [24.54–29.77] and 26.90% [24.12–29.88].

Conclusions
All indicators decreased or remained stable between 2015 and 2018, indicating progress in the elimination of viral hepatitis, especially for HCV infection.
Vertical head rotation as major source of differences between time-separated digital cephalometric radiographs of patients acquired in one cephalostat X-ray device
Authors: Schulze Ralf K. W. , Linnerth Lea K. M. 
Published: November 2022

Abstract
Background
The purpose of the retrospective study was to analyze the reliability and repeatability of specific landmark-positions used in cephalometry to determine the major sources of absolute landmark position differences for repeated, time-separated (time-point I and II) digital cephalometric radiographs (CEPH) of the same patients.

Methods
100 pairs of CPEHs from the database of a sample of adult patients (18 to 28 years) were analyzed by one calibrated observer and three landmark points (Sella: S, Nasion: N, Subspinale: A) were digitally marked using ImageJ-software. The coordinates of these points entered the evaluation using displacement vectors as primary endpoints between the coordinates of the landmarks in the two images as well as SNA-angles and the angle ω of SN relative to the floor.

Results
Displacement vectors between CEPHI and CEPHII were rather large (N: 7.95 ± 4.85 mm, S: 5.34 ± 3.50 mm, A: 4.81 ± 3.95 mm. SNA was rather stable between the two sequential radiographs (mean difference: 0.002° ± 1.85°). and did not correlate with age of the patient (SNAI: spearman-Rho: 0.0239, p = 0.8134; SNAII : spearman-Rho: 0.0244, p = 0.8096). Although the vertical angle ω did not differ between CEPHI and CEPHII (mean difference: 0.4° ± 4.7°, pwilcoxon = 0.8155), it showed a quadratic relationship (pF−statistic: < 2.2e−16) with the length of the displacement vector N.

Conclusion
The significantly varying location of the reference points S, N and A between time-separated CEPHs of one patient can largely be explained by different angulation (head rotation within the sagittal plane) of the Frankfurt plane to the floor (horizontal plane).
Diversities in the place of delivery choice: a study among expectant mothers in Ghana
Authors: Baba Mahama Ibrahim , Kyei Kofi Adesi , Kyei Justina Baaba , Daniels Joseph , Biney Isaac Justice Kobina , Oswald John , Tschida Patrick , Brunet Michael 
Published: November 2022

Abstract
Background
In this study, the factors that influence the choice of place of delivery among expectant mothers in both rural and urban settings in the northern part of Ghana were identified and compared using the conceptual framework provided by Thaddeus and Maine.

Methods
A mixed-method study was used to examine expectant mothers and their responses related to factors that affect their choice of place of delivery through a concurrent triangulation using health professional interviews and a detailed participant survey. The sample consisted of 552 expectant mothers between the ages of 15 and 49 years. Individual interviews were conducted with 8 health professionals. There was also a focus group discussion with randomly selected pregnant women and lactating mothers. Themes were generated through open coding of the interview data, while multiple regression was performed to identify the factors associated with choice of place of delivery.

Results
Major preference (60.1%) was for home delivery among rural dwellers compared to 20.7% for urban participants. Statistically significant variables affecting the choice of place of delivery among study participants were found to be educational background, the experience of previous deliveries, the attitude of hospital staff toward pregnant women during labor, and frequency of accessing antenatal care.

Conclusion
Majority of rural women prefer home delivery to facility delivery which is the opposite of the trend observed among urban women. The study’s implications may lead to positive change where stakeholders develop and implement policies to promote health facility delivery for expectant mothers in Ghana.
Diagnostic value of circN4BP2L2 in type I and type II epithelial ovarian cancer
Authors: Ning Li , Lang Jinghe , Long Bo , Wu Lingying 
Published: November 2022

Abstract
Background
CircN4BP2L2 was previously identified to be significantly decreased in epithelial ovarian cancer (EOC) and was associated with disease progression. The aim of this study was to evaluate the diagnostic value of plasma circN4BP2L2 using the unifying model of type I and type II EOC.

Methods
A total of 540 plasma samples were obtained from 180 EOC patients, 180 benign ovarian cyst patients, and 180 healthy volunteers. CircN4BP2L2 was assessed using reverse transcription-quantitative polymerase chain reaction (RT-qPCR). Cancer antigen 125 (CA125) and human epididymis protein 4 (HE4) were assessed using enzyme-linked immunosorbent assay (ELISA). Receiver operating curve (ROC), the area under the curve (AUC), sensitivity and specificity were estimated.

Results
Low level of circN4BP2L2 was associated with advanced tumor stage (p < 0.01) in type I EOC. Decreased circN4BP2L2 was associated with lymph node metastasis (LNM) (p = 0.04) in type II EOC. The expression level of circN4BP2L2 in type I was similar to that in type II. CircN4BP2L2 could significantly separate type I or type II from benign or normal cohort (p < 0.01). Early-stage type I or type II EOC vs. benign or normal cohort could also be distinguished by circN4BP2L2 (p < 0.01).

Conclusion
CircN4BP2L2 might serve as a promising diagnostic biomarker for both type I and type II EOC. The diagnostic safety for circN4BP2L2 in early-stage type I or type II EOC is also acceptable. Further large-scale well-designed studies are warranted to investigate whether circN4BP2L2 is specific for all histologic subgroups.
Effect of peripheral laser photocoagulation retinopexy on macular morphology and optic nerve fiber layer thickness; a prospective case series
Authors: Johari Mohammadkarim , Khani Salman , Amini Abdulrahim , Bolkheir Alireza 
Published: November 2022

Abstract
Purpose
The goal of the research was to determine the incidence of microstructural alterations in the macula and optic nerve head (ONH) occurred in eyes treated with peripheral laser photocoagulation retinopexy.

Methods
Patients with retinal breaks, retinal holes, retinal dialysis, and lattice degenerations who required peripheral laser photocoagulation retinopexy were recruited in this prospective case series investigation. We performed preoperative and postoperative evaluations, including best corrected visual acuity (BCVA), slit lamp examination, intraocular pressure (IOP) measurement, funduscopic examination, and macular and ONH optical coherence tomography (OCT).

Results
Thirty-three eyes of the twenty-three patients enrolled in this study, 14 of which were female. The mean age of the sample was 45.12 ± 9.12 years. The mean refractive error was − 2.45 ± 1.12 Diopters (D). The most prevalent reason for peripheral laser photocoagulation retinopexy was retinal thinning with symptomatic lattice degeneration (90%), followed by retinal hole and break (7%) and retinal dialysis (3%). Between preoperative and postoperative (6-month) evaluation, there was no statistically significant difference in BCVA (P = 0.82), IOP (P = 0.54), central foveal thickness in macular OCT (P = 0.39), or global retinal nerve fiber layer (RNFL) thickness (P = 0.51). There was no association between changes in central foveal thickness and global RNFL thickness and total laser spot numbers (r = − 0.17 P = 0.21, r = 0.06 P = 0.60, respectively). None of patients developed cystoid macular edema (CME) or macular epiretinal membrane (ERM) .

Conclusion
We found that OCT parameters were not significantly affected by laser retinopexy in patients with high-risk peripheral retinal lesions, also none of our patients had developed ERM, vitromacular traction or CME at 6 months follow up periods.
Monitoring European data with prospective space–time scan statistics: predicting and evaluating emerging clusters of COVID-19 in European countries
Authors: Xue Mingjin , Huang Zhaowei , Hu Yudi , Du Jinlin , Gao Miao , Pan Ronglin , Mo Yuqian , Zhong Jinlin , Huang Zhigang 
Published: November 2022

Abstract
Background
Coronavirus disease 2019 (COVID-19) has become a pandemic infectious disease and become a serious public health crisis. As the COVID-19 pandemic continues to spread, it is of vital importance to detect COVID-19 clusters to better distribute resources and optimizing measures. This study helps the surveillance of the COVID-19 pandemic and discovers major space–time clusters of reported cases in European countries. Prospective space–time scan statistics are particularly valuable because it has detected active and emerging COVID-19 clusters. It can prompt public health decision makers when and where to improve targeted interventions, testing locations, and necessary isolation measures, and the allocation of medical resources to reduce further spread.

Methods
Using the daily case data of various countries provided by the European Centers for Disease Control and Prevention, we used SaTScan™ 9.6 to conduct a prospective space–time scan statistics analysis. We detected statistically significant space–time clusters of COVID-19 at the European country level between March 1st to October 2nd, 2020 and March 1st to October 2nd, 2021. Using ArcGIS to draw the spatial distribution map of COVID-19 in Europe, showing the emerging clusters that appeared at the end of our study period detected by Poisson prospective space–time scan statistics.

Results
The results show that among the 49 countries studied, the regions with the largest number of reported cases of COVID-19 are Western Europe, Central Europe, and Eastern Europe. Among the 49 countries studied, the country with the largest cumulative number of reported cases is the United Kingdom, followed by Russia, Turkey, France, and Spain. The country (or region) with the lowest cumulative number of reported cases is the Faroe Islands. We discovered 9 emerging clusters, including 21 risky countries.

Conclusion
This result can provide timely information to national public health decision makers. For example, a country needs to improve the allocation of medical resources and epidemic detection points, or a country needs to strengthen entry and exit testing, or a country needs to strengthen the implementation of protective isolation measures. As the data is updated daily, new data can be re-analyzed to achieve real-time monitoring of COVID-19 in Europe. This study uses Poisson prospective space–time scan statistics to monitor COVID-19 in Europe.
Incorporating movement breaks into primary school classrooms; a mixed methods approach to explore the perceptions of pupils, staff and governors
Authors: Chorlton Rebecca A. , Williams Craig A. , Denford Sarah , Bond Bert 
Published: November 2022

Abstract
Background
Public health guidelines for children advocate physical activity (PA) and the restriction of continuous sedentary time. Schools offer an attractive setting for health promotion, however school-based interventions to increase PA typically fail, and primary school children may spend most of the school day sitting down. Classroom movement breaks have been identified as an attractive opportunity to address this concern and may positively influence behaviour, but little is known about the barriers to implementing movement within lessons from a multi stakeholder perspective. The purpose of this study was to explore (1) the perceptions of primary school pupils, staff members and governors regarding classroom movement breaks, and (2) their perceived barriers and facilitators to implementing PA into the classroom.

Methods
Thirty-four pupils (Key Stages 1 and 2, ages 5–7 y) took part in a focus group discussion. Sixty-four staff members and twenty governors completed a questionnaire and an optional follow up semi-structured telephone interview. Qualitative data were analysed using thematic analysis.

Results
Pupils, staff members and governors expressed an enthusiasm for movement breaks provided that they were short, simple, pupil-guided and performed at the discretion of the teacher. Time and concerns regarding transitioning back to work following a movement break were identified as key barriers by pupils and staff. Governors and some staff expressed that favourable evidence for movement breaks is needed to facilitate their adoption, particularly regarding the potential for improvements in cognitive functioning or classroom behaviour.

Conclusion
There is a wide appeal for classroom-based activity breaks, when delivered in a manner that is not disruptive. Future research which examines the potential benefits of such activity breaks is warranted.
The SLC6A19 gene mutation in a young man with hyperglycinuria and nephrolithiasis: a case report and literature review
Authors: Pan Yang , Wang Shangren , Liu Li , Liu Xiaoqiang 
Published: November 2022

Abstract
Background
Hyperglycinuria is a rare disorder, with few reported cases, caused by either a defect in glycine metabolism or a disturbance in renal glycine reabsorption. Genetic findings of hyperglycinuria are rare and have not previously been reported in Chinese young men.

Case presentation
A 24-year-old man presented with a compliant of bilateral lumbago for 1 month. Abdominal computed tomography revealed bilateral kidney stones and right upper ureteral dilatation. The 24-h urine analysis showed high urine oxalate levels of 63 mg/day. Analysis of amino acids in urine revealed that his urinary glycine levels were abnormally high (2.38 µmol/mg creatinine). Whole-exome sequencing detected the SLC6A19 variant c.1278 C > T p. (Cys426). Flexible ureteroscopy with holmium laser lithotripsy was conducted twice to remove his bilateral nephrolithiasis. Postoperative stone biochemical composition analysis revealed that the stones were composed of approximately 70% calcium oxalate monohydrate and 30% calcium oxalate dihydrate. The patient was subsequently diagnosed with hyperglycinuria. Three months after the stone surgery, ultrasonography revealed one nodule under the right thyroid lobe during a health checkup. His serum parathyroid hormone (PTH) levels increased to 392.3 pg/mL. Resection of the right parathyroid nodule was performed, and the histopathological examination confirmed right parathyroid adenoma. During the 2-year follow-up period, nephrolithiasis did not relapse, and serum PTH, calcium, and phosphorus levels were normal.

Conclusion
The SLC6A19 gene may have been significant in the development of hyperglycinuria in a Chinese young man. Further evaluation for the possibility of a glycine excretion disorder could be considered when encountering nephrolithiasis.