bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of an Intervention to Address Smoking and Food Insecurity at Preoperative Surgical Clinic Appointments
Authors: Lussiez Alisha , Hallway Alexander , Lui Maxine , Perez-Escolano Jose , Sukhon Deena , Palazzolo William , Elhady Hatim , Englesbe Michael , Howard Ryan 
Published: October 2022

ImportanceThe health of the US population is decreasing, and novel strategies are needed to reverse the trajectory. The surgical episode may be an opportune time to screen for poor health behaviors and social needs, yet little is known about the feasibility or acceptability of such efforts.ObjectiveTo assess the feasibility and acceptability of a pilot program that engages patients in health behavior change and addresses unmet social needs at the time of surgery.Design, Setting, and, ParticipantsThis quality improvement study was conducted among 10 338 patients seen in a preoperative clinic for elective surgery between February 8 and August 31, 2021. Patients who received a referral for institutional resources were contacted via telephone to complete follow-up surveys 30 to 90 days after surgery and between July 1, 2021, and March 31, 2022.InterventionsImplementation of a tool to screen patients for smoking and food insecurity in a preoperative clinic. Those who screened positive were offered referrals for institutional resources. Telephone surveys were conducted with patients who accepted referrals to understand attitudes toward addressing health behaviors and social needs.Main Outcomes and MeasuresScreening and referral rates, patient-perceived acceptability of addressing health behaviors and social needs at the time of surgery, smoking cessation rates, and resolution of food insecurity.ResultsA total of 10 338 patients (6052 women [58.5%]; mean [SD] age, 56.5 [17.9] years) were evaluated in the preoperative clinic. Of the 10 338 patients, 7825 (75.7%) were successfully screened. Of the 641 identified smokers, 152 (23.7%) accepted a referral for smoking cessation counseling. Of the 181 identified patients with food insecurity, 121 (66.9%) accepted a referral for nonmedical needs assistance. On follow-up surveys, 64 of 78 smokers (82.1%) agreed that the preoperative appointment was an appropriate time to discuss smoking cessation, and 34 of 78 smokers (43.6%) reported quitting smoking. Similarly, 69 of 84 patients with food insecurity (82.1%) agreed it was a good or very good idea for health systems to address nonmedical needs at the time of surgery, and 27 patients (32.1%) reported no longer being insecure about food since their preoperative visit.Conclusions and RelevanceThis study suggests that it is feasible to address patients’ foundational health at the time of surgery. Most patients agreed that these interventions were appropriate during the perioperative period. These results support using the surgical episode as an opportunity to address foundational health.
Clinical Trial Participation Among Older Adult Medicare Fee-for-Service Beneficiaries With Cancer
Authors: Green Angela K. , Tabatabai Sara M. , Aghajanian Carol , Landgren Ola , Riely Gregory J. , Sabbatini Paul , Bach Peter B. , Begg Colin B. , Lipitz-Snyderman Allison , Mailankody Sham 
Published: October 2022

ImportanceClinical trials play a critical role in the development of novel cancer therapies, and precise estimates of the frequency with which older adult patients with cancer participate in clinical trials are lacking.ObjectiveTo estimate the proportion of older adult Medicare Fee-for-Service (FFS) beneficiaries with cancer who participate in interventional cancer clinical trials, using a novel population-based methodology.Design, Setting, and ParticipantsIn this retrospective cohort study evaluating clinical trial participation among older adult patients with cancer from January 1, 2014, through June 30, 2020, claims data from Medicare FFS were linked with the ClinicalTrials.gov to determine trial participation through the unique National Clinical Trial (NCT) identifier. The proportion of patients with newly diagnosed or newly recurrent cancer in 2015 participating in an interventional clinical trial and receiving active cancer treatment from January 2014 to June 2020 was estimated. Data analysis was performed from November 18, 2020, to November 1, 2021.ExposuresPatients with cancer aged 65 years or older with Medicare FFS insurance, with and without active cancer treatment.Main Outcomes and MeasuresEnrollment in clinical trials among all patients with cancer 65 years and older and among patients receiving active cancer treatments as defined by the presence of at least 1 NCT identifier corresponding to an interventional cancer clinical trial in Medicare claims.ResultsAmong 1 150 978 patients (mean [SD] age, 75.7 [8.4] years; 49.9% men and 50.1% women) with newly diagnosed or newly recurrent cancer in 2015, 12 028 (1.0%) patients had a billing claim with an NCT identifier indicating enrollment in an interventional cancer clinical trial between January 2014 and June 2020. In a subset of 429 343 patients with active cancer treatment, 8360 (1.9%) were enrolled in 1 or more interventional trials. Patients enrolled in a trial tended to be younger, male, a race other than Black, and residing in zip codes with high median incomes.Conclusions and RelevanceFindings of this cohort study show that clinical trial enrollment among older adult patients with cancer remains low, with only 1.0% to 1.9% of patients with newly diagnosed or recurrent cancer in 2015 participating in an interventional cancer clinical trial as measured by the presence of NCT identifiers in Medicare claims. These data provide a contemporary estimate of trial enrollment, persistent disparities in trial participation, and only limited progress in trial access over the past 2 decades.
Prevalence and Incidence of Dry Eye and Meibomian Gland Dysfunction in the United States
Authors: McCann Paul , Abraham Alison G. , Mukhopadhyay Adhuna , Panagiotopoulou Kanella , Chen Hongan , Rittiphairoj Thanitsara , Gregory Darren G. , Hauswirth Scott G. , Ifantides Cristos , Qureshi Riaz , Liu Su-Hsun , Saldanha Ian J. , Li Tianjing 
Published: October 2022

ImportanceDry eye is a common clinical manifestation, a leading cause of eye clinic visits, and a significant societal and personal economic burden in the United States. Meibomian gland dysfunction (MGD) is a major cause of evaporative dry eye.ObjectiveTo conduct a systematic review and meta-analysis to obtain updated estimates of the prevalence and incidence of dry eye and MGD in the United States.Data SourcesOvid MEDLINE and Embase.Study SelectionA search conducted on August 16, 2021, identified studies published between January 1, 2010, and August 16, 2021, with no restrictions regarding participant age or language of publication. Case reports, case series, case-control studies, and interventional studies were excluded.Data Extraction and SynthesisThe conduct of review followed a protocol registered on PROSPERO (CRD42021256934). PRISMA guidelines were followed for reporting. Joanna Briggs Institute and Newcastle Ottawa Scale tools were used to assess risk of bias. Data extraction was conducted by 1 reviewer and verified by another for accuracy. Prevalence of dry eye and MGD were combined in separate meta-analyses using random-effects models.Main Outcomes and MeasuresPrevalence and incidence of dry eye and MGD in the United States. Summary estimates from meta-analysis of dry eye and MGD prevalence with 95% CI and 95% prediction intervals (95% PI).ResultsThirteen studies were included in the systematic review. Dry eye prevalence was reported by 10 studies, dry eye incidence by 2 studies, and MGD prevalence by 3 studies. Meta-analysis estimated a dry eye prevalence of 8.1% (95% CI, 4.9%-13.1%; 95% PI, 0%-98.9%; 3 studies; 9 808 758 participants) and MGD prevalence of 21.2% (95% CI, 7.2%-48.3%; 95% PI, 0%-100%; 3 studies; 19 648 participants). Dry eye incidence was 3.5% in a population 18 years and older and 7.8% in a population aged 68 years and older. No studies reported MGD incidence.Conclusions and RelevanceThis systematic review and meta-analysis demonstrated uncertainty about the prevalence and incidence of dry eye and MGD in the United States. Population-based epidemiological studies that use consistent and validated definitions of dry eye and MGD are needed for higher-certainty estimates of dry eye and MGD prevalence and incidence in the United States.
Quantitative Evaluation of Aerosol Generation During In-Office Flexible Laryngoscopy
Authors: Bastien Amanda J. , Wiredu Kwame , Lee Andrew Y. , Rees Christiaan , Hinchcliff Mason T. , Paydarfar Joseph A. 
Published: October 2022

ImportanceDespite growing scientific knowledge and research, it is still unknown if office flexible laryngoscopy (FL) is aerosol generating and thereby potentially increases the risk of SARS-CoV-2 transmission. The limited literature that exists is conflicting, precluding formal conclusions.ObjectiveTo determine whether FL is aerosol generating.Design, Setting, and ParticipantsThis prospective cohort study included 134 patients seen in the otolaryngology clinic at a single tertiary care academic institution between February and May 2021. Two optical particle sizer instruments were used, quantifying particles ranging from 0.02 μm to 5 μm. Measurements were taken every 30 seconds, with sample periods of 15 seconds throughout the patient encounter. Instruments were located 12 inches from the patient’s nares. Timing of events was recorded, including the start and end of physical examination, topical spray administration, start and end of laryngoscopy, and other potential aerosol-generating events (eg, coughing, sneezing). Data analysis was performed from February to May 2021.ExposuresOffice examination and office FL.Main Outcomes and MeasuresBayesian online change point detection (OCPD) algorithm was used to detect significant change points (CPs) in this time-series data. The primary outcome was significant CP after FL compared with baseline physiologic variations, such as breathing and phonation.ResultsData were collected from 134 patients between February and May 2021. Ninety-one encounters involved FL. Of this group, 51 patients (56%) wore no mask over their mouth during FL. There was no statistically significant CP in either visits involving FL or visits where FL was not performed. Use of nasal spray did not result in CP in aerosol levels. Overall, neither the number of people present in the examination room, masks over patients’ mouth, the duration of the visit, nor the duration of FL were associated with mean aerosol counts, regardless of the exposure. For larger aerosol sizes (≥1 μm), however, rooms with higher air exchange rates had significantly higher reductions in mean aerosol counts for visits involving FL.Conclusions and RelevanceThe findings of this cohort study support that FL, including topical spray administration, is not a significant aerosol-generating procedure. The Bayesian OCPD model has a promising application for future aerosol studies in otolaryngology.
Hospital Markup in Head and Neck Cancer Surgery in the US
Authors: Miller Jonas R. , Frick Kevin D. , Gourin Christine G. 
Published: October 2022

ImportanceMarked variation in hospital costs and payments is a target for health care reform efforts. Limited data exist to explain variability in prices for head and neck surgical procedures.ObjectiveTo characterize variations in hospital price markup for head and neck cancer surgery, and examine associations with market concentration and hospital for-profit status.Design, Setting, and ParticipantsIn this cross-sectional study, the Nationwide Inpatient Sample was used to identify 150 275 patients who underwent head and neck cancer surgery for a malignant upper aerodigestive tract neoplasm from 2001 to 2011. The markup ratio (charges to costs) was modeled as a continuous and categorical variable. Hospital market concentration was evaluated using a variable-radius Herfindahl-Hirschman Index from the 2000, 2003, 2006, and 2009 Hospital Market Structure files. Data were analyzed from May 2019 to July 2019.Main Outcomes and MeasuresMultivariable regression was used to evaluate associations between hospital and patient variables and hospital markup.ResultsThere were 150 275 patients (mean [SD] age, 61.8 [12.6] years; 104 974 [70.0%] male) from 2001 to 2011 for whom hospital market information was available. Hospital markup ratios ranged from 0.8 to 8.7, with a mean markup ratio of 2.8 (95% CI, 2.7-2.9). Hospitals in the lowest markup ratio quartile had a mean markup ratio of 1.8 (95% CI, 1.8-1.9), while hospitals in the top markup ratio quartile (extreme markup) had a mean markup ratio of 4.1 (95% CI, 4.0-4.2). Extreme markup hospitals were more often large (77.5% vs 66.6%), private for-profit hospitals (19.0% vs 1.3%), and were less likely to be high-volume hospitals (21.0% vs 9.4%) or in competitive markets (64.4% vs 82.0%). Postoperative complications occurred more often in extreme markup hospitals (22.7% vs 17.1%). On multivariate analysis, a significantly higher markup was associated with private, for-profit hospitals (47.9%; 95% CI, 33.3%-64.2%), hospitals in the West (25.5%; 95% CI, 12.6%-39.8%), Hispanic race (9.8%; 95% CI, 4.4%-15.5%), prior radiation therapy (5.3%; 95% CI, 1.3%-9.4%), comorbidity (3.5%; 95% CI, 1.7%-5.4%), and complications (2.8%; 95% CI, 0.3%-5.4%). Hospital market concentration modified the association between hospital for-profit status and markup, with higher markups in for-profit hospitals in moderately concentrated and concentrated (less competitive) markets.Conclusions and RelevanceIn this cross-sectional study, there was wide variation in hospital markup for head and neck cancer surgery, with a 4-fold increase in charges relative to costs in 25% of hospitals. Variations in surgical price were primarily associated with hospital profit status. These data suggest that greater transparency is needed to address disparities in hospital pricing.
Structural Defects in Phase‐Regulated High‐Entropy Oxides toward Superior Microwave Absorption Properties
Authors: Zhao Biao , Du Yiqian , Yan Zhikan , Rao Longjun , Chen Guanyu , Yuan Mingyue , Yang Liting , Zhang Jincang , Che Renchao 
Published: October 2022

AbstractHigh‐entropy (HE) oxides have become increasingly popular as electromagnetic wave‐absorbing materials owing to their customizable structure and unique HE effects. However, the weak loss property of single‐phase HE ceramics and the approaches implemented to improve them based on semi‐empirical rules severely limit their development. Herein, two biphasic HE oxides are prepared by simple sintering to realize accurate regulation of crystal phases and structural defects. It is verified that HE effects cause various defects that are beneficial for microwave dissipation within complex‐phase ceramics. In spinel/perovskite HE oxides, around the interface of spinel (111) and perovskite (110) planes, notable stress concentrations and lattice distortions are directly observed, inducing numerous point defects and stacking faults. Interestingly, besides the existing heterogeneous interface of rock salt (220)/spinel (220) plane and defects, rock salt/spinel HE oxides enabled synergistic effects via the precise regulation of components’ phase. Driven by structural defects and multi‐phases in HE complexes, the intense polarization is evidently found, confirmed by the first‐principles calculations. Accordingly, the two complex‐phase HE oxides demonstrate excellent microwave absorption performance, and the minimal reflection loss of −54.5 dB is achieved. Therefore, this study provides valuable guidelines for the design of microwave absorbers using HE oxides.
Bifacial Dye Membranes: Ultrathin and Free‐Standing although not Being Covalently Bound
Authors: Hupfer Maximilian L. , Dellith Jan , Seyring Martin , Diegel Marco , Dellith Andrea , Ghosh Soumik , Rettenmayr Markus , Dietzek‐Ivanšić Benjamin , Presselt Martin 
Published: October 2022

AbstractLayers of aligned dyes are key to photo‐driven charge separation in dye sensitized solar cells, but cannot be exploited as rectifying membranes in photocatalysis to separate half‐cells because they are not sufficiently stable. While impressive work on the fabrication of stable noncovalent membranes has been recently demonstrated, these membranes are inherently suffering from non‐uniform orientation of the constituting dyes. To stabilize layers made from uniformly assembled and aligned dyes, they can be covalently cross‐linked via functional groups or via chromophores at the expense of their optical properties. Here stable membranes from established dyes are reported that do not need to be elaborately functionalized nor do their chromophores need to be destroyed. These membranes are free‐standing, although being only non‐covalently linked. To enable uniform dye‐alignment, Langmuir layers made from linear, water‐insoluble dyes are used. That water‐soluble charge transfer dyes adsorb onto and intercalate into the Langmuir layer from the aqueous subphase, thus yielding free‐standing, molecularly thin membranes are demonstrated. The developed bifacial layers consist almost entirely of π‐conjugated units and thus can conduct charges and can be further engineered for optoelectronic and photocatalytic applications.
Emergent Magnetic States and Tunable Exchange Bias at 3d Nitride Heterointerfaces
Authors: Jin Qiao , Zhang Qinghua , Bai He , Huon Amanda , Charlton Timothy , Chen Shengru , Lin Shan , Hong Haitao , Cui Ting , Wang Can , Guo Haizhong , Gu Lin , Zhu Tao , Fitzsimmons Michael R. , Jin Kui‐juan , Wang Shanmin , Guo Er‐Jia 
Published: October 2022

AbstractInterfacial magnetism stimulates the discovery of giant magnetoresistance (MR) and spin–orbital coupling across the heterointerfaces, facilitating the intimate correlation between spin transport and complex magnetic structures. Over decades, functional heterointerfaces composed of nitrides have seldom been explored due to the difficulty in synthesizing high‐quality nitride films with correct compositions. Here, the fabrication of single‐crystalline ferromagnetic Fe3N thin films with precisely controlled thicknesses is reported. As film thickness decreases, the magnetization dramatically deteriorates, and the electronic state changes from metallic to insulating. Strikingly, the high‐temperature ferromagnetism is maintained in a Fe3N layer with a thickness down to 2 u.c. (≈8 Å). The MR exhibits a strong in‐plane anisotropy; meanwhile, the anomalous Hall resistivity reverses its sign when the Fe3N layer thickness exceeds 5 u.c. Furthermore, a sizable exchange bias is observed at the interfaces between a ferromagnetic Fe3N and an antiferromagnetic CrN. The exchange bias field and saturation moment strongly depend on the controllable bending curvature using the cylinder diameter engineering technique, implying the tunable magnetic states under lattice deformation. This work provides a guideline for exploring functional nitride films and applying their interfacial phenomena for innovative perspectives toward practical applications.
Gestational weight gain and breastfeeding practices in relation to offspring body mass index among Amazonian young children
Authors: Mosquera Paola Soledad , Villamor Eduardo , Malta Maíra Barreto , Cardoso Marly Augusto ,   for the MINA‐Brazil Study Group
Published: October 2022

AbstractObjectiveExcessive weight gain during childhood has been considered an early life risk factor for chronic disease in the long term. We examined the role of excessive gestational weight gain (GWG) and breastfeeding (BF) practices with the offspring's body mass index‐for‐age z‐score (zBMI) at 2 years.MethodsData from 743 Amazonian young children of the MINA‐Brazil population‐based birth cohort study were used. Linear regression models were run to estimate the associations between excessive GWG and BF practices (exclusive breastfeeding, EBF <3 months of age and BF <1 year) with zBMI.ResultsExcessive GWG and BF <1 year were associated with an adjusted 0.24 units (95% CI: 0.08, 0.41) and 0.28 units (95% CI: 0.12, 0.44) higher zBMI at age 2 years, respectively.ConclusionsGain excessive weight during pregnancy and shorter BF duration (<1y) were associated with a higher body mass index at 2 years of age among Brazilian Amazonian children.
‘That's the bloodline’: Does Kinship and care translate to Kinship care?
Authors: Beaufils James 
Published: October 2022

AbstractKinship for First Nations people is a fundamental, yet complex, element of one's culture, enabling both belonging and relationality, and extending beyond blood family and relations. Kinship is also recognized as important within out‐of‐home care (OOHC) systems, with kinship care being the predominant OOHC placement type in Australia (AIHW, 2021). However, when First Nations children and young people are removed by the state, and placed into OOHC, it is important to interrogate whether kinship placements enable cultural connection and continuity with First Nations ways of understanding Kinship. This article begins by contextualising current OOHC policy and practice in Australia where a westernised and homogenised concept of kinship care is touted as similar to First Nations notions of Kinship. Here, the Aboriginal and Torres Strait Islander Child Placement Principle (ATSICPP) has become oversimplified by equating kinship care with relative care, thus creating ambiguity in care and placements in OOHC, voiding First Nations traditions and ways of understanding Kinship while a young person is in care. This article then reports the findings of qualitative interviews with 37 First Nations and non‐Indigenous people concerning the use of the term ‘Kinship’ in OOHC in New South Wales (NSW), how it is operationalised and how it is understood. Wide‐ranging experiences by participants concerning Kinship within OOHC were evident, thus demonstrating the imperative for a broader understanding of Kinship. This understanding needs to be applied within OOHC in ways that are consistent with First Nations notions of Kinship, as kinship care placements on their own are not enough to keep children connected in culture. The findings from this study show that the term Kinship is applied problematically within OOHC in NSW by equating legal and policy definitions of kinship care with Aboriginal ways of understanding Kinship. Ensuring First Nations traditions, practices and notions of Kinship are applied for First Nations children and young people in OOHC contexts is paramount.
Mechanism‐Guided Computational Design of ω‐Transaminase by Reprograming of High‐Energy‐Barrier Steps
Authors: Yang Lin , Zhang Kaiyue , Xu Meng , Xie Youyu , Meng Xiangqi , Wang Hualei , Wei Dongzhi 
Published: October 2022

Abstractω‐Transaminases (ω‐TAs) show considerable potential for the synthesis of chiral amines. However, their low catalytic efficiency towards bulky substrates limits their application, and complicated catalytic mechanisms prevent precise enzyme design. Herein, we address this challenge using a mechanism‐guided computational enzyme design strategy by reprograming the transition and ground states in key reaction steps. The common features among the three high‐energy‐barrier steps responsible for the low catalytic efficiency were revealed using quantum mechanics (QM). Five key residues were simultaneously tailored to stabilize the rate‐limiting transition state with the aid of the Rosetta design. The 14 top‐ranked variants showed 16.9–143‐fold improved catalytic activity. The catalytic efficiency of the best variant, M9 (Q25F/M60W/W64F/I266A), was significantly increased, with a 1660‐fold increase in kcat/Km and a 1.5–26.8‐fold increase in turnover number (TON) towards various indanone derivatives.