bluuebunny/crossref_metadata_2025_split huggingface dataset:
The importance of external financing in management of innovative processes in the SME sector
Authors: Kokot-Stępień Patrycja 
Published: April 2022

Motivation: A broad approach to the SME sector causes that small and medium-sized enterprises are active in all segments of the economy. Each segment is characterized by a certain way of doing a business and thus financing it. Therefore, an important issue for the small and medium-sized entities is to provide both liquidity and continuity of financing and access to such sources of financing that will allow the implementation of innovative projects since innovation affects the pace and direction of development of the specific economic entity as well as significantly indicates the forms and structure of business cooperation.
Aim: The aim of the article is to analyze the extent to which the various sources of financing are used by small and medium-sized enterprises in the implementation of innovative projects, and to show the relationship between external sources of financing and the level of expenditure on innovation of SMEs in Poland.
Results: The analysis was based on examining the dependence of the scale of innovative activity of enterprises in the SME sector in Poland on the possibility of using not only own funds, but also funds from external sources, the use of which by small and medium-sized enterprises is still too low and is often limited to EU funds.
The past, present and future of advanced nursing practice
Authors: Swaby Kelly , Reynolds Julie , Mortimore Gerri 
Published: April 2022

Kelly Swaby, Julie Reynolds and Gerri Mortimore explore the historical, professional and national developments that have influenced advanced nursing practice in England This article considers the past, present and future development of advanced nursing practice. It traces the historical, professional and national developments that have impacted on advanced nursing practice in England. Current influence and future opportunities and challenges are explored, providing a comprehensive overview of advanced nursing practice in England.
Simplified hypertension screening methods across 60 countries: An observational study
Authors: Carrillo-Larco Rodrigo M. , Guzman-Vilca Wilmer Cristobal , Neupane Dinesh 
Published: April 2022

Background
Simplified blood pressure (BP) screening approaches have been proposed. However, evidence is limited to a few countries and has not documented the cardiovascular risk amongst missed hypertension cases, limiting the uptake of these simplified approaches. We quantified the proportion of missed, over-diagnosed, and consistently identified hypertension cases and the 10-year cardiovascular risk in these groups.

Methods and findings
We used 60 WHO STEPS surveys (cross-sectional and nationally representative; n = 145,174) conducted in 60 countries in 6 world regions between 2004 and 2019. Nine simplified approaches were compared against the standard (average of the last 2 of 3 BP measurements). The 10-year cardiovascular risk was computed with the 2019 World Health Organization Cardiovascular Risk Charts. We used t tests to compare the cardiovascular risk between the missed and over-diagnosed cases and the consistent hypertension cases. We used Poisson multilevel regressions to identify risk factors for missed cases (adjusted for age, sex, body mass index, and 10-year cardiovascular risk). Across all countries, compared to the standard approach, the simplified approach that missed the fewest cases was using the second BP reading if the first BP reading was 130–145/80–95 mm Hg (5.62%); using only the second BP reading missed 5.82%. The simplified approach with the smallest over-diagnosis proportion was using the second BP reading if the first BP measurement was ≥140/90 mm Hg (3.03%). In many countries, cardiovascular risk was not significantly different between the missed and consistent hypertension groups, yet the mean was slightly lower amongst missed cases. Cardiovascular risk was positively associated with missed hypertension depending on the simplified approach. The main limitation of the work is the cross-sectional design.

Conclusions
Simplified BP screening approaches seem to have low misdiagnosis rates, and cardiovascular risk could be lower amongst missed cases than amongst consistent hypertension cases. Simplified BP screening approaches could be included in large screening programmes and busy clinics.
Group B Streptococcus colonization at delivery is associated with maternal peripartum infection
Authors: Brigtsen Anne Karin , Jacobsen Anne Flem , Dedi Lumnije , Melby Kjetil Klaveness , Espeland Cathrine Nygaard , Fugelseth Drude , Whitelaw Andrew 
Published: April 2022

Background
Group B Streptococcus (GBS) is a major cause of serious neonatal infection but its role in maternal morbidity has received little investigation. The aim of this study was to determine whether GBS colonization at delivery is associated with increased risk of maternal peripartum infection.

Methods
In this prospective cohort study, 1746 unselected women had a vaginal-rectal culture taken at the onset of labor. Diagnosis of maternal peripartum infection was based on a combination of two or more signs or symptoms including fever, breast pain, severe wound or pelvic pain, purulent discharge and abnormal laboratory tests including C-reactive protein and white blood cell count occurring from labor until 2 weeks postpartum. The main outcome measure was the proportion of women with maternal peripartum infection according to GBS colonization status.

Results
A total of 25.9% (452/1746) women were colonized with GBS. The rate of peripartum infection was almost twice as high in colonized women (49/452 [10.8%]) vs. non-colonized women (81/1294 [6.3%]); OR 1.82 [1.26–2.64], p = 0.002). This association was confirmed in a multivariable model (OR 1.99 [1.35–2.95], p = 0.001). Women diagnosed with peripartum infection had a significantly longer hospital stay compared to women without peripartum infection (4 days (median) vs. 3 days, p < 0.001). Length of hospital stay did not differ between colonized and non-colonized women. Serotype IV GBS was more frequent in colonized women with peripartum infection than in women without peripartum infection (29.3% vs. 12.5%, p = 0.003).

Conclusions
GBS colonization at delivery is associated with increased risk of peripartum infection. Whether this increase is due directly to invasion by GBS or whether GBS colonization is associated with a more general vulnerability to infection remains to be determined.
A cost analysis of implementing mobile health facilitated tuberculosis contact investigation in a low-income setting
Authors: Turimumahoro Patricia , Tucker Austin , Gupta Amanda J. , Tampi Radhika P. , Babirye Diana , Ochom Emmanuel , Ggita Joseph M. , Ayakaka Irene , Sohn Hojoon , Katamba Achilles , Dowdy David , Davis J. Lucian 
Published: April 2022

Introduction
Mobile health (mHealth) applications may improve timely access to health services and improve patient-provider communication, but the upfront costs of implementation may be prohibitive, especially in resource-limited settings.

Methods
We measured the costs of developing and implementing an mHealth-facilitated, home-based strategy for tuberculosis (TB) contact investigation in Kampala, Uganda, between February 2014 and July 2017. We compared routine implementation involving community health workers (CHWs) screening and referring household contacts to clinics for TB evaluation to home-based HIV testing and sputum collection and transport with test results delivered by automated short messaging services (SMS). We carried out key informant interviews with CHWs and asked them to complete time-and-motion surveys. We estimated program costs from the perspective of the Ugandan health system, using top-down and bottom-up (components-based) approaches. We estimated total costs per contact investigated and per TB-positive contact identified in 2018 US dollars, one and five years after program implementation.

Results
The total top-down cost was $472,327, including $358,504 (76%) for program development and $108,584 (24%) for program implementation. This corresponded to $320-$348 per household contact investigated and $8,873-$9,652 per contact diagnosed with active TB over a 5-year period. CHW time was spent primarily evaluating household contacts who returned to the clinic for evaluation (median 30 minutes per contact investigated, interquartile range [IQR]: 30–70), collecting sputum samples (median 29 minutes, IQR: 25–30) and offering HIV testing services (median 28 minutes, IQR: 17–43). Cost estimates were sensitive to infrastructural capacity needs, program reach, and the epidemiological yield of contact investigation.

Conclusion
Over 75% of all costs of the mHealth-facilitated TB contact investigation strategy were dedicated to establishing mHealth infrastructure and capacity. Implementing the mHealth strategy at scale and maintaining it over a longer time horizon could help decrease development costs as a proportion of total costs.
Measuring quality of life with the Parkinson’s Disease Questionnaire-39 in people with cognitive impairment
Authors: Schönenberg Aline , Prell Tino 
Published: April 2022

Introduction
Quality of life (QoL) is a key outcome in healthcare. However, whether cognitively impaired people with Parkinson’s disease (PD) can reliably self-report QoL is unclear, and patients are often excluded from studies based on cognition test scores. The aim of this analysis was to assess the validity of the Parkinson’s Disease Questionnaire-39 (PDQ-39) in PD patients with and without cognitive impairment.

Methods
In this study, 221 individuals with PD completed the PDQ-39, Montreal Cognitive Assessment (MOCA), and Beck’s Depression Inventory (BDI-II). The PDQ-39’s internal consistency, convergent validity with BDI-II, and floor and ceiling effects were analyzed for patients with and without cognitive impairment.

Results
Ninety-four patients showed cognitive impairment (MOCA <21), whereas 127 patients had mild/no impairment. Both MOCA groups differed significantly with regards to PD severity. The PDQ-39’s internal consistency was adequate for most subdomains in both MOCA groups, but floor effects were present for the subdomains Stigmatization, Social Support and Communication, regardless of impairment. For some subdomains, the PDQ-39’s convergent validity with the BDI receded in the low MOCA group but remained significant for most PDQ-39 domains, especially for the PDQ total score (r = .386, p < .001) and for the subdomain emotional well-being (r = .446, p < .001).

Conclusion
The PDQ-39 can be used to measure QoL in cognitively impaired PD patients, thus test scores indicating cognitive impairment alone should not lead to exclusion of PD patients from clinical studies. Although the correlation between BDI-II and PDQ-39 shrinks for some subdomains in cognitively impairment patients, this finding may be explained by the difference in PD severity, as factors influencing QoL may shift with increasing age and PD symptoms.
Validation of xMAP SARS-CoV-2 Multi-Antigen IgG assay in Nigeria
Authors: Iriemenam Nnaemeka C. , Ige Fehintola A. , Greby Stacie M. , Mpamugo Augustine , Abubakar Ado G. , Dawurung Ayuba B. , Esiekpe Mudiaga K. , Thomas Andrew N. , Okoli Mary U. , Awala Samuel S. , Ugboaja Blessing N. , Achugbu Chicago C. , Odoh Ifeanyichukwu , Nwatu Felicia D. , Olaleye Temitope , Akayi Loveth , Akinmulero Oluwaseun O. , Dattijo Joseph , Onokevbagbe Edewede , Okunoye Olumide , Mba Nwando , Agala Ndidi P. , Uwandu Mabel , Aniedobe Maureen , Stafford Kristen A. , Abimiku Alash’le , Hamada Yohhei , Swaminathan Mahesh , Okoye McPaul I. , Steinhardt Laura C. , Audu Rosemary 
Published: April 2022

Objective
There is a need for reliable serological assays to determine accurate estimates of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence. Most single target antigen assays have shown some limitations in Africa. To assess the performance of a multi-antigen assay, we evaluated a commercially available SARS-CoV-2 Multi-Antigen IgG assay for human coronavirus disease 2019 (COVID-19) in Nigeria.

Methods
Validation of the xMAP SARS-CoV-2 Multi-Antigen IgG assay was carried out using well-characterized SARS-CoV-2 reverse transcription polymerase chain reactive positive (97) and pre-COVID-19 pandemic (86) plasma panels. Cross-reactivity was assessed using pre-COVID-19 pandemic plasma specimens (213) from the 2018 Nigeria HIV/AIDS Indicator and Impact Survey (NAIIS).

Results
The overall sensitivity of the xMAP SARS-CoV-2 Multi-Antigen IgG assay was 75.3% [95% CI: 65.8%– 82.8%] and specificity was 99.0% [95% CI: 96.8%– 99.7%]. The sensitivity estimate increased to 83.3% [95% CI: 70.4%– 91.3%] for specimens >14 days post-confirmation of diagnosis. However, using the NAIIS pre-pandemic specimens, the false positivity rate was 1.4% (3/213).

Conclusions
Our results showed overall lower sensitivity and a comparable specificity with the manufacturer’s validation. There appears to be less cross-reactivity with NAIIS pre-pandemic COVID-19 specimens using the xMAP SARS-CoV-2 Multi-Antigen IgG assay. In-country SARS-CoV-2 serology assay validation can help guide the best choice of assays in Africa.
American Indian and Alaska Native veterans in the Indian Health Service: Health status, utilization, and cost
Authors: Kaufman Carol E. , Grau Laura , Begay Rene , Reid Margaret , Goss Cynthia W. , Hicken Bret , Shore Jay H. , O’Connell Joan 
Published: April 2022

Purpose
Many rural American Indian and Alaska Native (AIAN) veterans receive care from the Indian Health Service (IHS). United States Department of Veterans Affairs (VA) has reimbursement agreements with some IHS facilities and tribal programs and seeks to expand community partnerships in tribal areas, but details of how AIAN veterans use IHS are unknown. We aimed to assess the health status, service utilization patterns, and cost of care of veterans who use IHS.

Methods
We used comprehensive and integrated IHS data to compare health status, health service utilization and treatment cost of veterans (n = 12,242) to a matched sample of non-veterans (n = 12,242). We employed logistic, linear, or negative binomial regressions as appropriate, by sex and overall.

Findings
Compared to non-veterans, veterans had lower odds of having hypertension, renal disease, all-cause dementia, and alcohol or drug use disorders, but had similar burden of other conditions. In service utilization, veterans had lower hospital inpatient days; patterns were mixed across outpatient services. Unadjusted treatment costs for veterans and non-veterans were $3,923 and $4,145, respectively; veteran adjusted treatment costs were statistically lower. Differences in significance by sex were found for health conditions and service use.

Conclusions
AIAN veterans, compared to AIAN non-veterans, were not less healthy, nor did they require more intensive or more costly care under IHS. Our results indicate the viability and importance of expanding IHS-VA partnerships in community care.
Associations between multiple long-term conditions and mortality in diverse ethnic groups
Authors: Stafford Mai , Knight Hannah , Hughes Jay , Alarilla Anne , Mondor Luke , Pefoyo Kone Anna , Wodchis Walter P. , Deeny Sarah R. 
Published: April 2022

Background
Multiple conditions are more prevalent in some minoritised ethnic groups and are associated with higher mortality rate but studies examining differential mortality once conditions are established is US-based. Our study tested whether the association between multiple conditions and mortality varies across ethnic groups in England.

Methods and findings
A random sample of primary care patients from Clinical Practice Research Datalink (CPRD) was followed from 1st January 2015 until 31st December 2019. Ethnicity, usually self-ascribed, was obtained from primary care records if present or from hospital records. Long-term conditions were counted from a list of 32 that have previously been associated with greater primary care, hospital admissions, or mortality risk. Cox regression models were used to estimate mortality by count of conditions, ethnicity and their interaction, with adjustment for age and sex for 532,059 patients with complete data. During five years of follow-up, 5.9% of patients died. Each additional condition at baseline was associated with increased mortality. The direction of the interaction of number of conditions with ethnicity showed a statistically higher mortality rate associated with long-term conditions in Pakistani, Black African, Black Caribbean and Other Black ethnic groups. In ethnicity-stratified models, the mortality rate per additional condition at age 50 was 1.33 (95% CI 1.31,1.35) for White ethnicity, 1.43 (95% CI 1.26,1.61) for Black Caribbean ethnicity and 1.78 (95% CI 1.41,2.24) for Other Black ethnicity.

Conclusions
The higher mortality rate associated with having multiple conditions is greater in minoritised compared with White ethnic groups. Research is now needed to identify factors that contribute to these inequalities. Within the health care setting, there may be opportunities to target clinical and self-management support for people with multiple conditions from minoritised ethnic groups.
Exploring microbiome from sediments of River Ganga using a metagenomic approach
Authors: Behera Bijay Kumar , Sahu Parameswar , Rout Ajaya Kumar , Parida Pranaya Kumar , Sarkar Dhruba Jyoti , Kaushik Nagendra Kumar , Rao Atmakuri Ramakrishna , Rai Anil , Das Basanta Kumar , Mohapatra Trilochan 
Published: April 2022

Abstract
The Ganga is a major riverine system of India providing ecosystem services to millions of households. However, this river is under stress due to various anthropogenic activities. River sediment harbours a variety of microorganisms which has a tremendous influence on river health. In the present study, metagenomic approach for microbial community characterization of three sediment samples collected from River Ganga at Farakka stretch was carried out. The sediment samples were sequenced using a high-throughput Next Generation Sequencing platform. Taxonomical classification study showed that the occurrence of bacteria is higher than other groups of microbes. The bacterial classes, such as Betaproteobacteria, Deltaproteobacteria, Gammaproteobacteria, and archaeal phylum, Thaumarchaeota, and Crenarchaeota were relatively higher than other communities. KEGG pathway analysis of three samples revealed that the number of genes associated with environmental information processing is higher in the Lalbag sample in comparison to Farakka barrage and Dhulian samples. The microbial community was categorized by functional classification using SEED analysis. Both COG and SEED analysis revealed that genes associated with carbohydrate metabolism are higher than other functional categories. The genus-level study confirms the higher occurrence of Pseudomonas, which corresponds to anthropogenic activities like mass bathing. The presence of bacterial genus Nitrospira and archaeal phylum Thaumarchaeota confirms a healthy nitrogen cycle in the environment. Moreover, the generated information would help in understanding the importance of microbial communities and their imperative function in maintaining the riverine ecosystem health.
Impact of Diagnostic Criteria on UTI Prevalence in Young Infants With Jaundice: A Meta-analysis
Authors: Chang Pearl W. , Schroeder Alan R. , Lucas Brian P. , McDaniel Corrie E. 
Published: April 2022

BACKGROUND AND OBJECTIVE
Previously reported prevalence of urinary tract infections (UTIs) in infants with jaundice range from &lt;1% to 25%. However, UTI criteria are variable and, as demonstrated in a meta-analysis on UTI prevalence in bronchiolitis, disease prevalence is greatly impacted by disease definition. The objective of this study was to conduct a systemic review and meta-analysis examining the impact of including positive urinalysis (UA) results as a diagnostic criterion on the estimated UTI prevalence in young infants with jaundice.

METHODS
The data sources used were Medline (1946–2020) and Ovid Embase (1976–2020) through January 2020 and bibliographies of retrieved articles. We selected studies reporting UTI prevalence in young infants with jaundice. Data were extracted in accordance with meta-analysis of observational studies in epidemiology guidelines. Random-effects models produced a weighted pooled event rate with 95% confidence intervals (CI).

RESULTS
We screened 526 unique articles by abstract and reviewed 53 full-text articles. We included 32 studies and 16 contained UA data. The overall UTI prevalence in young infants with jaundice from all 32 studies was 6.2% (95% CI, 3.9–8.9). From the 16 studies with UA data, the overall UTI prevalence was 8.7% (95% CI, 5.1–13.2), which decreased to 3.6% (95% CI, 2.0–5.8) with positive UA results included as a diagnostic criterion.

CONCLUSIONS
The estimated UTI prevalence in young infants with jaundice decreases substantially when UA results are incorporated into the UTI definition. Due to the heterogeneity of study subjects’ ages and definitions of jaundice, positive UA results, and UTI, there is uncertainty about the exact prevalence and about which infants with hyperbilirubinemia warrant urine testing.
The Autism Intervention Research Network on Physical Health (AIR-P) Research Agenda
Authors: Kuo Alice A. , Hotez Emily , Rosenau Kashia A. , Gragnani Candace , Fernandes Priyanka , Haley Madeline ,   on behalf of the AIR-P NATIONAL COORDINATING CENTER, Rudolph Dawn , Croen Lisa A. , Massolo Maria L. , Holmes Laura Graham , Shattuck Paul , Shea Lindsay , Wilson Rujuta , Martinez-Agosto Julian A. ,   on behalf of the AIR-P STEERING COMMITTEE, Brown Heather M. , Dwyer Patrick S.R. , Gassner Dena L. , Onaiwu Morénike Giwa , Kapp Steven K. , Ne'eman Ari , Ryan Jacalyn G. , Waisman TC , Williams Zachary J. ,   on behalf of the AUTISTIC RESEARCHER REVIEW BOARD, DiBari Jessica N. , Foney Dana M. , Ramos Lauren R. , Kogan, Michael D. ,   on behalf of the HEALTH RESOURCES AND SERVICES ADMINISTRATION MATERNAL AND CHILD HEALTH BUREAU
Published: April 2022

OBJECTIVES
In the United States, autistic individuals experience disproportionate physical and mental health challenges relative to non-autistic individuals, including higher rates of co-occurring and chronic conditions and lower physical, social, and psychological health-related quality of life. The Autism Intervention Research Network on Physical Health (AIR-P) is an interdisciplinary, multicenter research network for scientific collaboration and infrastructure that aims to increase the life expectancy and quality of life for autistic individuals, with a focus on underserved or vulnerable populations. The current paper describes the development of the AIR-P Research Agenda.

METHODS
Development of the research agenda involved an iterative and collaborative process between the AIR-P Advisory Board, Steering Committee, and Autistic Researcher Review Board. The methodology consisted of 3 phases: (1) ideation and design, (2) literature review and synthesis; and (3) network engagement.

RESULTS
Six core research priorities related to the health of autistic individuals were identified: (1) primary care services and quality, (2) community-based lifestyle interventions, (3) health systems and services, (4) gender, sexuality, and reproductive health, (5) neurology, and (6) genetics. Specific topics within each of these priorities were identified. Four cross-cutting research priorities were also identified: (1) neurodiversity-oriented care, (2) facilitating developmental transitions, (3) methodologically rigorous intervention studies, and (4) addressing health disparities.

CONCLUSIONS
The AIR-P Research Agenda represents an important step forward for enacting large-scale health-promotion efforts for autistic individuals across the lifespan. This agenda will catalyze autism research in historically underrepresented topic areas while adopting a neurodiversity-oriented approach to health-promotion.