bluuebunny/crossref_metadata_2025_split huggingface dataset:
National travel distances for emergency care
Authors: Tolpadi Anagha , Elliott Marc N. , Waxman Daniel , Becker Kirsten , Flow-Delwiche Elizabeth , Lehrman William G. , Stark Debra , Parast Layla 
Published: March 2022

Abstract
Background
Most emergency department (ED) patients arrive by their own transport and, for various reasons, may not choose the nearest ED. How far patients travel for ED treatment may reflect both patients’ access to care and severity of illness. In this study, we aimed to examine the travel distance and travel time between a patient’s home and ED they visited and investigate how these distances/times vary by patient and hospital characteristics.

Methods
We randomly sampled and collected data from 14,812 patients discharged to the community (DTC) between January and March 2016 from 50 hospital-based EDs nationwide. We geocoded and calculated the distance and travel time between patient and hospital-based ED addresses, examined the travel distances/ times between patients’ home and the ED they visited, and used mixed-effects regression models to investigate how these distances/times vary by patient and hospital characteristics.

Results
Patients travelled an average of 8.0 (SD = 10.9) miles and 17.3 (SD = 18.0) driving minutes to the ED. Patients travelled significantly farther to avoid EDs in lower performing hospitals (p < 0.01) and in the West (p < 0.05) and Midwest (p < 0.05). Patients travelled farther when visiting EDs in rural areas. Younger patients travelled farther than older patients.

Conclusions
Understanding how far patients are willing to travel is indicative of whether patient populations have adequate access to ED services. By showing that patients travel farther to avoid a low-performing hospital, we provide evidence that DTC patients likely do exercise some choice among EDs, indicating some market incentives for higher-quality care, even for some ED admissions. Understanding these issues will help policymakers better define access to ED care and assist in directing quality improvement efforts. To our knowledge, our study is the most comprehensive nationwide characterization of patient travel for ED treatment to date.
Converting the existing disease surveillance from a paper-based to an electronic-based system using district health information system (DHIS-2) for real-time information: the Lebanese experience
Authors: Youssef Dalal , Yaghi Ayat , Jouny Abbas , Abou-Abbas Linda , Chammaa Houssam , Ghosn Nada 
Published: March 2022

Abstract
Introduction
The Ministry of Public Health in Lebanon is in the process of converting the surveillance reporting from a cumbersome paper-based system to a web-based electronic platform (DHIS-2) to have real-time information for early detection of alerts and outbreaks and for initiating a prompt response.

Objectives
This paper aimed to document the Lebanese experience in implementing DHIS-2 for the disease surveillance system. It also targets to assess the improvement of reporting rates and timeliness of the reported data and to disclose the encountered challenges and opportunities.

Methodology
This is a retrospective description of processes involved in the implementation of the DHIS-2 tool in Lebanon. Initially, it was piloted for the school-based surveillance in 2014; then its use was extended in May 2017 to cover other specific surveillance systems. This included all surveillance programs collecting aggregate data from hospitals, medical centers, dispensaries, or laboratories at the first stage. As part of the national roll-out process, the online application was developed. The customized aggregated-based datasets, organization units, user accounts, specific and generic dashboards were generated. More than 80 training sessions were conducted throughout the country targeting 1290 end-users including health officers at the national and provincial levels, focal persons who were working in all public and private hospitals, laboratories, and medical centers as well. Completeness and timeliness of reported data were compared before and after the implementation of DHIS-2. The unveiled challenges and the main lessons learned during the roll-out process were discussed.

Results
For laboratory-based surveillance, completeness of reporting increased from 70.8% in May to 89.6% in October. Timeliness has improved from 25 to 74%. For medical centers, an improvement of 8.1% for completeness and 9.4% in timeliness was recorded before and after training sessions. For zero reporting, completeness remains the same (88%) and timeliness has improved from 74 to 87%. The main challenges faced during the implementation of DHIS-2 were mainly infrastructural and system-related in addition to poor internet connectivity, limited workforce, and frequent changes to DHIS-2 versions.

Conclusion
Implementation of DHIS-2 improved timeliness and completeness for aggregated data reporting. Continued on-site support, monitoring, and system enhancement are needed to improve the performance of DHIS-2.
Research on the design of serious illness insurance scheme in Shanghai based on micro-simulation
Authors: Li Yang , Duan Guangfeng , Xiong Linping 
Published: March 2022

Abstract
Background
Urban and rural residents’ basic medical insurance (URRBMI) is an institutional arrangement for rural residents and unemployed urban residents in China. The serious illness medical insurance system (SIMIS) was established to provide additional medical cover. At present, the SIMIS payment method in China is based on large expenses, and only a few areas, such as Shanghai, pay according to the treatment of serious diseases. This study aims to simulate and analyse the effect of the two payment methods on SIMIS in Shanghai.

Methods
We developed a micro-simulation model to predict the number and characteristics of SIMIS participants among urban and rural residents in Shanghai and to simulate the process of medical treatment, medical consumption, and medical insurance payments for each insured person from 2020 to 2025. We then summarised and analysed the payment compensation effect, and compared it with Shanghai’s current policies.

Results
The payment of SIMIS according to high expenses, the total medical expenses of seriously ill patients show an increasing trend, with an average annual growth rate of 3.56%. The URRBMI fund payment covers 56%–58% of total medical expenses, and the SIMIS fund covers 5%–7% of the total medical expenses. Both cover 62%–63% of total medical expenses. Self-payment under SIMIS covers 22%–23% of the total medical expenses, total self-payment covers 14%–15% of the total medical expenses, and the medical expenses borne by individuals cover 36%–38% of the total medical expenses.The fund expenditure is 213 million yuan and average annual cost borne by individual patients ranges from 40 000 to 60 000 yuan.

Conclusions
The policy of designing SIMIS according to national guidelines does not meet the development needs of Shanghai. Shanghai should take the current policy of paying compensation according to the treatment of serious illness as the policy basis, consider the security needs of patients with large medical expenses outside the scope of protection, and adjust policies appropriately to prevent poverty caused by illness.
Daily food insecurity is associated with diet quality, but not energy intake, in winter and during COVID-19, among low-income adults
Authors: Jimenez Rincon Sara , Dou Nan , Murray-Kolb Laura E. , Hudy Kristen , Mitchell Diane C. , Li Runze , Na Muzi 
Published: March 2022

Abstract
Background
Food insecurity (FI) is a dynamic phenomenon. Experiences of daily FI may impact dietary outcomes differently within a given month, across seasons, and before or during the COVID-19 pandemic.

Objectives
The aims of this study were to investigate the association of short-term FI with dietary quality and energy 1) over six weeks in two seasonal months and 2) before and during the COVID-19 pandemic.

Methods
Using an ecological momentary assessment framework on smartphones, this study tracked daily FI via the 6-item U.S. Adult Food Security Survey Module and dietary intake via food diaries in 29 low-income adults. A total of 324 person-days of data were collected during two three-week long waves in fall and winter months. Generalized Estimating Equation models were applied to estimate the daily FI-diet relationship, accounting for intrapersonal variation and covariates.

Results
A one-unit increase in daily FI score was associated with a 7.10-point (95%CI:-11.04,-3.15) and 3.80-point (95%CI: -6.08,-1.53) decrease in the Healthy Eating Index-2015 (HEI-2015) score in winter and during COVID-19, respectively. In winter months, a greater daily FI score was associated with less consumption of total fruit (-0.17 cups, 95% CI: -0.32,-0.02), whole fruit (-0.18 cups, 95%CI: -0.30,-0.05), whole grains (-0.57 oz, 95%CI: -0.99,-0.16) and higher consumption of refined grains (1.05 oz, 95%CI: 0.52,1.59). During COVID-19, elevated daily FI scores were associated with less intake of whole grains (-0.49 oz, 95% CI: -0.88,-0.09), and higher intake of salt (0.34 g, 95%CI: 0.15,0.54). No association was observed in fall nor during the pre-COVID-19 months. No association was found between daily FI and energy intake in either season, pre-COVID 19, or during-COVID-19 months.

Conclusion
Daily FI is associated with compromised dietary quality in low-income adults in winter months and during the COVID-19 period. Future research should delve into the underlying factors of these observed relationships.
Combined angiogenesis and PD-1 inhibition for immunomodulatory TNBC: concept exploration and biomarker analysis in the FUTURE-C-Plus trial
Authors: Wu Song-Yang , Xu Ying , Chen Li , Fan Lei , Ma Xiao-Yan , Zhao Shen , Song Xiao-Qing , Hu Xin , Yang Wen-Tao , Chai Wen-Jun , Guo Xiao-Mao , Chen Xi-Zi , Xu Yan-Hui , Zhu Xiao-Yu , Zou Jian-Jun , Wang Zhong-Hua , Jiang Yi-Zhou , Shao Zhi-Ming 
Published: March 2022

Abstract
Background
Immune checkpoint inhibitors had a great effect in triple-negative breast cancer (TNBC); however, they benefited only a subset of patients, underscoring the need to co-target alternative pathways and select optimal patients. Herein, we investigated patient subpopulations more likely to benefit from immunotherapy and inform more effective combination regimens for TNBC patients.

Methods
We conducted exploratory analyses in the FUSCC cohort to characterize a novel patient selection method and actionable targets for TNBC immunotherapy. We investigated this in vivo and launched a phase 2 trial to assess the clinical value of such criteria and combination regimen. Furthermore, we collected clinicopathological and next-generation sequencing data to illustrate biomarkers for patient outcomes.

Results
CD8-positivity could identify an immunomodulatory subpopulation of TNBCs with higher possibilities to benefit from immunotherapy, and angiogenesis was an actionable target to facilitate checkpoint blockade. We conducted the phase II FUTURE-C-Plus trial to assess the feasibility of combining famitinib (an angiogenesis inhibitor), camrelizumab (a PD-1 monoclonal antibody) and chemotherapy in advanced immunomodulatory TNBC patients. Within 48 enrolled patients, the objective response rate was 81.3% (95% CI, 70.2–92.3), and the median progression-free survival was 13.6 months (95% CI, 8.4–18.8). No treatment-related deaths were reported. Patients with CD8- and/or PD-L1- positive tumors benefit more from this regimen. PKD1 somatic mutation indicates worse progression-free and overall survival.

Conclusion
This study confirms the efficacy and safety of the triplet regimen in immunomodulatory TNBC and reveals the potential of combining CD8, PD-L1 and somatic mutations to guide clinical decision-making and treatments.

Trial registration
ClinicalTrials.gov: NCT04129996. Registered 11 October 2019.
Lockdown stringency and paediatric self-harm presentations during COVID-19 pandemic: retrospective cohort study
Authors: Wong Ben Hoi-ching , Vaezinejad Mehrak , Plener Paul L. , Mehdi Tauseef , Romaniuk Liana , Barrett Elizabeth , Hussain Haseena , Lloyd Alexandra , Tolmac Jovanka , Rao Manish , Chakrabarti Sulagna , Carucci Sara , Moghraby Omer S. , Elvins Rachel , Rozali Farah , Skouta Ereni , McNicholas Fiona , Baig Benjamin , Stevanovic Dejan , Nagy Peter , Davico Chiara , Mirza Hassan , Tufan Evren , Youssef Fatima , Meadowcroft Ben , Ougrin Dennis 
Published: March 2022

BackgroundLockdown during the pandemic has had significant impacts on public mental health. Previous studies suggest an increase in self-harm and suicide in children and adolescents. There has been little research on the roles of stringent lockdown.AimsTo investigate the mediating and predictive roles of lockdown policy stringency measures in self-harm and emergency psychiatric presentations.MethodThis was a retrospective cohort study. We analysed data of 2073 psychiatric emergency presentations of children and adolescents from 23 hospital catchment areas in ten countries, in March to April 2019 and 2020.ResultsLockdown measure stringency mediated the reduction in psychiatric emergency presentations (incidence rate ratio of the natural indirect effect [IRRNIE] = 0.41, 95% CI [0.35, 0.48]) and self-harm presentations (IRRNIE = 0.49, 95% CI [0.39, 0.60]) in 2020 compared with 2019. Self-harm presentations among male and looked after children were likely to increase in parallel with lockdown stringency. Self-harm presentations precipitated by social isolation increased with stringency, whereas school pressure and rows with a friend became less likely precipitants. Children from more deprived neighbourhoods were less likely to present to emergency departments when lockdown became more stringent,ConclusionsLockdown may produce differential effects among children and adolescents who self-harm. Development in community or remote mental health services is crucial to offset potential barriers to access to emergency psychiatric care, especially for the most deprived youths. Governments should aim to reduce unnecessary fear of help-seeking and keep lockdown as short as possible. Underlying mediation mechanisms of stringent measures and potential psychosocial inequalities warrant further research.
Association between serum lithium level and incidence of COVID-19 infection
Authors: De Picker Livia J. , Leboyer Marion , Geddes John R. , Morrens Manuel , Harrison Paul J. , Taquet Maxime 
Published: March 2022

SummaryAn antiviral effect of lithium has been proposed, but never investigated for coronavirus disease 2019 (COVID-19). Using electronic health records of 26 554 patients with documented serum lithium levels during the pandemic, we show that the 6-month COVID-19 infection incidence was lower among matched patients with ‘therapeutic’ (0.50–1.00) versus ‘subtherapeutic’ (0.05–0.50) lithium levels (hazard ratio (HR) = 0.82, 95% CI 0.69–0.97, P = 0.017) and among patients with ‘therapeutic’ lithium levels versus matched patients using valproate (HR = 0.79, 95% CI 0.67–0.92, P = 0.0023). Lower rates of infection were observed for both new COVID-19 diagnoses and positive polymerase chain reaction tests, regardless of underlying psychiatric diagnosis and vaccination status.
Branched-Chain and Aromatic Amino Acids Related to Visceral Adipose Tissue Impact Metabolic Health Risk Markers
Authors: Orozco-Ruiz Ximena , Anesi Andrea , Mattivi Fulvio , Breteler Monique M B 
Published: March 2022

AbstractContextVisceral (VAT) and subcutaneous adipose tissue (SAT) function as endocrine organs capable of influencing metabolic health across adiposity levels.ObjectiveWe aimed to investigate whether metabolites associated with VAT and SAT impact metabolic health through metabolite concentrations.MethodsAnalyses are based on 1790 participants from the population-based Rhineland Study. We assessed plasma levels of methionine (Met), branched-chain amino acids (BCAA), aromatic amino acids (AAA), and their metabolic downstream metabolites with liquid chromatography-mass spectrometry. VAT and SAT volumes were assessed by magnetic resonance imaging (MRI). Metabolically healthy and unhealthy phenotypes were defined using Wildman criteria.ResultsMetabolically unhealthy participants had higher concentrations of BCAA than metabolically healthy participants (P &lt; 0.001). In metabolically unhealthy participants, VAT volumes were significantly associated with levels of L-isoleucine, L-leucine, indole-3-lactic acid, and indole-3-propionic acid (in log SD units: β = 0.16, P = 0.003; β = 0.12, P = 0.038; β = 0.11, P = 0.035 and β = −0.16, P = 0.010, respectively). Higher concentrations of certain BCAA and AAA-downstream metabolites significantly increased the odds of cardiometabolic risk markers. The relation between VAT volume and cardiometabolic risk markers was mediated by BCAA (indirect effects 3.7%-11%, P = 0.02 to &lt; 0.0001), while the effect of VAT on systemic inflammation was mediated through higher kynurenine concentrations (indirect effect 6.4%, P &lt; 0.0001).ConclusionLarger volumes of VAT in metabolically unhealthy individuals are associated with altered concentrations of circulating BCAA and AAA-downstream metabolites, increasing the odds of cardiometabolic risk markers. This suggests that these metabolites are involved in the mechanisms that underlie the relationship of abdominal VAT with metabolic health.
Quinine Effects on Gut and Pancreatic Hormones and Antropyloroduodenal Pressures in Humans–Role of Delivery Site and Sex
Authors: Rezaie Peyman , Bitarafan Vida , Rose Braden D , Lange Kylie , Rehfeld Jens F , Horowitz Michael , Feinle-Bisset Christine 
Published: March 2022

Abstract

Context
The bitter substance quinine modulates the release of a number of gut and gluco-regulatory hormones and upper gut motility. As the density of bitter receptors may be higher in the duodenum than the stomach, direct delivery to the duodenum may be more potent in stimulating these functions. The gastrointestinal responses to bitter compounds may also be modified by sex.

Background
We have characterized the effects of intragastric (IG) versus intraduodenal (ID) administration of quinine hydrochloride (QHCl) on gut and pancreatic hormones and antropyloroduodenal pressures in healthy men and women.

Methods
14 men (26 ± 2 years, BMI: 22.2 ± 0.5 kg/m2) and 14 women (28 ± 2 years, BMI: 22.5 ± 0.5 kg/m2) received 600 mg QHCl on 2 separate occasions, IG or ID as a 10-mL bolus, in randomized, double-blind fashion. Plasma ghrelin, cholecystokinin, peptide YY, glucagon-like peptide-1 (GLP-1), insulin, glucagon, and glucose concentrations and antropyloroduodenal pressures were measured at baseline and for 120 minutes following QHCl.

Results
Suppression of ghrelin (P = 0.006), stimulation of cholecystokinin (P = 0.030), peptide YY (P = 0.017), GLP-1 (P = 0.034), insulin (P = 0.024), glucagon (P = 0.030), and pyloric pressures (P = 0.050), and lowering of glucose (P = 0.001) were greater after ID-QHCl than IG-QHCl. Insulin stimulation (P = 0.021) and glucose reduction (P = 0.001) were greater in females than males, while no sex-associated effects were found for cholecystokinin, peptide YY, GLP-1, glucagon, or pyloric pressures.

Conclusion
ID quinine has greater effects on plasma gut and pancreatic hormones and pyloric pressures than IG quinine in healthy subjects, consistent with the concept that stimulation of small intestinal bitter receptors is critical to these responses. Both insulin stimulation and glucose lowering were sex-dependent.
The Ambient Politics of Affective Computing
Authors: Wu Angela Xiao 
Published: March 2022

AbstractMuch attention to affective computing has focused on its alleged ability to “tap into human affects,” a trope also foundational to broader theorizations about big-data surveillance. What remains understudied and undertheorized is affective computing's social life, where interested parties contest and collude on its deployment. This essay traces how such portable technologies as sentiment analysis and “like” buttons wound up redefining collective action in China, which partly explains the conservative turn observed in Chinese online cultures since the mid-2010s. It unpacks affective computing's ambient politics — the fraught processes whereby social actors aggressively repackage, reinterpret, and remediate these technologies to fit their agendas, changing social standards for denoting emotions along the way. This essay calls to reorient critical analysis of affective computing away from its design epistemics to its ambient politics and, in parallel, to shift the focus from interiorized subjects to conditions of collective existence.
Bioremediation of Petroleum Contamination: A Short Review
Authors: Khan Saimah , Tripathi Ayush Kumar , Srivastava Rohan , Saleem Mohd Saad , Yeremenko Sergiy , Sydorenko Volodymyr 
Published: March 2022

The pros and cons of using the bioremediation method for the removal of petroleum pollutants are discussed in this review article. Other methods along with bioremediation have been used to remediate petroleum hydrocarbon contaminants in the past. Bioremediation is cheap and efficient method than any other because major constituents of the crude oils are biodegradable. Despite the fact that, as compared to physicochemical strategies, longer periods are normally required, complete pollutant degradation can be achieved, and no further containment of the contaminated matrix is required. According to hydrocarbon present in the contaminants different strategies and organism are used for the bioremediation.
Common strategies include controlling environmental factors such as oxygen availability, hydrocarbon solubility, nutrient balance and managing hydrocarbon degrading bacteria by eliminating the rate limiting factors that may slow down the bioremediation rate. Microorganism dynamics during bioremediation is most important for understanding how they respond, adapt and remediate pollution. However, bioremediation can be considered one of the best technologies to deal with petroleum product contaminants.
Relationship between resilience and health-related quality of life among patients with a permanent colostomy
Authors: El-Rahman Mohamed Mona Abed , El-Ata Amal Bakr Abo , Elezaby Hanan Hassan 
Published: March 2022

Background:The assessment of health-related quality of life (HRQoL) and resilience are important aspects of colorectal cancer care, as well as an indicator of patients' health status. This study was conducted to investigate the relationship between resilience and HRQoL among patients with a permanent colostomy.Method:A cross-sectional descriptive correlational design employing the City of Hope Quality of Life Ostomy Questionnaire and the Resilience Scale was adopted. A purposive sample population was recruited.Results:The study enrolled 158 colostomy patients. Half the participants (50.6%) were female and the mean age was 58.20 years [standard deviation (SD)=8.70]. Colostomy patients had a mean HRQoL score of 129.61 (SD)=98 (interquartile range: 109–148), with a spiritual domain that was lower than any other HRQoL domain. The Resilience Scale mean score was 106 (interquartile range: 82–126).Conclusion:This study observed a general low score on the HRQoL Questionnaire and this was reflected in the Resilience Scale score of this group of patients with a colostomy.