bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost of a lymphedema treatment mandate - 16 years of experience in the Commonwealth of Virginia
Authors: Weiss Robert 
Published: July 2022

Abstract
Background
Treatment of chronic illness accounts for over 90% of Medicare spending. Chronic lymphedema places 3–10 million Americans at risk for recurrent cellulitis. Without convincing predictions of the costs and benefits of lymphedema treatment, insurers are reluctant to fully cover treatment of this common condition. Earlier papers discussed the costs and benefits of the first 5, 7, and 10 years of a lymphedema treatment mandate in Virginia. This paper updates these costs and benefits to 16 years of experience, and includes the impacts of the Patient Protection and Affordable Care Act of 2010 and the transition to ICD-10-CM diagnostic codes in 2015. It provides added confidence that costs of a lymphedema treatment mandate are reasonable, and can result in health insurance contract savings for reduced medical visits and hospitalizations for lymphedema patients.

Methods
Virginia requires annual reporting of the segregated costs of each of its 30 medical mandates. Data on Virginia’s lymphedema treatment mandate for the years 2004 to 2019 have been collected from the series of annual reports. These data include actual lymphedema treatment claims data, utilization data, and claims-based estimates of the premium impact.

Results
The average actual lymphedema claim cost was $2.03 per individual contract and $3.54 per group contract for the years reported, representing 0.05 and 0.08% of average total claims. The estimated premium impact was 0.16–0.32% of total average premium for all mandated coverage contracts. While lymphedema claim costs increased 3–6% per year over the study period, generally following the rise of health care costs, claim costs as a percent of average contract claims fell at a rate of 1.26–1.52% per year over that period. Medical office visits for lymphedema-related services fell from 0.10 to 0.02 visits per year per contract from the beginning to the end of the study period, and hospitalizations for lymphedema or lymphedema-related cellulitis fell to almost zero.

Conclusions
The Virginia data confirmed previous conclusions that the costs of treatment of lymphedema are a small part of a typical health insurance contract, and that treatment of lymphedema by managing swelling results in lower overall medical costs and fewer hospitalizations. This is a potent model for reduction in healthcare costs while improving the quality of care for cancer survivors and others suffering with this chronic progressive condition.
Time-Domain Anti-Interference Method for Ship Radiated Noise Signal
Authors: Duan Yichen , Shen Xiaohong , Wang Haiyan 
Published: July 2022

AbstractShip radiated noise signal is one of the important ways to detect and identify ships, and emission of interference noise to shield its own radiated noise signal is a common countermeasure. In this paper, we try to use the idea of signal enhancement to enhance the ship radiated noise signal with extremely low signal-to-noise ratio, so as to achieve anti-explosive signal interference. We propose a signal enhancement deep learning model to enhance the ship radiated noise signal by learning a mask in the temporal domain. Our approach is an encoder–decoder structure with U-net. U-net consists of 1d-conv with skip connection. In order to improve the learning ability of the model, we directly connect the U-net in series. In order to improve the learning ability of the model’s time series information. The Transformer attention mechanism is adopted to make the model have the ability to learn temporal information. We propose a combine Loss function for scale-invariant source-to-noise ratio and mean squared error in time-domain. Finally, we use the actual collected data to conduct experiments. It is verified that our algorithm can effectively improve the signal-to-noise ratio of the ship radiated noise signal to 2 dB under the extremely low signal-to-noise ratio of − 20 dB to − 25 dB.
An energy-balanced head nodes selection scheme for underwater mobile sensor networks
Authors: Hu Yifan , Hu Keyong , Liu Hailin , Wan Xuexiao 
Published: July 2022

AbstractUnderwater sensor networks system is a promising technology for smart ocean monitoring applications. To address the imbalance problem of network overhead and limited energy of underwater sensor nodes, this paper presents a CH–SH Selection and Sink Path-planning (CSSP) scheme to collect vast amount of data from heterogeneous sensor nodes. The scheme firstly establishes a three-layer network structure model for underwater mobile sensor networks (UMSN) based on multi-mode communication mechanism and provides energy-balanced head nodes (cluster head and sub-cluster head nodes) selection algorithm based on particle swarm iterative optimization. Then, the optimal global-path-plan of mobile sink is proposed to visit all the head nodes to collect data, reduce the multi-hop underwater acoustic transmission distance of relay nodes, and avoid the energy hole problem. Lastly, the upper-layer multi-hop network of UMSN is designed to remotely control local-path-plan over mobile sink, in order to implement joint planning of global and local paths of mobile sink. Simulation results verified that the proposed CSSP scheme outperformed 11%, 16% and 22% over three typical protocols in terms of nodes energy consumption, CSSP was 9%, 12% and 19% lower than three typical protocols in terms of SD of energy consumption, packet delivery ratio of CSSP was 8%, 10% and 12% higher than three typical protocols. The scheme could significantly balance energy and reduce packet loss rate.
Weighted enclosing subgraph-based link prediction for complex network
Authors: Yuan Weiwei , Han Yun , Guan Donghai , Han Guangjie , Tian Yuan , Al-Dhelaan Abdullah , Al-Dhelaan Mohammed 
Published: July 2022

AbstractLink prediction is a fundamental research issue in complex network, which can reveal the potential relationships between users. Most of link prediction algorithms are heuristic and based on topology structure. Weisfeiler–Lehman Neural Machine (WLNM), regarded as a new-generation method, has shown promising performance and thus got attention in link prediction. WLNM extracts an enclosing subgraph of each target link and encodes the subgraph as an adjacency matrix. But it does not consider the relationship between other links of the enclosing subgraph and target links. Therefore, WLNM does not make full use of the topology information around the link, and the extracted enclosing subgraph can only partially represent the topological features around the target link. In this work, a novel approach is proposed, named weighted enclosing subgraph-based link prediction (WESLP). It incorporates the link weights in the enclosing subgraph to reflect their relationship with the target link, and the Katz index between nodes is used to measure the relationship between two links. The prediction models are trained by different classifiers based on these weighted enclosing subgraphs. Experiments show that our proposed method consistently performs well on different real-world datasets.
Root-order-associated variations in fine-root decomposition and their effects on soil in a subtropical evergreen forest
Authors: Wu Yibo , Zhang Mengling , Cheng Zhibao , Wang Fang , Cui Xiaoyong 
Published: July 2022

AbstractBackgroundDespite the importance of root decomposition in predicting ecosystem responses to future climate change, the effects of branch order on root decomposition and the feedback to soil still remains poorly understood. Here we separated root samples taken from two tree species (Castanopsis fargesiiandSchima superbain subtropical forests along the coastal area in eastern China) into four-order classes (1st–2nd order, 3rd order, 4th order, and 5th order) and conducted a 540-day litterbag incubation experiment in laboratory to examine root mass loss, nutrient release, and the influence on soil during decomposition.ResultsC. fargesiiroots of 1st–2nd and 3rd order decayed more slowly than those of 4th and 5th order, but this pattern was not significant forS. superba. Of all the measured root traits, the decomposition rates correlated best with root C/N ratio, diameter and specific root length (SRL) based on the structural equation modeling. Both tree species and root order exhibited significantly effects on root initial traits. Overall,C. fargesiiroots decay faster thanS. superba, and this appears to be associated with root initial C quality and N concentration. In addition, root order positively affected root decomposition rates mainly through root diameter and SRL. However, no significant difference was found in C and N content between soils below the litterbag with different-order roots.ConclusionsOur findings suggest the effects of branch order on root decomposition are dependent on tree species. Moreover, root morphological properties might also be the controlling factor in root decay besides root chemistry fractions. Overall, the integrative effects should be considered to improve our understanding of the fate of fine-root litter and their contribution to soil C and N pool.
Optimizing internet-delivered cognitive behaviour therapy for alcohol misuse—a randomized factorial trial examining effects of a pre-treatment assessment interview and guidance
Authors: Sundström Christopher , Peynenburg Vanessa , Chadwick Carly , Thiessen David , Wilhems Andrew , Nugent Marcie , Keough Matthew T. , Schaub Michael P. , Hadjistavropoulos Heather D. 
Published: July 2022

Abstract
Background
Internet-delivered cognitive behavioral therapy (ICBT) for alcohol misuse has potential to radically improve access to evidence-based care, and there is a need to investigate ways to optimize its delivery in clinical settings. Guidance from a clinician has previously been shown to improve drinking outcomes in ICBT, and some studies suggest that pre-treatment assessments may contribute in initiating early change. The objective of this study was to investigate the added and combined effects of a pre-treatment assessment interview and guidance on the outcomes of ICBT for alcohol misuse delivered in an online therapy clinic.

Methods
A 2X2 factorial randomized controlled trial was conducted where participants received access to an 8-week ICBT program, and either a pre-treatment assessment interview (Factor 1), guidance (Factor 2), a combination of these, or neither of these. Participants were 270 individuals (66.8% female, mean age = 46.5) scoring 8 or more on the Alcohol Use Disorders Identification Test and consuming 14 standard drinks or more in the preceding week. Primary outcomes were number of drinks consumed and number of heavy drinking days during the preceding week, 3 months post-treatment.

Results
Large within-group effects were found in terms of alcohol reductions (dw ≥ 0.82, p < 0.001), but neither of the factors significantly improved drinking outcomes. Guidance was associated with greater adherence (i.e. completed modules).

Conclusions
Neither a pre-treatment assessment interview nor guidance from a clinician appears to improve drinking outcomes resulting from internet-delivered cognitive behaviour therapy for alcohol misuse when delivered in a routine online therapy clinic.
Trial registration: NCT03984786. Registered 13 June 2019, https://clinicaltrials.gov/ct2/show/NCT03984786
Interhospital transmission of vancomycin-resistant Enterococcus faecium in Aomori, Japan
Authors: Saito Norihiro , Kitazawa Junichi , Horiuchi Hiroko , Yamamoto Takeo , Kimura Masahiko , Inoue Fumio , Matsui Mika , Minakawa Satoko , Itoga Masamichi , Tsuchiya Junichiro , Suzuki Satowa , Hisatsune Junzo , Gu Yoshiaki , Sugai Motoyuki , Kayaba Hiroyuki 
Published: July 2022

Abstract
Background
Spread of vancomycin-resistant Enterococcus (VRE) is a global concern as a significant cause of healthcare-associated infections. A series of VRE faecium (VREf) outbreaks caused by clonal propagation due to interhospital transmission occurred in six general hospitals in Aomori prefecture, Japan.

Methods
The number of patients with VREf was obtained from thirty seven hospitals participating in the local network of Aomori prefecture. Thirteen hospitals performed active screening tests for VRE. Whole genome sequencing analysis was performed.

Results
The total number of cases with VREf amounted to 500 in fourteen hospitals in Aomori from Jan 2018 to April 2021. It took more than three years for the frequency of detection of VRE to return to pre-outbreak levels. The duration and size of outbreaks differed between hospitals according to the countermeasures available at each hospital. Whole genome sequencing analysis indicated vanA-type VREf ST1421 for most samples from six hospitals.

Conclusions
This was the first multi-jurisdictional outbreak of VREf sequence type 1421 in Japan. In addition to strict infection control measures, continuous monitoring of VRE detection in local medical regions and smooth and immediate communication among hospitals are required to prevent VREf outbreaks.
A retrospective study of estrogen in the pretreatment for medical management of early pregnancy loss and the inference from intrauterine adhesion
Authors: Cao Chaoxia , Zhou Qin , Hu Zhuoying , Shu Chunmei , Chen Mingju , Yang Xiujun 
Published: July 2022

Abstract
Background
Estrogen has been usually used in clinic for medical pretreatment of early pregnancy loss. There was little reported the effect of estrogen combined with prostaglandin analogs in the medical management of early pregnancy loss. This retrospective study aimed to evaluate the efficacy of estrogen pretreatment for medical management of early pregnancy loss and explore the confounding factor of intrauterine adhesion (IUA) on the outcome of medical management.

Methods
A total of 226 early pregnancy loss patients who received pretreatment with estradiol valerate and/or mifepristone, followed by carboprost methylate suppositories (study groups), or carboprost methylate suppositories alone (control group) in a regional central institution from March 2020 to February 2021 were retrospectively studied. All patients were evaluated by hysteroscopy 6 h after carboprost methylate suppositories use to assess whether the gestational sac was complete expulsion and assess the morphology of uterine cavity.

Results
The complete expulsion rate was 56.94% in the mifepristone and estradiol valerate-pretreatment group, 20.69% in the estradiol valerate-pretreatment group, 62.5% in the mifepristone-pretreatment group, and 12.5% in the control group. Compared with the control group, pretreatment with estradiol valerate did not increase the complete expulsion rate significantly (P = 0.297), pretreatment with mifepristone increased the complete expulsion rate significantly (P < 0.001). Pretreatment with mifepristone combined with estradiol valerate did not increase the complete expulsion rate significantly comparing with pretreatment with mifepristone (P = 0.222). The data of IUA showed that the complete expulsion rate in patients with IUA was lower than that in those patients without IUA (P < 0.001).

Conclusions
Pretreatment with estrogen was not a sensible substitute for mifepristone in the medical management of early pregnancy loss. Mifepristone followed by carboprost methylate suppositories was likelihood of the ideal medical scheme in early pregnancy loss. IUA decreased the complete expulsion rate of medical management, it is cautious about medical management for early pregnancy loss with risk of IUA.
Trial Registration Number: ChiCTR2100046503. Date of registration (retrospectively registered): May 18, 2021. Trial registration website: http://www.chictr.org.cn/.
The overdose epidemic: a study protocol to determine whether people who use drugs can influence or shape public opinion via mass media
Authors: Jozaghi Ehsan ,   VANDU
Published: July 2022

Abstract
Background
We are currently witnessing an ongoing drug overdose death epidemic in many nations linked to the distribution of illegally manufactured potent synthetic opioids. While many health policy makers and researchers have focused on the root causes and possible solutions to the current crisis, there has been little focus on the power of advocacy and community action by people who use drugs (PWUDs). Specifically, there has been no research on the role of PWUDs in engaging and influencing mass media opinion.

Methods
By relying on one of the longest and largest peer-run drug user advocacy groups in the world, the Vancouver Area Network of Drug Users (VANDU), newspaper articles, television reports, and magazines that VANDU or its members have been directly involved in will be identified via two data bases (the Canadian Newsstream & Google News). The news articles and videos related to the health of PWUDs and issues affecting PWUDs from 1997 to the end of 2020 will be analyzed qualitatively using Nvivo software.

Discussion
As our communities are entering another phase of the drug overdose epidemic, acknowledging and partnering with PWUDs could play an integral part in advancing the goals of harm reduction, treatment, and human rights.
Intervention outcome preferences for youth who are out of work and out of school: a qualitative study
Authors: Zhu Na , Hawke Lisa D. , Prebeg Matthew , Hayes Em , Darnay Karleigh , Iyer Srividya N. , Henderson Joanna 
Published: July 2022

Abstract
Background
While interventions have been developed and tested to help youth who have become disconnected from work and school, there is a paucity of research on young people’s intervention preferences. This study aims to understand young people’s preferred intervention outcomes and approaches for youth who are out of work and school.

Methods
Thirty youth participated in virtual focus groups. Transcripts were analyzed using thematic analysis.

Results
Youth want interventions and approaches that support them in (1) vocational readiness, (2) securing a job, and (3) mental health and well-being, while providing them with (4) high-contact, individualized, and integrated support.

Conclusions
Young people want interventions to be individualized and integrated, providing a high level of support for their educational and employment pursuits as well as their mental health and well-being. Incorporating youth's perspectives when designing interventions can increase intervention relevance and potentially service uptake, helping youth continue to pursue their educational and vocational goals.
The effects of mifepristone on the structure of human decidua and chorion and Bax and Bcl-2 expression at early stage of pregnancy
Authors: Tian Fei , Han Hua , Jia Ligang , Zhang Junqin , Chu Zhaoping , Li Jie , Zhang Yuan , Yan Ping 
Published: July 2022

Abstract
Background
As a progesterone receptor antagonist, mifepristone combined with misoprostol is widely used to terminate early pregnancy in clinical practice. It has also been reported that mifepristone may cause cell death in decidual cells and result in hemorrhage of the decidua and insufficient blood supply. However, little is known about the histological effects of mifepristone on human decidua and chorion.

Methods
Histological and subcellular structural changes of decidua and chorionic villi from women taking mifepristone at early pregnancy times were examined by Hematoxylin and eosin (H&E) staining and transmission Electron microscope. The expression of apoptosis-related proteins Bax/Bcl-2 was examined by immunohistochemistry.

Results
After 48 h of mifepristone administration, the decidua tissue and chorionic villus structures were altered in women within 39–49 days of gestation and displayed varying degrees of degeneration and necrosis-like features. Apoptotic events were observed in the decidua and chorionic villi of early pregnancy, and mifepristone treatment significantly increases the number of apoptotic cells. The increased apoptotic events were concomitant with the increased expression of Bax and decreased expression of Bcl-2.

Conclusion
This study provides evidence that mifepristone induces histological and subcellular changes in decidua and chorionic villi. Mifepristone modulates the relative ratio of Bax/Bcl-2 and the increased apoptosis contributes to the pregnancy termination at early stage of pregnancy.
Association of multiple sclerosis with mortality in sepsis: a population-level analysis
Authors: Oud Lavi , Garza John 
Published: July 2022

Abstract
Background
Multiple sclerosis (MS) is associated with increased risk of sepsis and higher sepsis-related mortality, compared to the general population. However, the evidence on the prognostic impact of MS in sepsis has been scarce. We aimed to evaluate the population-level association of MS with short-term mortality in sepsis.

Methods
We performed a retrospective population-based cohort study using a statewide data set to identify hospitalizations aged ≥ 18 years in Texas with sepsis, with and without MS during 2010–2017. Multilevel logistic models were fit to estimate the association of MS with short-term mortality among all sepsis hospitalizations, and for sensitivity analyses among hospitalizations with septic shock and those admitted to ICU.

Results
Among 283,025 sepsis hospitalizations, 1687 (0.6%) had MS. Compared to sepsis hospitalizations without MS, those with MS were younger (aged ≥ 65 years 35.0% vs 56.8%), less commonly racial/ethnic minority (36.2% vs 48.1%), and had lower mean Deyo comorbidity index (1.6 vs 2.7). The rates of septic shock and ICU admission were similar for sepsis hospitalizations with and without MS (58.7% vs 59.6% and 46.7% vs 46.0%, respectively). The unadjusted short-term mortality among sepsis hospitalizations with and without MS for the whole cohort, among those with septic shock, and among ICU admissions were 20.2% vs 31.3%, 25.6% vs 40.0%, and 24.0% vs 34.8%, respectively. On adjusted analyses, MS was associated with 17% lower odds of short-term mortality (adjusted odds ratio [aOR] 0.828 [95% CI 0.723–0.947]). Similar findings were observed on sensitivity analyses of patients with septic shock (aOR 0.764 [95% CI 0.651–0.896]), but MS was not associated with mortality among sepsis hospitalizations admitted to ICU (aOR 0.914 [95% CI 0.759–1.101]).

Conclusions
MS was associated with lower short-term mortality among septic patients, with findings consistent among the subset with septic shock. Among septic patients admitted to ICU, MS was not associated with mortality.