bluuebunny/crossref_metadata_2025_split huggingface dataset:
A study of Primary health care service efficiency and its spatial correlation in China
Authors: Mei kangni , Kou Ruxin , Bi Yuqing , Liu Yuzhuo , Huang Jingwen , Li Wei 
Published: December 2022

Abstract

Background China's primary health care system has undergone major changes since the new round of medical reform in 2009, but the current status of primary health care institution service efficiency is still unsatisfactory. The purpose of this study is to compare and evaluate the China’s primary health care institution service efficiency and provide a reference for improving the efficiency and promoting the development of primary health care institution. Methods Based on panel data of 31 provinces (municipalities directly under the central government and autonomous regions) in mainland China from 2011 to 2020, using the super efficiency slack-based measure-data envelopment analysis model, to analyze the data from a static perspective, and the changes in the efficiency of primary health care services were analyzed from a dynamic perspective by using the Malmquist index method. Spatial autocorrelation analysis method was used to verify the spatial correlation of Primary health care service efficiency among various regions. Results The number of Primary health care institutions increased from 918,000 in 2011 to 970,000 in 2020. The average primary health care institution service efficiency in the northeastern region including Jilin (0.324), Heilongjiang (0.460), Liaoning (0.453) and northern regions such as Shaanxi (0.344) and Neimenggu (0.403) was at a low level, while the eastern coastal regions such as Guangdong (1.116), Zhejiang (1.211), Shanghai (1.402) have higher average service efficiency levels. The global Moran's I showed the existence of spatial autocorrelation, and the local Moran's I index suggested that the problem of uneven regional development was prominent, showing a contiguous regional distribution pattern. Among them, H-H (high-efficiency regions) were mainly concentrated in Jiangsu, Anhui and Shanghai, and L-L regions were mostly in northern and northeastern China. Conclusion The service efficiency of primary health care institution in China showed a rising trend in general, but the overall average efficiency was still at a low level, and there were significant geographical differences, which showed a spatial distribution of "high in the east and low in the west, high in the south and low in the north". The northwestern region, after receiving relevant support, has seen a rapid development of primary health care, and its efficiency was steadily improving and gradually reaching a high level. The average primary health care institution service efficiency in the northeastern region including the northern region of China was at a low level, while the average efficiency in the eastern coastal region and some economically developed regions was high, which also verifies the dependence and high symbiosis of primary health care institution service efficiency on regional economy.
Demographic characteristics and risk factors related to high blood pressure among healthy blood donors from Luanda, Angola
Authors: Sebastião Cruz , Sacomboio Euclides , Francisco Ngiambudulu , Paixão Joana , Cassinela Edson , de Vasconcelos Jocelyne Neto , Pimentel Victor , Morais Joana 
Published: December 2022

Abstract
Hypertension is a public health concern, mainly in resource-limited countries. We investigated the characteristics and risk factors related to high blood pressure in healthy blood donors from Angola. This was a multicentre retrospective study that includes 343 donors from December 2019 to September 2020. Men represented 93% of the population. The mean age was 32 ± 9 years. Mean systolic blood pressure (SBP) was 131 ± 12.3mmHg (ranging from 100mmHg to 160mmHg) and diastolic blood pressure (DBP) was 80.1 ± 9.72mmHg (from 56.0mmHg to 100mmHg). DBP was related to age and gender (p < 0.05). About 7.3% of the donors had high-pressure (> 140/90mmHg). Age between 20–40 years (OR: 2.52, p = 0.043), women (OR: 1.87, p = 0.548), non-urbanized areas (OR: 0.39, p = 0.067), high educational level (OR: 0.76, p = 0.637), employed (OR: 0.49, p = 0.491), voluntary donors (OR: 0.87, p = 0.799), blood group B (OR: 2.06, p = 0.346), and Rh- (OR: 0.26, p = 0.104), were potentially related with high-pressure. The high-pressure cases increased from December 2019 (4%) to September 2020 (28%) (p = 0.019). We showed high pressure among the healthy population. Demographic characteristics, ABO/Rh group, and year’s period are features that should be considered in cardiovascular disease control strategies. Biological and non-biological features related to blood pressure changes should be considered for further studies in the Angolan population.
Principles for the effective implementation of value-based healthcare: a scoping review and proposed process model for successful implementation
Authors: Renting Nienke , Nutma Ekelien , Roemeling Oskar , Smailhodzic Edin 
Published: December 2022

Abstract
Background
Porter's value-based healthcare (VBHC) idea has gained immense popularity in literature and practice in the past decade. While the value agenda clearly articulates the goal and content of VBHC, it provides no advice on an implementation strategy. This is problematic as, without an appropriate implementation strategy, even the most significant improvement initiatives are bound to fail. In this research, we adopt a change management perspective to understand better the critical principles that determine an effective implementation of VBHC. Furthermore, we provide guidelines to increase the likelihood of implementation success.
Methods
We performed a scoping review of the literature published in English on the topic of VBHC initiatives using Scopus and Web of Science. The studies were included if they offered empirical evidence on care providers' implementation of VBHC.
Results
The findings from the scoping review are based on 24 studies and underline that VBHC implementation is a complex concept. Implementing all ideas related to VBHC in practice appears to be challenging, and frequently, projects fail to measure or make progress in reducing costs and improving patient-centric outcomes. The findings also indicate that specific change management elements increased the likelihood of the VBHC implementation's success. The findings show the importance of 1) establishing the need and vision for change throughout the organization, 2) managing stakeholders' responses to change, 3) combining a supportive top-down and participative approach to change, and 4) using data on patient-centric outcomes and costs.
Conclusion:
The implementation of VBHC is a complex endeavor, demanding that the reason (why), content (what), and process (how) of the change to VBHC is well-developed. With no approach to VBHC implementation, there is little knowledge about the shift to VBHC from a change management perspective. By conducting a scoping study, this research aimed to systematically investigate the concept of VBHC implementation in the literature from a change management perspective by identifying and mapping the available empirical evidence on care providers' implementation of VBHC.
Regionalized life-cycle monetization method to thrive sustainable transition of rural food waste management in China
Authors: Liu Fang , Xin Liqing , Tang Hang , Qin Yong , Zhang Lei , Dong Xinyue , Zhang Yi , Wu Weixiang , Wang Lei 
Published: December 2022

Abstract
Monetization of externalities has served to thrive sustainable technology transition towards a low carbon scoiety. However, regional monetization method is lacking in China. Herein, ChinataxRCP was built to enable an environmental-economic (E-E) integration and analysis of environmental externalities in different medium (air-water-soil-human), facilitating decision making after considering tradeoffs among environmental impacts or between environment and economics. As a case study, ChinataxRCP was applied on evaluating technology-transition risks from landfill for rural FW management in Zhejiang who is a pioneer practicing “zero-waste city” in China. E-E integration results using ChinataxRCP indicated that biodrying & maturity, and two biotransformation options were promising. However, after transition from landfill, environmental pollution in air-soil-water and resource-related indicators were mostly relieved but with compromise on human health, which indicates efforts are required to control potential risks. Furthermore, policy scenarios revealed that subsidies are crucial for FW management and extra leverage should be reinforced to decouple them.
Construction of 3D sheet-packed hierarchical MoS2/BiOBr heterostructures with remarkably enhanced photocatalytic performance for tetracycline and levofloxacin degradation
Authors: Ma Zhanying , Li Xiaobo , Fan Guang , Deng lingjuan , He Yangqing 
Published: December 2022

Abstract
In this paper, MoS2 nanosheets were prepared and deposited on BiOBr microflowers to fabricate MoS2/BiOBr heterojuncitons through deposition-hydrothermal strategy. The SEM and TEM images evidenced that few-layer MoS2 were grafted on BiOBr surface to yield 3D sheet-packed MoS2/BiOBr heterostructures. The obtained MoS2/BiOBr samples exhibited tremendous enhanced catalytic activity in comparison with pure BiOBr and the degradation rate reached 92.96% and 90.31% for tetracycline and levofloxacin degradation, respectively. The remarkably enhanced performance could be attributed to the synergistic effect of strong visible-light harvesting ability and the formation of heterojunction between MoS2 and BiOBr. The reactive species capturing experiments evidenced that photo-generated holes and ⋅OH radicals played the dominant roles in the whole photocatalytic decomposition process. A plausible mechanism for the enhanced photocatalytic capability was also proposed.
Perception on Facilitators and Barriers to Adherence to COVID-19 Preventive Measures among Undergraduate Nursing Students at Muhimbili University of Health and Allied Sciences, Tanzania: a Cross-sectional Study.
Authors: Msengi Emanueli Amosi , Gosse Rashid A 
Published: December 2022

Abstract
Background
Considering the severity of COVID-19 and the lack of drugs to treat this pandemic, the WHO and other authorities introduced various preventive measures to prevent the transmission of COVID-19. Despite the recommendations on adherence to COVID-19 preventive measures, communities do not adhere effectively to these preventive measures which poses a risk of speeding up the transmission of the disease and ultimately high morbidity and mortality rates. Therefore, this study aimed to assess perception of facilitators and barriers to adherence to COVID-19 preventive measures among undergraduate nursing students at the Muhimbili University of Health and Allied Sciences, Tanzania.
Methods
This study employed a cross-sectional design. 250 undergraduate nursing students were recruited by stratified sampling technique. The data were collected by structured self-administered questionnaires adapted from previous studies. The collected data were analyzed by SPSS computer software version 25. Descriptive statistics were used to describe variables including; socio-demographic characteristics, adherence to various COVID-19 preventive measures, and perception of participants on barriers and facilitators for adherence to COVID-19 preventive measures. Bivariate analysis was used to determine statistically significant associated variables at a p-value less than 0.05.
Results
This study included 250 undergraduate nursing students. The majority (32.0%) of them were in the first year. The majority (70.8%) of the participants had poor adherence to COVID-19 preventive measures. The significant factors associated with adherence to COVID-19 preventive measures were the year of study (χ2=7.91, p = 0.04) and participants’ perception of barriers to adherence to COVID-19 preventive measures (χ2= 4.21, p = 0.04). The majority (93.6%) of the participants had a good perception of facilitators for adherence to COVID-19 preventive measures. More than half (51.2%) of the participants had a poor perception of barriers to adherence to COVID-19 preventive measures.
Conclusions
This study found that the majority of the participants had poor adherence to various COVID-19 preventive measures. In addition, the participant's perception of barriers to adherence to COVID-19 preventive measures was poor. However, the perception of facilitators for adherence to COVID-19 preventive measures was good. The concerned institution and organization should implement activities that increase adherence to COVID-19 preventive measures. Furthermore, it is important to provide students with appropriate information to correct their perceptions of barriers to adherence to COVID-19 preventive measures.
Intelligent path planning of mobile robot based on Deep Deterministic Policy Gradient
Authors: Gong Hui , Wang Peng , Ni Cui , Cheng Nuo , Wang Hua 
Published: December 2022

Abstract
Deep Deterministic Policy Gradient (DDPG) is a deep reinforcement learning algorithm that is widely used in the path planning of mobile robots. It solves the continuous action space problem and can ensure the continuity of mobile robot motion using the Actor-Critic framework, which has great potential in the field of mobile robot path planning. However, because the Critic network always selects the maximum Q value to evaluate the actions of mobile robot, there is the problem of inaccurate Q value estimation. In addition, DDPG adopts a random uniform sampling method, which can’t efficiently use the more important sample data, resulting in slow convergence speed during the training of the path planning model and easily falling into local optimum. In this paper, a dueling network is introduced based on DDPG to improve the estimation accuracy of the Q value, and the reward function is optimized to increase the immediate reward, to direct the mobile robot to move faster toward the target point. To further improve the efficiency of experience replay, a single experience pool is separated into two by comprehensively considering the influence of average reward and TD-error on the importance of samples, and a dynamic adaptive sampling mechanism is adopted to sample the two experience pools separately. Finally, experiments were carried out in the simulation environment created with the ROS system and the Gazebo platform. The results of the experiments show that the proposed path planning algorithm has a fast convergence speed and high stability, and the success rate can reach 100% and 93% in the environment without obstacles and with obstacles, respectively.
Remote Eradication of Delayed Infection on Orthopedic Implants via Magnesium-based Total Morphosynthesis of Biomimetic Mineralization Strategy
Authors: Wang Yikai , Ma Siyuan , Yu Xiaohua , Gou Zhongru , Jin Zhihui , Chen Sen , Ye Yuxiao , Zhang Chongda , Ye Zhaoming , Ren Yijun 
Published: December 2022

Abstract
Background: Orthopedic delayed and late infections are devastating afflictions for patients who have undergone implantation. Even though versatile antibacterial modification on medical devices brought the hope of eradicating pathogenic bacteria. The synthesis of late-term antibacterial properties with total morphosynthesis on medical devices nonetheless remains an elusive goal.
Methods: Herein, we utilize a mineralized strategy coupled with ion exchange to generate lamellar-type magnesium calcium phosphate thin films with a three-step pathway: Construction of nanofiber porous structure on the substrate as ions reservoir, incorporation of magnesium substitutional transition sodium titanate layer, and mineralization of a lamellar calcium phosphate coating.
Results: Synthetic lamellar coatings exhibit excellent osteointegration effects in infectious scenarios. More importantly, the underlying transition layer can blow up the possible delayed infection like a landmine after the upper calcium phosphate coating is degraded under the physiological environment.
Conclusions: This work highlights the pivotal role of the magnesium ions in mediating the growth of the total morphosynthesis of calcium phosphate coating and the underlying magnesium titanate layer in ensuring the possibility to eliminate delayed infections under time-dependent degradation.
Enhancing photosynthetic efficiency by assembling metal-organic frameworks on microalgae
Authors: Li Dingyi , Dong Hong , Cao Xupeng , Wang Wangyin , Li Can 
Published: December 2022

Abstract
The CO2 concentration at ribulose-1,5-bisphosphate carboxylase/oxygenase (Rubisco) is crucial to improve photosynthetic efficiency for biomass yield. However, how to concentrate and transport atmospheric CO2 towards to the Rubisco carboxylation is a big challenge. Here in, we report the self-assembly of metal-organic frameworks (MOFs) on the surface of a microalgae that can greatly enhance the photosynthetic efficiency. The non-genetic concentrating CO2 approach improved photosynthetic efficiency by about 2 folds, which is up to 7.5% in ambient air from an intrinsic 3.6%. We find that the efficient carbon fixation lies in the conversion of the captured CO2 to the transportable HCO3-species at bio-organic interface. This work demonstrated a non-genetic approach of concentrating atmospheric CO2 for enhancing biomass yield of photosynthesis.
Infinite number of Wada basins in a megastable nonlinear oscillator
Authors: Wang Jingwei , Zhang Yongxiang 
Published: December 2022

Abstract
Previous results show that some oscillators possess finite number of Wada basins. Here we find that a nonlinear oscillator can possess a countable infinity of Wada basins and these Wada basins are connected. Infinite number of coexisting attractors and their Wada basins are investigated by the basin cell theorem and generalized basin cell theorem. Infinite number of Wada basins are systematic, which identical basins structure can be identified in each periodic X-axis coordinate interval. This type of Wada basin boundary can lead to a high level of indeterminacy and an extreme sensitive dependence on initial condition.
Rapid hydrolysis of NO2 at high ionic strengths of deliquesced aerosol particles
Authors: Gen Masao , Zheng Haotian , Sun Yele , Xu Wanyun , Ma Nan , Su Hang , Cheng Yafang , Wang Shuxiao , Xing Jia , Zhang Shuping , Xue Likun , Xue Chaoyang , Mu Yujing , Tian Xiao , Matsuki Atsushi , Song Shaojie 
Published: December 2022

Abstract

Nitrogen dioxide (NO2) hydrolysis in deliquesced aerosol particles forms nitrous acid and nitrate and thus impacts air quality, climate, and nitrogen cycle. Traditionally, it is considered to proceed far too slowly in the atmosphere. However, the significance of this process is highly uncertain because kinetic studies have only been made in dilute aqueous solutions, and not under high ionic strength conditions of the aerosol particles. Here, we use laboratory experiments, air quality models, and field measurements to examine the effect of ionic strength on the reaction kinetics of NO2 hydrolysis. We find that high ionic strengths (I) enhance the reaction rate constants (kI) by more than two orders of magnitude compared to that at infinite dilution (kI=0), yielding log10(kI/kI=0) = 0.058I. A state-of-the-art air quality model shows that the enhanced NO2 hydrolysis reduces the negative bias in the simulated concentrations of nitrous acid by 27% on average when compared to field observations over the North China Plain. Rapid NO2 hydrolysis also enhances the levels of nitrous acid in other polluted regions such as North India and further promotes atmospheric oxidation capacity. This study highlights the need to evaluate various reaction kinetics of atmospheric aerosols with high ionic strengths.
Evaluating Physician Associate (PA) students’ perceptions of an Online Team Based Learning (TBL) session on Stroke Medicine
Authors: Aweid Basaam Adil , Wiseman Allison , Russell Anna , Mirchandani Anjaly , Parnis Natalie , Anas Shafeena , Rajalingam Preman 
Published: December 2022

Abstract
TBL is an effective, active learning strategy that has been validated and used in Medical schools (Wiener et al., 2009). It consists of 3 phases; preparation, readiness assurance tests and application exercise (Reimschisel et al., 2017). It follows a ‘flipped classroom’ model where assessment takes place at the beginning and encourages team discussions that emulate clinical practice. We explored the perceptions of a Stroke TBL session among Physician Associate students in a UK PA programme. The study took place during the COVID-19 pandemic therefore due to restrictions, TBL was implemented virtually using online video conferencing platforms. The students perceptions were then analysed using anonymous online questionnaires sent to them shortly after the session. The questionnaire included specific questions comparing TBL to other teaching methods such as PBL. Overall, the students felt that TBL was an effective teaching method that was better than other methods such as lectures and PBL. We encourage further use of this strategy to teach medical curricula with further studies in this area.
Predictors of CD4+ Count Changes in HIV-Infected Patients Receiving Antiretroviral Therapy
Authors: Kassie Abere Wondimu 
Published: December 2022

Abstract
Introduction

The CD4 + count is used to evaluate the clinical status of HIV-infected patients when deciding whether to initiate ART. To study the progression of HIV-infected patients on ART, CD4 + counts in each individual could be measured repeatedly to monitor the patient's AIDS progression and monitor treatment success. Therefore, this study aimed to identify predictors of CD4 + progression in HIV-positive patients receiving ART at the Debre Berhan Referral Hospital.

Methods

Retrospective data were collected from 322 HIV-infected patients who started ART in the hospital from September 2013 to February 2019. Exploratory analyses were applied to assess subject-specific and mean differences in terms of patients’ CD4 + progression. A linear mixed model was used as data analysis to account random effects.

Results

Of the 322 HIV-infected patients considered in the study, 225 (69.88%) were females. The baseline mean CD4 + counts was 335.7 and changed to 408.61 over 7 follow-up years. Moreover, predictors such as patients’ gender (male) (β =-0.7512, p-value = 0.019), age at initiation of ART (β = -0.02705, p-value = 0.047), bedridden functional status of the patients at initiation of ART (β = -0.03365, p-value = 0.021), TDF-3TC-NVP regimen class (β = -0.1474, p-value = 0.031), unmarried patients (β = 0.610, p-value = 0.011), patients’ WHO clinical stage-II (β = -0.402, p-value = 0.047), baseline CD4 count (β = 0.020, p-value = 0.0001) and follow-up time (β = 0.613, p-value = 0.0001) were positively as well as negatively associated and had significant impact on CD4 count progression.

Conclusions

Patients’ gender, age at initiation of ART, bedridden functional status at ART initiation, TDF-3TC-NVP treatment class, unmarried marital status, WHO clinical stage II, baseline CD4 count and follow-up time was found to be a significant predictor of the progression of a patient's CD4 count. Therefore, HIV-positive patients can be advised to start ART treatment as early as possible. Special guidance and attention is also required, especially in elderly patients, males with bedridden functional status, and late WHO clinical stage patients.