bluuebunny/crossref_metadata_2025_split huggingface dataset:
Research on the optimization of financing scheme of long-term care insurance in China based on system dynamics simulation
Authors: Zhang Liangwen , Fu Sijia , Wang Yifan , Fang Ya 
Published: September 2022

ObjectiveThe aging population in China highlights the significance of long-term care insurance (LTCI). This study provides policy suggestions for China to establish a sustainable LTCI financing mechanism by predicting the trend of funds balance and screening the appropriate financing scheme.MethodA system dynamics model (SDM) of LTCI funds was constructed by clarifying the current situation and its main influencing factors of revenue and expenditure of LTCI funds in China. Also, through literature research and expert consultation, we found the intervention goals and predicted the changing trend of LTCI fund balance from 2020 to 2050 under different intervention schemes.ResultsThe SDM of LTCI financing passes the dimensional consistency test, structural test, and historical test. Therefore, it can objectively reflect the structure and behavior of the financing system. It is found that the factors affecting the revenue and expenditure system of LTCI funds mainly include economic factors, demographic factors, and other factors. By adjusting three intervention indicators, namely, individual payment rate, reimbursement proportion, and severe disability rate, this study produces 45 financing combination schemes. By comparing the changing trend of LTCI fund balance under different intervention schemes, according to the screening principle, five better financing schemes are finally selected. These five financing schemes have no deficit and excessive balance in the forecast period, which is in line with the principle of sustainability. It can provide a reference for the selection of financing schemes in pilot areas.DiscussionThis study has optimized the policy of the LTCI financing mechanism, determined the suitable LTCI participants, financing channels and levels, and screened out the suitable LTCI financing policy optimization scheme for China. By appropriately increasing the individual payment rate, strengthening the disability intervention of the elderly, formulating scientific and objective disability evaluation standards, and finally establishing a dynamic financing adjustment mechanism of LTCI. This study can provide a basis for the scientific formulation of the LTCI financing mechanism in China and provide a reference for developing countries to establish a sustainable LTCI.
Effectiveness of the COVID-19 Community Vulnerability Index in explaining COVID-19 deaths
Authors: An Jinghua , Hoover Shelley , Konda Sreenivas , Kim Sage J. 
Published: September 2022

ObjectivesTo explore the effectiveness of a COVID-19 specific social vulnerability index, we examined the relative importance of four COVID-19 specific themes and three general themes of the COVID-19 Community Vulnerability Index (CCVI) in explaining COVID-19 mortality rates in Cook County, Illinois.MethodsWe counted COVID-19 death records from the Cook County Medical Examiner's Office, geocoded incident addresses by census tracts, and appended census tracts' CCVI scores. Negative binomial regression and Random Forest were used to examine the relative importance of CCVI themes in explaining COVID-19 mortality rates.ResultsCOVID-19 specific Themes 6 (High risk environments) and 4 (Epidemiological factors) were the most important in explaining COVID-19 mortality (incidence rate ratio (IRR) = 6.80 and 6.44, respectively), followed by a general Theme 2 (Minority status &amp; language, IRR = 3.26).ConclusionThe addition of disaster-specific indicators may improve the accuracy of social vulnerability indices. However, variance for Theme 6 was entirely from the long-term care resident indicator, as the other two indicators were constant at the census tract level. Thus, CCVI should be further refined to improve its effectiveness in identifying vulnerable communities. Also, building a more robust local data infrastructure is critical to understanding the vulnerabilities of local places.
Development and design of a culturally tailored intervention to address COVID-19 disparities among Oregon's Latinx communities: A community case study
Authors: Budd Elizabeth L. , McWhirter Ellen Hawley , De Anda Stephanie , Mauricio Anne Marie , Mueller Maryanne V. , Cioffi Camille C. , Nash Ashley , Van Brocklin Kelsey , Yarris Kristin , Jackson Arriell , Terral Heather , García Jorge I. Ramírez ,   Juntos Podemos Community and Scientific Advisory Board, Cresko William A. , DeGarmo David S. , Leve Leslie D. 
Published: September 2022

BackgroundLatinx communities are disproportionately affected by COVID-19 compared with non-Latinx White communities in Oregon and much of the United States. The COVID-19 pandemic presents a critical and urgent need to reach Latinx communities with innovative, culturally tailored outreach and health promotion interventions to reduce viral transmission and address disparities. The aims of this case study are to (1) outline the collaborative development of a culturally and trauma-informed COVID-19 preventive intervention for Latinx communities; (2) describe essential intervention elements; and (3) summarize strengths and lessons learned for future applications.MethodsBetween June 2020 and January 2021, a multidisciplinary team of researchers and Latinx-serving partners engaged in the following intervention development activities: a scientific literature review, a survey of 67 Latinx residents attending public testing events, interviews with 13 leaders of community-based organizations serving Latinx residents, and bi-weekly consultations with the project's Public Health and Community Services Team and a regional Community and Scientific Advisory Board. After launching the intervention in the field in February 2021, bi-weekly meetings with interventionists continuously informed minor iterative refinements through present day.ResultsThe resulting intervention, Promotores de Salud, includes outreach and brief health education. Bilingual, trauma-informed trainings and materials reflect the lived experiences, cultural values, needs, and concerns of Latinx communities. Interventionists (21 Promotores) were Latinx residents from nine Oregon counties where the intervention was delivered.ConclusionsSharing development and intervention details with public health researchers and practitioners facilitates intervention uptake and replication to optimize the public health effect in Oregon's Latinx communities and beyond.
Development of acceptable quality radiation dose levels for common computed tomography examinations: A focused multicenter study in United Arab Emirates
Authors: Elshami Wiam , Abuzaid Mohamed , Joseph Dlama Z. , Tekin H. O. , Ghonim Hatem 
Published: September 2022

PurposeDiagnostic Reference Level (DRL) is a practical tool for radiation dose optimization, yet it does not indicate the patient size or image quality. The Acceptable Quality Dose (AQD) introduced to address the limitations of the DRLs and it is based on image quality, radiation dose, and patient weight. The aim of this study is to establish the AQD for adult patients' undergoing Computed Tomography (CT) examinations (Head, chest, abdomen).MethodsThis study is conducted in the four main hospitals at the Ministry of Health and Prevention. Patient information and exposure parameters were extracted. All the acceptable images are scored for their quality assessments. Data is classified as seven weight groups, &lt;50, 50–59, 60–69, 70–79, 80–89, 90–99, and ≥100 kg. The mean ± SD, median, and 75th are calculated for the CTDIvol and DLP for each weight group per examination.ResultsOut of 392, 358 CT examinations are scored with acceptable quality. The median CTDIvol values for the weight groups are obtained as 24.6, 25.4, 25.4, 25.0, 26.0, 27.0, and 29.0 mGy. Moreover, median DLP values are obtained as 576.7, 601.0, 616.5, 636.1, 654.0, 650.0, 780.0, and 622.5 mGy.cm, respectively, for head CT without Contrast Media (CM). Similar calculation for head CT with (CM), chest without CM, abdomen without CM, and chest and abdomen (with and without CM) CTs are presented.ConclusionImages with bad, unacceptable and higher than necessary qualities contribute to increasing patient dose and increasing the DRLs. The AQD for the selected examinations were lower than the proposed DRLs in the United Arab Emirates. The integration of image quality and patients size in the assessment of the AQD values provide effective model to compare radiation dose indices within facility and compare with others. The obtained results may be useful in terms of improving dose and the diagnostic quality in the national and international levels.
What are the acceptances and associated influences of hospice care in Mainland China? A national cross-sectional study
Authors: Zhang Xinyue , Zhang Xun , Li Yiqi , Chen Tianle , Siow Lixuen , Ye Xinxin , Wang Yinlin , Wang Yujia , Ming Wai-Kit , Sun Xinying , Xiang Ze , Wu Yibo , Wu Jian 
Published: September 2022

BackgroundChina ranks 53rd out of 81 countries in the Quality of Death Index for 2021. Although hospice care demand is increasing, the progress remains slow. It is of great significance to explore the acceptances and associated influencing factors of hospice care.MethodsA cross-sectional survey by quota sampling was conducted in China from July 10th to September 15th, 2021. We collected demographic data and hospice care acceptance. A stepwise linear regression analysis was used.ResultsThis survey contained 11,031 valid questionnaire results to investigate the hospice care acceptance. It was found that individuals with undergraduate or above (β = 0.04), more properties [2 (β = 0.02), 3 (β = 0.01)], and higher reimbursement types of medical insurance [employee health insurance and commercial health (β = 0.03), government insurance (β = 0.04)] had higher hospice acceptance willingness, while males (β = −0.02) were less willing to accept than females. Psychological conditions [mild anxiety (β = 0.03), moderate anxiety (β = 0.01), moderate stress (β = 0.05), and severe stress (β = 0.06)] also played an important role. The Self-Management Scale (SHMS) (β = 0.12), EuroQol Five Dimensions Questionnaire (EQ-5D) (β = 0.05), EuroQol Visual Analog Scale (EQ-VAS) (β = 0.21), Short-Form Family Health Scale (FHS-SF) (β = 0.12), higher scores of the Short-Form Health Literacy Instrument (HLS-SF12) (β = 0.16), and Perceived Social Support Scale (PSSS) (β = 0.10) also contributed. Gender subgroup showed that in the male group, age, highest educational level, marital status, number of properties, whether having children, psychological conditions, the SHMS, EQ-5D, EQ-VAS, HLS-SF12, and PSSS showed significant difference. Urban and rural subgroups showed that age, highest educational level, number of properties, whether having chronic disease or psychological conditions, the SHMS, EQ-VAS, HLS-SF12, and PSSS were contributing factors in rural areas.ConclusionThe average score of acceptance of hospice care was 65.02 points. Gender, house, anxiety, pressure, social support, and health literacy were the main influencing factors on residents' attitudes.
Differences in health literacy domains among migrants and their descendants in Germany
Authors: Berens Eva-Maria , Klinger Julia , Carol Sarah , Schaeffer Doris 
Published: September 2022

BackgroundHealth literacy (HL) is considered to be an important precondition for health. HL research often identifies migrants as vulnerable for low HL. However, in-depth data on HL among migrants especially in its domains of health care, disease prevention and health promotion and its determinants are still scarce.ObjectiveThe aim of this study was therefore to analyse the current status of HL among migrants and their descendants from Turkey and from the former Soviet Union (FSU) in Germany and factors associated with it. This has not been studied using large-scale data and bilingual interviews. We differentiate between dimensions of HL, namely the domains of health care, disease prevention and health promotion which goes beyond many previous studies. In addition, we explore new mechanisms by testing the explanatory power of self-efficacy and interethnic contacts for migrants' HL.MethodsThe study includes 825 first- and second-generation adult migrants from two of the largest immigration groups in Germany, from Turkey and FSU, who were interviewed face-to-face in German, Turkish or Russian in late summer 2020. HL was measured using the HLS19-Q47 instrument. Age, gender, educational level, social status and financial deprivation, chronic illness, health-related literacy skills, self-efficacy, interethnic contacts, migration generation, duration of stay and region of origin were considered as possible determinants. Ordinary least square regressions were estimated.ResultsThe average general HL score was 65.5. HL in health promotion and disease prevention was lower than in health care. Low financial deprivation, health-related literacy skills, and self-efficacy were positively correlated with each HL domain. Educational level, social status, age, gender, duration of stay and interethnic contacts were positively correlated with HL in some domains. Region of origin was only correlated with the domain of disease prevention until interethnic contact was accounted for.ConclusionOur study contributes to the existing knowledge by analyzing different domains of HL and testing its correlations with self-efficacy and interethnic contact among migrants. We reveal that migrants cannot generally be considered as vulnerable for low HL, as oftentimes outlined. There is a need for interventions e.g. to enhance the understanding of health information among subgroups with lower HL.
The inclusion of disability within efforts to address menstrual health during humanitarian emergencies: A systematized review
Authors: Wilbur Jane , Clemens Felicity , Sweet Elisabeth , Banks Lena Morgon , Morrison Chloe 
Published: September 2022

IntroductionWomen and girls with disabilities may be excluded from efforts to achieve menstrual health during emergencies. The review objectives were to (1) identify and map the scope of available evidence on the inclusion of disability in menstrual health during emergencies and (2) understand its focus in comparison to menstrual health for people without disabilities in emergencies.MethodsEligible papers covered all regions and emergencies. Peer-reviewed papers were identified by conducting searches, in February 2020 and August 2021, across six online databases (PubMed, MEDLINE, EMBASE, Global Health, ReliefWeb, and Cinahal Plus); gray literature was identified through OpenGrey, Gray Literature Report, Google Scholar, and Million Short. Eligible papers included data on menstrual health for women and girls with and without disabilities in emergencies.ResultsFifty-one papers were included; most focused on Southern Asia and man-made hazards. Nineteen papers contained primary research, whilst 32 did not. Four of the former were published in peer-reviewed journals; 34 papers were high quality. Only 26 papers mentioned menstrual health and disability in humanitarian settings, but the discussion was fleeting and incredibly light. Social support, behavioral expectations, knowledge, housing, shelter, water and sanitation infrastructure, disposal facilities, menstrual material availability, and affordability were investigated. Women and girls with disabilities rarely participated in menstrual health efforts, experienced reduced social support, and were less able to access water, sanitation and hygiene facilities, including disposal facilities. Cash transfers and hygiene kit distribution points were often inaccessible for people with disabilities; few outreach schemes existed. Hygiene kits provided were not always appropriate for people with disabilities. Caregivers (all genders) require but lack guidance about how to support an individual with disabilities to manage menstruation.ConclusionMinimal evidence exists on menstrual health and disabilities in emergencies; what does exist rarely directly involves women and girls with disabilities or their caregivers. Deliberate action must be taken to generate data about their menstrual health requirements during humanitarian crises and develop subsequent evidence-based solutions. All efforts must be made in meaningful participation with women and girls with disabilities and their caregivers to ensure interventions are appropriate.Systematic review registrationIdentifier: CRD42021250937.
Accuracy of preoperative clinical staging for locally advanced gastric cancer in KLASS-02 randomized clinical trial
Authors: Kim Dong Jin , Hyung Woo Jin , Park Young-Kyu , Lee Hyuk-Joon , An Ji Yeong , Kim Hyoung-Il , Kim Hyung-Ho , Ryu Seung Wan , Hur Hoon , Kim Min-Chan , Kong Seong-Ho , Kim Jin-Jo , Park Do Joong , Ryu Keun Won , Kim Young Woo , Kim Jong Won , Lee Joo-Ho , Yang Han-Kwang , Han Sang-Uk , Kim Wook ,   on behalf of the Korean Laparoendoscopic Gastrointestinal Surgery Study (KLASS) Group
Published: September 2022

PurposeThe discrepancy between preoperative and final pathological staging has been a long-standing challenge for the application of clinical trials or appropriate treatment options. This study aimed to demonstrate the accuracy of preoperative staging of locally advanced gastric cancer using data from a large-scale randomized clinical trial.Materials and methodsOf the 1050 patients enrolled in the clinical trial, 26 were excluded due to withdrawal of consent (n = 20) or non-surgery (n = 6). The clinical and pathological staging was compared. Risk factor analysis for underestimation was performed using univariate and multivariate analyses.ResultsRegarding T staging by computed tomography, accuracy rates were 74.48, 61.62, 58.56, and 85.16% for T1, T2, T3 and T4a, respectively. Multivariate analysis for underestimation of T staging revealed that younger age, ulcerative gross type, circular location, larger tumor size, and undifferentiated histology were independent risk factors. Regarding nodal status estimation, 54.9% of patients with clinical N0 disease were pathologic N0, and 36.4% of patients were revealed to have pathologic N0 among clinical node-positive patients. The percentage of metastasis involvement at the D1, D1+, and D2 lymph node stations significantly increased with the advanced clinical N stage. Among all patients, 29 (2.8%), including 26 with peritoneal seeding, exhibited distant metastases.ConclusionsEstimating the exact pathologic staging remains challenging. A thorough evaluation is mandatory before treatment selection or trial enrollment. Moreover, we need to set a sufficient case number when we design the clinical trial considering the stage migration.
Invasive micropapillary breast carcinoma: A retrospective study on the clinical imaging features and pathologic findings
Authors: Nangong Jiarui , Cheng Zhongquan , Yu Leyi , Zheng Xiaodan , Ding Guoqian 
Published: September 2022

PurposeTo describe the clinical imaging and pathological features of invasive micropapillary breast carcinoma (IMPC), including breast mammography, sonography, magnetic resonance imaging (MRI), and molecular imaging findings.Patients and methodsWe retrospectively reviewed our institution's surgical pathology database and identified 65 patients with pathologically proven IMBC; 63/65 patients had available imaging results. Two radiologists retrospectively reviewed all imaging evaluations according to the Breast Imaging Reporting / Data System (BI-RADS) Lexicon. Clinical and histopathologic features, receptor statuses, and clinical follow-up data were recorded.ResultsSixty-three patients were admitted with palpable abnormalities; one patient's mammogram revealed no abnormality (3.3%, 1/32), whereas 31 had abnormal mammograms (31/32, 96.8%) demonstrating 37 lesions. Twenty-four had irregular, spiculated masses, 12 had microcalcifications, and 19 had architectural distortion. Sonography detected 69 masses (54 patients), characterized by irregular shapes (61/69, 88.4%), hypoechoic structures (50/69, 72.4%), angular or spiculated margins (38/69, 55.1%; 30/69, 43.4%), echogenic halo (8/69, 11.5%), and abnormal vascularity (52/69, 75.3%). MRI detected 68 lesions (52 patients); 59/68 (86.8%) appeared as masses with angular or spiculated margins (32/68, 47.1%; 35/68, 51.4%), 58 exhibited irregular or lobulated shapes (58/68, 89.7%), 29 displayed heterogeneous internal enhancement (29/68, 42.5%), and 64 demonstrated type II or III washout kinetic curves (37/68, 55%; 27/68, 40%). Breast molecular imaging showed mild-to-moderate radiotracer uptake in 15 focal areas among 13 patients. Thirty-two, 38, and 43 patients had abnormal lymph nodes identified mammographically, by breast sonography, and by MRI, respectively. Immunohistochemistry revealed high estrogen receptor (90.5%), high progesterone receptor (71.6%), and low HER-2 (26.4%) positivity.ConclusionIMPC mammography, sonography, and MRI clinical imaging features highly suggest malignancy. Breast molecular imaging also contributed to the diagnosis. IMPC's invasiveness correlated well with regional lymph node metastasis. Radiologists and surgeons should be more attentive to these imaging findings and additional clinical and pathological IMPC features.
Inflammatory Myofibroblastic Tumor of the Hilar Bile Duct: A Case Report and Literature Review
Authors: Gao Sheng-qiang , Bao Yong-jin , Luo Jian-sheng 
Published: September 2022

BackgroundInflammatory myofibroblastic tumor (IMT) is a very rare tumor and occurs seldom in the biliary tract. IMT can occur in any part of the body and in people of any age; however, it most commonly occurs in children or adolescents. Its etiology and pathogenesis are currently unknown. The clinical manifestations of a hilar inflammatory myofibroblastic tumor are atypical, and the imaging examination is nonspecific. The diagnosis is mainly based on histopathology and immunohistochemistry findings, and surgical resection is the preferred treatment method.Case DescriptionHerein, we report a rare case of hilar bile duct IMT and review the related literature. Our patient was a 54-year-old woman presenting with a 1-day history of upper abdominal pain as the main clinical symptom. She was misdiagnosed as having cholangiocarcinoma before the surgery. She underwent surgery and was ultimately diagnosed with IMT based on histopathology and immunohistochemistry findings. On 1-year follow-up, no tumor recurrence or related complications were noted.ConclusionsWe hope this case report helps clinicians gain a deeper understanding of biliary IMT of the hilum.
A Descriptive Comparison of Mass Testing During the COVID-19 Pandemic in Montreal, Paris, Bamako, and Recife
Authors: Savard Lamothe Ashley , Gabet Morgane , Richard Zoé , Oliveira Sydia Rosana de Araujo , Coulibaly Abdouramane , Cazarin Gisèle , Zacarias Amanda , Gautier Lara , Ridde Valéry , Zinszer Kate 
Published: September 2022

Objective: The aim of this descriptive article was to compare mass testing for SARS-CoV-2 during the first wave of the COVID-19 pandemic in Montreal, Canada; Bamako, Mali; Paris, France; and Recife, Brazil.Methods: Data was collected through interviews with key informants involved in the testing response and a review of the grey literature. The TIDieR-PHP checklist was then used to provide the basis of the intervention descriptions and to compare the data between cities.Results: Descriptive comparisons revealed that the type of test, the testing process, and materials used were similar between the cities during the first wave of the pandemic. In addition, all cities experienced similar material and personnel resource shortages, directly affecting testing accessibility and capacity. The main differences were related to testing capacity and implementation timelines, which were dependent on the state of the health care systems, governance, and access to resources.Conclusion: Results of this study highlight the similarities and differences in testing between the cities and demonstrate the importance of comprehensive intervention descriptions to highlight lessons learned, increase knowledge sharing, and inform policy decisions.