bluuebunny/crossref_metadata_2025 huggingface dataset:
Eat4Genes: a bioinformatic rational gene targeting app and prototype model for improving human health
Authors: Ford Morgan L. , Cooley Jessica M. , Sripada Veda , Xu Zhengwen , Erickson John S. , Bennett Kristin P. , Crawford Dana R.
Published: May 2023

Introduction and aims

Dietary Rational Gene Targeting (DRGT) is a therapeutic dietary strategy that uses healthy dietary agents to modulate the expression of disease-causing genes back toward the normal. Here we use the DRGT approach to (1) identify human studies assessing gene expression after ingestion of healthy dietary agents with an emphasis on whole foods, and (2) use this data to construct an online dietary guide app prototype toward eventually aiding patients, healthcare providers, community and researchers in treating and preventing numerous health conditions.

Methods

We used the keywords “human”, “gene expression” and separately, 51 different dietary agents with reported health benefits to search GEO, PubMed, Google Scholar, Clinical trials, Cochrane library, and EMBL-EBI databases for related studies. Studies meeting qualifying criteria were assessed for gene modulations. The R-Shiny platform was utilized to construct an interactive app called “Eat4Genes”.

Results

Fifty-one human ingestion studies (37 whole food related) and 96 key risk genes were identified. Human gene expression studies were found for 18 of 41 searched whole foods or extracts. App construction included the option to select either specific conditions/diseases or genes followed by food guide suggestions, key target genes, data sources and links, dietary suggestion rankings, bar chart or bubble chart visualization, optional full report, and nutrient categories. We also present user scenarios from physician and researcher perspectives.

Conclusion

In conclusion, an interactive dietary guide app prototype has been constructed as a first step towards eventually translating our DRGT strategy into an innovative, low-cost, healthy, and readily translatable public resource to improve health.
How is healthy eating index-2015 related to risk factors for cardiovascular disease in patients with type 2 diabetes
Authors: Zeinalabedini Mobina , Nasli-Esfahani Ensieh , Esmaillzadeh Ahmad , Azadbakht Leila
Published: May 2023

Background

Cardiovascular disease (CVD) is the primary cause of mortality and disability among diabetes. The aim of this study is to evaluate how healthy eating index-2015 related to risk factors for cardiovascular disease in patients with type 2 diabetes.

Methods

This cross-sectional study was conducted on 490 patients with type 2 diabetes in Tehran, Iran. The healthy eating index-2015 (HEI-2015) used as a diet quality indicator. Dietary intake was assessed by a valid and reliable semi-quantitative food frequency questionnaire (FFQ). Four indicators of CVD risk factor [Castelli risk index-1 and 2 (CRI-II), atherogenic index of plasma (AIP), cholesterol index (CI), and lipid accumulation of plasma (LAP)] were calculated. The anthropometric indices [a body shape index (ABSI), abdominal volume index (AVI), and body roundness index (BRI)] were computed.

Results

After adjusting for potential confounders, it is evident that participants in the highest tertile of HEI had a lower odds ratio of BRI (OR: 0.52; 95% CI: 0.29–0.95; p-trend = 0.03) and AIP (OR:0.56; 95% CI: 0.34–0.94; p-trend = 0.02). Also, HEI and CRI had a marginally significant negative relation (OR: 0.61; 95% CI: 0.38–1; p-trend = 0.05) in crude model, after adjusting the signification disappeared.

Conclusion

In conclusion, our finding shows that more adherence to HEI reduces about 50% of the odds of AIP, BRI among diabetic patients. Further, large-scale cohort studies in Iran need to confirm these findings, including diabetic patients of various racial, ethnic backgrounds, body composition and different components of HEI.
Quality-of-life impact of interstitial cystitis and other pelvic pain syndromes
Authors: Cunningham Andrew R. , Gu Lin , Dubinskaya Alexandra , De Hoedt Amanda M. , Barbour Kamil E. , Kim Jayoung , Freedland Stephen J. , Anger Jennifer T.
Published: May 2023

Objective

To compare health-related quality of life (HRQOL) and pelvic pain levels over time in patients with interstitial cystitis/bladder pain syndrome (IC/BPS) and those with other pelvic pain conditions (OPPC) including chronic prostatitis, dyspareunia, vaginismus, vulvodynia, and vulvar vestibulitis.

Methods

We prospectively enrolled male and female patients from any Veterans Health Administration (VHA) center in the US. They completed the Genitourinary Pain Index (GUPI) quantifying urologic HRQOL and the 12-Item Short Form Survey version 2 (SF-12) quantifying general HRQOL at enrollment and 1 year later. Participants were classified by ICD diagnosis codes and confirmed by chart review to be IC/BPS or OPPC (308 and 85 patients respectively).

Results

At baseline and follow-up, IC/BPS patients, on average, had worse urologic and general HRQOL than OPPC patients. IC/BPS patients demonstrated improvement in urologic HRQOL measures over the study but demonstrated no significant change in any general HRQOL measure suggesting a condition-specific impact. Patients with OPPC demonstrated similar improvements in urologic HRQOL but had deteriorating mental health and general HRQOL at follow-up suggesting a wider general HRQOL impact for these diseases.

Conclusions

We found that patients with IC/BPS had worse urologic HRQOL compared to other pelvic conditions. Despite this, IC/BPS showed stable general HRQOL over time, suggesting a more condition-specific impact on HRQOL. OPPC patients showed deteriorating general HRQOL, suggesting more widespread pain symptoms in these conditions.
Effectiveness of tumor necrosis factor inhibitors in children with enthesitis-related arthritis: a single-center retrospective analysis
Authors: Zhang Tonghao , Huang Shuoyin , Guo Yanli , Jin Jing , Yan Wu , Wang Panpan , Fang Yuying , Liu Yingying , Pan Yuting , Fan Zhidan , Yu Haiguo
Published: May 2023

Objective

In children with enthesitis-related arthritis (ERA), the hip and sacroiliac joint function might be impaired if not properly treated. We sought to evaluate the effectiveness of anti-tumor necrosis factor-α (TNF-α) therapy using the inflammatory indicators, Juvenile Arthritis Disease Activity Score 27 (JADAS27) and magnetic resonance imaging (MRI).

Methods

We conducted a single-center retrospective study of 134 patients with ERA. We evaluated the effect of anti-TNF therapy on the inflammatory indicators, active joint count, MRI quantitative score, and JADAS27 over 18 months. We used the Spondyloarthritis Research Consortium of Canada (SPARCC) and the Hip Inflammation MRI Scoring System (HIMRISS) scoring systems for hip and sacroiliac joints scoring.

Results

The average age of onset of children with ERA was 11.62 ± 1.95 years, and they were treated with disease-modifying antirheumatic drugs (DMARDs) combined with biologics (n = 87, 64.93%). There were no differences in HLA-B27 positivity between the biologics and non-biologics treatment groups [66 (49.25%) vs. 68 (50.75%), P > 0.05]. Children who received anti-TNF (71 received etanercept, 13 adalimumab, 2 golimumab, and 1 infliximab) therapy improved significantly. Children with ERA used DMARDs and biologics at baseline (Group A) were followed up to 18 months, and their active joint count (4.29 ± 1.99 vs. 0.76 ± 1.33, P = 0.000), JADAS27 (13.70 ± 4.80 vs. 4.53 ± 4.52, P = 0.000) and MRI quantitative scores (P = 0.001) were significantly lower than those at baseline. Some of the patients (n = 13, 9.70%) were treated with DMARDs at the onset of the disease, but did not show significant improvement (Group B). After 6−18 months of switching to anti-TNF therapy, related indicators of the children were significantly lower than at baseline and 1 month (P < 0.013). At 18 months, a total of 33 patients (n = 74, 44.59%) in Group A and 7 (n = 13, 53.85%) in Group B reached inactive state.

Conclusion

Eighteen months after diagnosis, anti-TNF therapy was found to be effective in children diagnosed with ERA. MRI is important for the early diagnosis of juvenile idiopathic arthritis. TNF-α inhibitors can significantly improve the clinical manifestations of sacroiliac joint and hip involvement in patients with ERA. Overall, the real-world study provides more evidence for precision diagnosis and treatment for other hospitals, families and patients.
Application of epicutaneo-cava catheters with 24G indwelling needles in very low birth weight infants: a safe and simple innovative technique
Authors: Wang Qin , Luo Feixiang , Fan Xiaoyan , Cheng Xiaoying , Ma Xiaolu , Shi Liping , Zhang Pei
Published: May 2023

Background

Epicutaneo-cava catheter (ECC) is an ideal venous access for very low birth weight (VLBW) infants. However, because veins of VLBW infants are thin, ECC catheter is difficult to insert, and the success rate of puncture is low. This study aimed to use ECC with 24G indwelling needles to improve the outcomes of VLBW infants.

Methods

This retrospective study enrolled 121 VLBW infants (birthweight <1,500 g) who required ECC catheterization and were admitted to the Neonatal Intensive Care Unit of the Children's Hospital of Zhejiang University School of Medicine between January 2021 and December 2021. The patients were divided into the indwelling needle group and the conventional technique group according to the technique of ECC. The demographic and treatment data of the two groups were collected, and the success rate of first attempt cannulation of ECC and catheter-related complications of the two groups were analyzed and compared.

Results

There were no significant differences in gender, age, and body weight between the two groups on the day of ECC insertion and venipuncture site. It can be seen through model analysis that the success rate of first-attempt cannulation of ECC in the indwelling needle group was significantly higher than in the conventional technique group. In contrast, average catheterization time and catheterization-related bleeding risk in the indwelling needle group were significantly lower than in the conventional technique group (p = 0.00,and 0.00, respectively). Infection during catheter placement, indwelling catheter duration and catheter-related infection between the two groups (p > 0.05).

Conclusion

Application of ECC with 24G indwelling needles in VLBW infants can improve the success rate of first attempt cannulation of ECC, reduce the time of catheterization and the risk of bleeding, which may be popularized for widespread application.
Opioid use in the era of COVID-19: a multifaceted study of the opioid epidemic in Canada
Authors: Hutchinson Molly , Lavigne Éric , Patterson Zachary
Published: May 2023

Introduction: The COVID-19 pandemic has had wide economic, social, and health impacts, and has disproportionately affected individuals who were already vulnerable. Individuals who use opioids have dealt with evolving public health measures and disruptions while also dealing with the ongoing opioid epidemic. Opioid-related mortalities in Canada increased throughout the COVID-19 pandemic, but it is unclear to what extent public health measures and the progression of the pandemic contributed to opioid-related harms.

Methods: To address this gap, we used emergency room (ER) visits recorded in the National Ambulatory Care Reporting System (NACRS) between 1 April 2017, and 31 December 2021, to investigate trends of opioid-related harms throughout the pandemic. This study also included semi-structured interviews with service providers in the field of opioid use treatment, to help contextualize the trends seen in ER visits and offer perspectives on how opioid use and services have changed throughout the COVID-19 pandemic.

Results: Overall, the number of hospitalizations related to an opioid use disorder (OUD) decreased with progressing waves of the pandemic and with increasing severity of public health measures in Ontario. The rate of hospitalizations related to opioid poisonings (e.g., central nervous system and respiratory system depression caused by opioids) significantly increased with the progressing waves of the pandemic, as well as with increasing severity of public health measures in Ontario.

Discussion: The increase in opioid-related poisonings is reflected in the existing literature whereas the decrease in OUDs is not. Moreover, the increase in opioid-related poisonings aligns with the observations of service providers, whereas the decrease in OUD contradicts the trends that service providers described. This discrepancy could be explained by factors identified by service providers, including the pressures on ERs during the pandemic, hesitancy to seek treatment, and drug toxicity.
Status and future of the soft X-ray free-electron laser beamline at the SHINE
Authors: Liu Tao , Huang Nanshun , Yang Hanxiang , Qi Zheng , Zhang Kaiqing , Gao Zhangfeng , Chen Si , Feng Chao , Zhang Wei , Luo Hang , Fu Xiaoxi , Liu He , Faatz Bart , Deng Haixiao , Liu Bo , Wang Dong , Zhao Zhentang
Published: May 2023

The Shanghai High repetition rate XFEL and Extreme light facility (SHINE) is under construction and aims at generating X-rays between 0.4 and 25 keV with three FEL beamlines at repetition rates of up to 1 MHz. The soft X-ray FEL beamline, FEL-II, will be ready for commissioning in 2025. It is designed to cover the photon energy from 0.4 to 3 keV, in which the baselines of the FEL operation modes are self-amplified spontaneous emission (SASE), self-seeding, echo-enabled harmonic generation (EEHG), and polarization control. Therefore, a high repetition-rate external seed laser, large period length modulator, soft X-ray monochromator, planar undulator, and elliptically polarized undulator have been adopted in the FEL-II beamline. Several potentials such as an ultra-short pulse mode and a multi-color mode are also foreseeable without significant equipment changes in the follow-up operation. A dual-period undulator design is suggested for the echo-enabled harmonic generation (EEHG) commissioning, and it has great potential to break through the unreachable energy of the fully coherent X-ray in the future. The FEL-II beamline will deliver SASE radiation and fully coherent radiation in all the wavelengths of interest.
Full-scale numerical simulation of hemodynamics based on left ventricular assist device
Authors: Gao Xinyi , Xu Zhike , Chen Chenghan , Hao Pengfei , He Feng , Zhang Xiwen
Published: May 2023

Ventricular assist devices have been widely used and accepted to treat patients with end-stage heart failure. The role of VAD is to improve circulatory dysfunction or temporarily maintain the circulatory status of patients. In order to be closer to the medical practice, a multi-Domain model of the left ventricular coupled axial flow artificial heart was considered to study the effect of its hemodynamics on the aorta. Because whether LVAD itself was connected between the left ventricular apex and the ascending aorta by catheter in the loop was not very important for the analysis of simulation results, on the premise of ensuring the multi-Domain simulation, the simulation data of the import and export ends of LVAD were imported to simplify the model. In this paper, the hemodynamic parameters in the ascending aorta, such as blood flow velocity vector, wall shear stress distribution, vorticity current intensity, vorticity flow generation, etc., have been calculated. The numerical conclusion of this study showed the vorticity intensity under LVAD was significantly higher than that under patients’ conditions and the overall condition is similar to that of a healthy ventricular spin, which can improve heart failure patients’ condition while minimizing other pitfalls. In addition, high velocity blood flow during left ventricular assist surgery is mainly concentrated near the lining of the ascending aorta lumen. What’s more, the paper proposes to use Q criterion to determine the generation of vorticity flow. The Q criterion of LVAD is much higher than that of patients with heart failure, and the closer the LVAD is to the wall of the ascending aorta, the greater the Q criterion is. All these are beneficial to the effectiveness of LVAD in the treatment of heart failure patients and provide clinical suggestions for the LVAD implantation in clinical practice.
Analyses of the Dmrt family in a decapod crab, Eriocheir sinensis uncover new facets on the evolution of DM domain genes
Authors: Zhang Peng , Yang Yanan , Xu Yuanfeng , Cui Zhaoxia
Published: May 2023

DM domain genes are a group of transcription factors that are integral to sexual development and its evolution in metazoans. Their functions and regulatory mechanisms are not well understood in Malacostraca (crabs and crayfish) while these sex regulators have been widely identified in the past decade. In this study, the Dmrt family was investigated in the decapod crab, Eriocheir sinensis. We find that most members of the EsDmrt family begin to enrich around the juvenile 1 stage. In reproductive organs, EsDsx1, EsDsx2, EsiDMY and EsiDmrt1a highly express in the male-specific androgenic gland (AG), while EsDmrt-like, EsDsx-like, EsDmrt11E, and EsiDmrt1b show relatively high expression in testis. Also, we find the highly aberrant expression of EsiDMY and EsiDmrt1a in the chimeric AG, strongly indicating their function in AG development. Moreover, RNA interference of EsDsx1, EsiDMY, and EsiDmrt1a results in a significant decrease in transcription of the Insulin-like androgenic hormone (IAG), respectively. Our findings suggest that Dmrt genes in E. sinensis primarily function in male sexual differentiation, especially in AG development. Besides, this study identifies two unique groups of Dmrt genes in Malacostraca: Dsx and iDmrt1. In Malacostraca Dsx, we uncover a cryptic mutation in the eight zinc motif-specific residues, which were firmly believed to be invariant across the Dmrt family. This mutation sets the Malacostraca Dsx apart from all the other Dmrt genes and implies a different way of transcriptional regulation. Genes from the iDmrt1 group show phylogenetical limitation to the malacostracan species and underwent positive selection, suggesting their highly specialized gene function to this class. Based on these findings, we propose that Dsx and iDmrt1 in Malacostraca have developed unique transcriptional regulation mechanisms to facilitate AG development. We hope that this study would contribute to our understandings of sexual development in Malacostraca and provide new insights into the evolutionary history of the Dmrt family.
Prospective associations between child screen time and parenting stress and later inattention symptoms in preschoolers during the COVID-19 pandemic
Authors: Almeida Maíra Lopes , Garon-Carrier Gabrielle , Cinar Eda , Frizzo Giana Bitencourt , Fitzpatrick Caroline
Published: May 2023

Introduction

Child attention skills are critical for supporting self-regulation abilities, especially during the first years of life. On the other hand, inattention symptoms in preschoolers have been associated with poor school readiness, literacy skills and academic achievement. Previous research has linked excessive screen time with increased inattention symptoms in early childhood. However, most research has only focused on TV exposure and did not investigate this association during the COVID-19 pandemic. This atypical context has increased screen time in children worldwide, including preschoolers. We hypothesize that higher levels of child screen media and parenting stress at age 3.5 will be associated with higher child inattention symptoms at age 4.5.

Method

This study draws on participants followed longitudinally over the span of 2-years for an investigation of Canadian preschoolers’ screen media use during the pandemic (N = 315, 2020). A follow-up with this sample was completed in 2021 (N = 264).

Results

Analyses using multiple linear regression, revealed a positive association between child screen time at age 3.5 and inattention symptoms at 4.5 years. Parental stress was also positively associated with child inattention symptoms. Associations were observed above individual (child age, inhibitory control, and sex) and family (parent education and family income) characteristics.

Discussion

These results confirmed our hypothesis and highlight that preschooler screen use and parenting stress may undermine attentional skills. Since attention is a crucial component for children development, behavior and academic outcomes, our study reinforces the importance for parents of adopting healthy media habits.
Machine learning techniques for identifying mental health risk factor associated with schoolchildren cognitive ability living in politically violent environments
Authors: Qasrawi Radwan , Vicuna Polo Stephanny , Abu Khader Rami , Abu Al-Halawa Diala , Hallaq Sameh , Abu Halaweh Nael , Abdeen Ziad
Published: May 2023

Introduction

Mental health and cognitive development are critical aspects of a child’s overall well-being; they can be particularly challenging for children living in politically violent environments. Children in conflict areas face a range of stressors, including exposure to violence, insecurity, and displacement, which can have a profound impact on their mental health and cognitive development.

Methods

This study examines the impact of living in politically violent environments on the mental health and cognitive development of children. The analysis was conducted using machine learning techniques on the 2014 health behavior school children dataset, consisting of 6373 schoolchildren aged 10–15 from public and United Nations Relief and Works Agency schools in Palestine. The dataset included 31 features related to socioeconomic characteristics, lifestyle, mental health, exposure to political violence, social support, and cognitive ability. The data was balanced and weighted by gender and age.

Results

This study examines the impact of living in politically violent environments on the mental health and cognitive development of children. The analysis was conducted using machine learning techniques on the 2014 health behavior school children dataset, consisting of 6373 schoolchildren aged 10-15 from public and United Nations Relief and Works Agency schools in Palestine. The dataset included 31 features related to socioeconomic characteristics, lifestyle, mental health, exposure to political violence, social support, and cognitive ability. The data was balanced and weighted by gender and age.

Discussion

The findings can inform evidence-based strategies for preventing and mitigating the detrimental effects of political violence on individuals and communities, highlighting the importance of addressing the needs of children in conflict-affected areas and the potential of using technology to improve their well-being.
Mental health adverse events with cannabis use diagnosed in the Emergency Department: what are we finding now and are our findings accurate?
Authors: Crocker Candice E. , Emsley Jason , Tibbo Philip G.
Published: May 2023

We have previously reviewed the types and numbers of cannabis-associated adverse events that have mental health presentations that are encountered in the Emergency Department. A particular challenge in examining these events is disentangling cannabis use adverse events from adverse events associated with use of multiple recreational substances. Since that review was published, cannabis legalization for recreational use has greatly expanded world-wide and with these changes in the legal climate has come clearer information around the frequency of adverse events seen in the Emergency Department. However, as we examined the current state of the literature, we also examined some of research designs and the biases that may be impacting the validity of the data in this field. The biases both of clinicians and researchers as well as research approaches to studying these events may be impacting our ability to assess the interaction between cannabis and mental health. For example, many of the studies performed examining cannabis-related admissions to the Emergency Department were administrative studies that relied on front line clinicians to identify and attribute that cannabis use was associated with any particular admission. This narrative review provides an overview on what we currently know about mental health adverse events in the Emergency Department with a focus on the mental health impacts both for those with and without a history of mental illness. The evidence that cannabis use can adversely impact genders and sexes differently is also discussed. This review outlines what the most common adverse events related to mental health with cannabis use are; as well as noting the most concerning but much rarer events that have been reported. Additionally, this review suggests a framework for critical evaluation of this field of study going forward.
Eating disorder symptoms among children and adolescents in Germany before and after the onset of the COVID-19 pandemic
Authors: Napp Ann-Kathrin , Kaman Anne , Erhart Michael , Westenhöfer Joachim , Ravens-Sieberer Ulrike
Published: May 2023

Background

Disordered eating is highly prevalent among children and adolescents. Since the outbreak of the COVID-19 pandemic, hospitalizations due to eating disorders have peaked and overweight has risen. The aim of this study was to determine differences in the prevalence of eating disorder symptoms among children and adolescents in Germany before and after the onset of the COVID-19 pandemic and to identify associated factors.

Materials and methods

Eating disorder symptoms and associated factors were examined in a sample of n = 1,001 participants of the nationwide population-based COPSY study in autumn 2021. Standardized and validated instruments were used to survey 11–17-year-olds along with a respective parent. To identify differences in prevalence rates, logistic regression was used to compare results with data from n = 997 participants of the prepandemic BELLA study. Multiple logistic regression analyses were performed to examine associations with relevant factors in the pandemic COPSY sample.

Results

Eating disorder symptoms were reported by 17.18% of females and 15.08% of males in the COPSY study. Prevalence rates were lower overall in the COPSY sample compared to before the pandemic. Male gender, anxiety, and depressive symptoms were associated with increased odds for eating disorder symptoms in the pandemic.

Conclusion

The pandemic underscores the importance of further research, but also prevention and intervention programs that address disordered eating in children and adolescents, with a focus on age - and gender-specific differences and developments. In addition, screening instruments for eating disorder symptoms in youths need to be adapted and validated.
Analysis of CEPH-accredited online public health doctoral programs and MPH degree holder demand
Authors: Lewis Barbara , Sy Francisco
Published: May 2023

Introduction

The number of doctoral programs to train future public health leaders is critical in meeting the demand of global health challenges in the 21st century. Ten United States online public health doctoral programs accept only a fraction of interested learners.

Methods

This research examines the launch of the first online public health doctoral program, accredited by the Council on Education for Public Health, and compares nine similar programs that have followed in the ensuing 12 years.

Results

Survey results highlight the demand by Master of Public Health degree holders for online public health doctoral programs; 84.11% of survey respondents indicated an interest in obtaining a doctoral degree.

Discussion

If we strive to answer the question posed by the Institute of Medicine in 2003, “Who will keep the public healthy?” then we need to provide education that is accessible, efficient and equitable for interested learners, most of whom are turned down by online public health doctoral programs that have limited capacity.
Evaluation of the public health empowerment program in the Eastern Mediterranean region
Authors: Alsoukhni Majd A. , Al Nsour Mohannad , Alsouri Ruba Kamal , Al Serouri Abdulwahed , Hussain Zakir , Annam Labiba Saeed , Al Kohlani Abdulhakeem , Khan Mumtaz Ali , Samy Sahar Mahmoud , ép Ben Alaya Nissaf Bouafif , Abu-Khader Ilham B. , Abbas Haitham Bashier , Khader Yousef
Published: May 2023

Background:

The Public Health Empowerment Program (PHEP) is a 3-month training program for frontline public health staff to improve surveillance quality and strengthen the early warning system capacities. Studies evaluating the program and its impact on the health systems in the Eastern Mediterranean Region (EMR) are lacking. Therefore, this study aimed to assess the level of PHEP graduates’ engagement in field epidemiology activities, assess their perceived skills and capacity to perform these activities and assess the extent to which PHEP helped the graduates to perform field epidemiology activities.

Methods:

A descriptive evaluation study was conducted based on levels 3 and 4 of Kirkpatrick’s model for evaluating training programs to assess the change in graduates’ behavior and the direct results of the program. Data were collected using two online surveys targeting PHEP graduates and programs’ directors/ technical advisers.

Results:

A total of 162 PHEP graduates and 8 directors/ technical advisers participated in the study. The majority of PHEP graduates reported that they are often involved in activities such as responding to disease outbreaks effectively (87.7%) and monitoring surveillance data collection (75.3%). High proportions of PHEP graduates rated their skills as good in performing most of field epidemiology activities. The majority of graduates reported that the PHEP helped them much in conducting, reviewing, and monitoring surveillance data collection (92%), responding effectively to public health events and disease outbreaks (91.4%), and communicating information effectively with agency staff and with the local community (85.2%).

Conclusion:

PHEP appears to be an effective program for improving the public health workforce’s skills and practices in epidemiological competencies in the EMR. PHEP strengthened the engagement of the graduates in most field epidemiology activities, especially during COVID-19.
Stigma and health inequality experienced by ethnic minorities during the COVID-19 pandemic in a Chinese community: an implication to health policymakers
Authors: Siu Judy Yuen-Man , Cao Yuan , Shum David H. K.
Published: May 2023

Introduction

Ethnic minorities are considered one of the most vulnerable groups during the COVID-19 pandemic. However, the explanatory pathway of how their disadvantaged experiences during epidemics are related to the embedded and longstanding stigmas against them and how these embedded stigmas can affect their resilience in disease outbreaks are not well understood. This study investigated the experiences of ethnic minorities in the COVID-19 pandemic, and how their experiences were related to the embedded stigma toward them.

Methods

This study adopted a qualitative approach, interviewed 25 individuals (13 women and 12 men) from ethnic minority groups residing in Hong Kong from August 2021 to February 2022 in a semi-structured format. Thematic analysis was conducted to analyze the data.

Results

The participants were isolated and stereotyped as infectious during the COVID-19 pandemic at community and institutional levels. Their experiences did not occur suddenly during the pandemic but were embedded in the longstanding segregation and negative stereotypes toward ethnic minorities in different aspects of life before the pandemic. These negative stereotypes affected their resilience in living and coping with the pandemic.

Conclusion

The participants’ experiences during the COVID-19 pandemic were mostly disadvantageous and predominantly initiated by the mainstream stigmatization toward them by the local Chinese residents and government. Their disadvantaged experiences in the pandemic should be traced to the embedded social systems, imposing structural disparities for ethnic minorities when accessing social and medical resources during a pandemic. Because of the preexisting stigmatization and social seclusion of ethnic minorities in Hong Kong, the participants experienced health inequality, which stemmed from social inequality and the power differential between them and the Chinese locals. The disadvantaged situation of the participants negatively affected their resilience to the pandemic. To enable ethnic minorities better cope with future epidemics, merely providing assistance to them during an epidemic is barely adequate, but a more supportive and inclusive social system should be established for them in the long run.
Evaluation of the prognostic value of the anatomical characteristics of the bony structures in the shoulder in bursal-sided partial-thickness rotator cuff tears
Authors: Liu Jun , Dai Simin , Deng Hui , Qiu Dewei , Liu Li , Li Mingzhang , Chen Zhijun , Kang Jiawei , Tao Jun
Published: May 2023

Background

In recent studies, individual scapular anatomy has been found to be related to degenerative full-thickness rotator cuff tears. However, research on the relationship between the anatomical characteristics of shoulder radiographs and bursal-sided partial-thickness rotator cuff tears (PTRCTs) is limited, and the risk factors for this pathology still need to be determined.

Methods

The bursal-sided PTRCTs group included 102 patients without a history of shoulder trauma who underwent arthroscopy between January 2021 and October 2022. A total of 102 demographically matched outpatients with intact rotator cuffs were selected as the control group. Radiographs were used to measure the lateral acromial angle (LAA), critical shoulder angle (CSA), greater tuberosity angle (GTA), β-angle, acromion index (AI), acromiohumeral distance (AHD), acromial tilt (AT), acromial slope (AS), acromial type, and acromial spur by two independent observers. Multivariate analyses of these data were used to identify potential risk factors for bursal-sided PTRCTs. Receiver operating characteristic (ROC) analysis was performed to assess the sensitivity and specificity of CSA, GTA, and AI for this type of pathology.

Result

The β-angle, AHD, AS and acromion type showed no difference between bursal-sided PTRCTs and controls (p = 0.009, 0.200, 0.747 and 0.078, respectively). CSA, GTA and AI were significantly higher in bursal-sided PTRCTs (p < 0.001). LAA, β-angle and AT were significantly lower in bursal-sided PTRCTs. Multivariate logistic regression analysis demonstrated significant correlations between the acromial spur (p = 0.024), GTA (p = 0.004), CSA (p = 0.003) and AI (p = 0.048) and bursal-sided PTRCTs. The areas under the ROC curves for AI, CSA, and GTA were 0.655 (95% CI 0.580–0.729), 0.714 (95% CI 0.644–0.784), and 0.695 (95% CI 0.622–0.767), respectively.

Conclusion

Acromial spur, GTA, CSA, and AI were independent risk factors for bursal-sided PTRCTs. Furthermore, CSA was the most powerful predictor of bursal-sided PTRCTs compared to GTA and AI.
An observational study of individual child journeys through autism diagnostic pathways, and associated costs, in the UK National Health Service
Authors: Male Ian , Farr William , Bremner Stephen , Gage Heather , Williams Peter , Gowling Emma , Honey Emma , Gain Aaron , Parr Jeremy
Published: May 2023

Background

Demand for diagnostic assessment in children with possible autism has recently increased significantly. Services are under pressure to deliver timely and high-quality diagnosis, following National Institute and Care Excellence multidisciplinary assessment guidelines. This UK National Health Service study aimed to answer: how many hours of health professional time are required to deliver autism diagnostic assessment, and how much does this cost?.

Method

Case notes of 20 children (1–16 yrs.) from 27 NHS trusts, assessed through an autism diagnostic pathway in the previous year, were examined retrospectively. Data included: hours of professional time, diagnostic outcome. Assessment costs calculated using standardised NHS tariffs.

Results

488 children (aged 21–195 months, mean 82.9 months, SD 39.36) from 22 Child Development Services (CDS), four Child and Adolescent Mental Health Services (CAMHS) and one tertiary centre; 87% were either under 5 (36%) or 5 to 11 years (51%). Children seen by CDS were younger than CAMHS (mean (SD) 6.10 (2.72) vs. 10.39 (2.97) years, p < 0.001). Mean days to diagnosis were 375 (SD 235), with large variation (range 41–1553 days). Mean hours of professional time per child was 11.50 (SD 7.03) and varied substantially between services and individuals. Mean cost of assessment was £846.00 (SD 536.31). 339 (70.0%) children received autism diagnosis with or without comorbidity; 54 (11%) received no neurodevelopmental diagnosis; 91 (19%) received alternative neurodevelopmental diagnoses. Children with one or more coexisting conditions took longer to diagnose, and assessment was more costly, on average 117 days longer, costing £180 more than a child with no neurodevelopmental diagnosis. Age did not predict days to diagnosis or assessment costs.

Conclusion

Typical assessment took 11 h of professional time and over 12-months to complete, costing GB£850 per child. Variation between centres and children reflect differences in practice and complexity of diagnostic presentation. These results give information to those delivering/planning autism assessments using multi-disciplinary team approach, in publicly funded health systems. Planning of future diagnostic services needs to consider growing demand, the need for streamlining, enabling context appropriate services, and child/family complexity.
The association between gut microbiome and hypertension varies according to enterotypes: a Korean study
Authors: Song Ju Sun , Kim Joung Ouk Ryan , Yoon Sung Min , Kwon Min-Jung , Ki Chang-Seok
Published: May 2023

Introduction

Several animal and clinical studies have reported that the state of the human gut microbiome is associated with hypertension. In this study, we investigated the association between the gut microbiome and hypertension in a Korean population from an enterotypic perspective.

Methods

A total of 623 participants were enrolled from a healthcare center and classified into four enterotypes, Bacteroides1- (Bac1), Bacteroides2- (Bac2), Prevotella- (Pre), and Ruminococcus enterotype-like-composition (Rum).

Results

When comparing the four enterotypes, clinical characteristics related to obesity, metabolic syndrome, and blood pressure were significantly associated with th e enterotypes, showing unfavorable associations with the Bac2 group and the opposite for the Rum group. Similarly, the prevalence of hypertension was highest in the Bac2 group and lowest in the Rum group. When analyzing the association between gut microbiota and blood pressure for each enterotype, gut microbial features of lower diversity, depletion of important short chain fatty acid-producing taxa, such as Faecalibacterium, Blautia, Anaerostipes, and enrichment of lipopolysaccharide -producing taxa, such as Megamonas, were found only in the dysbiotic Bac2 group.

Discussion

From an enterotype perspective, this study on a large Korean cohort shows that low-diversity Bacteroides2-enterotype-like composition is associated with hypertension, while the reverse is true for high-diversity Ruminococcus-enterotype-like composition and, to a limited degree, Bacteroides1-enterotype-like composition. In addition, we suggest that the effect of gut microbiota-mediated risk of hypertension could be modulated by altering the gut microbiome via diet. Dietary intervention trials promoting a balanced Korean diet instead of a more Western alternative may provide more definitive evidence for the involvement and role of the gut microbiome in relation to blood pressure.
Toward a preliminary research agenda for the circular economy adoption in Africa
Authors: Nijman-Ross Elke , Umutesi Jessie Umuhire , Turay Joseph , Shamavu David , Atanga Winifred Awinpoya , Ross David Lang
Published: May 2023

Circular economy (CE) research plays an important role in accelerating the CE transition globally and is an essential tool to contribute to climate change adaptation. However, prior CE research is primarily focused on countries in the Global North, whereas CE research in the Global South has been largely unexplored, especially in African countries and contexts. Therefore, this study aims to develop a preliminary research agenda for CE development in African countries by identifying the current body of knowledge on CE, the existing CE research gaps and barriers to conducting CE research in African countries. This research applied a mixed method research design, whereby this study reviewed a total of 275 English and French articles from Google Scholar through a scoping literature review and carried out a quantitative and qualitative survey with 38 CE industry experts working on CE projects in African countries. The findings suggest that South Africa is the front-runner in CE research, with the most relevant publications and ongoing research projects conducted by CE experts. The dominant focus on CE research in South Africa is an urgent call for scholars to conduct country-specific research for additional African countries, especially since a significant number of publications do not distinguish between countries. Based on findings, this study concludes that the current body of CE knowledge is primarily focused on one aspect of CE, circulating materials and products (keep products and materials in use), while there is consensus from published journal papers that there are meaningful gaps in other CE principles such as designing out waste and pollution and regenerating natural systems. Therefore, this paper suggests a list of research topics that can be further investigated. To the authors' knowledge, this study is the first attempt to establish a preliminary research agenda for CE across African contexts and countries.
Sustainable farming genes: spatial distribution and influencing factors of Chinese Agricultural Heritage Sites (CAHSs)
Authors: Li Chang , Tong Tong , Huang Xiaohui
Published: May 2023

Agricultural heritage is a fundamental aspect of cultural heritage, as it is of significant cultural, economic, and biological value. The objective of this study is to reveal the spatial distribution and change of the Chinese Agricultural Heritage Site (CAHS) by means of spatial analysis. The results show that: (1) The distribution of 532 CAHSs (7 types) is patchy, and the horticulture system is gaining the quantitative advantage (55.26%), (2) The distribution of CAHSs shows the spatial aggregation of “dense in the east and sparse in the west.” The areas of Beijing, Shandong, Zhejiang, and their surroundings form the densest belt region of the heritages, and 44.17% of the CAHSs are distributed in this belt, (3) Single factor analysis shows that culture, population, soil, and elevation are the most critical driving forces that influence the distribution (all explanatory power > 0.20). Two factors interaction analysis confirms that the distribution is influenced by the enhancement of both natural and human factors. Of these, a high explanatory power (>0.70) is related to the matching between culture factors, population factors, and geographic factors (i.e., elevation, soil, and river). This study has the potential to provide scientific evidence for CAHS assessment, protection, and sustainable development.
Can contract farming improve farmers’ technical efficiency and income? Evidence from beef cattle farmers in China
Authors: Liang Yuan , Bi Wentai , Zhang Yuejie
Published: May 2023

Introduction

Contract farming is seen as a tool to create new market opportunities that can address market imperfections in many developing countries and thus increase smallholder income.

Methods

This study examines the impact of contract farming on farm household income using survey data from 610 rural households in China. The propensity score matching method addresses the sample selection bias of participation in contract farming.

Results

Contract farming can significantly increase farmers’ income, and both marketing contracts and production-management contracts can substantially increase farmers’ income levels, with production-management contracts having a greater degree of impact. Additional analysis reveals that breeding years, farm size, and training time can significantly affect how contract farming enhances farmers’ income. At the same time, contract farming can also considerably improve farmers’ technical efficiency in agricultural production. Participation in contract farming enhances the tendency to centralize the technical efficiency of agricultural production. Further analysis shows that the technical efficiency of agricultural production partially mediates the effects of contract farming on farm household income.

Discussion

Contract farming can be an effective institutional arrangement for improving the technical efficiency of farm household production and revenue. We also point out that farmers should strengthen their comprehensive ability levels and actively participate in training to acquire new knowledge and improve their cognitive ability. Simultaneously, according to the characteristics of farmers’ resource endowments, small farmers are encouraged to cooperate with companies in depth and develop contractual contracts in a targeted manner. Promote win-win cooperation and benefit-sharing among various business entities to promote the sustainable and high-quality development of China’s beef cattle industry.
A Conceptual Framework for Evaluating National Organ Donation and Transplantation Programs
Authors: Johnston-Webber Charlotte , Mah Jasmine , Streit Simon , Prionas Apostolos , Wharton George , Mossialos Elias , Papalois Vassilios
Published: May 2023

Conceptual frameworks are valuable resources that can be used to guide the planning, evaluation, and development of healthcare services. However, there are currently no comprehensive frameworks focused on organ donation and transplantation that identify the critical factors underlying a successful national program. To address this knowledge gap, we developed a conceptual framework that takes into account all major domains of influence, including political and societal aspects as well as clinical implementation. The framework was initially constructed based on a targeted review of the relevant medical literature. Feedback provided by a panel of international experts was incorporated into the framework via an iterative process. The final framework features 16 essential domains that are critical for initiating and maintaining a successful program and improving the health of patients with organ failure. Of particular note, these domains are subject to three overarching health system principles: responsiveness, efficiency, and equity. This framework represents a first attempt to develop a whole-system view of the various factors that contribute to the success of a national program. These findings provide a useful tool that can be adapted to any jurisdiction and used to plan, evaluate, and improve organ donation and transplantation programs.