bluuebunny/crossref_metadata_2025 huggingface dataset:
Case Report: Implementation of a Multi-Component Behavioral Health Integration Program in Obstetrics for Perinatal Behavioral Health
Authors: Flynn Heather , Deichen Hansen Megan , Shabaka-Haynes Amandla , Chapman Shay , Roussos Ross Kay
Published: November 2021

Despite growing research and policy attention, perinatal behavioral health conditions (i.e., mental health and substance use disorders) remain prevalent, burdensome for families, and largely untreated in the US. Researchers have documented an array of barriers to accurate detection, linkage with effective treatment, and improved outcomes for perinatal women with behavioral health disorders. It is clear that a multi-component approach that integrates evidence-based detection and management of perinatal behavioral health in the context of obstetrics care can be effective. This paper presents the initial development of a clinical quality improvement program that includes evidence-based components of behavioral health integration in obstetrics in the state of Florida in the US. The FL BH Impact (Improving Maternal and Pediatric Access, Care and Treatment for Behavioral Health) program, guided by the RE-AIM model for program implementation, has been developed over the past 2 years. Program components, initial implementation, and preliminary findings are presented. Following the implementation phase, the program has enrolled 12 obstetrics practices and 122 obstetrics providers in program engagement and training activities. The primary program component allows for obstetrics clinician telephone access to a statewide listing of behavioral health referral resources for patients and access to consultation with psychiatry. Since program implementation, the program has received a total of 122 calls to this line, with an expected increasing trajectory of calls over time. Results suggest this program is feasible to implement across a large geographic area. Challenges to implementation and future directions are discussed. These types of multi-component approaches to improved management and outcomes for perinatal behavioral health are promising and must be expanded and sustained in the US.
Volunteering via Smart-Phone for People With Psychosis—Protocol of a Feasibility Trial
Authors: Pinto da Costa Mariana , Phone Pal Advisory Groups
Published: December 2021

The literature suggests that volunteering can be used to address social isolation and support patients with psychosis in the community. However, many expect in person meetings, requiring a greater effort of availability and commitment. There is therefore a need for more flexible, easily accessible support. Volunteering via smart-phone could be a useful intervention for people with psychosis. One patient and one volunteer have been matched for a duration of 12 weeks, and participants have been encouraged to communicate through a variety of communication methods (audio calls, video calls, text messages, WhatsApp messages and e-mails). The Phone Pal study aimed to investigate the feasibility of recruitment, participant retention, data collection procedures, intervention usage of the methods of communication and changes in outcome data. At baseline and follow-up outcome measures collected from patients and volunteers included their quality of life, physical activity, self-esteem and social comparison. Additional outcomes assessed patients' attachment, social contacts and symptoms; for volunteers, their social distance was evaluated. At follow-up both patients and volunteers rank their perception of their relationship with each other. This mixed method feasibility study has been conducted in two phases, the first stage evaluating a smaller sample of patients and volunteers recruited in London, and then a second phase with a larger sample of volunteers recruited from across the United Kingdom.

Trial registration: ISRCTN17586238.
The More, the Merrier…? Antipsychotic Polypharmacy Treatment Strategies in Schizophrenia From a Pharmacology Perspective
Authors: Hjorth Stephan
Published: November 2021

Antipsychotic polypharmacy/drug combination treatment (APP) is a remarkably common practice in the schizophrenia context, given the lack of general support in treatment Guidelines. There is also a vast literature on APP outcomes, but a paucity of high-quality evidence-based data to guide and optimize adequate use of APP. This seems particularly true regarding many pharmacology-based considerations involved in APP treatment strategies. This paper first briefly summarizes clinical literature related to the use of APP. Against this backdrop, the pharmacological target profile features are then described of frequently used antipsychotic agents, in relation to estimated free plasma exposure levels at clinically efficacious dosing. APP strategies based on the properties of these drugs are then scrutinized and gauged within the background literature framework. The anticipated usefulness of APP from the pharmacological standpoint is detailed regarding efficacy, adverse effect (AE)/tolerability, and safety perspective, including why, when, and how it may be used to its advantage. For the purpose, a number of theoretically beneficial combinations as well as instances with suboptimal—and even futile—APP approaches are exemplified and discussed from the rational pharmacodynamic and pharmacokinetic pros and cons point-of-view. In this exposé, particular attention is paid to the utility and features of 3rd Generation Antipsychotic dopamine (DA) D2-D3 agonists within an APP setting.
Longitudinal Bidirectional Relationships Between Maternal Depressive/Anxious Symptoms and Children's Tic Frequency in Early Adolescence
Authors: Yagi Tomoko , Ando Shuntaro , Usami Satoshi , Yamasaki Syudo , Morita Masaya , Kiyono Tomoki , Hayashi Noriyuki , Endo Kaori , Iijima Yudai , Morimoto Yuko , Kanata Sho , Fujikawa Shinya , Koike Shinsuke , Kano Yukiko , Hiraiwa-Hasegawa Mariko , Nishida Atsushi , Kasai Kiyoto
Published: November 2021

Background: Previous studies have revealed an association between maternal depressive/anxious symptoms and children's tics. However, the longitudinal relationships between these symptoms remain unclear. We examined the longitudinal relationships between maternal depressive/anxious symptoms and children's tic frequency in early adolescence with a population-based sample.

Methods: The participants consisted of 3,171 children and their mothers from the Tokyo Teen Cohort (TTC) study, a population-representative longitudinal study that was launched in Tokyo in 2012. Maternal depressive/anxious symptoms and children's tics were examined using self-report questionnaires at the ages of 10 (time 1, T1) and 12 (time 2, T2). A cross-lagged model was used to explore the relationships between maternal depressive/anxious symptoms and children's tic frequency.

Results: Higher levels of maternal depressive/anxious symptoms at T1 were related to an increased children's tic frequency at T2 (β = 0.06, p < 0.001). Furthermore, more frequent children's tics at T1 were positively related to maternal depressive/anxious symptoms at T2 (β = 0.06, p < 0.001).

Conclusions: These findings suggest a longitudinal bidirectional relationship between maternal depressive/anxious symptoms and children's tic frequency in early adolescence that may exacerbate each other over time and possibly create a vicious cycle. When an early adolescent has tics, it might be important to identify and treat related maternal depressive/anxious symptoms.
Depressive and Anxiety Symptoms Are Predictors of Seizure Recurrence in Adults With Newly Diagnosed Epilepsy
Authors: Zhong Rui , Chen Qingling , Zhang Xinyue , Li Nan , Lin Weihong
Published: November 2021

Objective: To investigate whether emerging depressive and anxiety symptoms are predictors of seizure recurrence in a cohort of patients with newly diagnosed epilepsy (PWNDE) who did not have a history of psychiatric diagnosis.

Methods: A cohort of 283 PWNDE were psychiatrically assessed before antiseizure medication (ASM) therapy and were followed for 12 months to assess seizure recurrence. The influence of depressive and anxiety symptoms score on seizure recurrence was assessed using univariate and multivariate binary logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was utilized.

Results: A total of 283 individuals were included in final analysis, and 115 patients (40.6%) experienced seizure recurrence during follow-up. In multivariate logistic regression analysis, NDDI-E and GAD-7 score were associated with an increased risk of seizure recurrence with an adjusted OR of 1.360 (CI: 1.176–1.572; P < 0.001) and 1.101 (CI: 1.004–1.209; P = 0.041), respectively. Additionally, the adjusted OR and 95% CI of seizure recurrence for the “high NDDI-E score and high GAD-7 score” vs. “not high NDDI-E score and not high GAD-7 score” was 7.059 (3.521–14.149) (P for trend < 0.001).

Conclusion: We found that an emergence of new psychiatric symptoms including depressive and anxiety symptoms were predictors of seizure recurrence in adults with newly diagnosed epilepsy who did not have psychiatric history.
Relationship Between Childhood Left-Behind Experience and Quality of Life Among Chinese University Freshmen: Place of Origin Matters
Authors: Li Hai-Mei , Xu Yan-Min , Zhong Bao-Liang
Published: November 2021

Background: Childhood left-behind experience (LBE) has a long-term detrimental effect on the mental health of Chinese University students, but it remains unclear whether childhood LBE negatively impacts the quality of life (QOL) of University students and whether the LBE–QOL association differs between students of rural origin and students of urban origin. This study examined the LBE–QOL relationship and the interactive effect between LBE and place of origin on QOL among Chinese University freshmen.

Methods: By using a two-stage random cluster sampling approach, a total of 5,033 freshmen were recruited from two comprehensive universities. The students completed an online, self-administered questionnaire that included sociodemographic variables, a 2-week physical morbidity assessment, and assessments of depressive symptoms, academic stress, and QOL. The Chinese six-item QOL scale was used to assess QOL. Multiple linear regression was used to test the independent LBE–QOL association and the interaction between LBE and place of origin.

Results: Students with childhood LBE had significantly lower QOL scores than those without LBE (60.1 ± 13.1 vs. 64.3 ± 11.7, p < 0.001). After adjusting for the potential confounding effects of other sociodemographic variables, 2-week physical morbidity, depressive symptoms, and academic stress, childhood LBE was significantly associated with a lower QOL score (β: −3.022, p < 0.001) and the LBE–place of origin interaction was still significantly associated with the QOL score (β: −2.413, p < 0.001). Overall, compared to non-LBE, LBE was associated with a QOL score decrease of 5.93 among freshmen of urban origin and of 3.01 among freshmen of rural origin.

Conclusion: In Chinese University freshmen, childhood LBE is independently associated with poor QOL, and the LBE–QOL association is greater among freshmen from urban backgrounds than among freshmen from rural backgrounds.
Risk Prediction Model for Esophageal Cancer Among General Population: A Systematic Review
Authors: Chen Ru , Zheng Rongshou , Zhou Jiachen , Li Minjuan , Shao Dantong , Li Xinqing , Wang Shengfeng , Wei Wenqiang
Published: December 2021

Objective: The risk prediction model is an effective tool for risk stratification and is expected to play an important role in the early detection and prevention of esophageal cancer. This study sought to summarize the available evidence of esophageal cancer risk predictions models and provide references for their development, validation, and application.

Methods: We searched PubMed, EMBASE, and Cochrane Library databases for original articles published in English up to October 22, 2021. Studies that developed or validated a risk prediction model of esophageal cancer and its precancerous lesions were included. Two reviewers independently extracted study characteristics including predictors, model performance and methodology, and assessed risk of bias and applicability with PROBAST (Prediction model Risk Of Bias Assessment Tool).

Results: A total of 20 studies including 30 original models were identified. The median area under the receiver operating characteristic curve of risk prediction models was 0.78, ranging from 0.68 to 0.94. Age, smoking, body mass index, sex, upper gastrointestinal symptoms, and family history were the most commonly included predictors. None of the models were assessed as low risk of bias based on PROBST. The major methodological deficiencies were inappropriate date sources, inconsistent definition of predictors and outcomes, and the insufficient number of participants with the outcome.

Conclusions: This study systematically reviewed available evidence on risk prediction models for esophageal cancer in general populations. The findings indicate a high risk of bias due to several methodological pitfalls in model development and validation, which limit their application in practice.
Understanding the Implications of Peer Support for Families of Children With Neurodevelopmental and Intellectual Disabilities: A Scoping Review
Authors: Chakraborti Michelle , Gitimoghaddam Mojgan , McKellin William H. , Miller Anton Rodney , Collet Jean-Paul
Published: November 2021

Background: Families are integrally involved in day-to-day caregiving of children with neurodevelopmental and intellectual disabilities (NDID). Given the widespread and increasing prevalence of children with NDID and the impact of family caregiving on psychological, social, and economic implications for both the child and family, understanding and supporting these families is an important public health concern.

Objective: We conducted a scoping review on peer support networks to understand their implications on families. Considering increasing prevalence of NDID's, understanding the implications of existing networks is critical to improve and nurture future support networks that can complement and reduce the burden on existing formal support systems.

Design: A comprehensive search of multiple databases was conducted. Articles were screened by two reviewers and any disagreements were resolved by a third reviewer. We explored existing research on parent-to-parent peer support networks, which included networks that developed informally as well as those that involved a formal facilitator for the group interpersonal processes. There were no limits on the study design, date and setting of the articles. We included all research studies in English that included an identifier for (i) “peer support networks,” (ii) “children with neurodevelopmental and intellectual disabilities” and (iii) “family caregiver outcomes.”

Results: We identified 36 articles. Majority of the studies were conducted in North America, and were face to face networks. They included families of children with a wide range of NDIDs. Relevant information extracted from different studies highlighted peer support network characteristics and development process, needs of family caregivers attending these networks, factors affecting caregiver participation and the impact of peer support networks on family caregivers. These networks represent a way to strengthen family caregivers, developing resilience and social interactions. Family caregivers sharing similar experiences support one another and provide critical information to each other. Although results are encouraging, future studies incorporating improved study designs are needed to better evaluate the effectiveness of peer support networks. Furthermore, studies where peer support networks develop organically while the child is supported are warranted.

Conclusion: Although results obtained are encouraging, our findings support the need for further research studies of peer support networks with better designs and more detailed description of the factors involved in the development.
Semmelweis Caring University Model Program Based on the Development of a Center of Preventive Services: Health for All Employees at a University Occupational Setting
Authors: Ungvári Zoltán , Ádány Róza , Szabó Attila J. , Dörnyei Gabriella , Moizs Mariann , Purebl György , Kalabay László , Varga Péter , Torzsa Péter , Kellermayer Miklós , Merkely Béla
Published: December 2021

The leadership of the Semmelweis University as a leading institution of higher education in Hungary and the Central Eastern European region within the area of medicine and health sciences has decided to reflect on the unfavorable public health situation in the country as well as the deteriorating health behavior and health status indicators in the Hungarian population by the development of an occupational setting-based personalized public health model program targeting its about 8500 employees. Based on its infrastructure and human resources the core element of the program is the establishment of the Center of Preventive Services (CPS) with units providing health risk assessment for each employee, and whenever necessary consultation with medical specialist in preventive medicine and public health, as well as counseling with dietician, physiotherapist and/or health psychologist. The service providers are the staff members of the relevant faculties in collaboration with partner primary and occupational care physicians. The units of the CPS can also serve as practical training sites for students at various levels of medical and health sciences training, and strongly contribute to the development and improvement of their skills to be able for working as a team in service provision. The employees are not only beneficiaries of health risk assessment and screening repeated on a regular basis and adequate interventions at the right time, but they also serve as a sample for a longitudinal cohort study and further ad hoc surveys for defining and implementing interventions to support health protection, disease prevention and healthy aging among them.
Efficiency of Iranian Hospitals Before and After Health Sector Evolution Plan: A Systematic Review and Meta-Analysis Study
Authors: Amini Saeed , Karami Matin Behzad , Didehdar Mojtaba , Alimohammadi Ali , Salimi Yahya , Amiresmaili Mohammadreza , Kazemi-Karyani Ali
Published: November 2021

Purpose: Aging, chronic diseases, and development of expensive and advanced technologies has increased hospitals costs which have necessitated their efficiency in utilization of resources. This systematic review and meta-analysis study has assessed the efficiency of Iranian hospitals before and after the 2011 Health Sector Evolution Plan (HSEP).

Methods: Internal and external databases were searched using specified keywords without considering time limitations. The retrieved articles were entered into EndNote considering inclusion and exclusion criteria, and the final analysis was performed after removing duplicates. Heterogeneity between the studies was assessed using Q and I2 tests. A forest plot with 95% confidence intervals (CI) was used to calculate different types of efficiency. The data were analyzed using STATA 14.

Results: Random pooled estimation of hospitals technical, managerial, and scale efficiencies were 0.84 (95%CI = 0.78, 0.52), 0.9 (95%CI = 0.85, 0.94), and 0.88 (95%CI = 0.84, 0.91), respectively. Sub-group analysis on the basis of study year (before and after HSEP in 2011) indicated that random pool estimation of technical (0.86), managerial (0.91), and scale (0.90) efficiencies of Iranian hospitals for 2011 and before were better than technical (0.78), managerial (0.86), and scale (0.74) efficiencies after 2011.

Conclusion: Type of hospital ownership was effective on hospital efficiency. However, HSEP has not improved hospital efficiency, so it is necessary for future national plans to consider all aspects.
Ageing Population's Impact on Economic Growth in Malaysia From 1981 to 2019: Evidence From an Autoregressive Distributed Lag Approach
Authors: Mohd Siti Nur Ain , Ishak Ayunee Anis , Selvaratnam Doris Padmini
Published: November 2021

This study investigates the impact of the ageing population on the economic growth for short- and long-run estimations in Malaysia, by using time series data from 1981 to 2019. This study adopts the autoregressive distributed lag (ARDL) method with the Bound test approach for the long-run estimation and the vector error correction model for the short-run estimation. Several econometric diagnostic tests were applied for validation and the appropriate model specification basis. The estimated result of this work indicates that the age dependency ratio proxy for the ageing population variable has a significant negative impact on economic growth in Malaysia. A 1% increase in old age dependency will decline gross domestic product's (GDP's) growth by an average of 6.6043% at the 5% level of significance. Hence, an increase in the ageing population will impede economic growth. Although controlled variables (e.g., physical capital, labour participation, and human capital) have a significant positive impact on economic growth in Malaysia, there is evidence of a long- and short-run relationship between economic growth and the ageing population variable, and also the control variable.
Study Protocol for Evaluation of an Extended Maintenance Intervention on Life Satisfaction and BMI Among 7–14-Year-Old Children Following a Stay at a Residential Health Camp in Denmark
Authors: Kristoffersen Mette Juul , Michelsen Susan Ishøy , Rasmussen Mette , Due Pernille , Thygesen Lau Caspar , Krølner Rikke Fredenslund
Published: November 2021

Background: It is challenging to maintain effects of public health interventions. For residential health camps benefits often disappear as the child returns home. Furthermore, long-term effects are often not measured or reported. This paper presents the study protocol for an evaluation of an extended maintenance intervention offered to children who have completed a 10-week residential health camp at one of the five Danish Christmas Seal Houses (DCSH). The target group of DSCH is 7–14-year-olds with social, mental, and/or overweight issues and the overall aim of the camp is to increase life satisfaction and a healthy lifestyle. The primary aim of this study is to assess the effectiveness of the maintenance intervention on children's life satisfaction (primary outcome) and BMI Z-score (secondary outcome) 1 year after health camp.

Methods: The extended maintenance intervention is developed by DCSH and delivered to each child and family individually by an intervention coordinator to help children maintain positive benefits of the health camp on life satisfaction and health behaviors after returning to their homes. Intervention activities target the child and the family. The effect will be tested in a quasi-experimental design: The intervention is offered to half of the children at one of the five DSCH (intervention group, N~144) while the other half and the children at the other four DSCH receive a standard maintenance intervention (control group, N~894). Children will complete questionnaires on life satisfaction measured by an adapted version of the Cantril ladder and height and weight prior to health camp, at the end of health camp, 3 months and 1 year after the end of health camp. To enable per protocol analysis and nuanced interpretation of effect estimates, we will monitor the implementation of the intervention by a process evaluation study among children, parents, and follow up coordinators using qualitative and quantitative methods.

Discussion: We present a systematic approach to evaluating practice-based interventions in a research design. The study will provide new knowledge on the effectiveness of individualized maintenance interventions on long-term effects on life satisfaction and weight loss among children.

Trial registration: Prospectively registered at Current Controlled Trials ISRCTN 13011465 https://www.isrctn.com/ISRCTN13011465
Food Access, Diet Quality, and Nutritional Status of Older Adults During COVID-19: A Scoping Review
Authors: Nicklett Emily J. , Johnson Kimson E. , Troy Lisa M. , Vartak Maitreyi , Reiter Ann
Published: December 2021

Background: COVID-19 has imposed challenges for older adults to access food, particularly in minority, lower income, and rural communities. However, the impact of COVID-19 on food access, diet quality, and nutrition of diverse older adult populations has not been systematically assessed.

Objective: To examine changes in food access, diet quality, and nutritional status among older adults during the COVID-19 pandemic and the potential differential impacts of the COVID-19 pandemic on these nutrition-related outcomes using the framework of the socio-ecological model.

Methods: An electronic search was conducted on 3 databases (PubMed, CINAHL, and Web of Science) on March 7, 2021. Original, peer-reviewed English-language studies published 10/1/2019–3/1/2021 were considered for which the mean age of participants was 50 years and older. In order to be considered, studies must have examined food access, food security, or nutrition constructs as an outcome.

Results: The initial search yielded 13,628 results, of which 9,145 were duplicates. Of the remaining 4,483 articles, 13 articles were in scope and therefore selected in the final analysis, which can be characterized as descriptive (n = 5), analytical (n = 6), and correlational (n = 2). Studies were conducted among community-dwelling older adult populations (n = 7) as well as those temporarily residing in hospital settings (n = 6) in 10 countries. None of the in-scope studies examined the impact of food programs or specific public policies or disaggregated data by race/ethnicity.

Conclusions: More research is needed to examine the impact of COVID-19 on food access/security and the differential barriers experienced by older adult populations.
Pharmacist's Perspectives on Administering a COVID-19 Vaccine in Community Pharmacies in Four Balkan Countries
Authors: Turcu-Stiolica Adina , Kamusheva Maria , Bogdan Maria , Tadic Ivana , Harasani Klejda , Subtirelu Mihaela-Simona , Meca Andreea-Daniela , Šesto Sofia , Odalović Marina , Arsić Jasmina , Stojkov Svetlana , Terzieva Emili , Petrova Guenka
Published: December 2021

Community pharmacists expanded their roles and engaged in vaccination services in many countries around the world, but not in Balkan countries. This research aimed to assess the perceptions of pharmacists on involvement in the coronavirus disease (COVID-19) vaccine administration in four Balkan countries (Albania, Bulgaria, Romania, and Serbia). A cross-sectional survey was conducted using an online questionnaire that was distributed to community pharmacists across these countries between February and March 2021. A total of 636 community pharmacists were included in the analysis of the survey. The willingness to administer vaccines for COVID-19 (or other vaccines well established in the practice, like a flu vaccine) in community pharmacies is significantly different among the countries: the pharmacists from Albania were more willing to administer vaccines. The factors associated with the eagerness to vaccinate are almost the same among the countries: the lack of training in the faculty classes and the lack of a special place where to administer vaccines. Additional significant factors were found in Bulgaria (pharmacists from independent pharmacies wanted more than the pharmacists working in chain pharmacies to administer vaccines) and in Serbia (male pharmacists agreed more with administering vaccines than female pharmacists). Further national reforms are needed for adopting the expanding role of community pharmacists.
Previous COVID-19 Infection and Antibody Levels After Vaccination
Authors: Ali Hamad , Alahmad Barrak , Al-Shammari Abdullah A. , Alterki Abdulmohsen , Hammad Maha , Cherian Preethi , Alkhairi Irina , Sindhu Sardar , Thanaraj Thangavel Alphonse , Mohammad Anwar , Alghanim Ghazi , Deverajan Sriraman , Ahmad Rasheed , El-Shazly Sherief , Dashti Ali A. , Shehab Mohammad , Al-Sabah Salman , Alkandari Abdullah , Abubaker Jehad , Abu-Farha Mohamed , Al-Mulla Fahd
Published: December 2021

Background: The emergence of new COVID-19 variants of concern coupled with a global inequity in vaccine access and distribution has prompted many public health authorities to circumvent the vaccine shortages by altering vaccination protocols and prioritizing persons at high risk. Individuals with previous COVID-19 infection may not have been prioritized due to existing humoral immunity.

Objective: We aimed to study the association between previous COVID-19 infection and antibody levels after COVID-19 vaccination.

Methods: A serological analysis to measure SARS-CoV-2 immunoglobulin (Ig)G, IgA, and neutralizing antibodies was performed on individuals who received one or two doses of either BNT162b2 or ChAdOx1 vaccines in Kuwait. A Student t-test was performed and followed by generalized linear regression models adjusted for individual characteristics and comorbidities were fitted to compare the average levels of IgG and neutralizing antibodies between vaccinated individuals with and without previous COVID-19 infection.

Results: A total of 1,025 individuals were recruited. The mean levels of IgG, IgA, and neutralizing antibodies were higher in vaccinated subjects with previous COVID-19 infections than in those without previous infection. Regression analysis showed a steeper slope of decline for IgG and neutralizing antibodies in vaccinated individuals without previous COVID-19 infection compared to those with previous COVID-19 infection.

Conclusion: Previous COVID-19 infection appeared to elicit robust and sustained levels of SARS-CoV-2 antibodies in vaccinated individuals. Given the inconsistent supply of COVID-19 vaccines in many countries due to inequities in global distribution, our results suggest that even greater efforts should be made to vaccinate more people, especially individuals without previous COVID-19 infection.
Development of Graves' Disease After SARS-CoV-2 mRNA Vaccination: A Case Report and Literature Review
Authors: Lui David Tak Wai , Lee Ka Kui , Lee Chi Ho , Lee Alan Chun Hong , Hung Ivan Fan Ngai , Tan Kathryn Choon Beng
Published: November 2021

Background: Mounting evidence has revealed the interrelationship between thyroid and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to explain the thyroid dysfunction and autoimmune thyroid disorders observed after coronavirus disease 2019 (COVID-19). There are limited reports of thyroid dysfunction after SARS-CoV-2 vaccination.

Methods: We report a case of a 40-year-old Chinese woman who developed Graves' disease after BNT162b2 mRNA vaccine. A search of PubMed and Embase databases from 1 September 2019 to 31 August 2021 was performed using the following keywords: “COVID,” “vaccine,” “thyroid,” “thyroiditis,” and “Graves.”

Results: A 40-year-old Chinese woman who had 8-year history of hypothyroidism requiring thyroxine replacement. Her anti-thyroid peroxidase and anti-thyroglobulin antibodies were negative at diagnosis. She received her first and second doses of BNT162b2 mRNA vaccine on 6 April and 1 May 2021, respectively. She developed thyrotoxicosis and was diagnosed to have Graves' disease 5 weeks after the second dose of vaccine, with positive thyroid stimulating immunoglobulin level, diffuse goiter with hypervascularity on thyroid ultrasonography and diffusely increased thyroid uptake on technetium thyroid scan. Both anti-thyroid peroxidase and anti-thyroglobulin antibodies became positive. She was treated with carbimazole. Literature search revealed four cases of Graves' disease after SARS-CoV-2 vaccination, all after mRNA vaccines; and nine cases of subacute thyroiditis, after different types of SARS-CoV-2 vaccines.

Conclusion: Our case represents the fifth in the literature of Graves' disease after SARS-CoV-2 vaccination, with an unusual presentation on a longstanding history of hypothyroidism. Clinicians should remain vigilant about potential thyroid dysfunction after SARS-CoV-2 vaccination in the current pandemic.
Identifying the Subtypes and Characteristics of Mental Workload Among Chinese Physicians in Outpatient Practice: A Latent Profile Analysis
Authors: Li Dehe , Hu Yinhuan , Chen Hao , Zhu Ximin , Wu Xiaoyue , Li Jiayi , Zhang Zemiao , Liu Sha
Published: November 2021

Objective: The purpose of this study is to investigate the mental workload level of physicians in outpatient practice since the normalization of prevention and control of the COVID-19 pandemic in China and explore the subtypes of physicians regarding their mental workload.

Methods: A cross-sectional survey of 1,934 physicians primarily in 24 hospitals in 6 provinces in Eastern, Central, and Western China was conducted from November 2020 to February 2021. A latent profile analysis was performed to identify clusters based on the six subscales of the Chinese version of physician mental workload scale developed by our research team. Chi-square tests were performed to explore the differences in demographic characteristics of the subtypes among the subgroups, and multinomial logistic regression analysis was further conducted to identify the determinants of the subtypes of physicians.

Results: Overall, the participating physicians reported high levels of task load but with high self-assessed performance (68.01 ± 14.25) while performing communication work tasks characterized by direct patient interaction in outpatient clinics. About 33.8% of the participating physicians were identified as “high workload and high self-assessment” subtype, compared to 49.7% “medium workload and medium self-assessment” subtype and 16.4% “low workload and low self-assessment” subtype. Physicians in “high workload and high self-assessment” subtype had the highest mean mental workload score. Physicians who were female, younger, married, worse health status, those who had lower educational level and an average monthly income of 5,001–10,000 RMB, those who worked in tertiary A hospitals, more hours per week and more than 40 h per week in outpatient clinics, and those who saw more outpatients per day, and spent more time per patient but with higher outpatient satisfaction were more likely to belong to “high workload and high self-assessment” subtype.

Conclusion: Our findings can help provide a solid foundation for developing targeted interventions for individual differences across physicians regarding their mental workload. We suggest the hospital managers should pay more attention to those physicians with characteristics of the “high workload and high self-assessment” subtype and strengthen the management of the workload of this subtype of physicians to reduce the risks of their mental health, and to maintain their high work performance in outpatient clinics.
Knowledge, Attitude, and Practices Associated With COVID-19 Among Healthcare Workers in Hospitals: A Cross-Sectional Study in India
Authors: Gopalakrishnan Shivkumar , Kandasamy Sangeetha , Abraham Bobby , Senthilkumar Monika , Almohammed Omar A.
Published: December 2021

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused phenomenal loss of lives and overburdened the health system in India. Low morale, fatigue, and inadequate knowledge among the healthcare workers (HCWs) are the perceived threats to pandemic control. We aimed to assess the COVID-19 related level of knowledge, attitude, and practices (KAP) among our HCWs. A cross-sectional, electronically distributed, questionnaire-based study was conducted which identified the demographics of HCWs and the current KAP related to coronavirus disease 2019 (COVID-19). The descriptive statistics were used to present the demographics of the participants and chi-square test was used to assess the differences in KAP among the participants. Of 1,429 total participants, 71.9% belonged to age group 21–40 years. Only 40.2% received any infection control training and 62.7% relied upon single source of information update. However, 82.9% of the participants had adequate knowledge. Being married, urban dwelling, and higher qualification were associated with knowledge adequacy (p < 0.001). Interestingly, the senior HCWs (age 41–50 years) were least likely to have adequate knowledge (74.1%). About 84% had positive attitude toward COVID-19, but 83.8% of the participants feared providing care to the patients with COVID-19. However, 93% of HCWs practiced safety precautions correctly most of the times and training had no influence on practice. In conclusion, more than 80% of HCWs in the study had adequate knowledge, positive attitude, and practiced safely most of the time. However, the pitfalls, such as poor training, knowledge uncertainties, and fear of disease acquisition among the HCWs need to be addressed.
The Impacts of Globalization on Inequality in the Post-COVID-19 World: Evidence From China
Authors: Cheong Tsun Se , Wu Yanrui , Wojewodzki Michal , Ma Ning
Published: December 2021

Empirical studies suggest that globalization (FDI and international trade) has been greatly affected by the COVID-19 and related anti-pandemic measures imposed by governments worldwide. This paper investigates the impact of globalization on intra-provincial income inequality in China and the data is based on the county level. The findings reveal that FDI is negatively associated with intra-provincial inequality, intra-provincial inequality increases as the primary industry sector (agriculture) declines. The result also finds that the increase in inequality stems not from the development in the tertiary or secondary industry sectors per se, but the unevenness in the distribution of these sectors.
Data-Driven Discovery of Mathematical and Physical Relations in Oncology Data Using Human-Understandable Machine Learning
Authors: Kurz Daria , Sánchez Carlos Salort , Axenie Cristian
Published: November 2021

For decades, researchers have used the concepts of rate of change and differential equations to model and forecast neoplastic processes. This expressive mathematical apparatus brought significant insights in oncology by describing the unregulated proliferation and host interactions of cancer cells, as well as their response to treatments. Now, these theories have been given a new life and found new applications. With the advent of routine cancer genome sequencing and the resulting abundance of data, oncology now builds an “arsenal” of new modeling and analysis tools. Models describing the governing physical laws of tumor–host–drug interactions can be now challenged with biological data to make predictions about cancer progression. Our study joins the efforts of the mathematical and computational oncology community by introducing a novel machine learning system for data-driven discovery of mathematical and physical relations in oncology. The system utilizes computational mechanisms such as competition, cooperation, and adaptation in neural networks to simultaneously learn the statistics and the governing relations between multiple clinical data covariates. Targeting an easy adoption in clinical oncology, the solutions of our system reveal human-understandable properties and features hidden in the data. As our experiments demonstrate, our system can describe nonlinear conservation laws in cancer kinetics and growth curves, symmetries in tumor’s phenotypic staging transitions, the preoperative spatial tumor distribution, and up to the nonlinear intracellular and extracellular pharmacokinetics of neoadjuvant therapies. The primary goal of our work is to enhance or improve the mechanistic understanding of cancer dynamics by exploiting heterogeneous clinical data. We demonstrate through multiple instantiations that our system is extracting an accurate human-understandable representation of the underlying dynamics of physical interactions central to typical oncology problems. Our results and evaluation demonstrate that, using simple—yet powerful—computational mechanisms, such a machine learning system can support clinical decision-making. To this end, our system is a representative tool of the field of mathematical and computational oncology and offers a bridge between the data, the modeler, the data scientist, and the practicing clinician.
Analyses of the Effects of Arginine, Nicotine, Serotype and Collagen-Binding Proteins on Biofilm Development by 33 Strains of Streptococcus mutans
Authors: Wagenknecht Dawn R. , Gregory Richard L.
Published: November 2021

Streptococcus mutans serotype k strains comprise <3% of oral isolates of S. mutans but are prominent in diseased cardiovascular (CV) tissue. Collagen binding protein (CBP) genes, cbm and cnm, are prevalent in serotype k strains and are associated with endothelial cell invasion. Nicotine increases biofilm formation by serotype c strains of S. mutans, but its effects on serotype k strains and strains with CBP are unknown. Saliva contains arginine which alters certain properties of the extracellular polysaccharides (EPS) in S. mutans biofilm. We examined whether nicotine and arginine affect sucrose-induced biofilm of S. mutans serotypes k (n = 23) and c (n = 10) strains with and without CBP genes. Biofilm mass, metabolism, bacterial proliferation, and EPS production were assessed. Nicotine increased biomass and metabolic activity (p < 0.0001); arginine alone had no effect. The presence of a CBP gene (either cbm or cnm) had a significant effect on biofilm production, but serotype did not. Nicotine increased bacterial proliferation and the effect was greater in CBP + strains compared to strains lacking CBP genes. Addition of arginine with nicotine decreased both bacterial mass and EPS compared to biofilm grown in nicotine alone. EPS production was greater in cnm + than cbm + strains (p < 0.0001). Given the findings of S. mutans in diseased CV tissue, a nicotine induced increase in biofilm production by CBP + strains may be a key link between tobacco use and CV diseases.
Understanding Gender Equality Policy and Practice Gaps Through the Lens of Organisational Justice: Development of an Employee Alignment Model
Authors: McCarthy Chrissi , Barnard Sarah , Thomson Derek , Dainty Andrew
Published: December 2021

Policies and actions to address gender inequalities are widespread across a range of institutional and organisational contexts. Concerns have been raised about the efficacy and impacts of such measures in the absence of sustained evaluation of these activities. It has been proposed that important contextual factors may propel or inhibit measures to promote gender equality, including a critical mass of women, role models, diverse leaders and inclusive organisational cultures. This paper explores relationships between organisational justice and equality interventions to better understand gaps between equality policies and practices using a comparative case study approach in a male-dominated sector. A combination of questionnaire and interview data analysis with employees in three case organisations in the construction sector are used to outline links between perceptions of gender equality initiatives and organisational justice, and the mechanisms used to reinforce in-group dominance. The findings culminate in the development of an Employee Alignment Model and a discussion of how this relates to the organisational climate for gender equality work. The findings suggest that the development of interactional organisational justice is an important precursor for successful gender equality interventions in organisations. These findings have implications for those looking to minimize unintentional harm of policies or interventions to improve gender equality.
Geographic Distribution of Colombian Spittlebugs (Hemiptera: Cercopidae) via Ecological Niche Modeling: A Prediction for the Main Tropical Forages' Pest in the Neotropics
Authors: Hernández Luis M. , Espitia Paula , Florian David , Castiblanco Valheria , Cardoso Juan Andrés , Gómez-Jiménez María I.
Published: November 2021

Spittlebugs (Hemiptera: Cercopidae) are the main tropical pests in Central and South America of cultivated pastures. We aimed to estimate the potential distribution ofAeneolamia varia, A. lepidior, A. reducta, Prosapia simulans, Zulia carbonaria, andZ. pubescensthroughout the Neotropics using ecological niche modeling. These six insect species are common in Colombia and cause large economic losses. Records of these species, prior to the year 2000, were compiled from human observations, specimens from CIAT Arthropod Reference Collection (CIATARC), Global Biodiversity Information Facility (GBIF), speciesLink (splink), and an extensive literature review. Different ecological niche models (ENMs) were generated for each species: Maximum Entropy (MaxEnt), generalized linear (GLM), multivariate adaptive regression spline (MARS), and random forest model (RF). Bioclimatic datasets were obtained from WorldClim and the 19 available variables were used as predictors. Future changes in the potential geographical distribution were simulated in ENMs generated based on climate change projections for 2050 in two scenarios: optimistic and pessimistic. The results suggest that (i) Colombian spittlebugs impose an important threat toUrochloaproduction in different South American countries, (ii) each spittlebug species has a unique geographic distribution pattern, (iii) in the future the six species are likely to invade new geographic areas even in an optimistic scenario, (iv)A. lepidiorandA. reductashowed a higher number of suitable habitats across Colombia, Venezuela, Brazil, Peru, and Ecuador, where predicted risk is more severe. Our data will allow to (i) monitor the dispersion of these spittlebug species, (ii) design strategies for integrated spittlebug management that include resistant cultivars adoption to mitigate potential economic damage, and (iii) implement regulatory actions to prevent their introduction and spread in geographic areas where the species are not yet found.
Practical Recommendations for the Preoperative Screening and Protective Protocols in Cancer Surgeries During COVID-19: A Systematic Review
Authors: Dorri Sara , Sari Fateme , Seyedhasani Seyedeh Nahid , Atashi Alireza , Hashemi Esmatalsadat , Olfatbakhsh Asiie
Published: November 2021

Introduction: The new coronavirus (COVID-19) has posed many new challenges to the health care and the timing of surgical care. At the beginning of the pandemic many guidelines recommended postponing elective surgical procedures to reallocate resources. As regards, delay in cancer treatment could be effective on cancer progression. The aim of this systematic review was to outline a guideline for preoperative screening before cancer surgeries and protecting health care workers during the pandemic.

Materials and Methods: This study was conducted through a search in electronic databases up to August 2020. PubMed, EMBASE, Web of Science, Scopus, Science Direct, and Google Scholar databases were searched without time limitation. The keywords were a combination of preoperative, cancer surgery, COVID-19, and their synonyms.

Results: The most commonly used ways to triage preoperatively were telephone pre-assessment for suspicious symptoms and history of contact or travel, 14-day self-isolation, in- hospital queries at admission, temperature monitoring, and isolation in a single room COVID-free ward or physical distancing. Reverse transcription-polymerase chain reaction (RT-PCR) test 24–72 h before operation was recommended commonly, except in inaccessible centers, but non-contrast chest-CT scan is not routinely advised for elective surgeries to salvage medical resources. Recommended personal protective equipment (PPE) for staffs were wearing N95 mask in addition to gown, gloves, eye protection in aerosol-generating procedures (AGPs), and wearing gloves, hats, and disposable surgical masks, practice distancing, and hand hygiene for all staffs. Meanwhile team separation of hospital staffs caring for COVID-19 patients, segregated areas for COVID-19 clean and contact, restriction of visitors and family members, and personal distancing are mostly recommended.

Conclusion: We hope this review would be a guidance for triage, preoperative testing, and summarizing safety principles during COVID-19 pandemic alongside with surgical reintegration.