bluuebunny/crossref_metadata_2025 huggingface dataset:
Art during tough times: reflections from an art-based health promotion initiative during the COVID-19 pandemic
Authors: Abdullahi Ilhan , Chana Navneet Kaur , Zenone Marco , Ardiles Paola
Published: March 2021

With the current COVID-19 pandemic impacting communities across the globe, diverse health promotion strategies are required to address the wide-ranging challenges we face. Art is a highly engaging tool that promotes positive well-being and increases community engagement and participation. The ‘Create Hope Mural’ campaign emerged as an arts-based health promotion response to inspire dialogue on why hope is so important for Canadians during these challenging times. This initiative is a partnership between a health promotion network based in Vancouver and an ‘open air’ art museum based in Toronto. Families were invited to submit artwork online that represents the concept of hope. This paper discusses the reflections of organizers of this arts-based health promotion initiative during the early months of the pandemic in Canada. Our findings reveal the importance of decolonizing practices, centring the voices of those impacted by crisis, while being attentive to the social and political context. These learnings can be adopted by prospective health promoters attempting to use arts-based methods to address social and health inequities.
Intracranial microhemorrhages in the setting of COVID-19: what we know so far
Authors: Benson John C , Hunt Christopher H , Klaas James P , Kallmes David F
Published: March 2021

Background

Diffuse intracranial susceptibility abnormalities have recently been described among patients with coronavirus disease 2019 (COVID-19), although prior studies have consisted of case reports and/or series. This brief literature review seeks to compile and catalogue the available data to elucidate characteristic features of such findings.

Materials and methods

Scientific articles and studies on intracranial microhemorrhages in the setting of COVID-19 were searched on PubMed, Google Scholar, and the Cochrane Library. Included studies described intracranial microbleed(s) on magnetic resonance imaging in patients with COVID-19. If multiple patients were described, only patients with intracranial microhemorrhage on magnetic resonance imaging were included for analysis. Patient demographics, severity of illness (e.g. intensive care unit admission and/or intubation), time from diagnosis of COVID-19 to magnetic resonance imaging, and location(s) of any observed microhemorrhages were noted.

Results

A total of 39 patients with suspected intracranial microhemorrhages have been described in prior studies. The average age of patients was 64.7 years; 21.9% were women. The average time between COVID-19 diagnosis and magnetic resonance imaging was 31.7 days. All patients in the cohort were admitted to critical care and were either intubated or treated with extracorporeal membrane oxygenation during their clinical course. Microhemorrhages were most commonly located in the subcortical/juxtacortical white matter and corpus callosum.

Conclusions

Intracranial microbleeds are a well-documented finding in patients with severe COVID-19, and are most commonly callosal and subcortical/juxtacortical in location.
The Loma Prieta earthquake and the cost of voting in the 1989 San Francisco municipal election: Evidence from a natural experiment
Authors: Glasgow Garrett , Oleinikov Pavel , Esteban Rhoanne
Published: March 2021

On October 17, 1989, the Loma Prieta earthquake struck the central coast of California. Three weeks later, on November 7, 1989, San Francisco held a municipal election. A dozen polling places had been destroyed or were otherwise inaccessible to the public due to the earthquake, so new polling places were selected for the affected precincts in the days leading up to the election. This case represents a credible natural experiment examining how changes in the costs of voting affect political participation, with the “as-if” random assignment of voters to the treatment group determined by earthquake damage to individual buildings rather than election administration decisions which could conceivably be related to turnout, such as precinct consolidation or the location of precinct boundaries. We use a difference-in-differences design, with the difference in turnout between the 1987 and 1989 municipal elections as the outcome variable. We find that voter turnout was 2.9 [5.1, 0.6] percentage points lower in precincts in which the polling place was relocated due to earthquake damage as compared to precincts that kept their original polling place.
The FDA’s Diverse and Dynamic Activities in the Social and Behavioral Sciences: Advancing and Supporting Health Equity
Authors: Lee Christine , McLean Melanie J. , Huang Caroline J. , Nguyen Zarndt Anh , Aikin Kathryn J. , Rausch Paula , Cohen Barbara R. , Delahanty Janine , Sholly Danielle M. , Slavit Wendy I. , Carlton Ewa D.
Published: March 2021

The U.S. encompasses a heterogenous mix of people and health disparities exist for various subpopulations, such as minorities, women, people with limited English proficiency, those with low socioeconomic status, and other underserved groups. Differences in health outcomes arise in part due to inequalities and injustices rooted in biological, social, and structural factors. Because the origins of health disparities are multifactorial, the approaches to reduce, or even eliminate them, must be multifactorial as well. The social and behavioral sciences are well poised to address the myriad and complex factors that affect health outcomes, including those at the individual level (eg, individuals’ behaviors, attitudes, and beliefs), the neighborhood level (eg, housing), the community level (eg, cultural values and norms), and the policy level (eg, public policies that influence healthcare funding and access to healthcare resources and educational materials). In addition, the social and behavioral sciences (1) help equip government agencies with the perspectives and tools needed to promote health equity and (2) contribute to rigorous, evidence-based solutions for public health issues, such as disparities found in childhood vaccination rates, childhood obesity, tobacco use, and access to health information technology. The FDA, in particular, actively conducts social and behavioral sciences research to guide the Agency’s efforts to advance and support health equity.
A Longitudinal Analysis of Academic Achievement and Its Correlates in Higher Education
Authors: Sakız Halis , Özdaş Faysal , Göksu İdris , Ekinci Abdurrahman
Published: March 2021

Achievement in higher education is gaining importance and attracting attention among educational psychologists who seek for determining its correlates. This study examined longitudinal associations between academic achievement in higher education, university entrance exam performance, the psychosocial climate of the campus, and instructional behavior and socioeconomic status. Data concerning 2,361 students from three universities were collected via surveys and university records at Year 1, Year 2, and Year 4. Socioeconomic status (SES), university exam performance, perceived instructional behavior, and perceived psychosocial climate at Grade 1 were associated positively with academic achievement, perceived instructional behavior, and perceived psychosocial climate at Grade 2 and Grade 4. Indirect effects from SES, university exam performance, perceived instructional behavior, and perceived psychosocial climate at Grade 1 to Grade 4 outcomes were significant, through academic achievement, perceived instructional behavior, and perceived psychosocial climate at Grade 2. These results support that students’ SES, earlier entrance exam performance, and perceptions of their academics’ instructional behaviors and the campus’ psychosocial atmosphere at the first year of university life are associated with their academic achievement at the final year through their relations with the developing levels of academic achievement, perceived instructional behavior, and psychosocial climate of the campus toward the middle of university life.
Factors Associated With Cardiovascular Disease Prevention Behavior Among Office Workers Based on an Ecological Model
Authors: Pahn Jihyon , Yang Youngran
Published: March 2021

The purpose of this study was to investigate the personal, interpersonal, and organizational factors associated with cardiovascular disease (CVD) prevention behavior among office workers using an ecological model. A total of 221 office workers working in areas such as personnel, design, and accounting, and who work in offices, completed the survey. Health Perception Questionnaire, General Self-Efficacy Scale (GSE), Multidimensional Scale of Perceived Social Support (MSPSS) Scale, the Korean Occupational Stress Scale–Short Form (KOSS-SF), and Social Environment Influencing Health form were used to measure each factor. Health perception (β = .207, p = .003), family support (β = .185, p = .005), and organizational health culture (β = .175, p = .012) were found to have a significant association with the CVD prevention behaviors of office workers. Comprehensive and multidimensional intervention is essential to enhance the CVD prevention behaviors of office workers. This study informs the development of a workplace-based intervention program to prevent CVD among office workers.
Adult Spinal Deformity Surgery and Frailty: A Systematic Review
Authors: Laverdière Carl , Georgiopoulos Miltiadis , Ames Christopher P. , Corban Jason , Ahangar Pouyan , Awadhi Khaled , Weber Michael H.
Published: March 2021

Study Design:

Systematic review.

Objectives:

Adult spinal deformity (ASD) can be a debilitating condition with a profound impact on patients’ health-related quality of life (HRQoL). Many reports have suggested that the frailty status of a patient can have a significant impact on the outcome of the surgery. The present review aims to identify all pre-operative patient-specific frailty markers that are associated with postoperative outcomes following corrective surgery for ASD of the lumbar and thoracic spine.

Methods:

A systematic review of the literature was performed to identify findings regarding pre-operative markers of frailty and their association with postoperative outcomes in patients undergoing ASD surgery of the lumbar and thoracic spine. The search was performed in the following databases: PubMed, Embase, Cochrane and CINAHL.

Results:

An association between poorer performance on frailty scales and worse postoperative outcomes. Comorbidity indices were even more frequently employed with similar patterns of association between increased comorbidity burden and postoperative outcomes. Regarding the assessment of HRQoL, worse pre-operative ODI, SF-36, SRS-22 and NRS were shown to be predictors of post-operative complications, while ODI, SF-36 and SRS-22 were found to improve post-operatively.

Conclusions:

The findings of this review highlight the true breadth of the concept of “frailty” in ASD surgical correction. These parameters, which include frailty scales and various comorbidity and HRQoL indices, highlight the importance of identifying these factors preoperatively to ensure appropriate patient selection while helping to limit poor postoperative outcomes.
Refractory eosinophilic fasciitis successfully treated with infliximab: A case report
Authors: Śmigielska Paulina , Czarny Justyna , Kowalski Jacek , Wilkowska Aleksandra , Nowicki Roman J.
Published: March 2021

Eosinophilic fasciitis is a rare connective tissue disease of unknown etiology. Therapeutic options include high-dose corticosteroids and other immunosuppressive drugs. We present a typical eosinophilic fasciitis case, which did not respond to first-line treatment, but improved remarkably after infliximab administration. This report demonstrates that in case of initial treatment failure, infliximab might be a relatively safe and effective way of eosinophilic fasciitis management.
Book review: Jyothibai Pariyadathu, Mayilamma: The Life of a Tribal Eco-Warrior
Authors: Dutt Payel Rai Chowdhury
Published: March 2021

Jyothibai Pariyadathu, Mayilamma: The Life of a Tribal Eco-Warrior. Orient Blackswan, 2018, 152 pp., ₹675 (Hardback). ISBN: 9789352873593.
战国陶文研究综述
Authors: 彪 汤志
Published: March 2021

学者们对陶文的研究可追溯到清代。不过，随着其他出土材料的不断增加，学界对陶文的重视程度始终不及其他古文字资料。事实上，与青铜器、简帛、玺印等相比起来，陶器几乎是所有阶层的人们均需要使用的器物，也是最常见的器物。而在此类器物上的文字，则是先秦人类日常生活和社会现实的最真实反映。其数量也应该是目前出土材料中最多的。如此大宗的材料，其所蕴含着的价值与其他材料是一样的，也就是说，陶文对于研究中国古代文字形体及其演变、用字情况、政治制度、职官制度、地理沿革、历史事实、姓氏状况、思想文化等问题均有重要价值。可见，战国陶文当可看作一个整体的类别进行专门研究。
In situtrace elements and S isotope systematics for growth zoning in sphalerite from MVT deposits: A case study of Nayongzhi, South China
Authors: Wei Chen , Ye Lin , Huang Zhilong , Hu Yusi , Wang Haoyu
Published: March 2021

Zoning texture in sphalerite has been described in many studies, although its genesis and ore formation process are poorly constrained. In this investigation, we compare thein situtrace element and isotopic composition of colour-zoned sphalerites from Nayongzhi, South China, to explain the zoning growth process. Petrographic observations identified two broad types of zoned sphalerite, core–rim (CR) and core–mantle–rim (CMR) textures. Each zoned sphalerite displays two or three colour zones, including brown core, light colour bands and/or pale-yellow zones.In situlaser ablation inductively coupled plasma mass spectrometry trace-element analyses show that the three colour zones display variable trace-element compositions. Brown cores exhibit distinctly high Mn, Fe, Co, Ge, Tl and Pb concentrations, whereas pale-yellow and light colour zones have elevated Ga, Cd, Sn, In and Sb concentrations. Copper, Sb, In and Sn show slight variations between pale-yellow and light zones, the latter having higher In and Sn, but lower Cu and Sb abundances. Given the low concentration range of Pb, Ge, Tl, Mn Sb, Cd, etc., the colour of sphalerite is attributed mainly to Fe compositional variation. The δ34S values of sphalerite from Nayongzhi range from +22.3 to +27.9‰, suggesting reduced sulfur was generated by thermochemical sulfate reduction of marine sulfate in ore-hosted strata. Single-crystal colour-zoned sphalerite exhibits intracrystalline δ34S variation (up to 4.3‰), which is attributed to the δ34S composition of H2S in the original fluid. The lack of correlation between trace elements and δ34S values indicates episodic ore solution influxes and mixes with the reduced sulfur-rich fluid derived from the aquifers of the ore-hosted strata, which play a key role in the formation of the zoned Nayongzhi sphalerite. In conclusion,in situtrace element and S isotope studies of zoned sphalerite crystals might provide insight into the ore-forming process of MVT deposits.
Development of a program to prevent sexual violence among teens in Japan: education using DVD video teaching materials and web-based learning
Authors: Nagamatsu Miyuki , Ooshige Narumi , Sonoda Nozomi , Niina Mika , Hara Ken-ichi
Published: March 2021

Background

This study aimed to develop an education system using DVD video-based teaching materials or web-based learning to reduce sexual violence among teens in Japan.

Methods

During the first stage, June 2018 to March 2019, an education program using DVD video teaching materials was carried out at three high schools and four universities with research consent from the director of the facility. From 1337 high school students and first- and second-year university students, subjects in their teen years were targeted for analysis. A survey was conducted at baseline and after the DVD video teaching. During the second stage, November 2019 to March 2020, web-based learning using improved video teaching materials was developed and carried out. From the adolescents who participated in the web-based learning, subjects in their teen years were targeted for analysis. A survey was conducted at baseline and after the web-based learning.

Results

In the first stage, 876 students consented to and participated in the education using DVD video teaching materials and baseline and after surveys (collection rate 65.5%). Among these, the number of respondents in their teens both baseline and after education was 705 persons (valid response rate 80.4%). In the second stage, the number of respondents in their teens both baseline and after education was 250 respondents in their teens who received web-based learning using the improved video teaching materials (valid response rate 87.1%). The improvement effect of the two programs was observed in attitudes that lead to physical violence, attitudes that lead to mental violence, attitudes that promote healthy conflict resolution, and dangerous attitudes that lead to sexual violence from persons in the community or through the Internet. The web-based learning program achieved an improvement of preventive attitudes toward sexual violence.

Conclusions

The education program using DVD video teaching materials or web-based learning may help prevent sexual violence among teens in Japan.
Genome-edited Camelina sativa with a unique fatty acid content and its potential impact on ecosystems
Authors: Kawall Katharina
Published: March 2021

‘Genome editing’ is intended to accelerate modern plant breeding enabling a much faster and more efficient development of crops with improved traits such as increased yield, altered nutritional composition, as well as resistance to factors of biotic and abiotic stress. These traits are often generated by site-directed nuclease-1 (SDN-1) applications that induce small, targeted changes in the plant genomes. These intended alterations can be combined in a way to generate plants with genomes that are altered on a larger scale than it is possible with conventional breeding techniques. The power and the potential of genome editing comes from its highly effective mode of action being able to generate different allelic combinations of genes, creating, at its most efficient, homozygous gene knockouts. Additionally, multiple copies of functional genes can be targeted all at once. This is especially relevant in polyploid plants such as Camelina sativa which contain complex genomes with multiple chromosome sets. Intended alterations induced by genome editing have potential to unintentionally alter the composition of a plant and/or interfere with its metabolism, e.g., with the biosynthesis of secondary metabolites such as phytohormones or other biomolecules. This could affect diverse defense mechanisms and inter-/intra-specific communication of plants having a direct impact on associated ecosystems. This review focuses on the intended alterations in crops mediated by SDN-1 applications, the generation of novel genotypes and the ecological effects emerging from these intended alterations. Genome editing applications in C. sativa are used to exemplify these issues in a crop with a complex genome. C. sativa is mainly altered in its fatty acid biosynthesis and used as an oilseed crop to produce biofuels.
Cost-impact analysis of baroreflex activation therapy in chronic heart failure patients in the United States
Authors: Bisognano John , Schneider John E. , Davies Shawn , Ohsfeldt Robert L. , Galle Elizabeth , Stojanovic Ivana , Deering Thomas F. , Lindenfeld JoAnn , Zile Michael R.
Published: March 2021

Background

The study evaluated the cost of baroreflex activation therapy plus guideline directed therapy (BAT + GDT) compared to GDT alone for HF patients with reduced ejection fraction and New York Heart Association Class III or II (with a recent history of III). Baroreflex activation therapy (BAT) is delivered by an implantable device that stimulates the baroreceptors through an electrode attached to the outside of the carotid artery, which rebalances the autonomic nervous system to regain cardiovascular (CV) homeostasis. The BeAT-HF trial evaluated the safety and effectiveness of BAT.

Methods

A cost impact model was developed from a U.S. health care payer or integrated delivery network perspective over a 3-year period for BAT + GDT versus GDT alone. Expected costs were calculated by utilizing 6-month data from the BeAT-HF trial and existing literature. HF hospitalization rates were extrapolated based on improvement in NT-proBNP.

Results

At baseline the expected cost of BAT + GDT were $29,526 per patient more than GDT alone due to BAT device and implantation costs. After 3 years, the predicted cost per patient was $9521 less expensive for BAT + GDT versus GDT alone due to lower rates of significant HF hospitalizations, CV non-HF hospitalizations, and resource intensive late-stage procedures (LVADs and heart transplants) among the BAT + GDT group.

Conclusions

BAT + GDT treatment becomes less costly than GDT alone beginning between years 1 and 2 and becomes less costly cumulatively between years 2 and 3, potentially providing significant savings over time. As additional BeAT-HF trial data become available, the model can be updated to show longer term effects.
Explaining the concept of maternal health information verification and assessment during pregnancy: a qualitative study
Authors: Taheri Safoura , Tavousi Mahmoud , Momenimovahed Zohre , Direkvand-Moghadam Ashraf , Rezaei Nazanin , Sharifi Nasibeh , Taghizadeh Ziba
Published: March 2021

Background

Pregnant women use information sources for their own health and health of their children. However, despite the importance of trusting the information sources, pregnant women may not have the ability to verify the maternal health information, which could have negative consequences for their health. The purpose of this study was to explain the concept of maternal health information verification and assessment in pregnant women according to their experiences and perception.

Methods

This is a qualitative study that was conducted in 2017 in Tehran, Iran. The participants in this study consisted of 19 pregnant women who were selected by purposeful sampling. To collect data, semi-structured, in-depth and face to face interviews were conducted with participants and continued until saturation of data. Conventional content analysis method was used to analyze the data and to identify concepts and synthesize them into general classes. MAXQDA software version 10 was used to manage the data.

Results

In the process of data analysis, the concept of verification and assessment of maternal health information in pregnancy was explained in two main categories, including “Validity of information resources” and “Reliance on information resources.” The category of Validity of information resources had two subcategories of valid and invalid sources, and the main category of Reliance on information resources had two subcategories of indicators of assurance, and confusion and trying to obtain assurance.

Conclusion

The results indicated that pregnant women used various sources and indicators, as well as different evaluation methods to obtain information and verify it, especially when they are confused. Thus, health authorities and healthcare professionals should provide appropriate programs to familiarize mothers with credible sources, train pregnant women on standards and practices for judging the accuracy of information, and create a safe margin of information.
Assessment of the association between non-suicidal self-injury disorder and suicidal behaviour disorder in females with conduct disorder
Authors: Szewczuk-Bogusławska Monika , Kaczmarek-Fojtar Małgorzata , Adamska Agnieszka , Frydecka Dorota , Misiak Błażej
Published: March 2021

Background

Non-suicidal self-injury (NSSI) and aggression have been demonstrated to serve as risk factors of suicidal behaviours (SB). Non-suicidal self-injury disorder (NSSID) and Suicidal Behaviour Disorder (SBD) are among new diagnostic categories for further studies in the DSM-5 classification.

Methods

We recruited 196 girls (aged 15.5 ± 1.2 years) diagnosed with conduct disorder (CD). All of them were assessed with respect of non-suicidal self-injury acts, suicidal attempts, psychopathology, self-esteem and general functioning.

Results

Age of NSSI onset was significantly lower compared to age of first suicidal attempt. SBD was present in 50.0% of patients with NSSID and the prevalence of NSSID in individuals with SBD was estimated at 52.2%. A diagnosis of NSSID, with at least 8 days of engagement in self-injuries during the preceding year, significantly predicted the risk of SBD. This effect appeared to be independent of depressive symptomatology.

Limitations

Our results cannot be generalized over the whole population of individuals diagnosed with CD because of a lack of male patients, as well as individuals with the most severe and mildest forms of CD. Causal inferences cannot be established due to a cross-sectional study design.

Conclusions

The NSSID with at least 8 days of engagement in self-injuries during the preceding year serves as a predictor of SBD independently of the effects of depressive symptoms. Longitudinal studies are required to confirm our findings.
Climate-related migration and population health: social science-oriented dynamic simulation model
Authors: Reuveny Rafael
Published: March 2021

Background

Social science models find the ecological impacts of climate change (EICC) contribute to internal migration in developing countries and, less so, international migration. Projections expect massive climate-related migration in this century. Nascent research calls to study health, migration, population, and armed conflict potential together, accounting for EICC and other factors. System science offers a way: develop a dynamic simulation model (DSM). We aim to validate the feasibility and usefulness of a pilot DSM intended to serve as a proof-of-concept and a basis for identifying model extensions to make it less simplified and more realistic.

Methods

Studies have separately examined essential parts. Our DSM integrates their results and computes composites of health problems (HP), health care (HC), non-EICC environmental health problems (EP), and environmental health services (ES) by origin site and by immigrants and natives in a destination site, and conflict risk and intensity per area. The exogenous variables include composites of EICC, sociopolitical, economic, and other factors. We simulate the model for synthetic input values and conduct sensitivity analyses.

Results

The simulation results refer to generic origin and destination sites anywhere on Earth. The effects’ sizes are likely inaccurate from a real-world view, as our input values are synthetic. Their signs and dynamics are plausible, internally consistent, and, like the sizes, respond logically in sensitivity analyses. Climate migration may harm public health in a host area even with perfect HC/ES qualities and full access; and no HP spillovers across groups, conflict, EICC, and EP. Deviations from these conditions may worsen everyone’s health. We consider adaptation options.

Conclusions

This work shows we can start developing DSMs to understand climate migration and public health by examining each case with its own inputs. Validation of our pilot model suggests we can use it as intended. We lay a path to making it more realistic for policy analysis.
Pathophysiological mechanisms of root resorption after dental trauma: a systematic scoping review
Authors: Galler Kerstin M. , Grätz Eva-Maria , Widbiller Matthias , Buchalla Wolfgang , Knüttel Helge
Published: March 2021

Background

The objective of this scoping review was to systematically explore the current knowledge of cellular and molecular processes that drive and control trauma-associated root resorption, to identify research gaps and to provide a basis for improved prevention and therapy.

Methods

Four major bibliographic databases were searched according to the research question up to February 2021 and supplemented manually. Reports on physiologic, histologic, anatomic and clinical aspects of root resorption following dental trauma were included. Duplicates were removed, the collected material was screened by title/abstract and assessed for eligibility based on the full text. Relevant aspects were extracted, organized and summarized.

Results

846 papers were identified as relevant for a qualitative summary. Consideration of pathophysiological mechanisms concerning trauma-related root resorption in the literature is sparse. Whereas some forms of resorption have been explored thoroughly, the etiology of others, particularly invasive cervical resorption, is still under debate, resulting in inadequate diagnostics and heterogeneous clinical recommendations. Effective therapies for progressive replacement resorptions have not been established. Whereas the discovery of the RANKL/RANK/OPG system is essential to our understanding of resorptive processes, many questions regarding the functional regulation of osteo-/odontoclasts remain unanswered.

Conclusions

This scoping review provides an overview of existing evidence, but also identifies knowledge gaps that need to be addressed by continued laboratory and clinical research.
Impact of COVID-19 on the oral health of adults in Wuhan and China: results of a nationwide online cross-sectional questionnaire survey
Authors: Zhang Shuang , Liu Chang , Zhang Chenzheng , Jiang Han , Tai Baojun , Du Minquan
Published: March 2021

Background

COVID-19 has seriously threatened the health and lives of people. This study aimed to investigate the impact of COVID-19 on the oral health of adults in Wuhan and other places of China amid the epidemic and to evaluate attitudes towards dental care in the post-epidemic period.

Methods

An online cross-sectional survey based on a questionnaire of 22 questions was conducted.

Results

A total of 3352 valid questionnaires were collected. Participants from Wuhan tended to be relatively psychologically affected and more concerned about future dental treatment. Toothbrushing frequency did not differ significantly between participants from Wuhan and other places and was associated with the prevalence of oral problems people encountered. Gingival bleeding, bad breath and oral ulcers were the three most common oral problems amid the epidemic, and significantly more participants in Wuhan experienced oral problems than other places in China.

Conclusion

The three most common oral problems amid the epidemic were gingival bleeding, bad breath and oral ulcers. Adults in Wuhan tended to be more seriously affected and suffered more oral problems than people from other places in China. Maintaining good oral health behaviours plays an important role in preventing dental problems. It is crucial to establish and to follow the standard guidelines for the provision of dental care during and after the epidemic.
Community Connectors (CCx): the strategies employed by peer to peer connectors to foster relationships with early years caregivers to improve universal early child health and development
Authors: Mills C. F. , Lowrie E. , Kinloch K. , Hall E.
Published: March 2021

Blackpool is one of the most deprived Local Authority (LA) areas in England; in April 2015 the Blackpool Better Start (BBS) Partnership was allocated £45 million over 10 years from the Big Lottery Fund (BLF) as one of five ‘A Better Start’ initiative areas in England. The aim of the ‘A Better Start’ initiative is to improve outcomes for children from conception to 3 years of age. Co-designed by professionals and the community, the Community Connector (CCx) programme employs residents to directly engage caregivers of children, in seven of Blackpool’s most socio-economically deprived wards. The CCx follow a socioecological framework which proposes that caregivers will be positively influenced to engage in early years activities because of connections to trained peers. Peer support models are commonly applied within targeted early years health settings (i.e., infant feeding support, literacy) yet their role to improve child outcomes at a universal level has received little attention. This paper focuses on caregiver-level evidence of the strategies employed by CCx - part of an early stage pilot study supported by Frontiers of Innovation, the Harvard Centre on the Developing Child’s Research and Development platform.

The study collated attendance data from Children’s Centres, these are publically funded community centres providing information and activities for families with children 0–5 years of age. The study data included individual interactions between a CCx and caregiver over a 1 year period (1st April 2018 – 31st March 2019). A sampling frame was created from which a total of 22 interviews with caregivers were undertaken in early years community settings. The interview data was thematically analysed; the findings highlighted the mechanisms by which CCx served to mediate service and caregiver communication boundaries, negotiate access to spaces, and encouraged sustained engagement in longer term activities such as volunteering and training. Value was embedded by the CCx in their process of establishing and maintaining connections with caregivers through the ‘everyday’ conversations, their individualised approach and in demonstrating self-efficacy behaviours. Further research is required to review the impact of the CCx role in caregiver’s recall of early years information, nevertheless the study provided important learning for establishing formalised CCx programmes elsewhere, and has implications for community health and early years policy and practice.
Co-location of out of hours primary care and emergency department in Belgium: patients’ and physicians’ view
Authors: Schoenmakers Birgitte , Van Criekinge Jasper , Boeve Timon , Wilms Jonas , Van Der Mullen Chris , Sabbe Marc
Published: March 2021

Background

In Belgium, General Practitioner Cooperatives (GPC) aim to improve working conditions for unplanned care and to reduce the number of low acuity emergency visits. Although this system is well organized, the number of low acuity visits does not decrease.

Methods

We explored the view of patients and physicians on the co-location of a GPC and an emergency service for unplanned care. The study was carried out in a cross section design in primary and emergency care services and included patients and physicians. Main outcome measure was the view of patients and physician on co-location of a GPC and an emergency service.

Results

404 patients and 488 physicians participated. 334 (82.7%) of all patients favoured a co-location. The major advantages were fast service (104, 25.7) and adequate referral (54, 13.4%). 237 (74%) of the GPs and 38 (95%) of the emergency physicians were in favour of a co-location. The major advantage was a more adequate referral of patients. 254 (79%) of the GPs and 23 (83%) of the emergency physicians believed that a co-location would lower the workload and waiting time and increase care quality (resp. 251 (78%), 224 (70%) and 37 (93%), 34 (85%).

Conclusions

To close the expectation gap between GP’s, emergency physicians and to reach for high care quality, information campaigns and development of workflows are indispensable for a successful implementation of a co-location of primary and emergency care.
A mobile phone application for malaria case-based reporting to advance malaria surveillance in Myanmar: a mixed methods evaluation
Authors: Win Han Oo  , Win Htike  , Cutts Julia C. , Kyawt Mon Win  , Kaung Myat Thu  , May Chan Oo  , Galau Naw Hkawng  , Agius Paul A. , Pyae Phyo Htoon  , Scott Nick , Kearney Ellen , Moreira Clarissa , Pedrana Alisa , Stoove Mark , Aung Thi  , Ye Win Aung  , Min Min Thein  , Rosecrans Kathryn , Kyi Tun Lwin  , Aung Kyi Min  , Fowkes Freya J. I.
Published: March 2021

Background

To achieve malaria elimination in the Greater Mekong Subregion, including Myanmar, it is necessary to ensure all malaria cases are detected, treated, and reported in a timely manner. Mobile phone-based applications for malaria reporting, case management, and surveillance implemented at a community-level may overcome reporting limitations associated with current paper-based reporting (PBR), but their effectiveness in this context is unknown.

Methods

A mixed methods evaluation study was undertaken to determine the effectiveness of a national Malaria Case-Based Reporting (MCBR) mobile phone application in improving malaria case reporting compared to the existing PBR reporting system in Myanmar. Methods included secondary analysis of malaria case report data, questionnaires, focus group discussions and field observations of community volunteers, interviews and direct observations of malaria programme stakeholders, and cost analysis. Using a combination of these approaches the following areas were investigated: data quality and completeness, data access and usage, capacity for timely reporting, the acceptability, functionality, and ease of use of the application and facilitators and barriers to its use, and the relative cost of MCBR compared to the PBR system.

Results

Compared to PBR, MCBR enabled more accurate and complete data to be reported in a much timelier manner, with 63% of MCBR users reporting they transmit rapid diagnostic test outcomes within 24 h, compared to 0% of PBR users. MCBR was favoured by integrated community malaria volunteers and their supervisors because of its efficiency. However, several technical and operational challenges associated with internet coverage, data transmission, and e-literacy were identified and stakeholders reported not being confident to rely solely on MCBR data for programmatic decision-making.

Conclusions

Implementation of MCBR provided timely and accurate data for malaria surveillance. Findings from this evaluation study will enable the optimization of an application-based reporting system for malaria monitoring and surveillance in the Greater Mekong Subregion and advance systems to track progress towards, and certify, the achievement of malaria elimination targets.
The science of spin: targeted strategies to manufacture doubt with detrimental effects on environmental and public health
Authors: Goldberg Rebecca F. , Vandenberg Laura N.
Published: March 2021

Background

Numerous groups, such as the tobacco industry, have deliberately altered and misrepresented knowable facts and empirical evidence to promote an agenda, often for monetary benefit, with consequences for environmental and public health. Previous research has explored cases individually, but none have conducted an in-depth comparison between cases. The purpose of this study was to compile a comprehensive list of tactics used by disparate groups and provide a framework for identifying further instances of manufactured doubt.

Methods

We examined scholarly books, peer-reviewed articles, well-researched journalism pieces, and legal evidence related to five disparate industries and organizations selected for their destructive impacts on environmental and public health (tobacco, coal, and sugar industries, manufacturers of the pesticide Atrazine, and the Marshall Institute, an institute focused on climate change research, and other scientists from the era that associated with those in the Institute). These documents provided evidence for a list of tactics used to generate pro-industry spin and manufacture doubt about conferred harm. We then identified trends among sets of strategies that could explain their differential use or efficacy.

Results

We recognized 28 unique tactics used to manufacture doubt. Five of these tactics were used by all five organizations, suggesting that they are key features of manufactured doubt. The intended audience influences the strategy used to misinform, and logical fallacies contribute to their efficacy.

Conclusions

This list of tactics can be used by others to build a case that an industry or group is deliberately manipulating information associated with their actions or products. Improved scientific and rhetorical literacy could be used to render them less effective, depending on the audience targeted, and ultimately allow for the protection of both environmental health and public health more generally.
Decreased mortality in acute respiratory distress syndrome patients treated with corticosteroids: an updated meta-analysis of randomized clinical trials with trial sequential analysis
Authors: Lin Ping , Zhao Yuean , Li Xiaoqian , Jiang Faming , Liang Zongan
Published: March 2021

Background

The possible benefits associated with corticosteroid treatment in acute respiratory distress syndrome (ARDS) patients are not fully known. We conducted an updated meta-analysis to assess the effect of corticosteroids in the treatment of patients with ARDS.

Methods

We systematically searched MEDLINE, Embase, and the Cochrane Library from inception to January 2021 via Ovid to identify randomized controlled trials evaluating the efficacy of glucocorticoids in the treatment of patients with ARDS. The primary outcome was hospital mortality. Secondary outcomes included the number of ventilator-free days at day 28, oxygenation improvement (PaO2/FIO2 ratios), and adverse events.

Results

Nine studies with 1371 participants were analyzed. The pooled analysis revealed that glucocorticoid use was associated with reduced mortality [relative risk (RR), 0.83; 95% confidence interval (CI) 0.74–0.93; P < 0.01; I2 = 37], and the statistical power was confirmed by trial sequential analysis. Glucocorticoids might also significantly increase the number of ventilator-free days at day 28 (mean deviation 3.66 days, 95% CI 2.64–4.68; P < 0.01) and improve oxygenation (standardized mean difference 4.17; 95% CI 2.32–6.02; P < 0.01). In addition, glucocorticoid use was not associated with increased risks of new infection (RR 0.84; 95% CI 0.70–1.01; P = 0.07) and hyperglycemia (RR 1.11; 95% CI 0.99–1.23; P = 0.06).

Conclusions

The use of glucocorticoids might result in reduced mortality in patients with ARDS. Glucocorticoids might be recommended as an adjunct to standard care for ARDS; however, the optimal dose and duration of steroid therapy remains unknown and further studies are needed.
Impact of disease activity on impaired glucose metabolism in patients with rheumatoid arthritis
Authors: Ristić Gorica G. , Subota Vesna , Stanisavljević Dejana , Vojvodić Danilo , Ristić Arsen D. , Glišić Branislava , Petronijević Milan , Stefanović Dušan Z.
Published: March 2021

Objective

To explore glucose metabolism in rheumatoid arthritis (RA) and its association with insulin resistance (IR) risk factors and disease activity indicators, including matrix metalloproteinase-3 (MMP3).

Methods

This single-center study included 127 non-diabetic subjects: 90 RA patients and 37 matched controls. IR-related risk factors, disease activity (DAS28-ESR/CRP), concentrations of inflammation markers, MMP3, glucose, specific insulin, and C-peptide (a marker of β-cell secretion) were determined. Homeostasis Model Assessment was used to establish insulin resistance (HOMA2-IR) and sensitivity (HOMA2-%S). Associations of HOMA2 indices with IR-related risk factors, inflammation markers, and RA activity were tested using multiple regression analyses.

Results

RA patients had significantly increased HOMA2-IR index than controls. In the RA group, multivariate analysis revealed DAS28-ESR, DAS28-CRP, tender joint counts, patient’s global assessment, and MMP3 level as significant positive predictors for HOMA2-IR (β = 0.206, P = 0.014; β = 0.192, P = 0.009; β = 0.121, P = 0.005; β = 0.148, P = 0.007; β = 0.075, P = 0.025, respectively), and reciprocal negative for HOMA2-%S index. According to the value of the coefficient of determination (R2), DAS28-ESR ≥ 5.1 has the largest proportion of variation in both HOMA2-IR indices. DAS28-ESR ≥ 5.1 and ESR were independent predictors for increased C-peptide concentration (β = 0.090, P = 0.022; β = 0.133, P = 0.022). Despite comparability regarding all IR-related risk factors, patients with DAS28-ESR ≥ 5.1 had higher HOMA2-IR than controls [1.7 (1.2–2.5) vs. 1.2 (0.8–1.4), P = 0.000]. There was no difference between patients with DAS28-ESR < 5.1 and controls [1.3 (0.9–1.9) vs. 1.2 (0.8–1.4), P = 0.375].

Conclusions

RA activity is an independent risk factor for impaired glucose metabolism. DAS28-ESR ≥ 5.1 was the main contributor to this metabolic disturbance, followed by MMP3 concentration, outweighing the impact of classic IR-related risk factors.
Design of a novel antimicrobial peptide 1018M targeted ppGpp to inhibit MRSA biofilm formation
Authors: Jiale Zhou , Jian Jiao , Xinyi Tan , Haoji Xie , Xueqin Huang , Xiao Wang
Published: March 2021

Methicillin-resistant staphylococcus aureus (MRSA) and its biofilm infection were considered as one of the main international health issues. There are still many challenges for treatment using traditional antibiotics. In this study, a mutant peptide of innate defense regulator (IDR-)1018 named 1018M was designed based on molecular docking and amino acid substitution technology. The antibacterial/biofilm activity and mechanisms against MRSA of 1018M were investigated for the first time. The minimum inhibitory concentration (MIC) of 1018M was reduced 1 time (MIC = 2 μg/mL) compared to IDR-1018. After treatment with 32 μg/mL 1018M for 24 h, the percentage of biofilm decreased by 78.9%, which was more effective than the parental peptide. The results of mechanisms exploration showed that 1018M was more potent than IDR-1018 at destructing bacterial cell wall, permeating cell membrane (20.4%–50.1% vs 1.45%–10.6%) and binding to stringent response signaling molecule ppGpp (increased 27.9%). Additionally, the peptides could also exert their activity by disrupting genomic DNA, regulating the expression of ppGpp metabolism and biofilm forming related genes (RSH, relP, relQ, rsbU, sigB, spA, codY, agrA and icaD). Moreover, the higher temperature, pH and pepsase stabilities provide 1018M better processing, storage and internal environmental tolerance. These data indicated that 1018M may be a potential candidate peptide for the treatment of MRSA and its biofilm infections.
Frailty inclusive care in acute and community-based settings: a systematic review protocol
Authors: Montgomery Carmel L. , Hopkin Gareth , Bagshaw Sean M. , Hessey Erin , Rolfson Darryl B.
Published: March 2021

Background

Frailty is a known risk factor for an array of adverse outcomes including more frequent and prolonged health services use and high health care costs. Aging of the population has implications for care provision across the care continuum, particularly for people living with frailty. Despite known risks associated with frailty, there has been limited research on care pathways that address the needs of persons living with frailty. Our study aims to review and examine, in a rigorous way, the quality of evidence for multi-component interventions and care pathways focused on frailty.

Methods

A comprehensive electronic search strategy will be used to identify studies that evaluate multi-component interventions or care pathways for persons living with frailty. The search strategy will include terms for frailty, multi-component interventions, effectiveness, and cost effectiveness applied to the following databases: MEDLINE (OVID), EMBASE (OVID), CINAHL (EBSCO), Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Database of Systematic Reviews. An adapted search for Google Scholar and gray literature databases will also be used. References of included studies will be hand-searched for additional citations of frailty-inclusive care. Known experts and corresponding authors of identified articles will be contacted by email to identify further eligible studies. Risk of bias will be assessed using the Effective Public Health Practice Project Quality Assessment tool. Data will be extracted from eligible studies and it is anticipated that narrative analysis will be used. If studies with sufficient homogeneity are found, then pooled effects will be reported using meta-analysis.

Discussion

This review will appraise the evidence currently available on multi-component frailty interventions. Results will inform on clinical pathway development for people living with frailty across the care continuum and will guide future research to address gaps in the literature and areas in need of further development.

Systematic review registration

PROSPEROCRD42020166733