bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of overweight, obesity and central obesity and factors associated with BMI in indigenous yaqui people: a probabilistic cross-sectional survey
Authors: Serna-Gutiérrez Araceli , Castro-Juarez Alejandro Arturo , Romero-Martínez Martín , Alemán-Mateo Heliodoro , Díaz-Zavala Rolando Giovanni , Quihui-Cota Luis , Álvarez-Hernández Gerardo , Gallegos-Aguilar Ana Cristina , Esparza-Romero Julián
Published: February 2022

Background

The Yaquis are an Indigenous group who inhabit in the state of Sonora in northwestern Mexico. This group has experienced changes in their lifestyle, moving from a traditional lifestyle to a more modern one, resulting in an increase of obesity and its comorbidities. However, few studies have been done in this group. The aim of this study was to determine the prevalence of overweight, obesity and central obesity and to identify the factors associated with body mass index (BMI) in a representative sample of Indigenous Yaqui people from Sonora, Mexico.

Methods

A cross-sectional survey with multistage sampling was conducted among adults (N = 351) with residence in Yaqui traditional villages (Vícam, Pótam, Loma de Guamúchil, Loma de Bácum, Tórim, Ráhum, Huiribis or Belem). Anthropometric measurements were taken to diagnose overweight, obesity and central obesity. Food frequency and physical activity (PA) questionnaires designed for the Yaqui population were applied, as well as sociodemographic and clinical history questionnaires. The factors associated with BMI were assessed using multiple linear regression considering the complex design of the sampling.

Results

The prevalence of overweight, obesity and central obesity in the population were 36.5%, 35.0% and 76.0%, respectively. Having higher values of the modernization index (β = 0.20, p = 0.049) was associated with a higher BMI, while having a higher consumption of a “prudent” dietary pattern (traditional dishes, fruits, vegetables and low-fat dairy) (β = -0.58, p = 0.009) and performing a greater number of hours per week of vigorous PA (β = -0.14, p = 0.017) were associated with a lower BMI.

Conclusions

The prevalence of the studied abnormalities is high. The evidence presented in this study suggests that interventions are needed and more research is required to determine the appropriate components of such interventions, in order to meet the needs of the Yaqui people.
Managing prior approval for site-of-service referrals: an algorithmic approach
Authors: Dada Maqbool , Mundly Vishal , Chambers Chester G. , Alamdar Yazdi Mohammad Ali , Ha Changhun , Toporcer Sonia E. , Zhou Yi , Gan Yunong , Xing Zhihua , Mooney Mark , Smith Ernest , Kumian Edward , Williams Kayode A.
Published: February 2022

Objectives

Many payers and health care providers are either currently using or considering use of prior authorization schemes to redirect patient care away from hospital outpatient departments toward free-standing ambulatory surgical centers owing to the payment differential between these facilities. In this work we work with a medium size payer to develop and lay out a process for analysis of claims data that allows payers to conservatively estimate potential savings from such policies based on their specific case mix and provider network.

Study Design

We analyzed payment information for a medium-sized managed care organization to identify movable cases that can reduce costs, estimate potential savings, and recommend implementation policy alternatives.

Methods

We analyze payment data, including all professional and institutional fees over a 15-month period. A rules-based algorithm was developed to identify episodes of care with at least one alternate site for each episode, and potential savings from a site-of-service policy.

Results

Data on 64,884 episodes of care were identified as possible instances that could be subject to the policy. Of those, 7,679 were found to be attractive candidates for movement. Total projected savings was approximately $8.2 million, or over $1,000 per case.

Conclusions

Instituting a site-of-service policy can produce meaningful savings for small and medium payers. Tailoring the policy to the specific patient and provider population can increase the efficacy of such policies in comparison to policies previously established by other payers.
Impact of the bidirectional relationship between communication and cognitive efficacy on orthopedic patient adherence behavior
Authors: Chang Dong-Shang , Chen Wil-Lie , Wang Rouwen
Published: February 2022

Background

There is growing interest in patient autonomy, and communication between physicians and patients has become the essential cornerstone for improving the quality of healthcare services. Previous research has concentrated on the direct effect of physician-patient communication on service outcomes. In the present study, we examined the influence among constructs in the service process and the impact on healthcare outcomes. The present study used behavioral theory to expand the process aspect of the Donabedian healthcare service quality structure-process-outcome model to examine the impact of cognitive changes and communication feedback on patients’ adherence behavior. In addition, the moderating effect of hospital facility levels is examined.

Methods

A conceptual model was developed and tested using a questionnaire administered to patients in eight hospitals. A total of 397 respondents returned usable surveys, with a response rate of 92.11%. Structural equation modeling was used to analyze the data in two steps that involved a measurement model and a structural model. The former was applied to estimate the Cronbach’s alphas, intercorrelations of factors, and descriptive statistics; the latter was used to test the hypothesized relationships of the constructs.

Results

The results identified three mediators of the healthcare process within the healthcare services framework: physician-patient communication, cognitive efficacy, and adherence behavior. Physician-patient communication influenced cognitive efficacy (β = 0.16, p < 0.001), and cognitive efficacy influenced physician-patient communication (β = 0.18, p < 0.001). The effect of this bidirectional relationship on adherence behavior was positive (β = 0.38, p < 0.001). The healthcare structure influenced healthcare outcomes via these three healthcare process constructs. The adherence behavior of patients who were treated in the medical center has greater influences by the structure and physician-patient communication than it was treated in the regional hospitals.

Conclusions

This study revealed a complex pattern in relationships among process constructs for healthcare services. The findings of this study acknowledge the important potential interrelationships among the healthcare service constructs to improve the quality of healthcare outcomes.

Trial registration

CRREC104107. Date: 22/01/2016. Prospectively Registered.
Difference in drug cost between private and public drug plans in Quebec, Canada
Authors: M. Chamoun , A. Forget , I. Chabot , M. Schnitzer , L. Blais
Published: February 2022

Background

We expect a difference in drug cost between private drug plans and the Public Drug Plan (PDP) because the dispensing fee is fixed and regulated by the PDP for publicly insured patients, whereas it is determined freely by the pharmacy owner for privately insured patients. This study compared the drug cost of Quebec residents covered by private drug plans with those covered by PDP.

Methods

We used a sample of prescriptions filled between 1 January 2015 and 23 May 2019 selected from reMed, a database of Quebecers’ drug claims. We created strata of prescriptions filled by privately insured patients and matched them with strata of prescriptions filled by publicly insured patients based on the Drug Identification Number, quantity dispensed, number of days of supply, pharmacy identifier, and a date corresponding to the publication of List of Medications of Régie de l’Assurance Maladie du Québec. The differences in drug cost between private plans and the PDP were analyzed with linear regression models using prescription strata as the unit of analysis.

Results

Based on 38 896 prescription strata, we observed that privately insured patients payed $9·35 (95% confidence interval [CI]: 5·58; 13·01) more on average per drug prescription than publicly insured patients, representing a difference of 17·6%.

Conclusions

This study showed that, on average, drug cost is substantially higher for privately insured Quebecers. Knowing that adherence to treatment is affected by drug cost, these results will help public health authorities to make informed decisions about drug policies.
O-GlcNAc transferase couples MRE11 to transcriptionally active chromatin to suppress DNA damage
Authors: Gondane Aishwarya , Girmay Samuel , Helevä Alma , Pallasaho Satu , Loda Massimo , Itkonen Harri M.
Published: February 2022

Background

Transcription, metabolism and DNA damage response are tightly regulated to preserve the genomic integrity, and O-GlcNAc transferase (OGT) is positioned to connect the three. Prostate cancer is the most common cancer in men, and androgen-ablation therapy halts disease progression. However, a significant number of prostate cancer patients develop resistance against anti-androgens, and this incurable disease is termed castration-resistant prostate cancer (CRPC). We have shown that combined inhibition of OGT and the transcription elongation kinase CDK9 induce CRPC-selective anti-proliferative effects. Here, we explain the functional basis for these combinatorial effects.

Methods

We used comprehensive mass spectrometry profiling of short-term CDK9 inhibitor effects on O-GlcNAcylated proteins in an isogenic cell line system that models transition from PC to CRPC. In addition, we used both ChIP-seq and RNA-seq profiling, and pulldown experiments in multiple CRPC models. Finally, we validated our findings in prostate cancer patient samples.

Results

Inhibition of CDK9 results in an OGT-dependent remodeling of the proteome in prostate cancer cells. More specifically, the activity of the DNA damage repair protein MRE11 is regulated in response to CDK9 inhibition in an OGT-dependent manner. MRE11 is enriched at the O-GlcNAc-marked loci. CDK9 inhibition does not decrease the expression of mRNAs whose genes are bound by both O-GlcNAc and MRE11. Combined inhibition of CDK9 and OGT or MRE11 further decreases RNA polymerase II activity, induces DNA damage signaling, and blocks the survival of prostate cancer cells. These effects are seen in CRPC cells but not in normal prostate cells. Mechanistically, OGT activity is required for MRE11 chromatin-loading in cells treated with CDK9 inhibitor. Finally, we show that MRE11 and O-GlcNAc are enriched at the prostate cancer-specific small nucleotide polymorphic sites, and the loss of MRE11 activity results in a hyper-mutator phenotype in patient tumors.

Conclusions

Both OGT and MRE11 are essential for the repair of CDK9 inhibitor-induced DNA damage. Our study raises the possibility of targeting CDK9 to elicit DNA damage in CRPC setting as an adjuvant to other treatments.

Graphical Abstract
Quantitative assessment the longitudinal changes of pulmonary vascular counts in chronic obstructive pulmonary disease
Authors: Park Sang Won , Lim Myoung-Nam , Kim Woo Jin , Bak So Hyeon
Published: February 2022

Background

Chest computed tomography (CT) is a widely used method to assess morphological and dynamic abnormalities in chronic obstructive pulmonary disease (COPD). The small pulmonary vascular cross-section (CSA), quantitatively extracted from volumetric CT, is a reliable indicator for predicting pulmonary vascular changes. CSA is associated with the severity of symptoms, pulmonary function tests (PFT) and emphysema and in COPD patients the severity increases over time. We analyzed the correlation longitudinal changes in pulmonary vascular parameters with clinical parameters in COPD patients.

Materials and methods

A total of 288 subjects with COPD were investigated during follow up period up to 6 years. CT images were classified into five subtypes from normal to severe emphysema according to percentage of low-attenuation areas less than -950 and -856 Hounsfield units (HU) on inspiratory and expiratory CT (LAA-950, LAA-856exp). Total number of vessels (Ntotal) and total number of vessels with area less than 5 mm2 (N<5 mm) per 1 cm2 of lung surface area (LSA) were measured at 6 mm from the pleural surface.

Results

Ntotal/LSA and N<5 mm/LSA changed from 1.16 ± 0.27 to 0.87 ± 0.2 and from 1.02 ± 0.22 to 0.78 ± 0.22, respectively, during Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage progression. Both parameters changed from normal to severe emphysema according to CT subtype from 1.39 ± 0.21 to 0.74 ± 0.17 and from 1.18 ± 0.19 to 0.67 ± 0.15, respectively. LAA-950 and LAA-856exp were negatively correlated with Ntotal/LSA (r = − 0.738, − 0.529) and N<5 mm /LSA (r = − 0.729, -− .497). On the other hand, pulmonary function test (PFT) results showed a weak correlation with Ntotal/LSA and N<5 mm/LSA (r = 0.205, 0.210). The depth in CT subtypes for longitudinal change both Ntotal/LSA and N<5 mm/LSA was (− 0.032, − 0.023) and (− 0.027) in normal and SAD, respectively.

Conclusions

Quantitative computed tomography features faithfully reflected pulmonary vessel alterations, showing in particular that pulmonary vascular alteration started.
“I got to catch my own baby”: a qualitative study of out of hospital birth
Authors: Sperlich Mickey , Gabriel Cynthia
Published: February 2022

Background

About 1.6% of planned births in the United States occur out of hospitals. Studies indicate that planned out-of-hospital birth (OOHB) is safe and satisfying for women; however, there is great variation among ethnic groups, and Black women are underrepresented. A recent phenomenon is the choice to have an unassisted birth (UAB) with no midwife or other professional maternity care attendant. The purpose of this study is to fill a gap in understanding reasons for choosing OOHB or UAB for two clinically important sub-groups of women: Black women, and women who have experienced childhood physical or sexual abuse.

Methods

This study recruited 18 women who had an OOHB or UAB and who identified as either Black or survivors of trauma to participate in in-depth qualitative interviews concerning their choice to give birth out of hospital. A grounded theory approach was utilized that involved a discursive process of data collection, coding textual passages to identify focused themes, memo writing to document analytic decision-making, and eventual conceptual modeling.

Results

All 18 participants endorsed a history of trauma. Focused coding to identify inherent concepts led to the emergence of a theoretical model of the arc of decision-making around choice of place of birth and birth attendant, or lack thereof. Women may choose OOHB or UAB because of a previous trauma, or because they feel discriminated against by healthcare professionals, either because of skin color, age, pregnancy, weight, or some other health condition. Women may choose OOHB or UAB because it affords more control during the process of giving birth.

Conclusion

Previous trauma and experiences of discrimination were influential factors for women in the study sample in their choice of birthplace setting and choice of provider. These findings can inform clinical understanding for birth professionals, including doctors, midwives, doulas, nurses, social workers, and psychologists, and contributes more broadly to the national conversation about birth choices in the USA.
The impact of COVID-related perceived stress and social support on generalized anxiety and major depressive disorders: moderating effects of pre-pandemic mental disorders
Authors: Monistrol-Mula Anna , Felez-Nobrega Mireia , Domènech-Abella Joan , Mortier Philippe , Cristóbal-Narváez Paula , Vilagut Gemma , Olaya Beatriz , Ferrer Montse , Gabarrell-Pascuet Aina , Alonso Jordi , Haro Josep Maria
Published: February 2022

Background

We assessed the moderating effect of pre-pandemic mental disorders on the association of COVID-related perceived stress and social support with mental health.

Methods

A nationally representative sample of 3500 Spanish adults was interviewed in June 2020 (mean age 49.25 years, ± 15.64; 51.50% females). Mental health included Generalized Anxiety Disorders (GAD; GAD-7, cut-off point of ≥ 10), Major Depressive Disorders (MDD; PHQ-8, cut-off point of ≥ 10) and the comorbid form (those screening positive for GAD and MDD). COVID-related stress was assessed using an adapted version of the Peri Life Events Scale, and social support using the Oslo Social Support Scale. Logistic regression models were used to assess if COVID-related stress and social support were related to mental health outcomes and interactions were conducted to examine whether these relationships differed according to the presence of pre-pandemic mental disorders.

Results

Higher COVID-related stress was associated with a higher risk of lower mental health. The association between COVID-related stress with GAD and MDD was significantly moderated by pre-pandemic mental disorders, except for comorbid GAD + MDD. Higher levels of social support were linked to better mental health. Only the association between social support and GAD was significantly moderated by pre-pandemic mental disorders. That is, for those without pre-pandemic mental disorders, higher levels of social support decreased the odds of GAD, while minor decreases were observed in those with pre-pandemic mental disorders.

Conclusions

The impact of COVID-related stress and social support on specific indicators of mental health may vary depending on the existence of a previous mental disorder.
Hypofractionated radiation leads to more rapid bleeding cessation in women with vaginal bleeding secondary to gynecologic malignancy
Authors: Moradi Luke A. , Schneider Craig S. , Deshane Alok S. , Popple Richard A. , Kim Robert Y. , Marcrom Samuel R.
Published: February 2022

Background

Vaginal bleeding (VB) is common in women with gynecologic (GYN) malignancies. Radiation therapy (RT) is used for the definitive treatment of GYN cancers and palliation of bleeding. The historical dogma is that high dose-per-fraction radiation leads to more rapid bleeding cessation, yet there is scant data supporting this claim. We sought to examine the effect of RT fraction size on VB via retrospective analysis of patients receiving hypofractionated radiation (HFRT) compared to conventionally fractionated radiation (CFRT) for control of bleeding secondary to GYN malignancies.

Methods

We identified patients receiving external beam RT for continuous VB from GYN malignancy treated in our department from 2012 to 2020. RT was classified as HFRT (> 2.0 Gy/fx) or CFRT (1.8–2.0 Gy/fx). Demographic information, disease characteristics, and treatment details were collected. The primary endpoint was days from RT initiation until bleeding resolution. Characteristics between groups were compared via Fisher’s exact test. Time to bleeding cessation was assessed via Kaplan–Meier and log-rank test. Univariable and multivariable Cox-proportional hazards were used to identify factors associated with bleeding cessation.

Results

We identified 43 patients meeting inclusion criteria with 26 and 17 patients receiving CFRT and HFRT, respectively. Comparison of baseline characteristics revealed patients receiving HFRT were older (p = 0.001), more likely to be post-menopausal (p = 0.002), and less likely to receive concurrent chemotherapy (p = 0.004). Time to bleeding cessation was significantly shorter for patients receiving HFRT (log-rank p < 0.001) with median time to bleeding cessation of 5 days (HFRT) versus 16 days (CFRT). Stratification by dose-per-fraction revealed a dose–response effect with more rapid bleeding cessation with increased dose-per-fraction. While HFRT, age, recurrent disease, prior pelvic RT, and prior systemic therapy were associated with time to bleeding cessation on univariable analysis, HFRT was the only factor significantly associated with time to bleeding cessation in the final multivariable model (HR 3.26, p = 0.008).

Conclusions

Patients with continuous VB from GYN tumors receiving HFRT experienced more rapid bleeding cessation than those receiving CFRT. For patients with severe VB, initiation of HFRT to control malignancy related bleeding quickly may be warranted.
ZNF384 rearrangement in acute lymphocytic leukemia with renal involvement as the first manifestation is associated with a poor prognosis: a case report
Authors: Ma Jinlong , Guan Jiaheng , Chen Baoan
Published: February 2022

Background

Novel fusion genes such as ZNF384, have been identified in B-cell precursor acute lymphoblastic leukemia (BCP-ALL) in recent years. Patients harboring ZNF384 rearrangements have a distinctive immunophenotype with weak CD10 and aberrant CD13 and/or CD33 expression. Thus, ZNF384-rearranged ALL is a unique subtype of BCP-ALL. However, research on the prognostic significance of ZNF384 rearrangements has been limited to date, especially in adolescents.

Case presentation

We described a 17-year-old adolescent who was diagnosed with ALL and had renal involvement as the first manifestation, which was very rare in the existing studies. FISH analysis indicated a rearrangement of ZNF384 according to its probe. The patient had a typical characteristic immunophenotype of ZNF384 rearrangement, with CD10 negativity and CD13 and CD33 positivity. She had an unfavorable prognosis because she responded poorly to chemotherapy and developed a relapse shortly after reaching CR.

Conclusion

The importance of ZNF384 rearrangements in terms of prognosis remains unclear. We reported an adolescent who was diagnosed with ZNF384-rearranged ALL with renal involvement. She underwent different therapies, but her prognosis remained poor. Since ZNF384 rearrangements may act as a prognostic predictor in children or adolescents, early detection based on its characteristic immunophenotype is of great necessity.
The effects of learning with various noise on Gait Kinematics in 3-to-5-year-old children: a randomized controlled trial
Authors: Ghorbani Maryam , Yaali Rasoul , Schöllhorn Wolfgang I. , Letafatkar Amir , Sadeghi Hassan
Published: February 2022

Background

Lack of the neuromuscular control during locomotion in the knee joint leads to an increased risk of anterior cruciate ligament (ACL) injury in children. Hence, we aimed to explore the effects of a repetitive, model-oriented, and self-organized approach on lower limb kinematics during gait in children.

Methods

In randomized controlled trial, 36 children with 4 ± 0.79 years of age from the children gym were randomly (a lottery method) allocated into three groups, including (1) the model-oriented (n = 10), (2) Differential Learning (n = 11), and (3) control (n = 10) groups. Kinematic data of hip, knee, and ankle joints in the sagittal plane were recorded by a GoPro camera at the moments of heel-ground contact and toe-off the ground before and after a 6-week intervention (two sessions per week).

Results

The results indicate a 35% post-intervention increase of ankle dorsiflexion (95% CI: − 5.63 _ − 0.96) in the moment of heel-ground contact in the model-oriented group; however, knee flexion (95% CI: − 1.05 _ 8.34) and hip flexion (95% CI: 3.01 _ 11.78) were respectively decreased by 20% and 20%. After the intervention, moreover, ankle plantar flexion (95% CI: − 9.18 _ − 2.81) and hip extension (95% CI: − 12.87 _ − 3.72) have respectively increased by 37% and 37%, while knee flexion (95% CI: 3.49 _ 11.30) showed a %16 decrease in the moment of toe off the ground. As for the Differential Learning group, ankle dorsiflexion (95% CI: − 5.19 _ − 1.52) increased by 33%, and knee (95% CI: 0.60 _ 5.76) and hip flexion (95% CI: 2.15 _ 7.85) respectively decreased by 17% and 17% at the moment of the heel-ground contact following the intervention. At toe lifting off the ground, the plantar flexion (95% CI: − 7.77 _ − 2.77) increased by 35%, knee flexion (95% CI: 2.17 _ 7.27) decreased to 14%, and hip extension (95% CI: − 9.98 _ − 4.20) increased by %35 following the intervention for the Differential Learning group subjects. Based on the results obtained from the one-way ANOVA, there was a significant difference between these groups and the control group in all kinematic gait variables (p ≤ 0.05). However, no statistically significant differences were found between the two experimental groups.

Conclusions

The results implied that the model-oriented repetitive and the self-organized Differential Learning approach were both appropriate to alter the kinematic gait pattern in the 3–5-year-old children. Previous research has almost exclusively recommended a model-oriented approach to change kinematic patterns and preventing non-contact motor injuries. However, the present study showed that the Differential Learning approach can help children to achieve the same goal by continuously changing environments and stimulating challenges.

Trial registration: Current Controlled Trials using the IRCT website with ID number of, IRCT20130109012078N5 “Prospectively registered” at 14/5/2021.
Role of ammonia for brain abnormal protein glycosylation during the development of hepatitis B virus-related liver diseases
Authors: Yang Jiajun , Yin Mengqi , Hou Yao , Li Hao , Guo Yonghong , Yu Hanjie , Zhang Kun , Zhang Chen , Jia Liyuan , Zhang Fan , Li Xia , Bian Huijie , Li Zheng
Published: February 2022

Background

Ammonia is the most typical neurotoxin in hepatic encephalopathy (HE), but the underlying pathophysiology between ammonia and aberrant glycosylation in HE remains unknown.

Results

Here, we used HBV transgenic mice and astrocytes to present a systems-based study of glycosylation changes and corresponding enzymes associated with the key factors of ammonia in HE. We surveyed protein glycosylation changes associated with the brain of HBV transgenic mice by lectin microarrays. Upregulation of Galβ1-3GalNAc mediated by core 1 β1,3-galactosyltransferase (C1GALT1) was identified as a result of ammonia stimulation. Using in vitro assays, we validated that upregulation of C1GALT1 is a driver of deregulates calcium (Ca2+) homeostasis by overexpression of inositol 1,4,5-trisphosphate receptor type 1 (IP3R1) in astrocytes.

Conclusions

We demonstrated that silencing C1GALT1 could depress the IP3R1 expression, an effective strategy to inhibit the ammonia-induced upregulation of Ca2+ activity, thereby C1GALT1 and IP3R1 may serve as therapeutic targets in hyperammonemia of HE.
Identity-based remote data checking with a designated verifier
Authors: Ji Yanyan , Shao Bilin , Chang Jinyong , Xu Maozhi , Xue Rui
Published: February 2022

Traditional remote data possession auditing mechanisms are usually divided into two types: private auditing and public auditing. Informally, private auditing only allows the original data owner to check the integrity of its outsourced data, whereas anyone is allowed to perform the checking task in public auditing. However, in many practical applications, the data owner expects some designated verifier (instead of others) to audit its data file, which cannot be covered by the existing private or public auditing protocols. Thus, in a recent work, Yan et al. proposed a new auditing technique with a designated verifier [IEEE Systems Journal, 12(4): 1788-1797, 2020]. Nevertheless, we note that this protocol suffers from complicated management of certificates and hence heavily relies on public key infrastructure. To overcome this shortcoming, in this paper, we propose an identity-based auditing protocol with a designated verifier, which not only avoids the introduction of certificates, but also has the desired property of only allowing specific verifier to audit. Its security is based on the classical computational Diffie-Hellman and Weil Diffie-Hellman assumptions. Finally, performance analysis shows that our proposed protocol is very efficient and suitable for some real-life applications.
Regional health care profiles – an improved method for generating case studies on the catchment areas of envisaged primary health care units in Austria: a report to the InfAct Joint Action
Authors: Mathis-Edenhofer Stefan , Röthlin Florian , Wachabauer David , Haneef Romana , Ventura Ilana , Fülöp Gerhard
Published: February 2022

Background

The recent Austrian Primary Care Act established new primary health care units (PHCUs) and obliged them to draw up a “care strategy” specifying their focal care tasks and objectives and emphasizing the health care needs of the population in their catchment area with its specific local health and epidemiological profile. The main purpose of these care strategies is thus to ensure that care-providers meet the local needs, but they also provide a rationale for evaluation and organizational development. To assist new PHCUs in establishing care strategies it was necessary to develop a method for automatically generating comprehensive local case studies for any freely definable location in Austria.

Results

We designed an interactive report generator capable of producing location-specific regional health care profiles for a PHCU located in any of Austria’s 2122 municipalities and of calculating the radius of its catchment area (defined by different levels of maximum car-travelling times). The reports so generated, called “regional health care profiles for primary health care” (RHCPs/PHC), are in comprehensive PDF report format. The core of each report is a set of 35 indicators, classified under five health and health service domains. The reports include an introductory text, definitions, a map, a graphic and tabular presentation of all indicator values, including information on local, supra-regional and national value distribution, a ranking, and numbers of service providers (e.g. pharmacies, surgeries, nursing homes) located within the catchment area.

Conclusions

The RHCPs/PHC support primary health care planning, efforts to improve care-effectiveness, and strategic organizational development by providing comprehensive information on the health of the population, the utilization of health services and the health care structures within the catchment area. In addition to revealing the scope and nature of the health care needed, they also provide information on what public health approaches are necessary. RHCPs/PHC for different locations have already been distributed to numerous stakeholders and primary health care providers in Austria.
Small hydropower plants in Western Balkan countries: status, controversies and a proposed model for decision making
Authors: Pavlakovič Barbara , Okanovic Andrea , Vasić Bojana , Jesic Jelena , Šprajc Polona
Published: February 2022

Background

As the countries of the Western Balkans (WB) have committed to sustainable development, the process of regulatory and economic adjustment is underway. As part of the aforementioned fact, the WB countries have commenced exploitation of energy from renewable sources, among which hydropower is the most important. The main objective of the study is to analyse the status of renewable energy transition in the WB region, focusing on the construction and exploitation of small hydropower plants (SHPPs), as well as a proposal for an original model for decision making in this field, based on a multidimensional decision-making space. Namely, in most cases, there is resistance to the construction of SHPPs in the WB territory, as well as divided opinion among investors, companies, environmental movements, academia, and citizens on this issue. This shows that the entire decision-making process has to be reviewed and re-designed.

Results

The results of the study show that the construction of SHPPs caused damage to environmentally protected areas, living conditions of local communities, touristic and agricultural potential. All of the foregoing matters have led to mass protests by citizens and a high degree of mistrust so that the future of SHPPs in the WB is extremely uncertain. The assessment of the acceptability of existing SHPPs through the proposed model showed that 74% of SHPPs cannot be considered acceptable from the aspect of the location where they were built, and from the aspect of the impact on the quality of life of the local population. Accordingly, this paper provides suggestions for much-needed improvements.

Conclusions

The construction of SHPPs is causing numerous controversies, opposition, and resistance. To find the right solution, and contribute to sustainable energy and economic development, it is necessary to develop a fully transparent and objective policy system in this field, and to use contemporary models for decision making with emphasis on the involvement local communities in the decision-making process.
How public health crises expose systemic, day-to-day health inequalities in low- and-middle income countries: an example from East Africa
Authors: Davis Alicia , Lembo Tiziana , Laurie Emma , Mutua Edna , Loosli Kathrin , Nthambi Mary , Nimegeer Amy , Mnzava Kunda , Msoka Elizabeth F. , Nasuwa Fortunata , Melubo Matayo , Shirima Gabriel , Matthews Louise , Hilton Shona , Mshana Stephen E. , Mmbaga Blandina T.
Published: February 2022

Background

The current Coronavirus disease pandemic reveals political and structural inequities of the world’s poorest people who have little or no access to health care and yet the largest burdens of poor health. This is in parallel to a more persistent but silent global health crisis, antimicrobial resistance (AMR). We explore the fundamental challenges of health care in humans and animals in relation to AMR in Tanzania.

Methods

We conducted 57 individual interviews and focus groups with providers and patients in high, middle and lower tier health care facilities and communities across three regions of Tanzania between April 2019 and February 2020. We covered topics from health infrastructure and prescribing practices to health communication and patient experiences.

Results

Three interconnected themes emerged about systemic issues impacting health. First, there are challenges around infrastructure and availability of vital resources such as healthcare staff and supplies. Second, health outcomes are predicated on patient and provider access to services as well as social determinants of health. Third, health communication is critical in defining trusted sources of information, and narratives of blame emerge around health outcomes with the onus of responsibility for action falling on individuals.

Conclusion

Entanglements between infrastructure, access and communication exist while constraints in the health system lead to poor health outcomes even in ‘normal’ circumstances. These are likely to be relevant across the globe and highly topical for addressing pressing global health challenges. Redressing structural health inequities can better equip countries and their citizens to not only face pandemics but also day-to-day health challenges.
The effectiveness of the early orthodontic correction of functional unilateral posterior crossbite in the mixed dentition period: a systematic review and meta-analysis
Authors: Alsawaf Danya Hassan , Almaasarani Salam Ghazwan , Hajeer Mohammad Y. , Rajeh Nada
Published: February 2022

Objective

This systematic review and meta-analysis aimed to critically appraise the available evidence of the effectiveness of early intervention of functional unilateral posterior crossbites (FPXB) between the ages of 6 and 12 years.

Materials and methods

Electronic search in four databases (PubMed, Scopus, Embase, and Google Scholar) for randomized controlled trials (RCTs) and controlled clinical trials (CCTs) was performed between 1st January 1990 and 31st October 2021. Methodological index for non-randomized studies (MINORS) for CCTs and Cochrane's risk of bias tool for RCTs were applied. The certainty of the evidence was evaluated according to the grading of recommendations, assessment, development, and evaluation (GRADE) approach.

Results

Nine studies (6 RCTs and 3 CCTs) were included in this review, and six of them were appropriate for quantitative synthesis. The meta-analysis revealed that the quad-helix (QH) was more effective than expansion plates (EP) in increasing the intermolar width (WMD = 1.25; 95% CI 0.75, 1.75; P < 0.001), and decreasing treatment time (WMD = − 3.36; 95% CI − 4.97, − 1.75; P < 0.001). The relapse rate at 5.6 years post-treatment was greater in the QH group than in the EP group (RR = 3.00); however, the difference was statistically insignificant. There was no significant difference between the QH and the EP in other outcome measures. When assessing the rapid maxillary expansion (RME), only one RCT compared the RME with an untreated control group and reported a significant increase in the maxillary intermolar and intercanine width (P < 0.001, P = 0.002, respectively) and a significant decrease in lower midline deviation (P < 0.001).

Conclusion

There is weak to moderate evidence that the treatment of functional posterior crossbite (FPXB) by the QH increased the maxillary intermolar width and the success rate and decreased the treatment duration compared to the EP. The relapse percentage was greater in the QH group. There is very weak evidence that the mandibular midline correction rate did not differ significantly between the QH and the EP modalities. The RME using the Hyrax appliance corrected the FPXB successfully; however, the strength of evidence in this regard is very low. As the quality of evidence ranged from very low to moderate in this review, we confirm the need for more RCTs with different expansion appliances in the early treatment of FPXB.
Social network data analysis to highlight privacy threats in sharing data
Authors: Cerruto Francesca , Cirillo Stefano , Desiato Domenico , Gambardella Simone Michele , Polese Giuseppe
Published: February 2022

Social networks are a vast source of information, and they have been increasing impact on people’s daily lives. They permit us to share emotions, passions, and interactions with other people around the world. While enabling people to exhibit their lives, social networks guarantee their privacy. The definitions of privacy requirements and default policies for safeguarding people’s data are the most difficult challenges that social networks have to deal with. In this work, we have collected data concerning people who have different social network profiles, aiming to analyse privacy requirements offered by social networks. In particular, we have built a tool exploiting image-recognition techniques to recognise a user from his/her picture, aiming to collect his/her personal data accessible through social networks where s/he has a profile. We have composed a dataset of 5000 users by combining data available from several social networks; we compared social network data mandatory in the registration phases, publicly accessible and those retrieved by our analysis. We aim to analyse the amount of extrapolated data for evaluating privacy threats when users share information on different social networks to help them be aware of these aspects. This work shows how users data on social networks can be retrieved easily by representing a clear privacy violation. Our research aims to improve the user’s awareness concerning the spreading and managing of social networks data. To this end, we highlighted all the statistical evaluations made over the gathered data for putting in evidence the privacy issues.
Image captioning model using attention and object features to mimic human image understanding
Authors: Al-Malla Muhammad Abdelhadie , Jafar Assef , Ghneim Nada
Published: February 2022

Image captioning spans the fields of computer vision and natural language processing. The image captioning task generalizes object detection where the descriptions are a single word. Recently, most research on image captioning has focused on deep learning techniques, especially Encoder-Decoder models with Convolutional Neural Network (CNN) feature extraction. However, few works have tried using object detection features to increase the quality of the generated captions. This paper presents an attention-based, Encoder-Decoder deep architecture that makes use of convolutional features extracted from a CNN model pre-trained on ImageNet (Xception), together with object features extracted from the YOLOv4 model, pre-trained on MS COCO. This paper also introduces a new positional encoding scheme for object features, the “importance factor”. Our model was tested on the MS COCO and Flickr30k datasets, and the performance is compared to performance in similar works. Our new feature extraction scheme raises the CIDEr score by 15.04%. The code is available at: https://github.com/abdelhadie-almalla/image_captioning
Evaluation of the landslide susceptibility and its spatial difference in the whole Qinghai-Tibetan Plateau region by five learning algorithms
Authors: Sajadi Payam , Sang Yan-Fang , Gholamnia Mehdi , Bonafoni Stefania , Mukherjee Saumitra
Published: February 2022

Landslides are considered as major natural hazards that cause enormous property damages and fatalities in Qinghai-Tibetan Plateau (QTP). In this article, we evaluated the landslide susceptibility, and its spatial differencing in the whole Qinghai-Tibetan Plateau region using five state-of-the-art learning algorithms; deep neural network (DNN), logistic regression (LR), Naïve Bayes (NB), random forest (RF), and support vector machine (SVM), differing from previous studies only in local areas of QTP. The 671 landslide events were considered, and thirteen landslide conditioning factors (LCFs) were derived for database generation, including annual rainfall, distance to drainage$${(\mathrm{Ds}}_{\mathrm{d}})$$(Dsd), distance to faults$${(\mathrm{Ds}}_{\mathrm{f}})$$(Dsf), drainage density ($${D}_{d})$$Dd), elevation (Elev), fault density$$({F}_{d})$$(Fd), lithology, normalized difference vegetation index (NDVI), plan curvature$${(\mathrm{Pl}}_{\mathrm{c}})$$(Plc), profile curvature$${(\mathrm{Pr}}_{\mathrm{c}})$$(Prc), slope$${(S}^{^\circ })$$(S∘), stream power index (SPI), and topographic wetness index (TWI). The multi-collinearity analysis and mean decrease Gini (MDG) were used to assess the suitability and predictability of these factors. Consequently, five landslide susceptibility prediction (LSP) maps were generated and validated using accuracy, area under the receiver operatic characteristic curve, sensitivity, and specificity. The MDG results demonstrated that the rainfall, elevation, and lithology were the most significant landslide conditioning factors ruling the occurrence of landslides in Qinghai-Tibetan Plateau. The LSP maps depicted that the north-northwestern and south-southeastern regions (< 32% of total area) were at a higher risk to landslide compared to the center, west, and northwest of the area (> 45% of total area). Moreover, among the five models with a high goodness-of-fit, RF model was highlighted as the superior one, by which higher accuracy of landslide susceptibility assessment and better prone areas management in QTP can be achieved compared to previous results.

Graphical Abstract
Coping behavior versus coping style: characterizing a measure of coping in undergraduate STEM contexts
Authors: Henry Meredith A. , Shorter Shayla , Charkoudian Louise K. , Heemstra Jennifer M. , Le Benjamin , Corwin Lisa A.
Published: February 2022

Background

As technology moves rapidly forward and our world becomes more interconnected, we are seeing increases in the complexity and challenge associated with scientific problems. More than ever before, scientists will need to be resilient and able to cope with challenges and failures en route to success. However, we still understand relatively little about how these skills manifest in STEM contexts broadly, and how they are developed by STEM undergraduate students. While recent studies have begun to explore this area, no measures exist that are specifically designed to assess coping behaviors in STEM undergraduate contexts at scale. Fortunately, multiple measures of coping do exist and have been previously used in more general contexts. Drawing strongly from items used in the COPE and Brief COPE, we gathered a pool of items anticipated to be good measures of undergraduate students’ coping behaviors in STEM. We tested the validity of these items for use with STEM students using exploratory factor analyses, confirmatory factor analyses, and cognitive interviews. In particular, our confirmatory factor analyses and cognitive interviews explored whether the items measured coping for persons excluded due to ethnicity or race (PEERs).

Results

Our analyses revealed two versions of what we call the STEM-COPE instrument that accurately measure several dimensions of coping for undergraduate STEM students. One version is more fine-grained. We call this the Coping Behaviors version, since it is more specific in its description of coping actions. The other contains some specific scales and two omnibus scales that describe what we call challenge-engaging and challenge-avoiding coping. This version is designated the Coping Styles version. We confirmed that both versions can be used reliably in PEER and non-PEER populations.

Conclusions

The final products of our work are two versions of the STEM-COPE. Each version measures several dimensions of coping that can be used in individual classrooms or across contexts to assess STEM undergraduate students’ coping with challenges or failures. Each version can be used as a whole, or individual scales can be adopted and used for more specific studies. This work also highlights the need to either develop or adapt other existing measures for use with undergraduate STEM students, and more specifically, for use with sub-populations within STEM who have been historically marginalized or minoritized.
Proposal of forceps force limiter design using leaf spring buckling
Authors: Noda Satsuya , Tokuoka Yasunori , Kuriu Satoru , Ishida Tadashi
Published: February 2022

To prevent accidents in minimally invasive surgeries, force limiters have been developed for forceps grippers. When a force limiter is in use, if the absolute value of its spring constant is reduced, the risk of damage to the organs decreases. This paper proposes the use of a leaf spring buckling mechanism as a force limiter for forceps. The results obtained indicate that the spring constant of a buckled leaf spring is lower than that of a normal coil spring. Furthermore, the use of a leaf spring allows the independent adjustment of its thickness and width, based on the stress and force values. This enables an easy calibration of the threshold value. In the experiments, the spring constant of the buckled leaf spring was$$1.5 \times 10^{-1}$$1.5×10-1 N/mm, which is half of that of a normal coil spring. After calibrating the gripping force, it was confirmed that the force limiter reduced the extent of damage to the dummy organs in the ex vivo experiments.