bluuebunny/crossref_metadata_2025 huggingface dataset:
Providing Person-Centered Care via Telemedicine in the Era of COVID-19 in Multiple Sclerosis
Authors: Abbatemarco Justin R , Hartman Jennifer , McGinley Marisa , Bermel Robert A , Boissy Adrienne , Chizmadia Desiree T , Sullivan Amy B , Rensel Mary R
Published: January 2021

The coronavirus disease 2019 (COVID-19) pandemic has catalyzed the rapid adoption of telemedicine which encompasses synchronous and asynchronous interactions between patients and providers. In order to facilitate this rapid deployment, there has been numerous regulatory changes to ensure caregivers can effectively communicate with patients during this time. We illustrate a model where people, processes, and technology work together to address the comprehensive needs of multiple sclerosis (MS) patients. We provide a template for how multidisciplinary, academic practices can implement a rapid shift to virtual management during the pandemic using existing infrastructure that can be widely adopted to care for patients with chronic diseases. Telemedicine was incorporated into our entire practice, which encompasses neurology, rehabilitation, advanced practice providers, fellows, social work, and behavioral medicine. Our patient satisfaction results remained stable across almost all domains when compared to survey results from our typical, in-office visits. Our experience demonstrates telemedicine’s transformative potential in successfully managing a multidisciplinary MS clinic during the time of a pandemic and outlines a potential path for other practices to follow.
Evaluation of Patient Experience During Virtual and In-Person Urgent Care Visits: Time and Cost Analysis
Authors: Khairat Saif , Lin Xi , Liu Songzi , Man Zhaohui , Zaman Tanzila , Edson Barbara , Gianforcaro Robert
Published: January 2021

Urgent care (UC) is one of the fastest growing venues of health care delivery for nonemergent conditions. This study compared the patient experience during virtual and in-person urgent care visits. We conducted a cross-sectional study of patients with the same diagnosis during Virtual Urgent Care (VUC) and in-person UC visits with the same diagnosis with regard to time and cost over a period of one year. We recorded and analyzed 16 685 urgent care visits: In-person UC (n = 14 734), VUC (n = 1262). Significant differences were found in the average total time for a visit in an in-person UC (70.89 minutes), and VUC (9.38 minutes). The average total cost of VUC ($49) and in-person UC ($142.657) differed significantly. Significant difference was found between UC turnaround time and VC turnaround time (Dependent variable (DV): 53.77, P < .01). We found significant differences in cost and time between in favor of virtual visits. Our findings suggest additional policy reform to expand the use of virtual care among target populations to improve access, reduce costs, meet the needs of patients, and reduce emergency department visits.
A Growing Educational Divide in the COVID-19 Economy Is Especially Pronounced among Parents
Authors: Kesler Christel , Bash Sarah
Published: January 2021

Economic disruption related to coronavirus disease 2019 (COVID-19) continued through the summer of 2020, affecting the lives of millions of Americans. In this visualization, the authors use recent data from the Current Population Survey to examine Americans’ cumulative risk for labor force detachment during the pandemic. The individuals in the analysis were interviewed eight times: in April, May, June, and July of 2019 and 2020. The authors document respondents’ employment experiences during the 2020 pandemic, using the 2019 data points as a baseline for comparison. Increasing detachment from the labor force varies by basic demographic characteristics (gender and parental status), but a more important divide in the COVID-19 economy is education, an already fundamental determinant of Americans’ life chances. The educational divide is especially pronounced among parents, with important repercussions for inequalities among children.
Trends in Dental Medication Prescribing in Australia during the COVID-19 Pandemic
Authors: Mian M. , Teoh L. , Hopcraft M.
Published: January 2021

Introduction:

The coronavirus disease 2019 (COVID-19) pandemic and subsequent restrictions on dental services have had a significant impact on the provision of dental care in Australia and around the world.

Objectives:

To investigate the impact of COVID-19 on medications prescribed by dentists under the Australian Pharmaceutical Benefits Scheme (PBS).

Methods:

Data on the number of dental prescriptions dispensed for all medications listed on the PBS Dental Schedule, from January 2019 to June 2020, were extracted from publicly available data sets. Analysis of prescription trends was performed for 1) total medications, 2) each major medication class, and 3) individual medications. The number of prescriptions dispensed in each month from January 2020 to June 2020 was compared to the same month in 2019 to determine the relative (percentage) change, and z statistics were used to determine whether changes were statistically significant.

Results:

There was a significant decrease in dental prescriptions in April 2020 compared to April 2019 (14,785, 18%; P < 0.05). Decreases in prescriptions for antibiotics (10,512, 16%; P < 0.05) and opioid analgesics (3,129, 18%; P < 0.05) were smaller compared to other major medication classes. There was a significant increase in June 2020, compared with June 2019, for prescriptions of amoxicillin with clavulanic acid (4,903, 20%; P < 0.05), tramadol (89, 46%; P < 0.05), and oxycodone (381, 73%; P < 0.05).

Conclusion:

Dental service restrictions during COVID-19 likely drove an unmet need for routine dental treatment, which had significant implications for public oral health following easing of restrictions. During the initial surge and subsequent lockdown, antibiotics and opioid analgesics may have been used an as alternative to routine operative treatment. Continued professional guidance is required to ensure dental prescribing remains evidence based during the pandemic period.

Knowledge Transfer Statement:

The COVID-19 pandemic and subsequent restrictions on dental practice have had a profound impact on the provision of dental care in Australia and elsewhere in the world. In this context, population-level medication surveillance is important to identify and respond to changes in prescribing patterns that have arisen due to COVID-19 and restrictions on the provision of dental care. This research is particularly important for governments, regulators, and professional associations to ensure therapeutic guidelines and recommendations during the pandemic period remain relevant and evidence based.
Perception of COVID-19 in Bangladesh: Interplays of Class and Capital
Authors: Begum Farhana
Published: January 2021

This article delineates the lay perceptions of COVID-19 pandemic in Bangladesh. More specifically, it discusses how people interpret the origin and transmission of COVID-19. Like the other countries of the world, this virus appeared as a new phenomenon in Bangladesh and is now known as coronarog. The transmission of this virus added new terms such as lockdown, quarantine, isolation, et cetera, to the popular discourse and produced a new experience. The high rates of infection and death caused by the virus have percolated fear and anxiety among people. Excessive fear about the disease has led to the stigmatisation of the disease and the infected. Drawing on observation, media reports and qualitative interviews, this article argues that laypeople use either a personalistic or a naturalistic explanation to make sense of the disease. Their explanations are associated with their access to different types of capital. This article contributes to medical anthropology literature on health and illness by explaining the cultural model of illness classification related to COVID-19.
Developments in the HRM–Performance Research stream: The mediation studies
Authors: Wood Stephen
Published: January 2021

Testing Human Resource Management (HRM)’s effect on organisational performance has been a core part of HRM research over the past 25 years. Whereas pioneering studies in the field neglected the mechanisms explaining this relationship, treating it as a ‘black box’, in the last decade the focus has been on examining the mediators of this relationship. Most recently, a series of reviews has been more critical of the field, particularly highlighting its diversity and underplaying of employee involvement, a concern central to its inception. This paper assesses these mediation studies in the light of these concerns, which provide criteria by which I summarise them and assess the extent to which they have advanced the field. The analysis demonstrates that the main problems of the black-box studies remain: the misalignment of the use of additive indexes and the theory of synergistic relationships, confusion over analysis methods, inadequate justification of the selection of practices in the empirical investigations, and under-representation of employee involvement. The researchers continue to present the field as a unified one. However, since the majority of studies are centred on high-performance work systems, there is a clear schism across them between these studies and those centred on high-involvement management. The paper reinforces the importance of this distinction, on the basis that a high-performance work system is a technology, a set of sophisticated personnel practices, whereas high-involvement management is a managerial philosophy or orientation towards fostering employee involvement. The paper concludes by suggesting ways of overcoming the recurring problems in HRM–performance research, and how these vary between the two perspectives.
Interstitial lung disease in systemic sclerosis quantification of disease classification and progression with high-resolution computed tomography: An observational study
Authors: Clukers Johan , Lanclus Maarten , Belmans Dennis , Van Holsbeke Cedric , De Backer Wilfried , Vummidi Dharshan , Cronin Paul , Lavon Ben R , De Backer Jan , Khanna Dinesh
Published: January 2021

Introduction:

Systemic sclerosis–associated interstitial lung disease accounts for up to 20% of mortality in these patients and has a highly variable prognosis. Functional respiratory imaging, a quantitative computed tomography imaging technique which allows mapping of regional information, can provide a detailed view of lung structures. It thereby shows potential to better characterize this disease.

Purpose:

To evaluate the use of functional respiratory imaging quantitative computed tomography in systemic sclerosis–associated interstitial lung disease staging, as well as the relationship between short-term changes in pulmonary function tests and functional respiratory imaging quantitative computed tomography with respect to disease severity.

Materials and methods:

An observational cohort of 35 patients with systemic sclerosis was retrospectively studied by comparing serial pulmonary function tests and in- and expiratory high-resolution computed tomography over 1.5-year interval. After classification into moderate to severe lung disease and limited lung disease (using a hybrid method integrating quantitative computed tomography and pulmonary function tests), post hoc analysis was performed using mixed-effects models and estimated marginal means in terms of functional respiratory imaging parameters.

Results:

At follow-up, relative mean forced vital capacity percentage change was not significantly different in the limited (6.37%; N = 13; p = 0.053) and moderate to severe disease (−3.54%; N = 16; p = 0.102) groups, respectively. Specific airway resistance decreased from baseline for both groups. (Least square mean changes −25.11% predicted ( p = 0.006) and −14.02% predicted ( p = 0.001) for limited and moderate to severe diseases.) In contrast to limited disease from baseline, specific airway radius increased in moderate to severe disease by 8.57% predicted ( p = 0.011) with decline of lower lobe volumes of 2.97% predicted ( p = 0.031).

Conclusion:

Functional respiratory imaging is able to differentiate moderate to severe disease versus limited disease and to detect disease progression in systemic sclerosis.
Consensus and entrepreneurship: The contrasting local and national politics of UK air pollution
Authors: Maltby Tomas
Published: January 2021

Air pollution in the UK has recently re-emerged as a major policy problem. Insights from the agenda-setting literature are used here to explain the extent to which air quality has become a national political issue, and a local issue in London. The article explores the development of a problem stream in which scientific experts and non-governmental actors have since the late 2000s, provided evidence related to the economic and particularly health costs of air pollution, and increasingly framed the problem as urgent. Key focusing events have also contributed to increasing media coverage and public concern. Explanations are offered for the limited policy response at the national level compared to London. The research is based on primary data which includes 16 elite interviews with key actors, manifestos from London Mayoral and UK general elections, and local and national government policy documents. In London there is broad cross-party consensus and relatively high public concern, and a mayor acting as a policy entrepreneur, able to build upon pre-existing congestion charging policy. In contrast, at the national level there is a shared understanding that air pollution constitutes a problem, but less consensus on its scale amongst the public and across political parties, fragmented policy making and responsibility for the issue and little agreement on the appropriate policy response.
Conflict, consent, dissensus: The unfinished as challenge to politics and planning
Authors: Pløger John
Published: January 2021

Public participation in planning politics is a legal right in many countries. Planners often see themselves as the defenders of public interests, whereas planning studies may see public planning as the institutionalization of politics, the politicized management or government of disputes on planning issues. Public participation is ultimately a political decision, and this article focuses on how phrases like planning is ‘a work in progress’ and agonistic consensus is a ‘solution for now’ in fact add a critical issue to planning politics: such statements indicate that planning should be seen as an unfinished process, and decisions as temporary. A ‘solution for now’ literally means a ‘planning for-the-time-being’ and a ‘coming-back-to’, highlighting that there are processual issues unresolved within planning praxis. Politics and planning cannot be separated. Two cases of urban planning conflict—the struggle of the homeless for shelter and the Occupy movement—show this: they are used to discuss how planning politics may benefit from having a temporary resting place and being unfinished.
Gender, households and sustainability: Disentangling and re-entangling with the help of ‘work’ and ‘care’
Authors: Murphy Joseph , Parry Sarah
Published: January 2021

In rich, developed countries, many stakeholders are focusing on households as settings where progress can be made on environmental and sustainability issues. Related research, policies and interventions, however, tend to ignore gender dynamics, thus treating them as irrelevant, or exploit them to achieve sustainability goals. We challenge this regressive treatment and show how household sustainability can be progressive in relation to gender and sustainability simultaneously – doubly progressive. Specifically, we ask: How do gender and sustainability intersect in households? What are the normative implications of these intersections? To answer these questions, we disentangle the perspectives of ‘work’ and ‘care’, drawing on feminist and gender scholarship, and explore both in the domestic setting by focusing on sustainable technologies and sustainable consumption. In this way, the twin normative agendas of equality of work and expansion of care emerge as ways of linking gender and sustainability in households. Our conclusion considers tensions and overlaps between work and care to identify how they can be re-entangled. We argue that re-entangling work and care requires holding them in dynamic tension with care being the context for work and in this way a doubly progressive approach to household sustainability emerges.
Alone laser versus bevacizumab plus laser for diffuse diabetic macular edema (ALBA randomized trial)
Authors: Pareja-Ríos Alicia , de Armas-Ramos Elena , Aldea-Perona Ana , Bonaque-González Sergio
Published: January 2021

Purpose:

To report the 12-month results of laser (treatment G1) versus intravitreal bevacizumab combined with laser (treatment G2) in patients with diffuse diabetic macular edema (DME).

Methods:

In this single-center randomized independent controlled trial, 32 patients were randomized to G1 ( n = 15) or G2 ( n = 17). In G1, laser was given at baseline and then pro re nata (PRN). In G2, three intravitreal bevacizumab (1.25 mg) injections were given once every 6 weeks, then laser and then PRN. Analysis was performed by treatment as administered. This study was registered in clinicaltrials.gov as NCT01572350 and EU Clinical Trial Registry as 2009-014654-15.

Results:

G2 was superior to G1 improving best corrected visual acuity (BCVA) with respect baseline (+8.0 vs + 3.0; p < 0.01). At month 12, a significantly greater proportion of patients had a BCVA letter score >15 and >73 in G2 (3 of 15 (20%) and 8 of 15 (53%), respectively) versus G1 (1 of 17 (6%) and 4 of 18 (23%), respectively). Health-related quality of life, assessed through National Eye Institute Visual Function Questionnaire, at 12 months was statistically indistinguishable between both groups.

Conclusion:

G2 provided superior visual acuity gains over G1 in patients with visual impairment due to center-involving diffuse DME, associated with significant gains in VFQ-25 scores.
Analysis of calendering process of non-isothermal flow of non-Newtonian fluid: A perturbative and numerical study
Authors: Khaliq S , Abbas Z
Published: January 2021

This paper numerically solves the third-order fluid flow during calendering with slip condition at the rolls. The basic equations are transformed into dimensionless forms and simplified by adopting LAT (Lubrication Approximation Theory). The flow equations are then solved with the perturbation technique. Whereas a finite difference scheme along with TDMA (Tridiagonal Matrix Algorithm) is implemented to solve the energy equation. Engineering parameters like power input, exit distance, and roll separating force are computed. The impact of slip parameter [Formula: see text] and material parameter [Formula: see text] on the velocity profile, pressure, pressure gradient, temperature profile, power input, detachment point, and roll separating force is portrayed through graphs and discussed. It is noticed that both the parameters [Formula: see text] and [Formula: see text] exhibit opposite behaviors and give insight to the mechanisms that control the physical and engineering parameters.
Linking the KIR phenotype with STAT3 and TET2 mutations to identify chronic lymphoproliferative disorders of NK cells
Authors: Pastoret Cédric , Desmots Fabienne , Drillet Gaëlle , Le Gallou Simon , Boulland Marie-Laure , Thannberger Alexia , Doncker Anne-Violaine , Salaun Véronique , Damaj Gandhi Laurent , Veyrat-Masson Richard , Tournilhac Olivier , Moignet Aline , Pangault Céline , Roussel Mikaël , Fest Thierry , Lamy Thierry
Published: January 2021

Distinguishing chronic lymphoproliferative disorders of NK cells (CLPD-NK) from reactive NK-cell expansion is challenging. We assessed the value of killer immunoglobulin-like receptor(KIR) phenotyping and targeted high-throughput sequencing in a cohort of 114 consecutive patients with NK cell proliferation, retrospectively assigned to a CLPD-NK group (n = 46) and a reactive NK group (n = 68). We then developed an NK-cell clonality score combining flow cytometry and molecular profiling with a positive predictive value of 93%. STAT3 and TET2 mutations were respectively identified in 27% and 34% of the patients with CLPD-NK, constituting a new diagnostic hallmark for this disease. TET2-mutated CLPD-NK preferentially exhibited a CD16low phenotype, more frequently displayed a lower platelet count, and was associated with other hematologic malignancies such as myelodysplasia. To explore the mutational clonal hierarchy of CLPD-NK, we performed whole-exome sequencing of sorted, myeloid, T, and NK cells and found that TET2 mutations were shared by myeloid and NK cells in 3 of 4 cases. Thus, we hypothesized that TET2 alterations occur in early hematopoietic progenitors which could explain a potential link between CLPD-NK and myeloid malignancies. Finally, we analyzed the transcriptome by RNA sequencing of 7 CLPD-NK and evidenced 2 groups of patients. The first group displayed STAT3 mutations or SOCS3 methylation and overexpressed STAT3 target genes. The second group, including 2 TET2-mutated cases, significantly underexpressed genes known to be downregulated in angioimmunoblastic T-cell lymphoma. Our results provide new insights into the pathogenesis of NK-cell proliferative disorders and, potentially, new therapeutic opportunities.
Identify RNA-associated subcellular localizations based on multi-label learning using Chou’s 5-steps rule
Authors: Wang Hao , Ding Yijie , Tang Jijun , Zou Quan , Guo Fei
Published: January 2021

Background

Biological functions of biomolecules rely on the cellular compartments where they are located in cells. Importantly, RNAs are assigned in specific locations of a cell, enabling the cell to implement diverse biochemical processes in the way of concurrency. However, lots of existing RNA subcellular localization classifiers only solve the problem of single-label classification. It is of great practical significance to expand RNA subcellular localization into multi-label classification problem.

Results

In this study, we extract multi-label classification datasets about RNA-associated subcellular localizations on various types of RNAs, and then construct subcellular localization datasets on four RNA categories. In order to study Homo sapiens, we further establish human RNA subcellular localization datasets. Furthermore, we utilize different nucleotide property composition models to extract effective features to adequately represent the important information of nucleotide sequences. In the most critical part, we achieve a major challenge that is to fuse the multivariate information through multiple kernel learning based on Hilbert-Schmidt independence criterion. The optimal combined kernel can be put into an integration support vector machine model for identifying multi-label RNA subcellular localizations. Our method obtained excellent results of 0.703, 0.757, 0.787, and 0.800, respectively on four RNA data sets on average precision.

Conclusion

To be specific, our novel method performs outstanding rather than other prediction tools on novel benchmark datasets. Moreover, we establish user-friendly web server with the implementation of our method.
Can indicators of myocardial damage predict carbon monoxide poisoning outcomes?
Authors: Koga Hitoshi , Tashiro Hideki , Mukasa Kouta , Inoue Tomohiro , Okamoto Aya , Urabe Shougo , Sagara Shuuichirou , Yano Kazumi , Onitsuka Kouhei , Yamashita Hisashi
Published: January 2021

Background

Carbon monoxide causes electrical, functional, and morphological changes in the heart. It is unclear, however, whether the indicators of myocardial damage can predict the patient’s prognosis after carbon monoxide poisoning. This retrospective study aimed to investigate the relationship between the carboxyhemoglobin level and electrocardiographic (ECG) changes and whether the ECG changes and troponin I levels are related to the patient’s prognosis after carbon monoxide poisoning.

Methods

Carboxyhemoglobin, troponin I, and ECG parameters were measured in 70 patients with carbon monoxide poisoning. The QT and RR intervals were measured for each ECG lead in all patients, and the corrected QT interval and corrected QT dispersion were calculated.

Results

The correlation between the maximum corrected QT interval and the carboxyhemoglobin level was significant (P = 0.0072, R2 = 0.1017), as were the relationships between QT dispersion and carboxyhemoglobin (P < 0.001, R2 = 0.2358) and the corrected QT dispersion and carboxyhemoglobin (P < 0.001, R2 = 0.2613). The multivariate logistic analysis showed that the significant predictors of sequential disability were corrected QT dispersion (P = 0.0042), and troponin I level (P = 0.0021).

Conclusions

Patients’ prognosis following carbon monoxide poisoning can be predicted based on corrected QT dispersion and the troponin I level. Patients with myocardial damage should be monitored not only for their cardiovascular outcome but also for their neurological outcome and their prognosis.
Age is not the only risk factor in COVID-19: the role of comorbidities and of long staying in residential care homes
Authors: D’ascanio M. , Innammorato M. , Pasquariello L. , Pizzirusso D. , Guerrieri G. , Castelli S. , Pezzuto A. , De vitis C. , Anibaldi P. , Marcolongo A. , Mancini R. , Ricci A. , Sciacchitano S.
Published: January 2021

Background

The actual SARS-CoV-2 outbreak caused a highly transmissible disease with a tremendous impact on elderly people. So far, few studies focused on very elderly patients (over 80 years old). In this study we examined the clinical presentation and the outcome of the disease in this group of patients, admitted to our Hospital in Rome.

Methods

This is a single-center, retrospective study performed in the Sant’Andrea University Hospital of Rome. We included patients older than 65 years of age with a diagnosis of COVID-19, from March 2020 to May 2020, divided in two groups according to their age (Elderly: 65–80 years old; Very Elderly > 80 years old). Data extracted from the each patient record included age, sex, comorbidities, symptoms at onset, the Pneumonia Severity Index (PSI), the ratio of the partial pressure of oxygen in arterial blood (PaO2) to the inspired oxygen fraction (FiO2) (P/F) on admission, laboratory tests, radiological findings on computer tomography (CT), length of hospital stay (LOS), mortality rate and the viral shedding.

The differences between the two groups were analyzed by the Fisher’s exact test or the Wilcoxon signed-rank test for categorical variables and the Mann-Whitney U test for continuous variables. To assess significance among multiple groups of factors, we used the Bonferroni correction.

The survival time was estimated by Kaplan-Meier method and Log Rank Test. Univariate and Multivariate logistic regression were performed to estimate associations between age, comorbidities, provenance from long-stay residential care homes (LSRCH) s and clinical outcomes.

Results

We found that Very Elderly patients had an increased mortality rate, also due to the frequent occurrence of multiple comorbidities. Moreover, we found that patients coming from LSRCHs appeared to be highly susceptible and vulnerable to develop severe manifestations of the disease.

Conclusion

We demonstrate that there were considerable differences between Elderly and Very Elderly patients in terms of inflammatory activity, severity of disease, adverse clinical outcomes. To establish a correct risk stratification, comorbidities and information about provenience from LSRCHs should be considered.
Identifying pre-outbreak signals of hand, foot and mouth disease based on landscape dynamic network marker
Authors: Zhang Xuhang , Xie Rong , Liu Zhengrong , Pan Yucong , Liu Rui , Chen Pei
Published: January 2021

Background

The high incidence, seasonal pattern and frequent outbreaks of hand, foot and mouth disease (HFMD) represent a threat for billions of children around the world. Detecting pre-outbreak signals of HFMD facilitates the timely implementation of appropriate control measures. However, real-time prediction of HFMD outbreaks is usually challenging because of its complexity intertwining both biological systems and social systems.

Results

By mining the dynamical information from city networks and horizontal high-dimensional data, we developed the landscape dynamic network marker (L-DNM) method to detect pre-outbreak signals prior to the catastrophic transition into HFMD outbreaks. In addition, we set up multi-level early warnings to achieve the purpose of distinguishing the outbreak scale. Specifically, we collected the historical information of clinic visits caused by HFMD infection between years 2009 and 2018 respectively from public records of Tokyo, Hokkaido, and Osaka, Japan. When applied to the city networks we modelled, our method successfully identified pre-outbreak signals in an average 5 weeks ahead of the HFMD outbreak. Moreover, from the performance comparisons with other methods, it is seen that the L-DNM based system performs better when given only the records of clinic visits.

Conclusions

The study on the dynamical changes of clinic visits in local district networks reveals the dynamic or landscapes of HFMD spread at the network level. Moreover, the results of this study can be used as quantitative references for disease control during the HFMD outbreak seasons.
Susceptibility pattern of Salmonella enterica against commonly prescribed antibiotics, to febrile-pediatric cases, in low-income countries
Authors: Khadka Priyatam , Thapaliya Januka , Thapa Shovana
Published: January 2021

Background

In most low-income countries, febrile-pediatric-cases are often treated empirically with accessible antibiotics without periodic epidemiological surveillance, susceptibility testing, or minimal lethal dose calculations. With this backdrop, the study was undertaken to evaluate the susceptibility trend of Salmonella enterica against the commonly prescribed antibiotics.

Methods

All isolates of Salmonella enterica were identified by standard protocols of biotyping and serotyping, then tested against antibiotics by the modified Kirby disk-diffusion method. Minimum Inhibitory Concentration (MIC) of isolates was determined by the agar-dilution method and compared with disk diffusion results and on nalidixic-acid sensitive/resistant strains.

Results

Among 1815 febrile-pediatric patients, 90(4.9%) isolates of Salmonella enterica [serovar: Salmonella Typhi 62(68.8%) and Salmonella Paratyphi A 28(31.1%)] were recovered. The incidence of infection was higher among males, age groups 5 to 9, and patients enrolling in the out-patient department (OPD). On the disk-diffusion test, most isolates were sensitive against first-line drugs i.e.cephalosporins, and macrolides. However, against quinolones, a huge percentile 93.3%, of isolates were resistant [including 58 Typhiand 26 Paratyphiserovar] while nearly 14% were resistant against fluoroquinolones.

When MICs breakpoint were adjusted as follows: 4 μg/ml for azithromycin, ≥1 μg/ml for ciprofloxacin, 2 μg/ml for ofloxacin, 8 μg/ml for nalidixic acid, and 1 μg/ml for cefixime, higher sensitivity and specificity achieved. Compared to other tested antibiotics, a low rate of azithromycin resistance was observed. Nevertheless, higher resistance against fluoroquinolones was observed on NARS strain.

Conclusion

Higher susceptibility of Salmonella enterica to the conventional anti-typhoidal drugs (amoxicillin, chloramphenicol, cotrimoxazole, cephotaxime) advocates for its reconsideration. Although, the lower susceptibility against fluoroquinolones among nalidixic-acid-resistant Salmonella (NARS) strain negates its empirical use among the study age group.
Low engagement in HIV services and progress through the treatment cascade among key populations living with HIV in Mozambique: alarming gaps in knowledge of status
Authors: Boothe Makini A. S. , Sathane Isabel , Baltazar Cynthia Semá , Chicuecue Noela , Horth Roberta , Fazito Erika , Raymond Henry F.
Published: January 2021

Background

Mozambique has a generalized HIV epidemic of 13.5% among the general population. Early modeling exercises in Mozambique estimate that key populations (KP), defined as men who have sex with men (MSM), female sex workers (FSW), and people who inject drugs (PWID), along with their partners account for about one third of all new infections. There is limited data describing the engagement of KP living with HIV in testing, care and treatment services.

Methods

We conducted a secondary data analysis of HIV-positive participants in the first Bio-behavioral Surveillance (BBS) surveys in Mozambique conducted 2011–2014 in order to assess service uptake and progress though the HIV treatment cascade among MSM, FSW, and PWID. Unweighted pooled estimates were calculated for each key population group.

Results

Among HIV-positive MSM, 63.2% of participants had ever received an HIV test, 8.8% were aware of their status, 6.1% reported having been linked to care, while 3.5% initiated ART and were currently on treatment. Of the HIV-infected FSW participants, 76.5% reported a previous HIV test and 22.4% were previously aware of their status. Linkage to care was reported by 20.1%, while 12.7% reported having initiated ART and 11.8% reported being on treatment at the time of the survey. Among HIV-infected PWID participants, 79.9% had previously received an HIV test, 63.2% were aware of their HIV status, and 49.0% reported being linked to care for their HIV infection. ART initiation was reported by 42.7% of participants, while 29.4% were on ART at the time of the survey.

Conclusion

Among the three high risk populations in Mozambique, losses occurred throughout critical areas of service uptake with the most alarming breakpoint occurring at knowledge of HIV status. Special attention should be given to increasing HIV testing and linkage to ART treatment. Future surveys will provide the opportunity to monitor improvements across the cascade in line with global targets and should include viral load testing to guarantee a more complete picture of the treatment cascade.
Empowerment and health care access barriers among currently married women in Myanmar
Authors: Htun Nang Mie Mie , Hnin Zar Lwin , Khaing Win
Published: January 2021

Background

Although Myanmar is moving to attain UHC in 2030, health care utilization indicators are still low, especially among women. Women’s health outcomes are determined by the lack of access to health care, and many factors influence this condition. The objective of the present work was to identify the association between women’s empowerment and barriers to accessing health care among currently married women in Myanmar.

Method

We performed a secondary analysis using the Myanmar Demographic and Health Survey (2015–16), including 7759 currently married women aged 15–49 years. The outcome variable, barriers to accessing health care, were asked about in terms of whether the respondent faced barriers to getting permission to go, getting money to go, the distance to the health facility, and not wanting to go alone. The variables were recoded into zero, one, and more than one barrier. After performing the exploratory factor analysis for women’s empowerment indicators (decision-making power and disagreement to justification to wife-beating), a multinomial logistic regression was carried out.

Results

Among currently married women, 48% experienced no barriers when accessing health care services, 21.9% had one barrier, and 30.1% had more than one barrier. After the exploratory factor analysis, scores were recoded into three levels. Women with low and middle empowerment had 1.5 odds (AOR 1.5, 95% CI: 1.2–1.8) and 1.5 odds (AOR 1.5, 95% CI: 1.3–1.9), respectively, to have barriers to accessing health care when compared to those with high empowerment for one barrier group. For the women who had more than one barrier, women with low empowerment were 1.4 times more likely (AOR 1.4, 95% CI: 1.1–1.7) to experience barriers in comparison to women with high empowerment. The barriers were seen to be reduced in the case of women who had a high level of education, had fewer children, came from rich households, and lived in urban areas.

Conclusion

When women are more empowered, they tend to face fewer barriers when accessing health care services. This finding could contribute to the policy formulation for reducing health inequity issues by increasing women’s empowerment.
The role of sexual compulsivity in unprotected intercourse among STI patients in Shanghai, China
Authors: Ni Yang , Liu Hengan , Gong Ruijie , Shi Mei , Zhang Shuxian , Wang Suping , Cai Yong
Published: January 2021

Background

Sexual compulsivity (SC) and its relationship with unprotected intercourse (UI) have long been an intriguing topic, but its existential meaning in the management of public health or, more precisely, sexually transmitted infections (STIs) has rarely been studied to date. This study examines whether SC plays a role in UI among sexually active STI patients.

Method

A cross-sectional study was conducted in two sexual transmitted disease (STD) clinicals of Shanghai Skin Diseases Hospital in Shanghai. Totally 664 sexually active STI patients were included.

Results

The ages of the 664 participants ranged from 18 to 76 years, with 58.73% between 26 and 40 years old. 449 (191 male and 258 female) reported had UI during the past 6 months. Although the only statistically significant difference (p < 0.01) was in relation to UI with a casual sexual partner, the difference between male/female and regular/casual sexual partners remained evident.

Conclusions

SC is evidently a potential predictor of UI with a casual sexual partner in male STI patients, while the use of condoms is more likely to be affected by other factors. In addition to general sexual education, counseling interventions should be provided by health institutions, and specific intervention methods targeting gender and sexual partners should be considered.
Socioeconomic disparity and the risk of contracting COVID-19 in South Korea: an NHIS-COVID-19 database cohort study
Authors: Oh Tak Kyu , Choi Jae-Wook , Song In-Ae
Published: January 2021

Background

The relationship between socioeconomic status and the risk of contracting coronavirus disease (COVID-19) remains controversial. We aimed to investigate whether socioeconomic status affected the risk of contracting COVID-19 in the South Korean population.

Methods

The NHIS-COVID-19 database cohort was used in this population-based study. We collected the data of COVID-19 patients who were diagnosed between January 1, 2020 and June 4, 2020 and those of the control population. The income levels of all individuals as of February 2020 were extracted, and study participants were classified into four groups based on quartiles: Q1 (the lowest) to Q4 (the highest). Data were statistically analyzed using multivariable logistic regression modeling.

Results

In total, 122,040 individuals—7669 and 114,371 individuals in the COVID-19 and control groups, respectively—were included in the final analysis. The multivariable logistic regression model showed that the Q1 group had a 1.19-fold higher risk of contracting COVID-19 than the Q4 group, whereas the Q2 and Q3 groups showed no significant differences. In the 20–39 years age group, compared with the Q4 group, the Q3 and Q2 groups showed 11 and 22% lower risks of contracting COVID-19, respectively. In the ≥60 years age group, compared with the Q4 group, the Q1, Q2, and Q3 groups showed a 1.39-, 1.29-, and 1.14-fold higher risks of COVID-19, respectively.

Conclusions

Lower socioeconomic status was associated with a higher risk of contracting COVID-19 in South Korea. This association was more evident in the older population (age ≥ 60 years), whereas both lower and higher socioeconomic statuses were associated with higher risks of contracting COVID-19 in the young adult population (in the 20–39 year age group). Strategies for the prevention of COVID-19 should focus on individuals of lower socioeconomic status and on young adults of higher and lower socioeconomic status.
An evaluation of obstetric ultrasound education program in Nepal using the RE-AIM framework
Authors: Kim Jieun , Shakya Prabin Raj , Choi Sugy , Park Joong Shin , Tamrakar Suman Raj , Heo Jongho , Kim Woong-Han
Published: January 2021

Background

Nepal has a high prevalence of congenital anomaly contributing to high infant mortality. Ultrasound, an important tool to detect congenital anomalies and manage maternity-related risk factors, is not properly used in Nepal because Nepali doctors have limited opportunities for learning ultrasound techniques. Hence, we developed and implemented an ultrasound education program from 2016 to 2018. The objective of this study is to evaluate the education program using the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework.

Methods

We conducted a mixed-method study to evaluate each component of RE-AIM. The team collected quantitative data from administrative records, tests, surveys, and an online follow-up survey. Qualitative data were collected from individual in-depth interviews at least a year after the program. The proportions, means, and t-tests were used for quantitative data, and thematic coding for qualitative data.

Results

A total of 228 healthcare workers representing 27.3% of the districts of Nepal were reached from 2016 to 2018. The program improved participants’ knowledge (29.3, 8.7, and 23.8 increases out of 100, each year, p< 0.001, n=85) and self-confidence (0.6, 0.3, 1.3 increases out of 4.0, p< 0.01, n=111). The participants were highly satisfied with the program (4.2, 4.1, and 4.0 out of 5.0, n=162). Among the respondents of the online follow-up survey (n=28), 60.7% had used ultrasound in their daily practice after the education program, and a medical institution established an ultrasound training center. The absence of clear accreditation and practical guidelines in ultrasound use were presented as barriers for adoption and maintenance.

Conclusion

The program was successful in improving participant’s knowledge and self-confidence in ultrasound techniques and showed great potential for the adoption and maintenance of the techniques in their practice. Continuous implementation of the program and institutional policy changes to facilitate ultrasound use may increase the ultrasound use and improve ultrasound service quality in Nepal.
Optimising the integration of technology-enabled solutions to enhance primary mental health care: a service mapping study
Authors: LaMonica Haley M. , Davenport Tracey A. , Ottavio Antonia , Rowe Shelley C. , Cross Shane P. , Iorfino Frank , Jackson Tanya A. , Easton Michael A. , Melsness Jennifer , Hickie Ian B.
Published: January 2021

Background

Despite the widely acknowledged potential for health information technologies to improve the accessibility, quality and clinical safety of mental health care, implementation of such technologies in services is frequently unsuccessful due to varying consumer, health professional, and service-level factors. The objective of this co-design study was to use process mapping (i.e. service mapping) to illustrate the current consumer journey through primary mental health services, identify barriers to and facilitators of quality mental health care, and highlight potential points at which to integrate the technology-enabled solution to optimise the provision of care based on key service performance indicators.

Methods

Interactive, discussion-based workshops of up to six hours were conducted with representative stakeholders from each participating service, including health professionals, service managers and administrators from Open Arms – Veterans & Families Counselling Service (Sydney), a counselling service for veterans and their families, and five headspace centres in the North Coast Primary Health Network, primary youth mental health services. Service maps were drafted and refined in real time during the workshops. Through both group discussion and the use of post-it notes, participants worked together to evaluate performance indicators (e.g. safety) at each point in the consumer journey (e.g. intake) to indicate points of impact for the technology-enabled solution, reviewing and evaluating differing opinions in order to reach consensus.

Results

Participants (n=84 across participating services) created service maps illustrating the current consumer journey through the respective services and highlighting barriers to and facilitators of quality mental health care. By consensus, the technology-enabled solution as facilitated by the InnoWell Platform was noted to enable the early identification of risk, reduce or eliminate lengthy intake processes, enable routine outcome monitoring to revise treatment plans in relation to consumer response, and serve as a personal data record for consumers, driving person-centred, coordinated care.

Conclusions

Service mapping was shown to be an effective methodology to understand the consumer’s journey through a service and served to highlight how the co-designed technology-enabled solution can optimise service pathways to improve the accessibility, quality and clinical safety of care relative to key service performance indicators, facilitating the delivery of the right care.
The product of trunk muscle area and density on the CT image is a good indicator of energy expenditure in patients with or at risk for COPD
Authors: Shirahata Toru , Sato Hideaki , Yogi Sanehiro , Inoue Kaiji , Niitsu Mamoru , Akagami Tomoe , Soma Machika , Mio Tomohiko , Nagata Makoto , Nakae Satoshi , Nishida Yuki , Tanaka Shigeho , Katsukawa Fuminori , Nakamura Hidetoshi
Published: January 2021

Background

Physical inactivity due to cachexia and muscle wasting is well recognized as a sign of poor prognosis in chronic obstructive pulmonary disease (COPD). However, there have been no reports on the relationship between trunk muscle measurements and energy expenditure parameters, such as the total energy expenditure (TEE) and physical activity level (PAL), in COPD. In this study, we investigated the associations of computed tomography (CT)-derived muscle area and density measurements with clinical parameters, including TEE and PAL, in patients with or at risk for COPD, and examined whether these muscle measurements serve as an indicator of TEE and PAL.

Methods

The study population consisted of 36 male patients with (n = 28, stage 1–4) and at risk for (n = 8) COPD aged over 50 years. TEE was measured by the doubly labeled water method, and PAL was calculated as the TEE/basal metabolic rate estimated by the indirect method. The cross-sectional areas and densities of the pectoralis muscles, rectus abdominis muscles, and erector spinae muscles were measured. We evaluated the relationship between these muscle measurements and clinical outcomes, including body composition, lung function, muscle strength, TEE, and PAL.

Results

All the muscle areas were significantly associated with TEE, severity of emphysema, and body composition indices such as body mass index, fat-free mass, and trunk muscle mass. All trunk muscle densities were correlated with PAL. The product of the rectus abdominis muscle area and density showed the highest association with TEE (r = 0.732) and PAL (r = 0.578). Several trunk muscle measurements showed significant correlations with maximal inspiratory and expiratory pressures, indicating their roles in respiration.

Conclusions

CT-derived measurements for trunk muscles are helpful in evaluating physical status and function in patients with or at risk for COPD. Particularly, trunk muscle evaluation may be a useful marker reflecting TEE and PAL.