bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seed Dispersal as a Search Strategy: Dynamic and Fragmented Landscapes Select for Multi-scale Movement Strategies in Plants
Authors: Treep Jelle , de Jager Monique , Bartumeus Frederic , Soons Merel B. 
Published: November 2020

Abstract
Background – Plant dispersal is a critical factor driving ecological responses to global changes. Knowledge on the mechanisms of dispersal is rapidly advancing, but selective pressures responsible for the evolution of dispersal strategies remain elusive. Recent advances in animal movement ecology identified general strategies that may optimize efficiency in animal searches for food or habitat. Here we explore the potential for evolution of similar general movement strategies for plants.Methods – We propose that seed dispersal in plants can be viewed as a strategic search for suitable habitat, where the probability of finding such locations has been optimized through evolution of appropriate dispersal kernels. Using model simulations, we demonstrate how dispersal strategies can optimize key dispersal trade-offs between finding habitat, avoiding kin competition, and colonizing new patches. These trade-offs depend strongly on the landscape, resulting in a tight link between optimal dispersal strategy and spatiotemporal habitat distribution.Results – Our findings reveal that multi-scale seed dispersal strategies that combine a broad range of dispersal scales, including Lévy-like dispersal, are optimal across a wide range of dynamic and patchy landscapes. At the extremes, static and patchy landscapes select for dispersal strategies dominated by short distances, while uniform and highly unpredictable landscapes both select for dispersal strategies dominated by long distances.Conclusions – By viewing plant seed dispersal as a strategic search for suitable habitat, we provide a reference framework for the analysis of plant dispersal data. Consideration of the entire dispersal kernel, including distances across the full range of scales, is key. This reference framework helps identify plant species’ dispersal strategies, the evolutionary forces determining these strategies and their ecological consequences, such as a potential mismatch between plant dispersal strategy and altered spatiotemporal habitat dynamics due to land use change. Our perspective opens up directions for future studies, including exploration of composite search behaviour and ‘informed searches’ in plant species with directed dispersal.
Effect of Female Sex Work Targeted Community-based Interventions Along the HIV Treatment Cascade in Sub-Saharan Africa: A Systematic Review and Meta-analysis
Authors: Atuhaire Lydia , Adetokunboh Olatunji , Shumba Constance , Nyasulu Peter S 
Published: November 2020

Abstract
Background: Female Sex Workers are extremely vulnerable and highly susceptibility to being infected with human immunodeficiency virus. As a result, community based targeted interventions have been recommended as one of the models of care to improve access to HIV services and continued engagement in care. However little is known about the specific community intervention packages that have optimal effect on FSWs access and retention in HIV care. This paper synthesized evidence on the effectiveness of community-based interventions that provided HIV services to FSWs across all stages of HIV care cascade.Methods: We defined the 5 steps that make up the HIV care cascade and categorized them as outcomes, namely HIV testing, HIV diagnosis, linkage to care, ART use and viral suppression. We conducted a systematic search of randomized controlled trials, cohort and cross sectional studies done in sub-Saharan African countries and published from 2004 to 2020. We reviewed studies with data on the implementation of community interventions for any of the HIV care cascade stage. The data were analyzed using random effects meta-analysis where possible and for the rest of the studies, data were synthesized using summary statistics. Results: The significant impact of the community interventions was observed on HIV testing, HIV diagnosis and ART use. However, for HIV testing and ART use, the improvement was not sustained for the entire period of implementation. There were minimal interventions that had impact on HIV diagnosis, with only one community service delivery model showing significance. Generally, the interventions that had reasonable impact are those that implemented targeted and comprehensive package of HIV services provided at one location, and with unique strategies specific to each cascade stage.Conclusions: The effect of community-based interventions varies across the different stages of HIV care cascade with impact observed in specific strategies with features unique to each cascade stage. Moreover, positive effects of these strategies were short term and with small-scale implementation. As such, the information on long-term treatment outcomes, and the extent to which FSWs remain engaged in care is sparse. There is need to conduct a further research to deepen the assessment of the effectiveness of community-based interventions on HIV care cascade for FSWs. This will enhance identification of evidence based optimal interventions that will guide effective allocation of scarce resources for strategies that would have a significant impact on HIV service delivery.Systematic review registration: PROSPERO CRD42020157623.
Neonatal Septicaemia in Sub-Saharan Africa: A Protocol for Systematic Review and Meta-analysis.
Authors: Alao Micheal Abel , Tongo Oluwakemi O , Ayede Idowu Adejumoke , Diala Michael Udochukwu , Ibrahim Olayinka Rasheed , Gbadero Daniel A , Nna Emmanuel Okechukwu , Slusher Tina M 
Published: November 2020

Abstract
Background: The morbidity and mortality from neonatal septicaemia (NNS) in low-middle income country remain high at the background of strained health care delivery system.The burden, pooled risks and outcomes of NNS are largely unknown. We aimed to produce a protocol for synthesizing evidence from available data for neonatal septicaemia in sub-Saharan Africa.Methods: We developed a search strategy using MeSH, text words and entry terms. Nine databases will be searched: PubMed, Embase, CINAHL, AJOL, Google Scholar, Web of Science, Cochrane Library, Research gate and Scopus. Only Observational studies retrievable in the English Language will be included. The primary measurable outcome is the proportion of neonatal with septicaemia while secondary outcomes include proportion of bacterial isolates and their antibiogram, risk factors for NNS, in hospital mortality, length of hospital stay, frequency of necrotizing enterocolitis and other sequel . All identified studies will be screened based on the inclusion criteria. Data will be deduplicated in Endnote version 9, before exporting to Rayyan QCRI for screening. Extractable data will include first author’s name and year of publication, the country and regions in sub-Saharan Africa, total neonatal admissions, number with sepsis, the sample size, bacterial isolates, antibiogram, in-hospital mortality, length of hospital stay and frequency of necrotizing enterocolitis.All studies will be assessed for methodological, clinical and statistical heterogeneity. The NIH Quality assessment tool for observational studies and the Cochrane tool of risk of bias will be used to assess for the strength of evidence. Publication bias will be assessed using the funnel plot.Discussion: Results will be presented as the prevalence, standard error and confidence interval of newborns with neonatal septicaemia in sub-Saharan Africa. Subgroup analysis using categorical data such as risk factors, bacterial isolates, antibiogram and outcomes of neonatal septicaemia will also be reported. A cumulative meta-analysis will be done to assess the time trend of the risk factors, pathogens and antibiogram.The CMA version 3 will be used for statistical analysis. Results will be presented in forest plots.Systematic Review Registration: This protocol is registered in PROSPERO, registration number CRD42020219604.
A Near-Peer Surgical Teaching Programme for Junior Doctors
Authors: Hussain Shoaib Fahad , Toi Teri Hsiao Hsui , Laurent Edward Peter , Seraj Shaikh Sanjid , Samer-ul-Haque  
Published: November 2020

Abstract
Background: Surgical departments across the UK are having to mitigate increasing service demands, budget constraints and changes to work patterns, with their statutory duty to provide high-quality training and education. In an overstretched NHS, securing consultant-led teaching for junior doctors has become increasingly difficult leading to the rise of near-peer teaching. We evaluate the long-term effectiveness of a near-peer surgical teaching programme for junior doctors. Methods: We developed a rolling 12-week trainee-led, didactic surgical education programme for junior doctors and incorporated a three-tiered leadership and handover mechanism involving lead junior doctors, registrars and a lead consultant to ensure consistency and programme continuity. Junior doctors delivered presentations to their peers with close supervision and input from registrars. Participants provided session and supervision feedback using 5-point scales and free-text responses. Data was collected using Google Forms™ and analysed using student’s t-test on Microsoft Excel®. Results: 42 junior doctors responded to our end-of-programme feedback surveys covering December 2018 to April 2020. The overall programme (8.83±1.08/10), topic relevance (4.62±0.58/5), presentation quality (4.60±0.50/5) and supervisor knowledge (4.81±0.40/5) were rated highly by respondents. 95.2% (n=40) of respondents had attended more than 3 sessions and 71.4 % (n=30) had delivered teaching. Respondents also reported significant improvements in subject knowledge (3.72±0.92/5 to 4.50±0.56/5, P<0.0001), clinical confidence, presentation and teaching skills following each session. Conclusions: This long-term near-peer teaching programme addressed the educational needs of junior doctors and developed their presentation and organisational skills. Supervision and input from registrars facilitated discussion and reinforced key concepts. Our strategy also facilitated workplace-based assessments and familiarisation with local management protocols for new cohorts of doctors rotating in Surgery at Basildon University Hospital. We also recently adapted this into a virtual programme in response to the COVID-19 pandemic, maintaining clinical education and expanding our audience. The success of this programme highlights the role that trainees can play in designing, developing and coordinating an effective surgical teaching programme.
No Difference in Effects of ‘PACE Steps to Success’ Palliative Care Program for Nursing Home Residents With and Without Dementia: A Pre-Planned Subgroup Analysis of the Seven-Country PACE Trial
Authors: Miranda Rose , Smets Tinne , Noortgate Nele Van Den , Steen Jenny T. van der , Deliens Luc , Payne Sheila , Szczerbińska Katarzyna , Pautex Sophie , Humbeeck Liesbeth Van , Gambassi Giovanni , Kylänen Marika , Block Lieve Van den 
Published: November 2020

Abstract
Background ‘PACE Steps to Success’ is a multicomponent training program aiming to integrate generalist and non-disease-specific palliative care in nursing homes. This program did not improve residents’ comfort in the last week of life, but it appeared to improve quality of care and dying in their last month of life. Because this program included only three dementia-specific elements, its effects might differ depending on the presence or stage of dementia. We aimed to investigate whether the program effects differ between residents with advanced, non-advanced, and no dementia.Methods Pre-planned subgroup analysis of the PACE cluster-randomized controlled trial in 78 nursing homes in seven European countries. Participants included residents who died in the previous four months and had advanced (n=104 to 177), non-advanced (n=110 to 167) or no dementia (n=137 to 157). The nursing home staff or general practitioner assessed the presence of dementia; severity was determined using two highly-discriminatory staff-reported instruments. Using after-death questionnaires, staff assessed comfort in the last week of life (Comfort Assessment in Dying–End-of-Life in Dementia-scale; primary outcome) and quality of care and dying in the last month of life (Quality of Dying in Long-Term Care scale; secondary outcome).Results We found no subgroup differences on comfort, comparing advanced versus without dementia (baseline-adjusted mean sub-group difference 2.1; p-value=0.177), non-advanced versus without dementia (2.7; p=0.092), and advanced versus non-advanced dementia (-0.6; p=0.698); or on quality of care and dying, comparing advanced and without dementia (-0.6; p=0.741), non-advanced and without dementia (-1.5; p=0.428), and advanced and non-advanced dementia (0.9; p=0.632).Conclusions The lack of subgroup difference suggests that while the program did not improve comfort in dying residents with or without dementia, it appeared to equally improve quality of care and dying in the last month of life for residents with dementia (regardless of the stage) and those without dementia. A generalist and non-disease-specific palliative care program, such as PACE Steps to Success, is a useful starting point for future palliative care improvement in nursing homes, but to effectively improve residents’ comfort, this program needs further development.Trial registration. ISRCTN, ISRCTN14741671. Registered 8 July 2015 – Retrospectively registered.http://www.isrctn.com/ISRCTN14741671
Facilitating Factors for Implementing Multigenerational Exchanges in Regional Locations: A Cross-sectional Study in Niigata City, Japan
Authors: Morita Kumiko , Kobayashi Minako , Aoki Rieko , Nagamine Hitomi , Yamamoto Harumi , Ohtake Fumi , Hoki Mika , Sumita Hiroko , Maruyama Kayo , Mitsuhashi Kayoko , Sasaki Akiko 
Published: November 2020

Abstract
Background: In the process of community building, it is important to create a place for multigenerational exchanges. To consider the promotion of multigenerational exchanges in regional locations, it is important to clarify whether operational systems, regional characteristics, and social capital are related to the implementation of multigenerational exchanges and how these exchanges contribute to community building.Methods: The participants were representatives from 455 Chiiki no Cha-no-Ma (hereafter “Cha-no-Ma”), and the study was implemented in Niigata City, Japan. There were 405 responses (a response rate of 89.0%), with the analytical target being the 401 locations that agreed to participate in the study. A cross-sectional study based on a self-assessment questionnaire method was implemented, and questionnaires were returned directly to the researchers after completion. The survey details included basic information (e.g., date of establishment, frequency of meetings, number of managers and users, qualification of the representative, etc.); characteristic of regional activities; a Social Capital Scale; the effects of the Cha-no-Ma being implemented by the representative (12 items); challenges for management (16 items); and the implementation of multigenerational exchanges.Results: The items that had a significant connection to the implementation of multigenerational exchanges were “Frequency of meetings” (p < 0.001) and “Characteristic regional activities” (p = 0.026). With the relevant factors, a binomial logistic regression analysis was conducted, and the odds ratio for those with a high frequency of meetings was 3.839.There was a significantly higher ratio of the implementation of multigenerational exchanges when the effects were a “connection with the region” (p = 0.006) and “conversations with different generations” (p = 0.004). There was a significantly higher ratio of the implementation of multigenerational exchanges when the challenge was “no support from residents” (p = 0.002).Conclusions: To promote multigenerational exchanges in regional locations, meetings should be held at least once a week, with qualified personnel and the use of regional activities such as making local foods and festivals. It is clear from this community-based study that the implementation of multigenerational exchanges is an important activity for community building because it is related to connection within the community.
Occupational risk factors for shoulder chronic tendinous pathology in the Spanish automotive manufacturing sector: a case-control study.
Authors: DIEZ-CABALLERO BEATRIZ RODRIGUEZ , Alfonso-Beltran Joaquin , Bautista Iker J. , Barrios Carlos 
Published: November 2020

Abstract
Background: Musculoskeletal Diseases (MSDs) are among the most prevalent health problems encountered in the workforce in Europe. Multiple risk factors contribute to their onset. In the present study, different individual risk factors for chronic tendinous pathology affecting the shoulder were analysed in a sample of workers from the automotive manufacturing sector.Methods: An observational retrospective study was conducted with 73 cases of officially recognised and compensated occupational diseases and 94 aleatory cases of healthy workers from the same car assembly company. The experimental group comprised individuals with tendinous chronic pathology of the rotator cuff. Multiple variables that identified the risks present in the job were assessed along with participants clinical evaluation. Furthermore, two standardised guidelines for risk factors assessment were also used: the Spanish National Institute of Social Security (INSS) and the American Occupational Information Network (O*Net). Both descriptive statistical analysis and Odds ratios calculations considering the occupational disease as a dependent variable were performed.Results: The use of hand tools, exposure to mechanical pressure in the upper limbs and awkward postures were the most prevalent risk factors. Pressure on the palm of the hand and the hand tool impacting the hand were also important risk factors. Some psychosocial factors such as lack of autonomy and mental workload were also associated shoulder tendinous diseases. The association of age, load handling, and awkward postures were the core risk factors responsible for most of the tendinous chronic injuries of the shoulder in this sample of car assembly workers.Conclusions: Both ergonomic and psychosocial factors were present and increased the risk of developing occupational chronic tendinopathies at the shoulder in this sample of workers. Aging, load handling, and awkward postures showed the strongest predictive values. Greater knowledge of how risk factors interact would facilitate the design of better preventive workplace strategies.
Knowledge and perception of COVID-19 pandemic. Before-and-after online community survey.
Authors: Nazar Wojciech , Leszkowicz Julia , Pieńkowska Agata , Brzeziński Michał , Szlagatys-Sidorkiewicz Agnieszka , Plata-Nazar Katarzyna Gabriela 
Published: November 2020

Abstract
Background COVID-19 pandemic impacts many communities worldwide. In this study the Poles' knowledge about COVID-19 as well as people’s behaviours, attitudes and fears during the pandemic were assessed. Changes in these between the outset of the pandemic and the imposition of the strictest lockdown measures in Poland were investigated.Methods Physicians, nurses, students of medicine-oriented faculties, non-medical professionals, students of non-medicine-oriented faculties and secondary school students were surveyed by an anonymous online questionnaire two times: at the onset of the pandemic and in the second week of the strictest lockdown. Statistical analyses were performed using non-parametric tests – Pearson Chi Square, Kruskal-Wallis tests.Results In total 2618 responses were collected. At the beginning people knew that the respiratory system was attacked (97.9%); correctly identified the major symptoms of COVID-19 (95.0%) and ways to prevent infection: hand washing (99.8%), covering mouth (85.9%) and the need to call sanitary-epidemiological services if one experienced COVID-19-like symptoms (92.1%).The biggest changes between the first and second phase of the study concerned behaviours: more people wearing facial masks (+37.5%) and staying at home (+66.1%). Respondents in the second wave of the survey were also more scared of the pandemic (+19.6%), economic crisis (+64.1%), and worried about their families (+26.5%). However, they were less afraid of the quarantine (lockdown) (-18.2%). Nurses and physicians were the most worried groups.Conclusions The study showed that even at the outset of the pandemic Polish population had a good initial knowledge about symptoms, transmission, and preventive behaviours regarding COVID-19. People revealed more short-term concerns, such as the worries about coping with quarantine and isolation. After a month, the knowledge and the concerns among the respondents changed. A shift towards long-term pandemic management issues was observed. Respondents reported to experience more fears concerning the pandemic in general, as well as economic and healthcare crises. Medical professionals reported higher level of fear of the pandemic than other groups included in this study. This study uses before-and-after approach which highlights the changes in people’s knowledge and perception of the COVID-19 pandemic during the pandemic’s progression.
The Evaluation of stomatology English Education in China Based on ‘Guanghua Cup’ International Clinical Skill Exhibition Activity
Authors: Wang Xi , Liu Yangjingwen , Yang Le , Zhou Kai , Cao Yang , Hong Yun , Huang Shuheng , Lin Zhengmei 
Published: November 2020

Abstract
Background: English education in professional areas has become more and more important with the increasing internationalization of health profession education in countries around the world. In this study, we aimed to evaluate current Chinese stomatology English education based on Chinese participants’ ability to apply stomatology English during an international stomatology skill competition called the ‘Guanghua Cup activity’.Methods: The registration rate of English and Chinese volunteers and the answer rate and accuracy of Chinese and international contestants on the English knowledge quiz were statistically described. A five-point Likert scale questionnaire was delivered to all participants. The data were analyzed using the Spearman test, Kruskal-Wallis rank sum test and Mann-Whitney U test.Results: Among the 194 students, the English and Chinese volunteer registration rate was 7.73% and 30.93%, respectively. The answer rate of Chinese contestants and international contestants in the English quiz was 25% and 75%, with an accuracy rate of 50% and 66.70%, respectively. The questionnaire was graded by Likert five-level classification. There was a positive correlation between the use of English textbooks in classes and the communication with international teachers and students in the competition (Rs=0.348, p=0.016). English volunteers had more preparation in English before the competition, more opportunities to communicate with international peers, and greater improvement in English ability than the contestants and Chinese volunteers(p<0.001). After the competition, all participants paid more attention to stomatology English (p<0.001).Conclusions: Chinese stomatology students have difficulty in stomatology English application. The ‘Guanghua Cup’ helps to improve English proficiency of English volunteers and arouses the interest of stomatology English for all participants. Chinese stomatology school needs to strengthen and reach a consensus in stomatology English education.