bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accountable Communities of Health, Health and Social Service Systems Alignment, and Population Health: Eastern Washington State, 2017–2019
Authors: Bultema Stephanie , Morrow Hadley , Wenzl Stacy 
Published: July 2020

Objectives. To assess health system transformation and alignment in the Better Health Together (BHT) accountable community of health (ACH) region of Eastern Washington. Methods. This trend study leveraged cross-sectional data collected in 2017 and 2019 in Eastern Washington. A total of 165 responses from individuals representing 112 organizations were collected in 2017, and 211 responses from individuals representing 92 organizations were collected in 2019. More than one third (38%; n = 35 organizations) of cases overlapped between the 2 samples. Implementation of the ACH model is the exposure. Outcomes of interest included indicators of system transformation and alignment. Results. Organizations throughout BHT’s region became more engaged, less siloed, and better connected from 2017 to 2019. At least some of the increased connectivity observed was directly attributable to the role BHT played in facilitating the creation or maintenance of interorganizational relationships across Eastern Washington. Conclusions. The ACH model is a promising approach to aligning health and social service systems for population health improvement. Evidence shows that ACH organizations can serve as trusted conveners able to facilitate interorganizational relationships across sectors.
Methods for Testing Ontogenetic Changes of Neanic Chamberlets in Lepidocyclinids
Authors: Hohenegger Johann , Torres Silva Ana I. 
Published: July 2020

ABSTRACTThe shapes of neanic chamberlets in equatorial sections of lepidocyclinids can be described by a set of measurements, allowing their complete geometric reconstruction. The approach provides the base for further investigation of test growth (including environmental perturbations of growth) of species determined by their nepionts. Ontogenetic changes in neanic chambers can be demonstrated using the character averages of annular rows calculated over row numbers. Fitting by regression analyses, function constants can then be used as growth-independent traits characterizing the growth of lepidocyclinid species after the development of their embryonic apparatus’.
Constraining the Role of Shell Porosity in the Regulation of Shell Calcification Intensity in the Modern Planktonic Foraminifer Orbulina Universa d'Orbigny
Authors: Weinkauf Manuel F. G. , Zwick Mike M. , Kučera Michal 
Published: July 2020

ABSTRACT
Porosity in planktonic foraminifers (the proportion of the shell surface covered by pores) is a conspicuous quantitative trait, well preserved in fossil shells and implicated as a source of environmental information. Despite its potential, the functional importance of porosity remains poorly understood. It is likely that pores are important in gas exchange, and differences in shell porosity among species or within species may reflect differences in metabolic rates or ambient oxygen concentration. Theoretically, porosity also affects the weight of the shell; and differences in porosity may reflect an adaptation to the specific density of the seawater or differences in allocation of resources to calcification (shell calcification intensity). Finally, there is evidence that porosity may differ between closely related cryptic species. Here we analyzed the potential role of porosity as a regulator of calcification intensity in Orbulina universa by combining biometric measurements based on sediment surface samples from the western Atlantic with a modelling approach. Specimens of O. universa were analyzed concerning their shell size, shell thickness, and shell porosity under light and scanning electron microscopy, and weighed using a microbalance. The resulting empirically derived model shows an effect size of shell thickness that is 7.5 times larger than the effect of shell porosity on the overall shell calcification intensity. This indicates that porosity is unlikely to be used by this species to regulate calcification intensity. By implementing the model on literature data which analyzed calcification intensity in O. universa, we also show that porosity differences among cryptic species in O. universa are unlikely to explain the observed differences in calcification intensity within the species. These findings indicate that functional explanations for differences in porosity in planktonic foraminifers have to be sought outside of calcification or density regulation and, conversely, that the observed differences in calcification intensity are likely driven by shell thickness and their relationship with environmental forcing can be applied without correction for porosity.
Trace Element Heterogeneity Across Individual Planktic Foraminifera from the Modern Cariaco Basin
Authors: Davis Catherine V. , Fehrenbacher Jennifer S. , Benitez-Nelson Claudia , Thunell Robert C. 
Published: July 2020

ABSTRACT
The trace element composition of planktic foraminifera shells is influenced by both environmental and biological factors (‘vital effects’). As trace elements in individual foraminifera shells are increasingly used as paleoceanographic tools, understanding how trace element ratios vary between individuals, among species, and in response to high frequency environmental variability is of critical importance. Here, we present a three-year plankton tow record (2010–2012) of individual shell trace element (Mg, Sr, Ba, and Mn) to Ca ratios in the planktic species Globigerina ruber (pink), Orbulina universa, and Globorotalia menardii collected throughout the upper 100 m of Cariaco Basin. Plankton tows were paired with in situ measurements of water column chemistry and hydrography. The Mg/Ca ratio reflects different calcification temperatures in all three species when calculated using species-specific temperature relationships from single-species averages of Mg/Ca. However, individual shell Mg/Ca often results in unrealistic temperate estimates. The Sr/Ca ratios are relatively constant among the four species. Ratios of Mn/Ca and Ba/Ca are highest in G. menardii and are not reflective of elemental concentrations in open waters. The Mn/Ca ratio is elevated in all species during upwelling conditions, and a similar trend is demonstrated in Neogloboquadrina incompta shells from the California margin collected during upwelling periods. Together this suggests that elevated shell Mn/Ca may act as a tracer for upwelling of deeper water masses. Our results emphasize the large degree of trace element variability present among and within species living within a limited depth habitat and the roles of biology, calcification environment, and physical mixing in mediating how trace element geochemistry reflects environmental variability in the surface ocean.
Serum 25 hydroxyvitamin D levels and affecting factors among preconception fertile women
Authors: Fan Haiyan , Hui Lingyun , Yan Xiaoting , Hou Wei , Bai E , Wang Li , Yu Xuewen 
Published: July 2020

Abstract
Background: Recent study found that vitamin D before conception was considered as a potential additional determinant for achieving pregnancy and live births. The study aimed to evaluate the serum 25 hydroxyvitamin D (25(OH)D) levels and its affecting factors among preconception fertile women. Methods: This cross-sectional study enrolled 410 women aged 22-44 years who attended a preconception genetic counseling clinic from January 2018 to May 2019. Sociodemographic characteristics and reproductive history of women were collected, and height and weight were measured. Serum 25(OH)D concentration was assayed with chemiluminescence immunoassay. Descriptive statistics were used to examine serum 25(OH)D concentration, and socio-demographic characteristics and reproductive history among preconception women. Determinants of vitamin D deficiency and its affecting factors were assessed using χ2 test. Results: Findings showed 84.4% of women had serum 25(OH)D concentration below 20 ng/mL. Women working indoors as well as without a history of childbirth had significantly lower 25(OH)D levels compared with those non-working individuals and having delivered a previous child (both P <0.05). The 25(OH)D levels were the lowest in winter than in spring, summer, and autumn (all P <0.001). Women in winter have significantly elevated OR of 5.00 (95%CI 1.75–14.25) to develop vitamin D deficiency. Seasonal variation in serum 25(OH)D levels was not present in non-working individuals and women aged 31-44 years. Conclusions: Vitamin D deficiency is common among preconception women especially nulliparous women and working women, which propose to screen serum 25(OH)D on preconception evaluation and emphasize need vitamin D supplements and get sunshine exposure.
The Effect of Air Pollution and Temperature on Pulmonary Function in Healthy People in Xi’an, China
Authors: Yao Yang , Zhou Jing , Tian Yao , Zhang Hongmei , Diao Xin , Chen Hui , Zhang Jinzhao , Wang Shengyu 
Published: July 2020

Abstract
Background: Temperature and air pollution has been reported to be associated with respiratory diseases. However, little is known about these effects on healthy people, and the potential interaction between the two factors is still uncertain. This study aims to estimate the effects of air pollution combined with temperature on lung function in healthy people. Methods: The lung function of 428 healthy people was measured in Xi’an, Shaanxi province of Northwest China in summer and winter. Meanwhile, the daily concentrations of air pollution and temperature were obtained from monitoring stations. Statistical analyses were assessed by generalized estimating equations (GEEs). Results: In winter, Every 10μg/m 3 increase of PM 2.5 concentration, PEF change amount is -0.015L/S(-0.028,-0.002), FEV1 is -0.007 L/S(-0.012,-0.001). The change is -0.022(-0.043,-0.001) and -0.010(-0.011,-0.009) after adjusting for SO 2 . In summer, PEF and FEV1 were were negatively correlated with the concontration of O3. We also found that temperature weaken the adverse effect of PM 2.5 on lung PEF in winter but aggravated effect of O3 on FEV1 in summer. Lag effects showed that Lag0 of FEV1, FEV1/FVC and FEF25-75% were more strongly associated with PM 2.5 . Conclusions: Our findings indicate that Lung function was significantly negative correlated with O3 in summer and PM 2.5 in winter, and a higher temperature has a greater impact on lung function in both summer and winter in Xi’an.
Respiratory, birth and health economic measures for use with Indigenous Australian infants in a research trial: A modified Delphi with an Indigenous panel
Authors: Perkes Sarah Jane , Bonevski Billie , Mattes Joerg , Hall Kerry , Gould Gillian 
Published: July 2020

Abstract
Background: There is significant disparity between the respiratory health of Indigenous and non-Indigenous Australian infants. There is no culturally accepted measure to collect respiratory health outcomes in Indigenous infants. The aim of this study was to gain end user and expert consensus on the most relevant and acceptable respiratory and birth measures for Indigenous infants at birth, between birth and 6 months, and at 6 months of age follow-up for use in a research trial. Methods: A three round modified Delphi process was conducted from February 2018 to April 2019. Eight Indigenous panel members, and 18 Indigenous women participated. Items reached consensus if 7/8 (≥80 %) panel members indicated the item was ‘very essential’. Qualitative responses by Indigenous women and the panel were used to modify the 6 months of age surveys. Results: In total, 15 items for birth, 48 items from 1 to 6 months, and five potential questionnaires for use at 6 months of age were considered. Of those, 15 measures for birth were accepted, i.e., gestational age, birth weight, Neonatal Intensive Care Unit (NICU) admissions, length, head circumference, sex, Apgar score, substance use, cord blood gas values, labour, birth type, health of the mother, number people living in the home, education of mother and place of residence. Seventeen measures from 1-to 6 months of age were accepted, i.e., acute respiratory symptoms (7), general health items (2), health care utilisation (6), exposure to tobacco smoke (1) and breastfeeding status (1). Three questionnaires for use at 6 months of age were accepted, i.e., a shortened 33-item respiratory questionnaire, a clinical history survey and a developmental questionnaire. Conclusions: In a modified Delphi process with an Indigenous panel, measures and items were proposed for use to assess respiratory, birth and health economic outcomes in Indigenous Australian infants between birth and 6 months of age. This initial step can be used to develop a set of relevant and acceptable measures to report respiratory illness and birth outcomes in community based Indigenous infants.
Prevalence and Predictors of Anxiety and Depressive Symptoms among Patients Diagnosed with Oral Cancer in China: A cross-sectional study
Authors: Yuan Lulu , Pan Bochen , Wang Weiren , Wang Lie , Zhang Xujie , Gao Yuqin 
Published: July 2020

Abstract
Background Anxiety and depression are common mental health problems among patients with cancer. While many psychological variables have been proven to influence anxiety and depressive symptoms, the variables are not mutually exclusive and their integrated effects on patients with oral cancer are yet unknown. The present study aims to explore the prevalence of anxiety and depressive symptoms among patients with oral cancer, to find out key potentially predictive factors associated with anxiety and depressive symptoms. Method A cross-sectional study was carried out for Chinese patients with oral cancer between May 2016 and October 2017 in two Grade-A Tertiary Hospitals in Shenyang, China. 230 patients with oral cancer were interviewed with questionnaires on demographic variables, Zung Self-Rating Anxiety Scale (SAS), Center for Epidemiologic Studies Depression Scale (CES-D), Herth Hope Index (HHI), Social Impact Scale, Multidimensional Scale of Perceived Social Support (MSPSS), Revised Life Orientation Test (LOT-R), Perceived Stress Scale-10 (PSS-10), and General Perceived Self-efficacy Scale(GSE). Chi-square test, nonparametric test, t-test and logistic regression analyses were conducted where appropriate to explore predictive factors of anxiety symptoms and depressive symptoms. Result The prevalence of anxiety symptoms and depressive symptoms in the sample population was 36.96% (85/230) and 65.21% (150/230), respectively. Social isolation dimension of stigma (β=0.436, OR=1.547, CI:1.211~1.975), optimism (β=-0.276, OR=0.759, CI:0.624~0.922), and perceived stress (β=0.217, OR=1.243, CI:1.092~1.414) were predictors of anxiety symptoms. Marriage (β=1.648, OR=5.198, CI:1.427~18.924), positive readiness and expectancy dimension of hope (β=-0.505, OR=0.604, CI:0.395~0.923), social isolation dimension of stigma (β=0.314, OR=1.368, CI:1.054~1.776) and perceived stress (β=0.273, OR=1.314, CI:1.134~1.524) were predictors of depressive symptoms among oral cancer patients. Conclusion The prevalence of anxiety symptoms and depressive symptoms was high among oral cancer patients in China. The communal predictors of anxiety and depressive symptoms in patients with oral cancer were levels of perceived stress and social isolation of stigma. In addition, optimism was a predictor of anxiety symptoms and hope was a predictor of depressive symptoms.
Accuracy of cone-beam computed tomography for the evaluation of mandible invasion by oral squamous cell carcinoma
Authors: Wang Zezheng , Zhang Shuang , Pu Yumei , Wang Yuxin , Lin Zitong , Wang Zhiyong 
Published: July 2020

Abstract
Background: Accurate evaluation of mandible invasion and resection with appropriate boundary for oral squamous cell carcinoma (OSCC) are important for preserving structure and function of mandible and preventing local recurrence. Although cone-beam computed tomography (CBCT), which has high spatial resolution, is now widely used in the diagnosis of oral and maxillofacial bone lesions. There were no studies systematically evaluate the accuracy of CBCT for evaluation of presence of bone invasion, boundary of bone invasion and presence of nerve invasion. Therefore, this study aimed to systemically explore the accuracy of CBCT in preoperative assessment of mandibular invasion by OSCC. Methods: Thirty mandibular specimens from OSCC patients were collected in this study. The samples were marked and subjected to CBCT examination. Hematoxylin–eosin staining was used for histopathological assessment and used as golden standard. The evaluation included the presence of bone invasion, boundary of bone invasion and presence of nerve invasion. The CBCT and histopathological boundaries of bone invasion were delineated and merged to compare and calculate the deviation of CBCT in boundary evaluation. Results: The accuracy of CBCT in evaluation of presence of mandible invasion was 100%, and the accuracy of CBCT in evaluation of presence of nerve invasion was 69.2%. A mean deviation of 2.97 mm was found for assessment the boundary of bone invasion using CBCT compared with the histopathological standard. Conclusion: CBCT is quite reliable in determine the presence or absence of mandible invasion, while not so reliable for nerve invasion. The deviation in bone invasion boundary estimation should be considered in the osteotomy for OSCC.
RE-AIM Evaluation of a Multilevel Decision Support and Navigation Intervention for Colorectal Cancer Screening in Hispanic Primary Care Patients
Authors: Careyva Beth , Johnson Melanie , Sifri Randa , DiCarlo Melissa , Daskalakis Constantine , Shaak Kyle , Payton Colleen , Stello Brian , Myers Ronald 
Published: July 2020

Abstract
Background: Hispanic adults in the United States have low colorectal cancer (CRC) screening rates and are more likely than non-Hispanic adults to be diagnosed with advanced-stage CRC. We evaluated the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) of a novel multilevel decision support and navigation intervention (DSNI) designed to increase CRC screening among Hispanic primary care patients.Methods: The trial enrolled 400 consented participants from a health system sampling frame of 2,720 Hispanic patients eligible for CRC screening in five primary care practices. We randomized 203 patients to receive a mailed standard intervention (SI Group) that included informational material, a fecal immunochemical test kit, a reminder versus 197 patients who received the SI plus a telephone screening DSNI (DSNI Group). We assessed DSNI effects using health system and study administrative data.Results: 1) Reach: DSNI delivery reached 84% of participants. 2) Effectiveness: The DSNI group produced a screening rate that was significantly greater (p < .001) than in the SI group (78% and 43%, respectively). 3) Adoption: All participating primary care practices and patients remained in the study. 4) Implementation: DSNI delivery required an average of 4.1 decision support and navigation call attempts with the total call effort averaging 35 minutes. 5) Maintenance: Health system leaders have acknowledged DSNI benefits and are actively engaged in determining how to sustain DSNI implementation.Conclusion: The DSNI achieved high levels of reach, effectiveness, adoption, and implementation with a modest investment of resources. The project team is addressing the challenge of DSNI maintenance in the health system. Further work is needed to determine intervention effectiveness in other health systems and in the general patient population. Trial Registration: ClinicalTrials.gov identifier : NCT02272244
Completed Absorption of Coronavirus Disease 2019 (COVID-19) Pneumonia Lesions: A Preliminary Study
Authors: Chu Zhi-gang , Liu Xue-yan , Lv Sheng-xiu , Fu Bin-jie , Li Wang-jia , Ouyang Yu , Lv Fajin 
Published: July 2020

Abstract
Background Complete absorption of coronavirus disease 2019 (COVID-19) pneumonia in a short term was not detailedly reported. We aimed to investigate the clinical and imaging characteristics of COVID-19 patients with complete absorption of pulmonary lesions.Methods Retrospectively collected the clinical and chest CT data of 224 patients with COVID-19 in one regional medical center. Currently, pulmonary lesions in 37 patients were completely absorbed. The clinical manifestations, laboratory examinations, and CT findings of lesions for these patients were summarized. Results Among the 37 patients (age, 39.0 ± 12.4 [14 - 63] years, 20 males), disease in 36 (97.3%) was mild and in 1 (3.7%) was from severe to mild. The most common symptoms were cough (24/37, 64.9%) and fever (23/37, 62.2%). Their laboratory indicators at admission were usually normal, while the white blood cell and neutrophil count significantly increased at discharge (p = 0.004, p = 0.006). On initial CT images, all patients had various pulmonary lesions (mean involved lobes:2.8 ± 1.5, range:1-5; mean involved segments: 6.6 ± 4.3, range: 1-16), which mainly manifested as multiple patchy and or spherical ground glass opacities (GGOs) (30/37, 81.1%) with fibrous strips (19/30, 63.3%) or consolidation (11/30, 36.7%). After treatment, lesions in most (33/37, 89.2%) patients were continuously absorbed. At discharge, previous lesions were mostly absorbed in 11 patients (11/37, 29.7%), the main residues were GGOs (24/37, 64.9%), followed by fibrous strips (13/37, 35.1%). On the latest CT, all the pulmonary lesions were completely absorbed, the duration of lesions was 31.6 ± 11.4 days (range: 5 - 50 days). Conclusion The pulmonary lesions in some mild COVID-19 patients (generally with normal laboratory indicators at admission, GGOs as the main manifestation on initial CT, and representation of continuous absorption after treatment) could be completely absorbed with a mean duration of 31.6 days.
Cross-Cultural Adaptation and Exploratory Factor Analysis of The Person-Centred Practice Inventory-Staff (PCPI-S) Questionnaire Among Malaysian Primary Healthcare Providers
Authors: Balqis-Ali Nur Zahirah , Saw Pui San , Jailani Anis Syakira , Fun Weng Hong , Saleh Noridah Mohd , Bahanuddin Tengku Putri Zaharah Tengku , Sararaks Sondi , Lee Shaun Wen Huey 
Published: July 2020

Abstract
Background: The Person-Centred Practice Inventory-Staff (PCPI-S) instrument was developed to measure healthcare providers’ perception towards their person-centred practice. The study aimed to explore the influence of culture, context, language and local practice towards the PCPI-S instrument adaptation process for use among public primary care healthcare providers in Malaysia.Methods: The original PCPI-S was reviewed and adapted for cultural suitability by an expert committee to ensure conceptual and item equivalence. The instrument was subsequently translated into the local Malay language using the forward-backward translation by two independent native speakers, and modified following pre-tests involving cognitive debriefing interviews. The psychometric properties of the corresponding instrument were determined by assessing the internal consistency, test-retest reliability, and correlation of the instrument, while the underlying structure was analysed using exploratory factor analysis.Results: Review by expert committee found items applicable to local context. Pre-tests on the translated instrument found multiple domains and questions were misinterpreted. Many translations were heavily influenced by culture, context, and language discrepancies. Results of subsequent pilot study found mean scores for all items ranged from 2.92 to 4.39. Notable ceiling effects were found. Internal consistency was found to be high (Cronbach’s alpha > 0.9). Exploratory factor analysis found formation of 11 components as opposed to the original 17 constructs. Conclusion: The results of this study provide evidence regarding the reliability and underlying structure of the PCPI-S instrument with regard to primary care practice. Culture, context, language and local practice heavily influenced the adaptation as well interpretation of the underlying structure and should be given emphasis when translating person-centred into practice.Trial registration: NMRR-18-309-40447