bluuebunny/crossref_metadata_2025_split huggingface dataset:
A human resources for health analysis of registered family medicine specialists in South Africa: 2002–19
Authors: Tiwari Ritika , Mash Robert , Karangwa Innocent , Chikte Usuf 
Published: July 2020

AbstractBackgroundIn South Africa, there is a need to clarify the human resources for health policy on family physicians (FPs) and to ensure that the educational and health systems are well aligned in terms of the production and employment of FPs.ObjectiveTo analyse the human resource situation with regard to family medicine in South Africa and evaluate the requirements for the future.MethodsA retrospective review of the Health Professions Council of South Africa’s (HPCSA) database on registered family medicine practitioners from 2002 until 2019. Additional data were obtained from the South African Academy of Family Physicians and published research.ResultsA total of 1247 family medicine practitioners were registered with the HPCSA in 2019, including 969 specialist FPs and 278 medical practitioners on a discontinued register. Of the 969, 194 were new graduates and 775 from older programmes. The number of FPs increased from 0.04/10 000 population in 2009 to 0.16/10 000 in 2019, with only 29% in the public sector. On average, seven registrars entered each of nine training programmes per year and three graduated. New graduates and registrars reflect a growing diversity and more female FPs. The number of FPs differed significantly in terms of age, gender, provincial location and population groups.ConclusionsSouth Africa has an inadequate supply of FPs with substantial inequalities. Training programmes need to triple their output over the next 10 years. Human resources for health policy should substantially increase opportunities for training and employment of FPs.
Primary care experience and remission of type 2 diabetes: a population-based prospective cohort study
Authors: Dambha-Miller Hajira , Day Alexander , Kinmonth Ann Louise , Griffin Simon J 
Published: July 2020

Abstract

Background
Remission of Type 2 diabetes is achievable through dietary change and weight loss. In the UK, lifestyle advice and referrals to weight loss programmes predominantly occur in primary care where most Type 2 diabetes is managed.

Objective
To quantify the association between primary care experience and remission of Type 2 diabetes over 5-year follow-up.

Methods
A prospective cohort study of adults with Type 2 diabetes registered to 49 general practices in the East of England, UK. Participants were followed-up for 5 years and completed the Consultation and Relational Empathy measure (CARE) on diabetes-specific primary care experiences over the first year after diagnosis of the disease. Remission at 5-year follow-up was measured with HbA1c levels. Univariable and multivariable logistic regression models were constructed to quantify the association between primary care experience and remission of diabetes.

Results
Of 867 participants, 30% (257) achieved remission of Type 2 diabetes at 5 years. Six hundred twenty-eight had complete data at follow-up and were included in the analysis. Participants who reported higher CARE scores in the 12 months following diagnosis were more likely to achieve remission at 5 years in multivariable models; odds ratio = 1.03 (95% confidence interval = 1.01–1.05, P = 0.01).

Conclusion
Primary care practitioners should pay greater attention to delivering optimal patient experiences alongside clinical management of the disease as this may contribute towards remission of Type 2 diabetes. Further work is needed to examine which aspects of the primary care experience might be optimized and how these could be operationalized.
River biofilms adapted to anthropogenic disturbances are more resistant to WWTP inputs
Authors: Freixa Anna , Perujo Núria , Langenheder Silke , Romaní Anna M 
Published: July 2020

ABSTRACT
The sensitivity and spatial recovery of river sediment biofilms along 1 km after the input of two wastewater treatment plants (WWTPs) located in two river reaches with different degrees of anthropogenic influence were investigated. First, at the upper reach, we observed an inhibition of some microbial functions (microbial respiration and extracellular enzyme activities) and strong shifts in bacterial community composition (16S rRNA gene), whereas an increase in microbial biomass and activity and less pronounced effect on microbial diversity and community composition were seen at the lower reach. Second, at the lower reach we observed a quick spatial recovery (around 200 m downstream of the effluent) as most of the functions and community composition were similar to those from reference sites. On the other hand, bacterial community composition and water quality at the upper reach was still altered 1 km from the WWTP effluent. Our results indicate that biofilms in the upstream sites were more sensitive to the effect of WWTPs due to a lower degree of tolerance after a disturbance than communities located in more anthropogenically impacted sites.
Psychological Resilience and Health Among Older Adults: A Comparison of Personal Resources
Authors: Taylor Miles G , Carr Dawn 
Published: July 2020

Abstract

Objectives
Research on life course inequality and successful aging has sought to understand how events and challenges may lead to poor outcomes in later life for some individuals, while others fare well in the face of adversity. Among internalized resources, research suggests psychological resilience is protective in the face of challenges, but little is known about the predictive efficacy of this measure compared to other resources such as mastery. This paper examines connections between psychological resilience and later life health compared to other internalized resources.

Method
Standardized associations between 4 resources (resilience, mastery, optimism, hopelessness) and 5 health outcomes were tested using short-term health transitions and longer term health trajectories in a structural equation modeling (SEM) framework using the Leave Behind Questionnaire (LBQ) and linked Health and Retirement Study (HRS) between 2006/2008 and 2014/2016 (n = 11,050–12,823).

Results
Psychological resilience had consistent and robust associations with health transitions and trajectories. Further, the effects of this resource were generally 4–10 times greater than for mastery, optimism, and hopelessness in combined models. Trajectory analyses replicate these findings and suggest the beneficial associations of resilience over time were persistent for some health outcomes, and cumulative for others.

Discussion
The results suggest that psychological resilience is powerfully associated with health in later life, with substantially greater predictive efficacy than other commonly used resource measures. Future research should establish how this intrapersonal resource works alongside structural and interpersonal resources to promote and protect health and functioning in the face of challenges and adversity.
Caregivers’ Mental Health and Somatic Symptoms During COVID-19
Authors: Park Sung S 
Published: July 2020

Abstract

Objectives
This study examines differences in the mental and physical health of the U.S. population during the early stages of the COVID-19 pandemic among 3 groups: noncaregivers, short-term caregivers (1 year or less), and long-term caregivers (greater than 1 year).

Methods
Data from the Understanding America Study are used to describe group differences in reports of psychological distress and somatic symptoms. Logistic and negative binomial regression models are used to examine whether these differences persist after adjusting for demographic, socioeconomic, and prepandemic health conditions. To understand within-group differences in caregiving demands, the intensity of care provided by short-term and long-term caregivers, as well as selected patients’ health conditions are summarized.

Results
Adults’ mental and physical health varied substantially by caregiver status. Caregivers continued to fare worse than noncaregivers in terms of mental health and fatigue, and long-term caregivers were more likely to report headache, body aches, and abdominal discomfort than both short-term caregivers and noncaregivers, net of controls. The nature of caregiving differed between short-term and long-term caregivers, with the latter more likely to provide greater hours of care, and to be looking after patients with permanent medical conditions.

Discussion
Efforts to understand and mitigate the impact of the pandemic on population health should include caregivers, whose mental and physical health were already vulnerable before COVID-19.
Outcome of reminder text messages intervention on completion of routine immunization in rural areas, Nigeria
Authors: Oladepo Oladimeji , Dipeolu Isaac Oluwafemi , Oladunni Opeyemi 
Published: July 2020

Summary
Completion of routine immunization for infants has been a challenge in Nigeria, and existing strategies implemented to promote immunization coverage yielded limited success. The use of reminder short services message (SMS) in mobilizing mothers of infants, especially in rural areas with lower immunization coverage has been suggested. This study investigated the effect of reminder SMS sent to mothers in rural communities on full and timely completion of routine childhood immunization. A quasi-experimental design was adopted, 3500 mothers of infants were categorized into the Intervention and Control groups recruited at various Primary Healthcare Centres in 6 states and the FCT, Nigeria. Reminder SMS were sent to mothers in the intervention group for 10 months. We adopted mixed methods of data collection, significance level set at p = 0.05. Majority of respondents were married (Control 94.3%; Intervention 95.5%), have experienced multiple births (Control 79.0%; Intervention 74.9%). Adherence to routine immunization appointment dates and completion of all immunizations was higher in the Intervention group (76.0%) compared with the Control (73.3%). A significant association between adherence to appointment dates and completeness of routine immunization vaccine was found. The Intervention group had a significantly higher completion rate for measles and yellow fever vaccines (55.3%; 75.9%) compared with the Control group (26.8%; 23.9%). Qualitative findings revealed positive comments from mothers in the intervention group that the messages increase awareness of immunization dates, assisted in readjusting their time which influenced timely completion. Interventions using reminder SMS enhanced infant immunization delivery; we recommend scale-up and integration into the health system to increase national immunization coverage.
Publishing and peer reviewing as indicators of the impact of COVID-19 on the productivity of the aquatic science community
Authors: Hobday Alistair J , Browman Howard I , Bograd Steven J 
Published: July 2020

AbstractBeginning in February 2020, COVID-19-related stay at home orders and workplace shutdowns worldwide have disrupted personal and professional lives, including those of aquatic scientists. Manuscript submission and peer reviewing data from journals may be indicators of productivity impacts among aquatic scientists. We tested four null hypotheses: the COVID-19 disruption has had no effect on (i) the number of submissions to journals, or (ii) the geographic region in which the corresponding author is based, nor on the peer review process in terms of (iii) acceptance rate of requests to review and (iv) time in review. We used data provided by seven leading aquatic science journals covering the period 2009–2020 and representing 32 756 submissions. Submission differences varied between journals and were lower than expected in March 2020, but due to increases in subsequent months, there was no overall change in the number of submissions during the COVID-19 disruption months of February–June 2020. Geographic patterns in the number of submissions varied more by journal than by region, with both higher and lower numbers of submissions relative to expected numbers. Acceptance rates of requests to review were ∼2% lower overall; however, time in review declined by an average of 5 days relative to earlier years, showing that those scientists undertaking reviews did them more quickly during the COVID-19 disruption. Collectively, these results show that the overall productivity of the aquatic science community, as measured by publications and reviewing rates and times, has thus far only been slightly disrupted, although the impacts will vary greatly among individuals depending on life circumstances. The breadth and longevity of this disruption are unprecedented, making it important to continue to assess the relative impacts across a wide demographic range of aquatic scientists and to consider approaches to allow those differentially affected to recover to pre-COVID-19 levels of productivity.
Association of prenatal maternal blood lead levels with birth outcomes in the Japan Environment and Children’s Study (JECS): a nationwide birth cohort study
Authors: Goto Yoshihito , Mandai Marie , Nakayama Takeo , Yamazaki Shin , Nakayama Shoji F , Isobe Tomohiko , Sato Tosiya , Nitta Hiroshi 
Published: July 2020

Abstract

Background
Despite dramatic declines in prenatal maternal blood lead levels (BLLs) in most developed countries, little is known about the effects of extremely low-level (&lt;1.0 µg/dL) lead exposure on fetal growth.

Methods
We measured maternal BLL during the second or third trimester of pregnancy and assessed birth outcomes, including birthweight, preterm birth (&lt;37 gestational weeks) risk, small for gestational age births (SGA; birthweight &lt;10th percentile) and low birthweight (LBW; &lt;2500 g). The association between birthweight and maternal BLL was estimated using linear and quadratic spline models. Multivariable logistic models were used to examine the risk of binary responses.

Results
From 103 099 pregnant women, 20 000 blood samples were randomly selected for analysis. The maternal BLL range was 0.16–7.4 µg/dL, and the median was 0.63 µg/dL. After adjusting for covariates, the linear model showed that each 0.1 μg/dL increase in maternal BLL was associated with a 5.4 g decrease in mean birthweight [95% confidence interval (CI), 3.4 to 7.5 g]. The risk of SGA [adjusted odds ratio (aOR), 1.03; 95% CI, 1.02 to 1.05) and LBW (aOR, 1.03; 95% CI, 1.02 to 1.05) increased, whereas the risk of preterm delivery did not (aOR, 0.99; 95% CI, 0.97 to 1.02).

Conclusions
Even at a maternal BLL below 1.0 µg/dL, prenatal lead exposure was associated with decreased birthweight and increased risk of SGA and LBW, but not preterm delivery. The adverse effect estimates of prenatal lead exposure on birth outcomes were quantitatively small and clinically limited at this low level.
Locating small inclusions in diffuse optical tomography by a direct imaging method
Authors: Jiang Yu , Nakamura Gen , Wang Haibing 
Published: July 2020

Abstract
Optical tomography is a typical non-invasive medical imaging technique, which aims to reconstruct geometric and physical properties of tissues by passing near infrared light through tissues for obtaining the intensity measurements. Other than optical properties of tissues, we are interested in finding locations of small inclusions inside the object from boundary measurements, based on the time-dependent diffusion model. First, we analyze the asymptotic behavior of the boundary measurements weighted by the fundamental solution of a backward diffusion equation as the diameters of inclusions go to zero. Then, we derive an efficient algorithm for locating small inclusions by finite boundary measurements. This algorithm is direct, simple and easy to be implemented numerically, since it only involves matrix operations and has no iteration process. Finally, some numerical results are presented to illustrate the feasibility and robustness of the algorithm. A new observation of the algorithm is that we can take the source points and test points independently and increase the resolution of numerical results by taking more test points.
Earthquakes and Graftings of Hyperbolic Surface laminations
Authors: Alvarez Sébastien , Smith Graham 
Published: July 2020

Abstract
We study compact hyperbolic surface laminations. These are a generalisation of closed hyperbolic surfaces, which appear to be more suited to the study of Teichmüller theory than arbitrary non-compact surfaces. We show that the Teichmüller space of any non-trivial hyperbolic surface lamination is infinite dimensional. In order to prove this result, we study the theory of deformations of hyperbolic surfaces, and we derive a new formula for the derivative of the length of a simple closed geodesic with respect to the action of grafting. This formula complements those derived by McMullen [ 24], in terms of the Weil–Petersson metric, and by Wolpert [ 34], for the case of earthquakes.
Influenza Vaccination and Hospitalization Outcomes Among Older Patients With Cardiovascular or Respiratory Diseases
Authors: Pang Yuanjie , Wang Qi , Lv Min , Yu Mengke , Lu Ming , Huang Yangmu , Wu Jiang , Xie Zheng 
Published: July 2020

AbstractBackgroundInfluenza vaccination has been suggested to protect against death and recurrent events among patients with cardiovascular disease or chronic obstructive respiratory disease, but there is limited evidence in older adults, who have higher risks of influenza-associated hospitalization and mortality.MethodsPatients aged ≥60 years hospitalized for cardiovascular or respiratory diseases from the Beijing Urban Employee Basic Medical Insurance database during 3 influenza seasons (2013–2014 through 2015–2016) were pooled to estimate the effects of influenza vaccination on hospitalization outcomes. Vaccination status was ascertained through cross-referencing the Beijing Elderly Influenza Vaccination database. The summer months (June–August) were used as a reference period to adjust for unmeasured confounders during influenza seasons.ResultsAfter adjustment for both measured and unmeasured confounders, influenza vaccination was associated with lower risks of in-hospital deaths among patients hospitalized for cardiovascular (odds ratio [95% confidence interval], 0.85 [.68–1.06]) or respiratory diseases (0.66 [.54–.82]). Influenza vaccination was associated with a lower risk of readmission among patients with cardiovascular (odds ratio [95% confidence interval], 0.81 [.69–.95]) but not respiratory diseases (1.12 [.92–1.35]). Influenza vaccination was also associated with lower direct medical costs, but not with length of stay.ConclusionsInfluenza vaccination protected against hospitalization outcomes among older adults with cardiovascular or respiratory diseases.
Within- and cross-species predictions of plant specialized metabolism genes using transfer learning
Authors: Moore Bethany M , Wang Peipei , Fan Pengxiang , Lee Aaron , Leong Bryan , Lou Yann-Ru , Schenck Craig A , Sugimoto Koichi , Last Robert , Lehti-Shiu Melissa D , Barry Cornelius S , Shiu Shin-Han 
Published: July 2020

Abstract
Plant specialized metabolites mediate interactions between plants and the environment and have significant agronomical/pharmaceutical value. Most genes involved in specialized metabolism (SM) are unknown because of the large number of metabolites and the challenge in differentiating SM genes from general metabolism (GM) genes. Plant models like Arabidopsis thaliana have extensive, experimentally derived annotations, whereas many non-model species do not. Here we employed a machine learning strategy, transfer learning, where knowledge from A. thaliana is transferred to predict gene functions in cultivated tomato with fewer experimentally annotated genes. The first tomato SM/GM prediction model using only tomato data performs well (F-measure = 0.74, compared with 0.5 for random and 1.0 for perfect predictions), but from manually curating 88 SM/GM genes, we found many mis-predicted entries were likely mis-annotated. When the SM/GM prediction models built with A. thaliana data were used to filter out genes where the A. thaliana-based model predictions disagreed with tomato annotations, the new tomato model trained with filtered data improved significantly (F-measure = 0.92). Our study demonstrates that SM/GM genes can be better predicted by leveraging cross-species information. Additionally, our findings provide an example for transfer learning in genomics where knowledge can be transferred from an information-rich species to an information-poor one.
Beyond “Bouncing”: Resilience as an Expansion–Contraction Dynamic within a Holonic Frame
Authors: Clark Janine Natalya 
Published: July 2020

AbstractThe concept of resilience is often discussed in relation to “bouncing,” whether bouncing back or bouncing forward. This interdisciplinary article looks beyond “bouncing” in either direction. In so doing, it offers a novel conceptualization of resilience as a dialectical process of expansion and contraction across multiple domains and levels. Drawing on fieldwork with victims-/survivors of conflict-related sexual violence in Bosnia and Herzegovina, Colombia, and Uganda, it uses the qualitative data both to empirically critique the notions of “bouncing back” and “bouncing forward” and to explore what expansion and contraction look like in practice. It situates the arguments within a broader holonic perspective, in order to accentuate the systemic dimensions of resilience, and ultimately it discusses what they mean for the field of transitional justice.
Population pharmacokinetics and dosing simulations of amoxicillin in obese adults receiving co-amoxiclav
Authors: Mellon G , Hammas K , Burdet C , Duval X , Carette C , El-Helali N , Massias L , Mentré F , Czernichow S , Crémieux A -C 
Published: July 2020

Abstract

Background
Pneumonia, skin and soft tissue infections are more frequent in obese patients and are most often treated by co-amoxiclav, using similar dosing regimens to those used for non-obese subjects. No data are available on amoxicillin pharmacokinetics among obese subjects receiving co-amoxiclav.

Materials and methods
Prospective, single-centre, open-label, non-randomized, crossover pharmacokinetic trial having enrolled obese otherwise healthy adult subjects. A first dose of co-amoxiclav (amoxicillin/clavulanate 1000/200 mg) was infused IV over 30 min, followed by a second dose (1000/125 mg) administered orally, separated by a washout period of ≥24 h. We assayed concentrations of amoxicillin by a validated ultra HPLC–tandem MS technique. We estimated population pharmacokinetic parameters of amoxicillin by non-linear mixed-effect modelling using the SAEM algorithm developed by Monolix.

Results
Twenty-seven subjects were included in the IV study, with 24 included in the oral part of the study. Median body weight and BMI were 109.3 kg and 40.6 kg/m2, respectively. Amoxicillin pharmacokinetics were best described by a two-compartment model with first-order elimination. Mean values for clearance, central volume, intercompartmental clearance and peripheral volume were, respectively, 14.6 L/h, 9.0 L, 4.2 L/h and 6.4 L for amoxicillin. Oral bioavailability of amoxicillin was 79.7%. Amoxicillin Cmax after oral administration significantly reduced with weight (P = 0.013). Dosing simulations for amoxicillin predicted that most of the population will achieve the pharmacodynamic target of fT&gt;MIC ≥40% with the regimen of co-amoxiclav 1000/200 mg (IV) or 1000/125 mg (oral) q8h for MICs titrated up to 0.5 mg/L (IV) and 1 mg/L (oral).

Conclusions
Pharmacokinetic/pharmacodynamic goals for amoxicillin can be obtained in obese subjects.