bluuebunny/crossref_metadata_2025_split huggingface dataset:
Community Connectors (CCx): the strategies employed by peer to peer connectors to foster relationships with early years caregivers to improve universal early child health and development
Authors: Mills C. F. , Lowrie E. , Kinloch K. , Hall E. 
Published: March 2021

AbstractBlackpool is one of the most deprived Local Authority (LA) areas in England; in April 2015 the Blackpool Better Start (BBS) Partnership was allocated £45 million over 10 years from the Big Lottery Fund (BLF) as one of five ‘A Better Start’ initiative areas in England. The aim of the ‘A Better Start’ initiative is to improve outcomes for children from conception to 3 years of age. Co-designed by professionals and the community, the Community Connector (CCx) programme employs residents to directly engage caregivers of children, in seven of Blackpool’s most socio-economically deprived wards. The CCx follow a socioecological framework which proposes that caregivers will be positively influenced to engage in early years activities because of connections to trained peers. Peer support models are commonly applied within targeted early years health settings (i.e., infant feeding support, literacy) yet their role to improve child outcomes at a universal level has received little attention. This paper focuses on caregiver-level evidence of the strategies employed by CCx - part of an early stage pilot study supported by Frontiers of Innovation, the Harvard Centre on the Developing Child’s Research and Development platform.The study collated attendance data from Children’s Centres, these are publically funded community centres providing information and activities for families with children 0–5 years of age. The study data included individual interactions between a CCx and caregiver over a 1 year period (1st April 2018 – 31st March 2019). A sampling frame was created from which a total of 22 interviews with caregivers were undertaken in early years community settings. The interview data was thematically analysed; the findings highlighted the mechanisms by which CCx served to mediate service and caregiver communication boundaries, negotiate access to spaces, and encouraged sustained engagement in longer term activities such as volunteering and training. Value was embedded by the CCx in their process of establishing and maintaining connections with caregivers through the ‘everyday’ conversations, their individualised approach and in demonstrating self-efficacy behaviours. Further research is required to review the impact of the CCx role in caregiver’s recall of early years information, nevertheless the study provided important learning for establishing formalised CCx programmes elsewhere, and has implications for community health and early years policy and practice.
Co-location of out of hours primary care and emergency department in Belgium: patients’ and physicians’ view
Authors: Schoenmakers Birgitte , Van Criekinge Jasper , Boeve Timon , Wilms Jonas , Van Der Mullen Chris , Sabbe Marc 
Published: March 2021

AbstractBackgroundIn Belgium, General Practitioner Cooperatives (GPC) aim to improve working conditions for unplanned care and to reduce the number of low acuity emergency visits. Although this system is well organized, the number of low acuity visits does not decrease.MethodsWe explored the view of patients and physicians on the co-location of a GPC and an emergency service for unplanned care. The study was carried out in a cross section design in primary and emergency care services and included patients and physicians. Main outcome measure was the view of patients and physician on co-location of a GPC and an emergency service.Results404 patients and 488 physicians participated. 334 (82.7%) of all patients favoured a co-location. The major advantages were fast service (104, 25.7) and adequate referral (54, 13.4%). 237 (74%) of the GPs and 38 (95%) of the emergency physicians were in favour of a co-location. The major advantage was a more adequate referral of patients. 254 (79%) of the GPs and 23 (83%) of the emergency physicians believed that a co-location would lower the workload and waiting time and increase care quality (resp. 251 (78%), 224 (70%) and 37 (93%), 34 (85%).ConclusionsTo close the expectation gap between GP’s, emergency physicians and to reach for high care quality, information campaigns and development of workflows are indispensable for a successful implementation of a co-location of primary and emergency care.
A mobile phone application for malaria case-based reporting to advance malaria surveillance in Myanmar: a mixed methods evaluation
Authors: Win Han Oo  , Win Htike  , Cutts Julia C. , Kyawt Mon Win  , Kaung Myat Thu  , May Chan Oo  , Galau Naw Hkawng  , Agius Paul A. , Pyae Phyo Htoon  , Scott Nick , Kearney Ellen , Moreira Clarissa , Pedrana Alisa , Stoove Mark , Aung Thi  , Ye Win Aung  , Min Min Thein  , Rosecrans Kathryn , Kyi Tun Lwin  , Aung Kyi Min  , Fowkes Freya J. I. 
Published: March 2021

Abstract
Background
To achieve malaria elimination in the Greater Mekong Subregion, including Myanmar, it is necessary to ensure all malaria cases are detected, treated, and reported in a timely manner. Mobile phone-based applications for malaria reporting, case management, and surveillance implemented at a community-level may overcome reporting limitations associated with current paper-based reporting (PBR), but their effectiveness in this context is unknown.

Methods
A mixed methods evaluation study was undertaken to determine the effectiveness of a national Malaria Case-Based Reporting (MCBR) mobile phone application in improving malaria case reporting compared to the existing PBR reporting system in Myanmar. Methods included secondary analysis of malaria case report data, questionnaires, focus group discussions and field observations of community volunteers, interviews and direct observations of malaria programme stakeholders, and cost analysis. Using a combination of these approaches the following areas were investigated: data quality and completeness, data access and usage, capacity for timely reporting, the acceptability, functionality, and ease of use of the application and facilitators and barriers to its use, and the relative cost of MCBR compared to the PBR system.

Results
Compared to PBR, MCBR enabled more accurate and complete data to be reported in a much timelier manner, with 63% of MCBR users reporting they transmit rapid diagnostic test outcomes within 24 h, compared to 0% of PBR users. MCBR was favoured by integrated community malaria volunteers and their supervisors because of its efficiency. However, several technical and operational challenges associated with internet coverage, data transmission, and e-literacy were identified and stakeholders reported not being confident to rely solely on MCBR data for programmatic decision-making.

Conclusions
Implementation of MCBR provided timely and accurate data for malaria surveillance. Findings from this evaluation study will enable the optimization of an application-based reporting system for malaria monitoring and surveillance in the Greater Mekong Subregion and advance systems to track progress towards, and certify, the achievement of malaria elimination targets.
The science of spin: targeted strategies to manufacture doubt with detrimental effects on environmental and public health
Authors: Goldberg Rebecca F. , Vandenberg Laura N. 
Published: March 2021

AbstractBackgroundNumerous groups, such as the tobacco industry, have deliberately altered and misrepresented knowable facts and empirical evidence to promote an agenda, often for monetary benefit, with consequences for environmental and public health. Previous research has explored cases individually, but none have conducted an in-depth comparison between cases. The purpose of this study was to compile a comprehensive list of tactics used by disparate groups and provide a framework for identifying further instances of manufactured doubt.MethodsWe examined scholarly books, peer-reviewed articles, well-researched journalism pieces, and legal evidence related to five disparate industries and organizations selected for their destructive impacts on environmental and public health (tobacco, coal, and sugar industries, manufacturers of the pesticide Atrazine, and the Marshall Institute, an institute focused on climate change research, and other scientists from the era that associated with those in the Institute). These documents provided evidence for a list of tactics used to generate pro-industry spin and manufacture doubt about conferred harm. We then identified trends among sets of strategies that could explain their differential use or efficacy.ResultsWe recognized 28 unique tactics used to manufacture doubt. Five of these tactics were used by all five organizations, suggesting that they are key features of manufactured doubt. The intended audience influences the strategy used to misinform, and logical fallacies contribute to their efficacy.ConclusionsThis list of tactics can be used by others to build a case that an industry or group is deliberately manipulating information associated with their actions or products. Improved scientific and rhetorical literacy could be used to render them less effective, depending on the audience targeted, and ultimately allow for the protection of both environmental health and public health more generally.
Decreased mortality in acute respiratory distress syndrome patients treated with corticosteroids: an updated meta-analysis of randomized clinical trials with trial sequential analysis
Authors: Lin Ping , Zhao Yuean , Li Xiaoqian , Jiang Faming , Liang Zongan 
Published: March 2021

Abstract
Background
The possible benefits associated with corticosteroid treatment in acute respiratory distress syndrome (ARDS) patients are not fully known. We conducted an updated meta-analysis to assess the effect of corticosteroids in the treatment of patients with ARDS.

Methods
We systematically searched MEDLINE, Embase, and the Cochrane Library from inception to January 2021 via Ovid to identify randomized controlled trials evaluating the efficacy of glucocorticoids in the treatment of patients with ARDS. The primary outcome was hospital mortality. Secondary outcomes included the number of ventilator-free days at day 28, oxygenation improvement (PaO2/FIO2 ratios), and adverse events.

Results
Nine studies with 1371 participants were analyzed. The pooled analysis revealed that glucocorticoid use was associated with reduced mortality [relative risk (RR), 0.83; 95% confidence interval (CI) 0.74–0.93; P < 0.01; I2 = 37], and the statistical power was confirmed by trial sequential analysis. Glucocorticoids might also significantly increase the number of ventilator-free days at day 28 (mean deviation 3.66 days, 95% CI 2.64–4.68; P < 0.01) and improve oxygenation (standardized mean difference 4.17; 95% CI 2.32–6.02; P < 0.01). In addition, glucocorticoid use was not associated with increased risks of new infection (RR 0.84; 95% CI 0.70–1.01; P = 0.07) and hyperglycemia (RR 1.11; 95% CI 0.99–1.23; P = 0.06).

Conclusions
The use of glucocorticoids might result in reduced mortality in patients with ARDS. Glucocorticoids might be recommended as an adjunct to standard care for ARDS; however, the optimal dose and duration of steroid therapy remains unknown and further studies are needed.
Impact of disease activity on impaired glucose metabolism in patients with rheumatoid arthritis
Authors: Ristić Gorica G. , Subota Vesna , Stanisavljević Dejana , Vojvodić Danilo , Ristić Arsen D. , Glišić Branislava , Petronijević Milan , Stefanović Dušan Z. 
Published: March 2021

Abstract
Objective
To explore glucose metabolism in rheumatoid arthritis (RA) and its association with insulin resistance (IR) risk factors and disease activity indicators, including matrix metalloproteinase-3 (MMP3).

Methods
This single-center study included 127 non-diabetic subjects: 90 RA patients and 37 matched controls. IR-related risk factors, disease activity (DAS28-ESR/CRP), concentrations of inflammation markers, MMP3, glucose, specific insulin, and C-peptide (a marker of β-cell secretion) were determined. Homeostasis Model Assessment was used to establish insulin resistance (HOMA2-IR) and sensitivity (HOMA2-%S). Associations of HOMA2 indices with IR-related risk factors, inflammation markers, and RA activity were tested using multiple regression analyses.

Results
RA patients had significantly increased HOMA2-IR index than controls. In the RA group, multivariate analysis revealed DAS28-ESR, DAS28-CRP, tender joint counts, patient’s global assessment, and MMP3 level as significant positive predictors for HOMA2-IR (β = 0.206, P = 0.014; β = 0.192, P = 0.009; β = 0.121, P = 0.005; β = 0.148, P = 0.007; β = 0.075, P = 0.025, respectively), and reciprocal negative for HOMA2-%S index. According to the value of the coefficient of determination (R2), DAS28-ESR ≥ 5.1 has the largest proportion of variation in both HOMA2-IR indices. DAS28-ESR ≥ 5.1 and ESR were independent predictors for increased C-peptide concentration (β = 0.090, P = 0.022; β = 0.133, P = 0.022). Despite comparability regarding all IR-related risk factors, patients with DAS28-ESR ≥ 5.1 had higher HOMA2-IR than controls [1.7 (1.2–2.5) vs. 1.2 (0.8–1.4), P = 0.000]. There was no difference between patients with DAS28-ESR < 5.1 and controls [1.3 (0.9–1.9) vs. 1.2 (0.8–1.4), P = 0.375].

Conclusions
RA activity is an independent risk factor for impaired glucose metabolism. DAS28-ESR ≥ 5.1 was the main contributor to this metabolic disturbance, followed by MMP3 concentration, outweighing the impact of classic IR-related risk factors.
Design of a novel antimicrobial peptide 1018M targeted ppGpp to inhibit MRSA biofilm formation
Authors: Jiale Zhou , Jian Jiao , Xinyi Tan , Haoji Xie , Xueqin Huang , Xiao Wang 
Published: March 2021

AbstractMethicillin-resistant staphylococcus aureus (MRSA) and its biofilm infection were considered as one of the main international health issues. There are still many challenges for treatment using traditional antibiotics. In this study, a mutant peptide of innate defense regulator (IDR-)1018 named 1018M was designed based on molecular docking and amino acid substitution technology. The antibacterial/biofilm activity and mechanisms against MRSA of 1018M were investigated for the first time. The minimum inhibitory concentration (MIC) of 1018M was reduced 1 time (MIC = 2 μg/mL) compared to IDR-1018. After treatment with 32 μg/mL 1018M for 24 h, the percentage of biofilm decreased by 78.9%, which was more effective than the parental peptide. The results of mechanisms exploration showed that 1018M was more potent than IDR-1018 at destructing bacterial cell wall, permeating cell membrane (20.4%–50.1% vs 1.45%–10.6%) and binding to stringent response signaling molecule ppGpp (increased 27.9%). Additionally, the peptides could also exert their activity by disrupting genomic DNA, regulating the expression of ppGpp metabolism and biofilm forming related genes (RSH, relP, relQ, rsbU, sigB, spA, codY, agrA and icaD). Moreover, the higher temperature, pH and pepsase stabilities provide 1018M better processing, storage and internal environmental tolerance. These data indicated that 1018M may be a potential candidate peptide for the treatment of MRSA and its biofilm infections.
Frailty inclusive care in acute and community-based settings: a systematic review protocol
Authors: Montgomery Carmel L. , Hopkin Gareth , Bagshaw Sean M. , Hessey Erin , Rolfson Darryl B. 
Published: March 2021

AbstractBackgroundFrailty is a known risk factor for an array of adverse outcomes including more frequent and prolonged health services use and high health care costs. Aging of the population has implications for care provision across the care continuum, particularly for people living with frailty. Despite known risks associated with frailty, there has been limited research on care pathways that address the needs of persons living with frailty. Our study aims to review and examine, in a rigorous way, the quality of evidence for multi-component interventions and care pathways focused on frailty.MethodsA comprehensive electronic search strategy will be used to identify studies that evaluate multi-component interventions or care pathways for persons living with frailty. The search strategy will include terms for frailty, multi-component interventions, effectiveness, and cost effectiveness applied to the following databases: MEDLINE (OVID), EMBASE (OVID), CINAHL (EBSCO), Cochrane Central Register of Controlled Trials (CENTRAL), and Cochrane Database of Systematic Reviews. An adapted search for Google Scholar and gray literature databases will also be used. References of included studies will be hand-searched for additional citations of frailty-inclusive care. Known experts and corresponding authors of identified articles will be contacted by email to identify further eligible studies. Risk of bias will be assessed using the Effective Public Health Practice Project Quality Assessment tool. Data will be extracted from eligible studies and it is anticipated that narrative analysis will be used. If studies with sufficient homogeneity are found, then pooled effects will be reported using meta-analysis.DiscussionThis review will appraise the evidence currently available on multi-component frailty interventions. Results will inform on clinical pathway development for people living with frailty across the care continuum and will guide future research to address gaps in the literature and areas in need of further development.Systematic review registrationPROSPEROCRD42020166733
Sampling weights in multilevel modelling: an investigation using PISA sampling structures
Authors: Mang Julia , Küchenhoff Helmut , Meinck Sabine , Prenzel Manfred 
Published: March 2021

Abstract
Background
Standard methods for analysing data from large-scale assessments (LSA) cannot merely be adopted if hierarchical (or multilevel) regression modelling should be applied. Currently various approaches exist; they all follow generally a design-based model of estimation using the pseudo maximum likelihood method and adjusted weights for the corresponding hierarchies. Specifically, several different approaches to using and scaling sampling weights in hierarchical models are promoted, yet no study has compared them to provide evidence of which method performs best and therefore should be preferred. Furthermore, different software programs implement different estimation algorithms, leading to different results.

Objective and method
In this study, we determine based on a simulation, the estimation procedure showing the smallest distortion to the actual population features. We consider different estimation, optimization and acceleration methods, and different approaches on using sampling weights. Three scenarios have been simulated using the statistical program R. The analyses have been performed with two software packages for hierarchical modelling of LSA data, namely Mplus and SAS.

Results and conclusions
The simulation results revealed three weighting approaches performing best in retrieving the true population parameters. One of them implies using only level two weights (here: final school weights) and is because of its simple implementation the most favourable one. This finding should provide a clear recommendation to researchers for using weights in multilevel modelling (MLM) when analysing LSA data, or data with a similar structure. Further, we found only little differences in the performance and default settings of the software programs used, with the software package Mplus providing slightly more precise estimates. Different algorithm starting settings or different accelerating methods for optimization could cause these distinctions. However, it should be emphasized that with the recommended weighting approach, both software packages perform equally well. Finally, two scaling techniques for student weights have been investigated. They provide both nearly identical results. We use data from the Programme for International Student Assessment (PISA) 2015 to illustrate the practical importance and relevance of weighting in analysing large-scale assessment data with hierarchical models.
Non-isothermal reaction mechanism and kinetic analysis for the synthesis of monoclinic lithium zirconate (m-Li2ZrO3) during solid-state reaction
Authors: Yasnó Juan P. , Conconi Susana , Visintin Arnaldo , Suárez Gustavo 
Published: March 2021

AbstractNon-isothermal reaction mechanism and kinetic analysis for the synthesis of monoclinic lithium zirconate (m-Li2ZrO3) were investigated by processing of TG-DTA, along with XRD, DLS, and HRTEM. For this purpose, the solid-state reaction of Li2CO3 with ZrO2 was carried out by TG-DTA at different heating rates (10, 20, and 30 °C/min) from room temperature to 1100 °C. The thermal data was used to calculate the kinetic parameters by two types of isoconversional methods: Flynn-Wall-Ozawa (FWO) and Kissinger-Akahira-Sunose (KAS). The reaction mechanism was determined by the model-fitting method, applying the Coats-Redfern (CR) approximation to the different solid-state reaction models. The results confirmed the formation of pure m-Li2ZrO3, consists of semispherical particles of about 490 nm, using a very short reaction time. The average activation energy obtained by FWO and KAS methods were 274.73 and 272.50 kJ/mol, respectively. It was found that the formation of m-Li2ZrO3 from Li2CO3 with ZrO2 is governed by the three-dimensional diffusion mechanism. Based on these results, a microscopic reaction model of the formation of m-Li2ZrO3 was proposed.
Volcanic unrest at Hakone volcano after the 2015 phreatic eruption: reactivation of a ruptured hydrothermal system?
Authors: Mannen Kazutaka , Abe Yuki , Daita Yasushi , Doke Ryosuke , Harada Masatake , Kikugawa George , Honma Naoki , Miyashita Yuji , Yukutake Yohei 
Published: March 2021

AbstractSince the beginning of the twenty-first century, volcanic unrest has occurred every 2–5 years at Hakone volcano. After the 2015 eruption, unrest activity changed significantly in terms of seismicity and geochemistry. Like the pre- and co-eruptive unrest, each post-eruptive unrest episode was detected by deep inflation below the volcano (~ 10 km) and deep low frequency events, which can be interpreted as reflecting supply of magma or magmatic fluid from depth. The seismic activity during the post-eruptive unrest episodes also increased; however, seismic activity beneath the eruption center during the unrest episodes was significantly lower, especially in the shallow region (~ 2 km), while sporadic seismic swarms were observed beneath the caldera rim, ~ 3 km away from the center. This observation and a recent InSAR analysis imply that the hydrothermal system of the volcano could be composed of multiple sub-systems, each of which can host earthquake swarms and show independent volume changes. The 2015 eruption established routes for steam from the hydrothermal sub-system beneath the eruption center (≥ 150 m deep) to the surface through the cap-rock, allowing emission of super-heated steam (~ 160 ºC). This steam showed an increase in magmatic/hydrothermal gas ratios (SO2/H2S and HCl/H2S) in the 2019 unrest episode; however, no magma supply was indicated by seismic and geodetic observations. Net SO2 emission during the post-eruptive unrest episodes, which remained within the usual range of the post-eruptive period, is also inconsistent with shallow intrusion. We consider that the post-eruptive unrest episodes were also triggered by newly derived magma or magmatic fluid from depth; however, the breached cap-rock was unable to allow subsequent pressurization and intensive seismic activity within the hydrothermal sub-system beneath the eruption center. The heat released from the newly derived magma or fluid dried the vapor-dominated portion of the hydrothermal system and inhibited scrubbing of SO2 and HCl to allow a higher magmatic/hydrothermal gas ratio. The 2015 eruption could have also breached the sealing zone near the brittle–ductile transition and the subsequent self-sealing process seems not to have completed based on the observations during the post-eruptive unrest episodes.