bluuebunny/crossref_metadata_2025_split huggingface dataset:
Good interaction skills are not enough – competency in mental health issues in child health clinics and school health services
Authors: Putkuri Tiina , Salminen Leena , Axelin Anna , Lahti Mari 
Published: January 2021

BackgroundMental health problems among children and adolescents are a worldwide issue of concern. Health professionals who have sufficient competency in mental health issues are crucial for responding to this situation.AimThe aim of the study was to describe the competency in mental health issues required by the work of public health nurses in child health clinics and school health services.MethodsThis qualitative, descriptive study was conducted with focus group interviews in March 2018. The sample consisted of public health nurses (n = 24) who were working in child health clinics or school health services in Finland. The data were analysed using inductive and deductive content analysis.ResultsThe competency in mental health issues required by the work of public health nurses was formulated from the identified strengths and topics required in continuing education. In total, 18 competencies were identified as covering mental health promotion, as well as the alleviation and treatment of symptoms and disorders. Intuitive and interpersonal competency was identified as the main strength of public health nurses. The theoretical and evidence‐based competency regarding mental health issues was identified as a main topic needed in continuing education.ConclusionPublic health nurses in child health clinics and school health services need competency in mental health issues for the promotion of mental health, the alleviation of symptoms and treatment of disorders. The results indicate that good interactional skills are not enough: the current competency of public health nurses in mental health issues is insufficient and does not meet the requirements of the work.The results were consistent with existing knowledge, but also provide a more comprehensive and precise insight into the current situation. In the future, the results should be verified with more studies. There is also a need for intervention studies aiming to improve competency in mental health issues.
Role of pattern recognition receptors and the microbiota in neurological disorders
Authors: Keogh Ciara E. , Rude Kavi M. , Gareau Mélanie G. 
Published: January 2021

AbstractIn recent years, the gut microbiota has been increasingly implicated in the development of many extraintestinal disorders, including neurodevelopmental and neurodegenerative disorders. Despite this growing connection, our understanding of the precise mechanisms behind these effects is currently lacking. Pattern recognition receptors (PRRs) are important innate immune proteins expressed on the surface and within the cytoplasm of a multitude of cells, both immune and otherwise, including epithelial, endothelial and neuronal. PRRs comprise four major subfamilies: the Toll‐like receptors (TLRs), the nucleotide‐binding oligomerization domain leucine rich repeats‐containing receptors (NLRs), the retinoic acid inducible gene 1‐like receptors and the C‐type lectin receptors. Recognition of commensal bacteria by PRRs is critical for maintaining host–microbe interactions and homeostasis, including behaviour. The expression of PRRs on multiple cell types makes them a highly interesting and novel target for regulation of host–microbe signalling, which may lead to gut–brain signalling. Emerging evidence indicates that two of the four known families of PRRs (the NLRs and the TLRs) are involved in the pathogenesis of neurodevelopmental and neurodegenerative disorders via the gut–brain axis. Taken together, increasing evidence supports a role for these PRRs in the development of neurological disorders, including Alzheimer's disease, Parkinson's disease and multiple sclerosis, via the microbiota–gut–brain axis.
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Effect of Supraglottal Acoustics on Fluid–Structure Interaction During Human Voice Production
Authors: Bodaghi Dariush , Jiang Weili , Xue Qian , Zheng Xudong 
Published: January 2021

Abstract
A hydrodynamic/acoustic splitting method was used to examine the effect of supraglottal acoustics on fluid–structure interactions during human voice production in a two-dimensional computational model. The accuracy of the method in simulating compressible flows in typical human airway conditions was verified by comparing it to full compressible flow simulations. The method was coupled with a three-mass model of vocal fold lateral motion to simulate fluid–structure interactions during human voice production. By separating the acoustic perturbation components of the airflow, the method allows isolation of the role of supraglottal acoustics in fluid–structure interactions. The results showed that an acoustic resonance between a higher harmonic of the sound source and the first formant of the supraglottal tract occurred during normal human phonation when the fundamental frequency was much lower than the formants. The resonance resulted in acoustic pressure perturbation at the glottis which was of the same order as the incompressible flow pressure and found to affect vocal fold vibrations and glottal flow rate waveform. Specifically, the acoustic perturbation delayed the opening of the glottis, reduced the vertical phase difference of vocal fold vibrations, decreased flow rate and maximum flow deceleration rate (MFDR) at the glottal exit; yet, they had little effect on glottal opening. The results imply that the sound generation in the glottis and acoustic resonance in the supraglottal tract are coupled processes during human voice production and computer modeling of vocal fold vibrations needs to include supraglottal acoustics for accurate predictions.
Refractive accuracy in eyes undergoing combined cataract extraction and Descemet membrane endothelial keratoplasty
Authors: Campbell Jack A , Ladas John G , Wang Kendrick , Woreta Fasika , Srikumaran Divya 
Published: January 2021

PurposeTo evaluate the refractive accuracy of current intraocular lens (IOL) formulas and propose a modification in calculation of corneal power in eyes undergoing combined cataract extraction and Descemet membrane endothelial keratoplasty (DMEK).DesignRetrospective cohort study.MethodsPatients with Fuchs endothelial corneal dystrophy undergoing uncomplicated combined cataract surgery and DMEK at a single institution were included. The Hoffer Q, SRK/T, Holladay I, Barrett Universal II and Haigis formulas were compared. A modified corneal power was calculated using a thick lens equation based on anterior and posterior corneal radii and corneal thickness from Pentacam imaging. Error calculations were adjusted based on the difference in optical biometry and the modified corneal power. Mean absolute error (MAE) for each formula was compared between the corneal power modification and optical biometry corneal power.ResultsIn 86 eyes, the mean error ranged from 0.90 D for the Barrett Universal II formula to −0.10 D for the Haigis formula, with 4 of 5 formulas resulting in a mean hyperopic error. The corneal power modification resulted in a significantly lower MAE for the Hoffer Q (0.82 D), Holladay I (0.85 D), SRK/T (0.85 D) and Barrett Universal II (0.90 D) formulas compared with optical biometry corneal power for the Hoffer Q (1.02 D; p<0.005), Holladay I (0.97 D; p<0.005), SRK/T (0.93 D; p<0.01) and Barrett Universal II (1.16 D; p<0.005) formulas.ConclusionsAll formulas except the Haigis formula resulted in a hyperopic error. The corneal power modification significantly reduced error in four out of five IOL formulas.
Use of proton pump inhibitors to treat persistent throat symptoms: multicentre, double blind, randomised, placebo controlled trial
Authors: O’Hara James , Stocken Deborah D , Watson Gillian C , Fouweather Tony , McGlashan Julian , MacKenzie Kenneth , Carding Paul , Karagama Yakubu , Wood Ruth , Wilson Janet A 
Published: January 2021

Abstract

Objective
To assess the use of proton pump inhibitors
(PPIs) to treat persistent throat symptoms.

Design
Pragmatic, double blind, placebo controlled,
randomised trial.

Setting
Eight ear, nose, and throat outpatient clinics,
United Kingdom.

Participants
346 patients aged 18 years or older with
persistent throat symptoms who were randomised
according to recruiting centre and baseline
severity of symptoms (mild or severe): 172 to
lansoprazole and 174 to placebo.

Intervention
Random blinded allocation (1:1) to either 30 mg
lansoprazole twice daily or matched placebo twice
daily for 16 weeks.

Main outcome measures
Primary outcome was symptomatic response at 16
weeks measured using the total reflux symptom
index (RSI) score. Secondary outcomes included
symptom response at 12 months, quality of life,
and throat appearances.

Results
Of 1427 patients initially screened for
eligibility, 346 were recruited. The mean age of
the study sample was 52.2 (SD 13.7) years, 196
(57%) were women, and 162 (47%) had severe
symptoms at presentation; these characteristics
were balanced across treatment arms. The primary
analysis was performed on 220 patients who
completed the primary outcome measure within a
window of 14-20 weeks. Mean RSI scores were
similar between treatment arms at baseline:
lansoprazole 22.0 (95% confidence interval 20.4 to
23.6) and placebo 21.7 (20.5 to 23.0).
Improvements (reduction in RSI score) were
observed in both groups—score at 16 weeks:
lansoprazole 17.4 (15.5 to19.4) and placebo 15.6
(13.8 to 17.3). No statistically significant
difference was found between the treatment arms:
estimated difference 1.9 points (95% confidence
interval −0.3 to 4.2 points; P=0.096) adjusted for
site and baseline symptom severity. Lansoprazole
showed no benefits over placebo for any secondary
outcome measure, including RSI scores at 12
months: lansoprazole 16.0 (13.6 to 18.4) and
placebo 13.6 (11.7 to 15.5): estimated difference
2.4 points (−0.6 to 5.4 points).

Conclusions
No evidence was found of benefit from PPI
treatment in patients with persistent throat
symptoms. RSI scores were similar between the
lansoprazole and placebo groups after 16 weeks of
treatment and at the 12 month follow-up.

Trial registration

ISRCTN Registry
ISRCTN38578686
and EudraCT
2013-004249-17.
Using human-centred design to develop an innovative female condom
Authors: Coffey Patricia S , Kilbourne-Brook Maggie 
Published: January 2021

ObjectiveThe female condom is a non-hormonal barrier method that can protect from unintended pregnancy and sexually transmitted infections such as HIV. Female condoms are an important contribution to women’s reproductive health globally as they are the only woman-initiated method currently available that can provide dual protection. This article describes how human-centred design (HCD) was applied to the development of the Woman’s Condom—a second-generation female condom.MethodsA multidisciplinary team pioneered the application of HCD principles to develop a novel reproductive health product. The Woman’s Condom design incorporated feedback from both female and male users from multiple sites in the USA and Cuernavaca, Mexico; Durban, South Africa and Khon Kaen, Thailand to inform product development.ResultsWe developed and tested more than 50 design iterations reflecting various solutions to user-related concerns. The final locked design confirmed that the Woman’s Condom was easy to use, stable, comfortable and provided satisfactory sensation during sex for both partners. The ‘dissolving capsule’ to facilitate insertion and ‘soft cling’ design are key innovative features of the Woman’s Condom.ConclusionThe Woman’s Condom is a second-generation female (or internal) condom product that has been shown to be highly acceptable to users throughout the world. The Woman’s Condom’s special design features enable easy insertion, secure fit during use, good sensation and easy removal. Engaging users as codesigners through an HCD approach resulted in a female condom that meets the needs of women and men from diverse regions.
Electroacupuncture for stress-predominant mixed urinary incontinence: a protocol for a three-armed randomised controlled trial
Authors: Sun Yuanjie , Liu Yan , Chen Huan , Yan Yan , Liu Zhishun 
Published: January 2021

IntroductionEvidence specific for stress-predominant mixed urinary incontinence is still lacking at present, and acupuncture may relieve the symptoms. We plan to conduct this multi-centre, three-armed, randomised controlled trial to investigate the efficacy and safety of electroacupuncture among women with stress-predominant mixed urinary incontinence.Methods and analysisThe trial will be conducted at five hospitals in China. Two hundred thirty-two eligible women will be randomly assigned (2:1:1) to the electroacupuncture, sham electroacupuncture or waiting-list group to receive either 24-session acupuncture/sham acupuncture treatment over 8 weeks and 24-week follow-up or 20-week watchful waiting. The primary outcome is the proportion of participants with at least 50% reduction in mean 24-hour stress incontinence episode frequencies from baseline to week 8. The outcome will be analysed with the intention to treatpopulation (defined as participants randomised) with a two-sided p value of less than 0.05 considered significant.Ethics and disseminationThe protocol has been approved by Guang’anmen Hospital Institutional Review Board (2019-241-KY). Detailed information of the trial will be informed to the participants, and written informed consent will be obtained from every participant. Results of the trial are expected to be published in a peer-reviewed journal.Trial registration numberClinicalTrials.gov Registry (NCT04299932).
Prevalence of comorbidities and their associated factors in patients with type 2 diabetes at a tertiary care department in Ningbo, China: a cross-sectional study
Authors: Li Xueyu , Chattopadhyay Kaushik , Xu Shengnan , Chen Yanshu , Xu Miao , Li Li , Li Jialin 
Published: January 2021

ObjectivesTo determine the prevalence of comorbidities in patients with type 2 diabetes mellitus (T2DM) and identify the factors independently associated with comorbidities in a tertiary care department in Ningbo, China.DesignA computerised medical records database was used to conduct a cross-sectional study.SettingThe study was conducted in a tertiary care department in Ningbo, China.ParticipantsThe study was conducted on adult patients with T2DM, and it included 8 years of data, from 1 January 2012 to 31 December 2019.The primary outcome measureComorbidity was defined as the coexistence of at least one other chronic condition, that is, either a physical non-communicable disease (duration ≥3 months), a mental health condition (duration ≥3 months) or an infectious disease (duration ≥3 months).ResultsIn total, 4777 patients with T2DM satisfied the eligibility criteria. Over 8 years, the prevalence of comorbidities was 93.7%. The odds of comorbidities increased with the age of patients (18 to 39 years: 1; 40 to 59 years: OR 2.80, 95% CI 1.98 to 3.96; 60 to 69 years: OR 4.43, 95% CI 3.04 to 6.44; and ≥70 years: OR 10.97, 95% CI 7.17 to 16.77). The odds were lower in female patients (OR 0.66, 95% CI 0.51 to 0.84), patients residing in rural areas (OR 0.75, 95% CI 0.59 to 0.95) and patients without health insurance (OR 0.62, 95% CI 0.46 to 0.83). The odds were higher in single/divorced/widowed patients compared with those in married patients (OR 1.95, 95% CI 1.21 to 3.12).ConclusionsA large percentage of patients with T2DM in the tertiary care department in Ningbo, China, had comorbidities, and the factors associated with comorbidities were identified. The findings could be used in developing, evaluating and implementing interventions aimed at improving outcomes in patients with T2DM with comorbidities.
Nurse-led PrEP-RN clinic: a prospective cohort study exploring task-Shifting HIV prevention to public health nurses
Authors: O'Byrne Patrick , Vandyk Amanda , Orser Lauren , Haines Marlene 
Published: January 2021

ObjectiveTo report the results of a nurse-led pre-exposure prophylaxis (PrEP) delivery service.DesignThis was a prospective cohort study conducted from 5 August 2018 to 4 March 2020. It involved manual chart review to collect data. Variables were described using frequencies and percentages and analysed using χ2 testing. Those significant in bivariate analysis were retained and entered into a binary multiple logistic regression. Hierarchical modelling was used, and only significant factors were retained.SettingThis study occurred in an urban public health unit and community-based sexually transmitted infection (STI) clinic in Ottawa, Canada.ParticipantsOf all persons who were diagnosed with a bacterial STI in Ottawa and everyone who presented to our STI clinic during the study period, there were 347 patients who met our high-risk criteria for PrEP; these criteria included patients who newly presented with any of the following: HIV contacts, diagnosed with a bacterial STI or single use of HIV PEP. Further, eligibility could be determined based on clinical judgement. Patients who met the foregoing criteria were appropriate for PrEP-RN, while lower-risk patients were referred to elsewhere. Of the 347 patients who met our high-risk criteria, 47% accepted and 53% declined. Of those who accepted, 80% selected PrEP-registered nurse (RN).Primary and secondary outcome measuresUptake, acceptance, engagement and attrition factors of participants who obtained PrEP through PrEP-RN.Findings69% of participants who were eligible attended their intake PrEP-RN visit. 66% were retained in care. Half of participants continued PrEP and half were lost to follow-up. We found no significant differences in the uptake, acceptance, engagement and attrition factors of participants who accessed PrEP-RN regarding reason for referral, age, ethnicity, sexual orientation, annual income, education attainted, insurance status, if they have a primary care provider, presence or absence of depression or anxiety and evidence of newly acquired STI during the study period.ConclusionsNurse-led PrEP is an appropriate strategy for PrEP delivery.
Estimating the COVID-19 epidemic trajectory and hospital capacity requirements in South West England: a mathematical modelling framework
Authors: Booton Ross D , MacGregor Louis , Vass Lucy , Looker Katharine J , Hyams Catherine , Bright Philip D , Harding Irasha , Lazarus Rajeka , Hamilton Fergus , Lawson Daniel , Danon Leon , Pratt Adrian , Wood Richard , Brooks-Pollock Ellen , Turner Katherine M E 
Published: January 2021

ObjectivesTo develop a regional model of COVID-19 dynamics for use in estimating the number of infections, deaths and required acute and intensive care (IC) beds using the South West England (SW) as an example case.DesignOpen-source age-structured variant of a susceptible-exposed-infectious-recovered compartmental mathematical model. Latin hypercube sampling and maximum likelihood estimation were used to calibrate to cumulative cases and cumulative deaths.SettingSW at a time considered early in the pandemic, where National Health Service authorities required evidence to guide localised planning and support decision-making.ParticipantsPublicly available data on patients with COVID-19.Primary and secondary outcome measuresThe expected numbers of infected cases, deaths due to COVID-19 infection, patient occupancy of acute and IC beds and the reproduction (‘R’) number over time.ResultsSW model projections indicate that, as of 11 May 2020 (when ‘lockdown’ measures were eased), 5793 (95% credible interval (CrI) 2003 to 12 051) individuals were still infectious (0.10% of the total SW population, 95% CrI 0.04% to 0.22%), and a total of 189 048 (95% CrI 141 580 to 277 955) had been infected with the virus (either asymptomatically or symptomatically), but recovered, which is 3.4% (95% CrI 2.5% to 5.0%) of the SW population. The total number of patients in acute and IC beds in the SW on 11 May 2020 was predicted to be 701 (95% CrI 169 to 1543) and 110 (95% CrI 8 to 464), respectively. The R value in SW was predicted to be 2.6 (95% CrI 2.0 to 3.2) prior to any interventions, with social distancing reducing this to 2.3 (95% CrI 1.8 to 2.9) and lockdown/school closures further reducing the R value to 0.6 (95% CrI 0.5 to 0.7).ConclusionsThe developed model has proved a valuable asset for regional healthcare services. The model will be used further in the SW as the pandemic evolves, and—as open-source software—is portable to healthcare systems in other geographies.
Cardiovascular and cerebrovascular health after pre-eclampsia: the Motherhealth prospective cohort study protocol
Authors: Miller Eliza C , Miltiades Andrea , Pimentel-Soler Nicole , Booker Whitney A , Landau-Cahana Ruth , Marshall Randolph S , D"Alton Mary E , Wapner Ronald , Lawrence Cleary Kirsten , Bello Natalie 
Published: January 2021

IntroductionCardiovascular and cerebrovascular diseases (CCVDs) are the leading cause of maternal mortality in the first year after delivery. Women whose pregnancies were complicated by pre-eclampsia are at particularly high risk for adverse events. In addition, women with a history of pre-eclampsia have higher risk of CCVD later in life. The physiological mechanisms that contribute to increased CCVD risk in these women are not well understood, and the optimal clinical pathways for postpartum CCVD risk reduction are not yet defined.Methods and analysisThe Motherhealth Study (MHS) is a prospective cohort study at Columbia University Irving Medical Center (CUIMC), a quaternary care academic medical centre serving a multiethnic population in New York City. MHS began recruitment on 28 September 2018 and will enrol 60 women diagnosed with pre-eclampsia with severe features in the antepartum or postpartum period, and 40 normotensive pregnant women as a comparison cohort. Clinical data, biospecimens and measures of vascular function will be collected from all participants at the time of enrolment. Women in the pre-eclampsia group will complete an additional three postpartum study visits over 12–24 months. Visits will include additional detailed cardiovascular and cerebrovascular phenotyping. As this is an exploratory, observational pilot study, only descriptive statistics are planned. Data will be used to inform power calculations for future planned interventional studies.Ethics and disseminationThe CUIMC Institutional Review Board approved this study prior to initiation of recruitment. All participants signed informed consent prior to enrolment. Results will be disseminated to the clinical and research community, along with the public, on completion of analyses. Data will be shared on reasonable request.