bluuebunny/crossref_metadata_2025_split huggingface dataset:
A systematic review of the use of positive deviance approaches in primary care
Authors: O’Malley Roisin , O’Connor Paul , Madden Caoimhe , Lydon Sinéad 
Published: November 2021

Abstract

Background
The Positive Deviance (PD) approach focuses on identifying and learning from those who demonstrate exceptional performance despite facing similar resource constraints to others. Recently, it has been embraced to improve the quality of patient care in a variety of healthcare domains. PD may offer one means of enacting effective quality improvement in primary care.

Objective(s)
This review aimed to synthesize the extant research on applications of the PD approach in primary care.

Methods
Seven electronic databases were searched; MEDLINE, CINAHL, Embase, PsycINFO, Academic Search Complete, Psychology and Behavioral Sciences Collection, and Web of Science. Studies reporting original data on applications of the PD approach, as described by the PD framework, in primary care were included, and data extracted. Thematic analysis was used to classify positively deviant factors and to develop a conceptual framework. Methodological quality was appraised using the Quality Assessment with Diverse Studies (QuADS).

Results
In total, 27 studies were included in the review. Studies most frequently addressed Stages 1 and 2 of the PD framework, and targeted 5 core features of primary care; effectiveness, chronic disease management, preventative care, prescribing behaviour, and health promotion. In total, 268 factors characteristic of exceptional care were identified and synthesized into a framework of 37 themes across 7 system levels.

Conclusion
Several useful factors associated with exceptional care were described in the literature. The proposed framework has implications for understanding and disseminating best care practice in primary care. Further refinement of the framework is required before its widespread recommendation.
Assemblies of the genomes of parasitic wasps using meta-assembly and scaffolding with genetic linkage
Authors: Wittmeyer Kameron T , Oppenheim Sara J , Hopper Keith R 
Published: November 2021

Abstract
Safe, effective biological-control introductions against invasive pests depend on narrowly host-specific natural enemies with the ability to adapt to a changing environment. As part of a project on the genetic architectures of these traits, we assembled and annotated the genomes of two aphid parasitoids, Aphelinus atriplicis and Aphelinus certus. We report here several assemblies of A. atriplicis made with Illumina and PacBio data, which we combined into a meta-assembly. We scaffolded the meta-assembly with markers from a genetic map of hybrids between A. atriplicis and A. certus. We used this genetic-linkage scaffolded (GLS) assembly of A. atriplicis to scaffold a de novo assembly of A. certus. The de novo assemblies of A. atriplicis differed in contiguity, and the meta-assembly of these assemblies was more contiguous than the best de novo assembly. Scaffolding with genetic-linkage data allowed chromosomal-level assembly of the A. atriplicis genome and scaffolding a de novo assembly of A. certus with this GLS assembly, greatly increased the contiguity of the A. certus assembly to the point where it was also at the chromosomal-level. However, completeness of the A. atriplicis assembly, as measured by percent complete, single-copy BUSCO hymenopteran genes, varied little among de novo assemblies and was not increased by meta-assembly or genetic scaffolding. Furthermore, the greater contiguity of the meta-assembly and GLS assembly had little or no effect on the numbers of genes identified, the proportions with homologs or functional annotations. Increased contiguity of the A. certus assembly provided modest improvement in assembly completeness, as measured by percent complete, single-copy BUSCO hymenopteran genes. The total genic sequence increased, and while the number of genes declined, gene length increased, which together suggest greater accuracy of gene models. More contiguous assemblies provide uses other than gene annotation, for example, identifying the genes associated with quantitative trait loci and understanding of chromosomal rearrangements associated with speciation.
Genetic and genomic architecture in eight strains of the laboratory opossum Monodelphis domestica
Authors: Xiong Xiao , Samollow Paul B , Cao Wenqi , Metz Richard , Zhang Chao , Leandro Ana C , VandeBerg John L , Wang Xu 
Published: November 2021

Abstract
The gray short-tailed opossum (Monodelphis domestica) is an established laboratory-bred marsupial model for biomedical research. It is a critical species for comparative genomics research, providing the pivotal phylogenetic outgroup for studies of derived vs ancestral states of genomic/epigenomic characteristics for eutherian mammal lineages. To characterize the current genetic profile of this laboratory marsupial, we examined 79 individuals from eight established laboratory strains. Double digest restriction site-associated DNA sequencing and whole-genome resequencing experiments were performed to investigate the genetic architecture in these strains. A total of 66,640 high-quality single nucleotide polymorphisms (SNPs) were identified. We analyzed SNP density, average heterozygosity, nucleotide diversity, and population differentiation parameter Fst within and between the eight strains. Principal component and population structure analysis clearly resolve the strains at the level of their ancestral founder populations, and the genetic architecture of these strains correctly reflects their breeding history. We confirmed the successful establishment of the first inbred laboratory opossum strain LSD (inbreeding coefficient F &gt; 0.99) and a nearly inbred strain FD2M1 (0.98 &lt; F &lt; 0.99), each derived from a different ancestral background. These strains are suitable for various experimental protocols requiring controlled genetic backgrounds and for intercrosses and backcrosses that can generate offspring with informative SNPs for studying a variety of genetic and epigenetic processes. Together with recent advances in reproductive manipulation and CRISPR/Cas9 techniques for Monodelphis domestica, the existence of distinctive inbred strains will enable genome editing on different genetic backgrounds, greatly expanding the utility of this marsupial model for biomedical research.
Do Epigenetic Clocks Provide Explanations for Sex Differences in Life Span? A Cross-Sectional Twin Study
Authors: Kankaanpää Anna , Tolvanen Asko , Saikkonen Pirkko , Heikkinen Aino , Laakkonen Eija K , Kaprio Jaakko , Ollikainen Miina , Sillanpää Elina 
Published: November 2021

Abstract

Background
The sex gap in life expectancy has been narrowing in Finland over the past 4–5 decades; however, on average, women still live longer than men. Epigenetic clocks are markers for biological aging which predict life span. In this study, we examined the mediating role of lifestyle factors on the association between sex and biological aging in younger and older adults.

Methods
Our sample consists of younger and older twins (21‒42 years, n = 1 477; 50‒76 years, n = 763) including 151 complete younger opposite-sex twin pairs (21‒30 years). Blood-based DNA methylation was used to compute epigenetic age acceleration by 4 epigenetic clocks as a measure of biological aging. Path modeling was used to study whether the association between sex and biological aging is mediated through lifestyle-related factors, that is, education, body mass index, smoking, alcohol use, and physical activity.

Results
In comparison to women, men were biologically older and, in general, they had unhealthier life habits. The effect of sex on biological aging was partly mediated by body mass index and, in older twins, by smoking. Sex was directly associated with biological aging and the association was stronger in older twins.

Conclusions
Previously reported sex differences in life span are also evident in biological aging. Declining smoking prevalence among men is a plausible explanation for the narrowing of the difference in life expectancy between the sexes. Data generated by the epigenetic clocks may help in estimating the effects of lifestyle and environmental factors on aging and in predicting aging in future generations.
Examining Consequences Related to Unmet Care Needs Across the Long-Term Care Continuum
Authors: Jenkins Morales Meghan , Robert Stephanie A 
Published: November 2021

Abstract

Objectives
To examine how different care arrangements across the long-term care continuum are associated with experiencing unmet care need consequences (UCNCs), such as skipping meals, going without clean clothes, or taking the wrong medication.

Methods
We include older adults receiving assistance with at least one self-care, mobility, or household activity (for health/functioning reasons) in the 2015 National Health and Aging Trends Study (N = 2,388). We examine the likelihood of experiencing a UCNC across the long-term care continuum: those receiving unpaid community care only, paid community care, and residential care. Cross-sectional logistic and longitudinal multinomial logistic regression models examine if type of care arrangement in 2015 is associated with UCNCs in 2015 and change in UCNCs by 2017.

Results
In adjusted cross-sectional models, paid community care recipients had roughly 2 times greater odds of experiencing a UCNC in 2015 compared to those living in residential care or receiving only unpaid care. In adjusted longitudinal models, the risk of experiencing persistent UCNCs (compared to having needs met in both years) was 4.81 times higher for those receiving paid community care compared to those in residential care and 2.17 times that of those receiving unpaid care only.

Discussion
Older adults receiving paid care face significant and consequential gaps in care, particularly in comparison to those in other care arrangements. More attention is needed to determine how paid care arrangements can be improved and/or expanded to meet the needs of the growing number of older adults receiving paid care in the community.
South Africa's experimental fisheries closures and recovery of the endangered African penguin
Authors: Sydeman William J , Hunt George L , Pikitch Ellen K , Parrish Julia K , Piatt John F , Boersma P Dee , Kaufman Les , Anderson Daniel W , Thompson Sarah Ann , Sherley Richard B 
Published: November 2021

Abstract
In a scientifically-transformative project, South Africa implemented a decade-long field experiment to understand how fisheries may be affecting its most iconic seabird, the African penguin Spheniscus demersus. This unique effort prohibits the take of anchovy and sardine within relatively small areas around four African penguin breeding colonies, two in the Benguela upwelling ecosystem and two in the adjacent Agulhas region. For the Benguela, fisheries closures within the birds’ primary foraging range increased their breeding productivity and perhaps reduced parental foraging efforts, indicating that the fisheries are competing with the birds for food. Results were less clear for foraging behaviour in the Agulhas, but no data on breeding success were collected there. The African penguin is endangered, its population continues to decline, and fisheries closures have been demonstrated to improve demographic traits that contribute to population growth. Therefore, given the critical status of the species, fisheries closures should be maintained, at least at Dassen Island where the population has great capacity to expand and support other nearby colonies. Continuing or implementing corresponding fisheries closures in the Agulhas region is also warranted, as well as creating and testing the value of pelagic closed areas during the non-breeding season when the penguins disperse widely across these ecosystems. These management actions would increase penguin food supplies and may help to meet societal goals of halting the decline of the penguin population, as well as maintaining the economic and cultural services provided by fisheries and ecotourism.
Global decentralized control for uncertain large-scale feedforward nonlinear time-delay systems via output feedback
Authors: Shao Yiming , Jia Xianglei , Ju Xinxu , Shi Xiaocheng 
Published: November 2021

Abstract
In this paper, the problem of global decentralized output feedback control is addressed for a class of large-scale nonlinear systems with zero dynamics and unknown time-varying delay. System disturbance nonlinearities are subject to feedforward growth restrictions with unknown growth rate. In the spirit of dynamic scaling change technique, a novel pair of time-varying-gain observer and controller is proposed. Compared with the existing results, the controller proposed is capable of handling the difficulties caused by the zero-dynamics, the uncertainties and the unknown time-varying delay. With the help of the Razumikhin theorem, it is shown that the closed-loop states asymptotically converge to zero. Finally, the effectiveness of the proposed control scheme is illustrated by a numerical example.
Estimating Tuberculosis Transmission Risks in a Primary Care Clinic in South Africa: Modeling of Environmental and Clinical Data
Authors: Zürcher Kathrin , Riou Julien , Morrow Carl , Ballif Marie , Koch Anastasia , Bertschinger Simon , Warner Digby F , Middelkoop Keren , Wood Robin , Egger Matthias , Fenner Lukas 
Published: November 2021

Abstract

Background
Congregate settings, such as healthcare clinics, may play an essential role in Mycobacterium tuberculosis (Mtb) transmission. Using patient and environmental data, we studied transmission at a primary care clinic in South Africa.

Methods
We collected patient movements, cough frequency, and clinical data, and measured indoor carbon dioxide (CO2) levels, relative humidity, and Mtb genomes in the air. We used negative binomial regression model to investigate associations.

Results
We analyzed 978 unique patients who contributed 14 795 data points. The median patient age was 33 (interquartile range [IQR], 26–41) years, and 757 (77.4%) were female. Overall, median CO2 levels were 564 (IQR 495–646) parts per million and were highest in the morning. Median number of coughs per day was 466 (IQR, 368–503), and overall median Mtb DNA copies/μL/day was 4.2 (IQR, 1.2–9.5). We found an increased presence of Mtb DNA in the air of 32% (95% credible interval, 7%–63%) per 100 additional young adults (aged 15–29 years) and 1% (0–2%) more Mtb DNA per 10% increase of relative humidity. Estimated cumulative transmission risks for patients attending the clinic monthly for at least 1 hour range between 9% and 29%.

Conclusions
We identified young adults and relative humidity as potentially important factors for transmission risks in healthcare clinics. Our approach should be used to detect transmission and evaluate infection control interventions.
Surfaces and Air Contamination by Severe Acute Respiratory Syndrome Coronavirus 2 Using High-Flow Nasal Oxygenation or Assisted Mechanical Ventilation in Intensive Care Unit Rooms of Patients With Coronavirus Disease 2019
Authors: Lebreil Anne-Laure , Greux Vincent , Glenet Marie , Huguenin Antoine , N’Guyen Yohan , Berri Fatma , Bajolet Odile , Mourvillier Bruno , Andreoletti Laurent 
Published: November 2021

Abstract

Background
Understanding patterns of environmental contamination by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is essential for infection prevention policies.

Methods
We screened surfaces and air samples from single-bed intensive-care unit rooms of adult patients with coronavirus disease 2019 (COVID-19) for SARS-CoV-2 RNA and viable viruses.

Results
We evidenced viral RNA environmental contamination in 76% of 100 surfaces samples and in 30% of 40 air samples without any viable virus detection by cell culture assays. No significant differences of viral RNA levels on surfaces and in ambient air were observed between rooms of patients with assisted mechanical ventilation and those of patients with a high-flow nasal cannula system. Using an original experimental SARS-CoV-2 infection model of surfaces, we determined that infectious viruses may have been present on benches within 15 hours before the time of sampling in patient rooms.

Conclusions
We observed that SARS-CoV-2 environmental contamination around patients with COVID-19 hospitalized in single-bed ICU rooms was extensive and that a high-flow nasal cannula system did not generate more viral aerosolization than a mechanical ventilation system in patients with COVID-19. Despite an absence of SARS-CoV-2 viable particles in study samples, our experimental model confirmed the need to apply strict environmental disinfection procedures and classic standard and droplet precautions in ICU wards.
The future of data management for pediatric cataract
Authors: Bartlett Sarah , Hassan Amina , Ibrahim Nazaradden , Isiyaku Sunday , Muhammad Nasiru , Ngom Babacar , Nwosu Christian 
Published: November 2021

Abstract
Cataract is a leading cause of blindness in children worldwide. Blindness can be treated with effective surgery, but in low-resource settings this treatment can be difficult to access. In addition, positive outcomes of the surgery are heavily dependent on comprehensive postoperative care. To date in Nigeria and many other low-resource countries, robust electronic data-management systems that help facility teams to manage their patient data, especially when it comes to tracking children for follow-up visits after surgery, have either yet to be put into place or are in place but have yet to be refined to respond to the specific needs of eye care programs. Sightsavers has worked with multiple state ministries in Nigeria to set up and test a system that responds to those needs.
A multimodal approach to improve asthmatic adolescents’ self-efficacy in Taiwan
Authors: Tseng Tzu-Jung , Wu Chiung-Jung (Jo) 
Published: November 2021

Abstract

Background
An efficient asthma self-management for adolescents must be based on adolescents’ needs, increase self-efficacy and adherence to treatment. The effects of such program are likely be dose dependent.

Aim
To examine the impact of the dose-effect of multiple components on an asthma self-management program for adolescents aged 12-18 years in Taiwan.

Methods
A scoring system was developed to classify intervention groups into high- (19-23), medium- (11-18) and low (&lt; 11) dose according to the number of components completed by participants. The impacts of the dose level on outcomes of asthma self-efficacy, prevention behaviors, asthma medication adherence, and asthma symptoms were examined.

Results/Conclusion
Our results suggest that a high dose of the intervention can improve adolescents’ self-efficacy, asthma prevention behavior, and medication adherence.

Trial Registration
Trial Registration No: ACTRN12613001294741.
Quality Management to Improve CSF Gram Stain Turnaround Time
Authors: Kerantzas Christopher A , Merwede Jacob P , Fadlallah Hasan , Durant Thomas J S , Peaper David R 
Published: November 2021

Abstract

Background
With appropriate turnaround time (TAT), cerebrospinal fluid (CSF) Gram stains can provide rapid, clinically actionable information in patients with meningitis. Monitoring CSF Gram stain TAT at our institution revealed workflow gaps that were causing result reporting delays. We then implemented a new quality management program to improve TAT.

Methods
We reviewed the TAT of all CSF specimens submitted for bacterial culture received between August 1, 2016, and July 31, 2020, and began prospectively monitoring CSF Gram stain TAT in January 2019. We then implemented the following changes in April 2019: (i) monthly reviews of TAT with staff, (ii) hand-off sheets for shift transitions, and (iii) pre- and post-shift walk throughs including centrifuge checks.

Results
A total of 6913 samples were included in the analysis. CSF samples with TAT &gt; 60 min decreased from 27.3% to 9.89% (P &lt; 0.0001), and median TAT decreased by 9 min (P &lt; 0.0001) with significantly reduced variability. These changes were sustained throughout the follow-up period across all shifts and shift transitions.

Conclusions
A new monthly quality metric allowed us to track CSF Gram stain TAT, identify barriers to TAT goals, and implement workflow changes that significantly improved TAT without the need for costly interventions.
Dark clouds and silver linings: impact of COVID-19 on internet users’ privacy
Authors: Gopal Ram D , Hidaji Hooman , Patterson Raymond A , Yaraghi Niam 
Published: November 2021

Abstract

Objectives
To examine the impact of coronavirus disease 2019 (COVID-19) pandemic on the extent of potential violations of Internet users’ privacy.

Materials and Methods
We conducted a longitudinal study of the data sharing practices of the top 1000 websites in the United States between April 9 and August 27, 2020. We fitted a conditional latent growth curve model on the data to examine the longitudinal trajectory of the third-party data sharing over the 21 weeks period of the study and examine how website characteristics affect this trajectory. We denote websites that asked for permission before placing cookies on users’ browsers as “privacy-respecting.”

Results
As the weekly number of COVID-19 deaths increased by 1000, the average number of third parties increased by 0.26 (95% confidence interval [CI] 0.15–0.37) P &lt; 0.001 units in the next week. This effect was more pronounced for websites with higher traffic as they increased their third parties by an additional 0.41 (95% CI 0.18–0.64); P &lt; 0.001 units per week. However, privacy respecting websites that experienced a surge in traffic reduced their third parties by 1.01 (95% CI −2.01 to 0); P = 0.05 units per week in response to every 1000 COVID-19 deaths in the preceding week.

Discussion
While in general websites shared their users’ data with more third parties as COVID-19 progressed in the United States, websites’ expected traffic and respect for users’ privacy significantly affect such trajectory.

Conclusions
Attention should also be paid to the impact of the pandemic on elevating online privacy threats, and the variation in third-party tracking among different types of websites.
The prevalence and risk factors of pubic bone marrow edema in femoroacetabular impingement and hip dysplasia
Authors: Shimodaira Hiroki , Hatakeyama Akihisa , Suzuki Hitoshi , Takada Shinichiro , Murata Yoichi , Sakai Akinori , Uchida Soshi 
Published: November 2021

ABSTRACT
Femoroacetabular impingement syndrome (FAIS) has been associated with osteitis pubis; however, it is still unclear whether hip dysplasia is associated with osteitis pubis. This study aimed to investigate (i) the incidence of pubic bone marrow edema (BME) on magnetic resonance imaging in symptomatic patients with FAIS, borderline developmental dysplasia of the hip (BDDH) and developmental dysplasia of the hip (DDH) undergoing hip arthroscopic surgery with labral preservation and (ii) the demographic and radiographic factors associated with pubic BME. A total of 259 symptomatic patients undergoing hip arthroscopic surgery between July 2016 and April 2019 were retrospectively reviewed and divided into three groups: FAIS (180 patients), BDDH (29 patients) and DDH (50 patients). Diffuse changes in the pubic bone adjacent to the pubic symphysis were labeled pubic BME, and the prevalence of their occurrence was examined. Multivariate logistic regression analysis was performed to identify factors involved in pubic BME, and odds ratios (ORs) for relevant factors were calculated. There was no significant difference in the prevalence of pubic BME among the three groups (20 [11.1%] of 180 FAIS patients, 6 [20.6%] of 29 BDDH patients and 7 [14%] of 50 DDH patients, P = 0.325). Multivariate logistic regression analysis showed that acetabular coverage was not associated with pubic BME, whereas younger age and greater alpha angle were still independent associated factors [age ≤26 years (OR, 65.7) and alpha angle ≥73.5° (OR, 4.79)]. Determining the possible association of osteitis pubis with cam impingement in dysplastic hips may provide insights toward a more accurate understanding of its pathophysiology.