bluuebunny/crossref_metadata_2025_split huggingface dataset:
Scoping review of stepped care interventions for mental health and substance use service delivery to youth and young adults
Authors: Berger Mai , Fernando Saranee , Churchill AnnMarie , Cornish Peter , Henderson Joanna , Shah Jai , Tee Karen , Salmon Amy 
Published: May 2021

AbstractAimsMany young people with mental health and/or substance use concerns do not have access to timely, appropriate, and effective services. Within this context, stepped care models (SCMs) have emerged as a guiding framework for care delivery, inspiring service innovations across the globe. However, substantial gaps remain in the evidence for SCMs as a strategy to address the current systemic challenges in delivering services for young people. This scoping review aims to identify where these gaps in evidence exist, and the next steps for addressing them.MethodsA scoping review was conducted involving both peer‐reviewed and grey literature. Eligible studies explored SCMs implemented in the various health care settings accessed by young people aged 12–24 seeking treatment for mental health and substance use challenges. After screening titles and abstracts, two reviewers examined full‐text articles and extracted data to create a descriptive summary of the models.ResultsOf the 656 studies that were retrieved, 51 studies were included and grouped by study team for a final yield of 43 studies. Almost half of the studies were focused on the adult population (i.e., 18 and over), and most did not specify interventions for young people. Among the SCMs, substantial variability was found in almost every aspect of the models.ConclusionsConsidering the current body of evidence, there is an urgent need for a consensus position on the definition, implementation, and outcome measures required for rigorously assessing the utility of SCMs for young people.
A knowledge‐based self‐pre‐diagnosis system to predict Covid‐19 in smartphone users using personal data and observed symptoms
Authors: Çelik Ertuğrul Duygu , Çelik Ulusoy Demet 
Published: May 2021

AbstractCovid‐19 is an acute respiratory infection and presents various clinical features ranging from no symptoms to severe pneumonia and death. Medical expert systems, especially in diagnosis and monitoring stages, can give positive consequences in the struggle against Covid‐19. In this study, a rule‐based expert system is designed as a predictive tool in self‐pre‐diagnosis of Covid‐19. The potential users are smartphone users, healthcare experts and government health authorities. The system does not only share the data gathered from the users with experts, but also analyzes the symptom data as a diagnostic assistant to predict possible Covid‐19 risk. To do this, a user needs to fill out a patient examination card that conducts an online Covid‐19 diagnostic test, to receive an unconfirmed online test prediction result and a set of precautionary and supportive action suggestions. The system was tested for 169 positive cases. The results produced by the system were compared with the real PCR test results for the same cases. For patients with certain symptomatic findings, there was no significant difference found between the results of the system and the confirmed test results with PCR test. Furthermore, a set of suitable suggestions produced by the system were compared with the written suggestions of a collaborated health expert. The suggestions deduced and the written suggestions of the health expert were similar and the system suggestions in line with suggestions of the expert. The system can be suitable for diagnosing and monitoring of positive cases in the areas other than clinics and hospitals during the Covid‐19 pandemic. The results of the case studies are promising, and it demonstrates the applicability, effectiveness, and efficiency of the proposed approach in all communities.
The Brazilian Cerrado is becoming hotter and drier
Authors: Hofmann Gabriel S. , Cardoso Manoel F. , Alves Ruy J. V. , Weber Eliseu J. , Barbosa Alexandre A. , de Toledo Peter M. , Pontual Francisco B. , Salles Leandro de O. , Hasenack Heinrich , Cordeiro José L. P. , Aquino Francisco E. , de Oliveira Luiz F. B. 
Published: May 2021

AbstractThe Brazilian Cerrado is a global biodiversity hotspot with notoriously high rates of native vegetation suppression and wildfires over the past three decades. As a result, climate change can already be detected at both local and regional scales. In this study, we used three different approaches based on independent datasets to investigate possible changes in the daytime and nighttime temperature and air humidity between the peak of the dry season and the beginning of the rainy season in the Brazilian Cerrado. Additionally, we evaluated the tendency of dew point depression, considering it as a proxy to assess impacts on biodiversity. Monthly increases of 2.2−4.0℃ in the maximum temperatures and 2.4−2.8℃ in the minimum temperatures between 1961 and 2019 were recorded, supported by all analyzed datasets which included direct observations, remote sensing, and modeling data. The warming raised the vapor pressure deficit, and although we recorded an upward trend in absolute humidity, relative humidity has reduced by ~15%. If these tendencies are maintained, gradual air warming will make nightly cooling insufficient to reach the dew point in the early hours of the night. Therefore, it will progressively reduce both the amount and duration of nocturnal dewfall, which is the main source of water for numerous plants and animal species of the Brazilian Cerrado during the dry season. Through several examples, we hypothesize that these climate changes can have a high impact on biodiversity and potentially cause ecosystems to collapse. We emphasize that the effects of temperature and humidity on Cerrado ecosystems cannot be neglected and should be further explored from a land use perspective.
Restoration of forest resilience to fire from old trees is possible across a large Colorado dry‐forest landscape by 2060, but only under the Paris 1.5℃ goal
Authors: Baker William L. 
Published: May 2021

AbstractFire‐prone dry forests often face increasing fires from climate change with low resistance and resilience due to logging of large, old fire‐resistant trees. Their restoration across large landscapes is constrained by limited mature trees, physical settings, and protection. Active restoration has been costly and shown limited effectiveness, but lower cost passive restoration is less studied. I used GIS and machine learning to see whether passive restoration of old trees could overcome constraints in time, by 2060, across 667,000 ha of montane forests in the San Juan Mountains, Colorado, where temperatures are increasing faster than the global average. Random Forest models of physical locations of reconstructed historical old growth (OG) and relatively frequent fire (RFF) show historical OG with RFF was favored between 6.1 and 7.9℃ annual mean temperatures. Random Forest models projected that similar temperature‐suitable locations were moved into the current middle montane ca 2015, and would be extended to just below the upper limit of the montane if the Paris 1.5℃ goal is reached, but beyond if not. US Forest Service common stand exam data, which covered ~15% of the study area and included 26,149 tree ages, show the highest potential for restoring resistance and resilience from old trees is a ≥120‐year age class. This class could become a ≥160‐year age class, which meets old‐growth age criteria, over 81% of the area by ca 2060, nearly fully restoring historical old‐growth levels. Half this age class is already protected, and much of the remainder could be retained using evidence‐based diameter caps. Datasets thus are sufficient to show that passive restoration of old‐tree resistance and resilience to fire is feasible by ca 2060 across a large montane landscape, although contingent on global success in achieving the Paris 1.5℃ goal. Passive restoration may be viable elsewhere.
Global quantitative synthesis of effects of biotic and abiotic factors on stemflow production in woody ecosystems
Authors: Zhang Yafeng , Wang Xinping , Pan Yanxia , Hu Rui , Chen Ning 
Published: May 2021

AbstractAimStemflow has been increasingly recognized as an indispensable component in water and nutrient budgets within vegetated ecosystems. Here we aim to quantify the stemflow percentage (St, %) of incident precipitation (i.e. stemflow production) at a global scale, and to provide a systematic evaluation on how biotic and abiotic factors affect St.LocationGlobal.Time period1970–2019.Major taxa studiedWoody plants (trees and shrubs).MethodsWe compiled a global stemflow dataset from 234 peer‐reviewed papers, which included 488 observations of St and the related biotic (stand characteristics) and abiotic factors (climate variables) at 283 sites within terrestrial woody plant ecosystems. We explored the global pattern of St and performed a machine learning method (boosted regression trees) to model the effects of biotic and abiotic variables on St.ResultsGlobally, the median (interquartile range, IQR) St was 2.7% (1.0–6.3%). We found that St in arid zones (type B in the Köppen‐Geiger climate classification) was significantly higher (p < .01) than in other climate types, and we also detected a significant difference (p < .01) in St between trees (median: 2.4%; IQR: 1.0–5.3%) and shrubs (median: 7.2%; IQR: 5.2–11.9%). Predictor variables that substantially accounted for the explained deviance of the final model included vegetation height (27.0%), mean annual precipitation (16.1%), mean annual temperature (14.4%), stand density (10.8%), stand age (8.9%) and bark type (5.5%). In contrast, leaf area index, diameter at breast height, basal area, phenology type, life‐form and leaf type were classified as low importance.Main conclusionsOur synthesis provides a cross‐site comparison of St, and gives a holistic view on how climate variables and stand characteristics contribute to and affect global stemflow production.
e‐Oral health interventions for older patients in an outreach primary dental care centre: A pilot trial nested acceptability study
Authors: Wanyonyi Kristina , Couch Courtney , John Jeyanthi , Louca Chris 
Published: May 2021

AbstractObjectiveTo compare the acceptability and perceived helpfulness of an e‐Oral Health intervention in form of text messages versus standard dental leaflets provided after a dental visit to patients aged 65 years and over.BackgroundOral health care needs for older people are increasing. Remote interventions using e‐Health can ensure oral care is provided despite physical hindrances or situations where dental appointments are limited such as has happened more widely during the COVID‐19 pandemic.Materials and methodsMixed‐method nested study within a pilot trial. Dental patients (n = 150) at an outreach primary dental care centre, ≥ 65 years old, were recruited and randomly allocated to e‐Oral health text messages or leaflet intervention arms. Post‐intervention (6 months), participants responded to open and closed‐ended two‐way survey phone texts. Survey questions investigated: (a) whether they would recommend the intervention, (b) intervention helpfulness and (c) OPEN feedback. Average helpfulness scores (Scale:1= Very Helpful to 5= Not Helpful at All) were compared for each arm using Independent Sample t‐test. Percentage of participants providing positive recommendations in each arm were compared using chi‐squared tests. Qualitative findings were analysed using thematic analysis.ResultsN = 68 (45%) responded. Mean helpfulness scores in text group M = 2.2, SD=1.1) and leaflet group M = 2.3, SD=1.9, P = .29. Amongst the text arm respondents, 89% compared with 68.2% in leaflet arm; P = .005 would recommend the intervention. Four qualitative themes were outlined: intervention approach, content, behavioural impact and recommendations.Conclusione‐Oral Health text interventions are acceptable and helpful to older people, but these messages need to be tailored.
Adherence to prophylaxis and its association with activation of self‐management and treatment satisfaction
Authors: Hoefnagels Johanna Wilhelmina , Schrijvers Liesbeth Hélène , Leebeek Frank W. G. , Eikenboom Jeroen , Schols Saskia E. M. , Smit Cees , Schutgens Roger E. G. , Gouw Samantha C. , Fischer Kathelijn ,   the Haemophilia in the Netherlands 6 Steering Group
Published: May 2021

AbstractIntroductionProphylactic replacement therapy (prophylaxis) in patients with haemophilia (PWH) requires lifelong, frequent (self)infusions. Prophylaxis effectiveness depends on adherence, and the drivers of treatment adherence among PWH are unclear.AimTo quantify prophylaxis adherence and associations between adherence and patients’ treatment attitudes and satisfaction in a large cohort of children and adults with haemophilia.MethodsIn a nationwide, cross‐sectional, questionnaire‐based study, PWH with complete information currently using prophylaxis were selected. Validated Hemophilia Regimen Treatment Adherence Scale‐Prophylaxis (VERITAS‐Pro; normalised score range: 0–100, optimum 0) measured treatment adherence; the Patient Activation Measure (PAM‐13; total score range 0–100, optimum 100) measured activation of self‐management; Hemophilia Patient Satisfaction Scale (Hemo‐Sat; range 0–100, optimum 0) measured treatment satisfaction. Groups were compared according to age (children: <12 years; adolescents: 12–18 years; adults >18 years) and adherence levels using non‐parametric tests, and correlations were assessed using Spearman's rho.ResultsAmong 321 participants (median age 33 years, interquartile range [IQR]:15–54 years), adherence was high (median VERITAS‐Pro total score 17, 89% adherent) but worsened with age, with median scores of 5, 14 and 20 in children, adolescents, adults, respectively (p < .001). Attitudes towards treatment (median 66 vs. 68) participants and treatment satisfaction (12 vs. 10) were similar between adherent and non‐adherent patients. The VERITAS‐Pro total score was moderately correlated with PAM‐13 (r = .41) but not with Hemo‐Sat (r = −.11).DiscussionProphylaxis adherence was high (89%) but decreased significantly with age and was not correlated with treatment attitude or treatment satisfaction.
Evaluation of an intervention to promote minimally invasive dentistry (MID) in an Australian community dental agency—A pilot study
Authors: Nguyen Tan Minh , Tonmukayakul Utsana , Calache Hanny 
Published: May 2021

AbstractObjectivesTo evaluate the impact of an intervention consisting of a 1‐day continuing professional development (CPD) education programme on the International Caries Classification and Management System (ICCMS™), and monthly performance feedback, and to promote minimally invasive dentistry (MID) for children aged under 12 years in an Australian community dental agency. The a priori hypotheses assumed the intervention would increase preventive services, and treatment demand was met.MethodsA quasi non‐randomized controlled trial with convenience sampling method was adopted. Fourteen dental practitioners received the intervention. The prevalence of dental caries and gingivitis in Australian children was used to determine the treatment demand and used as the performance benchmark. Ten types of preventive and non‐preventive dental services were examined. A Difference‐in‐Differences (DiD) of 12‐month pre‐ (baseline) and post‐intervention analysis was performed.ResultsThe intervention group demonstrated increases in topical fluoride application and dietary analysis and advice services. The standard care group had increases in oral prophylaxis or scale and clean, topical fluoride application and oral hygiene instructions (p‐value <0.05). The DiD analysis confirmed the above findings in the intervention group, while other preventive services declined. In the intervention group, the performance benchmark for oral prophylaxis or scale and clean and oral hygiene instructions was met at baseline and post‐intervention.ConclusionsOnly a few preventive services had already met the performance benchmark. The intervention was associated with varied changes to preventive and non‐preventive dental services. More robust study design addressing the study limitations and validating the performance benchmark is required.
Partial unilateral lentiginosis: a clinicopathological analysis of 32 cases on the head and neck area in Korea
Authors: Kim Hak Tae , Choi Myoung Eun , Na Hyoungmin , Lee Woo Jin , Won Chong Hyun , Lee Mi Woo , Choi Jee Ho , Chang Sung Eun 
Published: May 2021

AbstractBackgroundPartial unilateral lentiginosis (PUL) is a rare acquired circumscribed hyperpigmentation characterized by multiple simple lentigines involving half of the body. Since the previous studies of PUL were mostly based on case reports and the current literature lacks well‐designed retrospective studies that involve a large number of cases, PUL is not a well‐defined entity, and differential diagnosis with nevus spilus is still difficult. This study aims to evaluate clinical and histopathological characteristics and treatment outcomes of PUL on head and neck area of Koreans.MethodsThirty‐two patients with PUL on head and neck area were diagnosed clinicohistopathologically at the Asan Medical Center from 2004 to 2017. Their medical records, photographs, and biopsy specimens were reviewed, and immunohistochemical staining for protein kinase C (PKC)‐βΙΙ was evaluated for melanogenic activity.ResultsFour patients (12.5%) of PUL had congenital lesions, and 24 (75.0%) had age of onset younger than 10 years. Confluency of lentiginous lesions (100%) and mild to moderate background interlesional hyperpigmentation (90.6%) were observed. The lentiginous lesions showed increased melanocytes, melanophages, basal melanins, lentiginous hyperplasia, and perivascular inflammatory cells compared with background interlesional hyperpigmentation, and PKC‐βΙΙ was focally positive in 7 of 12 stained PUL lesions. Among the 16 patients who received laser treatments, 10 (62.5%) showed more than 50% of improvement.ConclusionsThe findings of this study will allow for improved diagnosis of PUL and understanding of its features, which may facilitate proper management in the future.
Prevalence of mental disorders in school children and adolescents in China: diagnostic data from detailed clinical assessments of 17,524 individuals
Authors: Li Fenghua , Cui Yonghua , Li Ying , Guo Lanting , Ke Xiaoyan , Liu Jing , Luo Xuerong , Zheng Yi , Leckman James F. 
Published: May 2021

BackgroundTo date, no national‐scale psychiatric epidemiological survey for children and adolescents has been conducted in China. In order to inform government officials and policymakers and to develop a comprehensive plan for service providers, there was a clear need to conduct an up‐to‐date systematic nationwide psychiatric epidemiological survey.MethodsWe conducted a two‐stage large‐scale psychiatric point prevalence survey. Multistage cluster stratified random sampling was used as the sampling strategy. Five provinces were selected by comprehensively considering geographical partition, economic development, and rural/urban factors. In Stage 1, the Child Behavior Checklist was used as the screening tool. In Stage 2, Mini‐International Neuropsychiatric Interview for Children and Adolescents and a diagnostic process based on the Diagnostic and Statistical Manual were used to make the diagnoses. Sampling weights and poststratification weights were employed to match the population distributions. Exploratory analyses were also performed using socio‐demographic factors. Prevalence in socio‐demographic factor subgroups and overall were estimated. Rao‐Scott adjusted chi‐square tests were utilized to determine if between‐group differences were present. Factor interactions were checked by logistic regression analyses.ResultsA total of 73,992 participants aged 6–16 years of age were selected in Stage 1. In Stage 2, 17,524 individuals were screened and diagnosed. The weighted prevalence of any disorder was 17.5% (95% CI: 17.2–18.0). Statistically significant differences in prevalence of any psychiatric disorder were observed between sexes [χ2(1, N = 71,929) = 223.0, p < .001], age groups [χ2(1, N = 71,929) = 18.6, p < .001] and developed vs. developing areas [χ2(1, N = 71,929) = 2,129.6, p < .001], while no difference was found between rural and urban areas [χ2(1, N = 71,929) = 1.4, p = .239]. Male, younger individuals, children, and adolescents from developed areas had higher prevalence of any psychiatric disorder. The prevalence of any psychiatric disorder was found to decrease with the age in the male group, while the female group increased with the age. Individuals diagnosed with attention‐deficit hyperactivity disorder, oppositional defiant disorder, a tic disorder, conduct disorder, and major depression disorder had the highest rates of comorbidity.ConclusionsThe prevalence of any psychiatric disorder we found is the highest ever reported in China. These results urgently need to be addressed by public mental health service providers and policymakers in order to provide access to the necessary treatments and to reduce the long‐term negative impact of these conditions on families and the society as a whole.
Association between Grit Scales and adherence to regular hospital visits among Japanese patients with type 2 diabetes: Prospective observational study
Authors: Nakanishi Shuhei , Shimoda Masashi , Tatsumi Fuminori , Kohara Kenji , Obata Atsushi , Sanada Junpei , Fushimi Yoshiro , Mune Tomoatsu , Kaku Kohei , Kaneto Hideaki 
Published: May 2021

AbstractThis study examined the association between Grit Scales and adherence to a schedule of regular hospital visits among Japanese type 2 diabetes patients. Patients with type 2 diabetes who visited the outpatient clinic as new patients comprised the study’s participants. Self‐administered Short Grit Scale data were obtained from 122 patients at the first consultation and were then observed for 1 year. As the results, 21 participants failed to attend the hospital. In a logistic regression analysis, the Grit Scale as a continuous variable was positively associated with adherence to regular clinical visits. Its odds ratio and 95% confidential interval was 9.68 and 2.87–32.65 (P = 0.0003). In conclusion, it is likely that the Grit Scale is closely associated with adherence to regular hospital visits among Japanese type 2 diabetes patients.