bluuebunny/crossref_metadata_2025_split huggingface dataset:
91 Health care needs and missed care among youth in care in British Columbia: A population study
Authors: Wang James , Marshall Sheila K , Poon Colleen S 
Published: October 2021

Abstract

Primary Subject area
Adolescent Medicine

Background
Youth in care (YIC), including those living in foster care, kinship care, group homes, and youth agreements, are a vulnerable population with many risk factors leading to a high prevalence of mental and physical health needs. YIC are recommended to have more frequent health care encounters than the general adolescent population, though it is unknown how Canadian YIC perceive whether their health care needs are sufficiently met.

Objectives
To assess YIC's perception of their health care needs and frequency of missed care, defined as not having received needed health care.

Design/Methods
A representative sample of 38,015 students in Grades 7 to 12 across British Columbia was surveyed in the 2018 BC Adolescent Health Survey (McCreary Centre Society). Questionnaire items on demographics, mental and physical health, and health care access in the past year were examined. Frequencies and cross-tabulations were performed using IBM SPSS® Complex Samples module software.

Results
In the past year, 1.9% of respondents reported living in government care. YIC had a mean age of 14.76 years and were 50.9% female. YIC reported worse mental health (46.5% vs. 27.6% poor/fair rating, p &lt; 0.01) and physical health (36.4% vs. 19.1% poor/fair rating, p &lt; 0.01) compared to non-YIC, with female and non-binary YIC most severely impacted. YIC were less likely to report not needing health care (15.6% vs. 21.3%, p &lt; 0.01) and more likely to report missed care (11.2% vs. 3.1%, p &lt; 0.01) compared to non-YIC. Although the rate of any health care usage was not significantly different between the groups, nearly one-quarter (23.7%) of YIC accessed health care at 3 or more locations, compared to only 16.4% of non-YIC (p &lt; 0.01), with YIC accessing counsellors/psychologists and youth clinics more frequently. YIC reported more missed mental health care (32.9% vs. 18.4%, p &lt; 0.01) and physical health care (21.6% vs. 7.8%, p &lt; 0.01) than non-YIC, with female YIC reporting more missed care than male YIC. Non-binary YIC also reported more missed mental health care than male YIC. YIC were more likely than non-YIC to have missed mental health care due to reasons such as prior negative experiences and lack of transportation.

Conclusion
YIC reported worse mental and physical health and greater frequencies of missed care compared to non-YIC, especially female and non-binary YIC. Further attention is needed in addressing systemic and individual barriers to health care in this vulnerable population.
116 Canadian Community Paediatricians' Perspectives of Sport Medicine in Residency and in Practice
Authors: Purcell Laura , Campos Sarah , Dickinson Mike , Thompson Graham 
Published: October 2021

Abstract

Primary Subject area
Community Paediatrics

Background
Participation by children and adolescents in organized sports and recreational sporting activities is increasingly popular in Canada. Although the health and psychosocial benefits of sports for children are significant, participation in sports confers an increased risk of injury, resulting in a considerable burden of visits to emergency departments and primary care offices. Despite the frequency of sport-related injuries, there are documented gaps in sport and exercise medicine (SEM) education in paediatric training, leading to many practicing paediatricians feeling uncomfortable in managing these issues.

Objectives
We sought to describe Canadian community paediatricians’ perspectives about SEM in training and practice. This descriptive, cross-sectional cohort study of practicing Canadian community paediatricians was designed to assess: i) self-reported practice profiles with respect to sport issues; ii) perceptions of SEM training during paediatric residency; and iii) comfort level with management of sport injuries.

Design/Methods
To address these questions, a cross-sectional electronic survey of Canadian community paediatricians was conducted between February and March 2020. A survey was emailed to full members of the community paediatrics section of the Canadian Paediatric Society (CPS) (n=370) by CPS administrative staff. Participants were asked about musculoskeletal (MSK)/sport issues seen, how they manage these cases, their comfort level with diagnosis and management of sport injuries (on a 5-point Likert scale), and their perceptions of MSK/SEM training during paediatric residency.

Results
The response rate was 23.0% (85/370). A quarter of respondents (20/85; 23.4%) reported seeing MSK/sport issues very often; a third (27/85; 31.7%) were comfortable managing these patients on their own. Almost all respondents did not feel that they had received adequate SEM training during paediatric residency (81/85; 95.3%). Respondents were most comfortable managing concussion, rating their comfort 4.17/5 on a 5-point scale (95% CI=3.96-4.38), and Osgood-Schlatter’s disease 3.86/5 (95% CI=3.60-4.11). Participants were uncomfortable managing acromioclavicular joint separations 1.81/5 (95% CI=1.58-20.6) and elbow pain 2.65/5 (95% CI=2.40-2.90). Regression analysis indicated that only the frequency of MSK/sport-related visits was associated with provider comfort level (p &lt; 0 .001).

Conclusion
Most Canadian community paediatricians do not manage many patients with sport-related issues and are not comfortable managing these patients on their own. They feel that SEM training during their paediatric residency inadequately prepared them for practice. Incorporating more SEM training into paediatric residency programs may increase comfort level with MSK/sport issues and change referral patterns and practice patterns amongst community paediatricians.
128 Evaluation of a Secure Messaging System for Children with Medical Complexity
Authors: Parpia Camilla , Miranda Susan , Beatty Madison , Moore Clara , Adams Sherri , Stinson Jennifer , Desai Arti , Bartlett Leah , Culbert Erin , Orkin Julia , Cohen Eyal 
Published: October 2021

Abstract

Primary Subject area
Complex Care

Background
The Connecting2gether (C2) platform is a secure online information-sharing tool that aims to improve care for Children with Medical Complexity (CMC) and their families. A key feature of C2 is secure messaging that enables parents to communicate with their child’s healthcare providers (HCPs) in an easy and timely manner.

Objectives
The objectives of this project are to (1) describe the usage of the secure messaging system; and (2) conduct a thematic comparative evaluation of the secure messaging tool, and email and phone calls.

Design/Methods
This study is a sub-component of a larger project investigating the overall feasibility and acceptability of the C2 platform. Parents of CMC were recruited from a tertiary level Complex Care program to use the C2 platform for a period of 6 months. Messaging data was extracted from C2 usage reports, and phone and email documentation was extracted from the patient’s electronic medical record. Codes were developed iteratively through comprehensive review of the C2 messages. Message, phone, and email data were then coded by two investigators using thematic analysis. Quantitative data from C2 usage reports were analyzed using descriptive statistics.

Results
Thirty-four parents and 90 care team members, including HCPs, family, and patient information coordinators were registered on the platform. 4027 messages were exchanged on C2. On average, parents sent 33.4 messages and received 66.4 messages on C2. Of all messages on C2, 32.6% were related to comments, questions, and concerns about the platform itself and its features. Figure 1 demonstrates the thematic content of messages related to care, and highlights the differences in messaging content between the 3 forms of communication. Email and phone content focused primarily on clinical care whereas C2 messaging content also emphasized other aspects of care including education, provision of resources, and personal support.

Conclusion
This study demonstrates the role that a secure messaging system can have for parents of CMC in being active members of their child’s care. Phone and email were mostly used to discuss medications or clinical issues, whereas C2 enabled the discussion of the patient as a whole. The use of secure messaging can therefore complement other forms of communication between providers and families, instead of replacing them. Further research is needed to understand clinical outcomes associated with the use of secure messaging in order to understand its role in improving patient care and overall caregiver and provider experience.
Patient-Reported Experience Measures in outpatient rheumatology care: a systematic review
Authors: Bryant Madeleine J , Schubert Jonathon P , Black Rachel J , Hill Catherine L 
Published: October 2021

Abstract

Objectives
There is a growing acceptance of the need for routine implementation of patient-reported experience measures (PREMs) in health care. Rheumatology patients, as frequent and long-term users of care, stand to benefit from collection of experience-related data. The aim of this study was to perform a systematic review to identify and critically appraise the development and psychometric validation of PREMs in rheumatology.

Methods
Six databases were searched systematically from inception to 14 December 2020: MEDLINE, EMBASE, PsycINFO, SCOPUS, Cochrane and Google Scholar. We included articles in English that described the use or development of PREMs, with results of psychometric testing, in an adult outpatient rheumatology context. This study is registered with PROSPERO (CRD42021233819). Articles were appraised using the COnsensus Based Standards for the selection of health status Measurement Instruments (COSMIN) (i) Risk of Bias checklist and (ii) criteria for good measurement properties.

Results
The search yielded 3809 publications, and six studies met inclusion criteria. All the included studies on PREM development fulfilled COSMIN standards for ‘doubtful’ or ‘inadequate’ quality of instrument development. One study fulfilled a ‘sufficient’ rating for content validity, and the remainder fulfilled ‘inconsistent’ ratings. During validity testing, studies fulfilled between one and four of the eight COSMIN checklist criteria for good measurement properties.

Conclusion
Methodological concerns regarding instrument development and validation limit the generalizability of the existing six validated PREMs in use in rheumatology contexts. There is a need for further well-designed studies to validate existing and new PREMs in this area.
High-throughput visual assessment of sleep stages in mice using machine learning
Authors: Geuther Brian , Chen Mandy , Galante Raymond J , Han Owen , Lian Jie , George Joshy , Pack Allan I , Kumar Vivek 
Published: October 2021

AbstractStudy ObjectivesSleep is an important biological process that is perturbed in numerous diseases, and assessment of its substages currently requires implantation of electrodes to carry out electroencephalogram/electromyogram (EEG/EMG) analysis. Although accurate, this method comes at a high cost of invasive surgery and experts trained to score EEG/EMG data. Here, we leverage modern computer vision methods to directly classify sleep substages from video data. This bypasses the need for surgery and expert scoring, provides a path to high-throughput studies of sleep in mice.MethodsWe collected synchronized high-resolution video and EEG/EMG data in 16 male C57BL/6J mice. We extracted features from the video that are time and frequency-based and used the human expert-scored EEG/EMG data to train a visual classifier. We investigated several classifiers and data augmentation methods.ResultsOur visual sleep classifier proved to be highly accurate in classifying wake, non-rapid eye movement sleep (NREM), and rapid eye movement sleep (REM) states, and achieves an overall accuracy of 0.92 ± 0.05 (mean ± SD). We discover and genetically validate video features that correlate with breathing rates, and show low and high variability in NREM and REM sleep, respectively. Finally, we apply our methods to noninvasively detect that sleep stage disturbances induced by amphetamine administration.ConclusionsWe conclude that machine learning-based visual classification of sleep is a viable alternative to EEG/EMG based scoring. Our results will enable noninvasive high-throughput sleep studies and will greatly reduce the barrier to screening mutant mice for abnormalities in sleep.
Use of low dosage amino acid blends to prevent stress-related piglet diarrhea
Authors: Wessels Anna G , Chalvon-Demersey Tristan , Zentek Jürgen 
Published: October 2021

Abstract
Weaning is a challenging period for piglets associated with reduced feed intake, impairment of gut integrity, and diarrhea. Previous studies demonstrate that supplementation with single functional amino acids (AA) promote piglets’ performance due to the improvement of intestinal health. Thus, we hypothesized that a combination of functional AA provided beyond the postulated requirement for growth could facilitate the weaning transition. Ninety piglets, initially stressed after weaning by 100 min overland transport, received a control diet or the same diet supplemented with a low-dosed (0.3%) mixture of AA (AAB-1: L-arginine, L-leucine, L-valine, L-isoleucine, L-cystine; AAB-2: L-arginine, L-leucine, L-valine, L-isoleucine, L-cystine, and L-tryptophan) for 28 days. Fecal consistency was ranked daily, growth performance was assessed weekly. On days 1 and 14 of the trial, blood samples were collected from a subset of 10 piglets per group to assess concentrations of insulin-like growth factor 1. After 28 days of feeding, tissues were obtained from the same piglets to analyze gut morphology and relative mRNA expression of genes related to gut function. Even if the stress response as indicated by rectal temperature was not different between the groups, pigs supplemented with AAB-2 showed firmer feces after weaning and less days with diarrhea compared to control. Furthermore, the jejunal expression of the MUC-2 gene was reduced (P &lt; 0.05) in group AAB-2. Both AA mixtures increased crypt depth in the duodenum. Collectively, the given results indicate that 0.3% extra AA supplementation might alleviate postweaning diarrhea but did not alter growth performance of weanling piglets.
COVID-19 vaccine brand hesitancy and other challenges to vaccination in the Philippines
Authors: Amit Arianna Maever L. , Pepito Veincent Christian F. , Sumpaico-Tanchanco Lourdes , Dayrit Manuel M. 
Published: October 2021

AbstractBackgroundCOVID-19 vaccines have been developed at a rapid and unprecedented pace to control the spread of the virus, and prevent hospitalisations and deaths. However, there are a series of events and factors that create barriers to vaccination. In this paper, we explore vaccination narratives and challenges experienced and observed by Filipinos during the early vaccination period in the Philippines.Material and methodsWe conducted 35 interviews from a subsample of 1,599 survey respondents ages 18 and older in the Philippines. The interviews were conducted in Filipino, Cebuano, and/or English via online platforms such as Zoom or via phone call. All interviews were recorded, transcribed verbatim, translated, and analysed using inductive content analysis. To highlight the complex reasons for delaying and/or refusing COVID-19 vaccines, we embedded our findings within the social ecological model.ResultsOur analysis showed that individual perceptions play a major role on the decision to vaccinate. Such perceptions are shaped by exposure to (mis)information amplified by the media, the community, and the health system. Social networks may either positively or negatively impact vaccination uptake, depending on their views on vaccines. Political issues contribute to vaccine brand hesitancy, resulting to vaccination delays and refusals. Perceived inefficiencies and inflexibility of the system also create additional barriers to the vaccine rollout in the country, especially among vulnerable and marginalised groups.ConclusionsChallenges to COVID-19 vaccination may be individual, interpersonal, and structural, which work individually and collectively. Among these barriers, our results suggest that many concerns regarding vaccination operate at the individual level. Vaccine brand hesitancy and misinformation are growing public health challenges in the country that need to be addressed. Recognising and addressing concerns at all levels are critical to solutions aimed at improving COVID-19 vaccination uptake and reach.
Accuracy of computer-aided chest X-ray screening in the Kenya National Tuberculosis Prevalence Survey
Authors: Mungai Brenda , Ong‘angò Jane , Ku Chu Chang , Henrion Marc YR , Morton Ben , Joekes Elizabeth , Onyango Elizabeth , Kiplimo Richard , Kirathe Dickson , Masini Enos , Sitienei Joseph , Manduku Veronica , Mugi Beatrice ,   The IMPALA Consortium, Squire Stephen Bertel , MacPherson Peter 
Published: October 2021

AbstractBackgroundCommunity-based screening for tuberculosis (TB) could improve detection but is resource intensive. We set out to evaluate the accuracy of computer-aided TB screening using digital chest X-ray (CXR) to determine if this approach met target product profiles (TPP) for community-based screening.MethodsCXR images from participants in the 2016 Kenya National TB Prevalence Survey were evaluated using CAD4TBv6 (Delft Imaging), giving a probabilistic score for pulmonary TB ranging from 0 (low probability) to 99 (high probability). We constructed a Bayesian latent class model to estimate the accuracy of CAD4TBv6 screening compared to bacteriologically-confirmed TB across CAD4TBv6 threshold cut-offs, incorporating data on Clinical Officer CXR interpretation, participant demographics (age, sex, TB symptoms, previous TB history), and sputum results. We compared model-estimated sensitivity and specificity of CAD4TBv6 to optimum and minimum TPPs.ResultsOf 63,050 prevalence survey participants, 61,848 (98%) had analysable CXR images, and 8,966 (14.5%) underwent sputum bacteriological testing; 298 had bacteriologically-confirmed pulmonary TB. Median CAD4TBv6 scores for participants with bacteriologically-confirmed TB were significantly higher (72, IQR: 58-82.75) compared to participants with bacteriologically-negative sputum results (49, IQR: 44-57, p<0.0001). CAD4TBv6 met the optimum TPP; with the threshold set to achieve a mean sensitivity of 95% (optimum TPP), specificity was 83.3%, (95% credible interval [CrI]: 83.0%—83.7%, CAD4TBv6 threshold: 55). There was considerable variation in accuracy by participant characteristics, with older individuals and those with previous TB having lowest specificity.ConclusionsCAD4TBv6 met the optimal TPP for TB community screening. To optimise screening accuracy and efficiency of confirmatory sputum testing, we recommend that an adaptive approach to threshold setting is adopted based on participant characteristics.Take home messageCAD4TBv6 met the optimal WHO target product profile for a community TB screening tool. Specificity was lower in adults with previous TB and those aged 41 years or older; an adaptive approach to setting CAD thresholds will likely be required to optimize use.
mTOR inhibition via Rapamycin treatment partially reverts the deficit in energy metabolism caused by FH loss in RPE cells
Authors: Merle David A. , Provenzano Francesca , Jarboui Mohamed Ali , Kilger Ellen , Clark Simon J. , Deleidi Michela , Armento Angela , Ueffing Marius 
Published: October 2021

AbstractAge-related macular degeneration (AMD) is a complex degenerative disease of the retina with multiple risk-modifying factors, including ageing, genetics and lifestyle choices. The combination of these factors leads to oxidative stress, inflammation and metabolic failure in the retinal pigment epithelium (RPE) with subsequent degeneration of photoreceptors in the retina. The alternative complement pathway is tightly linked to AMD. In particular, the genetic variant in the complement factor H gene (CFH), that leads to the Y402H polymorphism in the factor H protein (FH), confers the second highest risk for the development and progression of AMD. While the association between the FH Y402H variant and increased complement system activation is known, recent studies have uncovered novel FH functions not tied to this activity and highlighted functional relevance for intracellular FH. In our previous studies, we show that loss of CFH expression in RPE cells causes profound disturbances in cellular metabolism, increases the vulnerability towards oxidative stress and modulates the activation of pro-inflammatory signaling pathways, most importantly the NF-kB pathway. Here, we silenced CFH in hTERT-RPE1 cells to investigate the mechanism by which intracellular FH regulates RPE cell homeostasis. We found that silencing of CFH results in hyperactivation of mTOR signaling along with decreased mitochondrial respiration and that mTOR inhibition via rapamycin can partially rescue these metabolic defects. To obtain mechanistic insight into the function of intracellular FH in hTERT-RPE1 cells, we analyzed the interactome of FH via immunoprecipitation followed by Mass spectrometry-based analysis. We found that FH interacts with essential components of the ubiquitin-proteasomal pathway (UPS) as well as with factors associated with RB1/E2F signalling in a complement-pathway independent manner. Moreover, we found, that FH silencing affects mRNA levels of the E3 Ubiquitin-Protein Ligase Parkin and PTEN induced putative kinase (Pink1), both of them are associated with UPS. As inhibition of mTORC1 has been previoulsy shown to result in increased overall protein degradation via UPS and as FH mRNA and protein levels were shown to be affected by inhibition of UPS, our data stress a potential regulatory link between endogenous FH activity and the UPS.
Transcription disrupts DNA-scaffolded bacteriophage repressor complexes
Authors: Lu Yue , Voros Zsuzsanna , Borjas Gustavo , Hendrickson Cristin , Shearwin Keith , Dunlap David , Finzi Laura 
Published: October 2021

AbstractDNA can act as a scaffold for the cooperative binding of protein oligomers. For example, the phage 186 CI repressor forms a wheel of seven dimers wrapped in DNA carrying specific binding sites, while the phage λ CI repressor binds in units of dimers to two well-separated sets of operators, forming a DNA loop. Atomic force microscopy was used to measure transcription elongation by E. coli RNA polymerase through these protein complexes. 186 CI or λ CI bound along unlooped DNA negligibly interfered with transcription by RNAP. More complex topologies induced by scaffolded, cooperatively bound repressor oligomers did not form significantly better roadblocks to transcription. Thus, despite binding with rather high affinity, these repressors are not effective roadblocks to transcription.