bluuebunny/crossref_metadata_2025_split huggingface dataset:
Training Networks of Local Health Departments: A Regional Assessment
Authors: Harris Jenine K. , Leider Jonathon P. , Kulik Phoebe , Beck Angela 
Published: March 2021

Objective:
The public health system faces major challenges in 2020, including an aging workforce, reductions in funding, and 2 simultaneous major threats to public health—the coronavirus pandemic and racial injustice. To effectively harness promising new technologies and address these and other public health challenges ahead, public health professionals must be trained on evidence-based practices for protecting and improving public health. This project sought to understand the network of health departments and organizations that provide training in order to inform strategic efforts to fill training gaps and improve access to training for local health departments (LHDs), thereby strengthening the public health system.

Design/Setting/Participants:
We conducted a Web-based survey of 501 LHDs in the 6 states constituting Region V of the Department of Health & Human Services. The survey focused on the training relationship between LHDs and state and national organizations that provide public health training, allowing for a social network analysis. We used data visualization and descriptive statistics to examine the network.

Results:
Of 290 participating health departments (58% response rate), 248 had monthly or more frequent contact with at least 1 organization for the purpose of training. Altogether, the 248 LHDs were connected to 47 state-level organizations and 10 national-level organizations. In 5 of 6 states, more LHDs were connected to the state health department for training than to any other organization type. Universities, national nonprofits, and national membership organizations provided training to the fewest LHDs. Local health department characteristics did not have a clear relationship with its number of training connections.

Conclusions:
State health departments may benefit from the support of universities, national nonprofits, and national membership organizations by partnering to offer training or by recommending training from these organizations to LHDs. Additional qualitative information from local and state health departments would be useful to determine the best strategies for universities, national nonprofits, and national membership organizations to participate in training local practitioners to improve LHD capacity.
Public Health Emergency Response Leadership Training: A Qualitative Assessment of Existing Educational Opportunities and Perceived Facilitators, Barriers, and Priorities in Professional Development
Authors: Li Yang , Hsu Edbert B. , Davis Xiaohong M. , Stennies Gail M. , Pham Nhu N. , Fisher Mary C. , Pearson Juliana L. , Barnett Daniel J. , Trigoso Silvia M. , Podgornik Michelle N. , Hunter David W. , Vagi Sara J. 
Published: March 2021

Objective:
We aimed to understand the current training environment for developing public health emergency response leaders and highlight facilitators and barriers in accessing targeted training.

Design:
We designed 4 focus groups to gather organizational perspectives on public health emergency response leadership development. Discussions were recorded, transcribed, coded, and analyzed to synthesize key themes.

Setting:
Focus groups were convened at the 2019 Preparedness Summit (March 27-28) in St Louis, Missouri.

Participants:
Twenty-three public health professionals from 9 Public Health Emergency Preparedness (PHEP) Cooperative Agreement award recipient jurisdictions and 12 local health departments participated.

Main Outcome Measures:
We examined the current availability, relevance, specificity, and utility of educational content and delivery modalities. Facilitators and barriers were identified as opportunities to improve training access.

Results:
Generic emergency management training is considered important and widely available but with limited application in public health practice. Existing leadership training opportunities in public health emergency response are limited and not widely known. While organizational support and accessible training facilitate participation, resource constraints (ie, funding, time, and staff) exist as key barriers. In addition, frequent staff turnover and attrition that result in loss of institutional knowledge likely hinder effective public health emergency responses.

Conclusion:
Effective public health emergency response depends on capable leaders not only well versed in specialized technical disciplines and practices but also familiar with—or preferably fluent in—emergency management principles and functions. This study demonstrated that well-aimed training strategies and organizational planning are essential in developing public health emergency response leaders. Specifically, leadership development may accrue considerable benefit from a standardized training curriculum. In addition, scalable training programs developed through public, private, and academic partnerships may lessen resource demands on individual organizations to facilitate training access. Finally, training practicums (eg, mentoring, shadowing) may provide opportunities to facilitate active learning and preserve institutional knowledge through leadership transitions.
Training Needs and Awareness of Emerging Areas of Public Health Practice Among Epidemiologists Working in State Health Agency Central Offices in the United States, 2017
Authors: Daly Elizabeth R. , Gendelman Moriah , Arrazola Jessica , Sellers Katie 
Published: March 2021

Context:
Epidemiologists working in state health agency central offices (SHA-CO) are key professionals working to monitor population health indicators. Assessing training needs to identify gaps is critical to ensuring a competent public health workforce.

Objective:
The objective of this research was to identify training needs of SHA-CO epidemiologists and their awareness of emerging areas of public health practice (EAoP) using data from the 2017 Public Health Workforce Interests and Needs Survey (PH WINS).

Design:
SHA-CO epidemiologists were surveyed in fall 2017 using a Web-based tool. Balanced repeated replication weights were used to account for complex sample design. Differences in responses by tenure, education level, and supervisory status were assessed using multinomial logistic regression.

Setting:
Forty-seven state health agencies.

Participants:
Permanently employed SHA-CO epidemiologists.

Main Outcome Measures:
Training needs were identified by classifying skill gaps as those skills that participants self-reported as high relevance to day-to-day work but self-rated as having low proficiency. Awareness of EAoP was self-reported.

Results:
Systems and strategic thinking and budget and financial management were the areas with the greatest training needs. For most skill domains, fewer participants reported skill gaps with increasing years of public health work experience. Participants with 16 or more years of work experience were less likely to be motivated by most training motivators listed by epidemiologists with 5 or fewer years of experience. The EAoP participants reported greatest awareness of evidence-based public health practice (67%), and the EAoP they reported hearing least about was Health in All Policies (14%).

Conclusions:
Stratified analyses by tenure identified important differences in training needs and motivators that employers can use to customize workforce development strategies. SHA-CO epidemiologists reported varying amounts of awareness of EAoP. Specialized training approaches may contribute to improved employee engagement and reduce skill gaps among SHA-CO epidemiologists.
Applying Latent Class Analysis on Cancer Registry Data to Identify and Compare Health Disparity Profiles in Colorectal Cancer Surgical Treatment Delay
Authors: Montiel Ishino Francisco A. , Odame Emmanuel A. , Villalobos Kevin , Whiteside Martin , Mamudu Hadii , Williams Faustine 
Published: March 2021

Context:
Colorectal cancer (CRC) surgical treatment delay (TD) has been associated with mortality and morbidity; however, disparities by TD profiles are unknown.

Objectives:
This study aimed to identify CRC patient profiles of surgical TD while accounting for differences in sociodemographic, health insurance, and geographic characteristics.

Design:
We used latent class analysis (LCA) on 2005-2015 Tennessee Cancer Registry data of CRC patients and observed indicators that included sex/gender, age at diagnosis, marital status (single/married/divorced/widowed), race (White/Black/other), health insurance type, and geographic residence (non-Appalachian/Appalachian).

Setting:
The state of Tennessee in the United States that included both Appalachian and non-Appalachian counties.

Participants:
Adult (18 years or older) CRC patients (N = 35 412) who were diagnosed and surgically treated for in situ (n = 1286) and malignant CRC (n = 34 126).

Main Outcome Measure:
The distal outcome of TD was categorized as 30 days or less and more than 30 days from diagnosis to surgical treatment.

Results:
Our LCA identified a 4-class solution and a 3-class solution for in situ and malignant profiles, respectively. The highest in situ CRC patient risk profile was female, White, aged 75 to 84 years, widowed, and used public health insurance when compared with respective profiles. The highest malignant CRC patient risk profile was male, Black, both single/never married and divorced/separated, resided in non-Appalachian county, and used public health insurance when compared with respective profiles. The highest risk profiles of in situ and malignant patients had a TD likelihood of 19.3% and 29.4%, respectively.

Conclusions:
While our findings are not meant for diagnostic purposes, we found that Blacks had lower TD with in situ CRC. The opposite was found in the malignant profiles where Blacks had the highest TD. Although TD is not a definitive marker of survival, we observed that non-Appalachian underserved/underrepresented groups were overrepresented in the highest TD profiles. The observed disparities could be indicative of intervenable risk.
Pharmacokinetics of darunavir and cobicistat in pregnant and postpartum women with HIV
Authors: Momper Jeremiah D. , Wang Jiajia , Stek Alice , Shapiro David E. , Scott Gwendolyn B. , Paul Mary E. , Febo Irma L. , Burchett Sandra , Smith Elizabeth , Chakhtoura Nahida , Denson Kayla , Rungruengthanakit Kittipong , George Kathleen , Yang Derek Z. , Capparelli Edmund V. , Mirochnick Mark , Best Brookie M. 
Published: March 2021

Objective:
To evaluate darunavir and cobicistat pharmacokinetics during pregnancy compared with postpartum and in infant washout samples after delivery.

Design:
Nonrandomized, open-label, parallel-group, multicenter phase-IV prospective study of darunavir and cobicistat pharmacokinetics in pregnant women with HIV and their children in the United States.

Methods:
Intensive steady-state 24-h pharmacokinetic profiles were performed after administration of 800 mg of darunavir and 150 mg of cobicistat orally in fixed dose combination once-daily during the second trimester, third trimester, and postpartum. Infant washout samples were collected after birth. Darunavir and cobicistat were measured in plasma by validated HPLC-UV and liquid chromatography with tandem mass spectrometry detection (LC-MS)/MS assays, respectively. A two-tailed Wilcoxon signed-rank test (α = 0.10) was employed for paired within-participant comparisons.

Results:
A total of 29 pregnant women receiving darunavir and cobicistat once-daily enrolled in the study. Compared with paired postpartum data, darunavir AUC0--24 was 53% lower in the second trimester [n = 12, P = 0.0024, geometric mean of ratio (GMR)=0.47, 90% confidence interval (CI) 0.33 – 0.68] and 56% lower in the third trimester (n = 18, P < 0.0001, GMR = 0.44, 90% CI 0.36 – 0.54), whereas cobicistat AUC0--24 was 50% lower in the second trimester (n = 12, P = 0.0024, GMR = 0.50, 90% CI 0.36–0.69) and 56% lower in the third trimester (n = 18, P < 0.0001, GMR = 0.44, 90% CI 0.35–0.55). Placental transfer of darunavir and cobicistat was limited.

Conclusion:
Standard darunavir/cobicistat dosing during pregnancy results in significantly lower exposure during pregnancy, which may increase the risk of virologic failure and perinatal transmission.
Spirosoma utsteinense sp. nov. isolated from Antarctic ice-free soils from the Utsteinen region, East Antarctica
Authors: Tahon Guillaume , Lebbe Liesbeth , Willems Anne 
Published: March 2021

Between 2014 and 2016, 16 Gram-stain-negative, aerobic, rod-shaped and yellow-orange pigmented bacteria were isolated from exposed soils from the Utsteinen region, Sør Rondane Mountains, East Antarctica. Analysis of their 16S rRNA gene sequences revealed that the strains form a separate cluster in the genus

Spirosoma

, with

Spirosoma rigui

KCTC 12531T as its closest neighbour (97.8 % sequence similarity). Comparative genome analysis of two representative strains (i.e. R-68523T and R-68079) of the new group with the type strains of

Spirosoma rigui

(its closest neighbour) and

Spirosoma linguale

(type species of the genus), yielded average nucleotide identity values of 73.9–78.7 %. Digital DNA–DNA reassociation values of the two strains and these type strains ranged from 20.3 to 22.0 %. The predominant cellular fatty acids of the two novel strains were summed feature 3 (i.e. C16 : 1
ω7c and/or iso-C15 2-OH), C16 : 1
ω5c, C16 : 0 and iso-C15 : 0. The new

Spirosoma

strains grew with 0–0.5 % (w/v) NaCl, at pH 6.5–8.0 and displayed optimum growth between 15 and 25 °C. Based on the results of phenotypic, genomic, phylogenetic and chemotaxonomic analyses, the new strains represent a novel species of the genus

Spirosoma

for which the name Spirosoma utsteinense sp. nov. is proposed. The type strain is R-68523T (=LMG 31447T=CECT 9925T).
In vivoevaluation of the virucidal efficacy of Chlorhexidine and Povidone-iodine mouthwashes against salivary SARS-CoV-2
Authors: Elzein Rola , Abdel-Sater Fadi , Fakhreddine Soha , Hanna Pierre Abi , Feghali Rita , Hamad Hassan , Ayoub Fouad 
Published: March 2021

AbstractBackgroundThe oral cavity is potentially high-risk transmitter of COVID-19. Antimicrobial mouthrinses are used in many clinical pre procedural situations for prophylactic purposes. An evident-based investigation for an effective mouthwash solution against salivary SARS-CoV-2 is urgently required for the exposure reduction during dental procedures.AimsThis study aimed to evaluate in vivo virucidal efficacy of 2 mouthwashes: 1% Povidoneiodine and 0.2% Chlorhexidine as a dental preprocedural oral disinfection against salivary SARS-CoV-2.Materials and MethodsIn this randomized-controlled clinical trial, studied group comprised laboratory-confirmed COVID-19 positive patients through nasopharyngeal swabs. Participants were divided into 3 groups. For 30 seconds, group A gargled with 1% Povidone-iodine, group B mouthrinsed with 0.2% Chlorhexidine and control group C mouthrinsed with distilled water. Saliva samples were collected before and 5 minutes after mouthwash. SARS-CoV-2 rRT-PCR was then performed for each sample. Evaluation of the efficacy was based on difference in Ct value. The analysis of data was carried out usingGraphPad Prismversion 5 for Windows. Paired t test and unpaired t test were used. A probability value of less than 0.05 was regarded as statistically significant.ResultsSixty-one compliant participants (36 female and 25 male) with a mean age 45.3 ± 16.7 years-old were enrolled. A significant mean Ct value difference (p< 0.0001) between the paired samples in group A (n = 25) and also in group B (n = 27) (p< 0.0001) was found. In contrast, no significant difference (p= 0.566) existed before and after the experiment in the control group C (n = 9). Moreover, a significant difference was noted between the delta Ct of distilled water wash and each of the 2 solutions 1 % Povidone-iodine (p= 0.012) and Chlorhexidine 0.2% (p= 0.0024). No significant difference was found between the delta Ct of patients using 1% Povidone-iodine and Chlorhexidine 0.2% solutions (p= 0.24).ConclusionChlorhexidine 0.2% and 1% Povidone-iodine oral solutions are effective preprocedural mouthwashes against salivary SARS-COV-2 in dental treatments. Their use as a preventive strategy to reduce the spread of COVID-19 during dental practice should be systematically implemented.
KidneyNetwork: Using kidney-derived gene expression data to predict and prioritize novel genes involved in kidney disease
Authors: Boulogne Floranne , Claus Laura R. , Wiersma Henry , Oelen Roy , Schukking Floor , de Klein Niek , Li Shuang , Westra Harm-Jan , van der Zwaag Bert , van Reekum Franka , Sierks Dana , Schönauer Ria , Halbritter Jan , Knoers Nine V.A.M. ,   Genomics England Research Consortium, Deelen Patrick , Franke Lude , van Eerde Albertien M. 
Published: March 2021

AbstractBackgroundGenetic testing in patients with suspected hereditary kidney disease may not reveal the genetic cause for the disorder as potentially pathogenic variants can reside in genes that are not yet known to be involved in kidney disease. To help identify these genes, we have developed KidneyNetwork, that utilizes tissue-specific expression to predict kidney-specific gene functions.MethodsKidneyNetwork is a co-expression network built upon a combination of 878 kidney RNA-sequencing samples and a multi-tissue dataset of 31,499 samples. It uses expression patterns to predict which genes have a kidney-related function and which (disease) phenotypes might result from variants in these genes. We applied KidneyNetwork to prioritize rare variants in exome sequencing data from 13 kidney disease patients without a genetic diagnosis.ResultsKidneyNetwork can accurately predict kidney-specific gene functions and (kidney disease) phenotypes for disease-associated genes. Applying it to exome sequencing data of kidney disease patients allowed us to identify a promising candidate gene for kidney and liver cysts: ALG6.ConclusionWe present KidneyNetwork, a kidney-specific co-expression network that accurately predicts which genes have kidney-specific functions and can result in kidney disease. We show the added value of KidneyNetwork by applying it to kidney disease patients without a molecular diagnosis and consequently, we propose ALG6 as candidate gene in one of these patients. KidneyNetwork can be applied to clinically unsolved kidney disease cases, but it can also be used by researchers to gain insight into individual genes in order to better understand kidney physiology and pathophysiology.Significance statementGenetic testing in patients with suspected hereditary kidney disease may not reveal the genetic cause for the patient’s disorder. Potentially pathogenic variants can reside in genes not yet known to be involved in kidney disease, making it difficult to interpret the relevance of these variants. This reveals a clear need for methods to predict the phenotypic consequences of genetic variation in an unbiased manner. Here we describe KidneyNetwork, a tool that utilizes tissue-specific expression to predict kidney-specific gene functions. Applying KidneyNetwork to a group of undiagnosed cases identified ALG6 as a candidate gene in cystic kidney and liver disease. In summary, KidneyNetwork can aid the interpretation of genetic variants and can therefore be of value in translational nephrogenetics and help improve the diagnostic yield in kidney disease patients.
PD-1highCXCR5–CD4+ Peripheral Helper T (Tph) cells Promote Tissue-Homing Plasmablasts in COVID-19
Authors: Asashima Hiromitsu , Mohanty Subhasis , Comi Michela , Ruff William E. , Hoehn Kenneth B. , Wong Patrick , Cohen Inessa , Coffey Sarah , Raddassi Khadir , Chaudhary Omkar , Unterman Avraham , Emu Brinda , Kleinstein Steven H. , Montgomery Ruth R. , Iwasaki Akiko , Cruz Charles S. Dela , Kaminski Naftali , Shaw Albert C. , Hafler David A. , Sumida Tomokazu S. 
Published: March 2021

SummaryA dysregulated immune response against coronavirus-2 (SARS-CoV-2) plays a critical role in the outcome of patients with coronavirus disease 2019 (COVID-19). A significant increase in circulating plasmablasts is characteristic of COVID-19 though the underlying mechanisms and its prognostic implications are not known. Here, we demonstrate that in the acute phase of COVID-19, activated PD-1highCXCR5−CD4+ T cells, peripheral helper T cells, (Tph) are significantly increased and promote inflammatory tissue-homing plasmablasts in patients with stable but not severe COVID-19. Analysis of scRNA-seq data revealed that plasmablasts in stable patients express higher levels of tissue-homing receptors including CXCR3. The increased Tph cells exhibited “B cell help” signatures similar to that of circulating T follicular helper (cTfh) cells and promoted B cell differentiation in vitro. Compared with cTfh cells, Tph cells produced more IFNγ, inducing tissue-homing chemokine receptors on plasmablasts. Finally, expansion of activated Tph cells was correlated with the frequency of CXCR3+ plasmablasts in the acute phase of patients with stable disease. Our results demonstrate a novel role for Tph cells in acute viral immunity by inducing ectopic, antibody secreting plasmablasts.
The potential for bike riding across entire cities: quantifying spatial variation in interest in bike riding
Authors: Pearson Lauren K , Dipnall Joanna , Gabbe Belinda , Braaf Sandy , White Shelley , Backhouse Melissa , Beck Ben 
Published: March 2021

ABSTRACTBackgroundRiding a bike is beneficial for health, the environment and for reducing traffic congestion. Despite this, bike riding participation in the state of Victoria, Australia, is low. To inform planning and practice, there is a need to understand the proportion of the population (the ‘near-market’) that are interested in riding a bike, and how this varies across regions. The Geller typology classifies individuals into one of four groups, based on their confidence to ride a bike in various infrastructure types, and frequency of bike riding. The typology has been used at a city, state and country-wide scale, however not at a smaller spatial scale. We aimed to characterise and quantify the distribution of the Geller typology within Local Government Areas (LGAs) in the state of Victoria, Australia.MethodsAn online survey was conducted in 37 LGAs in Victoria, including all LGAs in Greater Melbourne, and a selection of six key regional centres. Participants were recruited from an opt-in online research company panel with the objective of recruiting a representative sample of adults across each LGA. The Geller typology classified individuals as either: ‘Strong and Fearless, ‘Enthused and Confident’, ‘Interested but Concerned’, or ‘No Way No How’. ‘Interested but Concerned’ participants are those that would ride a bike if protected infrastructure were provided.ResultsThe survey was completed by 3999 individuals. Most participants owned a bike (58%), however only 20% rode at least once per week. The distribution of the Geller groups was: ‘Strong and Fearless’ (3%), ‘Enthused and Confident’ (3%), ‘Interested but Concerned’ (78%), and ‘No Way No How’ (16%). While variation in the distributions of the Geller groups was observed between LGAs within Greater Melbourne., the ‘Interested but Concerned’ group, reflecting people who are comfortable riding only in protected lanes or off-road paths, was high across all LGAs and all demographic sub-groups. Even though the frequency of riding a bike was lower in women, interest in riding a bike was high and comparable to men. Participants who resided in the outer urban fringe regions of Greater Melbourne had high interest, but low participation in bike riding.ConclusionsWhile there was variation in interest in bike riding across an entire metropolitan region and across population groups, interest was high across all areas and demographics. Our results show the potential for substantial increases in cycling participation, but only when high-quality cycling infrastructure is provided. Further research is required to understand the policy and practice barriers to equitable provision of protected infrastructure.