bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient Exposure Through a Free Community Pre-Exposure Prophylaxis (PrEP) Clinic Improves Medical Student Comfort With Sexual Health and LGBTQIA+ Topics
Authors: Knecht Richard A. , Lu Claire M. , McLean Sierra R. , Westerdahl J. Skylar , Spivak Adam M. , Keeshin Susana 
Published: April 2021

Abstract
Background: Pre-exposure prophylaxis (PrEP) is an established preventative measure for HIV transmission, however not enough providers are prescribing PrEP for their patients. Reasons for inadequate PrEP coverage include discomfort among providers addressing sexual health and lack of adequate sexual health training among medical trainees.Objective: Our aim was to determine if volunteer experience in a free PrEP clinic improved medical student knowledge and comfort level addressing sexual health and PrEP with patients.Methods: An online survey was conducted to determine knowledge and comfort of PrEP, general sexual and LGBTQIA+ health knowledge among medical students who had and had not volunteered at our free PrEP clinic. Results: 269 students across all four years of medical school were surveyed. Demographics among the two groups were similar. Across the 10 primary survey questions assessing comfort with sexual health and PrEP, those who had volunteered reported significantly more comfort than students who had not. Responses between the two groups differed in the proportion of respondents who reported “extremely” or “very” comfortable with these sexual health topics. There were several affirming narratives provided by students regarding the importance of the PrEP clinic in their medical education. There was no difference between the groups in terms of general sexual health knowledge. Conclusions: This study demonstrates that volunteering at a PrEP clinic correlated with higher reported comfort with sexual health, including discussions surrounding PrEP. Given the importance of addressing sexual health topic with patients, we conclude that medical students would benefit from more in-person opportunities to learn about sexual health. This study illustrates the importance of exposure in generating comfort for trainees on sensitive topics which could lead to better sexual health care for patients.
Influence of the Spatial Distribution Pattern of Buildings on the Distribution of PM2.5 Concentration
Authors: Zhang Zhixuan , Shan Baoyan , Lin Qikai , Chen Yanqiu , Yu Xinwei 
Published: April 2021

Abstract
The spatial distribution pattern of buildings is an entry point for controlling the diffusion of pollution particles at an urban spatial structure scale. In this study, we adopted ordinary kriging interpolation and other methods to study the spatial distribution pattern of PM2.5 and constructed urban spatial structure indexes based on building distribution patterns to reveal the influence of building spatial distribution patterns on PM2.5 concentration across the study area and at different elevations. The present study suggests that: (1) Topographic elevation is an important factor influencing the distribution of PM2.5; the correlation coefficient reaches −0.761 and exceeds the 0.001 confidence level. As the elevation increases, the urban spatial structure indexes show significant correlations with PM2.5, and the regularity becomes stronger. (2) The PM2.5 concentration is negatively correlated with the mean and standard deviation of the DEM, the mean and maximum absolute building height, the outdoor activity area, and the average distance between adjacent buildings; and is positively correlated with the sum of the building base area, the building coverage ratio, the space area, the building coverage ratio, the space occupation ratio, and the sum of the building volume. These urban spatial structure indexes are important factors affecting PM2.5 concentration and distribution and should be considered in urban planning. (3) Spatio-temporal differences in PM2.5 concentration and distribution were found at different elevation and time ranges. Indexes, such as the average building height, the average building base area, the sum of the building volume, and the standard deviation of building volume experienced significant changes. Higher PM2.5 concentration yielded a more significant influence of urban spatial structure indexes on PM2.5 distribution. More discrete spatial distributions of PM2.5 yielded weaker correlations between PM2.5 concentrations and the urban spatial structure indexes.
Role of Positive Mental Health in Reducing Fears related to COVID-19 and General Anxiety Disorder in Khyber Pakhtunkhwa, Pakistan
Authors: Mahmood Qaisar Khalid , Sohail Malik Muhammad , Qureshi Waheed Ahmad , Zakar Rubeena , Fischer Florian 
Published: April 2021

Abstract
Background: The outbreak of the novel coronavirus disease (COVID-19) has posed multiple challenges to healthcare systems. Evidence suggests that mental well-being is badly affected due to compliance with preventative measures in containing the COVID-19 pandemic. This study aims to explore the role of positive mental health (subjective sense of wellbeing) to cope with fears related to COVID-19 and general anxiety disorder in the Pashtun community in Pakistan. Methods: A cross-sectional survey was conducted among 501 respondents from Khyber Pakhtunkhwa participating in an online-based study. We performed correlational analysis, hierarchical linear regression and structural equational modeling (SEM) to analyze the role of mental health in reducing fears and general anxiety disorder. Results: The results of the SEM show that positive mental health has direct effects in reducing the fear related to COVID-19 (β=-0.244, p<0.001) and general anxiety (β= -0.210, p<0.001). Fears of COVID-19 has a direct effect on increasing general anxiety (β=0.480). In addition, positive mental health also has an indirect effect (β=-0.117, p<0.001) on general anxiety (R2=0.32, p<0.001) through reducing fear of coronavirus. Conclusion: Based on these findings, there is a need to develop community health policies emphasizing on promotive and preventive mental health strategies for people practicing social/physical distancing.
Supplementation of Micronutrients Against COVID-19.
Authors: Unnithan Ajaya Kumar Ayyappan 
Published: April 2021

Abstract
Background and Objectives: There is no pharmacological treatment with proven efficacy against coronavirus disease-19. Certain micronutrients have roles in the maintenance of an effective immune system. From the point of view of public health, it will be good to adopt a nutrional strategy to enhance the immunity of the general population against viral diseases.Method and Study design: A review was done to now the evidence for the antiviral and immunomodulatory properties of micronutrients. A search was done in Pubmed, Scopus, and Google Scholar for the nutrients with proven effect against viral infection. Experimental studies, clinical studies, reviews, and meta-analyses were studied descripitively.Results: There are experimental studies about the effects of micronutrients against viral infection. Vitamins such as A, B6, B12, C, D, E, and folate, and trace elements such as zinc, selenium, iron, magnesium, and copper boost the immune response. The antioxidants like vitamin C and vitamin E can help in controlling the ‘cytokine storm’, produced by excessive inflammation. Vitamin D can increase anti-inflammatory cytokines. Selenium and zinc can protect the lungs in acute respiratory distress syndrome. There are many meta-analyses on the randomized controlled trials (RCT) about the effect of micronutrients on viral infection. The analyses of the trials supplementing vitamin C, vitamin D, vitamin E, and selenium have shown significance. Conclusions: There is level 2A evidence for the beneficial effects of vitamins and micronutrients in improving the immunity against viral infections. So a programme for nutritional supplementation of these can help in fighting the pandemic.
Development and Application of a High Sensitivity Immunochromatographic Test Strip for Detecting Classical Swine Fever Virus Antibody
Authors: Bai Yilin , Jia Rui , Wei Qiang , Wang Li , Sun Yaning , Li Yiwei , Luo Jun , Zhang Gaiping 
Published: April 2021

Abstract
Background: Classical swine fever (CSF) is caused by classical swine fever virus (CSFV) and has lead huge losses to the pig industry worldwide. Although vaccination and other control measures have been carried out, it is essential to establish a rapid valid method for CSF vaccination monitoring and clinical diagnosis. CSFV E2 protein has been well known as a major antigen for antibody detection. It is significant to improve affinity between E2 protein and CSFV antibody to result in a better performance of detection method. Results: In this study, a recombinant E2 extracellular protein (aa 1-331), which was with the native homodimer conformation and had a high affinity with anti-CSFV-E2 monoclonal antibody WH303, was expressed using Bac-to-Bac baculovirus expression system. A novel immunochromatographic test strip based on the recombinant CSFV E2 protein was developed for CSFV antibody detection. The sensitivity of this strip for detecting CSFV standard positive serum was 1:102400, 4 times higher than that of the former developed CnC2 test strip. No cross reaction with other swine virus antibodies was observed. The detection of clinical swine serum samples (n=138) demonstrated that the agreement of the new E2 test strip with three commercial ELISA kits was 88.40% (122/138), 86.23% (119/138), and 96.38% (133/138), respectively. Conclusion: Our data indicate that a novel E2 test strip with higher sensitivity has been developed and can be applied for clinical sample detections, providing a new powerful and simple approach for future monitoring CSFV antibodies.
Digital Web Archive Collection and Storage Model Based on Soft Computing and Edge-Driven System
Authors: Xie Lili , Zhao Jinbi , Sun Rui 
Published: April 2021

Abstract
With the continuous development of archives information network, it has become an important means to obtain archives information resources based on network means. At the same time, the number of users of network archives is increasing rapidly. It has become an urgent task to carry out the research on network archives users and do a good job in the management of network archives users. As the main body of archives utilization, archives users play a leading role in the content and direction of archives management and utilization. The informatization of archives management is not equivalent to computerization or networking, but a systematic project related to the whole educational reform and modernization. As the modern archives management has become a complex system, there are also multi-level division methods. The first level is divided into two subsystems: Archives entity management and archives information development, and each subsystem is further divided into several levels of small systems. Archives entity management is divided into collection, sorting, identification, storage, statistics and other work links. The whole file management system and its subsystems form feedback mechanism in operation. With the rapid development of computer technology and network technology, multimedia information system is penetrating into people's lives. Multimedia information system mainly includes three parts: central management system, terminal display system and network. Based on the multimedia information management system, this paper constructs a digital network archives collection and storage model.
Sustained Drug-related Reaction With Eosinophilia and Systemic Symptoms (DRESS) Triggered by Low Molecular Weight Heparins in COVID-19: Management and Precision Diagnosis.
Authors: Minenna Elena , Chaoul Nada , Rossi Maria Pia , Giliberti Lucia , Albanesi Marcello , Nettis Eustachio , Barbaro Maria Pia Foschino , Bona Danilo Di , Caiaffa Maria Filomena , Macchia Luigi 
Published: April 2021

Abstract
Background. Low molecular weight heparins (LMWHs) are administered routinely to COVID-19 patients. Systemic reactions to LMWHs (both IgE-mediated and non IgE-mediated) are considered rare. Particularly, a single case of drug-related reaction with eosinophilia and systemic symptoms (DRESS) due to enoxaparin has been described in the literature. Here, we report on the first case of DRESS related to administration of fondaparinux.Case presentation. An elderly woman was diagnosed with COVID-19, during the “first wave” of the pandemics in Italy, and treated with enoxaparin (for anti-coagulation). A DRESS syndrome developed after two weeks (RegiSCAR score = 7). Enoxaparin was considered the culprit drug and replaced with the fully synthetic LMWH fondaparinux. At the same time, high-dosage prednisone was added to the therapy. The DRESS slowly subsided and the patient survived. Upon recovery and corticosteroid washout, a lymphocyte proliferation test for both LMWHs was performed, yielding a positive response not only for enoxaparin but also for fondaparinux. Conclusions. By lymphocyte proliferation test we demonstrated that both enoxaparin and fondaparinux were implicated in this case of DRESS, occurring in an elderly COVID-19 patient. In retrospect, the choice of using a sustained high-dose corticosteroid treatment while maintaining anti-coagulation by fondaparinux proved to be right. Ultimately, the patient recovered from both DRESS and COVID-19.
Psychosocial and mental health challenges faced by emerging adults living with HIV and support systems aiding their positive coping: a qualitative study from the Kenyan coast
Authors: Nyongesa Moses K. , Nasambu Carophine , Mapenzi Rachael , Koot Hans M. , Cuijpers Pim , Newton Charles R.J.C. , Abubakar Amina 
Published: April 2021

Abstract
Background: In sub-Saharan Africa, there is little data on the challenges faced by young people living with HIV transitioning into adult life. Adapting the socio-ecological framework, this qualitative study investigated the challenges faced by emerging adults living with HIV from a rural Kenyan setting. Additionally, the study explored support systems that aid positive coping among these young adults. Methods: In April 2018, in-depth interviews were conducted with a convenience sample of 22 young adults living with HIV (12 females), 18-24 years old, from rural Kilifi, coast of Kenya. Data were analyzed thematically using NVIVO 11 software. Results: Young adults living with HIV from this setting face various challenges at different levels of the social ecosystem. At the individual level, key challenges they reported included acceptance of HIV positive status, antiretroviral adherence, economic burden associated with access to healthcare, building an intimate relationship, mental health problems, and HIV status disclosure. At the family level, death of parents, poverty, and being unaccepted were the commonly mentioned challenges. At the community level, socialization difficulties and long waiting time at the HIV clinic were highlighted. HIV stigma and discrimination were frequently reported across the different levels. Economic independence, social support (from families, friends, organizations, healthcare providers and peer meetings), and reliance on spirituality aided positive coping among these young adults amidst the challenges of living with HIV.Conclusions: In this rural setting, emerging adults living with HIV face various challenges at the individual, family, and community level, some of which are cross-cutting. Our findings underscore the need for designing multi-level youth-friendly interventions that can address modifiable challenges encountered by emerging adults living with HIV in this and similar settings. Such interventions should incorporate appropriate context-specific support structures that may help these young people smoothly transit into adult life.
Determinants of COVID-19 Vaccine Acceptance in Six Lower- and Middle-Income Countries
Authors: Kebede Adugna , Kanwagi Robert , Tolossa Asrat Dibaba , Kalam Md Abul , Davis Thomas , Larson Heidi 
Published: April 2021

Abstract
Background:

While a vaccine is the only clinical preventive measure to control the infection and mortality caused by SARS-CoV-2 (COVID-19), delayed acceptance or refusal of COVID-19 vaccines may increase and prolong the threat to global public health and the economy. Identifying behavioural determinants is considered a critical step in explaining and addressing the barriers of vaccine refusal, but there is a lack of evidence around COVID-19 vaccine refusal and delay from a behavioural perspective. This study aims to identify the behavioural determinants of COVID-19 vaccine acceptance and provide recommendations to design actionable interventions to increase the uptake of the COVID-19 vaccine in six lower-and-middle income countries.
Methods:

Taking into consideration the Health Belief Model (HBM), Theory of Reasoned Action (TRA), and other behavioural models, a Barrier Analysis (BA) approach was employed to examine twelve potential behavioural determinants of vaccine acceptance in Bangladesh, India, Myanmar, Kenya, the Democratic Republic of Congo, and Tanzania. In all six countries, at least 45 interviews with those who intended to take the vaccine (“Acceptors”) and another 45 or more interviews with those who did not (“Non-Acceptors”) were conducted, totalling 542 interviews. Data analysis was performed to find statistically significant (a p-value of less than 0.05) differences between Acceptors and Non-acceptors and to identify which beliefs were most highly associated with acceptance and non-acceptance of the behaviour based on estimated relative risk (ERR).
Results:

The analysis showed that perceived social norms, perceived positive and negative consequences, perceived risk of getting COVID-19, perceived severity of COVID-19, trust in COVID-19 vaccines, perceived safety of COVID-19 vaccines, and expected access to COVID-19 vaccines had the highest association with COVID-19 vaccine acceptance in Bangladesh, Kenya, Tanzania, and DRC. Additional behavioural determinants found to be significant in both Myanmar and India were perceived self-efficacy, trust in COVID-19 information provided by leaders, perceived divine will, and perceived action efficacy of the COVID-19 vaccines. The study also identified important perceptions and beliefs around COVID-19 and its severity, advantages and disadvantages of being vaccinated, and action efficacy of the vaccine to control the spread of the virus.
Conclusion:

Many of the determinants found to be significant and their level of significance varied from country to country. National and local plans should include messages and activities that address the behavioural determinants found in this study in order to significantly increase the uptake of COVID-19 vaccine across these countries.
Flu-IV score: a predictive tool for assessing the risk of invasive mechanical ventilation in patients with influenza-related pneumonia
Authors: Chen Liang , Han Xiudi , Li YanLi , Zhang Chunxiao , Xing Xiqian 
Published: April 2021

Abstract
Background The need for invasive mechanical ventilation (IMV) is linked to significant morbidity and mortality in patients with influenza-related pneumonia (Flu-p). We aimed to develop an assessment tool to predict IMV among Flu-p patients within 14 days of admission. Methods In total, 1107 Flu-p patients from five teaching hospitals were retrospectively enrolled from January 2012 - December 2019 and used to develop a predictive model. Results Overall, 10.6% (117/1107) of patients underwent IMV within 14 days of admission. Multivariate regression analyses revealed that the following factors were associated with IMV: early neuraminidase inhibitor use (-3 points), lymphocytes < 0.8×109/L (1 point), multi-lobar infiltrates (1 point), systemic corticosteroid use (1 point), age ≥ 65 years old (2 points), PaO2/FiO2 < 300 mmHg (2 points), respiratory rate ≥ 30 breaths/min (3 points), and arterial PH < 7.35 (4 points). A total score of five points was used to identify patients at risk of IMV. This model had a sensitivity of 85.5%, a specificity of 88.8%, and exhibited better predictive performance than the ROX index (AUROC = 0.909 vs 0.594, p = 0.004), modified ROX index (AUROC = 0.909 vs 0.633, p = 0.012), and HACOR scale (AUROC = 0.909 vs 0.622, p < 0.001) using the validation cohort.Conclusions Flu-IV score is a valuable prediction rule for 14-day IMV rates in Flu-p patients. However, it should be validated in a prospective study before implementation.
The Perceptions of Medical Physicists Towards Relevance and Impact of Artificial Intelligence
Authors: Santos Josilene C , Wong Jeannie Hsiu Ding , Pallath Vinod , Ng Kwan Hoong 
Published: April 2021

Abstract
Artificial intelligence (AI) is an innovative tool that is revolutionising healthcare and medical physics, possibly impacting clinical practices, research, and the profession. The relevance of AI and its impact on the clinical practice and routine of professionals in medical physics were evaluated by medical physicists and researchers in this field. An online survey questionnaire was designed for distribution to professionals and students in medical physics around the world. In addition to demographics questions, we surveyed opinions on the role of AI in medical physicists’ practice, the possibility of AI threatening/disrupting the medical physicists’ practice and career, the need for medical physicists to acquire knowledge on AI, and the need for teaching AI in postgraduate medical physics programmes. The level of knowledge of medical physicists on AI was also consulted. A total of 1019 responders from 94 countries participated. More than 85% of the responders agree that AI will play an essential role in medical physicists’ practice. AI should be taught in the postgraduate medical physics programmes, and that more applications such as quality control, treatment planning will be performed by AI. Half of them thought AI would not threaten/disrupt the medical physicists’ practice. AI knowledge was mainly acquired through self-taught and work-related activities. Nonetheless, many (40%) admitted that they have no skill in AI. The general perception of medical physicists is that AI is here to stay, and it will influence our practice. Medical physicists should be prepared with education and training for this new reality.