bluuebunny/crossref_metadata_2025_split huggingface dataset:
Employment and working conditions of nurses: where and how health inequalities have increased during the COVID-19 pandemic?
Authors: Llop-Gironés Alba , Vračar Ana , Llop-Gironés Gisela , Benach Joan , Angeli-Silva Livia , Jaimez Lucero , Thapa Pramila , Bhatta Ramesh , Mahindrakar Santosh , Bontempo Scavo Sara , Nar Devi Sonia , Barria Susana , Marcos Alonso Susana , Julià Mireia 
Published: September 2021

Abstract
Background
Nurses and midwives play a critical role in the provision of care and the optimization of health services resources worldwide, which is particularly relevant during the current COVID-19 pandemic. However, they can only provide quality services if their work environment provides adequate conditions to support them. Today the employment and working conditions of many nurses worldwide are precarious, and the current pandemic has prompted more visibility to the vulnerability to health-damaging factors of nurses’ globally. This desk review explores how employment relations, and employment and working conditions may be negatively affecting the health of nurses in countries such as Brazil, Croatia, India, Ireland, Italy, México, Nepal, Spain, and the United Kingdom.

Main body
Nurses’ health is influenced by the broader social, economic, and political system and the redistribution of power relations that creates new policies regarding the labour market and the welfare state. The vulnerability faced by nurses is heightened by gender inequalities, in addition to social class, ethnicity/race (and caste), age and migrant status, that are inequality axes that explain why nurses’ workers, and often their families, are exposed to multiple risks and/or poorer health. Before the COVID-19 pandemic, informalization of nurses’ employment and working conditions were unfair and harmed their health. During COVID-19 pandemic, there is evidence that the employment and working conditions of nurses are associated to poor physical and mental health.

Conclusion
The protection of nurses’ health is paramount. International and national enforceable standards are needed, along with economic and health policies designed to substantially improve employment and working conditions for nurses and work–life balance. More knowledge is needed to understand the pathways and mechanisms on how precariousness might affect nurses’ health and monitor the progress towards nurses’ health equity.
Identifying effective intervention strategies to reduce children’s screen time: a systematic review and meta-analysis
Authors: Jones Alexis , Armstrong Bridget , Weaver R. Glenn , Parker Hannah , von Klinggraeff Lauren , Beets M. W. 
Published: September 2021

Abstract
Background
Excessive screen time ($$\ge$$
≥
2 h per day) is associated with childhood overweight and obesity, physical inactivity, increased sedentary time, unfavorable dietary behaviors, and disrupted sleep. Previous reviews suggest intervening on screen time is associated with reductions in screen time and improvements in other obesogenic behaviors. However, it is unclear what study characteristics and behavior change techniques are potential mechanisms underlying the effectiveness of behavioral interventions. The purpose of this meta-analysis was to identify the behavior change techniques and study characteristics associated with effectiveness in behavioral interventions to reduce children’s (0–18 years) screen time.

Methods
A literature search of four databases (Ebscohost, Web of Science, EMBASE, and PubMed) was executed between January and February 2020 and updated during July 2021. Behavioral interventions targeting reductions in children’s (0–18 years) screen time were included. Information on study characteristics (e.g., sample size, duration) and behavior change techniques (e.g., information, goal-setting) were extracted. Data on randomization, allocation concealment, and blinding was extracted and used to assess risk of bias. Meta-regressions were used to explore whether intervention effectiveness was associated with the presence of behavior change techniques and study characteristics.

Results
The search identified 15,529 articles, of which 10,714 were screened for relevancy and 680 were retained for full-text screening. Of these, 204 studies provided quantitative data in the meta-analysis. The overall summary of random effects showed a small, beneficial impact of screen time interventions compared to controls (SDM = 0.116, 95CI 0.08 to 0.15). Inclusion of the Goals, Feedback, and Planning behavioral techniques were associated with a positive impact on intervention effectiveness (SDM = 0.145, 95CI 0.11 to 0.18). Interventions with smaller sample sizes (n < 95) delivered over short durations (< 52 weeks) were associated with larger effects compared to studies with larger sample sizes delivered over longer durations. In the presence of the Goals, Feedback, and Planning behavioral techniques, intervention effectiveness diminished as sample size increased.

Conclusions
Both intervention content and context are important to consider when designing interventions to reduce children’s screen time. As interventions are scaled, determining the active ingredients to optimize interventions along the translational continuum will be crucial to maximize reductions in children’s screen time.
Neuromyelitis optica spectrum disorders: from pathophysiology to therapeutic strategies
Authors: Carnero Contentti Edgar , Correale Jorge 
Published: September 2021

AbstractNeuromyelitis optica (NMO) is a chronic inflammatory autoimmune disease of the central nervous system (CNS) characterized by acute optic neuritis (ON) and transverse myelitis (TM). NMO is caused by a pathogenic serum IgG antibody against the water channel aquoporin 4 (AQP4) in the majority of patients. AQP4-antibody (AQP4-ab) presence is highly specific, and differentiates NMO from multiple sclerosis. It binds to AQP4 channels on astrocytes, triggering activation of the classical complement cascade, causing granulocyte, eosinophil, and lymphocyte infiltration, culminating in injury first to astrocyte, then oligodendrocytes followed by demyelination and neuronal loss. NMO spectrum disorder (NMOSD) has recently been defined and stratified based on AQP4-ab serology status. Most NMOSD patients experience severe relapses leading to permanent neurologic disability, making suppression of relapse frequency and severity, the primary objective in disease management. The most common treatments used for relapses are steroids and plasma exchange.Currently, long-term NMOSD relapse prevention includes off-label use of immunosuppressants, particularly rituximab. In the last 2 years however, three pivotal clinical trials have expanded the spectrum of drugs available for NMOSD patients. Phase III studies have shown significant relapse reduction compared to placebo in AQP4-ab-positive patients treated with satralizumab, an interleukin-6 receptor (IL-6R) inhibitor, inebilizumab, an antibody against CD19+B cells; and eculizumab, an antibody blocking the C5 component of complement. In light of the new evidence on NMOSD pathophysiology and of preliminary results from ongoing trials with new drugs, we present this descriptive review, highlighting promising treatment modalities as well as auspicious preclinical and clinical studies.
Identification of tissue-specific and common methylation quantitative trait loci in healthy individuals using MAGAR
Authors: Scherer Michael , Gasparoni Gilles , Rahmouni Souad , Shashkova Tatiana , Arnoux Marion , Louis Edouard , Nostaeva Arina , Avalos Diana , Dermitzakis Emmanouil T. , Aulchenko Yurii S. , Lengauer Thomas , Lyons Paul A. , Georges Michel , Walter Jörn 
Published: September 2021

Abstract
Background
Understanding the influence of genetic variants on DNA methylation is fundamental for the interpretation of epigenomic data in the context of disease. There is a need for systematic approaches not only for determining methylation quantitative trait loci (methQTL), but also for discriminating general from cell type-specific effects.

Results
Here, we present a two-step computational framework MAGAR (https://bioconductor.org/packages/MAGAR), which fully supports the identification of methQTLs from matched genotyping and DNA methylation data, and additionally allows for illuminating cell type-specific methQTL effects. In a pilot analysis, we apply MAGAR on data in four tissues (ileum, rectum, T cells, B cells) from healthy individuals and demonstrate the discrimination of common from cell type-specific methQTLs. We experimentally validate both types of methQTLs in an independent data set comprising additional cell types and tissues. Finally, we validate selected methQTLs located in the PON1, ZNF155, and NRG2 genes by ultra-deep local sequencing. In line with previous reports, we find cell type-specific methQTLs to be preferentially located in enhancer elements.

Conclusions
Our analysis demonstrates that a systematic analysis of methQTLs provides important new insights on the influences of genetic variants to cell type-specific epigenomic variation.
Genomic characterization of nine Clostridioides difficile strains isolated from Korean patients with Clostridioides difficile infection
Authors: Ahn Seung Woo , Lee Se Hee , Kim Uh Jin , Jang Hee-Chang , Choi Hak-Jong , Choy Hyon E. , Kang Seung Ji , Roh Seong Woon 
Published: September 2021

Abstract
Background
Clostridioides difficile infection (CDI) is an infectious nosocomial disease caused by Clostridioides difficile, an opportunistic pathogen that occurs in the intestine after extensive antibiotic regimens.

Results
Nine C. difficile strains (CBA7201–CBA7209) were isolated from nine patients diagnosed with CDI at the national university hospital in Korea, and the whole genomes of these strains were sequenced to identify their genomic characteristics. Comparative genomic analysis was performed using 51 reference strains and the nine isolated herein. Phylogenetic analysis based on 16S rRNA gene sequences confirmed that all 60 C. difficile strains belong to the genus Clostridioides, while core-genome tree indicated that they were divided into five groups, which was consistent with the results of MLST clade analysis. All strains were confirmed to have a clindamycin antibiotic resistance gene, but the other antibiotic resistance genes differ depending on the MLST clade. Interestingly, the six strains belonging to the sequence type 17 among the nine C. difficile strains isolated here exhibited unique genomic characteristics for PaLoc and CdtLoc, the two toxin gene loci identified in this study, and harbored similar antibiotic resistance genes.

Conclusion
In this study, we identified the specific genomic characteristics of Korean C. difficile strains, which could serve as basic information for CDI prevention and treatment in Korea.
Ultrasound in active surveillance for low-risk papillary thyroid cancer: imaging considerations in case selection and disease surveillance
Authors: Ghai Sangeet , O’Brien Ciara , Goldstein David P. , Sawka Anna M. ,   the Canadian Thyroid Cancer Active Surveillance Study Group, Rotstein Lorne , Brown Dale , de Almeida John , Gullane Patrick , Gilbert Ralph , Chepeha Douglas , Irish Jonathan , Pasternak Jesse , Ezzat Shereen , Brierley James P. , Tsang Richard W. , Monteiro Eric , Zahedi Afshan , James Jacqueline , Witterick Ian , Hernandez Karen Gomez , Eskander Antoine , Enepekides Danny , Higgins Kevin , Halperin Ilana J. , Zahedi Afshan , Devon Karen , Gooden Everton , Shah Manish , Korman Mark , Chung Janet , Nazarali Kareem , Arruda Eric , Gevorgyan Artur , Chang Michael , Anand Sumeet , Fernandes Vinay , Lin Denny , Banerjee Avik , Bindlish Vinita , Bharadwaj Vinod , Hafidh Maky , Seaburg Raewyn , Whiteacre Laura 
Published: September 2021

AbstractActive surveillance (AS) of small, low-risk papillary thyroid cancers (PTCs) is increasingly studied in prospective observational studies. Ultrasound is the primary imaging modality for case selection. While researchers have put forward selection criteria for PTCs based on size, absence of suspicious lymph nodes and tumor location, there are limited reported data highlighting inherent ultrasound limitations and guidelines for case selection and follow-up. We report our experience including imaging limitations encountered in the ongoing AS prospective observational study for PTCs measuring < 2 cm at our institute. We define disease progression as an increase in size of > 3 mm in the largest dimension of nodule or evidence of metastatic disease or extrathyroidal extension. Accurate, consistent and reproducible measurements of PTCs are essential in risk stratifying patients for the option of AS or disease progression. Interobserver discrepancy, shadowing from coarse calcification and background parenchyma heterogeneity or thyroiditis can limit accurate PTC size assessment and therefore hinder patient eligibility evaluation or AS follow-up. Following the ACR Thyroid Imaging, Reporting and Data System (TI-RADS) protocol of three-axes technique to measure a thyroid nodule enables reproducibility of measurements. In patients with multi-nodular goiter, accurate identification and labeling of the PTC is important to avoid mistaking with adjacent benign nodules at follow-up. Ultrasound assessment for extrathyroid extension of PTC, and relationship of PTC to trachea and the anatomic course of the recurrent laryngeal nerve are important considerations in evaluation for AS eligibility.
Optimizing integrated imaging service delivery by tier in low-resource health systems
Authors: DeStigter Kristen , Pool Kara-Lee , Leslie Abimbola , Hussain Sarwat , Tan Bien Soo , Donoso-Bach Lluis , Andronikou Savvas 
Published: September 2021

AbstractAccess to imaging diagnostics has been shown to result in accurate treatment, management, and optimal outcomes. Particularly in low-income and low-middle-income countries (LICs, LMICs), access is limited due to a lack of adequate resources. To achieve Sustainable Development Goal (SDG) 3, access to imaging services is critical at every tier of the health system. Optimizing imaging services in low-resource settings is best accomplished by prescriptive, integrated, and coordinated tiered service delivery that takes contextual factors into consideration. To our knowledge, this is the first recommendation for optimized, specific imaging care delivery by tier. A model for tier-based essential imaging services informs and guides policymakers as they set priorities and make budgetary decisions. In this paper, we recommend a framework for tiered imaging services essential to reduce the global burden of disease and attain universal health coverage (UHC). A lack of access to basic imaging services, even at the lowest tier of the health system, can no longer be justified by cost. Worldwide, affordable modalities of modern ultrasound and X-ray are becoming an accessible mainstay for the investigation of common conditions such as pregnancy, pneumonia, and fractures, and are safely performed and interpreted by qualified professionals. Finally, given the vast gap in access to imaging resources between LMICs and high-income countries (HICs), a scale-up of tiered imaging services in low-resource settings has the potential to reduce health disparities between, and within countries. As the access to appropriately integrated imaging services improves, UHC may be achieved.
Assessing direct healthcare costs when restricted to self-reported data: a scoping review
Authors: Jabakhanji Samira B. , Sorensen Jan , Valentelyte Gintare , Burke Lee Ann , McElroy Brendan , Murphy Aileen 
Published: September 2021

AbstractBackgroundIn the absence of electronic health records, analysis of direct healthcare costs often relies on resource utilisation data collected from patient-reported surveys. This scoping review explored the availability, use and methodological details of self-reported healthcare service utilisation and cost data to assess healthcare costs in Ireland.MethodsPopulation health surveys were identified from Irish data repositories and details were collated in an inventory to inform the literature search. Irish cost studies published in peer-reviewed and grey sources from 2009 to 2019 were included if they used self-reported data on healthcare utilisation or cost. Two independent researchers extracted studies’ details and the PRISMA-ScR guidelines were used for reporting.ResultsIn total, 27 surveys were identified containing varying details of healthcare utilisation/cost, health status, demographic characteristics and health-related risk and behaviour. Of those surveys, 21 were general population surveys and six were study-specific ad-hoc surveys. Furthermore, 14 cost studies were identified which used retrospective self-reported data on healthcare utilisation or cost from ten of the identified surveys. Nine of these cost studies used ad-hoc surveys and five used data from pre-existing population surveys. Compared to population surveys, ad-hoc surveys contained more detailed information on resource use, albeit with smaller sample sizes. Recall periods ranged from 1 week for frequently used services to 1 year for rarer service use, or longer for once-off costs. A range of perspectives (societal, healthcare and public sector) and costing approaches (bottom-up costing and a mix of top-down and bottom-up) were used. The majority of studies (n = 11) determined unit prices using multiple sources, including national healthcare tariffs, literature and expert views. Moreover, most studies (n = 13) reported limitations concerning data availability, risk of bias and generalisability. Various sampling, data collection and analysis strategies were employed to minimise these.ConclusionPopulation surveys can aid cost assessments in jurisdictions that lack electronic health records, unique patient identifiers and data interoperability. To increase utilisation, researchers wanting to conduct cost analyses need to be aware of and have access to existing data sources. Future population surveys should be designed to address reported limitations and capture comprehensive health-related, demographic and resource use data.
Understanding the effectiveness and underlying mechanisms of lifestyle modification interventions in adults with learning disabilities: protocol for a mixed-methods systematic review
Authors: Rana Dikshyanta , Westrop Sophie , Germeni Evi , McGarty Arlene , Ells Louisa , Lally Phillippa , McEwan Michael , Melville Craig , Harris Leanne , Wu Olivia 
Published: September 2021

Abstract
Background
Adults with learning disabilities have an increased disposition to unhealthy lifestyle behaviours which often occur simultaneously. Existing studies focus on complex interventions targeting unhealthy diet, physical inactivity, sedentary behaviour, smoking, and alcohol use to reduce health risks experienced. It is essential to understand how well these interventions work, what works, for whom, in what context and why. This study aims to investigate the effectiveness and underlying mechanisms of lifestyle modification interventions for adults with learning disabilities.

Methods
This is a mixed-methods systematic review consisting of a network meta-analysis (NMA) and realist synthesis. Electronic databases (ASSIA, CINAHL, EMBASE, MEDLINE, and PsycINFO) will be searched from inception to 14 January 2021 with no language restriction. Additionally, trial registries, grey literature databases and references lists will be searched. Studies related to lifestyle modification interventions on the adult population (>18 years) with learning disabilities will be eligible for inclusion. Two independent researchers will screen studies, extract data and assess its quality and risk of bias using the Cochrane Collaboration’s Risk of Bias Assessment Tool (RoB Version 2) and ROBINS-I. The strength of the body of evidence will be assessed based on the GRADE approach. The NMA will incorporate results from RCTs and quasi-experimental studies to estimate the effectiveness of various lifestyle interventions. Where appropriate, a component NMA (CNMA) will be used to estimate effectiveness. The realist synthesis will complement and explain the findings of NMA and CNMA by including additional qualitative and mixed-methods studies. Studies will be included based on their relevance to the programme theory and the rigour of their methods, as determined by quality appraisal tools appropriate to the study design. Results from both syntheses will be incorporated into a logic model.

Discussion
The paucity of population-specific lifestyle interventions contributes to the challenges of behaviour change in adults with learning disabilities. This study will provide an evidence-base from which various stakeholders can develop effective interventions for adults with learning disabilities. The evidence will also help prioritise and inform research recommendations for future primary research so that people with learning disabilities live happier, healthier and longer lives.

Trial registration
PROSPERO CRD 42020223290
Selection, optimization and compensation strategies and their relationship with well-being and impulsivity in early, middle and late adulthood in a Polish sample
Authors: Zając-Lamparska Ludmiła 
Published: September 2021

Abstract
Background
The model of selection, optimization, and compensation (SOC model) characterises the life management strategies that contribute to successful development. Although the SOC model is an important developmental theory, until now there has been no Polish version of a measurement tool for SOC strategies. The studies conducted so far have consistently indicated a relationship between the use of these strategies and well-being. In contrast, the relationship between SOC strategies and impulsivity has not yet been empirically examined, although there are theoretical premises to assume its existence. The aim of the study was to compare the use of SOC strategies in early, middle and late adulthood, and to investigate the relationship between the use of SOC strategies and well-being and impulsivity, using a newly developed Polish version of the SOC Questionnaire (SOC48-PL).

Methods
The study applied a quantitative approach. The sample comprised 589 Poles from three age groups: early adulthood (n = 186, 20–35 years), middle adulthood (n = 165, 40–55 years) and late adulthood (n = 238, 60–85 years). In the study, in addition to the SOC48-PL questionnaire, the Short Depression-Happiness Scale (SDHS) and the Short UPPS-P Impulsive Behavior Scale (S UPPS-P) were used.

Results
Developmental differences in the use of SOC strategies are rather slight, with considerable individual differences within age groups. The study revealed some indications of a ‘developmental peak’ of SOC strategies in middle adulthood. The use SOC strategies is positively related to well-being. In turn, the relationship between the use of SOC strategies and impulsivity is negative, especially for two dimensions of impulsivity: lack of premeditation and lack of perseverance.

Conclusions
The results only slightly confirm the assumed age-related differences in the use of SOC strategies and point to a large role of individual differences. The revealed positive relationships of SOC strategy use with well-being and negative with impulsivity are consistent with expectations. With the present study, the SOC48-PL questionnaire may find application in further studies on the SOC model involving the Polish population, as well as in the measurement of SOC strategies in psychological practice. Furthermore, the identified associations of SOC strategies with well-being and impulsivity can be taken as initial indications for the development of interventions based on teaching the use of SOC strategies. Cross-cultural comparisons, long-term longitudinal studies on changes in the use of SOC strategies over the life course, and combining quantitative and qualitative approaches in the analysis of the use of SOC strategies in practice are worth mentioning as directions for further research.