bluuebunny/crossref_metadata_2025_split huggingface dataset:
Climate and health concerns of Montana’s public and environmental health professionals: a cross-sectional study
Authors: Byron Lori , Akerlof Karen L. 
Published: September 2021

Abstract
Background
Rural health professionals stand at the forefront of community response to climate change, but few studies have assessed their perceptions of the threat. Further, no previous study has compared the opinions of environmental to public health professionals or extensively analyzed the factors related to these experts’ climate beliefs, risk perceptions, and issue prioritization.

Methods
In conjunction with the Montana Climate Assessment’s 2021 Special Report on Climate Change and Human Health, the 479 members of the Montana Public Health Association and Montana Environmental Health Association were surveyed during September–October 2019, with 39% completing the survey. We summarized descriptive data about their perceptions of local climate-related changes and their beliefs that global warming is happening, is mostly human-caused, is a risk to human health, and that their offices and others should take action. We also evaluated which sociodemographic and risk perception factors related to these climate beliefs, risk perceptions, and workplace issue prioritization.

Results
Health professionals in Montana, a politically conservative state, demonstrated high levels of awareness that global warming is happening, human-caused, and a threat to human health, well above reported rates of public concern. Eighty-eight percent said that global warming is occurring and 69% that it is mostly anthropogenic. Sixty-nine percent said that their own health was already affected by climate, and 86% said they were already seeing at least one climate change-related event in their communities. Seventy-two percent said that their departments should be preparing to deal with climate change’s health effects, but just 30% said that it is currently happening. We found no statistically significant differences between Montana environmental health and public health professionals in regression models predicting climate beliefs, risk perception, and prioritization. As in studies of the public, political ideology and the observation of local climate-related changes were the strongest factors.

Conclusions
Montana environmental and public health officials said that departmental action was needed on climate change, indicating the readiness of rural health professionals to take action. Further studies of health professionals in rural regions are warranted.
Stakeholder perspectives on proposed policies to improve distribution and retention of doctors in rural areas of Uttar Pradesh, India
Authors: Sriram Veena , Hariyani Shreya , Lalani Ummekulsoom , Buddhiraju Ravi Teja , Pandey Pooja , Bennett Sara 
Published: September 2021

Abstract
Background
In India, the distribution and retention of biomedical doctors in public sector facilities in rural areas is an obstacle to improving access to health services. The Government of Uttar Pradesh is developing a comprehensive, ten-year Human Resources for Health (HRH) strategy, which includes policies to address rural distribution and retention of government doctors in Uttar Pradesh (UP). We undertook a stakeholder analysis to understand stakeholder positions on particular policies within the strategy, and to examine how stakeholder power and interests would shape the development and implementation of these proposed policies. This paper focuses on the results of the stakeholder analysis pertaining to rural distribution and retention of doctors in the government sector in UP. Our objectives are to 1) analyze stakeholder power in influencing the adoption of policies; 2) compare and analyze stakeholder positions on specific policies, including their perspectives on the conditions for successful policy adoption and implementation; and 3) explore the challenges with developing and implementing a coordinated, ‘bundled’ approach to strengthening rural distribution and retention of doctors.

Methods
We utilized three forms of data collection for this study – document review, in-depth interviews and focus group discussions. We conducted 17 interviews and three focus group discussions with key stakeholders between September and November 2019.

Results
We found that the adoption of a coordinated policy approach for rural retention and distribution of doctors is negatively impacted by governance challenges and fragmentation within and beyond the health sector. Respondents also noted that the opposition to certain policies by health worker associations created challenges for comprehensive policy development. Finally, respondents believed that even in the event of policy adoption, implementation remained severely hampered by several factors, including weak mechanisms of accountability and perceived corruption at local, district and state level.

Conclusion
Building on the findings of this analysis, we propose several strategies for addressing the challenges in improving access to government doctors in rural areas of UP, including additional policies that address key concerns raised by stakeholders, and improved mechanisms for coordination, accountability and transparency.
Estimating the annual dengue force of infection from the age of reporting primary infections across urban centres in endemic countries
Authors: Biggs Joseph R. , Sy Ava Kristy , Sherratt Katharine , Brady Oliver J. , Kucharski Adam J. , Funk Sebastian , Reyes Mary Anne Joy , Quinones Mary Ann , Jones-Warner William , Avelino Ferchito L. , Sucaldito Nemia L. , Tandoc Amado O. , la Paz Eva Cutiongco-de , Capeding Maria Rosario Z. , Padilla Carmencita D. , Hafalla Julius Clemence R. , Hibberd Martin L. 
Published: September 2021

Abstract
Background
Stratifying dengue risk within endemic countries is crucial for allocating limited control interventions. Current methods of monitoring dengue transmission intensity rely on potentially inaccurate incidence estimates. We investigated whether incidence or alternate metrics obtained from standard, or laboratory, surveillance operations represent accurate surrogate indicators of the burden of dengue and can be used to monitor the force of infection (FOI) across urban centres.

Methods
Among those who reported and resided in 13 cities across the Philippines, we collected epidemiological data from all dengue case reports between 2014 and 2017 (N 80,043) and additional laboratory data from a cross-section of sampled case reports (N 11,906) between 2014 and 2018. At the city level, we estimated the aggregated annual FOI from age-accumulated IgG among the non-dengue reporting population using catalytic modelling. We compared city-aggregated FOI estimates to aggregated incidence and the mean age of clinically and laboratory diagnosed dengue cases using Pearson’s Correlation coefficient and generated predicted FOI estimates using regression modelling.

Results
We observed spatial heterogeneity in the dengue average annual FOI across sampled cities, ranging from 0.054 [0.036–0.081] to 0.249 [0.223–0.279]. Compared to FOI estimates, the mean age of primary dengue infections had the strongest association (ρ −0.848, p value<0.001) followed by the mean age of those reporting with warning signs (ρ −0.642, p value 0.018). Using regression modelling, we estimated the predicted annual dengue FOI across urban centres from the age of those reporting with primary infections and revealed prominent spatio-temporal heterogeneity in transmission intensity.

Conclusions
We show the mean age of those reporting with their first dengue infection or those reporting with warning signs of dengue represent superior indicators of the dengue FOI compared to crude incidence across urban centres. Our work provides a framework for national dengue surveillance to routinely monitor transmission and target control interventions to populations most in need.
Fluorescent carbon dots with excellent moisture retention capability for moisturizing lipstick
Authors: Dong Chen , Xu Mingsheng , Wang Shuna , Ma Menghui , Akakuru Ozioma U. , Ding Haizhen , Wu Aiguo , Zha Zhengbao , Wang Xuemei , Bi Hong 
Published: September 2021

AbstractLong-lasting moisture retention is a huge challenge to humectants, and effective methods or additives for promote these functions are limited, especially nano-additives. Carbon dots (CDs) have attracted increasing research interest due to its ultra-small size, excellent optical properties and low toxicity, etc. However, most of researches have been focused on the photoexcited CDs and its subsequent photophysical and chemical processes, such as photoluminescence, photodynamic, photothermal and photocatalytic behavior. The intrinsic chemo-physical properties of the pristine CDs are not fully explored. Here, we report an excellent moisture retention capability of a new carmine cochineal-derived CDs (Car-CDs) for the first time. The relationship between the structure of Car-CDs and its moisture retention capability is revealed. More interestingly, the effective applications of Car-CDs in moisturizing lipstick are demonstrated. This work expands the research and application of CDs into a broad, new area, potentially in skin care.
Utility of telemedicine in pediatric rheumatology during the COVID-19 pandemic
Authors: Perdue Ashley , Mullett Charles , Umer Amna , Rosen Paul 
Published: September 2021

Abstract
Background
During the COVID-19 pandemic, telemedicine has provided an alternative to in-person visits for patients practicing social distancing and undergoing quarantine. During this time, there has been a rapid expansion of telemedicine and its implementation in various clinical specialties and settings. In this observational study we aim to examine the utility of telemedicine in a pediatric rheumatology clinic, for 3 months during the COVID-19 pandemic.

Methods
A review of outpatient pediatric rheumatology telemedicine encounters were conducted from April–June 2020. Telemedicine visits (n = 75) were compared to patients seen in practice over the prior year in office-based visits (March 2019–March 2020) (n = 415). Patient characteristics, information on no-show visits, completed visits, new patient or follow-up status, and if new patients had received a visit within 2 weeks of calling to schedule an appointment were analyzed by chart review. An independent sample t-test and Chi Square statistic was used to determine statical significance between the two groups. A two-proportion z-test was used to compare visit metrics.

Results
The percentage of new patients utilizing telemedicine (60%) was lower and statistically significant compared to the percentage of new patient office visits (84%) the previous year (p < 0.0001). There was no change in no-show rate between groups and patient characteristics were similar.

Conclusions
This study demonstrates a statistically significant decrease in new patient visits during the pandemic with telemedicine-only appointments compared to in-office visits over the previous year. This suggests a possible hesitation to seek care during this time. However, there was no significant difference among patient characteristics between telemedicine visits during the pandemic and during in-office visits in the previous year. In our experience, patient visits were able to be conducted via telemedicine with a limited physical exam using caregiver’s help during the pandemic. However, further studies will need to ascertain patient satisfaction and preference for telemedicine in the future.
Powered air-purifying respirators used during the SARS-CoV-2 pandemic significantly reduce speech perception
Authors: Weiss Roxanne , Guchlerner Leon , Weissgerber Tobias , Filmann Natalie , Haake Birgit , Zacharowski Kai , Wolf Timo , Wicker Sabine , Kempf Volkhard A. J. , Ciesek Sandra , Stöver Timo , Diensthuber Marc 
Published: September 2021

Abstract
Background
Due to the coronavirus disease 2019 (COVID-19) pandemic, interventions in the upper airways are considered high-risk procedures for otolaryngologists and their colleagues. The purpose of this study was to evaluate limitations in hearing and communication when using a powered air-purifying respirator (PAPR) system to protect against severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) transmission and to assess the benefit of a headset.

Methods
Acoustic properties of the PAPR system were measured using a head and torso simulator. Audiological tests (tone audiometry, Freiburg speech test, Oldenburg sentence test (OLSA)) were performed in normal-hearing subjects (n = 10) to assess hearing with PAPR. The audiological test setup also included simulation of conditions in which the target speaker used either a PAPR, a filtering face piece (FFP) 3 respirator, or a surgical face mask.

Results
Audiological measurements revealed that sound insulation by the PAPR headtop and noise, generated by the blower-assisted respiratory protection system, resulted in significantly deteriorated hearing thresholds (4.0 ± 7.2 dB hearing level (HL) vs. 49.2 ± 11.0 dB HL, p < 0.001) and speech recognition scores in quiet (100.0 ± 0.0% vs. 2.5 ± 4.2%, p < 0.001; OLSA: 20.8 ± 1.8 dB vs. 61.0 ± 3.3 dB SPL, p < 0.001) when compared to hearing without PAPR. Hearing with PAPR was significantly improved when the subjects were equipped with an in-ear headset (p < 0.001). Sound attenuation by FFP3 respirators and surgical face masks had no clinically relevant impact on speech perception.

Conclusions
The PAPR system evaluated here can be considered for high-risk procedures in SARS-CoV-2-positive patients, provided that hearing and communication of the surgical team are optimized by the additional use of a headset.
METTL3-dependent RNA m6A dysregulation contributes to neurodegeneration in Alzheimer’s disease through aberrant cell cycle events
Authors: Zhao Fanpeng , Xu Ying , Gao Shichao , Qin Lixia , Austria Quillan , Siedlak Sandra L. , Pajdzik Kinga , Dai Qing , He Chuan , Wang Wenzhang , O’Donnell James M. , Tang Beisha , Zhu Xiongwei 
Published: September 2021

AbstractBackgroundN6-methyladenosine (m6A) modification of RNA influences fundamental aspects of RNA metabolism and m6A dysregulation is implicated in various human diseases. In this study, we explored the potential role of RNA m6A modification in the pathogenesis of Alzheimer disease (AD).MethodsWe investigated the m6A modification and the expression of m6A regulators in the brain tissues of AD patients and determined the impact and underlying mechanism of manipulated expression of m6A levels on AD-related deficits both in vitro and in vivo.ResultsWe found decreased neuronal m6A levels along with significantly reduced expression of m6A methyltransferase like 3 (METTL3) in AD brains. Interestingly, reduced neuronal m6A modification in the hippocampus caused by METTL3 knockdown led to significant memory deficits, accompanied by extensive synaptic loss and neuronal death along with multiple AD-related cellular alterations including oxidative stress and aberrant cell cycle events in vivo. Inhibition of oxidative stress or cell cycle alleviated shMettl3-induced apoptotic activation and neuronal damage in primary neurons. Restored m6A modification by inhibiting its demethylation in vitro rescued abnormal cell cycle events, neuronal deficits and death induced by METTL3 knockdown. Soluble Aβ oligomers caused reduced METTL3 expression and METTL3 knockdown exacerbated while METTL3 overexpression rescued Aβ-induced synaptic PSD95 loss in vitro. Importantly, METTL3 overexpression rescued Aβ-induced synaptic damage and cognitive impairment in vivo.ConclusionsCollectively, these data suggested that METTL3 reduction-mediated m6A dysregulation likely contributes to neurodegeneration in AD which may be a therapeutic target for AD.
Efficacy and cost-effectiveness of therapist-guided internet-delivered behaviour therapy for children and adolescents with Tourette syndrome: study protocol for a single-blind randomised controlled trial
Authors: Andrén Per , Fernández de la Cruz Lorena , Isomura Kayoko , Lenhard Fabian , Hall Charlotte L. , Davies E. Bethan , Murphy Tara , Hollis Chris , Sampaio Filipa , Feldman Inna , Bottai Matteo , Serlachius Eva , Andersson Erik , Mataix-Cols David 
Published: September 2021

AbstractBackgroundTreatment guidelines recommend behaviour therapy (BT) for patients with Tourette syndrome (TS) and chronic tic disorder (CTD). However, BT is rarely accessible due to limited availability of trained therapists and long travel distances to specialist clinics. Internet-delivered BT has the potential of overcoming these barriers through remote delivery of treatment with minimal therapist support. In the current protocol, we outline the design and methods of a randomised controlled trial (RCT) evaluating an internet-delivered BT programme referred to as BIP TIC. The trial’s primary objective is to determine the clinical efficacy of BIP TIC for reducing tic severity in young people with TS/CTD, compared with an active control intervention. Secondary objectives are to investigate the 12-month durability of the treatment effects and to perform a health economic evaluation of the intervention.MethodsIn this single-blind superiority RCT, 220 participants (9–17 years) with TS/CTD throughout Sweden will be randomised to 10–12 weeks of either therapist-supported internet-delivered BT based on exposure with response prevention (BIP TIC) or therapist-supported internet-delivered education. Data will be collected at baseline, 3 and 5 weeks into the treatment, at post-treatment, and 3, 6, and 12 months post-treatment. The primary endpoint is the 3-month follow-up. The primary outcome is tic severity as measured by the Yale Global Tic Severity Scale – Total Tic Severity Score. Treatment response is operationalised as scores of “Very much improved” or “Much improved” on the Clinical Global Impression – Improvement scale, administered at the primary endpoint. Outcome assessors will be blind to treatment condition at all assessment points. A health economic evaluation of BIP TIC will be performed, both in the short term (primary endpoint) and the long term (12-month follow-up). There are no planned interim analyses.DiscussionParticipant recruitment started on 26 April 2019 and finished on 9 April 2021. The total number of included participants was 221. The final participant is expected to reach the primary endpoint in September 2021 and the 12-month follow-up in June 2022. Data analysis for the primary objective will commence after the last participant reaches the primary endpoint.Trial registrationClinicalTrials.gov NCT03916055. Registered on 16 April 2019.
Dupuytren’s interventions surgery versus collagenase (DISC) trial: study protocol for a pragmatic, two-arm parallel-group, non-inferiority randomised controlled trial
Authors: Dias Joseph , Arundel Catherine , Tharmanathan Puvan , Keding Ada , Welch Charlie , Corbacho Belen , Armaou Maria , Leighton Paul , Bainbridge Christopher , Craigen Michael , Flett Lydia , Gascoyne Samantha , Hewitt Catherine , James Elaine , James Sophie , Johnson Nick , Jones Judy , Knowlson Catherine , Radia Priya , Torgerson David , Warwick David , Watson Michelle 
Published: September 2021

AbstractBackgroundDupuytren’s contracture is a fibro-proliferative disease of the hands affecting over 2 million UK adults, particularly the white, male population. Surgery is the traditional treatment; however, recent studies have indicated that an alternative to surgery—collagenase clostridium histolyticum (collagenase)—is better than a placebo in the treatment of Dupuytren’s contracture. There is however no robust randomised controlled trial that provides a definitive answer on the clinical effectiveness of collagenase compared with limited fasciectomy surgery. Dupuytren’s intervention surgery vs collagenase trial (DISC) trial was therefore designed to fill this evidence gap.Methods/designThe DISC trial is a multi-centre pragmatic two-arm parallel-group, randomised controlled trial. Participants will be assigned 1:1 to receive either collagenase injection or surgery (limited fasciectomy).We aim to recruit 710 adult participants with Dupuytren’s contracture. Potential participants will be identified in primary and secondary care, screened by a delegated clinician and if eligible and consenting, baseline data will be collected and randomisation completed.The primary outcome will be the self-reported patient evaluation measure assessed 1 year after treatment. Secondary outcome measures include the Unité Rhumatologique des Affections de la Main Scale, the Michigan Hand Questionnaire, EQ-5D-5L, resource use, further procedures, complications, recurrence, total active movement and extension deficit, and time to return to function. Given the limited evidence comparing recurrence rates following collagenase injection and limited fasciectomy, and the importance of a return to function as soon as possible for patients, the associated measures for each will be prioritised to allow treatment effectiveness in the context of these key elements to be assessed.An economic evaluation will assess the cost-effectiveness of treatments, and a qualitative sub-study will assess participants’ experiences and preferences of the treatments.DiscussionThe DISC trial is the first randomised controlled trial, to our knowledge, to investigate the clinical and cost-effectiveness of collagenase compared to limited fasciectomy surgery for patients with Dupuytren’s contracture.Trial registrationClinical.Trials.govISRCTN18254597. Registered on April 11, 2017.