bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of a microbial and pathogen source tracking toolbox to identify infrastructure problems in stormwater drainage networks: a case study
Authors: Carson Liam R. , Goodman Clint , van Duin Bert , Neumann Norman F. 
Published: August 2024

ABSTRACT

Water scarcity and increasing urbanization are forcing municipalities to consider alternative water sources, such as stormwater, to fill in water supply gaps or address hydromodification of receiving urban streams. Mounting evidence suggests that stormwater is often contaminated with human feces, even in stormwater drainage systems separate from sanitary sewers. Pinpointing sources of human contamination in drainage networks is challenging given the diverse sources of fecal pollution that can impact these systems and the non-specificity of traditional fecal indicator bacteria (FIB) for identifying these host sources. As such, we used a toolbox approach that encompassed microbial source tracking (MST), FIB monitoring, and bacterial pathogen monitoring to investigate microbial contamination of stormwater in an urban municipality. We demonstrate that human sewage frequently contaminated stormwater (in >50% of routine samples), based on the presence of the human fecal marker HF183, and often exceeded microbial water quality criteria.
Arcobacter butzleri
, a pathogen of emerging concern, was also detected in >50% of routine samples, with 75% of these pathogen-positive samples also being positive for the human fecal marker HF183, suggesting human municipal sewage as the likely source for this pathogen. MST and FIB were used to track human fecal pollution in the drainage network to the most likely point source of contamination, for which a sewage cross-connection was identified and confirmed using tracer dyes. These results point to the ubiquitous presence of human sewage in stormwater and also provide municipalities with the tools to identify sources of anthropogenic contamination in storm drainage networks.

IMPORTANCE
Water scarcity, increased urbanization, and population growth are driving municipalities worldwide to consider stormwater as an alternative water source in urban environments. However, many studies suggest that stormwater is relatively poor in terms of microbial water quality, is frequently contaminated with human sewage, and therefore could represent a potential health risk depending on the type of exposure (e.g., irrigation of community gardens). Traditional monitoring of water quality based on fecal bacteria does not provide any information about the sources of fecal pollution contaminating stormwater (i.e., animals/human feces). Herein, we present a case study that uses fecal bacterial monitoring, microbial source tracking, and bacterial pathogen analysis to identify a cross-connection that contributed to human fecal intrusion into an urban stormwater network. This microbial toolbox approach can be useful for municipalities in identifying infrastructure problems in stormwater drainage networks to reduce risks associated with water reuse.
Tectonostratigraphic evolution of a marginal basin during the transition from arc collision to subduction: The case of the northern Pacific forearc of Colombia
Authors: León Santiago , Parra Mauricio , Marulanda U. Mateo , Monsalve Gaspar , Jaramillo Carlos , Vallejo-Hincapié Felipe , Valencia Víctor A. 
Published: August 2024

Abstract
The forearc of the northern Pacific region of Colombia (Atrato basin) initially formed in an intra-oceanic setting related to the Central American arc, and its sedimentary record provides a unique opportunity to study the evolution of source-to-sink systems during the transition from arc collision to subduction. Intracrustal weaknesses, and the highly oblique approach to the continental South American paleomargin, favored an initial soft collision of the island arc and associated marginal basins during the Early Miocene. This is suggested by the lack of widespread deformation in the collisional front and the accumulation of hemipelagic rocks with little terrestrial input, sourced by the colliding arc and the continental paleomargin. A regional unconformity associated with a shift toward terrigenous deposition is attributed to a harder collision and subsequent buoyancy-driven uplift of the oceanic terrane ca. 15–13 Ma. The final docking of the oceanic arc and related basins to the continent and coeval surface uplift near the suture zone ca. 12–7 Ma marked the transition from collision to subduction and the establishment of the Atrato basin as a continental forearc. This was accompanied by postcollisional arc magmatism, shallowing of accumulation depths to nearshore conditions, and a dramatic decrease in the sediment contribution of the continental paleomargin. Subsequent shallow subduction of the Coiba microplate caused the Late Miocene uplift of the coastal Baudó Range and the fragmentation of the Atrato basin into inner and outer (coastal) segments. This episode drove a shift from predominantly transverse to longitudinal drainage systems and the final transition from marine to terrestrial settings in northwestern Colombia.
Promotion of Physical Activity by Health Professionals (PROMOTE-PA): protocol for effectiveness outcomes in a hybrid type I effectiveness-implementation cluster randomised controlled trial
Authors: Baldwin Jennifer Naomi , Purcell Kate , Hassett Leanne , Tiedemann Anne , Pinheiro Marina , Savage Roslyn , Wang Belinda , Haynes Abby , West Kerry , Noetel Michael , Richards Bethan , Jennings Matthew , Gupta Sandeep , Smith Ben J , Treacy Daniel , Halliday Mark , Harvey Lisa A , Phongsavan Philayrath , Rogers Kris , Howard Kirsten , Bauman Adrian , Hamdorf Phil , Shaw Ayden , Walkley Jeff , Dwyer Genevieve , Lonsdale Chris , Reece Lindsey , Clutterbuck Georgina , Lovitt Lorraine , Sturnieks Daina , Sherrington Catherine 
Published: August 2024

Promotion of physical activity by health professionals can increase physical activity participation among patients, however, implementing physical activity promotion within hospital systems is lacking. The Promotion of Physical Activity by Health Professionals (PROMOTE-PA) study is a hybrid type I effectiveness-implementation cluster randomised controlled trial evaluating the effectiveness of support for physical activity promotion by health professionals on physical activity participation of patients. Health professionals delivering outpatient healthcare services within four local health districts and one specialty health network in New South Wales, Australia will be included. The target patient population is children (5–17 years) and adults (18+ years) who are willing to receive additional support to be more physically active. The evidence-based intervention is brief physical activity promotion informed by the ‘5As’ physical activity counselling model and behavioural theory, embedded into routine clinical practice. Our multi-faceted strategy to support implementation of physical activity promotion was developed based on preliminary research and consultation with key stakeholders. The implementation strategy includes education and training as well as a selection of the following (tailored to each clinical team): community referral strategies, experts and clinical mentors, and clinical champions. 30 outpatient clinical teams will be randomised to receive the implementation strategy immediately or after a 3-month delay (waitlist control). Each team will seek to recruit 10–30 patients (n=approx. 720) to report moderate-vigorous physical activity (minutes per week, primary outcome), frequency of balance and strength exercise, mobility, and quality of life at baseline, 3-month and 6-month post patient recruitment. This study aims to address the increasing burden of physical inactivity in a high-risk population using the existing health workforce.Trial registration numberAustralian and New Zealand Clinical Trials Registry (ACTRN12623000920695).
Prevalence, determinants and care-seeking behaviour for anxiety and depression in Nepalese population: a secondary analysis of data from Nepal Demographic and Health Survey 2022
Authors: Pandey Achyut Raj , Adhikari Bikram , Bista Bihungum , Lamichhane Bipul , Joshi Deepak , K C Saugat Pratap , Sharma Shreeman , Baral Sushil 
Published: August 2024

ObjectiveTo determine the prevalence and factors associated with anxiety and depression and the care-seeking behaviour among Nepalese population.Design and settingsSecondary analysis of the data from nationally representative Nepal Demographic and Health Survey 2022.ParticipantsAnalysed data of 12 355 participants (7442 females and 4913 males) aged 15–49 years.Outcome measuresDepression and anxiety were assessed using Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder Assessment (GAD-7) tools, respectively.Statistical analysisWe performed weighted analysis to account for the complex survey design. We presented categorical variables as frequency, per cent and 95% confidence interval (CI), whereas numerical variables were presented as median, inter-quartile range (IQR) and 95% CI. We performed univariate and multivariable logistic regression to determine factors associated with anxiety and depression, and results were presented as crude OR (COR), adjusted OR (AOR) and their 95% CI.ResultsThe prevalence of depression and anxiety were 4.0% (95% CI 3.5 to 4.5) and 17.7% (95% CI 16.5 to 18.9), respectively. Divorced or separated participants were found to have higher odds of developing anxiety (AOR 2.40, 95% CI 1.74 to 3.31) and depression (AOR 3.16, 95% CI 1.84 to 5.42). Among ethnic groups, Janajati had lower odds of developing anxiety (AOR 0.77, 95% CI 0.65 to 0.92) and depression (AOR 0.67, 95% CI 0.49 to 0.93) compared with Brahmin/Chhetri. Regarding disability, participants with some difficulty had higher odds of developing anxiety (AOR 1.81, 95% CI 1.56 to 2.10) and depression (AOR 1.94, 95% CI 1.51 to 2.49), and those with a lot of difficulty had higher odds of anxiety (AOR 2.09, 95% CI 1.48 to 2.96) and depression (AOR 2.04, 95% CI 1.06 to 3.90) compared with those without any disability. Among those who had symptoms of anxiety or depression, only 32.9% (95% CI 30.4 to 34.4) sought help for the conditions.ConclusionsMarital status and disability status were positively associated with anxiety and depression, whereas Janajati ethnicity had relatively lower odds of experiencing anxiety and depression. It is essential to develop interventions and policies targeting females and divorced individuals to help reduce the burden of anxiety and depression in Nepal.
Demographic and geographic distribution of diabetes and pre-diabetes risk in rural settings: results from a cross-sectional, countywide rural health survey in Sullivan County, New York
Authors: Lee David C , Ross Leah , Quintero Arias Carolina , Rony Melissa , Patel Rahi , Jensen Erica , Petcu Robert , Imas Daniel , Elbel Brian , Thorpe Lorna E , Anthopolos Rebecca 
Published: August 2024

ObjectiveTo perform a detailed characterisation of diabetes burden and pre-diabetes risk in a rural county with previously documented poor health outcomes in order to understand the local within-county distribution of diabetes in rural areas of America.Design, setting, and participantsIn 2021, we prospectively mailed health surveys to all households in Sullivan County, a rural county with the second-worst health outcomes of all counties in New York State. Our survey included questions on demographics, medical history and the American Diabetes Association’s Pre-diabetes Risk Test.Primary outcome and methodsOur primary outcome was an assessment of diabetes burden within this rural county. To help mitigate non-response bias in our survey, raking adjustments were performed across strata of age, sex, race/ethnicity and health insurance. We analysed diabetes prevalence by demographic characteristics and used geospatial analysis to assess for clustering of diagnosed diabetes cases.ResultsAfter applying raking procedures for the 4725 survey responses, our adjusted diagnosed diabetes prevalence for Sullivan County was 12.9% compared with the 2019 Behavioural Risk Factor Surveillance System (BRFSS) estimate of 8.6%. In this rural area, diagnosed diabetes prevalence was notably higher among non-Hispanic Black (21%) and Hispanic (15%) residents compared with non-Hispanic White (12%) residents. 53% of respondents without a known history of pre-diabetes or diabetes scored as high risk for pre-diabetes. Nearest neighbour analyses revealed that hotspots of diagnosed diabetes were primarily located in the more densely populated areas of this rural county.ConclusionsOur mailed health survey to all residents in Sullivan County demonstrated higher diabetes prevalence compared with modelled BRFSS estimates that were based on small telephone samples. Our results suggest the need for better diabetes surveillance in rural communities, which may benefit from interventions specifically tailored for improving glycaemic control among rural residents.
Effect of home-based and remotely supervised combined exercise and cognitive intervention on older adults with mild cognitive impairment (COGITO): study protocol for a randomised controlled trial
Authors: Hong Chenlu , Tai TakChing , Zhou Jianwei , Gao Changqing , Shi Jianfei , Huang Jinsong , Xu Xuebing , Du Yushan , Liu Guangwen , Guan Boyuan , Ning Xin , Liu Xinran , Liu Zhaorui , Luo Yanan 
Published: August 2024

IntroductionMild cognitive impairment (MCI) is an intermediate phase between normal cognitive ageing and dementia and poses a serious threat to public health worldwide; however, it might be reversible, representing the best opportunity for secondary prevention against serious cognitive impairment. As a non-pharmacological intervention for those patients, interventions that combine physical exercise and cognitive training, whether delivered simultaneously or sequentially, may have superior effects on various cognitive domains, including global cognition, memory, executive function and attention. The supportive evidence remains incomplete. This study aims to assess the effectiveness of a combined exercise and cognitive intervention in Chinese older adults with mild cognitive impairment (COGITO), empowered by digital therapy and guided by the Health Action Process Model and the Theory of Planned Behaviour (HAPA-TPB theory) in a home-based setting.Methods and analysisThis study is a randomised controlled, assessor-blinded multi-centre study. Four parallel groups will include a total of 160 patients, receiving either a combined exercise and cognitive intervention, an isolated exercise intervention, an isolated cognitive intervention or only health education. These interventions will be conducted at least twice a week for 50 min each session, over 3 months. All interventions will be delivered at home and remotely monitored through RehabApp and Mini-programme, along with an arm-worn heart rate telemetry device. Specifically, supervisors will receive participants’ real-time training diaries, heart rates or other online monitoring data and then provide weekly telephone calls and monthly home visits to encourage participants to complete their tasks and address any difficulties based on their training information. Eligible participants are community-dwelling patients with no regular exercise habit and diagnosed with MCI. The primary outcome is cognitive function assessed by the Alzheimer’s Disease Assessment Scale-Cognitive (ADAS-Cog) and Community Screening Instrument for Dementia (CSI-D), with baseline and three follow-up assessments. Secondary outcomes include quality of life, physical fitness, sleep quality, intrinsic capacity, frailty, social support, adherence, cost-effectiveness and cost-benefit.Ethics and disseminationThe study was approved by the Institutional Review Board of Peking University. Research findings will be presented to stakeholders and published in peer-reviewed journals and at provincial, national and international conferences.Trial registration numberChiCTR2300073900.
Integrating programme theory into the development of a core outcome set for technology-assisted counselling interventions in dementia: study protocol of the ProCOS study
Authors: Bauernschmidt Dorothee , Wittmann Janina , Bieber Anja , Meyer Gabriele 
Published: August 2024

IntroductionDue to the increasing number of persons with dementia, the need for family and professional support is growing. Counselling services aim to support family dementia caregivers and the use of information and communication technology may improve accessibility to counselling. The effectiveness of technology-based counselling in dementia remains unclear so far. Few randomised controlled trials have been conducted assessing heterogeneous outcomes. Theoretical underpinnings for the development and evaluation of these complex interventions were lacking in most cases. We therefore aim to formulate an initial programme theory of a technology-assisted counselling intervention for family dementia caregivers and to create the data basis for the consensus process of a core outcome set.Methods and analysisThe methodological approaches for developing a programme theory and a core outcome set will be integrated. In a scoping review, data on the characteristics, theoretical foundations of counselling interventions and outcomes of clinical studies will be collected. The lifeworld perception of relevant stakeholders on the importance of counselling in family caregiving will be explored in a phenomenological substudy using semistructured interviews. The synthesis of data from the literature review and the qualitative substudy will be performed by developing a logic model. Mechanisms of action and assumed causal relationships are explicated in the elements of programme theory (theory of change, outcomes chain and theory of action). An initial programme theory is then formulated. In addition, a ‘long list’ of outcomes and assessment instruments will be compiled.Ethics and disseminationThe ethics committee of the Medical Faculty of the Martin Luther University Halle-Wittenberg approved the study protocol (no. 2023–093).Findings will be reported to participants and the funding organisation and disseminated in peer-reviewed journals and at national and international conferences.Trial registration numberThe ProCOS (Development and evaluation of a technology-assissted counselling intervention for family caregivers of persons with dementia - Programme theory and preparation of a core outcome set) project is registered with the Core Outcome Measures in Effectiveness Trials initiative (https://www.comet-initiative.org/Studies/Details/2884).
COVID-19 pandemic impact on hypertension management in North East London: an observational cohort study using electronic health records
Authors: Rison Stuart Christopher Gorthorn , Redfern Oliver C , Mathur Rohini , Dostal Isabel , Carvalho Chris , Raisi-Estabragh Zahra , Robson John 
Published: August 2024

ObjectiveThere are established inequities in the monitoring and management of hypertension in England. The COVID-19 pandemic had a major impact on primary care management of long-term conditions such as hypertension. This study investigated the possible disproportionate impact of the pandemic across patient groups.DesignOpen cohort of people with diagnosed hypertension.SettingsNorth East London primary care practices from January 2019 to October 2022.ParticipantsAll 224 329 adults with hypertension registered in 193 primary care practices.OutcomesMonitoring and management of hypertension were assessed using two indicators: (i) blood pressure recorded within 1 year of the index date and (ii) blood pressure control to national clinical practice guidelines.ResultsThe proportion of patients with a contemporaneous blood pressure recording fell from a 91% pre-pandemic peak to 62% at the end of the pandemic lockdown and improved to 77% by the end of the study. This was paralleled by the proportion of individuals with controlled hypertension which fell from a 73% pre-pandemic peak to 50% at the end of the pandemic lockdown and improved to 60% by the end of the study. However, when excluding patients without a recent blood pressure recording, the proportions of patients with controlled hypertension increased to 81%, 80% and 78% respectively.Throughout the study, in comparison to the White ethnic group, the Black ethnic group was less likely to achieve adequate blood pressure control (ORs 0.81 (95% CI 0.78 to 0.85, p<0.001) to 0.87 (95% CI 0.84 to 0.91, p<0.001)). Conversely, the Asian ethnic group was more likely to have controlled blood pressure (ORs 1.09 (95% CI 1.05 to 1.14, p<0.001) to 1.28 (95% CI 1.23 to 1.32, p<0.001)). Men, younger individuals, more affluent individuals, individuals with unknown or unrecorded ethnicity or those untreated were also less likely to have blood pressure control to target throughout the study.ConclusionThe COVID-19 pandemic had a greater impact on blood pressure recording than on blood pressure control. Inequities in blood pressure control persisted during the pandemic and remain outstanding.
Survival status and predictors of mortality among severely acute malnourished under-5 children admitted to stabilisation centers in selected government hospitals in Addis Ababa, Ethiopia, 2022: a retrospective cohort study
Authors: Abdu Amanuel Nuredin , Murugan Rajalakshmi , Tilahun Sosina Workineh 
Published: August 2024

ObjectiveThis study aims to assess the survival status and predictors of mortality among under-5 children with severe acute malnutrition in Addis Ababa, Ethiopia.DesignA retrospective cohort study was employed on randomly selected 422 medical records of children under the age of 5 admitted to stabilisation centres in Addis Ababa, Ethiopia. Survival analysis and Cox regression analysis were conducted to determine time spent before the outcome and predictors of desired outcome.SettingsThe stabilisation centres in four governmental hospitals in Addis Ababa, Ethiopia: Tikur Anbessa Specialised Hospital, Zewditu Memorial Hospital, Yekatit 12 Hospital and Tirunesh Beijing HospitalParticipantsOf 435 severely malnourished children under the age of 5 admitted to four governmental hospitals in Addis Ababa, Ethiopia, from January 2020 to December 2022, we were able to trace 422 complete records. The remaining 13 medical records were found to be incomplete due to missing medical history information for those children.Primary and secondary outcome measuresThe primary outcome is the survival status of under-5 children with severe acute malnutrition after admission to the stabilisation centres. The secondary outcome is predictors of survival among these children.ResultsOf 422 children, 44 (10.4%) died, with an incidence rate of 10.3 per 1000 person-days. The median hospital stay was 8 days. Full vaccination (adjusted HR (AHR) 0.2, 95% CI 0.088 to 0.583, p<0.05), feeding practices (F-75) (AHR 0.2, 95% CI 0.062 to 0.651, p<0.01), intravenous fluid administration (AHR 3.7, 95% CI 1.525 to 8.743, p<0.01), presence of HIV (AHR 2.2, 95% CI 1.001 to 4.650, p<0.05), pneumonia (AHR 2.2, 95% CI 1.001 to 4.650, p<0.01) and occurrence of shock (AHR3.5, 95% CI 1.451 to 8.321, p<0.01) were identified as significant predictors of mortality.ConclusionThe study identified a survival rate slightly higher than the acceptable range set by the social and public health economics study group. Factors like vaccination status, HIV, pneumonia, shock, intravenous fluid and the absence of feeding F-75 predicted mortality.