bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moderators of the response to deep TMS for smoking addiction
Authors: Gersner Roman , Barnea-Ygael Noam , Tendler Aron 
Published: January 2023

IntroductionDeep repetitive transcranial magnetic stimulation (Deep TMS™) was recently cleared by the FDA as a short-term treatment for smoking cessation. However, it is unknown which participants are more likely to benefit from the treatment.MethodsWe evaluated the data from the published randomized controlled trial of 262 participants 22–70 years old that led to the FDA clearance to characterize demographic and smoking history factors that moderate Deep TMS treatment efficacy. The current analysis included 75 completers in the active TMS group and 94 completers in the sham TMS group.ResultsWe found that participants younger than 40 had four times the quit rate than those older than 40. Additionally, participants who quit following treatment smoked 10 years less than non-quitters. Moreover, Caucasian participants had two times the quit rate than African–American participants. Strikingly, participants with more than 12 years of education had 7 times the quit rate than participants with less education.ConclusionThree weeks of Deep TMS has a higher smoking addiction quit rate in participants who are younger, more educated, Caucasian and with less extensive smoking history. Participants who are older, with less education and more extensive smoking history may need a longer treatment course and/or combined treatment modalities. Potential reasons may be related to the challenges of inducing neuronal modifications in those with greater physical and psychological dependence. Further investigation is warranted.
Clinical characteristics and clinical outcome of community clusters with SARS-CoV-2 infection
Authors: Zhu Xueling , Wu Wenrui , Ning Jianwen , Dai Tingting , Fang Daiqiong , Wu Jingjing , Shi Ding 
Published: January 2023

BackgroundCommunity clustering is one of the main features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, few studies have been conducted on the clinical characteristics and clinical outcome of clustered cases and sporadic cases with COVID-19.MethodsWe recruited 41 community clusters confirmed with SARS-CoV-2 infection compared with 49 sporadic cases in Zhejiang Province from 19 January 2020 to 9 June 2020. Clinical data were collected to evaluate the clinical outcome and characteristics of community clusters.ResultsCompared to sporadic cases, clustered cases had significantly lower Acute Physiology and Chronic Health Evaluation II (APACHE II) score {5.0 [interquartile range (IQR), 2.0–7.5] vs. 7.0 [IQR, 4.0–12.5]; P = 0.005}, less members in intensive care unit (ICU) (6 [14.6%] vs. 18 [36.7%]; P = 0.018), and shorter time of viral shedding in fecal samples (18.5 [IQR, 17.0–28.3] vs. 32.0 [IQR, 24.3–35.5]; P = 0.002). Univariable logistic regression revealed that older age (odds ratios 1.078, 95% confidence intervals 1.007–1.154, per year increase; p = 0.032), high APACHE II score (3.171, 1.147–8.76; P = 0.026), elevated interleukin-2 levels (3.078, 1.145–8.279; P = 0.026) were associated with ICU admission of clustered cases.ConclusionsCompared to sporadic cases, clustered cases exhibited milder disease severity and a better clinical outcome, which may be closely related to the management of early detection, early diagnosis, early treatment and early isolation of COVID-19.
Moderation effect of community health on the relationship between racial/ethnic residential segregation and HIV viral suppression in South Carolina: A county-level longitudinal study from 2013 to 2018
Authors: Shi Fanghui , Zhang Jiajia , Yang Xueying , Sun Xiaowen , Li Zhenlong , Zeng Chengbo , Ning Huan , Weissman Sharon , Olatosi Bankole , Li Xiaoming 
Published: January 2023

BackgroundViral suppression is the ultimate goal of the HIV treatment cascade and a primary endpoint of antiretroviral therapy. Empirical evidence found racial/ethnic disparities in viral suppression among people living with HIV (PWH), but the evidence of the relationship between racial/ethnic residential segregation and place-based viral suppression is scarce. Further exploring potential structural moderators in this relationship has substantial implications for healthcare policymaking and resource allocation. The current study aimed to investigate the spatial-temporal disparities in the HIV viral suppression rate across 46 counties in South Carolina from 2013 to 2018. We also examined the impact of racial/ethnic residential segregation and the moderation effect of community health, one measurement of community engagement and volunteerism.MethodsThe proportion of PWH who achieved viral suppression for each county and calendar year was calculated using de-identified electronic medical records. The isolation index was calculated and used to measure racial/ethnic residential segregation. The community health index and other county-level factors were directly extracted from multiple publicly available datasets. We used geospatial mapping to explore the spatial-temporal variations of HIV viral suppression rates. Hierarchical quasi-binominal regression models were used to examine the impacts of racial/ethnic residential segregation on county-level viral suppression rate by the extent of community health.ResultsFrom 2013 to 2018, the average viral suppression rate across 46 counties in SC increased from 64.3% to 65.4%. Regression results revealed that counties with high racial/ethnic residential segregation were more likely to have a low viral suppression rate (β = −0.56, 95% CI: −0.75 to −0.37). In counties with high levels of community health, the impact of racial/ethnic residential segregation on viral suppression rate decreased as compared with those with low levels of community health (β = 5.50, 95% CI: 0.95–10.05).ConclusionsRacial/ethnic residential segregation acts as a structural barrier to placed-based viral suppression rates and compromises the goal of the HIV treatment cascade. Concentrated and sustained county-level interventions aiming to improve community health can be practical approaches to promote health equity in HIV treatment and care.
Balance ability and all-cause death in middle-aged and older adults: A prospective cohort study
Authors: Xie Kaihong , Han Xiao , Hu Xuanhan 
Published: January 2023

ObjectiveThe present study aimed to explore the relationship between balance ability and all-cause death in middle-aged and elderly people and to provide a basis for formulating a balanced training plan for middle-aged and older people in China.MethodsBased on data from the China Health and Retirement Longitudinal Study (CHARLS) carried out in the years 2011, 2013, 2015, and 2018, 18,888 participants aged 45 years and above were included. Cox proportional hazard models were designed to evaluate the effect of balance ability on death events.ResultsThe present study found that there was an association between balance ability and death among middle-aged and older people. Multivariate Cox proportional hazard regression model analysis showed that the risk of death decreased by 10% (HR = 0.90,95% CI: 0.85–0.95) for every second increase in balance ability. With balance ability &lt;10 s as the reference group, the adjusted HRs were 0.61 (0.44–0.85) among middle-aged and elderly people. The death density of balance ability of &lt;10 s was 73.87 per thousand person-years higher than that of ≥10 s. There was no interaction between balance ability and chronic disease, overweight, and obesity (P &gt; 0.05).ConclusionThe risk of all-cause death in middle-aged and older people increased with the decrease in balance ability and showed no statistical significance between chronic disease, overweight, and obesity, as corroborated by the present study.
Persistence of IgG COVID-19 antibodies: A longitudinal analysis
Authors: Carvalho Álvaro , Henriques Ana Rita , Queirós Paula , Rodrigues Joana , Mendonça Nuno , Rodrigues Ana Maria , Canhão Helena , de Sousa Germano , Antunes Francisco , Guimarães Miguel 
Published: January 2023

Background and aimThe kinetics of antibody production in response to coronavirus disease 2019 (COVID-19) infection is not well-defined yet. This study aimed to evaluate the antibody responses to SARS-CoV-2 and its dynamics during 9-months in a cohort of patients infected during the first phase of the pandemic. As a secondary aim, it was intended to evaluate the factors associated with different concentrations of IgG antibodies.MethodsA prospective cohort study was conducted from June 2020 to January 2021. This study recruited a convenience sample of adult individuals who where recently diagnosed with COVID-19 and were living in mainland Portugal. A total of 1,695 blood samples were collected from 585 recovered COVID-19 patients up to 9 months after SARS-CoV-2 acute infection. A blood sample was collected at baseline and three, 6 and 9 months after SARS-CoV-2 acute infection to assess the concentration of IgG antibody against SARS-CoV-2.ResultsThe positivity rate of IgG reached 77.7% in the first 3 months after symptom onset. The IgG persists at all subsequent follow-up time-points, which was 87.7 and 89.2% in the 6th and 9th months after symptom onset, respectively. Three distinct kinetics of antibody response were found within the 9 months after infection. Kinetic 1 (K1) was characterized by a constant low IgG antibody concentration kinetic (group size: 65.2%); kinetic 2 (K2), composed by constant moderate IgG kinetic (group size: 27.5%) and kinetic 3 (K3) characterized by higher IgG kinetic (group size: 7.3%). People with ≥56 years old (OR: 3.33; CI 95%: [1.64; 6.67]; p-value: 0.001) and symptomatic COVID-19 (OR: 2.08; CI 95%: [1.08; 4.00]; p-value: 0.031) had higher odds of a “Moderate IgG kinetic.” No significant association were found regarding the “Higher IgG kinetic.”ConclusionOur results demonstrate a lasting anti-spike (anti-S) IgG antibody response at least 9 months after infection in the majority of patients with COVID-19. Younger participants with asymptomatic disease have lower IgG antibody positivity and possibly more susceptible to reinfection. This information contributes to expanding knowledge of SARS-CoV-2 immune response and has direct implications in the adoption of preventive strategies and public health policies.
COVID-19 epidemic and public health interventions in Shanghai, China: Statistical analysis of transmission, correlation and conversion
Authors: Yi Dali , Chen Xicheng , Wang Haojia , Song Qiuyue , Zhang Ling , Li Pengpeng , Ye Wei , Chen Jia , Li Fang , Yi Dong , Wu Yazhou 
Published: January 2023

BackgroundThe Shanghai COVID-19 epidemic is an important example of a local outbreak and of the implementation of normalized prevention and disease control strategies. The precise impact of public health interventions on epidemic prevention and control is unknown.MethodsWe collected information on COVID-19 patients reported in Shanghai, China, from January 30 to May 31, 2022. These newly added cases were classified as local confirmed cases, local asymptomatic infections, imported confirmed cases and imported asymptomatic infections. We used polynomial fitting correlation analysis and illustrated the time lag plot in the correlation analysis of local and imported cases. Analyzing the conversion of asymptomatic infections to confirmed cases, we proposed a new measure of the conversion rate (Cr). In the evolution of epidemic transmission and the analysis of intervention effects, we calculated the effective reproduction number (Rt). Additionally, we used simulated predictions of public health interventions in transmission, correlation, and conversion analyses.Results(1) The overall level of Rt in the first three stages was higher than the epidemic threshold. After the implementation of public health intervention measures in the third stage, Rt decreased rapidly, and the overall Rt level in the last three stages was lower than the epidemic threshold. The longer the public health interventions were delayed, the more cases that were expected and the later the epidemic was expected to end. (2) In the correlation analysis, the outbreak in Shanghai was characterized by double peaks. (3) In the conversion analysis, when the incubation period was short (3 or 7 days), the conversion rate fluctuated smoothly and did not reflect the effect of the intervention. When the incubation period was extended (10 and 14 days), the conversion rate fluctuated in each period, being higher in the first five stages and lower in the sixth stage.ConclusionEffective public health interventions helped slow the spread of COVID-19 in Shanghai, shorten the outbreak duration, and protect the healthcare system from stress. Our research can serve as a positive guideline for addressing infectious disease prevention and control in China and other countries and regions.
COVID-19 as a risk factor for long-term mortality in patients managed by the emergency medical system: A prospective, multicenter, ambulance-based cohort study
Authors: Martín-Conty José L. , Polonio-López Begoña , Sanz-García Ancor , del Pozo Vegas Carlos , Mordillo-Mateos Laura , Bernal-Jiménez Juan José , Conty-Serrano Rosa , Castro Villamor Miguel A. , López-Izquierdo Raúl , Martín-Rodríguez Francisco 
Published: January 2023

IntroductionCOVID-19 has initially been studied in terms of an acute-phase disease, although recently more attention has been given to the long-term consequences. In this study, we examined COVID-19 as an independent risk factor for long-term mortality in patients with acute illness treated by EMS (emergency medical services) who have previously had the disease against those who have not had the disease.MethodsA prospective, multicenter, ambulance-based, ongoing study was performed with adult patients with acute disease managed by EMS and transferred with high priority to the emergency department (ED) as study subjects. The study involved six advanced life support units, 38 basic life support units, and five emergency departments from Spain. Sociodemographic inputs, baseline vital signs, pre-hospital blood tests, and comorbidities, including COVID-19, were collected. The main outcome was long-term mortality, which was classified into 1-year all-cause mortality and 1-year in- and out-of-hospital mortality. To compare both the patients with COVID-19 vs. patients without COVID-19 and to compare survival vs non-survival, two main statistical analyses were performed, namely, a longitudinal analysis (Cox regression) and a logistic regression analysis.ResultsBetween 12 March 2020 and 30 September 2021, a total of 3,107 patients were included in the study, with 2,594 patients without COVID-19 and 513 patients previously suffering from COVID-19. The mortality rate was higher in patients with COVID-19 than in patients without COVID-19 (31.8 vs. 17.9%). A logistic regression showed that patients previously diagnosed with COVID-19 presented higher rates of nursing home residency, a higher number of breaths per minute, and suffering from connective disease, dementia, and congestive heart failure. The longitudinal analysis showed that COVID-19 was a risk factor for mortality [hazard ratio 1.33 (1.10–1.61); p &lt; 0.001].ConclusionThe COVID-19 group presented an almost double mortality rate compared with the non-COVID-19 group. The final model adjusted for confusion factors suggested that COVID-19 was a risk factor for long-term mortality.
The impact of trust in government on pandemic management on the compliance with voluntary COVID-19 vaccination policy among adolescents after social unrest in Hong Kong
Authors: Chung Gary Ka-Ki , Chan Yat-Hang , Chan Siu-Ming , Chen Ji-Kang , Wong Hung , Chung Roger Yat-Nork 
Published: January 2023

BackgroundThe launch of COVID-19 vaccines among students provides an opportunity to re-open schools safely. Nonetheless, under the voluntary vaccination policy, the lack of trust in government since the unprecedented massive social unrest in Hong Kong may hinder the vaccination progress. This study aims to assess the impact of trust in government regarding pandemic management on the willingness, uptake, and intention of COVID-19 vaccination among students in Hong Kong.MethodsBased on maximum variation sampling of 12 secondary schools of diverse socioeconomic background, 1,020 students aged 14–16 years completed an online survey between September and October 2021.Results59.2% of the sample received at least one dose of the COVID-19 vaccine, 25.2% showed willingness of vaccination, 44.7% of the unvaccinated intended to receive the vaccine, whereas 13.4% were trustful to the government regarding pandemic management. Results from multivariable logistic regressions showed independent associations of trust with greater vaccination uptake [aOR = 1.63 (95% CI = 1.06–2.52), compared to distrust], willingness [aOR = 12.40 (7.72–19.93)], and intention [aOR = 4.49 (2.06–9.75)]. However, the impact of trust on vaccine uptake reversed [aOR = 0.53 (0.32–0.87)] after additional adjustment for the willingness of vaccination.ConclusionStudents with higher trust in government regarding pandemic management tended to have greater vaccination willingness and hence uptake; nonetheless, given the same level of willingness, distrust might have facilitated a faster adoption of vaccination as a self-initiated protective behavior. As the level of trust is generally low among secondary school students in Hong Kong, rebuilding trust during adolescence is of importance for better preparedness of the next pandemic.
Strengthening financial management systems at primary health care: Performance assessment of the Facility Financial Accounting and Reporting System (FFARS) in Tanzania
Authors: Ruhago George M. , Ngalesoni Frida N. , Kapologwe Ntuli A. , Kengia James T. , Ngocho James , Kabusi Stephen M. , Kalolo Albino , Kitali Erick J. , Rwamiago Elisa , Mtei Gemini 
Published: January 2023

BackgroundUniversal coverage remains a challenging pursuit around the world, even among the highest-income countries. Strengthening financial management capacity is essential towards attaining the three universal health coverage (UHC) goals, namely, expanded coverage, quality service, and financial protection. In this regard, Tanzania introduced the Facility Financial Accounting and Reporting System (FFARS) in line with the introduction of the Direct Health Facility Financing (DHFF) initiative in primary health care (PHC) in 2017–2018. We aim to assess the functionality of the FFARS in management, accounting, and reporting funds received and disbursed in the stride forward strengthening public financial management in PHC facilities towards UHC.MethodsThe study applied implementation research using a concurrent convergent mixed-methods design to assess sources of revenue, expenditure priorities, and changes of revenues and to explore the usability and benefits of FFARS in improving facility finance and reporting systems in more than 5,000 PHC facilities in Tanzania. Quantitative methods assessed the changes in revenues and expenditure between the financial years (FYs) 2017–2018 and 2018–2019, while the qualitative part explored the usability and the benefits FFARS offers in improving facility finances and reporting systems. Data analysis involved a thematic and descriptive analysis for qualitative and quantitative data, respectively.ResultsOf the 5,473 PHC facilities, 88% were in rural areas; however, the annual average revenue was higher in urban facilities in FYs 2017–2018 and 2018–2019. Overall, district hospitals showed an increase whereas health centers reported a decline of more than 40% in revenue. The user fee was the predominant source of revenue, particularly in urban facilities, while revenue from health insurance was not among the top three highest sources of revenue. Expenditure priorities leaned more towards drugs and supplies (25%) followed by allowances and training (21%); these did not differ by facility geographies. In health centers, expenditure on facility infrastructure was predominant. Key Informant Interviews revealed an overall satisfaction and positive experiences related to the system.ConclusionThe implementation of FFARS in Tanzania demonstrated its high potential in improving facility financial management, including its ability to track revenue and expenditure at PHC facilities. Staffing shortages, ICT infrastructure, and limited opportunities for capacity building could be the limiting factors to reaching the potential of the implementation of FFARS and the attainment of its full impact on Tanzania's pursuit for UHC.
Reconstruction of a nail bed with double-layer artificial dermis for a pincer nail: A case report and literature review
Authors: Deng Weicong , Zhou Zelin , Leng Bo , Zeng Xinming , Shen Zi , Hong Yongchang 
Published: January 2023

BackgroundA pincer nail (PN) is a type of nail deformity. Although it is a minor ailment, it can cause intractable pain, affecting daily work and life. Currently, there is no standard invention for PN. The main purpose of treatment is to correct the curvature of the nail, so we apply double-layer artificial dermis (DLAD), a novel treatment, for PN according to this aim.Case presentationA 40-year-old man suffering from PN was treated with DLAD. After 1 year of follow-up, the patient's great toenail plate of the right foot was completely grown out. His pain was relieved, and the curvature of the toenail was corrected.ConclusionThe innovative method of using DLAD to fill the ingrown nail bed not only solves the problem of recurrent pincer nail deformity but also restores the original appearance of the toenail. It suggested that this simple procedure can be widely applied in clinical practice.
Pre-operative predictive factors of residual varus on the mechanical axis after Oxford unicompartmental knee arthroplasty
Authors: Ji Songjie , Huang Ye , Zhou Yixin , Wang Chao , Wang Xiaokai , Ma Chaoyi , Jiang Xu 
Published: January 2023

BackgroundResidual varus after Oxford unicompartmental knee arthroplasty (UKA) happens frequently. This study aims to evaluate the pre-operative contributing factors of residual varus.MethodsA total of 1,002 knees (880 patients, 201 patients were male, and 679 were female) underwent Oxford UKA in the Orthopedic Surgery Department of the Beijing Jishuitan Hospital from March 2018 to April 2021. The mean age of the patient was 64.7 ± 7.7 years. To assess residual varus, the full-length lower extremity is placed upright for EOS imaging, with the knee fully extended. The angle of post-operative residual varus was measured as described by Noyes et al. Of the knees studied, they were either categorized into an under-corrected group (post-operative Noyes angle &gt;5°) or a corrected group (post-operative Noyes angle ≤5°). Age, gender, body mass index (BMI), range of motion (ROM), Clinical American Knee Society Score (Clinical AKSS), and Function American Knee Society Score (Function AKSS) were compared. The following additional parameters were measured: pre-operative Noyes angle, lateral distal femoral angle (LDFA), medial proximal tibial angle (MPTA), the posterior slope of the proximal tibia angle (PPTA), joint line converge angle (JLCA), and fixed flexion deformity (FFD).ResultsThere was no statistically significant difference between the two groups in regards to gender (p = 0.428), surgical leg (p = 0.937), age (p = 0.851), BMI (p = 0.064), pre-operative Clinical AKSS (p = 0.206) and Function AKSS (p = 0.100). However, pre-operative ROM statistically differed between the two groups (p &lt; 0.001). The contributing factors of post-operative residual varus were determined to be the following parameters: pre-operative MPTA (p &lt; 0.001, OR = 4.522, 95% CI: 2.927–6.984), pre-operative Noyes (p &lt; 0.001, OR = 3.262, 95% CI: 1.802–5.907) and pre-operative FFD (p = 0.007, OR = 1.862, 95% CI: 1.182–2.934). The effects of pre-operative LDFA (p = 0.146), JLCA (p = 0.942), and pre-operative PPTA (p = 0.899) on the post-operative mechanical axis did not show statistical significance.ConclusionsPatients with severe pre-operative varus, particularly varus deformity mainly from the tibial side or pre-operative FFD, are more prone to get extremity mechanical axis residual varus after UKA with Oxford.