bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary care provider uptake of intensive behavioral therapy for obesity in Medicare patients, 2013–2019
Authors: Ozoor Mounira , Gritz Mark , Dolor Rowena J. , Holtrop Jodi Summers , Luo Zhehui 
Published: March 2023

Background
The delivery of Intensive Behavioral Therapy (IBT) for obesity by primary care providers (PCPs) has been covered by Medicare to support elderly individuals with obesity (BMI > 30 kg/m2) in managing their weight since 2011 for individual therapy and 2015 for group therapy. We conducted a cohort study of PCPs in an attempt to understand patterns of uptake of IBT for obesity services among PCPs serving the Medicare population across the U.S.

Methods
We used the Centers for Medicare and Medicaid Services Provider Utilization and Payment Data from 2013 to 2019 to identify all PCPs who served more than 10 Medicare beneficiaries in each of the seven-year period to form a longitudinal panel. The procedure codes G0447 and G0473 were used to identify PCPs who provided IBT; and the characteristics of these providers were compared by the IBT-uptake status.

Results
Of the 537,754 eligible PCPs who served Medicare patients in any of the seven years, only 1.2% were found to be IBT service providers in at least one year from 2013 through 2019 (246 always users, 1,358 early adopters, and 4,563 late adopters). IBT providers shared a few common characteristics: they were more likely to be male, internal medicine providers, saw a higher number of Medicare beneficiaries, and practiced in the South and Northeast regions. Having higher proportion of patients with hyperlipidemia was associated with higher likelihood of a provider being an IBT-user.

Conclusions
Very few PCPs continuously billed IBT services for Medicare patients with obesity. Further investigation is needed to mitigate barriers to the uptake of IBT services among PCPs.
Mental distress, COVID19 vaccine distrust and vaccine hesitancy in South Africa: A causal mediation regression analysis
Authors: Kollamparambil Umakrishnan , Oyenubi Adeola , Nwosu Chijioke 
Published: March 2023

Aim
Within the context of increasing mental distress noted since the beginning of the COVID19 pandemic, the study aims at analysing the relationship between mental health, vaccine distrust and vaccine hesitancy in South Africa.

Subject and methods
The study uses nationally representative panel data of 3241 individuals interviewed prior to and during the COVID19 pandemic. The study uses a range of regression techniques including logit, mediation and gradient-boosted causal mediation models to identify the causal relationship while accounting for selection bias.

Results
The results of multivariate logit regression reveal that vaccine distrust is the most important predictor of vaccine hesitancy [Coeff: 3.420, CI 3.122, 3.717]. Mental distress is not found to be a significant driver in a fully specified logit model, pointing to the need to analyse the pathways through which mental distress impacts vaccine hesitancy. The mediation regression undertaken for this purpose finds that the mental distress has a positive and significant association with vaccine distrust [Coeff: 0.027, CI: 0.0029, 0.052]. The increased vaccine distrust in turn results in increased vaccine hesitancy [Coeff: 0.661, CI: 0.611, 0.711]. The results of mediation regression therefore indicate strong and significant mediation effects, whereby mental health effects vaccine hesitancy through the mediating variable of vaccine distrust. These results are robust to the gradient boosted causal mediation model which establishes strong and significant indirect effects [Coeff: 0.015, CI: 0.01, 0.019], whereby mental health effects vaccine hesitancy through the mediating variable of vaccine distrust.

Conclusion
The study concludes that mental health impacts on vaccine intention through the mediating role of vaccine distrust. The findings indicate that individuals at high risk of depression are more concerned regarding the safety of vaccines, which in turn feeds into vaccine hesitancy. Therefore, depressive symptoms impact on vaccine hesitancy through the mediating factor of vaccine distrust.
Limiting spread of VIM-positive Pseudomonas aeruginosa from colonized sink drains in a tertiary care hospital: A before-and-after study
Authors: Pirzadian Jannette , Voor in ‘t holt Anne F. , Hossain Mehjabeen , Klaassen Corné H. W. , de Goeij Inge , Koene Heidy H. H. T. , Bode Lonneke G. M. , Vos Margreet C. , Severin Juliëtte A. 
Published: March 2023

Background
In healthcare environments, sinks are being increasingly recognized as reservoirs for multidrug-resistant Gram-negative bacteria. In our hospital, carbapenemase-producing, Verona Integron-encoded Metallo-beta-lactamase (VIM)-positive Pseudomonas aeruginosa (VIM-PA) was detected at low endemicity in patients, and environmental culturing revealed that sink drains were primary reservoirs. Therefore, an intervention was initiated in several wards to install sink drain plugs as physical barriers against splashing to prevent transmission of VIM-PA from drain reservoirs to the surrounding sink environment.

Aim
To assess the efficacy of the intervention on limiting spread of VIM-PA.

Methods
Swabs were taken from inner sink environments (i.e. drains), and outer sink environments (i.e. wash basins, faucet aerators, and countertops) twice before and three times after the intervention. Siphon water and drain wells were also sampled before and at the moment of the intervention, respectively. All samples were screened for VIM-PA, and isolates were typed with multiple-locus variable-number tandem repeat analysis (MLVA).

Results
There was a significant reduction in VIM-PA positivity in both inner (P-value <0.001) and outer (P-value 0.001) sink environments after the intervention. However, VIM-PA recolonization was observed in the inner sink environments of patient rooms, and also in rooms exclusive to healthcare personnel, over time. Surfaces in the outer sink environment were rarely positive for VIM-PA after the intervention. MLVA revealed three genetic clusters, with one found in all wards and room types during the study period.

Conclusions
Drain plugs are a simple and effective infection prevention and control measure to contain spread of VIM-PA from drain reservoirs.
Medical students’ perceptions towards distance e-Learning in gynecology ward during the COVID-19 pandemic
Authors: Rokhgireh Samaneh , Sabet Babak , Chaichian Shahla , Derakhshan Farzaneh , Haghighi Ladan , Derakhshan Roya , Kohan Noushin 
Published: March 2023

IntroductionThe coronavirus disease 2019 (COVID-19) pandemic has caused serious public health problems and compromised the health of individuals and communities. This study aimed to evaluate a Distance e-Learning from the perspective of medical students in the Gynecology ward during the COVID-19 Pandemic.Material and methodsThis cross-sectional study was conducted at the Iran University of Medical from the September 2020 to September 2021. The study sample included 130 medical students who participated in distance training courses in the gynecology ward during the COVID-19 pandemic. All medical students were included for the study. Medical students (externs and interns), who received Distance eLearning in the gynecology ward during the study, were included. The self-administered questionnaire was used in this study. Questionnaires was developed through literature review and consultation with gynecology and eLearning experts. Face and content validity was established by eight experts. Internal consistency was assessed with Cronbach’s alpha.ResultsThe questionnaire was sent to 170 medical students. Of the 130 respondents 65% were female and 35% were male. There were 57 (43.8%) externs and 73 (56.2) interns. Most students agreed that mobile devices increase their learning and home is the preferred place for participation in DE. Most students (66.9%) either strongly disagreed or disagreed that Distance e-Learning was an appropriate method for learning basic clinical skills.72.3% of respondents strongly disagreed or disagreed that Distance e-Learning provided them an opportunity to practice clinical skills effectively. Most medical students (69.3%) strongly agreed or agreed that Distance e-Learning created more opportunities to apply theoretical knowledge directly to medical practice.DiscussionThe results of the online survey suggest that medical students have found both positive and negative aspects of clinical learning by DEL format in Gynecology ward.
Anemia prevalence and associated factors among school-children of Kersa Woreda in eastern Ethiopia: A cross-sectional study
Authors: Gemechu Kabtamu , Asmerom Haftu , Gedefaw Lealem , Arkew Mesay , Bete Tilahun , Adissu Wondimagegn 
Published: March 2023

BackgroundAnemia in school children is a worldwide public health problem, affecting about a quarter of this population. It also remains a significant problem in developing countries, with multifactorial causes. Anemia in school children has adverse effects on the development of the physical, cognitive, immunity of affected children, and subsequently their educational achievement which may lead to loss of productivity at a later age in life. Regular surveillance that could provide evidence-based local data is required to intervene in the problems. Therefore, this study aimed to determine the prevalence and associated factors of anemia among school children in primary schools of eastern Ethiopia.MethodsSchool-based cross-sectional study was conducted by recruiting 482 school- children. Data on socio-demographic and dietary habits were collected from parents/legal guardians. Capillary blood for blood film preparation and hemoglobin measurement and stool sample for the diagnosis of intestinal parasites infection was collected. Hemoglobin concentration was measured using a hemoglobinometer HemoCue®301+, and stool examination by direct wet mount and concentration technique. Data were entered into epi-data and exported into SPSS for analysis. Bivariate and multivariate logistic regression was run to identify associated factors. Association was described using adjusted OR (AOR) along with 95% CI and variables with a p-value<0.05 were considered statistically significant.ResultsThe overall prevalence of anemia was 24.5%. Being female (AOR = 2.88, 95% CI: 1.69, 4.92), family size of more than 5 (AOR = 2.78, 95% CI: 1.60, 4.81), not consuming green leafy vegetables (AOR = 4.09, 95% CI: 2.42, 6.94), consumption of milk (AOR = 2.22, 95% CI: 1.27, 3.88), being stunting (AOR = 3.17, 95% CI: 1.70, 5.91) and parasite infections (AOR = 5.23, 95% CI: 2.77, 9.85) were significantly associated with anemia.ConclusionIn this study nearly one-fourth of children were anemic. Anemia was a moderate public health problem among schoolchildren in the study area. Thus, school-based interventions targeting nutritional factors and intestinal parasite infection need to be implemented.
Presence and severity of migraine is associated with development of primary open angle glaucoma: A population-based longitudinal cohort study
Authors: Ohn Kyoung , Han Kyungdo , Moon Jung Il , Jung Younhea 
Published: March 2023

Purpose
To examine the association between the presence and severity of migraine and development of primary open-angle glaucoma (POAG) using a nationwide population-based longitudinal cohort data.

Methods
Data were retrieved from the Korean National Health Insurance Service for 2,716,562 individuals aged ≥ 40 years and assessed for the development of POAG from 2009 through 2018. Subjects were classified into the following 3 groups: healthy control subjects, subjects with mild migraine, and those with severe migraine. Hazard ratios (HR) of glaucoma development were calculated for each group. Subgroup analyses of subjects stratified by age, sex, lifestyle factors (smoking, drinking, and body mass index (BMI)), and comorbidities (diabetes, hypertension, and dyslipidemia).

Results
During the 9-year follow-up period, the incidence rate of POAG per 1000 person-years was 2.41 and 3.25 in subjects without and with migraine, respectively. Among the migraine group, the incidence rate was 3.14 and 3.89 in mild and severe subgroups, respectively. The HR was 1.355 (95% CI, 1.300–1.412) and 1.188 (95% CI, 1.140–1.239) before and after adjusting for potential confounding factors in the migraine group per se. Regarding the severity of migraine, the adjusted HRs were 1.169 (95% CI, 1.117–1.224) in the mild migraine group, and 1.285 (95% CI, 1.166–1.415) in the severe migraine group compared to the control group. The results were consistent in subgroup analyses after stratifying by age, sex, lifestyle factors, and comorbidities.

Conclusions
Migraine is associated with increased risk of POAG development. Furthermore, chronic and severe migraine is associated with greater risk of POAG development.
Characteristics and clinical outcome in 312 patients with moderate to severe pneumonia due to SARS-COV-2 and hyperinflammation treated with anakinra and corticosteroids: A retrospective cohort study
Authors: Aomar-Millán Ismael Francisco , de Victoria-Carazo Javier Martínez , Fernández Reyes Daniel , Torres-Parejo Úrsula , Pérez Fernández Laura , Martínez-Diz Silvia , Ceballos Torres Angel , López Gómez Jairo , Bizzarri Francesco , Raya Álvarez Enrique , Salvatierra Juan 
Published: March 2023

Objective
To assess the clinical outcome (death and/or Intensive Care Unit (ICU) admission) based on the time from hospital admission to the administration of anakinra and the possible usefulness of a “simplified” SCOPE score to stratify the risk of worse prognosis in our cohort of patients with moderate/severe SARS-CoV-2 pneumonia, both vaccinated and unvaccinated, that received anakinra and corticosteroids. In addition, the clinical, analytical, and imaging characteristics of patients at admission are described.

Methods
Retrospective cohort study of 312 patients admitted to Hospital Clínico San Cecilio in Granada for moderate/severe pneumonia caused by SARS-CoV-2 that received anakinra and corticosteroids between March 2020 and January 2022. Clinical and analytical data were collected as well as the patient outcome at 30 and 60 days after admission. Three treatment groups were established according to the time from hospital admission to administration of anakinra: early (1st–2nd day), intermediate (3rd–5th day), and late (after the 5th day).

Results
The median age was 67.4 years (IQR 22–97 years) and 204 (65.4%) were male. The most common comorbidity was hypertension (58%). The median time from the start of symptoms to anakinra administration was 6 days (IQR 5–10) and the SaFi (SaO2/FiO2) was 228 (IQR 71–471). The cure rate was higher in the early-onset anakinra group versus the late-onset group (73% vs 56.6%). The latter had a higher percentage of deaths (27.4%) and a greater number of patients remained hospitalized for a month (16%). On admission, the patients had elevated C-reactive protein (CRP), ferritin, and D-dimer values and decreased total lymphocytes. Analytical improvement was observed at both 72 hours and one month after treatment. 42 (13.5%) required ICU admission, and 23 (7.3%) orotracheal intubation. At 60 days, 221 (70.8%) were discharged, 87 (27.8%) had died and 4 (1.4%) remained hospitalized. The mean dose of anakinra was 1000 mg (100–2600 mg) with differences found between the dose administered and the clinical outcome. There were no differences in the primary outcome based on vaccination.
A simplified SCOPE score at the start of anakinra administration was lower in patients with better clinical evolution.

Conclusions
Early treatment with anakinra and corticosteroids was associated with a better outcome regardless of vaccination status. A simplified SCOPE was found to be a good prognostic tool.
Neuroimaging findings and neurological manifestations in hospitalized COVID-19 patients: Impact of cancer and ventilatory support status
Authors: McCarthy Lily , Khegai Oleksandr , Goldstein Jonathan , Belani Puneet , Pawha Puneet , Kihira Shingo , Mathew Brian , Gururangan Kapil , Hao Qing , Singh Anuradha , Navis Allison , Delman Bradley N. , Jette Nathalie , Balchandani Priti 
Published: March 2023

Introduction
Coronavirus 2019 (COVID-19) is known to affect the central nervous system. Neurologic morbidity associated with COVID-19 is commonly attributed to sequelae of some combination of thrombotic and inflammatory processes. The aim of this retrospective observational study was to evaluate neuroimaging findings in hospitalized COVID-19 patients with neurological manifestations in cancer versus non-cancer patients, and in patients with versus without ventilatory support (with ventilatory support defined as including patients with intubation and noninvasive ventilation). Cancer patients are frequently in an immunocompromised or prothrombotic state with side effects from chemotherapy and radiation that may cause neurological issues and increase vulnerability to systemic illness. We wanted to determine whether neurological and/or neuroimaging findings differed between patients with and without cancer.

Methods
Eighty adults (44 male, 36 female, 64.5 ±14 years) hospitalized in the Mount Sinai Health System in New York City between March 2020 and April 2021 with reverse-transcriptase polymerase chain reaction-confirmed COVID-19 underwent magnetic resonance imaging (MRI) during their admissions. The cohort consisted of four equal subgroups based on cancer and ventilatory support status. Clinical and imaging data were acquired and analyzed.

Results
Neuroimaging findings included non-ischemic parenchymal T2/FLAIR signal hyperintensities (36.3%), acute/subacute infarcts (26.3%), chronic infarcts (25.0%), microhemorrhages (23.8%), chronic macrohemorrhages (10.0%), acute macrohemorrhages (7.5%), and encephalitis-like findings (7.5%). There were no significant differences in neuroimaging findings between cancer and non-cancer subgroups. Clinical neurological manifestations varied. The most common was encephalopathy (77.5%), followed by impaired responsiveness/coma (38.8%) and stroke (26.3%). There were significant differences between patients with versus without ventilatory support. Encephalopathy and impaired responsiveness/coma were more prevalent in patients with ventilatory support (p = 0.02). Focal weakness was more frequently seen in patients without ventilatory support (p = 0.01).

Discussion
This study suggests COVID-19 is associated with neurological manifestations that may be visible with brain imaging techniques such as MRI. In our COVID-19 cohort, there was no association between cancer status and neuroimaging findings. Future studies might include more prospectively enrolled systematically characterized patients, allowing for more rigorous statistical analysis.
The relationship between health literacy and internet addiction among middle school students in Chongqing, China: A cross-sectional survey study
Authors: Liu Yang , Wu Nannan , Yan Jie , Yu Junjie , Liao Liping , Wang Hong 
Published: March 2023

BackgroundInternet addiction has emerged as a major global concern as a potential adverse impact of internet exposure on adolescents. Internet addiction is associated with many demographic variables; however, there is a lack of consensus on its relationship with health literacy. Therefore, the aim of the present study was to assess the rates of internet addiction and health literacy level among middle school students (grades 7 to 12) in Chongqing, China, as well as to investigate the association between them.MethodsA cross-sectional, questionnaire-based study was conducted among 8971 students who were randomly selected by using stratified cluster sampling between November and December 2019. The Internet Addiction Diagnostic Questionnaire, Adolescent Health Literacy Scale and a self-designed basic information questionnaire were used to collect data. Chi-square tests were performed to compare the differences in the distribution of internet addiction across health literacy levels as well as some sociodemographic characteristics. Multivariate logistic regression analyses were conducted to identify the association between health literacy and internet addiction.ResultsThe prevalence of internet addiction among middle school students in Chongqing was 6.1%. The percentage of the students who spent more than 4 hours online every day in the past week was 14.3%. In addition, 26.7%, 26.0%, 28.3% and 26.3% of the participants reported low functional, interactive, critical and total health literacy, respectively. After adjusting for the confounding effects of demographics, multivariate regression analysis showed that critical health literacy was a protective variable for internet addiction, while functional, and interactive health literacy were the risk variable (P<0.05). Furthermore, the internet addiction rates were higher among boys, students with good peer relationships, and students without parental supervision, whereas internet addiction rates were lowest among students in grade 12.ConclusionsThe prevalence of internet addiction among middle school students in Chongqing is relatively high. Internet addiction is strongly negatively associated with critical health literacy, but it is positively associated with functional and interactive health literacy but not total health literacy. This study provides preliminary evidence for the predictive role of health literacy in internet addiction of adolescents.
Netflix and Streaming Video: The Business of Subscriber-Funded Video on Demand, Amanda D. Lotz (2022)
Authors: Lynch Andrew 
Published: March 2023

Review of: Netflix and Streaming Video: The Business of Subscriber-Funded Video on Demand, Amanda D. Lotz (2022)
Cambridge: Polity, 176 pp.,
ISBN 978-1-50955-294-8, p/bk, AUD 32.95
Jubilación, una mirada amable en El médico de Budapest (2020)
Authors: Moreta-Velayos Francisco Ignacio , Moreta-Montero Carolina , Montero-Sánchez Nieves , Sánchez-de-la-Mano Flori , Ramírez-Oribe Carmen , Sica-Sica Manuela Alina 
Published: March 2023

Contrariamente al significado etimológico de la palabra, la jubilación no siempre representa un periodo de alegría. Hasta una tercera parte de los trabajadores encuentran dificultades para adaptarse a esta nueva situación. La profesión y los antecedentes laborales, el grado de identificación y satisfacción con las tareas desarrolladas, así como una adecuada anticipación y expectativas de futuro condicionarán el éxito en el tránsito a la nueva situación, así como el pleno disfrute de la nueva etapa.
El relato que de la jubilación hacemos parte, por supuesto, de nuestro punto de vista como trabajadores de la sanidad con las peculiaridades que ello pueda representar.
Make-in-India: Moving from a Monocentric to a Polycentric Response to the COVID-19 Crisis!
Authors: Bose Feler 
Published: March 2023

AbstractThe paper will look at the initial and subsequent Indian government’s response to the COVID-19 focusing event. The strategy used to tackle the initial Covid-19 wave in India was copied from resource-rich countries and authoritarian countries and due to centralization bias in India’s institutions, a monocentric response to the crisis was the default instead of cooperative solutions. However, the response to the pandemic should have been by multiple decision centers and based on local and institutional knowledge, considering India’s institutions, culture, and state capacity, for a “Make-in-India” polycentric response. Solving large-scale health externalities requires coproduction to deal with nested externalities more effectively instead of monocentric global responses. I propose policy considering previous epidemic responses focusing on polycentric governance where civil society is incentivized.