bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding Break Needs, Break Experiences and Break Outcomes over the Care-giving Career: A Narrative Approach
Authors: Caulfield Maria , Seddon Diane , Williams Sion , Hedd Jones Catrin 
Published: September 2022

Abstract
UK social care policy recognises the importance of short breaks for sustaining care-giving relationships; however, there is limited understanding of how unpaid carers’ break needs evolve in response to the degenerative course of dementia and how these are supported. Using narrative analysis, the stories of thirteen spousal carers for people living with dementia were used to construct an experiential description of the care-giving career, in which spousal carers evolving break needs, experience of accessing breaks and desired break outcomes were explored. The care-giving career was marked by the continual adaptation and acceptance of acute and gradual changes to the care-giving relationship which influenced breaks needs. Irrespective of when in the care-giving career, the process of deciding upon a meaningful break was relational and emotive, emphasising the relevance of relational support to aid transitions to breaks of mutual value. With the deepening cognitive impairment of the person living with dementia, spousal carers encountered difficulties in achieving breaks due to relational and service factors. The conceptualisation of care-giving as a series of shifting configurations underlines the necessity for ongoing and skilful practitioner engagement to help unpaid carers consider ‘what matters’ to them, and proactively respond to changes in ‘what matters’.
“I totally didn’t need to be there in person”: New York women’s preferences for telehealth consultations for sexual and reproductive healthcare in primary care
Authors: Srinivasulu Silpa , Manze Meredith G , Jones Heidi E 
Published: September 2022

AbstractBackgroundExpanding telehealth in the United States during the COVID-19 pandemic supported patients with needed sexual and reproductive healthcare (SRH) for continuity of care and reproductive autonomy. While telehealth for SRH is feasible and acceptable, studies have not explored patient preferences towards telehealth SRH from primary care settings.ObjectiveWe explore New York women’s preferences for telehealth SRH in primary care.MethodsIn 2021, we conducted 5 focus groups and 8 interviews with New York women of reproductive age who had a consultation with a primary care provider in the last year as part of a larger study on assessing SRH quality in primary care. We queried on experiences with telehealth for SRH and perceptions of measuring SRH quality in primary care telehealth consultations. We employed reflexive thematic analysis.ResultsWe recruited 30 participants. They preferred telehealth for “basic” SRH conversations, such as contraceptive counselling, and desired in-person consultations for “complex” topics, like pregnancy and preconception, especially if nulliparous. Telehealth benefits included convenience, simplicity of some SRH needs, and alleviating power dynamics in patient–provider relationships. Challenges included lack of one-on-one connection, seriousness of pregnancy discussions, privacy, and internet access. Measuring quality of telehealth SRH should include fostering positive and engaging environments.ConclusionParticipants find telehealth SRH in primary care preferable, underscoring the importance of offering and expanding this care. As telehealth SRH expands, providers should strengthen quality by building rapport to facilitate conversations on “serious” topics and their ability to help patients remotely.
Alternative quinolone-resistance pathway caused by simultaneous horizontal gene transfer in Haemophilus influenzae
Authors: Tanaka Emi , Wajima Takeaki , Nakaminami Hidemasa , Uchiya Kei-ichi 
Published: September 2022

Abstract

Background
Quinolone-resistant bacteria are known to emerge via the accumulation of mutations in a stepwise manner. Recent studies reported the emergence of quinolone low-susceptible Haemophilus influenzae ST422 isolates harbouring two relevant mutations, although ST422 isolates harbouring one mutation were never identified.

Objectives
To investigate if GyrA and ParC from quinolone low-susceptible isolates can be transferred horizontally and simultaneously to susceptible isolates.

Methods
Genomic DNA was extracted from an H. influenzae isolate harbouring amino acid substitutions in both gyrA and parC and mixed with clinical isolates. The emergence of resistant isolates was compared, and WGS analysis was performed.

Results
By adding the genomic DNA harbouring both mutated gyrA and parC, resistant bacteria exhibiting recombination at gyrA only or both gyrA and parC loci were obtained on nalidixic acid and pipemidic acid plates, and the frequency was found to increase with the amount of DNA. Recombination events in gyrA only and in both gyrA and parC occurred with at least 1 and 1–100 ng of DNA, respectively. The genome sequence of a representative strain showed recombination events throughout the genome. The MIC of quinolone for the resulting strains was found to be similar to that of the donor. Although the recombination efficacy was different among the various strains, all strains used in this study obtained multiple genes simultaneously.

Conclusions
These findings indicate that H. influenzae can simultaneously obtain more than two mutated genes. This mechanism of horizontal transfer could be an alternative pathway for attaining quinolone resistance.
Systematic review of surveillance systems for AMR in Africa
Authors: Okolie Obiageli Jovita , Igwe Uzoma , Ismail Sanda Umar , Ighodalo Uzairue Leonard , Adukwu Emmanuel C 
Published: September 2022

Abstract

Aims
Surveillance is a useful tool for tracking antimicrobial resistance (AMR) trends, patterns, therapeutic and policy interventions. Proper correlation of surveillance data gives meaningful insight into the underlying epidemiology and facilitates development of rational interventions. This comprehensive review aims to identify, classify and assess gaps in Global Antimicrobial Resistance and Use Surveillance System (GLASS) reporting and national action plan (NAP) implementation in Africa.

Methods
Articles published in English were searched across five electronic databases (PubMed, Scopus, Embase, AJOL and Cochrane) and grey literature. Articles were screened against inclusion/exclusion criteria and data from eligible studies were retrieved and analysed. This systematic review was registered in the International Prospective Register of Systematic Reviews (PROSPERO) on 31 July 2020 under protocol CRD42020192165.

Results
Of the 4304 records found, only 32 met the initial inclusion criteria (4 peer reviews and 28 were grey literature). From these records, 41 surveillance systems were identified (30 national and 11 transnational). After final review of reported outcomes, only 23 national surveillance systems met the inclusion criteria. Indicators recorded from these systems shows lack of external quality assessment (EQA) in some systems and limited reporting of parameters such as infection origin, patient population and pathogen types.

Conclusions
The outcome of the review shows that although AMR surveillance has been implemented in 23 out of the 47 countries in the region, a number of limitations exist in the surveillance methods and reporting protocols that can impair the usefulness, validity and trustworthiness of data generated from these surveillance systems.
Supervised Exercise Therapy for Symptomatic Peripheral Artery Disease
Authors: Ehrman Jonathan K. , Gardner Andrew W. , Salisbury Dereck , Lui Karen , Treat-Jacobson Diane 
Published: September 2022

Purpose:
This review encompasses several practical components of supervised exercise therapy (SET) for patients with claudication including referral, exercise training, and billing issues. Real-life SET session examples are also provided. SET was approved for reimbursement by the Centers for Medicare & Medicaid Services (CMS) in 2017, and there is continual growth of programs offering SET and in participation. The purpose of this review is to provide useful information for the clinical exercise professionals working with these patients.

Review Methods:
The 2016 ACC/AHA Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease (PAD) provided a class I (highest level) recommendation for the use of SET in those with symptomatic PAD. Since there has been much growth in the literature about the utility of SET, the literature was reviewed (PubMed) to provide information for this article. Topics reviewed include the benefits of exercise training, exercise prescription, billing, referral and participation, and best practices.

Summary:
SET should be offered to all patients with symptomatic PAD who are not at risk of acute limb ischemia. For optimal results, SET should be implemented several times per week and in a progressive process to increase exercise intensity as tolerated. For best results, programs should recommend patients supplement SET with home exercise. Considerations for utilizing reimbursed sessions should also be discussed because patients have a maximum of 72 sessions/lifetime. Referral practices need refinement, and participation rates remain extremely low and may be influenced by demographics. Research on best practices and home or hybrid training must continue to address issues related to common enrollment and participation barriers.

Condensed abstract:
Supervised exercise training (SET) for symptomatic peripheral artery disease is a class IA recommendation and reimbursable by most insurances. Improvements in walking performance can be dramatic. However, referral and participation in SET remain very low and thus SET is vastly underutilized.
High co-circulation of influenza and SARS-CoV-2
Authors: Kubale John T , Frutos Aaron M , Balmaseda Angel , Saborio Saira , Ojeda Sergio , Barilla Carlos , Sanchez Nery , Shotwell Abigail , Meyers Alyssa , Lopez Roger , Plazaola Miguel , Kuan Guillermina , Gordon Aubree 
Published: September 2022

AbstractIn the first two years of the COVID-19 pandemic, influenza transmission decreased substantially worldwide meaning that health systems were not faced with simultaneous respiratory epidemics. In 2022, however, substantial influenza transmission returned to Nicaragua where it co-circulated with SARS-CoV-2 causing substantial disease burden.
Plasma phosphorylated tau 181 predicts amyloid status and conversion to dementia stage dependent on renal function
Authors: Lehmann Sylvain , Schraen-Maschke Susanna , Vidal Jean-Sébastien , Delaby Constance , Blanc Frédéric , Paquet Claire , Allinquant Bernadette , Bombois Stéphanie , Gabelle Audrey , Hanon Olivier 
Published: September 2022

AbstractObjectivesPlasma P-tau181 is an increasingly established diagnostic marker for Alzheimer’s disease (AD). Further validation in prospective cohorts is still needed, as well as the study of confounding factors that could influence its blood level.MethodsThis study is ancillary to the prospective multicenter BALTAZAR cohort that enrolled participants with mild cognitive impairment (MCI) who were examined for conversion to dementia for up to three years. Plasma Ptau-181 was measured using the ultrasensitive Quanterix HD-X assay.ResultsAmong 476 MCI participants, 67% were Aβ+ at baseline and 30% developed dementia. Plasma P-tau181 was higher in the Aβ+ population (3.9 [SD 1.4] vs. 2.6 [SD 1.4] pg/mL) and in MCI that converted to dementia (3.8 [SD 1.5] vs. 2.9 [SD 1.4] pg/mL). The addition of plasma P-tau181 to a logistic regression model combining age, sex, APOEε4 status and mini mental state examination (MMSE) improved predictive performance (AUC 0.691 to 0.744 for conversion and 0.786 to 0.849 for Aβ+). The Kaplan–Meier curve of conversion to dementia, according to the tertiles of plasma P-tau181, revealed a significant predictive value (Log rank P<.0001) with a hazard ratio of 3.8 [95%CI=2.5-5.8]. In addition, patients with plasma P-Tau(181) ≤2.32 pg/mL had a conversion rate of less than 20% over a 3-year period. Using a linear regression approach, chronic kidney disease (CKD), creatinine and glomerular filtration rate (eGFR) were independently associated with plasma P-tau181 concentrations.ConclusionsPlasma P-tau181 effectively detects Aβ+ status and conversion to dementia, confirming the value of this blood biomarker for the management of AD. However, renal function significantly modifies its levels and may thus induce diagnostic errors if not taken into account.What is already known on this topicThe clinical use of plasma phosphorylated tau 181 (P-tau181) for Alzheimer’s disease is being considered but further validation and study of confounding factors are still needed.What this study addsIn our large prospective cohort, P-tau181 predicts brain amyloidopathy and conversion to dementia in patients with mild cognitive impairment, but renal function significantly alters plasma levels and thus may induce diagnostic errors if not taken into account.How this study might affect research, practice or policyOur study suggests that measurement of creatinine or estimation of glomerular filtration rate, which are easy and standardizable ways to provide information on renal function, will contribute to optimal interpretation of plasma P-tau181 results in routine clinical practice.
Hospital vulnerability to spread of respiratory infections: close contact data collection and mathematical modelling
Authors: Shirreff George , Huynh Bich-Tram , Duval Audrey , Pereira Lara Cristina , Annane Djillali , Dinh Aurélien , Lambotte Olivier , Bulifon Sophie , Guichardon Magali , Beaune Sebastien , Toubiana Julie , Kermorvant-Duchemin Elsa , Chéron Gerard , Cordel Hugues , Argaud Laurent , Douplat Marion , Abraham Paul , Tazarourte Karim , Martin-Gaujard Géraldine , Vanhems Philippe , Hilliquin Delphine , Nguyen Duc , Chelius Guillaume , Fraboulet Antoine ,   EMEA-MESuRS Working Group on Nosocomial SARS-CoV-2 Modelling, Temime Laura , Opatowski Lulla , Guillemot Didier 
Published: September 2022

AbstractThe transmission risk of SARS-CoV-2 within hospitals can exceed that in the general community because of more frequent close proximity interactions. However, epidemic risk across wards is still poorly described. We measured CPIs directly using wearable sensors given to all those present in a clinical ward over a 36-hour period, across 15 wards in three hospitals in spring 2020. Data were collected from 2114 participants. These data were combined with a simple transmission model describing the arrival of a single index case to the ward to estimate the risk of an outbreak. Estimated epidemic risk ranged four-fold, from 0.12 secondary infections per day in an adult emergency to 0.49 per day in general paediatrics. The risk presented by an index case in a patient varied twenty-fold across wards. Using simulation, we assessed the potential impact on outbreak risk of targeting the most connected individuals for prevention. We found that targeting those with the highest cumulative contact hours was most impactful (20% reduction for 5% of the population targeted), and on average resources were better spent targeting patients. This study reveals patterns of interactions between individuals in hospital during a pandemic and opens new routes for research into airborne nosocomial risk.
Dehumanisation and Datafication: Key stressors of Algorithmic Management: A qualitative analysis of Chinese couriers
Authors: Wei Hua , Shi Huiyue , Kou Yilin , Yu Mengke , Li Shugang , O’Toole Thomas , Armitage Christopher J. , Chandola Tarani , Whelan Pauline , Zhang Yanchun , Xu Yan , van Tongeren Martie 
Published: September 2022

AbstractIntroductionTechnology is an important social determinant of health that has so far been poorly understood. Nevertheless, technologies such as algorithms and artificial intelligence are rapidly changing how work is organised and managed globally. Courier work is one of the most affected occupations due to the common use of digital labour platforms. This study will explore how AM shapes Chinese couriers’ work experience and engenders health inequity.MethodWe conducted 15 in-depth interviews with couriers in May-June 2021 in China. Thematic analysis was completed using Nvivo 12.ResultsAM can introduce new work stressors and interact with existing factors to alleviate or intensify work stress. Couriers’ responses to AM and its effects varied as some felt motivated while others frustrated. Key themes emerged from the interviews included ‘App the “boss”’, ‘Unequal exposure to AM and the role of human support’, ‘New work stressors of AM – Dehumanisation and Datafication’, ‘Job stressors intensified by AM’ and ‘Varying individual response to AM’. App ‘the boss’ described how the couriers felt when managed by algorithms. Employed, gig and agency couriers had different exposure to AM and human support of different quality. Dehumanisation characterizes how algorithmic systems fulfil managerial functions in ways that differ from managers qualitatively or quantitatively. Datafication refers to the conversion of real-world information and user behaviour into data and being input in the system to assist automated decision-making. Couriers also reported that the use of digital methods could intensify some work stressors, e.g. time pressure and customer behaviour. Nevertheless, some couriers reported that AM provided new job resources, e.g. flexible hours, job opportunities, pay transparency, and bypassing office politics.ConclusionThis paper identified key work stressors of AM and explored how AM interacts with existing work stressors to shape Chinese couriers’ work experience. Dehumanisation could reduce the quality of support and their sense of relatedness to the workplace. Datafication or extraction of data from workers and lack of transparency led to concerns about potential discrimination, workplace unfairness and power imbalance. Couriers’ responses to AM varied and future research should take such heterogeneity into account.
Dynamics-informed deconvolutional neural networks for super-resolution identification of regime changes in epidemiological time series
Authors: Vilar Jose M. G. , Saiz Leonor 
Published: September 2022

AbstractInferring the timing and amplitude of perturbations in epidemiological systems from their stochastically spread low-resolution outcomes is as relevant as challenging. It is a requirement for current approaches to overcome the need to know the details of the perturbations to proceed with the analyses. However, the general problem of connecting epidemiological curves with the underlying incidence lacks the highly effective methodology present in other inverse problems, such as super-resolution and dehazing from computer vision. Here, we develop an unsupervised physics-informed convolutional neural network approach in reverse to connect death records with incidence that allows the identification of regime changes at single-day resolution. Applied to COVID-19 data with proper regularization and model-selection criteria, the approach can identify the implementation and removal of lockdowns and other nonpharmaceutical interventions with 0.93-day accuracy over the time span of a year.
Improving estimates of waning immunity rates in stochastic SIRS models with a hierarchical framework
Authors: Alahakoon Punya , McCaw James M. , Taylor Peter G. 
Published: September 2022

AbstractAs most disease causing pathogens require transmission from an infectious individual to a susceptible individual, continued persistence of the pathogen within the population requires the replenishment of susceptibles through births, immigration, or waning immunity.Consider the introduction of an unknown infectious disease into a fully susceptible population where it is not known how long immunity is conferred once an individual recovers from infection. If, initially, the prevalence of disease increases (that is, the infection takes off), the number of infectives will usually decrease to a low level after the first major outbreak. During this post-outbreak period, the disease dynamics may be influenced by stochastic effects and there is a non-zero probability that the epidemic will die out. Die out in this period following the first major outbreak is known as an epidemic fade-out. If the disease does not die out, the susceptible population may be replenished by the waning of immunity, and a second wave may start.In this study, we investigate if the rate of waning immunity (and other epidemiological parameters) can be reliably estimated from multiple outbreak data, in which some outbreaks display epidemic fade-out and others do not. We generated synthetic outbreak data from independent simulations of stochasticSIRSmodels in multiple communities. Some outbreaks faded-out and some did not. We conducted Bayesian parameter estimation under two alternative approaches: independently on each outbreak and under a hierarchical framework. When conducting independent estimation, the waning immunity rate was poorly estimated and biased towards zero when an epidemic fade-out was observed. However, under a hierarchical approach, we obtained more accurate and precise posterior estimates for the rate of waning immunity and other epidemiological parameters. The greatest improvement in estimates was obtained for those communities in which epidemic fade-out was observed. Our findings demonstrate the feasibility and value of adopting a Bayesian hierarchical approach for parameter inference for stochastic epidemic models.
Genetic Disruption of System xc- Mediated Glutamate Release from Astrocytes Increases Negative-Outcome Behaviors While Preserving Basic Brain Function in Rat
Authors: Hess Evan M. , Kassel Sara , Simandl Gregory , Raddatz Nicholas J. , Maunze Brian , Hurley Matthew M. , Grzybowski Michael , Klotz Jason , Geurts Aron M. , Liu Qing-song , Choi SuJean , Twining Robert C. , Baker David A. 
Published: September 2022

AbstractThe impact of CNS disorders is exacerbated by the difficulty in developing safe, effective glutamatergic therapeutics. Synaptic glutamate transmission is vital for neural physiology throughout the brain, which contributes to the vast therapeutic potential and safety risk of glutamatergic therapeutics. Here, we created a genetically modified rat (MSxc) to survey the range of brain functions impacted by the loss of glutamate release from astrocytes involving system xc- (Sxc). Eliminating Sxc activity was not lethal and did not alter growth patterns, activity states, novel object recognition or performance of other simple tasks. In contrast, MSxc rats differed from WT in Pavlovian Conditioned Approach and cocaine self-administration/reinstatement paradigms. Both WT and MSxc rats readily learned that a cue predicted food delivery during Pavlovian Conditioned Approach training. However, WT rats were more likely to approach the food tray (i.e., goal tracking) whereas MSxc rats were more likely to approach the food-predicted cue (i.e., sign tracking) even when this behavior was punished. In the self-administration/reinstatement paradigm, MSxc rats had higher levels of cocaine-primed drug seeking in the absence of altered extinction or cocaine self-administration. These data demonstrate that Sxc-mediated glutamate release from astrocytes regulates non-reinforced and negative-outcome behaviors without altering simple learning or other forms of basic brain function.