Daily Access Research Articles

Evaluation of Oral Health Habits and Gingival Conditions after Covid-19 Lockdown

Background: The COVID-19 pandemic has had a profound impact on various aspects of health and healthcare practices, including oral health. With changes in daily routines and access to dental care services during lockdowns, there has been concern about the potential decline in oral hygiene and an increase in dental issues. Objective: This study aimed to evaluate oral health habits and the gingival condition of patients visiting a tertiary care dental hospital in the southern region of Sindh province after the COVID-19 lockdown. Methods: A cross-sectional study was conducted at Bibi Aseefa Dental College, Larkana, from January 20, 2021, to July 20, 2021. Ethical approval was obtained, and participants gave written informed consent. A total of 278 patients were sampled using a convenience sampling method. The inclusion criteria were patients of both genders, above the age of 7, with permanent teeth. Exclusion criteria included lack of consent and cases with jaw fractures or limited mouth opening. Data collection involved clinical examinations using a dental mirror and probe, and oral health practices were recorded. Statistical analysis was performed using SPSS version 21. Results: The study comprised 57.2% male and 42.8% female participants, with a mean age of 30.67 ± 10.31 years. An 81% adherence to daily tooth brushing was noted, while only 9% of participants used dental floss. The use of medicated toothpaste was reported by 18% of the participants. The prevalence of gingivitis was found to be 48%, with a significant relationship between gender and gingivitis severity (p=0.009). Conclusion: Oral hygiene practices during the lockdown were found to be inadequate, with a substantial prevalence of gingivitis among the study population. The study emphasizes the need for improved oral hygiene practices, including regular brushing and flossing, and suggests public health initiatives to promote oral health awareness.

Yabancı Dil Öğretimi Sınıflarında Derlem Kullanımı Eğitimi: Öğretmen Adaylarının Algıları

This study investigated the perceptions of 108 Turkish pre-service EFL teachers (PSTs) at a state university in Turkey regarding integrating corpora into language classrooms after the two-week training conducted. Despite the growing interest in using corpora in EFL contexts, very little research has addressed pre-service EFL teachers' perceptions of corpus use. Following a qualitative research design, multiple data collection tools, such as a background survey, pre- and post-training semi-structured interviews, and reflective logs, were utilized. The findings revealed that the PSTs found corpus use beneficial for teaching vocabulary and grammar and preparing authentic teaching materials despite a few drawbacks, such as providing limited daily access and having too much data to analyze. Their remarks revealed that the PSTs would consult corpora in their future teaching experiences. These findings would be useful for teacher educators and teachers who favor using corpora to enrich language learning experiences.

78 Remotely monitored in-home IADLs can discriminate between normal cognition and mild cognitive impairment

Objective:Approximately 6.5 million Americans ages 65 and older have Alzheimer’s disease and related dementias, a prevalence projected to triple by 2060. While subtle impairment in cognition and instrumental activities of daily living (IADLs) arises in the mild cognitive impairment (MCI) phase, early detection of these insidious changes is difficult to capture given limitations. Traditional IADL assessments administered infrequently are less sensitive to early MCI and not conducive to tracking subtle changes that precede significant declines. Continuous passive monitoring of IADLs using sensors and software in home environments is a promising alternative. The purpose of this study was to determine which remotely monitored IADLs best distinguish between MCI and normal cognition.Participants and Methods:Participants were 65 years or older, independently community-dwelling, and had at least one daily medication and home internet access. Clinical assessments were performed at baseline. Electronic pillboxes (MedTracker) and computer software (Worktime) measured daily medication and computer habits using the Oregon Center for Aging and Technology (ORCATECH) platform. The Survey for Memory, Attention, and Reaction Time (SMART; Trail A, Trail B, and Stroop Tests) is a self-administered digital cognitive assessment that was deployed monthly. IADL data was aggregated for each participant at baseline (first 90 days) in each domain and various features developed for each. The receiver operating characteristic area under the curve (ROC-AUC) was calculated for each feature.Results:Traditional IADL Questionnaires.At baseline, 103 participants (normal n = 59, Mage = 73.6±5.5; MCI n = 44, Mage = 76.0±6.1) completed three functional questionnaires (Functional Activities Questionnaire; Measurement of Everyday Cognition (ECog), both self-report and informant). The Informant ECog demonstrated the highest AUC (72% AUC, p = <.001).Remotely monitored in-home IADLs and self-administered brief online cognitive test performance.Eighty-four had medication data (normal n = 48, Mage = 73.2±5.4; MCI n = 36, Mage = 75.6±6.9). Four features related to pillbox-use frequency (73% AUC) and four features related to pillbox-use time (62% AUC) were developed. The discrepancy between self-reported frequency of use versus actual use was the most discriminating (67% AUC, p = .03).Sixty-six had computer data (normal n = 38, Mage = 73.6±6.1; MCI n = 28, Mage = 76.6±6.8). Average usage time showed 64% AUC (p = .048) and usage variability showed 60% AUC (p = .18).One hundred and two completed the SMART (normal n = 59, Mage = 73.6±5.5; MCI n = 43, Mage = 75.9±6.2). Eleven features related to survey completion time demonstrated 80% AUC in discriminating cognition. Eleven features related to the number of clicks during the survey demonstrated 70% AUC. Lastly, seven mouse movement features demonstrated 71% AUC.Conclusions:Pillbox use frequency combined features and self-administered brief online cognitive test combined features (e.g., completion times, mouse cursor movements) have acceptable to excellent ability to discriminate between normal cognition and MCI and are relatively comparable to informant rated IADL questionnaires. General computer usage habits demonstrated lower discriminatory ability. Our approach has applied implications for detecting and tracking older adults’ declining cognition and function in real world contexts.

Varying Built Environment Contexts and Trip Chain Decisions: A Multinomial-Choice Gradient Boosting Decision Trees Analysis

Understanding daily trip chain decisions is important for facilitating sustainable travel behavior and reducing traffic congestion. However, the relationships between varying built environment contexts across activity locations and trip chain choices remain unclear. This study adopts a multinomial-choice gradient boosting decision trees (MC-GBDT) model to compare the relative importance of socioeconomic variables with built environment variables. Additionally, it investigates the nonlinear and threshold effects between residential areas and primary activity areas. In the 2017 Beijing household activity survey, socioeconomic variables account for only about 21% of the relative importance in predicting the trip chain choices, whereas built environment variables constitute 78%, including 46% attribute to the primary activity area and 32% to the residential area. Moreover, several built environment variables have distinctive nonlinear and threshold effects, including local access to daily facilities, road density, and transit accessibility measures. Street design features and access to public transit have greater impacts on trip chain decisions in both residential and primary activity areas. These findings echo the uncertain geographic context problem (UGCoP) and imply that traditional built environment-trip chain research might underestimate the impact of built environment contexts at primary activity locations.

Trends in U.S. self-reported health and self-care behaviors during the COVID-19 pandemic.

The COVID-19 pandemic represents a unique stressor in Americans' daily lives and access to health services. However, it remains unclear how the pandemic impacted perceived health status and engagement in health-related behaviors. To assess changes in self-reported health outcomes during the COVID-19 pandemic, and to explore trends in health-related behaviors that may underlie the observed health changes. Interrupted time series stratified by age, gender, race/ethnicity, educational attainment, household income, and employment status. United States. All adult respondents to the 2016-2020 Behavioral Risk Factor Surveillance System (N = 2,146,384). Survey completion following the U.S. public health emergency declaration (March-December 2020). January 2019 to February 2020 served as our reference period. Self-reported health outcomes included the number of days per month that respondents spent in poor mental health, physical health, or when poor health prevented their usual activities of daily living. Self-reported health behaviors included the number of hours slept per day, number of days in the past month where alcohol was consumed, participation in any exercise, and current smoking status. The national rate of days spent in poor physical health decreased overall (-1.00 days, 95% CI: -1.10 to -0.90) and for all analyzed subgroups. The rate of poor mental health days or days when poor health prevented usual activities did not change overall but exhibited substantial heterogeneity by subgroup. We also observed overall increases in mean sleep hours per day (+0.09, 95% CI 0.05 to 0.13), the percentage of adults who report any exercise activity (+3.28%, 95% CI 2.48 to 4.09), increased alcohol consumption days (0.27, 95% CI 0.18 to 0.37), and decreased smoking prevalence (-1.11%, 95% CI -1.39 to -0.83). The COVID-19 pandemic had deleterious but heterogeneous effects on mental health, days when poor health prevented usual activities, and alcohol consumption. In contrast, the pandemic's onset was associated with improvements in physical health, mean hours of sleep per day, exercise participation, and smoking status. These findings highlight the need for targeted outreach and interventions to improve mental health in individuals who may be disproportionately affected by the pandemic.

248 Influence of self-efficacy on older adults’ perspectives and engagement with technology

Abstract Background Self-efficacy has been demonstrated to influence individuals’ perspectives and preferences in relation to technology use, and informs disparities observed among older adults in terms of their access and use of information communication technology. However, research exploring the effects of technological self-efficacy on the consequent virtual engagement among older adults is scarce. The relationship between self-efficacy and varying levels of technology use and proficiency needs to be considered. These factors not only shape older adults’ perspectives on technology use but also impact their adaptation and engagement in critical areas of daily life: including information access, advocacy, and social participation. This paper investigates the relationship between the adoption of and attitudes towards technology among older people, the role of self-efficacy in informing these attitudes, and the level of use or perceived usefulness of technology. Methods The study draws on in-depth interviews with older adult members (n = 40) and stakeholders (n = 30) of a nationally representative membership-based grassroots older adult organisation in Ireland. The semi-structured interviews explored individuals’ experiences of technology use, focusing on daily routines, social connectedness, information access, and civic participation. Results Findings reveal that narratives about daily routines involving technology are influenced by perceptions of self-efficacy in relation to technology in general. However, this self-efficacy is also influenced by other factors that influenced interaction with technology in the daily lives of older people. Dependence on social support can paradoxically impair self-efficacy when such support is withdrawn. An ideology of individual responsibility sometimes led participants to view themselves as the problem when struggling with digital engagement, contributing to a lack of confidence and motivation. Conclusion While technology development for older people is progressing, there is less consideration of the correlation between technology adoption rates and self-efficacy. This paper proposes interventions to empower individuals, enrich virtual engagement, and reduce technological inequalities. Understanding these dynamics could help shape inclusive technological engagement practices and policies for older adults.

Experience with dronabinol consumption facilitated a stimulant effect of alcohol and affected alcohol-related changes in frontal cortical endocannabinoid levels in male rats

Combined use of cannabis and alcohol is common in adolescents. However, the extent to which such polydrug exposure affects the brain and behaviors remains under-investigated in preclinical studies. This study tested the hypothesis that combined exposure of Δ-9-tetrahydrocannabinol (THC), the main psychoactive constituent of cannabis, and alcohol will have additive effects on cognitive impairments and altered endocannabinoid levels in the hippocampus and frontal cortex. Male Long Evans rats were provided with daily access to cookies laced with oil or dronabinol, a synthetic THC, during adolescence. Three days after discontinuation of edible THC, the effect of orally administered 3 g/kg alcohol on Barnes maze performance was assessed. The results showed that experience with edible THC facilitated the occurrence of increased moving speed on the maze induced by repeated alcohol administration. However, contrasting to the hypothesis, the combined THC and alcohol exposure did not lead to additive deficits in learning and memory on the Barnes maze. While little effect on endocannabinoid levels was observed in the hippocampus, acute abstinence from alcohol significantly reduced endocannabinoid levels in the frontal cortex. In particular, reduction of N-oleoyl ethanolamine (OEA) and N-stearoyl ethanolamine (SEA) were robust and had an interactive effect with discontinuation from edible THC. These findings add to the scarce literature on THC and alcohol associated changes in endocannabinoid levels and provide insights to future investigations on the roles of OEA and SEA on physiology and behaviors following THC and alcohol co-exposure during adolescence.

Incidence, risk factors, and therapeutic management of equine colic in Lamongan, Indonesia.

Colic is among the common health issues in equine health management. Gastrointestinal (GI) disorders are the most frequent causes of colic, but dysfunction of other organs and systems inside the abdominal cavity may also contribute. Therefore, it is crucial to identify risk factors for colic of specific etiologies. This study aimed to examine the incidence, risk factors, and best therapeutic management practices for horses with colic. A cohort of 256 horses living in Lamongan, East Java, Indonesia, was randomly recruited based on reports of colic symptoms by owners. Diagnosis and treatment were then conducted with the help of owners. Symptom profiles, risk factors, and therapeutic management strategies were analyzed by Chi-square tests. Of 256 horses enrolled, 217 (84%) were diagnosed with colic, of which 172 (79.3%) were cases of spasmodic colic, 33 (15.2%) of impaction colic, and 12 (5.5%) of intestinal obstruction/displacement. Male sex (χ2 = 16.27; p < 0.001), wheat bran feeding (χ2 = 15.49; p < 0.001), concentrate feed intake >5 kg/day (χ2 = 24.95; p < 0.001), no regular anthelmintic drug treatment (χ2 = 67.24; p < 0.001), GI parasite infection (χ2 = 65.11; p < 0.001), recurrent colic (χ2 = 91.09; p < 0.001), poor body condition score (χ2 = 71.81; p < 0.001), limited daily water access (χ2 = 127.92; p < 0.001), and indications of dental disease (χ2 = 9.03; p < 0.001) were identified as risk factors. The most effective therapies were gastric intubation (χ2 = 153.54; p < 0.001), Vitamin B complex injection (χ2 = 32.09; p < 0.001), fluid therapy (χ2 = 42.59; p < 0.001), and non-steroidal anti-inflammatory drug injection (NSAID). Colic is highly prevalent among horses in Lamongan, East Java, Indonesia. Proper diet, workload management, regular access to clean drinking water, and dental care can reduce colic risk. Recommended therapies include NSAID injection without other analgesics or spasmolytics, fluid therapy, Vitamin B complex, and gastric intubation.

An integrated resilience assessment model of urban transportation network: A case study of 40 cities in China

The transportation network is essential in providing daily accessibility and essential service to societies. An acceptable level of service needs to be maintained in critical infrastructures, even in the case of disruptions. We develop an integrated model to assess the resilience of urban transportation networks when exposed to different disruptions. Resilience is evaluated from perspectives of both traffic network topology and traffic flow. This model contains three parts: (1) a traffic flow simulation model to get flow distributed throughout the whole network, (2) different real-world disruptions are abstracted as random, localized, and flood disturbances, (3) functional and topological resilience are accessed by analyzing variations in travel time and connected components before and after a disruption occurs. 40 major cities are chosen to conduct resilience assessments. As the intensity of the disruption increases, common trends in the changes of functional and topological resilience values are observed and analyzed across all studied cities. In most cases, flood disruption is the least disruptive one of all three types of disruptions. Regression models are developed to estimate functional and topological resilience after random, localized, and flood disturbances. Possible resilience enhancement strategies are discussed based on analyses of regression models. This study could aid stakeholders in gaining a clear understanding of resilience not only topologically but also from the perspective of traffic flow and offer them practical strategies to enhance resilience in face of disruptions.

Feasibility study of a mobile application (ACT-ON) to complement acceptance and commitment therapy (ACT) intervention in cancer patients

ObjectivePsychological and physical distress commonly affect cancer patients. Acceptance and commitment therapy (ACT) has shown promising results when it comes to ameliorating symptoms that may develop as a result of this. Meanwhile, it has come to light that the impact of psychological interventions may be enhanced by the use of mobile applications. However, to date no mobile applications have been developed to support ACT-based interventions in cancer patients. The aim of the present study is to develop and test the usability of a mobile application designed to complement face-to-face ACT-based therapy in a group of cancer patients undergoing treatment. Materials and methodsA total of thirty-nine patients were recruited to participate in this pilot study. Participants had to be: 18 years of age or over, currently undergoing treatment for breast, lung or colorectal cancer, in stage I–III, a smartphone user with daily internet access. The intervention sessions were administered for a period of eight weeks, one hour per week to groups of four to six participants. Patients had the ACT-ON mobile application at their disposal, which provided them with access to therapy-related activities: mindfulness, metaphors and exercises to clarify values. ResultsThe application obtained adequate adoption (61.54%) and usage (54.17%) rates. Usability and ease of learning scores were as follows: good usability (M = 79.81, SD = 11.87); high usability (M = 80.53, SD = 14.04); ease of learning (M = 37.5, SD = 23.85). DiscussionThis is the first study to develop and evaluate the usability of an application designed to support ACT-based interventions in cancer patients undergoing treatment. The results show that the ACT-ON app is a feasible tool which achieves high levels of usability. However, said results ought to be confirmed by studies that include a larger number of cancer patients.

On their way to the north: larval performance of Hemigrapsus sanguineus invasive on the European coast—a comparison with the native European population of Carcinus maenas

The Asian shore crab Hemigrapsus sanguineus has become invasive in North Europe and it co-occurs and competes with the native European shore crab Carcinus maenas. Both species develop through a feeding and dispersive larval phase characterised by several zoeal and a settling megalopa stage. Larvae of marine crabs are vulnerable to food limitation and warming has the potential to exacerbate the negative effects of food limitation on survival and growth. We quantified the combined effects of temperature and food limitation on larval performance (survival and growth) of H. sanguineus and we compared our results with those reported on performance of C. maenas larvae, under the same experimental design and methodology. Larvae from four females of H. sanguineus collected on Helgoland (North Sea) were experimentally reared from hatching to megalopa, at four temperatures (range 15–24 °C) and two food conditions (permanent vs. daily limited access to food). Larval survival of H. sanguineus was low at 15 °C and increased with temperature, in contrast to the high survival reported for C. maenas larvae in the range 15–24 °C. Food limitation reduced survival and body mass of H. sanguineus larvae at all temperatures, but without evidence of the exacerbating effect caused by high temperatures and reported for C. maenas. By contrast, high temperature (24 °C) mitigated the negative effect of food limitation on body mass on H. sanguineus larvae. Advantages of H. sanguineus over C. maenas appear especially under the increased temperatures expected from climate change.

Maxillary Full Arch Restorations – Biological Complications: A Narrative Review Outlining Criteria for Long Term Success

Patients receiving full arch implant borne maxillary prostheses require functional, esthetic, and long term success. The importance of this review is to document the difficulty with implant maintenance, the prevalence of peri-implant disease, and the improvement in biologic health when using a prosthesis that can be maintained to minimize plaque. The objective is to provide surgeons with a reference to optimize surgical procedures that can result in improved hygiene and long term maintenance, as well as acceptable functional and esthetic goals. Pubmed.gov was the information source. Years reviewed included 1990-2022. Inclusion criteria included only articles in journals referenced in pubmed.gov. The reports excluded were case reports, reports that only included implant survival, and articles without a statistical analysis to generate meaningful conclusions. Biological complications included bone loss, hygiene difficulty, mucositis and recession, the incidence of peri-implantitis, and how complications related to patient co-morbidities. Data collected included outcomes of the study including statistical significance. The search identified articles for review using terms which included full arch maxillary restorations (n=736), long term success with full arch maxillary prostheses (n=22), ceramic full arch restorations (n=102), and complications with full arch restorations (n=231). From this search, 53 articles were collated that satisfied the inclusion criteria. Factors found to be significant contributors to biological complications included bone loss and peri-implant disease, difficulty with daily hygiene access, plaque and biofilm coverage, and the need for continued maintenance for long term implant health. The surgeon needs to place implants to allow a full arch maxillary prosthesis to be fabricated with full access to the implants for maintenance, which should decrease the incidence of biological complications. With excellent maintenance full arch implant restorations can have limited peri-implant disease.

Untangling the relationships among residential environment, destination choice, and daily walk accessibility

Accessibility to opportunities is strongly correlated with travel behaviors. This research, in particular, centered on individual daily accessibility, which quantifies the total number of opportunities of each type that can be reached within a certain travel time from the destinations an individual visited in a day. Existing studies rarely focused on the interrelationships among people’s socio-demographic characteristics, residential built environment, destination choice, and daily accessibility simultaneously. Using survey data from California, the present study develops a daily accessibility indicator summarizing the individual daily total number of opportunities that is reachable within a given travel time based on individual daily activities. Subsequently, a structural equation model jointly estimates the relationships among these factors showing that people’s social status and the residential built environment influence directly daily accessibility to retail opportunities significantly. The residential built environment has no significant direct impact on daily ocean-view open space accessibility. Both social status and residential built environment have a significant indirect impact on daily accessibility via the mediator number of distinct destinations showing the importance of designing cities with increased destination variety that are better served by non-motorized networks and public transportation.

Metabotropic glutamate group II receptor activation in the ventrolateral dorsal striatum suppresses incentive motivation for cocaine in rats.

After a history of intermittent cocaine intake, rats develop patterns of drug use characteristic of substance use disorder. The dorsal striatum is involved in the increased pursuit of cocaine after intermittent drug self-administration experience. Within the dorsal striatum, chronic cocaine use changes metabotropic glutamate type II receptor (mGlu2/3) density and function. We examined the extent to which activity at Glu2/3receptors mediates responding for cocaine after intermittent cocaine use. Male (n = 11) and female (n = 10) Wistar rats self-administered 0.25mg/kg/infusion cocaine during 10 daily intermittent access (IntA) sessions (5min ON/25min OFF, for 5h/session). We then examined the effects of microinjections of the mGlu2/3 receptor agonist LY379268 (0, 1, and 3µg/hemisphere) into the ventrolateral part of the dorsal striatum on cocaine self-administration under a progressive ratio schedule of reinforcement. Across 10 IntA sessions, the sexes showed similar levels of cocaine intake. In females only, locomotion significantly increased over sessions, suggesting that female rats developed psychomotor sensitization to self-administered cocaine. After 10 IntA sessions, intra-dorsal striatum LY379268 significantly reduced breakpoints achieved for cocaine, active lever presses, and cocaine infusions earned under progressive ratio. LY379268 had no effects on locomotion or inactive lever presses, indicating no motor effects. These results suggest that mGlu2/3 receptor activation in the ventrolateral dorsal striatum suppresses incentive motivation for cocaine, and this holds promise for new treatments to manage substance use disorder.

Intranasal administration of olanzapine has beneficial outcome in a rat activity-based anorexia model

The atypical antipsychotic drug olanzapine is prescribed despite clinical studies on olanzapine treatment showing mixed results on treatment efficacy in anorexia nervosa. We investigated the effect of systemic and intranasal administration of olanzapine in the activity-based anorexia (ABA) model. Rats were habituated to a running wheel and exposed to the ABA model while treated with olanzapine. During ABA rats had 1.5 h of daily access to food and ad libitum access to a running wheel for seven consecutive days. Olanzapine was administered via an osmotic minipump (1, 2.75, and 7.5 mg/kg) or intranasally 2 h before dark onset (1 and 2.75 mg/kg). We monitored body weight, food intake, wheel revolutions, body temperature, and adipose tissue.We found 2.75 and 7.5 mg/kg systemic olanzapine decreased wheel revolutions during ABA. Relative adipose tissue mass was increased in the 7.5 mg/kg olanzapine-treated group while body weight, food intake, and body temperature were unaltered by the systemic olanzapine. 1 and 2.75 mg/kg intranasal olanzapine diminished wheel revolutions and body temperature during the first 2 h after administration. The intranasal olanzapine-treated rats had a higher body weight at the end of ABA.We find that olanzapine has beneficial outcomes in the ABA via two administration routes by acting mainly on running wheel activity. Intranasal olanzapine showed a rapid effect in the first hours after administration in reducing locomotor activity. We recommend further exploring intranasal administration of olanzapine in anorectic patients to assist them in coping with restlessness.

Determinants of the Proper Functioning of School Canteens: Case of the Municipality of Athiémé

Many learners drop out of school because parents find it difficult to provide them with lunch or because of the long distances between their homes and the schools they attend. The objective of this study is to analyze the determinants of the proper functioning of school canteens in the municipality of Athiémé. The collection of data was based on an important work of exploration made of literature review and interviews. The central model used is similar to multi-criteria analysis, but carried out by consulting the actors for the weightings: this is a property of the Delphi method. The data was collected from 341 actors including 121 households, 84 teachers, 74 members of the CGCSI, 47 schoolchildren and 15 administrative staff from school districts and educational regions. The results reveal the existence of a trilogy on which the proper functioning of canteens depends, namely: learners, cooks and dry rations of food. The involvement and strong participation of parents and members of the management committee are essential for the success of school canteens, all of which allow a substantial improvement in the meals offered to learners. The effectiveness of learners' daily subscriptions and accessibility to water are essential for the success of school canteens.

The Association Between Central Line-Associated Bloodstream Infection and Central Line Access.

Identifying modifiable risk factors associated with central line-associated bloodstream infections (CLABSIs) may lead to modifications to central line (CL) management. We hypothesize that the number of CL accesses per day is associated with an increased risk for CLABSI and that a significant fraction of CL access may be substituted with non-CL routes. We conducted a retrospective cohort study of patients with at least one CL device day from January 1, 2015, to December 31, 2019. A multivariate mixed-effects logistic regression model was used to estimate the association between the number of CL accesses in a given CL device day and prevalence of CLABSI within the following 3 days. A 395-bed pediatric academic medical center. Patients with at least one CL device day from January 1, 2015, to December 31, 2019. None. There were 138,411 eligible CL device days across 6,543 patients, with 639 device days within 3 days of a CLABSI (a total of 217 CLABSIs). The number of per-day CL accesses was independently associated with risk of CLABSI in the next 3 days (adjusted odds ratio, 1.007; 95% CI, 1.003-1.012; p = 0.002). Of medications administered through CLs, 88% were candidates for delivery through a peripheral line. On average, these accesses contributed a 6.3% increase in daily risk for CLABSI. The number of daily CL accesses is independently associated with risk of CLABSI in the next 3 days. In the pediatric population examined, most medications delivered through CLs could be safely administered peripherally. Efforts to reduce CL access may be an important strategy to include in contemporary CLABSI-prevention bundles.

An Accessibility Measurement Based on Commuter Behaviour and Living Conditions: An Empirical Analysis of the High-Speed Railway Network in the East of China

High-speed railways as a competitive intercity transport solution in areas of high population density have been constructed rapidly in the last decade. Accessibility measurements have been frequently tested and applied with various definitions, indicators, and processing methods for assessing traffic system utility. In this paper, an improved method of accessibility measurement based on travellers’ profitability is introduced. Three levels of accessibility indicators, Daily Commute Accessibility (DACC), Daily Work Commute Accessibility (DWACC), and Weekly Commute Accessibility (WACC) were designed based on different commuting frequencies and purposes. The average traveller’s income and local living cost were integrated to simulate the real commute scenario and assess the status of the transport system. In the case study, a series of statistics, containing 50 lines of travelling data and 10 years of economic data, was collected from the historical railway service record and local economy yearbook, in an area with 11 cities connected by conventional normal-speed and upgraded HSR networks in the east of China. An index sheet measuring the three levels of accessibility indicated the changes in the travel benefit ratio throughout the test period following popularisation of the high-speed service. To validate the practicability of the new methodology, regression analysis of four groups of panel data, including the accessibility index and local demographic data, was implemented to illustrate the population fluctuation impacted by the HSR services. The results proved that the HSR service is more beneficial in reducing population aggregation than the conventional railway service, which has the opposite effect, leading to the generation of cities with a high population density, and could help to rebalance the local uneven population distribution and promote the progress of urbanisation.

Effects of one hour daily outdoor access on lying and sleeping postures, and immune traits of tethered cows.

We investigated the effects of outdoor access for 1 h per day on the animal welfare (AW) of tethered cows, in terms of lying and sleeping postures, and immune function. A total of five dry cows were tethered all day indoors (tethering) for 30 days and then tethered indoors with 1 h daily outdoor access (ODA-1h) for 30 days. To analyze the effects of ODA-1h, we calculated the total duration and bout frequency per day, and bout duration of lying and sleeping postures during the last five days of each treatment period. We also analyzed the populations of T cells, B cells, and NK cells in peripheral blood mononuclear cells (PBMC) by fluorescence-activated cell sorting and determined the concanavalin A (Con A) -induced proliferation rate of T cells. The mean total time per day of lying during the ODA-1h treatment was significantly shorter than that during the tethering treatment (p<0.001). The Con A-induced proliferation rate of T cells during the ODA-1h treatment was significantly higher than that during the tethering treatment (p = 0.007). The proportion of NK cells in PBMC during the ODA-1h treatment tended to be higher than that during the tethering treatment (p = 0.062). Although ODA-1h may decrease lying time, it increases the available space for tethered cows towards that typically found in grazing and free barn feeding systems. This increased available space promotes the expression of normal behaviors such as walking and social behaviors except lying and may also improve the immune function of tethered dry cows, thereby improving their overall welfare.

Racial/ethnic disparities in opioid overdose prevention: comparison of the naloxone care cascade in White, Latinx, and Black people who use opioids in New York City

BackgroundDrug overdose mortality is rising precipitously among Black people who use drugs. In NYC, the overdose mortality rate is now highest in Black (38.2 per 100,000) followed by the Latinx (33.6 per 100,000) and white (32.7 per 100,000) residents. Improved understanding of access to harm reduction including naloxone across racial/ethnic groups is warranted.MethodsUsing data from an ongoing study of people who use illicit opioids in NYC (N = 575), we quantified racial/ethnic differences in the naloxone care cascade.ResultsWe observed gaps across the cascade overall in the cohort, including in naloxone training (66%), current possession (53%) daily access during using and non-using days (21%), 100% access during opioid use (20%), and complete protection (having naloxone and someone who could administer it present during 100% of opioid use events; 12%). Naloxone coverage was greater in white (training: 79%, possession: 62%, daily access: 33%, access during use: 27%, and complete protection: 13%, respectively) and Latinx (training: 67%, possession: 54%, daily access: 22%, access during use: 24%, and complete protection: 16%, respectively) versus Black (training: 59%, possession: 48%, daily access:13%, access during use: 12%, and complete protection: 8%, respectively) participants. Black participants, versus white participants, had disproportionately low odds of naloxone training (OR 0.40, 95% CI 0.22–0.72). Among participants aged 51 years or older, Black race (versus white, the referent) was strongly associated with lower levels of being trained in naloxone use (OR 0.20, 95% CI 0.07–0.63) and having 100% naloxone access during use (OR 0.34, 95% CI 0.13–0.91). Compared to white women, Black women had 0.27 times the odds of being trained in naloxone use (95% CI 0.10–0.72).ConclusionsThere is insufficient protection by naloxone during opioid use, with disproportionately low access among Black people who use drugs, and a heightened disparity among older Black people and Black women.