bluuebunny/crossref_metadata_2025_split huggingface dataset:
109 Near-fatal suicide attempts among Canadian Youth: A CPSP Study
Authors: Mitchell Rachel , Ani Cornelius , Irvine James , Cyr Claude , Joffe Ari , Skinner Robin , Stang Antonia , Wong Sam , Yao Xiaoquan , Korczak Daphne J 
Published: August 2020

Abstract

Background
Suicide is the second leading cause of death among Canadian adolescents. Youth who make near fatal suicide attempts, such as those requiring intensive care unit (ICU) level care, are the closest proxy to those that die by suicide; however, there is limited data on this group.

Objectives
To evaluate the minimum incidence rate and patterns of presentation of youth (under 18 years of age) admitted to the ICU for medically serious self-inflicted injury.

Design/Methods
From January 2017 to December 2018, over 2,700 paediatricians/subspecialist members of the Canadian Paediatric Surveillance Program were electronically surveyed on a monthly basis regarding cases of medically serious self-harm. Participants completed a detailed questionnaire about the reported case and descriptive statistics were used for analyses.

Results
Ninety-four cases (71 female; mean age 15.2 years) of confirmed (n=87) and suspected/probable (n=7) medically serious self-harm were reported. The majority (87%) of cases were reported from 4 out of 13 provinces and territories in Canada (Alberta, British Columbia, Ontario, Quebec). There were 11 deaths by suicide (M&gt;F; p&lt;.05). Medication ingestion was the most common method of self-harm among females (76% F vs. 52% M; p=.03) compared with hanging among males (14% F vs. 39% M; p=.009). More females than males had a prior suicide attempt (62% F vs. 32% M; p=.07) and a history of non-suicidal self-injury (NSSI) (65% F vs. 14% M; p&lt;.05), although only history of NSSI reached significance. More females than males had a past psychiatric diagnosis (77% F vs. 55% M; p=.05), and past use of mental health services (69% F vs. 30% M; p&lt;.001), although only service use reached significance. Half of the youth left evidence of intent (54%) and 33% of parents of included youth were aware that their child was considering suicide. Family conflict was the most common precipitating factor for suicide attempt in both females and males (46%).

Conclusion
These Canadian findings are consistent with international epidemiologic data that observe a gender paradox of higher rates of suicide attempts in females and greater mental health care engagement but increased suicide mortality in males with decreased involvement with mental health care. This study suggests that family conflict is a potential target for suicide prevention interventions among youth. Future research focusing on gender-specificity in risk factor identification and effectiveness of primary prevention interventions among youth is warranted.
113 Patient navigation for improving outcomes in child and youth development and mental health: A prospective cohort study comparing patients who did and did not receive navigator services after program referral
Authors: Santarossa Alanna , Steckle Valerie , Yaseen Wid , Vojvoda Dorjana , Sgro Michael , Barozzino Tony , Suleman Shazeen 
Published: August 2020

Abstract

Background
Mental health and developmental conditions are common among Canadian children and youth and require multiple supports in both clinical and community settings. However, many families may find it difficult to access all of the appropriate services available to them. Thus, pediatric patient navigator programs have been developed to help families connect to resources that will support their child’s diagnosis. However, little is known about what barriers may prevent families from actually connecting with the patient navigator following an appropriate referral.

Objectives
The purpose of this study was to evaluate a Canadian Pediatric Patient Navigation Program (PPNP) for children with a formal or provisional mental health or developmental diagnosis. The primary objective was to determine which physician-identified barriers may prevent families from connecting with the pediatric patient navigator (PPN) once an appropriate referral has been made. Of those who did not connect, we were interested in families who booked but did not attend their appointment (i.e., no-show) and families who were unable to be contacted by administrative staff to schedule an appointment despite contact attempts (i.e., no-contact).

Design/Methods
This prospective cohort study included patients referred to a Canadian PPNP between October 1st 2017 and October 31st 2018. Data was collected via standardized PPNP referral forms. Statistical analyses were conducted using chi-square tests of independence.

Results
Of those who met the inclusion criteria (n=524), 78% connected with the PPN and 22% did not connect with the PPN. Of those who did not connect, 41% were classified as no-show and 40% were classified as no-contact. There were no significant differences between groups in terms of sex, diagnosis and time since diagnosis. Those who connected with the PPN were significantly more likely to have a settlement barrier identified compared to those who did not connect (29% vs. 18%, p&lt;.05). Those who no-showed were significantly more likely to have parental mental health identified as a barrier compared to those who connected (15% vs. 5%, p&lt;.05). Finally, families were significantly more likely to have a language/literacy barrier identified if there was no-contact compared to if they no-showed (35% vs. 15%, p&lt;.05).

Conclusion
Parental mental health issues may prevent families from showing up to booked appointments, highlighting the importance of ensuring concurrent parental mental health support. Additionally, language/literacy barriers are a key factor contributing to the inability of administrative staff to contact families, highlighting the need for interpreter services to aid in booking appointments.
115 An Evidence-Based Model of Care for Newcomer Children with Special Health Care Needs
Authors: Rizwan Ayesha , Suleman Shazeen 
Published: August 2020

Abstract

Background
In 2018, Canada resettled the most refugees in the world, in response to the greatest migration crisis in global history. The refugee and resettlement experience at critical stages of children’s development places children at risk for a number of chronic illnesses. Newcomer children with chronic illnesses or special health care needs (NCSHCN) require services and care providers across many systems, but face greater barriers to healthcare access and are at an increased risk of unmet needs, yet no research has been done to identify best practices for this vulnerable population.

Objectives
To develop an evidence-based model for high-quality, patient-centered care for NCSHCN and identify areas of need in a large Canadian city with a high density of newcomers.

Design/Methods
Using formative research design, a literature review and thematic analysis was performed to develop a conceptual model of care for NCSHCN. Next, a local environmental scan was conducted to identify and evaluate current clinics serving newcomers in a large urban Canadian city. Variables collected included the constructs identified in the conceptual model, and information about population served, providers and services offered including access to paediatrics.

Results
326 studies were identified, of which 43 studies underwent full-text review and 21 were included in the final synthesis. Six key components were identified to best support NCSHCN: access to interpreters and appropriately translated resources; delivery of culturally competent care; access to care coordination and system navigation; longer appointment times; family-centered care through medical homes and home-based services; and an enhanced knowledge and understanding of health insurance processes. The environmental scan identified 50 clinics and programs serving newcomers, with 88% providing referrals to paediatric services but only 12% with a paediatrician on-site. Eighty-eight percent offered some form of interpreter services and while 71% offered patient navigation/care coordination services, only one program was specific to navigating child health services and programs.

Conclusion
We propose a data-driven model of care for NCSHCN that can reduce the intersecting disparities these families face by promoting equitable access to health and community services, thereby improving child outcomes and quality of life. While many programs for newcomers exist, access to paediatric services remains elusive and training in cultural competency and insurance processes is variable. More programs that integrate paediatric services into the community to make quality care more accessible and family-centered are required.
Dissipative dynamical Casimir effect in terms of complex spectral analysis in the symplectic Floquet space
Authors: Tanaka Satoshi , Kanki Kazuki 
Published: August 2020

AbstractThe dynamical Casimir effect of the optomechanical cavity interacting with a one-dimensional photonic crystal is theoretically investigated in terms of complex spectral analysis of the Floquet–Liouvillian in the symplectic Floquet space. The quantum vacuum fluctuation of the intra-cavity mode is parametrically amplified by a periodic motion of the mirror boundary, and the amplified photons are spontaneously emitted to the photonic band. We have derived the non-Hermitian effective Floquet–Liouvillian from the total system Liouvillian using the Brillouin–Wigner–Feshbach projection method in the symplectic Floquet space. The microscopic dissipation process of the photon emission from the cavity has been taken into account by the energy-dependent self-energy. We have obtained the discrete eigenmodes of the total system by nonperturbatively solving the nonlinear complex eigenvalue problem of the effective Floquet–Liouvillian, where the eigenmodes are represented by the multimode Bogoliubov transformation. Based on the microscopic dynamics, the nonequilibrium stationary eigenmodes are identified as the eigenmodes with vanishing values of their imaginary parts due to the balance between the parametric amplification and dissipation effects. We have found that the nonlocal stationary eigenmode appears when the mixing between the cavity mode and the photonic band is caused by indirect virtual transition, where the external field frequency causing the dynamical Casimir effect can be largely reduced by using the finite-bandwidth photonic band.
DOSIMETRY WITH THE ABILITY TO DISTINGUISH PULSED AND NON-PULSED DOSE CONTRIBUTIONS
Authors: Makarevich Krystsina , Beyer Roland , Henniger Jürgen , Ma Yuzhen , Polter Sarah , Sommer Marian , Teichmann Tobias , Weinberger David , Kormoll Thomas 
Published: August 2020

Abstract
The concept of an active dosimetry system for pulsed radiation dose rate measurements is presented. Real-time distinction of pulsed and non-pulsed radiation contributions is based on the time structure of a single interaction. A fast tissue equivalent plastic scintillator is exploited to minimize the pile-up effect influence on absorbed energy measurements. Being connected to a fully digital signal processing board, the detector creates an active dosimetry system with adjustable parameters. With this system, absorbed dose rate measurements were carried out in a photon field with a time structure mimicking a radiotherapeutic beam, but also in the presence of a constant radiation field. Measurements show a linear dependence of a pulsed radiation contribution on the accelerator current in the investigated range of the total dose rate up to 8 μGy h−1. While increasing the accelerator current by 1 μA, the pulsed radiation dose rate grows by (26.2 ± 0.9) nGy h−1 when considering pile-up events.
Inter-State Competition and Transnational Capitalists across the North-South Divide: Different Strategies, New Configurations of Power
Authors: Quark Amy , Hopewell Kristen , Alsbergas Elias 
Published: August 2020

Abstract
Existing research emphasizes the rise of new coalitions of states from the global South, such as the BRICS, on one hand, and the rise of a transnational capitalist class on the other. Yet only a small body of work has considered how transnational capitalists shape, and are shaped by, inter-state competition. Research neglects explicitly comparative inquiries: do transnational capitalists in the global North and the global South interact with inter-state competition differently? This article analyzes two cases in which transnational firms in the global North and South attempted to shape state institutions at domestic and international levels to strengthen trade liberalization. We argue that, while firms in the global North and South increasingly share preferences for trade liberalization, the way in which these firms pursue that goal is shaped by their historical relationship to the institutions of U.S.-led hegemony. Transnational firms in the global South seek to foment inter-state competition in order to decenter U.S. leadership, while their counterparts in the North seek to minimize and accommodate inter-state competition to preserve U.S. leadership and their own private authority. Both the North and the South are contributing to the geographical re-centering of institutional power in the world economy.
Red fox viromes in urban and rural landscapes
Authors: Campbell Sarah J , Ashley Wilbur , Gil-Fernandez Margarita , Newsome Thomas M , Di Giallonardo Francesca , Ortiz-Baez Ayda Susana , Mahar Jackie E , Towerton Alison L , Gillings Michael , Holmes Edward C , Carthey Alexandra J R , Geoghegan Jemma L 
Published: August 2020

AbstractThe Red fox (Vulpes vulpes) has established large populations in Australia’s urban and rural areas since its introduction following European settlement. The cryptic and highly adaptable nature of foxes allows them to invade cities and live among humans whilst remaining largely unnoticed. Urban living and access to anthropogenic food resources also influence fox ecology. Urban foxes grow larger, live at higher densities, and are more social than their rural counterparts. These ecological changes in urban red foxes are likely to impact the pathogens that they harbour, and foxes could pose a disease risk to humans and other species that share these urban spaces. To investigate this possibility, we used a meta-transcriptomic approach to characterise the virome of urban and rural foxes across the Greater Sydney region in Australia. Urban and rural foxes differed significantly in virome composition, with rural foxes harbouring a greater abundance of viruses compared to their urban counterparts. We identified ten potentially novel vertebrate-associated viruses in both urban and rural foxes, some of which are related to viruses associated with disease in domestic species and humans. These included members of the Astroviridae, Picobirnaviridae, Hepeviridae, and Picornaviridae as well as rabbit haemorrhagic disease virus-2. This study sheds light on the viruses carried by urban and rural foxes and emphasises the need for greater genomic surveillance of foxes and other invasive species at the human–wildlife interface.
A patient with shortness of breath after total hip replacement
Authors: Marshall Jurga 
Published: August 2020

ABSTRACT
Clinical presentation of pulmonary embolism (PE) frequently is nonspecific, making patient evaluation and diagnosis challenging. Clinicians must be alert for signs and symptoms of PE in patients with risk factors and have a low threshold for ordering appropriate imaging and laboratory tests. Initial treatment concentrates on patient oxygenation and stabilization; further management of PE depends on the patient's hemodynamic stability and right ventricular strain. This article focuses on a minimally symptomatic patient with a history of hip fracture and total hip replacement who was found to have a saddle PE.
Understanding the most commonly billed diagnoses in primary care
Authors: Rogers Julia , Allen Jodi 
Published: August 2020

Abstract:
This next installment in the series on the most commonly billed diagnoses in primary care focuses on type 2 diabetes mellitus (T2DM). This article discusses the pathophysiologic processes of T2DM as well as how the clinical manifestations and treatments are linked to the pathogenesis of the disease.
Perspectives on and barriers to research among advanced practice provider and physician hospitalists
Authors: Dugani Sagar B. , Geyer Holly L. , Maniaci Michael J. , Schenzel Holly A. , Burton M. Caroline 
Published: August 2020

Abstract:
Advanced practice providers and physicians at an academic healthcare system comprising more than 15 hospitals across four US states were surveyed to identify barriers to participation in research. Overall, barriers reported by advanced practice providers and physicians were more similar than different, highlighting system-level opportunities to build research skills and accelerate academic productivity.
Analysis of the Incompletely Hoisted Vertebrae in the Anterior Controllable Antedisplacement and Fusion Surgery
Authors: Wang Yingjie , Sun Jingchuan , Zheng Bing , Shi Jiangang , Xu Guanghui , Shi Wentao 
Published: August 2020

Purpose:
Anterior controllable antedisplacement and fusion (ACAF) has been reported to be a safe and effective technique. However, incompletely hoisted vertebrae (IV) were found in the postoperative images. This study aims to analyze the causes and prevention of IV.

Methods:
The ACAF-treated case series subjects were retrospectively reviewed. The vertebrae were separated into the IV group and completely hoisted vertebrae (CV) group according to the gap between the vertebrae and plate. The radiographic data, degree of cervical lordosis, bone mineral density, number of hoisted vertebrae, operative time, blood loss, and Japanese Orthopaedic Association score were compared between the patients with IV and the patients without IV.

Results:
A total of 248 vertebrae were hoisted in the enrolled patients. Intervertebral disc height in the IV group was 3.7±0.4 mm, which is significantly lower than that in the CV group. The anterior or posterior overhanging lip, osteoporosis, and oblique osteotomy troughs and hinges existing after osteotomy were found to be impingements preventing the hoisting of the vertebrae. There were no differences in the age, sex, degree of cervical lordosis, number of hoisted vertebrae, and neurological improvement rate between the groups of patients with and without IV.

Conclusions:
Lower intervertebral space height and impingements preventing hoisting were found to be possible causes of IV in ACAF. Measures to prevent the problem should be carried out.
Radiographic Response of Vessel Involvement and Resectability After Neoadjuvant Chemoradiation in Patients With Locally Advanced Pancreatic Cancer
Authors: Naumann Patrick , Ottensmeier Friederike , Farnia Benjamin , Ben-Josef Edgar , Liermann Jakob , Maier-Hein Klaus H. , Hackert Thilo , Debus Jürgen 
Published: August 2020

Objectives:Survival of patients with locally advanced pancreatic cancer (LAPC) is improved when neoadjuvant chemoradiation enables subsequent surgical resection. Here, the authors assess changes in vessel involvement as a possible indicator of resectability.Methods:Pancreatic gross tumor and all major abdominal vessels were contoured for 49 patients with unresectable LAPC before and after neoadjuvant chemoradiation. Changes were compared by pairedttests. Tumor-vessel relationships were automatically quantified using Medical Imaging Interaction Toolkit and examined for correlation with resectability and outcome.Results:Tumor volumes were significantly reduced by chemoradiation (41 to 33 mL,P<0.0001). Maximum circumferential vessel involvement decreased for most patients and was statistically significant for the superior mesenteric (P<0.003) and splenic veins (P<0.038). Resection was possible in some patients and correlated positively with survival (28 vs. 15 mo,r=0.40), a decrease in CA 19.9 levels (r=0.48), and reduced involvement of most vessels. Nevertheless, surgical resection with a successful detachment of tumor tissue from major vessels was also achieved in some patients who did not show improvement in radiographic vessel involvement, but rather a reduction in tumor volume and CA 19.9 levels.Conclusions:The present analysis demonstrates that neoadjuvant chemoradiation can enable subsequent surgical resection in patients with LAPC. Complete resection substantially prolongs survival. Therefore, surgical exploration should be offered if vessel involvement is improved by chemoradiation and considered in radiographic unchanged vessel involvement if size and CA 19.9 levels decrease, as these factors may indicate resectable disease, too.
A 4-Year Retrospective Analysis of Patients Presenting at the Emergency Department With Synthetic Cannabinoid Intoxication in Turkey
Authors: Altintop Ismail 
Published: August 2020

Abstract

Purpose/Background
The number of patients with acute synthetic cannabinoid intoxication (SCI) has increased in recent years although the prohibition of its legal sale and use in Turkey despite other countries allowing to some extent sale and use. The reported clinical findings of acute SCI are similar to the symptoms of several diseases. The first case of acute SCI seen in our hospital was in 2014. The aim of this study was to share the data of synthetic cannabinoid use in a research hospital in Turkey and to contribute the epidemiologic data globally betwen 2014 and 2017.

Methods/Procedures
A retrospective evaluation was made of patients who presented at emergency department (ED) because of SCI between January 2014 and December 2017. The initial diagnosis of the patients was done either via their self-report or clinician's clinical observation (family history with hallucination, lethargy, convulsions, dizziness, etc.). Totally, 352 patients were included to the study whose cannabioid use was proven with their urine drug analysis.

Findings/Results
Men were predominantly high (93.8%). Nearly all patients (93.5%) were followed up and discharged in 24 hours. Among them, 21 (5.9%) patients were admitted for hospitalization, and mortality was seen in 2 (0.6%). The mean number of previous presentations at ED with a similar diagnosis was 8.6 ± 10.31.

Implications/Conclusions
Great care must be taken in respect of complications related to SCI, which can even result in death. Patients have a tendency to not disclose the substance they have taken because it is illegal. Patients presenting at ED with recurrent symptoms must be referred to relevant legal authorities. For patients presenting with different clinical effects, SCI must be considered.