bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Usability, Acceptability, and Functionality of Smart Oral Multidose Dispensing Systems for Medication Adherence: A Scoping Review
Authors: Faisal Sadaf , Ivo Jessica , Lee Catherine , Carter Caitlin , Patel Tejal 
Published: December 2020

Background: Medication non-adherence is a leading cause of non-optimal disease management, resulting in poor health outcomes, poor quality of life, and increased healthcare costs. Smart oral multidose dispensing systems (SOMDS) are being developed to address non-adherence; however, little is known about their integration into daily use by patients. Methods: Using Arksey and O’Malley’s scoping review framework, relevant literature was searched for in electronic databases (PubMed, EMBASE, International Pharmaceutical Abstracts, and Scopus). Observational and interventional studies reporting the integration and impact on adherence from SOMDS in adults ≥18 years and published after 1960 were included. Results: Thirteen articles including one case study, 8 cohort studies, and 4 randomized trials were eligible. SOMDS included smart blister packaging, automated dispensers, and electronic medication trays. The number of medications dispensed per SOMDS was one (n = 3), >1 (n = 2), placebo (n = 1) and not reported (n = 7). Reported outcomes included impact on medication adherence (n = 3), integration (n = 2) and both parameters (n = 8). Conclusion: Although most studies reported that SOMDS appear usable, there was significant variability in the SOMDS types, patient populations, medication adherence definitions, and measurements; impacting the interpretation of results. Future studies should be designed to address effectiveness of SOMDS on medication adherence in patients with multi-drug therapy and the utilization of real-time adherence data for informing clinical decision making.
Physical Health, Media Use, and Mental Health in Children and Adolescents With ADHD During the COVID-19 Pandemic in Australia
Authors: Sciberras Emma , Patel Pooja , Stokes Mark A. , Coghill David , Middeldorp Christel M. , Bellgrove Mark A. , Becker Stephen P. , Efron Daryl , Stringaris Argyris , Faraone Stephen V. , Bellows Susannah T. , Quach Jon , Banaschewski Tobias , McGillivray Jane , Hutchinson Delyse , Silk Tim J. , Melvin Glenn , Wood Amanda G. , Jackson Anna , Loram George , Engel Lidia , Montgomery Alicia , Westrupp Elizabeth 
Published: December 2020

Objective: To examine the impact of COVID-19 restrictions among children with attention-deficit/hyperactivity disorder (ADHD). Methods: Parents of 213 Australian children (5–17 years) with ADHD completed a survey in May 2020 when COVID-19 restrictions were in place (i.e., requiring citizens to stay at home except for essential reasons). Results: Compared to pre-pandemic, children had less exercise (Odds Ratio (OR) = 0.4; 95% CI 0.3–0.6), less outdoor time (OR = 0.4; 95% 0.3–0.6), and less enjoyment in activities (OR = 6.5; 95% CI 4.0–10.4), while television (OR = 4.0; 95% CI 2.5–6.5), social media (OR = 2.4; 95% CI 1.3–4.5), gaming (OR = 2.0; 95% CI 1.3–3.0), sad/depressed mood (OR = 1.8; 95% CI 1.2–2.8), and loneliness (OR = 3.6; 95% CI 2.3–5.5) were increased. Child stress about COVID-19 restrictions was associated with poorer functioning across most domains. Most parents (64%) reported positive changes for their child including more family time. Conclusions: COVID-19 restrictions were associated with both negative and positive impacts among children with ADHD.
Free vibration analysis of rectangular sandwich plates with compressible core and various boundary conditions
Authors: Farsani Sajjad Riahi , Ramian Arash , Jafari-Talookolaei Ramazan-Ali , Valvo Paolo S , Abedi Maryam 
Published: December 2020

Extended higher-order sandwich plate theory is used to analyze the free vibrations of rectangular sandwich plates with compressible core. Accordingly, first-order shear deformation theory is used to model the laminated face sheets. Besides, the in-plane and transverse displacements of the core are assumed to be cubic and quadratic functions of the thickness coordinate, respectively. To deduce the governing equations, Hamilton’s principle is used. Then, based on the Rayleigh-Ritz method, single series expansions with two-variable orthogonal polynomials – namely, the orthogonal plate functions – are considered to approximate the displacement components. Lastly, a generalized eigenvalue problem is solved to obtain the free vibrational characteristics of sandwich plates with both symmetric and anti-symmetric lay-ups subjected to various boundary conditions. The method is validated against the results obtained by different methods in the literature. Finally, the effects of the plate side-to-thickness ratio, in-plane aspect ratio, and core-to-face sheets thickness ratio on the natural frequencies are discussed.
Premenopausal breast cancer is a health challenge: nutritional habits show potential to prevent this disease
Authors: Silva-Igua Liliana , De La Peña Jairo , Rubiano Wilson , Ruiz-Sternberg Angela María 
Published: December 2020

Background: The incidence of breast cancer had increased around the world. More premenopausal women suffer from this condition with great economic and social impact. The objective of this study is to establish possible associations between lifestyle and the presence of breast cancer in premenopausal women. Methods: The study population was composed of 330 premenopausal patients younger than 55 years with breast disease, cared between 2013 and 2017 at the University Hospital Mayor Méderi. Two comparison groups were formed. Patients with a tumor diagnosed as malignant considering cases and control group of patients with a tumor diagnosed as benign. With factors associated significantly in the bivariate analysis ( P < .10), the hierarchically organized multiple regression model controlled by the confounding variables was constructed. The logistic regression model was adjusted by the age variable, to avoid residual confounder. Results: The population included 330 premenopausal women with benign and malignant breast disease: 134 cases and 196 controls. From the multivariate analysis, it was identified that the whole-grain consumption was inversely associated with presence of breast cancer (odds ratio [OR] = 0.579; 95% confidence interval [CI]: 0.339, 0.991; P = .046). On the other hand, consumption of fish was associated with the presence of breast malignancy (OR  =  2.560; 95% CI: 1.200, 5.460; P  =  .015). Conclusions: Considering the epigenetic and multiomics individual profiles in the development of premenopausal breast cancer and its social and economic impact can be useful in development of modern clinical strategies with crucial interventions at the primary, secondary, and tertiary prevention levels for this disease.
Vacuum assistance therapy as compared to early reconstructive treatment in deep sternal wound infection
Authors: Hämäläinen E. , Laurikka J. , Huhtala H. , Järvinen O. 
Published: December 2020

Background and Aims: Deep sternal wound infection is a major concern after cardiac surgery. This study describes the incidence of postoperative deep sternal wound infections after cardiac surgery and compares two available treatment modalities. Materials and Methods: In Tampere University Hospital, 7973 open heart operations were performed between 2007 and 2016. Patients treated for a postoperative deep sternal wound infection were categorized in two groups based on treatment: revision surgery with early reconstruction (revision group; 74 patients) or vacuum-assisted closure treatment (VAC group; 55 patients). The end points in comparisons were overall mortality and hospitalization time. Results: A total of 129 patients (1.6%) developed a postoperative deep sternal wound infection. The 30-day mortality rates were 8.1% and 3.6%, the 90-day mortality rates were 15.5% and 18.2%, and the 1-year mortality rates were 17.6% and 23.6% for the revision and VAC group, respectively. There was no statistically significant difference in mortality rates. The hospital stay was 18 days in the revision group and 38 days in the VAC group (p < 0.001). The secondary intensive care unit stay was longer in the VAC group (median 1 vs 4, p = 0.011). The most common pathogens isolated in the first reoperation were coagulase-negative staphylococci (33.8% and 41.8%, respectively; p = 0.366), and positive candida findings were more common in the VAC group (4.1% vs 37.0 %, p < 0.001). Conclusion: Vacuum-assisted closure treatment induces an inferior outcome in terms of fungal infections, treatment times, and the number of reoperations.
Treatment of Femoropopliteal Lesions With the BioMimics 3D Vascular Stent System: Two-Year Results From the MIMICS-2 Trial
Authors: Sullivan Timothy M. , Zeller Thomas , Nakamura Masato , Gaines Peter A. ,   on behalf of the MIMICS-2 Trial Investigators
Published: December 2020

Purpose To report the safety and effectiveness outcomes through 2 years of the BioMimics 3D Vascular Stent System in the treatment of symptomatic patients with atherosclerotic femoropopliteal disease. Materials and Methods The tubular, nitinol BioMimics 3D stent, which was designed to impart a helical shape to the arterial segment, was implanted in 271 patients (mean age 68.4±9.5 years; 180 men) with de novo femoropopliteal lesions enrolled at 43 investigational sites [31 US (n=162), 6 German (n=78), and 6 Japanese (n=31)] in the prospective, single-arm MIMICS-2 investigational device exemption trial ( ClinicalTrials.gov identifier NCT02400905) between June 2015 and October 2016. Mean lesion length was 81.2±38.4 mm, 30.0% of patients had total occlusions, and 45.9% had moderate to severe calcification. Primary safety and effectiveness endpoints were compared at 1 year with prespecified objective performance goals (OPGs) set by the VIVA Physicians organization. Outcomes through 2 years are reported. Results The primary effectiveness endpoint of 12-month primary stent patency was met by 182 of 249 patients (73.1%, 95% CI 67.3% to 78.2%), exceeding the OPG of 66%. The primary safety endpoint of 30-day freedom from major adverse events (MAEs) was met in 268 of 269 patients (99.6%, 95% CI 97.7% to 100%), exceeding the OPG of 88%. Kaplan-Meier estimates of freedom from loss of primary patency were 83.1% at 12 months and 70.2% at 24 months, freedom from MAEs estimates were 86.9% at 12 months and 79.2% at 24 months, and freedom from clinically-driven target lesion revascularization estimates were 88.0% at 12 months and 83.0% at 24 months. At 24 months, 88.2% of patients showed improvement of ≥1 Rutherford category; the ankle-brachial index was >0.9 for 64.4% vs 11.3% at baseline. There were no cases of stent fracture. Conclusion Through 24 months, the BioMimics 3D Vascular Stent System provided safe and effective treatment for femoropopliteal lesions in patients with symptomatic peripheral artery disease.
Inhibition of Microrna-766-5p Attenuates the Development of Cervical Cancer Through Regulating SCAI
Authors: Cai Yongqin , Zhang Kai , Cao Liya , Sun Hong , Wang Honggang 
Published: December 2020

Purpose: MicroRNAs (miRNAs) are considered to play anti-tumor roles in cancers. This study is designed to illustrate the role and potential mechanism of miR-766-5p in cervical cancer (CC) progression. Methods: MiR-766-5p expression in tissues and serum of CC patients was detected by quantitative reverse-transcription PCR (qRT-PCR). Receiver operating characteristic (ROC) curve was performed to evaluate the diagnostic value of serum miR-766-5p in CC. The 5-ethynyl-2′-deoxyuridine (EdU) assay, flow cytometry, wound healing as well as transwell assay were utilized to detect the proliferation, apoptosis, migration and invasion of CC cells, respectively. The interaction between miR-766-5p and SCAI was confirmed by dual-luciferase reporter gene assay. Xenografted tumor model was established to measure the growth of tumor xenograft in vivo. Results: MiR-766-5p was significantly increased in tissues and serum of CC patients. ROC curve suggested that serum miR-766-5p could serve as a biomarker for the diagnosis of CC. Inhibition of miR-766-5p suppressed the proliferation, migration and invasion, and promoted the apoptosis of CC cells. SCAI was proved to be a target of miR-766-5p. Silencing of SCAI eliminated the inhibiting effects of miR-766-5p inhibitor on the proliferation, migration and invasion of CC cells in vitro. Additionally, down-regulation of SCAI also reversed the inhibitory effect of miR-766-5p inhibitor on the growth of tumor xenograft in vivo. Conclusions: Inhibition of miR-766-5p restrains the cell proliferation, migration and invasion, and promotes the apoptosis in CC through negatively regulating SCAI.
Pre-placement examinations for newly recruited health care support staff
Authors: Wong Joyce Yuk Ping 
Published: December 2020

Objective While musculoskeletal disorders (MSD) and physical strength have been extensively studied in health care professionals, little attention has been paid to health care support staff, such as patient care assistants and operation patient assistants, whose jobs are physically demanding. The purpose of this paper was to examine the musculoskeletal symptoms and physical strength of newly recruited health care support staff. Method Convenience sampling was conducted on 111 newly employed health care support staff in a public hospital. A custom-made pre-placement examination was performed. Data were analysed using descriptive, correlation, and regression analyses. Results Nearly one-third (32%) of the newly recruited health care support staff had experienced musculoskeletal symptoms in at least one body part during the preceding 12 months. Two-thirds (68%) of subjects were physically inactive, and sixty percent was overweight or obese. Handgrip strength was weaker than the local norm. The subjects’ dominant handgrip strength, bilateral lifting, pushing, and pulling force were significantly correlated. Only bilateral lifting was significantly associated with MSD among the newly recruited health care workers. Conclusions This study reports the baseline prevalence of MSD symptoms in the newly recruited health care support staff. Their sedentary lifestyle and suboptimal physical strength may render them susceptible to occupational injuries and disease. An effective occupational health programme that provides periodic health surveillance should be considered for high-risk health care workers to allow proper interventions in a timely manner.
Sexual Harassment Among Medical Students: Prevalence, Prediction, and Correlated Outcomes
Authors: McClain T’Shana , Kammer-Kerwick Matt , Wood Leila , Temple Jeff R. , Busch-Armendariz Noël 
Published: December 2020

Background: Few studies are dedicated to understanding the extent and impact of sexual harassment among medical students. The aim of this study was to use behaviorally specific measures to examine prevalence of sexual harassment toward medical students. Associated mental health and academic impacts were also studied. Methods: A multisite survey was conducted at four medical schools. Sexual harassment was measured using the Sexual Experiences Questionnaire (SEQ), a valid and reliable instrument. Students were also surveyed about depressive and post-traumatic stress disorder (PTSD) symptoms and their level of academic engagement. We also assessed their perceptions of institutional response and whether they felt safe at their institution. Findings: The final sample included 524 medical students (response rate = 13%). Findings revealed that 36.6% reported sexual harassment by a faculty/staff member and 38.5% reported harassment by a fellow student. The odds of harassment by faculty/staff, as well as peers, were significantly higher for women with an adjusted odds ratio (AOR) = 9.83, 95% confidence interval (CI) = [3.74, 25.80] and multiracial students with an AOR: 2.93, 95% CI: [1.16, 7.39]. Those who experienced sexual harassment were more likely to report academic disengagement and symptoms of depression and PTSD. Conclusion/Application to Practice: Sexual harassment in medical schools can potentially limit a student’s academic success and negatively impact their mental health. Supportive services and efforts to address peer and professional cultures that promote harassment are needed. Experiences of harassment require swift and competent responses by medical school leadership in collaboration with occupational and/or student health services to mitigate detrimental impacts and support medical students throughout their training.
Recovery of Long Standing Neurological Deficit in Pediatric Dorsal Spinal Tuberculosis: A Single Center Experience of 13 Cases
Authors: Srivastava Sudhir , Raj Aditya , Bhosale Sunil , Purohit Shaligram , Marathe Nandan , Desai Jigar 
Published: December 2020

Study Design: Retrospective analysis of case series. Objective: The aim is to study the recovery of neurological deficit in pediatric spinal tuberculosis cases presenting to us more than 6 months after onset of motor weakness in lower limbs. Methods: This is a retrospective analysis of 13 consecutive patients of pediatric spinal tuberculosis presenting to us at least 6 months after the onset of neurologic deficit. All these patients underwent surgical intervention at our center and their neurological recovery was noted in terms of improvement in Frankel grading and spasticity improvement by modified Ashworth scale. All the patients were followed up to at least 18 months post op and final neurologic status was assessed at that time. Results: The mean age of the patients at presentation was 8.5 years. The mean duration of neurologic deficit at the time of presentation was 10.23 months (6-24 months). Seven patients had a Frankel grade B at presentation out of which 6 improved to Frankel grade D and one improved to Frankel C at final follow up. Out of the other 3 patients with Frankel A at presentation, 2 improved to Frankel grade D and 1 to Frankel grade C. The remaining 3 patients presented with Frankel grade C at presentation, 2 improved to Frankel D and one improved to Frankel E at the time of final follow up. Conclusion: Neurologic recovery in patients with neurological deficit is possible even in cases of long standing deficit more than 6 months and in some cases upto 24 months as shown in our study.
C-reactive protein in traditional melanesians on Kitava
Authors: Carrera-Bastos Pedro , Fontes-Villalba Maelán , Gurven Michael , Muskiet Frits A. J. , Åkerfeldt Torbjörn , Lindblad Ulf , Råstam Lennart , Frostegård Johan , Shapira Yinon , Shoenfeld Yehuda , Granfeldt Yvonne , Sundquist Kristina , Jönsson Tommy 
Published: December 2020

Abstract
Background
Population-based levels of the chronic low-grade systemic inflammation biomarker, C-reactive protein (CRP), vary widely among traditional populations, despite their apparent absence of chronic conditions associated with chronic low-grade systemic inflammation, such as type 2 diabetes, metabolic syndrome and cardiovascular disease. We have previously reported an apparent absence of aforementioned conditions amongst the traditional Melanesian horticulturalists of Kitava, Trobriand Islands, Papua New Guinea. Our objective in this study was to clarify associations between chronic low-grade systemic inflammation and chronic cardiometabolic conditions by measuring CRP in a Kitava population sample. For comparison purposes, CRP was also measured in Swedish controls matched for age and gender.

Methods
Fasting levels of serum CRP were measured cross-sectionally in ≥ 40-year-old Kitavans (N = 79) and Swedish controls (N = 83).

Results
CRP was lower for Kitavans compared to Swedish controls (Mdn 0.5 mg/L range 0.1—48 mg/L and Mdn 1.1 mg/L range 0.1—33 mg/L, respectively, r = .18 p = .02). Among Kitavans, there were small negative associations between lnCRP for CRP values < 10 and total, low-density lipoprotein (LDL) and non-high-density lipoprotein (non-HDL) cholesterol. Among Swedish controls, associations of lnCRP for CRP values < 10 were medium positive with weight, body mass index, waist circumference, hip circumference and waist-hip ratio and low positive with triglyceride, total cholesterol-HDL cholesterol ratio, triglyceride-HDL cholesterol ratio and serum insulin.

Conclusions
Chronic low-grade systemic inflammation, measured as CRP, was lower among Kitavans compared to Swedish controls, indicating a lower and average cardiovascular risk, respectively, for these populations.
Derivation and validation of a prognostic model for predicting in-hospital mortality in patients admitted with COVID-19 in Wuhan, China: the PLANS (platelet lymphocyte age neutrophil sex) model
Authors: Li Jiong , Chen Yuntao , Chen Shujing , Wang Sihua , Zhang Dingyu , Wang Junfeng , Postmus Douwe , Zeng Hesong , Qin Guoyou , Shen Yin , Jiang Jinjun , Yu Yongfu 
Published: December 2020

Abstract
Background
Previous published prognostic models for COVID-19 patients have been suggested to be prone to bias due to unrepresentativeness of patient population, lack of external validation, inappropriate statistical analyses, or poor reporting. A high-quality and easy-to-use prognostic model to predict in-hospital mortality for COVID-19 patients could support physicians to make better clinical decisions.

Methods
Fine-Gray models were used to derive a prognostic model to predict in-hospital mortality (treating discharged alive from hospital as the competing event) in COVID-19 patients using two retrospective cohorts (n = 1008) in Wuhan, China from January 1 to February 10, 2020. The proposed model was internally evaluated by bootstrap approach and externally evaluated in an external cohort (n = 1031).

Results
The derivation cohort was a case-mix of mild-to-severe hospitalized COVID-19 patients (43.6% females, median age 55). The final model (PLANS), including five predictor variables of platelet count, lymphocyte count, age, neutrophil count, and sex, had an excellent predictive performance (optimism-adjusted C-index: 0.85, 95% CI: 0.83 to 0.87; averaged calibration slope: 0.95, 95% CI: 0.82 to 1.08). Internal validation showed little overfitting. External validation using an independent cohort (47.8% female, median age 63) demonstrated excellent predictive performance (C-index: 0.87, 95% CI: 0.85 to 0.89; calibration slope: 1.02, 95% CI: 0.92 to 1.12). The averaged predicted cumulative incidence curves were close to the observed cumulative incidence curves in patients with different risk profiles.

Conclusions
The PLANS model based on five routinely collected predictors would assist clinicians in better triaging patients and allocating healthcare resources to reduce COVID-19 fatality.