bluuebunny/crossref_metadata_2025_split huggingface dataset:
Attaining full professor: Women’s and men’s experiences in medical education
Authors: Varpio Lara , Harvey Emily , Jaarsma Debbie , Dudek Nancy , Hay Margaret , Day Kathy , Bader Larsen Karlen , Cleland Jennifer 
Published: October 2020

AbstractIntroductionThe underrepresentation of women among senior faculty members in medical education is a longstanding problem. The purpose of this international qualitative investigation was to explore women and men's experiences of attaining full professorship and to investigate why women remain underrepresented among the senior faculty ranks.MethodsConducted within a social constructionist orientation, our qualitative study employed narrative analysis. Two female and two male participants working in medical education were recruited from five nations: Australia, Canada, the Netherlands, United Kingdom and United States. All participants held an MD or PhD. During telephone interviews, participants narrated the story of their careers. The five faculty members on the research team were also interviewed. Their narratives were included in analysis, rendering their experiences equal to those of the participants.ResultsA total of 24 full professors working in medical education were interviewed (n = 15 females and n = 9 males). While some aspects were present across all narratives (ie personal events, career milestones and facilitating and/or impeding factors), participants’ experience of those aspects differed by gender. Men did not narrate fatherhood as a role navigated professionally, but women narrated motherhood as intimately connected to their professional roles. Both men and women narrated career success in terms of hard work and overcoming obstacles; however, male participants described promotion as inevitable, whereas women narrated promotion as a tenuous navigation of social structures towards uncertain outcomes. Female and male participants encountered facilitators and inhibitors throughout their careers but described acting on those experiences differently within the cultural contexts they faced.DiscussionOur data suggest that female and male participants had different experiences of the work involved in achieving full professor status. Understanding these gendered experiences and their impact on career progression is an important advancement for better understanding what leads to the underrepresentation of women among senior faculty members in medical education.
Purgatory
Authors: Charlton William 
Published: October 2020

AbstractI say briefly what the Catholic Church now teaches about Purgatory. I offer an account of time which allows the purgatorial process to be genuinely temporal, but not precisely quantifiable or temporally relatable to processes and events in our space-time. I examine ancient, Enlightenment and modern notions of punishment, connect them with a theory of the relation of right and wrong to law and with the conception of a faculty of will, and argue that purgatorial process need not be considered punitive. I suggest it might consist in coming to share God's divine knowledge, and consider how prayers for the dead might help them.
Phytochrome A and its Functional Manifestations in Etiolated and Far‐red Light‐grown Seedlings of the Wild‐type Rice and its Hebiba and Cpm2 Mutants Deficient in the Defense‐related Phytohormone Jasmonic Acid
Authors: Sineshchekov Vitaly , Koppel Larissa , Riemann Michael , Nick Peter 
Published: October 2020

AbstractInteraction between phytochromes and hormones is becoming one of the major issues in plant photophysiology. In this work, effects of defense‐related jasmonic acid (JA) on phytochrome A (phyA) were investigated by fluorescence spectroscopy making use of two JA biosynthesis mutants of rice: cpm2 with the inactivated gene allene oxide cyclase and hebiba with additional genes deleted. Constant far‐red light (FRc) mediated by phyA reduced its content in the wild type (WT) and mutants, and brought about domination of its light‐stable pool (phyA″) in WT and light‐labile pool (phyA′) in the mutants. Pulsed FRp was much less effective. This FR effect classifies as primarily HIR with a low fluence threshold; it comprises inhibition of phyA biosynthesis, stimulation of phyA″→phyA′ transformation and phyA′ destruction. In the mutants, phyA suppresses [Pchlide] under FRp (VLFR) and stimulates it under FRc (HIR); these effects are lacking in WT. Similarly, phyA suppresses roots'growth under FRp in the mutants but not in WT. These JA mutant features suggest that JA reduces the phyA functional activity primarily in its phyA″ form mediating HIR. This modulating JA action on phyA functions under FR limiting their extreme manifestations may have contributed to the evolutionary advances of the land plants.
Bilateral temporal dacryops in a cat
Authors: Maggio Federica 
Published: October 2020

AbstractA 1‐year‐old Maine Coon female spayed cat was presented for a 7‐week history of bilateral pinkish masses located over the dorsotemporal conjunctival quadrants. Ophthalmic examination revealed the presence of bilateral temporal, slightly hyperemic, subconjunctival masses, fluctuant, and nonpainful. The remainder of the ocular examination was unremarkable. Ultrasound biomicroscopy and B‐scan ultrasonography confirmed the presence of a bilateral cavitated and tubular structure, extending within the temporal orbit, with anechoic fluid‐like content. Surgical removal was performed. Histopathology described the lesions as lacrimal gland tissue, markedly infiltrated by inflammatory cells, associated with cavitated structures filled with proteinaceous debris, and lined by flattened bilayered cuboidal epithelial cells. Bilateral adenitis of unknown origin and dacryops of the temporal lacrimal glands were diagnosed. Both surgical sites healed uneventfully, and no recurrence was reported on either eye during a 12‐month follow‐up period.
Hydroponic Chlorophytum comosum cultivating in distinct nutrient concentration, combined with biofilm treating eutrophic water bodies
Authors: Pan Fanghui , Wang Youbao , Gui Yanan 
Published: October 2020

AbstractPhytoremediation technology using aquatic plants combined with microorganisms in constructed ecological floating bed (EFB) is increasingly applied to remediate eutrophic water. Utilizing the hydroponic Chlorophytum comosum, in combination with biofilm developed in polymeric fibrous carriers from sequencing batch reactor (SBR), to fabricate EFB, was implemented to reduce pollution and improve water quality for eutrophic water. The results indicated that the hydroponic C. comosum with long root and leaf, rich Chlorophyll, low cell membrane permeability and strong antioxidant activity enzymes was obtained through different nutrient concentration test. The combination of the hydroponic C. comosum and the biofilm developed in polymeric fibrous carriers could remove 75% chemical oxygen demand (CODCr), 61% permanganate index (PI), 50% total nitrogen (TN) and 57% total phosphorus (TP). Specially, the combination group exhibited higher removal efficiency of CODCr, PI and TN, compared with the sole biofilm group or the sole hydroponic C. comosum group. The result demonstrated that the combination of hydroponic C. comosum and the biofilm to construct the EFB was capacity to repair the eutrophic Huajin River.
Table grapes irrigation with treated municipal wastewater in a Mediterranean environment
Authors: Abi Saab Marie Therese , Zaghrini Joanna , Makhlouf Hassane , Fahed Salim , Romanos Dany , Khairallah Yara , Hajjar Celine , Abi Saad Roula , Sellami Mohamed Houssemeddine , Todorovic Mladen 
Published: October 2020

AbstractThis study investigated the effect of different water quality regimes [Freshwater (FW), treated wastewater (TW) and alternating FW and TW (FW‐TW)] on drip‐irrigated table grape yield, quality and microbial contamination. Water and soil samples were analysed. In addition, grape samples were harvested for quantitative and qualitative evaluation. The results showed that the plants irrigated with TW and those irrigated with alternating FW and TW gave 19.57 and 14.95% higher marketable yield, respectively, than plants irrigated with FW. Total soluble sugars, total titratable acidity and sweetness ranged, respectively, between 18.43–20.13, 0.69–0.81% and 21.52–29.19, and were within the desirable levels for table grape harvest. In addition, there was no significant difference in terms of total phenols and mineral composition of berries, leaves, peduncle and pedicels. Finally, table grapes did not present any bacterial contamination which confirm the importance of the adopted irrigation regime for a safe wastewater reuse in agriculture.
Prospective validation of a virtual clinic pathway in the management of choroidal naevi: the NAEVUS study Report no. 1: safety assessment
Authors: Al Harby Lamis , Ali Zaria , Rajai Azita , Roberts Stephen A , Peto Tunde , Leung Irene , Gray Jane , Hay Gordon , Arora Amit K , Keane Pearse A , Cohen Victoria M L , Sagoo Mandeep , Balaskas Konstantinos 
Published: October 2020

BackgroundChoroidal naevi are a common incidental finding prompting specialist referrals to ocular oncology. Rarely, such lesions have sufficient suspicious features to diagnose a small melanoma. The aim of the study is to show that ‘virtual’ imaging-based pathways are a safe and efficient option to manage such referrals.MethodsA prospective cohort study at the Manchester Royal Eye Hospital and Moorfields Eye Hospital between June 2016 and July 2017 of the management decision of 400 patients reviewed by an ophthalmologist in a face-to-face consultation (gold standard) supported by fundus photography, optical coherence tomography, autofluorescence (AF) and B-mode ultrasound. The images were also read independently by blinded graders (non-medical) and blinded ophthalmologists, and a management decision was made based on image review alone (virtual pathway). The two pathways were compared for safety.ResultsThe agreement for management decisions between face-to-face and virtual pathways was 83.1% (non-medical) and 82.6% (medical). There were more over-referrals in the virtual pathway (non-medical 24.3%, medical 23.3% of gold standard discharge) and only two under-referrals (10.5% of gold standard referrals), both borderline cases with minimal clinical risk. The agreement for risk factors of growth (orange pigment, subretinal fluid, hyper-AF) ranged between 82.3% and 97.3%.ConclusionsWe prospectively validated a virtual clinic model for the safe management of choroidal naevi. Such a model of care is feasible with low rate of under-referral. An over-referral rate of almost 24% from the vitrual pathway needs to be factored into designing such pathways in conjunction with evidence on their cost-effectiveness.
Changes in the quality of care of colorectal cancer in Estonia: a population-based high-resolution study
Authors: Reima Heigo , Soplepmann Jaan , Elme Anneli , Lõhmus Mari , Tiigi Rena , Uksov Denis , Innos Kaire 
Published: October 2020

ObjectivesLarge disparities in colorectal cancer (CRC) management and survival have been observed across Europe. Despite recent increases, the survival deficit of Estonian patients with CRC persists, particularly for rectal cancer. The aim of this study was to examine diagnostic, staging and treatment patterns of CRC in Estonia, comparing clinical data from 1997 and 2011.DesignNationwide population-based retrospective study.SettingEstonia.ParticipantsAll incident cases of colon and rectal cancer diagnosed in 1997 and 2011 identified from the Estonian Cancer Registry. Clinical data gathered from medical records.Outcome measuresDifferences in diagnostic, staging and treatment patterns; 5-year relative survival ratios.ResultsThe number of colon cancer cases was 337 in 1997 and 498 in 2011; for rectal cancer, the respective numbers were 209 and 349. From 1997 to 2011, large increases were seen in the use of colonoscopy and lung and liver imaging. Radical resection rate increased from 48% to 59%, but emergency surgeries showed a rise from 18% to 26% in colon and from 7% to 14% in rectal cancer. The proportion of radically operated patients with ≥12 lymph nodes examined pathologically increased from 2% to 58% in colon cancer and from 2% to 50% in rectal cancer. The use of neoadjuvant radiotherapy increased from 6% to 39% among stage II and from 20% to 50% among patients with stage III rectal cancer. The use of adjuvant chemotherapy in stage III colon cancer increased from 42% to 63%. The 5-year RSR increased from 50% to 58% in colon cancer and from 37% to 64% in patients with rectal cancer.ConclusionsMajor improvements were seen in the diagnostics, staging and treatment of CRC in Estonia contributing to better outcomes. Increase in emergency surgeries highlights possible shortcomings in timely diagnosis and treatment.
Healthcare utilisation in overweight and obese children: a systematic review and meta-analysis
Authors: Hasan Taimoor , Ainscough Tom S , West Jane , Fraser Lorna Katharine 
Published: October 2020

ObjectiveThis systematic review and meta-analysis aims to systematically analyse the association of overweight and obesity with health service utilisation during childhood.Data sourcesPubMed, MEDLINE, CINAHL, EMBASE and Web of Science.MethodsObservational studies published up to May 2020 that assessed the impact of overweight and obesity on healthcare utilisation in children and adolescents were included. Studies were eligible for inclusion if the included participants were ≤19 years of age. Findings from all included studies were summarised narratively. In addition, rate ratios (RRs) and 95% CIs were calculated in a meta-analysis on a subgroup of eligible studies.Outcome measuresIncluded studies reported association of weight status with healthcare utilisation measures of outpatient visits, emergency department (ED) visits, general practitioner visits, hospital admissions and hospital length of stay.ResultsThirty-three studies were included in the review. When synthesising the findings from all studies narratively, obesity and overweight were found to be positively associated with increased healthcare utilisation in children for all the outcome measures. Six studies reported sufficient data to meta-analyse association of weight with outpatient visits. Five studies were included in a separate meta-analysis for the outcome measure of ED visits. In comparison with normal-weight children, rates of ED (RR 1.34, 95% CI 1.07 to 1.68) and outpatient visits (RR 1.11, 95% CI 1.02 to 1.20) were significantly higher in obese children. The rates of ED and outpatient visits by overweight children were only slightly higher and non-significant compared with normal-weight children.ConclusionsObesity in children is associated with increased healthcare utilisation. Future research should assess the impact of ethnicity and obesity-associated health conditions on increased healthcare utilisation in children with overweight and obesity.PROSPERO registration numberCRD42018091752
Impacts of social support on the treatment outcomes of drug-resistant tuberculosis: a systematic review and meta-analysis
Authors: Wen Shuqin , Yin Jia , Sun Qiang 
Published: October 2020

ObjectiveTo assess the effectiveness of social support on treatment success promotion or lost to follow-up (LTFU) reduction for patients with drug-resistant tuberculosis (DR-TB).DesignWe searched Pubmed, Web of Science, Embase, Scopus and Medline databases until 18 June 2020 for interventional or mixed-method studies which reported social support and treatment outcomes of DR-TB patients. Two independent reviewers extracted data and disagreements were resolved by consensus with a third reviewer. Random-effects meta-analysis was performed to calculate the OR and 95% CI for the effects of social support on the improvement of treatment outcomes and the heterogeneity and risk of bias were assessed.SettingLow-income and middle-income countries.ParticipantsDR-TB patients.OutcomesTreatment success is defined as the combination of the cured and treatment completion, and LTFU is measured as treatment being interrupted for two consecutive months or more.ResultsAmong 173 articles selected for full-text review, 162 were excluded through independent review (kappa=0.87) and 10 studies enrolling 1621 DR-TB patients in eight countries were included for qualitative analysis. In these studies, the most frequently introduced social support was material support (10 studies), followed by informational (eight studies), emotional (seven studies) and companionship support (four studies). Seven studies that reported treatment outcomes in both intervention arm and control arm are qualified for meta-analysis. An encouraging improvement on treatment success rate (OR: 2.58; 95% CI: 1.80 to 3.69) was found when material support was integrated into social support packages and no heterogeneity was observed (I1 of 0%, Q test p=0.72). Reduction on LTFU rate (OR: 0.17; 95% CI: 0.05 to 0.55) was also noted when material support was available but substantial heterogeneity was found (I2 of 80%, Q test p=0.002).ConclusionMaterial support appeared feasible and effective to improve treatment success for DR-TB patients combined with other social support interventions.PROSPERO registration numberCRD42019140824.
Attitudes and willingness toward out-of-hospital cardiopulmonary resuscitation: a questionnaire study among the public trained online in China
Authors: Jiang Yi , Wu Bangsheng , Long Long , Li Jiaxing , Jin Xiaoqing 
Published: October 2020

ObjectivesThe incidence of bystander cardiopulmonary resuscitation (CPR) is low in China. CPR training could improve public attitudes and willingness, but at present, the attitudes of the public after online training are unclear. This study investigated individual attitudes towards CPR, the willingness to perform it in emergencies along with the main obstacles and the overall effects of online training.DesignQuestionnaires were distributed to investigate the public attitudes and willingness towards performing bystander CPR.SettingQuestionnaires were accessible after the online course ‘First Aid’.Participants1888 students who attended ‘First Aid’ from December 2019 to 1 January 2020 and then completed the questionnaire voluntarily.ResultsThe majority understood CPR (96.7%) and displayed a willingness to learn (98.4%) and to disseminate CPR knowledge (82.0%). Characteristics associated with more positive attitudes included women, the 26–35-year olds and those in medical-related occupations (p<0.05). Only 34.8% had CPR training before. Most people would willingly perform CPR on a close family member. Compared with the standard CPR (S-CPR), the public preferred chest compression-only CPR (CO-CPR) (p<0.01). The top three obstacles to performing CO-CPR were lack of confidence (26.7%), fear of harming the victim (23.4%) and causing legal trouble (20.7%), while regarding S-CPR, fear of disease transmission (22.9%) ranked second. Women, those in poor health and in medical-related occupations, were more likely to perform CPR (p<0.05). The confidence to perform CPR was improved remarkably after online training (p<0.05).ConclusionsThe overwhelming majority of respondents showed positive attitudes and willingness towards CPR. In some cases, there is still reluctance, especially towards S-CPR. Obstacles arise mainly due to lack of confidence in administering CPR, while online CPR training can markedly improve it. Therefore, we should focus on disseminating CPR knowledge, targeting those who are less willing to perform CPR and helping overcome their obstacles by online training.
Anxiety levels, precautionary behaviours and public perceptions during the early phase of the COVID-19 outbreak in China: a population-based cross-sectional survey
Authors: Qian Mengcen , Wu Qianhui , Wu Peng , Hou Zhiyuan , Liang Yuxia , Cowling Benjamin J , Yu Hongjie 
Published: October 2020

ObjectiveTo investigate psychological and behavioural responses to COVID-19 among the Chinese general population.Design, setting and participantsWe conducted a population-based mobile phone survey between 1 February and 10 February 2020 via random digit dialling. A total of 1011 adult residents in Wuhan (n=510), the epicentre and quarantined city, and Shanghai (n=501) were interviewed. Proportional quota sampling and poststratification weighting were used. Multivariable logistic regression models were used to investigate perception factors associated with the public responses.Primary outcome measuresWe measured anxiety levels using the 7-item Generalised Anxiety Disorder Scale (GAD-7) and asked respondents to report their precautionary behaviours before and during the outbreak.ResultsThe prevalence of moderate or severe anxiety was significantly higher (p<0.001) in Wuhan (32.8%) than Shanghai (20.5%). Around 79.6%–88.2% residents reported always wearing a face mask when they went out and washing hands immediately when they returned home, with no discernible difference across cities. Only 35.5%–37.0% of residents reported a handwashing duration above 40 s as recommended by the WHO. The strongest predictor of moderate or severe anxiety was perceived harm of the disease (OR 1.8, 95% CI 1.5 to 2.1), followed by confusion about information reliability (OR 1.7, 95% CI 1.5 to 1.9). None of the examined perception factors were associated with odds of handwashing duration above 40 s.ConclusionsPrevalence of moderate or severe anxiety and strict personal precautionary behaviours was generally high, regardless of the quarantine status. Our results support efforts for handwashing education programmes with a focus on hygiene procedures in China and timely dissemination of reliable information.
Formative independent evaluation of a digital change programme in the English National Health Service: study protocol for a longitudinal qualitative study
Authors: Cresswell Kathrin , Sheikh Aziz , Dean Franklin Bryony , Krasuska Marta , Nguyen Hung , Hinder Susan , Lane Wendy , Mozaffar Hajar , Mason Kathy , Eason Sally , Potts Henry , Williams Robin 
Published: October 2020

IntroductionMany countries are launching large-scale, digitally enabled change programmes as part of efforts to improve the quality, safety and efficiency of care. We have been commissioned to conduct an independent evaluation of a major national change programme, the Global Digital Exemplar (GDE) Programme, which aims to develop exemplary digital health solutions and encourage their wider adoption by creating a learning ecosystem across English National Health Service (NHS) provider organisations.Methods and analysisThis theoretically informed, qualitative, longitudinal formative evaluation comprises five inter-related work packages. We will conduct a combination of 12 in-depth and 24 broader qualitative case studies in GDE sites exploring digital transformation, local learning and mechanisms of spread of knowledge within the Programme and across the wider NHS. Data will be collected through a combination of semistructured interviews with managers, implementation staff (clinical and non-clinical), vendors and policymakers, plus non-participant observations of meetings, site visits, workshops and documentary analysis of strategic local and national plans. Data will be analysed through inductive and deductive methods, beginning with in-depth case study sites and testing the findings against data from the wider sample and national stakeholders.Ethics and disseminationThis work is commissioned as part of a national change programme and is therefore a service evaluation. We have ethical approval from the University of Edinburgh. Results will be disseminated at six monthly intervals to national policymakers, and made available via our publicly accessible website. We will also identify lessons for the management and evaluation of large-scale evolving digital health change programmes that are of international relevance.