bluuebunny/crossref_metadata_2025_split huggingface dataset:
What patients with lung cancer with comorbidity tell us about interprofessional collaborative care across healthcare sectors: qualitative interview study
Authors: Bossert Jasmin , Forstner Johanna , Villalobos Matthias , Siegle Anja , Jung Corinna , Deis Nicole , Thomas Michael , Wensing Michel , Krug Katja 
Published: August 2020

BackgroundPatients with lung cancer with comorbidity often require treatment and care by different health professionals, in different settings and at different points in time during the course of the disease. In order to organise and coordinate healthcare efficiently, effective information exchange and collaboration between all involved care providers are required. The aim of this study was to assess the views of patients with advanced lung cancer with comorbidity regarding coordination of treatment and care across healthcare sectors.MethodsThis qualitative study, as part of the main study, The Heidelberg Milestones Communication Approach, used face-to-face guide-based semistructured interviews with patients with advanced lung cancer and their informal caregivers to explore cross-sectoral information exchange and collaboration in Germany. All generated data were audio-recorded, pseudonymised and transcribed verbatim. Data analysis was performed using qualitative content analysis to structure data into themes and subthemes. All data were managed and organised in MAXQDA.ResultsIn 15 interviews, participants reported that cross-sectoral collaboration functioned well, if treatments occurred as planned. However, treatment gaps were experienced, especially regarding medication and regimen. As a result, participants felt insecure and obliged to take responsibility for the coordination of healthcare. Patients reported to be in favour of an active patient role but felt that healthcare coordination should still be a responsibility of a care provider. A more intensive information exchange, potentially by using an electronic platform, was expected to strengthen cross-sectoral collaboration.ConclusionPatients with lung cancer are uncertain about their role in the coordination of treatment and care across healthcare sectors. Healthcare providers should be more aware of care recipients’ willingness of taking on a more active role in healthcare coordination.Trial registration numberDRKS00013469.
Utility of the COM-B model in identifying facilitators and barriers to maintaining a healthy postnatal lifestyle following a diagnosis of gestational diabetes: a qualitative study
Authors: Boyd Jennifer , McMillan Brian , Easton Katherine , Delaney Brigitte , Mitchell Caroline 
Published: August 2020

ObjectivesPrevious qualitative research investigating the experiences of women diagnosed with gestational diabetes (GD) has provided important insights into the development of behaviour change interventions. However, these studies often lack a theoretical underpinning. This study explored the use of the capability, opportunity, motivation and behaviour (COM-B) framework (which proposes that individuals need the capability, opportunity and motivation to perform a particular behaviour) to code and the socioecological model to contextualise participant responses to better inform intervention development.DesignQualitative semistructured interviews are using purposive sampling. Interviews were audio-recorded, transcribed and coded using the COM-B framework. A socioecological approach was adopted to understand the context of intervention facets.SettingInterviews were conducted in a secondary care setting in South Yorkshire.ParticipantsTwenty-seven postnatal women with a previous diagnosis of GD were interviewed.ResultsApplying the COM-B framework to code participant, responses identified 16 key subthemes which reflected either: capability, opportunity or motivation components of the model. Four domains adapted from the socioecological model: individual, family life, community and healthcare provision; contextualised factors are important for these women in terms of behaviour change. Emotional response at the individual level was highly motivating or demotivating. Factors related to family life and community were particularly dominant and had the potential to either facilitate or impede change. We found many participants relied on healthcare provision during the prenatal and postnatal periods with timing and positive relationships being key to good care.ConclusionsOur study provides further insight into the factors crucial for behaviour change in women diagnosed with GD. By innovatively applying the COM-B framework in a socioecological context, it is clear intervention facets need to target microlevel through the macrolevel to engage this population in behaviour change. Future work should consider family-level intervention as this could allow for sustained behaviour change and consequently prevent the development of type 2 diabetes mellitus.
Quality improvement study on early recognition and intervention of caregiver burden in a tertiary hospital
Authors: Towle Rachel Marie , Low Lian Leng , Tan Siok Bee , Hendrix Cristina 
Published: August 2020

BackgroundCaregivers play a crucial role in taking over the important task of looking after patients post-hospitalisation. Caregivers who are unfamiliar with patients’ post-discharge care often experience caregiver stress, while patients may see deterioration in their condition. As caregivers are our core partners in healthcare, it is therefore necessary for patient navigators to recognise, assess and address caregivers’ needs or burden as early as on admission to hospital. Patient navigators are trained registered nurses whose main role is to provide patients and caregivers with personalised guidance through the complex healthcare system.ObjectivesThis quality improvement study examined the efficacy of using the Zarit Burden Interview as a tool in helping patient navigators recognise caregiver burden early and the effectiveness of targeted interventions on caregiver burden.MethodsVarious quality improvement tools were used. Eighty-six patient-caregiver dyads who met the inclusion criteria were enrolled. Informal caregivers were assessed for caregiver burden using the Zarit Burden Interview during hospital admission (T0) and again at 30 days postdischarge (T1), post-intervention.ResultsThere was significant improvement in the Zarit Burden mean scores from T0 to T1 reported for the 80 dyads who completed the study, even after adjusting for covariates (T0 mean=11.08, SD=7.64; T1 mean=2.48, SD=3.36, positive ranks, p<0.001). Highest burden identified by most caregivers were the personal strain; trying to meet other responsibilities and uncertain about what to do in caring for their loved one. By recognising the different aspects of caregiver burden early, patient navigators were able to focus their interventions.ConclusionEarly recognition of caregiver burden and targeted interventions were found to be effective at reducing caregiver burden in a tertiary hospital.
Ultrasonography is insensitive but specific for detecting aortic wall abnormalities in dogs infected with Spirocerca lupi
Authors: Merhavi Nadav , Segev Gilad , Dvir Eran , Peery Dana 
Published: August 2020

BackgroundSpirocercosis is caused by the nematode Spirocerca lupi (S lupi). The disease mainly affects dogs and is typically diagnosed by oesophagoscopy or faecal examination; however, these diagnostic tests may deliver false negative results during the migration phase of the nematode. The aim of the present prospective study was to evaluate whether ultrasonography could detect abnormalities in the abdominal aorta, celiac artery, and gastric wall structure as a diagnostic aid to detect S lupi infection in dogs.MethodsOesophagoscopy and a focused abdominal ultrasound scan were performed in 40 dogs that presented to the Koret School of Veterinary Medicine Teaching Hospital, Hebrew University of Jerusalem, with gastrointestinal complaints. Ultrasonography scan findings of 20 dogs with oesophageal nodules, indicating S lupi infection (study group), were compared with those of 20 control dogs.ResultsVascular wall irregularity was significantly more common in the study group than in the control group (9/20 v 1/20, respectively; P=0.008).ConclusionUltrasonographic evaluation of the abdominal aorta, celiac artery, and gastric wall structure is not a sensitive diagnostic marker for spirocercosis in dogs. However, the presence of vascular wall irregularity of the abdominal aorta or celiac artery might indicate S lupi migration.
Soil respiration and net ecosystem productivity in a chronosequence of hybrid poplar plantations
Authors: Chang Scott X. , Shi Zheng , Thomas Barb R. 
Published: August 2020

Forest stand age can affect ecosystem carbon (C) cycling and net ecosystem productivity (NEP). In Canada, establishment of short-rotation plantations on previously agricultural lands has been ongoing, but the effect of stand development on soil respiration (Rs) and NEP in such plantations is poorly understood. These types of data are essential for constraining ecosystem models that simulate C dynamics over the rotation of a plantation. We studied Rs (including autotrophic, Ra, and heterotrophic, Rh) and NEP in 2008 and 2009 in a chronosequence of 5-, 8-, 14-, and 16-yr-old (ages in 2009) hybrid poplar (Populus deltoides × Populus × petrowskyana var. Walker) plantations in northern Alberta. The highest Rs and NEP were generally found in the 14-yr-old stand. Seasonal variations in Rs were similar among the plantations, with most of the variation explained by soil temperature at the 10 cm depth in 2008 with far less explained in 2009, a much drier year. In diurnal measurements, hysteresis was found between soil respiration and soil temperature, with the patterns of hysteresis different among stand ages. Soil respiration in the 14-yr-old plantation had the greatest sensitivity to temperature changes. Stand age did not affect the Rh:Rs ratio, whereas the NEP exhibited strong inter-annual variability. We conclude that stand age was a major factor affecting Rs and NEP, and such effects should be considered in empirical models used to simulate ecosystem C dynamics to evaluate potentials for C sequestration and the C source–sink relationship in short-rotation woody crop systems.
Bhabha scattering in very special relativity at finite temperature
Authors: dos Santos Alesandro Ferreira , Khanna Faqir C. 
Published: August 2020

AbstractIn this paper the differential cross section for Bhabha scattering in the very special relativity (VSR) framework is calculated. The main characteristic of the VSR is to modify the gauge invariance. This leads to different types of interactions appearing in a non-local form. In addition, using the Thermo Field Dynamics formalism, thermal corrections for the differential cross section of Bhabha scattering in VSR framework are obtained.
Wolfgang R. von Kempelen,
Le Mécanisme de la Parole, Suivi de la Description d’une Machine Parlante
. Vienne, ed. Bauer, 1791
Authors: Pettorino Massimo 
Published: August 2020

Abstract
Strange as it may seem, von Kempelen’s speaking machine from 1791 is the best result obtained in various attempts to build a mechanism similar to the speech apparatus, capable of producing a vocal signal. In this book discussion, we will illustrate von Kempelen’s work, along with the attempts, across history, to build talking devices. We will highlight the 2 paths that have been followed over the centuries: “vocal transport” and “artificial voice.” The first case was a trick, because the voice was produced by a hidden subject and transported through an artifice to a head or a statue. The other path, that of research, has tried to imitate the phonatory apparatus to produce sequences of sounds somewhat similar to those that make up the speech chain. Which of the 2 paths led to the production of today’s synthesized speech? The trick or the research? We will try to answer this question.
Effects of lightning impulse front time on substation grounding system performance
Authors: Adnan Muhammad , Adul Malek Zulkurnain , Din Nur Syazwani Mohd , Jambak Muhammad Irfan , Nawawi Zainuddin , Sidik Muhammad Abu Bakar 
Published: August 2020

<table width="593" border="1" cellspacing="0" cellpadding="0"><tbody><tr><td valign="top" width="387"><p>The role of the grounding system in the safety of the power system and protection of personnel is obvious during an unexpected short circuit or lightning discharge at the substation. The aim of this work is to analyze the effects of several parameters: lightning impulse front time, soil resistivity and types of grid materials on the grounding system of the Substation. The ground potential rise (GPR), touch voltage and step voltage of a 50 m x 60 m grounding grid buried at a depth of 0.5 m were computed using CDEGS when injected by impulse with different front times. Results show that the shorter the front time of lightning impulse waveform, the higher the value of GPR, touch voltage and step voltage. Meanwhile, when the value of soil resistivity is increased, the value of GPR, touch voltage and step voltage is also increased. Lastly, different types of grid conductor materials give different values of GPR, touch voltage and step voltage. However, it can be said that the differences are too small to be of any significance.</p><p> </p></td></tr></tbody></table>
Integration of a 31-Gene Expression Profile Into Clinical Decision-Making in the Treatment of Cutaneous Melanoma
Authors: Scott Anthony M. , Dale Paul S. , Conforti Arnold , Gibbs Jennifer N. 
Published: August 2020

Background The practice of utilizing gene expression profile (GEP) for the evaluation and treatment of cutaneous melanomas has been found to predict the risk of sentinel-node metastasis and recurrence. Information obtained from this assay has been used to determine clinical decision-making, including serving as an indication for sentinel lymph node biopsy and also for the intensity of screening measures. Methods Herein we present our early experience in utilizing 31-GEP in intermediate melanomas and its effect on clinical management. A retrospective review was conducted of patients who had undergone treatment for melanoma whose tumors had been subjected to 31-GEP. Additionally, patient characteristics, attributes of the original tumor biopsied, findings on final pathology, and procedures performed were evaluated. Results 31-GEP stratified patients into 4 groups; groups 1A and 1B are considered low risk of metastasis or recurrence, while 2A and 2B are considered high risk. Over the study period, 31-GEP was conducted on 26 cutaneous melanoma patients. Testing and treatment data are available for 23 of these patients. Eleven patients were found to be low risk (9 as 1A, 2 as 1B), 12 were found to be high risk (4 as 2A, 8 as 2B). Decision-making was altered such that sentinel lymph node biopsy was omitted in 2 cases in which the patients were found to be low risk with age >65 years. Discussion In 8 cases of node-negative disease in genetically high-risk patients, surveillance measures were augmented with positron emission tomography/computed tomography. Utilization of 31-GEP is ongoing at our institution.
BMI and VTE Risk in Emergency General Surgery, Does Size Matter?
Authors: Pahlkotter Maranda K. , Mohidul Shalwa , Moen Micaela R. , Digney Bradley W. , Holmes Sharon , Muertos Keely , Sciarretta Jason D. , Davis John M. 
Published: August 2020

Background Venous thromboembolism (VTE) is a preventable cause of morbidity and mortality. Emergency general surgery (EGS) patients comprise 7% of hospital admissions in America with a reported rate of VTE of 2.5%. Of these, >69% required hospital readmission, making VTE the second most common cause for readmission after infection in EGS patients. We hypothesize a correlation between body mass index (BMI) and VTE in EGS patients. Methods The American College of Surgeons National Surgery Quality Improvement Database (NSQIP) was queried from January 2015 to December 2016. 83 272 patients met inclusion criteria: age ≥18 and underwent an EGS procedure. Patients were stratified by BMI. Descriptive statistics were used for demographic and numerical data. Categorical comparisons between covariates were completed using the chi-square test. Continuous variables were compared using Student’s t-test, Mann Whitney U-test, or Kruskal-Wallis H test. Results 83 272 patients met the inclusion criteria. 1358 patients developed VTE (903 deep vein thrombosis (DVT) only, 335 pulmonary embolism (PE) only, and 120 with DVT and PE). Morbidly obese patients were 1.7 times more likely to be diagnosed with a PE compared with normal BMI ( P = .004). Increased BMI was associated with the co-diagnosis of PE and DVT ( P = .027). Patients with BMI <18.5 were 1.4 times more likely to experience a VTE compared with normal BMI ( P = .018). Patients with a VTE were 3.2 times more likely to die ( P < .001) and less likely to be discharged home ( P < .001). Discussion Our study found that obese and underweight EGS patients had an increased incidence of VTE. Risk recognition and chemoprophylaxis may improve outcomes in this population.
A Randomized Controlled Trial of Dexamethasone as a Prophylactic Treatment for Subglottic Stenosis in a Rabbit Model
Authors: Wistermayer Paul , Escalante Derek , McIlwain Wesley , Rogers Derek J. 
Published: August 2020

Objective: Iatrogenic injury is a common cause of subglottic stenosis (SGS). We investigated the role of pre-injury dexamethasone as a preventive treatment for iatrogenic subglottic stenosis. Methods: 16 New Zealand White rabbits were used in an IACUC approved study. Subjects were divided into two groups: intramuscular dexamethasone (DEX) at a dose of 2 mg/kg 15 minutes prior to an endoscopic injury to create SGS, and the same injury creation with a preoperative intramuscular saline (SAL) injection. Three independent, blinded raters evaluated endoscopic images to obtain cross sectional area (CSA) airway measurements. Rabbit airways were measured just prior to injury and at one week post-injury. All subjects were provided as-needed postoperative steroids and buprenorphine for symptoms of respiratory distress. Data analysis was performed using Student t-test. Intraclass correlation coefficients were used to assess inter-rater agreement. Results: All subjects survived to the one-week post-injury airway evaluation. There was no difference in airway size between groups prior to injury ( P = .28). Subjects in the DEX group demonstrated an average stenosis of 20.3% (95% CI 10.2-30.5) at one week compared to 60.6% (95% CI 40.3-80.9) in the SAL group ( P = .01). Subjects in the control group required significantly more doses of postoperative dexamethasone ( P = .02). Inter-rater agreement for between raters was excellent (ICC = .88). Conclusion: This is the first study to examine the role of pre-injury glucocorticoids in preventing iatrogenic subglottic stenosis. In our model, a single dose of intramuscular dexamethasone given prior to a subglottic injury resulted in a statistically significant reduction in airway stenosis. This research suggests that administering systemic dexamethasone should be considered prior to any procedure that may injure the subglottis, including traumatic intubation, to prevent iatrogenic subglottic stenosis.
Master’s-Level Education in the Governmental Public Health Workforce
Authors: Leider Jonathon P. , Sellers Katie , Bogaert Kyle , Castrucci Brian C. , Erwin Paul C. 
Published: August 2020

Objectives More than 16 000 graduate degrees in public health are awarded annually. Yet only 14% of the governmental public health workforce has formal public health training of any kind, and 8% has a master of public health (MPH) degree. We characterized the differences among governmental staff members with master’s degrees across US health departments. Methods We used data from the 2017 Public Health Workforce Interests and Needs Survey, a national survey of state and local public health departments (43 669 responses; response rate, 48%). We examined the characteristics of the workforce by educational attainment and compared respondents who had obtained a “terminal” (ie, highest degree obtained) MPH degree with respondents who had obtained a terminal non–public health (non-PH) master’s degree. Results Respondents who had a non-PH master’s degree were as likely as respondents who had an MPH degree to hold a supervisory role (43% vs 41%; P = .67). We found only 1 significant difference between the 2 groups: respondents aged ≤40 with a terminal MPH degree were significantly less likely than respondents aged ≤40 with a non-PH master’s degree to earn more than the national average salary (adjusted odds ratio = 0.67; 95% CI, 0.47-0.97; P = .03). Conclusions We found only marginal differences in career outcomes for people working in governmental public health who had a terminal MPH degree vs a terminal non-PH master’s degree. This finding does not necessitate a full reconsideration of the MPH as it relates to governmental public health practice but a greater recognition that there are multiple paths into practice.
Perspectives of primary school staff who work with children with additional needs: Insights that may help to improve support for visually impaired children
Authors: Pease Anna , Goodenough Trudy , Roe Joao , Rogers Sue , Williams Cathy 
Published: August 2020

Educational support for children with visual impairments (VIs) at school relies on effective information-sharing between hospital eye services and schools. There may be delays in this process which impede school staff’s efforts to help affected children. As part of a programme of work aiming to improve outcomes for children with cerebral visual impairments (CVIs), this study carried out qualitative interviews to understand the views of primary school staff about receiving and using external specialist advice in general. These data can be used to inform and improve information-sharing aimed at supporting children in primary school who have VI. Views of primary school teachers and staff with responsibility for supporting children with additional needs were elicited in nine interviews, across three mainstream primary school settings in Gloucestershire, UK. Interviews were carried out in October 2017. Participants were asked about their experiences of working with children with additional needs and engaging with outside specialist providers. Thematic analysis was used to look for patterns in the data. Interviews revealed four major themes: understanding the condition (including training, individual differences, and understanding the aim of the strategy); translating reports into action (including adaptations to recommendations, team working, and communication formats); follow-up (including feedback and measuring progress); and barriers and opportunities for accessing support (including systematic barriers, going private, and ideal scenarios). This small study provides insights into how teachers and school staff perceive the relationship with external specialists. Services for children with VI in primary schools may be enhanced if they provide information about the impact of VI; about the underlying conditions if known, training and awareness activities for staff and offer a route for follow-up or enquiries. These insights can be used to inform service design and policy.