bluuebunny/crossref_metadata_2025_split huggingface dataset:
Racial and ethnic disparities in SARS-CoV-2 pandemic: analysis of a COVID-19 observational registry for a diverse US metropolitan population
Authors: Vahidy Farhaan S , Nicolas Juan Carlos , Meeks Jennifer R , Khan Osman , Pan Alan , Jones Stephen L , Masud Faisal , Sostman H Dirk , Phillips Robert , Andrieni Julia D , Kash Bita A , Nasir Khurram 
Published: August 2020

IntroductionData on race and ethnic disparities for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are limited. We analysed sociodemographic factors associated with higher likelihood of SARS-CoV-2 infection and explore mediating pathways for race and ethnic disparities in the SARS-CoV-2 pandemic.MethodsThis is a cross-sectional analysis of the COVID-19 Surveillance and Outcomes Registry, which captures data for a large healthcare system, comprising one central tertiary care hospital, seven large community hospitals and an expansive ambulatory/emergency care network in the Greater Houston area. Nasopharyngeal samples for individuals inclusive of all ages, races, ethnicities and sex were tested for SARS-CoV-2. We analysed sociodemographic (age, sex, race, ethnicity, household income, residence population density) and comorbidity (Charlson Comorbidity Index, hypertension, diabetes, obesity) factors. Multivariable logistic regression models were fitted to provide adjusted OR (aOR) and 95% CI for likelihood of a positive SARS-CoV-2 test. Structural equation modelling (SEM) framework was used to explore three mediation pathways (low income, high population density, high comorbidity burden) for the association between non-Hispanic black (NHB) race, Hispanic ethnicity and SARS-CoV-2 infection.ResultsAmong 20 228 tested individuals, 1551 (7.7%) tested positive. The overall mean (SD) age was 51.1 (19.0) years, 62% were females, 22% were black and 18% were Hispanic. NHB and Hispanic ethnicity were associated with lower socioeconomic status and higher population density residence. In the fully adjusted model, NHB (vs non-Hispanic white; aOR, 2.23, CI 1.90 to 2.60) and Hispanic ethnicity (vs non-Hispanic; aOR, 1.95, CI 1.72 to 2.20) had a higher likelihood of infection. Older individuals and males were also at higher risk of infection. The SEM framework demonstrated a significant indirect effect of NHB and Hispanic ethnicity on SARS-CoV-2 infection mediated via a pathway including residence in densely populated zip code.ConclusionsThere is strong evidence of race and ethnic disparities in the SARS-CoV-2 pandemic that are potentially mediated through unique social determinants of health.
Complementary medicine visits by palliative care patients: a cross-sectional survey
Authors: Steel Amie , Schloss Janet , Diezel Helene , Palmgren Per J , Maret Jean Baptiste , Filbet Marilène 
Published: August 2020

BackgroundThe paucity of empirical research examining complementary medicine (CM) use in palliative care in France compared with other countries results in a gap in scientific knowledge. This study aims to describe the frequency and the cause of palliative care patients consulting with a CM clinician along with the conventional physicians.MethodsThis study is an observational cross-sectional survey conducted in three palliative care centres in Lyon, France, between July 2017 and May 2018: two tertiary hospitals and one palliative care unit in a private hospital. Inpatients and outpatients visiting the palliative care clinics with a primary diagnosis of cancer were invited to participate in the study. Using a 19-item paper-based survey instrument, we collected data on the participants’ personal characteristics, health service utilisation and attitudes towards CM.ResultsFrom the 138 participants meeting the inclusion criteria, 100 (72.4%) were included in the study. On average, they were 62.9 years old (SD 12.4) and the majority were women (60%). The primary cancer site was mostly colorectal (29.0%), breast (15.0%) and gynaecological (11.0%). The most commonly visited CM clinician was the aromatherapist (72.7%), recording more than six consultations (78.1%) for symptom management (21.9%). Visits to an osteopath were reported by 28.6% of patients, and 45.8% of osteopathy users reported visiting an osteopath more than six times for symptom management (62.5%). Participants visiting a naturopath (15.3%) reported less than four visits and indicated symptom management as the most common reason (76.9%).ConclusionsOur findings show a substantial proportion of palliative care patients visit CM clinicians and primarily seek symptom management from CM clinical care.
Symptom reduction in palliative care from single session mindful breathing: a randomised controlled trial
Authors: Look Mei Ling , Tan Seng Beng , Hong Li Li , Ng Chong Guan , Yee Hway Ann , Lim Liang Yik , Ng Diana Leh Ching , Chai Chee Shee , Loh Ee Chin , Lam Chee Loong 
Published: August 2020

ContextThere has been increasing evidence of the role of mindfulness-based interventions in improving various health conditions. However, the evidence for the use of mindfulness in the palliative care setting is still lacking.ObjectivesThe objective of our study was to determine the efficacy of a single session of 20 min mindful breathing in alleviating multiple symptoms in palliative care.MethodsAdult palliative care in patients with at least one symptom scoring ≥5/10 based on the Edmonton Symptom Assessment Scale (ESAS) were recruited from September 2018 to December 2018. Recruited patients were randomly assigned to either 20 min mindful breathing and standard care or standard care alone.ResultsForty patients were randomly assigned to standard care plus a 20 min mindful breathing session (n=20) or standard care alone (n=20). There was statistically significant reduction of total ESAS score in the mindful breathing group compared with the control group at minute 20 (U=98, n1= n2= 20, mean rank1= 15.4, mean rank2= 25.6, median reduction1= 6.5, median reduction2= 1.5, z=−2.763, r=0.3, p=0.005).ConclusionOur results provided evidence that a single session of 20 min mindful breathing was effective in reducing multiple symptoms rapidly for palliative care patients.
Depression treatment research in people with cancer does not reflect cancer prevalence: findings from a systematic review
Authors: Bravery Benjamin , Loughnan Siobhan , Murphy Michael 
Published: August 2020

BackgroundOne in six people with cancer will develop depression at some point in their care. Untreated depression affects quality of life, cancer care satisfaction and healthcare expenditure. Treatments for this vulnerable heterogenous population should be evidence based and specific. A common sentiment is that psychiatric research does not reflect the prevalence of patients with cancer and comorbid depression and is biased towards certain cancers, but this has not been empirically shown.Study selection and analysisA systematic review of studies on psychological and pharmacological treatments for depression in people with cancer was conducted. Of 4621 papers identified from a search of PubMed and PsycINFO up to 27 June 2020, 84 met inclusion criteria (eg, adults with cancer; depression diagnosis; treatment study) and comprised 6048 participants with depression with cancer.FindingsCancer types are not proportionally represented in depression research in accordance with their incidence. Breast cancer is over-represented (relative frequency in research 49.3%, but 11.7% of global cancer). Cancers of the head and neck and bone and soft tissue were close to parity. All other cancers are under-represented. Representativeness varied 40-fold across different cancers.ConclusionsThe evidence base for depression treatments is dominated by a single cancer. Given heterogeneity in cancer populations (eg, stage of illness; psychological impact; cancer treatments), it is possible that depression treatments may not have the same benefits and harms across all cancers, impeding the ability to offer people with different cancers the best depression treatment. While the dominant opinion within this research field is that a cancer bias exists, this is the first study to demonstrate as such.
Incidence and characteristics of paediatric abusive head trauma in Taiwan, 2006–2015: a nationwide population-based study
Authors: Chang Yi-Ting , Chang Hsin-Yi , Chen Li-Wen , Lu Tsung-Hsueh , Tsai Hui-Ju , Chen Yi-Wen , Chang Yu-Chun , Feng Jui-Ying 
Published: August 2020

ObjectivesTo examine the incidence rate and characteristics of paediatric abusive head trauma (PAHT) among children under age 5 years in Taiwan.MethodsThe International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) was used to identify broad and narrow definitions of children aged under 5 years with PAHT from 2006 to 2015 in Taiwan using a representative national insurance research database. Medical resource utilisation was also analysed. Incidence rates per 100 000 person-years were calculated and presented with 95% CI. Joinpoint regression analysis was used to detect the changes in trends and calculate the annual percentage change in PAHT incidence over time.ResultsFrom 2006 to 2015, 479 (narrow definition) and 538 (broad definition) PAHT cases were identified. Incidence rates of PAHT by narrow and broad definitions among children under 1 year of age (18.7/100 000 and 20.0/100 000) were nearly 10-fold or 20-fold higher than for children aged 1–2 (1.7/100 000 and 2.1/100 000) and 3–5 (0.9/100 000 and 1.2/100 000) years. The PAHT incidence significantly increased since 2012, with trends varying by age and gender. Our results suggest that over 40% of the children with PAHT experienced serious injury and nearly 13% were fatal cases. For 87% (n=57) of fatal cases, this was their first ever hospitalisation. The number of fatal cases among infants was fourfold higher than that of children aged 1–5 years.ConclusionsThis study provides a robust national estimate of PAHT and identifies infants as the most vulnerable group for PAHT in Taiwan. Education to enhance healthcare profession’s sensitivity and competence for the early identification and diagnosis of PAHT is critical.
Global systematic review of the effects of suicide prevention interventions in Indigenous peoples
Authors: Leske Stuart , Paul Elise , Gibson Mandy , Little Brock , Wenitong Mark , Kolves Kairi 
Published: August 2020

ObjectiveSuicide rates are often higher in Indigenous than in non-Indigenous peoples. This systematic review assessed the effects of suicide prevention interventions on suicide-related outcomes in Indigenous populations worldwide.MethodsWe searched CINAHL, Embase, PubMed, PsycINFO, ProQuest Dissertations & Theses and Web of Science from database inception to April 2020. Eligible were English language, empirical and peer-reviewed studies presenting original data assessing the primary outcomes of suicides and suicide attempts and secondary outcomes of suicidal ideation, intentional self-harm, suicide or intentional self-harm risk, composite measures of suicidality or reasons for life in experimental and quasi-experimental interventions with Indigenous populations worldwide. We assessed the risk of bias with the Cochrane Risk of Bias Tool and the Risk of Bias Assessment for Non-randomised Studies.FindingsWe included 24 studies from Australia, Canada, New Zealand and the USA, comprising 14 before–after studies, 4 randomised controlled trials (RCTs), 3 non-randomised controlled trials, 2 interrupted time-series designs and 1 cohort study. Suicides decreased in four and suicide attempts in six before–after studies. No studies had a low risk of bias. There was insufficient evidence to confirm the effectiveness of any one suicide prevention intervention due to shortage of studies, risk of bias, and population and intervention heterogeneity. Review limitations include language bias, no grey literature search and data availability bias.ConclusionFor the primary outcomes of suicides and suicide attempts, the limited available evidence supports multilevel, multicomponent interventions. However, there are limited RCTs and controlled studies.
Multilevel regression and poststratification for estimating population quantities from large health studies: a simulation study based on US population structure
Authors: Downes Marnie , Carlin John 
Published: August 2020

IntroductionRecruiting a representative sample of participants is becoming increasingly difficult in large-scale health surveys. Multilevel regression and poststratification (MRP) has been shown to be effective in estimating population descriptive quantities in non-representative samples. We performed a simulation study, previously applied to an Australian population, this time to a US population, to assess MRP performance.MethodsData were extracted from the 2017 Current Population Survey representing a population of US adult males aged 18–55 years. Simulated datasets of non-representative samples were generated. State-level prevalence estimates for a dichotomous outcome using MRP were compared with the use of sampling weights (with and without raking adjustment). We also investigated the impact on MRP performance of sample size, model misspecification, interactions and the addition of a geographic-level covariate.ResultsMRP was found to achieve generally superior performance, with large gains in precision vastly outweighing the increased accuracy observed for sampling weights with raking adjustment. MRP estimates were generally robust to model misspecification. We found a tendency of MRP to over-pool between-state variation in the outcome, particularly for the least populous states and small sample sizes. The inclusion of a state-level covariate appeared to mitigate this and further improve MRP performance.DiscussionMRP has been shown to be effective in estimating population descriptive quantities in two different populations. This provides promising evidence for the general applicability of MRP to populations with different geographic structures. MRP appears to be a valuable analytic strategy for addressing potential participation bias from large-scale health surveys.
Progression of coal workers’ pneumoconiosis absent further exposure
Authors: Almberg Kirsten S , Friedman Lee S , Rose Cecile S , Go Leonard H T , Cohen Robert A 
Published: August 2020

ObjectivesThe natural history of coal workers’ pneumoconiosis (CWP) after cessation of exposure remains poorly understood.MethodsWe characterised the development of and progression to radiographic progressive massive fibrosis (PMF) among former US coal miners who applied for US federal benefits at least two times between 1 January 2000 and 31 December 2013. International Labour Office classifications of chest radiographs (CXRs) were used to determine initial and subsequent disease severity. Multivariable logistic regression models were used to identify major predictors of disease progression.ResultsA total of 3351 former miners applying for benefits without evidence of PMF at the time of their initial evaluation had subsequent CXRs. On average, these miners were 59.7 years of age and had 22 years of coal mine employment. At the time of their first CXR, 46.7% of miners had evidence of simple CWP. At the time of their last CXR, 111 miners (3.3%) had radiographic evidence of PMF. Nearly half of all miners who progressed to PMF did so in 5 years or less. Main predictors of progression included younger age and severity of simple CWP at the time of initial CXR.ConclusionsThis study provides further evidence that radiographic CWP may develop and/or progress absent further exposure, even among miners with no evidence of radiographic pneumoconiosis after leaving the industry. Former miners should undergo regular medical surveillance because of the risk for disease progression.
Paediatric reproducibility limits for the forced expiratory volume in 1 s
Authors: Stanojevic Sanja , Filipow Nicole , Ratjen Felix 
Published: August 2020

BackgroundCurrent reproducibility standards for spirometry were derived using a small adult dataset and may not be optimal for interpretation of repeated measurements of lung function in children.ObjectiveTo define reproducibility limits for forced expiratory volume in 1 s (FEV1) change that represent the normal within-subject between-visit variability in healthy children and evaluate these limits as a tool to monitor children with cystic fibrosis (CF).MethodsRepeated FEV1 measurements (3 months to 5 years apart) from healthy children from the Global Lung Function Initiative data repository were used to derive a conditional change score. Spirometry and clinical data from a CF clinical database was used to verify utility in clinical practice.ResultsA reproducibility change score was derived from 47 938 FEV1 measures from 7885 healthy children 6–18 years of age. The simple algorithm, which is conditional on the initial measurement, also accounts for age and time interval between measurements. The change score limits of reproducibility were much narrower than currently used cut-offs. Specifically, changes, considered as improvements using either a 12% or 10% relative change from baseline, are too wide for children. In CF, there was overall agreement between different approaches, with the distinct advantage that the change score was not biased by regression to the mean.ConclusionsCompared with current approaches to interpretation of repeated lung function measurements, the proposed change score was less biased and provides a simple alternative to reduce misinterpretation.
Exercise above the maximal lactate steady state does not elicit a V̇O2 slow component that leads to attainment of V̇O2max
Authors: Hill David W. , McFarlin Brian K. , Vingren Jakob L. 
Published: August 2020

There is a pervasive belief that the severe-intensity domain is defined as work rates above the power associated with a maximal lactate steady state (MLSS) and by a oxygen uptake (V̇O2) response that demonstrates a rapid increase (primary phase) followed by a slower increase (slow component), which leads to maximal oxygen uptake (V̇O2max) if exercise is continued long enough. Fifteen university students performed 5 to 7 tests to calculate power at MLSS (154 ± 29 W). The tests included 30 min of exercise at each of 3 work rates: (i) below (–2 ± 1 W) power at MLSS, (ii) above (+4 ± 1 W) the power at MLSS, and (iii) well above (+19 ± 8 W) power at MLSS. The V̇O2 response in each test was described using mathematical modeling. Contrary to expectation, the response at the supra-MLSS work rates had not 2, but 3, distinct phases: the primary phase and the slow component, plus a “delayed” third phase, which emerged after ∼15 min. V̇O2max was not attained at supra-MLSS work rates. These results challenge commonly held beliefs about definitions and descriptions of exercise intensity domains. Novelty: The V̇O2 response at work rates that are too high to sustain a lactate steady state but not high enough to elicit V̇O2max features not 2, but 3, distinct phases. There is no consensus on whether intensity domains should be defined by their boundaries or by the responses they engender.
Abstract A014: Development of a culturally grounded brochure to enhance colorectal cancer screening in Southwestern American Indian communities
Authors: Sussman Andrew L. , English Kevin , Frank Matthew , Guest Dolores , Helitzer Deborah , Mishra Shiraz 
Published: August 2020

Abstract
Elimination of colorectal cancer disparities is a national priority. Despite the effectiveness of colorectal cancer (CRC) screening tests for average risk adults, these tests are underutilized by American Indians/Alaska Natives. Subsequently, these populations have experienced either no change or an increase in CRC incidence. Prior to conducting a trial to determine the efficacy of interventions of graded intensity on screening behavior among six tribal communities in the Southwest United States, we set out to develop a culturally appropriate and theoretically grounded brochure to increase community demand for CRC screening. In order to ensure the brochure's health literacy to diverse tribal participants, we utilized the Suitability Assessment of Materials and Comprehensibility of Materials (SAM+CAM) instrument as a basis for structuring this process. Using an iterative process, we conducted two focus groups and made modifications to the brochure. We then implemented the SAM+CAM assessment. We report here on the findings from both the focus groups and the SAM+CAM testing. We organized focus group findings by the SAM+CAM categories, including content, literacy demand, numeracy, graphic material, layout/typography, and learning stimulation/motivation. We will provide quotes and summaries of the relevance for each of these SAM+CAM categories. By structuring focus groups with American Indian participants using these categories, we then made revisions to the brochure. The resulting SAM+CAM scores confirmed that the brochure was suitable and comprehensible to participants. Overall, the SAM+CAM scores were generally high as the overall rating was 90%, which indicates a superior product. Using this participatory and iterative process, we found that structuring the development and revision of the brochure through the SAM+CAM categories provided a useful process to balance the presentation of evidence-based data for CRC screening with community preferences and norms.
Citation Format: Andrew L. Sussman, Kevin English, Matthew Frank, Dolores Guest, Deborah Helitzer, Shiraz Mishra. Development of a culturally grounded brochure to enhance colorectal cancer screening in Southwestern American Indian communities [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr A014.