bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cognitive skills of emergency medical services crew members: a literature review
Authors: Sedlár Martin 
Published: May 2020

Abstract
Background
Situation awareness and decision making, listed in non-technical skills taxonomies, are critical for effective and safe performance in high-risk professions. These cognitive skills and their behavioral markers have been studied less in emergency medical services (EMS) crew members. This paper aims to review the existing literature and identify important aspects and behavioral markers of situation awareness and decision making in EMS crew members – those who work in the role of prehospital emergency care providers – and to synthesize findings as a basis for developing a rating and training tool.

Method
The search for relevant articles was conducted using electronic databases, reference lists of relevant reviews and included articles and personal collection of articles. The selection process based on the PRISMA statement yielded a total of 30 articles that met the eligibility criteria. Their findings were qualitatively synthesized using the structured approach, informed by the already known structure: situation awareness and its elements (gathering information, interpreting information, anticipating future states), decision making and its elements (generating and considering options, selecting and implementing an option, reviewing outcome/decision). Moreover, the element of maintaining standards also emerged as highly relevant for cognitive skills.

Results
This review found an increased research interest in the non-technical cognitive skills of EMS crew members. The majority of included articles’ research designs were qualitative, then mixed, Delphi, and quantitative. It revealed several specifics of cognitive skills, such as EMS crew members need to holistically assess a wide range of cues and information, to make various health- and safety-related decisions and take EMS standards into account. However, there was only a limited number of observable markers of cognitive skills, such as acts and verbalizations, that could be considered as examples of good behavior. In addition, findings indicate a lack of articles focused on mass-casualty incidents and the interconnection of cognitive skills with other non-technical and medical skills.

Conclusion
Further research is needed to get a more comprehensive view of behavioral markers of cognitive skills and to develop a rating and training tool to improve EMS crew members’ cognitive performance.
Association of simple renal cysts and chronic kidney disease with large abdominal aortic aneurysm
Authors: Miszczuk Milena , Müller Verena , Althoff Christian E. , Stroux Andrea , Widhalm Daniela , Dobberstein Andy , Greiner Andreas , Kuivaniemi Helena , Hinterseher Irene 
Published: May 2020

Abstract
Background
Abdominal aortic aneurysms (AAA) primarily affect men over 65 years old who often have many other diseases, with similar risk factors and pathobiological mechanisms to AAA. The aim of this study was to assess the prevalence of simple renal cysts (SRC), chronic kidney disease (CKD), and other kidney diseases (e.g. nephrolithiasis) among patients presenting with AAA.

Methods
Two groups of patients (97 AAA and 100 controls), with and without AAA, from the Surgical Clinic Charité, Berlin, Germany, were selected for the study. The control group consisted of patients who were evaluated for a kidney donation (n = 14) and patients who were evaluated for an early detection of a melanoma recurrence (n = 86). The AAA and control groups were matched for age and sex. Medical records were analyzed and computed tomography scans were reviewed for the presence of SRC and nephrolithiasis.

Results
SRC (74% vs. 57%; p<0.016) and CKD (30% vs. 8%; p<0.001) were both more common among AAA than control group patients. On multivariate analysis, CKD, but not SRC, showed a strong association with AAA.

Conclusions
Knowledge about pathobiological mechanisms and association between CKD and AAA could provide better diagnostic and therapeutic approaches for these patients.
Feasibility of an integrated multidisciplinary geriatric rehabilitation programme for older stroke patients: a process evaluation
Authors: Vluggen Tom P. M. M. , van Haastregt Jolanda C. M. , Verbunt Jeanine A. , van Heugten Caroline M. , Schols Jos M. G. A. 
Published: May 2020

Abstract
Background
Almost half of the stroke patients admitted to geriatric rehabilitation has persisting problems after discharge. Currently, there is no evidence based geriatric rehabilitation programme available for older stroke patients, combining inpatient rehabilitation with adequate aftercare aimed at reducing the impact of persisting problems after discharge from a geriatric rehabilitation unit. Therefore, we developed an integrated multidisciplinary rehabilitation programme consisting of inpatient neurorehabilitation treatment using goal attainment scaling, home based self-management training, and group based stroke education for patients and informal caregivers. We performed a process evaluation to assess to what extent this programme was performed according to protocol. Furthermore, we assessed the participation of the patients in the programme, and the opinion of patients, informal caregivers and care professionals on the programme.

Methods
In this multimethod study, process data were collected by means of interviews, questionnaires, and registration forms among 97 older stroke patients, 89 informal caregivers, and 103 care professionals involved in the programme.

Results
A part of patients and informal caregivers did not receive all key elements of the programme. Almost all patients formulated rehabilitation goals, but among two thirds of the patients the goal attainment scaling method was used. Furthermore, the self-management training was considered rather complex and difficult to apply for frail elderly persons with stroke, and the percentage of therapy sessions performed in the patients’ home environment was lower than planned. In addition, about a quarter of the patients and informal caregivers attended the education sessions. However, a majority of patients, informal caregivers and care professionals indicated the beneficial aspects of the programme.

Conclusion
This study revealed that although the programme in general is perceived to be beneficial by patients, and informal and formal caregivers, the feasibility of the programme needs further attention. Because of persisting cognitive deficits and specific care needs in our frail and multimorbid target population, some widely used methods such as goal attainment scaling, and self-management training seemed not feasible in their current form. To optimize feasibility of the programme, it is recommended to tailor these elements more optimally to the population of frail older patients.
Percutaneous mastoid electrical stimulator improves Poststroke depression and cognitive function in patients with Ischaemic stroke: a prospective, randomized, double-blind, and sham-controlled study
Authors: Lu Taoli , He Lanying , Zhang Bei , Wang Jian , Zhang Lili , Dong Wei Wei , Yang Hao 
Published: May 2020

Abstract
Background
Poststroke depression can lead to functional dependence, cognitive impairment and reduced quality of life. The aim of this study was to evaluate the effects of a percutaneous mastoid electrical stimulator (PMES) plus antidepressants on poststroke depression and cognitive function.

Methods
This study was a prospective, randomized, double-blind, and sham-controlled study. A total of 258 clinically depressed ischaemic stroke patients within 14 days of index stroke were randomly assigned to the PMES plus antidepressant (PMES group, N = 125) and sham plus antidepressant (sham group, N = 133) groups. All patients underwent the Montreal Cognitive Assessment (MoCA) and Hamilton Rating Scale for Depression (HRSD) test at 2 weeks (baseline), and 6 months(M6) after ischaemic stroke. Primary outcomes were the percentage of patients showing a treatment response (≥50% reduction in HRSD score) and depression remission (HRSD score ≤ 9) at 6 months. The secondary outcome was the percentage of patients with a MoCA score < 26.

Results
The percentages of patients showing a treatment response and depression remission were significantly higher in the PMES group than in the sham group (57.60% vs 41.35%, P = 0.009; 44.00% vs 29.32%, P = 0.014 respectively). The mean value of the HRSD score change [M (month)6-baseline] was significantly higher in the PMES group than in the sham group at 6 months (− 11.93 ± 5.32 vs − 10.48 ± 6.10, P = 0.036, respectively). The percentage of patients with MoCA scores < 26 was lower in the PEMS group than in the sham group (12.0% vs 24.06%, P = 0.012,respectively), and the mean value of the MoCA score change (M6-baseline) was higher in the PMES group than in the sham group (3.50 ± 2.55 vs 2.72 ± 2.52, P = 0.005, respectively).

Conclusion
These findings demonstrate that PMES adjunctive to antidepressant therapy is effective in reducing depression, achieving remission in the short term, and improving cognition.

Trial registration
This trial was retrospectively registered (registration number: ChiCTR1800016463) on 03 June 2018.
Utilization pattern of kangaroo mother care after introduction in eight selected neonatal intensive care units in China
Authors: Liu Xin , Li Zhankui , Chen Xiaohui , Cao Bei , Yue Shaojie , Yang Changyi , Liu Qiongyu , Yang Chuanzhong , Zhao Gengli , Feng Qi 
Published: May 2020

Abstract
Background
Kangaroo mother care (KMC) is an evidence-based and cost-effective intervention that could prevent severe complications for preterm babies, however it has not been widely adopted in China. In this study, we aim to investigate the feasibility and parental experience of adopting KMC in a Chinese context by studying the implementation of a KMC program in eight self-selected neonatal intensive care units (NICUs).

Methods
A cross-sectional study of 135 preterm infants discharged from eight NICUs in April 2018. For infants information was collected on postnatal day and corrected gestational age (GA) at KMC initiation, frequency and duration of KMC provision and whether the infant was receiving respiratory support. A nurse-administered questionnaire on parents’ knowledge and experience of KMC provision was administered to parents providing KMC.

Results
One hundred thirty-five preterm infants received KMC, 21.2% of all preterm infants discharged. 65.2% of those who received KMC were below 32 weeks GA, 60.7% had a birth weight below 1500 g, and 20.7% needed respiratory support at KMC initiation. Average KMC exposure was greater in infants born at GA < 28 weeks that babies born at greater GA. 94.8% of parents that participated in the parental survey indicated that KMC was positively accepted by their family members; 60.4% of the parents claimed that KMC could relieve anxiety, 57.3% claimed it prompted more interactions with medical staff and 69.8% suggested it increased parental confidence in care for their infants.

Conclusions
After advocacy, training and promotion, intermittent KMC was initiated on more immature and high-risk infants, and well-accepted by parents. We suggest continuing to promote KMC education to parents and enhancing preterm infant health.
Emergency department attendance for injury and behaviours suggestive of attention deficit hyperactivity disorder (ADHD): a cross-sectional study
Authors: Conversano Ester , Tassinari Alice , Monasta Lorenzo , Skabar Aldo , Pavan Matteo , Maestro Alessandra , Barbi Egidio , Cozzi Giorgio 
Published: May 2020

AbstractBackgroundThe study aimed to investigate if the behaviours suggestive of ADHD were more frequent in a population of children attending the Emergency Department (ED) for injuries, rather than for other causes.MethodsA cross-sectional study was carried out. Patients, aged 6 to 17 years, attending the ED for acute injuries and other causes were considered cases and controls, respectively. We used a questionnaire, which investigates the presence in the child of inattention, hyperactivity, and impulsivity. The primary outcome was the number of children with behaviours suggestive of ADHD in cases and controls.ResultsFive hundred forty-five children were enrolled, 251 with injuries and 294 with other complains. Twenty two out of two hundred fifty one (9%) children visited for injuries, and 30 out of 294 (10%) visited for other causes had behaviours suggestive of ADHD (p = 0.661). Among these cases, children with evocative ADHD scores had a higher probability (OR 4.52; 95% CI 1.45–14.04;p = 0.009) of having had more than five previous ED accesses due to injury, compared to the others.ConclusionsThis study did non shown a difference in behaviours suggestive of ADHD between cases and controls, but identified a population of children with behaviours suggestive of ADHD who more frequently access the ED for injuries.
Number of children and the prevalence of later-life major depression and insomnia in women and men: findings from a cross-sectional study of 0.5 million Chinese adults
Authors: Wang Hanyu , Chen Minne , Xin Tong , Tang Kun 
Published: May 2020

Abstract
Background
Pregnancy and parenthood have been associated with physical and mental health. Previous literature concerning the impacts of parity on mental health was inconsistent and lack epidemiolocal evidence. China, with growing mental health problems and changing fertility patterns, faces unique challenges. This study aims to examine the relationship between parity and the prevalence of major depression and insomnia among men and women in the Chinese population.

Methods
Baseline data from a Chinese population-based study of 512,891 adults (59.01% women) from 10 areas, aged 30–79 were analyzed. Number of children was based on self-report by the participants. Major depression (MD) was assessed using the Composite International Diagnostic Inventory. Insomnia symptoms were accessed by a questionnaire comparable to that used in the Diagnostic and Statistical Manual of Mental Disorders. Logistic regression was used to assess the relationship between MD/Insomnia and number of children, after stratifications and adjustments.

Results
For women, each additional child was associated with a 9% decreased odds of MD (OR: 0.91, 95%CI: 0.88–0.96), with the associations significant for those who lived in urban areas (OR: 0.76, 95%CI: 0.70–0.83), or had a lower education (OR: 0.90, 95%CI: 0.85–0.94), or had lower household income (OR: 0.89, 95%CI: 0.85–0.94), or had ever used alcohol (OR: 0.89, 95%CI: 0.84–0.93). The association between per additional children and MD was not significant in men (OR: 1.02, 95%CI: 0.97–1.07), but a decreased odd of MD with per additional child was found in men who lived in urban areas (OR: 0.81, 95%CI: 0.71–0.96). For women, each additional child was associated with a 4% decreased odds of insomnia (OR: 0.96, 95%CI: 0.95–0.96). Each additional child was also associated with a 2% decreased odds of insomnia in men (OR: 0.98, 95%CI: 0.97–1.00).

Conclusions
MD and insomnia were inversely associated with number of children in women while the association was not overall significant in men. The association was mediated by socioeconomic and lifestyle factors. Future mental health public health programs should address parity and sex differences when designing interventions.
A comparison of the Indian diet with the EAT-Lancet reference diet
Authors: Sharma Manika , Kishore Avinash , Roy Devesh , Joshi Kuhu 
Published: May 2020

Abstract
Background
The 2019 EAT-Lancet Commission report recommends healthy diets that can feed 10 billion people by 2050 from environmentally sustainable food systems. This study compares food consumption patterns in India, from different income groups, regions and sectors (rural/urban), with the EAT-Lancet reference diet and highlights the deviations.

Methods
The analysis was done using data from the Consumption Expenditure Survey (CES) of a nationally representative sample of 0.102 million households from 7469 villages and 5268 urban blocks of India conducted by the National Sample Survey Organization (NSSO) in 2011–12. This is the most recent nationally representative data on household consumption in India. Calorie consumption (kcal/capita/day) of each food group was calculated using the quantity of consumption from the data and nutritional values of food items provided by NSSO. Diets for rural and urban, poor and rich households across different regions were compared with EAT-Lancet reference diet.

Results
The average daily calorie consumption in India is below the recommended 2503 kcal/capita/day across all groups compared, except for the richest 5% of the population. Calorie share of whole grains is significantly higher than the EAT-Lancet recommendations while those of fruits, vegetables, legumes, meat, fish and eggs are significantly lower. The share of calories from protein sources is only 6–8% in India compared to 29% in the reference diet. The imbalance is highest for the households in the lowest decile of consumption expenditure, but even the richest households in India do not consume adequate amounts of fruits, vegetables and non-cereal proteins in their diets. An average Indian household consumes more calories from processed foods than fruits.

Conclusions
Indian diets, across states and income groups, are unhealthy. Indians also consume excess amounts of cereals and not enough proteins, fruits, and vegetables. Importantly, unlike many countries, excess consumption of animal protein is not a problem in India. Indian policymakers need to accelerate food-system-wide efforts to make healthier and sustainable diets more affordable, accessible and acceptable.
Health-related quality of life associates with change in FEV1 in COPD: results from the COSYCONET cohort
Authors:   for the COSYCONET Study Group, Lutter Johanna I. , Jörres Rudolf A. , Kahnert Kathrin , Schwarzkopf Larissa , Studnicka Michael , Karrasch Stefan , Schulz Holger , Vogelmeier Claus F. , Holle Rolf 
Published: May 2020

AbstractBackgroundForced expiratory volume in one second (FEV1) characterizes the pathophysiology of COPD and different trajectories of FEV1decline have been observed in patients with COPD (e.g. gradual or episodic). There is limited information about the development of patient-reported health-related quality of life (HRQL) over the full range of the natural history of COPD. We examined the longitudinal association between change in FEV1and change in disease-specific and generic HRQL.MethodsWe analysed data of 1734 patients with COPD participating in the COSYCONET cohort with up to 3 years of follow-up. Patients completed the Saint George’s Respiratory Questionnaire (SGRQ) and the EQ-5D Visual Analog Scale (EQ VAS). Change score models were used to investigate the relationship between HRQL and FEV1and to calculate mean changes in HRQL per FEV1change categories [decrease (≤ − 100 ml), no change, increase (≥ 100 ml)] after 3 years. Applying hierarchical linear models (HLM), we estimated the cross-sectional between-subject difference and the longitudinal within-subject change of HRQL as related to a FEV1difference or change.ResultsWe observed a statistically significant deterioration in SGRQ (total score + 1.3 units) after 3 years, which was completely driven by the activity component (+ 4 units). No significant change was found for the generic EQ VAS. Over the same period, 58% of patients experienced a decrease in FEV1, 28% were recorded as no change in FEV1, and 13% experienced an increase. The relationship between HRQL and FEV1was found to be approximately linear with decrease in FEV1being statistically significantly associated with a deterioration in SGRQ (+ 3.20 units). Increase in FEV1was associated with improvements in SGRQ (− 3.81 units). The associations between change in FEV1and the EQ VAS were similar. Results of the HLMs were consistent and highly statistically significant, indicating cross-sectional and longitudinal associations. The largest estimates were found for the association between FEV1and the SGRQ activity domain.ConclusionsDifference and change in FEV1over time correlate with difference and change in disease-specific and generic HRQL. We conclude, that deterioration of HRQL should induce timely re-examination of physical status and lung function and possibly reassessment of therapeutic regimes.Trial registrationNCT01245933. Date of registration: 18 November 2010.
Protective effect of Tualang honey against cadmium-induced morphological abnormalities and oxidative stress in the ovary of rats
Authors: Ruslee Siti Suraya , Zaid Siti Sarah Mohamad , Bakrin Ikmal Hisyam , Goh Yong Meng , Mustapha Noordin Mohamed 
Published: May 2020

AbstractBackgroundTo investigate the protective effects of Tualang honey against the toxicity effects induced by cadmium (Cd) on the ovary.MethodsA total of 32 female Sprague Dawley rats were taken and randomly divided into four groups (n = 8). Throughout the experimental period of 6 weeks, negative control-NC (vehicle deionized water), positive control-CD (Cd at 5 mg/kg), Tualang honey followed by Cd exposure-TH (Tualang honey at 200 mg/kg and Cd at 5 mg/kg) and Tualang honey control-THC (Tualang honey at 200 mg/kg) groups, were administered orally on a daily basis.ResultsRats exposed to Cd were significantly higher in ovarian weight, number of antral and atretic follicles as compared to the NC group. The disruptive effects of Cd on ovarian follicles were associated with a disruption in gonadotropin hormones and decreases in follicular stimulating hormone (FSH) and luteinizing hormone (LH). Moreover, a significant formation of oxidative stress in ovarian Cd-exposed rats has been proven by increasing the level of lipid peroxidation products (malondialdehyde) and decreasing the levels of enzymatic antioxidant (catalase). Interestingly, a daily supplementation of high antioxidant agents such as Tualang honey in these animals, caused significant improvements in the histological changes. Additionally, less atretic follicles were observed, restoring the normal level of LH and FSH (P < 0.001), and normalizing the ovarian malondialdehyde (P < 0.05) and catalase levels in comparison with CD group (P < 0.05).ConclusionsTualang honey has protective effects against Cd-induced ovarian toxicity by reducing morphological abnormalities, restoring the normal levels of gonadotropin hormones and stabilizing equilibrium levels of lipid peroxidation and antioxidant enzyme in ovaries of rats.