bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-reported interpersonal and educational/vocational difficulties in young adults with a history of transient psychotic experiences: findings from a population-based study
Authors: Coughlan Helen , Walton-Ball Erin , Carey Eleanor , Healy Colm , O’Regan-Murphy Grace , Uidhir Aoife Nic , Clarke Mary , Cannon Mary 
Published: December 2020

Abstract
Background Psychotic experiences (PEs) are not uncommon in young people and are associated with both psychopathology and compromised global functioning. Although psychotic experiences are transient (short-lived, self-resolving and non-recurring) for most people who report them, few studies have examined the association between early transient PEs and later functioning in population samples. Additionally, studies using self-report measures of interpersonal and educational/ vocational difficulties are lacking. The aim of this study was to examine the relationship between transient psychotic experiences and self-reported interpersonal and educational/vocational difficulties in adolescence and young adulthood. Methods Participants were 103 young people from a longitudinal population-based study cohort of mental health in Ireland. They attended for baseline clinical interviews in childhood (age 11-13) and were followed up in young adulthood (age 19-25). Participants who reported psychotic experiences at baseline but not at follow-up were classified as having transient psychotic experiences. Data from both time-points were used to examine the association between transient psychotic experiences and self-reported interpersonal and educational/ vocational difficulties in young adulthood using poisson regression modelling.Results Young people with a history of transient psychotic experiences reported significantly higher interpersonal (adj IRR: 1.83, 95%ileCI: 1.10- 3.02, p = .02) and educational/vocational (adj IRR: 2.28, 95%ileCI: 1.43- 3.64, p = .001) difficulties during adolescence. However, no significant differences in interpersonal (adj IRR: 0.49, 95%ileCI: 0.10-2.30, p = .37) or educational/vocational (adj IRR: 0.88, 95%ileCI: 0.37-2.08, p = .77) difficulties were found in young adulthood. Self-reported interpersonal and educational/vocational difficulties in young people both with and without a history of transient psychotic experiences decreased between adolescence and young adulthood.Conclusions Young people with transient psychotic experiences have increased interpersonal and educational/vocational difficulties in adolescence but these may not persist into the young adult years. This finding indicates that early psychotic experiences may not confer high risk for long-term interpersonal or educational/vocational deficits among young people who experience these phenomena transiently.
Rural context, single institution prospective outcomes after Enhanced Recovery colorectal surgery protocol implementation
Authors: Smucker Levi , Victory Jennifer , Scribani Melissa , Oceguera Luis , Monzon Raul 
Published: December 2020

Abstract
Background: Rural hospitals face unique challenges to adopting Enhanced Recovery protocols after colorectal surgical procedures. There are few examples of successful implementation in the United States, and fewer yet of prospective, outcomes-based trials. Methods: This study drew data from elective bowel resection prospectively collected, retrospectively analyzed cases 2 years prior (n=214) and 3 years after (n=224) implementing an ERAS protocol at a small, rural health network in upstate New York. Primary outcomes were cost, length-of-stay, readmission rate, and complications.Results: The implementation required changes and buy-in at multiple levels of the institution. There was a statistically significant reduction in mean length of stay (6.9 versus 5.1 days) and per-patient savings to hospital ($3000) after implementation of ERAS protocol. There was no significant change in rate of 30-day readmissions or complications. Conclusions: The authors conclude that for rural-specific barriers to implementation of Enhanced Recovery protocols there are specific organizational strategies that can ultimately yield sustainable endpoints.
Eleven-year alterations in hand deformities in rheumatoid arthritis by comprehensive assessment using cluster analysis and analysis of covariance
Authors: Toyama Shogo , Tokunaga Daisaku , Tsuchida Shinji , Kushida Rie , Oda Ryo , Kawahito Yutaka , Takahashi Kenji 
Published: December 2020

Abstract
BackgroundAlthough drug therapy in rheumatoid arthritis has recently improved, treating established rheumatoid hand, consisting of three major deformities—thumb deformity, finger deformities, and ulnar drift— remains a challenge. Underlying complex pathophysiology makes it difficult to comprehensively understand these deformities, and comprehensive assessment methods require accumulated skill and long learning curves. We aimed to establish an easier composite method of understanding the pathophysiology and to elucidate alterations in deformities.MethodsWe established a rheumatoid hand cohort in 2004 and clinically evaluated 134 hands (67 patients). We repeated the evaluations in 2009 (100 hands in 52 patients) and 2015 (63 hands in 37 patients) after case exclusion. Thumb deformities, finger deformities (swan-neck and boutonnière deformity), and ulnar drift were semi-quantified and entered as parameters into a two-step cluster (cross-sectional) analysis for the data in 2004. The parameters in each cluster were plotted at each evaluation point. Two-way analysis of covariance was performed to examine whether differences existed between evaluation points and clusters for the deformity parameters.ResultsFive clusters were most appropriate to clarify each deformity: cluster 1: minimal deformity; cluster 2: type 1 thumb deformity; cluster 3: thumb deformity and severe boutonnière deformity; cluster 4: type 2 or 3 thumb deformity and severe ulnar drift; cluster 5: thumb deformity and severe swan-neck deformity. Clusters 1 and 2 had higher function than cluster 5, and cluster 3 had moderate function. Clusters 1–4 had similar disease duration, and showed different paths of deformity progression from disease onset. We considered clusters 1 and 2 as a conservative subset and clusters 3, 4, and 5 as a progressive subset. Over time, thumb deformity type altered to other types, and swan-neck deformity worsened significantly.ConclusionsOur comprehensive assessment indicated five deformity patterns and a progressive course in rheumatoid hand. Knowledge of the characteristics of the progressive subset may allow rheumatologists to more easily determine practical interventions and functional prognosis.
Analysis across diverse fish species highlights no conserved transcriptome signature for proactive behaviour.
Authors: Planellas Sonia Rey , Jin Xingkun , Damsgard Borge , Begout Marie-Laure , Mackenzie Simon 
Published: December 2020

Abstract
Background: Consistent individual differences in behaviour, known as animal personalities, have been demonstrated within and across species. In fish, studies applying an animal personality approach have been used to resolve variation in physiological and molecular data suggesting a linkage, genotype-phenotype, between behaviour and transcriptome regulation. In this study, using three fish species (zebrafish; Danio rerio, Atlantic salmon; Salmo salar and European sea bass; Dicentrarchus labrax), we firstly address whether personality-specific mRNA transcript abundances are transferrable across distantly-related fish species and secondly whether a proactive transcriptome signature is conserved across all three species.Results: Previous zebrafish transcriptome data was used as a foundation to produce a curated list of mRNA transcripts related to animal personality across all three species. mRNA transcript copy numbers for selected gene targets show that differential mRNA transcript abundance in the brain appears to be partially conserved across species relative to personality type. Secondly, we performed RNA-Seq using whole brains from S. salar and D. labrax scoring positively for both behavioural and molecular assays for proactive behaviour. We further enriched this dataset by incorporating a zebrafish brain transcriptome dataset specific to the proactive phenotype. Our results indicate that cross-species molecular signatures related to proactive behaviour are functionally conserved where shared functional pathways suggest that evolutionary convergence may be more important than individual mRNAs.Conclusions: Our data supports the proposition that highly polygenic clusters of genes, with small additive effects, likely support the underpinning molecular variation related to the animal personalities in the fish used in this study. The polygenic nature of the proactive brain transcriptome across all three species questions the existence of specific molecular signatures for proactive behaviour, at least at the granularity of specific regulatory gene modules, level of genes, gene networks and molecular functions.
Older persons’ thoughts about death and dying and their experiences of care in end-of-life: a qualitative study
Authors: Tjernberg Johanna , Bökberg Christina 
Published: December 2020

Abstract
Background: Few studies have focused on how older persons living in nursing homes perceive their last period of life. Furthermore, previous research on older persons’ perceptions of death and dying is limited. Hence, there is an urgent need to explore their experiences during their final period in life.Aim: To explore thoughts about death and dying and experiences of care in end-of-life among older persons living in nursing homes.Methods: This study employed a qualitative approach including individual interviews with 36 older persons living in Swedish nursing homes. Questions related to quality of life; physical health; thoughts about death, dying, and the future; and experiences related to the living condition and environment were asked. The interview transcripts were analysed through content analysis. The study was approved by the Regional Ethics Review Board (reference number: 2015/4).Results: The analysis resulted in the identification of three main thematic categories: The unavoidable and unknown end of life, Thoughts on control and Living your last period of life at a nursing home. The older persons did not fear death itself but had some worries about dying. Spending the last stage of life at a nursing home contributed to different thoughts and feelings among the older persons. With a few exceptions, older persons characterized life at the nursing home as boring and felt they were surrounded by people who did not belong there.Conclusions: This study indicates a need for older persons to talk about death, dying and end-life issues. Furthermore, this study highlighted that the co-residence of cognitively healthy persons and persons with dementia in the same ward adversely affected cognitively healthy persons. This situation resulted in there being not enough time to both handle the care needs of persons with dementia and have the conversations that cognitively healthy persons desired, such as conversations about thoughts about existence, that could have improved their quality of life.Trial registration: NCT02708498 Date of registration 16 February 2016.
Self-determination theory interventions versus usual care in people with diabetes: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis
Authors: Mathiesen Anne Sophie , Rothmann Mette Juel , Zoffmann Vibeke , Jakobsen Janus Christian , Gluud Christian , Lindschou Jane , Due-Christensen Mette , Rasmussen Bodil , Marqvorsen Emilie , Thomsen Thordis 
Published: December 2020

Abstract
BackgroundExisting self-management and behavioural interventions for diabetes vary widely in their content, and their sustained long-term effectiveness is uncertain. Autonomy supporting interventions may be a prerequisite to achieve ‘real life’ patient engagement and more long-term improvement through shared decision making and collaborative goal setting. Autonomy supportive interventions aim to promote that the person with diabetes' motivation is autonomous meaning that the person strives for goals they themselves truly believe in and value. This is the goal of self-determination theory and guided self-determination interventions. Self-determination theory has been reviewed but without assessing both benefits and harms and accounting for the risk of random errors using trial sequential analysis. The guided self-determination has not yet been systematically reviewed. The aim of this protocol is to investigate the benefits and harms of self-determination theory-based interventions versus usual care in adults with diabetes.Methods/designWe will conduct the systematic review following The Cochrane Collaboration guidelines. This protocol is reported according to the PRISMA checklist. A comprehensive search will be undertaken in the CENTRAL, MEDLINE, EMBASE, LILACS, PsycINFO, SCI-EXPANDED, CINAHL, SSCI, CPCI-S, and CPCI-SSH to identify relevant trials. We will include randomised clinical trials assessing interventions theoretically based on guided self-determination or self-determination theory provided face-to-face or digitally by any health care professional in any setting. The primary outcomes will be quality of life, mortality, and serious adverse events. The secondary will be diabetes distress, depressive symptoms, and adverse events not considered serious. Exploratory outcome will be glycated haemoglobin and motivation. Outcomes will be assessed at the end of the intervention and at maximum follow-up. The analyses will be performed using Stata version 16 and Trial Sequential Analysis. Two authors will independently screen, extract data from, and perform risk of bias assessment of included studies using the Cochrane risk of bias tool. Certainty of the evidence will be assessed by GRADE.DiscussionSelf-determination theory interventions aim to promote a more autonomous patient engagement and are commonly used. It is therefore needed to evaluate the benefit and harms according to existing trials. Systematic review registration The protocol has been registered in PROSPERO ID nr. CRD42020181144 on the 5th July 2020.
Temperament and character of patients with alcohol toxicity during COVID -19 pandemic
Authors: Estedlal AliReza , Mani Arash , Vardanjani Hossein Molavi , Kamali Mahsa , Zarei Leila , Heydari Seyed Taghi , Lankarani Kamran B 
Published: December 2020

Abstract
Background: Corona virus epidemic may be acts as a stressor or trauma that affects both physical health and mental health. People exhibited various reactive behaviors to confront with this stressful situation. In Iran, one of the common motives for alcohol consumption is to scape problems and cope with stresses. It has been shown that personality factors influence alcohol consumption, since they are associated with drinking motives. The main purpose of this study was to investigate the correlation between temperament and character and alcohol abuse.Methods: This cross-section study was conducted on 135 alcohol intoxicated patients admitted to emergency room in March 2020 and 255 participants who were randomly selected from public in Shiraz. A questionnaire consisted of TCI (Temperament and character inventory) and several questions about COVID-19 pandemic. It was completed by a trained interviewer using the matched answer technique. Demographic factors were self-reported. Results: Among the alcohol intoxicated group, 117 (86.7%) were males and 18(13.3%) were females. The mean age of the participants was 32.43±10.81 years. Among control group, 99 (38.8%) were males and 156 (61.2%) were females. The mean age of control group was 33.12±14.77 years. Alcohol toxicity was mostly observed among the young males (male/female ratio was 6.45). According to temperament and character index, mean scores of novelty seeking, harm avoidant, and self-transcendence were higher in the alcohol toxicity group than normal population (P<0.01). Mean scores of reward dependent, cooperativeness, and self-directedness were higher in normal population than the alcohol toxicity group (P<0.001). The mean score of persistence was not significantly different between methanol intoxicated and normal population groups (P=0.718). Conclusion: Alcohol intoxicated patients had higher scores of novelty-seeking and self-transcendence and lower scores of reward-dependency scores, cooperativeness and self-directedness. These scores are associated with higher likelihood of personality disorders.
Simulation-Based Curriculum Development: Lessons Learnt in Global Health Education
Authors: Sawaya Rasha , Mrad Sandra , Rajha Eva , Saleh Rana , Rice Julie 
Published: December 2020

Abstract
Abstract:
Background: Simulation based medical education (SBME) allows learners to acquire clinical skills without exposing patients to unnecessary risk. This is especially applicable to Emergency Medicine training programs where residents are expected to demonstrate proficiency in the management of time critical, low frequency, and highly-morbidity conditions. This study aims to describe the process through which a SBME curriculum was created, in a limited simulation resource setting at a 4-year Emergency Medicine (EM) residency program at the American University of Beirut Medical Center.
Methods : A case-based pilot simulation curriculum was developed following Kern’s 6 step approach to curriculum design. The curricular objectives were identified through an anonymous survey of the program’s residents and faculty. Curriculum outcomes were assessed, and the curriculum was revised to address curricular barriers. Evaluations of the revised curriculum were collected during the simulation sessions and through a whole revised curriculum evaluation at the end of the first year of its implementation.
Results : 14/20 residents (70%) and 8/8 faculty (100%) completed the needs assessment from which objectives for the pilot curriculum were developed and implemented through 6 2-hour sessions over a 1-year period. Objectives were not met and identified barriers included cost, scheduling, resources, and limited faculty time. The revised curriculum addressed these barriers and 24 40-minute sessions were successfully conducted during the following year. The sessions took place 3 at a time, in 2-hour slots, using the same scenario to meet the objectives of the different learners’ levels. 91/91 evaluations were collected from participants with overall positive results. The main differences between the pilot and the revised curricula included: a better understanding of the simulation center resources and faculty’s capabilities.
Conclusion : Simulation-based education is feasible even with limited-resources. However, understanding the resources available, and advocating for protected educator time are essential to implementing a successful EM simulation curriculum.
The effect of cognitive dysfunction on mid- and long-term mortality after vascular surgery
Authors: Szabo Andras , Toth Krisztina , Nagy Adam , Domokos Dominika , Czobor Nikoletta , Eke Csaba , Sandor Agnes , Merkely Bela , Susánszky Éva , Gal Janos , Szekely Andrea 
Published: December 2020

Abstract
Background: In recent decades, previous studies have noted the importance of frailty, which is a frequently used term in perioperative risk evaluations. Psychological and socioeconomical domains were investigated as part of frailty syndrome. The aim of this study was to assess the importance of these factors in mortality after vascular surgery.Methods: In our prospective, observational study (ClinicalTrials.gov Identifier: NCT02224222), we examined 164 patients who underwent elective vascular surgery between 2014 and 2017. At the outpatient anaesthesiology clinic, patients completed a questionnaire about cognitive functions, depression and anxiety, social support and self-reported quality of life were assessed using a comprehensive frailty index, in addition to medical variables. Propensity score matching was performed to analyse the difference between patients and controls in a nationwide population cohort. The primary outcome was 4 year mortality. The Kaplan-Meier method and Cox regression analysis were used for statistical analyses.Results: The patients’ mean age was 67.05 years (SD: 9.49 years). Mini-Mental State Examination scores of less than 27 points were recorded for 41 patients. Overall mortality rates were 22.4% and 47.6% in the control and cognitive impairment groups, respectively (p=0.013). In the univariate Cox regression analysis, cognitive impairment measured using age- and education-adjusted MMSE scores increased the risk of mortality (AHR: 2.842, 95% CI: 1.389-5.815, p=0.004).Conclusion: Even mild cognitive dysfunction measured preoperatively using the MMSE represents a potentially important risk factor for mortality after vascular surgery.
Effect of oxaliplatin plus 5-fluorouracil or capecitabine on circulating and imaging biomarkers in patients with metastatic colorectal cancer: a prospective biomarker study
Authors: Mahmood Reem , Shaw Danielle , Descamps Tine , Zhou Cong , Morgan Robert D. , Mullamitha Saifee , Saunders Mark , Mescallado Nerissa , Backen Alison , Morris Karen , Little Ross A. , Cheung Susan , Watson Yvonne , O’Connor James P. B. , Jackson Alan , Parker Geoff J. M. , Dive Caroline , Jayson Gordon C. 
Published: December 2020

Abstract
Background: Patients with metastatic colorectal cancer are treated with cytotoxic chemotherapy supplemented by molecularly targeted therapies. There is a critical need to define biomarkers that can optimise the use of these therapies to maximise efficacy and avoid unnecessary toxicity. However, it is important to first define the changes in potential biomarkers following cytotoxic chemotherapy alone. This study reports the impact of standard cytotoxic chemotherapy across a range of circulating and imaging biomarkers.Methods: A single-centre, prospective, biomarker-driven study. Eligible patients included those diagnosed with colorectal cancer with liver metastases that were planned to receive first line oxaliplatin plus 5-fluorouracil or capecitabine. Patients underwent paired blood sampling and magnetic resonance imaging (MRI), and biomarkers were associated with progression-free survival (PFS) and overall survival (OS).Results: 20 patients were recruited to the study. Data showed that chemotherapy significantly reduced the number of circulating tumour cells as well as the circulating concentrations of Ang1, Ang2, VEGF-A, VEGF-C and VEGF-D from pre-treatment to cycle 2 day 2. The changes in circulating concentrations were not associated with PFS or OS. On average, the MRI perfusion/permeability parameter, Ktrans, increased in response to cytotoxic chemotherapy from pre-treatment to cycle 2 day 2 and this increase was associated with worse OS (HR 1.099, 95%CI 1.01-1.20, p=0.025).Conclusions: In patients diagnosed with colorectal cancer with liver metastases, treatment with standard chemotherapy changes cell- and protein-based biomarkers, although these changes are not associated with survival outcomes. In contrast, the imaging biomarker, Ktrans, offers promise to direct molecularly targeted therapies such as anti-angiogenic agents.