bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smoking behavior and symptoms of depression and anxiety among young adult backpackers: Results from a short longitudinal study
Authors: Melamed Osnat C. , Walsh Sophie D. , Shulman Shmuel 
Published: December 2020

Levels of smoking and smoking initiation have been found to increase during the transition to adulthood. Symptoms of depression and anxiety may both precede or follow smoking behavior, yet there is equivocal evidence regarding the direction of this relationship. The aim of the current study was to examine the direction of this relationship in a group of young adult backpackers who traveled to social environments which are permissive of smoking. The current study involved a quasi‐experimental design examining 199 (52% men, mean age 24.27, SD = 1.05 years at time 1) young adults, before, during and following a backpacking experience of at least six months. Regression analyses was used to examine the association between smoking and symptoms of depression and anxiety over time. Relative to smoking levels before the journey, a significant transient increase in smoking was found during the journey. The increase in smoking during the journey predicted increases in both depressive and anxiety symptoms following the journey. The reverse direction models were not significant. Our study suggests that social contexts which are permissive of smoking, such as backpacking, increase young adult smoking behavior. Mood symptoms did not contribute to the observed increase in smoking behavior but, inversely, increases in smoking contributed to heightened mood symptoms. Additional longitudinal studies are needed to explore the role that smoking behavior plays in young adults’ mental health.
Multimedia resources to support the recruitment of committed hematopoietic stem cell donors: Perspectives of the most‐needed donors
Authors: Li Edward W. , Lee Anna , Vaseghi‐Shanjani Maryam , Anagnostopoulos Alexander , Jagelaviciute Gabriele , Kum Elena , Petraszko Tanya , Elmoazzen Heidi , Allan David , Fingrut Warren 
Published: December 2020

AbstractBackgroundRecruitment of committed unrelated hematopoietic stem cell donors from the most‐needed demographics remains a challenge for donor recruitment organizations worldwide. Multimedia resources are gaining attention as a modality to support recruitment efforts; however, there is a lack of guidance for the development of such tools. This qualitative study explores the perspectives of eligible stem cell donors on an educational whiteboard video about stem cell donation, generating insights into how whiteboard videos and related multimedia may be optimized for donor recruitment.Study Design and MethodsEight semistructured focus groups were conducted with 38 potential donors from the most‐needed demographics (young, male, and non‐Caucasian) after they had watched a 3.5‐minute whiteboard video explaining key concepts in stem cell donation (https://youtu.be/V4fVBtxnWfM). Constructivist grounded theory was used to identify themes and to develop a framework for understanding participants' preferred features of recruitment multimedia.ResultsParticipants identified a range of features contributing to the effectiveness of recruitment multimedia, adding that the whiteboard video is an effective, integrated, and readily accessible format for supporting donor recruitment. Topics that participants felt are important to address include knowledge gaps regarding donation procedures, concerns about donor safety, and the particular need for specific donor demographics. Suggested avenues for improvement include the addition of donor/recipient/patient personal experiences, attention‐grabbing hooks, and a call to action including opportunities for further learning.ConclusionsSeveral considerations were generated to inform the development of future multimedia for donor education/recruitment and are relevant to donor recruitment organizations worldwide.
A General Purpose Formulation for Nonsmooth Dynamics With Finite Rotations: Application to the Woodpecker Toy
Authors: Cosimo Alejandro , Cavalieri Federico J. , Galvez Javier , Cardona Alberto , Brüls Olivier 
Published: December 2020

Abstract
The aim of this work is to extend the finite element multibody dynamics approach to problems involving frictional contacts and impacts. The nonsmooth generalized-α (NSGA) scheme is adopted, which imposes bilateral and unilateral constraints both at position and velocity levels avoiding drift phenomena. This scheme can be implemented in a general purpose simulation code with limited modifications of pre-existing elements. The study of the woodpecker toy dynamics sets up a good example to show the capabilities of the NSGA scheme within the context of a general finite element framework. This example has already been studied by many authors who generally adopted a model with a minimal set of coordinates and small rotations. It is shown that good results are obtained using a general purpose finite element code for multibody dynamics, in which the equations of motion are assembled automatically and large rotations are easily taken into account. In addition, comparing results between different models of the woodpecker toy, the importance of modeling large rotations and the horizontal displacement of the woodpecker's sleeve is emphasized.
Childbirth Computational Models: Characteristics and Applications
Authors: Chen Sheng , Grimm Michele J. 
Published: December 2020

Abstract
The biomechanical process of childbirth is necessary to usher in new lives—but it can also result in trauma. This physically intense process can put both the mother and the child at risk of injuries and complications that have life-long impact. Computational models, as a powerful tool to simulate and explore complex phenomena, have been used to improve our understanding of childbirth processes and related injuries since the 1990s. The goal of this paper is to review and summarize the breadth and current state of the computational models of childbirth in the literature—focusing on those that investigate the mechanical process and effects. We first summarize the state of critical characteristics that have been included in computational models of childbirth (i.e., maternal anatomy, fetal anatomy, cardinal movements, and maternal soft tissue mechanical behavior). We then delve into the findings of the past studies of birth processes and mechanical injuries in an effort to bridge the gap between the theoretical, numerical assessment and the empirical, clinical observations and practices. These findings are from applications of childbirth computational models in four areas: (1) the process of childbirth itself, (2) maternal injuries, (3) fetal injuries, and (4) protective measures employed by clinicians during delivery. Finally, we identify some of the challenges that computational models still face and suggest future directions through which more biofidelic simulations of childbirth might be achieved, with the goal that advancing models may provide more efficient and accurate, patient-specific assessment to support future clinical decision-making.
Hip Joint Contact Loading and Muscle Forces During Running With a Transtibial Amputation
Authors: Sepp Lauren A. , Baum Brian S. , Nelson-Wong Erika , Silverman Anne K. 
Published: December 2020

Abstract
People with unilateral transtibial amputations (TTA) have greater risks of bilateral hip osteoarthritis, related to asymmetric biomechanics compared to people without TTA. Running is beneficial for physical health and is gaining popularity. However, people with TTA may not have access to running-specific prostheses (RSPs), which are designed for running, and may instead run using their daily-use prosthesis (DUP). Differences in joint loading may result from prosthesis choice; thus, it is important to characterize changes in peak and impulsive hip joint contact loading during running. Six people with and without TTA ran at 3.5 m/s while ground reaction forces, kinematics, and electromyography were collected. People with TTA ran using their own RSP and DUP. Musculoskeletal models incorporating prosthesis type of each individual were used to quantify individual muscle forces and hip joint contact forces (HJCFs) during running. People using RSPs had smaller bilateral peak hip joint contact forces compared to when wearing DUPs during stance and swing, and a smaller impulse over the entire gait cycle. Greater amputated leg peak hip joint contact forces for people wearing DUPs compared to RSPs occurred with greater forces from the ipsilateral gluteus maximus during stance. People with TTA also had greater bilateral peak hip joint contact forces during swing compared to people without TTA, which occurred with greater peak gluteus medius forces. Running with more compliant RSPs may be beneficial for long-term joint health by reducing peak and impulsive hip loading compared to DUPs.
Feasibility of non-invasive cardiac output monitoring at birth using electrical bioreactance in term infants
Authors: McCarthy Karen Nora , Pavel Andrea , Garvey Aisling A , Hawke Ana-Louise , Levins Criona , Livingstone Vicki , Dempsey Eugene M 
Published: December 2020

BackgroundNon-invasive cardiac output monitoring (NICOM) provides continuous estimation of cardiac output. This has potential for use in the delivery suite in the management of acutely depressed term infants. This study aims to measure cardiac output in term infants at delivery and in the first hours of life.MethodsParents of term infants due to be born by elective caesarean section or vaginal delivery at Cork University Maternity Hospital, Ireland were approached in the antenatal period to participate. Cardiac output was measured using a CHEETAH NICOM device, which uses electrical bioreactance technology, at birth and at 2 hours of life.ResultsForty-nine newborns were included. The median gestational age was 39 (IQR: 39–40) weeks and the median birth weight was 3.50 (IQR: 3.14–3.91) kg. Cardiac output measurements were obtained at a median of 8 (IQR: 5–12) min of life. The mean (SD) cardiac output was 101 (24) mL/kg/min in the delivery room and 89 (22) mL/kg/min at 2 hours of life. There was a statistically significant decrease in cardiac output from birth to 2 hours of life (difference in mean (95% CI): 13.5 (9.2 to 17.9) mL/kg/min, p<0.001, n=47). There were no adverse effects associated with NICOM.DiscussionThis technique is feasible and safe in the delivery room. Mean cardiac output measures using NICOM are lower than those found in studies which used echocardiography to determine cardiac output at birth.
Mortality surveillance and verbal autopsy strategies: experiences, challenges and lessons learnt in Papua New Guinea
Authors: Hart John D , Kwa Viola , Dakulala Paison , Ripa Paulus , Frank Dale , Lei Theresa , Moiya Ninkama , Lagani William , Adair Tim , McLaughlin Deirdre , Riley Ian D , Lopez Alan D 
Published: December 2020

Full notification of deaths and compilation of good quality cause of death data are core, sequential and essential components of a functional civil registration and vital statistics (CRVS) system. In collaboration with the Government of Papua New Guinea (PNG), trial mortality surveillance activities were established at sites in Alotau District in Milne Bay Province, Tambul-Nebilyer District in Western Highlands Province and Talasea District in West New Britain Province.Provincial Health Authorities trialled strategies to improve completeness of death notification and implement an automated verbal autopsy methodology, including use of different notification agents and paper or mobile phone methods. Completeness of death notification improved from virtually 0% to 20% in Talasea, 25% and 75% using mobile phone and paper notification strategies, respectively, in Alotau, and 69% in Tambul-Nebilyer. We discuss the challenges and lessons learnt with implementing these activities in PNG, including logistical considerations and incentives.Our experience indicates that strategies to maximise completeness of notification should be tailored to the local context, which in PNG includes significant geographical, cultural and political diversity. We report that health workers have great potential to improve the CRVS programme in PNG through managing the collection of notification and verbal autopsy data. In light of our findings, and in consultation with the main government CRVS stakeholders and the National CRVS Committee, we make recommendations regarding the requirements at each level of the health system to optimise mortality surveillance in order to generate the essential health intelligence required for policy and planning.
Effectiveness of immunosuppression minimisation, conversion or withdrawal strategies in paediatric solid organ and haematopoietic stem cell transplantation: a protocol of a systematic review and meta-analysis
Authors: Martin Saborido Carlos , Borobia Alberto M , Cobas Javier , D'Antiga Lorenzo , Frauca Esteban , Hernández-Oliveros Francisco , Jara Paloma , López-Granados Eduardo , Muñoz Jose María , Nicastro Emanuele , Ojeda Jose Jonay , Pérez-Martínez Antonio , Torres Juan Manuel , Carcas Antonio 
Published: December 2020

IntroductionPaediatric transplantation is the only curative therapeutic procedure for several end-stage rare diseases affecting different organs and body systems, causing altogether great impact in European children’s health and quality of life. Transplanted children shift their primary disease to a chronic condition of immunosuppression to avoid rejection. Longer life expectancy in children poses a greater risk of prolonged and severe side effects related to long-term immunosuppressive (IS) disabilities and secondary cancer susceptibility. The goal remains to find the best combination of IS agents that optimises allograft survival by preventing acute rejection while limiting drug toxicities. This systematic review will aim to determine the optimal IS strategy within the so-called minimisation, conversion or withdrawal strategies.Methods and analysisWe will search the following databases with no language restrictions: Cochrane Central Register of Controlled Trials in the Cochrane Library, OvidSP Medline and Epub Ahead of Print, In-Process & Other Non-Indexed Citations and Daily; OvidSP Embase Classic+Embase; Ebsco CINAHL Plus, complete database; WHO International Clinical Trials Registry Platform search portal. We will include controlled and uncontrolled clinical trials along with any prospective or retrospective study that includes a universal cohort (all participants from a centre/region/city over a certain period). Cases series and cross-sectional studies are excluded. Two review authors will independently assess the trial eligibility, risk of bias and extract appropriate data points. The outcomes included in this review are: patient survival, acute graft rejection, chronic graft rejection, diabetes, graft function, graft loss, chronic graft versus host disease, acute graft versus host disease, surgical complications, infusion complications, post-transplant lymphoproliferative disease, liver function, renal function, cognition, depression, health-related quality of life, hospitalisation, high blood pressure, low blood pressure, cancer—other, cancer—skin, cardiovascular disease, bacterial infection, Epstein-Barr infection, cytomegalovirus infection, other viral infections and growth.
Protocol for a multicentre longitudinal mixed-methods study: feeding and survivorship outcomes in previously healthy young paediatric Intensive care survivors (the PIES Study)
Authors: Morton Kathryn , Darlington Anne-Sophie Emma , Marino L V 
Published: December 2020

IntroductionAn admission to paediatric intensive care unit (PICU) is associated with multiple physical and environmental stressors, often involving many negative and painful oral experiences. Evidence from children with complex medical conditions suggests that feeding difficulties post-PICU stay are common, causing significant parental anxiety. Adult intensive care unit (ICU) survivor studies suggest feeding issues lasting up to 3 months post-discharge from ICU. There is, however, a paucity of evidence regarding feeding outcomes for previously healthy children following a PICU admission and whether painful oral experiences during an admission contribute to feeding difficulties post-discharge, negatively impacting on parental/caregiver anxiety.Methods and analysisThis longitudinal mixed-methods study will explore the impact of feeding difficulties, identifying any clinical risk factors during the first 6 months of PICU discharge in previously healthy young children (≤4 years). Parents/caregivers of children will be asked to complete questionnaires relating to: feeding difficulties, parental/caregiver stress, and child and parental/caregivers’ feeding behaviours at the point of PICU discharge, 1, 3 and 6 months post-discharge. Parents/caregivers will be invited to participate in qualitative semistructured interviews at 3 and 6 months post-PICU discharge exploring parental/caregiver experiences of feeding their child after PICU. Statistical analysis of the survey data will consist of descriptive and inferential statistics, plus qualitative analysis of any free text comments using thematic analysis.Ethics and disseminationThis study will provide an insight and increase our understanding of the prevalence of feeding difficulties in previously healthy children admitted to PICU and parental/caregiver experiences. Multiple methods will be used to ensure that the findings are effectively disseminated to service users, clinicians, policy and academic audiences. The study has full ethical approval from the National Health Service Research Ethics Committee (Ref: 20/YH/0160) and full governance clearance.
Developing open disclosure strategies to medical error using simulation in final-year medical students: linking mindset and experiential learning to lifelong reflective practice
Authors: Lane Andrew Stuart , Roberts Christopher 
Published: December 2020

Introduction and objectivesOpen disclosure is a policy outlining how healthcare practitioners should apologise for mistakes, discussing them with the harmed parties. Simulation is a training and feedback method in which learners practise tasks and processes in lifelike circumstances. We explore how final-year medical students experience the learning of open disclosure.MethodsA qualitative study of final-year medical students who had been involved a high-fidelity simulation session based on open disclosure after medication error was conducted. Students were selected using purposive sampling. Focus groups illuminated their experiences and interpretation of simulated open disclosure experiences. The data were analysed using interpretative phenomenological analysis and supported two superordinate themes: (1) identifying learning needs; and (2) learning to say sorryResultsThe medical students constructed their learning in three different ways: negotiating environmental relationships; embracing challenge and stress; and achieving learning outcomes. The data reinforced the need for psychological safety, emphasised the need for emotional arousal and demonstrated the need for both individual and collective reflective learning. Our data linked the benefits of experiential learning to the development of growth mindset and Jarvis’s theory.ConclusionsThe lived experience of the final-year medical student participants in this study reinforced the notions of continuous psychological safety and the need for emotional arousal during learning. Our data also demonstrated the variety of participant experiences when preparing to give open disclosure, reinforcing the need for facilitators to optimise learning for the whole group as well as the individuals, given that participants are at different parts of their learning cycle.
Initial experience with the CatchView thrombectomy device for acute ischemic stroke
Authors: Velioglu Murat , Onal Yilmaz , Agackiran Abdulbaki , Dogan Ak Pelin , Karakas Hakki Muammer 
Published: December 2020

BackgroundWe report our initial experience with the CatchView (CV) thrombectomy device in patients with acute ischemic stroke (AIS).MethodsA retrospective analysis of 53 of 284 AIS patients (mean age 66.6±14.8 years, range 37–94) treated with a CV device between January 2019 and February 2020 was performed. The baseline characteristics (gender, age, comorbidities, National Institutes of Health Stroke Scale (NIHSS) score, intravenous tissue plasminogen activator (IV-tPA) administration, and occlusion localization) of these subjects were recorded. Modified Thrombolysis in Cerebral Ischemia (mTICI) scores of 2b and 3 were considered to indicate successful recanalization, and subjects with a modified Rankin Scale score of ≤2 on day 90 was considered a good clinical outcomes.ResultsThe mean NIHSS score was 12.3±3. Successful recanalization was achieved in 45 subjects (84.90%), and the rate of good clinical outcomes on day 90 was 43.39%. The secondary distal embolus rate was 5.66%. Symptomatic hemorrhage was observed in 3.77% of the subjects, and the mortality rate was 13.2%.ConclusionsMechanical thrombectomy devices include a wide array of endovascular tools for removing clots in AIS patients. In terms of successful recanalization and good clinical outcomes on day 90, our initial experience with the CV devices was encouraging.
Effect of medical school attended on the chances of successfully embarking on a clinical-academic career in the UK
Authors: Donaldson Callum John , Sequeira Campos Miguel , Ridgley Joanne , Light Alexander 
Published: December 2020

AbstractPurpose of the studyThis study aimed to investigate whether, in the UK, medical school attended influences the propensity to apply to and be successful in obtaining an offer from the Academic Foundation Programme (AFP), thus taking the first step to embarking on a clinical-academic career.Study designA retrospective observational study was performed. Using the UK Foundation Programme's yearly statistical report data, mean application rates to, and mean offer rates from the AFP were calculated by medical school, between the years 2017–2019. Mean application and mean offer rates were subsequently correlated with metrics of medical school academic performance and research focus.ResultsMean application rates to the AFP were higher in medical schools that had a mandatory intercalated degree as part of the undergraduate medical curriculum (mean=33.99%, SD=13.93 vs mean=19.44%, SD=6.88, p&lt;0.001), lower numerical rank in the Times Higher Education 2019 World Rankings (correlation with higher numerical rank, r=−0.50, p=0.004), and lower numerical rank in the Research Excellence Framework 2014 UK rankings (correlation with higher numerical rank, r=−0.37, p=0.004). Mean offer rates from the AFP were not correlated with any metric of medical school academic performance or research focus.ConclusionsStudents attending a medical school with greater academic performance and research focus are more likely to apply and subsequently embark on a clinical-academic career. However, students wishing to embark a clinical-academic career from any medical school have an equal chance of success.