bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pragmatic Considerations in Incorporating Stakeholder Engagement Into a Palliative Care Transitions Study
Authors: de Forcrand Claire , Flannery Mara , Cho Jeanne , Reddy Pidatala Neha , Batra Romilla , Booker-Vaughns Juanita , Chan Garrett K. , Dunn Patrick , Galvin Robert , Hopkins Ernest , Isaacs Eric D. , Kizzie-Gillett Constance L. , Maguire Margaret , Navarro Martha , Rosini Dawn , Vaughan William , Welsh Sally , Williams Pluscedia , Young-Brinn Angela , Grudzen Corita R. 
Published: July 2021

Background:
Stakeholder involvement in health care research has been shown to improve research development, processes, and dissemination. The literature is developing on stakeholder engagement methods and preliminarily validated tools for evaluating stakeholder level of engagement have been proposed for specific stakeholder groups and settings.

Objectives:
This paper describes the methodology for engaging a Study Advisory Committee (SAC) in research and reports on the use of a stakeholder engagement survey for measuring level of engagement.

Methods:
Stakeholders with previous research connections were recruited to the SAC during the planning process for a multicenter randomized control clinical trial, which is ongoing at the time of this writing. All SAC meetings undergo qualitative analysis, while the Stakeholder Engagement Survey instrument developed by the Patient-Centered Outcomes Research Institute (PCORI) is distributed annually for quantitative evaluation.

Results:
The trial’s SAC is composed of 18 members from 3 stakeholder groups: patients and their caregivers; patient advocacy organizations; and health care payers. After an initial in-person meeting, the SAC meets quarterly by telephone and annually in-person. The SAC monitors research progress and provides feedback on all study processes. The stakeholder engagement survey reveals improved engagement over time as well as continued challenges.

Conclusions:
Stakeholder engagement in the research process has meaningfully contributed to the study design, patient recruitment, and preliminary analysis of findings.
Prevention of infection and optimizing vaccination in the solid organ transplant candidate and recipient
Authors: Ryu HaYoung , Narayanan Navaneeth , Bhatt Pinki J. 
Published: July 2021

Purpose of review
Infections can result in serious complications in solid organ transplant (SOT) patients. The need to remain up to date on recommendations on screening, vaccinations, and chemoprophylaxis is paramount in the management of SOT patients. The goal of this review is to provide an overview of current recommendations for the prevention of infections and optimization of vaccinations from the pretransplant through posttransplant periods.

Recent findings
There is an emphasis on thorough pretransplant evaluation to guide clinicians and pretransplant testing based on epidemiological and endemic risk factors. Additionally, recent studies on vaccine safety and efficacy of newer vaccine formulations in SOT recipients are addressed.

Summary
This review provides insight on updated recommendations for pretransplant screening, new data on vaccine optimization in SOT recipients and posttransplant prophylaxis. Further research is needed in order to improve preventive measures including screening tests, vaccines, and chemoprophylaxis.
Characteristics and Outcomes of Pediatric Patients With a Ventricular Assist Device Presenting to the Emergency Department
Authors: Pokrajac Nicholas , Cantwell Lauren M. , Murray Jenna M. , Dykes John C. 
Published: July 2021

Objectives
A growing number of children receive support from left ventricular assist devices (LVADs) in the outpatient setting. Unexpected complications of LVAD support occur that require emergent management, and no studies examine how pediatric LVAD patients present to the emergency department (ED). The goals of this study were (1) to describe frequency of visits, clinical characteristics, adverse events, and outcomes of LVAD-supported children treated in ED settings and (2) to evaluate for associations between specified patient outcomes and ED care location.

Methods
This was a retrospective cohort study of children in a single-center outpatient VAD program who presented to several EDs during a 10-year period. We defined adverse events according to the Advanced Cardiac Therapies Improving Outcomes Network registry guidelines. Secondary analysis evaluated for associations between specified patient outcomes (adverse events, hospitalizations, intensive care unit admissions) and ED care location (institutional vs other ED).

Results
Of 104 subjects with LVAD implantations during the study period, 30 (28.8%) transitioned to outpatient care. Among subjects in the outpatient VAD program, 24 (80%) of 30 had 54 visits to various EDs over 141.9 patient-months. The median age at time of ED visit was 13.5 years (range, 7.2–17.9 years). The median number of visits per subject was 1 (range, 0–6). The most common complaints on arrival to the ED were vomiting or abdominal pain (16.7%), fever (15.3%), and headache (13.9%). Seventeen adverse events occurred during 14 (25.9%) of 54 ED visits. The most common adverse events were major infection (33.3%) and right heart failure (16.7%). Hospital admission resulted from 41 (75.9%) of 54 ED visits, including 17 (41.5%) of 41 to a cardiovascular intensive care unit. Care at a nonspecialty ED was associated with a higher rate of hospitalization (93.8% vs 68.4%, P = 0.049). During the study period, 4 subjects (13.3%) died, including 1 patient on destination therapy, 1 with multisystem organ failure due to cardiogenic shock, and 2 with hemorrhagic stroke. No patient died while in the ED.

Conclusions
Among subjects in a single outpatient pediatric VAD program presenting to the ED, the most common complaints were abdominal pain/vomiting, fever, and headache. The most common adverse events were major infection and right heart failure. Subjects had a high rate of ED utilization and hospital admission.
Using Health Navigators to Connect At-Risk Clients to Community Resources
Authors: Menendez Telma , Barragan Noel C. , Kuo Tony , Morrison Janina L. 
Published: July 2021

Context:
The coupling of health care services with complementary resources that address unmet social needs is a progressively popular approach for improving health outcomes among low-income populations. Community health workers are increasingly recognized as a helpful intermediary for clients navigating community and clinical services.

Program:
The Wellness Center at the Historic General Hospital in East Los Angeles employs a team of community health workers, referred to as Health Navigators, who are trained to link low-income clients to resources such as chronic disease management programs, food pantries, free or low-cost legal aid, health insurance enrollment, group fitness classes, and counseling and peer support services.

Implementation:
The Center's model of practice has evolved over time, continuously increasing the breadth and depth of services provided by the Health Navigator team. Its goal has been to address clients' unmet social needs while optimizing their health outcomes through the building of stronger community-clinical linkages.

Evaluation:
A program review showed that Health Navigators serve as a critical bridge for clients navigating a complex network of health and social services. They actively engage, recruit, and deliver services to clients. Since 2014, the Health Navigator team has connected more than 28 000 unique clients to resources for health and well-being.

Discussion:
By using Health Navigators to assist clients with community resource engagement, the Center has prototyped and promoted an approach that complements clinical care, strengthening the community-clinical linkages that are needed to meaningfully manage chronic disease outside of the hospital or clinic setting.
A Prospective US National Trauma Center Study of Firearm Injury Survivors Weapon Carriage and Posttraumatic Stress Disorder Symptoms
Authors: Nehra Deepika , Bulger Eileen M. , Maier Ronald V. , Moloney Kathleen E. , Russo Joan , Wang Jin , Anderson Kristina , Zatzick Douglas F. 
Published: July 2021

Objective:
To describe the demographic, injury-related, and mental health characteristics of firearm injury patients and trace firearm weapon carriage and PTSD symptoms over the year after injury.

Summary and Background Data:
Based on the increasing incidence of firearm injury and need for novel injury prevention strategies, hospital-based violence intervention programs are being implemented in US trauma centers. There is limited data on the long-term outcomes and risk behaviors of firearm injury survivors to guide this work.

Methods:
We conducted a secondary analysis of a pragmatic 25-trauma center randomized trial (N = 635). Baseline characteristics of firearm-injured patients (N = 128) were compared with other trauma patients. Mixed model regression was used to identify risk factors for postinjury firearm weapon carriage and PTSD symptoms.

Results:
Firearm injury patients were younger and more likely to be black, male and of lower socioeconomic status, and more likely to carry a firearm in the year before injury. Relative to preinjury, there was a significant drop in firearm weapon carriage at 3- and 6-months postinjury, followed by a return to preinjury levels at 12-months. Firearm injury was significantly and independently associated with an increased risk of postinjury firearm weapon carriage [relative risk = 2.08, 95% confidence interval (1.34, 3.22), P < 0.01] and higher PTSD symptom levels [Beta = 3.82, 95% confidence interval (1.29, 6.35), P < 0.01].

Conclusions:
Firearm injury survivors are at risk for firearm carriage and high PTSD symptom levels postinjury. The significant decrease in the high-risk behavior of firearm weapon carriage at 3–6 months postinjury suggests that there is an important postinjury “teachable moment” that should be targeted with preventive interventions.

Trial Registration:
ClinicalTrials.gov NCT02655354
The effect of obesity on inpatient outcomes in lower extremity trauma: A systematic review and meta-analysis
Authors: Liu Qinxin , Wu Mengfan , Orgill Dennis P. , Bai Xiangjun , Panayi Adriana C. 
Published: July 2021

BACKGROUND
Obesity is a growing global health problem and a well-recognized risk factor for many medical conditions. This meta-analysis was conducted to assess the effect of obesity on overall complication occurrence, mortality, and hospital length of stay in patients with nonpathological lower limb trauma.

METHODS
The EMBASE, PUBMED, and MEDLINE electronic databases were searched from inception to April 1, 2020, for studies published in English. References cited by chosen studies were also checked manually for inclusion. Studies chosen for the analysis were prospective observational or retrospective cohort studies reporting on total complications of patients with acute traumatic, nonpathological, lower limb fractures that required internal fixation, with or without other underlying conditions. Two investigators independently reviewed the full text of eligible studies for inclusion and extracted data. Inconsistency was resolved through consultation with other authors.

RESULTS
Sixteen studies with 404,414 patients were investigated in this study. The data showed obesity was related with increased total complications (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.51–0.83; p < 0.01), increased wound complications (OR, 0.41; 95% CI, 0.25–0.66; p < 0.01), and increased mortality rate (OR, 0.64; 95% CI, 0.45–0.91; p < 0.05). Six cohort studies also showed prolonged hospital length of stay in obese patients.

CONCLUSION
Our results suggest that obesity is associated with increased complication and mortality rates, as well as longer hospital length of stay in patients with lower-limb trauma who required surgical treatment. These findings may raise attention to optimize surgical technique and develop individualized treatment for obese patients.

LEVEL OF EVIDENCE
Systematic reviews, level IV.
Impacts of school closure due to COVID-19 on the mobility trend of Japanese citizens
Authors: Nam Nguyen Hai , Nguyen Anh PN. , Do Le Bao-Tran , Gad Abdelrahman Gamil , Abdelnaeim Abdalla Abdelrahman Sherif Mohamed , Safi Adnan , Pham Anh Gia , Khanh Vo Duc , Huy Nguyen Tien 
Published: July 2021

AbstractSchool closure was the only main control measure that Japan took into action from late February to late March in 2020. Accurate evaluation of how Japanese citizens responded to the impact of school closure remains a challenge. Data from the Google COVID-19 Community Mobility Report was used to analyze the mobility trend of Japanese citizens regarding six categories, including retail and recreation, grocery and pharmacy, parks, transit stations, workplace, and residential. The median percentage of mobility in all 47 prefectures of Japan was calculated during five periods of time, including one week before school closure, one week, two weeks, three weeks, and four weeks after school closure. There was a significant decline in the mobility trend of transit stations, grocery and pharmacy, parks, retail and recreation, and workplace at the moment after school closure compared to the prior period. Inversely, the mobility trend in staying at home remarkably increased following the implementation of school closure. Our study determined a significant change in the mobility trend of Japanese citizens before and after school closure. These data reflected the responsibility and the consciousness of Japanese citizens in mitigating COVID-19.
A nationwide study of Chlamydia trachomatis infections in Denmark during the COVID-19 pandemic
Authors: Hedley Paula L. , Hoffmann Steen , Lausten-Thomsen Ulrik , Voldstedlund Marianne , Bjerre Karsten Dalsgaard , Hviid Anders , Krebs Lone , Jensen Jørgen S. , Christiansen Michael 
Published: July 2021

AbstractObjectivesCOVID-19 policies have been employed in Denmark since March 2020. We examined whether COVID-19 restrictions had an impact on Chlamydia trachomatis infections compared with 2018 and 2019.MethodsThis retrospective nation-wide Danish observational study was performed using monthly incidences of laboratory confirmed chlamydia cases and number of tests, obtained from nation-wide surveillance data. Additionally, Oxford COVID-19 Government Response Tracker data, and Google COVID-19 Community Mobility Reports were used to contextualise the behavioural adaptions seen as a result of COVID-19 policies. Testing rates were compared using Poisson regression and test positivity rates were compared using logistic regression.ResultsThe crude incidence rate (IR) of laboratory confirmed chlamydia infections was reduced to 66.5 per 105 during the first (March-April 2020) lockdown period as compared to 88.3 per 105 in March-April 2018-2019, but the testing rate was also reduced (Rate ratio 0.72 95% CI 0.71 – 0.73), whereas the odds ratio for a positive test between the two periods was 0.98 (95% CI 0.96 – 1.00). The period of eased COVID 19 restrictions (May – December 2020) and the second lockdown period (December 2020 – March 2021) were characterised by marginally increased crude IRs, while the number of tests performed, and test positivity rates returned very close to the levels seen in 2018-2019. These results were independent of sex, age group, and geographical location.ConclusionThe first Danish COVID-19 lockdown resulted in a reduction in the number of chlamydia tests performed and a consequent reduction in the number of laboratory-identified cases. This period was followed by a return of testing and test positivity close to the level seen in 2018 – 2019. Altogether the Danish COVID-19 restrictions have had negligible effects on laboratory confirmed C. trachomatis transmission.
SARS-CoV-2 B.1.1.7 lineage rapidly spreads and overwhelms R.1 lineage in Japan: serial and stationary observation in a community
Authors: Hirotsu Yosuke , Omata Masao 
Published: July 2021

AbstractBackgroundThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) circulates in the world and acquires mutations during evolution. To identify the new emergent variants, the surveillance of the variants of concern (VOC) and variants of interest (VOI) is ongoing. This study aimed to determine how the transition of viral lineage occurred by stationary genome analysis in Yamanashi, Japan.MethodsWe performed the whole genome sequencing using SARS-CoV-2 positive samples (n=325) collected from February 2020 to the end of June 2021. The number of analyzed samples accounted for 15.4% of the total 2,109 samples identified in our community. Viral lineage was defined by the Phylogenetic Assignment of Named Global Outbreak (PANGO) lineages.ResultsWe identified 13 types of viral lineages including R.1, P.1, B.1.1.7 (Alpha) and B.1.617.2 (Delta) These virus lineages had distinct periods of expansion and decline. After the emerging of the R.1 lineage harboring E484K variant (designated VOI in Japan), the prevalent B.1.1.214 lineage were no longer identified. The R.1 lineages were temporarily prevalent afterwards, but the influx of B.1.1.7 lineage (designated VOC) led to a decline in R.1. Currently, B.1.1.7 has become dominant after mid-April, 2021.ConclusionWe clearly elucidated the transition and replacement of viral lineage by the community-based analysis. The virus completely replaced by more infectious lineages, therefore, it will be necessary to continue to monitor the VOC and VOI.
The Ultra Fit Community Mask - Toward Maximal Respiratory Protection via Personalized Face Fit
Authors: Hyun Chulho , Jensen Mark Martin , Yang Kisuk , Weaver James C. , Wang Xiaohong , Kudo Yoshimasa , Gordon Steven J. , Karp Jeffrey M. , Samir Anthony E. 
Published: July 2021

AbstractEffective masking policies to prevent the spread of airborne infections depend on public access to masks with high filtration efficacy. However, poor face-fit is almost universally present in pleated multilayer disposable face masks, severely limiting both individual and community respiratory protection. We developed a set of simple mask modifications to mass-manufactured disposable masks, the most common type of mask used by the public, that dramatically improves both their personalized fit and performance in a low-cost and scalable manner. These modifications comprise a user-moldable full mask periphery wire, integrated earloop tension adjusters, and an inner flange to trap respiratory droplets. We demonstrate that these simple design changes improves quantitative fit factor by 320%, triples the level of protection against aerosolized droplets, and approaches the model efficacy of N95 respirators in preventing the community spread of COVID-19, for an estimated additional cost of less than 5 cents per mask with automated production.TeaserA personalizable, low-cost mask improves facial fit, reduces user exposure, and decreases spread of contagious aerosols.
Persistent HBV replication and serological response during up to fifteen years of tenofovir-based antiretroviral therapy in HIV-hepatitis B coinfected patients: a multicenter prospective cohort study
Authors: Dezanet Lorenza N. C. , Miailhes Patrick , Lascoux-Combe Caroline , Chas Julie , Maylin Sarah , Gabassi Audrey , Rougier Hayette , Delaugerre Constance , Lacombe Karine , Boyd Anders 
Published: July 2021

AbstractObjectivesTo determine the extent of hepatitis B virus (HBV) suppression and its association with hepatitis “e” antigen (HBeAg) and hepatitis B surface antigen (HBsAg)-seroclearance in HIV-HBV-coinfected patients undergoing long-term tenofovir (TDF)-based antiretroviral therapy (ART).MethodsWe prospectively followed 165 HIV-HBV-coinfected patients undergoing TDF-based ART. Serum HBV-DNA viral loads, HBeAg and HBsAg were obtained at TDF-initiation and every 6-12 months. We calculated the proportion achieving virological response (VR, <60 IU/mL) during follow-up. We also calculated rates of HBeAg- and HBsAg-seroclearance, which were compared between those who achieved versus never achieved VR during follow-up using an exact binomial test.ResultsDuring a median 8.1 years (IQR=4.0-13.2) of TDF-treatment, 152 (92.1%) patients were able to achieve VR and 13 (7.9%) never achieved VR (median HBV-DNA at the end of follow-up=608 IU/mL, range=67-52,400,000). The prevalence of individuals with detectable HBV-DNA (≥60 IU/mL) decreased during TDF-treatment: 15.1% (n=14/93) at 5-years, 3.2% (n=2/62) at 10-years and, 3.2% (n=1/31) at 15-years. 44/96 HBeAg-positive patients (6.15/100 person-years) had HBeAg-seroclearance and 13/165 patients overall (0.87/100 person-years) had HBsAg-seroclearance. No difference in HBeAg-seroclearance was observed between those who achieved versus never achieved VR (7.4 versus 3.7/100 person-years, p=0.33), while HBsAg-seroclearance was only observed in those with VR (1.0 versus 0/100 person-years, p=0.49; respectively). Individuals with VR also had a higher frequency of undetectable HIV-RNA during treatment (p<0.001).ConclusionsDuring long-term TDF-based ART for HIV-HBV coinfection, persistent HBV viremia is apparent, but becomes less frequent over time. HBsAg-seroclearance only occurred in those with full HBV and relatively high HIV suppression.
Global Measurement of Physical Intimate Partner Violence to Monitor Sustainable Development Goal 5
Authors: Yount Kathryn M. , Cheong Yuk Fai , Khan Zara , Bergenfeld Irina , Kaslow Nadine , Clark Cari Jo 
Published: July 2021

AbstractBackgroundOne third of women experience IPV and potential sequelae. Sustainable Development Goal (SDG) 5.2—to eliminate all violence against women, including IPV— compels national governments to monitor such violence. We conducted the first global measurement-invariance assessment of standardized physical IPV items.MethodsThirty-six Demographic and Health Surveys (DHS) from 36 Lower-/Middle-Income Countries (LMICs) administering the same 18 IPV items during 2012-2018 were included. We performed exploratory and confirmatory factor analyses (EFA/CFA) with seven physical IPV items, which are the most behaviorally specific and reliable. Datasets meeting EFA/CFA model fit criteria (loadings>.35, RMSEA<.08, CFI/TLI>.95) were included in multiple-group CFA to test strict measurement invariance, and in alignment optimization (AO) to test approximate measurement invariance. We compared national rankings based on AO-derived scores and lifetime physical IPV prevalences, and correlated AO-dervied scores with physical, sexual, and psychological IPV prevalences.ResultsEstimated lifetime physical IPV varied widely (5.6%-50.5%). All loadings and fit statistics met thresholds in country-specific EFA/CFAs. A unidimensional, seven-item physical IPV construct lacked scalar invariance in multiple-group CFA but achieved approximate measurement invariance in AO analysis, as 12.3% (<25%) of model parameters were non-invariant. National rankings of AO-derived scores and estimated physical IPV prevalences were similarly distributed, but national estimates often were not significantly different, so grouped score ranges or prevalence ranges are advised. Three items (slap, twist, choke) warrant cognitive testing to improve their psychometric performance. Correlations of AO-derived scores with IPV prevalences ranged from .48 to .66.ConclusionsSeven DHS physical-IPV items were approximately invariant across 36 LMICs spanning five regions and are reasonable for cross-national, grouped comparison of physical IPV. Measurement-invariance testing over time will inform their utility to monitor SDG5.2.1; cross-national and cross-time measurement-invariance testing of other IPV item sets is warranted.