bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of economic, educational and social resources in supporting the use of digital health technologies by people with T2D: a qualitative study
Authors: Turnbull Sophie , Lucas Patricia J. , Hay Alastair D. , Cabral Christie 
Published: February 2021

Abstract
Background
Type 2 Diabetes (T2D) is a common chronic disease, with socially patterned incidence and severity. Digital self-care interventions have the potential to reduce health disparities, by providing personalised low-cost reusable resources that can increase access to health interventions. However, if under-served groups are unable to access or use digital technologies, Digital Health Technologies (DHTs) might make no difference, or worse, exacerbate health inequity.

Study aims
To gain insights into how and why people with T2D access and use DHTs and how experiences vary between individuals and social groups.

Methods
A purposive sample of people with experience of using a DHT to help them self-care for T2D were recruited through diabetes and community groups. Semi-structured interviews were conducted in person and over the phone. Data were analysed thematically.

Results
A diverse sample of 21 participants were interviewed. Health care practitioners were not viewed as a good source of information about DHTs that could support T2D. Instead participants relied on their digital skills and social networks to learn about what DHTs are available and helpful. The main barriers to accessing and using DHT described by the participants were availability of DHTs from the NHS, cost and technical proficiency. However, some participants described how they were able to draw on social resources such as their social networks and social status to overcome these barriers. Participants were motivated to use DHTs because they provided self-care support, a feeling of control over T2D, and personalised advice or feedback. The selection of technology was also guided by participants’ preferences and what they valued in relation to DHTs and self-care support, and these in turn were influenced by age and gender.

Conclusion
This research indicates that low levels of digital skills and high cost of digital health interventions can create barriers to the access and use of DHTs to support the self-care of T2D. However, social networks and social status can be leveraged to overcome some of these challenges. If digital interventions are to decrease rather than exacerbate health inequalities, these barriers and facilitators to access and use must be considered when DHTs are developed and implemented.
Nutritional status and quality of life in interstitial lung disease: a prospective cohort study
Authors: Kanjrawi Alisar A. , Mathers Lara , Webster Susanne , Corte Tamera J. , Carey Sharon 
Published: February 2021

Abstract
Background
Malnutrition and altered body composition are well-documented in chronic pulmonary diseases; however, investigation of nutritional status in interstitial lung disease (ILD) is limited. This study aimed to describe the nutritional status of ILD patients within three diagnostic groups and explore the relationship between nutritional status and quality of life (QoL).

Methods
Consecutive patients attending an ILD clinic within a tertiary referral hospital in Sydney, Australia were studied. Weight, body-mass-index, anthropometrics, handgrip strength (HGS), subjective global assessment and QoL questionnaires (EQ-5D-5L and King’s-Brief Interstitial-Lung-Disease ‘K-BILD’) were collected. Associations between nutritional status and QoL were analysed.

Results
Ninety participants were recruited and categorised: (1) Idiopathic Pulmonary Fibrosis (IPF) (2) Connective-Tissue Disease associated-ILD (CTD-ILD) or (3) Other (non-IPF/non-CTD ILD). Median age was 66.5 (18) years. Four-percent of patients were underweight and 50% were overweight or obese. Median HGS was 71%-(25.3) of predicted and was correlated to all measures of QoL including EQ-5D health-state index (r = 0.376, p < 0.0001), patient-reported EQ-5D-5L Visual Analogue Score (r = 0.367, p < 0.0001) and K-BILD total score (r = 0.346, p = 0.001). Twenty-three percent of the variance in K-BILD total score (F = 12.888, p < 0.0001) was explained by HGS (ß = 0.273, p = 0.006) and forced vital capacity % predicted (ß = 0.331, p = 0.001).

Conclusions
Although a small number of ILD patients were malnourished, a large proportion of the cohort were overweight or obese. Handgrip strength was compromised and correlated to QoL. Future research with a larger cohort is required to explore the role of HGS as a predictor of QoL.
Evaluation and management of obstetric genital fistulas treated at a pelvic floor centre in Germany
Authors: Reisenauer Christl , Amend Bastian , Falch Claudius , Abele Harald , Brucker Sara Yvonne , Andress Jürgen 
Published: February 2021

Abstract
Background
Obstetric genital fistulas are an uncommon condition in developed countries. We evaluated their causes and management in women treated at a German pelvic floor centre.

Methods
Women who had undergone surgery for obstetric genital fistulas between January 2006 and June 2020 were identified, and their records were reviewed retrospectively.

Results
Eleven out of 40 women presented with genitourinary fistulas, and 29 suffered from rectovaginal fistulas. In our cohort, genitourinary fistulas were more common in multiparous women (9/11), and rectovaginal fistulas were more common in primiparous women (24/29). The majority of the genitourinary fistulas were at a high anterior position in the vagina, and all rectovaginal fistulas were at a low posterior position. While all genitourinary fistulas were successfully closed, rectovaginal fistula closure was achieved in 88.65% of cases. Women who suffered from rectovaginal fistulas and were at high risk of recurrence or postoperative functional discomfort and desired another child, we recommended fistula repair in the context of a subsequent delivery. For the first time, pregnancy-related changes in the vaginal wall were used to optimize the success rate of fistula closure.

Conclusions
In developed countries, birth itself can lead to injury-related genital fistulas. As fistula repair lacks evidence-based guidance, management must be tailored to the underlying pathology and the surgeon’s experience. Attention should be directed towards preventive obstetric practice and adequate perinatal and postpartum care. Although vesicovaginal fistulas occur rarely, in case of urinary incontinence after delivery, attention should be paid to the patient, and a vesicovaginal fistula should be ruled out.
Trial registration Retrospectively registered, DRKS 00022543, 28.07.2020.
“What is the actual goal of the pathway?”: examining emergency department physician and nurse perspectives on the implementation of a pediatric concussion pathway using the theoretical domains framework
Authors: Ly Anh , Zemek Roger , Wright Bruce , Zwicker Jennifer , Schneider Kathryn , Mikrogianakis Angelo , Conradi Alf , Johnson David , Clark Brenda , Barlow Karen , Burey Joseph , Kolstad Ash , Yeates Keith Owen 
Published: February 2021

Abstract
Background
Multiple evidence-based clinical practice guidelines (CPGs) exist to guide the management of concussion in children, but few have been translated into clinical pathways (CP), which operationalize guidelines into accessible and actionable algorithms that can be more readily implemented by health care providers. This study aimed to identify the clinical behaviours, attitudinal factors, and environmental contexts that potentially influence the implementation of a clinical pathway for pediatric concussion.

Methods
Semi-structured interviews were conducted from October 2017 to January 2018 with 42 emergency department clinicians (17 physicians, 25 nurses) at five urban emergency departments in Alberta, Canada. A Theoretical Domains Framework (TDF)-informed interview guide contained open-ended questions intended to gather feedback on the proposed pathway developed for the study, as well as factors that could potentially influence its implementation.

Results
The original 14 domains of the TDF were collapsed into 6 clusters based on significant overlap between domains in the issues discussed by clinicians: 1) knowledge, skills, and practice; 2) professional roles and identity; 3) attitudes, beliefs, and motivations; 4) goals and priorities; 5) local context and resources; and 6) engagement and collaboration. The 6 clusters identified in the interviews each reflect 2–4 predominant topics that can be condensed into six overarching themes regarding clinicians’ views on the implementation of a concussion CP: 1) standardization in the midst of evolving research; 2) clarifying and communicating goals; 3) knowledge dissemination and alignment of information; 4) a team-oriented approach; 5) site engagement; and 6) streamlining clinical processes.

Conclusion
Application of a comprehensive, evidence-based, and theory-driven framework in conjunction with an inductive thematic analysis approach enabled six themes to emerge as to how to successfullly implement a concussion CP.
Intraoperative collection of autologous platelet-rich plasma from the cardiopulmonary bypass circuit upon initiation of extracorporeal circulation
Authors: Honda Takeshi , Kanaoka Yuji , Furukawa Hiroshi , Tamura Taishi , Kuwada Noriaki , Yamasawa Takahiko , Watanabe Yoshiko , Yunoki Yasuhiro , Tabuchi Atsushi , Tanemoto Kazuo 
Published: February 2021

Abstract
Objectives
The aim of this study is to evaluate the possibility of the autologous platelet-rich plasma (PRP) collection from the cardiopulmonary bypass (CPB) circuit and to evaluate its effect on the aggregative function.

Methods
For seventy-two patients undergoing cardiac surgery with CPB, an autologous PRP was prepared using the Haemonetics Component Collection System® by drawing blood from the CPB circuit immediately after CPB was established. The blood samples were taken at three points for examination, A: beginning of surgery, B: immediately after heparin reversal with protamine following discontinuation of CPB, C: after the collected autologous PRP was returned to the patient. Platelet count and platelet aggregation ability were analyzed.

Results
The mean platelet count in autologous PRP was 5.5 (range: 3–14) units. Platelet count decreased by 115.0 (±27.3) × 1000/μl from A to B and increased by 27.3 ± 17.2 (× 1000/μl) from B to C.
When platelet aggregation was measured by Adenosine Diphosphate (ADP) 3.0 μM, it decreased by 42.6% ± 12.1% from A to B and increased by 8.7% ± 7.4% from B to C.

Conclusions
Autologous PRP can be safely collected by drawing blood from the CPB circuit, platelet count and aggregation ability significantly decreased after CPB including autologous PRP collection. Some improvement was detected in the number of the platelets count and platelet aggregation ability by administrating an autologous PRP even if autologous PRP is collected from CPB circuit.

Trial registration
UMI-CTR, UMIN000023776. Registered 1 October 2016.
Latour, Tiananmen, and Glass Slippers; or, What We Talk about When We Talk about Chinese Studies
Authors: Lee Haiyan 
Published: February 2021

Abstract
This article revisits a controversy that initially unfolded three decades ago. The immediate impetus for revisiting the controversy is the thirtieth anniversary of the 1989 protests that ended in a massacre in Tiananmen Square. An intermediate reason is to reflect on how the methodological questions at the heart of that controversy are still very much alive as the protean field of Chinese studies continues reinventing itself in relation to theory. A still deeper reason is to rethink, via Bruno Latour, the status of fiction in the age of posttruth and fake news—a task incumbent upon all of us who call ourselves literary scholars.
Η Βιοηθική και ο γενναίος, νέος κόσμος
Authors: Πρωτοπαπαδάκης Ευάγγελος Δ. 
Published: February 2021

Οι άνθρωποι επιλέγουμε τις ενασχολήσεις μας είτε παίζοντες είτε σπουδάζοντες – δηλαδή, είτε επειδή μας σαγηνεύουν κάποια αντικείμενα είτε διότι η ανάγκη μας επιβάλλει να εγκύπτουμε σε αυτά. Ενίοτε, όχι πολύ συχνά, η σαγήνη συναντάται με την ανάγκη, και η σύμπτωσή τους γεννά πεδία σπάνιας γονιμότητας – αυτή είναι η περίπτωση της Βιοηθικής. Στο σύντομο αυτό δοκίμιο θα σκιαγραφήσω τους λόγους οι οποίοι επιβάλλουν σήμερα την ενασχόλησή μας με τη Βιοηθική, ενώ, παράλληλα, φιλοδοξώ να μεταφέρω λίγη από τη γοητεία που αυτή ασκεί σε όποιον έρχεται σε επαφή μαζί της.
Public attitudes towards people who stutter in South Egypt
Authors: Arafa Ahmed , Senosy Shaimaa , Sheerah Haytham A. , St. Louis Kenneth 
Published: February 2021

Purpose
Stuttering is a multifactorial speech disorder with significant social and psychological consequences. There is a lack of knowledge about public attitudes towards people who stutter (PWS) and the factors that can determine such attitudes in underprivileged communities. This study aimed to assess the public attitudes in South Egypt towards PWS and compare our results with those stored in a reference database representing 180 different samples.

Methods
A multi-stage random sampling approach was used to recruit 650 people from Beni-Suef City in South Egypt. All participants were interviewed using the Arabic version of the Public Opinion Survey of Human Attributes-Stuttering (POSHA-S) after getting their informed consent. This instrument assesses people’s Beliefs and Self Reactions towards PWS in addition to their sociodemographic characteristics.

Results
The Beliefs and Self Reactions subscores in addition to the Overall Stuttering Score of the Egyptian sample were remarkably lower than the median values of the reference database (12 versus 34), (-4 versus 2), and (4 versus 18), respectively. TV, radio, and films were the main sources of knowledge about stuttering. Egyptian participants who reported average to high income were more likely to have a positive attitude (≥50% of Overall Stuttering Score) towards PWS than their counterparts with low income (Odds Ratio = 1.57, 95% Confidence Interval: 1.08–2.28).

Conclusion
People in South Egypt showed a less positive attitude towards PWS compared with other populations worldwide. Further studies should focus on changing the public attitudes towards PWS through awareness programs that consider the cultural perspectives of the society.
Primary care providers as a critical access point to HIV information and services for African American and Latinx communities
Authors: Carter Gregory , Woodward Brennan , Ohmit Anita , Gleissner Andrew , Short Meredith 
Published: February 2021

Purpose
This study aimed to examine the association between confidence in accessing HIV services, primary sources of HIV information, and primary care provider status for African American and Latinx individuals in Indiana.

Methods
An online survey was disseminated to African American and Latinx individuals using snowball and social media recruitment methods, resulting in a final sample size of n = 308. A multivariable linear regression analysis was performed to examine the relationships between confidence accessing HIV services, primary care provider status, sexual identification, and sources of HIV information.

Results
Of the total respondents, 62.5% (n = 193) identified as male and 36.9% (n = 114) identified as female. Most identified as African American (72.5%, n = 224), followed by 27.2% (n = 84) who identified as Latinx. Participants who used their primary care providers as a primary source of obtaining HIV information had a significantly higher level of comfort with accessing HIV services. Those who identified family members as a primary source of HIV information and those who identified as bisexual demonstrated a lower level of confidence in accessing HIV services.

Discussion
This study's results enhance our understanding of marginalization within minority groups regarding sexual identification and accessing HIV services. These results also offer insight into the importance of healthcare access because having a primary care provider was a strong predictor of increased confidence in accessing HIV services.
Rotavirus breakthrough infections responsible for gastroenteritis in vaccinated infants who presented with acute diarrhoea at University Teaching Hospitals, Children’s Hospital in 2016, in Lusaka Zambia
Authors: Simwaka Julia , Seheri Mapaseka , Mulundu Gina , Kaonga Patrick , Mwenda Jason M. , Chilengi Roma , Mpabalwani Evans , Munsaka Sody 
Published: February 2021

Background
In Zambia, before rotavirus vaccine introduction, the virus accounted for about 10 million episodes of diarrhoea, 63 000 hospitalisations and 15 000 deaths in 2015, making diarrhoea the third leading cause of death after pneumonia and malaria. In Zambia, despite the introduction of the vaccine acute diarrhoea due to rotaviruses has continued to affect children aged five years and below. This study aimed to characterise the rotavirus genotypes which were responsible for diarrhoeal infections in vaccinated infants aged 2 to 12 months and to determine the relationship between rotavirus strains and the severity of diarrhoea in 2016.

Methods
Stool samples from infants aged 2 to 12 months who presented to the hospital with acute diarrhoea of three or more episodes in 24 hours were tested for group A rotavirus. All positive specimens that had enough sample were genotyped using reverse transcriptase Polymerase Chain Reaction (RT-PCR). A 20-point Vesikari clinical score between 1–5 was considered as mild, 6–10 as moderate and greater or equal to 11 as severe.

Results
A total of 424 stool specimens were tested of which 153 (36%, 95% CI 31.5% to 40.9%) were positive for VP6 rotavirus antigen. The age-specific rotavirus infections decreased significantly (p = 0.041) from 2–4 months, 32.0% (49/118) followed by a 38.8% (70/181) infection rate in the 5–8 months’ category and subsequently dropped in the infants aged 9–12 months with a positivity rate of 27.2%. 38.5% of infants who received a single dose, 34.5% of those who received a complete dose and 45.2% (19/42) of the unvaccinated tested positive for rotavirus. The predominant rotavirus genotypes included G2P[6] 36%, G1P[8] 32%, mixed infections 19%, G2P[4] 6%, G1P[6] 4% and G9P[6] 3%.

Discussion and conclusion
Results suggest breakthrough infection of heterotypic strains (G2P[6] (36%), homotypic, G1P[8] (32%) and mixed infections (19%) raises concerns about the effects of the vaccination on the rotavirus diversity, considering the selective pressure that rotavirus vaccines could exert on viral populations. This data indicates that the rotavirus vaccine has generally reduced the severity of diarrhoea despite the detection of the virus strains.
Contribution of dental private practitioners to publications on anatomical variations using cone beam computed tomography
Authors: Hebda Aleksandra , Theys Stéphanie , De Roissart Jean , Perez Eytan , Olszewski Raphael 
Published: February 2021

Objective: To investigate the participation of citizens-dental private practitioner in scientific articles about anatomical variations on dentomaxillofacial CBCT. Our null hypothesis was that private practice practitioners are not involved in publications on anatomical variations using cone beam computed tomography.
Material and methods: This study was performed from home without access to our university library. Only PubMed database was used to perform our study. We found 384 articles published among 1830 articles corresponding to our inclusion/exclusion criteria. For each selected article we searched for affiliation of all of the authors (university, private dental practice, students, other). We applied a co-creation approach to involve colleagues from private practice in analyzing results of this study.
Results: A large majority of authors have university affiliation (96.5%). Only 3% of authors come from private practice. Most of articles belong to the group of 7 emergent economies (E7), and from Asia. 47.9% of 96 journals published only one article on anatomical variations discovered on CBCT. The higher number of articles (18.75%) were published by journals related to endodontics. The 84% of articles were dispersed among a vast span of general and specific dental, and maxillofacial journals. The 68.4% of articles on variations in CBCT were available in closed access and 31.6% of articles were available in open access. Only 6.7% of articles were published in open access without author publication charges (APC). The 31.6% of authors with university affiliation choose open access for their article. 7.8% of authors from private practice were involved in publishing in closed access journals and 2.34% in open access journals. Only 3 articles (0.78%) were published by authors affiliated to private practice without involvement of university authors. 2.6% of articles involved students as co-authors. Authors with other affiliation were involved only in one closed access publication. For the step of co-creation none of 183 private practitioners, and 3/33 (9%) university-affiliated members of Nemesis Facebook group actively participated in analyzing the results of this study.
Conclusions: the null hypothesis was accepted: dentists from private practice are exceptionally involved in publications on anatomical variations using CBCT in dentomaxillofacial area.
Comparison of Very Low Birth Weight Preterm Infants with And Without Experienced Target Weight Gain on The Administration of Human Milk Fortifier
Authors: Rizkiawan Diondra Eka , Radityo Adhie Nur , Pratiwi Rina , Tjahjono Kusmiyati 
Published: February 2021

Background: Human milk fortifier (HMF) is defined as a supplement added to breastmilk to increase calories, proteins, vitamins, and various nutrition of breastmilk. The purpose of HMF administration is to increase the concentration of breastmilk nutrients to improve the weight of very low birth weight preterm infants. The administration of HMF is insufficient to fulfill protein needs in 20-40% very low birth weight babies, thus the weight gain did not meet the expected target.Objective: To analyze characteristic differences between very low birth weight preterm infants who experienced weight gain according to the target and not according to the target on the administration of HMF.Methods: An analytical study with a case-control approach comparing case and control group, which was observed to determine characteristic differences between both groups. The samples were 52 very low birth weight preterm infants obtained by consecutive sampling. Data analysis includes descriptive analysis and hypothesis testing. Results: Data were obtained from medical records and consisted of 52 participants, including 26 very low birth weight premature infants who experienced weight gain according to the target and 26 who experienced weight gain not according to the target. There was no characteristic difference of cyanosis clinical symptoms (OR 2.3; 95% CI 0.51-10.4), chest retraction (OR 1.0; 95% CI 0.32-3.1), apnea of prematurity comorbid (OR 1.0; 95% CI 0.25-3.9), neonatal infections (OR 0.62; 95% CI 0.21-1.9), starting age of HMF administration (OR 0.62; 95% CI 0.21-1.89), bloating (OR 0.57; 95% CI 0.17-1.9), and vomiting (OR 1.18; 95% CI 0.38-3.7) in both groups.Conclusion: There was no characteristic difference between very low birth weight preterm infants who experienced weight gain according to the target and not according to the target on the administration of HMF.