bluuebunny/crossref_metadata_2025_split huggingface dataset:
The organ supply chain: Geography and the inequalities of transplant logistics
Authors: Cole Harrison 
Published: April 2021

AbstractThis paper describes how supply chain management practices are applied to the process of organ transplantation in the USA. While these practices are meant to increase the volume of organs available for transplantation, I argue that they may in fact exacerbate existing inequities of access to treatment. This is an especially pressing issue given that the number of people currently on the organ transplant waiting list far exceeds the number of organs available for transplantation, a situation referred to as the organ shortage crisis. A contributing factor to this disparity is the spatiotemporal distribution of transplant centres, donors, and recipients, considering that the transplant process is so time‐sensitive and time‐intensive. In response, the healthcare industry is developing systems that smooth and accelerate the procurement and delivery of organs, creating a logistical network that is standardised, data‐driven, and able to be deployed at a moment’s notice. However, these new systems draw design inspiration from those originally developed for profit‐based corporate supply chains, and thus risk employing the spatial logics of corporate supply chain management practices. Drawing from interviews with transplant and other medical professionals, I argue that applying these practices to the organ transplant network may end up privileging already‐advantaged patients, when instead, a truly equitable network must attend to the uneven landscape of transplantation in the USA. Furthermore, I argue that these technologies should not necessarily be resisted outright, but rather adopted in the interest of universal access as opposed to the maintenance of profitability.
Tracing Clostridium perfringens strains along the chicken production chain from farm to slaughter by multilocus sequence typing
Authors: Xu Wenping , Wang Hairong , Chen Suo , Chen Yong , Liu Lixue , Wu Wei 
Published: April 2021

AbstractThe current study is undertaken to characterize the prevalence, genotypes distribution, antibiotic resistance and genetic diversity of Clostridium perfringens (C. perfringens) collected from different stages of a chicken production chain. In total, 579 samples from a broiler farm and 378 samples from the slaughterhouse were collected from a large‐scale rearing and slaughter one‐stop enterprise in Weifang, China, between June and July 2019, of which 30.40% of the samples from farm and 54.50% of samples from slaughterhouse were determined to be positive for C. perfringens, respectively. The contamination of chicken products was relatively serious, with the total positive rate of carcasses at 59.73%; the positive rate of carcass samples was the highest in the evisceration process, which might be the critical point of C. perfringens contamination. A total of 476 isolates of C. perfringens were recovered; and 99.58% of recovered isolates were identified as type A, with the remaining isolates being type G. Antimicrobial susceptibility testing revealed that 97.15% of the isolates showed multiple antibiotic resistance and 67.89% of them were resistant to at least five classes of commonly used antibiotics. Multilocus sequence typing results of 91 representative isolates showed that the isolates can be divided into 74 sequences types (STs); 40.66% of the isolates can be included into seven clonal complexes (CCs). Although most of the isolates were classified as type A, considerable genetic diversity was observed, with the Simpson's diversity index of ST up to 0.9902. Some isolates from farm stage and slaughter stage were distributed in the same ST or CC, indicating that chicken products may be contaminated by the same ST or CC of C. perfringens originated from the farm stage. The high contamination rates of chicken products and the widespread multiple antibiotic resistance of isolates indicated potential public health risks, control measures at rearing and slaughtering stage should be considered to reduce this risk.
A Statistical Methodology to Estimate Soiling Losses on Photovoltaic Solar Plants
Authors: Ribeiro Kymberlim , Santos Ricardo , Saraiva Erlandson , Rajagopal Ram 
Published: April 2021

Abstract
One of the challenges in photovoltaic solar plants is the performance maintenance in the presence of adverse environmental conditions. Soiling on the solar panels is one of those challenges having a high decrease impact on the power generation. This work proposes a statistical methodology that estimates the energy losses due to soiling on photovoltaic solar plants. Using environmental and power generation data, the proposed methodology predicts the energy generation using a regression model; and then evaluates if the differences between the observed energy generation data and the predicted energy data are due to soiling. The experiments to validate the system are based on one-year dataset of environmental and power generation data from a solar plant located in the northeast region of Brazil. The results showed that the daily energy losses estimates ranged from 2.20% up to 12.31% in a period less than a month.
The Effects of Nordic Walking Compared to Conventional Walking on Aerobic Capacity and Lipid Profile in Women Over 55 Years of Age
Authors: Witkowska Anna , Grabara Małgorzata , Kopeć Dorota , Nowak Zbigniew 
Published: April 2021

Background: The purpose of this study was to investigate the effects of Nordic Walking compared to conventional walking on aerobic capacity, the lipid profile, left ventricular ejection fraction, body mass, and body mass index in women over 55 years old. Methods: The study was comprised of 74 women over 55 years of age. Participants were randomized to the Nordic Walking (n = 38) or conventional walking (n = 36) training groups. The echocardiogram, treadmill exercise stress test, lipid profile, and body mass were assessed at baseline (pretest) and after 12 weeks (posttest). Results: The authors found a significant main effect over time in duration (effect size [ES] = 0.59, P < .0001), distance covered (ES = 0.56, P < .0001), peak oxygen consumption (ES = 0.43, P < .0001), metabolic equivalent (ES = 0.29, P < .0001), peak heart rate (ES = 0.2, P < .0001), peak diastolic blood pressure (ES = 0.11, P = .0045), total cholesterol (ES = 0.26, P < .0001), and low-density lipoprotein cholesterol (ES = 0.16, P = .0005). The authors did not observe a time versus group interaction or the effect between groups. Post hoc tests revealed significant pretraining to posttraining differences in low-density lipoprotein cholesterol after the Nordic Walking training program and in peak diastolic blood pressure after the conventional walking training program. The heart rate, systolic blood pressure, and diastolic blood pressure at rest, peak diastolic blood pressure, somatic parameters (body mass and body mass index), and left ventricular ejection fraction did not change in either group. Conclusions: Both training programs resulted in increases in aerobic capacity and decreases in total cholesterol.
Differential Effects of Perturbation Magnitude on Reactive Balance Control in Young Sedentary Adults
Authors: Zemková Erika , Cepková Alena , Muyor José M. 
Published: April 2021

This study investigates postural responses to unexpected perturbations induced by a load release of different weights. Groups of 26 men (age 22.6 ± 2.4 years, height 178.0 ± 9.1 cm, and body mass 86.9 ± 11.5 kg) and 21 women (age 21.9 ± 2.7 years, height 168.8 ± 6.8 cm, and body mass 65.3 ± 8.7 kg) underwent load-triggered postural perturbations by 1 and 2 kg while standing on a force plate with either eyes open or eyes closed. Postural perturbations induced by a heavier load, representing about 2% and 3% of body weight in men and women, respectively, led to significantly higher peak anterior and peak posterior center of pressure displacements when compared with a lighter load (29.6% and 45.4%, respectively) both with eyes open (36.9%) and closed (42.1%). Their values were significantly lower in men than women only when a higher load was used (∼25%). However, there were no significant differences in time to peak anterior and posterior center of pressure displacements. These findings indicate that heavier load-induced postural perturbations are greater in women than men regardless of visual conditions. This underlines the importance of loading dose in the magnitude of postural responses to externally induced perturbations.
Traumatic life events and risk of post-traumatic stress disorder among the Indigenous population of regional, remote and metropolitan Central-Eastern Australia: a cross-sectional study
Authors: Nasir Bushra F , Black Emma , Toombs Maree , Kisely Steve , Gill Neeraj , Beccaria Gavin , Kondalsamy-Chennakesavan Srinivas , Nicholson Geoffrey 
Published: April 2021

ObjectiveTrauma is reported by 70% of the global population and 4% of those exposed develop post-traumatic stress disorder (PTSD), but data from Indigenous populations are limited. We aimed to determine the prevalence, types and age of occurrence of traumatic events among community-living Indigenous Australians and associations with PTSD.DesignLifetime trauma and PTSD were quantified among a broadly representative sample of 544 Indigenous participants using a diagnostic clinical interview. Logistic regression examined predictors of PTSD.SettingMetropolitan, regional and remote areas of Southern Queensland and Northern New South Wales.ParticipantsIndigenous Australians 18 years and older.Outcome measuresPrevalence of traumatic life events and risk of PTSD.Results64.9% of participants (standardised prevalence 62.6%) reported lifetime trauma, with more than one trauma category in 62.3%. Females reported 2.3 times more sexual violence, otherwise no gender differences existed. The prevalence of four common trauma categories were 1.7–3.0 times higher than in the Australian population; physical violence being the highest relative risk. Although overall childhood trauma was not increased, sexual or physical violence before age 15 was twice more common than in the Australian population.The standardised prevalence of 12-month PTSD was 13.3% (95% CI 10.4 to 16.1), 16.1% (95% CI 12.2 to 19.9) in females and 8.2% (95% CI 5.3 to 11.1) in males, three times the Australian rates. In multiple regression analysis, independent predictors of PTSD were female gender (OR 2.1), rural residence (OR 3.0), trauma under age 10 (OR 2.2), sexual (without physical) violence (OR 2.5), physical (without sexual) violence (OR 2.3), and both sexual and physical violence (OR 5.0).ConclusionIndigenous Australians are more likely to experience potentially harmful traumas and develop PTSD than other Australians. Mitigation of trauma among Indigenous Australians, particularly childhood exposure and sexual or physical violence, is essential to reduce their high burden of PTSD.
Urinary incontinence and sedentary behaviour in nursing home residents in Osona, Catalonia: protocol for the OsoNaH project, a multicentre observational study
Authors: Farrés-Godayol Pau , Jerez-Roig Javier , Minobes-Molina Eduard , Yildirim Meltem , Goutan-Roura Ester , Coll-Planas Laura , Escribà-Salvans Anna , Molas-Tuneu Miriam , Moreno-Martin Pau , Rierola-Fochs Sandra , Rierola-Colomer Sergi , Romero-Mas Montse , Torres-Moreno Miriam , Naudó-Molist Jordi , Bezerra de Souza Dyego Leandro , Booth Joanne , Skelton Dawn A , Giné-Garriga Maria 
Published: April 2021

IntroductionSeveral studies have shown that physical activity (PA) levels and sedentary behaviour (SB) are independent risk factors for many health-related issues. However, there is scarce evidence supporting the relationship between SB and urinary incontinence (UI) in community-dwelling older adults, and no information on any possible association in institutionalised older adults. Stage I of this project has the main objective of determining the prevalence of UI and its associated factors in nursing home (NH) residents, as well as analysing the association between UI (and its types) and SB. Stage II aims to investigate the incidence and predictive factors of functional and continence decline, falls, hospitalisations, mortality and the impact of the COVID-19 pandemic among NH residents.Methods and analysisStage I is an observational, multicentre, cross-sectional study with mixed methodology that aims to explore the current status of several health-related outcomes in NH residents of Osona (Barcelona, Spain). The prevalence ratio will be used as an association measure and multivariate analysis will be undertaken using Poisson regression with robust variance. Stage II is a 2-year longitudinal study that aims to analyse functional and continence decline, incidence of falls, hospitalisations, mortality and the impact of the COVID-19 pandemic on these outcomes. A survival analysis using the actuarial method for functional decline and continence, evaluated every 6 months, and the Kaplan-Meier method for falls, hospitalisations and deaths, and Cox regression for multivariate analysis will be undertaken.Ethics and disseminationThe study received the following approvals: University of Vic - Central University of Catalonia Ethics and Research Committee (92/2019 and 109/2020), Clinical Research Ethics Committee of the Osona Foundation for Health Research and Education (FORES) (code 2020118/PR249). Study results will be disseminated at conferences, meetings and through peer-reviewed journals.Trial registration numberNCT04297904.
Clinical practice competencies and associated factors among graduating nursing students attending at universities in Northern Ethiopia: institution-based cross-sectional study
Authors: Getie Addisu , Tsige Yosief , Birhanie Emebet , Tlaye Kenean Getaneh , Demis Asmamaw 
Published: April 2021

ObjectiveTo assess clinical practice competencies and associated factors among graduating nursing students attending public universities found in the Amhara Region, EthiopiaDesignInstitution-based cross-sectional study designSettingThe study was conducted in six universities found in the Amhara Region from February to April 2018.Participants307 graduating nursing students participated. Of these, 173 were male and 134 were females from different ethnic groups; Amhara 145, Oromo 84, Tigris 44 and Gurage 17. Graduating nursing students attending regular degree programmes were included.Outcome measurementsClinical instructor (good vs not good), clinical environment (conducive vs not conducive), assessment method (measurable vs not measurable), clinical staff-student interaction (good vs not good), clinical practice competency (competent vs incompetent).ResultThe study revealed that 33.6% (95% CI 26.3% to 39.41%) of students were clinically competent. Orientation about the objective of clinical practice (adjusted OR, AOR 2.387; 95% CI 1.011 to 5.635), enough time for mentoring during clinical practice (AOR 2.247; 95% CI 1.100 to 4.593). Students followed by instructors during conducting a procedure (AOR 2.655; 95% CI 1.294 to 5.449), assessment checklist during clinical practice (AOR 2.663; 95% CI 1.324 to 5.358), students who were allowed by clinical staffs to perform tasks (AOR 5.858; 95% CI 2.657 to 12.916), clinical instructor factors (AOR 3.051; 95% CI 1.717 to 5.421) and student–staff interaction factors (AOR 2.348; 95% CI (1.337 to 4.124) were statistically significant variables with the level of competency.ConclusionAround one-third of the students were clinically competent. Clinical instructor and staff–student interaction were significantly associated with clinical practice competencies among graduating nursing students. Therefore, designing an appropriate clinical practice protocol that includes improving the supervision of a clinical instructor is important to enhance the clinical practice competency of students.
Codesign and development of a primary school based pathway for child anxiety screening and intervention delivery: a protocol, mixed-methods feasibility study
Authors: Williamson Victoria , Larkin Michael , Reardon Tessa , Pearcey Samantha , Hill Claire , Stallard Paul , Spence Susan H , Breen Maria , Macdonald Ian , Ukoumunne Obioha , Ford Tamsin , Violato Mara , Sniehotta Falko , Stainer Jason , Gray Alastair , Brown Paul , Sancho Michelle , Creswell Cathy 
Published: April 2021

IntroductionAnxiety difficulties are among the most common mental health problems in childhood. Despite this, few children access evidence-based interventions, and school may be an ideal setting to improve children’s access to treatment. This article describes the design, methods and expected data collection of the Identifying Child Anxiety Through Schools – Identification to Intervention (iCATS i2i) study, which aims to develop acceptable school-based procedures to identify and support child anxiety difficulties.Methods and analysisiCATS i2i will use a mixed-methods approach to codesign and deliver a set of procedures—or ‘pathway’—to improve access to evidence-based intervention for child anxiety difficulties through primary schools in England. The study will consist of four stages, initially involving in-depth interviews with parents, children, school staff and stakeholders (stage 1) to inform the development of the pathway. The pathway will then be administered in two primary schools, including screening, feedback to parents and the offer of treatment where indicated (stage 2), with participating children, parents and school staff invited to provide feedback on their experience (stages 3 and 4). Data will be analysed using Template Analysis.Ethics and disseminationThe iCATS i2i study was approved by the University of Oxford’s Research Ethics Committee (REF R64620/RE001). It is expected that this codesign study will lead on to a future feasibility study and, if indicated, a randomised controlled trial. The findings will be disseminated in several ways, including via lay summary report, publication in academic journals and presentation at conferences. By providing information on child, parent, school staff and other stakeholder’s experiences, we anticipate that the findings will inform the development of an acceptable evidence-based pathway for identification and intervention for children with anxiety difficulties in primary schools and may also inform broader approaches to screening for and treating youth mental health problems outside of clinics.
Promoting physical health among people with enduring mental illness: a qualitative study of healthcare providers’ perspectives
Authors: Collins Claire , Finegan Pearse , O'Shea Marie , Larkin James , Pericin Ivana , Osborne Brian 
Published: April 2021

BackgroundPeople with enduring mental illness (EMI) have higher morbidity and mortality from chronic diseases than the general population, and this results in a signiﬁcantly reduced relative life expectancy—accounted for primarily by physical illness. This gap may be partly influenced by the reduced likelihood of access to and uptake of regular physical health screening.AimTo establish Irish service providers’ perspectives regarding the care of the physical health of people with EMI in an effort to inform future service developments aimed at improving the physical health of people with EMI.Design and settingQualitative study of healthcare providers—general practitioners (GPs) and members of the community mental health teams—in Ireland.ParticipantsGPs and mental health service providers.MethodsQualitative semi-structured interviews were conducted with 34 service providers. Thematic analysis was undertaken.ResultsParticipants considered that the physical health of people with EMI is not currently regularly addressed by the patient’s GP or the mental health team. Factors associated with this include patient compliance with attendance, time constraints in consultations to adequately support patient self-management, communication difficulties with the patient and between primary and secondary care, and lack of clarity as to whose responsibility it is to ensure physical health is monitored. In participants’ view, a barrier to improvement is the present funding approach.ConclusionThe evidence from this study has the potential to form the basis for innovation and change in service delivery for people with an EMI in Ireland and internationally, specifically in countries where it is not clear who has the overall responsibility to monitor the physical health of patients with EMI. This role requires time and regular contact, and both the organisation and the funding of the health system need to support it.
Perceptions of partial gland ablation for prostate cancer among men on active surveillance: a qualitative study
Authors: Hur Sonia , Tzeng Michael , Cricco-Lizza Eliza , Basourakos Spyridon , Yu Miko , Ancker Jessica , Abramson Erika , Saigal Christopher , Ross Ashley , Hu Jim 
Published: April 2021

ObjectivesPartial gland ablation (PGA) therapy is an emerging treatment modality that targets specific areas of biopsy-proven prostate cancer (PCa) to minimize treatment-related morbidity by sparing benign prostate. This qualitative study aims to explore and characterize perceptions and attitudes toward PGA in men with very-low-risk, low-risk, and favorable intermediate-risk PCa on active surveillance (AS).Design92 men diagnosed with very-low-risk, low-risk, and favorable intermediate-risk PCa on AS were invited to participate in semistructured telephone interviews on PGA.SettingSingle tertiary care center located in New York City.Participants20 men with very-low-risk, low-risk, and favorable intermediate-risk PCa on AS participated in the interviews.Main outcome measuresEmerging themes on perceptions and attitudes toward PGA were developed from transcripts inductively coded and analyzed under standardized methodology.ResultsFour themes were derived from 20 interviews that represent the primary considerations in treatment decision-making: (1) the feeling of psychological safety associated with low-risk disease; (2) preference for minimally invasive treatments; (3) the central role of the physician; (4) and the pursuit of treatment options that align with disease severity. Eleven men (55%) expressed interest in pursuing PGA only if their cancer were to progress, while nine men (45%) expressed interest at the current moment.ConclusionsAlthough an emerging treatment modality, patients were broadly accepting of PGA for PCa, with men primarily debating the risks versus benefits of proactively treating low-risk disease. Additional research on men’s preferences and attitudes toward PGA will further guide counseling and shared decision-making for PGA.