bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of focused cardiopulmonary ultrasonography on clinical outcome of septic shock: a randomized study
Authors: Li Li , Ai Yuhang , Wang Xiaoting , Zhang Hongmin , Ma Xinhua , Huang Li , Ai Meilin , Peng Qianyi , Zhang Lina 
Published: May 2021

Objective To investigate the effect of focused ultrasonography on clinical outcomes of septic shock. Methods Patients with septic shock were randomized into an integrated cardiopulmonary ultrasonography (ICUS) group and conventional (CON) group. Within 1 hour of admission, the ICUS group underwent ICUS examination for hemodynamic decision-making, while the CON group received standard treatment. The primary endpoint was 28-day mortality after admission. The secondary endpoints were cumulative fluid administration in the first 6, 24, and 72 hours; use of vasoactive drugs; lactate clearance; duration of ventilation; and ICU stay. Results Ninety-four qualified patients were enrolled (ICUS group, 49; CON group, 45). ICUS showed no significant effect on 28-day mortality. Within the initial 6 hours, the ICUS group tended to have a higher fluid balance and fluid intake than the CON group. The duration of vasopressor support was shorter in the ICUS group. There were no differences in the cumulative fluid infusion within 24 or 72 hours, lactate clearance, ICU stay, or duration of ventilation. Conclusions The initially focused ICUS did not affect the clinical outcomes of septic shock, but it tended to be associated with a higher fluid balance within the initial 6 hours and shorter duration of vasopressor support.
Development and external validation of a nomogram predicting overall survival after curative resection of colon cancer
Authors: Wang Shuanhu , Liu Yakui , Shi Yi , Guan Jiajia , Liu Mulin , Wang Wenbin 
Published: May 2021

Objective To develop and externally validate a prognostic nomogram to predict overall survival (OS) in patients with resectable colon cancer. Methods Data for 50,996 patients diagnosed with non-metastatic colon cancer were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database. Patients were assigned randomly to the training set (n = 34,168) or validation set (n = 16,828). Independent prognostic factors were identified by multivariate Cox proportional hazards regression analysis and used to construct the nomogram. Harrell’s C-index and calibration plots were calculated using the SEER validation set. Additional external validation was performed using a Chinese dataset (n = 342). Results Harrell’s C-index of the nomogram for OS in the SEER validation set was 0.71, which was superior to that using the 7th edition of the American Joint Committee on Cancer TNM staging (0.59). Calibration plots showed consistency between actual observations and predicted 1-, 3-, and 5-year survival. Harrell’s C-index (0.72) and calibration plot showed excellent predictive accuracy in the external validation set. Conclusions We developed a nomogram to predict OS after curative resection for colon cancer. Validation using the SEER and external datasets revealed good discrimination and calibration. This nomogram may help predict individual survival in patients with colon cancer.
Individual Risk, Country-Level Social Support, and Bullying and Cyberbullying Victimization Among Youths: A Cross-national Study
Authors: Deryol Rustu , Wilcox Pamela , Stone Sandra 
Published: May 2021

This study examined the relationships between three life domains—physical health, risky/deviant lifestyle, and psychosocial adjustment—and traditional bullying and cyberbullying victimization among youths in 23 countries. Methods: We first estimated logistic regression models that examined the relationships between indicators of physical health, risky/deviant lifestyle, and psychosocial adjustment using 23 distinct national samples. This analysis also allowed us to observe patterns of similarity and dissimilarity across countries regarding the correlates of for traditional bullying and cyberbullying victimization. Next, we estimated multilevel models of bullying victimization that combined data across 21 countries and estimated the effects of a country-level indicator of quality of human development (IHDI) in interaction with individual-level indicators of physical health, risky/deviant lifestyle, and psychosocial adjustment. Results: There were both cross-country similarities and differences regarding the individual-level correlates of traditional bullying and cyberbullying victimization. Additionally, countries that had relatively greater quality of human development tended to exhibit lower prevalence of traditional and cyberbullying victimization. Finally, country-level quality of human development conditioned relationships between individual level factors and both traditional and cyberbullying victimization. Conclusions: Findings suggest that student-level bullying-prevention programs should address risk/protective factors across three student life domains, with some risk/protective factors seemingly universally relevant. Moreover, cross-level interactions suggest that enhancing country-level quality of human development can also play an important role in youth bullying prevention.
“Helping Somebody Else Has Helped Me Too”: Resilience in Rural Women With Disabilities With Experiences of Interpersonal Violence
Authors: Aguillard Kimberly , Gemeinhardt Gretchen , McCurdy Sheryl , Schick Vanessa , Hughes Rosemary 
Published: May 2021

The concept of resilience, the ability to “bounce back,” from adversity, can inform interpersonal violence interventions and victim assistance services. Unfortunately, though women with disabilities (WWD) experience high rates of all forms of violence and multiple layers of adversity, existing resilience research overlooks this populations’ experiences, perspectives, and resilience strategies. The impairment, socially misperceived as a personal tragedy, precludes individuals with disabilities from being considered resilient; rather, they are designated almost universally as “at risk” or “vulnerable.” This study aims to remedy this gap in understanding and scholarship. This qualitative study engaged 33 rural women with diverse disabilities who experienced violence to learn about how they cultivated resilience to support recovery and growth after experiencing abuse. Women described key personal qualities and supportive networks and services, such as internal drive, connectedness, dedication, healthy and helpful outlets, and an evolution of thoughts and behaviors. Counter to prevailing perceptions of WWD as dependent and helpless, women described how living with a disability honed strengths fundamental to their resilience. Women also described an “altruism born of suffering” wherein their experiences of violence contributed to a desire to give back and help others in difficult circumstances. Women’s insights help to build a more comprehensive understanding of effective strategies and supports to bolster WWD’s resilience. These findings inform interventions and promote approaches to build on women’s strengths and resourcefulness.
Head Trauma in a Community-Based Sample of Victims of Intimate Partner Violence: Prevalence, Mechanisms of Injury and Symptom Presentation
Authors: Meyer Jessica E. , Jammula Varna , Arnett Peter A. 
Published: May 2021

Objective. The present study aimed to explore the prevalence of subconcussive head trauma, traumatic brain injury (TBI), potential hypoxic events, and hypoxic brain injury (HBI) in victims of physical intimate partner violence (IPV). The study also aimed to characterize the injury presentation and mechanisms of injury in this population. Method. A group of 47 female participants with a history of at least one relationship that included physical violence completed a structured interview assessing for subconcussive hits, TBI, and HBI. Participants ranged in age from 19 to 55, and had an average of 15.3 years of education. Forty-four participants completed the structured interview in person and three participants completed the interview over the phone. Results. The majority of participants reported sustaining at least one impact to the head and approximately half of the participants sustained at least one impact that resulted in a mild TBI. Approximately half of the participants experienced at least one incident of having difficulty breathing due to a violent act from their partner, and approximately one-third of participants reported symptoms consistent with mild HBI. The most common mechanisms of injury were being hit with a closed fist and being strangled. Conclusions. The high levels of head trauma observed in this study highlight the need for clinical and community providers to screen victims of physical IPV for head trauma. The unique characteristics of this population (female sex, high frequency of injuries, and presence of HBIs) indicate that research evaluating the cognitive effects of injuries in this population is needed.
Association of Behavioral Phenotypes With Changes in Sleep During a Workplace Wellness Program
Authors: Waddell Kimberly J. , Changolkar Sujatha , Szwartz Gregory , Godby Sarah , Patel Mitesh S. 
Published: May 2021

Purpose: Examine changes in sleep duration by 3 behavioral phenotypes during a workplace wellness program with overweight and obese adults. Design: Secondary analysis of a randomized clinical trial Setting: Remotely monitored intervention conducted across the United States Subjects: 553 participants with a body mass index ≥25 Intervention: Participants were randomized to 1 of 4 study arms: control, gamification with support, gamification with collaboration, and gamification with competition to increase their physical activity. All participants were issued a wrist-worn wearable device to record their daily physical activity and sleep duration. Measures: The primary outcome was change in daily sleep duration from baseline during the 24 week intervention and follow-up period by study arm within behavioral phenotype class. Analysis: Linear mixed effects regression. Results: Participants who had a phenotype of less physically active and less social at baseline, in the gamification with collaboration arm, significantly increased their sleep duration during the intervention period (30.2 minutes [95% CI 6.9, 53.5], P = 0.01), compared to the control arm. There were no changes in sleep duration among participants who were more extroverted and motivated or participants who were less motivated and at-risk. Conclusions: Changes in sleep during a physical activity intervention varied by behavioral phenotype. Behavioral phenotypes may help to precisely identify who is likely to improve sleep duration during a physical activity intervention.
Weight perception and symptoms of depression in rural Australian adolescents
Authors: Skidmore Samuel , Hawke Catherine , Luscombe Georgina , Hazell Philip , Steinbeck Katharine 
Published: May 2021

Objective To investigate associations between measured and perceived weight, and symptoms of depression in rural Australian adolescents. Method: At baseline a prospective rural adolescent cohort study collected demographic data, measured weight and height, weight self-perception, and presence of depression (Short Mood and Feelings Questionnaire). Using World Health Organisation’s (WHO) age and gender body mass index (BMI) standardisations, participants were classified into four perceptual groups: PG1 healthy/perceived healthy; PG2 overweight/perceived overweight; PG3 healthy/perceived overweight; and PG4 overweight/perceived healthy. Logistic regression analyses explored relationships between these groups and symptoms of depression. Results: Data on adolescents ( n = 339) aged 9–14. PG1 contained 63% of participants, PG2 18%, PG3 4% and PG4 14%. Across the cohort, 32% were overweight and 13% had symptoms of depression. PG2 (overweight/perceived overweight) were more likely to experience symptoms of depression than PG1 (healthy/perceived healthy; Adjusted Odds Ratio [AOR] 3.1, 95% CI 1.5–6.7). Females in PG3 (healthy/perceived overweight) were more likely to experience symptoms of depression (38%) than males (14%) and females in PG1 (10%, AOR 5.4, 95% CI 1.1–28.2). Conclusions: Results suggest that perceptions of being overweight may be a greater predictor for symptoms of depression than actual weight. This has public health implications for youth mental health screening and illness prevention.
Reflections on how to approach early career psychiatrist roles and challenges
Authors: Looi Jeffrey C L , Finlay Angus J F , Heard Daniel S 
Published: May 2021

Objective: To reflect upon and provide experiential advice to address the roles of early career psychiatrists. The main roles include leading patient care; working in teams; clinical supervision and governance of trainees, and of the psychiatrist by clinical directors/managers. While these roles vary across public and private sectors, the discussion focuses on common elements. Conclusions: The first several years of an early career psychiatrist’s work often involves roles for which formal training cannot provide direct guidance, and which benefit from planning and reflective practice. Learning how to navigate clinical care, clinical supervision and governance, formal/informal mentoring and peer review are necessary to effective practice.
An Evaluation of the Effect of Catheter-Directed Continuous Infusion of Local Anesthetic by Elastomeric Pump on Opioid Usage Following Donor Kidney Nephrectomy
Authors: Goldsby Jessica , Schwarz Kerry , Kim Ike , Lewis Victor , Lyda Clark 
Published: May 2021

Background Postoperative pain management following donor nephrectomy can prove challenging for immediate discharge on postoperative day 1 or 2. Although the standard for pain control is utilization of opioids, this increases the risk of postoperative ileus and, if continued inappropriately, increases excess opioids circulating in the community. One strategy that proposes to limit postoperative opioids in kidney donors is the continuous infusion of local anesthetics (CILA), though the effect on patient outcomes is unclear. Objective The purpose of this study was to evaluate the effectiveness of postoperative CILA to decrease opioid usage in kidney donors who undergo laparoscopic nephrectomy. Methods A retrospective analysis was conducted of kidney donors who underwent laparoscopic nephrectomy and received CILA (CILA group) compared with kidney donors who received standard-of-care (SOC) postoperative analgesia. The primary outcome was the mean total oral morphine equivalents (OMEs) administered following surgery. Results A total of 176 kidney donors were evaluated, 88 in each group. The mean OME administered in the CILA group was significantly higher than in the SOC group: 194.8 versus 133.5 mg ( P = 0.003). Mean total postoperative administration of acetaminophen was also increased in the CILA group: 3736.9 versus 2611.6 mg ( P = 0.0041). Mean length of stay following surgery was higher in the kidney donors who received CILA, whereas return to bowel function, time to ambulation, and pain scores were not significantly different. Conclusion and Relevance This report demonstrated that CILA is not an effective modality to reduce opioid utilization or improve recovery in kidney donors following laparoscopic nephrectomy.
Can biosimilar products be interchangeable? Pharmaceutical perspective in the implementation of biosimilars in oncology
Authors: Soares José Cleberson Santos , Cavalcanti Iago Dillion Lima , Vasconcelos Juliana Lúcia de Albuquerque 
Published: May 2021

Objective To evaluate the safety in the interchangeability of biosimilar products approved for cancer treatment from a pharmaceutical perspective. Methods A literature review was carried out using the descriptors “Biosimilar”, “Oncology Therapy”, “Interchangeable drugs” and “Biological Products”, in the Sciencedirect, MEDLINE, and CAPLUS databases. Results Fifty-one articles were selected, which addressed the importance of establishing standards that prove the efficacy and safety of biosimilars with reference products, as well as the growing interest of the pharmaceutical industry in the development of biosimilars and the impact on costs and changes in the perspective of the treatment of cancer patients. Conclusions As they are large and complex molecules, it is impossible to obtain identical copies of their reference products, which generates conflicts and concerns on the part of the pharmaceutical class regarding the safety in the interchangeability of these products, highlighting the importance of pharmacovigilance in this process.
Why don’t they do it? Handwashing barriers and influencer study in Faridabad district, India
Authors: Gupta V , Anand S 
Published: May 2021

Background: Handwashing has been widely accepted as the simplest protection against communicable diseases. However, despite proven effectiveness and cost-efficiency, adoption of regular handwashing is still poor in developing countries. As children in school-going age are vulnerable and continue to suffer from preventable illnesses, this study aims to spot barriers to handwashing among children while simultaneously recognizing the influencing factors to aid the solutions narrative for effective water, sanitation and hygiene (WASH) strategies. Methods: A school-based cross-sectional, mixed-method study was conducted in Ballabhgarh block, Faridabad district, India. A predesigned, pretested, structured questionnaire was administered to 106 class V students in five randomly selected rural government primary schools. Due permissions, consent and ethical clearances were taken. Results: The majority (>91%) of children were found to have low illness threat perception. The inability to visually see germs came out as one of the biggest barriers (46%) that were preventing children from practicing regular handwashing. Family, teachers and peers were found to be the most important sources of information for children and not any particular media channel. In fact, role of peers was found to be critical as 72% children said that they would wash hands if their friends were also washing hands. Conclusion: This study suggests children’s need for visible proof of germs and associated casual attitude toward illness threat as a hitherto unexplored potential barrier to practicing regular handwashing. In addition, the human channel of communication seems to be the most relevant regarding public health messaging in rural heartlands. Despite 100% penetration of mobile phones and commonplace presence of television, it is the community ecosystem that is still the most trusted sources of information and influence. The unique role of peers found in this study could have strategic implications for future behaviour change interventions making a case for peer-to-peer behaviour modeling.
The Action Scales Model: A conceptual tool to identify key points for action within complex adaptive systems
Authors: Nobles James D , Radley Duncan , Mytton Oliver T ,   The Whole Systems Obesity programme team
Published: May 2021

Background: Systems thinking is integral to working effectively within complex systems, such as those which drive the current population levels of overweight and obesity. It is increasingly recognised that a systems approach – which corrals public, private, voluntary and community sector organisations to make their actions and efforts coherent – is necessary to address the complex drivers of obesity. Identifying, implementing and evaluating actions within complex adaptive systems is challenging, and may differ from previous approaches used in public health. Methods: Within this conceptual article, we present the Action Scales Model (ASM). The ASM is a simple tool to help policymakers, practitioners and evaluators to conceptualise, identify and appraise actions within complex adaptive systems. We developed this model using our collective expertise and experience in working with local government authority stakeholders on the Public Health England Whole Systems Obesity programme. It aligns with, and expands upon, previous models such as the Intervention Level Framework, the Iceberg Model and Donella Meadows’ 12 places to intervene within a system. Results: The ASM describes four levels (synonymous with leverage points) to intervene within a system, with deeper levels providing greater potential for changing how the system functions. Levels include events, structures, goals and beliefs. We also present how the ASM can be used to support practice and policy, and finish by highlighting its utility as an evaluative aid. Discussion: This practical tool was designed to support those working at the front line of systems change efforts, and while we use the population prevalence of obesity as an outcome of a complex adaptive system, the ASM and the associated principles can be applied to other issues. We hope that the ASM encourages people to think differently about the systems that they work within and to identify new and potentially more impactful opportunities to leverage change.
Predictors of Change in Skin Intrinsic Fluorescence in Type 1 Diabetes: The Epidemiology of Diabetes Complications Study
Authors: Tomaszewski Erin L. , Orchard Trevor J. , Hawkins Marquis S. , Conway Rebecca B.N. , Buchanich Jeanine M. , Maynard John , Songer Thomas , Costacou Tina 
Published: May 2021

Background Skin intrinsic fluorescent (SIF) scores are indirect measures of advanced glycation end-products (AGEs). SIF scores are cross-sectionally associated with type 1 diabetes (T1D) complications such as increased albumin excretion rate (AER), coronary artery calcification (CAC) and neuropathy. We assessed predictors of SIF score change in those with T1D. Methods Data from the 30-year longitudinal Epidemiology of Diabetes Complications (EDC) study of childhood-onset T1D were used to assess AGEs measured with a SIF score produced by the SCOUT DS® device. SIF scores were assessed twice in 83 participants: between 2007-08 and again between 2010-14. Regression analyses were used to assess independent predictors of SIF score change Results At baseline, mean age was 47.9 ± 6.9 years, diabetes duration was 36.7 ± 6.4 years, and median glycosylated hemoglobin (HbA1c) was 7.1 (interquartile range: 6.5, 8.5). During a mean follow-up of 5.2 ± 0.9 years, mean change in SIF score was 2.9 ± 2.8 arbitrary units. In multivariable linear regression models, log HbA1c ( P < 0.001), log estimated glomerular filtration rate (eGFR) ( P < 0.001), overt nephropathy (defined as AER ≥ 200 µg/min, P = 0.06), and multiple daily insulin shots/pump use (MDI) exposure years ( P = 0.02) were independent predictors of SIF score change. Conclusions Increases in SIF score over 5 years were related to increased glycemic levels and decreased kidney function (eGFR). MDI and glomerular damage were related to a decreased SIF score. This is one of the first studies with repeated SIF assessments in T1D and provides unique, albeit preliminary, insight about these associations.