bluuebunny/crossref_metadata_2025_split huggingface dataset:
Qualitative study on mental health and well-being of Syrian refugees and their coping mechanisms towards integration in the UK
Authors: Paudyal Priyamvada , Tattan Mais , Cooper Maxwell J F 
Published: August 2021

ObjectiveThis study aimed to explore the mental well-being of Syrian refugees and identify their coping mechanisms and pathways towards integration into new communities.DesignQualitative study using in-depth semi-structured interviews.Setting and participantsAdult Syrian refugees (>18 years old) currently residing in South East of England.Results12 participants (3 women and 9 men) took part in the study, all were born in Syria and the majority (n=9) were over 45 years of age. Our findings show that Syrian refugees face constant challenges as they try to integrate into a new society. Loss of and separation from loved ones as well as the nostalgia for the homeland were often cited as a source of psychological distress that created an overwhelming sense of sadness. Participants reported that they struggled for connectedness due to cultural difference and the problematic nature of rapidly formed migrant communities in their new setting. They believed in ‘being their own doctor’ and turning to faith, ritual and nature for healing and comfort. Taboo and stigma around mental health and language barriers were cited as barriers to accessing mental healthcare services.ConclusionPast experiences and present challenges frame Syrian refugees’ sense of well-being, impact use of healthcare and risk future mental health problems. It is hoped that this study will act as a catalyst for further research on this vulnerable group to promote integration, community support and culturally sensitive mental health services.
Adolescents’ beliefs, attitudes and social norms with regard to smoking and sports: a qualitative study
Authors: Olsen Ingri Grimnes , Garritsen Heike H , van de Goor Ien , Kunst Anton E , Rozema Andrea D 
Published: August 2021

ObjectivesThe aim of this study is to explore the beliefs, attitudes and social norms of Dutch adolescents with regard to smoking and sports. In addition, we examine whether there are differences between adolescents at sports clubs with versus without an outdoor smoke-free policy (SFP).DesignQualitative design in the form of focus group interviews.SettingFocus group interviews (n=27) were conducted at 16 sports clubs in the Netherlands. Soccer, tennis, field hockey and korfball clubs were included. Focus group discussions were transcribed verbatim and analysed thematically using MAXQDA.Participants180 adolescents aged 13–18 years old were included in the study. All participants signed an informed consent form. For participants younger than 16 years, parental consent was required.ResultsWith respect to smoking in relation to sports, participants had mostly negative beliefs (ie, smoking has a negative effect on health and sports performance), attitudes (ie, sports and smoking are activities that do not fit together; at sports clubs smoking is not appropriate), and social norms (ie, it is not normal to smoke at sports clubs). The same beliefs, attitudes and social norms were expressed by participants at both sports clubs with and without an outdoor SFP. However, argumentation against smoking was more detailed and more consistent among participants at sports clubs with an outdoor SFP.ConclusionAdolescents have negative beliefs, attitudes and social norms with regard to smoking in relationship to sports. Outdoor SFP at sports clubs might reinforce these negative associations. These findings point to the potential importance of sports in the prevention of adolescent smoking.
Natural history of histologically confirmed high-grade cervical intraepithelial neoplasia during pregnancy: meta-analysis
Authors: Chen Cheng , Xu Yu , Huang Wu , Du Yi , Hu Cui 
Published: August 2021

ObjectivesThis study aimed to conduct a meta-analysis of estimates of the natural history of high-grade cervical intraepithelial neoplasia (CIN) during pregnancy.SettingStudies examining the clinical courses of histologically confirmed high-grade CIN during pregnancy.ParticipantsWe searched PubMed, Web of Science and Embase for eligible studies. Studies were included if they reported the data regarding the natural history of histologically confirmed high-grade CIN during pregnancy. Final estimates were from the meta-analysis of 10 eligible studies.Primary outcome measuresThe regression rate, persistence rate and progression rate of histologically proven untreated high-grade CIN during pregnancy.ResultsA total of 10 original studies were included in this meta-analysis. During pregnancy, the regression rate, persistence rate and progression rate of high-grade CIN were 40% (95% CI 35% to 45%), 59% (95% CI 54% to 64%) and 1% (95% CI 0% to 2%), respectively. There was moderate heterogeneity among the studies. The results of the subgroup meta-analysis show that the pooled rates of regression and persistence during pregnancy were 59% (95% CI 54% to 65%) and 40% (95% CI 35% to 45%) for CIN2, and 29% (95% CI 25% to 33%) and 70% (95% CI 65% to 73%) for CIN3.ConclusionsDuring pregnancy, the majority of histologically confirmed high-grade CIN would be persistent or regressed to lower grade CIN or normal. However, it is still worth noting that a small percentage of high-grade CIN would progress to cervical cancer during pregnancy.
Development and pilot testing of survey items to assess the culture of value and efficiency in hospitals and medical offices
Authors: Sorra Joann , Zebrak Katarzyna , Yount Naomi , Famolaro Theresa , Gray Laura , Franklin Martha , Smith Scott Allan , Streagle Suzanne 
Published: August 2021

BackgroundGiven rising costs and changing payment models, healthcare organisations are increasingly focused on value and efficiency. The goal of our study was to develop survey items to assess clinician and staff perspectives about the extent to which the organisational culture in hospitals and medical offices supports value and efficiency.MethodsDevelopment began with a literature review and interviews with experts and clinicians and staff from hospitals and medical offices. We identified key areas of value and efficiency culture, drafted survey items and conducted cognitive testing. Using purposive sampling to select sites, the 36-item surveys were pilot tested in 47 hospitals and 96 medical offices. Psychometric analysis was conducted on data from 3951 hospital respondents (42% response) and 1458 medical office respondents (63% response).ResultsFactor loadings, multilevel confirmatory factor analysis model fit and reliability estimates were acceptable for the 13 items grouped into 4 composite measures: Empowerment to Improve Efficiency (3 items), Efficiency and Waste Reduction (3 items), Patient Centeredness and Efficiency (3 items) and Management Support for Improving Efficiency and Reducing Waste (4 items). All composite measures were significantly intercorrelated and related to the four Overall Ratings of Healthcare Quality, indicating adequate conceptual convergence among the measures. Eight items assessing Experiences With Activities to Improve Efficiency were also included.ConclusionWe developed psychometrically sound survey items measuring value and efficiency culture. When added to the Agency for Healthcare Research and Quality Surveys on Patient Safety Culture, the item sets extend those surveys by assessing additional dimensions of organisational culture that affect care delivery. Healthcare organisations can use these item sets to assess how well their organisational culture supports value and efficiency and identify areas for improvement.
Prevalence of internet addiction among college students in the Indian setting: a systematic review and meta-analysis
Authors: Joseph Jaison , Varghese Abin , VR Vijay , Dhandapani Manju , Grover Sandeep , Sharma Suresh , Khakha Deepika , Mann Sucheta , Varkey Biji P 
Published: August 2021

BackgroundThe internet is an integral part of everyone’s life. College going adolescents are highly vulnerable to the misuse of the internet.AimsTo estimate the pooled prevalence of internet addiction (IA) among college students in India.MethodsLiterature databases (PubMed, Web of Science, Scopus, EMBASE, PsycINFO and Google Scholar) were searched for studies assessing IA using the Young Internet Addiction Test (Y-IAT) among adolescents from India, published in the English language up to December 2020. We included studies from 2010 to 2020 as this is the marked era of momentum in wireless internet connectivity in India. The methodological quality of each study was scored, and data were extracted from the published reports. Pooled prevalence was estimated using the fixed-effects model. Publication bias was evaluated using Egger’s test and visual inspection of the symmetry in funnel plots.ResultsFifty studies conducted in 19 states of India estimated the prevalence of IA and the overall prevalence of IA as 19.9% (95% CI: 19.3% to 20.5%) and 40.7% (95% CI: 38.7% to 42.8%) based on the Y-IAT cut-off scores of 50 and 40, respectively. The estimated prevalence of severe IA was significantly higher in the Y-IAT cut-off points of 70 than 80 (12.7% (95% CI: 11.2% to 14.3%) vs 4.6% (95% CI: 4.1% to 5.2%)). The sampling method and quality of included studies had a significant effect on the estimation of prevalence in which studies using non-probability sampling and low risk of bias (total quality score ≥7) reported lower prevalence. The overall quality of evidence was rated as ‘moderate’ based on the Grading of Recommendations Assessment, Development and Evaluation criteria.ConclusionsOur nationally representative data suggest that about 20% to 40% of college students in India are at risk for IA. There is a need for further research in the reconsideration of Y-IAT cut-off points among Indian college students.PROSPERO registration numberCRD42020219511.
Collecting affect: emotion and empathy in World War II photographs and drawings of plastic surgery
Authors: Slobogin Christine 
Published: August 2021

This article compares drawings by Diana ‘Dickie’ Orpen (1914–2008) with photographs by Percy Hennell (1911–1987); both of their oeuvres depict plastic reconstructive surgeries from World War II in Britain. Through visual analysis, personal experience and interviews with archivists who have worked with the collections, this article aims to determine the affective effects of these drawings and photographs. I argue that Hennell’s images are the more affective and subjective objects, even though their original purpose was objective and scientific. This article asks why Hennell’s photographs of plastic surgery produce such a vehement emotive response.Investigating Hennell’s use of colour, his compositional choices and the unexpected visual particulars of the operating theatre that he captures—all of which ‘collect affect’ within the photo-archival object—this analysis uses a phenomenological framework to determine the limitations and strengths of two very different styles and mediums of World War II surgical imagery.Beyond establishing which group of images is more affecting, this article also shows why it is empathy that is the most fitting emotional description of the typical responses to Hennell’s photographs. This type of visual analysis of empathic images can be applied to objects-based medical humanities pedagogy that encourages empathy—historical empathy as well as empathy in the present day—for surgical practitioners and trainees.
Automated emergent large vessel occlusion detection by artificial intelligence improves stroke workflow in a hub and spoke stroke system of care
Authors: Elijovich Lucas , Dornbos III David , Nickele Christopher , Alexandrov Andrei , Inoa-Acosta Violiza , Arthur Adam S , Hoit Daniel 
Published: August 2021

BackgroundEmergent large vessel occlusion (ELVO) acute ischemic stroke is a time-sensitive disease.ObjectiveTo describe our experience with artificial intelligence (AI) for automated ELVO detection and its impact on stroke workflow.MethodsWe conducted a retrospective chart review of code stroke cases in which VizAI was used for automated ELVO detection. Patients with ELVO identified by VizAI were compared with patients with ELVO identified by usual care. Details of treatment, CT angiography (CTA) interpretation by blinded neuroradiologists, and stroke workflow metrics were collected. Univariate statistical comparisons and linear regression analysis were performed to quantify time savings for stroke metrics.ResultsSix hundred and eighty consecutive code strokes were evaluated by AI; 104 patients were diagnosed with ELVO during the study period. Forty-five patients with ELVO were identified by AI and 59 by usual care. Sixty-nine mechanical thrombectomies were performed.Median time from CTA to team notification was shorter for AI ELVOs (7 vs 26 min; p<0.001). Door to arterial puncture was faster for transfer patients with ELVO detected by AI versus usual care transfer patients (141 vs 185 min; p=0.027). AI yielded a time savings of 22 min for team notification and a 23 min reduction in door to arterial puncture for transfer patients.ConclusionsAI automated alerts can be incorporated into a comprehensive stroke center hub and spoke system of care. The use of AI to detect ELVO improves clinically meaningful stroke workflow metrics, resulting in faster treatment times for mechanical thrombectomy.
The effect of tamping conditions on undrained shear strengths of a non-plastic sandy silt tailings
Authors: Reid David , Fanni Riccardo , DiDonna Peter 
Published: August 2021

A series of direct simple shear (DSS) tests were carried out on a non-plastic sandy silt lead−zinc−silver tailings to develop a relationship between undrained shearing behaviour and density for contractive states. The critical state line was also obtained through triaxial compression tests to enable the DSS tests to be viewed in a critical state framework and allow comparison with in situ testing. It was found that the gravimetric water content (GWC) used to tamp the specimens had a significant effect on the resulting undrained strengths when attempting to achieve dense states — with higher GWC giving lower strength at a given density than a lower GWC. Intact and slurry deposited (SD) samples were also tested to access denser states without inducing tamping-related stresses. These showed a more consistent trend with the loose-tamped specimens, and with other data from the literature. Plausible explanations as to the causes of the increased strength of dense-tamped samples were obtained through estimating potential preconsolidation stresses and “locked in” horizontal stresses that may occur from dense tamping. The importance of these observations on the development of density−strength profiles in engineering practice was outlined.
Bud dormancy pattern, chilling requirement, and cold hardiness inVitis viniferaL. ‘Chardonnay’ and ‘Riesling’
Authors: Rahemi Alireza , Fisher Helen , Dale Adam , Taghavi Toktam , Kelly John 
Published: August 2021

In recent years, new vineyards have been established in southwestern Ontario. The open water of Lake Erie provides some winter protection for Vitis hybrids and winter-hardy Vitis vinifera L. cultivars in this area. However, winter damage is possible when vines are grown distant from the open water or when lakes are frozen. To better understand the risks to winter survival, the dormancy and chilling phenology were studied over three winters from 2013–2016. Ten dormant canes of two V. vinifera cultivars, ‘Chardonnay’ and ‘Riesling’, were collected weekly from 1 September until 30 March from the mature vines in a commercial vineyard located at St. Williams (Ontario). The canes defoliated in early October, and the endodormancy was completed by the end of December. The cumulative chilling hours (0–7.2 °C) from defoliation until the completion of endodormancy were averaged 606 hours for ‘Chardonnay’ and 665 hours for ‘Riesling’. ‘Chardonnay’ buds were slightly less hardy than ‘Riesling’ to cold temperatures, with a threshold of about −24 °C for ‘Chardonnay’ and −25 °C for ‘Riesling’. Most primary buds of both cultivars died after 16 February 2015, and more than half died after 12 February 2014, due to severe low temperatures of −33.1 and −26 °C, respectively.
Lattice parameters and electronic bandgap of orthorhombic potassium sodium niobate K$$_{0.5}$$Na$$_{0.5}$$NbO$$_{3}$$ from density-functional theory
Authors: Bidaraguppe Ramesh Nithin , Schmidt Falko , Schindlmayr Arno 
Published: August 2021

Abstract
We perform a theoretical analysis of the structural and electronic properties of sodium potassium niobate K$$_{1-x}$$

1
-
x

Na$$_{x}$$

x

NbO$$_{3}$$

3

in the orthorhombic room-temperature phase, based on density-functional theory in combination with the supercell approach. Our results for $$x=0$$

x
=
0

and $$x=0.5$$

x
=
0.5

are in very good agreement with experimental measurements and establish that the lattice parameters decrease linearly with increasing Na contents, disproving earlier theoretical studies based on the virtual-crystal approximation that claimed a highly nonlinear behavior with a significant structural distortion and volume reduction in K$$_{0.5}$$

0.5

Na$$_{0.5}$$

0.5

NbO$$_{3}$$

3

compared to both end members of the solid solution. Furthermore, we find that the electronic bandgap varies very little between $$x=0$$

x
=
0

and $$x=0.5$$

x
=
0.5

, reflecting the small changes in the lattice parameters.

Graphic abstract
A complete set of Lorentz-invariant wave packets and modified uncertainty relation
Authors: Oda Kin-ya , Wada Juntaro 
Published: August 2021

AbstractWe define a set of fully Lorentz-invariant wave packets and show that it spans the corresponding one-particle Hilbert subspace, and hence the whole Fock space as well, with a manifestly Lorentz-invariant completeness relation (resolution of identity). The position–momentum uncertainty relation for this Lorentz-invariant wave packet deviates from the ordinary Heisenberg uncertainty principle, and reduces to it in the non-relativistic limit.
The Relationship Between Open Access Article Publishing and Short-Term Citations in Otolaryngology
Authors: Wassef David W. , Barinsky Gregory L. , Behbahani Sara , Peddireddy Sudeep , Grube Jordon G. , Fang Christina H. , Baredes Soly , Eloy Jean Anderson 
Published: August 2021

Objectives: The purpose of this study is to compare the number of citations received by open access articles versus subscription access articles in subscription journals in the Otolaryngology literature. Methods: Using the Dimensions research database, we examined articles indexed to PubMed with at least 5 citations published in 2018. Articles were included from Otolaryngology— Head and Neck Surgery, The Laryngoscope, JAMA Otolaryngology— Head and Neck Surgery, Annals of Otology, Rhinology, and Laryngology, and American Journal of Otolaryngology. Multivariate Poisson regression modeling was used to adjust for journal, article type, and topic. Practice guidelines, position statements, or retractions were excluded as potential outliers. Results: 137 open access articles and 337 subscription access articles meeting inclusion criteria were identified, with a median citation number of 8 (IQR 6-11). The most common article type was original investigation (82.5%), and the most common study topic was head and neck (28.9%). Open access articles had a higher median number of citations at 9 (IQR 6-13) when compared to subscription access articles at 7 (IQR 6-10) ( P = .032). Open access status was significantly associated with a higher number of citations than subscription access articles when adjusting for journal, article type, and topic (β = .272, CI 0.194-0.500, P < .001). Conclusions: Although comprising a minority of articles examined in this study of subscription journals, open access articles were associated with a higher number of citations than subscription access articles. Open access publishing may facilitate the spread of novel findings in Otolaryngology.
The Frequency and Clinical Assessment of COVID-19 in Patients With Chronic Rhinosinusitis
Authors: Akhlaghi Allahkarm , Darabi Amirhossein , Mahmoodi Marzieh , Movahed Ali , Kaboodkhani Reza , Mohammadi Zahra , Goreh Amir , Farrokhi Shokrollah 
Published: August 2021

Background: Chronic rhinosinusitis (CRS), as an inflammatory airway disease, could be a risk factor for COVID-19 patients. This study aimed to investigate the frequency and severity of symptoms of COVID-19 in patients with CRS and to assess the association between the status of CRS symptoms and the quality of life (QoL) of the patients. Methods: In this observational and cross-sectional study, 207 adult CRS patients participated. The patients, who presented the symptoms of COVID-19, were examined by taking the reverse transcription–polymerase chain reaction test. A questionnaire was completed by each patient, regarding their demographic and clinical data. In addition, the GA2LEN and Sino-Nasal Outcome Test (SNOT-22) standard questionnaires were used to identify the comorbid allergic condition and QoL of CRS patients. Results: The frequency of patients with COVID-19 was 25 (12.1%) of which 22 were treated as outpatients, 2 of them admitted in wards and 1 at intensive care unit. The severity of hyposmia in the patients was 2 (8%) as mild, 5 (20%) moderate, and 11 (72%) as anosmia. The most common allergic and underlying comorbid diseases were allergic rhinitis (88%) and thyroid disorders (28%). Further, the average SNOT-22 score in 4 SNOT-22 domains (nasal, otologic, sleep, and emotional symptoms) was significantly decreased in CRS patients after a period of one year since the pandemic started (40.1 ± 18.0 vs. 46.3 ± 17.7; P < .0001). Discussion: This study showed a low frequency of COVID-19 in patients with CRS and about the same rate of infection positivity in the general population; therefore, we concluded that CRS could not be considered as a risk factor for COVID-19. Interestingly, the lower average score of SNOT-22 after one year of the pandemic in the patients with CRS confirmed the necessity for performing the standard health protocols by the patients.
Emotion Processing Deficit in Euthymic Bipolar Disorder: A Potential Endophenotype
Authors: Reddy Preethi V. , Anandan Saravanakumar , Rakesh Gopalkumar , Shivakumar Venkatarama , Joseph Boban , Vasu Sunil Kalmady , Agarwal Sri Mahavir , Muralidharan Kesavan , Venkatasubramanian Ganesan , Narayanaswamy Janardhanan C. 
Published: August 2021

Background: Emotion processing deficits have been described in patients with bipolar disorder (BD) and are considered one of the core cognitive abnormalities in BD with endophenotype potential. However, the literature on specific impairments in emotion processing cognitive strategies (directive/cortical/higher versus intuitive/limbic/lower) in euthymic adult BD patients and healthy first-degree relatives/high-risk (HR) subjects in comparison with healthy controls (HCs) is sparse. Methods: We examined facial emotion recognition deficits (FERD) in BD ( N = 30), HR ( N = 21), and HC ( N = 30) matched for age (years), years of education, and sex using computer-administered face emotions–Matching And Labeling Task (eMALT). Results: The three groups were significantly different based on labeling accuracy scores for fear and anger (FA) (P < 0.001) and sad and disgust (SD) (P < 0.001). On post-hoc analysis, HR subjects exhibited a significant deficit in the labeling accuracy of FA facial emotions (P < 0.001) compared to HC. The BD group was found to have significant differences in all FA (P = 0.004) and SD (P = 0.003) emotion matching as well as FA (P = 0.001) and SD (P < 0.001) emotion labeling accuracy scores. Conclusions: BD in remission exhibits FERD in general, whereas specific labeling deficits of fear and anger emotions, indicating impaired directive higher order aspect of emotion processing, were demonstrated in HR subjects. This appears to be a potential endophenotype. These deficits could underlie the pathogenesis in BD, with possible frontolimbic circuitry impairment. They may have potential implications in functional recovery and prognosis of BD.