bluuebunny/crossref_metadata_2025_split huggingface dataset:
Towards flexible evaluation schemes in areas with lacking information: a case of waste governance in Mexico
Authors: Turcott Cervantes Dolores Elizabeth , Venegas Sahagún Beatriz Adriana , Lobo García de Cortázar Amaya 
Published: May 2021

Local governments face the need to achieve sustainability in the provision of public services, and to do so, proper governance is essential. This work proposes a method to assess governance in local waste management systems based on a set of indicators that are flexible and robust enough to allow objective and reliable evaluation even where the information that is available is deficient. The proposal is based on a set of indicators divided into six categories that represent an increasing order of governance maturity: institutional framework; government effectiveness; transparency and accountability; network creation; participation; and corruption control. The article presents the proposal and a first test in two Mexican municipalities, which are an example of municipal solid waste management systems in an incipient stage of development, where there may be serious limitations in terms of access to information. The results show that the methodology can be replicated in different contexts and can be useful for making decisions about improvements in municipal solid waste management systems or for comparing them with others. In addition, sufficient information was obtained for a first diagnosis of the cases studied, which indicates the coherence of the proposed framework. Points for practitioners Proper governance is essential to achieve sustainability in the provision of public services. The assessment of local governance must be robust enough to motivate changes and, at the same time, flexible enough to allow reliable evaluation where the quality of service and the availability of information may be scant. We propose a new framework for the assessment of governance in municipal solid waste management systems that meets these requirements, based on a set of indicators clustered according to governance maturity.
Psychological well-being in palliative care: A systematic review
Authors: Redondo Elvira Tamara , Ibáñez del Prado Celia , Cruzado Juan Antonio 
Published: May 2021

Objective To review which are the most influential variables in achieving levels of psychological well-being at the end of life and to verify whether, as certain studies suggest, spirituality, resilience and social support are the pillars on which the psychological well-being construct is based. Method A systematic search through the Scopus, Pubmed and PsycInfo electronic databases was carried out using keywords such as: “wellbeing” OR “psychological-well-being” AND “resilience” AND “spirituality” AND “social support” AND “palliative care” and their multiple combinations. Results Eleven studies were selected, in which terms such as spiritual well-being, absence of discomfort and quality of life were used in substitution of psychological well-being and a certain consensus was found regarding whether resilience, spirituality and social support are predictive variables of psychological well-being. Conclusions Resilience, social support and spirituality are highly relevant variables at the end of life and contribute decisively towards psychological well-being.
Emotion Recognition of Facial Expressions Presented in Profile
Authors: Surcinelli Paola , Andrei Federica , Montebarocci Ornella , Grandi Silvana 
Published: May 2021

Aim of the research The literature on emotion recognition from facial expressions shows significant differences in recognition ability depending on the proposed stimulus. Indeed, affective information is not distributed uniformly in the face and recent studies showed the importance of the mouth and the eye regions for a correct recognition. However, previous studies used mainly facial expressions presented frontally and studies which used facial expressions in profile view used a between-subjects design or children faces as stimuli. The present research aims to investigate differences in emotion recognition between faces presented in frontal and in profile views by using a within subjects experimental design. Method The sample comprised 132 Italian university students (88 female, Mage = 24.27 years, SD = 5.89). Face stimuli displayed both frontally and in profile were selected from the KDEF set. Two emotion-specific recognition accuracy scores, viz., frontal and in profile, were computed from the average of correct responses for each emotional expression. In addition, viewing times and response times (RT) were registered. Results Frontally presented facial expressions of fear, anger, and sadness were significantly better recognized than facial expressions of the same emotions in profile while no differences were found in the recognition of the other emotions. Longer viewing times were also found when faces expressing fear and anger were presented in profile. In the present study, an impairment in recognition accuracy was observed only for those emotions which rely mostly on the eye regions.
Emotional disclosure in palliative care: A scoping review of intervention characteristics and implementation factors
Authors: McInnerney Daisy , Kupeli Nuriye , Stone Paddy , Anantapong Kanthee , Chan Justin , Flemming Kate , Troop Nicholas , Candy Bridget 
Published: May 2021

Background: Emotional disclosure is the therapeutic expression of emotion. It holds potential as a means of providing psychological support. However, evidence of its efficacy in palliative settings is mixed. This may be due to variation in intervention characteristics. Aim: To derive a greater understanding of the characteristics of potentially effective emotional disclosure-based interventions in palliative care by: (1) Developing a taxonomy of emotional disclosure-based interventions tested in people with advanced disease and (2) Mapping and linking objectives, outcomes, underlying mechanisms, and implementation factors. Design: A scoping review drawing on Intervention Component Analysis to combine evidence from studies’ methods, results, and discussion sections. Data sources: Six databases were searched to May 2020 including CINAHL, PsycINFO, and MEDLINE. Studies of emotional disclosure in adults with advanced disease were included. Study quality was appraised using an established tool. Results: Seven thousand seven hundred ninety-two unique records were screened, of which 25 primary studies were included. Intervention characteristics were grouped into classes within three domains: topic of disclosure, format, and dose. Evidence was not available to determine which, if any, of the characteristics is most effective. Thematic synthesis of evidence from methods and discussion sections identified factors to consider in tailoring an emotional disclosure-based intervention to this setting, including: population characteristics (e.g. time since diagnosis), providing a safe environment, and flexibility in format. Conclusions: This review approach facilitated a clearer understanding of factors that may be key in developing emotional disclosure-based interventions for palliative populations. Intervention Component Analysis has potential for application elsewhere to help develop evidence-based interventions.
The COVID-19 pandemic: A tipping point for advance care planning? Experiences of general practitioners
Authors: Dujardin Janneke , Schuurmans Jaap , Westerduin Dieke , Wichmann Anne B , Engels Yvonne 
Published: May 2021

Background: In 2020, the COVID-19 pandemic caused an acute risk of deterioration and dying for many, and an urgent need to start advance care planning. Aim: To explore how general practitioners (GPs) experienced discussing values, goals and preferences with patients during COVID-19. Design and setting: Qualitative research in general practice. Methods: Semi-structured interviews for which Dutch GPs were recruited via purposive sampling. Content analysis was used. Results: Fifteen GPs were interviewed. Six themes were identified: (i) urge of advance care planning, (ii) the GP’s perceived role in it, (iii) preparations for it, (iv) (proactively) discussing it, (v) essentials for good communication and (vi) advance care planning in the (near) future. Calls for proactively discussing advance care planning in the media and in COVID-guidelines caused awareness of it’s importance. GPs envisaged an important role for themselves in initiating it, especially with patients at risk to deteriorate or die from COVID-19. Timing advance care planning appeared difficult but crucial. The recommended digital way of communication was considered problematic due to missing nonverbal communication and difficulties in involving relatives. It was noted that admission to the ICU, which was hardly discussed before the COVID-19 pandemic, should remain a topic during advance care planning. Conclusion: The COVID-19 pandemic brought advance care planning into a new light, GPs were more experienced with discussing it and patients were more aware of their frailty. Because of the nearing ‘grey wave’, advance care planning should remain top priority. Therefore, it should be central in GP and post-academic training.
Conserving dignity and facilitating adaptation to dependency with intimate hygiene for people with advanced disease: A qualitative study
Authors: Morgan Deidre D , Marston Celia , Barnard Elizabeth , Farrow Caroline 
Published: May 2021

Background: People at the end of life experience increased dependence with self-care as disease progresses, including care with intimate hygiene. Dependence with intimate hygiene has been identified as a factor that may compromise dignity at the end of life. However, adaption to increased dependency and subsequent impact on dignity with intimate hygiene is an under-researched area. Aim: This study sought to understand how people at the end of life experience dignity with intimate hygiene when function declines and how people adapt to increased dependence with intimate hygiene needs. Design: A qualitative design was employed using a hermeneutic phenomenological perspective which privileges participant perspectives. Findings were mapped against occupational therapy and dignity literature. Setting/participants: Participants were people with advanced disease receiving inpatient or community palliative care. Results: Eighteen interviews were conducted with people about their experiences and perspectives of dignity with intimate hygiene. The following themes were constructed from the data: (1) There’s a way of doing and a way of asking, (2) Putting each other at ease, (3) It’s just how it is, (4) Regaining and retaining control. How people adjust to dependence with intimate hygiene is individually mediated. Patterns of occupational adaptation to increased dependence with intimate hygiene and practical implications for care are discussed. Conclusion: Adaptation to increased dependence with intimate hygiene is facilitated by enabling moments of micro-competence and agency over how care is received. Carers play a pivotal role in compromising or conserving the dignity with intimate hygiene at the end of life.
Assessment of cognitive and psychomotor impairment, subjective effects, and blood THC concentrations following acute administration of oral and vaporized cannabis
Authors: Spindle Tory R , Martin Erin L , Grabenauer Megan , Woodward Thomas , Milburn Michael A , Vandrey Ryan 
Published: May 2021

Background: Cannabis legalization is expanding, but there are no established methods for detecting cannabis impairment. Aim: Characterize the acute impairing effects of oral and vaporized cannabis using various performance tests. Methods: Participants ( N = 20, 10 men/10 women) who were infrequent cannabis users ingested cannabis brownies (0, 10, and 25 mg Δ-9-tetrahydrocannabinol, THC) and inhaled vaporized cannabis (0, 5, and 20 mg THC) in six double-blind outpatient sessions. Cognitive/psychomotor impairment was assessed with a battery of computerized tasks sensitive to cannabis effects, a novel test (the DRiving Under the Influence of Drugs, DRUID®), and field sobriety tests. Blood THC concentrations and subjective drug effects were evaluated. Results: Low oral/vaporized doses did not impair cognitive/psychomotor performance relative to placebo but produced positive subjective effects. High oral/vaporized doses impaired cognitive/psychomotor performance and increased positive and negative subjective effects. The DRUID® was the most sensitive test to cannabis impairment, as it detected significant differences between placebo and active doses within both routes of administration. Women displayed more impairment on the DRUID® than men at the high vaporized dose only. Field sobriety tests showed little sensitivity to cannabis-induced impairment. Blood THC concentrations were far lower after cannabis ingestion versus inhalation. After inhalation, blood THC concentrations typically returned to baseline well before pharmacodynamic effects subsided. Conclusions: Standard approaches for identifying impairment due to cannabis exposure (i.e. blood THC and field sobriety tests) have severe limitations. There is a need to identify novel biomarkers of cannabis exposure and/or behavioral tests like the DRUID® that can reliably and accurately detect cannabis impairment at the roadside and in the workplace.
Addressing Health Literacy in Patient Decision Aids: An Update from the International Patient Decision Aid Standards
Authors: Muscat Danielle M. , Smith Jenna , Mac Olivia , Cadet Tamara , Giguere Anik , Housten Ashley J. , Langford Aisha T. , Smith Sian K. , Durand Marie-Anne , McCaffery Kirsten 
Published: May 2021

Background There is increasing recognition of the importance of addressing health literacy in patient decision aid (PtDA) development. Purpose An updated review as part of IPDAS 2.0 examined the extent to which PtDAs are designed to meet the needs of people with low health literacy/socially-disadvantaged populations. Data Sources Reference lists of Cochrane reviews of randomized controlled trials (RCTs) of PtDAs (2014, 2017, and upcoming 2021 versions). Study Selection RCTs that assessed the impact of PtDAs on low health literacy or other socially-disadvantaged groups (i.e., ≥50% participants from socially-disadvantaged groups and/or subgroup analysis in socially-disadvantaged group/s). Data Extraction Two researchers independently extracted data into a standardized form including PtDA development and evaluation details. We searched online repositories and emailed authors to access PtDAs to verify grade reading level, understandability, and actionability. Data Synthesis Twenty-five of 213 RCTs met the inclusion criteria, illustrating that only 12% of studies addressed the needs of low health literacy or other socially-disadvantaged groups. Grade reading level was calculated in 8 of 25 studies (33%), which is recommended in previous IPDAS guidelines. We accessed and independently assessed 11 PtDAs. None were written at sixth-grade level or below. Ten PtDAs met the recommended threshold for understandability, but only 5 met the recommended threshold for actionability. We also conducted a post hoc subgroup meta-analysis and found that knowledge improvements after receiving a PtDA were greater in studies that reported using strategies to reduce cognitive demand in PtDA development compared with studies that did not (χ2 = 14.11, P = 0.0002, I2 = 92.9%). Limitations We were unable to access 13 of 24 PtDAs. Conclusions. Greater attention to health literacy and socially-disadvantaged populations is needed in the field of PtDAs to ensure equity in decision support.
Effectiveness of Face Masks in Reducing the Spread of COVID-19: A Model-Based Analysis
Authors: Rao Isabelle J. , Vallon Jacqueline J. , Brandeau Margaret L. 
Published: May 2021

Background The World Health Organization and US Centers for Disease Control and Prevention recommend that both infected and susceptible people wear face masks to protect against COVID-19. Methods We develop a dynamic disease model to assess the effectiveness of face masks in reducing the spread of COVID-19, during an initial outbreak and a later resurgence, as a function of mask effectiveness, coverage, intervention timing, and time horizon. We instantiate the model for the COVID-19 outbreak in New York, with sensitivity analyses on key natural history parameters. Results During the initial epidemic outbreak, with no social distancing, only 100% coverage of masks with high effectiveness can reduce the effective reproductive number [Formula: see text] below 1. During a resurgence, with lowered transmission rates due to social distancing measures, masks with medium effectiveness at 80% coverage can reduce [Formula: see text] below 1 but cannot do so if individuals relax social distancing efforts. Full mask coverage could significantly improve outcomes during a resurgence: with social distancing, masks with at least medium effectiveness could reduce [Formula: see text] below 1 and avert almost all infections, even with intervention fatigue. For coverage levels below 100%, prioritizing masks that reduce the risk of an infected individual from spreading the infection rather than the risk of a susceptible individual from getting infected yields the greatest benefit. Limitations Data regarding COVID-19 transmission are uncertain, and empirical evidence on mask effectiveness is limited. Our analyses assume homogeneous mixing, providing an upper bound on mask effectiveness. Conclusions Even moderately effective face masks can play a role in reducing the spread of COVID-19, particularly with full coverage, but should be combined with social distancing measures to reduce [Formula: see text] below 1. [Box: see text]
Association between joint effusions and concomitant structural injuries (tendinitis and structural injury) on MRI in ankle trauma without fracture
Authors: Choi Yeon Gyu , Park Hee Jin , Kim Ji Na , Kim Myung Sub , Park Se Jin , Hong Seok Woo , Kim Young Hwan 
Published: May 2021

Background The evaluation of correlations among joint effusion, ligament injuries, tenosynovitis and osteochondral lesion of talus (OLT) in the ankle joint is important for developing a treatment plan and predicting prognosis. Purpose To evaluate correlations among tibiotalar (anterior) and talocalcaneal (posterior) joint effusion, tenosynovitis of major flexor tendons, ligaments, and OLT in a group of patients with ankle trauma. Material and Methods This retrospective study included 101 patients with ankle trauma who underwent magnetic resonance imaging. Two radiologists assessed the presence and amount of effusion in the tibiotalar and talocalcaneal joints from grade 0 to 2, according to the amount of capsular distension. Concomitant structural injuries were assessed in the tibialis posterior (TP), flexor digitorum longus, flexor hallucis longus, and peroneus tendons, and the anterior talofibular ligament, calcaneofibular ligament, anteroinferior tibiofibular ligament, posteroinferior tibiofibular ligament, and OLT. Results The proportion of anterior and posterior joint effusion according to grade was 67.3% for anterior joint effusion grade 0, 22.8% for grade 1, and 9.9% for grade 2; for posterior joint effusion, grade 0 was 74.2%, grade 1 was 22.8%, and grade 2 was 3.0%. We found statistically significant correlations between posterior joint effusion and tenosynovitis of TP ( P < 0.05) and between posterior joint effusion and OLT ( P < 0.05). Conclusion Posterior joint effusion is correlated with TP injury and OLT; however, tendon injuries have no correlation with other structural injuries of the ankle joint in a general population with ankle trauma.
Effects of alpha-lipoic acid treatment on serum progranulin levels and inflammatory markers in diabetic neuropathy
Authors: Nádró Bíborka , Lőrincz Hajnalka , Molnár Ágnes , Szentpéteri Anita , Zöld Eszter , Seres Ildikó , Páll Dénes , Paragh György , Kempler Péter , Harangi Mariann , Sztanek Ferenc 
Published: May 2021

Objectives Progranulin (PGRN) is a secreted growth factor that helps to regulate neuronal survival by blocking tumor necrosis factor-alpha (TNFα) receptors. The antioxidant alpha-lipoic acid (ALA) is used in diabetic neuropathy to improve nerve conduction and relieve neuropathic pain, but its effects on PGRN levels have not yet been elucidated. Methods In this prospective study, 54 patients with type 2 diabetes and peripheral neuropathy received 600 mg of ALA daily for 6 months. Twenty-four patients with diabetes without neuropathy were also included in the study. Serum PGRN and TNFα levels were determined using enzyme-linked immunosorbent assays. In addition, current perception threshold (CPT) testing was used to assess sensory neuropathy. Results After ALA treatment, serum PGRN levels were significantly increased and CPT values were significantly improved. Furthermore, there were significant positive correlations among TNFα, ICAM-1, and PGRN levels both before and after ALA treatment. A significant negative correlation was observed between the improvements in CPT and the PGRN levels. Furthermore, ICAM-1 levels were an independent predictor of PGRN levels. Conclusions Changes in serum PGRN levels indicate that ALA treatment may have beneficial effects on endothelial function and neuronal inflammation.
Evaluation of the construct reliability and validity of the DSM-5 Self-Rated Level 1 Cross-Cutting Symptom Measure-Chinese version in maintenance hemodialysis patients
Authors: Ma Shao-Jun , Wang Wen-Ji , Tang Min , Chen Han , Ding Feng 
Published: May 2021

Objective The study aim was to assess the construct reliability and validity of the internal structure of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition Self-Rated Level 1 Cross-Cutting Symptom Measure (CCSM)-Chinese version in maintenance hemodialysis (MHD) patients, and to clarify whether the CCSM is suitable for patients with psychological issues. Methods Participants were 190 MHD patients. Structural equation modelling was used to establish a measurement model to confirm the reliability and validity of the internal structure of the CCSM-Chinese version, and to compare it with the Chinese version of the Symptom Checklist-90 (SCL-90). Results Of the 13 CCSM domains, 8 showed stability and validity in the initial screening of psychological symptoms. Although the Chinese version of the SCL-90 is widely used, the measurement model of the 8-domain CCSM was a better fit than the SCL-90 (CCSM: chi-square = 35.668, chi-square/degrees of freedom [CMIN/df] = 1.877; root mean square error of approximation [RMSEA]  = 0.061; adjusted goodness of fit index [AGFI] = 0.931 vs. SCL-90: chi-square = 89.159, CMIN/df = 2.972; RMSEA = 0.084; AGFI = 0.879). Conclusion The Chinese version of the CCSM is a useful rapid screening tool to detect psychological symptom risk in MHD patients.