bluuebunny/crossref_metadata_2025_split huggingface dataset:
Knowledge–attitude–practice and psychological status of college students during the early stage of COVID-19 outbreak in China: a cross-sectional study
Authors: Jia Yuehui , Qi Yanbo , Bai Li , Han Yunfeng , Xie Zhiping , Ge Jie 
Published: February 2021

ObjectivesThis study aimed to investigate the knowledge–attitude–practice (KAP) of Chinese college students regarding COVID-19 and evaluate their psychological status against the background of the COVID-19 outbreak.DesignThis was a cross-sectional study.SettingThis study covered 31 provinces, municipalities and autonomous regions of mainland China.ParticipantsThe participants, who were college students with ordinary full-time status, were surveyed anonymously on their KAP regarding COVID-19 by using self-made questionnaires. In addition, the Self-Rating Anxiety Scale was used to assess the psychological status of the students.MethodsThe online cross-sectional study among Chinese college students was conducted in February 2020. Logistic regression analysis was used to analyse the predictors of anxiety symptoms.Primary outcome measuresThe level of KAP and anxiety symptoms.ResultsA total of 740 college students from 31 provinces, municipalities and autonomous regions in China were recruited in the survey. Among them, 139 (18.78%) revealed having anxiety. Multivariable logistic regression analysis revealed that female gender was the risk factor for anxiety symptoms with an increased 2.164-fold risk than male gender (OR=2.164, 95% CI=1.279 to 3.662). The knowledge (OR=0.825, 95% CI=0.779 to 0.873) and attitude (OR=0.822, 95% CI=0.762 to 0.887) regarding COVID-19 were protective factors against anxiety symptoms.ConclusionsThe level of KAP regarding COVID-19 was significantly negatively correlated with anxiety symptoms. Thus, understanding the level of KAP among college students during the early stages of major public health emergencies, such as a pandemic, is important. Such understanding plays an important role in adopting targeted health education strategies and reducing the psychological damage caused by these emergencies.
Supporting self-care for eczema: protocol for two randomised controlled trials of ECO (Eczema Care Online) interventions for young people and parents/carers
Authors: Muller Ingrid , Stuart Beth , Sach Tracey , Hooper Julie , Wilczynska Sylvia , Steele Mary , Greenwell Kate , Sivyer Katy , Yardley Lucy , Williams Hywel C , Chalmers Joanne R , Leighton Paul , Howells Laura M , Ridd Matthew J , Lawton Sandra , Griffiths Gareth , Nuttall Jacqui , Langan Sinead M , Roberts Amanda , Ahmed Amina , Kirk Hayden , Becque Taeko , Little Paul , Thomas Kim S , Santer Miriam 
Published: February 2021

IntroductionEczema care requires management of triggers and various treatments. We developed two online behavioural interventions to support eczema care called ECO (Eczema Care Online) for young people and ECO for families. This protocol describes two randomised controlled trials (RCTs) aimed to evaluate clinical and cost-effectiveness of the two interventions.Methods and analysisDesign: Two independent, pragmatic, unmasked, parallel group RCTs with internal pilots and nested health economic and process evaluation studies.Setting: Participants will be recruited from general practitioner practices in England.Participants: Young people aged 13–25 years with eczema and parents and carers of children aged 0–12 years with eczema, excluding inactive or very mild eczema (five or less on Patient-Oriented Eczema Measure (POEM)).Interventions: Participants will be randomised to online intervention plus usual care or to usual eczema care alone.Outcome measures: Primary outcome is eczema severity over 24 weeks measured by POEM. Secondary outcomes include POEM 4-weekly for 52 weeks, quality of life, eczema control, itch intensity (young people only), patient enablement, health service and treatment use. Process measures include treatment adherence, barriers to adherence and intervention usage. Our sample sizes of 303 participants per trial are powered to detect a group difference of 2.5 (SD 6.5) in monthly POEM scores over 24 weeks (significance 0.05, power 0.9), allowing for 20% loss to follow-up. Cost-effectiveness analysis will be from a National Health Service and personal social service perspective. Qualitative and quantitative process evaluation will help understand the mechanisms of action and participant experiences and inform implementation.Ethics and disseminationThe study has been approved by South Central Oxford A Research Ethics Committee (19/SC/0351). Recruitment is ongoing, and follow-up will be completed by mid-2022. Findings will be disseminated to participants, the public, dermatology and primary care journals, and policy makers.Trial registration numberISRCTN79282252.
Influence of lifestyle risk factors on work ability and sick leave in a general working population in Norway: a 5-year longitudinal study
Authors: De Bortoli Marit Müller , Oellingrath Inger M. , Fell Anne Kristin Moeller , Burdorf Alex , Robroek Suzan J. W. 
Published: February 2021

ObjectivesThe aim of this study is to assess (1) whether lifestyle risk factors are related to work ability and sick leave in a general working population over time, and (2) these associations within specific disease groups (ie, respiratory diseases, cardiovascular disease and diabetes, and mental illness).SettingTelemark county, in the south-eastern part of Norway.DesignLongitudinal study with 5 years follow-up.ParticipantsThe Telemark study is a longitudinal study of the general working population in Telemark county, Norway, aged 16 to 50 years at baseline in 2013 (n=7952) and after 5-year follow-up.Outcome measureSelf-reported information on work ability (moderate and poor) and sick leave (short-term and long-term) was assessed at baseline, and during a 5-year follow-up.ResultsObesity (OR=1.64, 95% CI: 1.32 to 2.05) and smoking (OR=1.62, 95% CI: 1.35 to 1.96) were associated with long-term sick leave and, less strongly, with short-term sick leave. An unhealthy diet (OR=1.57, 95% CI: 1.01 to 2.43), and smoking (OR=1.67, 95% CI: 1.24 to 2.25) were associated with poor work ability and, to a smaller extent, with moderate work ability. A higher lifestyle risk score was associated with both sick leave and reduced work ability. Only few associations were found between unhealthy lifestyle factors and sick leave or reduced work ability within disease groups.ConclusionLifestyle risk factors were associated with sick leave and reduced work ability. To evaluate these associations further, studies assessing the effect of lifestyle interventions on sick leave and work ability are needed.
Is there a sex difference in mortality rates for deaths occurring in paediatric intensive care units? Systematic literature review protocol
Authors: Almossawi Ofran , Friend Amanda , Palla Luigi , Feltbower Richard , De Stavola Bianca 
Published: February 2021

IntroductionIn the general population, female children have been reported to have a survival advantage. For children admitted to paediatric intensive care units (PICUs), mortality has been reported to be lower in males despite the higher admission rates for males into intensive care. This apparent sex reversal in PICU mortality is not well studied. To address this, we propose to conduct a systematic literature review to summarise the available evidence. Our review will study the reported differences in mortality between males and females aged 0–17, who died in a PICU, to examine if there is a difference between the two sexes in PICU mortality, and if so, to describe the magnitude and direction of this difference.Methods and analysisStudies that directly or indirectly addressed the association between sex and mortality in children admitted to intensive care will be eligible for inclusion. Studies that directly address the association will be eligible for data extraction. The search strings were based on terms related to the population (children in intensive care), the exposure (sex) and the outcome (mortality). We used the databases MEDLINE (1946–2020), Embase (1980–2020) and Web of Science (1985–2020) as these cover relevant clinical publications. We will assess the reliability of included studies using the risk of bias in observational studies of exposures tool. We will consider a pooled effect if we have at least three studies with similar periods of follow up and adjustment variables.Ethics and disseminationEthical approval is not required for this review as it will synthesise data from existing studies. This manuscript is a part of a larger data linkage study, for which Ethical approval was granted. Dissemination will be via peer-reviewed journals and via public and patient groups.PROSPERO registration numberCRD42020203009.
Qualitative exploration of the Medical Examiner role in identifying problems with the quality of patient care
Authors: O’Hara Rachel , Coster Joanne , Goodacre Steve 
Published: February 2021

ObjectiveA national system of Medical Examiners (MEs) implemented in England and Wales from April 2019 was intended to ensure that every death receives scrutiny from an independent, senior doctor, resulting in early detection of problems in care. The aim of this study was to increase understanding of how the ME role operates to identify problems related to quality of patient care and to explore the potential for development to maximise learning opportunities.DesignA qualitative approach involved the use of semi-structured interviews. Data analysis employed a framework approach.SettingStudy participants were recruited from 11 acute hospitals in England, known to be operating an ME service.ParticipantsA purposive sample of 20 MEs and one ME officer.ResultsMEs brought different perspectives to the role based on their medical background. The process for identifying and acting on quality of care concerns was broadly consistent, with a notable consensus regarding the value of speaking to bereaved relatives. Variation was identified within and between services in relation to how core components are carried out and the perceived salience of information, which appeared to reflect individual and service preferences as well as different organisational pathways. ME services required flexibility to accommodate fluctuating demand, but funding arrangements imposed restrictions. The majority of MEs highlighted limited opportunity for formal team contact and a lack of meaningful feedback as limiting scope for development.ConclusionCore components of the ME role were being conducted, although individual and systemic variations in practice were identified. The discussion with bereaved relatives is a unique feature of the ME role and was considered highly valuable, both for the organisation and relatives. Further development could consider the impact of the variation identified and address mechanisms for feedback and shared learning.
Added value of an open narrative in verbal autopsies: a mixed-methods evaluation from Malawi
Authors: Loh Patricia , Fottrell Edward , Beard James , Bar-Zeev Naor , Phiri Tambosi , Banda Masford , Makwenda Charles , Bird Jon , King Carina 
Published: February 2021

BackgroundThe WHO standardised verbal autopsy (VA) instrument includes closed questions, ascertaining signs and symptoms of illness preceding death, and an optional open narrative. As VA analyses increasingly use automated algorithms, inclusion of narratives should be justified. We evaluated the role of open narratives on VA processes, data quality and respondent’s emotional stress.MethodsA mixed-methods analysis was conducted using VA data for child deaths (0–59 months), between April 2013 and November 2016 in Mchinji district, Malawi. Deaths were prospectively randomised to receive closed questions only or open narrative followed by closed questions. On concluding the VA, interviewers self-completed questions on respondents’ emotional stress. Logistic regression was used to determine associations with visible emotional distress during VAs. A group discussion with interviewers was conducted at the project end, to understand field experiences and explore future recommendations; data were coded using deductive themes.Results2509 VAs were included, with 49.8% (n=1341) randomised to open narratives. Narratives lasted a median of 7 minuntes (range: 1–113). Interviewers described improved rapport and felt narratives improved data quality, although there was no difference in the proportion of deaths with an indeterminate cause using an automated algorithm (5.3% vs 6.1%). The majority of respondents did not display visible emotional stress (81%). Those with a narrative had higher, but not statistically significant, odds of emotional distress (adjusted OR: 1.20; 95% CI: 0.98 to 1.47). Factors associated with emotional stress were: infant deaths versus neonates; deaths at a health centre or en-route to hospital versus home; and higher socioeconomic status. Non-parental respondents and increased time between death and interview were associated with lower odds of emotional distress.ConclusionConducting an open narrative may help build rapport, something valued by the interviewers. However, additional time and emotional burdens should be further justified, with quality and utility of narratives promoted through standardised recommendations.
How can robot-assisted surgery provide value for money?
Authors: Patel Sejal , Rovers Maroeska M , Sedelaar Michiel J P , Zusterzeel Petra L M , Verhagen Ad F T M , Rosman Camiel , Grutters Janneke P C 
Published: February 2021

ObjectivesTo develop an interactive tool that estimates what potential benefits are needed for the robot to provide value for money when compared with endoscopic or open surgical interventions.DesignA generic online interactive tool was developed to analyze the (health) effects needed to compensate for the additional costs of using a surgical robotic system from a healthcare perspective. The application of the tool is illustrated with a hypothetical new surgical robotic platform. A synthesis of evidence from different sources was used combined with interviews with surgeons.SettingFlexible tool that can be adapted to flexible settings.ParticipantsAny hospital patient group for which robotic, endoscopic or open surgical procedures may be considered as appropriate treatment alternatives (eg, urology, gynecology, and so on).InterventionRobotically assisted surgical interventions.ComparatorEndoscopic or open surgical interventions.Main outcome measuresThresholds of how much (health) effect is needed for robot-assisted surgery to provide value for money and to become cost-effective.ResultsThe utilization rate of the surgical robotic system and a reduction in complications appeared to be important aspects in determining the value for money. To become cost-effective, it was deemed important for new surgical robotic systems to have added clinical benefit and become less costly than the current system.ConclusionsThis paper and its assisting interactive tool can be used by clinicians, researchers, and policymakers to gain insight in the benefit needed to provide value for money when using a (new) surgical robotic system or, when the effects are known or can be estimated, to assess the value for money for a specific indication. For robotic surgery to provide most value for money, we recommend assessing for each indication whether the necessary effects seem achievable.
Discovery of predictors of sudden cardiac arrest in diabetes: rationale and outline of the RESCUED (REcognition of Sudden Cardiac arrest vUlnErability in Diabetes) project
Authors: van Dongen Laura H , Harms Peter P , Hoogendoorn Mark , Zimmerman Dominic S , Lodder Elisabeth M , 't Hart Leen M , Herings Ron , van Weert Henk C P M , Nijpels Giel , Swart Karin M A , van der Heijden Amber A , Blom Marieke T , Elders Petra J , Tan Hanno L 
Published: February 2021

IntroductionEarly recognition of individuals with increased risk of sudden cardiac arrest (SCA) remains challenging. SCA research so far has used data from cardiologist care, but missed most SCA victims, since they were only in general practitioner (GP) care prior to SCA. Studying individuals with type 2 diabetes (T2D) in GP care may help solve this problem, as they have increased risk for SCA, and rich clinical datasets, since they regularly visit their GP for check-up measurements. This information can be further enriched with extensive genetic and metabolic information.AimTo describe the study protocol of the REcognition of Sudden Cardiac arrest vUlnErability in Diabetes (RESCUED) project, which aims at identifying clinical, genetic and metabolic factors contributing to SCA risk in individuals with T2D, and to develop a prognostic model for the risk of SCA.MethodsThe RESCUED project combines data from dedicated SCA and T2D cohorts, and GP data, from the same region in the Netherlands. Clinical data, genetic data (common and rare variant analysis) and metabolic data (metabolomics) will be analysed (using classical analysis techniques and machine learning methods) and combined into a prognostic model for risk of SCA.ConclusionThe RESCUED project is designed to increase our ability at early recognition of elevated SCA risk through an innovative strategy of focusing on GP data and a multidimensional methodology including clinical, genetic and metabolic analyses.
Description of multimorbidity clusters of admitted patients in medical departments of a general hospital
Authors: Matesanz-Fernández María , Seoane-Pillado Teresa , Iñiguez-Vázquez Iria , Suárez-Gil Roi , Pértega-Díaz Sonia , Casariego-Vales Emilio 
Published: February 2021

AbstractObjectiveWe aim to identify patterns of disease clusters among inpatients of a general hospital and to describe the characteristics and evolution of each group.MethodsWe used two data sets from the CMBD (Conjunto mínimo básico de datos - Minimum Basic Hospital Data Set (MBDS)) of the Lucus Augusti Hospital (Spain), hospitalisations and patients, realising a retrospective cohort study among the 74 220 patients discharged from the Medic Area between 01 January 2000 and 31 December 2015. We created multimorbidity clusters using multiple correspondence analysis.ResultsWe identified five clusters for both gender and age. Cluster 1: alcoholic liver disease, alcoholic dependency syndrome, lung and digestive tract malignant neoplasms (age under 50 years). Cluster 2: large intestine, prostate, breast and other malignant neoplasms, lymphoma and myeloma (age over 70, mostly males). Cluster 3: malnutrition, Parkinson disease and other mobility disorders, dementia and other mental health conditions (age over 80 years and mostly women). Cluster 4: atrial fibrillation/flutter, cardiac failure, chronic kidney failure and heart valve disease (age between 70–80 and mostly women). Cluster 5: hypertension/hypertensive heart disease, type 2 diabetes mellitus, ischaemic cardiomyopathy, dyslipidaemia, obesity and sleep apnea, including mostly men (age range 60–80). We assessed significant differences among the clusters when gender, age, number of chronic pathologies, number of rehospitalisations and mortality during the hospitalisation were assessed (p&lt;0001 in all cases).ConclusionsWe identify for the first time in a hospital environment five clusters of disease combinations among the inpatients. These clusters contain several high-incidence diseases related to both age and gender that express their own evolution and clinical characteristics over time.
Electron-impact ionization of the Pb atom
Authors: Pindzola M. S. , Loch S. D. , Colgan J. P. 
Published: February 2021

Abstract
Electron-impact ionization cross sections are calculated for the ground configuration of the Pb atom. Time-dependent close-coupling cross sections for the direct ionization of the 6s and 6p subshells leading to single ionization are calculated with and without a polarization potential. Configuration-average distorted-wave cross sections for the direct ionization of the 6s and 6p subshells leading to single ionization are also calculated with and without a polarization potential. We find the time-dependent close-coupling cross sections using a polarization potential to be in good agreement with convergent-close-coupling cross sections using a polarization potential. The total direct ionization cross sections are compared to two sets of experimental measurements. The differences between the direct ionization cross sections and the experimental measurements are mainly due to indirect ionization cross sections coming from the $$6s^2 6p^2 \rightarrow 6s 6p^3$$

6

s
2

6

p
2

→
6
s
6

p
3

excitation followed by autoionization.

GraphicAbstract
Teacher Incentives and Student Performance: Evidence from Brazil
Authors: Lépine Andrea 
Published: February 2021

Abstract
This paper provides evidence on a large-scale teacher incentive program in the state of São Paulo, Brazil, which awarded group bonuses to teachers and school staff conditional on improvements in student performance. By using a difference-in-differences and triple-differences framework with a series of alternative counterfactual groups, I show that the program had positive effects on student achievement up to seven years after implementation, although improvements vary across grades and subjects. Although it could be expected that free-riding effects increase with the number of teachers in schools, limiting the impact of the program, this does not seem to be the case.
A Direct Comparison of Spatial Attention and Stimulus–Response Compatibility between Mice and Humans
Authors: Schnabel Ulf H. , Van der Bijl Tobias , Roelfsema Pieter R. , Lorteije Jeannette A. M. 
Published: February 2021

Abstract
Mice are becoming an increasingly popular model for investigating the neural substrates of visual processing and higher cognitive functions. To validate the translation of mouse visual attention and sensorimotor processing to humans, we compared their performance in the same visual task. Mice and human participants judged the orientation of a grating presented on either the right or left side in the visual field. To induce shifts of spatial attention, we varied the stimulus probability on each side. As expected, human participants showed faster RTs and a higher accuracy for the side with a higher probability, a well-established effect of visual attention. The attentional effect was only present in mice when their response was slow. Although the task demanded a judgment of grating orientation, the accuracy of the mice was strongly affected by whether the side of the stimulus corresponded to the side of the behavioral response. This stimulus–response compatibility (Simon) effect was much weaker in humans and only significant for their fastest responses. Both species exhibited a speed–accuracy trade-off in their responses, because slower responses were more accurate than faster responses. We found that mice typically respond very fast, which contributes to the stronger stimulus–response compatibility and weaker attentional effects, which were only apparent in the trials with slowest responses. Humans responded slower and had stronger attentional effects, combined with a weak influence of stimulus–response compatibility, which was only apparent in trials with fast responses. We conclude that spatial attention and stimulus–response compatibility influence the responses of humans and mice but that strategy differences between species determine the dominance of these effects.