bluuebunny/crossref_metadata_2025_split huggingface dataset:
Becoming the Unseen Helmsman - Game facilitator competencies for novice, experienced, and non-game facilitators
Authors: Kortmann Rens , Peters Vincent 
Published: June 2021

Background. To facilitate game sessions for purposes beyond mere entertainment a facilitator needs to act like an ‘Unseen Helmsman’: steering their ship clear from rocks and storms without the players in the ship realizing. Previous work laid down a competency model for game facilitation. It reviewed several competency models for facilitators of generic (non-game) group sessions. Since no such model comprehensively provided guidelines to facilitate game sessions in particular, a new competency model was proposed using a bottom-up approach with the participation of game facilitation experts. The question remains what lessons may be drawn from this model. Methods. This contribution elaborates on the competency model for game facilitation and draws lessons from it. Thus it aims to empower both novice and experienced game facilitators to become an Unseen Helmsman. Also, it presents learnings for people who are experienced in facilitating groups in general, but who are new to facilitating game sessions. Conclusions. First, lessons for novice game facilitators include familiarising themselves with the core notions of the competency model: the characteristics of a complex systems game (session), and the attitudes, knowledge, and skills for successful game facilitation. Second, experienced game facilitators may learn from existing competency models for generic (non-game) group facilitation. Third, facilitators of generic (non-game) group sessions are encouraged to study the characteristics of game sessions in addition to the specific competencies contained in the competency model for game facilitators.
Sociodemographics and Quality of Life in Dutch-Speaking Adolescents and Adults With and Without a Cleft Lip and/or Palate
Authors: Alighieri Cassandra , D’haeseleer Evelien , Bettens Kim , Bonte Katrien , Vermeersch Hubert , Vermeire Nele , Claeys Merel , Sseremba Daniel , Galiwango George , Van Lierde Kristiane 
Published: June 2021

Objective: To investigate the impact of living with a cleft lip and/or cleft palate (CL/P) on sociodemographic variables, quality of life, aesthetics, life satisfaction, and social distress in Dutch-speaking adolescents and adults. Design: Cross-sectional study. Participants: Thirty Dutch-speaking participants with a CL/P with a mean age of 26.93 years (SD = 11.69) and an age- and gender-matched control group of 30 participants (19 men and 11 women) without a CL/P with a mean age of 26.87 years (SD = 11.73). Main Outcome Measures: Self-reported outcomes of sociodemographics, quality of life, aesthetics, life satisfaction, social distress, and impact of cleft on well-being and functioning. Results: No significant differences in educational level, employment, monthly net income, marital status, and having children were found between participants with and without a CL/P. In addition, quality of life, overall aesthetics, life satisfaction, and social distress did not differ between the 2 groups. Among participants with CL/P, there were no gender differences in the influence of their CL/P on daily functioning, well-being, social contacts, family life, applying for a job, work, education, or leisure time. Conclusion: The findings revealed no differences between participants with and without a CL/P with regard to sociodemographics, quality of life, aesthetics, life satisfaction, or social distress. There were no gender differences in the influence of cleft on well-being and functioning. Longitudinal research can help determine possible fluctuations in the impact of living with a CL/P across the life span.
A nurse-led, telehealth-driven hepatitis C management initiative in regional Victoria: Cascade of care from referral to cure
Authors: Rodrigues Beverly , Parsons Nola , Haridy James , Bloom Stephen , Day Caroline , Haar Geoffrey , Nicoll Amanda , Sawhney Rohit 
Published: June 2021

Introduction Elimination of hepatitis C virus stands as an unresolved World Health Organization target, and is associated with complications including cirrhosis and hepatocellular carcinoma. Hepatitis C virus management has been revolutionised following the widespread availability of direct-acting antiviral agents in Australia since 2016; however, large proportions of the population remain untreated. Telehealth-based service delivery is an accessible and effective alternative, and we aimed to assess qualitative and clinical outcomes in a clinical nurse consultant-led regional telehealth model. Methods A prospective cohort analysis of all patients referred to a Victorian regional hospital’s hepatitis C virus telehealth clinic between 1 April 2017 and 10 June 2020 was conducted. Data were collated from outpatient and electronic medical records. Results Fifty-five out of 71 referred patients were booked, with 44 patients (80%) attending at least one appointment. A history of alcohol use disorder and psychiatric comorbidity was seen in 25 (54%) and 24 (52%) patients, respectively. Twenty-one out of 24 (88%) eligible patients had direct-acting antiviral agent treatment and 14 out of 21 (67%) successfully completed the treatment. An average of 46.5 km, 54.6 min and $AUD30.70 was saved per patient for each visit. Observed benefits included: increased medical engagement, adherence to and completion of HCV treatment and cirrhosis monitoring. Telehealth-driven hepatocellular carcinoma surveillance was successful in the cirrhotic subgroup. Conclusion Clinical nurse consultant-led hepatitis C virus management via telehealth allows access to marginalised regional populations. Clinical outcomes were comparable to other cohorts with additional cost-benefit, efficiency gains and carbon footprint reduction amongst a previously unreported regional Victorian hepatitis C virus population.
Multicultural experience and multilingualism as predictors of creativity
Authors: Fürst Guillaume , Grin François 
Published: June 2021

Aims and objectives: Past research has shown that multicultural experience and multilingualism can be positively associated with creativity. However, very few studies have focused simultaneously on all these variables. Our aim is to consider both sets of predictors simultaneously, clarifying whether the impact of these variables on creativity is cumulative or redundant. Design/methodology/approach: The design combines correlational and quasi-experimental approaches. It is also strongly multivariate and includes various measurement methods. Variables of interest were assessed with questionnaires ( N = 596) and creativity tasks ( N = 174) in laboratory settings. The scope of the study, therefore, is relatively large and encompasses several indicators. Data and analysis: We use multiple regressions with latent and manifest variables. Latent variables were constructed for all sets of key predictors (multilingualism, traveling experience, living abroad experience); predictors were regressed on four types of creativity variables, also latent in most cases (creative potential; creative interests, activities, and achievements; creative performance in a writing task; creative performance on a remote association task). Findings/conclusions: Results shows that both multicultural experience and multilingualism are positively related with various manifestations of creativity. Overall, the results indicate complementary effects of multicultural experience and multilingualism on creativity. The most robust predictors are multilingualism and variables representing deep immersion in foreign countries. Originality: Three features make this study unique: (a) it examines both multilingualism and multiculturalism; (b) the sample population is broader than in most studies, which often focus on migrant populations; and (c) it implements a multimethod operationalization of creativity. Significance/implications: The paper goes beyond received approaches to the link between human diversity and creativity; the analysis is put in relation with other research work that focuses on policy implications for diversity, particularly in the areas of bilingualism and bicultural identity. Implications regarding the connections between creativity, multilingualism, and general executive functioning are also discussed.
A survey of Alberta pharmacists’ attitudes, comfort and perceived barriers to a community-based naloxone program
Authors: Nowlan Sarah-Emily , MacKinnon Neil J. , Hincapie Ana , Tachuk Matt 
Published: June 2021

Background: Community pharmacists play an important role in the wellness of patients, families and friends affected by prescription and illicit opioid drugs. They are key partners of the Community Based Naloxone (CBN) Program in Alberta and similar programs across other Canadian jurisdictions. This publicly funded program is an evidence-based response to the opioid overdose crisis, facilitating access to and distribution of naloxone kits through pharmacies. The study aimed to describe Alberta community pharmacists’ practices, training, comfort levels and views in dispensing naloxone kits through the CBN program and detail potential perceived barriers to program participation. Methods: The study was conducted as a cross-sectional online survey of Alberta pharmacists. Data collected from the survey were descriptive and evaluated using Microsoft Excel. Fisher exact tests were used to study the associations in responses among several demographic characteristics and related to dispensing practices, pharmacists’ beliefs and perceived barriers. Results: A total of 255 responses were included in the final analysis, with 89.8% of pharmacists replying “yes” to CBN program participation. Pharmacists on average were “comfortable” dispensing naloxone to patients for varying indications, with 85% reporting always providing education when dispensing naloxone to an individual for the first time. About 41% of pharmacists reported no barriers to the program, with the most common perceived barriers being lack of time (29%), demand (20%) and funding (19%). Conclusion: Most community pharmacists who responded to the survey participate in the CBN program in Alberta. They held positive beliefs about their role in screening patients for the risk of opioid overdose and are confident in their abilities to recommend and educate on naloxone kits. Proactive screening appeared lower, however, and dispensing kits were potentially variable. Addressing factors such as time, funding for services and demand may help further pharmacist uptake and success of the program. Can Pharm J (Ott) 2021;154:xx-xx.
Second-line treatment in renal cell carcinoma: clinical experience and decision making
Authors: Guadalupi Valentina , Cartenì Giacomo , Iacovelli Roberto , Porta Camillo , Pappagallo Giovanni , Ricotta Riccardo , Procopio Giuseppe 
Published: June 2021

Currently, conventional treatments for metastatic RCC (mRCC) include immune-based combination regimens and/or targeted therapies, the latter mainly acting on angiogenesis, a key element of the process of tumor growth and spread. Although these agents proved able to improve patients’ outcomes, drug resistance and disease progression are still experienced by a substantial number of VEGFR-TKIs-treated mRCC patients. Following the inhibition of the VEGF/VEGFRs axis, two strategies have emerged: either specifically targeting resistance pathways, at the same time continuing to inhibit angiogenesis, or using a completely different approach aimed at re-activating the immune system through the use of inhibitors of specific negative immune checkpoints. These two approaches, practically represented by the use of either cabozantinib or nivolumab, seem to remain a rational therapeutic approach also when first-line immune-based combinations are used. The objective of this study is to design a preferential therapeutic pathway for the second-line treatment of mRCC. The procedure applied in this project was a group discussion, based on the Nominal Group Technique (NGT) method in a meeting session, aimed at defining the therapeutic choice for the second-line treatment of mRCC. The NGT process defined the most relevant parameters that, according to the interviewed panelists, clinicians should consider for the selection of the second-line therapy in the context of advanced renal cell carcinoma of mRCC. The algorithm developed for the treatment selection as a result of this process should thus be considered by clinicians as reference for therapy selection. Plain language summary The result of this paper was the definition of an algorithm intended to suggest a preferential therapeutic pathway considering both the outputs of the Nominal Group Technique (NGT) process and the actual clinical practice and the experience of selected panelists. During the NGT process and the discussion phase, panelists defined the most important parameters to be included in the algorithm that are important for the treatment definition. Cabozantinib and nivolumab are identified as the most reasonable therapeutic options for patients progressing after first-line treatment and are the medication options included in the algorithm for therapy selection.
Biomechanical Evaluation of Achilles Tendon Midsubstance Repair: The Effects of Anchor Angle and Position
Authors: Stake Ingrid K. , Miles Jon W. , Douglass Brenton W. , Dornan Grant J. , Clanton Thomas O. 
Published: June 2021

Background The percutaneous knotless repair technique for Achilles tendon ruptures utilizes a Percutaneous Achilles Repair System (PARS) device for suturing the proximal tendon and 2 suture anchors for fixing the sutures into the calcaneus. Determining the best position of the suture anchors may optimize the strength of this repair. Methods Twelve pairs of human ankle cadaveric specimens were randomly assigned to receive suture anchors placed at 45°, 90°, or 135° from the sagittal plane. The anchors were tensioned according to a protocol representing progressive, postoperative rehabilitation. Load, number of loading cycles, displacement, and mode of failure were recorded. Results With the anchors placed at 45°, 90°, and 135°, the ultimate failure loads were mean 265 ± 64 N, 264 ± 75 N, and 279 ± 40 N, and the total number of loading cycles were mean 459 ± 166, 466 ± 158, and 469 ± 110, respectively. The effect of anchor angle on failure load, number of loading cycles, and displacement was not statistically significant. Visually, the anchors at 45° and 90° demonstrated sutures cutting through the bone. Conclusion We found no statistically significant difference in pullout strength between the 3 different anchor angles. Sutures cutting through the bone may be a concern with acute anchor angles. This suggests that a 135° anchor angle may result in a lower risk of tendon elongation with the percutaneous knotless repair technique. Levels of Evidence Cadaveric laboratory study
Applicability of deep learning-based reconstruction trained by brain and knee 3T MRI to lumbar 1.5T MRI
Authors: Kashiwagi Nobuo , Tanaka Hisashi , Yamashita Yuichi , Takahashi Hiroto , Kassai Yoshimori , Fujiwara Masahiro , Tomiyama Noriyuki 
Published: June 2021

Background Several deep learning-based methods have been proposed for addressing the long scanning time of magnetic resonance imaging. Most are trained using brain 3T magnetic resonance images, but is unclear whether performance is affected when applying these methods to different anatomical sites and at different field strengths. Purpose To validate the denoising performance of deep learning-based reconstruction method trained by brain and knee 3T magnetic resonance images when applied to lumbar 1.5T magnetic resonance images. Material and Methods Using a 1.5T scanner, we obtained lumber T2-weighted sequences in 10 volunteers using three different scanning times: 228 s (standard), 119 s (double-fast), and 68 s (triple-fast). We compared the images obtained by the standard sequence with those obtained by the deep learning-based reconstruction-applied faster sequences. Results Signal-to-noise ratio values were significantly higher for deep learning-based reconstruction-double-fast than for standard and did not differ significantly between deep learning-based reconstruction-triple-fast and standard. Contrast-to-noise ratio values also did not differ significantly between deep learning-based reconstruction-triple-fast and standard. Qualitative scores for perceived signal-to-noise ratio and overall image quality were significantly higher for deep learning-based reconstruction-double fast and deep learning-based reconstruction-triple-fast than for standard. Average scores for sharpness, contrast, and structure visibility were equal to or higher for deep learning-based reconstruction-double-fast and deep learning-based reconstruction-triple-fast than for standard, but the differences were not statistically significant. The average scores for artifact were lower for deep learning-based reconstruction-double-fast and deep learning-based reconstruction-triple-fast than for standard, but the differences were not statistically significant. Conclusion The deep learning-based reconstruction method trained by 3T brain and knee images may reduce the scanning time of 1.5T lumbar magnetic resonance images by one-third without sacrificing image quality.
Long-term mortality in young patients with spontaneous intracerebral haemorrhage: Predictors and causes of death
Authors: Verhoeven Jamie I , Pasi Marco , Casolla Barbara , Hénon Hilde , de Leeuw Frank-Erik , Leys Didier , Klijn Catharina JM , Cordonnier Charlotte 
Published: June 2021

Introduction Intracerebral haemorrhage (ICH) in young adults is rare but has devastating consequences. We investigated long-term mortality rates, causes of death and predictors of long-term mortality in young spontaneous ICH survivors. Patients and methods We included consecutive patients aged 18–55 years from the Prognosis of Intracerebral Haemorrhage cohort (PITCH), a prospective observational cohort of patients admitted to Lille University Hospital (2004–2009), who survived at least 30 days after spontaneous ICH. We studied long-term mortality with Kaplan-Meier analyses, collected causes of death, performed uni-/multivariable Cox-regression analyses for the association of baseline characteristics with long-term mortality. Results Of 560 patients enrolled in the PITCH, 75 patients (75% men) met our inclusion criteria (median age 50 years, interquartile range [IQR] 44–53 years). During a median follow-up of 8.2 years (IQR 5.0–10.1), 26 patients died (35%), with a standardized mortality ratio of 13.0 (95% confidence interval [95% CI] 8.5–18.0) compared to peers from the general population. Causes of death were vascular in 7 (27%) patients, non-vascular in 13 (50%) and unknown in 6 (23%). Global cerebral atrophy (hazard ratio [HR] 3.0, 95% CI 1.1–8.6), modified Rankin Score >2 before ICH (HR 3.4, 95% CI 1.0–11.0), and excessive alcohol consumption (HR 3.3, 95% CI 1.1–10.2) were independently associated with long-term mortality. Discussion We found a 13-fold higher mortality risk for young ICH survivors compared to the general French population. Predictors of long-term mortality were pre-existing conditions, not ICH-characteristics. Conclusion Young ICH survivors remain at increased mortality risk of vascular and non-vascular death for years after ICH.
Multi-omics analysis of the bioactive constituents biosynthesis of glandular trichome in Perilla frutescens
Authors: Zhou Peina , Yin Mengjiao , Dai Shilin , Bao Ke , Song Chenglin , Liu Chanchan , Wu Qinan 
Published: June 2021

Abstract
Background
Perilla frutescens (L.) Britt is a medicinal and edible plant widely cultivated in Asia. Terpenoids, flavonoids and phenolic acids are the primary source of medicinal ingredients. Glandular trichomes with multicellular structures are known as biochemical cell factories which synthesized specialized metabolites. However, there is currently limited information regarding the site and mechanism of biosynthesis of these constituents in P. frutescens. Herein, we studied morphological features of glandular trichomes, metabolic profiling and transcriptomes through different tissues.

Results
Observation of light microscopy and scanning electron microscopy indicated the presence of three distinct glandular trichome types based on their morphological features: peltate, capitate, and digitiform glandular trichomes. The oil of peltate glandular trichomes, collected by custom-made micropipettes and analyzed by LC–MS and GC–MS, contained perillaketone, isoegomaketone, and egomaketone as the major constituents which are consistent with the components of leaves. Metabolomics and transcriptomics were applied to explore the bioactive constituent biosynthesis in the leaves, stem, and root of P. frutescens. Transcriptome sequencing profiles revealed differential regulation of genes related to terpenoids, flavonoids, and phenylpropanoid biosynthesis, respectively with most genes expressed highly in leaves. The genes affecting the development of trichomes were preliminarily predicted and discussed.

Conclusions
The current study established the morphological and chemical characteristics of glandular trichome types of P. frutescens implying the bioactive constituents were mainly synthesized in peltate glandular trichomes. The genes related to bioactive constituents biosynthesis were explored via transcriptomes, which provided the basis for unraveling the biosynthesis of bioactive constituents in this popular medicinal plant.
Temporal trends in outcome and patient characteristics in dilated cardiomyopathy, data from the Swedish Heart Failure Registry 2003–2015
Authors: Sjöland Helen , Silverdal Jonas , Bollano Entela , Pivodic Aldina , Dahlström Ulf , Fu Michael 
Published: June 2021

Abstract
Background
Temporal trends in clinical composition and outcome in dilated cardiomyopathy (DCM) are largely unknown, despite considerable advances in heart failure management. We set out to study clinical characteristics and prognosis over time in DCM in Sweden during 2003–2015.

Methods
DCM patients (n = 7873) from the Swedish Heart Failure Registry were divided into three calendar periods of inclusion, 2003–2007 (Period 1, n = 2029), 2008–2011 (Period 2, n = 3363), 2012–2015 (Period 3, n = 2481). The primary outcome was the composite of all-cause death, transplantation and hospitalization during 1 year after inclusion into the registry.

Results
Over the three calendar periods patients were older (p = 0.022), the proportion of females increased (mean 22.5%, 26.4%, 27.6%, p = 0.0001), left ventricular ejection fraction was higher (p = 0.0014), and symptoms by New York Heart Association less severe (p < 0.0001). Device (implantable cardioverter defibrillator and/or cardiac resynchronization) therapy increased by 30% over time (mean 11.6%, 12.3%, 15.1%, p < 0.0001). The event rates for mortality, and hospitalization were consistently decreasing over calendar periods (p < 0.0001 for all), whereas transplantation rate was stable. More advanced physical symptoms correlated with an increased risk of a composite outcome over time (p = 0.0043).

Conclusions
From 2003 until 2015, we observed declining mortality and hospitalizations in DCM, paralleled by a continuous change in both demographic profile and therapy in the DCM population in Sweden, towards a less affected phenotype.