bluuebunny/crossref_metadata_2025_split huggingface dataset:
Depression facilitators from the perspective of Iranian patients with major depressive disorder: a qualitative research
Authors: Rezaiye Milad , Radfar Moloud , Hemmati MaslakPak Masumeh 
Published: March 2021

Abstract
Background
Major depressive disorder is the most common psychological disorder and affects many people worldwide. Therefore, it is important to identify the factors that cause or facilitate this disorder.

Objectives
The aim of this qualitative study was to identify the facilitating factors of depression from the perspective of Iranian patients with major depressive disorder.

Methods
This qualitative study was conducted by content analysis method. Data were collected via purposeful sampling (maximum variation sampling) by conducting semi-structured interviews until reaching data saturation. In-depth interviews were conducted with 12 participants, including patients with major depressive disorder and their families in Razi Psychiatric Training and Treatment Center in Urmia (RPsTT) from November 2018 to February 2020. The process of data analysis was based on the Landman and Grenheim method. The accuracy and trustworthiness of the data were obtained through the Lincoln and Guba criteria.

Results
The analysis of interviews with the participants indicated four major categories: a. Environmental factors (approved by 8 participants), b. Attitudinal factors (approved by 12 participants), c. Economic factors (approved by 9 participants) and d. Situational factors (approved by 10 participants).

Conclusion
In order to prevent major depressive disorder or to reduce the signs of this disorder and improve these patients quality of life, paying attention to the facilitating factors from patient’s perspective based on their community culture can be effective. Among facilitating factors, attitudinal factors have the most impact on the incidence and exacerbation of this disorder from the perspective of patients.
Impact of gender, depression severity and type of depressive episode on efficacy and safety of escitalopram: an observational study on major depressive disorder patients in southern India
Authors: Mandal Tatiyana , Bairy Laxminarayana Kurady , Sharma Podila Satya Venkata Narasimha , Valaparla Vijaya Lakshmi 
Published: March 2021

Abstract
Background
Antidepressant response is a complex trait influenced by clinical, demographic and genetic factors.

Objectives
To explore the influences of baseline depression severity, gender and type of depressive episode on efficacy and safety of escitalopram (10–20 mg/day) in South Indian patients with major depressive disorder (MDD).

Methods
The study was conducted on 18–65-year-old patients (n = 151) suffering from a first or recurrent episode of MDD with a 17-item Hamilton Depression Rating Scale (HDRS-17) score of ≥ 18 at baseline. Efficacy assessments were done using HDRS-17, Montgomery-Asberg Depression Rating Scale (MADRS), and Clinical Global Impression (CGI) at baseline and weeks 4, 8 and 12. Patients were monitored for adverse drug reactions (ADRs). Clinical outcomes were compared among various groups based on gender, type of depressive episode (first or recurrent episode) and baseline HDRS-17 scores (moderate depression—score between 17 and 23; severe depression—score ≥ 24).

Results
Among the 148 subjects who completed the 12-week study, 43.9% and 42.6% achieved response and remission, respectively. The decline in HDRS-17 and MADRS scores from baseline was significant (p value < 0.05) at all follow-up visits and a similar pattern was seen with CGI. Efficacy outcomes were better in the moderate baseline depression group compared with severe depression. There were no associations of efficacy with gender and type of depressive episode. A total of 247 adverse drug reactions (ADR) were reported and 119 (80.41%) subjects experienced at least one ADR during the study period. No serious ADR was reported. Male patients experienced more ADRs compared with females. The safety profile of escitalopram was similar across various groups based on baseline depression severity and type of depressive episode.

Conclusion
The study revealed that escitalopram is efficacious in south Indian MDD patients with a favourable safety profile. The efficacy was influenced by baseline depression severity whereas more ADRs were reported by male patients.
The impact of molded pulp product process on the mechanical properties of molded Bleached Chemi-Thermo-Mechanical Pulp
Authors: Dislaire Claire , Grohens Yves , Seantier Bastien , Muzy Marion 
Published: March 2021

AbstractThis study was carried out using bleached softwood Chemi-Thermo-Mechanical Pulp to evaluate the influence of Molded Pulp Products’ manufacturing process parameters on the finished products’ mechanical and hygroscopic properties. A Taguchi table was done to make 8 tests with specific process parameters such as moulds temperature, pulping time, drying time, and pressing time. The results of these tests were used to obtain an optimized manufacturing process with improved mechanical properties and a lower water uptake after sorption analysis and water immersion. The optimized process parameters allowed us to improve the Young’ Modulus after 30h immersion of 58% and a water uptake reduction of 78% with the first 8 tests done.
Acute ischemic stroke care in Germany – further progress from 2016 to 2019
Authors: Richter Daniel , Weber Ralph , Eyding Jens , Bartig Dirk , Misselwitz Björn , Grau Armin , Hacke Werner , Krogias Christos 
Published: March 2021

Abstract
Background
Stroke Unit Care (SUC), intravenous thrombolysis (IVT) and mechanical thrombectomy (MT) are evidence-based treatment options for acute ischemic stroke (AIS). Using nationwide comprehensive administrative data from Germany, we recently reported nationwide development of AIS admissions, SUC rates, IVT rates and MT rates in Germany between 2010 and 2016. In this update paper, we analyze data on the further development of these data to 2019 after publication of time window extensions for recanalization therapies.

Methods
We considered all hospitalized cases with the main diagnosis of the ICD-10-GM code I63 (AIS) for the year 2019. We identified stroke therapies by using the corresponding Operating and Procedure Keys for IVT, MT and SUC out of the DRG statistics. Regional analyses are based on data from the 412 German administrative districts and cities. We compared the results with those from 2016.

Results
Number of hospitalized AIS patients showed a mild decrease in 2019 (n = 225,531) compared with 2016 (n = 227,687), with significant more AIS patients treated on a stroke unit in 2019 (n = 167,799; 74.4% vs. n = 164,270; 72.1%, p < 0.001). The rate of IVT further increased from 14.9% (n = 33,916) in 2016 to 16.3% (n = 36,745) in 2019 (p < 0.001). Similarly, the MT rate increased from 4.3% (n = 9795) in 2016 to 7.2% (n = 16,135) in 2019 (p < 0.001). There was still a high regional variability for MT (1.4 to 15.2%) according to the place of residence of the AIS patients.

Conclusions
In Germany, the rates of recanalization therapies in patients with AIS continued to increase from 2016 to 2019. Compared to IVT-rates and numbers, the respective data for MT procedures showed an even more pronounced increase.
Epidemiologic Pattern of Cancer in Kathmandu Valley, Nepal: Findings of Population-Based Cancer Registry, 2018
Authors: Subedi Ranjeeta , Dhimal Meghnath , Budukh Atul , Chapagain Sandhya , Gyanwali Pradip , Gyawali Bishal , Dahal Uma , Dikshit Rajesh , Jha Anjani Kumar 
Published: March 2021

PURPOSE Although cancer is an important and growing public health issue in Nepal, the country lacked any population-based cancer registry (PBCR) until 2018. In this study, we describe the establishment of the PBCR for the first time in Nepal and use the registry data to understand incidence, mortality, and patterns of cancer in the Kathmandu Valley (consisting of Kathmandu, Lalitpur, and Bhaktapur districts), which comprises 10.5% of the estimated 29 million population of Nepal in 2018. MATERIALS AND METHODS The PBCR collects information from facilities and communities through the active process. The facilities include cancer or general hospitals, pathology laboratories, hospice, and Ayurvedic centers. In the communities, the field enumerators or female community health volunteers collected the data from the households. In addition, the Social Security and Nursing Division under the Department of Health Services, which provides subsidy for cancer treatment of underprivileged patients, was another major source of data. The collected data were verified for residence, accuracy, and completeness and then entered and analyzed using CanReg5 software. RESULTS In the Kathmandu Valley, the PBCR registered 2,156 new cancer cases with overall age-adjusted incidence rate for all cancers of 95.7 per 100,000 population (95.3 for males and 98.1 for females). The age-adjusted mortality rate for males was 36.3 (n = 365) and for females 27.0 (n = 305) per 100,000 population. We found that the commonest cancers in males were lung and stomach, whereas in females, they were breast and lung cancer. Gallbladder cancer was among the top five common cancers in both sex. CONCLUSION These findings provide a milestone to understand the cancer burden in the country for the first time using the PBCR and will be helpful to develop and prioritize cancer control strategies.
Exceptionality of Distant Metastasis in Node-Negative Hereditary and Sporadic Medullary Thyroid Cancer: Lessons Learned
Authors: Machens Andreas , Lorenz Kerstin , Weber Frank , Dralle Henning 
Published: March 2021

Abstract

Context
Risk factors of lymph node and distant metastases have rarely been analyzed in hereditary and sporadic medullary thyroid cancer (MTC) using large genetic-clinical data sets.

Objective
This comprehensive investigation aimed to explore risk factors of lymph node and distant metastases and interdependencies between age at thyroidectomy, primary tumor size, lymph node metastasis, and distant metastasis in patients with hereditary and sporadic MTC.

Methods
We performed comparative analyses of risk factors of metastasis, stratified by hereditary MTC (4 mutational risk categories) and sporadic MTC.

Results
There were 1115 patients with hereditary MTC (307 patients) or sporadic MTC (808 patients). Age at thyroidectomy increased proportionately from 12.2, 22.7, 34.3, and 49.8 years for patients with decreasing mutational risk, compared with 52.1 years for patients with sporadic MTC. Metastatic primary tumors overall were 10.7 to 19.4 mm larger in node-positive patients and 15.9 to 19.3 mm larger in distant metastatic patients at thyroidectomy than nonmetastatic tumors. Distant metastases were noted in 13% to 50% of node-positive vs 0% of node-negative hereditary MTC, and in 23.5% of node-positive vs 1.7% of node-negative sporadic MTC. In multivariable logistic regression analysis for sporadic MTC, lymph node metastasis contributed to distant metastasis (odds ratio 12.4) more than primary tumor size (odds ratios of 7.8, 5.5, and 2.4 for tumors measuring &gt;60, 41-60, and 21-40 mm, respectively).

Conclusion
When thyroidectomy is performed before lymph node metastases have developed, distant metastases are exceptional, both in patients with hereditary MTC (irrespective of mutational risk level) and patients with sporadic MTC.
The origin and mechanisms of smooth muscle cell development in vertebrates
Authors: Donadon Michael , Santoro Massimo M. 
Published: March 2021

ABSTRACTSmooth muscle cells (SMCs) represent a major structural and functional component of many organs during embryonic development and adulthood. These cells are a crucial component of vertebrate structure and physiology, and an updated overview of the developmental and functional process of smooth muscle during organogenesis is desirable. Here, we describe the developmental origin of SMCs within different tissues by comparing their specification and differentiation with other organs, including the cardiovascular, respiratory and intestinal systems. We then discuss the instructive roles of smooth muscle in the development of such organs through signaling and mechanical feedback mechanisms. By understanding SMC development, we hope to advance therapeutic approaches related to tissue regeneration and other smooth muscle-related diseases.
Implication of backward contact tracing in the presence of overdispersed transmission in COVID-19 outbreaks
Authors: Endo Akira ,   Centre for the Mathematical Modelling of Infectious Diseases COVID-19 Working Group, Leclerc Quentin J. , Knight Gwenan M. , Medley Graham F. , Atkins Katherine E. , Funk Sebastian , Kucharski Adam J. 
Published: March 2021

Introduction: Contact tracing has the potential to control outbreaks without the need for stringent physical distancing policies, e.g. civil lockdowns. Unlike forward contact tracing, backward contact tracing identifies the source of newly detected cases. This approach is particularly valuable when there is high individual-level variation in the number of secondary transmissions (overdispersion). Methods: By using a simple branching process model, we explored the potential of combining backward contact tracing with more conventional forward contact tracing for control of COVID-19. We estimated the typical size of clusters that can be reached by backward tracing and simulated the incremental effectiveness of combining backward tracing with conventional forward tracing. Results: Across ranges of parameter values consistent with dynamics of SARS-CoV-2, backward tracing is expected to identify a primary case generating 3-10 times more infections than a randomly chosen case, typically increasing the proportion of subsequent cases averted by a factor of 2-3. The estimated number of cases averted by backward tracing became greater with a higher degree of overdispersion. Conclusion: Backward contact tracing can be an effective tool for outbreak control, especially in the presence of overdispersion as is observed with SARS-CoV-2.
Monitoring of the Main Reactor Joint by Automated System
Authors: Povarov Vladimir 
Published: March 2021

Traditionally, on reactors of the VVER type, a manual measuring tool is used to inspect the sealing surfaces of the main joint. To automate testing, a PGR-59 system was developed, which was successfully applied to three new power units of type VVER-1200.
The purpose of the application is to measure the geometric characteristics of the main joint and determine the filling factor of the sealing grooves with nickel wire. Measurement is performed by laser scanning. Additionally, the article has a television camera for searching for defects with the possibility of measuring their dimensions.
The result of the work was the obtaining of actual profiles of seating surfaces of the main joint of the reactor. The use of the PGR-59 system allows you to monitor the change in the profile of the seating surfaces, which constantly changes due to mechanical impact on the seating surfaces, predict its condition and plan the necessary repairs in advance. Based on the measurement results, new data were found on the nature of the main connector seal.
The information obtained during the actual measurements made it possible to improve the operational and ergonomic characteristics of the system.
Procedural Competency Among Hospitalists: A Literature Review and Future Considerations
Authors: Cool Joséphine A , Huang Grace C 
Published: March 2021

BACKGROUNDAs general internists practicing in the inpatient setting, hospitalists at many institutions are expected to perform invasive bedside procedures, as defined by professional standards. In reality, hospitalists are doing fewer procedures and increasingly are referring to specialists, which threatens their ability to maintain procedural skills. The discrepancy between expectations and reality, especially when hospitalists may be fully credentialed to perform procedures, poses significant risks to patients because of morbidity and mortality associated with complications, some of which derive from practitioner inexperience.METHODSWe performed a structured search of the peer‐reviewed literature to identify articles focused on hospitalists performing procedures.RESULTSOur synthesis of the literature characterizes contributors to hospitalists' procedural competency and discusses: (1) temporal trends for procedures performed by hospitalists and their associated referral patterns, (2) data comparing use and clinical outcomes of procedures performed by hospitalists compared with specialists, (3) the lack of nationwide standardization of hospitalist procedural training and credentialing, and (4) the role of medical procedure services, although limited in supportive evidence, in concentrating procedural skill and mitigating risk in the hands of a few well‐trained hospitalists.CONCLUSIONWe conclude with recommendations for hospital medicine groups to ensure the safety of hospitalized patients undergoing bedside procedures.
Inflammatory bowel disease advice lines during the COVID-19 pandemic: a retrospective service evaluation
Authors: Avery Pearl , Younge Lisa , Dibley Lesley , Segal Jonathan 
Published: March 2021

Background: The COVID-19 pandemic significantly impacted on healthcare delivery worldwide, affecting many services, including those for inflammatory bowel disease (IBD). Aims: To evaluate the impact of COVID-19 on worldwide IBD telephone advice-line services. Methods: A mixed-methods 25-item online survey was distributed to IBD specialist nurses globally using IBD professional networks, email and social media. Data were analysed using descriptive statistics (quantitative data) and content and thematic analysis (qualitative data). Findings: Across 21 countries, 182 IBD specialists participated. With adjustments, all advice lines remained functional. Call content changed, and call volume increased exponentially. Strategies were recommended to maintain services. IBD specialist nurses faced considerable challenges, including overwhelming workload, disrupted referral pathways, fragmented IBD clinical team support, isolation and greatly lowered morale. Conclusions: To cope with similar future crises, advice-line training, resilience coaching and ringfencing of the IBD clinical team are essential. Development of global guidelines for maintaining advice-line functionality in any scenario is recommended.
A randomized controlled trial of infraorbital block using ketamine 1% for intra- and postoperative analgesia in children for ambulatory cleft lip correction
Authors: Ramlan Andi Ade Wijaya , Ratnaningrum Apriliana , Marsaban Arif Hari Martono 
Published: March 2021

BACKGROUND In Indonesia, cleft lip correction surgery is often done as a social program in remote areas with limited resources. This study aimed to assess the effectiveness of ketamine, a cheaper and more accessible alternative, as a local analgesia in infraorbital block and to determine the possibility of ketamine as an alternative local analgesic drug for intraoperative and postoperative periods.
METHODS This was a randomized controlled trial in children aged 2 months to 5 years who underwent cleft lip correction surgery at Cipto Mangunkusumo Hospital in 2016. Subjects were randomly divided into two groups: ketamine and bupivacaine. Standard general anesthesia with endotracheal intubation was performed in each group. Bilateral intraoral infraorbital block was performed using ketamine 1% 0.5 ml or bupivacaine 0.25% 0.5 ml. Postoperative evaluation includes pain scores based on the face, leg, activity, cry, and consolability (FLACC) scale and analgesic duration.
RESULTS A total of 36 subjects were enrolled in this study, with 18 in each group. Both groups received the same total amount of fentanyl addition intraoperatively (p = 1). The postoperative FLACC pain scale scores between the two groups were not different, with p>0.05 in every measurement. The mean duration of postoperative analgesia in the ketamine group was longer than the bupivacaine group (15–13.49 hours, p = 0.031).
CONCLUSIONS Infraorbital block with 1% ketamine 0.5 mg/kg was similarly effective for intraoperative and postoperative analgesia but had a longer duration than that with 0.25% bupivacaine 0.5 ml in ambulatory cleft lip correction.
Exploring a non-universal understanding of waged work and its consequences: sketching out employment activation for people with an intellectual disability
Authors: Dearing Kim 
Published: March 2021

Background: Supported Employment has been advocated for by successive governments and policymakers alike as the best approach to employment inclusion for people with an intellectual disability who are in receipt of social care. Yet only 5.2% of this demographic are in any form of work and these numbers have been persistently stagnant for many years.
Aims: This study aimed to explore the employment landscape and grapple with the intersecting layers of policy consequence for people who have an intellectual disability, and are in receipt of social care, who wish to engage with work preparation employment support.
Methods: As an active participant in the field, this study was ethnographic and conducted at a new job club that had been established in England. In addition, three further sites of complementary data were explored in Wales, through interviews and focus groups.
Findings: This study demonstrates that there is a mismatch between how evidence informs policy, and how funding is allocated to support with work preparation. Those unable to secure Supported Employment services are, instead, navigating extreme employment disadvantage and scant opportunities, in the open labour market. Further, bound up in this analysis is evidence of a non-universal understanding of waged work where any form of financial remuneration is welcome.
Discussion and conclusion: Overall, with a mismatch between evidence that informs policy, policy rhetoric, realistic employment prospects, and available work, without a fundamental employment policy shift, the very low employment rates within this demographic will not increase.
Use of a knowledge exchange event strategy to identify key priorities for implementing deprescribing in primary healthcare in Nova Scotia, Canada
Authors: Kennie-Kaulbach Natalie , Kehoe Sarah , Whelan Anne Marie , Reeve Emily , Bai Isaac , Burgess Sarah , Kits Olga , Isenor Jennifer E. 
Published: March 2021

Background:Deprescribing, the process of dose reduction or stopping of medication(s) that may no longer be required, may improve medication use and patient outcomes. A collaborative interprofessional deprescribing research team was formed in 2017 in Nova Scotia (NS), Canada with the goal of investigating potential deprescribing initiatives which could be translated to primary healthcare in NS. The knowledge-to-action framework, which includes knowledge exchange, was used to guide the work of this team. Preliminary work involved knowledge inquiry and synthesis through a scoping review of deprescribing strategies in primary healthcare, a qualitative study to understand influences on deprescribing by local practitioners, and an analysis that combined the two.
Aims and objectives:To describe and reflect on how an interactive knowledge exchange event strategy was used to (1) share the results, including knowledge tools, of previously conducted deprescribing research with stakeholders; (2) identify priorities for the development and implementation of collaborative deprescribing strategies in primary healthcare in NS.
Key conclusions:The knowledge exchange event strategy utilised in this project achieved the planned objectives of sharing research results, raising awareness about deprescribing, and providing direction for future initiatives. The successful implementation of the knowledge exchange event hinged on many factors such as hiring a research coordinator; limiting the in-person event to one half-day; and using a variety of strategies for participant engagement both before and after the event. Other research teams could adopt a similar knowledge exchange event process as an approach for sharing research results and identifying future research and translation priorities.