bluuebunny/crossref_metadata_2025_split huggingface dataset:
A qualitative study of experiences of NHS mental healthcare workers during the Covid-19 pandemic
Authors: Liberati Elisa , Richards Natalie , Willars Janet , Scott David , Boydell Nicola , Parker Jennie , Pinfold Vanessa , Martin Graham , Dixon-Woods Mary , Jones Peter B. 
Published: May 2021

Abstract
Background
The Covid-19 pandemic has imposed extraordinary strains on healthcare workers. But, in contrast with acute settings, relatively little attention has been given to those who work in mental health settings. We aimed to characterise the experiences of those working in English NHS secondary mental health services during the first wave of the pandemic.

Methods
The design was a qualitative interview-based study. We conducted semi-structured, remote (telephone or online) interviews with 35 members of staff from NHS secondary (inpatient and community) mental health services in England. Analysis was based on the constant comparative method.

Results
Participants reported wide-ranging changes in the organisation of secondary mental health care and the nature of work in response to the pandemic, including pausing of all services deemed to be “non-essential”, deployment of staff across services to new and unfamiliar roles, and moves to remote working. The quality of participants’ working life was impaired by increasing levels of daily challenge associated with trying to provide care in trying and constrained circumstances, the problems of forging new ways of working remotely, and constraints on ability to access informal support. Participants were confronted with difficult dilemmas relating to clinical decision-making, prioritisation of care, and compromises in ability to perform the therapeutic function of their roles. Other dilemmas centred on trying to balance the risks of controlling infection with the need for human contact. Many reported features of moral injury linked to their perceived failures in providing the quality or level of care that they felt service users needed. They sometimes sought to compensate for deficits in care through increased advocacy, taking on additional tasks, or making exceptions, but this led to further personal strain. Many experienced feelings of grief, helplessness, isolation, distress, and burnout. These problems were compounded by sometimes poor communication about service changes and by staff feeling that they could not take time off because of the potential impact on others. Some reported feeling poorly supported by organisations.

Conclusions
Mental health workers faced multiple adversities during the pandemic that were highly consequential for their wellbeing. These findings can help in identifying targets for support.
Somatic distress among Syrian refugees with residence permission in Germany: analysis of a cross-sectional register-based study
Authors: Borho Andrea , Morawa Eva , Schmitt Gregor Martin , Erim Yesim 
Published: May 2021

Abstract
Background
Previous studies have already proven high rates of common mental disorders in Syrian refugees. Nevertheless, little is known about the patterns of somatic distress among this refugee population. For this reason, we aimed to examine the prevalence, co-occurrence, and risk factors of somatic distress among Syrian refugees in Germany.

Methods
This study analyzes the second measurement point (N = 116) of a prospective register-based survey among 200 adult Syrian refugees with residence permission in Germany. The survey consisted of information on sociodemographic and migration-specific characteristics, health care utilization, traumatic life events, acculturative stress (Barcelona Immigration Stress Scale (BISS); subscales: perceived discrimination, intercultural contact stress, homesickness, and general psychosocial stress), and self-reported outcomes of somatic distress (Patient Health Questionnaire (PHQ-15)), depression (PHQ-9), generalized anxiety disorder (GAD-7), and post-traumatic symptoms (Essen Trauma Inventory (ETI)).

Results
Almost half of the respondents (49.1%) were identified as being at risk of somatic distress (PHQ-15 score ≥ 6), and even 24.1% being bothered by moderate-to-severe levels of somatic distress (PHQ-15 score ≥ 10). The most robust associations with somatic distress were found for female gender, the amount of health care utilization, multiple trauma exposures, general psychosocial stress, and self-reported depression and anxiety symptoms. High comorbidities with somatic distress were shown for all of the common mental disorders studied.

Conclusions
The presented study reveals a significant risk of somatic distress among this displaced population and highlights implications for policy and health care providers.
Trends of cervical cancer at global, regional, and national level: data from the Global Burden of Disease study 2019
Authors: Zhang Xingxing , Zeng Qingle , Cai Wenwen , Ruan Weiqing 
Published: May 2021

Abstract
Background
Cervical cancer is an important global health problem. In this study we aimed to analyze trends in cervical cancer at the global, regional, and national levels from 1990 to 2019, to inform health service decision-making.

Methods
Data on cervical cancer was extracted from the Global Burden of Disease study, 2019. Trends in cervical cancer burden were assessed based on estimated annual percentage change (EAPC) and age-standardized rate (ASR).

Results
Globally, decreasing trends were observed in incidence, death, and disability adjusted life years (DALYs) of cervical cancer from 1990 to 2019, with respective EAPCs of − 0.38 (95% confidence interval [CI]: − 0.41 to − 0.34), − 0.93 (95%CI: − 0.98 to − 0.88), and − 0.95 (95 CI%: − 1.00 to − 0.90). Meanwhile, decreasing trends were detected in most sociodemographic index (SDI) areas and geographic regions, particularly death and DALYs in Central Latin America, with respective EAPCs of − 2.61 (95% CI: − 2.76 to − 2.46) and − 2.48 (95% CI: − 2.63 to − 2.32); hhowever, a pronounced increasing trend in incidence occurred in East Asia (EAPC = 1.33; 95% CI: 1.12 to 1.55). At the national level, decreasing trends in cervical cancer were observed in most countries/territories, particularly DALYs in the Maldives (EAPC = − 5.06; 95% CI: − 5.40 to − 4.72), Whereas increasing trends were detected in Lesotho, Zimbabwe, and Bulgaria.

Conclusions
Slowly decreasing trends in cervical cancer were detected worldwide from 1990 to 2019. Cervical cancer remains a substantial health problem for women globally, requiring more effective prevention and control strategies.
Appendicitis during the COVID-19 pandemic: lessons learnt from a district general hospital
Authors: Pringle Heather C. M. , Donigiewicz Urszula , Bennett Melissa-Rose , Walker Eleanor , Fowler George E. , Narang Sunil , Ball Susan , Bethune Robert M. 
Published: May 2021

Abstract
Background
The COVID-19 pandemic dramatically influenced the delivery of healthcare. In line with the UK Royal Colleges’ advice the management of acute appendicitis (AA) changed with greater consideration for non-operative management (NOM) or open appendicectomy when operative management (OM) was sought. We describe our experience of the presentation, management and outcomes for these patients to inform care for future viral pandemics.

Methods
This retrospective, cohort study compared patients diagnosed with AA between March and July 2019 with those during the pandemic period of March to July 2020. Medical records were reviewed to obtain demographics, inflammatory markers, imaging, severity, management, histology, length of stay (LOS) and 90-day outcomes.

Results
There were 149 and 125 patients in the 2019 and 2020 cohorts respectively. 14 patients (9.4%) had NOM in 2019 versus 31 (24.8%) in 2020 (p = 0.001). In the 2019 operative management (OM) group 125 patients (92.6%) had laparoscopic appendicectomy versus 65 (69.1%) in 2020. 59 patients (39.6%) had a CT in 2019 versus 70 (56%) in 2020. The median LOS was 4 days in 2019 and 3 days in 2020 (p = 0.03). Two patients in each year who received NOM had treatment failure (14.3% in 2019 and 6.5% in 2020). Three patients in 2019 who received OM had treatment failure (2.2%). Of 95 patients tested for COVID-19 all but one tested negative.

Conclusion
During the COVID-19 pandemic there was no observed increase in severity of AA, patients had a shorter LOS and were more likely to have imaging. NOM proportionally increased with no observed change in outcomes.
Microsurgical endodontic treatment of the upper molar teeth and their relationship with the maxillary sinus: a retrospective multicentric clinical study
Authors: Taschieri S. , Morandi B. , Giovarruscio M. , Francetti L. , Russillo A. , Corbella S. 
Published: May 2021

AbstractPurposeTo assess the clinical and radiographic success rate of microsurgical endodontic treatment of upper molar teeth in relationship with the maxillary sinus, with 12 months follow-up.MethodsPatients treated with microsurgical endodontic treatment of upper molar teeth in the period between 2017 and 2019 were recruited from two dental clinics according to specific selection criteria. The outcomes were determined based on clinical and radiographic results taken three, six and 12 months post-operatively, compared with those taken immediately before and after surgery. Clinical and radiographic outcomes were recorded. The distance between the most apical part of the root and of the lesion to the maxillary sinus was measured on CBCT images before the surgery. Patient-related outcomes were recorded.ResultsOut of 35 patients evaluated, 21 were selected according with the selection criteria for a total of 27 roots and 29 canals treated. After 12 months, 18 patients showed a complete healing whereas three demonstrated incomplete healing. Consequently, the success rate in this study was 85.7% after one year. In 28.5% (6 patients) there was a perforation of the Schneiderian membrane that didn’t seem to affect the outcome. All patients kept the molar one year later. The pain level decreased significantly over the time during the first week after surgery.ConclusionMicrosurgical Endodontic treatment of the upper molar teeth should be considered a valid and predictable treatment option even in case of Schneiderian membrane perforation. Future clinical studies with a larger sample size are needed to compare the results obtained.
Something must happen before first breath
Authors: Polese Daniela , Fagioli Marcella , Virgili Fabio , Fiori Nastro Paolo 
Published: May 2021

Abstract
Background
Definition and concept of the ‘beginning of human life’ are weakened by co-existing contrasting hypotheses based on humanistic or religious beliefs rather than scientific foundations. This plethora of conceptually distant views have important common concerns in different fields of science and shape, in turn, several societal aspects including laws related, for instance, to inheritance eligibility or abortion, end-of-life care and euthanasia, and reproductive technology. Also, they are fundamental to evaluate opportunity for resuscitation vs. palliative care in extremely preterm infants. In this article, we address one of the most common tenets in medicine: the acceptance that human life starts with first breath, even though several events are well-documented to take place before its occurrence.

Main text
Several studies show how pivotal physiological events take place before first breath. Evidence of a number of neurological events occurring before first breath opens the way to the primacy of the Central Nervous System, given its immediate extra-uterine activation at birth. This activation eventually sets specific physiological conditions that allow the complex sequence of events determining the muscle activity associated with the influx of air in the lung and the settling of a continuous and successful extra-uterine respiration. We would like to invite the scientific community to endorse a clear-cut position against the paradigm of ‘first breath’ as the beginning of life. Herein, we also assume how, a still undefined, yet possibly specific quid in the external environment triggers further physiological response in newborns. Better understanding of the critical events that occur at the beginning of human life is likely to cause great concern and expectations in scientists, researchers and physicians working in the domain of brain, and its physiology, and mental health.

Conclusions
The comparison between beliefs and evidence-based observations generates confusion, misperceptions and false expectations in society, hence, in the scientific and medical community. Different and more solid alternatives about the carachterization of the ‘beginning of human life’ are indeed available and require to be explored and defined.
Acceptability of a complex team-based quality improvement intervention for transient ischemic attack: a mixed-methods study
Authors: Damush Teresa M. , Penney Lauren S. , Miech Edward J. , Rattray Nicholas A. , Baird Sean A. , Cheatham Ariel J. , Austin Charles , Sexson Ali , Myers Laura J. , Bravata Dawn M. 
Published: May 2021

Abstract
Background
The Protocol-guided Rapid Evaluation of Veterans Experiencing New Transient Neurologic Symptoms (PREVENT) program was a complex quality improvement (QI) intervention targeting transient ischemic attack (TIA) evidence-based care. The aim of this study was to evaluate program acceptability among the QI teams and factors associated with degrees of acceptability.

Methods
QI teams from six Veterans Administration facilities participated in active implementation for a one-year period. We employed a mixed methods study to evaluate program acceptability. Multiple data sources were collected over implementation phases and triangulated for this evaluation. First, we conducted 30 onsite, semi-structured interviews during active implementation with 35 participants at 6 months; 27 interviews with 28 participants at 12 months; and 19 participants during program sustainment. Second, we conducted debriefing meetings after onsite visits and monthly virtual collaborative calls. All interviews and debriefings were audiotaped, transcribed, and de-identified. De-identified files were qualitatively coded and analyzed for common themes and acceptability patterns. We conducted mixed-methods matrix analyses comparing acceptability by satisfaction ratings and by the Theoretical Framework of Acceptability (TFA).

Results
Overall, the QI teams reported the PREVENT program was acceptable. The clinical champions reported high acceptability of the PREVENT program. At pre-implementation phase, reviewing quality data, team brainstorming solutions and development of action plans were rated as most useful during the team kickoff meetings. Program acceptability perceptions varied over time across active implementation and after teams accomplished actions plans and moved into sustainment. We observed team acceptability growth over a year of active implementation in concert with the QI team’s self-efficacy to improve quality of care. Guided by the TFA, the QI teams’ acceptability was represented by the respective seven components of the multifaceted acceptability construct.

Conclusions
Program acceptability varied by time, by champion role on QI team, by team self-efficacy, and by perceived effectiveness to improve quality of care aligned with the TFA. A complex quality improvement program that fostered flexibility in local adaptation and supported users with access to data, resources, and implementation strategies was deemed acceptable and appropriate by front-line clinicians implementing practice changes in a large, national healthcare organization.

Trial registration
clinicaltrials.gov: NCT02769338.
Predicting recurrence of non-small cell lung cancer based on mean computed tomography value
Authors: Tamura Masaya , Matsumoto Isao , Tanaka Yusuke , Saito Daisuke , Yoshida Shuhei , Takata Munehisa 
Published: May 2021

Abstract
Background
The aim of this study was to assess the ability of using mean computed tomography (mCT) values to predict non-small cell lung cancer (NSCLC) tumor recurrence.

Methods
A retrospective study was conducted on 494 patients with stage IA NSCLC. Receiver operating characteristics analysis was used to assess the ability to use mCT value, C/T ratio, tumor size, and SUV to predict tumor recurrence. Multiple logistic regression analyses were performed to determine the independent variables for the prediction of tumor recurrence.

Results
The m-CT values were − 213.7 ± 10.2 Hounsfield Units (HU) for the recurrence group and − 594.1 ± 11.6 HU for the non-recurrence group (p < 0.0001). Recurrence occurred in 45 patients (9.1%). The tumor recurrence group was strongly associated with a high CT attenuation value, high C/T ratio, large solid tumor size, and SUV. The diagnostic value of mCT value was more accurate than the C/T ratio, excluding the pure ground-glass opacity and pure solid (0 < C/T ratio < 100) groups. The SUV and mCT are independent predictive factors of tumor recurrence.

Conclusions
The evaluation of mCT values was useful for predicting recurrence after the limited resection of small-sized NSCLC, and may potentially contribute to the selection of suitable treatment strategies.
Allergic contact versus irritant contact dermatitis in patients with hard-to-heal leg ulcer: clinical and diagnostic approach
Authors: Monari Paola , Fusano Marta , Moro Ruggero , Baiguini Ilaria , Calzavara-Pinton PierGiacomo , Vascellaro Annalisa , Gualdi Giulio 
Published: May 2021

Background:Dermatitis of surrounding skin may complicate hard-to-heal leg ulcers, delaying wound healing. The coexistence of hard-to-heal leg ulcers and irritant or allergic contact dermatitis may create difficulties for both diagnostic and therapeutic management.Objective:The aim of our study was to evaluate the incidence of dermatitis occurring in the surrounding skin in a population affected by hard-to-heal leg ulcers during treatment, and to differentiate between allergic contact dermatitis (ACD) and irritant contact dermatitis (ICD) with the use of a patch test. Furthermore, we investigated which medications were most probably related to these conditions.Method:We conducted an observational study from 21 February to 21 July 2017, enlisting all patients affected by hard-to-heal leg ulcers who attended the Wound Care Service of the Dermatologic Department of ASST, Spedali Civili, Brescia, Italy.Results:We enrolled 95 patients; 81 patients did not develop dermatitis, while 14 patients developed dermatitis of the surrounding skin. These patients underwent a patch test which gave a positive result in seven patients, permitting the diagnosis of ACD.Conclusion:Our study confirmed the incidence of dermatitis of the surrounding skin reported in the literature but reassessed the incidence of ACD as opposed to ICD.
D. Spivey-Grabs Field, Kingman and Harper Counties, Kansas
Authors: Frensley Robert W. , Darmstetter J. C. 
Published: May 2021

Abstract
The Spivey-Grabs field is in southwestern Kingman County and northwestern Harper County, Kansas. The Mississippian “Chert” produces gas and oil, and the Pennsylvanian reservoirs (Burlingame and Topeka Limestones) produce gas. Stratigraphic trapping is important in the Mississippian accumulations, and the Pennsylvanian accumulations are structurally controlled. Cumulative production to January 1,1967, was 27,686,822 bbls of oil and 168,622,087 Mcf of gas.
Red Oak-Norris Gas Field, Brazil Anticline, Latimer and LeFlore Counties, Oklahoma
Authors: Six David A. 
Published: May 2021

Abstract
The Red Oak-Norris gas field was the first of several fields discovered recently in the deeper part of the Arkoma basin which yield gas from the lower Atoka Spiro Sand. The Red Oak-Norris gas field is, however, the only field discovered to date in which gas is produced in large quantities from sandstone beds of middle Atokan age, namely the Red Oak Sand of the upper middle Atoka.
The middle Atokan gas sands recently discovered at Southwest Quinton by Skelly Oil Company, 12 mi west of Red Oak-Norris field, cannot be correlated definitely as Red Oak Sand, but the productive zone is in the middle Atokan section.
The Red Oak-Norris gas field is the largest single gas-producing field, in both area and reserves, discovered to date in the deeper part of the Arkoma basin; it is believed to be also the most complexly faulted field. Overthrust faulting from the south as well as both normal down-to-the-north and down-to-the-south faulting are in evidence. There is considerably more to be learned concerning the geology of this field as development progresses.
Washburn Anticline Gas Fields, Arkansas
Authors: Bartlett, Jr. Charles S. 
Published: May 2021

Abstract
The Washburn anticline trends east-west for 40 mi and covers at least 157 sq mi within 6,000 ft of closure. Commercial quantities of gas were discovered on the feature in 1954. Since then sporadic drilling has resulted in 31 gas wells, spaced on 640-acre governmental sections, and 12 dry holes. The Gragg, Booneville, and Chismville gas fields are all on surface expression of the Washburn anticline.
Production is essentially dry methane gas from at least 15 sandstone beds within the middle and lower parts of the Atoka Formation. Open-flow potentials range from less than 1 million to 33.5 million cu ft of gas a day with shut-in pressures of from 355 to 2,912 psi. Most of the wells in Chismville, T. 6 N., R. 27 W., and Booneville, T. 6 N., R. 28 W., were connected in 1961. The Gragg wells, in T. 6 N., Rs. 29, 30 W., were connected in June 1964. Arkansas-Louisiana Gas Company is the only purchaser from these fields.
The approximately 11,700 ft of the Atoka Formation at Washburn is subdivided into zones which can be recognized in most wells. Lenticularity of sandstone bodies and marked variation in porosity and permeability in the gas zones reflect the unstable shallow-basin environment in which the sands were deposited. Rocks of the Morrow Series have been tested in three wells, but were found nonproductive. There is one deep Arbuckle (Cambrian-Ordovician) test on structure. This well was dry in all of the pre-Atoka rocks at a total depth of 12,505 ft.
Strike-thrust faults, trending east-west near the crest of Washburn, complicate the structure. Nearly every well has cut at least one thrust fault with displacement commonly being between 1,000 and 1,500 ft.
It appears that the three gas fields on the anticline will ultimately be joined into one large gas field.
Jerusalem Gas Field, Conway County, Arkansas
Authors: Hartman F. H. 
Published: May 2021

Abstract
The Jerusalem field produces dry gas from two sands in the lower part of the Atoka Series. The upper sand is called the “Allen” and the lower sand the “Barton” or “Barton ‘B’.” A third sand, the McGuire, overlies the Allen Sand and may prove to be productive over a very small area on the structurally highest part of the field.
The gas is trapped in a faulted anticline. The Allen reservoir is limited downdip on both sides of the fault by a gas-water interface. The Barton Sand reservoir is limited on the west and the north flanks by lack of permeability and porosity, on the south by a normal fault, and on the east by a gas-water interface.
The oldest rock penetrated by drilling in the Jerusalem field was in the Carter Oil Co. No. 1 Morrilton Lumber Co. This well bottomed at 3,500 ft in the Fayetteville Shale of Mississippian age. The deeper formations have not been tested in this area. Three formations of Ordovician age can be considered to be potential reservoirs, not only here but also in a large part of the Arkansas valley, particularly along the north rim of the basin—the St. Peter Sandstone, the Cotter Dolomite, and the Powell Dolomite.
Twelve wells have been drilled in the process of defining the field limits. Six were producing wells and six were dry holes. Two of the producing wells are completed dually. The writer believes Jerusalem field is one of many small but economical fields which will be discovered on the north rim of the basin. The estimated gas reserve attributed to this field ranges from 18 to 25 billion cu ft.