bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of structure indicators influencing 3-h and 6-h compliance with the surviving sepsis campaign guidelines in China: a systematic review
Authors:   China National Critical Care Quality Control Center Group, Wang Lu , Ma Xudong , He Huaiwu , Su Longxiang , Guo Yanhong , Shan Guangliang , Zhou Xiang , Liu Dawei , Long Yun 
Published: March 2021

AbstractBackgroundCompliance with the surviving sepsis campaign (SSC) guidelines (Cssc) is a key factor affecting the effects of sepsis treatment. We designed this study to investigate the relationships of the structure indicators of ICU on 3 and 6-hCsscin China.MethodsA total of 1854 hospitals were enrolled in a survey, led by the China National Critical Care Quality Control Center (China-NCCQC) from January 1, 2018, through December 31, 2018. We investigated the 1854 hospitals’ 3 and 6-hCssc, including compliance with each specific measure of the 3-h and 6-h SSC bundles. We also investigated the actual level of the structure indicators of ICU, released by China-NCCQC in 2015.The outcomes were in adherence with the SSC guidelines (2016). Monitoring indicators included 3 and 6-hCssc.ResultsIn the subgroup, the rate of broad-spectrum antibiotic therapy was the highest, and the rate of CVP and ScvO2 measurement was the lowest among the items of 3 and 6-hCssc. Structure indicators related to 3 and 6-hCsscinclude the predicted mortality rate and the standardized mortality ratio (SMR). The relationships between 3 and 6-hCsscand the proportion of ICU in total inpatient bed occupancy, the proportion of acute physiology and chronic health evaluation (APACHE) II score ≥ 15 in all ICU patients were uncertain. There was no relationship of 3 and 6-hCsscwith the proportion of ICU patients among total inpatients.ConclusionsStructure indicators influencing 3 and 6-hCsscin China are the predicted mortality rate and the standardized mortality rate.
VEXAS syndrome in myelodysplastic syndrome with autoimmune disorder
Authors: Huang Huijun , Zhang Wenjun , Cai Wenyu , Liu Jinqin , Wang Huijun , Qin Tiejun , Xu Zefeng , Li Bing , Qu Shiqiang , Pan Lijuan , Huang Gang , Gale Robert Peter , Xiao Zhijian 
Published: March 2021

AbstractVEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome is a newly-described adult-onset inflammatory syndrome characterized by vacuoles in myeloid and erythroid precursor cells and somatic mutations affecting methionine-41 (p.Met41) in UBA1. The VEXAS syndrome often overlaps with myelodysplastic syndromes (MDS) with autoimmune disorders (AD). By screening the UBA1 gene sequences derived from MDS patients with AD from our center, we identified one patient with a p.Met41Leu missense mutation in UBA1, who should have been diagnosed as MDS comorbid with VEXAS syndrome. This patient respond poorly to immune suppressive drugs. Patients with MDS and AD who have characteristic vacuoles in myeloid and erythroid precursor cells should be screened for UBA1 mutation, these patients are likely to have VEXAS syndrome and unlikely to improve with immunosuppressive drugs and should be considered for other alternative therapies.
Adapting World Health Organization Disability Assessment Schedule 2.0 for Nepal
Authors: Risal Ajay , Kunwar Dipak , Karki Eliza , Adhikari Shambhu Prasad , Bimali Inosha , Shrestha Barsha , Khadka Subekshya , Holen Are 
Published: March 2021

AbstractBackgroundDisability is a vital public health issue for health care programs. Affluent countries usually prioritize disability-related research, while often it remains neglected in resource-poor countries like Nepal. The aim of this study was to make available a translated and culturally adapted version of the World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) for measuring disability in the Nepalese population.MethodsWHODAS 2.0 (12-items version) was translated into Nepali using a standard forward–backward translation protocol. Purposive and convenience recruitment of participants with psychiatric disabilities was done at the Psychiatry services in a tertiary care hospital. Age and gender-matched participants with physical disabilities were selected from the Internal Medicine department, and participants with no disability were recruited from their accompanying persons. A structured interview in Nepali including the translated WHODAS 2.0 was administered to all participants. Exploratory factor analysis and parallel analysis assessed the construct validity. Content validity was explored, and a quality of life instrument was used for establishing criterion validity. Reliability was measured via Cronbach alpha. Mann–Whitney test explored score differences between the disabled and non-disabled.ResultsIn total, 149 persons [mean age: 40.6 (12.8); 43.6% males, 56.4% females; 61.7% disabled, 38.3% non-disabled] consented to participate. Parallel analysis indicated that a single factor was adequate for the Nepali WHODAS version that captured 45.4% of the total variance. The translated scale got a good Cronbach alpha (= 0.89). Satisfactory construct, content and criterion validity was found. The WHODAS total scores showed a significant difference between the disabled and non-disabled (U = 2002.5; p = 0.015). However, the difference between psychiatric and physical disabilities was not significant, which underscores that the scale is rating disability in general.ConclusionThe one-factor structure of the translated and culturally adapted Nepali-version of WHODAS 2.0 showed acceptable validity and an adequate reliability. For epidemiological research purposes, this version of WHODAS 2.0 is now available for measuring global disability in Nepal.
Evidence of probability misconception in engineering students—why even an inaccurate explanation is better than no explanation
Authors: Kaplar Marija , Lužanin Zorana , Verbić Srđan 
Published: March 2021

AbstractBackgroundIn the rapidly changing industrial environment and job market, engineering profession requires a vast body of skills, one of them being decision making under uncertainty. Knowing that misunderstanding of probability concepts can lead to wrong decisions, the main objective of this study is to investigate the presence of probability misconceptions among undergraduate students of electrical engineering. Five misconceptions were investigated:insensitivity to sample size,base rate neglected,misconception of chance,illusory correlation, andbiases in the evaluation of conjunctive and disjunctive events.The study was conducted with 587 students who attended bachelor schools of electrical engineering at two universities in Serbia. The presence of misconceptions was tested using multiple-choice tasks. This study also introduces a novel perspective, which is reflected in examination of the correlation between students’ explanations of given answers and their test scores.ResultsThe results of this study show that electrical engineering students are, susceptible to misconceptions in probability reasoning. Although future engineers from the sample population were most successful in avoiding misconceptions of chance, only 35% of examinees were able to provide a meaningful explanation. Analysis of students’ explanations, revealed that in many cases majority of students were prone to common misconceptions. Among the sample population, significant percentage of students were unable to justify their own answers even when they selected the correct option. The results also indicate that formal education in probability and statistics did not significantly influence the test score.ConclusionsResults of the present study indicate a need for further development of students’ deep understanding of probability concepts, as well as the need for the development of competencies that enable students to validate their answers. The study emphasizes the importance of answer explanations, since they allow us to discover whether students who mark the correct answer have some misconceptions or may be prone to some other kind of error. We found that the examinees who failed to explain their choices had much lower test scores than those who provided some explanation.
Rapid estimation of tsunami earthquake magnitudes at local distance
Authors: Katsumata Akio , Tanaka Masayuki , Nishimiya Takahito 
Published: March 2021

AbstractA tsunami earthquake is an earthquake event that generates abnormally high tsunami waves considering the amplitude of the seismic waves. These abnormally high waves relative to the seismic wave amplitude are related to the longer rupture duration of such earthquakes compared with typical events. Rapid magnitude estimation is essential for the timely issuance of effective tsunami warnings for tsunami earthquakes. For local events, event magnitude estimated from the observed displacement amplitudes of the seismic waves, which can be obtained before estimation of the seismic moment, is often used for the first tsunami warning. However, because the observed displacement amplitude is approximately proportional to the moment rate, conventional magnitudes of tsunami earthquakes estimated based on the seismic wave amplitude tend to underestimate the event size. To overcome this problem, we investigated several methods of magnitude estimation, including magnitudes based on long-period displacement, integrated displacement, and multiband amplitude distribution. We tested the methods using synthetic waveforms calculated from finite fault models of tsunami earthquakes. We found that methods based on observed amplitudes could not estimate magnitude properly, but the method based on the multiband amplitude distribution gave values close to the moment magnitude for many tsunami earthquakes. In this method, peak amplitudes of bandpass filtered waveforms are compared with those of synthetic records for an assumed source duration and fault mechanism. We applied the multiband amplitude distribution method to the records of events that occurred around the Japanese Islands and to those of tsunami earthquakes, and confirmed that this method could be used to estimate event magnitudes close to the moment magnitudes.
Mathematical modeling of auxetic systems: bridging the gap between analytical models and observation
Authors: Grima-Cornish James N. , Grima Joseph N. , Attard Daphne 
Published: March 2021

AbstractThe Poisson’s ratio, a property which quantifies the changes in thickness when a material is stretched and compressed, can be determined as the negative of the transverse strain over the applied strain. In the scientific literature, there are various ways how strain may be defined and the actual definition used could result in a different Poisson’s ratio being computed. This paper will look in more detail at this by comparing the more commonly used forms of strain and the Poisson’s ratio that is computable from them. More specifically, an attempt is made to assess through examples on the usefulness of the various formulations to properly describe what can actually be observed, thus providing a clearer picture of which form of Poisson’s ratio should be used in analytical modelling.
Implementation and preliminary testing of a theory-guided nursing discharge teaching intervention for adult inpatients aged 50 and over with multimorbidity: a pragmatic feasibility study protocol
Authors: Pellet Joanie , Weiss Marianne , Zúñiga Franziska , Mabire Cedric 
Published: March 2021

Abstract
Background
Discharge teaching by nurses during hospitalization is essential to provide multimorbid inpatients with the knowledge and skills to self-manage their health conditions. However, available disease-specific teaching guidelines do not address the cumulative complexity of multiple chronic diseases that occur with greater frequency in older adults. Therefore, there is a need for a discharge teaching intervention which uses concepts that specifically address the needs of these patients, such as considering their level of activation (i.e. knowledge, skills and confidence to self-manage their health) and the burden of multimorbid disease. The objectives of this pragmatic study will be to (1) test the feasibility of implementing a nursing discharge teaching intervention and (2) conduct a preliminary test of this novel discharge teaching intervention with adult inpatients age 50 or greater who have multiple comorbid conditions.

Methods
This study uses a two-group pre-posttest design. Participants are drawn from medical units in three hospitals in the French-speaking part of Switzerland. The implementation of the intervention will be facilitated by implementation strategies from the Theoretical Domains Framework and the Behavior Change Wheel and will target change in nurses’ teaching behaviours. Implementation outcomes will include measures of feasibility of the implementation strategies and the intervention process. Participants in the intervention group will receive tailored discharge teaching by trained teaching nurses. Patient outcomes will inform the preliminary testing of the intervention and will be measured with validated questionnaires assessing patients’ activation level, health confidence, perceived readiness for discharge, experience with the discharge process and rate of and time to readmission.

Discussion
The study takes a pragmatic approach to examining the feasibility of implementing the discharge teaching intervention to contribute to the knowledge development within the context of the real-world practice setting. Results will provide the foundation for clinical trials to build evidence for widespread adoption of this intervention.

Trial registration
The trial is registered at ClinicalTrials.gov (ID: NCT04253665) on the 30 of January 2020 and has been approved by the Cantonal Ethics Committee Vaud in Switzerland (2020-00141).
A randomised-controlled feasibility study of the REgulate your SItting Time (RESIT) intervention for reducing sitting time in individuals with type 2 diabetes: study protocol
Authors: Bailey Daniel P. , Edwardson Charlotte L. , Pappas Yannis , Dong Feng , Hewson David J. , Biddle Stuart J. H. , Brierley Marsha L. , Chater Angel M. 
Published: March 2021

Abstract
Background
People with type 2 diabetes mellitus (T2DM) generally spend a large amount of time sitting. This increases their risk of cardiovascular disease, premature mortality, diabetes-related complications and mental health problems. There is a paucity of research that has evaluated interventions aimed at reducing and breaking up sitting in people with T2DM. The primary aim of this study is to assess the feasibility of delivering and evaluating a tailored intervention to reduce and break up sitting in ambulatory adults with T2DM.

Methods
This is a mixed-methods randomised controlled feasibility trial. Participants (n=70) with T2DM aged 18-85 years who sit ≥7 h/day and are able to ambulate independently will be randomly allocated to receive the REgulate your SItting Time (RESIT) intervention or usual care (control group) for 24 weeks. RESIT is a person-focused intervention that delivers a standardised set of behaviour change techniques to the participants, but the mode through which they are delivered can vary depending on the tools selected by each participant. The intervention includes an online education programme, health coach support, and a range of self-selected tools (smartphone apps, computer-prompt software, and wearable devices) that deliver behaviour change techniques such as self-monitoring of sitting and providing prompts to break up sitting. Measures will be taken at baseline, 12 and 24 weeks. Eligibility, recruitment, retention and data completion rates will be used to assess trial feasibility. Sitting, standing and stepping will be measured using a thigh-worn activity monitor. Cardiometabolic health, physical function, psychological well-being, sleep and musculoskeletal symptoms will also be assessed. A process evaluation will be conducted including evaluation of intervention acceptability and fidelity.

Discussion
This study will identify the feasibility of delivering a tailored intervention to reduce and break up sitting in ambulatory adults with T2DM and evaluating it through a randomised controlled trial (RCT) design. The findings will inform a fully powered RCT to evaluate the effectiveness of the intervention.

Trial registration
ISRCTN, ISRCTN14832389; Registered 6 August 2020.
Classic cardiovascular risk factors improve in very elderly hypopituitary patients treated on standard hormone replacement in long term follow- up
Authors: Rosa Isabella Naves , de Sousa Munhoz Soares Alexandre Anderson , Rodrigues Marcelo Palmeira , Naves Luciana Ansaneli 
Published: March 2021

Abstract
Background
Hypopituitarism in the elderly population is an underdiagnosed condition and may increase comorbidities related to glucose metabolism, dyslipidemia, and cardiovascular risk factors. Optimization of hormone replacement that considers alterations in clearance rates of hormones, interaction with other medications, and evaluation of the risk-benefit ratio of treatment is a big challenge for clinical practice.

Objectives
This study aimed to evaluate classic cardiovascular risk factors in hypopituitary septuagenarians and octagenarians by diagnosis and after long-term hormone replacement.

Methods
This is a retrospective observational study, with patients recruited and selected from a registry in a tertiary medical center. We included patients aged 70–99 years with hypopituitarism, evaluated hormonal and biochemical parameters, and cardiovascular risk scores were calculated by diagnosis and compared after long-term follow-up. All patients gave informed consent. Patient data were compared to a sex and age-matched control group, with long-term geriatric follow-up, without endocrine diseases.

Results
Thirty-five patients were included, 16 patients aged 70–75 years (72.61), 12 patients 76–80 years (72.28), 7 patients 81–99 years (89.28). Pituitary macroadenomas were the main cause of hypopituitarism, mean maximal diameter 3.4 cm (2.9–4.3), and invasive craniopharyngiomas. At the moment of diagnosis, most patients were overweight, and abdominal adiposity was observed in 76.9% of women and 36.4% of men, primarily in octagenarians and nonagenarians. Comorbidities were frequent; 85.7% presented hypertension, 37.1% diabetes, 53.1% low HDL, 51.5% hypertriglyceridemia. Most patients presented more than two combined pituitary deficiencies; hypogonadism in 88.6%, central hypothyroidism in 82.9%, GH deficiency in 65.7%, and adrenal insufficiency in 25.7%. Analysis of cardiovascular risk prediction in the total cohort showed that 57.1% of patients presented a reduction in the General Cardiovascular Disease (CVD) Risk Prediction Score and 45.7% in atherosclerotic CVD risk estimated by ACC/AHA 2013 Pooled Cohort Equation, despite being submitted to conventional hormone replacement, during the mean follow-up of 14.5 years. This reduction was not observed in the control group.

Discussion and conclusion
In this study, aged hypopituitary patients presented a reduction in estimated general CVD risk during long-term follow-up, despite replacement with corticosteroids, levothyroxine, or gonadal steroids. Early diagnosis and treatment of hypopituitarism in the elderly remain challenging. Larger studies should be performed to assess the risk-benefit ratio of hormone replacement on the metabolic profile in septuagenarian and octogenarian patients.
How to prevent and avoid barriers in co-production with family carers living in rural and remote area: an Italian case study
Authors: Gheduzzi Eleonora , Masella Cristina , Morelli Niccolò , Graffigna Guendalina 
Published: March 2021

Abstract
Background
Co-production has been widely recognised as a potential means to reduce the dissatisfaction of citizens, the inefficacy of service providers, and conflicts in relations between the former and the latter. However, the benefits of co-production has begun to be questioned: co-production has often been taken for granted, and its effects may not be effective. To understand and prevent unsuccessful citizen and provider collaboration, the recent literature has begun to focus on the causes of co-destruction. This paper investigates how the barriers that may arise during the co-production of a new social service with family carers can be identified and interpreted.

Methods
To investigate this topic, we undertook a single case study - a longitudinal project (Place4Carers (Graffigna et al., BMJ Open 10:e037570, 2020)) intended to co-produce a new social care service with and for the family carers of elderly patients living in rural and remote areas. We organised collaborative co-assessment workshops and semi-structured interviews to collect the views of family carers and service providers on the co-production process. A reflexive approach was used in the analysis for collecting the opinions of the research team that participated in the co-production process.

Results
The analysis revealed four main co-production barriers: lack of trust, lack of effectiveness of engagement, participants’ inability (or impossibility) to change and the lack of a cohesive partnership among partners. Despite these findings, the project increases carers’ satisfaction, competence and trust in service providers by demonstrating the positive effects of co-production.

Conclusions
Our article confirms that co-creation and co-destruction processes may coexist. The role of researchers and service providers is to prevent or remedy co-destruction effects. To this end, we suggest that in co-production projects, more time should be spent co-assessing the project before, during and after the co-production process. This approach would facilitate the adoption of adjustment actions such as creating mutual trust through conviviality among participants and fostering collaborative research between academia and organisations that are not used to working together.
Great expectations: minor differences in initial instructions have a major impact on visual search in the absence of feedback
Authors: Cox Patrick H. , Kravitz Dwight J. , Mitroff Stephen R. 
Published: March 2021

AbstractProfessions such as radiology and aviation security screening that rely on visual search—the act of looking for targets among distractors—often cannot provide operators immediate feedback, which can create situations where performance may be largely driven by the searchers’ own expectations. For example, if searchers do not expect relatively hard-to-spot targets to be present in a given search, they may find easy-to-spot targets but systematically quit searching before finding more difficult ones. Without feedback, searchers can create self-fulfilling prophecies where they incorrectly reinforce initial biases (e.g., first assuming and then, perhaps wrongly, concluding hard-to-spot targets are rare). In the current study, two groups of searchers completed an identical visual search task but with just a single difference in their initial task instructions before the experiment started; those in the “high-expectation” condition were told that each trial could have one or two targets present (i.e., correctly implying no target-absent trials) and those in the “low-expectation” condition were told that each trial would have up to two targets (i.e., incorrectly implying there could be target-absent trials). Compared to the high-expectation group, the low-expectation group had a lower hit rate, lower false alarm rate and quit trials more quickly, consistent with a lower quitting threshold (i.e., performing less exhaustive searches) and a potentially higher target-present decision criterion. The expectation effect was present from the start and remained across the experiment—despite exposure to the same true distribution of targets, the groups’ performances remained divergent, primarily driven by the different subjective experiences caused by each groups’ self-fulfilling prophecies. The effects were limited to the single-targets trials, which provides insights into the mechanisms affected by the initial expectations set by the instructions. In sum, initial expectations can have dramatic influences—searchers who do not expect to find a target, are less likely to find a target as they are more likely to quit searching earlier.