bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of left atrial appendage closure using cerebral protection system for thrombosis: no patient left behind
Authors: Limite Luca Rosario , Radinovic Andrea , Cianfanelli Lorenzo , Altizio Savino , Peretto Giovanni , Frontera Antonio , D'Angelo Giuseppe , Baratto Francesca , Marzi Alessandra , Ancona Francesco , Ingallina Giacomo , Capogrosso Cristina , Stella Stefano , Melillo Francesco , Agricola Eustachio , Della Bella Paolo , Mazzone Patrizio 
Published: November 2021

AbstractBackgroundLeft atrial appendage (LAA) thrombosis increases the risk of stroke and its management has to be assessed. The aim of the present study is to evaluate short and long‐term safety and efficacy of a standardized approach of percutaneous LAA closure (LAAC) routinely using a cerebral protection device (CPD) in patients with LAA thrombosis or sludge (LAAT).MethodsWe prospectively enrolled 14 consecutive patients with atrial fibrillation complicated by LAAT presenting in a high‐volume tertiary center. In seven patients (50%) LAAT was found after anticoagulant withdrawal for severe bleedings and in the remaining half LAAT was found despite appropriate anticoagulant therapy. All patients were treated with a standardized interventional approach of LAAC routinely using a CPD and guided by transoesophageal echocardiography.ResultsMean age was 68 ± 14 years and nine patients (64%) were male. Mean CHA2DS2‐VASc and HAS‐BLED scores were 3.3 ± 1.6 and 2.3 ± 1.1, respectively. Six patients (42.8%) presented organized thrombi while eight LAA sludge (57.1%). In 13 patients (92.8%) CPD was positioned through a right radial arterial access. Procedural success was achieved in all patients. In one patient we assisted to embolization of the thrombus during deployment of the device in the absence of neurological consequences. During a mean follow up of 426 ± 307 days, one patient died for non‐cardiac cause while no embolic event or major bleeding were reported.ConclusionIn an unselected cohort, LAAC with the systematic use of CPD was a feasible, safe and effective therapeutic option for LAAT both acutely and after long‐term follow‐up.
The impact of government‐mandated shared decision‐making for implantable defibrillators: A natural experiment
Authors: Rao Birju R. , Merchant Faisal M. , Abernethy Eli R. , Howard David H. , Matlock Daniel D. , Dickert Neal W. 
Published: November 2021

AbstractBackgroundIn 2018, the Centers for Medicare and Medicaid Services (CMS) mandated that patients considering implantation of an implantable cardioverter‐defibrillator (ICD) for primary prevention of sudden cardiac death undergo shared decision‐making (SDM) using a decision‐aid.ObjectiveTo observe the impact of the CMS's mandate on core measures of SDM using a natural experiment.Research design, subjects, and measuresPatients who underwent implantation of a primary prevention ICD within the Emory Healthcare system between 2017–2019 (pre and post SDM mandate) were surveyed. Survey domains included knowledge about the ICD, decisional conflict, values‐choice concordance, and engagement in decision‐making. Patients who had an ICD implant after the mandate were also asked about their views of the decision aid (DA). Responses of patients who had ICD implanted prior to the mandate were compared to those after the mandate using either Student t test or Chi‐Squared tests.ResultsOf 101 patients who completed the survey, 45 had an ICD placed before the mandate and 56 had an ICD placed after. There were no major differences between knowledge, decisional conflict, values choice concordance, or patient engagement. Compared to patients with ICDs placed before the mandate, patients with ICDs after the mandate were more likely to subjectively feel more informed about the benefits of the procedure but were less likely to be able to correctly identify the frequency of complications.ConclusionsPolicy effects to promote SDM that solely focus on a decision‐aid may not substantively impact patient centered care.
Central venous catheter‐related thrombosis in pediatric surgical patients: A prospective observational study
Authors: Kim Eun‐Hee , Lee Ji‐Hyun , Kim Hee‐Soo , Jang Young‐Eun , Ji Sang‐Hwan , Kang PyoYoon , Song In‐Sun , Kim Jin‐Tae 
Published: November 2021

AbstractBackgroundPerioperative central venous catheters are required but may be associated with various complications.AimsThe purpose of our study was to assess the incidence and perioperative risk factors for catheter‐related internal jugular vein thrombosis in pediatric surgical patients.MethodsThis prospective observational study included children under 6 years of age who were scheduled to undergo central venous catheterization of the right internal jugular vein under general anesthesia. A central venous catheter was inserted under real‐time ultrasound guidance. An investigator examined for thrombosis using ultrasonography at predetermined time points. The primary aim was the incidence of catheter‐related thrombosis from insertion until the 5th day postoperatively or the removal of the central venous catheter. The secondary aim was the determination of the risk factors for thrombosis.ResultsEighty patients completed the study. Internal jugular vein thrombi were found in 31 patients (38.8%, 95% CI 28.0–49.4). On multiple logistic regression analyses, the number of insertion attempts was the only influencing factor for catheter‐related thrombosis (p < .001). More than two insertion attempts increased the risk of thrombosis (odds ratio 5.6; 95% CI 1.7 – 18.7, p = .004). Anesthesia time (p = .017; mean difference 166.4 min; 95% CI 55.7–277.1), intraoperative red blood cell transfusion (p = .001; median difference 21.1 ml kg−1; 95% CI 6.6–34.4), and intensive care unit stay (p = .001; median difference 100.0 h; 95% CI 48–311) differed between patients with transient thrombosis and those with thrombosis lasting for more than 3 days.ConclusionInternal jugular vein thrombosis was frequently detected by ultrasound following central venous catheterization in pediatric surgical patients. Multiple insertion attempts may be associated with the incidence of thrombosis. The clinical relevance of thrombi detected via ultrasound surveillance has not been determined.
More accurate measurement of temperature in potato drills increases predicted potato cyst nematode population growth
Authors: Ewing David A. , Kettle Helen , Blok Vivian C. 
Published: November 2021

ABSTRACTPotato cyst nematodes (PCN) are economically important pests of potato plants worldwide that can result in yield losses exceeding 80%, with an estimated cost of £50 million annually in the United Kingdom alone. The life cycle of PCN, and in particular the hatching of eggs and development and survival of juveniles, is sensitive to temperatures in the soil. Despite this fact, relatively little is known about temperatures inside potato drills and how these may differ to temperatures in the surrounding soil. We monitored the temperature inside potato drills at 19 sites across the United Kingdom and used a published temperature‐driven process‐based PCN life cycle model to compare predictions of PCN population dynamics driven by these temperatures to predictions based on modelled soil temperatures derived from the HadUK‐Grid climate. We found that mean soil temperatures derived from the climate model were lower than those observed inside potato drills; thus, using temperatures measured directly in potato drills resulted in increased estimates of population growth and shorter estimated generation times than when using modelled soil temperatures. This finding suggests that greater understanding of the temperature inside potato drills is required if we are to make accurate predictions about the effects of temperature on PCN populations.
Job demands and resources and their relationship with satisfaction and thriving at work in a sample of Chinese doctors: a cross-sectional study
Authors: Zhang Shu'e , Shi Yu , Liu Bei , Wang Hongni , Zhao Xin , Wang Xiaohe , Sun Tao 
Published: November 2021

ObjectivesThe current study aimed to evaluate the status quo of perceived job demands and resources respectively among Chinese doctors, to examine the mediating role of work–family conflicts in the relationship between perceived job demands and various indicators of well-being, and to test the mediating role of psychological attachment in the relationship between perceived job resources and thriving at work among Chinese doctors.DesignA cross-sectional online survey study.SettingOnline questionnaires were administered across 30 provinces.ParticipantsA total of 2617 doctors provided sufficiently complete responses to be used in the study.ResultsPerceived job demands (M=3.843, SD=0.791) of participants were positively associated with work–family conflicts (B=0.454, p<0.001) and negatively associated with job satisfaction (B=−0.065, p<0.001) and life satisfaction (B=−0.261, p<0.001). Work–family conflicts partially mediated the relationship between job demands and life satisfaction and fully mediated the relationship between job demands and job satisfaction. Perceived job resources (M=2.474, SD=0.740) among Chinese doctors were positively associated with psychological attachment (B=0.988, p<0.001) and thriving at work (B=0.582, p<0.001). Furthermore, psychological attachment partially mediated the relationship between perceived job resources and thriving at work.ConclusionDoctors in China with high-level job demands tended to exhibit increased work–family conflicts, which in turn threatened their job and life satisfaction. On the contrary, doctors with greater job resources were more likely to thrive at work by increasing their degree of psychological attachment. The current study suggested that Chinese health policymakers and hospital administrators should provide a work environment with a dynamic equilibrium between doctors’ job demands and resources.
Do hospitals have a higher mortality rate on weekend admissions? An observational study to analyse weekend effect on urgent admissions to hospitals in Catalonia
Authors: Amigo Franco , Dalmau-Bueno Albert , García-Altés Anna 
Published: November 2021

Background‘Weekend effect’ is a term used to describe the increased mortality associated with weekend emergency admissions to hospital, in contrast with admission on weekdays. The objective of the present study is to determine whether the weekend effect is present in hospitals in Catalonia.MethodsWe analysed all urgent admissions in Catalonia in 2018, for a group of pathologies. Two groups were defined (those admitted on a weekday and those admitted on a weekend). We obtained mortality at 3, 7, 15 and 30 days, and applied a proportions test to both groups. Additionally, we used Cox’s regression for mortality at 30 days, using the admission on a weekend as the exposition, adjusting by socioeconomic and clinical variables. We used the hospital discharge database and the Central Registry of the Insured Population.Results72 427 admissions for the selected pathologies during 2018 were found. No statistically significant differences in mortality at 30 days (p=0.524) or at 15 days (p=0.119) according to the day of admission were observed. However, significant differences were found in mortality at 7 days (p=0.025) and at 3 days (p=0.002). The hazard rate associated with the weekend was 1.13 (95% CI: 1.04 to 1.23). By contrast, the adjusted HR of the weekend interaction with time was 0.99 (95% CI: 0.99 to 1.00).ConclusionsThere is a weekend effect, but it is not constant in time. This could suggest the existence of dysfunctions in the quality of care during the weekend.
Cohort profile: the Netherlands Cohort Study on Acute HIV infection (NOVA), a prospective cohort study of people with acute or early HIV infection who immediately initiate HIV treatment
Authors: Dijkstra Maartje , Prins Henrieke , Prins Jan M , Reiss Peter , Boucher Charles , Verbon Annelies , Rokx Casper , de Bree Godelieve 
Published: November 2021

PurposeInitiation of combination antiretroviral therapy (cART) during acute or early HIV-infection (AEHI) limits the size of the viral reservoir and preserves immune function. This renders individuals who started cART during AEHI promising participants in HIV-cure trials. Therefore, we established a multicentre prospective cohort study in the Netherlands that enrols people with AEHI. In anticipation of future cure trials, we will longitudinally investigate the properties of the viral reservoir size and HIV-specific immune responses among cohort participants.ParticipantsParticipants immediately initiate intensified cART: dolutegravir, emtricitabine/tenofovir and darunavir/ritonavir (DRV/r). After 4 weeks, once baseline resistance data are available, DRV/r is discontinued. Three study groups are assembled based on the preparedness of individuals to participate in the extensiveness of sampling. Participants accepting immediate treatment and follow-up but declining additional sampling are included in study group 1 (‘standard’) and routine diagnostic procedures are performed. Participants willing to undergo blood, leukapheresis and semen sampling are included in study group 2 (‘less invasive’). In study group 3 (‘extended’), additional tissue (gut-associated lymphoid tissue, peripheral lymph node) and cerebrospinal fluid sampling are performed.Findings to dateBetween 2015 and 2020, 140 individuals with AEHI have been enrolled at nine study sites. At enrolment, median age was 36 (IQR 28–47) years, and 134 (95.7%) participants were men. Distribution of Fiebig stages was as follows: Fiebig I, 3 (2.1%); II, 20 (14.3%); III, 7 (5.0%); IV, 49 (35.0%); V, 39 (27.9%); VI, 22 (15.7%). Median plasma HIV RNA was 5.9 (IQR 4.7–6.7) log10 copies/mL and CD4 count 510 (IQR 370–700) cells/mm3. Median time from cART initiation to viral suppression was 8.0 (IQR 4.0–16.0) weeks.Future plansThe Netherlands Cohort Study on Acute HIV infection remains open for participant enrolment and for additional sites to join the network. This cohort provides a unique nationwide platform for conducting future in-depth virological, immunological, host genetic and interventional studies investigating HIV-cure strategies.
Degree of personalisation in tailored activities and its effect on behavioural and psychological symptoms and quality of life among people with dementia: a systematic review and meta-analysis
Authors: Lu Shiyu , Zhang Anna Y , Liu Tianyin , Choy Jacky C P , Ma Maggie S L , Wong Gloria , Lum Terry 
Published: November 2021

ObjectivesTo understand and assess the degree of personalisation of tailored activities for people with dementia (PWD); and to estimate the magnitude of the effects of levels of personalisation on reducing behavioural and psychological symptoms of dementia (BPSD), improving quality of life (QoL) and level of engagement.DesignSystematic review with meta-analysis.Data sourcesProQuest, PubMed, Ovid, Cochrane Library, Web of Science and CINAHL were searched from the start of indexing to May 2020.Eligibility criteriaWe included randomised controlled trials and quasi-experimental studies assessing the effects of tailored activities for people aged 60 years or older with dementia or cognitive impairment on the outcomes of BPSD, QoL, depression and level of engagement with control groups.Data extraction and synthesisTwo researchers screened studies, extracted data and assessed risks of bias. A rating scheme to assess the degree of personalisation of tailored activities was developed to classify tailored activities into high/medium/low groups. Effect sizes were expressed using standardised mean differences at 95% Confidence Interval (CI). Subgroup analyses were conducted to assess whether the degree of personalisation of tailored activities affected outcomes of interest.ResultsThirty-five studies covering 2390 participants from 16 countries/regions were identified. Studies with a high-level of personalisation interventions (n=8) had a significant and moderate effect on reducing BPSD (standardised mean differences, SMD=−0.52, p<0.05), followed by medium (n=6; SMD=−0.38, p=0.071) and low-level personalisation interventions (n=6; SMD=−0.15, p=0.076). Tailored activities with a high-level of personalisation had a moderate effect size on improving QoL (n=5; SMD=0.52, p<0.05), followed by a medium level (n=3; SMD=0.41, p<0.05) of personalisation.ConclusionsTo develop high-level tailored activities to reduce BPSD and improve QoL among PWD, we recommend applying comprehensive assessments to identify and address two or more PWD characteristics in designed tailored activities and allow modification of interventions to respond to changing PWD needs/circumstances.PROSPERO registration numberCRD42020168556.
Understanding the low take-up of home-based dialysis through a shared decision-making lens: a qualitative study
Authors: Noyes Jane , Roberts Gareth , Williams Gail , Chess James , Mc Laughlin Leah 
Published: November 2021

ObjectivesTo explore how people with chronic kidney disease who are pre-dialysis, family members and healthcare professionals together navigate common shared decision-making processes and to assess how this impacts future treatment choice.DesignCoproductive qualitative study, underpinned by the Making Good Decisions in Collaboration shared decision-model. Semistructured interviews with a purposive sample from February 2019 - January 2020. Interview data were analysed using framework analysis. Coproduction of logic models/roadmaps and recommendations.SettingFive Welsh kidney services.Participants95 participants (37 patients, 19 family members and 39 professionals); 44 people supported coproduction (18 patients, 8 family members and 18 professionals).FindingsShared decision-making was too generic and clinically focused and had little impact on people getting onto home dialysis. Preferences of where, when and how to implement shared decision-making varied widely. Apathy experienced by patients, caused by lack of symptoms, denial, social circumstances and health systems issues made future treatment discussions difficult. Families had unmet and unrecognised needs, which significantly influenced patient decisions. Protocols containing treatment hierarchies and standards were understood by professionals but not translated for patients and families. Variation in dialysis treatment was discussed to match individual lifestyles. Patients and professionals were, however, defaulting to the perceived simplest option. It was easy for patients to opt for hospital-based treatments by listing important but easily modifiable factors.ConclusionsShared decision-making processes need to be individually tailored with more attention on patients who could choose a home therapy but select a different option. There are critical points in the decision-making process where changes could benefit patients. Patients need to be better educated and their preconceived ideas and misconceptions gently challenged. Healthcare professionals need to update their knowledge in order to provide the best advice and guidance. There needs to be more awareness of the costs and benefits of the various treatment options when making decisions.
Prevalence and associated factors with sexual violence victimisation youth before, during and after the COVID-19 lockdown: a cross-sectional study in Spain
Authors: Sanz-Barbero Belén , Saurina Carme , Serra Laura , Renart Vicens Gemma , Vall-Llosera Casanovas Laura , Otero-García Laura , López María José , Perez Glòria , Vives-Cases Carmen 
Published: November 2021

ObjectivesTo analyse the prevalence of sexual violence (SV) and associated factors in Spanish young adults in the last year and before, during and after the COVID-19 lockdown.DesignCross-sectional study based on the online ‘SV in Young People Survey’ (2020).SettingNon-institutionalised population residing in Spain.Participants2515 men and women aged 18–35 years old. The participants were obtained from a probability based, online closed panel of adults aged 16 or older that is representative of the non-institutionalised population. The sample designed includes quotas by sex, age, region and country of origin.Outcomes measures and analysesSV victimisation by sociodemographics, sexual attraction and couple-related characteristics during the past year and before, during and after the COVID-19 lockdown (March–June 2020). Prevalence ratios were calculated using robust Poisson regression models.ResultsIn Spain, 8.5% of young people experienced SV during the past year. The greatest prevalence was observed in women with bisexual attraction (17.5%) and in men with homosexual attraction (14.2%). During the COVID-19 lockdown, the prevalence of SV victimisation was lower (1.9%), but unwanted intercourses increased, affecting 64.4% of those exposed to SV during the period. People with homosexual or bisexual attraction were more likely to experience SV in all of the studied periods (PRbefore: 2.01; p<0.001; PRduring: 2.63 p=0.002; PRafter: 2.67; p<0.001). Women were more likely than men to experience SV prior to the lockdown, while no cohabitation increased the likelihood to experience SV after this periodConclusionsSV victimisation in Spanish youth is high. During COVID-19, there were changes in the magnitude of factors associated with SV. It seems that SV events decreased in people who did not live with their partners, but unwanted intercourses increased. The development of prevention strategies to address SV in youth should take into account social inequalities by sex, sexual orientation and origin.
Pylorus resection versus pylorus preservation in pancreatoduodenectomy (PyloResPres): study protocol and statistical analysis plan for a German multicentre, single-blind, surgical, registry-based randomised controlled trial
Authors: Renz Bernhard W , Adrion Christine , Klinger Carsten , Ilmer Matthias , D’Haese Jan G , Buhr Heinz-J , Mansmann Ulrich , Werner Jens 
Published: November 2021

IntroductionPartial pancreatoduodenectomy (PD) is the treatment of choice for various benign and malignant tumours of the pancreatic head or the periampullary region. For reconstruction of the gastrointestinal passage, two stomach-preserving PD variants exist: pylorus preservation PD (ppPD) or pylorus resection PD (prPD) with preservation of the stomach. In pancreatic surgery, delayed gastric emptying (DGE) remains a serious complication after PD with an incidence varying between 4.5% and 45%, potentially delaying hospital discharge or further treatment, for example, adjuvant chemotherapy. Evidence is lacking to assess, which variant of PD entails fewer postoperative DGE.Methods and analysisThe protocol of a large-scale, multicentre, pragmatic, two-arm parallel-group, registry-based randomised controlled trial (rRCT) using a two-stage group-sequential design is presented. This patient-blind rRCT aims to demonstrate the superiority of prPD over ppPD with respect to the overall incidence of DGE within 30 days after index surgery in a German real-world setting. A total of 984 adults undergoing elective PD for any indication will be randomised in a 1:1 ratio. Patients will be recruited at about 30 hospitals being members of the StuDoQ|Pancreas registry established by the German Society of General and Visceral Surgery. The postoperative follow-up for each patient will be 30 days. The primary analysis will follow an intention-to-treat approach and applies a binary logistic random intercepts model. Secondary perioperative outcomes include overall severe morbidity (Clavien-Dindo classification), blood loss, 30-day all-cause mortality, postoperative hospital stay and operation time. Complication rates and adverse events will be closely monitored.Ethics and disseminationThis protocol was approved by the leading ethics committee of the Medical Faculty of the Ludwig-Maximilians-Universität, Munich (reference number 19-221). The results will be published in a peer-reviewed journal and presented at international conferences. Study findings will also be disseminated via the website (http://www.dgav.de/studoq/pylorespres/).Trial registration numberDRKS-ID: DRKS00018842.