bluuebunny/crossref_metadata_2025_split huggingface dataset:
Computer‐delivered behavioural activation and approach‐avoidance training in major depression: Proof of concept and initial outcomes
Authors: Sweet Alison M. , Pearlstein Sarah L. , Paulus Martin P. , Stein Murray B. , Taylor Charles T. 
Published: March 2021

ObjectivesIndividuals with major depressive disorder (MDD) have problems with engaging in approach behaviour to potentially rewarding encounters, which contributes to the maintenance of depressive symptoms. Approach‐avoidance training (AAT) retrains implicit approach tendencies, and behavioural activation (BA) promotes explicit approach behaviour in MDD. As a novel MDD treatment strategy, this study aimed to implement a brief, computerized version of BA integrated with implicit AAT.DesignAdults with a principal diagnosis of MDD (N = 25) were randomly assigned to complete one of two versions of AAT – approach‐positive faces (n = 12) or balanced approach of positive and neutral faces (n = 13) – concurrently with self‐guided BA twice weekly for 2 weeks.MethodsOutcomes included treatment completion rates; bias scores for automatic approach towards positive social cues; and symptom scales for depression, positive affect, social relationship functioning, anhedonia, and anxiety.ResultsFeasibility and acceptability of computerized BA + AAT were supported by moderate pre‐treatment credibility and expectancy ratings and 80% treatment completion. Participants across both conditions displayed significant and large sized reductions in depression from pre‐ to post‐assessment (Cohen’s d = −1.23) that maintained three months later, as well as decreased anxiety and anhedonia and increased positive affect and social relationship functioning (medium to large effects).ConclusionResults support the feasibility and potential efficacy of brief, computerized BA + AAT. Research is needed to determine whether AAT is additive to BA, and what AAT parameters best enhance treatment outcomes.Practitioner Points

Brief, computerized behavioral activation plus approach/avoidance training (BA + AAT) may be acceptable and beneficial for some patients with moderate‐to‐severe major depression.

Computer‐delivered BA + AAT can be implemented as a largely self‐guided program for MDD and could be administered remotely and/or with minimal clinician interaction.

As this was a small proof of concept study, it cannot be determined which treatment components – AAT, BA, or both – contributed to positive clinical outcomes.

Because BA + AAT was implemented in a research clinic, it remains unknown what treatment engagement and response would look like in community settings.
Urological litigation trends in the UK National Health Service: an analysis of claims over 20 years
Authors: Lane Jenni , Bhome Rahul , Somani Bhaskar 
Published: March 2021

ObjectiveTo look into the urology litigation trends and successful claims in the National Health Service (NHS) over the last 20 years.MethodsWe requested data from NHS Resolutions to investigate current litigation numbers, costs and causes for claims. Data collected included the number of claims dating from 1996 to 2019, the total sum of damages paid out each year for urology and the causes for the claims dating from 2009 to 2019. Data from NHS Resolutions were analysed, stratified and categorized by the authors from this information, which was provided as two separate documents.ResultsThe total cost of damages between 1997 and 2017 was £74.5m (range: £241 325–£7.8m per year). While the number of successful claims was 1653 (range 7–168 per year), the total number of claims was 3341 (range 31–347 per year) and, over time, this has increased almost sevenfold. The cost of damages has increased roughly in line with the number of claims. Over the last 10 years, non‐operative‐related claims accounted for 984 claims, of which the largest subset was for ‘the failure to diagnose and/or treat’ (n = 639, 65%), with 88 (9%) successful consent‐related claims. There were 226 intra‐operative‐related claims. Of these, wrong‐site surgery, a never‐event, accounted for eight claims and there were six successful claims for failing to supervise juniors. A total of 1129 claims were postoperative claims, with retained foreign body or instrument accounting for 71 (6%) of these.ConclusionsThe number and cost of litigation claims have increased year on year. There is a need for continual improvement in patient care, surgical training, counselling, informed consent and early management of complications. The evidence reviewed in this paper suggests that the best approach to this is the combination of rigid adherence to and re‐enforcement of common surgical guidelines and implementation of the national ‘Getting it right first time’ initiative.
Proposing a model for promoting Children's Health in Early Childhood Education and Care Settings
Authors: Musgrave Jackie , Payler Jane 
Published: March 2021

AbstractThis pilot study was conducted in one early childhood pre‐school nursery setting in an area of high deprivation in England to explore the under‐researched area of how practitioners promote the health of children. The research used an original tool, Child Health Promotion: A Toolkit for Early Childhood Education and Care Practitioners, containing a 5 Step Programme as a model to guide practitioners in identifying and implementing a health promotion activity. The findings will help to set the onward agenda for a larger scale study which will foreground the voices of practitioners and highlight the role that ECEC practitioners can play in promoting the health of children.
Investigation of risk factors associated with erythrocyte engraftment after ABO‐incompatible hematopoietic stem cell transplantation
Authors: Yanagisawa Ryu , Nakazawa Hideyuki , Nishina Sayaka , Saito Shoji , Shigemura Tomonari , Tanaka Miyuki , Nakazawa Yozo 
Published: March 2021

AbstractABO‐incompatible hematopoietic stem cell transplantations (HSCTs) are widely practiced; however, the delay in erythrocyte engraftment can be problematic. While erythrocyte engraftment is usually indicated by an increase in reticulocyte levels without the need for erythrocyte transfusions, the disappearance of recipient‐derived anti‐A/B isoagglutinin and detection of donor‐derived A/B antigens can also be used as other parameters. We conducted a retrospective analysis of 68 ABO‐incompatible HSCTs, focusing on major and bidirectional mismatch. We analyzed known clinical risk factors associated with delayed erythrocyte engraftment using the three parameters (disappearance of anti‐A/B isoagglutinin in recipient, detection of donor‐derived A/B antigen, and reticulocyte levels >1%). Although the three parameters were well correlated, the results showed heterogeneity when analyzing the associated risk factors for delayed erythrocyte engraftment. In the analysis of all cases, the requirement for an HLA‐matched platelet transfusion was a common risk factor. Furthermore, erythrocyte engraftment was slower in adults than in children. In adults, cytomegalovirus antigenemia was a risk factor for two parameters; however, in children, underlying disease was a common risk factor for all parameters. There is a complex relationship between erythrocyte engraftment and various factors related to HSCTs. Our results suggest that greater accuracy is possible by using analysis methods other than the measurement of reticulocyte levels.
Pharmacological and neurosurgical interventions for individuals with cerebral palsy and dystonia: a systematic review update and meta‐analysis
Authors: Bohn Emma , Goren Katherine , Switzer Lauren , Falck‐Ytter Yngve , Fehlings Darcy 
Published: March 2021

AimTo update a systematic review of evidence published up to December 2015 for pharmacological/neurosurgical interventions among individuals with cerebral palsy (CP) and dystonia.MethodSearches were updated (January 2016 to May 2020) for oral baclofen, trihexyphenidyl, benzodiazepines, clonidine, gabapentin, levodopa, botulinum neurotoxin (BoNT), intrathecal baclofen (ITB), and deep brain stimulation (DBS), and from database inception for medical cannabis. Eligible studies included at least five individuals with CP and dystonia and reported on dystonia, goal achievement, motor function, pain/comfort, ease of caregiving, quality of life (QoL), or adverse events. Evidence certainty was evaluated using GRADE.ResultsNineteen new studies met inclusion criteria (two trihexyphenidyl, one clonidine, two BoNT, nine ITB, six DBS), giving a total of 46 studies (four randomized, 42 non‐randomized) comprising 915 participants when combined with those from the original systematic review. Very low certainty evidence supported improved dystonia (clonidine, ITB, DBS) and goal achievement (clonidine, BoNT, ITB, DBS). Low to very low certainty evidence supported improved motor function (DBS), pain/comfort (clonidine, BoNT, ITB, DBS), ease of caregiving (clonidine, BoNT, ITB), and QoL (ITB, DBS). Trihexyphenidyl, clonidine, BoNT, ITB, and DBS may increase adverse events. No studies were identified for benzodiazepines, gabapentin, oral baclofen, and medical cannabis.InterpretationEvidence evaluating the use of pharmacological and neurosurgical management options for individuals with CP and dystonia is limited to between low and very low certainty.
What this paper adds

Meta‐analysis suggests that intrathecal baclofen (ITB) and deep brain stimulation (DBS) may improve dystonia and pain.

Meta‐analysis suggests that DBS may improve motor function.

Clonidine, botulinum neurotoxin, ITB, and DBS may improve achievement of individualized goals.

ITB and DBS may improve quality of life.

No direct evidence is available for oral baclofen, benzodiazepines, gabapentin, or medical cannabis.
Living with diabetes alongside a severe mental illness: A qualitative exploration with people with severe mental illness, family members and healthcare staff
Authors: Bellass Sue , Lister Jennie , Kitchen Charlotte Emma Wray , Kramer Lyndsey , Alderson Sarah Louise , Doran Tim , Gilbody Simon , Han Lu , Hewitt Catherine , Holt Richard Ian Gregory , Jacobs Rowena , Prady Stephanie Louise , Shiers David , Siddiqi Najma , Taylor Johanna 
Published: March 2021

AbstractAimsDiabetes is two to three times more prevalent in people with severe mental illness, yet little is known about the challenges of managing both conditions from the perspectives of people living with the co‐morbidity, their family members or healthcare staff. Our aim was to understand these challenges and to explore the circumstances that influence access to and receipt of diabetes care for people with severe mental illness.MethodsFramework analysis of qualitative semi‐structured interviews with people with severe mental illness and diabetes, family members, and staff from UK primary care, mental health and diabetes services, selected using a maximum variation sampling strategy between April and December 2018.ResultsIn all, 39 adults with severe mental illness and diabetes (3 with type 1 diabetes and 36 with type 2 diabetes), nine family members and 30 healthcare staff participated. Five themes were identified: (a) Severe mental illness governs everyday life including diabetes management; (b) mood influences capacity and motivation for diabetes self‐management; (c) cumulative burden of managing multiple physical conditions; (d) interacting conditions and overlapping symptoms and (e) support for everyday challenges. People living with the co‐morbidity and their family members emphasised the importance of receiving support for the everyday challenges that impact diabetes management, and identified barriers to accessing this from healthcare providers.ConclusionsMore intensive support for diabetes management is needed when people's severe mental illness (including symptoms of depression) or physical health deteriorates. Interventions that help people, including healthcare staff, distinguish between symptoms of diabetes and severe mental illness are also needed.
‘I was ready for it at the beginning’: Parent experiences with early introduction of continuous glucose monitoring following their child's Type 1 diabetes diagnosis
Authors: Tanenbaum Molly L. , Zaharieva Dessi P. , Addala Ananta , Ngo Jessica , Prahalad Priya , Leverenz Brianna , New Christin , Maahs David M. , Hood Korey K. 
Published: March 2021

AbstractAimThis study aimed to capture the experience of parents of youth with recent onset Type 1 diabetes who initiated use of continuous glucose monitoring (CGM) technology soon after diagnosis, which is a new practice.MethodsFocus groups and individual interviews were conducted with parents of youth with Type 1 diabetes who had early initiation of CGM as part of a new clinical protocol. Interviewers used a semi‐structured interview guide to elicit feedback and experiences with starting CGM within 30 days of diagnosis, and the benefits and barriers they experienced when adjusting to this technology. Groups and interviews were audio recorded, transcribed and analysed using content analysis.ResultsParticipants were 16 parents (age 44.13 ± 8.43 years; 75% female; 56.25% non‐Hispanic White) of youth (age 12.38 ± 4.15 years; 50% female; 50% non‐Hispanic White; diabetes duration 10.35 ± 3.89 months) who initiated CGM 11.31 ± 7.33 days after diabetes diagnosis. Overall, parents reported high levels of satisfaction with starting CGM within a month of diagnosis and described a high level of reliance on the technology to help manage their child's diabetes. All participants recommended early CGM initiation for future families and were committed to continue using the technology for the foreseeable future, provided that insurance covered it.ConclusionParents experienced CGM initiation shortly after their child's Type 1 diabetes diagnosis as a highly beneficial and essential part of adjusting to living with diabetes.
Mortality in 98 type 1 diabetes mellitus and type 2 diabetes mellitus: Foot ulcer location is an independent risk determinant
Authors: Schofield Heather , Haycocks Samantha , Robinson Adam , Edmonds Michael , Anderson Simon G , Heald Adrian H. 
Published: March 2021

AbstractIntroductionWe previously demonstrated in both a longitudinal study and in meta‐analysis (pooled relative‐risk RR, 2.45) that all‐cause mortality is significantly higher in people with diabetes foot ulceration (DFU) than with those without a foot ulcer. In this prospective study, we looked at the factors linked to mortality after presentation to podiatry with DFU.MethodsNinety‐eight individuals recruited consecutively from the Salford Royal Hospital Multidisciplinary Foot Clinic in Spring 2016 were followed up for up to 48 months. Data concerning health outcomes were extracted from the electronic patient record (EPR).ResultsSeventeen people (17) had type 1 diabetes mellitus, and 81 had type 2 diabetes mellitus. Thirty‐one were women. The mean age (range) was 63.6 (28–90) years with maximum diabetes duration 45 years. Mean HbA1c was 72 (95% CI: 67–77) mmol/mol; 97% had neuropathy (International Working Group on the Diabetic Foot (IWGDF) monofilament); 62% had vascular insufficiency (Doppler studies); 69% of ulcers were forefoot, and 23% of ulcers were hind foot in location.Forty of 98 (40%) patients died in follow‐up with 27% of death certificates including sepsis (not foot‐related) and 35% renal failure as cause of death. Multivariate regression analysis indicated a 6.3 (95% CI: 3.9–8.1) fold increased risk of death with hind foot ulcer, independent of age/BMI/gender/HbA1c/eGFR/total cholesterol level.ConclusionThis prospective study has indicated a very high long‐term mortality rate in individuals with DFU, greater for those with a hind foot ulcer and shown a close relation between risk of sepsis/renal failure and DFU mortality, highlighting again the importance of addressing all risk factors as soon as people present with a foot ulcer.
The relationship between calcific severe aortic stenosis and systemic immune‐inflammation index
Authors: Erdoğan Mehmet , Öztürk Selçuk , Kardeşler Burak , Yiğitbaşı Murat , Kasapkara Hacı Ahmet , Baştuğ Serdal , Erdöl Mehmet Akif , Akar Bayram Nihal , Akçay Murat , Durmaz Tahir 
Published: March 2021

AbstractAimCalcific aortic stenosis (AS) is a common valvular disease especially in elderly population. Inflammation plays significant role in the pathophysiological mechanism. Systemic immune‐inflammation index (SII) is a novel marker of immune system and inflammation that includes neutrophil, lymphocyte, and platelet cell counts. The aim of this study was to investigate the predictive value of SII in calcific severe AS.Materials and MethodsSevere calcific AS patients were categorized into two groups: High flow‐high gradient (HFHG) AS (n = 289) and low flow‐low gradient AS (n = 79). Control group included 273 patients with similar clinical and demographic characteristics but without AS. SII was calculated as absolute platelet count × absolute neutrophil count/absolute lymphocyte count.ResultsSII levels were 525 ± 188, 835 ± 402, and 784 ± 348 in control, HFHG AS, and LFLG AS groups, respectively (P < .001). Correlation analyses revealed significant and positive correlation between SII and mean aortic transvalvular pressure gradient (r = .342, P < .001), and negative and significant correlation between SII and AVA (r = −.461, P < .001). Multivariate analysis performed in separate models demonstrated sex, CAD, LDL, and SII levels (Odds ratio [OR]: 1.004, 95 CI%:1.003–1.004) as independent predictors of severe AS in Model 1. According to Model 2, sex, CAD, LDL, and high SII (>661) (OR:5.78, 95 CI%:3.93–4.89) remained as independent predictors of severe AS.ConclusionSII levels can be useful to predict severe calcific AS patients and significantly correlate with AVA and mean aortic transvalvular pressure gradient.
COVID‐19 (SARS‐CoV‐2) infection and thrombotic conditions: A systematic review and meta‐analysis
Authors: Gabbai‐Armelin Paulo Roberto , de Oliveira Analú Barros , Ferrisse Túlio Morandin , Sales Luciana Solera , Barbosa Elis Rodrigues Oliveira , Miranda Marina Lins , Salomão Karina Borges , Brighenti Fernanda Lourenção 
Published: March 2021

AbstractBackgroundCOVID‐19 is an infectious disease caused by SARS‐CoV‐2 associated with haematological manifestations (thrombolytic events).AimsConsidering the high prevalence of the thrombotic scenarios associated with COVID‐19, the aim of this study was to perform a systematic review of the available literature, concerning the relation of COVID‐19 and the thrombotic events, and identify prognostic factors for these events.Materials & MethodsPubMed, Web of Science and Scopus databases were searched. Independent reviewers conducted all flow diagram steps. For qualitative analysis, Oxford level of evidence and Newcastle‐Ottawa scale were used in the eligible articles. For the prognostic factors, a meta‐analysis was conducted to age, number of neutrophils and platelets, and levels of ferritin, C‐reactive protein, lactate dehydrogenase and D‐dimer. Publication bias was accessed by funnel plot and by trim‐and‐fill test. Trim‐and‐fill test was also applied to evaluate meta‐analysis bias.ResultsTwenty articles were included in the qualitative analysis, and 6 articles were included in the meta‐analysis. Case‐control studies showed bias related to exposure, and the main bias in cohort studies were related to selection and outcome. All articles received score 4 for the level of evidence. Hypertension and diabetes were the comorbidities more frequently associated with thrombolytic events. Significant results were found regarding D‐dimer (P < .0001) and age (P = .0202) for thrombotic events in patients diagnosed with COVID‐19.ConclusionPatients older than 60 years, with hypertension, diabetes and D‐Dimer values above 3.17 µg/mL, can be considered prognostic factors for developing thrombotic events due to COVID‐19.
Point at, nudge, or push private provision of a public good?
Authors: Bruns Hendrik , Perino Grischa 
Published: March 2021

AbstractHow decision makers respond to behavioral and traditional interventions might depend on their and the regulator's attributes. This online experiment investigates the effect of defaults, recommendations, and mandatory minimum contributions accompanied by regulator information on the private provision of climate protection, accounting for intrinsic motivation. Findings show that all interventions increase the propensity of individuals to choose the focal value. There is no evidence that recommendations and defaults change average contributions. We report a negative interaction of the default with intrinsic motivation. Expert or political regulator information decreases intervention effectiveness. The study improves our understanding of behavioral public policy instruments.
The intervention of mechanical tactile stimulation modulates somatosensory evoked magnetic fields and cortical oscillations
Authors: Kojima Sho , Otsuru Naofumi , Miyaguchi Shota , Yokota Hirotake , Nagasaka Kazuaki , Saito Kei , Inukai Yasuto , Shirozu Hiroshi , Onishi Hideaki 
Published: March 2021

AbstractThe different cortical activity evoked by a mechanical tactile stimulus depends on tactile stimulus patterns, which demonstrates that simple stimuli (i.e., global synchronous stimulation the stimulus area) activate the primary somatosensory cortex alone, whereas complex stimuli (i.e., stimulation while moving in the stimulus area) activate not only the primary somatosensory cortex but also the primary motor area. Here, we investigated whether the effects of a repetitive mechanical tactile stimulation (MS) on somatosensory evoked magnetic fields (SEFs) and cortical oscillations depend on MS patterns. This single‐blinded study included 15 healthy participants. Two types interventions of MS lasting 20 min were used: a repetitive global tactile stimulation (RGS) was used to stimulate the finger by using 24 pins installed on a finger pad, whereas a sequential stepwise displacement tactile stimulation (SSDS) was used to stimulate the finger by moving a row of six pins between the left and right sides on the finger pad. Each parameter was measured pre‐ and post‐intervention. The P50m amplitude of the SEF was increased by RGS and decreased by SSDS. The modulation of P50m was correlated with its amplitude before RGS and with the modulation of beta band oscillation at the resting state after SSDS. This study showed that the effects of a 20‐min MS on SEFs and cortical oscillations depend on mechanical tactile stimulus patterns. Moreover, our results offer potential for the modulation of tactile functions and selection of stimulation patterns according to cortical states.