bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk Factors for Tracheobronchomalacia in Preterm Infants With Bronchopulmonary Dysplasia
Authors: Su Ya-Ting , Chiu Chun-Che , Lai Shen-Hao , Hsia Shao-Hsuan , Lin Jainn-Jim , Chan Oi-Wa , Chiu Chih-Yung , Tseng Pei-Ling , Lee En-Pei 
Published: June 2021

Aim:To identify the risk factors associated with the development of tracheobronchomalacia (TBM) in preterm infants with bronchopulmonary dysplasia (BPD).Methods:This was a retrospective cohort study using chart reviews of preterm infants born at ≤ 36 week's gestation who underwent flexible fiberoptic bronchoscopy in a tertiary pediatric referral center between January 2015 and January 2020. Indications for the bronchoscopy examination included lobar atelectasis on plain chest film, persistent CO2retention, recurrent extubation failure, or abnormal breathing sounds such as wheeze or stridor. Optimal cutoff values for each risk factor were also determined.Results:Fifty-eight preterm infants with BPD were enrolled, of whom 29 (50%) had TBM. There were no significant differences in gestational age and birth weight between those with and without TBM. Significantly more of the patients with TBM had severe BPD compared to those without TBM (68.9 vs. 20.6%,p&lt; 0.001). Clinical parameters that were significantly different between the two groups were included in multivariate analysis. Among these factors, severe BPD was the most powerful risk factor for the development of TBM (odds ratio 5.57, 95% confidence interval 1.32–23.5,p= 0.019). The areas under the receiver operating characteristic curves for peak inspiratory pressure (PIP) and the duration of intubation were 0.788 and 0.75, respectively. The best predictive cutoff values of PIP and duration of intubation for TBM were 18.5 mmHg and 82 days, respectively.Conclusion:Preterm infants with severe BPD are at high risk for the development of TBM, and the risk is even higher in those who receive a higher PIP or are intubated for longer. Bronchoscopy examinations should be considered for the early diagnosis and management of TBM in infants with these risk factors.
Exploring the Regulatory Mechanism of Hedysarum Multijugum Maxim.-Chuanxiong Rhizoma Compound on HIF-VEGF Pathway and Cerebral Ischemia-Reperfusion Injury’s Biological Network Based on Systematic Pharmacology
Authors: Yang Kailin , Zeng Liuting , Ge Anqi , Chen Yi , Wang Shanshan , Zhu Xiaofei , Ge Jinwen 
Published: June 2021

Background: Clinical research found that Hedysarum Multijugum Maxim.-Chuanxiong Rhizoma Compound (HCC) has definite curative effect on cerebral ischemic diseases, such as ischemic stroke and cerebral ischemia-reperfusion injury (CIR). However, its mechanism for treating cerebral ischemia is still not fully explained.Methods: The traditional Chinese medicine related database were utilized to obtain the components of HCC. The Pharmmapper were used to predict HCC’s potential targets. The CIR genes were obtained from Genecards and OMIM and the protein-protein interaction (PPI) data of HCC’s targets and IS genes were obtained from String database. After that, the DAVID platform was applied for Gene Ontology (GO) enrichment analysis and pathway enrichment analysis. Finally, a series of animal experiments were carried out to further explore the mechanism of HCC intervention in CIR.Results: The prediction results of systematic pharmacology showed that HCC can regulate CIR-related targets (such as AKT1, MAPK1, CASP3, EGFR), biological processes (such as angiogenesis, neuronal axonal injury, blood coagulation, calcium homeostasis) and signaling pathways (such as HIF-1, VEGF, Ras, FoxO signaling). The experiments showed that HCC can improve the neurological deficit score, decrease the volume of cerebral infarction and up-regulate the expression of HIF-1α/VEGF and VEGFR protein and mRNA (p &lt; 0.05).Conclusion: HCC may play a therapeutic role by regulating CIR-related targets, biological processes and signaling pathways found on this study.
Stigmatizing Attitudes Toward Depression Among Male and Female, Medical and Non-medical Major College Students
Authors: He Haoyu , Wu Qiuxia , Hao Yuzhu , Chen Shubao , Liu Tieqiao , Liao Yanhui 
Published: June 2021

Background: Stigma is often reported to be a barrier to the treatment and rehabilitation of depression. However, little is known about stigma toward people with depression among college students in China.Methods: Using a questionnaire with a case vignette describing depression, a total of 1,056 students from nine colleges/universities in Hunan Province of China were included in this study. The questionnaire addressed the attitudes toward depression and the desire for keeping a distance from depressed individuals. The current study explored the stigma attitudes of college students toward people with depression and the desire for social distancing, as well as the gender (male and female) and major (medical and non-medical) differences.Results: Over half of the respondents agreed that people described in the vignette were “dangerous” (60.7%) and “could snap out of the problem” (58.7%). Compared with female students, males were more likely to agree that “If I had this problem, I would not tell anyone” (7.0 vs. 13.2%, p = 0.001); compared with non-medical students, medical students were more likely to agree that “The problem is a sign of personal weakness” (38.0 vs. 50.0%, p &lt; 0.001). A lot of respondents would be unwilling to “marry into the family of people with depression” (71.1%) or “work closely with them” (45.1%). Compared with male students, females were more unwilling to “work closely with them” (40.3 vs. 47.5%, p = 0.026).Conclusion: This study found that a high proportion of Chinese college students showed stigma toward and desire for social distancing from people with depression, male students and medical major students showed higher stigma in some subscale items toward people with depression. The present results suggest that more anti-stigma interventions should be applied for Chinese college students to help prevent or reduce stigma attitudes toward people with depression.
Glutathione S-Transferase Polymorphisms and Clinical Characteristics in Autism Spectrum Disorders
Authors: Mandic-Maravic Vanja , Mitkovic-Voncina Marija , Pljesa-Ercegovac Marija , Savic-Radojevic Ana , Djordjevic Miroslav , Ercegovac Marko , Pekmezovic Tatjana , Simic Tatjana , Pejovic-Milovancevic Milica 
Published: June 2021

Background: Autism spectrum disorders (ASD) are a heterogeneous group of developmental disorders, with different levels of symptoms, functioning, and comorbidities. Recent findings suggested that oxidative stress and genetic variability in glutathione S-transferases (GSTs) might increase the risk of ASD development. We aimed to determine whether GST polymorphisms influence the severity of symptoms as well as the cognitive and adaptive abilities in children with ASD.Methods: The sample included 113 ASD cases. All participants were genotyped for GSTA1, GSTM1, GSTT1, and GSTP1 polymorphisms. The clinical characteristics were determined with Autism Diagnostic Interview-Revised (ADI-R) in all of the participants. In non-verbal participants, we explored the adaptive functioning using the Vineland Adaptive Behavior Scale II, while in verbal participants, we used the Wechsler Abbreviated Scale of Intelligence (WASI).Results: It was shown that the GSTA1*CC genotype was a predictor of a lower non-verbal communication impairment as well as of a lower chance of having seizures during life. GSTM1-active genotype predicted a higher adaptive functioning. The predictive effect of GSTA1, GSTM1, and GSTT1 genotype was moderated by exposure during pregnancy (maternal smoking and medication). The GSTP1*IleIle genotype was significantly associated to a better cognitive functioning in children with ASD.Conclusion: Besides the complex gene-environment interaction for the specific risk of developing ASD, there is also a possible complexity of interactions between genetic and environmental factors influencing the level of symptoms and impairment in people with ASD. Detoxification and antioxidant enzymes, such as GSTA1, might contribute to the core of this complexity.
Knowledge, Attitude, and Practice of Healthcare Providers Toward Novel Coronavirus 19 During the First Months of the Pandemic: A Systematic Review
Authors: Tegegne Gobezie T. , Kefale Belayneh , Engidaw Melaku Tadege , Degu Amsalu , Tesfa Desalegn , Ewunetei Amien , Yazie Taklo Simeneh , Molla Mulugeta 
Published: June 2021

Introduction: Coronavirus disease (COVID-19) is a highly contagious viral infection that has spread to every corner of the world. Lack of knowledge among healthcare providers (HCPs) about diseases such as COVID-19 may delay the diagnosis, disease spread, and produce poor infection control practices. Hence, this systematic review aimed to summarize the knowledge, attitudes, and practices (KAP) of HCPs toward COVID-19 during the first months of the pandemic.Methods: A systematic review was conducted according the PRISMA guidelines, and the protocol was registered on PROSPERO (CRD42020191742). A relevant article search was performed on EMBASE, PubMed, CINAHL, Scopus, and the Google Scholar database. The methodological quality of studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. The median percentage of HCPs with good KAP was computed.Results: Twenty studies involving 12,072 HCPs were included in the review process. Median percentages of 75.8% (IQR: 69.3–87.7%), 74.6% (IQR: 54.4–74.6), and 79.8% (IQR: 67.0–79.8%) of HCPs had good knowledge, and positive attitude and practice, respectively. Although the reported risk factors were inconsistent among studies, age, gender, level of education, experience, infection prevention training, and sources of information were associated with knowledge of HCPs. In addition, being elderly, having a high level of education, absence of chronic illness, and good knowledge and practice were significantly associated with the attitude of HCPs. Further, types of profession, experience, age, level of education, use of personnel protective equipment, and gender were significantly associated with the practice of HCPs.Conclusions: Approximately, three-fourths of HCPs had good knowledge, attitudes, and practices toward COVID-19 during the first months of the pandemic, although the percentage of HCPs was inconsistent in different study settings. In addition, associated factors of KAP were inconsistent among studies; hence, stake holders should target locally identified risk factors to design relevant education packages and infection prevention training to halt the rapid transmission of COVID-19.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42020191742, identifier: CRD42020191742.
Promoting University Students' Mental Health: A Systematic Literature Review Introducing the 4M-Model of Individual-Level Interventions
Authors: Nair Bhavana , Otaki Farah 
Published: June 2021

Objective:The purpose of this study is to systematically review recently published individual student-level interventions aimed at alleviating the burden of mental health challenges faced by the students and/ or at equipping them with coping mechanism that will foster their resilience.Methods:This study relied on a systematic literature review. PubMed dataset was used; the search was confined to the following period: July 2016-December 2020.Results:A total of 1,399 records were identified by the electronic search, out of which 40 studies were included in this study. The authors inductively identified four overlapping categories of interventions across all included articles, and coded them as follows: Mindfulness, Movement, Meaning, and Moderator. Accordingly, each study was linked to at least one of four overlapping categories based on the nature of the intervention(s) under investigation, leading to differing assortments of categories.Conclusions:The 4M-Model generated by this study encourages focusing on devising holistic, university-based interventions that embrace the individuality of students to improve their mental health through elements of mindfulness, movement, meaning, and moderator. Through this focused approach, university counselors are enabled to design interventions that address students' physical, psychological, emotional, and social needs.
Cancer detection via primary care urgent referral and association with practice characteristics: a retrospective cross-sectional study in England from 2009/2010 to 2018/2019
Authors: Round Thomas , Ashworth Mark , L’Esperance Veline , Møller Henrik 
Published: June 2021

BackgroundThere is substantial variation in the use of urgent suspected cancer referral (2-week wait [2WW]) between practices.AimTo examine the change in use of 2WW referrals in England over 10 years (2009/2010 to 2018/2019) and the practice and population factors associated with cancer detection.Design and settingRetrospective cross-sectional study of English general practices and their 2WW referral and Cancer Waiting Times database detection data (all cancers other than non-melanoma skin cancers) from 2009/2010 to 2018/2019.MethodA retrospective study conducted using descriptive statistics of changes over 10 years in 2WW referral data. Yearly linear regression models were used to determine the association between cancer detection rates and quintiles of practice and population characteristics. Predicted cancer detection rates were calculated, as well as the difference between lowest to highest quintiles.ResultsOver the 10 years studied there were 14.89 million 2WW referrals (2.24 million in 2018/2019), and 2.68 million new cancer diagnoses, of which 1.26 million were detected following 2WW. The detection rate increased from 41% to 52% over the time period. In 2018/2019 an additional 66 172 cancers were detected via 2WW compared with 2009/2010. Higher cancer detection via 2WW referrals was associated with larger practices and those with younger GPs. From 2016/2017 onwards more deprived practice populations were associated with decreased cancer detection.ConclusionFrom 2009/2010 to 2018/2019 2WW referrals increased on average by 10% year on year. The most consistent association with higher cancer detection was found for larger practices and those with younger GPs, though these differences became attenuated over time. The more recent association between increased practice deprivation and lower cancer detection is a cause for concern. The COVID-19 pandemic has led to significant impacts on 2WW referral activity and the impact on patient outcomes will need to be studied.
Impact of COVID-19 on the mental health of Singaporean GPs: a cross-sectional study
Authors: Lum Alvin , Goh Yen-Li , Wong Kai Sheng , Seah Junie , Teo Gina , Ng Jun Qiang , Abdin Edimansyah , Hendricks Margaret Mary , Tham Josephine , Nan Wang , Fung Daniel 
Published: June 2021

BackgroundCOVID-19 has stressed healthcare systems and workers worldwide. GPs, as first points of contact between suspected cases and the healthcare system, have assumed frontline roles in this crisis. While the prevalence of mental health problems and illnesses arising in healthcare workers (HCWs) from tertiary care settings during the COVID-19 pandemic is well-examined,1the impact on GPs remains understudied.AimTo describe the prevalence and predictors of anxiety, burnout, depression, and post-traumatic stress disorder (PTSD) among GPs during the COVID-19 pandemic.Design & settingSurvey of GPs operating in Singapore primary care clinics.MethodGPs completed a survey that comprised of four validated psychometric instruments. Open-ended questions asked about responders’ challenges and their envisaged support. Data were analysed with multiple logistic regression with demographic data as covariates; concepts of grounded theory were used to analyse the qualitative responses.ResultsA total of 257 GPs participated. Fifty-five (21.4%) met the scales’ criteria for anxiety, 211 (82.1%) for burnout, 68 (26.6%) for depression, and 23 (8.9%) for PTSD. Multivariate regression analysis showed working in a public primary care setting was associated with anxiety and depression. Qualitative analyses uncovered possible stressors: changes to clinical and operational practices; increased workloads; and financial difficulties.ConclusionMental health issues were found to be present in Singaporean GPs during the pandemic. Prevalence of anxiety, burnout, and depression were found to be higher than those reported pre-COVID-19. The findings also provide determinants of the issues that serve as possible foci for targeted interventions.
Enfants et nourrices à Ebla
Authors: Biga Maria Giovanna 
Published: June 2021

Les textes documentent de nombreuses naissances à la cour d’Ebla ; la plus fêtée est la naissance du fils du dernier couple royal, occasion pour des cadeaux et des offrandes aux divinités.
Les enfants de la cour étaient allaités par des nourrices (ga-du8), documentées pendant toute la durée des archives, en nombre variable. Nous connaissons le nom de certaines d’entre elles ; la plus fréquemment attestée et la mieux connue est Gišadu, nourrice du dernier roi d’Ebla, Iš’ar-Damu. Sa longue présence à la cour, même après que son service de nourrice a pris fin, et jusqu’à sa mort, a permis d’ordonner la chronologie relative de nombreux textes administratifs. Pour les dernières années de la cité, un groupe de nourrices anonymes, recevant des rations alimentaires, est au service de la cour.
Tucidide e Alcibiade
Authors: Luppino Manes Emma 
Published: June 2021

Tucidide fa un ritratto di Alcibiade coerente e quasi sempre illuminante, a partire dal suo primo ingresso sulla scena (420 a.C : cff. V, 43,2), fino alla drammatica circostanza del colpo di Stato del 41 1 a.C. e della controrivoluzione di Samo : cfr. Vili, 86,4 ove Tucidide dirà che Alcibiade rese per la prima volta e meglio di chiunque altro un servizio alla città.
Nel ritratto tucidideo, dunque, rango, bellezza fisica, ricchezza, carattere impetuoso e prorompente di Alcibiade, fanno di lui un protagonista di episodi fondamentali della guerra del Peloponneso : l’alleanza ateniese-argiva, la presa e la punizione di Melo, la spedizione in Sicilia, il colpo di Stato oligarchico e poi la controrivoluzione di Samo, le battaglie di Cizico e Nozio, il difficile e reiterato rientro ad Atene, il cui racconto apparterrà poi a Senofonte (Elleniche, I, 4,8-23).
Ma, nonostante lo spazio centrale attribuito allo stratega e all’uomo politico di successo, emergono talvolta anche riserve mentali profonde che inducono la fonte ad esprimere alterni giudizi, non sempre facili da cogliere. L’indagine condotta dall’ autrice, perciò, porta ad evidenziare, soprattutto attraverso l’analisi dei più importanti discorsi di Alcibiade, un giudizio tutto sommato sospeso.
Exploring the Decision Making Processes of Early Career Strength and Conditioning Coaches
Authors: P.W. Downes , D Collins 
Published: June 2021

The role of Strength and Conditioning coaches within sporting environments is growing in importance and more attention is being directed towards acknowledging the characteristics and decision making processes of these coaches. To date, most of the research has been with experienced coaches thus created a need to better understand those coaches at the early stages of their career. The present study utilised Applied Cognitive Task Analysis to elicit knowledge from eight strength and conditioning coaches with less than three years full time experience. Methods applied identified that less experienced strength and conditioning coaches operate in predominately stable conditions and feel comfortable delivering within this stability. Interviews revealed early career coaches to prioritise movement qualities and rely on previously acquired theoretical knowledge to make predetermined decisions on training content and responses within environments. A final theme generated demonstrated that connections with athletes were important for coaches to feel confident within their role. Implications for future coach development materials exploring the use of metacognition and its associated components of planning, monitoring and evaluation discussed.
A Physician-Driven Quality Improvement Stewardship Intervention Using Lean Six Sigma Improves Patient Care for Community-Acquired Pneumonia
Authors: Monday Lea M. , Yazdanpaneh Omid , Sokolowski Caleb , Chi Jane , Kuhn Ryan , Bazzy Kareem , Dhar Sorabh 
Published: June 2021

ABSTRACT

Introduction
The Infectious Diseases Society of America (IDSA) recommends a minimum of 5 days of antibiotic therapy in stable patients who have community-acquired pneumonia (CAP). However, excessive duration of therapy (DOT) is common. Define, measure, analyze, improve, and control (DMAIC) is a Lean Six Sigma methodology used in quality improvement efforts, including infection control; however, the utility of this approach for antimicrobial stewardship initiatives is unknown. To determine the impact of a prospective physician-driven stewardship intervention on excess antibiotic DOT and clinical outcomes of patients hospitalized with CAP. Our specific aim was to reduce excess DOT and to determine why some providers treat beyond the IDSA minimum DOT.

Methods
A single-center, quasi-experimental quality improvement study evaluating rates of excess antimicrobial DOT before and after implementing a DMAIC-based antimicrobial stewardship intervention that included education, prospective audit, and feedback from a physician peer, and daily tracking of excess DOT on a Kaizen board. The baseline period included retrospective CAP cases that occurred between October 2018 and February 2019 (control group). The intervention period included CAP cases between October 2019 and February 2020 (intervention group).

Results
A total of 123 CAP patients were included (57 control and 66 intervention). Median antibiotic DOT per patient decreased (8 versus 5 days; p &lt; 0.001), and the proportion of patients treated for the IDSA minimum increased (5.3% versus 56%; p &lt; 0.001) after the intervention. No differences in mortality, readmission, length of stay, or incidence of Clostridioides difficile infection were observed between groups. Almost half of the caregivers surveyed were aware that as few as 5 days of antibiotic treatment could be appropriate.

Conclusions
A physician-driven antimicrobial quality improvement initiative designed using DMAIC methodology led to reduced DOT and increased compliance with the IDSA treatment guidelines for hospitalized patients with CAP reduced without negatively affecting clinical outcomes.
Вплив методики визначення на величину структуруючої здатності мінеральних порошків
Authors: Оксак С.В. 
Published: June 2021

Визначено структуруючу здатність мінеральних порошків із сировини різного походження за методиками, наведеними в ДСТУ 8772:2018 та EN 13179-1:2013. Оцінено вплив дійсної густини мінеральних порошків на величину їх структуруючої здатності. Порівняно результати структуруючої здатності мінеральних порошків, визначеної за різними методиками.