bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicians’ perceptions of the Australian Paediatric Mental Health Service System: Problems and solutions
Authors: Paton Kate , Gillam Lynn , Warren Hayley , Mulraney Melissa , Coghill David , Efron Daryl , Sawyer Michael , Hiscock Harriet 
Published: January 2021

Objectives: Despite substantial investment by governments, the prevalence of mental health disorders in developed countries remains unchanged over the past 20 years. As 50% of mental health conditions present before 14 years of age, access to high-quality mental health care for children is crucial. Barriers to access identified by parents include high costs and long wait times, difficulty navigating the health system, and a lack of recognition of the existence and/or severity of the child’s mental health disorder. Often neglected, but equally important, are clinician views about the barriers to and enablers of access to high-quality mental health care. We aimed to determine perspectives of Australian clinicians including child and adolescent psychiatrists, paediatricians, psychologists and general practitioners, on barriers and enablers within the current system and components of an optimal system. Methods: A total of 143 clinicians (approximately 35 each of child and adolescent psychiatrists, paediatricians, child psychologists and general practitioners) from Victoria and South Australia participated in semi-structured phone interviews between March 2018 and February 2019. Inductive content analysis was applied to address the broad study aims. Findings: Clinician-identified barriers included multi-dimensional family factors, service fragmentation, long wait times and inadequate training for paediatricians and general practitioners. Rural and regional locations provided additional challenges but a greater sense of collaboration resulting from the proximity of clinicians in rural areas, creating an opportunity to develop support networks. Suggestions for an optimal system included novel ways to improve access to child psychiatry expertise, training for paediatricians and general practitioners, and co-located multidisciplinary services. Conclusion: Within the current mental health system for children, structural, training and workforce barriers prevent optimal access to care. Clinicians identified many practical and systemic ideas to improve the system. Implementation and evaluation of effectiveness and cost effectiveness of these ideas is the next challenge for Australia’s children’s mental health.
Ideal standards for policy on student self-harm: What research and practice tells us
Authors: Matthews Emily L. , Townsend Michelle L. , Gray Annaleise S. , Grenyer Brin F. S. 
Published: January 2021

School communities face challenges in responding effectively to the rising incidence of student self-harm. Evidence-informed guidelines may provide a platform for schools to provide better responses and improve the outcomes of students who engage in self-harm. This paper critically reviews policies published in English targeted for schools or education settings on effective early identification and intervention for children and adolescent self-harm. A grey literature search was conducted using Start Page web search engine with a documentary analysis approach applied to review polices that met criteria. The review identified 16 policies that aim to help school and education staff to identify and respond to student self-harm. The key themes include identification and risk assessment, intervention, roles and responsibilities, as well as addressing issues surrounding evidence-based psychological education and intervention. An evidence-informed policy that addresses multiple aspects of responding to and reducing student self-harm may be a vital foundation of a school’s response to this growing public health issue. This paper outlines key points that will help inform the development of evidence-informed guidelines for schools to respond to student self-harm and presents an exemplar policy framework for use by schools.
Correlation of Symptom Distress, Self-Efficacy, and Social Support With Problem-Solving and Glycemic Control Among Patients With Type 2 Diabetes
Authors: Ji Meihua , Sereika Susan M. , Dunbar-Jacob Jacqueline , Erlen Judith A. 
Published: January 2021

Purpose The purpose of the study was to examine the associations of self-efficacy, social support, and symptom distress with perceived problem-solving and glycemic control among patients with type 2 diabetes. Method Using baseline data from a parent study, which examined the effect of a problem-solving-focused intervention on medication adherence among patients with type 2 diabetes, this secondary analysis examined the relationships among self-efficacy, social support, symptom distress, problem-solving, and A1C. Of 358 patients enrolled at baseline, 304 (mean age = 64.1 years, 57.2% female) were included in the current analysis. Multiple linear regression was used to identify potential correlates of problem-solving and A1C. Results The results showed that self-efficacy, social support, and symptom distress were independent predictors of problem-solving; they significantly improved the prediction of perceived problem-solving in diabetes management after controlling covariates. Adding problem-solving to the model did not improve the prediction for A1C. Conclusion The current study suggests that self-efficacy, social support, and symptom distress are essential factors associated with patients’ perceived problem-solving in diabetes management. Researchers and clinicians should consider both personal factors and psychosocial factors such as self-efficacy, social support, and symptom distress when examining patients perceived problem-solving and developing tailored interventions to improve diabetes management. In addition, health care providers should consider these important aspects when providing tailored care to this patient population.
Use of the Change in Weaning Parameters as a Predictor of Successful Re-Extubation
Authors: Trivedi Suraj , Davis Ryan , Engoren Milo C. , Lorenzo Javier , Mentz Graciela , Jewell Elizabeth S. , Maile Michael D. 
Published: January 2021

Objective: Weaning parameters are well studied in patients undergoing first time extubation. Fewer data exists to guide re-extubation of patients who failed their first extubation attempt. It is reasonable to postulate that improved weaning parameters between the first and second extubation attempt would lead to improved rates of re-extubation success. To investigate, we studied a cohort of patients who failed their first extubation attempt and underwent a second attempt at extubation. We hypothesized that improvement in weaning parameters between the first and the second extubation attempt is associated with successful reextubation. Interventions: Rapid shallow breathing index (RSBI), maximum inspiratory pressure (MIP), vital capacity (VC), and the blood partial pressure of CO2 (PaCO2) were measured and recorded in the medical record prior to extubation along with demographic information. We examined the relationship between the change in extubation and re-extubation weaning parameters and re-extubation success. Measurements and Main results: A total of 1283 adult patients were included. All weaning parameters obtained prior to re-extubation differed between those who were successful and those who required a second reintubation. Those with reextubation success had slightly lower PaCO2 values (39.5 ± 7.4 mmHg vs. 41.6 ± 9.1 mmHg, p = 0.0045) and about 13% higher vital capacity volumes (1021 ± 410 mL vs. 907 ± 396 mL, p = 0.0093). Lower values for RSBI (53 ± 32 breaths/min/L vs. 69 ± 42 breaths/min/L, p < 0.001) and MIP (−41 ± 12 cmH2O vs. −38 ± 13 cm H2O), p = 0.0225) were seen in those with re-extubation success. Multivariable logistical regression demonstrates lack of independent associated between the change in parameters between the 2 attempts and re-extubation success. Conclusions: The relationship between the changes in extubation parameters through successive attempts is driven primarily by the value obtained immediately prior to re-extubation. These findings do not support waiting for an improvement in extubation parameters to extubate patients who failed a first attempt at extubation if extubation parameters are compatible with success.
Alternate Nostril Breathing to Reduce Stress: An Option for Pregnant Women Survivors of Intimate Partner Violence?
Authors: Rung Ottilie , Stauber Leah , Loescher Lois J. , Pace Thaddeus W. 
Published: January 2021

Background: Stress resulting from intimate partner violence (IPV) on pregnant women causes and sustains poor health and contributes to poor pregnancy and birth outcomes. Appropriate interventions to reduce stress in this population of women are warranted. Objective: To present a systematic review and the state of the science of evidence on alternate nostril breathing (ANB) as a holistic intervention for stress reduction for pregnant survivors of IPV, framed by complex adaptive systems theory and psychoneuroimmunology. Data Sources: Eight databases and reference lists of potential articles. Study Eligibility Criteria: Randomized controlled trials published between January 2013 and July 2019. Participants: Adults. Intervention: ANB. Study Appraisal and Synthesis Method: PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Results: ANB is effective in reducing stress, as measured by psychological and biological indicators. Limitations: Studies were limited in ethnic and gender diversity, most of the populations being Asian Indian and predominately male. Conclusions: Use of ANB as a safe and effective holistic intervention for stress reduction shows promise, but research in pregnant survivors of IPV is limited. Implications: Stress reduction benefits may be significant for pregnant survivors of IPV and their fetuses, with minimal risk.
Community-Based Interventions to Reduce Child Maltreatment
Authors: Lo Camilla Kin-Ming , Cho Yuet Wing 
Published: January 2021

Purpose: This review seeks to summarize selected literature on existing findings on the impacts of community-based interventions on the actual reduction of child maltreatment and to identify the core components of the interventions. Methods: This study systematically searched electronic databases, including PsycInfo, Medline, and Web of Science. The findings of the selected studies were summarized using narrative synthesis. Results: A total of four studies met the inclusion criteria of this study. The studies showed declines in child maltreatment incidences reported by child protective services and hospitals during the study periods. Four major components and approaches were identified among the selected interventions, including (1) the involvement of community members, (2) partnerships with community institutions, (3) multidisciplinary collaboration, and (4) responsiveness to the needs of the communities involved. Conclusions: The results of this review support the need for further development of community-based interventions using a hybrid approach.
Unbiased examination of genome-wide human endogenous retrovirus transcripts in MS brain lesions
Authors: Elkjaer Maria L , Frisch Tobias , Tonazzolli Arianna , Röttger Richard , Reynolds Richard , Baumbach Jan , Illes Zsolt 
Published: January 2021

Background: Human endogenous retrovirus (HERV) expression in multiple sclerosis (MS) brain lesions may contribute to chronic inflammation, but expression of genome-wide HERVs in different MS lesions is unknown. Objective: We examined the HERV expression landscape in different MS lesions compared to control brains. Methods: Transcripts from 71 MS brain samples and 25 control WM were obtained by next-generation RNA sequencing and mapped against HERV transcripts across the human genome. Differential expression of mapped HERV-W and HERV-H reads between MS lesion types and controls was analysed. Results: Out of 6.38 billion high-quality paired end reads, 174 million reads (2.73%) mapped to HERV transcripts. There was no difference in HERVs expression level between MS and control brains, but HERV-W transcripts were significantly reduced in chronic active lesions. Of the four HERV-W transcripts exclusively present in MS, ERV3633503 located on chromosome 7q21.13 close to the MS genetic risk locus had the highest number of reads. In the HERV-H family, 75% of transcripts located to nearby 7q21-22 were overrepresented in MS, and ERV3643914 was expressed more than 16 times in MS compared to control brains. Conclusion: Novel HERV-W and HERV-H transcripts located at chromosome 7 regions were uniquely expressed in MS lesions, indicating their potential role in brain lesion evolution.
Urgent and non-emergent telehealth care for seniors: Findings from a multi-site impact study
Authors: Bernstein Paul , Ko Kelly J , Israni Juhi , Cronin Alexandria O , Kurliand Michael M , Shi Jiaxiao M , Chung Joanie , Borgo Lina , Reed Amanda , Kosten Larissa , Chang Anna Marie , Sites Frank D , Funahashi Tadashi , Agha Zia 
Published: January 2021

Introduction The global pandemic has raised awareness of the need for alternative ways to deliver care, notably telehealth. Prior to this study, research has been mixed on its effectiveness and impact on downstream utilization, especially for seniors. Our multi-institution study of more than 300,000 telehealth visits for seniors evaluates the clinical and utilization outcomes for urgent and non-emergent symptoms. Methods We conducted a retrospective cohort study from November 2015 to March 2019, leveraging different models of telehealth from three health systems, comparing them to in-person visits for urgent and non-emergent needs of seniors based on International Classification of Diseases, 10th edition diagnoses. The study population was adults aged 60 years or older who had access to telehealth, and were affiliated with and resided in the geographic region of the healthcare organization providing telehealth. The primary outcomes of interest were visit resolution and episodes of care for those that required follow-up. Results In total, 313,516 telehealth visits were analysed across three healthcare organizations. Telehealth encounters were successful in resolving urgent and non-emergent needs in 84.0–86.7% of cases. When visits required follow-up, over 95% were resolved in less than three visits for both telehealth and in-person cohorts. Discussion While in-person visits have traditionally been the gold standard, our results suggest that when deployed within the confines of a patient’s existing primary care and health system provider, telehealth can be an effective alternative to in-person care for urgent and non-emergent needs of seniors without increasing downstream utilization.
A crossover trial investigating the atmospheric content of improvised respirators
Authors: Greig Paul R , Carvalho Clarissa , Ramessur Suniel , Schumacher Jan , El-Boghdadly Kariem 
Published: January 2021

Introduction This study was designed to determine the respiratory safety of improvised respirators based on modified full-face snorkel masks, making comparisons with a purpose-designed mask Methods This is a prospective crossover study conducted on ten recruits. Volunteers wore snorkel masks mated to an anaesthetic heat and moisture exchange filter. The system was worn at rest then during exercise. Gases were sampled from the mask at 5-min intervals. Results The modified snorkel was satisfactory in seven participants. For three carbon dioxide concentrations were >1%. Two participants exposed to excessive CO2 also experienced oxygen concentrations <19%. All participants exposed to unsatisfactory gas mixtures were non-white. Conclusions Modifying snorkel masks changes the way that gases circulate through the system. These modifications increase the risk of rebreathing in some users, which may yield an unsafe gas mixture. These improvised masks cannot be recommended as a substitute for purpose-designed equipment.
Renal response in real-world carfilzomib- vs bortezomib-treated patients with relapsed or refractory multiple myeloma
Authors: Kumar Shaji , Fu Alan , Niesvizky Ruben , Jagannath Sundar , Boccia Ralph , Raje Noopur 
Published: January 2021

Abstract
In the phase 3 ENDEAVOR study, carfilzomib-dexamethasone (Kd) improved survival over bortezomib-dexamethasone (Vd) in patients with relapsed or refractory multiple myeloma (RRMM), regardless of baseline renal function. This real-world study compared renal response in patients with RRMM (1-3 prior lines) and renal impairment (estimated glomerular filtration rate ≤50 mL/min) treated with Kd vs Vd. Electronic medical records data from the Oncology Services Comprehensive Electronic Records database were assessed (from January 2012 through February 2018). Time to renal response (defined according to International Myeloma Working Group criteria) was evaluated using the Kaplan-Meier method and log-rank test. Incidence rate ratios (IRRs) and 95% confidence intervals (CIs) were calculated for renal overall response (ROR) and renal complete response (RCR) using Cox proportional hazard models adjusted for baseline covariates. Included were 543 Kd-treated and 1005 Vd-treated patients. In line 2 (2L), compared with Vd, Kd achieved significantly higher ROR (51.4% vs 39.6%; P &lt; .0001) and RCR (26.6% vs 22.2%; P = .0229). After baseline covariate adjustment, 2L patients receiving Kd vs Vd were 45% more likely to achieve ROR (IRR, 1.45; 95% CI, 1.18-1.78), and 68% were more likely to achieve RCR (IRR, 1.68; 95% CI, 1.24-2.28). The renal response benefit with Kd remained consistent in 2L to line 4 (4L). In a combined analysis of patients receiving Kd and Vd (2L and 2L-4L), renal responders had longer overall survival and time to next treatment than renal nonresponders. These results demonstrate improved real-world effectiveness of Kd over Vd in RRMM renal rescue, and the positive association between renal response and improved survival.
Custom-made reverse shoulder arthroplasty for severe glenoid bone loss: review of the literature and our preliminary results
Authors: Porcellini G. , Micheloni G. M. , Tarallo L. , Paladini P. , Merolla G. , Catani F. 
Published: January 2021

Abstract
The treatment of severe glenoid bone loss in shoulder arthroplasty represents a challenge, and the results of current prosthetic designs with only glenoid fixation still remain unsatisfactory. In the past decade, customized glenoid prostheses have been developed to address severe glenoid arthritis and in the revision setting. In this review, we analyzed the current surgical options, the classification limits, past literature evidence, and our preliminary results of 6 patients (3 male, 3 female) treated with a reverse implant and custom-made glenoid implant (ProMade; LimaCorporate, Italy). Computer analysis of the residual shape and the amount of glenoid bone stock in association with new classifications could help the surgeon to obtain good clinical and radiological outcomes. The development of navigation systems could improve the adequacy of the implant and, thus, the reliability and longevity of the implant itself.
Comparative whole-genome and proteomics analyses of the next seed bank and the original master seed bank of MucoRice-CTB 51A line, a rice-based oral cholera vaccine
Authors: Sasou Ai , Yuki Yoshikazu , Honma Ayaka , Sugiura Kotomi , Kashima Koji , Kozuka-Hata Hiroko , Nojima Masanori , Oyama Masaaki , Kurokawa Shiho , Maruyama Shinichi , Kuroda Masaharu , Tanoue Shinjiro , Takamatsu Narushi , Fujihashi Kohtaro , Goto Eiji , Kiyono Hiroshi 
Published: January 2021

AbstractBackgroundWe have previously developed a rice-based oral vaccine against cholera diarrhea, MucoRice-CTB. UsingAgrobacterium-mediated co-transformation, we produced the selection marker–free MucoRice-CTB line 51A, which has three copies of the cholera toxin B subunit (CTB) gene and two copies of an RNAi cassette inserted into the rice genome. We determined the sequence and location of the transgenes on rice chromosomes 3 and 12. The expression of alpha-amylase/trypsin inhibitor, a major allergen protein in rice, is lower in this line than in wild-type rice. Line 51A was self-pollinated for five generations to fix the transgenes, and the seeds of the sixth generation produced by T5 plants were defined as the master seed bank (MSB). T6 plants were grown from part of the MSB seeds and were self-pollinated to produce T7 seeds (next seed bank; NSB). NSB was examined and its whole genome and proteome were compared with those of MSB.ResultsWe re-sequenced the transgenes of NSB and MSB and confirmed the positions of the three CTB genes inserted into chromosomes 3 and 12. The DNA sequences of the transgenes were identical between NSB and MSB. Using whole-genome sequencing, we compared the genome sequences of three NSB with three MSB samples, and evaluated the effects of SNPs and genomic structural variants by clustering. No functionally important mutations (SNPs, translocations, deletions, or inversions of genic regions on chromosomes) between NSB and MSB samples were detected. Analysis of salt-soluble proteins from NSB and MSB samples by shot-gun MS/MS detected no considerable differences in protein abundance. No difference in the expression pattern of storage proteins and CTB in mature seeds of NSB and MSB was detected by immuno-fluorescence microscopy.ConclusionsAll analyses revealed no considerable differences between NSB and MSB samples. Therefore, NSB can be used to replace MSB in the near future.
Disability, Frailty and Depression in the community-dwelling older adults with Osteosarcopenia
Authors: Park Ki-Soo , Lee Gyeong-Ye , Seo Young-Mi , Seo Sung-Hyo , Yoo Jun-Il 
Published: January 2021

Abstract
Background
The purpose of this study was to investigate the prevalence of osteosarcopenia in the over 60-year-old community and to evaluate whether osteosarcopenia is associated with disability, frailty and depression.

Methods
This study was performed using the baseline data of Namgaram-2, among the 1010 surveyed subjects, 885 study subjects who were 60 years or older and had all necessary tests performed were selected. The Kaigo-Yobo checklist (frailty), World Health Organization Disability Assessment Schedule (WHODAS) and Geriatric Depression Scale-Short Form-Korean (GDSSF-K) were used. The Asian Working Group for Sarcopenia (AWGS 2019) were applied in this study. Osteopenia was measured using data from dual energy X-ray absorptiometry (DEXA) and osteopenia was diagnosed when the T-score was less than − 1.0.
The study subjects were divided into four groups: the normal group, in which both sarcopenia and osteopenia were undiagnosed, osteopenia only, sarcopenia only and the osteosarcopenia group, which was diagnosed with both sarcopenia and osteopenia.

Results
Of the 885 subjects over 60 years old evaluated, the normal group comprised 34.0%, the only osteopenia group 33.7%, the only sarcopenia group 13.1%, and the osteosarcopenia group 19.2%. WHODAS (17.5, 95% CI: 14.8-20.1), Kaigo-Yobo (3.0, 95% CI: 2.6-3.4), and GDSSF mean score (4.6, 95% CI: 3.9-5.4) were statistically significantly higher in the osteosarcopenia group compared the other groups. Partial eta squared (ηp2) of WHODAS (0.199) and Kaigo-Yobo (0.148) values ​​according to Osteosarcopenia were large, and GDSSF (0.096) was medium

Conclusions
Osteosarcopenia is a relatively common disease group in the older adults community that may cause deterioration of health outcomes. Therefore, when evaluating osteopenia or sarcopenia in the older adults, management of those in both disease groups should occur together.