bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Kidney Disease With Outcomes in COVID‐19: Results From the American Heart Association COVID‐19 Cardiovascular Disease Registry
Authors: Rao Anjali , Ranka Sagar , Ayers Colby , Hendren Nicholas , Rosenblatt Anna , Alger Heather M. , Rutan Christine , Omar Wally , Khera Rohan , Gupta Kamal , Mody Purav , DeFilippi Christopher , Das Sandeep R. , Hedayati S. Susan , de Lemos James A. 
Published: June 2021

Background
Emerging evidence links acute kidney injury (AKI) in patients with COVID‐19 with higher mortality and respiratory morbidity, but the relationship of AKI with cardiovascular disease outcomes has not been reported in this population. We sought to evaluate associations between chronic kidney disease (CKD), AKI, and mortality and cardiovascular outcomes in patients hospitalized with COVID‐19.

Methods and Results
In a large multicenter registry including 8574 patients with COVID‐19 from 88 US hospitals, data were collected on baseline characteristics and serial laboratory data during index hospitalization. Primary exposure variables were CKD (categorized as no CKD, CKD, and end‐stage kidney disease) and AKI (classified into no AKI or stages 1, 2, or 3 using a modification of the Kidney Disease Improving Global Outcomes guideline definition). The primary outcome was all‐cause mortality. The key secondary outcome was major adverse cardiac events, defined as cardiovascular death, nonfatal stroke, nonfatal myocardial infarction, new‐onset nonfatal heart failure, and nonfatal cardiogenic shock. CKD and end‐stage kidney disease were not associated with mortality or major adverse cardiac events after multivariate adjustment. In contrast, AKI was significantly associated with mortality (stage 1 hazard ratio [HR], 1.72 [95% CI, 1.46–2.03]; stage 2 HR, 1.83 [95% CI, 1.52–2.20]; stage 3 HR, 1.69 [95% CI, 1.44–1.98]; versus no AKI) and major adverse cardiac events (stage 1 HR, 2.17 [95% CI, 1.74–2.71]; stage 2 HR, 2.70 [95% CI, 2.07–3.51]; stage 3 HR, 3.06 [95% CI, 2.52–3.72]; versus no AKI).

Conclusions
This large study demonstrates a significant association between AKI and all‐cause mortality and, for the first time, major adverse cardiovascular events in patients hospitalized with COVID‐19.
Clinical Effectiveness of the Queen Square Intensive Comprehensive Aphasia Service for Patients With Poststroke Aphasia
Authors: Leff Alexander P. , Nightingale Sarah , Gooding Beth , Rutter Jean , Craven Nicola , Peart Makena , Dunstan Alice , Sherman Amy , Paget Andrew , Duncan Morvwen , Davidson Jonathan , Kumar Naveen , Farrington-Douglas Claire , Julien Camille , Crinion Jennifer T. 
Published: June 2021

Background and Purpose:
Poststroke aphasia has a major impact on peoples’ quality of life. Speech and language therapy interventions work, especially in high doses, but these doses are rarely achieved outside of research studies. Intensive Comprehensive Aphasia Programs (ICAPs) are an option to deliver high doses of therapy to people with aphasia over a short period of time.

Methods:
Forty-six people with aphasia in the chronic stage poststroke completed the ICAP over a 3-week period, attending for 15 days and averaging 6 hours of therapy per day. Outcome measures included the Comprehensive Aphasia Test, an impairment-based test of the 4 main domains of language (speaking, writing, auditory comprehension, and reading) which was measured at 3 time points (baseline, immediately posttreatment at 3 weeks and follow-up at 12-week post-ICAP); and, the Communicative Effectiveness Index, a carer-reported measure of functional communication skills collected at baseline and 12 weeks.

Results:

A 2-way repeated measures multivariate ANOVA was conducted. We found a significant domain-by-time interaction,
F
=12.7,
P
<0.0005, indicating that the ICAP improved people with aphasia’s language scores across all 4 domains, with the largest gains in speaking (Cohen’s
d
=1.3). All gains were maintained or significantly improved further at 12-week post-ICAP. Importantly, patients’ functional communication, as indexed by changes on the Communicative Effectiveness Index, also significantly improved at 12-week post-ICAP,
t
=5.4,
P
<0.0005, also with a large effect size (Cohen’s
d
=0.9).

Conclusions:
People with aphasia who participated in the Queen Square ICAP made large and clinically meaningful gains on both impairment-based and functional measures of language. Gains were sustained and in some cases improved further over the subsequent 12 weeks.
Selective Facial Muscle Activation with Acute and Chronic Multichannel Cuff Electrode Implantation in a Feline Model
Authors: Sahyouni Ronald , Goshtasbi Khodayar , Presacco Alessandro , Birkenbeuel Jack , Cheung Dillon , Abiri Arash , Berger Michael H. , Djalilian Hamid R. , Lin Harrison W. 
Published: June 2021

Objectives: Facial paralysis is a debilitating condition with substantial functional and psychological consequences. This feline-model study evaluates whether facial muscles can be selectively activated in acute and chronic implantation of 16-channel multichannel cuff electrodes (MCE). Methods: Two cats underwent acute terminal MCE implantation experiments, 2 underwent chronic MCE implantation in uninjured facial nerves (FN) and tested for 6 months, and 2 underwent chronic MCE implantation experiments after FN transection injury and tested for 3 months. The MCE were wrapped around the main trunk of the skeletonized FN, and data collection consisted of EMG thresholds, amplitudes, and selectivity of muscle activation. Results: In acute experimentation, activation of specific channels (ie, channels 1-3 and 6-8) resulted in selective activation of orbicularis oculi, whereas activation of other channels (ie, channels 4, 5, or 8) led to selective activation of levator auris longus with higher EMG amplitudes. MCE implantation yielded stable and selective facial muscle activation EMG thresholds and amplitudes up to a 5-month period. Modest selective muscle activation was furthermore obtained after a complete transection-reapproximating nerve injury after a 3-month recovery period and implantation reoperation. Chronic implantation of MCE did not lead to fibrosis on histology. Field steering was achieved to activate distinct facial muscles by sending simultaneous subthreshold currents to multiple channels, thus theoretically protecting against nerve damage from chronic electrical stimulation. Conclusion: Our proof-of-concept results show the ability of an MCE, supplemented with field steering, to provide a degree of selective facial muscle stimulation in a feline model, even following nerve regeneration after FN injury. Level of evidence: N/A
Fabrication of 3D Models for Microtia Reconstruction Using Smartphone-Based Technology
Authors: You Peng , Liu Yi-Chun Carol , Silva Rodrigo C. 
Published: June 2021

Objective: Microtia reconstruction is technically challenging due to the intricate contours of the ear. It is common practice to use a two-dimensional tracing of the patient’s normal ear as a template for the reconstruction of the affected side. Recent advances in three-dimensional (3D) surface scanning and printing have expanded the ability to create surgical models preoperatively. This study aims to describe a simple and affordable process to fabricate patient-specific 3D ear models for use in the operating room. Study design: Applied basic research on a novel 3D optical scanning and fabrication pathway for microtia reconstruction. Setting: Tertiary care university hospital. Methods: Optical surface scanning of the patient’s normal ear was completed using a smartphone with facial recognition capability. The Heges application used the phone’s camera to capture the 3D image. The 3D model was digitally isolated and mirrored using the Meshmixer software and printed with a 3D printer (MonopriceTM Select Mini V2) using polylactic acid filaments. Results: The 3D model of the ear served as a helpful intraoperative reference and an adjunct to the traditional 2D template. Collectively, time for imaging acquisition, editing, and fabrication was approximately 3.5 hours. The upfront cost was around $210, and the recurring cost was approximately $0.35 per ear model. Conclusion: A novel, low-cost approach to fabricate customized 3D models of the ear is introduced. It is feasible to create individualized 3D models using currently available consumer technology. The low barrier to entry raises the possibility for clinicians to incorporate 3D printing into various clinical applications.
Supporting Direct Breastfeeding in a Tracheostomy-Dependent Neonate: A Case Report
Authors: Van Osch Kylen , Hunter Kerry , Graham M. Elise 
Published: June 2021

Objectives: There are numerous well-described benefits to breastfeeding to both infant and mother. Even in healthy children with an uncomplicated perinatal course, there may be significant struggles maintaining a breastfeeding relationship. Infants with a complicated clinical course have been shown to benefit even more from the provision of breastmilk, however they are seldom encouraged to feed directly at the breast. There are no reports of successful direct breastfeeding in an infant with a tracheostomy. Methods and Results: We present the case of a breastfeeding dyad including a trach-dependent infant with congenital idiopathic bilateral vocal fold immobility who successfully initiated and maintained an inclusive breastfeeding relationship. Conclusion: This case illustrates that successful direct breastfeeding can be achieved in an infant with a tracheostomy. If a patient is felt to be capable of oral feeding via bottle, there is no reason that there should not be a trial of direct feeding at the breast, for the benefit of both members of the breastfeeding dyad.
A County-Level Analysis of Socioeconomic and Clinical Predictors of COVID-19 Incidence and Case-Fatality Rates in Georgia, March–September 2020
Authors: Berman Adam E. , Miller D. Douglas , Rahn Daniel W. , Hess David C. , Thompson Mark A. , Mossialos Elias A. , Waller Jennifer L. 
Published: June 2021

Objectives The global COVID-19 pandemic has affected various populations differently. We investigated the relationship between socioeconomic determinants of health obtained from the Robert Wood Johnson Foundation County Health Rankings and COVID-19 incidence and mortality at the county level in Georgia. Methods We analyzed data on COVID-19 incidence and case-fatality rates (CFRs) from the Georgia Department of Public Health from March 1 through August 31, 2020. We used repeated measures generalized linear mixed models to determine differences over time in Georgia counties among quartile health rankings of health outcomes, health behaviors, clinical care, social and economic factors, and physical environment. Results COVID-19 incidence per 100 000 population increased across all quartile county groups for all health rankings (range, 23.1-51.6 in May to 688.4-1062.0 in August). COVID-19 CFRs per 100 000 population peaked in April and May (range, 3312-6835) for all health rankings, declined in June and July (range, 827-5202), and increased again in August (range, 1877-3310). Peak CFRs occurred later in counties with low health rankings for health behavior and clinical care and in counties with high health rankings for social and economic factors and physical environment. All interactions between the health ranking quartile variables and month were significant ( P < .001). County-level Gini indices were associated with significantly higher rates of COVID-19 incidence ( P < .001) but not CFRs. Conclusions From March through August 2020, COVID-19 incidence rose in Georgia’s counties independent of health rankings categorization. Differences in time to peak CFRs differed at the county level based upon key health rankings. Public health interventions should incorporate unique strategies to improve COVID-19–related patient outcomes in these environments.
Minimally invasive versus transcatheter closure of secundum atrial septal defects: a systematic review and meta-analysis
Authors: Goh Esther , Mohammed Haya , Salmasi Mohammad Yusuf , Ho Samantha , Benedetto Umberto , Caputo Massimo , Angelini Gianni , Vohra Hunaid A 
Published: June 2021

Background: Limited data exists demonstrating the efficacy of minimally invasive surgery (MIS) compared to transcatheter (TC) closure of atrial septal defects (ASD). This systematic review and meta-analysis aims to compare post-operative outcomes of MIS versus TC repair in ASD closure. Methods: PubMed, Medline and EMBASE were searched from inception until June 2018 for randomised and observational studies comparing post-operative outcomes for MIS and TC repair. The studies were reviewed for bias using the ROBINS-I Score and pooled in a meta-analysis using STATA (version 15). Results: Six observational studies, involving 1524 patients assessing three primary and five secondary outcomes were included. Evidence suggests TC repair yielded shorter hospital stay (MD = 3.32, 95% CI 1.04–5.60) and lower rates of transient atrial fibrillation (AF) (RR = 0.48, 95% CI 0.20–1.15). TC repair patients also had fewer pericardial effusions (RR = 0.27, 95% CI 0.05–1.54, I2 = 0.0%) and pneumothoraxes (RR = 0.18, 95% CI 0.04–0.80, I2 = 0.0%). However, TC repair results in more minor residual shunts (RR = 6.04, 95% CI 1.69–21.63 in favour of MIS, I2 = 39.0%). No differences were found for incidences of strokes (RR = 1.58, 95% CI 0.23–10.91, I2 = 19.3%), unexpected bleeding (RR = 0.44, 95% CI 0.19–1.04, I2 = 0.0%) and blood transfusion (RR = 0.39, 95% CI 0.09–1.59, I2 = 0.0%). Conclusions: MIS closure for ASD has similar outcomes compared to TC repair. However, the lack of randomised literature related to MIS versus TC repair for ASD closure warrants further evidence in the form of RCTs to further support these findings.
Variability of three activated clotting time point-of-care systems in cardiac surgery: reinforcing available evidence
Authors: Solís Clavijo Diego , Cotano Abel Ortega , Peña Nuria Alonso , Caballero Gálvez Sergio , Arellano Núñez Fernando , Carballo Caro Juan Manuel , Muñoz-Cacho Pedro , Tocón Alé Cristina 
Published: June 2021

Background: Cardiac surgery with extracorporeal circulation (ECC) requires the administration of anticoagulant drugs to maintain ACT ranges 400–600 seconds, which requires exhaustive coagulation monitoring for which various point-of-care devices are available. However, there is variability between them, so we aimed to compare the values in ACT measurement. Methods: Simultaneous ACT measurements were performed with the Hemochron Response®, Hemostasis Management System Plus® (HMS Plus®) and Hemochron Signature® systems. Results: A total of 255 simultaneous measurements were taken, the mean and standard deviation (SD) of each device were: Hemochron Signature® 361.1 seconds (SD: 156.9), HMS Plus® 412.8 seconds (SD: 180.9) and Hemochron Response® 422.8 seconds (SD: 187.9), being these differences statistically significant (Fridman’s test p < 0.01). For comparisons the Bland–Altman method was used, resulting the Hemochron Response® has 61.7 seconds higher mean values than the Hemochron Signature®, the Hemochron Response® 10 seconds higher than the HMS Plus® and the HMS Plus® 51.7 seconds higher than the Hemochron Signature®. Conclusion: The differences found in comparisons are considered to be clinically relevant, which is why it is considered important to make the variability of the different monitoring systems known and to take them into account for optimal control of this parameter and its clinical repercussions.
What does effective end-of-life care at home for children look like? A qualitative interview study exploring the perspectives of bereaved parents
Authors: Malcolm Cari , Knighting Katherine 
Published: June 2021

Background: End-of-life care for children with life-shortening conditions is provided in a range of settings including hospital, hospice and home. What home-based, end-of-life care should entail or what best practice might look like is not widely reported, particularly from the perspective of parents who experienced the death of a child at home. Aim: To explore the value and assess the effectiveness of an innovative model of care providing home-based, end-of-life care as perceived by families who accessed the service. Design: A qualitative descriptive study design was employed with in-depth semi-structured interviews conducted with bereaved parents. Setting/participants: Thirteen bereaved parents of 10 children supported by the home-based end-of-life care service. Results: Parents reported effective aspects of end-of-life care provided at home to include: (1) ability to facilitate changes in preferred place of death; (2) trusted relationships with care providers who really know the child and family; (3) provision of child and family-centred care; (4) specialist care and support provided by the service as and when needed; and (5) quality and compassionate death and bereavement care. Parents proposed recommendations for future home-based end-of-life care including shared learning, improving access to home-based care for other families and dispelling hospice myths. Conclusion: Parents with experience of caring for a dying child at home offer valuable input to future the policy and practice surrounding effective home-based, end-of-life care for children. New models of care or service developments should consider the key components and attributes for effective home-based end-of-life identified by bereaved parents in this study.
Health Literacy of Parents and Carers in a Regional Community: A Cross-Sectional Study
Authors: Leach Matthew J. , Nichols Sue , Trenholm Sven , Jones Martin 
Published: June 2021

Background Supporting a child’s healthy development is determined, in part, by a parent’s ability to seek, access, interpret and effectively utilize health information. This aspect of parenting draws on a set of skills referred to as health literacy. Objective To assess the level of health literacy among parents/carers in a regional South Australian community. Methods Parents/carers of primary school-aged children, residing in Whyalla, South Australia, were invited to complete the 13-item All Aspects of Health Literacy Survey. Results 155 parents/carers completed the survey (79% mothers). Most participants were English-speaking (97%), employed (62%) and had 2–3 children (62%), with 52% completing tertiary education. Median total health literacy scores were mostly in the moderate-high range (median 27, IQR 26,27), as were critical health literacy scores (median 7, IQR 6,8). Higher scores were reported for functional health literacy (median 8, IQR 7,9), communicative health literacy (median 9, IQR 8,9) and empowerment health literacy (median 4, IQR 3,5). Conclusions Our findings reveal modest levels of health literacy among a sample of parents/carers of primary school-aged children in a regional South Australian community. Further work is needed to understand the differential effect of parental health literacy on child health outcomes, and the types of strategies that may mitigate the impact of these barriers on a child’s healthy development.
The Development and Psychometric Assessment of a Coping Inventory for Intimate Partner Violence Among Abused Iranian Women
Authors: Taherkhani Sakineh 
Published: June 2021

Helping abused Iranian women better cope with intimate partner violence (IPV) requires measuring their coping strategies. The review of literature on the subject showed that there is no context-based instrument for measuring coping with IPV among abused Iranian women. The present study was thus conducted to develop and perform the psychometric assessment of a coping inventory for intimate partner violence (CIIPV) in abused Iranian women. In this methodological study, two consecutive studies were carried out for the development and psychometric assessment of CIIPV. In the first study, the inventory items were designed based on the results of a previous qualitative study that was conducted to identify the coping strategies used for IPV among abused Iranian women. In the second study, the inventory’s validity and reliability were examined. The face validity, content validity, construct validity, and convergent validity of the inventory were also evaluated. Moreover, to assess the reliability of the inventory, its internal consistency was estimated using Cronbach’s alpha coefficient. A total of 58 items were designed in the first study and then psychometrically assessed. The final version of the inventory comprised 29 items and 6 factors, including negotiation, instrumental action, help-seeking, positive cognitive restructuring, spiritual support-seeking, and distraction. The content validity index of the entire inventory was 1. The extracted factors explained 75.44% of the variance. The convergent validity of the CIIPV was confirmed with a medium positive relationship between the conceptually similar subscales in the two instruments CIIPV and the Ways of Coping Questionnaire. Furthermore, the Cronbach’s alpha coefficient of the entire inventory was 0.86, indicating its suitable reliability. Given the results, the CIIPV is a valid and reliable domain-specific tool to measure the coping strategies used for IPV among abused Iranian women.
Stalkers: Specialists Versus Generalists
Authors: Sheridan Lorraine , Bendlin Martyna , House Paul 
Published: June 2021

Abstract It is known that many domestic violence (DV) offenders also commit violent and nonviolent offences that are not domestic in nature. Stalking frequently evolves from DV contexts. The present study used police data to explore (i) the extent to which stalking offenders in Western Australia specialize in stalking, (ii) the frequency of involvement in DV offending by stalking offenders, and (iii) the types of offences that co-occur with stalking offences. The dataset covered 404 individuals who were identified by the Western Australia Police Force as the offender for a stalking offence between January 1st, 2003 and July 30th, 2017. Only a minority of the offenders specialized in stalking, with the majority offending in other ways against the index victim and also offending against others via a broad range of offences. Although less than 10% were recorded as having carried out domestic assaults, more than half had broken restraining orders. Like DV offenders, the stalkers in this sample were largely generalist offenders. It was not clear, however, what proportion of offences against the same index victim were directly related to stalking. Stalking is a course of conduct that often involves individual acts that may be offences in themselves. What is clearer is the finding that for many stalkers, stalking forms part of a wider pattern of antisocial activity. Those stalkers who do not specialize in stalking may be less likely to benefit from intervention efforts that are focused solely on stalking.
Disability Law in a Pandemic: The Temporal Folds of Medico-legal Violence
Authors: Spivakovsky Claire , Steele Linda Roslyn 
Published: June 2021

Disabled people are subject to disability laws – such as guardianship, mental health and mental capacity legislation – which only apply to them, and which enable legal violence on the basis of disability (‘disability-specific lawful violence’). While public health laws during the COVID-19 pandemic enabled coercive interventions in the general population, disabled people have additionally been subject to the continued, and at times intensified, operation of disability laws and their lawful violence. In this article we engage with scholarship on law, temporality and disability to explore the amplification of disability-specific lawful violence during the pandemic. We show how this amplification has been made possible through the folding of longstanding assumptions about disabled people – as at risk of police contact; as vulnerable, unhealthy and contaminating – into the immediate crisis of the pandemic; ignoring structural drivers of oppression, and responsibilising disabled people for their circumstances and the violence they experience.