bluuebunny/crossref_metadata_2025_split huggingface dataset:
Remote robotic endovascular thrombectomy for acute ischaemic stroke
Authors: Singer Justin , VanOosterhout Stacie , Madder Ryan 
Published: June 2021

BackgroundIn acute ischaemic stroke, endovascular thrombectomy (ET) significantly reduces disability compared with thrombolytic therapy, but access to ET is currently limited. Leveraging telerobotic technology to disseminate neurosurgical expertise could increase access to ET. This proof-of-concept evaluation was performed to determine whether remote robotic ET (RRET), wherein an offsite neurosurgeon and an onsite interventional cardiologist collaboratively use telerobotics to perform ET, is technically feasible.MethodsAn ex vivo model of RRET was constructed by establishing a network connection between a robotic drive in a simulation laboratory and a robotic control unit 5 miles away. Using onsite assistance from an interventional cardiologist in the simulation laboratory, an offsite neurosurgeon used the robotic controls to attempt RRET on a fluid-filled silicone model of human vasculature containing simulated thrombus material in the left middle cerebral artery (MCA).ResultsFrom the offsite location 5 miles away, the neurosurgeon used the robotic system to successfully navigate a guidewire from the carotid artery to simulated thrombus in the MCA. Under the direction of the neurosurgeon, the onsite interventional cardiologist then successfully manually advanced an aspiration catheter over the guidewire to the thrombus, removed the guidewire and performed aspiration.ConclusionsIn this proof-of-concept evaluation, the technical feasibility of RRET was demonstrated in an ex vivo model and was collaboratively performed by an offsite neurosurgeon and an onsite interventional cardiologist. This report supports the design of future studies to determine if RRET could be used to increase access to ET for patients with acute ischaemic stroke.
Clinician perceptions of common mental disorders before and after implementation of a consultation-liaison psychiatry service: a longitudinal qualitative study in government-operated primary care settings in Penang, Malaysia
Authors: Russell Vincent , Loo Ching Ee , Walsh Aisling , Bharathy Arokiamary , Vasudevan Umadevi , Looi Irene , Smith Susan M 
Published: June 2021

ObjectivesTo explore primary care clinician perceptions of barriers and facilitators in delivering care for common mental disorders (CMD) before and after implementation of a consultation-liaison psychiatry service (Psychiatry in Primary Care (PIPC)) in government-operated primary care clinics and to explore the clinicians’ experience of the PIPC service itself.DesignThis longitudinal qualitative study was informed by the Normalisation Process Model and involved audiotaped semi-structured individual interviews with front-line clinicians before (Time 1) and after (Time 2) the PIPC intervention. The Framework Method was used in the thematic analysis of pre/post interview transcripts.SettingTwo government-operated primary care clinics in Penang, Malaysia.Participants17 primary care medical, nursing and allied health staff recruited purposely to achieve a range of disciplines and a balanced representation from both clinics.InterventionPsychiatrists, accompanied by medical students in small numbers, provided one half-day consultation visit per week, to front-line clinicians in each clinic over an 8-month period. The service involved psychiatric assessment of patients with suspected CMDs, with face-to-face discussion with the referring clinician before and after the patient assessment.ResultsAt Time 1 interviewees tended to equate CMDs with stress and embraced a holistic model of care while also reporting considerable autonomy in mental healthcare and positively appraising their current practices. At Time 2, post-intervention, participants demonstrated a shift towards greater understanding of CMDs as treatable conditions. They reported time pressures and the demands of key performance indicators in other areas as barriers to participation in PIPC. Yet they showed increased awareness of current service deficits and of their potential in delivering improved mental healthcare.ConclusionsDespite resource-related and structural barriers to implementation of national mental health policy in Malaysian primary care settings, our findings suggest that front-line clinicians are receptive to future interventions designed to improve the mental healthcare capacity.
Supporting active ageing before retirement: a systematic review and meta-analysis of workplace physical activity interventions targeting older employees
Authors: Merom Dafna , Stanaway Fiona , Gebel Klaus , Sweeting Joanna , Tiedemann Anne , Mumu Shirin , Ding Ding 
Published: June 2021

ObjectiveWith the growing representation of older adults in the workforce, the health and fitness of older employees are critical to support active ageing policies. This systematic review aimed to characterise and evaluate the effects on physical activity (PA) and fitness outcomes of workplace PA interventions targeting older employees.DesignWe searched Medline, PreMedline, PsycInfo, CINAHL and the Cochrane Controlled Register of Trials (CENTRAL) for articles published from inception to 17 February 2020. Eligible studies were of any experimental design, included employees aged ≥50 years, had PA as an intervention component and reported PA-related outcomes.ResultsTitles and abstracts of 8168 records were screened, and 18 unique interventions were included (3309 participants). Twelve studies were randomised controlled trials (RCTs). Seven interventions targeted multiple risk factors (n=1640), involving screening for cardiovascular disease risk factors, but had a non-specific description of the PA intervention. Four interventions targeted nutrition and PA (n=1127), and seven (n=235) focused only on PA. Interventions overwhelmingly targeted aerobic PA, compared with only four interventions targeting strength and/or balance (n=106). No studies involved screening for falls/injury risk, and only two interventions targeted employees of low socioeconomic status. Computation of effect sizes (ESs) was only possible in a maximum of three RCTs per outcome. ESs were medium for PA behaviour (ES=0.25 95% CI −0.07 to 0.56), muscle strength (ES=0.27, 95% CI −0.26 to 0.80), cardiorespiratory fitness (ES=0.28, 95% CI −22 to 0.78), flexibility (ES=0.50, 95% CI −0.04 to 1.05) and balance (ES=0.74, 95% CI −0.21 to 1.69). Grading of Recommendations Assessment, Development and Evaluation criteria-rated quality of evidence was ‘low’ due to high risk of bias, imprecision and inconsistency.ConclusionsThe lack of high-quality effective workplace PA interventions contrasts the importance and urgency to improve the health and fitness in this population. Future interventions should incorporate strength and balance training and screening of falls/injury risk in multi risk factors approaches.PROSPERO registration numberCRD42018084863. (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=84863).
Long-term effectiveness of group-based diabetes self-management on glycosylated haemoglobin for people with type 2 diabetes in community: a protocol of systematic review and meta-analysis
Authors: Xia Zhang , Jiang Ying-ying , Shang Wei-jing , Guo Hai-jun , Mao Fan , Dong Wen-lan , Dong Jian-qun 
Published: June 2021

IntroductionThe rapid rise in the prevalence of diabetes has a negative impact on patients’ quality of life. Diabetes self-management group education is cost-effective and efficient for patients to control blood glucose. However, there are no consistent standards for self-management group education, and its long-term effects (≥12 months) are unclear. Although a few systematic reviews evaluated the long-term effects, they did not make clear provisions on the content of self-management, and the number and sample size of included studies were small, which may lead to misclassification bias and reporting bias. Therefore, we plan to conduct this systematic review to evaluate the long-term effects of self-management group education and determine the effects of different self-management characteristics on glycosylated haemoglobin (HbA1c).Methods and analysisWe will retrieve Chinese databases (Wanfang, Chinese Hospital Knowledge Warehouse) and English databases (PubMed, ScienceDirect, EMBASE, Web of Science, Bailian Platform, Cochrane Central Register of Controlled Trials, Google Scholar) for randomly controlled trials and cluster randomly controlled trials of which participants are adults with type 2 diabetes mellitus. We will manually search citation lists and trial registries, and consult authors to obtain relevant articles. The retrieval time range will be from the establishment of the database to July 2020 to avoid omitting relevant studies. The primary outcome will be HbA1c. The secondary outcomes will be fasting plasma glucose, postprandial blood glucose, total cholesterol, triglyceride, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, body mass index, waist circumference and death event. Two reviewers will independently conduct article screening and assessment of risk of bias, with a third reviewer arbitrating if necessary. We will give priority to the use of meta-analysis to evaluate the pooled effects of all outcomes. For the outcomes of unrecognised sources of heterogeneity, missing data and less than three related studies, narrative synthesis approach will be used.Ethics and disseminationEthical approval is not required for this systematic review. We plan to present the findings in a peer-reviewed scientific journal, relevant and responsible organisations, and training meetings.PROSPERO registration numberCRD42020209011.
Healthcare use during COVID-19 and the effect on psychological distress in patients with chronic cardiopulmonary disorders in the Netherlands: a cross-sectional study
Authors: Pouwels Beau D C , Simons Sami O , Theunissen Maurice , Peters Madelon L , Schoenmaekers Janna J , Bekkers Sebastiaan C , van den Beuken-van Everdingen Marieke H J 
Published: June 2021

ObjectivesThe COVID-19 pandemic caused a massive shift in the focus of healthcare. Such changes could have affected health status and mental health in vulnerable patient groups. We aimed to investigate whether patients with chronic pulmonary and cardiac diseases had experienced high levels of psychological distress during the COVID-19 pandemic in the Netherlands.DesignA cross-sectional study.SettingCOVID-19 pandemic-related changes in healthcare use, health status and psychological distress were investigated among patients with chronic obstructive pulmonary disease (COPD), pulmonary fibrosis (PF) and congestive heart failure (CHF), using an online nationwide survey.Participants680 patients completed the survey. COPD was the most often reported diagnosis 334 (49%), followed by congestive heart failure 219 (32%) and PF 44 (7%). There were 79 (12%) patients with primary diagnosis ‘other’ than chronic cardiopulmonary disease, who also completed this survey.InterventionsPsychological distress was assessed via the DASS-21 score (Depression Anxiety Stress Scale). Moreover, specific worries and anxieties regarding COVID-19 were explored.ResultsThe frequency of contact with healthcare professionals changed in 52%. Changes in treatment were reported in 52%. Deterioration in health status was self-reported in 39%. Moderate to extremely severe levels of depression, anxiety and stress was observed in 25.8%, 28.5% and 14%, respectively. Over 70% reported specific worries and anxieties, such as about their own health and fear of being alone. Both the deterioration in health status and increased levels of anxiety were significantly (p<0.001, p<0.006) associated with changes in treatment. Exploratory analyses indicated that lack of social support may further increase anxiety.ConclusionHealthcare use changed during the COVID-19 pandemic in the Netherlands. It was associated with a decrease in health status, and increased psychological stress among patients with chronic cardiopulmonary disorders. Provision of healthcare should be more sensitive to the mental health needs of these patients during subsequent COVID-19 waves.
Association between community deprivation and practising health behaviours among South Korean adults: a survey-based cross-sectional study
Authors: Jang Bich Na , Youn Hin Moi , Lee Doo Woong , Joo Jae Hong , Park Eun-Cheol 
Published: June 2021

ObjectivesThis study aimed to determine the association between community deprivation and poor health behaviours among South Korean adults.DesignThis was a survey-based cross-sectional study.Setting and participantsData of 224 552 participants from 244 communities were collected from the Korea Community Health Survey, conducted in 2015.Primary and secondary outcome measuresWe defined health behaviours by combining three variables: not smoking, not high-risk drinking and walking frequently. Community deprivation was classified into social and economic deprivation.ResultsMultilevel logistic analysis was conducted to determine the association of poor health behaviours through a hierarchical model (individual and community) for the 224 552 participants. Among them, 69.9% did not practice healthy behaviours. We found that a higher level of deprivation index was significantly associated with higher odds of not-practising healthy behaviours (Q3, OR: 1.15, 95% CI: 1.00 to 1.31; Q4 (highest), OR: 1.22, 95% CI: 1.06 to 1.39). Economic deprivation had a positive association with not-practising health behaviours while social deprivation had a negative association.ConclusionThese findings imply that community deprivation levels may influence individual health behaviours. Accordingly, there is a need for enforcing the role of primary healthcare centres in encouraging a healthy lifestyle among the residents in their communities, developing national health policy guidelines for health equity and providing financial help to people experiencing community deprivation.
Smoking cessation using preference-based tools among socially disadvantaged smokers: study protocol for a pragmatic, multicentre randomised controlled trial
Authors: El-Khoury Fabienne , El Aarbaoui Tarik , Héron Mégane , Hejblum Gilles , Métadieu Brigitte , Le Faou Anne-Laurence , Ibanez Gladys , Melchior Maria 
Published: June 2021

IntroductionMany smoking cessation aids such as nicotine replacement treatments and e-cigarettes have been proven effective in aiding smoking cessation attempts. Encouraging smokers with low socioeconomic position (SEP) to choose their smoking aid tool based on their preferences, and giving that tool free of charge, might increase the odds of smoking cessation. This trial examines the effectiveness of the ‘STOP’ (Sevrage Tabagique à l’aide d’Outils dédiés selon la Préférence: Smoking cessation using preference-based tools), a preference-based smoking cessation intervention for smokers with low SEP.Methods and analysisThe STOP study is a randomised, multicentre, controlled trial (RCT). Smokers with low SEP and wishing to quit will be randomised to either the intervention or the control group (standard care). Participants in the intervention group will be asked to choose between different types of nicotine substitutes (patches, inhalers, gum, tablets, etc) and/or an electronic cigarette which will be delivered free of charge to aid their smoking cessation attempt.The primary outcome will be smoking abstinence at 6 months after inclusion, defined as self-reported 7-day point prevalence of tobacco abstinence. Secondary outcomes include the total number of days of abstinence at 6 months after inclusion, 7-day point prevalence tobacco abstinence at 1 and 3 months after inclusion and number of relapses.The study will also include an economic evaluation, and a process evaluation using a mixed methods approach.Ethics and disseminationThe study was approved by the ‘Île de France II’ Institutional Review Board on 8 September 2020 (CPP Île de France II; Ref No: 20.01.31.65528 RIPH2 HPS), and results will be published in a peer-reviewed journal.Trial registration numberNCT04654585.
Exploring the impact of the COVID-19 pandemic on doctors’ core workplace needs: a qualitative study of internal medicine trainees in Scotland
Authors: Kerins Joanne , Hamilton Ailsa Lauren , Pringle Jemma , Farquhar Fiona , Tallentire Victoria Ruth 
Published: June 2021

ObjectivesThis study aimed to explore how the COVID-19 pandemic has impacted the workplace core needs of internal medicine (IM) trainees in Scotland.DesignThis qualitative study used an observational approach of interprofessional workshops combined with subsequent individual interviews with IM trainees. Workshops and interviews were audiorecorded, transcribed verbatim and analysed utilising NVivo software. Template analysis was used with the Autonomy/control, Belonging and Competence (ABC) of doctors’ core needs outlined in the 2019 General Medical Council report Caring for doctors, caring for patients as a conceptual lens for the study.SettingThe national IM boot camp in Scotland includes a 2-hour interprofessional workshop which is trainee led and explores current challenges in the workplace, including the impact of the pandemic on such relationships.ParticipantsTwelve workshops, involving 72 trainees, were included with ten trainees taking part in the subsequent interview process. Trainees representing all four regions in Scotland were involved.ResultsTrainees described all core needs having been impacted by the pandemic. They described a loss of autonomy with emergency rotas but also through a pervasive sense of uncertainty. The data revealed that work conditions improved initially with additional resources which have since been removed in some areas, affecting trainees’ sense of value. Analysis found that belonging was affected positively in terms of increased camaraderie but also challenged through inability to socialise. There were concerns regarding developing competence due to a lack of teaching opportunities.ConclusionsUsing the ABC of doctor’s core needs as a conceptual framework for this study highlighted the impact of the COVID-19 pandemic on all domains for IM trainees in Scotland. It has highlighted an opportunity to foster the renewed sense of camaraderie among healthcare teams, while rebuilding work conditions to support autonomy and competence.
Integrated palliative medicine in public oncology: a 10-year review
Authors: Chan Sik Kwan , Lam Tai Chung , Choi Horace Cheuk-Wai , Tsang Ka Chun , Yuen Kwok-Keung , Soong Inda , Wong Kam Hung , Lui Louisa , Lo Sing Hung , Tong Macy , Lo Raymond , Lam Po Tin , Lam Wai Man , Li Bryan 
Published: June 2021

ObjectivesThe rapid ageing population of Hong Kong has a high demand on oncology and palliative care (PC) service. This study was the first territory-wide assessment in Hong Kong to assess the palliative service coverage in patients with advanced cancer in the past decade.MethodsCancer deaths of all 43 public hospitals of Hong Kong were screened. Randomly selected 2800 cancer deaths formed a representative cohort in all seven service clusters of Hospital Authority at 4 time points (2006, 2009, 2012, 2015). Individual patient records were thoroughly reviewed. Predictors of PC coverage was evaluated in univariable and multivariable analyses.ResultsFrom 2006 to 2015, PC coverage improved steadily from 55.4% to 68.9% (p<0.001). Median time of referral to PC service to death was 25 days (IQR: 53). For duration of inpatient PC, the median time was 22 days (IQR: 44) and it was stable over the past 10 years. Median time of referral to outpatient service to death was 74 days (IQR: 144) and there was an improvement observed (p<0.05). The current system was highly heterogeneous that PC varied between 9.8% and 84.8% in different hospitals depending on the PC service infrastructure. Multivariable Cox model identified patients associated with lower PC coverage: male, <50, rapid disease deterioration and staying in hospitals without multidisciplinary team clinic and designated palliative bed support (all p<0.01).ConclusionThere was concrete achievement in palliative service development in the past decade. Heterogeneity and late service provision should be addressed in future.
Green banana flour supplementation improves obesity-associated systemic inflammation and regulates gut microbiota profile in mice fed high-fat diets
Authors: Rosado Carolyne Pimentel , Rosa Victor Hugo Cordeiro , Martins Bruna Cadete , Soares Aruanna Cajaty , Almo André , Monteiro Elisa Bernardes , Mulder Alessandra da Rocha Pinheiro , Moura-Nunes Nathália , Daleprane Julio Beltrame 
Published: June 2021

This study evaluated the effect of green banana flour (GBF) consumption on obesity-related conditions in mice fed high-fat diets. GBF was prepared using stage 1 green banana pulp, which was dehydrated and milled. Mice were fed a control diet (n = 20; 10% of energy from lipids) or a high-fat diet (n = 20; 50% of energy from lipids). After 10 weeks, mice were divided into 4 groups based on feed: standard chow (SC; n = 10), standard with 15% GBF (SB; n = 10), high-fat diet (HF; n = 10) and high-fat diet with 15% GBF (HFB; n = 10) for 4 weeks. HFB exhibited lower gains in body weight (–21%; p < 0.01) and in all fat pads (p < 0.01) compared with the HF group. SC, SB, and HFB showed smaller retroperitoneal white adipose tissue diameters (p < 0.001). SB and HFB-treated mice showed lower levels of leptin, IL-6, and TNF-α compared with the SC and HF groups (p < 0.01). In the GBF-fed groups, there was a reduction in the abundance of Firmicutes (SB: –22%; HFB: –23%) and an increase in Bacteroidetes (SB: +25%; HFB: +29%) compared with their counterparts. We demonstrated that GBF consumption attenuated inflammation and improved metabolic status, adipose tissue remodeling, and the gut microbiota profile of obese mice. Novelty: Green banana flour (GBF) consumption, rich in resistant starch, regulates body weight in mice fed high-fat diets. GBF consumption improves fat pad distribution in mice fed high-fat diets. GBF improves obesity-associated systemic inflammation and regulates gut microbiota profile in mice fed high-fat diets.
The light invisible boson in FCNC decays of B and $$B_c$$ mesons
Authors: Li Geng , Wang Tianhong , Zhang Jing-Bo , Wang Guo-Li 
Published: June 2021

AbstractIn this paper, we study the FCNC decay processes of B and $$B_c$$

B
c

meson, in which one invisible particle is emitted. Both the spin-0 and spin-1 cases are considered. The model-independent effective Lagrangian is introduced to describe the coupling between the light invisible boson and quarks. The constraints of the coupling coefficients are extracted by experimental upper limits of the missing energy in B meson decays. The bounds are used to predict the upper limits of branching fractions of corresponding $$B_c$$

B
c

decays, which are of the order of $$10^{-6}$$

10

-
6

or $$10^{-5}$$

10

-
5

when final meson is pseudoscalar or vector, respectively. The maximum branch ratios are achieved when $$m_\chi \approx 3.5$$

m
χ

≈
3.5

–4 GeV, where $$m_\chi $$

m
χ

is the mass of the invisible particle.
Detection of gravitational waves by light perturbation
Authors: Kim Dong-Hoon , Park Chan 
Published: June 2021

AbstractLight undergoes perturbation as gravitational waves pass by. This is shown by solving Maxwell’s equations in a spacetime with gravitational waves; a solution exhibits a perturbation due to gravitational waves. We determine the perturbation for a general case of both light and gravitational waves propagating in arbitrary directions. It is also shown that a perturbation of light due to gravitational waves leads to a delay of the photon transit time, which implies an equivalence between the perturbation analysis of Maxwell’s equations and the null geodesic analysis for photon propagation. We present an example of application of this principle with regard to the detection of gravitational waves via a pulsar timing array, wherein our perturbation analysis for the general case is employed to show how the detector response varies with the incident angle of a light pulse with respect to the detector.