bluuebunny/crossref_metadata_2025_split huggingface dataset:
An intervention to improve coping strategies in adult male prisoners with a history of traumatic brain injury: A pilot randomised clinical trial
Authors: Mitchell Tracey , du Preez Elizabeth , Theadom Alice 
Published: March 2021

Objective: To determine whether a psychological intervention improves coping, post-concussion symptoms and decreases in-prison infractions in adult males with a history of traumatic brain injury. Design: A single centre, randomised, wait-list, pilot study. Setting: A high security prison in New Zealand. Subjects: Fifty-five adult male participants who had experienced at least one traumatic brain injury in their lifetime (mean age 37.29 +/−9.81 years). Intervention: A manualised ten session, in-person, group based combined Cognitive Behavioural Therapy /Mindfulness Based Stress Reduction intervention versus wait list control. Main measures: The Negative Affect Repair Questionnaire and Rivermead Post-concussion Symptom Questionnaire were completed at baseline, post-intervention (five weeks) and at 12 week follow up. In-prison misconduct charges and negative file notes were reviewed for the previous five weeks at each assessment time point. Results: There was an improvement in the use of calming and distraction strategies in the intervention group from baseline ( x̄ = 17.38, SD = 3.57) to post-intervention ( x̄ = 18.67, SD = 3.84) and 12-week follow up ( x̄ = 18.13, SD = 2.63). Participants in the intervention group had significantly higher negative affect repair on the calming and distractive strategies subscale following completion of the intervention, compared to wait-list controls ( F = 4.69, P = 0.04) with a moderate effect size (ηp2 = 0.11). Improvements in use of calming and distractive strategies was not sustained at the twelve-week follow-up ( F = 0.87, P = 0.36). There was no-significant improvement on other negative affect subscales or for post-concussion symptoms or decrease in-prison infractions. Conclusion: A manualised psychological intervention may have the potential to facilitate the development of positive coping strategies in prisoners with a history of traumatic brain injury.
Treatment with astragaloside IV reduced blood glucose, regulated blood lipids, and protected liver function in diabetic rats
Authors: Han Dong 
Published: March 2021

Objectives To investigate the effects of astragaloside IV on blood glucose, blood lipids, and liver function in diabetic rats. Methods Fifty diabetic rats were randomly placed into five groups (n = 10 each): the diabetes mellitus (DM) group received intragastric saline, the metformin hydrochloride group received intragastric metformin hydrochloride, and the astragaloside-30, -60, and -120 groups received intragastric astragaloside 30 mg/kg, 60 mg/kg, and 120 mg/kg for 28 days, respectively. Ten non-diabetic rats received intragastric saline as controls. Results Relative to the DM group, fasting blood glucose, triglyceride, total cholesterol, serum alanine transaminase, and serum aspartate aminotransferase levels decreased in the astragaloside-60 and astragaloside-120 groups; serum alkaline phosphatase decreased solely in the astragaloside-120 group. Serum superoxide dismutase (SOD), glutathione (GSH-Px), and catalase (CAT) levels were elevated, while maleic dialdehyde (MDA) decreased in the astragaloside-120 group, relative to the DM group. Relative to the DM group, the liver index and liver cell apoptosis rate were reduced, while histopathological changes in liver tissue were ameliorated in the astragaloside groups; moreover, liver tissue SOD, GSH-Px, and CAT levels were increased, while liver tissue MDA was reduced. Conclusions Astragaloside IV can lower blood glucose, regulate blood lipids, and protect liver function in diabetic rats.
Comparative Evaluation of Adenoids and Airway Space in 12 to 14-Year-Old Children With Different Growth Patterns Using Cephalometric Methods Commonly Used by ENT Specialists
Authors: Choudhari Smita Mangesh , Shrivastav Sunita 
Published: March 2021

Introduction: Altered airway and growth are interrelated; hence, a study was planned to develop a diagnostic protocol that may help in diagnosing difficult airway by utilizing routine radiographic assessment. Material and Methods: Lateral cephalograms of 60 children aged 12 to 14 years who were grouped based on the growth pattern into 3 groups with 20 cases each (Group 1—normodivergent cases; Group 2—hypodivergent cases; Group 3—hyperdivergent cases) were observed. The diagnostic protocol included 3 diagnostic methods (Handelman–Osborne area method, Maw et al method, and Holmberg et al method) routinely used by ENT surgeons for altered airway evaluation, and their diagnostic efficacy was correlated with McNamara’s airway analysis. Results: Highest specificity and diagnostic accuracy were found with Holmberg et al method followed by Maw et al method. Poor specificity was observed with Handelman–Osborne area method. Conclusion: The new diagnostic protocol which includes commonly used cephalometric methods by ENT surgeons can be helpful for orthodontists in early evaluation of altered airways, so that preventive and interceptive procedures can be carried out to normalize the altered craniofacial growth. Among the methods used in this diagnostic protocol, Holmberg et al and Maw et al methods had better sensitivity and specificity.
Ventilated Patients With COVID-19 Show Airflow Obstruction
Authors: Koppurapu Vikas S. , Puliaiev Maksym , Doerschug Kevin C. , Schmidt Gregory A. 
Published: March 2021

Objective: Many patients with coronavirus disease 2019 (COVID-19) need mechanical ventilation secondary to acute respiratory distress syndrome. Information on the respiratory system mechanical characteristics of this disease is limited. The aim of this study is to describe the respiratory system mechanical properties of ventilated COVID-19 patients. Design, Setting, and Patients: Patients consecutively admitted to the medical intensive care unit at the University of Iowa Hospitals and Clinics in Iowa City, USA, from April 19 to May 1, 2020, were prospectively studied; final date of follow-up was May 1, 2020. Measurements: At the time of first patient contact, ventilator information was collected including mode, settings, peak airway pressure, plateau pressure, and total positive end expiratory pressure. Indices of airflow resistance and respiratory system compliance were calculated and analyzed. Main Results: The mean age of the patients was 58 years. 6 out of 12 (50%) patients were female. Of the 21 laboratory-confirmed COVID-19 patients on invasive mechanical ventilation, 9 patients who were actively breathing on the ventilator were excluded. All the patients included were on volume-control mode. Mean [±standard deviation] ventilator indices were: resistive pressure 19 [±4] cmH2O, airway resistance 20 [±4] cmH2O/L/s, and respiratory system static compliance 39 [±16] ml/cmH2O. These values are consistent with abnormally elevated resistance to airflow and reduced respiratory system compliance. Analysis of flow waveform graphics revealed a pattern consistent with airflow obstruction in all patients. Conclusions: Severe respiratory failure due to COVID-19 is regularly associated with airflow obstruction.
Does the Presence of a Physical Disability Affect Classification of Sexual Assault?
Authors: Dalton Alec , Henry Dayna , Blackstone Sarah , Passuth Julia , Gutowski Karlie , Birchfield Haley , Peterson Brett 
Published: March 2021

The occurrence of sexual assault is common and problematic, especially among those with disabilities. While many other characteristics of the victim, perpetrator, and situation involving a sexual assault have been shown to affect perceptions, only one study has examined the impact of a hypothetical victim with a physical disability. Therefore, the purpose of this study was to explore the effect that a victim and/or perpetrator’s physical disability status has on individuals’ classification of encounters as sexual assault. University students over the age of 18 ( n = 207) completed an anonymous online survey which included reading an ambiguous scenario involving a sexual assault in which either the victim, perpetrator or neither was in a wheelchair. Participants classified the scenario as either representing a sexual assault or not and completed the Illinois Rape Myth Acceptance scale and demographic information. A binary logistic regression model was conducted to examine the effects of conditions, participant gender and RMA score on sexual assault classification. In the scenario with the victim in a wheelchair, 71.6% of participants agreed sexual assault occurred; when the perpetrator was in a wheelchair 58.6% classified the scenario as sexual assault. In the control condition 61.4% agreed sexual assault occurred. Condition was not associated with classification at a statistically significant level; however, the effect sizes indicate participants were more likely to classify sexual assault when the victim was in a wheelchair (OR = 1.41), but less likely to blame a perpetrator in a wheelchair (OR = 0.69) compared to the control condition. Despite a lack of statistical significance, the data show a clear trend away from blaming individuals with disabilities in sexual assault scenarios. These findings can have implications within the legal system where incorrect decisions may be made due to bias based on disability status.
Implementation of PDOPPS in a middle-income country: Early lessons from Thailand
Authors: Kanjanabuch Talerngsak , Puapatanakul Pongpratch , Halue Guttiga , Lorvinitnun Pichet , Tangjittrong Kittisak , Pongpirul Krit , Narenpitak Surapong , Boonyakrai Chanchana , Tatiyanupanwong Sajja , Chieochanthanakij Rutchanee , Treamtrakanpon Worapot , Parinyasiri Uraiwan , Lounseng Niwat , Songviriyavithaya Phichit , Sritippayawan Suchai , Perl Jeffrey , Pecoits-Filho Roberto , Robinson Bruce , Davies Simon J , Johnson David W , Tungsanga Kriang 
Published: March 2021

Background: Despite the implementation of a ‘Peritoneal Dialysis (PD) First’ policy in Thailand since 2008, nationwide PD practices and patients’ outcomes have rarely been reported. Methods: As part of the multinational PD Outcomes and Practice Patterns Study (PDOPPS), PD patients from 22 PD centres from different geographic regions, sizes and affiliations, representing Thailand PD facilities, have been enrolled starting in May 2016. Demographic, clinical and laboratory data and patients’ outcomes were prospectively collected and analysed. Results: The pilot and implementation phases demonstrated excellent concordance between study data and validation data collected at enrolment. In the implementation phase, 848 PD patients (including 262 (31%) incident PD patients) were randomly sampled from 5090 patients in participating centres. Almost all participants (95%) performed continuous ambulatory PD (CAPD), and a high proportion had hypoalbuminemia (67%, serum albumin < 3.5 g/dL), anaemia (42%, haemoglobin <10 g/dL) and hypokalaemia (37%, serum potassium < 3.5 mmol/L). The peritonitis rate was 0.40 episodes/year, but the culture-negative rate was high (0.13 episodes/year, 28% of total episodes). The patients from PD clinics located in Bangkok metropolitan region had higher socio-economic status, more optimal nutritional markers, blood chemistries, haemoglobin level and lower peritonitis rates compared to the provincial regions, emphasizing the centre effect on key success factors in PD. Conclusions: Participation in the PDOPPS helps unveil the critical barriers to improving outcomes of PD patients in Thailand, including a high prevalence of hypokalaemia, anaemia, poor nutritional status and culture-negative peritonitis. These factors should be acted upon to formulate solutions and implement quality improvement on a national level.
Lean leadership: Towards continuous improvement capability in healthcare
Authors: van Elp Bianca , Roemeling Oskar , Aij Kjeld Harald 
Published: March 2021

This research focuses on the role of leadership styles during Lean Management (LM) initiatives in healthcare environments. Specifically, this study examined the role of leadership styles in the development of Continuous Improvement (CI) capability of teams. The empirical evidence was collected by applying a multiple-case design, and consisted of interviews, observations, and documentation. These data sources were used to develop case studies, and to identify leadership behaviours supportive of LM. Through qualitative case analysis, the influence of leadership styles on CI capability was determined. The results show that a hybrid leadership style is associated with higher levels of CI capability, and that the duration of a LM program in itself does not dictate maturity. A mix of both transactional and transformational leadership styles seems a necessary condition for teams to reach higher levels of CI capability. Based on these findings, this paper provides a framework to structure thinking on LM and leadership styles, and concludes with supporting propositions. The current outcomes imply that leaders should be sensitive towards their adopted leadership style, and should adopt a leadership style that combines both transformational as well as transactional elements, when leading LM teams. This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Investigation of grease lubricated deep groove ball bearing with multi-defected outer race using vibration signature analysis
Authors: Utpat Abhay A , Kulkarni Sham , Ingle Ravindra B 
Published: March 2021

Failure of any rotary machine is mainly due to bearing failure being the key element. Defect frequency is the function of speed, ball diameter, and pitch circle diameter of bearing. The number of defects does not affect the excitation frequency, but increase in the level of vibrations is observed in total. The inner race is mounted on the rotary shaft, and the outer race is fixed in the housing. Hence, a defect on the outer race does not rotate with the shaft. This article highlights the study of the multi-crack detection technique at a comparatively higher speed. Amplitudes of vibrations increase with speed, but with load, they almost remain the same. The experiment has been performed at the range from 1000 to 5000 r/min with 5 kg load on the test bearing. The location and size of the defect affect the level of vibrations with noticeable increase. However, the presence of a second defect with respect to the load zone plays an important role. As the defect is at the peak position in the load zone, outer race defect frequency excites more in the vibration spectra. The location and size of the second defect are varied, and acceleration amplitude parameters like RMS, peak, and peak to peak are compared. The current work emphasizes the effect of location and severity of the second defect on the vibration spectra and amplitude parameters of the vibrations.
Predictive value of quad serum markers for adverse pregnancy outcome in antiphospholipid antibody syndrome
Authors: Hong Sir-Yeon , Kim Seo-Yeon , Kim Jin-Ha , Hong Jee-Youn , Sung Ji-Hee , Choi Suk-Joo , Oh Soo-Young , Roh Cheong-Rae 
Published: March 2021

Purpose We investigated the validity of quad serum markers for the prediction of adverse pregnancy outcome (APO) in women with antiphospholipid antibody syndrome (APS). Methods We included 75 women with APS delivered at our institution. APO was defined as stillbirth, small for gestational age (SGA), severe preeclampsia, or preterm delivery. First, we compared clinical characteristics between patients with or without composite APO. Second, we compared the rate of APO according to abnormal level of quad serum markers. Lastly, receiver operating characteristic (ROC) curve analysis was performed. Results APS mothers with APO showed higher median α-fetoprotein (AFP) and inhibin A compared with those without APO. They were also associated with higher rates of positive risk of Down syndrome and neural tube defect. Elevated AFP, human chorionic gonadotropin (hCG), and inhibin A level was associated with higher rates of stillbirth, SGA, preterm delivery, and composite APO. ROC curve for prediction of stillbirth revealed an area under the curve of 0.835 for AFP, 0.781 for hCG, and 0.932 for inhibin A. For composite APO, the area under the ROC curve was 0.692 for AFP and 0.810 for inhibin A. Conclusion Elevated AFP, hCG, and inhibin A in women with APS demonstrated a high predictive value for APO, especially stillbirth.
Ethical and culturally competent care of transgender patients: A scoping review
Authors: Sundus Amara , Shahzad Sharoon , Younas Ahtisham 
Published: March 2021

Background: Transgender individuals experience discrimination, stigmatization, and unethical and insensitive attitudes in healthcare settings. Therefore, healthcare professionals must be knowledgeable about the ways to deliver ethical and culturally competent care. Ethical considerations: No formal ethical approval was required. Aim: To synthesize the literature and identify gaps about approaches to the provision of ethical and culturally competent care to transgender populations. Design: A Scoping Review Literature Search: Literature was searched within CINAHL, Science Direct, PubMed, Google Scholar, EMBASE, and Scopus databases using indexed keywords such as “transgender,” “gender non-conforming,” “ethically sensitive care,” and “culturally sensitive care.” In total, 30 articles, which included transgender patients and their families and nurses, doctors, and health professionals who provided care to transgender patients, were selected for review. Data were extracted and synthesized using tabular and narrative summaries and thematic synthesis. Findings: Of 30 articles, 23 were discussion papers, 5 research articles, and 1 each case study and an integrative review. This indicates an apparent dearth of literature about ethical and culturally sensitive care of transgender individuals. The review identified that healthcare professionals should educate themselves about sensitive issues, become more self-aware, put transgender individual in charge during care interactions, and adhere to the principles of advocacy, confidentiality, autonomy, respect, and disclosure. Conclusions: The review identified broad approaches for the provision of ethical and culturally competent care. The identified approaches could be used as the baseline, and further research is warranted to develop and assess organizational and individual-level approaches.
Ethical climate and moral distress in paediatric oncology nursing
Authors: Ventovaara Päivi , Sandeberg Margareta af , Räsänen Janne , Pergert Pernilla 
Published: March 2021

Background: Ethical climate and moral distress have been shown to affect nurses’ ethical behaviour. Despite the many ethical issues in paediatric oncology nursing, research is still lacking in the field. Research aim: To investigate paediatric oncology nurses’ perceptions of ethical climate and moral distress. Research design: In this cross-sectional study, data were collected using Finnish translations of the Swedish Hospital Ethical Climate Survey–Shortened and the Swedish Moral Distress Scale–Revised. Data analysis includes descriptive statistics and non-parametric analyses. Respondents and research context: Ninety-three nurses, working at paediatric oncology centres in Finland, completed the survey. Ethical considerations: According to Finnish legislation, no ethical review was needed for this type of questionnaire study. Formal research approvals were obtained from all five hospitals. Return of the questionnaire was interpreted as consent to participate. Results: Ethical climate was perceived as positive. Although morally distressing situations were assessed as highly disturbing, in general they occurred quite rarely. The situations that did appear often reflected performing procedures on school-aged children who resist such treatment, inadequate staffing and lack of time. Perceptions of ethical climate and frequencies of morally distressing situations were inversely correlated. Discussion: Although the results echo the recurrent testimonies of busy work shifts, nurses could most often practise nursing the way they perceived as right. One possible explanation could be the competent and supportive co-workers, as peer support has been described as helpful in mitigating moral distress. Conclusion: Nurturing good collegial relationships and developing manageable workloads could reduce moral distress among nurses.
Autistic differences in the temporal dynamics of social attention
Authors: Hedger Nicholas , Chakrabarti Bhismadev 
Published: March 2021

Individuals with autism spectrum disorders typically exhibit reduced visual attention towards social stimuli relative to neurotypical individuals. Importantly, however, attention is not a static process, and it remains unclear how such effects may manifest over time. Exploring these momentary changes in gaze behaviour can more clearly illustrate how individuals respond to social stimuli and provide insight into the mechanisms underlying reduced social attention in autism spectrum disorder. Using a simple passive eye-tracking task with competing presentations of social and nonsocial stimuli, we examine the different ways in which attention to social stimuli evolves over time in neurotypical adults and adults with and autism spectrum disorders. Our temporal modelling of gaze behaviour revealed divergent temporal profiles of social attention in neurotypical and observers with autism. Neurotypical data showed an initial increase in social attention, a ‘decay’ and subsequent ‘recovery’ after prolonged viewing. By contrast, in individuals with autism spectrum disorder, social attention decayed over time in a linear fashion without recovery after prolonged viewing. We speculate that the ‘gaze cascade’ effect that maintains selection of social stimuli in neurotypical observers is disrupted in individuals with high autistic traits. Considering these temporal components of gaze behaviour may enhance behavioural phenotypes and theories of social attention in autism spectrum disorder. Lay abstract One behaviour often observed in individuals with autism is that they tend to look less towards social stimuli relative to neurotypical individuals. For instance, many eye-tracking studies have shown that individuals with autism will look less towards people and more towards objects in scenes. However, we currently know very little about how these behaviours change over time. Tracking these moment-to-moment changes in looking behaviour in individuals with autism can more clearly illustrate how they respond to social stimuli. In this study, adults with and without autism were presented with displays of social and non-social stimuli, while looking behaviours were measured by eye-tracking. We found large differences in how the two groups looked towards social stimuli over time. Neurotypical individuals initially showed a high probability of looking towards social stimuli, then a decline in probability, and a subsequent increase in probability after prolonged viewing. By contrast, individuals with autism showed an initial increase in probability, followed by a continuous decline in probability that did not recover. This pattern of results may indicate that individuals with autism exhibit reduced responsivity to the reward value of social stimuli. Moreover, our data suggest that exploring the temporal nature of gaze behaviours can lead to more precise explanatory theories of attention in autism.