bluuebunny/crossref_metadata_2025_split huggingface dataset:
Caregiver burden and proxy-reported outcomes of people without natural speech: a cross-sectional survey study
Authors: Zinkevich Anna , Lubasch Johanna Sophie , Uthoff Sarah Anna Katharina , Boenisch Jens , Sachse Stefanie Kalén , Bernasconi Tobias , Ansmann Lena 
Published: August 2021

ObjectiveTo examine interrelations between care-related burden on informal caregivers and their proxy assessments of outcomes in people without natural speech.DesignA cross-sectional survey.SettingData were collected in January 2019 from a postal survey of informal caregivers of people without natural speech who are insured by a large regional health insurance company in the German federal state of Lower Saxony.Participantsn=714 informal caregivers of people without natural speech of all ages and with various underlying disabilities were identified and contacted via the health insurance company. Data from n=165 informal caregivers (26.4%) were obtained.Main outcome measuresCaregiver burden (self-reported, Burden Scale for Family Caregivers), pragmatic communication skills of people without natural speech (proxy report, self-developed), health-related quality of life of people without natural speech (proxy report, DISABKIDS Chronic Generic Measure - DCGM-12) and functioning of people without natural speech (proxy report, WHO Disability Assessment Schedule 2.0).ResultsThe analyses revealed significant associations between caregiver burden on the one hand and both proxy-reported health-related quality of life (b=−0.422; p≤0.001) and functioning (b=0.521; p≤0.001) on the other. Adding caregiver burden to the regression model leads to a substantial increase in explained variance in functioning (R² Model 1=0.349; R² Model 2=0.575) as well as in health-related quality of life (R² Model 1=0.292; R² Model 2=0.460).ConclusionsCaregiver burden should be considered an important determinant when informal caregivers report outcomes on behalf of people without natural speech. Longitudinal studies are recommended to better understand the burdens experienced by caregivers when supporting people without natural speech.Trial registration numberDRKS00013628.
Biopsychosocial implications of living with multiple sclerosis: a qualitative study using interpretative phenomenological analysis
Authors: Kassie Seada A , Alia Jannat , Hyland Lynda 
Published: August 2021

BackgroundMultiple sclerosis (MS) is estimated to affect 2.8 million people worldwide, with increasing prevalence in all world regions (Waltonet al). While there is no cure for MS, medication and lifestyle modifications can slow disease progression and enhance patients’ quality of life. The biopsychosocial model of health recognises important interactions among biological, psychological and social factors in illness, including those relating to illness management, which contribute to the experience of those diagnosed with MS.ObjectiveThis qualitative, idiographic study aimed to explore the lived experiences of patients in the United Arab Emirates (UAE) diagnosed with MS.MethodsSemistructured interviews were conducted with a purposive sample of eight patients with MS ranging in age from 25 to 56 years. All participants were residing in the UAE at the time of data collection. Interpretative phenomenological analysis was used to analyse the data.ResultsThree superordinate themes were identified from patients’ candid accounts of their lives with MS, highlighting issues of illness management, acceptance and gratitude, and adaptive coping. These themes broadly illustrate biological, psychological and social aspects of patients’ MS experiences.ConclusionThe study emphasised the importance of adopting the biopsychosocial model to treat and manage MS. Additionally, it highlights the need for routine assessment and early, multidimensional approach with multidisciplinary team efforts to improve patients’ quality of life.
Association between acute psychiatric bed availability in the Veterans Health Administration and veteran suicide risk: a retrospective cohort study
Authors: Kaboli Peter J , Augustine Matthew R , Haraldsson Bjarni , Mohr Nicholas M , Howren M Bryant , Jones Michael P , Trivedi Ranak 
Published: August 2021

BackgroundVeteran suicides have increased despite mental health investments by the Veterans Health Administration (VHA).ObjectiveTo examine relationships between suicide and acute inpatient psychiatric bed occupancy and other community, hospital and patient factors.MethodsRetrospective cohort study using administrative and publicly available data for contextual community factors. The study sample included all veterans enrolled in VHA primary care in 2011–2016 associated with 111 VHA hospitals with acute inpatient psychiatric units. Acute psychiatric bed occupancy, as a measure of access to care, was the main exposure of interest and was categorised by quarter as per cent occupied using thresholds of ≤85%, 85.1%–90%, 90.1%–95% and >95%. Hospital-level analyses were conducted using generalised linear mixed models with random intercepts for hospital, modelling number of suicides by quarter with a negative binomial distribution.ResultsFrom 2011 to 2016, the national incidence of suicide among enrolled veterans increased from 39.7 to 41.6 per 100 000 person-years. VHA psychiatric bed occupancy decreased from a mean of 68.2% (IQR 56.5%–82.2%) to 65.4% (IQR 53.9%–79.9%). VHA hospitals with the highest occupancy (>95%) in a quarter compared with ≤85% had an adjusted incident rate ratio (IRR) for suicide of 1.10 (95% CI 1.01 to 1.19); no increased risk was observed for 85.1%–90% (IRR 0.96; 95% CI 0.89 to 1.03) or 90.1%–95% (IRR 0.96; 95% CI 0.89 to 1.04) compared with ≤85% occupancy. Of hospital and community variables, suicide risk was not associated with number of VHA or non-VHA psychiatric beds or amount spent on community mental health. Suicide risk increased by age categories, seasons, geographic regions and over time.ConclusionsHigh VHA hospital occupancy (>95%) was associated with a 10% increased suicide risk for veterans whereas absolute number of beds was not, suggesting occupancy is an important access measure. Future work should clarify optimal bed occupancy to meet acute psychiatric needs and ensure adequate bed distribution.
Demographic and epidemiological decomposition analysis of global changes in suicide rates and numbers over the period 1990–2019
Authors: Yip Paul Siu Fai , Zheng Yan , Wong Clifford 
Published: August 2021

BackgroundSuicide presents an ongoing public health challenge internationally. Nearly 800 000 people around the world lose their life to suicide every year, and many more attempt suicide.MethodsA decomposition analysis was performed using global suicide mortality and population data from the Global Burden of Disease Study 2019.ResultsDespite a significant decrease in age-specific suicide rate between 1990 and 2019 (-4.01; from 13.8% to 9.8% per 100 000), the overall numbers of suicide deaths increased by 19 897 (from 738 799 to 758 696) in the same time period. The reductions in age-specific suicide rates (−6.09; 152%) contributed to the overall reductions in suicide rates; however, this was offset by overtime changes in population age structure (2.08; −52%). The increase in suicide numbers was partly attributable to population growth (300 942; 1512.5%) and population age structure (189 512; 952.4%), which was attenuated by the significant reduction in overall suicide rates (−470 556; 2364.9%). The combined effect of these factors varied across the World Bank income level regions. For example, in the upper-middle-income level region, the effect of the reduction in age-specific suicide rates (−289 731; −1456.1%) exceeded the effect of population age structure (124 577; 626.1%) and population growth (83 855; 421.4%), resulting in its substantial decline in total suicide deaths (−81 298; −408.6%). However, in lower-middle income region, there was a notable increase in suicide death (72 550; 364.6%), which was related to the net gain of the reduction in age-specific suicide rates (-115 577; -580.9%) and negated by the increase in the number of suicide deaths due to population growth (152 093; 764.4%) and population age structure (36 034; 181.1%).ConclusionMore support and resources should be deployed for suicide prevention to the low-income and middle-income regions in order to achieve the reduction goal. Moreover, suicide prevention among older adults is increasingly critical given the world’s rapidly ageing populations in all income level regions.
Cosmological evolution and dark energy in osculating Barthel–Randers geometry
Authors: Hama Rattanasak , Harko Tiberiu , Sabau Sorin V. , Shahidi Shahab 
Published: August 2021

AbstractWe consider the cosmological evolution in an osculating point Barthel–Randers type geometry, in which to each point of the space-time manifold an arbitrary point vector field is associated. This Finsler type geometry is assumed to describe the physical properties of the gravitational field, as well as the cosmological dynamics. For the Barthel–Randers geometry the connection is given by the Levi-Civita connection of the associated Riemann metric. The generalized Friedmann equations in the Barthel–Randers geometry are obtained by considering that the background Riemannian metric in the Randers line element is of Friedmann–Lemaitre–Robertson–Walker type. The matter energy balance equation is derived, and it is interpreted from the point of view of the thermodynamics of irreversible processes in the presence of particle creation. The cosmological properties of the model are investigated in detail, and it is shown that the model admits a de Sitter type solution, and that an effective cosmological constant can also be generated. Several exact cosmological solutions are also obtained. A comparison of three specific models with the observational data and with the standard $$\Lambda $$
Λ
CDM model is also performed by fitting the observed values of the Hubble parameter, with the models giving a satisfactory description of the observations.
A New Double Truncated Generalized Gamma Model with Some Applications
Authors: Bakery Awad A. , Zakaria Wael , Mohamed OM Kalthum S. K. 
Published: August 2021

The generalized Gamma model has been applied in a variety of research fields, including reliability engineering and lifetime analysis. Indeed, we know that, from the above, it is unbounded. Data have a bounded service area in a variety of applications. A new five-parameter bounded generalized Gamma model, the bounded Weibull model with four parameters, the bounded Gamma model with four parameters, the bounded generalized Gaussian model with three parameters, the bounded exponential model with three parameters, and the bounded Rayleigh model with two parameters, is presented in this paper as a special case. This approach to the problem, which utilizes a bounded support area, allows for a great deal of versatility in fitting various shapes of observed data. Numerous properties of the proposed distribution have been deduced, including explicit expressions for the moments, quantiles, mode, moment generating function, mean variance, mean residual lifespan, and entropies, skewness, kurtosis, hazard function, survival function,

r

th

order statistic, and median distributions. The delivery has hazard frequencies that are monotonically increasing or declining, bathtub-shaped, or upside-down bathtub-shaped. We use the Newton Raphson approach to approximate model parameters that increase the log-likelihood function and some of the parameters have a closed iterative structure. Six actual data sets and six simulated data sets were tested to demonstrate how the proposed model works in reality. We illustrate why the Model is more stable and less affected by sample size. Additionally, the suggested model for wavelet histogram fitting of images and sounds is very accurate.
Impact of Genetic Testing for Cardiomyopathy on Emotional Well-Being and Family Dynamics: A Study of Parents and Adolescents
Authors: Ahimaz Priyanka , Sabatello Maya , Qian Min , Wang Aijin , Miller Erin M. , Parrott Ashley , Lal Ashwin K. , Chatfield Kathryn C. , Rossano Joseph W. , Ware Stephanie M. , Parent John J. , Kantor Paul , Yue Lisa , Wynn Julia , Lee Teresa M. , Addonizio Linda J. , Appelbaum Paul S. , Chung Wendy K. 
Published: August 2021

Background:Genetic testing is indicated for children with a personal or family history of hereditary cardiomyopathy to determine appropriate management and inform risk stratification for family members. The implications of a positive genetic result for children can potentially impact emotional well-being. Given the nuances of cardiomyopathy genetic testing for minors, this study aimed to understand how parents involve their children in the testing process and investigate the impact of genetic results on family dynamics.Methods:A survey was distributed to participants recruited from the Children’s Cardiomyopathy Foundation and 7 North American sites in the Pediatric Cardiomyopathy Registry. The survey explored adolescent and parent participants’ emotions upon receiving their/their child’s genetic results, parent-child result communication and its impact on family functionality, using the McMaster Family Assessment Device.Results:One hundred sixty-two parents of minors and 48 adolescents who were offered genetic testing for a personal or family history of cardiomyopathy completed the survey. Parents whose child had cardiomyopathy were more likely to disclose positive diagnostic genetic results to their child (P=0.014). Parents with unaffected children and positive predictive testing results were more likely to experience negative emotions about the result (P≤0.001) but also had better family functioning scores than those with negative predictive results (P=0.019). Most adolescents preferred results communicated directly to the child, but parents were divided about whether their child’s result should first be released to them or their child.Conclusions:These findings have important considerations for how providers structure genetic services for adolescents and facilitate discussion between parents and their children about results.
Turkey and Indonesia: A Relationship of Muslim-Majority Middle Powers
Authors: Bishku Michael B. 
Published: August 2021

Abstract
Turkey and Indonesia are both members of the Organization of Islamic Cooperation, a group of 57 Muslim-populated countries, and the D-8 Organization for Economic Cooperation, a group of Muslim-majority states, but their respective Constitutions do not give preference to the Islamic faith. While developing relations as part of the Muslim world, Turkey and Indonesia are also members of the G20, an organization of countries with some of the most important economies as well as mikta, a less formal group of middle powers in the G20 to deal with matters of common interest designed to enhance their soft power vis-à-vis the political dominance of major world and other regional powers. In addition, the founding fathers of modern Indonesia in their struggle for independence against the colonial power of the Netherlands following the Second World War found inspiration in the actions of founding father of the Republic of Turkey following the First World War. Yet despite all these connections and the importance of these two countries in world affairs, the study of the bilateral relations of Turkey and Indonesia and their interactions as part of multilateral organizations has been either neglected or extremely limited in coverage. This article attempts to ameliorate that situation.
Why Good Governance Goes Wrong: Government and Village in the Supply of Public Goods in Rural China
Authors: Wang (王海侠) Haixia , Yuan (袁陆仪) Luyi 
Published: August 2021

Abstract
Following the rural tax-for-fee reform and the abolition of agricultural taxes in the early 2000s, the overall supply of rural public goods has improved, but its performance is still deficient. During a field study of ecological migrants in rural Ningxia, the authors witnessed the problems encountered in the implementation of a public housing project. This episode demonstrates how the provision of rural public goods depends on rural governance that responds to the tension between modern development and the values of rural society. The failure of the project stems from the clash between the logic of peasant actions and the performance indicators of cadres, producing an internal rupture between rural society and rural governance. In the process of modernization and urbanization, grassroots government is becoming more bureaucratic and technical, with the prevalence of e-government and especially with village committees turning increasingly administrativized and beholden to superior levels of government, and thus is failing to fully embed itself in rural society.
Religious Identity Exploration in the Life Stories of Strictly Reformed-Raised Emerging Adults in the Netherlands
Authors: de Bruin-Wassinkmaat Anne-Marije , de Kock Jos , Visser-Vogel Elsbeth , Bakker Cok , Barnard Marcel 
Published: August 2021

Abstract
This article presents the findings from a qualitative study on the religious identity exploration processes and experiences of emerging adults who grew up in strictly Reformed contexts in the Netherlands. We discuss three forms of exploration that appeared in our data: asking questions, exploring alternatives and rebelling against things that are disallowed or undesirable in the strictly Reformed tradition. We also discuss patterns that emerged from our analysis of exploration related to participants’ current religious identity commitments and a strictly Reformed upbringing. Finally, we discuss our findings and propose directions for further research and implications for those who guide youth in religious identity development.
On the formation mechanism of cirrus banding: radiosonde observations, numerical simulations, and stability analyses
Authors: Yamazaki Kazuya , Miura Hiroaki 
Published: August 2021

AbstractThe structures and formation mechanisms of cirrus banding are investigated by analyzing radiosonde observations, conducting high-resolution numerical experiments, and performing linear stability analyses. In all 29 cases of cirrus bands that were analyzed, radiosonde observational data indicate that statically unstable layers exist. The detected banding clouds were aligned nearly parallel to the vertical shear vector in the unstable layer. In high-resolution numerical experiments using the cloud-resolving model SCALE-RM, cirrus bands forming in the outflow layer of a tropical cyclone are explicitly simulated. The existence of statically unstable layers and band-parallel background vertical wind shear are commonly identified in the simulations. Sensitivity experiments and heat budget analyses demonstrated that the unstable stratification within the cirrus clouds was maintained by the cloud-radiation interactions. To reveal the behavior of fluid instabilities in the cirrus bands, linear stability analyses in a basic state constructed from the radiosonde observations were performed. The fastest-growing disturbance is highly similar to that of the previously known thermal-shear instability in a uniform and isolated unstable layer and the results obtained by radiosonde observations and numerical simulations. All of the results consistently indicate that thermal-shear instability is responsible for the formation of cirrus banding. Our results not only follow previous modeling studies but also provide observational support, quantification of the destabilization by the cloud-radiation interactions, as well as a theoretical basis of the thermal-shear instability in a complex environment near cirrus bands.
Primary Repair of Traumatic Complete Pancreatic Rupture
Authors: Venianaki Maria , Ierodiakonou Despoina , Chryssou Evangelia , Chrysos Emmanuel , Chalkiadakis Georgios , Lasithiotakis Konstantinos 
Published: August 2021

Isolated pancreatic injury with transection of the pancreatic duct is generally treated with pancreatic resection, but the optimal management is not based on high-level evidence. Herein, we report a case of primary repair of complete rupture of the pancreas and pancreatic duct after a blunt abdominal trauma and a review of the literature. A 33-year-old patient had an isolated pancreatic injury after blunt abdominal trauma. At laparotomy, an even transection was found with minimal necrosis and tissue loss and an end-to-end anastomosis of the duct and the parenchyma with omental patch was performed. Patient’s postoperative course was complicated by a 6 cm pseudocyst and a low output pancreatic fistula which did not require any intervention and were self-limited. In the literature, 17 cases with primary repair of similar grade IV pancreatic injuries have been reported. Postoperative complications included mostly fistulas and pseudocysts.
Financial and Intellectual Conflicts of Interest Among Japanese Clinical Practice Guidelines Authors for Allergic Rhinitis
Authors: Murayama Anju , Kida Futa , Ozaki Akihiko , Saito Hiroaki , Sawano Toyoaki , Tanimoto Tetsuya 
Published: August 2021

ObjectiveTo elucidate financial and intellectual conflicts of interest (COIs) among clinical practice guideline (CPG) authors of allergic rhinitis in Japan and to evaluate the extent of transparency and accuracy in COIs by CPG authors of allergic rhinitis.Study DesignA cross‐sectional analysis of the payment data from all 79 pharmaceutical companies in Japan between 2016 and 2017.SettingJapan.MethodsWe considered all 27 CPG authors from 2 different versions of the most prominent CPGs for allergic rhinitis in Japan. Using payment data disclosed by 79 major pharmaceutical companies between 2016 and 2017, we assessed the magnitude and characteristics of financial COIs of CPG authors. We also evaluated the intellectual COIs of the CPG authors by counting self‐citations of research articles related to CPG statements and recommendations.ResultsOf 27 CPG authors, 26 authors (96.3%) received at least 1 payment from a combined total of $1,333,552 between 2016 and 2017. The 2‐year combined average and median monetary values per author were $49,391 (SD, $67,438) and $18,400 (interquartile range: $6,216‐$72,494), respectively. Pharmaceutical companies with novel drugs predominantly made these payments. The percentage of citations with at least 1 CPG author relative to total citations was 47.6% in 2016 and 27.9% in 2020. There were no formal COI disclosure statements in either version.ConclusionThis study found that allergic rhinitis CPG authors had significant financial relationships with pharmaceutical companies, particularly those marketing novel drugs. In addition, CPG authors had relatively high self‐citation rates, a potential marker of intellectual COIs. More rigorous and comprehensive COI management strategies are needed.