bluuebunny/crossref_metadata_2025_split huggingface dataset:
Longitudinal Perspectives on Children’s Physical Activity Patterns: “Do Physical Education–Related Factors Matter?”
Authors: Adank Anoek M. , Van Kann Dave H.H. , Remmers Teun , Kremers Stef P.J. , Vos Steven B. 
Published: August 2021

Background: This study examined longitudinal associations of motor competence (MC) and physical activity (PA) enjoyment with moderate to vigorous PA and sedentary behavior among boys and girls aged 10–12 years old. In addition, this study explored the predictive strength of satisfaction of basic psychological needs in physical education (PE) and PA enjoyment. Methods: At 3 time points (baseline, +1 y, and +2 y), PA levels, MC, PA enjoyment, satisfaction of basic psychological needs in PE and height and weight of 371 children were measured. Data were analyzed using repeated-measures linear mixed model analyses stratified for gender and adjusted for relevant covariates. Results: Sedentary behavior decreased over time and was significantly predicted by PA enjoyment in boys and by PA enjoyment and MC in girls. Boys’ moderate to vigorous PA decreased over time and was predicted by MC, whereas girls’ moderate to vigorous PA remained low, yet stable over time and was predicted by PA enjoyment and MC. Furthermore, children’s need for competence and teacher relatedness (girls only) during PE significantly predicted PA enjoyment. Conclusions: Children need sufficient and well-designed opportunities to improve their MC and PA enjoyment. PE may be pivotal in advancing PA enjoyment, indicating that PE could have more beneficial effects on PA levels in children, especially in girls.
Spectral Stability Conditions for an Explicit Three-Level Finite-Difference Scheme for a Multidimensional Transport Equation with Perturbations
Authors: Zlotnik A. A. , Chetverushkin B. N. 
Published: August 2021

AbstractWe study difference schemes associated with a simplified linearized multidimensional hyperbolic quasi-gasdynamic system of differential equations. It is shown that an explicit two-level vector difference scheme with flux relaxation for a second-order hyperbolic equation with variable coefficients that is a perturbation of the transport equation with a parameter multiplying the highest derivatives can be reduced to an explicit three-level difference scheme. In the case of constant coefficients, the spectral condition for the time-uniform stability of this explicit three-level difference scheme is analyzed, and both sufficient and necessary conditions for this condition to hold are derived, in particular, in the form of Courant type conditions on the ratio of temporal and spatial steps.
Compact Difference Schemes on a Three-Point Stencil for Second-Order Hyperbolic Equations
Authors: Matus P. P. , Hoang Thi Kieu Anh  
Published: August 2021

Abstract
We consider compact difference schemes of approximation order $$4+2
$$ on a three-point spatial stencil for the
Klein–Gordon equations with constant and variable coefficients. New compact schemes are
proposed for one type of second-order quasilinear hyperbolic equations. In the case of constant
coefficients, we prove the strong stability of the difference solution under small perturbations of
the initial conditions, the right-hand side, and the coefficients of the equation. A priori estimates
are obtained for the stability and convergence of the difference solution in strong mesh norms.
Video-based reflection on neonatal interventions during COVID-19 using eye-tracking glasses: an observational study
Authors: Wagner Michael , den Boer Maria C , Jansen Sophie , Groepel Peter , Visser Remco , Witlox Ruben S G M , Bekker Vincent , Lopriore Enrico , Berger Angelika , te Pas Arjan B 
Published: August 2021

ObjectiveThe aim of this study was to determine the experience with, and the feasibility of, point-of-view video recordings using eye-tracking glasses for training and reviewing neonatal interventions during the COVID-19 pandemic.DesignObservational prospective single-centre study.SettingNeonatal intensive care unit at the Leiden University Medical Center.ParticipantsAll local neonatal healthcare providers.InterventionThere were two groups of participants: proceduralists, who wore eye-tracking glasses during procedures, and observers who later watched the procedures as part of a video-based reflection.Main outcome measuresThe primary outcome was the feasibility of, and the proceduralists and observers’ experience with, the point-of-view eye-tracking videos as an additional tool for bedside teaching and video-based reflection.ResultsWe conducted 12 point-of-view recordings on 10 different patients (median gestational age of 30.9±3.5 weeks and weight of 1764 g) undergoing neonatal intubation (n=5), minimally invasive surfactant therapy (n=5) and umbilical line insertion (n=2). We conducted nine video-based observations with a total of 88 observers. The use of point-of-view recordings was perceived as feasible. Observers further reported the point-of-view recordings to be an educational benefit for them and a potentially instructional tool during COVID-19.ConclusionWe proved the practicability of eye-tracking glasses for point-of-view recordings of neonatal procedures and videos for observation, educational sessions and logistics considerations, especially with the COVID-19 pandemic distancing measures reducing bedside teaching opportunities.
Observational cohort study of changing trends in non-invasive ventilation in very preterm infants and associations with clinical outcomes
Authors: Sand Laura , Szatkowski Lisa , Kwok T'ng Chang , Sharkey Don , Todd David A , Budge Helen , Ojha Shalini 
Published: August 2021

ObjectiveTo determine the change in non-invasive ventilation (NIV) use over time in infants born at <32 weeks’ gestation and the associated clinical outcomes.Study designRetrospective cohort study using routinely recorded data from the National Neonatal Research Database of infants born at <32 weeks admitted to neonatal units in England and Wales from 2010 to 2017.ResultsIn 56 537 infants, NIV use increased significantly between 2010 and 2017 (continuous positive airway pressure (CPAP) from 68.5% to 80.2% in 2017 and high flow nasal cannula (HFNC) from 14% to 68%, respectively) (p<0.001)). Use of NIV as the initial mode of respiratory support also increased (CPAP, 21.5%–28.0%; HFNC, 1%–7% (p<0.001)).HFNC was used earlier, and for longer, in those who received CPAP or mechanical ventilation. HFNC use was associated with decreased odds of death before discharge (adjusted OR (aOR) 0.19, 95% CI 0.17 to 0.22). Infants receiving CPAP but no HFNC died at an earlier median chronological age: CPAP group, 22 (IQR 10–39) days; HFNC group 40 (20–76) days (p<0.001). Among survivors, HFNC use was associated with increased odds of bronchopulmonary dysplasia (BPD) (aOR 2.98, 95% CI 2.81 to 3.15) and other adverse outcomes.ConclusionsNIV use is increasing, particularly as initial respiratory support. HFNC use has increased significantly with a sevenfold increase soon after birth which was associated with higher rates of BPD. As more infants survive with BPD, we need robust clinical evidence, to improve outcomes with the use of NIV as initial and ongoing respiratory support.
Youth ice hockey COVID-19 protocols and prevention of sport-related transmission
Authors: Krug Allison , Appleby Richard , Pizzini Robert , Høeg Tracy Beth 
Published: August 2021

ObjectivesThis observational study evaluated the impact of return-to-play protocols to prevent transmission of SARS-CoV-2 in a youth ice hockey programme in Virginia Beach, Virginia.MethodsFollowing an outbreak of SARS-CoV-2 in November 2020, a COVID-19 Response Team evaluated the epidemiological data to identify transmission dynamics and develop enhanced protocols to prevent transmission. During the subsequent 18-week study period, incident cases were investigated to identify the likely transmission source; testing, quarantine and isolation recommendations were provided to families in accordance with Centers for Disease Control and Prevention guidelines.ResultsSimple but stringent protocols were implemented among 148 youth ice hockey players ages 6–18. Players were required to arrive at the rink in full gear; locker rooms were closed, building entry was limited to one parent per player, and masks were required at all times except for players on the ice. Following implementation of the enhanced protocols, more than 500 practices and games were completed with at least 15 858 athlete-hours of exposure and no within-programme COVID-19 transmission was detected despite high community incidence and sporadic household exposures.ConclusionThis study suggests indoor youth sports can operate safely with appropriate protocols in place, even within communities of high COVID-19 transmission, even when athletes are not yet vaccinated or wearing masks during play. Transmission appears to be more likely in congested indoor areas involving adults than on the ice during play. Protocols should be developed in collaboration with programme participants. Strong collaboration in the interest of youth sports can motivate adoption of protocols which prevent within-team transmission.
Identifying patients with cerebral infarction within the time window compatible with reperfusion therapy, diagnostic performance of glutathione S-transferase-π (GST-π) and peroxiredoxin 1 (PRDX1): exploratory prospective multicentre study FLAG-1 protocol
Authors: Karakus Arif , Girerd Nicolas , Sanchez Jean-Charles , Sabben Candice , Wietrich Anthony , Lavandier Karine , Marchal Sophie , Aubertin Anne , Humbertjean Lisa , Mione Gioia , Bouali Sanae , Duarte Kevin , Reymond Sandrine , Gory Benjamin , Richard Sébastien 
Published: August 2021

IntroductionPlasma biomarkers may be useful in diagnosing acute cerebral infarction requiring urgent reperfusion, but their performance remains to be confirmed. If confirmed, these molecules could be used to develop rapid and reliable decentralised measurement methods, making it possible to initiate reperfusion therapy before hospital admission. The FLAG-1 large prospective study will constitute a plasma bank to assess the diagnostic performance of two biomarkers: glutathione S-transferase-π and peroxiredoxin 1. These molecules are involved in the oxidative stress response and could identify cerebral infarction within a therapeutic window of less than 4.5 hours following the onset of symptoms. Secondary objectives include assessing performance of these biomarkers within 3-hour and 6-hour windows; identifying additional biomarkers diagnosing cerebral infarction and significant criteria guiding therapeutic decisions: ischaemic features of stroke, presence of diffusion/fluid-attenuated inversion recovery mismatch, volume of cerebral infarction and penumbra on cerebral MRI.Methods and analysisThe exploratory, prospective, multicentre FLAG-1 Study will include 945 patients with acute stroke symptoms (onset ≤12 hours, National Institute of Health Stroke Scale score ≥3). Each patient’s 25 mL blood sample will be associated with cerebral MRI data. Two patient groups will be defined based on the time of blood collection (before and after 4.5 hours following onset). Receiver operating characteristic analysis will determine the diagnostic performance of each biomarker, alone or in combination, for the identification of cerebral infarction <4.5 hours.Ethics and disseminationThe protocol has been approved by an independent ethics committee. Biological samples are retained in line with best practices and procedures, in accordance with French legislation. Anonymised data and cerebral imaging records are stored using electronic case report forms and a secure server, respectively, registered with the French Data Protection Authority (Commission Nationale de l"Informatique et des Libertés (CNIL)). Results will be disseminated through scientific meetings and publication in peer-reviewed medical journals.Trial registration numberClinicalTrials.gov Registry (NCT03364296).
Internet-based cognitive–behavioural therapy for tinnitus: secondary analysis to examine predictors of outcomes
Authors: Rodrigo Hansapani , Beukes Eldré W , Andersson Gerhard , Manchaiah Vinaya 
Published: August 2021

ObjectivesThe current study examined predictors of outcomes of internet-based cognitive–behavioural therapy (ICBT) for individuals with tinnitus.DesignSecondary analysis of intervention studies.SettingInternet-based guided tinnitus intervention provided in the UK.Participants228 individuals who underwent ICBT.InterventionsICBT.Primary and secondary outcome measuresThe key predictor variables included demographic, tinnitus, hearing-related and treatment-related variables as well as clinical factors (eg, anxiety, depression, insomnia), which can have an impact on the treatment outcome. A 13-point reduction in Tinnitus Functional Index (TFI) scores has been defined as a successful outcome.ResultsOf the 228 subjects who were included in the study, 65% had a successful ICBT outcome. As per the univariate analysis, participants with a master’s degree or above had the highest odds of having a larger reduction in tinnitus severity (OR 3.47; 95% CI 1.32 to 12.51), compared with the participants who had education only up to high school or less. Additionally, the baseline tinnitus severity was found to be a significant variable (OR 2.65; 95% CI 1.50 to 4.67) contributing to a successful outcome with the intervention. Both linear and logistic regression models have identified education level and baseline tinnitus severity to be significant predictor variables contributing to a reduction in tinnitus severity post-ICBT. As per the linear regression model, participants who had received disability allowance had shown a 25.3-point lower TFI reduction compared with those who did not experience a decrease in their workload due to tinnitus after adjusting for baseline tinnitus severity and their education level.ConclusionsPredictors of intervention outcome can be used as a means of triaging patients to the most suited form of treatment to achieve optimal outcomes and to make healthcare savings. Future studies should consider including a heterogeneous group of participants as well as other predictor variables not included in the current study.ClinicalTrial.gov Registration:NCT02370810(completed);NCT02665975(completed)
Early warning and rapid public health response to prevent COVID-19 outbreaks in long-term care facilities (LTCF) by monitoring SARS-CoV-2 RNA in LTCF site-specific sewage samples and assessment of antibodies response in this population: prospective study protocol
Authors: Lee Bonita E , Sikora Christopher , Faulder Douglas , Risling Eleanor , Little Lorie A , Qiu Yuanyuan , Gao Tiejun , Bulat Ross , Craik Stephen , Hrudey Steve E , Ohinmaa Arto , Estabrooks Carole A , Gingras Anne-Claude , Charlton Carmen , Kim John , Wood Heidi , Robinson Alyssia , Kanji Jamil N , Zelyas Nathan , O’Brien Sheila F , Drews Steven , Pang Xiao-Li 
Published: August 2021

IntroductionThe COVID-19 pandemic has an excessive impact on residents in long-term care facilities (LTCF), causing high morbidity and mortality. Early detection of presymptomatic and asymptomatic COVID-19 cases supports the timely implementation of effective outbreak control measures but repetitive screening of residents and staff incurs costs and discomfort. Administration of vaccines is key to controlling the pandemic but the robustness and longevity of the antibody response, correlation of neutralising antibodies with commercial antibody assays, and the efficacy of current vaccines for emerging COVID-19 variants require further study. We propose to monitor SARS-CoV-2 in site-specific sewage as an early warning system for COVID-19 in LTCF and to study the immune response of the staff and residents in LTCF to COVID-19 vaccines.Methods and analysisThe study includes two parts: (1) detection and quantification of SARS-CoV-2 in LTCF site-specific sewage samples using a molecular assay followed by notification of Public Health within 24 hours as an early warning system for appropriate outbreak investigation and control measures and cost–benefit analyses of the system and (2) testing for SARS-CoV-2 antibodies among staff and residents in LTCF at various time points before and after COVID-19 vaccination using commercial assays and neutralising antibody testing performed at a reference laboratory.Ethics and disseminationEthics approval was obtained from the University of Alberta Health Research Ethics Board with considerations to minimise risk and discomforts for the participants. Early recognition of a COVID-19 case in an LTCF might prevent further transmission in residents and staff. There was no direct benefit identified to the participants of the immunity study. Anticipated dissemination of information includes a summary report to the immunity study participants, sharing of study data with the scientific community through the Canadian COVID-19 Immunity Task Force, and prompt dissemination of study results in meeting abstracts and manuscripts in peer-reviewed journals.
Improving diagnostic performance through feedback: the Diagnosis Learning Cycle
Authors: Fernandez Branson Carolina , Williams Michelle , Chan Teresa M , Graber Mark L , Lane Kathleen P , Grieser Skip , Landis-Lewis Zach , Cooke James , Upadhyay Divvy K , Mondoux Shawn , Singh Hardeep , Zwaan Laura , Friedman Charles , Olson Andrew P J 
Published: August 2021

BackgroundErrors in reasoning are a common cause of diagnostic error. However, it is difficult to improve performance partly because providers receive little feedback on diagnostic performance. Examining means of providing consistent feedback and enabling continuous improvement may provide novel insights for diagnostic performance.MethodsWe developed a model for improving diagnostic performance through feedback using a six-step qualitative research process, including a review of existing models from within and outside of medicine, a survey, semistructured interviews with individuals working in and outside of medicine, the development of the new model, an interdisciplinary consensus meeting, and a refinement of the model.ResultsWe applied theory and knowledge from other fields to help us conceptualise learning and comparison and translate that knowledge into an applied diagnostic context. This helped us develop a model, the Diagnosis Learning Cycle, which illustrates the need for clinicians to be given feedback about both their confidence and reasoning in a diagnosis and to be able to seamlessly compare diagnostic hypotheses and outcomes. This information would be stored in a repository to allow accessibility. Such a process would standardise diagnostic feedback and help providers learn from their practice and improve diagnostic performance. This model adds to existing models in diagnosis by including a detailed picture of diagnostic reasoning and the elements required to improve outcomes and calibration.ConclusionA consistent, standard programme of feedback that includes representations of clinicians’ confidence and reasoning is a common element in non-medical fields that could be applied to medicine. Adapting this approach to diagnosis in healthcare is a promising next step. This information must be stored reliably and accessed consistently. The next steps include testing the Diagnosis Learning Cycle in clinical settings.
Anxiety and depression prevalence in digestive cancers: a systematic review and meta-analysis
Authors: Zamani Mohammad , Alizadeh-Tabari Shaghayegh 
Published: August 2021

BackgroundCancers of the digestive system can be associated with disturbing and disabling symptoms, which can contribute to a negative psychological pressure on patients.AimTo investigate the reported prevalence of symptoms of anxiety and depression in patients with major digestive cancers, including oesophageal, gastric, colorectal, pancreatic or hepatic cancers.MethodsWe searched Embase, PubMed, Scopus and Web of Science for articles published from inception to December 2020. We included studies reporting the prevalence of anxiety or depression symptoms using validated questionnaires in adult patients (≥18 years).ResultsIn total, 51 eligible papers were finally included. Overall, the pooled prevalence of anxiety symptoms was 20.4% (95% CI 17% to 23.8%). The estimate in patients with gastrointestinal (GI) cancers was 19.1% and in patients with hepatic cancer was 29.1%. Among GI cancers, the highest pooled prevalence of anxiety symptoms related to oesophageal cancer (20.6%), while the lowest pooled prevalence pertained to gastric cancer (18.7%). Regarding depression symptoms, the overall pooled prevalence was 30.2% (95% CI 24.3% to 36.1%). The estimate in patients with GI cancers was 31% and in patients with hepatic cancer was 21.5%. Among GI cancers, the highest pooled prevalence of depression symptoms related to oesophageal cancer (45.2%), while the lowest pooled prevalence pertained to colorectal cancer (22.9%).ConclusionA considerable prevalence of anxiety and depression symptoms is observed in patients with digestive cancers. Screening and preventive measures with early management of these psychological problems by clinicians could possibly improve outcomes for these patients.PROSPERO registration numberCRD42020210079.
PP18 Is there provider induced demand at emergency departments with primary care services? Patient, local and wider system factors described to influence demand for primary care in emergency departments: realist evaluation
Authors: Edwards Michelle , Cooper Alison , Stevens Andrew Carson , Edwards Adrian , Hughes Thomas , Snooks Helen , Anderson Pippa , Porter Alison , Evans Bridie , Dale Jeremy , Cooke Matthew , Hibbert Peter , Siriwardena Aloysius Niroshan 
Published: August 2021

BackgroundEvidence from evaluations of emergency departments (EDs) with co-located primary care services suggests that they influence additional demand for non-urgent care (provider-induced demand). In a realist review of the literature on the effects of primary care services in EDs we proposed a theory that when primary care services are distinct at an ED they may encourage additional primary care demand and when primary care clinicians work indistinctly in the ED there is no additional demand. We aimed to explore evidence for this theory and explain contexts, mechanisms and outcomes that influence such demand.MethodsWe used realist evaluation methodology and carried out observations of key processes. We interviewed 23 patients, 21 ED clinical directors, 26 other ED staff members and 26 GPs at 13 EDs (England & Wales). Field notes and audio-recorded interviews were transcribed and analysed by creating context, mechanism and outcome configurations to refine and develop theories relating to provider induced demand.ResultsEDs with distinct primary care services were perceived to attract more demand for primary care than EDs where primary care clinicians worked indistinctly because the primary care service was visible, widely known about, enabled direct access, and received NHS 111 referrals. Other influences on demand were patients’ experiences of accessing primary care, the capacity for urgent care in the community, location of the ED and public transport links, service design and developments (new buildings, renovations) and population characteristics (unfamiliarity with local healthcare services, not registered with a GP or different cultural perceptions of seeking health care).ConclusionsA range of patient, local-system and wider-system factors contribute to additional demand at an ED with co-located primary care services. Our findings can inform providers and policymakers in developing strategies to limit the effect of these influences on additional demand.