bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends in prescription of psychotropic medications to children and adolescents in Australian primary care from 2011 to 2018
Authors: Klau Julie , Bernardo Carla De Oliveira , Gonzalez-Chica David Alejandro , Raven Melissa , Jureidini Jon 
Published: December 2021

Objective: To examine trends in prescribing psychotropic medications to children and adolescents in Australian primary care from 2011 to 2018. Method: A retrospective cohort study examined prescriptions written by general practitioners using MedicineInsight, a large Australian primary care database, covering approximately 9% of all general practitioner practices. Numbers of patients receiving prescriptions for five main classes of psychotropics (antipsychotics, antidepressants, attention deficit hyperactivity disorder medications, anxiolytics, and hypnotics/sedatives [including benzodiazepines and Z-drugs, but excluding melatonin]) were examined annually by age-group (0–4, 5–9, 10–14, 15–18 years). Melatonin was analysed separately. Results: The number of patients prescribed any psychotropic increased from 25.6 to 36.2 per 1000 individuals from 2011 to 2018 (average annual increase +4.5%, 95% confidence interval [4.1%, 4.9%]; overall +41.4%). Among the five main classes, the largest annual increase was for attention deficit hyperactivity disorder medications (+9.6%, 95% confidence interval [8.8%, 10.5%]; overall +95.8%), followed by antipsychotics (+6.2%, 95% confidence interval [5.0%, 7.3%]; overall +62.8%) and antidepressants (+4.5%, 95% confidence interval [4.0%, 5.0%]; overall +42.8%). Hypnotic/sedative prescribing decreased on average 6.5% per year (95% confidence interval [–8.0%, –5.0%]; overall −40.2%). Anxiolytic prescribing remained steady. Melatonin prescriptions showed the highest increase of all (+24.7%, 95% confidence interval [23.7%, 25.8%]; overall +606.7%). The largest annual increase in antipsychotic, antidepressant or attention deficit hyperactivity disorder medication prescribing occurred in 10- to 14-year-olds (+7.5%, +6.5% and +10.4%, respectively). The largest point prevalence occurred in 2018 among 15- to 18-year-olds, with 98.5 per 1000 prescribed antidepressants. Antidepressants were more frequently prescribed to females; antipsychotics, attention deficit hyperactivity disorder medications and melatonin more often to males. The most prescribed antipsychotics were risperidone (<15 years) and quetiapine (15- to 18-year-olds). Fluoxetine was the most prescribed antidepressant in those aged 5+ years and amitriptyline in 0- to 4-year-olds. Conclusion: General practitioner prescribing of melatonin, antipsychotics, antidepressants and attention deficit hyperactivity disorder medications to under-19-year-olds increased markedly from 2011 to 2018. Although benzodiazepine and Z-drug prescriptions declined, this was offset by a substantial increase in melatonin prescribing.
Grab Bar Use Influences Fall Hazard During Bathtub Exit
Authors: Levine Iris C. , Montgomery Roger E. , Novak Alison C. 
Published: December 2021

Objective This study evaluated the hazard (risk of unrecovered balance loss and hazardous fall) and strategies associated with grab bar use, compared to no grab bar use, during unexpected balance loss initiated whilst exiting a bathtub. Background While independent bathing is critical for maintaining self-sufficiency, injurious falls during bathing transfer tasks are common. Grab bars are recommended to support bathing tasks, but no evidence exists regarding fall prevention efficacy. Method Sixty-three adults completed a hazardous bathtub transfer task, experiencing an unpredictable external balance perturbation while stepping from a slippery bathtub to a dry surface. Thirty-two were provided a grab bar, while 31 had no grab bar available. Slips and grab bar use were recorded via four video cameras. Slip occurrence and strategy were identified by two independent video coders. Results Participants who had a grab bar were 75.8% more likely to recover their balance during the task than those who did not have a grab bar. Successful grab bar grasp was associated with balance recovery in all cases. Attempts to stabilize using other environmental elements, or using internal strategies only, were less successful balance recovery strategies. Grab bar presence appeared to cue use of the environment for stability. Proactive grasp and other strategies modified grasping success. Conclusion Grab bars appear to provide effective support for recovery from unexpected balance loss. Grab bar presence may instigate development of fall prevention strategies prior to loss of balance. Application Bathroom designs with grab bars may reduce frequency of fall-related injuries during bathing transfer tasks.
Cryogenic thermal insulating and mechanical properties of rigid polyurethane foams blown with hydrofluoroolefin: Effect of perfluoroalkane
Authors: Kim Tae Seok , Lee Yeongbeom , Hwang Chul Hyun , Song Kwang Ho , Kim Woo Nyon 
Published: December 2021

The effect of perfluoroalkane (PFA) on the morphology, thermal conductivity, mechanical properties and thermal stability of rigid polyurethane (PU) foams was investigated under ambient and cryogenic conditions. The PU foams were blown with hydrofluorolefin. Morphological results showed that the minimum cell size (153 μm) was observed when the PFA content was 1.0 part per hundred polyols by weight (php). This was due to the lower surface tension of the mixed polyol solution when the PFA content was 1.0 php. The thermal conductivity of PU foams measured under ambient (0.0215 W/mK) and cryogenic (0.0179 W/mK at −100°C) conditions reached a minimum when the PFA content was 1.0 php. The low value of thermal conductivity was a result of the small cell size of the foams. The above results suggest that PFA acted as a nucleating agent to enhanced the thermal insulation properties of PU foams. The compressive and shear strengths of the PU foams did not appreciably change with PFA content at either −170°C or 20°C. However, it shows that the mechanical strengths at −170°C and 20°C for the PU foams meet the specification. Coefficient of thermal expansion, and thermal shock tests of the PU foams showed enough thermal stability for the LNG carrier’s operation temperature. Therefore, it is suggested that the PU foams blown by HFO with the PFA addition can be used as a thermal insulation material for a conventional LNG carrier.
Coastal development in southwestern Bangladesh: understanding the interplay between storms and sea level rise
Authors: Haque Md. Masidul , Ghosh Manoj Kumer , Hoyanagi Koichi 
Published: December 2021

Sea-level rise and sediment supply have influenced coastal morphology and sedimentation on Bangladesh’s southwestern Ganges‐Brahmaputra‐Meghna (GBM) delta coast. Satellite images and geological core from the Haringhata coastal region were analyzed to explain the morphological changes and to understand the influences on deposits. The results derived from satellite images indicate that the southern coastline experienced a retreat that ranges between 2.3 and 2.9 km. In contrast, the eastern and western coastline advanced. The erosion and accretion ratio was 0.29 from 1977 to 1989, while the ratio was higher 2.90–4.77 from 1989 to 2020. Two sedimentary facies were identified using 130 cm thick successions. A parallel to wavy laminated bluish gray mud facies of deeper part was deposited in a marine-influenced environment. A planar to hummocky cross stratified, gray to grayish white silty sand facies of storm overwash deposits overlies the mud facies with sharp contacts. Unimodal to bimodal grain distributions of sandy sediments suggest two sources: sand derived from the beach and mud carried by adjacent tidal rivers and resuspended offshore sediment. Coastline dynamics and sedimentation of the area were influenced by inequality of accommodation and sediment supply ratio in the river mouth. This occurs due to sea-level rise and deficit in upstream water and sediment discharge. Morphological change along the southwestern GBM delta coast was not only caused by wave energy, but also by rising sea levels which shifted sediment accommodation space landward.
An inverse relationship between moisture and grazing intensity in an arid mountain-basin system
Authors: Zhang Jun , Huang Xiao-zhong , Wang Jia-le , Bradshaw Richard HW , Wang Tao , Xiang Li-xiong , Luo De-rui , Wang Zong-li , Chen Fa-hu 
Published: December 2021

Precipitation has been suggested as a crucial influencing factor in the primary productivity in arid and semi-arid regions, yet how moisture fluctuation in an arid mountain-basin system of the north Qinghai–Tibetan Plateau has affected human activities is poorly understood. Here, we reconstruct the variations of grazing intensity in high elevations and regional humidity based on independent and high-resolution records of Sporormiella-type coprophilous fungal spores and pollen grains in the same well-dated sediment core from Lake Tian’E in the western Qilian Mountains over the past 3500 years. We find that stronger grazing activity was associated with low regional effective moisture, and propose that the drier regional climate pushed people and their livestock into the mountainous areas. A notable exception was a reduction of human and grazing activities in arid region with high mountains during 380–580 CE caused by centennial-length dry and cold conditions. In addition, it is also noteworthy that intensified grazing activity occurred during 580–720 CE and after ∼1920 CE, corresponding to a warmer and wetter climate and diverse subsistence strategies with social developments in the lowlands of the Hexi Corridor. Our findings potentially provide a historical reference for understanding how ancient people adapted to the climate change in arid region with high mountains.
Estimation of haemodynamic changes in varicocele testis and results after microsurgical sub-inguinal varicocelectomy
Authors: Sharma Satyadeo , Shimpi Rajendra K 
Published: December 2021

Introduction: Varicocele is among the most frequently encountered, surgically correctable causes of male infertility. Since varicocele is a primary abnormality of testicular vessels, a thorough understanding of haemodynamic changes in the microcirculation of varicocele testis is needed. Objectives: To estimate changes in the microcirculation of varicocele testis and correlate them with symptomatic and semen parameters changes before and after varicocelectomy. Material and methods: This prospective, observational study includes 47 patients of age group 18–40 years who underwent microsurgical varicocelectomy during June 2016 to April 2018 at a tertiary medical institute. Testicular haemodynamic was evaluated using a colour spectral doppler study (PSV-Peak systolic velocity/ESV-End diastolic velocity/RI-Resistive index/PI-Pulsatility index). Semen analysis parameters and testicular blood flow were compared with pre-operative values. Results: RI in the capsular artery of varicocele affected testis, which was 0.61 ± 0.11 (mean ± SD), significantly reduced to 0.56 ± 0.09 (mean ± SD) in post-operative follow-up, indicating improved perfusion. Pre-operative sperm density was noted to be 15.94 ± 7.88 (mean ± SD), which improved to 28.41 ± 10.99, Progressive sperm motility from 33.81 ± 10.88 to 38.32 ± 9.21 and morphology from 36.13 ± 10.68 to 41.43 ± 9.29 on 6-month follow-ups ( p < 0.05). Conclusion: Varicocele testis is associated with altered testicular haemodynamic, which insults spermatogenesis. Microsurgical varicocelectomy with testicular artery and lymphatic preservation leads to correction of this altered haemodynamic state and improves the testicular microcirculation.
Addition of CT to Improve the Diagnostic Confidence for the Detection of Sacroiliac Joint Erosions in Patients with Equivocal MRI Findings
Authors: Nadeem Ibrahim M. , Munir Sohaib , Leung Vincent , Stubbs Euan 
Published: December 2021

Purpose To determine if CT can improve the diagnostic confidence for the detection of sacroiliac joint (SIJ) erosions in patients with equivocal MRI findings. Methods A retrospective analysis of adult patients who had an SIJ MRI and a subsequent SIJ CT within 12 months was conducted. Using a 5-point Likert scale, two reviewers evaluated the de-identified MRI and CT images in randomized order and in separate sessions to answer the question: “Does the patient have SIJ erosions?”. A Fisher’s exact test was used to analyze the difference in diagnostic confidence, and intraclass correlation coefficient (ICC) was used to determine interrater reliability. Results 54 patients were included in the analysis (average age, 43.9 years). The average time interval between initial SIJ MRI and subsequent CT was 14.4 weeks (range, 5.6–50.3 weeks). CT resulted in significantly more cases with definitive diagnostic confidence than cases with probable or equivocal confidence compared to MRI ( P < .001). Amongst cases with equivocal findings on MRI, 73.2% of cases had definitive diagnoses on CT. There was moderate interrater agreement for MRI, with an ICC of .490 [95% CI, .258–.669], and excellent agreement for CT, with an ICC of .832 [95% CI, .728–.899]. Conclusion Overall, CT led to significantly increased diagnostic confidence and higher interrater reliability for the detection of SIJ erosions compared to MRI. Judicious use of CT may be useful in detecting SIJ erosions in patients with equivocal MRI findings.
The Long-Term Impact of Childhood Disability on Mental Health Trajectories in Mid- to Late-Life
Authors: West Jessica S. , Kamis Christina 
Published: December 2021

Objectives We draw from the life course and stress process frameworks to examine how experiencing disability in early life influences mental health in adulthood. Methods Data come from the Health and Retirement Study Cross-Wave Childhood Health and Family Aggregated Data file (2008-2018, n = 15,289). Childhood disability status is a retrospective self-report of whether respondents were disabled for six months or more because of a health problem before the age of 16 ( n = 581). We used age-based growth curve models to construct trajectories of depressive symptoms by childhood disability status. Results Respondents who experienced childhood disability exhibit more depressive symptoms at age 50 compared to those who did not experience this stressor. However, there is no difference in the growth of depressive symptoms with age between these groups, suggesting maintained inequality over the late adulthood life course. Discussion Findings suggest that childhood disability has long-term implications for life course mental health.
Factors associated with offering HIV testing to people aged ≥ 50 years: A qualitative study
Authors: Youssef Elaney , Wright Juliet , A Davies Kevin , Delpech Valerie , Brown Alison , Cooper Vanessa , Sachikonye Memory , de Visser Richard 
Published: December 2021

Background Individuals aged ≥ 50 years continue to be disproportionately affected by late HIV diagnosis, which is associated with poorer health outcomes and onward transmission. Despite HIV testing guidelines and high acceptability of HIV testing among all patients, clinicians are less likely to offer a test to an older individual. The aim of this study was to identify clinician-related factors associated with offering HIV testing to patients aged ≥ 50 years. Methods Twenty clinicians who had been involved in the care of an older patient diagnosed late with HIV were interviewed. Results Thematic analysis identified seven factors associated with offering HIV testing to older people: knowledge, stigma, stereotyping and perception of risk, symptom attribution, discussing HIV with patients, consent procedures and practical issues. Conclusions Although some factors are not unique to older patients, some are unique to this group. Many clinicians lack up-to-date HIV-related knowledge, feel anxious discussing HIV with older patients and perceive asexuality in older age. In order to increase the offer of HIV testing to this group, we identified clinician-related barriers to test offer that need to be addressed.
Pepaxto: A New Peptide-Drug Conjugate for Heavily Pretreated Relapsed and Refractory Multiple Myeloma
Authors: Jessee Jeremiah K. 
Published: December 2021

Objective: The objective of this article was to review existing data of melflufen (Pepaxto) as an additional treatment option for heavily pretreated relapsed and refractory multiple myeloma. Data sources: A PubMed search was completed using the search terms melphalan flufenamide; melflufen; melflufen AND relapsed refractory multiple myeloma; melphalan flufenamide and relapsed refractory multiple myeloma between January 1, 2013, and October 18, 2021. Additional information was obtained from the National Institutes of Health Clinical Trial Registry, Federal Drug Administration (FDA) web updates, and Pepaxto prescribing information. Study selection/data extraction: Clinical trials including melflufen in relapsed refractory multiple myeloma and trials related to safety and clinical pharmacology were included. Data synthesis: The findings of this review show melflufen in combination with dexamethasone can be used as a treatment option for patients with relapsed and refractory multiple myeloma who have previously received greater than 4 previous lines of therapy, and documented resistance to a proteosome inhibitor, an anti-CD38 monoclonal antibody, and an immunomodulator. Relevance to patient care and clinical practice: Melflufen in combination with dexamethasone is a reasonable option for patients with relapsed and refractory multiple myeloma who have received at least 4 previous lines of therapy and considered ineligible for autologous stem cell transplant. Further clinical utilization in earlier lines of therapy is under review, pending the in-depth safety analysis by the FDA. Conclusions: The FDA approval of melflufen in combination with dexamethasone provides an additional therapy option for patients with heavily pretreated relapsed and refractory multiple myeloma.
Development of MDS-Based Predication Model for COPD Severity in Nursing Home Residents
Authors: Blaylock Barbara , Niu Xiaoli , Davidson H. Edward , Gravenstein Stefan , DePue Ronald , Williams G. Rhys , Steinberg Karl E. 
Published: December 2021

Background Assessing chronic obstructive pulmonary disease (COPD) severity is challenging in nursing home (NH) residents due to incomplete symptom assessments and exacerbation history. Objective The objective of this study was to predict COPD severity in NH residents using the Minimum Data Set (MDS), a clinical assessment of functional capabilities and health needs. Methods A cohort analysis of prospectively collected longitudinal data was conducted. Residents from geographically varied Medicare-certified NHs with age ≥60 years, COPD diagnosis, and ≥6 months NH residence at enrollment were included. Residents with severe cognitive impairment were excluded. Demographic characteristics, medical history, and MDS variables were extracted from medical records. The care provider–completed COPD Assessment Test (CAT) and COPD exacerbation history were used to categorize residents by Global Initiative for Chronic Lung Disease (GOLD) A to D groups. Multivariate multinomial logit models mapped the MDS to GOLD A to D groups with stepwise selection of variables. Results Nursing home residents (N = 175) were 64% women and had a mean age of 77.9 years. Among residents, GOLD B was most common (A = 13.1%; B = 44.0%; C = 5.7%; D = 37.1%). Any long-acting bronchodilator (LABD) use and any dyspnea were significant predictors of GOLD A to D groups. The predicted MDS-GOLD group (A = 6.9%; B = 52.6%; C = 4.6%; D = 36.0%) showed good model fit (correctly predicted = 60.6%). Nursing home residents may underuse group-recommended LABD treatment (no LABD: B = 53.2%; C = 80.0%; D = 40.0%). Conclusion and Relevance The MDS, completed routinely for US NH residents, could potentially be used to estimate COPD severity. Predicted COPD severity with additional validation could provide a map to evidence-based treatment guidelines and may help to individualize treatment pathways for NH residents.
Fibula Nail Outcomes in Soft Tissue Compromised Ankle Fractures
Authors: Ahmed Maryam , Barrie Andrew , Kozhikunnath Arun , Thimmegowda Abilash , Ho Sebastian , Kunasingam Kumar , Guryel Enis , Ahluwalia Raju , Ladha Nafisah , Horseman Laura , Fell Adam , Perera Edward , Bhadresha Ashwin , Qamar Mubasher , Bowyer Henry , Basma Zeinab , West Alexander , Bradbury Jack , Gajula Parthasaradhi , Mahmood Ansar , Ochogwu Joanna , Mcdonald Stephen , Bishop Kilanalei , Fung Amy 
Published: December 2021

Background: To determine the clinical outcomes following fibula nail fixation and to identify the indication for the use of fibula nails in lower limb fractures. Methods: Retrospective study of adult patients from 2 major trauma centers (MTCs) and 9 trauma units (TUs) who underwent fibula nail fixation for AO/OTA 44 fractures between January 1, 2018, and October 31, 2020. Outcome measures included infection, metalwork complications, nonunion or malunion, time to union, and length of inpatient hospital stay. Results: Ninety-five patients were included, with a mean age of 66 years; 57.9% of patients were female. The average body mass index was 30. Sixty-nine patients (72.6%) sustained a Weber B and 24 (27.4%) sustained a Weber C fracture. In addition, 26.3% were open fractures and all patients had soft tissue compromise affecting the lateral malleolus. The calculated infection rate for fibula nail was 4.2% and metalwork complication rate was 5.2%. The nonunion and malunion rate was 8.4% and rate of removal of hardware was 2.1%. The average time to union was 12.5 weeks, and length of inpatient stay was 9.4 days (SD 10). Conclusion: This multicenter study demonstrates that use of a fibula nail appears to be a safe approach to treating patients who have a physiologically higher risk of surgery, poor skin condition, and a complex fracture pattern. Level of Evidence: Level III, case-control study.
Depressive Symptoms Account for Loss of Positive Attention Bias in ADHD Patients: An Eye-Tracking Study
Authors: Schuthof Cassandra C. , Tendolkar Indira , Bergman Maria Annemiek , Klok Margit , Collard Rose M. , van Eijndhoven Philip F.P. , Schene Aart H. , Vrijsen Janna N. 
Published: December 2021

Objectives: Depression and ADHD often co-occur and are both characterized by altered attentional processing. Differences and overlap in the profile of attention to emotional information may help explain the co-occurence. We examined negative attention bias in ADHD as neurocognitive marker for comorbid depression. Methods: Patients with depression ( n = 63), ADHD ( n = 43), ADHD and depression ( n = 25), and non-psychiatric controls ( n = 68) were compared on attention allocation toward emotional faces. The following eye-tracking indices were used: gaze duration, number of revisits, and location and duration of first fixation. Results: Controls revisited the happy faces more than the other facial expressions. Both the depression and the comorbid group showed significantly less revisits of the happy faces compared to the ADHD and the control group. Interestingly, after controlling for depressive symptoms, the groups no longer differed on the number of revisits. Conclusion: ADHD patients show a relative positive attention bias, while negative attention bias in ADHD likely indicates (sub)clinical comorbid depression.