bluuebunny/crossref_metadata_2025_split huggingface dataset:
Parent and staff experiences of a feasibility trial evaluating neurally adjusted ventilatory assist in infants with acute viral bronchiolitis: A qualitative study
Authors: Harris Julia , Tibby Shane M. , Latour Jos M. 
Published: March 2024

AbstractBackgroundThere is limited literature regarding family and staff experiences of participating in clinical trials. A qualitative study was embedded in the NAVABronch feasibility trial evaluating the effectiveness of a novel mode of ventilation, neurally adjusted ventilatory assist (NAVA), in infants with acute viral bronchiolitis.AimThe aim of this qualitative study was to explore the experiences of parents and health care practitioners (HCPs) involved in the NAVABronch Trial.Study DesignSemi‐structured interviews were conducted with two parents and two focus groups were held with six HCPs.ResultsFour themes were identified from the focus groups: (1) Creating staff engagement, (2) Education to deliver NAVA, (3) Normalizing NAVA in clinical practice (4) Creating meaningful study outcomes and (5) support of parents during the trial, this theme was generated from the parent interviews. The findings indicated the need for education regarding NAVA for HCPs which would lead to increased confidence, better guidance around the use of NAVA and the need for NAVA to be normalized and embedded into the unit culture. Parents identified the need for further support around preparation for what may happen as a result of the interventions, particularly the weaning of sedation.ConclusionOur study indicates that staff and parents had no concerns regarding the trial methods and procedures.Relevance to Clinical PracticeConducting clinical trials in Paediatric Intensive Care Units (PICUs) is challenging and complex. There is limited literature regarding family and staff experiences of participating in clinical trials. Understanding their experiences is crucial in ensuring trial success.
Pediatric en bloc kidney transplant from donors <15 kg: An excellent approach to expand the pediatric deceased donor pool
Authors: Azzam Ahmad , Tawfeeq Mansour , Obeid Mahmoud , Khan Iftikhar , Almaghrabi Mohammed , AlQahtani Mohammed , Alshami Alanoud 
Published: March 2024

AbstractIntroductionMost kidneys from small pediatric donors are transplanted to adult recipients because of the perceived risk of surgical complications and graft thrombosis. In this study, we aim to demonstrate our favorable outcomes in transplanting pediatric kidneys from donors <15 k into pediatric recipients.MethodsThis study retrospectively analyzes the outcomes of seven pediatric recipients of en block kidney transplants from pediatric donors weighing <15 kg performed at King Fahad Specialist Hospital‐Dammam from December 2014 to January 2018.Baseline characteristics of donors and recipients were collected. The incidences of surgical complication, immediate, and intermediate graft function were the primary outcomes.ResultsThe study included seven recipients monitored for a mean duration of 6.86 ± 1.35. Donors’ and recipients’ mean weights were 7.4 ± 3.2 kg and 20.7 ± 9.2 kg, respectively. Ureteric stricture occurred in one patient. There was a substantial improvement of 1‐year estimated glomerular filtration rate (eGFR) compared to the 1‐week mark (106.7 ± 26.38 mL/min. 1.73 m2 vs. 63.7 ± 22.92 mL/min/1.73 m2, p = .0069). The observed improvement in renal function persisted at the 5‐year mark and during the last follow‐up, with eGFR of 70.3 ± 40.7 mL/min/1.73 m2, and 79.8 ± 30.8 mL/min/1.73 m2, respectively. There was also increase of 27.9% in the size of the en bloc kidney observed at the 6 months.ConclusionIn a specialized transplant center with highly skilled surgeons, the utilization of en bloc kidney transplant from donors weighing less than 15 kg is an effective strategy for expanding the donor pool and ensuring favorable graft outcomes.
Optimizing the approach to monitoring allograft inflammation using serial urinary CXCL10/creatinine testing in pediatric kidney transplant recipients
Authors: Barrett‐Chan Ella , Wang Li , Bone Jeffrey , Thachil Amy , Vytlingam Kevin , Blydt‐Hansen Tom 
Published: March 2024

AbstractBackgroundUrinary CXCL10/creatinine (uCXCL10/Cr) is proposed as an effective biomarker of subclinical rejection in pediatric kidney transplant recipients. This study objective was to model implementation in the clinical setting.MethodsBanked urine samples at a single center were tested for uCXCL10/Cr to validate published thresholds for rejection diagnosis (>80% specificity). The positive predictive value (PPV) for rejection diagnosis for uCXCL10/Cr‐indicated biopsy was modeled with first‐positive versus two‐test‐positive approaches, with accounting for changes associated with urinary tract infection (UTI), BK and CMV viremia, and subsequent recovery.ResultsSeventy patients aged 10.5 ± 5.6 years at transplant (60% male) had n = 726 urine samples with n = 236 associated biopsies (no rejection = 167, borderline = 51, and Banff 1A = 18). A threshold of 12 ng/mmol was validated for Banff 1A versus no‐rejection diagnosis (AUC = 0.74, 95% CI = 0.57–0.92). The first‐positive test approach (n = 69) did not resolve a clinical diagnosis in 38 cases (55%), whereas the two‐test approach resolved a clinical diagnosis in the majority as BK (n = 17/60, 28%), CMV (n = 4/60, 7%), UTI (n = 8/60, 13%), clinical rejection (n = 5/60, 8%), and transient elevation (n = 18, 30%). In those without a resolved clinical diagnosis, PPV from biopsy for subclinical rejection is 24% and 71% (p = .017), for first‐test versus two‐test models, respectively. After rejection treatment, uCXCL10/Cr level changes were all concordant with change in it‐score. Sustained uCXCL10/Cr after CMV and BK viremia resolution was associated with later acute rejection.ConclusionsUrinary CXCL10/Cr reliably identifies kidney allograft inflammation. These data support a two‐test approach to reliably exclude other clinically identifiable sources of inflammation, for kidney biopsy indication to rule out subclinical rejection.
Relaxed realism, robust realism, and the truthmaker challenge
Authors: Karimi Paiman 
Published: March 2024

AbstractRelaxed realist theories are becoming more common in metanormative theory. They want the advantages of robust forms of realism but without their metaphysical underpinnings. However, it is not always clear how we should understand relaxed realist theories in general. In this paper I clarify and defend relaxed realism. First, I characterise and distinguish relaxed realist theories from robust realist theories. Second, I defend relaxed realism against a challenge from truthmaker theory.
Predicting adolescents' continuation in club sports: A prospective cohort study of the importance of personal and contextual motivational factors in five sports in Denmark
Authors: Nielsen Glen , Wikman Johan Michael , Appleton Paul R. , Bentsen Peter , Elsborg Peter 
Published: March 2024

AbstractPurposeThe purpose of this prospective cohort study was to investigate the influence of types of motivation, basic psychological needs satisfaction and of a coach‐created motivational climate on continued participation in youth sports across types of sport, competitive levels, ages, and gender.MethodsParticipants were 7110 adolescent (age 12–20 years) members of leisure time club organized in basketball, handball, football, badminton, and gymnastics in Denmark. Motivational regulation was measured with BRSQ‐6, basic psychological needs satisfaction and frustration were measured with PNSS‐S, and coach‐created climate was measured with the EDMCQ‐C. The participants' continuation or dropout was measured at the beginning of the following season with a short electronic questionnaire.ResultsIntrinsic motivation, identified behavior regulation, experiences of competence, relatedness, and autonomy, as well as a coach‐created empowering motivational climate, were associated with continuation both in the sport and in the club the following season across different sports, genders, age groups, and competitive levels. Introjected and external behavior regulation, frustrations with the need to experience competence, relatedness, and autonomy, as well as a disempowering coach‐created climate, were associated with dropout.ConclusionIn Danish youth sports, autonomous motivation, satisfaction of basic psychological needs, and an empowering coach‐created motivational climate have a positive impact on the continuation of the sport and the club the following season. In contrast, controlled types of motivation, needs frustration, and a disempowering coach‐created climate are associated with dropout. This is the case at both elite and recreational levels, for boys and girls, adolescents, and youth.
Revisiting the role of social work in the substantial realization of social rights in local welfare systems: Transforming and changing the rules of the institutional game?
Authors: Dewanckel Lore , Schiettecat Tineke , Hermans Koen , Roose Rudi , Van Lancker Wim , Kessl Fabian , Roets Griet 
Published: March 2024

AbstractAlthough diverse European welfare states have institutionalized an extensive infrastructure of public welfare services to redistribute resources, governments have been confronted with barriers in realizing the social rights of certain groups of citizens. Decentralization and increasingly local welfare provision has been promoted as a strategy to substantially realize social rights. In that sense, the vital role of frontline social work has been stressed in local welfare systems, being considered as dynamic arrangements in which local policymakers and professional social work actors are involved in the substantial realization of social rights. These trends have been frequently studied from a social policy perspective, but the role of professional social work on the frontline level has received much less attention. In this study, we accordingly rely on neo‐institutional theory to explore how frontline social workers employ their professional discretion during processes of local social policy implementation, related to the broader circumstances in which they operate. Our qualitative study aims to tease out whether their strategic actions might transform and/or change the rules of the local institutional game. The qualitative analysis is based on policy documents and qualitative interviews with key actors in two municipalities in Belgium. Our research findings reveal three central fields of tension: (1) Rescaling of responsibilities to the local welfare system and community level versus in‐built spatial concentrations of social problems and inequalities, (2) Efficient local welfare system organization versus wicked social problems, and (3) Fast local welfare system logics versus slow realities.
The Enhanced Literate Mind Hypothesis
Authors: Huettig Falk , Hulstijn Jan 
Published: March 2024

AbstractIn the present paper, we describe the Enhanced Literate Mind (ELM) hypothesis. As individuals learn to read and write, they are, from then on, exposed to extensive written‐language input and become literate. We propose that acquisition and proficient processing of written language (“literacy”) leads to, both, increased language knowledge as well as enhanced language and nonlanguage (perceptual and cognitive) skills. We also suggest that all neurotypical native language users, including illiterate, low literate, and high literate individuals, share a Basic Language Cognition (BLC) in the domain of oral informal language. Finally, we discuss the possibility that the acquisition of ELM leads to some degree of “knowledge parallelism” between BLC and ELM in literate language users, which has implications for empirical research on individual and situational differences in spoken language processing.
A criterion for nondensity of integral points
Authors: Garcia‐Fritz Natalia , Pasten Hector 
Published: March 2024

AbstractWe give a general criterion for Zariski degeneration of integral points in the complement of a divisor with components in a variety of dimension defined over or over a quadratic imaginary field. The key condition is that the intersection of the components of is not well approximated by rational points, and we discuss several cases where this assumption is satisfied. We also prove a greatest common divisor (GCD) bound for algebraic points in varieties, which can be of independent interest.
Intrinsic motoneuron properties in typical human development
Authors: Mohammadalinejad Ghazaleh , Afsharipour Babak , Yacyshyn Alex , Duchcherer Jennifer , Bashuk Jack , Bennett Erin , Pearcey Gregory E. P. , Negro Francesco , Quinlan Katharina A. , Bennett David J. , Gorassini Monica A. 
Published: March 2024

AbstractMotoneuron properties and their firing patterns undergo significant changes throughout development and in response to neuromodulators such as serotonin. Here, we examined the age‐related development of self‐sustained firing and general excitability of tibialis anterior motoneurons in a young development (7–17 years), young adult (18–28 years) and adult (32–53 years) group, as well as in a separate group of participants taking selective serotonin reuptake inhibitors (SSRIs, aged 11–28 years). Self‐sustained firing, as measured by ΔF, was larger in the young development (∼5.8 Hz, n = 20) compared to the young adult (∼4.9 Hz, n = 13) and adult (∼4.8 Hz, n = 8) groups, consistent with a developmental decrease in self‐sustained firing mediated by persistent inward currents (PIC). ΔF was also larger in participants taking SSRIs (∼6.5 Hz, n = 9) compared to their age‐matched controls (∼5.3 Hz, n = 26), consistent with increased levels of spinal serotonin facilitating the motoneuron PIC. Participants in the young development and SSRI groups also had higher firing rates and a steeper acceleration in initial firing rates (secondary ranges), consistent with the PIC producing a steeper acceleration in membrane depolarization at the onset of motoneuron firing. In summary, both the young development and SSRI groups exhibited increased intrinsic motoneuron excitability compared to the adults, which, in the young development group, was also associated with a larger unsteadiness in the dorsiflexion torque profiles. We propose several intrinsic and extrinsic factors that affect both motoneuron PICs and cell discharge which vary during development, with a time course similar to the changes in motoneuron firing behaviour observed in the present study.
imageKey points
Neurons in the spinal cord that activate muscles in the limbs (motoneurons) undergo increases in excitability shortly after birth to help animals stand and walk.
We examined whether the excitability of human ankle flexor motoneurons also continues to change from child to adulthood by recording the activity of the muscle fibres they innervate.
Motoneurons in children and adolescents aged 7–17 years (young development group) had higher signatures of excitability that included faster firing rates and more self‐sustained activity compared to adults aged ≥18 years.
Participants aged 11–28 years of age taking serotonin reuptake inhibitors had the highest measures of motoneuron excitability compared to their age‐matched controls.
The young development group also had more unstable contractions, which might partly be related to the high excitability of the motoneurons.
Pre-COVID-19 hospital quality and hospital response to COVID-19: examining associations between risk-adjusted mortality for patients hospitalised with COVID-19 and pre-COVID-19 hospital quality
Authors: Peter Doris , Li Shu-Xia , Wang Yongfei , Zhang Jing , Grady Jacqueline , McDowell Kerry , Norton Erica , Lin Zhenqiu , Bernheim Susannah , Venkatesh Arjun K , Fleisher Lee A , Schreiber Michelle , Suter Lisa G , Triche Elizabeth W 
Published: March 2024

ObjectivesThe extent to which care quality influenced outcomes for patients hospitalised with COVID-19 is unknown. Our objective was to determine if prepandemic hospital quality is associated with mortality among Medicare patients hospitalised with COVID-19.DesignThis is a retrospective observational study. We calculated hospital-level risk-standardised in-hospital and 30-day mortality rates (risk-standardised mortality rates, RSMRs) for patients hospitalised with COVID-19, and correlation coefficients between RSMRs and pre-COVID-19 hospital quality, overall and stratified by hospital characteristics.SettingShort-term acute care hospitals and critical access hospitals in the USA.ParticipantsHospitalised Medicare beneficiaries (Fee-For-Service and Medicare Advantage) age 65 and older hospitalised with COVID-19, discharged between 1 April 2020 and 30 September 2021.Intervention/exposurePre-COVID-19 hospital quality.OutcomesRisk-standardised COVID-19 in-hospital and 30-day mortality rates (RSMRs).ResultsIn-hospital (n=4256) RSMRs for Medicare patients hospitalised with COVID-19 (April 2020–September 2021) ranged from 4.5% to 59.9% (median 18.2%; IQR 14.7%–23.7%); 30-day RSMRs ranged from 12.9% to 56.2% (IQR 24.6%–30.6%). COVID-19 RSMRs were negatively correlated with star rating summary scores (in-hospital correlation coefficient −0.41, p<0.0001; 30 days −0.38, p<0.0001). Correlations with in-hospital RSMRs were strongest for patient experience (−0.39, p<0.0001) and timely and effective care (−0.30, p<0.0001) group scores; 30-day RSMRs were strongest for patient experience (−0.34, p<0.0001) and mortality (−0.33, p<0.0001) groups. Patients admitted to 1-star hospitals had higher odds of mortality (in-hospital OR 1.87, 95% CI 1.83 to 1.91; 30-day OR 1.46, 95% CI 1.43 to 1.48) compared with 5-star hospitals. If all hospitals performed like an average 5-star hospital, we estimate 38 000 fewer COVID-19-related deaths would have occurred between April 2020 and September 2021.ConclusionsHospitals with better prepandemic quality may have care structures and processes that allowed for better care delivery and outcomes during the COVID-19 pandemic. Understanding the relationship between pre-COVID-19 hospital quality and COVID-19 outcomes will allow policy-makers and hospitals better prepare for future public health emergencies.
Mixed-methods study exploring health service access and social support linkage to the mental well-being of Canadian Indigenous pregnant persons during the COVID-19 pandemic
Authors: Mollons Meghan , Levasseur-Puhach Sydney , Kaur Jasleen , Doyle Jennifer , Giesbrecht Gerald , Lebel Catherine A , Woods Lindsay , Tomfohr-Madsen Lianne , Roos Leslie 
Published: March 2024

ObjectivesThis study aimed to explore how the unprecedented stressors associated with the COVID-19 pandemic may have contributed to heightened levels of depression and anxiety among pregnant Indigenous persons, and identify protective individual-level factors.DesignThe current study used a mixed-methods design including standardised questionnaires and open-ended response questions. Using hierarchical regression models, we examined the extent to which COVID-19-related factors of service disruption (ie, changes to prenatal care, changes to birth plans and social support) were associated with mental well-being. Further, through qualitative analyses of open-ended questions, we examined the coping strategies used by pregnant Indigenous persons in response to the pandemic.SettingParticipants responded to an online questionnaire consisting of standardised measures from 2020 to 2021.ParticipantsThe study included 336 self-identifying Indigenous pregnant persons in Canada.ResultsDescriptive results revealed elevated rates of clinically relevant depression (52.7%) and anxiety (62.5%) symptoms among this population. 76.8% of participants reported prenatal care service disruptions, including appointment cancellations. Thematic analyses identified coping themes of staying informed, social and/or cultural connections and activities, and internal mental well-being strategies. Disruptions to services and decreased quality of prenatal care negatively impacted mental well-being of Indigenous pregnant persons during the COVID-19 pandemic.ConclusionsGiven the potential for mental well-being challenges to persist and long-term effects of perinatal distress, it is important to examine the quality of care that pregnant individuals receive. Service providers should advance policies and practices that promote relationship quality and health system engagement as key factors linked to well-being during the perinatal period for Indigenous persons.
Influence of COVID-19 pandemic in India on coronary artery disease clinical presentation, angiography, interventions and in-hospital outcomes: a single centre prospective registry-based observational study
Authors: Gupta Rajeev , Sharma Krishnakumar , Khedar Raghubir Singh , Sharma Sanjeev Kumar , Makkar Jitender Singh , Natani Vishnu , Bana Ajeet , Sharma Samin 
Published: March 2024

ObjectiveThe study examined the influence of the COVID-19 pandemic in India on variation in clinical features, management and in-hospital outcomes in patients undergoing percutaneous coronary intervention (PCI).DesignProspective registry-based observational study.SettingA tertiary care hospital in India participant in the American College of Cardiology CathPCI Registry.Participants7089 successive patients who underwent PCI from April 2018 to March 2023 were enrolled (men 5627, women 1462). Details of risk factors, clinical presentation, coronary angiography, coronary interventions, clinical management and in-hospital outcomes were recorded. Annual data were classified into specific COVID-19 periods according to Government of India guidelines as pre-COVID-19 (April 2018 to March 2019, n=1563; April 2019 to March 2020, n=1594), COVID-19 (April 2020 to March 2020, n=1206; April 2021 to March 2022, n=1223) and post-COVID-19 (April 2022 to March 2023, n=1503).ResultsCompared with the patients in pre-COVID-19 and post-COVID-19 periods, during the first COVID-19 year, patients had more hypertension, non-ST elevation myocardial infarction (NSTEMI), lower left ventricular ejection fraction (LVEF) and multivessel coronary artery disease (CAD). In the second COVID-19 year, patients had more STEMI, lower LVEF, multivessel CAD, primary PCI, multiple stents and more vasopressor and mechanical support. There were 99 (1.4%) in-hospital deaths which in the successive years were 1.2%, 1.4%, 0.8%, 2.4% and 1.3%, respectively (p=0.019). Compared with the baseline year, deaths were slightly lower in the first COVID-19-year (age-sex adjusted OR 0.68, 95% CI 0.31 to 1.47) but significantly more in the second COVID-19-year (OR 1.97, 95% CI 1.10 to 3.54). This variation attenuated following adjustment for clinical presentation, extent of CAD, in-hospital treatment and duration of hospitalisation.ConclusionsIn-hospital mortality among patients with CAD undergoing PCI was significantly higher in the second year of the COVID-19 pandemic in India and could be one of the reasons for excess deaths in the country. These patients had more severe CAD, lower LVEF, and more vasopressor and mechanical support and duration of hospitalisation.