bluuebunny/crossref_metadata_2025_split huggingface dataset:
9 MV LINAC Photoneutron Interrogation of Uranium With Advanced Acoustically Tensioned Metastable Fluid Detectors
Authors: Boyle Nathan , Ozerov Stepan , Harabagiu Catalin , Taleyarkhan Rusi P. 
Published: July 2023

Abstract
Active special nuclear material (SNM) photoneutron interrogation research with acoustically tensioned metastable fluid detector (ATMFD) sensor technology is discussed, which provides evidence for enabling real-time detection of SNM even when deployed under extreme 15,000 R h−1 (9 MeV endpoint) X-ray beams. Experiments to detect 3.2 kg depleted uranium (DU) are described with the use of two designs of the economical acoustically tensioned metastable fluid detector (E-ATMFD), viz., E-ATMFD.Ver.0 and E-ATMFD.Ver.1, respectively, at standoffs ranging from 0.1 m to 10 m—including with the E-ATMFD directly within the interrogating beam. Under similar conditions and with 100% photon rejection (i.e., 0 cpm with beam on, and without SNM), the E-ATMFD.Ver.1 design operating at ∼0.9 W of drive power was shown capable of ∼6× (600%) higher gain over E-ATMFD.Ver.0 operating at ∼7 W (with beam on and with SNM). The sensitivity gain rises to ∼27× (i.e., 2700%) with the E-ATMFD.Ver.1 operating at 0.99 W and a background count rate of ∼1 cpm. The E-ATMFD.Ver.1 demonstrated 100% photon blindness (0 cpm) while operating at ∼0.56 W drive power and placed directly within the beam under 15,000 R/h; including the SNM target led to a count rate of up to 50 cpm—revealing the E-ATMFD.Ver.1 is potential field capable of detecting U-based SNMs within seconds from photofission neutron signals, even when deployed directly within the intense (15,000 R/h) high energy (9 MeV endpoint X-Ray) interrogating photon beam.
Infrared Thermography—A Novel Tool for Monitoring Fracture Healing: A Critically Appraised Topic With Evidence-Based Recommendations for Clinical Practice
Authors: Castonguay Tristan , Dover Geoff 
Published: July 2023

Clinical Scenario: Stress fractures are one of the most common injuries in athletes. Unfortunately, they are hard to diagnose, require multiple radiology exams and follow-up which leads to more exposure to radiation and an increase in cost. Stress fractures that are mismanaged can lead to serious complications and poorer outcomes for the athlete. During the rehabilitation process, it would be beneficial to be able to monitor the healing of fractures to know when it is safe to gradually allow a patient to a return to sport because the return to activity is not usually objective and based on pain level. Clinical Question: Can infrared thermography (IRT) be a useful tool to measure the pathophysiological state of the fracture healing? The aim of this critically appraised topic is to analyze the current evidence of IRT for measuring the temperature change in fractures to provide recommendations for medical practitioners. Summary of Key Findings: For this critically appraised topic, we examined 3 articles that compared medical imaging and IRT over multiple time points during the follow-up. The 3 articles concluded that a 1 °C asymmetry in temperature followed by a return to normal (less than 0.3 °C) temperature during the healing process of fractures can be monitored using IRT. Clinical Bottom Line: Once the patient has been diagnosed with a fracture, IRT can safely be used to monitor the evolution of a fracture. When the thermogram progresses from a hot thermogram to a cold thermogram, the healing is considered good enough to return to sport. Strength of Recommendation: Grade 2 evidence exists to support IRT being used by clinicians to monitor fracture healing. Due to the limited research and novelty of the technology, the current recommendations are for following the treatment of the fracture once the initial diagnosis is made.
Impact of childhood burns on academic performance: a matched population-based cohort study
Authors: Halim Nicole , Holland Andrew J A , McMaugh Anne , Cameron Cate M , Lystad Reidar P , Badgery-Parker Tim , Mitchell Rebecca 
Published: July 2023

ObjectiveThis study aimed to compare academic performance and high school completion of young people hospitalised for a burn compared with young people not hospitalised for an injury.DesignA retrospective population-based matched case-comparison cohort study.ParticipantsYoung people aged ≤18 years hospitalised for a burn during 2005–2018 in New South Wales, Australia, with age, sex and residential postcode-matched peers not hospitalised for any injury during 1 July 2001 and 31 December 2018.Main outcome measuresPerformance below the national minimum standard (NMS) on the National Assessment Plan for Literacy and Numeracy assessments and not completing high school.ResultsYoung females hospitalised for a burn had a 72% higher risk of poorer reading compared with their peers (adjusted relative risk (ARR) 1.72; 95% CI 1.33 to 2.23), while young males hospitalised with a burn showed no higher risk (ARR 1.14; 95% CI 0.91 to 1.43). Young males (ARR 1.05; 95% CI 0.81 to 1.35) and females (ARR 1.34; 95% CI 0.93 to 1.94) hospitalised with a burn had no higher risk of not reaching the NMS for numeracy compared with peers. Young people hospitalised with a burn had at least twice the risk of not completing year 10 (ARR 3.86; 95% CI 1.68 to 8.86), year 11 (ARR 2.45; 95% CI 1.89 to 3.18) and year 12 (ARR 2.09; 95% CI 1.63 to 2.67) compared with matched counterparts.ConclusionsYoung females hospitalised with a burn displayed poorer academic performance for reading compared with matched peers, while males and females were more likely to leave school earlier. Identifying unmet learning support needs of young burn survivors should be investigated.
Persistence of severe global inequalities in the burden of blindness and vision loss from 1990 to 2019: findings from the Global Burden of Disease Study 2019
Authors: Li Yuancun , Wang Hongxi , Guan Zhiqiang , Guo Chengyao , Guo Pi , Du Yali , Yin Shengjie , Chen Binyao , Jiang Jiao , Ma Yueting , Jing Liu , Huang Yingzi , Zheng Ke , Ma Qian , Zhou Ruiqing , Chen Min , Congdon Nathan , Qiu Kunliang , Zhang Mingzhi 
Published: July 2023

AimsTo assess the global burden and economic inequalities in the distribution of blindness and vision loss between 1990 and 2019.MethodsA secondary analysis of the Global Burden of Diseases, Injuries and Risk Factors Study (GBD) 2019. Data for disability-adjusted life-years (DALYs) due to blindness and vision loss were extracted from the GBD 2019. Data for gross domestic product per capita were extracted from the World Bank database. Slope index of inequality (SII) and concentration index were computed to assess absolute and relative cross-national health inequality, respectively.ResultsCountries with high, high-middle, middle, low-middle and low Socio-demographic Index (SDI) had decline of age-standardised DALY rate of 4.3%, 5.2%, 16.0%, 21.4% and 11.30% from 1990 to 2019, respectively. The poorest 50% of world citizens bore 59.0% and 66.2% of the burden of blindness and vision loss in 1990 and 2019, respectively. The absolute cross-national inequality (SII) fell from −303.5 (95% CI −370.8 to −236.2) in 1990 to −256.0 (95% CI −288.1 to −223.8) in 2019. The relative inequality (concentration index) for global blindness and vision loss remained essentially constant between 1991 (−0.197, 95% CI −0.234 to −0.160) and 2019 (−0.193, 95% CI −0.216 to −0.169).ConclusionThough countries with middle and low-middle SDI were the most successful in decreasing burden of blindness and vision loss, a high level of cross-national health inequality persisted over the past three decades. More attention must be paid to the elimination of avoidable blindness and vision loss in low-income and middle-income countries.
Association between contrast sensitivity function and structural damage in primary open-angle glaucoma
Authors: Pang Ruiqi , Peng Jieting , Cao Kai , Sun Yunxiao , Pei Xue-Ting , Yang Diya , Lu Zhong-Lin , Wang Ningli 
Published: July 2023

AimsTo evaluate the association between contrast sensitivity function (CSF) and glaucomatous structural damage in primary open-angle glaucoma (POAG).MethodsA cross-sectional study was performed with 103 patients (103 eyes) aged 25–50 years who had POAG without any other ocular disease. CSF measurements were obtained by the quick CSF method, a novel active learning algorithm that covers 19 spatial frequencies and 128 contrast levels. The peripapillary retinal nerve fibre layer (pRNFL), macular ganglion cell complex (mGCC), radial peripapillary capillary (RPC) and macular vasculature were measured by optical coherence tomography and angiography. Correlation and regression analyses were used to assess the association of area under log CSF (AULCSF), CSF acuity and contrast sensitivities at multiple spatial frequencies with structural parameters.ResultsAULCSF and CSF acuity were positively associated with pRNFL thickness, RPC density, mGCC thickness and superficial macular vessel density (p<0.05). Those parameters were also significantly associated with contrast sensitivity at 1, 1.5, 3, 6, 12, 18 cycles per degree spatial frequencies (p<0.05) and, the lower the spatial frequency, the higher the correlation coefficient. RPC density (p=0.035, p=0.023) and mGCC thickness (p=0.002, p=0.011) had significant predictive value for contrast sensitivity at 1 and 1.5 cycles per degree, with adjustedR2of 0.346 and 0.343, respectively.ConclusionsFull spatial frequency contrast sensitivity impairment, most notably at low spatial frequencies, is a characteristic change in POAG. Contrast sensitivity is a potential functional endpoint for the measurement of glaucoma severity.
Prevalence of fear of hypoglycemia in adults with type 1 diabetes using a newly developed screener and clinician’s perspective on its implementation
Authors: Peter Megan E , Rioles Nicole , Liu Jingwen , Chapman Katherine , Wolf Wendy A , Nguyen Huyen , Basina Marina , Akturk Halis Kaan , Ebekozien Osagie , Perez-Nieves Magaly , Poon Jiat Ling , Mitchell Beth 
Published: July 2023

IntroductionFear of hypoglycemia (FoH) affects quality of life, emotional well-being, and diabetes management among people with type 1 diabetes (PwT1D). American Diabetes Association’s (ADA) guidelines recommend assessing FoH in clinical practice. However, existing FoH measures are commonly used in research and not in clinical practice. In this study, prevalence of FoH was assessed in PwT1D using a newly developed FoH screener for clinical practice; its association with established measures and outcomes was also determined. In addition, healthcare providers’ (HCPs) perspectives on implementing FoH screener into real-world practice were explored.Research design and methodsThis multiphase observational study used mixed methods in two phases. First, we collected a cross-sectional survey (including the screener) from PwT1D (≥18 years) from T1D Exchange Quality Improvement Collaborative adult clinics. Pearson correlations and regression analyses were performed on diabetes outcome measures using screener scores. Second, we conducted focus groups among HCPs who treat PwT1D and descriptive analysis to summarize results.ResultsWe included 553 PwT1D. Participants had a mean±SD age of 38.9±14.2 years and 30% reported a high FoH total score. Regression analyses showed that higher A1c and higher number of comorbidities were significantly associated with high FoH (p<0.001). High FoH worry and behavior scores were significantly associated with 8-Item Patient Health Questionnaire and 7-Item Generalized Anxiety Disorder Scale scores. Participants with ≥1 severe hypoglycemia event(s) and impaired awareness of hypoglycemia had higher odds of high FoH. Eleven HCPs participated in focus group interviews; they expressed that the FoH screener is clinically necessary and relevant but poses implementation challenges that must be addressed.ConclusionsOur results demonstrate FoH is common in PwT1D and affects their psychosocial well-being and diabetes management. In alignment with ADA position statement, HCP focus group results emphasize importance of screening for FoH. Implementing this newly developed FoH screener may help HCPs identify FoH in PwT1D.
Prevalence of externalising disorder comorbidities in adolescents: a systematic review and meta-analysis protocol
Authors: Norozpour Marzieh , Pourshahbaz Abbas , Poursharifi Hamid , Dolatshahi Behrooz , Habibi Nastaran 
Published: July 2023

IntroductionExternalising disorders are some of the most prevalent problems in childhood and particularly during adolescence that can change into more severe psychopathology in adulthood if left unattended. In the research literature, these disorders include attention deficit/hyperactivity disorder, oppositional/defiant disorder, conduct disorder and substance use disorders. The comorbidity prevalence of these disorders is significant and cannot be considered a random factor. The dimensional structure of psychopathology has always been studied by researchers to address disorder comorbidities and aetiology. There has always been controversy over the number of spectra and the lower levels. Currently, the new top-down, Hierarchical Taxonomy of Psychopathology model conceptualising psychopathology is being used, which is a dimensional classification system for the different spectra of psychopathology based on a combination of conceptual modelling and factor analysis of symptoms. This systematic review investigates the comorbidity prevalence of spectra of externalising disorders to provide valuable information and feedback on this model.Methods and analysisThis systematic review will include all the studies conducted from 1/1/1990 to 1/12/2020 to examine the prevalence and comorbidity of each of the externalising disorders in the general population, schools and outpatients using any instrument (questionnaires or interviews). There will be no language restrictions in selecting the studies. The studies are age restricted and must be conducted on adolescents only, but there are no restrictions on the gender and nationality of the participants.Ethics and disseminationThis systematic review is based on previously published articles and therefore will not require ethical approval. The results of the systematic review will be disseminated as publication in a peer-reviewed journal and conference presentation.PROSPERO registration numberCRD42022327629.
Smartphone-based versus traditional face-to-face collaborative care for community-dwelling older adults living with dementia in China: protocol for an implementation science-based sequential multiple assignment randomised trial
Authors: Wan Yang , Cai Yan , Liao Shiyi , Zhao Qin , Wang Yangyang , Song Xiaozhen , Meng Steven Siyao , Ji Xiaoyi , Wu Yue , Qiu Peiyuan 
Published: July 2023

IntroductionThe high costs of institutional care and the burdensome demands of home care are challenging for families of adults with dementia. The collaborative care model (CCM) provides a potential solution to these challenges. Leveraging advancements in mobile technologies, smartphone-based management could offer a feasible means of providing collaborative care in a community setting. Therefore, this study aims to establish a CCM for home-cared older adults with dementia to determine the best strategy to deliver collaborative care, including both the channel and frequency of delivery.Methods and analysisThis study will be conducted in the communities of Chengdu city, Sichuan province, China. It is designed under the framework of implementation science. In the first stage, intervention strategies for community-dwelling older adults with dementia and their caregivers will be developed using Delphi methods and focus group interviews. The second stage will involve designing a sequential multiple assignment randomised trial to compare the effectiveness of face-to-face intervention versus a WeChat mini program-based intervention. This comparison will involve 358 pairs of older adults with dementia and their caregivers, with the frequency of intervention also assessed. Follow-up evaluations will be implemented at the 6th, 12th and 18th months post-intervention initiation. Primary outcomes encompass the proportion of patients demonstrating an improvement in quality of life and the proportion of caregivers exhibiting a reduction in caregiver burden. Analysis will be based on the intention-to-treat principle, and the generalised estimating equation approach will be used. Incremental cost-effectiveness ratios will be used to evaluate the cost-effectiveness of different delivery methods and frequencies.Ethics and disseminationThis study has received approval from the Ethics Committee of West China Fourth Hospital/School of Public Health, Sichuan University (Gwll2022004). Informed consent will be obtained for all participants. The findings of the study will be disseminated through peer-reviewed scientific journals.Trial registration numberChiCTR2200057945.
Lower haemoglobin-to-red blood cell distribution width ratio is independently associated with frailty in community-dwelling older adults: a cross-sectional study
Authors: Zhu Mengpei , Wei Chao , Yang Xiongjun , Huang Yumei , Xu Yushuang , Xiong Zhifan 
Published: July 2023

ObjectivesThe importance of blood cell markers in frailty has been studied. However, research on haemoglobin-to-red blood cell distribution width ratio (HRR) and frailty in older persons is still limited. We investigated the association between HRR and frailty in older adults.DesignCross-sectional population-based study.SettingCommunity-dwelling older adults older than 65 years were recruited from September 2021 to December 2021.ParticipantsA total of 1296 community-dwelling older adults (age ≥65 years) in Wuhan were included in the study.Main outcome measuresThe main outcome was the presence of frailty. The Fried Frailty Phenotype Scale was used to evaluate the frailty status of the participants. Multivariable logistic regression analysis was performed to determine the relationship between HRR and frailty.ResultsA total of 1296 (564 men) older adults were included in this cross-sectional study. Their mean age was 70.89±4.85 years. Receiver operating characteristic curve analysis showed that HRR is a good predictor of frailty in older people, the area under the curve (AUC) was 0.802 (95% CI: 0.755 to 0.849), and the highest sensitivity was 84.5% and the specificity was 61.9% with the optimal critical values 9.97 (p<0.001). Multiple logistic regression analysis indicated that lower HRR (<9.97) (OR: 3.419, 1.679 to 6.964, p=0.001) is independently associated with frailty in older people, even after adjusting confounding factors.ConclusionLower HRR is closely associated with an increased risk of frailty in older people. Lower HRR may be an independent risk factor for frailty in community-dwelling older adults.
Cultural adaptation of a UK evidence-based problem-solving intervention to support Polish prisoners at risk of suicidal behaviour: a cross-sectional survey using an Ecological Validity Model
Authors: Perry Amanda E , Zawadzka Maja , Lapinski Piotr , Moore Keeley , Rychlik Jaroslaw , Nowak Beata 
Published: July 2023

ObjectiveTo complete a cultural adaptation of a UK evidence-based problem-solving intervention to support Polish prisoners at risk of suicidal behaviour.DesignA cross-sectional survey participatory design using an Ecological Validity Model.SettingThe study was a collaboration between: the Academy of Justice, in Warsaw, the University of Lodz, two Polish prisons (ZK Raciborz and ZK Klodzko) and the University of York (UK).MethodsThe adaptation process included an examination of the use of language, metaphors and content (ie, culturally appropriate and syntonic language), the changing of case study scenarios (relevance and acceptability) and maintenance of the theoretical underpinning of the problem-solving model (intervention comprehensibility and completeness). Four stages used: (1) a targeted demonstration for Polish prison staff, (2) a wider audit of the skills with Polish prison staff and students, (3) forward and back-translation of the adapted package, and (4) two iterative consultations with participants from stages (1) and (2) and prison officers from two Polish prisons.ParticipantsSelf-selecting volunteer participants included: targeted prison staff (n=10), prison staff from the wider Polish penitentiary system (n=39), students from the University of Lodz (n=28) and prison officers from two Polish prisons (n=12).Main outcomes and measuresAcceptability and feasibility of the training package, reported in a series of knowledge user surveys.ResultsThe recognised benefits of using the skills within the training package included: enhancing communication, reflective development, collaborative working, changing behaviour, empowering decision-making, relevance to crisis management situations and use of open-ended questions. The skills were endorsed to be used as part of future penitentiary training for prison officers in Poland.ConclusionsThe skills had widespread appeal for use across the Polish penitentiary system. The materials were deemed relevant while adhering to the comprehensibility of the intervention. Further evaluation of the intervention should be explored using a randomised controlled trial design.
Characteristics, clinical course and outcome of ventilated patients at a non-surgical intensive care unit in Germany: a single-centre, retrospective observational cohort analysis
Authors: Grünewaldt Achim , Peiffer Kai-Henrik , Bojunga Jörg , Rohde Gernot G U 
Published: July 2023

ObjectivesThe objective of this study was to evaluate epidemiological characteristics, clinical course and outcome of mechanically ventilated non-surgical intensive care unit (ICU) patients, with the aim of improving the strategic planning of ICU capacities.DesignWe conducted a retrospective observational cohort analysis. Data from mechanically ventilated intensive care patients were obtained by investigating electronic health records. The association between clinical parameters and ordinal scale data of clinical course was evaluated using Spearman correlation and Mann-Whitney U test. Relations between clinical parameters and in-hospital mortality rates were examined using binary logistic regression analysis.SettingA single-centre study at the non-surgical ICU of the University Hospital of Frankfurt, Germany (tertiary care-level centre).ParticipantsAll cases of critically ill adult patients in need of mechanical ventilation during the years 2013–2015 were included. In total, 932 cases were analysed.ResultsFrom a total of 932 cases, 260 patients (27.9%) were transferred from peripheral ward, 224 patients (24.1%) were hospitalised via emergency rescue services, 211 patients (22.7%) were admitted via emergency room and 236 patients (25.3%) via various transfers. In 266 cases (28.5%), respiratory failure was the reason for ICU admission. The length of stay was higher in non-geriatric patients, patients with immunosuppression and haemato-oncological disease or those in need of renal replacement therapy. 431 patients died, which corresponds to an all-cause in-hospital mortality rate of 46.2%. 92 of 172 patients with presence of immunosuppression (53.5%), 111 of 186 patients (59.7%) with pre-existing haemato-oncological disease, 27 of 36 patients (75.0%) under extracorporeal membrane oxygenation (ECMO) therapy, and 182 of 246 patients (74.0%) undergoing renal replacement therapy died. In logistic regression analysis, these subgroups and older age were significantly associated with higher mortality rates.ConclusionsRespiratory failure was the main reason for ventilatory support at this non-surgical ICU. Immunosuppression, haemato-oncological diseases, the need for ECMO or renal replacement therapy and older age were associated with higher mortality.