bluuebunny/crossref_metadata_2025_split huggingface dataset:
Burnout and coping strategies among resident physicians at an Indonesian tertiary referral hospital during COVID-19 pandemic
Authors: Menaldi Sri Linuwih , Raharjanti Natalia Widiasih , Wahid Mardiastuti , Ramadianto Adhitya Sigit , Nugrahadi Nadia Rahmadiani , Adhiguna G. M. Yudi Prasetia , Kusumoningrum Dewi Anggraeni 
Published: January 2023

Background
The COVID-19 pandemic has increased the burden on resident physicians. They may use different coping strategies to manage those burdens, which partly determine their mental health outcomes, including burnout syndrome. This study explores the relationship between coping strategies and burnout among resident physicians during the COVID-19 pandemic in an Indonesian tertiary referral hospital.

Methods
This online cross-sectional study was conducted from June to August 2020, involving nine residency programs in the Faculty of Medicine Universitas Indonesia–Cipto Mangunkusumo Hospital. Burnout syndrome was assessed using Maslach Burnout Inventory, while Brief COPE measured coping strategies.

Results
A total of 388 residents participated in this study. High emotional exhaustion (EE), depersonalization (DP), and low personal accomplishment (PA) were found in 15.5%, 5.2%, and 39.2%, respectively. Residents more often use adaptive than maladaptive coping strategies. Higher PA was correlated to residents using problem-focused (r = 0.299; p < 0.001) and emotion-focused (r = 0.397; p < 0.001). Meanwhile, dysfunctional coping strategies are moderately correlated with EE (r = 0,518; p <0,001) and DP (r = 0,507; p<0,001).

Conclusion
The use of dysfunctional coping strategies is linked to higher emotional exhaustion and depersonalization aspect of burnout. However, a higher sense of personal accomplishment is linked to problem-focused and emotion-focused strategies. Appropriate identification and intervention of residents with dysfunctional coping strategies may be beneficial in reducing burnout risk.
Left ventricle segmentation in transesophageal echocardiography images using a deep neural network
Authors: Kang Seungyoung , Kim Sun Ju , Ahn Hong Gi , Cha Kyoung-Chul , Yang Sejung 
Published: January 2023

Purpose
There has been little progress in research on the best anatomical position for effective chest compressions and cardiac function during cardiopulmonary resuscitation (CPR). This study aimed to divide the left ventricle (LV) into segments to determine the best position for effective chest compressions using the LV systolic function seen during CPR.

Methods
We used transesophageal echocardiography images acquired during CPR. A deep neural network with an attention mechanism and a residual feature aggregation module were applied to the images to segment the LV. The results were compared between the proposed model and U-Net.

Results
The results of the proposed model showed higher performance in most metrics when compared to U-Net: dice coefficient (0.899±0.017 vs. 0.792±0.027, p<0.05); intersection of union (0.822±0.026 vs. 0.668±0.034, p<0.05); recall (0.904±0.023 vs. 0.757±0.037, p<0.05); precision (0.901±0.021 vs. 0.859±0.034, p>0.05). There was a significant difference between the proposed model and U-Net.

Conclusion
Compared to U-Net, the proposed model showed better performance for all metrics. This model would allow us to evaluate the systolic function of the heart during CPR in greater detail by segmenting the LV more accurately.
Increased Angiopoietin-1 and -2 levels in human vitreous are associated with proliferative diabetic retinopathy
Authors: Tsai Teresa , Alwees Mohannad , Asaad Mohammad Ali , Theile Janine , Kakkassery Vinodh , Dick H. Burkhard , Schultz Tim , Joachim Stephanie C. 
Published: January 2023

Background
Diabetic retinopathy is a frequent complication of diabetes mellitus and a leading cause of blindness in adults. The objective of this study was to elucidate the diabetic retinopathy pathophysiology in more detail by comparing protein alterations in human vitreous of different diabetic retinopathy stages.

Methods
Vitreous samples were obtained from 116 patients undergoing pars plana vitrectomy. Quantitative immunoassays were performed of angiogenic factors (VEGF-A, PIGF, Angiopoietin-1, Angiopoietin-2, Galectin-1) as well as cytokines (IL-1β, IL-8, IFN-γ, TNF-α, CCL3) in samples from control patients (patients who don’t suffer from diabetes; n = 58) as well as diabetes mellitus patients without retinopathy (n = 25), non-proliferative diabetic retinopathy (n = 12), and proliferative diabetic retinopathy patients (n = 21). In addition, correlation analysis of protein levels in vitreous samples and fasting glucose values of these patients as well as correlation analyses of protein levels and VEGF-A were performed.

Results
We detected up-regulated levels of VEGF-A (p = 0.001), PIGF (p<0.001), Angiopoietin-1 (p = 0.005), Angiopoietin-2 (p<0.001), IL-1β (p = 0.012), and IL-8 (p = 0.018) in proliferative diabetic retinopathy samples. Interestingly, we found a strong positive correlation between Angiopoietin-2 and VEGF-A levels as well as a positive correlation between Angiopoietin-1 and VEGF-A.

Conclusion
This indicated that further angiogenic factors, besides VEGF, but also pro-inflammatory cytokines are involved in disease progression and development of proliferative diabetic retinopathy. In contrast, factors other than angiogenic factors seem to play a crucial role in non-proliferative diabetic retinopathy development. A detailed breakdown of the pathophysiology contributes to future detection and treatment of the disease.
Behavioural activation for depressive symptoms in young people with emerging or early psychosis: A pilot study protocol
Authors: Byrne Mitchell K. , Easpaig Bróna Nic Giolla , Gray Richard , Creek Rebecca , Jones Martin , Brown Ellie , Mitchell David , Zhai Jianxia , Tan Jing-Yu , Denis Shaun , Bressington Daniel 
Published: January 2023

Background
Theoretically, behavioural activation may have a valuable role to play in the treatment of depression among young people with emerging/early psychosis, however we lack trial evidence concerning its acceptability and feasibility. This study will establish the feasibility of clinician-delivered behavioural activation as an adjunct to standard care for this population. We aim to train and support clinicians in delivering behavioural activation to improve depressive symptoms in young people with early/emerging psychosis. Our objectives are to:

Establish the number of young people with early/emerging psychosis with clinically meaningful depression symptoms.
Establish the proportion of clinicians that complete the behavioural activation training and are deemed to be competent.
Determine the proportion of eligible participants approached who agree to consent to the research.
Determine the proportion of participants that complete baseline measures, complete behavioural activation treatment (attending for at least fifteen minutes in a minimum of eight sessions), and complete follow-up measures (immediately post-intervention and at 3 months follow-up).
Establish clinicians’ fidelity to treatment (by recording randomly selected treatment sessions and completing a fidelity checklist).
Calculate preliminary efficacy of behavioural activation against primary and secondary outcomes.
Explore participants’ experiences of facilitating behavioural activation (clinicians) and receiving behavioural activation (young people with emerging/early psychosis).

Method
This is a pilot controlled clinical trial with a two-arm parallel-group study. Approximately 60 young people with emerging/early psychosis will be randomly allocated to either behavioural activation treatment plus standard care or standard care alone. The primary outcome: depressive symptoms; and secondary outcomes: negative symptoms, overall psychiatric symptoms, medication side effects and functioning, will be assessed at baseline, post-intervention and at 3-months follow-up. The protocol is registered with the Australian New Zealand Clinical Trials Registry (reference number: ACTRN12622000756729).

Discussion
The findings will inform the design of a full-scale randomised controlled trial.
Long-term respiratory follow-up of ICU hospitalized COVID-19 patients: Prospective cohort study
Authors: Ribeiro Carvalho Carlos Roberto , Lamas Celina Almeida , Chate Rodrigo Caruso , Salge João Marcos , Sawamura Marcio Valente Yamada , de Albuquerque André L. P. , Toufen Junior Carlos , Lima Daniel Mario , Garcia Michelle Louvaes , Scudeller Paula Gobi , Nomura Cesar Higa , Gutierrez Marco Antonio , Baldi Bruno Guedes ,   HCFMUSP Covid-19 Study Group
Published: January 2023

Background
Coronavirus disease (COVID-19) survivors exhibit multisystemic alterations after hospitalization. Little is known about long-term imaging and pulmonary function of hospitalized patients intensive care unit (ICU) who survive COVID-19. We aimed to investigate long-term consequences of COVID-19 on the respiratory system of patients discharged from hospital ICU and identify risk factors associated with chest computed tomography (CT) lesion severity.

Methods
A prospective cohort study of COVID-19 patients admitted to a tertiary hospital ICU in Brazil (March-August/2020), and followed-up six-twelve months after hospital admission. Initial assessment included: modified Medical Research Council dyspnea scale, SpO2 evaluation, forced vital capacity, and chest X-Ray. Patients with alterations in at least one of these examinations were eligible for CT and pulmonary function tests (PFTs) approximately 16 months after hospital admission. Primary outcome: CT lesion severity (fibrotic-like or non-fibrotic-like). Baseline clinical variables were used to build a machine learning model (ML) to predict the severity of CT lesion.

Results
In total, 326 patients (72%) were eligible for CT and PFTs. COVID-19 CT lesions were identified in 81.8% of patients, and half of them showed mild restrictive lung impairment and impaired lung diffusion capacity. Patients with COVID-19 CT findings were stratified into two categories of lesion severity: non-fibrotic-like (50.8%-ground-glass opacities/reticulations) and fibrotic-like (49.2%-traction bronchiectasis/architectural distortion). No association between CT feature severity and altered lung diffusion or functional restrictive/obstructive patterns was found. The ML detected that male sex, ICU and invasive mechanic ventilation (IMV) period, tracheostomy and vasoactive drug need during hospitalization were predictors of CT lesion severity(sensitivity,0.78±0.02;specificity,0.79±0.01;F1-score,0.78±0.02;positive predictive rate,0.78±0.02; accuracy,0.78±0.02; and area under the curve,0.83±0.01).

Conclusion
ICU hospitalization due to COVID-19 led to respiratory system alterations six-twelve months after hospital admission. Male sex and critical disease acute phase, characterized by a longer ICU and IMV period, and need for tracheostomy and vasoactive drugs, were risk factors for severe CT lesions six-twelve months after hospital admission.
Access to medicines among the Brazilian population based on the 2019 National Health Survey
Authors: Leal Adriana Amorim de Farias , Rodrigues Galvão Maria Helena , Medeiros Arthur de Almeida , Roncalli Ângelo Giuseppe 
Published: January 2023

Introduction
Access to medicines is a challenge, especially in developing countries, highlighting the need of population-based research to evaluate access and related factors.

Objective
This study aimed to assess access to medicines and identify associated factors using data from the 2019 Brazilian National Health Survey (PNS).

Methods
This population-based cross-sectional study used data from the 2019 PNS and considered access to prescription medicines as the primary outcome. The sample included 24,753 individuals aged 15 years or older who looked for medical care in the last 15 days and received a medicine prescription. Andersen’s behavioral model was used to select independent variables. After descriptive analysis, a multinomial logistic regression multilevel analysis was performed using the independent variables with a significance level lower than 0.20 in the bivariate analysis.

Results
The lowest chances of getting access to medicines were observed in individuals aged between 40 and 59 years, women, with complete middle and high school, with lower-income families, who attended public services, with worse self-assessed health, and those who looked for health care for disease prevention and health promotion.

Conclusions
Access to medicines among the Brazilian population is associated with social, economic, and health perception factors. Our findings may update and guide the development of public policies on medication and pharmaceutical care, facilitating medication purchases by the care user and promoting health equity.
Evaluation of pharmacist consults within a collaborative enhanced primary care team model to improve diabetes care
Authors: Firkus Danielle , McCoy Rozalina G. , Matulis John , Kessler Maya , Mara Kristin , Herges Joseph 
Published: January 2023

Background
An enhanced primary care team model was implemented to provide proactive, longitudinal care to patients with diabetes, grounded in close partnership between primary care providers (PCPs), nurses, and Medication Management Services (MMS) pharmacists. The purpose of this study is to evaluate the impact of the MMS pharmacist involvement in the enhanced primary care model for patients with diabetes.

Methods
This retrospective cohort study compared the quality of diabetes care between patients referred to a pharmacist and propensity score matched controls who were not. Eligible patients were adults (age 18 to 75 years) enrolled in the enhanced primary care team process who did not meet at least one of four diabetes quality indicators at 13 Mayo Clinic Rochester primary care practice locations. The intervention examined was asynchronous e-consults by pharmacists affiliated with the primary care practice.

Main measures
The primary outcome was change in the proportion of patients meeting the composite of four diabetes treatment goals (D4), including hemoglobin A1c (HbA1c) control, blood pressure control, aspirin use, and statin use at six months from enrollment among patients who received pharmacist intervention compared to matched patients who did not. Secondary outcomes were each of the D4 goal individually.

Results
The proportion of patients meeting the D4 increased with pharmacist e-consults (N = 85) compared to matched controls with no review (N = 170) (27% vs 7.0%, p<0.001). The change in patients meeting treatment goals of HbA1c (12.9% vs 4.1%, p = 0.020), blood pressure (9.4% vs 2.4%, p = 0.023), aspirin use (10.6% vs 2.9%, p = 0.018), and statin use (17.6% vs -1.2%, p<0.001) all increased with pharmacist e-consults.

Conclusions
Pharmacist engagement in the enhanced primary care team improved diabetes management. This supports the inclusion and utilization of pharmacists in multidisciplinary efforts to improve diabetes care.
Comparative analysis of the mechanical limits of resistance in implant/abutment set of a new implant design: An in vitro study
Authors: Bianchini Marco Aurélio , Junior Nilton De Bortoli , Dedavid Berenice Anina , De Aza Piedad N. , Gehrke Sergio Alexandre 
Published: January 2023

Objective
The aim of the present in vitro study was to evaluate the resistance on quasi-static forces and in the fatigue mechanical cycling of a new implant design compared to two other conventional implant designs.

Materials and methods
Eighty-eight implants with their respective abutments were tested and distributed into four groups (n = 22 per group): Morse taper connection implant (MT group), conventional external hexagon implant (EH con group), new Collo implant of external hexagon with the smooth portion out of the bone insertion (EH out group), and new Collo implant of external hexagon with the implant platform inserted to the bone level (EH bl group). All the sets were subjected to quasi-static loading in a universal testing machine, and we measured the maximum resistance force supported by each sample. Another 12 samples from each group were submitted to the cyclic fatigue test at 4 intensities of forces (n = 3 per force): 80%, 60%, 40%, and 20%. The number of cycles supported by each sample at each force intensity was evaluated.

Results
The three groups of implants with external hexagon connection had similar maximum strength values of the sets (p > 0.05). Meanwhile, samples from the MT group showed the highest resistance values in comparison to the other three groups (p < 0.05). In the fatigue test, the Collo out group supported a smaller number of cycles that led to the fracture than the other 3 groups proposed at loads of 80%, 60%, and 40%, and only at the load value of 20% all groups had the same performance.

Conclusions
Within the limitations of the present in vitro study, the results showed that the new Collo implant performs better when installed at bone level.
Bases para uma Atenção Primária à Saúde integral, resolutiva, territorial e comunitária no SUS: aspectos críticos e proposições
Authors: Claudius Queiroz Barbosa Allan , Tasca Renato 
Published: January 2023

A Rede de Pesquisa em Atenção Primária (APS) à Saúde da Associação Brasileira de Saúde Coletiva (Abrasco) realizou durante 13º Congresso Brasileiro de Saúde Coletiva, oficina de trabalho intitulada “Bases para uma Atenção Primária à Saúde integral, resolutiva, territorial e comunitária no SUS: aspectos críticos e proposições” com a participação de 200 congressistas. Os objetivos traçados para esta atividade foram analisar os avanços, desafios, ameaças e retrocessos na política nacional de atenção primária/atenção básica à saúde; apresentar uma agenda estratégica política para a APS no SUS; e discutir com atores chave um conjunto de proposições para uma Atenção Primária à Saúde integral, resolutiva, territorial e comunitária de qualidade no SUS. A dinâmica das atividades realizou-se através de apresentações e debates em interlocução com participantes e representantes de gestores do SUS e de profissionais atuantes na APS no SUS. Os principais resultados das apresentações e debates apontaram a necessidade de se adotar um amplo espectro de ações e medidas e de caráter estratégico e tático para recuperar os princípios da APS em uma ação voltada à sociedade para fortalecimento do SUS.
Afinal, o que é dado de pesquisa?
Authors: Sayão Luis Fernando , Sales Luana Farias 
Published: January 2023

No contexto científico contemporâneo em que a geração, coleta e análise intensiva de dados se tornam etapas essenciais para o progresso científico, os sistemas de gestão e curadoria de dados se reconfiguram como infraestruturas-chave na composição das ciberinfraestruturas de pesquisa. Porém, a curadoria e gestão de dados só se efetivam se forem consideradas as especificidades dos domínios disciplinares, os fluxos de pesquisa e, sobretudo, as características dos dados coletados, aproximando o ciclo de vida da pesquisa com o ciclo de vida dos dados. Com o objetivo de contribuir para a superação desse desafio, o presente estudo procura explicitar e discutir os principais conceitos, características e propriedades dos dados de pesquisa – sistematizando-os na forma de uma taxonomia - em função dos impactos que eles têm na concepção das infraestruturas tecno-socias e organizacionais dos sistemas de gestão e curadoria de dados de pesquisa.
Análise do sistema de identificação penal da polícia penal de Santa Catarina
Authors: Rahhal Daniela , Medina Kern Vinícius 
Published: January 2023

Os sistemas de informação auxiliam no arquivamento, gestão e recuperação de informações. Contudo, podem apresentar lacunas, surgindo a necessidade da Avaliação de Sistemas de Informação. Sendo assim, o presente estudo, derivado de uma dissertação de mestrado, consiste em realizar uma análise da qualidade do sistema de identificação penal (IPEN) sob a perspectiva dos usuários policiais penais nas unidades prisionais de Santa Catarina. Para tanto, definiu-se como objetivo principal: verificar a qualidade do sistema de identificação penal. Quanto aos procedimentos metodológicos, se caracterizam como uma pesquisa aplicada, de abordagem qualitativa. O método para a coleta de dados consistiu na aplicação de um checklist com o objetivo de verificar a qualidade do sistema. Os resultados apontaram sete respostas negativas, uma não se aplica ao contexto e vinte e uma respostas atenderam positivamente. Para preencher as lacunas detectadas, algumas sugestões foram indicadas: a elaboração de um manual detalhado; a implantação de um campo com informações de ajuda (help); a criação de uma linha de comunicação direta de usuário-sistema e aplicação de questionários aos usuários. Os resultados contribuem para os estudos acerca da Avaliação de Sistemas de Informação pois o checklist abordado pode servir de base para a coleta de dados, contribuindo como uma ferramenta de análise de trabalhos futuros.
Physician Decision-Making About Surveillance in Older Adults With Prior Adenomas: Results From a National Survey
Authors: Schoenborn Nancy L. , Pollack Craig E. , Gupta Samir , Boyd Cynthia M. 
Published: January 2023

INTRODUCTION:
There is no clear guidance on when surveillance colonoscopies should stop in older adults with prior adenomas. We aimed to examine physicians' decision-making regarding surveillance colonoscopies in older adults.

METHODS:
In a national mailed survey of 1,800 primary care physicians (PCP) and 600 gastroenterologists, we asked whether physicians would recommend surveillance colonoscopy in vignettes where we varied patient age (75 and 85 years), health (good, medium, and poor), and prior adenoma risk (low and high). We examined the association between surveillance recommendations and patient and physician characteristics using logistic regression. We also assessed decisional uncertainty, need for decision support, and decision-making roles.

RESULTS:
Of 1,040 respondents (response rate 54.8%), 874 were eligible and included. Recommendation for surveillance colonoscopies was lower if patient was older (adjusted proportions 20.6% vs 49.8% if younger), in poor health (adjusted proportions 7.1% vs 28.8% moderate health, 67.7% good health), and prior adenoma was of low risk (adjusted proportions 29.7% vs 41.6% if high risk). Family medicine physicians were most likely and gastroenterologists were least likely to recommend surveillance (adjusted proportions 40.0% vs 30.9%). Approximately 52.3% of PCP and 35.4% of gastroenterologists reported uncertainty regarding the benefit/harm balance of surveillance in older adults. Most (85.9% PCP and 77.0% gastroenterologists) would find a decision support tool helpful. Approximately 32.8% of PCP vs 71.5% of gastroenterologists perceived it as the gastroenterologist's role to decide about surveillance colonoscopies.

DISCUSSION:
Studies to better evaluate the benefits/harms of surveillance colonoscopy in older adults and decisional support tools that help physicians and patients incorporate such data are needed.