bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a Naturalness Preference Scale
Authors: Bayerman Shawna F. , Li Meng , Syed Adnan , Scherer Laura D. 
Published: July 2023

Objective Naturalness preference can influence important health decisions. However, the literature lacks a reliable way to measure individual differences in naturalness preferences. We fill this gap by designing and validating a scale to measure individual differences in naturalness preference. Methods We conducted 3 studies among Amazon Mechanical Turk participants. In study 1 ( N = 451), we created scale items through an iterative process that measured naturalness preference in hypothesized domains. We conducted exploratory factor analysis (EFA) to identify items that assess the naturalness preference construct. In study 2 ( N = 448), we conducted confirmatory factor analysis (CFA) and tests of criterion, discriminant, convergent, and incremental validity. In study 3 ( N = 607), we confirmed test-retest reliability of the scale and performed additional validity tests. Results EFA revealed 3 correlated factors consistent with naturalness preference in medicine, food, and household products. The CFA confirmed the 3-factor structure and led to the decision to drop reverse-coded items. The finalized Naturalness Preference Scale (NPS) consists of 20 items and 3 subscales: NPS-medicine, NPS-food, and NPS-household products. The NPS demonstrated good test-retest reliability, and subscales had good validity in their respective domains. The NPS-medicine subscale was predictive of the uptake of a hypothetical COVID-19 vaccine ( r = −0.45) and belief in unproven natural COVID remedies and treatments ( r = 0.29). Conclusions The NPS will allow researchers to better assess individual differences in naturalness preference and how they influence decision making and health behaviors. Highlights This research created and validated a scale to measure individual differences in naturalness preference in 3 domains: medicine, food, and household products. This study confirms that the strength of the naturalness preference differs in different domains. An important and timely finding is that higher scores in the naturalness preference medical subscale are associated with belief in COVID-19 misinformation and reluctance toward COVID-19 vaccination.
Early ribavirin for hepatitis E virus infection in patients receiving immunosuppressive therapy: a retrospective, observational study
Authors: Franz Anika , Reuken Philipp A , Guliyeva Sura , Rose Michael , Boden Katharina , Stallmach Andreas , Bruns Tony 
Published: July 2023

Objective Hepatitis E virus (HEV) infections are common, self-limiting causes of acute viral hepatitis. This study aimed to analyze hepatic injury, viremia, and chronicity rates in patients with acute HEV infection receiving immunosuppressive (IS) therapy taking into account ribavirin treatment. Methods In this retrospective, single-center, observational study, we analyzed the disease course of 25 non-cirrhotic patients receiving IS therapy who were diagnosed with acute HEV viremia. Forty-four patients with acute HEV viremia without IS therapy were controls. Results Demographics, symptoms at presentation, and extrahepatic manifestations were not different between patients with and without IS therapy, but liver injury at presentation was less severe in patients with IS therapy. Among the patients with IS therapy, 18 (72%) received ribavirin for a median of 56 days. Sustained viral clearance was observed in 21 patients with IS therapy, whereas 3 patients relapsed after ribavirin, and 1 patient had viral persistence. Among patients with sustained viral clearance, there was a longer duration of viremia in patients with IS therapy than in those without. Conclusions In this cohort of non-cirrhotic patient with IS, early treatment with ribavirin for acute HEV infection did not improve viral clearance rates, but may have shortened the duration of viremia.
U.S. Breastfeeding Outcomes at the Intersection: Differences in Duration Among Racial and Ethnic Groups With Varying Educational Attainment in a Nationally Representative Sample
Authors: Butler Margaret S. , Smart Britney P. , Watson Elijah J. , Narla Shreya S. , Keenan-Devlin Lauren 
Published: July 2023

Background: As breastfeeding rates in the United States increase, barriers persist for Black, Latine, and low-socioeconomic status household dyads when compared to White and high-socioeconomic status household dyads. Previous breastfeeding disparities research has almost exclusively considered the influence of race, ethnicity, and socioeconomic status separately, although these attributes are not randomly distributed across the population. Research Aim: To identify breastfeeding duration patterns by race/ethnicity and educational attainment in a nationally representative U.S. National Immunization Survey sample. Method: We conducted a cross-sectional, secondary analysis of the U.S. Centers for Disease Control and Prevention’s 2020 National Immunization Survey–Child public-use data. To examine breastfeeding and exclusive breastfeeding durations at the intersection of race/ethnicity and educational attainment, we created a 12-item, cross-classified variable using three educational attainment groups and four race/ethnicity groups. We used linear regressions to test these associations. Results: In all, 83% of the sample breastfed. Mean durations of breastfeeding were 7.5 ( SE = 1.95) months and exclusive breastfeeding duration was 4.9 ( SE = 0.87) months. In adjusted models, multi-race/other high-educational attainment participants had the longest breastfeeding duration by almost 3 weeks (β: 19.53, 95% CI [5.27, 33.79]), and Black low-educational attainment participants exclusively breastfed for 1 month less than White high-educational attainment participants (β:−30.23, 95% CI [−40.87, −19.58]). Conclusions: Examining race/ethnicity and educational attainment together provides an intersectional understanding of breastfeeding outcomes and can inform targeted, culturally appropriate interventions.
Dosing and Administration Strategies of Tocilizumab in Patients With COVID-19: A Retrospective Cohort Analysis
Authors: Steuber Taylor D. , Rosandich Thomas , Cadwallader Tiffany , Steil Lauren , Belk Madeline , Yendrapalli Usha , Hassoun Ali , Edwards Jonathan 
Published: July 2023

Background: Tocilizumab may reduce the risk of death, length of stay, and time of mechanical ventilation in patients hospitalized with COVID-19. Limited data are available evaluating low-dose subcutaneous administration of tocilizumab in this setting. Objective: To compare outcomes of 2 tocilizumab dosing and administration strategies in patients hospitalized with COVID-19. Methods: A retrospective, observational cohort study was conducted to compare clinical outcomes in patients hospitalized with COVID-19 receiving tocilizumab 400 mg intravenously (400 mg IV) or 162 mg subcutaneously (162 mg SC). Hospitalized patients receiving a single dose of tocilizumab were eligible for inclusion and grouped by dosing and administration strategy. The primary endpoint was ventilator-free days at day 28. Secondary endpoints included length of stay (LOS), intensive care unit (ICU) LOS, mechanical ventilation required after dose, 28-day readmission, 28-day mortality, and change in inflammatory markers. Results: A total of 303 patients were included, with 147 who received tocilizumab 400 mg IV and 156 who received 162 mg SC. There was no significant difference in average ventilator-free days at day 28 in patients receiving 400 mg IV compared with 162 mg SC (26.4 ± 5.3 vs 25.6 ± 6.8 days, respectively; P = 0.812). There was also no difference in LOS (10.4 ± 12.6 vs 10.5 ± 14.0 days; P = 0.637), ICU LOS (3.9 ± 9.0 vs 3.5 ± 8.3 days; P = 0.679), mechanical ventilation after dose (15.6% vs 19.2%; P = 0.412), 28-day readmission (6.1% vs 9.6%; P = 0.268), or 28-day mortality (23.1% vs 25.6%; P = 0.611). Finally, there was no difference regarding change in inflammatory markers at 48 hours ( P > 0.05 for all interactions). Conclusion and Relevance: In this retrospective study involving hospitalized patients with COVID-19, there was no difference between tocilizumab 162 mg SC and 400 mg IV in terms of efficacy. The 162 mg SC dose may be a reasonable alternative to traditional doses.
Association of Socioeconomic Disparities With Nasopharyngeal Carcinoma Survival in an Endemic Area, China
Authors: Meng Dong-Fang , Zhang Hai-Bo , Liu Guo-Ying , Peng Li-Xia , Yang Qi , Liu Zi-Hao , Tian Yaru , Ma Ji , Fu Lei 
Published: July 2023

Objectives This retrospective cohort study investigated the association of socioeconomic status with survival outcomes among patients with nasopharyngeal carcinoma in an endemic area of China. Methods The primary endpoint was overall survival. Survival outcomes were estimated by the Kaplan-Meier method and compared by the log-rank test, and the multivariate Cox proportional hazards model was used to estimate hazard ratios, 95% CIs, and independent prognostic factors. Results A total of 11 069 adult patients with NPC were enrolled and included in the analysis. Kaplan-Meier survival analysis revealed that overall survival was significantly different among socioeconomic status. Compared with high socioeconomic status patients, low socioeconomic status patients (HR, 1.190; 95% CI, 1.063-1.333) and medium socioeconomic status patients (HR, 1.111; 95% CI, 1.006-1.226) were associated with increased hazard ratio (HR) of overall survival. Conclusion This analysis highlights patients with nasopharyngeal carcinoma who had high socioeconomic status had better overall survival compared with those who had low and medium socioeconomic status.
Bringing researchers to the consumer table: The process and outcomes of a consumer roundtable on telehealth
Authors: Jenkinson Bec , Maxwell Jo , Bell Alison , Young Adrienne , Smith Anthony C , Christoffersen Anja , Trevor Dale , Young Leonie , Russell Trevor 
Published: July 2023

Introduction Despite the significant expansion and rapid uptake of telehealth services as a COVID-19 response, the pandemic restricted opportunities to involve health consumers in telehealth research. Authentic consumer and community involvement in research begins with engagement in priority-setting. We report here on the process and outcomes of a consumer-led event intended to support involvement of consumers, from early in the research process. Methods In 2022, The University of Queensland's Consumer and Community Network hosted a Consumer Roundtable to ‘bring researchers to the consumer table’ and explore emerging issues and priorities for future research. The event used World Café Method, with three 20-min rounds of small group discussion centred on questions about telehealth experiences, followed by a facilitated harvest discussion about future research directions. Participants’ notes from small group discussions were subjected to conventional inductive content analysis, and a visual record was created in real-time by a graphic artist. Results Twenty-eight consumers and 22 researchers took part. Content analysis identified three main foci from discussions: person-centred care, better access to better care, the (unrealised) potential of telehealth. Research questions prioritised by consumer vote focussed on marginalised groups and stigmatised conditions; differences between telehealth and face-to-face healthcare delivery; and the experience of conveying and receiving compassion via telehealth. Discussion The Consumer Roundtable created early engagement between health consumer representatives and telehealth researchers, which has yielded ongoing partnerships. World Café method proved particularly useful for seeding relationships between researchers and consumers. However, there was limited opportunity to generate consensus about research priorities.
A systematic review of informatics competencies: requirements for nurse managers in healthcare organisations
Authors: Hajizadeh Alireza , Khodavandi Milad , Eslami Zahra , Irannejad Behrooz , Monaghesh Elham 
Published: July 2023

Introduction: One vital strategy for the success of healthcare organisations currently resides in the capacity of the nurse managers (NMs) to develop informatics competencies in management. Aim: The aim of this review was to synthesise the evidence related to the informatics competencies of NMs in healthcare settings. Methods: The databases of PubMed, Web of Science, Scopus and Education Resources Information Center were searched. All publications were accepted if they had been published in English and full texts were accessible. The study was carried out using a systematic literature search of work published between January 2000 and December 2021. The Endnote v.17 software was used to facilitate reference management. Quality assessment of publications was carried out independently by two reviewers using the Critical Appraisal Skills Programme guidance. A descriptive summary with data tables was produced to summarise the literature. Results: After screening the search results, 12 studies published between the period 2001 and 2019 met the inclusion criteria. Analysis of the included studies led to the classification of informatics competencies in three main themes: skills related to work with computers (four sub-themes), informatics skills of NMs (three sub-themes) and knowledge of NMs about informatics (five sub-themes). Conclusion: These systematic review results can lead to the identification of informatics competency gaps and recommend and provide solutions to address these gaps and increase competencies for nursing managers.
Graphic Paper: Moving and handling care of bariatric patients: a survey of clinical nurse managers
Authors: Brenchley Alex 
Published: July 2023

Background: The prevalence of obesity is rising, and obese persons are more likely to use healthcare services and require moving and handling care. Aims: This study explored the frequency, logistics and barriers to the provision of bariatric patient-handling care including equipment availability in acute hospitals. Methods: A cross-sectional study design using an anonymous 24-item questionnaire was used to survey 322 clinical nurse managers. Completed hard-copy questionnaires ( n = 132) were returned by post. Results: Most clinical nurse managers (93.1%) provided care for bariatric patients and 85.6% reported barriers to the provision of bariatric care within their clinical area. The principal barriers were lack of equipment (75%), staff (65.2%) and training (57.6%). Only 11.4% owned all the required equipment. Owning equipment provided significantly greater access to a hoist ( P = 0.001) and chair ( P = 0.032) than renting. Only 9.5% reported that rented equipment always arrives on time. The majority (74.4%) did not have guidelines for caring for bariatric patients, and 46.2% considered this to be a barrier. Conclusions: Barriers to caring for bariatric patients were identified. Most of the equipment was rented, and significant delays in its delivery were reported. The need for education and training and the dissemination of policies and guidelines were identified.
Middle small-bowel segment Lewis score may predict long-term outcomes among patients with quiescent Crohn’s disease
Authors: Ukashi Offir , Yablecovitch Doron , Lahat Adi , Selinger Limor , Neuman Sandra , Eliakim Rami , Ben-Horin Shomron , Kopylov Uri 
Published: July 2023

Background: Video capsule endoscopy (VCE) has been proven to accurately diagnose small-bowel inflammation and predict flares among patients with quiescent Crohn’s disease (CD). However, data regarding its predictive role in this population over an extended follow-up are scarce. Objectives: To predict clinical exacerbation and to assess the yield of Lewis score in identifying CD patients with future clinical exacerbation during an extended follow-up (>24 months). Design: A post hoc analysis study. Methods: Adult patients with quiescent small-bowel CD who were followed with VCE, inflammatory biomarkers and magnetic resonance enterography in a prospective study (between 2013 and 2018). We extracted extended clinical data (up to April 2022). The primary composite outcome (i.e. clinical exacerbation) was defined as intestinal surgery, endoscopic dilation, CD-related admission, corticosteroid administration, or biological/immunomodulator treatment change during follow-up. Results: Of the 61 patients in the study [median age 29 (24–37) years, male 57.4%, biologic treatment 46.7%], 18 patients met the primary outcome during an extended follow-up [median 58.0 (34.5–93.0) months]. On univariable analysis, complicated [hazard ratio (HR) 7.348, p = 0.002] and stricturing disease phenotype (HR 5.305, p = 0.001) were associated with higher risk for clinical exacerbation during follow-up. A baseline VCE middle small-bowel segment Lewis score (midLS) ⩾ 135 identified patients with future exacerbation [AUC (area under the curve) 0.767, 95% confidence interval (CI) 0.633–0.902, p = 0.001, HR 6.317, 93% negative predictive value], whereas the AUC of the conventional Lewis score was 0.734 (95% CI: 0.589–0.879, p = 0.004). Sensitivity analysis restricted to patients with either complicated ( n = 34) or stricturing ( n = 26) disease phenotype revealed that midLS still predicted clinical exacerbation during follow-up (AUC 0.747/0.753, respectively), in these patients. Conclusion: MidLS predicts treatment failure in quiescent CD patients (median follow-up of 5 years) independently of disease phenotype.
A nomogram based on clinical factors to predict calendar year readmission in patients with ulcerative colitis
Authors: Xiang Ying , Yuan Ying , Liu Jinyan , Xu Xinwen , Wang Zhenyu , Hassan Shahzeb , Wu Yue , Sun Qi , Shen Yonghua , Wang Lei , Yang Hua , Sun Jing , Xu Guifang , Huang Qin 
Published: July 2023

Background: Readmission shortly after discharge is indicative of an increased disease severity for patients with ulcerative colitis (UC) and ineffectiveness to medical therapy, which may contribute to a dismal prognosis. Objectives: This study aimed to explore prognostic variables with a nomogram to predict unplanned UC-related readmission within 1 year after discharge. Design: A retrospective cohort study. Methods: Electronic medical records of all UC patients treated at our center between 1 January 2014 and 31 June 2021 were reviewed. A comprehensive analysis of various characteristics, such as demographics, comorbidities, medical history, follow-up appointments, admission endoscopy, histopathologic features, etc., was used to determine the primary end point, which was unplanned UC-related calendar year readmission. Results: We found that the unplanned UC-related readmission rate within 1 year was 20.8%. In multivariable cox analysis, the predictors of the Elixhauser comorbidity index [Hazard ratio (HR): 3.50, 95% confidence interval (CI): 1.93–6.37], regular follow-up (HR: 0.29, 95% CI: 0.16–0.53), any history of corticosteroid use (HR: 3.38, 95% CI: 1.83–6.27), seral level of C-reactive protein (HR: 1.01, 95% CI: 1.00–1.02), and the UC endoscopic index of severity (HR: 1.29, 95% CI: 1.05–1.57) independently predicted calendar year readmission after discharge. The established nomogram had a consistently high accuracy in predicting calendar year readmission in the training cohort, with a concordance index of 0.784, 0.825, and 0.837 at 13, 26, and 52 weeks, respectively, which was validated in both the internal and external validation cohorts. Therefore, UC patients were divided into clinically low-, high-, and extremely high-risk groups for readmission, based on the calculated score of 272.5 and 378. Conclusion: The established nomogram showed good discrimination and calibration powers in predicting calendar year readmission in high-risk UC patients, who may need intensive treatment and regular outpatient visits.
CYBER-AIDD: A novel approach to implementing improved cyber security resilience for large Australian healthcare providers using a Unified Modelling Language ontology
Authors: Dart Martin , Ahmed Mohiuddin 
Published: July 2023

Purpose This paper proposes a novel cyber security risk governance framework and ontology for large Australian healthcare providers, using the structure and simplicity of the Unified Modelling Language (UML). This framework is intended to mitigate impacts from the risk areas of: (1) cyber-attacks, (2) incidents, (3) data breaches, and (4) data disclosures. Methods Using a mixed-methods approach comprised of empirical evidence discovery and phenomenological review, existing literature is sourced to confirm baseline ontological definitions. These are supplemented with Australian government reports, professional standards publications and legislation covering cyber security, data breach reporting and healthcare governance. Historical examples of healthcare cyber security incidents are reviewed, and a cyber risk governance UML presented to manage the defined problem areas via a single, simplified ontological diagram. Results A clear definition of ‘cyber security’ is generated, along with the ‘CYBER-AIDD’ risk model. Specific examples of cyber security incidents impacting Australian healthcare are confirmed as N = 929 over 5 years, with human factors the largest contributor. The CYBER-AIDD UML model presents a workflow across four defined classes, providing a clear approach to implementing the controls required to mitigate risks against verified threats. Conclusions The governance of cyber security in healthcare is complex, in part due to a lack of clarity around key terms and risks, and this is contributing to consistently poor operational outcomes. A focus on the most essential avenues of risk, using a simple UML model, is beneficial in describing these risks and designing governance controls around them.
The effect of digitalization on service orientation and service perception among Israeli healthcare professionals: A qualitative study
Authors: Naamati-Schneider Lior 
Published: July 2023

Objective Healthcare systems globally are adapting to rapid changes, including digitalization, to thrive. The main objective of this study is to investigate the impact of adapting to rapid changes, including embracing digitalization on the services provided by healthcare organizations, by mapping the healthcare professionals’ perceptions and characterizing their experiences, as well as examining the difficulties and barriers they face in transforming their organization. Methods This qualitative study, based on semi-structured in-depth interviews with 38 healthcare professionals, examines the impact of embracing digitalization in service and clinical care and their perception of service. Interviews were analyzed using a categorial deductive and inductive approach across three levels. Results Eight main themes arose from the analysis: The need for change, The importance of change, Communication, Training, Competitive leverage, Challenges and barriers and Implications for patient–therapist relationship. The themes and subthemes were examined through the three levels of organizational change—the system, the organization, and the personal level. The results of the study indicate limited embrace of change within the systemic and organizational levels and inconsistencies across the three levels. The study also highlights the barriers and difficulties that stand in the way of these processes of change and development. Conclusions To ensure successful implementation, these processes require systemic planning, including budgeting for personnel training, organizational adjustments, and technological equipment. Additionally, addressing personal-level considerations such as relevant training and setting boundaries for caregivers is crucial to prevent burnout. Effective planning and management of these changes will facilitate optimal assimilation and enhance system efficiency.