bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reducing health inequalities through skills training, support and removing barriers to employment
Authors: Woodall James , Coan Susan , Stanley Michelle 
Published: May 2023

Objective: This paper reports on a programme which sought to engage individuals and groups who are underrepresented in the UK labour market. The programme aimed to improve access to employment opportunities and provide practical support in job applications. The focus was on encouraging people to seek employment in the health and social care sectors and on tackling health inequalities in the region. Design: Qualitative inquiry. Setting: Leeds, UK. Method: Using focus groups and interviews, this paper explores key learning from the programme and the experience of programme delivery, both from the perspective of the professionals working on the programme and the individuals participating. Results: A coordinated strategic partnership in which key agencies share a common purpose is critical. The value of a localised strategy to engage communities is an important mechanism for success. Working closely with schools and businesses provides opportunities to access individuals who might usually find employment services difficult to access. The programme examined here sought to put people’s aspirations at the heart of delivery, offering choice and tailored opportunities to develop their careers. This could include developing specific skills or raising awareness of potential careers. The programme also promoted opportunities by removing barriers in the job application process. A range of positive health outcomes were reported for participants engaging in the programme that require further exploration. Conclusion: Meaningful employment is an important health determinant, but some communities face barriers to employment and consequently find the labour market difficult to access. Findings suggest a range of ways to engage people in finding meaningful employment and support.
Review of current status of cardiovascular and thoracic surgery in Nepal: An analysis from collection of institutional database
Authors: Rajbanshi Bijoy G , Panthee Nirmal , Joshi Dharmendra , Pradhan Sidhartha , Gauttam Navin , Timala Rabindra , Koirala Raamesh , Bhattarai Anil , Sapkota Ranjan , Sharma Jyotindra , Tuladhar Sampurna , Karmacharya Robin , Jaiswal Lokesh , Shrestha Uttam , Shrestha Kiran , Koirala Bhagawan 
Published: May 2023

Objective Data collected from various institutions around the country was analyzed to assess the current status of cardiovascular and thoracic surgery in the country. Methods We collected data from institutions performing cardiovascular and thoracic surgery from all over the country through direct correspondence for the year 2019. Individual institution data on the number of surgeries performed for cardiac, vascular, and thoracic surgery and its outcome in terms of mortality were compiled. The data were further evaluated depending on the type of procedures performed. Results Overall, a total of 2264 cardiac surgeries were performed in the country in the year 2019. The majority of the surgeries were for valvular heart surgery accounting for 34.3%, followed by congenital surgeries (32.8%) and surgeries for coronary artery disease (25.9%). A total of 649 thoracic surgeries were documented, which is probably marginally less than the actual numbers because we were unable to include an additional few institutions performing low-volume or isolated thoracic procedures in this report. A total of 852 vascular procedures were performed in the country, which is probably underreported. The mortality rates for complex congenital procedures were higher than those reported in the literature and that of adult procedures such as valvular heart disease and coronary artery disease similar to literature. Conclusion We evaluated the recent status of cardiovascular and thoracic surgery in the country with respect to the type of procedures and the postoperative outcomes.
Serious illness care quality during COVID-19: Identifying improvement opportunities in narrative reports from a National Bereaved Family Survey
Authors: Giannitrapani Karleen F , McCaa Matthew D , Maheta Bhagvat J , Raspi Isabella G , Shreve Scott T , Lorenz Karl A 
Published: May 2023

Background: COVID-19 significantly impacted care delivery to seriously ill patients, especially around including family and caregivers in patient care. Aim: Based on routinely collected bereaved family reports, actionable practices were identified to maintain and improve care in the last month of life, with potential application to all seriously ill patients. Design: The Veterans Health Administration’s Bereaved Family Survey is used nationally to gather routine feedback from families and caregivers of recent in-patient decedents; the survey includes multiple structured items as well as space for open narrative responses. The responses were analyzed using qualitative content analysis with dual review. Setting/participants: Between February 2020 and March 2021, there were 5372 responses to the free response questions of which 1000 (18.6%) responses were randomly selected. The 445 (44.5%) responses from 377 unique individuals included actionable practices. Results: Bereaved family members and caregivers identified four opportunities with a total of 32 actionable practices. Opportunity 1: Facilitate the use of video communication, included four actionable practices. Opportunity 2: Provide timely and accurate responses to family concerns, included 17 actionable practices. Opportunity 3: Accommodate family/caregiver visitation, included eight actionable practices. Opportunity 4: Offer physical presence to the patient when family/caregivers are unable to visit, included three actionable practices. Conclusion: The findings from this quality improvement project are applicable during a pandemic, but also translate to improving the care of seriously ill patients in other circumstances, such as when family members or caregivers are geographically distant from a loved one during the last weeks of life.
Comparison of Preferences and Data Quality between Discrete Choice Experiments Conducted in Online and Face-to-Face Respondents
Authors: Jiang Ruixuan , Pullenayegum Eleanor , Shaw James W. , Mühlbacher Axel , Lee Todd A. , Walton Surrey , Kohlmann Thomas , Norman Richard , Pickard A. Simon 
Published: May 2023

Introduction Discrete choice experiments (DCE) are increasingly being conducted using online panels. However, the comparability of such DCE-based preferences to traditional modes of data collection (e.g., in-person) is not well established. In this study, supervised, face-to-face DCE was compared with its unsupervised, online facsimile on face validity, respondent behavior, and modeled preferences. Methods Data from face-to-face and online EQ-5D-5L health state valuation studies were compared, in which each used the same experimental design and quota sampling procedure. Respondents completed 7 binary DCE tasks comparing 2 EQ-5D-5L health states presented side by side (health states A and B). Data face validity was assessed by comparing preference patterns as a function of the severity difference between 2 health states within a task. The prevalence of potentially suspicious choice patterns (i.e., all As, all Bs, and alternating As/Bs) was compared between studies. Preference data were modeled using multinomial logit regression and compared based on dimensional contribution to overall scale and importance ranking of dimension-levels. Results One thousand five Online respondents and 1,099 face-to-face screened (F2FS) respondents were included in the main comparison of DCE tasks. Online respondents reported more problems on all EQ-5D dimensions except for Mobility. The face validity of the data was similar between comparators. Online respondents had a greater prevalence of potentially suspicious DCE choice patterns ([Online]: 5.3% [F2FS] 2.9%, P = 0.005). When modeled, the relative contribution of each EQ-5D dimension differed between modes of administration. Online respondents weighed Mobility more importantly and Anxiety/Depression less importantly. Discussion Although assessments of face validity were similar between Online and F2FS, modeled preferences differed. Future analyses are needed to clarify whether differences are attributable to preference or data quality variation between modes of data collection.
Experimental investigation on RFID-odometer-based localization of an automated shunting vehicle
Authors: Jung Hyun-Suk , Eschmann Frank , Schindler Christian 
Published: May 2023

Continuous information on the current location of a vehicle in its infrastructure is essential for automated driving. However, industrial railways and shunting operations may entail boundary conditions which are not suitable for widespread satellite-based positioning. Hence, this paper presents a positioning system, based on radio-frequency identification (RFID) and odometer, which was developed and tested on an automated road-rail vehicle for shunting at low velocities. The achieved accuracy for discrete positioning with RFID was estimated at 0.22 m. In quasi-continuous positioning between consecutive RFID tags, the odometer exhibited an error of −2.2% to 0.7% of travelled distance depending on the investigated stationary driving states and sensor data evaluation. Apart from enhancement potentials for the RFID system, the results also indicated the odometer to be prone to the shunting vehicle dynamics when the rotation of its rail wheels is measured. Furthermore, the shunting vehicle appears to run constantly with a notable lateral displacement even on straight tracks due to the property of its running gear, causing a systematic underestimation of the travelled distance.
Three-Dimensional Evaluation of Nasolabial Morphology After Applying Presurgical Nasoalveolar Molding in Primary Unilateral Cheiloplasty Using the Modified Millard Technique
Authors: Ho Nguyen Chon T. , La Tuyen N. , Nguyen Dau V. 
Published: May 2023

Objective To compare the soft tissue measurements of the upper lip and the nose on the cleft side and the noncleft side before surgery, immediately after cheiloplasty and two months after surgery. Design Descriptive clinical study with one group, prospective. Setting Department of Odonto-Stomatology, Children's Hospital 1, at Ho Chi Minh City - Vietnam. Patients 31 patients with a unilateral complete cleft lip participated in this study, 30 patients were evaluated at the time two months after surgery. Interventions Interventions include PNAM and cheiloplasty by modified Millard technique. Main Outcome Measures Patients proceed to acquire 3D images of lips and nose, define landmarks and measure dimensions. There are 11 evaluators to be compared, p < 0.05 was considered statictical significance. Results After two months of surgery, on cleft side and noncleft side, the lengths of the upper lip were 10.87 ± 0.80 and 11.92 ± 0.78 (mm), the widths of the upper lip were 16.06 ± 1.10 and 16.40 ± 1.02 (mm), the heights of the nostril were 4.85 ± 0.44 and 5.93 ± 0.43 (mm), the lengths of columella were 4.08 ± 0.37 and 4.93 ± 0.38 (mm), and the widths of the nostril were 9.07 ± 0.37 and 8.37 ± 0.40 (mm). Conclusion Cheiloplasty by modified Millard technique on the patients who used PNAM showed that after two months of surgery, the morphology of the upper lip and nose has a slight disproportion with the nasolabial measurements of the cleft side being smaller than on the noncleft side.
A single, oral dose of the TLR7 agonist JNJ-64794964 induces transcriptomic and phenotypic changes in peripheral immune cells in healthy adults
Authors: Pierson Wim , Tuefferd Marianne , Herschke Florence , Slaets Leen , Crabbe Marjolein , Verstappen Dorien , De Pelsmaeker Steffi , Strickland Ian , Gane Edward J , Schwabe Christian , Zhang Yingjie , Meerts Peter , Vandenbossche Joris , Van Remoortere Pieter , Verbrugge Inge , De Creus An 
Published: May 2023

Background Chronic hepatitis B (CHB) is responsible for major disease burden worldwide. However, the number of available therapies is limited; cure remains an elusive goal. JNJ-64794964 (JNJ-4964) is an oral toll-like receptor-7 (TLR7) agonist being evaluated for the treatment of CHB. Here, we investigated the capacity of JNJ-4964 to induce transcriptomic and immune cell changes in peripheral blood in healthy volunteers. Methods Peripheral blood was collected in the JNJ-4964 first-in-human phase 1 trial at multiple time points to assess transcriptomics and changes in frequency and phenotype of peripheral-blood mononuclear cells. Correlation of changes to JNJ-4964 exposure (Cmax) and changes in cytokine levels (C-X-C motif chemokine ligand 10 [CXCL10] and interferon alpha [IFN-α]) were evaluated. Results Fifty-nine genes, mainly interferon-stimulated genes, were up-regulated between 6 hours and 5 days after JNJ-4964 administration. JNJ-4964 increased frequencies of CD69, CD134, CD137, and/or CD253-expressing natural killer (NK) cells, indicative of NK cell activation. These changes correlated with Cmax, increase of CXCL10, and induction of IFN-α and were observed at IFN-α levels that are associated with no/acceptable flu-like adverse events. JNJ-4964 administration resulted in increased frequencies of CD86-expressing B cells, indicative of B-cell activation. These changes were predominantly observed at high IFN-α levels, which are associated with flu-like adverse events. Conclusions JNJ-4964 administration led to changes in transcriptional profiles and immune cell activation phenotype, particularly for NK cells and B cells. Together, these changes could represent a set of biomarkers for the characterization of the immune response in CHB patients receiving TLR7 agonists.
Palliation, end of life care and ventilation withdrawal in neuromuscular disorders
Authors: Elverson Joanna , Evans Hayley , Dewhurst Felicity 
Published: May 2023

Background/objectives The role of palliative care in the support of patients with neuromuscular disorders (NMDs) is generally recognised in spite of the scarcity of condition-specific evidence in the literature. Methods We have focussed specifically on palliative and end-of-life care for patients whose neuromuscular disease has an impact on their respiratory function. Reviewing the literature, we have examined where existing palliative care knowledge can be applied to the specific challenges faced by patients with NMDs, identifying where lessons learnt during the management of one condition may need to be judiciously applied to others. Results We highlight lessons for clinical practice centring on six themes: management of complex symptoms; crisis support; relief of caregiver strain; coordination of care; advance care planning; and end of life care. Conclusions The principles of palliative care are well suited to addressing the complex needs of patients with NMDs and should be considered early in the course of illness rather than limited to care at the end of life. Embedding relationships with specialist palliative care services as part of the wider neuromuscular multidisciplinary team can facilitate staff education and ensure timely referral when more complex palliative care problems arise.
Predicting Features of Visceral Stent Failure in Fenestrated Endovascular Aortic Aneurysm Repair
Authors: Mancuso Enrico , Bootun Roshan , Stather Philip W. , Crawford Michael , Delbridge Michael , Tariq Ali Mohammad , Al-Jundi Wissam 
Published: May 2023

Purpose: Visceral stents in fenestrated endovascular aortic repair (FEVAR) have a significant risk of complications and carry a considerable burden of reinterventions. The aim of this study is to identify preoperative and intraoperative predictors of visceral stent failure. Materials: A retrospective review of 75 consecutive FEVARs in a single center from 2013 to 2021 was undertaken. Data on mortality, stent failure, and reintervention pertaining to 226 visceral stents were collected. Methods: Anatomical features including aortic neck angulation, aneurysm diameter, and angulation of target viscerals were obtained from preoperative computed tomography (CT) scans. Stent oversizing and intraprocedural complications were recorded. Postoperative CT scans were analyzed to determine the length of cover of target vessels. Results: Only bridging stents through fenestrations to visceral vessels were considered; 28 (37%) cases had 4 visceral stents, 24 (32%) had 3, 19 (25%) had 2, 4 (5%) had 1. Thirty day mortality was 8%, a third of which was related to visceral stent complications. Intraprocedural complexity was documented during the cannulation of 8 (3.5%) target vessels, with a technical success rate of 98.7%. A significant endoleak or visceral stent failure was identified in 22 stents (9.8%) postoperatively, of which 7 (3%) had in-patient reintervention within 30 days. Further reinterventions at 1, 2, and 3 years were 12 (5.4%), 2 (1%), and 1 (0.4%), respectively. Most reinterventions were for renal stents (n=19, 86%). A smaller stent diameter and a shorter length of visceral stent were significant predictors of failure. No other anatomical feature or stent choice was found to be a significant predictor of failure. Conclusions: The modality of visceral stent failures varies, but renal stents with a smaller diameter and/or shorter length are more likely to fail over time. Their complications and reinterventions are common and carry a significant burden; therefore, close surveillance must be continued long term. Clinical impact With this work we share the methodology adopted at our centre to treat juxtarenal aneurysm with FEVAR. Thanks to this detailed review of anatomical and technical features we provide guidance for endovascular surgeons to face hostile aneurysm with peculiar visceral vessels anatomy. With our findings will also motivate industries in their attempt to produce improved technologies able to overcome issues identified in this paper.
Correlation and differences of patient-reported outcomes vs. Likert-Rating of MS symptoms in a real-world cohort using a digital patient app
Authors: Mountford Steffeni , Kahn Maria , Balakrishnan Preetha , Jacyshyn-Owen Elizabeth , Eberl Markus , Friedrich Benjamin , Joschko Natalie , Ziemssen Tjalf 
Published: May 2023

Background Multiple Sclerosis (MS) is a chronic and progressive neurological autoimmune disease currently affecting 250,000 individuals in Germany. Patients suffering from the disease can be severely impaired in their day-to-day activities. BRISA is a digital app specifically designed to help MS patients monitor their disease by regularly tracking symptoms. Lengthy and time-consuming questionnaires for patient-reported outcomes (PRO) are the standard method to assess the patients’ current condition. Here, we examine whether simplified versions of these questionnaires can provide comparable information regarding individual symptom presentations in BRISA users. Methods 828 users were included in the analysis. Patients who provided onboarding information and answered at least one questionnaire and the corresponding simplified smiley symptoms assessment were included. Correlation of questionnaire and symptom scores was calculated using Pearson's correlation. Results Our analysis cohort predominantly consisted of female, 26–55-year-olds. Relapsing-remitting MS (RRMS) was the most common MS type recorded. Most patients were diagnosed 2–5 years ago. Questionnaires regarding fatigue and vision impairment were among the most answered, those regarding bowel movement and sexual satisfaction received fewest responses. Overall, the scores from questionnaires and symptoms correlated positively. Scoring correlation could also be shown across the subgroups divided by gender, age groups, type of MS, and time since diagnosis of the disease. Conclusion Scores recorded from traditional PRO questionnaires can be reflected more easily as a trend in a simplified scale using smileys. Nevertheless, traditional questionnaires are needed to also maintain a more objective assessment. In conclusion, the patient will benefit most from an adaptive combination of regular traditional PRO questionnaire assessments and simplified symptom recording.
Heart Rate Variability and Perceived Stress in Teacher Training: Facing the Reality Shock With Mindfulness?
Authors: Beuchel Philipp , Cramer Colin 
Published: May 2023

Background The beginning of the career of teachers is a demanding phase. In the combined roles of teacher and trainee, and in the shift from academic to practical learning, trainee teachers have to acquire competencies in teaching as well as coping with stress. In this phase, the phenomenon of “reality shock” is widely observed. Objective A mindfulness training was developed to support teacher trainees during their first year. This intervention study investigated perceived and physiological stress at teachers’ career start and the stress reducing effects of the mindfulness training in this phase. Methods In a quasi-experimental design, 19 out of 42 participants from this sample underwent mindfulness-based stress reduction training and a wait-list control group (N = 23) underwent a compact course after post measurements. We measured physiological stress parameters and perceived stress at 3 different time points. Heart rate signals were acquired in ambulatory assessment sequences, including teaching, rest periods, and cognitive tasks. The data were analyzed in linear mixed-effects models. Results We found high physiological stress in the very beginning of teacher training, which attenuated over time. The mindfulness intervention only led to a greater reduction in heart rate ( d = .53 to .74) in situations where the intervention group had shown higher heart rate levels initially, but not in heart rate variability. However, the mindfulness group significantly reduced ( d = .63) their perceived stress and maintained ( d = .55) this improvement, while the control group maintained a highly elevated perceived stress level throughout. Conclusion The mindfulness training could reduce subjective stress, which otherwise seems to be a long-lasting aspect of beginning teachers’ “reality shock”. Indications of a superior reduction of physiological stress in demanding situations were weak, while generally, undue physiological stress seems to be a temporary phenomenon in the initial phase of teacher induction.