bluuebunny/crossref_metadata_2025_split huggingface dataset:
Closed intravenous systems for central vascular access: A difference maker for CLABSI rates in neonates?
Authors: van Rens Matheus F.P.T. , Hugill Kevin , Francia Airene L.V. , Mahmah Mohamad Adnan , Al Shadad Afaf Boulous J , Chiuco Imelda Caseres , Garcia Krisha L.P. 
Published: April 2022

Background: Infants in neonatal units are susceptible to numerous potential iatrogenic risks. One key concern is central line-associated blood stream infection (CLABSI). To ensure patient safety and reduce the incidence of CLABSI toward zero, numerous evidence-based clinical interventions and product innovations have been implemented. Nevertheless, sustaining zero CLABSI for sustained periods remains challenging. Aim: The purpose of this study was to evaluate the impact on CLABSI rates of introducing a preassembled closed intravenous (IV) administration set in a neonatal intensive care unit (NICU). Methods: This was a retrospective observational analysis of routinely collected anonymized IV therapy infection data in a NICU. The study period was from January 2019 through June 2020. Results: Nine-hundred eighty five patients with a Epicutaneo-Caval Catheter (ECC) were included (456 legacy IV set, 529 closed IV set). Patient demographics were comparable between the two groups. ECC dwell time was the only IV characteristic associated ( p = 0.04) with CLABSI. Mann-Whitney U-test demonstrated significant differences between the two sets for CLABSI complication events ( p = 0.031). Prior to using the closed IV administration sets (January 2019–September 2019) the mean monthly CLABSI rate was 2.87 (/1000 device days). This figure declined to 0.22 (/1000 device days) afterwards (October 2019–June 2020). Zero CLABSIs were observed during January to June 2020. Conclusions: Utilization of a pre-assembled closed IV administration set was associated with a reduction in CLABSI rates. The study results suggest that using a pre-assembled closed IV set concurrently with evidence-based central line infection control interventions can help attain extended periods of zero CLABSI.
Patients With Autism Spectrum Disorder and Co-occurring Substance Use Disorder: A Clinical Intervention Study
Authors: Walhout Sharon JN , Zanten Johan van , DeFuentes-Merillas Laura , Sonneborn Christina KME , Bosma Marc 
Published: April 2022

Background: The prevalence of substance use disorders (SUD) in individuals with autism spectrum disorders (ASD) appears to be higher than previously described. Attention has been drawn to developing new treatment approaches for this patient population, as they appear to do less well with traditional addiction treatment. There is very little research addressing treatment outcome. This study aims to introduce and evaluate a manualized group treatment intervention developed specifically for patients with ASD and co-occurring SUD. Methods: We developed a group treatment based on cognitive behavioural therapy (CBT) and evaluated outcome measures at the end of treatment and 3-month follow-up. Fifty-seven patients with ASD and co-occurring SUD were included of which 30 completed the group intervention, 27 of them also participated at 3-month follow-up. Results: The findings suggest that group treatment can work for patients with ASD and co-occurring SUD. Lower levels of alcohol use ( t = 3.61, P = .002, d = 0.75), craving ( t = 2.65, P = .013, d = 0.51), passive coping styles ( t = 2.32, P = .030, d = 0.48), depression ( t = 3.48, P = .002, d = 0.67), anxiety ( t = 3.02, P = .006, d = 0.58), and stress ( t = 2.62, P = .015, d = 0.51) symptoms were reported after completing the group intervention, with even stronger effects at 3 months follow-up. Conclusions: The present study shows promising results of a tailor-made group intervention in a heterogeneous patient population with ASD and co-occurring SUD with positive effects on both symptoms of ASD and SUD.
Seasonal Variability Influence on the Prevalence of Diarrhoea among Under-Five-Year-old Children in Kersa District, Eastern Ethiopia: A Community-Based Longitudinal Study
Authors: Mengistie Bezatu , Gobena Tesfaye , Admassu Desalegn , Assefa Nega , Mekbib Ayele Dinku , Mengistu Dechasa Adare , Worku Alemayehu , Kumie Abera , Terfa Waltaji , Bikila Zerihun , Azage Muluken 
Published: April 2022

Background: The health effects of climate change have been found to be a global concern for the last 2 centuries. However, the effect of climate variability on diarrhoea among under-five-year-old children is perhaps undocumented or otherwise unknown. The aim of the present study was to determine the effect of climate variability on diarrhoea among children under 5 years of age. Methods: A community-based longitudinal study was conducted over 8 repeated visits from June 2016 to May 2018 at the Kersa Demographic Surveillance and Health Research Center. A total of 500 randomly selected households and their 48 improved water sources were included in the survey from 3 agro-ecological zones, the rural and urban areas of the study area. Data was collected on household characteristics, diarrhoea, WASH practices, water quality and quantity in households, and improved water sources. A structured pre-tested questionnaire, an observational check list and laboratory tests were used for data collection. The data was entered into Epi Data Version 3.01 and transferred to Stata Version 12 for analysis. Multilevel mixed-effect Poisson regression was used to determine the relationship between predictors and outcome variables. A P-value of less than .05 was the cut-off point for statistically significant. Results: The prevalence of diarrhoea in 2 weeks among children under 5 years of age was 17.2% (95% CI: 15.8-19.71). Rainfall, E. coli contamination of drinking water at the source and in the home, 20 L of water consumption per capita per day, sharing water sources with animals and home water treatment by residents of the mid- and lowlands were all predictors of diarrhoea. The space-time scan statistic confirmed that child diarrhoea had random variation in both space and time. Conclusion: Climate variability has influenced the prevalence of diarrhoea among under-five-year-old children. Climate-resilient measures should be taken to reduce the burden of diarrhoea in the community.
Minimally Invasive Treatment of Recurrent Anal Fistulas with Autologous Platelet-Rich Plasma Combined With Internal Orifice Closure
Authors: Cwaliński Jarosław , Hermann Jacek , Paszkowski Jacek , Banasiewicz Tomasz 
Published: April 2022

Aim Minimally invasive procedures for the treatment of anal fistulas are gaining more and more popularity. For this purpose, Platelet-Rich Plasma (PRP) are administered to accelerate the healing process of various difficult wounds or lesions. The aim of this study was to evaluate preliminary results of PRP injection into the tissues adjacent to anal fistulas. Patients and methods A cohort of 42 patients with recurrent anal fistula, who underwent at least one cutting procedure previously, were enrolled into this preliminary and prospective trial. Closure of internal orifice was performed in all investigated patients, however, in 22 patients from group I, that procedure was combined with topical injection of PRP. In the postoperative period, the PRP administration could be repeated in case of incomplete fistula closure. Follow-up consisted of out-patient visits in a fortnight, 1, 2, and 12 months. Results Complete closure of anal fistulas was achieved in 16 (75%) patients from group I and 10 (45,5%) patients from group II. The fistulas were healed in 9 patients from group I after single application of PRP. In the next 9 patients with incomplete fistula closure, the injection was repeated 2 to 4 times every fortnight leading finally to complete recovery in 6 of them. Conclusions Surgical fistula closure with local PRP application spares the anal sphincter and gives the opportunity to repeat the procedure several times if necessary. Treatment of recurrent anal fistulas with PRP can be considered as last resort therapy.
Willingness to use and distribute HIV self-test kits to clients and partners: A qualitative analysis of female sex workers’ collective opinion and attitude in Côte d’Ivoire, Mali, and Senegal
Authors: Ky-Zerbo Odette , Desclaux Alice , Boye Sokhna , Vautier Anthony , Rouveau Nicolas , Kouadio Brou Alexis , Fotso Arlette Simo , Pourette Dolorès , Maheu-Giroux Mathieu , Sow Souleymane , Camara Cheick Sidi , Doumenc-Aïdara Clémence , Keita Abdelaye , Boily Marie Claude , Silhol Romain , d’Elbée Marc , Bekelynck Anne , Gueye Papa Alioune , Diop Papa Moussa , Geoffroy Olivier , Kamemba Odé Kanku , Diallo Sanata , Ehui Eboi , Ndour Cheick Tidiane , Larmarange Joseph ,   for the ATLAS team
Published: April 2022

Background: In West Africa, female sex workers are at increased risk of HIV acquisition and transmission. HIV self-testing could be an effective tool to improve access to and frequency of HIV testing to female sex workers, their clients and partners. This article explores their perceptions regarding HIV self-testing use and the redistribution of HIV self-testing kits to their partners and clients. Methods: Embedded within ATLAS, a qualitative study was conducted in Côte-d’Ivoire, Mali, and Senegal in 2020. Nine focus group discussions were conducted. A thematic analysis was performed. Results: A total of 87 participants expressed both positive attitudes toward HIV self-testing and their willingness to use or reuse HIV self-testing. HIV self-testing was perceived to be discreet, confidential, and convenient. HIV self-testing provides autonomy from testing by providers and reduces stigma. Some perceived HIV self-testing as a valuable tool for testing their clients who are willing to offer a premium for condomless sex. While highlighting some potential issues, overall, female sex workers were optimistic about linkage to confirmatory testing following a reactive HIV self-testing. Female sex workers expressed positive attitudes toward secondary distribution to their partners and clients, although it depended on relationship types. They seemed more enthusiastic about secondary distribution to their regular/emotional partners and regular clients with whom they had difficulty using condoms, and whom they knew enough to discuss HIV self-testing. However, they expressed that it could be more difficult with casual clients; the duration of the interaction being too short to discuss HIV self-testing, and they fear violence and/or losing them. Conclusion: Overall, female sex workers have positive attitudes toward HIV self-testing use and are willing to redistribute to their regular partners and clients. However, they are reluctant to promote such use with their casual clients. HIV self-testing can improve access to HIV testing for female sex workers and the members of their sexual and social network.
Coaches’ opinions about teaching defensive skills for youth handball teams
Authors: Musa Vinicius da Silva , Menezes Rafael Pombo 
Published: April 2022

Purpose It can be observed that coaching in youth sports may be based on technique development, while it is inspired by high-performance sports. As it is observed a lack of research that addressed the coaching process with youth handball teams in the Brazilian context, this study aimed to analyze what is expected for the defensive phase and how it is taught. Methods We interviewed 22 handball coaches from the U-12, U-14, U-16, and U-18 teams addressing the teaching of defensive skills when facing different offensive systems and the approaches used in the training sessions. The interviews were analyzed using the Collective Subject Discourse (CSD) method. Results and discussion The coaches’ discourses revealed an increasing expectation due to players’ experience, but with stimulation of high-level sport since the youngest teams. The discourses also emphasized the use of traditional approaches and game-based approaches to apply the learned skill in the game context, independently of the age group. It was noted that the expectations of the coaches about players’ technical-tactical development and the approaches are controversial, especially when comparing the specific skills with the use of the traditional approach in the younger teams (U-12 and U-14 teams). It is suggested that more attention must be paid when choosing the defensive skills to be taught for youth players, and the chosen teaching approaches must promote a reflexive environment to learners.
Effect of match-related contextual factors on positional performance in the national rugby league
Authors: Wedding C. J. , Gomez M. A. , Woods C. T. , Sinclair W. H. , Leicht A. S. 
Published: April 2022

Objectives To examine the effects of match-related contextual variables on positional groups and success in the National Rugby League (NRL). Methods Data relating to match location, match outcome, quality of opposition and match type (absolute score differential) from all matches across the 2015–2019 NRL seasons were collected, in addition to 14 previously identified Factors (technical performance indicators). A decision tree, grown using the Exhaustive Chi-square Automatic Interaction Detector (CHAID) algorithm, was used to model the effect of each of these match-related contexts on positional contribution according to match outcome. Results The accuracy of the exhaustive CHAID model in explaining the influence of positional groups on match outcome was 66%. The model revealed four primary splits: interchange forwards, utility backs, adjustables and a group containing the remaining three positional groups (forwards, backs, and interchange). Conclusions Results suggest that interchange forwards, utility backs and adjustables could have a definitive role within the team compared to the remaining positional groups in determining match outcome. In contrast to team-level research, there is a greater emphasis on the importance of defensive actions (e.g. try causes, tackles made) at a positional level than attacking performance indicators. The moderate classification accuracy justifies the use of this approach for examination of the interactions between match-related contextual variables, performance indicators and positional groups.
Hemiarthroplasty versus open reduction internal fixation for intra-articular distal humerus fractures in older patients
Authors: Dirckx Margo , Tathgar Anand , Bellringer Simon , Phadnis Joideep 
Published: April 2022

Background Intra-articular distal humerus fractures in the older population remain a challenge to fix, due to the comminution of fragments and poor bone stock. Recently Elbow Hemiarthroplasty (EHA) has gained popularity to treat these fractures, however no studies exist comparing EHA to Open Reduction Internal Fixation (ORIF). Objectives To compare the clinical outcomes of patients over the age of 60 years treated with ORIF or EHA for multi-fragmentary distal humerus fractures. Methods Thirty-six patients (mean age 73 years) treated surgically for a multi-fragmentary intra-articular distal humeral fracture were followed up for a mean duration of thirty-four months (12–73 months). Eighteen patients were treated with ORIF and eighteen with EHA. The groups were matched for fracture type, demographic characteristics and follow up time. Outcome measures collected included Oxford Elbow Score (OES), Visual Analogue pain Score (VAS), range of motion (ROM), complications, re-operations and radiographic outcomes. The quality of ORIF was judged against set radiographic criteria in order to understand the effect of sub-optimal ORIF technique. Results No significant clinical difference was found between EHA and ORIF in mean OES (42.5 vs 39.6, p = 0.28), mean VAS (0.5 vs 1.7, p  = 0.08) or mean flexion-extension arc (123° vs 112°, p  = 0.12). There were significantly more complications associated with ORIF compared to EHA (39% vs 6%, p = 0.04). ORIF executed with satisfactory fixation technique had a comparable complication rate compared to EHA (17% vs 6%, p = 0.6). Two ORIF patients required revision to Total Elbow Arthroplasty (TEA). None of the EHA patients required revision surgery. Conclusion This study demonstrated similar short-term functional outcomes between EHA and ORIF for the treatment of multi-fragmentary intra-articular distal humeral fractures in patients >60 years of age. Early complications and re-operations were higher in the ORIF group, although this could be related to improper ORIF technique and patient selection.
GUIDE: a randomised non-comparative phase II trial of biomarker-driven intermittent docetaxel versus standard-of-care docetaxel in metastatic castration-resistant prostate cancer (clinical trial protocol)
Authors: Conduit Ciara , Mak Blossom , Qu Wenjia , Lulio Juliana Di , Burder Ronan , Bressel Matthias , Cusick Thomas , Dhillon Haryana M. , Lourenço Richard De Abreu , Underhill Craig , Torres Javier , Crumbaker Megan , Honeyball Florian , Linton Anthony , Allen Ray , Davis Ian D. , Clark Susan J. , Horvath Lisa G. , Mahon Kate L. 
Published: April 2022

Objective: To determine the efficacy and safety of intermittent docetaxel chemotherapy guided by circulating methylated glutathione S-transferase Pi-1 ( mGSTP1) in men with metastatic castration-resistant prostate cancer (CRPC). Patients and Methods: GUIDE (NCT04918810) is a randomised, two-arm, non-comparative phase-2 trial recruiting 120 patients at six Australian centres. Patients with Prostate Cancer Working Group-3 defined metastatic CRPC who are commencing docetaxel 75 mg/m2 q3w will be pre-screened for detectable mGSTP1 at baseline ± following two cycles of treatment. Those with detectable plasma mGSTP1 at baseline that becomes undetectable after two cycles of chemotherapy will be eligible for GUIDE. Prior to Cycle 4 of docetaxel, these patients are randomised 2:1 to one of two treatment arms: Arm A (cease docetaxel and reinstitute if mGSTP1 becomes detectable) or Arm B (continue docetaxel 75 mg/m2 q3w in accordance with clinician’s usual practice). The primary endpoint is radiographic progression-free survival. Secondary endpoints include time on treatment holidays, safety, patient-reported outcomes, overall survival, health resource use, and cost associated with treatment. Enrolment commenced November 2021. Results and Conclusion: The results of this trial will generate data on the clinical utility of mGSTP1 as a novel biomarker to guide treatment de-escalation in metastatic CRPC.
The global burden of thyroid cancer in high-income Asia-Pacific: a systematic analysis of the Global Burden of Disease study
Authors: Li Yike , Huang Yinqiong , He Xue , Han Cheng , Wu Wei , Shen Hui , Xu Yanbing , Liu Yazhuo , Zhu Zizhao 
Published: April 2022

Background: Thyroid cancer has become increasingly prevalent and threatens human health. Few studies have explored the incidence of thyroid cancer in Asia and its relationship with social-progress factors. Methods: We analyzed Global Burden of Disease (GBD) Study 2019 data specific to thyroid cancer. Incidence, prevalence, mortality, and disability-adjusted life year (DALY) rates were used to evaluate the burden of thyroid cancer. Results: The age-standardized incidence, prevalence, and DALY rates per 100,000 population were 1.34% (95% UI, 2.44–3.07), 2.79% (95% UI, 18.82–23.77) and 16.49% (95% UI, 14.6–18), respectively, for all of Asia in 2019. In 2019, the DALY rate of thyroid cancer in the High-income Asia-Pacific region was the highest and mortality due to thyroid cancer in the High-income Asia-Pacific region was also the highest. The growth trend of DALYs in the High-income Asia-Pacific region was much steeper than those in other Asian regions. In all Asian regions and in the High-income Asia-Pacific region, the incidence, prevalence, mortality and DALY rates of thyroid cancer in female patients were drastically higher than those in male patients. Among Asian patients with thyroid cancer, the DALY rate was higher in men aged 80–89 years than in women. The DALY rate gradually increased with age. In the High-income Asia-Pacific region, the mortality rate of patients with thyroid cancer decreased with age. The prevalence was highest in those aged 40–79 years. Conclusion: The disease burden of thyroid cancer in the High-income Asia-Pacific region was significantly higher than those in other regions, which may be due to overdiagnosis. The increasing incidence of thyroid cancer seems to indicate that thyroid cancer is still a public health problem in Asia. Therefore, some health policy adjustments will be meaningful.
The association between diabetes mellitus and incidence of depressive episodes is different based on sex: insights from ELSA-Brasil
Authors: Barbosa Elizabeth Leite , Moreno Arlinda B. , Van Duinkerken Eelco , Lotufo Paulo , Barreto Sandhi Maria , Giatti Luana , Nunes Maria Angélica , Viana Maria Carmen , Figueiredo Roberta , Chor Dóra , Griep Rosane Harter 
Published: April 2022

Objective: To investigate the association between diabetes mellitus (DM) and incidence of depressive episodes among men and women. Methods: Data were used from 12,730 participants (5866 men and 6864 women) at baseline (2008–2010) and follow-up 1 (2012–2014) of the Longitudinal Study of Adult Health (ELSA-Brasil), a multicenter cohort of Brazilian civil servants. Participants were classified for diabetes using self-reported and clinical information, and evaluated for presence of depressive episodes by the Clinical Interview Schedule–Revised (CIS-R). Associations were estimated by means of logistic regression models (crude and adjusted for socio-demographic variables). Results: Women classified as with DM prior to the baseline were at 48% greater risk (95% confidence interval (CI) = 1.03–2.07) of depressive episodes in the crude model and 54% greater risk (95% CI = 1.06–2.19) in the final adjusted model compared to women classified as non-DM. No significant associations were observed for men. The regression models for duration of DM and incidence of depressive episodes ( n = 2143 participants; 1160 men and 983 women) returned no significant associations. Conclusion: In women classified as with prior DM, the greater risk of depressive episodes suggests that more frequent screening for depression may be beneficial as part of a multi-factorial approach to care for DM.