bluuebunny/crossref_metadata_2025_split huggingface dataset:
Planned Peri-Extubation Fasting in Critically Ill Children: An International Survey of Practice
Authors: Nabialek Tomasz , Tume Lyvonne N. , Cercueil Eloise , Morice Claire , Bouvet Lionel , Baudin Florent , Valla Frederic V. 
Published: May 2022

IntroductionCumulative energy/protein deficit is associated with impaired outcomes in pediatric intensive care Units (PICU). Enteral nutrition is the preferred mode, but its delivery may be compromised by periods of feeding interruptions around procedures, with peri-extubation fasting the most common procedure. Currently, there is no evidence to guide the duration of the peri-extubation fasting in PICU. Therefore, we aimed to explore current PICU fasting practices around the time of extubation and the rationales supporting them.Materials and MethodsA cross sectional electronic survey was disseminated via the European Pediatric Intensive Care Society (ESPNIC) membership. Experienced senior nurses, dieticians or doctors were invited to complete the survey on behalf of their unit, and to describe their practice on PICU fasting prior to and after extubation.ResultsWe received responses from 122 PICUs internationally, mostly from Europe. The survey confirmed that fasting practices are often extrapolated from guidelines for fasting prior to elective anesthesia. However, there were striking differences in the duration of fasting times, with some units not fasting at all (in patients considered to be low risk), while others withheld feeding for all patients. Fasting following extubation also showed large variations in practice: 46 (38%) and 26 (21%) of PICUs withheld oral and gastric/jejunal nutrition more than 5 h, respectively, and 45 (37%) started oral feeding based on child demand. The risk of vomiting/aspiration and reducing nutritional deficit were the main reasons for fasting children [78 (64%)] or reducing fasting times [57 (47%)] respectively.DiscussionThis variability in practices suggests that shorter fasting times might be safe. Shortening the duration of unnecessary fasting, as well as accelerating the extubation process could potentially be achieved by using other methods of assessing gastric emptiness, such as gastric point of care ultrasonography (POCUS). Yet only half of the units were aware of this technique, and very few used it.
A Review of Economic Models Submitted to NICE’s Technology Appraisal Programme, for Treatments of T1DM & T2DM
Authors: Daly Marie-Josée , Elvidge Jamie , Chantler Tracey , Dawoud Dalia 
Published: May 2022

Background: In the UK, 4.7 million people are currently living with diabetes. This is projected to increase to 5 million by 2025. The direct and indirect costs of T1DM and T2DM are rising, and direct costs already account for approximately 10% of the National Health Service (NHS) budget.Objective: The aim of this review is to assess the economic models used in the context of NICE’s Technology Appraisals (TA) Programme of T1DM and T2DM treatments, as well as to examine their compliance with the American Diabetes Association’s (ADA) guidelines on computer modelling.Methods: A review of the economic models used in NICE’s TA programme of T1DM and T2DM treatments was undertaken. Relevant TAs were identified through searching the NICE website for published appraisals completed up to April 2021. The review also examined the associated Evidence Review Group (ERG) reports and Final Appraisal Documents (FAD), which are publicly accessible. ERG reports were scrutinised to identify major issues pertaining to the economic modelling. The FAD documents were then examined to assess how these issues reflected on NICE recommendations.Results: Overall, 10 TAs pertaining to treatments of T1DM and T2DM were identified. Two TAs were excluded as they did not use economic models. Seven of the 8 included TAs related to a novel class of oral antidiabetic drugs (OADs), gliflozins, and one to continuous subcutaneous insulin infusion (CSII) devices. There is a lack of recent, robust data informing risk equations to enable the derivation of transition probabilities. Despite uncertainty surrounding its clinical relevance, bodyweight/BMI is a key driver in many T2DM-models. HbA1c’s reliability as a predictor of hard outcomes is uncertain, chiefly for macrovascular complications. The external validity of T1DM is even less clear. There is an inevitable trade-off between the sophistication of models’ design, their transparency and practicality.Conclusion: Economic models are essential tools to support decision-making in relation to market access and ascertain diabetes technologies’ cost effectiveness. However, key structural and methodological issues exist. Models’ shortcomings should be acknowledged and contextualised within the framework of technology appraisals. Diabetes medications and other technologies should also be subject to regular and consistent re-appraisal to inform disinvestment decisions. Artificial intelligence could potentially enhance models’ transparency and practicality.
A Lumped Two-Compartment Model for Simulation of Ventricular Pump and Tissue Mechanics in Ischemic Heart Disease
Authors: Koopsen Tijmen , Van Osta Nick , Van Loon Tim , Van Nieuwenhoven Frans A. , Prinzen Frits W. , Van Klarenbosch Bas R. , Kirkels Feddo P. , Teske Arco J. , Vernooy Kevin , Delhaas Tammo , Lumens Joost 
Published: May 2022

Introduction: Computational modeling of cardiac mechanics and hemodynamics in ischemic heart disease (IHD) is important for a better understanding of the complex relations between ischemia-induced heterogeneity of myocardial tissue properties, regional tissue mechanics, and hemodynamic pump function. We validated and applied a lumped two-compartment modeling approach for IHD integrated into the CircAdapt model of the human heart and circulation.Methods: Ischemic contractile dysfunction was simulated by subdividing a left ventricular (LV) wall segment into a hypothetical contractile and noncontractile compartment, and dysfunction severity was determined by the noncontractile volume fraction (NCVF). Myocardial stiffness was determined by the zero-passive stress length (Ls0,pas) and nonlinearity (kECM) of the passive stress-sarcomere length relation of the noncontractile compartment. Simulated end-systolic pressure volume relations (ESPVRs) for 20% acute ischemia were qualitatively compared between a two- and one-compartment simulation, and parameters of the two-compartment model were tuned to previously published canine data of regional myocardial deformation during acute and prolonged ischemia and reperfusion. In six patients with myocardial infarction (MI), the NCVF was automatically estimated using the echocardiographic LV strain and volume measurements obtained acutely and 6 months after MI. Estimated segmental NCVF values at the baseline and 6-month follow-up were compared with percentage late gadolinium enhancement (LGE) at 6-month follow-up.Results: Simulation of 20% of NCVF shifted the ESPVR rightward while moderately reducing the slope, while a one-compartment simulation caused a leftward shift with severe reduction in the slope. Through tuning of the NCVF, Ls0,pas, and kECM, it was found that manipulation of the NCVF alone reproduced the deformation during acute ischemia and reperfusion, while additional manipulations of Ls0,pas and kECM were required to reproduce deformation during prolonged ischemia and reperfusion. Out of all segments with LGE&gt;25% at the follow-up, the majority (68%) had higher estimated NCVF at the baseline than at the follow-up. Furthermore, the baseline NCVF correlated better with percentage LGE than NCVF did at the follow-up.Conclusion: We successfully used a two-compartment model for simulation of the ventricular pump and tissue mechanics in IHD. Patient-specific optimizations using regional myocardial deformation estimated the NCVF in a small cohort of MI patients in the acute and chronic phase after MI, while estimated NCVF values closely approximated the extent of the myocardial scar at the follow-up. In future studies, this approach can facilitate deformation imaging–based estimation of myocardial tissue properties in patients with cardiovascular diseases.
A Phone Consultation Call Line to Support SBIRT in Pediatric Primary Care
Authors: Levy Sharon , Fuller Alyssa , Kelly Shawn , Lunstead Julie , Weitzman Elissa R. , Straus John H. 
Published: May 2022

BackgroundScreening Brief Intervention Referral to Treatment (SBIRT) is recommended as a routine part of pediatric primary care, though managing patients with positive screens is challenging. To address this problem, the state of Massachusetts created a call line staffed by pediatric Addiction Medicine specialists to provide consultations to primary care providers and access to a behavioral health provider specially trained in managing adolescent substance use.ObjectiveTo describe the uptake and outcomes of a consultation call line and virtual counseling for managing substance use disorders (SUD) in pediatric primary care.MethodsService delivery data from consultations and counseling appointments were captured in an electronic database including substance, medication recommendations, level of care recommendations and number of counseling appointments completed for each patient. Summary data is presented here.ResultsIn all, there were 407 encounters to 108 unique families, including 128 consultations and 279 counseling visits in a one-year period. The most common substances mentioned by healthcare providers were cannabis (64%), nicotine (20%), alcohol (20%), vaping (9%) and opioids (5%). Management in primary care was recommended for 87 (68%) of the consultations. Medications for SUD treatment were recommended for 69 (54%) consultations including two for opioid use disorder.ConclusionWe found that both a statewide consultation call line and virtual counseling to support SBIRT in pediatric primary care were feasible. The majority of consultations resulted in recommendations for treatment in primary care.
The Effects of Immediate vs Gradual Reduction in Nicotine Content of Cigarettes on Smoking Behavior: An Ecological Momentary Assessment Study
Authors: Li Qianling , Chen Xijing , Li Xiuli , Gorowska Monika , Li Zimin , Li Yonghui 
Published: May 2022

BackgroundIn recent years, much research has examined the effects of various interventions and treatments for smoking cessation. The results suggest that interventions targeting changes of nicotine content can help smokers reduce tobacco use or quit smoking. A number of clinical studies show that smokers who received an immediate reduction in nicotine content to very low levels have significantly greater reductions in the number of cigarettes smoked and toxic substance exposure compared to those with gradual reductions. However, from the perspective of smoking craving, whether the immediate and gradual reduction in nicotine content reduce smoking by reducing cravings needs further investigation.Methods74 eligible Participants were randomly allocated to one of the two experimental conditions: (1) immediate reduction to 0.1 mg of nicotine per cigarette (n = 40); (2) gradual reduction from 1.0 (0.8 g ~ 1.2 mg) to 0.1 mg of nicotine per cigarette (n = 34). All participants completed 1-week baseline period during which they smoked their usual cigarette, followed by 16-week of interventions. The primary outcomes included cigarette cravings and number of cigarettes smoked per day (CPD); secondary outcomes included the number of cigarette-free day and emotional states.ResultsAmong the 52 participants [51 (98.1%) men; mean (SD) age, 33.44 (6.71) years; mean (SD) CPD, 16.83 (9.94)] who completed the trial, significantly lower cravings for cigarettes were observed in the immediate (n = 25) vs. gradual nicotine reduction group (n = 27) in the morning (t = −2.072, p = 0.039) and after dinner (t = –2.056, p = 0.041). Compared with the baseline daily smoking, the number of cigarettes smoked per day was significantly reduced at the beginning of week 12 in the immediate nicotine reduction group (p = 0.001) and at week 16 in the gradual nicotine reduction group (p &lt; 0.001). The number of participants with any cigarette-free day was not significantly different between the groups (p = 0.198). The number of cigarette-free days was significantly more in the immediate vs. gradual nicotine reduction group (p = 0.027).ConclusionsThe significantly lower cravings were observed in the immediate vs. gradual nicotine reduction group, and led to faster reduction in the number of CPD, and a significant increase in the number of cigarette-free days. These findings add to the evidence base for reduced nicotine content in cigarettes.Clinical Trial RegistrationClinicalTrials.gov, identifier: ChiCTR2100048216.
Suicidal Behavior in Emergency Child and Adolescent Psychiatric Service Users Before and During the 16 Months of the COVID-19 Pandemic
Authors: Kirič Barbara , Leben Novak Lara , Lušicky Petra , Drobnič Radobuljac Maja 
Published: May 2022

BackgroundSlovenia is among the countries with the highest suicide rates in the world. The COVID-19 pandemic has had a significant impact on the mental health of children and adolescents. Our hypothesis is that the school closure during the pandemic with a gradual transfer to virtual schooling had an important impact on children's and adolescents' suicidal behavior. Therefore, we aimed to determine possible changes in the frequency of assessments as well as frequency and severity of suicidal behavior in the population of Slovene children and adolescents seeking emergency psychiatric help in correlation with the progression of the pandemic and online schooling.MethodsWe performed a retrospective observational analysis of medical records of all children and adolescents referred to the only 24-h emergency in- and outpatient child and adolescent psychiatry service in Slovenia from March 2019 through the end of July 2021. We extracted number of assessments, number of patients with suicidal ideation and with attempted suicide. A comparison between the same periods prior to the pandemic and during the pandemic was made. The months of school closure due to the COVID-19 restriction measures and the months without closures were also compared.ResultsDuring this period, 1966 children and adolescents were assessed. There was no statistically significant difference in the observed frequency of emergency visits when we compared all the months with to all the months without school closures, or when individual corresponding months with and without school closures were compared. However, there were statistically significantly more patients with suicidal ideation [t(16) = −2.739, p = 0.015; W = 25.0, p = 0.016] and patients who had attempted suicide [t(16)= −3.412, p= 0.004; W = 14.5, p =0.006] during the pandemic as individually compared to the corresponding pre-pandemic months.ConclusionsOur results show that the number of Slovene children and adolescents who required emergency psychiatric help with suicidality and attempted suicide increased during the COVID-19 pandemic. The increase was shown only after the first year of the pandemic. The observed increase did not appear to directly correspond to the school closures, but was more likely related to the duration of the pandemic.
Association Between Internet Use, Cognitive Function, and Globus Pallidus Volumes: A Study Among the Elderly in Chinese Communities
Authors: Li Wei , Yue Ling , Xiao Shifu 
Published: May 2022

BackgroundPrevious studies have linked internet use with several beneficial outcomes for brain health, but there is little data on this among older Chinese.ObjectiveThe goal of this study was to explore the association between internet use and cognitive impairment and to explore the possible mechanisms by which internet use prevents cognitive decline.MethodsThe current study consisted of two cohorts: one from the China Longitudinal Aging Study (CLAS), which included 610 older adults with mild cognitive impairment (MCI), 192 with dementia, and 2,218 healthy older adults; the second cohort included 39 healthy adults from the Shanghai brain health foundation (SHBHF2016001), who underwent T1 cranial magnetic resonance imaging at baseline, from which their volumes of the hippocampus, amygdala, and globus pallidus were calculated. Moreover, they were also followed up for 1 year. Through standardized questionnaires, detailed general demographic information and internet use information was obtained. The cognitive diagnosis of each participant was made by attending psychiatrists at baseline, and their overall cognitive function was assessed by the mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA).ResultsIn cohort 1, after controlling age, gender, smoker, tea drinker, take exercise, diabetes, and hypertension, we found that internet use was associated with MCI (P = 0.015, OR = 0.478, 95% CI: 0.264~0.867), but not for dementia (P = 0.205, OR = 0.393, 95% CI: 0.093~1.665). In cohort 2, we found that the globus pallidus volume of internet users was significantly larger than that of non-users, and the MMSE change score was lower (P &lt; 0.05). The results of partial correlation analysis (controlled for sex, age and education) showed that the change of MMSE value was positively correlated with the volume of left globus pallidus (r = 0.547, P = 0.004).ConclusionsInternet use might be a protective factor for mild cognitive impairment among the Chinese elderly, and it may prevent a decline in cognitive decline by affecting the volume of the globus pallidus.
Assessing the Impact of Atmospheric CO2 and NO2 Measurements From Space on Estimating City-Scale Fossil Fuel CO2 Emissions in a Data Assimilation System
Authors: Kaminski Thomas , Scholze Marko , Rayner Peter , Houweling Sander , Voßbeck Michael , Silver Jeremy , Lama Srijana , Buchwitz Michael , Reuter Maximilian , Knorr Wolfgang , Chen Hans W. , Kuhlmann Gerrit , Brunner Dominik , Dellaert Stijn , Denier van der Gon Hugo , Super Ingrid , Löscher Armin , Meijer Yasjka 
Published: May 2022

The European Copernicus programme plans to install a constellation of multiple polar orbiting satellites (Copernicus Anthropogenic CO2 Monitoring Mission, CO2M mission) for observing atmospheric CO2 content with the aim to estimate fossil fuel CO2 emissions. We explore the impact of potential CO2M observations of column-averaged CO2 (XCO2), nitrogen dioxide (NO2), and aerosols in a 200 × 200 km2 domain around Berlin. For the quantification of anticipated XCO2 random and systematic errors we developed and applied new error parameterisation formulae based on artificial neural networks. For the interpretation of these data, we further established a CCFFDAS modelling chain from parameters of emission models to XCO2 and NO2 observations to simulate the 24 h periods preceeding simulated CO2M overpasses over the study area. For one overpass in winter and one in summer, we present a number of assessments of observation impact in terms of the posterior uncertainty in fossil fuel emissions on scales ranging from 2 to 200 km. This means the assessments include temporal and spatial scales typically not covered by inventories. The assessments differentiate the fossil fuel CO2 emissions into two sectors, an energy generation sector (power plants) and the complement, which we call “other sector.” We find that combined measurements of XCO2 and aerosols provide a powerful constraint on emissions from larger power plants; the uncertainty in fossil fuel emissions from the largest three power plants in the domain was reduced by 60%–90% after assimilating the observations. Likewise, these measurements achieve an uncertainty reduction for the other sector that increases when aggregated to larger spatial scales. When aggregated over Berlin the uncertainty reduction for the other sector varies between 28% and 48%. Our assessments show a considerable contribution of aerosol observations onboard CO2M to the constraint of the XCO2 measurements on emissions from all power plants and for the other sector on all spatial scales. NO2 measurements onboard CO2M provide a powerful additional constraint on the emissions from power plants and from the other sector. We further apply a Jacobian representation of the CCFFDAS modelling chain to decompose a simulated CO2 column in terms of spatial emission impact. This analysis reveals the complex structure of the footprint of an observed CO2 column, which indicates the limits of simple mass balances approaches for interpretation of such observations.
A Scoping Review Exploring Whether a Free “Offer” Devalues or Widens Sport and Physical Activity Participation Amongst Children and Young Adults Aged 0–25?
Authors: Durden-Myers E. J. , Swaithes L. 
Published: May 2022

BackgroundSocio-economic status continues to mediate physical activity engagement, despite a range of interventions aimed at reducing inequalities and widening sport and physical activity participation. As a result there has been increasing interest amongst policy makers, national governing bodies (NGB), county sports partnerships (CPS) and the sport and physical activity sector more broadly, in understanding how best to reduce inequalities and widen participation. The “price point” of offers and whether a “free offer” enables or devalues participation, has been a key area of interest. This scoping review aimed to explore this topic further by investigating whether “a free “offer” devalues or widens sport and physical activity participation amongst children and young adults aged 0-25?”.MethodsThis scoping review searched three electronic bibliographic databases (MEDLINE, PsycINFO, SPORTDiscus) using a structured search strategy to identify articles published between 2017 and January 2022. Studies were included using the PICO criteria of; Population: children and young adults aged 0-25; Intervention: free “offer” relating to physical activity; Context: areas of deprivation in the UK; Outcome: engagement, involvement, participation in sport and physical activity.Results and DiscussionFive studies were eligible after screening 1301 titles and reviewing 14 full-text studies. Features reported included intervention design, outcomes, potential challenges and wider implications / future recommendations. Specifically, a narrative synthesis of the key themes of participation deprivation and cost effectiveness were outlined in more detail. A subsidized cost or free offer can improve participation generally and in attracting those from lower socio-economic backgrounds. However, the impact of such initiatives decrease with increasing deprivation highlighting that groups with the highest levels of deprivation have wider complexities affecting their participation. Competing priorities and potentially unrealistic expectations at stakeholders level was also identified.ConclusionDespite the paucity of current research exploring the impact of a “free offer” in children and young adults, recommendations for future research, practice and policy included the need for longitudinal, more holistic and participant centric approaches. Further research is required to explore the impact of a “free offer” from an individual, societal and policy-level perspective, in widening and increasing participation in sport and physical activity.