bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID-19 as a trigger for innovation in policy action for older persons? Evidence from Asia
Authors: Gietel-Basten Stuart , Matus Kira , Mori Rintaro 
Published: January 2022

Abstract
COVID-19 has had a disproportionate impact on older people, in terms of their susceptibility to the disease and increased fatality rates, while also by creating barriers to health care access, social isolation, psychological and financial burdens. Policy responses provide an opportunity to understand whether the demands of this crisis have led to the development of policy innovations to meet the needs of aging populations. We analyzed an illustrative corpus of policies collected by HelpAge International across Asia in Afghanistan, Bangladesh, India, Iran, Japan, Korea, Myanmar, Pakistan, and Vietnam. We identified different policy types that impacted older persons during the pandemic. We also observed the degree to which these policies support arguments for paradigmatic policy changes by examining different models of intersectoral and multisectoral collaborations, and the kinds of policies where these multiactor arrangements were the most common. From our analysis, we identify two main areas where COVID-19 policies are most likely to lead to more long-lasting innovation in Asia. The first is in the upgrading of infrastructures to ensure access to benefits, and to develop remote and doorstep banking. The second area is well-being and caring support, such as the development of programs to provide increased services to support home-based older persons, including telemedicine, delivery services for medical and other supplies, and remote support for older persons and their carers. These changes, while important, are consistent with “acceleration” models of policy change, where COVID-19 responses sped up, and scaled up, programs consistent with current institutional and organizational structures.
The return of Keynesianism? Exploring path dependency and ideational change in post-covid fiscal policy
Authors: Chohan Usman W 
Published: January 2022

Abstract
The aim of this article is to explore the nature of policy change in the domain of public finance (fiscal policy) in the wake of the coronavirus disease (Covid-19) pandemic as well as for a post-Covid era. It draws upon the literatures of path dependency and ideational change in public policy to consider three broad questions: (1) whether the pandemic really is a critical juncture for policy change; (2) whether the extant neoliberal austerity paradigm has faced lasting ideational displacement by Keynesianism; and (3) whether Covid-19 has really punctuated the existing fiscal policy equilibrium or rather served as a path-clearing accelerator of public finance trends that were already underway. The article then suggests three potential future trajectories: Keynesian, neoliberal, and mixed/other to consider how the path of policy change might materialize in the fiscal realm in the post-Covid era.
Effect of Varying Repositioning Frequency on Pressure Injury Prevention in Nursing Home Residents: TEAM-UP Trial Results
Authors: Yap Tracey L. , Horn Susan D. , Sharkey Phoebe D. , Zheng Tianyu , Bergstrom Nancy , Colon-Emeric Cathleen , Sabol Valerie K. , Alderden Jenny , Yap Winston , Kennerly Susan M. 
Published: January 2022

ABSTRACT

OBJECTIVE
To investigate the clinical effectiveness of three nursing-home-wide repositioning intervals (2-, 3-, or 4-hour) without compromising pressure injury (PrI) incidence in 4 weeks.

METHODS
An embedded pragmatic cluster randomized controlled trial was conducted in nine nursing homes (NHs) that were randomly assigned to one of three repositioning intervals. Baseline (12 months) and 4-week intervention data were provided during the TEAM-UP (Turn Everyone And Move for Ulcer Prevention) study. Intervention residents were without current PrIs, had PrI risk (Braden Scale score) ≥10 (not severe risk), and used viable 7-inch high-density foam mattresses. Each arm includes three NHs with an assigned single repositioning interval (2-, 3-, or 4-hour) as standard care during the intervention. A wireless patient monitoring system, using wearable single-use patient sensors, cued nursing staff by displaying resident repositioning needs on conveniently placed monitors. The primary outcome was PrI incidence; the secondary outcome was staff repositioning compliance fidelity.

RESULTS
From May 2017 to October 2019, 1,100 residents from nine NHs were fitted with sensors; 108 of these were ineligible for some analyses because of missing baseline data. The effective sample size included 992 residents (mean age, 78 ± 13 years; 63% women). The PrI incidence during the intervention was 0.0% compared with 5.24% at baseline, even though intervention resident clinical risk scores were significantly higher (P < .001). Repositioning compliance for the 4-hour repositioning interval (95%) was significantly better than for the 2-hour (80%) or 3-hour (90%) intervals (P < .001).

CONCLUSIONS
Findings suggest that current 2-hour protocols can be relaxed for many NH residents without compromising PrI prevention. A causal link was not established between repositioning interval treatments and PrI outcome; however, no new PrIs developed. Compliance improved as repositioning interval lengthened.
Nonoperative Treatment of Posterior Wall Acetabular Fractures After Dynamic Stress Examination Under Anesthesia: Revisited
Authors: McNamara Andrew R. , Boudreau John A. , Moed Berton R. 
Published: January 2022

Objectives:
Performing an examination under general anesthesia (EUA) using dynamic stress fluoroscopy of patients with posterior wall acetabular fractures has been used as a tool to determine hip stability and the need for surgical intervention. The purpose of this study was to further evaluate the effectiveness of this technique, from a source other than its primary advocates, in patients with posterior wall acetabular fractures less than or equal to 50% who were stable on EUA and treated nonoperatively.

Design:
Retrospective case series.

Setting:
University Level 1 Trauma Center.

Participants:
Seventeen patients with a posterior wall acetabular fracture stable on EUA treated nonoperatively.

Intervention:
The patients were treated nonoperatively as guided by an EUA negative for instability. Patient follow-up averaged 30 months (range, 6–64 months).

Main Outcome Measurements:
Outcome evaluation included the modified Merle d'Aubigné clinical score and the Short Musculoskeletal Function Assessment Questionnaire. Radiographic evaluation for subluxation or arthritis consisted of the 3 standard pelvic radiographs.

Results:
Radiographic evaluation showed all hips to be congruent with a normal joint space. Sixteen of the 17 patients had radiographic outcomes rated as “excellent”; 1 patient was rated “good.” The modified Merle d'Aubigné score (obtained in 12 patients) averaged very good, with only 1 having less than a good (graded as fair) clinical outcome. The Short Musculoskeletal Function Assessment Questionnaire scores (from 11 patients) were not significantly different from normal and were within the normal reported values for all indices and categories. There was no correlation between fracture fragment size and outcome.

Conclusions:
This study further supports the contention that a stable hip joint, as determined by EUA, after posterior wall acetabular fracture treated nonoperatively is predictive of continued joint congruity, an excellent radiographic outcome, and good-to-excellent early clinical and functional outcomes.

Level of Evidence:
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Identification and Assessment of Strategies to Address Gender Inequity in the Specialty of Critical Care Medicine: A Scoping Review, Modified Consensus Process, and Stakeholder Meeting
Authors: Parsons Leigh Jeanna , de Grood Chloe , Brundin-Mather Rebecca , Dodds Alexandra , FitzGerald Emily A. , Kemp Laryssa , Mizen Sara J. , Whalen-Browne Liam , Stelfox Henry T. , Fiest Kirsten M. ,   on behalf of the Canadian Critical Care Gender Equity Forum Panel
Published: January 2022

OBJECTIVES:
We sought to identify and prioritize improvement strategies that Critical Care Medicine (CCM) programs could use to inform and advance gender equity among physicians in CCM.

DESIGN:
This study involved three sequential phases: 1) scoping review that identified strategies to improve gender equity in all medical specialties; 2) modified consensus process with 48 CCM stakeholders to rate and rank identified strategies; and 3) in-person stakeholder meeting to refine strategies and discuss facilitators and barriers to their implementation.

SETTING:
CCM.

SUBJECTS:
CCM stakeholders (physicians, researchers, and decision-makers; mutually inclusive).

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We identified 190 unique strategies from 416 articles. Strategies were grouped thematically into 20 categories across four overarching pillars of equity: access, participation, reimbursement, and culture. Participants prioritized 22 improvement strategies for implementation in CCM. The top-rated strategy from each pillar included: 1) nominate gender diverse candidates for faculty positions and prestigious opportunities (equitable access); 2) mandate training in unconscious bias and equitable treatment for committee (e.g., hiring, promotion) members (equitable participation); 3) ensure equitable starting salaries regardless of sex or gender (equitable reimbursement); and, 4) conduct 360° evaluations of leaders (including their direct work circle of supervisors, peers, and subordinates) through a diversity lens (equitable culture). Interprofessional collaboration, leadership, and local champions were identified as key enablers for implementation.

CONCLUSIONS:
We identified stakeholder-prioritized strategies that can be used to inform and enhance gender equity among physicians in CCM under four overarching equity pillars: access, participation, reimbursement, and culture. Implementation approaches should include education, policy creation, and measurement, and reporting.
Serial Thromboelastography and the Development of Venous Thromboembolism in Critically Ill Patients With COVID-19
Authors: Marvi Tanya K. , Stubblefield William B. , Tillman Benjamin F. , Tenforde Mark W. , Patel Manish M. , Lindsell Christopher J. , Self Wesley H. , Grijalva Carlos G. , Rice Todd W. ,   for the Influenza and Other Viruses in the Acutely Ill (IVY) Network
Published: January 2022

OBJECTIVES:
To test the hypothesis that relatively lower clot strength on thromboelastography maximum amplitude (MA) is associated with development of venous thromboembolism (VTE) in critically ill patients with COVID-19.

DESIGN:
Prospective, observational cohort study.

SETTING:
Tertiary care, academic medical center in Nashville, TN.

PATIENTS:
Patients with acute respiratory failure from COVID-19 pneumonia admitted to the adult medical ICU without known VTE at enrollment.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Ninety-eight consecutive critically ill adults with laboratory-confirmed COVID-19 were enrolled. Thromboelastography parameters and conventional coagulation parameters were measured on days 0 (within 48 hr of ICU admission), 3, 5, and 7 after enrollment. The primary outcome was diagnosis of VTE with confirmed deep venous thrombosis and/or pulmonary embolism by clinical imaging or autopsy. Twenty-six patients developed a VTE. Multivariable regression controlling for antiplatelet exposure and anticoagulation dose with death as a competing risk found that lower MA was associated with increased risk of VTE. Each 1 mm increase in enrollment and peak MA was associated with an 8% and 14% decrease in the risk of VTE, respectively (enrollment MA: subdistribution hazard ratio [SHR], 0.92; 95% CI, 0.87–0.97; p = 0.003 and peak MA: SHR, 0.86; 95% CI, 0.81–0.91; p < 0.001). Lower enrollment platelet counts and fibrinogen levels were also associated with increased risk of VTE (p = 0.002 and p = 0.01, respectively). Platelet count and fibrinogen level were positively associated with MA (multivariable model: adjusted R
2 = 0.51; p < 0.001).

CONCLUSIONS:
When controlling for the competing risk of death, lower enrollment and peak MA were associated with increased risk of VTE. Lower platelet counts and fibrinogen levels at enrollment were associated with increased risk of VTE. The association of diminished MA, platelet counts, and fibrinogen with VTE may suggest a relative consumptive coagulopathy in critically ill patients with COVID-19.
Contribution of Coagulopathy on the Risk of Bleeding After Central Venous Catheter Placement in Critically Ill Thrombocytopenic Patients
Authors: van Baarle Floor L.F. , Tisheh Arezoe , Jhingoeriesingh Shanisa S. , Vlaar Alexander P. J. , Biemond Bart J. 
Published: January 2022

Objectives:
Critically ill patients often undergo central venous catheter placement during thrombocytopenia and/or coagulopathy. It is unclear whether severe coagulopathy increases the risk of postprocedural bleeding in critically ill patients with severe thrombocytopenia.

Design:
Single-center retrospective cohort study.

Setting:
Academic mixed ICU in Amsterdam, the Netherlands.

Patients:
Consecutive severely thrombocytopenic (platelet count ≤ 50 × 109/L) patients who underwent central venous catheter placement between February 2016 and February 2020.

Interventions:
Central venous catheter placement in patients with both severe thrombocytopenia and severe coagulopathy (international normalized ratio > 1.5 and/or activated partial thromboplastin time > 45 s) versus patients with severe thrombocytopenia and normal or mildly prolonged international normalized ratio and activated partial thromboplastin time.

Measurements and Main Results:
We included 289 central venous catheter placements in 175 patients, 112 in patients with and 172 in patients without severe coagulopathy. Median (interquartile range) platelet count was 27 (16–38) and equal for both groups. There were 44 bleeding episodes at the central venous catheter insertion site (15.5%), of which four (1.4%) were grade 2 and two (0.7%) were grade 3. There were 19 bleeding episodes (17.0%) versus 25 bleeding episodes (14.5%) in the coagulopathy and noncoagulopathy groups, of which one and five were of grade 2 or higher, respectively. After correction for confounders, coagulopathy had no effect on bleeding: odds ratio (95% CI) 0.96 (0.24–3.88). Before central venous catheter placement, 116 (40.8%) patients received platelet transfusion. Bleeding at the central venous catheter insertion site occurred in 19 of 116 patients (16.4%) and 25 of 168 patients (14.9%) who did and did not receive platelet transfusion. After correction for confounders, platelet transfusion had no effect on bleeding: odds ratio (95% CI) 0.73 (0.18–2.83).

Conclusions:
Coagulopathy was not associated with an increased bleeding risk in severely thrombocytopenic ICU patients undergoing ultrasound guided central venous catheter placement. Prophylactic platelet transfusion in patients with severe thrombocytopenia was not associated with a reduced risk of bleeding.
Effectiveness of Angiotensin II for Catecholamine Refractory Septic or Distributive Shock on Mortality: A Propensity Score Weighted Analysis of Real-World Experience in the Medical ICU
Authors: Quan Michele , Cho Nam , Bushell Thomas , Mak Joseph , Nguyen Nolan , Litwak Jane , Rockwood Nicholas , Nguyen H. Bryant 
Published: January 2022

IMPORTANCE:
Angiotensin II (ATII) was approved for septic or other distributive shock due to its property of increasing blood pressure within 3 hours. Limited data exist regarding its effectiveness when used in real-world clinical practice.

OBJECTIVES:
This study examined ATII as a third-line vasopressor based on institutional approval.

DESIGN:
Retrospective observational cohort study.

SETTING AND PARTICIPANTS:
Medical ICU at an academic tertiary care medical center. Adult patients requiring 3 or more vasopressor agents for septic shock or other forms of distributed shock from September 1, 2018, to January 31, 2020.

MAIN OUTCOMES AND MEASURES:
Effect of ATII after norepinephrine and vasopressin on mortality and mean arterial blood pressure response after 3 hours of administration.

RESULTS:
One-hundred forty-seven patients, 56 receiving ATII and 91 receiving another vasopressor (non-ATII), were enrolled. Patients in the ATII group had higher mortality compared to the non-ATII group, and more required 5 or greater vasopressor agents (p < 0.01). After propensity score weighting, there remains a trend in higher mortality in the ATII compared to non-ATII group, but not statistically significant (86.0% vs 71.0%, p = 0.16). More patients in the ATII group continued to require 5 or greater vasopressor agents compared to the non-ATII group after propensity score weighting (45.9% vs 12.5%, p < 0.01). SOFA score was the only variable associated with mortality (OR = 1.25, 95% CI, 1.05–1.49; p = 0.01). Patients were considered a “responder” if mean arterial pressure greater than 65 mm Hg at 3 hours after the third vasopressor was initiated. Among the ATII group, 37.5% patients were responders compared to 45.1% responders in the non-ATII group (relative risk = 1.07, 95% CI, 0.6–1.93; p = 0.81).

CONCLUSIONS AND RELEVANCE:
Although previous data support the use of ATII due to its favorable hemodynamic response in patients with distributive shock, there was no observed benefit in mortality or hemodynamic response with ATII as a third-line vasopressor in our study of real-world patients.
Adapting digital health interventions for the evolving HIV landscape: examples to support prevention and treatment research
Authors: Budhwani Henna , Kiszla B. Matthew , Hightow-Weidman Lisa B. 
Published: January 2022

Purpose of review
Although many HIV prevention and/or treatment digital health interventions (DHIs) have shown feasibility and acceptability, fewer have indicated efficacy, and only a subset have been adapted for new contexts. Adaptation is a key element of pragmatic implementation science research. Adaptation is cost effective and time efficient compared with new development. Leveraging adaptation can lead to accelerated scale-up and enhanced public health impact. Considering the value of adaptation, the purpose of this piece is to present examples of DHI to DHI adaptation sequences to inform future HIV prevention and/or treatment research.

Recent findings
From an examination of recent academic articles (01 November 2016 to 31 October 2021), we identified adaptation sequences that included an original DHI with at least two adaptations. Four models are presented herein; examples consist of adapted DHIs for new population, health outcome, geography, or a combination thereof.

Summary
Adaptation is a promising scientific approach to expeditiously respond to the evolving HIV landscape. We present examples of DHI adaptations alongside considerations for each type of adaptation; we also present adaptation challenges with responsive strategies. We suggest when conducted with attention to rigor (leveraging adaptation frameworks, community engagement, and tailoring content), adaptation is a powerful tool to pragmatically address the HIV epidemic.
Psychological Distress of Healthcare Workers in Québec (Canada) During the Second and the Third Pandemic Waves
Authors: Carazo Sara , Pelletier Mariève , Talbot Denis , Jauvin Nathalie , De Serres Gaston , Vézina Michel 
Published: January 2022

Abstract

Objective
We aimed to measure the prevalence of psychological distress among Quebec healthcare workers (HCWs) during the second and third pandemic waves and to assess the effect of psychosocial risk factors (PSRs) on work-related psychological distress among severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected (cases) and non-infected (controls) HCWs.

Methods
A self-administered survey was used to measure validated indicators of psychological distress (K6 scale) and PSR (questions based on Karasek and Siegrist models, value conflicts, and work-life balance). Adjusted robust Poisson models were used to estimate prevalence ratios.

Results
Four thousand sixty eight cases and 4152 controls completed the survey. Prevalence of high work-related psychological distress was 42%; it was associated with PSRs (mainly work-life balance, value conflicts, and high psychological demands) but not with SARS-CoV-2 infection.

Conclusion
Primary prevention measures targeting PSRs are needed to reduce mental health risks of HCWs.
Vestibular and Balance Impairment Is Common in Children With Primary Ciliary Dyskinesia
Authors: Zawawi Faisal , Papsin Blake C. , Dell Sharon , Cushing Sharon L. 
Published: January 2022

Objective:
Primary ciliary dyskinesia (PCD) is a rare genetic disorder that presents with a wide range of respiratory complaints. The most common otologic associated disorder is middle ear effusion. We ask if children with PCD suffer from vestibular impairment.

Study Design:
Cross-sectional cohort study.

Setting:
Tertiary pediatric referral hospital.

Patients/Participants:
Children with confirmed PCD.

Intervention/Methods:
All included participants were clinically assessed to be at baseline then basic demographics and medical histories were collected, including the specific genetic mutation these patients have. After which, all patients underwent two vestibular tests. The first was to assess their ability to stand on one foot with their eyes open and then with their eyes closed and the second was video head impulse test (vHIT).

Main Outcome Measures:
Ability standing on one foot with the eyes closed and vHIT.

Results:
During this period, 25 children with PCD were recruited for the study. The mean age at recruitment was 11.26 years (4–18 yr). There were 11 women and 14 men. All patients were able to participate in both tests. Nineteen participants (76%) had vestibular impairment. Fifteen of them failed to stand on one foot with their eyes closed and six of 25 had abnormal vHIT. The most common involved gene was DNAH5 8/25 (32%) and it was associated with vestibular impairment in seven of eight participants (87.5%).

Conclusion:
The majority of children with PCD that we tested suffered from vestibular impairment that was previously undiagnosed. This potentially indicates that imbalance and vestibular pathology is under-diagnosed in children with PCD.