bluuebunny/crossref_metadata_2025_split huggingface dataset:
Variations in Definitions of Evidence-Based Interventions for Behavioral Health in Eight Selected U.S. States
Authors: Maranda Michael J. , Lee-Easton Miranda J. , Magura Stephen 
Published: May 2022

Background U.S. state legislatures fill a vital role in supporting the use of evidence-based interventions (EBIs) through statutes and regulations (mandates). Objective The study determined the terms used by selected states to describe EBIs and how those terms are defined in mandates. Research Methods The mandates of eight purposely selected states were accessed and coded using the Westlaw Legal Research Database. Results Considerable variation was found in the terms used by states to describe EBIs. Although “evidence-based” was the most frequently utilized term (60% of mandates), an additional 29 alternative terms appeared with varying frequencies. Most terms were simply mentioned, with no further definition or elaboration. When terms were further defined or elaborated, the majority were defined using numerous and different types of external sources or references. Three approaches were found in the mandates defining EBIs: “single definition,” “hierarchies of evidence levels,” and “best available evidence”; the states differed considerably in the approaches used in their mandates. Conclusions The variations in EBI-related terminology across states and within states, coupled with a lack of elaboration on the meaning of important terms and the predominant use of external rather than internal guidelines, may be a source of confusion for behavioral health provider agencies that seek direction about what constitutes an EBI. Prior studies indicate that many agencies may lack staff with the technical ability to adequately evaluate what constitutes an EBI. Thus, lack of clear guidance from official state government mandates may impede the implementation of EBIs within states.
Extracorporeal membrane oxygenation during pregnancy and peripartal. An international retrospective multicenter study
Authors: Malfertheiner S Fill , Brodie D , Burrell A , Taccone FS , Broman LM , Shekar K , Agerstrand C L , Serra A L , Fraser J , Malfertheiner MV 
Published: May 2022

Introduction Extracorporeal Membrane Oxygenation (ECMO) may be used in the setting of pregnancy or the peripartal period, however its utility has not been well-characterized. This study aims to give an overview on the prevalence of peripartel ECMO cases and further assess the indications and outcomes of ECMO in this setting across multiple centers and countries. Methods A retrospective, multicenter, international cohort study of pregnant and peripartum ECMO cases was performed. Data were collected from six ECMO centers across three continents over a 10-year period. Results A total of 60 pregnany/peripartal ECMO cases have been identified. Most frequent indications are acute respiratory distress syndrome ( n = 30) and pulmonary embolism ( n = 5). Veno-venous ECMO mode was applied more often (77%). ECMO treatment during pregnancy was performed in 17 cases. Maternal and fetal survival was high with 87% ( n = 52), respectively 73% ( n = 44). Conclusions Various emergency scenarios during pregnancy and at time of delivery may require ECMO treatment. Peripartal mortality in a well-resourced setting is rare, however emergencies in the labor room occur and knowledge of available rescue therapy is essential to improve outcome. Obstetricians and obstetric anesthesiologists should be aware of the availability of ECMO resource at their hospital or region to ensure immediate contact when needed.
Moral distress amongst palliative care doctors working during the COVID-19 pandemic: A narrative-focussed interview study
Authors: Fish Ellis C. , Lloyd Anna 
Published: May 2022

Background: Palliative care professionals have had to adapt to rapidly changing COVID-19 restrictions with personal protective equipment and physical distancing measures impacting face-to-face communication with patients and relatives. Aim: To explore the narratives of palliative care doctors working during the pandemic to understand their experiences at a personal and professional level. Design: In-depth narrative interviews were carried out via video call. Interviews were transcribed verbatim and analysed using a joint paradigmatic and narrative approach to elucidate common themes and closely explore individual narratives. Setting/participants: Eight palliative care doctors who had worked on a hospice inpatient unit in the UK before and during the pandemic were recruited from two hospices in Scotland. Results: Three intersecting themes are described, the most significant being moral distress. Participants articulated a struggle to reconcile their moral convictions with the restrictions enforced, for example, wanting to provide support to patients through physical proximity but being unable to. To differing degrees, this resulted in internal conflict and emotional distress. Two further themes arose: the first concerned a loss of humanity in interaction and a striving to re-humanise communication through alternative means; the second being a change in staff morale as the pandemic progressed. Conclusions: Restrictions had a considerable impact on palliative care doctors’ ability to communicate with and comfort patients which led to moral distress and contributed to decreasing morale. Future research could explore moral distress in palliative care settings internationally during the pandemic with a view to compare the factors affecting how moral distress was experienced.
The State of our Breastfeeding Friendly Childcare Programs: Ten Years After the 2011 Surgeon General’s Call to Action to Support Breastfeeding
Authors: Roig-Romero Regina M. , Livingston Taylor A. , Schafer Ellen J. , Reyes Martinez Estefanny , Wachira Maret , Marhefka Stephanie 
Published: May 2022

Background: Ten years ago, the U.S. Surgeon General’s Call to Action to Support Breastfeeding made recommendations for childcare settings, including: (1) accommodating and supporting breastfeeding families; and (2) adopting national guidelines on breastfeeding support in childcare settings. Research Aims: To (1) describe the existing breastfeeding friendly childcare designation programs in the United States; and (2) describe how states are accommodating breastfeeding families in childcare settings. Method: The study design was cross-sectional, prospective thematic description of existing publicly available documents. A search of state breastfeeding coalitions was conducted to assess the number of states with breastfeeding friendly childcare designation programs. A definitive yes-or-no answer regarding whether each state had a program was obtained from all 50 states. For states with programs, designation materials were analyzed using thematic analysis and the framework method to compare designation components. Results: Fifteen states had evidence of breastfeeding friendly childcare designation programs and similarities exist across designation program components. Four standards were common to all 15 programs: written policy on breastfeeding, suitable space within the center where mothers can breastfeed or express their milk, educational materials, and resources on breastfeeding available to parents. Most states required self-assessment to achieve designation status. Conclusion: Research is needed to enable evidence-based programs and decision-making regarding components and processes. Federal funding should support these programs’ mission, including funding research to assess how and in what circumstances these programs are improving breastfeeding-related outcomes and supporting breastfeeding families.
Influence of acupuncture needle physical–chemical properties on needling quality
Authors: Lenoch Rafael Yamaguti , More Ari Ojeda Ocampo , Cubillos Patricia Ortega , Min Li Shih , More Ari Digiácomo Ocampo , Roesler Carlos Rodrigo de Mello 
Published: May 2022

Objectives: This study analyzed the physical–chemical properties of three different brands of acupuncture needle, classified by acupuncturists as high (A), medium (B) and low (C) quality. Methods: Experienced acupuncturists, rated, in terms of perceived needling quality, three acupuncture needle brands as high (A), medium (B) and low (C) quality. Next, scanning electron microscopy (SEM) images of the tip and surface finish of the needles of each brand were analyzed. A mechanical test was developed and performed to evaluate the compressive force required to insert the needles through a smooth surface (silicon). In addition, X-ray fluorescence spectroscopy (XRF) and dispersive energy spectroscopy (DES) were conducted to analyze the material composition of the needles and presence of oxidation. Results: SEM images revealed that needle brands A and B presented a sharper tip and a more regular surface finish in comparison to brand C. In the insertion test, needle brands A and B had similar performance characteristics, with A requiring less force to penetrate the silicon device when compared to B, while C failed to penetrate the silicon and complete the test. The XRF analysis did not reveal any differences in material composition between the three brands. However, brand C exhibited particles embedded on the needle surface and DES confirmed oxidation. Conclusion: This study demonstrates that perceived needling quality by acupuncturists can be correlated with physical–chemical properties of the needles, especially those related to finishing quality of the tip and the surface of the needles.
Moral distress and moral resilience of nurse managers
Authors: Faraco Michel Maximiano , Gelbcke Francine Lima , Brehmer Laura Cavalcanti de Farias , Ramos Flávia Regina Souza , Schneider Dulcinéia Ghizoni , Silveira Luciana Ramos 
Published: May 2022

Background Moral distress is a phenomenon that can lead to an imbalance of the mind and body. There are many coping strategies to overcome the obstacles that lead the subject to this condition. Some coping strategies are capable of being achieved through the cultivation of moral resilience. Aim The aim is to identify the strategies of moral resilience in the nursing management of University Hospitals in Brazil. Research design The research design is the qualitative study with discursive textual analysis. Participants and research context : 44 nurse managers and nurses in leadership positions participated in a total of 30 University Hospitals in Brazil. Data were collected online, using a questionnaire with open questions. Ethical considerations The Ethics Committee approved the study. Participants received information about the research, agreed to respond to the questionnaire, and were guaranteed anonymity. Findings Personal adaptive strategies (intrapersonal and interpersonal) and organizational collaborative strategies (intrinsic and transformational management) emerged from this process. The intrapersonal strategies involved elements of rationality, flexibility, rebalancing practices, moral courage, and detachment. The interpersonal strategies addressed support networks, team involvement, and dialog. Organizational strategies dealt with actions which reorient ethical infrastructure, ethical education, and psychological protection, as well as fostering dialogical relationships, empowerment, and cooperation. Conclusion From the perspective of social historical construction, it is understood that developing personal and organizational strategies is essential to cultivating moral resilience.
Foot Osteomyelitis Location and Rates of Primary or Secondary Major Amputations in Patients With Diabetes
Authors: Winkler Elin , Schöni Madlaina , Krähenbühl Nicola , Uçkay Ilker , Waibel Felix W. A. 
Published: May 2022

Background: Diabetic foot osteomyelitis (DFO) often leads to amputations in the lower extremity. Data on the influence of the initial anatomical DFO localization on ultimate major amputation are limited. Methods: In this retrospective analysis, 583 amputation episodes in 344 patients (78 females, 266 males) were analyzed. All received a form of amputation in combination with antibiotic therapy. A multivariate logistic regression analysis with the primary outcome “major amputation” defined as an amputation above the ankle joint was performed. The association of risk factors including location of DFO, coronary artery disease, peripheral artery disease, neuropathy, nephropathy, and Charcot neuro-osteoarthropathy was analyzed. Results: Among 583 episodes, DFO was located in the forefoot in 512 (87.8%), in the midfoot in 43 (7.4%), and in the hindfoot in 28 episodes (4.8%). Overall, 53 of 63 (84.1%) major amputations were performed because of DFO in the setting of peripheral artery disease as primary indication. Overall, limb loss occurred in 6.1% (31/512) of forefoot, 20.9% (9/43) of midfoot, and 46.4% (13/28) of hindfoot DFO. Among these, 22 (41.5%) were performed as the primary treatment, whereas 31 (58.5%) followed previously failed minor amputations. Among this latter group of secondary major amputations, the DFO was localized to the forefoot in 23 of 583 (3.9%), the midfoot in 4 of 583 (0.7%) and the hindfoot in 4 of 583 (0.7%). In multivariate logistic regression analysis, initial hindfoot localization was a significant factor ( P < .05), whereas peripheral artery disease, smoking, and a midfoot DFO were not found to be risk factors. Conclusion: In our retrospective series, the frequency of limb loss in DFO increased with more proximal initial foot DFO lesions, with almost half of patients losing their limbs with a hindfoot DFO. Level of Evidence: Level IV, retrospective cohort study.
Safety Assessment of L-β-Aminoisobutyric Acid (L-BAIBA): Subchronic Toxicity Study in Sprague Dawley Rats
Authors: Shanmugasundaram Devanand , Fan Qiru , Wang Mingru , Yi Ronghua , Wang Ou 
Published: May 2022

L-3-Aminoisobutyric acid (L-BAIBA) is an endogenous compound in human metabolism when thymine and valine undergo catabolism. L-BAIBA represents one of the two isomers of BAIBA in biological systems. BAIBA has been shown to reduce body fat percentage via an increase in fatty acid oxidation and a decrease in hepatic lipogenesis. However, no toxicological effects of L-BAIBA in animals or humans have been established. The present study was designed to evaluate the safety and toxic potentials of this compound, where L-BAIBA was administered orally to Sprague Dawley rats at 100, 300, and 900 mg/kg/day for 90 days. No treatment-related adverse effects were observed in any of the treatment groups. Based on the results, the No-Observed-Adverse-Effect Level (NOAEL) of L-BAIBA was 900 mg/kg/day.
Improving the Identification of Frailty in Long-Term Care Residents: A Cross-Sectional Study
Authors: Arrieta Haritz , Rezola-Pardo Chloe , Sanz Begoña , Virgala Janire , Lacunza-Zumeta Mertxe , Rodriguez-Larrad Ana , Irazusta Jon 
Published: May 2022

Purpose To compare the capacity of blood myostatin concentration and physical, cognitive, and affective function tests to predict frailty among long-term care (LTC) residents. Methods This cross-sectional analysis used baseline data from three randomized controlled trials involving 260 older adults in 14 LTC centers. Serum myostatin levels were analyzed by enzyme-linked immunosorbent assay. Frailty, physical fitness, cognitive and affective functions were assessed using validated tests and scales. Results The Timed Up and Go, gait speed, 6-minute walk, and Berg Balance Scale had excellent capabilities in identifying frail individuals in accordance with Fried’s Frailty Phenotype (FFP). The best tests for identifying frailty in accordance with the Clinical Frailty Scale (CFS) were Timed Up and Go and Berg Balance Scale. For the Tilburg Frailty Indicator (TFI), the best tests were Quality of Life in Alzheimer’s Disease (QoL-AD) and Goldberg Anxiety. Myostatin, along with physical, cognitive, and affective function tests, improved the capability of the hand grip, arm-curl, Montreal Cognitive Assessment, Goldberg Anxiety, Goldberg Depression, and QoL-AD to identify frailty according to FFP, while myostatin improved CFS-defined frailty identification by the hand grip, arm-curl, 6-minute walk test, Berg Balance Scale, 30-second chair-stand, gait speed, Montreal Cognitive Assessment, Goldberg Anxiety, and De Jong-Gierveld Loneliness Scale. Conclusion Among LTC residents, serum myostatin was associated with being frail according to FFP and CFS. However, this measure was less discriminating of frailty than physical fitness tests (for FFP and CFS) and affective function parameters (for TFI). However, evaluated concurrently with physical, cognitive, and affective parameters, myostatin improved the capabilities of these measures to predict CFS-defined frailty.
Effect of aging and lifestyle on healthy macular photoreceptors and retinal pigment epithelium-Bruch membrane complex thickness
Authors: Ghanem Kadhim Zahraa , Mohammad Najah K. 
Published: May 2022

Objectives Investigate how aging and some lifestyle factors correlate with changes in macular photoreceptor and retinal pigment epithelium-Bruch membrane complex layers thickness in a sample of healthy population by using OCT segmentation technique. Subjects and methods A cross-sectional study conducted at the ophthalmology department in the Medical City in Baghdad. All participants underwent an interview of medical history and lifestyle habits. Maculae of all participants were scanned using spectral domain optical coherence tomography, followed by manual segmentation of retinal layers. Results The study included 152 healthy participants (152 eyes), their mean age was 57.3 ± 6.7 years, gender distribution was 82(53.9%) males and 70(46.1%) females. There was a decrement in retinal pigment epithelium-Bruch membrane layer thickness at central subfield (500 µm radius from fovea minimum) by − 0.178 µm/year (p = 0.019), inner macula (500–1500 µm radius from fovea minimum) by − 0.263 µm/year (p = 0.002), outer macula (1500–3000 µm radius from fovea minimum) by − 0.225 µm/year (p = 0.015) with no statistically significant effect on photoreceptor thickness. Physical activity and smoking had statistically no significant effect on these layers thickness, however smokers had higher photoreceptor thickness at fovea minimum and central subfield. Body mass index increase by one kg/m2 correlated with a decrement in photoreceptor layer thickness by − 0.108 µm (p = 0.007). Conclusion Aging process affected the retinal pigment epithelium-Bruch membrane complex and photoreceptor layer thickness in a healthy population, and this process can be slowed down by avoiding some lifestyles which aggravate these changes like obesity.
Assessment of Microbiological Quality of Indoor Air at Different Hospital Sites of Dilla University: A Cross-Sectional Study
Authors: Ashuro Zemachu , Diriba Kuma , Afework Abel , Husen Washo Gose , Shiferaw Areba Abriham , G/meskel Kanno Girum , Hareru Habtamu Endashaw , Kaso Abdene Weya , Tesfu Mehret 
Published: May 2022

Background: In both residential and hospital indoor environments, humans can be exposed to airborne microorganisms. The hospital’s indoor air may contain a large number of disease-causing agents brought in by patients, staff, students, visitors, ventilation, or the outside. Hospitalized patients are at a higher risk of infection due to confined spaces, crowdedness, and poor infection prevention practices, which can accumulate and create favorable conditions for the growth and multiplication of microorganisms. Therefore, the aim of this study was to evaluate the indoor air bacterial load in Dilla University Hospital, Southern Ethiopia. Methods: An institutional-based cross-sectional study design was used to assess the bacterial load in the indoor air at Dilla University Hospital. To determine the bacterial load, a passive air sampling technique was used. The settle plate method was used to collect data, which involved exposing Petri-dishes filled with blood agar media to the indoor air of the sampled rooms for 60 minutes. Result: A total of 72 indoor air samples were collected once a week for 2 weeks at 14-day intervals from 18 rooms in 8 wards, and samples were collected twice a day in the morning and afternoon. The mean bacterial concentrations ranged from 450 to 1585.83 CFU/m3 after 60 minutes of culture media exposure. The mean bacterial concentrations in the obstetrics, surgical, pediatric, gynecology, and medical wards exceeded WHO guidelines. A high indoor air bacterial load was found in 58 (80.6%) of the samples in this study. Gram-positive bacteria in the air were the most common 51 (71%) of the bacterial population measured in all indoor environments. Fungal growth was found in 65 (90.3%) of the samples. Temperatures (26.5°C-28.3°C) and relative humidity (61.1%-67.8%) in the rooms were both above WHO guidelines, creating favorable conditions for bacterial growth and multiplication. Conclusion: The majority of the wards at Dilla University Hospital had bacterial loads in the air that exceeded WHO guidelines. Overcrowding, high temperatures, inadequate ventilation, improper waste management, and a lack of traffic flow control mechanisms could all contribute to a high concentration of bacteria in the indoor air. To control the introduction of microorganisms by patients, students, caregivers, and visitors, it is critical to regularly monitor indoor air bacterial load and implement infection prevention and control measures.
Insulin Resistance in Gestational Diabetes Mellitus and Its Association With Anthropometric Fetal Indices
Authors: Dinh Le Tuan , Minh Bui Tien , Hien Vu Trinh , Phi Thi Nguyen Nga , Thanh Thi Tran Hoa , Nguyen Son Tien , Ho Thi Nguyen Lan , Van Ngo Manh , Huy Duong Hoang , Thanh Vu Binh , Dinh Hoa Trung , Nhu Do Binh , Le Duc-Cuong , Thi Nguyen Hien , Trung Nguyen Kien 
Published: May 2022

Background: In pregnant women with gestational diabetes mellitus (GDM), insulin resistance (IR) increases the risk of developing manifest type 2 diabetes mellitus and is associated with complications in both mother and fetus. Objectives: This research aimed to evaluate the associations between IR evaluated by 3 indices (namely updated homeostasis model assessment model (HOMA2), QUICKI, and McAuley’s index) and the diabetes risk factors and the fetal growth indices in Vietnamese women with GDM. Methods: A cross-sectional descriptive study was conducted on 370 women with GDM and 40 healthy pregnant women from January 2015 to May 2019. IR was calculated by HOMA2 (HOMA2-IR), QUICKI, and McAuley’s index. Fetal anthropometric measurements were assessed via ultrasound which was performed and interpreted by ultrasound experts. Results: In the simple regression analysis, McAuley’s index illustrated had statistically significant correlations to the highest number of risk factors of diabetes mellitus compared with HOMA2-IR and QUICKI indices. Moreover, McAuley’s index correlated statistically significantly to the highest number of fetal ultrasound measurements factors such as including biparietal diameter (BPD) ( r = −0.271, P < .001), head circumference (HC) ( r = −0.225, P < .001), abdominal circumference (AC) ( r = −0.214, P < .001), femur length (FL) ( r = −0.231, P < .001), estimated fetal weight (EFW) ( r = −0.239, P < .001) and fetal estimated age ( r = −0.299, P < .001). In the multivariable analysis, the McAuley’s index contributed the greatest to AC (Standardized B of −0.656, P < .001). Conclusion: The McAuley’s index was significantly associated with a higher number of more risk factors for diabetes mellitus as well as fetal ultrasound sonography findings measurements than compared with HOMA2-IR and QUICKI indices.