bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical activity in older adults with metastatic gastrointestinal cancer: a pilot and feasibility study
Authors: Brown Justin C , Brighton Elizabeth , Campbell Nancy , McCleary Nadine J , Abrams Thomas A , Cleary James M , Enzinger Peter C , Ng Kimmie , Rubinson Douglas , Wolpin Brian M , Yurgelun Matthew B , Meyerhardt Jeffrey A 
Published: May 2022

ObjectivesThis study determined the feasibility of delivering a 12-week structured physical activity programme during chemotherapy to older adults recently diagnosed with metastatic gastrointestinal (GI) cancer.MethodsThis study used a single-cohort design. Older adults (aged ≥65 years) diagnosed with metastatic oesophageal, gastric, pancreatic or colorectal cancer who planned to initiate chemotherapy were enrolled. The physical activity programme included a combination of aerobic, flexibility, strength and balance modalities delivered by a certified cancer exercise trainer during chemotherapy infusion appointments, then translated and sustained at home by participants. The co-primary endpoints included: (1) accrual of 20 participants in 12 months and (2) physical activity adherence of ≥50%.ResultsBetween March and October 2018, 29 participants were screened, and 20 were enrolled within 12 months (recruitment rate: 69% (90% CI: 55% to 83%); p<0.001), meeting the first co-primary endpoint. The median age of participants was 73.3 years (IQR: 69.3–77.2). At week 12, 67% (90% CI: 48% to 85%) of participants adhered to ≥50% of the prescribed physical activity (p=0.079 (statistically significant)), meeting the second co-primary endpoint. From baseline to week 12, accelerometer-measured light-intensity and moderate-intensity to vigorous-intensity physical activity increased by 307.4 (95% CI: 152.6 to 462.2; p<0.001) and 25.0 min per week (95% CI: 9.9 to 40.1; p=0.001), respectively. There were no serious or unexpected adverse events. The median overall survival was 16.2 months (8.4–22.4).ConclusionThese results establish the feasibility of a larger scale randomised controlled trial that enrols older adults with metastatic GI cancer and delivers a structured physical activity programme during chemotherapy.Trial registration numberNCT03331406.
Debridement of diabetic foot ulcers: public health and clinical implications – a systematic review, meta-analysis, and meta-regression
Authors: Dayya David , O'Neill Owen , Habib Nusrat , Moore Joanna , Iyer Kartik , Huedo-Medina Tania B 
Published: May 2022

BackgroundDiabetic foot ulceration (DFU) has devastating complications and a lifetime occurrence of 15%–34%. Debridement of DFU is regarded as an intervention that accelerates ulcer healing and may reduce complications including amputations, infections, and poor quality of life (QoL), which have serious public health and clinical implications. A systematic review (SR) of SRs and of randomized controlled trials (RCTs) with meta-analyses (MAs) on debridement of DFU that synthesizes all human experimental evidence is warranted.ObjectivesAre debridement methods in DFU beneficial over other forms and standard gauze dressings (control condition) in these outcomes?Study eligibility criteriaAll SRs/MAs/RCTs comparing debridement methods for DFU with alternative methods of debridement and with control.Data sourcesCochrane Wounds Group Specialized Register, Cochrane Central Register of Controlled Trials (Cochrane Library), Ovid MEDLINE, PubMed, EMBASE, EBSCO, CINAHL, and Web of Science.Participants and interventionsAdults with type 1/2 diabetes with DFU and any debridement method compared with alternative debridement methods or control.Main OutcomesAmputation rates, wound infections, QoL, proportion of ulcers healed, time to complete healing, ulcer recurrence, and treatment cost.Study selection and analysisData extraction/synthesis by two independent reviewers pooled using a random-effects model with sensitivity analysis.Results10 SRs were retrieved and reported qualitatively. Six SRs included MAs. This SR included 30 studies, with 2654 participants, using 19 debridement combinations. The debridement methods were compared with findings pooled into MAs. Meta-regression (MR) did not identify significant predictors/moderators of outcomes.LimitationsThe studies may have been under-powered. The inclusion/exclusion criteria varied and the increased risk of bias contributed to low-quality evidence.Discussion/ConclusionWeak evidence exists that debridement methods are superior to other forms of debridement or control in DFU.ImplicationsResearchers should follow standardized reporting guidelines (Consolidated Standards of Reporting Trials). Clinicians/investigators could use the findings from this SR/MA/MR in guiding patient-individualized decision making and designing future RCTs.
Comparing the effects of peripheral nerve block and general anesthesia with general anesthesia alone on postoperative delirium and complications in elderly patients: a retrospective cohort study using a nationwide database
Authors: Yoshimura Manabu , Shiramoto Hiroko , Koga Mami , Yoshimatsu Aya , Morimoto Yasuhiro 
Published: May 2022

IntroductionThe difference between the effects of peripheral nerve block (PNB) with general anesthesia (GA) and GA alone on the patients’ postoperative clinical outcomes remains unknown. We assessed whether there is a difference in postoperative delirium and composite morbidity between patients receiving GA with PNB and GA alone using a national clinical database in Japan.MethodsWe compared the outcomes of patients receiving GA with PNB and GA alone from April 2016 to October 2019. The primary outcome was postoperative delirium, defined as a status requiring newly prescribed antipsychotic drugs or that given the code of a reimbursable disease after the surgery date. The secondary outcome was morbidity incidence as the occurrence of at least one of any of the following life-threatening complications. We conducted propensity score-matched analyses using covariates for patients who underwent any surgical procedure. We used instrumental variables and restricted the definition of postoperative delirium and subgroup for sensitivity analyses.ResultsOf 653,759 patients, 90,358 received GA-PNB and 563,401 received only GA. After 1:4 propensity score matching, 89,754 patients were included in the GA-PNB and 359,015 in the GA. The adjusted ORs for postoperative delirium and composite morbidity were 0.96 (95% CIs 0.94 to 0.99; p<0.01), 0.80 (95% CIs 0.76 to 0.83; p<0.001), respectively, for the GA-PNB concerning the GA. For sensitivity analyses, findings were also consistent with instrumental variables and subgroup analyses.DiscussionThis retrospective, nationwide cohort study demonstrated that GA-PNB was associated with a small reduction in the likelihood of postoperative delirium and a moderate reduction in the likelihood of composite morbidity.
Sown Men and Rome’s Civil Wars
Authors: Biggs Thomas 
Published: May 2022

Abstract
Melinno’s so-called Hymn to Rome was composed sometime between the third century BCE and the third century CE. Nearly all scholars judge the poem to be a relatively straightforward panegyric of Rome’s power. The final stanza compares the Romans to the Sown Men. This article argues that the appearance of Theban or Colchian Spartoi could have evoked a more complex response from many probable readers of Melinno’s poem in antiquity, especially those who were well versed in Latin literature and Rome’s harrowing histories of civil war. It proposes that the closing comparison underscores the Romans’ fatal flaw: their inborn compulsion to engage in internecine strife. By concluding the hymn with a destabilizing reference, Melinno’s linking of Rome and Thebes points to a more nuanced evaluation of Roman power than scholars have yet to recognize.
A Mixed-Methods Social Psychology Application Evaluating the Role of Citizen Science in Mitigating Human-Wildlife Conflict
Authors: Teel Tara L. , Adams Morgan , Don Carlos Andrew W. , Bonnell Mary Ann , Breck Stewart W. 
Published: May 2022

Abstract
Human-wildlife conflict (HWC) is a global phenomenon with serious implications for biodiversity conservation and human well-being. Innovative solutions demand greater attention to the social factors contributing to HWC, including human thought and behavior, which can be examined through the lens of social psychology. Using the case of human-coyote conflict in North America, this study employed a mixed-methods social psychology approach to explore the potential for citizen science to serve as a tool for HWC mitigation. Quantitative surveys and interviews with volunteers in a coyote-focused citizen science program in Colorado revealed that the program is positively affecting participants’ attitudes/beliefs and empowering them to take action to address conflicts in their communities. The article concludes with recommendations for future evaluative research in this area as well as ways to more generally improve social-psychology applications in wildlife conservation.
Niederländische und niederdeutsche Sprachvarietäten bei Johannes Drusius dem Älteren
Authors: Stern Heidi 
Published: May 2022

Abstract
This study is based on the third part Censura of the lexicographical work Nomenclator Eliae Levitae Germani (Franeker: Albert 1652), revised by the scholar Johannes Drusius. Censura (pp. 48–234) contains 796 Latin and Hebrew dictionary entries from the Old Testament. Those entries are brief comparisons between the three Linguae sacrae Latin, Greek and Hebrew or present a longer discussion on the respective words in Latin. This article focuses on those Dutch and Low-German variants which Drusius labeled in 26 articles as regional variants, namely Saxon (in fact Low-Saxon), Flandric (Flemish region), Frisian, Sicambric (Lower Rhine region), Batavian (Lower Rhine region) and Hollandic. The study analyses regional variants in the context of their word entries and in regard to their grammatical distinctions. The inclusion of the regional variants by Drusius is not systematic, but their presentation probably aimed at didactic purposes and, in some cases, towards a better understanding of etymological relations.
Einmal, zweimal, dreimal: Warum wurde die mittelniederdeutsche Apokalypse populär?
Authors: Langbroek Erika , Brands Francis 
Published: May 2022

Abstract
Thirteenth- and fourteenth-century fragments of the Middle Low German Apocalypse in verses, probably written during the thirteenth century, are handed down to us, as well as three complete texts from the fifteenth century. In the course of the fifteenth century this text was shortened in two different ways and was used in several places in the North of Germany. Eight more or less complete versions give evidence of this. Our study investigates the reasons why this text from the thirteenth century regained popularity in the fifteenth century.
Photo-Elicitation Interviews—a Possibility for Collaborative Provocation of Preconceptions
Authors: Birkeland Åsta , Grindheim Liv Torunn 
Published: May 2022

Abstract
This article investigates researchers’ methodological preconceptions when aiming at insight by involving visual methods in focus group interviews. The authors examine the photos used in photo-elicited focus group interviews in a project investigating Chinese and Norwegian early childhood education master students and teacher educators’ values and beliefs about proper artifacts for local and national belonging. They aim to adopt a “defamiliarizing mode” for their interpretations while emphasizing conflicting perspectives among the interviewees using provocative photos to prompt the discussion. To critically investigate the photos and problematize the authors’ choices of photos that reflect their preconceptions, this article is structured around the research question: how can photo-elicited interviews (pei) provoke researchers’ methodological preconceptions? The conflicting perspectives were analyzed building on Bakhtin’s concepts on outsideness, chronotope and polyphony. The authors’ analysis surfaces new insight into the limitations and strengths of photo-elicited focus group interviews contextualized in educational research.
Street-level bureaucracy in weak state institutions: a systematic review of the literature
Authors: Peeters Rik , Campos Sergio A. 
Published: May 2022

The study of street-level bureaucracy has been dominated by research from the Global North. Mainstream conceptualizations are, therefore, based on observations from institutional contexts that may vary significantly from the working conditions of frontline workers elsewhere. This article takes stock of the growing body of literature on street-level bureaucracy in weak institutional contexts and brings together relevant insights from comparative political science and public administration into a coherent analytical framework. We identify four institutional factors that shape frontline working conditions and three behavioral patterns in frontline worker agency. These patterns in frontline agency – ranging from policy improvisation to informal privatization – can be understood as an institutional waterbed effect caused by institutional deficiencies, such as resource scarcity and accountability gaps: if the complexity of public service provision is not tackled at the institutional level, it is pushed towards the street-level where frontline workers cope with it in highly diverse ways. Points for practitioners Frontline workers in weak state institutions are commonly faced with highly precarious working conditions. If the structural preconditions for policy implementation and rule enforcement are unresolved, these complexities are pushed towards frontline workers that cope with them through informal privatization, policy improvisation, or alienative commitment focused on mere job survival. Frontline agency is an indispensable factor for understanding the selective and often distributive nature of service delivery and rule enforcement in the Global South.
Can vaccine adherence against Sars-CoV-2 become a criterion for access to medical care?
Authors: Cioffi Andrea , Cecannecchia Camilla 
Published: May 2022

Vaccine hesitancy and anti-vax movements are increasing globally. Covid-19 pandemic has caused and causes emergency situations where available resources do not always meet the need for community care. In this article, the authors analyse the bioethical and medico-legal implications of the possibility – in conditions of scarcity of resources – of selecting patients who must have access to medical care based on vaccination against Sars-CoV-2.
Helping Behavior of Older Adults during the Early COVID-19 Lockdown in Belgium
Authors: Dury Sarah , Brosens Dorien , Pan Honghui , Principi Andrea , Smetcoren An-Sofie , Perek-Białas Jolanta , De Donder Liesbeth 
Published: May 2022

This study aimed to understand whether older adults not only received but also provided help during the first COVID-19 lockdown in Belgium, which factors motivated them to help, and whether older adults differed from younger age groups in terms of helping behavior and motives. Bivariate analyses were performed using data generated from an online cross-sectional survey in Belgium ( N = 1892). The results showed that older adults who received help also provided it. This “interdependence” – mutual or reciprocal dependence – occurred regardless of age. In terms of motives for providing help, both older adults and their younger peers were primarily motivated by present-oriented and emotion-related motivation: older people were motivated to provide help by altruistic values and humanism, and enhancement motives linked to self-development. Policy implications of these results entail: during crisis situations, make use of the bond between older adults and their neighbors, such as caring communities.
Transfusion policy in pediatric extracorporeal membrane oxygenation patients: Less could be more
Authors: Duarte Catarina Marques , Lopes Maria Inȇs , Abecasis Francisco 
Published: May 2022

Objective To evaluate a restrictive transfusion policy of red blood cells (RBC) and platelets in pediatric patients submitted to extracorporeal membrane oxygenation (ECMO). Methods Retrospective descriptive study of pediatric patients supported with ECMO, from January 2010 to December 2019. Hemoglobin, platelet, lactate and mixed venous oxygen saturation (SvO2) values of each patient while on ECMO, were collected. Transfusion efficiency and tissue oxygenation were statistically evaluated comparing pre-transfusion hemoglobin, lactate and SvO2 with post-transfusion values. Ranges of hemoglobin and platelets were established, and the number of transfusions registered. The bleeding complications and outcome were documented. Results Of a total of 1016 hemoglobin values, the mean value before transfusion was 8.6 g/dl. Hemoglobin and SvO2 increased significantly post-transfusion. Red blood cell transfusion varied with hemoglobin values: when hemoglobin value was less than 7 g/dl, 89% (41/46) were transfused but just 23% (181/794) when greater or equal to 7 g/dl. In the presence of active bleeding, the frequency of RBC transfusion increased from 32% to 62%, with hemoglobin between 7 g/dl and 8 g/dl. The mean value for platelet transfusion was 32 x 109/L. Thirty-eight (43%) platelet values between 20 x 109/L and 30x109/L, and 31 (40%) between 30 x 109/L and 40 x 109/L led to platelet transfusion; between 40 x 109/L and 50 x 109/L, only 7 (9%) prompted platelet transfusion. Comparing the 2010–2015 to 2016–2019 periods there was a decrease in RBC and platelet transfusion threshold with similar survival ( p = .528). Survival to discharge was 68%. Conclusions Using a restrictive RBC and platelet transfusion policy was safe and allowed a good outcome in this case series. The presence of active bleeding was an important decision factor when hemoglobin was above 7 g/dl and platelets were above 30 x 109/L.
Implementation of perioperative breathing exercises and its effect on postoperative pulmonary complications and long-term prognosis in elderly patients undergoing laparoscopic colorectal surgery: A randomized controlled trial
Authors: Chen Jing , Peng Li-Hua , Min Su 
Published: May 2022

Objective This study was to investigate the impact of breathing exercises on recovery in elderly patients receiving laparoscopic colorectal surgery. Design A prospective randomized controlled trial. Setting University hospital. Subject A total of 264 elder patients undergoing laparoscopic colorectal surgery participated in this study. Intervention Patients in intervention group received respiratory-related exercises based on standardized enhanced recovery after surgery strategies from admission to 90 days after surgery. The control group received perioperative standardized enhanced recovery after surgery strategies without formatted breathing exercises. Main measures The primary outcome was the incidence of postoperative pulmonary complications. The secondary outcomes included 6-minute walking distance, surgery-related complications, length of stay, mortality postoperatively, and hospitalization costs. Results Completion rate of breathing exercise in intervention group was over 80% till 90 days postoperatively. The incidence of postoperative pulmonary complications was lower in breathing exercises group (17/132 [12.9%] vs. 43/132 [32.6%], p < 0.001). The mean value of 6-minute walking distance increased more in intervention group compared with baseline values preoperatively (44.2 ± 4.3 vs. 3.2 ± 0.2, p < 0.001). On 90 days postoperatively, the mean value of 6-minute walking distance in breathing exercises group increased by 18.8 m compared with its baseline (557.0 ± 133.5 vs. 538.2 ± 112.7, p = 0.022), while that of control group decreased by 53.2 m from baseline (481.9 ± 102.5 vs. 535.1 ± 123.4, p < 0.001). Patients who received breathing exercises had shorter length of stay and lower hospitalization costs ( p < 0.050). Conclusions Perioperative breathing exercises helped prevent postoperative pulmonary complications and improve long-term prognosis in elderly patients undergoing laparoscopic colorectal surgery.
How effective is virtual reality technology in palliative care? A systematic review and meta-analysis
Authors: Mo Jiping , Vickerstaff Victoria , Minton Ollie , Tavabie Simon , Taubert Mark , Stone Patrick , White Nicola 
Published: May 2022

Background: The efficacy of virtual reality for people living with a terminal illness is unclear. Aim: To determine the feasibility and effectiveness of virtual reality use within a palliative care setting. Design: Systematic review and meta-analysis. PROSPERO (CRD42021240395). Data sources: Medline, Embase, AMED, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science were searched from inception to March 2021. Search terms included ‘virtual reality’ and ‘palliative care’. Eligibility: (1) adult (>18 years old) with a terminal illness (2) at least one virtual reality session and (3) feasibility data and/or at least one patient outcome reported. The ROB-2 and ROBINS tools assessed risk of bias. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) tool assessed the quality of the evidence. Standardised mean differences (Hedges’s g) were calculated from the pre- and post-data. A DerSimonian-Laird random effects model meta-analysis was conducted. Results: Eight studies were included, of which five were in the meta-analysis. All studies had at least some concern for risk of bias. Virtual reality statistically significantly improved pain ( p = 0.0363), tiredness ( p = 0.0030), drowsiness ( p = 0.0051), shortness of breath ( p = 0.0284), depression ( p = 0.0091) and psychological well-being ( p = 0.0201). The quality of the evidence was graded as very low due to small sample sizes, non-randomisation methods and a lack of a comparator arm. Conclusions: Virtual reality in palliative care is feasible and acceptable. However, limited sample sizes and very low-quality studies mean that the efficacy of virtual reality needs further research.
Preferences of patients with palliative care needs and their families for engagement with service improvement work within the hospital setting: A qualitative study
Authors: Virdun Claudia , Luckett Tim , Lorenz Karl , Davidson Patricia , Phillips Jane 
Published: May 2022

Background: There is growing recognition of the importance of involving patients and families with lived experiences of illness in healthcare service quality improvement, research and implementation initiatives. Ensuring input from people with palliative care needs is important, but how to enable this is not well understood. Aim: To seek the perspectives of Australian patients with palliative care needs, and their family members, to elicit their views on how to best contribute to inpatient palliative care quality improvement initiatives. Design: An exploratory qualitative study, using semi-structured interviews. Setting/participants: Eligible participants were adult patients with palliative care needs receiving care within a hospital setting, and their family members. Recruitment occurred through: five hospitals in New South Wales, Australia; and snowballing. Results: Fifty participants took part (21 patients and 29 family members). Results confirmed four themes: (1) Mechanisms for providing feedback about care quality need to be supportive and individualised; (2) The clinician-patient/family power imbalance makes real time feedback challenging to provide; (3) Willingness to contribute varies according to diagnosis, timing and role and (4) Face to face feedback is preferred for health service improvement work. Conclusions: Enabling meaningful consumer input to quality improvement requires careful consideration due to the unique requirements of the palliative care population. Embedding tailored outcome and experience measures to inform real-time care provision coupled with focussed opportunities for input into service improvement may best foster improvements in inpatient palliative care, founded in what matters most for people requiring this care.