bluuebunny/crossref_metadata_2025_split huggingface dataset:
First Outpatient Clinical Trial of a Full Closed-Loop Artificial Pancreas System in South America
Authors: Garelli Fabricio , Fushimi Emilia , Rosales Nicolás , Arambarri Delfina , Mendoza Leandro , Serafini María Cecilia , Moscoso-Vásquez Marcela , Stasi Marianela , Duette Patricia , García-Arabehety Julia , Giunta Javier Nicolás , De Battista Hernán , Sánchez-Peña Ricardo , Grosembacher Luis 
Published: May 2022

Background: The first two studies of an artificial pancreas (AP) system carried out in Latin America took place in 2016 (phase 1) and 2017 (phase 2). They evaluated a hybrid algorithm from the University of Virginia (UVA) and the automatic regulation of glucose (ARG) algorithm in an inpatient setting using an AP platform developed by the UVA. The ARG algorithm does not require carbohydrate (CHO) counting and does not deliver meal priming insulin boluses. Here, the first outpatient trial of the ARG algorithm using an own AP platform and doubling the duration of previous phases is presented. Method: Phase 3 involved the evaluation of the ARG algorithm in five adult participants (n = 5) during 72 hours of closed-loop (CL) and 72 hours of open-loop (OL) control in an outpatient setting. This trial was performed with an own AP and remote monitoring platform developed from open-source resources, called InsuMate. The meals tested ranged its CHO content from 38 to 120 g and included challenging meals like pasta. Also, the participants performed mild exercise (3-5 km walks) daily. The clinical trial is registered in ClinicalTrials.gov with identifier: NCT04793165. Results: The ARG algorithm showed an improvement in the time in hyperglycemia (52.2% [16.3%] OL vs 48.0% [15.4%] CL), time in range (46.9% [15.6%] OL vs 50.9% [14.4%] CL), and mean glucose (188.9 [25.5] mg/dl OL vs 186.2 [24.7] mg/dl CL) compared with the OL therapy. No severe hyperglycemia or hypoglycemia episodes occurred during the trial. The InsuMate platform achieved an average of more than 95% of the time in CL. Conclusion: The results obtained demonstrated the feasibility of outpatient full CL regulation of glucose levels involving the ARG algorithm and the InsuMate platform.
Exploring the weight bias of professionals working in the field of obesity with a mobile IAT: a pilot study
Authors: Jungnickel Tobias , von Jan Ute , Engeli Stefan , Albrecht Urs-Vito 
Published: May 2022

Background: Obesity is common in many industrialized nations and often accompanied by related health issues. Furthermore, individuals living with overweight or obesity are often confronted with stigmatization in their daily lives. These problems may be aggravated if the objectivity of health care professionals is compromised due to (unconscious) prejudices. If pharmaceutical companies, regulatory agencies, and health insurers are also susceptible to these biases, decisions related to the development, approval, and reimbursement of obesity-related therapies may be negatively impacted. Materials and Methods: The ‘Implicit Association Test’ (IAT) is a psychometric test allowing to measure these attitudes and could therefore assist to reveal unconscious preferences. A self-developed mobile version, in the form of a ResearchKit-based IAT app was employed in the presented study. The objective was to determine (potential) weight bias and its characteristics for professionals attending a national obesity-related conference in Germany (G1), compared to a control group (without stated interest in the topic, G2) – both using the mobile app – and a historical control (G3) based on data provided by Project Implicit acquired by a web app. Results: Explicit evaluations of G1 were neutral at a higher percentage compared with G2 and G3, while implicit preference toward lean individuals did not differ significantly between G2 and G3, and G1. Conclusion: The greater discrepancy between the (more neutral) explicit attitude and the unconscious preference pointing in the anti-obesity direction could indicate an underestimated bias for the professional participants in G1. Implicit preference is often ingrained from childhood on, and difficult to overcome. Thus, even for professionals, it may unconsciously influence decisions made in the care they provide. Professionals in any given health care sector directed at obesity care should thus be made aware of this inconsistency to enable them to consciously counteract this potential effect.
The core minimum dataset for measuring pain outcomes in pain services across Scotland. Developing and testing a brief multi-dimensional questionnaire
Authors: Laskawska Magdalena S , Hébert Harry L , Richardson Cara , Berlouis Katherine , Cameron Paul , Colvin Lesley A , Smith Blair H 
Published: May 2022

Background:There is currently no agreed minimum dataset to inform specialist chronic pain service provision. We aimed to develop a Core Minimum Dataset (CMD) for pain services in Scotland and perform preliminary analysis to evaluate its psychometric properties in adults with chronic pain.Methods:The questionnaire was developed following a review of existing relevant data collection instruments and national consultation. The CMD questionnaire was completed alongside a routine pre-clinic questionnaire by patients attending two pain services over 3 months. Concurrent validity was tested by comparing scores between the CMD and pre-existing questionnaires. Reliability was assessed by test-retest and discriminative validity via receiver operating characteristic (ROC) curves.Results:The final CMD questionnaire consisted of five questions on four domains: pain severity (Chronic Pain Grade [CPG] Q1); pain interference (CPG Q5); emotional impact (Patient Health Questionnaire-2 [PHQ-2], two questions); and quality of life (Short Form Health Survey-36 [SF-36] Q1). 530 patients completed the questionnaire. Strong correlation was found with the Hospital Anxiety and Depression Scale (rs= 0.753, p < 0.001). Moderate correlations were found with the Brief Pain Inventory for pain interference (rs= 0.585, p < 0.001) and pain severity (rs= 0.644, p < 0.001). Moderate to good reliability was demonstrated (Intra-class Correlation Coefficient = 0.572–0.845). All items indicated good discrimination for relevant health states.Conclusions:The findings represent initial steps towards developing an accurate questionnaire that is feasible for assessing chronic pain in adults attending specialist pain clinics and measuring service improvements in Scotland. Further validation testing, in clinical settings, is now required.
Evaluation of antibiotic prescribing patterns among inpatients using World Health Organization indicators: A cross-sectional study
Authors: Tadesse Tesfaye Yimer , Molla Mulugeta , Yimer Yohannis Shumet , Tarekegn Benyas Shishigie , Kefale Belayneh 
Published: May 2022

Objective: Even though antibiotic resistance is one of the most serious threats to global public health, it is becoming more common due to inappropriate antibiotic prescribing patterns. Thus, the purpose of this study is to assess antibiotic prescribing patterns among inpatients at an Ethiopian comprehensive specialized hospital. Methods: An institutional-based cross-sectional study was used. During the study period, data were collected from the charts of admitted patients in selected wards of Debre Tabor comprehensive specialized hospital. The World Health Organization’s developed questionnaire and conventional antibiotic prescribing indicators were used to assess rational drug usage, with an emphasis on antibiotic prescribing trends. The data were analyzed using SPSS 25.0 statistical software. Results: For 861 patients admitted to medical and pediatric wards, a total of 1444 antibiotics were prescribed. Overall, 60.6% of inpatients were prescribed at least one antibiotic, with an average (mean ± SD) number of antibiotics prescribed per patient of 1.7 ± 1.6. During their hospital stay, patients were given antibiotics for an average (mean ± SD) of 6.4 ± 2.7 days. Furthermore, 83.3% of antibiotics were prescribed for therapeutic purposes, whereas 100% were provided for empiric purposes. Ceftriaxone was the most commonly administered antibiotic in the study settings (49.2%). During the study period, Debre Tabor comprehensive specialized hospital had access to 67.5% of key antibiotics. Conclusion: The antibiotic prescribing pattern in our study diverged from the World Health Organization-recommended guidelines. Furthermore, all antibiotics were given without a culture or sensitivity test in every case. Setting up an antibiotic stewardship program, introducing antibiotic use based on culture and sensitivity tests, and adopting institutional guidelines could all help to address this issue.
Expecting parents’ perceptions of the digital parental support “childbirth journey” constructed as a serious game—an intervention study
Authors: Bäckström Caroline , Rolfson Tanja , Engström Henrik , Knez Rajna , Larsson Margaretha 
Published: May 2022

Objective The aim of this study was to explore expecting parents’ perceptions of the Childbirth Journey as an intervention that includes medical information for parental support, constructed as a serious game. Methods In this qualitative study, semi-structured interviews were held with expecting parents in Sweden who were able to talk about specific parts of the Childbirth Journey they appreciated or found difficult to understand. A phenomenographic methodology was employed for data analysis. Results Participants perceived the Childbirth Journey to be easily accessible and customized with reliable information. The design and features of the intervention were perceived by the expecting parents to enhance the intervention’s usability, appeal, and trustworthiness. When parental couples used the Childbirth Journey together, it gave them an opportunity to discuss and better understand each other’s situation. The participants proposed several changes to the existing version of the game, mostly related to extending practical information and illustrated scenarios but also to the further development of the game’s design and animations. The participants found the Knowledge portal to be the most appealing part of the Childbirth Journey. Conclusions The Childbirth Journey intervention was concluded to be a valuable digital complement to in-person professional support, especially given the current COVID-19 pandemic restrictions in place in Sweden, which do not allow antenatal visits by partners. However, in its current form, the Childbirth Journey has some deficiencies and would therefore benefit from further development and exploration.
Latecomers’ Isomorphic R&D Strategy and the Relationship With Performance: A Study on Chinese Pharmaceutical Firms
Authors: Zhao Ziyi , Zhou Banghao 
Published: May 2022

Institutional environment plays a key role in shaping latecomers’ strategic choices. Conforming with the institutional environment is believed to alleviate uncertainties and resource deficiency for latecomers. However, does being isomorphic with institutional environment help latecomers in R&D activities that aims at making differences? The purpose of this study is to comprehensively explore how the interplay of institutional and competitive pressures from institutional environment manifests in latecomers’ R&D practices. Based on multiple case studies of four pharmaceutical firms in China, the occurrence of isomorphic R&D strategy and its relationship with performance have been uncovered in this paper. The subjective initiative and efficiency predictability of isomorphic R&D strategies are characterized through investigating its differences with general isomorphic behaviors. With these findings, this study provides a strategic approach to study institutional isomorphism, draws the attention on the dynamic interaction between institutional context and R&D strategies and adds to the literature on latecomer firms’ R&D strategies.
Occupational Health and Safety of Immigrant Hotel Housekeepers
Authors: Shapoval Valeriya , Sönmez Sevil , Hsieh Yu-Chin (Jerrie) , Apostolopoulos Yorghos 
Published: May 2022

Background: The accommodations sector is one of the largest employers of immigrant and minority workers in the United States. Hotel housekeepers represent the industry’s largest workforce while facing difficult work conditions, health hazards, and psychological stress. This is one of the few empirical studies that address the working conditions of housekeepers in the United States and their perspective of health challenges they face. Methods: A cross-sectional survey study was conducted with hotel housekeepers ( N = 140) in Florida and in collaboration with the local labor union as a rapid assessment of occupational health and safety risk exposures, work-related injuries, coping mechanisms, and perceived management responses. Experienced union workers recruited study participants and administered interviewer-administered surveys. The analysis included descriptive statistics and multivariate regression. Findings: Sampled hotel housekeepers were found to work under significant time pressures to complete excessive workloads and to experience chemical and biological exposures and physical and psychosocial strains. Poor work equipment/insufficient supplies had a negative impact on hotel housekeepers’ health, these include heavy wet towels vacuum cleaners having a significant effect on ( p < .001) sprains and strains. Poor cleaning supplies had a significant effect ( p < .001) on chemical burns. Other significant findings are provided in the article. Conclusion/Application to Practice: While housekeeping work conditions include many challenges, relatively simple changes by hotels’ management can provide potential relief and improve workers’ health and safety outcomes, such as functional equipment, sufficient inventory, management support, and proper rest breaks—subsequently increasing workers’ health and reducing accidents, and thus potentially improving productivity at a relatively low cost.
Age-Dependent Differences of Paraspinal Muscle Endurance and Morphology in Chinese Community Population Without Chronic Low Back Pain
Authors: Han Gengyu , Wang Wei , Yue Lihao , Fan Zheyu , Li Zonglin , Li Jiaming , Sun Zhuoran , Li Weishi 
Published: May 2022

Study Design: Cross-sectional study. Objectives: Our aim was to describe age-dependent changes of lumbar paraspinal muscle endurance and morphology in Chinese healthy population. We also explored the relationship between paraspinals endurance and morphology. Methods: A total of 181 participants from Chinese community population without chronic low back pain were included. The participants were divided into three groups: young (20-39 years old, n = 29), middle (40-59 years old, n = 93), and elderly (≥ 60 years old, n = 59). The Ito test was performed to evaluate the isometric endurance of paraspinal muscles. The total cross-sectional area (TCSA) and fat infiltration (FI) of multifidus (MF) and erector spinae (ES) were measured at L1-L5 levels on magnetic resonance imaging. Physical activity level was evaluated using the physical activity index and comorbidities were assessed by the modified 5-item frailty index. Results: The elderly group had a shorter performance time of endurance test than the young group and middle-aged group. Correlation analysis showed that age had a significant correlation with endurance test, the average MF TCSA, MF FI, ES TCSA and ES FI of L1-5. In addition, PAI had a significant correlation with endurance test and MF FI. In multiple linear regression analysis, paraspinals endurance was associated with MF FI, ES FI, physical activity level and comorbidities. Conclusion: Age-related decreases in paraspinals endurance and TCSA, and an increase in FI were revealed. Besides, paraspinal muscles FI, but not TCSA, was negatively associated with the endurance of paraspinals.
Racial Differences in Trust and Risk Disclosure Preferences Among Older Registered Research Volunteers Screened for Prodromal Synucleinopathies
Authors: Marshall Carly , Havis Isabelle , Herreshoff Emily , Lewis Cate , Kotagal Vikas 
Published: May 2022

Background/Objectives The equitable enrollment of minority participants in synucleinopathy trials is an emerging public health concern. Differing views regarding risk disclosure may influence research involvement in at-risk adults. Methods We conducted a brief mailed survey, including questions about trust and hypothetical risk disclosure preferences, to 100 participants in the Healthier Black Elders Center cohort in Detroit, MI and 100 participants in the Claude D. Pepper Older Americans Independence Center Research Participant Program at the University of Michigan. Results 125 recipients without a diagnosis of a neurodegenerative disorder returned the survey, 52 (41.6%) of whom identified as being Black or African American. Black respondents reported less trust in medical providers (t=2.02, p=0.045) and medical researchers (t=2.52, p=0.013) and a greater desire to be informed about the presence of unchangeable risk factors for neurodegenerative disorders (t=2.02, p=0.045). Conclusions These findings have implications for the recruitment of representative populations in prodromal neurodegenerative research.
Book review: Robert Eric Frykenberg, ed., Land Control and Social Structure in Indian History and Robert Eric Frykenberg, ed., Land Tenure and Peasant in South Asia
Authors: Habib Irfan 
Published: May 2022

Robert Eric Frykenberg, ed., Land Control and Social Structure in Indian History (Delhi: Primus Books), 2020, 273 pp., ₹300 (Pb) [originally published in 1969]. Robert Eric Frykenberg, ed., Land Tenure and Peasant in South Asia, (Delhi: Primus Books), 2020, ₹350 (Pb) [originally published 1977].
Relationship between Resilience and the Impostor Phenomenon among Undergraduate Medical Students
Authors: Camara Gisele Ferreira , de Santiago Campos Isabele Fontenele , Carneiro Amanda Galdino , de Sena Silva Ismael Nobre , de Barros Silva Paulo Goberlânio , Peixoto Raquel Autran Coelho , Augusto Kristopherson Lustosa , Peixoto Arnaldo Aires 
Published: May 2022

Introduction Impostor Phenomenon (IP) is the inability to internalize success and a tendency to attribute success to external causes. Social and institutional support are strategies to avoid the problem, but only partially successful. Resilience has been considered protective against mental health disorders in medical students. This study aims to investigate the association between IP and resilience in undergraduate medical students. Methods Using Clance Impostor Phenomenon Scale (CIPS), Connor-Davidson Resilience Scale (CD-RISC), and a socio-demographic questionnaire, we conducted a cross-sectional, quantitative study with undergraduate medical students. Results The study included 425 pre-clerkship medical students of average age of 23.03 years. The prevalence of IP was 47.76% (CIPS ≥ 62 score, as recommended in prior literature.) and there were no differences among age, gender, current semester, religion. The majority student's CD-RISC score was 68.57 ± 14.66 and there was no statistical difference in resilience scale among age, gender, religion and training semester. “Other religions” group was associated with a higher resilience score when compared to “Catholic” or “Non-religious” students. We found an inverse correlation between the level of resilience by CD-RISC and the level of symptoms related to IP by CIPS (ρ = −0.409; p-value < .001). Conclusions Findings from this study suggest that higher levels of resilience are likely protective against IP among undergraduate medical students. Furthermore, the non-inclusion of medical internship students and the cross-sectional design of this study are restraining aspects noticed within the project, suggesting the need for further studies to adjust those limitations.
Repression of Uyghur Muslims and the Freedom of Religious Beliefs in China
Authors: Anand Amit 
Published: May 2022

China has been accused by the international community for placing tight constraints on the religious freedom of Uyghurs in the northwest Xinjiang Uighur Autonomous Region (XUAR). It has been widely reported that China has placed in detention over a million Uyghur Muslims in order to ‘re-educate’ them to adapt to ‘Chinese culture’. It has been alleged that China is using a system of surveillance, control, and suppression of religious activity aimed particularly at Uyghurs accusing them of actively involving in separatist activity with foreign funding in order to destabilise the region. Note that, China has also brought in polices on regulation of religious affairs that makes it difficult for a religious body or a church, mosque to exist in China without prior State approval. The policy also gives unfettered power of oversight to the government over minority religious institutions and their day to day management. In light of the above, this article examines the issue of right to freedom of religion or belief in the backdrop of China’s treatment of Uyghur Muslims in the Xinjiang region. Further, this article also comments upon China’s current domestic policy regulating religion and its commitment at the international level to protect and promote freedom of religion or belief of all its citizens.
The Hyperintense study: Assessing the effects of induced blood pressure increase and decrease on MRI markers of cerebral small vessel disease: Study rationale and protocol
Authors: Janssen Esther , ter Telgte Annemieke , Verburgt Esmée , de Jong Joost JA , Marques José P , Kessels Roy PC , Backes Walter H , Maas Marnix C , Meijer Frederick JA , Deinum Jaap , Riksen Niels P , Tuladhar Anil M , de Leeuw Frank-Erik 
Published: May 2022

Background: Neuroimaging markers of cerebral small vessel disease (SVD) are common in older individuals, but the pathophysiological mechanisms causing these lesions remain poorly understood. Although hypertension is a major risk factor for SVD, the direct causal effects of increased blood pressure are unknown. The Hyperintense study is designed to examine cerebrovascular and structural abnormalities, possibly preceding SVD, in young adults with hypertension. These patients undergo a diagnostic work-up that requires patients to temporarily discontinue their antihypertensive agents, often leading to an increase in blood pressure followed by a decrease once effective medication is restarted. This allows examination of the effects of blood pressure increase and decrease on the cerebral small vessels. Methods: Hyperintense is a prospective observational cohort study in 50 hypertensive adults (18–55 years) who will temporarily discontinue antihypertensive medication for diagnostic purposes. MRI and clinical data is collected at four timepoints: before medication withdrawal (baseline), once antihypertensives are largely or completely withdrawn ( T = 1), when patients have restarted medication ( T = 2) and reached target blood pressure and 1 year later ( T = 3). The 3T MRI protocol includes conventional structural sequences and advanced techniques to assess various aspects of microvascular integrity, including blood-brain barrier function using Dynamic Contrast Enhanced MRI, white matter integrity, and microperfusion. Clinical assessments include motor and cognitive examinations and blood sampling. Discussion: The Hyperintense study will improve the understanding of the pathophysiological mechanisms following hypertension that may cause SVD. This knowledge can ultimately help to identify new targets for treatment of SVD, aimed at prevention or limiting disease progression.