bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feedback of aggregate patient-reported outcomes (PROs) data to clinicians and hospital end users: findings from an Australian codesign workshop process
Authors: Ryan Olivia Francis , Hancock Shaun L , Marion Violet , Kelly Paulette , Kilkenny Monique F , Clissold Benjamin , Gunzburg Penina , Cooke Shae , Guy Lauren , Sanders Lauren , Breen Sibilah , Cadilhac Dominique A 
Published: July 2022

ObjectivesPatient-reported outcomes (PROs) are increasingly used to measure the patient’s perspective of their outcomes following healthcare interventions. The aim of this study was to determine the preferred formats for reporting service-level PROs data to clinicians, researchers and managers to support greater utility of these data to improve healthcare and patient outcomes.SettingHealthcare professionals receiving PRO data feedback at the health service level.ParticipantsAn interdisciplinary Project Working Group comprised of clinicians participated in three workshops to codesign reporting templates of summarised PRO data (modified Rankin Scale, EuroQol Five Dimension Descriptive System, EuroQol Visual Analogue Scale and Hospital Anxiety and Depression Scale) using a modified Delphi process. An electronic survey was then distributed to short list the preferred templates among a broad sample of clinical end users. A final workshop was undertaken with the Project Working Group to review results and reach consensus on the final templates.Primary and secondary outcome measuresThe recommendation of preferred PRO summary data feedback templates and guiding principles for reporting aggregate PRO data to clinicians was the primary outcome. A secondary outcome was the identification of perceived barriers and enablers to the use of PRO data in hospitals. For each outcome measure, quantitative and qualitative data were summarised.Results31 Working Group members (19 stroke, 2 psychology, 1 pharmacy, 9 researchers) participated in the workshops, where 25/55 templates were shortlisted for wider assessment. The survey was completed by 114 end users. Strongest preferences were identified for bar charts (37/82 votes, 45%) and stacked bar charts (37/91 votes, 41%). At the final workshop, recommendations to enhance communication of PROs data for comparing health service performance were made including tailoring feedback to professional roles and use of case-mix adjustment to ensure fair comparisons.ConclusionsOur research provides guidance on PROs reporting for optimising data interpretation and comparing hospital performance.
Xpert Ultra stool testing to diagnose tuberculosis in children in Ethiopia and Indonesia: a model-based cost-effectiveness analysis
Authors: Mafirakureva Nyashadzaishe , Klinkenberg Eveline , Spruijt Ineke , Levy Jens , Shaweno Debebe , de Haas Petra , Kaswandani Nastiti , Bedru Ahmed , Triasih Rina , Gebremichael Melaku , Dodd Peter J , Tiemersma Edine W 
Published: July 2022

ObjectivesThe WHO currently recommends stool testing using GeneXpert MTB/Rif (Xpert) for the diagnosis of paediatric tuberculosis (TB). The simple one-step (SOS) stool method enables processing for Xpert testing at the primary healthcare (PHC) level. We modelled the impact and cost-effectiveness of implementing the SOS stool method at PHC for the diagnosis of paediatric TB in Ethiopia and Indonesia, compared with the standard of care.SettingAll children (age <15 years) presenting with presumptive TB at primary healthcare or hospital level in Ethiopia and Indonesia.Primary outcomeCost-effectiveness estimated as incremental costs compared with incremental disability-adjusted life-years (DALYs) saved.MethodsDecision tree modelling was used to represent pathways of patient care and referral. We based model parameters on ongoing studies and surveillance, systematic literature review, and expert opinion. We estimated costs using data available publicly and obtained through in-country expert consultations. Health outcomes were based on modelled mortality and discounted life-years lost.ResultsThe intervention increased the sensitivity of TB diagnosis by 19–25% in both countries leading to a 14–20% relative reduction in mortality. Under the intervention, fewer children seeking care at PHC were referred (or self-referred) to higher levels of care; the number of children initiating anti-TB treatment (ATT) increased by 18–25%; and more children (85%) initiated ATT at PHC level. Costs increased under the intervention compared with a base case using smear microscopy in the standard of care resulting in incremental cost-effectiveness ratios of US$132 and US$94 per DALY averted in Ethiopia and Indonesia, respectively. At a cost-effectiveness threshold of 0.5×gross domestic product per capita, the projected probability of the intervention being cost-effective in Ethiopia and Indonesia was 87% and 96%, respectively. The intervention remained cost-effective under sensitivity analyses.ConclusionsThe addition of the SOS stool method to national algorithms for diagnosing TB in children is likely to be cost-effective in both Ethiopia and Indonesia.
Does an increase in physiological indexes predict better cognitive performance: the PhyCog randomised cross-over protocol in type 2 diabetes
Authors: Magnon Valentin , Dutheil Frederic , Tauveron Igor , Mille Jordan , Baker Julien S , Brusseau Valentin , Silvert Laetitia , Izaute Marie , Vallet Guillaume T 
Published: July 2022

IntroductionThere has been a growing interest towards cognitive-training programmes to improve cognition and prevent cognitive impairment despite discrepant findings. Physical activity has been recognised in maintaining or improving cognitive ability. Based on a psychoneurophysiological approach, physiological indexes should partly determine neuronal dynamics and influence cognition as any effects of cognitive training. This study’s primary aim was to examine if improved physiological indexes predict improved cognitive variables in the context of a clinical intervention programme for type 2 diabetes (T2D).Method and analysisPhyCog will be a 22-week randomised controlled trial comparing cognitive performance between three arms: (1) physical activity (1 month), a 15-day wash-out, then cognitive training (1 month), (2) cognitive training (1 month), a 15-day wash-out and physical activity (1 month), and (3) an active breathing condition (psychoeducation and resonance frequency breathing for 1 month), then a 15-day wash-out, and combined physical activity and cognitive training (1 month), allowing to determine the most effective intervention to prevent cognitive impairment associated with T2D. All participants will be observed for 3 months following the intervention. The study will include a total of 81 patients with T2D.Cognitive performance and physiological variables will be assessed at baseline (week 0—W0), during the washout (W5, 72–96 hours after week 4), at the end of the intervention (W10), and at the end of the follow-up (W22). The main variables of interest will be executive function, memory and attention. Physiological testing will involve allostatic load such as heart rate variability, microcirculation, cortisol and dehydroepiandrosterone sulfate levels. Sociodemographic and body composition will also be a consideration. Assessors will all be blinded to outcomes. To test the primary hypothesis, the relationship between improvement in physiological variables and improvement in cognitive variables (executive, memory and attention) will be collected.Ethics and disseminationThis protocol was approved by the Est III French Ethics Committee (2020-A03228-31). Results will be published in peer-reviewed journals.Trial registration numberNCT04915339.
A Study on Early Death Prognosis Model in Adult Patients with Secondary Hemophagocytic Lymphohistiocytosis
Authors: Zhang Ruoxi , Cui Tingting , He Lingbo , Liu Menghan , Hua Zhengjie , Wang Zhao , Wang Yini 
Published: July 2022

Background. The mortality risks for secondary hemophagocytic lymphohistiocytosis in the induction stage and investigated prognostic factors need to be further discussed. Objective. The aim of this study is to establish a clinical model for predicting early death in adult patients with secondary hemophagocytic lymphohistiocytosis. Design, Participants, and Main Measures. The baseline characteristics, laboratory examination results, and 8-week survival rate of 139 adult sHLH patients diagnosed from January 2018 to December 2018 were analyzed retrospectively, and a prognostic model was constructed with low-risk (score 0–2), medium-risk (score 3), and high-risk (score ≥ 4) as parameters. Key Results. Univariate analysis confirmed that early death was not related to the type of HLH but significantly related to the patient’s response to first-line treatment. The peripheral blood cell count was significantly decreased, C-reactive protein was higher, glutamyl transpeptidase and total bilirubin were higher, albumin was significantly lower, urea nitrogen was higher, hypocalcemia and hyponatremia, deep organ hemorrhage and D-dimer increased, cardiac function damage and HLH central involvement, sCD25 increased, and EB virus infection were predictive factors of early death. In the multivariate model, patients’ response to first-line treatment was a good predictor of overall survival, and hypocalcemia and deep organ bleeding were associated with poor survival. The risk factors were scored and graded according to the risk ratio. The 8-week overall survival rates of the low-risk group (82 cases), medium-risk group (36 cases), and high-risk group (21 cases) were 85.4%, 52.8%, and 23.8%, respectively (

P

< 0.001). Conclusions. The early death of sHLH patients is closely related to some laboratory examination results. Attention should be paid to identify high-risk patients, choose effective first-line induction therapy, achieve deep remission as soon as possible, prevent deep organ bleeding, correct electrolyte disorders, and improve the early survival rate of sHLH patients.
5-Alpha Reductase Inhibitor Use and Prostate Cancer Prevention: A Victim of the Times?
Authors: Hamilton Robert J. 
Published: July 2022

Abstract
Vaselkiv and colleagues present strong evidence of the long-term safety of 5-alpha reductase inhibitor (5-ARI) use. They demonstrated no association with developing advanced prostate cancer, nor dying of prostate cancer. This commentary covers the strengths and weaknesses of the article, and highlights the long and vacillating journey 5-ARIs and prostate cancer prevention have traveled. As 5-ARIs preferentially prevent low-grade prostate cancer, a fact confirmed in the study by Vaselkiv and colleagues, this commentary highlights how 5-ARI chemoprevention may be irrelevant now. With increasing use of active surveillance for low-grade prostate cancers found, and prebiopsy MRI and biomarkers shifting focus to only find those clinically significant cancers, it maybe that 5-ARIs are a victim of the times in their chemoprevention role.
See related article by Vaselkiv et al., p. 1460
Hyper content e-module in information behavior course with the assistant of screencast
Authors: Johan Riche Cynthia , Rullyana Gema , Ardiansah Ardiansah 
Published: July 2022

In the 21st century, continuous innovation and adaptation in every component of learning is required in education, both in the competency component, material content, strategy and media, as well as its evaluation. This study emphasized the development of an electronic or digital module in the information behavior course, it is one of the courses regarding the characteristics of the student activity level that accommodates information retrieval and strives to use appropriate information. The e-module design is developed utilize the 4D model by define, design, develop and disseminate. The participants of this research involved media experts, material experts and students of the Library and Information Science study program at two universities, which are are Universitas Pendidikan Indonesia and Universitas Negeri Malang, there are 20 people in total who used e-modules in limited dissemination on information behavior course. This research revealed the electronic module in the course, the emphasis of the module content design which is enriched with digital-based information sources or in another word called as hyper content that becomes a differentiator in presenting the module content, coupled with the power of audio and visual media or called as screencast. Through this research, lecturers able to prepare independent learning materials by utilizing digital technology.
Virtual worlds in distance learning
Authors: Cruz Vázquez Jonathan Axel , Ruiz Ledesma Elena Fabiola , Chavarría Báez Lorena 
Published: July 2022

<span lang="EN-US">Virtual worlds are considered an additional proposal within the e-learning model. Online platforms have not been enough resources to be successful in the teaching and learning processes, therefore, it is necessary to search more options that contribute to their improvement. Virtual worlds, through inverse and visual experiences for the student, offer new panoramas that allow living situations and solving problems in different areas, such as mathematics. This article analyzes the opinion of higher-level students regarding the use of virtual worlds in their distance classes. Likewise, the virtual worlds provide help in improving teacher-student and student-student relationships. Some cases of educational institutions that integrated the use of virtual worlds into their classes are shown. A Likert-type scale questionnaire has been applied to a sample of 65 higher-level students. Its reliability was validated by means of Cronbach's alpha coefficients and Pearson's. It was found that students consider that the use of virtual worlds would improve class work and relationships between their peers and their teachers. It is remarkably undoubted that virtual worlds within education path are considered an excellent tool for e-learning. However, although the interest on the part of students is high, it is necessary to carry out more researching and developing procedures on the virtual worlds as an alternative to support learning. </span>
Free drawing learning to recognize children’s characters
Authors: Mayar Farida , Putra Febri Wandha , Fadli Rima Pratiwi 
Published: July 2022

<span lang="EN-US">This descriptive qualitative study described the personality or characteristics of children based on the colors used in drawing activities. The subjects in this study were the Pembina Kindergarten students in the city of Padang, West Sumatra, Indonesia. They were determined by using snowball sampling technique. The data collected through observations and documentation analysis by researchers without being directly involved in activities. The data analysis technique used was an interactive model which consists of three activity lines: i) Data reduction; ii) Data display; and iii) Drawing conclusions and data verification. </span>
Paper Soldiers on the March: Colonial Toys for Imperial Play
Authors: Garvin Diana 
Published: July 2022

Abstract
Under the Fascist regime, young Italians amused themselves by practicing the war games of adulthood. Paper soldiers marched across board games set in the newly established empire of Italian East Africa. To reveal how these vicious lessons worked, this article examines three types of toys. It starts with the design and deployment of paper soldiers: Italian Alpinisti, Eritrean Ascari, and Somali Dubat. Next, a playbook for The Conquest of Abyssinia boardgame provides a guide to military conquest. Finally, I examine where these toys come from, revealing the financial structures that underpinned colonial propaganda for Fascist government projects. Ultimately, toys wrote scripts for adult violence in the colonies.
STRAUMA: A Novel Alert System for a Combined Stroke and Trauma
Authors: Lee Janet S. , Finch Heather , Higa Kelly , Khan Abid D. , Millar Janice , O’Neil Jonathan , MacIndoe Chamisa , Brockman Valerie , Stringer Donna , Schroeppel Thomas J. 
Published: July 2022

Introduction Cerebrovascular accident (CVA) can lead to traumatic injury. While timely administration of tissue plasminogen activator (tPA) can be lifesaving in CVAs, it is contraindicated with active bleeding. A STRAUMA is a combined stroke and highest-level trauma activation for patients with suspected CVA and signs of trauma. The purpose of this study is to evaluate the impact of the STRAUMA activation on time to CT and patient outcomes. Methods A retrospective review was conducted on adult patients presenting to a Level 1 trauma and comprehensive stroke center with signs of CVA between 01/2019 and 09/2020. Patients who had a STRAUMA activation were compared to patients who had a stroke alert. Results Five hundred and eighty patients met the inclusion criteria. Of these, 111 had STRAUMA activations and 469 had stroke alerts. There were no differences in age, gender, or anticoagulation use. The STRAUMA group had a higher NIH stroke scale (NIHSS) (11 vs 5, P<.0001). The STRAUMA group had a longer time to CT (23.1 min vs 16.9 min, P<.0001) and a lower rate of tPA (13.5% vs 27.9%, P = .001). Time to tPA and thrombectomy were similar. The STRAUMA group had a 15% rate of traumatic injury with a median injury severity score of 9. Mortality was higher in the STRAUMA group (14.4% vs 6.0%, P = .003). Multivariable logistic regression identified NIHSS and time to CT as predictors of mortality. STRAUMA did not predict mortality. Conclusion The novel STRAUMA activation allows for an evaluation of both stroke and trauma to facilitate safe and timely administration of lifesaving interventions.
Posttraumatic Cognitions and Posttraumatic Stress Symptoms Among Young People Who Have Experienced Commercial Sexual Exploitation and Trafficking
Authors: Perry Elizabeth W. , Osborne Melissa C. , Lee NaeHyung , Kinnish Kelly , Self-Brown Shannon R. 
Published: July 2022

Objectives The impact of posttraumatic cognitions on the development and maintenance of posttraumatic stress symptoms (PTSS) is understudied among children and adolescents who have experienced commercial sexual exploitation/trafficking (CSE/T). The objectives of this study were to (1) explore posttraumatic cognitions among help-seeking young people aged 11-19 who have experienced CSE/T; (2) determine whether experiencing direct violence, witnessing violence, polyvictimization (ie, multiple exposures to different categories of potentially traumatic events), or demographic characteristics differentially affect whether these young people meet clinical criteria for posttraumatic cognitions using established cutoffs; and (3) explore associations between posttraumatic cognitions and PTSS among young people who have experienced CSE/T. Methods This study is a secondary analysis of a baseline cross-sectional survey of 110 young people with substantiated CSE/T experiences who started trauma-focused cognitive behavioral therapy (mean [SD] age = 15.8 [1.5]) from August 1, 2013, through March 31, 2020, in a southeastern US state. We used descriptive statistics, adjusted modified Poisson regression, and adjusted linear regression to test study objectives. Results Fifty-seven of 110 (51.8%) young people aged 11-19 met clinical criteria for posttraumatic cognitions. Increased age and a greater number of trauma categories experienced were significantly associated with meeting clinical criteria for posttraumatic cognitions. On average, higher posttraumatic cognition scores were associated with higher PTSS scores, controlling for demographic characteristics (β = 0.95; 95% CI, 0.64-1.26). Conclusions These findings underscore the importance of assessing comprehensive trauma history and PTSS of young people who have experienced CSE/T, with added usefulness of measuring cognitive appraisals to inform a therapeutic treatment plan. Measuring cognitive appraisals that may influence PTSS and therapeutic success can ensure an effective public health response for this population.
The effect of a buddy-style intervention on physical activity in community-dwelling older adults with disabilities: A 24-week follow-up of a randomized controlled trial
Authors: Takeda Hiromichi , Takatori Katsuhiko 
Published: July 2022

Objective To assess the sustained effects of a buddy-style intervention aiming to improve physical activity. Design A parallel-group, open-label, randomized controlled trial. Setting Three adult day-care centers. Participants Sixty-five community-dwelling older adults with disabilities. Intervention All participants received a 12-week home-based exercise program. An intervention group ( n = 33) received a 5–10 min buddy-style intervention once a week at an adult day-care center for older adults. Main measures The primary outcome was the average daily time spent performing “walking outside home” and “muscle strength exercises” at 24 weeks follow-up post-intervention. Results Of the 65 participants, one participant in each group dropped out before the program began, 4 and 5 in the intervention and control groups by the 12-week assessment, and 4 and 3 by the 24-week assessment, respectively. Analysis of covariance of the 47 participants who were able to be assessed after 24 weeks revealed that outdoor walking time (min/day) was significantly longer in the intervention group ( n = 24) than in the control group ( n = 23) at 24 weeks (intervention group, 73.5 [66.1]; control group, 42.7 [45.5]; P = 0.030, f = 0.38). There was no significant difference in the duration of muscle strength exercises (min/day) between the two groups at 24 weeks (intervention group, 8.2 [9.7]; control group, 6.5 [9.3]; P = 0.593, f = 0.08). Conclusions The buddy-style intervention increased the duration of outdoor walking, with a sustained effect up to 12 weeks after the end of the intervention.
Pull-out Strength of Suture Anchor and Torque of Buddy Anchor for an Osteoporotic Humeral Head in Rotator Cuff Repair: Parallel Versus Divergent Insertion
Authors: Do Woo-Sung , Kim Joo-Hyung , Lim Joon-Ryul , Yoon Tae-Hwan , Chun Yong-Min 
Published: July 2022

Background: The buddy anchor technique is useful to reinforce loose anchors in the osteoporotic humeral head during arthroscopic rotator cuff repair. However, theoretical parallel insertion of the buddy anchor to index a loose anchor is challenging in arthroscopy and can widen the entry site and decrease structural integrity. Purpose: To investigate and compare the biomechanical stability between 2 buddy anchor insertion techniques (parallel insertion vs divergent insertion) in the osteoporotic humeral head. Study Design: Controlled laboratory study. Methods: A total of 24 paired fresh-frozen cadaveric shoulders were used, and each pair was randomly assigned to either the parallel insertion group or the divergent insertion group. In the parallel insertion group, the buddy anchor was inserted parallel to the index loose anchor. In the divergent insertion group, the buddy anchor was inserted at a 20° angle in the medial direction to the index loose anchor. The insertion torque of the buddy anchor and ultimate pull-out strength of the index anchor were measured and compared between the 2 groups. Results: The mean maximum insertion torque was significantly higher in the parallel insertion group (16.1 ± 1.8 cN·m) compared with the divergent insertion group (12.0 ± 1.5 cN·m) ( P < .001). The mean ultimate pull-out strength was significantly higher with divergent insertion (192.2 ± 28.6 N) than with parallel insertion (147.7 ± 23.6 N) ( P < .001). Conclusion: For application of the buddy anchor system in the cadaveric osteoporotic humeral bone model, divergent insertion showed better ultimate pull-out strength than conventional parallel insertion, despite inferior maximum insertion torque. Clinical Relevance: The results of this study widen the applicability and accessibility for the buddy anchor system.