bluuebunny/crossref_metadata_2025_split huggingface dataset:
Adolescent suicide assessment and management in primary care
Authors: Aalsma M. , Keys J. , Ferrin S. , Shan M. , Garbuz T. , Scott T. , Adams Z. , Hulvershorn L. , Downs S. 
Published: July 2022

AbstractBackgroundTo understand how suicide management occurs within the primary care setting in terms of follow-up assessments and referral practices.MethodsAt an initial primary care visit, adolescents (aged 12–20 years old) completed electronic screening. Data were focused on youth who endorsed a suicidal risk item while completing screening at two Midwestern primary care clinics. Data were collected through retrospective chart reviews to analyze actions taken by the primary care physician at the youth’s initial visit and follow-up visit within the next 12 months.ResultsAt initial visits 200 adolescents endorsed a suicidal risk item and 39 (19.5%) were considered to be concerning by their primary care physician. The average age was 14.7 years old (SD ± 2.0). Seventy-two percent (n = 144) were female, and 65% (n = 129) identified as Black. At initial visits, significant differences between suicidal concern groups were found in reporting active suicidal ideation, past suicide attempts, those who were referred to behavioral health counseling, and those who had a diagnosis of depression. Interestingly, only 13% (n = 25) of all patients who endorsed the suicide item were asked whether or not there were weapons in their home and primary care providers asked only 7% (n = 13) of all patients whether they had a safety plan.ConclusionsThere was inconsistent follow-up for adolescents with a history of suicide concerns. At this time, national guidelines do not exist regarding primary care follow-up of youth with suicide concerns. Guidelines are a necessary precursor for practice improvement.Trial RegistrationClinical Trials Registry:NCT02244138. Registration date, September 1, 2014.
Impacts of COVID-19 on trans and non-binary people in Canada: a qualitative analysis of responses to a national survey
Authors: Kia Hannah , Rutherford Leo , Jackson Randy , Grigorovich Alisa , Ricote Carol Lopez , Scheim Ayden I. , Bauer Greta R. 
Published: July 2022

Abstract
Background
Emerging international evidence indicates the COVID-19 pandemic has exacerbated socioeconomic and health challenges faced by transgender (trans) and non-binary populations globally. This qualitative study is among the first to characterize impacts of the pandemic on these groups in Canada.

Methods
Drawing on data from the Trans PULSE Canada survey (N = 820), we used thematic analysis to examine the free-form responses of 697 participants to one open-ended question on impacts of the pandemic. We first organized responses into descriptive themes, and then used this preliminary analytical process to construct more refined, higher order themes that provided a rich account of the pandemic’s impacts.

Results
Our results are organized into five themes that highlight the pandemic’s impacts on trans and non-binary populations in Canada. These include: (1) reduced access to both gender-affirming and other healthcare, (2) heightened financial, employment, and housing precarity, (3) strained social networks in an era of physical distancing and virtual communication, (4) an intensification of safety concerns, and (5) changes in experiences of gender affirmation.

Conclusion
Our findings highlight the pandemic’s systemic impacts on the lives of trans and non-binary people in domains such as healthcare, employment, and housing, and on the social networks of these groups, many of which reflect an exacerbation of pre-existing inequities. Based on our analysis, we recommend that public health researchers, policymakers, and practitioners attend to the structural impacts of the pandemic on these groups as primary sites of inquiry and intervention.
Comparative intra- and inter-observer reliability of two methods for evaluating intraoperative ultrasonography-based spinal cord hyperechogenicity intensity in degenerative cervical myelopathy
Authors: Wu Huachuan , Chen Guoliang , Li Xianlong , Zhu Zhengya , Xu Zuofeng , Liu Xizhe , Liu Shaoyu 
Published: July 2022

Abstract
Objectives
During French-door laminoplasty, a linear array transducer of IOUS was used to observe and record the spinal cord decompression. To acquire a higher-reliability method, and compare the in-observer and inter-observer reliability of two methods in evaluating the hyperechoic intensity of spinal cord ultrasound in degenerative cervical myelopathy (DCM).

Background
The intensity of spinal cord hyperechogenicity is considered as a potential predictor of neurological recovery in DCM after decompression, but the accuracy of gray value ratio (GVR) is affected by many factors.

Methods
Totally 28 patients (20 males and 8 females) who had been followed up for 12 months were included. Their mean age at surgery was 61.2 ± 10.8 years and the average symptom duration was 23.36 ± 22.11 months. The gray values of circles 1, 2 and 3 were recorded as Gcompression, Gnorml and Gsac, respectively. Circle 1 was drawn with the maximum brightness point within the spinal cord as the center, circle 2 with the same area was plotted on the spinal cord with uniform echogenicity, without compression and at least 1 cm away from the circle 1, and circle 3 was drawn on the dorsal dural sac at the same segment as circle 1. GVR was calculated as follows: GVR-A = Gcompression/Gnorml (method A), and GVR-B = Gcompression/Gsac (method B). The in-observer and inter-observer reliabilities of the two methods were compared. It is generally believed a reliability coefficient < 0.40 and > 0.75 indicate poor and good reliability respectively. The images-based GVR-B using this protocol demonstrates higher inter- and intraobserver reliabilities than GVR-A, and can be used as the basis for prognostic prediction and future studies.

Results
All examination acquisitions were successfully completed. GVR-A averaged 2.043 (0.318–5.56), and GVR-B averaged 0.578(0.06–1.41). GVR-B has better repeatability of gray value measurement, smaller relative standard deviation (RSD%) (0.298 vs. 0.32) and larger inter-group correlation coefficient compared with GVR-A. The mean value (MD) of the GVR difference calculated by GVR-B between the two clinicians was closer to 0.

Conclusions
For DCM patients routinely using ultrasound for real-time cord visualization during spinal cord decompression by French-door laminoplasty, the images-based GVR-B using this protocol demonstrates better inter- and intraobserver reliabilities compared with GVR-A.
Sequence of flexion contracture development in the lower limb: a longitudinal analysis of 1,071 children with cerebral palsy
Authors: Cloodt Erika , Lindgren Anna , Lauge-Pedersen Henrik , Rodby-Bousquet Elisabet 
Published: July 2022

Abstract
Background
To prevent severe contractures and their impact on adjacent joints in children with cerebral palsy (CP), it is crucial to treat the reduced range of motion early and to understand the order by which contractures appear. The aim of this study was to determine how a hip–knee or ankle contracture are associated with the time to and sequence of contracture development in adjacent joints.

Methods
This was a longitudinal cohort study of 1,071 children (636 boys, 435 girls) with CP born 1990 to 2018 who were registered before 5 years of age in the Swedish surveillance program for CP and had a hip, knee or ankle flexion contracture of ≥ 10°. The results were based on 1,636 legs followed for an average of 4.6 years (range 0–17 years). The Cox proportional-hazards model adjusted for Gross Motor Function Classification System (GMFCS) levels I–V was used to compare the percentage of legs with and without more than one contracture.

Results
A second contracture developed in 44% of the legs. The frequency of multiple contractures increased with higher GMFCS level. Children with a primary hip or foot contracture were more likely to develop a second knee contracture. Children with a primary knee contracture developed either a hip or ankle contracture as a second contracture.

Conclusions
Multiple contractures were associated with higher GMFCS level. Lower limb contractures appeared in specific patterns where the location of the primary contracture and GMFCS level were associated with contracture development in adjacent joints.
Effects of neuromuscular training on postural control of children with intellectual disability and developmental coordination disorders
Authors: Balayi Esmail , Sedaghati Parisa , Ahmadabadi Somayeh 
Published: July 2022

Abstract
Background
Children with Intellectual disabilities who suffer from developmental coordination disorder represent insignificant physical fitness, strength, and balance. The prime objective of this research is to explore the impact of eight weeks of neuromuscular (combined physio-hemsball) training on postural control and balance of students with intellectual disabilities suffering from developmental coordination disorder.

Methods
The present study was a prospective randomized clinical trial with a pretest–posttest design. The statistical population consisted of boys with intellectual disabilities, suffering from developmental coordination disorder randomly divided into two groups: the experimental group (n = 15) and the control group (n = 15). informed consent was obtained from all participants’ parents. Parents completed developmental coordination disorder questionnaires. Tests (Balance Error Scoring System, Y-Balance, timed Get Up & Go) were used to determine postural control, dynamic balance, and functional balance of subjects. The experimental group performed a combined physio-hemsball training for 8 weeks. Ethical considerations were observed according to the Helsinki Declaration and the CONSORT guidelines and regulations were followed to report this study.

Results
Results showed that combined physio-hemsball training for 8 weeks can greatly improve postural control and dynamic and postural balance among students with intellectual disabilities suffering from developmental coordination disorder.

Conclusions
According to the results, instructors can use this type of training to improve postural control and balance in boys with intellectual disabilities enduring developmental coordination disorders.

Trial registration
This research was registered by the clinical trial centers of Iran (code IRCT20200125046254N1, Date of registration: 24/04/2020).
Isolated compounds from Dracaena angustifolia Roxb and acarbose synergistically/additively inhibit α-glucosidase and α-amylase: an in vitro study
Authors: Yi Jiling , Zhao Ting , Zhang Yuanlin , Tan Yanxing , Han Xiao , Tang Yulin , Chen Guangying 
Published: July 2022

AbstractBackgroundAs a traditional herbal medicine,Dracaena angustifoliaRoxb has been used as an anti-inflammatory agent by the Li people in Hainan, China. In preliminary phytochemical studies conducted in our lab, its fractions were found to inhibit α-glucosidase in vitro, indicating a potential for alleviating glucose dysregulation.MethodsThrough in vitro enzymatic assays, the abilities of the separated components to affect α-glucosidase and α-amylase were evaluated. By establishing concentration gradients and generating Lineweaver–Burk plots, the corresponding inhibition modes together with kinetic parameters were assessed. Following the evaluation of the outcomes of their combination with acarbose, computational docking and molecular dynamic simulations were carried out to analyse the interaction mechanisms and perform virtual screening against human enzymes.ResultsCompared with acarbose, 7 compounds, including flavonoid derivatives, amides and aromatic derivatives, with higher α-glucosidase inhibitory efficiencies were confirmed. It was found that those competitive/mixed candidates and acarbose interacted synergistically or additively on α-glucosidase. Moreover, 3 of them were able to inhibit α-amylase in mixed mode, and additive effects were observed in combination with acarbose. Through in silico docking, it was found that the active site residues as well as adjacent residues were involved in α-glucosidase and α-amylase binding, which were mainly achieved through hydrogen bonding. Among those dual-function flavonoids, Compound 9 was predicted to be a considerable inhibitor of human enzymes, as the formation of ligand–enzyme complexes was mediated by the residues responsible for substrate recognition and catalysis, the stabilities of which were reiterated by molecular dynamics simulations.ConclusionDespite their mild effects on α-amylase, considerable α-glucosidase inhibitory efficiencies and potential synergy with acarbose were exhibited by these natural candidates. Furthermore, a stable ligand, human α-glucosidase, was predicted by the performed simulations, which provided useful information for the application ofDracaena angustifoliaRoxb in diabetes treatment.
Are there differences between SIMG surgeons and locally trained surgeons in Australia and New Zealand, as rated by colleagues and themselves?
Authors: Narayanan Ajit , Greco Michael , Janamian Tina , Fraser Tamieka , Archer Julian 
Published: July 2022

Abstract
Background
Representation of specialist international medical graduates (SIMGs) in specific specialties such as surgery can be expected to grow as doctor shortages are predicted in the context of additional care provision for aging populations and limited local supply. Many national medical boards and colleges provide pathways for medical registration and fellowship of SIMGs that may include examinations and short-term training. There is currently very little understanding of how SIMGs are perceived by colleagues and whether their performance is perceived to be comparable to locally trained medical specialists. It is also not known how SIMGs perceive their own capabilities in comparison to local specialists. The aim of this study is to explore the relationships between colleague feedback and self-evaluation in the specialist area of surgery to identify possible methods for enhancing registration and follow-up training within the jurisdiction of Australia and New Zealand.

Methods
Feedback from 1728 colleagues to 96 SIMG surgeons and 406 colleagues to 25 locally trained Fellow surgeons was collected, resulting in 2134 responses to 121 surgeons in total. Additionally, 98 SIMGs and 25 Fellows provided self-evaluation scores (123 in total). Questionnaire and data reliability were calculated before analysis of variance, principal component analysis and network analysis were performed to identify differences between colleague evaluations and self-evaluations by surgeon type.

Results
Colleagues rated SIMGs and Fellows in the ‘very good’ to ‘excellent’ range. Fellows received a small but statistically significant higher average score than SIMGs, especially in areas dealing with medical skills and expertise. However, SIMGs received higher scores where there was motivation to demonstrate working well with colleagues. Colleagues rated SIMGs using one dimension and Fellows using three, which can be identified as clinical management skills, inter-personal communication skills and self-management skills. On self-evaluation, both SIMGs and Fellows gave themselves a significant lower average score than their colleagues, with SIMGs giving themselves a statistically significant higher score than Fellows.

Conclusions
Colleagues rate SIMGs and Fellows highly. The results of this study indicate that SIMGs tend to self-assess more highly, but according to colleagues do not display the same level of differentiation between clinical management, inter-personal and self-management skills. Further research is required to confirm these provisional findings and possible reasons for lack of differentiation if this exists. Depending on the outcome, possible support mechanisms can be explored that may lead to increased comparable performance with locally trained graduates of Australia and New Zealand in these three dimensions.
Effect of introducing interprofessional education concepts on students of various healthcare disciplines: a pre-post study in the United Arab Emirates
Authors: Zaher Shroque , Otaki Farah , Zary Nabil , Al Marzouqi Amina , Radhakrishnan Rajan 
Published: July 2022

Abstract
Background
The value of interprofessional education (IPE) in nurturing healthcare professionals, and in shaping their professional identities, and their attitudes towards interdisciplinary teamwork and collaboration is established in the literature. IPE is an emerging concept in the Middle East and North Africa (MENA) region and is new to the United Arab Emirates (UAE). To date, the applicability and feasibility of IPE and of the corresponding collaborative practice in MENA countries remain largely unexamined.

Purpose
To investigate the effect of one of the first experiences of IPE in the UAE, which was purposefully designed in alignment with the principles of the Situated Learning Theory (SLT), on the readiness for interprofessional learning and collaboration among students of various healthcare disciplines in the UAE.

Methods
A pre-post intervention quantitative research design was adopted for this study. The intervention focused on communication skills, and consisted of 2 tailor-made case-based scenarios. A total of 90 students (40 medical, 16 nursing, 16 pharmacy, and 18 physiotherapy), spread across two sessions (1 session per academic year across 2 academic years), took part in the IPE intervention. Readiness for Interprofessional Learning Scale (RIPLS) was used as the pre- and post- intervention assessments; aggregate data was analyzed using SPSS.

Results
Of those who participated in the intervention (across both rounds), 77 participants responded to the pre-assessment (85. 6%) and 84 responded to the post-assessment (93. 3%). The IPE intervention under investigation significantly increased the level of readiness to engage in cross-disciplinary learning and collaboration among participating health professions’ students. In terms of the subscales, the participants’ openness to engage in teamwork was raised and their professional identity was fostered. Yet, no statistical significance around clarity of roles and responsibilities was detected.

Conclusion
The findings of this study encourage other universities in the MENA region to adopt IPE to improve future health professionals’ capacity to develop shared understanding and mutual respect within cross-disciplinary teams. This, ultimately, feeds into improved quality of care and patient outcomes.
Escape box and puzzle design as educational methods for engagement and satisfaction of medical student learners in emergency medicine: survey study
Authors: Cantwell Christina , Saadat Soheil , Sakaria Sangeeta , Wiechmann Warren , Sudario Gabriel 
Published: July 2022

AbstractBackgroundGamification in medical education has gained popularity over the past several years. We describe a virtual escape box in emergency medicine clerkship didactics to teach chest pain and abdominal pain and compare this instructional method to a traditional flipped classroom format.MethodsA virtual escape box was designed at our institution and incorporated into the mandatory two-week emergency medicine clerkship. The game consisted of a PDF with four cases containing puzzles to unlock a final clue. Likert scale surveys were administered to assess participants’ perceptions of the escape box format; of clerkship didactics as a whole; and of the clerkship overall. These responses were compared to the prior year’s evaluations on flipped classroom didactics and clerkship.ResultsOne hundred thirty-four learners participated in the escape box and completed the survey. Eighty-six percent strongly agreed with feeling more engaged with the escape box, 84% strongly agreed with learning something new, 81% strongly agreed with finding the escape box to be satisfying, 78% strongly agreed with being able to apply knowledge gained, and 74% strongly agreed with wanting more escape boxes incorporated into medical education. The escape box showed a higher average score (3.6 ± 0.63) compared to chest pain (3.5 ± 0.67) and abdominal pain (3.2 ± 0.77) flipped classroom sessions (p = 0.0491) for the category of “lecturer explaining content clearly and at the proper level of complexity.” For the category of “lecturer provided effective instructional materials,” the escape box showed higher scores (3.6 ± 0.63) compared to flipped classroom for chest pain (3.4 ± 0.77) and abdominal pain (3.1 ± 0.80) (p < 0.001).ConclusionsEscape boxes are adaptable to a virtual format and can teach abstract concepts such as teamwork and communication in addition to traditional lecture content. Ratings of didactics were higher for the escape box compared to the flipped classroom, while ratings of overall clerkship experience were not found to change significantly.
Undergraduate perceptions on transitioning into E-learning for continuation of higher education during the COVID pandemic in a developing country: a cross-sectional study from Sri Lanka
Authors: Subashini Nirma , Udayanga Lahiru , De Silva L. H. N. , Edirisinghe J. C. , Nafla M. N. 
Published: July 2022

Abstract
Background
The higher education was significantly influenced by the COVID pandemic within many developing countries, including Sri Lanka, necessitating to adopt more E-Learning opportunities. Therefore, this study was conducted to characterize the perceptions of Sri Lankan undergraduates to accept E-Learning in higher education, during the COVID crisis.

Method
A total of 657 randomly selected undergraduates of three state universities in Sri Lanka, were recruited as the study population. Information on Socio-demographic factors, Knowledge, Attitudes and Practices on E-Learning methods were acquired using an interviewer administered questionnaire. A Probit regression model was fitted to identify the driving factors for the willingness of undergraduates to engage in E-Learning.

Results
Around, 80.2% of the respondents were females. Majority were residing in semi-urban areas (44.7%), followed by rural areas (39.9%). More than two third of the respondents were familiar with E-Learning and different Learning Management Systems (LMS) that facilitate E-Learning (68.9%). Majority of the respondents (73.7%) were using different E-Learning platforms, mostly 2 to 3 days per week (25.7%). Only around one third (36.4%) had received any formal training in using LMS or other E-Learning platforms. Smart phones (77.8%) were found to be the most preferred device used for E-Learning activities, followed by computers and laptops (21.3%). Meanwhile, LMS/MOODLE (45.4%), WhatsApp/Viber (33.0%) and Zoom (32.7%), were the most commonly used E-Learning platforms. The average acceptance of E-Learning methods was found to be 70.7% among Sri Lankan undergraduates during the COVID epidemic. Based on the Probit regression, nature of the residing locality (P=0.009), family income (P=0.048), academic field (P<0.001) and year (P=0.028), knowledge on Information and Communications Technology [ICT] (P=0.012), and previous training experiences on E-Learning (P<0.001) were found as significant drivers that influence the acceptance of E-Learning practices of the Sri Lankan undergraduates.

Conclusion
Adopting E-learning into higher education sector could be recognized as a viable solution to facilitate the higher education during a crisis like COVID. However, relevant authorities in Sri Lanka should take immediate actions to empower the physical resources for E-Learning, improve the basic telecommunication infrastructure and conduct appropriate training programmes to promote E-Learning among Sri Lankan undergraduates.