bluuebunny/crossref_metadata_2025_split huggingface dataset:
ALMA observations of transient heating in a solar active region
Authors: da Silva Santos J. M. , de la Cruz Rodríguez J. , White S. M. , Leenaarts J. , Vissers G. J. M. , Hansteen V. H. 
Published: September 2020

Aims. We aim to investigate the temperature enhancements and formation heights of solar active-region brightenings such as Ellerman bombs (EBs), ultraviolet bursts (UVBs), and flaring active-region fibrils (FAFs) using interferometric observations in the millimeter (mm) continuum provided by the Atacama Large Millimeter/submillimeter Array (ALMA).
Methods. We examined 3 mm signatures of heating events identified in Solar Dynamics Observatory observations of an active region and compared the results with synthetic spectra from a 3D radiative magnetohydrodynamic simulation. We estimated the contribution from the corona to the mm brightness using differential emission measure analysis.
Results. We report the null detection of EBs in the 3 mm continuum at ∼1.2″ spatial resolution, which is evidence that they are sub-canopy events that do not significantly contribute to heating the upper chromosphere. In contrast, we find the active region to be populated with multiple compact, bright, flickering mm-bursts – reminiscent of UVBs. The high brightness temperatures of up to ∼14 200 K in some events have a contribution (up to ∼7%) from the corona. We also detect FAF-like events in the 3 mm continuum. These events show rapid motions of > 10 kK plasma launched with high plane-of-sky velocities (37 − 340 km s−1) from bright kernels. The mm FAFs are the brightest class of warm canopy fibrils that connect magnetic regions of opposite polarities. The simulation confirms that ALMA should be able to detect the mm counterparts of UVBs and small flares and thus provide a complementary diagnostic for localized heating in the solar chromosphere.
Distance spectral radius of series-reduced trees with parameters
Authors: Deng Yuyuan , Li Dangui , Lin Hongying , Zhou Bo 
Published: September 2020

For a connected graph G, the distance matrix is a real-symmetric matrix where the (u, v)-entry is the distance between vertex u and vertex v in G. The distance spectral radius of G is the largest eigenvalue of the distance matrix of G. A series-reduced tree is a tree with at least one internal vertex and all internal vertices having degree at least three. Those series-reduced trees that maximize the distance spectral radius are determined over all series-reduced trees with fixed order and maximum degree and over all series-reduced trees with fixed order and number of leaves, respectively.
Comparison of Chest Ultrasound and Standard X-Ray Imaging in COVID-19
Patients
Authors: Shumilov Evgenii , Hosseini Ali Seif Amir , Petzold Golo , Treiber Hannes , Lotz Joachim , Ellenrieder Volker , Kunsch Steffen , Neesse Albrecht 
Published: September 2020

AbstractThe COVID-19 pandemic poses new challenges for the medical
community due to its large number of patients presenting with varying
symptoms. Chest ultrasound (ChUS) may be particularly useful in the early
clinical management in suspected COVID-19 patients due to its broad
availability and rapid application. We aimed to investigate patterns of ChUS
in COVID-19 patients and compare the findings with results from chest X-ray
(CRX).24 patients (18 symptomatic, 6 asymptomatic)
with confirmed SARS-CoV-2 by polymerase chain reaction underwent bedside
ChUS in addition to CRX following admission. Subsequently, the results of
ChUS and CRX were compared.94% (n=17/18) of patients with
respiratory symptoms demonstrated lung abnormalities on ChUS. ChUS was
especially useful to detect interstitial syndrome compared to CXR in
COVID-19 patients (17/18 vs. 11/18; p<0.02). Of
note, ChUS also detected lung consolidations very effectively (14/18
for ChUS vs. 7/18 cases for CXR; p<0.02). Besides
pathological B-lines and subpleural consolidations, pleural line abnormality
(89%; n=16/18) was the third most common feature in
patients with respiratory manifestations of COVID-19 detected by ChUS.Our findings support the high value of ChUS in the
management of COVID-19 patients.
Eine nicht „ganz normale“ Reanimation bei Kammerflimmern – Wachheit während der Wiederbelebung
Authors: Czerwonka Holger , Sroka Michael 
Published: September 2020

ZusammenfassungWährend einer Reanimation bei Kammerflimmern wurde „Wachheit unter CPR“ beobachtet. Dies führte in der Folge zu einer kritischen Auseinandersetzung und der ethischen Fragestellung, ob eine Sedierung während der Reanimation zum ärztlichen Selbstverständnis gehören müsste, um traumatische Erinnerungen auszuschließen. Im vorliegenden Fall konnte ein junger Reisender am Frankfurter Flughafen erfolgreich wiederbelebt werden und ohne Residuen und Erinnerungen an „seine Reanimation“ nach 11 Tagen die Heimreise antreten.
Trastuzumab Biosimilars in the Therapy of Breast Cancer – “Real World” Experiences from four Bavarian University Breast Centres
Authors: Hester Anna , Gaß Paul , Fasching Peter A. , Krämer Anne Katrin , Ettl Johannes , Diessner Joachim , Wöckel Achim , Egger Tobias , Stock Katja , Redlin Jutta , Andraschko Monika , Harbeck Nadia , Würstlein Rachel 
Published: September 2020

Abstract
Introduction With the introduction of the first trastuzumab biosimilar in the summer of 2018, biosimilar antibodies for breast cancer have found their way into the area of gynaecological oncology. The switch of anti-human epidermal growth factor receptor 2 (HER2) therapy from the reference drug Herceptin® to a biosimilar has presented challenges to the clinics. In addition to structural and organisational measures, training of employees as well as patient briefing and acceptance were major challenges. The study presented here records – within the context of quality assurance – how the switch to a trastuzumab biosimilar was implemented at four Bavarian university clinics in the Purchasing Association of Bavarian University Pharmacies.
Materials/Methods Questionnaires on treatment figures and the switching process were sent to breast centres and pharmacies of four Bavarian university clinics between July and December 2019. The neoadjuvant, adjuvant and metastasised anti-HER2 therapy with trastuzumab with or without pertuzumab was recorded, evaluated and summarised.
Results In the anti-HER2-therapy, trastuzumab was used intravenously (i. v.) and subcutaneously. Between July and December 2018, all four clinics in the Purchasing Association switched the i. v. trastuzumab therapy from the reference drug (Herceptin) to a biosimilar (for 2018: Kanjinti®). Over 200 patients were treated with trastuzumab i. v. in each of the two half-years of 2018 (before and after the switch). The spectrum of side effects and pCR rates under therapy with the biosimilar were comparable to the experiences made with the reference drug. Three out of four clinics provided training to employees and informed patients by means of a defined information leaflet. Patient acceptance was high.
Summary The anti-HER2 therapy could be switched successfully and safely to trastuzumab biosimilars at the Bavarian university hospitals. This may serve as guideline for the further implementation of biosimilars. The structures necessary for this initial switching process have been prepared with trastuzumab as an example.
Important Aspects of Human Behavior in Road Traffic Accidents
Authors: Lakhan Ram , Pal Ranabir , Baluja Arushi , Moscote-Salazar Luis Rafael , Agrawal Amit 
Published: September 2020

AbstractWorldwide road traffic accidents have been increasing. Human behaviors and environmental factors are often responsible for such events. This being a serious public health concern, public health interventions are needed to minimize the rate of road traffic accidents. We aimed to identify broader human behaviors, sociodemographic factors, and environmental factors associated with the risk of road traffic accidents. We searched for the relevant studies in electronic database including PubMed, Cochrane, Web of Science, Google Scholar, and World Health Organization global health library. In addition, a manual search was also performed. Findings from scientific literature were presented in a summative form. Young age, male gender, speed, influence of substance, use of mobile phone, driving experience, temperament, attitude, aggression, stress, anxiety, emotionality, fatigue, lack of sleep, and road conditions were found closely associated with a risk of road traffic accidents. Despite having substantial driving training and ability to handling motor vehicles, professional drivers such as bus and taxi drivers are very vulnerable to road traffic accidents. This study reports that the increasing prevalence of road traffic accidents can be addressed significantly by applying behavior change theories. The health belief model was found useful in promoting safer driving.
Implementation of a Postpartum Hemorrhage Safety Bundle at an Urban Safety-Net Hospital
Authors: Joseph Naima T. , Worrell Nikkia H. , Collins Janice , Schmidt Melanie , Sobers Grace , Hutchins Kathlyn , Chahine E. Britton , Faya Christine , Lewis Luanne , Green Victoria L. , Castellano Penny Z. , Lindsay Michael K. 
Published: September 2020

AbstractBackground Postpartum hemorrhage (PPH) is a leading cause of preventable maternal morbidity and mortality. Standardized response to obstetric hemorrhage is associated with significant improvement in maternal outcomes, yet implementation can be challenging.Objective The primary objective is to describe the methodology for program implementation of the Alliance for Innovation on Maternal Health Safety Bundle on PPH at an urban safety-net hospital.Methods Over an 18-month period, interventions geared toward (1) risk assessment and stratification, (2) hemorrhage identification and management, (3) team communication and simulation, and (4) debriefs and case review were implemented. Hemorrhage risk assessment stratification rates were tracked overtime as an early measure of bundle compliance.Results Hemorrhage risk assessment stratification rates improved to >90% during bundle implementation.Conclusion Keys to implementation included multidisciplinary stakeholder commitment, stepwise and iterative approach, and parallel systems for monitoring and evaluation Implementation of a PPH safety bundle is feasible in a resource-constrained setting.
Initial Outcomes of a Novel High-Visibility Endoscopic Carpal Tunnel Release Technique
Authors: Liu Bo , Wu Feiran 
Published: September 2020

Abstract
Background A large variety of endoscopic carpal tunnel release methods have been described in efforts to shorten recovery time, reduce scar discomfort, and allow earlier return to work. The majority of existing techniques are the modifications of the Agee, Chow, and Menon techniques, all of which require dedicated equipment that can increase facility and surgical fees for the patient and institution. We present a novel high-visibility endoscopic carpal tunnel release technique that uses common hand surgery instruments available in all surgical units, without requiring disposable or custom devices.
Description of Technique The cases were performed under local anesthesia using routine reusable instruments and a conventional 2.5-mm 30-degree small joint arthroscope. Following proximal dissection, a clear, colorless, plastic shield was created from a standard syringe that offered a 360-degree vision of the carpal tunnel and protection of the median nerve. Release of the transverse carpal ligament was performed under full arthroscopic vision using Metzenbaum dissection scissors.
Methods This pilot study analyses the first nine cases in eight patients who were operated on using this technique, with a minimum of 6 months of follow-up.
Results No peri- or postoperative complications were encountered. All patients demonstrated significant improvements in the Disabilities of the Arm, Shoulder, and Hand score, the Boston Carpal Tunnel Questionnaire score, and a visual analog score for pain.
Conclusion The high-visibility endoscopic carpal tunnel release technique is safe and effective, and offers a viable cost-reducing alternative to the existing endoscopic methods for carpal tunnel syndrome. Future comparative trials are required to validate these findings in a larger series.
Level of Evidence This is a Level IV study.
Implementation of Artificial Intelligence-Based Clinical Decision Support to Reduce Hospital Readmissions at a Regional Hospital
Authors: Romero-Brufau Santiago , Wyatt Kirk D. , Boyum Patricia , Mickelson Mindy , Moore Matthew , Cognetta-Rieke Cheristi 
Published: September 2020

Abstract
Background Hospital readmissions are a key quality metric, which has been tied to reimbursement. One strategy to reduce readmissions is to direct resources to patients at the highest risk of readmission. This strategy necessitates a robust predictive model coupled with effective, patient-centered interventions.
Objective The aim of this study was to reduce unplanned hospital readmissions through the use of artificial intelligence-based clinical decision support.
Methods A commercially vended artificial intelligence tool was implemented at a regional hospital in La Crosse, Wisconsin between November 2018 and April 2019. The tool assessed all patients admitted to general care units for risk of readmission and generated recommendations for interventions intended to decrease readmission risk. Similar hospitals were used as controls. Change in readmission rate was assessed by comparing the 6-month intervention period to the same months of the previous calendar year in exposure and control hospitals.
Results Among 2,460 hospitalizations assessed using the tool, 611 were designated by the tool as high risk. Sensitivity and specificity for risk assignment were 65% and 89%, respectively. Over 6 months following implementation, readmission rates decreased from 11.4% during the comparison period to 8.1% (p < 0.001). After accounting for the 0.5% decrease in readmission rates (from 9.3 to 8.8%) at control hospitals, the relative reduction in readmission rate was 25% (p < 0.001). Among patients designated as high risk, the number needed to treat to avoid one readmission was 11.
Conclusion We observed a decrease in hospital readmission after implementing artificial intelligence-based clinical decision support. Our experience suggests that use of artificial intelligence to identify patients at the highest risk for readmission can reduce quality gaps when coupled with patient-centered interventions.
Acute Viral Bronchiolitis: A Narrative Review
Authors: Angurana Suresh K. , Williams Vijai , Takia Lalit 
Published: September 2020

AbstractAcute viral bronchiolitis (AVB) is the leading cause of hospital admissions among infants in developed and developing countries and associated with increased morbidity and cost of treatment. This review was performed to guide the clinicians managing AVB in light of evidence accumulated in the last decade. We searched published English literature in last decade regarding etiology, diagnosis, treatment, and prevention of AVB using PubMed and Cochrane Database of Systematic Reviews. Respiratory syncytial virus is the most common causative agent. The diagnosis is mainly clinical with limited role of diagnostic investigations and chest radiographs are not routinely indicated. The management of AVB remains a challenge, as the role of various interventions is not clear. Supportive care in form of provision of heated and humidified oxygen and maintaining hydration are main interventions. The use of pulse oximetry helps to guide the administration of oxygen. Trials and systematic reviews evaluated various interventions like nebulized adrenaline, bronchodilators and hypertonic saline, corticosteroids, different modes of noninvasive ventilation (high-flow nasal cannula [HFNC], continuous positive airway pressure [CPAP], and noninvasive positive pressure ventilation [NPPV]), surfactant, heliox, chest physiotherapy, and antiviral drugs. The interventions which showed some benefits in infants and children with AVB are adrenaline and hypertonic saline nebulization, HFNC, CPAP, NIV, and surfactant. The routine administration of antibiotics, bronchodilators, corticosteroids, steam inhalation, chest physiotherapy, heliox, and antiviral drugs are not recommended.
Vitamin D Status of Epileptic Children in India: A Prospective Cross-Sectional Study from a Tertiary Care Centre
Authors: Azad Chandrika , Guglani Vishal , Kaur Jasbinder , Aulakh Roosy , Singh Sukhvinder , Banga Sumiti 
Published: September 2020

AbstractVitamin D deficiency is prevalent all over the world, especially in tropical countries. In epileptics, antiepileptic drugs (AED) and associated comorbidities further impact vitamin D status. The aim of this study is to estimate the prevalence of 25(OH) vitamin D deficiency in epileptic children and evaluate probable risk factors. A cross-sectional study of 200 children between 1 and 18 years of age on AED was undertaken in the pediatric neurology clinic of a tertiary care center of Northern India. In all children, serum 25(OH) vitamin D levels, calcium, phosphorus, and alkaline phosphatase were estimated. The deficiency levels of vitamin D were categorized as: deficiency <20 ng/mL, insufficiency 20 to 30 ng/mL, and sufficiency >30 ng/mL. The potential risk factors for hypovitaminosis D, including type of epilepsy, AED regimen (specific medications, polytherapy vs. monotherapy), cerebral palsy, ambulatory status, intellectual disability, body mass index, gender, and vegetarianism were examined. Among the 200 enrolled children (60% boys), 106/200 (53%) were vitamin D deficient. There was no significant relation of vitamin D levels with gender, type of epilepsy, neurological deficit, and type of AED. An inverse relationship of higher phenytoin doses during monotherapy associated with lower vitamin D levels in monotherapy was found, thereby suggesting adverse effect of high doses of phenytoin on vitamin D levels. VDD is common among epileptic children on AED therapy. Vitamin D deficiency is common prevalent among epileptic children on AED therapy, and its detection and treatment correction should be an integral part of epilepsy management.
Neurological Manifestations of Novel Coronavirus Disease in a 2-Month-Old Infant: A Case Report
Authors: Kamali Aghdam Mojtaba , Bakhtiari Hassan , Diaz Diana Noemi , Eftekhari Kambiz 
Published: September 2020

AbstractThe main manifestations of novel coronavirus usually include fever and cough. Neurological manifestations have not been properly identified in children. A 65-day-old infant was hospitalized due to poor feeding, weakness, lethargy, and occasional cough. She suffered several seizures during her hospitalization. The brain computed tomography scan depicted a minor hemorrhage. Due to the exacerbation of her condition during hospital stay and the presence of respiratory symptoms in her parents, coronavirus disease was suspected. Reverse transcription–polymerase chain reaction (PCR) of coronavirus was positive for both: child and parents. In children with neurological manifestations such as lethargy, recurrent seizures, cerebral hemorrhage, and clinical evidence of respiratory symptoms in his/her relatives, PCR testing for coronavirus is recommended.
A Hospital-Based Insight into the Antinuclear Antibody Patterns in Autoimmune Disorders
Authors: Gupta Prishni , Priya Ritu , Nanda Rachita , Patel Suprava , Mohapatra Eli 
Published: September 2020

AbstractBackground The incidence of autoimmune disorders has seen a rise in India in recent times. The symptoms and signs of these conditions are caused by a systemic autoimmune response, essentially characterized by the expression of the antinuclear antibodies (ANA). Presence of ANA in serum of patient could be the prime evidence of an autoimmune disorder.Aim This study aimed to determine the antibody patterns and assess the clinical significance of ANA in patients of a teaching tertiary care hospital of central India.Material and Methods This retrospective cross-sectional data analysis study retrieved 538 reports of individuals, who were prescribed the ANA test by indirect immunofluorescence assay over a period of 11 months, from the archives of the Department of Biochemistry. For continuous data, student t-test was used while Chi-square and Fisher exact was conducted for categorical data. A p value less than 0.05 were taken as significant.Results Out of the 538 patients investigated for ANA testing by indirect immunofluorescence assay, 33% were positive, among which 74% were female, and majority belonged to the young adult age group. The most common pattern identified was nuclear, subpattern nuclear speckled.Conclusion A high-ANA pattern positivity could be related to a high-autoimmunity prevalence in this region, and also promotes its use as a tool of evidence of suspected autoimmune disorders.
Analysis of Patterns of Adverse Transfusion Reactions and Management: A Novel Initiative toward Hemovigilance in a Teaching Hospital of South India
Authors: Krishnamurthy Anandraj Vaithy , Mathialagan Janani , Raghavan A.T.M. Venkat , Srinivasan Sowmya 
Published: September 2020

Abstract
Objective Blood transfusion being a major lifesaving frontline procedure in majority of clinical wards, has a high potential with risk for adverse events ranging in severity, thus warranting optimal usage of blood. Continuous monitoring of adverse transfusion reaction (ATR) and analysis of the reactions can promote better comprehension of various contributing risk factors. Hemovigilance being a quality indicator with data system assists in ensuring quality and safe blood transfusion. The present study was designed to analyze the incidence and nature of adverse transfusion-associated events reported to the blood bank from our teaching hospital located in the remote part of South-East Coastal region with emphasis on corrective and preventive actions.
Materials and Methods The prospective study included all the ATR reported to our hospital blood bank over a period of 42 months. The transfusion reactions report forms filled by the clinicians were analyzed and the reactions were categorized into patterns. The associated risk factors for the reaction are evaluated with substantial laboratory and clinical parameters in reference to hemovigilance.
Results Among 19,800 transfusions, 189 transfusion reactions were encountered with a ratio of 10:0.9 with age ranging from 12 to 80, with female preponderance. Reactions associated with whole blood (WB) transfusion were common (50%, p = 0.002) followed by packed red blood cells transfusion (PRBC) (1.4%, p = 0.006) and platelets (0.8%, p = 0.1). Febrile nonhemolytic transfusion reactions were predominant patterns noted in 122 cases followed by allergic reactions in 43 cases with more commonly associated PRBC transfusion whereas hemolytic reactions showed association with WB transfusion. No delayed reactions or mortalities were encountered.
Conclusion The present study concludes with novelty showing the overall incidence of transfusion-associated reactions in the study domain is slightly higher than more advanced centers in India owing to lack of leukodepletion units which could enable to substantially retard the incidence of adverse events of transfusion as a general measure and febrile reactions in particular. Hemovigilance and pattern analysis of ATR provide scope for corrective and preventive action and give referral guidelines to prevent future recurrence.