bluuebunny/crossref_metadata_2025_split huggingface dataset:
A 180 nm Self-biased Bandgap Reference with High PSRR Enhancement
Authors: Shi Yue , Li Shilei , Cao Jianwen , Zhou Zekun , Ling Weiwei 
Published: May 2020

AbstractIn this paper, an improved self-biased bandgap reference (BGR) with high power supply rejection ratio (PSRR) is presented. An operational amplifier constructing feedback loop is multiplexed with the generation of positive temperature coefficient (TC) voltage for lower power consumption, where an offset voltage is adopted to achieve proportional to absolute temperature (PTAT) voltage. With the temperature-independent reference generation, two feedback loops are realized at the same time for PSRR enhancement, which form a local negative feedback loop (LNFL) and a global self-biased loop (GSBL). The proposed BGR is implemented in a 180 nm BCD technology, whose results show that the generated reference voltage is 2.506 V, and the TC is 25 ppm/°C in the temperature range of −55 to 125 °C. The line sensitivity (LS) is 0.08 ‰/V. Without any filter capacitor, the PSRR is 76 dB at low frequencies, over 46 dB up to 1 MHz.
The use of clinical decision rules for pulmonary embolism in the emergency department: a retrospective study
Authors: Al Dandan Omran , Hassan Ali , Alnasr Afnan , Al Gadeeb Mohammed , AbuAlola Hossain , Alshahwan Sarah , Al Shammari Malak , Alzaki Alaa 
Published: May 2020

Abstract
Background
Pulmonary embolism (PE) is a common and life-threatening medical condition with non-specific clinical presentation. Computed tomography pulmonary angiography (CT-PA) has been the diagnostic modality of choice, but its use is not without risks. Clinical decision rules have been established for the use of diagnostic modalities for patients with suspected PE. This study aims to assess the adherence of physicians to the diagnostic algorithms and rules.

Methods
A retrospective observational study examining the utilization of CT-PA in the Emergency Department of King Fahd Hospital of Imam Abdulrahman Bin Faisal University for patients with suspected PE from May 2016 to December 2019. The electronic health records were used to collect the data, including background demographic data, clinical presentation, triage vital signs, D-dimer level (if ordered), risk factors for PE, and the CT-PA findings. The Wells score and pulmonary embolism rule-out (PERC) criteria were calculated retrospectively without knowledge of the results of D-dimer and the CT-PA.

Results
The study involved a total of 353 patients (125 men and 228 women) with a mean age of 46.7 ± 18.4 years. Overall, 200 patients (56.7%) were classified into the “PE unlikely” group and 153 patients (43.3%) in the “PE likely” group as per Wells criteria. Out of all the CT-PA, 119 CT-PA (33.7%) were requested without D-dimer assay (n = 114) or with normal D-dimer level (n = 5) despite being in the “PE unlikely” group. Only 49 patients had negative PERC criteria, of which three patients had PE.

Conclusions
The study revealed that approximately one-third of all CT-PA requests were not adhering to the clinical decision rules with a significant underutilization of D-dimer assay in such patients. To reduce overutilization of imaging, planned interventions to promote the adherence to the current guidelines seem imperative.
Management of upper calyceal stone by percutaneous nephrolithotomy through lower calyx access: prone versus supine position
Authors: Soliman Tarek , Khalil Mostafa , Omar Rabea , Mohey Ahmed , Ahmed Shabieb , Sherif Hammoda , Abdelazim Mohamed 
Published: May 2020

Abstract
Background
The best way in the management of calyceal stone by percutaneous nephrolithotomy (PCNL) is to go directly into the desired calyx. However, in upper calyx, this direct entry may be associated with undesired complications, and through lower calyx is limited in prone PCNL. Recently, there is another option about reaching it through the lower calyx in supine position with more accessibility and better manipulation. This study aimed to evaluate the management of the upper calyceal stone by PCNL through lower calyx access in prone versus supine position.

Methods
A total of 38 patients with upper calyceal stone (≥ 2 cm) were randomly divided into two groups; the first group included 18 patients managed by PCNL in the prone position, and the second group included 20 patients managed in supine position. All data of both procedures were collected and statistically analyzed to compare between both groups.

Results
There is no statistically significant difference between groups as regards demographic and stone characters. The angle between the access to the lower calyx and access of the upper calyx was significantly wider in the supine group versus prone group (130.2° ± 23.46° vs. 89.67° ± 14.56°, respectively). The mean operative and fluoroscopy time was significantly longer in the prone group. There is no significant difference in intraoperative or postoperative morbidity. The stone-free rate was significantly higher in the supine group than the prone group (85% vs 38.9%, respectively). Also stone approachability was higher in the supine group than prone group (95% vs. 66.7%, respectively).

Conclusion
Management of upper calyceal stone by PCNL through the lower calyx is safe, but it is more effective in the supine position than in prone position.
MEPHAS: an interactive graphical user interface for medical and pharmaceutical statistical analysis with R and Shiny
Authors: Zhou Yi , Leung Siu-wai , Mizutani Shosuke , Takagi Tatsuya , Tian Yu-Shi 
Published: May 2020

Abstract
Background
Even though R is one of the most commonly used statistical computing environments, it lacks a graphical user interface (GUI) that appeals to students, researchers, lecturers, and practitioners in medicine and pharmacy for conducting standard data analytics. Current GUIs built on top of R, such as EZR and R-Commander, aim to facilitate R coding and visualization, but most of the functionalities are still accessed through a command-line interface (CLI). To assist practitioners of medicine and pharmacy and researchers to run most routines in fundamental statistical analysis, we developed an interactive GUI; i.e., MEPHAS, to support various web-based systems that are accessible from laptops, workstations, or tablets, under Windows, macOS (and IOS), or Linux. In addition to fundamental statistical analysis, advanced statistics such as the extended Cox regression and dimensional analyses including partial least squares regression (PLS-R) and sparse partial least squares regression (SPLS-R), are also available in MEPHAS.

Results
MEPHAS is a web-based GUI (https://alain003.phs.osaka-u.ac.jp/mephas/) that is based on a shiny framework. We also created the corresponding R package mephas (https://mephas.github.io/). Thus far, MEPHAS has supported four categories of statistics, including probability, hypothesis testing, regression models, and dimensional analyses. Instructions and help menus were accessible during the entire analytical process via the web-based GUI, particularly advanced dimensional data analysis that required much explanation. The GUI was designed to be intuitive for non-technical users to perform various statistical functions, e.g., managing data, customizing plots, setting parameters, and monitoring real-time results, without any R coding from users. All generated graphs can be saved to local machines, and tables can be downloaded as CSV files.

Conclusion
MEPHAS is a free and open-source web-interactive GUI that was designed to support statistical data analyses and prediction for medical and pharmaceutical practitioners and researchers. It enables various medical and pharmaceutical statistical analyses through interactive parameter settings and dynamic visualization of the results.
Physiological effects of the combined stresses of freezing-thawing, acid precipitation and deicing salt on alfalfa seedlings
Authors: Bao Guozhang , Tang Wenyi , An Qirui , Liu Yaoxin , Tian Jiaqi , Zhao Nan , Zhu Saning 
Published: May 2020

Abstract
Background
Frequent freeze-thaw phenomena, together with widely used deicing salt and intense acid precipitation, often occur in northeastern China, causing damage to various aspects of plants, such as the permeability of biological membranes, osmotic adjustment, and photosystems. Aiming to explore the resistance of alfalfa to freezing-thawing (F), acid precipitation (A) and deicing salt (D), this study used Medicago sativa cv. Dongmu-70 as the experimental material, and the contents of malondialdehyde (MDA), soluble protein, soluble sugars, proline and chlorophyll were evaluated.

Results
As the temperature decreased, the MDA content in the seedlings of the group under combined stress (A-D-F) increased and was significantly higher than that of group F (by 69.48 ~ 136.40%). Compared with those in the control (CK) group, osmotic substances such as soluble sugars and proline in the treatment groups were higher, while the soluble protein content was lower. The chlorophyll contents in the seedlings of the treatment groups were lower than those of the CK group; however, the chlorophyll content displayed a non-significant change during the free-thaw cycle.

Conclusion
Injury to the permeability of the biological membranes and photosystems of alfalfa results from stress. Moreover, alfalfa maintains osmotic balance by adaptively increasing the potential of osmotic substances such as soluble sugars and proline. Furthermore, the influence of stress from freezing-thawing and deicing salt is highly substantial, but the combined stresses of acid precipitation with the two factors mentioned above had little effect on the plants.
Retrospective evaluation of pain in patients with coccydynia who underwent impar ganglion block
Authors: Sagir Ozlem , Demir Hafize Fisun , Ugun Fatih , Atik Bulent 
Published: May 2020

Abstract
Background
We aimed to evaluate pain scores one year after impar ganglion block in patients with coccydynia who did not benefit from conservative treatment.

Methods
The medical records of 29 patients with coccydynia were reviewed. Patients who were referred to the algology clinic and underwent impar ganglion blocks were retrospectively evaluated. Demographic data, time to the onset of pain, causes of pain, X-ray findings, administered invasive procedures, and visual analog scale (pain) scores were recorded.

Results
A total of 29 patients were included in the study, 10 males (34%) and 19 females (66%). The average age and body mass index were 53.45 ± 9.6 and 29.55 ± 4.21 respectively. In 21 patients, the onset of pain was associated with trauma. Nineteen patients (65.5%) had anterior coccygeal angulation. The average visual analog scale score before undergoing an impar ganglion block was 7.4 ± 1. After the procedure, the scores at < 3 months, 3–6 months and 6 months-1 year follow-up intervals were significantly lower (p < 0.05). Furthermore, visual analog scale scores at the 3–6 months and 6 months-1 year periods were significantly lower in patients who received diagnostic blocks plus pulse radiofrequency thermocoagulation than in patients who underwent a diagnostic block only.

Conclusions
The impar ganglion block provides effective analgesia without complications in patients with coccydynia. Pulse radiofrequency thermocoagulation combined with a diagnostic block prolongs the analgesic effect of the procedure.
Experiences of maternity care in New South Wales among women with mental health conditions
Authors: Corscadden L. , Callander E. J. , Topp S. M. , Watson D. E. 
Published: May 2020

Abstract
Background
High quality maternity care is increasingly understood to represent a continuum of care. As well as ensuring a positive experience for mothers and families, integrated maternity care is responsive to mental health needs of mothers. The aim of this paper is to summarize differences in women’s experiences of maternity care between women with and without a self-reported mental health condition.

Methods
Secondary analyses of a randomized, stratified sample patient experience survey of 4787 women who gave birth in a New South Wales public hospital in 2017. We focused on 64 measures of experiences of antenatal care, hospital care during and following birth and follow up at home. Experiences covered eight dimensions: overall impressions, emotional support, respect for preferences, information, involvement, physical comfort and continuity. Multivariable logistic regression was used to compare experiences of women with and without a self-reported longstanding mental health condition.

Results
Compared to women without a condition, women with a longstanding mental health condition (n = 353) reported significantly less positive experiences by eight percentage points on average, with significant differences on 41 out of 64 measures after adjusting for age, education, language, parity, type of birth and region. Disparities were pronounced for key measures of emotional support (discussion of worries and fears, trust in providers), physical comfort (assistance, pain management) and overall impressions of care. Most women with mental health conditions (75% or more) reported positive experiences for measures related to guidelines for maternity care for women with mental illness (discussion of emotional health, healthy behaviours, weight gain). Their experiences were not significantly different from those of women with no reported conditions.

Conclusions
Women with a mental health condition had significantly less positive experiences of maternity care across all stages of care compared to women with no condition. However, for some measures, including those related to guidelines for maternity care for women with mental illness, there were highly positive ratings and no significant differences between groups. This suggests disparities in experiences of care for women with mental health conditions are not inevitable. More can be done to improve experiences of maternity care for women with mental health conditions.
Severity and prevalence of various types of mental ill-health in a general adult population: age and sex differences
Authors: Höglund Per , Hakelind Camilla , Nordin Steven 
Published: May 2020

Abstract
Background
Taking a broad approach, the aim of this study was to better understand severity and prevalence of various types of mental ill-health across age and sex groups in the general adult population. A first objective was to determine symptom severity of anxiety, depression, insomnia, burnout and somatization in combinations of different age groups and sex. A second objective was to determine prevalence of caseness of these types of mental ill-health in both absolute and relative terms in the combinations of age groups and sex.

Methods
Cross-sectional data based on validated questionnaire instruments were used from the Västerbotten Environmental Health Study in Sweden. In total, 3406 participants, aged 18 to 79 years, constituted a random sample stratified for age and sex.

Results
Severity and prevalence of anxiety, insomnia and burnout were high in women, in particular young women, and lower in older age groups. The prevalence rates for insomnia, burnout and somatization were particularly high based on the used cut-off scores. Men aged 30–49 years had the highest prevalence of mental ill-health compared to other age groups among men. Men and women aged 60–69 years had generally the lowest symptom severity and caseness. The prevalence of depression was similar in men and women in all age groups, whereas sex-related differences in extent in general were largest in the youngest age group, and gradually decreased with age.

Conclusion
The results suggest that focus in primary healthcare regarding mental ill-health should to be directed more towards insomnia, burnout and somatization, in particular in young women.
Chronic obstructive pulmonary disease, lung function and risk of type 2 diabetes: a systematic review and meta-analysis of cohort studies
Authors: Peng Yang , Zhong Guo-Chao , Wang Lingxiao , Guan Lijuan , Wang Ao , Hu Kai , Shen Jing 
Published: May 2020

AbstractBackgroundThe association between chronic obstructive pulmonary disease (COPD), lung function and risk of type 2 diabetes mellitus (T2DM) remains controversial. We performed a meta-analysis to clarify this issue.MethodsThe PubMed and EMBASE databases were searched. Cohort studies on COPD, lung function and risk of T2DM in adults were included. A random effects model was adopted to calculate the summary risk ratio (RR) and 95% confidence interval (CI). Dose-response analysis was conducted where possible.ResultsA total of 13 eligible cohort studies involving 307,335 incident T2DM cases and 7,683,784 individuals were included. The risk of T2DM was significantly higher in patients with COPD than those without COPD (RR = 1.25, 95% CI 1.16–1.34). Compared to the highest category of percentage forced vital capacity (FVC%), the lowest category of FVC% was associated with a higher risk of T2DM (RR = 1.43, 95% CI 1.33–1.53). Similarly, the summary RR of T2DM for the lowest versus highest category of percentage forced expiratory volume in 1 s (FEV1%) was 1.49 (95% CI 1.39–1.60). Significant linear associations of FVC% and FEV1% with risk of T2DM were found (Pnon-linearity > 0.05); the RR of T2DM was 0.88 (95% CI 0.82–0.95) and 0.87 (95% CI 0.81–0.94) per 10% increase in FVC% and FEV1%, respectively. There was a non-significant relationship between the FEV1/FVC ratio and the risk of T2DM.ConclusionsBoth COPD and impaired lung function, especially restricted ventilation dysfunction, could increase the risk of T2DM. However, these findings should be interpreted with caution due to the limited number of studies, and need to be validated by future studies.
The association between labor epidural analgesia and postpartum depression: a systematic review and meta-analysis
Authors: Almeida Marcela , Kosman Katherine A. , Kendall Mark C. , De Oliveira Gildasio S. 
Published: May 2020

Abstract
Background
Previous studies have demonstrated that appropriate treatment for postoperative pain can lead to improvement in depressive symptoms, however the association between adequate intrapartum pain control and the development of postpartum depression is not clear. The purpose of the study was to examine the effects of labor epidural analgesia and postpartum depression.

Methods
We performed a quantitative systematic review in compliance with the PRISMA statement. We conducted a search of PubMed, Embase, the Cochrane Database of Systematic Reviews and Google Scholar databases. The primary outcome was a positive screen of postpartum depression among women who received labor epidural analgesia up to 3 months into the postpartum period. Meta-analysis was performed using the random effect model.

Results
Of the 148 studies available, 9 studies with 4442 patients were included in the analysis. The use of labor analgesia on positive depression screen compared to control revealed no significant effect, OR (95% CI) of 1.02 (0.62 to 1.66, P = 0.94).

Conclusion
Based on current literature, the use of epidural analgesia for pain relief during labor doesn’t appear to affect the likelihood of postpartum depression. Future studies are warranted to further investigate these findings and identity other possible preventative interventions that reduce postpartum depression.
Should I stay or should I go? The role of leadership and organisational context for hospital physicians’ intention to leave their current job
Authors: Martinussen Pål E. , Magnussen Jon , Vrangbæk Karsten , Frich Jan C. 
Published: May 2020

Abstract
Background
Physician turnover is a concern in many health care systems globally. A better understanding of physicians’ reasons for leaving their job may inform organisational policies to retain key personnel. The aim of this study was to investigate hospital physicians’ intention to leave their current job, and to investigate if such intentions are associated with how physicians assess their leaders and the organisational context.

Methods
Data was derived from a survey of 971 physicians working in public hospitals in Norway in 2016. The data was analysed using descriptive statistics and multivariate analysis.

Results
We found that 21.0% of all hospital physicians expressed an intention to leave their current job for another job. An additional 20.3% of physicians had not made up their mind whether to stay or leave. Physicians’ perceptions of their leaders and the organisational context influence their intention to leave their hospital. Respondents who perceived their leaders as professional-supportive had a significantly lower probability of reporting an intention to leave their job. The analysis suggests that organisational context, such as department mergers, weigh in on physicians’ considerations about leaving their current job. Social climate and commitment are important reasons why physician stay.

Conclusions
A professional-supportive leadership style may have a positive influence on retention of physicians in public hospitals. Further research should investigate how retention of physicians is associated with performance related to organisational and leadership style.
High frequency of benzimidazole resistance alleles in trichostrongyloids from Austrian sheep flocks in an alpine transhumance management system
Authors: Hinney Barbara , Schoiswohl Julia , Melville Lynsey , Ameen Vahel J. , Wille-Piazzai Walpurga , Bauer Karl , Joachim Anja , Krücken Jürgen , Skuce Philip J. , Krametter-Frötscher Reinhild 
Published: May 2020

Abstract
Background
Infections of small ruminants with trichostrongyloid nematodes often result in reduced productivity and may be detrimental to the host. Anthelmintic resistance (AR) against most anthelmintic drug classes is now widespread amongst the trichostrongyloids. Baseline establishment, followed by regular monitoring of the level of AR, is necessary for farmers and veterinarians to make informed decisions about parasite management. The detection of single nucleotide polymorphisms (SNPs) is a sensitive method to detect AR against benzimidazoles (BZs), one of the most widely used anthelmintic classes. Alpine transhumance constitutes a special type of pasturing of sheep from many different farms, the aim of this study was to investigate the prevalence of benzimidazole resistance alleles in this particular management system.

Results
Sixteen sheep flocks in Styria and Salzburg in Austria were examined by pyrosequencing for SNPs at codons 167, 198 and 200 of the isotype-1 β-tubulin gene. The frequency of the resistance-associated exchange F200Y was 87–100% for H. contortus, 77–100% for T. colubriformis and <  5–66% for T. circumcincta. Additionally, the F167Y polymorphism was detected in T. colubriformis from two farms at a frequency of 19 and 23% respectively.

Conclusions
The high resistance allele frequency in H. contortus and T. colubriformis in the examined sheep population urgently calls for the development of new treatment strategies to sustainably control trichostrongyloid infections for this kind of pasturing, since the frequent mixing of flocks during the alpine summer grazing must be considered an important risk factor for the spread of resistant nematodes to a large number of farms.