bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of a hydrogel dressing as an analgesic adjunct to first aid for the treatment of acute paediatric burn injuries: a prospective randomised controlled trial
Authors: Holbert Maleea Denise , Kimble Roy M , Chatfield Mark , Griffin Bronwyn R 
Published: January 2021

ObjectiveTo compare the effectiveness of two acute burn dressings, Burnaid hydrogel dressing and plasticised polyvinylchloride film, on reducing acute pain scores in paediatric burn patients following appropriate first aid.DesignSingle-centre, superiority, two-arm, parallel-group, prospective randomised controlled trial.Participants and settingPaediatric patients (aged ≤16) presenting to the Emergency Department at the Queensland Children’s Hospital, Brisbane, Australia, with an acute thermal burn were approached for participation in the trial from September 2017–September 2018.InterventionsPatients were randomised to receive either (1) Burnaid hydrogel dressing (intervention) or (2) plasticised polyvinylchloride film (Control) as an acute burn dressing.Primary and secondary outcomesObservational pain scores from nursing staff assessed 5 min post application of the randomised dressing, measured using the Face Legs Activity Cry and Consolability Scale was the primary outcome. Repeated measures of pain, stress and re-epithelialisation were also collected at follow-up dressing changes until 95% wound re-epithelialisation occurred.ResultsSeventy-two children were recruited and randomised (n=37 intervention; n=35 control). No significant between-group differences in nursing (mean difference: −0.1, 95% CI −0.7 to 0.5, p=0.72) or caregiver (MD: 1, 95% CI −8 to 11, p=0.78) observational pain scores were identified. Moreover, no significant differences in child self-report pain (MD: 0.3, 95% CI −1.7 to 2.2, p=0.78), heart rate (MD: −3, 95% CI −11 to 5, p=0.41), temperature (MD: 0.6, 95% CI −0.13 to 0.24, p=0.53), stress (geometric mean ratio: 1.53, 95% CI 0.93 to 2.53, p=0.10), or re-epithelialisation rates (MD: −1, 95% CI −3 to 1, p=0.26) were identified between the two groups.ConclusionsA clear benefit of Burnaid hydrogel dressing as an analgesic adjunct to first aid for the treatment of acute paediatric burns was not identified in this investigation.Trial registration numberAustralian New Zealand Clinical Trials Registry (ACTRN12617001274369).
Epidemiology, clinical characteristics and treatment of critically ill patients with COVID-19): a protocol for a living systematic review
Authors: Milovanovic Lazar , Hessey Erin , Sebastianski Meghan , Keto-Lambert Diana , Vandermeer Ben , Bagshaw Sean M , Rewa Oleksa 
Published: January 2021

Introduction
In December 2019, the first cases of COVID-19 associated with SARS-CoV-2 viral infection were described in Wuhan, Hubei Province, China. Since then, it has spread rapidly affecting 188 countries and was declared a pandemic by the WHO on 11 March 2020. Preliminary reports suggest up to 30% of patients require intensive care unit (ICU) admission and case fatality rate estimate is 2.3%–7.2%. The primary reason for ICU admission is hypoxaemic respiratory failure, while factors associated with ICU admission include increased age, presence of comorbidities and cytokine storm. Case series and retrospective trials initially assessed proposed treatments with randomised controlled trials now reporting early outcomes. We conduct a systematic review and meta-analysis to identify epidemiological factors, treatments and complications that predict mortality among critically ill patients with COVID-19.

Methods and analysis
Our comprehensive search strategy was developed in consultation with a research librarian. We will search electronic databases: Ovid Medline, Ovid Embase, Ovid Cumulative Index to Nursing and Allied Health Literature (CINAHL) and Wiley Cochrane Library. The search strategy combines concepts from COVID-19, validated COVID-19 search filters and geographical locations of large outbreaks. Citation screening, selection, quality assessment and data abstraction will be performed in duplicate. Clinically homogenous epidemiological characteristics, interventions and complications will be pooled in statistical meta-analysis. Within the framework of a living systematic review, the search and data analysis will be updated every 6 months.

Ethics and dissemination
Our systematic review will synthesise literature on risk factors and interventions associated with mortality in critically ill patients with COVID-19. Results will be presented at national and international conferences and submitted for peer-reviewed publication. The pooled analysis can provide guidance to inform clinical guidelines for care of critically ill patients with COVID-19. Iterative updates will be made public through open access. Research ethics approval is not required.

PROSPERO registration number
CRD42020176672.
Assessing seropositivity for IgG antibodies against SARS-CoV-2 in Ahmedabad city of India: a cross-sectional study
Authors: Prakash Om , Solanki Bhavin , Sheth Jay K , Joshi Bhavin , Kadam Mina , Vyas Sheetal , Shukla Aparajita , Tiwari Hemant , Rathod Sanjay , Rajput Anil , Trivedi Toral , Ramanuj Vaibhav , Solanki Anand 
Published: January 2021

ObjectivesTo study the percentage seropositivity for SARS-CoV-2 to understand the pandemic status and predict the future situations in Ahmedabad.Study designCross-sectional study.SettingsField area of Ahmedabad Municipal Corporation.ParticipantsMore than 30 000 individuals irrespective of their age, sex, acute/past COVID-19 infection participated in the serosurvey which covered all the 75 Urban Primary Health Centres (UPHCs) across 48 wards and 7 zones of the city. Study also involved healthcare workers (HCWs) from COVID-19/non-COVID-19 hospitals.InterventionsSeropositivity of IgG antibodies against SARS-CoV-2 was measured as a mark of COVID-19 infection.Primary and secondary outcomesSeropositivity was used to calculate cumulative incidence. Correlation of seropositivity with available demographic detail was used for valid and precise assessment of the pandemic situation.ResultsFrom 30 054 samples, the results were available for 29 891 samples and the crude seropositivity is 17.61%. For all the various age groups, the seropositivity calculated between 15% and 20%. The difference in seropositivity for both the sex group is statistically not significant. The seropositivity is significantly lower (13.64%) for HCWs as compared with non-HCWs (18.71%). Seropositivity shows increasing trend with time. Zone with maximum initial cases has high positivity as compared with other zones. UPHCs with recent rise in cases are leading in seropositivity as compared with earlier and widely affected UPHCs.ConclusionsThe results of serosurveillance suggest that the population of Ahmedabad is still largely susceptible. People still need to follow preventive measures to protect themselves till an effective vaccine is available to the people at large. The data indicate the possibility of vanishing immunity over time and need further research to cross verify with scientific evidences.
Choice architecture in physician–patient communication: a mixed-methods assessments of physicians’ competency
Authors: Hart Joanna , Yadav Kuldeep , Szymanski Stephanie , Summer Amy , Tannenbaum Aaron , Zlatev Julian , Daniels David , Halpern Scott D 
Published: January 2021

BackgroundClinicians’ use of choice architecture, or how they present options, systematically influences the choices made by patients and their surrogate decision makers. However, clinicians may incompletely understand this influence.ObjectiveTo assess physicians’ abilities to predict how common choice frames influence people’s choices.MethodsWe conducted a prospective mixed-methods study using a scenario-based competency questionnaire and semistructured interviews. Participants were senior resident physicians from a large health system. Of 160 eligible participants, 93 (58.1%) completed the scenario-based questionnaire and 15 completed the semistructured interview. The primary outcome was choice architecture competency, defined as the number of correct answers on the eight-item scenario-based choice architecture competency questionnaire. We generated the scenarios based on existing decision science literature and validated them using an online sample of lay participants. We then assessed senior resident physicians’ choice architecture competency using the questionnaire. We interviewed a subset of participating physicians to explore how they approached the scenario-based questions and their views on choice architecture in clinical medicine and medical education.ResultsPhysicians’ mean correct score was 4.85 (95% CI 4.59 to 5.11) out of 8 scenario-based questions. Regression models identified no associations between choice architecture competency and measured physician characteristics. Physicians found choice architecture highly relevant to clinical practice. They viewed the intentional use of choice architecture as acceptable and ethical, but felt they lacked sufficient training in the principles to do so.ConclusionClinicians assume the role of choice architect whether they realise it or not. Our results suggest that the majority of physicians have inadequate choice architecture competency. The uninformed use of choice architecture by clinicians may influence patients and family members in ways clinicians may not anticipate nor intend.
Ten-week Intensive Group Program (IGP) for borderline personality disorder: making the case for more accessible and affordable psychotherapy
Authors: Gec Dervila , Broadbear Jillian Helen , Bourton David , Rao Sathya 
Published: January 2021

BackgroundThe availability of specialist psychotherapies for treating borderline personality disorder (BPD) is limited by costs associated with training, resourcing and treatment duration. Developing a programme that incorporates effective strategies from a range of evidence-based specialist treatments, concentrates their delivery and uses a group-based format will improve treatment access.ObjectiveTo assess the short-term clinical efficacy, acceptability and feasibility of a bespoke manualised programme for the treatment of BPD. This 10-week group-based outpatient programme was delivered 2 days per week in 4 hour sessions; participants received 80 hours of treatment in total.MethodsForty-three participants, many having severe BPD symptomatology, were assessed before and after the 10-week programme using a range of validated self-report questionnaires and a self-appraisal feedback form. The primary outcome measured was BPD symptom severity.FindingsStatistically significant improvements were measured in BPD symptom severity, depression, trait anxiety, emotional regulation, general health, hopefulness, self-compassion and anger, several with moderate to large effect sizes. Many of these improvements remained at 4–6 months post treatment. More than 90% of surveyed participants expressed a moderate or high level of satisfaction with the programme.ConclusionsThis integrated treatment programme delivered in a highly concentrated format demonstrated short-term efficacy across many BPD-relevant endpoints; its acceptability was endorsed by most clients.Clinical implicationsIncorporation of key aspects of evidence-based treatment using a time-intensive group format could greatly enhance the capacity of mental health services to meet the needs of people who experience BPD within a population-based mental health service framework.
Salting the Soil: Targeting the Microenvironment of Brain Metastases
Authors: Srinivasan Ethan S. , Tan Aaron C. , Anders Carey K. , Pendergast Ann Marie , Sipkins Dorothy A. , Ashley David M. , Fecci Peter E. , Khasraw Mustafa 
Published: January 2021

AbstractPaget's “seed and soil” hypothesis of metastatic spread has acted as a foundation of the field for over a century, with continued evolution as mechanisms of the process have been elucidated. The central nervous system (CNS) presents a unique soil through this lens, relatively isolated from peripheral circulation and immune surveillance with distinct cellular and structural composition. Research in primary and metastatic brain tumors has demonstrated that this tumor microenvironment (TME) plays an essential role in the growth of CNS tumors. In each case, the cancerous cells develop complex and bidirectional relationships that reorganize the local TME and reprogram the CNS cells, including endothelial cells, pericytes, astrocytes, microglia, infiltrating monocytes, and lymphocytes. These interactions create a structurally and immunologically permissive TME with malignant processes promoting positive feedback loops and systemic consequences. Strategies to interrupt interactions with the native CNS components, on “salting the soil,” to create an inhospitable environment are promising in the preclinical setting. This review aims to examine the general and specific pathways thus far investigated in brain metastases and related work in glioma to identify targetable mechanisms that may have general application across the spectrum of intracranial tumors.
Determinants of Morbidity and Mortality Associated With Isolated Tricuspid Valve Surgery
Authors: Kawsara Akram , Alqahtani Fahad , Nkomo Vuyisile T. , Eleid Mackram F. , Pislaru Sorin V. , Rihal Charanjit S. , Nishimura Rick A. , Schaff Hartzell V. , Crestanello Juan A. , Alkhouli Mohamad 
Published: January 2021

Background
Whether the poor outcomes of isolated tricuspid valve surgery are related to the operation itself or to certain patient characteristics including late referral is unknown.

Methods and Results

Adult patients who underwent isolated tricuspid valve surgery were identified in the Nationwide Readmissions Database (2016–2017). Patients who had redo tricuspid valve surgery, endocarditis, or congenital heart disease were excluded. Multivariable logistic regression was performed to identify contributors to postoperative mortality. A total of 1513 patients were included (mean age 55.7±16.6 years, 49.6% women). Surrogates of late referral were frequent: 41% of patients were admitted with decompensated heart failure, 44.3% had a nonelective surgery status, 16.8% had advanced liver disease, and 31% had an unplanned hospitalization in the prior 90 days. The operation was performed on day 0 to 1 of the hospitalization in only 50% of patients, and beyond day 10 in 22% of patients. In‐hospital mortality occurred in 8.7% of patients. Median length of stay was 14 days (7–35 days), and median cost was $87 223 ($43 122–$200 872). In multivariable logistic regression analysis, surrogates for late referrals (acute heart failure decompensation, nonelective surgery status, or advanced liver disease) were the strongest predictors of in‐hospital mortality (odds ratio [OR], 4.75; 95% CI, 2.74–8.25 [
P
<0.001]). This was also consistent in a second model incorporating unplanned hospitalizations in the 90 days before surgery as a surrogate for late referral (OR, 5.50; 95% CI, 2.28–10.71 [
P
<0.001]).

Conclusions
The poor outcomes of isolated tricuspid valve surgery may be largely explained by the late referral for intervention. Studies are needed to determine the role of early intervention for severe isolated tricuspid regurgitation.
Losing Track of Time
Authors: Greenberg Jonathan 
Published: January 2021

Abstract
Ottessa Moshfegh's My Year of Rest and Relaxation tells a story of doing nothing; it is an antinovel whose heroine attempts to sleep for a year in order to lose track of time. This desire to lose track of time constitutes a refusal of plot, a satiric and passive-aggressive rejection of the kinds of narrative sequences that novels typically employ but that, Moshfegh implies, offer nothing but accommodation to an unhealthy late capitalist society. Yet the effort to stifle plot is revealed, paradoxically, as an ambition to be achieved through plot, and so in resisting what novels do, My Year of Rest and Relaxation ends up showing us what novels do. Being an antinovel turns out to be just another way of being a novel; in seeking to lose track of time, the novel attunes us to our being in time.
Campaigning for the Prize: The Quests by Sweden and the Kingdom of the Netherlands for Security Council Membership, 2017–2018
Authors: Ekengren Ann-Marie , Möller Ulrika 
Published: January 2021

Summary
Competition for a non-permanent seat in the UN Security Council is getting tougher, not the least between candidates within the Western European and Others Group. This empirical study compares the campaigns carried out by Sweden and the Kingdom of the Netherlands, in order to explain the Swedish victory in the first round of the elections in 2016. A theoretical framework identifies three logics of campaigning: contributions, commitment and competence. The study maps out the features of the campaigns, including organisation, key participants, activities and message. It includes interviews with diplomats and public officials involved in the campaigns, as well as available campaign documentation and concluding reports. A main difference detected between the candidatures is the more active political involvement in the Swedish campaign, which shows the Swedish commitment and competence to serve on the Council. Further use of this theoretical framework on additional cases of international campaigning is encouraged.
Barotropic and Baroclinic Inverse Kinetic Energy Cascade in the Antarctic Circumpolar Current
Authors: Li Hongjie , Xu Yongsheng 
Published: January 2021

AbstractStratified geostrophic turbulence theory predicts an inverse energy cascade for the barotropic (BT) mode. Satellite altimetry has revealed a net inverse cascade in the baroclinic (BC) mode. Here the spatial variabilities of BT and BC kinetic energy fluxes in the Antarctic Circumpolar Current (ACC) were investigated using ECCO2 data, which synthesize satellite data and in situ measurements with an eddy-permitting general circulation model containing realistic bathymetry and wind forcing. The BT and BC inverse kinetic energy cascades both reveal complex spatial variations that could not be explained fully by classical arguments. For example, the BC injection scales match better with most unstable scales than with the first-mode deformation scales, but the opposite is true for the BT mode. In addition, the BT and BC arrest scales do not follow the Rhines scale well in terms of spatial variation, but show better consistency with their own energy-containing scales. The reverse cascade of the BT and BC modes was found related to their EKE, and better correlation was found between the BT inverse cascade and barotropization. Speculations of the findings were proposed; however, further observations and modeling experiments are needed to test these interpretations. Spectral flux anisotropy exhibits a feature associated with oceanic jets that is consistent with classical expectations. Specifically, the spectral flux along the along-stream direction remains negative at scales up to that of the studied domain (~2000 km), while that in the perpendicular direction becomes positive close to the scale of the width of a typical jet.
Cylinder Pressure Prediction of An HCCI Engine Using Deep Learning
Authors: Yaşar Halit , Çağıl Gültekin , Torkul Orhan , Şişci Merve 
Published: January 2021

AbstractEngine tests are both costly and time consuming in developing a new internal combustion engine. Therefore, it is of great importance to predict engine characteristics with high accuracy using artificial intelligence. Thus, it is possible to reduce engine testing costs and speed up the engine development process. Deep Learning is an effective artificial intelligence method that shows high performance in many research areas through its ability to learn high-level hidden features in data samples. The present paper describes a method to predict the cylinder pressure of a Homogeneous Charge Compression Ignition (HCCI) engine for various excess air coefficients by using Deep Neural Network, which is one of the Deep Learning methods and is based on the Artificial Neural Network (ANN). The Deep Learning results were compared with the ANN and experimental results. The results show that the difference between experimental and the Deep Neural Network (DNN) results were less than 1%. The best results were obtained by Deep Learning method. The cylinder pressure was predicted with a maximum accuracy of 97.83% of the experimental value by using ANN. On the other hand, the accuracy value was increased up to 99.84% using DNN. These results show that the DNN method can be used effectively to predict cylinder pressures of internal combustion engines.
Arthrofibrosis after total knee arthroplasty: patients with keloids at risk
Authors: Flick Travis R. , Wang Cindy X. , Patel Akshar H. , Hodo Thomas W. , Sherman William F. , Sanchez Fernando L. 
Published: January 2021

Abstract
Background
Arthrofibrosis remains one of the leading causes for revision in primary total knee arthroplasty (TKA). Similar in nature to arthrofibrosis, hypertrophic scars and keloid formation are a result of excessive collagen formation. There is paucity in the literature on whether there is an association between keloid formation and the development of arthrofibrosis following TKA. Therefore, the purpose of this study was to utilize a large nationwide database to identify and compare the rates of postoperative complications related to arthrofibrosis after primary TKA in patients with history of hypertrophic scar and keloid disorders versus those without.

Methods
Patient records from 2010 to the second quarter of 2016 were queried from an administrative claims database, comparing rates of arthrofibrosis, manipulation under anesthesia (MUA), lysis of adhesions (LOA), and revision TKA in patients with chart diagnosis of keloids versus those without in patients who underwent primary TKA. Data analysis was performed using R statistical software (R Project for Statistical Computing, Vienna, Austria) utilizing multivariate logistic regression, chi square analysis, or Welch’s t- test where appropriate with p values < 0.05 being considered statistically significant.

Results
Of 545,875 primary TKAs, 11,461 (2.1%) had a keloid diagnosis at any time point in their record, while 534,414 (97.9%) had not. Patients in the keloid cohort had a significantly higher association with ankylosis within 30 days (OR, 1.7), 90 days (OR, 1.2), 6 months (OR, 1.2), and 1 year (OR, 1.3) following primary TKA. The keloid cohort also had a significantly greater risk of MUA (90-day OR, 1.1; 6-month OR, 1.1; 1-year OR, 1.2) and LOA (90-day OR, 2.2; 6-month OR, 2.0; 1-year OR, 1.9).

Conclusion
Patients with keloids have increased odds risk of arthrofibrosis following primary TKA. These patients are subsequently at a higher odds risk of undergoing the procedures necessary to treat arthrofibrosis, such as MUA and LOA. Future studies investigating confounding factors such as race, prior surgery, range of motion, and postoperative recovery are needed to confirm the association of keloid diagnosis and arthrofibrosis following primary TKA demonstrated in this study.

Level of Evidence
Level III retrospective comparative study.