bluuebunny/crossref_metadata_2025_split huggingface dataset:
Undertriage in trauma: an ignored quality indicator?
Authors: Jeppesen Elisabeth , Cuevas-Østrem Mathias , Gram-Knutsen Cathrine , Uleberg Oddvar 
Published: May 2020

AbstractBackgroundEarly identification of life-threatening injuries is essential to reduce morbidity and mortality in trauma patients. Failure to detect severe injury may cause delayed diagnosis and therapeutic interventions and is associated with increased morbidity. A national trauma system will contribute to ensure the optimal care for seriously injured patients throughout the treatment chain by, among other things, defining a sensitive triage tool for identifying severe injury and contribute to correct treatment destination. In 2017, a National trauma plan was implemented in Norway and several quality indicators were recommended to ensure an evaluation of potential gaps between achieved and desired quality, and thereby highlighting areas with potential for quality improvement. With this commentary, we want to draw attention to, what we believe is, an ignoring of an important quality indicator: undertriage in trauma.Main bodySeverely injured patients not met by a trauma team is commonly referred to as undertriage. An undertriage rate below 5 % is an internationally recognized quality indicator in trauma care and is emphasized in the Norwegian national trauma plan. However, whether hospitals measure and report data about undertriage, have received little attention. Therefore, a national survey was performed among Norwegian hospitals, where thirty-seven of forty trauma receiving hospitals contributed. The results of the survey showed that only half of Norwegian trauma hospitals were capable of providing these data. The results of this survey show that currently the national trauma system is not equipped to obtain important data on an important and specific quality indicator. An ongoing discussion at a national level is how to define severe injury, which may alter future definitions on undertriage.ConclusionsKnowledge of undertriage in trauma is important to enhance patient safety, increase the precision of the triage tool and provide valuable learning information to individual hospitals and prehospital services. Currently only half of Norwegian hospitals who receive trauma patients report undertriage rates and unfortunately, only few hospital administrators request these data.
Acute respiratory failure in COVID-19: is it “typical” ARDS?
Authors: Li Xu , Ma Xiaochun 
Published: May 2020

AbstractIn December 2019, an outbreak of coronavirus disease 2019 (COVID-19) was identified in Wuhan, China. The World Health Organization (WHO) declared this outbreak a significant threat to international health. COVID-19 is highly infectious and can lead to fatal comorbidities especially acute respiratory distress syndrome (ARDS). Thus, fully understanding the characteristics of COVID-19-related ARDS is conducive to early identification and precise treatment. We aimed to describe the characteristics of COVID-19-related ARDS and to elucidate the differences from ARDS caused by other factors. COVID-19 mainly affected the respiratory system with minor damage to other organs. Injury to the alveolar epithelial cells was the main cause of COVID-19-related ARDS, and endothelial cells were less damaged with therefore less exudation. The clinical manifestations were relatively mild in some COVID-19 patients, which was inconsistent with the severity of laboratory and imaging findings. The onset time of COVID-19-related ARDS was 8–12 days, which was inconsistent with ARDS Berlin criteria, which defined a 1-week onset limit. Some of these patients might have a relatively normal lung compliance. The severity was redefined into three stages according to its specificity: mild, mild-moderate, and moderate-severe. HFNO can be safe in COVID-19-related ARDS patients, even in some moderate-severe patients. The more likely cause of death is severe respiratory failure. Thus, the timing of invasive mechanical ventilation is very important. The effects of corticosteroids in COVID-19-related ARDS patients were uncertain. We hope to help improve the prognosis of severe cases and reduce the mortality.
Revisited: Therapeutic and toxic blood concentrations of more than 1100 drugs and other xenobiotics
Authors: Schulz Martin , Schmoldt Achim , Andresen-Streichert Hilke , Iwersen-Bergmann Stefanie 
Published: May 2020

AbstractIn order to assess the significance of drug/substance levels measured in intensive care medicine and clinical and forensic toxicology as well as for therapeutic drug monitoring, it is essential that a comprehensive collection of data is readily available. We revisited and expanded our 2012 compilation of therapeutic and toxic plasma concentration ranges as well as half-lives of now more than 1100 drugs and other xenobiotics.Data have been abstracted from original papers, text books, and previous compilations and have been completed with data collected in our own forensic and clinical toxicology laboratories. We compiled the data presented in the table and the corresponding annotations over the past 30+ years. A previous compilation was completely double-checked, revised, and updated, if necessary. In addition, more than 200 substances, especially drugs who have been introduced since 2012 to the market as well as illegal drugs and other xenobiotics which became known to cause intoxications were added. We carefully referenced all data. Moreover, the annotations providing details were updated and revised, when necessary.For more than 1100 drugs and other xenobiotics, therapeutic (“normal”) and, if data was available, toxic, and comatose-fatal plasma/blood concentrations as well as elimination half-lives were compiled in a table.In case of intoxications, the blood concentration of the substance and/or metabolite better predicts the clinical severity of the case when compared to the assumed amount and time of ingestion. Comparing and contrasting the clinical case against the data provided, including the half-life, may support the decision for or against further intensive care. In addition, the data provided are useful for the therapeutic monitoring of pharmacotherapies, to facilitate the diagnostic assessment and monitoring of acute and chronic intoxications as well as to support forensic and clinical expert opinions.
Efficacy of ultrasound-guided technique for radial artery catheterization in pediatric populations: a systematic review and meta-analysis of randomized controlled trials
Authors: Zhang Wen , Li Kunpeng , Xu Hui , Luo Dawei , Ji Changbin , Yang Keshi , Zhao Qinghua 
Published: May 2020

Abstract
Background
The use of an ultrasound-guided technique for radial arterial catheterization has not been well established in pediatric patients. We conducted a systematic review and meta-analysis to evaluate the efficacy of the ultrasound-guided technique for radial artery catheterization in pediatric populations.

Method
A systematic review of PubMed, Medline, Embase, and the Cochrane library was performed from their date of inception to December 2019. In this meta-analysis, we conducted online searches using the search terms “ultrasonography,” “ultrasonics,” “ultrasound-guided,” “ultrasound,” “radial artery,” “radial arterial,” “catheter,” “cannula,” and “catheterization.” The rate of the first-attempt and total success, mean attempts to success, mean time to success, and incidence of complications (hematomas) were extracted. Data analysis was performed with RevMan 5.3.5.

Results
From 7 relevant studies, 558 radial artery catheterizations were enrolled, including 274 ultrasound-guided and 284 palpation catheterizations. The ultrasound-guided technique could significantly improve the rate of first-attempt and total success (RR 1.78, 95% CI 1.46 to 2.18, P < 0.00001; RR 1.33; 95% CI 1.20 to 1.48; P < 0.00001). However, there was significant heterogeneity for the total success rate among the included studies (I2 = 67%). The ultrasound-guided radial artery catheterization was also associated with less mean attempts and mean time to success (WMD − 1.13, 95% CI − 1.58 to − 0.69; WMD − 72.97 s, 95% CI − 134.41 to − 11.52) and lower incidence of the hematomas (RR 0.17, 95% CI 0.07 to 0.41).

Conclusions
The use of the ultrasound-guided technique could improve the success rate of radial arterial catheterization and reduce the incidence of hematomas in pediatric patients. However, the results should be interpreted cautiously due to the heterogeneity among the studies.
Serum calprotectin: a promising biomarker in rheumatoid arthritis and axial spondyloarthritis
Authors:   on behalf of the physicians of the Swiss Clinical Quality Management (SCQM) registry, Jarlborg Matthias , Courvoisier Delphine S. , Lamacchia Céline , Martinez Prat Laura , Mahler Michael , Bentow Chelsea , Finckh Axel , Gabay Cem , Nissen Michael J. 
Published: May 2020

Abstract
Background
Calprotectin (S100A8/S100A9 protein) is known as a damage-associated molecular pattern (DAMP) protein and reflects mainly neutrophil activation. Serum calprotectin levels might be a good alternative to acute-phase protein as a biomarker in inflammatory rheumatic diseases. The aim of this study is to investigate the association of serum calprotectin with disease activity and severity in rheumatoid arthritis (RA), axial spondyloarthritis (axSpA), and psoriatic arthritis (PsA).

Methods
Serum calprotectin was measured in patients with RA, axSpA, and PsA from the prospective Swiss Clinical Quality Management (SCQM) registry. Asymptomatic first-degree relatives of RA patients were used as healthy controls (HC). Outcomes included swollen joint count (SJC), Disease Activity Score (DAS), Health Assessment questionnaire (HAQ), joint radiographs, and ultrasound power Doppler (USPD) score for RA; Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS) and coxitis for axSpA; and SJC and Disease Activity Index for PSoriatic Arthritis (DAPSA) for PsA. Comparison of outcomes by calprotectin quartile levels was performed using Kruskal-Wallis tests for continuous outcomes or trend tests for categorical outcomes.

Results
A total of 1729 subjects [RA = 969, axSpA = 451, PsA = 237, and HC = 72] were included. Median levels of serum calprotectin were higher in each disease group compared to HC (p < 0.01). In RA patients, all clinical outcomes were statistically different between quartiles of serum calprotectin, indicating an association between calprotectin levels and higher disease activity (SJC, DAS, and USPD scores) and severity (joint radiographs and HAQ). In axSpA, an association between calprotectin levels and ASDAS score (p < 0.01) and prevalence of coxitis (p = 0.02) was observed. For PsA patients, SJC and DAPSA did not differ across calprotectin quartiles.

Conclusions
This large study supports the association of serum calprotectin levels with disease activity in both RA and axSpA, but not in PsA.
Low levels of serum urate are associated with a higher prevalence of depression in older adults: a nationwide cross-sectional study in Korea
Authors: Kim Woo-Joong , Kim Hye Ri , Song Jung Soo , Choi Sang Tae 
Published: May 2020

Abstract
Background
Soluble urate has been shown to serve as an antioxidant, especially in the central nervous system. Although there are intriguing data suggesting that low levels of serum urate are associated with worse outcomes in neurodegenerative diseases, its impact on mental health has not been adequately assessed. Thus, we aimed to investigate the association between serum urate and depression using a large, nationally representative sample.

Methods
Information on participants’ socio-demographic characteristics as well as physical and mental health conditions were retrieved from the Korea National Health and Nutrition Examination Survey (KNHANES) 2016 dataset. The Patient Health Questionnaire (PHQ)-9 was applied to identify depressive symptoms. Analyses were stratified by age: young adults (aged 19–39 years), middle-aged adults (aged 40–59 years), and older adults (aged 60 years and older).

Results
A total of 5332 participants were included. Serum urate concentrations were divided into sex-specific quartiles based on their distribution: ≤ 4.9 (Q1), 5.0–5.7 (Q2), 5.8–6.6 (Q3), and ≥ 6.7 (Q4) mg/dL in men and ≤ 3.7 (Q1), 3.8–4.3 (Q2), 4.4–4.9 (Q3), and ≥ 5.0 (Q4) mg/dL in women. There was a significant negative linear relationship between serum urate quartiles and PHQ-9 scores in older adults (p for trend = 0.020 in men and p for trend = 0.048 in women). Compared to high levels (Q3 and Q4) of serum urate, low levels (Q1 and Q2) were significantly associated with the overall burden of depression in older women (OR 1.78, 95% CI 1.21, 2.61) and clinically relevant depression in older men (OR 3.35, 95% CI 1.16, 9.70), even after adjustment.

Conclusions
Based on the KNHANES data, low levels of serum urate are associated with a higher prevalence of depression in older adults. This may have clinical implications for mental health.
One-repetition submaximal protocol to measure knee extensor muscle strength among older adults with and without sarcopenia: a validation study
Authors: Abdalla Pedro Pugliesi , Carvalho Anderson dos Santos , dos Santos André Pereira , Venturini Ana Claudia Rossini , Alves Thiago Cândido , Mota Jorge , Machado Dalmo Roberto Lopes 
Published: May 2020

Abstract
Background
Dynamic knee extensor muscle strength is a valid measure among healthy older adults but has not been tested in the sarcopenia condition. This study’s objective was to test the validity of a one-repetition submaximal strength protocol to measure dynamic knee extension strength in older adults with and without sarcopenia.

Methods
Ninety-four physically independent older adults (female: n = 64, 60 to 85 years; male: n = 29, 60 to 85 years) participated in this study in Brazil during 2016–2017. Sarcopenia was classified and isokinetic unilateral knee extension strength was measured at 60°/s. Bilateral dynamic knee extension strength was estimated with an extensor chair using one-repetition submaximal protocol. Validity was determined using Spearman’s correlation with isokinetic muscle strength.

Results
The frequency of sarcopenia was 11.7%. Sarcopenic individuals presented lower body mass, body mass index and skeletal muscle index. Only chronological age was higher among the sarcopenic individuals. A high correlation was found between isokinetic unilateral knee extension strength and bilateral estimated one-repetition with submaximal protocol (r = 0.74; p <  0.001), when the presence (r = 0.71; p = 0.014) and absence of sarcopenia (r = 0.74; p <  0.001) were considered. The validity of the one-repetition submaximal protocol for bilateral knee extension was confirmed.

Conclusions
The estimated measure of bilateral knee extension muscle strength can be used to monitor adaptations promoted by physical exercise for older adults with and without sarcopenia. The validation enable studies that will propose cutoff points to identify sarcopenia with this submaximal protocol. This will enable early diagnosis and better management of sarcopenia, a disease with adverse impacts for older adults.
Media views of the Stromboli 2002–2003 eruption and evacuation: a content analysis to understand framing of risk communication during a volcanic crisis
Authors: Calabrò Laura , Harris Andrew J. L. , Thouret Jean-Claude 
Published: May 2020

AbstractThe 2002–2003 eruption of Stromboli (Aeolian Islands, Italy) was one of Stromboli’s most important effusive events of the last two centuries and began on 28 December 2002. On 30 December 2002, two days after the beginning of the eruption, a landslide entered the sea and caused a tsunami that struck Stromboli’s coastal areas. The events of 30 December led to a “voluntary evacuation” by Stromboli’s inhabitants. To understand the role of the media in framing risk and the evacuation,we analyzed the content of five newspapers, including two national newspapers (Il Corriere della Sera and La Repubblica) and three regional newspapers (La Gazzetta del Sud, La Sicilia and Il Giornale di Sicilia), published during the period covering the onset of the eruption, the tsunami and the voluntary evacuation (28 December 2002–18 January 2003). Our aim was to assess the type of hazard information given, how it was delivered, and how this may have helped (or not) with the population’s resilience, especially in regard to viewing a potential need to evacuate in a favorable light. News regarding the eruption covered a total area of 12,000 cm2for the national newspapers (~ 6000 cm2/paper) against 41,700 cm2for the regionals (14,000 cm2/paper); making the regional newspapers the more important sources by quantity. For both newspaper categories, most of this area was occupied by interviews with experts, followed by quotes from residents and tourists, and, finally, those involved in the response (i.e., hazard managers, including civil protection and local government). Out of a total of 9286 words analyzed, the most popular was “tsunami” (426 cases), with the word “volcano” being repeated 315 times (the 6th most popular word); so it would have been difficult for the population not to have known there was a potential risk of tsunami associated with the volcano. In texturally framing the eruptive crisis, negative words, such as “fear”, “terror” and “apocalypse”, were much more frequent than positive words, which were rare and even not present in some newspapers. The reporting focused on the tsunami threat with little link back to the eruption and other hazards, and contrasted with imagery (that took up 41% of the reporting space) which comprised relaxing pictures of a tranquil island surrounded by a calm blue sea. This, coupled with a confused message through selection of quoted expert sources, may have led to an exaggerated and alarmist frame for the eruption and attendant hazards. This was in spite of widespread use of scientific sources, as well as pleas from the population itself, to the journalists and published in the newspapers themselves, to tone the reporting down. The newspaper agenda was, thus, plainly not compatible with effective communication in support of disaster management.
Land cover classification combining Sentinel-1 and Landsat 8 imagery driven by Markov random field with amendment reliability factors
Authors: Shi Xiaofei , Deng Zhiyu , Ding Xing , Li Li 
Published: May 2020

AbstractReliability factors in Markov random field (MRF) could be used to improve classification performance for synthetic aperture radar (SAR) and optical images; however, insufficient utilization of reliability factors based on characteristics of different sources leaves more room for classification improvement. To solve this problem, a Markov random field (MRF) with amendment reliability factors classification algorithm (MRF-ARF) is proposed. The ARF is constructed based on the coarse label field of urban region, and different controlling factors are utilized for different sensor data. Then, ARF is involved into the data energy of MRF, to classify the sand, vegetation, farmland, and urban regions, with the gray level co-occurrence matrix textures of Sentinel-1 imagery and the spectral values of the Landsat 8 imagery. In the experiments, Sentinel-1 and Landsat-8 images are used with overall accuracy and Kappa coefficient to evaluate the proposed algorithm with other algorithms. Results show that the overall accuracy of the proposed algorithm has the superiority of about 20% in overall precision and at least 0.2 in Kappa coefficient than the comparison algorithms. Thus, the problem of insufficient utilization of different sensors data could be solved.
Robust non-negative least mean square algorithm based on step-size scaler against impulsive noise
Authors: Fan Kuangang , Qiu Haiyun , Pei Chunyang , Chen Yuhang 
Published: May 2020

AbstractConventional non-negative algorithms restrict the weight coefficient vector under non-negativity constraints to satisfy several inherent characteristics of a specific system. However, the presence of impulsive noise causes conventional non-negative algorithms to exhibit inferior performance. Under this background, a robust non-negative least mean square (R-NNLMS) algorithm based on a step-size scaler is proposed. The proposed algorithm uses a step-size scaler to avoid the influence of impulsive noise. For various outliers, the step-size scaler can adjust the step size of the algorithm, thereby eliminating the large error caused by impulsive noise. Furthermore, to improve the performance of the proposed algorithm in sparse system identification, the inversely-proportional R-NNLMS (IP-RNNLMS) algorithm is proposed. The simulation result demonstrates that the R-NNLMS algorithm can eliminate the influence of impulsive noise while showing fast convergence rate and low steady-state error under other noises. In addition, the IP-RNNLMS algorithm has faster convergence rate compared with the R-NNLMS algorithm under sparse system.
Bacteremia in critical care units at Bugando Medical Centre, Mwanza, Tanzania: the role of colonization and contaminated cots and mothers’ hands in cross-transmission of multidrug resistant Gram-negative bacteria
Authors: Silago Vitus , Kovacs Dory , Msanga Delfina R. , Seni Jeremiah , Matthews Louise , Oravcová Katarina , Zadoks Ruth N. , Lupindu Athumani M. , Hoza Abubakar S. , Mshana Stephen E. 
Published: May 2020

Abstract
Background
Multidrug resistance (MDR) is a major clinical problem in tertiary hospitals in Tanzania and jeopardizes the life of neonates in critical care units (CCUs). To better understand methods for prevention of MDR infections, this study aimed to determine, among other factors, the role of MDR-Gram-negative bacteria (GNB) contaminating neonatal cots and hands of mothers as possible role in transmission of bacteremia at Bugando Medical Centre (BMC), Mwanza, Tanzania.

Methods
This cross-sectional, hospital-based study was conducted among neonates and their mothers in a neonatal intensive care unit and a neonatology unit at BMC from December 2018 to April 2019. Blood specimens (n = 200) were sub-cultured on 5% sheep blood agar (SBA) and MacConkey agar (MCA) plates. Other specimens (200 neonatal rectal swabs, 200 maternal hand swabs and 200 neonatal cot swabs) were directly inoculated on MCA plates supplemented with 2 μg/ml cefotaxime (MCA-C) for screening of GNB resistant to third generation cephalosporins, r-3GCs. Conventional biochemical tests, Kirby-Bauer technique and resistance to cefoxitin 30 μg were used for identification of bacteria, antibiotic susceptibility testing and detection of MDR-GNB and screening of potential Amp-C beta lactamase producing GNB, respectively.

Results
The prevalence of culture confirmed bacteremia was 34.5% of which 85.5% were GNB. Fifty-five (93.2%) of GNB isolated from neonatal blood specimens were r-3GCs. On the other hand; 43% of neonates were colonized with GNB r-3GCs, 32% of cots were contaminated with GNB r-3GCs and 18.5% of hands of neonates’ mothers were contaminated with GNB r-3GCs. The prevalences of MDR-GNB isolated from blood culture and GNB r-3GCs isolated from neonatal colonization, cots and mothers’ hands were 96.6, 100, 100 and 94.6%, respectively. Significantly, cyanosis (OR[95%CI]: 3.13[1.51–6.51], p = 0.002), jaundice (OR[95%CI]: 2.10[1.07–4.14], p = 0.031), number of invasive devices (OR[95%CI]: 2.52[1.08–5.85], p = 0.031) and contaminated cot (OR[95%CI]: 2.39[1.26–4.55], p = 0.008) were associated with bacteremia due to GNB. Use of tap water only (OR[95%CI]: 2.12[0.88–5.09], p = 0.040) was protective for bacteremia due to GNB.

Conclusion
High prevalence of MDR-GNB bacteremia and intestinal colonization, and MDR-GNB contaminating cots and mothers’ hands was observed. Improved cots decontamination strategies is crucial to limit the spread of MDR-GNB. Further, clinical presentations and water use should be considered in administration of empirical therapy whilst awaiting culture results.