bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of a New Precipitation-Based Index for Global Seasonal Forecasting of Unusually Wet and Dry Periods
Authors: Lavaysse Christophe , Stockdale Tim , McCormick Niall , Vogt Jürgen 
Published: April 2020

AbstractThis paper describes the assessment of the performance of a method for providing early warnings of unusually wet and dry precipitation conditions globally. The indicator that is used for forecasting these conditions is computed from forecasted standardized precipitation index (SPI) values for accumulation periods of 1, 3, and 6 months. The SPI forecasts are derived from forecasted precipitation produced by the latest probabilistic seasonal forecast of ECMWF. Early warnings of unusual precipitation periods are shown only when and where the forecast is considered robust (i.e., with at least 40% of ensemble members associated with intense forecasts), and corresponding with significant SPI values (i.e., below −1 for dry, or above +1 for wet conditions). The intensity of the forecasted events is derived based on the extreme forecast index and associated shift of tails products developed by ECMWF. Different warning levels are then assessed, depending on the return period of the forecast intensity, and the coherence of the ensemble forecast members. The assessment of the indicators performance is based on the 25-member ensemble forecast system that is carried out every month during the 36 years of the hindcast period (1981–2016). The results show that significant information is provided even for the longest lead time, albeit with a large variability across the globe with the highest scores over central Russia, Southeast Asia, and the northern part of South America or Australia. Because of the loss of predictability, each SPI is based on the first lead time. A sensitivity test highlights the influence on the robustness of the forecasts of the warning levels used, as well as the effects of prior conditions and of seasonality.
Assessing the Efficiency of Health-care Facilities in Sub-Saharan Africa: A Systematic Review
Authors: Babalola Tesleem K. , Moodley Indres 
Published: April 2020

Background: The provision of health-care services is dependent on the effective and efficient functioning of various components of a health-care system. It is therefore important to evaluate the functioning of these various components. Hence, the aim of this study was to review studies on health-care facilities efficiency in sub-Saharan Africa (SSA) with respect to the methodologies used as well as outcomes and factors influencing efficiency. Methods: The review was conducted through a comprehensive search of electronic databases which included PubMed, Web of science, academic search complete via EBSCOhost, Science Direct, and Google scholar. A search was also conducted by looking into citations in the reference list of selected articles and through gray literature. Studies were screened by examining their titles, abstracts, and full-text based on stated inclusion and exclusion criteria. The concurrent screening and data extraction were conducted by the two authors. Results: A total of 40 studies were shortlisted for the review. The majority (90.0%) of the studies employed the data envelopment analysis technique for their efficiency measurements. The input and output variables utilized by most of the studies were predominantly human resources and health-related services respectively. The outcome from majority of the studies showed that less than 40% of the studied facilities were efficient. The leading influencing factors reported by the studies were catchment population, facility ownership, and location. Conclusions: The review showed that there was a marked degree of inefficiency across the health-care facilities. Consequently, due to severe resource constraints facing SSA, there is a need to determine how to use the available resources optimally to improve health systems performance.
Assessing the appropriateness of paediatric antibiotic overuse in Australian children: a population-based sample survey
Authors:   on behalf of the CareTrack Kids investigative team, Arnolda Gaston , Hibbert Peter , Ting Hsuen P. , Molloy Charli , Wiles Louise , Warwick Meagan , Snelling Tom , Homaira Nusrat , Jaffe Adam , Braithwaite Jeffrey 
Published: April 2020

Abstract
Background
Infections caused by antibiotic resistant pathogens are increasing, with antibiotic overuse a key contributing factor.

Objective
The CareTrack Kids (CTK) team assessed the care of children in Australia aged 0–15 years in 2012 and 2013 to determine the proportion of care in line with clinical practice guidelines (CPGs) for 17 common conditions. This study analyses indicators relating to paediatric antibiotic overuse to identify those which should be prioritised by antimicrobial stewardship and clinical improvement programs.

Method
A systematic search was undertaken for national and international CPGs relevant to 17 target conditions for Australian paediatric care in 2012–2013. Recommendations were screened and ratified by reviewers. The sampling frame comprised three states containing 60% of the Australian paediatric population (South Australia, New South Wales and Queensland). Multi-stage cluster sampling was used to select general practices, specialist paediatric practices, emergency departments and hospital inpatient services, and medical records within these. Medical records were reviewed by experienced paediatric nurses, trained to assess eligibility for indicator assessment and compliance with indicators. Adherence rates were estimated.

Results
Ten antibiotic overuse indicators were identified; three for tonsillitis and one each for seven other conditions. A total of 2621 children were assessed. Estimated adherence for indicators ranged from 13.8 to 99.5% while the overall estimate of compliance was 61.9% (95% CI: 47.8–74.7). Conditions with high levels of appropriate avoidance of antibiotics were gastroenteritis and atopic eczema without signs of infection, bronchiolitis and croup. Indicators with less than 50% adherence were asthma exacerbation in children aged > 2 years (47.1%; 95% CI: 33.4–61.1), sore throat with no other signs of tonsillitis (40.9%; 95% CI: 16.9, 68.6), acute otitis media in children aged > 12 months who were mildly unwell (13.8%; 95% CI: 5.1, 28.0), and sore throat and associated cough in children aged < 4 years (14.3%; 95% CI: 9.9, 19.7).

Conclusion
The results of this study identify four candidate indicators (two for tonsillitis, one for otitis media and one for asthma) for monitoring by antibiotic stewardship and clinical improvement programs in ambulatory and hospital paediatric care, and intervention if needed.
Lactic acid level as an outcome predictor in pediatric patients with intussusception in the emergency department
Authors: Lee Jeong-Yong , Byun Young-Hoon , Park Jun-Sung , Lee Jong Seung , Ryu Jeong-Min , Choi Seung Jun 
Published: April 2020

Abstract
Background
Intussusception decreases blood flow to the bowel, and tissue hypoperfusion results in increased lactic acid levels. We aimed to determine whether lactic acid levels are associated with pediatric intussusception outcomes.

Methods
The electronic medical records of our emergency department pediatric patients diagnosed with intussusception, between January 2015 and October 2018, were reviewed. An outcome was considered poor when intussusception recurred within 48 h of reduction or when surgical reduction was required due to air enema failure.

Results
A total of 249 patients were included in the study, including 39 who experienced intussusception recurrence and 11 who required surgical reductions; hence, 50 patients were included in the poor outcome group. The poor and good outcome groups showed significant differences in their respective blood gas analyses for pH (7.39 vs. 7.41, P = .001), lactic acid (1.70 vs. 1.30 mmol/L, P < .001), and bicarbonate (20.70 vs. 21.80 mmol/L, P = .036). Multivariable logistic regression analyses showed that pH and lactic acid levels were the two factors significantly associated with poor outcomes. When the lactic acid level cutoff values were ≥ 1.5, ≥2.0, ≥2.5, and ≥ 3.0 mmol/L, the positive predictive values for poor outcomes were 30.0, 34.6, 50.0, and 88.9%, respectively.

Conclusion
Lactic acid levels affect outcomes in pediatric patients with intussusception; higher lactic acid levels are associated with higher positive predictive values for poor outcomes.
How to measure blood pressure using an arterial catheter: a systematic 5-step approach
Authors: Saugel Bernd , Kouz Karim , Meidert Agnes S. , Schulte-Uentrop Leonie , Romagnoli Stefano 
Published: April 2020

AbstractArterial blood pressure (BP) is a fundamental cardiovascular variable, is routinely measured in perioperative and intensive care medicine, and has a significant impact on patient management. The clinical reference method for BP monitoring in high-risk surgical patients and critically ill patients is continuous invasive BP measurement using an arterial catheter. A key prerequisite for correct invasive BP monitoring using an arterial catheter is an in-depth understanding of the measurement principle, of BP waveform quality criteria, and of common pitfalls that can falsify BP readings. Here, we describe how to place an arterial catheter, correctly measure BP, and identify and solve common pitfalls. We focus on 5 important steps, namely (1) how to choose the catheter insertion site, (2) how to choose the type of arterial catheter, (3) how to place the arterial catheter, (4) how to level and zero the transducer, and (5) how to check the quality of the BP waveform.
Nationwide system to centralize decisions around ECMO use for severe COVID-19 pneumonia in Japan (Special Correspondence)
Authors:   Japan ECMOnet for COVID-19
Published: April 2020

AbstractThe novel coronavirus disease 2019 (COVID-19) is spreading in Japan. We have collected a total of 26 patients with COVID-19 who required extracorporeal membranous oxygenation (ECMO). The available data from the first 14 cases demonstrated that the median age of patients was 71 and the median PaO2/FIO2 ratio, positive end-expiratory pressure, mean airway pressure, and lung compliance were 70, 15 cmH2O, 21 cmH2O, and 28 mL/cmH2O, respectively. Median serum KL-6 level was 333 U/mL. Consequently, 16 (62%) out of the 26 have been weaned off and 6 (26%) have been extubated and on rehabilitation, while the other 10 (38%) remain on ECMO. There seemed to be two phenotypes of COVID-19: one with impaired lung compliance and one with preserved lung compliance. The latter phenotype was likely to be favored from the use of ECMO. Further investigation is necessary to clasrify the optimal use of ECMO in patients with COVID-19.
A review of the bioelectronic implications of stimulation of the peripheral nervous system for chronic pain conditions
Authors: Deer Timothy R. , Naidu Ramana , Strand Natalie , Sparks Dawn , Abd-Elsayed Alaa , Kalia Hemant , Hah Jennifer M. , Mehta Pankaj , Sayed Dawood , Gulati Amitabh 
Published: April 2020

Abstract
Background
Peripheral Nerve Stimulation has been used to treat human disease including pain for several decades. Innovation has made it a more viable option for treatment of common chronic pain processes, and interest in the therapy is increasing.

Main body
While clinical data is forthcoming, understanding factors that influence successful outcomes in the use of PNS still needs to be delineated. This article reviews the evolution and bioelectronic principles of peripheral nerve stimulation including patient selection, nerve targets, techniques and guidance of target delivery. We collate the current evidence for outcomes and provide recommendations for salient topics in PNS.

Conclusion
Peripheral nerve stimulation has evolved from a surgically invasive procedure to a minimally invasive technique that can be used early in the treatment of peripheral nerve pain. This review identifies and addresses many of the variables which influence the success of PNS in the clinical setting.
Avoiding Peg-Filgrastim Prophylaxis During the Paclitaxel Portion of the Dose-Dense Doxorubicin-Cyclophosphamide and Paclitaxel Regimen: A Prospective Study
Authors: Vaz-Luis Ines , Barroso-Sousa Romualdo , Di Meglio Antonio , Hu Jiani , Rees Rebecca , Sinclair Natalie , Milisits Lindsey , Leone Jose Pablo , Constantine Michael , Faggen Meredith , Briccetti Frederick , Block Caroline , O'Neil Kelly , Partridge Ann , Burstein Harold , Waks Adrienne G. , Trippa Lorenzo , Tolaney Sara M. , Hassett Michael , Winer Eric P. , Lin Nancy U. 
Published: April 2020

PURPOSE The use of growth factors adds considerable expense and some toxicity to adjuvant breast cancer chemotherapy. We tested the feasibility and safety of omitting routine peg-filgrastim use during the paclitaxel portion of the dose-dense doxorubicin-cyclophosphamide–paclitaxel regimen. PATIENTS AND METHODS This was a prospective, single-arm study in which patients 18 to 65 years of age who completed 4 cycles of dose-dense doxorubicin-cyclophosphamide for stage I-III breast cancer received paclitaxel 175 mg/m2 every 2 weeks. Peg-filgrastim was administered after paclitaxel only if patients had had febrile neutropenia in a prior cycle or at investigator discretion if patients had infections or treatment delays of > 1 week. Once a patient received peg-filgrastim, it was administered in all future cycles. The primary end point was the rate of paclitaxel completion within 7 weeks from cycle 1 day 1 to cycle 4 day 1. If ≥ 100 out of 125 patients completed 4 cycles of paclitaxel without dose delay, the regimen would be considered feasible. RESULTS The enrollment goal of 125 patients was met. Median age was 46 years (range, 21-65 years), and 112 patients (90% [95% CI, 83% to 94%]) completed dose-dense paclitaxel within 7 weeks. Omission of peg-filgrastim was not causally related to noncompletion of paclitaxel in any patients. The most common reasons for dose reduction or delays were nonhematologic. One patient experienced febrile neutropenia but was able to complete paclitaxel on time. Eight patients (6.4%) received peg-filgrastim during the trial. Overall, peg-filgrastim was administered in only 4.3% of paclitaxel cycles. CONCLUSION Omission of routine peg-filgrastim during dose-dense paclitaxel according to a prespecified algorithm seems to be safe and feasible and was associated with a 95.7% reduction in the use of peg-filgrastim relative to the current standard of care.
Multiparametric mapping in post-mortem perinatal MRI: a feasibility study
Authors: McDowell Amy R , Shelmerdine Susan C , Lorio Sara , Norman Wendy , Jones Rod , Carmichael David W , Arthurs Owen J 
Published: April 2020

Objectives:
To demonstrate feasibility of a 3 T multiparametric mapping (MPM) quantitative pipeline for perinatal post-mortem MR (PMMR) imaging.

Methods:
Whole body quantitative PMMR imaging was acquired in four cases, mean gestational age 34 weeks, range (29–38 weeks) on a 3 T Siemens Prisma scanner. A multicontrast protocol yielded proton density, T1 and magnetic transfer (MT) weighted multi-echo images obtained from variable flip angle (FA) 3D fast low angle single-shot (FLASH) acquisitions, radiofrequency transmit ﬁeld map and one B0 ﬁeld map alongside four MT weighted acquisitions with saturation pulses of 180, 220, 260 and 300 degrees were acquired, all at 1 mm isotropic resolution.

Results:
Whole body MPM was achievable in all four foetuses, with R1, R2*, PD and MT maps reconstructed from a single protocol. Multiparametric maps were of high quality and show good tissue contrast, especially the MT maps.

Conclusion:
MPM is a feasible technique in a perinatal post-mortem setting, which may allow quantification of post-mortem change, prior to being evaluated in a clinical setting.

Advances in knowledge:
We have shown that the MPM sequence is feasible in PMMR imaging and shown the potential of MT imaging in this setting.
Autism Cognizance: A dilemma among medical and Allied Medical practitioners
Authors: Akhter Naheed , Mumtaz Nazia , Saqulain Ghulam 
Published: April 2020

Objectives: To determine the awareness about autism among Medical and Allied-Medical Practitioners.
Methods: This cross-sectional survey recruited a sample of n=300 participants including n=150 Medical and n=150 Allied-Medical practitioners using convenience sampling from Benazir Bhutto Hospital and Autism Resource Centre, Rawalpindi, Pakistan between 20th May 2018 to 20th October 2018. Sample included both genders, aged 21 to 50 years. Basic demographic sheet and Knowledge about Childhood Autism among Health Workers (KCAHW) Questionnaire was used to collect data. Statistical analysis was done using SPSS 21.
Results: Study revealed the total mean KCAHW score of 15.20±5.17 and 8.84±6.31 for Allied-Medical and Medical practitioners respectively. While the Domain-I mean KCAHW scores was 6.28±2.10 and 3.68±2.41; Domain-II score 0.86±0.35 and 0.45±0.50; Domain-III score 3.28±1.00 and 1.91±1.65; and Domain 4 score of 4.83±1.72 and 2.80±1.75 for Allied-Medical and Medical practitioners respectively.
Conclusion: The present study shows that there is significant awareness regarding autism among Allied-Medical compared to Medical practitioners.
doi: https://doi.org/10.12669/pjms.36.4.1703
How to cite this:Akhter N, Mumtaz N, Saqulain G. Autism Cognizance: A dilemma among medical and Allied Medical practitioners. Pak J Med Sci. 2020;36(4):678-682. doi: https://doi.org/10.12669/pjms.36.4.1703
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Variations in the management of adolescents with blunt splenic trauma in England and Wales: are we preserving enough?
Authors: Green PA , Wilkinson DJ , Bouamra O , Fragoso M , Farrelly PJ 
Published: April 2020

Introduction Management of blunt splenic injury has changed drastically with non-operative management increasingly used in paediatric and adult patients. Studies from America and Australia demonstrate disparities in care of patients treated at paediatric and adult centres. This study assessed management of splenic injuries in UK adolescents. Materials and methods Data were acquired from the Trauma Audit and Research Network on isolated blunt splenic injuries reported 2006–2015. Adolescents were divided into age groups of 11–15 years and 16–20 years, and injuries classified as minor (grades 1/2) or major (3+). Primary outcomes were needed for splenectomy and blood transfusion. Results A total of 445 adolescents suffered isolated blunt splenic injuries. Road traffic collisions were the most common mechanism. There were no deaths as a result of isolated blunt splenic injuries, but 49 (11%) adolescents needed transfusions and 105 (23.6%) underwent splenectomies. There was no significant difference observed in the management of adolescents with minor trauma. In major trauma, 11–15-year-olds were more likely to have splenectomies when managed at local trauma units compared with major trauma centres (31% vs 4%, odds ratio 11.5; 95% confidence interval 3.82–34.38, p < 0.0001). Within major trauma centres, older adolescents were more likely to have splenectomies than younger adolescents (35.5% vs 3.8%, odds ratio 14; 95% confidence interval 4.55–43.26, p < 0.0001). There were no significant differences in haemodynamic status, transfusion requirement or embolisation rates. Conclusions There appears to be a large variation in the management of isolated blunt splenic injuries in the UK. The reasons for this remain unclear however non-operative management is safe and should be first line management in the haemodynamically stable adolescent, even with major splenic injuries.
Necrotising enterocolitis in an adult with anorexia nervosa
Authors: Schapira B , Nazarian S , Thanapal M , Parmar C , Mukhtar H 
Published: April 2020

Necrotising enterocolitis (NEC) is a rare cause of the acute abdomen in adults and carries one of the highest mortality rates in gastroenterology. However, its rarity confines research to small case reports. Both its pathogenesis and aetiology remain enigmatic in adult patients, proving timely diagnosis and management a challenge. This paper reports on one case of NEC in an adult patient with underlying anorexia nervosa, following a seven-day period of starvation. She underwent emergency laparotomy for resection of necrotic bowel and subsequently made a good recovery. To date, there have only been eight reports linking NEC with anorexia nervosa. We review our patient in the context of plausible mechanisms hypothesised in these cases. Successful management depends on prompt diagnosis, resuscitation and surgical intervention.
Silicon photonic subsystem for broadband and RoF detection while enabling carrier reuse
Authors: Lyu Mingyang , Shi Wei , Rusch Leslie A. 
Published: April 2020

We experimentally validate a silicon photonic subsystem designed for passive optical networks with carrier reuse. The subsystem is intended for future wavelength division multiplexed (WDM) PONs. It enables radio-over-fiber signals to cohabit an assigned wavelength slot without perturbing the PON signal, while conserving carrier power for the uplink. A microring modulator remodulates the residual carrier for the RoF uplink. We successfully detected the dropped 8 GHz broadband signal and five 125 MHz radio-over-fiber signals. Two 125 MHz radio over fiber signals are remodulated onto the carrier. The uplink signal shows good performance, validating the residual downlink signals have been well rejected by the microring filters. The subsystem conserves a clean carrier for remodulation with good signal-to-carrier ratio.
IT-Compliance in KMU – State of the art
Authors: Deistler Nico , Rentrop Christopher 
Published: April 2020

ZusammenfassungKleine und mittelständische Unternehmen (KMU) sind bekannt für ihre Innovationskraft und bilden das Rückgrat der deutschen Wirtschaft. Wie Studien zeigen sind sie in Bezug auf Compliance-Maßnahmen im Vergleich zu kapitalmarktorientierten Unternehmen jedoch im Rückstand. Eine gesonderte Betrachtung der IT-Compliance erfolgt dabei in den Studien in der Regel nicht. Auch wenn zu den Gründen und Motiven fehlender IT-Compliance-Strukturen in KMU kaum Forschungsergebnisse vorliegen, zeigen doch die vielen Publikationen, die sich mit Teilaspekten von Compliance und KMU beschäftigen, dass Handlungsbedarf besteht. Insbesondere die aktuellen Veränderungen unter dem Stichwort Digitalisierung deuten auf eine gesteigerte Bedeutung von IT-Compliance-Maßnahmen vor allem in mittelständischen Unternehmen. In dieser Arbeit sollen daher mithilfe einer Literaturrecherche die aktuell behandelten Themen in Bezug auf IT-Compliance und KMU analysiert sowie aktuelle Themenschwerpunkte herausgearbeitet werden.
Singapore Cinema: New Perspectives, Liew Khai Khiun and Stephen Teo (eds) (2017)
Authors: Bernards Brian 
Published: April 2020

Review of: Singapore Cinema: New Perspectives, Liew Khai Khiun and Stephen Teo (eds) (2017)
Abingdon: Routledge, 194 pp.
ISBN 978-1-13859-569-9, p/bk, US$57.95
50 Years in the World of Oil – Memoirs and Autobiography
Authors: Jiyad Ahmed Mousa 
Published: April 2020

Review of: 50 Years in the World of Oil – Memoirs and Autobiography

عاما في عالم النفط – سيرة وذكريات 50
Issam Al-Chalabi (2019)
Beirut/Lebanon: Arab Establishment for Studies and Publications, 820 pp.,
ISBN 978-6-14419-945, h/bk