bluuebunny/crossref_metadata_2025_split huggingface dataset:
Secondary Overtriage of Trauma Patients to a Central Hospital in Malawi
Authors: Maine Rebecca G. , Kajombo Chifundo , Mulima Gift , Kincaid Jennifer , Purcell Laura , Gallaher Jared R. , Reid Trista D. , Charles Anthony G. 
Published: February 2020

AbstractIntroductionSecondary overtriage (OT) is the unnecessary transfer of injured patients between facilities. In low‐ and middle‐income countries (LMICs), which shoulder the greatest burden of trauma globally, the impact of wasted resources on an overburdened system is high. This study determined the rate and associated characteristics of OT at a Malawian central hospital.MethodsA retrospective analysis of prospectively collected data from January 2012 through July 2017 was performed at Kamuzu Central Hospital (KCH) in Lilongwe, Malawi. Patients were considered OT if they were discharged alive within 48 h without undergoing a procedure, and were not severely injured or in shock on arrival. Factors evaluated for association with OT included patient demographics, injury characteristics, and transferring facility information.ResultsOf 80,915 KCH trauma patients, 15,422 (19.1%) transferred from another facility. Of these, 8703 (56.2%) were OT. OT patients were younger (median 15, IQR: 6–31 versus median 26, IQR: 11–38, p < 0.001). Patients with primary extremity injury (5308, 59.9%) were overtriaged more than those with head injury (1991, 51.8%) or torso trauma (1349, 50.8%), p < 0.001. The OT rate was lower at night (18.9% v 28.7%, p < 0.001) and similar on weekends (20.4% v 21.8%, p = 0.03). OT was highest for penetrating wounds, bites, and falls; burns were the lowest. In multivariable modeling, risk of OT was greatest for burns and soft tissue injuries.ConclusionsThe majority of trauma patients who transfer to KCH are overtriaged. Implementation of transfer criteria, trauma protocols, and interhospital communication can mitigate the strain of OT in resource‐limited settings.
Characteristics of Intestinal Volvulus and Risk of Mortality in Malawi
Authors: Purcell Laura N. , Reiss Rachel , Mabedi Charles , Gallaher Jared , Maine Rebecca , Charles Anthony 
Published: February 2020

AbstractBackgroundIntestinal volvulus is a common cause of mechanical intestinal obstruction (MIO) in Africa. Sigmoid volvulus has been well characterized in both high‐income and low‐income countries, but there is also a predilection for small bowel volvulus in sub‐Saharan Africa.MethodsAn analysis was performed of the Kamuzu Central Hospital Acute Care Surgery Registry from 2013 to 2019 on patients presenting with intestinal volvulus. Bivariate analysis was performed for covariates based on the intestinal volvulus type. Multivariate Poisson regression models estimated the relative risk of volvulus and mortality.ResultsA total of 4352 patients were captured in the registry. Overall, 1037 patients (23.8%) were diagnosed with MIO. Intestinal volvulus accounted for 499 (48.1%) of patients with MIO. Sigmoid volvulus, midgut volvulus, ileosigmoid knotting, and cecal volvulus accounted for 57.7% (n = 288), 19.8% (n = 99), 20.8% (n = 104), and 1.6% (n = 8), respectively. Mean age was 46.8 years (SD 17.2) with a male preponderance (n = 429, 86.0%) and 14.8% (n = 74) mortality. Overall, the most common operations performed were large bowel (n = 326, 74.4%) and small bowel (n = 76, 16.7%) resections with 18.0% (n = 90) ostomy formation. Upon regression modeling, the relative risk for volvulus was 2.7 times higher in men than women after controlling for season and age. There was no statistically significant difference in the relative risk of mortality based on the type of volvulus.ConclusionVolvulus is a significant cause of primary bowel obstruction in sub‐Saharan Africa. Type of intestinal volvulus is not associated increased risk of mortality. Reasons for increases in the incidence of small bowel volvulus are still largely undetermined.
Concomitant chronic venous insufficiency in patients with peripheral artery disease: insights from MR angiography
Authors: Ammermann Felix , Meinel Felix G. , Beller Ebba , Busse Anke , Streckenbach Felix , Teichert Christine , Weinrich Malte , Neumann Andreas , Weber Marc-André , Heller Thomas 
Published: February 2020

Abstract
Objectives
The clinical presentation of peripheral artery disease (PAD) and chronic venous insufficiency (CVI) can overlap and the conditions may co-exist. The purpose of our study was to investigate the prevalence and clinical significance of concomitant CVI in patients with PAD examined with run-off MR angiography (MRA).

Methods
We analysed 180 patients (median age 69 years, range 27 to 91) with known or suspected PAD who underwent MRA at our institution between 2012 and 2018. MRA datasets were re-evaluated for manifestations of CVI. Electronic charts were reviewed to analyse whether diagnosis of CVI was documented and to determine Fontaine stage of PAD.

Results
Evidence of possible CVI on MRA was found in 38 (21%) patients. Only seven (18%) of these patients had a documented diagnosis of CVI. Patients with co-existing PAD and CVI were more likely obese (median BMI 29.7 vs. 26.3 kg/m2, p = 0.001) and diabetic (55 vs. 35%, p = 0.039) than patients without CVI. The frequency of concomitant CVI manifestations decreased from distal to proximal with the lower leg affected in all 38 patients and the thigh in 17 patients (45%). Patients with co-existing PAD and CVI were more likely to have a clinical diagnosis of stage IV PAD than patients without co-existing CVI (57% vs. 34%, relative risk 1.68, p = 0.018).

Conclusions
Signs of possible concomitant CVI can be seen in approximately one-fifth of patients with known or suspected PAD examined with run-off MRA. If present, these findings should be reported since CVI may mimic or contribute to symptoms attributed to PAD.

Key Points
• In total, 21% of patients with PAD patients examined with MR angiography show signs of possible co-existing CVI.
• Patients with co-existing CVI were 1.7-fold more likely to have a clinical diagnosis of stage IV PAD.
• Our data also showed that co-existing chronic venous insufficiency is under-diagnosed in patients with PAD.
Die Schmerzasymbolie – um 1930 von Paul F. Schilder entdeckt und heute fast vergessen?
Authors: Jahn Martin , Steinberg Holger 
Published: February 2020

ZusammenfassungPaul Ferdinand Schilder (1886–1940) blieb der Nachwelt insbesondere in Erinnerung als Psychoanalytiker und Psychotherapeut. Allerdings forschte er auch auf neurowissenschaftlichem Gebiet umfassend und innovativ, so gilt er z. B. als Erstbeschreiber der nach ihm benannten Schilder-Krankheit. Im Mittelpunkt der hier vorliegenden Studie steht das ebenfalls von ihm erstbeschriebene Störungsbild der Schmerzasymbolie, das heute eher wenig bekannt ist und als selten gilt. Dabei handelt es sich um eine zentral bedingte Beeinträchtigung des Schmerzerlebens, die charakterisiert ist durch das Fehlen negativ-emotionaler Wahrnehmungen. Basis für Schilders Entdeckung und differenzialdiagnostische Abgrenzung der Schmerzasymbolie war die ausführliche Untersuchung von elf Krankengeschichten zwischen 1928 und 1930. Seine diesbezüglichen Publikationen kennzeichnen Akribie, vorwärtsgewandtes Denken und kritische Selbstreflexion. Er ordnete die Schmerzasymbolie nosologisch den Agnosien zu und integrierte sie in das Konzept des Körperschemas, das zeitlebens ein zentrales Thema seines wissenschaftlichen Wirkens war. Dieser Artikel geht auch auf die Frage ein, inwieweit Schilders Annahmen noch heute gültig sind und welche Konsequenzen sich hieraus ergeben könnten.
An evaluation of Monte Carlo-based hyper-heuristic for interaction testing of industrial embedded software applications
Authors: Ahmed Bestoun S. , Enoiu Eduard , Afzal Wasif , Zamli Kamal Z. 
Published: February 2020

AbstractHyper-heuristic is a new methodology for the adaptive hybridization of meta-heuristic algorithms to derive a general algorithm for solving optimization problems. This work focuses on the selection type of hyper-heuristic, called the exponential Monte Carlo with counter (EMCQ). Current implementations rely on the memory-less selection that can be counterproductive as the selected search operator may not (historically) be the best performing operator for the current search instance. Addressing this issue, we propose to integrate the memory into EMCQ for combinatorial t-wise test suite generation using reinforcement learning based on the Q-learning mechanism, called Q-EMCQ. The limited application of combinatorial test generation on industrial programs can impact the use of such techniques as Q-EMCQ. Thus, there is a need to evaluate this kind of approach against relevant industrial software, with a purpose to show the degree of interaction required to cover the code as well as finding faults. We applied Q-EMCQ on 37 real-world industrial programs written in Function Block Diagram (FBD) language, which is used for developing a train control management system at Bombardier Transportation Sweden AB. The results show that Q-EMCQ is an efficient technique for test case generation. Addition- ally, unlike the t-wise test suite generation, which deals with the minimization problem, we have also subjected Q-EMCQ to a maximization problem involving the general module clustering to demonstrate the effectiveness of our approach. The results show the Q-EMCQ is also capable of outperforming the original EMCQ as well as several recent meta/hyper-heuristic including modified choice function, Tabu high-level hyper-heuristic, teaching learning-based optimization, sine cosine algorithm, and symbiotic optimization search in clustering quality within comparable execution time.
Lifelines NEXT: a prospective birth cohort adding the next generation to the three-generation Lifelines cohort study
Authors: Warmink-Perdijk Willemijn D. B. , Peters Lilian L. , Tigchelaar Ettje F. , Dekens Jackie A. M. , Jankipersadsing Soesma A. , Zhernakova Alexandra , Bossers Willem J. R. , Sikkema Jan , de Jonge Ank , Reijneveld Sijmen A. , Verkade Henkjan J. , Koppelman Gerard H. , Wijmenga Cisca , Kuipers Folkert , Scherjon Sicco A. 
Published: February 2020

AbstractEpidemiological research has shown there to be a strong relationship between preconceptional, prenatal, birth and early-life factors and lifelong health. The Lifelines NEXT is a birth cohort designed to study the effects of intrinsic and extrinsic determinants on health and disease in a four-generation design. It is embedded within the Lifelines cohort study, a prospective three-generation population-based cohort study recording the health and health-related aspects of 167,729 individuals living in Northern Netherlands. In Lifelines NEXT we aim to include 1500 pregnant Lifelines participants and intensively follow them, their partners and their children until at least 1 year after birth. Longer-term follow-up of physical and psychological health will then be embedded following Lifelines procedures. During the Lifelines NEXT study period biomaterials—including maternal and neonatal (cord) blood, placental tissue, feces, breast milk, nasal swabs and urine—will be collected from the mother and child at 10 time points. We will also collect data on medical, social, lifestyle and environmental factors via questionnaires at 14 different time points and continuous data via connected devices. The extensive collection of different (bio)materials from mother and child during pregnancy and afterwards will provide the means to relate environmental factors including maternal and neonatal microbiome composition) to (epi)genetics, health and developmental outcomes. The nesting of the study within Lifelines enables us to include preconceptional transgenerational data and can be used to identify other extended families within the cohort.
Impact of HIV and chronic kidney disease comorbidities on hepatitis C treatment choices, drug–drug interactions and hepatitis C cure
Authors: Ali Salamat , Ur-Rehman Tofeeq , Lougher Eleri , Mutimer David , Ali Mashhood , Paudyal Vibhu 
Published: February 2020

AbstractBackground Human immunodeficiency virus (HIV) co-infection and chronic kidney disease add challenges to hepatitis C virus treatment. Objective To conduct a comparative study of treatment choices, drug–drug interactions and clinical outcomes in hepatitis C mono-infected patients, or those with HIV or chronic kidney disease comorbidities. Setting Hepatitis C treatment centers of West Midlands England, United Kingdom. Method An observational study was conducted analyzing datasets of all hepatitis C patients that were referred to a large tertiary liver unit in the West Midlands, UK between July 2015 and January 2018. Patients aged ≥ 18 years with diagnosis of hepatitis C alone or co-infected with HIV or comorbid with chronic kidney disease were eligible. Main outcome measures The treatment choices, relevant potential drug–drug interactions and sustained virologic response 12 weeks post end of treatment were assessed. Results Out of 313 patients, 154 (49.2%) were hepatitis C mono-infected, 124 (39.6%) hepatitis C/HIV co-infected and 35 (11.2%) were hepatitis C/chronic kidney disease comorbid. There were 151 (98.1%) of hepatitis C mono-infected, 110 (88.7%) of hepatitis C/HIV and 20 (57.1%) of hepatitis C/chronic kidney disease patients treated with 1st line regimens. Significantly more patients who had co-morbidity with either HIV or chronic kidney disease were prescribed 2nd line regimens (8.1% and 37.1% respectively), compared to patients with hepatitis C mono-infection (1.9%) (P value < 0.05). Comorbid patients (12.1% of HIV and 25.8% of chronic kidney disease) were more likely to required drug–drug interactions advice (grade 5) than hepatitis C mono-infected (1.8%). Higher cure rates were observed in hepatitis C mono-infected (95.33%), hepatitis C/HIV (96.1%) compared to hepatitis C/chronic kidney disease patients (90.3%). Conclusion This study shows that treatment pathways permitting access to individual treatment adjustments in accordance with comorbidities and with consideration of drug–drug interaction in a multi-disciplinary team, provides successful outcomes in hepatitis C patients co-morbid with HIV or chronic kidney disease.
The pollution indices of trace elements in soils and plants close to the copper and zinc smelting works in Poland’s Lower Silesia
Authors: Hołtra Anna , Zamorska-Wojdyła Dorota 
Published: February 2020

AbstractThe quality of soils polluted by trace elements around the facilities with the Cu and Zn smelting activities and the post-flotation tailings pond from copper industry were assessed. The level of the contamination of soils was determined on the basis of the contamination factor and the geoaccumulation index. The geoaccumulation index allows to distinguish more degrees of soil contamination and simplifies the assessment of the useable value of soil. The degrees of soil contamination and the pollution load index were shown. It has been shown that the pollution indices are a useful tool in describing the soil quality and planning corrective actions in the areas contaminated as a result of industrial activity. Histograms of pollution indices were used in order to detect the distribution of trace elements in soils. The content of metals in biomass was assessed using bioaccumulation indices. Triticum L. and Brassica napus L. show low bioaccumulation of studied metals in cereal plants. The correlations were used in order to detect the relationship among trace elements in soil as well as the relationship of metal (soil)-metal (plant) and metal bioaccumulation (plant)-metal (soil). The highest values of indices were recorded for the Oława smelter, presumably due to the long operation period before technological changes limiting the emission of pollutants were introduced. This research area was classified as very highly contaminated with all trace elements. Soils around other facilities are at least moderately contaminated.
Deep Reinforcement Learning-Based Approach to Tackle Topic-Aware Influence Maximization
Authors: Tian Shan , Mo Songsong , Wang Liwei , Peng Zhiyong 
Published: February 2020

AbstractMotivated by the application ofviral marketing, the topic-aware influence maximization (TIM) problem has been proposed to identify the most influential users under given topics. In particular, it aims to findkseeds (users) in social networkG, such that the seeds can maximize the influence on users under the specific query topics and diffusion model such as independent cascade (IC) or linear threshold (LT). This problem has been proved to be NP-hard, and most of the proposed techniques suffer from the efficiency issue due to the lack of generalization. Even worse, the design of these algorithms requires significant specialized knowledge which is hard to be understood and implemented. To overcome these issues, this paper aims to learn a generalized heuristic framework to solve TIM problems by meta-learning. To this end, we first propose two topic-aware social influence propagation models based on IC and LT model, respectively, which is conducive to better advertising injections. We then encode the feature of each node by a vector and introduce a model, calleddeep influence evaluation model, to evaluate the user influence under different circumstances. Based on this model, we can construct the solution according to the influence evaluations efficiently, rather than spending a high cost to compute the exact influence by considering the complex graph structure. We conducted experiments on generated graph instances and real-world social networks. The results show the superiority in performance and comparable quality of our framework.
Behavioural responses of Tribolium castaneum (Herbst) to different types of uninfested and infested feed
Authors: Đukić Nikola , Andrić Goran , Ninkovic Velemir , Pražić Golić Marijana , Kljajić Petar , Radonjić Andja 
Published: February 2020

AbstractTribolium castaneum is one of the most economically important insects that damages stored products. The effects of several infested or uninfested raw feed materials (wheat bran, coarse wheat meal, corn feed flour), feed products (compound feed for pigs and for laying hens) and flour mixed with brewer's yeast on the food-searching behaviour of T. castaneum adults were studied in a total of 48 combinations. Preference and olfactometer tests revealed that all the tested uninfested and intraspecific infested substrates were significantly more attractive to T. castaneum than the control (represented by part of an arena or olfactometer arm without substrate). We determined that all infested substrates were 2–9 times more attractive than uninfested in the preference test, while in the olfactometer test, they were 3–8 times more attractive. In comparing the attractiveness of the infested and uninfested substrates, in both tests wheat bran was found to be the most attractive substrate to T. castaneum adults and coarse wheat meal the least. The results of the present study contribute to our knowledge of how raw feed materials and products influence the behaviour of T. castaneum and their susceptibility to infestation, and indicate the possible utilization of wheat bran in monitoring processes of T. castaneum in pest management programmes.
Formation of Toxic Unsaturated Multifunctional and Organosulfur Compounds From the Photosensitized Processing of Fluorene and DMSO at the Air‐Water Interface
Authors: Mekic Majda , Zeng Jiafa , Jiang Bin , Li Xue , Lazarou Yannis G. , Brigante Marcello , Herrmann Hartmut , Gligorovski Sasho 
Published: February 2020

AbstractPolycyclic aromatic hydrocarbons and dimethyl sulfoxide (DMSO) are ubiquitous at the sea surface. Photochemistry at the air‐sea interface is a potentially important source of volatile organic compounds, but the relevant chemical processes are currently not well known. When aqueous solutions containing a mixture of fluorene (FL) and DMSO are irradiated with actinic radiation, a large suite of unsaturated high molecular weight compounds appear in the aqueous phase; a broad variety of saturated and unsaturated oxygenated multifunctional compounds are also observed in the gas phase, most of which are more toxic than FL. A possible sequence of steps leading to some of the observed compounds in aqueous solution as well as in the gas phase is proposed. The reaction pathways initiated by excited triplet state of FL (3FL*) are supported by theoretical calculations of the reaction Gibbs energies. The formation of organosulfur compounds has been observed to occur in the gas and the aqueous phases initiated by the reaction between 3FL* and DMSO. The aforementioned photosensitized chemistry at the water surface can have an important impact on the formation of secondary organic aerosol in marine boundary layer as polycyclic aromatic hydrocarbons and DMSO enriched at the water surface are ubiquitous.
Spatiotemporal Variations in Upper Crustal Extension Across the Different Basement Terranes of the Lake Tanganyika Rift, East Africa
Authors: Wright Lachlan J. M. , Muirhead James D. , Scholz Christopher A. 
Published: February 2020

AbstractPreexisting crustal heterogeneities are shown to influence rift process at a variety of scales. However, our understanding of how crustal inheritance influences rift‐scale spatiotemporal kinematics of faulting in magma‐poor rift environments is still very limited. Studies of active continental rifts can provide high‐fidelity assessments of extensional processes and structures that are not possible through examination of ancient rifts that have undergone subsequent deformation events or are buried deeply beneath passive margins. We examine the influence of crustal inheritance on active rifting through balancing and restoring a series of regional cross sections across the Lake Tanganyika Rift in the Western Branch of the East African Rift System. The cross sections are produced using legacy seismic reflection data, reprocessed through prestack depth migration. This type example of a young, magma‐poor continental rift transects several different basement terranes, including an Archean/Paleoproterozoic craton, and Proterozoic mobile belts. The Lake Tanganyika Rift exhibits two classic bell‐shaped profiles of extension along strike, reaching a maximum of 7.15 km. A spatiotemporal integration of the extension data, and comparison with the various basement terranes the rift transects, reveals that extension in cratonic blocks is more widely distributed compared to mobile belt terranes, where strain rapidly localizes onto border faults by later rift stages. These results reveal how crustal inheritance exerts a fundamental control on the evolution of extension localization, ultimately impacting the geometry and structural architecture of rift basins.