bluuebunny/crossref_metadata_2025_split huggingface dataset:
Inequity in discharge pain management for trauma patients with limited English proficiency
Authors: Schwartz Hope E.M. , Matthay Zachary A. , Menza Rebecca , Fernández Alicia , Mackersie Robert , Stein Deborah M. , Bongiovanni Tasce 
Published: May 2021

INTRODUCTION
Pain management is critical for optimal recovery after trauma. Previous work at our institution revealed differences in pain assessment by patient language, which may impact management. This study aimed to understand differences in discharge opioid prescribing for trauma patients with limited English proficiency (LEP).

METHODS
We conducted a cross-sectional study of adult trauma patients discharged to the community from a diverse, urban level 1 trauma center in 2018. Opioid prescriptions were obtained from discharge pharmacy records and converted to standard oral morphine equivalents (OMEs). Multivariable logistic and quantile regression was used to examine the relationship between LEP, opioid prescriptions, and OMEs at discharge, controlling for demographic and clinical characteristics.

RESULTS
Of 1,419 patients included in this study, 83% were English proficient (EP) and 17% were LEP. At discharge, 56% of EP patients received an opioid prescription, compared with 41% of LEP patients. In multivariable models, EP patients were 1.63 times more likely to receive any opioid prescription (95% CI, 1.17–2.25; p = 0.003). Mean OME was 147 for EP and 94 for LEP patients. In multivariable models, the difference between EP and LEP patients was 40 OMEs (95% CI, 21.10–84.22; p = 0.004). In adjusted quantile regression models, differences in total OMEs increased with the amount of OMEs prescribed. There was no difference in OMEs at the 20th and 40th percentile of total OMEs, but LEP patients received 26 fewer OMEs on average at the 60th percentile (95% CI, −3.23 to 54.90; p = 0.081) and 45 fewer OMEs at the 80th percentile (95% CI, 5.48–84.48; p = 0.026).

CONCLUSION
Limited English proficiency patients with traumatic injuries were less likely to receive any opioid prescription and were prescribed lower quantities of opiates, which could contribute to suboptimal pain management and recovery. Addressing these disparities is an important focus for future quality improvement efforts.

LEVEL OF EVIDENCE
Care Management, level IV.
Predeployment training of Army medics assigned to prehospital settings
Authors: Suresh Mithun R. , Valdez-Delgado Krystal K. , Staudt Amanda M. , Trevino Jennifer D. , Papalski Wayne N. , Greydanus Dominique J. , Twilligear Kaleb J. , Mann-Salinas Elizabeth A. , VanFosson Christopher A. 
Published: May 2021

BACKGROUND
Medics have numerous responsibilities in the combat theater, which include performing lifesaving interventions, providing basic medical and nursing care, and caring for casualties in a variety of scenarios unique to the battlefield. An evaluation of the medic predeployment training paradigm is important and will help to understand its current state and identify areas for improvement. Therefore, the purpose of this study was to perform a focused assessment of Army medic predeployment training to identify patterns that might inform future medic training.

METHODS
A web-based survey was created using the Intelink.gov platform and sent by e-mail to Army medics who deployed since 2001. Medics were asked to reflect upon the predeployment training from their most recent deployment experience. There were multiple choice, Likert-type scale, and free-text response questions. Descriptive statistics were used to analyze the results.

RESULTS
There were 254 respondents who met the study inclusion criteria. Most of the respondents had their clinical competency evaluated (68.5%, n = 174). Respondents reported several acute trauma, basic nursing, and battlefield medicine skills as being critical but also felt that many of these same skills would have benefited from additional predeployment training. Most of the respondents felt very or fully confident and prepared to provide combat casualty care (74.8%, n = 190 and 74.8%, n = 190). There were 64 respondents (25.2%) who reported feeling not at all, slightly, or moderately confident, and 54 (84.4%) of these respondents described in a free-text question wanting additional training before deployment.

CONCLUSION
Respondents reported many skills as being critical to combat casualty care, but several of these skills would have benefited from additional predeployment training. Respondents with more deployment experience or completion of more predeployment training reported feeling more confident and prepared to provide combat casualty care. A common sentiment was the desire for more training of any form before deployment.

LEVEL OF EVIDENCE
Epidemiological, level IV.
Role of albumin on endothelial basement membrane and hemostasis in a rat model of hemorrhagic shock
Authors: Torres Luciana N. , Salgado Christi L. , Dubick Michael A. , Cap Andrew P. , Torres Filho Ivo P. 
Published: May 2021

BACKGROUND
We sought to determine the extent of loss of endothelial basement membrane (BM), leukocyte recruitment, and changes in coagulation after hemorrhagic shock, followed by limited-volume resuscitation (LVR) with 5% albumin (ALB).

METHODS
Anesthetized rats were bled 40% of blood volume and assigned to treatment groups: untreated (n = 6), LVR with normal saline (NS; n = 8), or LVR with ALB (n = 8). Sham rats (n = 6) underwent all procedures except hemorrhage or resuscitation. Blood samples were assayed for active proteases, such as metalloproteinase 9 (MMP-9) and a disintegrin and metalloproteinase 10 (ADAM-10), BM-type heparan sulfate proteoglycan (perlecan), cell count, and coagulation function. Leukocyte transmigration was used to estimate the net efficiency of leukocyte recruitment in cremaster venules.

RESULTS
Hemorrhage significantly lowered red cell count, but white cell and platelet counts did not change (vs. sham). Ionized calcium in plasma was significantly reduced in untreated and remained so after NS. In contrast, ionized calcium was normalized after ALB. Plasma expansion after NS and ALB further reduced leukocyte and platelet counts. Metalloproteinase 9, ADAM-10, and perlecan were significantly higher in untreated rats (vs. sham). Albumin normalized MMP-9, ADAM-10, and perlecan levels, while NS further increased MMP-9, ADAM-10, and perlecan (vs. sham). Transmigrated leukocytes doubled in the untreated group and remained elevated after NS (vs. sham) but normalized after ALB. Albumin reduced every stage of the leukocyte recruitment process to sham levels.

CONCLUSION
Despite similar plasma expansion, NS weakened platelet function contrary to ALB. Plasma expansion with ALB resulted in restoration of BM integrity and attenuation of leukocyte recruitment to tissues, in contrast to NS. Albumin plays a critical role in restoring BM integrity, attenuating leukocyte recruitment to tissues, and optimizing hemostasis by increasing ionized calcium in plasma.
Measuring the exposure of primate reservoir hosts to mosquito vectors in Malaysian Borneo
Authors: Brown Rebecca , Salgado-Lynn Milena , Jumail Amaziasizamoria , Jalius Cyrlen , Chua Tock-Hing , Vythilingam Indra , Ferguson Heather M. 
Published: May 2021

AbstractSeveral vector-borne pathogens of primates have potential for human spillover. An example is the simian malaria Plasmodium knowlesi which is now a major public health problem in Malaysia. Characterization of exposure to mosquito vectors is essential for assessment of the force of infection within wild primate populations, however few methods exist to do so. Here we demonstrate the use of thermal imaging and Mosquito Magnet Independence Traps (MMIT) to assess the abundance, diversity and infection rates in mosquitoes host seeking near long-tailed macaque (Macaca fasicularis) sleeping sites in the Lower Kinabatangan Wildlife Sanctuary, Malaysian Borneo. The primary Plasmodium knowlesi vector, Anopheles balabacensis, was trapped at higher abundance near sleeping sites than control trees. Although none of the An. balabacensis collected (n=15) were positive for P. knowlesi, two were infected with another primate malaria Plasmodium inui. Analysis of macaque stools from sleeping sites confirmed a high prevalence of Plasmodium infection, suspected to be P. inui. Plasmodium inui infections have not yet been reported in humans, but its presence in An. balabacensis here and previously in human-biting collections highlight its potential for spillover. We advocate the use of MMITs for non-invasive sampling of mosquito vectors that host seek on wild primate populations.
Capturing Global, Predicting Local for Controlling Antimicrobial Resistance: a retrospective multivariable analysis
Authors: Awasthi Raghav , Rakholia Vaidehi , Agarwal Samprati , Dhingra Lovedeep Singh , Nagori Aditya , Sethi Tavpritesh 
Published: May 2021

AbstractBackgroundAntimicrobial resistance (AMR) is a complex multifactorial outcome of health, socio-economic and geopolitical factors. Therefore, tailored solutions for mitigation strategies could be more effective in dealing with this challenge. Knowledge-synthesis and actionable models learned upon large datasets are critical in order to diffuse the risk of entering into a post-antimicrobial era.ObjectiveThis work is focused on learning Global determinants of AMR and predicting the susceptibility of antibiotics at the isolate level (Local) for WHO (world health organization) declared critically important pathogens Pseudomonas aeruginosa, Klebsiella pneumoniae, Escherichia coli, Acinetobacter baumannii, Enterobacter cloacae, Staphylococcus aureus.MethodsIn this study, we used longitudinal data (2004-2017) of AMR having 633820 isolates from 70 Middle and High-income countries. We integrated AMR data with the Global burden of disease (GBD), Governance (WGI), and Finance data sets in order to find the unbiased and actionable determinants of AMR. We chose a Bayesian Decision Network (BDN) approach within the causal modeling framework to quantify determinants of AMR. Finally Integrating Bayesian networks with classical machine learning approaches lead to effective modeling of the level of AMR.ResultsFrom MAR (Multiple Antibiotic Resistance) scores, we found that developing countries are at higher risk of AMR compared to developed countries, for all the critically important pathogens. Also, Principal Components Analysis(PCA) revealed that governance, finance, and disease burden variables have a strong association with AMR. We further quantified the impact of determinants in a probabilistic way and observed that health system access and government effectiveness are strong actionable factors in reducing AMR, which was in turn confirmed by what-if analysis. Finally, our supervised machine learning models have shown decent performance, with the highest on Staphylococcus aureus. For Staphylococcus aureus, our model predicted susceptibility to Ceftaroline and Oxacillin with the highest AUROC, 0.94(with SE of 0.01%) and 0.89(with SE of 0.002%) respectively.
Effect of δ-ferrite on susceptibility to hydrogen embrittlement of 304 austenitic stainless steel in high-pressure hydrogen atmosphere
Authors: Bao Fan , Zhang Kaiyu , Zhou Zhengrong , Zhang Wenli , Cai Xiao , Zhang Lin 
Published: May 2021

Purpose
The purpose of this paper is to demonstrate the effect of δ-ferrite on the susceptibility to hydrogen embrittlement of type 304 stainless steel in hydrogen gas environment.

Design/methodology/approach
The mechanical properties of as-received and solution-treated specimens were investigated by the test of tensile and fatigue crack growth (FCG) in 5 MPa argon and hydrogen.

Findings
The presence of δ-ferrite reduced the relative elongation and the relative reduction area (H2/Ar) of 304 stainless steel, indicating that δ-ferrite increased the susceptibility of hydrogen embrittlement in 304 stainless steel. Moreover, δ-ferrite promoted the fatigue crack initiation and propagation at the interface between δ-ferrite and austenite. The FCG tests were used to investigate the effect of δ-ferrite on the FCG rate in hydrogen gas environment, and it was found that δ-ferrite accelerated the FCG rate, which was attributed to rapid diffusion and accumulation of hydrogen around the fatigue crack tip through δ-ferrite in high-pressure hydrogen gas environment.

Originality/value
The dependence of the susceptibility to hydrogen embrittlement on δ-ferrite was first investigated in type 304 steel in hydrogen environment with high pressures, which provided the basis for the design and development of a high strength, hydrogen embrittle-resistant austenitic stainless steel.
Differential responses of soil nitrogen‐oxide emissions to organic substitution for synthetic fertilizer and biochar amendment in a subtropical tea plantation
Authors: Han Zhaoqiang , Wang Jinyang , Xu Pinshang , Li Zhutao , Liu Shuwei , Zou Jianwen 
Published: May 2021

AbstractTropical and subtropical acidic soils have been well documented as hotspots of global soil nitrogen (N) oxide (i.e., nitrous oxide (N2O) and nitric oxide (NO) emissions). While the effectiveness of possible mitigation options has been extensively examined in croplands, little is known about their effectiveness in reducing N‐oxide emissions from acidic soils of rapidly expanding tea plantations in China. Here, we conducted a 2‐year field experiment to investigate how organic substitution for synthetic fertilizer and biochar amendment affect soil N‐oxide emissions from a subtropical tea plantation. Across the 2‐year measurement period, full organic substitution for synthetic fertilizer significantly increased N2O emissions by an average of 17% while had a lower NO emission compared to synthetic fertilizer alone. Our global meta‐analysis further revealed that full or partial organic fertilizer substitution resulted in a 29% (95% confidence interval: 5%–60%) increase of N2O emissions from acidic soils. In contrast, irrespective of fertilizer type, biochar amendment significantly reduced N2O emissions by 14% in the first but not second experimental year, suggesting a transient effect. The trade‐off effect of full organic substitution on N2O and NO emissions may be attributed to the favorable conditions for N2O production due to the stimulated activity of nitrifiers and denitrifiers. The suppression of N2O emission following biochar amendment was probably due to promoted further reduction of N2O to dinitrogen. The fertilizer‐induced emission factor (EF) of N2O (2.1%) in the tea plantation was greater than the current IPCC default value, but the EF of NO (0.8%) was comparable to the global estimate. Taken together, while biochar amendment could have mitigation potential, cautions are needed when applying organic substitution for synthetic fertilizer as mitigation options for acidic soils as hotspots of N‐oxide emissions.
The effect of ligation methods on biofilm formation in patients undergoing multi‐bracketed fixed orthodontic therapy – A systematic review
Authors: Skilbeck Michael G , Mei Li , Mohammed Hisham , Cannon Richard D , Farella Mauro 
Published: May 2021

AbstractBackgroundMany modifications to fixed orthodontic appliances have been introduced to manage biofilm formation. The aim of this review was to investigate elastomeric ligation in comparison with stainless steel ligation and self‐ligation with regard to microbiological and clinical indicators of biofilm formation in patients wearing multi‐bracketed fixed orthodontic appliances.MethodsThe MEDLINE and the EMBASE databases were searched up to February 2021 and supplemented by additional manual searches of bibliographies. Parallel‐group and split‐mouth randomized controlled trials (RCTs) comparing different ligation methods were identified. The Cochrane Risk of Bias‐2 tool was applied to assess the quality of evidence.ResultsA total of 11 RCTs were included in this review. Nine RCTs compared self‐ligation and elastomeric ligation; two compared elastomeric ligation and stainless steel ligation. The included studies had either some concerns or were at a high risk of bias. Qualitative assessment of the studies identified that there were no significant differences in biofilm formation between elastomeric ligation and self‐ligation, but that stainless steel ligation was less susceptible to biofilm formation than elastomeric ligation.ConclusionsThere were no significant differences between self‐ligation and elastomeric ligation for biofilm formation in patients wearing multi‐bracketed fixed orthodontic appliances. Stainless steel ligation may accumulate less biofilm than elastomeric ligation; however, the clinical significance of the difference could not be evaluated. Further high‐quality studies are required in order to determine which ligation method is better for managing biofilm formation in patients wearing multi‐bracketed fixed orthodontic appliances.
Search for single production of vector-like B quark decaying to bZ at future linear colliders
Authors: Han Lin , Shen Jie-Fen 
Published: May 2021

AbstractNew vector-like quarks are predicted in many new physics scenarios beyond the Standard Model (SM). Based on a model-independent framework, we investigate the prospect of discovering the SU(2) singlet vector-like bottom quark (VLQ-B) in $$e^{+}e^{-}$$

e
+

e
-

collisions at 3 TeV Compact Linear Collider. We study the single VLQ-B production process $$e^{-}e^{+}\rightarrow B{\bar{b}}\rightarrow Zb{\bar{b}}$$

e
-

e
+

→
B

b

¯

→
Z
b

b

¯

with two types of decay channel: $$Z\rightarrow \ell ^{+}\ell ^{-}$$

Z
→

ℓ
+

ℓ
-

, and $$Z\rightarrow \nu {\bar{\nu }}$$

Z
→
ν

ν

¯

. By carrying out a full simulation for the signals and the relevant SM backgrounds, the $$2\sigma $$

2
σ

exclusion limit and $$5\sigma $$

5
σ

discovery prospects are, respectively, obtained on the B quark mass and the coupling strength $$g^{*}$$

g

∗

with the integrated luminosity of 5 $$\hbox {ab}^{-1}$$

ab

-
1

. Our numerical results show that the possible signals of the singlet VLQ-B might be detected at the future high-energy $$e^{+}e^{-}$$

e
+

e
-

linear colliders.
Giles of Lessines on Starlight and the Colour of the Sky
Authors: Nothaft C. Philipp E. 
Published: May 2021

Abstract
This article provides the first discussion of the unpublished treatise De crepusculis (“On twilight”), written in the second half of the thirteenth century by the Dominican scholar Giles of Lessines. It is shown that De crepusculis was intended as a critical supplement to a treatise on the height of the atmosphere by Ibn Muʿādh (eleventh century). In this supplement, Giles recapitulates Ibn Muʿādh’s geometrical arguments while furnishing proofs and covering relevant questions not included in the earlier work. One area where Giles greatly expands on his predecessor is in addressing relevant physical questions such as the causes of stellar luminosity. Giles here takes a nuanced view, acknowledging that all celestial bodies emit some form of light. He also provides a unique explanation of the blue colour of the sky, which draws on the extramission postulate used by thirteenth-century writers on optics.
The Application of International Humanitarian Law to Peacekeepers
Authors: Kaiser Thierry , Ruers Carlijn 
Published: May 2021

Abstract
Peacekeepers deployed as part of the United Nations Multidimensional Integrated Stabilization Mission in Mali (minusma) are operating in an increasingly hostile environment, requiring them to use force regularly in order to defend civilians, themselves and, more generally, minusma’s mandate. Over the last few years, minusma’s mandate has been expanded to enable the Mission to address the growing threat posed by hostile armed groups, including terrorist armed groups, and to provide support to counter-terrorist forces. The frequent hostilities, coupled with the Mission’s enhanced “robust” mandate and the rising number of demands made on minusma by non-UN forces for operational and logistical support, have raised questions concerning the status and legal protection of minusma’s peacekeepers under international humanitarian law, and more broadly the adequacy of the legal framework applicable to modern UN peacekeeping operations deployed in a “no peace to keep” environment. This article argues that a clarification of the application of the legal framework is required in order to afford better protection to Mission personnel and to more accurately capture the situation on the ground.
Lateral rectus muscle differentiation potential in paralytic esotropia patients
Authors: Xia Qing , Ling Xiangtian , Wang Zhonghao , Shen Tao , Chen Minghao , Mao Danyi , Ma Xinqi , Ning Jie , Zhang Han , Chen Dongli , Gu Qiong , Shen Huangxuan , Yan Jianhua 
Published: May 2021

Abstract
Purpose and background
Recently, we found that maximal medial rectus recession and lateral rectus resection in patients with complete lateral rectus paralysis resulted in a partial restoration of abduction. In an attempt to understand some of the mechanisms involved with this effect we examined gene expression profiles of lateral recti from these patients, with our focus being directed to genes related to myogenesis.

Materials and methods
Lateral recti resected from patients with complete lateral rectus paralysis and those from concomitant esotropia (controls) were collected. Differences in gene expression profiles between these two groups were examined using microarray analysis and quantitative Reverse-transcription PCR (qRT-PCR).

Results
A total of 3056 differentially expressed genes (DEGs) were identified between these two groups. Within the paralytic esotropia group, 2081 genes were up-regulated and 975 down-regulated. The results of RT-PCR revealed that PAX7, MYOG, PITX1, SIX1 and SIX4 showed higher levels of expression, while that of MYOD a lower level of expression within the paralytic esotropia group as compared with that in the control group (p < 0.05).

Conclusion
The decreased expression of MYOD in the paralytic esotropia group suggested that extraocular muscle satellite cell (EOMSCs) differentiation processes were inhibited. Whereas the high expression levels of PAX7, SIX1/4 and MYOG, suggested that the EOMSCs were showing an effective potential for differentiation. The stimulation resulting from muscle surgery may induce EOMSCs to differentiate and thus restore abduction function.
Spontaneous remission in adult patients with IgA nephropathy treated with conservative therapy
Authors: Sato Hirotaka , Ichikawa Daisuke , Okada Eri , Suzuki Tomo , Watanabe Shiika , Shirai Sayuri , Shibagaki Yugo 
Published: May 2021

Background
There are few studies describing the clinical course and spontaneous remission of IgA nephropathy (IgAN) in adult patients receiving conservative treatment.

Method
Data from 62 adult patients with biopsy-diagnosed IgAN, who received conservative treatment at least 5 years prior, were retrospectively investigated. No patients received corticosteroids, other immunosuppressants, or tonsillectomy. Remission of proteinuria and hematuria were defined as proteinuria <0.3 g/gCr and urine red blood cells (RBC) <5 / high power field (HPF) on three consecutive urinalyses obtained during an observation period of ≥6 months.

Result
Thirty-eight (61.3%) patients had remission of hematuria, 24 (38.7%) had remission of proteinuria, and 19 (30.6%) had remission of both. Remission rates increased in patients with proteinuria <0.5 g/g Cr at diagnosis. The median time to remission of hematuria was 2.8 years and that of proteinuria was 2.6 years. Patients who showed renal function decline (defined as 30% decline of estimated glomerular filtration rate [eGFR] from baseline) were older, had significantly lower eGFR, and higher proteinuria at diagnosis. Two patients with preserved renal function and normal proteinuria at diagnosis experienced renal function decline. Renal function did not decline within 3 years of diagnosis in patients with proteinuria <1 g/gCr at diagnosis.

Conclusions
Relatively high rates of spontaneous remission were observed. Remission of both hematuria and proteinuria were frequent within 3 years after diagnosis, and renal function was well preserved during this period. These data indicate that it is rational to use conservative treatment for 3 years after the diagnosis instead of aggressive treatments.