bluuebunny/crossref_metadata_2025_split huggingface dataset:
Le recours des professionnels de santé à la pluriactivité dans un pays en développement: Le cas des métropoles du Cameroun
Authors: Nkoumou Ngoa Gaston Brice , Tsafack Nanfosso Roger , Fomba Kamga Benjamin 
Published: May 2021

RésuméCet article analyse les déterminants de la pluriactivité pratiquée par les professionnels de santé, à partir des données issues d'une enquête réalisée dans les hôpitaux de Yaoundé et Douala, les principales villes du Cameroun. En utilisant des modèles de choix discrets, cette étude montre que la pluriactivité des médecins s’accroit avec les revenus du travail alors que cette association n'est pas significative pour les infirmiers et les techniciens de la santé. De plus, les arriérés de salaires incitent les infirmiers et les techniciens de la santé à occuper plusieurs emplois alors que la détention d'un emploi permanent et une forte perception du contrôle externe à l'hôpital diminuent cette pratique. Ces résultats suggèrent des implications importantes en termes de politiques publiques. Premièrement, un accent devrait être mis sur la sécurité de l'emploi des travailleurs de la santé, en particulier ceux du secteur privé, et sur la crédibilité des mesures de contrôle externe appliquées dans les formations sanitaires. Ensuite, le paiement régulier des salaires dans les formations sanitaires devrait être encouragé pour maintenir les infirmiers et les techniciens de la santé dans leur emploi principal. Enfin, décourager ou promouvoir le cumul d'emplois en agissant uniquement sur le revenu du travail pourrait être une politique inefficace.
Confounding and regression adjustment indifference‐in‐differencesstudies
Authors: Zeldow Bret , Hatfield Laura A. 
Published: May 2021

AbstractObjectiveTo define confounding bias in difference‐in‐difference studies and compare regression‐ and matching‐based estimators designed to correct bias due to observed confounders.Data sourcesWe simulated data from linear models that incorporated different confounding relationships: time‐invariant covariates with a time‐varying effect on the outcome, time‐varying covariates with a constant effect on the outcome, and time‐varying covariates with a time‐varying effect on the outcome. We considered a simple setting that is common in the applied literature: treatment is introduced at a single time point and there is no unobserved treatment effect heterogeneity.Study designWe compared the bias and root mean squared error of treatment effect estimates from six model specifications, including simple linear regression models and matching techniques.Data collectionSimulation code is provided for replication.Principal findingsConfounders in difference‐in‐differences are covariates that change differently over time in the treated and comparison group or have a time‐varying effect on the outcome. When such a confounding variable is measured, appropriately adjusting for this confounder (ie, including the confounder in a regression model that is consistent with the causal model) can provide unbiased estimates with optimal SE. However, when a time‐varying confounder is affected by treatment, recovering an unbiased causal effect using difference‐in‐differences is difficult.ConclusionsConfounding in difference‐in‐differences is more complicated than in cross‐sectional settings, from which techniques and intuition to address observed confounding cannot be imported wholesale. Instead, analysts should begin by postulating a causal model that relates covariates, both time‐varying and those with time‐varying effects on the outcome, to treatment. This causal model will then guide the specification of an appropriate analytical model (eg, using regression or matching) that can produce unbiased treatment effect estimates. We emphasize the importance of thoughtful incorporation of covariates to address confounding bias in difference‐in‐difference studies.
Characterizing the role of early alcohol reexposure in associations of prenatal alcohol exposure with adolescent alcohol outcomes
Authors: Zaso Michelle J. , Youngentob Steven L. , Park Aesoon 
Published: May 2021

AbstractBackgroundPrenatal alcohol exposure has been linked to a host of negative outcomes, although it is largely unknown whether prenatal exposure leads to an earlier age of initiation of alcohol use or exacerbates early alcohol initiation. The current study examined whether adolescents exposed to heavy drinking during gestation began drinking earlier than their nonexposed peers and whether an earlier age of alcohol reexposure in adolescence exacerbated associations with adverse alcohol outcomes.MethodsAdolescents (17 years of age; 57% female; 96% White) from a longitudinal, population‐based cohort study, the Avon Longitudinal Study of Parents and Children, reported on the age they first consumed a whole drink and other alcohol behaviors. Adolescents’ mothers also reported on their own heavy drinking during pregnancy (i.e., any consumption of 4+ U.K. units in a drinking day at either 18 or 32 weeks of gestation).ResultsSurvival analyses indicated that prenatal heavy drinking exposure was not associated with an earlier initiation of alcohol use after controlling for potential demographic and parental mental health and substance use confounds. Generalized negative binomial models demonstrated that prenatal heavy drinking exposure moderated associations of the age of alcohol initiation with alcohol quantity and heavy drinking frequency (but not alcohol frequency or Alcohol Use Disorders Identification Test score), after controlling for the same demographic and parental confounds. Specifically, earlier alcohol initiation was associated with more adverse alcohol outcomes regardless of prenatal exposure. However, the protective associations of delayed alcohol initiation were lower among adolescents exposed to prenatal heavy drinking.ConclusionsThis study provides evidence for the interplay between prenatal and postnatal alcohol exposures. Importantly, adolescents who were prenatally exposed to heavy drinking appeared to be less protected by later alcohol initiation than those who were not exposed in utero.
Non‐thiazide diuretics and hospitalization due to hyponatraemia: A population‐based case‐control study
Authors: Mannheimer Buster , Falhammar Henrik , Calissendorff Jan , Lindh Jonatan D , Skov Jakob 
Published: May 2021

AbstractObjectiveDiuretics are often implicated in hyponatraemia. While thiazides constitute one of the most common causes of hyponatraemia, data on loop diuretics and potassium‐sparing agents are limited and partly conflicting. The objective of this investigation was to study the association between use of different types of non‐thiazide diuretics and hospitalization due to hyponatraemia.Design, Patients and MeasurementsThis was a register‐based case‐control study on the adult Swedish population. By linking national registers, patients hospitalized with a principal diagnosis of hyponatraemia (n = 11,213) from 1 October 2005 through 31 December 2014 were compared with matched controls (n = 44,801). Multivariable logistic regression, adjusted for multiple confounders, was used to analyse the association between use of diuretics and hyponatraemia. In addition, newly initiated use (≤90 days) and ongoing use were examined separately.ResultsAdjusted odds ratios (aORs) (95% CI) were 0.61 (0.57–0.66) for the use of furosemide, 1.69 (1.54–1.86) for the use of amiloride and 1.96 (1.78–2.18) for the use of spironolactone and hospitalization due to hyponatraemia. For newly initiated therapy, aORs ranged from 1.23 (1.04–1.47) for furosemide to 3.55 (2.75–4.61) for spironolactone. The aORs for ongoing use were 0.52 (0.47–0.57) for furosemide, 1.62 (1.47–1.79) for amiloride and 1.75 (1.56–1.98) for spironolactone.ConclusionsOngoing use of furosemide was inversely correlated with hospitalization due to hyponatraemia, suggesting a protective effect. Consequently, if treatment with furosemide precedes the development of hyponatraemia by some time, other causes of hyponatraemia should be sought. Spironolactone and amiloride may both contribute to hyponatraemia; this effect is most prominent early in treatment.
Impact of heart transplant allocation change on competing waitlist outcomes among listing strategies
Authors: Patel Jay N. , Chung Joshua S. , Seliem Ahmed , Sakr Antoine , Stoletniy Liset , Rabkin David G. , Abramov Dmitry 
Published: May 2021

AbstractIn 2018, the United Network for Organ Sharing (UNOS) adopted a 6‐tier system for heart allocation which shifted patterns in listing strategies. The effects of the change on waitlist survival and transplantation rates have yet to be substantiated by analysis of competing outcomes among various listing strategies. This study included all adult patients listed for first‐time heart transplantation in UNOS between 10/17/15 and 6/12/20. Clinical characteristics were compared before and after allocation change among various listing strategies: no support, inotropes, intra‐aortic balloon pump, durable left ventricular assist device (LVAD), temporary VAD, and extracorporeal membrane oxygenation. Fine‐Gray proportional subhazard models were used to estimate the effect of allocation change on competing waitlist outcomes—transplantation, death, or removal from waitlist—among each strategy. During the study period, there were 17 422 patients listed for heart transplantation. Among each listing strategy, clinical characteristics were similar before and after allocation change. Subhazard models demonstrated reduced risk for waitlist mortality (p < .001) among each strategy except temporary VAD and increased transplantation rates (p < .001) among each strategy except for durable LVAD. These results validate the association of the new allocation system on waitlist outcomes across listing strategies.
A systematic review of the histopathologic survey on skin biopsies in patients with Corona Virus Disease 2019 (COVID‐19) who developed virus or drug‐related mucocutaneous manifestations
Authors: Najar Nobari Niloufar , Seirafianpour Farnoosh , Dodangeh Milad , Sadeghzadeh‐Bazargan Afsaneh , Behrangi Elham , Mozafarpoor Samaneh , Goodarzi Azadeh 
Published: May 2021

AbstractThe mucocutaneous manifestations of Corona Virus Disease 2019 (COVID‐19) logically may reflect systemic visceral involvements. These findings are visible and easy to approach like biopsies for exact histopathologic evaluations. This systematic review was conducted to collect the mucocutaneous histopathologic data of COVID‐19 patients for future investigations and interpretations. The COVID‐19 dermatology resource of the Centre of Evidence‐Based Dermatology (CEBD) at the University of Nottingham, PubMed, Scopus, Google Scholar and Medscape was searched for relevant English articles published by June 3, 2020. This review included 31 articles, involving 459 patients. The common primary virus‐related mucocutaneous manifestations are easy to approach in the course of COVID‐19. The authors of this study supposed dermatopathological findings as the predictors of the nature of potential systemic involvements and outcomes of COVID‐19. Scrutinizing these findings can help with adopting more effective therapeutic and management strategies; nevertheless, this review found the severity and time of onset of symptoms not to be associated with the laboratory and histopathological findings. Deterioration of clinical conditions and laboratory tests was also not related to the histopathological findings. It is recommended that meta‐analyses be conducted in the future to detail on these data for having more comprehensive and better conclusion.
Performance Analysis of the χMD Matrix Solver Package for MODFLOW‐USG
Authors: Ibaraki Motomu , Zhang Yiding , Niswonger Richard G. , Panday Sorab 
Published: May 2021

AbstractThe χMD matrix solver package is incorporated into USGS groundwater modeling software, such as MODFLOW‐NWT, MODFLOW‐USG, and MT3D. The solver is used to solve matrices assembled through numerical discretization of the groundwater flow equation, and solute transport equations. χMD has demonstrated its higher robustness, faster execution speed, and more efficient memory usage compared to the existing solvers for many types of groundwater flow problems. χMD uses preconditioned iterative Krylov‐subspace methods and consists of preconditioning and acceleration modules. Because the solver package uses a variety of preconditioning features including level‐based incomplete lower‐upper (ILU) factorization method with a drop tolerance scheme, users must choose optimal preconditioning parameters to improve execution speed and robustness. In order to examine how the preconditioning parameters, ILU factorization level, and drop tolerance values affect the overall performance of the matrix solver, we evaluated five different groundwater model applications using MODFLOW‐USG that include different numerical complexities. For those five cases, the number of discretization nodes varied from 10,000 cells to 730,300 cells. From the analysis, we found that the preconditioning parameters greatly affect execution times and memory usage of the preconditioning and acceleration procedures. In addition, a combination of the ILU level between five to seven and the drop tolerance value between 10−2 and 10−3 usually resulted in shorter overall execution time. Our study suggests that the users can elicit higher performance and robustness of the χMD matrix solver using this combination of the parameters and enhance computational efficiency of solving groundwater and solute transport problems.
A preliminary investigation of caramelisation and isomerisation of allulose at medium temperatures and alkaline pHs: a comparison study with other monosaccharides
Authors: Ertugrul Ulku , Tas Ozan , Namli Serap , Oztop Mecit H. 
Published: May 2021

SummaryAllulose, also known as rare sugar, is a very reactive monosaccharide in browning reactions. In this study, the caramelisation of allulose was investigated for the first time. To study caramelisation, sugar solutions (glucose, fructose and allulose) were prepared with distilled water and buffer solutions at pH 7, 10, 12 and were freeze‐dried afterwards. To let caramelisation occur, samples were incubated at 55% relative humidity (RH) and 50 °C. Results showed that samples prepared with pH 10 and pH 12 buffer solutions resulted in a higher browning rate than samples prepared with distilled water (DW) and pH 7 buffer solution. Moreover, according to HPLC and total reducing sugar content results, allulose (Allu) samples had the lowest remaining reducing sugar (RRS) amount, indicating that Allu samples depleted more in the reaction. Overall, the approach followed in this study can be considered as a novel strategy to obtain allulose‐containing caramel‐like products more efficiently than conventional methods.
Environmental factors related to sleep latency among inpatients in rehabilitation wards according to functional independence measure cognitive scores
Authors: Fukui Sakiko , Ohama Etsuko , Hattori Satoshi 
Published: May 2021

AbstractBackgroundNo study has investigated sleep‐related environmental factors in patients according to their functional independence measure (FIM) cognitive scores.AimsThe aim of this study is to examine the associations between environmental factors such as noise and sleep latency according to the FIM cognitive scores among inpatients in rehabilitation wards.DesignThis is a prospective longitudinal study.MethodsThis study measured the sleep state using a bed‐based actigraphy, environmental data from Environmental Sensor®, and medical record information of 33 inpatients in the rehabilitation wards during 2018. A linear mixed‐effect model was used to analyse the associations between sleep latency and environmental factors. Participants were grouped according to high or low FIM cognitive scores.ResultsThe average patient age was 77.2 ± 10.9 years, and 48.5% were male. In the high FIM cognitive score group, the loudness and frequency of noise exceeding 40 dB during sleep latency were significantly associated with sleep latency. In the low FIM cognitive score group, only the noise frequency was associated with sleep latency, and intra‐individual variance was larger than that of the high group.ConclusionThese findings suggest that providing night care with attention to subdued noise is important, particularly for patients with low cognitive functional independence levels measured by the FIM cognitive score.
RECONSIDERING THE RELATIONSHIP BETWEEN VITORIA AND GROTIUS’S CONTRIBUTIONS TO THE INTERNATIONAL LAW AND NATURAL LAW TRADITIONS
Authors: Carter John E. 
Published: May 2021

AbstractIn light of recent reevaluations of the work of Hugo Grotius, this essay analyzes the respective roles of Francisco de Vitoria and Grotius in the construction of the “Grotian tradition” of international law and human rights. In contrast to conventional accounts which understand the two within a progression, this essay argues that Vitoria and Grotius can alternatively be understood as representing two distinct strains of international law and ethics, forms of which persist to this day. The first is that strain which privileges local governance based on the natural law and which insists that international law must have a moral or equitable valence (represented today by liberal internationalism). The second, competing strain which, with its focus on “neutral” rules of commerce and international order, presumes that it need not have such a valence (essentially, neoliberalism). In the process, this essay examines the role of the natural law in Vitoria’s thought, which for him was most often a reason against interference or intervention, not for. The essay also highlights the role of the Eighty Years’ War between the Dutch United Provinces and Spain in the development of Grotius’s understanding of sovereignty, in contrast to the Thirty Years’ War which is given more prominence in conventional accounts.
Pharmacokinetics of oral and compounded intravenous gabapentin in Duroc swine (SusScrofa)
Authors: Hampton Chiara E. , Queiroz‐Williams Patricia , Oubre Montana J. , Martin Anna , Gisclair Andrea T. , Pypendop Bruno H. 
Published: May 2021

AbstractThe objective of this study was to determine the pharmacokinetics (PK) of oral (OS; 20 mg/kg) and compounded intravenous (IV; 5.5 mg/kg) gabapentin in 6 healthy, adult, Duroc pigs. Subjects were randomized to receive IV and OS gabapentin in a cross‐over design, with at least 14 days of wash‐out period between the two rounds of drug administrations. Blood samples were obtained before gabapentin administration and at various times up to 24 h, and harvested plasma was stored at −80°C until analysis. Concentration of gabapentin was quantified using a previously validated liquid chromatography/tandem mass spectrometry method, and compartment models were fitted to time‐concentration data using non‐linear mixed effect (population) analysis. A two‐compartment model best fitted the data following IV administration. Typical values for volume of the central compartment and clearance and calculated volume of distribution at steady‐state and terminal half‐life were 170 ml/kg, 1.2 ml/(kg*min), and 594 ml/kg and 360 min, respectively. For the oral route, absorption half‐life, estimated maximal plasma concentration and time to reach maximal plasma concentration were 58 min, 9155 ng/ml, and 194 min, respectively. Estimated oral bioavailability was 47%. Short‐lived sedation (approximately 15 min) with sternal or lateral recumbency after IV administration was observed in all subjects without adverse clinical effects. Simulation based on the results of this study suggests that a first oral gabapentin dose of 15 mg/kg and subsequent doses of 8.5 mg/kg every 8 h would achieve and maintain plasma concentrations between 5 and 8 μg/ml in pigs.
Aetiological changes of tinea capitis in the Hubei area in 60 years: Focus on adult tinea capitis
Authors: He Mengwen , Zeng Jingsi , Mao Yehong , Zheng Yuechen , Lian Xin , Chen Hongxiang 
Published: May 2021

AbstractBackgroundTinea capitis is a common dermatophyte infection of the scalp primarily affecting children, with less frequent, though not rare, observation in adults.ObjectiveThis study aimed to assess changes in the causative agents of adult tinea capitis over a 60‐year period in the Hubei area.MethodsA retrospective, single‐centre study was performed on 164 adults with tinea capitis between 1960 and 2020.ResultsOut of 1113 cases of tinea capitis, 164 patients were adults, representing 14.7% of all patients. Adult tinea capitis was slightly more prevalent in males (91, 55.5%) than in females (73, 44.5%), but gender difference was not statistically significant between adults and children. Adult tinea capitis was most prevalent between the ages of 18 and 29 years, with a mean age of 22 years.Trichophyton schoenleiniiwas the most common dermatophyte in adult tinea capitis (78, 47.6%), followed byTrichophyton violaceum(58, 35.4%). Most adult tinea capitis cases before the 1980s were caused byT. schoenleinii, butT. violaceumhas become the leading pathogen for recent adult tinea capitis cases.ConclusionTinea capitis is not a disease exclusive to children. On the contrary, an upward trend of tinea capitis in adults has been observed in recent years.T. violaceumhas become the dominant causative agent of adult tinea capitis in the Hubei area, replacingT. schoenleinii. These results provide a better understanding of the treatment and prevention of tinea capitis in adults.
Adult‐onset medulloblastoma presenting with atypical MRI findings
Authors: Watanabe Masashi , Miki Hitoshi , Kito Katsumi , Ohue Shiro , Okamoto Kensho 
Published: May 2021

AbstractWe report an extremely rare case of an 18‐year‐old girl with chronic progressive speech and gait disturbances due to abnormalities around the fourth ventricle, diagnosed as classic medulloblastoma with WNT signaling dysregulation by brain biopsy. Brain MRI showed atypical findings of symmetrical midline located adult medulloblastoma with no mass effect. PET‐CT scans revealed marked uptake of only 11C‐methionine. Medulloblastoma with atypical MRI findings should be considered in the differential diagnosis of tumors around the fourth ventricle in adults, even approximately symmetrical midline tumors with no mass effect. 11C‐methionine PET‐CT may be superior in detecting adult medulloblastomas with unique characteristics.