bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multivariate analysis of the impact of weather and air pollution on emergency department visits for night-time headaches among children: retrospective, clinical observational study
Authors: Yamaguchi Hiroshi , Nozu Kandai , Ishiko Shinya , Nagase Hiroaki , Ninchoji Takeshi , Nagano China , Takeda Hiroki , Unzaki Ai , Ishibashi Kazuto , Morioka Ichiro , Iijima Kazumoto , Ishida Akihito 
Published: April 2021

ObjectivesTo examine the association between the number of visits to the emergency department (ED) by children for night-time headaches and exposure to multifaceted factors, such as meteorological conditions and air pollution.DesignWe conducted a clinical observational time-series analysis study.SettingWe reviewed consecutive patients younger than 16 years of age at the primary ED centre in Kobe city, Japan, during the night shift (19:30–7:00 hours) between 1 January 2011 and 31 December 2019.ParticipantsIn total, 265 191 children visited the ED; 822 presented with headache during the study period.Primary outcome measuresWe investigated the effects of meteorological factors and air pollutants by multivariate analysis of Poisson regression estimates. A subanalysis included the relationship between the number of patients with night-time headaches and the above factors by sex. Furthermore, the effect of typhoon landing on patient visits for headache was also analysed. Headache was not classified because examinations were performed by general paediatricians (non-specialists).ResultsThe number of patients with night-time headaches displayed distinct seasonal changes, with peaks during the summer. Multivariate analysis of Poisson regression estimates revealed a significant positive relationship between the number of patients for headache and mean temperature. Subanalysis by sex indicated a positive relationship between the number of patients with headache and mean temperature in both sexes; however, it was significant only for females. No relationship was found between the number of patients with headache and air pollution. There was no change in the number of patients for night-time headaches 3 days before and after typhoon landing.ConclusionsHigh temperature is the main factor for visiting ED for night-time headaches among children in Kobe city. Our results suggest that preventive measures against night-time headaches may be possible by reducing time spent outside during summer.
Policy changes and the screening, diagnosis and treatment of drug-resistant tuberculosis patients from 2015 to 2018 in Zhejiang Province, China: a retrospective cohort study
Authors: Jiang Weixi , Peng Ying , Wang Xiaomeng , Elbers Chris , Tang Shenglan , Huang Fei , Chen Bin , Cobelens Frank 
Published: April 2021

ObjectivesTo examine changes in the screening, diagnosis, treatment and management of drug-resistant tuberculosis (DRTB) patients, and investigate the impacts of DRTB-related policies on patients of different demographic and socioeconomic characteristics.DesignA retrospective cohort study using registry data, plus a survey on DRTB-related policies.SettingAll prefecture-level Centres for Disease Control in Zhejiang Province, China.Main outcome measuresAlongside the care cascade, we examined: (1) reported number of presumptive DRTB patients; (2) percentage of presumptive patients with drug susceptibility testing (DST) records; (3) percentage of DRTB/rifampicin-resistant (RR) patients registered; (4) percentage of RR/multidrug-resistant TB (MDRTB) patients that received anti-DRTB treatment; and (5) percentage of RR/MDRTB patients cured/completed treatment among those treated. Multivariate logistic regressions were conducted to explore the impacts of DRTB policies after adjusting for other factors.ResultsThe number of reported presumptive DRTB patients and the percentage with DST records largely increased during 2015–2018, and the percentage of registered patients who received anti-DRTB treatment also increased from 59.0% to 86.5%. Patients under the policies of equipping GeneXpert plus expanded criteria for DST had a higher likelihood of being registered compared with no GeneXpert (adjusted OR (aOR)=2.57, 95% CI: 1.20 to 5.51), while for treatment initiation the association was only significant when further expanding the registration criteria (aOR=2.38, 95% CI: 1.19 to 4.79). Patients with registered residence inside Zhejiang were more likely to be registered (aOR=1.96, 95% CI: 1.52 to 2.52), treated (aOR=3.83, 95% CI: 2.78 to 5.28) and complete treatment (aOR=1.92, 95% CI: 1.03 to 3.59) compared with those outside.ConclusionThe policy changes on DST and registration have effectively improved DRTB case finding and care. Nevertheless, challenges remain in servicing vulnerable groups such as migrants and improving equity in the access to TB care. Future policies should provide comprehensive support for migrants to complete treatment at their current place of residence.
A good death: non-negotiable personal conditions for clinicians, healthcare administrators and support staff
Authors: Zaman Mehreen , Andoniou Ellena , Wind Keiwan , Gibson Jennifer , Upshur Ross , Rojas German , Jadad-Garcia Tamen , Jadad Alejandro R 
Published: April 2021

ObjectivesTo ask all clinical, administrative and support staff affiliated with a large network of healthcare facilities to identify the conditions that they consider as non-negotiable for their own deaths to be regarded as good.MethodsAll 3495 staff of a healthcare network were asked to rank 10 conditions according to how non-negotiable they would be for themselves during their final 3 months or few hours for their own deaths to be considered as good. They were also asked about whether they had thought about their own death in the last 3 months, if they had a will, believed in God, and in the possibility of a good death, and the intensity of their fear of death.Results2971 (85%) completed the survey. Most were female (79%) and clinical staff (65%). 93% believed in God, 60% had thought about their death recently, 33% had an intense fear of death, and 4% had a will. 64% considered a good death possible. Participants ranked dying at a preferred place, emotional support from family and friends and relief from physical symptoms as their top priorities. The lowest ranked conditions were (from the bottom) relief from psychological distress, performance of rituals and the right to terminate life. There were no statistically significant differences across genders or individual occupational groups.ConclusionMost of conditions for a good death of interest to healthcare professionals could be provided without sophisticated medical infrastructure or specialised knowledge, opening the door for new support services to make it possible for everyone, anywhere.
Evaluation of a simulation faculty training workshop in a low-resource setting: a qualitative study
Authors: Seethamraju Rajasri Rao , Stone Kimberly , Shepherd Michael 
Published: April 2021

IntroductionSimulation instructor training courses are infrequent in low-resource countries. PediSTARS India organisation has been conducting a Training of Trainers (TOT) workshop annually since 2014 and has trained 380 instructors in the last 6 years. The objective of this study is to evaluate this workshop using the basic Kirkpatrick model with a blended evaluation approach.MethodsA qualitative study design was used with purposive sampling from the 2018 workshop cohort. An initial online questionnaire gathered demographic and professional profile of participants. Semistructured interviews with those who consented explored their perceptions about the workshop and their experiences using simulation for training at their workplaces. The analysis was done based on a deductive research approach around the framework of the first three levels of the Kirkpatrick model.ResultsA total of 11 in-depth interviews were conducted. Participants reported long-term retention, translation and positive impact of the knowledge and skills gained at the TOT workshop. The results achieved saturation and underwent respondent validation.ConclusionThis study provides evidence to support simulation faculty training workshops as an effective educational intervention in promoting simulation-related workplace-based education and training among health practitioners and that follow-up activity may be useful in some cases. This is the first study of its kind in a low-resource setting, and supports similar simulation instructor training in these settings and provides a blueprint for such training. Follow-up studies are required to evaluate the longer term impact of this simulation instructor training.
Severe liver trauma among pediatric patients in the Japan Trauma Registry
Authors: Aoki Makoto , Abe Toshikazu , Hagiwara Shuichi , Saitoh Daizoh , Oshima Kiyohiro 
Published: April 2021

BackgroundLimited information exists regarding the clinical characteristics, management practices, and outcomes of pediatric patients with liver injury in Japan. The aim of this study is to evaluate the characteristics, management, and outcome of pediatric patients with liver injury in Japan.MethodsWe conducted a multicenter, retrospective cohort study using data from the Japan Trauma Data Bank between 2004 and 2018. Pediatric patients with liver injury were classified into the following management groups: nonoperative management (NOM); NOM with angioembolization (AE); operative management (OM). The primary outcome was in-hospital survival, and the secondary outcomes were dispositions, hospital length of stay (LOS), and rate of discharge to home.ResultsThere were 308 pediatric patients with severe liver injury (organ injury scale grades ≥Ⅲ) during the study period; 135 patients had isolated liver injury and 173 patients had non-isolated liver injury. The rates of NOM, NOM with AE, and OM among all patients were 65%, 23%, and 12%, respectively. AE was highly used both in patients with isolated liver injury (27%) and non-isolated liver injury (22%). In-hospital survival of patients with isolated liver injury and those with non-isolated liver injury were 99% and 88%, respectively. Regarding secondary outcomes among patients with isolated liver injury, 82% were admitted to the intensive care unit. LOS was 11 (8–14) days and 82% were discharged to home.ConclusionsOur retrospective observational study showed that management of pediatric patients with severe liver injury in Japan was characterized by high utilization of AE. The in-hospital survival rate in Japan was comparable with that of other developed countries.
Analyticity and Regge asymptotics in virtual Compton scattering on the nucleon
Authors: Caprini Irinel 
Published: April 2021

AbstractWe test the consistency of the data on the nucleon structure functions with analyticity and the Regge asymptotics of the virtual Compton amplitude. By solving a functional extremal problem, we derive an optimal lower bound on the maximum difference between the exact amplitude and the dominant Reggeon contribution for energies$$\nu $$νabove a certain high value$$\nu _h(Q^2)$$νh(Q2). Considering in particular the difference of the amplitudes$$T_1^\text {inel}(\nu , Q^2)$$T1inel(ν,Q2)for the proton and neutron, we find that the lower bound decreases in an impressive way when$$\nu _h(Q^2)$$νh(Q2)is increased, and represents a very small fraction of the magnitude of the dominant Reggeon. While the method cannot rule out the hypothesis of a fixed Regge pole, the results indicate that the data on the structure function are consistent with an asymptotic behaviour given by leading Reggeon contributions. We also show that the minimum of the lower bound as a function of the subtraction constant$$S_1^\text {inel}(Q^2)$$S1inel(Q2)provides a reasonable estimate of this quantity, in a frame similar, but not identical to the Reggeon dominance hypothesis.
Submersion of rubidium clusters in helium nanodroplets
Authors: Schiller Arne , Martini Paul , Al Maalouf Elias Emile Jabbour , Scheier Paul 
Published: April 2021

Abstract
Alkali atoms and small clusters are known to reside on the surface of a helium droplet rather than its inside as most other dopant species. A theoretical investigation suggested that alkali clusters (Li–Rb) exceeding a certain critical size can become submerged in the droplet, which was experimentally confirmed for sodium and potassium. Here, we report an analogous experimental study of rubidium cluster submersion by means of electron impact mass spectrometry. We recorded size distributions of Rb cluster ions at various electron energies between 8 and 160 eV. Our data suggest that Rb clusters attached to helium droplets undergo a gradual submersion transition similar to potassium, ultimately leading to the full submersion of clusters larger than $$\sim 100~\hbox {Rb}$$

∼
100

Rb

atoms. Our findings are consistent with previous theoretical and experimental studies.

Graphic abstract
Doma: a new multi-technological lithic occurrence in the Lower Son Valley (north-central India) and its regional context
Authors: Mehra Shashi B. 
Published: April 2021

Abstract

The Lower Son Valley is generally overlooked despite a lengthy history of archaeological and geological studies in the adjacent Middle Son Valley. However, recent explorations in the former have yielded a large number of Palaeolithic and microlithic sites. This paper provides an initial report on Doma, a newly discovered site with the first-known stratified bifaces in this part of the valley. The site preserves multi-period technologies in different contexts, including terminal Acheulean/early Middle Palaeolithic and Upper Palaeolithic (all tentatively assigned based on respective typologies). Preliminary field observations are presented on the sedimentary sequence, archaeological surveys, topographical mapping, raw material and the overall palaeoanthropological assessment of Doma. The raw material utilized at the site is primarily porcellanite, derived from exposures of the Semri Group of the Vindhyan Supergroup. The oldest Palaeolithic evidence at Doma broadly resembles Late Acheulean sites dated to
c.
140–120 ka in the nearby Middle Son Valley. The Pleistocene sediments here also yielded mammalian fossil specimens, such as long bone fragments, dental specimens and antler fragments. Along with the lithics and fossils, the site also preserves datable sedimentary sequences with calcrete, all key proxies in developing a testable model of technological transitions within a palaeoenvironmental framework, in the future.
Thrombocytopenia as a Diagnostic Marker for Malaria in Patients with Acute Febrile Illness
Authors: Gebreweld Angesom , Erkihun Yonas , Feleke Daniel Getacher , Hailu Gebru , Fiseha Temesgen 
Published: April 2021

Background. Thrombocytopenia is the most common hematological abnormality in patients with acute malaria. This study aimed to determine the role of thrombocytopenia as a diagnostic marker for malaria in patients with acute febrile illness. Method. A cross-sectional health facility-based study was conducted on 423 consecutively selected acute febrile patients at Ataye District Hospital from February to May 2019 GC. A complete blood count and malaria microscopy were performed for each acute febrile patient. ROC curve analysis was performed to calculate sensitivity, specificity, positive predictive value, and negative predictive value of platelet count in predicting malaria. A

P

≤ 0.05 was considered statistically significant. Result. Out of the 423 acute febrile patients, 73 (17.3%) were microscopically confirmed malaria cases and the rest 350 (82.7%) patients had negative blood film results. Of the microscopically confirmed malaria cases, 55 (75.34%) were P. vivax and 18 (24.66%) were P. falciparum. The prevalence of thrombocytopenia among malaria patients (79.5%) was significantly higher than those in malaria negative acute febrile patients (13.7%),

P

< 0.001. About 67% malaria-infected patients had mild to moderate thrombocytopenia and 12.3% had severe thrombocytopenia. The ROC analysis demonstrated platelet counts <150,000/μl as an optimal cutoff value with 0.893 area under the curve, 79.5% sensitivity, 86.3% specificity, 95.3% negative predictive value, and 54.7% positive predictive value to predict malaria. Conclusion. Malaria is still among the major public health problems in the country. Thrombocytopenia is a very good discriminatory test for the presence or absence of malaria with 79.5% sensitivity and 86.3% specificity. Therefore, this may be used in addition to the clinical and microscopic parameters to heighten the suspicion of malaria.
Incidence and Factors Associated with Postoperative Delayed Hyponatremia after Transsphenoidal Pituitary Surgery: A Meta-Analysis and Systematic Review
Authors: Lee Cheng-Chi , Wang Yu-Chi , Liu Yu-Tse , Huang Yin-Cheng , Hsu Peng-Wei , Wei Kuo-Chen , Chen Ko-Ting , Lin Ya-Jui , Chuang Chi-Cheng 
Published: April 2021

Introduction. Postoperative delayed hyponatremia is a complication associated with transsphenoidal pituitary surgery. Due to a wide spectrum of symptoms, the reported incidence and predictors of postoperative delayed hyponatremia vary among studies, and this deserves to be reviewed systematically. Methods. PubMed, EMBASE, and CENTRAL databases were searched until September 1, 2020. Studies were included when (1) the event number of delayed hyponatremia after transsphenoidal pituitary surgery was reported, or (2) the associated factors of such complication were evaluated. Results. A total of 27 studies were included for meta-analysis. The pooled incidence of overall and symptomatic delayed hyponatremia was 10.5% (95% confidence interval (CI) = 7.4–14.7%) and 5.0% (95% CI = 3.6–6.9%), respectively. No overt variations of the pooled estimates were observed upon subgroups stratified by endoscopic and microscopic procedure, publication year, and patients’ age. In addition, 44.3% (95% CI = 29.6–60.2%) of unplanned hospital readmissions within 30 days were caused by delayed hyponatremia. Among the predictors evaluated, older age was the only significant factor associated with increased delayed hyponatremia (odds ratio = 1.16, 95% CI = 1.04–1.29,

P

= 0.006). Conclusion. This meta-analysis and systematic review evaluated the incidence of postoperative delayed hyponatremia and found it as a major cause of unplanned readmissions after transsphenoidal pituitary surgery. Older patients are more prone to such complications and should be carefully followed. The retrospective nature and heterogeneity among the included studies and the small number of studies used for risk factor evaluation might weaken the corresponding results. Future prospective clinical studies are required to compensate for these limitations.
The Diagnostic Value of Serum Gastrin-17 and Pepsinogen for Gastric Cancer Screening in Eastern China
Authors: Shen Hongzhang , Xiong Kangwei , Wu Xiangyu , Cheng Sile , Lou Qifeng , Jin Hangbin , Zhang Xiaofeng 
Published: April 2021

Objective. To evaluate the diagnostic value of gastrin-17 (G-17) and pepsinogen (PG) in gastric cancer (GC) screening in China, especially eastern China, and to determine the best diagnostic combination and threshold (cutoff values) to screen out patients who need gastroscopy. Methods. The serum concentrations of G-17 and pepsinogen I and II (PGI and PGII) in 834 patients were analyzed, and the PGI/PGII ratio (PGR) was calculated. According to pathological results, patients can be divided into chronic nonatrophic gastritis (NAG)/chronic atrophic gastritis (CAG)/intraepithelial neoplasia (IN)/GC groups. The differences in G-17, PG, and PGR in each group were analyzed, and their values in GC diagnosis were evaluated separately and in combination. Results. There were differences in serum G-17, PGII, and PGR among the four groups (NAG/CAG/IN/GC) (

P
≤
0.001

). In total, 54 GC cases were diagnosed, of which 50% were early GC. There was no significant difference in the PGI levels among the four groups (

P
=
0.377

). NAG and CAG composed the chronic gastritis (CG) group. The G-17 and PGII levels in the IN and GC groups were higher than those in the CG group (both

P
≤
oth

C

), while the PGR levels were lower (

P
≤
lower

). When distinguishing NAG from CAG, the best cutoff value for G-17 was 9.25 pmol/L, PGII was 7.06 μg/L, and PGR was 12.07. When distinguishing CG from IN, the best cutoff value for G-17 was 3.86 pmol/L, PGII was 11.92 μg/L, and PGR was 8.26. When distinguishing CG from GC, the best cutoff value for G-17 was 3.89 pmol/L, PGII was 9.16 μg/L, and PGR was 14.14. The sensitivity, specificity, accuracy, and positive and negative predictive values of G-17/PGII/PGR for GC diagnosis were 83.3%/70.4%/79.6%, 51.8%/56.3%/47.8%, 53.8%/57.2%/49.9%, 10.7%/10.9%/9.6%, and 97.8%/96.5%/97.1%, respectively. The sensitivity, specificity, accuracy, and positive predictive and negative predictive values of PGII/G-17 vs. PGR/G-17 vs. PGR/PGII in the diagnosis of GC were 63.0% vs. 70.4% vs. 64.8%, 70.5% vs. 70.1% vs. 60.4%, 70.0% vs. 70.1% vs. 60.7%, 12.9% vs. 14.0% vs. 10.2%, and 96.5% vs. 97.2% vs. 96.1%, respectively. Conclusion. The PGII and G-17 levels in patients with gastric IN and GC were significantly increased, while the serum PGR level was significantly decreased. Serological detection is effective for screening GC. The combination of different markers can improve the diagnostic efficiency. The highest diagnostic accuracy was G-17 combined with PGR, and the best cutoff values were

G
−
17
>
3.89

pmol
/
L

and

PGR
<
14.14

.
MAP3K7 Loss Drives Enhanced Androgen Signaling and Independently Confers Risk of Recurrence in Prostate Cancer with Joint Loss of CHD1
Authors: Jillson Lauren K. , Rider Leah C. , Rodrigues Lindsey U. , Romero Lina , Karimpour-Fard Anis , Nieto Cera , Gillette Claire , Torkko Kathleen , Danis Etienne , Smith Elizabeth E. , Nolley Rosalie , Peehl Donna M. , Lucia M. Scott , Costello James C. , Cramer Scott D. 
Published: April 2021

Abstract

Prostate cancer genomic subtypes that stratify aggressive disease and inform treatment decisions at the primary stage are currently limited. Previously, we functionally validated an aggressive subtype present in 15% of prostate cancer characterized by dual deletion of MAP3K7 and CHD1. Recent studies in the field have focused on deletion of CHD1 and its role in androgen receptor (AR) chromatin distribution and resistance to AR-targeted therapy; however, CHD1 is rarely lost without codeletion of MAP3K7. Here, we show that in the clinically relevant context of co-loss of MAP3K7 and CHD1 there are significant, collective changes to aspects of AR signaling. Although CHD1 loss mainly impacts the expansion of the AR cistrome, loss of MAP3K7 drives increased AR target gene expression. Prostate cancer cell line models engineered to cosuppress MAP3K7 and CHD1 also demonstrated increased AR-v7 expression and resistance to the AR-targeting drug enzalutamide. Furthermore, we determined that low protein expression of both genes is significantly associated with biochemical recurrence (BCR) in a clinical cohort of radical prostatectomy specimens. Low MAP3K7 expression, however, was the strongest independent predictor for risk of BCR over all other tested clinicopathologic factors including CHD1 expression. Collectively, these findings illustrate the importance of MAP3K7 loss in a molecular subtype of prostate cancer that poses challenges to conventional therapeutic approaches.

Implications:
These findings strongly implicate MAP3K7 loss as a biomarker for aggressive prostate cancer with significant risk for recurrence that poses challenges for conventional androgen receptor–targeted therapies.