bluuebunny/crossref_metadata_2025_split huggingface dataset:
Reactive Oxygen Species Scavenger in Acute Intracerebral Hemorrhage Patients
Authors: Kim Moinay , Byun Joonho , Chung Yeongu , Lee Si Un , Park Ji Eun , Park Wonhyoung , Park Jung Cheol , Ahn Jae Sung , Lee Seungjoo 
Published: February 2021

Background and Purpose:
Patients with intracerebral hemorrhage (ICH) have oxidative stress. Oxidative stress contributes to the development and progression of perihematomal edema (PHE) in brain hemorrhage patients. We hypothesized that reactive oxygen species (ROS) scavengers might have a neuroprotective role in the acute period of patients with ICH.

Methods:
This prospective, multicenter, single-blind, randomized study was conducted between June 2017 and October 2019. Intracranial bleeding, including spontaneous ICH, secondary ICH due to vascular anomalies, venous thrombosis, neoplasms, or hemorrhagic infarction, were included in our study. These ROS scavengers were given for 14 days with a dose of N-acetylcysteine 2000 mg/d and selenium 1600 µg/d intravenously. Other patients received a placebo. The primary outcome was hemorrhage and PHE volume changes in 2-week follow-up computed tomography between ROS scavenger versus placebo groups.

Results:

In total, 448 patients were enrolled with 123 patients remaining after applying the inclusion and exclusion criteria. There were no significant differences in baseline characteristics between the ROS scavenger (n=57) and placebo (n=66) groups. No significant differences in baseline hematoma and PHE volumes were observed but 2 weeks follow-up computed tomography showed significant differences in PHE volume (21.90±17.63 versus 30.66±32.35,
P
<0.01) and PHE ratio (1.19±0.73 versus 2.05±1.27,
P
<0.01). Among clinical factors, time to reach target Richmond Agitation Sedation Scale (5.98 hours [95% CI, 4.82–7.241 versus 8.42 hours], [95% CI, 6.57–10.77],
P
<0.01) and the length of intensive care unit stays (6.46 days [95% CI, 2.38–10.55 versus 12.66 days], [95% CI, 8.47–16.85],
P
<0.01) were significantly shortened among patients who received ROS scavengers than among patients who did not receive ROS scavenger.

Conclusions:
ROS scavenger showed a significantly reduced PHE volume, time to reach target Richmond Agitation Sedation Scale, and shortened length of intensive care unit stay in patients with acute ICH. Early and high doses of ROS scavengers in a combination regimen may have played a key role in obtaining a favorable outcome in our study.

Registration:

URL:
https://cris.nih.go.kr/cris/en
; Unique identifier: KCT0004628.
Can Technology Transform Communication Between Schools, Teachers, and Parents? Evidence from a Randomized Field Trial
Authors: Kraft Matthew A. , Bolves Alexander J. 
Published: February 2021

Abstract
We study the adoption and implementation of a new mobile communication application (app) among a sample of 132 New York City public schools. The app provides a platform for sharing general announcements and news, as well as engaging in personalized two-way communication with individual parents. We provide participating schools with free access to the app and randomize schools to receive intensive support (training, guidance, monitoring, and encouragement) for maximizing the efficacy of the app. Although user supports led to higher levels of communication within the app in the treatment year, overall usage remained low and declined in the following year when treatment schools no longer received intensive supports. We find few subsequent effects on perceptions of communication quality or student outcomes. We leverage rich internal user data to explore how take-up and usage patterns varied across staff and school characteristics. These analyses help to identify early adopters and reluctant users, revealing both opportunities and obstacles to engaging parents through new communication technology.
Simulation of the Water Table Elevation in Shallow Unconfined Aquifers by means of the ERA5 Soil Moisture Dataset: The Umbria Region Case Study
Authors: Cerlini Paolina Bongioannini , Silvestri Lorenzo , Meniconi Silvia , Brunone Bruno 
Published: February 2021

AbstractThis paper concerns the simulation of the water table elevation in shallow unconfined aquifers where infiltration is assumed as the main mechanism of recharge. The main aim is to provide a reliable tool for groundwater management that satisfies water supply managers. Such a tool is a candidate as a physically based alternative to the use of empirical methods or general circulation models. It is based on the use of two widely available sets of data: the water table elevation measurements and soil moisture time series. In fact, the former are usually provided by government agencies on public websites whereas the latter are included in the atmospheric global datasets (reanalysis). It is notable that data from reanalysis are accessible to any citizen and organization around the world on an open-access basis (e.g., Copernicus). In the proposed method, the measured water table elevations are correlated quantitatively with the water fluxes toward the aquifer evaluated using the soil moisture data from ERA5 reanalysis (provided by ECMWF) within a Richards equation–based approach. The analysis is executed using data from the Umbria region (Italy) on both a daily and monthly scale. In fact, these are the time intervals of interest for a proper management of groundwater resources. The proposed relationships include both a logarithmic and linear term and point out the possible different regimes of the shallow aquifers with regard to the recharge due to infiltration. These different mechanisms reflect in the different role played by the water fluxes toward the aquifer in terms of water table elevation changes according to the considered time scale.
Seasonal, Interannual, and Interdecadal Variations of the East Asian Summer Monsoon: A Diurnal-Cycle Perspective
Authors: Chen Guixing , Du Yu , Wen Zhiping 
Published: February 2021

AbstractThis study revisits the long-term variabilities of the East Asian summer monsoon (EASM) in 1958–2017 through examination of diurnal cycles. We group monsoon days into four dynamic quadrants (Q1 to Q4), with emphasis on the strong daily southerlies coupled with a large (Q1) or small (Q4) diurnal amplitude over Southeast China. The occurrence day of Q1 increases in June–July with the seasonal progress of the EASM. It is most pronounced in the 1960s to the 1970s and declines to the lowest in the 1980s to the 1990s, whereas the Q4 occurrence increases notably from the 1970s to the 1990s; both groups return to normal in recent years. The interdecadal decrease (increase) of Q1 (Q4) occurrence corresponds well to the known weakening of EASM in the twentieth century, and it also coincides with the rainfall anomalies over China shifting from a “north flooding and south drought” to a “north drought and south flooding” mode. The rainfall under Q1 (Q4) can account for ~60% of the interannual variance of summer rainfall in northern (southern) China. The contrasting effects of Q1 and Q4 on rainfall are due to their remarkably different regulation on water vapor transport and convergence. The interannual/interdecadal variations of Q1 (Q4) occurrence determine the anomalous water vapor transports to northern (southern) China, in association with the various expansion of the western Pacific subtropical high. In particular, Q1 conditions can greatly intensify nighttime moisture convergence, which is responsible for the long-term variations of rainfall in northern China. The results highlight that the diurnal cycles in monsoon flow act as a key regional process working with large-scale circulation to regulate the spatial distributions and long-term variabilities of EASM rainfall.
Role of Short-Term Neoadjuvant Chemoradiotherapy for Potentially Resectable Pancreatic Cancer
Authors: Okano Keiichi , Suto Hironobu , Oshima Minoru , Ando Yasuhisa , Matsukawa Hiroyuki , Kamada Hideki , Kobara Hideki , Masaki Tsutomu , Suzuki Yasuyuki 
Published: February 2021

Although the efficacy of neoadjuvant therapies for pancreatic cancer (PDAC) is reported in recent years, ideal neoadjuvant treatment for patients with potentially resectable (R) PDAC remains uncertain. We conducted the retrospective study about the effect of short-term neoadjuvant chemoradiotherapy (sNACRT) on R PDAC. The 94 patients received curative intent pancreatectomy for R PDAC between 2000 and 2016. Among them, 31 patients received sNACRT (S1 60 mg/m2/day for 2w and RTx 30 Gy/2w). Clinical outcomes of the 31 patients with sNACRT were analyzed in comparison with 63 patients without sNACRT. The 1-, 3-, and 5-year overall survival (OS) rates were 93, 71, and 62% in the patients with sNACRT and 78, 35, and 26% in the patients without sNACRT ( P = .0007), respectively. Lymph node metastasis was found in 41.9% of patients with sNACRT and 56.5% of patients without sNACRT ( P = .09). Microscopic tumor infiltration at resection margins (R1) was found in no patient with sNACRT and 5 patients (7.9%) without sNACRT ( P=.042). Retropancreatic infiltration ( P = .04), lymphatic invasion ( P = .002), plexus invasion ( P = .042), and main pancreatic duct extension ( P = .004) were significantly fewer in patients with sNACRT than the patients without sNACRT. The recurrences were found in 64% of patients with sNACRT (39% distant, 16% local, and 10% mix pattern) and 68% in patients without sNACRT (28% distant, 21% local, and 19% mix pattern). The recurrence patterns were significantly different ( P = .008) between the groups. Short-term neoadjuvant chemoradiotherapy decreased R1 resection rate and improved OS. Short-term neoadjuvant chemoradiotherapy may provide ideal local control during the short term and improve clinical outcome of R PDAC.
Advanced Endoscopic Evaluation of Gastroesophageal Reflux Disease in Morbidly Obese Patients in a Rural Setting
Authors: Fanous Medhat , Wei Wei , Lorenson David , Gould Jamison 
Published: February 2021

Introduction Obesity is a known risk factor for gastroesophageal reflux disease (GERD). Morbidly obese patients in rural areas are usually referred to the local surgeon for endoscopic evaluation. This situation poses significant challenges given the increased risk for perioperative complications due to anatomical and metabolic factors. This study aims to evaluate the safety of performing GERD diagnostic workup studies in a rural setting. Methods Institutional review board approval was obtained for a retrospective chart review of patients who presented with GERD symptoms to a rural antireflux clinic between August 2015 and October 2020. Patients were included if their body mass index (BMI) was over 35 with comorbidities or over 40 kg/m2 who underwent upper gastrointestinal endoscopy with or without concomitant placement of wireless pH probe and/or functional luminal imaging probe. Results A total of 117 patients met the inclusion criteria. There were 94 (80.3%) females and 23(19.7%) males. The average age was 56.0 ± 13.4 years. The average BMI was 40.4 (35-66.4). Proton pump inhibitor use was noted in 97/117 (82.9%) with an average duration of 12.0 ± 9.2 years. The average GERD-Health Related Quality of Life, Reflux Symptom Index and GERD Symptom Score (GERSS) were 29.8 ± 20, 24.5 ± 14.2 and 21.3 ± 15.4 respectively. There were no procedural complications. All the endoscopic examinations were successfully completed and patients were discharged. Conclusion Performing diagnostic studies for GERD for morbidly obese patients in critical access hospitals is safe. Patient selection, proper training and adequate preparation are critical prerequisites for good outcomes.
Current Status of Handheld Otoscopy Training: A Systematic Review
Authors: Frithioff Andreas , Guldager Mads Juhl , Andersen Steven Arild Wuyts 
Published: February 2021

Objective: Otoscopy is a frequently performed procedure and competency in this skill is important across many specialties. We aim to systematically review current medical educational evidence for training of handheld otoscopy skills. Methods: Following the PRISMA guideline, studies reporting on training and/or assessment of handheld otoscopy were identified searching the following databases: PubMed, Embase, OVID, the Cochrane Library, PloS Medicine, Directory of Open Access Journal (DOAJ), and Web of Science. Two reviewers extracted data on study design, training intervention, educational outcomes, and results. Quality of educational evidence was assessed along with classification according to Kirkpatrick’s model of educational outcomes. Results: The searches yielded a total of 6064 studies with a final inclusion of 33 studies for the qualitative synthesis. Handheld otoscopy training could be divided into workshops, physical simulators, web-based training/e-learning, and smartphone-enabled otoscopy. Workshops were the most commonly described educational intervention and typically consisted of lectures, hands-on demonstrations, and training on peers. Almost all studies reported a favorable effect on either learner attitude, knowledge, or skills. The educational quality of the studies was reasonable but the educational outcomes were mostly evaluated on the lower Kirkpatrick levels with only a single study determining the effects of training on actual change in the learner behavior. Conclusion: Overall, it seems that any systematic approach to training of handheld otoscopy is beneficial in training regardless of learner level, but the heterogeneity of the studies makes comparisons between studies difficult and the relative effect sizes of the interventions could not be determined.
The Early Impact of COVID-19 on Textile Industry: An Empirical Analysis
Authors: Kaur Kiranpreet 
Published: February 2021

The COVID-19 pandemic has exposed the economy to immense distress, ruptured multiple systems and left the economy out of breath. The present study has made an exploratory attempt to unleash the business-related issues faced by the textile entrepreneurs of India (Punjab) due to COVID-19. The data were collected from 123 entrepreneurs from the textile industry in Punjab. Factor analysis and regression analysis have been used for the purpose of analysis. It was found that the major business-related issues faced by entrepreneurs due to COVID-19 include the radical effect on the working capital of the business and on future marketing campaigns to seek new orders. However, the majority of them were found to be digitally equipped to accept digital know-how instantly and grabbed opportunities by manufacturing N95 masks and personal protective equipment (PPE). The present study is a maiden attempt to unleash the early impact of COVID-19 on the textile industry in Punjab. JEL Codes: E30, E32, L26
Perceived environmental supports for fruit and vegetable consumption among older adults in the US
Authors: Jiang Qianzhi , Francis Sarah L. , Chapman-Novakofski Karen M. , Wilt McKenzie , Carbone Elena T. , Cohen Nancy L. 
Published: February 2021

Background: The physical and social environments surrounding food, whether perceived or observed, can influence consumers’ food choices by changing food access, and affordability, or by changing settings where food-related behaviors occur. Aim: To describe older adults’ perceived food environment, identify the most important sites and factors that enable healthy eating, and explore older adults’ recommendations for communities to facilitate fruit and vegetable consumption. Methods: Participants aged 60 and older from metropolitan areas in Massachusetts, Iowa, and Illinois completed a researcher-administered survey to rate the perceived environment including accessibility, availability, and affordability of fruits and vegetables, and perceived importance of factors and establishments related to fruit and vegetable consumption. Participants also suggested changes for establishments to facilitate fruit and vegetable consumption. Results: The majority of the 142 participants perceived their food environment for fruits and vegetables as not difficult to access (85.2%) with good or excellent availability (90.1%). Education, marital status, and race were associated with some aspects of the perceived food environment. Perceived accessibility and supermarkets were rated as the most important factor and establishment, respectively, to facilitate fruit and vegetable consumption across all study sites. Participants proposed recommendations to address the availability, quality, accessibility and affordability of fruits and vegetables. Conclusion: Interventions promoting accessible, affordable, quality fruits and vegetables may improve older adult consumers’ perceptions of their food environment. Communities may also use undervalued resources such as mobile markets more strategically to provide additional support for healthy eating in older adults.
Educational Intervention Reduced Family Medicine Residents’ Intention to Request Diagnostic Tests: Results of a Controlled Trial
Authors: Schneider Antonius , Bühner Markus , Herzog Therese , Laverty Siona , Ziehfreund Stefanie , Hapfelmeier Alexander , Schneider Dagmar , Berberat Pascal O. , Roos Marco ,   for the Bavarian Competence Center for Residency Training (BCCRT) Network
Published: February 2021

Objective Dealing with uncertainty is a core competence for physicians. To evaluate the impact of an educational intervention on family medicine residents’ (FMRs’) intention to request diagnostic tests and their attitudes toward uncertainty. Methods Nonrandomized controlled trial. Intervention group (IG) FMRs participated in interactive “dealing with uncertainty” seminars comprising statistical lessons and diagnostic reasoning. Control group (CG) FMRs participated in seminars without in-depth diagnostic lessons. FMRs completed the Dealing with Uncertainty Questionnaire (DUQ), comprising the Diagnostic Action and Diagnostic Reasoning scales. The Physicians’ Reaction to Uncertainty (PRU) questionnaire, comprising 4 scales (Anxiety Due to Uncertainty, Concern about Bad Outcomes, Reluctance to Disclose Uncertainty to Patients, and Reluctance to Disclose Mistakes to Physicians) was also completed. Follow-up was performed 3 months later. Differences were calculated with repeated-measures analysis of variance. Results In total, 107 FMRs of the IG and 102 FMRs of the CG participated at baseline and follow-up. The mean (SD) Diagnostic Action scale score decreased from 24.0 (4.8) to 22.9 (5.1) in the IG and increased in the CG from 23.7 (5.4) to 24.1 (5.4), showing significant group difference ( P = 0.006). The Diagnostic Reasoning scale increased significantly ( P = 0.025) without a significant group difference ( P = 0.616), from 19.2 (2.6) to 19.7 (2.4) in the IG and from 18.1 (3.3) to 18.8 (3.2) in the CG. The PRU scale Anxiety Due to Uncertainty decreased significantly ( P = 0.029) without a significant group difference ( P = 0.116), from 20.5 (4.8) to 18.5 (5.5) in the IG and from 19.9 (5.5) to 19.0 (6.0) in the CG. Conclusion The structured seminar reduced self-rated diagnostic test requisition. The change in Anxiety Due to Uncertainty and Diagnostic Reasoning might be due to an unspecific accompanying effect of the extra-occupational seminars for residents.
Isolated cerebellar progressive multifocal leukoencephalopathy after allogeneic bone marrow transplantation: focus on imaging
Authors: Mazzai Linda , Facchinelli Davide , Borghero Carlo , Vitale Valerio , Ruggeri Marco , Iannucci Giuseppe 
Published: February 2021

Introduction: Progressive multifocal leukoencephalopathy (PML) is caused by JC virus opportunistic infection in the setting of immunodeficiency. Typical imaging features are multifocal and asymmetric lesions within supratentorial subcortical white matter in parieto-occipital regions. Case description: A 47-year-old patient experienced a relapse of acute myeloid leukemia 21 months after hematopoietic stem cell transplantation. He also had visual impairment and magnetic resonance imaging showed an isolated cerebellar lesion without mass effect or enhancement. Common opportunistic infections and leukemic central nervous system involvement were excluded by cerebrospinal fluid (CSF) analysis. Given the worsening clinical and radiologic scenario, PML was suspected, and CSF protein chain reaction analysis was positive for JC virus. Conclusions: Given its potential curability, PML should be thoroughly investigated in patients with hematologic neoplasms and atypical isolated cerebellar presentation.
Cotrimoxazole prophylaxis prevents major infective episodes in patients with systemic lupus erythematosus on immunosuppressants: A non-concurrent cohort study
Authors: Ganu Salil A , Mathew Ashish J , Nadaraj Ambily , Jeyaseelan L , Danda Debashish 
Published: February 2021

Background Prophylactic trimethoprim-sulfamethoxazole (TMP-SMX) prevents pneumocystis jirovecii infection in SLE on immunosuppression. Its role in preventing other major infections in immuno suppressed SLE patients is unknown. Methods A non-concurrent cohort study was conducted on patients of SLE fulfilling SLICC and/or ACR 1997 criteria, who received tapering dose of steroid starting with ≥0.5 mg/kg/day of prednisolone or equivalent dose of deflazacort and mycophenolate mofetil ≥1 g/day (or equivalent dose of mycophenolate sodium) at least for the preceding 1 year. Interviewing patients & documenting relevant data from hospital electronic Medical records (EMR), followed by comparison of Incidence densities of major infections between those on prophylactic Trimethoprim 160 mg + Sulfamethoxazole 800 mg and those not on it, was done by student ‘t’ test. Multivariate logistic regression was performed for independent risk of any major infection between the two groups. Results Of 228 patients, 162 did not receive TMP-SMX prophylaxis, and 66 had received. The incidence density of major infection was found to be significantly lower in TMP-SMX group (1.25 per 100 person year) as compared to those not on TMP-SMX group (11.201 per 100 person year); P < 0.001 (95% CI 0.027 – 0.449) and odds ratio of 0.03 (CI 0 – 0.24). Conclusion Cotrimoxazole prophylaxis in SLE patients on immunosuppression prevents major infections.
Confidence of psychiatry trainees in meeting the needs of borderline personality disorder in comparison with schizophrenia
Authors: Nithianandan Mithira , Heidari Parvaneh , Broadbear Jillian , Rao Sathya 
Published: February 2021

Objective: Borderline personality disorder (BPD) and schizophrenia are both serious and chronic mental health conditions of similar prevalence. This study was designed to assess trainees’ confidence in the assessment, management and treatment of BPD in comparison with schizophrenia. Methods: A survey was used to assess psychiatry trainees’ confidence and experience of training with regard to managing BPD and schizophrenia. Results: Eighty-two psychiatry trainees completed the survey. Overall, confidence scores of respondents with respect to BPD were significantly lower in comparison with schizophrenia. Trainees reported a preference for working with patients with schizophrenia compared with BPD. Respondents reported receiving less adequate supervision and training in the assessment, management and treatment of BPD than for schizophrenia. Conclusions: The results suggest an urgent need to enhance training and supervision in skills related to the diagnosis, management and treatment of BPD, with a greater focus on psychotherapy to improve trainee psychiatrists’ confidence in working with people diagnosed with BPD.