bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Impact of COVID-19 on the Socio-economic Indicators of the Selected Asian Countries
Authors: Babshetti Vaijanath , Singh Jyothi E. , Yaragol Prakash B. 
Published: December 2021

The COVID-19 pandemic originated in Wuhan, China, in December 2019. The virus has spread across the globe over the last 20 months. In the interest of public health, the World Health Organization (WHO) has declared a public health emergency to harmonise international responses to the virus. In a strongly interconnected world, the effect of the pandemic goes beyond mortality and morbidity. The unprecedented outbreak of COVID-19 has also resulted in a global economic crisis. Almost every sector of the economy has been gravely affected by the pandemic to various degrees. In an attempt to curb the spread of the virus many countries have initiated measures such as lockdowns, travel restrictions, ban on public and private transportation, closure of schools and colleges and restrictions on public and social gatherings. These initiatives have led to the decline in GDP, foreign trade and foreign exchange reserves, the rise of unemployment, the crash of stock markets and the depreciation of national currencies among other things. This study assesses the impact of COVID-19 on selected macroeconomic parameters of various Asian countries to present insights on the economic and health crisis caused due to COVID-19. The study analyses the effect of the pandemic on the macroeconomic factors listed above as well as the human cost of the pandemic during the last 20 months. The research finds that the outbreak adversely affected the economy and lives of people in India when compared to selected Asian nations.
The case for continuity of care for people with chronic obstructive pulmonary disease
Authors: Medves Jennifer , Pare Genevieve , Woodhouse Kimberly , Smith-Romeril Carol , Li Wenbin , Tranmer Joan 
Published: December 2021

Introduction Continuity of care by family physicians in primary care settings may play a role in reducing health resource utilization and improving clinical outcomes and satisfaction of patients with chronic obstructive pulmonary disease. Clear evidence on the impact of continuity of care will support clinical programing and integration of services across health settings. Methods The association between continuity of care and unplanned health service utilization in persons with a diagnosis of chronic obstructive pulmonary disease in a rural region in Ontario, Canada was evaluated. A retrospective cohort study was conducted using population-level health administrative data. The main exposure variable was continuity of care. Results A continuity of care index was calculated for patients with at least five visits to a healthcare provider during the 5-year follow-up period ( n  =  40,033). Higher continuity of care ( n  =  20,008) and lower continuity of care ( n  =  20,025), based on the median continuity of care score were calculated. Patients with lower continuity of care had an increased adjusted relative risk of 2.12 (2.08, 2.33) of an emergency department visit, 2.81 (2.72, 2.9) risk of hospitalization, and 3.52 (3.24, 3.82) of being readmitted to hospital compared to those with higher continuity of care. Discussion An association between continuity of care and unplanned health services utilization, where a lower use of unplanned health services was observed in the cohort of patients with chronic obstructive pulmonary disease experiencing higher continuity of care. Continuity of care makes philosophical and social sense in that care is provided by a known provider to a known patient and unnecessary investigations can be avoided.
Managing the economic challenges in the treatment of heart failure
Authors: Piña Ileana L. , Allen Larry A. , Desai Nihar R. 
Published: December 2021

Abstract
Background
Treatment of heart failure is complex and inherently challenging. Patients traverse multiple practice settings as inpatients and outpatients, often resulting in fragmented care. The Center for Medicare and Medicaid Services is implementing payment programs that reward delivery of high-quality, cost-effective care, and one of the newer programs, the Bundled Payment for Care Improvement Advanced program, attempts to improve the coordination of care across practices for a hospitalization episode and post-acute care. The quality and cost of care contribute to its value, but value may be defined in different ways by different entities.

Conclusions
The rapidly changing world of digital health may contribute to or detract from the quality and cost of care. Health systems, payers, and patients are all grappling with these issues, which were reviewed at a symposium at the Heart Failure Society of America conference in Philadelphia, Pennsylvania on September 14, 2019. This article constitutes the proceedings from that symposium.
A case of anterior persistent hyperplastic primary vitreous associated with morning glory disc anomaly and retinopathy of prematurity like retinopathy in a term-born child
Authors: Zhang Hao , She Kaiqin , Lu Fang 
Published: December 2021

Abstract
Background
Association of morning glory disc anomaly (MGDA) with persistent hyperplastic primary vitreous (PHPV) has been reported earlier. Retinopathy of prematurity (ROP) like retinopathy in preterm babies with optic disc anomalies has also been published. Our case is unique in terms of presence MGDA, PHPV, unilateral ROP like retinopathy in a term infant with normal birth weight.

Case presentation
A 5-month-old girl, born at term with a birth weight of 3750 g, presented with anterior PHPV, MGDA and ROP like retinopathy. In order to prevent retinal detachment, she received 360 degree barrage laser photocoagulation at the edge of the optic disc excavation of the left eye. In the follow-up a month later, laser scars were found in her left fundus without other complications.

Conclusion
PHPV and MGDA with ROP like retinopathy in term and normal weight baby is rare. The peripheral avascular retinal area, caused by the dragging of the defected optic disc, might have been more vulnerable to the oxygen change after birth which resulted in ROP like retinopathy. High sensitivity to oxygen results in a series of changes such as upregulation of VEGF and IGF-1 may cause ROP-like retinopathy.
Congenital orbital teratoma: a case report with preservation of the globe and 18 years of follow-up
Authors: Tsoutsanis Panagiotis A. , Charonis George C. 
Published: December 2021

Abstract
Background
Congenital orbital teratomas are extremely rare, usually benign neoplasms, comprised of cells originating from all three germ cell layers. Clinically the tumor appears solid, most of the times is intraconal and presents as a rapidly growing mass leading to a massive unilateral axial proptosis, chemosis, exposure keratopathy, markedly distended eyelids and often, loss of vision. To prevent these complications, tumor excision usually involves enucleation or even orbital exenteration.

Case presentation
We report a case of a 1-day old infant who presented with dramatic proptosis at birth due to a true congenital orbital teratoma. We describe the clinical findings, the preoperative neuroimaging, the surgical management which included complete tumor resection with preservation of the globe to allow for optimal orbital growth, the histopathological evaluation, and the clinical course during 18 years of follow up.

Conclusion
Every effort to salvage the globe should be made to achieve the best possible orbito-facial development. Furthermore, the value of prompt surgical management with a less invasive transconjunctival globe sparing procedure can be appreciated in our case.
Acute liver failure caused by Amanita verna: a case series and review of the literature
Authors: Wu Jianlong , Gong Xueyi , Hu Zemin , Sun Qiang 
Published: December 2021

Abstract
Background
Amanita verna is one of the most harmful wild fungi in China. Amanita verna poisoning occurs every year, and the mortality is as high as 50%. However, its clinical manifestations are complex and diverse.

Case presentation
In March 2019, three patients took a large amount of Amanita, and one of them received liver transplantation in Zhongshan hospital, Sun Yat-sen University. All patients had vomiting and diarrhea 8–12 h after eating wild mushrooms (Amanita). The patients were initially diagnosed with Amanita poisoning. One case (case 3) was complicated and diagnosed as mushroom poisoning (fatal Amanita), toxic hepatitis, acute liver failure, toxic encephalopathy, hemorrhagic colitis, toxic myocarditis, disseminated intravascular coagulation (DIC) and pregnancy. The general clinical data of all patients were recorded, who received early treatment such as hemodialysis, artificial liver plasma exchange, hormone shock and anti-infection. One case (case 1) recovered smoothly after liver transplantation, and the indexes of liver, kidney, coagulation function and infection were improved. The other two cases died of intracerebral hemorrhage.

Conclusion
Liver transplantation is an effective method for the treatment of acute liver failure caused by mushroom poisoning and can improve the survival rate of patients with toxic liver failure.
Self-administered succus entericus reinfusion before ileostomy closure improves short-term outcomes
Authors: Liu Zhen , Fang Liang , Lv Liang , Niu Zhaojian , Hou Litao , Chen Dong , Zhou Yanbing , Guo Dong 
Published: December 2021

Abstract
Objective
The study aims to assess whether reinfusion of succus entericus prior to ileostomy closure can decrease postoperative length of stay and ameliorate low anterior resection score.

Methods
This study is a retrospective analysis based on prospectively collected data. Patients were screened from May 2016 to November 2019. A total of 30 patients who underwent reinfusion with succus entericus (SER) were enrolled in the SER group and 42 patients without SER were enrolled in the non-SER group.

Results
There was no significant difference in the incidence of postoperative ileus between succus entericus reinfusion (SER) group and the control group. Time to first passage of flatus or stool after surgery in the SER group (27.9 ± 6.02 h) is significantly shorter than the control group (32.3 ± 6.26, hours p = 0.004). Compared with the control group (5.52 (4.0–7.0) days), postoperative length of stay in the SER group was 4.90 (3.0–7.0)days (p = 0.009). As for low anterior resection score(LARS), the SER group had a lower score 1 week after discharge than the control group (p = 0.034). However, 1 month after discharge, the LARS in the two groups had no significant difference.

Conclusions
Self-administered succus entericus reinfusion is a feasible prehabilitation management for outpatients and can improve better outcomes. Compared with non-reinfusion group, succus enterius reinfusion group displays significantly shorter time for gastrointestinal function recovery and postoperative hospital stay without increasing complication, and it can bring better quality of life in a short term.
Age at menarche, age at menopause, reproductive years and risk of fatal stroke occurrence among Chinese women: the Guangzhou Biobank Cohort Study
Authors: Hu Zhi-bing , Lu Ze-xiong , Zhu Feng 
Published: December 2021

Abstract
Background
The relationship between women’s reproductive characteristics and stroke events is unclear. We aimed to investigate age at menarche, age at menopause and number of reproductive years in relation to fatal stroke occurrence in the Guangzhou Biobank Cohort Study.

Methods
In total, 16,504 postmenopausal women without stroke, heart disease or a cancer history at baseline were included and followed up for a median of 12.0 years. After review of available records, 222 stroke deaths were recorded. Cox proportional hazards regression was used to assess the associations between the risk of fatal stroke occurrence and age at menarche, age at menopause and number of reproductive years.

Results
In the whole cohort, compared with those aged 15 years at menarche, an increased risk of fatal stroke among women at menarche showed respectively in those aged 12 years (aHR (adjusted hazard ratio) = 1.86, 95% confidence interval (CI) 0.96–3.60), aged 13 years (aHR = 1.69, 95% CI 0.98–2.92), aged 17 years (aHR = 1.83, 95% CI 1.10–3.05) and aged ≥ 18 years (aHR = 1.66, 95% CI 1.03–2.70), wherein the associations revealed an atypically U-shaped; similar U-shaped association to the cohort of postmenopausal women born before 1940 released a range of incremental risks of fatal stroke in women at menarche aged ≤ 12 years (aHR = 3.68, 95% CI 1.68–8.05), aged 13 years (aHR = 2.11, 95% CI 1.02–4.34), aged 14 years (aHR = 2.07, 95% CI 1.04), aged 17 years (aHR = 2.30, 95% CI 1.20–4.39) and aged 18 years (aHR = 2.50, 95% CI 1.37–4.57), respectively. Compared with menopausal women aged 51–52 years, those aged < 43 years at menopause had an increased risk for fatal stroke among postmenopausal women born in and after 1940 (aHR = 1.64, 95% CI 0.97–2.78) and postmenopausal women born before 1940 (aHR = 1.97, 95% CI 1.05–3.69). Additionally, compared with those with 32–34 reproductive years, women with ≤ 28 reproductive years had an increased risk for fatal stroke in the whole cohort (aHR = 1.91, 95% CI 1.28–2.86) and the cohort of postmenopausal women born before 1940 (aHR = 1.79, 95% CI 1.15–2.80).

Conclusions
Younger and older age at menarche, younger age at menopause and fewer reproductive ages were related to an increased risk of fatal stroke in postmenopausal women.
Group-based physical activity interventions for postpartum women with children aged 0–5 years old: a systematic review of randomized controlled trials
Authors: Peralta L. R. , Cotton W. G. , Dudley D. A. , Hardy L. L. , Yager Z. , Prichard I. 
Published: December 2021

Abstract
Background
It is estimated that less than one third of women (28%) worldwide, are not sufficiently active, and there is evidence indicating physical activity (PA) participation is lower during pregnancy and the postpartum period. Despite the importance of educating and encouraging postpartum women to engage in PA, existing systematic reviews have only focused on examining the impact of individually tailored PA interventions and on specific postpartum populations such as women who are inactive (i.e., do not meet PA recommendations) or women at risk of gestational diabetes mellitus or postnatal depression. This review aims to fill this gap by examining the impact of group-based PA interventions on postpartum women’s PA levels or other health behavior outcomes.

Methods
A systematic literature search was conducted using four electronic databases (MEDLINE, CINAHL, EMBASE and PsychInfo) of published studies between 1st January 2000 and 31st October 2020. Studies were included if they targeted postpartum women with no current health conditions, had children aged 0–5 years, and engaged postpartum women in a group-based PA program that reported PA or other health behavior outcomes. Out of a total of 1091 articles that were initially identified, six were included.

Results
Group-based PA interventions were moderately successful in changing or increasing postpartum women’s self-reported PA levels and psychological wellbeing in the first 2 years of their offspring’s life. Overall, group-based PA interventions were not successful in changing or increasing postpartum women’s objectively measured PA levels, but only one study objectively measured postpartum women’s PA levels. Narrative synthesis highlights the heterogeneity of the outcomes and methodologies used, and the low to medium risk of bias in the included studies.

Conclusion
To strengthen the evidence-base for group-based PA programs with postpartum women there is an on-going need for more rigorous randomised controlled trials of appropriate length (at least 3 months in duration) with an adequate dose of group-based PA sessions per week (to meet PA guidelines), and that utilise objective measures of PA. In addition, future PA interventions for this population should include, at the very least, fidelity and process data to capture the characteristics or design features that appeal most to postpartum women.
Ethical considerations for HIV remission clinical research involving participants diagnosed during acute HIV infection
Authors: Gilbertson Adam , Tucker Joseph D. , Dubé Karine , Dijkstra Maartje , Rennie Stuart 
Published: December 2021

AbstractHIV remission clinical researchers are increasingly seeking study participants who are diagnosed and treated during acute HIV infection—the brief period between infection and the point when the body creates detectable HIV antibodies. This earliest stage of infection is often marked by flu-like illness and may be an especially tumultuous period of confusion, guilt, anger, and uncertainty. Such experiences may present added ethical challenges for HIV research recruitment, participation, and retention. The purpose of this paper is to identify potential ethical challenges associated with involving acutely diagnosed people living with HIV in remission research and considerations for how to mitigate them. We identify three domains of potential ethical concern for clinicians, researchers, and ethics committee members to consider: 1) Recruitment and informed consent; (2) Transmission risks and partner protection; and (3) Ancillary and continuing care. We discuss each of these domains with the aim of inspiring further work to advance the ethical conduct of HIV remission research. For example, experiences of confusion and uncertainty regarding illness and diagnosis during acute HIV infection may complicate informed consent procedures in studies that seek to recruit directly after diagnosis. To address this, it may be appropriate to use staged re-consent procedures or comprehension assessment. Responsible conduct of research requires a broad understanding of acute HIV infection that encompasses its biomedical, psychological, social, and behavioral dimensions. We argue that the lived experience of acute HIV infection may introduce ethical concerns that researchers and reviewers should address during study design and ethical approval.
How to reveal disguised paternalism: version 2.0
Authors: Lynøe Niels , Engström Ingemar , Juth Niklas 
Published: December 2021

Abstract
Background
We aim to further develop an index for detecting disguised paternalism, which might influence physicians’ evaluations of whether or not a patient is decision-competent at the end of life. Disguised paternalism can be actualized when physicians transform hard paternalism into soft paternalism by questioning the patient’s decision-making competence.

Methods
A previously presented index, based on a cross-sectional study, was further developed to make it possible to distinguish between high and low degrees of disguised paternalism using the average index of the whole sample. We recalculated the results from a 2007 study for comparison to a new study conducted in 2020. Both studies are about physicians’ attitudes towards, and arguments for or against, physician-assisted suicide.

Results
The 2020 study showed that geriatricians, palliativists, and middle-aged physicians (46–60 years old) had indices indicating disguised paternalism, in contrast with the results from the 2007 study, which showed that all specialties (apart from GPs and surgeons) had indices indicating high degrees of disguised paternalism.

Conclusions
The proposed index for identifying disguised paternalism reflects the attitude of a group towards physician assisted suicide. The indices make it possible to compare the various medical specialties and age groups from the 2007 study with the 2020 study. Because disguised paternalism might have clinical consequences for the rights of competent patients to participate in decision-making, it is important to reveal disguised hard paternalism, which could masquerade as soft paternalism and thereby manifest in practice. Methods for improving measures of disguised paternalism are worthy of further development.
ECG signal classification based on deep CNN and BiLSTM
Authors: Cheng Jinyong , Zou Qingxu , Zhao Yunxiang 
Published: December 2021

AbstractBackgroundCurrently, cardiovascular disease has become a major disease endangering human health, and the number of such patients is growing. Electrocardiogram (ECG) is an important basis for {medical doctors to diagnose the cardiovascular disease, which can truly reflect the health of the heart. In this context, the contradiction between the lack of medical resources and the surge in the number of patients has become increasingly prominent. The use of computer-aided diagnosis of cardiovascular disease has become particularly important, so the study of ECG automatic classification method has a strong practical significance.MethodsThis article proposes a new method for automatic identification and classification of ECG.We have developed a dense heart rhythm network that combines a 24-layer Deep Convolutional Neural Network (DCNN) and Bidirectional Long Short-Term Memory (BiLSTM) to deeply mine the hierarchical and time-sensitive features of ECG data. Three different sizes of convolution kernels (32, 64 and 128) are used to mine the detailed features of the ECG signal, and the original ECG is filtered using a combination of wavelet transform and median filtering to eliminate the influence of noise on the signal. A new loss function is proposed to control the fluctuation of loss during the training process, and convergence mapping of the tan function in the range of 0–1 is employed to better reflect the model training loss and correct the optimization direction in time.ResultsWe applied the dataset provided by the 2017 PhysioNet/CINC challenge for verification. The experiment adopted ten-fold cross validation,and obtained an accuracy rate of 89.3$$\%$$%and an F1 score of 0.891.ConclusionsThis article proposes its own method in the aspects of ECG data preprocessing, feature extraction and loss function design. Compared with the existing methods, this method improves the accuracy of automatic ECG classification and is helpful for clinical diagnosis and self-monitoring of atrial fibrillation.