bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of injuries between US Army paratroopers and their non-paratrooper soldier counterparts
Authors: Hauschild Veronique D , Rappole C A , Forrest L J , Dada E O , Beymer M R , Grier T , Jones B H 
Published: July 2021

IntroductionMilitary studies have investigated acute injuries associated with parachute jumps, but the literature does not address paratroopers’ cumulative microtraumatic (CMT) injury risk, nor does it compare injury risks between paratroopers and the rest of the military population. This study determined whether US active duty Army paratroopers experienced greater injury risks than their non-paratrooper soldier counterparts and whether their injuries cost more to treat suggesting greater injury severity.MethodsThis retrospective study evaluated electronic medical records (2016–2018) for 31 621 paratroopers and a randomly selected comparison group of 170 715 non-paratrooper soldiers. Analyses included univariate and multivariate regression to quantify odds of injuries associated with risk variables and additional descriptive statistics.ResultsParatroopers had a 57% increase in the odds of experiencing one or more injuries (OR=1.57, 95% CI: 1.52 to 1.62) after controlling for sex, race and age, with a greater proportion of acute injuries (OR=1.38, 95% CI: 1.34 to 1.42), relative to comparison group soldiers. Injury types proportionally higher among paratroopers included head trauma and shoulder injuries. Average injury cost among paratroopers was 13% lower than for non-paratroopers ($2470 vs $2830 per injury). Among both populations, acute injury costs were notably higher than for CMT injuries (paratroopers, $1710/$630; non-paratroopers, $1860/$880 per injury).ConclusionsParatroopers were more likely to incur injury, especially an acute injury, than non-paratroopers. However, paratroopers’ average injury costs were less. This may be due to higher return-to-duty motivations, fitness levels, and/or facility-specific cost of care. Future studies should investigate causes of injuries found to be proportionally higher among paratroopers.
Study protocol: epidemiological and clinical characteristics of acute viral hepatitis in Brazilian health services
Authors: Sitnik Roberta , Maluf Maira Marranghello , Oliveira Ketti G , Siqueira Ricardo Andreotti , Ferreira Carlos Eduardo dos Santos , Mangueira Cristóvão Luis Pitangueira , Azevedo Raymundo Soares , Ferraz Maria Lucia Cardoso Gomes , Correa Maria Cassia Jacintho Mendes , Ferreira Paulo Roberto Abrão , Mendes Pereira Gerson Fernando , de Souza Flávia Moreno Alves , Pimenta Cristina , Pinho João Renato Rebello 
Published: July 2021

IntroductionAcute viral hepatitis is a disease of great clinical importance. This study proposes actions to better characterise cases of acute hepatitis in Brazil and to provide relevant information to institutionalised health policies within the Unified Health System. Available data on acute hepatitis in Brazil need to be re-evaluated regarding the different hepatotropic agent (hepatitis A to E virus) frequencies, as well as other agents that can cause similar clinical conditions, such as Herpes Simplex Virus 1 and 2(HSV1, HSV2), Varicella Zoster Virus (VZV), Cytomegalovirus (CMV), Epstein Barr Virus (EBV), Human Herpes Virus 6 and 7 (HHV6, HHV7), arbovirus (yellow fever, dengue, chikungunya, Zika), parvovirus B19, adenovirus, parechovirus, enterovirus, HIV, leptospirosis, toxoplasmosis and syphilis, in addition to autoimmune hepatitis. In this context, the primary aim of this study is the clinical-epidemiological and molecular characterisation of acute viral hepatitis in Brazilian health services from all geographical regions of the country. The present article describes the study protocol.Methods and analysisThis study will evaluate 2280 patients with symptoms and/or signs suggestive of acute liver disease in Brazilian health institutions in all five geographic Brazilian regions. Demographic, epidemiological and clinical data will be collected, as well as blood samples to be analysed at Hospital Israelita Albert Einstein Clinical Laboratory.Ethics and disseminationEthics approval was obtained at the national research ethics committee (Conselho Nacional de Ética em Pesquisa— CONEP–CAAE 00952818.4.1001.0071) and at all participating sites. Results will be published in journals and presented at scientific meetings.
Interventional treatments for chronic, axial or radicular, non-cancer, spinal pain: a protocol for a systematic review and network meta-analysis of randomised trials
Authors: Wang Xiaoqin , Martin Grace , Sadeghirad Behnam , Darzi Andrea J , Couban Rachel J , Florez Ivan D , Crandon Holly N , Kum Elena , Chang Yaping , Esfahani Meisam Abdar , Sivananthan Laxsanaa , Mehrabi Fatemeh , Sengupta Neil K , Rathod Preksha , Morsi Rami Z , Buckley D Norman , Guyatt Gordon H , Rampersaud Y Raja , Standaert Christopher J , Agoritsas Thomas , Busse Jason W 
Published: July 2021

IntroductionChronic, non-cancer, axial or radicular spinal pain is a common condition associated with considerable socioeconomic burden. Clinicians frequently offer patients various interventional procedures for the treatment of chronic spine pain; however, the comparative effectiveness and safety of available procedures remains uncertain.MethodsWe will conduct a systematic review of randomised controlled trials that explores the effectiveness and harms of interventional procedures for the management of axial or radicular, chronic, non-cancer, spine pain. We will identify eligible studies through a systematic search of Medline, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials and Web of Science from inception without language restrictions. Eligible trials will: (1) enrol primarily adult patients (≥18 years old) with axial or radicular, chronic, non-cancer, spine pain, (2) randomise patients to different, currently available, interventional procedures or to an interventional procedure and a placebo/sham procedure or usual care, and (3) measure outcomes at least 1 month after randomisation.Pairs of reviewers will independently screen articles identified through searches and extract information and assess risk of bias of eligible trials. We will use a modified Cochrane instrument to evaluate risk of bias. We will use frequentist random-effects network meta-analyses to assess the relative effects of interventional procedures, and five a priori hypotheses to explore between studies subgroup effects. We will use the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in evidence for each outcome, including direct, indirect and network estimates.Ethics and disseminationNo research ethics approval is required for this systematic review, as no confidential patient data will be used. We will disseminate our findings through publication in a peer-reviewed journal and conference presentations, and our review will support development of aBMJRapid Recommendations providing contextualised clinical guidance based on this body of evidence.PROSPERO registration numberCRD42020170667.
Current status of health systems financing and oversight for end-stage kidney disease care: a cross-sectional global survey
Authors: Yeung Emily , Bello AK , Levin Adeera , Lunney Meaghan , Osman Mohamed A , Ye Feng , Ashuntantang Gloria , Bellorin-Font Ezequiel , Benghanem Gharbi Mohammed , Davison Sara , Ghnaimat Mohammad , Harden Paul , Jha Vivekanand , Kalantar-Zadeh Kamyar , Kerr Peter , Klarenbach Scott , Kovesdy Csaba , Luyckx Valerie , Neuen Brendon , O'Donoghue Donal , Ossareh Shahrzad , Perl Jeffrey , Ur Rashid Harun , Rondeau Eric , See Emily , Saad Syed , Sola Laura , Tchokhonelidze Irma , Tesar Vladimir , Tungsanga Kriang , Turan Kazancioglu Rumeyza , Wang Angela Yee-Moon , Wiebe Natasha , Yang Chih-Wei , Zemchenkov Alexander , Zhao Minhui , Jager Kitty J , Caskey Fergus , Perkovic Vlado , Jindal Kailash , Okpechi Ikechi G , Tonelli Marcello , Feehally John , Harris David CH , Johnson David 
Published: July 2021

ObjectivesThe Global Kidney Health Atlas (GKHA) is a multinational, cross-sectional survey designed to assess the current capacity for kidney care across all world regions. The 2017 GKHA involved 125 countries and identified significant gaps in oversight, funding and infrastructure to support care for patients with kidney disease, especially in lower-middle-income countries. Here, we report results from the survey for the second iteration of the GKHA conducted in 2018, which included specific questions about health financing and oversight of end-stage kidney disease (ESKD) care worldwide.SettingA cross-sectional global survey.ParticipantsKey stakeholders from 182 countries were invited to participate. Of those, stakeholders from 160 countries participated and were included.Primary outcomesPrimary outcomes included cost of kidney replacement therapy (KRT), funding for dialysis and transplantation, funding for conservative kidney management, extent of universal health coverage, out-of-pocket costs for KRT, within-country variability in ESKD care delivery and oversight systems for ESKD care. Outcomes were determined from a combination of desk research and input from key stakeholders in participating countries.Results160 countries (covering 98% of the world’s population) responded to the survey. Economic factors were identified as the top barrier to optimal ESKD care in 99 countries (64%). Full public funding for KRT was more common than for conservative kidney management (43% vs 28%). Among countries that provided at least some public coverage for KRT, 75% covered all citizens. Within-country variation in ESKD care delivery was reported in 40% of countries. Oversight of ESKD care was present in all high-income countries but was absent in 13% of low-income, 3% of lower-middle-income, and 10% of upper-middle-income countries.ConclusionSignificant gaps and variability exist in the public funding and oversight of ESKD care in many countries, particularly for those in low-income and lower-middle-income countries.
Psychological distress and trauma in doctors providing frontline care during the COVID-19 pandemic in the United Kingdom and Ireland: a prospective longitudinal survey cohort study
Authors: Roberts Tom , Daniels Jo , Hulme William , Hirst Robert , Horner Daniel , Lyttle Mark David , Samuel Katie , Graham Blair , Reynard Charles , Barrett Michael , Foley James , Cronin John , Umana Etimbuk , Vinagre Joao , Carlton Edward ,   on behalf of TheTrainee Emergency Research Network (TERN),   Paediatric Emergency Research in the UK and Ireland (PERUKI)
Published: July 2021

ObjectivesThe psychological impact of the COVID-19 pandemic on doctors is a significant concern. Due to the emergence of multiple pandemic waves, longitudinal data on the impact of COVID-19 are vital to ensure an adequate psychological care response. The primary aim was to assess the prevalence and degree of psychological distress and trauma in frontline doctors during the acceleration, peak and deceleration of the COVID-19 first wave. Personal and professional factors associated with psychological distress are also reported.DesignA prospective online three-part longitudinal survey.SettingAcute hospitals in the UK and Ireland.ParticipantsFrontline doctors working in emergency medicine, anaesthetics and intensive care medicine during the first wave of the COVID-19 pandemic in March 2020.Primary outcome measuresPsychological distress and trauma measured using the General Health Questionnaire-12 and the Impact of Events-Revised.ResultsThe initial acceleration survey distributed across networks generated a sample of 5440 doctors. Peak and deceleration response rates from the original sample were 71.6% (n=3896) and 56.6% (n=3079), respectively. Prevalence of psychological distress was 44.7% (n=1334) during the acceleration, 36.9% (n=1098) at peak and 31.5% (n=918) at the deceleration phase. The prevalence of trauma was 23.7% (n=647) at peak and 17.7% (n=484) at deceleration. The prevalence of probable post-traumatic stress disorder was 12.6% (n=343) at peak and 10.1% (n=276) at deceleration. Worry of family infection due to clinical work was the factor most strongly associated with both distress (R2=0.06) and trauma (R2=0.10).ConclusionFindings reflect a pattern of elevated distress at acceleration and peak, with some natural recovery. It is essential that policymakers seek to prevent future adverse effects through (a) provision of vital equipment to mitigate physical and psychological harm, (b) increased awareness and recognition of signs of psychological distress and (c) the development of clear pathways to effective psychological care.Trial registration numberISRCTN10666798.
The Standardisation of handoffs in a large academic paediatric emergency department using I-PASS
Authors: Chladek Melissa Sydow , Doughty Cara , Patel Binita , Alade Kyetta , Rus Marideth , Shook Joan , LIttle-Weinert Kim 
Published: July 2021

Background and objectivesDespite the American College of Emergency Physicians and American Academy of Pediatrics recommendations for standardised handoffs in the emergency department (ED), few EDs have an established tool. Our aim was to improve the quality of handoffs in the ED by establishing compliance with the I-PASS handoff tool.MethodsThis is a quality improvement (QI) initiative to standardise handoffs in a large academic paediatric ED. Following review of the literature and focus groups with key stakeholders, I-PASS was selected and modified to fit departmental needs. Implementation throughPlan–Do–Study–Act cycles included the development of educational materials, reminders and real-time feedback. Required use of I-PASS during designated team sign-out began in June 2016. Compliance with the handoff tool and handoff deficiencies was measured through observations by faculty trained in I-PASS. As a balancing measure, time to complete handoff was monitored and compared with preintervention data.ResultsCompliance with I-PASS reached 80% within 6 months, 100% within 7 months and sustained at 100% during the remainder of the study period. The average percent of omissions of crucial information per handoff declined to 8.3%, which was a 53% decrease. Average percentage of tangential information and miscommunications per handoff did not show a decline. The average handoff took 20 min, which did not differ from the preintervention time. Survey results demonstrated a perceived improvement in patient safety through closed-loop communication, clear action lists and contingency planning and proper patient acuity identification.ConclusionsI-PASS is applicable in the ED and can be successfully implemented through QI methodology contributing to an overall culture of safety.
Explaining Xenon-1T signal with FIMP dark matter and neutrino mass in a $$U(1)_{X}$$ extension
Authors: Khan Sarif 
Published: July 2021

AbstractIn the present work, we have extended the standard model by an abelian $$U(1)_{X}$$

U

(
1
)

X

gauge group and additional particles. In particular, we have extended the particle content by three right handed neutrinos, two singlet scalars and two vectors like leptons. Charged assignments under different gauge groups are such that the model is gauge anomaly free and the anomaly contributions cancel among generations. Once the symmetry gets broken then three physical Higgses are produced, one axion like particle (ALP), which also acts as the keV scale FIMP dark matter is produced and the remaining component is absorbed by the extra gauge boson. Firstly, we have successfully generated neutrino mass by the type-I seesaw mechanism for normal hierarchy with the $$3\sigma $$

3
σ

bound on the oscillation parameters. The ALP in the present model can explain the Xenon-1T electron recoil signal at keV scale through its coupling with the electron. We have shown that ALP can be produced from the right handed neutrino decay through the freeze in mechanism. Electron and tauon get masses from dimensional-5 operators at the Planck scale and if we consider the vevs $$v_{1,2} \simeq 10^{12}$$

v

1
,
2

≃

10
12

GeV then we can obtain the correct value of the electron mass but not the tauon mass. The vector like leptons help in getting the correct value of the tauon mass through another higher dimensional operator which also has a role in DM production by the $$2 \rightarrow 2$$

2
→
2

process, giving the correct ballpark value of relic density for suitable reheat temperature of the Universe. We have shown that the ALP production by the higher dimensional operator can explain the electron, tauon mass and Xenon-1T signal simultaneously whereas the decay production can not explain all of them together.
Probing the dark matter density evolution law with large scale structures
Authors: Bora Kamal , Holanda R. F. L. , Desai Shantanu 
Published: July 2021

AbstractWe propose a new method to explore a possible departure from the standard time evolution law for the dark matter density. We looked for a violation of this law by using a deformed evolution law, given by $$\rho _c(z) \propto (1+z)^{3+\epsilon }$$

ρ
c

(
z
)

∝

(
1
+
z
)

3
+
ϵ

, and then constrain $$\epsilon $$
ϵ
. The dataset used for this purpose consists of Strong Gravitational Lensing data obtained from SLOAN Lens ACS, BOSS Emission-line Lens Survey, Strong Legacy Survey SL2S, and SLACS; along with galaxy cluster X-ray gas mass fraction measurements obtained using the Chandra Telescope. Our analyses show that $$\epsilon $$
ϵ
is consistent with zero within 1 $$\sigma $$
σ
c.l., but the current dataset cannot rule out with high confidence level interacting models of dark matter and dark energy.
CRP (C-Reactive Protein) in Outcome Prediction After Subarachnoid Hemorrhage and the Role of Machine Learning
Authors: Gaastra Ben , Barron Peter , Newitt Laura , Chhugani Simran , Turner Carole , Kirkpatrick Peter , MacArthur Ben , Galea Ian , Bulters Diederik 
Published: July 2021

Background and Purpose:
Outcome prediction after aneurysmal subarachnoid hemorrhage (aSAH) is challenging. CRP (C-reactive protein) has been reported to be associated with outcome, but it is unclear if this is independent of other predictors and applies to aSAH of all grades. Therefore, the role of CRP in aSAH outcome prediction models is unknown. The purpose of this study is to assess if CRP is an independent predictor of outcome after aSAH, develop new prognostic models incorporating CRP, and test whether these can be improved by application of machine learning.

Methods:
This was an individual patient-level analysis of data from patients within 72 hours of aSAH from 2 prior studies. A panel of statistical learning methods including logistic regression, random forest, and support vector machines were used to assess the relationship between CRP and modified Rankin Scale. Models were compared with the full Subarachnoid Hemmorhage International Trialists’ (SAHIT) prediction tool of outcome after aSAH and internally validated using cross-validation.

Results:

One thousand and seventeen patients were included for analysis. CRP on the first day after ictus was an independent predictor of outcome. The full SAHIT model achieved an area under the receiver operator characteristics curve (AUC) of 0.831. Addition of CRP to the predictors of the full SAHIT model improved model performance (AUC, 0.846,
P
=0.01). This improvement was not enhanced when learning was performed using a random forest (AUC, 0.807), but was with a support vector machine (AUC of 0.960,
P
<0.001).

Conclusions:
CRP is an independent predictor of outcome after aSAH. Its inclusion in prognostic models improves performance, although the magnitude of improvement is probably insufficient to be relevant clinically on an individual patient level, and of more relevance in research. Greater improvements in model performance are seen with support vector machines but these models have the highest classification error rate on internal validation and require external validation and calibration.
Prediction of Independent Walking in People Who Are Nonambulatory Early After Stroke
Authors: Preston Elisabeth , Ada Louise , Stanton Rosalyn , Mahendran Niruthikha , Dean Catherine M. 
Published: July 2021

Background and Purpose:
One systematic review has examined factors that predict walking outcome at one month in initially nonambulatory patients after stroke. The purpose of this systematic review was to examine, in nonambulatory people within a month of stroke, which factors predict independent walking at 3, 6, and 12 months.

Methods:
Prognostic factors: Any factors measured within one month after stroke with the aim of predicting independent walking. Outcome of interest: Independent walking defined as walking with or without an aid but with no human assistance.

Results:

Fifteen studies comprising 2344 nonambulatory participants after stroke were included. Risk of bias was low in 7 studies and moderate in 8 studies. Individual meta-analyses of 2 to 4 studies were performed to calculate the pooled estimate of the odds ratio for 12 prognostic factors. Younger age (odds ratio [OR], 3.4,
P
<0.001), an intact corticospinal tract (OR, 8.3,
P
<0.001), good leg strength (OR, 5.0,
P
<0.001), no cognitive impairment (OR, 3.5,
P
<0.001), no neglect (OR, 2.4,
P
=0.006), continence (OR, 2.3,
P
<0.001), good sitting (OR, 7.9,
P
<0.001), and independence in activities of daily living (OR 10.5,
P
<0.001) predicted independent walking at 3 months. Younger age (OR, 2.1,
P
<0.001), continence (OR, 13.8,
P
<0.001), and good sitting (OR, 19.1,
P
<0.001) predicted independent walking at 6 months. There were insufficient data at 12 months.

Conclusions:
Younger age, an intact corticospinal tract, good leg strength, continence, no cognitive impairment, no neglect, good sitting, and independence in activities of daily living in patients who are nonambulatory early after stroke predict independent walking at 3 months.

REGISTRATION:

URL:
https://www.crd.york.ac.uk/prospero/
; Unique identifier: CRD42018108794.
The impact of COVID-19 on antipsychotic prescriptions for patients with schizophrenia in Australia
Authors: Kisely Steve , Dangelo-Kemp Dante , Taylor Mark , Liu Dennis , Graham Simon , Hartmann Jodie , Colman Sam 
Published: July 2021

Objective: To assess the impact, in the Australian setting, of the COVID-19 lockdown on antipsychotic supplies for patients with schizophrenia following a prescription from a new medical consultation when compared to the same periods in the previous 4 years. A secondary objective was to assess the volume of all antipsychotic supplies, from new and repeat prescriptions, over these same periods. Methods: A retrospective pharmaceutical claims database study was undertaken, using the Department of Human Services Pharmaceutical Benefits Scheme 10% sample. The study population included all adult patients with three or more supplies of oral or long-acting injectable antipsychotics for the treatment of schizophrenia at any time between 1 June 2015 and 31 May 2020. The primary outcome compared volumes of dispensed antipsychotics from new prescriptions (which require a medical consultation) between 1 April and 31 May each year from 2016 to 2020. This was to analyse the period during which the Australian Government imposed a lockdown due to COVID-19 (April to May 2020) when compared the same periods in previous years. Results: There was a small (5.7%) reduction in the number of antipsychotics dispensed from new prescriptions requiring a consultation, from 15,244 to 14,372, between April and May 2019 and the same period in 2020, respectively. However, this reduction was not statistically significant ( p = 0.75) after adjusting for treatment class, age, gender, location and provider type. Conclusion: The COVID-19 restrictions during April and May 2020 had no significant impact on the volume of antipsychotics dispensed from new prescriptions for patients with schizophrenia when compared to the volume of antipsychotics dispensed from new prescriptions during the same period in previous years.