bluuebunny/crossref_metadata_2025_split huggingface dataset:
Epidemiology of pediatric trauma in the Kingdom of Bahrain: a national pediatric trauma registry pilot study
Authors: Liu Jay C. , Ismael Aieshah A. , Zaidi Ayesha , Sha’ban Ban W. , Almutawa Shaikha Ebrahim , Chatha Asad Amin , Abuzeyad Feras H. , Jaafar Ruqaya Isa , Alghanem Salah Ali , Qassim Ghada Al , Kumar Nitya , Corbally Martin 
Published: July 2021

Abstract
Background
A pediatric trauma registry for the Kingdom of Bahrain would be a novel public health tool for the Bahraini health system. The aim of this study was to explore the epidemiology of pediatric trauma at the national level by describing the distribution of pediatric injury in the Kingdom, and quantifying the burden of injury shouldered by the study population.

Methods
This multicenter observational cross-sectional study was conducted in Bahrain using data from the Pediatric Trauma Registry (PTR), which was a short-term paper-based prospective trauma registry that collected data over a three-month period in 2018. PTR was based in the pediatric emergency departments (ED) of the three national referral hospitals in the Kingdom. By simultaneously collecting data from all three trauma hospitals in the country, it was assumed that during the data collection period all major pediatric trauma patients in the country would be captured by the study, and that the data collected would provide national estimates of trauma. Inclusion criteria for the study was any individual under the age of 14, that arrived at the ED seeking care for intentional and unintentional injuries.

Results
A total of 1328 patients were included in the study. Sixty-nine percent of patients were treated and discharged from the ED, 30.5% were admitted to the hospital, admitted for surgery, or seen by a specialist, and 0.5% were declared deceased. The percentage of patients documented as unrestrained during Motor Vehicle Collisions (MVC) was 92.3%, and amongst those involved in MVC, 12% were ejected from the cabin of the vehicle.

Conclusions
There are significant implications that this study holds for policy implementation and practice surrounding injury prevention in the Kingdom of Bahrain. Low seatbelt utilization and the high proportion of ejection amongst MVC victims warrant immediate public health policy implementation, including enforcement of seat belt laws, strengthening of the traffic court system, and awareness campaigns for MVC prevention. Additionally, pediatric drowning prevention programs centered on constant adult supervision, pool isolation fencing, personal flotation devices, and swimming education should be created to address the mortality attributable to drowning in this study.
Firearm purchasing and firearm violence during the coronavirus pandemic in the United States: a cross-sectional study
Authors: Schleimer Julia P. , McCort Christopher D. , Shev Aaron B. , Pear Veronica A. , Tomsich Elizabeth , De Biasi Alaina , Buggs Shani , Laqueur Hannah S. , Wintemute Garen J. 
Published: July 2021

Abstract
Background
Firearm violence is a significant public health problem in the United States. A surge in firearm purchasing following the onset of the coronavirus pandemic may have contributed to an increase in firearm violence. We sought to estimate the state-level association between firearm purchasing and interpersonal firearm violence during the pandemic.

Methods
Cross-sectional study of the 48 contiguous states and the District of Columbia from January 2018 through July 2020. Data were obtained from the National Instant Criminal Background Check System (a proxy for firearm purchasing) and the Gun Violence Archive. Using negative binomial regression models, we estimated the association between cumulative excess firearm purchases in March through July 2020 (measured as the difference between observed rates and those expected from autoregressive integrated moving average models) and injuries (including nonfatal and fatal) from intentional, interpersonal firearm violence (non-domestic and domestic violence).

Results
We estimated that there were 4.3 million excess firearm purchases nationally from March through July 2020 and a total of 4075 more firearm injuries than expected from April through July. We found no relationship between state-level excess purchasing and non-domestic firearm violence, e.g., each excess purchase per 100 population was associated with a rate ratio (RR) of firearm injury from non-domestic violence of 0.76 (95% CI: 0.50–1.02) in April; 0.99 (95% CI: 0.72–1.25) in May; 1.10 (95% CI: 0.93–1.32) in June; and 0.98 (95% CI: 0.85–1.12) in July. Excess firearm purchasing within states was associated with an increase in firearm injuries from domestic violence in April (RR: 2.60; 95% CI: 1.32–5.93) and May (RR: 1.79; 95% CI: 1.19–2.91), though estimates were sensitive to model specification.

Conclusions
Nationwide, firearm purchasing and firearm violence increased substantially during the first months of the coronavirus pandemic. At the state level, the magnitude of the increase in purchasing was not associated with the magnitude of the increase in firearm violence. Increases in purchasing may have contributed to additional firearm injuries from domestic violence in April and May. Results suggest much of the rise in firearm violence during our study period was attributable to other factors, indicating a need for additional research.
CBCT analysis of the tissue thickness at immediate implant placement with contour augmentation in the maxillary anterior zone: a 1-year prospective clinical study
Authors: Fujita Yuya , Nakano Tamaki , Ono Shinji , Shimomoto Takuya , Mizuno Keiichiro , Yatani Hirofumi , Ishigaki Shoichi 
Published: July 2021

Abstract
Background
Immediate implant placement with simultaneous contour augmentation such as guided bone regeneration (GBR) or connective tissue grafting (CTG) has been widely performed. However, few prospective studies have evaluated both peri-implant bone and soft tissue changes between the preoperative and postoperative periods. The purpose of this study is to quantify the horizontal dimensional changes of the facial bone and soft tissue following immediate implant placement with contour augmentation.

Material and methods
Twenty patients who underwent immediate implant placement in the anterior maxilla received GBR and CTG (test group) or GBR only (control group). Cone-beam computed tomography (CBCT) scans were taken preoperatively and 1 year after the definitive prosthesis connection, and then, they were superimposed. On the CBCT images of the two stages, the horizontal distance from the implant platform to the facial bone surface (BW) and the horizontal soft tissue width (GW) were measured at the implant platform level and 2 mm apical to the implant platform level. The sum of BW and GW (=TW) was used to assess the facial mucosal contour.

Results
BW decreased significantly from preoperative to 1 year after prosthesis connection with a mean decrease of 0.47 mm (P =0.021) in the control group and a mean decrease of 0.50 mm (P = 0.019) in the test group at the implant platform level. GW increased significantly with a mean increase of 1.37 mm (P =0.005) in the test group at the implant platform level. TW decreased significantly with a mean decrease of 0.46 mm in the control group (P =0.049) but increased significantly with a mean increase of 0.87 mm in the test group (P =0.005) at the implant platform level.

Conclusions
Immediate implant placement with CTG showed a soft tissue gain of 1.37 mm compensated for bone resorption, thus still preserving the preoperative mucosal contour. CTG should be performed with immediate implant placement in cases where preoperative mucosal contours need to be maintained.
Removal of a suture needle: a case report
Authors: Seon Suyun , Lee Baek-Soo , Choi Byung-Joon , Ohe Joo-Young , Lee Jung-Woo , Jung Junho , Hwang Bo-Yeon , Kim Min-Ah , Kwon Yong-Dae 
Published: July 2021

Abstract
Background
Foreign bodies may be embedded or left behind in the oral cavity during oral surgical procedure. The loss of instruments such as impression material, surgical gauze, and broken injection needles are commonly reported in the dental field. These complications are generally symptomatic and show signs of inflammation, pain, and purulent discharge. Accidental breakage of suture needles is a rare but potentially dangerous event.

Case presentation
In this report, we present one case of lost suture needle during the procedure of flap operation at local dental clinic and its successful removal under local/general anesthesia administration via CBCT with a help of two reference needles to localize the 6-0 nylon needle and consulting with the clinician.

Conclusion
CT scanning taken while mouth-closing may not be accurate with regard to real location measurement performed while mouth-opening. If so, other up-to-date radiographic devices and methods to retrieve a needle are recommended.
Positioning spice tourism as an emerging form of special interest tourism: perspectives and strategies
Authors: Nair Bipithalal Balakrishnan , Mohanty Patita Paban 
Published: July 2021

AbstractThe COVID-19 pandemic has halted activities in the global tourism industry, and the situation has only been worsened by the general air of uncertainty and lack of effective vaccinations. Consequently, people have begun testing various remedies to enhance their immunity, primarily turning to traditional medical practices and home remedies. The medicinal use of spices, given their immune-boosting properties, is increasingly popular globally and has enhanced global awareness of spices and their products. In light of this surging popularity, this study examines spice tourism as a concept of niche tourism. This study proposes spice tourism as a valuable post-COVID-19 strategy by providing four different approaches to position spice tourism within special interest tourism. This paper also suggests a tourism development plan for spice tourism and proposes a strategy for its resilience post-COVID-19.
Metaphloem development in the Arabidopsis root tip
Authors: Graeff Moritz , Hardtke Christian S. 
Published: July 2021

ABSTRACT
The phloem transport network is a major evolutionary innovation that enabled plants to dominate terrestrial ecosystems. In the growth apices, the meristems, apical stem cells continuously produce early ‘protophloem’. This is easily observed in Arabidopsis root meristems, in which the differentiation of individual protophloem sieve element precursors into interconnected conducting sieve tubes is laid out in a spatio-temporal gradient. The mature protophloem eventually collapses as the neighboring metaphloem takes over its function further distal from the stem cell niche. Compared with protophloem, metaphloem ontogenesis is poorly characterized, primarily because its visualization is challenging. Here, we describe the improved TetSee protocol to investigate metaphloem development in Arabidopsis root tips in combination with a set of molecular markers. We found that mature metaphloem sieve elements are only observed in the late post-meristematic root, although their specification is initiated as soon as protophloem sieve elements enucleate. Moreover, unlike protophloem sieve elements, metaphloem sieve elements only differentiate once they have fully elongated. Finally, our results suggest that metaphloem differentiation is not directly controlled by protophloem-derived cues but rather follows a distinct, robust developmental trajectory.
Normoxic limitation of maximal oxygen consumption rate, aerobic scope and cardiac performance in exhaustively exercised rainbow trout (Oncorhynchus mykiss)
Authors: McArley Tristan J. , Morgenroth Daniel , Zena Lucas A. , Ekström Andreas T. , Sandblom Erik 
Published: July 2021

ABSTRACT
In fish, maximum O2 consumption rate (ṀO2,max) and aerobic scope can be expanded following exhaustive exercise in hyperoxia; however, the mechanisms explaining this are yet to be identified. Here, in exhaustively exercised rainbow trout (Oncorhynchus mykiss), we assessed the influence of hyperoxia on ṀO2,max, aerobic scope, cardiac function and blood parameters to address this knowledge gap. Relative to normoxia, ṀO2,max was 33% higher under hyperoxia, and this drove a similar increase in aerobic scope. Cardiac output was significantly elevated under hyperoxia at ṀO2,max because of increased stroke volume, indicating that hyperoxia released a constraint on cardiac contractility apparent with normoxia. Thus, hyperoxia improved maximal cardiac performance, thereby enhancing tissue O2 delivery and allowing a higher ṀO2,max. Venous blood O2 partial pressure (PvO2) was elevated in hyperoxia at ṀO2,max, suggesting a contribution of improved luminal O2 supply in enhanced cardiac contractility. Additionally, despite reduced haemoglobin and higher PvO2, hyperoxia treated fish retained a higher arterio-venous O2 content difference at ṀO2,max. This may have been possible because of hyperoxia offsetting declines in arterial oxygenation that are known to occur following exhaustive exercise in normoxia. If this occurs, increased contractility at ṀO2,max with hyperoxia may also relate to an improved O2 supply to the compact myocardium via the coronary artery. Our findings show ṀO2,max and aerobic scope may be limited in normoxia following exhaustive exercise as a result of constrained maximal cardiac performance and highlight the need to further examine whether or not exhaustive exercise protocols are suitable for eliciting ṀO2,max and estimating aerobic scope in rainbow trout.
New insights into the allosteric effects of CO2 and bicarbonate on crocodilian hemoglobin
Authors: Bautista Naim M. , Malte Hans , Natarajan Chandrasekhar , Wang Tobias , Storz Jay F. , Fago Angela 
Published: July 2021

ABSTRACT
Crocodilians are unique among vertebrates in that their hemoglobin (Hb) O2 binding is allosterically regulated by bicarbonate, which forms in red blood cells upon hydration of CO2. Although known for decades, this remarkable mode of allosteric control has not yet been experimentally verified with direct evidence of bicarbonate binding to crocodilian Hb, probably because of confounding CO2-mediated effects. Here, we provide the first quantitative analysis of the separate allosteric effects of CO2 and bicarbonate on purified Hb of the spectacled caiman (Caiman crocodilus). Using thin-layer gas diffusion chamber and Tucker chamber techniques, we demonstrate that both CO2 and bicarbonate bind to Hb with high affinity and strongly decrease O2 saturation of Hb. We propose that both effectors bind to an unidentified positively charged site containing a reactive amino group in the low-O2 affinity T conformation of Hb. These results provide the first experimental evidence that bicarbonate binds directly to crocodilian Hb and promotes O2 delivery independently of CO2. Using the gas diffusion chamber, we observed similar effects in Hbs of a phylogenetically diverse set of other caiman, alligator and crocodile species, suggesting that the unique mode of allosteric regulation by CO2 and bicarbonate evolved &gt;80–100 million years ago in the common ancestor of crocodilians. Our results show a tight and unusual linkage between O2 and CO2 transport in the blood of crocodilians, where the build-up of erytrocytic CO2 and bicarbonate ions during breath-hold diving or digestion facilitates O2 delivery, while Hb desaturation facilitates CO2 transport as protein-bound CO2 and bicarbonate.
Development and Psychometric Validation of a Patient-Reported Outcome Measure for Arm Lymphedema: The LYMPH-Q Upper Extremity Module
Authors: Klassen Anne F. , Tsangaris Elena , Kaur Manraj N. , Poulsen Lotte , Beelen Louise M. , Jacobsen Amalie Lind , Jørgensen Mads Gustaf , Sørensen Jens Ahm , Vasilic Dalibor , Dayan Joseph , Mehrara Babak , Pusic Andrea L. 
Published: July 2021

Abstract
Background
A multiphased mixed-methods study was performed to develop and validate a comprehensive patient-reported outcome measure (PROM) for arm lymphedema in women with breast cancer (i.e., the LYMPH-Q Upper Extremity Module).

Methods
Qualitative interviews (January 2017 and June 2018) were performed with 15 women to elicit concepts specific to arm lymphedema after breast cancer treatment. Data were audio-recorded, transcribed, and coded. Scales were refined through cognitive interviews (October and Decemeber 2018) with 16 patients and input from 12 clinical experts. The scales were field-tested (October 2019 and January 2020) with an international sample of 3222 women in the United States and Denmark. Rasch measurement theory (RMT) analysis was used to examine reliability and validity.

Results
The qualitative phase resulted in six independently functioning scales that measure arm symptoms, function, appearance, psychological function, and satisfaction with information and with arm sleeves. In the RMT analysis, all items in each scale had ordered thresholds and nonsignificant chi-square p values. For all the scales, the reliability statistics with and without extremes for the Person Separation Index were 0.80 or higher, Cronbach’s alpha was 0.89 or higher, and the Intraclass Correlation Coefficients were 0.92 or higher. Lower (worse) scores on the LYMPH-Q Upper Extremity scales were associated with reporting of more severe arm swelling, an arm problem caused by cancer and/or its treatment, and wearing of an arm sleeve in the past 12 months.

Conclusions
The LYMPH-Q Upper Extremity Module can be used to measure outcomes that matter to women with upper extremity lymphedema. This new PROM was designed using a modern psychometric approach and, as such, can be used in research and in clinical care.
Clinical value of SMI Combined with Low-Dose CT Scanning in differential diagnosis of Thyroid Lesions and Tumor Staging
Authors: Xue Shao-wei , Luo Yu-kun , Jiao Zi-yu , Xu Lin 
Published: July 2021

Objectives: To investigate the clinical value of Superb Microvascular Imaging (SMI) combined with low dose CT scanning in differential diagnosis of thyroid lesions and tumor staging.
Methods: A total of 120 patients with thyroid nodules admitted to the Chinese PLA General Hospital from January 2017 to July 2020 were selected. Paired design was adopted in this study. SMI and SMI combined with low-dose CT scanning were respectively carried out to these patients. The results were judged by two senior imaging physicians and two senior sonographers respectively. And t-test, χ2 test, Pearson correlation coefficient check and other methods were adopted to comparatively analyze the above two methods and the pathological results after operation or puncture.
Results: Compared with pathologic findings, the coincidence rate of SMI was 40%, and the coincidence rate of SMI combined with low dose CT scanning was 84%. The difference was significant (p=0.00); among the 120 thyroid nodule patients, 50 were diagnosed as malignant by pathological diagnosis, and 70 as benign; 27 malignant cases and 93 benign cases were detected by SMI; 48 malignant cases and 72 benign cases were detected by SMI combined with low dose CT scanning. The sensitivity and accuracy of the latter were significantly higher than those of the former, and the difference was statistically significant (p=0.00); the enhancement, edge sharpness and homogeneity of SMI increased with the increase of tumor malignancy, showing positive correlation property.
Conclusion: SMI combined with low dose CT scanning has a higher diagnostic coincidence rate. Its sensitivity and accuracy are significantly superior. With the increase of tumor malignancy, the enhancement and unhomogeneity of SMI increase, and the edge is more blurred. That suggests: with the increase of tumor malignancy, neovascularization in the tumor is more obvious and more unevenly distributed; the increase of edge blur indicates more obvious tumor infiltration. The method has considerable clinical value for predicting the malignancy of tumors.
doi: https://doi.org/10.12669/pjms.37.5.4144
How to cite this:Xue SW, Luo YK, Jiao ZY, Xu L. Clinical value of SMI Combined with Low-Dose CT Scanning in differential diagnosis of Thyroid Lesions and Tumor Staging. Pak J Med Sci. 2021;37(5):1347-1352. doi: https://doi.org/10.12669/pjms.37.5.4144
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effect of Intensity Modulated Radiotherapy (IMRT) on the immunity, physical status and clinical effect of locally advanced NSCLC patients
Authors: Xu Jun-kai 
Published: July 2021

Objectives: To evaluate the clinical value of radiotherapy combined with Camrelizumab in treating locally advanced non-small cell lung cancer (NSCLC) patients.
Methods: 80 locally advanced NSCLC patients were randomly divided into two groups (n=40). The control group was administered with intensity modulated radiation therapy (IMRT), whereas the experimental group with Camrelizumab in addition to IMRT. All the patients underwent clinical efficacy evaluation in terms of adverse drug reaction (ADR), physical status improvement after the treatment, and changes in T lymphocyte subpopulations (incl. CD3+, CD4+, CD8+, CD4+/CD8+).
Results: The efficacy was found to be 70% and 47.5 in experimental group and control group, respectively, with the former being significantly better than the latter (p=0.03). The ADR rates were 50% and 37.5% in the experimental group and control group, respectively; but the difference remained insignificant (p=0.26). As for physical status improvement, experimental group evidently excelled the control group (p=0.04). The post-treatment indicators such as CD3+, CD4+, CD8+, CD4+/CD8+ were significantly more improved in the experimental group than the control group (CD3+, p=0.02; CD4+, p=0.00; and CD4+/CD8+, p=0.01). However, the changes in CD8+ were not significant at all (p=0.46).
Conclusions: The combined therapy of IMRT with Camrelizumab appeared effective in dealing with the locally advanced NSCLC patients, as such patients presented significantly better immune state and physical status improvement but not increased ADR. The therapy is both safe and effective.
doi: https://doi.org/10.12669/pjms.37.5.4188
How to cite this:Xu JK. Effect of Intensity Modulated Radiotherapy (IMRT) on the immunity, physical status and clinical effect of locally advanced NSCLC patients. Pak J Med Sci. 2021;37(5):1480-1485. doi: https://doi.org/10.12669/pjms.37.5.4188
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.