bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Novel “BISSHOAP” Score for Predicting Severe and Moderately Severe Acute Pancreatitis in Emergency Room
Authors: Zanwar Shankar , Mohan Arumugam T. , Paramsivan Piramanayagam , Parmeswaran Sarojini Ashok , Srinivas Usha , Mutthuswamy Hariharan , Dhus Ubal , Venkatesh Seshadri , Mahalingam Preethi , Ramasamy Palanisamy Kallipatti , Nayak Sathish , Parikh Pallav 
Published: June 2021

Background:
The existing scores for predicting severity of acute pancreatitis (AP) underperform in sensitivity. The existing scores do not predict moderately severe pancreatitis.

Methods:
We performed a prospective observational study from August 2014 to April 2016 on patients hospitalized at Apollo Hospitals, Chennai, with a clinical diagnosis of AP (as per Atlanta 2012 classification). Three established scoring systems – Complete Ranson's (at 48 h), Acute Physiology and Chronic Health Evaluation (APACHE-II), Bedside Index of Severity in AP (BISAP) and new score BISAP + saturation of oxygen, hematocrit (BISAP + SHO) (packed cell volume [PCV]) and overweight by body mass index [BMI]) were calculated at admission. In BISAP + SHO score 5 points were given as in BISAP and 3 points were added 1 each for low oxygen saturation ≤92%, PCV ≥47% and BMI of ≥23 making BISAP + SHO an 8-point score. The prediction by scores was validated against the actual clinical outcome of severity.

Results:
Of 102 patients with AP, 34 (33%) patients had organ failure (OF) and in 17 patients (16.5%) it lasted >48 h, classified as severe AP. Remaining 17 were moderately severe AP as OF resolved within <48 h. Cut-off values to predict severe pancreatitis were - Ranson's score - ≥3, APACHE-II - ≥8, BISAP - ≥3, and BISAP + SHO - ≥5. Area under receiver operator curve (AUC) for Ranson's, APACHE-II, BISAP and BISAP + SHO were 0.958, 0.953, 0.899 and 0.989, respectively. With a score 3 or 4, BISAP + SHO predicted moderately severe AP with a sensitivity of 94.12%, specificity 97.6%.

Conclusions:
The BISAP + SHO (rephrased as BISSHOAP) stratifies AP with better AUC than existing scores and is also able to predict moderately severe pancreatitis in the ER.
Cost-Effectiveness Analysis of Head Computed Tomography in Children with Mild Traumatic Brain Injury
Authors: Tunthanathip Thara , Phuenpathom Nakornchai , Sae-heng Sakchai , Oearsakul Thakul , Sakarunchai Ittichai , Krewborisutsakul Anukoon , Taweesomboonyat Chin 
Published: June 2021

Background:
Head computed tomography (CT) is used as a diagnostic tool for intracranial injury following traumatic brain injury (TBI). However, the long-term effects of radiation exposure should be of concern in children. This study compared the cost-effectiveness of the early head CT (ECT) strategy with that of initial conservative treatment with parent education of the nonearly CT (NECT) in pediatric TBI with a Glasgow Coma Scale (GCS) score of 15.

Methods:
A retrospective study was conducted with TBI children with a GCS of 15, who were treated at an emergency department (ED). The costs and outcomes of the children were recorded. The authors used a decision tree model (Plant-A-Tree, International Decision Support Initiative, United Kingdom) to compare the cost-effectiveness analysis of two strategies. The incremental cost-effectiveness ratio (ICER) was also calculated.

Results:
For the ECT group, the rate of the positive results following head CT was 17.6%, and the common intracranial injuries were epidural hematoma, skull fracture, and subdural hematoma in 11.5%, 9.8%, and 6.6%, respectively. The children in the ECT group who underwent surgery were 3.2%. For the NECT group, revisions were observed in 5.3%, and all patients with revision underwent CT. Therefore, the frontal contusion was observed in 10% following CT, and none underwent surgery in the NECT group. From a healthcare provider’s perspective, the expected cost of the ECT group was US $597.49, whereas the expected cost of the NECT group that included overall costs at ED was US $115.27. The expected outcome of the ECT group was less than the NECT group that caused the base-case ICER to be negative (−US $30,715.28 per outcome gained). A sensitivity analysis revealed that an early CT strategy became a dominant strategy that needed a low revision rate but a high rate of positive findings after head CT.

Conclusion:
The initial conservative treatment was the dominant strategy. This strategy was safe and effective and could diminish the unnecessary exposure to radiation in children.
A study to understand the pattern of hyponatremia in patients using selective serotonin reuptake inhibitors and serotonin dopamine antagonists
Authors: Tomar Love Kumar , Patra Priyadarshee , Nigam Ankur 
Published: June 2021

Introduction:
Hyponatremia can be a common but often overlooked side effects of psychotropics drugs. Most patients with drug-induced hyponatremia are asymptomatic and diagnosis is made incidentally following routine blood tests.

Objectives:
The aim of the study was to understand the pattern of hyponatremia in patients using selective serotonin reuptake inhibitors (SSRI) and serotonin dopamine antagonists (SDA).

Materials and Methods:
All inpatients and outpatients who were diagnosed with International Classification of Diseases-10 psychiatric disorders and undergoing treatment with SSRI, SDA, or combination of both for the same, were included in the study after simple random sampling, subject to inclusion and exclusion criteria.

Statistical Analysis Used:
Categorical variables were observed as numbers and percentages. Continuous variables were evaluated as mean ± standard deviation. A Chi-square test was done to find the association between categorical variables. SPSS (IBM) version 21 was used for data analysis.

Results:
In 150 patients, we found hyponatremia in 17 patients (11.33%). About 66–75 age group patients had maximum found cases of hyponatremia (66.66%). About 20.31% of females found hyponatremia. Among SSRIs, 16% of individuals had hyponatremia whereas among SDA it was 6%. Patients who were taking both SSRIs and SDA total prevalence of hyponatremia was 12%.

Conclusions:
Older age groups and females had higher chances of hyponatremia while taking SSRIs and SDAs. Among SSRIs, escitalopram had maximum percentage of hyponatremia, whereas fluvoxamine had minimum. Among SDAs, risperidone had maximum percentage, whereas quetiapine had minimum percentage of hyponatremia. Patients who were taking both fluoxetine + olanzapine or fluoxetine + risperidone had higher percentage of hyponatremia.
Coping strategies and social support as moderators of occupational stress and mental health link among police personnel
Authors: Singh Shweta , Gupta Bandna , Mishra P. C. 
Published: June 2021

Background:
The occupation of police personnel is known to be enormously stressful. The occupational stress research shows that coping strategies and social support have a buffering effect on stress and a protective role on mental health. The present research study was set out to investigate the role of coping strategies and social support as moderating factors of the relationship between occupational stress and mental health in police personnel of Uttar Pradesh in terms of their ranking.

Methodology:
The present cross-sectional study was conducted using standardized questionnaires. The sample comprised a total of 300 male police personnel. Hundred constables, 100 inspectors, and 100 officers were incidentally selected from six districts of Uttar: Lucknow, Varanasi, Meerut, Raebareli, Ghaziabad, and Noida.

Results:
Study results showed coping strategies and social support to have a moderating effect on the relationship between stress and mental health in inspectors and officers but failed to show such relationship in constables.

Conclusion:
There is the implication for the training in terms of teaching-specific active and adaptive coping strategies for the management of workplace-related stress and promotion of health and well-being in the police personnel.
A Study on the Cardiac Manifestations and their Short-Term Outcome in Patients with Kawasaki Disease in an Indian Population
Authors: Rajesh Gopalan Nair , Prasanth S , Vellani Haridasan , Jose Jomy Vadasseril 
Published: June 2021

Objectives:
This study aimed to assess the prevalence of cardiac manifestations and their short-term outcome in patients with Kawasaki disease (KD) in an Indian population.

Methods:
This single-center prospective study enrolled a total of 56 consecutive patients with classic and incomplete KD. Six months and 1-year clinical outcomes were analyzed.

Results:
Fifty-six consecutive patients were enrolled in the study and followed up for 1 year. About 87% completed 6 months follow-up. A diagnosis of complete KD was made in 41 (73%) patients and incomplete KD in 15 (27%). Cardiac manifestations were present in 25% of patients with KD. Coronary involvement was observed in 11 (20%) patients by either Japanese Ministry of Health Criteria or a z score of ≥2.5. Nonpurulent conjunctivitis was significantly higher among children with cardiac involvement (79% vs. 43% P= 0.04). The mean value of erythrocyte sedimentation rate (ESR) was significantly higher among patients with cardiac involvement (101.92 ± 22 vs. 74.26 ± 28.6; P= 0.002). An ESR value of >100 mm/hr was predictive of cardiac involvement (P = 0.03). The mean serum glutamic-pyruvic transaminase value was higher among those with cardiac involvement (P = 0.008). Coronary dilatation got resolved in 3 months in 73% of patients. Valvular regurgitations, aortic root involvement, and depressed left ventricular myocardial function were not observed in the population studied.

Conclusions:
Cardiac manifestations were present in 25% of patients with KD, 20% of children had coronary involvement in the form of an aneurysm, or ectasia. About 73% of patients with coronary dilatation got resolved in 3 months. Significant valvular heart diseases, aortic root involvement, and myocardial contractile dysfunction were not seen in the studied population with KD.
Utility of Napsin-A in Diagnosis of nOn-Small Cell Lung Carcinomas and its Addition with Thyroid Transcription Factor-1 (TTF-1) in Small Biopsies of Lung
Authors: Ranjan Richa , Prashar Manoj , Taur Nishant , Singh Sankalp , Lohia Nishant , Sivasubramananian R. , Sundaram Viswanath , Subramananiam Anand 
Published: June 2021

Background:
Lung cancer is the leading cause of cancer-related deaths in the world. Primary lung carcinomas were being divided simply as small cell lung carcinoma (SCLC) and non-small cell lung carcinoma (NSCLC) in recent past as the chemotherapy offered in NSCLC was not majorly different in the various subtypes. With the advent of targeted therapy, the management of primary lung adenocarcinomas (PLA) and squamous cell carcinomas (SqCCs) became divergent and hence a stringent separation of the two subgroups is imperative. This study was designed to see whether inclusion of immunohistochemistry (IHC) for Napsin-A in the panel of CK7, CK20, p40, and thyroid transcription factor-1 (TTF-1) improves the diagnostic rates of lung adenocarcinomas.

Materials and Methods:
A total of 56 cases of primary lung malignancies were studied and subtyped, based on Hematoxylin and Eosin stained slides along with IHC for CK 7, CK 20, p40, TTF-1, and Napsin-A. NSCLC was divided into five groups-PLA, SqCC, NSCLC–favor adenocarcinoma, NSCLC–favor SqCC, and NSCLC–not otherwise specified (NOS).

Results:
Out of the total, 38 cases were diagnosed to be NSCLC. Of these 38, only 55% cases were diagnosed using histomorphology alone. The rest required immunohistochemical stains for classification. The NSCLC-NOS group comprised 11% in this study. It was observed that by including Napsin-A in the panel, 01/04 (25%) cases in NSCLC-NOS group could be included in NSCLC–favor adenocarcinoma group.

Conclusions:
This study finds that Napsin-A labels additional cases as adenocarcinomas in NSCLC-NOS group. Napsin-A is more sensitive but less specific than TTF-1 in diagnosis of PLA and has a definite use, in conjunction with TTF-1 to classify NSCLC.
Influence of catechol-O-methyltransferase enzyme gene polymorphism on alcohol and tobacco consumption in North Indian treatment seeking population
Authors: Quraishi Rizwana , Sharma Jaydeep , Jain Raka , Ambekar Atul 
Published: June 2021

Background:
The co-occurrence of alcohol and tobacco dependence is frequently witnessed in treatment settings. It is a challenge for clinicians to treat such patients due to their powerful biological association.

Aim:
The study is aimed to assess the relationship of Catechol-O-methyltransferase (COMT) Val158Met polymorphism with substance intake among individuals who are dependent on both alcohol and tobacco.

Materials and Methods:
A cross-sectional study involving patients coming to the outpatient department was planned. Brief information on their sociodemographic and substance use profile was recorded. Genotyping of COMT Val158Met was carried out using established polymerase chain reaction-restriction fragment length polymorphism method. The COMT genotyping was classified based on the presence or absence of Met allele using the dominant model. Descriptive statistics, Chi-square test, Mann–Whitney test, and Binary logistic regression analysis were performed to analyze the data.

Results:
The study included 104 alcohol and nicotine co-dependent subjects. More than eighty percent of the participants were educated above secondary level, married, and employed. The allele frequencies of met and Val were found to be 0.23 and 0.77, respectively. Forty percent of the participants reported tobacco-related health problems. The odds of consuming alcohol and nicotine were four times high among Met allele carriers. While the Fagerström test for nicotine dependence and heaviness of smoking index scores were up to four and eight times higher among met allele (odds ratio 4.3 and 8.9, respectively).

Conclusion:
Patients carrying Met allele are reported to consume higher amounts of alcohol and tobacco and were likely to score high among measures of nicotine dependence. Thus met allele carriers needs additional attention for a successful treatment outcome.
De druk van te hoge verwachtingen
Authors: van Wijngaarden Gert Jan 
Published: June 2021

Abstract
The pleasant, quiet archaeological site of Olympia appears a far cry from the fame of the ancient Olympic Games, or from the spectacle of the modern variety. In this article, I discuss the end of ancient Olympia and the gradual re-emergence of the archaeological site. After Olympia was abandoned in early Byzantine times, its location was no longer remembered. However, its fame remained, partly through translations of ancient texts, notably Pausanias, partly through the revival of the Olympic Games in the 19th century. Early modern travelers and the French scholars who worked at the site as part of the Expedition de la Morée hoped that the site could fulfill their high expectations, in particular with regards to ancient sculpture. As the excavations continued, since 1875 as part of the research program of the German Archaeological Institute, the buried remains have revealed a different material reality. As a result of the combination of continuous research and restoration up until the present day the site of Olympia now provides an independent view on the past.
De Olympische Spelen van 1936 en de Duitse aanspraken op het antieke Griekenland
Authors: Moormann Eric 
Published: June 2021

Abstract
The modern Olympic Games started with a modest, but international event in Athens in 1896, the result of a long preparation process launched by Baron De Coubertin. Some ancient elements were included, but as a whole these and subsequent Olympics were purely modern manifestations. Several classical references in the modern games were only introduced in the 1936 games which took place in a sinister Nazi Berlin. Here the organizers, in the context of a temporarily international and ‘open to the world’ national socialism, connected classical antiquity to contemporary ideology and instrumentalized ancient body culture as expressions of the ideology of Aryanism and German superiority. These claims of the Nazi games on antiquity form the subject of this contribution.
ATIVIDADES DE LEITURA NOS MODOS DE SUBJETIVAÇÃO ESCOLAR DO POVO AKWÉN-XERENTE (JÊ)
Authors: Sousa Filho Sinval Martins de 
Published: June 2021

Analiso atividades de leitura no âmbito da educação escolar Akwén-Xerente e estabeleço como essas atividades são usadas nos modos de subjetivação dos professores e alunos Xerente. Para tanto, discuto como se dão os processos linguístico-discursivos de subjetivação dos sujeitos escolares e como tais imperativos são expressos nas práticas realizadas em sala de aula, em documentos, parâmetros, políticas educacionais e outros que dizem respeito à educação escolar indígena, particularmente os documentos que dizem respeito aos Xerente (Braggio e Sousa Filho, 2006 e Sousa Filho, 2011). A fundamentação teórica parte das concepções de sujeito elaboradas por Foucault (1995) e Bakhtin (2000). Trata-se de um estudo de natureza qualitativo-descritiva cuja proposta metodológica converge à análise dos documentos oficiais que regulamentam as propostas de educação escolar indígena no país e às observações etnográficas das práticas pedagógicas dos Xerente. Os resultados apontam para a construção de elementos de subjetivação elaborados nas práticas discursivas de leitura, as quais fornecem bases para a apreensão de novos regimes de verdade sobre o sujeito e seus modos de agir socialmente.
COOPERAÇÃO FEDERATIVA E METAS PARA A EDUCAÇÃO SUPERIOR NOS PLANOS ESTADUAIS DE EDUCAÇÃO:
Authors: Carvalho Renata Ramos da Silva , Anderi Eliane Gonçalves Costa 
Published: June 2021

Este texto apresenta o resultado de uma análise realizada nos Planos Estaduais de Educação (PEEs) com o objetivo de verificar como os conteúdos das metas e estratégias para a educação superior do PNE (2014-2024) estão previstos (ou não) nesses planos estaduais. Buscou-se também, observar se há menção/intenção de algum comprometimento objetivo do estado com a expansão da educação superior pública estadual. Trata-se de um estudo documental que analisou os 20 PEEs aprovados até o momento da realização da pesquisa. O texto está estruturado em quatro seções: Introdução; Metas para a educação superior nos Planos Estaduais de Educação: desafios de articulação com o PNE (2014-2024); O papel das universidades estaduais nas estratégias das metas para a educação superior dos Planos Estaduais de Educação; e, as considerações finais. O estudo identificou que foram poucos os estados que expressaram, em seus PEEs, algum compromisso de expansão da educação superior por meio de suas UEs.
High-resolution 14C bomb peak dating and climate response analyses of subseasonal stable isotope signals in wood of the African baobab – a case study from Oman
Authors: Slotta Franziska , Wacker Lukas , Riedel Frank , Heußner Karl-Uwe , Hartmann Kai , Helle Gerhard 
Published: June 2021

Abstract. The African baobab, Adansonia digitata L., has great paleoclimatological
potential because of its wide distributional range and millennial length
life span. However, dendroclimatological approaches are hampered by dating
uncertainties due to its unique, parenchyma-dominated stem anatomy. Here,
securely dated time series of annual wood increment growth and intra-ring
stable isotopes of carbon and oxygen of cellulose for a baobab tree from
Oman covering 1941 to 2005 were established and tested for relationships to
hydroclimate variability. Precise dating with the atomic bomb peak (ABP)
using highly resolved 14C measurements confirmed the annual character
of the baobab's growth rings. F14C values of tree-ring cellulose were
found up to 8.8 % lower than in the corresponding atmospheric CO2
for the period around the ABP, which in conjunction with a considerable
autocorrelation of the δ13C series points to the incorporation
of previous year's carbon contributing to the average age of intra-ring wood
samples. F14C of terminal parenchyma bands, marking the tree-ring
boundaries, were found to be considerably younger than their corresponding
tree ring, indicating that parenchyma tissue is alive for many years, probably
undergoing cell division and structural reorganization and contributing to
secondary growth. In contrast to the δ13C time series, no
significant autocorrelation was found in the δ18O series of
tree-ring cellulose despite the enormous water storage potential of this
stem-succulent tree species. Year-to-year variability in tree-ring width and
stable isotope ratios revealed radial stem growth and the geochemistry of
wood cellulose are influenced by fluctuations in the hydroclimate. In
particular, δ18O was found to be a good climate proxy, followed
by tree-ring width and δ13C. Tree-ring width and intra-ring
δ18Omin correlated well with each other and with
precipitation amount for the period from pre-monsoon May to the end of the
monsoon season in September/October. Intra-annual stable isotope courses
were found to be rather similar for both δ13C and δ18O.
Years with particularly low monsoon rain were reflected by increased stable
isotope values in the mid-section of intra-annual courses. Distinct patterns
with low subseasonal isotope values seem indicative for years with heavy
rainfall events from pre-monsoonal cyclones. Rain events from post-monsoonal
cyclones may also be recorded; however, only 2 years of observation
prevented a more conclusive evaluation.
Enhanced terrestrial runoff during Oceanic Anoxic Event 2 on the North Carolina Coastal Plain, USA
Authors: Lowery Christopher M. , Self-Trail Jean M. , Barrie Craig D. 
Published: June 2021

Abstract. A global increase in the strength of the hydrologic cycle drove an increase
in the flux of terrigenous sediments into the ocean during the
Cenomanian–Turonian Oceanic Anoxic Event 2 (OAE2) and was an important
mechanism driving nutrient enrichment and thus organic carbon burial. This
global change is primarily known from isotopic records, but global average
data do not tell us anything about changes at any particular location.
Reconstructions of local terrigenous flux can help us understand the role of
regional shifts in precipitation in driving these global trends. The
proto-North Atlantic basin was one of the epicenters of enhanced organic
carbon burial during OAE2, so constraining terrigenous flux is
particularly important in this region; however, few local records exist.
Here, we present two new OAE2 records from the Atlantic Coastal Plain of
North Carolina, USA, recognized with calcareous nannoplankton
biostratigraphy and organic carbon isotopes. We use carbon / nitrogen ratios
to constrain the relative contribution of marine and terrestrial organic
matter; in both cores we find an elevated contribution from vascular plants
beginning just before OAE2 and continuing through the event, indicating a
locally strengthened hydrologic cycle. Terrigenous flux decreased during the
brief change in carbon isotope values known as the Plenus carbon isotope
excursion; it then increased and remained elevated through the latter part of
OAE2. Total organic carbon (TOC) values reveal relatively low organic carbon burial in the inner
shelf, in contrast to black shales known from the open ocean. Organic carbon
content on the shelf appears to increase in the offshore direction,
highlighting the need for cores from the middle and outer shelf.