bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feasibility of oral antibiotic prophylaxis in elective laparoscopic cholecystectomy during periods of limited cefazolin supply
Authors: Tsunematsu Masashi , Nakashima Shunsuke , Ishiyama Satoshi 
Published: June 2021

AbstractIntroductionIn March 2019, the supply of cefazolin sodium (CEZ) became difficult owing to contamination of the drug substance. We investigated the efficacy and safety of the oral administration of cephalexin (CEX) in preventing infectious complications following elective laparoscopic cholecystectomy (LC).MethodsFrom July 2018 to June 2019, 1 g of CEZ was administered intravenously within 30 min prior to LC (IV group). From July 2019 to June 2020, 0.5 g of CEX was administrated orally within 2 h prior to LC (oral group). We compared clinicopathologic variables and perioperative results between these two groups.ResultsDuring the period, 60 patients underwent elective LC; 35 from the oral group and 25 from the IV group. There was no significant difference in the surgical site infection (P = 0.37), distant infection (P = 0.23), and postoperative medical costs (P = 0.11) between both groups. Postoperative nausea and vomiting were significantly higher in the oral group (P = 0.04), whereas the C‐reactive protein value on the first day after the operation was significantly lower in the oral group (P < 0.01).ConclusionDuring the period of limited CEZ supply, oral administration of CEX may be an alternative antibiotic prophylaxis in LC.
Intentional machines: A defence of trust in medical artificial intelligence
Authors: Starke Georg , van den Brule Rik , Elger Bernice Simone , Haselager Pim 
Published: June 2021

AbstractTrust constitutes a fundamental strategy to deal with risks and uncertainty in complex societies. In line with the vast literature stressing the importance of trust in doctor–patient relationships, trust is therefore regularly suggested as a way of dealing with the risks of medical artificial intelligence (AI). Yet, this approach has come under charge from different angles. At least two lines of thought can be distinguished: (1) that trusting AI is conceptually confused, that is, that we cannot trust AI; and (2) that it is also dangerous, that is, that we should not trust AI—particularly if the stakes are as high as they routinely are in medicine. In this paper, we aim to defend a notion of trust in the context of medical AI against both charges. To do so, we highlight the technically mediated intentions manifest in AI systems, rendering trust a conceptually plausible stance for dealing with them. Based on literature from human–robot interactions, psychology and sociology, we then propose a novel model to analyse notions of trust, distinguishing between three aspects: reliability, competence, and intentions. We discuss each aspect and make suggestions regarding how medical AI may become worthy of our trust.
Learning of paediatric dentistry with the flipped classroom model
Authors: Gallardo Nuria E. , Caleya Antonia M. , Sánchez Maria Esperanza , Feijóo Gonzalo 
Published: June 2021

AbstractIntroductionThe flipped classroom (FC) is a pedagogical model that can be very useful in obtaining a dentistry degree. The main objective of this study was to compare learning between student groups introducing FC in the area of paediatric dentistry at the Complutense University of Madrid in 2019.Materials and MethodsIn this study, 76 students enrolled for the first time in the Pediatric Dentistry programme and completed a questionnaire (pre‐Q) regarding specific theoretical knowledge about pulpotomies. Subsequently, they were divided into two groups: group A, which had free access before the class to an explanatory video about the indications and techniques of pulpotomy and group B, which viewed the same video only one time in class. After that, all students completed the same questionnaire (post‐Q) again and a survey on the degree of satisfaction about the teaching method.ResultsThe differences in score between the post‐Q and pre‐Q in group A had a mean (SD) value of 3.5 (2.4) and in group B, a mean (SD) of 2.5 (2.2), with a p value of .07. In questions 3, 5 and 8, learning was greater in the experimental group (p = .007, p = .02 and p = .001, respectively). For 74.4% of the students in group A, accessing the video previous to the class was a very useful tool.ConclusionsThese results suggest that implementing FC in paediatric dentistry classes help students to acquire more theoretical knowledge, which is necessary before practical teaching.
Incidental reactive focus on form in language classes: Learners' formulaic versus nonformulaic errors, their treatment, and effectiveness in communicative interactions
Authors: Gholami Leila 
Published: June 2021

AbstractResearch on incidental focus on form (FonF) has established associations among the nature of learner error, corrective feedback (CF), and effectiveness of CF measured through uptake. In this line of research, the analysis of learner error has been limited to errors with grammar, pronunciation, vocabulary, and spelling (nonformulaic). Consequently, learners' errors with formulaic sequences (FSs) comprising collocations, lexical bundles, idioms, and compounds (formulaic) have not yet been investigated in FonF studies. This study examined the extent to which learners made errors with formulaic versus nonformulaic forms, and the degree to which teachers treated learners' errors with formulaic versus nonformulaic foci in communicatively oriented teacher‐learner interactions. Learners' production of uptake and successful uptake after receiving CF was also investigated. The data consisted of 36 h of audio‐recordings from primarily communicative activities in three English as a foreign language classrooms. The findings demonstrated, while learners' formulaic‐oriented errors outnumbered nonformulaic ones, the teachers provided CF significantly more often for nonformulaic errors. However, learners produced significantly more uptake and successful uptake when CF was provided for formulaic‐oriented errors compared to nonformulaic ones. The learners' higher successful uptake following formulaic‐oriented errors could be attributed to the relatively higher saliency, noticeability, and significance of FSs in meaning making.
The quest to reduce stroke treatment delays at a Melbourne metropolitan primary stroke centre over the past two decades
Authors: Park Peter S. W. , Frost Tanya , Tan Shuangyue , Wong Joseph , Pope Alun , Dewey Helen M. , Choi Philip M. C. 
Published: June 2021

AbstractBackgroundReducing door‐to‐needle time (DNT) for intravenous thrombolysis in acute ischaemic stroke can lead to improved patient outcomes. Long‐term reports on DNT trends in Australia are lacking in the setting of extension of the thrombolysis time window, addition of mechanical thrombectomy and increasing presentations.AimsTo examine 17‐year trends of DNT and identify factors associated with improved DNT at a high‐volume, metropolitan primary stroke centre.MethodRetrospective study between 2003 and 2019 of all thrombolysis cases using departmental stroke database. Since most strategies were implemented from 2012 onwards, intervention period has been defined as period 2012–2019. Factors associated with DNT reduction were examined by regression modelling.ResultsFifteen strategies were identified including alterations to ‘Code Stroke’ processes. One thousand, two hundred and fifty patients were thrombolysed, with 737 (58.8%) treated during the intervention period. The proportion of DNT ≤60‐min rose from average of 22.5% during 2003–2012 to 63% during 2015–2018 and 71% in 2019. However, median DNT has only marginally improved from 58 to 51 min between 2015 and 2019. Faster DNT was independently associated with two modifiable workflow factors, ‘Direct‐to‐CT’ protocol (P < 0.001) and acute stroke nurse presence (P < 0.005). Over time, treated patients were older and less independent (P < 0.001), and the number of annual stroke admissions and ‘Code Stroke’ activations have risen by fourfold and 10‐fold to 748 and 1298 by 2019 respectively.ConclusionsTargeted quality improvement initiatives are key to reducing thrombolysis treatment delays in the Australian metropolitan setting. Relative stagnation in DNT improvement is concerning and needs further investigation.
Integrative Community Therapy – interventive strategies in the reduction of depression symptoms in adolescents: A quasi‐experimental study
Authors: Alves Mariane Inaraí , Felipe Adriana Olimpia Barbosa , Moreira Denis da Silva 
Published: June 2021

AbstractThis study aimed to evaluate the effects of Integrative Community Therapy on depression symptoms in adolescents in the school context. This is a quantitative, quasi‐experimental, pre‐, and post‐test study that compared depression scores before and after the Integrative Community Therapy intervention was applied, conducted with 56 adolescent students. The guidelines recommended by the Standards for Quality Improvement Reporting Excellence were used to present this study. The instruments used for data collection were the following: Participants' characterization, Economic Classification, and the Children's Depression Inventory. This depression inventory was applied before and after the intervention was carried out. Most of the participants presented depressive symptoms (53.6%). Girls presented higher depression scores and were more likely to develop depression; to be working proved to be a protective factor for depression and adolescents with depression symptoms presented a higher proportion of suicidal ideation. The analysis of the depression variable indicated a reduction of the scores in the post‐intervention period; however, in the gender analysis, there was a reduction in the depression scores only for the girls. The Integrative Community Therapy was an effective intervention in reducing depression scores, being a relevant strategy for healthcare services and schools in assisting adolescents to deal with their emotions, mitigate psycho‐emotional suffering, and contribute as a support tool in the context of vulnerabilities inherent to the process of becoming an adolescent.
Formation of ferrospinel layer at the corroded interface between Al2O3‐spinel refractory and molten steel in RH refining ladle
Authors: Chen Junfeng , Cheng Yaping , Li Yuanyuan , Xiao Junli , Zhang Yu , Liu Guangping , Wei Yaowu , Li Guangqiang , Zhang Shaowei , Li Nan 
Published: June 2021

AbstractRefining ladle is generally the last inclusion‐removal vessel before the continuous casting of steel, so, it has a vital effect on the final steel quality. In this work, degradation process of a cement‐free Al2O3‐MgAl2O4 refractory in contact with molten steel/slag in the metal bath area of a Ruhrstahl Heraeus (RH) refining ladle was investigated. A reaction product layer with the formation of ferrospinel (hercynite) and Fe‐rich phases was observed, suggesting that the interactions/reactions between the refractory lining and the molten steel should also be considered to have a better understanding of overall degradation mechanism of the refractory served under the RH refining conditions. The two types of alumina grains in the refractory, sintered and fused alumina, were attacked in an active way and a passive way, respectively. The effect of the crack generation and steel infiltration on degradation of the refractory was also discussed in detail, based on the microstructural characterizations.
Impact of sense of coherence, resilience and loneliness on quality of life amongst older adults in long‐term care: A correlational study using the salutogenic model
Authors: Tan Jia Yi , Tam Wai San Wilson , Goh Hongli Sam , Ow Chee Chung , Wu Xi Vivien 
Published: June 2021

AbstractAimsThis study aimed to identify the predicting factors of quality of life (QoL) from a set of psychosocial, sociodemographic and clinical variables amongst older adults in a long‐term care setting.DesignA cross‐sectional, descriptive correlational study.MethodThe study was conducted in a nursing home and a day care centre from July to December 2019. Two hundred older adults were recruited. Guided by the salutogenic model, the sense of coherence (SOC) scale, Connor–Davidson resilience scale, de Jong Gierveld loneliness scale and World Health Organization quality of life instrument‐older adults (WHOQOL‐OLD) were used. The sociodemographic and clinical profiles of participants were collected. Descriptive statistics, Pearson product‐moment correlation coefficient, independent‐samples t test, one‐way analysis of variance and stepwise regression were utilised in the analysis.ResultsThe mean score for WHOQOL‐OLD was 94.42 ± 19.55. The highest mean score was observed in the “Death and Dying” facet, while the lowest mean scores were reflected in the “Autonomy” and “Intimacy” facets of QoL. Regardless of resident type, most QoL scores were similar across different variables. Based on the stepwise regression, higher manageability and meaningfulness in SOC, higher resilience, lower social loneliness, lower emotional loneliness and hearing impairments are significantly associated with higher QoL.ConclusionManageability, meaningfulness and resilience should be enhanced while ameliorating feelings of loneliness to improve the QoL amongst older adults receiving long‐term care. Age, marital status, educational level, care arrangement, body mass index, performance in activities of daily living, comorbidities and hearing and mobility impairments could influence QoL and thus warrant more attention.ImpactFuture interventions can be conducted in group sessions to facilitate social interaction and alleviate loneliness. More resources should be allocated to enhance older adults’ care arrangements and coping mechanisms to provide them with the support, as they face challenges in daily life due to mobility impairment and other restrictions.
The anomalous diffusion model based on a fractional calculus approach applied to describe the rehydration process of dried vegetal food matrices
Authors: Lemus‐Mondaca Roberto , Nuñez Helena , Jaques Aldonza , Ramírez Cristian , Simpson Ricardo 
Published: June 2021

AbstractThe rehydration process has been traditionally modeled by Fick's second law; however, due to the poor goodness of fit, empirical models such as Peleg's and Weibull models have been implemented. The aim of this work was to demonstrate that the anomalous diffusion model based on fractional calculus can be used to model rehydration process and simultaneously provide a phenomenological understanding of the process. The food matrices assessed were aloe vera, apple, Chilean papaya, and bell peppers rehydrated at 20, 40, and 60°C. The results showed that the anomalous diffusion model was not only able to improve the goodness of fit of rehydration data (R2 >.99), but also that Deff can be used under different temperatures given the goodness of fit of the Arrhenius model (R2 >.88) compared with empirical and Fick's models. Finally, an anomalous diffusion model based on fractional calculus can be successfully used to model the rehydration process in food materials.Practical ApplicationsThe novelty of this research is based on the implementation of the anomalous diffusion model that has the simplicity and accuracy of empirical models (e.g., Peleg's model) but with the advantage of a physical interpretation and predictive capacity. Furthermore, although the anomalous model has already been successfully tested in the dehydration process, this is the first time that it has been validated in a rehydration process. Due to the predictive capacity of the anomalous under different operation conditions, the food industry not only could estimate processing time with high accuracy, but also optimize the rehydration process.
Burnout and moral resilience in interdisciplinary healthcare professionals
Authors: Antonsdottir Inga , Rushton Cynda Hylton , Nelson Katie Elizabeth , Heinze Katherine E. , Swoboda Sandra M. , Hanson Ginger C. 
Published: June 2021

AbstractAims and objectivesTo examine demographic and work characteristics of interdisciplinary healthcare professionals associated with higher burnout and to examine whether the four domains of moral resilience contribute to burnout over and above work and demographic variables.BackgroundHealthcare professionals experience complex ethical challenges on a daily basis leading to burnout and moral distress. Measurement of moral resilience is a new and vital step in creating tailored interventions that will foster moral resilience at the bedside.DesignCross‐sectional descriptive design.MethodsHealthcare professionals in the eastern USA were recruited weekly via email for 3 weeks in this cross‐sectional study. Online questionnaires were used to conduct the study. The STROBE checklist was used to report the results.ResultsWork and demographic factors, such as religious preference, years worked in a healthcare profession, practice location, race, patient age, profession and education level, have unique relationships with burnout subscales and turnover intention, with the four subscales of moral resilience demonstrating a protective relationship with outcomes above and beyond the variance explained by work and demographic characteristics.ConclusionsHigher moral resilience is related to lower burnout and turnover intentions, with multiple work demographic correlates allowing for potential areas of intervention to deal with an increase in morally distressing situations occurring at the bedside. Additionally, patterns of significant and non‐significant relationships between the moral resilience subscales and burnout subscales indicate that these subscales represent unique constructs.Relevance to clinical practiceUnderstanding the everyday, pre‐pandemic correlations of moral resilience and burnout among interdisciplinary clinicians allows us to see changes that may exist. Measuring and understanding moral resilience in healthcare professionals is vital for creating ways to build healthier, more sustainable clinical work environments and enhanced patient care delivery.
The roles of free iron, heme, haemoglobin, and the scavenger proteins haemopexin and alpha‐1‐microglobulin in preeclampsia and fetal growth restriction
Authors: Erlandsson Lena , Masoumi Zahra , Hansson Lucas R. , Hansson Stefan R. 
Published: June 2021

AbstractBackgroundPreeclampsia (PE) is a complex pregnancy syndrome characterised by maternal hypertension and organ damage after 20 weeks of gestation and is associated with an increased risk of cardiovascular disease later in life. Extracellular haemoglobin (Hb) and its metabolites heme and iron are highly toxic molecules and several defence mechanisms have evolved to protect the tissue.ObjectivesWe will discuss the roles of free iron, heme, Hb, and the scavenger proteins haemopexin and alpha‐1‐microglobulin in pregnancies complicated by PE and fetal growth restriction (FGR).ConclusionIn PE, oxidative stress causes syncytiotrophoblast (STB) stress and increased shedding of placental STB‐derived extracellular vesicles (STBEV). The level in maternal circulation correlates with the severity of hypertension and supports the involvement of STBEVs in causing maternal symptoms in PE. In PE and FGR, iron homeostasis is changed, and iron levels significantly correlate with the severity of the disease. The normal increase in plasma volume taking place during pregnancy is less for PE and FGR and therefore have a different impact on, for example, iron concentration, compared to normal pregnancy. Excess iron promotes ferroptosis is suggested to play a role in trophoblast stress and lipotoxicity. Non‐erythroid α‐globin regulates vasodilation through the endothelial nitric oxide synthase pathway, and hypoxia‐induced α‐globin expression in STBs in PE placentas is suggested to contribute to hypertension in PE. Underlying placental pathology in PE with and without FGR might be amplified by iron and heme overload causing oxidative stress and ferroptosis. As the placenta becomes stressed, the release of STBEVs increases and affects the maternal vasculature.
Rural‐urban differences in hospitalizations for opioid use‐associated infective endocarditis in Kentucky, 2016‐2019
Authors: Siddiqi Kamran , Freeman Patricia R. , Fanucchi Laura C. , Slavova Svetla 
Published: June 2021

AbstractPurposeIn 2016, the US rate of opioid use‐associated infective endocarditis (OUA IE) hospitalizations was 3.86/100,000 for rural and 3.49/100,000 for urban residents. This study estimates the Kentucky OUA IE hospitalization rates, 2016‐2019, describing differences in rural‐urban residency trends, demographics, relevant comorbidities, and discharge disposition. OUA IE hospitalization rates between counties with and without syringe services programs (SSPs) are also compared.MethodsWe used Kentucky statewide inpatient discharge records from 2016 to 2019. An OUA IE hospitalization was identified by an infective endocarditis discharge diagnosis in any diagnosis field and a concurrent diagnosis indicating opioid use. Rurality was determined based on the 2013 Rural‐Urban Continuum Codes (RUCC).FindingsKentucky's rate of OUA IE hospitalizations in 2016 was 8.9/100,000, with no significant variation between rural and urban residents. By 2019, the average rate for urban residents doubled to 17.9/100,000, significantly higher than the rural resident rate, 13.2/100,000. There were no significant rural‐urban differences in percentages of those with concurrent diagnoses of HIV (<1%) or HCV (>60%). Counties that established SSPs in 2017‐2018 had a 39.4% increase in OUA IE rates from 2016 to 2019, while counties without SSPs had a 79.5% increase.ConclusionThe estimated 2016 Kentucky rates of OUA IE hospitalizations are 2 times higher than reported national rates, highlighting Kentucky as one of the areas most affected by this particular opioid use disorder complication. Despite challenges and barriers to the effectiveness of SSPs as a harm reduction measure, our study suggests a positive effect that should be further investigated.
Increased prevalence of gastrointestinal symptoms and disorders of gut‐brain interaction during the COVID‐19 pandemic: An internet‐based survey
Authors: Nakov Radislav , Dimitrova‐Yurukova Desislava , Snegarova Violeta , Nakov Ventsislav , Fox Mark , Heinrich Henriette 
Published: June 2021

AbstractBackgroundQuarantine with social distancing has reduced transmission of COVID‐19; however, fear of the disease and these remedial measures cause anxiety and stress. It is not known whether these events have impacted the prevalence of gastrointestinal (GI) symptoms and disorders of brain‐gut interaction (DGBI).MethodsAn online platform evaluated the prevalence of GI symptoms during the COVID‐19 pandemic. Data collection utilized validated questionnaires and was fully anonymized. Findings were compared with identical data acquired in 2019. The association of results with stress and anxiety was analyzed.ResultsData were collected from 1896 subjects May ‐ August 2019 to 980 non‐identical subjects May ‐ June 2020. GI symptoms were reported by 68.9% during the COVID‐19 lockdown compared with 56.0% the previous year (p < 0.001). The prevalence of irritable bowel syndrome (26.3% vs. 20.0%; p < 0.001), functional dyspepsia (18.3% vs. 12.7%; p < 0.001), heartburn (31.7% vs. 26.2%, p = 0.002), and self‐reported milk intolerance (43.5% vs. 37.8% p = 0.004) was higher during the pandemic. Many individuals reported multiple symptoms. Anxiety was associated with presence of all GI symptoms. High levels of stress impacted functional dyspepsia (p = 0.045) and abdominal pain (p = 0.013). The presence of DGBI (p < 0.001; OR 22.99), self‐reported milk intolerance (p < 0.001; OR 2.50), and anxiety (p < 0.001; OR 2.18) was independently associated with increased GI symptoms during COVID‐19 pandemic.ConclusionsThe prevalence of GI symptoms was significantly higher during the COVID‐19 lockdown than under normal circumstances the previous year. This increase was attributable to increased numbers of patients with DGBI, an effect that was associated with anxiety.