bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cannabidiol use and effectiveness: real-world evidence from a Canadian medical cannabis clinic
Authors: Rapin Lucile , Gamaoun Rihab , El Hage Cynthia , Arboleda Maria Fernanda , Prosk Erin 
Published: June 2021

Abstract
Background
Cannabidiol (CBD) is a primary component in the cannabis plant; however, in recent years, interest in CBD treatments has outpaced scientific research and regulatory advancement resulting in a confusing landscape of misinformation and unsubstantiated health claims. Within the limited results from randomized controlled trials, and lack of trust in product quality and known clinical guidelines and dosages, real-world evidence (RWE) from countries with robust regulatory frameworks may fill a critical need for patients and healthcare professionals. Despite growing evidence and interest, no real-world data (RWD) studies have yet investigated patients’ reports of CBD impact on symptom control in the common expression of pain, anxiety, depression, and poor wellbeing. The objective of this study is to assess the impact of CBD-rich treatment on symptom burden, as measured with a specific symptom assessment scale (ESAS-r).

Methods
This retrospective observational study examined pain, anxiety, depression symptoms, and wellbeing in 279 participants over 18 years old, prescribed with CBD-rich treatment at a network of clinics dedicated to medical cannabis in Quebec, Canada. Data were collected at baseline, 3 (FUP1), and 6 (FUP2) month after treatment initiation. Groups were formed based on symptom severity (mild vs moderate/severe) and based on changes to treatment plan at FUP1 (CBD vs THC:CBD). Two-way mixed ANOVAs were used to assess ESAS-r scores differences between groups and between visits.

Results
All average ESAS-r scores decreased between baseline and FUP1 (all ps < 0.003). The addition of delta-9-tetrahydrocannabinol (THC) during the first follow-up had no effect on symptom changes. Patients with moderate/severe symptoms experienced important improvement at FUP1 (all ps < 0.001), whereas scores on pain, anxiety, and wellbeing of those with mild symptoms actually increased. Differences in ESAS-r scores between FUP1 and FUP2 were not statistically different.

Conclusion
This retrospective observational study suggests CBD-rich treatment has a beneficial impact on pain, anxiety, and depression symptoms as well as overall wellbeing only for patients with moderate to severe symptoms; however, no observed effect on mild symptoms. The results of this study contribute to address the myths and misinformation about CBD treatment and demand further investigation.
Involuntary isolation: interpreting mental health legislation during the COVID-19 pandemic
Authors: Sediqzadah Saadia , Ghebrehariat Lwam , Weersink Kristen T. , Fisman David N. , Naidoo Kendra A. 
Published: June 2021

SummaryThe coronavirus disease 2019 (COVID-19) pandemic poses new and unprecedented challenges to the interpretation of mental health law. The authors present pragmatic and ethical considerations in the psychiatric safety assessment at the intersection of COVID-19 and severe mental illness.
The Use of Morning Urinary Gonadotropins and Sex Hormones in the Management of Early Puberty in Chinese Girls
Authors: Zhan Shumin , Huang Ke , Wu Wei , Zhang Danni , Liu Ana , Dorazio Robert M , Shi Jianrong , Ullah Rahim , Zhang Li , Wang Jinling , Dong Guanping , Ni Yan , Fu Junfen 
Published: June 2021

AbstractContextAlthough gonadotropin-releasing hormone stimulation test (GnRHST) is the gold standard in diagnosing central precocious puberty (CPP), it is invasive, expensive, and time-consuming, requiring multiple blood samples to measure gonadotropin levels.ObjectiveWe evaluated whether urinary hormones could be potential biomarkers for prepuberty or postpuberty, aiming to simplify the current diagnosis and prognosis procedure.MethodsWe performed a cross-sectional study of a total of 355 girls with CPP in National Clinical Research Center for Child Health in China, including 258 girls with positive and 97 girls with negative results from GnRHST. Twenty patients received GnRH analogue (GnRHa) treatment and completed a 6-month follow up. We measured luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, prolactin, progesterone, testosterone, and human chorionic gonadotropin in the first morning voided urine samples.ResultsTheir urinary LH levels and the ratios of LH to FSH increased significantly with the advancement in Tanner stages. uLH levels were positively associated with basal and peak LH levels in the serum after GnRH stimulation. A cutoff value of 1.74 IU/L for uLH reached a sensitivity of 69.4% and a specificity of 75.3% in predicting a positive GnRHST result. For the combined threshold (uLH ≥ 1.74 + uLH-to-uFSH ratio &gt; 0.4), the specificity reached 86.6%. After 3 months of GnRHa therapy, the uLH and uFSH levels decreased accordingly.ConclusionuLH could be a reliable biomarker for initial CPP diagnosis and screening; uLH could also be an effective marker for evaluating the efficacy of clinical treatment.
Carcinoma ex pleomorphic adenoma of major salivary glands: CT and MR imaging findings
Authors: Wang Can , Yu Qiang , Li Siyi , Sun Jingjing , Zhu Ling , Wang Pingzhong 
Published: June 2021

Objectives: To describe the CT and MR imaging characteristics of primary carcinoma ex pleomorphic adenoma (Ca-ex-PA) in major salivary glands and present more information for recognizing this malignancy. Methods: 212 patients with primary Ca-ex-PA in major salivary glands (169 in the parotid gland, 36 in the submandibular gland, 7 in the sublingual gland) underwent CT and MR imaging (plain and contrast-enhanced scans) prior to surgical management and histopathological examination. The CT and MR imaging findings of this condition were retrospectively reviewed and correlated with their pathological types: non-invasive carcinoma (Type I, 37 cases), minimally invasive carcinoma (Type II, 18 cases), and widely invasive carcinoma (TypeIII, 157 cases). The binary logistic regression analysis was used to analyze the independent influencing factors of morphology and boundary for differentiating between Type I/II and Type III of Ca-ex-PA, and the sensitivity, specificity and positive predictive value were calculated. Differences in apparent diffusion coefficient (ADC) values between Type I/II and Type III of Ca-ex-PA were calculated by independent sample t-tests. Results: On CT and MR imaging, there were 190/212 cases (89.6%) identified as lobular, 203/212 cases (95.8%) with enhancement, and 173/212 cases (81.6%) with inhomogeneous after contrast administration.Calcification within the mass was shown in 76 of 192 cases (39.6%) on plain CT examination. Of 55 neoplasms with Type I and II, 38 (69.1%) were presented as round or oval and 42 (76.4%) as well-defined margins. Of 157 neoplasms with Type III, 103 (65.6%) were presented as irregular form and 110 (70.1%) as uneven margins or with partial uneven margins.The sensitivity, specificity and positive predictive value for distinguishing Type I/II and Type III tumors according to the morphology and boundary were 78.34%, 63.64% and 86.01%, respectively. The mean ADC value of Ca-ex-PA (22 cases) in major salivary glands was about 0.93 × 10−3 mm2 s−1, and there was no significant difference in mean ADC value between Type I/II and Type III of this neoplasm. Cervical lymph node metastasis and distance metastasis were found in 67 patients (31.6%, Type III) and 32 patients (15.1%, Type I in 1; Type II in 1; and Type III in 30), respectively. Conclusions: Most Ca-ex-PA is characterized by an irregular, lobular, and inhomogeneous enhanced neoplasm with uneven margin or partial uneven margin on CT and MR imaging, which is frequently corresponding with Type III. And a round or oval mass with well-defined margin usually correlates with Type I and II. Morphology and boundary are important basis for distinguishing Type I/II and Type III tumors. Calcification within the neoplasm shown on CT may be regarded as a specific sign for indicating this malignancy. Low ADC value is an important manifestation of this neoplasm.Ca-ex-PA with Type III is more likely to have cervical lymph node metastasis and distant metastasis.
Controle Judicial da Reforma Administrativa
Authors: Meneses Clara 
Published: June 2021

O artigo aborda o papel do Poder Judiciário no contexto da reforma administrativa e de políticas fiscais tomadas em tempos de crise. Busca-se testar a aplicabilidade da Teoria do Equilíbrio Pontuado e contribuir para a compreensão da judicialização da política pública durante a crise das dívidas soberanas, especificamente as medidas administrativas de corte remuneratório aos trabalhadores do setor público. A metodologia adotada foi pesquisa qualitativa, bibliográfica e documental, através de um estudo do caso que visa compreender a atuação do Tribunal Constitucional português de 2010 a 2014, no controle de constitucionalidade dessas políticas. Tais medidas foram tomadas durante o acordo de resgate financeiro, Programa de Assistência Económica e Financeira - PAEF que emprestou €78 mil milhões de euros, com a Comissão Europeia, o Banco Central Europeu e o Fundo Monetário Internacional. A jurisprudência de crise foi desenvolvida em graus de permissibilidade com o legislador e culmina com a pontuação e mudança da política inicialmente estabelecida. No seu conteúdo, os julgamentos adotaram a técnica da ponderação de princípios, cuja inerente subjetividade deixa espaço para uma mudança de política. Conclui-se que a Teoria do Equilíbrio Pontuado demonstra poder explicativo para a compreensão da participação do Judiciário na política pública, e sua aplicação deve ser testada por pesquisas futuras, considerando outros momentos de ruptura.
Burocracia e desempenho da administração pública
Authors: Gomide Alexandre , Da Silva Lins Rafael , Amorim Machado Raphael 
Published: June 2021

O trabalho tem como objetivo contribuir com a discussão sobre o Estado do século XXI ao apontar para características críticas da burocracia pública que merecem mais pesquisas empíricas para o fornecimento de evidências, visando a embasar propostas de reforma administrativas em países em desenvolvimento. Nesse sentido, a partir da análise multivariada de bases de dados disponíveis, o artigo verifica se as características institucionais da burocracia brasileira questionadas pela PEC 32/2020 – o recrutamento por concurso, a profissionalização dos cargos de alta gestão, a existência de um regime especial de trabalho para os servidores e a adoção de salários atrativos– - estão associadas a indicadores internacionais de desempenho da administração pública. Os achados corroboram os argumentos teóricos de que, além dos salários atrativos e do recrutamento por meio de concurso, a existência de regime especial de trabalho com estabilidade funcional para os servidores civis apresenta relações significativas com a diminuição da corrupção e melhoria da governança pública nos países em desenvolvimento. Isso porque os riscos de práticas de patronagem nesses países são maiores quando comparados a países desenvolvidos com burocracias bem estabelecidas.
As reformas da administração pública em Portugal
Authors: Bilhim João 
Published: June 2021

O objetivo deste trabalho é discutir as reformas implementadas em Portugal nos últimos 20 anos e apreciar o seu impacto nos cidadãos, pois frequentemente essas reformas são apresentadas como referências, mas raramente é evidenciado o seu fraco impacto na população. Do ponto de vista metodológico, seguiu-se uma abordagem qualitativa: foi feito o levantamento da documentação relevante – relatórios técnicos e textos jurídicos – e nela tiveram origem as questões que foram discutidas com 30 informadores qualificados escolhidos em bola de neve, amostra indicativa. Neste trabalho sustenta-se que as reformas efetuadas em Portugal durante os últimos 20 anos foram de caráter reativo, assimétrico e fragmentário, provocadas pela necessidade de equilibrar as finanças públicas e por mimetismo e necessidade de legitimação face à pressão externa.
Pharmacokinetics and pharmacodynamics of azithromycin in severe malaria bacterial co-infection in African children (TABS-PKPD): a protocol for a Phase II randomised controlled trial
Authors: Olupot-Olupot Peter , Okiror William , Mnjalla Hellen , Muhindo Rita , Uyoga Sophie , Mpoya Ayub , Williams Thomas N , terHeine Rob , Burger David M , Urban Britta , Connon Roisin , George Elizabeth C , Gibb Diana M , Walker A Sarah , Maitland Kathryn 
Published: June 2021

Background: African children with severe malaria are susceptible to Gram-negative bacterial co-infection, largely non-typhoidal Salmonellae, leading to a substantially higher rates of in-hospital and post-discharge mortality than those without bacteraemia. Current evidence for treating co-infection is lacking, and there is no consensus on the dosage or length of treatment required. We therefore aimed to establish the appropriate dose of oral dispersible azithromycin as an antimicrobial treatment for children with severe malaria and to investigate whether antibiotics can be targeted to those at greatest risk of bacterial co-infection using clinical criteria alone or in combination with rapid diagnostic biomarker tests. Methods: A Phase I/II open-label trial comparing three doses of azithromycin: 10, 15 and 20 mg/kg spanning the lowest to highest mg/kg doses previously demonstrated to be equally effective as parenteral treatment for other salmonellae infection. Children with the highest risk of bacterial infection will receive five days of azithromycin and followed for 90 days. We will generate relevant pharmacokinetic data by sparse sampling during dosing intervals. We will use population pharmacokinetic modelling to determine the optimal azithromycin dose in severe malaria and investigate azithromycin exposure to change in C-reactive protein, a putative marker of sepsis at 72 hours, and microbiological cure (seven-day), alone and as a composite with seven-day survival. We will also evaluate whether a combination of clinical, point-of-care diagnostic tests, and/or biomarkers can accurately identify the sub-group of severe malaria with culture-proven bacteraemia by comparison with a control cohort of children hospitalized with severe malaria at low risk of bacterial co-infection. Discussion: We plan to study azithromycin because of its favourable microbiological spectrum, its inherent antimalarial and immunomodulatory properties and dosing and safety profile. This study will generate new data to inform the design and sample size for definitive Phase III trial evaluation. Registration: ISRCTN49726849 (27th October 2017).
Methodology Assessment of Working Environment Factors on Health Status of Workers of Radiation Hazardous Productions
Authors: Bobrov Alexandr , Kuznetsova L. , Sedin V. , Tukov A. , Shcheblanov V. , Proskuryakova N , Afonin S. , Smirnov Yu. 
Published: June 2021

Purpose: Development of methodology and criteria for establishing causal relationships between the health status of workers in radiation-hazardous industries with factors of the working environment.
Results: A methodology and criteria have been developed for assessing the cause-and-effect relationships of the health of workers in radiation-hazardous industries with the factors of the working environment. The assessment is carried out in three stages. At the 1st stage, according to the data of periodic medical examinations and psychophysiological examinations, the level of the employee’s health loss is assessed, at the 2nd stage (using the risk matrix) – the level of occupational risk. At the 3rd stage, according to the relative risk of a specific disease (or its etiological share) and the level of occupational risk, a decision is made on the causation of the disease by unfavorable factors of the working environment.
Bioelectric Activity of the Brain in the Operational Personnel of the Russian Nuclear Power Plant with a Low Level of Psychophysiological Adaptation
Authors: Torubarov F. , Zvereva Z , Luk'yanova S. 
Published: June 2021

Purpose: The aim is to study the bioelectric activity of the brain in the operational workers of the Novovoronezh and Beloyarsk nuclear power plants with a low level of psychophysiological adaptation.
Material and methods: An EEG study of 101 operational employees of the NPP was conducted, visual and spectral analyses were used. EEG indicators of individuals with a low level of psychophysiological adaptation and low functional activity of structural and functional formations of the central nervous system were compared with those of individuals with a high level of adaptation, high functional activity of structural and functional formations of the central nervous system.
Results: Visual analysis of individuals with a low level of psychophysiological adaptation revealed abnormal EEG indicators, indicating functional disorders of the central nervous system. The greatest violations were revealed in the structural and functional formation responsible for the central regulation of the cardiovascular system. A comparative assessment of the spectral power of the EEG at different levels of psychophysiological adaptation revealed a state of tension (tense adaptation) observed in individuals with both low and high levels of adaptation. The similarity between the structural and functional formation "central regulation of the cardiovascular system" with low functional activity and a low level of psychophysiological adaptation in terms of the number of abnormal EEG indicators can be considered as evidence of its greatest contribution to the formation of a low level of adaptation.The evaluation of interhemispheric interactions in structural and functional formations at their low and high activity, as well as at low and high levels of adaptation, suggested that the formation of a high level of psychophysiological adaptation as an integral characteristic of the main role played by the formation of the "Cortex" and "central regulation of the cardiovascular system".
In the formation of a low level of psychophysiological adaptation as an integral characteristic, the main role is played by the formations "cortex" and "cortical-subcortical interaction".
Conclusion: A violation of the bioelectric activity of the brain may be one of the pathogenetic mechanisms of reduced adaptation. The presence of statistically significant differences in EEG indicators in individuals with low and high levels of adaptation, revealed by visual and spectral analysis, allows us to consider these indicators as informative not only in terms of identifying deviations in the diagnosis of functional disorders, but also in assessing the effectiveness of rehabilitation and health measures.
Dose Estimation on Surgeon for radionuclide Vertobroplasty Yu.G. Zabaryansky1, A.A. Golovin2, Yu.A. Kurachenko
Authors: Zabaryanskiy Yu. , Golovin A , Kurachenko Yu. 
Published: June 2021

Purpose: To estimate the doses to a surgeon for a new operation – radionuclide vertebroplasty. To normalize the irradiation for the maximum number of operations in which the total equivalent dose will not exceed the values specified in the NRB-99/2009.
Material and methods: The widespread Monte-Carlo code MCNP used with data libraries, as well as the ICRP-38 data on radionuclide characteristics.
Results: Using the radionuclide 188Re, the most promising for this procedure, the equivalent dose in the doctor’s palms does not exceed 1 mSv per operation. A surgeon can perform up to 580 operations per year without violating radiation safety standards.
Conclusion: Calculation methods proved the safety of radionuclide vertebroplasty for the surgeon and service personnel.
A Randomized Controlled Trial Evaluating a Pain Assessment and Management Program for Respite Workers Supporting Children With Disabilities Part One: Pain-Related Knowledge and Perceptions
Authors: Genik Lara M. , Aerts Elisabeth L. , Barata Paula C. , Barney Chantel C. , Lewis Stephen P. , Newby-Clark Ian , McMurtry C. Meghan 
Published: June 2021

Abstract
This parallel group randomized controlled trial tested effectiveness of the Let's Talk About Pain training on respite workers' (RW) pain-related knowledge and feasibility-confidence-skill ratings using between-group and within-group analyses. Fourteen children's respite organizations were randomized to pain or control training. Participants (nintervention = 66; ncontrol = 92) underwent a 3–3.5 hour training and completed measures at pre-, post-, and 4–6 week follow-up. Intention-to-treat (nintervention = 65; ncontrol = 92) and per-protocol (nintervention = 26–38; ncontrol = 40–57) analyses were conducted. Pain training participants demonstrated significantly higher pain knowledge and feasibility-confidence-skill ratings post-follow-up versus control group and significant increases in knowledge from pre-post. Significant gains were maintained from post-follow-up. Results represent a promising step towards enhancing pain-related care for children with IDD.
Mothers With Mild Levels of Intellectual Disability: Emotion-Interpretation, Traumatization, and Child Attachment Representations
Authors: Hammarlund Mårten , Granqvist Pehr , Forslund Tommie 
Published: June 2021

Abstract
Prior research indicates links between parents' experiences of interpersonal trauma and emotion-interpretation difficulties, and between such difficulties and child attachment insecurity and disorganization. Although mothers with mild levels of intellectual disability (ID) are at heightened risk for trauma and emotion-interpretation difficulties, and their children for attachment insecurity, corresponding links in this population have not been examined. We therefore investigated emotional interpretations among mothers with mild levels of ID (n = 23) and matched comparison mothers without ID (n = 25), in relation to mothers' experiences of trauma and their children's attachment representations. Mothers with mild levels of ID were not less accurate than comparison mothers with regard to general positive and negative emotion-interpretation accuracy, but they were significantly more likely to misinterpret shame and anger. Among mothers with mild levels of ID, misinterpretations of shame were positively related to maternal experiences of trauma, and to child attachment insecurity and disorganization.
Improvement of frequency resolution using a sub-bin structure in the discrete Fourier transform
Authors: Sato Manabu , Kimura Yuuki , Masuta Junpei , Kosaka Tetsuo , Nishidate Izumi 
Published: June 2021

To improve frequency resolution, assignments of sub-bins within the bin interval of the conventional discrete Fourier transform are proposed by decreasing the number of sampled data. The simulated and experimental results of the basic sub-bin spectrum characteristics are presented. Using a signal oscillator, digital oscilloscope, and PC, the sub-bin line spectrum between two conventional bins is measured, and nine line spectra of sub-bins corresponding to the simulated results are measured. The linearity of the sub-bin spectrum intensity for amplitudes of 0.001–10 V of the input signal is also measured. The Doppler signals from the optical interferometer using a He–Ne laser are measured using a mixer to tune the frequency. A sub-bin spectrum of 104.89 kHz between two bin frequencies of 104.49 and 105.47 kHz is measured using 256 data points at a sampling frequency of 250 kHz and an acquisition time of 1.024 ms. The precision of displacement for the acquisition time is improved by one order to 32 nm for a full displacement of 2.342 µm. The sub-bins, as a composition of bin structure, are applicable to various fields.