bluuebunny/crossref_metadata_2025_split huggingface dataset:
Analysis of primary care prescription trends in England during the COVID-19 pandemic compared against a predictive model
Authors: Frazer John Scott , Frazer Glenn Ross 
Published: August 2021

ObjectivesThe COVID-19 pandemic has had an unprecedented impact across primary care. Primary care services have seen an upheaval, and more and more patients are engaging in telephone consultations in order to maintain social distancing. In the present study, we seek to quantify the effect of the pandemic on primary care prescribing.DesignWe conducted a retrospective analysis of the English Prescribing Dataset from January 2014 to November 2020, totalling 7 542 293 921 prescriptions. Data were separated into prepandemic and pandemic sets. A Holt-Winters predictive model was used to forecast individual drug prescribing based on historic trends. Observed data were compared with the forecast quantitatively and qualitatively.SettingAll prescriptions signed in England and dispensed during the years 2014–2020.ParticipantsAll residents of England who received a prescription from primary care facilities during 2014–2020.ResultsPrescribing of numerous health-critical medications was above predicted in March 2020, including salbutamol (53.0% (99% CI (41.2% to 66.9%))), insulin aspart (26.9% (99% CI (18.5% to 36.6%))) and tacrolimus (18.6% (99% CI (8.3% to 31.1%))). Medications for end-of-life symptom control increased in April, including levomepromazine hydrochloride (94.7% (99% CI (54.6% to 163.0%))). Medications requiring face-to-face visits decreased, including the local anaesthetic bupivacaine hydrochloride (86.6% (99% CI (89.3% to 82.0%))). There was no observed change in medications relating to type 2 diabetes, hypertension or mental health conditions.ConclusionsSignificantly increased prescribing of several medications was observed, especially among those critical for health. A dramatic spike in end-of-life prescribing highlights the adversity faced by community practitioners during 2020. Medications involving face-to-face consultations declined, as did contraceptives, travel-related vaccines and drugs used in dementia and Parkinson’s disease. Drugs relating to type 2 diabetes, hypertension and mental health were unchanged.
Ascorbic Acid and Polyphenols Mediated Green Synthesis of Silver Nanoparticles from Tagetes erecta L. Aqueous Leaf Extract and Studied Their Antioxidant Properties
Authors: Tyagi Pankaj Kumar , Tyagi Shruti , Gola Deepak , Arya Arvind , Ayatollahi Seyed Abdulmajid , Alshehri Mohammed M. , Sharifi-Rad Javad 
Published: August 2021

Silver nanoparticle synthesis of the leaf extract Tagetes erecta L. enriched with ascorbic acid and polyphenols has been investigated. The color of the golden yellow extract has changed to pinkish-brown due to the reduction of Ag+ to the colloidal solution of AgNPs and a sharp absorption peak at 420 nm under the UV-Vis spectrophotometer. In addition, the Fourier Transfer Infrared Spectroscopy (FTIR) estimation was completed in order to recognize and identify the biomolecules present in the extract acting as a reducing and capping agent for the AgNPs. The X-ray diffraction (XRD) peaks at (111), (201), (220), and (311) confirm the presence of monoclinic crystals in the solution. The morphology and size of the particles were provided by transmission electron microscopy (TEM) images of AgNPs. At a scale of 100 nm, synthesized AgNPs were predominantly spherical with a size range of 7-35 nm. In comparison to 7.39 mg/100 g in AgNPs, aqueous leaf extract was 55.14 mg/100 g higher in ascorbic acid. The phenolic and flavonoid content of extract was

52.54
±
2.15

mg (GAE/100 g) and

15.43
±
0.34

mg (QE/mL), and the colloidal AgNP solution was

21.45
±
1.15

mg (GAE/100 g) and

8.05
±
2.42

mg (QE/mL), respectively. Phenolic and flavonoid contents play a major role as a reducing agent and reduce the precursor AgNO3 into AgNPs. The DPPH scavenging assay also assessed the antioxidant properties of extract and its derived AgNPs. As compared antioxidant value to aqueous leaf extract (mg/mL), higher percentage inhibition (PI) was found in AgNPs and free-radical scavenging activity of extract and AgNPs were directly linked to their concentrations. Results of this research have discovered a higher potential for free-radical scavenging AgNPs and will help to develop new and more potent antioxidants for the treatment of different diseases caused by oxidative stress; the higher antioxidant properties bearing AgNPs might be used.
Wavelet Bilateral Filter Algorithm-Based High-Frequency Ultrasound Image Analysis on Effects of Skin Scar Repair
Authors: Xuan Zhidong , Liu Haixia , Li Chao , Liu Yongrong 
Published: August 2021

It aimed to explore the application value of high-frequency ultrasound image based on the wavelet bilateral filtering algorithm in the repair evaluation of hypertrophic scar and keloid, as well as the expression change of nerve growth factor (NGF). 72 patients with scars admitted to hospital from October 2018 to October 2019 were chosen and classified as hypertrophic scar patients (group A) and keloid patients (group B), with 36 cases in each group. All patients received scar repair treatment, and another 30 normal skin volunteers (group C) were selected. High-frequency ultrasound images based on the wavelet bilateral filter algorithm were utilized for skin examination. The expression differences of NGF and pro-NGF in each group were measured by immunohistochemical staining and Western blot. The results showed that the denoising effect (signal-to-noise ratio (PSNR) = 33.2762), structural similarity (SSIM = 0.8963), and edge similarity (FoM = 0.2975) of the proposed algorithm were better than those of bilateral filtering and wavelet soft-threshold algorithms. The skin thickness of groups A and B was considerably higher relative to that of group C (

P

< 0.05), but the echo intensity of the skin dermis of groups A and B was evidently inferior to that of group C (

P

< 0.05). The results of immunohistochemistry showed that in contrast to group C, the average optical density of NGF in groups A and B increased remarkably (

P

< 0.01). In contrast to group C, the positive expression of pro-NGF in groups A and B was notably reduced (

P

< 0.05). Western blot results showed that relative to group C, the expression of NGF protein in groups A and B was increased greatly (

P

< 0.01), but the expression of pro-NGF protein in groups A and B was reduced (

P

< 0.01). The results suggested that the wavelet bilateral filter algorithm can be adopted to evaluate pathological skin scars, and pathological skin scar formation was closely related to the expression levels of NGF and pro-NGF.
Consolidating Radiotherapy with Immunotherapy
Authors: Rodriguez-Ruiz Maria E. , Sanmamed Miguel F. , Serrano-Mendioroz Irantzu , Melero Ignacio 
Published: August 2021

Abstract
Radiotherapy and immunotherapy can be concomitantly or sequentially combined seeking synergistic effects in terms of control of irradiated tumors and abscopal effects on nonirradiated lesions. Clinical-trial testing of such combinations faces several obstacles to demonstrate efficacy and needs improvements in trial design, patient selection, evaluation of results and biomarker discovery.
See related article by Foster et al., p. 5510
From Goethe to Gundolf
Authors: Paulin Roger 
Published: August 2021

From Goethe to Gundolf: Essays on German Literature and Culture is a collection of Roger Paulin’s groundbreaking essays, spanning the last forty years. The work represents his major research interests of Romanticism and the reception of Shakespeare in Germany, but also explores a broader range of themes, from poetry and the public memorialization of poets to fairy stories - all meticulously researched, yet highly accessible.
As a comprehensive examination of German literary history in the period 1700-1900, the collection not only includes accounts of the lives and work of Goethe, Schiller, the Schlegels, and Gundolf (amongst others), serving to nuance our understanding of these figures in history, but also considers diverse (and often underexplored) topics, from academic freedom to the rise of travel literature.
The essays have been reformulated, corrected, and updated to add references to recent works. However, the core foundations of the originals remain, and just as when they were first published, the value of these essays – to researchers, students, and all those who are interested in German literary history – cannot be overstated.
The One-Two Punch of High Wages and Empowerment on CNA Retention
Authors: Kennedy Katherine A. , Abbott Katherine M. , Bowblis John R. 
Published: August 2021

Objectives: The objective of this study was to examine the relationship between high wages and empowerment practices on certified nursing assistant (CNA) retention, necessary for providing high-quality care for nursing home (NH) residents. Methods: Measures of provider-level CNA empowerment and wages from the 2015 Ohio Biennial Survey were used to estimate two regression models on retention ( n = 719), one without and one with an interaction term of high wages and high empowerment. Results: Only in the context of the interacted model were NHs that provided both high wages and high empowerment associated with a 7.09 percentage-point improvement in the CNA retention rate ( p = .0003). Individually, high wages and a high empowerment score were not statistically significant in either regression model. Discussion: Retaining CNAs in NH communities requires a combination of empowerment practices (e.g., involving CNAs in decision-making about hiring other staff) and high hourly wages.
Impact of granulocyte-colony stimulating factor on docetaxel-induced febrile neutropenia in patients with breast cancer
Authors: Zekri Jamal , Nawaz Azhar , Rasool Haleem , Ahmad Imran , Abdel Rahman Hossam , Dada Reyad , Abdelghany Ehab Mosaad , Farag Kamel , Ibrahim Refaei Belal , Deibas Mohamed Youssef , Kamel Mohamed Kamal , Allithy Ahmed 
Published: August 2021

Background Febrile neutropenia (FN) is a life-threatening complication of Docetaxel-based chemotherapy regimens (DBRs). Prophylactic granulocyte-colony stimulating factor (G-CSF) can reduce the risk of FN. This study investigated the effect of G-CSF on FN in patients receiving DBRs for breast cancer. Methods Patients treated between 2015 and 2017 were identified from the hospital’s pharmacy database and their medical records were examined retrospectively. Data from patients’ first four cycles of DBR were collected. FN rate, FN associated length of hospital stay (FN-LOS), and chemotherapy dose modification/delay due to FN were compared between patients who did (G-CSF group) or did not (non-GCSF group) receive prophylactic G-CSF. Results Of the 276 included patients, 83.3% received a DBR as adjuvant or neoadjuvant therapy, and 50% received docetaxel as combination therapy. Prophylactic G-CSF was administered with the first cycle of a DBR in 69.9% of patients who were significantly less likely to experience FN compared to the non-G-CSF group (6.2% vs. 15.7%; odds ratio: 0.36 [95% CI: 0.16–0.82]; p = 0.020). Collectively and after the 4 DBR treatment cycles, FN rate (4.8 vs. 8.5; odds ratio: 0.54 [95% CI: 0.30–0.97]; p = 0.043) and the mean FN-LOS (3.55 vs. 5.28 days; t = –2.22; p = 0.037) were reduced in the G-CSF group. There was no difference in DBR dose delay/reduction between both groups in cycles 2–4. Conclusion In patients receiving DBRs for breast cancer, prophylactic G-CSF significantly reduced both the rate of FN and duration of hospitalization for FN.
Novel Education Modules Addressing the Underrepresentation of Skin of Color in Dermatology Training
Authors: Slaught Christa , Madu Pamela , Chang Aileen Y. , Williams Victoria L. , Kebaetse Masego B. , Nkomazana Oathokwa , Molefe-Baikai Onkabetse Julia , Bekele Negussie A. , Omech Bernard , Kellman Philip J. , Krasne Sally , Kovarik Carrie L. 
Published: August 2021

Background Representative images of pathology in patients with skin of color are lacking in most medical education resources. This particularly affects training in dermatology, which relies heavily on the use of images to teach pattern recognition. The presentation of skin pathology can vary greatly among different skin tones, and this lack of representation of dark skin phototypes challenges providers’ abilities to provide quality care to patients of color. In Botswana and other countries in sub-Saharan Africa, this challenge is further compounded by limited resources and access to dermatologists. There is a need for improved and accessible educational resources to train medical students and local medical providers in basic skin lesion description and diagnosis. Objectives We examined whether online Perceptual and Adaptive Learning Modules (PALMs) composed of representative dark skin images could efficiently train University of Botswana medical students to more accurately describe and diagnose common skin conditions in their community. Methods Year 4 and 5 medical students voluntarily completed PALMs that teach skin morphology, configuration, and distribution terminology and diagnosis of the most common dermatologic conditions in their community. Pre-tests, post-tests and delayed-tests assessed knowledge acquisition and retention. Results PALMs training produced statistically significant ( P < .0001) improvements in accuracy and fluency with large effect sizes (1.5, 3.7) and good retention after a 12.5-21-week median delay. Limitations were a self-selected group of students, a single institution, slow internet connections, and high drop-out rates. Conclusions Overall, population-specific PALMs are a useful tool for efficient development of pattern recognition in skin disease description and diagnosis.
Exploring how limiting the number of ball touches during small-sided games affects youth football players’ performance across different age groups
Authors: Coutinho Diogo , Gonçalves Bruno , Santos Sara , Travassos Bruno , Folgado Hugo , Sampaio Jaime 
Published: August 2021

This study explored how the number of allowed ball touches per player possession affected the performance of different age groups (U9, U11, U13, U15, U17 and U19) during a Gk + 4vs4+Gk small-sided games. Each day, players randomly performed the following three conditions (for a total of 6 days): i) free-play (FP); ii) maximum of 2 touches (2 T); iii) 1 touch (1 T). Players’ positional data was used to compute time-motion and positional-related variables, while video analysis was used to capture technical performance. In general, no effects were identified in relation to the players distances (team centroid, opponents’ centroid, nearest teammate, and nearest opponent). There were small to moderate decreases in the longitudinal synchronization while playing with 1 T and 2 T in the U9 and U17, but a moderate increase in the U15. There was a general decrease in the distance covered and distance covered while running (small to moderate effects) when playing with limited touches in all age groups. Limiting the touches promoted small to moderate increases in the number of successful passes in the U9, U15, and U17 and a general increase in unsuccessful actions. Overall, playing with limited touches emphasized the passing skill while it also contributed to more unsuccessful actions and lower physical demands. As so, coaches may use the 2 T in young age groups (U9-U13) as they seem less able to successfully cope with 1 T, while using 1 T in older age groups due to their higher ability to interact with environmental information.
Bent or broken: analysis of set screw fracture in the TFNa implant
Authors: Klima Matthew 
Published: August 2021

Abstract
Objectives
To evaluate set screw fracture in the Trochanteric Femoral Nail Advanced implant (TFNa, Synthes, West Chester, PA) and to identify additional mechanisms of set screw failure in the TFNa.

Materials and methods
Patients who had experienced failure after open reduction and internal fixation (ORIF) with the TFNa were identified. TFNa implants were explanted and inspected following revision surgery. Medical device reports (MDRs) and manufacturer’s inspection reports describing similar failures for the TFNa in the United States Food and Drug Administration (FDA) Manufacturer and User Facility Device Experience (MAUDE) database were also reviewed.

Results
Four set screw fractures that occurred at a level II trauma center were observed. Sixty-seven reported failures were identified in the MAUDE database for review. Twenty-eight failed implants were returned to the manufacturer for inspection with a published inspection report available for analysis. Set screw fractures can occur in the TFNa when the set screw is deployed prematurely into the proximal screw aperture prior to blade/screw insertion. The set screw can also bend and deform if it is advanced against a helical blade/lag screw that is not fully seated into position, thereby potentially compromising its function.

Conclusion
The TFNa set screw allows for potential fracture during implant insertion leading to uncontrolled collapse, early excessive proximal femoral shortening, and rotational instability of the helical blade/lag screw. Similar failures in the TFNa can be prevented by having the surgeon inspect the proximal screw aperture after attachment of the proximal aiming aim to ensure the set screw has not been deployed prematurely.

Level of evidence
Therapeutic Level III.
Molecular typing of human adenoviruses among hospitalized patients with respiratory tract infections in a tertiary Hospital in Guangzhou, China between 2017 and 2019
Authors: Wang Xinye , Wang Dawei , Umar Sajid , Qin Sheng , Ling Qiong , Gray Gregory C. , Liu Yuntao 
Published: August 2021

Abstract
Background
Human Adenoviruses (HAdVs) cause a wide array of illnesses in all age groups. They particularly cause frequent morbidity among children. In China, human adenovirus types 3, 4, 7, 11, 14, 21, and 55 have caused at least seven outbreaks since 2000. However, limited studies are available regarding the epidemiological patterns and diversity of HAdVs types among hospitalized patients with respiratory tract infections (RTIs).

Methods
To understand the epidemiology and subtype distribution of HAdV infections associated with RTIs in China, nasal swab (NS) clinical samples were collected from 4129 patients in a Guangzhou hospital between August 2017 and October 2019. PCR, sequencing, and phylogenetic analysis were performed on these specimens to identify HAdV subtypes.

Results
HAdV was successfully sequenced in 99 (2.4%) of the 4129 NS specimens, with the highest HAdV prevalence (6.3%) found in children between the ages of 5 and 10 years. Among HAdV-positive specimens, the most prevalent genotypes identified were HAdV-B3 (55.6%) and HAdV-B7 (25.3%). The most common symptoms in the HAdV-infected patients were fever (100%), cough (80.8%), and rhinorrhea (71.8%). HAdV infections were detected throughout the year with a relatively higher prevalence in summer.

Conclusion
All ages suffer adenovirus infections, but young children are at the greatest risk. This study data demonstrates that at least three species of HAdVs (species B, C, and E) are circulating in Guangzhou City, China. As antiviral therapies and type-specific vaccines become available, such epidemiological data will be useful in guiding therapy and public health interventions.
Serum surfactant protein D in COVID-19 is elevated and correlated with disease severity
Authors: Tong Ming , Xiong Ying , Zhu Chen , Xu Hong , Zheng Qing , Jiang Yu , Zou Lianhong , Xiao Xiaolin , Chen Fang , Yan Xiquan , Hu Changping , Zhu Yimin 
Published: August 2021

Abstract
Background
The serum surfactant protein D (SP-D) level is suggested to be a useful biomarker for acute lung injuries and acute respiratory distress syndrome. Whether the serum SP-D level could identify the severity of coronavirus disease 2019 (COVID-19) in the early stage has not been elucidated.

Methods
We performed an observational study on 39 laboratory-confirmed COVID-19 patients from The Fourth People’s Hospital of Yiyang, Hunan, China. Receiver operating characteristic (ROC) curve analysis, correlation analysis, and multivariate logistic regression model analysis were performed.

Results
In the acute phase, the serum levels of SP-D were elevated significantly in severe COVID-19 patients than in mild cases (mean value ± standard deviation (SD), 449.7 ± 125.8 vs 245.9 ± 90.0 ng/mL, P<0.001), while the serum levels of SP-D in the recovery period were decreased dramatically than that in the acute phase (mean value ± SD, 129.5 ± 51.7 vs 292.9 ± 130.7 ng/ml, P<0.001), and so were for the stratified patients. The chest CT imaging scores were considerably higher in the severe group compared with those in the mild group (median value, 10.0 vs 9.0, P = 0.011), while markedly lower in the recovery period than those in the acute phase (median value, 2.0 vs 9.0, P<0.001), and so were for the stratified patients. ROC curve analysis revealed that areas under the curve of lymphocyte counts (LYM), C-reaction protein (CRP), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), and SP-D for severe COVID-19 were 0.719, 0.833, 0.817, 0.837, and 0.922, respectively. Correlation analysis showed that the SP-D levels were negatively correlated with LYM (r = − 0.320, P = 0.047), while positively correlated with CRP (r = 0.658, P<0.001), IL-6 (r = 0.471, P = 0.002), the duration of nucleic acid of throat swab turning negative (r = 0.668, P<0.001), chest CT imaging score on admission (r = 0.695, P<0.001) and length of stay (r = 0.420, P = 0.008). Multivariate logistic regression model analysis showed that age (P = 0.041, OR = 1.093) and SP-D (P = 0.008, OR = 1.018) were risk factors for severe COVID-19.

Conclusions
Elevated serum SP-D level was a potential biomarker for the severity of COVID-19; this may be useful in identifying patients whose condition worsens at an early stage.