bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paediatric to adult healthcare transition in resource-limited settings: a narrative review
Authors: Narla Nirmala Priya , Ratner Leah , Bastos Fernanda Viera , Owusu Sheila Agyeiwaa , Osei-Bonsu Angela , Russ Christiana M 
Published: April 2021

BackgroundAgeing into adulthood is challenging at baseline, and doing so with a chronic disease can add increased stress and vulnerability. Worldwide, a substantial care gap exists as children transition from care in a paediatric to adult setting. There is no current consensus on safe and equitable healthcare transition (HCT) for patients with chronic disease in resource-denied settings. Much of the existing literature is specific to HIV care. The objective of this narrative review was to summarise current literature related to adolescent HCT not associated with HIV, in low-income and middle-income countries (LMICs) and other resource-denied settings, in order to inform equitable health policy strategies.MethodsA literature search was performed using defined search terms in PubMed and Cumulative Index to Nursing and Allied Health Literature databases to identify all peer-reviewed studies published until January 2020, pertaining to paediatric to adult HCT for adolescents and young adults with chronic disease in resource-denied settings. Following deduplication, 1111 studies were screened and reviewed by two independent reviewers, of which 10 studies met the inclusion criteria. Resulting studies were included in thematic analysis and narrative synthesis.ResultsTwelve subthemes emerged, leading to recommendations which support equitable and age-appropriate adolescent care. Recommendations include (1) improvement of community health education and resilience tools for puberty, reproductive health and mental health comorbidities; (2) strengthening of health systems to create individualised adolescent-responsive policy; (3) incorporation of social and financial resources in the healthcare setting; and (4) formalisation of institution-wide procedures to address community-identified barriers to successful transition.ConclusionLimitations of existing evidence relate to the paucity of formal policy for paediatric to adult transition in LMICs for patients with childhood-onset conditions, in the absence of a diagnosis of HIV. With a rise in successful treatments for paediatric-onset chronic disease, adolescent health and transition programmes are needed to guide effective health policy and risk reduction for adolescents in resource-denied settings.
The effectiveness of interruptive prescribing alerts in ambulatory CPOE to change prescriber behaviour & improve safety
Authors: Cerqueira Oliver , Gill Mohsain , Swar Bishr , Prentice Katherine Ann , Gwin Shannon , Beasley Brent W 
Published: April 2021

BackgroundPrescribing alerts of an electronic health record are meant to be protective, but often are disruptive to providers. Our goal was to assess the effectiveness of interruptive medication-prescriber alerts in changing prescriber behaviour and improving patient outcomes in ambulatory care settings via computerised provider order entry (CPOE) systems.MethodsA standardised search strategy was developed and applied to the following key bibliographical databases: PubMed, Embase, CINAHL and The Cochrane Library. Non-comparison studies and studies on non-interrupted alerts were eliminated. We developed a standardised data collection form and abstracted data that included setting, study design, category of intervention alert and outcomes measured. The search was completed in August 2018 and repeated in November of 2019 and of 2020 to identify any new publications during the time lapse.ResultsUltimately, nine comparison studies of triggered alerts were identified. Each studied at least one outcome measure illustrating how the alert affected prescriber decision-making. Provider behaviour was influenced in the majority, with most noting a positive change. Alerts decreased pharmaceutical costs, moved medications toward preferred medications tiers and steered treatments toward evidence-based choices. They also decreased prescribing errors. Clinician feedback, rarely solicited, expressed frustration with alerts creating a time delay.ConclusionThe current evidence shows a clear indication that many categories of alerts are effective in changing prescriber behaviour. However, it is unclear whether these behavioural changes lead to improved patient outcomes. Despite the rapid transition to CPOE use for patient care, there are few rigorous studies of triggered alerts and how workflow interruptions impact patient outcomes and provider acceptance.
Stellate ganglion block used to treat reversible cerebral vasoconstriction syndrome
Authors: Davis Jeffrey , Ozcan Mehmet S , Kamdar Jay K , Shoaib Maria 
Published: April 2021

BackgroundWe present a case report of a patient who developed severe reversible cerebral vasoconstriction syndrome, which was worsening despite typical interventional and supportive care. We administered a stellate ganglion block (SGB) and monitored the vasospasm with transcranial Doppler measurements.Case reportA 25-year-old woman was admitted with recurrent headaches and neurological symptoms, which angiography showed to be caused by diffuse, multifocal, segmental narrowing of the cerebral arteries leading to severe ischemia in multiple regions. Typical treatment was initiated with arterial verapamil followed by supportive critical care, including nimodipine, intravenous fluids, permissive hypertension, and analgesia. Vasospasm was monitored daily via transcranial Doppler ultrasound (TCD). After symptoms and monitoring suggested worsening vasospasm, an SGB was administered under ultrasound guidance. Block success was confirmed via pupillometry, and repeat TCD showed improved flow through the cerebral vasculature. Improvement in vascular flow was accompanied by a gradual reduction in acute neurological symptoms, with the patient reporting no headaches the following morning.ConclusionsFor patients with reversible cerebral vasoconstriction syndrome who develop severe signs or symptoms despite typical treatment, sympathetic blockade may be a possible rescue therapy. This may extend to other causes of severe vasospasm as well, and further study is needed to determine if the SGB should be included in routine or rescue therapy.
Semiclassical two-step model for ionization by a strong laser pulse: further developments and applications
Authors: Shvetsov-Shilovski N. I. 
Published: April 2021

Abstract
We review the semiclassical two-step model for strong-field ionization. The semiclassical two-step model describes quantum interference and accounts for the ionic potential beyond the semiclassical perturbation theory. We discuss formulation and implementation of this model, its further developments, as well as some of the applications. The reviewed applications of the model include strong-field holography with photoelectrons, multielectron polarization effects in ionization by an intense laser pulse, and strong-field ionization of the hydrogen molecule.

Graphic Abstract
Accounting for the resistivity contribution of grain boundaries in metals: critical analysis of reported experimental and theoretical data for Ni and Cu
Authors: Bakonyi I. 
Published: April 2021

AbstractIn the present paper, reported literature data on the grain-size dependence of resistivity of Ni and Cu are critically evaluated by two conceptually different methods. One is the phenomenological approach of Andrews (Phys. Lett. 19: 558, 1965) according to which in a polycrystalline metal there is a resistivity contribution inversely proportional to the average grain diameter, the proportionality constant defined as the Andrews parameter A. The other method is the customary Mayadas–Shatzkes (MS) model (Phys Rev B 1: 1382, 1970) yielding a grain-boundary reflection coefficient R. During the analysis, special care was taken to rely only on data for which the surface scattering resistivity contribution was definitely negligibly small and the grain size was determined by direct microscopy imaging. By sorting out with this analysis the most reliable grain-size-dependent resistivity data for polycrystalline Ni and Cu metals with random grain boundaries, we have then derived the current best room-temperature values of the Andrews parameter A, the specific grain-boundary resistivity and the reflection coefficient R. We have also found a fairly good relation between the parameters A and R and compared the experimental values with their theoretical estimates reported in the literature. Then, the conceptual differences between the two approaches are discussed and the deficiencies of the MS model, especially in connection with the validity of Matthiessen’s rule, are highlighted. A major conclusion is that by the Andrews method one can derive a model-independent reliable parameter characterizing the grain-boundary contribution to the resistivity of metals.
Mathematical modeling of diabetes and its restrain
Authors: Anusha S. , Athithan S. 
Published: April 2021

In this paper, we have developed a mathematical model of diabetes (type-2 diabetes) in a deterministic approach. We have described our model in the population dynamics with four compartments. Namely, Susceptible, Imbalance Glucose Level (IGL), Treatment and Restrain population. Our model exhibits two nonnegative equilibrium points namely Disease Free Equilibrium (DFE) and Endemic Equilibrium (EE). The expression for the Treatment reproduction number [Formula: see text] is computed. We have proved that the equilibrium points of the model are locally and globally asymptotically stable under some conditions. Numerical simulation is performed to verify our analytical findings such as stability of DFE and EE. The simulations show better results based on the required conditions. We tried to fit our model with the data given by the International Diabetes Federation (IDF) [D. Atlas, IDF Diabetes Atlas, 8th edn. (International Diabetes Federation, Brussels, Belgium, 2017)] and it suits well with the data. It has been found that our model shows the decrease in diabetes-affected population compared with the data given by the IDF [D. Atlas, IDF Diabetes Atlas, 8th edn. (International Diabetes Federation, Brussels, Belgium, 2017)].
Abraham–Rubin–Shelah open colorings and a large continuum
Authors: Gilton Thomas , Neeman Itay 
Published: April 2021

We show that the Abraham–Rubin–Shelah Open Coloring Axiom is consistent with a large continuum, in particular, consistent with [Formula: see text]. This answers one of the main open questions from [U. Abraham, M. Rubin and S. Shelah, On the consistency of some partition theorems for continuous colorings, and the structure of [Formula: see text]-dense real order types, Ann. Pure Appl. Logic 325(29) (1985) 123–206]. As in [U. Abraham, M. Rubin and S. Shelah, On the consistency of some partition theorems for continuous colorings, and the structure of [Formula: see text]-dense real order types, Ann. Pure Appl. Logic 325(29) (1985) 123–206], we need to construct names for the so-called preassignments of colors in order to add the necessary homogeneous sets. However, the known constructions of preassignments (ours in particular) only work assuming the [Formula: see text]. In order to address this difficulty, we show how to construct such names with very strong symmetry conditions. This symmetry allows us to combine them in many different ways, using a new type of poset called a partition product. Partition products may be thought of as a restricted memory iteration with stringent isomorphism and coherent-overlap conditions on the memories. We finally construct, in [Formula: see text], the partition product which gives us a model of [Formula: see text] in which [Formula: see text].
Anderson t-motives and abelian varieties with MIQF: Results coming from an analogy
Authors: Grishkov A. , Logachev D. 
Published: April 2021

Analogy between Anderson [Formula: see text]-motives and abelian varieties with multiplication by an imaginary quadratic field (MIQF) is a source of 2 results: (1) A description of abelian varieties with MIQF of dimension [Formula: see text] and signature [Formula: see text] in terms of ”lattices” of dimension [Formula: see text] in [Formula: see text]; (2) A construction of exterior powers of abelian varieties with MIQF having [Formula: see text].
Changes in Patient Volumes and Outcomes After Adding Thrombectomy Capability
Authors: Zhou Minerva H. , Kansagra Akash P. 
Published: April 2021

Background and Purpose:
With the rising demand for endovascular thrombectomy (EVT) and introduction of thrombectomy-capable stroke centers (TSC), there is interest among existing stroke hospitals to add EVT capability to attract and retain stroke patient referrals. In this work, we quantify changes in patient volumes and outcomes when adding EVT capability to an existing stroke center.

Methods:
In MATLAB 2017a Simulink, we simulate a 3-center system comprising an EVT-capable comprehensive stroke center, an EVT-incapable primary stroke center, and an EVT-incapable primary stroke center that gains EVT capability (TSC). We model these changes in 2 geographic settings (urban and rural) using 2 routing paradigms (Nearest Center and Bypass). In Nearest Center, patients are sent to the nearest center regardless of EVT capability. In Bypass, patients with severe strokes are sent to the nearest EVT-capable center, and all others are sent to the nearest center. Probability of good clinical outcome is determined by type and timing of treatment using outcomes reported in clinical trials.

Results:
Adding EVT capability in the Bypass model produced an absolute increase of 40.1% in total volume of patients with stroke and 31.2% to 31.9% in total volume of acute stroke treatments at the TSC. In the Nearest Center model, the total volume of patients with stroke did not change, but total volume of acute stroke treatment at the TSC had an absolute increase of 9.3% to 9.5%. Good clinical outcomes saw an absolute increase of 0.2% to 0.6% in the whole population and 0.3% to 1.8% in the TSC population.

Conclusions:
Adding EVT capability shifts patient and treatment volume to the TSC. However, these changes produce modest improvement in overall population health. Health systems should weigh relative hospital and patient benefits when considering adding EVT capability.
Return to sport and patient satisfaction after arthroscopic Bankart repair: a single-institution experience
Authors: Tan Yeow Boon , Puah Ken Lee , Chong Roland Weng Wah , Ong Kee Leong , Lim Yi-Jia , Lee Dave Yee Han 
Published: April 2021

Abstract

Introduction:
Arthroscopic Bankart repair is a widely accepted procedure to treat recurrent shoulder dislocation. This study aims to describe our experience with arthroscopic Bankart repair and its functional outcome.

Methods:
107 patients who underwent arthroscopic Bankart repair from 2008 to 2013 were followed up for a minimum of three years and reviewed by an independent observer. 80 consented to being interviewed using the Oxford Shoulder Instability Score (OSIS) and Simple Shoulder Test.

Results:
82 shoulders (two bilateral) were studied. Mean age at first dislocation was 19.4 ± 3.4 (12.0–31.0) years. Mean follow-up was 4.4 ± 1.3 (3.0–9.0) years and 2.5 ± 3.0 (0.1–15.4) years elapsed from first dislocation to surgery. 41 (50.0%) patients played overhead or contact sports and 44 (53.7%) played competitive sports before injury; 8 (9.8%) patients reported recurrence of dislocation, which was significantly associated with playing competitive sports before injury (p <0.039), 5 (6.1%) underwent revision surgery and 22 (26.8%) reported residual instability after surgery. 49 (59.8%) patients returned to playing sports, 75 (91.5%) were satisfied with their surgery and 79 (96.3%) were willing to undergo the surgery again. 74 (90.2%) patients had two-year good/excellent OSIS, which was significantly associated with playing competitive sports before injury (p = 0.039), self-reported stability after surgery (p = 0.017), satisfaction with surgery (p = 0.018) and willingness to undergo surgery again (p = 0.024).

Conclusion:
Arthroscopic Bankart repair yields good functional outcomes and is associated with high patient satisfaction, although not all patients return to sports.
Simultaneous cardiocerebral infarctions: a five-year retrospective case series reviewing natural history
Authors: Chong Cheryl Zhiya , Tan Benjamin Yong-Qiang , Sia Ching-Hui , Khaing Thet , Yeo Leonard Leong Litt 
Published: April 2021

Introduction:
Concurrent cardiocerebral infarction (CCI), a rare condition defined as simultaneous occlusions in the cerebrovascular and coronary vessels, has high mortality but very limited literature on optimum treatment methods. A better understanding of the natural history and effect of treatment would improve patient outcomes.

Methods:
Using our prospective stroke database from 2014 to 2018, ten consecutive patients with CCI were identified (incidence = 0.29%). We recorded patient demographics, cardiovascular risk factors, cardiac and cerebral occlusions, circumstances of admission and management of each patient. Patient notes and imaging findings were reviewed to determine the underlying cause of CCI.

Results:
Median National Institute of Health Stroke Scale score was 15 (range 4–27). Mean patient age was 59 years and 90% were men. Two patients were treated with intravenous tissue plasminogen activator (IV tPA) only and three underwent endovascular treatment in both the cerebral and coronary vessels sequentially. One patient underwent percutaneous coronary intervention (PCI) only and two underwent PCI after IV tPA therapy. Two patients were conservatively treated due to poor premorbid status. At the three-month follow-up, five patients had excellent functional outcomes (modified Rankin Scale 0–1) while three died.

Conclusion:
CCI is a rare but devastating clinical scenario, with high incidence of morbidity and mortality. Treatment strategy can impact patient outcome, and further research is warranted on the ideal acute and post-reperfusion treatments for CCI. In this series, IV tPA at stroke doses appeared to be the preferred initial step for its treatment, with subsequent coronary or cerebral endovascular therapy, if necessary.
Perceptions of healthcare workers in high-risk areas of a Singapore hospital during COVID-19: a cross-sectional study
Authors: Au-Yong Phui-Sze Angie , Peh Wee-Ming , Koh Frederick Hong-Xiang , Teo Li-Ming , Ng Siok-Peng , Tan Alina Li-Na , Ng Aven Shan-Hua , Chew Min-Hoe 
Published: April 2021

Introduction:
There is worldwide concern over the psycho-emotional impact of COVID-19 on healthcare workers (HCWs). This study aimed to elicit HCWs’ perceptions of the adequacy of protective measures in high-risk clinical areas and the factors associated with these perceptions.

Methods:
This was a cross-sectional study conducted in April 2020. An anonymous electronic survey was sent via email to operating theatre (OT) and intensive care unit (ICU) staff of Sengkang General Hospital, Singapore.

Results:
Of the 358 eligible participants, 292 (81.6%) responded to the survey. 93.2% of the participants felt that precautionary measures at work were sufficient and 94.9% acknowledged that adequate training was provided. More than 60% of the participants opined that their chances of contracting COVID-19 were moderate to high. Female gender, nursing occupation and duration of service <10 years were significantly associated with increased fear of contracting COVID-19, less control over occupational exposure and lower perceived need to care for COVID-19 patients. Having young children at home did not significantly affect these perceptions. The most important ICU precautions were availability of personal protective equipment outside the rooms of COVID-19 positive patients (95.3%) and having visitor restrictions (95.3%). The most important OT measures were having a dedicated OT for COVID-19 positive patients (91.2%) and having simulation as part of protocol familiarisation (91.7%).

Conclusion:
Overall, there was high confidence in the adequacy of COVID-19 protective measures to prevent healthcare transmission in Singapore. The pandemic had a lower degree of psycho-emotional impact on HCWs here as compared to other countries.
Language Ideologies, Chinese Identities and Imagined Futures
Authors: Toh (陶琳琳) Audrey Lin Lin , Liu (刘宏) Hong 
Published: April 2021

Abstract
Since independence in 1965, the Singapore government has established a strongly mandated education policy with an English-first and official mother tongue Mandarin-second bilingualism. A majority of local-born Chinese have inclined toward a Western rather than Chinese identity, with some scholars regarding English as Singapore’s “new mother tongue.” Other research has found a more local identity built on Singlish, a localized form of English which adopts expressions from the ethnic mother tongues. However, a re-emergent China and new waves of mainland migrants over the past two decades seem to have strengthened Chinese language ideologies in the nation’s linguistic space. This article revisits the intriguing relationships between language and identity through a case study of Chineseness among young ethnic Chinese Singaporeans. Guided by a theory of identity and investment and founded on survey data, it investigates the Chinese language ideologies of university students and their agency in choosing for themselves a Chinese imagined identity and community. Our survey found that ethnic Chinese Singaporean university students still possess a strong affinity for Mandarin and a desire to develop this aspect of their identity, in the context of Singapore’s multiracial national identity. There exists a high propensity for imagined futures in Chineseness, with a majority of survey respondents who claimed English-speaking and bilingual identities also expressing the desire to become more bilingual and more Mandarin-speaking. This paper also deciphers the external and internal factors contributing to this development and suggests some areas of future research.
Loneliness among Chinese Migrants in Portugal
Authors: Neto Félix , Pinto Maria da Conceição 
Published: April 2021

Abstract
The goal of this research is to explore the acculturation and adaptation factors that are likely to predict the level of loneliness among Chinese migrants residing in Portugal. The sample is constituted by one hundred and eighty-nine participants (25 percent women and 75 percent men) with an average age of 29 years. The average length of sojourn was 8 years. We used the ULS-6 scale to assess loneliness. Other instruments were utilized to evaluate ethnic identity, perceived discrimination, mental health, sociocultural adaptation, and tolerance. In agreement with expectations, ethnic identity negatively predicted loneliness, and perceived discrimination positively predicted loneliness. Lastly, sociocultural adaptation and tolerance negatively predicted loneliness, and mental health problems positively predicted loneliness. The adaptation factors predicted 60 percent of the variance in loneliness. Implications of these findings for reducing migrants’ loneliness are considered.