bluuebunny/crossref_metadata_2025_split huggingface dataset:
Etiologic Profile of Childhood Stroke from North India: Is It Different from Developed World?
Authors: Sood Abhinandan , Suthar Renu , Sahu Jitendra K. , K. Baranwal Arun , Saini Arushi G. , Saini Lokesh , Vyas Sameer , Khandelwal Niranjan , Sankhyan Naveen 
Published: February 2021

Objective: To describe the etiology of childhood arterial-ischemic stroke from a developing country and assess short-term neurologic outcome. Methods: Prospective observational study. Consecutive children between the age of >28 days to <12 years, admitted with the diagnosis of arterial-ischemic stroke were enrolled during the study period from January 2017 to December 2018. Short-term neurologic outcome was assessed with Pediatric Cerebral Performance Category (PCPC) scale and Pediatric Stroke Outcome Measure (PSOM). Results: We enrolled 76 children with arterial-ischemic stroke, with a median age of 24 months (interquartile range 12-69), and 43 (57%) were boys. The most common risk factor for childhood arterial-ischemic stroke was arteriopathy in 59 (77%), followed by cardiovascular disorder in 12 (16%) children. Among 59 children with arteriopathy, 32 (42%) had infection-associated arteriopathies, 10 (13%) had mineralizing angiopathy, 10 (13%) had moyamoya disease. Pediatric stroke risk factors were classified according to Pediatric Stroke Classification and CASCADE primary classification. Short-term neurologic outcome was assessed at 3 months in 62 (82%) survivors. Among stroke survivors, 33 (61%) had sensory-motor deficits, and 24 (39%) had severe neurologic disability (PCPC ≥ 4). The presence of fever, encephalopathy, low Glasgow coma score at presentation, seizures, and infection-associated arteriopathy predicted severe neurologic disability at follow-up. Conclusion: The risk factors for pediatric arterial-ischemic stroke are different from developed countries in our cohort. Infection-associated arteriopathies, mineralizing angiopathy, and moyamoya disease are the most common risk factors in our cohort. Two-thirds of pediatric stroke survivors have neurologic disability at short-term follow-up.
Using the CYP3A Activity Evaluation to Predict the Efficacy and Safety of Diazepam in Patients With Alcohol Withdrawal Syndrome
Authors: Skryabin Valentin Yu. , Zastrozhin Mikhail S. , Grishina Elena A. , Ryzhikova Kristina A. , Shipitsyn Valery V. , V. Barna Ilya , Galaktionova Tatiana E. , Ivanov Andrey V. , Sorokin Alexander S. , Bryun Evgeny A. , Sychev Dmitry A. 
Published: February 2021

Background: Diazepam is one of the most commonly prescribed tranquilizers for the therapy of alcohol withdrawal syndrome (AWS). Despite its popularity, there is currently no precise information on the effect of genetic polymorphisms on the efficacy and safety of diazepam therapy. Objective: The objective of our study was to study the effect of CYP3A isoenzymes activity on the efficacy and safety of diazepam in patients with AWS. Methods: The study was conducted on 30 Russian male patients suffering from the AWS who received diazepam in injections at a dosage of 30.0 mg / day for 5 days. The efficacy and safety assessment was performed using psychometric scales and scales for assessing the severity of adverse drug reactions. Results: Based on the results of the study, we revealed the differences in the efficacy of therapy in patients with different CYP3A4 C>T intron 6 ( rs35599367) genotypes: ( CC) −9.0 [−13.0; −5.0], ( CT+TT) −13.5 [−15.0; −10.0], p = 0.014. The scores on the UKU scale, which was used to evaluate the safety of therapy, were also different: ( CC) 7.5 [6.0; 11.0], ( CT+TT) 11.0 [8.0; 12.0], p = 0.003. Conclusion: Possible relationship between the CYP3A activity, evaluated by the content of the urinary endogenous substrate of the given isoenzyme and its metabolite, the 6-beta-hydroxy cortisol (6-β-HC) / cortisol ratio, and the efficacy of diazepam was demonstrated. This possible relationship was also supported by the genotyping results. This should be taken into consideration when prescribing this drug to such patients in order to reduce the risk of pharmacoresistance.
Wage Gap Between Formal and Informal Regular Workers in India: Evidence from the National Sample Survey
Authors: Kumar Manik , Pandey Sweety 
Published: February 2021

This article elucidates the wage differential between formal and informal workers across different sectors, gender, occupation, and industry by using the 61st (2004–2005) and 68th (2011–2012) Rounds of National Sample Survey Office (NSSO) unit-level data. The study emphasizes two things: first, identifying the existence of the absolute wage gap between formal and informal workers and, second, finding the intensity of discrimination in wage between formal and informal workers. The vast body of literature available on this issue identifies gender, caste, religion, and region as the factors causing wage discrimination. This literature makes a shift from these traditional concepts by explaining the importance of job contract as a basis of wage discrimination. This study utilizes the percentage relative gap (PGR) to work out the absolute wage gap between the two types of workers (formal and informal) and thereafter decomposes it to arrive at the source of the wage gap. The study applies the threefold Blinder–Oaxaca (B–O) decomposition method, which categorizes the total wage gap into three parts. The dependent variable chosen for the equation is the natural logarithm of daily wage. While the wage gap between formal and informal workers did not significantly fall during the study period, the results, on the other hand, indicate that the component of discrimination is larger than the component of endowment. This explains the discrimination perpetrated against informal workers in the Indian labor market. Tackling such discrimination necessitates implementation of more proactive policies for achieving wage equality in India.
Understanding developmental psychopathology in Type 1 diabetes through attachment, mentalisation and diabetes distress
Authors: Garrett Christopher J. , Ismail Khalida , Fonagy Peter 
Published: February 2021

This article examines the combined roles of attachment mentalisation and diabetes distress in the psychological development of young people with Type 1 diabetes (T1D). We use these ideas to unify the evidence for psychological variables affecting young people and their families and suggest how diabetes distress and mentalisation might be part of the pathways for development of psychiatric diagnoses. Attachment theory’s central hypothesis is that a secure relationship with a care-giver in the early life of a child is essential to normal emotional and relational development, whilst diabetes distress is a well recognised phenomena of burden experienced by both child and parent in relation to the condition. We extend the ideas of attachment, into the psychological adaptation processes for young people at the time of diagnosis of T1D with emphasis on the function of the parent/caregiver in mentalising the experience of the child. We also connect our current understanding of diabetes distress to the associated increased risk for disorders of eating and personality in T1D. Using principles learnt in other areas of psychotherapeutic practice we end by suggesting interventions that could impact mental health and diabetes outcomes using the mentalisation model.
Complex emergencies: overcoming barriers to health care
Authors: Tønnessen-Krokan Morten , Bringedal Houge Anette 
Published: February 2021

Background: At the intersection of the Sustainable Development Goals, humanitarian assistance and health, the umbrella term ‘health in the last mile’ has gained traction. In August 2019, the Norwegian Red Cross commissioned a global report to conceptualise and assess what ‘health in the last mile’ refers to, in terms of access, needs and structural and geographical barriers and vulnerabilities, and describe how these vulnerabilities overlap in different humanitarian settings and regions. Aims: The purpose of this commentary article is to highlight the report’s most important findings for an academic audience, from the perspective of the Norwegian Red Cross. Discussion: The aim of the report was to propose a definition and create a methodology to help identify people and populations living in the last mile of healthcare; acknowledging that these go far beyond those affected by armed conflicts and sudden onset disasters. As the report reveals, last-mile populations are not adequately reached by current universal health coverage strategies. The report highlights the key role played by local humanitarian actors in reducing barriers to access to healthcare. Local stakeholders have first-hand knowledge of the needs of populations in the last mile and on how they navigate the barriers to healthcare access. The report also addresses questions such as: Who are the people with least access to healthcare? What are their health needs and what barriers do they face? Not least, when many live without access to healthcare services, how do we determine where the last mile begins? The report proposes a definition of ‘the last mile’ involving converging factors that exacerbate barriers to healthcare and identifies 18 groups that are considered potential last-mile populations. Global epidemics, such as the latest COVID-19, have shown that the concept of vulnerability is continually changing. These situations can bring new vulnerable populations to the edge of the last mile which were already vulnerable and ignored before the outset of the outbreak. Conclusions: Millions of people do not and will not benefit from the global progress in universal health coverage under current health systems. To reach the Sustainable Development Goals 3 and 16, we need solutions to overcome the barriers they face to access basic healthcare.
Exploring the effect of various match factors on team playing styles in the National Rugby League
Authors: Wedding C , Woods CT , Sinclair WH , Gomez MA , Leicht AS 
Published: February 2021

Objectives This study examined the effect of match location, score-line, team quality and match outcome on the expression of team playing styles in the National Rugby League (NRL) across the 2015–2019 seasons. Methods Thirty-eight performance indicators (e.g. offloads, runs) from all NRL games (n = 2010) were collected. Match-related factors examined were location (home/away/neutral), match type (absolute score differential), team quality (end of season ladder position) and outcome (win/draw/loss). Factor analysis using principal component analysis (PCA) were run to identify team playing styles, which were inferred from the clustered dimensions (Factors) of team performance indicators. Discriminant analysis was then used to determine the effect of the match factors on team playing styles. Results PCA revealed nine Factors accounting for ∼54% of team performance variance. Discriminant analysis did not meaningfully resolve team playing styles for match type, team quality or location (∼34%, ∼46% and ∼58% classification accuracy, respectively). One discriminant function correctly classified ∼81% of matches based on outcome, including four team playing styles defined as ‘attacking play’, ‘linebreaks’, ‘handling errors’ and ‘conceded linebreaks’. Conclusions Team playing styles characterised by ‘attacking play’ and ‘linebreaks’, coupled with relative defensive efficiency showed the greatest association with winning regardless of team quality, match location or match type. Using similar sport analytical techniques, additional insight into the importance of various team playing styles over the time-course of a match may allow teams to further extrapolate the likelihood of success in real-time.
Acute and sub-chronic toxicity evaluation of a standardized green coffee bean extract (CGA-7™) in Wistar albino rats
Authors: K Venkatakrishna , HV Sudeep , K Shyamprasad 
Published: February 2021

Objective: Despite having numerous physiological benefits, toxicological assessment of green coffee beans is sparce. Here, we document the oral acute and sub-chronic toxicity of a standardized decaffeinated green coffee bean extract containing 50% chlorogenic acids (CGA-7™) in rats. Methods: We have performed a limit test at single oral dose of 2000 mg/kg to evaluate the acute toxicity in female Wistar rats. Furthermore, repeated dose 90-day toxicity study was conducted to assess the risk of long-term use of CGA-7. Result: A 14-day observation revealed no clinical signs of toxicity or mortality in animals at 2000 mg/kg acute oral dose of CGA-7. The administration of 250, 500, and 1000 mg/kg CGA-7 showed significant alterations in some parameters such as food consumption, relative organ weights of brain and spleen, haematological and biochemical parameters compared to control. These changes were not consistent and dose-dependent throughout the study. Furthermore, the changes were within the physiological range and toxicologically insignificant. CGA-7 did not affect the normal metabolism and physiology of the animals up to 1000 mg/kg dose. Macroscopic and histological examination of organs did not reveal any organ toxicity. Conclusion: Finally, the findings from this study suggest the safety of green coffee bean extract.
The Effect of Femoral Nerve Block and Adductor Canal Block Methods on Patient Satisfaction in Unilateral Knee Arthroplasty: Randomized Non-Inferiority Trial
Authors: Kaçmaz Mustafa , Turhan Zeynep Yüksel 
Published: February 2021

Introduction: Femoral Nerve Block (FNB) and Adductor Canal Block (ACB) methods, which are regional analgesic techniques, are successfully used in postoperative pain control after total knee arthroplasty. This study aimed to compare adductor canal block method that was preoperatively used and femoral nerve block method in total knee arthroplasty (TKA) patients who underwent spinal anesthesia in terms of factors effecting patient satisfaction and determine whether these methods were equally effective or not. Methods: A total of 80 patients between the ages of 60 and 75 who were in the American Society of Anesthesia (ASA) physical status of I-III were prospectively included in this randomized study. Patients (n = 40) who received FNB were called Group FNB and patients (n = 40) who received Adductor Canal Block were called Group ACB. Results: Although mean postoperative VAS values were lower in FNB group only in the first hour (p = 0.02) there was no significant difference between the groups in the third, fifth, seventh, ninth, 12th and 24th hours (p≥0.05). Although Bromage scores were lower in FNB group in the first, second, third, fourth and fifth hours there was no statistically significant difference between the groups (p≥0.05). When mobilization time, patient satisfaction level, time of first analgesia, intraoperative sedation need, and recovery time of sensorial block were compared no statistically significant difference was found (p≥0.05). Discussion: When ACB and FNB that are used for postoperative analgesia in patients who undergo total knee arthroplasty are compared in terms of factors affecting patient satisfaction it is observed that they result in the same level (non-inferiority) of patient satisfaction. Conclusion: We recommend the routine use of ACB method with FNB in total knee arthroplasty. More studies focusing especially on measuring patient satisfaction are needed.
Inner Retinal Morphology and Visual Outcomes in Idiopathic Epiretinal Membrane Surgery: A Retrospective Optical Coherence Tomography Study
Authors: Dimopoulos Ioannis S. , Dollin Michael 
Published: February 2021

Purpose: Epiretinal membrane (ERM) is a common retinal finding for patients older than 50 years. Disorganization of the retinal inner layers (DRIL) has emerged as a novel predictor of poor visual acuity (VA) in eyes with inner retinal pathology. The aim of our study is to correlate preoperative DRIL with visual outcomes after ERM surgery. Methods: Medical records and optical coherence tomography (OCT) images of 81 pseudophakic patients who underwent treatment of idiopathic ERM were reviewed. Preoperative DRIL on OCT was correlated with VA at baseline and at 3 and 6 months after ERM surgery. DRIL was defined as the loss of distinction between the ganglion cell–inner plexiform layer complex, inner nuclear layer, and outer plexiform layer. DRIL severity was based on its extent within the central 2-mm region of a transfoveal B-scan (absent/mild: <one-third, severe: >one-third horizontal width). Results: Review of preoperative OCT showed severe DRIL in 41% and absent/mild DRIL in 59%. Severe DRIL was associated with worse baseline VA ( P < .001). Preoperative VA and DRIL status at baseline were both predictors of postoperative VA at follow-up time points ( P < .001). Severe DRIL was associated with significantly less improvement in VA at 6 months (–0.23 logMAR for absent/mild vs –0.14 for severe DRIL). Conclusions: Presence of severe preoperative DRIL correlates with worse baseline VA in patients with ERM and reduced VA improvement at 6 months. DRIL can be a strong predictor of long-term poor visual outcomes in ERM surgery.
Impact of Exchange Rate Fluctuations on India’s Manufacturing Exports: An Empirical Investigation on Long-Run Relation
Authors: Jyoti  
Published: February 2021

After the collapse of the fixed exchange rate system of Bretton Woods, the fluctuations of exchange rate and its impact on macroeconomic performance and trade in countries around the world are becoming an increasing debate among researchers and policymakers. This study empirically investigates whether fluctuations in real exchange rate may affect real exports in the Indian context. The study has employed autoregressive distributed lag (ARDL) bound test procedure to analyse the long-run relationship among variables using quarterly data from 2005Q1 to 2017Q4. The results of the ARDL bound test reveal that real exports are cointegrated with relative prices, real exchange rate volatility and world real GDP. The study has found negative but insignificant impact of exchange rate volatility on exports, but world GDP as a proxy of foreign economic activity and real effective exchange rate as relative prices have positive and statistically significant impact on Indian manufacturing exports. Further, the ARDL short-run error correction model implies that while the model may temporarily deviate from its long-run equilibrium, the deviations adjust towards the equilibrium level in the long run. JEL Codes: F01, F31, F14
Risk factors for refracture of the femoral shaft in children after removal of external fixation
Authors: Guo Meizhen , Su Yuxi 
Published: February 2021

Abstract
Background
External fixation is the primary treatment option in children for femoral shaft fractures, such as open femoral or multiple fractures. One complication is refracture, which is the biggest limitation of fixation devices. This study aims to investigate the risk factors associated with refracture after the removal of external fixation devices and decrease the frequency of refracture.

Materials and methods
Retrospectively reviewed clinical data of 165 patients treated at our hospital for fresh femoral shaft fractures with external fixation between May 2009 and February 2018 were included in this study. Patients with pathological fractures, fractures of the femoral neck, fractures that were fixed using plates or elastic stable intramedullary nailing, and old fractures, as well as those who underwent postoperative femoral surgery were excluded. Potential risk factors included: patient age, gender, and weight, fracture sides, open or closed fracture, fracture sites, reduction methods, operation time, perioperative bleeding, number and diameter of the screws, and immobilization time. These factors were identified by univariate and logistic regression analyses.

Results
Femoral shaft refracture developed in 24 patients. Univariate analysis revealed that refracture was not statistically significantly associated with any of the above factors, except AO Pediatric Comprehensive Classification of Long Bone Fractures (PCCF) classification type 32-D/4.2 and L2/L3 ratio (L2, length of femur fixed by the two screws farthest from the fracture line; L3, the total length from the greater trochanter to the distal end of femur; P < 0.001 and P = 0.0141, respectively). Multivariate analysis showed that PCCF classification type 32-D/4.2 and L2/L3 ratio were also independent risk factors for femoral refracture.

Conclusions
Femoral shaft refracture is relatively common in children treated with external fixation. Because of the limited number of cases in this study, we cautiously concluded that the PCCF classification type 32-D/4.2 and L2/L3 ratio were independent risk factors for femoral shaft refracture in these patients.

Level of evidence
IV
Implementation of isopropyl alcohol (IPA) inhalation as the first-line treatment for nausea in the emergency department: practical advantages and influence on the quality of care
Authors: Veldhuis Peter , Melse Maartje , Mullaart Nieke 
Published: February 2021

Abstract
Background
Nasal inhalation of isopropyl alcohol (IPA) seems an effective anti-emetic for the symptomatic treatment of nausea in the emergency department (ED) compared to conventional anti-emetics (Ondansetron and Metoclopramide). However, it is not yet known what the practical consequences are related to the use of IPA in the ED.

Objectives
The purpose of this study was to assess the practical implications for patient care associated with IPA use and to evaluate the viability of permanent implementation of IPA inhalation as a first-line therapy for nausea in the ED.

Methods
We conducted a prospective, single-center implementation study comparing ED-based care for nauseated patients before (n=106) and after (n=104) the introduction of IPA. We evaluated the treatment process and cost and assessed implementation using a survey based on recommended implementation outcome measures.

Results
Comparing baseline phase to implementation phase, we found a significant increase in the percentage of patients receiving nausea treatment (66.0% versus 97.1%; p<0.001) and a reduction in time to treatment initiation (7 versus 1 min, p<0.001). Additionally, IPA introduction was associated with a decrease in the administration of conventional anti-emetics (0.52 versus 0.23 administrations per patient, p<0.001) and a notable drop in treatment cost (€1.33 versus €0.67 per patient). Nurses were content with IPA implementation and regarded definitive implementation as feasible and sustainable.

Conclusion
Implementation of IPA as the first-line nausea treatment in the ED can increase the quality of care and improve care efficiency. Definitive implementation of IPA as a first-line treatment in the ED is both viable and practically feasible.

Trial registration
NTR, NL7717, Registered on March 23, 2018 - Retrospectively registered