bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding doctors’ emergency department antibiotic prescribing decisions in children with respiratory symptoms in the UK: a qualitative study
Authors: Hampton Thomas , Ogden Jane , Higgins Helen Mary 
Published: December 2021

ObjectiveExploration of the factors that influence hospital doctors’ antibiotic prescribing decisions when treating children with respiratory symptoms in UK emergency departments.MethodsA qualitative study using semistructured interviews based on a critical incident technique with 21 physicians of different grades and specialties that treat children in the UK. Interviews were audio-recorded then transcribed verbatim and analysed using thematic analysis.ResultsFour themes were identified. These themes illustrate factors which influence clinician prescribing. The three principal themes were authorities, pressures and risk. The fourth transcending theme that ran through all themes was clinician awareness and complicity (‘knowing but still doing’).ConclusionsHospital doctors prescribe antibiotics even when they know they should not. This appears to be due to the influence of those in charge or external pressures experienced while weighing up the immediate and longer term risks but clinicians do this with full insight into their actions. These findings have implications for invested parties seeking to develop future antimicrobial stewardship programmes. It is recommended that stewardship interventions acknowledge and target these themes which may in turn facilitate behaviour change and antimicrobial prescribing practice in emergency departments.
Gender perspective of psychological discomfort during COVID-19 confinement among Spanish adult population: a cross-sectional study
Authors: Gómez-Salgado Juan , Domínguez-Salas Sara , Rodríguez-Domínguez Carmen , Allande-Cussó Regina , Romero-Martín Macarena , Ruiz-Frutos Carlos 
Published: December 2021

ObjectiveCOVID-19 disease has affected more than a hundred countries worldwide and has exposed the population to an increase in mental health problems. The objective of this study was to assess the emotional impact of the pandemic from a gender perspective, as well as to study the modulating variables of that impact.DesignA descriptive and cross-sectional study through the General Health Questionnaire scale and the Sense of Coherence (SOC) scale is developed.SettingGeneral population of Spain was the target of this studyParticipantsThe sample consisted of 3801 adult subjects living in Spain, without diagnosis for Sars-Cov-2 virus infection during confinement.InterventionData collection was carried out using an online questionnaire, from 26 March 2020 to 26 April 2020.Primary and secondary outcomes measuresA sample profile description was obtained, regarding to the study variables. Later, a regression model was implemented in order to test the relationship between these variables, and to achieve a predictive model of psychological discomfort controlling the gender variable.ResultsThe results showed that women, as compared with men, had increased psychological discomfort during confinement (t=−12.877; p<0.001; d=0.470). In contrast, significantly higher scores were observed on the SOC scale (t=6.336; p<0.001; d=0.231) in men, as compared with those obtained by women.ConclusionsWomen have higher levels of psychological discomfort, increased concern about getting infected with COVID-19 and infecting others, as well as a lower level of SOC and perceived health. In addition, low levels of SOC predict greater concern about contagion and increased psychological discomfort.
Was there any change in tobacco smoking among adults in Bangladesh during 2009–2017? Insights from two nationally representative cross-sectional surveys
Authors: Rahman Md. Ashfikur , Kundu Satyajit , Ahinkorah Bright Opoku , Okyere Joshua , Halder Henry Ratul , Rahman Md. Mahmudur , Yadav Uday Narayan , Mistry Sabuj Kanti , Rahman Muhammad Aziz 
Published: December 2021

ObjectiveThis study assessed the changes in prevalence and associated factors of tobacco smoking among Bangladeshi adults over time.DesignNationally representative cross-sectional surveys.SettingTwo most recent Global Adults Tobacco Survey (GATS) data from Bangladesh, carried out in 2009 and 2017.ParticipantsAdult population aged 15 and above (n=9629 in 2009; n=12 783 in 2017).Outcome measuresCurrent use of tobacco smoke, including cigarettes, bidi, hukkah, cigars or pipes, which was dichotomised (‘yes’/‘no’).MethodsWe analysed data from two recent rounds of GATS (2009 and 2017). Multivariate logistic regression analysis was used.ResultsThe overall prevalence of tobacco smoking among Bangladeshi adults was noted (23.00%, 95% CI 22.98 to 23.00 in 2009; 16.44%, 95% CI 16.43 to 16.45 in 2017). Being male (adjusted OR (AOR)=59.72, CI 40.56 to 87.93 for 2009; AOR=71.17, CI 41.08 to 123.32 for 2017), age between 25 and 64 years (all AORs >2 and p<0.05), smoking permissible at home (AOR=7.08, CI 5.88 to 8.52 for 2009; AOR=5.90, CI 5.34 to 6.95 for 2017), and watching tobacco smoking product use in movie/drama scenes (AOR=1.26, CI 1.11 to 1.44 for 2009; AOR=1.34, CI 1.17 to 1.54 for 2017) were found to be significantly associated with increased tobacco smoking among adults both in 2009 and in 2017. However, being offered free tobacco sample products (AOR=0.66, CI 0.57 to 0.77 for 2009; AOR=0.87, CI 0.76 to 0.99 for 2017) and having primary, secondary or higher education (all AORs <1 and p<0.05) as well as being a student (AOR=0.16, CI 0.09 to 0.29 for 2009; AOR=0.32, CI 0.19 to 0.53) were associated with lower odds of tobacco smoking in both surveys.ConclusionsAlthough the prevalence of tobacco smoking has declined over the period, it is still high among those who were relatively older, men, less educated and exposed to a movie/drama where tobacco smoking is promoted. Therefore, appropriate interventions are required to stop tobacco smoking among the Bangladeshi population.
Impact of benzalkonium chloride-preserved and preservative-free latanoprost eye drops on cultured human conjunctival goblet cells upon acute exposure and differences in physicochemical properties of the eye drops
Authors: Müllertz Olivia , Hedengran Anne , Mouhammad Zaynab Ahmad , Freiberg Josefine , Nagymihály Richárd , Jacobsen Jette , Larsen Susan Weng , Bair Jeffrey , Utheim Tor P , Dartt Darlene A , Heegaard Steffen , Petrovski Goran , Kolko Miriam 
Published: December 2021

ObjectiveTo investigate the short-term impact on human conjunctival goblet cell (GC) survival and mucin release of acute exposure to benzalkonium chloride (BAK) preserved and preservative-free (PF) 0.005% (w/v) latanoprost (LT) eye drops, and to compare the eye drops’ physicochemical properties.Methods and analysisPrimary GC cultures were established from human conjunctival donor tissue. The impact of eye drops on GC survival was assessed using a lactate dehydrogenase assay. Mucin release was evaluated through mucin-specific immunostaining. pH value, osmolality, drop mass and surface tension for all LT eye drops were measured.ResultsAfter application with PF-LT for 30 min (min), the GC survival was maintained compared with control (p=0.9941), while all BAK-LT eye drops reduced survival with approximately 30% (p<0.02). Following application with PF-LT for 30 min, mucin was found around the GC nucleus, as seen in the vehicle control, indicating no secretion. In contrast, BAK-LT caused diffuse staining of mucin, similar to the secretagogue histamine, indicating stimulation of secretion. The pH value of the BAK-LT and PF-LT eye drops were 6.0–6.9 and 6.8, respectively. The osmolality was 258–288 mOsm/kg for the BAK-LT eye drops and 276 for PF-LT eye drops. The mean drop mass was 26–31 mg for the BAK-LT eye drops and 30 mg for PF-LT. The surface tension was lower for all BAK-LT eye drops (31.1–32.1 mN/m) compared with PF-LT (42 mN/m).ConclusionPF-LT compared with various branded and generic LT preparations containing BAK are less cytotoxic when applied to cultured GCs.
A Minimalist Method Toward Severity Assessment and Progression Monitoring of Obstructive Sleep Apnea on the Edge
Authors: Rahman Md Juber , Morshed Bashir I. 
Published: December 2021

Artificial Intelligence-enabled applications on edge devices have the potential to revolutionize disease detection and monitoring in future
smart health (sHealth)
systems. In this study, we investigated a minimalist approach for the severity classification, severity estimation, and progression monitoring of
obstructive sleep apnea (OSA)
in a home environment using wearables. We used the recursive feature elimination technique to select the best feature set of 70 features from a total of 200 features extracted from polysomnogram. We used a multi-layer perceptron model to investigate the performance of OSA severity classification with all the ranked features to a subset of features available from either Electroencephalography or
Heart Rate Variability (HRV)
and time duration of SpO2 level. The results indicate that using only computationally inexpensive features from HRV and SpO2, an area under the curve of 0.91 and an accuracy of 83.97% can be achieved for the severity classification of OSA. For estimation of the apnea-hypopnea index, the accuracy of RMSE = 4.6 and R-squared value = 0.71 have been achieved in the test set using only ranked HRV and SpO2 features. The Wilcoxon-signed-rank test indicates a significant change (p < 0.05) in the selected feature values for a progression in the disease over 2.5 years. The method has the potential for integration with edge computing for deployment on everyday wearables. This may facilitate the preliminary severity estimation, monitoring, and management of OSA patients and reduce associated healthcare costs as well as the prevalence of untreated OSA.
Religion and Development
Authors: Klaasen John 
Published: December 2021

Abstract
This article is a contribution to the discourse on religion and development. The contribution seeks to investigate the role of religious conceptualisations in development. Theological anthropology, and specifically the Christian doctrine of the imago Dei, is critically analysed from the historical-biblical approach, a feminist and postcolonial approach, and a contextual approach. Themes such as progression, responsibility, relationships, and the spiritual dimension of personhood are identified as contributing toward the role of religion in development. Drawing from theological concepts such as “vocation,” “rule,” “image,” and “likeness,” the specific connections between religion and development derives from the central theological anthropological doctrine of the imago Dei. The themes that are identified are not explored exhaustively but are nonetheless highlighted as markers that should be considered by both practitioners and academics in the broad-based development discourse and practices. The limitations of the modernisation and materialistic approaches of the post-war period are countered by the centrality of personhood.
Human Rights and Structural Inequality in the Shadow of COVID-19—A New Chapter in the Culture Wars?
Authors: Zagor Matthew 
Published: December 2021

Abstract
This article takes as its starting point the convergence of two rights-related grassroots movements given momentum by the pandemic’s manifestly discriminatory impact: the push to recognise and address racism as a public health crisis, and the global influence of the Black Lives Matter (‘BLM’) movement. It considers the relevance of this moment to international human rights law, the adequacy of the response from its key institutions, and the conservative backlash, framed within the rhetoric of rights, that is challenging the very idea of structural racism. In doing so, it argues that we are witnessing a new stage of the culture wars around the language, method and assumptions of human rights law with which the discipline must engage pragmatically and strategically.
A new species of Ischnocnema (Anura: Brachycephalidae) from the mountainous region of Atlantic Forest, southeastern Brazil, with a new phylogeny and diagnose for Ischnocnema parva series
Authors: SILVA-SOARES THIAGO , FERREIRA RODRIGO BARBOSA , ORNELLAS IAGO SILVA , ZOCCA CÁSSIO Z. , CARAMASCHI ULISSES , CRUZ CARLOS ALBERTO GONÇALVES 
Published: December 2021

We describe a new species of Rain Frog from Brazil’s Atlantic Forest, which harbors high richness, endemism and threatened species of anurans. Ischnocnema crassa sp. nov. is a leaf litter breeder from the montane rainforest of Santa Teresa, state of Espírito Santo, southeastern Brazil. Remarkably, the new species is so far unique amongst Ischnocnema for having moderate hand webbing between fingers. Ischnocnema crassa sp. nov. is the third species belonging to I. parva series and we present a new phylogeny based on molecular data and propose a new diagnosis for the series. We provide field and laboratory observations regarding amplexus, antipredator mechanisms, microhabitat preferences and conservation remarks. Although Santa Teresa is one of the most sampled areas in Brazil, new species are often discovered. Santa Teresa is a priority for amphibian conservation because it harbors 109 species of anurans (9% of Brazil’s species).
Compulsory and voluntary admissions in comparison: A 9-year long observational study
Authors: Draghetti Stefano , Alberti Siegfried , Borgiani Gianluca , Panariello Fabio , De Ronchi Diana , Atti Anna Rita 
Published: December 2021

Background: Few studies, so far, have been specifically designed to highlight the features related to Compulsory Admissions (CA) and Voluntary Admissions (VA) in Italian psychiatric emergency wards. Aims: The main purpose of this observational study was to compare the sociodemographic and clinical characteristics of VA and CA and to explore possible predictors of re-admissions. Methods: During a 6-month Index Period (February, the 1st–July, the 31st 2008) all psychiatric admissions were documented and then followed-up through all available informatic systems for the next 9 years. Results: Out of 390 hospitalizations, 101 (25.9%) were compulsory (CA rate was 2.79 per 10,000 inhabitants per year, mean duration of hospitalizations of 7.33 ± 7.84 days). Diagnoses were recorded for the 325 patients who had been hospitalized during index period: schizophrenic psychoses ([ p = .042], in particular schizophrenia [ p = .027]), manic episode ( p = .044), and delusional disorders ( p = .009) were associated with CA; conversely, the diagnosis of unipolar major depression ( p = .005) and personality disorders ( p = .048) were significantly more frequent in VA. The 325 admitted patients were followed up for 1,801 person-years. No significant differences were found in terms of drop-outs, transferring, and discharge rates, and mortality rates due to both natural causes and suicides. Factors associated with at least one compulsory readmission were younger age and having had a previous CA ( p = .011); conversely having been engaged with psychiatric services for over 1 year prior to index hospitalization was protective for a subsequent CA ( p = .013). Conclusions: After a 40-year old political reform, the current study shows that, in a context of integrated outpatient and inpatient services, engagement with outpatient care may be protective for compulsory rehospitalization.
Quantitative magnetic resonance imaging of chronic kidney disease: an experimental in vivo study using rat chronic kidney disease models
Authors: Kim Sang Youn , Kim Hyeonjin , Lee Joongyub , Jung Sung Il , Moon Min Hoan , Joo Kwon Wook , Cho Jeong Yeon 
Published: December 2021

Background Recent advances in magnetic resonance imaging (MRI) may allow it to be an alternative emerging tool for the non-invasive evaluation of renal parenchymal disease. Purpose To validate the usefulness of quantitative multiparametric MRI protocols and suggest the suitable quantitative MR sequence protocol to evaluate parenchymal fibrosis using an animal model of chronic kidney disease (CKD) by long-term adenine intake. Material and Methods In this prospective animal study, 16 male Wistar rats were analyzed and categorized into three groups. Rats in the CKD groups underwent 0.25% adenine administration for three or six weeks. Quantitative MRI protocols, including diffusion-weighted imaging (DWI), T1ρ (T1 rho), and T2* mapping were performed using a 9.4-T animal MR scanner. A semi-quantitative histopathologic analysis for renal fibrosis was conducted. Quantitative MR values measured from anatomic regions of kidneys underwent intergroup comparative analyses. Results The apparent diffusion coefficient (ADC) and T1 (T1 rho) values were significantly increased in all CKD groups. Values measured from the cortex and outer medulla showed significant intergroup differences. Total ADC values tended to increase according to periods, and T1ρ values increased in three weeks and decreased in six weeks. Conclusion Quantitative MRI protocols could be a non-invasive assessment modality in the diagnosis and evaluation of CKD. Particularly, T1ρ may be a suitable MR sequence to quantitatively assess renal parenchymal fibrosis.
Postoperative progression of intracranial grade II–III solitary fibrous tumor/hemangiopericytoma: predictive value of preoperative magnetic resonance imaging semantic features
Authors: Li Shenglin , Zhang Bin , Zhang Peng , Xue Caiqiang , Deng Juan , Liu Xianwang , Zhou Junlin 
Published: December 2021

Background Preoperative prediction of postoperative tumor progression of intracranial grade II–III hemangiopericytoma is the basis for clinical treatment decisions. Purpose To use preoperative magnetic resonance imaging (MRI) semantic features for predicting postoperative tumor progression in patients with intracranial grade II–III solitary fibrous tumor/hemangiopericytoma (SFT/HPC). Material and Methods We retrospectively analyzed the preoperative MRI data of 42 patients with intracranial grade II–III SFT/HPC, as confirmed by surgical resection and pathology in our hospital from October 2010 to October 2017, who were followed up for evaluation of recurrence, metastasis, or death. We applied strict inclusion and exclusion criteria and finally included 37 patients. The follow-up time was in the range of 8–120 months (mean = 57.1 months). Results Single-factor survival analysis revealed that tumor grade (log-rank, P = 0.024), broad-based tumor attachment to the dura mater (log-rank, P = 0.009), a blurred tumor-brain interface (log-rank, P = 0.008), skull invasion (log-rank, P = 0.002), and the absence of postoperative radiotherapy (log-rank, P = 0.006) predicted postoperative intracranial SFT/HPC progression. Multivariate survival analysis revealed that tumor grade ( P = 0.009; hazard ratio [HR] = 11.42; 95% confidence interval [CI] = 1.832–71.150), skull invasion ( P = 0.014; HR = 5.72; 95% CI = 1.421–22.984), and the absence of postoperative radiotherapy ( P = 0.001; HR = 0.05; 95% CI = 0.008–0.315) were independent predictors of postoperative intracranial SFT/HPC progression. Conclusion Broad-based tumor attachment to the dura mater, skull invasion, and blurring of the tumor–brain interface can predict postoperative intracranial SFT/HPC progression.
Effect of decreased contrast injection flow rate on aortic enhancement in 80-KV peak CT with contrast dose reduction
Authors: Morisaka Hiroyuki , Matsuura Koichiro , Yamaguchi Haruomi , Ichikawa Tomoaki , Onishi Hiroshi 
Published: December 2021

Background Effect of decreased injection flow rate of contrast agent at the same iodine dose and delivery rate on aortic enhancement has not been clearly elucidated. Purpose To evaluate the effect of decreased injection flow rate of contrast agent on aortic peak enhancement in a dynamic flow phantom and on aortic enhancement in clinical dynamic 80-kVp computed tomography (CT) with contrast dose reduction. Material and Methods In the dynamic flow phantom experiment, the effect of a decreased injection flow rate at the same total iodine dose and delivery rate on simulated aortic peak enhancement was evaluated. In the clinical retrospective study, we searched 312 patients with renal dysfunction who underwent an 80-kVp abdominal dynamic CT with 40% reduction of contrast agent from a standard 120-kVp protocol and measured the aortic enhancement at the level of the hepatic hilum. Independent predictors for aortic enhancement were determined by multiple linear regression analysis, and after adjustment of significant predictors, independent variables for acquiring optimal aortic enhancement, ≥300 HU, were determined by multiple logistic regression analysis. Results In the phantom experiment, decreased flow rate showed a significant but small descent effect (6%–9%) on simulated aortic peak enhancement. In the multiple linear regression analysis, only age was an independent predictor of aortic enhancement; there was no independent predictor for optimal age-adjusted aortic enhancement of ≥300 HU. Conclusions Decreased injection flow rate had a small influence on aortic enhancement in vitro but had no significant effect on the aortic enhancement in clinical dynamic 80-kVp CT.
A structural equation modeling of supply chain strategies for artemisinin-based combination therapies in Uganda
Authors: Nagitta Oluka Pross , Mkansi Marcia , Nyesiga Sylvia Desire , Kajjumba George William 
Published: December 2021

Introduction: Malaria is a killer disease in the tropical environment; artemisinin-based combination therapies (ACTs) play a central role in treating malaria. Thus, the supply and presence of ACT drugs in hospitals are a key feature in the fight against malaria. Supply chain management literature has focused on the private sector, and less attention has been paid to the public sector, especially hospitals. Aim: This study uses an interdisciplinary lens in investigating how to boost the supply and distribution of ACTs to save lives in low-income countries, specifically in Uganda. Methodology: The study adopted a quantitative research design using a questionnaire as the data collection instrument. Of the 440-population size, 304 of the sample population participated in the study. The model was estimated using structural equation modeling (SEM) to establish the causal relationship among the variables. Results: From the SEM analysis, all the hypotheses were significant at p < 0.05. The availability of ACTs is strongly affected by strategic dimensions (0.612), followed by operation dimensions (0.257); strategic determinants significantly affect operational determinants by a magnitude of 0.599. The indirect influence of the strategic determinants via operational determinants on the availability of ACTs is not significant. Overall, the factors explained 63.9% of the observed variance in the availability of ACTs, and the ACT availability can be predicted as follows: ACT availability = 0.612 × strategic determinants + 0.256 × operation determinants. Top management commitment and organizational responsiveness are among the items that positively affect the availability of ACTs. Conclusion: Strategically, hospital management should invest in cheap technology and software to minimize the unavailability of medicines. Our research suggests that strategic and operational determinants should be integrated into the hospitals’ core business and implemented by the top management. The article contributes to theoretical and policy direction in the public sector medicine supply chain, specifically in public hospitals.