bluuebunny/crossref_metadata_2025_split huggingface dataset:
Developing a new national MDMA policy: Results of a multi-decision multi-criterion decision analysis
Authors: van Amsterdam Jan , Peters Gjalt-Jorn Ygram , Pennings Ed , Blickman Tom , Hollemans Kaj , Breeksema Joost J Jacobus , Ramaekers Johannes G , Maris Cees , van Bakkum Floor , Nabben Ton , Scholten Willem , Reitsma Tjibbe , Noijen Judith , Koning Raoul , van den Brink Wim 
Published: February 2021

Background: Ecstasy (3,4-methylenedioxymethamphetamine (MDMA)) has a relatively low harm and low dependence liability but is scheduled on List I of the Dutch Opium Act (‘hard drugs’). Concerns surrounding increasing MDMA-related criminality coupled with the possibly inappropriate scheduling of MDMA initiated a debate to revise the current Dutch ecstasy policy. Methods: An interdisciplinary group of 18 experts on health, social harms and drug criminality and law enforcement reformulated the science-based Dutch MDMA policy using multi-decision multi-criterion decision analysis (MD-MCDA). The experts collectively formulated policy instruments and rated their effects on 25 outcome criteria, including health, criminality, law enforcement and financial issues, thematically grouped in six clusters. Results: The experts scored the effect of 22 policy instruments, each with between two and seven different mutually exclusive options, on 25 outcome criteria. The optimal policy model was defined by the set of 22 policy instrument options which gave the highest overall score on the 25 outcome criteria. Implementation of the optimal policy model, including regulated MDMA sales, decreases health harms, MDMA-related organised crime and environmental damage, as well as increases state revenues and quality of MDMA products and user information. This model was slightly modified to increase its political feasibility. Sensitivity analyses showed that the outcomes of the current MD-MCDA are robust and independent of variability in weight values. Conclusion: The present results provide a feasible and realistic set of policy instrument options to revise the legislation towards a rational MDMA policy that is likely to reduce both adverse (public) health risks and MDMA-related criminal burden.
High expression of tissue O-linked glycans is associated with a malignant phenotype of cholangiocarcinoma
Authors: Talabnin Krajang , Talabnin Chutima , Khiaowichit Juthamas , Sutatum Nuchanard , Asavaritikrai Pundit , Suksaweang Sanong , Tongtawee Taweesak , Ishihara Mayumi , Azadi Parastoo , Sripa Banchob 
Published: February 2021

Objective This study aimed to investigate the expression of O-linked glycoprotein glycans in tissue of patients with cholangiocarcinoma compared with adjacent normal tissue. Methods Sixty patients with cholangiocarcinoma were included in the study. Permethylated O-linked glycans from intrahepatic cholangiocarcinoma tissue and adjacent normal tissue were analyzed using nano-spray ionization-linear ion trap mass spectrometry. Histochemistry of peanut agglutinin lectin was used for detection and localization of galactose (Gal) 1, N-acetyl-galactosamine (GalNAc) 1. Results O-linked glycans from patients with cholangiocarcinoma were composed of di- to hexa-saccharides with a terminal galactose and sialic acids (N-acetylneuraminic acid [NeuAc]). A total of eight O-linked glycan structures were detected. Gal1GalNAc1 and Gal2 N-acetyl-glucosamine 1 GalNAc1 expression was significantly higher in tissue from patients with cholangiocarcinoma compared with adjacent normal tissue, while NeuAc1Gal1GalNAc1 expression was significantly lower. High Gal1GalNAc1 expression was significantly associated with the late stage of cholangiocarcinoma (stages II–IV), lymphatic invasion, and vascular invasion. Conclusion Our study shows expression of O-linked glycans in progression of cholangiocarcinoma and highlights the association of Gal1GalNAc1 with lymphatic and vascular invasion of cholangiocarcinoma.
Application of virtual scenario simulation combined with problem-based learning for paediatric medical students
Authors: Peng Wan-Sheng , Wang Lian , Zhang Hui , Zhang Zhen , Wu Yu-Meng , Sang Xu , Zhou Rui , Xu Jia-Li , Chen Xin 
Published: February 2021

Objectives To examine the application and effects of virtual scenario simulation combined with problem-based learning (PBL) in teaching paediatric medical students. Methods Participants were 300 paediatric medical students randomly divided into a study group and control group. Students in the study group were taught using virtual scenario simulation combined with PBL; students in the control group were taught using conventional teaching methods. Academic performance, knowledge of paediatrics, self-evaluation of comprehensive ability and degree of learning satisfaction were evaluated. Results Students in the study group showed considerably higher academic performance and noticeably higher classroom performance. Paediatric knowledge, comprising initiating communication, collecting information, giving information, understanding the paediatric patient and concluding communication, was higher for students in the study group. The degree of learning satisfaction was higher for students in the study group. Conclusion Virtual scenario simulation combined with PBL can effectively improve students’ academic performance, mastery of paediatric knowledge, comprehensive ability evaluation and learning satisfaction. The broader application of this approach should be explored for medical student education.
Effect of regular third-trimester ultrasound examination on antenatal detection and perinatal outcomes of small for gestational age infants
Authors: Wang Yan , Wei Jun , Liu Guoli , Yan Yani , Yang Zhenjuan , Li Yuntao , Pei Qiuyan 
Published: February 2021

Objective To assess the effect of regular third-trimester ultrasound on antenatal detection and perinatal outcomes of small for gestational age (SGA) infants. Methods Data from SGA infants delivered at ≥28 weeks’ gestation were retrospectively studied. Each pregnancy had undergone three regular third-trimester ultrasound examinations, and data were grouped according to with or without antenatal ultrasound suspicion of fetal growth restriction (FGR). Adjusted risk ratios (aRRs) of perinatal outcomes were analysed. Results A total of 407 infants were included, comprising 268 (65.85%) with antenatal ultrasound suspicion of FGR. Antenatal suspicion of FGR was associated with increased risk of iatrogenic delivery (aRR 2.03, 95% confidence interval [CI] 1.31, 3.14) that included risk of preterm birth (aRR 10.61, 95% CI 1.35, 83.62) and elective caesarean section (aRR 1.306, 95% CI 1.051, 1.623). Differences in fetal death, 1-min Apgar score, and admission to neonatal intensive care unit were not statistically significant. Resuscitation risk was reduced (aRR 0.22, 95% CI 0.06, 0.79). Conclusions Regular use of third-trimester ultrasound in one teaching hospital in China showed satisfactory antenatal detection of FGR among SGA infants. Ultrasound suspicion of FGR was associated with higher incidence of iatrogenic deliveries, but not improved neonatal outcomes, except for reduced perinatal resuscitation.
Custodiol-MP for ex vivo lung perfusion – A comparison in a porcine model of donation after circulatory determination of death
Authors: Kalka Katharina , Keldenich Zoe , Carstens Henning , Walter Björn , Rauen Ursula , Ruhparwar Arjang , Weymann Alexander , Kamler Markus , Reiner Gerald , Koch Achim 
Published: February 2021

Introduction: Ex vivo lung perfusion (EVLP) is an established technique to evaluate and eventually recondition lungs prior to transplantation. Custodiol-MP (C-MP) solution is a new solution, designed for clinical machine perfusion, that has been used for kidneys. The aim of this study was to compare the effects of EVLP with Custodiol-MP on lung functional outcomes to the gold standard of EVLP with Steen Solution™. Material and Methods: In a porcine EVLP model of DCDD (Donation after Circulatory Determination of Death), lungs were perfused with Steen Solution™ (SS, n = 7) or Custodiol-MP solution supplemented with 55 g/l albumin (C-MP, n = 8). Lungs were stored cold for 4 h in low potassium dextran solution and subsequently perfused ex vivo for 4 h. During EVLP pulmonary gas exchange, activities of lactate dehydrogenase (LDH) and alkaline phosphatase (AP) as well as levels of lactate in the perfusate were recorded hourly. Results: Oxygenation capacity differed significantly between groups (averaged over 4 h: SS 274 ± 178 mmHg; C-MP 284 ± 151 mmHg p = 0.025). Lactate dehydrogenase activities and lactate concentrations were significantly lower in Custodiol-MP perfused lungs. In a porcine model of DCDD with 4 h of EVLP the use of modified Custodiol-MP as perfusion solution was feasible. The use of C-MP showed at least comparable lung functional outcomes to the use of Steen SolutionTM. Furthermore C-MP perfusion resulted in significantly lower lactate dehydrogenase activity and lactate levels in the perfusate and higher oxygenation capacity.
Theorizing untranslatability: Temporalities and ambivalence in colonial literature of Taiwan and Korea
Authors: Chen Pei Jean 
Published: February 2021

This paper theorizes and historicizes the ideas of modern language and translation and challenges the imperialist and nationalistic mode of worlding with the notion of ‘untranslatability’ that is embedded in the linguistic and cultural practices of colonial Taiwan and Korea. I redefine the notion of translation as a bordering system – the knowledge-production of boundaries, discrimination, and classification – that simultaneously creates the translatable and the untranslatable (i.e. the equivalence and incommensurability) in asymmetrical power relations. With this, I discuss how this ambivalence is embodied in the experiences of colonial writers Wu Yung-fu and Pak T’aewŏn and their novellas ‘Head and Body’ (1933) and ‘A Day in the life of Kubo the Novelist’ (1934). I illustrate two characteristics of the ambivalent untranslatability embedded in their novellas: the linguistic untranslatability and the experience of ‘unhomeness’. The linguistic untranslatability and unhomeness, I argue, result in the colonized’s dislocation in homogeneous time-space relationships, resulting to the incompletion of the modernization project through colonialism. At the same time untranslatability offers a site to explore the transnational space that crosses linguistic boundaries, and to caution against the legacy of colonialism.
Leadership Development Programs for Radiology Residents: A Literature Review
Authors: Ahrari Aida , Abbas Aazad , Bhayana Rajesh , Harris Alison , Probyn Linda 
Published: February 2021

Purpose: Leadership development has become increasingly important in medical education, including postgraduate training in the specialty of radiology. Since leadership skills may be acquired, there is a need to establish leadership education in radiology residency training. However, there is a paucity of literature examining the design, delivery, and evaluation of such programs. The purpose of this study is to collate and characterize leadership training programs across postgraduate radiology residencies found in the literature. Methods: A scoping review was conducted. Relevant articles were identified through a search of Ovid MEDLINE, Ovid EMBASE, Cochrane, PubMed, Scopus, and ERIC databases from inception until June 22, 2020. English-language studies characterizing leadership training programs offered during postgraduate radiology residency were included. A search of the grey literature was completed via a web-based search for target programs within North America. Results: The literature search yielded 1168 citations, with 6 studies meeting inclusion criteria. Four studies were prospective case series and two were retrospective. There was heterogeneity regarding program structure, content, teaching methodology, and evaluation design. All programs were located in the United States. Outcome metrics and success of the programs was variably reported, with a mix of online and in person feedback used. The grey literature search revealed 3 American-based programs specifically catered to radiology residents, and none within Canada. Conclusion: The review highlighted a paucity of published literature describing leadership development efforts within radiology residency programs. The heterogeneity of programs highlighted the need for guidance from regulatory bodies regarding delivery of leadership curricula.
Machine learning algorithms to predict seizure due to acute tramadol poisoning
Authors: Behnoush B , Bazmi E , Nazari SH , Khodakarim S , Looha MA , Soori H 
Published: February 2021

Introduction: This study was designed to develop and evaluate machine learning algorithms for predicting seizure due to acute tramadol poisoning, identifying high-risk patients and facilitating appropriate clinical decision-making. Methods: Several characteristics of acute tramadol poisoning cases were collected in the Emergency Department (ED) (2013–2019). After selecting important variables in random forest method, prediction models were developed using the Support Vector Machine (SVM), Naïve Bayes (NB), Artificial Neural Network (ANN) and K-Nearest Neighbor (K-NN) algorithms. Area Under the Curve (AUC) and other diagnostic criteria were used to assess performance of models. Results: In 909 patients, 544 (59.8%) experienced seizures. The important predictors of seizure were sex, pulse rate, arterial blood oxygen pressure, blood bicarbonate level and pH. SVM (AUC = 0.68), NB (AUC = 0.71) and ANN (AUC = 0.70) models outperformed k-NN model (AUC = 0.58). NB model had a higher sensitivity and negative predictive value and k-NN model had higher specificity and positive predictive values than other models. Conclusion: A perfect prediction model may help improve clinicians’ decision-making and clinical care at EDs in hospitals and medical settings. SVM, ANN and NB models had no significant differences in the performance and accuracy; however, validated logistic regression (LR) was the superior model for predicting seizure due to acute tramadol poisoning.
Basic Newborn Resuscitation: Health Care Providers’ Level of Knowledge and Factors Affecting in the Hospitals of Southern Ethiopia
Authors: Mersha Abera , Shibiru Shitaye , Gultie Teklemariam , Degefa Nega , Bante Agegnehu 
Published: February 2021

Background: The health care provider’s knowledge and clinical experience determine the success of newborn resuscitation. Adequate knowledge of health care providers on newborn resuscitation is vital to avert adverse neonatal outcomes. But, a few studies assessed health care providers’ level of knowledge on basic newborn resuscitation, including Ethiopia. Objective: To assess the health care provider’s level of knowledge on basic newborn resuscitation and factors affecting it. Methods: In this cross-sectional survey, 445 health care providers involved by using a simple random sampling method from the hospitals of southern Ethiopia. The data were collected by self-administered questionnaires and an observational checklist. A binary logistic regression model was used and P-value < .05 was considered to declare a statistically significant association. Results: Health care providers with an adequate level of knowledge on basic newborn resuscitation indicated 76.2% (95% CI [72.2%, 80.3%]). Age, training, recent involvement in basic newborn resuscitation, and the well-equipped facility had shown significant association. Conclusions: This study indicated that adequate knowledge of health care providers on basic newborn resuscitation was optimum. Hence, health care providers train periodically, and the health facilities should equip with materials to provide essential life support for the newborns.
Social Work Paradigms and Their Effect on Decision Making About Out-of-Home Placement
Authors: Przeperski Jarosław 
Published: February 2021

Purpose: This research aimed to understand the views of social workers on factors influencing decision making toward child placement and any possible differences in perception of these factors among social workers with experience in placement decision making and those without it. Methods: The Q sort methodology was used to analyze the opinions of 64 social workers by presenting them 54 statements on single sheets and asked to rank them on a grid. Results: Analysis showed five distinct paradigms: family-centered; veiled shared concept; child-centered; paternalistic; and professional evidence-based, which influence the entire process and outcomes of the decision making process. Both groups (those with experience in decisions towards placement and those without such experience) believed in family centeredness. Workers without prior experience of deciding to place children, regarded highly the role of workers in the decision-making process. They highlighted the need for data to guide decisions and the responsibility of workers to protect the child's welfare. Workers with prior experience focused mostly on generalized concepts and highlighted a detachment of the social worker from the decisions made. They attributed responsibility for decisions to the wider environment. Conclusion: Reflecting on the paradigms within which decisions concerning child welfare are made is essential to improving on the decision-making processes and has implications for both research and practice.
Understanding Quality of Life for Palliative Patients With Dysphagia Using the Swallowing Quality of Life (SWAL-QOL) Questionnaire
Authors: Tan Laurence Lean Chin , Lim Yujun , Ho Peiyan , Lim Lee Yen , Lim Ying Yin , Low James Alvin 
Published: February 2021

Objective: There are few studies concerning the differences in quality-of-life (QOL) between palliative care patients with and without dysphagia to date. We aimed to compare the QOL and symptoms in palliative patients with and without dysphagia using Swallowing Quality of Life (SWAL-QOL). Methods: Eighty-one palliative patients with and without dysphagia underwent the SWAL-QOL questionnaire. A series of Mann Whitney U tests were performed between non-dysphagic and dysphagic groups for the total SWAL-QOL score and the 11 SWAL-QOL domains. Results: Dysphagia significantly impacted patients’ QOL in the dysphagic group (mean, 69.5; SD 21.9) than non-dysphagic group (mean, 83.2; SD 14.8) ( P = 0.006). Significant differences were observed between both groups for the domains of burden, eating desire, eating duration, symptoms, food selection, communication and mental health. The results also showed that the dysphagic group had lower symptom score across all symptoms, suggesting higher symptom burdens. Conclusions: This study is the first to examine QOL and swallow symptoms in palliative care patients with and without dysphagia. Dysphagia causes significantly worse QOL in palliative care patients. Screening for dysphagia and managing its impact on symptoms and QOL domains is important in palliative care.
The Effects of Propofol on Left Ventricular Global Longitudinal Strain
Authors: Coleman Scott R. , Cios Theodore J. , Riela Steven , Roberts S. Michael 
Published: February 2021

Objectives To determine if hemodynamic changes secondary to propofol administration are a result of direct myocardial depression as measured by global longitudinal strain (GLS). The authors hypothesized that propofol would cause a significant worsening in GLS, indicating direct myocardial depression. Design Prospective, observational. Setting Endoscopy suite at a single academic medical center. Participants Patients undergoing outpatient, elective endoscopic procedures at an outpatient clinic of a single tertiary care academic medical center. Interventions None. Measurements and Main Results Limited transthoracic echocardiograms were performed before and after patients received propofol for endoscopic procedures. Post-processing measurements included GLS, 2D (dimensional) ejection fraction (2D EF), and 3D EF. Using paired sample Student’s t test, no statistically significant change in GLS, 2D EF, or 3D EF was found despite statistically significant hypotension. In fact, there was a trend toward more negative GLS (improved myocardial function) in patients after receiving propofol. Conclusion We found propofol did not cause a reduction in systolic function as measured by GLS, a sensitive measure of myocardial contractility. Therefore, decreases in blood pressure after a propofol bolus in spontaneously breathing patients are likely due to decreased vascular tone and not impaired left ventricular systolic function. These results should be considered in the management of propofol-induced hypotension for spontaneously breathing patients.
The Relationship Between Thyroid Function and Body Composition, Leptin, Adiponectin, and Insulin Sensitivity in Morbidly Obese Euthyroid Subjects Compared to Non-obese Subjects
Authors: Al Mohareb Ohoud , Al Saqaaby Moath , Ekhzaimy Aishah , Hamza Muaawia , AlMalki Mussa H. , Bamehriz Fahad , Abukhater Muhammad , Brema Imad 
Published: February 2021

Background/Objectives: Thyroid function tests (TFTs) changes in obese people have been studied with increasing interest, however, studies have been inconsistent hence it remains poorly understood. We compared the TFTs of morbidly obese euthyroid Saudi subjects with non-obese controls and then we examined the influence of leptin, adiponectin, and insulin resistance on TFTs. Subjects/Methods: Fifty-five euthyroid obese subjects attending bariatric surgery clinic and 52 non-obese age-and gender-matched controls were recruited. We measured body weight, BMI, body composition, thyroid-stimulating hormone (TSH), Free T4 (FT4), Free T3(FT3), thyroid antibodies, fasting leptin, adiponectin, and lipid profile. Insulin resistance was quantified by HOMA-IR. Data are presented as mean ± SEM. Results: Mean BMI was 45.6 ± 1.5 and 23.2 ± 0.5 kg/m2, for the obese and non-obese controls, respectively, P value < 0.001. Mean TSH was 2.7 ± 0.18 mIU/L in obese subjects and 1.7 ± 0.13 mIU/L (0.27-4.2) in the non-obese controls, respectively, P value .014. Mean FT3 was 3.9 ± 0.1 pmol/L (3.1-6.8) in obese subjects compared to 5.0 ± 0.1 pmol/L in non-obese controls, respectively, P value 0.001, however, FT4 was similar in the 2 groups. In the whole group ( N = 107), BMI correlated positively with TSH and negatively with FT3. Leptin correlated negatively with both FT4 and FT3 in the non-obese group only while none of the TFTs correlated with HOMA-IR or adiponectin in either group. Binary logistic regression showed that each 1 unit increase in TSH increased the odds of becoming obese by 12.7, P value 0.009, 95 C.I. (1.9-85.0). Conversely, each - unit increase in FT3 decreased the odds of becoming obese by 0.2, P value 0.023, 95% C.I. (0.05-0.80). Conclusions: We report a small increase in TSH and a small decrease in FT3 within the normal range in obese subjects compared to non-obese controls. We also report a positive correlation between TSH and BMI with increased odds ratio of becoming obese with the increase in TSH and decrease in FT3. These changes may be either causally related or adaptive to the obesity state. FT4 and FT3 seem to correlate with leptin (but not with adiponectin or HOMA-IR) in the non-obese controls only. Larger mechanistic studies are needed to further elucidate the interesting association between obesity and TFTs.