bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pretend play ability in preschool‐aged children with an acquired brain injury
Authors: Thorne Adrienne , Stagnitti Karen , Parson Judi 
Published: July 2021

IntroductionThis study compares the self‐initiated pretend play abilities of preschool‐aged children with an acquired brain injury, with the self‐initiated pretend play ability of their neurotypical peers.MethodA non‐experimental group comparison was conducted between 22 preschool‐aged neurotypical children (M = 52.8 months, SD = 7.1 months) and 21 children with an acquired brain injury (ABI, M = 50.5 months, SD = 11.9 months), who had been discharged from inpatient rehabilitation and who were able to engage in a play session. The children were assessed individually using the Child‐Initiated Pretend Play Assessment (ChIPPA).ResultsThe children with an ABI had significantly lower scores in pretend play ability than their neurotypical peers as measured by the percentage of elaborate play actions in both the conventional (P < .000) and symbolic (P < .000) sections of the ChIPPA, as well as the number of object substitutions (P < .000). The children with an ABI completed significantly less of the play time required compared with their neurotypical peers (P = .001); 66% could not play for the required time. There was no significant difference in the ChIPPA scores of the children with an ABI injured before and after the age of 18 months, nor between children with a severe or moderate injury.ConclusionThe quality and the quantity of pretend play of preschool‐aged children with an ABI are significantly below that of their neurotypical peers. Assessment of pretend play ability and direct intervention in ABI rehabilitation by occupational therapists is essential to enable children with an ABI to participate in pretend play and garner the developmental benefit this affords.
The absorption and multiplication of uncertainty in machine‐learning‐driven finance
Authors: Hansen Kristian Bondo , Borch Christian 
Published: July 2021

AbstractUncertainty about market developments and their implications characterize financial markets. Increasingly, machine learning is deployed as a tool to absorb this uncertainty and transform it into manageable risk. This article analyses machine‐learning‐based uncertainty absorption in financial markets by drawing on 182 interviews in the finance industry, including 45 interviews with informants who were actively applying machine‐learning techniques to investment management, trading, or risk management problems. We argue that while machine‐learning models are deployed to absorb financial uncertainty, they also introduce a new and more profound type of uncertainty, which we call critical model uncertainty. Critical model uncertainty refers to the inability to explain how and why the machine‐learning models (particularly neural networks) arrive at their predictions and decisions—their uncertainty‐absorbing accomplishments. We suggest that the dialectical relation between machine‐learning models’ uncertainty absorption and multiplication calls for further research in the field of finance and beyond.
The psychological impact of gestational trophoblastic disease: a prospective observational multicentre cohort study
Authors: Blok LJ , Frijstein MM , Eysbouts YK , Custers JAE , Sweep FCGJ , Lok CAR , Ottevanger PB 
Published: July 2021

ObjectiveTo evaluate the short‐term psychological consequences of gestational trophoblastic disease (GTD).DesignA prospective observational multicentre cohort study.SettingNationwide in the Netherlands.PopulationGTD patients.MethodsOnline questionnaires directly after diagnosis.Main outcome measuresHospital Anxiety and Depression Scale (HADS), Distress Thermometer (DT), Impact of Event Scale (IES) and Reproductive Concerns Scale (RCS).ResultsSixty GTD patients were included between 2017 and 2020. Anxious feelings (47%) were more commonly expressed than depressive feelings (27%). Patients experienced moderate to severe adaptation problems in 88%. Patients who already had children were less concerned about their reproductivity than were patients without children (mean score 10.4 versus 15.0, P = 0.031), and patients with children experienced lower distress levels (IES mean score 25.7 versus 34.7, P = 0.020). In addition, patients with previous pregnancy loss scored lower for distress compared with patients without pregnancy loss (IES mean score 21.1 versus 34.2, P = 0.002).DiscussionWe recommend that physicians monitor physical complaints and the course of psychological wellbeing over time in order to provide personalised supportive care in time for patients who have high levels of distress at baseline.ConclusionsGTD patients experience increased levels of distress, anxiety and depression, suggesting the diagnosis has a substantial effect on the psychological wellbeing of patients. The impact of GTD diagnosis on intrusion and avoidance seems to be ameliorated in patients who have children or who have experienced previous pregnancy loss.Tweetable abstractPatients with gestational trophoblastic disease (GTD) experience short‐term psychological consequences such as distress, anxiety and depression, suggesting that the diagnosis GTD has a substantial effect on the psychological wellbeing of patients. Various patient characteristics affect the impact of GTD diagnosis.
Outcomes for emergency department patients with suspected and confirmed COVID‐19: An analysis of the Australian experience in 2020 (COVED‐5)
Authors: O'Reilly Gerard M , Mitchell Rob D , Mitra Biswadev , Akhlaghi Hamed , Tran Viet , Furyk Jeremy S , Buntine Paul , Wong Anselm , Gangathimmaiah Vinay , Knott Jonathan , Moore Allison , Ahn Jung Ro , Chan Quillan , Wang Andrew , Goh Han , Loughman Ashley , Lowry Nicole , Hackett Liam , Sri‐Ganeshan Muhuntha , Chapman Nicole , Raos Maximilian , Noonan Michael P , Smit De Villiers , Cameron Peter A ,   the COVED Project Team
Published: July 2021

AbstractObjectiveThe aim of the present study was to describe the characteristics and outcomes of patients presenting to Australian EDs with suspected and confirmed COVID‐19 during 2020, and to determine the predictors of in‐hospital death for SARS‐CoV‐2 positive patients.MethodsThis analysis from the COVED Project presents data from 12 sites across four Australian states for the period from 1 April to 30 November 2020. All adult patients who met local criteria for suspected COVID‐19 and underwent testing for SARS‐CoV‐2 in the ED were eligible for inclusion. Study outcomes were mechanical ventilation and in‐hospital mortality.ResultsAmong 24 405 eligible ED presentations over the whole study period, 423 tested positive for SARS‐CoV‐2. During the ‘second wave’ from 1 July to 30 September 2020, 26 (6%) of 406 SARS‐CoV‐2 patients received invasive mechanical ventilation, compared to 175 (2%) of the 9024 SARS‐CoV‐2 negative patients (odds ratio [OR] 3.5; 95% confidence interval [CI] 2.3–5.2, P < 0.001), and 41 (10%) SARS‐CoV‐2 positive patients died in hospital compared to 312 (3%) SARS‐CoV‐2 negative patients (OR 3.2; 95% CI 2.2–4.4, P = 0.001). For SARS‐CoV‐2 positive patients, the strongest independent predictors of hospital death were age (OR 1.1; 95% CI 1.1–1.1, P < 0.001), higher triage category (OR 3.5; 95% CI 1.3–9.4, P = 0.012), obesity (OR 4.2; 95% CI 1.2–14.3, P = 0.024) and receiving immunosuppressive treatment (OR 8.2; 95% CI 1.8–36.7, P = 0.006).ConclusionsED patients who tested positive for SARS‐CoV‐2 had higher odds of mechanical ventilation and death in hospital. The strongest predictors of death were age, a higher triage category, obesity and receiving immunosuppressive treatment.
Decision Behavior of Different Participants in Industrial Water Recycling and the Sharing of Water Recycling Value
Authors: Liu Zhihua , Jia Shaofeng 
Published: July 2021

AbstractWater reclamation and reuse are an important means to alleviate the shortage of water resources. This paper proposes several different decision‐making models to investigate what different participants in industrial water recycling, including users, suppliers, and local governments, should do in different situations. In the models, different decision logics of the participants about water reclamation are presented. Finally, the models are used in a case study and some meaningful results are obtained. The study explains the gap between the relatively low utilization and the strong demand for water recycling.
Risk Assessment of Water Resources Carrying Capacity in China
Authors: Lv Aifeng , Han Yan , Zhu Wenbin , Zhang Shifeng , Zhao Weihua 
Published: July 2021

AbstractAs a fundamental natural resource and a strategic economic resource, water resources play a key supporting role in the process of social and economic development. In this paper, risk factors influencing the water resources carrying capacity (WRCC) were investigated based on risk theory and resources carrying capacity theory, and a method for the risk assessment of the WRCC was proposed. The vulnerability of WRCC system was evaluated by using the Fuzzy Comprehensive Evaluation method, the hazard of WRCC system was calculated by using the comprehensive hazard index, and then the risk of WRCC was obtained by combining the vulnerability with the hazard. The risk of WRCC in China due to climate change, urbanization, and industrialization was thoroughly investigated. The results demonstrated that the risk of WRCC was higher in Northern China than in Southern China and was higher in developed areas than in developing areas. The risk was observed to be highest in the Beijing–Tianjin–Hebei region. Meanwhile, the results also suggested that the risk of WRCC can be reduced in two ways: (1) Reducing the pressure on the water resources carrying system caused by economic and social activities; and (2) increasing the water resources supply in certain areas. The risk assessment of the WRCC presented here provides a valuable reference for the management and sustainable utilization of water resources in China.
Self‐concept and body image of people living with lupus: A systematic review
Authors: Rodrigues Larissa , Sim‐Sim Maria M. F. , Sousa Luis , Faria‐Schützer Débora B. , Surita Fernanda G. 
Published: July 2021

AbstractAimTo summarize existing evidence regarding body image in patients with systemic lupus erythematosus, with the following considerations: (a) the perceptions patients have of their body changes; (b) how patients cope with changes in their body; (c) and what their perceptions are of body changes.MethodA systematic review of literature integrating quantitative and qualitative studies. We searched databases (PubMed, CINAHL, Embase, SCOPUS, the Web of Science, Medline, Medline Complete, and Academic Search Premier) and publications from 2010 to 2020 with “Systemic Lupus Erythematosus” AND “Self‐Concept” OR “Body Image” AND “Woman” as medical subheading terms. The studies included were subjected to a thematic content analysis, which allowed subjective interpretation of data through a systematic classification process for coding themes or patterns.ResultsWe identified 647 studies, of which 22 were analyzed in this study. Our results indicate that changes in the body image of people with lupus and their perception are issues that must be treated as characteristics of the disease; therefore, they need to receive the same attention as is given to physical disabilities and pain. The analysis identified 3 thematic categories: (a) depression and anxiety associated with body changes (hair loss, weight gain); (b) body image reflecting the disease; and (c) confrontations and interventions to promote acceptance and adaptation to the new image.ConclusionsThe dimensions of self‐concept and body image are essential for assessing the quality of life of individuals with lupus. The formation of a adjusted self‐concept can be managed by health professionals supporting these people.
Successful treatment of idiopathic Harlequin Syndrome with oxybutynin and propranolol
Authors: Naharro‐Fernández Cristina , de Quintana‐Sancho Adrián , López‐Sundh Ana Elizabet , Reguero‐del Cura Leandra , Gónzalez‐López Marcos A. 
Published: July 2021

AbstractHarlequin syndrome (HS) is a rare entity derived from the dysfunction of the sympathetic nervous system. It is characterised by unilateral facial flushing and sweating induced by exercise, heat and emotion. Most cases are primary with an unknown pathogenic mechanism. In these cases, the prognosis is favourable. Medical or surgical treatments are not usually required for idiopathic HS. However, symptomatic treatment may be indicated when symptoms affect the quality of life of patients. We present the case of a patient with idiopathic HS successfully treated with oxybutynin and propranolol. In this patient, a marked improvement in both hyperhidrosis and facial erythema was noted with this combined therapy. We consider it of interest to highlight the response of our patient to the treatment employed, which may be advantageous in future cases of this rare disorder.
One hundred and ten years of Allergen Immunotherapy: A journey from empiric observation to evidence
Authors: Pfaar Oliver , Bousquet Jean , Durham Stephen R. , Kleine‐Tebbe Jörg , Larché Mark , Roberts Graham , Shamji Mohamed H. , Gerth van Wijk Roy 
Published: July 2021

AbstractOne hundred and ten years after Noon's first clinical report of the subcutaneous application of allergen extracts, allergen immunotherapy (AIT) has evolved as the most important pillar of the treatment of allergic patients. It is the only disease‐modifying treatment option available and the evidence for its clinical efficacy and safety is broad and undisputed. Throughout recent decades, more insights into the underlying mechanisms, in particular the modulation of innate and adaptive immune responses, have been described. AIT is acknowledged by worldwide regulatory authorities, and following the regulatory guidelines for product development, AIT products are subject to a rigorous evaluation before obtaining market authorization. Knowledge and practice are anchored in international guidelines, such as the recently published series of the European Academy of Allergy and Clinical Immunology (EAACI). Innovative approaches continue to be further developed with the focus on clinical improvement by, for example, the usage of adjuvants, peptides, recombinants, modification of allergens, new routes of administration, and the concomitant use of biologicals. In addition, real‐life data provide complementary and valuable information on the effectiveness and tolerability of this treatment option in the clinical routine. New mobile health technologies and big‐data approaches will improve daily treatment convenience, adherence, and efficacy of AIT. However, the current coronavirus disease 2019 (COVID‐19) pandemic has also had some implications for the feasibility and practicability of AIT. Taken together, AIT as the only disease‐modifying therapy in allergic diseases has been broadly investigated over the past 110 years laying the path for innovations and further improvement.
Adverse COVID‐19 outcomes in immune deficiencies: Inequality exists between subclasses
Authors: Karakoc Aydiner Elif , Bilgic Eltan Sevgi , Babayeva Royale , Aydiner Omer , Kepenekli Eda , Kolukisa Burcu , Sefer Asena Pinar , Yalcin Gungoren Ezgi , Karabiber Esra , Yucel Esra Ozek , Ozdemir Oner , Kiykim Ayca , Artac Hasibe , Yakici Nalan , Yalcin Koray , Cokugras Haluk , Celkan Tulin Tiraje , Orhan Fazil , Yesilipek Mehmet Akif , Baris Safa , Ozen Ahmet 
Published: July 2021

AbstractBackgroundGenetic deficiencies of immune system, referred to as inborn errors of immunity (IEI), serve as a valuable model to study human immune responses. In a multicenter prospective cohort, we evaluated the outcome of SARS‐CoV‐2 infection among IEI subjects and analyzed genetic and immune characteristics that determine adverse COVID‐19 outcomes.MethodsWe studied 34 IEI patients (19M/15F, 12 [min: 0.6‐max: 43] years) from six centers. We diagnosed COVID‐19 infection by finding a positive SARS‐CoV‐2 PCR test (n = 25) and/or a lung tomography scoring (CORADS) ≥4 (n = 9). We recorded clinical and laboratory findings prospectively, fitted survival curves, and calculated fatality rates for the entire group and each IEI subclass.ResultsNineteen patients had combined immune deficiency (CID), six with predominantly antibody deficiency (PAD), six immune dysregulation (ID), two innate immune defects, and one in the autoinflammatory class. Overall, 23.5% of cases died, with disproportionate fatality rates among different IEI categories. PAD group had a relatively favorable outcome at any age, but CIDs and IDs were particularly vulnerable. At admission, presence of dyspnea was an independent risk for COVID‐related death (OR: 2.630, 95% CI; 1.198–5.776, p < .001). Concerning predictive roles of laboratory markers at admission, deceased subjects compared to survived had significantly higher CRP, procalcitonin, Troponin‐T, ferritin, and total‐lung‐score (p = .020, p = .003, p = .014, p = .013, p = .020; respectively), and lower absolute lymphocyte count, albumin, and trough IgG (p = .012, p = .022, p = .011; respectively).ConclusionOur data disclose a highly vulnerable IEI subgroup particularly disadvantaged for COVID‐19 despite their youth. Future studies should address this vulnerability and consider giving priority to these subjects in SARS‐Cov‐2 therapy trials.
Disability, straight time, and the American Dream
Authors: WOOL ZOË H. 
Published: July 2021

ABSTRACTIn the lives of injured US veterans of the post‐9/11 wars, rehabilitation and heteronormativity are intertwined.Straight timenames the ways these imperatives come together in fantasies of the heteronormative life course. This life course is central to the middle‐class, white‐coded American Dream, in which disability appears only at life's end. Chasing this dream brings many into the US military, but military service often imperils, rather than secures, that dream. Attention to efforts to straighten out life's temporality in the long aftermath of injury reveals a tension between a desire for a heteronormative life course and the experience of living otherwise. As these tensions surface, the cruelty of normative aspirations and their temporal frames become clear. The framework of straight time thus highlights how normative desires are complicated by sometimes‐unexpected attachments to queerness and disability, even in the intensely normative cultural space of the US military. [disability,veterans,heteronormativity,temporality,United States]
Ultrasound vs routine care before instrumental vaginal delivery: A systematic review and meta‐analysis
Authors: Mappa Ilenia , Tartaglia Silvio , Maqina Pavjola , Makatsariya Alexander , Ghi Tullio , Rizzo Giuseppe , D’Antonio Francesco 
Published: July 2021

AbstractIntroductionThe objective was to report the role of intrapartum ultrasound examination in affecting maternal and perinatal outcome in women undergoing instrumental vaginal delivery.Material and methodsMEDLINE, Embase, CINAHL, Google Scholar and ClinicalTrial.gov databases were searched. Inclusion criteria were randomized controlled trials comparing ultrasound assessment of fetal head position vs routine standard care (digital examination) before instrumental vaginal delivery (either vacuum or forceps). The primary outcome was failed instrumental delivery extraction followed by cesarean section. Secondary outcomes were postpartum hemorrhage, 3rd or 4th degree perineal lacerations, episiotomy, prolonged hospital stay, Apgar score<7 at 5 min, umbilical artery pH <7.0 and base excess greater than −12 mEq, admission to neonatal intensive care unit (NICU), shoulder dystocia, birth trauma, a composite score of adverse maternal and neonatal outcome and incorrect diagnosis of fetal head position. Risk of bias was assessed using the Revised Cochrane risk‐of‐bias tool for randomized trials (RoB‐2). The quality of evidence and strength of recommendations were assessed using the Grading of Recommendations Assessment Development and Evaluation (GRADE) methodology. Head‐to‐head meta‐analyses using a random‐effect model were used to analyze the data and results are reported as relative risk with their 95% confidence intervals.ResultsFive studies were included (1463 women). There was no difference in the maternal, pregnancy or labor characteristics between the two groups. An ultrasound assessment prior to instrumental vaginal delivery did not affect the cesarean section rate compared with standard care (p = 0.805). Likewise, the risk of composite adverse maternal outcome (p = 0.428), perineal lacerations (p = 0.800), postpartum hemorrhage (p = 0.303), shoulder dystocia (p = 0.862) and prolonged stay in hospital (p = 0.059) were not different between the two groups. Composite adverse neonatal outcome was not different between the women undergoing and those not undergoing ultrasound assessment prior to instrumental delivery (p = 0.400). Likewise, there was no increased risk with abnormal Apgar score (p = 0.882), umbilical artery pH < 7.2 (p = 0.713), base excess greater than −12 (p = 0.742), admission to NICU (p = 0.879) or birth trauma (p = 0.968). The risk of having an incorrect diagnosis of fetal head position was lower when ultrasound was performed before instrumental delivery, with a relative risk of 0.16 (95% confidence interval 0.1–0.3; I2:77%, p < 0.001).ConclusionsAlthough ultrasound examination was associated with a lower rate of incorrect diagnoses of fetal head position and station, this did not translate to any improvement of maternal or neonatal outcomes.
Systematic review: duodenogastroesophageal (biliary) reflux prevalence, symptoms, oesophageal lesions and treatment
Authors: Basnayake Chamara , Geeraerts Annelies , Pauwels Ans , Koek Ger , Vaezi Michael , Vanuytsel Tim , Tack Jan 
Published: July 2021

SummaryBackgroundThe prevalence of duodenogastroesophageal reflux (DGER) and its effect on symptoms and oesophageal lesions in gastroesophageal reflux disease (GERD) is unclear.AimsTo conduct a systematic review to determine the prevalence of DGER among patients with GERD, the effect of DGER on symptoms and oesophageal lesions, and the treatment of DGER.MethodsWe searched Pubmed and MEDLINE for full text, English language articles until October 2020 that evaluated DGER prevalence among patients with GERD, the effect of DGER on symptoms and oesophageal lesions, and the treatment of DGER.ResultsWe identified 3891 reports and included 35 which analysed DGER prevalence in GERD, 15 which evaluated its effect in non‐erosive reflux disease (NERD), 17 on erosive oesophagitis, 23 in Barrett's, and 13 which evaluated the treatment of DGER. The prevalence of DGER, when evaluated by Bilitec, among all GERD patients ranged from 10% to 97%, in NERD 10%‐63%, in erosive oesophagitis 22%‐80% and in Barrett's 50%‐100%. There were no differences in the presence or degree of DGER among patients who were asymptomatic or symptomatic on proton pump inhibitors (PPI). The most commonly evaluated treatments for DGER were PPIs and DGER reduced post‐PPI therapy in all studies.ConclusionsThe prevalence of DGER increased with more advanced oesophageal lesions and did not explain persisting symptoms among patients taking PPI therapy. PPIs appear to be effective in the treatment of DGER. DGER remains an important consideration in patients with GERD and future therapies deserve more study.