bluuebunny/crossref_metadata_2025_split huggingface dataset:
Subacute combined degeneration of the cord secondary to nitrous oxide misuse: No laughing matter
Authors: Charters Pia F P , Morrison Hamish Duncan , Witherick Jonathan , King Susan 
Published: February 2021

Nitrous oxide (N2O) has several traditional uses as a surgical and dental anaesthetic, as well as in aerosol spray propellants. It is the combination of analgesic and euphoric qualities coupled with accessibility as an over-the-counter household item that lends N2O to recreational use. Despite increasing evidence that prolonged use of N2O both medically and as a drug of abuse can cause disabling neurological side-effects, it remains widely used. We present the case of an 18-year-old male who was diagnosed with subacute combined degeneration of the cord (SCDC) secondary to acute, heavy recreational use of N2O. The patient presented with progressive paraesthesia affecting his hands and feet associated with distal weakness. MRI of the cervical spine revealed symmetric bilateral high T2 signal within the dorsal columns extending from the level of C2 to T2 with the inverted ‘V’ sign on axial T2-weighted slices indicative of SCDC. Although vitamin B12 levels were within normal range, marked elevation of methylmalonic acid and homocysteine support the diagnosis of B12 inactivation and functional B12 deficiency, which fully resolved with treatment.
Occupational therapy productions in times of pandemic: a systematic review of occupational therapeutic actions against the new coronavirus (COVID-19) epidemic
Authors: Ramos Ataide Carlos Eduardo , Gonçalves Matos Junior Alberto , Araújo Dias Lorena Henriete , Ferreira Farias Luciane , Monteiro de Vasconcelos Filho Carlos Roberto , Zanona Aristela de Freitas 
Published: February 2021

Background: In March 2020, the World Health Organization classified infection and contagion of coronavirus disease 2019 (COVID-19) as a worldwide pandemic. Since then, health professionals have been tirelessly researching the symptoms and consequences of this disease in people's daily lives. Occupational therapists have also been mobilized to implement effective actions in order to guarantee the functionality and quality of life of individuals and groups. The aim of this article was to investigate what available resources there are regarding occupational therapy during the pandemic, and thus support and enrich professional practice during this time. Methods: A search for was carried out for materials such as technical notes, guidelines for working with COVID-19 patients, clinical trials, and reflections and debates on occupational therapeutic practice during the COVID-19 pandemic. Articles in English, Portuguese and Spanish were included. The search was carried out in the Virtual Health Library (VHL), Google Scholar, Latin American & Caribbean Health Sciences Literature (LILACS), Scientific Electronic Library Online (SCIELO) databases, Medical Literature Analysis and Retrieval System Online (MEDLINE), Pubmed, and the websites of occupational therapy entities and organizations. Results: A total of 44 materials were found and categorised into performance guides, technical notes and scientific articles. The materials dealt with different themes, with a predominance of guidelines for hospital practices. However, there was also a significant amount of notes on the positioning of representative bodies in the preparation of intervention guides in wards, intensive care units, and outpatient and patient homes to support these professionals. Conclusions: The results demonstrate the quick response of authors in the field of occupational therapy, to combat the challenges and barriers of the COVID-19 pandemic. The texts promote scientifically-based strategies to provide the best assistance to patients during the pandemic period.
Analysis of rs1048943 in the CYP1A1 gene in laryngeal cancer - a case control study
Authors: Abdalwahab Marwa , Ellaithi Mona 
Published: February 2021

Background: The CYP1A1 gene is essential in the metabolism of carcinogenic polycyclic aromatic hydrocarbons (PAHs). Numerous studies have investigated the links between the polymorphism Ile462Val rs1048943 A>G and its association with different cancers but the results have been variable. In this study, we studied rs1048943 in Sudanese patients diagnosed with laryngeal cancer. Methods: This is a case-control study of 49 laryngeal cancer cases and 50 healthy controls. Restriction fragment length polymorphisms (RFLP) were used to analyse the fragment region of the CYP1A1 gene that contains rs1048943. Results: The average age of the patients was 51.2 years old and the male to female ratio was 1:1. Well differentiated squamous cell carcinoma constituted most of the histopathological diagnoses. Ile462Val rs1048943 A>G was not found in any of the cases but was found in heterozygous form in four controls (p = 0.1331, OR 0.1044, 95% CI, 0.0054-1.9924). Conclusions: Our study did not show a significant association of CYP1A1 Ile462Val rs1048943 A>G with laryngeal cancer. Future studies may need to test additional single nucleotide polymorphisms (SNPs) in laryngeal cancer tissue samples to identify the effect of those SNPs on laryngeal cancer.
Effect of dietary protein level on growth, food utilization, food conversion and survival rate of giant trevally (Caranx ignobilis)
Authors: Muhammadar Abdullah A. , Firdus Firdus , Muchlisin Zainal A. , Samadi Samadi , Sarong Muhammad A. , Boihaqi Boihaqi , Sartira Satria , Sahidir Ibnu , Batubara Agung Setia 
Published: February 2021

Background: Proper feed formulation is required for successful fish farming activities. Therefore, it is necessary for fish feed to provide optimal growth so that the cultivation business generates profits. Currently, there is very limited information about the appropriate feed for Caranx ignobilis, causing problems with its development. This study aims to provide feed with different protein levels to C. ignobilis. Methods: We will examine the protein levels’ effects on the daily growth rate (DGR), specific growth rate (SGR), absolute growth rate (AGR), feed conversion ratio (FCR), feed efficiency (FE), and survival rate (SR). This research was conducted for 35 days, from June to October 2017, at the Center Brackiswater Aquaculture Development (BPBAP) Ujung Batee, Ministry of Marine Affairs and Fisheries, Aceh Besar, Indonesia. This study used a completely randomized design method, with five treatment levels (30%, 40%, 50%, 60%, and 70% protein feed) and four replications. Results: The results showed that feeding with different proteins on C. ignobilis had a significant effect on the mean values ​​of DGR, SGR, AGR, FCR, FE, and SR. The 50% protein feed gave the best results for C. ignobilis, with a mean DGR value of 0.267 ± 0.005 g / day, a mean SGR of 1.722 ± 0.030% / day, a mean AGR of 0.081 ± 0.003 cm/day, a mean FCR of 1.290, a mean FE 77.755% and a mean SR was 86.667%. Conclusions: Furthermore, feed treatment with increased protein content between 30%–50% has a positive correlation with the growth of C. ignobilis. However, the ability to grow fish will decrease if the feed protein content is >50%.
Development of a Simple Index to Measure Overuse of Diagnostic Testing at the Hospital Level Using Administrative Data
Authors: Ellenbogen Michael I , Prichett Laura , Johnson Pamela T , Brotman Daniel J 
Published: February 2021

OBJECTIVEWe developed a diagnostic overuse index that identifies hospitals with high levels of diagnostic intensity by comparing negative diagnostic testing rates for common diagnoses.METHODSWe prospectively identified candidate overuse metrics, each defined by the percentage of patients with a particular diagnosis who underwent a potentially unnecessary diagnostic test. We used data from seven states participating in the State Inpatient Databases. Candidate metrics were tested for temporal stability and internal consistency. Using mixed‐effects ordinal regression and adjusting for regional and hospital characteristics, we compared results of our index with three Dartmouth health service area‐level utilization metrics and three Medicare county‐level cost metrics.RESULTSThe index was comprised of five metrics with good temporal stability and internal consistency. It correlated with five of the six prespecified overuse measures. Among the Dartmouth metrics, our index correlated most closely with physician reimbursement, with an odds ratio of 2.02 (95% CI, 1.11‐3.66) of being in a higher tertile of the overuse index when comparing tertiles 3 and 1 of this Dartmouth metric. Among the Medicare county‐level metrics, our index correlated most closely with standardized costs of procedures per capita, with an odds ratio of 2.03 (95% CI, 1.21‐3.39) of being in a higher overuse index tertile when comparing tertiles 3 and 1 of this metric.CONCLUSIONSWe developed a novel overuse index that is preliminary in nature. This index is derived from readily available administrative data and shows some promise for measuring overuse of diagnostic testing at the hospital level.
Supercontinuum generation from zinc borate glasses: bandgap versus rare-earth doping
Authors: Neethish M. M. , Kumar V. V. Ravi Kanth , Nalam Samuel Anurag , Harsha S. Sree , Kiran P. Prem 
Published: February 2021

We report an enhanced supercontinuum generation (SCG) from a rare-earth (

P
r

3
+

) doped low bandgap zinc borate glass when excited with 60 fs pulses from a Ti-sapphire laser. The emission associated with the absorption bands due to

P
r

3
+

doping (around 420–500 and 580–600 nm) is observed to assist the enhanced SCG.
Thermo-optically tunable spectral broadening in a nonlinear ultra-silicon-rich nitride Bragg grating
Authors: Cao Yanmei , Sahin Ezgi , Choi Ju Won , Xing Peng , Chen George F. R. , Ng D. K. T. , Eggleton Benjamin J. , Tan Dawn T. H. 
Published: February 2021

Spectral tunability methods used in optical communications and signal processing leveraging optical, electrical, and acousto-optic effects typically involve spectral truncation that results in energy loss. Here we demonstrate temperature tunable spectral broadening using a nonlinear ultra-silicon-rich nitride device consisting of a 3-mm-long cladding-modulated Bragg grating and a 7-mm-long nonlinear channel waveguide. By operating at frequencies close to the grating band edge, in an apodized Bragg grating, we access strong grating-induced dispersion while maintaining low losses and high transmissivity. We further exploit the redshift in the Bragg grating stopband due to the thermo-optic effect to achieve tunable dispersion, leading to varying degrees of soliton-effect compression and self-phase-modulation-induced spectral broadening. We observe an increase in the bandwidth of the output pulse spectrum from 69 to 106 nm as temperature decreases from 70°C to 25°C, in good agreement with simulated results using the generalized nonlinear Schrödinger equation. The demonstrated approach provides a new avenue to achieve on-chip laser spectral tuning without loss in pulse energy.
High efficiency all-dielectric pixelated metasurface for near-infrared full-Stokes polarization detection
Authors: Zhang Chong , Hu Jingpei , Dong Yangeng , Zeng Aijun , Huang Huijie , Wang Chinhua 
Published: February 2021

Pixelated metasurfaces integrating both the functions of linear polarization and circular polarization filters on a single platform can achieve full-Stokes polarization detection. At present, the pixelated full-Stokes metasurfaces mainly face the following problems: low transmission, low circular dichroism (CD) of circular polarization filters, and high requirements in fabrication and integration. Herein, we propose high performance ultracompact all-dielectric pixelated full-Stokes metasurfaces in the near-infrared band based on silicon-on-insulator, which is compatible with the available semiconductor industry technologies. Circular polarization filters with high CD are achieved by using simple two-dimensional chiral structures, which can be easily integrated with the linear polarization filters on a single chip. In addition, the dielectric materials have higher transmission than metal materials with intrinsic absorption. We experimentally demonstrated the circular polarization filter with maximum CD up to 70% at a wavelength of 1.6 μm and average transmission efficiency above 80% from 1.48 μm to 1.6 μm. Therefore, our design is highly desirable for many applications, such as target detection, clinical diagnosis, and polarimetric imaging and sensing.
On the upper limit of laser intensity attainable in nonideal vacuum
Authors: Wu Yitong , Ji Liangliang , Li Ruxin 
Published: February 2021

The upper limit of the laser field strength in a perfect vacuum is usually considered as the Schwinger field, corresponding to

∼

10

29

W
/

cm

2

. We investigate such limitations under realistic nonideal vacuum conditions and find that intensity suppression appears starting from

10

25

W
/

cm

2

, showing an upper threshold at

10

26

W
/

cm

2

level if the residual electron density in chamber surpasses

10

9

cm

−
3

. This is because the presence of residual electrons triggers the avalanche of quantum electrodynamics cascade that creates copious electron and positron pairs. The leptons are further trapped within the driving laser field due to radiation reaction, which significantly depletes the laser energy. The relationship between the attainable intensity and the vacuity is given according to particle-in-cell simulations and theoretical analysis. These results answer a critical problem on the achievable light intensity based on present vacuum conditions and provide a guideline for future hundreds of petawatt class laser development.
Pathways to service access for pre-eclampsia and eclampsia in rural Bangladesh: Exploring women’s care-seeking
Authors: Dempsey Amy , Sripad Pooja , Sultana Kanij , Kirk Karen , Hossain Sharif Mohammed Ismail , Warren Charlotte 
Published: February 2021

Background
While women in low- and middle-income countries face a range of barriers to accessing care for hypertensive disorders of pregnancy, there is little understanding of the pathways taken to overcome these constraints and reach the services they need. This study explores the perspectives of women and communities on the influences that impact care-seeking decisions and pathways to health services.

Methods
To understand individual perspectives, we conducted 22 in-depth interviews (IDIs) with pre-eclampsia and eclampsia survivors (PE/E) in a tertiary hospital, where they received care after initiating PE/E services in different parts of the country. In four districts, we conducted one male and one female focus group discussion (FGD) to unearth care-seeking pathways and explore normative perspectives and the range of internal and external influences. Careful thematic analysis using Atlas-ti was applied.

Results
Prevailing views of women and communities across settings in Bangladesh indicate varied pathways to care throughout their pregnancy, during childbirth, and in the postnatal period influenced by internal and external factors at the individual, familial, social, and health systems levels. Internal influences draw on women’s own awareness of hypertension complications and options, and their ability to decide to seek care. External factors include social influences like family and community norms, culturally-accepted alternatives, and community perceptions of the health system’s capacity to provide quality care. The interaction of these factors often delay care seeking and can lead to complex pathways to care.

Conclusion
Women’s individual pathways to care were diverse, despite the homogenous community perceptions of the influences on women’s care-seeking behaviors. This finding supports the need for improving quality of care in primary healthcare facilities and strengthening gender equity and community-based promotion activities through targeted policy and programming.
Diphtheria outbreak in Jakarta and Tangerang, Indonesia: Epidemiological and clinical predictor factors for death
Authors: Arguni Eggi , Karyanti Mulya Rahma , Satari Hindra Irawan , Hadinegoro Sri Rezeki 
Published: February 2021

Background
In 2017, a diphtheria outbreak occurred in several provinces in Indonesia. The aim of this study was to identify predictors of mortality outcome of pediatric patients with clinical diphtheria.

Methods
A retrospective cohort study was conducted using patient medical records at five referral hospitals in the Province of Jakarta and one in Tangerang District, Banten Province during January 2017 to 31 August 2018. All children in the age group of 1–18 years old discharged with diagnosis of clinical diphtheria formed the study group. All anonymized patient data were evaluated for demographic issues, clinical features, immunization status, complication, laboratory profiles and outcome.

Results
A total of 283 patients with clinical diphtheria were included in the study group with case fatality rate of 3.5%. All mortal patients had the complication of myocarditis. Regression analyses revealed factors for predicting mortality. Incomplete primary diphtheria toxoid immunization, stridor, bull neck, leukocytosis ≥15 x109 cells/L and thrombocytopenia ≤150 x109 cells/L in each combination for 2 predictors modeling were correlated with death.

Conclusions
We report key predictors of mortality in pediatric patients with clinical diphtheria. The presence of these features when admitted to the hospital must be taken into account, because they can lead to fatal outcome.
Predicting mortality of patients with acute kidney injury in the ICU using XGBoost model
Authors: Liu Jialin , Wu Jinfa , Liu Siru , Li Mengdie , Hu Kunchang , Li Ke 
Published: February 2021

Purpose
The goal of this study is to construct a mortality prediction model using the XGBoot (eXtreme Gradient Boosting) decision tree model for AKI (acute kidney injury) patients in the ICU (intensive care unit), and to compare its performance with that of three other machine learning models.

Methods
We used the eICU Collaborative Research Database (eICU-CRD) for model development and performance comparison. The prediction performance of the XGBoot model was compared with the other three machine learning models. These models included LR (logistic regression), SVM (support vector machines), and RF (random forest). In the model comparison, the AUROC (area under receiver operating curve), accuracy, precision, recall, and F1 score were used to evaluate the predictive performance of each model.

Results
A total of 7548 AKI patients were analyzed in this study. The overall in-hospital mortality of AKI patients was 16.35%. The best performing algorithm in this study was XGBoost with the highest AUROC (0.796, p < 0.01), F1(0.922, p < 0.01) and accuracy (0.860). The precision (0.860) and recall (0.994) of the XGBoost model rank second among the four models.

Conclusion
XGBoot model had obvious advantages of performance compared to the other machine learning models. This will be helpful for risk identification and early intervention for AKI patients at risk of death.
Knowledge, attitudes, and practices of seasonal influenza vaccination in healthcare workers, Honduras
Authors: Madewell Zachary J. , Chacón-Fuentes Rafael , Jara Jorge , Mejía-Santos Homer , Molina Ida-Berenice , Alvis-Estrada Juan Pablo , Ortiz Maria-Renee , Coello-Licona Rosa , Montejo Belinda 
Published: February 2021

BackgroundSeasonal influenza is a highly contagious vaccine-preventable disease that may cause high morbidity and mortality in susceptible populations. Healthcare workers are a priority group for seasonal influenza vaccination to protect them from contracting influenza and prevent nosocomial transmission to patients. This study aimed to evaluate knowledge, attitudes, and practices (KAP) of seasonal influenza vaccination among healthcare workers in Honduras.MethodFrom August 24 to October 21, 2018, we conducted a cross-sectional KAP survey regarding seasonal influenza vaccination to a random sample of healthcare workers who attended patients in hospitals of the Ministry of Health of Honduras (SESAL) and Honduran Social Security Institute (IHSS). We reported frequency distributions of demographics, vaccination KAP, sources of information, and reasons for non-vaccination. We used principal components factor analysis to create knowledge and attitude scores. We used linear regression to analyze associations between demographics and sources of information about the influenza vaccine, and knowledge and attitude scores. We used logistic regression to analyze associations between demographics, sources of information, knowledge scores, and attitude scores, and influenza vaccination.ResultWe surveyed 947 healthcare workers who attended patients in 13 SESAL hospitals and two IHSS hospitals. Only 4.6% of participants knew the seasonal influenza vaccine was composed of inactivated viruses, 94.7% believed vaccination causes flu-like symptoms, and 52.0% were vaccinated for influenza in 2018. Knowledge scores were lower for nursing assistants and other healthcare professionals compared to doctors, and higher for healthcare workers who attended a healthcare facility training (P-values≤0.030). Attitude scores were higher for healthcare workers who attended ≥11 patients per day having ≤10 patients per day as reference, self-reported influenza vaccination in previous year, and cited trainings and informal information at the healthcare facility as sources of information for influenza vaccination (P-values≤0.030). Factors associated with self-reported vaccination were self-reported influenza vaccination in previous year (aOR: 7.61; 95% CI: 5.24–11.04), attitude score (aOR: 1.14; 95% CI: 1.07–1.21), and worked in a SESAL hospital (aOR: 1.73; 95% CI: 1.12–2.68) having IHSS as reference.ConclusionAlthough influenza vaccination is required by law in Honduras and available for free in public health centers, coverage of healthcare workers in 2018 was half that reported in 2017. Lower coverage may be attributed to misconceptions of vaccination side effects.
Effect of food processing on the antioxidant activity of flavones from Polygonatum odoratum (Mill.) Druce
Authors: Xia Guanghui , Li Xinhua , Zhang Zhen , Jiang Yuhang 
Published: February 2021

Abstract

Polygonatum odoratum (Mill.) Druce (POD) is a natural plant widely used for food and medicine, thanks to its rich content of a strong antioxidant agent called homoisoflavones. However, food processing methods could affect the stability of POD flavones, resulting in changes to their antioxidant activity. This study attempts to evaluate the antioxidant activity of POD flavones subject to different processing methods and determines which method could preserve the antioxidant activity of POD flavones. Therefore, flavones were extracted from POD samples, which had been treated separately with one of the four processing methods: extrusion, baking, high-pressure treatment, and yeast fermentation. After that, the antioxidant activity of the flavones was subject to in vivo tests in zebrafish embryos. The results show that yeast fermentation had the least disruption to the antioxidant activity of POD flavones, making it the most suitable food processing method for POD. By contrast, extrusion and high-pressure treatment both slightly weakened the antioxidant activity of the flavones and should be avoided in food processing. The research results provide a reference for the development and utilization of POD and the protection of its biological activity.