bluuebunny/crossref_metadata_2025_split huggingface dataset:
Continued Relevance of Initial Temperature Measurement in Trauma Patients
Authors: Balmer Jacob C. , Hieb Nathan , Daley Brian J. , Many Heath R. , Heidel Eric , Rowe Shaun , McKnight Catherine L. 
Published: November 2021

Objectives Hypothermia occurs in 30-50% of severely injured trauma patients and is associated with multiple metabolic derangements and worsened outcomes. However, hypothermia continues to be under-diagnosed which leads to inadequate triage and treatment in trauma patients. Our study set out to determine if hypothermia is an independent predictor of mortality in trauma patients. Methods We retrospectively reviewed data of all trauma activation patients over a 5-year period. Data were collected on patient demographics, initial core temperature, Glasgow Coma Scale (GCS) on presentation, and injury severity score (ISS). Patients were then stratified into groups based on presenting temperature, ISS, and GCS. Outcomes compared were mortality, blood products received, and intensive care unit (ICU) length of stay. Correlations and logistic regression were used to test the hypotheses. Results Survival and temperature data were reviewed on 15,567 patients. Initial temperature was not significantly associated with ICU length of stay or blood products transfused ( P = .21 and P = .08, respectively). However, odds ratio of mortality in hypothermic patients (<35°C) compared to normothermic patients (35-39°C) was 3.95 (95% CI 2.90-5.41). When controlling for GCS and ISS, separately, temperature remained an independent predictor of mortality. Conclusions Hypothermia is an independent risk factor for mortality in trauma patients. It remains crucial to obtain accurate presenting temperatures in trauma patients in order to triage and treat hypothermia. Based on our data, obtaining core temperatures and rapidly treating hypothermia continues to be a vital part of the secondary survey of trauma patients.
Trampoline Injuries in a Statewide Trauma System
Authors: Sullivan Megan C. , Morgan Madison E. , Bradburn Eric , Perea Lindsey L. 
Published: November 2021

Introduction It is well known that trampolines can be a particular source of danger, especially in children. We sought to examine the profile of those patients with trampoline injuries. We hypothesized there would be certain injury patterns predicative of trampoline injuries. Methods All patients submitted to Pennsylvania Trauma Outcome Study database from 2016 to 2018 were analyzed. Trampoline injury was determined by ICD-10 activity code. Injury patterns in the form of abbreviated injury scale body regions were examined. Patient demographics and clinical variables were compared between those with trampoline injury vs those without. Results There were 107 patients with a trampoline injury. All of these patients were discharged alive and had a blunt mechanism of injury. The most common injury type was injury to the extremities (n=90,[84.1%]) with 54(50.5%) upper extremity injuries and 36(33.6%) lower extremity injuries. Ten (9.35%) patients had injury to the spine and five (4.67%) had head injury. Those with trampoline injuries were significantly younger (13y vs. 48.6y) and more likely to be white or of Hispanic ethnicity. Almost half of the patients injured (49.5%) were under 10 years. Patients with trampoline injuries had significantly lower Injury Severity Scores and significantly higher shock index. Discussion The majority of patients with trampoline injuries had injury to an extremity. These results help better understand the demographic, physiologic, and anatomic patterns surrounding trampoline injuries. Current government standards recommend that no child under age six should use a full-sized trampoline; however, based of this study, we advise that this age be increased to ten.
Open Abdomen after Two Trauma Laparotomies: Do Diuretics Help?
Authors: Williamson Sigrid , Qatanani Anas , Muller Alison , Martin Anthony , Geng Thomas A. , Ong Adrian W. 
Published: November 2021

Data are lacking regarding the use of diuretics in facilitating closure of the open abdomen (OA). For patients with an OA after 2 laparotomies, we hypothesized that diuretic use was associated with a higher rate of primary fascial closure than no diuretic use. A retrospective review of patients with trauma laparotomies over 7 years was performed. Primary fascial closure (PFC) was defined as apposition of fascial edges without interposition mesh. Of 321 patients, 30 (9%) remained with an OA after 2 laparotomies. Prior to the third laparotomy, median cumulative fluid balance was +12.6 L. Thirteen (43%) received diuretics. Primary fascial closure rates were similar for diuretic use vs no diuretic (38% vs 59%, P = .46). Primary fascial closure was not associated with age ( P = .2), gender ( P = 0.7), cumulative fluid balance ( P = .3), or units of packed cells ( P = .4). Diuretic use in trauma patients with an OA after 2 laparotomies was not associated with successful PFC.
Pediatric Mild Traumatic Brain Injury: Who Can Be Managed at a Non-pediatric Trauma Center Hospital? A Systematic Review of the Literature
Authors: Keane Olivia A. , Escobar Mauricio A. , Neff Lucas P. , Mitchell Ian C. , Chern Joshua J. , Santore Matthew T. 
Published: November 2021

Background Pediatric traumatic brain injury (TBI) affects about 475,000 children in the United States annually. Studies from the 1990s showed worse mortality in pediatric TBI patients not transferred to a pediatric trauma center (PTC), but did not examine mild pediatric TBI. Evidence-based guidelines used to identify children with clinically insignificant TBI who do not require head CT were developed by the Pediatric Emergency Care Applied Research Network (PECARN). However, which patients can be safely observed at a non-PTC is not directly addressed. Methods A systematic review of the literature was conducted, focusing on management of pediatric TBI and transfer decisions from 1990 to 2020. Results Pediatric TBI patients make up a great majority of preventable transfers and admissions, and comprise a significant portion of avoidable costs to the health care system. Majority of mild TBI patients admitted to a PTC following transfer do not require ICU care, surgical intervention, or additional imaging. Studies have shown that as high as 83% of mild pediatric TBI patients are discharged within 24 hrs. Conclusions An evidence-based clinical practice algorithm was derived through synthesis of the data reviewed to guide transfer decision. The papers discussed in our systematic review largely concluded that transfer and admission was unnecessary and costly in pediatric patients with mild TBI who met the following criteria: blunt, no concern for NAT, low risk on PECARN assessment, or intermediate risk on PECARN with negative imaging or imaging with either isolated, nondisplaced skull fractures without ICH and/or EDH, or SDH <0.3 cm with no midline shift.
Prolonged Emergency Department Stay at Referring Facilities: A Poor Trauma Performance Improvement Tool
Authors: Udekwu Pascal , Simonson Brian , Stiles Anquonette , Mclntyre Sarah , Tann Kimberly , Schiro Sharon 
Published: November 2021

Background Delays in the transfers of injured patients are perceived to increase morbidity and mortality and drive initiatives to limit the emergency department length of stay (LOS) at referring facilities (RF). RF LOS >4 hours is used for performance improvement (PI) with a large review burden with few improvement opportunities. Methods A statewide trauma registry 2013-2018 was used. Descriptive and inferential statistics including logistic regression were used to evaluate nongeriatric adult patients with ED LOS <12 hours. Paired data analyses utilizing prehospital (PH) and RF variables, vital signs (VS), Glasgow Coma Score–Motor component (GCS-M), RF LOS, mortality, trauma center hospital LOS (HLOS), and intensive care unit (ICU) LOS were performed. Results 13,721 of 56,702 transfer patients were selected. Mortality fell over time in all abbreviated injury score groups. GCS-M and systolic blood pressure (SBP) were correlated with mortality in both prehospital and RF data and highest in patients with abnormal GCS-M or SBP in both settings (38.0%, 30.1%). Examination of mortality over time in the group with abnormal VS showed SBP as the only variable with increasing mortality related to RF LOS. Average HLOS and ICU LOS were longest in patients with abnormal PH and RF SBP and GCS-M. Discussion Support for PI evaluation of RF LOS >4 hours was not identified. Increased survival over time is explained by early transfers of high mortality patients. Our data support existing efficient statewide transfers and recommend PI review of transfer patients with abnormal GCS-M and SBP in a narrower timeframe.
Does Adding a Fissurectomy to Botox Sphincterotomy Increase Success Rate or Just Cost?
Authors: Winter Kelly A. , Savolt Todd , Quinn Karson R. , Helmer Stephen D. , Porter Michael G. , Sanchez Noel C. 
Published: November 2021

Background While Botox sphincterotomy with or without fissurectomy has been proven effective in healing anal fissures, they have not been directly compared. We evaluated cost-effectiveness and outcomes between Botox sphincterotomies with and without fissurectomy. Methods A 5-year retrospective review was conducted comparing all patients undergoing Botox sphincterotomy for anal fissure with or without fissurectomy. Outcomes including recurrence/persistence, additional treatments, complications, and total charges were compared between study groups. Results Patients treated without fissurectomy (n = 53) had recurrent/persistent fissure more often (56.6 vs 31.0%, P = .001), and required more Botox treatments. Those treated with fissurectomy (n = 154) had more complications (13.5 vs 0%, P = .003). Patients initially treated without fissurectomy had a median total charge of $2 973, while median total charge for those initially treated with fissurectomy was $17 925 (P < .001). Conclusions Botox sphincterotomy in an office without fissurectomy is a viable option. It may result in longer healing times but is associated with reduced cost, lower complication rates, and no need for anesthesia or operative intervention in most cases. But the choice of treatment route must be individualized.
Increasing lengths of rank order lists of applicants and programs of US medical residencies
Authors: Newsome Kevin , Sen-Crowe Brendon , Fanfan Dino , McKenny Mark , Elkbuli Adel 
Published: November 2021

Background To match medical students into residency training programs, both the program and student create rank order lists (ROLs). We aim to investigate temporal trends in ROL lengths across 7 match cycles between 2014 and 2021 for both matched and unmatched residency applicants and programs. Methods retrospective study of ROLs of 7 match cycles, 2014-2021. Residency match and ROL data were extracted from the NRMP database to assess the number of programs filled and unfilled, length of ROLs, position matched, and average ranks per position for osteopathic (DO) and allopathic (MD) medical programs. Results For filled residency programs, the average ROL length consistently increased from 70.72 in 2015 to 88.73 in 2021 ( P = .003), with ROL lengths consistently longer for filled vs unfilled residency programs ( P < .001). The average ROL length for matched applicants increased consistently from 10.41 in 2015 to 12.35 in 2021 ( P = .002), with matched applicants having consistently longer ROLs than unmatched applicants ( P < .001). From 2015 to 2021, in both MD and DO applicants, progressively lower proportions of applicants matched their first and second choices. Conclusion Trends across the past 7 residency match cycles suggest that ROL lengths for both programs and applicants have been increasing with matched programs and applicants submitting significantly longer ROLs than unmatched applicants. Additionally, fewer applicants are matching at their preferred programs over time. Our findings support the mounting evidence that the Match has become increasingly congested and we discuss the possible factors that may be contributing to the current state of the Match as well as potential solutions.
Experimental analysis on the bonding conditions of thermoset-thermoplastic composite parts manufactured by the hybrid single shot method
Authors: Kazan Hakan , Farahani Saeed , Zheng Ting , Pilla Srikanth 
Published: November 2021

The hybrid single shot method is an innovative manufacturing technique that allows thermoset composite sheets to be formed and cured while they are also bonded into an injected thermoplastic body all in a single integrated operation. This integration concept is complex in nature but promising to overcome the drawbacks of the traditional procedures for manufacturing such multi-material structures by reducing the cycle time, energy consumption, and cost of the required tools and machinery. In this study, CF/Epoxy prepreg sheets are selected as the inserted material which is then later deformed and bonded to an injected body made of a polypropylene compound. The bonding between these two dissimilar materials is mostly achieved by taking the advantages of the melt penetration and the tackiness of the prepreg sheet. Therefore, an experimental study is here designed and carried out to evaluate the bonding conditions of the final hybrid parts regarding several influential process parameters. To better monitor the process and analyze the physics behind this integration, a set of real-time process variables are measured and analyzed using an instrumented experimental setup. The results show that the pre-heating time has the largest effect on the bonding strength, and the best combination of the deformation and bonding strength is achieved when the cavity pressure and temperature are at the highest level compared to the other experiments. The maximum bonding strength attained in the optimum process settings was 6.8 MPa which shows a 51% improvement compared to the average value of the other experiments.
Influence of charge carrier density, mobility and diffusivity on conductivity–temperature dependence in polyethylene oxide–based gel polymer electrolytes
Authors: Abdukarimov Abdullaziz , Noor Ikhwan Syafiq Mohd , Mamatkarimov Odiljon , Arof Abdul Kariem Mohd 
Published: November 2021

Determining the transport properties of charge carriers is essential to understand the factors that affect the conductivity trend of a polymer electrolyte system. In this work, charge carrier transport parameters of polyethylene oxide–based gel polymer electrolytes were estimated from fitting the Nyquist plot with the impedance equation, derived from the equivalent circuit that consists of a resistor in series with a constant phase element. The increase in electrolyte conductivity with temperatures from 303 K to 373 K is attributed to the increase of free ions, n (TPA+ cations and I¯ anions) and not to ionic mobility, μ. The decrease in μ with temperature is associated with the increase in the Stokes drag coefficient due to increase in ion collisions. This work explains how conductivity changes with number density of ions and mobility at various temperatures.
Addressing Marine Wildlife Entanglement in Derelict Fishing Nets Using Community-Based Social Marketing: Case Study and Lessons Learnt
Authors: Sarrouf Willson Maïa , Turley Craig , Daar Lamees A. , Al Masroori Hussein , Al Muscati Hussain , Al Aufi Madrak , Al Bulushi Asma , Al Harthi Suaad , Willson Andrew 
Published: November 2021

Background Entanglement of marine species, particularly endangered sea turtles and cetaceans, in abandoned, lost or otherwise discarded fishing gear is a major conservation concern. Focus of the Article This case study applies Community-Based Social Marketing (CBSM) to reduce marine wildlife net entanglement in the waters surrounding Masirah Island, a marine biodiversity hotspot in Oman. Importance to the Social Marketing Field The study demonstrates the use of social marketing tools in biodiversity conservation, bringing new knowledge to the cross-application of these two fields. Methods The CBSM methodology was applied to select behaviours, identify barriers and benefits, develop strategies and design a pilot study. The responsible disposal of derelict nets in skip bins was selected as the target behaviour, and a mix of behavioural change tools was applied to achieve change: convenience (installation of three skip bins), education (installation of informative signs, distribution of awareness posters, one-to-one engagement with fishers on the beaches), prompts (installation of signs and posters on vessels) and social norms (one-to-one engagement with key influencers and decision makers). The monitoring of behaviour change took place through structured observations over 23 weeks, focussing on the number of nets disposed of in the allocated skip bins. Results Results showed a low level of behaviour adoption rate by skiff and launch vessel fisheries, respectively, 5.36% and 2.58%. Positive results were observed for a short time but did not reach the estimated target value throughout the study period. Recommendations for Research Our pilot study did not lead to broad-scale implementation and we recommend further awareness and engagement with the target audience, trials of various behaviour change tools and increase field monitoring time. We further recommend the application and funding of behaviour change methods applied to fishers with the incorporation of conventional financial, conservation and regulatory tools to support resource management. Limitations Our results show that focussing on specific behaviours with appropriate measurement is both resource and time demanding to solve pressing conservation problems, particularly ones generated by complex industries such as fishing. Various lessons, useful for other social marketers, have been drawn from our evaluation of the overall study.
Retailer Volunteerism as a Plastic Shopping Bag Governance Tool: Shoppers’ Reflections and Contributions to Environmental Social Marketing
Authors: Muposhi Asphat , Shamhuyenhanzva Roy 
Published: November 2021

Introduction The pollution of landscapes and coastal environments with plastic shopping bag litter is an escalating global problem. The introduction of plastic bag tax aimed at addressing this challenge achieved limited success in South Africa. This study explores South African shoppers’ perceptions towards social marketing anchored retailer voluntary initiatives, which is an emerging plastic bag policy option. Literature Adverse environmental and social effects of plastic shopping bags are discussed. Retailer voluntary initiatives used to de-market plastic shopping bags, including jurisdictions where they were implemented, are also reviewed. The focus is on retailer anti-plastic bag initiatives such as ‘reusable shopping bags’ and ‘plastic bag-free’ shops. Methods This study is situated within a constructivist research paradigm and a qualitative methodology. Data were collected from a sample of 31 grocery shoppers recruited from retailer outlets in South Africa’s metropolitan cities, Johannesburg and Pretoria. In-depth interviews were conducted to explore shoppers’ perceptions towards retailer-driven anti-plastic bag voluntary initiatives. Thematic content analysis was used to analyse interview data. Findings The findings of this study highlight shoppers’ negative perceptions towards retailer anti-plastic bag voluntary initiatives. Shoppers perceived retailer anti-plastic bag voluntary initiatives as forms of green capitalism, green entrepreneurship, symbolic corporate social responsibility, strategic business posture, commandeered green consumerism, measured environmental morality, masked green washing and calculated pre-emptive behaviour. Future studies may seek to extend the generalisability of these findings by using a larger sample size. Conclusion The study’s findings highlight the trust deficit associated with retailer anti-plastic bags voluntary initiatives and the importance of enhancing market acceptance and legitimacy. Mistrust and cynicism directed towards retailer anti-plastic bag voluntary initiatives point to the importance of consumer education aimed at emphasising the negative effects of single-use plastic shopping bags. This study concludes that reliance on retailer self-regulation may not be the best approach to solve the escalating problem of plastic bag litter. We argue that national governments need to implement interventions that strike a balance between environmental sustainability and economic development.
Identification of Hub Genes Related to Alzheimer’s Disease and Major Depressive Disorder
Authors: Cheng Yajing , Sun Meiyue , Wang Feng , Geng Xin , Wang Fei 
Published: November 2021

Background Although many studies reported a close relationship between depression and Alzheimer’s disease (AD), the underlying pathophysiological mechanism remains unclear. The present study aimed to investigate the mechanism of AD and major depressive disorder (MDD). Method: The datasets were downloaded from the Gene Expression Omnibus. After screening differentially expressed genes (DEGs), gene ontology and pathway analysis were performed and protein–protein interaction, TF-target gene, and miRNA-target gene networks were established. Results: 171 DEGs of AD-related datasets and 79 DEGs shared by AD and MDD were detected. Functional analysis revealed that AD and MDD common genes were significantly enriched in circadian entrainment and long-term depression signaling pathways. Five hub genes were identified after construction of networks and validation of hub gene signatures. In conclusion, DYNC1H1, MAPRE3, TTBK2, ITGB1, and WASL may be potential targets for the diagnosis and treatment of AD and MDD.
Lung function trajectory in progressive fibrosing interstitial lung disease
Authors: Oldham Justin M. , Lee Cathryn T. , Wu Zhe , Bowman Willis S. , Pugashetti Janelle Vu , Dao Nam , Tonkin James , Seede Hasan , Echt Gabrielle , Adegunsoye Ayodeji , Chua Felix , Maher Toby M. , Garcia Christine K. , Strek Mary E. , Newton Chad A. , Molyneaux Philip L. 
Published: November 2021

BackgroundProposed criteria for progressive fibrosing interstitial lung disease (PF-ILD) have been linked to increased mortality risk, but lung function trajectory after satisfying individual criteria remains unknown. Because survival is rarely employed as the primary end-point in therapeutic trials, identifying PF-ILD criteria that best predict subsequent change in forced vital capacity (FVC) could improve clinical trial design.MethodsA retrospective, multicentre longitudinal cohort analysis was performed in consecutive patients with fibrotic connective tissue disease-associated ILD (CTD-ILD), chronic hypersensitivity pneumonitis and idiopathic interstitial pneumonia at three US centres (test cohort) and one UK centre (validation cohort). 1-year change in FVC after satisfying proposed PF-ILD criteria was estimated using joint modelling. Subgroup analyses were performed to determine whether results varied across key subgroups.Results1227 patients were included, with CTD-ILD predominating. Six out of nine PF-ILD criteria were associated with differential 1-year change in FVC, with radiological progression of fibrosis, alone and in combination with other features, associated with the largest subsequent decline in FVC. Findings varied significantly by ILD subtype, with CTD-ILD demonstrating little change in FVC after satisfying most PF-ILD criteria, while other ILDs showed significantly larger changes. Findings did not vary after stratification by radiological pattern or exposure to immunosuppressant therapy. Near-term change in FVC after satisfying proposed PF-ILD criteria was heterogeneous depending on the criterion assessed and was strongly influenced by ILD subtype.ConclusionsThese findings may inform future clinical trial design and suggest ILD subtype should be taken into consideration when applying PF-ILD criteria.