bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antibiotic Prescribing for Acute, Non-Complicated Infections in Primary Care in Germany: Baseline Assessment of in the Cluster Randomized Trial ARena
Authors: Poss-Doering Regina , Kronsteiner Dorothea , Kamradt Martina , Andres Edith , Kaufmann-Kolle Petra , Wensing Michel , Szecsenyi Joachim 
Published: March 2021

Abstract
BackgroundAntimicrobial resistance is fueled by inappropriate use of antibiotics. Global and national strategies support rational use of antibiotics to retain treatment options and reduce resistance. In Germany, the ARena project (Sustainable reduction of antibiotic-induced antimicrobial resistance) intended to promote rational use of antibiotics for acute non-complicated infections by addressing network-affiliated physicians, primary care teams and patients through multiple interacting interventions. The present study documented patterns of antibiotic prescribing for patients with acute non-complicated infections who consulted a physician in these networks at the start of the ARena project. It explored variation across subgroups of patients and draws comparisons to prescribing patterns of non-targeted physicians. MethodsThis retrospective cross-sectional analysis used mixed logistic regression models to explore factors associated with the primary outcome, which was the proportion of patients with acute non-complicated infections consulting primary care practices who received an antibiotic prescription. Secondary outcomes concerned the prescription of different types of antibiotics. Descriptive methods were used to summarize the data referring to targeted physicians in primary care networks, non-targeted physicians (reference groups), and patient subgroups. ResultsOverall, antibiotic prescription rates were 31.7% in reference groups and 32.0% in primary care networks. General practitioners prescribed antibiotics more frequently than other medical specialist groups (otolaryngologists vs. General practitioners OR=0.465 CI=[0.302; 0.719], p<0.001, pediatricians vs. General practitioners: OR=0.369 CI=[0.135; 1.011], p=0.053). Quinolone prescription rates were 8.1% in reference groups and 9.9% in primary care networks. Patients with comorbidities had a higher likelihood of receiving an antibiotic and quinolone prescription and were less likely to receive a guideline-recommended substance. Younger patients were less likely to receive antibiotics (OR=0.771 CI=[0.636; 0.933], p=0.008). Female gender was associated with higher rates of antibiotic prescriptions (OR=1.293 CI=[1.201, 1.392], p<0.001).Conclusion At the start of the ARena project, observed antibiotic prescription rates for acute non-complicated infections showed room for improvement. This clearly supports the need for the ARENA-Project.
The correlation between the change of Hounsfield units value and Modic changes in the lumbar vertebral endplate
Authors: Zhu Jiandong , Wu Hao , Chen Yilei , Liu Junhui , Shan Zhi , Fan Shunwu , Zhao Fengdong 
Published: March 2021

Abstract
Objectives

To evaluate the changes of Hounsfield units (HU) value in different types of Modic changes (MCs) and to analyze the correlation between the change of HU value and area ratio of MCs region, bone mineral density (BMD), and degree of intervertebral disc degeneration.
Methods

158 endplates with MCs were included and analyzed. HU values of MCs regions and adjacent vertebral corresponding regions without MCs were measured. The area ratio of MCs region was defined as the area of MCs divided by the area of endplate or the vertebral sagittal plane. BMD was measured by Dual-energy x-ray absorptiometry (DXA). Degree of intervertebral disc degeneration was evaluated based on Pfirrmann classification. According to the types of variables, descriptive statistics, Kolmogorove-Smirnov test, paired t-test, Wilcoxon signed-rank test, Independent-Samples T Test, and Pearson correlation analysis were used.
Results

The HU values in any types of MCs are significantly higher than that of adjacent vertebral corresponding regions without MCs(P < 0.001). The HU value of the type III MCs is higher than that of the type I and type II MCs. HU value was positively correlated with BMD. In the levels with Grade V disc degeneration, the area ratio of MCs region was significant increased.
Conclusions

HU values of the vertebral endplate and bone marrow were increased in most MCs regions with all types of MCs. HU value of endplates had a significantly positive correlation with BMD. Higher area ratio of MCs region is associated with more severe intervertebral disc degeneration.
The best of both worlds: Shortcutting evolution through adaptive hybridization in hares
Authors: Pohjoismäki Jaakko L.O. , Michell Craig , Levänen Riikka , Smith Steve 
Published: March 2021

Abstract
Brown hares (Lepus europaeus Pallas) are able to hybridize with mountain hares (L. timidus Linnaeus) and produce fertile offspring, which results in cross-species gene flow. However, not much is known about the functional significance of this genetic introgression. Using targeted sequencing of candidate loci combined with mtDNA genotyping, we found the ancestral genetic diversity in the brown hare to be small, likely due to founder effect and range expansion, while gene flow from mountain hares constitutes an important source of functional genetic variability. Some of this variability, such as the alleles of the mountain hare thermogenin (uncoupling protein 1, UCP1), is likely of adaptive advantage for brown hares, whereas immunity-related MHC alleles are reciprocally exchanged and maintained via balancing selection. Our study offers a rare example where an expanding species can ease its expansion load through hybridization and obtain beneficial alleles to shortcut evolutionary adaptation to the novel environmental conditions.
Association between serum phosphorus levels and adverse outcomes in chronic kidney disease: an observational cohort study
Authors: Oda Akira , Tanaka Kenichi , Saito Hirotaka , Iwasaki Tsuyoshi , Watanabe Shuhei , Kanno Makoto , Kimura Hiroshi , Shimabukuro Michio , Asahi Koichi , Watanabe Tsuyoshi , Kazama Junichiro James 
Published: March 2021

Abstract
Background

Although an association between serum phosphorus levels and poor prognosis has been noted in dialysis patients, these associations have been insufficiently reported in non-dialysis dependent chronic kidney disease (NDD-CKD) patients. This study attempted to determine the association between serum phosphorus levels and adverse outcomes in Japanese NDD-CKD patients.
Methods

We investigated the relationships between serum phosphorus levels and adverse outcomes such as kidney events, cardiovascular events, and all-cause death in Japanese NDD-CKD patients, using the longitudinal data of the Fukushima CKD Cohort Study. The study evaluated 822 patients with NDD-CKD enrolled between June 2012 and July 2014. A kidney event was defined as a combination of doubling of the baseline serum creatinine or end-stage renal disease. Cox regression was performed to analyze the relationships of the quartile of the serum phosphorus with kidney events, cardiovascular events, and all-cause death.
Results

Over a median follow-up period of 2.8 years, 46 patients died, there were 50 cardiovascular events, and 102 kidney events occurred. Increased risk of kidney events was observed in patients with higher serum phosphorus, with the lowest risk shown to be a second quartile of serum phosphorus level of 2.9–3.2 mg/dL. Multivariable Cox regression analysis showed an increased risk of kidney events for the highest quartile of the serum phosphorus levels (≥ 3.7 mg/dL) versus the second quartile (2.9–3.2 mg/dL, hazard ratio, 3.62; 95% confidence interval, 1.65–7.94; P = 0.001). A 1 mg/dL increase of the serum phosphorus was associated with an adjusted hazard ratio of 1.66 (95% CI; 1.24–2.20) for the kidney events. There were no significant associations between the serum phosphorus levels at baseline and the risk of cardiovascular events and all-cause death.
Conclusions

Serum phosphorus levels were associated with an increased risk of CKD progression in Japanese NDD-CKD patients.
Knowledge, Perception and Women's Experience on Induction of Labour – A Questionnaire-based observational study in South India
Authors: Bhat Rajeshwari G , vinod vinutha , Bhat Parvati V , Zahoor Nida 
Published: March 2021

Abstract
Background Induction of labour is an indispensable obstetric procedure.Very few studies have concentrated on women;s experience of induction of labour. Its been reported that women generally have a negative experience with Induction...There is a lack of data regarding the experience of labour induction among Indian women. .We carried out this study womens experience on the induction of labour in this part of South Asia. This study highlights the unmet need of women undergoing induction of labour and changes obstetricians can implement in their day to day practice to make childbirth a positive experienceMethods The aim was to study the Knowledge, Perception and Women’s experience on Induction of labour and to compare this labour experience with women who have come in spontaneous labour. During the study period 300 women who were induced, formed the study group, every consecutive women who came in spontaneous labour formed the control group. Validated. Questionnaires were given after delivery for both induced and to women who delivered spontaneously. Ethical clearance was obtained by the institution (MUEC/13/2015-2016) Data were analysed using SPSS 16. Percentage was used to summarize the categorical data, Chi-square test for associations and Independent t test to compare visual analogue scoresResults Out of 300 women who were induced 65%(196) were aware of induction .84% (249) women knew the reason for their induction.57%(170/300) were aware of benefits of induction of labour, whereas only 15% (45/300) were informed about adverse effects .54% (162/300) of women felt analgesia given was not satisfactory.61 %(177) of women had positive, and 14 %(40) had negative attitude towards induction.32 %(94)spontaneously labouring women felt labour unbearable compared to 45% (126) induced women which is statistically significant (p value 0.001). While comparing the two groups, induced women felt more sad (p<0.001) and tired (p=0.01) compared to women in spontaneous group.Discussion Induced women were not well informed about adverse effects and felt labour was unbearable .Induced women were more tired and sad at the end of labour..Women should be provided with realistic information,and better analgesia in labor Conclusion Induced women were not well informed about adverse effects and felt labour was unbearable .Induced women were more tired and sad at the end of labour. Women should be offered better analgesia in labour. Good counselling and compassionate care from healthcare workers may increase the satisfaction levels of induced women.
A Time-Driven Activity-Based Costing Approach for Identifying Variability in Costs of Childbirth Between and within Types of Delivery
Authors: Dubron Kathia , Verschaeve Mathilde , Roodhooft Filip 
Published: March 2021

Abstract
Background Recently, time-driven activity-based costing (TDABC) is put forward as an alternative, more accurate costing method to calculate the cost of a medical treatment because it allows the assignment of costs directly to patients. The objective of this paper is to demonstrate how the overall cost of childbirth at the maternity department can be calculated by implementing a TDABC analysis. In addition, this study outlines how this costing method can be utilized to provide insights into how patient and disease characteristics drive variability within childbirth cost. Through the use of process mapping, TDABC allows to exactly identify which activities and corresponding resources are impacted by these characteristics, leading to a more detailed understanding of childbirth cost.Methods Process maps were developed for two types of childbirth, vaginal delivery (VD) and caesarean section (CS). Costs were obtained from the financial department and capacity cost rates were calculated accordingly. Results Overall, the cost of childbirth equals €1894,12 and is mainly driven by personnel costs (89,0%). Monitoring after birth is the most expensive activity on the pathway, costing €1149,70. Significant cost variations between type of delivery were found, with VD costing €1808,66 compared to €2463,98 for a CS. Prolonged clinical visit (+33,3 min) and monitoring (+775,2 min) in CS were the main contributors to this cost difference. Within each delivery type, age, parity, number of gestation weeks and education attainment were found to drive cost variations. In particular, for VD an age >25 years, nulliparous, gestation weeks > 40 weeks and higher education attainment were associated with higher costs. Similar results were found within CS for age, parity and number of gestation weeks.Conclusions TDABC is a valuable approach to measure and understand the variability in costs of childbirth and its associated drivers over the full care cycle. Accordingly, these findings can inform health care providers, managers and regulators on process improvements and cost containment initiatives.
Influence of the interaction between parental myopia and poor reading and writing habits on prevalence of myopia in school students in Urumqi, China
Authors: Shi Haonan , Fu Jing , Liu Xiaojing , Wang Yingxia , Yong Xianting , Jiang Lan , Ma Shaowei , Yin Zhe , Yao Jian , Yao Xuan , Chen Xueyi , Wang Tingting 
Published: March 2021

Abstract
Background: To evaluate the prevalence of myopia in school students in Urumqi, China, and explore the influence of the interaction between parental myopia and poor reading and writing habits on myopia to identify the at-risk population and provide evidence to help school students avoid developing myopia.Methods: A cross-sectional survey was conducted with 6,883 school students aged 7–20 years in Urumqi in December 2019. The Standard Eye Chart and mydriatic optometry were used to determine whether students had myopia. Falconer’s method was used to calculate the heritability of parental myopia. Multivariate unconditional logistic regression models were used to analyze the risk factors for myopia and the additive and multiplicative interaction of parental myopia and poor reading and writing habits.Results After standardizing the age of the 6,883 students, the overall prevalence rate of myopia was 47.50%. The heritability of parental myopia was 66.57% for boys, 67.82% for girls, 65.02% for the Han group, and 52.71% for other ethnicities. There were additive interactions between parental myopia and poor reading and writing habits; among them, parental myopia and poor reading and writing habits (1) (the distance between the eyes and book is less than 30 cm when reading and writing, fingers block the sight of one eye while holding the pen, and leaning one’s body when reading and writing) increased the risk of myopia by 10.99 times (odds ratio [OR]=10.99, 95% confidence interval [CI]=8.33–14.68), parental myopia and poor reading and writing habits (2) (reading while lying down, walking, or in the car) increased the risk of myopia by 5.92 times (OR=5.92, 95% CI=4.84–7.27). There was no multiplicative interaction between parental myopia and poor reading and writing habits (1) or (2) (OR=0.69, 95% CI=0.44–1.08; OR=0.89, 95% CI=0.66–1.21, respectively).Conclusion The prevalence of myopia among students in Urumqi, Xinjiang is relatively high. The risk of developing myopia is affected by parental myopia and poor reading and writing habits. In addition, parental myopia amplifies the harm caused by poor reading and writing habits, thereby increasing the risk of myopia. Students with parents who have myopia should be targeted during myopia prevention efforts.
Investigation of Surface Scaling, Optical and Microwave Dielectric Studies of Bi0.5Na0.5TiO3 thin Films
Authors: Pattipaka Srinivas , D Pamu , J Pundareekam Goud , C James Raju K , Pradhan Gbinda , V Sridhar 
Published: March 2021

Abstract
Herein, we have investigated the optical and microwave dielectric properties of Bi 0.5 Na 0.5 TiO 3 (BNT) thin films grown under different oxygen pressure ( P O2 ) using pulsed laser deposition (PLD) technique. The X-ray diffraction measurements confirms the single phase of BNT along with secondary phase and further reduction in secondary phase and increase in BNT phase with P O2 , signifies the close relation between the crystal structure and oxygen content. The shift of Raman-active TO1, TO2 and TO3 modes towards higher wavelengths and increase in mode intensity with P O2 indicating the films degree of crystallinity. The local roughness ( α loc ) of all films obtained as ~ 0.85, and the interface width ( w ) and lateral correlation length ( ξ ) of films varies with P O2 . Also, the films exhibit the increase in refractive index and reduction in optical bandgap of due to improvement in crystallinity and reduction in the oxygen vacancies. The microwave dielectric properties show a strong P O2 depends with higher dielectric constant ( ε r = 336) with lower loss (tan δ = 0.0093) at 5 GHz which show the potential applications in high frequency devices.
Qualitative analysis of first-person accounts of noetic experiences
Authors: Wahbeh Helané , Fry Nina , Speirn Paolo , Hrnjic Lutvija , Ancel Emma , Niebauer Erica 
Published: March 2021

Abstract
The term “noetic” comes from the Greek word noēsis/noētikos that means inner wisdom, direct knowing, intuition, or implicit understanding. Strong cultural taboo exist about sharing these experiences. Thus, many may not feel comfortable transparently discussing or researching these topics, despite growing evidence that these experiences may be real. The study’s objective was to qualitatively evaluate first-hand accounts of noetic experiences. 521 English-speaking adults from around the world completed an online survey collected demographic data and four open-ended questions about noetic experiences. Thematic analysis was used to characterize the data. The ten most used codes were expressing to or sharing with others, impacts decision making, intuition/”just knowing,” meditation/hypnosis, inner visions, setting intentions/getting into the “state,” healing others, writing for self, and inner voice. There were five main themes identified: 1. Ways of Engagement; 2. Ways of Knowing; 3. Types of Information; 4. Ways of Affecting; and 5. Ways of Expressing. Subthemes. Future research will include investigating the nuances of these themes and also establishing standardized methods for evaluating them. This would also then inform curricula and therapies to support people in these experiences.
A scoping review of global vaccine certificate solutions for COVID-19
Authors: Mithani Salima S. , Bota A. Brianne , Zhu David T. , Wilson Kumanan 
Published: March 2021

Abstract
Background: Globally, measures such as lockdown, quarantining, and physical distancing have been implemented to curb the spread of COVID-19. As the vaccines are now available and reintegration into the society is beginning, measures such as vaccine certificates are being implemented around the world. Objective: The objective of the scoping review is to identify the initial digital solutions available globally for COVID-19 vaccine certificates and evaluate them on the basis of purpose and use case, technological architecture, and ethical and legal implications. Methods: We conducted a Google search on November 18 and 19, 2020 as well as a search of Embase on November 26, 2020, Ovid MEDLINE and preprint servers (MedRXIV, BioRXIV). The search terms used were “coronavirus”, “COVID-19”, “SARS COV2”, “immunization passport”, “immunization certificate”, “vaccine certificate”, “vaccination certificate” and “digital”. Articles were included for review if they included any discussion of a digital solution for vaccine certificates and English language. Data was extracted using an electronic data extraction form and included date, location, type of article, source, companies identified, technology used, type of evidence provided, digital architecture, security and privacy measures, and use cases. The articles were categorized based on the following six pre-identified themes: 1) legal, 2) technology, 3) ethics, 4) travel, 5) policy, and 6) science. Results: A total of 70 articles were included in the final analysis. Technology emerged as the most dominant theme, appearing in 58.5% (n=41) articles followed by ethics (n=22, 31%), travel (n=21, 30%), legal concerns (n=10, 14%), public policy (n=9, 13%), and scientific concerns (n=1, 1.5%. Our review identified 8 global solutions that are working towards COVID-19 vaccine certificate, all optimizing blockchain technology. COVID-19 vaccine certificates are being considered in 13 countries and are in place in 3 countries. All the solutions we identified are using blockchain technology.Conclusion: Several countries have implemented or are considering COVID-19 vaccine certificates. Many issues concerning the themes we identified remain to be addressed to facilitate successful implementation.
The Thalamus in Trigeminal Neuralgia: Structural and Metabolic Abnormalities, and Influence on Surgical Response
Authors: Danyluk Hayden , Andrews Jennifer , Kesarwani Rohit , Seres Peter , Broad Robert , Wheatley Matt , Sankar Tejas 
Published: March 2021

Abstract
Background: Medically-refractory trigeminal neuralgia (TN) can be treated successfully with operative intervention, but a significant proportion of patients are non-responders despite undergoing technically successful surgery. The thalamus is a key component of the trigeminal sensory pathway involved in transmitting facial pain, but the role of the thalamus in TN, and its influence on durability of pain relief after TN surgery, are relatively understudied. We aimed to test the hypothesis that variations in thalamic structure and metabolism are related to surgical non-response in TN. Methods: We performed a longitudinal, peri-operative neuroimaging study of the thalamus in medically-refractory TN patients undergoing microvascular decompression or percutaneous balloon compression rhizotomy. Patients underwent structural MRI and MR spectroscopy scans pre-operatively and at 1-week following surgery, and were classified as responders or non-responders based on 1-year post-operative pain outcome. Thalamus volume, shape, and metabolite concentration (choline/creatine [Cho/Cr] and N-acetylaspartate/creatine [NAA/Cr]) were evaluated at baseline and 1-week, and compared between responders, non-responders, and healthy controls. Results: Twenty healthy controls and 23 patients with medically-refractory TN treated surgically (17 responders, 6 non-responders) were included. Pre-operatively, TN patients as a group showed significantly larger thalamus volume contralateral to the side of facial pain. However, vertex-wise shape analysis showed significant contralateral thalamus volume reduction in non-responders compared to responders in an axially-oriented band spanning the outer thalamic circumference (peak p = 0.019). Further, while pre-operative thalamic metabolite concentrations did not differ between responders and non-responders, as early as 1-week after surgery, every single long-term non-responder showed a distinct decrease in contralateral thalamic Cho/Cr and NAA/Cr, irrespective of surgery type, which was not observed in responders.Conclusions: Atrophy of the contralateral thalamus is a consistent feature across patients with medically-refractory TN. Regional alterations in preoperative thalamic structure, and very early post-operative metabolic changes in the thalamus, both appear to influence the durability of pain relief after TN surgery.