bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validity&nbsp;of the Emergency Severity Index in a&nbsp;Finnish&nbsp;Emergency Department&nbsp;
Authors: Kemp Kirsi Maria , Alakare Janne , Kätkä Minna , Lääperi Mitja , Lehtonen Lasse , Castren Maaret 
Published: March 2021

Abstract
Background: The purpose of acuity assessment, triage, in the emergency department is to recognize critically ill patients and to allocate resources. The Emergency Severity Index (ESI) is used widely around the world and has been shown to be at least as good as other 5-level assessment instruments. In this study, we assess validity of the ESI triage system in a Finnish Emergency department for predicting 30-day mortality as primary outcome and hospital admissions, high dependency unit or intensive care unit admissions as secondary outcomes, and efficiency for predicting emergency department length-of-stay and utilized resources as secondary outcomes. Methods: We collected data of all adult patient visits to the emergency department during a one-month period. The data was analyzed for the primary and secondary outcomes stratified by age: younger adults (18-64 years), older adults (65-79 years) and oldest old (>80 years). Results: Of the 5909 visits, 5511 were eligible for analysis, 2725 of them men. Median age was 59 years; 30-day mortality was 150 (2.7%). In all age groups, 30-day mortality was consecutively higher with statistical significance between each step from between categories 1 to 3. There were 2274 admissions, 190 of the to HDU or ICU.  Hospital admission rates were significantly higher between each step between categories 2 to 4 for all adults. HDU/ICU admissions were higher in category 2 than in category 3 in all age groups. Resource utilization was higher in category 3 than in category 4; categories 4 and 5 differed only in the younger adult group. Most patients in categories 4 and 5 required ≥2 and 0 resource, respectively. Median length of stay at the emergency department was 3h 47min. For all patients ED-LOS varied without linearity; LOS was longest in category 3 in all age groups. Conclusions: ESI seems to be a valid tool for acuity assessment in all age groups in our population: it recognized severely ill patients by predicting mortality and hospital admissions in the higher triage categories in all age groups. Having failed to predict both resource consumption and ED-LOS, ESI was not associated with efficiency in our population.
Technological Shells in the Processes of Rolling Thin Sheets From Hard-To-Deform Materials
Authors: Salikhyanov Denis R , Kamantsev Ivan 
Published: March 2021

Abstract
The present work is devoted to the study of deformability of high-strength and hard-to-deform materials. Today the most promising technology for their forming is a rolling in a ductile shell also known as sandwich rolling. Despite the fact that the use of such technological shells allows to effectively reduce the rolling forces and soften the stress state, they have not got wide application in manufacturing practice due to the accompanying disadvantages. On the basis of finite element (FE) simulation, we carried out an all-around analysis of the effect of shell material on process parameters of method: rolling force, total reduction of hard-to-deform material, deformation inhomogeneity and thickness variation of rolled sheet, stress state scheme. Analysis of computer models allowed us to highlight the main reason for the low efficiency of the known method and propose a new design of technological shells. Preliminary FE-simulation of the rolling process of hard-to-deform material in the new technological shells showed an improvement in process parameters and method efficiency. Approbation was carried out via rolling U12 high-carbon tool steel (Russian analogue of DIN C110W2 tool steel), which has low plasticity and high hardness, on the rolling mill Duo 250 under laboratory conditions. Evaluation according to technological criteria – reducing the rolling force, increase of the total reduction and the deformation uniformity of hard-to-deform material, improvement of its deformability – showed the prospects of using proposed technological shells in manufacturing practice.
Low prevalence of hypertension in children with renal cysts and diabetes syndrome is the hallmark of the disease
Authors: Seeman Tomas , Weigel Friederike , Blahova Kveta , Fencle Filip , Pruhova Stepanka , Hermes Katharina , Klaus Richard , Lange-Sperandio Bärbel , Grote Veit , John-Kroegel Ulrike 
Published: March 2021

Abstract
Cystic kidney diseases such as autosomal recessive or dominant polycystic kidney disease (ARPKD and ADPKD) are associated with high prevalence of arterial hypertension. On the contrary, studies on hypertension in children with renal cysts and diabetes (RCAD) syndrome caused by abnormalities in the HNF1B gene are rare. Therefore, the aim of our study was to investigate the prevalence of hypertension in children with RCAD syndrome due to HNF1B gene abnormalities and to search for possible risk factors for development of hypertension. Data on all children with genetically proven RCAD syndrome from three pediatric nephrology tertiary centers were retrospectively reviewed (office blood pressure (BP), ambulatory blood pressure monitoring (ABPM), creatinine clearance, renal ultrasound, echocardiography, albuminuria/proteinuria). Hypertension was defined using the current ESH 2016 criteria and/or by the use of antihypertensive drugs. Thirty-two children with RCAD syndrome were investigated. Three children received ACE-inhibitors for hypertension and/or proteinuria. Hypertension was diagnosed using office BP in 22% of the children (n = 7) In the 7 performed ABPM 1 child (14%) was diagnosed with hypertension. Creatinine clearance, proteinuria, albuminuria, body mass index, enlargement or hypodysplasia of the kidneys and prevalence of HNF1B-gene deletion or mutation were not significantly different between hypertensive and normotensive children. Conclusion: Hypertension is rare in children with RCAD syndrome. The low prevalence of hypertension seems to be the hallmark of the disease.
Emission sources, Characteristics and risk assessment of particulate bound Polycyclic Aromatic Hydrocarbons (PAHs) from traffic sites
Authors: Ambade Balram , Kumar Amit , Latif Mohd 
Published: March 2021

Abstract
Atmospheric PM2.5 size particulate-associated Polycyclic Aromatic Hydrocarbons (PAHs) were analyzed from December 2018 to May 2019 over three traffic sites of Chota Nagpur Plateau (CNP) of India were analyzed to study their temporal and seasonal variations. Over the last few decades, CNP becomes a hotspot of air pollution due to traffic and anthropogenic activities. The PM2.5 concentration was higher than the value given by the National Ambient Air Quality (NAAQ) standard value. The results show the total average concentration of PAHs was found 141.48±22.86, 163.80 ±30.43, and 171.60±26.23 ng/m3 over site (Adityapur) ADP, (Sakchi) SKI, and Mango (MGO), respectively. The PM2.5 total average concentration was found 67.91± 14.04, 79.70± 13.53, and 103.20± 21.77µg/m3 over site ADP, SKI, and MGO, respectively. Diagnostic ratio analysis reveals that the source of PM2.5 associated with PAHs was petrogenic, pyrogenic, coal combustion, and vehicular emission. Backward trajectories model and fire count data were also used for air parcel movement up to height 4500 m above the earth’s surface. The traffic campaign has provided a rare opportunity for the CNP region for the collection of more air pollution baseline data, which could be helpful in the formulation of air pollution reduction policies in the future
Design and fabrication of high performance photovoltaic based Controllable SnS/rGO hybrid composite: An excellent counter electrode for dye sensitized solar cell
Authors: Indhumathy M. , Praksam A , Hegazy H. H. 
Published: March 2021

Abstract
To catalyse the decrease of triiodide in the electrolyte, state-of-the-art dye-sensitized sun directed cells (DSSCs) usually use respectable and uncommon Pt as counter electrodes, which greatly limits the practical applications of DSSCs. Appropriately, choices with low cost, fabulous electro- catalytic action, and predominant electrochemical stability to Pt are exceedingly looked for after. Herein, we report tin sulfide/reduced graphene oxide (SnS/rGO) composites are facile synthesized via a simple one-pot hydrothermal route and characterized by XRD, FESEM, Raman, UV-DRS, BET and PL studies. Due to the synergic effect between the SnS nanoparticles and rGO, these composite samples showed outstanding electro-catalytic property on reducing the triiodide. Therefore, the DSSC equipped with SnS/rGO nanocomposite CE achieved a power conversion efficiency (PCE) of 7.72%, which was higher than those of use SnS nanoparticles (5.21%). The improved mechanism of SnS/rGO nanocomposite was also discussed.
Synergistic Effect of Ag and Cu Codoping on the Structural, Optical and Photocatalytic Performance of BiVO4
Authors: Velusamy Maheskumar , Jiang Zhenyi , Lin Yanming , Bhojan Vidhya , S Sasikumar 
Published: March 2021

Abstract
In this work, Ag or/and Cu doped BiVO 4 samples has been prepared successfully via hydrothermal and photoreduction method. Ag/Cu co-doped BiVO 4 exhibited high photocatalytic degradation efficiency in the degradation of methylene blue (MB) and displayed a significantly superior property compared to pure BiVO 4, as well as only Ag or Cu doped BiVO 4 upon exposure to visible light source. Interestingly, we found that enhanced photocatalytic activity of Ag/Cu co-doped BiVO 4 arises from the synergistic effect between the Ag and Cu co-doped BiVO 4 with smaller crystalline size, improved photocatalytic reaction sites, improved life-time and enhanced separation of photogenerated charge carriers which are confirmed using different characterization techniques. The degradation of MB was mainly indicated by superoxide radical species as confirmed by the trapping experiment. Based on the collective results obtained an excellent photocatalytic activity in Ag/Cu co-doped BiVO 4 has been confirmed.
Trade, skill premium and the gender wage gap: Evidence from manufacturing industries
Authors: Guei Kore Marc Antoine 
Published: March 2021

Abstract
The paper assesses the impact of trade liberalization on the labour market by focusing on skill wage premium. The paper tests these effects by developing a monopolistic competition model with two factors of production characterized by their skill levels (skilled and unskilled labour). The paper finds that tariff’s level reductions cause a moderate increase in the wage gap. Thus, our analysis shows that a 10% decrease in tariffs is accompanied by a 16.1 % increase in the skill premium. Also, the same level of tariffs’ cut will on average increase the gender wage gap by 26.8%. The study implies that trade liberalization tends to benefit more workers in the skilled labour market compared to workers in the unskilled labour market.
Endogenous miR-21 and TIMP-1 Regulate Hepatic Injury and Fibrosis by Bile Duct Ligation in Vivo
Authors: Lee Chung-Hsin , Yang Yi-Chin , Hung Yi-Wen , Cheng Ching-Chang , Peng Yen-Chung 
Published: March 2021

Abstract
TIMP metallopeptidase inhibitor 1 (TIMP-1) has been identified as a multifunctional molecule with divergent functions. It participates in wound healing and regeneration, cell morphology and survival, tumor metastasis, angiogenesis, and inflammatory responses. An imbalance of Matrix Metalloproteinase/TIMP regulation has been implicated in several inflammatory diseases. TIMP-1 could be considered an important regulator in the process of liver fibrosis and bile duct degeneration. Thus, we aimed to determine the role of TIMP-1 in a rat model of Common Bile Duct Ligation (CBDL). Male Sprague-Dawley rats were divided into several groups, including those with/ without CBDL surgery and those with/without amiodarone or simvastatin administration. Amiodarone/simvastatin treatment was given at a daily dose of 15 mg/kg and 18 mg/kg by means of intergalactic gavage, which began 7 days prior to CBDL induction. Two weeks after surgery, the animals in each group were sacrificed and hepatocyte degeneration severity was examined using histological morphologies. Large-scale array for secretory factors is intended for the purpose of finding key functional protein after CBDL. The hepatic level of miR-21 was determined through Taqman miRNA analysis. Furthermore, the TIMP-1 level in liver tissue was also visualized by histological stain. Liver injury and fibrosis were founded in CBDL rats based upon histopathological examination and serum biochemical analysis. Hepatic miR-21 and TIMP-1 were significantly up-regulated in CBDL rats, while being slightly rescued in response to amiodarone or simvastatin treatment. Up-regulation of miR-21 and TIMP-1 may result in the progression of hepatic cirrhosis after bile duct obstruction. Drug intervention for cirrhosis, like the use of statin, may function via similar mechanisms.
Direct Cost Analysis of Patients With Brain Tumors Submitted to Microsurgical Neurosurgical Procedures - An Epidemiological and Economic Analysis in a Large Developing Country
Authors: Paiva Aline Lariessy Campos , Vitorino-Araujo João Luiz , Lovato Renan Maximilian , Costa Guilherme Henrique Ferreira da , Veiga José Carlos Esteves 
Published: March 2021

Abstract
Purpose

In low- and middle-income countries, there is a lack of data on neurosurgical costs. These data are relevant to help international cooperation, especially for huge trials. This study aims to estimate the direct cost of an adult neurooncological patient during hospital admission in the largest philanthropic hospital in Latin America.
Methods

This observational economic analysis describes the direct cost of a neurooncological patient at Santa Casa de São Paulo, Brazil. For this analysis, only adult patients with the two more common primary brain tumors were considered.
Results

Between January 2008 and December 2019 a total of 1279 charts were reviewed. 53.57% were female patients. Most patients had an age range between 56 and 65 years (22.5%). A statistically significant sample of patients with meningiomas and gliomas were analyzed. The estimated mean cost of neurosurgical hospitalization was U$ 4.166. The operating room and ICU costs represented the largest proportion of the total cost (29.24% and 24.95%, respectively). 17.5% of patients had some types of infection and 66.67% them occurred in nonelective procedures. The mortality rate was 12.7% and 92.3% occurred in emergency procedures.
Conclusions

This study evaluated the cost of oncological neurosurgical patients. The operating room was the most expensive variable, followed by the ICU hospitalization period. Surgery performed in an emergency was more associated with infections and mortality. Findings from this study could be used by stakeholders and policymakers for resource allocation and to perform economic analyses to establish the value of neurosurgery in achieving global health goals.
Stable Chronic Obstructive Pulmonary Disease (COPD) Management Under a Tiered Medical System in China
Authors: Mao Ruolin , Liu Zilong , Zhao Yunfeng , Du Chunlin , Zhou Jintao , Wang Qian , Lu Jinchang , Gao Lei , Cui Bo , Ma Yuan , Sun Tieying , Zhu Lei , Chen Zhihong 
Published: March 2021

Abstract
Background: Early diagnosis and proper management of a large number of chronic obstructive pulmonary disease (COPD) patients are great challenges for the Chinese health care system. Although tiered medical services have been promoted by the Chinese government since 2015, they have not been ideally implemented for COPD diagnosis and management.Methods: We designed a cross-sectional study. Eligible COPD patients (n=648) and physicians (n=161) were consecutively recruited from 8 hospitals in different tiers in East China. COPD characteristics and treatments were compared among hospitals in different tiers. Multivariate logistic regression was performed to identify risk factors associated with airflow limitation, symptoms and acute exacerbation.Results: The PFT rate at first diagnosis was 99%, 69.4% and 29.9% in teaching, second-tier and community hospitals (P<0.001). Only approximately 10.9%, 1.7% and 9.6% and 21.8%, 6.9% and 32% of COPD patients received influenza or pneumococcal vaccines (P<0.001). The proportion of patients who did not use inhaled drugs or had irregular inhalation was 2%, 24.6% and 78.8% (P <0.001). Education level (RR-1=-41.26%, P=0.007), FEV1%pred (RR-1=-2.76%, P<0.001), and influenza vaccination in the last year (RR-1=-64.53%, P=0.006) were all negatively correlated with COPD acute exacerbation (AE). COPD duration (RR-1=131.73%, P=0.009), AE (RR-1=151.39%, P<0.001), and COPD Assessment Test (CAT) scores (RR-1=3.82%, P=0.019) were all positively correlated with COPD airflow limitation severity. Conclusions: Differences exist in the diagnosis, treatment and management of COPD among different tiers of hospitals in East China. Teaching and second-tier hospitals can manage COPD patients relatively well. There are still some gaps compared with developed countries.
Clinical features and prognostic factors for status epilepticus in the pediatric emergency department: A retrospective study
Authors: Eun Sohyun , Kwon Hye Eun , Kim Heoung Jin , Yoon Seo Hee , Kim Moon Kyu , Kim Se Hee , Lee Joon Soo , Kim Heung Dong , Kang Hoon-Chul , koo Chungmo 
Published: March 2021

Abstract
Background: Uncontrolled seizures cause damage to all organs, especially the brain. Although there are guidelines regarding the management of status epilepticus (SE) involving motor seizures, the timing for administering first-line rescue medications (RMeds) remains unclear. Therefore, we analyzed patients with persistent SE lasting for >30 min and who visited the pediatric emergency department (pED) to determine clinical features and risk factors and provide directions for management on arrival to the pED. Methods: This study was conducted by retrospectively reviewing medical charts of patients aged 0–19 years who were diagnosed with SE accompanying motor seizures and who visited the pED between January 2010 and December 2019. After pED arrival, patients were divided into two groups, namely ≥30 min (n = 12) and <30 min (n = 13), according to the additional seizure time and receipt of the first dose of RMeds before and after 5 min.Results: Seizures lasting for <30 min were mainly observed for the etiology of idiopathic SE in the pED. Among four SE patients who needed intensive care unit (ICU) management, three had delayed administration of RMeds of more than 5 min, which was statistically significant because more hospitalizations in the ICU were observed when RMed administration was delayed. (p = 0.047). In acute symptomatic SE such as encephalitis, more than three doses of RMeds were needed to stop seizures.Conclusions: Patients with convulsive status epilepticus should receive RMeds after arrival at the pED.
Relationship Between Creatinine and Body Weight Ratio and Diabetes Mellitus in a Chinese Cohort Study
Authors: Wang Xinyu , Chen Zhuangsen , Yang Fan , Ding Xiaohan , Cao Changchun , Hu Haofei , Zou Yang 
Published: March 2021

Abstract
Background: Research on the relationship between Creatinine to Body Weight Ratios (Cre/BW ratios) and the prevalence of diabetes is still lacking. The aim of this study was to investigate the potential association between Cre/BW ratios and incident of diabetes in Chinese adults.Methods: This retrospective study was conducted in 199,526 patients from Rich Healthcare Group in China from 2010 to 2016. The participants were divided into quartiles of the Cre/BW ratios. Multivariate multiple imputation and dummy variables were used to handle missing values. Cox proportional-hazards regression was used to investigate the association of Cre/BW and diabetes. Generalized additive models(GAM) were used to identify non-linear relationships.Results: Of all participants,after handling missing values and adjustment for potential confounders, the multivariate Cox regression analysis results showed that Cre/BW ratios was inversely associated with diabetes risk( HR: 0.268; 95% CI:0.229 to 0.314, P < 0.00001).For men, the hazard ratios(HRs) of incident diabetes was 0.255(95%CI: 0.212-0.307);and for women HR= 0.297 (95%CI: 0.218-0.406).Moreover, sensitivity analysis confirmed the stability of the results. Furthermore, GAM revealed a saturation effect on the independent association between Cre/BW and incident of diabetes.Conclusions: This study demonstrated that increased Cre/BW is negatively correlated with incident of diabetes in Chinese for the first time. And we found that the relationship between Cre/BW and incident of diabetes was non-linear.
STUDY OF LOADING OF THE LOAD-BEARING STRUCTURE OF HOPPER WAGONS ON Y25 BOGIES
Authors: Fomin Oleksij , Lovska Alyona , Ivanchenko Dmytro , Zinchenko Sergii , Píštěk Václav 
Published: March 2021

To increase the efficiency of using railway transport, the possibility of using new designs of bogies, for example, Y25 under "wide gauge" wagons was considered. In order to substantiate the proposed solution, mathematical modeling of the dynamic loading of the hopper wagon Y25 bogies was carried out. A hopper wagon for the transportation of pellets and hot sinter model 20-9749 built by the State Enterprise "Ukrspetsvagon" (Ukraine) was chosen as a prototype. The simulation results showed that the use of Y25 bogies for hopper wagons allows to reduce the acceleration of its load-bearing structure, in comparison with the use of conventional 18100 bogies, by 36 %. Other performance indicators are also significantly improved.
The use of Y25 bogies for hopper wagons with actual parameters allows to reduce the acceleration of its load-bearing structure, in comparison with the use of conventional 18100 bogies, by 28 %.
The determination of the main indicators of the strength of the bearing structure of the hopper wagon Y25 bogie was carried out. The calculation was carried out in the SolidWorks Simulation software package (CosmosWorks), (France), which implements the finite element method. The calculations showed that the maximum equivalent stresses in the load-bearing structure of a hopper wagon with nominal parameters are 17 % lower than the stress acting in the load-bearing structure of a wagon on bogies 18–100 V of the load-bearing structure of a hopper wagon with actual parameters, the maximum equivalent stresses are 12 % lower per voltage in the load-bearing structure on bogies 18100.
The conducted research will help to reduce the load on the load-bearing structures of hopper wagons in operation, improve the dynamics and strength indicators, as well as their service life