bluuebunny/crossref_metadata_2025_split huggingface dataset:
Helicopter emergency medical service dispatch in older trauma: time to reconsider the trigger?
Authors:   on behalf of Air Ambulance Kent Surrey Sussex, Griggs J. E. , Barrett J. W. , ter Avest E. , de Coverly R. , Nelson M. , Williams J. , Lyon R. M. 
Published: May 2021

Abstract
Background
Helicopter Emergency Medical Services (HEMS) respond to serious trauma and medical emergencies. Geographical disparity and the regionalisation of trauma systems can complicate accurate HEMS dispatch. We sought to evaluate HEMS dispatch sensitivity in older trauma patients by analysing critical care interventions and conveyance in a well-established trauma system.

Methods
All trauma patients aged ≥65 years that were attended by the Air Ambulance Kent Surrey Sussex over a 6-year period from 1 July 2013 to 30 June 2019 were included. Patient characteristics, critical care interventions and hospital disposition were stratified by dispatch type (immediate, interrogate and crew request).

Results
1321 trauma patients aged ≥65 were included. Median age was 75 years [IQR 69–89]. HEMS dispatch was by immediate (32.0%), interrogation (43.5%) and at the request of ambulance clinicians (24.5%). Older age was associated with a longer dispatch interval and was significantly longer in the crew request category (37 min [34–39]) compared to immediate dispatch (6 min [5–6] (p = .001). Dispatch by crew request was common in patients with falls < 2 m, whereas pedestrian road traffic collisions and falls > 2 m more often resulted in immediate dispatch (p = .001). Immediate dispatch to isolated head injured patients often resulted in pre-hospital emergency anaesthesia (PHEA) (39%). However, over a third of head injured patients attended after dispatch by crew request received PHEA (36%) and a large proportion were triaged to major trauma centres (69%).

Conclusions
Many patients who do not fulfil the criteria for immediate HEMS dispatch need advanced clinical interventions and subsequent tertiary level care at a major trauma centre. Further studies should evaluate if HEMS activation criteria, nuanced by age-dependant triggers for mechanism and physiological parameters, optimise dispatch sensitivity and HEMS utilisation.
Parascaris spp. eggs in horses of Italy: a large-scale epidemiological analysis of the egg excretion and conditioning factors
Authors: Scala Antonio , Tamponi Claudia , Sanna Giuliana , Predieri Giulio , Meloni Luisa , Knoll Stephane , Sedda Giampietro , Dessì Giorgia , Cappai Maria Grazia , Varcasia Antonio 
Published: May 2021

Abstract
Background
Equine ascariosis, caused by Parascaris spp., is a worldwide endoparasitic disease affecting young horses in particular. Despite the great number of horses reared in Italy, large-scale epidemiological surveys dealing with ascariosis prevalence in the country are not reported in the current literature. For this reason, the present survey aims to describe, for the first time, the spread and infestation of Parascaris spp. in a large population of Italian horses (6896 animals) using faecal egg counts, and further to identify risk factors associated with ascarid egg shedding.

Methods
Individual rectal faecal samples collected during routine veterinary examinations were used and Parascaris spp. prevalence was tested against the animal’s age, sex, housing conditions, geographic provenance as well as the respective sampling season.

Results
Among the examined stables, 35.8% showed at least one horse to be positive for Parascaris spp. eggs and an overall prevalence of 6.3% was found. Ascariosis rates tended to decrease significantly with age and, proportionally, 80.0% of the recorded Parascaris spp. eggs were found in 0.7% of the examined animals. Statistically significant differences among prevalence rates were found between the different geographic areas of provenance and prevalence was found to be higher in horses reared outdoors compared to those raised indoors. Analysis of data based on sex and season did not show any significant differences. Despite the lower prevalence found compared to other European countries, ascariosis was concluded to represent a significant health challenge for horses reared in Italy, especially foals. Age (foals and yearlings) and outdoor rearing were identified to be significant risk factors for Parascaris spp. egg shedding. Furthermore, the relevance of the infected horses over 6 years of age should not be underestimated as these represent a significant source of contamination for younger animals.

Conclusions
The development of improved treatment protocols based on regular faecal examination combined with follow-up assessment of the efficacy of integrated action plans would prove beneficial in regard to animal health and anthelmintic resistance reduction in the field.

Graphical Abstract
Using historical data to facilitate clinical prevention trials in Alzheimer disease? An analysis of longitudinal MCI (mild cognitive impairment) data sets
Authors: Berres Manfred , Monsch Andreas U. , Spiegel René 
Published: May 2021

Abstract
Background
The Placebo Group Simulation Approach (PGSA) aims at partially replacing randomized placebo-controlled trials (RPCTs), making use of data from historical control groups in order to decrease the needed number of study participants exposed to lengthy placebo treatment. PGSA algorithms to create virtual control groups were originally derived from mild cognitive impairment (MCI) data of the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database. To produce more generalizable algorithms, we aimed to compile five different MCI databases in a heuristic manner to create a “standard control algorithm” for use in future clinical trials.

Methods
We compared data from two North American cohort studies (n=395 and 4328, respectively), one company-sponsored international clinical drug trial (n=831) and two convenience patient samples, one from Germany (n=726), and one from Switzerland (n=1558).

Results
Despite differences between the five MCI samples regarding inclusion and exclusion criteria, their baseline demographic and cognitive performance data varied less than expected. However, the five samples differed markedly with regard to their subsequent cognitive performance and clinical development: (1) MCI patients from the drug trial did not deteriorate on verbal fluency over 3 years, whereas patients in the other samples did; (2) relatively few patients from the drug trial progressed from MCI to dementia (about 10% after 4 years), in contrast to the other four samples with progression rates over 30%.

Conclusion
Conventional MCI criteria were insufficient to allow for the creation of well-defined and internationally comparable samples of MCI patients. More recently published criteria for MCI or “MCI due to AD” are unlikely to remedy this situation. The Alzheimer scientific community needs to agree on a standard set of neuropsychological tests including appropriate selection criteria to make MCI a scientifically more useful concept. Patient data from different sources would then be comparable, and the scientific merits of algorithm-based study designs such as the PGSA could be properly assessed.
Flumazenil therapy for a gabapentin-induced coma: a case report
Authors: Masciullo M. , Pichiorri F. , Scivoletto G. , Foti C. , Molinari M. 
Published: May 2021

Abstract
Background
Spasticity and neuropathic pain are common in patients after spinal cord injury and negatively affect patients’ quality of life. Gabapentin and baclofen are frequently used to treat these conditions. We present a flumazenil-reversed gabapentin-induced coma case, which, to our knowledge, is the second one described in scientific literature.

Case presentation
A 70-year-old Caucasian man was admitted to our neurorehabilitation ward following a fall with cervical trauma that resulted in immediate tetraplegia. During his stay, he suffered from lower limb pain, both neuropathic and due to severe spasticity. Gradual baclofen and gabapentin administration was prescribed, with reduction in both pain and spasticity. One morning, the patient was found unresponsive, with a Glasgow Coma Score of 3. Head computerized tomography, electrocardiogram, electroencephalogram, vital signs, blood tests, breathing, and blood oxygenation were normal. Renal and liver failure were ruled out. Intravenous 0.25 mg of flumazenil (Anexate) was administered, resulting in complete neurocognitive recovery with a Glasgow Coma Score of 15.

Discussion and conclusions
This case report highlights the importance of the individual response to certain pharmacological agents and suggests that further studies need to be conducted both on flumazenil and gabapentin pharmacodynamics to better understand their molecular–receptor activity, and on possible multiple flumazenil mechanisms of action, beyond its classical strict benzodiazepine antagonist action.
Advanced gastric cancer with abdominal wall invasion treated with curative resection after chemotherapy: a case report
Authors: Nakamura Naohiko , Kinami Shinichi , Fujita Jun , Kaida Daisuke , Tomita Yasuto , Miyata Takashi , Fujita Hideto , Ueda Nobuhiko , Takamura Hiroyuki 
Published: May 2021

Abstract
Introduction
In patients with gastric cancer, 6–27% of patients are diagnosed with T4b disease that invades adjacent organs, and curative resection can improve the prognosis of these patients.

Case presentation
A 70-year-old Japanese man presented with an abdominal tumor and was diagnosed with advanced gastric cancer (L-Circ type 3 T4b N2 M0 H0 stage IVA, based on the 15th edition of the Japanese Classification of Gastric Carcinoma) with extensive abdominal wall invasion. We performed open gastrojejunal bypass for gastric obstruction and initiated a chemotherapeutic regimen comprising S-1 (120 mg/day) and oxaliplatin (100 mg/m2). Upper gastrointestinal endoscopy performed after the administration of six courses of the S-1 and oxaliplatin regimen revealed a persistent primary lower gastric wall lesion; however, the diameter of the abdominal wall invasion and metastatic lymph nodes was significantly reduced, in addition to decreased serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels. Subsequently, the patient underwent distal gastrectomy with D2 lymphadenectomy combined with transverse colon and abdominal wall resection. We performed radical en bloc resection and achieved a tumor-free resection margin. Simple abdominal wall closure was performed without mesh or musculocutaneous flap placement. Histopathological examination of the resected tumor specimen showed direct invasion of the mesocolon and rectus abdominis muscle. The patient was postoperatively diagnosed with L Gre-Ant type5 T4b (SI: rectus abdominis muscle) N2 PM0 DM0 Stage IIIA R0 Grade 2a gastric cancer based on histopathological findings and received S-1 as adjuvant chemotherapy, 2 months postoperatively. No recurrence was detected 6 months postoperatively.

Conclusions
We report a case of advanced gastric cancer with extensive abdominal wall invasion that was successfully treated with gastrectomy combined with resection of adjacent organs showing tumor invasion after effective systemic chemotherapy. A therapeutic approach comprising curative surgery combined with perioperative chemotherapy is useful in patients with T4b gastric cancer.
A secure and privacy-preserving authentication protocol for wireless sensor networks in smart city
Authors: Xie Qi , Li Keheng , Tan Xiao , Han Lidong , Tang Wen , Hu Bin 
Published: May 2021

AbstractSmart city can improve the efficiency of managing assets and resources, optimize urban services and improve the quality of citizens’ life. Wireless sensor networks (WSNs) can solve many problems in smart city, such as smart transportation, smart healthcare and smart energy. However, security and privacy are the biggest challenges for WSN. Recently, Banerjee et al. proposed a security-enhanced authentication and key agreement scheme for WSN, but their scheme cannot resist offline password guessing attack, impersonation attack, and does not achieve session key secrecy, identity unlinkability, and perfect forward secrecy. In order to fix these flaws, a secure and privacy-preserving authentication protocol for WSN in smart city is proposed. We prove the security of the proposed protocol by using applied pi calculus-based formal verification tool ProVerif and show that it has high computational efficiency by comparison with some related schemes.
Illness perceptions of adults with eczematous skin diseases: a systematic mixed studies review
Authors: Rocholl Marc , Ludewig Michaela , Brakemeier Carola , John Swen Malte , Wilke Annika 
Published: May 2021

AbstractBackgroundEczematous skin diseases, e.g., atopic dermatitis or contact dermatitis, are associated with a high disease burden, a significant impact on quality of life and a higher risk for anxiety and depression. Therefore, coping strategies are of interest. In order to understand coping processes, it is necessary to examine the patients’ perspectives on their illness. The aim of this systematic mixed studies review is to investigate the illness perceptions of patients with eczematous skin diseases to get a better understanding of their coping processes.MethodsWe performed a systematic literature search in PubMed, The Cochrane Library, PsycInfo, PSYNDEX, CINAHL, Web of Science, and Scopus until February 20, 2019. Both qualitative and quantitative studies were included in the review. Two independent reviewers conducted data extraction and carried out a narrative synthesis. We assessed study quality with the Mixed Methods Appraisal Tool.ResultsThree qualitative and four quantitative studies were included in the systematic review. We found different methodological approaches for investigating illness perceptions: guided interviews, focus group interviews as well as standardized questionnaires, e.g., the Brief Illness Perception Questionnaire. All studies report suspected causes of the skin disease, such as endogenous and exogenous causes (namely, psychological or occupational factors). We found long timeline beliefs as well as various perceived and experienced social, economic, and psychological consequences. Our analysis reveals complex emotional representations in patients with eczematous skin diseases, in particular impairment of emotional well-being, and feelings of shame or helplessness. Qualitative and quantitative data were predominantly complementary and convergent.ConclusionPatients with eczematous skin diseases have complex illness representations regarding their disease. These representations interrelate with the coping behavior of patients. Therefore, medical professionals should consider them for counseling and treatment.Systematic review registrationPROSPERO 2018CRD42018109217.
A new class of nonlinear Gronwall–Bellman delay integral inequalities with power and its applications
Authors: Fang Bo , Liu Yujiao , Xu Run 
Published: May 2021

AbstractIn this paper, we establish some new delay Gronwall–Bellman integral inequalities with power, which can be used as a convenient tool to study the qualitative properties of solutions to differential and integral equations. We also give some examples to illustrate the application of our results to obtain the estimation for the solution of the integral and differential equations.
Detecting anxiety and depression among people with limited literacy living with chronic low back pain in Nigeria: adaptation and validation of the hospital anxiety and depression scale
Authors: Igwesi-Chidobe Chinonso Nwamaka , Muomah Rosemary C. , Sorinola Isaac Olubunmi , Godfrey Emma Louise 
Published: May 2021

Abstract
Background
The Hospital Anxiety and Depression Scale (HADS) is one of the most popular measures of anxiety and depression. The original HADS is mostly used in Nigeria precluding people with limited literacy. This study aimed to cross-culturally adapt and psychometrically test the HADS for rural and urban Nigerian Igbo populations with chronic low back pain (CLBP) who have limited literacy.

Methods
The HADS was forward translated, back translated, and appraised. Face and content validity was ensured by pre-testing the translated measure among a convenience sample of twelve rural Nigerian dwellers with CLBP. Reliability utilising Cronbach’s alpha, intraclass correlation coefficient, Bland–Altman plots and minimal detectable change were investigated amongst a convenience sample of 50 people living with CLBP in rural and urban Nigerian communities. Construct validity testing involving correlations between Igbo-HADS and Roland Morris Disability Questionnaire measuring self-reported back pain-specific disability, World Health Organisation Disability Assessment Schedule assessing generic self-reported disability, Fear Avoidance Beliefs Questionnaire measuring fear avoidance beliefs, and eleven-point box scale assessing pain intensity, and exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) among a random sample of 200 adults with CLBP in rural Nigerian communities were conducted.

Results
Idioms and colloquialisms were difficult to adapt. Internal consistency was good (α = 0.78) and acceptable (α = 0.67) for anxiety and depression subscales respectively. Intraclass correlation coefficients were very good (ICC ≃ 0.8) for both subscales. Minimal detectable change was 6.23 and 5.06 for anxiety and depression subscales respectively. The Igbo-HADS and the anxiety subscale had strong correlations (≃ 0.7) with generic self-reported disability; moderate correlations (≃ 0.5–0.6) with pain intensity, self-reported back pain-specific disability, and fear avoidance beliefs. The depression subscale had the lowest correlations (≃ 0.3–0.4) with these outcomes. The EFA produced a two-factor structure with cross-loading of items. The CFA showed poor fit indices for the EFA structure, the original two-factor structure, and one-factor structure.

Conclusion
The HADS may not be suitable for assessing anxiety and depression, or emotional distress in this population due to difficulty achieving cross-cultural equivalence with western idioms; and the expression of emotional distress through somatisation in this culture.
Deconstructing leisure time and workload: case of women bean producers in Kenya
Authors: Nchanji Eileen Bogweh , Mutua Mercy , Odhiambo Collins , Nchanji Yvonne Kiki , Karanja David 
Published: May 2021

Abstract
Background
The notion of leisure became pronounced more than 20 years ago when women who worked on or out of the farm came home to a “second shift,” which entailed domestic work and childcare. This gap continues today not only between men and women but also among women and men. Women's challenges in terms of their leisure arise out of or are shaped by social norms and different life contexts.

Method
The Women's Empowerment in Agriculture Index (WEAI) was conducted to understand women's empowerment and disempowerment status in agricultural activities in five counties in Kenya in 2017. In 2019, focus group discussions were carried out in two of the five counties to understand how men and women farmers define leisure and assess the leisure gap and its effect on women's farm and household activities. We were also interested in understanding how men's and women's workload affects leisure and other productive economic activities, resulting in empowerment and how women’s unpaid work contributes to income poverty.

Result
The WEAI showed that 28% of disempowerment (5DE) in women farmers is due to lack of time for leisure activities and 18% from being overworked. This means that the time indicator accounts for 46% of disempowerment in Kenyan women bean farmers. Men in Bomet and Narok spent more time than women in raising large livestock and leisure. Women in Bomet spent more time than men in cooking and domestic work (fetching water and collecting fuelwood), while men in Bomet spent more time than women in managing their businesses.

Conclusion
Work overload is a constraining factor to women's empowerment in bean production and agricultural productivity. What is considered leisure for men and women is embedded in society’s social fabrics, and it is contextual. This paper highlights instances where leisure provides a way for women to embody and/or resist the discourses of gender roles in the bean value chain and households to enhance food security and health.
Coronavirus disease 2019 outbreak in Beijing’s Xinfadi Market, China: a modeling study to inform future resurgence response
Authors: Wang Xiao-Li , Lin Xin , Yang Peng , Wu Zun-You , Li Gang , McGoogan Jennifer M. , Jiao Zeng-Tao , He Xin-Jun , Li Si-Qi , Shi Hong-Hao , Wang Jing-Yuan , Lai Sheng-Jie , Huang Chun , Wang Quan-Yi 
Published: May 2021

Abstract
Background
A local coronavirus disease 2019 (COVID-19) case confirmed on June 11, 2020 triggered an outbreak in Beijing, China after 56 consecutive days without a newly confirmed case. Non-pharmaceutical interventions (NPIs) were used to contain the source in Xinfadi (XFD) market. To rapidly control the outbreak, both traditional and newly introduced NPIs including large-scale management of high-risk populations and expanded severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR-based screening in the general population were conducted in Beijing. We aimed to assess the effectiveness of the response to the COVID-19 outbreak in Beijing’s XFD market and inform future response efforts of resurgence across regions.

Methods
A modified susceptible–exposed–infectious–recovered (SEIR) model was developed and applied to evaluate a range of different scenarios from the public health perspective. Two outcomes were measured: magnitude of transmission (i.e., number of cases in the outbreak) and endpoint of transmission (i.e., date of containment). The outcomes of scenario evaluations were presented relative to the reality case (i.e., 368 cases in 34 days) with 95% Confidence Interval (CI).

Results
Our results indicated that a 3 to 14 day delay in the identification of XFD as the infection source and initiation of NPIs would have caused a 3 to 28-fold increase in total case number (31–77 day delay in containment). A failure to implement the quarantine scheme employed in the XFD outbreak for defined key population would have caused a fivefold greater number of cases (73 day delay in containment). Similarly, failure to implement the quarantine plan executed in the XFD outbreak for close contacts would have caused twofold greater transmission (44 day delay in containment). Finally, failure to implement expanded nucleic acid screening in the general population would have yielded 1.6-fold greater transmission and a 32 day delay to containment.

Conclusions
This study informs new evidence that in form the selection of NPI to use as countermeasures in response to a COVID-19 outbreak and optimal timing of their implementation. The evidence provided by this study should inform responses to future outbreaks of COVID-19 and future infectious disease outbreak preparedness efforts in China and elsewhere.

Graphical abstract