bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of treatment applied in sepsis on intensive care unit and hospital stay: how effective are albumin/steroid/vasopressor agents?
Authors: Kayaalti Selda , Kayaalti Ömer 
Published: February 2021

Abstract
Background
The incidence and prevalence of sepsis have increased in recent years and it is the most common cause of intensive care admission. The aim of this study was to determine the effects of albumin, steroid, and vasopressor agents and other possible factors on the duration of intensive care unit and hospital stay in sepsis patients. Open access data set obtained from Tohoku Sepsis Registry database was used. Four hundred sixty-two patients admitted to intensive care unit with the diagnosis of sepsis were divided into four groups according to their intensive care unit (≤ 5 or > 5 days) and hospital length of stay (≤ 24 or > 24 days). Demographic data, vital signs, laboratory values, mechanical ventilation requirement, and treatment protocols such as albumin, steroid, and vasopressor agent use were used in the evaluation of the groups.

Results
The use of albumin (odds ratio [OR] = 3.76 [95% confidence interval (CI), 2.16–6.56]; p < 0.001), steroids (OR = 2.85 [95% CI, 1.67–4.86]; p < 0.001), and vasopressor agents (OR = 3.56 [95% CI, 2.42–5.24]; p < 0.001) were associated with an increasing risk of prolonged intensive care unit length of stay. Also, it was found that the use of albumin (OR = 3.43 [95% CI, 2.00–5.89]; p < 0.001), steroids (OR = 2.81 [95% CI, 1.66–4.78]; p < 0.001), and vasopressor agents (OR = 4.47 [95% CI, 3.02–6.62]; p < 0.001) were associated with an increasing risk of prolonged hospital length of stay. In addition, prognostic scoring systems, body temperature, mean arterial pressure, pH, PaO2/FiO2 ratio, and mechanical ventilation requirement in the first 24 h were also found to be associated with length of stay in intensive care unit and hospital. There was a significant relationship between platelet count, creatinine, Na, lactic acid, and time between diagnosis of sepsis and source control and intensive care unit length of stay, and between hematocrit and C-reactive protein and hospital length of stay.

Conclusions
The use of albumin, steroid, and vasopressor agents has been found to be significantly correlated with both intensive care unit and hospital length of stay. Further studies are needed to determine in what order or at what dosage these agents will be administered in sepsis treatment.
Application of amphoteric polymers in the process of leather post-tanning
Authors: Wang Xuechuan , Sun Siwei , Zhu Xing , Guo Peiying , Liu Xinhua , Liu Chunlin , Lei Meng 
Published: February 2021

Abstract
With the characteristics of controllable charge and environmental friendliness, amphoteric polymers can be used in post-tanning process to solve the problems that arise during leather making and are caused by the low absorption rate of single-charge chemicals, incompatibility with new tanning methods, and complex operation process. In this review, the structure, performance, and preparation of amphoteric polymers are reported. Then, the charge change of collagen during different tanning and pH treatments is introduced. Finally, the application and development of amphoteric polymers during the post-tanning process of leather making are discussed. This review has certain guiding significance to the preparation and application of amphoteric polymers for tanning system.

Graphical abstract
Is there a role for casein phosphopeptide–amorphous calcium phosphate (cpp-acp) in paediatric dentistry?
Authors: Warner Claire , Rogers Helen J 
Published: February 2021

In the age of minimally invasive dentistry, products with the ability to prevent and reverse common dental diseases are becoming increasingly popular. Casein phosphopeptide–amorphous calcium phosphate (CPP–ACP) contains the compounds casein, phosphate and calcium, which all have the ability to remineralize enamel. Dental caries, visible demineralization following removal of orthodontic appliances, non-carious tooth surface loss and dentine hypersensitivity due to structural anomalies are frequently seen in children and young people. The evidence for CPP–ACP and fluoride-containing CPP–ACP is positive for managing dental caries and non-carious tooth surface loss, specifically erosion, but is less clear in the management of visible demineralization following orthodontic appliance removal and dentine hypersensitivity owing to structural anomalies. When recommending CPP–ACP-containing products, dental practitioners should be aware of medical and social contra-indications that preclude its use. CPD/Clinical Relevance: CPP–ACP may have a role in the management of common paediatric dental conditions.
Traumatic ulcers with a hidden cause: A case report
Authors: Chana Pavneet , Ion Daniela 
Published: February 2021

Oral ulceration is a common condition that can affect the oral mucosa, and patients often present in both primary and secondary care. There are a number of causes of oral ulceration, ranging from trauma to malignancy. The cause of the oral ulceration can be difficult to establish, especially when the history and investigations do not support an obvious cause. We report a case of a 19-year-old male who presented with a 2-month history of worsening oral ulceration. Despite further questioning and investigations, the cause of the oral ulceration remained elusive. CPD/Clinical Relevance: To understand the clinical presentation and causes of oral ulceration.
Comparative dental analysis: should dentists release dental records?
Authors: Sallis Claire , Mânica Scheila 
Published: February 2021

Comparative dental analysis is the main role of a UK forensic dentist. It is undertaken to determine whether postmortem findings are in agreement with the provided antemortem data for an individual, in order to achieve a positive identification. It requires dentists to maintain accurate dental records and, when a confirmatory identification is required, to breach their confidentiality obligations to their patients. Several different dental records can prove helpful during the process, which are outlined in a novel checklist designed to guide both practitioners and law enforcement officers. It is supported by the UK Missing Persons Unit and the British Association of Forensic Odontology (BAFO) and is available to download in a PDF format from dentalidrecordchecklist.com. CPD/Clinical Relevance: All dental practitioners should be aware of forensic dentistry as a specialism and how they may be required to help during a human identification. Understanding the principles of comparative dental analysis should be attained, thus recognizing the importance of releasing dental records, preventing delays and uncertainty around breaching confidentiality obligations.
Fracture of the maxillary tuberosity: Troubleshooting in general dental practice and a proposed fracture classification
Authors: Wright Fiona , Ritchie Colin , Malden Nicholas J , Besi Eleni 
Published: February 2021

A tuberosity fracture can prevent or delay the timely delivery of the most appropriate treatment option for a maxillary molar. This is a relatively common complication, but should not prevent treatment in general practice provided the clinician has adequately risk assessed, planned and obtained informed consent. Should a fracture occur, its initial management in general practice is encouraged. This article aims to improve patient outcomes by providing a troubleshooting guide. A fracture classification is suggested to aid assessment, recognition and management. Should referral to secondary care be required, a classification system will provide a basis for discussion and clarity on further management.CPD/Clinical Relevance: This article provides a tuberosity fracture classification to guide clinicians in the management of patients who have sustained such a fracture.
Significant inefficiency in running community health systems: The case of health posts in Southwest Ethiopia
Authors: Yitbarek Kiddus , Abraham Gelila , Berhane Melkamu , Hurlburt Sarah , Mann Carlyn , Adamu Ayinengida , Tsega Gebeyehu , Woldie Mirkuzie 
Published: February 2021

BackgroundAlthough much has been documented about the performance of the health extension program, there is a lack of information on how efficiently the program is running. Furthermore, the rising cost of health services and the absence of competition among publicly owned health facilities demands strong follow up of efficiency. Therefore, this study aimed to assess the technical efficiency of the health posts and determinants in Southwestern Ethiopia.Methods and materialsWe used data for one Ethiopian fiscal year (from July 2016 to June 2017) to estimate the technical efficiency of health posts. A total of 66 health posts were included in the analysis. We employed a two-stage data envelopment analysis to estimate technical efficiency. At the first stage, technical efficiency scores were calculated using data envelopment analysis program version 2.1. Predictors of technical efficiency were then identified at the second stage using Tobit regression, with STATA version 14.ResultsThe findings revealed that 21.2% were technically efficient with a mean technical efficiency score of 0.6 (± 0.3), indicating that health posts could increase their service volume by 36% with no change made to the inputs they received. On the other hand, health posts had an average scale efficiency score of 0.8 (± 0.2) implying that the facilities have the potential to increase service volume by 16% with the existing resources. The regression model has indicated average waiting time for service has negatively affected technical efficiency.ConclusionMore than three-quarters of health posts were found inefficient. The technical efficiency score of more than one-third of the health posts is even less than 50%. Community mobilization to enhance the uptake of health services at the health posts coupled with a possible reallocation of resources in less efficient health posts is a possible approach to improve the efficiency of the program.
Adult mice are unresponsive to AAV8-Gremlin1 gene therapy targeting the liver
Authors: Khatib Shahidi Roxana , M. Hoffmann Jenny , Hedjazifar Shahram , Bonnet Laurianne , K. Baboota Ritesh , Heasman Stephanie , Church Christopher , Elias Ivet , Bosch Fatima , Boucher Jeremie , Hammarstedt Ann , Smith Ulf 
Published: February 2021

Objective
Gremlin 1 (GREM1) is a secreted BMP2/4 inhibitor which regulates commitment and differentiation of human adipose precursor cells and prevents the browning effect of BMP4. GREM1 is an insulin antagonist and serum levels are high in type 2 diabetes (T2D). We here examined in vivo effects of AAV8 (Adeno-Associated Viral vectors of serotype eight) GREM 1 targeting the liver in mature mice to increase its systemic secretion and also, in a separate study, injected recombinant GREM 1 intraperitoneally. The objective was to characterize systemic effects of GREM 1 on insulin sensitivity, glucose tolerance, body weight, adipose cell browning and other local tissue effects.

Methods
Adult mice were injected with AAV8 vectors expressing GREM1 in the liver or receiving regular intra-peritoneal injections of recombinant GREM1 protein. The mice were fed with a low fat or high fat diet (HFD) and followed over time.

Results
Liver-targeted AAV8-GREM1 did not alter body weight, whole-body glucose and insulin tolerance, or adipose tissue gene expression. Although GREM1 protein accumulated in liver cells, GREM1 serum levels were not increased suggesting that it may not have been normally processed for secretion. Hepatic lipid accumulation, inflammation and fibrosis were also not changed. Repeated intraperitoneal rec-GREM1 injections for 5 weeks were also without effects on body weight and insulin sensitivity. UCP1 was slightly but significantly reduced in both white and brown adipose tissue but this was not of sufficient magnitude to alter body weight. We validated that recombinant GREM1 inhibited BMP4-induced pSMAD1/5/9 in murine cells in vitro, but saw no direct inhibitory effect on insulin signalling and pAkt (ser 473 and thr 308) activation.

Conclusion
GREM1 accumulates intracellularly when overexpressed in the liver cells of mature mice and is apparently not normally processed/secreted. However, also repeated intraperitoneal injections were without effects on body weight and insulin sensitivity and adipose tissue UCP1 levels were only marginally reduced. These results suggest that mature mice do not readily respond to GREMLIN 1 but treatment of murine cells with GREMLIN 1 protein in vitro validated its inhibitory effect on BMP4 signalling while insulin signalling was not altered.
The role of quantitative diffusion-weighted imaging in characterization of hypovascular liver lesions: A prospective comparison of intravoxel incoherent motion derived parameters and apparent diffusion coefficient
Authors: Kovač Jelena Djokić , Daković Marko , Janković Aleksandra , Mitrović Milica , Dugalić Vladimir , Galun Daniel , Đurić-Stefanović Aleksandra , Mašulović Dragan 
Published: February 2021

Background
The utility of intravoxel incoherent motion (IVIM) related parameters in differentiation of hypovascular liver lesions is still unknown.

Purpose
The purpose of this study was to evaluate the value of IVIM related parameters in comparison to apparent diffusion coefficient (ADC) for differentiation among intrahepatic mass-forming cholangiocarcinoma (IMC), and hypovascular liver metastases (HLM).

Methods
Seventy-four prospectively enrolled patients (21 IMC, and 53 HLM) underwent 1.5T magnetic resonance examination with IVIM diffusion-weighted imaging using seven b values (0–800 s/mm2). Two independent readers performed quantitative analysis of IVIM-related parameters and ADC. Interobserver reliability was tested using a intraclass correlation coefficient. ADC, true diffusion coefficient (D), perfusion-related diffusion coefficient (D*), and perfusion fraction (ƒ) were compared among the lesions using Kruskal-Wallis H test. The diagnostic accuracy of each parameter was assessed by receiver operating characteristic (ROC) curve analysis.

Results
The interobserver agreement was good for ADC (0.802), and excellent for D, D*, and ƒ (0.911, 0.927, and 0.942, respectively). ADC, and D values were significantly different among IMC and HLM (both p < 0.05), while there was no significant difference among these lesions for ƒ and D* (p = 0.101, and p = 0.612, respectively). ROC analysis showed higher diagnostic performance of D in comparison to ADC (AUC = 0.879 vs 0.821).

Conclusion
IVIM-derived parameters in particular D, in addition to ADC, could help in differentiation between most common hypovascular malignant liver lesions, intrahepatic mass—forming cholangiocarcinoma and hypovascular liver metastases.
Predictors of sexual violence among female students in higher education institutions in Ethiopia: A systematic review and meta-analysis
Authors: Kefale Bereket , Yalew Melaku , Damtie Yitayish , Arefaynie Mastewal , Adane Bezawit 
Published: February 2021

Background
Sexual violence is a profound social and public health problem in Ethiopia. Female students in institutions of higher education are highly vulnerable to sexual violence. Different studies conducted on sexual violence at higher education institutions lack consistency and inclusiveness. Thus, this systematic review and meta-analysis were conducted to estimate the lifetime and twelve-month prevalence, and predictors of sexual violence among female students in institutions of higher education in Ethiopia.

Methods
This study used a systematic review and meta-analysis of studies conducted from January 1, 2000, to June 1, 2020, in Ethiopia. This review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Electronic databases including PubMed, Cochrane Library, Hinari, Google Scholar, CINAHL, and Global Health were searched using relevant search terms. Meta-analysis was performed using STATA 14 software. The I2 statistics and Egger’s test were used to assess heterogeneity and publication bias, respectively. Forest plots were used to present the prevalence and odds ratio (OR) with a 95% confidence interval (CI).

Results
This systematic review and meta-analysis included 10 studies, 5790 study participants. The pooled lifetime and twelve-month prevalence of sexual violence among female students in Ethiopia was 49.4% (95%CI: 37.87, 60.96) and 36.02% (95%CI: 26.42, 45.62) respectively. Rural residence (OR = 2.13;95%CI: 1.33, 3.42), alcohol drinking (OR = 2.03; 95%CI: 1.44, 2.87), and ever had a boyfriend (OR = 2.07; 95%CI: 1.32, 3.62) were factors associated with sexual violence.

Conclusions
The lifetime prevalence of sexual violence among female students in institutions of higher education in Ethiopia was high. Place of residence, alcohol drinking, and ever had a boyfriend were statistically significant factors of sexual violence. Life skill training and law enforcement are needed to control alcohol consumption. Additionally, more focused interventions should be done in rural settings.

Registration
This systematic review has been registered in the International Prospective Registry of Systematic Review (PROSPERO) with a specific registration number CRD42020155894.
Context-sensitive smart glasses monitoring wear position and activity for therapy compliance—A proof of concept
Authors: Januschowski Kai , Ihmig Frank R. , Koch Timo , Velten Thomas , Rickmann Annekatrin 
Published: February 2021

Purpose
To improve the acceptance and compliance of treatment of amblyopia, the aim of this study was to show that it is feasible to design an electronic frame for context-sensitive liquid crystal glasses, which can measure the state of wear position in a robust manner and detect distinct motion patterns for activity recognition.

Methods
Different temple designs with integrated temperature and capacitive sensors were developed to realize the detection of the state of wear position to distinguish three states (correct position/wrong position/glasses taken off). The electronic glasses frame was further designed as a tool for accelerometer data acquisition, which was used for algorithm development for activity classification. For this purpose, training data of 20 voluntary healthy adult subjects (5 females, 15 males) were recorded and a 10-fold cross-validation was computed for classifier selection. In order to perform functional testing of the electronic glasses frame, a proof of concept study was performed in a small group of healthy adults. Four healthy adult subjects (2 females, 2 males) were included to wear the electronic glasses frame and to protocol their activities in their everyday life according to a defined test protocol. Individual and averaged results for the precision of the state of wear position detection and of the activity recognition were calculated.

Results
Context-sensitive control algorithms were developed which detected the state of wear position and activity in a proof of concept. The pilot study revealed an average of 91.4% agreement of the detected states of wear position. The activity recognition match was 82.2% when applying an additional filter criterion. Removing the glasses was always detected 100% correctly.

Conclusion
The principles investigated are suitable for detecting the glasses’ state of wear position and for recognizing the wearer´s activity in a smart glasses concept.
Healthcare workers hospitalized due to COVID-19 have no higher risk of death than general population. Data from the Spanish SEMI-COVID-19 Registry
Authors: Díez-Manglano Jesús , Solís-Marquínez Marta Nataya , Álvarez García Andrea , Alcalá-Rivera Nicolás , Maderuelo Riesco Irene , Gericó Aseguinolaza Martín , Beato Pérez José Luis , Méndez Bailón Manuel , Labirua-Iturburu Ruiz Ane-Elbire , García Gómez Miriam , Martínez Cilleros Carmen , Pesqueira Fontan Paula María , Abella Vázquez Lucy , Blázquez Encinar Julio César , Boixeda Ramon , Gil Sánchez Ricardo , de la Peña Fernández Andrés , Loureiro Amigo José , Escobar Sevilla Joaquín , Guzmán Garcia Marcos , Martín Escalante María Dolores , Magallanes Gamboa Jeffrey Oskar , Martínez González Ángel Luis , Lumbreras Bermejo Carlos , Antón Santos Juan Miguel ,   for the SEMI-COVID-19 Network
Published: February 2021

Aim
To determine whether healthcare workers (HCW) hospitalized in Spain due to COVID-19 have a worse prognosis than non-healthcare workers (NHCW).

Methods
Observational cohort study based on the SEMI-COVID-19 Registry, a nationwide registry that collects sociodemographic, clinical, laboratory, and treatment data on patients hospitalised with COVID-19 in Spain. Patients aged 20–65 years were selected. A multivariate logistic regression model was performed to identify factors associated with mortality.

Results
As of 22 May 2020, 4393 patients were included, of whom 419 (9.5%) were HCW. Median (interquartile range) age of HCW was 52 (15) years and 62.4% were women. Prevalence of comorbidities and severe radiological findings upon admission were less frequent in HCW. There were no difference in need of respiratory support and admission to intensive care unit, but occurrence of sepsis and in-hospital mortality was lower in HCW (1.7% vs. 3.9%; p = 0.024 and 0.7% vs. 4.8%; p<0.001 respectively). Age, male sex and comorbidity, were independently associated with higher in-hospital mortality and healthcare working with lower mortality (OR 0.211, 95%CI 0.067–0.667, p = 0.008). 30-days survival was higher in HCW (0.968 vs. 0.851 p<0.001).

Conclusions
Hospitalized COVID-19 HCW had fewer comorbidities and a better prognosis than NHCW. Our results suggest that professional exposure to COVID-19 in HCW does not carry more clinical severity nor mortality.
Factors associated with registration for organ donation among clinical nurses
Authors: Weng Li-Chueh , Chiang Yang-Jen , Huang Hsiu-Li , Tsai Yu-Hsia , Chen Kang-Hua , Wang Woan-Shyuan , Lin Mei-Hsiu 
Published: February 2021

Purpose
Healthcare professionals play an important role in the organ donation process. The aim of this study was to examine the organ donation registration rate and related factors among clinical nurses.

Material and methods
In this cross-sectional, correlational study, we used mailed questionnaires to collect data from four geographical areas and three hospital levels in Taiwan from June 6 to August 31, 2018. Two thousand and thirty-three clinical nurses participated in this study.

Results
Participants’ mean age was 34.47 years, and 95.7% were women. Of them, 78.3% were willing to donate their organs and 20.6% had registered for organ donation after death. The results of logistic regression showed that in the personal domain, higher age (odds ratio (OR) = 1.03, p < 0.001), better knowledge of organ donation (OR = 1.09, p < 0.001), and a positive attitude toward organ donation (OR = 2.91, p < 0.001) were positively associated with organ donation registration, while cultural myths (OR = 0.69, p < 0.001) were negatively correlated. In the policy domain, the convenience of the registration procedure (OR = 1.45, p < 0.001) was positively associated with registration. A gap between willingness to donate and actual registration was observed.

Conclusions
Personal factors played an important role in organ donation registration. Therefore, efforts to improve knowledge and inculcate positive cultural beliefs about organ donation among clinical nurses are recommended. There is also a need to cooperate with government policies to provide appropriate in-service training and policy incentives and establish an efficient registration process.