bluuebunny/crossref_metadata_2025_split huggingface dataset:
The student perspective on teaching and assessment during initial COVID-19 related closures at Irish universities: implications for the future
Authors: Hyland Diarmaid , O’Shea Ann 
Published: September 2021

Abstract
The aim of this research is to investigate the impact of the COVID-19 closures from the perspective of students studying mathematics at university level in Ireland. A survey was designed and administered to students who were enrolled in at least one mathematics module in an Irish university at the time of the closures. The survey comprised three sections: teaching and learning, assessment and personal experience, with a focus on how the changes in teaching and assessment were viewed by students. A total of 263 students from six universities responded to the survey. The corresponding data are described, as are various trends that were identified through open-response questions. The data offer a window into the student experience during the tertiary level closures and show the effect that the sudden shifts (e.g., in delivery and support) had on learning, assessment and student well-being. The survey responses show that most students dealt with the rapid changes in a resilient and mature manner, particularly when confronted with adversity. Numerous insights can be gleaned from the students’ perspectives that have the potential to improve the teaching and learning of mathematics at tertiary level in Ireland in the future. Many of the findings could also apply to teaching and learning in other subjects and internationally.
Metabolomics of Lung Microdissections Reveals Region- and Sex-Specific Metabolic Effects of Acute Naphthalene Exposure in Mice
Authors: Stevens Nathanial C , Edwards Patricia C , Tran Lisa M , Ding Xinxin , Van Winkle Laura S , Fiehn Oliver 
Published: September 2021

Abstract
Naphthalene is a ubiquitous environmental contaminant produced by combustion of fossil fuels and is a primary constituent of both mainstream and side stream tobacco smoke. Naphthalene elicits region-specific toxicity in airway club cells through cytochrome P450 (P450)-mediated bioactivation, resulting in depletion of glutathione and subsequent cytotoxicity. Although effects of naphthalene in mice have been extensively studied, few experiments have characterized global metabolomic changes in the lung. In individual lung regions, we found metabolomic changes in microdissected mouse lung conducting airways and parenchyma obtained from animals sacrificed at 3 timepoints following naphthalene treatment. Data on 577 unique identified metabolites were acquired by accurate mass spectrometry-based assays focusing on lipidomics and nontargeted metabolomics of hydrophilic compounds. Statistical analyses revealed distinct metabolite profiles between the 2 lung regions. Additionally, the number and magnitude of statistically significant exposure-induced changes in metabolite abundance were different between airways and parenchyma for unsaturated lysophosphatidylcholines, dipeptides, purines, pyrimidines, and amino acids. Importantly, temporal changes were found to be highly distinct for male and female mice with males exhibiting predominant treatment-specific changes only at 2 h postexposure. In females, metabolomic changes persisted until 6 h postnaphthalene treatment, which may explain the previously characterized higher susceptibility of female mice to naphthalene toxicity. In both males and females, treatment-specific changes corresponding to lung remodeling, oxidative stress response, and DNA damage were observed. Overall, this study provides insights into potential mechanisms contributing to naphthalene toxicity and presents a novel approach for lung metabolomic analysis that distinguishes responses of major lung regions.
Comparison of Expanded New Ballard, Eregie and Parkin Scores in Predicting Gestational Age in Newborns
Authors: Raj Mani , Kadirvel Karthikeyan , Anandaraj Lokeshmaran , Palanisamy Soundararajan 
Published: September 2021

AbstractBackgroundPostnatal gestational age (GA) estimation is crucial in neonates with absent early trimester ultrasonography (USG) reports to evaluate the risk of morbidity and mortality. Widely used Expanded New Ballard (ENBS) is complex and needs an expert medical professional to assess. Eregie (ES) and Parkin (PS) scores are easy to perform with good inter-observer reliability. We aimed to compare these scores for their ability in predicting GA with early trimester USG-GA as the gold standard.MethodsThis cross-sectional study was conducted among 1114 intramural neonates who qualified according to the selection criteria. All neonates were evaluated using the three scores by residents (blinded to USG-GA) with a pre-defined inter-observer difference of &lt;10%. Method applicability was compared in terms of accuracy, precision and validity.ResultsGA was systematically overestimated by 0.65, 0.68 and 0.32 weeks by ENBS, PS and ES, respectively. For GA subgroups, ES had better overall accuracy with mean difference of 0.32 ± 0.88 weeks. Validity was highest for ES (79.6%).InterpretationWe conclude that all three scores were found to be of acceptable accuracy and validity. ES had better overall accuracy and validity among the subjects and for subgroups. In limited resource settings, ES or PS can substitute for ENBS.
Estimating the Volume of Equine Rabies Immunoglobulin (eRIG) Required for Local Infiltration in Soft Tissue Animal Bites in Children Using a Wound Size-Based Approach
Authors: Agarwal Anurag , Kumar Pawan , Mathur Surendra Bahadur , Khan Amir Maroof 
Published: September 2021

Abstract

Introduction
Post-exposure prophylaxis using rabies immunoglobulin (RIG) is universal recommendation for category III exposures. This study was conducted to determine quantity of RIG used to infiltrate animal bite wounds in relation to longest dimension and area of wound.

Methods
Children aged 2–18 years reporting within 7 days of category III animal bite were included. eRIG (300 IU/ml) was used in all subjects. A predesigned proforma was filled for clinical and epidemiological details of subjects. Maximum length and width of wounds was measured by using non-stretchable measuring tape. RIG was infiltrated in wounds as per WHO recommendations and volume infiltrated was noted.

Results and conclusion
A total of 100 subjects were enrolled. The mean (±SD) volume of RIG infiltrated in wounds per unit length was 0.75 (±0.21) ml/cm and per unit area was 3.18 (±1.75) ml/cm2. Regression equations were calculated. Proposed equations y = 0.6x + 0.3, where y is the volume of RIG (ml) and x is the length of the wound (cm) and y = 0.9x + 1.1, where y is the volume of RIG (ml) and x is the area of the wound (cm2) can prove to be a useful tool in RIG volume calculation for primary health care providers.
Unexpected slowdown in the decline of tuberculosis mortality rates in Brazil from 1997 to 2017: an ecological study
Authors: Lobo Andréa de Paula , Pinheiro Rejane Sobrino , Rocha Marli Souza , Oliveira Patricia Bartholomay , de Araújo Wildo Navegantes 
Published: September 2021

Abstract

Background
Brazil is a signatory to the World Health Organization End TB Strategy and the United Nations Sustainable Development Goals. This study aims to characterize tuberculosis (TB) deaths and TB mortality rates in Brazil for the period 1997–2017.

Methods
We performed an ecological study based on information for TB deaths between 1997 and 2017 extracted from the Mortality Information System of the Brazilian Ministry of Health. Data included gender, age group and geographic regions. The trends in mortality rates were estimated using Joinpoint regression analysis, which identifies years in which there is a change in slope of the time series by the Monte Carlo permutation.

Results
Between 1997 and 2017 there were 104 172 recorded TB deaths in Brazil and the mortality rates were higher for men and the elderly. The age-adjusted mortality rate decreased from 4.2 per 100 000 in 1997 to 3.0 per 100 000 in 2003 to 2.0 per 100 000 in 2017. The average percentage reduction from 1997 to 2003 was 6.2% (95% confidence interval [CI] −7.7 to −4.7) per year, while from 2003 to 2017 it was 3.0% (95% CI −3.4 to −2.5) per year, representing a slowdown in the rate of decline.

Conclusion
The high number of deaths and the slowdown in the decline of mortality rates from TB in Brazil maintain the disease as an important public health concern and an obstacle to reaching goals set by international commitments.
The immature platelet fraction, a predictive tool for early recovery from dengue-related thrombocytopenia: a prospective study
Authors: Abeysuriya Visula , Seneviratne Suranjith L , de Mel Primesh , Clarice Choong Shi Hui , de Mel Chandima , Chandrasena Lal , Yip Christina , Yap Eng-Soo , de Mel Sanjay 
Published: September 2021

AbstractBackgroundThere is a paucity of predictive factors for early recovery from thrombocytopenia related to dengue. The immature platelet fraction (IPF%) is reflective of megakaryopoiesis and may correlate with recovery from dengue-related thrombocytopenia. Our objective was to assess the predictive value of IPF% on days 2 and 3 of illness for recovery from dengue-related thrombocytopenia.MethodsA prospective study was conducted among patients with dengue admitted to our institution (Nawaloka Hospital PLC) from December 2019 to October 2020. Dengue was diagnosed based on positive non-structural antigen 1 or IgM. IPF% data were extracted from the Sysmex-XN-1000 automated hematology analyzer. Clinical data were obtained from electronic medical records. Statistical analyses were performed using SPSS version 20.ResultsWe included 240 patients. An IPF% on day 2 of illness of &gt;7.15% had a sensitivity of 80.0% and specificity of 70.4% for prediction of platelet recovery (defined as platelet count ≥60×109/L) on day 7 of illness. An IPF% of &gt;7.25% on day 3 of illness had a sensitivity of 88.9% and specificity of 47.1% for predicting platelet recovery &gt;60×109/L on day 8 of illness. The IPF% was significantly lower in patients with severe dengue. Platelet recovery was observed within 48 h after the peak IPF% was reached, regardless of severity.ConclusionWe propose that IPF% values on days 2 and 3 of illness are a promising predictive tool for early recovery from dengue-related thrombocytopenia.
The management of moderate acute malnutrition in children aged 6-59 months in low- and middle-income countries: a systematic review and meta-analysis
Authors: Gluning Imara , Kerac Marko , Bailey Jeanette , Bander Amela , Opondo Charles 
Published: September 2021

Abstract

Background
Malnutrition is a leading cause of morbidity and mortality in children aged &lt;5 y, especially in low- and middle-income countries (LMICs). Unlike severe acute malnutrition, moderate acute malnutrition (MAM) affects greater numbers globally, and guidelines lack a robust evidence base. This systematic review and meta-analysis assessed the evidence for lipid-based nutrient supplements (LNSs), fortified blended flours (FBFs) and nutrition counselling, in the treatment of MAM.

Methods
Four databases were systematically searched for studies conducted in LMICs that compared the effectiveness of food-based products with any comparator group in promoting recovery from MAM in children aged 6-59 mo. Where appropriate, pooled estimates of effect were estimated using random-effects meta-analyses.

Results
A total of 13 trials were identified for inclusion. All used active controls. There was evidence of increased probability of recovery (gaining normal weight-for-height and/or mid-upper arm circumference) among children treated with LNSs compared with children treated with FBFs (risk ratio 1.05, 95% CI 1.01 to 1.09, p=0·009).

Conclusion
Based on a relatively small number of studies mainly from Africa, LNSs are superior to FBFs in improving anthropometric recovery from MAM. Current evidence for the use of food supplements in MAM treatment is based on comparisons with active controls. Future studies should assess a wider range of comparator groups, such as nutrition education/counselling alone, and outcomes, including body composition, morbidity and development.
An investigation of a new cutaneous leishmaniasis endemic area in Western Sri Lanka
Authors: Mallawarachchi Chandana H , Chandrasena Nilmini , Wijerathna Tharaka , Dalpadado Rasika , Mallawarachchi Maleesha S M N S , Gunarathna Dinesh G A M , Gunathilaka Nayana 
Published: September 2021

Abstract

Background
The aim was to investigate an emerging focus of cutaneous leishmaniasis (CL) in Gampaha district, Western Sri Lanka.

Methods
Sociodemographics of CL patients in Mirigama, Gampaha district, were compared with controls using a structured questionnaire. Clinical data and geographic positioning system coordinates of patients were recorded. Sandflies collections were performed in four selected sites using indoor hand collection (162 units) and cattle-baited net traps (n=3).

Results
Of 73 patients (mean age 43.6 y; SD 20), 58.9% were males. Lesions consisted of nodules (52.1%) and ulcers (47.9%). Single lesions were seen in 69.9% of patients, while 30.1% had multiple lesions. Except for one mucosal lesion, all the others were cutaneous. Treatment consisted of sodium stibogluconate and cryotherapy (46.6%), sodium stibogluconate (45.2%) or cryotherapy (8.2%). Multiple lesions were more likely to receive combination therapy (p=0.013). The majority of those employed (81.1%; 27/33) were engaged in outdoor work. Male gender, low education attainment and poor disease awareness were significant risk factors for CL (p&lt;0.05). Four households reported multiple cases. Phlebotomus argentipes was detected in all cattle-baited net traps and 35.3% of indoor hand collection units.

Conclusions
CL is emerging in Gamapha district with Mirigama as the epicentre. Case distribution indicates local transmission, with P. argentipes as the probable vector.
Diversity, distribution and molecular species delimitation in frogs and toads from the Eastern Palaearctic
Authors: Dufresnes Christophe , Litvinchuk Spartak N 
Published: September 2021

Abstract
Biodiversity analyses can greatly benefit from coherent species delimitation schemes and up-to-date distribution data. In this article, we have made the daring attempt to delimit and map described and undescribed lineages of anuran amphibians in the Eastern Palaearctic (EP) region in its broad sense. Through a literature review, we have evaluated the species status considering reproductive isolation and genetic divergence, combined with an extensive occurrence dataset (nearly 85k localities). Altogether 274 native species from 46 genera and ten families were retrieved, plus eight additional species introduced from other realms. Independent hotspots of species richness were concentrated in southern Tibet (Medog County), the circum-Sichuan Basin region, Taiwan, the Korean Peninsula and the main Japanese islands. Phylogeographic breaks responsible for recent in situ speciation events were shared around the Sichuan Mountains, across Honshu and between the Ryukyu Island groups, but not across shallow water bodies like the Yellow Sea and the Taiwan Strait. Anuran compositions suggested to restrict the zoogeographical limits of the EP to East Asia. In a rapidly evolving field, our study provides a checkpoint to appreciate patterns of species diversity in the EP under a single, spatially explicit, species delimitation framework that integrates phylogeographic data in taxonomic research.
New insights in mite immunotherapy – sublingual tablets
Authors: Creticos Peter Socrates 
Published: September 2021

Purpose of review
Sublingual tablet immunotherapy has been demonstrated to be effective for allergies induced by exposure to grass, ragweed, specific trees (Japanese Cedar; birch homologous tree mix), and house dust mites (HDM). This review provides both an overview of the evidence-based clinical studies that address the use of the HDM SLIT-tablet for the treatment of HDM-induced allergic rhinitis/conjunctivitis and its appropriate use in carefully selected asthmatic patients and provides the clinician with practical management considerations.

Recent findings
Solid evidence-based clinical studies have shown that the HDM SLIT-tablet is both well tolerated in patients with mild-to-moderate asthma and has demonstrated a meaningful improvement in exacerbations, need for rescue medication, quality of life, and asthma control.

Summary
The HDM SLIT-tablet provides the allergy specialist with a well-tolerated treatment that has established superior safety to subcutaneous injection therapy, which can be administered easily as a sublingual dissolvable tablet, and which provides the opportunity to address one of the more difficult aspects in the management of an inducer of perennial allergic disease – that of persistent airway inflammation and allergic asthma.
Association of Socioeconomic Status With Postdischarge Pediatric Resource Use and Quality of Life
Authors: Kachmar Alicia G. , Watson R. Scott , Wypij David , Perry Mallory A. , Curley Martha A. Q. ,   for the Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) Investigative Team
Published: September 2021

OBJECTIVES:
Socioeconomic factors may impact healthcare resource use and health-related quality of life, but their association with postcritical illness outcomes is unknown. This study examines the associations between socioeconomic status, resource use, and health-related quality of life in a cohort of children recovering from acute respiratory failure.

DESIGN:
Secondary analysis of data from the Randomized Evaluation of Sedation Titration for Respiratory Failure clinical trial.

SETTING:
Thirty-one PICUs.

PATIENTS:
Children with acute respiratory failure enrolled whose parent/guardians consented for follow-up.

MEASUREMENTS AND MAIN RESULTS:
Resource use included in-home care, number of healthcare providers, prescribed medications, home medical equipment, emergency department visits, and hospital readmission. Socioeconomic status was estimated by matching residential address to census tract–based median income. Health-related quality of life was measured using age-based parent-report instruments. Resource use interviews with matched census tract data (n = 958) and health-related quality of life questionnaires (n = 750/958) were assessed. Compared with high-income children, low-income children received care from fewer types of healthcare providers (β = –0.4; p = 0.004), used less newly prescribed medical equipment (odds ratio = 0.4; p < 0.001), and had more emergency department visits (43% vs 33%; p = 0.04). In the youngest cohort (< 2 yr old), low-income children had lower quality of life scores from physical ability (–8.6 points; p = 0.01) and bodily pain/discomfort (+8.2 points; p < 0.05). In addition, health-related quality of life was lower in those who had more healthcare providers and prescribed medications. In older children, health-related quality of life was lower if they had prescribed medications, emergency department visits, or hospital readmission.

CONCLUSIONS:
Children recovering from acute respiratory failure have ongoing healthcare resource use. Yet, lower income children use less in-home and outpatient services and use more hospital resources. Continued follow-up care, especially in lower income children, may help identify those in need of ongoing healthcare resources and those at-risk for decreased health-related quality of life.
A Simple Risk Score for Predicting Neurologic Outcome in Out-of-Hospital Cardiac Arrest Patients After Targeted Temperature Management*
Authors: Chen Chung-Ting , Lin Jin-Wei , Wu Cheng-Hsueh , Kuo Raymond Nien-Chen , Shih Chia-Hui , Hou Peter Chuanyi , Yen David Hung-Tsang , How Chorng-Kuang 
Published: September 2021

OBJECTIVES:
Although several risk factors for outcomes of out-of-hospital cardiac arrest patients have been identified, the cumulative risk of their combinations is not thoroughly clear, especially after targeted temperature management. Therefore, we aimed to develop a risk score to evaluate individual out-of-hospital cardiac arrest patient risk at early admission after targeted temperature management regarding poor neurologic status at discharge.

DESIGN:
Retrospective observational cohort study.

SETTING:
Two large academic medical networks in the United States.

PATIENTS:
Out-of-hospital cardiac arrest survivors treated with targeted temperature management with age of 18 years old or older.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Based on the odds ratios, five identified variables (initial nonShockable rhythm, Leucocyte count < 4 or > 12 K/μL after targeted temperature management, total Adrenalin [epinephrine] ≥ 5 mg, lack of oNlooker cardiopulmonary resuscitation, and Time duration of resuscitation ≥ 20 min) were assigned weighted points. The sum of the points was the total risk score known as the SLANT score (range 0–21 points) for each patient. Based on our risk prediction scores, patients were divided into three risk categories as moderate-risk group (0–7), high-risk group (8–14), and very high-risk group (15–21). Both the ability of our risk score to predict the rates of poor neurologic outcomes at discharge and in-hospital mortality were significant under the Cochran-Armitage trend test (p < 0.001 and p < 0.001, respectively).

CONCLUSIONS:
The risk of poor neurologic outcomes and in-hospital mortality of out-of-hospital cardiac arrest survivors after targeted temperature management is easily assessed using a risk score model derived using the readily available information. Its clinical utility needed further investigation.
Postmastectomy radiotherapy: a review
Authors: Kunkler Ian H. , Chua Boon H. 
Published: September 2021

Purpose of review
We review the role of postmastectomy radiotherapy (PMRT) in the management of patients with early breast cancer.

Recent findings
PMRT in patients with 4 or more involved axillary lymph nodes is the current standard of care but the indications for PMRT in patients with 1–3 involved nodes remain controversial. The Early Breast Cancer Trialists’ Collaborative Group meta-analysis of randomised trials of PMRT provides the most comprehensive level 1 evidence base. However, its applicability in contemporary practice in the context of recent multidisciplinary advances in surgery, radiation therapy and systemic therapy remains challenging.

Summary
The lack of consensus on the indications for PMRT in patients with 1–3 positive nodes underpins the variations in the national and international guidelines on PMRT. We emphasise the need for contemporary randomised trial data, and the potential to refine patient selection for PMRT using novel biomarkers of recurrence and radiosensitivity.
Twin Deliveries - East Meets West
Authors: Barrett Jon , Zhou Qiongjie 
Published: September 2021

Abstract
Mode of delivery in twin gestation has been a matter of debate for decades. In 2013, the only randomized controlled trial concerning mode of delivery in twin gestations was published, answering some of the most pressing questions in this matter. The Twin Birth Study randomized patients carrying dichorionic-diamniotic or monochorionic-diamniotic twins, with the first twin in cephalic presentation, between 32 and 39 weeks of gestation, to planned vaginal vs. planned cesarean delivery, and found no significant differences in perinatal or maternal outcomes. These clinical findings greatly benefit our clinical practice, but there lacks related study investigating how the practices have changed. In this review, we searched PubMed from 1980 through January 2021 using combinations of the following terms: twin, delivery, vaginal delivery, and cesarean section. We will try to address the known literature before and after the publication of the Twin Birth Study in western countries and compare that to what has been practiced in China.