bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cost-effectiveness of the fixed-dose combination tiotropium/olodaterol versus tiotropium monotherapy or a fixed-dose combination of long-acting β2-agonist/inhaled corticosteroid for COPD in Finland, Sweden and the Netherlands: a model-based study
Authors: Hoogendoorn Martine , Corro Ramos Isaac , Soulard Stéphane , Cook Jennifer , Soini Erkki , Paulsson Emma , Rutten-van Mölken Maureen 
Published: August 2021

ObjectivesChronic obstructive pulmonary disease (COPD) guidelines advocate treatment with combinations of long-acting bronchodilators for patients with COPD who have persistent symptoms or continue to have exacerbations while using a single bronchodilator. This study assessed the cost-utility of the fixed dose combination of the bronchodilators tiotropium and olodaterol versus two comparators, tiotropium monotherapy and long-acting β2 agonist/inhaled corticosteroid (LABA/ICS) combinations, in three European countries: Finland, Sweden and the Netherlands.MethodsA previously published COPD patient-level discrete event simulation model was updated with most recent evidence to estimate lifetime quality-adjusted life years (QALYs) and costs for COPD patients receiving either tiotropium/olodaterol, tiotropium monotherapy or LABA/ICS. Treatment efficacy covered impact on trough forced expiratory volume in 1 s (FEV1), total and severe exacerbations and pneumonias. The unit costs of medication, maintenance treatment, exacerbations and pneumonias were obtained for each country. The country-specific analyses adhered to the Finnish, Swedish and Dutch pharmacoeconomic guidelines, respectively.ResultsTreatment with tiotropium/olodaterol gained QALYs ranging from 0.09 (Finland and Sweden) to 0.11 (the Netherlands) versus tiotropium and 0.23 (Finland and Sweden) to 0.28 (the Netherlands) versus LABA/ICS. The Finnish payer’s incremental cost-effectiveness ratio (ICER) of tiotropium/olodaterol was €11 000/QALY versus tiotropium and dominant versus LABA/ICS. The Swedish ICERs were €6200/QALY and dominant, respectively (societal perspective). The Dutch ICERs were €14 400 and €9200, respectively (societal perspective). The probability that tiotropium/olodaterol was cost-effective compared with tiotropium at the country-specific (unofficial) threshold values for the maximum willingness to pay for a QALY was 84% for Finland, 98% for Sweden and 99% for the Netherlands. Compared with LABA/ICS, this probability was 100% for all three countries.ConclusionsBased on the simulations, tiotropium/olodaterol is a cost-effective treatment option versus tiotropium or LABA/ICS in all three countries. In both Finland and Sweden, tiotropium/olodaterol is more effective and cost saving (ie, dominant) in comparison with LABA/ICS.
Antimicrobial stewardship and infection prevention interventions targeting healthcare-associatedClostridioides difficileand carbapenem-resistantKlebsiella pneumoniaeinfections: a scoping review
Authors: Okeah Bernard Ojiambo , Morrison Valerie , Huws Jaci C 
Published: August 2021

ObjectivesThis study assessed antimicrobial stewardship (AMS) and infection prevention (IP) interventions targeting healthcare-associatedClostridioides difficileand carbapenem-resistantKlebsiella pneumoniae(CRKP) infections, their key outcomes and the application of behaviour change principles in these interventions.DesignThis scoping review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-analysis Extension for Scoping Reviews (PRISMA-ScR) guidelines while focusing on acute healthcare settings in both low-to-middle income and high-income countries.Data sourcesThe databases searched were MEDLINE, PubMed, Web of Science and CINAHL between 22 April 2020 and 30 September 2020.EligibilityThe review included peer-reviewed articles published in English language between 2010 and 2019. Studies that focussed on IP and/or AMS interventions primarily targetingC. difficileor CRKP were included. Studies that assessed effectiveness of diagnostic devices or treatment options were excluded from this review.Data extraction and synthesisAn abstraction sheet calibrated for this study was used to extract data on the main study characteristics including the population, intervention and outcomes of interest (antimicrobial use, compliance with IP interventions and risk forC. difficileand CRKP). A narrative synthesis of the results is provided.ResultsThe review included 34 studies. Analysis indicates that interventions targetingC. difficileand CRKP include Education, Surveillance/Screening, Consultations, Audits, Policies and Protocols, Environmental measures, Bundles, Isolation as well as Notifications or alerts (represented using the ESCAPE-BIN acronym). The identified outcomes include antimicrobial use, resistance rates, risk reduction, adherence to contact precautions, hospital stay and time savings. AMS and IP interventions tend to be more adhoc with limited application of behaviour change principles.ConclusionThis scoping review identified the AMS and IP interventions targetingC. difficileand CRKP in healthcare settings and described their key outcomes. The application of behaviour change principles in AMS and IP interventions appears to be limited.
Association of lipocalin-2 and low-density lipoprotein receptor-related protein-1 (LRP1) with biomarkers of environmental enteric dysfunction (EED) among under 2 children in Bangladesh: results from a community-based intervention study
Authors: Hasan Md. Mehedi , Gazi Md. Amran , Das Subhasish , Fahim Shah Mohammad , Hossaini Farzana , Alam Md. Ashraful , Mahfuz Mustafa , Ahmed Tahmeed 
Published: August 2021

BackgroundEnvironmental enteric dysfunction (EED) is thought to occur from persistent intestinal inflammation. Studies also revealed the association of lipocalin-2 (LCN2) and low-density lipoprotein receptor-related protein-1 (LRP1) with intestinal inflammation. Therefore, we intended to explore the relationship of LCN2 and LRP1 with gut inflammation and biomarkers of EED in Bangladeshi malnourished children.MethodsA total of 222 children (length-for-age z-score (LAZ) <-1) aged 12–18 months were enrolled in this study in a cross-sectional manner. Among the participants, 115 were stunted (LAZ <-2) and 107 were at risk of being stunted (LAZ −1 to −2) children. Plasma and faecal biomarkers were measured using ELISA. Spearman’s rank correlation was done to see the correlation among LCN2, LRP1 and biological biomarkers.ResultsLCN2 correlates positively with myeloperoxidase (r=0.19, p=0.005), neopterin (r=0.20, p=0.004), calprotectin (r=0.3, p=0.0001), Reg1B (r=0.20, p=0.003) and EED score (r=0.20, p=0.003). Whereas, LRP1 correlates negatively with myeloperoxidase (r = −0.18, p=0.006), neopterin (r = −0.30, p=0.0001), alpha-1-antitrypsin (r = −0.18, p=0.006), Reg1B (r=−0.2, p=0.003) and EED score (r = −0.29, p=0.0001).ConclusionsOur findings imply that LCN2 might be a promising biomarker to predict gut inflammation and EED. Whereas, increased level of LRP1 may contribute to alleviating intestinal inflammation.
Optimising undergraduate medico-legal and professionalism teaching through a student-selected component
Authors: Pandya Tej , Muneeb Ferhan , Gibb Jonathan , Metcalfe Neil H 
Published: August 2021

PurposeWe sought to understand how best to teach medico-ethics, law and professionalism to undergraduate medical students using a student selected component.Materials and methodsStudents received small-group, seminar-based teaching from the module organiser and external representatives from organisations such as the General Medical Council and Medical Protection Society. Experiential learning was also facilitated through attendance at fitness to practice tribunals and Coroner’s court, followed by structured debrief sessions. Two cohorts of medical students(n=40) from Manchester University were surveyed before and after undergoing the placement, with qualitative interviews and thematic analysis for a subset of this group(n=16) and course leaders(n=4).ResultsThere were significant (p<0.05) improvements in students’ self-reported understanding of key medicolegal organisations and accessing guidance on professionalism. Thematic analysis uncovered increasing confidence in the role of the medicolegal system, barriers to challenging unprofessional behaviour, and a desire for this to be placed in the curricula.ConclusionsThis placement was well received and demonstrates an importance for this content to be taught effectively in the medical curricula. Having protected time to attend sessions while an undergraduate may reduce anxiety felt by doctors fearing medicolegal proceedings and help challenge unprofessional behaviours. Further work could explore mechanisms into how best to incorporate this into the medical curricula.
Trauma center funding: time for an update
Authors: Grossman Verner Heather M , Figueroa Brian A , Salgado Crespo Marcos , Lorenzo Manuel , Amos Joseph D 
Published: August 2021

BackgroundUncompensated care (UC) is healthcare provided with no payment from the patient or an insurance provider. UC directly contributes to escalating healthcare costs in the USA and potentially impacts patient care. In Texas, there has been a steady increase in the number of trauma centers and UC volumes without an increase in trauma funding of UC. The method of calculating UC trauma funds in Texas is imprecise as it is driven by Medicaid volumes and not actual trauma care costs.MethodsFive years of annual trauma UC disbursement reports from the Texas Department of State Health Services were used to determine changes in UC economic considerations for level I, II, and III trauma centers in the largest urban trauma service areas (TSAs). Data for UC costs, compensation, and TSA demographics were used to assess variations. Statistical significance was determined using a Kruskal-Wallis test with Dunn’s pairwise comparison post-hoc analysis and logistic regression.ResultsTSA-E (Dallas-Fort Worth area) has 33% of the level I trauma centers in Texas (n=6) and yet serves only 27% of the total state population across 14 metropolitan and 5 non-metropolitan counties. Since 2015, TSA-E has shown higher UC costs (p<0.02) and lower reimbursement (p<0.01) than the second largest urban hub, TSA-Q (Houston area). TSA-E level I trauma centers trended towards decreased UC reimbursements.DiscussionThe unregulated expansion of trauma centers in Texas has led to an unprecedented increase in hospitals participating in trauma care. The unbalanced allocation of UC funding could lead to further economic instability, compromise resource allocation, and negatively impact patient care in an already fragile healthcare environment.Level of evidenceLevel IV; Retrospective economic analysis and evaluation.
What are the strongest indicators of intracerebral hemorrhage in mild traumatic brain injury?
Authors: Teeratakulpisarn Panu , Angkasith Phati , Wannakul Thanakorn , Tanmit Parichat , Prasertcharoensuk Supatcha , Thanapaisal Chaiyut , Wongkonkitsin Narongchai , Kitkhuandee Amnat , Sukeepaisarnjaroen Wattana , Phuttharak Warinthorn , Sawanyawisuth Kittisak 
Published: August 2021

BackgroundAlthough there are eight factors known to indicate a high risk of intracranial hemorrhage (ICH) in mild traumatic brain injury (TBI), identification of the strongest of these factors may optimize the utility of brain CT in clinical practice. This study aimed to evaluate the predictors of ICH based on baseline characteristics/mode of injury, indications for brain CT, and a combination of both to determine the strongest indicator.MethodsThis was a descriptive, retrospective, analytical study. The inclusion criteria were diagnosis of mild TBI, high risk of ICH, and having undergone a CT scan of the brain. The outcome of the study was any type of ICH. Stepwise logistic regression analysis was used to find the strongest predictors according to three models: (1) injury pattern and baseline characteristics, (2) indications for CT scan of the brain, and (3) a combination of models 1 and 2.ResultsThere were 100 patients determined to be at risk of ICH based on indications for CT of the brain in patients with acute head injury. Of these, 24 (24.00%) had ICH. Model 1 found that injury due to motor vehicle crash was a significant predictor of ICH, with an adjusted OR (95% CI) of 11.53 (3.05 to 43.58). Models 2 and 3 showed Glasgow Coma Scale (GCS) score of 13 to 14 after 2 hours of observation and open skull or base of skull fracture to be independent predictors, with adjusted OR (95% CI) of 11.77 (1.32 to 104.96) and 5.88 (1.08 to 31.99) according to model 2.DiscussionOpen skull or base of skull fracture and GCS score of 13 to 14 after 2 hours of observation were the two strongest predictors of ICH in mild TBI.Level of evidenceIII.
Hunting BFKL in semi-hard reactions at the LHC
Authors: Celiberto Francesco Giovanni 
Published: August 2021

AbstractThe agreement between calculations inspired by the resummation of energy logarithms, known as BFKL approach, and experimental data in the semi-hard sector of QCD has become manifest after a wealthy series of phenomenological analyses. However, the contingency that the same data could be concurrently portrayed at the hand of fixed-order, DGLAP-based calculations, has been pointed out recently, but not yet punctually addressed. Taking advantage of the richness of configurations gained by combining the acceptances of CMS and CASTOR detectors, we give results in the full next-to-leading logarithmic approximation of cross sections, azimuthal correlations and azimuthal distributions for three distinct semi-hard processes, each of them featuring a peculiar final-state exclusiveness. Then, making use of disjoint intervals for the transverse momenta of the emitted objects, i.e. $$\kappa $$
κ
-windows, we clearly highlight how high-energy resummed and fixed-order driven predictions for semi-hard sensitive observables can be decisively discriminated in the kinematic ranges typical of current and forthcoming analyses at the LHC. The scale-optimization issue is also introduced and explored, while the uncertainty coming from the use of different PDF and FF set is deservedly handled. Finally, a brief overview of , a numerical tool recently developed, suited for the computation of inclusive semi-hard reactions is provided.
X(6200) as a compact tetraquark in the QCD string model
Authors: Nefediev A. V. 
Published: August 2021

AbstractRecently the LHCb Collaboration announced the first observation of nontrivial structures in the double-$$J/\psi $$

J
/
ψ

mass spectrum in the mass range 6.2–7.2 GeV, and a theoretical coupled-channel analysis of these data performed in Dong et al. (Phys Rev Lett 126:132001, 2021) evidenced the existence of a new state X(6200) close to the double-$$J/\psi $$

J
/
ψ

threshold. Although its molecular interpretation seems the most plausible assumption, the present data do not exclude an admixture of a compact component in its wave function, for which a fully-charmed compact tetraquark is the most natural candidate. It is argued in this work that the QCD string model is compatible with the existence of a compact $$cc{\bar{c}}{\bar{c}}$$

c
c

c

¯

c

¯

state bound by QCD forces just below the double-$$J/\psi $$

J
/
ψ

threshold. A nontrivial interplay of the quark dynamics associated with this compact state and the molecular dynamics provided by soft gluon exchanges between $$J/\psi $$

J
/
ψ

mesons is discussed and the physical X(6200) is argued to be a shallow bound state, in agreement with the results of the aforementioned coupled-channel analysis of the LHCb data.
The SIR model towards the data
Authors: Lazzizzera Ignazio 
Published: August 2021

AbstractIn this work, the SIR epidemiological model is reformulated so to highlight the important effective reproduction number, as well as to account for the generation time, the inverse of the incidence rate, and the infectious period (or removal period), the inverse of the removal rate. The aim is to check whether the relationships the model poses among the various observables are actually found in the data. The study case of the second through the third wave of the Covid-19 pandemic in Italy is taken. Given its scale invariance, initially the model is tested with reference to the curve of swab-confirmed infectious individuals only. It is found to match the data, if the curve of the removed (that is healed or deceased) individuals is assumed underestimated by a factor of about 3 together with other related curves. Contextually, the generation time and the removal period, as well as the effective reproduction number, are obtained fitting the SIR equations to the data; the outcomes prove to be in good agreement with those of other works. Then, using knowledge of the proportion of Covid-19 transmissions likely occurring from individuals who didn’t develop symptoms, thus mainly undetected, an estimate of the real numbers of the epidemic is obtained, looking also in good agreement with results from other, completely different works. The line of this work is new, and the procedures, computationally really inexpensive, can be applied to any other national or regional case besides Italy’s study case here.
Efficacy of Auricular Acupressure in Prevention and Treatment of Chemotherapy-Induced Nausea and Vomiting in Patients with Cancer: A Systematic Review and Meta-Analysis
Authors: Chen Lichan , Wu Xiaohong , Chen Xisui , Zhou Chunjiao 
Published: August 2021

Background. More than 40% of patients with cancer have reported that chemotherapy-induced nausea and vomiting (CINV) remained the most debilitating side effects of treatment even in the era of new antiemetics. Objective. The purpose of this review was to systematically evaluate the clinical effect of auricular acupressure (AA) in prevention and treatment of chemotherapy-induced nausea and vomiting. Methods. The following databases were searched: PubMed, Cochrane Library, EMBASE, the Web of Science, Chinese Biological Medicine (CBM), Chinese National Knowledge Infrastructure (CNKI), Wanfang, and VIP (from database inception to April 2020). Eligible randomized controlled trials of auricular acupressure in treating CINV were collected, including crossover randomized design study. The meta-analysis was carried out by RevMan software (5.3). Results. Totally 19 RCTs with 1449 patients met the inclusion criteria. Compared with control groups, the relief efficiency of overall CINV was enhanced by AA combined with antiemetics (RR = 1.31, CI 1.22 to 1.41,

p

≤ 0.001). Although the therapeutic effect on acute nausea and vomiting was not obvious, AA still played an important role in reducing delayed nausea and vomiting (delayed nausea frequency: RR = 0.68, CI −1.01 to −1.35,

p

≤ 0.001; delayed vomiting frequency: RR = 0.91, CI −1.22 to −0.61,

p

≤ 0.001). The likelihood of adverse reactions related to antiemetics was reduced by AA combined with antiemetics (RR = 0.62, CI 0.53 to 0.74,

p

≤ 0.001). Statistically significant association was found between AA and incidence of constipation, diarrhea, and tiredness, while there was no statistically significant association between AA and abdominal distension or headache. Conclusion. Auricular acupressure supplementation benefited delayed chemotherapy-induced nausea and vomiting as well as constipation, diarrhea, and tiredness. AA alone or AA supplementation has little effect on acute nausea and acute vomiting. There is no conclusion on whether AA alone is superior to antiemetics in the management of delayed CINV. Further studies are needed to confirm the efficacy of auricular acupressure alone in delayed CINV and anticipatory CINV. The results of this review provided the basis for further research with more rigorous study designs, adequate sample sizes, and standardized implementation to confirm the efficacy of auricular acupressure.
Who Are the Engineers? Solar Geoengineering Research and Justice
Authors: Táíwò Olúfẹ́mi O. , Talati Shuchi 
Published: August 2021

Abstract
Solar geoengineering research is a small but growing field as concerns arise that reducing emissions will not be sufficient to limit severe climate impacts. With this increasing attention, ensuring that the field advances equitably and inclusively is of immense importance. This commentary is a response to arguments that advocate for abandoning solar geoengineering research altogether because it perpetuates colonialism and promotes injustice. We find, however, that this brand of argument is itself performatively colonial and recommend a more inclusive framework for solar geoengineering governance that integrates existing research on relevant structures.
Tracing the Historical Culture of Spalting in Spain to Its Potential Influence on Peru
Authors: Vega Gutiérrez Patricia , Robinson Seri C. 
Published: August 2021

Abstract
In Europe, from the fifteenth to the eighteenth century, intarsia and marquetry woodworks relied heavily on the use of spalted wood (wood colored by fungi) especially the blue-green stained wood from the Chlorociboria species. Although the use of spalted wood is well documented in Italy, Germany, Switzerland, and England, little is known about how guild traditions migrated from Spain during European colonization. This research sought to determine if the techniques or woodworks of the time moved to the viceroyalty of Peru. While numerous examples of spalted marquetry have previously been found in Spain, all were made by German artisans and imported to the country. For this research, only one piece of spalted furniture was found in Peru, and it was of English origin. Noting Spain’s lack of production of spalted woodworks and the few pieces found in Peru, it is likely that this niche product did not move to Peru with Spanish colonists and may have instead come over later with English colonists in the 1800s when spalted wood was popular in that region.
Learning from patient safety incidents involving acutely sick adults in hospital assessment units in England and Wales: a mixed methods analysis for quality improvement
Authors: Urquhart Alexandra , Yardley Sarah , Thomas Elin , Donaldson Liam , Carson-Stevens Andrew 
Published: August 2021

Objective Six per cent of hospital patients experience a patient safety incident, of which 12% result in severe/fatal outcomes. Acutely sick patients are at heightened risk. Our aim was to identify the most frequently reported incidents in acute medical units and their characteristics. Design Retrospective mixed methods methodology: (1) an a priori coding process, applying a multi-axial coding framework to incident reports; and, (2) a thematic interpretative analysis of reports. Setting Patient safety incident reports (10 years, 2005–2015) collected from the National Reporting and Learning System, which receives reports from hospitals and other care settings across England and Wales. Participants Reports describing severe harm/death in acute medical unit were identified. Main outcome measures Incident type, contributory factors, outcomes and level of harm were identified in the included reports. During thematic analysis, themes and metathemes were synthesised to inform priorities for quality improvement. Results A total of 377 reports of severe harm or death were confirmed. The most common incident types were diagnostic errors ( n = 79), medication-related errors ( n = 61), and failures monitoring patients ( n = 57). Incidents commonly stemmed from lack of active decision-making during patient admissions and communication failures between teams. Patients were at heightened risk of unsafe care during handovers and transfers of care. Metathemes included the necessity of patient self-advocacy and a lack of care coordination. Conclusion This 10-year national analysis of incident reports provides recommendations to improve patient safety including: introduction of electronic prescribing and monitoring systems; forcing checklists to reduce diagnostic errors; and increased senior presence overnight and at weekends.