bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective study regarding factors related to unscheduled revisit within 72 hours in adult Emergency Department, Al Khor Hospital, State of Qatar
Authors: Hassan Nesiya , Mustafa Wafa , Mercado Ann Cristine , Varughese Bincy Mary , Mohanan Chippy , Nair Deepa , Yohannan Jessy , Jose Jisha , Sebastian Joby , George Saritha , Augustine Vipin 
Published: May 2017

Background: Crowding in hospital Emergency Departments (EDs) is a commonly observed problem all over the world.

Objectives: To identify the factors related to patients’ unscheduled revisits to ED.

Methods: The Al Khor Hospital annual ED patient volume of 158,000. The census sample of patients who had revisited within 72 hours of discharge from the ED was recruited in the study. The CERNER system was utilized to collect all revisited patients’ data. Two experts from the pool of ED consultants reviewed the data independently.

Results: During the study period, 24,933 patients visited in ED, 849 revisited within 72 hours of their discharge, which accounts for 3.4%. The characteristics of revisited patients included young adults between 20–40 years of age (59.79%), mostly males (78.94%). Physician-related factors were: missed diagnosis (1.6%), adverse drug reaction (1.3%) and discharged without home medication (8.4%). Patient related, 60.26% (331) perceived that they were not improved with initial treatment. The vast majority of this patients (97.2 %) were discharged from the ED. Illness-related factors were the most common reason for revisits to ED; 52.9% (362) returned with same complaints while 21.3% (146) returned with related complaints, out of which 97.6% patients were discharged and 1.3 % (7) were admitted to the hospital. Of the remainder, 22.8% of the patients (156) reported to ED with new complaints. System related factors: 23.49% revisited patients lived in Al Khor or nearby, with their primary health center facility being 70 km away from their residential area.

Conclusion: From our study, we found the majority of revisits were due to illness or system-related factors. Effective educational program and initiation of telenursing service for discharged patients can prevent unnecessary ED visits.
Epidemiological investigation of measles outbreak in Mansehra Colony Landhi, Karachi. Sindh, Pak, March 2015
Authors: Khan Jahed Ahmed , Nabil Muhammad Furqan 
Published: May 2017

Background: On 3rd March the local newspaper published report regarding measles outbreak in Mansehra Colony Landhi, Karachi. In response to the report the Executive District Office health Karachi constituted a three members investigating team with the objectives to investigate the outbreak and propose recommendations for control of outbreak the affected Mansehra Colony Landhi having population of 600 households.

Methods: Investigation was carried out from 4th to 7th March, 2015. Case was defined as a child having 15 years of age residing in Mansehra Colony Landhi, with: a generalized rash and fever for three or more days and one or more of the associated symptoms, including cough, or coryza or conjunctivitis from 1st March to 7th March, 2015. Active case finding was carried out, line list maintained and six blood samples were taken and shipped to NIH Islamabad for lab confirmation.

Results: Sixteen cases were line listed, out of which 75% (n = 12) were females. Median age was 9 years (range: 3 to 13 years). All cases were from same family. Index case was 6 years old girl who visited her parents at Balochistan province (measles endemic) 6 days prior to development of sign symptoms. NIH Lab confirmed four cases positive out of six. As per EPI record all cases were fully immunized against measles.

Conclusion: Cases appeared in vaccinated children implicate that either there is some problem with the quality of vaccine, cold chain maintenance or vaccination techniques. Mopping -up activities conducted in Mansehra colony Landhi and surroundings, Health Education sessions conducted by Lady Health Workers on hygiene and disease prevention.

Keywords: measles outbreak, vaccinated, Health Education
Prevalence of main risk factors of diabetic foot among diabetic patients attending specialized center for diabetes in Baghdad, Iraq 2013
Authors: Saleh Hana Khudair , Raheem Yousif Abdul 
Published: May 2017

Introduction: Diabetic foot is one of the most disabling complications with substantial morbidity. It remains the most common reason for hospital admission, impairs quality of life, engenders high treatment costs and is the most important risk factor for amputation.

Objectives: To determine the prevalence of diabetic foot among diabetic patients and the prevalence of main related risk factors.

Methods: A cross-sectional study was performed in Specialized Center for Diabetes in Baghdad - Iraq in which 410 diabetic patients age range 30–83 years were selected using convenient sample from 1st June - 31st September 2013. Data was collected by direct interview using a questionnaire, physical examination, patients' records and laboratory investigations. The data was analyzed using Minitab software version 16.

Results: Among 410 diabetic patients, females (56.83%) and males (43.17%). The prevalence of diabetic foot among diabetic patients was 19.27%. The following risk factors showed a statistically significant association with diabetic foot development: male gender (P = 0.047), duration of diabetes mellitus (P = 0.001), history of bare foot (P = 0.001), non-self-cleaning of foot (P = 0.001), hypertension (P = 0.006), irregular visits to diabetes center (P = 0.016) and uncontrolled level of HbA1c (P = 0.001). Applying binary logistic regression analysis revealed an independent significant association with diabetic foot development with: history of barefoot (AOR = 2.95), non-self-cleaning of foot (AOR = 2.24), male gender (AOR = 2.17), duration of diabetes mellitus (AOR = 1.37) and uncontrolled level of HbA1c level (AOR = 5).

Conclusions and recommendations: There is a high prevalence of diabetic foot among diabetic patients. The study recommends implementing the knowledge of main risk factors into preventive policies and investing more financial support on training programs in primary health care and specialized centers, patient education and DF problem awareness programs.
Assessment of functional outcome using GOSE over 3 years post-injury in patients with moderate and severe trauma
Authors: Chan Stewart , Graham Colin , Yuen Kai Yeung , Yeung Janice , Poon Wai Sang , Ho Hiu Fai , Kam Chak Wah , Rainer Timothy 
Published: May 2017

Background: The aim of this study was to evaluate post-injury functional recovery over three years in patients with moderate and major trauma in Hong Kong.

Methods: This is a multicentre prospective cohort study conducted in Hong Kong. The inclusion criteria were: trauma patients admitted to one of three trauma centres, with age ≥ 18 years, injury severity score (ISS) ≥ 9, meeting Trauma Registry criteria, and surviving to 48 hours. Functional outcome was measured by the extended Glasgow Outcome Scale (GOSE) at 3 years post-injury. Good outcomes were defined as an extended Glasgow Outcome Scale (GOSE) ≥ 7, i.e. trauma patients' status rated as lower good recovery or upper good recovery categories.

Results: From 1st January 2010 to 30th September 2010, 400 patients were included. Mean age was 53.3 years; range 18–106 years; and 70% were male. 139 (35%) patients had ISS 9–15; 261 (65%) patients had ISS ≥ 16. Among those included, 38 % required ICU admission; and 58% had healthy pre-existing comorbidity status. For the GOSE analysis, the number of surviving responders at 3 years post-injury reaching a GOSE ≥ 7 was 86, which represented 54.1% of the 159 surviving responders, and 21.5% (86/400) of the original cohort. As there were no statistically significant differences between surviving responders and non-responders at baseline, the assumption is made that 54.1% of the 167 non-responders (N = 90) also reached a GOSE ≥ 7. The total number of cases reaching a GOSE ≥ 7 is therefore estimated to be (86+90), or 176, which is 44.1% of the original 400 cases.

Conclusion: The proportion of cases reaching a GOSE ≥ 7 at 3 years post-injury is 44.1%.
Demographic variation of cancer incidence in Jordan 2001–2011 (age and sex an example)
Authors: Arqowb Kamal Hasan 
Published: May 2017

Background: Age and sex are major determinants of cancer incidence. The objective of the study is to explore epidemiology of cancer in Jordan by age and sex for 2001–2011.

Methods: Descriptive study done, cases were identified from Jordan cancer registry (JCR), all Jordanian cancers patients that diagnosed and registered in 2001–2011 were included variables collected SPSS 20 used for analysis.

Results: Total number of cases in JCR were (45063), 22009 (48.8%) were males (23054) (51.2%) were females, M:F ratio 0.95:1. There is difference of distribution of cancer cases by age group, sex, (41.5%) of the cases in < 60 years, Male (57.7%) than female (42.3%), while females (60.1%) more common in the age group 30–59 years than males (39.9%), in the age>15 years males (57.8%) were more than female (42.2%). Top ten cancers in by different age groups: leukemia, lymphoma, and brain were predominant cancers in 0–19 years in both sexes, while breast cancer is the commonest cancer in female in 20–49 years then thyroid cancer. In males, lymphoma and colorectal are the commonest. In the age group < 50 years breast cancer (33.7%), again is the first in females followed by colorectal cancer (12.1%) while in males lung cancer (14.8%), colorectal (14.5%) and prostate cancers (11.6%) are the commonest.

Conclusion: There is variation of percentages of top ten cancers by different age groups in Jordan compared with other countries, efforts and attention to each age group and sex with type of cancer should be consider in cancer prevention. Further detailed studies about risk factors of cancer to age group and sex. Considering these data about age and sex in cancer screening programs in the future.
Compartment syndrome- A rare complication of intraosseous access in adult patients
Authors: Khan Ashfaq , Gopala Pillai Suresh Kumar 
Published: May 2017

Background: Intraosseous (IO) access are being widely used in resuscitation of patients with difficult intra-venous (IV) access. The United Kingdom Resuscitation Council guidelines recommend the use of IO access, after two minutes of failed IV access in adult patients or two failed IV attempts in pediatric patients. There are various complications associated with IO access such as extravasation of the infusion fluid or medications, bleeding, infection and pain1. Compartment syndrome is a rare complication associated with IO access. This is reported commonly in children where in certain cases the affected limb required amputation. We report a case where an adult patient developed compartment syndrome secondary to IO access.

Methods: A 52-year-old lady who was on dialysis for renal failure presented to the Emergency Department (ED) with septic shock. She was in peri-arrest and had a difficult IV access. Therefore an IO needle was inserted to her right tibia and resuscitation was carried out with fluids and medications. She required emergency intubation and ventilation and was later admitted to the Intensive Care Unit (ICU). The following day, it was found that she developed a compartment syndrome of the right lower leg where she had the IO access.

Results: Patient was taken to the theatre for an urgent fasciotomy of the affected leg by the orthopedic surgeons with input from plastic surgeons. She made a steady but full recovery and was discharged home later.

Conclusions: Compartment syndrome is a rare complication of IO access (0.6%) 1. Careful monitoring of the IO site is recommended. It is advisable to remove the IO needle once a definitive IV access is established.
1. Complication with Intraosseous Access: Scandinavian Users' Experience. Hallas et al. West J Emerg Med. 2013 Sep; 14(5): 440–443.
Trends of the management of acute meningococcal septicaemia in Al-Nasser Paediatric Hospital, Gaza, Palestine
Authors: Al Barqouni Nabil M.A , Shorafa Awni Al , Dabour Belal , Albarqouni Loai N 
Published: May 2017

Backgrounds: Infection with Neisseria meningitides can produce a variety of clinical manifestations. Mortality and long-term morbidity can be very high in patients with invasive meningococcal disease if the infection is not treated appropriately. Our main objective was to evaluate mortality of all children admitted with acute meningococcal septicaemia (AMS).

Methods: We conducted a retrospective study of all paediatric-cases of acute meningococcal septicaemia admitted to Al-Nasser Paediatric Hospital, the largest paediatric hospital in Gaza Strip, between January-2009 and September-2015. All AMS cases were diagnosed based on the clinical presentation, skin smear and blood culture. Outcome measures were predicted mortality using Paediatric Risk of Mortality score III (PRISM III), actual mortality and standardised mortality ratio.

Results: A total of 240-children were admitted with proven AMS. Aged range from 1-month to 12-years, and 113 of them (47%) were male. The number of admitted children with AMS was decreased from 47–59 cases/year in the 2009–2011 period to 21–22 cases/year in the 2012-201. The total mortality predicted by PRISM III was 25.56%, however the actual overall mortality was 49 children (20.8%): 16(48.5%) aged less than-a-year, 17(22.1%) 1–3 year-old, 9(18.8%) 3–5 year-old and 7(8.5%) 5–12 year-old (p value = 0.00299). Standardised mortality ratio was 0.814. Forty-one children (82%) were died within the first 24-hours of admission. Sixty-nine (28.8%) children received corticosteroid, 85(35.4%) received inotropic medications and 46(19.2%) required mechanical ventilation for a median of 24-hours. In 75(31.3%) children, AMS was associated with meningitis. Multi-organ failure (n = 22, 9.2%) was the most common complication, followed by skin necrosis (n = 13, 5.4%), convulsions (n = 13, 5.4%), and disseminated intravascular coagulopathy (n = 10, 4.2%).

Interpretation: The mortality rate of the disease still high, however, this can be explained by the high predicted score of mortality, which reflect the severity of admitted cases. The mortality was significantly associated with younger age-group. New model of treatment (e.g. plasmapheresis) may be useful in decreasing mortality.
Pediatric parapneumonic effusion and empyema - Criteria to predict the need for surgical intervention
Authors: Janahi Ibrahim , Habib Fajish , Mathew Vinu , Al Khair Abdul Hafeez M , Kayoum Anas Abdul , Kini Vishwanatha 
Published: May 2017

To assess if stratification of patients based on clinical severity, laboratory markers and radiological findings at presentation would enable better prediction for the need for a surgical intervention. Single-centre retrospective cohort study done in the in-patient pediatric wards of a tertiary care centre in the State of Qatar. Participants – 56 children (aged 6 months – 14 years) with empyema or parapneumonic effusion, from July 2009- June 2013. Patients were classified into mild and severe clinical presentation based on the 2011 British thoracic society (BTS) pneumonia guidelines. Interventions were categorized as conservative (antibiotics only), non-conservative (antibiotic and surgical intervention). The values of CRP, ESR, WBC count, upon admission and follow up were also assessed, along with pleural fluid markers such as LDH, glucose and PH. The chest X-ray and chest USG were also assessed for severity and loculations. Of the 56 patients included, 29 (52%) had severe and 27 (48%) had mild clinical presentation. 26 patients (46.4%) were managed conservatively, while 30 patients (53.6%) required intervention. Younger patients (3.8 ± 3 years) tend to have increased risk for intervention, severe clinical presentation and loculations on USG. Age ≤ 5 years, severe clinical presentation, serum WBC count ≥ 20,000/mm3, ESR ≥ 80 mm/hr, serum CRP ≥ 100 mg/dl, moderate to severe effusion on chest radiograph and presence of loculation on USG individually increased the likelihood for a surgical intervention in pediatric patients with parapneumonic effusion. Having ≥ 4 out of 7 criteria accurately predicted a high risk for the need for surgical intervention (OR-6.93, 95%CI-1.2-37, p-0.023, sensitivity 72%, specificity 73%). Having ≥ 4 out of 7 criteria accurately predicted a high risk for the need for surgical intervention. Prospective trials are recommended to see if this would enable homogeneity in deciding when to intervene in patients with parapneumonic effusion thereby reducing the LOS and cost-burden on the healthcare system.
Para ser humanos necesitamos ser libres
Authors: Montoya Aquiles 
Published: May 2017

El ser humano es el único ser vivo que por su naturaleza puede ser libre. El trabajo es una necesidad interna al ser humano y es que el trabajo como actividad libre y consciente, es una forma de realización humana. En el capitalismo, no sólo estamos acabando con la naturaleza, sino que impedimos la plena realización humana. Nos hemos transformado en depredadores de toda forma de vida. Si no transformamos esta forma histórica de sociedad, corremos el peligro de no tener historia, porque ya no habría seres humanos.Realidad: Revista de Ciencias Sociales y Humanidades No. 131, 2012: 53-64
Gringo iracundo: Roque Dalton y su padre
Authors: Atwood Roger 
Published: May 2017

Roque Dalton escribió en muchas oportunidades sobre su padre, el estadounidense Winnall Dalton, y su migración a El Salvador. A través de la figura del padre, Dalton desarrolló sus ideas sobre la opresión, la identidad y la relación entre los excluidos y los poderosos. En este artículo el autor se refiere a la manera en que la representación que Dalton dio de su padre reflejó la evolución de sus ideas sobre el imperialismo y el ejercicio del poder a nivel personal y político. Se propone aquí una nueva perspectiva sobre la relación de Dalton con su padre sobre la base de datos biográficos inéditos.Realidad: Revista de Ciencias Sociales y Humanidades No. 134, 2012: 525-551
La imaginación global y la ética cosmopolita en El asco de Horacio Castellanos Moya
Authors: Galindo-Doucette Evelyn 
Published: May 2017

La crítica ha propuesto que El asco de Horacio Castellanos Moya muestra el desencanto y el cinismo típico de las novelas centroamericanas de “posguerra” que critican el fracaso de los proyectos sociales de carácter utópico. En este trabajo, en cambio, se considera El asco dentro del contexto de un mundo en que el concepto de la nación y específicamente el nacionalismo, en el marco del neoliberalismo, ha entrado en crisis. Arguyo que no hay una estrategia narrativa desencantada que denuncia los errores de la nación, sino una ética que muestra una ruptura con la identidad nacional y el nacionalismo. El tono crítico no debe interpretarse como desencanto dado no hay evidencia de un encanto nacional previo. El monólogo, en cambio, anuncia una renovada ética humanitaria y cosmopolita que ha reemplazado la identificación nacional. Realidad: Revista de Ciencias Sociales y Humanidades No. 134, 2012: 553-565
Orientalism, Modernism, and Gender in Edith Wharton’s Late Novels
Authors: Toth Margaret A. 
Published: May 2017

Given the excellent scholarship on Edith Wharton and race appearing in the last two decades, surprisingly little critical attention has been given to a racial discourse that pervades much of Wharton’s writing: Orientalism. This essay demonstrates that Orientalism informs several of Wharton’s novels and, in the case of late works like Twilight Sleep, The Glimpses of the Moon, Hudson River Bracketed, and The Gods Arrive, shapes them in fundamental and complex—if sometimes inconsistent—ways. Specifically, Wharton uses references to Orientalism as a vehicle through which to identify and critique various ills she perceives in modernist social and aesthetic trends. Attending to Wharton’s engagement with Orientalism, then, opens up new interpretations of her late works, particularly with respect to race, gender, and modernism. Moreover, understanding Wharton’s Orientalism allows us to situate her as a global citizen and grapple with the imperialist views subtending her fiction.
De Roboré aos anos 2000: A Bolívia como Vértice de (In)Segurança Energética Brasileira?
Authors: Tasca Tiago 
Published: May 2017

<p>Este artigo tem como tema a segurança energética brasileira e sua relação com o gás natural importado da Bolívia. A construção do elo gasífero brasileiro-boliviano tem seu desenvolvimento desde os anos 1950, confluindo com a assinatura do Tratado de La Paz (1996) e com a edificação do Gasoduto Brasil-Bolívia. Essa trajetória não esteve isenta de desafios e dificuldades para a segurança energética brasileira, sobretudo após os anos 2000. Destarte, o objetivo central é apresentar a Bolívia como vetor de (in)segurança energética brasileira. Parte-se da seguinte pergunta: a Bolívia configura-se como ameaça à segurança energética brasileira depois de 2000? Para respondê-la, utiliza-se do estudo de caso do Gasbol e da estratégia metodológica da inferência descritiva. Conclui-se, a partir de um <em>framework </em>analítico de fonte de risco, escopo da medida de impacto e certeza da ameaça que a Bolívia pode configurar uma ameaça à segurança energética brasileira. Todavia, dois mecanismos devem ser levados em conta no cálculo das decisões energéticas brasileiras concernentes às negociações de renovação do Gasbol, em 2019: diversificação de suprimento e resiliência. </p>
Twists of the Lily: Floral Ambivalence in the Work of Virginia Woolf and Georgia O’Keeffe
Authors: Sparks Elisa Kay 
Published: May 2017

Building on recent scholarship such as Amy King’s Bloom, this chapter complicates the simple identification of female and floral beauty, revealing with particular reference to Virginia Woolf and Georgia O'Keeffe how modernist women artists re-coded flower imagery to express gender conventions covertly. Woolf’s floral imagery can be informatively compared with Georgia O’Keeffe’s similarly complicated deployment of flowers as a challenge to over-simplistic Freudian interpretations of her work; both women self-consciously manipulated, reversed, and sometimes deconstructed traditional floral symbolism in an effort to create a new female rhetoric of modernism.
Picture this: Virginia Woolf in the British Good Housekeeping!? or Moving Picture This: Woolf’s London Essays and the Cinema
Authors: Hankins Leslie Kathleen 
Published: May 2017

This chapter assesses the illustrations for Virginia Woolf's London Scene essays as they were first published in the British Good Housekeeping magazine, 1920–32. Are etchings, paintings, or photographs adequate for capturing Woolf's kinetic prose? No, but moving pictures are, such as the Wonderful London and Open Road series of cinema shorts from 1924.
Sexual Cryptographies and War in Virginia Woolf’s Between the Acts and Elizabeth Bowen’s The Heat of the Day
Authors: Lonnquist Barbara 
Published: May 2017

This chapter examines Elizabeth Bowen’s and Virginia Woolf ’s shared use of the cryptographic in their novels bracketing World War II: Woolf’s Between the Acts (1941) and Bowen’s The Heat of the Day (1948). Although Bowen realizes a landscape only intimated by Woolf, both use war as a focalizing point for examining the intersection of history and private experience as embodied in the ages of their female protagonists.