bluuebunny/crossref_metadata_2025_split huggingface dataset:
A simple electronic medical record-based predictors of illness severity in sepsis (sepsis) score
Authors: Cressman Alex M. , Wen Bijun , Saha Sudipta , Jun Hae Young , Waters Riley , Lail Sharan , Jabeen Aneela , Koppula Radha , Lapointe-Shaw Lauren , Sheehan Kathleen A. , Weinerman Adina , Daneman Nick , Verma Amol A. , Razak Fahad , MacFadden Derek 
Published: June 2024

Objective
Current scores for predicting sepsis outcomes are limited by generalizability, complexity, and electronic medical record (EMR) integration. Here, we validate a simple EMR-based score for sepsis outcomes in a large multi-centre cohort.

Design
A simple electronic medical record-based predictor of illness severity in sepsis (SEPSIS) score was developed (4 additive lab-based predictors) using a population-based retrospective cohort study.

Setting
Internal medicine services across four academic teaching hospitals in Toronto, Canada from April 2010—March 2015 (primary cohort) and 2015–2019 (secondary cohort).

Patients
We identified patients admitted with sepsis based upon receipt of antibiotics and positive cultures.

Measurements and main results
The primary outcome was in-hospital mortality and secondary outcomes were ICU admission at 72 hours, and hospital length of stay (LOS). We calculated the area under the receiver operating curve (AUROC) for the SEPSIS score, qSOFA, and NEWS2. We then evaluated the SEPSIS score in a secondary cohort (2015–2019) of hospitalized patients receiving antibiotics. Our primary cohort included 1,890 patients with a median age of 72 years (IQR: 56–83). 9% died during hospitalization, 18.6% were admitted to ICU, and mean LOS was 12.7 days (SD: 21.5). In the primary and secondary (2015–2019, 4811 patients) cohorts, the AUROCs of the SEPSIS score for predicting in-hospital mortality were 0.63 and 0.64 respectively, which were similar to NEWS2 (0.62 and 0.67) and qSOFA (0.62 and 0.68). AUROCs for predicting ICU admission at 72 hours, and length of stay > 14 days, were similar between scores, in the primary and secondary cohorts. All scores had comparable calibration for predicting mortality.

Conclusions
An EMR-based SEPSIS score shows a similar ability to predict important clinical outcomes compared with other validated scores (qSOFA and NEWS2). Because of the SEPSIS score’s simplicity, it may prove a useful tool for clinical and research applications.
High viral suppression rates among PLHIV on dolutegravir who had an initial episode of viral non-suppression in Uganda September 2020–July 2021
Authors: Namayanja Grace A. , Da Silva Juliana de Fatima , Elur Bill , Nasirumbi Pamela M. , Raizes Elliot , Ssempiira Julius , Nazziwa Esther , Nabukenya Miriam , Sewanyana Isaac , Balaba Jennifer , Ntale Jonathan , Calnan Jackie , Birabwa Estella , Akao Juliet , Mwangi Christina , Naluguza Mary , Ahimbisibwe Arthur , Katureebe Cordelia , Nabadda Susan , Nelson Lisa , Dirlikov Emilio 
Published: June 2024

Background
In 2019, WHO recommended dolutegravir (DTG) as a backbone for first- and second-line antiretroviral therapy (ART) regimens for people living with HIV (PLHIV). According to the 2018 Uganda’s HIV treatment guidelines, patients with viral non-suppression (≥1,000 copies/mL) should receive intensive adherence counseling (IAC) with repeat viral load (VL) within 6 months. This analysis focused on the prevalence and factors associated with viral suppression following IAC among PLHIV on DTG-based regimens (DBRs) with an initial episode of viral non-suppression (VNS) in Uganda.

Methods
We conducted a retrospective analysis for PLHIV on DBRs with an initial episode of VNS (≥1,000 copies/mL) in Uganda during October 2019–September 2020 who had a follow up VL test result during September 2020–July 2021. Data were abstracted from the Central Public Health Laboratory (CPHL) database, including patient demographics and VL results. Viral non-suppression (VNS) was defined as a VL test result of ≥1,000 copies/mL. We characterized PLHIV on DBRs and used logistic regression models to determine factors associated with VL suppression after an initial episode of VNS.

Results
A total of 564 PLHIV on DBRs with an initial episode of VNS were followed up and 43 were excluded due to missing data. Of the 521, 220 (42.2%) were children (<15 years) and 231 (44.3%) were female. Median age was 28 years (interquartile range [IQR]: 12–43 years), and median duration on DBRs was 12 months (IQR: 6–15 months). Overall, 80.8% (421/521) PLHIV had a suppressed viral load at first follow up testing (children = 74.5% [164/220]; adults = 85.4% [257/301]). Children with initial VL results ≥5,000 copies/mL were less likely to achieve viral suppression at follow up testing compared to those with <5,000 copies/mL (AOR: 0.38; 95% CI: 0.20–0.71; p = 0.002).

Conclusions
In a programmatic setting, most adults and children suppressed following an initial episode of VNS on DBRs. High rates of suppression after VNS suggest adherence challenges, rather than drug resistance. Continuation of DBRs should be considered before regimen switch.
The Hong Kong version of Montreal Cognitive Assessment for the Visually Impaired (HKMoCA-VI): Proposed cut-off and cognitive functioning survey of visually impaired elderly in residential homes
Authors: Yip Calvin Chi Kong , Wong Winsy Wing Sze , Cheng Calvin Pak Wing , Chiu Armstrong Tat San 
Published: June 2024

Background
Visual impairment has been strongly associated with the incidence of dementia. Appropriate cognitive screening for the elderly with visual impairment is crucial for early identification of dementia and its management. Due to challenges in processing visually presented stimuli among participants, the cut-off score of the Hong Kong version of the Montreal Cognitive Assessment for the Visually Impaired (HKMoCA-VI), also known as MoCA-BLIND or MoCA-22, was unknown. Besides, the cognitive status of elderly with visual impairment residing in care homes is rarely investigated. The current study aimed to 1) establish the cut-off score for HKMoCA-VI and 2) examine the general cognitive functioning of elderly with visual impairment living in residential homes in Hong Kong in terms of MoCA-VI percentile scores.

Method
HKMoCA-VI and the Cantonese version of the Mini-Mental State Examination (CMMSE) were administered to 123 visually impaired elderly residents in care homes in Hong Kong. Percentile scores of HKMoCA-VI by age and education level were determined, and the concurrent validity, sensitivity, and specificity of HKMoCA-VI were assessed.

Results
A cut-off score 12 was suggested for HKMoCA-VI, which yielded a sensitivity and specificity of 89.29% and 83.58%, respectively. Moreover, it strongly correlated with CMMSE, indicating satisfactory concurrent validity.

Conclusions
HKMoCA-VI is suggested to be a viable cognitive screening tool for elderly individuals with visual impairment in residential homes. Further modifications to enhance the sensitivity and specificity of the measure are proposed.
Association of dietary total antioxidant capacity with general and abdominal obesity in type 2 diabetes mellitus patients
Authors: El Frakchi Najia , El Kinany Khaoula , El Baldi Marwa , Saoud Younes , El Rhazi Karima 
Published: June 2024

Background
The dual existence of Type 2 Diabetes Mellitus (T2DM) and obesity within a single individual may describe a combined adverse health effects, including impaired quality of life and increased risk for cardiovascular diseases (CVDs). Oxidative stress is a contributing factor to the pathogenesis of obesity. Meanwhile, dietary antioxidants may improve the antioxidant defense system and thereby decrease oxidative injury. Dietary total antioxidant capacity (TAC) is usually used to investigate the potential health effects of dietary antioxidant intake on several oxidative stress induced chronic diseases. This study aimed to examine the association of dietary TAC with obesity-related features in T2DM patients.

Methods
The present study included 254 type 2 diabetes outpatients with a mean (SD) age of 54.52 (7.21) years and mean (SD) diabetes duration of 8.2 (6.4) years. Data on dietary intake was assessed using a validated food frequency questionnaire. Dietary TAC was estimated by ferric reducing antioxidant potential (FRAP) method. Anthropometric, clinical and lifestyle characteristics were all collected.

Results
In linear regression analyses, dietary antioxidant capacity was inversely associated with body mass index (β = −0,231; 95% CI, −0,419 to −0,042), waist circumference (β = −0,427; 95% CI, −0,849 to −0,006) and fat mass percentage (β = −0,328; 95% CI, −0,545 to −0,112) independently of the assessed confounding variables. Interestingly, dietary TAC showed positive and significant associations with vitamin A, vitamin C, β-carotene, magnesium, folic acid and iron intakes, after adjusting for age and daily energy intake.

Conclusions
Higher intake of dietary TAC was in association with lower indices of general and central obesity in T2DM patients. Therefore, dietary recommendations for counteracting obesity in patients with T2DM should take into account a high dietary TAC.
Enhancing long COVID care in general practice: A qualitative study
Authors: Broughan John , Sietiņš Emīls , Emily Siu Ka Yuet , Clendennen Nia , Collins Claire , Fawsitt Ronan , Lambert John S. , Savinelli Stefano , Skeffington Stephanie , McCombe Geoff , Cullen Walter 
Published: June 2024

Introduction
Research suggests that general practice can play an important role in managing long COVID. However, studies investigating the perspectives of general practitioners (GPs) and patients are lacking and knowledge regarding optimal long COVID care in general practice is therefore limited.

Aim
To investigate GPs’ and patients’ perspectives on the topic of long COVID and its management in general practice.

Methods
Brief questionnaires (GP n = 11, Patient n = 7) and in-depth semi-structured interviews (GP n = 10, Patient n = 7) were conducted with GPs and patients from Irish general practices during July 2022-January 2023. Interviews were conducted via telephone and audio recordings were transcribed. A phenomenological analysis involving reflexive thematic analysis and constant comparison techniques was adopted.

Results
Analysis of interviews with GPs (male = 7, female = 3; median age = 50yrs (IQR = 39.5–56)) and patients (males = 2, female = 5; median age = 58yrs (IQR = 45-62yrs) generated four themes. These were (1) Complex presentations (2) the value of standardising care, (3) choosing the right path, and (4) supportive and collaborative doctor-patient relationships. Strong agreement was observed among GPs and patients regarding the need for holistic and integrated multidisciplinary care. Supportive and collaborative doctor-patient relationships were largely well received by GPs and patients also. GPs strongly endorsed standardising long COVID care operations.

Conclusion
GPs and patients indicated that structured, integrated, and collaborative care can help optimise long COVID management in general practice. GPs are advised to incorporate these elements into their long COVID care practices going forward. Future research examining stakeholder’s perspectives using larger and longitudinal samples is advised to enhance the generalisability of evidence in this area.
Transcatheter Arterial Radioembolization–Induced Gastric Ulcer in an Excluded Stomach After Roux-en-Y Gastric Bypass
Authors: Kim Grace E. , Chen Dennis 
Published: June 2024

ABSTRACT
Transcatheter arterial radioembolization (TARE) is a common locoregional treatment for hepatocellular carcinoma. It is associated with peptic ulcer disease in up to 5% of patients. A 70-year-old man with Roux-en-Y gastric bypass and liver cirrhosis with hepatocellular carcinoma treated with TARE 6 months earlier was evaluated for continued melena and was found to have an ulcer in the excluded stomach. This was successfully treated with liquid proton pump inhibitor through gastrostomy tube to the excluded stomach. This represents a unique case of successful management of TARE-induced peptic ulcer disease in the excluded stomach of a Roux-en-Y gastric bypass patient.
Distinct Longitudinal Trajectories of Symptom Burden Predict Clinical Outcomes in End-Stage Liver Disease
Authors: Hansen Lissi , Chang Michael F. , Hiatt Shirin , Dieckmann Nathan F. , Lee Christopher S. 
Published: June 2024

INTRODUCTION:
Little has been reported about the clinical relevance and trajectories of symptoms in end-stage liver disease (ESLD). The purpose of this prospective study was to identify trajectories of change in symptom burden over the course of 12 months in adults with ESLD.

METHODS:
Patients were recruited from hepatology clinics at 2 healthcare systems. Validated measures were used to assess physical and psychological symptoms. Latent growth mixture modeling and survival and growth modeling were used to analyze the survey data.

RESULTS:
Data were available for 192 patients (mean age 56.5 ± 11.1 years, 64.1% male, mean Model for ESLD (MELD) 3.0 19.2 ± 5.1, ethyl alcohol as primary etiology 33.9%, ascites 88.5%, encephalopathy 70.8%); there were 38 deaths and 39 liver transplantations over 12 months. Two symptom trajectories were identified: 62 patients (32.3%) had high and unmitigated symptoms, and 130 (67.7%) had lower and improving symptoms. Patients with high and unmitigated symptoms had twice the hazard of all-cause mortality (subhazard ratio 2.53, 95% confidence interval: 1.32–4.83) and had worse physical (P < 0.001) and mental quality of life (P = 0.012) compared with patients with lower and improving symptoms. Symptom trajectories were not associated with MELD 3.0 scores (P = 0.395). Female sex, social support, and level of religiosity were significant predictors of symptom trajectories (P < 0.05 for all).

DISCUSSION:
There seems to be 2 distinct phenotypes of symptom experience in patients with ESLD that is independent of disease severity and associated with sex, social support, religiosity, and mortality. Identifying patients with high symptom burden can help optimize their care.
Serum Anion Gap at Admission Predicts All-Cause Mortality in Critically Ill Patients With Cirrhosis: A Retrospective Cohort Study
Authors: Kou Yanqi , Du Shenshen , Zhang Mingcheng , Nie Biao , Yuan Weinan , He Kun , Qin Ling , Ye Shicai , Yang Yuping 
Published: June 2024

INTRODUCTION:
The primary objective of this study was to evaluate admission serum anion gap (AG) as a predictor of all-cause mortality in critically ill patients with cirrhosis.

METHODS:
A total of 3,084 cirrhotic patients were included and randomly divided into training and validation cohorts (n = 2,159 and 925, respectively). Patients were categorized into high and normal AG groups based on their AG values. Cox regression and Kaplan-Meier survival analysis were used to assess the relationships between AG levels and outcomes.

RESULTS:
Both cohorts showed strong parameter similarity (P > 0.05). High AG was associated with significantly lower survival probabilities. Cox models confirmed elevated AG as a risk factor, even after adjusting for covariates (hazard ratio: 1.920, 1.793, and 1.764 for 30-day, 60-day, and hospital mortality, respectively). Subgroup analyses, especially regarding chronic kidney disease, revealed complex interactions. Serum AG displayed predictive power comparable with established scoring systems.

DISCUSSION:
Elevated AG at admission is a valuable predictor of poor outcomes and increased mortality risk in critically ill cirrhotic patients. Serum AG can serve as an easily accessible tool for risk assessment and prognosis evaluation in this population.
Legal Reasoning and Compensation Determination in Sharia Economics: An In-Depth Analysis of Unlawful Acts in Case 84/Pdt.G/2019/PA.Yk
Authors: Widad Zaqil - , Saifuddin Saifuddin 
Published: June 2024

AbstractThe limitations of regulations in determining compensation for unlawful acts prompt judges in Religious Courts to engage in legal reasoning (ijtihad). This research aims to examine the determination of compensation in Sharia Economics disputes involving unlawful acts. The case under investigation is case number 84/Pdt.G/2019/PA.Yk, the plaintiff demands compensation as the defendant closed the BTN Sharia savings account without prior confirmation. The judicial panel upheld the compensation claim, referencing Articles 1375 and 1372 of the Indonesian Civil Code (KUHPerdata) and jurisprudence number 650/PK/Pdt./1994. The research employs a juridical-normative approach within qualitative research, gathering data through literature review and interviews. The findings reveal that judges refer to existing legal provisions to determine compensation based on trial facts and the parties' circumstances. Secondly, the legal basis and considerations align with the principles of legal discovery and Islamic law, particularly the maqasid asy-syariah, such as hifz al-mal (protection of wealth) and hifz al-‘ird (protection of dignity and reputation). This study underscores the judge's role in upholding justice and the subjective rights of the parties in the context of Sharia Economics. AbstrakKeterbatasan regulasi dalam menetapkan ganti rugi akibat perbuatan melawan hukum mendorong hakim Pengadilan Agama untuk melakukan ijtihad hukum. Penelitian ini bertujuan untuk mengkaji penetapan ganti rugi dalam sengketa Ekonomi Syari’ah yang melibatkan perbuatan melawan hukum. Kasus konkret dalam penelitian ini adalah perkara nomor 84/Pdt.G/2019/PA.Yk, di mana penggugat menuntut ganti rugi karena tergugat menutup buku tabungan BTN Syari’ah tanpa konfirmasi. Majelis hakim memutuskan untuk mengabulkan tuntutan ganti rugi, merujuk pada Pasal 1375 dan 1372 KUHPerdata, serta yurisprudensi nomor 650/PK/Pdt./1994. Pendekatan yang digunakan adalah yuridis-normatif dalam penelitian kualitatif, dengan pengumpulan data melalui studi kepustakaan dan wawancara. Hasil penelitian menunjukkan bahwa, pertama, hakim mengacu pada ketentuan hukum yang ada untuk menetapkan ganti rugi, berdasarkan fakta-fakta di persidangan dan kondisi para pihak. Kedua, dasar hukum dan pertimbangan hakim sejalan dengan prinsip penemuan hukum dan hukum Islam, terutama maqasid asy-syariah, seperti hifz al-mal (perlindungan harta) dan hifz al-‘ird (perlindungan martabat dan nama baik). Penelitian ini menyoroti peran hakim dalam menjaga keadilan dan hak-hak subjektif para pihak dalam konteks Ekonomi Syari’ah.
Determination of the Reserved Gap Between the Obturator Ring and the Breechblock in the Metallic Obturation Mechanism of a Large Caliber Gun Howitzer
Authors: Ding Shukui , Wang Heng , Qin Wenjie 
Published: June 2024

A reserved gap between the obturator ring and the breechblock in the obturation mechanism of a large-caliber gun is required in the locked state of the gun, which is the main cause of gas leakage. In this study, the finite element analysis of the dynamic contact between the obturator ring and the breechblock and the computational fluid dynamics (CFD) analysis of the high-pressure gas flow through the gap between the obturator ring and the breechblock are conducted. The results show that the smaller the reserved gap is, the shorter the time period during which the contact pressure is zero after the obturator ring contacts with the breechblock will be under a low-bore pressure condition. The results also demonstrate that the leakage flow at the outlet of the gap and the gas flow in the external domain increase with the reserved gap size, and the gas flow in the external domain decays rapidly if the reserved gap is less than or equal to 0.02 mm under a high bore pressure condition. Based on the simulation results, the appropriate reserved gap value is determined and adopted in the studied gun, and good results are achieved in the firing tests.
Landnutzungskarten – Ein Versuch zur Darstellung der Flächenbeanspruchung
Authors: Becker-Platen Jens Dieter , Hofmeister Erich , Klemz Burkhard , Stein Volker 
Published: June 2024

Es ist das Ziel, darzustellen, welche Flächennutzungen mit den Ansprüchen der Rohstoffwirtschaft konkurrieren, d. h. welche Flächen einer Region wegen anderer Nutzungszuweisungen nicht oder nur eingeschränkt für die Rohstoffsicherung zur Verfügung stehen. Dafür wurde, in Anlehnung an die Profiltypenkarten des Niedersächsischen Landesamtes für Bodenforschung, ein neuer Kartentyp entwickelt, der die Flächen mit Überlagerungen verschiedener Nutzungsansprüche schnell erkennen läßt und der auf einfachem Wege eine Bestimmung der jeweiligen Flächengrößen erlaubt, und zwar für Bebauung Natur- und Landschaftsschutz, Wasserwirtschaft und Rohstoffsicherung. Andere Flächenansprüche wurden nicht berücksichtigt, da sie für die Rohstoffsicherung nicht von überragender Bedeutung sind. Die einzelnen Flächennutzungen können aber nach Belieben ausgetauscht werden.Den einzelnen Flächen wird ein vierstelliger Zahlenkode zugewiesen, der sich aus den konkurrierenden Nutzungsansprüchen entsprechend ihrer vertikalen Abfolge in der Natur ergibt (1. Stelle = Bebauung, 2. Stelle = Natur- und Landschaftsschutz, 3. Stelle = Rohstoffwirtschaft, 4. Stelle = Wasserwirtschaft – Grundwasser). Die Gewichtung und die Verbindlichkeit des Anspruchs wird durch Zahlen von 1–5 angegeben (0 = kein Anspruch).Die Landnutzungskarten wurden sowohl für den Farbdruck als auch für den Schwarz-Weiß-Druck konzipiert. Die Möglichkeiten der EDV-Bearbeitung (Digitalisieren der Flächenumgrenzungen, Flächenkodierungen, Flächenberechnungen) werden beschrieben.
Developing Intercultural Communicative Competence (ICC) of English majors in courses dealing with the culture of English-speaking countries
Authors: Laskowska Martyna 
Published: June 2024

UNESCO (2013: 16) describes “intercultural competences” as: (1) the necessary linguistic knowledge and awareness when interacting with people from different cultures; (2) relevant knowledge about specific cultures; (3) broad comprehension about the issues that arise when members of different cultures interact; (4) adaptable attitudes that encourage creating and sustaining contact with diverse members of society. The development of intercultural competence has increasingly been recognized as a vital aim of foreign language (L2) education. The aim of the study was to investigate the relationship between courses related to the culture of English-speaking countries and the development of intercultural communicative competence of English philology students. Specifically, it explores participants’ opinions on whether the culture courses support students’ ability to acquire academic-level communicative competence, fluency in formal and informal language, and a holistic understanding of the spectrum of Anglophone communities. The participants of the study were English philology students and lecturers teaching culture courses. A mixed methodology was used with two types of research methods: a student survey and semi-structured interviews with lecturers. The results of the study allow for a formulation of didactic implications for the development of intercultural competence of English philology students.