bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical profile of functional constipation in Saudi children
Authors: El Mouzan Mohammad , Kambal Mohammed , Alabdulkarim Hayfa , Alshammari Nawaf Rahi , Alanazi Rehab , Al Sarkhy Ahmed , Alhamid Nouf , Assiri Asaad Muhammed , Alzahrani Alhanouf , Shaik Shaffi Ahamed , Alasmi Mona 
Published: April 2024

BACKGROUND:
Functional constipation (FC) is a common condition in children, and information on the clinical characteristics of FC in Saudi children is scarce.

OBJECTIVE:
Describe the clinical profile of FC in Saudi children.

DESIGN:
Retrospective

SETTING:
Hospital that provides primary, intermediate and tertiary care.

PATIENTS AND METHODS:
All children diagnosed with FC according to the Rome IV criteria were included and had at least one follow-up clinic visit. Demographic and clinical data collected from medical records included the age at onset, duration of constipation, clinical features, treatment modalities, and factors associated with clinical response. Descriptive statistics and Pearson's chi-squared test were used in the statistical analysis to see how categorical study variables were linked to clinical response. A P value of ≤.05 was used to report statistical significance.

MAIN OUTCOME MEASURE:
Compliance and clinical response to polyethylene glycol (PEG) compared with lactulose.

SAMPLE SIZE:
370 children from 0.1 to 13 years of age.

RESULTS:

The median (IQR) age of onset was 4 (5) years and less than one year in 14%. The median (IQR) duration of constipation was 4 months (11) and less than two months in 93/370 (25%). Abdominal pain was the most commonly associated feature (44%). Screening for celiac disease and hypothyroidism was negative. A Fleet enema was the most common disimpaction method (54%) and PEG was the most common maintenance medication (63.4%). PEG was significantly better tolerated (
P
=.0008) and more effective than lactulose (
P
<.0001). Compliance was the only variable significantly associated with clinical response.

CONCLUSIONS:
PEG was better tolerated and more effective than lactulose in our study, a finding in agreement with the literature. Therefore, PEG should be the drug of choice in the initial management of FC in Saudi children. Prospective studies on the causes of noncompliance are needed to improve the response to treatment.

LIMITATIONS:
The limitations of retrospective design are missing data, recall bias, and hospital-based limitation, such as missing milder cases treated at the outpatient level. However, the sample size of 370 may have minimized these limitations.
Predicting COVID-19 outcomes with the Edmonton Obesity Staging System
Authors: Ali Sajjad , Khan Omar Sufyan , Youssef Amira M. , Saba Iram , Alqahtani Leena , Alduhaim Renad Abdulaziz , Almesned Renad 
Published: April 2024

BACKGROUND:
Multiple studies have demonstrated a correlation between a high body mass index and discriminatory COVID-19 outcomes. Studies appear to indicate that there is a correlation between obesity-related comorbidities and less favorable outcomes.

OBJECTIVES:
The primary aim of the current investigation is to conduct a thorough assessment of the correlation between BMI and comorbidities associated with obesity, and their potential impact on the severity and consequences of COVID-19 infection among patients receiving care in a tertiary healthcare setting.

DESIGN:
Retrospective cohort

SETTINGS:
Tertiary rehabilitation center, Riyadh, Saudi Arabia

PATIENTS AND METHODS:
The study included all individuals who received medical treatment and tested positive for COVID-19 by means of RT-PCR during the period from March to September 2020. COVID-19 patients were classified using Edmonton Obesity Staging System (EOSS).

MAIN OUTCOME MEASURES:
COVID-19-related complications, including pneumonia and cytokine release syndrome, as well as the time length to COVID-19 negativization.

SAMPLE SIZE:
315 patients

RESULTS:
The median (25th–75th percentiles) age of the patients was 38 (31.5-49) years old. Males outnumbered females, and 66% of patients were non-Saudis. Forty-eight patients (15.2%) had obesity class I, whereas 13 patients (4.1%) had class II. Thirty-two patients (10.2%) were classified as EOSS stage 1, 105 patients (33.3%) were classified as EOSS stage 2, and 25 patients (7.9%) were assigned to EOSS stage 3. Males predominated in EOSS stages 1 and 2, whereas females predominated in stage 3. In EOSS stage 3, 52% of cases had moderate severity and 48% had severe illness.

CONCLUSIONS:
EOSS distinguishes the COVID-19 risks of poor outcomes beyond BMI. Patients who were overweight or obese but remained in the stage 1 of the EOSS had a lower risk of a poor COVID-19 outome than normal-weight patients. The health status of obese patients is a more precise indicator of the progression of COVID-19 during hospitalization than BMI alone.

LIMITATIONS:
Given the limited capacity of urgent care facilities to conduct a comprehensive evaluation of comorbidities and other relevant outcomes in all patients, it is plausible that certain patients may have been erroneously classified with an EOSS stage 2 diagnosis, when in fact they ought to have been assigned a stage 3 diagnosis.
Microorganism diversity and contamination risk in mosque rosaries and carpets
Authors: Özdemir Metin , Karat Erhan , Savci Ünsal , Isler Hacer 
Published: April 2024

BACKGROUND:
Inevitably, the floors of mosques are contaminated with microorganisms, and the risk of pathogen transmission is probably high between the many visitors, but the issue has been infrequently studied.

OBJECTIVES:
Investigate microorganism variety and risk of contamination on commonly used carpets and rosaries (prayer beads).

DESIGN:
Cross-sectional

SETTINGS:
Mosques

METHODS:
This study was carried out in three different cities of Turkey in 2023, focusing on mosques located around hospitals. Forty mosques were included in the study and from each mosque 10 samples were collected from various parts of carpets and rosaries. The number of positive culture isolates were identified.

MAIN OUTCOME MEASURES:

Diversity and distribution of microorganisms isolated from mosque carpets and rosaries; methicillin-resistance rates in
Staphylococci
.

SAMPLE SIZE:
400 samples

RESULTS:

Growth was observed in 368 (92%) of 400 samples examined. The microorganisms isolated in the highest number were methicillin-susceptible coagulase negative
Staphylococci
(MSCoNS) (59.8%),
Microcooccus
(41%) and diphtheroids (31.3%). The rates of total growth (
P
=.001), including diphtheroids (
P
=.018), methicillin-resistant coagulase negative
Staphylococci
(P=.001),
Bacillus spp.
(
P
=.036) and
Aspergillus spp.
(
P
=.002) rates were significantly higher in the rosary samples than carpet samples. At mosques in Tokat, a province center, 4 samples were positive for
Acinetobacter baumannii
, two samples were positive for
Pseudomonas aeruginosa
and one sample for methicillin-resistant
Staphylococcus aureus
(MRSA), and these were isolated from rosaries. 0.3% of
Staphylococcus
isolates were MRSA.

CONCLUSION:
As there is a high risk of contamination of carpets and prayer beads on the mosque floor with human flora, the use of appropriate hygiene practices is necessary. We also found some emerging bacteria in addition to the normal human flora.

LIMITATIONS:
Our study was conducted in three provinces. Further studies might cover a wider geography.
The variation in preventable hospitalization in patients with type 2 diabetes in Kentucky before and after the Medicaid expansion
Authors: Arbaein Turky , Little Bert , Monshi Sarah , Al-Wathinani Ahmed M. , Zaidan Amal 
Published: April 2024

BACKGROUND:
Hospitalizations are more resource intensive and expensive than outpatient care. Therefore, type 2 diabetes-related preventable hospitalization are a major topic of research efficiency in the healthcare system.

OBJECTIVES:
Analyze county level variation in type 2 diabetes-related preventable hospitalization rates in Kentucky before the Medicaid expansion (2010-2013) and after the Medicaid expansion (2014-2017).

DESIGN:
Geographic mapping and cluster analysis

SETTING:
Data for a state of the United States of America

METHODS:
We used the KID data to generate geographic mapping for type 2 diabetes-related preventable hospitalizations to visualize rates. We included all Kentucky discharges of age 18 years and older with the ICD9/10 principal diagnosis code for type 2 diabetes. Then, we conducted cluster analysis techniques to compare county-level variation in type 2 diabetes-related preventable hospitalization rates across Kentucky counties pre- and post-Medicaid expansion.

MAIN OUTCOME AND MEASURES:
County type 2 diabetes-related preventable hospitalization pre- and post-Medicaid expansion.

RESULTS:

From 2010-2017, type 2 diabetes-related preventable hospitalization discharge rates reduced significantly in the period of the post-Medicaid expansion (
P
=.001). The spatial statistics analysis revealed a significant spatial clustering of counties with similar rates of type 2 diabetes-related preventable hospitalization in the south, east, and southeastern Kentucky pre- and post-Medicaid expansion (positive z-score and positive Moran's Index value (
P
>.05). Also, there was a significant clustering of counties with low type 2 diabetes-related preventable hospitalization rates in the north, west, and central regions of the state pre-Medicaid expansion and post-Medicaid expansion (positive z-score and positive Moran's Index value (
P
>.05).

CONCLUSION:
Kentucky counties in the southeast have experienced a significant clustering of highly avoidable hospitalization rates during both periods. Focusing on the vulnerable counties and the economic inequality in Kentucky could lead to efforts to lowering future type 2 diabetes-related preventable hospitalization rates.

LIMITATIONS:
We used de-identified data which does not provide insights into the frequency of hospitalizations per patient. An individual patient may be hospitalized several times and counted as several individuals.
Does red blood cell transfusion affect clinical outcomes in critically ill patients? A report from a large teaching hospital in south Iran
Authors: Naderi-Boldaji Vida , Zand Farid , Asmarian Naeimehossadat , Banifatemi Mahsa , Masjedi Mansoor , Sabetian Golnar , Ouhadian Maryam , Bayati Najmeh , Saeedizadeh Hamideh , Naderi Nima , Kasraian Leila 
Published: April 2024

BACKGROUND:
Despite the beneficial effects, RBC transfusion can be associated with infectious and non-infectious complications in critically ill patients.

OBJECTIVES:
Investigate current RBC transfusion practices and their effect on the clinical outcomes of patients in intensive care units (ICUs).

DESIGN:
Retrospective observational study

SETTING:
Three mixed medical-surgical adult ICUs of a large academic tertiary hospital

PATIENTS AND METHODS:
From March 2018 to February 2020, all adult patients admitted to medical or surgical ICU. Patients who received one or more RBC transfusions during the first month of ICU admission were included in the “transfusion” group, while the remaining patients were assigned to the “non-transfusion” group.

MAIN OUTCOME MEASURES:
Mortality and length of ICU and hospital stay.

SAMPLE SIZE:
2159 patients

RESULTS:
Of 594 patients who recieved transfusions, 27% of patients received red blood cell (RBC) products. The mean pre-transfusion hemoglobin (Hb) level was 8.05 (1.46) g/dL. There was a significant relationship between higher APACHE II scores and ICU mortality in patients with Hb levels of 7–9 g/dL (OR adjusted=1.05). Also, ICU mortality was associated with age (OR adjusted=1.03), APACHE II score (OR adjusted=1.08), and RBC transfusion (OR adjusted=2.01) in those whose Hb levels were >9 (g/dL).

CONCLUSION:
RBC transfusion was associated with an approximately doubled risk of ICU mortality in patients with Hb>9 g/dL. High APACHE II score and age increase the chance of death in the ICU by 8% and 3%, respectively. Hence, ICU physicians should consider a lower Hb threshold for RBC transfusion, and efforts must be made to optimize RBC transfusion practices.

LIMITATIONS:
Single-center and retrospective study.
Improved long-term survival rate in the responders to bortezomib, cyclophosphamide, dexamethasone induction therapy in a transplant-eligible cohort of predominantly middle-age multiple myeloma patients
Authors: Abdrabou Ahmed Kotb , Al Sharif Fahad , El Fakih Riad , Zahrani Hazaa Al , Al Yamany Ruah , Saleh Mostafa , Alhayli Saud , Al Somali Zakia , Alotaibi Ahmad , AlShaibani AlFadel , Deeba Farah , Asif Maryam , Ahmed Syed Ahmed Osman Ali , Al Fraih Feras , Shaheen Marwan , Alahmari Ali , Rasheed Walid , Chaudhri Naeem Arshad , Al Mohareb Fahad , Aljurf Mahmoud , Hanbali Amr 
Published: April 2024

BACKGROUND:
Multiple myeloma (MM) represents the second most common hematologic malignancy (15%). Induction with bortezomib, cyclophosphamide, and dexamthasone VCd (d: low dose dexamthasone) regimen is widely used due to its high effectiveness, low toxicity and good tolerability, particularly with renal impairment. Real-world data on the use of VCD in clinical practice is lacking.

OBJECTIVES:
Evaluate the real-world experience of the VCD regimen

DESIGN:
Retrospective

SETTING:
Tumor registry database of tertiary cancer care center

PATIENTS AND METHODS:
Newly diagnosed MM patients who received VCD induction and underwent autologous stem cell transplant (ASCT) from July 2007 to July 2020

MAIN OUTCOME MEASURES:
Response evaluation, progression-free survival (PFS) and overall survival (OS).

SAMPLE SIZE:
87 patients

RESULTS:

Of 102 patients who started induction with VCd, 87 patients experienced a partial response or more overall response rate of 85%). The median age of these 87 patients at diagnosis was 52 years, of which 29.9% presented with renal impairment and 60.3% of patients had stage 2 by the Revised International Staging System (R-ISS). Patients with a standard cytogenetic risk achieved a better response compared to those with a poor cytogenetic risk (
P
=.044). The post-induction response rates were 6.9% stringent complete remission (sCR), 35% complete remission (CR); 41.4% very good partial response (VGPR), and 16.1% partial response (PR), respectively; the response rates became greater for sCR and CR post-transplantation at day 100 with 16.1% sCR, 35.6% CR, 32.2% VGPR and 16.1% PR, respectively. The median PFS was 49 months and 5 years OS was 84%. PFS was better in patients who achieved sCR vs PR (83 vs 35 months,
P
=.037). High LDH, high-risk cytogenetic and stage 3 R-ISS showed a worse median PFS and OS.

CONCLUSIONS:
VCD induction in newly diagnosed MM is highly effective, convenient, tolerable and affordable regimen, especially in low and middle-income countries with limited resources, also with favorable outcomes and survival. while those who did not respond successfully shifted to VRD or VTD.

LIMITATIONS:
The usual limitations of a retrospective analysis using registry-level data, no data on quality of life.
THE INFLUENCE OF EXTERNAL ENVIRONMENTAL FACTORS ON THE IMPLEMENTATION OF THE HUMAN RESOURCE INFORMATION SYSTEM IN GHANA. AN EMPIRICAL STUDY IN THE UPPER WEST REGION MMDA’S
Authors: Yahaya Haleem  , E.M George Ditsa  
Published: April 2024

The study examines the relationship between the external factors (government policy, external support and competitive pressure) and the implementation of the HRIS (acceptance and effectiveness). The study assessed the level of acceptability of each variable in the study. The study was a quantitative study which centers on question-based survey. The study used purposive sampling technique and a sample of 187 line managers of the eleven (11) MMDAs in the Upper West Region of Ghana were selected. The unit of analysis was at the individual level where opinions of the line managers were sought to assess the relationship between the individual characteristics and the implementation the HRIS. The unit of measurement was likert scale. SPSS was used to carry out the analysis of this study. Bivariate correlation was used to establish one-on-one relationship between variables operationalized in this study. The findings revealed that Competitive Pressure and External Support had a moderate level of acceptance whereas Government Policies have a low level of acceptance as factors that affect the implementation of the HRIS. The study revealed that, government policies, external support, competitive pressure had correlation with the acceptance of the HRIS. Lastly, it concluded that government colicies, competitive pressure had correlation with the effectiveness of the HRIS whereas external support had no correlation with the effectiveness of the HRIS. The study recommended Ghana's government to create sound regulations that will facilitate the HRIS adoption and implementation.
Keywords: Human Resource Information System, Environmental Factors, Implementation, Government Policy, External Support, Competitive Advantage, Acceptance, Effectiveness.
Evinacumab (Evkeeza)
Authors: CADTH  
Published: April 2024

CADTH reimbursement reviews are comprehensive assessments of the clinical effectiveness and cost-effectiveness, as well as patient and clinician perspectives, of a drug or drug class.
The assessments inform non-binding recommendations that help guide the reimbursement decisions of Canada’s federal, provincial, and territorial governments, with the exception of Quebec.
This review assesses evinacumab (Evkeeza), 150 mg/mL (345 mg/2.3 mL and 1,200 mg/8 mL) solution in single-dose vials for IV infusion.
Indication: As an adjunct to diet and other low-density lipoprotein cholesterol–lowering therapies for the treatment of adult and pediatric patients aged 5 years and older with homozygous familial hypercholesterolemia.
Comparing the simulated influence of biomass burning plumes on low-level clouds over the southeastern Atlantic under varying smoke conditions
Authors: Baró Pérez Alejandro , Diamond Michael S. , Bender Frida A.-M. , Devasthale Abhay , Schwarz Matthias , Savre Julien , Tonttila Juha , Kokkola Harri , Lee Hyunho , Painemal David , Ekman Annica M. L. 
Published: April 2024

Abstract. Biomass burning plumes are frequently transported over the southeast Atlantic (SEA) stratocumulus deck during the southern African fire season (June–October). The plumes bring large amounts of absorbing aerosols and enhanced moisture, which can trigger a rich set of aerosol–cloud–radiation interactions with climatic consequences that are still poorly understood. We use large-eddy simulation (LES) to explore and disentangle the individual impacts of aerosols and moisture on the underlying stratocumulus clouds, the marine boundary layer (MBL) evolution, and the stratocumulus-to-cumulus transition (SCT) for three different meteorological situations over the southeast Atlantic during August 2017. For all three cases, our LES shows that the SCT is driven by increased sea surface temperatures and cloud-top entrainment as the air is advected towards the Equator. In the LES model, aerosol indirect effects, including impacts on drizzle production, have a small influence on the modeled cloud evolution and SCT, even when aerosol concentrations are lowered to background concentrations. In contrast, local semi-direct effects, i.e., aerosol absorption of solar radiation in the MBL, cause a reduction in cloud cover that can lead to a speed-up of the SCT, in particular during the daytime and during broken cloud conditions, especially in highly polluted situations. The largest impact on the radiative budget comes from aerosol impacts on cloud albedo: the plume with absorbing aerosols produces a total average 3 d of simulations. We find that the moisture accompanying the aerosol plume produces an additional cooling effect that is about as large as the total aerosol radiative effect. Overall, there is still a large uncertainty associated with the radiative and cloud evolution effects of biomass burning aerosols. A comparison between different models in a common framework, combined with constraints from in situ observations, could help to reduce the uncertainty.
Hailstorm events in the Central Andes of Peru: insights from historical data and radar microphysics
Authors: Valdivia Jairo M. , Flores-Rojas José Luis , Prado Josep J. , Guizado David , Villalobos-Puma Elver , Callañaupa Stephany , Silva-Vidal Yamina 
Published: April 2024

Abstract. Hailstorms, while fascinating from a meteorological perspective, pose significant risks to communities, agriculture, and infrastructure. In regions such as the Central Andes of Peru, the characteristics and frequency of these extreme weather events remain largely uncharted. This study fills this gap by investigating the historical frequency and vertical structure of hailstorms in this region. We analyzed historical hailstorm records dating back to 1958 alongside 4 years of observations (2017–2021) from the Parsivel2 disdrometer and a cloud-profiling radar MIRA35c. Our findings indicate a trend of decreasing hail frequency (−0.5 events per decade). However, the p value of 0.07 suggests the need for further investigation, particularly in relation to environmental changes and reporting methods. The results show that hailstorms predominantly occur during the austral summer months, with peak frequency in December, and are most common during the afternoon and early evening hours. The analysis of radar variables such as reflectivity, radial velocity, spectral width, and linear depolarization ratio (LDR) reveals distinct vertical profiles for hail events. Two case studies highlight the diversity in the radar measurements of hailstorms, underscoring the complexity of accurate hail detection. This study suggests the need for refining the Parsivel2 algorithm and further understanding its classification of hydrometeors. Additionally, the limitations of conventional radar variables for hail detection are discussed, recommending the use of LDR and Doppler spectrum analysis for future research. Our findings lay the groundwork for the development of more efficient hail detection algorithms and improved understanding of hailstorms in the Central Andes of Peru.
PRODUTIVIDADE DE CLONES DE EUCALYPTUS NAS CONDIÇÕES AMBIENTAIS DE JABOTICABAL, SP
Authors: Oliveira José Carlos , De Paula Nádia Figueiredo , De Paula Rinaldo César 
Published: April 2024

O Brasil é referência mundial em plantio de Eucalyptus, com mais de 7 milhões de hectares cultivados com espécies/híbridos do gênero. Os plantios são constituídos por genótipos de alta produtividade desenvolvidos e selecionados em programas de melhoramento. De maneira geral existem clones selecionados para as diversas regiões do país, em que as condições ambientais exercem forte influência na escolha desses genótipos. Nos últimos anos tem havido queda na produtividade, a qual é atribuída a mudanças climáticas, como aumento das temperaturas e redução na quantidade de chuvas. Essa situação levou a necessidade de reavaliação da capacidade de adaptação de clones a ambientes diversos daqueles para o qual foram selecionados. Oito genótipos selecionados para diferentes regiões foram plantados em Jaboticabal, SP e aos cinco anos de idade foram avaliados quanto ao diâmetro do fuste e volume de madeira. Foi possível a distinção de dois grupos, com maior (C1, C3, C4, C7 e C8) e menor (C2, C5 e C6) produtividade. Os genótipos de maior crescimento correspondem àqueles procedentes de regiões com clima similar ao local de plantio, evidenciando que estes podem se adaptar a essa condição. Os genótipos de menor produtividade (procedentes de regiões mais frias) não seriam indicados para plantio nessa região.