bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical clowns versus sedation for paediatric urinary catheter insertion—A randomised pilot study
Authors: Raisin Galiya , Cohen Rachel , Galant Orit , Vaisfish Miriam , Jaworowski Sol , Jaber Jawdat , Kocherov Stanislav , Chertin Boris 
Published: February 2023

AbstractAimTo investigate the potential benefits of medical clowns (MCs) in reducing anxiety and pain during paediatric urinary catheter insertion.MethodsIn this prospective pilot study, 51 children who required urinary catheter insertion were randomised into two groups; the first group (n = 29) underwent the procedure in the presence of a MCs, and the second control group (n = 22) underwent the procedure using sedation. Pain and anxiety levels as well as procedural duration were recorded. All procedures were filmed and evaluated for anxiety level by a paediatric psychiatrist. General satisfaction questionnaires were filled by the medical team and parents in the clown group.ResultsThere were no differences in pain scores or anxiety levels between the two groups. Procedure duration and total hospital stay were significantly shorter in the MC group (p < 0.001). One hundred percent of the parents and the medical team were in favour of incorporating MCs during urinary catheter insertion.ConclusionMCs are as good as sedation in lowering anxiety and pain levels in children undergoing urinary catheter insertion. In addition, MCs reduce the duration of the procedure and elicit a high degree of overall satisfaction from the parents and medical team.
Challenges in using fractional excretion of sodium in the assessment of salt poisoning
Authors: Shenoy Savitha , Bockenhauer Detlef 
Published: February 2023

AbstractAimHypernatraemia typically reflects dehydration, yet in rare instances may be caused by salt poisoning. Identifying these rare cases is a difficult challenge. Making the diagnosis of salt poisoning can have severe consequences, such as the removal of the child from its home or even prison sentences for the implicated carer. It is therefore imperative to get the diagnosis right. Guidelines for the assessment of hypernatraemia emphasise the importance of the fractional excretion of sodium to distinguish between dehydration and salt poisoning, but no generally accepted cut‐off value exists. Opinions about the diagnosis of salt poisoning in some cases consequently may differ. Here, we aim to highlight the challenges and stimulate discussion on how to improve the tools for the assessment of hypernatraemia.MethodsReport of a case of unexplained hypernatraemia in which the treating paediatrician raised the suspicion of salt poisoning.ResultsTwo consulted experts made opposing judgements about the aetiology of the observed hypernatraemia.ConclusionClear diagnostic criteria for the diagnosis of salt poisoning are lacking and more data are needed for their establishment. Without this, victims may experience further harm and carers are at risk of devastating, yet potentially erroneous accusations.
Gastrointestinal parasites in ancient South American camelid feces from the Atacama Desert (Pampa del Tamarugal, Tarapacá, northern Chile)
Authors: Ramirez Darío Alejandro , Herrera‐Soto María José , González Andreu Josefina , Santana‐Sagredo Francisca , Uribe Rodríguez Mauricio , Nores Rodrigo 
Published: February 2023

AbstractFaunal remains from archeological sites worldwide, especially feces and regurgitated pellets, are usually subjected to paleoparasitological examination, allowing the identification of past animal parasites. In this study, we analyzed 10 samples of South American camelid dung, which played an important role for the ancient human groups in the South‐Central Andes, dated between 341 and 1635 calCE, from the Iluga Túmulos site (Pampa del Tamarugal, Tarapacá region, Atacama Desert, Chile). Microscopy examination revealed parasite remains in seven samples, in which oocysts of Eimeria macusaniensis and eggs of Lamanema chavezi/Nematodirus lamae, Trichuris sp., Moniezia sp., capillariids, strongylids, and unidentified nematodes were found. Although some of these species pose a potential health risk to camelids, most are not considered to be of major zoonotic importance, which could explain the absence of these parasites on human coprolites from this site analyzed previously. This first paleoparasitological study on camelid fecal remains from northern Chile sheds light on the occurrence of gastrointestinal parasites and its relationship with Andean ancient human populations and the environment.
Overseas imports on the Blue Nile: Chemical compositional analysis of glass beads from Soba, Nubia
Authors: Then‐Obłuska Joanna , Dussubieux Laure 
Published: February 2023

AbstractArchaeological evidence as well as textual sources leave no doubt about Alwa's (Alodia's) intense transcultural connections, further corroborated by understudied overseas glass bead imports found there. This paper presents results of an analysis of 23 glass beads from Soba, the most prosperous capital of medieval Nubia. Compositional analyses using laser ablation‐inductively coupled plasma‐mass spectrometry (LA‐ICP‐MS) have identified glass belonging to a number of broad compositional groups. Three samples were made of soda lime low‐alumina glass produced in the Middle East (v‐Na‐Ca) and Egypt (m/v‐Na‐Ca). The remaining beads were made of two types of mineral–soda high‐alumina glass (m‐Na‐Al) North Indian in origin. The results of this study provide new evidence for the provenance and chronology of glass beads available in medieval Soba and Northeast Africa, and contribute new data to research on trade contacts of that time.
Evaluation of acquired antithrombin deficiency in paediatric patients supported on extracorporeal membrane oxygenation
Authors: Procaccini David E. , Roem Jennifer , Ng Derek K. , Rappold Thomas E. , Jung Dawoon , Gobburu Jogarao V. S. , Bembea Melania M. 
Published: February 2023

AimsThere remains a paucity of literature regarding best practice for antithrombin (AT) monitoring, dosing and dose–response in paediatric extracorporeal membrane oxygenation (ECMO) patients.MethodsWe conducted a retrospective cohort study at a quaternary care paediatric intensive care unit in all patients <18 years of age supported on ECMO from 1 June 2011 to 30 April 2020. Adverse events and outcomes were characterized for all ECMO runs. AT activity and replacement were characterized and compared between two clinical protocols. AT activities measured post‐ vs. pre‐AT replacement were compared in order to characterize a dose–response relationship.ResultsThe final cohort included 191 patients with 201 ECMO runs and 2028 AT activity measurements. The median AT activity was 65% (interquartile range [IQR], 51–82) and 879 (43.3%) measurements met the criteria of deficient. The overall median AT dose and increase in AT activity were 50.6 units/kg/dose (IQR, 39.5–67.2) and 23.5% (IQR, 9.8–36.0), respectively. In the protocol that restricted AT activity measurements to clinical scenarios concerning for heparin resistance, there was significantly higher dosing in conjunction with significantly fewer overall administrations. Approximately one third of AT activity remained deficient after repletion. There was no difference in mechanical complications, reasons for discontinuation of ECMO support, time on ECMO or survival between protocols.ConclusionsThere was a high prevalence of AT deficiency in paediatric ECMO patients. An AT replacement protocol based on evaluating heparin resistance is associated with fewer AT administrations, with similar circuit and patient outcomes. Further data are needed to identify optimal dosing strategies.
Single‐cell atlas of the immune microenvironment reveals macrophage reprogramming and the potential dual macrophage‐targeted strategy in multiple myeloma
Authors: Li Jing , Yang Yang , Wang Wenjing , Xu Jiadai , Sun Yifeng , Jiang Jifeng , Tan Hui , Ren Liang , Wang Yue , Ren Yuhong , Zhang Yian , Xu Tianhong , Jia Xuebing , Huang Xiaoyun , Liu Peng 
Published: February 2023

SummaryThe tumour microenvironment (TME) plays a critical role in disease progression in multiple myeloma (MM). This study aimed to present an atlas of MM‐TME in disease progression and explore TME‐directed therapeutic strategies. We performed single‐cell RNA sequencing (scRNAseq) in samples from different disease stages. We validated the findings by bulk RNAseq, flow cytometry (FCM) and in vitro and in vivo functional experiments. We delineated a compromised TME during disease progression, characterized by enrichment of exhausted NK cells and CD8+ T cells and reprogramming of macrophages (MPs). The reprogrammed tumour‐associated MPs (TAMs) displayed a mixed phenotype showing both M1 and M2 features, with two TAM clusters exclusively present in the MM stage showing higher M2 scores. We validated the mixed M1/M2 phenotype in TAMs in a clinical cohort and verified phagocytic dysfunction in reprogrammed TAMs. Cellular interaction analysis identified two enriched ligand–receptor pairs between MPs and malignant plasma cells (PCs), including the SIRPA‐CD47 pathway suppressing phagocytosis and the CD74–MIF (macrophage inhibitory factor) reshaping the phenotype of MPs. The expression of CD47 and MIF correlated with disease progression and adverse outcomes. We designed a dual‐MP‐targeted strategy by combining an anti‐CD47 antibody and MIF inhibitor to activate phagocytosis and repolarize MP to a functional phenotype and proved its potent antitumour effect in vitro and in vivo. We drafted alterations in MM‐TME during disease progression and unravelled TAM's reprogramming. The dual MP‐targeted approach blocking both CD47 and MIF showed potent antitumour effects.
Single‐cell RNA sequencing reveals tumor heterogeneity, microenvironment, and drug‐resistance mechanisms of recurrent glioblastoma
Authors: Wu Haibin , Guo Chengcheng , Wang Chaoye , Xu Jiang , Zheng Suyue , Duan Jian , Li Yiyun , Bai Hongming , Xu Qiuyan , Ning Fangling , Wang Feng , Yang Qunying 
Published: February 2023

AbstractGlioblastomas are highly heterogeneous brain tumors. Despite the availability of standard treatment for glioblastoma multiforme (GBM), i.e., Stupp protocol, which involves surgical resection followed by radiotherapy and chemotherapy, glioblastoma remains refractory to treatment and recurrence is inevitable. Moreover, the biology of recurrent glioblastoma remains unclear. Increasing evidence has shown that intratumoral heterogeneity and the tumor microenvironment contribute to therapeutic resistance. However, the interaction between intracellular heterogeneity and drug resistance in recurrent GBMs remains controversial. The aim of this study was to map the transcriptome landscape of cancer cells and the tumor heterogeneity and tumor microenvironment in recurrent and drug‐resistant GBMs at a single‐cell resolution and further explore the mechanism of drug resistance of GBMs. We analyzed six tumor tissue samples from three patients with primary GBM and three patients with recurrent GBM in which recurrence and drug resistance developed after treatment with the standard Stupp protocol using single‐cell RNA sequencing. Using unbiased clustering, nine major cell clusters were identified. Upregulation of the expression of stemness‐related and cell‐cycle‐related genes was observed in recurrent GBM cells. Compared with the initial GBM tissues, recurrent GBM tissues showed a decreased proportion of microglia, consistent with previous reports. Finally, vascular endothelial growth factor A expression and the blood–brain barrier permeability were high, and the O6‐methylguanine DNA methyltransferase‐related signaling pathway was activated in recurrent GBM. Our results delineate the single‐cell map of recurrent glioblastoma, tumor heterogeneity, tumor microenvironment, and drug‐resistance mechanisms, providing new insights into treatment strategies for recurrent glioblastomas.
Multi‐agent Path Planning with Heterogenous Interactions in Tight Spaces
Authors: Modi V. , Chen Y. , Madan A. , Sueda S. , Levin D. I. W. 
Published: February 2023

AbstractBy starting with the assumption that motion is fundamentally a decision making problem, we use the world‐line concept from Special Relativity as the inspiration for a novel multi‐agent path planning method. We have identified a particular set of problems that have so far been overlooked by previous works. We present our solution for the global path planning problem for each agent and ensure smooth local collision avoidance for each pair of agents in the scene. We accomplish this by modelling the collision‐free trajectories of the agents through 2D space and time as rods in 3D. We obtain smooth trajectories by solving a non‐linear optimization problem with a quasi‐Newton interior point solver, initializing the solver with a non‐intersecting configuration from a modified Dijkstra's algorithm. This space–time formulation allows us to simulate previously ignored phenomena such as highly heterogeneous interactions in very constrained environments. It also provides a solution for scenes with unnaturally symmetric agent alignments without the need for jittering agent positions or velocities.
Corporate Endowment Insurance Fee Reduction and Employee Wages: Evidence from China
Authors: Zhang Xufei , Fang Hongsheng , Guo Lin 
Published: February 2023

AbstractTo stimulate economic growth, the Chinese government implemented three consecutive policies between 2016 and 2019 to reduce the corporate endowment insurance contribution ratio (CEICR), the highest payment item for Chinese companies. Using China's CEICR reduction policies as a quasi‐natural experiment, this paper evaluates the impact of corporate payment burden reduction on employee wages. Generally, reducing CEICR appears to prompt companies to increase employee wages. Corporate cash flow is a possible channel of influence. Moreover, the positive effect is found to be more pronounced in companies that are more labor intensive, performing better in labor payment compliance, and located in regions with higher pressure for elderly care. This paper offers evidence in favor of implementing CEICR reduction policies from the perspective of improving the well‐being of employees.
Impact of Outward Foreign Direct Investment on Chinese Manufacturing Firms' Financialization and Servitization
Authors: Nie Fei , Li Jian , Etienne Xiaoli , Li Gucheng 
Published: February 2023

AbstractThis study examines the impact of outward foreign direct investment (OFDI) on Chinese manufacturing firms' financialization and servitization. Using a difference‐in‐differences approach with propensity score matching, we found that OFDI encouraged firms' financial and service activities. The effects of OFDI on financialization were stronger for firms specializing in short‐term financial assets, operating in labor and technology‐intensive sectors, investing overseas to pursue production, resources and markets there, and investing in non‐OECD and Belt and Road Initiative (BRI) countries. Meanwhile, firms investing overseas were more likely to provide services at the sale or postsale stages. Outward foreign direct investment has also boosted the service activities of firms operating in the technology‐intensive sector by investing overseas to seek resources and markets, as well as investing in non‐OECD and BRI countries. Finally, OFDI partially influenced the extent of financialization and servitization of firms by affecting their profit‐making ability.
Challenges of methadone maintenance treatment decentralisation from Vietnamese primary care providers' perspectives
Authors: Nguyen Diep Bich , Nguyen Trang Thu , Lin Chunqing , Dinh Thuy Thi Thanh , Le Giang Minh , Li Li 
Published: February 2023

AbstractIntroductionDecentralising methadone maintenance treatment to primary care improves patients' access to care and their drug and HIV treatment outcomes. However, primary care providers (PCP), especially those working in limited‐resource settings, are facing great challenges to provide quality methadone treatment. This study explores the challenges perceived by PCP providing methadone treatment at commune health centres in a mountainous region in Vietnam.MethodWe conducted in‐depth interviews with 26 PCP who worked as program managers, physicians, counsellors, pharmacists and medication dispensing staff at the methadone programs of eight commune health centres in Dien Bien, Vietnam, in November and December 2019. We used the health‐care system framework in developing the interview guides and in summarising data themes.ResultsParticipants identified major challenges in providing methadone treatment in commune health centres at the individual, clinic and environmental levels. Individual‐level challenges included a lack of confidence and motivation in providing methadone treatment. Clinic‐level factors included inadequate human resources, lack of institutional support, insufficient technical support, lack of referral resources and additional support for patients. Environment‐level factors comprised a lack of reasonable policies on financial support for providers at commune health centres for providing methadone treatment, lack of regulations and mechanisms to ensure providers' safety in case of potential violence by patients and to share responsibility for overdose during treatment.Discussion and ConclusionPCP in Vietnam faced multi‐level challenges in providing quality methadone treatment. Supportive policies and additional resources are needed to ensure the effectiveness of the decentralisation program.
Cross‐sectional survey of a convenience sample of Australians who use alcohol home delivery services
Authors: Colbert Stephanie , Wilkinson Claire , Thornton Louise , Feng Xiaoqi , Campain Anna , Richmond Robyn 
Published: February 2023

AbstractIntroductionOnline alcohol purchasing and home delivery has increased in recent years, accelerated by the onset of the coronavirus disease 2019 pandemic. This article aims to investigate the purchasing and drinking behaviour of Australians who use online alcohol delivery services.MethodA cross‐sectional self‐report survey with a convenience sample of 1158 Australians ≥18 years (49.3% female) who used an online alcohol delivery service in the past 3 months, recruited through paid social media advertisements from September to November 2021. Quota sampling was used to obtain a sample with age and gender strata proportional to the Australian adult population. Descriptive statistics were generated and logistic regression used to explore variables that predict hazardous/harmful drinking (Alcohol Use Disorders Identification Test score ≥8).ResultsOne‐in‐five (20.1%, 95% confidence interval [CI] 17.8–22.5) participants had used an alcohol delivery service to extend a home drinking session because they had run out of alcohol and wanted to continue drinking and, of these, one‐third (33.9%, 95% CI 27.9–40.4) indicated that if the service was not available they would have stopped drinking. Using delivery services in this way was associated with six times higher odds of drinking at hazardous/harmful levels (odds ratio 6.26, 95% CI 3.78–10.36). Participants ≤25 years were significantly more likely to report never having their identification verified when receiving their alcohol delivery at the door compared with purchasing takeaway alcohol in‐person at a bottle shop (p < 0.001, McNemar).Discussion and ConclusionGiven the risks associated with alcohol delivery, regulation of these services should be improved to meet the same standards as bricks‐and‐mortar bottle shops.
Disasters collide at the intersection of extreme weather and infectious diseases
Authors: Drake John M. , Marty Éric , Gandhi Kamal J. K. , Welch‐Devine Meredith , Bledsoe Brian , Shepherd Marshall , Seymour Lynne , Fortuin Christine C. , Montes Cristian 
Published: February 2023

AbstractNatural disasters interact to affect the resilience and prosperity of communities and disproportionately affect low income families and communities of colour. However, due to lack of a common theoretical framework, these are rarely quantified. Observing severe weather events (e.g. hurricanes and tornadoes) and epidemics (e.g. COVID‐19) unfolding in southeastern US communities led us to conjecture that interactions among catastrophic disturbances might be much more considerable than previously recognized. For instance, hurricane evacuations increase human aggregation, a factor that affects the transmission of acute infections like SARS‐CoV‐2. Similarly, weather damage to health infrastructure can reduce a community's ability to provide services to people who are ill. As globalization and human population and movement continue to increase and weather events are becoming more intense, such complex interactions are expected to magnify and significantly impact environmental and human health.
It is past time to use ecosystem models tactically to support ecosystem‐based fisheries management: Case studies using Ecopath with Ecosim in an operational management context
Authors: Craig J. Kevin , Link Jason S. 
Published: February 2023

AbstractThe implementation of ecosystem management requires ecosystem modelling within the context of a natural resource management process. Ecopath with Ecosim (EwE) is the most widely used modelling platform for investigating the dynamics of marine ecosystems, but has played a limited role in fisheries management and in multi‐sector resource decision‐making. We review 10 case studies that demonstrate the use of EwE to support operational resource management. EwE models are being used to inform tactical decision‐making in fisheries and other ocean use sectors, as well as to identify key trade‐offs, develop appropriate policy objectives, and reconcile conflicting legislative mandates in a variety of ecosystems. We suggest the following criteria to enhance the use of EwE and other ecosystem models in operational resource management: (1) a clear management objective that can be addressed through modelling; (2) an important trade‐off and a receptive policy context amenable to trade‐off evaluation; (3) an accessible and well‐documented model that follows best practices; (4) early and iterative engagement among scientists, stakeholders, and managers; (5) integration within a collaborative management process; (6) a multi‐model approach; and (7) a rigorous review process. Our review suggests that existing management frameworks are as much or more of a limitation to the operational use of EwE than technical issues related to data availability and model uncertainty. Ecosystem models are increasingly needed to facilitate more effective and transparent decision‐making. We assert that the requisite conditions currently exist for enhanced strategic and tactical use of EwE to support fisheries and natural resource management.