bluuebunny/crossref_metadata_2025_split huggingface dataset:
Descriptive statistics and risk factor analysis of children with community-acquired septic shock
Authors: Miura Shinya , Michihata Nobuaki , Hashimoto Yohei , Matsui Hiroki , Fushimi Kiyohide , Yasunaga Hideo 
Published: February 2023

AbstractBackgroundChildren with community-acquired septic shock can rapidly deteriorate and die in acute-care hospitals. This study aimed to describe the mortality, timing, and risk factors in children with community-acquired septic shock.MethodsThis is a retrospective cohort study using a national inpatient database in Japan. The study population included children (age < 20 years) who were admitted to acute-care hospitals with a diagnosis of sepsis from July 2010 to March 2020, who were treated with antibiotics, and who were supported with vasoactive drugs within three days of hospitalization. We used a Cox proportional-hazards regression model to identify risk factors for earlier death.ResultsAmong 761 eligible children, the median age was 3 (interquartile range, 0–11) years and 57.2% had underlying conditions. Among these, 67.1% were admitted to accredited intensive care units within three days of hospitalization and 38.6% were transported from other hospitals. The median hospital volume, defined as the number of eligible children in each hospital over the study period, was 4 (interquartile range, 2–11). Overall, 244 children died (in-hospital mortality rate, 32.1%). Among them, 77 (31.6%) died on the first day, and 156 (63.9%) died within three days of hospitalization. A Cox proportional-hazards regression model showed that earlier death was associated with lower hospital volume and age 1–5 years, whereas it was inversely associated with admission to an accredited intensive care unit and transport from other hospitals. Among 517 survivors, 178 (34.4%) were discharged with comorbidities.ConclusionsChildren with community-acquired septic shock had high mortality, and early death was common. Our findings may warrant future efforts to enhance the quality of initial resuscitation for sepsis in low-volume hospitals and to ensure a healthcare system in which children with sepsis can be treated in accredited intensive care units.
Towards automatic text-based estimation of depression through symptom prediction
Authors: Milintsevich Kirill , Sirts Kairit , Dias Gaël 
Published: February 2023

AbstractMajor Depressive Disorder (MDD) is one of the most common and comorbid mental disorders that impacts a person’s day-to-day activity. In addition, MDD affects one’s linguistic footprint, which is reflected by subtle changes in speech production. This allows us to use natural language processing (NLP) techniques to build a neural classifier to detect depression from speech transcripts. Typically, current NLP systems discriminate only between the depressed and non-depressed states. This approach, however, disregards the complexity of the clinical picture of depression, as different people with MDD can suffer from different sets of depression symptoms. Therefore, predicting individual symptoms can provide more fine-grained information about a person’s condition. In this work, we look at the depression classification problem through the prism of the symptom network analysis approach, which shifts attention from a categorical analysis of depression towards a personalized analysis of symptom profiles. For that purpose, we trained a multi-target hierarchical regression model to predict individual depression symptoms from patient–psychiatrist interview transcripts from the DAIC-WOZ corpus. Our model achieved results on par with state-of-the-art models on both binary diagnostic classification and depression severity prediction while at the same time providing a more fine-grained overview of individual symptoms for each person. The model achieved a mean absolute error (MAE) from 0.438 to 0.830 on eight depression symptoms and showed state-of-the-art results in binary depression estimation (73.9 macro-F1) and total depression score prediction (3.78 MAE). Moreover, the model produced a symptom correlation graph that is structurally identical to the real one. The proposed symptom-based approach provides more in-depth information about the depressive condition by focusing on the individual symptoms rather than a general binary diagnosis.
A critical review of the research evidence on early childhood education and care in refugee contexts in low- and middle-income countries
Authors: Stevens Katharina Ereky , Siraj Iram , Kong Kimberley 
Published: February 2023

AbstractRefugee children are some of the most vulnerable populations in the world. Early Childhood Education and Care (ECEC) for refugee children can have positive impacts on child outcomes, however most of the evidence stems from research from high income countries. This paper reports on a critical review, carried out to evaluate what we know about benefits and the quality of ECEC programmes for refugee children in low- and middle-income countries (LMICs). 15 studies were identified, located in refugee camps and resettlement contexts in seven different countries. Whilst acknowledging limitations due to the small number and low rigour of the studies included in this review, the findings indicate benefits of ECEC participation for children across developmental domains, showing particular the potential to support socio-emotional learning and emotional recovery. Findings confirm the challenge of resources for the provision of high-quality refugee ECEC in LMICs, including lack of materials, space, and training and support needs of staff. By bringing together what we learn from the existing research in the field, this review helps to identify successful strategies, that call for play-based approaches, interactions that focus on socio-emotional support and recovery, the engagement of communities and families, and the provision of culturally responsive environments. These findings strengthen the wider knowledge base about the characteristics of ECEC provision which are important for supporting refugee children and families in lower-resource contexts.
Cost-effectiveness of increased contraceptive coverage using family planning benefits cards compared with the standard of care for young women in Uganda
Authors: Nuwamanya Elly , Babigumira Joseph B. , Svensson Mikael 
Published: February 2023

AbstractBackgroundUganda has a high population growth rate of 3%, partly due to limited access to and low usage of contraception. This study assessed the cost-effectiveness of the family planning benefits cards (FPBC) program compared to standard of care (SOC). The FPBC program was initiated to increase access to modern contraception among young women in slums in Kampala, Uganda.MethodsWe developed a decision-analytic model (decision tree) and parameterized it using primary intervention data together with previously published data. In the base case, a sexually active woman from an urban slum, aged 18 to 30 years, was modelled over a one-year time horizon from both the modified societal and provider perspectives. The main model outcomes included the probability of unintended conception, costs, and incremental cost-effectiveness ratio (ICER) in terms of cost per unwanted pregnancy averted. Both deterministic and probabilistic sensitivity analyses were conducted to assess the robustness of the modelling results. All costs were reported in 2022 US dollars, and analyses were conducted in Microsoft Excel.ResultsIn the base case analysis, the FPBC was superior to the SOC in outcomes. The probability of conception was lower in the FPBC than in the SOC (0.20 vs. 0.44). The average societal and provider costs were higher in the FPBC than in the SOC, i.e., $195 vs. $164 and $193 vs. $163, respectively. The ICER comparing the FPBC to the SOC was $125 per percentage reduction in the probability of unwanted conception from the societal perspective and $121 from the provider perspective. The results were robust to sensitivity analyses.ConclusionGiven Uganda’s GDP per capita of $1046 in 2022, the FPBC is highly cost-effective compared to the SOC in reducing unintended pregnancies among young women in low-income settings. It can even get cheaper in the long run due to the low marginal costs of deploying additional FPBCs.Trial registrationMUREC1/7 No. 10/05-17. Registered on July 19, 2017.
Pediatricians’ perspectives on childhood behavioral and mental health problems in Jordan
Authors: Nasir Arwa , Masri Amira , Nasir Laeth 
Published: February 2023

Abstract
Background
Mental health disorders among children are highly prevalent worldwide. In most countries, the primary care physician is point of first contact with the medical system for children with these problems. There are few data from developing countries about the ways in which these children present barriers that may hinder appropriate recognition, treatment, or referral. This study sought to explore the range and expression of childhood behavioral disorders encountered by primary care pediatricians in Jordan, as well as barriers to the identification and management of these conditions.

Results
We used qualitative methodology to conduct 8 focus-group interviews with physicians in Jordan. A total of 36 physicians participated. Themes that emerged from the interviews were organized into four categories. The first category described specific behavioral disorders encountered by physicians, autism being the most common and problematic. Second were themes related to system issues impacting the approach to behavioral problems. These included deficiencies in physician training and a lack of mental health services. Third were family-related issues such as parenting practices and family structure that were perceived to contribute to behavioral morbidity. Finally, sociocultural attitudes that included resistance to medicalization, reluctance to discuss behavioral issues, and interpretation of certain childhood behaviors affected help-seeking behavior and acceptance of diagnosis and treatment.

Conclusions
Sociocultural and structural issues strongly influence the presentation and management of behavioral and mental health conditions among pediatric patients in Jordan. These findings have significant implications for the development of approaches to the detection and management of these problems in developing countries. The creation of robust pathways for early detection and intervention among children at risk for mental health can help reduce the burden of mental health morbidity in the region.
Assessment of role of cranial ultrasound (CUS) in the evaluation of high-risk preterm and term neonates
Authors: Sherwani Aliya Shabir , Parry Arshed Hussain , Bhat Mudasir Hamid , Gojwari Tariq Ahmad , Charoo Bashir Ahmad , Choh Naseer Ahmad 
Published: February 2023

AbstractBackgroundCranial ultrasonography (CUS) has become an important tool to depict normal brain anatomy and to detect the ischemic and hemorrhagic brain injury patterns in high-risk neonates. The present study aimed to assess the utility of CUS to diagnose the spectrum of brain injury patterns in high-risk preterm and term neonates admitted to the neonatal intensive care unit (NICU) and to find the association of CUS findings in various adverse antenatal and perinatal feto-maternal factors.ResultsOut of the 200 neonates, 76 (38%) neonates had abnormal CUS findings and 124 (62%) had a normal CUS. Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) (28/76; 36.8 %) was the commonest abnormality with GMH (grade 1) in 14/76 (18.4%), grade 2 in 7 (9.2%), grade 3 in 5 (6.5%), and grade 4 in 2 (2.63%). The other findings observed were cerebral edema (14/76; 18.4%), thalamic hyperechogenicity (10/76; 13.1%), periventricular leukomalacia (PVL) (4/76; 5.2%), and congenital anomalies (8; 10.5%). Abnormal CUS findings had a statistically significant association with birth weight <2000 g, prematurity, Apgar score <7, and adverse peri-natal fetal and maternal factors (allp-values <0.05). Abnormal CUS findings had a statistically significant association with poor cry, poor activity, abnormal tone, and presence of cyanosis (allp-values <0.05).ConclusionIn this cohort study of high-risk preterm and term infants GMH-IVH, cerebral edema, thalamic hyperechogenicity, PVL, and congenital malformations were the commonest lesions detected on CUS. Abnormal CUS findings were found to have a statistically significant association with various adverse peri-natal fetal and maternal factors.
The effect of different direct antivirals on hepatic steatosis in nondiabetic and naïve hepatitis C-infected Egyptian patients
Authors: El-Ghandour Ahmed , Youssif Tarek , Ibrahim Wesam , Abdelsattar Hoda Ahmed , Bawady Somia Abd elhamid , Wagih Mariam , El-Nakeep Sarah 
Published: February 2023

AbstractBackgroundHepatitis C is associated with metabolic effects and fatty liver disease. The effect of different direct antivirals on the liver steatosis, and the metabolic profile, still needs to be established. The aim of this study is to determine the effect of achieving the sustained virological response after 12 weeks (SVR-12 weeks) with different combinations of direct antiviral drugs, on the hepatic steatosis, and fibrosis presented by laboratory and transient elastography parameters. Our study population is nondiabetic, chronically infected HCV Egyptian patients and naïve to any form of HCV treatment.MethodsThis cohort study was carried on 100 nondiabetic HCV treatment-naïve patients attending the Hepatology Clinic, in the Gastroenterology and Hepatology Department, Ain Shams University, and Kobry El Koba Military Hospital. The patients were divided into four groups according to their treatment regimens as follows: group A: 25 patients who received sofosbuvir (400 mg) and daclatasvir (60 mg) daily for 12 weeks; group B: 25 patients who received sofosbuvir (400 mg) and ledipasvir (90 mg) daily for 12 weeks; group C: 25 patients who received ombitasvir (12.5 mg), paritaprevir (75 mg), and ritonavir (50 mg) daily for 12 weeks; and group D: 25 patients who received sofosbuvir (400 mg) and simeprevir (150 mg) daily for 12 weeks. All patients were subjected to the following investigations: HCV quantitative PCR before and after 12 weeks of treatment, clinical and laboratory metabolic evaluation including alfa-fetoprotein level, thyroid profile assessment, ferritin level, pelvi-abdominal ultrasound, and FibroScan examination.ResultsAll patients achieved SVR after 12 weeks. FibroScan median decreased (P< 0.001) from 19.29 ± 6.97 kPa at baseline to 14.15 ± 6.48 kPa at SVR12. NAFLD score median increased from 1.88 (1.49–2.22) at baseline to 2.01 (1.61–2.33) after 12 weeks of treatment. The highest level of NAFLD score was in group C, and the lowest was in group B. The BMI mean decreased from 28.31 ± 1.53 at baseline to 28.07 ± 1.52 at SVR12. HbA1C level mean decreased from 5.73 ± 0.23 at baseline to 5.40 ± 0.24 at SVR12. In addition, liver enzymes, cholesterol, triglycerides, APRI score (AST-platelet ratio index), and HBA1C decreased after 12-week treatment with a statistically significant difference, while the mean LDL increased after 12 weeks of treatment.ConclusionsDAAs affect the metabolic profile of the treated patients. There is a noticed improvement in the FibroScan, NAFLD score, and lipid profile after achieving the SVR-12 weeks. However, LDL is increased after viral cure, mostly due to viral-host molecular interaction.
Dietary Inflammatory Index and Fractures in Midlife Women: Study of Women's Health Across the Nation
Authors: Shieh Albert , Karlamangla Arun S , Huang Mei-Hua , Shivappa Nitin , Wirth Michael D , Hébert James R , Greendale Gail A 
Published: February 2023

Abstract

Context
While evidence suggests that chronic, low-grade inflammation is a risk factor for bone loss and fractures, the potential relation between an inflammatory dietary profile and greater fracture risk is uncertain.

Objective
We examined whether a more inflammatory diet, consumed during pre- and early perimenopause, is associated with more incident fractures starting in the menopause transition (MT) and continuing into postmenopause.

Methods
Dietary inflammatory potential was quantified using 2 energy-adjusted dietary inflammatory index scores: one for diet only (E-DII), and one for diet plus supplements (E-DII-S). We included 1559 women from the Study of Women's Health Across the Nation, with E-DII and E-DII-S scores from the baseline visit (during pre- or early perimenopausal), and up to 20 years of follow-up. We excluded women using bone-beneficial medications at baseline; subsequent initiators were censored at first use. The associations of E-DII or E-DII-S (each tested as separate exposures) with incident fracture were examined using Cox proportional hazards regression.

Results
Adjusted for age, BMI, cigarette use, diabetes, MT stage, race/ethnicity, prior fracture, bone-detrimental medication use, aspirin or nonsteroidal anti-inflammatory drug use, and study site, greater E-DII and E-DII-S (tested separately) were associated with more future fractures. Each SD increment in E-DII and E-DII-S predicted 28% (P = .005) and 21% (P = .02) greater fracture hazard, respectively. Associations were essentially unchanged after controlling for bone mineral density.

Conclusion
A more pro-inflammatory diet in pre- and early perimenopause is a risk factor for incident fracture. Future studies should consider whether reducing dietary inflammation in midlife diminishes fracture risk.
The Novel's Cybernetic Hypothesis: Coetzee and McCarthy in the Closed World
Authors: Draney James 
Published: February 2023

AbstractHow do novels come to terms with the social and economic structures engendered by big data and surveillance capitalism? This question weighs heavily on J. M. Coetzee's Diary of a Bad Year (2007) and Tom McCarthy's Satin Island (2015), two novels whose intellectual protagonists struggle against systems of data capture and control. Both novels suggest that the ubiquity of computational systems has generated new problems for the form and function of literary thinking in the twenty-first century. The first problem is both practical and aesthetic: how to narrate or describe a world that already diagrams and archives itself in dizzying detail via computational media. The second is theoretical and political: how to conceive of an effective mode of opposition to the political economy of surveillance capitalism. This essay takes account of the formal strategies by which Diary and Satin Island dramatize these aesthetic and political dilemmas. The readings account for these novels’ peculiar endings, both of which suggest a longing to escape the seemingly “closed world” of cybernetic control. The narrators of Diary and Satin Island reach an impasse when they discover that the cybernetic universe has obviated their critical methods, including the ethics of “evasion,” on the one hand, and the humanism of “literalist criticism,” on the other. What if the genre of the novel is no longer capable of generating a critical anthesis to the alienated world of informatic control?
Typicality in the Novel and Novel Theory
Authors: Lee Yoon Sun 
Published: February 2023

AbstractThis essay examines the phenomenon of typicality as a horizon of the novel's activity. The novel's manner of representing seems to require a certain belief in the existence of types. Yet how the novel goes about demonstrating this belief does not sit easily with usual ideas about what classification looks like or how it proceeds. Novels seem to manifest typicality while pulling away from taxonomic endeavors in the empirical world. If taxonomy aims at systematically arranging things in order to express how they are related to each other, typicality in the novel proceeds differently. Instead of linking typicality to quantitative occurrence, this essay examines how it asserts itself through a kind of representational intensity that can shift from one mode or object to another and take different forms. This intensity comes about not so much through description, or through the accumulation of detail, as through a kind of supercharged observation and modulations of narrative pace and speed. If taxonomy ends in an array, the novel's typicality manifests itself more phenomenologically and affectively, through sentiments and hard-to-define sensations that include those of decline and deficiency, of something missing or of something running down. There is also a phenomenon that occurs when types suddenly disclose themselves in all their fullness; such an event can even bring the narrative to a halt. This essay focuses on the question of how types appear, or, in other words, the phenomenology of the novel as form.
Three Contemporary Imaginaries of Sortition
Authors: Abbas Nabila , Sintomer Yves 
Published: February 2023

Abstract
A contribution to the Common Knowledge symposium “Antipolitics,” this article examines the diverse types of imaginary that support sortition, which is currently at the heart of important debates on the reform of existing democratic institutions. Different and often diametrically opposed actors now advocate sortition as a tool for addressing crises of political representation. How are we to understand this convergence? Over the past two decades, the field of experience and the horizon of expectation of citizens in the global North have profoundly changed, and this article seeks to assess those changes in the context of three ideal types that advocate the use of randomly selected minipublics. This article analyzes, each in turn, the attraction of sortition for supporters and theorists of deliberative democracy, antipolitical democracy, and radical democracy, outlining the elements that unite and divide these imaginaries to help explain the astonishing convergence of voices in defense of sortition in politics.
The Boundary of Chinese Music: A Cultural and Aesthetic Comparison betweenPipaandGuqin
Authors: Zou Ivan Yifan , Tsai Yaching , Wang William Shi-Yuan 
Published: February 2023

AbstractReform and innovation toward the Western standards have been a perennial theme in the modern history of Chinese music. However, reformers can be easily overwhelmed by various details, to the point that the most fundamental question, What is Chinese music?, is often obscured. In a sense, we have to define the boundary of Chinese music to determine what new elements should be integrated and what traditional features should be preserved. Chinese music is a highly diverse and complex system, yet traditional Chinese culture emphasizes the importance of homogeneity over heterogeneity due to the constant need for political unity and demand of a single market. However, cultural identity cannot be constructed by homogeneity alone since the boundary of culture can only be best identified when examining its heterogeneity. Pipa and guqin, which represent Chinese musical cultures under significant and little Western influence, respectively, provide an ideal window through which the boundary of Chinese music might be delineated. By discussing the aesthetic pursuits and evolutionary paths that are distinct between the two instruments, the article aims to initiate a small step toward a better understanding of how Chinese music is indeed a highly complex and heterogeneous system in which various musical cultures, despite their distinct origins, can come into contact, interact, fuse, and eventually achieve the state of “unity in diversity.”