bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of General Practitioners in transforming surgical care in rural Nepal - A descriptive study from eastern Nepal.
Authors: Dangal Binod , Kwan Ng Jessica Yuen , Gauchan Bikash , Khadka Man Bahadur , Pathak Mandeep 
Published: March 2023

Introduction: Nepal is a low-to-middle-income country (LMIC) with a predominantly rural population. Almost 10-20% of patients presenting to hospital require surgical care. The availability of skilled human resources in managing surgical care in rural areas of Nepal has to expand to meet this need. The objective of this study is to describe and demonstrate how General Practitioners (GPs) can be upskilled to provide surgical care in rural district hospitals in Nepal.
Method: It is a retrospective review of all surgical procedures performed by GPs from 1st February 2016 to 31st January 2021 at Charikot hospital. Data was collected from a prospectively maintained Electronic Health Record (EHR) system (Bahmini). Details of data collected included name of the procedure and its respective specialty. GP Task shifting and targeted surgical training programs for common orthopedic procedures and pediatric herniotomy were described in detail.
Result: A wide range of surgical procedures were performed by GPs over 5 years. This included interventions for obstetric emergencies, trauma and orthopedics, gynecological issues, general surgery of adult and childhood. A total of 2037 surgeries were performed by GPs including: Cesarean section 25%, 19.7% were orthopedics surgeries followed by 13.5% of mesh repair for abdominal hernia, 9.3% eversion of sac for Hydrocele, 8.7% appendectomy, 5.2% hysterectomy, 3% of pediatric herniotomy and others.
Conclusion: GPs can be further trained to perform important common surgical procedures to improve access to surgical care for rural communities.
Keywords: Continuing medical education, general practitioner, leadership, rural surgery
Forecasting cesarean deliveries with robust time series models in a tertiary care hospital
Authors: Bhandary Shital , Pradhan Binita 
Published: March 2023

Introduction: Caesarian section rate was 47% at Patan Hospital in 2014 despite the recommendation of keeping it below 15%. This has become a public health problem and it is debated as human right violation of childbearing women. This study aims use robust time series model to forecast caesarian deliveries to keep track of it at the hospital.
Method: Univariate time series models were used to forecast 3-year caesarean deliveries at Patan Hospital using 60-month (2010-2014) data. A robust time series model with low mean average percentage error from validation period and without autocorrelation problem was selected and used to forecast caesarean deliveries for 2015-2017 period.
Result: Winterâ€™s additive model had lowest validation forecasting error and showed decreasing trend of caesarian deliveries but it showed autocorrelation. Quadratic regression gave similar result but is also autocorrelation problem. Artificial Neural Network â€“ Multilayer Perceptron model gave close forecasts but autocorrelation was not assessed. Best Autoregressive Integrated Moving Average (ARIMA) model gave valid forecasts without autocorrelation problem.
Conclusion: ARIMA (0,1,1),(0,0,0) model with one difference and one level of moving error correction gave valid forecasts for Patan Hospital. Advanced univariate and multivariate time series models with large samples can be used to get precise forecasts of caesarean deliveries in Nepal.
Diarrheal disease outbreak in Muskkot, Gulmi, Nepal â€“ 2019
Authors: Pachya Uttam 
Published: March 2023

Introduction: Diarrhea outbreak was observed in Dajakot, Musikot Municipality, Gulmi, Nepal on April 2019. This study analyzes the data that were collected during this outbreak.
Method: This is a descriptive, cross sectional study defining the diarrheal outbreak at Gulmi in time, place and person.
Result: There were 188 patients presenting with symptom of diarrhea between April 23 to 29, 2019. There were 108 (57.4%) female and 80 (42.5%) male. Maximum (69) number of patients were on day 3 of outbreak.
Conclusion: The outbreak observed at Musikot in 2019 was due to contaminated source of water.
Volcanic-associated ecosystems of the Mediterranean Sea: a systematic map and an interactive tool to support their conservation
Authors: Costa Valentina , Sciutteri Valentina , Consoli Pierpaolo , Manea Elisabetta , Menini Elisabetta , Andaloro Franco , Romeo Teresa , Danovaro Roberto 
Published: March 2023

Background
Hydrothermal vents, cold seeps, pockmarks and seamounts are widely distributed on the ocean floor. Over the last fifty years, the knowledge about these volcanic-associated marine ecosystems has notably increased, yet available information is still limited, scattered, and unsuitable to support decision-making processes for the conservation and management of the marine environment.

Methods
Here we searched the Scopus database and the platform Web of Science to collect the scientific information available for these ecosystems in the Mediterranean Sea. The collected literature and the bio-geographic and population variables extracted are provided into a systematic map as an online tool that includes an updated database searchable through a user-friendly R-shiny app.

Results
The 433 literature items with almost one thousand observations provided evidence of more than 100 different volcanic-associated marine ecosystem sites, mostly distributed in the shallow waters of the Mediterranean Sea. Less than 30% of these sites are currently included in protected or regulated areas. The updated database available in the R-shiny app is a tool that could guide the implementation of more effective protection measures for volcanic-associated marine ecosystems in the Mediterranean Sea within existing management instruments under the EU Habitats Directive. Moreover, the information provided in this study could aid policymakers in defining the priorities for the future protection measures needed to achieve the targets of the UN Agenda 2030.
Assessment of Transient and Spatial Noise Pollution Levels at Selected Junctions in Port Harcourt Metropolis, Rivers State
Authors: Chumu John , Nwaogazie Ify L. , Nwaobakata Chukwuemeka 
Published: March 2023

This study focused on assessing of transient and spatial noise levels at selected Port Harcourt Metropolis junctions. Spatial noise measurement and vehicle count were conducted at Eleme and Akpajo junctions. Comparative analyses of noise level and noise pollution level using line graph/t-test and determination of decline rate of noise pollution level using regression analysis were carried out. Comparative analyses of noise levels at the two study locations using traffic count were also done. The noise pollution level was compared with National Environmental Standards and Regulations Enforcement Agency (NESREA) and World Health Organization (WHO) noise standards and a safe zone determined at study locations. Maximum and minimum noise recorded were 88.99dB(A) and 50.05dB(A) at Eleme junction, 87.51dB(A) and 49.02dB(A) at Akpajo junction. Findings showed that the noise pollution level was relatively higher than noise level with distance away from the junctions; however, there was no significant difference between noise level and noise pollution level. Maximum noise pollution level average decline rate of -0.3691dB was observed at Eleme junction in the morning, while the minimum noise pollution level average decline rate of -0.2656dB was observed at Akpajo junction, in the morning hours. External sources also contributed to noise level at the junctions. Those living or doing business within 100m and 120m of Akpajo and Eleme junctions, respectively are at risk of having noise-induced auditory, physiological and behavioral problems. There is need for continuous monitoring of noise level at study locations. Regular health assessment of people living within the study locations. Noise control regulations should be made and enforced by the Government.
Progress in the Diagnosis and Treatment of Kawasaki Disease and Other Multi-system Inflammatory Syndromes by Artificial Intelligence
Authors: Zhong Hongping , Lv Xin , Sun Xiaoya , Jiao Wenyan 
Published: March 2023

Purpose: To explore the role of artificial intelligence in distinguishing Kawasaki disease from other multi-system inflammatory syndromes.
Methods: We refer to the existing relevant articles at home and abroad for analysis.
Results: The clinical application of artificial intelligence has played a time-saving and labour-saving role in the differentiation of Kawasaki disease and other multi-system inflammatory syndromes, suggesting that the application of big data in clinical practice can bring new development opportunities for medical treatment.
Conclusion: Kawasaki disease and other multi-system inflammatory syndromes are similar and overlapping in clinical practice, which is difficult to distinguish and easy to misdiagnose and miss diagnose. Artificial intelligence is applied to analyze the above disease data, to achieve the effect of accurate differentiation, timely diagnosis, symptomatic treatment and reduction of complications.
Assessing the Burden of Suicide Death Associated With Nonoptimum Temperature in a Changing Climate
Authors: Zhou Yuchang , Gao Ya , Yin Peng , He Cheng , Liu Wei , Kan Haidong , Zhou Maigeng , Chen Renjie 
Published: March 2023

ImportanceFew studies have projected future suicide burden associated with daily temperatures in a warming climate.ObjectivesTo assess the burden of suicide death associated with daily nonoptimal temperature and to project the change of suicide burden associated with nonoptimal temperature in different regions and seasons under various climate change scenarios.Design, Setting, and ParticipantsBetween January 1, 2013, and December 31, 2019, we conducted a time-stratified, case-control study among more than 430 000 individual suicide decedents from all counties in mainland China.ExposuresDaily meteorological data were obtained from the European Centre for Medium-Range Weather Forecasts Reanalysis Fifth Generation (ERA5) reanalysis product. Historical and future temperature series were projected under 3 scenarios of greenhouse-gas emissions from 1980 to 2099, with 10 general circulation models.Main Outcomes and MeasuresThe relative risk (RR) and burden of suicide death associated with nonoptimal temperature (ie, temperatures greater than or less than minimum-mortality temperature); the change of suicide burden associated with future climate warming in different regions and seasons under various climate change scenarios.ResultsOf 432 008 individuals (mean [SD] age; 57.6 [19.0] years; 253 093 male [58.6%]) who died by suicide, 85.8% (370 577) had a middle school education or less. The temperature-suicide associations were approximately linear, with increasing death risks at higher temperatures. The excess risk was more prominent among older adults (ie, ≥75 years; RR, 1.71; 95% CI, 1.46-1.99) and those with low education level (ie, middle school education or less; RR, 1.46; 95% CI, 1.36-1.57). There were 15.2% suicide deaths (95% estimated CI [eCI], 14.6%-15.6%) associated with nonoptimal temperature nationally. Consistent and drastic increases in excess suicide deaths over this century were predicted under the high-emission scenario, whereas a leveling-off trend after the mid–21st century was predicted under the medium- and low-emission scenarios. Nationally, compared with the historical period (1980-2009), excess suicide deaths were predicted to increase by 8.3% to 11.4% in the 2050s and 8.5% to 21.7% in the 2090s under the 3 scenarios. The projected percentage increments of excess suicide deaths were predicted to be greater in the South (55.0%; 95% eCI, 30.5%-85.6%) and in winter (54.5%; 95% eCI, 30.4%-77.0%) in the 2090s under the high-emission scenario.Conclusions and RelevanceFindings of this nationwide case-control study suggest that higher temperature may be associated with the risk and burden of suicide death in China. These findings highlight the importance of implementing effective climate policies to reduce greenhouse gas emissions and tailoring public health policies to adapt to global warming.
Association of Receipt of Opioid Use Disorder–Related Telehealth Services and Medications for Opioid Use Disorder With Fatal Drug Overdoses Among Medicare Beneficiaries Before and During the COVID-19 Pandemic
Authors: Jones Christopher M. , Shoff Carla , Blanco Carlos , Losby Jan L. , Ling Shari M. , Compton Wilson M. 
Published: March 2023

ImportanceFederal emergency authorities were invoked during the COVID-19 pandemic to expand clinical telehealth for opioid use disorder (OUD).ObjectiveTo examine the association of the receipt of telehealth services and medications for OUD (MOUD) with fatal drug overdoses before and during the pandemic.Design, Setting, and ParticipantsThis cohort study used exploratory longitudinal data from 2 cohorts (prepandemic cohort: September 1, 2018, to February 29, 2020; pandemic cohort: September 1, 2019, to February 28, 2021) of Medicare Fee-for-Service beneficiaries aged 18 years or older initiating an episode of OUD-related care using Medicare Fee-for-Service data from the Centers for Medicare &amp;amp; Medicaid Services and National Death Index data from the Centers for Disease Control and Prevention. Data analysis was performed from September 19 to October 17, 2022.ExposuresPrepandemic vs pandemic cohort demographic, medical, substance use, and psychiatric characteristics.Main Outcomes and MeasuresReceipt of OUD-related telehealth services, receipt of MOUD, and fatal drug overdose.ResultsThe prepandemic cohort comprised 105 162 beneficiaries (58.1% female; 67.6% aged 45-74 years). The pandemic cohort comprised 70 479 beneficiaries (57.1% female; 66.3% aged 45-74 years). The rate of all-cause mortality was higher in the pandemic cohort (99.9 per 1000 beneficiaries; 7041 deaths) than in the prepandemic cohort (76.8 per 1000; 8076 deaths) (P &amp;lt; .001). The rate of fatal drug overdoses was higher in the pandemic cohort (5.1 per 1000 beneficiaries; n = 358) than in the prepandemic cohort (3.7 per 1000; n = 391) (P &amp;lt; .001). The percentage of deaths due to a fatal drug overdose was similar in the prepandemic (4.8%) and pandemic (5.1%) cohorts (P = .49). In multivariable analysis of the pandemic cohort, receipt of OUD-related telehealth was associated with a significantly lower adjusted odds ratio (aOR) for fatal drug overdose (aOR, 0.67; 95% CI, 0.48-0.92) as was receipt of MOUD from opioid treatment programs (aOR, 0.41; 95% CI, 0.25-0.68) and receipt of buprenorphine in office-based settings (aOR, 0.62; 95% CI, 0.43-0.91) compared with those not receiving MOUD; receipt of extended-release naltrexone in office-based settings was not associated with lower odds for fatal drug overdose (aOR, 1.16; 95% CI, 0.41-3.26).Conclusions and RelevanceThis cohort study found that, among Medicare beneficiaries initiating OUD-related care during the COVID-19 pandemic, receipt of OUD-related telehealth services was associated with reduced risk for fatal drug overdose, as was receipt of MOUD from opioid treatment programs and receipt of buprenorphine in office-based settings. Strategies to expand provision of MOUD, increase retention in care, and address co-occurring physical and behavioral health conditions are needed.
Hybrid forecasting of geopolitical events†
Authors: Benjamin Daniel M. , Morstatter Fred , Abbas Ali E. , Abeliuk Andres , Atanasov Pavel , Bennett Stephen , Beger Andreas , Birari Saurabh , Budescu David V. , Catasta Michele , Ferrara Emilio , Haravitch Lucas , Himmelstein Mark , Hossain KSM Tozammel , Huang Yuzhong , Jin Woojeong , Joseph Regina , Leskovec Jure , Matsui Akira , Mirtaheri Mehrnoosh , Ren Xiang , Satyukov Gleb , Sethi Rajiv , Singh Amandeep , Sosic Rok , Steyvers Mark , Szekely Pedro A , Ward Michael D. , Galstyan Aram 
Published: March 2023

AbstractSound decision‐making relies on accurate prediction for tangible outcomes ranging from military conflict to disease outbreaks. To improve crowdsourced forecasting accuracy, we developed SAGE, a hybrid forecasting system that combines human and machine generated forecasts. The system provides a platform where users can interact with machine models and thus anchor their judgments on an objective benchmark. The system also aggregates human and machine forecasts weighting both for propinquity and based on assessed skill while adjusting for overconfidence. We present results from the Hybrid Forecasting Competition (HFC)—larger than comparable forecasting tournaments—including 1085 users forecasting 398 real‐world forecasting problems over 8 months. Our main result is that the hybrid system generated more accurate forecasts compared to a human‐only baseline, which had no machine generated predictions. We found that skilled forecasters who had access to machine‐generated forecasts outperformed those who only viewed historical data. We also demonstrated the inclusion of machine‐generated forecasts in our aggregation algorithms improved performance, both in terms of accuracy and scalability. This suggests that hybrid forecasting systems, which potentially require fewer human resources, can be a viable approach for maintaining a competitive level of accuracy over a larger number of forecasting questions.
VEGFA Promotes Skeletal Muscle Regeneration in Aging
Authors: Endo Yori , Hwang Charles D. , Zhang Yuteng , Olumi Shayan , Koh Daniel J. , Zhu Christina , Neppl Ronald L. , Agarwal Shailesh , Sinha Indranil 
Published: March 2023

AbstractAging is associated with loss of skeletal muscle regeneration. Differentially regulated vascular endothelial growth factor (VEGF)A with aging may partially underlies this loss of regenerative capacity. To assess the role of VEGFA in muscle regeneration, young (12–14 weeks old) and old C57BL/6 mice (24,25 months old) are subjected to cryoinjury in the tibialis anterior (TA) muscle to induce muscle regeneration. The average cross‐sectional area (CSA) of regenerating myofibers is 33% smaller in old as compared to young (p < 0.01) mice, which correlates with a two‐fold loss of muscle VEGFA protein levels (p = 0.02). The capillary density in the TA is similar between the two groups. Young VEGFlo mice, with a 50% decrease in systemic VEGFA activity, exhibit a two‐fold reduction in the average regenerating fiber CSA following cryoinjury (p < 0.01) in comparison to littermate controls. ML228, a hypoxia signaling activator known to increase VEGFA levels, augments muscle VEGFA levels and increases average CSA of regenerating fibers in both old mice (25% increase, p < 0.01) and VEGFlo (20% increase, p < 0.01) mice, but not in young or littermate controls. These results suggest that VEGFA may be a therapeutic target in age‐related muscle loss.
Fast Kinetic Carbon Anode Inherited and Developed from Architectural Designed Porous Aromatic Framework for Flexible Lithium Ion Micro Capacitors
Authors: Li Xing , Sun Mengxiao , Xu Chunyi , Zhang Xin , Wang Gongkai , Tian Yuyang , Zhu Guangshan 
Published: March 2023

AbstractLithium ion micro capacitors (LIMCs) demonstrate competitive advantages of simultaneously high energy/power densities and long cycle life over many other micro supercapacitors and micro batteries. However, these performances are significantly determined by the carbon anode with fast Li+ storage kinetics. Herein, a design strategy at the precursor side of a typical porous aromatic framework‐5 (PAF‐5) from the carbon bonding levels is proposed, and coupling with the post pyrolysis, the sp2/sp3 domains ratio, interlayer spacing, and pore structure of derived carbons can be synergistically balanced. The inherited sp2 domains and porous structure from PAF‐5 endow the derived carbon with high electron transport capability and fast Li+ adsorption capacity. Meanwhile, the developed sp3 domains and enlarged interlayer spacing also enable abundant and fast Li+ intercalation contribution, giving rise to a superior rate capability (141.9 mAh g−1 at 4 A g−1) that is 13 times better than a commercial graphite anode. A flexible LIMCs based on this carbon anode are fabricated, and simultaneously high energy/power densities (71.1 mWh cm−3/1.9 W cm−3), long cycle life (94.7% after 6,000 cycles), and flexibility are achieved, demonstrating a great feasibility of designed PAFs as the trimmed carbon anode precursors for high performance Li+ storage.
Photomultiplication‐Type Organic Photodetectors with High EQE‐Bandwidth Product by Introducing a Perovskite Quantum Dot Interlayer
Authors: Jeong Minyoung , Han Se Gyo , Sung Woong , Kim Seunghyun , Min Jiwoo , Kim Mi Kyong , Choi Wookjin , Lee Hansol , Lee Dongki , Kim Min , Cho Kilwon 
Published: March 2023

AbstractA photomultiplication (PM)‐type organic photodetector (OPD) that exploits the ionic motion in CsPbI3 perovskite quantum dots (QDs) is demonstrated. The device uses a QD monolayer as a PM‐inducing interlayer and a donor–acceptor bulk heterojunction (BHJ) layer as a photoactive layer. When the device is illuminated, negative ions in the CsPbI3 QD migrate and accumulate near the interface between the QDs and the electrode; these processes induce hole injection from the electrode and yield the PM phenomenon with an external quantum efficiency (EQE) >2000% at a 3 V applied bias. It is confirmed that the ionic motion of the CsPbI3 QDs can induce a shift in the work function of the QD/electrode interface and that the dynamics of ionic motion determines the response speed of the device. The PM OPD showed a large EQE‐bandwidth product >106 Hz with a −3 dB frequency of 125 kHz at 3 V, which is one of the highest response speeds reported for a PM OPD. The PM‐inducing strategy that exploits ionic motion of the interlayer is a potential approach to achieving high‐efficiency PM OPDs.
Nanoconfined Expansion Behavior of Hollow MnS@Carbon Anode with Extended Lithiation Cyclic Stability
Authors: Ma Zhipeng , Song Ailing , Liu Zhan , Guo Yaqian , Yang Xin , Li Qing , Fan Yuqian , Dai Lei , Tian Hao , Qin Xiujuan , Liu Hao , Shao Guangjie , Wang Guoxiu 
Published: March 2023

AbstractThe construction of hollow nanostructure by compositing with carbonaceous materials is generally considered an effective strategy to mitigate the drastic volume expansion of transition metal sulfides (TMSs) with high theoretical specific capacity in the process of lithium storage. However, designing well‐controlled architectures with extended lithiation cyclic stability, and ease the expansion of the electroactive materials into the reserved hollow spaces still needs to be developed. Herein, using MnS as an example, the hollow double‐shell carbon‐coated TMSs architecture is designed to achieve the controllable operation of shell thickness to regulate interfacial stress. The functional architecture enables the high‐capacity MnS to reach reversible capacities and extended lithiation cycling stability at high current densities. In situ transmission electron microscopy, optical observation characterizations and finite elements are used to analyze the nanoconfined expansion behavior of hollow MnS@C anodes. The as‐designed hollow structure with a carbon shell thickness ≈12.5 nm can effectively restrict the drastic expansion of MnS nanoshell into inner voids with compressive stress. This study demonstrates a general strategy to design functional carbon coating metal sulfides with tailored interfacial stress.