bluuebunny/crossref_metadata_2025_split huggingface dataset:
Bubbles in the belly: How well do radiology trainees recognize pneumatosis in pediatric patients on plain film?
Authors: Sharma Priya G. , Rajderkar Dhanashree A. , Sistrom Christopher L , Slater Roberta M. , Mancuso Anthony A. 
Published: January 2022

Objectives:
Pneumatosis intestinalis is a radiographic finding that refers to the presence of gas within the walls of the small or large bowel. This sign is diagnostic in the setting of premature infants with suspected necrotizing enterocolitis. Earlier detection of NEC on X-ray is vital to improve the overall management in these infants. The identification of pneumatosis intestinalis concerning for necrotizing enterocolitis by the “on-call” trainee is critical in the care of the preterm infant. Our objective was to study trainees’ ability to identify pneumatosis on an emergent overnight film.

Methods:
The Emergent/Critical Care Imaging SIMulation (WIDI SIM) is a strategically designed computer-aided simulation of an emergency imaging experience that has been rigorously tested and proven to be a reliable means for assessing radiology trainee preparedness to competently and independently cover radiology call. One test case each year included requires the trainee to accurately identify pneumatosis on a plain radiograph of the abdomen in a neonate.

Results:
A total of 463 radiology trainees from 32 distinct training programs across the country were given a case of pneumatosis using the WIDI simulation web-based testing platform. On average only 28% of radiology trainees were able to correctly identify pneumatosis intestinalis on plain film. Although the sample sizes in the upper-level trainees were smaller, those with greater number years of training performed better.

Conclusions:
Further training must be given to radiology trainees to accurately recognize pneumatosis and report concerns for necrotizing enterocolitis.

Advances in knowledge:
This paper is the first to describe and assess the ability of the “on-call” radiology trainee to accurately recognize pneumatosis and report concerns for necrotizing enterocolitis. Our paper includes the largest cohort of radiology trainees evaluated to this date.
Determinants of very low birth weight in India: The National Family Health Survey – 4
Authors: Scaria Liss , Soman Biju , George Babu , Ahamed Zulfikar , Hariharan Sankar , Jeemon Panniyammakal 
Published: January 2022

Background Low birth weight (LBW) is susceptible to neonatal complications, chronic medical conditions, and neurodevelopmental disabilities. We aim to describe the determinants of very low birth weight (VLBW) in India based on the National Family Health Survey – 4 (NHFS-4). Methods Data from the NFHS 4 on birthweight and other socio-demographic characteristics for the youngest child born in the family during the five years preceding the survey were used. Data of 147,762 infant–mother pairs were included. Multiple logistic regression models were employed to delineate the independent predictors of VLBW (birth weight<1500 g) or LBW (birth weight <2500 g). Results Of the 147,762 children included in the study, VLBW and LBW were observed in 1.2% and 15.8% of children, respectively. The odds of VLBW were higher in female children (aOR: 1.36, 95% CI: 1.15–1.60), among mothers aged 13–19 years (aOR: 1.58, 95% CI: 1.22–2.07), mothers with severe or moderate anaemia (aOR: 1.61, 95% CI: 1.34–1.94), mothers without recommended antenatal care (aOR: 1.47, 95% CI: 1.31–1.90), maternal height less than 150 cm (aOR: 1.54, 95% CI: 1.29–1.85) and among mothers with multiple pregnancy (aOR: 21.34, 95% CI: 14.70–30.96) in comparison to their corresponding counterparts. In addition to the variables associated with VLBW, educational status of mothers (no education; aOR: 1.08, 95% CI: 1.02–1.15 and primary education; aOR: 1.16, 95% CI: 1.08–1.25), caste of the children (scheduled tribe; aOR: 1.13, 95% CI: 1.03–1.24), and wealthiness of the family (poorest wealth quintiles; aOR: 1.11, 95% CI: 1.03–1.19) were associated with LBW. Conclusions Interventions targeting improvements in antenatal care access, maternal health, and nutritional status may reduce the number of VLBW infants. Social determinants of LBW require further detailed study to understand the high propensity of low birth-weight phenotypes in the disadvantaged communities in India.
Gejala Gastrointestinal sebagai Faktor Prognostik Keparahan dan Kematian pada Pasien COVID-19: Sebuah Meta-Analisis Global
Authors: Ridwan Hadi Kusuma Taufik , Sholihah Mentari Maratus , Hanif Muhammad Ifham 
Published: January 2022

<p><strong>Pendahuluan: </strong><em>Coronavirus disease </em>2019 (COVID-19) merupakan pandemi global yang menimbulkan manifestasi klinis yang luas termasuk gejala gastrointestinal. Beberapa studi telah meneliti tingkat keparahan dan mortalitas COVID-19 dengan manifestasi gastrointestinal, tetapi hanya di tingkat regional. Penelitian ini bertujuan untuk menggabungkan beberapa literatur tentang keparahan dan mortalitas akibat COVID-19 dengan manifestasi gastrointestinal di beberapa pusat studi dari berbagai negara.</p><p><strong>Metode: </strong>Studi ini merupakan studi meta-analisis. Penelitian ini dilakukan dengan menggunakan data sekunder yang diperoleh dari proses pencarian dan pemilihan data dari studi klinis di seluruh dunia. Pencarian artikel melalui database yang sistematik dan komprehensif dari PubMed, ScienceDirect, Google Scholar, ProQuest, dan Springer Link. Artikel dikumpulkan dengan diagram PRISMA, dilakukan telaah kritis menggunakan PRISMA checklist dan analisis PICO kemudian data dianalisis dengan menggunakan perangkat Review Manager 5.4.1 dengan <em>Random Effect Model</em> (REM). Hasil analisis yang didapatkan berupa besarnya efek, heterogenitas dan model studi.</p><p><strong>Hasil: </strong>Berdasarkan analisis data dari berbagai studi di beberapa negara, hasil menunjukkan bahwa gejala gastrointestinal tidak memiliki hubungan signifikan terhadap peningkatan keparahan (aOR 0.77; 95% CI 0.35-1.70; I<sup>2</sup>=0.73; p=0.52) dan mortalitas (aOR 0.87; 95% CI 0.34-2.21; I<sup>2</sup>=0.63; p=0.77) COVID-19.</p><p><strong>Kesimpulan: </strong>Pasien COVID-19 dengan gejala gastrointestinal lebih kecil kemungkinannya untuk mengalami penyakit yang parah serta mortalitas dibandingkan pasien tanpa gejala gastrointestinal.</p><p><strong>Kata Kunci: </strong><strong>Gejala Gastrointestinal, COVID-19, Faktor Prognosis, Keparahan, Kematian.</strong></p>
Optical dichroism in ZnGeP2 crystals at deep levels
Authors: Medvedkin Gennady 
Published: January 2022

Undoped single crystals

Z
n
G
e

P

2

have been studied by optical absorption spectroscopy in the range of 0.65–3.0 µm, where the unwanted absorption by intrinsic point defects plays a decisive role in highly efficient nonlinear optical devices. An increased optical dichroism up to 70% is achieved due to rearrangement of deep levels after low-temperature annealing (LTA). Zinc vacancies among other defects (phosphorus vacancies, cationic antisites) make the main contribution to the local structure transformation. A surprising fact is that the amplitude of optical dichroism at the deep acceptor

V

Z
n

exceeds the maximum photopleochroism

∼

55

%

for direct optical transitions in

Z
n
G
e

P

2

. Structural improvement based on the distorted tetrahedron model is discussed.
MEMS-tunable dielectric metasurface lens using thin-film PZT for large displacements at low voltages
Authors: Dirdal Christopher A. , Thrane Paul C. V. , Dullo Firehun T. , Gjessing Jo , Summanwar Anand , Tschudi Jon 
Published: January 2022

Tunable focusing is a desired property in a wide range of optical
imaging and sensing technologies but has tended to require bulky
components that cannot be integrated on-chip and have slow actuation
speeds. Recently, integration of metasurfaces into electrostatic
micro-electromechanical system (MEMS) architectures has shown
potential to overcome these challenges but has offered limited
out-of-plane displacement range while requiring large voltages. We
demonstrate for the first time, to the best of our knowledge, a
movable metasurface lens actuated by integrated thin-film PZT MEMS,
which has the advantage of offering large displacements at low
voltages. An out-of-plane displacement of a metasurface in the range
of 7.2

μ

m is demonstrated under a voltage
application of 23 V. This is roughly twice the displacement at a
quarter of the voltage of state of the art electrostatic out-of-plane
actuation of metasurfaces. Using this tunability, we demonstrate a
varifocal lens doublet with a focal shift of the order of 250

μ

m at the wavelength 1.55 μm. The
thin-film PZT MEMS-metasurface is a promising platform for
miniaturized varifocal components.
Efficacy, cost-minimization, and budget impact of a personalized discharge letter for basal cell carcinoma patients to reduce low-value follow-up care
Authors: van Egmond Sven , van Vliet Ella D. , Wakkee Marlies , Hollestein Loes M. , Pouwels Xavier G. L. V. , Koffijberg Hendrik , Misirli Yesim , Bakkum Rachel S. L. A. , Bastiaens Maarten T. , Kukutsch Nicole A. , Oosting Albert J. , Plasmeijer Elsemieke I. , van Rengen Annik , de Roos Kees-Peter , Nijsten Tamar E. C. , de Vries Esther , de Bekker-Grob Esther W. 
Published: January 2022

Background
The incidence of keratinocyte carcinomas is high and rapidly growing. Approximately 80% of keratinocyte carcinomas consist of basal cell carcinomas (BCC) with 50% of these being considered as low-risk tumors. Nevertheless, 83% of the low-risk BCC patients were found to receive more follow-up care than recommended according to the Dutch BCC guideline, which is one visit post-treatment for this group. More efficient management could reduce unnecessary follow-up care and related costs.

Objectives
To study the efficacy, cost-utility, and budget impact of a personalized discharge letter for low-risk BCC patients compared with usual care (no personalized letter).

Methods
In a multi-center intervention study, a personalized discharge letter in addition to usual care was compared to usual care in first-time BCC patients. Model-based cost-utility and budget impact analyses were conducted, using individual patient data gathered via surveys. The outcome measures were number of follow-up visits, costs and quality adjusted life years (QALY) per patient.

Results
A total of 473 first-time BCC patients were recruited. The personalized discharge letter decreased the number of follow-up visits by 14.8% in the first year. The incremental costs after five years were -€24.45 per patient. The QALYs were 4.12 after five years and very similar in both groups. The national budget impact was -€2,7 million after five years.

Conclusions
The distribution of a personalized discharge letter decreases the number of unnecessary follow-up visits and implementing the intervention in a large eligible population would results in substantial cost savings, contributing to restraining the growing BCC costs.
Learning outcomes of structured perioperative teaching based on adult learning
Authors: Chen Nan-Chieh , Chang Yu-Tang , Chang Po-Chih , Chen Cheng-Sheng , Lai Chung-Sheng 
Published: January 2022

Background
Self-directed learning is the cornerstone of adult learning. The aim of the study was to investigate the improvement of core competency and increase interest to be a surgeon among medical students after a perioperative training through a structured learning with written record model. The mediating role of adult learning pattern on core competency was also examined.

Methods
A 2-week training protocol was based on a structural learning model which included a structured written record by the learner for postoperative immediate feedback. An adult learning questionnaire (ALQ) was developed to assess learners’ adult learning pattern and a clinical core competency questionnaire (CCCQ) was developed to assess learning outcomes. A two-way repeated measured of ANCOVA would be used to analyze the interaction effect of adult learning pattern and learning effect on learning outcomes.

Results
From Jan 2017 to Dec 2019, 412 medical students were enrolled in the study. The increase scores of CCCQ and a significant numbers of increase interest to be a surgeon were shown after the perioperative training. Two-way repeated measure ANOVA revealed that there were significant differences in change between pre- and post-CCCQ across four levels of ALQ (interaction effect F = 13.0, p <0.001). The more adult learning patterns medical students own, the more they will benefit from the training.

Conclusions
The structural learning with written record model provides an effective perioperative training represented with clinical core competency and increase the interest to be a surgeon in the future. Medical students with tendency of adult learning pattern would learn better.
Out-of-pocket payment for healthcare among urban citizens in Dhaka, Bangladesh
Authors: Sarker Abdur Razzaque , Ali S. M. Zulfiqar , Ahmed Maruf , Chowdhury S. M. Zahedul Islam , Ali Nausad 
Published: January 2022

Objectives
Out-of-pocket (OOP) payment is the major payment strategy for healthcare in Bangladesh, and the share of OOP expenditure has increased alarmingly. Dhaka is recognised as one of the fastest-growing megacities in the world. The objective of this study is to capture the self-reported illnesses among urban citizens and to identify whether and to what extent socioeconomic, demographic and behavioural factors of the population influence OOP healthcare expenditures.

Subject and methods
This study utilises cross-sectional survey data collected from May to August 2019 in urban Dhaka, Bangladesh. A total of 3,100 households were randomly selected. Simple descriptive statistics including frequencies, percentage, mean (95% CI), median and inter-quartile range were presented. Bivariate analysis and multivariate regression models were employed.

Results
We observed that acute illnesses (e.g., fever, flu/cough) were dominant among participants. Among the chronic illnesses, approximately 9.6% of people had diabetes, while 5.3% had high/low blood pressure. The richest quintile only spent 5.2% of their household income on healthcare, while the poorest households spent approximately six times more than the richest households. We noted that various factors such as marital status, religion, source of care, access to safe water, income quintile and even the location of households had a significant relationship with OOP expenditure.

Conclusions
Our findings can serve as important source of data in terms of disease- specific symptoms and out-of-pocket cost among urban citizens in Dhaka. The people belonging to wealthier households tended to choose better healthcare facilities and spend more. A pro-poor policy initiative and even an urban health protection scheme may be necessary to ensure that healthcare services are accessible and affordable, in line with the Bangladesh National Urban Health Strategy.
Rhythmic contraction but arrhythmic distension of esophageal peristaltic reflex in patients with dysphagia
Authors: Muta Kazumasa , Mittal Ravinder K. , Zifan Ali 
Published: January 2022

Background
Reason for dysphagia in a significant number of patients remains unclear even after a thorough workup. Each swallow induces esophageal distension followed by contraction of the esophagus, both of which move sequentially along the esophagus. Manometry technique and current system of classifying esophageal motility disorders (Chicago Classification) is based on the analysis of the contraction phase of peristalsis.

Goal
Whether patients with unexplained dysphagia have abnormalities in the distension phase of esophageal peristalsis is not known.

Methods
Using Multiple Intraluminal esophageal impedance recordings, which allow determination of the luminal cross-sectional area during peristalsis, we studied patients with nutcracker esophagus (NC), esophagogastric junction outflow obstruction (EGJOO), and functional dysphagia (FD).

Results
Distension contraction plots revealed that swallowed bolus travels significantly faster through the esophagus in all patient groups as compared to normals. The luminal cross-sectional area (amplitude of distension), and the area under the curve of distension were significantly smaller in patients with NC, EGJOO, and FD as compared to normals. Bolus traverses the esophagus in the shape of an “American Football” in normal subjects. On the other hand, in patients the bolus flow was fragmented. ROC curves revealed that bolus flow abnormalities during peristalsis are a sensitive and specific marker of dysphagia.

Conclusion
Our findings reveal abnormality in the distension phase of peristalsis (a narrow lumen esophagus) in patients with dysphagia. We propose that the esophageal contraction forcing the swallowed bolus through a narrow lumen esophagus is the cause of dysphagia sensation in patients with normal contraction phase of peristalsis.
Prevalence and determinants of undernutrition among adolescents in India: A protocol for systematic review and meta-analysis
Authors: Parida Jayashree , Jena Samanta Lopamudra , Badamali Jagatdarshi , Singh Prasant Kumar , Patra Prasanna Kumar , Mishra Bijay Kumar , Pati Sanghamitra , Kaur Harpreet , Acharya Subhendu Kumar 
Published: January 2022

Background
Undernutrition is one of the serious health problems among adolescents in India where 253 million adolescents are in the age group of 10–19 years. Since adolescents represent the next generation of adults, it is important to understand the nutritional status of adolescents. Even though several studies have been carried out in different states in India on adolescent undernutrition (stunting, wasting /underweight), there is no study or review that estimated the national pooled prevalence of adolescent undernutrition and its determinants. Therefore, this review aims to determine the pooled prevalence and determinants of undernutrition (stunting, underweight/wasting) among Indian adolescents.

Methods
A systematic review of eligible articles will be conducted using preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines. A comprehensive searching of the literature will be made in Pub Med, EMBASE, SCOPUS, Google, Google Scholar, and Cochrane databases. The quality of the articles included in the review will be evaluated using the Newcastle-Ottawa Scale (NOS) for observational studies in meta-analyses. The pooled prevalence and odds ratio of the associated risk factors or determinants with their 95% confidence interval will be computed using STATA version 16 software. The existence of heterogeneity among studies will be assessed by computing p-values of Higgins’s I2 test statistics and Cochran’s Q-statistics based on chi-square with a 5% level of significance among reported prevalence. Sensitivity analysis and subgroup analysis will be conducted based on study quality to investigate the possible sources of heterogeneity. Publication bias will be assessed through visual examination of funnel plots and objectively by Egger’s regression test. This review protocol has been registered at PROSPERO (CRD42021286814).

Discussion
By collecting and summarizing information on adolescent undernutrition can be a step towards a better understanding of the prevalence of nutritional status of Indian adolescents and how the associated factors influence the prevalence of undernutrition. This review will provide directions for further research and healthcare practitioners. This summarized finding at the national level will provide impetus to build nutritional strategies and proper healthcare services to fight against undernutrition among the most ignored population.
Repeated glucose spikes and insulin resistance synergistically deteriorate endothelial function and bardoxolone methyl ameliorates endothelial dysfunction
Authors: Ogiso Kazuma , Shayo Sigfrid Casmir , Kawade Shigeru , Hashiguchi Hiroshi , Deguchi Takahisa , Nishio Yoshihiko 
Published: January 2022

BackgroundBoth insulin resistance and postprandial glucose spikes are known for their potential to induce vascular endothelial dysfunction in individuals with metabolic syndrome. However, these factors are inextricable, and therefore, their relative contributions to inducing endothelial dysfunction remain elusive. In this study, we aimed to disentangle the effects of these factors and clarify whether bardoxolone methyl (CDDO-Me), a novel nuclear factor erythroid 2-related factor 2 (Nrf2) activator, protects against glucose spike-induced endothelial dysfunction.MethodsWe induced glucose spikes twice daily for a duration of 1 week to rats fed a standard/control diet (CD) and Western-type diet (WTD). Endothelium-dependent relaxation (EDR) was evaluated using isolated thoracic aortas. Gene expression and dihydroethidium (DHE)-fluorescence studies were carried out; the effect of CDDO-Me on aortic endothelial dysfunction in vivo was also evaluated.ResultsNeither WTD-induced insulin resistance nor pure glucose spikes significantly deteriorated EDR. However, under high-glucose (20 mM) conditions, the EDR of thoracic aortas of WTD-fed rats subjected to glucose spikes was significantly impaired. In this group of rats, we observed significantly enhanced DHE fluorescence as a marker of reactive oxygen species, upregulation of an oxidative stress-related gene (NOX2), and downregulation of an antioxidant gene (SOD2) in the thoracic aortas. As expected, treatment of the thoracic aorta of this group of rats with antioxidant agents significantly improved EDR. We also noted that pretreatment of aortas from the same group with CDDO-Me attenuated endothelial dysfunction, accompanied by a correction of the redox imbalance, as observed in gene expression and DHE fluorescence studies.ConclusionsFor the first time, we showed that insulin resistance and glucose spikes exert a synergistic effect on aortic endothelial dysfunction. Furthermore, our study reveals that CDDO-Me ameliorates endothelial dysfunction caused by glucose spikes in a rat model of metabolic syndrome.
Community Radio in South Asia: Reclaiming the Airwaves, Kanchan K. Malik and Vinod Pavarala (eds) (2020)
Authors: Backhaus Bridget 
Published: January 2022

Review of: Community Radio in South Asia: Reclaiming the Airwaves, Kanchan K. Malik and Vinod Pavarala (eds) (2020)
Abingdon and New York: Taylor & Francis, 294 pp.,
ISBN 978-1-13855-853-3, h/bk, AUD 252.00