bluuebunny/crossref_metadata_2025_split huggingface dataset:
Acute Kidney Disease in Hospitalized Pediatric Patients With Acute Kidney Injury in China
Authors: Deng Ying-Hao , Yan Ping , Zhang Ning-Ya , Luo Xiao-Qin , Wang Xiu-Fen , Duan Shao-Bin 
Published: May 2022

ObjectiveThe epidemiology and outcomes of acute kidney disease (AKD) after acute kidney injury (AKI) in hospitalized children are poorly described. The aim of this study is to investigate the prevalence, predictive factors, and clinical outcomes of AKD in hospitalized children with AKI.MethodsChildren (1 month–18 years) with AKI during hospitalization in the Second Xiangya Hospital from January 2015 to December 2020 were identified. AKD was defined based on the consensus report of the Acute Disease Quality Initiative 16 workgroup. The endpoints include adverse outcomes in 30 and 90 days. Multivariable logistic regression analyses were used to estimate the odds ratio of 30- and 90-day adverse outcomes associated with AKD and identify the risk factors of AKD.ResultsAKD was developed in 42.3% (419/990) of the study patients, with 186 in AKD stage 1, 107 in AKD stage 2, and 126 in AKD stage 3. Pediatric patients with AKD stages 2–3 had significantly higher rates of developing 30- and 90-day adverse outcomes than those with AKD stage 0 and 1. The adjusted odds ratio of AKD stage 2–3 was 12.18 (95% confidence interval (CI), 7.38 - 20.09) for 30-day adverse outcomes and decreased to 2.49 (95% CI, 1.26 - 4.91) for 90-day adverse outcomes. AKI stages 2 and 3, as well as glomerulonephritis, were the only predictive factors for AKD stage 2–3.ConclusionAKD is frequent among hospitalized pediatric AKI patients. AKD stage 2–3 represents a high-risk subpopulation among pediatric AKI survivors and is independently associated with 30- and 90-day adverse outcomes. Awareness of the potential risks associated with AKD stage 2–3 and its risk factors may help improve outcomes through careful monitoring and timely intervention.
Herb Formula (GCis) Prevents Pulmonary Infection Secondary to Intracerebral Hemorrhage by Enhancing Peripheral Immunity and Intestinal Mucosal Immune Barrier
Authors: Miao Yulu , Wang Bin , Hu Jing , Zhang Hanyu , Li Xiaojin , Huang Yingying , Zhuang Pengwei , Zhang Yanjun 
Published: May 2022

Lung infection is a common complication induced by stroke and seriously affects the prognosis and life quality of patients. However, effective therapeutic strategies are still lacking. In the present study, the herb formula GCis was confirmed to prevent pulmonary infection induced by intracerebral hemorrhage (ICH). The animal model of lung infection induced by ICH, GCis (Ginseng Radix et Rhizoma, Aconiti Lateralis Radix Praeparata, and Cistanches Herba) was orally administrated every day for 7 days. Lung microbial biomass and pathological results showed that the GCis formula pretreatment significantly reduced lung bacterial biomass and alleviated pathological abnormalities. These results indicated that the GCis formula has a clear pharmacological effect on preventing lung infection induced by ICH. Immunosuppression induced by ICH seemed to be the main mechanism of lung infection. Our results showed that the spleen and thymus indexes, WBC, and LY% contents were significantly increased in the GCis formula group. Moreover, bone marrow cells were further analyzed by transcriptome sequencing, and GO and KEGG enrichment analysis results showed that immune function was the main pathway enriched by differential genes after GCis formula intervention. More importantly, our results showed that GCis pretreatment had no significant effect on the mRNA expression of IL-1β, IL-6, and TNF-α in the brain. These results indicated that the GCis formula could enhance immunity after ICH. The intestinal barrier function was further investigated in the present study, considering the origin of the source of infection. Our results showed that the mRNA expressions of intestinal ZO-1, SIgA, and MUC2 were significantly increased, villi structure was intact, inflammatory cell infiltration was reduced, and goblet cell number was increased after GCis formula treatment. These results suggest that the GCis formula can enhance the intestinal mucosal immune barrier. This study provides a herb formula (GCis) that could enhance peripheral immunity and intestinal mucosal immune barrier to prevent pulmonary infection induced by ICH. It would be beneficial in the prevention of severe clinical infections.
A Hemodynamic Analysis of the Thrombosis Within Occluded Coronary Arterial Fistulas With Terminal Aneurysms Using a Blood Stasis Model
Authors: Jiang Xudong , Cao Haoyao , Zhang Zijian , Zheng Tinghui , Li Xiaoqiang , Wu Peng 
Published: May 2022

Objective: The aim of this study is to numerically evaluate thrombosis risk within occluded coronary arterial fistulas (CAF) with terminal aneurysms, and provide guidance in choosing occlusion positions, with clinical observations as reference.Method: Four patients with CAF were studied, with different occlusion positions in actual treatments. Hemodynamics simulations were conducted, with blood residue predicted using the blood stasis model. Three types of models (untreated model, aneurysm-reserved model and aneurysm-removed model) were studeid for each patient. Four metrics, i.e., proportion of high oscillatory shear index (OSI), area of high OSI, old blood volume fraction (OBVF)) and old blood volume (OBV) was obtained to distinguish the thrombosis risk of different treatments (proximal or distal occlusion), comparing with the follow-up CTA.Results: For all the postopertive models, the high OBVF, high OSI(&gt;0.3) and low time-averaged wall shear stress (TAWSS) regions were mainly at the distal fistula, indicating these regions were prone to thrombosis. The regions where blood residue remains are roughly regions of high OSI, corresponding well with clinical observations. In contrast, TAWSS failed to distinguish the difference in thrombosis risk. Absolute values (area of high OSI, OBV) can better reflect the degree of thrombosis risk between treatment types compared with percentage values (proportion of high OSI, OBVF). By comparing with the actual clinical treatments and observations, the OBV is superior to the area of high OSI in determining treatment type.Conclusion: The OBV, a volumetric parameter for blood stasis, can better account for the CAF thrombosis and reflect the degree of blood stasis compared with OSI or TAWSS, is a more appropriate metric for thrombosis in the fistula. Together with morphological parameters, the OBV could guide clinicians to formulate more appropriate surgical plans, which is of great significance for the preoperative evaluation and treatment prognosis of CAF patients.
In-Session-Reflective-Functioning in Anorexia Nervosa: An Analysis of Psychotherapeutic Sessions of the ANTOP Study
Authors: Zeeck Almut , Taubner Svenja , Gablonski Thorsten C. , Lau Inga , Zipfel Stephan , Herzog Wolfgang , Wild Beate , Friederich Hans-Christoph , Resmark Gaby , Giel Katrin , Teufel Martin , Burgmer Markus , Dinkel Andreas , Herpertz Stephan , Löwe Bernd , Tagay Sefik , von Wietersheim Jörn , De Zwaan Martina , Zettl Max , Meier Alexander F. , Hartmann Armin 
Published: May 2022

ObjectivePrevious research suggests that patients with anorexia nervosa (AN) show an impaired capacity to mentalize (reflective functioning, RF). RF is discussed as a possible predictor of outcome in psychotherapeutic processes. The study aimed to explore RF in sessions of patients with AN and its association with outcome and type of treatment.MethodsA post-hoc data analysis of selected cases from a randomized trial on outpatient psychotherapy for AN was conducted. Transcripts from 84 sessions of 28 patients (early phase, middle phase, and end of treatment) were assessed using the In-Session-Reflective-Functioning-Scale [14 cognitive-behavior therapy, enhanced (CBT-E); 14 focal psychodynamic therapy (FPT); 16 with good, 12 with poor outcome after 1 year]. Relations between the level of RF, type of treatment, and outcome were investigated using mixed linear models. Additionally, associations with depressive symptoms, weight gain, and therapeutic alliance were explored.ResultsMean in-session RF was low. It was higher in FPT when compared to CBT-E treatments. The findings point to an association between RF increase and a positive outcome. An increase in BMI in the first half of treatment was associated with higher subsequent in-session RF. There was no association between RF and depressive symptoms or the therapeutic alliance.DiscussionPatients with AN show a low capacity to mentalize in sessions, which seems to be at least partly dependent on the degree of starvation. The results suggest a possible relationship between an increase in in-session RF and outcome, which has to be replicated by further studies.
Catatonia Psychopathology and Phenomenology in a Large Dataset
Authors: Dawkins Eleanor , Cruden-Smith Leola , Carter Ben , Amad Ali , Zandi Michael S. , Lewis Glyn , David Anthony S. , Rogers Jonathan P. 
Published: May 2022

BackgroundThe external clinical manifestations (psychopathology) and internal subjective experience (phenomenology) of catatonia are of clinical importance but have received little attention. This study aimed to use a large dataset to describe the clinical signs of catatonia; to assess whether these signs are associated with underlying diagnosis and prognosis; and to describe the phenomenology of catatonia, particularly with reference to fear.MethodsA retrospective descriptive cross-sectional study was conducted using the electronic healthcare records of a large secondary mental health trust in London, United Kingdom. Patients with catatonia were identified in a previous study by screening records using natural language processing followed by manual validation. The presence of items of the Bush-Francis Catatonia Screening Instrument was coded by the investigators. The presence of psychomotor alternation was assessed by examining the frequency of stupor and excitement in the same episode. A cluster analysis and principal component analysis were conducted on catatonic signs. Principal components were tested for their associations with demographic and clinical variables. Where text was available on the phenomenology of catatonia, this was coded by two authors in an iterative process to develop a classification of the subjective experience of catatonia.ResultsSearching healthcare records provided 1,456 validated diagnoses of catatonia across a wide range of demographic groups, diagnoses and treatment settings. The median number of catatonic signs was 3 (IQR 2–5) and the most commonly reported signs were mutism, immobility/stupor and withdrawal. Stupor was present in 925 patients, of whom 105 (11.4%) also exhibited excitement. Out of 196 patients with excitement, 105 (53.6%) also had immobility/stupor. Cluster analysis produced two clusters consisting of negative and positive clinical features. From principal component analysis, three components were derived, which may be termed parakinetic, hypokinetic and withdrawal. The parakinetic component was associated with women, neurodevelopmental disorders and longer admission duration; the hypokinetic component was associated with catatonia relapse; the withdrawal component was associated with men and mood disorders. 68 patients had phenomenological data, including 49 contemporaneous and 24 retrospective accounts. 35% of these expressed fear, but a majority (72%) gave a meaningful narrative explanation for the catatonia, which consisted of hallucinations, delusions of several different types and apparently non-psychotic rationales.ConclusionThe clinical signs of catatonia can be considered as parakinetic, hypokinetic and withdrawal components. These components are associated with diagnostic and prognostic variables. Fear appears in a large minority of patients with catatonia, but narrative explanations are varied and possibly more common.
Combination of Fusiform Capsulectomy of the Posterior Capsule and Percutaneous Flexion Tendon Release in the Treatment of Fused Knee with Severe Flexion Contracture During Total Knee Arthroplasty—A Report of Six Cases
Authors: Chen Qun-Qun , He Min-Cong , Cao Zheng , Kong Xiang-Peng , Wang Hai-Bin , Chai Wei 
Published: May 2022

PurposeThis clinical research aims to assess the safety and efficacy of a combination of fusiform capsulectomy of the posterior capsule and percutaneous flexion tendon release in the treatment of a fused knee with severe flexion contracture during total knee arthroplasty (TKA).MethodsA retrospective analysis was performed in three patients (six knees) who had preoperative severe bony fused flexion contracture (&gt;80°) prior to TKA and received a combination of fusiform capsulectomy of posterior capsule and percutaneous flexion tendon release during TKA between January 2016 and December 2019. The range of motion (ROM), knee functional score, postoperative complications, and radiographic results were evaluated.ResultThree patients (six knees) were enrolled in this study. The mean duration of follow-up was 42.83 ± 15.77 months. The postoperative knee ROM was 100.0 (76.0, 102.75) (p &lt; 0.01). The knee society score (KSS) clinical score increased from a preoperative 30.0 (25.0, 36.0) to a postoperative 64.0 (65.0, 78.0) (p &lt; 0.01), and the KSS function score increased from a preoperative 0.0 (0.0, 30.0) to a postoperative 55.0 (40.0, 55.0) (p &lt; 0.01). No implant loosening, infection, neurovascular complications, or revision were recorded in the cohort until the last follow-up.ConclusionThe technique of a combination of fusiform capsulectomy of the posterior capsule and percutaneous flexion tendon release is an effective and safe method during primary TKA for a fused knee with severe flexion contracture.
Feedback of actionable individual patient prescription data to improve asthma prescribing: pragmatic cluster randomised trial in 233 UK general practices
Authors: MacBride-Stewart Sean , Marwick Charis , Ryan Margaret , Guthrie Bruce 
Published: May 2022

BackgroundPotentially inappropriate prescribing (PIP) of asthma bronchodilator inhalers is associated with increased morbidity and mortality.AimTo evaluate the effectiveness of feedback on the PIP of bronchodilator inhalers.Design and settingPragmatic cluster randomised trial involving 235 of 244 (96.3%) GP practices in one Scottish health board.MethodPractices were randomly allocated (1:1 ratio) to individualised feedback (including visualised medication histories for each patient and action-oriented messages) on PIP of bronchodilator inhalers from prescription data; feedback reports were sent in July 2015, February 2016, and August 2016. Controls were sent feedback on an unrelated subject. The primary outcome was the change in the mean number of patients per practice with PIP of bronchodilator inhalers from the baseline period (August 2014–July 2015) until the post-feedback period (February 2016–January 2017), identified through a composite of five individual measures using prescription data.ResultsIn the analysis of the primary outcome, the mean number of patients with PIP of bronchodilator inhalers fell in the 118 practices that were sent feedback from 21.8 per practice to 17.7 per practice. Numbers fell marginally in the 115 control practices, from 20.5 per practice to 20.2 per practice, with a statistically significant difference between the two groups. There were 3.7 fewer patients per practice with PIP of bronchodilator inhalers in the intervention practices versus the control practices (95% confidence interval = −5.3 to −2.0).ConclusionIndividualised feedback of PIP of asthma bronchodilators that included background information, visualised medication histories for each patient, and action-oriented messages was effective at reducing the number of patients exposed to excess or unsafe prescribing of bronchodilator inhalers.
Perspectives of GPs working in or alongside emergency departments in England: qualitative findings from the GPs and Emergency Departments Study
Authors: Anderson Helen , Scantlebury Arabella , Leggett Heather , Salisbury Chris , Benger Jonathan , Adamson Joy 
Published: May 2022

BackgroundAround 43% of emergency department (ED) attendances can be managed in general practice. Strategies to address this include directing appropriate patients to GPs working in or alongside EDs (GPED). Views of GPs choosing to work in GPED roles may inform planning and implementation of GPED services as well as wider general practice provision.AimTo explore the experiences and motivations of GPs choosing to work in GPED services in England, and to identify factors that may support or hinder GPs working in GPED roles.Design and settingThematic analysis of 42 semi-structured interviews of GPs working in 10 GPED case sites across England.MethodQualitative GP interviews from a mixed-methods study of GPs in GPED roles were thematically analysed in relation to research aims.ResultsFour themes were generated: the ‘pull’ of a portfolio career; the ‘push’ of disillusionment with general practice; professional reciprocity; sustainability of GPED services and core general practice. Flexible, favourable working conditions, collaboration, and professional development made GPED an attractive workplace, often as part of a portfolio career or after retiring from core general practice. Working in GPED services was largely driven by disillusionment with core general practice. Both GPED and core general practice were thought to benefit from GPED GPs’ skills. There were concerns about GPED sustainability and destabilisation of core general practice.ConclusionGPED may extend the clinical careers of experienced GPs and support recruitment and retention of more recently qualified GPs. Despite some benefits, GPED may destabilise core general practice and increase pressure on both environments.
Early implementation of the structured medication review in England: a qualitative study
Authors: Madden Mary , Mills Thomas , Atkin Karl , Stewart Duncan , McCambridge Jim 
Published: May 2022

BackgroundNHS England has introduced a new structured medication review (SMR) service within primary care networks (PCNs) forming during the COVID-19 pandemic. Policy drivers are addressing problematic polypharmacy, reducing avoidable hospitalisations, and delivering better value from medicines spending. This study explores early implementation of the SMR from the perspective of the primary care clinical pharmacist workforce.AimTo identify factors affecting the early implementation of the SMR service.Design and settingQualitative interview study in general practice between September 2020 and June 2021.MethodTwo semi-structured interviews were carried out with each of 10 newly appointed pharmacists (20 in total) in 10 PCNs in Northern England; and one interview was carried out with 10 pharmacists already established in GP practices in 10 other PCNs across England. Audiorecordings were transcribed verbatim and a modified framework method supported a constructionist thematic analysis.ResultsSMRs were not yet a PCN priority and SMR implementation was largely delegated to individual pharmacists; those already in general practice appearing to be more ready for implementation. New pharmacists were on the primary care education pathway and drew on pre-existing practice frames, habits, and heuristics. Those lacking patient-facing expertise sought template-driven, institution-centred practice. Consequently, SMR practices reverted to prior medication review practices, compromising the distinct purposes of the new service.ConclusionEarly SMR implementation did not match the vision for patients presented in policy of an invited, holistic, shared decision-making opportunity offered by well-trained pharmacists. There is an important opportunity cost of SMR implementation without prior adequate skills development, testing, and refining.
Analysis of Organizational Commitment against Employee Performance with Organizational Culture Moderation (Study at Walisongo State Islamic University (UIN) Semarang)
Authors: Sutaat Sutaat 
Published: May 2022

This research that is done in University Agama Islam Walisongo Semarang. Data used by primary data taken with questionnaire with 82 respondents for sample research. The writer did the reseach by using purposive sampling, with some criteria. Those criteria are the respondents have to had level stratum -2 for level education and tree year minimum in a work periode. Analysis appliance weared by instrument test, the test reliability, and while the test models, test the Adj R2 (coefficient of determination), Test the hypothesizing used regression analysis, test the F Test (Goodness of Fit), and test the moderation using analysis path (path analysis). The results of the analysis in this study resulted in regersi determination coefficient of 0.423, or in other words, changes in performance can be influenced by effective commitment, continuance commitment, normative commitment and organizational culture of 43.3%. The results of this study indicate that affective commitment does not affect the employee performance, ccontinuance commitment has the influence a significant effect on employee performance, normative commitment does not effect on employee performance, organizational culture did not moderate the influence of affective organizational commitment to employee performance, organizational culture did’t moderate the influence of continuance organizational commitment to employee performance and organizational culture moderates the effect of normative commitment on employee performance.
Independence of Financial Performance of Jombang Regency Regional Government
Authors: Suprapto Sugeng 
Published: May 2022

With regard to the granting of autonomy, regions are obliged to find alternative development funding without reducing the expectations of central government support. The purpose of this study was to analyze the ratio of financial independence of Jombang Regency in five years, namely 2016 to 2020. This study uses qualitative descriptive methods. (especially the central and provincial governments) is very high. Data collection by observation and dokumkentasi. Data analysis by trianggulation. The results showed that the average ratio of independence of Jombang Regency for five years from 2016 to 2020 was 30% so that in the low category and showed a pattern of consultative relations this means that the level of regional dependence on external assistance
Fabrication and evaluation of rib-waveguide-type wavelength conversion devices using GaN-QPM crystals
Authors: Ishihara Hiroki , Shimada Keiya , Umeda Soshi , Yokoyama Naoki , Honda Hiroto , Kurose Kazuhiro , Kawata Yoshimasa , Sugita Atsushi , Inoue Yoku , Uemukai Masahiro , Tanikawa Tomoyuki , Katayama Ryuji , Nakano Takayuki 
Published: May 2022

Abstract
A GaN crystal comprises two polar structures along the c-axis direction, and functions as a quasi-phase-matching (QPM) crystal by fabricating a periodic inversion structure. We fabricated GaN-QPM crystals to design rib-waveguide-type devices for achieving highly efficient wavelength conversion. The QPM period required for wavelength conversion was calculated in the design phase of the device structure. GaN-QPM crystals with the obtained period were fabricated using double-polarity selective-area growth (DP-SAG). The GaN-QPM crystal was then used to fabricate a second-harmonic generation (SHG) device with a rib waveguide structure. Optical measurements revealed that the device achieved wavelength conversion from 840 to 420 nm. Further, the SHG device exhibited a wavelength conversion efficiency of 1.5 × 10–4% W−1. These results indicated that GaN-QPM crystals fabricated by DP-SAG can be used for wavelength conversion.