bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of an electronic alert system for pediatric sepsis screening: a tertiary hospital experience
Authors: Alturki Abdullah , Al-Eyadhy Ayman , Alfayez Ali , Bendahmash Abdulrahman , Aljofan Fahad , Alanzi Fawaz , Alsubaie Hadeel , Alabdulsalam Moath , Alayed Tareq , Alofisan Tariq 
Published: April 2022

Abstract
Objectives
This study aimed to assess the potential impact of implementing an electronic alert system (EAS) for systemic inflammatory syndrome (SIRS) and sepsis in pediatric patients mortality.
Method
This retrospective study had a pre and post design. We enrolled patients aged ≤ 14 years who were diagnosed with sepsis/severe sepsis upon admission to the pediatric intensive care unit (PICU) of our tertiary hospital from January 2014 to December 2018.
Intervention
We implemented an EAS for the patients with SIRS/sepsis. The patients who met the inclusion criteria pre-EAS implementation comprised the control group, and the group post-EAS implementation was the experimental group. Mortality was the primary outcome, while length of stay (LOS) and mechanical ventilation in the first hour were the secondary outcomes.
Results
Of the 308 enrolled patients, 147 were in the pre-EAS group and 161 in the post-EAS group. In terms of mortality, 44 patients in the pre-EAS group and 28 in the post-EAS group died (p 0.011). The average LOS in the PICU was 7.9 days for the pre-EAS group and 6.8 days for the post-EAS group (p 0.442). Early recognition of SIRS and sepsis via the EAS led to faster treatment interventions, which included fluid boluses (163.42 ± 107 vs. 100.85 ± 30, p 0.014) and the initiation of antimicrobial therapy (303.06 ± 451 vs. 198.94 ± 214, p 0.011). The difference in mechanical ventilation in the first hour of admission was not significant between the groups (25.17% vs. 24.22%, p 0.895).
Conclusion
The implementation of the EAS resulted in a statistically significant reduction in the mortality rate among the patients admitted to the PICU in our study. An EAS can play an important role in saving lives and subsequent Reduction in healthcare costs. Further enhancement of systematic screening is therefore highly recommended to improve the prognosis of pediatric SIRS and sepsis and warrants further validation in multicenter or national studies.
Choosing the right model for unified flexibility modeling
Authors: Brandt Jonathan , Frost Emilie , Ferenz Stephan , Tiemann Paul Hendrik , Bensmann Astrid , Hanke-Rauschenbach Richard , Nieße Astrid 
Published: April 2022

Abstract
Using aggregated flexibility from distributed small-scale power devices is an extensively discussed approach to meet the challenges in modern and increasingly stochastic energy systems. It is crucial to be able to model and map the flexibility of the respective power devices in a unified form to increase the value of the cumulative flexibility from different small-scale power devices by aggregation. In order to identify an already existing modeling approach suitable for unified flexibility modeling, we provide a comprehensive overview of the broad range of flexibility models described in scientific literature. Additionally, we present in detail five selected modeling approaches allowing the generation of a unified flexibility representation for different power devices. By using an evaluation metric we assess the suitability of the selected approaches for unified flexibility modeling and their applicability. To allow a more detailed performance analysis, the best evaluated models are implemented and simulations with different small-scale devices are performed. The results shown in this paper highlight the heterogeneity of modeling concepts deriving from the various interpretations of flexibility in scientific literature. Due to the varying complexity of the modeling approaches, different flexibility potentials are identified, necessitating a combination of approaches to capture the entire spectrum of the flexibility of different small-scale power devices. Furthermore, it is demonstrated that a complex model does not necessarily lead to the discovery of higher flexibility potentials, and recommendations are given on how to choose an appropriate model.
The Upshot of Varied Aerobic Exercise Intensity on Overweight Women: the Case of Arbaminch City.
Authors: Belete Aychew Kassa , Ayenew Zenebe Widu , Asfaw Fasiledes Fetene 
Published: April 2022

Abstract
Aim
The intention of existing study was to compare the effects of varied aerobic exercise intensity on body composition of sedentary overweight females in arbaminch.
Method
Forty[40] overweight participants [body mass index (BMI) ≥ 25 kg/m2, age 18–32 years] were randomized into four equal groups (n = 10): light-intensity training group (LITG), 40–60% heart rate reserve (HRR); middle intensity training group (MITG), 60–70% HRR; high-intensity training group (HITG), 70–80% HRR; and control group (CG).Aerobic exercise training program was conducted for 40–60 min per day on a treadmill 3 days per week for 12 weeks. All participant height, weight, WHR, BMI and %of BF were measured at pre and after 12 weeks.
Result
At the starting point, the component of body composition indicates did not differ significantly among the four groups (p > 0.05). After 12- week exercise intervention, the HITG and MITG had significantly more changes in body weight, waist-to-hip ratio (WHR), %BF and BMI than the LITG.
Conclusions
A 12-week high and moderate intensity exercise intervention can considerably reduce body weight, body fat, WHR, and BMI, whereas a light-intensity exercise intervention can significantly reduce body weight and body fat. Based on my investigation all types of intensity can reduce body weight. But high and moderate intensity training had reduced weight quickly than low intensity training.
Translation and validation of a Chinese version of the Wayfinding Effectiveness Scale: A cross-sectional study
Authors: Chiu Yi-Chen , Chang Ting-Huan , Krӧger Teppo , Hsu Wen-Chun 
Published: April 2022

Abstract
Background: Getting lost is a serious problem for elders with dementia. In North America, the Wayfinding Effectiveness Scale (WES) evaluates wayfinding effectiveness in persons with cognitive impairment. In Taiwan, such approach had not been implemented. As a consequence, this study translated the original scale into Chinese and tested its psychometric properties for family caregivers to evaluate persons with cognitive impairment in northern Taiwan. Methods: It was a cross-sectional study design. Participants were 180 dyads (persons with cognitive impairment and their family caregivers, PWCIs and FCGs) from two memory disorder clinics at two teaching hospitals and from local community long-term care service programs. Results: Forward/back translation was applied to develop the Chinese Wayfinding Effectiveness Scale (CWES). Factor analyses yielded a six-factor solution (explained variance = 66.77%): finding a destination and path in (1) familiar environments and (2) unfamiliar environments; sense of direction with (3) analytic strategies and (4) global strategies; (5) landmark and distance in familiar/unfamiliar environments; and (6) using a map in familiar/unfamiliar environments. One single-loaded factor item was deleted, yielding a 29-item scale. Construct validity using hypothesis testing was demonstrated by significant correlation coefficients between the total scale and its six subscales, among the total scale and the Chinese Mini-Mental Status Exam (CMMSE) and Chinese Neuropsychiatric Inventory (CNPI), and among five subscales and the CMMSE and CNPI. Only one subscale had subpar validity, suggesting future minor revision by a larger sample. Conclusion: The Chinese Wayfinding Effectiveness Scale (CWES) is a valid instrument to measure wayfinding effectiveness in persons with cognitive impairment in Taiwan.
Clinical evaluation of automated bridging immunoassay TSI in the diagnosis of Graves’ disease and the relationship with hyperthyroidism degree
Authors: Liu Tianqi , Zhang Xiuying , Long Li , Zhou Lingli , Chen Jing , Li Meng , Gao Ying , Zhou Xianghai , Han Xueyao , Ji Linong 
Published: April 2022

Abstract
Background: Accurate and rapid detection of stimulating thyroid-stimulating hormone (TSH) receptor antibody has always been an urgent need for clinical diagnosis and management of thyroid-related diseases. We aimed to evaluate the use of thyroid stimulating immunoglobulin (TSI) assay in the diagnosis of Graves’ disease (GD) and analyze the relationship between TSI and the degree of hyperthyroidism. Methods: 227 new-onset GD patients, 29 Hashimoto thyroiditis, 43 non-autoimmune thyroid diseases and 37 euthyroid controls were consecutively recruited. All participants accepted the measurement of serum thyroid function and thyroid associated antibody including TSI measured by Immulite 2000 bridging immunoassay and TSH receptor autoantibodies (TRAb) measured by third-generation Roche electrochemiluminescence immunoassay. The quantitative consistency between TSI and TRAb detection methods was analyzed by using Passing-Bablock regression and Bland-Altman scatter plot. Diagnostic performance of GD was assessed by receiver operating characteristics (ROC) curve analysis. Results: Among 227 GD patients (174 female, 53 male, with mean age of 39 years old), quantitative TSI was positively correlated with TRAb (r=0.8099). According to the cutoff value proposed by the manufacture (TSI 0.55IU/L, TRAb 1.75IU/L), the positive rates of TSI and TRAb in new-onset GD patients were 96.92% and 95.15%, respectively. Both TSI and TRAb levels positively correlated to FT4 levels (TSI: r=0.243, TRAb: r=0.317, all P<0.001) and FT3 levels (TSI: r=0.288, TRAb: r=0.360, all P<0.001) in new-onset GD patients. ROC analysis showed that the optimal cut-off TSI value was 0.577 IU/L for GD diagnosis in this Chinese population, with sensitivity 96.92% and specificity 97.25%, respectively. The optimal cut-off value of TRAb was 1.38 IU/L, with sensitivity 96.92% and specificity 99.08%, respectively. There were no significant differences between the cutoff values obtained through ROC analysis and provided by the manufacturer both for TSI and TRAb when calculating the sensitivity and specificity of GD diagnosis. Among 8 newly GD cases with discordant antibody qualitative results, TSI was more likely to match the clinical diagnosis of GD than TRAb (6 TSI positive, 2 TRAb positive).Conclusion: The automated bridging-based TSI immunoassay was positively correlated with thyroxine levels in newly onset GD patients and more likely to be consistent with the clinical diagnosis of GD than TRAb. The positive cut-off value 0.577IU/L of Immulite 2000 TSI for GD diagnosis in Chinese population were closed to the value recommended by the manufacturer.
On letters, words, and sentences
Authors: Brossette Brice , Grainger Jonathan , Lété Bernard , Dufau Stéphane 
Published: April 2022

Abstract
Much prior research on reading has focused on a specific level of processing, with this often being letters, words, or sentences. Here, for the first time, we provide a combined investigation of these three key component processes of reading comprehension. We did so by testing the same group of participants in three tasks thought to reflect processing at each of these levels: alphabetic decision, lexical decision, and grammatical decision. Participants also performed a non-reading classification task, with an aim to partial-out common binary decision processes from the correlations across the three main tasks. We examined the pairwise partial correlations for response times (RTs) in the three reading tasks. The results revealed strong significant correlations across adjacent levels of processing (i.e., letter-word; word-sentence) and a non-significant correlation between non-adjacent levels (letter-sentence). The results fit best with hierarchically organized cascaded-interactive accounts of how letters, words, and sentences contribute to reading comprehension.
Shock index-based risk indices as prognostic predictor for in-hospital mortality in patients with ST-elevation myocardial infarction, the results from Henan STEMI registry
Authors: Wang Shan , Zhang You , Cheng Qianqian , Qi Datun , Wang Xianpei , Zhu Zhongyu , Li Muwei , Zhang Junhui , Hu Dayi , Gao Chuanyu 
Published: April 2022

Abstract
Background: Shock index-based risk indices predicting in-hospital mortality for ST-elevation myocardial infarction (STEMI) patients have been recently described, debate continues about their accuracy, especially compared with classic scoring system. Thus, we aim to evaluate the predictive value of shock index-based risk indices in STEMI patients and compared with thrombolysis in myocardial infarction (TIMI) risk score.Method: Consecutive 5063 STEMI patients were divided into 2 groups: non-survivor (392, 7.7%) and survivor (4671, 92.3%). Predictive performance of shock index-based risk indices and TIMI risk score were assessed by C-statistic, Hosmer-Lemeshow test, Nagelkerke-R2, brier scores, integrated discrimination improvement(IDI) and net reclassification improvement(NRI). Odd ratios (OR) and corresponding 95% confidence intervals of bipartite shock index-based risk indices were estimate by generalized linear mixed model.Results: The area under the curves (AUC) of shock index-based risk indices were smaller, whereas the sensitivity and specificity of age shock index (age SI) (0.73, 0.69) and age modified shock index (age MSI) (0.70, 0.73) were comparable to TIMI risk score (0.73, 0.77). The Hosmer-Lemeshow P values and the Nagelkerke-R2 of shock index-based risk indices were lower, whereas the brier scores were comparable with TIMI risk score. In-hospital mortality was increasing with the SI based risk indices, when the cut-off value were set, in-hospital mortality in the patients with larger shock index-based risk indices were relatively higher. The prognostic performance of shock index (SI, C-statistic: z=7.944, P<0.001; NRI: 0.749; IDI: 0.067), modified shock index(MSI, C-statistic: z=8.088, P<0.001; NRI: 0.774; IDI: 0.067), age SI(C-statistic: z=3.361, P<0.001; NRI: 0.534; IDI: 0.025), and age MSI(C-statistic: z=3.578, P<0.001; NRI: 0.680; IDI: 0.040) were inferior to TIMI risk score. Univariate and multivariate analysis showed that elevated shock index-based risk indices were associated with a higher rate of in-hospital mortality. Conclusions: Shock index-based risk indices do not have a significant advantage over TIMI risk score. Age SI and age MSI, with comparable sensitivity, were valuable prognostic tools to identify STEMI patients at high risk of in-hospital death.Trial registration: [NCT02641262] [29 December, 2015].
Prevalence of Keratoconus in Egyptian Subjects With High Corneal Astigmatism
Authors: Ibrahim Mennatullah M. , kher Amr Abo-El , Helaly Hany H. , Said Amr A. 
Published: April 2022

Abstract
Purpose: to determine the prevalence of keratoconus in subjects with astigmatism of two dioptres (2D) or greater using data from the Pentacam Scheimpflug images.Materials and Methods: This prospective cross-sectional study included 600 eyes of 600 patients with refractive errors aged ≥ 18 years who had no Present or past ocular pathology other than refractive error. Patients were equally divided into Group I (Patients with 2 diopters or greater of corneal astigmatism) and Group II (Patients with less than 2 corneal astigmatism).Results: the cylindrical refractive error among normal individuals in group I (high astigmatism) was -2.93 ± 0.89 ranging from -5.00 to -7.0, while that among keratoconus patients was -3.22 ± 1.17 ranging from to -2.00 to -8.00. No significant difference was found (P= 0.107). In group II (low astigmatism) the cylindrical refractive error among normal individuals was -0.7 ± 0.49 ranging from 0.0 to -2.0, while that among keratoconus patients was -0.75 ± 0.43 ranging from to 0.0 to 1.0. No significant difference was found (P= 0.65). It was found that among group I population (high astigmatism) 12.3% diagnosed as keratoconus patients, while 1.7% of group II (low astigmatism) were keratoconus patients. There was a highly significant difference between the two groups (P < 0.00001).Conclusions: The current study showed that subjects with 2D or more of astigmatism who present to outpatient clinics had higher prevalence of keratoconus than subjects with less than 2 D astigmatism. Therefore, it can be concluded that magnitude of astigmatism can be a risk factor for development of keratoconus.
Trichomonas vaginalis infection and pregnancy outcome
Authors: Hamouda Marwa M. , Mohamed Sara A. , Nabih Nairmen , El-Henawy Abeer A. , Eldeen Nora Esam , EL-zayady Wafaa M. 
Published: April 2022

Abstract
Trichomoniasis is the most common curable sexually transmitted disease worldwide; T. vaginalis increases the risk for adverse pregnancy outcomes. In this study, we aimed to detect the prevalence of T. vaginalis infection in pregnant women and to determine the influence of trichomoniasis on pregnancy outcome. Vaginal swab specimens were obtained from 200 symptomatic and asymptomatic pregnant females, for whom clinical examination, vaginal discharge wet mount, Giemsa stain, and culture in modified Diamond’s media were performed. Metronidazole treatment was given for all positive cases. Sociodemographic information was collected, and cases were divided into two groups, the study group (infected) and the control group (not infected). Twenty four cases were positive for T. vaginalis infection. Cases were mostly detected by culture (12%) followed by wet mount microscopy and Giemsa staining (8.5%). Twelve of the 24 positive cases (50%) had preterm delivery. Low birth weight infant were observed in 17/24 cases (70%). The high rate of infection was observed in age group of 26–35 years (P = 0.017). In addition, there was a significant T. vaginalis infection in pregnant women with vaginal discharge and a history of previous infection (P < 0.05). Preterm delivery was statistically significant in cases with bad compliance to metronidazole treatment (p = 0.004). Our results highlight the presence of preterm delivery and delivery of Low birth weight infants in pregnant women infected with trichomonas vaginalis with vaginal discharge and a history of previous infection. So married women should be screened for trichomoniasis to reduce the incidence of preterm delivery and low birth weight.
The ICU-Venous Thromboembolism Score and tumor grade can predict in-hospital venous thromboembolism occurrence in critical patients with tumors
Authors: Mei Ruqi , Wang Guodong , Chen Renxiong , Wang Hongzhi 
Published: April 2022

Abstract
Background
Venous thromboembolism (VTE) is a threat to the prognosis of tumor patients, especially for critically ill patients. No uniform standard model of VTE risk for critically ill patients with tumors was formatted by now. We thus analyzed risk factors of VTE from the perspectives of patient, tumor and treatment, and assessed the predictive value of the ICU-VTE score, which consisted of six independent risk factors (central venous catheterization, 5 points; immobilization ≧ 4 days, 4 points; prior VTE, 4 points; mechanical ventilation, 2 points; lowest hemoglobin during hospitalization ≧ 90 g/L, 2 points; and baseline platelet count > 250 000/µL, 1 points).
Methods
We evaluated the data of tumor patients admitted to the Intensive Care Unit of the Peking University Cancer Hospital between November 2011 and January 2022, 560 cases who received VTE-related screening during hospitalization were chosen for this retrospective study.
Results
The in-hospital VTE occurrence rate in our cohort was 55.7% (312/560), with a median interval from ICU admission to VTE diagnosis of 8.0 days. After the multivariate logistic regression analysis, several factors were proved to be significantly associated with in-hospital VTE: age ≧ 65 yrs, high tumor grade (G3-4), medical diseases, fresh frozen plasma transfusion, and anticoagulant prophylaxis. The medium-high risk group according to the ICU-VTE score was positively correlated with VTE when compared with the low risk group (9–18 points vs. 0–8 points, OR, 3.13; 95% CI, 2.01–4.85, P < 0.001). The AUC of the ICU-VTE scores according to the ROC curve was 0.714 (95% CI, 0.67–0.75, P < 0.001).
Conclusions
The ICU-VTE score, as well as tumor grade, might assist in the assessment of in-hospital VTE risk for critically ill patients with tumors. The predictive accuracy might be improved when combining two of them, further follow-up researches are needed to confirm it.
Ways of being resilience on nursing home nursing staffs: A phenomenographic approach
Authors: CHANG Sung Ok , KIM Eun Young 
Published: April 2022

Abstract
Aim: The study’s aim is to identify the methods behind nursing staff resiliency in nursing homes (NHs)Method: Phenomenography was used. Data collection was conducted with semi-structured interviews with 20 nursing staff members in NHs, and a data analysis based on phenomenography was conducted.Results: Eight categories were derived. The eight categories were then divided into two groups of four representing perception and strategy. Perception had three levels of awareness, valuing, and assuring, while strategy had three levels of identifying, introspecting, and concretizing.Conclusion: The ways NH nursing staff enhanced and employed their resilience to overcome professional crises included considering both internal and external factors for residents and themselves while seeking a positive direction for growth. This study will suggest a roadmap for future educational interventions to improve the resilience of nursing staff working in NHs.
11C-methionine PET aids localization of microprolactinomas in patients with intolerance or resistance to dopamine agonist therapy
Authors: Bashari WA , Meulen M van der , MacFarlane J , Gillett D , Senanayake R , Serban L , Powlson AS , Brooke AM , Scoffings DJ , Jones J , O'Donovan DG , Tysome J , Santarius T , Donnelly N , Boros I , Aigbirhio F , Jefferies S , Cheow HK , Mendichovszky IA , Kolias AG , Mannion R , Koulouri O , Gurnell M 
Published: April 2022

Abstract
Purpose
To assess the potential for 11C-methionine PET (Met-PET) coregistered with volumetric magnetic resonance imaging (Met-PET/MRCR) to inform clinical decision making in patients with poorly visualized or occult microprolactinomas and dopamine agonist intolerance or resistance.
Patients and methods:
Thirteen patients with pituitary microprolactinomas, and who were intolerant (n = 11) or resistant (n = 2) to dopamine agonist therapy, were referred to our specialist pituitary centre for Met-PET/MRCR between 2016 and 2020. All patients had persistent hyperprolactinaemia and were being considered for surgical intervention, but standard clinical MRI had shown either no visible adenoma or equivocal appearances.
Results
In all 13 patients Met-PET/MRCR demonstrated a single focus of avid tracer uptake. This was localized either to the right or left side of the sella in 12 subjects. In one patient, who had previously undergone surgery for a left-sided adenoma, recurrent tumor was unexpectedly identified in the left cavernous sinus. Five patients underwent endoscopic transsphenoidal selective adenomectomy, with subsequent complete remission of hyperprolactinaemia and normalization of other pituitary function; three patients are awaiting surgery. In the patient with inoperable cavernous sinus disease PET-guided stereotactic radiosurgery (SRS) was performed with subsequent near-normalization of serum prolactin. Two patients elected for a further trial of medical therapy, while two declined surgery or radiotherapy and chose to remain off medical treatment.
Conclusions
In patients with dopamine agonist intolerance or resistance, and indeterminate pituitary MRI, molecular (functional) imaging with Met-PET/MRCR can allow precise localization of a microprolactinoma to facilitate selective surgical adenomectomy or SRS.