bluuebunny/crossref_metadata_2025_split huggingface dataset:
Business as (un)usual: A qualitative study of clerkship experiences during a health crisis
Authors: Noerholk Laerke Marijke , Bader‐Larsen Karlen S. , Morcke Anne Mette , Vamadevan Anishan , Andreasen Lisbeth Anita , Svendsen Jesper Hastrup , Jørsboe Hanne , Tolsgaard Martin G. 
Published: February 2022

AbstractIntroductionDuring a health crisis, hospitals must prioritise activities and resources, which can compromise clerkship‐based learning. We explored how health crises affect clinical clerkships using the COVID‐19 pandemic as an example.MethodsIn a constructivist qualitative study, we conducted 22 semi‐structured interviews with key stakeholders (i.e. medical students and doctors) from two teaching hospitals and 10 different departments. We used thematic analysis to investigate our data and used stakeholder theory as a sensitising concept.ResultsWe identified three themes: (1) emotional triggers and reactions; (2) negotiation of legitimacy; and (3) building resilience. Our results suggest that the health crisis accentuated already existing problems in clerkships, such as students' feelings of low legitimacy, constant negotiation of roles, inconsistencies navigating rules and regulations and low levels of active participation. Medical students and doctors adapted to the new organisational demands by developing increased resilience. Students responded by reaching out for guidance and acceptance to remain relevant in the clinical clerkships. Doctors developed a behaviour of closing in and focused on managing themselves and their patients. This created tension between these two stakeholder groups.ConclusionA health crisis can critically disrupt the hierarchical structure within the clinical clerkships and exacerbate existing conflicts between stakeholder groups. When medical students are not perceived as legitimate stakeholders in clinical clerkships during a health crisis, their attendance is perceived as unnecessary or even a nuisance. Despite increased student proactiveness and resilience, their roles inevitably shift from being doctors‐to‐be to students‐to‐be‐managed.
Development and validation of a novel scoring system for bloating and distension: The Mayo Bloating Questionnaire
Authors: Lacy Brian E. , Cangemi David J. , Wise Journey L. , Crowell Michael D. 
Published: February 2022

AbstractBackgroundAbdominal bloating and distension are prevalent gastrointestinal symptoms. Our aim was to design and validate a questionnaire to reliably measure the multiple symptom components of bloating and distension in the outpatient setting.MethodsA 45‐item questionnaire was developed after an extensive literature review. Face and content validity were established through expert review and a focus group. Validation was achieved by administering an identical questionnaire 1 week apart. Data were assessed using standard methods.Key resultsForty one patients returned both questionnaires (85% women; mean age = 44 years). Respondents reported a variety of diagnoses, including irritable bowel syndrome (63%), gastroesophageal reflux disease (54%), functional dyspepsia (27%), small intestinal bacterial overgrowth (22%), and gastroparesis (17%). Test‐retest reliability revealed excellent agreement (k ≥ 0.81) and substantial agreement (0.61 ≤ k < 0.81) for 29% and 43% of categorical questions, respectively. Alternate‐parallel form reliability was supported by association between responses for questions that evaluated missing school/work and questions that evaluated symptom impact on daily activities (p < 0.05). Patients who missed school/work due to bloating symptoms were more likely to report a severe impact on their ability to enjoy life (p < 0.05) and their overall well‐being (p < 0.01). Contingency analyses revealed an association between overall 7‐day symptom severity and impact on daily activities (p < 0.001), enjoying life (p < 0.001), and overall well‐being (p < 0.001).Conclusions and InferencesThis novel questionnaire demonstrated good validity and reliability in patients with symptoms of bloating and distension. The questionnaire was easy to use and score, making it a potentially useful tool for both research studies and clinical purposes.
Young Children Allergic Rhinitis Questionnaire is a novel tool for allergy screening in children
Authors: Xiao Xiao , Feng Guoshuang , Zhang Yawei , Liu Yuanhu , Xiang Li , Yang Yang , Sun Hao , Geng Rong , Liu Xuanshi , Zhang Xiaofen , Jin Feng , Hao Chanjuan , Zhang Yamei , Zhang Jie , Tang Lixing , Wang Pengpeng , Yang Xiaojian , Zhang Wei , Han Yang , Ge Wentong , Li Wei , Ni Xin 
Published: February 2022

AbstractBackgroundThere are a limited number of validated questionnaires available for use in the clinical screening for allergic rhinitis (AR) in children ≤3 years old. We developed a novel self‐reported questionnaire and assessed its accuracy and reliability.MethodsAfter establishing a pool of items, which were screened by experts, the Young Children Allergic Rhinitis Questionnaire (YCAR‐Q) was administered to a birth cohort in the Shunyi District (Beijing, China). The electronic version of the YCAR‐Q was distributed through the online community. Children were invited to visit a physician for examination. The diagnostic criteria included symptoms, physical examination findings, and specific serum immunoglobulin E tests. Each item on the questionnaire was evaluated, and the questionnaire's internal consistency, content validity, criterion‐related validity, and diagnostic accuracy were assessed.ResultsThe six‐item YCAR‐Q was distributed to 7423 parents, and 3037 valid questionnaires were recovered. In total, 1521 children visited a physician for examination, of which 82 were found to have AR. In terms of internal consistency, Cronbach's coefficient was 0.777 and all six questionnaire items were retained. The average scale‐level content validity index value was 1. The area under the curve was 0.755. The total scores ranged from 0 to 6, and the cutoff value for diagnosing AR was 3, with a sensitivity of 68.29% and a specificity of 76.58%.ConclusionsThis cross‐sectional study indicated that the YCAR‐Q could detect AR in children ≤3 years old. This brief and simple test may be used effectively in clinical practice.
Interspecific divergence of circadian properties in duckweed plants
Authors: Isoda Minako , Ito Shogo , Oyama Tokitaka 
Published: February 2022

AbstractThe circadian clock system is widely conserved in plants; however, divergence in circadian rhythm properties is poorly understood. We conducted a comparative analysis of the circadian properties of closely related duckweed species. Using a particle bombardment method, a circadian bioluminescent reporter was introduced into duckweed plants. We measured bioluminescence circadian rhythms of eight species of the genus Lemna and seven species of the genus Wolffiella at various temperatures (20, 25, and 30°C) and light conditions (constant light or constant dark). Wolffiella species inhabit relatively warm areas and lack some tissues/organs found in Lemna species. Lemna species tended to show robust bioluminescence circadian rhythms under all conditions, while Wolffiella species showed lower rhythm stability, especially at higher temperatures. For Lemna, two species (L. valdiviana and L. minuta) forming a clade showed relatively lower circadian stability. For Wolffiella, two species (W. hyalina and W. repanda) forming a clade showed extremely long period lengths. These analyses reveal that the circadian properties of species primarily reflect their phylogenetic positions. The relationships between geographical and morphological factors and circadian properties are also suggested.
Markers for severe disease and long‐term sequelae in pediatric patients with severe acute respiratory syndrome coronavirus 2 infection
Authors: Hazan Guy , Shah Mehr Zahra , Brennan Steven 
Published: February 2022

AbstractBackgroundCoronavirus disease 2019 (COVID‐19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) and has resulted in substantial global morbidity and mortality since late 2019. Children can be infected but the disease predominantly affects adults, and research into the acute and chronic sequelae mostly pertains to this population. This study determines the clinical and demographic parameters associated with severe acute disease and chronic complications from COVID‐19 in the pediatric population.MethodsA retrospective chart review was undertaken of all patients between birth and 21 years of age who were positive for SARS‐CoV‐2 by polymerase chain reaction (PCR) and were admitted to two tertiary care hospitals between March 1, 2020, and January 21, 2021. Markers for severe disease were defined as supplemental oxygen requirement, positive pressure ventilation, and acute chest radiograph abnormality at presentation. Chronic disease was defined as symptoms persisting >4 weeks.ResultsReview of 101 patients with positive SARS‐CoV2 testing found 67 presentations consistent with acute symptomatic infection. Age distribution was bimodal, with predominance in infancy and adolescence. Most (75%) had an extrapulmonary comorbidity, and fewer patients (33%) had pre‐existing lung disease. A history of pulmonary comorbidity and obesity was significantly associated with markers for severe disease. Long‐term chronic complications were associated with history of underlying lung disease and acute severe COVID‐19.ConclusionsDemographic and clinical markers were associated with severe COVID‐19 in children. Moreover, both the presence of pulmonary comorbidity and severe acute COVID‐19 are associated with long‐term sequelae.
Make it loud and simple: Coalition politics and problem framing in the French policy process of hydraulic fracturing
Authors: Moyson Stéphane , Fievet Bastien , Plancq Maximilien , Chailleux Sébastien , Aubin David 
Published: February 2022

AbstractBased on a case study and media content analysis, we rely on insights from the advocacy coalition framework and from the narrative policy framework to conduct a congruence analysis of the French politics of hydraulic fracturing (2010–2017). Despite the lobbying of a resourceful coalition of pro‐fracturing policy actors and their strategy of active participation in various professional forums, hydraulic fracturing was partially banned in 2011 and completely prohibited in 2017. Our results relate this ban to the stronger repetition of a simpler framing of the policy problem by the members of the anti‐fracturing coalition. In other words, coalition members willing to transform their policy beliefs into concrete decisions should frame them into loud and simple policy narratives. These findings call for further articulation between the narrative policy framework and the advocacy coalition framework to account for narratives as the essence of strategies that advocacy coalitions develop for influencing policy processes.
Prediction of Dynamic Stick-Slip Events in Belt-Drives Using a High-Fidelity Finite Element Model
Authors: Khattab Mohammed , Wasfy Tamer 
Published: February 2022

AbstractA high-fidelity dynamic finite element model of a one-pulley belt-drive system is used to study how Coulomb friction coefficient and adhesion stress affect belt stick-slip events over driver and driven pulleys. The model shows that at Coulomb friction coefficient below a certain critical value, the belt undergoes pure sliding in the slip arc on driver and driven pulleys with no stick-slip dynamic events. Above that critical friction coefficient value dynamic stick-slip events start to occur in both driver and driven pulleys resulting in torque pulses, which for practical belt-drives may cause nonsmooth operation, excessive belt noise and/or excessive belt wear. For driver pulleys the dynamic stick-slip events are in the form of Schallamach waves, while for driven pulleys the dynamic stick-slip events are in the form of expansion pulses. The model results are validated using recently generated experimental results.
Over- to under- to back-filled: Early evolution of the Sevier foreland basin in Wyoming, USA
Authors: Foreman* Brady Z. , D’Emic Michael D. , Malone David , Craddock John 
Published: February 2022

ABSTRACT
Strata preserved within the Sevier foreland basin of North America contain a suite of lithologic variations influenced by hinterland tectonic processes. Using U-Pb detrital zircon geochronology, we compared provenance signals of Upper Jurassic and Lower Cretaceous strata from a west-to-east, foredeep-to-forebulge-to-backbulge depozone transect across the state of Wyoming and evaluated major tectonic mechanisms operating during the early evolution of the Sevier orogeny. Our data included new and compiled U-Pb detrital zircon ages (n = 6013) from 50 localities that were integrated into a revised chronostratigraphic framework and subsidence history for the basin. At the onset of the Sevier orogeny, we found evidence for uplift and erosion of early Mesozoic and late Paleozoic strata within the nascent Sevier fold-and-thrust belt. This event occurred prior to the Aptian Stage of the Early Cretaceous and is recorded by the coordinated progradation of coarse-grained fluvial systems across the overfilled foreland basin. Continued emplacement of thrust loads in the hinterland generated accommodation in excess of sediment supply, a condition likely exacerbated by a relative reduction of siliciclastic sediment supply due to greater unroofing of Paleozoic carbonates during the Aptian and Albian Stages of the Early Cretaceous. This led to an underfilled condition characterized by widespread calcareous lacustrine deposition across much of the foredeep depozone and condensed stratigraphic intervals in the forebulge and backbulge depozones. During the late Albian–earliest Cenomanian, fluvial systems sourced in the Appalachians invaded the foreland basin from the east, followed by the rapid incursion of the Western Interior Seaway, driven by accelerated thrust emplacement, flexural subsidence, and potentially the onset of dynamic subsidence.
Effect of fingolimod on health-related quality of life in paediatric patients with multiple sclerosis: results from the phase 3 PARADIGMSStudy
Authors: Krupp Lauren , Banwell Brenda , Chitnis Tanuja , Deiva Kumaran , Gaertner Jutta , Ghezzi Angelo , Huppke Peter , Waubant Emmanuelle , DeLasHeras Virginia , Azmon Amin , Karan Rajesh 
Published: February 2022

BackgroundIn the PARADIGMSStudy, fingolimod demonstrated superior efficacy versus interferon (IFN) β-1a and comparable overall incidence of adverse events but slightly higher rate of serious adverse events in patients with paediatric-onset multiple sclerosis (PoMS). Here, we report the health-related quality of life (HRQoL) outcomes from PARADIGMS.MethodsPatients with PoMS (N=215; aged 10–<18 years) were randomised to once-daily oral fingolimod (N=107) or once-weekly intramuscular IFN β-1a (N=108). HRQoL outcomes were assessed using the 23-item Pediatric Quality of Life (PedsQL) scale that comprises Physical and Psychosocial Health Summary Scores (including Emotional, Social and School Functioning). A post hoc inferential analysis evaluated changes in self-reported or parent-reported PedsQL scores from baseline up to 2 years between treatment groups using an analysis of covariance model.ResultsTreatment with fingolimod showed improvements versus IFN β-1a on the PedsQL scale in both the self-reported and parent-reported Total Scale Scores (4.66 vs −1.16, p≤0.001 and 2.71 vs −1.02, p≤0.05, respectively). The proportion of patients achieving a clinically meaningful improvement in the PedsQL Total Scale Score was two times higher with fingolimod versus IFN β-1a per the self-reported scores (47.5% vs 24.2%, p=0.001), and fingolimod was favoured versus IFN β-1a per the parent-reported scores (37.8% vs 24.7%, p=non-significant). Group differences in self-reported Total Scale Scores in favour of fingolimod were most pronounced among patients who had ≥2 relapses in the year prior to study entry or who showed improving or stable Expanded Disability Status Scale scores during the study.ConclusionFingolimod improved HRQoL compared with IFN β-1a in patients with PoMS as evidenced by the self-reported and parent-reported PedsQL scores.
A proposed laboratory method to evaluate the durability of concrete pavement joints against freezing in the presence of deicer salts
Authors: Elbakari Ramy , Shehata Medhat H. 
Published: February 2022

Deicer salts were found to cause deterioration to the concrete pavement, particularly at joints. This paper introduces a laboratory procedure that engineers and scientists can use to evaluate the durability of joints. Concrete samples were tested under different salt concentrations and exposure conditions, including freeze–thaw cycles, wet–dry cycles, and a combination thereof. The test sample comprises a square slab measuring 200 mm × 200 mm × 120 mm and a joint running in the middle at 40 mm depth. The results showed that the test method needs to include two salts with two exposure conditions for accelerated damage. The first exposure used NaCl at a 10% concentration with 50 cycles of freeze/thaw–wet/dry alternating every 5 consecutive cycles. The second exposure used CaCl2 at a 15% concentration with 50 cycles of wetting and drying at 5 and 35 °C, respectively. Damage is assessed using the following two approaches: (1) strength loss under flexural loading and (2) visual damage.
Efficacy and safety of ustekinumab in the treatment of moderate to severe plaque psoriasis in Singapore
Authors: Chan Wai Sze Agnes , Wong Yisheng , Oon Hazel Hwee Boon , Theng Colin Thiam Seng , Chong Wei-Sheng 
Published: February 2022

Introduction:
Ustekinumab is a human monoclonal antibody that binds to the p40 subunit of both interleukin (IL)-12 and IL-23, and it is approved for the treatment of moderate to severe plaque psoriasis. In this study, we assessed the efficacy and safety of patients receiving ustekinumab for psoriasis.

Methods:
This retrospective study included all adults with chronic plaque psoriasis who were prescribed ustekinumab in a tertiary dermatologic centre between December 2009 and December 2015. Efficacy end points included a proportion of patients achieving at least 50% and 75% improvement from baseline psoriasis area and severity index (PASI) and body surface area (BSA) at Weeks 4 and 16.

Results:
A total of 99 patients were prescribed ustekinumab; 69% of these were Chinese, followed by 15% Indians and 9% Malays. 31 patients had documented PASI scores and 55 patients had documented BSA improvements. In patients with recorded PASI scores, 29 (93.5%) of 31 patients achieved PASI 50, and 21 (67.7%) of 31 achieved PASI 75 at week 16. In patients with recorded BSA, 43 (78.2%) of 55 had at least 50% BSA improvement, and 31 (56.4%) of 55 achieved 75% BSA improvement at 16 weeks. Regarding safety, no patient experienced tuberculosis reactivation. A total of 11 (11%) of 99 patients had latent tuberculosis infection and were treated with prophylactic isoniazid. No patient experienced serious adverse events. No cardiovascular events, cutaneous malignancies or deaths were reported over six years.

Conclusion:
Ustekinumab is safe and efficacious in the treatment of patients with moderate to severe plaque psoriasis in a multiethnic Asian population.
Management of acute testicular pain in children: changing trends with improvements in scrotal ultrasonography over 18 years
Authors: Kyaw Lin , Choo Candy Suet Cheng , Ong Lin Yin , Yap Te-Lu , Teo Harvey James , Nah Shireen Anne 
Published: February 2022

Introduction:
Doppler scrotal ultrasonography (US) is the modality of choice in diagnosing testicular torsion. We aimed to evaluate the performance of scrotal US in diagnosing testicular torsion over the past 18 years in our institution and determine the factors contributing to the length of wait times for it.

Methods:
A retrospective review was conducted of boys who presented with acute scrotal pain from 2014 to 2015. US reports, operative findings, final diagnosis and key time points of the patients’ journey (time to emergency department consultation, time to admission, time to US and time to operating theatre [OT]) were collected. US performance results were compared with those observed in a historical cohort from 1998 to 2004. Wait times were compared between operated and non-operated patients.

Results:
Data from 519 boys with a mean age of 9.15 years was collected. Of these, 438 (84.4%) boys had undergone initial scrotal US; of these scrotal US cases, 28 were surgically explored, with 23 confirmed to have torsion. Another five cases were explored without prior US, and all were confirmed to have torsion. Performance analysis of US showed a sensitivity of 100% and a specificity of 98.8%. There was no significant difference between wait times of operated and non-operated patients. Time to US (P < 0.0001, r = 0.96) and time to OT (P < 0.0001, r = 0.64) correlated significantly with the total time from presentation to surgery.

Conclusion:
There has been an improvement in the diagnostic performance of scrotal US for testicular torsion over the past 18 years. Quality improvement programmes targeted at reducing wait times for patients presenting with acute scrotum should target time to US and time to OT.
Short-term Outcomes of Emergent Versus Elective Gastrectomy for Gastric Adenocarcinoma: A National Surgical Quality Improvement Program Study
Authors: Fisher Benjamin W. , Jammula Shreya , Wang Shengxuan , Fluck Marcus , Young Katelyn , Shabahang Mohsen , Blansfield Joseph 
Published: February 2022

Background Gastric adenocarcinoma is a leading cause of cancer death worldwide and in the United States, and can present emergently with upper GI hemorrhage, obstruction, or perforation. Few large studies have examined how emergency surgery for gastric cancer affects patient outcomes. Methods All patients from National Surgical Quality Improvement Program with gastric adenocarcinoma from 2005 to 2017 were examined retrospectively. Univariate and multivariate analysis of patient factors and perioperative outcomes was performed. P-values < .05 were significant. Results Of 4663 total patients, 115 had emergency surgery and 4548 had elective surgery. Emergency surgery patients were more likely to be non-white, underweight, higher ASA class, require a preoperative blood transfusion, and were less likely to be functionally independent. Multivariate analysis demonstrates an increased likelihood of unplanned intubation, prolonged ventilation, and deep vein thrombosis (DVT). Discussion There are no significant differences in mortality, reoperation, or infection when comparing emergent surgery for gastric cancer and elective surgery; however, there is an increased risk of reintubation, prolonged intubation, and DVT in patients undergoing emergent surgery. Patients requiring emergent surgery have more comorbidities, higher blood transfusion requirements, and worse preoperative functional status, and this study demonstrates that they also have worse perioperative outcomes. Previous studies have shown that long-term oncologic outcomes are worse for patients undergoing urgent surgery, and this study shows that perioperative outcomes are also somewhat worse. Thus, definitive surgery performed on a patient who presents emergently with gastric cancer should be considered but may come at the cost of increased perioperative respiratory complications, DVTs, and worse oncologic outcomes.