bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dimensiones de la vía aérea en la población de Cuenca-Ecuador
Authors: Serrano Bejar Leonardo Alfredo , Reinoso Murillo Priscila Victoria , Peñafiel Martínez Nadia Rosalía , Vaca Morocho Andrea Jackeline , Serrano Béjar Mónica Viviana 
Published: February 2022

Objetivo: describir las características de la vía aérea en una población local con la cabeza en posición neutra, según: distancia entre incisivos superiores medios hasta cuerdas vocales, cartílago cricoides, carina y el punto entre el tercer y cuarto anillo traqueal, contado desde la carina en sentido cefálico; cuerdas vocales a carina, tráquea, número de anillos traqueales y correlacionar con estatura y sexo.
Metodología: estudio descriptivo en pacientes intervenidos quirúrgicamente en el Hospital de Especialidades “José Carrasco Arteaga” y Hospital Regional “Vicente Corral Moscoso” durante marzo 2019 a marzo 2020. Se recogieron los datos por medio de un flexómetro, estadímetro y broncoscopio flexible Ambu Scope 3. El análisis de los datos se efectuó en el software IBM-SPSS 22.0 con medidas estadísticas descriptivas y correlaciones.
Resultados: se valoraron 151 pacientes. La longitud de los incisivos medios: a la carina fue de 23.32 ± (1.98) cm, al cricoides de 14.93 ± (1.38) cm, a las cuerdas vocales de 13.07 ± (1.36) cm, al tercer o cuarto anillo traqueal contado desde la carina hacia cefálico 20.81 ± (2.03) cm; de las cuerdas vocales a carina de 10.24 ± (1.45) cm; la tráquea en promedio midió 8.40 ± (1.37) cm, con 13 anillos traqueales.
Conclusión: Las medidas de la vía aérea obtenidas están en concordancia con los estudios de poblaciones parecidas a la del estudio, lo cual indica que el extrapolar los datos de los textos clásicos de etnias caucásicas puede ocasionar errores en la intubación endobronquial o extubación inadvertida.
Konseling Lintas Budaya dan Agama dalam Penanggulangan Radikalisme di Lingkungan Sekolah
Authors: Rostini Rena , Ruhyadi Siti Sri Afira , Miftahurrazikin Muh , Fauzi Wildan Nuril Ahmad 
Published: February 2022

Indonesia ialah negara multikultural yang memiliki budaya, agama, dan suku beragam. Hal tersebut menjadikan peluang yang besar terjadinya radikalisme di Indonesia. Paham radikalisme agama cenderung mengabaikan aspek perdamaian yang diajarkan oleh agama dan mengabaikan Bhineka Tunggal Ika. Psikologis saat remaja ialah usia yang sangat rentan juga sensitif mudah terpengaruh oleh lingkungan sekitar. Pada usia ini, remaja sedang memantapkan diri untuk mencari jati dirinya. Ada beberapa layanan yang strategis untuk menanggulangi penyebaran radikalisme di ranah Pendidikan untuk usia anak-anak dan remaja, misalnya layanan bimbingan konseling Lintas Agama dan Budaya. Layanan konseling ini dilakukan melalui konsep multibudaya yang dibutuhkan agar dapat membentuk pribadi seseorang agar dapat menghormati dalam bermacam keberagaman. Untuk itu penelitian yang dilakukan bermaksud agar dapat memperlihatkan bahwa bimbingan konseling lintas budaya dan agama yaitu bagian dari cara untuk menanamkan sikap toleransi yang tinggi sehingga tidak terjerumus dalam pemahaman yang kurang tepat terhadap keberagaman yang ada disekitarnya.
Delirium management and current practice among Intensive Care Units Doctors, Khartoum, 2021
Authors: El-Raheem Ghada Omer Hamad Abd , Hamid Sheema Hamid Seidna , Abdallah Mudawi Mohammed Ahmed 
Published: February 2022

Abstract
Background: Delirium is a brain dysfunction that is characterized by attention and cognition disturbances in a fluctuating pattern. International guidelines recommend daily screening of delirium. The Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) and the Intensive Care Delirium Screening Checklist (ICDSC) were the most commonly used for delirium assessment. The reasons why this study was developed were to identify the barriers and gaps in knowledge and practice.Methods: Multi-center Hospital-based Cross-Sectional study was developed. Multistage sampling technique was used. 72 ICU doctors were randomly selected. Statistical analysis was performed through chi-square test to determine association among variables. It was considered significant when p ≤ 0.05.Results: More than 70% of doctors were ≤ 30 years and females. 69.4% had < 1year experience. 94.4% worked in medical ICUs. Less than 20% of the doctors used delirium assessment tools with a statistically significant difference based on experience (p=0.012). 13.9% had not assessed delirium regularly. Non-pharmacological management was applied by 76.4% of the doctors, communication with patients was the most frequent (75%). Haloperidol was the most used agent (83.3%). 40.3% of doctors had not stopped delirium medications on ICU discharge.Conclusions: Regular assessment of delirium was applied. Yet, the use of validated assessment tools was not common. Non-pharmacological management of delirium is important which is mostly done. Our doctors prescribed anti-psychotics for treatment of both forms of delirium and almost half of them did not stop medications on ICU discharge. Medication reconciliation and contact with the next in-charge of patients is important.
Impact of the COVID-19 Pandemic on Clinical Trial Conduct: Lessons for the Future
Authors: Harrison Francisco , Coladangelo Rino , Heutte Maël , Hardman Timothy Colin , Marini Stefano 
Published: February 2022

Abstract
Background: The COVID-19 outbreak was declared to be a pandemic by the WHO in March 2020. Ongoing clinical trials were suspended, some never to re-start. A survey was conducted to get a better understanding of both the successes and failures in dealing with the pandemic.Methods: European contract research organisations (CROs) were asked to determine the extent to which the pandemic impacted on their operations in terms of the trial site conduct and investigator performance as well as its impact on subjects and patients involved in ongoing trials and the quality of data generated. Results: Forty-nine companies provided responses to the questionnaire. Data indicated that the challenges faced during the pandemic had a marked impact on clinical trial conduct and delivery. We saw an almost immediate decline in clinical trial activity associated with reduced subject/patient recruitment and a reluctance of study participants to undergo follow-up due to their fears of exposure to infection. There was insufficient data to determine the full extent of the pandemic on clinical trial performance and associated limitations in access to bed spaces and the resources necessary to perform procedures and subject follow-up. The introduction of remote monitoring by CROs provided the opportunity for essential activities associated with clinical trials to resume/continue. However, implementing these solutions required research organisations to implement changes to trial documentation and procedures. This placed marked burdens on budgets and clinical resources.Conclusions: Those involved in clinical trials advanced a flexible approach to addressing the challenges posed by COVID-19, with all parties working closely together to find solutions.
Pulmonary Hypertension at Admission predicts ICU Mortality in Elderly Critically ill with Severe COVID-19 Pneumonia: retrospective cohort study
Authors: Kurnik Marko , Božič Helena , Vindišar Anže , Kolar Petra , Podbregar Matej 
Published: February 2022

Abstract
Background Point-of-care ultrasound (POCUS) is a useful diagnostic tool for non-invasive assessment of critically ill patients. Mortality of elderly patients with COVID-19 pneumonia is high and there is still scarcity of definitive predictors. Aim of our study was to assess the prediction value of combined lung and heart POCUS data on mortality of elderly critically ill patients with severe COVID-19 pneumonia. Methods This was a retrospective observational study. Data of patients older than 70 years, with severe COVID-19 pneumonia admitted to 25-bed mixed, level 3, intensive care unit (ICU) was analyzed retrospectively. POCUS was performed at admission; our parameters of interest were pulmonary artery systolic pressure (PASP) and presence of diffuse B-line pattern (B-pattern) on lung ultrasound. Results Between March 2020 and February 2021, 117 patients aged 70 years or more (average age 77±5 years) were included. Average length of ICU stay was 10.7±8.9 days. High-flow oxygenation, non-invasive ventilation and invasive mechanical ventilation were at some point used to support 36/117 (31%), 39/117 (33%) and 75/117 (64%) patients respectively. ICU mortality was 50.9%. ICU stay was shorter in survivors (8.8±8.3 vs 12.6±9.3 days, p=0.02). PASP was lower in ICU survivors (32.5±9.8 vs. 40.4±14.3 mmHg, p=0.024). B-pattern was more often detected in non-survivals (35/59 (59%) vs. 19/58 (33%), p=0.005). PASP and B-pattern at admission were both univariate predictors of mortality. PASP at admission was an independent predictor of ICU (OR 1.0683, 95%CI: 1.0108-1.1291, p=0.02) and hospital (OR 1.0813, 95%CI 1.0125-1.1548, p=0.02) mortality. Ventilator associated pneumonia (VAP) was a strong predictor of ICU and hospital mortality. Conclusions PASP at admission is an independent predictor of ICU and hospital mortality of elderly patients with severe COVID-19 pneumonia. During ICU stay development of VAP was a strong predictor of ICU and hospital mortality.
Typical Antibiotic Exposure And Dysglycemia Risk In An Elderly Chinese Population
Authors: Yu Shuixin , Kong Li , Gu Lvfen , Zhu Yitian , Liu Xinji , Sang Yanru , Wang Qunan , Wang Sufang , Zhang Dongmei , Cao Hongjuan , Tao Fangbiao , Liu Kaiyong 
Published: February 2022

Abstract
Studies examined the connection between antibiotic exposure in urine and dysglycemia risk (including prediabetes and diabetes) in the elderly were limited. Multiple linear regression, binary logistic regression, restricted cubic splines (RCS) and stratified analysis were applied to analyze the relationship between antibiotic exposure and dysglycemia risk. We observed that sulfaclozine exposure 0.07 (95% confidence interval [CI]: 0.01–0.23) significantly increased fasting blood glucose (FBG) level. By mechanism, usage and antimicrobial action, sulfonamides 0.08 (95% CI: 0.06–0.36), veterinary antibiotics (VA) 0.07 (95% CI: 0.01–0.30) or bacteriostatic antibiotics 0.07 (95% CI: 0.02–0.29) significantly increased FBG level. Additionally, sulfaclozine exposure 1.54 (95% CI: 1.02–2.33) resulted in a higher dysglycemia risk, while doxycycline exposure 0.53 (95% CI: 0.30–0.95) resulted in a lower dysglycemia risk. By mechanism, usage and antimicrobial action, sulfonamides 1.44 (95% CI: 1.02–2.04), VA 1.68 (95% CI: 1.21–2.35) or bacteriostatic antibiotics 1.40 (95% CI: 1.02–1.93) exposure had a higher dysglycemia risk. Taken together, exposure to sulfonamides, VA, especially sulfaclozine, was correlated with a higher dysglycemia risk in the elderly. Exposure to bacteriostatic antibiotics was associated with a higher dysglycemia risk in the female.
Development and evaluation of a bead-based Multiplexed Fluorescent ImmunoAssay (MFIA) for detection of antibodies to Salmonella enterica serogroup B and C1 in pigs
Authors: Berger Sanne Schou , Riber Ulla , Jensen Vibeke Frøkjaer , Lauritsen Klara Tølbøll , Andresen Lars Ole 
Published: February 2022

Abstract
Background: Since 1995, a surveillance program for Salmonella has been applied in the Danish pig industry in order to reduce cases of human salmonellosis. The objective of this study was to develop a bead-based Multiplexed Fluorometric ImmunoAssay (MFIA) as an improved serological surveillance method compared to the Salmonella mix ELISA, which has been the national reference immunoassay in the Danish Salmonella surveillance program for about 20 years.Results: An MFIA for detection of antibodies to Salmonella serogroup B and C1 was developed and optimized with regard to coupling of beads with Salmonella lipopolysaccharide antigens and establishing suitable assay conditions. The Salmonella MFIA was validated by testing sera from experimentally infected pigs as well as field sera from uninfected and infected pig herds, and by comparing to results from the Salmonella mix ELISA, which was run in parallel. Sensitivity and specificity was evaluated using receiver operating curve analysis showing an area under curve for the serogroup B and C1 MFIA of 0.984 and 0.998, respectively. The Salmonella MFIA was shown to detect more antibody-positive samples in seropositive herds compared to the Salmonella mix ELISA, and Bayesian statistics confirmed that the MFIA had a considerably higher sensitivity (94.5%) compared to the mix ELISA (75.1%). The assay specificity was slightly lower for the Salmonella MFIA (96.8%) compared to Salmonella mix ELISA (99.5%). Coupled beads were stable for at least 1 year at 4˚C, and MFIA reproducibility and repeatability of the Salmonella MFIA were acceptable. Results from proficiency tests also indicated that the Salmonella MFIA was more sensitive than the Salmonella mix ELISA and that they had similar specificity.Conclusions: A bead-based MFIA for simultaneous detection of porcine serum antibodies to Salmonella enterica serogroup B and C1 was developed and implemented in the Danish porcine serological Salmonella surveillance program in 2018. The Salmonella MFIA can distinguish, as opposed to the Salmonella mix ELISA, between antibodies to serogroup B and C1 and the MFIA shows considerably better sensitivity.
Developing an Interpretable Machine Learning Model to Predict In-Hospital Mortality in Sepsis Patients: A Retrospective Study of MIMIC-IV
Authors: Li Shuhe , Song Xiaodong , Lui Ka Yin , Zhu Yanping , Xu Jinghong , Guo Zilu , Hu Xiaoguang , Guan Xiangdong , Cai Changjie 
Published: February 2022

Abstract
Background: Risk stratification plays an essential role in the decision-making of sepsis management, whereas neither a single serum biomarker nor traditional scoring tools can satisfy the need to assess this heterogeneous population comprehensively. The study intended to develop an interpretable machine learning model for predicting in-hospital mortality in critically ill patients with sepsis. Methods: Adult patients fulfilling the definition of Sepsis-3 were included in the Medical Information Mart for Intensive Care (MIMIC)-IV database. Relevant clinical features were extracted within the first 24 hours in ICU, and missing data were analyzed and imputed. We randomly separated the dataset into train and test sub-cohort by the ratio of 7:3, then an outcome-balanced train dataset was synthesized for model training. Extreme gradient boosting (XGBoost) was employed when feature selection and hyperparameter tuning were performed afterward. The fine-tuned XGBoost model was then compared with stepwise logistic regression (LR) and established severity scores. Eventually, we inspected the interpretability of the new model using XGBoost feature importance and Shapley Additive exPlanations (SHAP) plot. Results: The final cohort had 24,573 patients, of which 3,785 patients died during hospitalization (15.4%). Ten iterations of multiple imputations were executed to fill missing data in all 91 incomplete variables. Subsequently, 10,572 patients formed the balanced dataset used for training. The XGBoost model showed greater discrimination than stepwise LR and severity scores such as Simplified Acute Physiology Score (SAPS)-III score (AUC: 0.849, 95% CI: 0.8386-0.8599; AUC: 0.618, 95% CI: 0.3927-0.8437; AUC: 0.803, 95% CI: 0.7898-0.8165 respectively). Based on model interpretation, some decisive factors, including elevated lactate and anion gap level, prolonged partial thromboplastin time, decreased urine volume, were greatly correlated with poor survival outcomes in sepsis. Conclusions: In the field of predicting the mortality risk of sepsis patients in hospitals, the XGBoost-based model demonstrated superior performance to stepwise LR and other scores. In addition, the model exhibited good interpretability and might provide valuable hints on future directions of clinical practice and research.
Assessing Medical Students’ Perception of Cross-Cultural Competence at a Private University in Karachi
Authors: Amanullah Fatima Syed , Manji Adil Al-Karim , Usmani Bilal Ahmed , Khan Muhammad Muntazir Mehdi , Sohail Hadia , Zahid Muhammad Haris , Baig Meryum Ishrat , Merani Inara , Larik Shehryar Ali , Khan Shahmeer Raza , Sania Syeda Ramlah Tul 
Published: February 2022

Abstract
Background: Cross-cultural competence is widely regarded to play an important role in being able to deliver appropriate and effective health care to patients with different backgrounds, race, gender orientation and cultural beliefs. This study aims to assess how medical students feel about their comfort, knowledge, and skill level in handling a diverse patient population using a validated questionnaire. Methods: This study was carried out over a period of three weeks from July 5th to July 26th of 2021, in the Aga Khan University Hospital, Karachi, Pakistan. All medical students who fulfilled the eligibility criteria and gave informed consent were included in the study. A modified version of the Harvard cross-cultural care survey was used to assess the medical students’ comfort, knowledge and skill level in a variety of circumstances related to patients with different backgrounds and cultures. Descriptive statistical analysis of the questionnaire items was carried out. We reported frequencies and percentages for gender and year of study. For the questionnaire items, we reported mean, assuming that our Likert scale had equivariant intervals. Furthermore, multivariate analysis between demographics and themes was carried out. A p-value of < 0.05 was taken as statistically significant. Results: It was found that students of year 5 considered themselves more knowledgeable, comfortable and skilled in dealing with patients of different backgrounds, religions and beliefs compared to students of year 1 and had a higher average score in all of these categories which was statistically significant. Additionally, students who believed it is extremely important to practice medicine with a diverse patient population also had the highest averages in perceived knowledge, comfort and skills in dealing with patients of different sociocultural backgrounds compared to students who believed it wasn’t important at all. Conclusion: This is a first of its kind study in a private medical university in Pakistan and highlights the students’ self-assessment of their competence when caring for patients from different backgrounds. This study can be used as a reference study in the region to carry out further studies and to assess and improve the gaps in medical training being provided.
Prussian Blue Technique is Prone To Yield False Negative Results In Magnetoreception Research
Authors: Curdt Franziska , Haase Katrin , Ziegenbalg Laura , Greb Helena , Heyers Domink , Winklhofer Michael 
Published: February 2022

Abstract
Perls’s Prussian blue staining technique has been used in magnetoreception research to screen tissues for iron-rich structures as proxies for putative magnetoreceptor structures based on magnetic particles. However, seemingly promising structural candidates in the upper beak of birds detected with Prussian Blue turned out to be either irreproducible or located in non-neuronal cells, which has spurred a controversy that has not been settled yet. Here we identify possible pitfalls in the previous works and apply the Prussian Blue technique to tissues implicated in magnetic-particle-based magnetoreception, in an effort to reassess its suitability for staining single-domain magnetite, i.e., the proposed magnetic substrate for the interaction with the external magnetic field. In the upper beak of night-migratory songbirds, we found staining products in great numbers, but not remotely associated with fiber terminals of the traced ophthalmic branch of the trigeminal nerve. Surprisingly, staining products were absent from the lamina propria in the olfactory rosette of rainbow trout where candidate magnetoreceptor structures were identified with different techniques earlier. Critically, magnetosome chains in whole cells of magnetotactic bacteria remained unstained. The failure to label single-domain magnetite in positive control samples is a serious limitation of the technique and suggests that two most influential but antipodal studies conducted previously stood little chances of obtaining correct positive results under the assumption that magnetosome-like particles were present in the tissues. Nonetheless, the staining technique appears suitable to identify tissue contamination with iron-rich fine dust trapped in epithelia already in vivo.
Developing a Successful Implementation Plan for a High Frequency, Low Touch Care Model at Specialized Type 1 diabetes Clinics: The Type 1 Diabetes Virtual Self-Management and Education support (T1ME) Trial
Authors: de Sequeira Stephanie , Presseau Justin , Booth Gillian , Lipscombe Lorraine , Perkins Isabelle , Perkins Bruce A. , Shulman Rayzel , Lakhanpal Gurpreet , Ivers Noah 
Published: February 2022

Abstract
Objective
To understand the provider- and system-level factors affecting successful implementation of a virtual care intervention into type 1 diabetes (T1D) clinics.
Methods
Semi-structured interviews with managers and certified diabetes educators (CDEs) at diabetes clinics across Southern Ontario, prior to the COVID-19 pandemic. Deductive analysis using the Theoretical Domains Framework, then mapping to Behaviour Change Techniques to inform potential implementation strategies for high frequency virtual care for T1D.
Results
There was considerable intention to deliver high frequency virtual care to patients with T1D. Participants believed that this model of care could lead to improved patient outcomes and engagement, but would likely increase the workload of CDEs. Some felt there were insufficient resources at their site to enable them to participate in the program. Member-checking conducted during the pandemic revealed that clinics and staff had already developed strategies to overcome resource barriers to the adoption of virtual care during the pandemic.
Conclusion
Existing enablers for high frequency virtual care can be leveraged, and barriers can be overcome with targeted clinical incentives and support.
The effect of hydrogen on the deformation of pearlite in steels
Authors: Cairney Julie , Niu Ranming , Li Hanyu , Liu Pang-Yu , Burr Patrick , Feng Yi , Yen Hung-Wei , Ma Mintu , Guo Aimin , Lu Hongzhou , Chen Yi-Sheng 
Published: February 2022

Abstract
Hydrogen embrittlement in steel gas infrastructure is a serious challenge for the use of hydrogen energy for global decarbonization. Steel gas pipelines contain a significant fraction of pearlite, which consists of lamellar cementite in ferrite. How exactly hydrogen affects deformation and failure in this structure, and hence the role that pearlite plays in embrittlement, is not well understood. Here we have studied the behavior of hydrogen around the cementite–ferrite interface, the defining microstructural feature in pearlite. Our micromechanical testing results show softening in the ferrite adjacent to the interface, consistent with hydrogen-enhanced local plasticity, rather than interfacial weakening. Atom probe tomography (APT) observations of hydrogen at the interface show no evidence of trapping at the cementite–ferrite interface, instead hydrogen trapping in pearlite occurs in the cementite bulk. Density functional theory calculations, accounting for the configuration of the lattice defects and local interfacial misfits, are consistent with the experimental observations. These findings explain how hydrogen leads to degradation in pearlite. This information is critical for the development of next-generation pipeline materials that can better withstand hydrogen embrittlement.