bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Platelet Transfusions on Extracorporeal Life Support Oxygenator’s Function
Authors: Chegondi Madhuradhar , Vijayakumar Niranjan , Badheka Aditya , Karam Oliver 
Published: March 2022

ObjectiveBleeding is a common complication of extracorporeal membrane oxygenation (ECMO), leading to increased mortality. Since one of its main complications is bleeding, platelet transfusions are frequently prescribed for children on ECMO. However, there is currently very little information on the effect of platelet transfusions on the function of the ECMO oxygenator. Our objective was to describe the effect of platelet transfusions on oxygenator function.MethodsIn this retrospective study, we included all children (&lt;18 years) who received ECMO support in our pediatric intensive care unit (PICU) between January 2017 and December 2019. Oxygenator function, measured before and after platelet transfusion, was assessed by post-oxygenator PECMOO2and the gradient in pre- post-oxygenator pressures (Delta Pressure).ResultsOver 3 years, we analyzed 235 platelet transfusions from 55 children who received ECMO support. Thirty-two (80%) of children were on veno-arterial ECMO and majority of them were peripherally cannulated. When looking at all transfusions, the post-transfusion change in delta-pressure was 0.1 mmHg (p= 0.69) and post-membrane PECMOO2was 6 mmHg (p= 0.49). However, in the subgroup with the lowest quartile of pre-transfusion oxygenator function, the post-transfusion change in delta-pressure was −5.2 ± 2.7 mmHg (p&lt; 0.001) and the post-transfusion change in PECMOO2was −118 ± 49 (p&lt; 0.001). The area under the ROC curve for the pre-transfusion delta-pressure and PECMOO2to predict a worsening of the oxygenator function were 0.72 (95%CI 0.63–0.81) and 0.71 (95%CI 0.64–0.78), respectively. Using regression models, pre-transfusion delta-pressure and PECMOO2were the only independent factors associated with oxygenator function worsening (p&lt; 0.001).ConclusionOur study suggests that overall, platelet transfusions do not seem to impact the ECMO oxygenator’s function. However, in the subgroup of patients with the lowest pre-transfusion oxygenator function, platelet transfusions were independently associated with a worsening function. Future studies should investigate if this warrants adjustments of the anticoagulation strategy around the platelet transfusion, especially among patients with lower oxygenator function.
Case Report: Simil-Appendicitis Presentation May Precede Cardiac Involvement in MIS-C Patient
Authors: Trevisan Matteo , Amaddeo Alessandro , Taddio Andrea , Boscarelli Alessandro , Barbi Egidio , Cozzi Giorgio 
Published: March 2022

IntroductionMultisystem inflammatory syndrome in children (MIS-C) is a new clinical entity characterized by a systemic hyperinflammation triggered by SARS-CoV-2 infection in children and adolescents. This condition could potentially involve all organs with main complications concerning cardiovascular system. Despite up to 90% of patients complain gastrointestinal symptoms (nausea, vomit, and diarrhea), a presentation mimicking acute appendicitis has rarely been reported, and can be the presenting feature of the disease, potentially leading to misdiagnosis and delayed treatment.Case DescriptionA 15-year-old boy presented to the Emergency Department for a 2-day history of fever, vomiting, and mild abdominal pain. One month before, the patient complained ageusia and anosmia while his mother tested positive for Sars-CoV2 nasopharyngeal swab. At admission, laboratory tests showed leukocytosis with lymphopenia and elevation of inflammatory markers, while cardiac enzymes, electrocardiogram and echocardiography were unremarkable. An abdominal ultrasound displayed a thickening of terminal ileus and cecum with ascites. Because of the worsening abdominal pain and a physical examination suggestive of acute appendicitis, a laparoscopy was performed but no surgical condition was found. After surgery, fever and generalized malaise persisted, so a cardiac evaluation was repeated, showing a relevant increase in inflammatory markers and cardiac enzymes. Electrocardiogram demonstrated a QTc prolongation with mild decrease in left ventricular ejection fraction at echocardiogram. A MIS-C was diagnosed and intravenous immunoglobulin along with a steroid treatment started. After 36 h, the patient presented a complete clinical recovery with fever cessation. Cardiac anomalies normalized in 3 weeks.ConclusionMIS-C has been defined as a systemic inflammation, involving at least two organs, after a previous SARS-CoV2 infection in children and adolescents. Physicians should be aware that while gastrointestinal manifestations are common, a pseudo appendicitis presentation may also occur, leading to misdiagnosis and delayed treatment. This report suggests that in patients with symptoms suggestive of an acute appendicitis, the presence of lymphopenia, hypoalbuminemia and ultrasound images of terminal ileus inflammation, should raise the suspect for MIS-C even without initial overt signs of cardiac involvement.
Trauma Exposure and Mental Health Prevalence Among First Aiders
Authors: Rowe Charlotte , Ceschi Grazia , Boudoukha Abdel Halim 
Published: March 2022

IntroductionFirst aiders are commonly exposed to different forms of traumatic event (TE) during their duties, such as Chronic Indirect Vicarious Exposure which refers to an indirect exposure to aversive details of the trauma (APA, 2013). If the psychopathological impact of TE is well documented, the mental health of first aiders remains neglected. Therefore, our main objectives are (i) to study the link between exposure to traumatic events and psychopathological outcomes and (ii) to quantify the rates of mental health disorders among first aiders.MethodOur sample comprised of 53 volunteer first aiders (21 females and 32 males) with an average age of 32.4 years (SD = 13.6 years). Traumatic event exposure and mental health were assessed through a set of validated questionnaires completed online.ResultsRates of mental health outcomes were higher than within the general population. Females showed higher scores of post-traumatic stress disorder (PTSD) than males. PTSD scores were significantly correlated with all mental issues scores, apart from tobacco use and eating disorders scores. There was a significant correlation between the number of traumatic events and the years of experience. Exposure to traumatic events only correlated with nicotine dependency. No other correlation reaches statistical significance.DiscussionThe scores of all mental health outcomes were high; a surprising result, as volunteer first aiders are thought to be recruited for their strong dispositional cognitive and emotional abilities. The high levels of post-traumatic stress disorder and burnout, along with the prevalent anxiety and depression, highlight the need for greater psychosocial support. Resilience training and peer support would be useful interventions in this group.
Prevalence of Behavioral and Psychological Symptoms in Patients With Cognitive Decline Before and During the COVID-19 Pandemic
Authors: Kuroda Yujiro , Sugimoto Taiki , Matsumoto Nanae , Uchida Kazuaki , Kishino Yoshinobu , Suemoto Claudia Kimie , Sakurai Takashi 
Published: March 2022

ObjectivePreventive measures to limit the spread of COVID-19 are essential, but often cause social isolation, affecting the physical and mental health of older adults. Patients with dementia are likely to have worsening behavioral and psychological symptoms of dementia (BPSD) owing to pandemic restrictions. To examine this, we described BPSD before and during the COVID-19 pandemic.MethodsWe identified patients at a memory clinic in Japan between October 2018 and December 2019 (15 months before the pandemic began, n = 1,384) and between April 2020 and June 2021 (15 months after the State of Emergency was declared; n = 675 patients). A propensity score was used to match 576 patients from each group. The Mini-Mental State Exam was used to classify cognitive function into mild and moderate/severe. Dementia Behavioral Disturbance Scale was used to evaluate BPSD. The association between BPSD before and during the pandemic was evaluated using binomial logistic regression models.ResultsThe levels of frequent night waking were higher in individuals before the pandemic than in those evaluated during the pandemic in both the mild group [adjusted odds ratio (AOR) = 1.82, 95% CI 1.02–3.23] and the moderate/severe group (AOR = 1.96, 95% CI 1.19–3.23). During the pandemic, physical attacks were higher in the mild group (AOR = 4.25, 95% CI 1.12–16.07), while night wandering was higher in the moderate/severe group (AOR = 2.22, 95% CI 1.03–4.81).ConclusionIn patients with cognitive impairment, some BPSD were more prevalent during the pandemic, depending on dementia severity. The findings pertaining to the higher frequency of sleep disturbance and aggressiveness during COVID-19 should be used to guide BPSD screening in patients with dementia and to provide evidence-based interventions.
An Easy-to-Use Public Health-Driven Method (the Generalized Logistic Differential Equation Model) Accurately Simulated COVID-19 Epidemic in Wuhan and Correctly Determined the Early Warning Time
Authors: Li Zhuoyang , Lin Shengnan , Rui Jia , Bai Yao , Deng Bin , Chen Qiuping , Zhu Yuanzhao , Luo Li , Yu Shanshan , Liu Weikang , Zhang Shi , Su Yanhua , Zhao Benhua , Zhang Hao , Chiang Yi-Chen , Liu Jianhua , Luo Kaiwei , Chen Tianmu 
Published: March 2022

IntroductionModeling on infectious diseases is significant to facilitate public health policymaking. There are two main mathematical methods that can be used for the simulation of the epidemic and prediction of optimal early warning timing: the logistic differential equation (LDE) model and the more complex generalized logistic differential equation (GLDE) model. This study aimed to compare and analyze these two models.MethodsWe collected data on (coronavirus disease 2019) COVID-19 and four other infectious diseases and classified the data into four categories: different transmission routes, different epidemic intensities, different time scales, and different regions, using R2 to compare and analyze the goodness-of-fit of LDE and GLDE models.ResultsBoth models fitted the epidemic curves well, and all results were statistically significant. The R2 test value of COVID-19 was 0.924 (p &lt; 0.001) fitted by the GLDE model and 0.916 (p &lt; 0.001) fitted by the LDE model. The R2 test value varied between 0.793 and 0.966 fitted by the GLDE model and varied between 0.594 and 0.922 fitted by the LDE model for diseases with different transmission routes. The R2 test values varied between 0.853 and 0.939 fitted by the GLDE model and varied from 0.687 to 0.769 fitted by the LDE model for diseases with different prevalence intensities. The R2 test value varied between 0.706 and 0.917 fitted by the GLDE model and varied between 0.410 and 0.898 fitted by the LDE model for diseases with different time scales. The GLDE model also performed better with nation-level data with the R2 test values between 0.897 and 0.970 vs. 0.731 and 0.953 that fitted by the LDE model. Both models could characterize the patterns of the epidemics well and calculate the acceleration weeks.ConclusionThe GLDE model provides more accurate goodness-of-fit to the data than the LDE model. The GLDE model is able to handle asymmetric data by introducing shape parameters that allow it to fit data with various distributions. The LDE model provides an earlier epidemic acceleration week than the GLDE model. We conclude that the GLDE model is more advantageous in asymmetric infectious disease data simulation.
Smoking and Risk of Urolithiasis: Meta-Analysis of Observational Studies
Authors: Yue Ling , Pai Qiaofeng , Wu Xiaolin , Zhang Jinghua 
Published: March 2022

BackgroundEarlier studies have warned about the effects of smoking on urolithiasis. Some studies have deemed that smoking has a promoting effect on urolithiasis, whereas others have considered that no inevitable association exists between the two. Therefore, we conducted a meta-analysis to estimate whether smoking is associated with urolithiasis risk.MethodsTo identify publications from related observational studies, we performed a search on PubMed, Web of Science, Embase, and the Cochrane Library databases from inception until October 1, 2021. According to the heterogeneity, random-effect model was used to calculate the odds ratios (ORs) and corresponding 95% confidence intervals (CIs).ResultsFive articles were included in the meta-analysis, representing data for 20,402 subjects, of which 1,758 (8.62%) had urolithiasis as defined according to the criteria. Three articles are concerned with analysis between ex-smokers and non-smokers, in which a significant difference was observed (OR = 1.73, 95% CI: 1.48–2.01). Our comparison of current smokers with non-smokers in another meta-analysis of three articles revealed no significant difference between them (OR = 1.08, 95% CI: 0.94–1.23). Finally, we separated subjects into ever-smokers and never-smokers and found a significant difference between the two groups in the analysis of three articles (OR = 1.31, 95% CI: 1.17–1.47). Sensitivity analysis confirmed the stability of the current results.ConclusionCombined evidence from observational studies demonstrates a significant relation between smoking and urolithiasis. The trend of elevated urolithiasis risk from smoking was found in ever-smokers vs. never-smokers.
Does the Efficacy of Behavior Management Techniques Differ Between Children From Single-Child and Multi-Child Families?: A Quasi-Experimental Study
Authors: Dai Lina , Wu Tingting , Hu Yun , Li Shunyi , Liu Weiwei 
Published: March 2022

AimBehavior management techniques (BMTs) efficiently deliver dental treatment to children with dental anxiety. The objective of this quasi-experimental study was to examine whether the efficacy of BMTs applied for the improvement of compliance in pediatric patients differs between children 3–10-year-olds from single-child and multi-child families.Materials and MethodsIn this quasi-experimental, 197 caregiver-child couples were divided into two groups: single-child group (116 couples) and multi-child group (81 couples). Children's pre- and post-treatment anxiety levels were measured by facial mood scale (FMS) and Frankl Behavior Rating Scale (FBRS), respectively.Caregivers' dental anxiety was measured by the Chinese version of the Modified Dental Anxiety Scale (MDAS), which was included in the self-designed questionnaire. Data were analyzed by using the Mann-Whitney U-test, chi-square tests, and binary multivariate regression analysis.ResultsThere was no statistically significant difference in the demographic characteristics of the children between the two groups. BMTs were found to be capable of reducing children's dental anxiety (CDA): the compliance rate was 45.69–88.79% in the single-child group and 44.44–85.79% in the multi-child group pre- and post-BMTs, but there was no significant difference in the change of compliance between the two groups (p &gt; 0.05). In the subgroup analysis, parenting style (odds ratio [OR] = 0.054, p &lt; 0.05) and father's education (OR = 8.19, p &lt; 0.05) affected the varies of children's compliance in the single-child group. In contrast, in the multi-child group, gender (OR = 8.004, p &lt; 0.05) and mother's occupation (OR = 0.017, p &lt; 0.05) were associated with these changes in compliance.ConclusionsIn this study, BMTs were proved to be beneficial in improving compliance in 3- to 10-year-olds children in dental treatment. Though there was no significant difference in the change of compliance between children from single-child and multi-child families, different associated factors may affect the two groups. Therefore, the related family factors should be taken into account when professionals manage each child's behavior in dental practice.
Value of CRP, PCT, and NLR in Prediction of Severity and Prognosis of Patients With Bloodstream Infections and Sepsis
Authors: Liang Peipei , Yu Feng 
Published: March 2022

ObjectiveTo investigate the value of C-reactive protein (CRP), procalcitonin (PCT), and neutrophil to lymphocyte ratio (NLR) in assessing the severity of disease in patients with bloodstream infection and sepsis, and to analyze the relationship between the levels of three inflammatory factors and the prognosis of patients.MethodsThe clinical data of 146 patients with bloodstream infection and sepsis admitted to our intensive care unit (ICU) from October 2016 to May 2020 were retrospectively analyzed. The differences in the levels of inflammatory indicators such as CRP, PCT, and NLR within 24 h in patients with bloodstream infection sepsis with different conditions (critical group, non-critical group) and the correlation between these factors and the condition (acute physiology and chronic health evaluation II, APACHE II score) were analyzed. In addition, the prognosis of all patients within 28 days was counted, and the patients were divided into death and survival groups according to their mortality, and the risk factors affecting their death were analyzed by logistic regression, and the receiver operating characteristic (ROC) curve was used to analyze the value of the relevant indicators in assessing the prognosis of patients.ResultsThe levels of NLR, CRP, PCT, total bilirubin (TBIL), glutamic oxaloacetic transaminase (AST), and serum creatinine (Scr) were significantly higher in the critically ill group than in the non-critically ill group, where correlation analysis revealed a positive correlation between CRP, PCT, and NLR and APACHE II scores (P &lt; 0.05). Univariate logistic regression analysis revealed that CRP, PCT, NLR, and APACHE II scores were associated with patient prognosis (P &lt; 0.05). Multi-factor logistic regression analysis found that PCT, NLR, and APACHE II scores were independent risk factors for patient mortality within 28 days (P &lt; 0.05). ROC curve analysis found that PCT and NLR both had an AUC area &gt; 0.7 in predicting patient death within 28 days (P &lt; 0.05).ConclusionInflammatory factors such as NLR, CRP, and PCT have important clinical applications in the assessment of the extent of disease and prognosis of patients with bloodstream infection and sepsis.
Nonlinear Hydrodynamic Analysis of Ships Moored in a VLFS Service Basin in the East Mediterranean Sea
Authors: Gafter Roy , Drimer Nitai 
Published: March 2022

Very large floating structure (VLFS) is an environmentally sensitive technology which creates artificial land at sea. Designated for the open sea, the Delta is a new type of VLFS. Formed, inherently, by the innovative geometry, the sheltered basin is a unique feature of the Delta. Its year-round operability as the gateway of the structure directly affects the Delta’s utilization. This study examines the basin in terms of its operability as a service port. Relying on potential flow theory and applying the boundary element method, we conducted a nonlinear hydrodynamic analysis of a moored vessel at the basin. It consists of a time-domain simulation of a tanker, berthed via nonlinear mooring system along the Delta’s side hull under severe wave conditions typical to the East Mediterranean Sea. The system is evaluated in terms of acceptable motion of the ship and permissible load on the mooring system. The favorable results indicate that the basin enables most cargo handling operations under waves conditions of Hmo=2.5 m, and minimal downtime of less than 6% of the year. In this paper we present the analysis procedure, the evaluation criteria, and the mooring system’s design. The study results and their significance are presented and discussed as well.
Analysis of Puumala orthohantavirus Genome Variants Identified in the Territories of Volga Federal District
Authors: Kabwe Emmanuel , Al Sheikh Walaa , Shamsutdinov Anton F. , Ismagilova Ruzilya K. , Martynova Ekaterina V. , Ohlopkova Olesia V. , Yurchenko Yuri A. , Savitskaya Tatiana A. , Isaeva Guzel S. , Khaiboullina Svetlana F. , Rizvanov Albert A. , Morzunov Sergey P. , Davidyuk Yuriy N. 
Published: March 2022

Hemorrhagic fever with renal syndrome (HFRS) is a zoonotic disease commonly diagnosed in the Volga Federal District (VFD). HFRS is caused by Puumala orthohantavirus (PUUV), and this virus is usually detected in bank voles as its natural host (Myodes glareolus). The PUUV genome is composed of the single-stranded, negative-sense RNA containing three segments. The goal of the current study is to identify genome variants of PUUV strains circulating in bank voles captured in the Udmurt Republic (UR) and Ulyanovsk region (ULR). The comparative and phylogenetic analysis of PUUV strains revealed that strains from Varaksino site UR are closely related to strains previously identified in the Pre-Kama area of the Republic of Tatarstan (RT), whilst strains from Kurlan and Mullovka sites ULR are similar to strains from the Trans-Kama area of the RT. It was also found that Barysh ULR strains form a separate distinct group phylogenetically equidistant from Varaksino and Kurlan–Mullovka groups. The identified groups of strains can be considered as separate sub-lineages in the PUUV Russian genetic lineage. In addition, the genomes of the strains from the UR, most likely, were formed as a result of reassortment.
Removal of Phosphorus from Hypolimnetic Lake Water by Reactive Filter Material in a Recirculating System—Laboratory Trial
Authors: Renman Agnieszka , Renman Gunno 
Published: March 2022

A toolbox of methods must be available for the remediation of lakes and water bodies suffering from eutrophication. One method suggested is hypolimnetic withdrawal based on a closed-circuit system. Prior to the start of a pilot-scale test at Lake Hönsan, Sweden, a laboratory trial with containers filled with water and bottom sediment from this lake was performed. A peristaltic pump distributed equal bottom water volume to four columns, two filled with glass beads and two with the filter material Polonite, and then back to the surface of the containers. The reactive filter medium (RFM) removed phosphate (PO4-P) efficiently (98.6%), despite the relatively low influent concentration (390 µg L−1). The control column filled with glass beads, removed 2.9% of the PO4-P. The anoxic sediment, containing 2.47 mg P g−1, released PO4-P, which was indicated by the increased concentration in near-bottom water. The redirected water after RFM filtration had high pH (x¯=11.1); however, an equalization took place in the water mass to a lower but still increased pH value (x¯=8.7) compared to the control (x¯=7.02). This article reports the pros and cons of a full-scale system using the proposed method.
Influence of Transferred Arc Plasma Melting Time on the Formation of Phase and Microstructure of Mullite-Zirconia Composite
Authors: P Amarnath , S Yugeswaran , K Suresh , K Navaneetha Pandiyaraj 
Published: March 2022

Transferred arc plasma is an effective and simple technique to synthesis a high temperature reaction ceramic composite material. In this paper, 20 kW transferred arc plasma torch was used to synthesis mullite-zirconia composites through the solid-state reaction of 3:2 mole ratio of ball milled alumina and zircon powders. Dissociation of zircon in a thermal plasma arc is utilized as to prepare mullite-zirconia composites. The ball milled samples are melted for 3, 6, 9 and 12 minutes in transferred arc plasma torch at 20 kW power level with 10 lpm of argon flow rate and cooled by air. The phase and microstructure of melted samples were determined from X-ray diffraction (XRD) and SEM images. The obtained results shows that the processing time significantly influence on the formation of phase and microstructure of the mullite- zirconia composite.