bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Utility of an Online Forward Triage Tool During the SARS-CoV-2 Pandemic: Health Care Provider and Health Authority Perspectives
Authors: Michel Janet , Kilb Tim S. , Mettler Annette , Müller Martin , Hautz Wolf E. , Hautz Stefanie C. , Sauter Thomas C. 
Published: July 2022

IntroductionThe SARS CoV-2 pandemic poses major challenges not only to patients but also to health care professionals and policy-makers, with rapidly changing, sometimes complex, recommendations, and guidelines to the population. Online forward triage tools (OFTT) got a major boost from the pandemic as they helped with the implementation and monitoring of recommendations.MethodsA multiphase mixed method sequential explanatory study design was employed. Quantitative data were collected first and informed the qualitative interview guides. Video interviews were held with key informants (health care providers and health authorities) between 2 September and 10 December 2020. Audio-recordings were transcribed verbatim, coded thematically and compared with patient perspectives (framework).ObjectivesTo explore the perspectives of health care providers and authorities in Canton Bern on the utility of a COVID-19 OFTT, as well as elicit recommendations for telehealth in future.ResultsThe following themes emerged; (i) accessibility (ii) health system burden reduction (iii) utility in preventing onward transmission (iv) utility in allaying fear and anxiety (v) medical decision-making utility (vi) utility as information source (vii) utility in planning and systems thinking. The health care providers and health authorities further provided insights on potential barriers and facilitators of telehealth in future.ConclusionSimilar to patients, health care providers acknowledge the potential and utility of the COVID-19 OFTT particularly as an information source and in reducing the health system burden. Data privacy, doctor-patient relationship, resistance to change, regulatory, and mandate issues, and lack of systems thinking were revealed as barriers to COVID-19 OFTT utility.
Prevalence and Genotype Distribution of High-Risk Human Papillomavirus Infection Among Sub-Saharan African Women: A Systematic Review and Meta-Analysis
Authors: Seyoum Ayichew , Assefa Nega , Gure Tadesse , Seyoum Berhanu , Mulu Andargachew , Mihret Adane 
Published: July 2022

BackgroundAmong sub-Saharan African women, cervical cancer is steadily increasing with more than 75,000 new cases and 50,000 deaths annually. Due to the vast ethno geography variation, Africa harbors heterogeneous genotypes of HPV. High-risk HPV [hr HPV] genotypes such as hr HPV-16,−18,-35, and−52 are abundantly reported in sub-Saharan Africa. The purpose of this systematic review and meta-analysis is to generate an evidence on the prevalence and the genotype distribution of hr HPV among sub-Saharan African countries.MethodsThe review was conducted by following the preferred reporting items for systematic reviews and Meta-analysis. PubMed/Medline, Embase, Scopus, Google Scholar, Heath Technology assessment and Cochrane Library databases were used to retrieve published original studies between 2001 and 2021. It included studies that used PCR-based or hybrid testing to assess the presence of HPV DNA in a cervical biopsy, cervical swelling, and vaginal swelling. Statistical software for data science (STATA V16) software using a random-effects model was used to determine the pooled prevalence and type-specific distribution of HPV with 95% confidence intervals (CI). The I-squared statistic was used to describe the level of heterogeneity. The study protocol is registered on PROSPERO with reference number CRD42022311157.ResultsThe review included 27 studies conducted in 19 sub-Saharan countries. A total of 16,506 study participants from 27 studies were included in a systematic review and 5,303 of them were infected with the hr HPV infection. Out these, only 3,075 of them were eligible for meta-analysis. The incidence proportion of estimatesof hr HPV infection among study participants with different health conditions ranges from 10.7 to 97.2% while the pooled incidence proportion of estimates is 34% (95%CI: 29–39). Among 3,075 women, 424 (13.8%), 305 (9.9%) and 279 (9%) were infected with HPV-16,−52 and−18, respectively. HPV-16 and−52 are the main genotypes causing the hr HPV infection in the Eastern and Southern African sub-contents, whereas HPV-16 and−35 are the main genotypes in the Western African countries.ConclusionsDepending on several factors, especially women's health conditions, the high rate of hr HPV infection with inconsistent genotype distribution shows that it is a growing public health challenge in sub-Saharan African countries. Therefore, to implement a vaccination-based prevention strategy and be effective, considering factors associated with hr HPV infection is crucial.
Impact of DMFT, PUFA, DAI, and TDIs on Oral Health-Related Quality of Life (OHRQoL) Among Foundling, Delinquent, and Mainstream School Children: A Prilimenary Study
Authors: Alsaif Abdulaziz Abdullah , Alkhadra Thamer Adel , AlJameel AlBandary Hassan 
Published: July 2022

ObjectivesTo assess oral health and its implication on oral health-related quality of life (OHRQoL) among groups of foundling and delinquent children compared to mainstream children in Riyadh, Saudi Arabia.Materials and MethodsThis cross-sectional observational study was conducted on children in care houses and mainstream school-going children. The following variables were measured for each group: Demographic data (age, gender); subjective oral health condition; (OHRQoL); clinical oral health condition including the decayed, missing, and filled teeth (DMFT) index; pulpally involved, ulceration, fistula, and abscess (PUFA) index; Dental Aesthetic Index (DAI) for malocclusion, and traumatic dental injuries (TDI).Statistical AnalysisA one-way ANOVA test, Chi-square test, and Pearson correlation coefficient were used.ResultsThe total OHRQoL score was significantly higher for the delinquent compared to the mainstream group. In addition, the DMFT and mean PUFA scores were significantly higher for the delinquent group than the others. The DAI revealed statistical significance in occlusion status within the foundling and delinquent groups, and the prevalence of TDI was significantly higher in the delinquent vs. the mainstream group.ConclusionOral health status appeared to have an association with the OHRQoL among foundling, delinquent, and mainstream children.
Adverse Impacts of Temporomandibular Disorders Symptoms and Tooth Loss on Psychological States and Oral Health-Related Quality of Life During the COVID-19 Pandemic Lockdown
Authors: Weng Siwei , Hou Sicong , Jiao Xiuping , Sun Yun 
Published: July 2022

BackgroundEmotion and quality of life may have been impacted by the coronavirus disease 2019 (COVID-19) crisis, especially in the lockdown. The impact of temporomandibular disorders (TMD) symptoms and tooth loss on mental status and Oral Health-Related Quality of Life (OHRQoL) are not fully understood in a stressful situation.ObjectivesWe aimed to investigate whether TMD and tooth loss were the impaired risks of psychological states and OHRQoL in COVID-19 lockdown, and attempt to explore other potential risk factors.MethodsThis cross-sectional study surveyed residents via an online self-reported questionnaire, when Yangzhou was in lockdown. Demographic data, clinical information, the level of anxiety, depression and OHRQoL were collected and analyzed.ResultsPainful TMD symptoms and tooth loss are the risks of more severe anxiety and depression. TMD symptoms and tooth loss worsened OHRQoL. Lower education degree (OR: 6.31, P = 0.019), TMD-related pain symptoms (OR: 10.62, P = 0.005), tooth loss (OR: 3.12, P = 0.035), sleep disorders (OR: 2.92, P = 0.049) and relatively close contacts (OR: 3.95, P = 0.020) were verified as risk factors for increased level of anxiety. With respect to depression, low socio-economic status (OR: 6.22, P = 0.021), TMD-related pain (OR: 7.35, P = 0.012), tooth loss (OR: 4.48, P = 0.009), sleep disorders (OR: 5.13, P = 0.007) and relatively close contacts (OR: 12.94, P = 0.001) were identified as independent factors for developing depression. Additionally, drinking (B: −2.584, P = 0.013) and never going to the dental clinic (B: −3.675, P = 0.024) were relevant to better OHRQoL, while TMD without pain (B: 2.797, P = 0.008), TMD-related pain (B: 12.079, P &lt; 0.001), tooth loss (B: 2.546, P = 0.006), sleep disorders (B: 2.598, P = 0.003) were independent factors for impaired OHRQoL.ConclusionPainful TMD symptoms, tooth loss and sleep disorders were the impaired risks of psychological states. TMD symptoms and tooth loss damaged OHRQoL when the city was in lockdown. Therefore, individualized psychological counseling is supposed to maintain control of mental health and OHRQoL under the stressful event.
Risk Factors for Postoperative Pneumonia: A Case-Control Study
Authors: Xiang Bingbing , Jiao Shulan , Si Yongyu , Yao Yuting , Yuan Feng , Chen Rui 
Published: July 2022

BackgroundPostoperative pneumonia is a preventable complication associated with adverse outcomes, that greatly aggravates the medical expenses of patients. The goal of our study is to identify risk factors and outcomes of postoperative pneumonia.MethodsA matched 1:1 case-control study, including adult patients who underwent surgery between January 2020 and June 2020, was conducted in the Second Affiliated Hospital of Kunming Medical University in China. Cases included all patients developing postoperative pneumonia within 30 days after surgery, defined using consensus criteria. Controls were selected randomly from the matched eligible population.ResultsOut of 17,190 surgical patients, 264 (1.54%) experienced postoperative pneumonia. Increased age, chronic obstructive pulmonary disease, emergency surgery, postoperative reduced albumin, prolonged ventilation, and longer duration of bed rest were identified as significant risk factors independently associated with postoperative pneumonia. Regarding prognostic implications, postoperative pneumonia was associated with longer length of hospital stay, higher ICU occupancy rate, higher unplanned re-operation rate, and higher in-hospital mortality rate. Postoperative pneumonia was most commonly caused by Gram-negative pathogens, and multidrug resistant bacteria accounted for approximately 16.99% of cases.ConclusionsPostoperative pneumonia is associated with severe clinical outcomes. We identified six independent risk factors that can aid in risk stratification and management of patients at risk of postoperative pneumonia, and the distribution of causative pathogens can also help in the implementation of effective interventions.Clinical Trial Registrationwww.chictr.org.cn, identifier: chiCTR2100045986.
Secular Trends in the Burden of Multiple Myeloma From 1990 to 2019 and Its Projection Until 2044 in China
Authors: Zhao Yumei , Niu Dongdong , Ye Enlin , Huang Jiasheng , Wang Jia , Hou Xuefei , Wu Jiayuan 
Published: July 2022

ObjectiveMultiple myeloma (MM) imposes a heavy burden in China. Understanding the secular trend of MM burden and projecting its future trend could facilitate appropriate public health planning and improve the management of MM.MethodsSex-specific incidence and mortality rates of MM in China from 1990 to 2019 were collected from the Global Burden of Disease 2019 study. The secular trend of MM burden was analyzed by joinpoint regression. Age–period–cohort model was used to analyze the effects of age, period, and birth cohort on MM burden and project future trends up to 2044.ResultsFrom 1990 to 2019, the age-standardized incidence and mortality rates of MM continued to increase in males. For females, the age-standardized rates were stable in MM incidence and decreased in MM mortality. Males had a higher disease burden of MM than females. Age effects were the most significant risk factor for MM incidence and mortality. Moreover, the risk of MM incidence and mortality increased with increasing time period but decreased with birth cohort in males and females. The age-standardized incidence and mortality rates of MM in China is predicted to be continuously increasing over the next 25 years.ConclusionThe burden of MM in China is expected to continue to increase in the future, with significant sex difference. A comprehensive understanding of the risk characteristics and disease pattern of MM could help develop timely intervention measures to effectively reduce its burden.
Icy Moon Penetrator Organic Analyzer Post-Impact Component Analysis
Authors: Govinda Raj Chinmayee , Cato Michael , Speller Nicholas Colby , Duca Zachary , Putman Philip , Epperson Jason , Foreman Shaun , Kim Jungkyu , Stockton Amanda 
Published: July 2022

Europa is an established high-priority astrobiology target where identifying chemical signatures of life is one of NASA’s highest-priority goals. Remote sensing techniques are powerful tools for extraterrestrial exploration, but in situ data through analyses of subsurface materials is necessary for ground-truthing these habitability investigations. Instrument designs fitting small volume, mass, and power consumption envelopes have a high potential for enabling efficient, low-cost missions. The Ice Shell Impact Penetrator (IceShIP) is a state-of-the-art miniaturized payload design dedicated to lower-cost extraterrestrial impact-penetrator missions. It houses the Icy Moon Penetrator Organic Analyzer (IMPOA), a first-of-its-kind payload housing miniaturized analytical instrumentation employing laser-induced fluorescence for the detection of low concentration organic species pervasive in the solar system. IMPOA is capable of sustaining high g-loads, avoiding the need for soft landing platforms, and facilitating crustal penetration for subsurface sample analyses. Three IMPOA test articles with varying material choices, construction designs, and internal components were modeled using COMSOL Multiphysics and then tested at 12 k-g, 25 k-g, and 50 k-g accelerations in an air gun assembly. The internal components consisted of linear piezoelectric micro-actuators, microcontroller board, mock microfluidic glass wafers, collimating lens, optical filters, and laser diodes. This work focuses on an extensive analysis of the impact-tested components. All components physically survived the impact tests except the mock microfluidic disk. Functionality tests of the individual components confirm their survival post-impact. All components used in this design are commercially available or easily machinable, which will simplify technology transfer for further technology elevation. Impact-resistance, miniaturization, energy efficiency, and cost-effectiveness are pivotal for impact-penetrator space-flight missions. This work satisfies these key aspects and demonstrates technology of a novel design for astrobiological in situ instrumentation.
Impact of Surgery on Non-Functional Pancreatic Neuroendocrine Tumors ≤2 cm: Analyses With Propensity Score–Based Inverse Probability of Treatment Weighting
Authors: Ye Jingyuan , Wu Hongyu , Li Jinzheng , Liu Changan 
Published: July 2022

PurposeThe impact of surgery on non-functional pancreatic neuroendocrine tumors (NF-PNETs) ≤2 cm is controversial. This study sought to demonstrate the impact of surgery on the prognosis of NF-PNETs ≤2 cm with different biological behaviors.MethodsPatients with NF-PNETs ≤2 cm from 2004 to 2015 in the Surveillance, Epidemiology, and End Results database were included in this study. An inverse probability of treatment weighting (IPTW) method was used to reduce the selection bias. Kaplan–Meier survival analysis and Cox proportional hazards regression were used to evaluate the effect of surgery on the prognosis.ResultsIn the IPTW-adjusted Cox proportional hazards regression analysis, surgery improved the cancer-specific survival (CSS) in the overall cohort (hazard ratio [HR], 0.187; 95% confidence interval [CI], 0.102–0.343; p &lt; 0.001), patients with poorly differentiated or undifferentiated tumor grades (HR, 0.238; 95% CI, 0.105–0.64; p &lt; 0.001), patients with distant metastasis (HR, 0.102; 95% CI, 0.021–0.496; p = 0.005), and patients with local invasion (HR, 0.059; 95% CI, 0.005–0.683; p = 0.002). Surgery did not improve the CSS in patients with lymph node metastasis only (HR, 0.26; 95% CI, 0.0462–1.461; p = 0.126) or patients with well or moderate differentiation while without distant and lymph node metastasis (HR, 0.387; 95% CI, 0.146–1.028; p = 0.057).ConclusionsAmong patients with NF-PNETs ≤2 cm, different biological behaviors correlate with different prognostic impacts of surgery. As long as distant metastasis does not occur and the grade is well–moderately differentiated, these patients will not benefit from surgery no matter whether lymph node metastasis occurs or not. However, when local invasion appears in this group of patients, surgery should be performed. Moreover, patients with a tumor grade of poorly differentiated or undifferentiated or those with distant metastases may benefit from surgery.
Comparative Genomic Analysis of the Marine Cyanobacterium Acaryochloris marina MBIC10699 Reveals the Impact of Phycobiliprotein Reacquisition and the Diversity of Acaryochloris Plasmids
Authors: Yamamoto Haruki , Uesaka Kazuma , Tsuzuki Yuki , Yamakawa Hisanori , Itoh Shigeru , Fujita Yuichi 
Published: July 2022

Acaryochloris is a marine cyanobacterium that synthesizes chlorophyll d, a unique chlorophyll that absorbs far-red lights. Acaryochloris is also characterized by the loss of phycobiliprotein (PBP), a photosynthetic antenna specific to cyanobacteria; however, only the type-strain A. marina MBIC11017 retains PBP, suggesting that PBP-related genes were reacquired through horizontal gene transfer (HGT). Acaryochloris is thought to have adapted to various environments through its huge genome size and the genes acquired through HGT; however, genomic information on Acaryochloris is limited. In this study, we report the complete genome sequence of A. marina MBIC10699, which was isolated from the same area of ocean as A. marina MBIC11017 as a PBP-less strain. The genome of A.marina MBIC10699 consists of a 6.4 Mb chromosome and four large plasmids totaling about 7.6 Mb, and the phylogenic analysis shows that A.marina MBIC10699 is the most closely related to A. marina MBIC11017 among the Acaryochloris species reported so far. Compared with A. marina MBIC11017, the chromosomal genes are highly conserved between them, while the genes encoded in the plasmids are significantly diverse. Comparing these genomes provides clues as to how the genes for PBPs were reacquired and what changes occurred in the genes for photosystems during evolution.
Exploring doctors’ reasons for not granting a request for euthanasia: a mixed-methods study
Authors: van den Ende Caroline , Bunge Eveline Margaretha , Eeuwijk Jennifer , van de Vathorst Suzanne 
Published: July 2022

BackgroundIn a growing number of jurisdictions, physician-assisted death (PAD) is now an established part of medical care. Although PAD is allowed under certain criteria in The Netherlands, physicians can always refuse a request. The Euthanasia Expertise Centre (EEC) offers PAD to patients whose request was declined in circumstances where their own physician could have satisfied the legal criteria. The number of requests reaching EEC has increased, suggesting the threshold for treating physicians to refer patients to EEC has become lower.AimTo explore the reasons of physicians for not granting a request for PAD and/or referring a patient to EEC, and any needs physicians may have in handling requests for PAD.Design & settingSurvey and interviews among Dutch physicians in The Netherlands.MethodA questionnaire was sent to 500 physicians who declined a request for PAD and whose patient subsequently requested PAD at EEC. This was followed by a qualitative study, in which in-depth interviews were held with 21 of the physicians who responded to the survey.ResultsDoctors were identified as those who had objections on principle, or with other reasons for refusing a request for PAD and/or to refer the patient to EEC. These reasons were mostly related to concerns about complying with the due care criteria for PAD, or to difficulties with PAD in specific patient groups. In these cases they often valued support from another healthcare professional.ConclusionFor patients of physicians with objections on principle against PAD, EEC offered a good solution. Doctors who struggle with whether they can comply with the legal criteria might benefit from peer support.
In-Hospital Prescription Checking System for Hospitalized Patients with Decreased Glomerular Filtration Rate
Authors: Sonoda Akihiro , Kondo Yuki , Iwashita Yoshitaka , Nakao Shoji , Ishida Kazuhisa , Irie Tetsumi , Ishitsuka Yoichi 
Published: July 2022

Key Points

We introduced a simple in-hospital prescription checking system to alert for the presence of renally excreted drugs and to support dosage settings.The in-hospital prescription checking system reduced the dosage error rate of renally excreted drugs in hospitalized patients.

Background
Clinical decision support systems (CDSS) are reported to be useful in preventing dosage errors in renally excreted drugs by alerting hospital pharmacists to inadequate dosages for hospitalized patients with decreased GFR. However, it is unclear whether CDSS can reduce dosage errors in renally excreted drugs in hospitalized patients. To prevent dosage errors in renally excreted drugs, we introduced a prescription checking system (PCS) for in-hospital prescriptions. This retrospective study aimed to evaluate whether a prescription audit by hospital pharmacists using the PCS reduced the rate of dosage errors in renally excreted drugs.

Methods
The target drugs were allopurinol, cibenzoline, famotidine, and pilsicainide. Interrupted time series analysis was used to evaluate trends in the 4-weekly dosage error rates over 52 weeks before PCS implementation and 52 weeks after PCS implementation.

Results
Before and after PCS implementation, 474 and 331 prescriptions containing one of the targeted drugs, respectively, were generated. The estimated baseline level of the 4-weekly dosage error rates was 34%. The trend before the PCS implementation was stable with no observable trend. The estimated level change from the last point in the pre-PCS implementation to the first point in the PCS implementation was −20% (P<0.001). There was no change in the trend after PCS implementation.

Conclusions
We demonstrated that a prescription audit by hospital pharmacists using the PCS reduced the rate of dosage errors in the target renally excreted drugs in hospitalized patients. Although further studies are needed to confirm whether our results can be generalized to other health facilities, our findings highlight the need for a PCS to prevent the overdose of renally excreted drugs.