bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of cut-off values in acute paracetamol overdose following the United Kingdom guidelines
Authors: Jeong Hyun Ho , Cha Kyungman , Choi Kyoung Ho , So Byung Hak 
Published: January 2022

Abstract
Background
The United Kingdom guideline for acute paracetamol overdose has recommended the use of ‘100-treatment line’. Emergency medical centers in some developing countries lack the resources for timely reporting of paracetamol concentrations, hence treatment depends on reported dose. This study aimed to examine whether using an reported dose is safe to predict concentration above the 100-line.

Methods
Data were retrieved from two emergency medical centers retrospectively, between 2010 and 2017. The inclusion criteria were single acute paracetamol overdose, presentation within 15 h, and age ≥ 14 years. Multiple linear regression was performed to determine the effect of ingested dose on paracetamol concentration. Subgroups were created based on ingested dose, rate of concentration above 100-line were investigated.

Results
One hundred and seventy-two patients were enrolled in the primary analysis; median dose was 133.3 mg/kg and 46 (37.8%) had concentration above 100-line in the first test. Only dose per weight was moderately correlated with the first concentration (R2 = 0.410, p < 0.001). In the ≤200 mg/kg ingestion group, 18 patients showed concentration above 100-line and 8 showed acute liver injury. The cut-off value of 150 mg/kg showed 82.6% sensitivity and 73.8% specificity to predict concentration above 100-line.

Conclusion
Where paracetamol concentration is not available and activated charcoal is readily used, following United Kingdom guideline, it is safe to use an ingested dose of > 150 mg/kg as the cut-off value for N-acetylcysteine treatment with risk stratification for hepatotoxicity if the patient is ≥14 years and visit the ED within 15 h after an acute paracetamol overdose.
Environmental drivers of autumn migration departure decisions in midcontinental mallards
Authors: Weller Florian G. , Beatty William S. , Webb Elisabeth B. , Kesler Dylan C. , Krementz David G. , Asante Kwasi , Naylor Luke W. 
Published: January 2022

Abstract
Background
The timing of autumn migration in ducks is influenced by a range of environmental conditions that may elicit individual experiences and responses from individual birds, yet most studies have investigated relationships at the population level. We used data from individual satellite-tracked mallards (Anas platyrhynchos) to model the timing and environmental drivers of autumn migration movements at a continental scale.

Methods
We combined two sets of location records (2004–2007 and 2010–2011) from satellite-tracked mallards during autumn migration in the Mississippi Flyway, and identified records that indicated the start of long-range (≥ 30 km) southward movements during the migration period. We modeled selection of departure date by individual mallards using a discrete choice model accounting for heterogeneity in individual preferences. We developed candidate models to predict the departure date, conditional on daily mean environmental covariates (i.e. temperature, snow and ice cover, wind conditions, precipitation, cloud cover, and pressure) at a 32 × 32 km resolution. We ranked model performance with the Bayesian Information Criterion.

Results
Departure was best predicted (60% accuracy) by a “winter conditions” model containing temperature, and depth and duration of snow cover. Models conditional on wind speed, precipitation, pressure variation, and cloud cover received lower support. Number of days of snow cover, recently experienced snow cover (snow days) and current snow cover had the strongest positive effect on departure likelihood, followed by number of experienced days of freezing temperature (frost days) and current low temperature. Distributions of dominant drivers and of correct vs incorrect prediction along the movement tracks indicate that these responses applied throughout the latitudinal range of migration. Among recorded departures, most were driven by snow days (65%) followed by current temperature (30%).

Conclusions
Our results indicate that among the tested environmental parameters, the dominant environmental driver of departure decision in autumn-migrating mallards was the onset of snow conditions, and secondarily the onset of temperatures close to, or below, the freezing point. Mallards are likely to relocate southwards quickly when faced with snowy conditions, and could use declining temperatures as a more graduated early cue for departure. Our findings provide further insights into the functional response of mallards to weather factors during the migration period that ultimately determine seasonal distributions.
The use of a single-piece bone flap for cranial reshaping in anterior craniosynostosis patients: clinical experience and a description of a novel technique
Authors: Mortada Hatan , Altuawijri Ikhlas , Alhumsi Taghreed 
Published: January 2022

Abstract
Background
Craniosynostosis is known as premature closure of one or more of the cranial sutures. Anterior craniosynostosis involves anterior plagiocephaly and trigonocephaly. One of the issues in anterior craniosynostosis skull reshaping is maintaining an aesthetically pleasing forehead curve. Therefore, in this article, we demonstrate our novel technique to use a single-piece bone flap for cranial reshaping of the anterior mold in patients diagnosed with anterior craniosynostosis. A retrospective record review of patients who underwent single piece bone flap cranial reshaping for correction of unicoronal synostosis (UCS) and metopic synostosis (MS) at an Academic Institute in Riyadh, Saudi Arabia, between 2018 and 2020, was conducted.

Results
Six non-syndromic consecutive patients were included. Three of the patients had MS. The mean age at surgery was 11.16 months (range, 6–19 months). The average OR time was 315 min (range, 263–368 min). The average intraoperative blood loss was 225 ml (range, 100–400 ml). All patients had achieved acceptable functional and aesthetic results.

Conclusion
Our novel technique is an innovative and efficient reconstructive technique to simultaneously address MS and UCS and minimize intraoperative bleeding and surgery time. However, more studies with more cases are required.
A computational fluid dynamics assessment of 3D printed ventilator splitters and restrictors for differential multi-patient ventilation
Authors: Duke Daniel J. , Clarke Alexander L. , Stephens Andrew L. , Djumas Lee , Gregory Shaun D. 
Published: January 2022

Abstract
Background
The global pandemic of novel coronavirus (SARS-CoV-2) has led to global shortages of ventilators and accessories. One solution to this problem is to split ventilators between multiple patients, which poses the difficulty of treating two patients with dissimilar ventilation needs. A proposed solution to this problem is the use of 3D-printed flow splitters and restrictors. There is little data available on the reliability of such devices and how the use of different 3D printing methods might affect their performance.

Methods
We performed flow resistance measurements on 30 different 3D-printed restrictor designs produced using a range of fused deposition modelling and stereolithography printers and materials, from consumer grade printers using polylactic acid filament to professional printers using surgical resin. We compared their performance to novel computational fluid dynamics models driven by empirical ventilator flow rate data. This indicates the ideal performance of a part that matches the computer model.

Results
The 3D-printed restrictors varied considerably between printers and materials to a sufficient degree that would make them unsafe for clinical use without individual testing. This occurs because the interior surface of the restrictor is rough and has a reduced nominal average diameter when compared to the computer model. However, we have also shown that with careful calibration it is possible to tune the end-inspiratory (tidal) volume by titrating the inspiratory time on the ventilator.

Conclusions
Computer simulations of differential multi patient ventilation indicate that the use of 3D-printed flow splitters is viable. However, in situ testing indicates that using 3D printers to produce flow restricting orifices is not recommended, as the flow resistance can deviate significantly from expected values depending on the type of printer used.

Trial registration
Not applicable.
Values of Retinoblastoma Survivors and Parents Regarding Treatment Outcomes: A Qualitative Study
Authors: Janic Ana , Vincent Ajoy , Stinson Jennifer , Dimaras Helen 
Published: January 2022

PURPOSE: Retinoblastoma is an aggressive pediatric eye cancer. Patient-reported outcome measures reveal important insights into how patients perceive their own health. Currently, there is no widely used or validated measure for assessment of retinoblastoma outcomes. The purpose of this research was to uncover which treatment outcomes that retinoblastoma survivors and their parents value, to inform the development of a future measure. METHODS: This qualitative, cross-sectional study included retinoblastoma survivors age 6 years and older and parents of retinoblastoma survivors. Participants who did not demonstrate fluency in English were excluded. Study participants participated in semistructured interviews or focus groups, either in person at The Hospital for Sick Children, Toronto, Canada, or through secure videoconference, between March 3, 2019, and January 25, 2020. Iterative rounds of opening coding, codebook development, and coresearcher analysis were used to identify key emergent themes and subthemes. RESULTS: Seventeen adults participated in six focus groups. Nine pediatric survivors participated in individual interviews. Four common themes emerged from all participant groups: (1) definition of treatment success, (2) enucleation—acceptance and challenges, (3) treatment outcomes to measure, and (4) need for outcome reporting. An additional, unique theme was identified in all pediatric discussions: worries and coping mechanisms. Treatment outcomes deemed valuable were related to the following domains: psychosocial outcomes, daily functioning, functional vision, retinoblastoma education, cosmetic outcomes, and secondary eye conditions. CONCLUSION: This study represents the first stage in the development of a retinoblastoma-specific patient-reported outcome measure. The findings reveal insight into what outcomes are valued by survivors after treatment and offer promise to improve outcomes assessment for retinoblastoma.
Flux-Based Formulation Development—A Proof of Concept Study
Authors: Kádár Szabina , Tőzsér Petra , Nagy Brigitta , Farkas Attila , Nagy Zsombor K. , Tsinman Oksana , Tsinman Konstantin , Csicsák Dóra , Völgyi Gergely , Takács-Novák Krisztina , Borbás Enikő , Sinkó Bálint 
Published: January 2022

AbstractThe work aimed to develop the Absorption Driven Drug Formulation (ADDF) concept, which is a new approach in formulation development to ensure that the drug product meets the expected absorption rate. The concept is built on the solubility-permeability interplay and the rate of supersaturation as the driving force of absorption. This paper presents the first case study using the ADDF concept where not only dissolution and solubility but also permeation of the drug is considered in every step of the formulation development. For that reason, parallel artificial membrane permeability assay (PAMPA) was used for excipient selection, small volume dissolution-permeation apparatus was used for testing amorphous solid dispersions (ASDs), and large volume dissolution-permeation tests were carried out to characterize the final dosage forms. The API-excipient interaction studies on PAMPA indicated differences when different fillers or surfactants were studied. These differences were then confirmed with small volume dissolution-permeation assays where the addition of Tween 80 to the ASDs decreased the flux dramatically. Also, the early indication of sorbitol’s advantage over mannitol by PAMPA has been confirmed in the investigation of the final dosage forms by large-scale dissolution-permeation tests. This difference between the fillers was observed in vivo as well. The presented case study demonstrated that the ADDF concept opens a new perspective in generic formulation development using fast and cost-effective flux-based screening methods in order to meet the bioequivalence criteria.
Evaluation of Excipient Risk in BCS Class I and III Biowaivers
Authors: Metry Melissa , Polli James E. 
Published: January 2022

AbstractThe objective of this review article is to summarize literature data pertinent to potential excipient effects on intestinal drug permeability and transit. Despite the use of excipients in drug products for decades, considerable research efforts have been directed towards evaluating their potential effects on drug bioavailability. Potential excipient concerns stem from drug formulation changes (e.g., scale-up and post-approval changes, development of a new generic product). Regulatory agencies have established in vivo bioequivalence standards and, as a result, may waive the in vivo requirement, known as a biowaiver, for some oral products. Biowaiver acceptance criteria are based on the in vitro characterization of the drug substance and drug product using the Biopharmaceutics Classification System (BCS). Various regulatory guidance documents have been issued regarding BCS-based biowaivers, such that the current FDA guidance is more restrictive than prior guidance, specifically about excipient risk. In particular, sugar alcohols have been identified as potential absorption-modifying excipients. These biowaivers and excipient risks are discussed here.
Space-log: a novel approach to inferring gene-gene net-works using SPACE model with log penalty
Authors: Wu Qian (Vicky) , Sun Wei , Hsu Li 
Published: January 2022

Gene expression data have been used to infer gene-gene networks (GGN) where an edge between two genes implies the conditional dependence of these two genes given all the other genes. Such gene-gene networks are of-ten referred to as gene regulatory networks since it may reveal expression regulation. Most of existing methods for identifying GGN employ penalized regression with L1 (lasso), L2 (ridge), or elastic net penalty, which spans the range of L1 to L2 penalty. However, for high dimensional gene expression data, a penalty that spans the range of L0 and L1 penalty, such as the log penalty, is often needed for variable selection consistency. Thus, we develop a novel method that em-ploys log penalty within the framework of an earlier network identification method space (Sparse PArtial Correlation Estimation), and implement it into a R package space-log. We show that the space-log is computationally efficient (source code implemented in C), and has good performance comparing with other methods, particularly for networks with hubs.Space-log is open source and available at GitHub, https://github.com/wuqian77/SpaceLog
Detection of pathogens associated with early-onset neonatal sepsis in cord blood at birth using quantitative PCR
Authors: Obiero Christina W. , Gumbi Wilson , Mwakio Stella , Mwangudzah Hope , Seale Anna C. , Taniuchi Mami , Liu Jie , Houpt Eric , Berkley James A. 
Published: January 2022

Background: Early onset neonatal sepsis (EONS) typically begins prior to, during or soon after birth and may be rapidly fatal. There is paucity of data on the aetiology of EONS in sub-Saharan Africa due to limited diagnostic capacity in this region, despite the associated significant mortality and long-term neurological impairment. Methods: We compared pathogens detected in cord blood samples between neonates admitted to hospital with possible serious bacterial infection (pSBI) in the first 48 hours of life (cases) and neonates remaining well (controls). Cord blood was systematically collected at Kilifi County Hospital (KCH) from 2011-2016, and later tested for 21 bacterial, viral and protozoal targets using multiplex PCR via TaqMan Array Cards (TAC). Results: Among 603 cases (101 [17%] of whom died), 179 (30%) tested positive for ≥1 target and 37 (6.1%) tested positive for multiple targets. Klebsiella oxytoca, Escherichia coli/Shigella spp., Pseudomonas aeruginosa, and Streptococcus pyogenes were commonest. Among 300 controls, 79 (26%) tested positive for ≥1 target, 11 (3.7%) were positive for multiple targets, and K. oxytoca and P. aeruginosa were most common. Cumulative odds ratios across controls: cases (survived): cases (died) were E. coli/Shigella spp. 2.6 (95%CI 1.6-4.4); E. faecalis 4.0 (95%CI 1.1-15); S. agalactiae 4.5 (95%CI 1.6-13); Ureaplasma spp. 2.9 (95%CI 1.3-6.4); Enterovirus 9.1 (95%CI 2.3-37); and Plasmodium spp. 2.9 (95%CI 1.4-6.2). Excluding K. oxytoca and P. aeruginosa as likely contaminants, aetiology was attributed in 9.4% (95%CI 5.1-13) cases using TAC. Leading pathogen attributions by TAC were E. coli/Shigella spp. (3.5% (95%CI 1.7-5.3)) and Ureaplasma spp. (1.7% (95%CI 0.5-3.0)). Conclusions: Cord blood sample may be useful in describing EONS pathogens at birth, but more specific tests are needed for individual diagnosis. Careful sampling of cord blood using aseptic techniques is crucial to minimize contamination. In addition to culturable bacteria, Ureaplasma and Enterovirus were causes of EONS.
Feasibility of the modified 30-second sit-to-stand test in an isolation ward of moderate COVID-19
Authors: Hidayati Evi Rachmawati Nur , Suharti Amien , Suratinoyo Adis Tiara , Zahra Silma Rahima , Nusdwinuringtyas Nury 
Published: January 2022

BACKGROUND The recovery after prolonged immobilization during hospitalization because of COVID-19 is the primary goal of moderate to severe COVID-19 rehabilitation. Lower extremity muscle function assessment after immobilization is needed before starting mobilization. Hence, this study aimed to evaluate the feasibility of the modified 30-second sit-to-stand test (m30STS) as one of the prospective tools of functional capacity assessment in moderate COVID-19.
METHODS This cross-sectional study recruited the subjects consecutively. All eligible subjects with oxygen saturation (SaO2) ≥95% with or without oxygen supplementation performed the m30STS following the Bohannon’s guidelines. The score of m30STS was calculated based on the number of stands completed within 30 sec. A higher score of the m30STS indicated better lower extremity function.
RESULTS Mean score of m30STS was 13.3. No subjects had oxygen desaturation or increased heart rate, and no fall incidents occurred.
CONCLUSIONS The m30STS is feasible and safe to evaluate lower extremity for moderate COVID-19 patients with SaO2 >95%. The absence of oxygen desaturation and increase in heart rate showed no increased oxygen consumption during the test.
Perception and preventive behavior during COVID-19 pandemic among urban residents in Banda Aceh, Indonesia: a cross-sectional study
Authors: Husnah  , Salawati Liza , Sakdiah  , Nazira Nurul , Firdausa Sarah , Nawawi Yusuf Syaeful 
Published: January 2022

BACKGROUND It is critical to evaluate the perception and preventive behavior of COVID-19 to formulate the optimal public health strategies for tackling the ongoing pandemic. This study aimed to enhance knowledge on the perception and preventive behavior toward COVID-19 among urban residents in Banda Aceh, Indonesia.
METHODS A cross-sectional population-based survey was conducted from September to October 2020 using a structured questionnaire for the attendants of the six public health centers in Banda Aceh. Information about sociodemographic, perception, and preventive behavior toward COVID-19 were collected. The data were analyzed to find the association between the level of preventive behavior and covariates.
RESULTS Among 1,067 respondents, 71.1% were female, 52.5% were aged between 40 and 60 years, 31.2% were university graduates, and >60% were unemployed with underlying diseases such as diabetes, hypertension, and cardiopulmonary diseases. The responses of each statement toward COVID-19 were varied. The multivariable model of covariates showed that females had good preventive behavior toward COVID-19 (adjusted OR: 1.849, 95% CI: 1.359–2.515). Urban residents in Banda Aceh with the underlying diseases had poor preventive behavior, while those with higher educational level and perception scores were more inclined to engage in good preventive behavior.
CONCLUSIONS Most urban residents in Banda Aceh showed positive perception and propensity for adopting preventive measures. Health education is necessary for susceptible residents, such as males, less educated people, and people with underlying diseases. It should be stressed on specific practices and knowledge.
A clinical trial to evaluate the dayzz smartphone app on employee sleep, health, and productivity at a large US employer
Authors: Robbins Rebecca , Weaver Matthew D. , Quan Stuart F. , Sullivan Jason P. , Cohen-Zion Mairav , Glasner Laura , Qadri Salim , Czeisler Charles A. , Barger Laura K. 
Published: January 2022

Sleep deficiency is a hidden cost of our 24–7 society, with 70% of adults in the US admitting that they routinely obtain insufficient sleep. Further, it is estimated that 50–70 million adults in the US have a sleep disorder. Undiagnosed and untreated sleep disorders are associated with diminished health for the individual and increased costs for the employer. Research has shown that adverse impacts on employees and employers can be mitigated through sleep health education and sleep disorder screening and treatment programs. Smartphone applications (app) are increasingly commonplace and represent promising, scalable modalities for such programs. The dayzz app is a personalized sleep training program that incorporates assessment of sleep disorders and offers a personalized comprehensive sleep improvement solution. Using a sample of day workers affiliated with a large institution of higher education, we will conduct a single-site, parallel-group, randomized, waitlist control trial. Participants will be randomly assigned to either use the dayzz app throughout the study or receive the dayzz app at the end of the study. We will collect data on feasibility and acceptability of the dayzz app; employee sleep, including sleep behavioral changes, sleep duration, regularity, and quality; employee presenteeism, absenteeism, and performance; employee mood; adverse and safety outcomes; and healthcare utilization on a monthly basis throughout the study, as well as collect more granular daily data from the employee during pre-specified intervals. Our results will illuminate whether a personalized smartphone app is a viable approach for improving employee sleep, health, and productivity.
Trial registration: ClinicalTrials.gov Identifier: NCT04224285.
Aprender a viver em conjunto, uma utopia necessária
Authors: Baltazar Isabel 
Published: January 2022

No âmbito da recente Estratégia Nacional de Educação para a Cidadania, é proposta uma nova componente curricular nos ensinos básico e secundário: Cidadania e Desenvolvimento, onde se inclui a dimensão europeia da Educação. A dimensão europeia da educação visa formar jovens conscientes da sua pertença à União, intervindo direta e ativamente no projeto de construção europeia. Com esta Cidadania Europeia, pretende-se desenvolver uma identidade europeia assente num conjunto de valores e no sentimento de pertença em relação à Europa e ao mundo. Como aprender a viver em conjunto, respeitando o outro, o diferente, quer o vizinho do lado, o europeu, quer os outros povos, culturas e religiões, numa democracia em que o respeito pelos direitos humanos seja o princípio para uma cidadania ativa, é a questão de partida deste estudo. Este processo de aprender a viver em conjunto, inclui a compreensão da Europa, da sua história e do seu futuro, o desenvolvimento dos Direitos Humanos e o aprofundamento da Democracia, constituindo, por um lado, uma oportunidade dos povos europeus partilharem e beneficiarem de uma herança diversa e rica, e, por outro, de servirem de exemplo de cultura e civilização para o mundo. Esta dimensão europeia da educação é um desafio.