dataesr/scientific-paragraphs-categorization huggingface dataset:
NICU nurses may rigorously record the use of pain medications, whereas pain assessments and nonpharmacological interventions may be recorded less rigorously. Many NICUs require the regular charting of bedside pain scores every 4-6 hours with the patient's vital signs. Data collection occurred from any existing record, including patient notes, nursing flowsheet at bedside or other sources. We believe that all pain assessments occurring at the bedside were recorded in our data collection. Despite the aforementioned limitations, this is the largest study to date, using prospective data collection, robust data quality assurance, enrolling 94% of all eligible neonates, accounting for all nonenrolled neonates, while overcoming the language, cultural and research regulatory barriers in 18 countries.
Meaning of the study Infrequent and highly variable assessments of continuous pain in newborns may contribute to analgesic complications  (46) , oversedation  (47)  or tolerance/withdrawal  (48). Given the limitations and controversies reviewed above, the variability noted in this study is not unexpected and mirrors similar findings in adult patients  (49). Our data show that local NICU guidelines and local nurse champions substantially increased the odds for pain assessment, whereas the availability of pain consult services did not (   Not included in the model because this variable was not significant in the univariable analysis. **Reference category. † † Odds ratio per point increase in CRIB score. The CRIB score is a measure of illness severity in neonates. It consists of six items collected in the first 12 hours after birth (range: 0-23, higher scores indicate great clinical risk of mortality).
‡ ‡ Data collection was stopped on day 28 of hospital stay: 566 (28. 4%) of 1994 neonates were hospitalised for longer than 28 days. § § Ventilator-free days were defined as the number of calendar days from the time of tracheal extubation to day 28 after NICU admission. If a neonate was reintubated and subsequently extubated before day 28, ventilator-free days were counted from the end of the last period of tracheal intubation. If a neonate was still receiving tracheal ventilation on day 28 or had died before day 28, then 0 ventilator-free days were noted. For neonates discharged before day 28 of admission, ventilator-free days were zero if the neonate was still intubated at discharge (transfer) and ventilator-free days were counted from the time of tracheal extubation to day 28 after NICU admission if the neonate was already extubated at discharge.
† † Not included in the model because this variable was highly correlated with gestational age. ‡ ‡ Odds ratio per point increase in CRIB score. The CRIB score is a measure of illness severity in neonates. It consists of six items collected in the first 12 hours after birth (range: 0-23, higher scores indicate great clinical risk of mortality). § § Not included in the model because this variable was highly correlated with Apgar scores at five minutes. ¶ ¶ Patients were classified in three groups according to the highest level of ventilation they received during the study period. ***Data collection was stopped on day 28 of hospital stay; 989 (15. 7%) of 6303 neonates were hospitalised for longer than 28 days. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd 2017 106, pp.
ACKNOWLEDGEMENTS This study was supported by the  European Community's Seventh Framework Programme  grant no. 223767. This funding agency did not participate in the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the manuscript. Authors had full access to all study data and take responsibility for data integrity and the accuracy of data analyses. We thank the physicians, nurses and other healthcare providers at participating institutions for their contributions and parents who allowed us to gather data related to their infants. We sincerely acknowledge  Colin Gentile ,  Juliana Guilheri ,  K eb e Korka ,  Alicia Marzouk ,  Liliane Peneau ,  Astrid Polaert ,  Nathalie Quiniou ,  Dalila Selmane ,  Dienaba Sylla ,  Tony Toulorge  and  Stephen Ulric-Gervaise  for special assistance with data collection.
**Reference category. † † Not included in the model because this variable was highly correlated with gestational age. ‡ ‡ Odds ratio per point increase in CRIB score. The CRIB score is a measure of illness severity in neonates. It consists of six items collected in the first 12 hours after birth (range: 0-23, higher scores indicate great clinical risk of mortality). § § Not included in the model because this variable was highly correlated with Apgar scores at five minutes. ¶ ¶ Patients were classified in three groups according to the highest level of ventilation they received during the study period. ***Data collection was stopped on day 28 of hospital stay; 989 (15. 7%) of 6303 neonates were hospitalised for longer than 28 days. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd 2017 106, pp.
Postoperative follow-up was based on repeated otoscopic and audiometric evaluation, and postoperative imaging evaluation, which was performed between 12 and 18 months after the procedure. During the study period, particularly at the beginning, CT scan was the firstline imaging modality  [3]  , according to a previously published algorithm  [4]. All patients underwent CT scan, and some underwent MRI with special protocols to detect cholesteatoma when CT scan was not conclusive (delayed postcontrast T1 and/or diffusion weighted MR imaging), except one who was lost of follow-up after 3 months. Indications for revision surgery were selected according to clinical, audiometric, and radiological data. For reporting hearing results in case of revision surgery, we took into account the last available audiometric data if primary cartilage ossiculoplasty was not modified, and we took into account the pre-revision audiometric data in case of ossiculoplasty revision.
In this work, the preset built in version 3. 0. 5 of DO3SE model (SEI, 2014) with collection of parameters for coniferous forests (CF) was used (Table  S1 ). Maximum level of stomatal O3 conductance Gmax (mmol O3 m -2 PLA s -1 ) of dwarf mountain pine and Swiss stone pine were obtained according to field experiments in SK-HT. Model requires input files that include measured O3 concentration and meteorological data, for each experimental site separately. were used for estimation of O3 concentration. These passive O3 sensors allow large-scale monitoring in remote areas  (Krupa and Legge, 2000)  but do not provide real-time O3 concentrations which are essential for O3 flux calculations. Method proposed by Loibl  (Loibl et al. , 1994; Loibl and Schmidt, 1996)  was used for recalculation of aggregated data from passive samplers to hourly O3 concentrations.
Stomatal conductance of montane pines Maximum level of stomatal conductance (Gmax, mmol O3 m -2 PLA s -1 ) as key parameter (Eq. 1) for calculation of stomatal O3 flux (Eq. 2) has not been specified neither for dwarf mountain pine nor for Swiss stone pine. Data required for Gmax parameterization were obtained by measurement on both pine species in SK-HT. For this purpose LI-6400 photosynthesis system (Li-Cor, Inc. , Lincoln, NE) equipped with a standard Licor 6400-22 Opaque Conifer Chamber and 6400-18 RGB Light Source was used. To capture wide range of climatic conditions stomatal conductance was measured from June to November at study sites situated in two different elevations: site A (Stará Lesná, 810 m a. s. l. ) and site C1 (Skalnaté Pleso, 1,778 m a. s. l. ). During the experiment, inside chamber temperature ranged from 5 to 35 °C, VPD from 0.
Soil water potential Soil moisture data were obtained by two approaches: field measurement and modelling. Both, real-time and modelled data of soil water potential (SWP) are useful for specification of the fSWP function (Eq. 4). 𝑓 𝑆𝑊𝑃 = 𝑚𝑖𝑛 {1, {𝑓 𝑚𝑖𝑛 ((1 -𝑓 𝑚𝑖𝑛 ) * (𝑆𝑊𝑃 𝑚𝑖𝑛 -𝑆𝑊𝑃)/(𝑆𝑊𝑃 𝑚𝑖𝑛 -𝑆𝑊𝑃 𝑚𝑎𝑥 )) + 𝑓 𝑚𝑖𝑛 }} (4) Function of fSWP defines the effect of soil moisture on Gsto (Eq. 1). It is expressed in relative terms (i. e. , it takes values between 0 and 1 as a proportion Gmax). Additional parameters such as fmin, SWPmin, SWPmax are listed in Table  S1. Differences between fSWP based on measured and modelled SWP allow to verify the reliability of the soil moisture module included in DO3SE model. Verification cannot be done at FR-Alp plot due to deficiency of SWP data measured in field conditions.
Field measurement of SWP at three soil depths (-0. 1, -0. 2, -0. 4 m) was carried out only in SK-HT region at all experimental sites (except the cliff of Lomnický štít). SWP values were measured with gypsum blocks in the range up to -1. 5 MPa (GB2, Delmhorst Instrument, U. S. A. ) and stored with integrated data loggers (MicroLog SP3, EMS Brno, CZ). Modelling approach was used in both study areas and incorporated hydraulic resistance (steady state, SS) to water flow through the plant system  (Büker et al. , 2012). In model options is possible to choose appropriate alternative for simulation of soil water influence on Gsto (Eq. 1). We selected an alternative using factor fSWP (Eq. 4) in calculation of Gsto. The choice with disabled fSWP should show different results Gsto, primarily in dry areas we expect higher values of Gsto, Fst (Eq.
Humid environment leads to a greater capture of O3 gas in tissues of plants exposed to high O3 doses. Observations of visible O3 injury confirmed that older needles were more damaged by O3 than the younger ones. Despite the favourable humid soil conditions for stomatal O3 uptake, we observed relatively weak visible O3 injury on two year needles of Swiss stone pine at SK-HT. Dwarf mountain pine with more pronounced visual symptoms seems to be an appropriate conifer species for further monitoring of O3 injury at SK-HT. Severe foliar O3 injury symptoms were identified on Swiss stone pine at the FR-Alp experimental site. Presented results confirm high phytotoxic potential of O3 air pollution in different bioclimatic regions of Europe, although the biologically-based field data do not completely correspond with the calculated O3 metrics.
Acknowledgements This work was supported by the  Slovak Research and Development Agency  under the contracts No. APVV-0429-12 ,  APVV-16-0325 , and by the  Grant Agency of the Slovak Republic (VEGA , No. 2/0053/14  and No. 2/0026/16 ). We acknowledge also the project ITMS 26220220066 funded by  ERDF  (10 %). The authors are grateful to the  Slovak Hydrometeorological Institute (SHMI)  for providing of meteorological, climatic and EMEP data. The development of DO3SE model interface has been made possible through funding provided by the  UK Department of Environment, Food and Rural Affairs (Defra)  and through institutional support provided to the  Stockholm Environment Institute  from the  Swedish International Development Agency (Sida).
Loop electrosurgical excision procedure was only performed after colposcopic assessment, and indications were of 2 types: biopsyproven high-grade CIN and persistent PAP smear abnormality. For the latter surgical indication, LEEP was performed as a diagnostic excision procedure after 18-month persistent low-grade squamous intraepithelial lesion or atypical squamous cells of undetermined significance PAP smear result or a 12-month persistent high-grade squamous intraepithelial lesion or atypical squamous cells-cannot exclude HSIL (high-grade squamous intraepithelial lesion) PAP smear result, associated with a normal colposcopy. These were excluded from the study: iterative LEEP and missing LEEP or obstetrical data (see Figure  1 ). Data were collected through our institution's centralized medical computerized record.
Results: The experts selected articles over a span of 26 years, more clustered in the last 15 years. The most voted article studied the role of NIV in acute exacerbation chronic pulmonary disease. Concerning the future of clinical applications for and research on NIV, most of the experts forecast the development of innovative new interfaces more adaptable to patients characteristics, the need for good well-designed large randomized controlled trials of NIV in acute "de novo" hypoxemic respiratory failure (including its comparison with high-flow oxygen nasal therapy) and the development of software-based NIV settings to enhance patient-ventilator synchrony. Conclusions: The selection made by the experts suggests that some applications of NIV in critical care are supported by solid data (e. g.
Hill, Samir Jaber, Paolo Navalesi, Paolo Pelosi, Raffaele Scala). Three experts refused and another expert sent his report but the selected studies included not eligible articles and it was eventually excluded. After collecting the forms, the methodology group ranked the studies basing on the number of votes for each study by the experts. In case of ex aequo, the methodology group considered for ranking the number of citations from SCOPUS database. The insights for the future were also collected and reported.
Absent were some pioneering articles as the one published by Meduri in 1989  [2]  and articles related to the use of pre-oxygenation before endotracheal intubation and those referring to patient-ventilator dyssynchrony, use of interfaces as mouth piece  [50] , or use of NIV in the palliative care setting  [51, 52]. Articles on these topics were suggested by some reviewers (see Additional file 1), but were not voted frequently enough by the experts to be ranked in the 10 selected articles  [53] [54] [55]. Surprisingly there are not studies related to airway humidification during NIV. Humidification and warming of the inspired gas may be needed to prevent the adverse effects of cool, dry gases on the airway epithelium  [56]. Data on the level of humidity delivered with different humidification strategies during NIV, demonstrated that active humidifiers and heat and moisture exchangers provide gas with the highest water content compared to no humidification  [57].
However, we based the selection of experts not only on the rank from a public database and on scientific merit but also on professional background (e. g. intensivists Table  2  Future insights for the future of NIV reported by the experts Expert's code What are the insights for the future on NIV? 1 • "A good, well-designed, large randomized controlled trial of NIV vs. oxygen in acute de novo hypoxemic respiratory failure, not specifically designed for immunocompromised patients" • "The perfect interface" • "Reliable early predictors of NIV failure" 2 • "Randomized controlled trial of HFNT + NIV vs continuous NIV vs HFNT in hypoxemic respiratory failure" 3 • "Comparison of HFNT vs NIV in acute hypoxemic respiratory failure, performed according to the usual practice (in the Frat's paper NIV was not really the clinical practice)" 4 • "The most important insight for the future is the development of HFNT in conjunction and not as an absolute replacement for NIV" 5 • "New inclusion criteria: better definition of patients clinical characteristics to be assisted by NIPPV/CPAP, timing of treatment initiation and interruption" • "New devices: new masks and interfaces more adaptable to patients" • "New comparisons: NIV vs invasive ventilation is hypoxemic respiratory failure and severe COPD.
Acknowledgments None. UMRS1158 Neurophysiologie respiratoire expérimentale et clinique,  Sorbonne Universités ,  UPMC Univ Paris 06, INSERM, Paris, France. 6AP-HP ,  Groupe Hospitalier Pitié-Salpêtrière Charles Foix ,  Service de Pneumologie et Réanimation Médicale  (Département "R3S"), 75013 Paris, France. 7Department of  Pneumology, Respiratory Institute, Hospital Clinic-Institut d'Investigacions Biomèdiques August Pi i Sunyer, CibeRes  ( CB06/06/0028 ),  University of Barcelona, Barcelona, Spain. 8Division of Pulmonary, Critical Care and Sleep Medicine, Tufts Medical Center, Boston, MA, USA. 9  Department of Anesthesiology and Critical Care Medicine B (DAR B), Saint-Eloi Hospital, University Teaching Hospital of Montpellier, Montpellier, France. 10 Anesthesia and Intensive Care, Department of Medical and Surgical Science, Magna Graecia University, Catanzaro, Italy.
Background We have previously estimated that respiratory syncytial virus (RSV) was associated with 22% of all episodes of (severe) acute lower respiratory infection (ALRI) resulting in 55 000 to 199 000 deaths in children younger than 5 years in 2005. In the past 5 years, major research activity on RSV has yielded substantial new data from developing countries. With a considerably expanded dataset from a large international collaboration, we aimed to estimate the global incidence, hospital admission rate, and mortality from RSV-ALRI episodes in young children in 2015.
Systematic review We did a systematic literature review (appendix pp 3-6), hand searching of online journals, and scanning reference lists of identified citations to update our previous review. 3 The search included MEDLINE (Ovid), Embase,  CINAHL, Global Health (1973 onwards), Global Health Library, Web of Science, IndMed, and grey literature (OpenGrey) databases and studies published between June 1, 2009, and Dec 31, 2016. Three authors (TS, EB, and SC) searched the literature (with no language or publication restrictions, and including three Chinese language databases [CNKI, Wanfang and ChongqingVIP for period 1/1/95-31/12/2016 (TS)] and extracted data independently (disagreements arbitrated and abstractions validated by HN). We included studies reporting community incidence, hospital admissions, and in-hospital case fatality ratios (CFRs) for RSV confirmed ALRI in 0-4-year-old children.
Added value of this study This study used data from a vastly expanded dataset (329 studies of which 291 were not included in our previous estimates). Another important and unique feature is the use of unpublished data-23% of the included data are unpublished. We have now reported RSV-associated disease burden by severity and World Bank income region for narrow non-overlapping age bands particularly in the first year of life. We developed a risk-factor based model to provide the first estimates of RSV-ALRI burden in young children at national level. We estimated that RSV is associated with about 28% of all ALRI episodes and 13-22% of all ALRI mortality in young children. Using historical RSV case fatality data, we show that, in general, there has been a decreasing trend for RSV associated case fatality ratio across all age groups and income regions.
Statistical analysis For studies not reporting 0-59 month incidence rates, we imputed any missing age group data using median incidence rate ratios (appendix p 7). 3, 8, 10  We did a sensitivity analysis using un-imputed data and noted final estimates did not differ substantially. When the study was longer than 12 months, but not in multiples of 1 year, we calculated annualised incidence by adjusting for population at risk. If clinical specimens were systematically collected in a proportion of eligible cases and data for all eligible cases were available, we scaled results for proportion sampled. Figure  1  summarises and gives the rationale for our approach. We did a data meta-analysis (by region and narrow age bands, where possible) for RSV and severe RSV-ALRI incidence, hospital admission rate for RSV-ALRI (studies with well-defined catchment population), proportion of hospital admissions for ALRI that were RSV positive (RSV+ve) and in-hospital RSV-ALRI CFR, and report pooled estimates (with 95% CI).
11 Because in-study and between study data heterogeneity was anticipated, we used random effects models. 12, 13 Incidence and hospital admission rate meta-estimates for RSV-ALRI and severe RSV-ALRI were applied to 0-5 year regional populations estimates to yield new episodes of RSV-ALRI and severe RSV-ALRI in 2015. We validated hospital admissions for RSV-ALRI estimates with independent data by abstracting the proportion of ALRI hospital admissions that were RSV+ve. We then computed (WHO) regional proportion metaestimates and applied these to regional estimates of hospital admissions for ALRI updated for 2015. 10 e estimated RSV-ALRI episodes in young children in 132 developing countries using a risk-factor based model similar to that described previously. 1  We calculated country level RSV-ALRI incidence using odds or rate ratios for six RSV risk factors [prematurity (<37 weeks), low birthweight (<2500 g), siblings, maternal smoking, HIV and crowding] from a meta-analysis of published studies, 14 country-level risk factor prevalence (from relevant surveys and UN estimates), and estimates of RSV-ALRI incidence in developing countries.
This figure summarises our approach for each of these categories and also shows how they relate to (and feed into each other). Global estimates of hospital admissions for RSV-ALRI have been estimated using two independent approaches and datasets (after ensuring all included studies satisfy the common case definition that hospital admission was based on a physician diagnosis of ALRI). Similarly, the in-hospital deaths due to RSV-ALRI are based on studies reporting in-hospital CFR for RSV and RSV-ALRI hospital admissions (again ensuring that all included studies satisfy the common case definition). RSV=respiratory syncytial virus. ALRI=acute lower respiratory infection. hCFR=in-hospital case fatality ratio. VA=verbal autopsy. DHS=demographic and health survey. *For details description of imputation see appendix p 7.
Using this independent dataset we estimated that about 2•9 million (95% CI 2•6-3•3) hospital admissions for RSV-ALRI occurred in young children in 2015 (appendix pp 46-47). About 85% of all hospital admission cases had chest wall indrawing (data not shown). 28 (61%) of 46 studies recording SpO 2 by pulse oximetry used our hypoxaemia case definition and these reported about 20% of all hospital admissions for RSV-ALRI cases aged 0-4 years (all age groups) had hypoxaemia (appendix pp 45, 83-84). This translates to about 1•0 million (UR 0•6-1•6) episodes of hospital admissions for severe RSV-ALRI with hypoxaemia in young children from developing countries, 58% in infants younger than 6 months. We also estimated 0•6 million (UR 0•4-1•1) hospital admissions for very severe RSV-ALRI in young children in developing countries in 2015, 51% in infants younger than 6 months.
Data were insufficient to provide global incidence or hospital admissions by RSV subtype. RSV-A was the more common circulating subtype and resulted in more severe disease (with substantially higher hospital admissions and hCFR) across all age groups (appendix p 48). 48 published and 55 unpublished studies reported hCFR data for young children with RSV-ALRI (appendix pp 33-38). We identified 41 studies from developing countries that reported RSV-associated hCFR in children aged 0-5 months, 6-11 months, and 12-59 months (table 2; appendix pp 39-41, 63). Overall, the highest hCFR was observed in neonates [5•3% (95% CI  2•8-9•8)] and in children from low-income countries. This translates to a substantial in-hospital mortality of about 59 600 deaths (UR 48 000-74 500) in children younger than 5 years globally, 46% occurring in infants younger than 6 months.
Acknowledgments This study was funded by  The Bill & Melinda Gates Foundation  ( OPP1088499 ; principal investigator: HN). The funder of the study had no role in the study design, data collection, data analysis, data interpretation, or writing of the report. HN and TS had full access to all the data in the study and HN had final responsibility for the decision to submit for publication. TS is supported by a scholarship from  China Scholarship Council. DAM is funded via a  Wellcome Trust   Intermediate Clinical Fellowship  ( 201492/Z/16/Z ). HN, HC and LB are members of the  Respiratory Syncytial Virus Consortium in Europe (RESCEU). RESCEU has received funding from the  Innovative Medicines Initiative 2 Joint Undertaking  under grant agreement Nº  116019. This Joint Undertaking receives support from the  European Union 's  Horizon 2020 research and innovation programme and EFPIA.