bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Intelligent Web-Based Decision Support System for Monitoring the Chronic Kidney Disease in Brazilian Communities
Authors: Sobrinho Álvaro , Queiroz Andressa C. M. da S. , Cavalcanti Gyovanne Bezerra , Silva Josaias de Moura , Silva Leandro Dias da , Costa Evandro de Barros , Perkusich Angelo , Pinheiro Maria Eliete 
Published: December 2020

Abstract
Background: Chronic Kidney Disease (CKD) is a worldwide public health problem, usually diagnosed in the late stages of the disease, increasing public health costs and mortality rates. The late diagnosis is even more critical in developing countries due to the high levels of poverty, a large number of hard-to-reach locations, and sometimes lack/precarious primary care. Methods: We designed and evaluated an intelligent web-based Decision Support System (DSS) using the J48 decision tree machine learning algorithm, knowledge-based system concepts, the clinical document architecture, Cohen's kappa statistic, and interviews with an experienced nephrologist. Results: We provided a DSS methodology that guided the development of the system, that provides remote monitoring features, to assist patients, primary care physicians, and the government in identifying and monitoring the CKD in Brazilian communities. A CKD dataset enabled the training and evaluation of the J48 decision tree algorithm, while Cohen's kappa statistic guided the evaluation of the knowledge-based system by interviews with an experienced nephrologist. Conclusion: The DSS facilitates the identification and monitoring of the CKD considering low-income populations in Brazil. In addition, the methodology and DSS can be reused in other developing countries with similar scenarios.
The Influence of Exercise During Pregnancy on Racial/Ethnic Health Disparities and Birth Outcomes
Authors: Raper Madigan , McDonald Samantha , Johnston Carol , Isler Christy , Newton Edward , Kuehn Devon , Collier David , Broskey Nicholas , Muldrow Adrienne , May Linda 
Published: December 2020

Abstract
Background: Non-Hispanic black (NHB) pregnant women disproportionately experience adverse birth outcomes compared to NH white (NHW) pregnant women. The positive effects of prenatal exercise on maternal and neonatal health may mitigate these disparities. This study evaluated the influence of prenatal exercise on racial/ethnic disparities in gestational age (GA), birthweight (BW), and risks of preterm birth (PTB), cesarean section (CS), and low-birthweight (LBW) neonates.Methods: This study performed a secondary data analysis using data from a 24-week, two-arm exercise intervention trial (ENHANCED by Mom). Women with singleton pregnancies (<16 weeks), aged 18-40 years, BMI between 18.5-34.99 kg/m2, and no preexisting health conditions were eligible. The aerobic exercisers (EX) participated in 150 minutes of moderate-intensity weekly exercise while non-exercising controls (CON) attended low-intensity stretching/breathing sessions. Data on GA, PTB (<37 weeks), BW, LBW (< 2.5 kg), and delivery mode were collected. Poisson, median and linear regressions were performed. Results: Participants with complete data (n=125) were eligible for analyses (EX: n=58, CON: n=67). NHB pregnant women delivered lighter neonates (β=-0.43 kg, 95% CI: -0.68, -0.18, p=0.001). After adjusting for prenatal exercise, racial/ethnic disparities in BW were reduced (β=-0.39 kg, 95% CI: -0.65, -0.13, p=0.004). Prenatal exercise reduced borderline significant racial/ethnic disparities in PTB (p=0.053) and GA (p=0.07) with no effects found for CS and LBW. Conclusions: The findings of this study demonstrate that prenatal exercise may attenuate the racial/ethnic disparities observed in neonatal BW, and possibly GA and PTB. Larger, diverse samples and inclusion of maternal biomarkers (e.g., cytokines) are encouraged to further evaluate these relationships.
First Isolation and Genotyping of Toxoplasma Gondii Strains From Domestic Animals in Tunisia
Authors: Lachkhem Arwa , Galal Lokman , Lahmar Ibtissem , Passebosc Karine , Riahi Homayoun , Plault Nicolas , Dardé Marie-Laure , Mercier Aurélien , Babba Hamouda 
Published: December 2020

Abstract
The isolation and molecular typing of Toxoplasma gondii strains provides an essential basis for a better understanding of the distribution of genetic diversity and associated human health risks. In this context, we report, the molecular characterization of strains of T. gondii isolated from domestic animals infected with T. gondii in Southern and coastal area of Tunisia. This diversity is compared to that known for the Western European and Mediterranean sub-region.Blood, hearts and/or brains were collected from 766 domestic animals (630 sheep and 136 free-range chickens). Strain isolation from these samples were performed using mouse bioassay. The strains genotyping was carried out with a multiplex PCR technique using 15 microsatellite markers. Viable strains of T. gondii were isolated from 13.4% sheep and 33.3% chickens. Furthermore, the parasite was also detected in three DNA extracts from animal tissue digestates.This study showed a large predominance of type II strains (87.9%) from which two samples were type II variants for W35 locus. The other genotypes were three type III sheep isolates (9.1%) and, for the first time in Tunisia, an isolate of sheep origin of the Africa 4 genotype (3.0%). The comparison of microsatellite alleles of type II strains shows the recent migration of strains between Tunisia and other countries of the world.
Metabolic equivalent of task (MET) in the preoperative assessment in aortic surgery: a retrospective analysis
Authors: Zientara Alicja , Schwegler Igor , Dzemali Omer , Bruijnen Hans , Bernheim Alain , Dick Florian , Attigah Nicolas 
Published: December 2020

Abstract
Background: Reliable prediction of the preoperative risk is of crucial importance for patients undergoing aortic repair. In this retrospective cohort study we evaluated the metabolic equivalent of task (MET) in the preoperative risk assessment with clinical outcome in a cohort of consecutive patients.Methods: Retrospective analysis of prospectively collected data in a single center unit of 296 patients undergoing open or endovascular aortic repair. Out of these, 276 patients had a preoperative statement of their functional capacity in metabolic units and were evaluated concerning their postoperative outcome. Results: Mean survival of the whole cohort was 74 months. There was no significant difference between patients with a functional capacity of more or less than 4 MET respectively (74.5 vs 65.4 months; p=0.64). The infrarenal cohort was subdivided based on the operative technique (open or endovascular) and the preoperative MET status. Survival analysis of all four subgroups showed no significant differences. The median follow-up of the patients’ cohort was 10.8 months. In 46 patients with >4MET (20.9%) perioperative complications occurred compared to the group with <4MET with 18 patients (32.1%) (p=0.075). The risk to miss a potential need for cardiac optimization in patients >4MET was 7%.Conclusion: Functional preoperative evaluation by MET in patients undergoing aortic surgery is used as standardized tool for patients’ assessment and is meant to act as a useful surrogate marker of perioperative performance. However, it could not discern patients in need for cardiopulmonary testing.Trial registration: clinicaltrials.gov, registration number NCT03617601 (retrospectively registered)
Phenotypic and genotypic drug sensitivity profiles of Mycobacterium tuberculosis infection and associated factors in northeastern Ethiopia
Authors: Gashaw Fikru , Erko Berhanu , Mekonnen Yalemtsehay , Yenew Bazezew , Amare Misikir , Gumi Balako , Ameni Gobena 
Published: December 2020

Abstract
Background
Tuberculosis is a devastating and a deadly disease despite the novel advances in its diagnostic tools and drug therapy. Drug resistant Mycobacterium contributes a great share to tuberculosis mortality. Status of drug resistance and patients’ awareness toward the disease is unknown in northeastern Ethiopia. Thus, the aim of this study was to determine the phenotypic and genotypic drug sensitivity patterns and associated factors in Oromia Special Zone and Dessie Town, northeastern Ethiopia.
Methods
In a cross-sectional study, 384 smear positive tuberculosis cases were recruited and Löwenstein-Jensen culture was done. The performance of GenoTypic MTBDRplus assay using the conventional BACTEC MGIT 960 as a "gold standard" was determined. Drug resistant strains were identified using spoligotyping. Pearson Chi-square test was used to determine the association of drug sensitivity test and tuberculosis type, lineages, dominant strains and clustering of the isolates. For the assessment of patients’ awareness towards the disease questionnaires were used.
Results
A fair agreement was found between MTBDRplus assay and the conventional MGIT test in detecting the Mycobacterium tuberculosis with sensitivity, specificity, positive and negative predictive value of 94.2%, 30.2%, 68.4% and 76.5%, respectively. The MTBDRplus assay detected 16.8% (16/95) of the isolates as drug resistant and MGIT detected a comparable number 15.9% (11/69) as resistant. Cohen's kappa value showed almost a perfect agreement between the two testing methods in detecting rifampicin (sensitivity 100% and specificity 98.3%) and multi-drug resistance (sensitivity 83.3% and specificity 100%). Spoligotyping identified 76.5% (13/17) of the drug resistant isolates as Euro-American and family 33 as the predominant family. Significant association was observed between drug resistant isolates and the dominant strains (χ2: 34.861; p = 0.040). Majority of the patients heard about tuberculosis as compared to drug resistant Mycobacterium.
Conclusion
Higher magnitude of drug resistance was found in the study area. The GenoTypic MDRTBplus assay had an acceptable drug sensitivity testing performance. Patients’ awareness towards the disease specifically to the resistant Mycobacterium was low.
Molecular epidemiology, risk factors, species distribution, antifungal susceptibility and outcome of candidemia in the capital of Iran: a prospective study
Authors: Kord Mohammad , Salehi Mohammadreza , Hashemi Seyed Jamal , Rezaie Sassan , Maleki Ayda , Mahmoudi Shahram , Ahmadikia Kazem , Izadi Alireza , Abdollahi Alireza , Alijani Neda , Parsamehr Nasrin , Aala Farzad , Moradi Masoud , Fesharaki Shirin Sadat Hashemi , Badali Hamid , Khodavaisy Sadegh 
Published: December 2020

Abstract
Background

Candidemia is a major cause of morbidity and mortality among patients receiving immunosuppressive therapy and those hospitalized with serious underlying diseases despite the commencement of antifungal therapy. We investigated the molecular epidemiology, clinical characteristics, comorbidity risk factors, species distribution, antifungal susceptibility profile, and outcome of candidemia to provide appropriate perspectives in Tehran, Iran.
Methods

A prospective observational study of all patients diagnosed with candidemia was performed at two referral teaching hospitals in Tehran. Demographic characteristics, underlying diseases, risk factors, clinical symptoms, and laboratory analyses were mined.
Results

One-hundred and fifty-two Candida isolates from 89 patients with candidemia were recovered. The overall crude mortality was 47.2%. The most common underlying disease was sepsis (48.3%) followed by malignancy (46.1%), renal failure/ dialysis (43.8%), and Hypertension (40.0%). C. albicans (43.8%) was the most frequent causative agent followed by C. glabrata (21.3%), C. parapsilosis complex (15.7%), C. tropicalis (11.2%), and C. lusitaniae (3.4%). Result of antifungal susceptibility test show that activity of all the four azole antifungal agents was low against non-albicans Candida species, especially C. tropicalis.
Conclusion

Increase in non-albicans Candida species with reduced susceptibility to antifungal drugs might be alarming in high-risk patients. Therefore, accurate knowledge of predisposing factors and epidemiological patterns in candidemia are effective steps for managing and decreasing the mortality rate in candidemia.
WITHDRAWN: Effectiveness of Intraoperative Dexmedetomidine on Early Postoperative Cognitive Dysfunction in Elderly Patients Undergoing Video-Assisted Thoracoscopic Lobectomy: A Randomized Controlled Trial
Authors: He Na , Shi Haixia , Hu Yajuan , Uribe Alberto , Mu Xinhua , Song Fei , Yu Jianshe 
Published: December 2020

Abstract
Background: Postoperative cognitive dysfunction (POCD) is the decline in cognitive ability that occurs between one week and one year following surgery. POCD has been reported to occur in 5% to 26% of elderly surgical patients and its incidence varies with demographic, clinical, and surgical variables. Previous studies have shown that dexmedetomindine (DEX), a highly selective α2 adrenergic receptor agonist, has many effects that include opioid-sparing properties, decreased required anesthetic medication, and neuroprotection in animal models. Ultimately, DEX may benefit cognitive ability in the postoperative period. Therefore, we hypothesized that intraoperative infusion of DEX would reduce early POCD and interleukin-6 (IL-6) levels in elderly surgical patients compared to placebo. Methods: This randomized, double-blind, controlled trial enrolled 96 elderly patients that underwent video-assisted thoracoscopic lobectomy (VATL) between May 2017 and April 2018. The enrolled subjects were randomly assigned in a 1:1 ratio to receive intravenous dexmedetomidine (DEX Group) or placebo (0.9% normal saline, Saline Group) as a continuous infusion at a rate of 0.5μg/kg/hr starting at anesthesia induction until incision closure. All subjects received total intravenous anesthesia (TIVA) during surgery and patient controlled epidural analgesia (PCEA) following surgery. The primary outcomes were to determine the incidence of POCD and IL-6 expression at postoperative day (POD) 1, 2, and 7. The secondary outcomes were to evaluate the degree of pain on POD 1 and 2, as well as adverse events throughout the study. Results: 96 eligible subjects (48 per group) were randomized, dosed with study medication, and evaluated per protocol. There was a significant difference on POCD between the DEX and saline groups on POD 1 (6.3% vs. 20.8%, p-value <0.05) and POD 2 (4.2% vs. 16.7%, p-value <0.05). The IL-6 levels were significantly lower in the DEX group when compared with saline group during POD 1 and 2 (p-value <0.05). IL-6 returned to baseline levels on POD 7. There was no significant difference in POCD on POD7, and overall there were no significant differences in the incidence of adverse events between both groups.Conclusions: The administration of intraoperative DEX in elderly patients undergoing VATL decreased the incidence of early POCD. Clinical Trial Registry: This study was registered on Chinese Clinical Trial Registry with the ID ChiCTR-IPR-17010958.
Self-assembly using a retro Diels-Alder reaction
Authors: Park Jaeyoung , Heo Jung-Moo , Seong Sicheon , Noh Jaegeun , Kim Jong-Man 
Published: December 2020

Abstract
Despite their great utility in synthetic and materials chemistry, Diels-Alder (DA) and retro Diels-Alder (rDA) reactions have been vastly unexplored in promoting self-assembly processes. Herein we describe the first example of a retro Diels-Alder (rDA) reaction-triggered self-assembly method. Release of the steric bulkiness associated with the bridged bicyclic DA adduct by the rDA reaction allowed generation of two building blocks that spontaneously self-assembled to form a supramolecular polymer. By employing photopolymerizable lipid building blocks, we demonstrated the efficiency of the rDA-based self-assembly strategy. Generation of reactive functional groups (maleimide and furan) that can be used for further modification of the supramolecular polymer is an additional meritorious feature of the rDA-based approach. Advantage was taken of reactive functional groups to fabricate stimulus-responsive selective and tunable colorimetric sensors. The strategy developed in this study could open new avenues to the design of systems that participate in triggered molecular assembly.
Spatial and Temporal Analysis of Cumulative Environmental Effects of Offshore Wind Farms in the North Sea Basin
Authors: Gusatu Laura , Menegon Stefano , Depellegrin Daniel , Zuidema Christian , Faaij André , Yamu Claudia 
Published: December 2020

Abstract
The North Sea basin is one of the busiest maritime areas globally with a considerable number of anthropogenic pressures impacting the functioning of the marine ecosystem. Due to growing EU ambitions for the deployment of large-scale offshore wind farms (OWF), as part of the 2050 renewable energy roadmap, there is a key need for a holistic understanding of OWF potential impacts on the marine ecosystem. We propose a holistic Cumulative Effect Assessment methodology, applied using a geo-spatial open-source software, to assess impacts of OWF related pressures on selected seabed habitats, fish, seabird and mammal species. We take into account pressures specific to the three OWF development phases, spanning 1999–2050, for the entire North Sea basin. Our results underline 2022 as the peak year of cumulative impacts for the approved OWFs, followed by a considerable increase in potential impacts of the planned 212GWs, by 2050. The spatio-temporal analysis of the OWF environmental impacts presents the shift between highly impacted areas over the studied timeline and distinguishes between concentrated areas of high impacts (S-E of UK) and dispersed areas of high impacts (Germany). Our results can inform decision-makers and the OWF industry in a joint effort to mitigate the environmental impacts of future large-scale OWF developments.
Distinction Between Natural and Artificial Agarwood Based on Electronic Nose Data
Authors: Wu Shenghong , Huang Yueqian , Chen Xiaoying , Zhou Xin , Zhang Weimin , Gao Xiaoxia 
Published: December 2020

Abstract
Background: Agarwood is widely used as a traditional medicine all over the world. Distinction between the qualities of natural and artificial agarwood is a current hot research topic among agarwood research communities. An important sensory characteristic of agarwood lies in its incense smoke, and an analysis of incense smoke has been traditionally used to evaluate the agarwood quality since ancient times. The aim of this study is to establish a rapid detection method using electronic nose (E-nose) systems to distinguish between natural and artificial agarwood. Result: Incense smokes of 45 natural and artificial agarwood samples were analyzed by E-nose, and principal component analysis (PCA) was employed to cluster the E-nose data. The chemical markers which could be used to distinguish between artificial and natural agarwood were identified by GC-MS combined with information value and decision tree algorithm. The results showed that the smellprints of artificial agarwood contained more peaks, while those of natural agarwood had higher response intensities. The compounds that were different between the two types of agarwood were three sesquiterpenes and six chromone derivatives. The result from decision tree algorithm further showed that 6-hydroxy-2-(2-phenylethyl)chromone was the chemical marker that could be used to distinguish between artificial and natural agarwood. Nootkatone and 2-(2-phenylethyl)chromone were the chemical markers that may contributed to the clustering of the E-nose data; the two compounds can be used to evaluate the incense smoke of agarwood. Conclusion: We demonstrated that our developed E-nose-based method could rapidly distinguish between the incense smokes of artificial and natural agarwood; this method could be applied to evaluate the quality of agarwood in the future.
Surgical Outcomes of Vitreous Needle Aspiration Combined With Phacoemulsification for Acute Angle Closure With Continuous High Intraocular Pressure-A Retrospective Analysis
Authors: Xiang Xiaoli , Chen Yuan , Wang Jinyu , Gu Zheng , Huang Zhengru 
Published: December 2020

Abstract
Background: The management of acute angle closure combined with an extremely shallow anterior chamber and cataracts remains complex. This study evaluated a technique of vitreous needle aspiration combined with phacoemulsification for the treatment of acute angle closure with continuous high intraocular pressure (IOP).Methods: We retrospectively reviewed the results of vitreous needle aspiration combined with phacoemulsification in 17 eyes (17 patients) with acute angle closure with continuous high IOP and coexisting visually significant cataracts between September 2018 and April 2020 at the glaucoma unit of the affiliated Changshu Hospital of Xuzhou Medical University. The main outcomes were the best corrected visual acuity (BCVA), IOP, anterior chamber depth (ACD), number of anti-glaucoma medications, and surgery-associated complications.Results: There were no complications during phacoemulsification and a foldable acrylic intraocular lens was implanted in the capsular bag in all 17 patients. For all patients, vitreous needle aspiration was successful at the first attempt. The BCVA improved from 2.02±0.54 logMAR preoperatively to 0.73±0.57 logMAR postoperatively at the final examination (p<0.001). The mean IOP was 54.47±5.33 mmHg preoperatively and 15.59± 2.35 mmHg at the final examination (p<0.001), without any medication. The ACD was 1.70±0.16 mm (range, 1.17-1.94 mm) preoperatively and 3.35±1.51 mm at the final examination (p<0.001).Conclusions: Our vitreous needle aspiration technique can be performed safely in phacoemulsification for the management of acute angle closure with continuous high IOP.