bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Road Fencing on Ungulate-Vehicle Collisions and Hotspot Patterns
Authors: Kučas Andrius , Balčiauskas Linas 
Published: July 2020

Abstract
Background:The number of road traffic accidents was decreasing in Lithuania in 2002–2017, while ungulate-vehicle collision (UVC) number was increasing and accounted for about 69% of all wildlife-vehicle collisions (WVC) in the country. Identification of impact of locomotor wildlife behavior and locations where accidents occurs most frequently is important for the effective application of mitigation measures.Methods:We assessed the effect of annual average daily traffic (AADT) and wildlife fencing on UVC using regression analysis of changes in annual UVC and UVC hotspots (KDE+ method based clusters) for different categories of roads.Results:At the greatest rates annual UVC numbers and UVC hotspots increased on lower category (national and regional) roads forming denser network. Lower rates of UVC increase occurred on higher category (main) roads, forming sparser road network and characterised by highest AADT. Before 2011, both UVC occurrence and fenced road sections were most common on higher category roads. However, as of 2011, the majority of UVC occurred on lower category roads where AADT and fencing had no impact on UVC.Conclusions:We conclude that wildlife fencing on roads characterised by higher speed and traffic intensity may decrease UVC numbers, in the same time shifting UVC occurrence towards roads characterised by lower speed and traffic intensity. Wildlife fencing re-allocates wildlife movement pathways towards roads with insufficient or no mitigation measures.
Serum Metabolomic Patterns in Young Patients with Ischemic Stroke
Authors: Liu Jia , Yuan Junliang , Zhao Jingwei , Zhang Lin , Wang Qiu , Wang Guang 
Published: July 2020

Abstract
Background: Ischemic stroke is one of the leading causes of death and adult disability. The incidence of ischemic stroke continues to rise in young adults. This study aimed to provide a comprehensive evaluation of metabolic changes and explore possible mechanisms in young ischemic stroke patients without common risk factors. Methods: This study investigated serum metabolomics in 50 young patients with newly suffered ischemic stroke and 50 age-, sex-, and body mass index–matched healthy controls. The metabolomic data were analyzed by performing a multivariate statistical analysis.Results: The 197 metabolites, including amino acids, bile acids, free fatty acids, and lipids, were identified in all participants. Multivariate models showed significant differences in serum metabolomic patterns between young patients with ischemic stroke and healthy controls. The stroke patients had increased L-methionine, homocysteine, glutamine, uric acid, GCDCA, and PE (18:0/20:4, 16:0/22:5), and decreased levels of L-citrulline, taurine, PC (16:2/22:6, 16:2/20:5, 15:0/18:2), and SM (d18:1/23:0, d20:0/19:1, d18:1/22:0, d16:0/26:1, d16:0/18:0, d16:0/22:1, d18:1/19:1, d16:0/17:1, d16:1/24:1, d18:1/19:0). Based on the identified metabolites, the metabolic pathways of arginine biosynthesis, glycerophospholipid metabolism, and taurine and hypotaurine metabolism were significantly enriched in the young patients with ischemic stroke. Conclusions: Serum metabolomic patterns were significantly different between young patients with ischemic stroke and healthy controls.
Customized Neurotization for Hindlimb Hemiplegia After a Hemorrhagic Stroke
Authors: Qian TengDa , Zheng XiFeng , Shi Jing , Song ZeWu , You WeiYan , Ma Tao , Wu JiaHuan , Huang BaoSheng , Tao Yi , Wang Xi , Li LiXin 
Published: July 2020

Abstract
Background Hemiplegia after hypertensive intracerebral hemorrhage(HICH) is prevalent,devasta-ting,and currently unable to intervene satisfactorily.Established success in neurotization spurs our interest in restoring skilled lower-limb movement.Here,we explored whether contralesional L4 transfer to ipsilesional L4 root,featuring simultaneous invigoration of flexors and extensors,reanimated dexterous locomotion for the hemiplegic hindlimb after HICH.Methods We manufactured eligible rat models by injecting autologous vein blood into the left posterior limb of internal capsule (PLIC) and randomized thirty rats into three groups. We did not transect but expose bilateral L4 in group A (sham operation) after injection of saline,and infused equal blood followed by bilateral L4 transection and contralateral L4 transfer,in group B and group C,respectively.Behavioral,ultrastru-ctural,immunofluorescent,and electromyographic assessments were applied to efficacy analysis.MRI localized the PLIC impact.Results We could see marked reduction in movements and capture a denervated potential in the right hindlimb of model rats (P༞0.05).In the walking tests,group C exhibited an initially high slip,but,later, a larger increment in accuracy on the paretic side, compared to group B and group A(P༜0.001).Also,at Week 17,rats gained ∼58.2% accuracy and actuated ankle motions in group C(P༞0.05). In the retrograde tracing,at Week 9,fluoro-gold labeled motoneurons had been numerously present in the left anterior horn of the spinal cord from the L4-to-L4 root.Histological and ultra-microstructural assessments certified efficient axons regeneration.Electrom-yography and pawprint analysis implied the denervated muscles were reliably reinnervated,and myodynamia improvement(p>0.05).Conclusions Contralateral L4 transfer could render favorable outcomes for major joints,particularly for the ankle,therefore efficaciously repaired the hemiplegic hindlimb after HICH.
Design of A Lightweight Multifunctional Composite Railway Axle Utilising Coaxial Skins
Authors: Mistry Preetum Jayantilal , McRobie Charles Allan , Johnson Michael Sylvester , Jones Ivor Arthur 
Published: July 2020

Abstract

The potential for lightweighting of railway axles was investigated to primarily reduce the unsprung mass of rail vehicles. The reduction of unsprung mass equates to an overall lighter train which will help to reduce: track damage, energy consumption and total operating costs. This paper presents the design of a lightweight multifunctional hybrid metallic-composite railway axle utilising coaxial skins. The lightweight axle assembly comprises a carbon fibre reinforced polymer composite tube with steel stub axles bonded into either end. The structural hybrid metallic-composite railway axle is surrounded by coaxial skins each performing a specific function to meet secondary requirements. These include fire and ballast skins to protect the axle core. An outer pigmented layer provides visual identification of the axle class, along with protection against environmental agents. Integrated into the railway axle is a structural health monitoring layer to provide feedback on the integrity of the composite tube and adhesive bonds during the operating life. A tether assembly acts as a failsafe against wheel detachment resulting from catastrophic axle damage. The optimised hybrid metallic-composite railway axle design concept has a mass of 200 kg representing a reduction of 50% over the solid steel version.
Predictive value of prognostic nutritional index and systemic immune‐inflammation index on tumor progression in bladder cancer patients with after radical cystectomy
Authors: Zhou Jiatong , Xu Xitong , Liu RanLu 
Published: July 2020

Abstract
OBJECTIVES: The purpose of this study was to explore the predictive value of preoperative prognostic nutritional index(PNI) and systemic immune‐inflammation index(SII) for local tumor stage in bladder cancer(BC) after radical cystectomy(RC).METHODS: We researched our database between April 2011 and October 2019. There were 195 BC patients who underwent RC. The PNI and SII were calculated using preoperative blood sample results. The predictive value of SII and PNI was analysed with univariate and multivariate Cox regression models. Receiver operating characteristic (ROC) was used to determine the optimum PNI. Signifcant P was P<0.05.RESULTS: Of patients, all patients were males with a mean age of 67.94±8.97years. Mean serum albumin was 42.13±4.28(g/L), mean PNI score was 51.29±6.09 and mean SII was 661.67±506.22. Multivariable Cox regression analysis demonstrated that PNI scores and SII could not play a significantly predictive factor between muscle invasive bladder cancer(MIBC) and non-muscle-invasive bladder cancer(NMIBC). While we also found PNI was an independent risk factors for predicting tumor stagep(pT＜3a and pT≥3a).CONCLUSIONS: Our research revealed that preoperative low PNI but not SII could be used as an independent factor to predict worse pathologically stage(pT≥3a). But preoperative PNI and SII might not were significantly related with the incidence risk of muscle invasive. We still need future studies with large cohorts to identify our results.
Categorisation of Sit-To-Stand Motion Pattern. Human vs Automated Quantitative Assessments.
Authors: Job Mirko , Battista Simone , Stanzani Ronny , Signori Alessio , Testa Marco 
Published: July 2020

Abstract
BACKGROUND: The Sit-to-Stand (STS) test is widely used in clinical practice as an indicator of lower-limb functionality decline, especially for older adults. Hitherto, due to its high variability, there is no standard approach for categorising the STS motion pattern, and the vision-based evaluation remains the most reliable method to evaluate people’ performance. This paper presents a comparative analysis between visual assessments and an automated-software approach for the categorisation of STS, relying on registrations from a force plate. METHODS: A group of 5 participants (30 ± 6 years) took part in 2 different sessions of visual inspections on 200 STS movements randomly extracted from a dataset of 742 acquisitions under self-paced and controlled speed conditions. Assessors were asked to identify three specific STS events from the Ground Reaction Force, simultaneously with the software analysis: the start of the trunk movement (Initiation), the beginning of the stable upright stance (Standing) and the sitting movement (Sitting). The Test-Retest Reliability between first and second visual evaluations was compared with the Inter-Rater Agreement between visual and software assessments, as indexes of human and software performance, respectively.RESULTS: No statistical differences between methods were found for the identification of the Initiation and the Sitting events at self-paced speed and for only the Sitting event at controlled speed. The estimated significant values of maximum discrepancy between visual and automated assessments were 0.200 s [0,039; 0.361] in unconstrained conditions and 0,340 s [0,014; 0,666] for standardised movements.CONCLUSIONS: The software assessments displayed an overall good agreement against visual evaluations of the Ground Reaction Force, relying, at the same time, on objective measures. In this sense, the proposed approach can provide robust and consistent data in the field of Big Data analytics, augmenting the performance of artificial intelligence methods for Human Activity Recognition tasks.
Novel instellation calculations for close-in exoplanets
Authors: Sadh Mradumay 
Published: July 2020

Abstract
The distribution of instellation at the top of a planet's atmosphere or surface is usually calculated using the inverse-square law of radiation. This is based on the assumption that the host star is far enough to be considered a point-sized Lambertian source. This assumption, which works well for the solar system planets and most exoplanets, must be revised for close-in exoplanets.
Spatial analysis of perceived health system capability and actual health system capacity for COVID-19 in South Africa
Authors: Mokhele Tholang , Sewpaul Ronel , Sifunda Sibusiso , Weir-Smith Gina , Dlamini Simangele , Manyaapelo Thabang , Naidoo Inbarani , Parker Whadi-Ah , Dukhi Natisha , Jooste Sean , Parker Saahier , Zuma Khangelani , Moshabela Mosa , Mabaso Musawenkosi , Reddy Sasiragha Priscilla 
Published: July 2020

Abstract
People’s confidence on the health system capability in managing COVID-19 outbreak can determine public support, risk perceptions and compliance behaviours during the pandemic. Therefore, this paper investigated people’s perception on health system capability using online survey data and current state of health system capacity to deal with COVID-19 pandemic at different spatial areas across the country. Simple and multiple logistic regression models were used to examine the factors associated with perception of the health system’s capability to manage the COVID-19 pandemic at a national level and within each province. Spatial comparative analysis was conducted on perception of health system capability and density indicators of health system capacity. Findings showed South Africans had low confidence on health system capability with only two in five (40.7%) reporting that they thought that the country’s health system was able to manage the COVID-19 pandemic. Sex and knowledge on COVID-19 were significantly associated with the perception of the health system’s capability to manage the pandemic at the national level and in four of the nine provinces. Overall, the findings of this study clearly highlights the challenges on the country’s health system both perceived or real that needed to be addressed as part of the preparation for the COVID-19 pandemic. Timeous implementation of a countrywide National Health Insurance (NHI) system is now more critical than ever in improving health care outcomes of the South African population even beyond the existence of the COVID-19 epidemic.
The Impact of the lockdown on ENT services during the COVID-19 Pandemic, a report from the developing world.
Authors: Hari Kapila , Maharaj Shivesh 
Published: July 2020

Abstract
The novel coronavirus and accompanying lockdown measures have resulted in the disruption of specialist clinic services. There have been reports of a decrease in the number of clinic attendees and surgical procedures performed in clinics throughout the worldThe study period was from the 2 January 2020 until 19 June 2020 which was divided by the lockdown date of the 26 March 2020, into two periods of 85 days for comparative review.During the pre-lockdown phase (2 January 2020 to 25 March 2020), 2160 patients were booked for the outpatient clinics and 1911 attended in this period (88.5%). In contrast during the post-lockdown period (26 March 2020 to 19 June 2020), 1220 visits were scheduled. Of these, 937 (76.8%) visits were completed. The number of patient visits booked (p=0.01) and completed (0.0001) after lockdown declined significantly. The total number of outpatient procedures performed pre-lockdown was 1892 (0.99/ patient) compared to 937 (1.04/ patient) post-lockdown. This represents an approximate decrease of 50% in the number of procedures completed post-lockdown but the change in the number of procedures/ patient was not significant (p=0.4).During the pre-lockdown phase 228 theatre cases were completed, including 66 emergencies and post-lockdown there were 188 cases together with 48 emergencies. There were no elective cases post-lockdown. The study illustrates that even during a stringent lockdown period there is an ongoing need for specialist ENT services and health care systems need to be tailored to manage all patients such that care is not shifted away from vulnerable groups and solely focused on Covid19 patients.
Telemedicine: A cornerstone of healthcare assistance during the recent pandemic outbreak of COVID-19 but also a great opportunity for the future. A pilot experience in the largest Teaching Hospital in Southern Italy.
Authors: Edoardo MD; Tartaglia , Anna Vozzella Emilia , Anna LLD Iervolino , Rosanna Egidio , Gaetano Buonocore , Antonietta EngD Perrone , Gugliemo EngD Toscano , Raffaele EngD Tremante , Francesca EngD Cesaro , Vincenzo Sommella , Paola Magri , Lanfranco Iodice 
Published: July 2020

Abstract
Background: At the end of 2019, Wuhan, China, experienced an outbreak of a novel coronavirus. The epidemiologic burden of COVID-19 is constantly evolving, with numbers of infected persons, hospital admissions and deaths growing near exponentially. The recent pandemic outbreak of COVID-19 worldwide caught the health care systems in every country around the world by storm and without a proper defense mechanism to cope and control such a pandemic. In fact, this outbreak is causing an overwhelming burden of illnesses that stresses health system capacity and adverse effects on healthcare workers including the risk of infection. In this context, telemedicine has been promoted and scaled up to reduce the risk of transmission. In this paper the Authors reports their own experience with Telemedicine. Methods: During the “lockdown”, the AOU“Federico II” was forced to create peculiar pathways to ensure the safety of the patients and medical staff, and to keep an appropriate medical assistance, therefore it was introduced the telemedicine, wherever possible, by modifying the Information Technology (IT) related to the waiting times, rescheduling all booked visits and identifying several outpatient’s clinics suitable for telemedicine activities. Besides, safe pathways were properly studied to screening all patients who had a medical consult in person.Results: Since the introduction of telemedicine service, 953 consultations were provided in this way, about 13 % of all medical consults delivered by AOU “Federico II” in this period; 97,38% of them were follow-up visits, that otherwise would have been missed during the current pandemic, so an economic loss has been avoided. In addition, it has been calculated that, using Telemedicine visits vs a face-to-face consultation, about 65-70% of direct costs were spared by our Healthcare Company.Conclusions: Telemedicine has been the keystone that has allowed a rapid, appropriate response of whole overloaded healthcare systems to current Pandemic, and, as reported by Ohannessian et al., all stakeholders are encouraged to address the challenges and collaborate to promote the safe and evidence-based use of telemedicine during the current pandemic and future outbreaks, and the COVID-19 pandemic is a call to adopt the necessary regulatory changes supporting wide adoption of telemedicine.
Toll-like Receptor 2 Polymorphisms Impose Considerable Impacts On Acute Myelocytic Leukemi Occurrence
Authors: Qu Hong , Chen Yongfang , Zeng Wenjing , Huang Xiaohua , Cheng Shuqin 
Published: July 2020

Abstract
Background: This research aimed to explore the genetic association of Toll-like receptor 2 (TLR2) gene polymorphisms with acute myelocytic leukemia (AML) susceptibility in Chinese population.Methods: Firstly, the genotypes of TLR2 polymorphism were detected in 148 AML patients and 126 healthy controls by polymerase chain reaction (PCR). The genotype distribution of every polymorphism in the control group was detected whether conformed to Hardy-Weinberg equilibrium (HWE). The genotype frequency difference of TLR2 polymorphism between the case and control groups was compared by chi-square test and odds ratio (OR) with 95% confidence interval (95%CI) was calculated to express the risk of AML resulted from genetic variant of TLR2.Results: For TLR2 rs3804099 polymorphism, the heterozygous genotype TC was detected the significantly lower frequency in AML patients than that in the controls (P=0.031), so was C allele (P=0.021), which showed that rs3804099 was associated with the decreased the risk of AML (OR=0.580, 95%CI=0.354-0.953; OR=0.641, 95%CI=0.438-0.938). Similarly, GG genotype and G allele of rs1898830 also showed the obviously association with the risk reduction of AML (GG vs. AA: OR=0.430, 95%CI=0.200-0.924, G vs. A: OR=0.644, 95%CI=0.451-0.919). However, no significant association was found in rs7656411 with AML.Conclusions: TLR2 rs3804099 and rs1898830 polymorphisms may be the protective factors for AML, but not rs7656411.
Remote clinician-based home management of COVID-19 associated pneumonia in a resource limited setting
Authors: Kana Nadir , Maharaj Shivesh 
Published: July 2020

Abstract
The coronavirus disease (COVID-19) pandemic has resulted in an increased number of patients that require respiratory support in terms of oxygen and ventilation. Due to the burden on the healthcare system there has been a shortage of hospitals beds in both the public and private sector. This has led to many patients being managed at home. Currently there is no consensus regarding best practice guidelines in terms of treatment of this subset of patients.We hereby present a case of a patient who was treated using appropriate respiratory support (a combination of low flow oxygen therapy via nasal prongs or face mask as high flow oxygen was not available), oral corticosteroids and anti-coagulants managed by remote clinician intervention. We also include our home management protocol.
Percutaneous Screw Fixation for Acute Scaphoid Fractures Through K-wire-assisted Reduction and Maintenance
Authors: Bai Jiangbo , Kong Lingde , Tian Siyu , Yu Kunlun , Lu Jian , Liu Chunjie , Tian Dehu 
Published: July 2020

Abstract
Background: Percutaneous screw fixation was introduced for acute scaphoid fractures through K-wire-assisted reduction and maintenance, and the effectiveness of the methods was evaluated.Methods: Ten patients with acute scaphoid fractures were consecutively treated with the proposed technique from January 2015 to December 2018. With the wrist placed in ulnar deviation, one K-wire was introduced perpendicularly through the styloid process of radius into the proximal pole of scaphoid under fluoroscopic guidance. The scaphoid fragment was reduced by dorsiflexing the wrist and translating the distal pole into an extended position. A headless compression screw was then inserted in a standardised manner. Operation time, time to union, time to return to previous activity and complication were recorded. Function outcomes including pain, work status, range of motion (ROM) and grip strength were assessed according to the modified Mayo wrist scoring system.Results: Final follow-up examination was performed on an average of 12 months (range, 10–15 months) after surgery. No immediate postoperative complication occurred. All scaphoid fractures united at an average of 9.2 weeks (range, 7–11.4 weeks). The following average values were achieved: operation time was 48.2 minutes (range, 38–65 minutes), the time that patients returned to previous activity levels was 9.4 weeks (range, 7–11 weeks) and function scores were 92.5 (range, 80–100). At 3 months post-operation, the wrist range of motion was generally 62.5° wrist extension (range, 50°–70°) and 68.2° wrist flexion (range, 55°–75°). Grip strength was approximately 40.1 kg (range, 28–45 kg) and 83.5% (range, 85%–100%) of the contralateral sides. The mean post-operative height-to-length ratio was 0.61.Conclusions: Our novel percutaneous screw fixation method is beneficial to minimise injury to the blood supply of the scaphoid. Primary percutaneous screw fixation for acute scaphoid fractures is a superior method with reduced time to bony union, early return to daily activity or employment and predictably lessened complications of wrist stiffness, diminished grip strength, delayed union, non-union and osteonecrosis.Trial registration: Clinicaltrials.gov; NCT04482868; Registered 19 July 2020-Retrospectively registered.