bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mechanism of interaction between hydroxypropyl cellulose and water in aqueous solutions: Importance of polymer chain length
Authors: Martin‐Pastor Manuel , Stoyanov Edmont 
Published: May 2020

AbstractThe utilization of hydroxypropyl cellulose (HPC) can be regarded as unexpected with regard to certain applications, such as being employed as a solubility enhancer for poorly soluble drugs and as a solubilizing agent for nano‐suspensions and amorphous solid dispersions. However, the best results were obtained for low‐molecular weight (Mw) HPC grades with a short‐chain structure. Therefore, in this study, seven grades of HPC with different polymer chain lengths (Mw) are analyzed in various aqueous solutions by a combination of 1H quantitative NMR spectroscopy, diffusion NMR spectroscopy, and water ligand observed via gradient spectroscopy; these investigations provide insights into the remarkable solubilizing property of HPC at the molecular and supramolecular levels. Furthermore, the hydration and the water residence time are found to be strongly dependent on the polymer chain length of HPC. The quantitative results obtained herein indicate that HPCs with shorter chain lengths retain smaller amounts of water around their hydrated molecules, as compared to their counterparts with longer chain lengths.
Areas of plant diversity—What do we know?
Authors: Brummitt Neil , Araújo Ana Claudia , Harris Timothy 
Published: May 2020

Societal Impact StatementIdentifying regions of the world that are rich in plant species will enable conservation efforts to be more effectively targeted. We present a review of global studies of plant diversity, including novel analyses from our own work, and highlight areas of the world that are consistently identified by multiple studies utilizing varied data sets as being particularly rich in plant species. This will be of interest to botanical professionals and conservationists seeking to identify and conserve priority species‐rich environments, including those working to progress international conservation targets, and to all those interested in the global distribution of biodiversity and its conservation.SummaryAreas of high diversity for vascular plants, both for numbers of species and of endemic species, are by now well established and in agreement across a variety of studies using a wide range of data from different sources. Here we review the current state of knowledge of geographical patterns of plant diversity around the world, compare this with our knowledge of vertebrate taxonomic groups, and reflect on next steps for better characterizing patterns of diversity in order to achieve effective conservation prioritization. We illustrate this with analyses of geographical patterns of plant diversity from three different data types with differing degrees of geographical and ecological resolution. At broad spatial scales these analyses are largely congruent with each other and with areas of high diversity and endemism for species of terrestrial vertebrates.
Investigating the appropriateness of different concordance measures in a time‐to‐event setting
Authors: Caetano Samantha‐Jo , Pond Gregory 
Published: May 2020

SummaryPurposePrediction models that assess a patient's risk of an event are used to inform treatment options and confirm screening tests. The concordance (c) statistic is one measure to validate the accuracy of these models, but has many extensions when applied to censored data. The purpose was to determine which c‐statistic is most accurate at different rates of censoring.MethodsA simulation study was conducted for n = 750, and censoring rates of 20%, 50%, and 80%. The mean of three different concordance definitions were compared as well as the mean of three different c‐statistics, including one, parametric c‐statistic for exponentially distributed data, developed by the authors. The SE was also calculated but was of secondary interest.ResultsThe c‐statistic developed by the authors yielded the a mean closest to the gold standard concordance measure when censoring is present in data, even when the exponentially distributed parametric assumptions do not hold. Similar results were found for SE.ConclusionsThe c‐statistic developed by the authors appears to be the most robust to censored data. Thus, it is recommended to use this c‐statistic to validate prediction models applied to censored data. This will improve the reliability and comparability across future time‐to‐event studies.
A 55‐year‐old COVID‐19‐positive man managed with self‐regulation of high‐flow oxygen by high‐velocity nasal insufflation therapy
Authors: Ciment Ari J. , Ciment Lawrence M. 
Published: May 2020

AbstractManagement of critically ill coronavirus disease 2019 (COVID‐19) patients remains both risky and technically challenging. A 55‐year‐old male COVID‐19‐positive patient with obstructive sleep apnoea (OSA), diabetes, and obesity presented with cough and shortness of breath, escalating to requiring high‐flow oxygen therapy by high‐velocity nasal insufflation. The patient's flow rate and oxygen fraction remained labile throughout much of the hospitalization. This lability required frequent clinician interactions and use of personal protective equipment. The patient was alert and oriented and was instructed on the operation of the high‐flow system, specifically the adjustment of both flow rate and oxygen percentage. The patient was instructed to modify oxygen to maintain an SpO2 (peripheral capillary oxygen saturation) target range, and flow rate to address dyspnoea as well as reduction of flow as tolerated when other staff entered the room. The patient was successfully self‐regulated for 10 days and was discharged on 2 L/min nasal cannula on day 14 of his illness.
Economic analysis of prenatal fetoscopic vs open‐hysterotomy repair of open neural tube defect
Authors: King B. C. , Hagan J. , Corroenne R. , Shamshirsaz A. A. , Espinoza J. , Nassr A. A. , Whitehead W. , Belfort M. A. , Sanz Cortes M. 
Published: May 2020

ABSTRACTObjectiveFetal repair of an open neural tube defect (ONTD) by open hysterotomy has been shown to reduce the need for ventriculoperitoneal shunting and improve motor outcomes for infants, but increases the risk of Cesarean section and prematurity. Fetoscopic repair is an alternative approach that may confer similar neurological benefits but allows for vaginal delivery and reduces the incidence of hysterotomy‐related complications. We sought to compare the costs of care from fetal surgery until neonatal discharge, as well as the clinical outcomes, associated with each surgical approach.MethodsThis was a retrospective cohort study of patients who underwent prenatal ONTD repair, using either the open‐hysterotomy or the fetoscopic approach, at a single institution between 2012 and 2018. Clinical outcomes were collected by chart review. A cost–consequence analysis was conducted from the hospital perspective, and included all inpatient and ambulatory hospital and physician costs incurred for the care of mothers and their infants, from the time of maternal admission for fetal ONTD repair up to postnatal maternal and infant discharge. Costs were estimated using cost‐to‐charge ratios for hospital billing and the Medicare physician fee schedule for physician billing.ResultsSeventy‐eight patients were included in the analysis, of whom 47 underwent fetoscopic repair and 31 underwent open‐hysterotomy repair. In the fetoscopic‐repair group, compared with the open‐repair group, fewer women underwent Cesarean section (53% vs 100%; P < 0.001) and the median gestational age at birth was significantly higher (38.1 weeks (interquartile range (IQR), 35.2–39.1 weeks) vs 35.7 weeks (IQR, 33.9–37.0 weeks); P < 0.001). No case of uterine dehiscence was observed in the fetoscopic‐repair group, compared with an incidence of 16% in the open‐repair group. After adjusting for baseline characteristics, there was no significant difference in the total cost of care between the fetoscopic‐repair and the open‐repair groups (median, $76 978 (IQR, $60 312–$115 386) vs $65 103 (IQR, $57 758–$108 103); P = 0.458).ConclusionsFetoscopic repair of ONTD, when compared with the open‐hysterotomy approach, reduces the incidence of Cesarean section and preterm delivery with no significant difference in total costs of care from surgery to infant discharge. This novel approach may represent a cost‐effective alternative to improve maternal and neonatal outcomes for this high‐risk population. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.
Operational aspect of the policy coordination for financial stability: role of Jeffreys–Lindley’s paradox in operations research
Authors: Nasir Muhammad Ali , Soliman Alaa M. , Shahbaz Muhammad 
Published: May 2020

AbstractThis study analyses the implications of Jeffery–Lindley’s paradox and Global Financial Crisis (GFC) for the operational aspect of macroeconomic policy coordination for financial stability. Using a Bayesian Vector Auto-regressive model and data from Jan 1985 to June 2016, our key findings suggest that the claim of macroeconomic policy interaction, interdependence and significance of coordinated policy operations for the financial stability holds its ground. The argument in the support for policy coordination for financial stability was found to be robust against the Jeffreys–Lindley’s paradox and in the Post-GFC era. A profound practical, operational and philosophical implication of this study is the positive aspects of Jeffreys–Lindley’s paradox and the possibility of employing the Frequentist and Bayesian estimation techniques as complementing rather competing frameworks.
The Clinical Role of Angiopoietin-Like Protein 3 in Evaluating Coronary Artery Disease in Patients with Obstructive Sleep Apnea
Authors: Li Juan , Yang Yunyun , Jiao Xiaolu , Yu Huahui , Du Yunhui , Zhang Ming , Hu Chaowei , Wei Yongxiang , Qin Yanwen 
Published: May 2020

Abstract
Purpose
Hyperlipidemia is the most important early atherosclerosis and coronary artery disease (CAD) indicator. Angiopoietin-like proteins (ANGPTLs) 3, 4, and 8 are lipid dysfunction markers that may be linked to CAD. We investigated whether these circulating ANGPTLs are associated with CAD in patients with obstructive sleep apnea (OSA).

Methods
A total of 327 individuals participated in this study: 221 patients with OSA and CAD, 50 patients with OSA alone, and 56 controls. The Gensini Score was used to assess the severity of CAD. Serum ANGPTL3, ANGPTL4, and ANGPTL8 were measured in all subjects using Human Magnetic Luminex Screening Assay. The independent association between levels of ANGPTLs and CAD was evaluated by multivariate regression analysis.

Results
Serum ANGPTL3 levels were significantly higher in patients suffering from OSA and CAD compared with patients having OSA alone (46.97 ± 13.89 vs 38.25 ± 15.94 ng/ml, P < 0.001). Univariate analysis demonstrated that ANGPTL3 was a risk factor for CAD (OR = 1.72/10 ng ANGPTL3, 95% CI, 1.29–2.28, P < 0.001). In addition, multivariate analysis revealed that ANGPTL3 was independently associated with the presence of CAD (OR = 1.74/10 ng ANGPTL3, 95% CI, 1.29–2.35, P < 0.001) even after adjusting for cofounding factors. Furthermore, circulating ANGPTL3 levels were positively associated with triglyceride (r = 0.16, P = 0.01) and total cholesterol (r = 0.14, P = 0.02) levels, while ANGPTL3 levels had no significant correlation with the severity of CAD. No significant associations were found between the levels of ANGPTL4 and ANGPTL8 and CAD even after adjusting for established risk factors.

Conclusion
Elevated levels of ANGPTL3 were independently associated with a higher likelihood of CAD in patients with OSA. It may be a novel biomarker for OSA patients at high risk of developing cardiovascular diseases.
E-Portfolio: value tensions encountered in documenting design case studies
Authors: Li Qinyu , Tolmie Peter , Weibert Anne , Schorch Marén , Müller Claudia , Wulf Volker 
Published: May 2020

AbstractWe present here the “e-Portfolio” concept, which aims to provide access to documented design case studies of design researchers’ practices. Our e-Portfolio has its origins in Grounded Design. We examine here how the e-Portfolio concept grew out of Grounded Design, the way it instantiates values, and how it contributes to our understanding of the ways in which shifting values in practice can have an impact beyond the individual.
Motivation for and adherence to growth hormone replacement therapy in adults with hypopituitarism: the patients‘ perspective
Authors: Kreitschmann-Andermahr Ilonka , Siegel Sonja , Unger Nicole , Streetz-van der Werf Christine , Karges Wolfram , Schilbach Katharina , Schröder Bernadette , Szybowicz Janine , Sauerwald Janina , Zopf Kathrin , Grzywotz Agnieszka , Bidlingmaier Martin , Sommer Heide , Strasburger Christian J. 
Published: May 2020

Abstract
Introduction
While reasons for non-adherence in children requiring growth hormone (GH) replacement (GH-Rx) are well researched, few studies have investigated adherence in adult GH deficient patients. Against the background of the adverse medical sequelae of untreated severe GH deficiency (GHD) in adults, we explored adherence to GH-Rx and associated factors in this patient group.

Method
Cross-sectional analysis including 107 adult patients with severe GHD on GH-Rx, 15 untreated GDH patients and 19 who had discontinued therapy. Patients completed self-developed ad hoc surveys on adherence to medication and GH-Rx, specific beliefs about GH-Rx, side effects and burden of injection, reasons for never receiving or dropping out of therapy, respectively.

Results
Adherence to GH-Rx was high (mean 15.8/18 points on the self-developed adherence score) and significantly correlated with general medication adherence. Higher age was significantly associated with better adherence to GH-Rx, while injection side effects, duration of treatment or device used were not. The most frequent reasons for not being on GH-Rx apart from medical reasons included fear of side effects, lack of belief in treatment effects and dislike of injections. In patients not on GH-Rx, the proportion of patients in employment was significantly smaller than in the treatment group, despite similar age and comorbidities.

Conclusions
Adherence to GH-Rx was high for those patients on therapy. Instead of focusing on improving adherence in those adults already on GH-Rx, efforts should be undertaken to ally fear of side effects and provide education on positive treatment effects for those eligible but not receiving therapy.
Obstructive sleep apnea syndrome and risk of renal impairment: a systematic review and meta-analysis with trial sequential analysis
Authors: Liu Tongtong , Zhan Yongli , Wang Yuyang , Li Qian , Mao Huimin 
Published: May 2020

Abstract
Background
Obstructive sleep apnea syndrome (OSAS) is associated with a variety of systemic diseases. Among patients with chronic kidney diseases (CKD), the prevalence of OSAS is high. OSAS can induce progression of CKD. However, whether or not OSAS can cause renal damage in healthy people is not clear. Thus, the purpose of this meta-analysis was to elucidate whether or not there was an association between OSAS and early renal damage.

Methods
PubMed, Embase Database, Cochrane Library, Web of Science, China National Knowledge Infrastructure, China Biology Medicine Database, Chinese Scientific Journals Database, and Wanfang Database were searched systematically. The relative risk (RR), weighted mean difference (WMD), and 95% confidence intervals (CI) were used to evaluate the relationship between OSAS and early renal damage. Funnel plot and Egger’s test were used to evaluate publication bias, and trial sequential analysis (TSA) was employed to verify the sufficiency of the research conclusions.

Results
A total of 18 studies were analyzed comprising 4,567 participants. Compared with the healthy control group, levels of cystatin C (MD = 0.530, 95% CI 0.423, 0.637, P < 0.01) and proteinuria in patients with OSAS were significantly increased, while the levels of estimated glomerular filtration rate (eGFR) (MD = − 0.194, 95% CI − 0.268, − 0.121, P < 0.01) were significantly decreased. Furthermore, patients with OSAS also had an increased risk of CKD. Subgroup analysis showed that compared with patients without OSAS, the level of serum cystatin C in patients with OSAS was significantly increased independent of hypertension and diabetes, and the eGFR was significantly decreased in patients with moderate to severe OSAS and comorbid hypertension and/or diabetes.

Conclusion
In this meta-analysis, OSAS was associated with a higher risk of early renal damage. Patients with OSAS and comorbid hypertension and/or diabetes appear to suffer from severe renal damage.
Weighted $$L^2$$ Version of Mergelyan and Carleman Approximation
Authors: Biard Séverine , Fornæss John Erik , Wu Jujie 
Published: May 2020

AbstractWe study the density of polynomials in $$H^2(E,\varphi )$$

H
2

(
E
,
φ
)

, the space of square integrable functions with respect to $$\mathrm{e}^{-\varphi }\mathrm{d}m$$

e

-
φ

d
m

and holomorphic on the interior of E in $${\mathbb {C}}$$
C
, where $$\varphi $$
φ
is a subharmonic function and dm is a measure on E. We give a result where E is the union of a Lipschitz graph and a Carathéodory domain, which we state as a weighted $$L^2$$

L
2

-version of the Mergelyan theorem. We also prove a weighted $$L^2$$

L
2

-version of the Carleman theorem.
A pilot geo-ethnoarchaeological study of dung deposits from pastoral rock shelters in the Monti Sibillini (central Italy)
Authors: Égüez Natalia , Dal Corso Marta , Wieckowska-Lüth Magdalena , Delpino Chiara , Tarantini Massimo , Biagetti Stefano 
Published: May 2020

AbstractIn recent years, ethnoarchaeological studies focusing on herbivore faecal remains within the soils, especially those from goat, sheep and cattle, have shown the importance of their study for identifying socio-economic activities. Thus, an accurate microstratigraphic examination of these deposits can provide us new insights into past land use, site formation processes, activity areas and intensity of use of space, mobility, domestic use of fuel, manuring, and foddering strategies. Mountain landscapes represent a relatively new terrain of investigation for geo-ethnoarchaeology. In this paper, we present a pilot project featuring an applied inter-disciplinary methodology that includes micromorphology, bulk stable isotope analysis (δ13C and δ15N), phytolith, pollen and non-pollen palynomorphs (NPPs) analyses. These were carried out on samples from three high-mountain (up to 1400 m a.s.l.) pastoral sites located at Monti Sibillini, in the Italian central Apennines. Results show that the presence of anthropic organic-rich deposits, even when poorly preserved, (1) allows for an accurate description of herbivore dung internal characteristics, (2) establishes precise microstratigraphy of anthropogenic deposits and husbandry practices related to intensity of use of space, and (3) gives accurate information about former vegetation and landscape use in the local area. Based on this exploratory ethnoarchaeological approach, we discuss the potential of micro-analyses of archaeological decayed or burnt livestock dung in a small set of samples collected during a initial survey for obtaining insights into the environment and husbandry practices from dung and goat stabling floors in a high-mountain context.
Caregiver Delivered Sensory Electrical Stimulation for Post Stroke Upper Limb Spasticity: A Single Blind Crossover Randomized Feasibility Study
Authors: Reeves Mark L. , Chotiyarnwong Chayaporn , Nair Krishnan Padmakumari Sivaraman , Slovak Martin , Healey T. Jamie , McCarthy Avril D. , Patterson Louise , Lavender Katharine , Strachan Linda , Ali Ali N. , Baster Kathleen 
Published: May 2020

AbstractWe developed a 64 channel sensory electrical stimulator which delivers a dynamic and variable ‘Sensory Barrage’ Stimulation (SBS). Our aim was to assess the feasibility of caregivers delivering the stimulation in the community for a clinical trial comparing single channel Transcutaneous Electrical Nerve Stimulation (TENS) with SBS for post stroke upper limb spasticity. We trained caregivers of 16 participants with post stroke upper limb spasticity to sequentially administer SBS and TENS for 60 min daily for four weeks each, with a washout period of two weeks in between. Outcome measures tested were recruitment and retention rates, compliance with interventions and daily recording of Participant -reported Numerical Rating Scale (NRS). We also collected results of Action Research Arm Test (ARAT), Leeds Arm Spasticity Impact Scale (LASIS) and Modified Ashworth Scale (MAS) for spasticity. Out of 21 potential participants, 16 consented and 15 completed the protocol. Ten participants received TENS for 80% (23/28) of the intended hours. Eleven participants completed NRS for at 80% (45/56) of the study days. All participants attended all visits. The MAS reduced by at least one in five participants after SBS and in three after TENS. Minimal Clinically Important Difference (MCID) of four points increase in ARAT was seen in five participants following TENS, and in four following SBS. A MCID of 18% decrease in NRS was reported by eight participants after TENS and three after SBS. This study demonstrated the feasibility of undertaking a trial of sensory electrical stimulation for post-stroke spasticity with caregivers delivering intervention in community. The study was not powered to detect efficacy of the interventions.Trial registration number:NCT02907775.Date 20-9-2016.
Empirical studies of factors associated with child malnutrition: highlighting the evidence about climate and conflict shocks
Authors: Brown Molly E. , Backer David , Billing Trey , White Peter , Grace Kathryn , Doocy Shannon , Huth Paul 
Published: May 2020

AbstractChildren who experience poor nutrition during the first 1000 days of life are more vulnerable to illness and death in the near term, as well as to lower work capacity and productivity as adults. These problems motivate research to identify basic and underlying factors that influence risks of child malnutrition. Based on a structured search of existing literature, we identified 90 studies that used statistical analyses to assess relationships between potential factors and major indicators of child malnutrition: stunting, wasting, and underweight. Our review determined that wasting, a measure of acute malnutrition, is substantially understudied compared to the other indicators. We summarize the evidence about relationships between child malnutrition and numerous factors at the individual, household, region/community, and country levels. Our results identify only select relationships that are statistically significant, with consistent signs, across multiple studies. Among the consistent predictors of child malnutrition are shocks due to variations in climate conditions (as measured with indicators of temperature, rainfall, and vegetation) and violent conflict. Limited research has been conducted on the relationship between violent conflict and wasting. Improved understanding of the variables associated with child malnutrition will aid advances in predictive modeling of the risks and severity of malnutrition crises and enhance the effectiveness of responses by the development and humanitarian communities.