bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anterior-Posterior View by Full-Body Digital X-Ray to Rule Out Severe Spinal Injuries in Polytraumatized Patients
Authors: Häckel Sonja , Hofmann Elena , Anwander Helen , Albers Christoph , Basedow Jasmin , Bigdon Sebastian , Exadaktylos Aristomenis , Keel Marius , Dunn Robert , Maqungo Sithombo , Benneker Lorin , Hoppe Sven 
Published: December 2020

Abstract
BackgroundSpinal injuries are present in 16-31% of polytraumatized patients. Rapid identification of spinal injuries requiring immobilization or operative treatment is essential. The Lodox-Statscan (LS) has evolved into a promising time-saving diagnostic tool to diagnose life-threatening injuries with an anterior-posterior (AP)-full-body digital X-ray.MethodsWe aimed to analyze the diagnostic accuracy and the interrater reliability of AP-LS to detect spinal injuries in polytraumatized patients. Therefore, within three years, AP-LS of polytraumatized patients (ISS≥16) were retrospectively analyzed by three independent observers. The sensitivity and specificity of correct diagnosis with AP-LS compared to CT scan were calculated. The diagnostic accuracy was evaluated by using the area under the ROC (receiver operating characteristic curve) for sensitivity and specificity. Interrater reliability between the three observers was calculated using Fleiss' Kappa. The sensitivity of AP-LS was further analyzed by the severity of spinal injuries. ResultsThe study group included 320 patients (48.5 years ± 19.5, 89 women). On CT scan, 207 patients presented with a spinal injury (65%, total of 332 injuries). AP-LS had a low sensitivity of 9% (31 of 332, range 0-24%) and high specificity of 99% (range 98-100%). The sensitivity was highest for thoracic spinal injuries (14%). The interrater reliability was slight (κ = 0.02; 95% CI: 0.00, 0.03). Potentially unstable spinal injuries were more likely to be detected than stable injuries (sensitivity 18% and 6%, respectively).ConclusionThis study demonstrated high specificity with low sensitivity of AP-LS in detecting spinal injuries compared to CT scan. In polytraumatized patients, AP-LS, implemented in the Advanced Trauma Life Support-algorithm, is a helpful tool to diagnose life-threatening injuries. However, if spinal injuries are suspected, performing a full-body CT scan is necessary for correct diagnosis.
Cost-Effectiveness of Intensive Care for Hospitalized Covid-19 Patients: Experience From South Africa
Authors: Cleary Susan , Wilkinson Tommy , Tchuem Cynthia Tamandjou , Docrat Sumaiyah , Solanki Geetesh 
Published: December 2020

Abstract
BackgroundAmidst shortages of critical care capacity in the public sector during the COVID-19 pandemic, the South African government embarked on an initiative to purchase critical bed capacity from the private sector. To inform the decision, we assessed the cost-effectiveness of ICU management for admitted COVID-19 patients across the public and private health systems in South Africa.MethodsUsing a Markov modelling framework and health system perspective, costs and health outcomes of inpatient management of severe and critical COVID-19 patients in (1) general ward and intensive care (GW+ICU) and (2) general ward only were assessed. Disability adjusted life years (DALYs) were evaluated and the cost per admission in public and private sectors was determined. The models made use of four variables: mortality rates, utilisation of inpatient days for each management approach, disability weights associated to the severity of the disease, and the unit cost per general ward day and per ICU day in public and private hospitals. Unit costs were multiplied by utilisation estimates to determine the cost per admission. DALYs were calculated as the sum of years of life lost (YLL) and years lived with disability (YLD). An incremental cost-effectiveness ratio (ICER) - representing the difference in costs and health outcomes of the two management strategies - was compared to a cost-effectiveness threshold to determine the value for money of ICU management.ResultsA cost per admission of ZAR 75,127 was estimated for inpatient management of severe and critical COVID-19 patients in general wards only as opposed to ZAR 103,030 in GW+ICU. DALYs were 1.48 and 1.10 in the general ward only and GW+ICU, respectively. The ratio of difference in costs and health outcomes between the two management strategies produced an ICER equal to ZAR 73,091 per DALY averted, a value above the cost-effectiveness threshold of ZAR 38,465.ConclusionsResults indicated that purchasing ICU capacity from the private sector may not be a cost-effective investment. The ‘real time’, rapid, pragmatic, and transparent nature of this analysis demonstrates an approach for evidence generation for decision making relating to the COVID-19 pandemic response and South Africa’s wider priority setting agenda.
Characteristic Time in Highly Motivated Movements of Children and Adults Through Bottlenecks
Authors: Li Hongliu , Zhang Jun , Xia Long , Yang Libing , Song Weiguo , Yuen Kwok Kit Richard 
Published: December 2020

Abstract
Current codes for fire protection of buildings are mainly based on the movement of adults and neglect the movement characteristic of pre-school children. Having a profound comprehension of the difference between children and adults passing bottlenecks is of great help to improve the safety levels of preschool children. This paper presents an experimental study on the bottleneck flow of pre-school children in a room. The movement characteristics of children’s and adults’ bottleneck flow are investigated with two macroscopic properties: density and speed profiles as well as microscopic characteristic time: motion activation time, relaxation time, exit travel time and headway time. Arch-like density distributions are observed both for highly motivated children and adults, while the distance between the peak density region and the exit location is shorter for children and longer for adults. Children’s movement is less flexible manifested as longer motion activation time and longer relaxation time compared to that of adults. The findings from this study could enhance the understanding of crowd dynamics among the children population and provide supports for the scientific building design for children’s facilities.
Interaction Between Early in Ovo Stimulation of the Gut Microbiota and Chicken Host – Splenic Changes in Gene Expression and Methylation
Authors: Dunislawska Aleksandra , Slawinska Anna , Gryzinska Magdalena , Siwek Maria 
Published: December 2020

Abstract
Epigenetic regulation of the gene expression results from interaction between the external environment and transcription of the genetic information encoded in DNA. Methylated CpG regions within the gene promoters lead to silencing of the gene expression. Factors contributing to epigenetic regulation include intestinal microbiota, which in chicken can be potently modified by in ovo stimulation. The main aim of this study was to determine global and specific methylation patterns for the spleen under the influence of host-microbiome interaction. Incubating eggs were in ovo stimulated on day 12 of incubation in two chicken genotypes: Ross broilers and Green-legged Partridgelike. The injected compounds included: probiotic – Lactococcus lactis subsp. cremoris, prebiotic – galactooligosaccharides, and synbiotic – combination of both. Chickens were sacrificed on day 42 post-hatching. Spleen was collected, RNA and DNA were isolated and intended to gene expression, gene methylation and global methylation analysis. We have proved that negative regulation of gene expression after administration of bioactive substances in ovo might have epigenetic character. Epigenetic changes depend on the genotype and the substance administered in ovo. Epigenetic nature of microbial reprogramming in poultry and extension of issues related to host-microbiome interaction is a new direction of this research.
Emotional and Instrumental Social Support as Determinants of Happiness: A Cross-Sectional Study of Malaysian Elderly
Authors: Shah Shamsul Azhar , Safian Nazarudin , Ahmad Saharuddin , Ibadullah Wan Abdul Hannan Wan , Mohammad Zulkefley , Nurumal Siti Rohani , Mansor Juliana , Addnan Mohd Fairuz , Shobugawa Yugo 
Published: December 2020

Abstract
Background: Happiness is an essential component for experience healthy ageing. Hence, understanding the factors that contribute to happiness is essential for a better quality of life. This study aimed to determine the factors associated with happiness among the elderly population in Malaysia.Methods: In this study, 1204 respondents were recruited from urban and rural areas in Selangor. The face-to-face interview was conducted using the Bahasa Malaysian version of the Japan Gerontological Evaluation Study questionnaire. The inclusion criteria include Malaysians who are 60 years old and above and can converse in the Malaysian language. Those who encounter less than seven scores for the Abbreviated Mental Test were excluded from the study.Result: Among the 1204 respondents, 953 (79.2%) of them were happy. In terms of sociodemographic characteristics, men who were happy, 60 to 74 years old and live in urban areas were significantly associated with happiness. Multiple logistic regression analysis showed that the significant factors associated with happiness among the elderly include the social support they receive, both emotional support (adjusted OR 2.33) and instrumental support (adjusted OR 1.59); the locality they reside in (adjusted OR 1.65); how they self-rated themselves in terms of their health status (adjusted OR 1.58); their educational level (adjusted OR 4.20) and their household income (adjusted OR 0.77).Conclusion: Thus, ensuring the elderly population in receiving emotional and instrumental support can enhance their happiness level.
Building a Virtual Summer Research Experience in Cancer for High School and Early Undergraduate Students: Lessons From the COVID-19 Pandemic
Authors: Corson Timothy , Hawkins Shannon , Sanders Elmer , Byram Jessica , Cruz Leigh-Ann , Olson Jacob , Speidell Emily , Schnabel Rose , Balaji Adhitya , Ogbeide Osas , Dinh Julie , Hinshaw Amy , Cummings Laura , Bonds Vicki , Nakshatri Harikrishna 
Published: December 2020

Abstract
Background: The COVID-19 pandemic posed a unique challenge for summer research programs in 2020, particularly for programs aimed at hands-on experience for younger trainees. The Indiana University Melvin and Bren Simon Comprehensive Cancer Center supports two pipeline programs, which traditionally immerse high school juniors, seniors, and early undergraduate students from underrepresented populations in science in hands-on projects in cancer biology labs. However, due to social distancing policies during the pandemic and reduction of research operations, these students were not physically allowed on campus. Thus, the authors set out to strategically pivot to a wholly virtual curriculum and evaluate the Virtual Summer Research Experience in Cancer outcomes.Methods: The virtual program included four components: 1. a core science and professional development curriculum led by high school teachers and senior undergraduates; 2. faculty-delivered didactic sessions on cancer science; 3. mentored, virtual research projects with research faculty; and 4. online networking events to encourage vertical mentoring. Outcomes data were measured using an 11-item Research Preparation scale, daily electronic feedback, and structured evaluation and feedback via Zoom weekly.Results: Outcome data suggested high self-reported satisfaction with the virtual program. Outcome data also revealed the importance of coordination between multiple entities for seamless program implementation. This includes the active recruitment and participation of high school teachers and further investment in information technology capabilities of institutions.Conclusions: Findings reveal a path to educate and train high school and early undergraduate students in cancer research when hands-on, in-person training is not feasible. Virtual research experiences are not only useful to engage students during public health crises but can provide an avenue for cancer centers to expand their cancer education footprints to remotely located schools and universities with limited resources to provide such experiences to their students.
Facility-Level Determinants of Quality Routine Intrapartum Care in Afghanistan
Authors: Lydon Megan , Maruf Farzana , Tappis Hannah 
Published: December 2020

Abstract
Background Although there have been notable improvements in availability and utilization of maternal health care in Afghanistan over the last few decades, risk of maternal mortality remains very high. Previous studies have highlighted gaps in quality of emergency obstetric and newborn care practices, however, little is known about the quality of routine intrapartum care at health facilities in Afghanistan.Methods We analyzed a subset of data from the 2016 Afghanistan Maternal and Newborn Health Quality of Care Assessment that comprised of observations of labor, delivery and immediate post-partum care, as well as health facility assessments and provider interviews across 77 high volume public health facilities. Using the Quality of the Process of Intrapartum and Immediate Postpartum Care index, we calculated a quality of care score for each observation. We conducted descriptive and bivariate analyses and built a multivariate linear regression model to identify facility-level factors associated with quality of care scores.Results Across the 665 childbirth observations, low quality of care was observed such that no health facility type received an average quality score over 56%. The multivariate regression model indicated that availability of routine labor and delivery supplies, training in respectful maternity care, perceived gender equality for training opportunities, recent supervision and observation during supervision were significantly positively associated with quality of care. Conclusions Quality of routine intrapartum care at health facilities in Afghanistan is concerningly low. Our analysis suggests that multi-faceted interventions are needed to address direct and indirect contributors to quality of care including clinical care practices, attention to client experiences during labor and delivery and attention to staff welfare and opportunities, including gender equality within the health workforce.
Detection of Passive Liver Congestion in Pericarditis Patients With Constrictive Physiology Using MR Relaxometry of the Liver.
Authors: Bogaert Jan , Dresselaers Tom , Imazio Massimo , Sinnaeve Peter , Tassetti Luigi , Masci Pier Giorgio , Symons Rolf 
Published: December 2020

Abstract
Constrictive pericarditis is a common cause of right heart failure, characterized by increased filling pressures and passive liver congestion. As magnetic resonance (MR) T1 and T2 mapping allow quantification of liver relaxation times, we hypothesized liver mapping may allow depiction of passive liver congestion. We studied 45 pericarditis patients, of whom 25 presented constrictive physiology (CP+) and 20 normal physiology (CP-), and 30 control subjects. Pericarditis patients were predominantly male, but CP+ patients were on average 13 years older than CP- patients (p=0.003). Native T1 and T2 values as well as extracellular volume (ECV) values of the liver were significantly higher in CP+ than in CP- patients and controls, i.e. native T1: 765±102ms vs 581±56ms and 537±30ms; T2: 63±13ms vs 50±4ms and 46±4ms; ECV: 42±7% vs 31±3% and 30±3% control (all p<0.001). Using a cut-off right atrial (RA) pressure of >5 mm Hg to discriminate between normal and increased RA pressure, native T1 liver yielded the highest AUC (0.926) at ROC analysis with a sensitivity of 79.3% and specificity of 95.6%. Moreover, liver mapping showed excellent intra- and inter-reader agreement. In conclusion, liver mapping as part of a comprehensive cardiovascular MR exam is valuable to depict liver congestion in pericarditis patients.
Enteric Reabsorption: Influence on Drug Pharmacokinetics Depending on The Underlying Mechanism
Authors: Ibarra Manuel , Trocóniz Iñaki , Fagiolino Pietro 
Published: December 2020

Abstract
Enteric reabsorption occurs when a drug is secreted into the intestinal lumen and reabsorbed into the systemic circulation. This distribution process is evidenced by multiple peaks in pharmacokinetic profiles. Commonly, hepatobiliary drug secretion is assumed to be the underlying mechanism (enterohepatic reabsorption, EHR), neglecting other possible mechanisms such as gastric secretion (enterogastric reabsorption, EGR). In addition, the impact of drug reabsorption on systemic clearance, volume of distribution and bioavailability has been a subject of long-standing discussions. In this work, we propose semi-mechanistic pharmacokinetic models to reflect EHR and EGR and compare their respective impact on primary pharmacokinetic parameters. A simulation-based analysis was carried out considering three drug types with the potential for reabsorption, classified according to their primary route of elimination and their hepatic extraction: A)hepatic metabolism – low extraction; B)hepatic metabolism – intermediate/high extraction; C)renal excretion. Results show that an increase in EHR can significantly reduce the clearance of drugs A and B, increase bioavailability of B drugs, and increase the volume of distribution for all drugs. Conversely, EGR had negligible impact in all pharmacokinetic parameters. Findings provide background to explain and forecast the role that this process can play in pharmacokinetic variability, including drug-drug interactions and disease states.
Triboelectrification induced self-powered microbial disinfection using nanowire-enhanced localized electric field
Authors: Huo Zheng-Yang , Kim Young Jun , Suh In-Yong , Lee Dong-Min , Lee Jeong Hwan , Du Ye , Wang Si , Yoon Hong-Joon , Kim Sang-Woo 
Published: December 2020

Abstract
Air-transmitted pathogens may lead to severe epidemics (e.g., COVID-19) showing huge threats to public health. Inactivation of the pathogenic microbes in the air is an essential process, whereas the feasibility of existing air disinfection technologies has encountered obstacles including only achieving physical separation but no inactivation, obvious pressure drops, and energy intensiveness. Here we report a rapid disinfection method for inactivating air-transmitted bacteria and viruses using the nanowire-enhanced localized electric field to damage the outer structures of microbes. This air disinfection system is driven by a triboelectric nanogenerator that converts mechanical vibration to electricity effectively and achieves self-powered. Assisted by a rational design for the accelerated charging and trapping of microbes, this self-powered air disinfection system promotes the microbial transport and achieves high performance: >99.99% microbial inactivation within 0.025s in a fast airflow (2 m/s) while only causing low pressure drops (<24 Pa). This rapid, self-powered air disinfection method may fill the urgent need for the air-transmitted microbial inactivation to protect public health.
Hyperglycemic Hyperosmolar State (HHS) with New-onset Diabetes Mellitus in a Patient with SARS CoV-2 Infection.
Authors: Al-Naami Awaji Q. , Khan Liaqat A. , Zaidan Faisal I. , Al-Neami Ibrahim A. , Awad Akram S. , Hobani Abdulwahab I. , Sheikh Ali H. , Ahmadini Mousa A. 
Published: December 2020

Abstract

New-onset DM or unmasking existing one, with or without metabolic complications, has been reported in SARS CoV-2 infection. New-onset DM in association with HHS alone or combination with DKA is uncommon but a possible manifestation of SARS CoV-2 infection that poses management challenges where the outcome may be worst.
Spatial Variation in Risk Factors of Lymphatic Filariasis in Hotspot Zones in Ghana
Authors: Kwarteng Efiba Vidda , Andam-Akorful Samuel Ato , Kwarteng Alexander , Asare Da-Costa Boakye Mensah , Quaye-Ballard Jonathan Arthur , Osei Frank Babu , Duker Alfred Allan 
Published: December 2020

Abstract
Lymphatic Filariasis (LF), a parasitic nematode infection, often resulting in disability poses huge economic burden to affected countries. To meet eradication deadlines in line with the global Neglected Tropical Diseases elimination and health system strengthening goals, novel strategies are needed to complement existing approaches. LF endemicity is localized and prevalence, spatially heterogeneous. Species distribution models (SDMs) can help identify subtle differences in risk factors that influences the transmission of LF in geographically distinct regions. Thus in this contribution, presence absence records of microfilaria (m)f in Ghana were stratified into Northern and Southern Zones and used to run SDMs, whilst climate, socioeconomic and land coverage variables provided explanation information. GLM (Generalized Linear model), GBM (Generalized Boosted Model), ANN (Artificial Neural Network), SRE (Surface Range Envelope), MARS (Multivariate Adaptive Regression Splines) and RF (Random Forests) algorithms were run for both study zones and also for the entire country for the purpose of comparison. Best model quality was obtained with RF and GBM algorithms with highest AUC between 0.98 and 0.95, respectively. The models predicted high suitable environments for LF transmission in the short grass savanna areas in the northern and along the coastal southern parts of Ghana. Mainly, land cover and socioeconomic variables such as, proximity to inland waterbodies and population density uniquely influenced LF transmission in the South while poor housing was a distinctive risk factors in the North. Precipitation, temperature, slope and poverty were common risk factors but with subtle variations in response values, which was confirmed by the countrywide model. This study has demonstrated that, an understanding of the geographic distinctness in risk factors is required to inform the development of area-specific transmission control systems towards LF elimination in Ghana and internationally.
Upregulation of Human Endogenous Retroviruses in Bronchoalveolar Lavage Fluid of COVID-19 Patients
Authors: Kitsou Konstantina , Kotanidou Anastasia , Paraskevis Dimitrios , Karamitros Timokratis , Katzourakis Aris , Tedder Richard , Hurst Tara , Sapounas Spyros , Kotsinas Athanassios , Gorgoulis Vassilis , Spoulou Vana , Tsiodras Sotirios , Lagiou Pagona , Magiorkinis Gkikas 
Published: December 2020

Abstract
BackgroundSevere COVID-19 pneumonia has been associated with the development of intense inflammatory responses during the course of infections with SARS-CoV-2. Given that Human Endogenous Retroviruses (HERVs) are known to be activated during and participate in inflammatory processes, we examined whether HERV dysregulation signatures are present in COVID-19 patients. ResultsBy comparing transcriptomes of Peripheral Blood Monocytes (PBMCs) and Bronchoalveolar Lavage Fluid (BALF) from patients and normal controls we have shown that HERVs are intensely dysregulated in BALF, but not in PBMCs. In particular, upregulation in the expression of multiple HERV families was detected in BALF samples of COVID-19 patients, with HERV-H being the most highly upregulated family among the families analysed. In addition, we compared the expression of HERVs in Human Bronchial Epithelial Cells (HBECs) without and after senescence induction in an oncogene-induced senescence model, in order to quantitatively measure changes in the expression of HERVs in bronchial cells during the processes of cellular senescence.ConclusionsThis apparent difference of HERV dysregulation between PBMCs and BALF warrants further studies in involvement of HERVs in inflammatory pathogenetic mechanisms as well as exploration of HERVs as potential biomarkers for disease progression. Furthermore, the increase in the expression of HERVs in senescent HBECs in comparison to non-induced HBECs provides a potential link for increased COVID-19 severity and mortality in aged populations.