bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a support vector machine learning and smart phone Internet of Things-based architecture for real-time sleep apnea diagnosis
Authors: Ma Bin , Wu Zhaolong , Li Shengyu , Benton Ryan , Li Dongqi , Huang Yulong , Kasukurthi Mohan Vamsi , Lin Jingwei , Borchert Glen M. , Tan Shaobo , Li Gang , Yang Meihong , Huang Jingshan 
Published: December 2020

Abstract
Background
The breathing disorder obstructive sleep apnea syndrome (OSAS) only occurs while asleep. While polysomnography (PSG) represents the premiere standard for diagnosing OSAS, it is quite costly, complicated to use, and carries a significant delay between testing and diagnosis.

Methods
This work describes a novel architecture and algorithm designed to efficiently diagnose OSAS via the use of smart phones. In our algorithm, features are extracted from the data, specifically blood oxygen saturation as represented by SpO2. These features are used by a support vector machine (SVM) based strategy to create a classification model. The resultant SVM classification model can then be employed to diagnose OSAS. To allow remote diagnosis, we have combined a simple monitoring system with our algorithm. The system allows physiological data to be obtained from a smart phone, the data to be uploaded to the cloud for processing, and finally population of a diagnostic report sent back to the smart phone in real-time.

Results
Our initial evaluation of this algorithm utilizing actual patient data finds its sensitivity, accuracy, and specificity to be 87.6%, 90.2%, and 94.1%, respectively.

Discussion
Our architecture can monitor human physiological readings in real time and give early warning of abnormal physiological parameters. Moreover, after our evaluation, we find 5G technology offers higher bandwidth with lower delays ensuring more effective monitoring. In addition, we evaluate our algorithm utilizing real-world data; the proposed approach has high accuracy, sensitivity, and specific, demonstrating that our approach is very promising.

Conclusions
Experimental results on the apnea data in University College Dublin (UCD) Database have proven the efficiency and effectiveness of our methodology. This work is a pilot project and still under development. There is no clinical validation and no support. In addition, the Internet of Things (IoT) architecture enables real-time monitoring of human physiological parameters, combined with diagnostic algorithms to provide early warning of abnormal data.
Can breastfeeding protect against antimicrobial resistance?
Authors: Nadimpalli Maya L. , Bourke Claire D. , Robertson Ruairi C. , Delarocque-Astagneau Elisabeth , Manges Amee R. , Pickering Amy J. 
Published: December 2020

AbstractBackgroundThe proportion of infections among young children that are antimicrobial-resistant is increasing across the globe. Newborns may be colonized with enteric antimicrobial-resistant pathogens early in life, which is a risk factor for infection-related morbidity and mortality. Breastfeeding is actively promoted worldwide for its beneficial impacts on newborn health and gut health. However, the role of breastfeeding and human milk components in mitigating young children’s carriage of antimicrobial-resistant pathogens and antibiotic resistance genes has not been comprehensively explored.Main bodyHere, we review how the act of breastfeeding, early breastfeeding, and/or human milk components, such as the milk microbiota, secretory IgA, human milk oligosaccharides, antimicrobial peptides, and microRNA -bearing extracellular vesicles, could play a role in preventing the establishment of antimicrobial-resistant pathogens in young children’s developing gut microbiomes. We describe findings from recent human studies that support this concept.ConclusionGiven the projected rise in global morbidity and mortality that will stem from antimicrobial-resistant infections, identifying behavioral or nutritional interventions that could decrease children’s susceptibility to colonization with antimicrobial-resistant pathogens may be one strategy for protecting their health. We suggest that breastfeeding and human milk supplements deserve greater attention as potential preventive measures in the global effort to combat antimicrobial resistance, particularly in low- and middle-income settings.
Early detection of cholera epidemics to support control in fragile states: estimation of delays and potential epidemic sizes
Authors: Ratnayake Ruwan , Finger Flavio , Edmunds W. John , Checchi Francesco 
Published: December 2020

Abstract
Background
Cholera epidemics continue to challenge disease control, particularly in fragile and conflict-affected states. Rapid detection and response to small cholera clusters is key for efficient control before an epidemic propagates. To understand the capacity for early response in fragile states, we investigated delays in outbreak detection, investigation, response, and laboratory confirmation, and we estimated epidemic sizes. We assessed predictors of delays, and annual changes in response time.

Methods
We compiled a list of cholera outbreaks in fragile and conflict-affected states from 2008 to 2019. We searched for peer-reviewed articles and epidemiological reports. We evaluated delays from the dates of symptom onset of the primary case, and the earliest dates of outbreak detection, investigation, response, and confirmation. Information on how the outbreak was alerted was summarized. A branching process model was used to estimate epidemic size at each delay. Regression models were used to investigate the association between predictors and delays to response.

Results
Seventy-six outbreaks from 34 countries were included. Median delays spanned 1–2 weeks: from symptom onset of the primary case to presentation at the health facility (5 days, IQR 5–5), detection (5 days, IQR 5–6), investigation (7 days, IQR 5.8–13.3), response (10 days, IQR 7–18), and confirmation (11 days, IQR 7–16). In the model simulation, the median delay to response (10 days) with 3 seed cases led to a median epidemic size of 12 cases (upper range, 47) and 8% of outbreaks ≥ 20 cases (increasing to 32% with a 30-day delay to response). Increased outbreak size at detection (10 seed cases) and a 10-day median delay to response resulted in an epidemic size of 34 cases (upper range 67 cases) and < 1% of outbreaks < 20 cases. We estimated an annual global decrease in delay to response of 5.2% (95% CI 0.5–9.6, p = 0.03). Outbreaks signaled by immediate alerts were associated with a reduction in delay to response of 39.3% (95% CI 5.7–61.0, p = 0.03).

Conclusions
From 2008 to 2019, median delays from symptom onset of the primary case to case presentation and to response were 5 days and 10 days, respectively. Our model simulations suggest that depending on the outbreak size (3 versus 10 seed cases), in 8 to 99% of scenarios, a 10-day delay to response would result in large clusters that would be difficult to contain. Improving the delay to response involves rethinking the integration at local levels of event-based detection, rapid diagnostic testing for cluster validation, and integrated alert, investigation, and response.
Effects of collagen fiber addition on the combustion and thermal stability of natural rubber
Authors: Xu Weixing , Wu Xintao , Wen Qilin , Li Shuangyang , Song Yongjiao , Shi Bi 
Published: December 2020

AbstractCollagen fiber (CF) and silane coupling agent-modified collagen fiber (MCF) were used as flame retardant filler for natural rubber (NR) modification. The combustion phenomena and properties of composites blended with different dosages of CF or MCF were compared to elucidate the flame retardant mechanism of the composites. The flame retardancy of NR can be enhanced effectively by increasing nitrogen content (the nitrogen content of CF is about 18%), creating air pockets, and structuring the flame retardant network in the composites. MCF failed to structure a flame retardant network in the composite, indicating that its modification effects of MCF are weaker than those of CF. When CF dosage was 30 wt%, the composite can achieve the best flame retardancy, with limited oxygen index of 29.4% and without smoke and dripping during burning. This study demonstrated a new method for the flame retardant modification of NR.Graphical abstract
Current trends in leather science
Authors: Covington Anthony D. , Wise William R. 
Published: December 2020

AbstractIn preparing the second edition of ‘Tanning Chemistry. The Science of Leather.’, the literature was updated and the content was revised and reviewed. Here, the new findings are presented and discussed.Notable developments include the necessary rethinking of the mechanism of sulfide unhairing because of new understanding of the aqueous chemistry of sulfide species. Revision upwards of the value of the second pKa for sulfide species ionisation means that S2−cannot exist in an aqueous medium, so the unhairing species in hair burn reactions is HS−. Although the technology remains the same, this means the mechanisms of associated reactions such as immunisation must be revised.Rawstock preservation has benefitted from studies of the potential role of materials from plants which accumulate salt, but which also contribute terpene compounds. There is also further discussion on the continuing issue of chromium (VI) in the leather industry.The application to processing of new solvents, ionic liquids and deep eutectics, is the coming technology, which offers transforming options for new chemistries and products. Renewed interest in vegetable tanning and methods of wet white processing are current trends. Also, within the topic of reagent delivery is processing in a solid medium of plastic beads.Graphical abstract
Identification of primary copy number variations reveal enrichment of Calcium, and MAPK pathways sensitizing secondary sites for autism
Authors: Agarwala Swati , Veerappa Avinash M. , Ramachandra Nallur B. 
Published: December 2020

Abstract
Background
Autism is a neurodevelopmental condition with genetic heterogeneity. It is characterized by difficulties in reciprocal social interactions with strong repetitive behaviors and stereotyped interests. Copy number variations (CNVs) are genomic structural variations altering the genomic structure either by duplication or deletion. De novo or inherited CNVs are found in 5–10% of autistic subjects with a size range of few kilobases to several megabases. CNVs predispose humans to various diseases by altering gene regulation, generation of chimeric genes, and disruption of the coding region or through position effect. Although, CNVs are not the initiating event in pathogenesis; additional preceding mutations might be essential for disease manifestation. The present study is aimed to identify the primary CNVs responsible for autism susceptibility in healthy cohorts to sensitize secondary-hits. In the current investigation, primary-hit autism gene CNVs are characterized in 1715 healthy cohorts of varying ethnicities across 12 populations using Affymetrix high-resolution array study. Thirty-eight individuals from twelve families residing in Karnataka, India, with the age group of 13–73 years are included for the comparative CNV analysis. The findings are validated against global 179 autism whole-exome sequence datasets derived from Simons Simplex Collection. These datasets are deposited at the Simons Foundation Autism Research Initiative (SFARI) database.

Results
The study revealed that 34.8% of the subjects carried 2% primary-hit CNV burden with 73 singleton-autism genes in different clusters. Of these, three conserved CNV breakpoints were identified with ARHGAP11B, DUSP22, and CHRNA7 as the target genes across 12 populations. Enrichment analysis of the population-specific autism genes revealed two signaling pathways—calcium and mitogen-activated protein kinases (MAPK) in the CNV identified regions. These impaired pathways affected the downstream cascades of neuronal function and physiology, leading to autism behavior. The pathway analysis of enriched genes unravelled complex protein interaction networks, which sensitized secondary sites for autism. Further, the identification of miRNA targets associated with autism gene CNVs added severity to the condition.

Conclusion
These findings contribute to an atlas of primary-hit genes to detect autism susceptibility in healthy cohorts, indicating their impact on secondary sites for manifestation.
Anorectal anomalies in the male: revisiting the radiological classification
Authors: AbouZeid Amr Abdelhamid , Mohammad Shaimaa Abdelsattar , Ibrahim Sherif Elhussiny , ElDieb Leila Rawash 
Published: December 2020

Abstract
Background
Classifying anorectal anomalies (ARA) has always been a matter of debate among pediatric surgeons. A new classification does not necessarily imply discarding older ones. Several concepts have been introduced in the past and stood the test of time being still valid up till now
In this report, we present our experience in managing a group of boys with ARA by PSARP. We have tried to enhance the current classification to include information about the level of the rectum in relation to sacrum, not just the location of the fistula.

Results
The study included 62 consecutive male patients with anorectal anomalies who underwent PSARP between 2009 and 2019. Included cases were either recto-bulbar fistula (21 cases), recto-prostatic fistula (30 cases), or imperforate anus without fistula (11 cases). Their age at operation ranged from 3 to 36 months (mean 7.8 months).
Cases with recto-prostatic fistula were further subclassified according to the level of distal rectum into two subgroups: (type 1) those with the rectum ending opposite the level of S4/S5, and (type 2) those with the rectum ending at a higher level opposite S3.
The PSARP procedure proved to be a successful surgical approach to reach, separate, and mobilize the rectum in all cases of recto-bulbar fistula, imperforate anus without fistula, and recto-prostatic fistula type (1). In cases of recto-prostatic fistula type (2), the perineal approach (PSARP) failed to reach and mobilize the rectum in two out of the eleven cases.

Conclusion
In management of anorectal anomalies, the sacrum can provide two important indicators: a prognostic value for continence, and anatomical landmark to stratify the level of distal rectum in the pelvis which is crucial for planning the best surgical approach.
Repeat Adrenal Vein Sampling in Aldosteronism: Reproducibility and Interpretation of Persistently Discordant Results
Authors: Kline Gregory A , Leung Alexander Ah-Chi , Sam Davis , Chin Alex , So Benny 
Published: December 2020

Abstract

Context
The reproducibility of adrenal vein sampling (AVS) is unknown.

Objective
This work aimed to determine reproducibility of biochemical results and diagnostic lateralization in patients undergoing repeat AVS.

Methods
A retrospective chart review was conducted of single-center, single-operator AVS procedures at a tertiary care center. Included were patients with confirmed primary aldosteronism (PA) undergoing repeat AVS because of concerns about technical success or discordant diagnostic results. Simultaneous AVS was performed by an experienced operator using a consistent protocol of precosyntropin and postcosyntropin infusion. Among successfully catheterized adrenal veins (selectivity index ≥ 2), the correlation of the adrenalaldosterone/cortisol (A/C) ratio was measured between the first and second AVS. The secondary outcome measure was diagnostic agreement on repeat AVS lateralization (lateralization index ≥ 3).

Results
There were 46 sets of AVS from 23 patients at a median of 3 months apart. There was moderate correlation in A/C ratios in the adrenal veins and inferior vena cava (Spearman r = 0.49-0.59, P &lt; .05) pre cosyntropin. Post cosyntropin, the correlation was better (Spearman r = 0.67-0.76, P &lt; .05). In technically successful AVS, there was moderate correlation between the repeated lateralization indices (Spearman r = 0.53, P &lt; .05). In 15 patients in whom repeat AVS was performed because of apparent lateralization discordance with computed tomography imaging, the final diagnosis was the same in the second AVS procedure. Initial failed AVS was successful 75% of the time on repeat attempt.

Conclusion
Repeat AVS was feasible and usually successful when an initial attempt failed. There was modest correlation between individual repeat adrenal A/C ratios and lateralization indices when AVS was performed twice. The final lateralization diagnosis was identical in all cases. This demonstrates that AVS is a reliable and reproducible localizing test in PA.
Derivation and internal validation of a data-driven prediction model to guide frontline health workers in triaging children under-five in Nairobi, Kenya
Authors: Mawji Alishah , Akech Samuel , Mwaniki Paul , Dunsmuir Dustin , Bone Jeffrey , Wiens Matthew O. , Görges Matthias , Kimutai David , Kissoon Niranjan , English Mike , Ansermino Mark J. 
Published: December 2020

Background: Many hospitalized children in developing countries die from infectious diseases. Early recognition of those who are critically ill coupled with timely treatment can prevent many deaths. A data-driven, electronic triage system to assist frontline health workers in categorizing illness severity is lacking. This study aimed to develop a data-driven parsimonious triage algorithm for children under five years of age. Methods: This was a prospective observational study of children under-five years of age presenting to the outpatient department of Mbagathi Hospital in Nairobi, Kenya between January and June 2018. A study nurse examined participants and recorded history and clinical signs and symptoms using a mobile device with an attached low-cost pulse oximeter sensor. The need for hospital admission was determined independently by the facility clinician and used as the primary outcome in a logistic predictive model. We focused on the selection of variables that could be quickly and easily assessed by low skilled health workers. Results: The admission rate (for more than 24 hours) was 12% (N=138/1,132). We identified an eight-predictor logistic regression model including continuous variables of weight, mid-upper arm circumference, temperature, pulse rate, and transformed oxygen saturation, combined with dichotomous signs of difficulty breathing, lethargy, and inability to drink or breastfeed. This model predicts overnight hospital admission with an area under the receiver operating characteristic curve of 0.88 (95% CI 0.82 to 0.94). Low- and high-risk thresholds of 5% and 25%, respectively were selected to categorize participants into three triage groups for implementation. Conclusion: A logistic regression model comprised of eight easily understood variables may be useful for triage of children under the age of five based on the probability of need for admission. This model could be used by frontline workers with limited skills in assessing children. External validation is needed before adoption in clinical practice.
PROJETO DE EXTENSÃO DIÁLOGOS URBANOS NO TERRITÓRIO PAULO FREIRE: POLÍTICAS PÚBLICAS E CONSTRUÇÃO DO DIREITO À CIDADE
Authors: Castro Amanda , Da Costa Bernardo Leonardo , Silveira Custódio Maike , Ricardo Guadagnin Mário , Cabral Eugênio Thainá , De Moura da Cunha Yasmine , Silva de Valentim Vinicius , Ferrazzo Débora 
Published: December 2020

A gestão ambiental no espaço urbano ocorre na interface ambiente natural/ambiente construído, e apropriação do espaço, na transformação da paisagem, na identidade com o lugar, no exercício de poder, no território e suas novas territorialidades. O projeto “Diálogos Urbanos no Território Paulo Freire – políticas públicas e construção do direito à cidade” discute o espaço urbano e seus processos de gestão, tendo o fator ambiental como elo de religação das pessoas com o espaço habitado, ou concebido, percebido e vivido para o resgate das relações dialógicas homem/ambiente na reflexão das ações e reações das territorialidades construídas no Bairro Cidade Mineira, na periferia de Criciúma, SC, Brasil. Na busca de caminhos para resolver e amenizar as situações vivenciadas de vulnerabilidades sociais do bairro, o projeto utiliza metodologias participativas. Isto envolve atividades de integração e troca de saberes entre Universidade e Sociedade; a mobilização dos participantes em torno de processos de construção de mecanismos e estratégias participativas que permitam o desenvolvimento da identidade territorial; o diagnóstico e mapeamento dos problemas ambientais e sociais percebidos e vividos pela comunidade; a contribuição na busca de soluções e a consolidação das políticas públicas ambientais urbanas. As atividades são realizadas com encontros quinzenais, por meio de oficinas e rodas de conversas voltadas para diálogos e debates com problematização e levantamento de questões socioambientais percebidas pelos moradores do bairro em metodologias participativas e dinâmicas de grupo, tais como: linha do tempo, diagnóstico rápido participativo, muro das lamentações, árvore dos sonhos, atividades e exposições com resgate histórico do processo de construção e reprodução do espaço urbano. A comunidade por meio da participação e integração ao longo dos encontros, atinge um novo nível de empoderamento, territorialidade e exercício de poder sobre o espaço urbano que possibilita a autonomia comunitária e socioambiental.
Relato de experiência: projeto Planeta Azul numa escola municipal de Lavras – MG
Authors: Tavares Antônio Gilmar Carvalho , Soares da Silva Sabrina 
Published: December 2020

As questões socioambientais estão cada vez mais em pauta nos ambientes escolares. Portanto, este trabalho busca relatar uma experiência em educação ambiental, ao ar livre, com crianças, realizada no Parque Ecológico Quedas do Rio Bonito (PEQRB), envolvendo o Projeto Planeta Azul e uma escola municipal no município de Lavras – Minas Gerais. Ressalta-se a abrangência do termo Educação Ambiental (EA) e a importância de se trabalhar esse tema com atividades pedagógicas interdisciplinares e ações concretas. As atividades aconteceram em dois momentos distintos: sendo o primeiro dia, na escola, e o segundo, no Parque Ecológico quedas do Rio Bonito. O objetivo desse relato é descrever a experiência vivenciada nos dias de atividade que abordaram Educação Ambiental ao ar livre, por intermédio do projeto Planeta Azul. Participaram das atividades 120 estudantes de ambos os sexos com a idade entre oito e nove anos, alunos do terceiro ano do ensino fundamental. Tive a oportunidade de participar do projeto como extensionista, no dia de visita ao parque, proporcionando aos alunos jogos, brincadeiras e desafios em meio à natureza, contribuindo para a experimentação prática e formação cidadã das crianças. Além disso, a experiência permitiu conhecer como a Educação Ambiental está sendo trabalhada dentro e fora da instituição escolar.