bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative Risk Stratification for Early Recurrence of HBV-related Hepatocellular Carcinoma After Deceased Donor Liver Transplantation:A Five-Eight Model Development and Validation
Authors: Al-Ameri Abdulahad Abdulrab Mohammed , Wei Xuyong , Lin Lidan , Shao Zhou , Guo Haijun , Xie Haiyang , Zhou Lin , Zheng Shusen , Xu Xiao 
Published: October 2019

Abstract
Background
Early recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) is associated with poor surgical outcomes.
Objectives
To construct a preoperative model to predict individual risk of post-LT HCC recurrence.
Methods
Data of 748 adult patients who underwent deceased donor LT for HCC between January 2015, and February 2019 were collected retrospectively from the China Liver Transplant Registry database and randomly divided into training (n=486) and validation(n=262) cohorts. A multivariate analysis was performed and the five-eight model was developed.
Results
A total of 748 patients were included in the study; of them, 96% had hepatitis B virus (HBV) and 84 % had cirrhosis. Pre-LT serum alpha-fetoprotein (AFP), tumor number and largest tumor diameter were incorporated to construct the 5-8 model which can stratify patients accurately according to their risk of recurrence into three prognostic subgroups; low-(0-5 points), medium-(6–8 points) and high-risk (>8 points) with 2-year post-LT recurrence rate of (5%,20% and 51%,p<0.001) respectively.The 5-8 model was better than Milan, Hangzhou, and AFP-model for prediction of HCC early recurrence. These findings were confirmed by the results of the validation cohort.
Conclusions
The 5-8 model is a simple validated and accurate tool for preoperative stratification of early recurrence of HCC after LT.
Diagnosis of tuberculosis from smear-negative presumptive TB cases using Xpert MTB/Rif assay: a cross-sectional study from Nepal
Authors: Khadka Priyatam , Thapaliya Januka , Basnet Ramesh Bahadur , Ghimire Gokarna Raj , Amatya Jyoti , Rijal Basista Parsad 
Published: October 2019

Abstract
Background
In most developing countries, smear-negative pulmonary TB (SNPT) often gets missed from the diagnosis of consideration, though it accounts 30-65% of total PTB cases, due to deficient or inaccessible molecular diagnostic modalities.
Methods
The cross-sectional study enrolled 360 patients with clinical-radiological suspicion of SNPT in Tribhuvan University Teaching Hospital (TUTH). The patient selection was done as per the algorithm of Nepal’s National Tuberculosis Programme (NTP) for Xpert MTB/RIF testing. Participants’ demographic and clinical information were collected using a pre-tested questionnaire. The specimens were collected, processed directly for Xpert MTB/RIF test according to the manufacturer’s protocol. The same samples were stained using the Ziehl-Neelsen technique then observed microscopically. Both findings were interpreted; rifampicin-resistant, if obtained, on Xpert testing was confirmed with a Line Probe Assay.
Result
Of 360 smear-negative sputum samples analyzed, 85(23.61%) found positive while 3(0.8%) of them were rifampicin resistance. The infection was higher in males, i.e. 60(25.3%) compared to female 25(20.3%). The age group, >45(nearly 33%) with median age 42± 21.5, were prone to the infection. During the study period, 4.6% (515/11048) sputum samples were reported as smear-positive in TUTH. Consequently, with Xpert MTB/RIF assay, the additional case 16.5% (n=85/515) from smear-negative presumptive TB cases were detected. Among the most occurring clinical presentations, cough and chest pain were positively associated with SNPT. While upper lobe infiltrates (36.4%) and pleural effusion (40.4%) were the most peculiar radiological impression noted in PTB patient. 94 multi-drug resistant(MDR) suspected cases were enrolled; of total suspects, 29(30.8%) samples were rifampicin sensitive, 1(1.06%) indeterminant, 3(3.19%) rifampicin-resistant while remaining of them were negative. 2(2.2%) MDR cases were recovered from the patient with a previous history of ATT, of total 89 previously treated cases enrolled However, a single rifampicin-resistant from the new suspects.
Conclusion
With an application of the assay, the additional cases, missed with smear microscopy, could be sought and exact incidence of the diseases could be revealed.
Keywords: Xpert MTB/Rif assay, Mycobacterium tuberculosis, Line Probe Assay, MDR-TB, smear-negative
The Oxidoreductase DsbA1 negatively influences 2,4-diacetylphloroglucinol biosynthesis by interfering the function of Gcd in Pseudomonas fluorescens 2P24
Authors: Zhang Bo , Zhao Hui , Wu Xiaogang , Zhang Li-Qun 
Published: October 2019

Abstract
The polyketide antibiotic 2,4-diacetylphloroglucinol (2,4-DAPG), produced by Pseudomonas fluorescens 2P24, is positively regulated by the GacS-GacA two-component system. Here we reported on the characterization of DsbA1 (disulfide oxidoreductase) as novel regulator of biocontrol activity in P. fluorescens . Our data showed that mutation of dsbA1 caused the accumulation of 2,4-DAPG in a GacA-independent manner. Further analysis indicated that DsbA1 interacts with membrane-bound glucose dehydrogenase Gcd, which positively regulates the production of 2,4-DAPG. Mutation of cysteine (C)-235, C275, and C578 of Gcd, significantly reduced the interaction with DsbA1, enhanced the activity of Gcd and increased 2,4-DAPG production. Taken together, our results suggest that DsbA1 regulates the 2,4-DAPG concentration via fine-tuning the function of Gcd in P. fluorescens 2P24.
Evaluation of the Effect of Mouth Gag Application on Ultrasonographic Optic Nerve Sheath Diameter of Pediatric Patients Undergoing Tonsillectomy or Adenotonsillectomy: Observational study
Authors: ALTIPARMAK Basak , Toker Melike Korkmaz , UYSAL Ali Ihsan , KOSEOGLU Sabri , Demirbilek Semra Gumus 
Published: October 2019

Abstract
Background: Mouth gag is usually used during Adeno/tonsillectomy surgeries, cleft palate repair, obstructive sleep apnea surgery and intraoral tumor excision. The placement of gag causes hemodynamic changes similar to laryngoscopy. The aim of this study is to evaluate the effect of mouth gag placement on optic nerve sheath diameter (ONSD) of pediatric patients. The secondary aim is to assess the relationship between neck extension for positioning of head and increase in ONSD measurement. Methods: The trial is registered to Australian New Zealand Clinical Trials Registry with Trial ID: ACTRN12618000551291. This prospective, observational study was performed in a tertiary university hospital operating theatre between 01.05.2018-01.07.2018. Thirty-five children aged < 18 years, with ASA I status, and scheduled for adeno/tonsillectomy surgeries were prospectively included in the study. Measurements of ONSD were performed (T0) after induction of anesthesia, (T1) after endotracheal intubation, (T2) after the placement of mouth gag and (T3) 20 minutes after the placement of mouth gag. The degree of neck extension was assessed by the angle between the Frankfort plane and horizontal plane of the operation table in natural position Results: All participants completed the study. There were significant differences in ONSD values according to time (p < 0.001). The maximum increase in ONSD values was detected after intubation (0.69±0.06 mm) and immediately after mouth gag placement (0.67±0.07 mm). ONSD values continued to increase 20 minutes after the gag placement. There was no relation between degree of neck extension and ONSD values (b = 0.63, p=0.715) Conclusions: Mouth gag application causes significant increases in ONSD measurements of children. Therefore, the duration of mouth gag application during surgeries might be limited. Trial registration: The trial is registered to Australian New Zealand Clinical Trials Registry with Trial ID: ACTRN12618000551291.
Treatment Outcome of Severe Acute Malnutrition and associated factors among under-five children in outpatient therapeutics unit in Gubalafto Wereda, North Wollo Zone, Amara Regional State, North Ethiopia, 2019 G.C
Authors: Abate Biruk Beletew , Dress Befkad , Kassie Ayelign Mengesha , Kassaw Mesifn Wudu 
Published: October 2019

Abstract
Background: In Ethiopia uncomplicated severe acute malnutrition is managed through the outpatient therapeutic program at health posts level. This brings the services for the management of Severe Acute Malnutrition closer to the community by making services available at decentralized treatment points within the primary health care settings. So far, evidence on the treatment outcome of the program is limited. Thus, the main aim of this study was to determine the magnitude of treatment outcomes of severe acute malnutrition and associated factors among under-five children at outpatient therapeutic feeding units. Methods: This was a retrospective cohort study conducted on 600 children who had been managed for SAM under OTP in Gubalafto Wereda from April to May/2019. The children were selected using systematic random sampling from 9 health posts. The structured, pre-tested and adapted questionnaire was used to collect the data. The data was entered by using EPI-data Version 4.2 and exported to SPSS version 24.0 for analysis. Bivariate and Multivariate regression was also carried out to determine the association between dependent and independent variables. Results: A total of 600 records of children with a diagnosis of severe acute malnutrition were reviewed. Of these cases of malnutrition, the recovery rate was revealed as 65 %. The death rate, default rate, and medical transfer were 2.0, 16.0, and 17.0 respectively. Children who took immunization were had 6.85 times higher odds of recovery than children who were not immunized (AOR=6.85 at 95% CI (3.68-12.76)). The likelihood of recovery was 3.78 times higher among children with new admission than those with re-admission (AOR=3.78at 95% CI ((1.77-8.07))). Likewise, children provided with amoxicillin were 3.38 times more likely to recover compared to their counterparts who were not provided (AOR=3.38 at 95% CI ((1.61-7.08))). Conclusions: The recovery rate and medical transfer were lower than sphere standard. Presence of cough, presence of diarrhea admission category, provision of amoxicillin, and immunization status were factors identified as significantly associated with treatment outcome of Sever Acute Malnutrition. Building capacity of OTP service providers and regular monitoring of service provision based on the management protocol were recommended.
Gender Disparities in the Relationship between Education and Self-Reported Health Across Cohorts in China
Authors: Zhu Bowen , Ye Yiwan 
Published: October 2019

Abstract
Background: Variation in the relationship between education and health has been studied intensely over the past few decades. Although there is abundant research on gender disparity and cohort variations in the relationship between education and health, based on samples from the U.S. and Europe, research about China is limited. Giventhe specificsocial changes in China, the study is designed to analyze the gender difference and cohort variations in the education-health relationship.Method: Longitudinal, nationwide data from the Chinese Family Panel Studies from the years 2010 to 2016 are statistically analyzed. Self-reported health is measured by respondents’ subjective assessment of their health. The highest level of education earned operationalizes the education measure. Each cohort is defined by a distinct period of social change in China. The age-vector model is used to analyze gender and cohort variations in the association between education and self-rated health. Results: Men report better health than women, but the relationship between education and health for women is stronger than for men. Educational gaps in self-rated health do not change significantly for cohorts before 1955 and cohorts after 1977, but the gaps become stronger for cohorts between 1956 and 1976. There is gender disparity within the cohort variations in the education-health relationship. For women, the education-health relationship in the 1956-1960, 1967-1976 and 1977-1983 cohorts is significantly stronger than for the 1908-1938 cohort. While not as strong, the education-health relationship remains consistent across all cohorts for men. Conclusions: The study findings support the resource substitution hypothesis and not the rising importance hypothesis in China. Considering the findings on gender disparity and difference in cohort effects, we discuss the potential influences of the unique social transformation and educational expansion in China.
Differences and diversity of autoimmune-mediated encephalitis in 77 cases from a single tertiary care center
Authors: Saraya Abhinbhen Wasontiwong , Worachotsueptrakun Kanthita , Vutipongsatorn Kritchai , Sonpee Chanikarn , Hemachudha Thiravat 
Published: October 2019

Abstract
Background
The incidence of autoimmune encephalitis has risen globally. There are two general categories of disease-associated antibodies that can be tested for: neuronal surface and intracellular. However, testing both groups of autoantibodies are costly. This study aims to identify differences between groups by comparing clinical presentations, radiological findings and CSF profile of patients, and determine if any parameters are indicative of one group of autoantibodies over another. Additionally, we aim to report the local incidence of less common groups of disease-associated antibodies as well.
Methods
77 records of autoimmune encephalitis/encephalomyelitis patients admitted to King Chulalongkorn Memorial Hospital, Bangkok, Thailand, between October 2010 and February 2017 were reviewed. Patients with infections or those with classic central nervous system demyelinating features were excluded.
Results
Of 77 patients, 40% presented with neuronal surface antibodies and 33% had intracellular antibodies. The most common autoantibody detected in each group was anti-NMDAr antibody (25/31, 81%) and anti-Ri antibody (7/25, 28%) respectively. In the neuronal surface antibody group, behavioral change was the most common complaint (45%), followed by seizures (39%) and abnormal movements (29%). In the latter group, seizure was the most common presenting symptom (32%), followed by motor weakness (20%), behavioural change (16%) and abnormal movements (16%). Patients with neuronal surface antibodies were younger (35 vs 48 years old, p=0.04) and more likely to present with behavioral change (45% vs 16%, p=0.02). Mortality rate was higher in the intracellular group (16% vs 3.2%, p=0.09). No differences were detected in magnetic resonance imaging (MRI) and CSF profile.
Conclusions
In the early stages of the disease, both groups have comparable clinical outcomes. Although there were significant differences in age and percentage of patients with behavioral change, both groups of autoimmune encephalitis still shared many clinical features and could not be distinguished based on MRI and CSF profiles. Therefore, we recommend that patients with features of autoimmune encephalitis should be screened for both the neuronal surface and intracellular antibodies regardless of clinical presentation.
The effects of anesthesia induction and positive pressure ventilation on right-ventricular function: An echocardiography-based prospective observational study
Authors: Magunia Harry , Jordanow Anne , Keller Marius , Rosenberger Peter , Nowak-Machen Martina 
Published: October 2019

Abstract
Background:
General anesthesia induction with the initiation of positive pressure ventilation creates a vulnerable phase for patients. The impact of positive intrathoracic pressure on cardiac performance has been studied but remains controversial. 3D echocardiography is a valid and MRI-validated bed-side tool to evaluate the right ventricle (RV). The aim of this study was to assess the impact of anesthesia induction (using midazolam, sufentanil and rocuronium, followed by sevoflurane) with positive pressure ventilation (PEEP 5, tidal volume 6 – 8 ml/kg) on 2D and 3D echocardiography derived parameters of RV function.
Methods:
A prospective observational study on fifty-three patients undergoing elective cardiac surgery in a tertiary care university hospital was designed. Transthoracic echocardiography exams were performed before and immediately after anesthesia induction and were recorded together with hemodynamic parameters and ventilator settings.
Results:
After anesthesia induction TAPSE (mean difference -1.6mm (95% CI -2.6mm to -0.7mm; p=0.0013) as well as the Tissue Doppler derived tricuspid annulus peak velocity (TDITVs’) were significantly reduced (mean difference -1.9% (95% CI: -2.6 to -1.2; p<0.0001), but global right ventricular ejection fraction (RVEF; p=0.1607) and right ventricular stroke volume (RVSV; p=0.1838) did not change.
Conclusions:
This data shows a preserved right ventricular ejection fraction and right ventricular stroke volume after anesthesia induction and initiation of positive pressure ventilation. However, the baso-apical right ventricular function is significantly reduced. Larger studies are needed in order to determine the clinical impact of these findings especially in patients presenting with impaired right ventricular function before anesthesia induction.
Trial registration:
Retrospecitvely registered, 6 th June 2016, ClinicalTrials.gov Identifier NCT02820727.
Analyzing the Maximum Likelihood Score Estimation Method with Fences in ca-MST
Authors: ŞAHİN Melek Gülşah , BOZTUNÇ ÖZTÜRK Nagihan 
Published: October 2019

New statistical methods are being added to the
literature as a result of scientific developments each and every day. This
study aims at investigating one of these, Maximum Likelihood Score Estimation
with Fences (MLEF) method, in ca-MST. The results obtained from this study will
contribute to both national and international literature since there is no such
study on the applicability of MLEF method in ca-MST. In line with the aim of
this study, 48 conditions (4 module lengths (5-10-15-20) x 2 panel designs
(1-3; 1-3-3) x 2 ability distribution (normal-uniform) x 3 ability estimation
methods (MLEF-MLE-EAP) were simulated and the data obtained from the simulation
were interpreted with correlation, RMSE and AAD as an implication of
measurement precision; and with conditional bias calculation in order to show
the changes in each ability level. This study is a post-hoc simulation study
using the data from TIMSS 2015 at the 8th grade in mathematics. “xxIRT” R
package program and MSTGen simulation software tool were used in the study. As
a result, it can be said that MLEF, as a new ability estimation method, is
superior to MLE method in all conditions.
EAP estimation method gives the best results in terms of the measurement
precision based on correlation, RMSE and AAD values, whereas the results gained
via MLEF estimation method are pretty close to those in EAP estimation method.
MLE proves to be less biased in ability estimation, especially in extreme
ability levels, when compared to EAP ability estimation method.
Spatial and temporal pattern of extreme temperature during 1961–2018 in China
Authors: Liu Xiaowan , Xu Zongxue 
Published: October 2019

AbstractAs extreme climate events in China occur frequently, the characteristics of temperature extremes have changed substantially. Spatial and temporal pattern in the selected temperature extreme indices was analyzed by using the Mann–Kendall method (MK), sliding t-test and standard t-test, and Pearson correlation analysis method. In addition, the relationship between them and AO/NAO (Arctic Oscillation/North Atlantic Oscillation) was investigated during 1961–2018 in mainland China. The results show regional and seasonal pattern in temperature extremes. Both ELTs (extreme low temperatures) and EHTs (extreme high temperatures) show increasing trend in autumn and winter, but decreasing trend in spring and summer. In particular, ELTs in all northern basins have more significant increasing trend, while EHTs in the southern areas show insignificant or even decreasing trend. The AO plays an important role in the change of ELTs in summertime (summer and autumn), while the NAO accounts for it during wintertime (winter and spring). Moreover, the NAO is partly responsible for the change of EHTs.
Melamchi water supply project: potential to replenish Kathmandu's groundwater status for dry season access
Authors: Chinnasamy Pennan , Shrestha Surendra Raj 
Published: October 2019

Abstract
Kathmandu Upatyaka Khanepani Limited (KUKL) currently uses 35 surface and 57 groundwater sources to supply water for Nepal's capital, Kathmandu. It is necessary to understand if the Melamchi Water Supply Project (MWSP) can assist lean period water supply by indirectly increasing groundwater storage, through diverting excess water supply to groundwater recharge zones. The current study analyzed long-term groundwater depletion to assess available groundwater storage, followed by assessment of groundwater balance for the Kathmandu Valley. Results show that total groundwater extraction for Kathmandu was 69.44 million cubic meters (MCM) and drawdown of the groundwater surface was 15–20 m since the construction of wells in 1984/85, indicating substantial overexploitation. Results indicate that the ongoing unmet demand of 170 MCM/year can be easily satisfied if groundwater storage is recharged effectively, as underground water storage potential is 246 MCM/year due to a groundwater depletion rate of 2–10 m. From results, it is evident that that the timely implementation of the MWSP can help ease ongoing water stress and aid in reversing the damage caused to groundwater storage. In the long run, MWSP can supply water and recharge groundwater during monsoon periods, thus improving the quality of life and socio-economic status in Kathmandu.
Evolving artificial intelligence techniques to model the hydrate-based desalination process of produced water
Authors: Sadi Maryam , Fakharian Hajar , Ganji Hamid , Kakavand Majid 
Published: October 2019

Abstract
In this study, two artificial intelligence models based on an adaptive neuro-fuzzy inference system (ANFIS) and a support vector machine (SVM) technique have been successfully developed to predict the desalination efficiency of produced water through a hydrate-based desalination treatment process. A genetic algorithm as an evolutionary optimization method has been used to determine the optimal values of SVM model coefficients. To this end, compressed natural gas and CO2 hydrate formation experiments were carried out, and the desalination efficiency of produced water was measured and utilized for model training and validation. After model development, graphical and statistical analysis approaches have been applied to evaluate the performance of suggested models by a comparison of model predictions with measured experimental data. For the ANFIS model, the coefficient of determination (R2) and average absolute relative error (AARE) are 0.9927 and 0.58%, respectively. The values of AARE and R2 for the SVM model are obtained 0.35% and 0.9985, respectively. These statistical criteria confirm excellent accuracy and robustness of intelligent models in predicting the desalination efficiency of produced water through the hydrate-based desalination treatment process. Furthermore, the Leverage statistical technique has been carried out to define the outliers. The obtained results demonstrate that all experimental data are reliable and both ANFIS and SVM models are statistically valid.