bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preparation of hospitals for mass casualty incidents in Bavaria, Germany: care capacities for penetrating injuries and explosions in TerrorMASCALs
Authors: Thies Nina , Zech Alexandra , Kohlmann Thorsten , Biberthaler Peter , Bayeff-Filloff Michael , Kanz Karl-Georg , Prückner Stephan 
Published: October 2021

Abstract
Background
In a terror attack mass casualty incident (TerrorMASCAL), compared to a “normal” MASCAL, there is a dynamic course that can extend over several hours. The injury patterns are penetrating and perforating injuries. This article addresses the provision of material and personnel for the care of special injuries of severely injured persons that may occur in the context of a TerrorMASCAL.

Methods
To answer the research question about the preparation of hospitals for the care of severely injured persons in a TerrorMASCAL, a survey of trauma surgery departments in Bavaria (Germany) was conducted using a questionnaire, which was prepared in three defined steps based on an expert consensus. The survey is divided into a general, neurosurgical, thoracic, vascular and trauma surgery section. In the specialized sections, the questions relate to the implementation of and material and personnel requirements for special interventions that are required, particularly for injury patterns following gunshot and explosion injuries, such as trepanation, thoracotomy and balloon occlusion of the aorta.

Results
In the general section, it was noted that only a few clinics have an automated system to notify off-duty staff. When evaluating the data from the neurosurgical section, the following could be established with regard to the performance of trepanation: the regional trauma centers do not perform trepanation but nevertheless have the required material and personnel available. A similar result was recorded for local trauma centers. In the thoracic surgery section, it could be determined that almost all trauma centers that do not perform thoracotomy have the required material available. This group of trauma centers also stated that they have staff who can perform thoracotomy independently. The retrograde endovascular aortic occlusion procedure is possible in 88% of supraregional, 64% of regional and 10% of local trauma centers. Pelvic clamps and external fixators are available at all trauma centers.

Conclusion
The results of the survey show potential for optimization both in the area of framework conditions and in the care of patients. Consistent and specific training measures, for example, could improve the nationwide performance of these special interventions. Likewise, it must be discussed whether the abovementioned special procedures should be reserved for higher-level trauma centers.
Determinant factors of under-five mortality in Southern Nations, Nationalities and People’s region (SNNPR), Ethiopia
Authors: Gobebo Gizachew 
Published: October 2021

Abstract
Background
Child mortality is a key indicator of the performance of the health system of a nation. Impressive progress in the reduction of under-five mortality has been made in Ethiopia. However, still there are some regions where the under-five mortality rates are high. Southern Nations, Nationalities, and Peoples’ Region (SNNPR) is among those regions in Ethiopia with high under-five mortality rates. This study aimed to identify the determinant factors of under-five mortality in SNNPR.

Methods
Data used for the study were drawn from the 2016 EDHS. A total of 1277 under-five children were included in the study. A multivariable logistic regression model was fitted to identify determinant factors associated with under-five mortality.

Results
Children with second or third birth order (OR = 1.316, 95% CI: (1.097, 2.343)), fourth or fifth birth order (OR = 1.934, 95% CI: (1.678, 3.822)), sixth or above birth order (OR = 3.980, 95% CI: (2.352, 6.734)) were significantly associated with increased risk of under-five mortality as compared to those with first birth order. Increased risk of under-five mortality was also significantly associated with a family size of five or more (OR = 3.397, 95% CI: (1.702, 6.782)) as compared to the family size of less than five; smaller size at birth (OR = 1.714, 95% CI: (1.120, 2.623)) as compared to larger size at birth; multiple births (OR = 1.472, 95% CI: (1.289, 2.746)) as compared to singletons. On the other hand, female children (OR = 0.552, 95% CI: (0.327, 0.932)), children born at health institutions (OR = 0.449, 95% CI: (0.228, 0.681)) and children who were breastfed (OR = 0.657, 95% CI: (0.393, 0.864)) were significantly associated with decreased risk of under-five mortality as compared to male children, those born at home and those who were not breastfed respectively.

Conclusions
Sex of a child, birth order, size of a child at birth, place of delivery, birth type, breastfeeding status, and family size were significant factors associated with under-five mortality in SNNPR, Ethiopia. Thus, planning and implementing relevant strategies that focus on those identified determinant factors of under-five mortality is required for the improvement of child survival in SNNPR, Ethiopia.
Adjuvant SOX chemotherapy versus concurrent chemoradiotherapy after D2 radical resection of locally advanced esophagogastric junction (EGJ) adenocarcinoma: study protocol for a randomized phase III trial (ARTEG)
Authors: Shen Jinwen , Zhu Xiu , Du Yian , Zhu Yuan , Yu Pengfei , Yang Litao , Xu Zhiyuan , Huang Ling , Zhang Yunli , Zhang Yanqiang , Liu Luying , Cheng Xiangdong 
Published: October 2021

Abstract
Background
Survival benefit of adjuvant radiotherapy for locally advanced gastric cancer following gastrectomy plus D2 lymphadenectomy has always been controversial. Esophagogastric junction (EGJ) adenocarcinoma, which is usually classified as gastric cancer in East Asia, often has a higher locoregional recurrence rate after operation because of its special anatomical characteristics. The aim of this study is to determine whether adjuvant radiotherapy can improve survival of locally advanced EGJ adenocarcinoma after D2 radical resection.

Methods
In this phase III, randomized, open label, controlled trial, we plan to recruit 378 patients with Siewert type II and III adenocarcinoma of EGJ, who had undergone transabdominal radical surgery and D2 lymphadenectomy, and were divided into pathological stage IIB to IIIC. All patients will be randomized 1:1 to receive either adjuvant chemotherapy alone (control group) or adjuvant chemotherapy plus chemoradiotherapy (experimental group). Patients allocated to control group will receive eight cycles of S-1 plus oxaliplatin (SOX), while the experimental group will receive two cycles of SOX followed by 45-Gy RT combined with S-1 and four additional cycles of SOX. The primary endpoint is 3-year disease-free survival rate (DFS). The secondary endpoints are 3-year overall survival rate (OS), 3-year locoregional recurrence-free survival rate (LRFS), 3-year distant metastasis-free survival rate (DMFS), and quality of life (QoL).

Discussion
In the past, the adjuvant treatment of EGJ adenocarcinoma needs to draw on the experience of esophageal adenocarcinoma or gastric adenocarcinoma. In this study, EGJ adenocarcinoma is considered as an independent disease, and the conclusion will provide evidence for optimal adjuvant therapy of locally advanced EGJ adenocarcinoma after D2 radical resection.

Trial registration
ClinicalTrials.govNCT03973008. Registered on 1 June 2019 (retrospectively registered), URL: https://clinicaltrials.gov/ct2/show/NCT03973008?term=NCT03973008&draw=2&rank=1
Efficacy and safety of thread embedding acupuncture for facial expression muscles atrophy after peripheral facial paralysis: study protocol for a randomized controlled trial
Authors: Yu Binyan , Xuan Lihua , Jin Yutong , Chen Shan , Liu Shan , Wan Yijia 
Published: November 2021

AbstractBackgroundFacial expression muscles atrophy is one kind of sequelae after peripheral facial paralysis. It causes critical problems in facial appearance of patient as well as social and psychological problems. This study aims to evaluate the efficacy and safety of Thread-embedding acupuncture (TEA) for the management of facial expression muscles atrophy after peripheral facial paralysis.MethodsThis is a patient-assessor blinded, randomized, sham-controlled trial. A total of fifty-six eligible patients will be randomly divided into TEA (n=28) and sham TEA (STEA) (n=28) groups. Both groups will receive TEA or STEA treatment at the frontal muscle and the depressor anguli oris muscle, at one predefined points once a week for eight weeks. Additionally, both groups will receive traditional acupuncture treatment at ten acupoints (GB20, LI4, LR3, GB12, ST7, SI18, LI20, BL2, SJ23, ST4) twice a week for eight weeks as a concurrent treatment. B-mode ultrasonography will be used to assess the changes in facial expression muscle thickness ratio of the affected/healthy side at baseline and at 10 weeks after screening, as the primary outcome. House-Brackmann Grade and lip mobility score will be measured and analyzed at baseline and 4, 8, 10, and 12 weeks after screening, as secondary outcomes.DiscussionThe study will compare TEA with sham TEA to explore the feasibility for TEA in improving facial expression muscles atrophy after peripheral facial paralysis.Trial registrationChinese Clinical Trial Registry, ChiCTR1900027170. Registered on 3 November 2019,http://www.chictr.org.cn/edit.aspx?pid=45173&htm=4
Is antibiotic treatment effective in the management of chronic low back pain with disc herniation? Study protocol for a randomised controlled trial
Authors: Urquhart Donna M. , Rosenfeld Jeffrey V. , van Tulder Maurits , Wluka Anita E. , Leder Karin , Cheng Allen C. , Forbes Andrew B. , Chan Patrick , O’Sullivan Richard , Liew Susan , Cicuttini Flavia M. 
Published: October 2021

Abstract
Background
There has been immense interest and debate regarding the effectiveness of antibiotic treatment for chronic low back pain. Two randomised controlled trials have examined the efficacy of antibiotics for chronic low back pain with disc herniation and Modic changes, but have reported conflicting results. The aim of this double-blind, randomised, placebo-controlled trial is to determine the efficacy of antibiotic treatment in a broader patient subgroup of chronic low back pain with disc herniation and investigate whether the presence of Modic changes predicts response to antibiotic therapy.

Methods
One hundred and seventy individuals with chronic low back pain will be recruited through hospital and private medical and allied health clinics; advertising in national, community and social media; and posting of flyers in community locations. They will be randomly allocated to receive either amoxicillin-clavulanate (500 mg/125 mg) twice per day for 90 days or placebo. The primary outcome measure of pain intensity will be assessed using the Low Back Pain Rating scale and a 100-mm visual analogue scale at 12 months. Secondary measures of self-reported low back disability and work absence and hindrance will also be examined, and an economic analysis will be conducted. Intention-to-treat analyses will be performed.

Discussion
There is uncertainty about whether antibiotic treatment is effective for chronic low back pain and, if effective, which patient subgroup is most likely to respond. We will conduct a clinical trial to investigate the efficacy of antibiotics compared with placebo in individuals with chronic low back pain and a disc herniation. Our findings will provide high-quality evidence to assist in answering these questions.

Trial registration
Australian New Zealand Clinical Trials Registry ACTRN12615000958583. Registered on 11 September 2015
Insulin-like growth factor-1 in articular cartilage repair for osteoarthritis treatment
Authors: Wen Caining , Xu Limei , Xu Xiao , Wang Daping , Liang Yujie , Duan Li 
Published: October 2021

AbstractArticular cartilage repair is a critical issue in osteoarthritis (OA) treatment. The insulin-like growth factor (IGF) signaling pathway has been implicated in articular cartilage repair. IGF-1 is a member of a family of growth factors that are structurally closely related to pro-insulin and can promote chondrocyte proliferation, enhance matrix production, and inhibit chondrocyte apoptosis. Here, we reviewed the role of IGF-1 in cartilage anabolism and catabolism. Moreover, we discussed the potential role of IGF-1 in OA treatment. Of note, we summarized the recent progress on IGF delivery systems. Optimization of IGF delivery systems will facilitate treatment application in cartilage repair and improve OA treatment efficacy.
Effect of the internet combined with exercise-based individualized nursing intervention in patients with gestational diabetes mellitus
Authors: Chen Yaer , Qiu Chunbo , Chen Jie , Li Lu , Xu Jichao , Sheng Zhiren 
Published: October 2021

Abstract
Background
Gestational diabetes mellitus (GDM) is the most frequent medical complication of pregnancy. This condition is manifested by glucose intolerance resulting in hyperglycemia of variable severity during pregnancy. One of the most important clinical tools for efficiently regulating maternal blood glucose is strictly monitoring blood glucose levels. However, due to a lack of appropriate intervention tools, managing the occurrence of GDM is still unfeasible. This study aimed to determine clinical efficacy of the internet combined with exercise-based individualized nursing intervention in patients with gestational diabetes mellitus (GDM).

Methods
In total, 139 patients with GDM were divided into two groups, with 79 patients in the observation group (internet combined with exercise-based individualized nursing intervention) and 60 patients in the control group (routine nursing intervention only). The two groups were given specified nursing intervention for 8 weeks and then compared for changes in their blood glucose, blood lipids, blood pressure, insulin resistance (IR), and rate of adverse pregnancy outcomes. Additionally, the psychological state was analyzed, and their nursing satisfaction with the care from nurses that they received was investigated before and after the nursing intervention.

Results
Compared with the control group, the following indices of the observation group were lowered: blood glucose-related indices (FBG and 2 h PG), blood lipids and blood pressure associated indices (TG, TC, and HbA1c, DBP, SBP, and MAP), and IR-related indices (FINS, 2 h INS, and HOMA -IR) (all P < 0.05). The observation group also showed a lower rate of adverse pregnancy outcomes than the control group (7.59% vs. 20.00%; P < 0.05). In addition, SAS and SDS scores of the observation group were both lower than the control group (P < 0.05). Accordingly, the nursing satisfaction score also displayed that the observation group (93.67%) had a higher satisfaction outcome than the control group (76.67%; P < 0.05).

Conclusions
Internet combined with exercise-based individualized nursing intervention in GDM patients can effectively improve their blood glucose, IR, and psychological status, thus significantly improving their pregnancy outcomes and mental condition.
Global, regional, and national prevalence of diabetes mellitus in patients with pulmonary tuberculosis: a systematic review and meta-analysis
Authors: Li Minmin , Chen Tao , Hua Zhongqiu , Yan Hong , Wang Duolao , Li Zhaoqing , Kang Yijun , Zhu Ni , Li Chao 
Published: October 2021

Abstract
Background
Both pulmonary tuberculosis (PTB) and diabetes mellitus (DM) are major global public health problems. We estimated the global, regional, and national prevalence of diabetes mellitus in a population with PTB.

Methods
We searched for observational studies of DM in people with PTB using the PubMed and Embase electronic bibliographic databases, focusing on articles published in the English language from database inception until March 31, 2021. We included original research that reported the prevalence of DM in PTB or those that had sufficient data to compute these estimates. Studies were excluded if they did not provide primary data or were case studies or reviews. Two authors independently extracted the articles and collected detailed information using a predefined questionnaire. A country-specific random-effects meta-analysis was used for countries with two or more available studies, and a fractional response regression model was employed to predict the prevalence of DM in PTB for countries with one or no study. The study was registered with the International Prospective Register of Systematic Reviews, using the registration number CRD42018101989.

Results
We identified 22,658 studies, and 153, across 51 countries, were retained for data extraction. The global prevalence of DM among patients with PTB was estimated to be 13.73% (95% confidence interval [CI] 12.51–14.95). The prevalence rates were 19.32% (95% CI 13.18–25.46) in the region of the Americas, 17.31% (95% CI 12.48–22.14) in the European region, 14.62% (95% CI 12.05–17.18) in Southeast Asia, 13.59% (95% CI 7.24–19.95) in the western Pacific region, 9.61% (95% CI 4.55–14.68) in the eastern Mediterranean region, and 9.30% (95% CI 2.83–15.76) in the African region. The country with the highest estimated prevalence was the Marshall Islands (50.12%; 95% CI 4.28–95.76).

Conclusion
Comorbid PTB and DM remain prevalent worldwide.
Single cell Raman spectroscopy to identify different stages of proliferating human hepatocytes for cell therapy
Authors: Ma Chen , Zhang Ludi , He Ting , Cao Huiying , Ren Xiongzhao , Ma Chenhui , Yang Jiale , Huang Ruimin , Pan Guoyu 
Published: October 2021

Abstract
Background
Cell therapy provides hope for treatment of advanced liver failure. Proliferating human hepatocytes (ProliHHs) were derived from primary human hepatocytes (PHH) and as potential alternative for cell therapy in liver diseases. Due to the continuous decline of mature hepatic genes and increase of progenitor like genes during ProliHHs expanding, it is challenge to monitor the critical changes of the whole process. Raman microspectroscopy is a noninvasive, label free analytical technique with high sensitivity capacity. In this study, we evaluated the potential and feasibility to identify ProliHHs from PHH with Raman spectroscopy.

Methods
Raman spectra were collected at least 600 single spectrum for PHH and ProliHHs at different stages (Passage 1 to Passage 4). Linear discriminant analysis and a two-layer machine learning model were used to analyze the Raman spectroscopy data. Significant differences in Raman bands were validated by the associated conventional kits.

Results
Linear discriminant analysis successfully classified ProliHHs at different stages and PHH. A two-layer machine learning model was established and the overall accuracy was at 84.6%. Significant differences in Raman bands have been found within different ProliHHs cell groups, especially changes at 1003 cm−1, 1206 cm−1 and 1440 cm−1. These changes were linked with reactive oxygen species, hydroxyproline and triglyceride levels in ProliHHs, and the hypothesis were consistent with the corresponding assay results.

Conclusions
In brief, Raman spectroscopy was successfully employed to identify different stages of ProliHHs during dedifferentiation process. The approach can simultaneously trace multiple changes of cellular components from somatic cells to progenitor cells.
Stem cell-based therapy for ameliorating intrauterine adhesion and endometrium injury
Authors: Song Yu-Ting , Liu Peng-Cheng , Tan Jie , Zou Chen-Yu , Li Qian-Jin , Li-Ling Jesse , Xie Hui-Qi 
Published: October 2021

AbstractIntrauterine adhesion refers to endometrial repair disorders which are usually caused by uterine injury and may lead to a series of complications such as abnormal menstrual bleeding, recurrent abortion and secondary infertility. At present, therapeutic approaches to intrauterine adhesion are limited due to the lack of effective methods to promote regeneration following severe endometrial injury. Therefore, to develop new methods to prevent endometrial injury and intrauterine adhesion has become an urgent need. For severely damaged endometrium, the loss of stem cells in the endometrium may affect its regeneration. This article aimed to discuss the characteristics of various stem cells and their applications for uterine tissue regeneration.
Mesenchymal stem cells-derived exosomes for drug delivery
Authors: Sun Yao , Liu Guoliang , Zhang Kai , Cao Qian , Liu Tongjun , Li Jiannan 
Published: October 2021

AbstractExosomes are extracellular vesicles secreted by various cells, mainly composed of lipid bilayers without organelles. In recent years, an increasing number of researchers have focused on the use of exosomes for drug delivery. Targeted drug delivery in the body is a promising method for treating many refractory diseases such as tumors and Alzheimer's disease (AD). Finding a suitable drug delivery carrier in the body has become a popular research today. In various drug delivery studies, the exosomes secreted by mesenchymal stem cells (MSC-EXOs) have been broadly researched due to their immune properties, tumor-homing properties, and elastic properties. While MSC-EXOs have apparent advantages, some unresolved problems also exist. This article reviews the studies on MSC-EXOs for drug delivery, summarizes the characteristics of MSC-EXOs, and introduces the primary production and purification methods and drug loading methods to provide solutions for existing problems and suggestions for future studies.
srBERT: automatic article classification model for systematic review using BERT
Authors: Aum Sungmin , Choe Seon 
Published: October 2021

AbstractBackgroundSystematic reviews (SRs) are recognized as reliable evidence, which enables evidence-based medicine to be applied to clinical practice. However, owing to the significant efforts required for an SR, its creation is time-consuming, which often leads to out-of-date results. To support SR tasks, tools for automating these SR tasks have been considered; however, applying a general natural language processing model to domain-specific articles and insufficient text data for training poses challenges.MethodsThe research objective is to automate the classification of included articles using the Bidirectional Encoder Representations from Transformers (BERT) algorithm. In particular, srBERT models based on the BERT algorithm are pre-trained using abstracts of articles from two types of datasets, and the resulting model is then fine-tuned using the article titles. The performances of our proposed models are compared with those of existing general machine-learning models.ResultsOur results indicate that the proposed srBERTmymodel, pre-trained with abstracts of articles and a generated vocabulary, achieved state-of-the-art performance in both classification and relation-extraction tasks; for the first task, it achieved an accuracy of 94.35% (89.38%), F1 score of 66.12 (78.64), and area under the receiver operating characteristic curve of 0.77 (0.9) on the original and (generated) datasets, respectively. In the second task, the model achieved an accuracy of 93.5% with a loss of 27%, thereby outperforming the other evaluated models, including the original BERT model.ConclusionsOur research shows the possibility of automatic article classification using machine-learning approaches to support SR tasks and its broad applicability. However, because the performance of our model depends on the size and class ratio of the training dataset, it is important to secure a dataset of sufficient quality, which may pose challenges.