bluuebunny/crossref_metadata_2025_split huggingface dataset:
Is increased mortality by multiple exposures to COVID-19 an overseen factor when aiming for herd immunity?
Authors: Helle Kristina Barbara , Sadiku Arlinda , Zelleke Girma Mesfin , Ibrahim Toheeb Babatunde , Bouba Aliou , Tsoungui Obama Henri Christian , Appiah Vincent , Ngwa Gideon Akumah , Teboh-Ewungkem Miranda Ijang , Schneider Kristan Alexander 
Published: July 2021

Background
Governments across the globe responded with different strategies to the COVID-19 pandemic. While some countries adopted measures, which have been perceived controversial, others pursued a strategy aiming for herd immunity. The latter is even more controversial and has been called unethical by the WHO Director-General. Inevitably, without proper control measures, viral diversity increases and multiple infectious exposures become common, when the pandemic reaches its maximum. This harbors not only a potential threat overseen by simplified theoretical arguments in support of herd immunity, but also deserves attention when assessing response measures to increasing numbers of infection.

Methods and findings
We extend the simulation model underlying the pandemic preparedness web interface CovidSim 1.1 (http://covidsim.eu/) to study the hypothetical effect of increased morbidity and mortality due to ‘multi-infections’, either acquired at by successive infective contacts during the course of one infection or by a single infective contact with a multi-infected individual. The simulations are adjusted to reflect roughly the situation in the USA. We assume a phase of general contact reduction (“lockdown”) at the beginning of the epidemic and additional case-isolation measures. We study the hypothetical effects of varying enhancements in morbidity and mortality, different likelihoods of multi-infected individuals to spread multi-infections and different susceptibility to multi-infections in different disease phases. It is demonstrated that multi-infections lead to a slight reduction in the number of infections, as these are more likely to get isolated due to their higher morbidity. However, the latter substantially increases the number of deaths. Furthermore, simulations indicate that a potential second lockdown can substantially decrease the epidemic peak, the number of multi-infections and deaths.

Conclusions
Enhanced morbidity and mortality due to multiple disease exposure is a potential threat in the COVID-19 pandemic that deserves more attention. Particularly it underlines another facet questioning disease management strategies aiming for herd immunity.
Trends in COVID-19 case-fatality rates in Brazilian public hospitals: A longitudinal cohort of 398,063 hospital admissions from 1st March to 3rd October 2020
Authors: Zimmermann Ivan Ricardo , Sanchez Mauro Niskier , Frio Gustavo Saraiva , Alves Layana Costa , Pereira Claudia Cristina de Aguiar , Lima Rodrigo Tobias de Sousa , Machado Carla , Santos Leonor Maria Pacheco , Silva Everton Nunes da 
Published: July 2021

Background
Almost 200,000 deaths from COVID-19 were reported in Brazil in 2020. The case fatality rate of a new infectious disease can vary by different risk factors and over time. We analysed the trends and associated factors of COVID-19 case fatality rates in Brazilian public hospital admissions during the first wave of the pandemic.

Methods
A retrospective cohort of all COVID-19-related admissions between epidemiological weeks 10–40 in the Brazilian Public Health System (SUS) was delimited from available reimbursement records. Smoothing time series and survival analyses were conducted to evaluate the trends of hospital case fatality rates (CFR) and the probability of death according to factors such as sex, age, ethnicity, comorbidities, length of stay and ICU use.

Results
With 398,063 admissions and 86,452 (21.7%) deaths, the overall age-standardized hospital CFR trend decreased throughout the period, varying from 31.8% (95%CI: 31.2 to 32.5%) in week 10 to 18.2% (95%CI: 17.6 to 18.8%) in week 40. This decreasing trend was observed in all sex, age, ethnic groups, length of stay and ICU admissions. Consistently, later admission (from July to September) was an independent protective factor. Patients 80+ year old had a hazard ratio of 8.18 (95% CI: 7.51 to 8.91). Ethnicity, comorbidities, and ICU need were also associated with the death risk. Although also decreasing, the CFR was always around 40–50% in people who needed an ICU admission.

Conclusions
The overall hospital CFR of COVID-19 has decreased in Brazilian public hospitals during the first wave of the pandemic in 2020. Nevertheless, during the entire period, the CFR was still very high, suggesting the need for improving COVID-19 hospital care in Brazil.
Percutaneous hepatic melphalan perfusion: Single center experience of procedural characteristics, hemodynamic response, complications, and postoperative recovery
Authors: Struck Manuel Florian , Kliem Peter , Ebel Sebastian , Bauer Alice , Gössmann Holger , Veelken Rhea , van Bömmel Florian , Dennecke Timm , Stehr Sebastian N. , Girrbach Felix F. 
Published: July 2021

Background
Percutaneous hepatic melphalan perfusion (PHMP) for the selective treatment of hepatic metastases is known to be associated with procedural hypotension and coagulation disorders. Studies on anesthetic management, perioperative course, complications, and postoperative recovery in the intensive care unit (ICU) have not been published.

Methods
In a retrospective observational study, we analyzed consecutive patients who were admitted for PHMP over a 6-year period (2016–2021). Analyses included demographic, treatment, and outcome data with regard to short-term complications until ICU discharge.

Results
Fifty-three PHMP procedures of 16 patients were analyzed. In all of the cases, procedure-related hypotension required the median (range) highest noradrenaline infusion rate of 0.5 (0.17–2.1) μg kg min-1 and fluid resuscitation volume of 5 (3–14) liters. Eighty-four PHMP-related complications were observed in 33 cases (62%), of which 9 cases (27%) involved grade III and IV complications. Complications included airway constriction (requiring difficult airway management), vascular catheterization issues (which resulted in the premature termination of PHMP, as well as to the postponement of PHMP and to the performance of endovascular bleeding control after PHMP), and renal failure that required hemodialysis. Discharge from the ICU was possible after one day in most cases (n = 45; 85%); however, in 12 cases (23%), prolonged mechanical ventilation was required. There were no procedure-related fatalities.

Conclusions
PHMP is frequently associated with challenging cardiovascular conditions and complications that require profound anesthetic skills. For safety reasons, PHMP should only be performed in specialized centers that provide high-level hospital infrastructures and interdisciplinary expertise.
Repeatability and agreement of white-to-white measurements between slit-scanning tomography, infrared biometry, dual rotating Scheimpflug camera/Placido disc tomography, and swept source anterior segment optical coherence tomography
Authors: Buckenham Boyle Alexander , Namkung Soobin , Shew William , Gokul Akilesh , McGhee Charles N. J. , Ziaei Mohammed 
Published: July 2021

Purpose
To assess the agreement and repeatability of horizontal visible iris diameter (HVID) or white-to-white (WTW) measurements between four imaging modalities; combination slit scanning elevation/Placido tomography, infrared biometry, dual rotating scheimpflug camera/Placido tomography, and swept source anterior segment optical coherence tomography (AS-OCT).

Methods
A prospective study of 35 right eyes of healthy volunteers were evaluated using the Orbscan IIz, IOL Master 700, Galilei G2, and DRI Triton OCT devices. The inter-device agreement and repeatability of HVID/WTW measurements for each device were analysed.

Results
Mean HVID/WTW values obtained by the Orbscan IIz, IOL Master 700, Galilei G2 and DRI Triton OCT were 11.77 ± 0.40 mm, 12.40 ± 0.43 mm, 12.25 ± 0.42 mm, and 12.42 ± 0.47 mm, respectively. All pairwise comparisons revealed statistically significant differences in mean HVID/WTW measurements (p = <0.01) except for the IOL Master 700—DRI OCT Triton pair (p = 0.56). Mean differences showed that the DRI Triton OCT produced the highest HVID/WTW values, followed by the IOL Master 700, Galilei G2 and Orbscan IIz, respectively. The limits of agreement were large on all device pairs. There was high repeatability for all devices (ICC ≥ 0.980). The highest repeatability was seen in the Galilei G2 (ICC = 0.995) and lowest in the Orbscan IIz (ICC = 0.980).

Conclusions
The four devices exhibit high repeatability, but should not be used interchangeably for HVID/WTW measurements in clinical practice.
Incidence, predictors, and outcomes of DAPT non-compliance in planned vs. ad hoc PCI in chronic coronary syndrome
Authors: Malik Jahanzeb , Yousaf Husnain , Abbasi Waleed , Hameed Nouman , Mohsin Muhammad , Shahid Abdul Wahab , Fatima Mahnoor 
Published: July 2021

Objective
The disruption of dual antiplatelet therapy (DAPT) causes more adverse events after percutaneous coronary intervention (PCI). However, incidence and predictors of DAPT non-compliance are unknown in chronic coronary syndrome patients when compared between planned and ad hoc PCI.

Methods
This investigation was aimed to assess the incidence, predictors, outcomes, and primary mode of non-compliance of DAPT in patients with chronic coronary syndrome undergoing their first PCI. We analyzed the patients between planned (group 1) and ad hoc (group 2) PCI.

Results
There were a total of 628 participants in this investigation (370 were in planned PCI and 270 in the ad hoc PCI group). Out of 628 patients, by one month, 10% left DAPT in planned PCI group and 19.7% in ad hoc PCI group (aOR: 0.451, 95% CI: 0.285–0.713, p = 0.001). At 12 months, DAPT non-compliance was significantly more in ad hoc PCI group (52.7% vs. 47.8%; aOR: 0.647 95% CI: 0.470–0.891, p = 0.008). Age > 65 years (p < 0.001), low education status (p = 0.012), residents of rural areas (p < 0.001), ad hoc PCI group (p = 0.036), and angina class II (p = 0.038) were predictors for DAPT non-compliance in this cohort.

Conclusion
Approximately 5 out of 10 patients disrupt DAPT due to non-compliance. This investigation provides an insight on additional predictors of non-compliance to DAPT, helping us to identify and address specific patient-related factors for disruption.
Risk Evaluation Factor of Health Promotion Medical Insurance: An Analysis Focusing on Cost of Telematics and Policyholder’s Coverage Selection
Authors: Suzawa Yoshihiko 
Published: July 2021

AbstractThis study aims to demonstrate the effect of the cost of telematics and loss ratio improvement on the coverage demand for health promotion medical insurance. Real-time monitoring via telematics is expected to alleviate moral hazard of insured persons through the “analogical experience rating system,” resulting in a decreased claim cost and an improved loss ratio. In reality, however, the real-time monitoring on a continuous basis imposes a cost burden on insurers and thus, certain expense loadings apply to insurance premiums. The analysis based on the modified separating market equilibrium model reveals that people tend to opt for partial insurance coverage, and high-risk individuals even stay uninsured unless the expense loadings are not excessive. This result implies that the demand for health promotion medical insurance can decrease, and may conduce a market shrinkage, unless the improvement of loss ratio sufficiently surpasses the cost of telematics utilization.
Relationship of Gensini score with retinal vessel diameter and arteriovenous ratio in senile CHD
Authors: Wang Ning , Liang Changsen 
Published: July 2021

Abstract

Background
This study aimed to find the correlation of Gensini score with retinal vessel diameter and arteriovenous ratio in elderly patients with coronary heart disease (CHD).

Methods
This study included 120 senile CHD patients as the CHD group and 100 healthy individuals as the normal group (NG). Gensini score was used to evaluate the severity of coronary artery lesions. Central retinal artery equivalents (CRAE), central retinal venular equivalents (CRVE), and arteriovenous ratio (AVR) were measured.

Results
CHD group has lower CRAE and AVR than NG, while higher CRVE was observed in NG. CRAE and AVR in UAP (unstable angina pectoris) and AMI (acute myocardial infarction) groups showed reduction (stable angina pectoris); however, enhanced CRVE and Gensini scores in UA and AMI groups were observed as compared to the SAP group. CRAE and AVR in moderate and severe groups were reduced to a greater extent compared to the mild groups, while enhanced CRVE and Gensini scores were observed more often in the severe group than the mild group. CRAE and AVR were negatively correlated with the Gensini score; however, CRVE was positively correlated with the Gensini score.

Conclusion
AVR is expected to be a noninvasive index to diagnose and predict senile CHD, which has a certain evaluation value. Diabetes, smoking history, and TC are independent risk factors of senile CHD.
Sulfoquinovose metabolism in marine algae
Authors: Scholz Sabine , Serif Manuel , Schleheck David , Sayer Martin D.J. , Cook Alasdair M. , Küpper Frithjof Christian 
Published: July 2021

Abstract
This study aimed to survey algal model organisms, covering phylogenetically representative and ecologically relevant taxa. Reports about the occurrence of sulfonates (particularly sulfoquinovose, taurine, and isethionate) in marine algae are scarce, and their likely relevance in global biogeochemical cycles and ecosystem functioning is poorly known. Using both field-collected seaweeds from NW Scotland and cultured strains, a combination of enzyme assays, high-performance liquid chromatography and matrix-assisted laser-desorption ionization time-of-flight mass spectrometry was used to detect key sulfonates in algal extracts. This was complemented by bioinformatics, mining the publicly available genome sequences of algal models. The results confirm the widespread presence of sulfonates and their biosynthetic pathways in macro- and microalgae. However, it is also clear that catabolic pathways, if present, must be different from those documented from the bacterial systems since no complete cluster of gene homologues of key genes could be detected in algal genomes.
Vitamin D retesting by general practitioners: a factor and cost analysis
Authors: Scully Helena , Laird Eamon , Healy Martin , Crowley Vivion , Walsh James Bernard , McCarroll Kevin 
Published: July 2021

Abstract

Objectives
Vitamin D testing by Primary Care doctors is increasing, placing greater workloads on healthcare systems. There is little data though on vitamin D retesting in Ireland. This study aims to investigate the factors associated with vitamin D retesting by Irish General Practitioners (GPs) and examine the resulting costs.

Methods
This is a retrospective analysis over 5 years (2014–2018) of GP requested 25-hydroxyvitamin D (25(OH)D) results in 36,458 patients at a major city hospital in Dublin, Ireland. Those with one test were compared with individuals who were retested and samples categorised to determine changes in status between tests.

Results
Nearly one in four patients (n=8,305) were retested. Positive predictors of retesting were female (p<0.001), age (60–69 years, p<0.001), location (Co. Kildare, p<0.001) and initial deficiency (<30 nmol/L, p<0.001) or insufficiency (30–49.9 nmol/L, p<0.001). Vitamin D status improved on retesting, with deficiency halving on first retest (9 vs. 18%, p<0.001) and dropping to 6% on further retests. About 12.2% of retests were done within 3 months and 29% had ≥2 retests within 1 year. 57% of retests were in those initially vitamin D replete (>50 nmol/L). The annual cost of inappropriate testing was €61,976.

Conclusions
One in four patients were retested and this varied by age, gender and patient location. Over 10% of retests were inappropriately early (<3 months), a third too frequent and over half were in replete individuals incurring significant costs. Clear guidance for GPs on minimum retesting intervals is needed, as well as laboratory ordering systems to limit requests using pre-defined criteria.
Using Complete Monotonicity to Deduce Local Error Estimates for Discretisations of a Multi-Term Time-Fractional Diffusion Equation
Authors: Chen Hu , Stynes Martin 
Published: July 2021

Abstract
Time-fractional initial-boundary problems of parabolic type are considered. Previously, global error bounds for computed numerical solutions to such problems have been provided by Liao et al. (SIAM J. Numer. Anal. 2018, 2019) and Stynes et al. (SIAM J. Numer. Anal. 2017). In the present work we show how the concept of complete monotonicity can be combined with these older analyses to derive local error bounds (i.e., error bounds that are sharper than global bounds when one is not close to the initial time

t
=
0

{t=0}

). Furthermore, we show that the error analyses of the above papers are essentially the same – their key stability parameters, which seem superficially different from each other, become identical after a simple rescaling. Our new approach is used to bound the global and local errors in
the numerical solution of a multi-term time-fractional diffusion equation, using the L1 scheme for the temporal discretisation of each fractional derivative. These error bounds are α-robust. Numerical results show they are sharp.
Fleshing out Language and Intersubjectivity: An Exploration of Merleau-Ponty’s Legacy to Cognitive Linguistics
Authors: Sambre Paul 
Published: July 2021

Abstract
This paper examines how recent cognitive linguistic work on conceptualization and intersubjectivity (Verhagen 2005, 2008; Langacker 2008) echoes Merleau-Ponty’s older reflection on the notion of intersubjectivity, a key factor in embodiment and language. Three topics are explored in this respect. First, the largely implicit references to Merleau-Ponty in Lakoff and Johnson’s Philosophy in the Flesh (1999) are related more explicitly to Merleau-Ponty’s notion of flesh. Second, the discursive status of usage events is shown to be directly connected to the linguistic consequences of Merleau-Ponty’s intercorporality, as it brings together living bodies in intersubjective experiences. The third objective is methodological: the focus is not only on Merleau-Ponty’s often quoted Phenomenology of Perception 1945, 1958), but shows lines of continuity with the explicit philosophy of language in his later work, like Eloge de la philosophie (1960,1963), Signes (1960, 1968b), Conscience et acquisition du langage (1964, 1973a) and La prose du monde (1969, 1973b). This discussion includes Merleau’s relation to Saussurean linguistics, and gives rise, perhaps surprisingly, to a dynamic view on language as a locus of intersubjective creativity, which reaches beyond the individual basis of perception, gesture and incorporated language.
A Narrative of National Reform: Quanto vale ou é por quilo? (2005)
Authors: Gordon Richard A. 
Published: July 2021

Abstract

Quanto vale ou é por quilo? tells the story of two groups of characters: one that profits from the continued misery of much of the Brazilian population, and another that tries to expose and punish those in the private and political sectors who are responsible for such exploitation. By exploring parallels between a time marked by African slavery in Brazil and the presumably more illuminated present, the film attempts to lay bare a systemic social and economic disparity that continues to be intertwined with race. This article hypothesizes that the narrative locates the solution for some of the nation’s woes in the realm of social identity. More specifically, it argues that the film proposes that the country’s pernicious inequities are grounded in the perpetuation of nefarious and persistent attributes in understandings of Brazilianness among much of the population. If Brazil is to improve, the film advises, then prevailing definitions of the national group must be modified. Drawing on research in social psychology, and work in the area of cognitive approaches to literature and culture, this article seeks to decipher what sort of intervention on identity the film is making, and which of its elements might lead to influencing viewers’ social identities.
Emplotting Immigration: The Rhetoric of Border Narratives
Authors: Bancroft Corinne 
Published: July 2021

Abstract
Most everyone in the U.S. knows the stories told about illegal immigration, whether or not they subscribe to those stories. Right-wing narratives explain how ‘illegals’ or ‘aliens’ invade our country to ‘steal our jobs’ and ‘smuggle drugs’. Liberal narratives justify the illegal entrance of ‘desperately poor people’ who come here to feed their families. Patrick Hogan, in Understanding Nationalism, reveals the national and psychological purposes of such stories and explains how they are formed. This essay addresses the relationship between these national narratives and migrants’ actual experiences. As long-time volunteer of a humanitarian aid organization on the U.S./Mexico border, the author has heard stories about and witnessed the violence and death caused both by the desert and law enforcement. The more familiar narratives frame and consequently limit debate about the nation’s border enforcement policies, which force people to the most isolated desert areas where these atrocities occur. Through personal anecdotes about motivations for crossing and experiences in the desert, migrants offer critical stories that challenge standard emplotments, providing a new perspective on an apparently familiar problem.
Construction work cost and duration analysis with the use of agent-based modelling and simulation
Authors: Śladowski Grzegorz , Sroka Bartłomiej 
Published: July 2021

Abstract
Assuming a systemic approach, a construction project can be treated as a complex system composed of many different interlinked elements such as construction works, human agents, equipment, materials and the knowledge needed to perform the said work. The system’s structure can be divided into many mutually connected precision levels. This multilevel decomposition of the system facilitates a bottom-up approach in assessing the performance of a planned project, while starting the analysis at its lowest aggregation levels. The basic level distinguishes three typical units and their attributes: persons, knowledge and construction resources. Unit attributes and their dynamic interactions under changing environmental conditions affect the properties and performance of a given construction work and, as a consequence, the properties and performance of the project. The objective of this article is to analyse the attributes and micro-behaviours of units through bottom-up project assessment, allowing the estimation of its parameters such as completion time and cost. We utilised multiagent modelling that allows for performing micro-simulations in complex systems with adaptive components. The analysis was backed by a case study of road renovation work performed under specific conditions on the grounds of a listed heritage site.
Solvability for nonlocal boundary value problems with generalized 𝑝-Laplacian on an unbounded domain
Authors: Matyjasik Marek , Szymańska-Dȩbowska Katarzyna 
Published: July 2021

Abstract
This paper is devoted to the existence of solutions for a class of nonlinear boundary value problems with integral boundary conditions and generalized 𝑝-Laplacian on the positive half-line.
We establish sufficient conditions to guarantee the existence of solutions in a special function space by using Leray–Schauder-type arguments.
Examples are also given to illustrate the main results.