bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global Surgery indicators and pediatric hydrocephalus: a multicenter cross-country comparative study building the case for health systems strengthening
Authors: Ferraris Kevin Paul , Palabyab Eric Paolo , Kim Sergei , Matsumura Hideaki , Yap Maria Eufemia , Cloma-Rosales Venus Oliva , Letyagin German , Muroi Ai , Baticulon Ronnie , Alcazaren Jose Carlos , Seng Kenny , Navarro Joseph Erroll 
Published: April 2021

Abstract
Purpose: The aim of this study is to compare specific three-institution, cross-country data that are relevant to the Global Surgery indicators and the functioning of health systems. Methods: We retrospectively reviewed clinical and socioeconomic characteristics of pediatric patients who underwent CSF diversion surgery for hydrocephalus in three different centers: University of Tsukuba Hospital in Ibaraki, Japan (HIC), Jose R. Reyes Memorial Medical Center in Manila, Philippines (LMIC), and the Federal Neurosurgical Center in Novosibirsk, Russia (UMIC). The outcomes of interest were timing of CSF diversion surgery and mortality. Statistical tests included descriptive statistics, Cox proportional hazards model, and logistic regression. Nation-level data were also obtained to provide the relevant socioeconomic contexts in discussing the results. Results: In total, 159 children were included—13 from Japan, 99 from the Philippines, and 47 from the Russian Federation. The median time to surgery at the specific neurosurgical centers were 6 days in the Philippines and 1 day in both Japan and Russia. For the cohort from the Philippines, non-poor patients were more likely to receive CSF diversion surgery at an earlier time (HR=4.74, 95%CI 2.34–9.61, p<0.001). In the same center, those with infantile or post-hemorrhagic hydrocephalus (HR=3.72, 95%CI 1.70–8.15, p=0.001) were more likely to receive CSF diversion earlier compared to those with congenital hydrocephalus, and those with post-infectious (HR=0.39, 95%CI 0.22–0.70, p=0.002) or myelomeningocele-associated hydrocephalus (HR=0.46, 95%CI 0.22–0.95, p=0.037) were less likely to undergo surgery at an earlier time. For Russia, older patients were more likely to receive or require early CSF diversion (HR=1.07, 95%CI 1.01–1.14, p=0.035). EVD insertion was found to be associated with mortality (cOR 14.45, 95% CI 1.28–162.97, p = 0.031). Conclusion: In this study, Filipino children underwent late time-interval of CSF diversion surgery and had mortality differences compared to their Japanese and Russian counterparts. These disparities may reflect on the functioning of the respective country’s health systems.
Patients’ and Oncologists’ Perspectives On A Novel Clinician Led Fear of Cancer Recurrence (CIFeR) Intervention
Authors: Serafimovska Anastasia , Liu Jia , Beith Jane , Butow Phyllis 
Published: April 2021

Abstract
PurposeDespite strong demand from breast cancer survivors, there is a dearth of flexibly delivered, accessible psychological interventions addressing fear of cancer recurrence (FCR). This study aimed to explore patients’ and clinicians’ perspectives concerning the experience, utility and barriers to a novel clinician-led FCR intervention (CIFeR).MethodsTwenty female participants (Mean age; 59.8, SD = 11.43), diagnosed with early-stage breast cancer (mean years since diagnosis = 2.8, SD = 1.37 years) participated in telephone interviews, and their five oncologists completed a semi-structured electronic survey. Thematic qualitative analyses were performed on interview transcripts and survey responses.ResultsFindings indicated both patients and clinicians were positive about CIFeR with perceived cognitive, behavioural and emotional benefits of CIFeR most pronounced for patients with clinically significant FCR. All patients, however, found that receiving CIFeR (especially the tailored prognostic information) from their oncologists with whom they had a long-standing relationship, added a much-needed human element to addressing FCR. Similarly, clinicians valued CIFeR as a clear and consistent way to address unmet needs around FCR, with some barriers around time, language and cultural issues noted.ConclusionOverall, all participants perceived CIFeR as strongly beneficial in reducing FCR and related worries, thus warranting further evaluation of its utility in clinical practice.This study was prospectively registered on the 2nd of October, 2018 in the Australian New Zealand Clinical Trials Registry (ACTRN12618001615279).
Design and performance enhancement of a dense wavelength division multiplexing MIMO-FSO systems using DPPM and OOK modulation
Authors: Elsayed Ebrahim E. 
Published: April 2021

Abstract
In this paper, we design and analyze the dense wavelength division multiplexing (DWDM) in the multiple-input multiple-output (MIMO) free-space optical (FSO) communications system using the digital-pulse position modulation (DPPM) and on-off keying (OOK). We show the effects noises, interchannel crosstalk, and atmospheric turbulence for the proposed system in the weak and strong turbulence with the modulation techniques. DWDM channels suffer from the inter-channel crosstalk while the communication performance in an obviously limited by the MIMO-FSO caused by atmospheric scintillation. All Impairments, in addition to noises of the optical amplification which is emerged the amplified spontaneous emission and are likely to be problematic, particularly in the upstream direction, which are investigated, the results obtained a high enough crosstalk ratio can achieve access to high-capacity in a system network safe and human. DPPM is a more power efficient modulation and lower power penalty 0.2 ~ 0.3 dB from the OOK modulation.
Bridging the gap between Morphometric Similarity Mapping and gene transcription in Alzheimer's disease
Authors: Zhang Yang , Ma Min , Xie Zhonghua , Wu Heng , Zhang Nan , Shen Junlin 
Published: April 2021

Abstract
Disruptions of brain connectivity have been widely reported in Alzheimer's disease (AD). Morphometric similarity (MS) mapping provides a new way of estimating structural connectivity by inter-regional correlation of T1WI and DTI derived parameters within individual brains. Here, we aimed to identify AD-related MS changing patterns and genes related to the changes and further explore the molecular and cellular mechanism underlying MS changes in AD. Both 3D-T1WI and DTI data of 106 AD patients and well-matched 106 healthy elders from the ADNI database were included in our study. Cortical regions with significantly decreased MS were found in the temporal and parietal cortex, increased MS in the frontal cortex and variant changes in the occipital cortex in AD patients. Mean MS in regions with significantly changed MS was positively or negatively associated with memory function. The negative MS-related genes were significantly down-regulated in AD, specifically enriched in neurons, and participated in biological process with the most significant term in synaptic transmission. This study revealed AD-related cortical MS changes associated with memory function. Linking gene expression to cortical MS changes may provide a possible molecular and cellular substrate for MS abnormality and cognition decline in AD.
Prevalence and associated factors of acute diarrhea among under five children living in Hargeisa IDPs, Somaliland
Authors: Mohamed Ahmed Ismail , Abdilahi Mohamed Mussa 
Published: April 2021

Abstract
Background: In developing countries, diarrhea is the major cause for child death when children are less than five years’ old. Dehydration, malnutrition, delayed physical development and early childhood mortality are the major consequences of diarrheal diseases. In Somaliland, diarrheal diseases have been endemic and a major problem since 1994, with epidemics occurring annually. Objective: The aim of this study was to assess prevalence and risk factors of acute diarrhea among under five children living in Hargeisa IDPs, SomalilandMethods: A community based cross sectional study was conducted among mothers of under five children from August to September, 2020, in Hargeisa IDPs. 383 mothers were selected by using single population proportional formula. Data was entered, cleaned and analyzed using SPSS version 22. To explore association between variables, bivariate logistic regression was done for each independent variable with the dependent variable and those variables with a p-value of < 0.05 were adjusted into multivariate logistic regression. Finally, those variables having a P value < 0.05 were recognized as determinants of acute diarrheal disease.Results: The prevalence of diarrhea among under five children ling in Hargeisa IDPs was 51%. The children whose age older than one year [AOR= 3.586, 95% CI, 1.054, 12.196], didn’t breastfed exclusively [AOR= 4.006, 95% CI, 3.274, 4.596], didn’t met colostrum milk [AOR= 36.41, 95% CI, 24.312, 40.489], drinks water stored in Jerry-cans [AOR = 4.901 95% CI, 1.306, 8.387] and poorly practices hand washing [A0R = 5.739, 95% CI, 1.382, 7.822] were more likely to develop diarrhea than their respective contraparts. Conclusion: From this study we concluded that the prevalence of was very high (51%). Lack of awareness of exclusive breastfeeding and colostrum feeding, storing drinking water in unprotected container and poor hand washing practice were identified to be significance predictors for childhood diarrhea (P < 0.05).
Real-World Clinical Burden and Economic Assessment Associated with Hyperkalaemia in a Large Integrated Healthcare System: A Retrospective Analysis
Authors: Muhlestein Joseph B. , Kammerer Jennifer , Bair Tami L. , Knowlton Kirk U. , Le Viet T. , Anderson Jeffrey L. , Lappé Donald L. , May Heidi T. 
Published: April 2021

Abstract
Background: Hyperkalaemia (HK) is a serious and potentially life-threatening condition. Both acute and chronic conditions may alter potassium homeostasis. Our aim is to describe HK incidence, clinical outcomes, and associated resource use within a large, integrated healthcare system.Methods: Adult patients seen at Intermountain Healthcare facilities with a serum potassium (sK) result between January 1, 2003 and December 31, 2018 were retrospectively studied. Descriptive assessment of a population with HK, defined by any sK >5.0 mmol/L and HK frequency and severity to associated resource use and characteristics of HK predictors were made. Multivariable Cox hazard regression was used to evaluate HK to outcomes.Results: Of 1,208,815 patients included, 13% had HK. Compared to no-HK, HK patients were older (60±18 vs 43±18 years, P<0.001), male (51% vs 41%, P<0.001), and had greater disease burden (Charlson Comorbidity Index 3.5±2.8 vs 1.7±1.4, P<0.001). At 3 years, more HK patients experienced major adverse cardiovascular events (MACEs) (19% vs 3%, P<0.001), persisting post-adjustment (multivariable hazard ratio=1.60, P<0.001). They incurred higher costs for emergency department services ($552±7,574 vs $207±1,930, P<0.001) and inpatient stays ($10,956±93,026 vs $1,477±21,423, P<0.001). HyperK Risk Scores for the derivation and validation cohorts were: 44% low-risk, 45% moderate-risk, 11% high-risk. Strongest HK predictors were renal failure, dialysis, aldosterone blockers, diabetes, and smoking.Conclusion: Within this large system, HK was associated with a large clinical burden, affecting over 1 in 10 patients; HK was also associated with increased 3-year MACE risk and higher medical costs. Although risk worsened with more severe or persistently recurring HK, even mild or intermittent HK episodes were associated with significantly greater adverse clinical outcomes and medical costs. The HyperK Score predicted patients who may benefit from closer management to reduce HK risk and associated costs.
Epidemic spreading under pathogen evolution
Authors: Zhang Xiyun , Zhongyuan Ruan , Zheng Muhua , Zhou Jie , Stefano Boccaletti , Barzel Baruch 
Published: April 2021

Abstract
Battling a widespread pandemic is an arms race between our mitigation efforts, e.g., social distancing or vaccination, and the pathogen's evolving persistence. This is being observed firsthand during the current COVID-19 crisis, as novel mutations are constantly challenging our global vaccination race. To address this, we introduce here a general framework for epidemic spreading under pathogen evolution, which
shows that mutations can fundamentally alter the projection of the spread. Specifically, we detect a new pandemic phase - the mutated phase - in which, despite the fact that the pathogen is initially non-pandemic (R0 < 1), it may still spread due to the emergence of a critical mutation. The boundaries of this phase portray a balance between the epidemic and the evolutionary time-scales. If the mutation rate is too low, the pathogen prevalence decays prior to the appearance of a critical mutation. On the other hand, if mutations are too rapid, the pathogen evolution becomes volatile and, once again, it fails to spread. Between these two extremes, however, a broad range of conditions exists in which an initially sub-pandemic pathogen will eventually gain prevalence. This is especially relevant during vaccination, which creates, as it progresses, increasing selection pressure towards vaccine-resistance. To overcome this, we show that vaccination campaigns must be accompanied by fierce mitigation efforts, to suppress the potential rise of a resistant mutant strain.
Clinical Characteristics of Chinese Pediatric Obstructive Sleep Apnea Hypopnea Syndrome
Authors: He Yanyu , Xu Xueyun , Gu Wenjing , Zhang xinxing , Wang Yuqing , Dou Xunwu , Hao Chuangli 
Published: April 2021

Abstract
We aim to analyze the clinical characteristics of obstructive sleep apnea hypopnea syndrome (OSAHS) in children. Polysomnography (PSG) and nasopharynx lateral film were performed, and clinical data were collected in 469 children who came to the outpatient department due to "snoring during sleep with mouth opening breathing, hard breathing or suffocation". Among the enrolled children, 123 (22.6%) were diagnosed with OSAHS, with 70 were mild and 53 were moderate-severe. Percentage of adenoid hypertrophy was higher in OSAHS patients (p <0.01), instead of tonsil enlargement. The OSAHS children were agged 5 (4, 7). Compared with PS, the percentage of snoring, apnea, dyspnea, increased nocturia, and daytime sleepness were significsntly higher in moderate-severe patients (p <0.01). In OSAHS groups, AHI, ODI, Longest time of apnea were increased, while minimum SpO2 and mean SpO2 during sleep were decreased significantly (p <0.01) than PS. Time ratio of NREM1 was elevated in moderate-severe OSAHS patients (p <0.01). Time ratio of REM was elevated in mild patients(p <0.01). Compared with the preschoolers, the percentage of leg movement and sleepness were significsntly higher in school-agers (p <0.05). The youngers had higher time ratio of NREM3 and better sleep efficieny (p<0.01). However, AHI(p<0.05) and ODI(p<0.01) were higher in elder OSAHS significantly. Snoring (OR =5.745, p < 0.01), adenoid hypertrophy (OR =4.381, p < 0.01), apnea (OR =2.670, p < 0.001), dyspnea (OR =1.975, p < 0.01), and CRP (OR =1.172, p < 0.001) were independent risk factors for OSAHS. Conclusion AHI, ODI, Longest time of apnea, minimum SpO2 and mean SpO2 should be considered and analyzed simultaneously in diagnosis. The school-age OSAHS patients seems to more serious than the preschoolers. Snoring, apnea, dyspnea, adenoid hypertrophy, and CRP are risk factors for OSAHS.
Pronounced loss of Amazon rainforest resilience since the early 2000s
Authors: Boulton Chris , Lenton Timothy , Boers Niklas 
Published: April 2021

Abstract
The resilience of the Amazon rainforest to climate and land-use change is of critical importance for biodiversity, regional climate, and the global carbon cycle. Some models project future climate-driven Amazon rainforest dieback and transition to savanna1. Deforestation and climate change, via increasing dry-season length2,3 and drought frequency – with three 1-in-100-year droughts since 20054-6 – may already have pushed the Amazon close to a critical threshold of rainforest dieback7,8. However, others argue that CO2 fertilization should make the forest more resilient9,10. Here we quantify Amazon resilience by applying established indicators11 to remotely-sensed vegetation data with focus on vegetation optical depth (1991-2016), which correlates well with broadleaf tree coverage. We find that the Amazon rainforest has been losing resilience since 2003, consistent with the approach to a critical transition. Resilience is being lost faster in regions with less rainfall, and in parts of the rainforest that are closer to human activity. Given observed increases in dry-season length2,3 and drought frequency4-6, and expanding areas of land use change, loss of resilience is likely to continue. We provide direct empirical evidence that the Amazon rainforest is losing stability, risking dieback with profound implications for biodiversity, carbon storage and climate change at a global scale.
Disentangling causes of the dieback of littoral stands in an overloaded water-bird reserve: roles of eutrophication, fish and geese
Authors: Svidenský Richard , Kučerová Andrea , Čížková Hana 
Published: April 2021

Abstract
European fishponds used for semi-intensive fish production can serve for refuges of water birds if the fish stocks are limited but the effects of other ecological factors on the ecosystem stability are seldom considered. The aim of this study is to elucidate causes of a marked decline of littoral stands dominated with Typha angustifolia in a hypertrophic fishpond forming a part of a valuable water-bird reserve. Field investigation and two experiments were conducted in order to separate the effects of mineral nutrient availability, redox condition, fish and geese. The physico-chemical characteristics of water and sediments confirmed hypertrophic conditions in the fishpond but a follow-up mesocosm experiment did not prove a negative effect of the sediment quality on the plant growth. On the other hand, a field enclosure experiment showed a significant negative effect on shoot density, which was attributed to grazing by geese. An additional damage to plant belowground parts was ascribed to large carp individuals, albeit in small numbers. The study points to a conservation dilemma caused by large numbers of geese destroying littoral stands in a fishpond nature reserve, which then looses its nesting function for other water-bird species.
HO-1/Bmmscs Perfusion Using a Normothermic Machine Perfusion System Reduces the Acute Rejection of DCD Liver Transplantation by Regulating NKT Cell Co-Inhibitory Receptors
Authors: Cao Huan , Wu Longlong , Tian Xuan , Zheng Weiping , Yuan Mengshu , Li Xiang , Tian Xiaorong , Wang Yuxin , Song Hongli , Shen Zhongyang 
Published: April 2021

Abstract
Background: Liver transplantation (LT) represents the most effective treatment for many end-stage liver diseases. While donation after cardiac death (DCD) donor livers are used due to organ shortage, acute rejection (ACR) remains an important risk factor affecting the survival of recipients following transplantation. Although immunosuppressive agents can be used, they are associated with complications. Bone marrow mesenchymal stem cells (BMMSCs) are used in the treatment of organ transplantation; however, there is limited colonization in the target organs and a short survival time following BMMSCs application. Thus, an optimized BMMSCs application method is required to suppress immune rejection and promote the long-term survival of allogeneic liver transplant recipients. Methods: BMMSCs were isolated and modified with heme oxygenase 1 (HO-1) gene. HO-1/BMMSCs were perfused into the donor liver in vitro using a normothermic machine perfusion (NMP) system, followed by LT. The severity of ACR was evaluated based on the liver histopathology. Gene chip technology was used to detect differential gene expression, and the flow cytometry was used to analyze changes in natural killer (NK) T cells. Results: NMP can induce BMMSCs to colonize the donor liver during in vitro preservation, and the survival of HO-1/BMMSCs in the liver grafts was significantly longer than that of BMMSCs. When the donor liver contained HO-1/BMMSCs, the ACR is obviously controlled, and the survival time was significantly prolonged. The application of HO-1/BMMSCs reduces the number of NKT cells in the liver grafts, increases the expression of the NKT cell co-inhibitory receptors, and reduces the level of NKT cell expression of IFN-γ. Thus, NK cell and CD8+ T cell activation was inhibited, which reduced acute of rejection of the transplanted liver. Conclusions: The NMP system preserves the DCD donor liver in vitro, and also allows large quantities of BMMSCs to colonize the liver. HO-1-modified BMMSCs are able to improve and prolong the local immunosuppressive effect of BMMSCs following transplantation by reducing the number of NKT cells and up-regulating NKT cell co-inhibitory receptor expression. This results in the transmission of inhibitory signals to NKT cells, reduced NKT cell IFN-γ levels, and the inhibition of ACR.
Valorization of Microcrystalline Cellulose using Heterogeneous Protonated Zeolite Catalyst: An experimental and kinetics approach
Authors: Kassaye Samuel , Gupta Dinesh , Pant Kamal. K. , Jain Sapna 
Published: April 2021

Abstract

This study aims to valorize microcrystalline cellulose (MCC) using protonated zeolite catalysts such as (H-ZSM-5) and Cr/H-ZSM-5 (5 %) in ionic liquid. The catalytic effect in synergy with 1-butyl-3-methylimidazolium Chloride ([BMIM] Cl) ionic liquid was studied in detail. The total reducing sugar (TRS) was determined using 3, 5-dinitrisalcylic acid (DNS) array method. The catalysts were characterized using techniques such as Fourier transform infrared (FT-IR), X-ray diffraction analysis (XRD), temperature-programmed desorption of ammonia (NH3-TPD), and BET-surface area analyzer. H-ZSM-5 effectively depolymerized cellulose with a maximum yield of 70% total reducing sugar (34% glucose, 8% fructose, and 4.5% 5-HMF) Cr/H-ZSM-5 catalyst dehydrates fructose to 5-HMF with a yield of 53%. The use of ionic liquid significantly reduced the activation energy of formation and decomposition. The activation energy determined in cellulose hydrolysis was 85.83 KJ mol− 1 for a reaction time of 180 min while the decomposition energy was found to be 42.5 kJ mol− 1.