bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutritious mushroom protein crisp – healthy alternative to starchy snack
Authors: Balan Venkatesh , Novak Dianne , Knudson William , Jones A. Daniel , Iñiguez-Franco Fabiola Maria , Auras Rafael , Cho Sungeun , Rodgers Amanda , Ubanwa Bryan 
Published: December 2021

Abstract
Global salty snacks category had reached USD 137 billion in sales in 2018. Due to growing health concerns and awareness, consumers are looking for healthy snack choices by avoiding ingredients such as fat, sugar, cholesterol, and sodium and selecting baked and salt free multigrain chips. A sizable number of consumers are concerned about snack nutrition and look for quality ingredients and minimally processed foods called as “Good Health Snack (GHS)”. In this work, we present the development of method of producing and testing mushrooms protein crisps (MPC), a healthy alternative to conventional starchy snacks that are rich in protein, nutraceutical compounds, minerals, vitamin, dietary fiber, and immunity inducing beta-glucans. The methods of producing MPC with different seasoning and hydrolyzed protein, calorie, nutritional and chemical composition, consumer response, shelf life after packing and market analysis are described. These systematic studies will help to market potential of this product which is a healthy alternative to other calorie rich snacks sold in the market benefiting the consumers.

Graphical abstract
Combined presentation of severe pulmonary COVID-19 and multisystem inflammatory syndrome in children (MIS-C): two reported Egyptian pediatric cases
Authors: Hamed Tarek , Sarhan Dina T. 
Published: December 2021

Abstract
Background
Initial reports from the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic described children as being less susceptible to coronavirus disease (COVID-19) than adults. Later on, a severe and novel pediatric disorder termed multisystem inflammatory syndrome in children (MIS-C) emerged. Pediatric patients with SARS-CoV-2 are at risk for critical illness with severe pulmonary COVID-19 and MIS-C. Both are described as two distinct conditions, and the differentiation between them was the scope of many studies. In this report from Egypt, we will describe two unique pediatric cases presented by combined manifestations of severe pulmonary COVID-19 and MIS-C.

Case presentation
Two patients presented with severe pulmonary COVID-19 evident by pulmonary symptoms, signs, and advanced CO-RADS stage in lung CT were simultaneously fulfilling the clinical criteria of MIS-C including fever, multi-system affection, increased inflammatory markers in addition to the proved COVID-19 by positive serologic tests for SARS-CoV-2 but PCR was negative. Both patients responded well to immune-modulation therapy by IVIG and steroids and discharged well under closed follow-up.

Conclusions
Although it is debatable to present simultaneously, MIS-C should be considered in patients presenting with typical clinical findings and concerns for pulmonary COVID-19 once the criteria for MIS-C diagnosis is fulfilled. Starting treatment without delay can favor better prognosis.
Signal-to-noise ratio uniformity and stability of agar gel phantom with iron (III) oxide as relaxation modifier
Authors: Er W. X. , Lim W. J. , Dwihapsari Y. , Awang M. N. A. , Yusoff A. N. 
Published: November 2021

Abstract
Background
Agar has been commonly used as one of the materials to fabricate magnetic resonance imaging phantoms in the past few decades. In this study, eleven agar gel phantoms with different iron (III) oxide (Fe2O3) masses were prepared. This study was aimed to evaluate the signal-to-noise ratio (SNR) uniformity and stability of agar gel phantoms with and without the addition of Fe2O3 at two different time points (TPs). Fe2O3 powder was used as a relaxation modifier to manipulate and produce various SNR, T1 and T2 values. These phantoms were scanned using turbo spin echo pulse sequence to produce T1- and T2-measurement images. The SNR was then computed by plotting 1, 3 and 25 regions of interest on the images using ImageJ software. The T1 and T2 relaxation equations were then fitted to the experimental results of SNR versus TR and SNR versus TE curves for the determination of saturation (SNRo), T1 and T2 values.

Results
The results demonstrated that the agar gel phantoms were able to maintain SNR uniformity but not SNR stability after 4 weeks of phantom preparation. The change in the water content and microstructure of the phantoms have no significant effect on T2 relaxation but on T1 relaxation. The T1 and T2 of the agar gel phantoms were minimally affected although there was a systemic increase in the content of the Fe2O3 powder.

Conclusions
It can be concluded that the agar gel phantoms exhibited the characteristics of SNR uniformity, but they showed instability of SNR at TP2. The Fe2O3 in powder form is not an effective relaxation modifier to reduce the T1 and T2 when it is introduced into the agar gel phantoms. Dissolved nanosized particles should be the focus of future studies.
Acute abdominal pain and nephrotic syndrome: pediatric case reports and review of the literature
Authors: Conti Giovanni , Carucci Nicolina Stefania , Comito Valentina , Impellizzeri Pietro , Visalli Carmela , Ventrici Claudia , Chimenz Roberto , Romeo Carmelo 
Published: December 2021

Abstract
Background
Acute abdominal pain in nephrotic syndrome (NS) is a well-known clinical symptom and is mainly related to peritonitis. The presence, although rare, of red umbilicus may guide the diagnosis as a suggestive sign of peritonitis also in the non-neonatal period. Instead, the association between intussusception and NS is quite limited. We reviewed all published cases in the literature, and to our knowledge, this is one of the few pediatric cases of spontaneous resolution of intussusception in the setting of NS. Finally, a review of the causes of abdominal pain during the course of NS was made.

Cases presentation
We report two pediatric patient cases who complained of acute abdominal pain during a relapse episode of their NS. The first case is a 4-year-old boy with NS (fourth relapse) who presented with acute abdominal pain, ascites, and red umbilicus. Our suspect of primary peritonitis was clinically confirmed because of the subsequent appearance of the classical peritoneal signs. The second case is a 4-year-old boy who developed an ileo-ileal intussusception during the treatment of his first NS relapse, with spontaneous reduction.

Conclusions
Gastrointestinal disorders are frequently encountered in the course of NS. The appearance of acute abdominal pain in children with NS requires quick management, both clinical and instrumental. A multidisciplinary team approach needs to be encouraged to lead to an accurate diagnosis and a correct treatment.
Surgical extraction of an unusual macrocystic lymphatic malformation in the buttock: case report
Authors: Rodríguez-García Francisco Antonio , Gallegos-Sierra Cuauhtly , Villarreal-Salgado José Luis , Jimenez-Pavon Karla , Morfin-Meza Karen , Ramos-Maciel Joel , Fierro-Rodríguez Diego Armando , Romero-Algara Enrique , Bonilla-Catalán Pablo , Dorado-Hernández Emmanuel , Torres-Salazar Quitzia Libertad 
Published: December 2021

Abstract
Background
Macrocystic lymphatic malformation is a rare benign skin disorder, especially the anogenital area, which covers less than .5% of the reported cases. It can cause vesicular and papular lesions on the face, trunk, extremities, and, less frequently, anogenital areas. Although there are currently several therapeutic options, surgical excision is the most widely used, considering the lowest recurrence rate.

Case presentation
In this article, we describe the case of a 15-year-old male patient who presented with herpetiform skin lesions, corresponding to the diagnosis of macrocystic lymphatic malformation, in the lower region of the right buttock. After confirmation of the diagnosis by histopathology, surgical excision was performed with a tensor fascia lata graft, with successful aesthetic and functional results.

Conclusions
Considering the diagnosis of macrocystic lymphatic malformation is of utmost importance, although its presence is unusual, to differentiate it from other herpetiform lesions. Despite the existence of multiple approaches today, definitive treatment with surgical extraction is necessary, both to improve the cosmetic aspect and to prevent associated complications. It is suggested that histopathological and imaging diagnostic tools be used as a routine element, in order to increase therapeutic success, as well as decrease the risk of recurrences.

Evidence-based medicine ranking
Level IV
Case report of a near-fatal case of Mycobacterium massiliense sepsis after de-clotting of an arteriovenous fistula
Authors: Nawaz Haroon , Choudhry Ayesha A. , Morse William 
Published: December 2021

Abstract
Background
Mycobacterium massiliense is a rapidly growing a non-tuberculous mycobacterium that has been validated as a separate species from the Mycobacterium abscessus group. Only few antibiotics have demonstrated germicidal activity against Mycobacterium massiliense, and some of those include amikacin, clarithromycin, and cefoxitin.

Case presentation
We present the first reported case of near-fatal septic shock caused by disseminated Mycobacterium massiliense after de-clotting of an infected arteriovenous fistula, in a patient with end-stage renal disease with concomitant human immunodeficiency virus infection. Early recognition of the culprit organism and treatment with a combination therapy of clarithromycin and amikacin led to rapid improvement.

Conclusion
This unique case can highlight the importance of taking into consideration Mycobacterium massiliense infection as a cause of arteriovenous fistula thrombosis and highlights the risk of disseminated infection leading to life threatening sepsis upon de-clotting of the fistula.
Young age and the risk of violent behaviour in people with severe mental disorders: prospective, multicentre study
Authors: Micciolo Rocco , Bianconi Giorgio , Canal Luisa , Clerici Massimo , Ferla Maria Teresa , Giugni Camilla , Iozzino Laura , Sbravati Giulio , Tura Giovanni Battista , Vita Antonio , Zagarese Laura , de Girolamo Giovanni ,   for the Violence Risk and Mental Disorder 2 (VIORMED-2) Group
Published: December 2021

BackgroundDuring adolescence and young adulthood people appear to be more prone to violent behaviour. A greater tendency to violent behaviour appears to be associated with hyperactivity, impulsivity and low tolerance for frustration and provocation in social settings.AimsThis prospective cohort study aimed to evaluate rates of violent behaviour among young people with mental disorders, compared with older age groups.MethodA total of 340 individuals with severe mental disorders (125 living in residential facilities and 215 out-patients) were evaluated at baseline with the SCID-I and II, Brief Psychiatric Rating Scale, Specific Level of Functioning scale, Brown–Goodwin Lifetime History of Aggression scale, Buss–Durkee Hostility Inventory, Barratt Impulsiveness Scale and State–Trait Anger Expression Inventory-2. Aggressive behaviour was rated every 15 days with the Modified Overt Aggression Scale (MOAS).ResultsThe sample comprised 28 individuals aged 18–29 years, 202 aged 30–49 and 110 aged 50 and over. Younger age was associated with a personality disorder diagnosis, substance use disorder, being single and employed. These results were confirmed even controlling for the gender effect. The patterns of the cumulative MOAS mean scores showed that younger (18–29 years old) individuals were significantly more aggressive than older (≥50) ones (P< 0.001).ConclusionsThis study highlights how young age in people with severe mental disorders is correlated with higher levels of impulsivity, anger and hostility, confirming previous analyses. Our results may assist clinicians in implementing early interventions to improve anger and impulsivity control to reduce the risk of future aggressive behaviours.
Ergocalciferol in New-onset Type 1 Diabetes: A Randomized Controlled Trial
Authors: Nwosu Benjamin Udoka , Parajuli Sadichchha , Jasmin Gabrielle , Fleshman Jody , Sharma Rohit B , Alonso Laura C , Lee Austin F , Barton Bruce A 
Published: December 2021

Abstract

Context
The effect of the anti-inflammatory and immunomodulatory actions of vitamin D on the duration of partial clinical remission (PR) in youth with type 1 diabetes (T1D) is unclear.

Objective
This work aimed to determine the effect of adjunctive ergocalciferol on residual β-cell function (RBCF) and PR in youth with newly diagnosed T1D who were maintained on a standardized insulin treatment protocol. The hypothesis was that ergocalciferol supplementation increases RBCF and prolongs PR.

Methods
A 12-month, randomized, double-blind, placebo-controlled trial was conducted of 50 000 IU of ergocalciferol per week for 2 months, and then once every 2 weeks for 10 months, vs placebo in 36 individuals aged 10 to 21 years, with T1D of less than 3 months and a stimulated C-peptide (SCP) level greater than or equal to 0.2 nmol/L (≥ 0.6 ng/mL). The ergocalciferol group had 18 randomly assigned participants (10 male/8 female), mean age 13.3 ± 2.8 years, while the control group had 18 participants (14 male/4 female), aged 14.3 ± 2.9 years.

Results
The ergocalciferol treatment group had statistically significantly higher serum 25-hydroxyvitamin D at 6 months (P = .01) and 9 months (P = .02) than the placebo group. At 12 months, the ergocalciferol group had a statistically significantly lower serum tumor necrosis factor α (TNF-α) concentration (P = .03). There were no statistically significant differences between the groups at each time point from baseline to 12 months for SCP concentration (P = .08), glycated hemoglobin A1c (HbA1c) (P = .09), insulin dose–adjusted A1c (IDAA1c), or total daily dose of insulin. Temporal trends for rising HbA1c (P = .04) and IDAA1c (P = .02) were statistically significantly blunted in the ergocalciferol group.

Conclusion
Ergocalciferol statistically significantly reduced serum TNF-α concentration and the rates of increase both in A1c and IDAA1c, suggesting a protection of RBCF and PR in youth with newly diagnosed T1D.
“We shall have gone to a higher standard”: Training village heath teams (VHTs) to use a smartphone-guided intervention to link older Ugandans with hypertension and diabetes to care
Authors: Mugisha Joseph Okello , Seeley Janet 
Published: December 2021

Background: It is not clear whether village health teams (VHTs) can be empowered to participate in interventions to prevent and control hypertension and diabetes in older adults in Uganda. We conducted this study in rural Uganda to establish if VHTs could be effectively trained to use a smart phone guided intervention to link older people with hypertension and diabetes to care. We also explored the experiences of VHTs in managing older adults with health problems, their knowledge of hypertension and diabetes and their understanding of referral systems. We also explored their experiences with smartphones. Methods: We conducted in-depth interviews (IDIs) with and trained 20 VHTs randomly selected from Bukulula sub-county in Kalungu district from October 2017-December 2018. We used interview guides to explore topics relevant to our study objectives. VHTs were trained to measure blood sugar and blood pressure using digital machines. VHTs were trained on identifying symptoms of diabetes mellitus. Data from IDIs were analysed using thematic content analysis. Competence tests were used to evaluate the training. Results: Most of the VHTs were female (75%). All VHTs had some knowledge on hypertension and diabetes and other chronic diseases. They did not have any experience in treating older adults since they had been trained to deal mainly with children. Half of the VHTs owned smartphones. All were willing to participate in an intervention using a smartphone to link older adults with hypertension and diabetes mellitus to care. By the end of the training, all but three participants could comprehend the symptoms of diabetes and measure blood sugar and blood pressure. Conclusion: Village health teams in the study setting need training in managing the health needs of older adults before engaging with an intervention using smartphones to link older adults with diabetes mellitus and hypertension to care.
Human-centred design of a new microneedle-based hormonal contraceptive delivery system
Authors: Gualeni Benedetta , Hughes Louise , Stauber Isabelle , Ackers Louise , Gorman Angela , Gashuga Dorothy , Dzabala Nettie , Chimimba Frider , Chikowe Ibrahim , Coulman Sion A. , Birchall James C. 
Published: December 2021

Background: It is estimated that 225 million women worldwide have an unmet need for family planning, and more than half live in low- and middle-income countries. Increasing the choice of contraceptive methods available can reduce this unmet need. Microneedle drug delivery systems represent a new technology for minimally invasive self-administration of contraceptives. We explored stakeholders’ views on different aspects of a proposed microneedle-based hormonal contraceptive delivery system. The feedback was used to iteratively develop this delivery system. Methods: Focus group discussions and semi-structured interviews were conducted with potential stakeholders (women and trans males of childbearing age, their partners, and health professionals and organisations that provide family planning advice and contraception services) in Uganda, The Gambia, Malawi, and the UK, exploring concept acceptability and gathering feedback on different aspects of design and usability of the proposed delivery system. Results: Participants viewed the concept of a new, microneedle-based contraceptive favourably. In Uganda, participants were presented with 7 different prototype applicators and identified desirable features of a preferred delivery device; their input reducing the number of prototypes that were subsequently evaluated by stakeholders in The Gambia and the UK. Participants in these countries helped to identify and/or confirm the most desirable characteristics of the applicator, resulting in design consolidation into a refined concept applicator. The final, optimised applicator prototype was validated during user research in Malawi. This human-centred design approach was also used to iteratively develop an information leaflet for the device. During these user studies, other preferred aspects of a contraceptive delivery system were also evaluated, such as anatomical site of application, duration of action, and return to fertility. Conclusions: A new microneedle-based contraceptive delivery system was iteratively developed using a human-centred design approach and was favourably received by potential stakeholders. The product is now being refined for testing in pre-clinical studies.
Data-Driven Robust Resource Allocation with Monotonic Cost Functions
Authors: Chen Ye , Marković Nikola , Ryzhov Ilya O. , Schonfeld Paul 
Published: December 2021

Using Data to Allocate Resources Efficiently In city logistics systems, a fleet of vehicles is divided between service regions that function autonomously. Each region finds optimal routes for its own fleet and incurs costs accordingly. More vehicles lead to lower costs, but the trade-off is that fewer vehicles are left for other regions. Costs are difficult to quantify precisely because of demand uncertainty but can be estimated using data. The paper “Data-driven robust resource allocation with monotonic cost functions” by Chen, Marković, Ryzhov, and Schonfeld develops a principled risk-averse approach for two-stage resource allocation. The authors propose a new uncertainty model for decreasing cost functions and show how it can be leveraged to efficiently find resource allocations that demonstrably reduce the frequency of high-cost scenarios. This framework combines statistics and optimization in a novel way and is applicable to a general class of resource allocation problems, encompassing facility location, vehicle routing, and discrete-event simulation.
Patients' attitudes toward their health literacy and the use of digital apps in health and disease management
Authors: Klösch Michael , Sari-Kundt Firuzan , Reibnitz Christine , Osterbrink Jürgen 
Published: November 2021

Background: No qualitative studies have so far been conducted about patients' attitudes and perceptions toward their own health literacy and the use of digital apps in health and disease management based in Austria. Aim: In the context of digital apps, what are patients' attitudes and perceptions with regard to their own health literacy? Method: Guided interviews were conducted with patients in an Austrian hospital to obtain qualitative data. Qualitative content analysis was used to analyse the data. Findings: Responses to the research questions fell into three main categories: ‘health’, ‘health literacy’ and ‘digital applications in health and disease management’, with each having its own set of subcategories. Digital apps appear to be an important strategy for helping patients optimise their own health literacy, as well as their health or disease management. Challenges referred to the handling of sensitive data or the possibility of publishing unfiltered information. Conclusion: Further studies need to be carried out to gain a more detailed understanding of the findings. Personal experience plays an important role in supporting quantitative findings.
The experiences of adult nursing students completing a placement during the COVID-19 pandemic
Authors: Cushen-Brewster Noreen , Barker Anne , Driscoll-Evans Paul , Wigens Lynne , Langton Helen 
Published: November 2021

Background: The emergency measures implemented by the Nursing and Midwifery Council in response to the COVID-19 pandemic provided nursing students in their final 6 months of study with the opportunity to complete a paid consolidation clinical placement and thus increase their personal responsibility for the care they delivered under supervision. Aim: To explore the experiences of third-year nursing students who completed their final clinical placement during the COVID-19 pandemic. Methods: Semi-structured interviews were conducted via a virtual platform. Findings: Three themes were identified: the importance of support mechanisms, the development of confidence, and innovative learning opportunities. Students reported improved confidence in the transition period to registered practitioner and felt well supported, which enabled them to take greater responsibility. Conclusion: This study provided insight into the experience of nursing students during the COVID-19 pandemic, and found that support mechanisms, and a sense of belonging, helped to increase their confidence in clinical practice.
Estimating the time point for nutritional failure in patients suffering from acute brain attacks in the intensive care unit
Authors: Al-Kalaldeh Mahmoud , Shosha Ghada Abu , Shoqirat Noordeen , Alsaraireh Mahmoud , Haddadin Rawan 
Published: November 2021

Background: Severe brain attack patients demonstrate hypermetabolic state and gastrointestinal dysfunction, leading to faster onset of nutritional failure. Aim: To estimate the time point where the development of nutritional failure is more probable among patients with acute brain attacks in the intensive care unit (ICU). Methods: Direct bedside observation for selected nutritional parameters was performed. When enteral nutrition was initiated, observation was performed at five points over 9 days. Findings: 84 patients with 55% mortality risk and on mechanical ventilation were included. Over the observation period, gastric residual volume increased (144 ml vs 196 ml), body weight decreased (79.4 kg vs 74.3 kg), and serum albumin reduced (3.6 g/dl to 3.1 g/dl). Caloric attainment and malnutrition score deteriorated, and feeding-related complications increased. Nutritional failure was evidently prevalent between the third and fifth day of observation. Conclusion: An earlier period of enteral nutrition entails higher probability of nutritional failure among severe brain attack patients in the ICU.