bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aortic Hypoplasia in Young Adult Patients With Sudden Intrinsic Cardiopulmonary Arrest: An Observational Study
Authors: Bando Misaki , Yoshioka Yuki , Akagawa Yoko 
Published: June 2021

Abstract
Background: The leading cause of sudden cardiac death in adults over 40 is ischemic heart disease due to vascular atherosclerosis, especially in developed countries. In contrast, sudden cardiac death in adults younger than 40 (young adults) may be caused by aortic hypoplasia (AH). In 1968, Laurie described 14 young adults who died suddenly, and AH was a possible cause of death. In 2002, Gouveia also described AH as a cause of death in young adults. To date, few detailed studies of AH exist. This study evaluated AH patients in our hospital for sudden cardiopulmonary arrest in young adults. Methods: We selected young adult patients who transferred to our center with cardiopulmonary arrest status between April 2010 and March 2020. Their cause of death was supposed to be cardiac or unknown. In the chart review, sex, age, rate of computed tomography (CT) being performed, and outcome were described. For patients with CT being performed, we assessed the diameters of the aortic root (outlet and inlet), ascending aorta, descending aorta, abdominal aorta, and right femoral artery.Results: There were 1268 cardiopulmonary arrest cases during the study period. Thirteen young adults died of intrinsic diseases, such as sudden cardiac death or unknown cause of death. Twelve patients underwent CT scans, and eight (61.5%) had AH.Conclusions: For a decade, 61.5% of young adults who died of intrinsic diseases had AH. Further studies should be conducted to reveal AH’s clinical significance in young adults.
Association Between the Food Security Status and Dietary Patterns With Polycystic Ovary Syndrome (PCOS) in Overweight and Obese Iranian Women: A Case-Control Study
Authors: Badri-Fariman Mahtab , Naeini Amirmansour Alavi , Mirzaei Khadijeh , Moeini Ashraf , Hosseini Mostafa , Bagheri Seyedeh Elaheh , Daneshi-Maskooni Milad 
Published: June 2021

Abstract
Background

Polycystic ovary syndrome (PCOS) as one of the major types of endocrine disorders is common among women worldwide. Frequently reported that food insecurity (FI) and unhealthy diets can exert negative effects on reproductive health. There are contradictory results on optimal lifestyle modification especially dietary components with PCOS. This paper aimed to assess the association between PCOS with food security status and dietary patterns of overweight and obese Iranian women.
Methods

This case-control study was performed on 240 overweight and obese adult women with PCOS (n = 120) and without PCOS (n = 120) referred to the infertility clinic of Arash Hospital in Tehran, Iran. Participants' data on anthropometry, scio-economic factors, and physical activity were collected. Food security status and dietary intakes were assessed by validated questionnaires.
Results

The prevalence of FI was 60% in women with PCOS and 30% in healthy women. There was a positive association between the risk of PCOS with FI, quasi-western dietary pattern, low economic level, waist circumference, and menstrual age and a negative association between physical activity and healthy dietary pattern with this risk even after controlling the potential confounders (P < 0.05). PCOS women had a higher intake of saturated fats, monounsaturated fats, oleic acid, fluorine, sucrose, and caffeine and a lower intake of vitamins A, B5, B6, B12, C, and D, potassium, proteins, carbohydrates, cholesterols, docosahexaenoic acid, potassium, carotenes, lutein, beta-cryptoxanthin, lycopene, calcium, iron, thiamine, riboflavin, niacin, tetra- and dihydrofolate, biotin, phosphorus, magnesium, zinc, copper, total, insoluble, and crude fiber, glucose, galactose, fructose, and lactose compared to the healthy group (P < 0.05).
Conclusions

FI, quasi-western dietary pattern, low economic status, and waist circumference were significantly associated with the higher risk of PCOS. Modifying lifestyle especially in dietary patterns may be an important strategy for the reduction of PCOS. Future prospective studies are warranted to confirm these findings and to identify the underlying mechanisms.
A Local Perspective: Experiences and Handling of Mental Health Burden during the COVID-19 Pandemic in Uganda.
Authors: Muzyamba Choolwe , Munyati Bob Mwiinga , Makova Ogylive , Mushibi Geofrey 
Published: June 2021

Abstract
Background The COVID-19 pandemic has increased the prevalence of mental health illness around the world. While research has espoused these realities from the context of western countries, however, similar evidence from low income countries like Uganda is still missing. This is despite the fact that scholars have pointed out that given inadequate funding, health facilities and personnel to treat people with mental health challenges, the impact of the COVID-19 pandemic could be severe. Further, it is still unclear how locals in low income countries like Uganda manage to cope with mental health challenges given the lack of adequate skilled response, especially during a pandemic that has increased the pressure on the healthcare system. Therefore, this study aims to fill this gap by investigating local people’s experience and handling of mental health burden during the COVID-19 pandemic n Uganda. Methods Qualitative primary data was collected from Uganda in November and December 2020. The sample selection involved a two-staged cluster sampling technique via the AfriSight online platform. Our study included a total of 1249 participants picked from the 4 different regions of Uganda. On the basis of this, thematic analysis was used to analyze the data. Results Our study revealed that the COVID-19 pandemic and its associated interventions contributed to the increasing mental health burden in Uganda. The four most pronounced forms of mental health illnesses included stress, anxiety, depression and traumatic disorders with the leading causes being closure of income-generating activities, fear of dying, sexual and domestic abuse. While a few people had access to skilled mantel health care, the majority of the people struggled to access this form of care. Skilled maternal care remained an attractive yet unattainable form of care for many. Thus, most people relied on various forms of local strategies that were feasible.Conclusion Our study revealed that Uganda was home to various local survival strategies that counter the inadequacies presented by the weak health care system. Particularly, a culture of reciprocity, family and community network forms important coping avenues for many left stranded by the lack of adequate skilled care. Thus, in the context of Uganda during the COVID-19 pandemic, it seemed more logical to promote scaling up feasibly and locally-available solutions rather than idealistically focusing on attractive yet unattainable forms of care.
Micro/Nanostructured Lignonanocellulose Obtained from Steam-Exploded Sugarcane Bagasse
Authors: Fontes André Mazega , Pirich Cleverton L. , Tanobe Gustavo Ryo Oliveira de Andrade , Tarrés Quim , Delgado-Aguilar Marc , Ramos Luiz Pereira 
Published: June 2021

Abstract
This work demonstrates the isolation of lignocellulose micro-nanofibrils, nanocrystals and nanospheres from steam-exploded sugarcane bagasse (SEB). First, steam-explosion was carried out in sugarcane bagasse at 195 °C for 7.5 and 15 min (SEB-7.5 and SEB-15). Untreated sugarcane bagasse was also pretreated by mechanical refining (MRB) in a PFI mill for comparison. Then, SEB and MRB fibers were submitted to alkaline delignification, hypochlorite bleaching for 60 or 180 min (HB60 and HB180), enzymatic hydrolysis (endoglucanase), and high-pressure homogenization. The resulting materials were characterized regarding chemical composition by high-performance liquid chromatography, width and morphology by transmission electron microscopy, crystallinity by X-ray powder diffraction and aspect ratio (length/diameter) by rheology. Levels of glucans (mostly cellulose), hemicelluloses and lignin were: 53.8%, 19.7% and 11.6% in MRB-HB180; 87.8%, <0.1% and 7.2% in SEB-7.5-HB60; 84.3%, <0.1% and 4.8% in SEB-7.5-HB180, 85.9%, <0.1% and 8.4% in SE-15-HB60; and 82.2%, <0.1% and 5% in SE-15-HB180, respectively. Aspect ratios and crystallinity indexes were similar among all groups (~100 and ~73%, respectively), except for SE-15-HB180 (~ 78.5 and 77%, respectively). MRB-HB180 and SE-15 (HB60 and HB180) had the lowest fiber widths (<20 nm) with the presence of nanocrystals in SE-15-HB180, while in the SE-7.5 (HB60 and HB180), fiber widths were greater than 50 nm with the presence of lignin nanospheres in SE-7.5-HB60. Hence, lignocellulose nanomaterials with aspect ratios ranging from micro/nanofibers to nanocrystals were isolated from SEB using a cost-effective production process.
Sustainable Purchase Behavior Through Religious Orientation, Psychological Contract &amp; Intention-evidence From Pakistani Retail Industry
Authors: Sulehri Numair , Dar Imran , Hussain Sajjad 
Published: June 2021

Abstract
The purchase patterns have been shifted from tangibles to societal orientations, where religious orientation is the way forward for sustainable purchase behavior in expanding urban areas of a middle-income country. The ethical and responsiveness considerations through the connection between Islamic religious orientation (IsRO), purchase intention (PI), and total psychological contract (TPsC) is a research gap projected to be filled from multiple dimensions. Captivating the purchase intention and total psychological contract as mediating variables and analytical approach for religious orientation on purchase behavior constructed in the present research. The empirical assessment was executed through Structural Equation Modeling (SEM) approach based on the cross-sectional research design. There were 669 participants selected from large superstores, with ages ranging from 16 to 55 (M=3.38, SD=1.06), from Islamabad and Rawalpindi in Pakistan, from September 2018 to March 2019. The findings revealed that religious orientation level positively enhanced customer purchase behavior, purchase intention and psychological contract in organized retail stores and psychological contract played a mediating role in the influencing on the purchase behavior; whereas, the purchase intention also played a mediating role between religious orientation and customer purchase behavior. Therefore, the religious orientation stimulated a higher level of purchase behavior since it favored of the higher level of psychological contract and purchase intention in organized retail store customer. The study highlighted the value of cognitive and moral processes and psychological needs could be one of the crucial factors for improvement of perceptual change in terms of purchase behavior of retail consumers that connect psychological dimension with suitability indicators of being responsiveness and ethical consideration sourced from religious orientation. The implications pave the way forward for product development, purchase strategies, and retail market sensing for corporate retail chains and government utility stores for ethical business processes. Meanwhile, the government and enterprises need to strengthen the popularization and dissemination of environmental protection and food safety knowledge to enhance consumers’ environmental and food safety awareness, improving the social environment of the cultivation of the organic food market.
Toxicity of Hypofractionated Whole Breast Radiotherapy Without Boost in a Large “Real-Life” Cohort of Consecutive Early-Stage Breast Cancer Patients
Authors: Fodor Andrei , Brombin Chiara , Mangili Paola , Tummineri Roberta , Pasetti Marcella , Zerbetto Flavia , Longobardi Barbara , Galvan Ariadna Sanchez , Deantoni Chiara L. , Dell'Oca Italo , Rancoita Paola M.V. , Fiorino Claudio , Vecchio Antonella Del , Serio Mariaclelia S. Di , Muzio N.G. Di 
Published: June 2021

Abstract
AimTo report toxicity of hypofractionated whole-breast radiotherapy (HWBRT) in a large cohort of early-stage breast cancer (BCA) patients.Methods and MaterialsFrom 02/2009-05/2017, 1325 consecutive BCA patients were treated with 40.05 Gy/15 fractions, without boost with manually optimized IMRT. Median age: 62 (IQR:51.1-70.5) years. Chemotherapy was prescribed for 28% of patients, hormonal therapy for 80.3%, monoclonal antibodies for 8.2%. Ten% of patients <45 years, 23.8% obese, 5.9% diabetic, 34% hypertensive. ResultsMedian follow-up: 72.4 (IQR: 44.6-104.1) months. Acute RTOG toxicity was: 69.8% Grade(G)1, 14.3% G2 and 1.7% G3. Late SOMA-LENT toxicities were: edema-hyperpigmentation(E-H): G1 28.67%, G2 4.41%, G3 0.15%; fibrosis-atrophy-telangiectasia-pain(F-A-T-P): G1 14.6%, G2 3.2%, G3 0.8%, G4 0.1%. Median time to first occurrence was 6 and 18 months, respectively.Aesthetic result after surgery was excellent in 28.7%, good in 41.5%, acceptable in 20.3% and poor in 9.5% of patients. Change in breast appearance after radiotherapy was mild in 6.9%, moderate in 2.3% and marked in 1.3% of patients.Concomitant chemotherapy, obesity, smoking, use of bolus and planning target volume (PTV) were associated with higher acute toxicity. Patients ≥55 years old were less likely to experience acute toxicity. PTV and acute G2 toxicity were associated with ≥G2 E-H. PTV, concomitant chemotherapy, hypertension and ≥G2 acute toxicity were associated with increased risk of F-A-T-P. ConclusionHWBRT without boost demonstrated mild acute and late toxicity in a large cohort of consecutive patients. Timing of changes in breast appearance after radiotherapy was registered and patient, therapy and dosimetric predictive toxicity factors were identified.
Scaling Theory of Rubber Sliding Friction
Authors: Hentschke Reinhard , Plagge Jan 
Published: June 2021

Abstract
Current theoretical descriptions of rubber or elastomer friction are complex-usually due to extensive mathematical detail describing the topography of the solid surface. In addition, the viscoelastic properties of the elastomer material itself, in particular if the rubber is highly filled, further increase the complexity. On the other hand, experimental coefficients of sliding friction plotted versus sliding speed, temperature or other parameters do not contain much structure, which suggests that a less detailed approach is possible. Here we investigate the coefficient of sliding friction on dry surfaces via scaling and dimensional analysis. We propose that adhesion promotes viscoelastic dissipation by increasing deformation amplitude at relevant length scales. Finally, a comparatively simple expression for the coefficient of friction is obtained, which allows an intuitive understanding of the underlying physics and fits experimental data for various speeds, temperatures and pressures.
Effects of the Number of Removed Lymph Nodes on Survival Outcome in Patients With Sentinel Node-negative Breast Cancer.
Authors: Cipolla Calogero , Galvano Antonio , Vieni Salvatore , Saputo Federica , Lupo Simona , Latteri Mario , Graceffa Giuseppa , Valerio Maria Rosaria 
Published: June 2021

Abstract
Background It is still uncertain what is the optimal number of sentinel lymph nodes (SLN) to be removed to reduce the false negative rate. The aim of this study was to investigate whether patients with a single negative SLN have a worse prognosis than those with two or more negative SLNs.Methods A retrospective review was conducted on a large series of SLN-negative breast cancer patients. Survival outcomes were evaluated according to the number of removed SLNs. Statistical analysis included Chi-square, Wilcoxon Mann Whitney test and Kaplan–Meier survival analysis.Results There was no relevant difference in median DFS (64.9 vs 41.4) for SLN=1 vs SLN>1 groups (HR 0.76, CI 95% 0.39 – 1.46; p = 0.38). A statistically significant difference in mDFS was showed only for HT treated patients who were SLN= 1 if compared to SLN>1 (100.6 months versus 35.3 months). Conclusions Our results showed no relevant difference in median DFS for SLN=1 vs SLN>1 group, except for a subset of the patients treated with hormone therapy.
Community Knowledge and Practice on Sanitation, Hygiene and Household Water Utilization in Afabet City, Northern Red Sea Zone of Eritrea: Cross Sectional Study
Authors: Tesfai Berhe , Milkyas Hagos , Kibreab Fitsum , Goitom Meron , Berhe Hermon , Amine Asrat 
Published: June 2021

Abstract
Background: Water and sanitation entitles the human right to affordable access and sanitation. The objective of this study was to determine the knowledge and practice on sanitation, hygiene and water utilization and to estimate the prevalence of diarrhea in Afabet city.Methods: It was a community-based descriptive cross-sectional type of study with a multistage cluster sampling technique. First, 12 clusters were selected from the city and 30 households were nominated from each cluster. Then, a total of 360 individuals were sampled and every family head was interviewed. A structured interviewer administered questionnaire and field observation was used for data collection from December 05-20, 2020. Cross tabulation and association of variables using chi-square test was determined and results were weighted as cluster sampling was used. Results: A total of 360 respondents were enrolled in the study with females (75.3%) and Muslin (99.0%) predominance. About 66.2% and 66.9% respondents were satisfied with the amount and quality of water they received respectively. The prevalence of diarrhea in the community in the last six months of 2020 was 13.0%. The investigators practically approved that 90.7% of the communities revealed functional toilets and feces were observed in only 5.7% of the living area of the community. The community’s comprehensive good knowledge and practice was 99.4% and 93.0% respectively. Their comprehensive knowledge and practice showed significant association with age, sex, marital status, level of education, household size and distance to municipality water source (p<0.001). Furthermore, their comprehensive knowledge and practice, prevalence of diarrhea, presence of latrine, distance from their home to municipality water source and hand washing practice were significantly associated with the administrative area of the study participants (p<0.001).Conclusion: The community had good level of knowledge and practice but the prevalence of diarrhea was relatively high. Latrines were highly utilized but the usage of soap, personal and food hygiene was slightly low. The level of comprehensive practice, prevalence of diarrhea, distance to municipality water source and hand washing practice was associated to the administrative areas. Enhancing environmental sanitation, personal hygiene and provision of adequate and clean water are highly recommended.
Environmental Friendly Multi-step Processing of Efficient Mixed-cation Mixed Halide Perovskite Solar Cells from Chemically Bath Deposited Lead Sulphide
Authors: Gozalzadeh Sahel , Nasirpouri Farzad , Seok Sang Il 
Published: June 2021

Abstract
Organic-inorganic hybrid perovskite is the most promising active layer for new generation of solar cells. Despite of highly efficient perovskite active layer conventionally fabricated by spin coating methods, the need for using toxic solvents like dimethylformamide (DMF) required for dissolving low soluble metal precursors as well as the difficulties for upscaling the process have restricted their practical development. To deal with these shortcomings, in this work, lead sulphide as the lead metal precursor was produced by aqueous chemical bath deposition. PbS films were subsequently chemically converted to PbI2 and finally to mixed-cation mixed halide perovskite films. The microstructural, optical and solar cell performance of mixed cation mixed halide perovskite films were exploited. Results show that controlling the morphology of PbI2 platelets achieved from PbS precursor films enabled efficient conversion to perovskite. Using this processing technique, smooth and pin hole-free perovskite films having columnar grains of about 800 nm and a bandgap of 1.55 eV were produced. The solar cell performance consisting of such perovskite layers gave rise to a notable power conversion efficiency of 11.35% under standard solar conditions. The proposed processing technique is a very promising environmentally friendly method for the production of large-scale high efficient perovskite solar cells.
Clinical Features of Patients Without Fever Infected by SARS-CoV-2: an Observational Study
Authors: Guo Tuo , Ding Ning , Zhou Yang , Yang Guifang , Guo Cuirong , Tang Fengning , Chai Xiangping 
Published: June 2021

Abstract
Objective: A large number of patients had infected by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2). We aimed to clarify the clinical features of the patients without fever infected by SARS-CoV-2.Methods: This is a retrospective and single-center study. We collected and analyzed the data of demographic, clinical presentation, laboratory tests, radiological results, treatment, and complications. The patients with fever and without fever were compared.Results: 113 patients were enrolled in the study, 36 (31.9%) patients without fever on admission. Among the patients without fever, the mean age was 41 years (IQR, 30-53; Range, 8-82years) and 18 (50%) were male. The median from the onset of illness to the first admission was 3.0 days. None of the patients without fever had complications and received high-flow oxygen therapy or invasive ventilation. As of Feb 22, 2020, 8 patients (22.2%) were discharged, and the remaining patients were still hospitalized. Conclusions: Out of 113 patients with SARS-COV-2 infection, patients without fever accounted for 31.9% in total. The clinical prognosis of patients without fever may be better than those of patients with fever on admission.
Closures and Other Anchor Characteristics of for-profit Hospitals: A Cross-sectional Study
Authors: Franz Berkeley , Cronin Cory , Rodriguez Vanessa , Choyke Kelly , Simon Janet E. , Hall Maxwell T. 
Published: June 2021

Abstract
Background:By definition, anchor institutions have a long-term presence in their communities. Case studies of nonprofit anchor hospitals are common, but it is not clear whether for-profit hospitals are stable enough to fill this role. Our purpose is to determine whether for-profit hospitals are stable enough to fill the role of anchor institutions by strengthening their communities and elevating population health through a long-term presence stabilizing local economies. Methods: In this cross-sectional study, we analyzed national, secondary data between 2008 and 2017 compiled from the Dartmouth Atlas of Health Care, the American Hospital Association Annual Survey, and County Health Rankings. We used descriptive statistics to calculate the number of closures and mergers of hospitals of different ownership type, as well as the employment data. Using logistic regression, we assess whether for profit hospitals had higher odds of closing and merging, controlling for both organization and county characteristics.Results: For-profits are less stable than other hospitals, experiencing disproportionately more closures and mergers over time; a multivariate analysis found that this was a statistically significant difference. Additionally, for-profit hospitals have fewer full-time employees relative to their size than hospitals of other ownership types, as well as lower total payroll expenditures.Conclusions: Our findings suggest that for-profit hospitals are more efficient in terms of operating expenses, but this also may translate into a lower level of economic investment in the surrounding community. For-profit hospitals may also not have the stability required to serve as long-standing anchor institutions. Nonetheless, these organizations still have considerable potential due to their size, tax contributions, and impact on vulnerable communities where other types of hospitals have not been able to operate successfully. Identifying new policy incentives to engage these institutions may help improve population health in surrounding communities.