bluuebunny/crossref_metadata_2025_split huggingface dataset:
Protocol for a systematic review of outcomes from microsurgical free-tissue transfer performed on short-term collaborative surgical trips in low-income and middle-income countries
Authors: de Berker Henry T. , Čebron Urška , Bradley Daniel , Patel Vinod , Berhane Meklit , Almas Fernando , Walton Gary , Eshete Mekonen , McGurk Mark , Martin Dominique , Honeyman Calum 
Published: September 2021

Abstract

Background
In many units around the world, microsurgical free-tissue transfer represents the gold standard for reconstruction of significant soft tissue defects following cancer, trauma or infection. However, many reconstructive units in low-income and middle-income countries (LMICs) do not yet have access to the resources, infrastructure or training required to perform any microsurgical procedures. Long-term international collaborations have been formed with annual short-term reconstructive missions conducting microsurgery. In the first instance, these provide reconstructive surgery to those who need it. In the longer-term, they offer an opportunity for teaching and the development of sustainable local services.

Methods
A PRISMA-compliant systematic review and meta-analysis will be performed. A comprehensive, predetermined search strategy will be applied to the MEDLINE and Embase electronic databases from inception to August 2021. All clinical studies presenting sufficient data on free-tissue transfer performed on short-term collaborative surgical trips (STCSTs) in LMICs will be eligible for inclusion. The primary outcomes are rate of free flap failure, rate of emergency return to theatre for free flap salvage and successful salvage rate. The secondary outcomes include postoperative complications, cost effectiveness, impact on training, burden of disease, legacy and any functional or patient reported outcome measures. Screening of studies, data extraction and assessments of study quality and bias will be conducted by two authors. Individual study quality will be assessed according to the Oxford Evidence-based Medicine Scales of Evidence 2, and risk of bias using either the ‘Revised Cochrane risk of bias tool for randomized trials’ (Rob2), the ‘Risk of bias in non-randomized studies of interventions’ (ROBINS-I) tool, or the National Institute for Health Quality Assessment tool for Case Series. Overall strength of evidence will be assessed according to the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.

Discussion
To-date the outcomes of microsurgical procedures performed on STCSTs to LMICs are largely unknown. Improved education, funding and allocation of resources are needed to support surgeons in LMICs to perform free-tissue transfer. STCSTs provide a vehicle for sustainable collaboration and training. Disseminating microsurgical skills could improve the care received by patients living with reconstructive pathology in LMICs, but this is poorly established. This study sets out a robust protocol for a systematic review designed to critically analyse outcomes.

Systematic review registration
PROSPERO 225613
Effect of the protection zone in a diffusive ratio-dependent predator–prey model with fear and Allee effect
Authors: Wang Huan , Xing Hui 
Published: September 2021

AbstractIn this paper, we study the influence of a protection zone for the prey on a diffusive predator–prey model with fear factor and Allee effect. The prior estimate, global existence, nonexistence of nonconstant positive solutions and bifurcation from semitrivial solutions are well discussed. We show the existence of a critical patch value $\lambda ^{D}_{1}(\Omega _{0})$

λ
1
D

(

Ω
0

)
of the protection zone, described by the principal eigenvalue of the Laplacian operator over $\Omega _{0}$

Ω
0

with Neumann boundary conditions. When the mortality rate of the predator $\mu \geq d_{2}\lambda ^{D}_{1}(\Omega _{0})$
μ
≥

d
2

λ
1
D

(

Ω
0

)
, we show that the semitrivial solutions $(1,0)$
(
1
,
0
)
and $(\theta,0)$
(
θ
,
0
)
are unstable and there is no bifurcation occurring along respective semitrivial branches.
Solving common nonmonotone equilibrium problems using an inertial parallel hybrid algorithm with Armijo line search with applications to image recovery
Authors: Suantai Suthep , Yambangwai Damrongsak , Cholamjiak Watcharaporn 
Published: September 2021

AbstractIn this work, we modify the inertial hybrid algorithm with Armijo line search using a parallel method to approximate a common solution of nonmonotone equilibrium problems in Hilbert spaces. A weak convergence theorem is proved under some continuity and convexity assumptions on the bifunction and the nonemptiness of the common solution set of Minty equilibrium problems. Furthermore, we demonstrate the quality of our inertial parallel hybrid algorithm by using image restoration, as well as its superior efficiency when compared with previously considered parallel algorithms.
The influence of window size on remote sensing-based prediction of forest structural variables
Authors: Ozkan Ulas Yunus , Demirel Tufan 
Published: September 2021

Abstract
Background
Determining the appropriate window size is a critical step in the estimation process of stand structural variables based on remote sensing data. Because the value of the reference laser and image metrics that affect the quality of the prediction model depends on window size. However, suitable window sizes are usually determined by trial and error. There are a limited number of published studies evaluating appropriate window sizes for different remote sensing data. This research investigated the effect of window size on predicting forest structural variables using airborne LiDAR data, digital aerial image and WorldView-3 satellite image.

Results
In the WorldView-3 and digital aerial image, significant differences were observed in the prediction accuracies of the structural variables according to different window sizes. For the estimation based on WorldView-3 in black pine stands, the optimal window sizes for stem number (N), volume (V), basal area (BA) and mean height (H) were determined as 1000 m2, 100 m2, 100 m2 and 600 m2, respectively. In oak stands, the R2 values of each moving window size were almost identical for N and BA. The optimal window size was 400 m2 for V and 600 m2 for H. For the estimation based on aerial image in black pine stands, the 800 m2 window size was optimal for N and H, the 600 m2 window size was optimal for V and the 1000 m2 window size was optimal for BA. In the oak stands, the optimal window sizes for N, V, BA and H were determined as 1000 m2, 100 m2, 100 m2 and 600 m2, respectively. The optimal window sizes may need to be scaled up or down to match the stand canopy components. In the LiDAR data, the R2 values of each window size were almost identical for all variables of the black pine and the oak stands.

Conclusion
This study illustrated that the window size has an effect on the prediction accuracy in estimating forest structural variables based on remote sensing data. Moreover, the results showed that the optimal window size for forest structural variables varies according to remote sensing data and tree species composition.
The epidemiology of bloodstream infections and antimicrobial susceptibility patterns in Thuringia, Germany: a five-year prospective, state-wide surveillance study (AlertsNet)
Authors: Schöneweck Franziska , Schmitz Roland P. H. , Rißner Florian , Scherag André , Löffler Bettina , Pletz Mathias W. , Weis Sebastian , Brunkhorst Frank M. , Hagel Stefan 
Published: September 2021

Abstract
Background
Monitoring pathogens of bloodstream infections (BSI) and their antibiotic susceptibility is important to guide empiric antibiotic treatment strategies and prevention programs.
This study assessed the epidemiology of BSI and antibiotic resistance patterns at the German Federal State of Thuringia longitudinally.

Methods
A surveillance network consisting of 26 hospitals was established to monitor BSIs from 01/2015 to 12/2019. All blood culture results, without restriction of age of patients, of the participating hospitals were reported by the respective microbiological laboratory. A single detection of obligate pathogens and a repeated detection of coagulase-negative staphylococci, Bacillus spp., Corynebacterium spp., Micrococcus spp. and Propionibacterium spp., within 96 h were regarded as a relevant positive blood culture. If one of the aforementioned non-obligate pathogens has been detected only once within 96 h, contamination has been assumed. Logistic regression models were applied to analyse the relationship between resistance, year of BSI and hospital size. Generalized estimating equations were used to address potential clustering.

Results
A total of 343,284 blood cultures (BC) of 82,527 patients were recorded. Overall, 2.8% (n = 9571) of all BCs were classified as contaminated. At least one relevant pathogen was identified in 13.2% (n = 45,346) of BCs. Escherichia coli (25.4%) was the most commonly detected pathogen, followed by Staphylococcus aureus (15.2%), Staphylococcus epidermidis (8.1%) and Klebsiella pneumoniae (4.6%). In S. aureus, we observed a decline of methicillin resistance (MRSA) from 10.4% in 2015 to 2.5% in 2019 (p < 0.001). The rate of vancomycin resistance in Enterococcus faecium (VRE) has increased from 16.7% in 2015 to 26.9% in 2019 (p < 0.001), with a peak in 2018 (42.5%). In addition, we observed an increase of Cefotaxime (3GC) resistance in E. coli from 10.7% in 2015 to 14.5% in 2019 (p = 0.007) whereas 3GC resistance in K. pneumoniae was stable (2015: 9.9%; 2019: 7.4%, p = 0.35). Carbapenem resistance was less than 1% for both pathogens. These patterns were robustly observed across sensitivity analyses.

Conclusions
We observed evidence for a decline in MRSA, an increase in VRE and a very low rate of carbapenem resistance in gram-negative bacteria. 3GC resistance in E. coli increased constantly over time.
Genetic parameters of drinking and feeding traits of wean-to-finish pigs under a polymicrobial natural disease challenge
Authors: Cheng Jian , Putz Austin M. , Harding John C. S. , Dyck Michael K. , Fortin Frederic , Plastow Graham S. , Canada Pig Gen , Dekkers Jack C. M. 
Published: September 2021

AbstractBackgroundThe pork industry faces unprecedented challenges from disease, which increases cost of production and use of antibiotics, and reduces production efficiency, carcass quality, and animal wellbeing. One solution is to improve the overall resilience of pigs to a broad array of common diseases through genetic selection. Behavioral changes in feeding and drinking are usually the very first clinical signs when animals are exposed to stressors such as disease. Changes in feeding and drinking behaviors in diseased pigs may reflect the way they cope with the challenge and, thus, could be used as indicator traits to select for disease resilience. The objectives of this study were to estimate genetic parameters of feeding and drinking traits for wean-to-finish pigs in a natural polymicrobial disease challenge model, to estimate genetic correlations of feeding and drinking traits with growth rate and clinical disease traits, and to develop indicator traits to select for disease resilience.ResultsIn general, drinking traits had moderate to high estimates of heritability, especially average daily water dispensed, duration, and number of visits (0.44 to 0.58). Similar estimates were observed for corresponding feeding traits (0.35 to 0.51). Most genetic correlation estimates among drinking traits were moderate to high (0.30 to 0.92) and higher than among feeding traits (0 to 0.11). Compared to other drinking traits, water intake duration and number of visits had relatively stronger negative genetic correlation estimates with treatment rate and mortality, especially across the challenge nursery and finisher (− 0.39 and − 0.45 for treatment rate; − 0.20 and − 0.19 for mortality).ConclusionMost of the recorded drinking and feeding traits under a severe disease challenge had moderate to high estimates of heritability, especially for feed or water intake duration and number of visits. Phenotypic and genetic correlations among the recorded feeding traits under disease were generally low but drinking traits showed high correlations with each other. Water intake duration and number of visits are potential indicator traits to select for disease resilience because of their high heritability and had moderate genetic correlations with treatment and mortality rates under severe disease.
Problematic smartphone use and affective temperaments among Lebanese young adults: scale validation and mediating role of self-esteem
Authors: Zeidan Joanne , Hallit Souheil , Akel Marwan , Louragli Ismail , Obeid Sahar 
Published: September 2021

Abstract
Background
Adults all over the world face serious issues from problematic smartphone use (PSU). It influences them negatively on a cognitive, behavioral, and emotional level, as well as on their tendencies and well-being. In Lebanon, the prevalence of PSU was shown to be 20.2% within the adult population, specifically with young adults (18–34 years old). This study investigates the validity and reliability of the Smartphone Addiction Scale (SAS) Arabic version. In addition, this study evaluates the association between PSU and affective temperaments and the mediating role of self-esteem in this association.

Method
A cross-sectional study was carried out between August and September 2020, using a sample of community-dwelling participants aged 18 to 29 years. The Smartphone Addiction Scale—Short Version was used to evaluate smartphone addiction among adolescents and adults. The five different temperaments of the patients were assessed by using the Affective temperament Scale (TEMPS‐A). The Rosenberg Self-Esteem Scale was used to evaluate self-esteem.

Results
461 participants were included in this study. All items of the SAS were extracted and yielded a one-factor solution with Eigenvalues > 1 (variance explained = 49.96%; αCronbach = 0.886). The confirmatory analysis results consolidated those obtained from the factor analysis. Higher depressive temperament (B = 0.46) was significantly associated with more smartphone addiction, whereas higher self-esteem (B =  − 0.28) was significantly associated with less smartphone addiction. Self-esteem was found to mediate the association between depressive and hyperthymic temperaments with smartphone addiction.

Conclusion
This study added a better understanding of the high smartphone addiction rate among adults in Lebanon. It confirms the association between affective temperaments and PSU through the mediating effect of self-esteem on Lebanese adults.
A cross-sectional study of COVID-19-related bullying in a sample of Lebanese adults: scale validation, correlates, and mediating effect of fear and anxiety
Authors: Haddad Chadia , Sacre Hala , Bou Malhab Sandrella , Malaeb Diana , Saadeh Danielle , Abou Tayeh Christine , Salameh Pascale 
Published: September 2021

AbstractBackgroundThe COVID-19 pandemic has led to prolonged exposure to stress and anxiety, raising concerns about a large spectrum of psychological side effects. The primary objective of the study was to validate the COVID-19 Bullying Scale (CBS-11). The second objective was to explore factors associated with COVID-19-related bullying and evaluate the mediating effect of fear and anxiety between knowledge and COVID-19-related bullying.MethodsA cross-sectional online survey conducted between December 20, 2020, and January 5, 2021, recruited 405 Lebanese adults using a snowball sampling technique. The CBS-11, an 11-item tool specifically created for this study, was used to measure bullying behaviors towards COVID-19 patients.ResultsAll items of the CBS-11 converged over a 1-factor solution with an eigenvalue over 1, accounting for a variance of 75.16%. The scale has a high Cronbach’s alpha (.974), indicating excellent reliability. A positive correlation was found between the COVID-19 bullying scale and fear, anxiety, and stigma discrimination. The logistic regression showed that higher fear of COVID-19 (ORa = 1.04), a positive attitude toward COVID-19 preventive measures and hygiene recommendations (ORa = 1.18), higher stigma discrimination scores (ORa = 1.09), and having a health professional family member (ORa = 2.42) were significantly associated with bullying.ConclusionOur main findings showed that the CBS-11 could be an efficient tool to measure bullying behaviors toward COVID-19 patients. Stigma discrimination and fear from COVID-19 were associated with higher bullying attitudes. Future prospective studies are needed to understand better the factors related to bullying among adults during a pandemic, such as COVID-19.
Immune cell deconvolution of bulk DNA methylation data reveals an association with methylation class, key somatic alterations, and cell state in glial/glioneuronal tumors
Authors: Singh Omkar , Pratt Drew , Aldape Kenneth 
Published: September 2021

AbstractIt is recognized that the tumor microenvironment (TME) plays a critical role in the biology of cancer. To better understand the role of immune cell components in CNS tumors, we applied a deconvolution approach to bulk DNA methylation array data in a large set of newly profiled samples (n = 741) as well as samples from external data sources (n = 3311) of methylation-defined glial and glioneuronal tumors. Using the cell-type proportion data as input, we used dimensionality reduction to visualize sample-wise patterns that emerge from the cell type proportion estimations. In IDH-wildtype glioblastomas (n = 2,072), we identified distinct tumor clusters based on immune cell proportion and demonstrated an association with oncogenic alterations such as EGFR amplification and CDKN2A/B homozygous deletion. We also investigated the immune cluster-specific distribution of four malignant cellular states (AC-like, OPC-like, MES-like and NPC-like) in the IDH-wildtype cohort. We identified two major immune-based subgroups of IDH-mutant gliomas, which largely aligned with 1p/19q co-deletion status. Non-codeleted gliomas showed distinct proportions of a key genomic aberration (CDKN2A/B loss) among immune cell-based groups. We also observed significant positive correlations between monocyte proportion and expression of PD-L1 and PD-L2 (R = 0.54 and 0.68, respectively). Overall, the findings highlight specific roles of the TME in biology and classification of CNS tumors, where specific immune cell admixtures correlate with tumor types and genomic alterations.
A multi-scalar investigation of the colouring materials used in textile wrappings of Egyptian votive animal mummies
Authors: Tamburini Diego , Dyer Joanne , Vandenbeusch Marie , Borla Matilde , Angelici Debora , Aceto Maurizio , Oliva Cinzia , Facchetti Federica , Aicardi Sara , Davit Patrizia , Gulmini Monica 
Published: September 2021

Abstract
Commonly exhibited in museum galleries, animal mummies have been the focus of interest of both visitors and researchers alike. The study of these animal remains not only provides new insights into embalming techniques, but also brings a unique perspective on religious, social and economic practices. Twenty animal mummies are discussed in this study, including cats, ibises, crocodiles, calves and birds of prey from the collections of the British Museum (London, UK) and the Museo Egizio (Turin, Italy). The external textile wrappings encasing the mummified body of the animals were investigated with the main aim of identifying the colourants used. In fact, these are mostly patterned using undyed and coloured (mostly red, brown and black) linen strips. Broadband multispectral imaging (MSI) was initially carried out to obtain preliminary information at the macro-scale on the distribution and chemical nature of the colouring agents. Fibre optic reflectance spectroscopy (FORS) was then used to survey several coloured areas of the textile wrappings. Safflower (Carthamus tinctorius) and red ochre were identified non-invasively. Representative samples were then taken and observed using optical microscopy (OM) and scanning electron microscopy (SEM), in order to obtain information at the micro-scale on the distribution of the colouring agents on the fibres, as well as the presence of other materials, including those from environmental contamination. Energy dispersive X-ray spectrometry (EDX) revealed the elemental composition of particles and clear areas of the fibres, whereas high performance liquid chromatography tandem mass spectrometry (HPLC–MS/MS) provided the identification of the organic dyes at a molecular level. The use of hydrolysable and condensed tannins, in combination with iron as a mordant, was found to be used in the very dark shades, which generally corresponded to the textiles with the worst state of preservation. Nevertheless, other aspects, such as fibre processing and bleaching, fungal attack and presence of coating materials appeared to play a role in the evaluation of the conservation state of these textiles. The characterisation of the dyes and the additional inorganic materials contributed to elucidating the production technology of the colours used for animal mummification, and provided insights into ancient dyeing methods.
Prognosis of hemodialysis patients with progressive aortic stenosis: a prospective cohort study
Authors: Horiguchi Yoriko , Uemura Kaoru , Aoyama Naoyoshi , Nakajima Shinichi , Asai Tomoki , Motohashi Sachiko , Harada Manae , Ida Maoko , Yoshida Atsushi 
Published: September 2021

Abstract
Background
Whether progressive mild to moderate aortic stenosis in hemodialysis patients influences their prognosis has not been elucidated. This prospective cohort study explored whether progressive aortic stenosis predicted the rate of cardiac events and mortality in those patients.

Methods
A total of 283 consecutive hemodialysis patients (no aortic stenosis, 248; progressive aortic stenosis, 35) underwent echocardiography for assessment of aortic stenosis, with a median follow-up period of 4.1 years. Study endpoints were cardiac events, all-cause mortality, and cardiac death. Kaplan–Meier analysis and multivariate Cox proportional hazard analysis were performed to estimate cardiac events, all-cause mortality, and cardiac death.

Results
Cumulative cardiac event rate, all-cause mortality rate, and the rate of cardiac death at 3-year follow-up were 44.9%, 40.5%, and 26.4% in patients with progressive aortic stenosis and 22.1%, 19.0%, and 7.5% in those without aortic stenosis, respectively. Kaplan–Meier analysis demonstrated the cumulative rates of cardiac events and all-cause mortality. And cardiac death was significantly higher in patients with progressive aortic stenosis than in those without aortic stenosis. Multivariate Cox proportional hazard analysis revealed that progressive aortic stenosis was predictive of cardiac events (adjusted hazard ratio 2.47; 95% confidence interval 1.38–4.39) and cardiac death (adjusted hazard ratio 4.21; 95% confidence interval 2.10–8.46). Age, physical activity, C-reactive protein, and serum albumin levels—but not progressive aortic stenosis—predicted all-cause mortality.

Conclusions
The rates of cardiac events and cardiac death were higher in hemodialysis patients with progressive aortic stenosis than in those without aortic stenosis. Furthermore, progressive aortic stenosis predicted cardiac events and cardiac death. Compared with those without aortic stenosis, patients with progressive aortic stenosis had higher all-cause mortality, which was related to their comorbidities.
Trial registration This study was retrospectively registered with University Hospital Medical Information Network Clinical Trials Registry (registration number, UMIN 000024023) at September 12th, 2016.