bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Hafnium Coating on Osseointegration of Titanium Implants: A Split Mouth Animal Study
Authors: Rajaraman Vaishnavi , Nallaswamy Deepak , Ganapathy Dhanraj , Rajeshkumar S. , Ariga Padma , Ganesh Karthik 
Published: December 2021

The behaviour of hafnium as surface coating in biological environments has not been studied. Little is known about osseointegration of hafnium-coated titanium implants. Thus, further studies of hafnium coating under biological conditions are required in order to determine the suitability of this material, as a surface coating for biomedical application. The aim of the study is to analyse the difference between hafnium-coated titanium and uncoated titanium by evaluating the osseointegration ability of hafnium metal and mechanism of which promotes better bone integration. The study was conducted with a split mouth design on 16 Wistar Albino rats of both sexes, at the age of 6-7 months, weighing

2526.5
±
74.4

g

. Self-tapping titanium osteosynthesis screws (

4

mm
×
2

mm

) (LeForte System Bone Screw®) were implanted in the mandible of rats: Group A (pure titanium screws,

n
=
12

) and Group B (hafnium-coated screws,

n
=
12

). The implanted screws’ stability was checked and noted with a specially customised torque apparatus during insertion and removal of implant. The tissue sections were then processed for hematoxylin and eosin and Masson’s trichrome for bone and connective tissue examination, after 4 and 8 weeks of placement. Hafnium coating appears to have offered similar biocompatibility (aspartate transaminase (AST), alanine aminotransferase (ALT), and creatine kinase (CK) enzyme assay), statistically significant improvement (independent Student’s

t

-test,

p
<
0.05

) in insertion torque (

25.42
±
3.965

) and removal torque (

29.17
±
2.887

) than commercially pure titanium with insertion torque (

22.08
±
.575

) and removal torque (

25.42
±
2.575

). Hafnium coating in the rat mandible showed promising osseointegration with good tissue biocompatibility. Further human trials of hafnium-coated implants are needed to understand the biological behaviour better to enhance clinical performance.
Psychosis in Parkinson's disease in a Southeast Asian cohort: prevalence and clinical correlates
Authors: Mok Vanessa Wai Ling , Chan Lai Gwen , Goh Justine Chay Boon , Tan Louis Chew Seng 
Published: December 2021

Introduction:
Psychosis is a prominent neuropsychiatric symptom of Parkinson's disease (PD) and is associated with negative outcomes, such as poorer quality of life and greater rate of functional impairment. Early identification of patients with PD at risk of developing psychosis facilitates appropriate management to improve outcomes. However, this phenomenon has not been examined locally. This study aimed to examine the prevalence of PD-associated psychosis in the local setting, identify any associated risk factors, as well as characterise the cognitive trajectory of patients with PD with psychosis.

Methods:
A retrospective cohort of 336 patients with PD, who presented to the National Neuroscience Institute, Singapore, in 2006 and 2007 and attended follow-up visits through to 2013 was analysed. The data analysed included scores from clinician assessments of cognitive function, disease severity and presence of psychotic symptoms, conducted when clinically appropriate during patients’ medical visits. Survival analysis and logistic and linear regression analysis were performed.

Results:
Psychosis was diagnosed in 63 patients with PD, indicating a prevalence of 18.8% for PD-associated psychosis. Incidence of psychosis in PD was calculated to be 40 per 1,000 person-years. No significant association was found between demographic variables and the odds of developing psychosis in PD. Regression analyses found that the presence of psychosis significantly predicted greater cognitive decline and disease severity.

Conclusion:
Psychosis has a significant presence among the PD population in Singapore, possibly serving as an indicator of more rapid cognitive decline and progression of PD severity.
Relationship between weather parameters and risk of exertional heat injuries during military training
Authors: Poon Beng Hoong , Gorny Alexander Wilhelm , Zheng Kaiyuan , Cheong Wee Kiong 
Published: December 2021

Introduction:
The Singapore Armed Forces (SAF) collaborated with the Meteorological Service Singapore (MSS) to study the relationship between weather parameters and the incidents of exertional heat injury (EHI) to mitigate the risk of EHI in a practical manner.

Methods:
Data from the SAF's heat injury registry and MSS’ meteorological data from 2012 to 2018 were used to establish a consolidated dataset of EHI incidents and same-day weather parameters rank-ordered in deciles. Poisson regression modelling was used to determine the incidence rate ratios (IRRs) of the EHI, referencing the first decile of weather parameters. Two frames of analysis were performed - the first described the relationship between the weather parameters and the adjusted IRR for the same day (D), and the second described the relationship between the weather parameters and the adjusted IRR on the following day (D + 1).

Results:
For wet-bulb temperature, the IRR on D + 1 approximated unity for the first nine deciles but rose to 3.09 at the tenth decile. For dew-point temperature, the IRR on D + 1 approximated unity for the first nine deciles but rose to 3.48 at the tenth decile. By designating a single dew-point temperature cut-off at ≥25.1°C (transition between the ninth and tenth decile), the adjusted IRR on D + 1 was 2.26 on days with dew-point temperature ≥25.1°C.

Conclusion:
Integrating the data from the SAF and MSS demonstrated that a dew-point temperature ≥25.1°C on D correlates statistically with the risk of EHI on D + 1 and could be used to supplement the risk mitigation system.
Environmental Response in Coupled Energy and Water Cloud Impact Parameters Derived from A-Train Satellites, ERA-Interim, and MERRA-2
Authors: Sun Lu , Rapp Anita D. , S. L’Ecuyer Tristan , Daloz Anne S. , Nelson Ethan 
Published: December 2021

Abstract
Understanding the connections between latent heating from precipitation and cloud radiative effects is essential for accurately parameterizing cross-scale links between cloud microphysics and global energy and water cycles in climate models. Although commonly examined separately, this study adopts two cloud impact parameters (CIPs), the surface radiative cooling efficiency Rc and atmospheric radiative heating efficiency Rh, that explicitly couple cloud radiative effects and precipitation to characterize how efficiently precipitating cloud systems influence the energy budget and water cycle using A-Train observations and two reanalyses. These CIPs exhibit distinct global distributions that suggest cloud energy and water cycle coupling are highly dependent on cloud regime. The dynamic regime ω500 controls the sign of Rh, whereas column water vapor (CWV) appears to be the larger control on the magnitude. The magnitude of Rc is highly coupled to the dynamic regime. Observations show that clouds cool the surface very efficiently per unit rainfall at both low and high sea surface temperature (SST) and CWV, but reanalyses only capture the former. Reanalyses fail to simulate strong Rh and moderate Rc in deep convection environments but produce stronger Rc and Rh than observations in shallow, warm rain systems in marine stratocumulus regions. Although reanalyses generate fairly similar climatologies in the frequency of environmental states, the response of Rc and Rh to SST and CWV results in systematic differences in zonal and meridional gradients of cloud atmospheric heating and surface cooling relative to A-Train observations that may have significant implications for global circulations and cloud feedbacks.

Significance Statement
Studying climate change requires understanding coupled interactions between clouds, precipitation, and their environment. Here we calculate two parameters to reveal how efficiently clouds can heat the atmosphere or cool the surface per unit rain. The satellite observations and reanalyses show similar global patterns, but there are some differences in areas of deep convection and low cloud regions. Examination of these parameters as a function of their environment shows that reanalyses cool the atmosphere too much per unit rain in environments with low sea surface temperatures and water vapor. Vertical velocity determines whether clouds heat or cool the atmosphere. Both observations and reanalyses suggest that water vapor is the stronger control on how much clouds heat the atmosphere per unit rain.
Quasi-Biweekly Oscillation over the Western North Pacific in Boreal Winter and Its Influence on the Central North American Air Temperature
Authors: Dong Zizhen , Wang Lin 
Published: December 2021

AbstractThis study investigates the characteristics and climate impacts of the quasi-biweekly oscillation (QBWO) over the western North Pacific (WNP) in boreal winter based on observational and reanalysis data and numerical experiments with a simplified model. The wintertime convection over the WNP is dominated by significant biweekly variability with a 10–20-day period, which explains about 66% of the intraseasonal variability. Its leading mode on the biweekly time scale is a northwestward-propagating convection dipole over the WNP, which oscillates over a period of about 12 days. When the convection-active center of this QBWO is located to the east of the Philippines, it can generate an anticyclonic vorticity source to the south of Japan via inducing upper-tropospheric divergence and excite a Rossby wave train propagating toward North America along the Pacific rim. The resultant lower-tropospheric circulation facilitates cold advection and leads to cold anomalies over central North America in the following week. This result highlights a cause–effect relationship between the WNP convection and the North American climate on the quasi-biweekly time scale and may provide some prediction potential for the North American climate.Significance StatementThis study establishes a cause–effect relationship between the wintertime western North Pacific convection and the central North American air temperature on the quasi-biweekly time scale. In boreal winter, the convection over the western North Pacific oscillates significantly with a 10–20-day period. When the convection is active, it can disturb the atmosphere to the south of Japan and excite a midlatitude Rossby wave train. The latter propagates along the North Pacific rim and leads to cold spells over central North America within one week. This information connects the climate variability across the Pacific and provides an additional subseasonal-to-seasonal prediction potential for the North American winter climate.
Aquatic Animal Foods for Nutrition Security and Child Health
Authors: Iannotti Lora L. , Blackmore Ivy , Cohn Rachel , Chen Feng , Gyimah Emmanuel A. , Chapnick Melissa , Humphries Austin 
Published: December 2021

Background: Aquatic animal source foods (AASF) can provide vital nutrients and bioactive factors essential for human health, yet disparities in consumption patterns prevail globally. Limited evidence exists for the implications of AASF access on child health outcomes. Objective: This study aimed to examine global AASF intakes longitudinally in association with critical nutrient intakes and childhood stunting and anemia. Methods: The analysis draws from compiled longitudinal country data (1993-2013) based on a constructed conceptual framework encompassing social and ecological factors that influence fish consumption and human health. Longitudinal generalized linear models were used to estimate the association of apparent AASF intake on country-level nutrient availability (docosahexaenoic acid [DHA], choline, vitamin B12, iron, and zinc) and prevalence of undernourishment, child stunting, and child anemia. Results: Across 175 countries, the median per capita daily apparent intake of all AASF was 37.87 g, with marginally significant differences observed between countries with low (46.65 g) versus high child mortality (23.50 g). The combined category of all AASF was significantly associated with increased total apparent intakes of DHA, choline, and vitamin B12 and reduced child stunting. Finfish (pelagic and demersal) and crustaceans inversely correlated with child stunting, while apparent intakes of mollusks and crustaceans were associated with reduced child anemia. Conclusions: This study uniquely showed that AASF were associated with improved child health outcomes and the critical nutrients necessary for growth, development, and maintaining health throughout the life course. Policies should ensure increased access to AASF across food systems and within sustainable healthy diets globally.
Thrombosis with Thrombocytopenia Syndrome After Administration of AZD1222 or Ad26.COV2.S Vaccine for COVID-19: A Systematic Review
Authors: Waqar Usama , Ahmed Shaheer , Gardezi Syed M.H.Ali , Tahir Muhammad Sarmad , Abidin Zain ul , Hussain Ali , Ali Natasha , Mahmood Syed Faisal 
Published: December 2021

Background Cases of thrombosis with thrombocytopenia syndrome (TTS) have been reported following vaccination with AZD1222 or Ad26.COV2.S. This review aimed to explore the pathophysiology, epidemiology, diagnosis, management, and prognosis of TTS. Methods A systematic review was conducted to identify evidence on TTS till 4th September 2021. Case reports and series reporting patient-level data were included. Descriptive statistics were reported and compared across patients with different sexes, age groups, vaccines, types of thrombosis, and outcomes. Findings Sixty-two studies reporting 160 cases were included from 16 countries. Patients were predominantly females with a median age of 42.50 (22) years. AZD1222 was administered to 140 patients (87·5%). TTS onset occurred in a median of 9 (4) days after vaccination. Venous thrombosis was most common (61.0%). Most patients developed cerebral venous sinus thrombosis (CVST; 66.3%). CVST was significantly more common in female vs male patients (p = 0·001) and in patients aged <45 years vs ≥45 years (p = 0·004). The mortality rate was 36.2%, and patients with suspected TTS, venous thrombosis, CVST, pulmonary embolism, or intraneural complications, patients not managed with non-heparin anticoagulants or IVIG, patients receiving platelet transfusions, and patients requiring intensive care unit admission, mechanical ventilation, or inpatient neurosurgery were more likely to expire than recover. Interpretation These findings help to understand the pathophysiology of TTS while also recommending diagnostic and management approaches to improve prognosis in patients. Funding This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.
Child Maltreatment Prevention Service Cases are Significantly Reduced During the COVID-19 Pandemic: A Longitudinal Investigation Into Unintended Consequences of Quarantine
Authors: Whaling Kelly M. , Der Sarkissian Alissa , Larez Natalie , Sharkey Jill D. , Allen Michael A. , Nylund-Gibson Karen 
Published: December 2021

Unprecedented financial and emotional stress, paired with measures to slow the spread of COVID-19 (e.g., school closures), place youth at risk for experiencing increased rates of abuse. We analyzed data from New York City’s Administration for Children’s Services to investigate the frequency of child maltreatment prevention service case openings during this time. Longitudinal counts of case openings were compiled for January through June of the years 2014–2020. An independent samples Kruskal–Wallis H-test suggested that pre-quarantine case openings were significantly larger than case openings during quarantine. To account for the possible influence of other historical events impacting data, a secondary Kruskal–Wallis H-test was conducted comparing only the 4 months of quarantine data available to the 4 months immediately preceding quarantine orders. The second independent samples Kruskal–Wallis H-test again suggested that pre-quarantine case openings were significantly larger than case openings during quarantine. A Poisson regression model further supported these findings, estimating that the odds of opening a new child maltreatment prevention case during quarantine declined by 49.17%. These findings highlight the severity of COVID-19 impacts on child maltreatment services and the gap between demand for services and service accessibility. We conclude with recommendations for local governments, community members, and practitioners.
Associations between adverse childhood experiences and need and unmet need for care coordination
Authors: Anyigbo Chidiogo , Fuller Anne E. , Cheng Yao I , Fu Linda Y. , Belcher Harolyn M. , Tarini Beth A. , Brown Nicole M. 
Published: December 2021

Introduction Children exposed to adverse childhood experiences (ACEs) may access multiple systems of care to address medical and social complexities. Care coordination (CC) optimizes health outcomes for children with special health care needs who often use multiple systems of care. Little is known about whether ACEs are associated with the need and unmet need for CC. Methods Use of the 2016–2017 National Survey of Children’s Health to identify children who saw ≥1 health care provider in the last 12 months. The study team used weighted logistic regression analyses to examine associations between 9 ACE types, ACE score, and need and unmet need for CC. Results In the sample ( N  = 39,219, representing 38,316,004 US children), material hardship (adjusted odds ratio (aOR), 1.50; 95% confidence interval (CI), 1.29–1.75), parental mental illness (aOR, 1.31; 95% CI, 1.07–1.60), and neighborhood violence (aOR, 1.33; 95% CI, 1.01–1.74) were significantly associated with an increased need for CC. Material hardship was also associated with an unmet need for CC (aOR, 2.37; 95% CI, 1.80–3.11). Children with ACE scores of 1, 2, 3, and ≥4 had higher odds of need and unmet need for CC than children with 0 ACEs. Discussion Specific ACE types and higher ACE scores were associated with the need and unmet need for CC. Evaluating the unique needs of children who endured ACEs should be considered in the design and implementation of CC processes in the pediatric health care system.
Mannose-binding lectin serum levels and (Gly54asp) gene polymorphism in recurrent aphthous stomatitis: A case-control study
Authors: Baioumy Shereen A , Fouad Shaimaa H , Abdalgeleel Shaimaa A , Baiomy Ahmed A , Sallam Dina E , Taha Sara I 
Published: December 2021

Objectives: Dysregulation of the immune response appears to play a significant role in recurrent aphthous stomatitis (RAS) development. The main objective of this case–control study is to investigate the blood levels of mannose-binding lectin (MBL) and the frequency of the MBL2 gene (gly54asp) polymorphism in RAS patients, including 40 RAS patients and 40 healthy controls. Methods: Serum MBL levels were determined by ELISA, while the PCR-restriction fragment length polymorphism was used in MBL2 genotyping. Results: The median serum MBL level was significantly lower in the RAS group than in the control group (975 ng/mL (545–1320) vs. 1760 ng/mL (1254–2134); p≤ 0.001). The MBL levels were significantly lower in the BB genotype, whereas they were significantly higher in the wild type AA with a median of 525 and 1340 ng/mL, respectively ( p =0.005). The B allele was expressed in significantly higher percentages of RAS patients than in controls. There was no significant association between MBL serum levels ( p=0.685) or MBL2 codon 54 genotypes ( p=0.382) with the type of ulcers. Conclusion: There was an association between low MBL serum levels and the variant allele B of the MBL2 (gly54asp) gene, and the susceptibility to RAS. As a result, potential novel therapeutic options for RAS patients with MBL deficiency should be investigated.
“It just fits my needs better”: Autistic students and parents’ experiences of learning from home during the early phase of the COVID-19 pandemic
Authors: Heyworth Melanie , Brett Simon , Houting Jacquiline den , Magiati Iliana , Steward Robyn , Urbanowicz Anna , Stears Marc , Pellicano Elizabeth 
Published: December 2021

Background and aims The COVID-19 pandemic has caused unprecedented disruption to people's lives, especially for families, whose children have been taken out of schools during lockdown restrictions and required to learn from home. Little is known, however, about the perceived impact of the lockdown restrictions on the educational experiences of autistic children and young people – a group whose conventional schooling experiences are already often challenging. In this study, we sought to (1) understand these experiences from the perspectives of autistic young people and their parents, and (2) identify the underlying sources of positive experiences at this challenging time, in order to inform the ways in which autistic children might flourish at school in more normal times. Methods Ninety-one Australian participants, including 16 autistic young people aged 12–18 years, 32 autistic parents and 43 non-autistic parents of autistic young people aged 3–18 years, took part in semi-structured interviews about their experiences of life during the initial phase of the COVID-19 pandemic. The interviews were subjected to reflexive, thematic analysis to identify themes and subthemes for each research question. Results Overall, our participants initially found the transition to learning from home extremely challenging, with parents reporting that the support received from schools was far from adequate. After that initial period of transition, however, many autistic children reported flourishing at home both educationally and personally. For these children and families, we identified three key ingredients essential to this flourishing, including: (i) the importance of connected, trusting relationships (‘people’); (ii) the sensory and social safety of home (‘place’); and (iii) the flexibility to pace and structure learning to suit the individual child (‘time’). Conclusions While the initial COVID-19 lockdown presented many challenges to children learning at home, there were aspects of this otherwise-unsettling situation that enabled children to thrive and from which we can learn for the future. Implications These findings have important implications for understanding how and when autistic children might thrive in institutional educational settings once the pandemic subsides, focusing on the relationships between teachers and students, the nature of the physical learning environment and the need for greater flexibility in planning the school day.
Resistance mechanisms to inhibitors of p53-MDM2 interactions in cancer therapy: can we overcome them?
Authors: Haronikova Lucia , Bonczek Ondrej , Zatloukalova Pavlina , Kokas-Zavadil Filip , Kucerikova Martina , Coates Philip J. , Fahraeus Robin , Vojtesek Borivoj 
Published: December 2021

AbstractSince the discovery of the first MDM2 inhibitors, we have gained deeper insights into the cellular roles of MDM2 and p53. In this review, we focus on MDM2 inhibitors that bind to the p53-binding domain of MDM2 and aim to disrupt the binding of MDM2 to p53. We describe the basic mechanism of action of these MDM2 inhibitors, such as nutlin-3a, summarise the determinants of sensitivity to MDM2 inhibition from p53-dependent and p53-independent points of view and discuss the problems with innate and acquired resistance to MDM2 inhibition. Despite progress in MDM2 inhibitor design and ongoing clinical trials, their broad use in cancer treatment is not fulfilling expectations in heterogenous human cancers. We assess the MDM2 inhibitor types in clinical trials and provide an overview of possible sources of resistance to MDM2 inhibition, underlining the need for patient stratification based on these aspects to gain better clinical responses, including the use of combination therapies for personalised medicine.