bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinicopathological features and outcomes in gastric-type of HPV-independent endocervical adenocarcinomas
Authors: Chen Lili , Niu Yizhen , Wan Xiaoyun , Yu Lina , Zhang Xiaofei , Strickland Amanda Louise , Dong Liya , Zhou Feng , Lu Weiguo 
Published: October 2021

Abstract
Background
We aimed to analyze the clinicopathological features and outcomes of patients with gastric-type of HPV-independent endocervical adenocarcinoma (GAS HPVI ECA), and compare them with non-GAS HPVI ECA cases.

Methods
Thirty-eight GASs [including 17 minimal deviation adenocarcinoma (MDA), 21 non-MDA GAS] and 17 non-GAS HPVI ECAs were studied. Data of clinical features, pathological characteristics, treatment, and outcomes were evaluated.

Results
The median age of patients with GAS and non-GAS HPVI ECA was 46 and 48 years, respectively (p = 0.93). Compared with non-GAS HPVI ECAs, GAS had more common complains of vaginal watery discharge (p = 0.04). GAS cases were also associated with higher clinical stage (p = 0.036), more common in deeper cervical stromal invasion (p = 0.002) and lymphoavascular invasion (p = 0.044). GAS was associated with worse median progression-free survival (PFS) (p = 0.02) and median overall survival (OS) (p = 0.03) over patients with non-GAS HPVI ECAs. MDA had similar clinical and pathological features and prognosis compared with non-MDA GAS. Of note, serum CA19–9 levels were significantly higher in GAS than that in non-GAS HPVI ECA cases.

Conclusions
GAS cases were more likely to have high risk pathological factors and poorer PFS and OS compared with non-GAS HPVI ECAs. Serum CA19–9 may be helpful for diagnosis and screening in patients with GAS.
Hybrid versus total sublaminar wires in patients with spinal muscular atrophy undergoing scoliosis surgery
Authors: Chou Shih-Hsiang , Li Wen-Wei , Lu Cheng-Chang , Lin Kun-Ling , Lin Sung-Yen , Shen Po-Chih , Tien Yin-Chun , Huang Hsuan-Ti 
Published: October 2021

Abstract
Background
Early versions of spinal muscular atrophy (SMA) scoliosis correction surgery often involved sublaminar devices. Recently, the utilization of pedicle screws has gained much popularity. Pedicle screws are generally believed to provide additional deformity correction, but pedicle size and rotational deformity limit their application in the thoracic spine, resulting in a hybrid construct involving pedicle screws and sublaminar wire. Studies of the efficacy of hybrid instrumentation in SMA scoliosis are often limited by the scarcity of the disease itself. In this study, we aimed to compare the surgical outcomes between hybrid constructs involving pedicle screws and sublaminar wire and sublaminar wire alone in patients with SMA scoliosis.

Methods
We retrospectively reviewed the clinical records and radiographic assessments of patients with SMA scoliosis who underwent corrective surgery between 1993 and 2017. The radiographic assessments included deformity correction and progressive changes in the major curve angle, pelvic tilt (PT) and coronal balance (CB). The correction of deformities was observed postoperatively and at the patient’s 2-year follow-up to test the efficacy of each type of construct.

Results
Thirty-three patients were included in this study. There were 14 and 19 patients in the wiring and hybrid construct groups, respectively. The hybrid construct group demonstrated a higher major curve angle correction (50.5° ± 11.2° vs. 36.4° ± 8.4°, p < 0.001), a higher apical vertebral rotation correction (10.6° ± 3.9° vs. 4.8° ± 2.6°, p < 0.001), and a reduced progression of the major curve angle at the 2-year follow-up (5.1° ± 2.9° vs. 8.7° ± 4.8°, p < 0.001). A moderate correlation was observed between the magnitude of correction of the apical vertebral rotation angle and the major curve (r = 0.528, p = 0.002).

Conclusion
This study demonstrated that hybrid instrumentation can provide a greater magnitude of correction in major curve and apical rotation as well as less major curve progression than sublaminar wire instrumentation alone in patients with SMA scoliosis. Level of evidence III
The impact of a computerized physician order entry system implementation on 20 different criteria of medication documentation—a before-and-after study
Authors: Jungreithmayr Viktoria , Meid Andreas D. ,   Implementation Team, Bittmann Janina , Fabian Markus , Klein Ulrike , Kugler Silvia , Löpprich Martin , Reinhard Oliver , Scholz Lucienne , Zeeh Birgit , Bitz Wolfgang , Bugaj Till , Kihm Lars , Kopf Stefan , Liemann Anja , Wagenlechner Petra , Zemva Johanna , Benkert Claudia , Merle Christian , Roman Sergej , Welte Stefan , Haefeli Walter E. , Seidling Hanna M. 
Published: October 2021

Abstract
Background
The medication process is complex and error-prone. To avoid medication errors, a medication order should fulfil certain criteria, such as good readability and comprehensiveness. In this context, a computerized physician order entry (CPOE) system can be helpful. This study aims to investigate the distinct effects on the quality of prescription documentation of a CPOE system implemented on general wards in a large tertiary care hospital.

Methods
In a retrospective analysis, the prescriptions of two groups of 160 patients each were evaluated, with data collected before and after the introduction of a CPOE system. According to nationally available recommendations on prescription documentation, it was assessed whether each prescription fulfilled the established 20 criteria for a safe, complete, and actionable prescription. The resulting fulfilment scores (prescription-Fscores) were compared between the pre-implementation and the post-implementation group and a multivariable analysis was performed to identify the effects of further covariates, i.e., the prescription category, the ward, and the number of concurrently prescribed drugs. Additionally, the fulfilment of the 20 criteria was assessed at an individual criterion-level (denoted criteria-Fscores).

Results
The overall mean prescription-Fscore increased from 57.4% ± 12.0% (n = 1850 prescriptions) before to 89.8% ± 7.2% (n = 1592 prescriptions) after the implementation (p < 0.001). At the level of individual criteria, criteria-Fscores significantly improved in most criteria (n = 14), with 6 criteria reaching a total score of 100% after CPOE implementation. Four criteria showed no statistically significant difference and in two criteria, criteria-Fscores deteriorated significantly. A multivariable analysis confirmed the large impact of the CPOE implementation on prescription-Fscores which was consistent when adjusting for the confounding potential of further covariates.

Conclusions
While the quality of prescription documentation generally increases with implementation of a CPOE system, certain criteria are difficult to fulfil even with the help of a CPOE system. This highlights the need to accompany a CPOE implementation with a thorough evaluation that can provide important information on possible improvements of the software, training needs of prescribers, or the necessity of modifying the underlying clinical processes.
Traditional knowledge of medicinal plants on Gau Island, Fiji: differences between sixteen villages with unique characteristics of cultural value
Authors: Miyamoto Kana , Ehara Hiroshi , Thaman Randolph , Veitayaki Joeli , Yoshida Takehito , Kobayashi Hikaru 
Published: October 2021

AbstractBackgroundTraditional resource management (TRM) systems develop depending on local conditions, such as climate, culture, and environment. Most studies have focused on the TRM system itself, excluding the people who manage the system, and the relationship between the system and the people. The use of resources and people is intimately linked through the practice of TRM systems on Gau Island and this relationship needs to be understood to advance sustainable resource use.MethodsA survey was conducted on the use of medicinal plants on Gau Island, Fiji. Interviews were conducted from September 2013 to January 2015 with knowledgeable members of each community. The types of plants, prescriptions, and health problems were documented, and social and ecological factors affecting the sustainability of TRM of medicinal plants used in each of the 16 villages were statistically analysed by linear regression analysis.ResultsA total of 58 medicinal plants used on a daily basis to treat 27 health problems were identified on Gau. Two medicinal plants, Botebotekoro (Ageratum conyzoides) and Totodro (Centella asiatica), were used in all districts to treat various health problems. There were contrasts between the villages in the medical lore and prescriptions, and villages often used different traditional treatments than others for the same ailment; therefore, the status and knowledge of medicinal plants have developed distinctly in each village. Geographical and social factors have been suggested as possible reasons for the differences in regional resource utilisation among villages. Statistical analysis of the relationship between the state of TRM and social and ecological factors suggest that community solidarity has a positive impact on the sustainable practice of TRM. This study showed that traditional practices simultaneously contribute to the conservation of the natural environment and the binding of communities.ConclusionsThe results highlight the importance of understanding how TRM systems can contribute to the conservation of the natural environment. Cultural activities are essential to raise community solidarity, which has led to the sustainable use of natural resources. This suggests that merely documenting the use of medicinal plants is not enough to ensure that the skills and knowledge are passed down to the next generation.
Pathological and genomic phenotype of second neuroendocrine carcinoma during long-term follow-up after radical radiotherapy for nasopharyngeal carcinoma
Authors: Peng Ying-peng , Liu Qiao-dan , Lin Yu-jing , Peng Shun-li , Wang Rong , Xu Xi-wei , Wei Wei , Zhong Gui-hua , Zhou Yu-ling , Zhang Ya-qin , Liu Ye , Wang Si-yang , Hong Hai-yu , Liu Zhi-gang 
Published: October 2021

Abstract
Background
Second head and neck neuroendocrine carcinoma (NEC) after radical radiotherapy for nasopharyngeal carcinoma (NPC) treatment is rarely reported. The prognosis of second cancer is poor, and our research focuses on finding a breakthrough in the treatment. In this study, we aimed to investigate clinicopathological characteristics and to identify the genomic landscape of second head and neck NECs.

Methods
We collected five second head and neck NEC cases in the recent three years from our patient database. Clinicopathological data and images were obtained. Genomic analysis was performed using high-throughput second generation sequencing. KEGG pathway enrichment analyses between high-frequency mutations were performed using the STRING database.

Results
All patients had been diagnosed with second NEC, according to the pathological observations. The interval between diagnosis of NPC and NEC ranged from 10 to 18 years. Two patients had brain or liver metastasis at three and nine months, respectively, after the diagnosis of NEC. Three patients died of the disease with the overall survival time ranging from three to nine months. Commonly altered genes (50%) in second head and neck NECs included TP53, RB1, NOTCH2, PTEN, POLG, KMT2C, U2AF1, EPPK1, ELAC2, DAXX, COL22A1, and ABL1. Those genetic lesions might affect p53 signaling, MAPK signaling, PI3K-Akt signaling, sphingolipid signaling, and neurotrophin signaling pathways.

Conclusions
Second head and neck NECs had poor prognosis. We revealed, for the first time, the mutational landscape, high-frequency somatic mutations, and potential signaling pathways of second head and neck NECs. Its optimal treatment model needs to be further studied in future clinical trials.
Epigenetic targeting of the ACE2 and NRP1 viral receptors limits SARS-CoV-2 infectivity
Authors: Saiz Maria Laura , DeDiego Marta L. , López-García Darío , Corte-Iglesias Viviana , Baragaño Raneros Aroa , Astola Ivan , Asensi Victor , López-Larrea Carlos , Suarez-Alvarez Beatriz 
Published: October 2021

Abstract
Background
SARS-CoV-2 uses the angiotensin-converting enzyme 2 (ACE2) and neuropilin-1 (NRP1) receptors for entry into cells, and the serine protease TMPRSS2 for S protein priming. Inhibition of protease activity or the engagement with ACE2 and NRP1 receptors has been shown to be an effective strategy for blocking infectivity and viral spreading. Valproic acid (VPA; 2-propylpentanoic acid) is an epigenetic drug approved for clinical use. It produces potent antiviral and anti-inflammatory effects through its function as a histone deacetylase (HDAC) inhibitor. Here, we propose VPA as a potential candidate to tackle COVID-19, in which rapid viral spread and replication, and hyperinflammation are crucial elements.

Results
We used diverse cell lines (HK-2, Huh-7, HUVEC, Caco-2, and BEAS-2B) to analyze the effect of VPA and other HDAC inhibitors on the expression of the ACE-2 and NRP-1 receptors and their ability to inhibit infectivity, viral production, and the inflammatory response. Treatment with VPA significantly reduced expression of the ACE2 and NRP1 host proteins in all cell lines through a mechanism mediated by its HDAC inhibitory activity. The effect is maintained after SARS-CoV-2 infection. Consequently, the treatment of cells with VPA before infection impairs production of SARS-CoV-2 infectious viruses, but not that of other ACE2- and NRP1-independent viruses (VSV and HCoV-229E). Moreover, the addition of VPA 1 h post-infection with SARS-CoV-2 reduces the production of infectious viruses in a dose-dependent manner without significantly modifying the genomic and subgenomic messenger RNAs (gRNA and sg mRNAs) or protein levels of N protein. The production of inflammatory cytokines (TNF-α and IL-6) induced by TNF-α and SARS-CoV-2 infection is diminished in the presence of VPA.

Conclusions
Our data showed that VPA blocks three essential processes determining the severity of COVID-19. It downregulates the expression of ACE2 and NRP1, reducing the infectivity of SARS-CoV-2; it decreases viral yields, probably because it affects virus budding or virions stability; and it dampens the triggered inflammatory response. Thus, administering VPA could be considered a safe treatment for COVID-19 patients until vaccines have been rolled out across the world.
The impact of feature extraction and selection for the classification of gait patterns between ACL deficient and intact knees based on different classification models
Authors: Zeng Wei , Ismail Shiek Abdullah , Pappas Evangelos 
Published: October 2021

AbstractThe anterior cruciate ligament (ACL) plays an important role in stabilizing translation and rotation of the tibia relative to the femur. Individuals with ACL deficiency usually demonstrate alterations in gait characteristics. Evidence indicates that walking speed, alterations in kinetics and kinematics on the ACL deficient limb, and inter-limb asymmetries between deficient and intact knees may contribute to poor long-term outcomes following ACL deficiency. They corrode function of the knee joint and put it at higher risk of degeneration. For the purpose of developing an automatic and highly accurate system for detection of ACL deficiency, this study investigated the classification capability of different dynamical features extracted from gait kinematic and kinetic signals when evaluating their impact on different classification models. A general feature extraction framework was proposed and various dynamical features, such as recurrence rate, determinism and entropy from the recurrence quantification analysis, fuzzy entropy, Teager-Kaiser energy feature and statistical analysis, were included. Different classification models, including support vector machine (SVM), K-nearest neighbor (KNN), naive Bayes (NB) classifier, decision tree (DT) classifier and ensemble learning based Adaboost (ELA) classifier, derived for discriminant analysis of multiple dynamical gait features were evaluated for a comparative study. The effectiveness of this strategy was verified using a dataset of knee, hip and ankle kinematic and kinetic waveforms from 43 patients with unilateral ACL deficiency. When evaluated with 2-fold, 10-fold and leave-one-out cross-validation styles, the highest classification accuracy for discriminating between groups of ACL deficient and contralateral ACL intact knees was reported to be 91.22 $$\%$$
%
, 95.12$$\%$$
%
and 96.34$$\%$$
%
, respectively,by using the SVM classifier and the optimal feature set. For other four classifiers, KNN achieved the accuracy of 78.05$$\%$$
%
, 85.37$$\%$$
%
and 87.80$$\%$$
%
, respectively. NB achieved the accuracy of 57.56$$\%$$
%
, 60.98$$\%$$
%
and 61.22$$\%$$
%
, respectively. DT achieved the accuracy of 77.56$$\%$$
%
, 80.49$$\%$$
%
and 83.66$$\%$$
%
, respectively. ELA achieved the accuracy of 73.66$$\%$$
%
, 78.05$$\%$$
%
and 79.27$$\%$$
%
, respectively. Compared with other state-of-the-art methods, the results demonstrate superior performance and support the validity of the proposed method.
Delineating investment opportunities for stakeholders in sorghum seed systems: a logit model perspective
Authors: Ndossi Judith , Akpo Essegbemon , Ojiewo Chris O. , Ringo Justin , Kongola Eliud , Vernooy Ronnie , Muricho Geoffrey , Lukurugu Gerald Alex , Makoye Lameck Nyaligwa , Tabo Ramadjita , Varshney Rajeev 
Published: October 2021

AbstractBackgroundSeed systems are considered as a vehicle through which the sustainable agricultural intensification can be achieved. However, most sub-Saharan African countries have been ineffective to provide sufficient incentives for stakeholders to consistently invest in the seed systems specifically for crops like sorghum. This study was therefore conducted to uncover investment opportunities for stakeholders in the sorghum seed systems to attain an impact-oriented seed production and delivery systems.ResultsThe study applied descriptive statistics, Logit regression model, and Gross margin to analyze possible areas for investments. Descriptive statistics analyzed the percentage of farmers using sorghum improved varieties and sources used to obtained improved variety seeds. Logit regression model was applied to analyze factors correlating with planting of improved seeds. Gross margin was applied to show profitability of growing improved sorghum seeds and grain. Findings revealed that 39.2% of the sampled farmers were growing improved sorghum variety seeds. Farmers obtained improved variety seeds from both informal (57.8%) and formal (42.2%) sources. Logit estimates indicate that variety preference, unavailability of seeds, resistance to diseases, and drought had significant correlation with planting of improved variety seeds. Seed companies and quality declared seed (QDS) producers earned high margin of 53,08,900 Tanzanian Shillings per hectare (TZS/ha, 1 USD = 2315 TZS during the period of data collection) and 33,94,709 TZS/ha, respectively. Farmers using improved variety seed earned higher margin (8,19,805 TZS/ha) than farmers who did not use improved variety seeds (3,17,373 TZS/ha)ConclusionsThe identified investment opportunities were increasing number of farmers using improved variety seeds that would drive increased production, distribution, and marketing of quality seed. The large number of farmers still sourcing seed from the informal channel provides avenue to reach out to these farmers through demand creation and wide variety popularization meeting farmer preferences. The huge margin seed producers make provides good incentive to drive private seed companies and individual seed entrepreneurs to make sustainable business out of sorghum seed. The policy implications for reviving sorghum production and productivity are further discussed.
The underlying components of data-driven smart sustainable cities of the future: a case study approach to an applied theoretical framework
Authors: Bibri Simon Elias 
Published: October 2021

AbstractThe increased pressure on cities has led to a stronger need to build sustainable cities that can last. Planning sustainable cities of the future, educated by the lessons of the past and anticipating the challenges of the future, entails articulating a multi-scalar vision that, by further interplaying with major societal trends and paradigm shifts in science and technology, produce new opportunities towards reaching the goals of sustainability. Enabled by big data science and analytics, the ongoing transformative processes within sustainable cities are motivated by the need to address and overcome the challenges hampering progress towards sustainability. This means that sustainable cities should be understood, analyzed, planned, designed, and managed in new and innovative ways in order to improve and advance their contribution to sustainability. Therefore, sustainable cities are increasingly embracing and leveraging what smart cities have to offer in terms of data-driven technologies and applied solutions so as to optimize, enhance, and maintain their performance and thus achieve the desired outcomes of sustainability—under what has been termed “data-driven smart sustainable cities.” Based on a case study analysis, this paper develops an applied theoretical framework for strategic sustainable urban development planning. This entails identifying and integrating the underlying components of data-driven smart sustainable cities of the future in terms of the dimensions, strategies, and solutions of the leading global paradigms of sustainable urbanism and smart urbanism. The novelty of the proposed framework lies in combining compact urban design strategies, eco-city design strategies and technology solutions; data-driven smart city technologies, competences, and solutions for sustainability; and environmentally data-driven smart sustainable city solutions and strategies. These combined have great potential to improve and advance the contribution of sustainable cities to the goals of sustainability through harnessing its synergistic effects and balancing the integration of its dimensions. The main contribution of this work lies in providing new insights into guiding the development of various types of strategic planning processes of transformative change towards sustainability, as well as to stimulate and inspire future research endeavors in this direction. This study informs policymakers and planners about the opportunity of attaining important advances in sustainability by integrating the established models of sustainable urbanism and the emerging models of smart urbanism thanks to the proven role and untapped potential of data-driven technologies in catalyzing sustainable development and thus boosting sustainability benefits.