bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cardiogenic shock treated with immunosuppression: a case presentation of acute fulminant eosinophilic myocarditis
Authors: Chatrath Nikhil , Dar Owais 
Published: August 2021

Abstract
Eosinophilic Myocarditis is a rapidly progressive form of myocarditis, associated with several underlying conditions including inflammatory bowel disease. A 34-year old male with a history of Ulcerative Colitis on Infliximab presented with chest pain, dyspnoea and a recent febrile illness. Serum troponin levels were raised and ECG showed right bundle brunch block. Subsequent emergency coronary angiography showed unobstructed coronary arteries but echocardiography revealed severely impaired left ventricular function. He clinically deteriorated rapidly, developing atrio-ventricular block and cardiogenic shock requiring inotropic and mechanical circulatory support. Endomyocardial biopsy specimens showed diffuse eosinophilic infiltration. Aggressive corticosteroid therapy was initiated and there was a gradual resolution of ventricular function. Peripheral eosinophil counts were within the normal range throughout the illness. Disease activity was monitored with multimodality imaging including PET-CT. Immunosuppression was maintained with Ciclosporin and Mycophenolate Mofetil, avoiding long-term steroid therapy.
A General Numerical Scheme for the Optimal Control of Fractional Birkhoffian Systems
Authors: He Lin , Wei Chunqiu , Sha Jiang , Mao Delong , Wang Kangshuo 
Published: August 2021

Abstract
This paper deals with the optimal control of fractional Birkhof-fian systems based on the numerical method of variational integrators. Firstly, the fractional forced Birkhoff equations within Riemann–Liouville fractional derivatives are derived from the fractional Pfaff–Birkhoff–d'Alembert principle. Secondly, by directly discretizing the fractional Pfaff–Birkhoff–d'Alembert principle, we develop the equivalent discrete fractional forced Birkhoff equations, which are served as the equality constraints of the optimization problem. Together with the initial and final state constraints on the configuration space, the original optimal control problem is converted into a nonlinear optimization problem subjected to a system of algebraic constraints, which can be solved by the existing methods such as sequential quadratic programming. Finally, an example is given to show the efficiency and simplicity of the proposed method.
Blepharospasm as a Tardive Manifestation of Covid-19 Disease
Authors: Farci Roberta , Carta Arturo , Fossarello Maurizio 
Published: August 2021

Abstract
Purpose: to describe a new clinical manifestation caused by Covid-19.Observations: We report two confirmed case of COVID-19 who showed blepharospasm as a tardive sequel of the infection.Conclusions and Importance: blepharospasm could represent a tardive clinical sign of Covid-19 infection, responsible for the 2020 pandemia.
Natural Waste to Electricity: Engineering Pomegranate Peels and Ag-Doped ZnO for Photovoltaic Applications
Authors: Lourdusamy Vincent Joseph Kanniyambatti , Thomas Mary Rosana Nalzala , Kabali Vijai Anand , Rajaiah Dhilip Kumar 
Published: August 2021

Abstract
Utilization of natural waste for energy conversion offers the method for clean energy production with sustainable development. The pomegranate peels are the natural waste generated every day and we describe the conversion of this waste into electricity by a simple and cost-effective method. Dye Sensitized Solar Cells (DSSCs) offer simple and cost-effective method for the preparation of solar cells. The advantages include easy to fabrication, lower cost of the materials and electricity generation under low illumination indoor conditions. DSSCs involve two Transparent Conducting Oxide (TCO) photoelectrodes acting as photoanode and photocathode. In one photoelectrode, Semiconducting oxide (TiO2/ZnO) and dye (Natural/Organometallic) are coated that acts as photo-absorbing materials. The role of dyes and semiconducting material play an important role in determining the photovoltaic conversion efficiency of fabricated solar cells. In this work, hydrothermal method has been adopted for the preparation of pure and silver doped ZnO nanoparticles using polyethylene glycol (PEG) as capping agent via wet chemical route. The structural and optical properties of the prepared samples were studied using X-ray diffraction (XRD), Fourier Transform Infrared Spectroscopy (FT-IR), Scanning Electron Microscopy (SEM) with Energy Dispersive X-ray Analysis (EDAX) and UV-Visible absorption spectra. A Natural dye from the peels of pomegranate was extracted and dye sensitized solar cells were fabricated with pure and Ag-doped nanoparticles. Both the materials showed the photovoltaic conversion capabilities and showed photoconversion efficiencies. The solar cell fabricated with Ag-doped ZnO semiconducting nanoparticle showed higher short circuit current density as compared to the pure ZnO-nanoparticle synthesized in this study. The photoconversion efficiency of the DSSC based on Ag-doped ZnO showed 30% more conversion efficiency than the cell without silver doping.
Safety and Efficacy of Non-Vitamin K Antagonists in Atrial Fibrillation in the real world: A pooled-analysis and comparison of XANTUS and ETNA-AF-EU studies
Authors: Ferreira Hilaryano , Morais Humberto , Augusto Joao , Ferreira Ana Rita , Madeira Francisco , Morais Jose , Morais Carlos 
Published: August 2021

Abstract
Background: This study aims to assess the efficacy and safety of treatment with edoxaban or rivaroxaban for stroke prevention in patients with atrial fibrillation. Methods: Pooled analysis from two real-world cohorts. Efficacy outcomes were all-cause mortality, cardiovascular mortality and thromboembolic events at 1 year. Safety outcomes were assessed by major or nonmajor bleeding. Results: A total of 19876 patients were enrolled in both trials. All-cause mortality at 1 year was lower in the rivaroxaban group (118 of 6784 patients [1.7%]) than in the edoxaban group (442 of 13092 patients [3.5%]) (unadjusted odds ratio was 1.97 (95% CI, 1.61 to 2.42; P=<0.00001). Cardiovascular mortality was edoxaban (206 of 13092 patients [1.63%]) vs rivaroxaban 49 of 6784 patients [0.72%]) (unadjusted OR, 2.20; 95% CI, 1.61 to 3.00; p=<0.00001). Overall, the efficacy outcomes favoured the rivaroxaban cohort (OR 1.97, 95% CI, 1.33 to 2.91; P=0.0002), with no significant difference in ischaemic stroke between the two cohorts (unadjusted OR 1.13, 95% CI, 0.75 to 1.73; P=0.56). Overall, safety outcomes tended to occur more often in the edoxaban cohort (unadjusted OR 0.43, 95% CI, 0.20 to 0.40; P=<0.00001). Conclusion: Rivaroxaban and edoxaban seem to be effective and safe. However, real-world prospective studies evaluating safety and efficacy in certain subgroups are needed.
Detection of Factors That Cause Delay to Surgical Treatment of Patients with Gastrointestinal Malignancies in Patients of Hospital during 2 Years
Authors: Yahyazadeh Hossein , Beheshti Marzieh , Molanaei Saadat , Tahbaz Sahel Valadan 
Published: August 2021

Abstract
Background: Many patients with gastrointestinal malignancies suffer from false treatments and incorrect diagnostic studies before diagnosis. This study examines the time taken to diagnose gastrointestinal cancer, identify the cause of delay, and judge its clinical importance. Materials and Methods: Patients with gastrointestinal malignancies (Esophageal, gastric, and colorectal) who were admitted for the first surgery were considered. The delay of diagnosis and treatment and responsible factors were analyzed from patients' history by recall of patients and reviewing para-clinical data, patient's records, and pathology report. Results: A total of 123 patients underwent diagnostic endoscopy 140 times. This study shows that the rate of biopsy in the three groups of patients with esophageal, gastric and colorectal cancers was 0.8%, 11.4% and 87.8%, respectively, which was not significantly different. A comparison of the number of patients who have undergone endoscopy more than once in the three groups of esophageal, gastric and colorectal malignancies shows that 6% of patients with esophageal cancer and 12% of patients with gastric cancer have undergone endoscopy more than once. This rate was 82%% in patients with colorectal cancer (P Value = 0.05). Conclusion: from this study can we educate the public about the symptoms of these diseases; and work that can be offered as a suggestion in this field, in prioritizing surgeries related to malignancies referred to medical centers, as well as establishing a systemic management of the initial diagnosis and finally treatment leading to surgery in patients with malignancies in each classification is.
Tumor Markers Reflect Tumor Burden of Pseudomyxoma Peritonei
Authors: Bai Mingjian , Pang Shaojun , Lu Yiyan , Wei Hongjiang , Feng Jing , Zong Hounian , Xu Hongbin , Liang Guowei 
Published: August 2021

Abstract
Background: Accurate assessment of preoperative tumor burden contribute to formulate a scientific surgical plan and improve the prognosis of patients with pseudomyxoma peritonei (PMP). Present study aimed to assess whether preoperative serum tumor markers could reflect tumor burden. Methods: A total of 198 PMP patients were included, the peritoneal cancer index (PCI) was employed to reflect tumor burden for PMP patients. All participants were divided into low (PCI ≤ 19) and high (PCI ≥ 20) tumor burden subgroups according to PCI. All serum tumor markers (carcinoembryonic antigen (CEA), carbohydrate antigen 125 (CA125), CA 19-9, CA 724, and CA 242) were compared between the two subgroups. The correlation between tumor markers and PCI will be calculated and compared with each other. Two-sided P value less than 0.05 is considered statistically significant.Results: The level of CEA (ng/ml), CA125 (U/ml), CA 19-9 (U/ml), CA 724 (U/ml), and CA 242 (kU/L) between low and high tumor burden subgroup were [3.35 (1.64, 16.31) vs. 23.12 (8.80, 67.62), Z = -5.381, p<0.001], [19.10 (7.61, 56.95) vs. 72.75 (40.41, 130.55), Z = -5.978, p < 0.001], [6.17 (3.26, 16.22) vs. 45.50 (13.95, 123.61), Z = -5.413, p < 0.001], [7.89 (1.57, 45.10) vs. 84.61 (33.87, 236.93), Z = -5.898, p < 0.001], and [13.32 (3.39, 96.50) vs. 150.00 (102.13, 308.88), Z = -5.166, p < 0.001], respectively. The Spearman correlation between tumor markers and PCI were 0.415 for CEA (p < 0.001), 0.372 for CA 125 (p < 0.001), 0.466 for CA 19-9 (p < 0.001), 0.379 for CA 724 (p < 0.001), and 0.317 for CA 242 (p < 0.001), respectively. Conclusions: Preoperative serum tumor markers could moderately reflect tumor burden for PMP, which may contribute to develop a better surgical plan before operation.
Noise-Induced Hearing Loss and Hypertension: A Preliminary Analysis of Baseline Data of Occupational Noise-Exposed Workers
Authors: Miao Long , Yin Lihong , Pu Yuepu 
Published: August 2021

Abstract
The present study aimed to determine the current levels of systolic blood pressure (SBP), diastolic blood pressure (DBP) and binaural high frequency (3, 4, and 6 kHz) threshold on average (BHFTA), to assess the prevalence of noise-induced hearing loss (NIHL) and hypertension and determine the factors influencing the risk of both, and to evaluate the association between NIHL and hypertension among occupational noise-exposed workers. Questionnaire and occupational health checkup were performed to collect the personal information and physical examination data. Finally, baseline data from 42,588 occupational noise-exposed workers were analyzed. The mean levels of SBP, DBP, and BHFTA were 126.85 ± 15.94 mm Hg, 79.94 ± 11.61 mm Hg and 23.09 ± 11.32 dB, respectively. Of the 42,588 subjects, the prevalence of NIHL and hypertension were 24.38% (n = 10,383) and 25.40% (n = 10,816). The results suggested that higher risk of NIHL and hypertension were more likely to be the groups of male gender, aged > 35 years, exposure time to noise > 5 years, and smoking. The SBP, DBP and BHFTA levels increased with age and noise exposure time (Ptrend < 0.001). Besides, similar trends were also observed in the prevalence of NIHL and hypertension. Furthermore, there was a significant association of NIHL with hypertension. We found that 32.25% (n = 3,348) workers with NIHL had hypertension. The mean levels of SBP and DBP in NIHL workers were significantly higher than those with normal hearing (P < 0.001). In addition, NIHL workers had a significantly higher risk of developing hypertension than normal hearing workers (adjusted OR = 1.08, 95%CI = 1.03–1.14). Our current findings suggest that the prevalence of NIHL and hypertension are high in our study workers and occupational noise exposure is an important factor. Therefore, it is urgent to reduce noise exposure in the workplaces and to strengthen industrial noise monitoring.
An Insight into the Battery Degradation for a Proposal of a Battery Friendly Charging Technique
Authors: Sah Bikash , Kumar Praveen 
Published: August 2021

Abstract
Li-ion batteries are widely used in electric vehicles because of their promising characteristics that meet high specific power and energy density requirements. The only setback is the capacity fading due to degradation in Li-ion batteries. The rate of capacity fade in Li-ion batteries in EVs vary based on the charging rate, changes in internal cell temperature and external ambient temperature, and user driving patterns. Since the Li-ion battery is electrochemical, determining the actual cause of degradation at a particular instant and constraining the rate is a big challenge. Further, the causes are related to parameters which are chemical, electrical and mechanical. In this work, the causes of degradation are studied by analysing the variation of parameters for multiple charge types and rates at different ambient temperatures. The analysis leads to developing a new universal charging scheme suitable to fast charge battery at different ambient temperatures appropriately and constrain battery degradation.
Pomiferin Exerts Anti-Neuroinflammatory Effects Through Activating Akt /Nrf2 Pathway and Inhibiting NF-κB pathway
Authors: Zhao Yan , Sang Yuxuan , Sun Yanan , Wu Jie 
Published: August 2021

Abstract
Background:Neurodegenerative diseases are associated with neuroinflammation. However, the pro-inflammatory mediators produced during the occurrence of neuroinflammation will damage neurons and aggravate the process of neurodegenerative diseases. Therefore, inhibiting neuroinflammation may be an effective way to alleviate neurodegenerative diseases. The orange mulberry brass has a wide range of anti - oxidation and anti - inflammatory effects in peripheral tissues. However, it is not clear whether it inhibits neuroinflammation. Methods:In our experiment, we studied the effect of Pomiferin on BV2 cell inflammation and its mechanism with Quantitative PCR, ELISA and western blot.Results:The results showed that Pomiferin inhibited the production of ROS, NO and proinflammatory mediators (IL-6, TNF-α, iNOS, COX2) in BV2 cells. Further mechanism studies showed that Pomiferin activated the Akt /Nrf2 pathway and inhibited the NF-κB pathway. Conclusion: Our study demonstrated that Pomiferin exerts anti-neuroinflammatory effects through activating Akt /Nrf2 pathway and inhibiting NF-κB pathway.
Clinical Application of a Modified Local Transposition Flap Surgery in Repairing Fingertip Defects
Authors: Zhang YingKai , Wang Yao , Wu Rongbo , Zhou Jiaqi , Zhao Mingdong 
Published: August 2021

Abstract
Purpose: A modified local transposition flap surgery was performed for fingertip injuries. Given the shape of the flap turnover resembling a parallelogram, we called it a parallelogram flap. This transposition flap surgery allows a more significant transfer distance with good outcomes.Method: The study collected patients who underwent parallelogram transposition flaps to repair fingertip defects from 2017 to 2020. 32 cases (32 fingers) were included in our study, including 20 males and 12 females, aged 17 to 60 years, with an average age of 36 years. The causes of injury were crush injury in 13 cases, punch injury in 11 cases and sharp cutting injury in 8 cases. There were 6 cases in thumbs, 6 cases in index fingers, 14 cases in middle fingers, 4 cases in ring fingers and 2 cases in little fingers. The area of fingertip defects was 1.2 cm × 2~3 cm × 4 cm, with bone exposure. The interval between the injury and operation was 5.78 h (the mean value was 4.7-8.4 h). All operations were performed by one surgical team, and the average operation time was 31.2 min.Record The length and width of the finger，two-point discrimination（2PD），Total Active Movement (TAM)and the MHQ (Michigan Hand Questionnaire) of the injured fingers to evaluate the therapeutic effect.Results: all our parallelogram flaps had survived postoperatively.，At last follow-up,There was no difference between the length and width of the reconstructed finger and that of the healthy side（P>0.05）. The qualification rate of the static 2PD of the flaps were 84.37% .The qualification rate of the TAM of injured figures were 100% . Evaluation of the MHQ subscale performance showed that the score of the overall hand function is 93.71, activities of daily living is 95.22, work performance is 94.23,pain score is 4.34 , aesthetics is 92.15 and satisfaction score is 92.45.All of these were perform well.Conclusion: This transposition flap surgery allows a more significant transfer distance with good outcomes.
Intramedullary Nailing of Intertrochanteric Fractures - Minimal Invasive Techniques for Reduction
Authors: Duan Xuzhou , Tong Dake , Zhang Hao , Ji Fang 
Published: August 2021

Abstract
Background: An intramedullary nail has become the implant of choice for intertrochanteric fractures. This paper introduced some minimal invasive techniques were used to improve quality of intertrochanteric fracture reduction. Methods: Of 119 intertrochanteric fractures treated from January 2014 to October 2019. All patients who received internal fixation on traction bed, and who could not achieve satisfactory closed reduction through the process of "external rotation, abduction, traction, adduction and internal rotation". Reductions were classified as good, acceptable, or poor. We had acceptable reduction in 83 cases and poor reduction in 37 cases though closed reduction. The displacement was reduced using some minimal invasive techniques. Results: After performing the relative techniques in these cases, no case had a poor result. 112(94.9%) cases were in a good reduction. Anatomical reduction should always be achieved in intertrochanteric fractures. Conclusion: The minimal invasive techniques could help the surgeon achieve satisfactory reduction in intertrochanteric fractures. This work had the potential to improve the cognition of reduction of intertrochanteric fractures for surgeons, especially beginners and juniors.
Groundwater Hydrochemical Characteristics in a Plain River Network Region: Effects of Dissolved Organic Carbon and Possible Traceability of Pollution Sources
Authors: Ma Ning , Gao Li , Ge Zhengkui , Hu En , Pan Baozhu , Wang Jian , Li Ming 
Published: August 2021

Abstract
The chemical composition of groundwater indicates the water quality and provides useful information for identifying pollution sources. The aim of this study was to explore the effects of dissolved organic matter inputs on the ionic composition of groundwater and identify ions that can be used as indicators of pollution sources. Descriptive statistics, a Piper diagram, a Gibbs plot, major ion ratios, and Pearson’s correlation coefficients were used to analyze the chemical data of 40 groundwater samples collected from the shallow aquifer surrounding Lake Taihu. The results showed that the water quality index values of most sampling points were less than 50 (excellent water quality), except for one point in the southeast direction of the lake basin (good water quality). The dominant hydrochemical type of groundwater was Ca–Mg–HCO3 type, and rock dominance was the major mechanism controlling the groundwater chemistry. With an increasing concentration of dissolved organic carbon, the Na+, Mg2+, and HCO3- concentrations all showed a sharp increase followed by a slow increase, while the NO3– concentration initially decreased sharply and then decreased slowly. The K+ concentration was positively correlated with total dissolved nitrogen and phosphorus, nitrate, As, and Cd concentrations (p < 0.05). The Ca2+, Na+, Mg2+, Cl-, HCO3-, and CO32- concentrations were all positively correlated with Pb concentration (p < 0.001). The results indicated that high organic matter inputs can directly or indirectly change the hydrochemical type of groundwater, and K+ can be used as a tracer ion for the sources of As and Cd in groundwater in the study area.
Opioid Prescribing Patterns by Drug Type: The Pennsylvania Experience
Authors: Bakewell Brock K. , Miller Chain , Sherman Matthew , Ilyas Asif M. 
Published: August 2021

Abstract
Background: Opioid abuse persists as a significant public health issue in the United States; many states are implementing education and monitoring programs in response. This study examined opioid prescribing patterns and trends after implementing a prescription drug monitoring program in Pennsylvania from 2016 to 2020.Methods: A cross-sectional data analysis using de-identified data from Pennsylvania's PDMP delivered by the Pennsylvania Department of Health was undertaken.Results: In 2016, nearly 2 million opioid prescriptions were given to patients across the state. However, by the end of the study period in 2020, there was a 38% decrease in opioid prescriptions written. Specifically, over 700,000 fewer prescriptions in the first quarter of 2020 compared to the third quarter in 2016. The opioids that were most frequently prescribed were oxycodone, hydrocodone, and morphine.Conclusion: While fewer prescriptions were being prescribed overall, the breakdown of drug type being prescribed remained similar in 2020 compared to 2016. Fentanyl and hydrocodone saw the largest decrease between 2016 and 2020.
Significance of Subchondral Bone Microfracture In The Human Osteoarthritic Tibial Plateau On Cartilage Tidemark Drift
Authors: WANG XIAOJIAN , Zhang Yu-min , Lu Xiao , Tian Wei , Zhang Jian , Xu Wei-wei , Li Li-jun , Chang Feng 
Published: August 2021

Abstract
Objective: To observe the significance of subchondral bone microfracture in the human osteoarthritic tibial plateau on cartilage tidemark drift.Methods: Human knee tibial plateau cartilage samples with different OARSI grades were obtained, and the numbers of cartilage tidemarks and microfracture lines were determinedafter safranin O staining and compared among groups. Osteogenesis caused by microfracture in subchondral bone was observed and staged according to biological properties.Immunohistochemistry, western blotting, PCR and laser microdissection were performedto detect the biological properties of osteogenic areas caused by microfractures.The accompanying relationship between the ossification process and new tidemark formation inosteogenic areas caused by microfractures was then evaluated.Results: With the increase in OARSI grade, the numbers of cartilage tidemarks and subchondral bone microfracture lines in human knee tibial plateau cartilage tissue samples showed increasing trends.The subchondral bone microfracture line was observed toextend as far asthe basal area of hyaline cartilage and cause endochondral osteogenesis.The endochondral osteogenesis caused by subchondral microfracture was categorized into chondrocyte,calcareous sedimentary and ossification stages. A new tidemark appeared in the osteogenic region near the hyaline cartilage when the ossification process of the osteogenic region was completed.Conclusions:Endochondral osteogenesis canoccur at the base of hyaline cartilage induced by microfractures in the tibial plateau subchondral bone. A new cartilage tidemark can form on the side of the osteogenic tissue close to hyaline cartilage when the process of osteogenesis is completed.There is a positive correlation between the degree of cartilage tissue degeneration and the number of tidemarks in articular cartilage.