bluuebunny/crossref_metadata_2025_split huggingface dataset:
Value of sonographic pseudogestational sac sign in the diagnosis of Meckel diverticulum in children presenting with bleeding per rectum: a 15-year prospective study
Authors: El-Maadawy Samar M. , Alaaeldin Nesreen , Zefov Vassil N. 
Published: August 2021

Abstract
Background
Meckel diverticulum is the most common congenital abnormality of the gastrointestinal tract. Gastrointestinal bleeding is the most common complication of Meckel diverticulum in the paediatric population; the bleeding mostly occurs in the first 2 years of life. Because the diverticulum is seldom seen in clinical practice, misdiagnosis and delayed diagnosis are not uncommon. CT and nuclear studies are the most used diagnostic tools in clinical practice. However, radiation and sensitivity concerns remain an issue. Ultrasound has been suggested as an alternative diagnostic tool in diagnosing Meckel diverticulum with mixed results. The aim of our study is to assess the value of using a new sonographic sign, the pseudogestational sac sign in diagnosing Meckel diverticulum in children presenting with bleeding per rectum. Ultrasound was performed for all children. Results were correlated with nuclear studies, histopathology and clinical follow-up findings.

Results
Seventy-three children were included in our study. The pseudogestational sac sign was present in 46 (63%) and absent in 27 (37%) cases. Forty-five children were ultimately diagnosed as Meckel diverticulum. The age ranged from 2 months to 9 years with a mean of 2.3 years. The boy-to-girl ratio was 4.6:1 with 60% of children presenting during their first 2 years of life. The ultrasound performance using the pseudogestational sac sign revealed a sensitivity of 91.1%, specificity of 82.1%, positive predictive value of 89.1%, negative predictive value of 85.2%, positive likelihood ratio of 5.1, negative likelihood ratio of 0.11 and accuracy of 87.7%.

Conclusion
The sonographic pseudogestational sac sign is a reliable diagnostic tool for diagnosing Meckel diverticulum in children presenting with bleeding per rectum. The sonographic diagnosis of Meckel diverticulum complies with the international standards of “Image Gently”.
Investigating the impact of quarantine on mental health: insights from the COVID-19 international border surveillance study in Canada
Authors: Regehr Cheryl , Goel Vivek , De Prophetis Eric , Jamil Munaza , Mertz Dominik , Rosella Laura C. , Bulir David , Smieja Marek 
Published: August 2021

Background
Nations throughout the world are imposing mandatory quarantine on those entering the country. Although such measures may be effective in reducing the importation of COVID-19, the mental health implications remain unclear.

Aims
This study sought to assess mental well-being and factors associated with changes in mental health in individuals subject to mandatory quarantine following travel.

Method
Travellers arriving at a large, urban international airport completed online questionnaires on arrival and days 7 and 14 of mandated quarantine. Questionnaire items, such as travel history, mental health, attitudes toward COVID-19, and protection behaviours, were drawn from the World Health Organization Survey Tool for COVID-19.

Results
There was a clinically significant decline in mental health over the course of quarantine among the 10 965 eligible participants. Poor mental health was reported by 5.1% of participants on arrival and 26% on day 7 of quarantine. Factors associated with a greater decline in mental health were younger age, female gender, negative views toward quarantine measures and engaging in fewer COVID-19 prevention behaviours. For instance, travellers who stated that they rarely wore masks had nearly three times higher odds of developing poor mental health.

Conclusions
Although the widespread use of quarantine may be effective in limiting the spread of COVID-19, the mental health implications are profound and have largely been ignored in policy decisions. Psychiatry has a role to play in contributing to the public policy debate to ensure that all aspects of health and well-being are reflected in decisions to isolate people from others.
Prognostic Model for De Novo and Recurrent Metastatic Breast Cancer
Authors: Barcenas Carlos H. , Song Juhee , Murthy Rashmi K. , Raghavendra Akshara S. , Li Yisheng , Hsu Limin , Carlson Robert W. , Tripathy Debu , Hortobagyi Gabriel N. 
Published: August 2021

PURPOSE Metastatic breast cancer (MBC) has a heterogeneous clinical course. We sought to develop a prognostic model for overall survival (OS) that incorporated contemporary tumor and clinical factors for estimating individual prognosis. METHODS We identified patients with MBC from our institution diagnosed between 1998 and 2017. We developed OS prognostic models by Cox regression using demographic, tumor, and treatment variables. We assessed model predictive accuracy and estimated annual OS probabilities. We evaluated model discrimination and prediction calibration using an external validation data set from the National Comprehensive Cancer Network. RESULTS We identified 10,655 patients. A model using age at diagnosis, race or ethnicity, hormone receptor and human epidermal growth factor receptor 2 subtype, de novo versus recurrent MBC categorized by metastasis-free interval, Karnofsky performance status, organ involvement, frontline biotherapy, frontline hormone therapy, and the interaction between variables significantly improved predictive accuracy (C-index, 0.731; 95% CI, 0.724 to 0.739) compared with a model with only hormone receptor and human epidermal growth factor receptor 2 status (C-index, 0.617; 95% CI, 0.609 to 0.626). The extended Cox regression model consisting of six independent models, for < 3, 3-14, 14-20, 20-33, 33-61, and ≥ 61 months, estimated up to 5 years of annual OS probabilities. The selected multifactor model had good discriminative ability but suboptimal calibration in the group of 2,334 National Comprehensive Cancer Network patients. A recalibration model that replaced the baseline survival function with the average of those from the training and validation data improved predictions across both data sets. CONCLUSION We have generated and validated a robust prognostic OS model for MBC. This model can be used in clinical decision making and stratification in clinical trials.
Making External Validation Valid for Molecular Classifier Development
Authors: Wu Yilin , Huang Huei-Chung , Qin Li-Xuan 
Published: August 2021

PURPOSE Accurate assessment of a molecular classifier that guides patient care is of paramount importance in precision oncology. Recent years have seen an increasing use of external validation for such assessment. However, little is known about how it is affected by ubiquitous unwanted variations in test data because of disparate experimental handling and by the use of data normalization for alleviating such variations. METHODS In this paper, we studied these issues using two microarray data sets for the same set of tumor samples and additional data simulated by resampling under various levels of signal-to-noise ratio and different designs for array-to-sample allocation. RESULTS We showed that (1) unwanted variations can lead to biased classifier assessment and (2) data normalization mitigates the bias to varying extents depending on the specific method used. In particular, frozen normalization methods for test data outperform their conventional forms in terms of both reducing the bias in accuracy estimation and increasing robustness to handling effects. We make available our benchmarking tool as an R package on GitHub for performing such evaluation on additional methods for normalization and classification. CONCLUSION Our findings thus highlight the importance of proper test-data normalization for valid assessment by external validation and call for caution on the choice of normalization method for molecular classifier development.
Reactive Amphiphilic Aprotic Ionic Liquids Based on Functionalized Oligomeric Silsesquioxanes
Authors: Shevchenko Valery V , Gumenna Mariana , Lee Hansol , Klimenko Nina , Stryutsky Oleksandr , Trachevsky Vladimir , Korolovych Volodymyr , Tsukruk Vladimir V 
Published: August 2021

Abstract
This paper discusses a method for the synthesis of ionic liquids which are mixtures of oligomeric silsesquioxanes (OSS) of polyhedral structure and their analogs with open chains containing aprotic cationic ionic groups with different lengths of alkyl substituents and reactive hydroxyl groups in the organic shell (OSS-ILs). This method includes the quaternization reaction of OSS with tertiary amine and primary and secondary hydroxyl groups by n-bromopropane or n-bromodecane. Obtained compounds were amorphous with glass transition temperature below 0 °C. The ionic conductivity of OSS-ILs increases with decreasing the alkyl substituent length and reaches 1.4·10−3 S/cm at 120 °C.
Dynamic light scattering reveals that the length of alkyl substituent of OSS-ILs affects the assembly behavior in aqueous solutions. According to atomic force microscopy images, the surface morphology of the film of OSS-IL with short substituents showed disk-like flat micelles with an average diameter of 229 ± 92 nm and height of 2 nm. OSS-IL with long substituents formed polydisperse micellar morphologies, of which a majority showed elongated, worm-like structures with an average height of 2 nm. The ability to endow ionic conductivity and to tune morphology makes these materials promising as potential polymer electrolytes for various electrochemical applications, in particular ionic sensors and energy storage devices.
Ein Aufschluss der Inneren Stadtmauer am St. Alban-Graben
Authors: Helmig Guido 
Published: August 2021

Am St. Alban-Graben sind, trotz grossflächiger Neubauten des 19. und 20. Jahrhunderts, noch grössere, zusammenhängende Abschnitte der Inneren Stadtmauer erhalten geblieben; die Tore eingangs der Freien Strasse und der Rittergasse hingegen sind bereits im 19. Jahrhundert abgebrochen worden.
Die Südfassade des nach 1758 erbauten barocken Gartenflügels des Ritterhofes (Rittergasse 20) ruht wie auch die westlich angrenzenden Gebäude des Antikenmuseums (Nrn. 5 und 7) auf der Abbruchkrone der Inneren Stadtmauer am St. Alban-Graben. Die beiden Befunde werden im Bericht vorgestellt.
Leitungsgrabungen zwischen Spalenberg und Stadthausgasse
Authors: Matt Christoph Ph. , Bing Christian 
Published: August 2021

Am Fusse des Spalenbergs, zwischen Rümelinsplatz und Stadthausgasse, wurden zwischen 1979 und 1990 zwei grössere Tiefbauprojekte und eine kleinere Leitungsgrabung durchgeführt.
Bei der Grabung Schneidergasse/Stadthausgasse (A), bei der eine neue, tiefliegende Kanalisationsleitung verlegt wurde, konnten mehrere Mauerzüge und Gehhorizonte nachgewiesen werden, bei der Leitungsgrabung an der Stadthausgasse 10 (A) ein möglicherweise zu einem romanischen Kernbau gehörender Mauerzug eingemessen und eine romanische Wandsäule als Streufund geborgen werden. An der Stelle des romanischen Kernbaus (erbaut wohl um 1100 oder wenig danach) stand später die erstmals 1349 genannte Trinkstube, das sog. Haus zum Seufzen.
Bei der Grabung von 1990 wurden anlässlich des Ausbaus des Fernheizungsnetzes die Fassaden der älteren Überbauung im Bereich Münzgasse/Schneidergasse freigelegt. Ausserdem wurde eine Reihe weiterer, kleinerer Leitungsgrabungen aus der unmittelbaren Umgebung in die Auswertung miteinbezogen.
Die baugeschichtliche Untersuchung in der Liegenschaft «zum Frösch»
Authors: Reicke Daniel 
Published: August 2021

Die Untersuchungen haben ergeben , dass an der Schützenmattstrasse 11 ein Gebäude - aufgrund der äusserlichen Bausubstanz ins 19. Jahrhundert datiert - von 1545 erhalten war. Im oberen Geschoss waren die Innenwände dieses Hauses bis 1992 - nur geringfügig verändert - in Gebrauch; von der ehemaligen Einrichtung konnten noch interessante Reste freigelegt werden.
Vor 1545 stand hier wahrscheinlich ein Ökonomiegebäude von grösserer Tiefe, das nicht vollständig erfasst werden konnte. Dieser Bau ist in den historischen Quellen des späteren 14. Jahrhunderts erwähnt.
Die älteste Bebauung auf der untersuchten Parzelle wird im Beitrag von Ch. Matt und Ch. Bing beschrieben.
Gerbergasse 78/Lohnhofgässlein 6 (1992/12)
Authors: Matt Christoph Ph. , Bing Christian 
Published: August 2021

Die ältesten mittelalterlichen Funde und Befunde legen eine Begehung bereits im 12. Jahrhundert nahe. Hinweise auf Holzbauten lassen sich nur indirekt aus wenigen Spuren rot verbrannten Lehms erschliessen. Ein in Gassennähe gelegenes Holzhaus wurde im Laufe des zweiten und dritten Viertels des 13. Jahrhunderts erbaut und fiel danach einem Brand zum Opfer.
Die ersten Steinbauten auf der Parzelle Nr. 78 dürften nach Ausweis der Befunde nicht vor dem späten 13. Jahrhundert entstanden sein; erste schriftliche Nachrichten über ein (zweifellos steinernes) Haus stammen aus der Zeit um 1300.
Die archäologische Untersuchung auf der Parzelle Nr. 78 ergänzt das bisher bekannte Bild von der frühen Besiedlung der oberen Talstadt. Die ersten Steinbauten im Gebiet der oberen Talstadt sind an verschiedenen Fundstellen gefasst worden. Die Bauweise in Stein erfolgte hier etwas später als in der unteren Talstadt.
Archäologische Untersuchungen im Hause Webergasse 25, 1990/34
Authors: Matt Christoph Ph. , Bing Christian 
Published: August 2021

An der Webergasse in Kleinbasel stehen noch zahlreiche alte Häuser. Das kleine Gärtchen (Hinterhof) hinter dem Haus an der Webergasse 25 liegt über dem zugeschütteten Abschnitt des Hinteren Teichs, eines Hauptarms der drei innerhalb der Stadtmauern gelegenen Kleinbasler Gewerbekanäle, der am 3. September 1917 aufgehoben und trockengelegt worden ist.
Im hinteren Teil des Hauses konnten zwei Zimmer vollständig ausgegraben werden. Verschiedene im Laufe der Zeit im Haus ausgeübte Gewerbe haben Spuren im Boden hinterlassen. Eine grosse, innen mit Holz verkleidete, quadratische Grube, bei der unter Anrechnung des nicht erhaltenen Splintholzes mit einem Fälldatum frühestens nach 1560 gerechnet werden darf, gehörte wohl zu einer Gerberei, wie der damals unmittelbar hinter dem Haus vorbeiführende Gewerbekanal nahelegt. Zu einem späteren Zeitpunkt wurden zwei runde Gerbgruben eingegraben, die als gemauerte Negative mit Abdrücken von Holzbottichen und Resten von horizontalen Rutenbündeln (zum zusammenhalten der Dauben) erhalten waren. Als dritte Generation von Gerb- oder Färbeinrichtungen sind zwei rechteckige, aus Backsteinen gemauerte Becken zu bezeichnen.
Die archäologischen Untersuchungen im Bereich des Energieleitungstunnels (ELT) Gerbergasse - Barfüsserplatz- Steinenberg, 1991/2
Authors: Matt Christoph Ph. , Bing Christian 
Published: August 2021

Zu den hervorragendsten Befunden der Ausgrabungen im Bereich des ELT gehört die Freilegung von zwei Teilstücken der Inneren Stadtmauer aus der 1. Hälfte des 13. Jahrhunderts, u.a. auch der Eselturm. Ältere Stadtbefestigungen kamen hingegen nicht zum Vorschein.
Im Bereich des ELT-Tunnels am Barfüsserplatz konnten am Rande der Baugrube noch Reste der ehemaligen mittelalterlichen Bebauung gefasst werden, die Hinweise auf die vorklosterzeitliche Überbauung im Westen des Barfüsserplatzes lieferten.
Clinical characteristics and radiological domains among patients with recurrent strokes-a descriptive cross-sectional study from a tertiary care center in central Nepal
Authors: Bhattarai Binod , Sah Shashi Bhushan 
Published: August 2021

Background: Stroke is a significant global health hazard that ripples continuum multi-spectral effects to the patients as well their caretakers. Methods: We studied 28 consecutive cohorts of patients with recurrent strokes managed in our centre within the last two years. Results: The most common recurrence stroke pattern was of that of hemorrhagic to hemorrhagic subtype observed in 50% of the patients. The most common anatomical region of involvement was cortical – cortical seen in 39.28% of our cohorts. The surgical intervention was required in 17.85% whereas 42.85% of them were managed conservatively. Paradoxically, 39.28% of patients left against medical advice. The receiver operating curve (ROC) predicting mode of management was highest (area under the curve (AUC) =0.635) for compliance to therapy followed by stroke territory (AUC=0.578), age (AUC=0.457) and motor grading (AUC=0.374). The receiver operating curve (ROC) for influencing decision to leave against medical advice was highest (area under the curve (AUC) =0.861) for motor score followed by sex (AUC=0.701) and age (AUC=0.564). The analysis of variance (ANOVA) study pertaining to the mode of management was significantly connoted by the motor score and the stroke territory only. The ANOVA study pertaining to the decision to leave against medical advice was significantly governed by the motor score, stroke territory, and sex respectively. The multivariate analysis for variables governing mode of management was significant for motor score and the stroke territory only. The multivariate analysis for variables governing leave against medical advice was significant for sex, motor score and the stroke territory. Conclusions: This study aims to appraise early dichotomization of high-risk patients for recurrent strokes to reduce the continuum of neurological events as well as to mitigate the financial aspects governing stroke care.
A multi-center, adaptive, randomized, platform trial to evaluate the effect of repurposed medicines in outpatients with early coronavirus disease 2019 (COVID-19) and high-risk for complications: the TOGETHER master trial protocol
Authors: Reis Gilmar , Silva Eduardo Augusto dos Santos Moreira , Silva Daniela Carla Medeiros , Thorlund Kristian , Thabane Lehana , Guyatt Gordon H. , Forrest Jamie I. , Glushchenko Alla V. , Chernecki Cameron , McKay Paula , Sprague Sheila , Harari Ofir , Ruton Hinda , Rayner Craig R. , Mills Edward J. 
Published: August 2021

Background: Although vaccines are currently available for coronavirus disease 2019 (COVID-19), there remains a need for an effective and affordable outpatient treatment for early COVID-19. Multiple repurposed drugs have shown promise in treating COVID-19. We describe a master protocol that will assess the efficacy of different repurposed drugs as treatments for early COVID-19 among outpatients at a high risk for severe complications. Methods: The TOGETHER Trial is an international (currently in Brazil and Africa), multi-center platform adaptive randomized, placebo-controlled, clinical trial. Patients are included if they are at least 18 years of age, have a positive antigen test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and have an indication for high risk of disease severity, including co-morbidities, older age, or high body mass index. Eligible patients are randomized with equal chance to an investigational product (IP) or to placebo. The primary endpoint is hospitalization due to clinical worsening of COVID-19 or emergency room required observation for more than 6 hours up to 28 days after randomization. Key secondary endpoints include viral clearance, clinical improvement, hospitalization for any cause, mortality for any cause, and safety and tolerability of each IP. Scheduled interim analyses are conducted and reviewed by the Data and Safety Monitoring Committee (DSMC), who make recommendations on continuing or stopping each IP. The platform adaptive design go-no-go decision rules are extended to dynamically incorporate external evidence on COVID-19 interventions from ongoing independent randomized clinical trials. Discussion: Results from this trial will assist in the identification of therapeutics for COVID-19 that can easily be scaled in low- and middle-income settings. The novel methodological extension of the platform adaptive design to dynamically incorporate external evidence is one of the first of its kind and may provide highly valuable information for all COVID-19 trials going forward. Clinicaltrials.gov registration: NCT04727424 (27/01/2021)
Exposure to parasitic infections determines features and phenotypes of active convulsive epilepsy in Africa
Authors: Langat Nelson K. , Kariuki Symon M. , Kamuyu Gathoni , Kakooza-Mwesige Angelina , Owusu-Agyei Seth , Ae-Ngibise Kenneth , Wang'ombe Anne , Ngugi Anthony K. , Masaja Honorati , Wagner Ryan G. , Newton Charles R.J.C. ,   on behalf of the Study of Epidemiology of Epilepsy in Demographic Sites (SEEDS) group
Published: August 2021

Background: Epilepsy affects 70 million people worldwide, 80% of whom are in low-and-middle income countries (LMICs). Infections of the central nervous system (CNS) contribute considerably to the burden of epilepsy in LMICs, but the nature and presentation of epilepsy following these infections is not fully understood. We examined if epilepsy foutcomes are associated with the exposure to parasitic infections. Methods: This was a case-comparison study nested in a cross-sectional survey of people with active convulsive epilepsy, with cases as those exposed to parasitic infections, and comparison as those unexposed. Associations of exposure to parasites with clinical and electroencephalographic features of epilepsy were done using a modified mixed effects Poisson regression model across five sites in Africa. Multiplicative and additive scale (RERI) interactions were explored to determine the effect of co-infections on epilepsy features. Population attributable fractions (PAF) were calculated to determine the proportion of severe clinical and electroencephalographic features of epilepsy attributable to CNS infections. Results: A total of 997 participants with active convulsive epilepsy from the five African sites were analyzed, 51% of whom were males. Exposure to parasitic infections was associated with more frequent seizures in adult epilepsy (relative risk (RR)=2.58, 95% confidence interval (95%CI):1.71-3.89). In children, exposure to any parasite was associated with convulsive status epilepticus (RR=4.68, (95%CI: 3.79-5.78), intellectual disabilities (RR=2.13, 95%CI: 1.35-3.34) and neurological deficits (RR=1.92, 95%CI: 1.42-2.61). Toxoplasma gondii and Onchocerca volvulus interacted synergistically to increase the risk of status epilepticus (RERI=0.91, 95%CI=0.48-1.35) in the data pooled across the sites. Exposure to parasitic infections contributed to 30% of severe features of epilepsy as shown by PAF. Conclusions: Parasitic infections may determine features and phenotypes of epilepsy through synergistic or antagonistic interactions, which can be different in children and adults. Interventions to control or manage infections may reduce complications and improve prognosis in epilepsy.