bluuebunny/crossref_metadata_2025_split huggingface dataset:
Water quality assessment of the Perm city’ small rivers
Authors: Kitaev A B 
Published: September 2021

Abstract
The environmental monitoring since 2009 in various water regime phases has been conducted by the Department of Ecology and Environmental Management for the water quality assessment of the Perm city’ small rivers. Such assessment of the water quality in the urban area of Mulyanka, Danilikha, Yegoshikha and Iva rivers catchments are presented in this study. The analysis is given for the background and mouth sections. The data of river’s water chemical composition was used for periods 2009-2010 and 2015-2018. A comparative analysis of water quality in terms of pollution indices is given.
Natural background and transformation of water quality in the Moskva River
Authors: Erina O , Tereshina M , Shinkareva G , Sokolov D , Lychagin M 
Published: September 2021

Abstract
Longitudinal transformation of several hydrochemical parameters in the Moskva River was reviewed based on the data of extensive monitoring studies conducted in 2019-2020. Changes of the chemical composition and their seasonal variation were quantified in relation to the only remaining natural part of the river above the Mozhaysk Reservoir. We found that the overall variability of element concentrations in the part of the Moskva River not affected by anthropogenic pressure is much lower than the magnitude of changes caused by urban influence. The effect of residential and industrial development in the watershed is comparable to, or sometimes much lower than the impact of polluted wastewater discharged by Lyubertsy and Kurianovo treatment plants. Point-source pollution therefore plays the key part in the transformation of the natural water quality in the Moskva River.
Problems and trends in water resources use in the Russian-Kazakhstan transboundary region
Authors: Padalko Yu A 
Published: September 2021

Abstract
This article considers the trends in use of water resources of transboundary rivers in the adjacent regions of Russia and Kazakhstan. The problems of transboundary water use in the river basins of the Ural and the Irtysh in the Russian-Kazakh region as well as the influence of economic activity in China are outlined. Among the regions under study, we identified those areas of the three countries whose water economy depends on the transboundary rivers of neighbouring regions or significantly regulates the hydrological regime of these rivers. To study and calculate water use trends, data on the water use from 2010 to 2019 was used. The structural specifics of water use are shown and the ratio of water consumption to available renewable water resources for the regions of Russia, Kazakhstan and the Xinjiang-Uygur Autonomous Region of China is determined. General trends and differences in water use in the water sectors of the transboundary river basins of the Ural and Irtysh have been identified.
To the question of water resistance of the Talas Valley
Authors: Moldoshev K O , Akmatov R T , Choduraev T M 
Published: September 2021

Abstract
The Talas Valley has the necessary water resource potential for the intensive development of agricultural sectors and the provision of domestic needs and the needs of industrial enterprises with water, subject to compliance with environmental requirements. According to the nature of the water balance in the territory under consideration, two hydrological areas are distinguished- the area of formation and the area of dispersion of runoff. The first is the mountainous part of the territory, where the arrival of moisture over its discharge prevails and where economic activity has not yet had a significant impact on the river flow. Here an important role in the formation of runoff is the connection. The area of dispersion is located in the valley areas where irrigation is intensively developed, in connection with which the natural regime of large rivers drastically changes. It was revealed that the main source of water pollution with suspended substances is flushing of fine-grained particles from the territory of the catchment area with atmospheric precipitation and irrigation water. The proportion of anthropogenic pollution by suspended substances does not exceed 0.05% of natural pollution.
Fish parasites and blood parameters as bioindicators of technogenic salination of freshwater ecosystems
Authors: Mikheev P B , Mikheeva O I , Sheina T A , Baklanov M A 
Published: September 2021

Abstract
Blood parameters and the composition of parasite fauna of fishes could indicate different processes in aquatic ecosystems. This study aims examine the parasite fauna composition and to analyse the haemotological parameters of the adult ruffe Gymnocephalus cernua in the Volim River (Perm Krai) with the high degree of water salinity under the technogenic impact from the mining of the potash-magnesium salts, as well as in the Gaiva River (the city of Perm) with natural water salinity. We found wide scope of parasite species and a high infection rate, as well as the development of leucopenia, erythropenia, and dramatic morphological changes in the erythrocyte cells of ruffe in Volim River. This can be caused by high degree of salinity with its adverse effect on fish’s immunity and a wide range of species-specific intermediate hosts of parasites. The results demonstrates an opportunity to apply the parasitological and haemotological markers for the bioindication of the rivers’ technogenic salination.
CADA: phenotype-driven gene prioritization based on a case-enriched knowledge graph
Authors: Peng Chengyao , Dieck Simon , Schmid Alexander , Ahmad Ashar , Knaus Alexej , Wenzel Maren , Mehnert Laura , Zirn Birgit , Haack Tobias , Ossowski Stephan , Wagner Matias , Brunet Theresa , Ehmke Nadja , Danyel Magdalena , Rosnev Stanislav , Kamphans Tom , Nadav Guy , Fleischer Nicole , Fröhlich Holger , Krawitz Peter 
Published: September 2021

Abstract
Many rare syndromes can be well described and delineated from other disorders by a combination of characteristic symptoms. These phenotypic features are best documented with terms of the Human Phenotype Ontology (HPO), which are increasingly used in electronic health records (EHRs), too. Many algorithms that perform HPO-based gene prioritization have also been developed; however, the performance of many such tools suffers from an over-representation of atypical cases in the medical literature. This is certainly the case if the algorithm cannot handle features that occur with reduced frequency in a disorder. With Cada, we built a knowledge graph based on both case annotations and disorder annotations. Using network representation learning, we achieve gene prioritization by link prediction. Our results suggest that Cada exhibits superior performance particularly for patients that present with the pathognomonic findings of a disease. Additionally, information about the frequency of occurrence of a feature can readily be incorporated, when available. Crucial in the design of our approach is the use of the growing amount of phenotype–genotype information that diagnostic labs deposit in databases such as ClinVar. By this means, Cada is an ideal reference tool for differential diagnostics in rare disorders that can also be updated regularly.
An Innovative Approach to Deliver Student-Directed Livestream Simulations During a Pandemic
Authors: Crews Cynthia S. , Parker Elizabeth , Taylor Kelli 
Published: September 2021

Abstract
University and facility closures because of COVID-19 required nursing programs to develop innovative ways to ensure students met clinical hour requirements, standards, and expectations. One rural university utilized student-directed livestream virtual simulation sessions that included synchronous prebriefing, student-directed simulation activity, and immediate debriefing. Students were anonymously surveyed for feedback and evaluation of the activities. Students reported the sessions were helpful for learning and required use of prioritization, clinical judgment, and communication/collaboration skills. Other responses included communication issues, audiovisual issues, and low realism, which prompted future recommendations.
The Clinical Relevance of the Cervical Disc Prosthesis
Authors: Goedmakers Caroline M.W. , Bartels Ronald H.M.A. , Donk Roland D. , Arts Mark P. , van Zwet Erik W. , Vleggeert-Lankamp Carmen L.A. 
Published: September 2021

Study Design.
Retrospective analysis was performed on data from 251 patients that were included in two randomized, double-blinded clinical trials comparing clinical results of anterior cervical discectomy and arthroplasty (ACDA) to anterior cervical discectomy and fusion (ACDF), and anterior cervical discectomy (ACD), for single-level disc herniation.

Objective.
This study aimed to investigate whether the ACDA procedure offers superior clinical results 2 years after surgery, to either ACDF or ACD without instrumentation, in the entire group of patients or in a particular subgroup of patients.

Summary of Background Data.
The cervical disc prosthesis was introduced to provide superior clinical outcomes after ACD.

Methods.
Neck Disability Index (NDI), and subscales of the 36-item short-form health survey (SF-36) and McGill pain score were collected at baseline, 1 year and 2 years after surgery. Reoperations and complications were also evaluated. A preliminary subgroup analysis was performed for age, disc height, body mass index (BMI), smoking, and sex.

Results.
The NDI decreased comparably in all treatment arms to circa 50% of the baseline value and marginal mean NDI differences varied from 0.4 to 1.1 on a 100 point NDI scale, with confidence intervals never exceeding the 20-point minimal clinical important difference (MCID). Secondary outcome parameters showed comparable results. Preliminary subgroup analysis could not demonstrate clinically relevant differences in NDI between treatments after 2 years.

Conclusion.
After combining data from two Randomized Controlled Trials it can be concluded that there is no clinical benefit for ACDA, when compared with ACDF or ACD 2 years after surgery. Preliminary subgroup analysis indicated outcomes were similar between treatment groups, and that no subgroup could be appointed that benefited more from either ACD, ACDF, or ACDA.

Level of Evidence: 1
Postoperative Glycemic Variability as a Predictor of Adverse Outcomes Following Lumbar Fusion
Authors: Canseco Jose A. , Chang Michael , Karamian Brian A. , Nicholson Kristen , Patel Parthik D. , Shenoy Kartik , Hartman Joe , Kurd Mark F. , Rihn Jeffrey A. , Anderson David Greg , Hilibrand Alan S. , Kepler Christopher K. , Vaccaro Alexander R. , Schroeder Gregory D. 
Published: September 2021

Study Design.
A retrospective cross-sectional study.

Objective.
This study aims to evaluate the effect size of postoperative glycemic variability on surgical outcomes among patients who have undergone one- to three-level lumbar fusion.

Summary of Background Data.
While numerous patient characteristics have been associated with surgical outcomes after lumbar fusion, recent studies have described the measuring of postoperative glycemic variability as another promising marker.

Methods.
A total of 850 patients were stratified into tertiles (low, moderate, high) based on degree of postoperative glycemic variability defined by coefficient of variation (CV). Surgical site infections were determined via chart review based on the Centers for Disease Control and Prevention definition. Demographic factors, surgical characteristics, inpatient complications, readmissions, and reoperations were determined by chart review and telephone encounters.

Results.
Overall, a statistically significant difference in 90-day adverse outcomes was observed when stratified by postoperative glycemic variability. In particular, patients with high CV had a higher odds ratio (OR) of readmission (OR = 2.19 [1.17, 4.09]; P = 0.01), experiencing a surgical site infection (OR = 3.22 [1.39, 7.45]; P = 0.01), and undergoing reoperations (OR = 2.65 [1.34, 5.23]; P = 0.01) compared with patients with low CV. No significant association was seen between low and moderate CV groups. Higher CV patients were more likely to experience longer hospital stays (β: 1.03; P = 0.01). Among the three groups, high CV group experienced the highest proportion of complications.

Conclusion.
Our study establishes a significant relationship between postoperative glycemic variability and inpatient complications, length of stay, and 90-day adverse outcomes. While HbA1c has classically been used as the principal marker to assess blood glucose control, our results show CV to be a strong predictor of postoperative adverse outcomes. Future high-quality, prospective studies are necessary to explore the true effect of CV, as well as its practicality in clinical practice. Nevertheless, fluctuations in blood glucose levels during the inpatient stay should be limited to improve patient results.

Level of Evidence: 4
Clinical and Patient-reported Outcomes After Posterior Versus Transforaminal Lumbar Interbody Fusion—A Propensity Score-matched Cohort Study on 422 Patients with 2-year Follow-up
Authors: Ohrt-Nissen Søren , Carreon Leah Y. , Andresen Andreas K. , Andersen Mikkel Ø. , Udby Peter 
Published: September 2021

Study Design.
This was a dual-center study over an eight-year period on patients undergoing single level fusion surgery with either posterior- (PLIF) or transforaminal lumbar interbody fusion (TLIF). We analyzed prospectively collected pre- and postoperative data from the national Danish surgical spine database (DaneSpine).

Objective.
The aim of this study was to compare clinical and patient-reported outcome (PRO) 2 years after TLIF or PLIF in patients with symptomatic lumbar mechanical disc degeneration.

Summary of Background Data.
PLIF and TLIF are well-described techniques for treating lumbar mechanical disc degeneration but whether the theoretical differences between the two techniques translate to different clinical outcomes is unknown.

Methods.
The primary outcome was Oswestry Disability Index (ODI) score at 2-year follow-up. Secondary outcome measures were scores on the European Quality of Life–5 Dimensions (EQ-5D) and visual analog scale (VAS) and the rate of intraoperative complications. To minimize baseline differences between the groups, propensity-score matching was employed in a 1:1 fashion, balancing the groups on preoperative factors including age, sex, back and leg pain, ODI, EQ-5D, and previous spine surgery.

Result.
The matched cohort included 211 patients in each cohort. There was no significant difference between the groups in the mean score on the ODI at two years (PLIF: 33 ± 20 vs. TLIF: 35 ± 20, P = 0.328). We found no statistically significant differences in EQ-5D score (0.54 ± 0.35 vs. 0.51 ± 0.34, P = 0.327), VAS score for back pain (47 ± 32 vs. 48 ± 29, P = 0.570) or leg pain (42 ± 33 vs. 41 ± 32, P = 0.936) between the PLIF and TLIF groups, respectively, at 2-year follow-up. Dural tears occurred in 9.5% in the PLIF group and 1.9% in the TLIF group (P = 0.002) corresponding to a relative risk of 5.0 (95% CI 1.7–14.4).

Conclusion.
We found no significant difference in PRO at 2-year follow-up between PLIF and TLIF for the treatment of lumbar disc degeneration. PLIF is associated with a five times higher risk of dural tears.

Level of Evidence: 3
The changing landscape for patients with relapsed/refractory acute myeloid leukaemia
Authors: Isidori Alessandro , Ferrara Felicetto 
Published: September 2021

Purpose of review
The treatment of patients with relapsed or refractory (R/R) acute myeloid leukaemia (AML) has been an unequal challenge for many decades. Although significant progress has been made in the discovery of the mechanisms underlying the molecular pathogenesis of the disease, more than 50% of AML patients still die, mostly from relapsed disease. Currently, the only potential curative option for patients with R/R AML remains allogeneic bone marrow transplantation in second complete remission, which is far being easy to achieve, mainly for patients with primary induction failure or older than 65 years. The purpose of this review is to discuss recent advances in the management of patients with R/R AML, with particular emphasis to new therapeutic options that are replacing conventional salvage chemotherapy.

Recent findings
The development of new agents selectively targeting molecular abnormalities offer more effective and less toxic alternative to chemotherapy, potentially useful as a bridge to allogeneic stem cell transplantation in second complete remission.

Summary
The recent approval of new drugs for R/R is transforming the paradigm of care we have relied on for the past 50 years. Ongoing clinical trials will tell us how bright is the future for R/R AML patients.
Reducing the Negative Impact of Social Distancing Through Intentional Connectedness
Authors: Akers Shanna W. , Joseph Rachel A. 
Published: September 2021

ABSTRACT:
Social distancing during the COVID-19 pandemic resulted in both positive and negative effects. Nursing education was significantly impacted by the necessity of remote learning and absence of clinical experiences. The purpose of this article is to discuss how intentionality in social connectedness can combat the negative impact of social distancing in nursing education. Lessons learned and strategies employed by nursing educators during the intentional application of social connectedness are presented.
The Educator's Art of Prayer and Caring
Authors: Mingo Sharon 
Published: September 2021

ABSTRACT:
Baccalaureate nursing students often encounter significant academic and personal hardships that produce stress-induced anxiety. Nursing educators can foster the practice of prayer and caring with struggling nursing students as a means of helping students manage anxiety and stress. Christian educators can offer prayer when guiding and counseling students who are struggling with academics or other situations that negatively influence their progress toward professional practice. Three case studies illustrate an educator's use of prayer with students.
The Pain of Infertility
Authors: Schoonover-Shoffner Kathy 
Published: September 2021

ABSTRACT:
Infertility, the inability to conceive and/or carry a baby to term, is an agonizing experience for many. Both the experience and pain of infertility are ancient, shared by women and men of the Bible and by couples today. An insider's look into infertility can help nurses understand the suffering that occurs, suggest what can be said and done that can be helpful as well as hurtful, and offer insight into what can be gained personally and spiritually through the experience of infertility.
The impact of bolus versus continuous infusion of intravenous ketamine on bispectral index variations and desflurane administration during major surgery
Authors: Carrara Lucie , Nault Mathieu , Morisson Louis , Godin Nadia , Idrissi Moulay , Fortier Annik , Guertin Marie Claude , Brulotte Véronique , Fortier Louis-Philippe , Verdonck Olivier , Richebe Philippe 
Published: September 2021

BACKGROUND
Although ketamine, a NMDA-receptor antagonist, tends to increase the bispectral index (BIS), it remains a widely used analgesic whenever administered in low doses during major surgery.

OBJECTIVE
The objective of this study was to compare the impact of intravenous ketamine (given either as a continuous infusion or as a bolus) on BIS and to compare desflurane administration and postoperative outcomes between the groups.

DESIGN
Prospective, randomised, parallel-group, open-label study.

SETTING
University hospital, operating room.

PARTICIPANTS
Fifty patients, scheduled for major abdominal surgery.

INTERVENTIONS AND MAIN OUTCOMES MEASURES
Patients were randomised into two groups: ketamine by intravenous continuous infusion – group (KI) and ketamine by i.v. bolus – group (KB). In the KI group, ketamine at a rate of 0.25 mg kg−1 h−1 was commenced at skin incision (T0) and maintained at this rate for the duration of surgery. In group KB, a ketamine bolus of 0.25 mg kg−1was administered at T0 and repeated every hour. The difference in BIS between the groups was compared from T0 onwards. The amount of desflurane administered to keep BIS within the usual recommended range (40–60) was compared, as were the doses of phenylephrine and remifentanil. Postoperative pain and recovery outcomes were also assessed.

RESULTS
After T0, the BIS increased significantly from baseline in group KB compared with group KI: the rise in BIS was 20 ± 8 vs. 11 ± 6, respectively (P = 0.0001). The between-group mean difference (95% confidence interval (CI), was 9 (5 to 13). In group KB, desflurane administration significantly increased for the first 15 min after T0: 6.3 ± 1.8 vs. 3.8 ± 1.3 ml (P < 0.0001) with a mean intergroup group difference (95% CI) of 2.4 (1.5 to 3.4) ml. There was no difference in desflurane administration when considering the full hour from T0 to T60 min: 16 ± 9 vs. 15 ± 5 ml (P = 0.63) with a mean intergroup difference (95% CI) of 1 (−3 to 5) ml. After surgery, pain scores, opioid consumption, incidence of nausea and vomiting and recovery scores were similar between groups.

CONCLUSION
Compared with a continuous ketamine infusion, a ketamine bolus significantly increased the BIS after T0. In order to keep the BIS below 60, significantly more desflurane was administered from T0 to T15 min in group KB. To prevent such higher desflurane administration and its related atmospheric pollution, our results suggest administering intra-operative intravenous ketamine as an infusion rather than a bolus.

TRIAL REGISTRATION
Clinicaltrials.gov registration identifier: NCT03781635.
The bladder microbiome and interstitial cystitis: is there a connection?
Authors: Abernethy Melinda G. , Tsuei Angie 
Published: September 2021

Purpose of review
Interstitial cystitis/painful bladder syndrome (PBS) is a debilitating condition, the etiology of which remains unclear and for which there are variable and often unsatisfactory treatment options. Within the last decade, evolving knowledge regarding the presence and role of the urinary microbiome has led to investigations regarding its impact on symptoms and severity of interstitial cystitis PBS.

Recent findings
Since 2017, five studies have investigated differences between the microbiome of female patients with interstitial cystitis /PBS to asymptomatic controls. While varied in methodology, specifically with regard to urine collection processing and microbial detection, the majority of studies (4/5) found no association between urinary microbiota and interstitial cystitis /PBS.

Summary
Research regarding the role of the urinary microbiome and lower urinary tract function and dysfunction, including interstitial cystitis /BPS, remains in preliminary stages. While data regarding the role of lactobacillus in lower urinary tract homeostasis is inconclusive, further research is warranted.