bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrity at end of life in the intensive care unit: a qualitative study of nurses’ views
Authors: Palmryd Lena , Rejnö Åsa , Godskesen Tove E. 
Published: February 2021

Abstract
Background
Integrity is a core value for delivering ethical health care. However, there is a lack of precision in defining what integrity is and how nurses understand it. In the setting of nurses caring for critically ill and dying patients in intensive care units (ICUs), integrity has not received much attention. Therefore, the aim of this study was to explore how nurses perceive and maintain the integrity of patients during end-of-life care in the ICU setting.

Methods
This study had a qualitative descriptive design. Data were collected using individual semi-structured interviews with 16 intensive care nurses working at ICUs in four Swedish hospitals. The data were analysed by applying qualitative content analysis.

Results
Five overall categories were explored: seeing the unique individual; sensitive to patient vulnerability; observant of patients’ physical and mental sphere; perceptive of patients’ religion and culture; and being respectful during patient encounters. Many nurses found it difficult to define integrity and to explain what respecting integrity entails in the daily care of dying patients. They often used notions associated with respect and patient-centred attitudes, such as listening and being sensitive or by trying to describe good care. Integrity was nonetheless seen as a central value for their clinical work and a precondition for ethical nursing practice. Some nurses were concerned about patient integrity, which is at risk of being “wiped out” due to the patient’s illness/injury, unfamiliarity with the ICU environment and utter dependence on others for care. Protecting patients from harm and reducing patient vulnerability were also seen as important and a way to maintain the integrity of patients.

Conclusions
The study results show that even though integrity is a fundamental ethical concept and a core value in nursing, ethical codes and guidelines are not always helpful in clinical situations in the end-of-life care of ICU patients. Hence, opportunities must regularly be made available for ICU nurses to reflect on and discuss ethical issues in terms of their decision-making and behaviour.
Polar poly(n-butyl acrylate)-g-polyacrylonitrile elastomer with high temperature elasticity and healability as flexible electronic substrate
Authors: Zheng Yuzhu , Xu Deli , Tian Shiyou , Li Manli , Wang Wenwen , Liu Ke 
Published: February 2021

AbstractIn this work, graft copolymer poly (n-butyl acrylate)-g-polyacrylonitrile with poly (n-butyl acrylate) as backbones and polyacrylonitrile as side chains (PnBA-g-PAN) was synthesized by macromonomer method and emulsion polymerization. The macromonomer was synthesized by atom transfer radical polymerization and end-group modification. The chemical structures and thermal properties of macromonomer and graft copolymer were investigated by FTIR, GPC, NMR and TGA, etc. The mechanical properties of graft copolymer elastomer was also measured by uniaxial tensile test. Rheological properties at different temperature and mechanical property demonstrated that graft copolymer elastomer possessed elasticity until 180 oC because of cyclization of cyano groups. Ag nanowires@PnBA-g-PAN composite elastomer was developed, and the resulted material exhibited autonomic healing property on account of segments’ flexibility and dynamic interaction between Ag nanowires (AgNWs) and cyano groups. This is a general method for generation of elastomer with high temperature elasticity and fast self-healing. The composite elastomer has potential application in flexible electronic conductor.
Design of optimal hybrid power system to provide reliable supply to rural areas of Ethiopia using MATLAB and Homer
Authors: Nebey Abraham Hizkiel 
Published: February 2021

AbstractIntegrating different energy resources, like solar PV, wind, and hydro is used to ensure reliable power to the rural community loads. Hybrid power system offers sufficient power supply for the rural villages by providing alternative supply for intermittent nature of renewable energy resource. Hence, intermittency of renewable energy resources is a challenge to electrify the rural community in a sustainable manner with the above sources. Thus, efficient resources management is a reasonable choice for intermittent renewable energy resources. The majority of rural villages in Ethiopia are suffering from lack of electricity. This causes deforestation, travel for long distance to fetch water, and no good social services, like clinic and schools, sufficiently. Therefore, the objective of this study was to maximize reliability of power supply by renewable energy sources. Data on wind speed and solar radiation are obtained from the NASA surface meteorological agency. While hydro data are obtained from physical measurements. Different configuration options are considered by Homer software to find the optimal configuration of hybrid system. The optimal configuration system is selected and hybrid components are sized. The optimal hybrid system consists of solar PV, wind, and hydro to supply a community load with a share of 13%, 52%, and 35% respectively. The fuzzy logic controller is designed to manage the intermittent nature of energies. Hence, the demand and energy sources are unpredictable; intelligent control system is important to manage the system accordingly. The control system is designed in MATALAB software. The result obtained from resource combination shows demand and supply are balanced. From the Twelve probabilistic combinations of demand and energy sources, one of the combinations shows that when 7.5 kW is demanded, the power generated/output from hybrid system is 10 kW which is greater than demand. To satisfy 7.5 kW demand control system takes 4.25 kW, 2.75 kW, and 1.08 kW share from wind, hydro, and solar sources respectively. The fuzzy logic control system is designed, to monitor the resource availability and load demand. This controller was managing the demand and the available resources according to the rule.
Infection dynamics and persistence of hepatitis E virus on pig farms – a review
Authors: Meester M. , Tobias T. J. , Bouwknegt M. , Kusters N. E. , Stegeman J. A. , van der Poel W. H. M. 
Published: February 2021

Abstract
Background
Hepatitis E virus (HEV) genotype 3 and 4 is a zoonosis that causes hepatitis in humans. Humans can become infected by consumption of pork or contact with pigs. Pigs are the main reservoir of the virus worldwide and the virus is present on most pig farms.

Main body
Though HEV is present on most farms, the proportion of infected pigs at slaughter and thus the level of exposure to consumers differs between farms and countries. Understanding the cause of that difference is necessary to install effective measures to lower HEV in pigs at slaughter. Here, HEV studies are reviewed that include infection dynamics of HEV in pigs and on farms, risk factors for HEV farm prevalence, and that describe mechanisms and sources that could generate persistence on farms. Most pigs become infected after maternal immunity has waned, at the end of the nursing or beginning of the fattening phase. Risk factors increasing the likelihood of a high farm prevalence or proportion of actively infected slaughter pigs comprise of factors such as farm demographics, internal and external biosecurity and immunomodulating coinfections. On-farm persistence of HEV is plausible, because of a high transmission rate and a constant influx of susceptible pigs. Environmental sources of HEV that enhance persistence are contaminated manure storages, water and fomites.

Conclusion
As HEV is persistently present on most pig farms, current risk mitigation should focus on lowering transmission within farms, especially between farm compartments. Yet, one should be aware of the paradox of increasing the proportion of actively infected pigs at slaughter by reducing transmission insufficiently. Vaccination of pigs may aid HEV control in the future.
Clinical differentiation of psychogenic non-epileptic seizure: a practical diagnostic approach
Authors: Widyadharma I. Putu Eka , Soejitno Andreas , Samatra D. P. G. Purwa , Sinardja Anna M. G. 
Published: February 2021

AbstractBackgroundPsychogenic non-epileptic seizure (PNES) has long been the counterpart of epileptic seizure (ES). Despite ample of evidence differentiating the two, PNES mistakenly diagnosed as ES was still common, resulting in unnecessary exposure to long-term antiepileptic medications and reduced patient’s and caregiver’s quality of life, not to mention the burgeoning financial costs.ObjectivesIn this review, we aimed to elucidate various differences between PNES and epileptic seizure with respect to baseline characteristics, seizure semiology, EEG pattern, and other key hallmark features.MethodsAn unstructured search was carried out in PubMed, MEDLINE, and EMBASE using keywords pertinent to PNES and ES differentiation. Relevant information was subsequently summarized herein.ResultsPNES differs significantly with ES in terms of baseline characteristics, prodromal symptoms, seizure semiology, presence of pseudosleep, and other hallmark features (for instance provoking seizure with suggestion). The combined approach, if applied appropriately, can yield high diagnostic yield.ConclusionsPNES can be clearly differentiated from ES via careful adherence to a set of valid clinical cues. The summarized clinical hallmarks is highly useful to prevent unnecessary ES diagnosis and treatment with AEDs.
Quantitative 3-tesla multiparametric MRI in differentiation between renal cell carcinoma subtypes
Authors: Elsorougy Ali , Farg Hashim , Bayoumi Dalia , El-Ghar Mohamed Abou , Shady Magda 
Published: February 2021

Abstract
Background
MRI provides several distinct quantitative parameters that may better differentiate renal cell carcinoma (RCC) subtypes. The purpose of the study is to evaluate the diagnostic accuracy of apparent diffusion coefficient (ADC), chemical shift signal intensity index (SII), and contrast enhancement in differentiation between different subtypes of renal cell carcinoma.

Results
There were 63 RCC as regard surgical histopathological analysis: 43 clear cell (ccRCC), 12 papillary (pRCC), and 8 chromophobe (cbRCC). The mean ADC ratio for ccRCC (0.75 ± 0.13) was significantly higher than that of pRCC (0.46 ± 0.12, P < 0.001) and cbRCC (0.41 ± 0.15, P < 0.001). The mean ADC value for ccRCC (1.56 ± 0.27 × 10−3 mm2/s) was significantly higher than that of pRCC (0.96 ± 0.25 × 10−3 mm2/s, P < 0.001) and cbRCC (0.89 ± 0.29 × 10−3 mm2/s, P < 0.001). The mean SII of pRCC (1.49 ± 0.04) was significantly higher than that of ccRCC (0.93 ± 0.01, P < 0.001) and cbRCC (1.01 ± 0.16, P < 0.001). The ccRCC absolute corticomedullary enhancement (196.7 ± 81.6) was significantly greater than that of cbRCC (177.8 ± 77.7, P < 0.001) and pRCC (164.3 ± 84.6, P < 0.001).

Conclusion
Our study demonstrated that multiparametric MRI is able to afford some quantitative features such as ADC ratio, SII, and absolute corticomedullary enhancement which can be used to accurately distinguish different subtypes of renal cell carcinoma.
Evaluation of chemo-preventive efficacy of Ficus religiosa latex extract by flow cytometry analysis and gene expression studies performed by RT-PCR in various cell lines
Authors: Saida L. , Tulasi C. D. S. L. N. , Narasu M. Lakshmi 
Published: February 2021

Abstract
Background
An extract of Ficus religiosa latex has been previously found to possess potent pharmacological activity with high antioxidant content phytochemical. The present research was conducted to investigate the chemo-preventive efficacy of latex extract on human breast adenocarcinoma MDA MB 231, human neroblastoma IMR 32, and human colorectal HCT 116 cell lines.

Results
The results showed that the latex crude extract induced cytotoxicity in all the selected cell lines with IC50 value 4.8 ± 1.13 μg/ml against the IMR 32 cell line. The cell cycle analysis results indicated the arrest and accumulation of cells at G1 phase in case of MDA MB 231 cells and HCT 116 cells whereas in the case of IMR 32 cells the arrest was in G2/M phase. The clear bands of fragments observed in DNA ladder experiments showed that apoptosis is induced by extracts in the cell lines. This could be correlated with the gene level expression studies on selected pro-apoptotic (p53 and caspase-3) and anti-apoptotic (Bcl-2, AKT) genes, which got upregulated and downregulated, respectively.

Conclusion
Based on the experimental evidence, Ficus religiosa contains phytochemicals with potent antitumor activities.
Effect of addition of platelet-rich fibrin to tragal perichondrium graft in the endoscopic trans-canal myringoplasty
Authors: el Awady Mohamed Kamel , Sharkawy Mohammed E. L. , abo Mohamed Nagah Mohamed 
Published: February 2021

Abstract
Background
Myringoplasty operation is the reconstruction of the tympanic membrane (TM) which is performed to prevent recurrent discharge of the ear and to improve the hearing impairment which is caused by TM perforation. Platelets are the key factors in tissue repair mechanisms. They provide essential growth factors, which stimulate fibroblasts to create extracellular matrix deposition and neovascularization. The aim of this study is the assessment of the topical use of autologous platelet-rich fibrin (PRF) in the improvement of myringoplasty success rate.

Results
Patients were divided to two groups, group A included 20 patients who were submitted to myringoplasty operation with adding of PRF from the same patient, and group B included 20 patients who were submitted to myringoplasty operation without adding of PRF. At 6 months postoperatively, the success rate (graft taking) in case group A (95%) was significantly higher than in the control group (70%) (P value = 0.037). Success in terms of hearing gain of the air-bone gap was more than 10 dB achieved in 19 patients (95%) in case group A, and 14 patients (70%) in control group B were with a statistically non-significant difference (P value = 0.079). There was no effect of PRF use on hearing gain in graft-taken cases because hearing gain is related to the closure of TM.

Conclusion
Topical PRF application over tragal perichondreal graft during myringoplasty is successful, safe, and highly efficient with no complications. PRF improves healing of chronic TM perforations and prevents postoperative infection.
Determinants of persistent post-COVID-19 symptoms: value of a novel COVID-19 symptom score
Authors: Galal Islam , Hussein Aliae A. R. Mohamed , Amin Mariam T. , Saad Mahmoud M. , Zayan Hossam Eldeen E. , Abdelsayed Mustafa Z. , Moustafa Mohamed M. , Ezzat Abdel Rahman , Helmy Radwa E. D. , Abd_Elaal Howida K. , Al Massry Nasrallah A. , Soliman Mohamed A. , Ismail Asmaa M. , Kholief Karima M. S. , Fathy Enas , Hashem Maiada K. 
Published: February 2021

Abstract
Background
Being a newly emerging disease, little is known about its long-lasting post-COVID-19 consequences. The aim of this work is to assess the frequency, patterns, and determinants of persistent post-COVID-19 symptoms and to evaluate the value of a proposed novel COVID-19 symptom score. Patients with confirmed COVID-19 in a hospital-based registry were included in a cross-sectional study (the hospitals including Assiut University Hospital, Assiut Chest Hospital, Aswan University Hospital, and Aswan Specialized Hospital). The patient demographics, comorbid disorders, the mean duration since the onset of the symptoms, history of hospital or ICU admittance, and the treatment taken during the acute state, as well as symptom score before and after convalescence, were recorded.

Results
The most frequent constitutional and neurological symptoms were myalgia (60.0%), arthralgia (57.2%), restriction of daily activities (57.0%), and sleeping troubles (50.9%), followed by anorexia (42.6%), chest pain (32.6%), gastritis (32.3%), cough (29.3%), and dyspnea (29.1%). The mean total score of acute stage symptoms was 31.0 ± 16.3 while post-COVID 19 symptom score was 13.1 ± 12.6 (P < 0.001). The main determinants of the persistent post-COVID-19 symptoms were the need for oxygen therapy (P < 0.001), pre-existing hypertension (P = 0.039), chronic pulmonary disorders (P = 0.012), and any chronic comorbidity (P = 0.004). There was a correlation between the symptom score during the acute attack and post-COVID-19 stage (P < 0.001, r = 0.67). The acute phase score had 83.5% sensitivity and 73.3% specificity for the cutoff point > 18 to predict occurrence of post-COVID-19 symptoms.

Conclusions
COVID-19 can present with a diverse spectrum of long-term post-COVID-19 symptoms. Increased acute phase symptom severity and COVID-19 symptom score > 18 together with the presence of any comorbid diseases increase the risk for persistent post-COVID-19 manifestations and severity.
Flash CGM Is Associated With Reduced Diabetes Events and Hospitalizations in Insulin-Treated Type 2 Diabetes
Authors: Bergenstal Richard M , Kerr Matthew S D , Roberts Gregory J , Souto Diana , Nabutovsky Yelena , Hirsch Irl B 
Published: February 2021

Abstract

Purpose
Suboptimal glycemic control among individuals with diabetes is a leading cause of hospitalizations and emergency department utilization. Use of flash continuous glucose monitoring (flash CGM) improves glycemic control in type 1 and type 2 diabetes, which may result in lower risk for acute and chronic complications that require emergency services and/or hospitalizations.

Methods
In this retrospective, real-world study, we analyzed IBM MarketScan Commercial Claims and Medicare Supplemental databases to assess the impact of flash CGM on diabetes-related events and hospitalizations in a cohort of 2463 individuals with type 2 diabetes who were on short- or rapid-acting insulin therapy. Outcomes were changes in acute diabetes-related events (ADE) and all-cause inpatient hospitalizations (ACH), occurring during the first 6 months after acquiring the flash CGM system compared with event rates during the 6 months prior to system acquisition. ICD-10 codes were used to identify ADE for hypoglycemia, hypoglycemic coma, hyperglycemia, diabetic ketoacidosis, and hyperosmolarity.

Results
ADE rates decreased from 0.180 to 0.072 events/patient-year (hazard ratio [HR]: 0.39 [0.30, 0.51]; P &lt; 0.001) and ACH rates decreased from 0.420 to 0.283 events/patient-year (HR: 0.68 [0.59 0.78]; P &lt; 0.001). ADE reduction occurred regardless of age or gender.

Conclusions
Acquisition of the flash CGM system was associated with reductions in ADE and ACH. These findings provide support for the use of flash CGM in type 2 diabetes patients treated with short- or rapid-acting insulin therapy to improve clinical outcomes and potentially reduce costs.
Theory and Practice of the Long Novel
Authors: Ng Kenny K. K. 
Published: February 2021

Abstract
This article examines the promises and predicaments of May Fourth writers in their experimental writing of the “long novel” (changpian xiaoshuo 長篇小說) as a Chinese brand of the modern epic. May Fourth intellectuals showed a conscious effort to institute a new brand of fictional genre to enlighten the reading public. Yet their “education of the novel” was far from complete, as New Literature writers found fictional expressions primarily in the form of the short story, with strong undertones of individualism, subjective lyricism, and elitism. By focusing on Mao Dun's 茅盾 (1896–1981) Ziye 子夜 (Midnight; 1933), the article examines his call for the establishment of the long novel and his strenuous efforts to “take over” the modern novel as an ideological form to narrate a teleological progression of history. How do Mao Dun's fictional narratives illuminate the representational problems between fiction, locality, and modernity? For Mao Dun and his May Fourth contemporaries, modernity at large was expressed in a teleological mode of time and progress, both in the rhetoric of modernity and in fiction writing. The article reflects on Mao Dun's creative and ideological impasse by teasing out the narrative loopholes of traditional voices and popular fictional registers in the modern epic.
The GTPase Rab8 differentially controls the long- and short-range activity of the Hedgehog morphogen gradient by regulating Hedgehog apico-basal distribution
Authors: Gore Tanvi , Matusek Tamás , D'Angelo Gisela , Giordano Cécile , Tognacci Thomas , Lavenant-Staccini Laurence , Rabouille Catherine , Thérond Pascal P. 
Published: February 2021

ABSTRACT
The Hedgehog (Hh) morphogen gradient is required for patterning during metazoan development, yet the mechanisms involved in Hh apical and basolateral release and how this influences short- and long-range target induction are poorly understood. We found that depletion of the GTPase Rab8 in Hh-producing cells induces an imbalance between the level of apically and laterally released Hh. This leads to non-cell-autonomous differential effects on the expression of Hh target genes, namely an increase in its short-range targets and a concomitant decrease in long-range targets. We further found that Rab8 regulates the endocytosis and apico-basal distribution of Ihog, a transmembrane protein known to bind to Hh and to be crucial for establishment of the Hh gradient. Our data provide new insights into morphogen gradient formation, whereby morphogen activity is functionally distributed between apically and basolaterally secreted pools.
Plasticity in parental effects confers rapid larval thermal tolerance in the estuarine anemoneNematostella vectensis
Authors: Rivera Hanny E. , Chen Cheng-Yi , Gibson Matthew C. , Tarrant Ann M. 
Published: February 2021

ABSTRACTParental effects can prepare offspring for different environments and facilitate survival across generations. We exposed parental populations of the estuarine anemone, Nematostella vectensis, from Massachusetts to elevated temperatures and quantified larval mortality across a temperature gradient. We found that parental exposure to elevated temperatures resulted in a consistent increase in larval thermal tolerance, as measured by the temperature at which 50% of larvae die (LT50), with a mean increase in LT50 of 0.3°C. Larvae from subsequent spawns returned to baseline thermal thresholds when parents were returned to normal temperatures, indicating plasticity in these parental effects. Histological analyses of gametogenesis in females suggested that these dynamic shifts in larval thermal tolerance may be facilitated by maternal effects in non-overlapping gametic cohorts. We also compared larvae from North Carolina (a genetically distinct population with higher baseline thermal tolerance) and Massachusetts parents, and observed that larvae from heat-exposed Massachusetts parents had thermal thresholds comparable to those of larvae from unexposed North Carolina parents. North Carolina parents also increased larval thermal tolerance under the same high-temperature regime, suggesting that plasticity in parental effects is an inherent trait for N. vectensis. Overall, we find that larval thermal tolerance in N. vectensis shows a strong genetic basis and can be modulated by parental effects. Further understanding of the mechanisms behind these shifts can elucidate the fate of thermally sensitive ectotherms in a rapidly changing thermal environment.