bluuebunny/crossref_metadata_2025_split huggingface dataset:
National COVID-19 Hospital Admissions and Mortality Among Healthcare Workers in South Africa, 2020-2021
Authors: Tlotleng Nonhlanhla , Jassat Waasila , Cohen Cheryl , Made Felix , Kootbodien Tahira , Masha Maureen , Naicker Nisha 
Published: June 2021

Abstract
Background: Healthcare workers (HCWs) in close contact with SARS-CoV-2-infected patients have an increased risk of infection compared to non-HCWs, but little is known about the clinical course and risks for mortality amongst HCWs in South Africa. In this study, we compared characteristics of hospitalised HCWs with non-HCWs with COVID-19 and assessed factors associated with COVID-19 mortality among HCWs. Methods: Data from 5 March 2020 to 30 April 2021 was obtained from DATCOV, the national surveillance programme monitoring COVID-19 admissions in private and public hospitals across South Africa. A logistic regression model was used to determine factors associated with COVID-19 HCW admissions and mortality.Results: There were a total 169,678 confirmed COVID-19 admissions reported on DATCOV, of which 6,364 (3.8%) were HCWs. Compared to non-HCWs, HCWs were less likely to be male [aOR 0.3, 95%CI (0.3-0.4)], and more likely to be younger, white or other race, have pre-existing obesity and asthma, and be admitted in the private sector, in Eastern Cape, Gauteng, Kwa-Zulu Natal, Limpopo, Northern Cape and North West provinces. Pre-wave 1 [aOR 3.0; 95%CI 2.4-3.7)], wave 1 [aOR 2.1; 95%CI (1.8-2.5)] and post-wave 1 [aOR 1.3; 95%CI (1.0-1.7)] were associated with increase in HCW admissions compared to wave 2. There was an increased risk for in-hospital mortality among HCWs in the older age group (40-49 [aOR 3.8; 95%CI (1.6-8.80)]; 50-59 [aOR 4.7; 95%CI (2.0-10.9)] and 60-65 years [aOR 9.8; 95%CI (4.2-23.0)] compared to HCWs less than 40 years, with comorbidities such as hypertension, diabetes, chronic kidney diseases, malignancy and TB. Mortality was decreased for HCWs who were coloured [aOR 0.5; 95%CI (0.3-0.8)], admitted in the public sector [aOR 0.7; 95%CI (0.5-0.9)] in pre-wave 1 [aOR 0.6; 95%CI (0.3-0.9)] compared to wave one period. Conclusion: In-hospital mortality in HCWs was associated with age, race, wave period, presence of comorbidites and sector. Policies should be put in place to remove older HCWs with comorbidities from direct patient care. Optimal management of comorbid conditions is advised and improvement of infection prevention and control measures in healthcare settings for those that come into direct contact with infected patients.
Quick Identification of Genetic Provenances and Best Practice Woodland Management of Chinese Pine (Pinus tabuliformis)
Authors: Xia Hanhan , Yang Minyi , Yang Feicui , Xie Haoran , Li Juan 
Published: June 2021

Abstract
Chinese pine (Pinus tabuliformis) is one of the most widespread, ecologically and economically important tree species in North China. In this study, we analyzed and compared the genetic diversity and population structure of 158 individuals from 17 populations of P. tabuliformis, by group III, a new mitochondrial marker system (nad1-2, nad4-3, nad5-1 and nad7-1) with two other groups of marker systems. In contrast to the conservation in the evolution of the mitochondrial sequence, the new mitochondrial marker system of P. tabuliformis shows as extremely high polymorphism as 25, whose haplotypes are more than four times of the group I marker system (nad1-2, nad4-3, and nad5-1) as 8 haplotypes. Although the group II, nad7-1 (19 haplotypes), showed high resolution in the provenance identification of P. tabuliformis, the new mitochondrial marker system is more accurate for detection of specific groups like HL, WT and NS and powerful to differentiate populations between GD and SS. The results suggested that the new mitochondrial marker system is as high as the resolution of GBS (genotype by seqencing). It is much more available and will be of great help to provenance identification and molecular assisted breeding of P. tabuliformis. This study will make theoretical foundation for the following studies on the evaluation, cultivation and germplasm management of P. tabuliformis populations and aid the breeding, biodiversity and conservation programs of forest species.
Elevated Expression of MKRN3 in Squamous Cell Carcinoma of the Head and Neck and Its Clinical Significance
Authors: Zhang Shuiting , Qiu Yuanzheng 
Published: June 2021

Abstract
Background: Squamous cell carcinoma of the head and neck (SCCHN) is one of the most common types of cancer and is a relevant cause of cancer-related deaths. Our previous study has revealed that makorin ring finger protein 3 (MKRN3) may serve as a key regulator of the SCCHN tumorigenesis, but its specific role in SCCHN progression has never been reported.Method: TCGA data analysis and qPCR were used to quantify the level of MKRN3 in SCCHN and its clinical significance was further analyzed. Immunohistochemical staining or immunoblotting analysis was carried out to detect protein expression.Results: MKRN3 was ectopically expressed between cancerous and noncancerous SCCHN tissues, and its expression level was tightly associated with high T classifications and advanced clinical stages. qPCR analysis revealed that MKRN3 was upregulated in the SCCHN cell line. Moreover, Kaplan–Meier and Cox regression analyses indicated that SCCHN patients with high MKRN3 expression had poorer prognosis and that MKRN3 was a potential prognostic factor for SCCHN. Using gene ontology and Kyoto Encyclopedia of Genes and Genomes analyses, we determined that MKRN3 may be involved in the regulation of synthesis and metabolism, cell growth, death and motility, and cancer pathways associated with SCCHN progression. Mechanism investigation further revealed that P53, as a potential target of MKRN3, may implicate in the SCCHN tumorigenesis mediated by MKRN3.Conclusions: MKRN3 is a valuable predictive biomarker and potential therapeutic target in SCCHN.
Effect of Fermentation Time On The Content of Bioactive Compounds With Cosmetic and Dermatological Properties in Kombucha Yerba Mate Extracts
Authors: Ziemlewska Aleksandra , Nizioł-Łukaszewska Zofia , Bujak Tomasz , Zagórska-Dziok Martyna , Wójciak-Kosior Magdalena , Sowa Ireneusz 
Published: June 2021

Abstract
Kombucha is a beverage made by fermenting sugared tea using a symbiotic culture of bacteria belonging to the genus Acetobacter, Gluconobacter, and the yeasts of the genus Saccharomyces along with glucuronic acid, contribute to health protection. The paper presents the evaluation of ferments as a potential cosmetic raw material obtained from Yerba Mate after different fermentation times with the addition of kombucha. Fermented and unfermented extracts were compared in terms of chemical composition and biological activity. Studies of antioxidant properties were carried out using DPPH and ABTS radicals. A significant decrease in the intracellular level of free radicals was also observed. Cytotoxicity was determined on keratinocyte and fibroblast cell lines, resulting in significant increase in cell viability for the ferments. In addition, the ferments showed strong ability to inhibit the activity of lipoxygenase and collagenase and elastase enzymes and long‐lasting hydration after their application on the skin. Extract obtained after 21 days of fermentation contained the highest amount of phenolic acids and xanthines. The results showed that both the analyzed Yerba Mate extract and the ferments obtained with kombucha may be valuable ingredients in cosmetic products.
Low-intensity, Long-wavelength Red Light Slows the Progression of Myopia in Children: an Eastern China-based Cohort
Authors: Zhou Lei , Xing Chao , Qiang Wei , Hua Chaoqun , Tong Liyang 
Published: June 2021

Abstract
Myopia is prevalent worldwide, particularly in East and Southeast Asia. Recent studies have suggested that the spectral composition of ambient lighting influences refractive development, especially in humans. We aimed to determine the effect of 650-nm single-wavelength red light on the inhibition of myopia progression in children. In this retrospective cohort study, 105 myopic children (spherical equivalent refractive error [SER], -6.75 to -1.00 dioptres (D)) aged from 4 to 14 years old were retrospectively reviewed. Subjects were treated with 650-nm, low-intensity, single-wavelength red light twice a day for 3 minutes each session, with at least a 4-hour interval between sessions. IOL Master was utilized to measure the axial length (AL) and corneal curvature. Choroidal images were assessed using enhanced depth imaging optical coherence tomography (EDI-OCT), and the luminal area (LA) and stromal area were converted to binary images by the Niblack method. At baseline, the mean SER was -3.09 ± 1.74 D and -2.87 ± 1.89 D at 9 months, and significant changes occurred over time (P = 0.019). The AL increased by -0.06 ± 0.19 mm for 9 months (0.21 ± 0.15 mm pretreatment; P＜0.001). The subfoveal choroidal thickness (SFChT) had changed by 45.32 ± 30.88 μm at the 9-month examination (P＜0.001). Repetitive exposure to 650-nm, low-intensity, single-wavelength red light effectively slowed the progression of myopia and reduced axial growth after short treatment durations. These results require further validation in a longitudinal study, as well as further research in animal models.
Application of Blended Learning on the Antenatal Education Center Course: A Review of Flipped Classroom with Team-based Learning
Authors: Lin Yingying , Xiu Xiaoyan , Lin Juan , Chen Zhiwei , Zheng Cui Xian , Pan Xuehong , Lin Lihua , Yan Jianying 
Published: June 2021

Abstract
Background: The goal is to evaluate the effects of a flipped class strategy on knowledge, self-directed learning ability, learning satisfaction and pregnancy outcomes in primiparas undergoing antenatal education. Methods: A convenience sampling method was adopted. A total of 621 primiparas who were diagnosed with early pregnancy in a first-class hospital in southeast China and received continuous prenatal health education from May to July 2020 were selected as the research subjects. The primiparas were divided into two groups in the antenatal education centre. One was the experimental group, who used the prenatal health education model based on blended learning (a flipped classroom with team-based learning); the other was the control group, who used the traditional mode of prenatal health education. The two groups were compared on the following outcomes: knowledge, self-directed learning ability, learning satisfaction and pregnancy outcomes. Results: The blended learning approach enhanced the primiparas’ knowledge, self-directed learning ability, and learning satisfaction, effectively controlled the gestational weight gain (GWG), alleviated the degree of anxiety and depression in the pregnant women during pregnancy, improved the self-efficacy and the natural delivery rate of the primipara, shortened the delivery process and reduced the risk of gestational diabetes mellitus (GDM), all P<0.05. Conclusions: Blended learning may be an effective strategy because of its validity and practicality in antenatal education.
Event-triggered Control of Uncertain Nonlinear Discrete-time Systems with Extended State Observer
Authors: Wang Xianming , Shen Mouquan , Park Ju H. 
Published: June 2021

Abstract
This paper is dedicated to extended state observer-based event-triggered model free iterative learning control (ET-MFILC) for nonlinear systems with disturbances. A modified MFILC scheme is proposed by using the estimated uncertainties for the disturbed system. With the help of the estimated errors, an iterative extended state observer (IESO) is constructed to estimate the unknown uncertainties. New triggering mechanism integrated true tracking errors, the estimated errors and the estimated uncertainties is designed for multiple inputs and multiple outputs (MIMO) systems. Sufficient conditions are proposed to make the resultant ET-MFILC tracking error systems be uniformly ultimately bounded. An illustrative example is presented to demonstrate the effectiveness of the proposed scheme.
A Game Theoretic Analysis of Cryptocurrency Market for Sustainable Development of Smart Cities
Authors: Singh Rajani , Dwivedi Ashutosh Dhar , Wiszniewska-Matyszkiel Agnieszka 
Published: June 2021

Abstract
Cryptocurrency was first began to use in 2009 and features technology such as blockchain that is used in the development of smart cities. Game theory play an important role when designing secure economic system such as Bitcoin. In this paper, we study a dynamic game model of brand advertising in continuous time with the finite time horizon. The total payoff or profit of players or firms is discounted over time and the rate at which the firms attract the customers from its rival, called attraction rate, is taken from the economic theory of contest. As a novelty of our game model, the attraction rate of a firm depends on both: player’s or firm’s advertising effort and the advertising effort of players or firm’s rivalry. We solve the game for Stackelberg equilibrium (with the leader and follower differing by information and/or the sequence of choosing strategies) as well as for Nash equilibrium. Further, we graphically compare the results obtained for the Stackelberg and the Nash equilibrium. Surprisingly, we have obtained that if the revenue per unit of market share is equal for Nash and Stackelberg equilibrium then the results for Nash player 1 overlaps with the leader and the results for Nash player 2 overlaps with follower. Finally, we present the application of our dynamic game model in the cryptocurrency market where two firms compete with each other for the cryptocurrency market share.
Impact of the Covid-19 Pandemic on Primary Care Utilization: Evidence From Sweden Using National Register Data
Authors: Ekman Björn , Arvidsson Eva , Thulesius Hans , Wilkens Jens , Cronberg Olof 
Published: June 2021

Abstract
Objective: To analyze changes in primary care utilization as a result of the Covid-19 pandemic. Swedish national register data from 2019 and 2020 on utilization of services were used to compare overall utilization levels and across types of contacts and patient groups. A specific objective was to assess the extent to which remote types of patient consultations were able to compensate for any observed fall in on-site visits. Data were stratified by sex and age to investigate any demographic pattern. Results: Findings show significant reductions in overall utilization of services as the pandemic occurred the first quarter of 2020. On-site visits fell during the first wave of the pandemic and rebounded thereafter. Patients over 65 years of age appear to have reduced utilization to a larger extent compared with younger groups. Simultaneously, remote contacts increased from around 12% before the pandemic to 17% of total number of consultations. However, the net effect of changes in service utilization suggests an overall reduction of around 12 percent in the number of primary care consultations as a result of the pandemic. No differences between men and women were observed. Further research will continue to monitor changes in primary care utilization as the pandemic continues.
Adherence to DASH Dietary Pattern and Polycystic Ovarian Syndrome: A Case-control Study
Authors: panjeshahin asieh , Ghadiri-Anari Akram , Hosseinzadeh Mahdieh 
Published: June 2021

Abstract
Objective: Polycystic Ovary Syndrome (PCOS) as one of the endocrine and metabolic abnormalities is prevalent in reproductive-aged women. This study aimed to investigate the relevance between adherence to the DASH diet and PCOS.Results: This is an age and BMI-matched case-control study including (n=108) new diagnosis PCOS women as a case group and women without PCOS as a control group (n=108). Also, the validated 168-item food frequency questionnaire was used to determine the usual dietary intake. The method of Fung et al. was used to calculate the DASH score. Moreover, logistic regression was assessed to evaluate the relationship between adherence to the DASH diet and the odds of PCOS. After adjustment for potential confounders, an increase in adherence to the DASH diet significantly reduced the odds of PCOS (OR for the highest vs. lowest quartile = 0.18; 95% CI 0.07, 0.47). There was a significant decreasing trend in the odds of PCOS across increasing quintiles of the DASH diet (p-trend <0.001). The results showed that adherence to the DASH diet could reduce the odds of PCOS by 82 percent. It’s worth noting that more prospective studies are required to confirm the findings of the current study.
Association between Axial Length of the Eye and Length of Each Part of the Body
Authors: Shinojima Ari , Kurihara Toshihide , Mori Kiwako , Iwai Yujiro , Hanyuda Akiko , Negishi Kaznuno , Torii Hidemasa , Tsubota Kazuo 
Published: June 2021

Abstract
Objective: The purpose of this study is to analyze axial length, body height, hand length, and foot length to find new factors that predict myopia and to identify gender differences as one of the factors of high myopia. A cross-sectional study was conducted as a single observation. Body height, hand length, and foot length were measured according to standard anthropometric methods. Axial length, retinal thickness, and choroidal thickness were measured using the IOL Master 700 and the Heidelberg Spectralis-OCT. To account for body height differences among participants, foot length / body height and hand length / body height were analyzed using a mixed-effects model.Results: A total of 80 eyes (men, n=20, 40 eyes; women, n=20, 40 eyes) were analyzed. The mean age was 33.5 years (range 21-59 years, SD: 9.6). For choroidal thickness, there was a significant association with axial length in men (p<0.001) and a trend toward an association in women (p=0.072). There was also a significant association between foot length / body height and axial length in men (p=0.015), but not in women (p=0.58). These results suggest that factors that determine body height and foot length may be related to axial length, although they vary by gender.
Impacts of FcγRIIB and FcγRIIIA Gene Polymorphisms on Systemic Lupus Erythematous Disease Activity Index
Authors: Karimifar Mansoor , Akbari Khosro , Fathi Farshid , ArefNejad Reza , Moosaeepour Mohammad , Motedayyen Hossein 
Published: June 2021

Abstract
Objective: Systemic lupus erythematous (SLE) disease is a chronic autoimmune disease with unknown etiology that can involve different organs. Polymorphisms in Fcγ receptors have been identified as genetic factors in susceptibility to SLE. This study was aimed to investigate effects of two single nucleotide polymorphisms (SNPs) within FcγRIIB and FcγRIIIA genes on systemic lupus erythematous disease activity index (SLEDAI) in an Iranian population. Results: Our findings indicated TT and GG genotypes were the common genotypes of FcγRIIB and FcγRIIIA SNPs in SLE patients, respectively. There were no significant differences in genotype and allele frequencies of FcγRIIB and FcγRIIIA SNPs in SLE and healthy subjects. However, the frequencies of genotypes and alleles of FcγRIIB and FcγRIIIA SNPs were significantly associated with some clinical manifestations used to determine SLEDAI (P<0.001-0.5).
Invasive Micropapillary Carcinoma of Mixed Breast Cancer Metastasizing Faster Into Thyroid: A Rare Case Report
Authors: Yu Yupei , Wang Ruifeng , Deng Junqi , Zhou Jiayu , Zhou Haiyan , Wang Junpu 
Published: June 2021

Abstract
Background: The incidence of metastatic breast cancer tumors in the thyroid gland is very rare, however, invasive micropapillary carcinoma of breast metastasizes to thyroid gland is rarer. As far as we know, there has never been reported that both invasive ductal carcinoma– no special type (IDC-NST) and invasive micropapillary carcinoma (IMPC) exist in breast whereas only the latter metastasizes into the thyroid gland.Case presentation: we report a case of a 59-year-old Chinese woman first diagnosed as IDC-NST of breast with involvement of axillary lymph node, grade 2 in 2015. However, five years later, blood tests revealed increased tumor markers. Multiple solid nodules were found in both side of thyroid gland by imaging. Total thyroidectomy and bilateral cervical lymph nodes dissection were presentation: the findings showed both IDC-NST and IMPC in lymph nodes but only the later in thyroid gland. Immunohistochemically, these tumor cells were positive for ER, PR, GATA3 and Mammaglobin, but negative for TG and TTF-1. Ultimately, the patient was diagnosed as mixed breast cancer with metastatic IMPC in thyroid and radiation therapy was still continued.Conclusion: Apart from the possibility of metastatic no special type of breast cancer to thyroid tumor, IMPC of breast metastasis must be taken into consideration, especially when the patient has a history of breast cancer and thyroid nodes. Accurate diagnose of metastatic breast carcinoma is vital for precise treatment and can improve the prognosis for patients.
Potential for the Lung Recruitment and the Risk of Lung Overdistension During 21 Days of Mechanical Ventilation in Patients With COVID-19 After Noninvasive Ventilation Failure: the COVID-VENT Observational Trial
Authors: Yaroshetskiy Andrey , Avdeev Sergey N. , Politov Mikhail E. , Nogtev Pavel V. , Beresneva Victoria G. , Sorokin Yury D. , Konanykhin Vasily D. , Krasnoshchekova Anna P. , Merzhoeva Zamira M. , Tsareva Natalia A. , Trushenko Natalia V. , Mandel Irina A. , Yavorovskiy Andrey G. 
Published: June 2021

Abstract
Background: Data on the lung respiratory mechanics and gas exchange in the time course of COVID-19-associated respiratory failure is limited. This study aimed to explore respiratory mechanics and gas exchange, the lung recruitability and risk of overdistension during the time course of mechanical ventilation. Methods: This was a prospective observational study in critically ill mechanically ventilated patients (n=116) with COVID-19 admitted into Intensive Care Units of Sechenov University. The primary endpoints were: «optimum» positive end-expiratory pressure (PEEP) level balanced between the lowest driving pressure and the highest SpO2 and number of patients with recruitable lung on Days 1 and 7 of mechanical ventilation. We measured driving pressure at different levels of PEEP (14, 12, 10 and 8 cmH2O) with preset tidal volume, and with the increase of tidal volume by 100 ml and 200 ml at preset PEEP level, and calculated static respiratory system compliance (CRS), PaO2/FiO2, alveolar dead space and ventilatory ratio on Days 1, 3, 5, 7, 10, 14 and 21.Results: The «optimum» PEEP levels on Day 1 were 11.0 (10.0-12.8) cmH2O and 10.0 (9.0-12.0) cmH2O on Day 7. Positive response to recruitment was observed on Day 1 in 27.6% and on Day 7 in 9.2% of patients. PEEP increase from 10 to 14 cmH2O and VT increase by 100 and 200 ml led to a significant decrease in CRS from Day 1 to Day 14 (p<0.05). Ventilatory ratio was 2.2 (1.7-2,7) in non-survivors and in 1.9 (1.6-2.6) survivors on Day 1 and decreased on Day 7 in survivors only (p<0.01). PaO2/FiO2 was 105.5 (76.2-141.7) mmHg in non-survivors on Day 1 and 136.6 (106.7-160.8) in survivors (p=0.002). In survivors, PaO2/FiO2 rose on Day 3 (p=0.008) and then between Days 7 and 10 (p=0.046). Conclusion: Lung recruitability was low in COVID-19 and decreased during the course of the disease, but lung overdistension occurred at «intermediate» PEEP and VT levels. In survivors gas exchange improvements after Day 7 mismatched CRS.Trial registration: ClinicalTrials.gov, NCT04445961. Registered 24 June 2020 - Retrospectively registered, http://https://clinicaltrials.gov/ct2/show/NCT04445961?cond=COVID-19&cntry=RU&city=Moscow&draw=3&rank=23