bluuebunny/crossref_metadata_2025_split huggingface dataset:
Electrocardiographic Changes and Serum Troponin Levels in Patients with Acute Stroke, A Prospective Descriptive Analytical Study from Sudan
Authors: Ibrahim Etedal Ahmed A , Taha Salma Mohmed , Ahmed Khabab Abbasher Hussien Mohamed , Omer Mohammed Eltahier Abdalla , Haroun Mazin S. 
Published: October 2021

Abstract
Background:Electrocardiographic changes and elevated serum troponin are frequent findings in acute stroke. They may reflect what is known as the neuro-genic myocardial injury. However, as stroke and cardiac diseases share the same risk factors. Coexistence of the two is highly susceptible.Objectives:To determine the electrocardiographic changes and serum troponin level in acute stroke patients and to correlate these changes to the anatomical location and pathological type of the stroke.Methods:A prospective descriptive analytical study was conducted at the national center of neurological Science, from January to December 2019 Study was done at the neurological center in Sudan, The National Center of Neurological sciences. All cases presented with acute stroke during the study period were included. Non-probability sampling, with total coverage during study period was considered. 50 patients were included in the study. Data were analyzed by using (SPSS) version 25. 12 standards ECG were performed in the first hours of admission. 2 samples from each patient were obtained for serum troponin with at least 8 hours apart.Results:All patients had wide variants of ECG changes. But tachycardia was the most frequent one identified in 54% of patients (27/50). Half of them were found to have an anterior circulation stroke. 14% of patients (7/50) have positive troponin; ECG changes identified in all of patients who represent positive troponin100 %( 7patients). Moreover, anterior circulation stroke was recognized in all patients with positive troponin I marker.Conclusion:This study suggests that ECG abnormalities in patients with acute stroke are very common, especially tachycardia. The site of lesion appears to play major factor as a cause of genesis of arrhythmia. Concomitant cardiac diseases may present .Serum troponin elevation may play a role in diagnosing neuro-cardiogenic injury but, ECG appears to be more sensitive and familial.
Retrospective Comparison of Outcomes between Closed and Open Reduction for Developmental Dysplasia of the Hip in Children Aged 6–24 Months
Authors: Ma Shuyu , Zhou Weizheng , Li Lianyong , Wang Enbo , Zhang Lijun , Li Qiwei 
Published: October 2021

Abstract
Background: This study aimed to compare the early outcomes between closed reduction (CR) and open reduction (OR) in children aged 6–24 months with developmental dysplasia of the hip (DDH) who could be reduced safely and stably by the closed method.Methods: We retrospectively reviewed the medical records of 77 patients who underwent CR or OR treatment for DDH from August 2012 to October 2017. Fifty-one patients (56 hips) underwent CR, while 26 (29 hips) underwent OR. The demographic data, International Hip Dysplasia Institute classification, and acetabular index (AI) before reduction were analysed. The centre-edge angle (CEA), AI, Alsberg angle (AA), Reimer’s migration index (RMI), and height-to-width index (HWI) of the epiphysis were compared between the CR and OR groups at the final follow-up. The percentages of avascular necrosis (AVN), residual acetabular dysplasia (RAD), HWI < 0.357, RMI > 33%, AA > 81˚, and coxa magna > 15% of the normal side were calculated.Results: At the final follow up, the mean AA in the CR and OR groups were 77.66˚ (60˚–89˚) and 81.97˚ (73˚–91˚) (p=0.001), respectively, and there were 32.14% and 58.62% of the hips with an AA > 81˚ (p=0.019). The frequency of coxa magna > 15% of the normal side was higher in the OR group (60.9%) than in the CR group (6.5%) (p<0.001). There was no difference in the improvement of AI, CEA, HWI, and RMI at the final follow-up. The percentages of RAD, HWI < 0.357, RMI > 33%, and AVN were not statistically different.Conclusion: In children aged 6–24 months with DDH, if a stable and safe CR can be obtained but with a widening joint space, an OR may not benefit acetabular remodelling more than a CR procedure, and thus, CR should be attempted.
Clarifying Key Cellulase Component Cooperated With Lactic Acid Bacteria for Alfalfa Lignocellulose Degradation to Improve Lactic Acid Production
Authors: Li Junfeng , Wu Qifeng , Ceng Zong , Wu Aili , Huang Zhongyong , Shao Tao , Liu Qinhua 
Published: October 2021

Abstract
Clarifying key cellulase component that played synergistic roles with lactic acid bacteria (LAB) in fermenting alfalfa lignocellulose into lactic acid (LA) is valuable in low-temperature seasons. Last cut and low dry matter (DM) alfalfa was ensiled by 9 treatments, combinations of cellulase component genes engineered Lactoc. lactis subsp. lactis MG1363 strains (HT2, HT3, HT4, HT5, E1C1, E1B1, and C1B1, separately containing bgl1, cbh2, and egl3 gene were mixed at 1:1:1, 2:1:1, 1:2:1, 1:1:2, 1:1:0, 1:0:1, and 0:1:1), cellulase (EN), and a combination of Lactobacillus plantarum and cellulase (LPEN), and without treatments, as the control, with 4 replicates each. After anaerobic preservation in a silo from late fall through winter (3-20℃) for 140 d, the ensiled alfalfa was sampled and analysed. EN degraded lignocellulose best but the pH was the key limiting factor for lignocellulose saccharification of commercial EN in the simultaneous saccharification and fermentation of LPEN. The optimal combination HT4 caused the fewest disaccharide (1.02 g/kg DM) and the highest conversion of water-soluble carbohydrates (WSC) to LA (170%) and increased LA content to 80.0 g/kg DM maximally since cellobiohydrolase better cooperated with Lactoc. lactis host to ferment lignocellulose into LA than endoglucanase and β-glucosidase. Therefore, strong LA production was approached in HT4 by clarifying key cellulase component played synergistic roles with Lactoc. lactis host. This study could benefit the development of LA production in fermenting lignocellulosic biomass.
Sepsis Awareness at the University Hospital Level: A Survey-Based Cross-Sectional Study
Authors: Regina Jean , Pogam Marie-Annick Le , Niemi Tapio , Akrour Rachid , Pepe Santino , Lehn Isabelle , Wasserfallen Jean-Blaise , Calandra Thierry , Meylan Sylvain 
Published: October 2021

Abstract
Background: Sepsis is a leading cause of morbidity and mortality. Prompt recognition and management are critical to improved outcomes. In 2019, the Lausanne University Hospital (LUH) launched a quality of care project aiming to improve sepsis management. As part of this effort, we aimed to assess sepsis awareness among nurses and physicians of the LUH and among the local paramedics. Methods: We conducted a survey on nurses and physicians at our institution and local paramedics between January and October 2020 representing over 1,000 professionals distributed over all hospital departments. The survey assessed professionals’ knowledge of sepsis epidemiology, definition, recognition and initial evaluation (nurses and paramedics) or sepsis epidemiology, diagnosis, and management (physicians). Pediatrics and the neonatal unit were excluded. Results: A total of 1,116 of 1,216 contacted persons among the 4417 targeted population participated and completed the survey (participation rate 91.8%). This included 619 of 2,463 (25.1%) of hospital nurses, 348 of 1,664 (20.9 %) of physicians and 149 of 290 (51.4%) of canton paramedics. Our nurse and physician sample was slightly imbalanced for sex and age. Thirteen percent of participants (28.4% of physicians, 5.9% of nurses, 6.8% of paramedics) correctly identified the Sepsis-3 consensus definition. Similarly, 48.6% of physicians and 10.0% of nurses identified the SOFA (sequential organ failure assessment) score as a sepsis defining score for infected patients. Furthermore, 24% of participants identified the Quick Sepsis-related Organ Failure Assessment (qSOFA) score as a predictor of increased mortality; 6% identified correctly the components of the score. For a patient with suspected sepsis, 96.1%, 91.6% and 75.8% of physicians respectively identified blood cultures, broad-spectrum antibiotics and fluid resuscitation as required interventions; 76.4% and 18.2% of physicians requested these initial measures within 1 and 3 hours, respectively. For physicians, recent training correlated with awareness regarding definitions, SOFA score and qSOFA score use and components: ORs (95%CI) 2.2 (1.4-3.6), 4.3 (2.7-6.7), 3.4 (2.2-5.2), and 2.6 (1.5-4.6), respectively).Conclusions: We identify a deficit of awareness among physicians, nurses and paramedics at LUH correlating with a lack of sepsis-specific training. Enhanced sepsis-specific educational efforts could significantly improve early identification and treatment of affected patients.
Effects of long-term flue gas exposure on chemical-structural properties of South African coals: perspective on advanced analytical techniques
Authors: Mabuza Major , Premlall Kasturie , Daramola Michael O. 
Published: October 2021

Abstract
The sequestration of carbon dioxide (CO 2 ) in unmineable coal seams is one of the geologic options earmarked to alleviate the emissions of the greenhouse gases to the atmosphere. Direct flue gas injection into unmineable coal seams has been considered to partially offset the cost of the utilizing this technology. This paper presents findings of the evolution of chemical structural properties of two South African coals from Somkhele (Coal SML) and Ermelo (Coal EML) coalfields after long-term (2 232 hours) flue gas exposure by applying advanced analytical techniques. The two coal samples were exposed to a synthetic flue gas simulating coal-fired power plant gas emissions containing 12% CO 2 , 5.5% O 2 , 82% N 2 , 0.38% SO 2 , and 0.12% NO 2 under in-seam temperature and pressure conditions of 60 °C and 9.0 MPa, respectively. The advanced analytical techniques applied included universal attenuated total reflectance-Fourier transform infrared (UATRFTIR), carbon-13 solid state nuclear magnetic resonance spectroscopy ( 13 C ss NMR), and field emission scanning electron microscopy with energy dispersive X-ray spectroscopy (FESEM-EDX) wide-angle X-ray diffraction (WAXRD). The UATR-FTIR spectra revealed weakened C─H, aliphatic C─C, C─O, ─OH, and out-of-plane aromatic C─H functional groups. The results from the treated coals of 13 C ss NMR for the structural parameters show notable changes in the oxygen functionalities reporting the aliphatic carbon bonded to oxygen, 𝑓 𝑎𝑙 𝑂 , while the WAXRD data showed some significant changes in the inter-layer spacing and the crystalline diameter as compared to the untreated coals.
Analysis of HIV pre-exposure prophylaxis (PrEP) needs and PrEP use among men who have sex with men in Germany
Authors: Marcus Ulrich , Schmidt Daniel , Schink Susanne B. , Koppe Uwe 
Published: October 2021

Abstract
Aims:We aim to estimate the number of PrEP users among men having sex with men (MSM) in Germany from 2017 through 2020, and analyse if PrEP needs expressed in 2017 might have been met by the expansion of PrEP until 2020.Subject and Methods:We estimated the number of PrEP users by using drug prescription data and information on on-demand/intermittent PrEP use from online surveys to determine the proportion of on-demand/intermittent and daily PrEP use as well as the average number of PrEP pills used.The number of MSM in need of PrEP in 2017 was estimated based on four groups defined among respondents to a large online survey, combining respondents with PrEP use intention and respondents indicating substantial sexual risks. The size of each group was estimated based on self-selection biases. MSM with PrEP need in 2017 were compared with the estimated number of persons taking PrEP by June 2020.Results:We estimated a total of 15,600 to 21,600 PrEP users in Germany by the end of June 2020, corresponding to 40-55% of men with PrEP use intention in 2017. A correlation between the regional distribution of PrEP use intention in 11/2017 and actual PrEP use by 06/2020 suggested an unequal regional distribution of unsatisfied needs. The number of men with unmet PrEP needs ranged between 27,500 and 93,000 in 06/2020.Conclusion:PrEP use in Germany has increased considerably between 10/2017 and 06/2020, but large regional inequalities persist. PrEP is not yet readily accessible and there is a need to expand services and encourage uptake.
An Unusual Case of Small Bowel Volvulus Associated with Pneumatosis Intestinalis: A Case Report
Authors: Zouaghi Alia , Hadded Dhafer , Mesbahi meryam , Benzarti Y , Cherif M , Zaafouri H , Massoud K Ben , Chammekhi C , Maamer Anis Ben 
Published: October 2021

Abstract
INTRODUCTION: Pneumatosis cystoid intestinalis (PCI) is a rare disease reported in the literature affecting 0.03% of the population. It has a variety of causes and its manifestation may change widely. In the acute complicated form of pneumatosis intestinalis, management is challenging for physicians and surgeons. CASE PRESENTATION: We present a case of a 60-year-old patient who was admitted to our surgical department with a symptomatology suggestive of small bowel occlusion. Computed tomography demonstrated ileal volvulus associated with parietal signs suffering and pneumoperitoneum. An emergent exploratory laparoscopy followed by conversion was performed demonstrating segmental ileal pneumatosis intestinalis secondary to a small bowel volvulus due to an inflammatory appendix wrapping around the distal ileum. Detorsion, retrograde draining, and appendectomy were performed. DISCUSSION: PCI is an uncommon disease, affecting 0.03% of the population. It is usually presenting as a marginal finding resulting from various gastrointestinal pathologies. This case is exceedingly rare in the literature, featured by the ileal volvulus due to appendicitis.CONCLUSION: This work emphasizes the importance of surgical procedures in the management of symptomatic pneumatosis intestinalis.
Interstitial Lung Disease and Partial Resection are Poor Prognostic Factors for pStage IA NSCLC: A Retrospective Study
Authors: Motono Nozomu , Ishikawa Masahito , Iwai Shun , Yamagata Aika , Iijima Yoshihito , Uramoto Hidetaka 
Published: October 2021

Abstract
Introduction: The prognostic factors in patients who underwent pulmonary resection with early stage non-small cell lung cancer (NSCLC) have not been elucidated.Materials and methods: Clinical data of 540 patients with pathological stage IA NSCLC were analyzed. Patient factors such as sex, age, comorbidities, carcinoembryonic antigen (CEA), smoking history, and operative aspects such as operative approach and operative procedures were collected and analyzed.Results: There were significant prognostic differences according to the interstitial lung disease (p<0.0001), CEA (p = 0.007), and partial resection (p = 0.002) in the relapse-free survival (RFS). There were significant prognostic differences according to the interstitial lung disease (p = 0.0015), CEA (p < 0.0001), and smoking history (p = 0.0003) in the overall survival (OS). Interstitial lung disease (hazard ratio [HR]: 7.725, p = 0.003), CEA (HR: 1.923, p = 0.045), and operative procedure (HR: 2.086, p = 0.025) were risk factors for RFS in a multivariate analysis. Smoking history (HR: 2.539, p = 0.002) and CEA (HR: 2.464, p = 0.002) were risk factors for OS in a multivariate analysis.Conclusion: Interstitial lung disease, CEA, and operative procedure were risk factors for RFS, while smoking history and CEA were risk factors for OS.
Warming effects on biomass allocation are jointly regulated by precipitation and mycorrhizal association in terrestrial plants
Authors: Zhou Xuhui , Zhou Lingyan , He Yanghui , Fu Yuling , Du Zhenggang , Lu Meng , Sun Xiaoying , Li Chenghao , Lu Chunyan , Liu Ruiqiang , Zhou Guiyao , Bai Shahla Hosseni , Thakur Madhav 
Published: October 2021

Abstract
Biomass allocation in plants is fundamental for understanding and predicting terrestrial carbon storage. Recent studies suggest that climate warming can differentially affect root and shoot biomass, and subsequently alter root: shoot ratio. However, warming effects on root: shoot ratio and their underlying drivers at a global scale remain unclear. Using a global synthesis of >300 studies, we here show that warming significantly increases biomass allocation to roots (by 13.1%), and two factors drive this response: mean annual precipitation of the site, and the type of mycorrhizal fungi associated with a plant. Warming-induced allocation to roots is greater in relatively drier habitats compared to shoots (by 15.1%), but lower in wetter sites (by 4.9%), especially for plants associated with arbuscular mycorrhizal fungi compared to ectomycorrhizal fungi. Root-biomass responses to warming predominantly determine the biomass allocation in terrestrial plants suggesting that warming can reinforce the importance of belowground resource uptake. Our study highlights that the wetness or dryness of a site and plants’ mycorrhizal associations strongly regulate terrestrial carbon cycle by altering biomass allocation strategies in a warmer world.
Constructing ecological indices for urban environments using species distribution models
Authors: Simons Ariel Levi , Caldwell Stevie , Fu Michelle , Gallegos Jose , Gatheru Michael , Riccardelli Laura , Truong Nhi , Viera Valeria 
Published: October 2021

Abstract
In an increasingly urbanized world, there is the need for a framework to assess ecological conditions in these anthropogenically dominated environments. Using species observations from the Global Biodiversity Information Facility (GBIF), along with remotely sensed environmental layers, we used MaxEnt to construct species distribution models (SDMs) of native and non-native species in Los Angeles. 25 native and non-native Indicator species were selected based on the sensitivities of their SDM, as measured by the Symmetric Extremal Dependence Index (SEDI), to environmental gradients. These SDMs were summarized to produce ecological indices of native and non-native biodiversity in Los Angeles.
We found native indicator species to have a greater sensitivity to environmental conditions than their non-native counterparts, with the mean SEDI score of native and non-native species MaxEnt models being 0.72 and 0.71 respectively. While both sets of species were sensitive to land use categories and housing density, native species were more sensitive to natural landscape variables while non-native ones were more sensitive to measures of water and soil contamination. Using random forest modeling we also found our native index could be more reliably predicted, given environmental conditions, than its non-native counterpart. The mean Pearson correlation between actual and predicted index values were 0.86 and 0.84 for native and non-native species. From these results we conclude that using SDMs to predict the biodiversity of environmental species is a suitable approach towards evaluating ecological conditions in urban environments, with the environmental sensitivity of native SDMs outperforming non-native ones.
Invasion in a Community Context: Genetic Variation in the Strength of Direct and Indirect Effects
Authors: Hoffbeck Carmen , Cammisa Nicole , terHorst Casey P 
Published: October 2021

Abstract
Predicting invasion success requires understanding how abiotic and biotic factors in the local environment interact with the particular traits of potential invaders. Relative to studies of direct antagonistic effects, fewer studies have examined how positive species interactions, such as facilitation or mutualism, or indirect interactions in multispecies communities, can affect invasion success. We examined the effects of drought and mutualisms with rhizobia bacteria on the performance of a widely invasive legume, Medicago polymorpha. In a greenhouse experiment, we found that watering regime affected plant performance, but non-linear patterns in response to decreasing water were dependent on the specific plant genotype. In a second experiment, we found that the effects of drought on plant performance were dependent on the presence of rhizobia, particularly for genotypes collected from the invasive range. This suggests that indirect ecological effects may have important consequences for invasion success. We contextualize the strength of these direct and indirect effects by comparing this study to effect sizes in other studies of the same species. In this species, predicting invasion into a natural community context will require understanding multiple direct and indirect effects in the local environment, as well as their effects on the specific genetic composition of the invading population.
Cartilage Thickness and Bone Shape Variations as a Function of Sex, Height, Body Mass, and Age in Adult Knees.
Authors: Schneider Marco Tien-Yueh , Rooks Nynke , Besier Thor 
Published: October 2021

Abstract
The functional relationship between bone and cartilage is modulated by mechanical factors. Scarce data exist on the relationship between bone shape and the spatial distribution of cartilage thickness. This study has three aims: first, to characterise the coupled variation in knee bone morphology and cartilage thickness distributions in knees with healthy cartilage. The second aim was to investigate this relationship as a function of sex, height, body mass, and age. The third aim was to characterise the morphological differences between males and females. MR images of 51 adult knees (28.4±4.1 years) were obtained from a previous study and used to train a statistical shape model of the femur, tibia, and patella and their cartilages. Five linear regression models were fitted to characterise morphology as a function of sex, height, body mass, and age. A logistic regression classifier was fitted to characterise morphological differences between males and females, and 10-fold cross-validation was performed to evaluate the models’ performance. Our results showed that cartilage thickness and its distribution was coupled to bone morphology, including both size (mode 1) and shape variations (mode 2 onwards). The first three shape modes captured over 90% of the variance and described the overall size, diaphysis size, femoral shaft angle, and corresponding changes to the spatial distribution of the cartilages. These modes were sex-linked (p < .0001, p < .05, p < .01, for modes 1, 2, and 3 respectively) and could classify sex with an accuracy of 94.1% (95% CI [83.8%, 98.8%]). Height was a predictor of joint size (p <. 0001) and diaphysis size (p < .05). Body mass was a predictor of joint size (p < .1) and femoral shaft angle (p < .1). Age was not correlated with any of the modes. This study demonstrated the coupled relationship between bone and cartilage, showing that cartilage is thicker with increased bone size, diaphysis size, and decreased femoral shaft angle. Our findings show that sexual dimorphism is strong in these first three modes, and that bone shape and cartilage thickness at the joint are strongly correlated with height but weakly correlated with mass.