bluuebunny/crossref_metadata_2025_split huggingface dataset:
Obstetric neonatal emergency simulation workshops in remote and regional South India: a qualitative evaluation
Authors: Zhong Bella , Sarkar Mahbub , Menon Nandakumar , Devi Shylaja , Budanoor Jayaram K. , Beerappa Naresh , Malhotra Atul , Kumar Arunaz 
Published: October 2021

Abstract
Background
Healthcare facilities in remote locations with poor access to a referral centre have a high likelihood of health workers needing to manage emergencies with limited support. Obstetric and neonatal clinical training opportunities to manage childbirth emergencies are scant in these locations, especially in low- and middle-income countries.

Objectives
This study aimed to explore the factors, which influenced healthcare worker experience of attending birth emergencies in remote and regional areas of South India, and the perceived impact of attending the Obstetric and Neonatal Emergency Simulation (ONE-Sim) workshop on these factors.

Design
Qualitative descriptive study using pre- and post-workshop qualitative surveys.

Settings
Primary healthcare facilities in remote/regional settings in three states of South India.

Participants
A total of 125 healthcare workers attended the workshops, with 85 participants completing the pre- and post-workshop surveys included in this study. Participants consisted of medical and nursing staff and other health professionals involved in care at childbirth.

Methods
ONE-Sim workshops (with a learner-centred approach) were conducted across three different locations for interprofessional teams caring for birthing women and their newborns, using simulation equipment and immersive scenarios. Thematic analysis was employed to the free-text responses obtained from the surveys consisting of open-ended questions.

Results
Participants identified their relationship with the patient, the support provided by other health professionals, identifying their gaps in knowledge and experience, and the scarcity of resources as factors that influenced their experience of birth emergencies. Following the workshops, participant learning centred on improving team and personal performance and approaching future emergencies with greater confidence.

Conclusions
Challenges experienced by healthcare workers across sites in remote and regional South India were generally around patient experience, senior health professional support and resources. The technical and interpersonal skills introduced through the ONE-Sim workshop may help to address some of these factors in practice.
Role of circulating endothelial progenitors in responsiveness to erythropoiesis-stimulating agents in hemodialysis patients
Authors: Ishimitsu Akira , Satonaka Hiroshi , Furuichi Masahito , Murayama Yoshiki , Tojo Akihiro , Ishimitsu Toshihiko 
Published: October 2021

AbstractBackgroundThough treatment of anemia in chronic kidney disease (CKD) patients has been improved remarkably by erythropoiesis-stimulating agents (ESA), hypo-responsiveness to ESA poses a persistent problem in a subgroup of CKD patients, especially those on dialysis, with deteriorated mortality or cardiovascular risks. Pathomechanism of this condition including cardiovascular implications has not been sufficiently investigated.MethodsClinical parameters of 101 chronic hemodialysis patients which included those hospitalized in our university hospital were examined cross-sectionally. As a marker estimating ESA hypo-responsiveness, erythropoietin resistance index (ERI) was calculated. Numbers of circulating endothelial progenitor cells (EPC) were measured by flow cytometry. Associations among values were analyzed by methods including multiple linear regression.ResultsMajority (93%) of the subjects were hospitalized patients with various comorbidities. ERI (18.4 [7.2–33.0] IU/week/kg/g/dL) and ESA dose (161.6 [75.0–320.9] IU/week/kg) of all the subjects were relatively high. Factors negatively correlated with EPC included age, HD vintage, CRP, pulse rate, ESA dose and ERI, while male sex and systolic blood pressure were positively correlated. By multiple linear regression analysis, age, sex and ERI (standardized coefficient beta − 0.202,p = 0.039) remained as the independently predicting factors of EPC (log CD133/Flk1+ EPC). Darbepoetin alpha was used in 65 patients, especially predominant when requiring higher ESA doses, but by correlation or multivariable analyses, this did not substantially modify the negative association between ERI and EPC.ConclusionsERI was independently associated with EPC paucity in a cohort with various comorbidities. This may suggest a link which connects ESA hypo-responsiveness to compromised cardiovascular prognosis of dialysis patients.
Serial dependence in the perceptual judgments of radiologists
Authors: Manassi Mauro , Ghirardo Cristina , Canas-Bajo Teresa , Ren Zhihang , Prinzmetal William , Whitney David 
Published: October 2021

AbstractIn radiological screening, clinicians scan myriads of radiographs with the intent of recognizing and differentiating lesions. Even though they are trained experts, radiologists’ human search engines are not perfect: average daily error rates are estimated around 3–5%. A main underlying assumption in radiological screening is that visual search on a current radiograph occurs independently of previously seen radiographs. However, recent studies have shown that human perception is biased by previously seen stimuli; the bias in our visual system to misperceive current stimuli towards previous stimuli is called serial dependence. Here, we tested whether serial dependence impacts radiologists’ recognition of simulated lesions embedded in actual radiographs. We found that serial dependence affected radiologists’ recognition of simulated lesions; perception on an average trial was pulled 13% toward the 1-back stimulus. Simulated lesions were perceived as biased towards the those seen in the previous 1 or 2 radiographs. Similar results were found when testing lesion recognition in a group of untrained observers. Taken together, these results suggest that perceptual judgements of radiologists are affected by previous visual experience, and thus some of the diagnostic errors exhibited by radiologists may be caused by serial dependence from previously seen radiographs.
Model predictive control of grid-connected PV power generation system considering optimal MPPT control of PV modules
Authors: Zhao Yingying , An Aimin , Xu Yifan , Wang Qianqian , Wang Minmin 
Published: October 2021

AbstractBecause of system constraints caused by the external environment and grid faults, the conventional maximum power point tracking (MPPT) and inverter control methods of a PV power generation system cannot achieve optimal power output. They can also lead to misjudgments and poor dynamic performance. To address these issues, this paper proposes a new MPPT method of PV modules based on model predictive control (MPC) and a finite control set model predictive current control (FCS-MPCC) of an inverter. Using the identification model of PV arrays, the module-based MPC controller is designed, and maximum output power is achieved by coordinating the optimal combination of spectral wavelength and module temperature. An FCS-MPCC algorithm is then designed to predict the inverter current under different voltage vectors, the optimal voltage vector is selected according to the optimal value function, and the corresponding optimal switching state is applied to power semiconductor devices of the inverter. The MPPT performance of the MPC controller and the responses of the inverter under different constraints are verified, and the steady-state and dynamic control effects of the inverter using FCS-MPCC are compared with the traditional feedforward decoupling PI control in Matlab/Simulink. The results show that MPC has better tracking performance under constraints, and the system has faster and more accurate dynamic response and flexibility than conventional PI control.
The cardioprotective effect of intralipid in decreasing the ischemic insults during off-pump coronary artery revascularization
Authors: El Derh Maha Sadek , Twab Samar Mohamed Abdel , Elgouhary Mohamed 
Published: October 2021

Abstract
Background
Off pump coronary artery revascularization (OPCAB) surgeries have benefits over the conventional on pump cardiac surgery, because it avoids the trauma caused by cardiopulmonary bypass (CPB) and minimize aortic manipulation. However, some disadvantages of OPCAB include the concern of ineffective coronary revascularization. Some drugs have shown the ability to protect the myocardium in different studies, by different methods. The usage of intralipid has been shown to make a better functional recovery of the cardiac muscles and help to decrease the myocardial infarct size, it shortens the action potential time, which show polyunsaturated fatty acids diets mechanism as an antiarrhythmic drug, and are associated with low incidence of coronary artery disease.

Methods
We divided patients into two groups according to the randomization envelopes: intralipid group (group A) received 1.5 ml/kg intralipid 20% through central venous line after sternotomy over 1 h and during infusion, blood pressure, heart rate, and temperature were monitored all through the infusion time. Control group (group B) received normal saline 0.9% in the same volume over the same duration.

Results
This study showed that infusion of 1.5 ml/kg intralipid after sternotomy in off pump coronary artery revascularization given as preconditioning agent improve the myocardial ischemia reperfusion injury, decrease the need for high doses of nor adrenaline infusion after revascularization, earlier normalization in troponin levels starting 24 h after surgery and higher values of cardiac index were measured in ICU using PICCO.

Conclusions
This study showed the benefits of infusion of 1.5 ml/kg of intralipid after sternotomy, in preconditioning during OPCABG. Preconditioning with intralipid proved to decrease reperfusion injury in myocardium expressed by improvement in cardiac functions (EF and cardiac index) and normalization of specific cardiac marker (cardiac troponin I).
The association between 24-h blood pressure variability and major adverse cardiac events (MACE) in hospitalized patients with acute myocardial infarction: a retrospective cohort study
Authors: Harefa  , Wijaya Ika Prasetya , Muhadi  , Rumende Cleopas Martin , Nasution Sally Aman , Koesnoe Sukamto , Marbun Maruhum Bonar , Shatri Hamzah 
Published: October 2021

Abstract
Background
Acute myocardial infarction (AMI) is major cardiovascular disease that causes high morbidity and mortality. In AMI, ischemia and necrosis affected some cardiomyocytes leading to a decrease in myocardial contractility which is followed by an acute proinflammation reaction and increased sympathetic tone. Meanwhile, high blood pressure variability (BPV) causing an increased left ventricular workload, heart rate, myocardial oxygen demand and induces proinflamations and endothelial dysfunction. Therefore a high BPV and its associated pathological effects are likely to aggravate the physiological function of the heart and affect the emergence of acute cardiac complications in AMI patients. This study aims to investigate the association’s between short-term BPV and major adverse cardiac events (MACE) in AMI patients. This retrospective cohort study used simple random sampling to identify AMI patients who were hospitalized at Cipto Mangunkusumo National Hospital between January 2018 and December 2019. Mann Withney was performed to investigate the association between BPV and MACE.

Results
The average systolic BPV value which was calculated as standard deviation (SD) and average real variability (ARV) was higher in the MACE group than in the non-MACE group. Systolic SD and systolic ARV in the MACE group were 13.28 ± 5.41 mmHg and 9.88 ± 3.81 mmHg respectively. In the non-MACE group, systolic SD and systolic ARV were 10.76 (4.59–26.17) mmHg and 8.65 (3.22–19.35) mmHg respectively. There was no significant association between BPV and MACE. However, there were significant differences between systolic SD and systolic ARV in patients with hypertension who experienced MACE and patients without hypertension who experienced MACE.

Conclusions
The BPV of AMI patients who experience MACE was higher than that of non-MACE AMI patients. There was no significant association between BPV ​​and MACE during the acute phase of AMI.
Clinical outcomes and impact of prognostic factors following adjuvant radiotherapy in oral tongue cancer patients
Authors: Pant Sidharth , Lal Punita , Misra Shagun , Gupta Piyush , Das K. J. Maria , Kumar Senthil , Nautiyal Vipul , Bhawna Kranti , Kumar Shaleen 
Published: October 2021

AbstractBackgroundThe purpose of the study was to evaluate survival outcomes in post-operative oral tongue cancer patients undergoing adjuvant radiotherapy (RT) at a tertiary cancer care center and to critically review the impact of various clinical-pathological factors on recurrence and survival. Demographic factors, stage of all the histology proven oral tongue cancer, and treatment details were documented. Overall survival (OS) and recurrence-free survival (RFS) were analyzed along with the potential prognostic factors affecting outcome.ResultsOne hundred forty-four post-operative oral tongue cancer patients referred to our department for adjuvant treatment were evaluated. Median age at presentation was 45 years. Forty-seven patients had pathological early stage disease (stages I and II) and 95 had locally advanced (stages III and IV) disease while post-op details were not present in 2 patients. At a median follow-up of 87 months (60–124) of alive patients, the median RFS for entire cohort was 62 months while median OS was 74 months respectively. Age, perineural invasion (PNI), and grade of the tumor emerged as independent prognostic factors for OS and RFS. Among patients with early stage disease, depth of invasion (DOI), age, and PNI were found as independent prognostic factors for RFS and OS. In locally advanced disease, higher grade, age, and PNI independently impacted the respective survival end points.ConclusionsAge (> 45 years), higher grade, and presence of PNI showed inferior survival outcomes across the sub-groups (early versus locally advanced disease). This may warrant adjuvant treatment intensification. DOI > 10 mm was particularly found to worsen survival in early node negative SCC oral tongue patients.
Germline competent mesoderm: the substrate for vertebrate germline and somatic stem cells?
Authors: Savage Aaron M. , Alberio Ramiro , Johnson Andrew D. 
Published: October 2021

ABSTRACTIn vitro production of tissue-specific stem cells [e.g. haematopoietic stem cells (HSCs)] is a key goal of regenerative medicine. However, recent efforts to produce fully functional tissue-specific stem cells have fallen short. One possible cause of shortcomings may be that model organisms used to characterize basic vertebrate embryology (Xenopus, zebrafish, chick) may employ molecular mechanisms for stem cell specification that are not conserved in humans, a prominent example being the specification of primordial germ cells (PGCs). Germ plasm irreversibly specifies PGCs in many models; however, it is not conserved in humans, which produce PGCs from tissue termed germline-competent mesoderm (GLCM). GLCM is not conserved in organisms containing germ plasm, or even in mice, but understanding its developmental potential could unlock successful production of other stem cell types. GLCM was first discovered in embryos from the axolotl and its conservation has since been demonstrated in pigs, which develop from a flat-disc embryo like humans. Together these findings suggest that GLCM is a conserved basal trait of vertebrate embryos. Moreover, the immortal nature of germ cells suggests that immortality is retained during GLCM specification; here we suggest that the demonstrated pluripotency of GLCM accounts for retention of immortality in somatic stem cell types as well.This article has an associated Future Leaders to Watch interview with the author of the paper.
Supported, ∼1-nm-Sized Platinum Clusters: Controlled Preparation and Enhanced Catalytic Activity
Authors: Kawawaki Tokuhisa , Shimizu Nobuyuki , Mitomi Yusuke , Yazaki Daichi , Hossain Sakiat , Negishi Yuichi 
Published: October 2021

Abstract
We have been aiming to reduce the amount of platinum (Pt) needed in catalysts for automobile exhaust-gas purification and fuel cell electrodes. To achieve this, we have attempted to: 1) establish simple methods for synthesizing ligand-protected ∼1-nm-sized Pt clusters with a narrow distribution in the number of constituent atoms; 2) load these clusters onto supports, while retaining their number of constituent atoms, to prepare supported ∼1-nm-sized Pt clusters; and 3) elucidate the catalytic activity of each type of supported ∼1-nm-sized Pt cluster. These studies have revealed that: 1) ligand-protected ∼1-nm-sized Pt clusters stable in the atmosphere can be isolated with high purity by a combination of polyol reduction and ligand-exchange reaction; 2) ∼1-nm-sized Pt clusters can be loaded onto the support without aggregation when the clusters are adsorbed on the support and then calcined at an appropriate temperature; and 3) Pt17 clusters loaded onto γ-alumina exhibit high activity and durability for exhaust-gas purification, whereas Ptn clusters (n = ∼35, ∼51, or ∼66) loaded onto carbon black exhibit high activity and durability for the oxygen reduction reaction (which occurs at fuel cell electrodes). This account describes our previous studies and explores future prospects for supported ∼1-nm-sized Pt clusters.
Presentation of cytokine profile in relation to oxidative stress parameters in patients with severe COVID-19: a case-control pilot study
Authors: Petrushevska Marija , Zendelovska Dragica , Atanasovska Emilija , Eftimov Aleksandar , Spasovska Katerina 
Published: October 2021

Introduction: COVID-19 can be worsened by hyper-production of cytokines accompanied by increased level of oxidative stress. The aim of this study was to investigate the correlation between a set of cytokines and the markers of the oxidative stress. Methods: The levels of cytokines IL-2, IL-4, IL-6, IL8, IL-10, VEGF, IFN-γ, TNF-α, IL-1α, MCP-1 and EGF were determined by using High Sensitivity Evidence Investigator™ Biochip Array technology. The oxidative stress parameters (d-ROM, PAT, OS index) were measured in serum on FRAS5 analytical photometric system. Results: IL-6, IL-8, IL-10, VEGF, MCP-1 and EGF were significantly higher (p<0.05) in the patients with severe COVID-19 with increased levels of IL-2, IFN-y, TNF-α and IL-1α. The d-ROM, OS index, and PAT were significantly higher (p<0.05) in severe COVID-19 patients. IL-6 demonstrated the strongest correlation with all of the markers of the oxidative stress, d-ROM (r=0.9725, p=0.0001), PAT (r=0.5000, p=0.0001) and OS index (r=0.9593, p=0.012). Similar behavior was evidenced between IFN-y and d-ROM (r=0.4006, p=0.0001), PAT (r=0.6030, p=0.0001) and OS index (r=0.4298, p=0.012). Conclusion: The oxidative stress markers show good correlation with the tested cytokines which can be measured at the beginning of the disease in a primary care setting to predict the course of COVID-19.
Differential enrichment of yeast DNA in SARS-CoV-2 and related genomes supports synthetic origin hypothesis
Authors: Lisewski Andreas Martin 
Published: October 2021

Background: Knowledge about the origin of SARS-CoV-2 is necessary for both a biological and epidemiological understanding of the COVID-19 pandemic. Evidence suggests that a proximal evolutionary ancestor of SARS-CoV-2 belongs to the bat coronavirus family. However, as further evidence for a direct zoonosis remains limited, alternative modes of SARS-CoV-2 biogenesis should be also considered. Results: Here we show that the genomes from SARS-CoV-2 and from SARS-CoV-1 are differentially enriched with short chromosomal sequences from the yeast S. cerevisiae at focal positions that are known to be critical for virus replication, host cell invasion, and host immune response. Specifically, for SARS-CoV-2, we identify two sites: one at the start of the viral replicase domain, and the other at the end of the spike gene past its critical domain junction; for SARS-CoV-1, one at the start of the RNA dependent RNA polymerase gene, and the other at the start of the spike protein’s receptor binding domain. As yeast is not a natural host for this virus family, we propose a directed passage model for viral constructs, including virus replicase, in yeast cells based on co-transformation of virus DNA plasmids carrying yeast selectable genetic markers followed by intra-chromosomal homologous recombination through gene conversion. Highly differential sequence homology data across yeast chromosomes congruent with chromosomes harboring specific auxotrophic markers further support this passage model. Model and data together allow us to infer a hypothetical tripartite genome assembly scheme for the synthetic biogenesis of SARS-CoV-2 and SARS-CoV-1. Conclusions: These results provide evidence that the genome sequences of SARS-CoV-1, SARS-CoV-2, but not that of RaTG13, BANAL-20-52 and all other closest SARS coronavirus family members identified, are carriers of distinct homology signals that might point to large-scale genomic editing during a passage of directed replication and chromosomal integration inside genetically modified yeast cells.
The Gambia National Eye Health Survey 2019: survey protocol
Authors: Hydara Abba , Bastawrous Andrew , Bell Suzannah , Boggs Dorothy , Bright Tess , Bobat Hannaa , Eaton Julian , Faal Hannah , Jobe Modou , Kim Min J. , Kirkpatrick Ben , McCormick Ian , Okoh John Atta , Olaniyan Segun Isaac , Prentice Andrew M. , Ramke Jacqueline , Taylor Ruth , Burton Matthew J , Mactaggart Islay 
Published: October 2021

Two national surveys of vision impairment and blindness were undertaken in The Gambia in 1986 and 1996. These provided data for the inception of The Gambia’s National Eye Health Programme (NEHP) within the Ministry of Health and Social Welfare. There have been important developments in the eye health services provided by the NEHP in the last 20 years. At the same time, the population has also undergone major demographic changes that may have led to substantial changes in the burden of eye disease. We conducted a National Eye Health Survey of vision impairment, blindness and its comorbidities in adults in The Gambia in 2019. We examined a nationally representative population-based sample of adults 35 years and above to permit direct comparison with the data available from the previous surveys. Alongside a comprehensive vision and eye examination, the survey provides nationally representative data on important comorbidities in this population: diabetes, hypertension, obesity, hearing impairment, disability and mental health. Secondly, it estimates access to assistive technologies and eye health services. Thirdly, it is powered to allow a five-year follow up cohort study to measure the incidence and progression of eye disease.