bluuebunny/crossref_metadata_2025_split huggingface dataset:
Incidence of neural tube defects and their risk factors within a cohort of Moroccan newborn infants
Authors: Forci Khenata , Bouaiti El Arbi , Alami Mohamed Hassan , Mdaghri Alaoui Asmaa , Thimou Izgua Amal 
Published: March 2021

Abstract
Background
Neural tube defects (NTDs) are a group of birth defects that result from a partial or complete failure of the neural tube to close during embryogenesis. Their prevalence varies between 0.5 to 2 per 1000 births in countries without folic acid supplementation. The aim of our study is to assess the NTDs incidence and describe the risk factors within Moroccan newborn infants.

Method
This is a descriptive study over a period of 5 and a half years including all births at “Les Orangers” Maternity and Reproductive Health Hospital of Rabat with notification of NTD cases, whether isolated or combined with other anomalies. Data were reported on pre-established sheets and on the teratovigilance registry. Statistical analysis was performed with SPSS version 18 statistical software.

Results
During the study period, 43,923 births were recorded including 44 cases of neural tube defects, an incidence rate of 1 per 1000 births, with a female predominance; sex ratio = 0.8. These defects included anencephaly (50%), spina bifida (38.6%) and encephalocele (11.4%). The risk factors detected during this study include consanguinity (34%), consumption of fenugreek or other plants (36%), diabetes (4.5%) and medication (2.2%). A family history of malformation was reported in 6.8% of cases and among siblings in 4.5% of cases. The average maternal age was 30.38 ± 6.88 and the average gestational age was 36.80 ± 5.11. A quarter of mothers did not benefit from any medical monitoring during pregnancy while 59% did not take folic acid supplementation during the first trimester of pregnancy and none of them took B9 vitamin during the periconceptional period. The antenatal diagnosis was performed in 63% of cases. The mortality rate was 3.8 per 10,000 and 16% of cases evolved positively.

Conclusion
NTDs require high intensity and multidisciplinary care which stresses the importance, in our context, of strengthening and optimizing acid folic supplementation strategies during the periconceptional period.
Correspondence: systematic reviews do not always capture context of real-world intervention programmes for childhood obesity (response to Littlewood, et al., 2020 in BMC Public Health)
Authors: Wild Cervantée E. K. , Cave Tami L. , Willing Esther J. , Derraik José G. B. , Grant Cameron C. , Hofman Paul L. , Anderson Yvonne C. 
Published: March 2021

AbstractIn a recent issue of the BMC Public Health journal, Littlewood et al. described the results of a systematic review of interventions to prevent or treat childhood obesity in Māori or Pacific Island peoples. They found that studies to date have had limited impact on improving health outcomes for Māori and Pacific Island peoples, and suggest this may be due to a lack of co-design principles in the conception of the various studies. Ensuring that interventions are appropriate for groups most affected by obesity is critical; however, some inaccuracies should be noted in the explanation of these findings. There is a risk with systematic reviews that the context of intervention trials is lost without acknowledging the associated body of literature for programmes that refer to the ongoing commitment to communities and groups most affected by obesity.
Ultrasound and non-ultrasound imaging techniques in the assessment of diaphragmatic dysfunction
Authors: Laghi Franco A. , Saad Marina , Shaikh Hameeda 
Published: March 2021

AbstractDiaphragm muscle dysfunction is increasingly recognized as an important element of several diseases including neuromuscular disease, chronic obstructive pulmonary disease and diaphragm dysfunction in critically ill patients. Functional evaluation of the diaphragm is challenging. Use of volitional maneuvers to test the diaphragm can be limited by patient effort. Non-volitional tests such as those using neuromuscular stimulation are technically complex, since the muscle itself is relatively inaccessible. As such, there is a growing interest in using imaging techniques to characterize diaphragm muscle dysfunction. Selecting the appropriate imaging technique for a given clinical scenario is a critical step in the evaluation of patients suspected of having diaphragm dysfunction. In this review, we aim to present a detailed analysis of evidence for the use of ultrasound and non-ultrasound imaging techniques in the assessment of diaphragm dysfunction. We highlight the utility of the qualitative information gathered by ultrasound imaging as a means to assess integrity, excursion, thickness, and thickening of the diaphragm. In contrast, quantitative ultrasound analysis of the diaphragm is marred by inherent limitations of this technique, and we provide a detailed examination of these limitations. We evaluate non-ultrasound imaging modalities that apply static techniques (chest radiograph, computerized tomography and magnetic resonance imaging), used to assess muscle position, shape and dimension. We also evaluate non-ultrasound imaging modalities that apply dynamic imaging (fluoroscopy and dynamic magnetic resonance imaging) to assess diaphragm motion. Finally, we critically review the application of each of these techniques in the clinical setting when diaphragm dysfunction is suspected.
Cadaveric biomechanical analysis of multilevel lateral lumbar interbody fusion with and without supplemental instrumentation
Authors: Lai Oujie , Chen Yunlin , Chen Qixin , Hu Yong , Ma Weihu 
Published: March 2021

Abstract
Background
This study was to evaluate and compare the biomechanical features of multilevel lateral lumbar interbody fusion (LLIF) with or without supplemental instrumentations.

Methods
Six human lumbar specimens were tested under multidirectional nondestructive moments (7.5 N·m), with a 6 degree-of-freedom spine simulator. The overall and intervertebral range of motion (ROM) were measured optoelectronically. Each specimen was tested under the following conditions at L2–5 levels: intact; stand-alone; cage supplemented with lateral plate (LP); cage supplemented with unilateral or bilateral pedicle screw/rod (UPS or BPS).

Results
Compared with intact condition, the overall and intersegmental ROM were significantly reduced after multilevel stand-alone LLIF. The ROM was further reduced after using LP instrumentation. In flexion-extension (FE) and axial rotation (AR), pedicle screw/rod demonstrated greater overall ROM reduction compared to LP (P < 0.01), and bilateral greater than unilateral (P < 0.01). In lateral bending (LB), BPS demonstrated greater overall ROM reduction compared to UPS and LP (P < 0.01), however, UPS and LP showed similar reduction (P = 0.245). Intervertebral ROM reductions showed similar trend as the overall ones after using different types of instrumentation. However, at L2/3 (P = 0.57) and L3/4 (P = 0.097) levels, the intervertebral ROM reductions in AR were similar between UPS and LP.

Conclusions
The overall and intervertebral stability increased significantly after multilevel LLIF with or without supplemental instrumentation. BPS provided the greatest stability, followed by UPS and LP. However, in clinical practice, less invasive adjunctive fixation methods including UPS and LP may provide sufficient biomechanical stability for multilevel LLIF.
Natural combinatorial genetics and prolific polyamine production enable siderophore diversification in Serratia plymuthica
Authors: Cleto Sara , Haslinger Kristina , Prather Kristala L. J. , Lu Timothy K. 
Published: March 2021

AbstractBackgroundIron is essential for bacterial survival. Bacterial siderophores are small molecules with unmatched capacity to scavenge iron from proteins and the extracellular milieu, where it mostly occurs as insoluble Fe3+. Siderophores chelate Fe3+for uptake into the cell, where it is reduced to soluble Fe2+. Siderophores are key molecules in low soluble iron conditions. The ability of bacteria to synthesize proprietary siderophores may have increased bacterial evolutionary fitness; one way that bacteria diversify siderophore structure is by incorporating different polyamine backbones while maintaining the catechol moieties.ResultsWe report thatSerratia plymuthicaV4 produces a variety of siderophores, which we term thesiderome, and which are assembled by the concerted action of enzymes encoded in two independent gene clusters. Besides assembling serratiochelin A and B with diaminopropane,S. plymuthicautilizes putrescine and the same set of enzymes to assemble photobactin, a siderophore found in the bacteriumPhotorhabdus luminescens. The enzymes encoded by one of the gene clusters can independently assemble enterobactin. A third, independent operon is responsible for biosynthesis of the hydroxamate siderophore aerobactin, initially described inEnterobacter aerogenes. Mutant strains not synthesizing polyamine-siderophores significantly increased enterobactin production levels, though lack of enterobactin did not impact the production of serratiochelins. Knocking out SchF0, an enzyme involved in the assembly of enterobactin alone, significantly reduced bacterial fitness.ConclusionsThis study shows the natural occurrence of serratiochelins, photobactin, enterobactin, and aerobactin in a single bacterial species and illuminates the interplay between siderophore biosynthetic pathways and polyamine production, indicating routes of molecular diversification. Given its natural yields of diaminopropane (97.75 μmol/g DW) and putrescine (30.83 μmol/g DW),S. plymuthicacan be exploited for the industrial production of these compounds.
The effect of COVID-19 on maternal newborn and child health (MNCH) services in Bangladesh, Nigeria and South Africa: call for a contextualised pandemic response in LMICs
Authors: Ahmed Tanvir , Rahman Ahmed Ehsanur , Amole Taiwo Gboluwaga , Galadanci Hadiza , Matjila Mushi , Soma-Pillay Priya , Gillespie Bronwen M. , El Arifeen Shams , Anumba Dilly O. C. 
Published: March 2021

AbstractGlobal response to COVID-19 pandemic has inadvertently undermined the achievement of existing public health priorities and laregely overlooked local context. Recent evidence suggests that this will cause additional maternal and childhood mortality and morbidity especially in low- and middle-income countries (LMICs). Here we have explored the contextual factors influencing maternal, neonatal and children health (MNCH) care in Bangladesh, Nigeria and South Africa amidst the pandemic. Our findings suggest that between March and May 2020, there was a reduction in utilisation of basic essential MNCH services such as antenatal care, family planning and immunization due to: a) the implementation of lockdown which triggered fear of contracting the COVID-19 and deterred people from accessing basic MNCH care, and b) a shift of focus towards pandemic, causing the detriment to other health services, and c) resource constraints. Taken together these issues have resulted in compromised provision of basic general healthcare. Given the likelihood of recurrent waves of the pandemic globally, COVID-19 mitigation plans therefore should be integrated with standard care provision to enhance system resilience to cope with all health needs. This commentary suggests a four-point contextualised mitigation plan to safeguard MNCH care during the pandemic using the observed countries as exemplars for LMIC health system adaptations to maintain the trajectory of progress regarding sustainable development goals (SDGs).
Examining the role of wind in human illness due to pesticide drift in Washington state, 2000–2015
Authors: Kasner Edward J. , Prado Joanne B. , Yost Michael G. , Fenske Richard A. 
Published: March 2021

Abstract
Background
Pesticides play an important role in protecting the food supply and the public’s health from pests and diseases. By their nature, pesticides can be toxic to unintended target organisms. Changing winds contribute to pesticide drift— the off-target movement of pesticides—and can result in occupational and bystander illness.

Methods
We systematically linked historical weather data to documented pesticide drift illnesses. We used Washington State Department of Health data to identify 252 drift events that included 690 confirmed cases of illness from 2000 to 2015. To characterize wind speed and direction at the time of the events, we paired these data with meteorological data from a network of 171 state weather stations. We report descriptive statistics and the spatio-temporal extent of drift events and compare applicator-reported weather conditions to those from nearby meteorological stations.

Results
Most drift events occurred in tree fruit (151/252 = 60%). Ground spraying and aerial applications accounted for 68% and 23% of events, respectively; 69% of confirmed cases were workers, and 31% were bystanders. Confirmed cases were highest in 2014 (129) from 22 events. Complete applicator spray records were available for 57 drift events (23%). Average applicator-reported wind speeds were about 0.9 m •sec− 1 (2 mi •hr− 1) lower than corresponding speeds from the nearest weather station values.

Conclusions
Drift events result from a complex array of factors in the agricultural setting. We used known spatio-temporal aspects of drift and historical weather data to characterize these events, but additional research is needed to put our findings into practice. Particularly critical for this analysis is more accurate and complete information about location, time, wind speed, and wind direction. Our findings can be incorporated into new training materials to improve the practice of pesticide application and for better documentation of spray drift events. A precision agriculture approach offers technological solutions that simplify the task of tracking pesticide spraying and weather conditions. Public health investigators will benefit from improved meteorological data and accurate application records. Growers, applicators, and surrounding communities will also benefit from the explanatory and predictive potential of wind ramping studies.
Dynamic contrast enhanced-MRI and diffusion-weighted image as predictors of lymphovascular invasion in node-negative invasive breast cancer
Authors: Choi Bo Bae 
Published: March 2021

Abstract
Background
Lymphovascular invasion (LVI) is an important risk factor for prognosis of breast cancer and an unfavorable prognostic factor in node-negative invasive breast cancer patients. The purpose of this study was to evaluate the association between LVI and pre-operative features of dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and diffusion-weighted imaging (DWI) in node-negative invasive breast cancer.

Methods
Data were collected retrospectively from 132 cases who had undergone pre-operative MRI and had invasive breast carcinoma confirmed on the last surgical pathology report. MRI and DWI data were analyzed for the size of tumor, mass shape, margin, internal enhancement pattern, kinetic enhancement curve, high intratumoral T2-weighted signal intensity, peritumoral edema, DWI rim sign, and apparent diffusion coefficient (ADC) values. We calculated the relationship between presence of LVI and various prognostic factors and MRI features.

Results
Pathologic tumor size, mass margin, internal enhancement pattern, kinetic enhancement curve, DWI rim sign, and the difference between maximum and minimum ADC were significantly correlated with LVI (p < 0.05).

Conclusions
We suggest that DCE-MRI with DWI would assist in predicting LVI status in node-negative invasive breast cancer patients.
Re-operation rate after surgical treatment of osteochondral lesions of the talus in paediatric and adolescent patients
Authors: Körner Daniel , Gonser Christoph E. , Döbele Stefan , Konrads Christian , Springer Fabian , Keller Gabriel 
Published: March 2021

Abstract
Background
The aim of this study is to analyse the re-operation rate after surgical treatment of osteochondral lesions of the talus (OCLTs) in children and adolescents.

Methods
Between 2009 and 2019, 27 consecutive patients with a solitary OCLT (10 male, 17 female; mean age 16.9 ± 2.2 years; 8 idiopathic vs. 19 traumatic) received primary operative treatment (arthroscopy + bone marrow stimulation [BMS], n = 8; arthroscopy + retrograde drilling, n = 8; autologous chondrocyte implantation [ACI]/autologous bone grafting, n = 9; arthroscopy + BMS + retrograde drilling; n = 1; flake fixation, n = 1). Seventeen OCLTs were located at the medial and ten at the lateral talus.
‘Re-operation’ as the outcome measure was evaluated after a median follow-up of 42 months (range 6–117 months). Patients were further subdivided into groups A (re-operation, n = 7) and B (no re-operation, n = 20). Groups A and B were compared with respect to epidemiological, lesion- and therapy-related variables.

Results
Seven of 27 patients needed a re-operation (re-operation rate 25.9% after a median interval of 31 months [range 13–61 months]). The following operative techniques were initially used in these seven patients: arthroscopy + BMS n = 2, arthroscopy + retrograde drilling n = 4, ACI + autologous bone grafting n = 1. A comparison of group A with group B revealed different OCLT characteristics between both groups. The intraoperative findings according to the International Cartilage Repair Society (ICRS) classification revealed significantly more advanced cartilage damage in group B than in group A (p = 0.001).

Conclusions
We detected a re-operation rate of 25.9% after primary surgical OCLT treatment. Patients with re-operation had significantly lower ICRS classification stages compared to patients without re-operation.
Bacterial survival on inanimate surfaces: a field study
Authors: Katzenberger Ruth Hanna , Rösel Anja , Vonberg Ralf-Peter 
Published: March 2021

Abstract
Objective
Environmental surfaces may serve as potential reservoirs for nosocomial pathogens and facilitate transmissions via contact depending on its tenacity. This study provides data on survival kinetics of the most important nosocomial bacteria on a panel of commonly used surfaces. Type strains of S. aureus, K. pneumoniae, P. aeruginosa, A. baumannii, S. marcescens, E. faecium, E. coli, and E. cloacae were suspended in 0.9% NaCl solution at a McFarland of 1 and got then plated via cotton swabs either on glass, polyvinyl chloride, stainless steel, or aluminum. Surfaces were stored at regular ambient temperature and humidity to simulate routine daycare conditions. Sampling was performed by contact plates for a time period of four weeks.

Results
The longest survival was observed for A. baumannii and E. faecium on all materials (at least four weeks). S. aureus remained viable for at least one week. Gram negative species other than A. baumannii were usually inactivated in less than two days. Nosocomial transmission of the above mentioned bacteria may easily occur if no appropriate infection control measures are applied on a regular daily basis. This might be of particular importance when dealing with outbreaks of A. baumannii and E. faecium.
Platelet desialylation and TFH cells–the novel pathway of immune thrombocytopenia
Authors: Chen Yuwen , Hu Jianda , Chen Yingyu 
Published: March 2021

AbstractImmune thrombocytopenia (ITP) is an autoimmune disease characterized by immune-mediated destruction of one’s own platelets. The progression of thrombocytopenia involves an imbalance of platelet production and clearance. B cells can induce autoantibodies, and T cells contribute to the pathological progression as well. Some patients with ITP have a poor response to common first-line therapies. Recent studies have shown that a novel Fc-independent platelet clearance pathway is associated with poor prognosis in these patients. By this pathway, desialylated platelets can be cleared by Ashwell-Morell receptor (AMR) on hepatocytes. Research has demonstrated that patients with refractory ITP usually have a high level of desialylation, indicating the important role of sialylation on platelet membrane glycoprotein (GP) in patients with primary immune thrombocytopenia, and neuraminidase 1(NEU1) translocation might be involved in this process. Patients with ITP who are positive for anti-GPIbα antibodies have a poor prognosis, which indicates that anti-GPIbα antibodies are associated with this Fc-independent platelet clearance pathway. Experiments have proven that these antibodies could lead to the desialylation of GPs on platelets. The T follicular helper (TFH) cell level is related to the expression of the anti-GPIbα antibody, which indicates its role in the progression of desialylation. This review will discuss platelet clearance and production, especially the role of the anti-GPIbα antibody and desialylation in the pathophysiology of ITP and therapy for this disease.
Organic colorants based on lac dye and brazilwood as markers for a chronology and geography of medieval scriptoria: a chemometrics approach
Authors: Nabais Paula , Melo Maria J. , Lopes João A. , Vieira Márcia , Castro Rita , Romani Aldo 
Published: March 2021

Abstract
This work presents the first proof of concept for the use of molecular fluorescence signatures in medieval colours based on lac dye and brazilwood lake pigments. These two important medieval dyes were tested as markers using their UV–Visible emission and excitation spectra. These medieval paints had been previously fully characterized through a multi-analytical approach. In this work, molecular fluorescence spectra were acquired in manuscripts dating from 12th to 15th c., which were produced in monastic scriptoria or workshops. First, the spectral distribution and relative intensity of the emission and excitation spectra were discussed in detail by comparison with reference compounds, including reproductions of paints based on medieval technical texts. It was possible to group the spectra according to recipe specificities. Then, statistical methods (principal component analysis and hierarchical cluster analysis) were applied to the same fluorescence spectra and the generated clusters were compared with the previous ones. Principal component analysis was initially employed to eliminate redundancy in fluorescence data, so minimizing bias on the hierarchical cluster analysis results. Except for some misplaced spectra, the placement of samples per group was confirmed. The outliers resulted from either a poor signal to noise ratio or occurred because certain paints were unique, such as the colour produced by mixing lac dye and brazilwood, which was found in manuscripts from the Alcobaça monastic scriptorium. Previously, by using infrared or Raman spectroscopies, only lac dye could be detected. Notably, these paints compare well with a recipe that was reproduced from the text by Jean Le Begue, in which both dyes were required.