bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns, Predictors and Outcome of Time to Presentation Among Critically ill Paediatric Patients at Emergency Department of Muhimbili National Hospital, Dar es Salaam, Tanzania
Authors: Simbila Alphonce N , Kilindimo Said S. , Sawe Hendry R. , Kalezi Zawadi E. , Yussuf Amne O. , Manji Hussein K. , Leyna Germana , Mfinanga Juma A. , Weber Ellen J. 
Published: November 2021

Abstract
Background: Mortality among under-five children in Tanzania remains high. While early presentation for treatment increases likelihood of survival, delays to care are common and factors causing delay to presentation among critically ill children are unknown. Methodology: This was a prospective cohort study of critically ill children aged 28days to 14 years attending emergency department (ED) at Muhimbili National Hospital in Tanzania from September 2019 to January 2020. We documented demographics, time to ED presentation, ED interventions and 30-day outcome. The primary outcome was delay (>48 hours) from the onset of illness to ED presentation. Logistic regression and relative risk were calculated to measure the strength of the predictor and relationship between delay and mortality respectively. Results: We enrolled 440 (59.1%) critically ill children, their median age was 12 [IQR =9-60] months and 63.9% were males. The median time to ED arrival was 3 days [IQR=1-5] and more than half (56.6%) of critically ill children presented to ED in > 48 hours where by being an infant, self-referral and belonging to poor family were independent predictors of delay. Infants and those referred from other facilities had 2.2 (95% CI 1.3-3.8) and 1.7 (95% CI 1.1-2.7) times increased odds of presenting late to the ED respectively. The overall 30-day in-hospital mortality was 26.5% in which those who presented late were 1.3 more likely to die than those who presented early (RR=1.3, CI: 0.9-1.9). Majority died >24 hours of ED arrival (P-value=0.021).Conclusion: Delayed ED presentation of more than 48 hours from onset of illness was associated with in-hospital mortality. A larger study is needed to evaluate the care pathway of critically ill paediatric patients to identify preventable course of delay to tertiary care facility.
Femtosecond Laser-Assisted in Situ Keratomileusis with Topography-Guided or Asphericity-Adjusted Derived Data: A Comparative Contralateral Eye Study
Authors: Alves Ermano M , Lyra Adriana F , Tenório Manuela , Mesquita Natália , Bacelar Carolina , Montenegro Afra , Alves Lucas , Alves Márcio 
Published: November 2021

Abstract
Background: Wavefront-optimized laser-assisted in situ keratomileusis (LASIK) ablation is the most commonly performed procedure in refractive surgery, but new technologies have become available. Our goal was to compare topography-guided (Contoura) and asphericity-guided (Custom-Q) customized ablation treatments for the correction of myopia with or without astigmatism.Methods: This prospective, randomized, double-blind, contralateral eye study included 60 eyes of 30 patients with myopia or myopic astigmatism requiring femtosecond LASIK (FemtoLASIK) treatment. For each patient, one eye was randomized to undergo Contoura treatment, and the other underwent Custom-Q abaltion. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refractive spherical equivalent (MRSE), sphere (SPH), cylinder (CYL), 6.0-mm total corneal aberration root mean square (RMS), coma (COMA), trefoil (TREF), and spherical aberration (SA) were measured and analysed after a 1-year follow-up.Results: The UDVA was -0.08 ±0.06 logMAR in Contoura eyes and -0.08 ± 0.05 logMAR in Custom-Q eyes (p = 0.309) after 12 months. Twenty-five eyes (83%) in the Contoura group and twenty-six eyes (87%) in the Custom-Q group had a UDVA of 20/16 at the end of 12 months, and 100% of eyes in both groups reached a UDVA of 20/25 or better. Ninety and 100% of eyes in the Contoura and Custom-Q groups, respectively, achieved a residual CYL ≤0.50 D (p=0.237). No statistically significant difference was observed between the surgical techniques in the preoperative to 1-year postoperative changes for any of the parameters evaluated (MRSE, CYL, RMS, DEF, COMA, TREF, and SA).Conclusions: The Contoura and Custom-Q techniques yielded excellent visual and refractive results, but the evidence did not reveal any clear differences between these two methods after one year of follow-up. Trial registration: RBR-8rs5kt Myopia and Astigmatism Topography-guided Refractive Surgery by Contoura Method Versus Customized by Asphericity in Contralateral Eyes: A prospective Double-blind Randomized Study. UTN code: U111-1243-7257
Diversity Patterns of Protists are Highly Affected by Methods Disentangling Inter-specific Variants: A Case Study in Oligotrich (s.l.) Ciliates
Authors: Xu Jiahui , Han Jianlin , Su Hua , Zhu Changyu , Quan Zijing , Yi Zhenzhen , Wu Lei 
Published: November 2021

Abstract
An enormous amount of environmental sequences produced by high-throughput sequencing (HTS) is popular for inferring diversity and distribution patterns of protists, which are widely distributed and playing important roles in energy flux and nutrient cycling. However, study testing whether methods disentangling inter-specific variants affect the diversity and distribution patterns of protists using field samples is insufficient. Using oligotrich (s.l.) ciliates, one group of abundant and dominate planktonic protists, in field samples as an example, the present study indicates that DADA2 performs better than UCLUST and UPARSE for inferring diversity patterns of oligotrich (s.l.) ciliates in Pearl River Estuary and surrounding regions. UPARSE, as an OTU-construction method might underestimate species richness and produce less reliable beta diversity pattern than DADA2. UCLUST with 97% and 99% clustering thresholds overestimate species richness, and the beta diversity pattern inferred by the former one is unreasonable. Salinity is shown to be one of the key factors responsible for variations in community distribution of ciliates, but infrequent marine-freshwater transitions occurred during evolutionary terms of this group.
Assessing the Agronomical and Environmental Impacts of the Application of Green Waste-derived Compost on Sugar Beet Under Deficit Irrigation Conditions
Authors: Al-Dhumri Sami A. , El-darder Amr M. , Alfurayji Mohammed A. , Abou-Elwafa Salah Fatouh 
Published: November 2021

Abstract
In the light of global warming and climate changes, as well as the rapid expansion in sugar beet production in the arid and semi-arid regions, improving sugar beet productivity under deficit irrigation is of great importance. Green waste-derived compost (GWC) is a valuable soil amendment for improving soil organic matter, decreasing waste products and potential pollutants. The application of 14 ton ha-1 of GWC resulted in the highest root and recoverable sugar yields especially under the well-irrigated conditions under drip irrigation. Although, the impurities% in the beet root juice was increased under deficit irrigation conditions, sugar beet root biofortification and juice quality were significantly improved under drip irrigation in response to the application of 14 ton ha-1 of GWC by increasing sucrose content, QZ% and RS%. The application of GWC under drip irrigation enhanced water use efficiency for root yield (WUERY) and recoverable sugar yield (WUERSY), in particular under drip irrigation. The soil chemical and physical properties were significantly improved in response to the application of GWC. The results indicate that the application of GWC is essential for the sustainable sugar beet production and efficient irrigation water use in sandy soils.
Complete Response of a Colonic High-Grade Neuroendocrine Carcinoma to Platinum-Based Therapy: Insights from Comprehensive Genomic Profiling
Authors: Wood Richard , Rayson Daniel , Arnason Thomas , DeCoste Ryan C , Gaston Daniel , Carter Michael D 
Published: November 2021

Abstract
Background
Comprehensive genomic profiling (CGP) is an essential tool in precision medicine, providing diagnostic, prognostic, and predictive (therapeutic) information that enables personalized optimal care for cancer patients. We present the case of a 54-year-old woman with stage IV large-cell neuroendocrine carcinoma (LCNEC) of the colon with liver and nodal metastases with complete response to therapy and demonstrate the value of CGP in identifying potential targets for treatment in these tumors.
Results
CGP performed on the tumor showed pathogenic mutations in multiple oncogenes and tumor suppressor genes including BRCA1, BAP1, and BRAF, high tumor mutation burden (TMB), and high microsatellite instability (MSI-H). Treatment with platinum-based therapy resulted in a complete radiographic response of the metastases, with no evidence of recurrence after 6.5 years. Assessment by Medical Genetics did not identify any evidence of hereditary cancer syndrome. The dramatic response to therapy is likely due to loss of BRCA1 and/or BAP1 function, as deleterious mutations in both genes predict response to platinum-based therapy through exploitation of deficient homologous recombination repair (HRR). The information provided by CGP also suggested potential tumor sensitivity to poly(ADP-Ribose) polymerase inhibitors (PARPi), immunotherapy (IT) and BRAF/MEK inhibitor therapy, should the tumor recur.
Conclusion
This case highlights the value of CGP in guiding diagnosis and management of rare and aggressive tumors.
Hemostatic Efficacy of a Flowable Collagen-Thrombin Matrix During Coronary Artery Bypass Grafting: A Double-Blind Randomized Controlled Trial
Authors: Kim Hyohyun , Lee Kang Ju , Lee Seung Hyun , Kang Dae yong , Lee Jun Hyuk , Youn Young-Nam 
Published: November 2021

Abstract
Background
Flowable hemostatic agents are advantageous in that they can be applied to irregular wound surfaces and to areas that are difficult to approach directly. We sought to compare the effectiveness and safety of the flowable hemostatic sealants Collastat® (collagen hemostatic matrix, [CHM]) and Floseal® (gelatin hemostatic matrix, [GHM]) during off-pump coronary artery bypass (OPCAB).
Methods
In this prospective, randomized trial, 160 patients undergoing elective OPCAB surgery were enrolled between March 2018 and February 2020. After primary suture of the aortocoronary anastomosis, an area of hemorrhage was identified, and patients were double blind randomized to receive either CHM or GHM (n = 80, each). Study endpoints were the following: rate of successful intraoperative hemostasis and time required for hemostasis overall postoperative bleeding, rate of transfusion of blood products, rate of surgical revision for bleeding, postoperative morbidity, and intensive care unit stay.
Results
Of the total patients, 23% were female, and the mean age was 63 years (range: 42–81 years). Successful hemostasis within 5 min was achieved for 78 patients (97.5%) in the GHM group, compared to 80 patients (100%) in the CHM group (p = 0.497). Two patients receiving GHM required surgical revision to achieve hemostasis. There were no differences in the mean time required to obtain hemostasis (GHM vs. CHM, 1.49 ± 0.94 vs. 1.35 ± 0.60 min, p = 0.272), as confirmed by time-to-event analysis (p = 0.605). The two groups had similar amounts of mediastinal drainage for 24 h postoperatively (p = 0.298). The CHM group required less packed red blood cells, fresh frozen plasma, and platelets for transfusion than the GHM group (0.5 vs. 0.7 units per patient, p = 0.047; 17.5% vs. 25.0%, p = 0.034; 7.5% vs. 15.0%, p = 0.032; respectively).
Conclusions
CHM performed similarly to a commonly used hemostatic agent with regard to achieving effective and fast interoperative hemostasis during OPCAB. The topical flowable hemostatic agent, CHM, could be effectively used during cardiac surgery for intraoperative hemostasis of great vessels with high pressure.
Trial registration
: ClinicalTrials.gov, NCT 04310150
Association between serum uric acid level and carotid atherosclerosis and metabolic syndrome in patients with type 2 diabetes mellitus
Authors: Li Wei , Wang Yan , Ouyang Shengrong , Li Mengdi , Liu Rui , Zhang Yuqi , Liu Xiaojun , Li Tianfang , Liu Shengyun 
Published: November 2021

Abstract
Background

Serum uric acid (SUA) is associated with many cardiovascular risk factors, such as metabolic syndrome (MetS) and subclinical atherosclerosis. However, the relationship of SUA with carotid atherosclerosis remains controversial. We aimed to investigate whether elevated SUA levels are associated with a high risk of carotid atherosclerosis and MetS in patients with type 2 diabetes mellitus (T2DM).
Methods

This cross-sectional study was performed with a sample of 1,947 hospitalized patients with T2DM. Carotid intima-media thickness (CIMT) and carotid artery plaques (CAP) were measured via Doppler ultrasound.
Results

Uric acid levels were negatively associated with HbA1C, eGFR, and HDL-C (all P < 0.001) and positively associated with WBC, BMI, ACR, creatinine, total cholesterol, triglycerides, LDL-C, systolic blood pressure, and diastolic blood pressure (all P < 0.001). After adjusting for multiple potential confounders, the risks were substantially higher for MetS in the highest quartile of SUA levels (odds ratio: 2.91, 95% confidence interval: 1.54–5.51, P = 0.003 for trend) than in the lowest quartile of SUA levels. Furthermore, a significant increase was observed in the prevalence of overweight/obesity, hypertension, and dyslipidemia across the SUA quartiles independent of confounders. However, no significant association was found between SUA quartile with the presence of carotid atherosclerosis.
Conclusions

In patients with T2DM, SUA levels were closely associated with MetS and its components but not with carotid atherosclerosis.
Investigation of Climate and Land Use Change Impacts on Stream Flow of Guder Catchment, Ethiopia
Authors: Gulti Bekam Bekele , Manyazew Boja Mokonnen , Serur Abdulkerim Bedewi 
Published: November 2021

Abstract
Climate change (CC) and land use/cover change (LUCC) are the main drivers of streamflow change. In this paper, we investigate the impact of climate and LULC change impact on stream flow of Guder catchment by using Soil and Water Assessment model (SWAT). The scenarios were designed in a way that LULC was changed while climate conditions remain constant; LULC was then held constant under a changing climate and combined effect of both. The result shows that, the combined impacts of climate change and LULC dynamics can be rather different from the effects that follow-on from LULC or climate change alone. Streamflow would be more sensitive to climate change than to the LULC changes scenario, even though changes in LULC have far-reaching influences on streamflow in the study region. A comprehensive strategy of low impact developments, smart growth, and open space is critical to handle future changes to streamflow systems.
Number of Experiments that Should be Considered in the Cluster Analysis of Common Bean Genotypes for Plant Architecture and Grain Yield Traits
Authors: Ribeiro Nerinéia Dalfollo , Maziero Sandra Maria 
Published: November 2021

Abstract
The number of experiments that allows the choice of parents to be used in controlled crossings in a more assertive way in cluster analysis is unknown for plant architecture and grain yield traits in common bean. Therefore, the objective of this work was to determine the number of experiments that should be considered in Tocher's and the unweighted pair group method with arithmetic mean (UPGMA) cluster analyses to identify promising common bean parents for several plant architecture and grain yield traits. Four experiments were carried out in different years and growing seasons, in the same site. The randomized block design was used and 17 common bean genotypes with carioca (beige seed coat with brown streaks) and black grains were evaluated in relation to 12 traits related to plant architecture and five traits related to grain yield. Statistical analyses were performed with data obtained from individual and combined experiments. Significant genotype × experiment interaction was observed for most of the evaluated traits. When Tocher's and UPGMA cluster analyses was performed from data obtained in individual experiments different groups were formed. The use from data obtained in two, three ou four experiments allowed greather reliability in the formation of groups. Three and two experiments are sufficient in the Tocher's and the UPGMA cluster analyses, respectively, to identify promising carioca and black common bean parents for several plant architecture and grain yield traits in a more assertive way.
Analysis of Dairy Farming Systems in the Sahelian Zone of Burkina Faso
Authors: Sanon Hadja , Samuel NEYA , Salif KONFE , Valérie BOUGOUMA 
Published: November 2021

Abstract
The insufficiency and variability of pasture production is a determining factor in milk production, particularly in the Sahelian zone. The objective of this study was to characterize dairy production systems and their relationship with crops to meet livestock needs. It consisted of surveys of 120 farmers in four communes in the Séno province. The results show three groups of dairy farmers that are essentially differentiated by the main activity and the sex of the farmers as well as the size of the cattle herd on the farm. The first group is made of male agropastoralists, with herds averaging 12 cattle. Group 2 consists of male agropastoralists with an average of 22 cattle. Group 3 consists of female pastoralists (96.15%), with a herd size of about 19 head. The cows are fed on pasture and supplemented with crop residues with cotton cake, which is more important in group 2, where more farmers have hayloft for fodder conservation and manure pits compared to the other two groups. Crop residues are used primarily as feed in all groups from January to May. This supplementation allows the maintenance of milk production in the dry season and group 2, with more dairy cows, records more milk milked (6.5 and 3.8 l) and consumed in wet and dry seasons compared to the other two groups. The results suggest that the farmers in the area have low technical level and need capacity building in agropastoral fields to improve their production.
Alcohol Promotes Hepatocellular Carcinoma Metastasis Through SIRT7-Dependent EMT Regulation
Authors: Zhang Chen , Zhao Jinqiu , Zhao Jie , Liu Bohao , Tang Wenbin , Liu Yi , Huang Wenxiang , Weinman Steven A , LI ZHUAN 
Published: November 2021

Abstract
Background

Long-term alcohol use is a confirmed risk factor of liver cancer tumorigenesis and metastasis. Multiple mechanisms responsible for alcohol related tumorigenesis have been proposed, including toxic reactive metabolite production, oxidative stress and fat accumulation which trigger hepatocyte cell death and inflammation. However, mechanisms underlying alcohol-mediated liver cancer metastasis remain largely unknown.
Methods

SIRT7 expression pattern and its association with HCC metastasis were investigated by bioinformatic analysis and verified by western blot and immunochemistry in HCC tissues. The biological consequences of overexpression and knockdown of SIRT7 in HCC metastasis were studied in vitro and in vivo. qRT-PCR, immunofluorescence assay, ChIP assay were utilized to assess the effects of SIRT7 on E-cadherin expression. Effects of alcohol on SIRT7 expression were evaluated by qRT-PCR, immunofluorescence and inhibitor treatments and pulmonary metastasis model mice fed with Lieber Decarli alcohol diet were used to clarify the mechanisms by which SIRT7 facilitated alcohol mediated HCC metastasis.
Results

SIRT7 is a critical factor in promoting liver cancer metastasis. SIRT7 expression is closely associated with disease stage and high SIRT7 predicts worse overall and disease-free survival. Overexpression of SIRT7 promotes HCC cell migration and EMT while knockdown of SIRT7 showed opposite effects. Mechanistically, we found that SIRT7 suppresses E-Cadherin expression through promoter binding and H3K18 deacetylation. Most importantly, we identified that alcohol upregulates SIRT7 expression in hepatocyte both in vitro and in vivo. Reducing SIRT7 activity completely abolished alcohol-mediated liver cancer metastasis in vivo.
Conclusion

SIRT7-dependent EMT regulation is a pivotal regulatory mechanism of alcohol-mediated HCC metastasis and reveals previously unidentified roles of SIRT7 in promoting EMT and metastasis in human HCC. Therapeutic strategies that inhibit SIRT7 may offer novel options for the treatment of HCC.
A Gaussian model approach to determine the commencement, termination and length of the major growing season over the dry zone of Sri Lanka
Authors: Ampitiyawatta Asanga D , Nilmalgoda E.P.R.H.H.W. , Wimalasiri Eranga M. 
Published: November 2021

Abstract
The commencement, termination and length of the major (Maha) growing season over the dry zone of Sri Lanka were determined using daily rainfall records from 1981 to 2019 of five meteorological stations (Anuradhapura, Polonnaruwa, Hambantota, Puttalam and Batticaloa). Cumulative percentages of daily rainfall were plotted against the time and maximum positive and maximum negative curvatures were derived as the commencement and termination dates of the season. A Gaussian model was fitted on the cumulative distribution curve in order to remove limitations in deriving maximum positive and maximum negative curvatures. The difference between commencement and termination dates were taken as the length of the growing season. Results disclosed that there is a considerable inter-annual variation of commencement and termination dates and the length of the Maha season. Mean commencement and termination dates fall in the standard week 44.04±2.61 (end of October) and 5.10±4.20 (1st week of February). The average seasonal length is 13.7±4.24 weeks. Terminating date acts as the key determinant of the seasonal length. Any significant (p > 0.05) trend could not be observed for commencement, termination and length of the season for the analyzed period in any of the locations. It can be concluded that cumulative distribution of rainy days can be successfully used to determine commencement and termination dates of the Maha season over the dry zone of Sri Lanka where a single peak rainy period is available. However, the method needs modifications, when it applies in wet zone of the country where bimodal rainfall pattern is prominent.
Association of accumulated number of underweight with occurrence of tuberculosis
Authors: Park Ga Eun , Ki Hyun Kyun , Eun Yeonghee , Han Kyungdo , Kim Hyungjin 
Published: November 2021

Abstract
Underweight might be a risk factor of tuberculosis (TB), but the association between duration of underweight and occurrence of TB is inconclusive. The objective of this study was to determine whether there is a difference in occurrence of TB according to the cumulative number of underweight in an intermediate TB burden country. The National Health Insurance database was used. Eligible subjects were individuals without history of TB before 2006, and who underwent national health examination between January 2009 and 31 December 2010. Included individuals in the analysis were followed until 31 December 2017. Accumulated number of underweight was defined as the number of times recorded as underweight during the national health examination over four consecutive years. The primary outcome of the study was newly diagnosed TB according to accumulated number of underweight. Among a study population of 2,396,434, TB was identified in 9,322 (3.89%) cases. A high accumulated number of underweight and low body mass index (BMI) level were significantly associated with occurrence of TB. This association remained consistent after adjusting for demographic factors and underlying diseases. In stratified analysis based on age, sex, diabetes (DM), hypertension (HTN), and waist circumference (WC) in metabolic syndrome (MS), the accumulated number of underweight was related consistently to occurrence of TB. A high accumulated number of underweight was associated with increased risk of TB.