bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficiency of fine scale and spatial regression in modelling associations between healthcare service spatial accessibility and their utilization
Authors: Gao Fei , languille Clara , karzazi Khalil , Guhl Mélanie , Boukebous Baptiste , Deguen Séverine 
Published: May 2021

AbstractBackgroundHealthcare accessibility, a key public health issue, includes potential (spatial accessibility) and realized access (healthcare utilization) dimensions. Moreover, the assessment of healthcare service potential access and utilization should take into account the care provided by primary and secondary services. Previous studies on the relationship between healthcare spatial accessibility and utilization often used conventional statistical methods without addressing the scale effect and spatial processes. This study investigated the impact of spatial accessibility to primary and secondary healthcare services on length of hospital stay (LOS), and the efficiency of using a geospatial approach to model this relationship.MethodsThis study focused on the ≥ 75-year-old population of the Nord administrative region of France. Inpatient hospital spatial accessibility was computed with the E2SFCA method, and then the LOS was calculated from the French national hospital activity and patient discharge database. Ordinary least squares (OLS), spatial autoregressive (SAR), and geographically weighted regression (GWR) were used to analyse the relationship between LOS and spatial accessibility to inpatient hospital care and to three primary care service types (general practitioners, physiotherapists, and home-visiting nurses). Each model performance was assessed with measures of goodness of fit. Spatial statistical methods to reduce or eliminate spatial autocorrelation in the residuals were also explored.ResultsGWR performed best (highest R2and lowest Akaike information criterion). Depending on global model (OLS and SAR), LOS was negatively associated with spatial accessibility to general practitioners and physiotherapists. GWR highlighted local patterns of spatial variation in LOS estimates. The distribution of areas in which LOS was positively or negatively associated with spatial accessibility varied when considering accessibility to general practitioners and physiotherapists.ConclusionsOur findings suggest that spatial regressions could be useful for analysing the relationship between healthcare spatial accessibility and utilization. In our case study, hospitalization of elderly people was shorter in areas with better accessibility to general practitioners and physiotherapists. This may be related to the presence of effective community healthcare services. GWR performed better than LOS and SAR. The identification by GWR of how these relationships vary spatially could bring important information for public healthcare policies, hospital decision-making, and healthcare resource allocation.
Novel mechanism for OSM-promoted extracellular matrix remodeling in breast cancer: LOXL2 upregulation and subsequent ECM alignment
Authors: Dinca Simion C. , Greiner Daniel , Weidenfeld Keren , Bond Laura , Barkan Dalit , Jorcyk Cheryl L. 
Published: May 2021

Abstract
Background
Invasive ductal carcinoma (IDC) is a serious problem for patients as it metastasizes, decreasing 5-year patient survival from > 95 to ~ 27%. The breast tumor microenvironment (TME) is often saturated with proinflammatory cytokines, such as oncostatin M (OSM), which promote epithelial-to-mesenchymal transitions (EMT) in IDC and increased metastasis. The extracellular matrix (ECM) also plays an important role in promoting invasive and metastatic potential of IDC. Specifically, the reorganization and alignment of collagen fibers in stromal ECM leads to directed tumor cell motility, which promotes metastasis. Lysyl oxidase like-2 (LOXL2) catalyzes ECM remodeling by crosslinking of collagen I in the ECM. We propose a novel mechanism whereby OSM induces LOXL2 expression, mediating stromal ECM remodeling of the breast TME.

Methods
Bioinformatics was utilized to determine survival and gene correlation in patients. IDC cell lines were treated with OSM (also IL-6, LIF, and IL-1β) and analyzed for LOXL2 expression by qRT-PCR and immunolabelling techniques. Collagen I contraction assays, 3D invasion assays, and confocal microscopy were performed with and without LOXL2 inhibition to determine the impact of OSM-induced LOXL2 on the ECM.

Results
Our studies demonstrate that IDC patients with high LOXL2 and OSM co-expression had worse rates of metastasis-free survival than those with high levels of either, individually, and LOXL2 expression is positively correlated to OSM/OSM receptor (OSMR) expression in IDC patients. Furthermore, human IDC cells treated with OSM resulted in a significant increase in LOXL2 mRNA, which led to upregulated protein expression of secreted, glycosylated, and enzymatically active LOXL2. The expression of LOXL2 in IDC cells did not affect OSM-promoted EMT, and LOXL2 was localized to the cytoplasm and/or secreted. OSM-induced LOXL2 promoted an increase in ECM collagen I fiber crosslinking, which led to significant fiber alignment between cells and increased IDC cell invasion.

Conclusions
Aligned collagen fibers in the ECM provide pathways for tumor cells to migrate more easily through the stroma to nearby vasculature and tissue. These results provide a new paradigm through which proinflammatory cytokine OSM promotes tumor progression. Understanding the nuances in IDC metastasis will lead to better potential therapeutics to combat against the possibility.
Outbreaks of clinical toxoplasmosis in humans: five decades of personal experience, perspectives and lessons learned
Authors: Dubey Jitender P. 
Published: May 2021

Abstract
Background
The protozoan parasite Toxoplasma gondii has a worldwide distribution and a very wide host range, infecting most warm-blooded hosts. Approximately 30% of humanity is infected with T. gondii, but clinical toxoplasmosis is relatively infrequent. Toxoplasmosis has a wide range of clinical symptoms involving almost all organ systems. In most persons that acquire infection postnatally, symptoms (when present) are mild and mimic other diseases such as flu, Lyme disease, Q fever, hematological alterations, or mumps. It is likely that clinical disease is more common than reported. The ingestion of infected meat or food and water contaminated with oocysts are the two main modes of postnatal transmission of Toxoplasma gondii. The infective dose and the incubation period of T. gondii infection are unknown because there are no human volunteer experiments.

Methods
Here, I have critically reviewed outbreaks of clinical toxoplasmosis in humans for the past 55 years, 1966–2020. Information from oocyst-acquired versus meat-acquired infections was assessed separately.

Results
Most outbreaks were from Brazil. There were no apparent differences in types or severity of symptoms in meat- versus oocyst-acquired infections. Fever, cervical lymphadenopathy, myalgia, and fatigue were the most important symptoms, and these symptoms were not age-dependent. The incubation period was 7–30 days. A genetic predisposition to cause eye disease is suspected in the parasites responsible for three outbreaks (in Brazil, Canada, and India). Only a few T. gondii tissue cysts might suffice to cause infection, as indicated by outbreaks affecting some (but not all) individuals sharing a meal of infected meat.

Conclusions
Whether the high frequency of outbreaks of toxoplasmosis in humans in Brazil is related to environmental contamination, poor hygiene, socioeconomic conditions, or to genotypes of T. gondii needs investigation.

Graphical Abstract
Dynamical features of pine wilt disease through stability, sensitivity and optimal control
Authors: Khan Riaz Ahmad , Hussain Takasar , Ozair Muhammad , Tasneem Fatima , Faizan Muhammad 
Published: May 2021

AbstractThis work investigates the dissemination mechanism of pine wilt disease. The basic reproduction number is computed explicitly, and an ultimate invariable level of contagious hosts and vectors, without and with disease, is discussed by using this number. Highly effective techniques, Lyapunov functional and graph theoretic, are utilised to obtain the ultimate constant level of the whole population. The idea of complete disease eradication and reduction of endemic level is explored through the utilisation of two efficient methods. Using sensitivity analysis approach, necessary control measures are suggested to overcome the disease. Using the literature data, the robustness of control strategies is shown graphically.
Numerical simulation of the experimental behavior of RC beams at elevated temperatures
Authors: Issa Camille A. , Izadifard Ramezan A. 
Published: May 2021

AbstractThe danger of fire is present always and everywhere. The imminent danger depends upon the actual type and length of fire exposure. Reinforced concrete structural members are loadbearing components in buildup structures and are therefore at high risk, since the entire structure might potentially collapse upon their failure. Thus, it is imperative to comprehend the behavior of reinforced concrete members at high temperatures in case of fire. In this study, the mechanical properties of concrete exposed to high temperatures were experimentally determined through the testing of 27 concrete cylinder starting at room temperature and increasing up to 260 °C. The concrete material behavior was implemented into the ABAQUS software and a finite simulation of reinforced concrete beams exposed to actual fire conditions were conducted. The finite element models compared favorably with the available experimental results. Thus, providing a valuable tool that allows for the prediction of failure in case of a fire event.
Preferences for pre-exposure prophylaxis among U.S. military men who have sex with men: results of an adaptive choice based conjoint analysis study
Authors: Gutierrez José I. , Dubov Alex , Altice Frederick L. , Vlahov David 
Published: May 2021

Abstract
Background
Pre-exposure prophylaxis (PrEP) prevents human immunodeficiency virus (HIV) infection, but its use remains low among U.S. military men who have sex with men (MSM), likely due to mis-matching with personal preferences. We conducted a study to characterize preferences to PrEP measures within this population.

Methods
HIV-negative military MSM were recruited through a closed, Lesbian, Gay, Bisexual, and Transgendered (LGBT) military social media group. The survey was anonymous, and consisted of five experimentally varied attributes in service delivery: dosing method, provider type, visit location, lab work evaluation location, and dispensing venue. Relative importance and part-worth utility scores were generated using hierarchical bayes (HB) estimation, and the randomized first choice model was used to examine participation interest across eight possible PrEP program scenarios.

Results
A total of 429 participants completed the survey. Among the eight scenarios with varying attributes, the most preferred scenario featured a daily tablet, PrEP injection or implant, along with a military provider, smartphone/telehealth visit, and on-base locations for lab evaluation and medication pick-up. The results also emphasized the importance for providers to be familiar with PrEP prescription knowledge, and to provide interactions sensitive to sexual identity and mental health.

Conclusion
A PrEP program consisting of daily tablet is preferred in military healthcare settings is preferred. Long-acting implants and injections are also desired.
Preparing accessible and understandable clinical research participant information leaflets and consent forms: a set of guidelines from an expert consensus conference
Authors: Coleman Eleanor , O’Sullivan Lydia , Crowley Rachel , Hanbidge Moira , Driver Seán , Kroll Thilo , Kelly Aoife , Nichol Alistair , McCarthy Orlaith , Sukumar Prasanth , Doran Peter 
Published: May 2021

Abstract
Background
In line with Good Clinical Practice and the Declaration of Helsinki, it is the investigator’s responsibility to ensure that research participants are sufficiently informed, to enable the provision of informed consent. The Participant Information Leaflet/Informed Consent Form is key to facilitating this communication process. Although studies have indicated that clinical research Participant Information Leaflets/Informed Consent Forms are not optimal in terms of accessibility, there is little or no specific guidance available. The aim of this research was to propose and agree a set of guidelines for academic researchers and sponsors for preparing accessible and understandable Participant Information Leaflets/Informed Consent Forms.

Methods
A literature review identified guidance for the preparation of patient-facing documents. Following critical appraisal, key recommendations were extracted and a set of recommendations which can be applied to clinical research Participant Information Leaflets/Informed Consent Forms were prepared. These recommendations were evaluated and amended by an Expert Consensus Conference consisting of a group of key stakeholders. The stakeholders included members of a Research Ethics Committee (both lay and expert), a patient advocate, experienced clinical researchers, a plain English editor and a Data Protection Officer. Consensus was reached regarding a final set of recommendations.

Results
44 recommendations were agreed upon and grouped into five categories: Layout, Formatting, Content, Language and Confirming Readability. These recommendations aimed to maximize accessibility for lay participants, including readers with dyslexia, literacy or numeracy challenges, thereby improving the quality of the consent process.

Conclusions
More empirical research is needed to further improve the informed consent process for research participants. However, these recommendations are informed by the current literature and have been ratified by expert stakeholders. It is hoped that these recommendations will help investigators and sponsors to consistently and efficiently produce more accessible clinical research Participant Information Leaflets/Informed Consent Forms.
Conducting invasive urodynamics in primary care: qualitative interview study examining experiences of patients and healthcare professionals
Authors: Milosevic Sarah , Joseph-Williams Natalie , Pell Bethan , Cain Elizabeth , Hackett Robyn , Murdoch Ffion , Ahmed Haroon , Allen A. Joy , Bray Alison , Clarke Samantha , Drake Marcus J. , Drinnan Michael , Hood Kerenza , Schatzberger Tom , Takwoingi Yemisi , Thomas-Jones Emma , White Raymond , Edwards Adrian , Harding Chris 
Published: May 2021

Abstract
Background
Invasive urodynamics is used to investigate the causes of lower urinary tract symptoms; a procedure usually conducted in secondary care by specialist practitioners. No study has yet investigated the feasibility of carrying out this procedure in a non-specialist setting. Therefore, the aim of this study was to explore, using qualitative methodology, the feasibility and acceptability of conducting invasive urodynamic testing in primary care.

Methods
Semi-structured interviews were conducted during the pilot phase of the PriMUS study, in which men experiencing bothersome lower urinary tract symptoms underwent invasive urodynamic testing along with a series of simple index tests in a primary care setting. Interviewees were 25 patients invited to take part in the PriMUS study and 18 healthcare professionals involved in study delivery. Interviews were audio-recorded, transcribed verbatim and analysed using a framework approach.

Results
Patients generally found the urodynamic procedure acceptable and valued the primary care setting due to its increased accessibility and familiarity. Despite some logistical issues, facilitating invasive urodynamic testing in primary care was also a positive experience for urodynamic nurses. Initial issues with general practitioners receiving and utilising the results of urodynamic testing may have limited the potential benefit to some patients. Effective approaches to study recruitment included emphasising the benefits of the urodynamic test and maintaining contact with potential participants by telephone. Patients’ relationship with their general practitioner was an important influence on study participation.

Conclusions
Conducting invasive urodynamics in primary care is feasible and acceptable and has the potential to benefit patients. Facilitating study procedures in a familiar primary care setting can impact positively on research recruitment. However, it is vital that there is a support network for urodynamic nurses and expertise available to help interpret urodynamic results.
A review on SARS-CoV-2 and stroke pathogenesis and outcome
Authors: Roushdy Tamer , Hamid Eman 
Published: May 2021

AbstractSevere acute respiratory syndrome corona virus 2 hit strongly and hardly the entire globe for more than 1 year with a morbidity exceeding 139 million and a mortality approaching 3 million worldwide since its emergence in China in December 2019 until April 2021.Although being termed after its ancestor the acute respiratory syndrome corona virus that emerged in 2002. Yet, the current corona virus has its unique devastating presentations being pulmonary and extra pulmonary.In the current review, a highlight on the role played by corona virus 2 on pathogenesis and outcome of stroke is presented with an attempt to point to the most approved ways through which the corona virus induce stroke being disturbance in renin angiotensin system and angiotensin-converting enzyme 2 receptors downregulation, endothelial cell damage with coagulopathy, cytokine storm, and platelet as well as outcome and risks in patients who are suffering stroke with modifiable vascular risk factors and catching the severe acute respiratory syndrome corona virus 2.
Effect of mandibular complete dentures relining on occlusal force distribution using T-scan system
Authors: Ibraheem Eman M. , ElGabry Hisham S. 
Published: May 2021

Abstract
Background
This study aimed to evaluate the effect of mandibular complete dentures relining using soft relining material on the distribution of various occlusal forces using T-Scan system. Fifty completely edentulous patients having their conventional complete dentures earlier fabricated and utilized were selected for this study. Patients were controlled diabetics, characterized by having their residual alveolar ridges moderately developed and lined with firm mucoperiosteum. Mandibular complete dentures were relined with soft denture liner and T-Scan device was used for occlusal force distribution measurement prior to denture relining and three months thereafter the relinning procedure.

Results
Comparison between occlusal forces percentages before and after denture relining revealed that occlusal forces percentages was significantly lower after denture relining in anterior area, significantly higher after denture relining in right posterior area, where it was insignificantly higher after relining in left posterior area.

Conclusions
Our findings revealed that the use of soft denture liner for mandibular complete denture relining significantly improved the occlusal load distribution.
Clinical trial registration Trial registration NCT, NCT04701970. Registered 23/11/2020—Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04701970
A record of deglaciation-related shifting of the proximal zone of a sandur — a case study from the Gwda sandur, NW Poland (MIS 2)
Authors: Mleczak Mateusz , Pisarska-Jamroży Małgorzata 
Published: May 2021

AbstractThe study analyses a 7.5-m-thick sedimentary succession deposited in the largest sandur (the Gwda sandur, a glacial outwash plain) in NW Poland, during the late Weichselian (MIS 2). Although the study site is located in the distal zone of the sandur, its sedimentological features and palaeohydrological parameters reflect the presence of an energetic, powerful environment typical of the proximal zone. Three sedimentary units were recognized in the studied sedimentary succession: (1) lower unit — fine-grained sands with ripple cross-lamination and horizontal lamination; (2) middle unit — gravelly coarse-grained sands and sandy gravels with planar cross-stratification; and, (3) upper unit — sands and gravelly sands with trough cross-stratification. Although the age of deposition of the sandur is accepted to be convergent with that of end-moraines of the same phase, the sediments in the distal zone of the Gwda sandur correlate with an earlier glaciation phase/subphase. Our findings hint at a complex problem: large sandurs such as the Gwda sandur were probably deposited over a long time, and their successions might record the textural and structural features of the proximal subenvironment, even in their distal parts due to deglaciation-related shifting of the proximal zone of a sandur. This paper presents a new approach to analysing the depositional processes in large sandurs, shows a new light on glaciofluvial water supply dynamics of distal parts of sandurs, and may solve several fundamental problems related to the sandur deposition.
Prevalence and risk factors of delirium and subsyndromal delirium in older adults
Authors: Ibrahim Maha Hosam El-Din , Elmasry Manal , Nagy Fady , Abdelghani Ahmed 
Published: May 2021

Abstract
Background
Delirium is a common geriatric problem associated with poor outcomes. Subsyndromal delirium (SSD) is characterized by the presence of certain symptoms of delirium yet, not satisfying the definition of full-blown delirium, defined by categorical elements, and is usually referred to as the presence of one or more symptoms in the confusion assessment method (CAM). This study aimed to investigate the prevalence and risk factors of delirium and SSD in older adults admitted to the hospital. Five hundred eighty-eight elderly (above 65 years) Egyptian patients were recruited from January 2019 to February 2020. After explaining the purpose of the study and assuring the confidentiality of all participants, an informed consent was obtained from the participant or a responsible care giver for those who were not able to give consent. All patients were subjected ‘on admission’ to thorough history taking, clinical examination, and comprehensive geriatric assessment including confusion assessment tools, mini-mental state examination, and functional assessment using Barthel index score.

Results
The current study showed that 19.6% of patients had delirium and 14.1% of patients had SSD with combined prevalence of 33.7%. Most common causes included metabolic, infection, organic brain syndrome, and dehydration. The current study reported significant proportionate relation between cognitive assessment and functional ability, so patients with a score of 23 MMSE had good functional ability, while cognitive assessment using mini-mental score shows inversed relation to delirium and SSD using CAM score.

Conclusion
Delirium is independently associated with adverse short-term and long-term outcomes, including an increase in mortality, length of hospital stay, discharge to an institution, and functional decline on discharge. Subsyndromal delirium (SSD) is characterized by the presence of certain symptoms of delirium, not yet satisfying the definition of full-blown delirium but it can identify patients with early cognitive and functional disabilities, and because of high prevalence of delirium and SSD. Efforts to prevent or early detection may identify patients who warrant clinical attention.