bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dissenting Opinions of Judges of the unclos Tribunal in the Chagos Case
Authors: Mahadew Roopanand , Bhowarkan Arzeena 
Published: June 2021

Abstract
Mauritius won its first victory when the “tribunal constituted under Annex vii of the United Nations Convention on the Law of the Sea” delivered its award “in the matter of the Chagos Marine Protected Area (mpa) Arbitration, between the Republic of Mauritius and the United Kingdom”. The award declared that the mpa established around Chagos by the United Kingdom was against international law. However, the decision desired by both Mauritius and the Chagossians is found in the dissenting opinion, which is, as a matter of law, non-binding. The dissenting opinion is to the effect that the tribunal had jurisdiction to consider the issue of sovereignty over Chagos and that if such issue was considered, Mauritius had a strong case for winning back sovereignty over Chagos. This article aims to make the dissenting opinions more widely known and reflect on the legal value of such opinions, alongside their high political and moral value and relevance to Mauritius and the Chagossians.
Financial Sustainability of Microfinance Institutions at Growth Stage: Do Lending Terms Matter?
Authors: Nyamsogoro Ganka Daniel 
Published: June 2021

Abstract
The financial sustainability of microfinance institutions (mfi s) is crucial if their benefits are to be enjoyed in the long run. This study investigated the determinants of mfi s’ financial sustainability at growth stage. The study aimed to address the following questions: are factors influencing financial sustainability at maturity equally important at growth stage? What influence do lending terms have on financial sustainability at growth stage? The study used panel regression models and four-year survey data from 106 rural mfi s in Tanzania. Decomposition of lending types was adopted to unveil the contribution of lending terms to financial sustainability. We found that most factors influencing financial sustainability at maturity stage are equally important in influencing sustainability at growth stage. In addition, two factors appear to affect financial sustainability at growth stage only. Moreover, lending terms matter in determining financial sustainability at growth stage. The study provides insights on how lending terms can be used to influence financial sustainability at growth stage.
Outcomes of Mastoidectomy With Antibiotic Catheter Irrigation for Patients With Draining Ventilation Tubes
Authors: Jones Joel W. , Ballard Daniel P. , Hillman Todd A. , Chen Douglas A. 
Published: June 2021

Objectives: To evaluate the effectiveness of mastoidectomy with antibiotic catheter irrigation in patients with chronic tympanostomy tube otorrhea. Methods: A chart review of adult and pediatric patients with persistent tympanostomy tube otorrhea who had failed outpatient medical management and underwent mastoidectomy with placement of a temporary indwelling catheter for antibiotic instillation was performed. Patients were retrospectively followed for recurrent drainage after 2 months and outcomes were categorized as resolution (0-1 episodes of otorrhea or otitis media with effusion during follow-up), improvement (2-3 episodes), or continued episodic (>3 episodes). Results: There were 22 patients and 23 operated ears. Median age was 46 years (interquartile range, IQR = 29-65). The median duration of otorrhea from referral was 5.5 months (IQR = 2.8-12). Following surgery, 14 ears had resolution of drainage, 6 had improvement, and 3 had episodic. The observed percentage of resolved/improved ears (87%) was significant ( P = .0005, 95% CI = 67.9%-95.5%). Median follow-up time was 25 months (IQR = 12-59). Pre and postoperative pure tone averages improved (difference of medians = −3.3 dB, P = .02) with no significant difference in word recognition scores ( P = .68). Methicillin-resistant Staphylococcus aureus was the most common isolated microbe while no growth was most frequently noted on intraoperative cultures. Conclusions: Mastoidectomy with antibiotic catheter irrigation may be an effective surgical strategy, and single stage alternative to intravenous antibiotics, for select patients with persistent tube otorrhea who have failed topical and oral antibiotics.
Outcomes of early hemivertebrectomy in children with congenital scoliosis: A prospective follow-up study
Authors: Oksanen Hanna M. , Jalanko Tuomas , Helenius Ilkka J. 
Published: June 2021

Background and objective: Posterolateral hemivertebrectomy with monosegmental instrumentation at an early age is an established method to correct congenital scoliosis but is associated with a relatively high risk of instrumentation failure and health-related quality of life outcomes are not available. We aimed to investigate the effects hemivertebrectomy with postoperative hip spica cast on complications and health-related quality of life in small children with congenital scoliosis. Methods: A follow-up study of 30 children (at mean age = 3.4 years, range = 1.0–8.5 years) undergoing posterolateral hemivertebrectomy and short pedicle instrumentation. Children were immobilized postoperative with hip spica cast for 6 weeks and immobilization for 4 months using a rigid thoracolumbosacral orthosis. The Caregivers filled out Scoliosis Research Society 24 outcome questionnaire preoperatively, at 6 months, and at final follow-up visit on behalf of their child. Standing radiographs were obtained preoperatively, postoperatively in the cast, and standing at final follow-up. Results: Mean major curve was 41° (range = 26°–87°) preoperatively and was corrected to 14° (4.0°–35°) at final follow-up. Eight (27%) children had postoperative complications, including three (10%) deep surgical site infections. The Scoliosis Research Society 24 back domain showed an improvement from a mean of 3.8 preoperatively to 4.4 at final follow-up ( p < 0.001). Function from back condition domain showed a significant deterioration from 4.2 preoperatively to 3.7 at 6 months ( p = 0.020) but improved back to baseline at final follow-up (4.2, p = 0.0022 6 months vs final follow-up). Conclusions: Hemivertebrectomy with short instrumentation resulted into 64% correction of scoliosis and improved health-related quality of life in back pain and function domains.
Mediastinal effusion due to pericardiocentesis with cardiac tamponade: a case report
Authors: Zhang Qian , Wang Difen , Liu Ying 
Published: June 2021

Abstract
Background
Pericardiocentesis is an effective treatment for cardiac tamponade, but there are risks, including haemorrhagic events, cardiac perforation, pneumothorax, arrhythmia, acute pulmonary oedema and so on. Mediastinal effusion caused by puncture is rarely reported.

Case presentation
A 47-year-old man who had a history of right leg deep vein thrombosis and pulmonary artery embolism with implantation of an inferior vena cava filter presented for inferior vena cava filter removal. Within 30 min after the procedure, he developed chest pain, nausea, vomiting and presyncope with shock. Echocardiography confirmed massive pericardial effusion with evidence of cardiac tamponade. Emergency pericardiocentesis was performed. Confusingly, only 3 mL of bloody pericardial effusion was drained in total, and subsequently, the patient’s symptoms rapidly improved with stable haemodynamics. Repeat echocardiography showed that the pericardial effusion had disappeared. Urgent computed tomography pulmonary angiography demonstrated localized effusion, which was not seen the previous computed tomography results and was noted around the left ventricle in the mediastinal apace. No intervention was performed, given that there was no bleeding tendency or further adverse events related to the mediastinal effusion. The patient was subsequently discharged in a stable condition a few days later, and outpatient follow-up was advised.

Conclusions
Mediastinal effusion is a rare complication of pericardiocentesis. In the case described herein, the most likely cause was pericardial effusion extravasated into the mediastinum through the needle insertion site in the puncture process due to large pressure variations in the intrapericardial space with tamponade, differing from cases of over-anticoagulation reported in the previous literature. Just as our case demonstrates that conservative treatment of an hemodynamic insignificant mediastinal effusion may be appropriate. Echocardiography is useful and effective to minimize complication rates.
Seroprevalence of diphtheria toxoid IgG antibodies in the Malaysian population
Authors: Yusoff Ahmad Faudzi , Mohd Sharani Zatil Zahidah , Kee Chee Cheong , Md Iderus Nuur Hafizah , Md Zamri Ahmed Syahmi Syafiq , Nagalingam Tharmarajah , Mohamad Bashaabidin Mohd Safrin , Wan Ibadullah Wan Abdul Hannan , Ghazali Sumarni Mohd , Yusof Ainur Yusniza , Ching Yee Ming , Mohamed Nor Nurhanani , Kamarudin Balqis , Ahmad Norazah , Arip Masita 
Published: June 2021

AbstractBackgroundDespite high childhood immunization coverage, sporadic cases of diphtheria have been reported in Malaysia in recent years. This study aims to evaluate the seroprevalence of diphtheria among the Malaysian population.MethodsA total of 3317 respondents age 2 years old to 60 years old were recruited in this study from August to November 2017. Enzyme-linked immunosorbent assay (ELISA) was used to measure the level of IgG antibody against the toxoid of C. diphtheriae in the blood samples of respondents. We classified respondent antibody levels based on WHO definition, as protective (≥0.1 IU/mL) and susceptible (< 0.1 IU/mL) to C. diphtheriae infection.ResultsAmong the 3317 respondents, 57% were susceptible (38.1% of children and 65.4% of adults) and 43% (61.9% of children and 34.6% of adults) had protective antibody levels against diphtheria. The mean antibody level peaked among individuals aged 1–2 years old (0.59 IU/mL) and 6–7 years old (0.64 IU/mL) but generally decreased with age, falling below 0.1 IU/mL at around 4–6 years old and after age 20 years old. There was a significant association between age [Children: χ2 = 43.22(df = 2),p < 0.001)], gender [Adults: χ2 = 5.58(df = 1),p = 0.018] and ethnicity [Adults: χ2 = 21.49(df = 5),p = 0.001] with diphtheria toxoid IgG antibody level.ConclusionsAbout 57% of the Malaysian population have inadequate immunity against diphtheria infection. This is apparently due to waning immunity following childhood vaccination without repeated booster vaccination in adults. Children at age 5–6 years old are particularly vulnerable to diphtheria infection. The booster vaccination dose normally given at 7 years should be given earlier, and an additional booster dose is recommended for high-risk adults.
Cerebellar venous thrombosis mimicking a cerebellar tumor due to polycythemia vera: a case report
Authors: Wen Hongfeng , Jin Di , Chen Yu , Cui Bin , Xiao Tianyi 
Published: June 2021

AbstractBackgroundCerebral venous thrombosis (CVT) occurs rarely in the general population and is frequently associated with confused clinical findings and delayed diagnosis. Isolated cerebellar cortical vein thrombosis is a very rare phenomenon.Case presentationThis report describes a case with CVT, which is manifested as space-occupying lesions of the cerebellar hemisphere and mimics a cerebellar tumor at the beginning. The diagnosis of CVT was finalized given the laboratory and brain biopsy findings. The etiology may be related to polycythemia vera with Janus Kinase 2 V617F mutation.ConclusionIsolated cerebellar vein thrombosis should be considered when swelling and enhancing cerebellar lesions are detected. Polycythemia vera, especially with a positive JAK2 V617F mutation, may be a rare risk factor for CVT.
Accuracy of pre-operative fistula diagnostics in anorectal malformations
Authors: Tofft Louise , Salö Martin , Arnbjörnsson Einar , Stenström Pernilla 
Published: June 2021

Abstract
Background
Surgical safety during posterior sagittal anorectal plasty (PSARP) for anorectal malformations (ARM) depends on accurate pre-operative fistula localization. This study aimed to evaluate accuracy of pre-operative fistula diagnostics.

Methods
Ethical approval was obtained. Diagnostic accuracy of pre-PSARP symptoms (stool in urine, urine in passive ostomy, urinary tract infection) and examination modalities (voiding cystourethrogram (VCUG), high-pressure colostogram, cystoscopy and ostomy endoscopy) were compared to final intra-operative ARM-type classification in all male neonates born with ARM without a perineal fistula treated at a tertiary pediatric surgery center during 2001–2020.

Results
The 38 included neonates underwent reconstruction surgery through PSARP with diverted ostomy. Thirty-one (82%) had a recto-urinary tract fistula and seven (18%) no fistula. Ostomy endoscopy yielded the highest diagnostic accuracy for fistula presence (22 correctly classified/24 examined cases; 92%), and pre-operative symptoms the lowest (21/38; 55%). For pre-operative fistula level determination, cystoscopy yielded the highest diagnostic accuracy (14/20; 70%), followed by colostogram (23/35; 66%), and VCUG (21/36; 58%). No modality proved to be statistically superior to any other.

Conclusions
Ostomy endoscopy has the highest diagnostic accuracy for fistula presence, and cystoscopy and high-pressure colostogram for fistula level determination. Correct pre-operative ARM-typing reached a maximum of 60–70%.
Female genital mutilation/cutting (FGM/C) coding capacities in Swiss university hospitals using the International Classification of Diseases (ICD)
Authors: Cottler-Casanova S. , Horowicz M. , Gayet-Ageron A. , Abdulcadir J. 
Published: June 2021

Abstract
Background
The real prevalence and incidence of women living with or at risk of female genital mutilation/cutting (FGM/C) is unknown in Switzerland and many parts of Europe, as there are no representative surveys similar to DHS or MICS for European countries. Indirect estimates are commonly used to estimate the number of women with FGM/C in high-income countries, but may not reflect the actual FGM/C prevalence among migrants. Direct measures may provide more accurate estimates that could guide policy- and clinical decision-making. Swiss hospital data may provide a sample of patients that can be used to describe the prevalence of FGM/C in Swiss hospitals. Our study assesses the number of inpatient women and girls in Swiss university hospitals from countries with high FGM/C prevalence, and of inpatients with a coded diagnosis of FGM/C.

Methods
We conducted an exploratory descriptive study in Switzerland to assess the number of women and girls admitted to Swiss university hospitals between 2016 and 2018 from 30 FGM/C practicing countries, as well as inpatients with a coded diagnosis of FGM/C using anonymized data. We calculated indirect estimates for inpatient women and girls living with or at risk of FGM/C and compared them with the number of inpatients with a coded diagnosis of FGM/C.

Results
8720 women and girls from FGM/C practicing countries were admitted. 207 patients had a coded diagnosis of FGM/C, including 7 with a nationality outside the 30 targeted countries, corresponding to an overall prevalence of 2.3% (95%CI, 2.0–2.6). The number of FGM/C cases by hospital was significantly different across years (P < 0.001), with a higher proportion of cases collected in Geneva, Switzerland.

Conclusions
The comparison between indirect estimates of inpatients with or at risk of FGM/C and the low number of FGM/C cases coded, suggests low recording and coding capacities of FGM/C.

Tweetable abstract
The capacity of coding primary and secondary diagnosis of FGM/C in Swiss university hospitals seems low.
Protocol number: 2018–01851: SwissEthics Committee, Canton of Geneva, Switzerland.
Hidden patterns among the fatally injured pedestrians in an Iranian population: application of categorical principal component analysis (CATPCA)
Authors: Jamali-Dolatabad Milad , Sarbakhsh Parvin , Sadeghi-bazargani Homayoun 
Published: June 2021

Abstract
Background
Identifying hidden patterns and relationships among the features of the Fatal Pedestrian Road Traffic Injuries (FPRTI) can be effective in reducing pedestrian fatalities. This study is thus aimed to detect the patterns among the fatally injured pedestrians due to FPRTI in East Azerbaijan province, Iran.

Methods
This descriptive-analytic research was carried out based on the data of all 1782 FPRTI that occurred in East Azerbaijan, Iran from 2010 to 2019 collected by the forensic organization. Categorical Principal Component Analysis (CATPCA) was performed to recognize hidden patterns in the data by extracting principal components from the set of 13 features of FPRTI. The importance of each component was assessed by using the variance accounted for (VAF) index.

Results
The optimum number of components to fit the CATPCA model was six which explained 71.09% of the total variation. The first and most important component with VAF = 22.04% contained the demographic and socioeconomic characteristics of the killed pedestrians. The second-ranked component with VAF = 12.96% was related to the injury type. The third component with VAF = 10.56% was the severity of the injury. The fourth component with VAF = 9.07% was somehow related to the knowledge and observance of the traffic rules. The fifth component with VAF = 8.63% was about the quality of medical relief and finally, the sixth component with VAF = 7.82% dealt with environmental conditions.

Conclusion
CATPCA revealed hidden patterns among the fatally injured pedestrians in the form of six components. The revealed patterns showed that some interactions between correlated features led to a higher mortality rate.
Elevated mean platelet volume in oral lichen planus and increased blood urea nitrogen level in its red-form: an observational study
Authors: Yao Hui , Deng Yiwen , Du Guanhuan , Wang Yufeng , Tang Guoyao 
Published: June 2021

Abstract
Background
This retrospective observational study aims to assess platelet count, mean platelet volume (MPV), blood biochemical tests for liver and kidney function in Chinese oral lichen planus (OLP) patients.

Methods
Eighty pathologically confirmed OLP patients and 51 healthy controls were enrolled. Data on full blood count and biochemical tests were obtained from the electronic medical record system of the hospital.

Results
MPV was elevated in OLP patients compared to controls (10.68 ± 0.97 fL versus 10.33 ± 0.89 fL, P = 0.042) while platelet count showed no difference between them. Red-form OLP group had increased blood urea nitrogen (BUN, 5.24 ± 1.15 mmol/L versus 4.69 ± 0.98 mmol/L, P = 0.036) than white-form OLP group. By contrast, there were no differences between those two groups in the other variables including MPV, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and creatinine. In terms of C-reactive protein (CRP), 92.5% of the OLP patients had a value of less than 3.48 mg/L. Besides, 75% of the OLP patients were overweight with body mass index (BMI) more than 25 kg/m2.

Conclusions
These findings indicate MPV might play roles in inflammation in OLP. The red-form OLP might be associated with damage or reduction of kidney function.
Root canal morphology of the mandibular second premolar: a systematic review and meta-analysis
Authors: Wolf Thomas Gerhard , Anderegg A. L. , Wierichs R. J. , Campus G. 
Published: June 2021

AbstractBackgroundThe aim of this paper was to systematically review the root canal configuration (RCC) and morphology literature of the mandibular second premolar (Mn2P).MethodsSystematic research of five electronic databases was performed to identify published literature concerning the root canal configuration (RCC) of the Mn2P up through July 2020. Studies were selected according to predefined search terms and keywords inclusion criteria: “root canal configuration”, “root canal system”, “root canal morphology”, “mandibular second premolar”, “mandibular premolars”, “morphology” and “anatomy”. Further possible studies were identified by cross-referencing and screening the bibliographies of the selected articles.ResultsFrom 1622 retrieved studies, 44 studies investigating the internal morphology of 17,839 Mn2Ps were included. Most examined Mn2Ps were single-rooted (89.5–100%); two-rooted (0.1–8%) and three-rooted (0.1–3.5%) Mn2Ps at lower frequency. Most frequent RCCs reported were 1–1–1/1 (55.3–99.6%) followed by 1–1–2/2 (0.5–57%) and 2–2–2/2 (0.6–18%). The meta-analysis of seven studies demonstrated that a significantly higher number of RCC type 1–2–1/1 (OR [95%CI] = 2.05 [1.27, 3.33]) and 2–2–2/2 (OR [95%CI] = 2.32 [0.65, 8.63]) were observed in male than in female patients.ConclusionsDifferent RCC research methods have been reported. Whereas clearing and radiographs were commonly used in the past, CBCT has been prevalent in recent years. A globally high frequency of a 1–1–1/1 RCC in the Mn2P has been reported. Nevertheless, the probability that different, more complicated RCCs can appear in Mn2Ps should not be underestimated and, thus, should be taken into consideration when making decisions during an endodontic treatment.
The risk of ischemic stroke and hemorrhagic stroke in Chinese adults with low-density lipoprotein cholesterol concentrations < 70 mg/dL
Authors: Wu Zhijun , Huang Zhe , Lichtenstein Alice H. , Liu Yesong , Chen Shuohua , Jin Yao , Na Muzi , Bao Le , Wu Shouling , Gao Xiang 
Published: June 2021

Abstract
Background
The risk of stroke in individuals with very low low-density lipoprotein cholesterol (LDL-C) concentrations remains high. We sought to prioritize predictive risk factors for stroke in Chinese participants with LDL-C concentrations < 70 mg/dL using a survival conditional inference tree, a machine learning method.

Methods
The training dataset included 9327 individuals with LDL-C concentrations < 70 mg/dL who were free of cardiovascular diseases and did not use lipid-modifying drugs from the Kailuan I study (N = 101,510). We examined the validity of this algorithm in a second Chinese cohort of 1753 participants with LDL-C concentrations < 70 mg/dL from the Kailuan II study (N = 35,856).

Results
During a mean 8.5–9.0-year follow-up period, we identified 388 ischemic stroke cases and 145 hemorrhagic stroke cases in the training dataset and 20 ischemic stroke cases and 8 hemorrhagic stroke cases in the validation dataset. Of 15 examined predictors, poorly controlled blood pressure and very low LDL-C concentrations (≤ 40 mg/dL) were the top hierarchical predictors of both ischemic stroke risk and hemorrhagic stroke risk. The groups, characterized by the presence of 2–3 of aforementioned risk factors, were associated with a higher risk of ischemic stroke (hazard ratio (HR) 7.03; 95% confidence interval (CI) 5.01–9.85 in the training dataset; HR 4.68, 95%CI 1.58–13.9 in the validation dataset) and hemorrhagic stroke (HR 3.94, 95%CI 2.54–6.11 in the training dataset; HR 4.73, 95%CI 0.81–27.6 in the validation dataset), relative to the lowest risk groups (presence of 0–1 of these factors). There was a linear association between cumulative average LDL-C concentrations and stroke risk. LDL-C concentrations ≤ 40 mg/dL was significantly associated with increased risk of ischemic stroke (HR 2.07, 95%CI 1.53, 2.80) and hemorrhagic stroke (HR 2.70, 95%CI 1.70, 4.30) compared to LDL-C concentrations of 55–70 mg/dL, after adjustment for age, hypertension status, and other covariates.

Conclusion
Individuals with extremely low LDL-C concentrations without previous lipid-modifying treatment could still be at high stroke risk.

Trial registration
Chinese Clinical Trial Register, ChiCTR-TNRC-11001489. Registered on 24-08-2011.