bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does Patent Foramen Ovale Presence Procure Favourable Outcomes In Patients With Severe Rheumatic Mitral Stenosis ?
Authors: Guler Gamze , Dogan Arda Can , Kalkan Ali Kemal , Demir Ali Riza , Uygur Begum , Birant Ali , Agus Hicaz Zencirkiran , Pastore Maria Concetta , Memic Kadriye , Uzun Fatih , Cameli Matteo , Erturk Mehmet 
Published: March 2021

Abstract
Purpose:Mitral stenosis (MS) is torelated for an extended period in patients with atrial septal defect (ASD) known as Lutembacher syndrome due to depressurizing effect. In a similar way, patients with patent foramen ovale (PFO) may have clinical benefits in severe MS. We aim to evaluate the clinical effects of PFO in rheumatic MS. Methods and Results:Transthoracic and transesophageal echocardiography records of the patients with symptomatic severe MS were screened for the period between 2008-2019 in a single center. Three-hundred-twenty symptomatic patients with severe MS were included and presence of PFO recorded. Left atrial appendix (LAA) thrombotic status was defined as clear, spontaneous echo contrast, and thrombus. Two different statistical models were used to determine the predictors of either smallest (mitral valve area) MVA at symptomatic presentation or more thrombogenic LAA. Thirty-four patients had PFO. Multivariable ordinary least square model demonstrated that increase in systolic pulmonary arterial pressure, ejection fraction and presence of PFO were associated with smaller MVA on presentation. Multivariable proportional odds logistic regression model demonstrated that advanced age, increased left atrial diameter, absence of PFO were associated with more thrombotic status whereas larger MVA was associated with decreased thrombotic status in LAA. Conclusion:Presence of PFO in severe MS results in two clinical benefits as i) being asymptomatic with smaller MVA and ii) having less LAA thrombosis probably caused by depressurizing effect on the left atrial pressure. Our study, could serve as an example for patient groups with expected symptomatic benefits from left atrium pressure offloading interventions.
Optimizing Frontline Networking Between Consultant-Led Neonatal Teams in the West Midlands: A Qualitative Report on the Utility of Modified Simulation Training.&nbsp;
Authors: pillay Tilly , Clarke Lynsey , Abbott Lee , Surana Pinki , Shenvi Asha , Deshpande Sanjeev , Cookson Joanne , Nash Matthew , Fawke Joe , Rasiah Vishna , Cusack Jonathan 
Published: March 2021

Abstract
Background: In England neonatal care is delivered within operational delivery networks. Units within these networks are one of three designations (Neonatal Intensive Care, Local-Neonatal or Special-Care Units), based on their ability to care for babies with different degrees of illness or prematurity. With the development of network care-pathways, the most premature and sickest are triaged where possible for delivery in services linked to Neonatal Intensive Care units. This has created anxiety for teams in Local-Neonatal and Special-Care units. Less exposure to sicker babies meant limited opportunities to maintain expertise for when they do unexpectedly deliver at services linked to their own units, and thereafter require transfer for ongoing care, to Neonatal Intensive Care units. Simultaneously, Local-Neonatal and Special-Care teams develop skills in care of the less ill and premature baby which was considered of benefit to all. A need for mutual learning through networking between teams of different designations emerged.Method: An interactive programme, ‘Supporting The Sick Neonate’ was developed in the West Midlands. It focused on equal partnership between unit designations, employing high, medium and low fidelity simulation as the vehicle around which networking between units was centered. Sessions of simulation and debrief were augmented with novel networking time to enable multidirectional learning and understanding of practices. Candidates and facilitators were regarded as participants, spanning different designations. A consultant-focus was adopted to promote long term networking. Qualitative assessment of the programme over four years was captured through -graded and free text surveys.Results: 155 individuals involved in frontline neonatal care participated. 77 were consultants, supported by neonatal trainees, staff grade doctors, clinical fellows, advanced neonatal nurse practitioners and nurses in training. All were invited to participate in the qualitative survey. 79% felt that it was highly relevant; 96% agreed that for consultants this was appropriate adult learning. 98% agreed that consultant training encompassed more than bedside clinical management, including forging communication links between teams. Thematic responses around networking were positive.Conclusion: Simulation augmented with networking time with a consultant-focused model proved successful for networking and shared learning for the Neonatal fraternity in the West Midlands.
The Study of Screw Placement Parameters for Ogawa Type I Acromial Fractures by 3D Technology
Authors: Zhang Wei , Sun Zhongye , Li Weiyan , Yan Jun , Han Liren , Han Shizhang , Yang Xiaofei , Zhao Bei 
Published: March 2021

Abstract
Background: Acromial fractures are rare and there is no consensus on fixation, but more and more studies have reported using two screws to fix Ogawa type I acromial fractures. The objective of this study was to obtain the ideal length, diameter, insertion point and angle of the screw using a novel 3D technology. Methods: Scapula CT data of 100 human subjects were obtained to reconstruct 3D models. The transparency of 3D models was then downgraded along the axial perspective (the view perpendicular to the cross section of the acromial axial) to find the maximum translucent area. Two virtual screws were placed from the anterior edge of the acromial until they penetrated the posterior cortical bone. The largest diameters and lengths of the screw were measured, and the direction and insertion point of the screw were observed.Results: The mean maximum lengths of medial and lateral screws were 43.33±6.17mm and 39.23±6.01mm, respectively. The mean maximum diameters of medial and lateral screws were 4.71±1.23 mm and4.97±1.07mm, respectively. The study found differences in screw length, diameter and insertion point between males and females. The differences sexes in screw angle were not statistical significance.Conclusions: Using the 3D model, we demonstrated that the distal acromial can be safely placed with two screws and provide valuable guidance for screw fixation of Ogawa type I acromial fractures.
Hypoactivity, Abnormal Musculature, and Learning and Memory Defects in slc6a3 zebrafish Mutant Larvae
Authors: Jiang Yu , Geng Nan , Wang Peisong , Lu Xiaojie 
Published: March 2021

Abstract
Dopamine (DA) is one of the most common neurotransmitters in living organisms and is involved in the regulation of behavior, physiology, and disease. The dopamine transporter (DAT, encoded by the slc6a3 gene) re-uptakes dopamine from the synaptic cleft back into neurons, which plays a critical role in regulating dopamine signaling. Clinically, mutations in slc6a3 have been implicated in various diseases. Zebrafish are good model organisms for studying the functions of slc6a3 and dopamine. Work using the zebrafish slc6a3 mutant has previously been reported, but this mutant is not a complete loss-of-function mutant. In the present study, we knocked out the slc6a3 gene using CRISRP/Cas9 technology and obtained a zebrafish mutant with complete loss of function of slc6a3. Behavioral assessments and quantitative reverse transcription (qRT)-PCR revealed musculature injury, decreased activity, and decreased learning and memory ability in the slc6a3 mutant. This study provides a new theoretical basis for understanding the function of slc6a3 and provides a new model organism for studying the molecular pathology underscoring dopamine metabolism-related diseases. It also provides a suitable model for high-throughput screening of small-molecule drugs targeting slc6a3.
Diverse Analysis of Data Mining and Machine Learning Algorithms to Secure Computer Network
Authors: Kumar Neeraj , Kumar Upendra 
Published: March 2021

Abstract
Information and Communication Technologies, to a long extent, have a major influence on our social life, economy as well as on worldwide security. Holistically, computer networks embrace the Information Technology. Although the world is never free from people having malicious intents i.e. cyber criminals, network intruders etc. To counter this, Intrusion Detection System (IDS) plays a very significant role in identifying the network intrusions by performing various data analysis tasks. In order to develop robust IDS with accuracy in intrusion detection, various papers have been published over the years using different classification techniques of Data Mining (DM) and Machine Learning (ML) based hybrid approach.
The present paper is an in-depth analysis of two focal aspects of Network Intrusion Detection System that includes various pre-processing methods in the form of dimensionality reduction and an assortment of classification techniques. This paper also includes comparative algorithmic analysis of DM and ML techniques, which applied to design an intelligent IDS. An experiment al comparative analysis has been carried out in support the verdicts of this work using ‘Python’ language on ‘kddcup99’ dataset as benchmark . Experimental analysis had been done in which we had found more impact on dimensionality reduction and MLP performed well in the true classification to establish secure network. The motive behind this effort is to detect different kinds of malware as early as possible with accuracy, to provide enhanced observant among various existing techniques that may help the fascinated researchers for future potential works.
JAK2 V617F Mutational Burden and Clinical Findings Relationship in Myeloproliferative Neoplasms
Authors: Kahraman Cigdem Yuce , Sincan Gulden , Tatar Abdulgani 
Published: March 2021

Abstract
Background: Philadelphia-negative chronic myeloproliferative neoplasms(MPN) are associated with various genetic abnormalities. JAK2 V617F mutation is the most common one and important for diagnosis. We aimed to evaluate JAK2 mutation status and clinical parameters relationship of the MPN patients referred to our clinic.Methods and Results: We evaluate 143 JAK-2 positive patients diagnosed with polycythemia vera (PV), essential thrombocythemia (ET) and primary myelofibrosis (PMF). JAK2 mutational burden was higher in PV and PMF than ET. Laboratory findings were different in MPN groups and higher –lower JAK2 mutational burden groups. JAK2 mutational burden was correlated with spleen size and LDH level, particularly in PMF. There was no significant difference in age, gender, jak2 mutation burden and laboratory findings in patients with and without thrombosis and bleeding. Common treatment protocols were acetylsalicylic acid (ASA) + hydroxyurea, ASA and ASA + phlebotomy and others respectively. JAK2 mutational burden, mean age and LDH level were higher significantly in the patients treated with ASA+ hydroxyurea than the patients treated with ASA.Conclusion: We speculate that if the spleen size in MPN is as large as the massive splenomegaly and the LDH level is high, the JAK2 mutation burden may tend to be higher. This relationship is more pronounced for PMF.
One-plasmid based CRISPR-Cas9 editing for gene deletion in Lactococcus lactis
Authors: Santos José Miguel Miquelão , Monteiro Gabriel António Amaro , Prazeres Duarte Miguel de França Teixeira dos , Duarte Sofia de Oliveira Dias 
Published: March 2021

Abstract
Lactococcus lactis strains are promising cell factories and delivery vehicles of plasmid DNA and recombinant protein for therapeutic applications. However, the limited yields of recombinant molecules obtained with these bacteria limits their wide applicability. Genome engineering of this host may solve the problem. However, the current genome editing toolbox available for L. lactis is either too laborious or incapable of large edits, limiting the scope of strain editing experiments. In this work, the basis for a one-plasmid CRISPR-Cas9 based genome editing plasmid was developed and tested. The new plasmid (pTCas9dO) adapted from the pKCcas9dO plasmid was used to delete 657 bp of the lactococcal nuclease nth of L. lactis subsp. lactis LMG19460, with the aim of improving yield and quality of plasmid DNA replicated in this strain. Although deletion mutants were successfully generated, plasmid curing was unsuccessful. Thus, further modifications are required before the plasmid is truly applicable for genome editing experiments. Unexpectedly, the generated deletion mutants generated a roughly 40% decrease in plasmid yield alongside with a decrease in the quality of produced pDNA.
The effect of mistletoe extract on tumor response in neoadjuvant chemoradiotherapy for rectal cancer
Authors: Baek Jeong-Heum , Jeon Youngbae , Han Kyoung-Won , Kim Kyung-Ok 
Published: March 2021

Abstract
Background

Mistletoe extract, which is usually used as a complementary agent for cancer patients, provides an anticancer effect on various malignancies. The present study aimed to evaluate the effect of mistletoe extract (Abnoba Viscum Q®) on tumor responses in neoadjuvant chemoradiotherapy for locally advanced rectal cancer.
Methods

The rectal cancer patients who underwent neoadjuvant chemoradiotherapy were analyzed from Jan 2018 to Jul 2020. In the mistletoe group (MG), the patients were administered Abnoba Viscum Q® subcutaneously during chemoradiotherapy, and it was maintained just before surgery. Patients' demographics, clinical outcomes, and histopathological outcomes were compared between chemoradiation with the MG and nonmistletoe group (NMG).
Results

A total of 52 patients were included. There were MG of 15 patients and NMG of 37 patients. Baseline demographics were statistically similar between the two groups except the CA19-9 and tumor location levels from anal verge. There was no difference in the clinical stage for both groups. We also observed better tumor response in MG in terms of TRG, T stage, and overall TNM stage. Tumor response was significantly better in MG comparing NMG in terms of pathologic complete response rate (53.3% vs 21.6%, p = 0.044), good responder of tumor regression grade (66.7% vs 32.4%, p = 0.024), T downstaging (86.7% vs 43.2%, p = 0.004), and overall downstaging (86.7% vs 56.8%, p = 0.040). The toxicities during NCRT in both groups were minimal.
Conclusion

MG treated with chemoradiation combined with mistletoe extract showed better outcomes than NMG in terms of tumor responses. This diversity in treatment may elevate the method to hope for better oncologic outcomes. Prospective and randomized studies with long-term follow-up are warranted to confirm and extend this study.
Clinical Features of Patients With Major Depressive Disorder and Bipolar Disorder Depressive Episodes With Mixed Features&nbsp;
Authors: Wang Hong , Xiao Yan-Xia , Du Jing-Ge , Du Xia , Chen Lin 
Published: March 2021

Abstract
Background: To investigate the clinical phenomenology and clinical features of the new concept of major depressive disorder and bipolar disorder depressive episodes with mixed features.Methods: A total of 357 patients with major depressive disorder or bipolar disorder depressive episodes were assessed, we compared the differences of clinical features with or without mixed features.Results: According to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, the overall prevalence of mixed features was 9.52% (34/357) in major depressive disorder and bipolar disorder depressive episodes; specifically, the prevalence was 6.0% in major depressive disorder and 23.3% in bipolar disorder depressive episodes. Compared with the non-mixed features group, the mixed features group had more single individuals (P=0.002), earlier onset age (P=0.003), more patients with an onset age <25 years (P=0.001), and more previous incidences and prior hospitalizations (P<0.001, P=0.004, respectively), and fewer melancholic features (P=0.013).Logistic regression analysis showed that marital status (OR=0.237) and previous incidence (OR=1.478) was associated with mixed features.Conclusion: It indicates that previous incidence may be a risk factor of in patients with major depressive disorder and bipolar disorder depressive episodes with mixed features, and marital status may be a protective factor.
MVP (Micro Vascular Plug®) Embolization Experience on 104 Patients: How to Select to Proper Model and Avoid Technical Failures
Authors: Giurazza Francesco , Ierardi Anna Maria , Contegiacomo Andrea , Corvino Fabio , Carrafiello Gianpaolo , Niola Raffaella 
Published: March 2021

Abstract
Aim: To describe a three years experience of peripheral arterial embolization with Micro Vascular Plug (MVP) (Medtronic, USA).Materials and methods: 116 MVP have been released in 104 patients (67 males and 37 females; mean age 61.3 years). The pullback release technique was adopted in each case. The following parameters were investigated: angiographic appearance of the vascular injury, anticoagulation therapy at time of procedure, district, caliper of the target artery, course of the landing zone, additional embolics, technical and clinical success.Technical success was defined as complete embolization without deployment of additional embolics.Primary clinical success was considered as hemodynamic stability in emergency setting and resolution of the underlying vascular pathology in elective cases; secondary clinical success was considered clinical success after a second embolization session.Results: Vessel occlusion was achieved in 78 patients after MVP release, while in 26 subjects additional embolics were required; the overall technical success was 75%. Primary clinical success was 96.1%.MVP was oversized between 30% and 40% compared to the target vessel caliper; MVP-3 and MVP-5 were the most frequently adopted in this sampleNo statistical differences in terms of effectiveness were observed among patients assuming anticoagulation. A straight and longer landing zone were statistically associated with higher technical success compared to a curved and a shorter ones, respectively. No clinically adverse events directly related to MVP device occurred; in 3 cases migration was registered without clinical complications.Conclusion: MVP is a safe and effective embolic device. Oversizing is recommended. While eventual concomitant anticoagulation therapy did not influence the technical outcome, straight course and length of the landing zone are essential parameters to evaluate before deployment.
Overweight and Obesity Among The Army Personnel with Low Socio-Economic Status In Kuala Lumpur: A Cross-Sectional Study
Authors: NAR Nik Qistina , MZ Nor Afiah , Moideen M Arshil , Ahmad Rozali 
Published: March 2021

Abstract
Background: The prevalence of overweight and obesity in adults worldwide was 52%, which is a major public health concern. Military institutions worldwide were also plagued with this problem. 57.2% of the army personnel in Malaysia were overweight and obese, in which 52.6% had low socioeconomic status (SES). This led to negative impacts on the overall combat readiness due to the obesity-associated-diseases. This study determined the prevalence and predictors of overweight and obesity among the low SES army personnel in Kuala Lumpur.Methods: A cross-sectional study was conducted using a proportionate random sampling among 772 army personnel from low SES group in army camps in Kuala Lumpur. Online questionnaires were distributed while latest anthropometric measurements’ data were obtained from the Military Lifetime Health Record (MLHR) system. The outcome of this study was overweight and obesity (BMI of > 25kg/m2). Data were analysed using SPSS version 23.0 involving descriptive and inferential statistics.Results: The median age of the respondents was 30 (IQR=7) years. The prevalence of overweight and obese army personnel was 41.1% (95%CI:37.6-44.6). The predictors found were being married (AOR:2.026, 95%CI:1.318-3.113), secondary education (AOR:2.545, 95%CI:1.245-5.203), Lance Corporal (AOR:1.994, 95%CI:1.061-3.748), Corporal (AOR:2.814, 95%CI:1.578-5.020), Sergeant (AOR:4.174, 95%CI:2.076-8.390), past injury (AOR:1.879, 95%CI: 1.191-2.965), history of obese sibling (AOR:1.737, 95%CI:1.013-2.973), history of obese parent (AOR:3.344, 95%CI:1.965-5.688), history of obese grandparent (AOR:11.321, 95%CI:2.207-58.072), poor knowledge on dietary intake (AOR:1.524, 95%CI:1.077-2.157), less than 2 litres daily plain water intake (AOR:1.606, 95%CI:1.166-2.210).Conclusions: Knowledge on dietary intake and plain water intake are the two modifiable predictors for overweight and obesity found in this study, while the other nine predictors are non-modifiable. Understanding on issues surrounding the low SES group will help the strategic level in planning for future comprehensive interventions on overweight and obesity, specifically targeting on those predictors.
Barriers and Facilitators to COVID-19 screening at Jaipur International Airport, India.
Authors: Mantri Neha , Joshi Nitin Kumar , Bhardwaj Pankaj , Goel Akhil Dhanesh , Gupta Manoj Kumar , Singh Kuldeep , Misra Sanjeev 
Published: March 2021

Abstract
The authors have requested that this preprint be removed from Research Square.
Interspecific Potato Somatic Hybrids Between Solanum Malmeanum and S. Tuberosum Provide Valuable Resources for Freezing-Tolerance Breeding
Authors: Tu Wei , Dong Jianke , Zou Ying , Zhao Qinghao , Wang Haibo , Ying Jingwen , Wu Jianghai , Du Juan , Cai Xingkui , Song Botao 
Published: March 2021

Abstract
Freezing stress affects the geographic distribution, growth, and development of potato, resulting in loss of its yield. Solanum malmeanum , a diploid wild species with strong freezing tolerance, was fused with a freezing sensitive dihaploid S. tuberosum by somatic hybridization. In our study, 980 calli were obtained, and 248 differentiate shoots from the calli. Parental-specific SSR markers were used to analyze the chromosome composition of the randomly selected 80 regenerated plants, resulting in 51 somatic hybrids. Among them, 44 somatic hybrids were tested with ploidy analysis in the years 2016 and 2020. During subculture, the genomic ploidy levels changed due to the composition of the unstable chromosome in 56.82% of the somatic hybrids. Compared with the cultivated parent, somatic hybrids showed better freezing tolerance. After freezing-tolerant somatic hybrids were selected to backcross with cultivars, we obtained some valuable breeding resources with enhanced freezing tolerance while similar tuberization capacity close to cultivars. The correlation analysis shows that freezing tolerance has no relation with tuberization capacity, which indicates that they are controlled by independent genetic loci. In all, we successfully conducted the protoplast fusion between S. malmeanum and S. tuberosum for the first time, which provided valuable resources for freezing-tolerant breeding.