bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why COVID-19 symptomatic patients did not seek healthcare service in Bangladesh: Evidence from a cross-sectional study
Authors: Siam Md. Hasanul , Hasan Md. Mahbub , Rahman Mohammad Meshbahur , Rouf Rashawan Raziur , Hossain Mohammad Sorowar 
Published: December 2021

Abstract
Background: During an outbreak, the health-seeking behaviour (HSB) of patients plays a vital role to mitigate the disease spread. Poor HSB may significantly increase mortality and complicate contact tracing. In our study, we aimed to assess the status of HSB among the educated young adults of Bangladesh.Methods: A cross-sectional study was conducted online in June-July 2020 when the country was under strict social distancing measures. A snowball sampling method was employed to capture the suspected COVID-19 patients who did not undergo the COVID-19 test. Descriptive and inferential analyses were performed with statistical significance defined as p < 0.05. Results: Among the 390 participants, more male (79.5%) and urban-dwelling residents (80.3%) participated in the study. About 45% of the participants had a bachelor’s degree followed by 25.9% of post-graduation degrees such as master’s and Ph.D. Common symptoms included fever (77.7%), cough (50.5%), headache (46.2%), body pain (36.4%), sore throat (35.6%), anosmia (31.3%), anorexia (13.8%), diarrhea (11.4%) and dyspnea (11.3%). Compared to females, males were more likely to self-medicate. The odds of male participants considering COVID-19 infection as harmless was 3.2 times higher (AOR: 3.2, CI: 1.28-7.98) than the female participants. Smokers were more likely to use government hotlines for support and take drugs at home. Participants from rural areas were 2.5 times more likely to purchase drugs from nearby stores. The most common reasons for not taking the COVID-19 test were limited testing facilities (48%), risk of infection from the test centre (46%), fear of social stigma (19%), belief that COVID-19 will not cause any harm (18%) and fear of forced quarantine (5%). Respondents having higher monthly income were less likely to fear forced quarantine (AOR: 0.27, CI: 0.4-2.02) but more likely to consider the risk of being infected from the test centre (AOR: 1.75, CI: 0.88-3.49). Conclusion: Non-compliance with public health guidelines by educated people in the epidemic reflects the absence of health literacy and distrust in the healthcare system. Along with enhanced infrastructure, improved public health risk communication and health literacy efforts are needed to rebuild public trust in the healthcare system.
Immune Dysregulation Resulting From Impaired Interleukin-10 And The Interleukin-10 Receptor Signaling: A Systematic Review of 284 Monogenic Patients
Authors: Sharifinejad Niusha , Zaki-Dizaji Majid , Sepahvandi Roya , Fayyaz Farimah , Vilela Maria Marluce dos Santos , ElGhazali Gehad , Abolhassani Hassan , Ochs Hans D , Azizi Gholamreza 
Published: December 2021

Abstract
Purpose: Interleukin-10 (IL-10) and IL-10 receptor (IL-10R) deficiency are monogenic inborn errors of immunity (IEI) causing early-onset inflammatory bowel diseases (IBD). Methods: We systematically reviewed articles that included related keywords using PubMed, Web of Science, and Scopus databases. The articles were screened for eligibility criteria before data extraction. Results: We assessed 284 patients (44.1% female) with IL-10 and/or IL-10R deficiencies who were predominantly from China (41.0%), Italy (14.1%), and South Korea (8.6%). The median age of onset was 1.0 (0.3-4.0) months with a median age of genetic diagnosis at 16.0 (7.4-81.0) months. Consanguinity was reported in all evaluable patients with IL-10 deficiency and in 38.8% of patients with IL-10R deficiency (23.4% of patients with IL-10RA, and 79.4% of patients with IL-10RB deficiency). The most prevalent mutations in IL-10RA were c.301C>T (p.R101W) and c.537G>A (p.T179T), those in IL-10RB were c.139A>G (p.K47E) and c.611G>A (p.W204X). Autoimmunity and enteropathy were present in all cases. The first presentation of both groups was protracted diarrhea (45.7%), bloody diarrhea (18.1%), and colitis (15.7%). Patients with IL-10R deficiency had a high frequency of dermatologic manifestations (50.5%) and failure to thrive (60%), while IL-10 deficient patients lacked those complications. In the majority of patients, the basic immunologic parameters were in normal ranges. Of the entire publications, 30% underwent hemopoietic stem cell transplantation, 61.5% surgery, and 87% immunosuppressive treatment. The ten-year survival rate was higher in patients with IL-10 deficiency than in patients with IL-10R deficiency.Conclusion: IL-10/IL-10R deficiency predominantly presents with treatment-resistant, early-onset IBD within the first months of life. No clear genotype-phenotype correlation was present among these patients. The high prevalence of distinct clinical manifestations reported in IL-10RA- and IL-10RB-deficient patients might be attributable to the interaction between the target tissue and cytokines other than IL- 10 capable of binding to IL-10RB. These results gain translational significance by contributing to earlier diagnosis, adequate therapy, and avoiding delay in the diagnosis and unfavorable outcome.
An alternative model of gravitational forces in nature using the combined effects of repulsion and attraction forces on gaseous molecules
Authors: Piyadasa Chithra Kirthi Gamini 
Published: December 2021

Abstract
Laboratory experiments and natural phenomena investigations in this research series experimentally revealed the existence of gravitational repulsion force dependent on thermal energy content, pervading our surroundings both microscopically and macroscopically. This paper presents an alternative mathematical model of both gravitational repulsion and attraction forces between two gaseous molecules, validated by experimental data. The model is self-standing and independent of existing models built on idealistic assumptions. While existing models considered gravitational interaction as a single force, the presented experimental model considers it the resultant of two distinct forces: gravitational repulsion and attraction. When established experimental data on nitrogen, hydrogen, oxygen, water vapor, carbon monoxide and carbon dioxide were applied, the model performed, both analytically and experimentally: (1) confirming the existence of both gravitational repulsion and attraction forces among gas molecules, (2) demonstrating that the two forces follow Inverse-Cube relationship with the distance between molecules, (3) revealing that repulsion force is linearly proportional to the absolute temperature, thus filling the critical gap between energy and fundamental forces. Orders of magnitude of gravitational repulsion and attraction forces are very large compared to the gravitational force between gas molecules calculated according to the classical theory, enabling manipulation to achieve hitherto unknown outcomes and developments.
Gender differences in guilt aversion in Korea and the United Kingdom
Authors: Nihonsugi Tsuyoshi , Tanaka Toshiko , Haruno Masahiko 
Published: December 2021

Abstract
Guilt aversion, which describes the tendency to reduce the discrepancy between a partner’s expectation and his/her actual outcome, is a key driving force for cooperation in both the East and the West. A recent study based on functional magnetic resonance imaging and online behavioral experiments reported that men show stronger guilt aversion than women and also suggested that men’s predominance in guilt aversion arises from stronger sensitivity to social norms. However, since the participants of that study were all Japanese, it remains unaddressed how common the gender difference in guilt aversion is. Here, we conducted online behavioral studies on people from Korea and the U.K. (Korea; n = 294, U.K.; n = 347) using the same trust game. We confirmed that men exhibit stronger guilt aversion than women in both countries. Furthermore, consistent with the Japanese study, our Lasso regression analysis for U.K. participants revealed that Big Five Conscientiousness (rule-based decision) correlated with guilt aversion in men. In contrast, guilt aversion in Korean men correlated with Big Five Neuroticism. Thus, our results suggest that gender differences in guilt aversion is universal but the underlying cognitive processes may be influenced by cultural differences.
Barriers and Facilitators to Implementing a Stepped Care Cognitive-behavioral Therapy for Insomnia in Cancer Patients: a Qualitative Study.
Authors: Savard Josée , Filion Catherine , Gagnon Marie-Pierre , Caplette-Gingras Aude , Bélanger Lynda , Morin Charles M. 
Published: December 2021

Abstract
Purpose: Insomnia affects 30-60% of cancer patients and tends to become chronic when left untreated. While cognitive-behavioral therapy for insomnia (CBT-I) is the recommended first-line treatment, this intervention is not readily accessible. This qualitative study investigated current practices in the assessment and management of insomnia in five hospitals offering cancer care and identified the barriers and facilitators to the implementation of a stepped care CBT-I (i.e., web-based CBT-I followed, if needed, by 1-3 booster sessions) in these settings. Methods: Nine focus groups composed of a total of 43 clinicians (e.g., physicians, nurses, technologists, psychologists), six administrators, and 10 cancer patients were held. The Consolidated Framework for Implementing Research (CFIR) was used to develop the semi-structured interview and analyze the data. Results: Sleep difficulties are not systematically discussed in clinical practice and when a treatment is offered, most often, it is a pharmacological one. Barriers and facilitators to the implementation of a stepped care CBT-I included individual characteristics (e.g., lack of knowledge about CBT-I); intervention characteristics (e.g., increased accessibility offered by a web-based format); inner setting characteristics (e.g., resistance to change); and process factors (e.g., motivation to offer a new service). Conclusions: This qualitative study confirms the need to better address insomnia in routine cancer care and suggests that, while some barriers were mentioned, the implementation of a stepped care CBT-I is feasible. Keys to a successful implementation include accessibility, training, inclusion of stakeholders in the process, and ensuring that they are supported throughout the implementation.
Impact of a Dementia-friendly Program on Detection and Management of Patients with Cognitive Impairment and Delirium in Acute-care Hospital Units: A Controlled Clinical Trial Design
Authors: Weldingh Nina Mickelson , Mellingsæter Marte Rognstad , Hegna Bendik Westlund , Benth Jūratė Šaltytė , Einvik Gunnar , Juliebø Vibeke , Thommessen Bente , Kirkevold Marit 
Published: December 2021

Abstract
Background: Frail older persons with cognitive impairment (CI) are at special risk of experiencing delirium during acute hospitalisation. The purpose of this study was to investigate whether a dementia-friendly hospital program contributes to improved detection and management of patients with CI and risk of delirium at an acute-care hospital in Norway. Furthermore, we aimed to explore whether the program affected the prevalence of delirium, pharmacological treatment, 30-day re-hospitalisation, 30-day mortality and institutionalisation afterwards. Methods: This study had a controlled clinical trial design with a historical control group. It was conducted at two different medical wards at a large acute-care hospital in Norway from September 2018 to December 2019. A total of 423 acute hospitalised patients 75 years of age or older were included in the study. Delirium screening and cognitive tests were recorded by research staff with the 4 ‘A’s Test (4AT) and the Confusion Assessment Measure (CAM), while demographic and medical information was recorded from the electronic medical records (EMR). Results: Implementation of the dementia-friendly hospital program did not show any significant changes in the identification of patients with CI. However, the share of patients screened with 4AT within 24 hours increased from 0% to 35.5% (P<.001). The proportion of the patients with CI identified by the clinical staff, who received measures to promote “dementia-friendly” care and reduce the risk for delirium increased by 32.2% (P<.001), compared to the control group. Furthermore, the number of patients with CI who were prescribed antipsychotic, hypnotic or sedative medications was reduced by 24.5% (P<.001). There were no differences in prevalence of delirium, 30-day readmission or 30-day mortality. Conclusions: A model for early screening and multifactorial non-pharmacological interventions for patients with CI and delirium may improve management of this patient group, and reduce prescriptions of antipsychotic, hypnotic and sedative medications. The implementation in clinical practice of early screening using quality improvement methodology deserves attention. Trial registration: The protocol of this study was retrospectively registered in the ClinicalTrials.gov Protocol Registration and Results System with the registration number: NCT04737733 and date of registration: 03/02/2021.
Odour-Mediated Interactions Between an Apex Reptilian Predator and its Mammalian Prey
Authors: Dickman Christopher R. , Fardell Loren L. , Hills Nicole 
Published: December 2021

Abstract
An important but understudied modality for eavesdropping between predators and prey is olfaction, especially between non-mammalian vertebrate predators and their prey. Here we test three olfactory eavesdropping predictions involving an apex reptilian predator, the sand goanna Varanus gouldii, and several species of its small mammalian prey in arid central Australia: 1) small mammals will recognise and avoid the odour of V. gouldii; 2) V. gouldii will be attracted to the odour of small mammals, especially of species that maximise its energetic returns; and 3) small mammals will be less mobile and will show higher burrow fidelity where V. gouldii is absent compared with where it is present. As expected, we found that small mammals recognised and avoided faecal odour of this goanna, feeding less intensively at food patches where the odour of V. gouldii was present than at patches with no odour or a pungency control odour. Varanus gouldii also was attracted to the odour of small mammals in artificial burrows, and dug more frequently at burrows containing the odour of species that were energetically profitable than at those of species likely to yield diminished returns. Our third prediction received mixed support. Rates of movement of three species of small mammals were no different where V. gouldii was present or absent, but burrow fidelity in two of these species increased as expected where V. gouldii had been removed. We conclude that olfaction plays a key role in the dynamic interaction between V. gouldii and its mammalian prey, with the interactants using olfaction to balance their respective costs of foraging and reducing predation risk. We speculate that the risk of predation from this apex reptilian predator drives the highly unusual burrow-shifting behaviour that characterises many of Australia's small desert mammals.
An Integrative Multi-Omics Analysis Based On Liquid-liquid Phase Separation Delineates Distinct Subtypes of Lower-Grade Glioma and Identifies a Prognostic Signature
Authors: Zheng Jianglin , Wu Zhipeng , Qiu Yue , Wang Xuan , Jiang Xiaobing 
Published: December 2021

Abstract
Background: Emerging evidences have indicated that the aberrant liquid-liquid phase separation (LLPS) leads to the dysfunction of biomolecular condensates, thereby contributing to the tumorigenesis and progression. Nevertheless, it remains unclear whether or how the LLPS of specific molecules affects the prognosis and tumor immune microenvironment (TIME) of patients with lower-grade glioma (LGG).Methods: We integrated the transcriptome information of 3585 LLPS-related genes to comprehensively evaluate the LLPS patterns of 423 patients with LGG in The Cancer Genome Atlas (TCGA) cohort. Then, we systematically demonstrated the differences among four LLPS subtypes based on multi-omics analyses. In addition, we constructed the LLPS-related prognostic risk score (LPRS) for individualized integrative assessment. Results: Based on the expression profiles of 85 scaffolds, 355 regulators, and 3145 clients in LGG, we identified four LLPS subtypes, namely LS1, LS2, LS3 and LS4. We confirmed that there were significant differences in prognosis, clinicopathological features, cancer hallmarks, genomic alterations, TIME patterns and immunotherapeutic responses among four LLPS subtypes. In addition, a prognostic signature called LPRS was constructed for individualized integrative assessment. LPRS exhibited a robust predictive capacity for prognosis of LGG patients in multiple cohorts. Moreover, LPRS was found to be correlated with clinicopathological features, cancer hallmarks, genomic alterations and TIME patterns of LGG patients. The predictive power of LPRS in response to immune checkpoint inhibitor (ICI) therapy was also prominent.Conclusions: This study provided a novel classification of LGG patients based on LLPS. The constructed LPRS might facilitate individualized prognosis prediction and better immunotherapy options for LGG patients.
Flow Indices Variability in Humid Subtropical of Upper Awash River Basin, Ethiopia
Authors: Tola Sintayehu Yadete , Shetty Amba 
Published: December 2021

Abstract
Investigating the hydrological extremes indices at high resolutions describing the whole stream spectrum is essential for the comprehensive assessment of watershed hydrology. The study focuses on a wide-ranging assessment of river discharge in annual mean, peak, and high and low percentiles flow at the Upper Awash River basin, Ethiopia. Statistical tests such as coefficient of variation, flood variability to characterize the flow regime and Tukey’s test to detect decadal variability. Modified Mann-Kendall test, Sen’s slope estimator, innovative trend analysis and Pettitt’s test were applied to see trends, and change points in time series, respectively. Results showed that the basin was characterized by moderate to high variability. Spatially, main tributaries showed a higher variability, almost in all-time step and characterized by higher flood variability. The large discharge receiving rivers resulted in a moderate to high and lower discharge variability. Test statistics resulted in a positive increasing trend dominating most time scales at a 5% significant level and higher magnitude of slope trend in peak flow. A negative trends were also exhibited. Hombole main outlet site experienced decreasing trend in high percentile flow. In comparison, complete trend direction agreements were observed (except in few series). Flow indices showed an upward shift and downward shift mainly in the year 2000s and the significant decadal variation resulted in comparable with change points. The study provides an understanding of water resources variability, which will be necessary to apply operational water resources strategies and management to restrain the potential impacts of variability nature of the streamflow.
Melanoma Detection by AFM Indentation of Histological Specimens
Authors: Jeon ByoungJun , Jung Hyo Gi , Lee Sang Won , Lee Gyudo , Shim Jung Hee , Kim Mi Ok , Kim Byung Jun , Kim Sang-Hyon , Lee Hyungbeen , Lee Sang Woo , Yoon Dae Sung , Jo Seong Jin , Choi Tae Hyun , Lee Wonseok 
Published: December 2021

Abstract
Melanoma is visible unlike other types of cancer, but it is still challenging to diagnose correctly because of the difficulty in distinguishing between benign nevus and melanoma. We conducted a robust investigation of melanoma, identifying considerable differences in local elastic properties between nevus and melanoma tissues by using atomic force microscopy (AFM) indentation of histological specimens. Specifically, the histograms of the elasticity of melanoma displayed multimodal Gaussian distributions, exhibiting the heterogeneous mechanical properties, in contrast with the unimodal distributions of elasticity in the benign nevus. We identified this notable signature was consistent regardless of blotch incidence by sex, age, anatomical site (e.g., thigh, calf, arm, eyelid, and cheek), or cancer stage (I, IV, and V). In addition, we found that the non-linearity of the force-distance curves for melanoma is increased compared to benign nevus. We believe that AFM indentation of histological specimens may technically complement conventional histopathological analysis for earlier and more precise melanoma detection.
High Tibial Osteotomy versus Unicompartmental Knee Arthroplasty for Compartmental Knee Osteoarthritis: A Systematic Review and Meta-Analysis
Authors: Seth Ishith , Seth Nimish , Bulloch Gabriella , Gibson Damien , Lower Kirk , Rodwell Aaron , Bruce Warwick 
Published: December 2021

Abstract
Purpose High tibial osteotomy (HTO) and unicompartmental knee arthroplasty (UKA) are commonly performed procedures for the treatment of compartmental knee osteoarthritis. However, the optimal procedure remains controversial. Therefore, we conducted this systematic review and meta-analysis to compare the functional outcomes, complications, and revision between the two techniques.Methods We searched electronic databases for relevant studies comparing HTO versus UKA for unicompartmental knee osteoarthritis. Continuous data as visual analogue scale (VAS), range of motion, and free walking speed were pooled as mean differences (MDs). Dichotomous data as functional knee outcomes, complications, and revision were pooled as odds ratios (ORs), with 95% confidence interval (CI), using R software for windows.Results Twenty-five studies involving 8185 patients were included. Meta-analysis showed that HTO was associated with higher risk of complications (OR= 2.47, 95% CI [1.52, 4.04]), poor functional results (excellent/good) (OR= 0.32, 95% CI [0.21, 0.49]), and larger range of motion (MD= 7.05, 95% CI [2.41, 11.68]) compared to UKA. No significant differences were found between the compared groups in terms of VAS (MD= 0.14, 95% CI [-0.08, 0.36]), revision (OR= 1.30, 95% CI [0.65, 2.60]), and free walking speed (MD= -0.05, 95% CI [-0.11, 0.00]).Conclusion This study showed that UKA achieved fewer complications, better functional outcomes, and less range of motion compared to HTO. No significant differences were detected between HTO and UKA in terms of VAS and revision rate.