bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association Between Health Insurance and Race With Mortality From Trauma: a Retrospective Study
Authors: Gwarzo Ibrahim , Perez-Patron Maria , Xu Xiaohui , Radcliff Tiffany , Horney Jennifer 
Published: May 2021

Abstract
Background: The population health implications of the growing burden of trauma-related mortality may be influenced by access to health insurance coverage, and demographic characteristics such as race and ethnicity. We investigated the effects of health insurance status and race/ethnicity on the risk of mortality among trauma victims in Texas.Methods: Using Texas trauma registry data from 2014 - 2016, we categorized health insurance coverage into private, public, and uninsured, and categorized patients with serious injuries into Non-Hispanic Whites, Non-Hispanic Blacks, Hispanics Any-Race, and Others. Multivariate logistic regression was used to estimate the effects of health insurance status and race/ethnicity on mortality, controlling for age, gender, severity of the trauma, cause of trauma, presence of comorbid conditions, trauma center designation, presence of a traumatic brain injury (TBI), and severity of a TBI. Results: From January 1, 2014, to December 31, 2016, there were 415,159 trauma cases in Texas; 8,827 (2.1%) were fatal. Among patients with at least a moderate injury, 24, 606 (17.4%) were uninsured, and 98, 237 (69.4%) identified as Non-Hispanic White. In the multivariate analysis, Hispanics of any race and Non-Hispanic Blacks had higher adjusted odds of trauma mortality compared to Non-Hispanic Whites [ORHispanics= 1.25: 95% CI (1.16 – 1.36)] [ORBlacks= 2.11: 95% CI (1.87 – 2.37)]. Similarly, compared to privately insured, uninsured patients had 86% higher odds of trauma-related death [OR= 1.86: 95% CI (1.66 – 2.05)]. The effects of lack of health insurance on trauma mortality varied across race/ethnicity of the victims; uninsured Non-Hispanic Blacks had disproportionately higher adjusted odds of trauma mortality than uninsured Whites. Conclusion: Using Texas trauma registry data, we found significant disparities in trauma-related mortality risk based on race/ethnicity and health insurance coverage. The identification of trauma mortality inequalities could inform the design and implementation of future public health interventions.
Adipogenic Differentiation Was Inhibited by Downregulation of PPARγ Signaling Pathway in Aging Tendon Stem/ Progenitor Cells
Authors: Lai Fan , Wang Jingjing , Tang Hong , Bian Xuting , Lu Kang , He Gang , Huang Pan , Liu Juan , Zhou Mei , Liu Jian , Tao Xu , Tang Kang-lai 
Published: May 2021

Abstract
Background: Tendon stem/progenitor cells (TSPCs) play a vital role in tendon repair and regeneration. Previously we found more adipocytes accumulated in the patellar tendon injury sites in aging rats compared with the young ones, of which the mechanism is still unknown. Here we want to identify whether erroneous differentiation of TSPCs by aging accounts for the adipocyte accumulation. Methods: TSPCs from young and aging rats were isolated and propagated. Both young and aging TSPCs were induced to differentiate into adipocytes, and Oil red O staining, quantitative real-time polymerase chain reaction(qRT-PCR), western-blot and immunofluorescent staining were used to evaluate the capability of TSPCs. RNA sequencing was utilized to screen out different genes and signaling pathways related to adipogenesis between young and aging TSPCs. Results: The Oil red O staining showed there were more adipocytes formed in young TSPCs. Besides, adipogenic markers perilipin, peroxisome proliferator-activated receptor γ(PPARγ), CCAAT/enhancer-binding proteins alpha (C/EBPα) and Fatty acid-binding protein 4(FABP4) were elevated both at gene and protein level. PPARγ signaling pathway was selected as our target via RNA sequencing. After adding the signaling activators, Rosiglitazone maleate (RM), inhibited adipogenesis of aging TSCs was reversed. Conclusions: In conclusion, aging inhibited adipogenesis of TSPCs by down‐regulating PPARγ signaling. It is not likely that the adipocyte accumulation in aging tendon during repair was due to the aging of TSPCs. This may provide new targets for curing aging tendon injuries or tendinopathies.
MRI Assessment of Degeneration of Multifidus and Erector Spinae Muscles in Patients With Chronic Low Back Pain
Authors: Yazici Alikemal , Yerlikaya Tuba , Oniz Adile 
Published: May 2021

Abstract
Background: The aim of this study was to investigate the degeneration of lumbar musculus multifidus (L.MF) and lumbar musculus erector spinae (L.ES) muscles in healthy individuals and patients with mechanical low back pain and lumbar discopathy without root compression (radiculopathy), and to examine the relationship between low back pain by comparing the results according to gender, pain and lumbar segments between the groups. Methods: The study included 30 healthy individuals (Group 1), 30 patients with mechanical low back pain (Group 2) and 30 patients with lumbar discopathy without root compression (radiculopathy) (Group 3). Pain severity was evaluated using a Visual Analogue Scale (VAS). Right and left L.MF and L.ES cross-sectional areas (CSA), total cross-sectional areas (TCSA =L.MF+L.ES), fat infiltrations, and asymmetries between the right and left sides were evaluated. L.MF and L.ES muscles CSA and TCSA, fat infiltrations, asymmetries between the right and left sides were evaluated in the patients at the L3-S1 level, in axial Magnetic Resonance Imaging.Results: The mean value of the CSA differed between the groups only in the right L.MF and in the healthy group (p=0.011). No statistically significant difference was observed between the TCSA values of the groups, but a significant difference was found between the groups in terms of fat infiltration in right and left L.MF and left L.ES (p=0.011, p=0.001, p=0.027, respectively). When CSA and TCSA were examined according to gender within the group, the values were found to be significantly higher in males (p<0.001). The CSA and TCSA values ​​of L.MF and L.ES differed between segments (L3-L4, L4-L5, L5-S1) (p<0.001). There was no asymmetry between the right/left CSA and TCSA of the groups. Fat infiltration differed according to gender (p=0.001) and segments (p<0.001).Conclusion: Fat infiltration in the lumbar multifidus muscle was associated with mechanical low back pain and lumbar discopathy. The fact that there was no difference between the cross-sectional area and the total cross-sectional area between the groups indicates the need to measure the FCSA or muscle atrophy due to fat infiltration in the evaluation of muscle mass, rather than CSA and TCSA.
Radiotherapy Increases Major Complications and Complication-related Reconstruction Failures in Patients with Implant-based Breast Reconstruction
Authors: Li Zhang , Wang Xuanyi , Jin Kairui , Yang Zhaozhi , Wang Junqi , Shi Wei , Mei Xin , Chen Xingxing , Wang Xiaofang , Meng Jin , Ma Jinli , Wu Jiong , Shao Zhimin , Zhang Zhen , Yu Xiaoli , Guo Xiaomao 
Published: May 2021

Abstract
Purpose This study was designed to assess the impact of post-mastectomy radiation therapy (PMRT) on reconstruction complications and failures in patients undergoing mastectomy and different types of breast reconstruction.Methods We retrospectively identified 832 breast cancer patients who underwent mastectomy and breast reconstruction at Fudan University Shanghai Cancer Center between June 2001 and December 2015. Of these, 159 patients received PMRT, and 673 patients did not receive PMRT. The endpoints of the reconstruction outcomes included any complications, major complications, overall reconstruction failures and complication-related reconstruction failures. Multivariate analysis was applied to identify independent predictors of reconstruction outcomes in patients with different types of breast reconstruction. The nomogram model was built on the basis of the multivariate analysis to predict complication-related reconstruction failures.Results The median follow-up time was 58.5 months. Of all 832 patients, 394 patients received implant-based reconstruction, and 438 patients received autologous reconstruction. For patients with implant-based reconstruction, multivariate analysis showed that PMRT was associated with 3.16 times (95% CI 1.17-8.54, p=0.023) higher odds of major complications and 3.22 times (95% CI 1.01-10.20, p=0.047) higher odds of complication-related reconstruction failures but was not associated with any complications (OR 1.73, 95% CI 0.88-3.38, p=0.113) or overall reconstruction failures (OR 2.09, 95% CI 0.76-5.73, p=0.152). The nomogram model for implant-based reconstruction showed good predictive performance for complication-related reconstruction failures (AUC =0.714).Conclusions PMRT appears to be associated with an increased risk of major complications and complication-related reconstruction failures in patients with implant-based reconstruction.
Leucine-rich repeats and immunoglobulin-like domains protein 1 (LRIG1) is downregulated in Invasive ductal carcinoma: a potential prognostic marker of breast cancer
Authors: Piracha Zahra Zahid , Saeed Umar 
Published: May 2021

Abstract
LRIG1 (leucine-rich repeat and immunoglobulin-like domain containing), belongs to LRIG family of transmembrane proteins containing leucine rich repeats. LRIGs are considered as tumor suppressor as they negatively regulate receptor tyrosine kinases. The role of LRIG1 as an EGFR regulator makes it an important marker to be studied in various epithelial-derived cancers. LRIG1 expression was low in Erbb2+ cell lines and more cell motility were observed. AKT/GSK3-β/β-catenin pathway was activated when LRIG1 was downregulated and consequently, Erbb2 was upregulated. So far, no study has reported the expression of LRIG1 in benign forms of tumor such as fibroadenoma. Current study aims to analyze LRIG1 expression in fibroadenoma and Invasive ductal carcinoma (IDC) tissues. In this study, we compared the LRIG1 expression with different clinicopathological parameters of patients having IDC or fibroadenoma. Our results indicated that LRIG1 expression can be significantly correlated with age, Nottingham index and Her2/ neu status of cancer. The expression of LRIG1 in IDC and fibroadenoma were found to be significantly different. The fibroadenoma tissue sections were found to express LRIG1 more intensely as compared to the IDC sections which are in line with the studies reporting reduced copy number of the gene either due to gene deletion or transcriptional inhibition. This further lends supports to the previous studies showing that the down regulation of LRIG1 may lead to a more aggressive and malignant tumor thus acting as a tumor suppressor.
Eggs With Trilobite Larvae in a Cambrian Community. Modeling the Hydrodynamics
Authors: Lan Tian , Zhao Yuanlong , Esteve Jorge , Zhao Fangchen , Li Cong , Martinez Pedro 
Published: May 2021

Abstract
Background: Reproductive behaviors include mating, pregnancy, birth, and ulterior brood care. Fossil records (eggs, nests, etc.) provide a glimpse into the reproductive sequences of ancient animals. Here, we show putative trilobite egg clusters from the middle Cambrian (Miaolingian, Wuliuan Stage) that were found in the Kaili Formation, South China. The arrangement of these egg clusters would ensure efficient oxygen diffusion from the water into cells.Results: We applied a computational fluid mechanics simulation method to understand the behavior of Kaili trilobite eggs in Cambrian seawater under different flow patterns. The drag force and lift force load on the eggs increased rapidly when current speeds exceeded 0.2 m/s. Moreover, the drag coefficient of the single egg model was 1.8–2 times larger than that of each egg in the egg cluster model. The trilobite larva within the egg cluster (ca. 0.5 mm in size) are smaller than the eggs (ca. 0.6 mm), which indicates that they had recently hatched.Conclusions: We suggest that not all trilobites had an unmineralized preliminary stage in their ontogeny and that some protaspis shield may have been formed before hatching. Moreover, we hypothesize that aquatic animals can use egg clustering to effectively reduce the effects of drag and lift forces from the surrounding water.
Enhancement of Reputation Aggregation based Dynamic Trust Protocols for Edge Computing based E-Health Care System
Authors: Christo Mary Subaja , M Bommi R , P Anandaraj S , M Udhaya Sankar S , V Anbarasu , G Ramkumar 
Published: May 2021

Abstract
In recent years, E-services such as e-healthcare, e-learning, e-ticketing, depend on computer networks where the attackers have started introducing new types of attacks. Therefore, it is necessary to enhance security for communication which is needed for the transfer of confidential information relating to patients through the network. In our research we have developed a reputation aggregation based dynamic trust model for edge computing based E-health care systems. In this model, the edge node evaluates the trust value of a user and allows the user to access the E-health care system only when the trust value is satisfied. In order to do this, initially the user information is collected with the help of user agents and then this information is processed and the relevant data alone is sent to the edge nodes for evaluating the trust. Finally, the trusted users can be identified through edge nodes and they are only given the permission to access the e-health care system. Attacks generated in the simulations are detected using the prevailing algorithms and also the suggested techniques. The simulation results of this work prove the ability of the proposed techniques which are used to detect the attacks accurately and to prevent them effectively.
Pre-hospital Management in Trauma Patients: a Comparison Between Austria and Germany
Authors: Kanovsky Amelie , Deininger Christian , Wichlas Florian , Traweger Andreas , Lefering Rolf , Mueller Ernst J. 
Published: May 2021

Abstract
ObjectivesTo compare the pre-hospital treatment and intervention regimen for major trauma patients with comparable injury patterns between Austria (AUT) and Germany (GER). Patients and MethodsThis analysis is based on data retrieved from the TraumaRegister DGU®. Data included severely injured trauma patients with an Injury Severity Score (ISS) ≥ 16, an age ≥ 16, and who were primary admitted to an Austrian (n=4.186) or German (n=41.670) Level I Trauma Center from 2008 to 2017. Endpoints included pre-hospital times and interventions performed until final hospital admission. The analyzed data include patients’ demographics, mode of transportation, pre-hospital time management, hemodynamic stability, and various pre-hospital interventions.ResultsThe cumulative time for transportation from the site of accident to the hospital did not significantly differ between the countries (62 min. in AUT, 65 min. in GER). Overall, 53% of all trauma patients in AUT were transported to the hospital with a helicopter compared to 37% in GER (P<0.001). The rate of intubation - 48% in both countries, the number of chest tubes placed (5.7% GER, 4.9% AUT), and the frequency of administered catecholamines (13.4% GER, 12.3% AUT) was comparable (Φ=0.00). Hemodynamic instability upon arrival in the TC was higher in AUT, (20.6% vs. 14.7% in GER; P<0.001). A median of 500mL of fluid was administered in AUT, whereas in GER 1000mL were infused (P<0.001). Patient demographics did not reveal a relationship (Φ=0.00) and the majority of patients sustained a blunt trauma (96%). ConclusionA significant higher number of Helicopter EMS transports (HEMS) were carried out in AUT. This can be explained by the overall lack of a unified transport algorithm. The authors suggest implementing an international guideline to explicitly use the HEMS system for trauma patients only a) for the rescue/care of people who have had an accident or are in life-threatening situations, b) for the transport of emergency patients with ISS>16, c) for transport of rescue personnel to hard-to-reach regions or, d) for the transport of medicinal products. Further, the amount of administered fluid in the pre-clinical setting should follow the concept of permissive hypotension/ hypotensive resuscitation, however the data are still inconclusive and mandate further research.
Injury protection strategies for H63D syndrome patients suffering from cataplexy
Authors: Adams Jacob S , Seideman David , Honda Riku , Smith Lucas , Diamandis Carolina 
Published: May 2021

Abstract
Patients suffering from H63D syndrome have a significant incidence of narcolepsy with cataplexy as a symptom. Previous studies have shown that the presence of narcolepsy with cataplexy in the context of H63D syndrome is a surrogate marker for structural brain damage. Now, the aim was to clarify which measures best protect affected patients with cataplexy from injury.
Effects of information and communication technology use in nursing and obstetric learning in low- and middle-income countries: a systematic review
Authors: Pilabré Arzouma Hermann , Ngangué Patrice , Bationo Nestor , Tassembédo Issouf , Traoré Doulaye , Kinda Abel , Soubeiga Dieudonné 
Published: May 2021

Abstract
Background

The use of ICT in learning has become commonplace in higher education and, consequently, in nurses, midwives, and other health professionals worldwide. This use has become widespread and intensified since the advent of the COVID-19 pandemic. Despite growing evidence that e-learning has positive effects, studies on the effects of ICT use in nursing and midwifery learning in low- and middle-income countries are limited.
Objectives

This systematic review aims to identify and synthesize the effects of information and communication technologies utilization in nursing and obstetric learning in low- and middle-income countries.
Methods

A search of articles published from 2016 to 2020 on the effects of ICT use in nursing and obstetric learning was conducted in PubMed, CINAHL, Epistemonikos and ERIC using free and controlled vocabularies. All original articles meeting the predefined criteria were included. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols (PRISMA-P) guidelines, searches were performed among published and unpublished articles. Data were extracted and assessed for quality using the Mixed Methods Analysis Tool (MMAT).
Results

Of 483 articles identified, eleven were reviewed, and eight were found to be relevant. The included articles were synthesized into a narrative synthesis. The effects of using ICT in learning are related to student motivation, autonomy in learning, meaningful acquisition of knowledge and skills. Furthermore, students have a positive perception of the use of ICT in learning.
Conclusion

The results of this study on the use of ICTs in nursing and midwifery learning in low- and middle-income countries show that ICTs are used primarily as a medium for distance learning. In addition, it was found that e-learning has several advantages or positive effects. However, many students do not have a personal computer, and they have low or average skills in the use of computer tools, and access to the Internet is low. A limitation of this study is the lack of primary data on the effects of ICT use in midwifery learning in low- and middle-income countries.
Novel Mixed Ligand Complexes of Alkaline Earth Metal Cations Containing Nicotinamide and Diphenic Acid. Synthesis and Structural Properties
Authors: Yurdakul Omer , Köse Dursun Ali , Şahin Zarife Sibel , Şahin Onur 
Published: May 2021

Abstract
Mixed-ligand coordination compounds containing neutral nicotinamide and monoanionic diphenate organic molecules of alkaline earth metal cations, Mg2+ (I), Ca2+ (II), Sr2+ (III) and Ba2+ (IV) were synthesised. Chemical composition analysis, single crystal XRD, spectroscopic and thermal analysis methods were used to determine the structural properties of the compounds obtained. According to the data obtained from single-crystal XRD analysis of the Mg2+ complex, the coordination environment of the metal cation was surrounded by four aqua and two nicotinamide ligands to form a distorted octahedral geometry. The charge balance of the complex sphere was provided by two diphenate ligands placed mono-anionically outside the coordination sphere. The structure is a salt type complex. Since crystals suitable for single crystal structure analysis of other metal cations complexes (II, III and IV) could not be formed, the structural properties were tried to be explained by chemical composition analysis, spectroscopic and thermal analysis methods. Accordingly, it is thought that the coordination circles of metal cations are octal and all ligands (two aqua, two neutral nicotinamide and two monoanionic-double-toothed diphenate) coordinate with the metal in the coordination sphere. The geometries of the complexes are thought to be of distorted cubic structure.
Synthesis of Silica/Hydroxyapatite Nanocomposite by Mechanochemical Method
Authors: Hannora Ahmed , Mostafa M. M. 
Published: May 2021

Abstract
Biocompatibility of Silica makes it a suitable material for biomedical applications. The main components of teeth and bones are calcium phosphate (CP). Hydroxyapatite (HA) is expected to be used in different fields not only in biomedical applications but also in agriculture as a fertilizer and pollution treatment. Various substitutions in the apatite lattice play a significant role in its properties. In the present work, Silica-50, 40, 30 and 25 mol.% Hydroxyapatite nanocomposites were prepared successfully by mechanochemical processing method. X-ray diffraction (XRD) and Fourier Transform Infrared (FT-IR) indicated that silica stimulates the HA decomposition to β-tricalcium phosphate (β-TCP). XRD of heat-treated compacted sample at 1200oC confirmed β-TCP and calcium phosphate silicate phases formation. Mechanical properties decreased with decreasing HA content. Electrochemical impedance spectroscopy (EIS) results revealed that pure HA possess the highest resistivity to corrosion, while the silica/HA samples showed lower corrosion resistance. The polarization resistance increases with HA content.
Preparation of EDTA modified cotton fiber iron complex and catalytic properties for aqueous Cr(VI) reduction and dye degradation
Authors: Wu Hongfang , Wang Peng , Wang Zongqian , Sun Yufang , Li Changlong , Dong Yongchun 
Published: May 2021

Abstract
Cotton fabric was modified with Na2EDTA using a hydrothermal method to introduce surface hydroxyl groups, and subsequent coordination of Fe(III) ions to produce an Na2EDTA modified cotton-fiber-Fe complex (Fe-EDTA-Cotton). After characterization by SEM and FTIR, Fe-EDTA-Cotton was used as a heterogeneous photocatalyst to reduce Cr(VI) and degrade Reactive Red 195 oxidatively, to evaluate its catalytic activity. The results indicated that high Na2EDTA and/or NaH2PO4 concentrations, and/or high hydrothermal temperature increased the carboxyl group content (QCOOH) of the cotton fiber; high Fe content and elevated temperature could enhance coordination. Fe-EDTA-Cotton had a significant photocatalytic function in reducing Cr(VI). Increasing the QFe value of the complex or stronger irradiation favored photocatalytic reduction of Cr(VI) species. Increasing the system's pH did not help the reduction reaction. Fe-EDTA-Cotton could also remove Cr(VI) and Reactive Red 195 simultaneously from aqueous solution, and showed strong photocatalytic capacity. The reduction or oxidation reaction could be regulated by changing Na2S2O8 concentration in the reaction system, which might provide a new way to treat wastewater containing organic pigments and Cr(VI) species.
Highlight
Hydrothermal process enhanced EDTA modification of cotton fabric EDTA-modified cotton fiber Fe complex was prepared Cr(VI) removal was improved by its synergistic effect Fe complexes can remove Cr (VI) and organic dyes from aqueous solution in one bath The work might provide a new way to purify the wastewater containing organic pigments and Cr (VI) species.