bluuebunny/crossref_metadata_2025_split huggingface dataset:
StrokeCog Markov Model: Projected Prevalent and Incident Cases of Stroke and Poststroke Cognitive Impairment to 2035 in Ireland
Authors: Sexton Eithne , Donnelly Nora-Ann , Merriman Niamh A. , Hickey Anne , Wren Maev-Ann , O’Flaherty Martin , Bandosz Piotr , Guzman-Castillo Maria , Williams David J. , Horgan Frances , Pender Niall , Feeney Joanne , de Looze Céline , Kenny Rose Anne , Kelly Peter , Bennett Kathleen 
Published: September 2021

Background and Purpose:
Cognitive impairment no dementia (CIND) and dementia are common stroke outcomes, with significant health and societal implications for aging populations. These outcomes are not included in current epidemiological models. We aimed to develop an epidemiological model to project incidence and prevalence of stroke, poststroke CIND and dementia, and life expectancy, in Ireland to 2035, informing policy and service planning.

Methods:
We developed a probabilistic Markov model (the StrokeCog model) applied to the Irish population aged 40 to 89 years to 2035. Data sources included official population and hospital-episode statistics, longitudinal cohort studies, and published estimates. Key assumptions were varied in sensitivity analysis. Results were externally validated against independent sources. The model tracks poststroke progression into health states characterized by no cognitive impairment, CIND, dementia, disability, stroke recurrence, and death.

Results:
We projected 69 051 people with prevalent stroke in Ireland in 2035 (22.0 per 1000 population [95% CI, 20.8–23.1]), with 25 274 (8.0 per 1000 population [95% CI, 7.1–9.0]) of those projected to have poststroke CIND, and 12 442 having poststroke dementia (4.0 per 1000 population [95% CI, 3.2–4.8]). We projected 8725 annual incident strokes in 2035 (2.8 per 1000 population [95% CI, 2.7–2.9]), with 3832 of these having CIND (1.2 per 1000 population [95% CI, 1.1–1.3]), and 1715 with dementia (0.5 per 1000 population [95% CI, 0.5–0.6]). Life expectancy for stroke survivors at age 50 was 23.4 years (95% CI, 22.3–24.5) for women and 20.7 (95% CI, 19.5–21.9) for men.

Conclusions:
This novel epidemiological model of stroke, poststroke CIND, and dementia draws on the best available evidence. Sensitivity analysis indicated that findings were robust to assumptions, and where there was uncertainty a conservative approach was taken. The StrokeCog model is a useful tool for service planning and cost-effectiveness analysis and is available for adaptation to other national contexts.
International Production Networks Are Overcoming COVID-19 Shocks:
Evidence from Japan's Machinery Trade
Authors: Ando Mitsuyo , Kimura Fukunari , Obashi Ayako 
Published: September 2021

Abstract
This paper investigates the impacts of COVID-19 on international production networks in machinery sectors by shedding light on negative supply shocks, negative demand shocks, and positive demand shocks. Specifically, we examined changes in trade in the trade-fall periods amid COVID-19 in 2020 using Japan's machinery trade at the most disaggregated level and decomposed them into two intensive margins (i.e., the quantity effect and the price effect) and two extensive margins (i.e., the entry effect and the exit effect). Our empirical results show that trade relationships for parts and components were robust even amid COVID-19 and that international production networks in machinery sectors were almost intact. They also demonstrate that COVID-19 brought positive demand shocks for specific products with special demand due to its nature in addition to negative supply shocks and negative demand shocks, which partially explains heterogeneous effects not only among sectors but also among products in the same sector. As of October 2020, Japan's machinery trade seems to have mostly recovered.
Molecular studies of Iranian populations support the morphology-based taxonomic separation of Medicago rigidula and M. rigiduloides
Authors: BAYAT MITRA , ASSADI MOSTAFA , SMALL ERNEST , MEHREGAN IRAJ 
Published: September 2021

A comprehensive study was undertaken to understand the genetic status and help to clarify the division of Medicago rigidula (largely European) and Medicago rigiduloides (largely Asian). Genetic diversity parameters collectively suggested a low genetic diversity (avg. Ho, 0.073; He, 0.374) accompanied by high population differentiation (avg. F, 0.832; Gst, 0.362). Structure analysis divided 71 individuals (14 Iranian populations) into two highly distinct genetic groups (K=2) with significant genetic homogeneity. It also indicated the strong effect of the selfing mating-system as the main reason for the genetic diversity status and population structure. The population grouping was strongly confirmed by various clustering methods. Populations from north and northwestern Iran made up a distinctive genetic group corresponding to M. rigidula while the second group corresponding to M. rigiduloides harboured the western and two of the northwestern populations. The outcomes of this study provide the first reliable molecular evidence supporting the M. rigidula-M. rigiduloides separation previously suggested by morphology.
Time scales of the Greenland Freshwater Anomaly in the Subpolar North Atlantic
Authors: Dukhovskoy D.S. , Yashayaev I. , Chassignet E.P. , Myers P.G. , Platov G. , Proshutinsky A. 
Published: September 2021

AbstractThe impact of increasing Greenland freshwater discharge on the subpolar North Atlantic (SPNA) remains unknown as there are uncertainties associated with the time scales of the Greenland freshwater anomaly (GFWA) in the SPNA. Results from numerical simulations tracking GFWA and an analytical approach are employed to estimate the response time suggesting a decadal time scale (13 years) required for the SPNA to adjust for increasing GFWA. Analytical solutions obtained for a long-lasting increase of freshwater discharge show a non-steady state response of the SPNA with increasing content of the GFWA. In contrast, solutions for a short-lived pulse of freshwater demonstrate different responses of the SPNA with a rapid increase of freshwater in the domain followed by an exponential decay after the pulse has passed. Derived theoretical relation between time scales show that residence time scales are time-dependent for a non-steady state case and asymptote the response time scale with time. Residence time of the GFWA deduced from Lagrangian experiments is close to and smaller than the response time, in agreement with the theory. The Lagrangian analysis shows dependence of the residence time on the entrance route of the GFWA and on the depth. The fraction of the GFWA exported through Davis Strait has limited impact on the interior basins, whereas the fraction entering the SPNA from the southwest Greenland shelf spreads into the interior regions. In both cases, the residence time of the GFWA increases with depth demonstrating long persistence of the freshwater anomaly in the subsurface layers.
A prognostic model (BATAP) with external validation for patients with transplant-associated thrombotic microangiopathy
Authors: Zhao Peng , Wu Ye-jun , He Yun , Chong Shan , Qu Qing-yuan , Deng Rui-xin , Sun Xiao-wan , Huang Qiu-sha , Liu Xiao , Zhu Xiao-lu , Wang Feng-rong , Zhang Yuan-yuan , Mo Xiao-dong , Han Wei , Wang Jing-zhi , Wang Yu , Chen Huan , Chen Yu-hong , Zhao Xiang-yu , Chang Ying-jun , Xu Lan-ping , Liu Kai-yan , Huang Xiao-jun , Zhang Xiao-hui 
Published: September 2021

Abstract
Transplant-associated thrombotic microangiopathy (TA-TMA) is a potentially life-threatening complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT). Information on markers for early prognostication remains limited, and no predictive tools for TA-TMA are available. We attempted to develop and validate a prognostic model for TA-TMA. A total of 507 patients who developed TA-TMA following allo-HSCT were retrospectively identified and separated into a derivation cohort and a validation cohort, according to the time of transplantation, to perform external temporal validation. Patient age (odds ratio [OR], 2.371; 95% confidence interval [CI], 1.264-4.445), anemia (OR, 2.836; 95% CI, 1.566-5.138), severe thrombocytopenia (OR, 3.871; 95% CI, 2.156-6.950), elevated total bilirubin (OR, 2.716; 95% CI, 1.489-4.955), and proteinuria (OR, 2.289; 95% CI, 1.257-4.168) were identified as independent prognostic factors for the 6-month outcome of TA-TMA. A risk score model termed BATAP (Bilirubin, Age, Thrombocytopenia, Anemia, Proteinuria) was constructed according to the regression coefficients. The validated c-statistic was 0.816 (95%, CI, 0.766-0.867) and 0.756 (95% CI, 0.696-0.817) for the internal and external validation, respectively. Calibration plots indicated that the model-predicted probabilities correlated well with the actual observed frequencies. This predictive model may facilitate the prognostication of TA-TMA and contribute to the early identification of high-risk patients.
Stability of alteplase for ultrasound-facilitated catheter-directed thrombolysis
Authors: Fanikos John , Marquis Kathleen , Buckley Leo , Tran Lena K. , McLaughlin Kevin , Golash Abby Jane , Campia Umberto , Piazza Gregory , Connors Jean M. , Goldhaber Samuel Z. 
Published: September 2021

Abstract
Ultrasound-facilitated catheter-directed thrombolysis is used with low-dose alteplase to treat pulmonary embolism. This reduces the risk of bleeding that accompanies systemic administration of higher alteplase doses. Some studies suggest that alteplase given over 2 to 6 hours is safe and effective, but there are few data to support the stability of alteplase under these conditions. Therefore, we undertook this in vitro study to determine the duration of alteplase stability. Alteplase was prepared in solutions of 8 mg in 100 mL, 6 mg in 150 mL, and 8 mg in 200 mL. Solutions were administered through the EkoSonic Endovascular System (with and without ultrasound) to simulate administration over 2, 4, and 6 hours. Alteplase was assessed with reversed-phase high-performance liquid chromatography (RP-HPLC). Assays were performed at time 0 and at 30-minute intervals during simulated infusion. An enzyme-linked immunosorbent assay was used to measure alteplase concentrations at time 0 and at 15-minute intervals during simulated infusion. By using RP-HPLC in the absence of ultrasound, the alteplase concentration remained within 1% of the original concentration through 120, 240, and 360 minutes of infusion. By using RP-HPLC for measurement, alteplase in the presence of ultrasound degraded steadily over time to ∼90% of its original amount in 120 minutes, ∼80% in 240 minutes, and ∼70% in 360 minutes. The remaining alteplase was available for enzymatic activity. Alteplase solutions of 0.04 and 0.08 mg/mL degraded steadily over time during simulated ultrasound-facilitated catheter-directed administration. Alteplase that did not degrade remained available for enzymatic activity.
Multisystem inflammatory syndrome in children (MIS-C): a mini-review
Authors: Giacalone Martina , Scheier Eric , Shavit Itai 
Published: September 2021

AbstractMultisystem inflammatory syndrome in children (MIS-C) is a novel, life-threatening hyperinflammatory condition that develops in children a few weeks after infection with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). This disease has created a diagnostic challenge due to overlap with Kawasaki disease (KD) and KD shock syndrome. The majority of patients with MIS-C present with the involvement of at least four organ systems, and all have evidence of a marked inflammatory state. Most patients show an increase in the level of at least four inflammatory markers (C-reactive protein, neutrophil count, ferritin, procalcitonin, fibrinogen, interleukin-6, and triglycerides). Therapy is primarily with immunomodulators, suggesting that the disease is driven by post-infectious immune dysregulation. Most patients, even those with severe cardiovascular involvement, recover without sequelae. Since coronary aneurysms have been reported, echocardiographic follow-up is needed.Further study is needed to create uniform diagnostic criteria, therapy, and follow-up protocols.
A big white dot after CPR
Authors: Kola Sushma , Ginsburg Alexander D. , Harper Laura , Walker Laura E. , Braksick Sherri , Wijdicks Eelco F. M. 
Published: September 2021

Abstract
Introduction
Patients may remain comatose after the resumption of spontaneous circulation with cardiopulmonary resuscitation. A primary neurologic event may precede a cardiac standstill.

Case report
We present a 33-year-old patient with successful resuscitation for pulseless electrical activity and a “normal computed tomography (CT) scan.” Further scrutiny showed a hyperdense basilar artery sign (‘big white dot’) that led to a CT angiogram confirming an embolus to the proximal basilar artery. His examination showed fixed and dilated midsize (mesencephalic) pupils and extensor posturing. Endovascular retrieval of the clot was successful, but there was a devastating ischemic injury to the brainstem.

Conclusion
This case reminds us to consider neurologic causes of cardiac arrest.
Mining microbe–disease interactions from literature via a transfer learning model
Authors: Wu Chengkun , Xiao Xinyi , Yang Canqun , Chen JinXiang , Yi Jiacai , Qiu Yanlong 
Published: September 2021

Abstract
Background
Interactions of microbes and diseases are of great importance for biomedical research. However, large-scale of microbe–disease interactions are hidden in the biomedical literature. The structured databases for microbe–disease interactions are in limited amounts. In this paper, we aim to construct a large-scale database for microbe–disease interactions automatically. We attained this goal via applying text mining methods based on a deep learning model with a moderate curation cost. We also built a user-friendly web interface that allows researchers to navigate and query required information.

Results
Firstly, we manually constructed a golden-standard corpus and a sliver-standard corpus (SSC) for microbe–disease interactions for curation. Moreover, we proposed a text mining framework for microbe–disease interaction extraction based on a pretrained model BERE. We applied named entity recognition tools to detect microbe and disease mentions from the free biomedical texts. After that, we fine-tuned the pretrained model BERE to recognize relations between targeted entities, which was originally built for drug–target interactions or drug–drug interactions. The introduction of SSC for model fine-tuning greatly improved detection performance for microbe–disease interactions, with an average reduction in error of approximately 10%. The MDIDB website offers data browsing, custom searching for specific diseases or microbes, and batch downloading.

Conclusions
Evaluation results demonstrate that our method outperform the baseline model (rule-based PKDE4J) with an average $$F_1$$

F
1

-score of 73.81%. For further validation, we randomly sampled nearly 1000 predicted interactions by our model, and manually checked the correctness of each interaction, which gives a 73% accuracy. The MDIDB webiste is freely avaliable throuth http://dbmdi.com/index/
Effects of the COVID-19 pandemic on trauma-related emergency medical service calls: a retrospective cohort study
Authors: Azbel Michael , Heinänen Mikko , Lääperi Mitja , Kuisma Markku 
Published: September 2021

Abstract
Background
The COVID-19 pandemic has had profound effects on the utilization of health care services, including Emergency Medical Services (EMS). Social distancing measures taken to prevent the spread of the disease have greatly affected the functioning of societies and reduced or halted many activities with a risk of injury. The aim of this study was to report the effects of lockdown measures on trauma-related EMS calls in the Finnish capital area.

Methods
We conducted a retrospective cohort study of all EMS calls in the Helsinki University Hospital (HUH) catchment area between 1 January and 31 July 2020. Calls were identified from the HUH EMS database. Calls were grouped into pre-lockdown, lockdown, and post-lockdown periods according to the restrictions set by the Finnish government and compared to the mean number of calls for the corresponding periods in 2018 and 2019. Statistical comparisons were performed using Mann-Whitney U-test for weekly numbers and percentages.

Results
During the study period there was a total of 70,705 EMS calls, of which 14,998 (21.2%) were related to trauma; 67,973 patients (median age 61.6 years; IQR 35.3–78.6) were met by EMS. There was no significant change in the weekly number of total or trauma-related EMS calls during the pre-lockdown period. During the lockdown period, the number of weekly total EMS calls was reduced by 12.2% (p = 0.001) and the number of trauma-related calls was reduced by 23.3% (p = 0.004). The weekly number of injured patients met by EMS while intoxicated with alcohol was reduced by 41.8% (p = 0.002). During the post-lockdown period, the number of total and trauma-related calls and the number of injured patients intoxicated by alcohol returned to previous years’ levels.

Conclusions
The COVID-19 pandemic and social distancing measures reduced the number of trauma-related EMS calls. Lockdown measures had an especially significant effect on the number of injured patients intoxicated by alcohol met by the EMS.

Trial registration
Not applicable.
The effect of COVID-19 on mental well-being in Switzerland: a cross-sectional survey of the adult Swiss general population
Authors: Diaz Hernandez Laura , Giezendanner Stéphanie , Fischer Roland , Zeller Andreas 
Published: September 2021

Abstract
Background
In addition to the threat of the COVID-19 pandemic to physical health, mental health is challenged by the emotional response to the situation and the official measures taken to stop the pandemic. This study aimed to assess the prevalence of impaired mental well-being due to COVID-19 and explore associated factors.

Methods
The study was an observational, population-based, nationwide, cross-sectional online survey of a representative sample of the general Swiss population performed between March and April 2020. Participants reported on mental well-being, self-isolation/quarantine, their risk for developing severe COVID-19, and their work situation. Multivariable logistic regression analyses assessed risk factors for impaired mental well-being due to the pandemic.

Results
Data from 1022 individuals were analysed. The median age was 44 years (range 18 to 78) and 49% were women. A third of respondents reported that the COVID-19 pandemic impaired their mental well-being and almost half reported specific mental health concerns. Impaired mental well-being was associated with having health problems (OR = 1.88, 95% CI: 1.29–2.74, vs no problems), being or living with someone at risk for severe COVID-19 (OR = 1.38, 95% CI: 1–1.9,), smoking (OR = 1.8, 95% CI: 1.24–2.61), living in urban residential environments (OR = 1.62, 95% CI: 1.13–2.32, vs rural), not being able to work due to closed workplace (OR = 1.66, 95% CI: 1.04–2.67), aged between 18 and 29 years old (OR = 1.99, 95% CI: 1.32–3.01, vs 45 to 59 years old), and living in a single household (living with someone, OR = 0.65, 95% CI: 0.44–0.97,vs single household). Overall, the most significant covariates of impaired mental well-being were specific mental health concerns: feeling depressed (OR = 7.21, 95% CI: 4.5–11.55), feeling less pleasure in doing things than before (OR = 6.28, 95% CI: 4.1–9.62), feeling anxious (OR = 6.13, 95% CI: 3.91–9.59) and feeling lonely (OR = 4.08, 95% CI: 2.53–6.58).

Conclusion
Impaired mental well-being can carry long-term consequences. We encourage policymakers to implement strategies to promote mental health during this pandemic situation. Special attention should be addressed to the youngest, those at risk for severe COVID-19 and those with government-imposed work restrictions.
Epidemiology and risk factors for pyogenic liver abscess in the Calgary Health Zone revisited: a population-based study
Authors: Losie Jennifer A. , Lam John C. , Gregson Daniel B. , Parkins Michael D. 
Published: September 2021

Abstract
Background
Pyogenic liver abscess (PLA), although uncommon in North America, is associated with significant morbidity and mortality. We sought to re-examine the epidemiology, risk factors, and outcomes of PLA in a large, diverse Canadian health zone.

Methods
All Calgary Health Zone (CHZ) residents aged ≥20 with PLA between 2015 and 2017 were identified. Incidence and mortality rates were calculated using census data. Risk factors for PLA were identified using a multivariate analysis. Data was compared to 1999–2003 data, also collected in the CHZ.

Results
There were 136 patients diagnosed with PLA between 2015 and 2017. Incidence rate during this period increased significantly relative to 1999–2003 (3.7 vs 2.3 cases/100,000 population, p < 0.01), however, mortality rates remained similar. The microbiological composition of PLA did not change over this 15-year time period but the number of antimicrobial resistant isolates did increase (8% vs 1%, p = 0.04). The greatest risk factors for PLA relative to general populations included current malignancy, liver-transplant, end-stage renal disease, and cirrhosis. Thirty-day mortality was 7.4% and independent risk factors included polymicrobial bacteremia, absence of abscess drainage, congestive-heart failure, a history of liver disease, and admission bilirubin.

Conclusions
Pyogenic liver abscess is a health concern with rising incidence rate. The increasing prevalence of comorbidities in our population and factors that are associated with risk of PLA suggests this will continue to be an emerging diagnosis of concern. Increasing prevalence of antibiotic resistant organisms compounding unclear optimal treatment regimens is an issue that requires urgent study.
Might life-threatening acute pulmonary edema occur after using recombinant tissue plasminogen activator? A case report
Authors: Chen Xue-Bing , Qu Dong , Zhang Qing , Yue Xia , Qiao Dong-Fang 
Published: September 2021

Abstract
Background
Recombinant tissue plasminogen activator (rt-pa) is the first-line drug for the treatment of acute ischemic stroke, and can lead to some complications.There were rare reports of death due to acute pulmonary edema during rt-pa thrombolysis treatment.

Case presentation
This study reports a 30-year-old man was diagnosed with acute ischemic stroke and underwent rt-pa thrombolytic therapy. Finally he died despite active rescue.

Conclusions
The autopsy revealed that he died of acute pulmonary edema. This case suggests that it is necessary to pay close attention to the changes of vital signs during thrombolysis and be aware of possibility of pulmonary edema during thrombolysis.