bluuebunny/crossref_metadata_2025_split huggingface dataset:
Approximation algorithm for rearrangement distances considering repeated genes and intergenic regions
Authors: Siqueira Gabriel , Alexandrino Alexsandro Oliveira , Oliveira Andre Rodrigues , Dias Zanoni 
Published: October 2021

AbstractThe rearrangement distance is a method to compare genomes of different species. Such distance is the number of rearrangement events necessary to transform one genome into another. Two commonly studied events are the transposition, which exchanges two consecutive blocks of the genome, and the reversal, which reverts a block of the genome. When dealing with such problems, seminal works represented genomes as sequences of genes without repetition. More realistic models started to consider gene repetition or the presence of intergenic regions, sequences of nucleotides between genes and in the extremities of the genome. This work explores the transposition and reversal events applied in a genome representation considering both gene repetition and intergenic regions. We define two problems called Minimum Common Intergenic String Partition and Reverse Minimum Common Intergenic String Partition. Using a relation with these two problems, we show a $$\Theta \left( k \right)$$

Θ

k

-approximation for the Intergenic Transposition Distance, the Intergenic Reversal Distance, and the Intergenic Reversal and Transposition Distance problems, where k is the maximum number of copies of a gene in the genomes. Our practical experiments on simulated genomes show that the use of partitions improves the estimates for the distances.
Periappendiceal fat-stranding models for discriminating between complicated and uncomplicated acute appendicitis: a diagnostic and validation study
Authors: Lin Hui-An , Tsai Hung-Wei , Chao Chun-Chieh , Lin Sheng-Feng 
Published: October 2021

Abstract
Background
Recent studies have reported promising outcomes of non-operative treatment for uncomplicated appendicitis; however, the preoperative prediction of complicated appendicitis is challenging. We developed models by incorporating fat stranding (FS), which is commonly observed in perforated appendicitis.

Material and methods
We reviewed the data of 402 consecutive patients with confirmed acute appendicitis from our prospective registry. Multivariate logistic regression was performed to select clinical and radiographic factors predicting complicated acute appendicitis in our model 1 (involving backward elimination) and model 2 (involving stepwise selection). We compared c statistics among scoring systems developed by Bröker et al. (in J Surg Res 176(1):79–83. https://doi.org/10.1016/j.jss.2011.09.049, 2012), Imaoka et al. (in World J Emerg Surg 11(1):1–5, 2016), Khan et al. (in Cureus. https://doi.org/1010.7759/cureus.4765, 2019), Kim et al. (in Ann Coloproctol 31(5):192, 2015), Kang et al. (in Medicine 98(23): e15768, 2019), Atema et al. (in Br J Surg 102(8):979–990. https://doi.org/10.1002/bjs.9835, 2015), Avanesov et al. (in Eur Radiol 28(9):3601–3610, 2018), and Kim et al. (in Abdom Radiol 46:1–12, 2020). Finally, we examined our models by performing the integrated discrimination improvement (IDI) test.

Results
Among enrolled patients, 64 (15.9%) had complicated acute appendicitis. We developed new 10-point scoring models by including the following variables: C-reactive protein, neutrophil to lymphocyte ratio, and computed tomography features of FS, ascites, and appendicolith. A cutoff score of ≥ 6 exhibited a high sensitivity of 82.8% and a specificity of 82.8% for model 1 and 81.3% and 82.3% for model 2, respectively, with c statistics of 0.878 (model 1) and 0.879 (model 2). Compared with the model developed by Bröker et al. which included C-reactive protein and the abdominal pain duration (c statistic: 0.778), the models developed by Atema et al. (c statistic: 0.826, IDI: 5.92%, P = 0.0248), H.Y Kim et al. (c statistics: 0.838, IDI: 13.82%, P = 0.0248), and our two models (IDI: 18.29%, P < 0.0001) demonstrated a significantly higher diagnostic accuracy.

Conclusion
Our models and the scoring systems developed by Atema et al. and Kim et al. were validated to have a high diagnostic accuracy; moreover, our models included the lowest number of variables.
Additional nerve blocks are not superior to multiple-site infiltration analgesia in total knee arthroplasty under adductor canal block
Authors: Li Qianhao , Hu Qinsheng , Alqwbani Mohammed , Li Donghai , Yang Zhouyuan , Wang Qiuru , Kang Pengde 
Published: October 2021

Abstract
Background
Adductor canal block (ACB) with additional nerve blocks (ANBs) is reported to provide adequate analgesia and enhanced functional rehabilitation in total knee arthroplasty (TKA). The present study aims to evaluate whether ANBs are superior to multiple-site infiltration analgesia (MIA) in patients undergoing TKA under ACB.

Methods
We enrolled 530 patients undergoing primary TKA from 2015 to 2019 at our institution in this retrospective cohort study. Patients were divided into two groups: Group A was treated with ANBs + ACB; Group B was treated with MIA + ACB. Primary outcomes were pain scores and morphine consumption. Functional recovery was the secondary outcome. Other outcomes included satisfaction score, cost-effectiveness, adverse events, and length of hospital stay (LOS).

Results
Pain scores at rest and morphine consumption were slightly lower in the ANBs + ACB group than in the MIA + ACB group. No significant difference was found in functional recovery, post-operative complications or LOS between the groups. Meanwhile, the cost of analgesic intervention in the MIA + ACB group was less than that in the ANBs + ACB group.

Conclusion
The present study suggests that ANBs do not provide superior pain relief compared to MIA for patients undergoing TKA under ACB.

Trial registration
Chinese Clinical Trial Registry, ChiCTR2100043227. Registered 9 February 2021, https://www.chictr.org.cn/showproj.aspx?proj=121745.
Hepatobiliary disease in XLMTM: a common comorbidity with potential impact on treatment strategies
Authors: D’Amico Adele , Longo Antonella , Fattori Fabiana , Tosi Michele , Bosco Luca , Chiarini Testa Maria Beatrice , Paglietti Maria Giovanna , Cherchi Claudio , Carlesi Adelina , Mizzoni Irene , Bertini Enrico 
Published: October 2021

Abstract
Background
X-linked myotubular myopathy (XLMTM) is a rare congenital myopathy resulting from pathogenic variants in the MTM1 gene. Affected male subjects typically present with severe hypotonia and respiratory distress at birth and they often require intensive supportive care. Long-term survivors are often non-ambulant, ventilator and feeding tube–dependent and they generally show additional organ manifestations, indicating that myotubularin does play a vital role in tissues other than muscle. For XLMTM several therapeutic strategies are under investigation. For XLMTM several therapeutic strategies are under investigation including a study of intravenous MTM1 gene transfer using a recombinant AAV8 vector of which has some concerns arises due to hepatotoxicity.

Results
We report prospective and retrospective clinical data of 12 XLMTM patients collected over a period of up to 10 years. In particular, we carried out a thorough review of the data about incidence and the course of hepatobiliary disease in our case series.

Conclusions
We demonstrate that hepatobiliary disease represents a common comorbidity of XLMTM that seems irrespective to age and diseases severity. We recommend to carefully explore and monitor the hepatobiliary function in XLMTM patients. We believe that a better understanding of the pathogenic mechanisms that induce hepatobiliary damage is essential to understand the fatal events that may occur in the gene therapy program.
Predictive power of extubation failure diagnosed by cough strength: a systematic review and meta-analysis
Authors: Duan Jun , Zhang Xiaofang , Song Jianping 
Published: October 2021

AbstractBackgroundThe predictive power of extubation failure diagnosed by cough strength varies by study. Here we summarise the diagnostic power of extubation failure tested by cough strength.MethodsA comprehensive online search was performed to select potentially eligible studies that evaluated the predictive power of extubation failure tested by cough strength. A manual search was also performed to identify additional studies. Data were extracted to calculate the pooled sensitivity, specificity, positive likelihood ratio (LR), negative LR, diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC) to evaluate the predictive power of extubation failure.ResultsA total of 34 studies involving 45 study arms were enrolled, and 7329 patients involving 8684 tests were analysed. In all, 23 study arms involving 3018 tests measured cough peak flow before extubation. The pooled extubation failure was 36.2% and 6.3% in patients with weak and strong cough assessed by cough peak flow, respectively. The pooled sensitivity, specificity, positive LR, negative LR, DOR, and AUC were 0.76 (95% confidence interval [CI]: 0.72–0.80), 0.75 (0.69–0.81), 2.89 (2.36–3.54), 0.37 (0.30–0.45), 8.91 (5.96–13.32), and 0.79 (0.75–0.82), respectively. Moreover, 22 study arms involving 5666 tests measured the semiquantitative cough strength score (SCSS) before extubation. The pooled extubation failure was 37.1% and 11.3%, respectively, in patients with weak and strong cough assessed by the SCSS. The pooled sensitivity, specificity, positive LR, negative LR, DOR, and AUC were 0.53 (95% CI: 0.41–0.64), 0.83 (0.74–0.89), 2.50 (1.93–3.25), 0.65 (0.56–0.76), 4.61 (3.03–7.01), and 0.74 (0.70–0.78), respectively.ConclusionsWeak cough is associated with increased extubation failure. Cough peak flow is superior to the SCSS for predicting extubation failure. However, both show moderate power for predicting extubation failure.
Comparison of a tube core and Magill forceps for nasotracheal intubation: a randomised controlled trial
Authors: Hu Rui , Niu Jing-Yi , Wu Li-Ning , Sun Hao , Sun Peng , Huang Jia-Ying , Yu Jun-Ma 
Published: October 2021

Abstract
Background
Magill forceps are frequently used to complete nasotracheal intubation (NTI). We aimed to identify a tube core that could conveniently facilitate the NTI process without using Magill forceps.

Methods
Sixty patients scheduled for oral and maxillofacial surgeries were enrolled in our study and divided into two groups (30 per group) with no differences with regard to demographic data. In the Magill forceps group (Group M), a wire-reinforced endotracheal catheter was inserted into the trachea using Magill forceps. However, in the tube core group (Group T), a tube core bent to the physiological curve of the nasal cavity and lubricated with aseptic paraffin oil was inserted into the endotracheal catheter and was then withdrawn after the endotracheal catheter was advanced through the glottis under direct vision.

Results
All NTIs were completed successfully, and Magill forceps were not used on any patient in Group T. There was a significant difference in total NTI time between the two groups (Group M, 59.7 (5.1) s vs Group T, 52.4 (3.1) s). Mild epistaxis was observed in 6 patients in Group M and 5 patients in Group T (6/30 vs 5/30, respectively). No damage to oral tissue or teeth was observed in either group.

Conclusions
We conclude that using a tube core, consisting of a disposable sterilised stylet, is a convenient choice for NTI.

Trial registration
Patient enrolment was conducted after registration in the Chinese Clinical Trial Registry (www.Chictr.org.cn, ChiCTR190002 7387). This trial was prospectively registered on 11 November 2019.
Bartonella spp. seroprevalence in tick-exposed Swedish patients with persistent symptoms
Authors: Edvinsson Marie , Norlander Camilla , Nilsson Kenneth , Mårtensson Andreas , Skoog Elisabet , Olsen Björn 
Published: October 2021

Abstract
Background
Bartonella spp. are emerging pathogens transmitted by arthropod vectors, possibly including ticks. We have investigated signs of bartonellosis in Swedish patients with presumed tick-bite exposure and symptom duration of at least 6 months.

Methods
Serological testing for Bartonella henselae and Bartonella quintana was performed in 224 patients. Symptoms, tick exposure, evidence of co-infection and previous treatments were evaluated. Seropositive patients were compared to a matched group (twofold larger and negative serology) from the same study cohort.

Results
Seroprevalence was 7% for B. henselae and 1% for B. quintana, with one patient testing positive to both agents. Tick bites were reported by 63% of the patients in the seropositive group and 88% in the seronegative group and presumed tick exposure was more common in the seronegative group. Animal contact was equally common in both groups, along with reported symptoms. The most common symptoms were fatigue, muscular symptoms, arthralgia and cognitive symptoms. Exposure to co-infections was evenly distributed in the seropositive and seronegative groups.

Conclusions
Antibodies to Bartonella were more common in this cohort of patients than in cohorts of healthy Swedish blood donors in previous studies but lower than those in blood donors from southern Europe. Positive Bartonella serology was not linked to any specific symptom, nor to (suspected) tick-bite exposure.

Graphical abstract
Radial BMD and serum CTX-I can predict the progression of carotid plaque in rheumatoid arthritis: a 3-year prospective cohort study
Authors: Han Seungwoo , Kim Na-Ri , Kang Jong-Wan , Eun Jung-Su , Kang Young-Mo 
Published: October 2021

Abstract
Objective
Patients with rheumatoid arthritis (RA) are almost twice as likely to develop cardiovascular disease (CVD) as those without. However, traditional CVD risks have been shown to underperform in RA patients; thus, we aimed to identify new surrogate risk factors to better reflect their atherosclerotic burden.

Methods
A total of 380 RA patients with carotid atherosclerosis data were analyzed in this prospective cohort study. The primary outcome was carotid plaque progression over the 3-year follow-up period. Risk parameters assessed for the progression of carotid plaque were categorized as demographics, traditional CVD risks, RA-related risks, and bone parameters.

Results
The progression of carotid plaque was associated with the level of rheumatoid factor (p = 0.025), serum C-terminal telopeptide of type-I collagen (CTX-I) (p = 0.014), and femur and distal radius bone mass density (BMD) (p = 0.007 and 0.004, respectively), as well as traditional CVD risk factors. In multivariable analyses, the bone parameters of serum CTX-I and distal radius BMD proved to be independent predictors of the progression of carotid plaque along with hyperlipidemia, smoking, and baseline carotid plaque (all, p < 0.05). Adding both serum CTX-I and distal radius BMD increased the carotid plaque progression prediction model’s percentage of explained variance from 24 to 30%.

Conclusion
High serum CTX-I and lower radius BMD, reflecting high bone turnover, were independent risk factors for the progression of carotid plaque in RA patients, implicating the direct or indirect role of bone metabolism on the atherosclerotic burden.
Regulatory T lymphocytes/Th17 lymphocytes imbalance in autism spectrum disorders: evidence from a meta-analysis
Authors: Ellul Pierre , Rosenzwajg Michelle , Peyre Hugo , Fourcade Gwladys , Mariotti-Ferrandiz Encarnita , Trebossen Vincent , Klatzmann David , Delorme Richard 
Published: October 2021

Abstract
Background
Immune system dysfunction has been proposed to play a critical role in the pathophysiology of autism spectrum disorders (ASD). Conflicting reports of lymphocyte subpopulation abnormalities have been described in numerous studies of patients with ASD. To better define lymphocytes abnormalities in ASD, we performed a meta-analysis of the lymphocyte profiles from subjects with ASD.

Methods
We used the PRISMA recommendations to query PubMed, Embase, PsychoINFO, BIOSIS, Science Direct, Cochrane CENTRAL, and Clinicaltrials.gov for terms related to clinical diagnosis of ASD and to lymphocytes’ populations. We selected studies exploring lymphocyte subpopulations in children with ASD. The search protocol has been registered in the international Prospective Register of Systematic Reviews (CRD42019121473).

Results
We selected 13 studies gathering 388 ASD patients and 326 healthy controls. A significant decrease in the CD4+ lymphocyte was found in ASD patients compared to controls [− 1.51 (95% CI − 2.99; − 0.04) p = 0.04] (I2 = 96% [95% CI 94.6, 97.7], p < 0.01). No significant difference was found for the CD8+ T, B and natural killer lymphocytes. Considering the CD4+ subpopulation, there was a significant decrease in regulatory T lymphocytes (Tregs) in ASD patients (n = 114) compared to controls (n = 107) [− 3.09 (95% CI − 4.41; − 1.76) p = 0.0001]; (I2 = 90.9%, [95% CI 76.2, 96.5], p < 0.0001) associated with an increase oin the Th17 lymphocytes (ASD; n = 147 controls; n = 128) [2.23 (95% CI 0.79; 3.66) p = 0,002] (I2 = 95.1% [95% CI 90.4, 97.5], p < 0.0001).

Limitations
Several factors inducing heterogeneity should be considered. First, differences in the staining method may be responsible for a part in the heterogeneity of results. Second, ASD population is also by itself heterogeneous, underlying the need of studying sub-groups that are more homogeneous.

Conclusion
Our meta-analysis indicates defects in CD4+ lymphocytes, specifically decrease oin Tregs and increase in Th17 in ASD patients and supports the development of targeted immunotherapies in the field of ASD.
Rationale for MYC imaging and targeting in pancreatic cancer
Authors: Schneider Günter , Wirth Matthias , Keller Ulrich , Saur Dieter 
Published: October 2021

AbstractThe incidence and lethality of pancreatic ductal adenocarcinoma (PDAC) will continue to increase in the next decade. For most patients, chemotherapeutic combination therapies remain the standard of care. The development and successful implementation of precision oncology in other gastrointestinal tumor entities point to opportunities also for PDAC. Therefore, markers linked to specific therapeutic responses and important subgroups of the disease are needed. The MYC oncogene is a relevant driver in PDAC and is linked to drug resistance and sensitivity. Here, we update recent insights into MYC biology in PDAC, summarize the connections between MYC and drug responses, and point to an opportunity to image MYC non-invasively. In sum, we propose MYC-associated biology as a basis for the development of concepts for precision oncology in PDAC.
Firm performance under financial constraints: evidence from sub-Saharan African countries
Authors: Abdisa Lamessa T. , Hawitibo Alemu L. 
Published: October 2021

AbstractThe business environment in which a firm operates has an important impact on firm performance. This study examined the impact of credit constraint and power outages on the firm’s investment decision using World Bank Enterprise Survey (WBES) data collected from firms operating in 13 sub-Saharan Africa (SSA) countries. The study employed a two-part model and the Heckman selection model to estimate the impact of lack of access to finance and poor power supply on a firm’s decision to invest in self-generation. The result obtained suggest that there is a negative correlation between credit constraint and a firm’s decision to invest in self-generation. This indicates that credit constraint negatively affects a firm’s decision to invest in self-generation and firms that are credit constrained have less incentive to invest in self-generation compared to those that are not credit constrained. To test the robustness of the result obtained, alternative definitions of credit constraints were used. Results from alternative regressions using different definitions of credit constraints show that credit constraint affects a firm’s decision to invest in self-generation but not the volume of investment.
Factorial experimentation on photodegradation of historical paper by polychromatic visible radiation
Authors: Liu Yun , Fearn Tom , Strlič Matija 
Published: October 2021

Abstract
Quantification of the degradation behaviour of heritage objects is essential to manage the rate of degradation and hence optimise their lifetime. In this research, a 23 full factorial experiment was carried out to deepen the understanding of the photodegradation of historical rag paper induced by continuous polychromatic visible radiation. Oxygen concentration, relative humidity and illuminance were investigated as the three environmental factors of primary concern. The effects of these factors on the rate constant of change in diffuse reflectance and tristimulus discolouration were investigated by analysis of variance and multiple linear regression. The three main effects were found to contribute the most to the rate of photodegradation of historical paper, among which relative humidity played the most important role whereas illuminance played the least. This observation is likely to hold when extrapolating the experimental conditions to real conditions in collection storage and display.
Investigation the determinants of pharmaceutical expenditure share of GDP in Iran and selected OECD countries
Authors: Kadkhodamanesh Azin , Varahrami Vida , Zarei Leila , Peiravian Farzad , Hadidi Mohammad , Yousefi Nazila 
Published: October 2021

Abstract
Aim
This study estimated the GDP share of pharmaceuticals in Iran based on the drivers of pharmaceutical expenditure and compared it with that of 31 members of the Organisation for Economic Cooperation and Development (OECD).

Subject and methods
The factors contributing to pharmaceutical expenditure were identified through literature review and studied by 8 experts to classify the factors. Then, using the panel data method, a model was built to estimate the GDP share of pharmaceutical expenditure based on the extracted factors of the selected countries in Iran’s model. To explain the observed differences, several regression analyses were performed based on cross-sectional data. The analyses were performed using EVIEWS software, version 10.

Results
The explanatory variables for the selected countries in the panel model (R2 = 0.98) were specified. Government health expenditure (β = 0.1432), the share of generic drugs (β = − 0.0143), gross domestic product (GDP) per capita (β = − 0.0058) and the rate of disability-adjusted life-years (DALY) (β = 0.0028) contributed most to pharmaceutical expenditure. In comparison, in the Iranian estimation model (R2 = 0.84), government health expenditure (β = 0.0536) and the share of generic drugs (β = 0.0369) had a significant impact on pharmaceutical expenditure. In the estimation model with more estimators for Iran (R2 = 0.99), government health expenditure (β = 0.1694), disease prevalence (β = 0.0537), the share of generic drugs (β = 0.0102), the DALY rate (β = 0.0039), GDP per capita (β = − 0.0033), and the drug price index (β = 0.0007) contribute most to pharmaceutical expenditure.

Conclusion
In the models of the study, factors related to the structure of the healthcare system and the pharmaceutical system contributed most to pharmaceutical expenditure as a share of GDP. Moreover, disease profiles show its predictive role in the second model for Iran.