bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dinitrogen Cleavage and Hydrogenation to Ammonia with a Uranium Complex
Authors: Maron Laurent , Xin Xiaoqing , Douair Iskander , Wang Shuao , Zhu Congqing , Zhao Yue 
Published: September 2021

Abstract
The Haber–Bosch process produces ammonia (NH3) from dinitrogen (N2) and dihydrogen (H2), but requires high temperature and pressure. Before iron-based catalysts were exploited in the current industrial Haber–Bosch process, uranium-based materials were used as effective catalysts for production of NH3 from N2. Although some molecular uranium complexes are capable of combining and even reducing N2, however, further hydrogenation with H2 to NH3 has not yet been reported. Here, we report the first example of N2 cleavage and hydrogenation with H2 to NH3 with a molecular uranium complex. The N2 cleavage product contains three uranium centers that are bridged by three imido μ2-NH ligands and one nitrido μ3-N ligand. Labeling experiments with 15N demonstrate that the nitrido ligand in the product originates from N2. Reaction of the N2-cleaved complex with H2 or H+ forms NH3 under mild conditions. A synthetic cycle has been established by the reaction of the N2-cleaved complex with TMSCl. The isolation of this trinuclear imido-nitrido product implies that a multimetallic uranium assembly plays an important role in the activation of N2.
Ten-Year Trends of Adult Trauma Patients in Denmark from 2010 to 2019: A Retrospective Cohort Study
Authors: Trier Frederik , Fjølner Jesper , Raaber Nikolaj , Sørensen Anders Høyer , Søndergaard Rasmus , Kirkegaard Hans 
Published: September 2021

Abstract
Background: Trauma causes a considerable economic and societal burden and the trauma patient population and its prognosis changes over time. The aim of this study is to analyze ten-year trends of trauma patients at a major trauma center in Denmark. Methods: 5366 patients aged ≥ 16 years with Injury Severity Score (ISS) > 0 admitted by trauma team activation at Aarhus University Hospital Trauma Center between January 1, 2010 and December 31, 2019 were included. Descriptive statistics, incidence rate calculation, parametric and non-parametric test were used. An annual percent change with 95% confidence interval was used to estimate trend in mechanism of injuries. Multiple logistic regression with mortality as outcome were adjusted for age, sex and ISS. Results: The median age increased from 37 in 2010 to 49 in 2019 and the proportion of patients aged ≥ 65 doubled. The incidence of minor injuries (ISS 1-15) decreased from 181.3/105 inhabitants in 2010 to 112.7/105 in 2019 corresponding to an incidence rate ratio between 2019 and 2010 of 0.62 (95% CI: 0.54 to 0.72). Severe injuries (ISS > 15) increased from 10.1/105 inhabitants in 2010 to 13.6/105 in 2019 corresponding to an incidence rate ratio between 2019 and 2010 of 1.35 (95% CI: 1.04 to 1.76). The proportion of patients with ISS > 15 increased from 18.1% in 2010 to 31.1% in 2019. Multivariable logistic regression showed lower 30-day mortality for all trauma patients with ISS > 0 over the study period when adjusting for age, sex and ISS (Odds ratio: 0.94, 95% CI: 0.90 to 0.99). The 30-day mortality for severely injured patients with ISS > 15 decreased during the study period when adjusting for age, sex and ISS (Odds ratio: 0.92, 95% CI: 0.87 to 0.97). Fall injuries increased with an annual percent change of 4.1% (95% CI: 2.3% to 6.1%). Conclusions: Ten-year trends of trauma patients in Central Denmark Region show an increasing median age, injury severity and number of fall injuries. The 30-day mortality of trauma patients decreased for both minor injuries and severe injuries when adjusting for age, sex and injury severity. Trial registration: Not applicable.
Salinity reduces coastal marsh respiration more than photosynthesis
Authors: Kominoski John , Neubauer Scott , Bremen Ryan , Camacho Antonio , Camacho-Santamans Alba , Charles Sean , Cherry Julia , Gaiser Evelyn , Gedan Keryn , Helton Ashley , Herbert Ellen , Ishtiaq Khandker , Kirwan Matthew , Krauss Ken , Lamb-Wotton Lukas , Morant Daniel , Noe Gregory , Osland Michael , Solohin Elena , Troxler Tiffany , Tully Kate , Wilson Benjamin 
Published: September 2021

Abstract
A paradigm in carbon cycling science predicts that sea-level rise will enhance carbon accumulation in an apparent negative carbon-climate feedback1,2. However, ecosystems exposed to combinations of stressors and subsidies – such as saltwater intrusion and sea-level rise – may adapt, transition to an alternative state, or experience a decline in functions, such as carbon storage, thereby altering their response trajectories to environmental changes3,4. Climate change is increasing salinity in coastal ecosystems worldwide yet the effects on ecosystem metabolism remain uncertain4-8. Here, we synthesized gross ecosystem productivity (GEP), ecosystem respiration [CO2 and CH4 (ERCO2 and ERCH4)], and net ecosystem productivity (NEP) from diverse coastal marshes exposed to experimental additions and observational gradients in salinity. Increases in salinity generally caused decreases in median GEP, ERCO2, and ERCH4 but increases in GEP and NEP from ~5 to 10 ppt. Increased saltwater intrusion can stimulate or stress wetlands based on relative exposure and acclimation to increased salinities, and we detected positive NEP where salinity increases had greater negative effects on ERCO2 and ERCH4 than GEP. Although increases in NEP are detectable at low salinities, saltwater intrusion and climate-driven disturbances may reduce carbon storage capacity of coastal ecosystems as productivity declines toward higher salinities.
The Role of Entrepreneurship in Changing The Employment Rate in The European Union
Authors: Anastasiou Athanasios , Argiri Vasiliki , Komninos Dimitrios , Dermatis Zacharias , Papageorgiou Christos 
Published: September 2021

Abstract
The aim of this research is to examine the concept of entrepreneurship in the context of modern economic realities by presenting features and factors that contribute to economic growth. High unemployment, low economic growth and shrinking investment are key features of the long-term economic crisis at both national and European level.New entrepreneurship, combined with the strengthening of the existing one, is a powerful antidote to the fight against unemployment, as it provides the opportunity, mainly to young people, to innovate and create new products and services contributing to the wider economic and social whole, reducing unemployment while creating the right conditions for a remarkable and outward-looking economy. Taking into account the literature research, it is examined how the development of entrepreneurship actually contributes to the encouragement of economic activity, creating a favorable ground for growth in all sectors of the economy and the creation of new jobs.
Effect of Sizes on the Lung-Targeting and Biocompatibility of Intravenously Administered Biodegradable PLGA Microspheres
Authors: Lang Fengting , Qu Shaoqi , Li Kang , Zhong Muqi , Wang Cuncai , Hao Zhihui 
Published: September 2021

Abstract
Background: In the treatment of lung diseases, drug showed low bioavailability and efficacy by conventional administration methods. Passive lung-targeting microspheres provide a method to deliver drugs from the vascular side, there is still a paucity of systematic studies on the biocompatibility of biodegradable-polymer microspheres. Results: We used poly (lactic acid-glycolic acid) (PLGA) microspheres with different particle sizes (3, 10, 25, and 40 mm) as a model. The optimal lung-targeting particle size of the PLGA microspheres is 10 mm and the corresponding range of maximum tolerated dose is 125-150 mg/kg. We hypothesized that the decrease of blood oxygen saturation under treatment of microspheres was caused by pulmonary embolism. We found varying degrees of blood circulation loss of lungs by micro computed tomography test, which indicated severe pulmonary embolism subsequent to intravenous injection of microspheres with a particle size >25 mm. Furthermore, we found lung injury and microspheres leaked from the blood vessels into the alveoli by H&E staining. This process was likely induced by increased secretion of matrix metalloproteinases (MMPs), which destroyed the alveolar-capillary barrier and trigger an inflammatory cascade. Finally, we found that optimal particle size and dose conditions did not affect normal physiological activities after the microspheres degraded. The upregulation of vascular endothelial growth factor (VEGF) and platelet endothelial cell adhesion molecule-1 (PECAM-1 or CD31) induced vessel recanalization and reestablishment, which promoted the progress of lung repair. Conclusions: Collectively, our results highlight the importance of accurately designing the optimal size and dose of microspheres for passive lung-targeting delivery.
Experience of Using An e-portfolio In Clinical Practice at a Medical School
Authors: Song Mi Ryoung , Yu Ji Hye , Lee Mi Jin , Lee Su Kyung , Kim Mi Ran , Moon So Young , Lee Jang Hoon 
Published: September 2021

Abstract
Background: The electronic portfolio(e-portfolio) is a useful tool for storing learning-related information, gathering and organizing learning evidence, and demonstrating student learning and growth over time. According to various studies, e-portfolio content criteria should be kept simple and adaptable in relation to educational aims. However, there is a paucity of empirical studies on whether the content composition of an e-portfolio as seen by learners using the real e-portfolio is acceptable. The purpose of this study is to determine whether the appropriateness of electronic portfolio content items and feedback affects self-reflection and learning ability in clinical practice for medical students who used an electronic portfolio.Methods: This research was carried out in 2020 with 40 fifth-grade students at Ajou University College of Medicine in Korea. The benefits and utility of e-portfolios were investigated in clinical practice courses in pediatrics, obstetrics and gynecology, and neurology. Descriptive statistics, analysis of variance (ANOVA), correlation analysis, and a regression analysis were performed on the obtained data.Results: Satisfaction with neurology was the greatest among the clinical practice courses in pediatrics, obstetrics and gynecology, and neurology as compared to clinical practice course using an e-portfolio for the first time. Self-reflection, learning performance improvement, and prompt feedback were all found to be more satisfying than in previous clinical practice courses. Furthermore, as the quantity of content items in the e-portfolio dropped and the faculty in charge rapidly provided feedback, medical students' satisfaction with e-portfolio usage increased.Conclusions: The number of content items in the e-portfolio decreased as the number of content items in the e-portfolio declined in the clinical practice course of the medical school; moreover, the faculty in charge provided timely feedback. This suggests that for medical students to effectively use the e-portfolio in the clinical practice course, a plan should be developed to reduce the number of e-portfolio content items. Subsequently, there should be a focus on the most important items while considering the unique characteristics of each clinical practice course. It also indicates that professors should provide prompt feedback on students' academic performances.
Reconstruction of the Coracoclavicular Ligament With Palmaris Longus Tendon and Mersilene Tape for Acromioclavicular Dislocations
Authors: Lee Yoon Min , Yeo Joo Dong , Hwang Zin Ouk , Whan Seok , Sur Yoo Joon 
Published: September 2021

Abstract
Background

Acromioclavicular (AC) joint dislocation is common among shoulder injuries, and various surgical methods have been introduced for effective ligament reconstruction. Reconstruction of the coracoclavicular (CC) ligament in the anatomical position using autologous tendons is a recent surgical trend. This study is to report clinical and radiologic results of reconstruction of the CC ligament using an autologous palmaris longus tendon interweaved with Mersilene tape (PLMT) with a minimum 2-year follow-up.
Methods

This retrospective study analyzed 76 patients (mean age, 43.4 ± 11.2 years) with AC joint dislocation treated by reconstruction of the CC ligament with PLMT, from March 2004 to February 2017. The mean follow-up period was 28 ± 6.7 months (range, 24–66 months). The Visual Analog Scale (VAS) for pain assessment, American Shoulder and Elbow Surgeons rating scale (ASES), and Constant Score (CS) were used to evaluate clinical outcomes at the final follow-up. CC and AC distances were measured using anteroposterior (AP) X-ray preoperatively, 6 weeks postoperatively, and at the final follow-up for radiologic outcomes. Complications were also assessed.
Results

The mean preoperative VAS, ASES, CS were 5.7 ± 0.7, 77.1 ± 6.2, and 61.5 ± 5.2, respectively. These scores at the last follow-up improved to 2.1 ± 0.5, 90.9 ± 4.3, and 94 ± 7.0, respectively (p = 0.043, p < 0.001, p < 0.001). The mean preoperative CC and AC distances were 16.49 ± 3.73 mm and 13.84 ± 3.98 mm, respectively. They were 7.16 ± 1.22 mm and 3.86 ± 2.34 mm at 6 weeks postoperative, and became 9.29 ± 2.72 mm and 5.30 ± 2.09 mm at the final follow-up. The mean CC and AC distances decreased significantly at the final follow-up (p < 0.001, p < 0.001). Although a slight re-widening of the CC distance occurred in 10 patients (13.1%), most patients regained full range of motion of the affected shoulder at the final follow-up.
Conclusion

The CC ligament reconstruction with PLMT for the treatment of AC joint dislocation showed good clinical and radiological results. This technique could be a good alternative treatment for AC dislocations.
Mapping the unjust global impact of harmful fisheries subsidies
Authors: Skerritt Daniel , Schuhbauer Anna , Villasante Sebastian , Cisneros-Montemayor Andrés , Bennett Nathan , Mallory Tabitha , Lam Vicky W.Y. , Arthur Robert , Cheung William , Teh Louise , Roumbedakis Katina , Sumaila U. Rashid 
Published: September 2021

Abstract
Harmful fisheries subsidies contribute to overfishing leading to environmental and societal impacts1. If only fisheries within the subsidising nations’ jurisdiction were affected, then unilateral actions might be sufficient to help safeguard our ocean and the people reliant upon it. However, just as fish move between jurisdictions2, so too do the subsidised fishing fleets targeting them3. As such, the impacts and solutions to subsidies-induced overfishing are matters of international concern. Mapping that impact is therefore key to understanding these concerns and informing multilateral reform. Here we combine existing datasets4–6 to quantify the amount of harmful fisheries subsidies impacting the high seas, domestic and foreign waters, respectively. We estimate that between 24% and 43% of all harmful fisheries subsidies impact foreign waters or the high seas. We show that harmful subsidies primarily originate from countries with high-Human Development Index (HDI), strong fisheries management capacity and relatively sustainable fish stocks, yet disproportionately impact countries with low-HDI, lower management capacity and more vulnerable stocks. Indeed, over 40% of the harmful subsidies impacting low-HDI countries originate from high-HDI countries. This discrepancy between the source of harmful subsidies and the nations that are ultimately impacted is unsustainable and unjust. Policy-makers from all nations must push for effective multilateral subsidies reform. Prohibiting subsidies to distant-water fishing should be prioritised to support equitable and sustainable fisheries worldwide.
Hybrid Robot-Assisted Gait Training for Motor Function in Subacute Stroke: A Single-Blind Randomized Controlled Trial
Authors: Lin Yen-Nung , Huang Shih-Wei , Kuan Yi-Chun , Chen Hung-Chou , Jian Wen-Shan , Lin Li-Fong 
Published: September 2021

Abstract
Background:Robot-assisted gait training (RAGT) is a practical treatment adjunctive to conventional rehabilitation to provide high-intensity repetitive training for patients with stroke. The robot models designed are usually either the end-effector type or the exoskeleton type. We developed a novel hybrid RAGT system that combines the advantages of both types.Objective:This randomized controlled trial (RCT) evaluated whether the novel RAGT system was beneficial and assessed long-term effects (at the 3-month follow-up) for nonambulatory patients with subacute stroke.Methods:This trial recruited 40 patients with subacute stroke who were equally randomized to receive conventional rehabilitation or 15 add-on RAGT sessions. We assessed lower-extremity motor function, balance, and gait performance by using the following tools: active range of motion (AROM), manual muscle test (MMT), the Fugl-Meyer Assessment (FMA) lower-extremity subscale (FMA-LE) and total (FMA-total), Postural Assessment Scale for Stroke (PASS), Berg Balance Scale (BBS), Tinetti Performance Oriented Mobility Assessment (POMA) balance and gait subscores, and the 3- and 6-m walking speed and Timed Up and Go (TUG) tests. These measurements were performed before and after the intervention and at the 3-month follow-up.Results:Both groups demonstrated significant within-group changes in the AROM, MMT, FMA-LE, FMA-total, PASS, BBS, POMA, TUG, and 3- and 6-m walking speeds before and after intervention and at the 3-month follow-up (p < 0.05). Only FMA-LE (p = 0.014) and total (p = 0.002) scores differed significantly between groups (RAGT vs. control).Conclusion:Although the novel hybrid RAGT was beneficial, no powerful evidence to supported its effectiveness relative to the control group in substantial leg dysfunction after stroke.Trial Registration: The study was registered with an International Standard Randomized Controlled Trial Number, ISRCTN, ISRCTN15088682. Registered 16 September 2016, Retrospectively registered https://www.isrctn.com/ISRCTN15088682
Intermittent Theta Burst Stimulation Modulates Biceps Brachii Corticomotor Excitability in Individuals with Tetraplegia
Authors: Mittal Neil , Majdic Blaize , Peterson Carrie 
Published: September 2021

Abstract
Background: Intermittent theta burst stimulation (iTBS) is a form of repetitive transcranial magnetic stimulation (TMS) that can increase corticomotor excitability of hand muscles in individuals with spinal cord injury (SCI). The objective of this study was to determine the effect of iTBS on the corticomotor excitability of the biceps brachii in individuals with tetraplegia.Methods: Ten individuals with low cervical SCI (C5-C8) and ten nonimpaired individuals completed three independent sessions. Motor evoked potentials (MEPs) served as our measure of corticomotor excitability and were collected before and after iTBS. MEPs were normalized by the electromyography corresponding to maximum voluntary contraction and analyzed using linear mixed effects models to determine the effect of iTBS (active or sham) on normalized MEPs (nMEPs). iTBS effects were compared to a ratio of active and resting motor thresholds as a measurement of corticomotor conductance potential.Results: Relative to sham, active iTBS increased nMEPs over time (p < 0.001) in individuals with SCI, but not nonimpaired individuals (p = 0.915). The amplitude of nMEPs were correlated with the biceps corticomotor conductance potential (p < 0.001), with nMEPs decreasing as the ratio increased at different rates after sham or active iTBS.Conclusions: Preliminary results suggest that iTBS increases biceps corticomotor excitability in individuals with tetraplegia with effects that may be predicted by corticomotor conductance potential. Clinical Trial Registration: NCT03277521 Registered on clinicaltrials.gov on August 24, 2017.
Young People’s Choice and Voice Concerning Sex and Relationships: Effects of the Multicomponent Get Up Speak Out! Programme in Iganga, Uganda
Authors: Kakal Tasneem , Nalwadda Christine , Reeuwijk Miranda van , Veen Maaike van , Chatterjee Ophelia , Owekmeno Charles , Kok Maryse , Kusters Lincie 
Published: September 2021

Abstract
Background

Young people in Uganda face challenges in achieving their sexual and reproductive health and rights (SRHR), such as lack of information, limited access to services, teenage pregnancy and sexually transmitted infections. To address this, their empowerment – including their ability to express themselves and make decisions, is a key strategy. This study assessed how young people’s voice and choice concerning sex and relationships changed over the period of three years of implementation of the GUSO programme.
Methods

Data were collected through a household survey with young people (15–24 years) and through focus group discussions, in-depth interviews and key informant interviews with youth and community stakeholders in 2017 for the baseline and 2020 for the end-line. Using the difference-in-difference technique and thematic analysis, changes in key outcomes were assessed over time between intervention and control area.
Results

There were limited changes over time in the intervention area, which did not differ from changes in the control area. Young people were able to express themselves and expand their decision-making space on sex and relationships, in particular if they were older, male and in a relationship. Young women negotiated their agency, often by engaging in transactional sex. However, youth were still restricted in their self-expression and their choices as speaking about sexuality was taboo, particularly with adults. This was influenced by the political and religious climate around SRHR in Uganda, which emphasised abstinence as the best option for young people to prevent SRHR-related problems.
Conclusions

Young people’s SRHR remains a challenge in Uganda in the context of a conservative political and religious environment. The limited effect of the programme on increasing young people’s voice and choice concerning relationships in Uganda can be understood in the context of a ban on CSE and the COVID-19 pandemic. These structural and emerging contextual factors enforce the taboo around youth sexuality and hinder their access to SRHR information and services. Multi-component and targeted programmes are needed to influence changes at the structural, community and individual level.
Predictive Values of Initial Severity Scores at Intensive Care Unit Admission for Patients With Overnight or Prolonged Stay
Authors: Hosokawa Koji , Shime Nobuaki 
Published: September 2021

Abstract
Background: The predictive value of disease severity scores for intensive care unit (ICU) patients is occasionally inaccurate because ICU patients with mild symptoms are also considered. We, thus, aimed to evaluate the accuracy of severity scores in predicting mortality of patients with complicated conditions admitted for > 24 hours. Methods: Overall, 35,353 adult patients using nationwide ICU data were divided into two groups: (1) overnight ICU stay after elective surgery and alive on discharge within 24 hours and (2) death within 24 hours or prolonged stay. The performance and accuracy of Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation (APACHE) II and III, and Simplified Acute Physiology Score (SAPS) II scores in predicting in-hospital mortality were evaluated. Results: In the overnight stay group, the correlation between SOFA and APACHE III scores or SAPS II was low because many had a SOFA score of 0. In the prolonged stay group, the predictive value of SAPS II and APACHE II and III showed high accuracy but that of SOFA was moderate. Conclusions: When overnight ICU stay patients were not included, the high predictive value for in-hospital mortality of SAPS II and APACHE II and III was evident.