bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cluster seizures and status epilepticus in new onset seizures among adult Egyptians
Authors: Mahmoud Mahmoud Hemeida , Awad Eman Mahmoud , Mohamed Ahmed Khalil , Shafik Mohamed Ahmed 
Published: July 2021

Abstract
Background
New onset seizure (NOS) is defined as the first seizure within a 24-h period ever experienced by the patient. Cluster seizures (CS) or status epilepticus (SE) can be the first manifestation of epilepsy or it may be a symptom of a brain tumor, a systemic disorder, an infection, or a syndrome. This study aims to determine the etiology of CS and SE in NOS among adult Egyptians. One hundred twenty adult Egyptian patients presented with NOS were enrolled in a hospital-based cross-sectional observational study within a time period of 6 months from March till September 2018. All patients were subjected to neurological examination including mini mental status examination, laboratory, neuroimaging, and electroencephalogram.

Results
Among 120 adult patients presented with NOS, males were prevalent (63%). Older adults (> 55 years) were prevalent (60%). Of the patients, 25% presented by CS, while 11% presented by SE. Post-stroke epilepsy (41%) was the predominant etiology of NOS. Cerebrovascular diseases (CVDs) were the prevalent etiology of SE in NOS (35%). NOS presented by CS were more prevalent among patients with brain tumors (29%) in comparison to CVDs (25%).

Conclusion
CS represented 25% of NOS in adult Egyptian patients. SE is prevalent among 11% of NOS. Despite CVDs being the most prevalent etiology of NOS in adult population (41%) including those presented with SE (35%), brain tumors are the most prevalent etiology of new onset CS (29%).
Socio-demographic status and 12 years trend of completed suicide in East Azerbaijan Province, Iran, during the period 2007–2018
Authors: Farahbakhsh Mostafa , Asgari Maryam Nejad , Aslrahimi Vahab , Hemmati Azam , Iranzad Ilnaz , Azizi Hosein 
Published: July 2021

Abstract
Background
The incidence rate of suicide has been increased in Iran over the past decades especially in East Azerbaijan Province which there are limited studies on suicide. We aimed to investigate the 12-year trend of suicide and demographic characteristics in East Azerbaijan Province during the period 2007–2018. We obtained the data on the suicide mortality and socio-demographic status from the Death Registry Information System (DRIS) and compared with legal medicine suicide statistics during the study period.

Results
A total of 2422 and 1783 suicide cases were reported by legal medicine and DRIS (average incidence rate 5.94 vs 4.4 per 100,000) in the 12-year period from 2007 to 2018, respectively. The suicide rate in males was more than two times that of females. The mean and median age of suicide was 34.07 and 31 years, respectively. The most common suicide method was hanging (51.9%). The incidence rate of suicide cases was decreasing between 2007 and 2014, however from 2015 to 2018 has been increased.

Conclusions
The incidence rate of suicide in this province has been increasing with a smooth slope. Community-based programs and measures should be taken to stop the growth rate of suicide.
COVID-19-associated rhino-orbital mucormycosis (CAROM)—a case report
Authors: Sethi Humsheer Singh , Sen Kamal Kumar , Mohanty Sudhansu Sekhar , Panda Sangram , Krishna Kolluru Radha , Mali Chayasmita 
Published: July 2021

Abstract
Background
There has been a rapid rise in the number of COVID-19-associated rhino-orbital mucormycosis (CAROM) cases especially in South Asian countries, to an extent that it has been considered an epidemic among the COVID-19 patients in India. As of May 13, 2021, 101 CAROM cases have been reported, of which 82 cases were from India and 19 from the rest of the world. On the other hand, pulmonary mucormycosis associated with COVID-19 has a much lesser reported incidence of only 7% of the total COVID-19-associated mucormycosis cases (Singh AK, Singh R, Joshi SR, Misra A, Diab Metab Syndr: Clin Res Rev, 2021). This case report attempts to familiarize the health care professionals and radiologists with the imaging findings that should alarm for follow-up and treatment in the lines of CAROM.

Case presentation
Rhino-orbital mucormycosis (ROM) is a manifestation of mucormycosis that is thought to be acquired by inhalation of fungal spores into the paranasal sinuses. Here, we describe a 55-year-old male, post COVID-19 status with long standing diabetes who received steroids and ventilator therapy for the management of the viral infection. Post discharge from the COVID-19 isolation ICU, the patient complained of grayish discharge from the right nostril and was readmitted to the hospital for the nasal discharge. After thorough radiological and pathological investigation, the patient was diagnosed with CAROM and managed.

Conclusion
Uncontrolled diabetes and imprudent use of steroids are both contributing factors in the increased number of CAROM cases. Our report emphasizes on the radiological aspect of CAROM and reinforces the importance of follow-up imaging in post COVID-19 infection cases with a strong suspicion of opportunistic infections.
Implementation for Sustained Impact in Teleophthalmology (I-SITE): applying the NIATx Model for tailored implementation of diabetic retinopathy screening in primary care
Authors: Torres Diaz Alejandra , Lock Loren J. , Molfenter Todd D. , Mahoney Jane E. , Boss Deanne , Bjelland Timothy D. , Liu Yao 
Published: July 2021

Abstract
Background
Teleophthalmology provides evidence-based, telehealth diabetic retinopathy screening that is underused even when readily available in primary care clinics. There is an urgent need to increase teleophthalmology use in the US primary care clinics. In this study, we describe the development of a tailored teleophthalmology implementation program and report outcomes related to primary care provider (PCP) adoption.

Methods
We applied the 5 principles and 10 steps of the NIATx healthcare process improvement model to develop and test I-SITE (Implementation for Sustained Impact in Teleophthalmology) in a rural, the US multi-payer health system. This implementation program allows patients and clinical stakeholders to systematically tailor teleophthalmology implementation to their local context. We aligned I-SITE components and implementation strategies to an updated ERIC (Expert Recommendations for Implementing Change) framework. We compared teleophthalmology adoption between PCPs who did or did not participate in various components of I-SITE. We surveyed PCPs and clinical staff to identify the strategies they believed to have the highest impact on teleophthalmology use.

Results
To test I-SITE, we initiated a year-long series of 14 meetings with clinical stakeholders (n=22) and met quarterly with patient stakeholders (n=9) in 2017. Clinical and patient stakeholder groups had 90.9% and 88.9% participant retention at 1 year, respectively. The increase in teleophthalmology use was greater among PCPs participating in the I-SITE implementation team than among other PCPs (p < 0.006). The proportion of all PCPs who used the implementation strategy of electing diabetic eye screening for their annual performance-based financial incentive increased from 0% (n=0) at baseline to 56% (n=14) following I-SITE implementation (p = 0.004). PCPs and clinical staff reported the following implementation strategies as having the highest impact on teleophthalmology use: reminders to ask patients about diabetic eye screening during clinic visits, improving electronic health record (EHR) documentation, and patient outreach.

Conclusions
We applied the NIATx Model to develop and test a teleophthalmology implementation program for tailored integration into primary care clinics. The NIATx Model provides a systematic approach to engaging key stakeholders for tailoring implementation of evidence-based telehealth interventions into their local context.
Are NCCN Resource-Stratified Guidelines for Breast Cancer Systemic Therapy Achievable? A Population-Based Study of Global Need and Economic Impact
Authors: Wilson Brooke E. , Jacob Susannah , Do Viet , Amir Eitan , Bray Freddie , Ferlay Jacques , Knaul Felicia M. , Elawawy Ahmed , Pearson Sallie-Anne , Barton Michael B. 
Published: July 2021

PURPOSE Resource-stratified guidelines (RSG) for cancer provide a hierarchy of interventions, based on resource availability. We quantify treatment need and cost if National Comprehensive Cancer Network (NCCN) RSGs for breast cancer (BC) are adopted globally. METHODS We developed decision trees for first-course systemic therapy, merged with SEER and Global Cancer Observatory 2018 incidence data to estimate treatment need and cost if NCCN RSG are implemented globally based on country-level income. Simulations were used to quantify need and cost of globally scaling up services to Maximal. RESULTS Based on NCCN RSG, first-course chemotherapy is indicated in 0% (Basic), 87% (Core), and 86% (Enhanced) but declined to 50% (Maximal) because of incorporation of genomic profiling. First-course endocrine therapy (ET) is indicated in 80% in all settings. In 2018, treatment need was 1.4 million people for chemotherapy, 183,943 for human epidermal growth factor receptor 2 (HER2) therapies and 1.6 million for ET. The cost per person for chemotherapy or HER2 or immunotherapy increased by 17-fold from Core to Maximal ($1,278-$22,313 Australian dollars [AUD]). The cost of ET per person rose eight-fold from Basic to Maximal ($1,236-$9,809 AUD). If all patients with BC globally were treated with Maximal resources, the need for chemotherapy would decline by 28%, whereas cost of first-course treatment would rise by 1.8-fold ($21-$37 billion AUD) because of more costly therapies. CONCLUSION NCCN RSGs for BC could result in chemotherapy overtreatment in Core and Enhanced settings. The absence of chemotherapy in Basic settings should be reconsidered, and future iterations of RSG should perform cross-tumor comparisons to ensure equitable resource distribution and maximize population-level outcomes. Our model is flexible and can be tailored to the costs, population attributes, and resource availability of any institution or country for health-services planning.
Health Care Utilization and Costs Associated With Systemic First-Line Metastatic Melanoma Therapies in the United States
Authors: van Boemmel-Wegmann Sascha , Brown Joshua D. , Diaby Vakaramoko , Huo Jinhai , Silver Natalie , Park Haesuk 
Published: July 2021

PURPOSE: US Food and Drug Administration approvals of immune checkpoint inhibitors and targeted therapies revolutionized the treatment of metastatic melanoma. Our aim was to assess health care resource utilization and costs for patients with metastatic melanoma treated with systemic therapies in first line between January 2012 and December 2017. METHODS: We conducted a retrospective cohort study of patients with metastatic melanoma using MarketScan data. We included patients diagnosed with melanoma and secondary malignant neoplasm who used pembrolizumab, nivolumab, ipilimumab, ipilimumab plus nivolumab, BRAF-inhibitor (BRAF-i) plus MEK inhibitor (MEK-i), BRAF-i or MEK-i monotherapy, or chemotherapy in first line. We compared health care utilization and costs per patient per month (PPPM) using two-part and generalized linear models. RESULTS: We identified 1,870 patients, including 185 pembrolizumab, 103 nivolumab, 689 ipilimumab, 185 nivolumab plus ipilimumab, 214 BRAF-i plus MEK-i, 240 BRAF-i or MEK-i monotherapy, and 254 chemotherapy users. Highest PPPM rates of hospitalizations, emergency room visits, and outpatient visits were observed in patients with ipilimumab plus nivolumab therapy (adjusted difference v pembrolizumab [aDiff], 0.18, 0.12, and 0.88, respectively; all P < .001). Ipilimumab monotherapy users (aDiff, 0.07 and 0.93; all P < .001) and chemotherapy users (aDiff, 0.10 and 2.63; all P < .001) showed higher PPPM rates of hospitalizations and outpatient visits compared with pembrolizumab users, respectively. Utilization rates in nivolumab, BRAF-i plus MEK-i, and BRAF-i or MEK-i groups were similar to the pembrolizumab group. Highest PPPM total costs and drug-related costs were observed in the ipilimumab group ($80,139 US dollars [USD] and $70,051 USD; all P < .001), followed by the ipilimumab plus nivolumab ($71,689 USD and $56,217 USD; all P < .001) and the BRAF-i plus MEK-i group ($31,184 USD and $19,648 USD; all P < .001). PPPM costs in the nivolumab group were similar to the pembrolizumab group. CONCLUSION: Significant differences in health care resource utilization and costs were found across first-line metastatic melanoma regimens. Utilization rates were highest in patients using ipilimumab-containing therapies. High drug costs constituted a major fraction of total PPPM health care costs.
Mammalian tracheal development and reconstruction: insights from in vivo and in vitro studies
Authors: Kishimoto Keishi , Morimoto Mitsuru 
Published: July 2021

ABSTRACT
The trachea delivers inhaled air into the lungs for gas exchange. Anomalies in tracheal development can result in life-threatening malformations, such as tracheoesophageal fistula and tracheomalacia. Given the limitations of current therapeutic approaches, development of technologies for the reconstitution of a three-dimensional trachea from stem cells is urgently required. Recently, single-cell sequencing technologies and quantitative analyses from cell to tissue scale have been employed to decipher the cellular basis of tracheal morphogenesis. In this Review, recent advances in mammalian tracheal development and the generation of tracheal tissues from pluripotent stem cells are summarized.
Yorkie ensures robust tissue growth in Drosophila ribosomal protein mutants
Authors: Wada Yayoi , Ohsawa Shizue , Igaki Tatsushi 
Published: July 2021

ABSTRACT
Heterozygosity of ribosomal protein genes causes a variety of developmental abnormalities in humans, which are collectively known as ribosomopathies, yet the underlying mechanisms remain elusive. Here, we analyzed Drosophila Minute (M)/+ mutants, a group of mutants heterozygous for ribosomal protein genes that exhibit a characteristic thin-bristle phenotype. We found that, although M/+ flies develop essentially normal wings, simultaneous deletion of one copy of the Hippo pathway effector yki resulted in severe wing growth defects. These defects were caused by JNK-mediated cell death in the wing pouch via Eiger/TNF signaling. The JNK activation in M/+, yki/+ wing discs required the caspase Dronc, which is normally blocked by DIAP1. Notably, heterozygosity of yki reduced DIAP1 expression in the wing pouch, leading to elevation of Dronc activity. Dronc and JNK formed a positive-feedback loop that amplifies Dronc activation, leading to apoptosis. Our observations suggest a mechanism of robust tissue growth whereby tissues with reduced ribosomal protein prevent ectopic apoptosis via Yki activity.
The energetics of social signaling during roost location in Spix's disc-winged bats
Authors: Chaverri Gloriana , Sandoval-Herrera Natalia Ivone , Iturralde-Pólit Paula , Romero-Vásquez Adarli , Chaves-Ramírez Silvia , Sagot Maria 
Published: July 2021

ABSTRACT
Long-term social aggregations are maintained by multiple mechanisms, including the use of acoustic signals, which may nonetheless entail significant energetic costs. To date, however, no studies have gauged whether there are significant energetic costs to social call production in bats, which heavily rely on acoustic communication for a diversity of social tasks. We measured energetic expenditure during acoustic signaling in Spix's disc-winged bats (Thyroptera tricolor), a species that commonly uses contact calls to locate the ephemeral furled leaves that they use for roosting. To determine the cost of sound production, we measured oxygen consumption using intermittent-flow respirometry methods, with and without social signaling. Our results show that the emission of contact calls significantly increases oxygen consumption; vocal individuals spent, on average, 12.42 kJ more during social signaling trials than they spent during silent trials. We also found that as resting metabolic rate increased in males, there was a decreasing probability that they would emit response calls. These results provide support to the ‘allocation model’, which predicts that only individuals with lower self-maintenance costs can afford to spend energy in additional activities. Our results provide a step forward in our understanding of how physiology modulates behavior, specifically how the costs of call production and resting metabolic rate may explain the differences in vocal behavior among individuals.
Trends of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody prevalence in selected regions across Ghana
Authors: Quashie Peter Kojo , Mutungi Joe Kimanthi , Dzabeng Francis , Oduro-Mensah Daniel , Opurum Precious C. , Tapela Kesego , Udoakang Aniefiok John ,   WACCBIP COVID-19 Team, Asante Ivy , Paemka Lily , Kumi-Ansah Frederick , Quaye Osbourne , Amoako Emmanuela , Armah Ralph , Kilba Charlyne , Boateng Nana Afia , Ofori Michael , Kyei George B. , Bediako Yaw , Ndam Nicaise , Abugri James , Ansah Patrick , Ampofo William K. , Mutapi Francisca , Awandare Gordon A. 
Published: July 2021

Background: We set out to estimate the community-level exposure to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in Ghana. Methods: Phased seroprevalence studies of 2729 participants at selected locations across Ghana were conducted. Phase I (August 2020) sampled 1305 individuals at major markets/lorry stations, shopping malls, hospitals and research institutions involved in coronavirus disease 2019 (COVID-19) work. The study utilized a lateral flow rapid diagnostic test (RDT) which detected IgM and IgG antibodies against SARS-CoV-2 nucleocapsid protein. Results: During Phase I, 252/1305 (19%) tested positive for IgM or IgG or both. Exposure was significantly higher at markets/lorry stations (26.9%) compared to malls (9.4%), with 41–60-year group demonstrating highest seropositivity (27.2%). Exposure was higher in participants with no formal education (26.2%) than those with tertiary education (13.1%); and higher in informally employed workers (24.0%) than those in the formal sector (15.0%). Results from phases II and III, in October and December 2020 respectively, implied either reduced transmissions or loss of antibody expression in some participants. The Upper East region showed the lowest seropositivity (2%). Phase IV, in February 2021, showed doubled seropositivity in the upper income bracket (26.2%) since August 2020, reflective of Ghana’s second wave of symptomatic COVID-19 cases. This suggested that high transmission rates had overcome the initial socioeconomic stratification of exposure risk. Reflective of second wave hospitalisation trends, the 21-40 age group demonstrated modal seropositivity (24.9) in Phase IV whilst 40-60 years and 60+ previously demonstrated highest prevalence. Conclusions: Overall, the data indicates higher COVID-19 seroprevalence than officially acknowledged, likely implying a considerably lower-case fatality rate than the current national figure of 0.84%. The data also suggests that COVID-19 is predominantly asymptomatic COVID-19 in Ghana. The observed trends mimic clinical trends of infection and imply that the methodology used was appropriate.
Nitrous Oxide and Methane Emissions from Beef Cattle Feedyard Pens Following Large Rainfall Events
Authors: Parker David B. , Casey Kenneth D. , Willis Will , Meyer Beverly 
Published: July 2021

HighlightsNitrous oxide and methane emissions were measured from a commercial beef feedyard following large rainfall events.Nitrous oxide emissions dropped below detection levels for ten days following a 77 mm rainfall event.Daily N2O and CH4 emissions followed a diel pattern, peaking at manure temperatures of 36°C to 38°C.Results will be used to refine empirical models for predicting GHG emissions from open-lot feedyards.Abstract. More than six million beef cattle are fed annually in feedyards on the semiarid Southern Great Plains (SGP). Manure deposited on the open-lot pen surfaces contributes to greenhouse gas (GHG) emissions. Nitrous oxide (N2O) and methane (CH4) are GHGs linked to climate change, and both have global warming potentials greater than carbon dioxide (CO2). Two sampling campaigns were conducted in 2019 to quantify N2O and CH4 emissions from open-lot pen surfaces. The occurrence of large, unforecast rainfall events during both campaigns provided an opportunity to compare GHG emissions from the dry manure before rainfall and from the wetted pen surface for one to two weeks following precipitation. Temporal variability was quantified by continuous sampling using six to eight automated flux chambers, a multiplexer system, and real-time analyzers. Spatial variability was quantified using a recirculating portable chamber on a 5 × 8 grid. Nitrous oxide emissions dropped below detection levels for ten days after the precipitation event. Nitrous oxide emissions were related to nitrification or other aerobic processes. Methane emissions dropped below detection levels for five days after the precipitation event and then increased to pre-rainfall levels by day 8. When present, N2O and CH4 emissions followed a diel pattern, with the highest emissions occurring during the afternoon when manure pack temperatures at the 25 mm depth were 36°C to 38°C and ambient temperatures were 31°C to 32°C. Average CH4 emissions from the feedyard pen surface were 96-fold lower than estimated enteric CH4 emissions. The results of this field research will be used to refine empirical models for predicting annual N2O and CH4 emissions from open-lot beef cattle feedyards on the semiarid SGP. Keywords: Beef cattle, Flux chamber, Greenhouse gas, Manure, Nitrous oxide, Rainfall.
Anti-reflection subwavelength gratings for InP-based waveguide facets
Authors: Puts Lukas , Leijtens Xaveer , Cheben Pavel , Schmid Jens , Reniers Sander , Melati Daniele 
Published: July 2021

We demonstrate the anti-reflection properties of lithographically defined subwavelength gratings applied to the facets of integrated waveguides realized in the InP membrane-on-silicon platform. The subwavelength gratings are based on the gradient index effect to create a smooth index transition between the core material and air, making it possible to obtain reflections below

−

30

d
B

at a wavelength of 1550 nm for both TE and TM polarized modes, as shown by 3D finite-difference time-domain simulations. Characterizations performed using Mach–Zehnder interferometers as test structures show relative reflections as low as

−

25

d
B

, confirming the effectiveness of the technique.
Multi-color method for the self-correction of the air refractive index
Authors: Xiong Shilin , Wang Yue , Chen Jiayang , Zhang Jinxu , Wu Guanhao 
Published: July 2021

We propose a multi-color method for the self-correction of the air refractive index based on the dispersive interferometry of an optical frequency comb. This method can be applied to correct the air refractive index for long-distance measurements in moist air. Optical lengths of multiple wavelengths were obtained simultaneously by the dispersive interferometry of an optical frequency comb. Interferometric measurement results and calculations from the empirical equation of air refractive indices were similar, with a standard deviation of

2.0

×

10

−
9

throughout the 2 h continuous measurement period. By applying the multi-color method, correction of the air refractive index with an uncertainty of

3.5

×

10

−
7

was achieved.