bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of Sputum Ordering for Tuberculosis Diagnosis in People Living with HIV in the Greater Accra Region, Ghana
Authors: Kasozi Daniel , Govule Philip , Katongole Simon Peter , Sarfo Bismark 
Published: July 2021

Abstract
BackgroundTuberculosis (TB) remains a significant public health concern, and a leading cause of ill-health and death globally. More so, People living with HIV have been shown to carry an increased risk of developing TB with an estimated one-third of deaths in this population. The World Health Organization recommends systematic and routine screening of PLHIV for TB on every clinic visit and further testing using sputum for those with a positive TB screen test. Not all PLHIV with a positive TB screen test in Ghana are further tested for TB using sputum and the factors for this are not well understood. This study assessed factors associated with sputum ordering for TB diagnosis in PLHIV who were screened positive for TB in three hospitals providing HIV care and treatment services in the Greater Accra region of Ghana.MethodsMixed method study performed at three purposively selected hospitals providing HIV care and treatment services in the Greater Accra region. The study involved a cross sectional review of patients’ charts and in-depth interviews with health workers involved in the care and treatment of PLHIV. Quantitative data was analyzed using STATA version 15. Chi square test was used for bivariate analysis. Logistic regression was used for multivariate analysis. P≤ 0.05 was considered statistically significant. Inductive thematic analysis was used to determine emerging themes from the interviews. The major themes were represented with representative quotations.ResultsFour hundred (400) patient charts were reviewed of which 67.7% were female with median age of 39 (IQR 31-49). TB screening was recorded in 78% (95% CI 73.6, 82.0) of the patients of whom ninety-two (92) patients had a positive TB screen test. Only 53 (57.6%) who had a positive screen test had sputum ordered for further TB testing. In the multivariate analysis, patient general appearance described as abnormal (OR=3.05, p=0.036), having more than one TB symptom (OR=3.42, p=0.028) and presence of an alternative presumptive diagnosis (OR=0.34, p=0.023) were associated with having a sputum test ordered. High patient numbers, inability to produce sputum, unwillingness of the not so sick patients to provide sputum and the costs associated with chest X-ray were perceived as the challenges to further testing for TB.ConclusionTB screening in PLHIV is still lower than recommended and almost half of PLHIV with a positive TB screen test did not have a sputum test documented. Sputum testing was likely to be done in patients with an abnormal general appearance and more than one TB symptom and unlikely in those with an alternative presumptive diagnosis. High workload, costs of TB tests, lack of training for health workers and inability to produce sputum by patients were the barriers to sputum testing highlighted by the health workers.
A Spatio-Temporal Hybrid Strauss Hardcore Point Process for Forest Fire Occurrences
Authors: Raeisi Morteza , Bonneu Florent , Gabriel Edith 
Published: July 2021

Abstract
We propose a new point process model that combines, in the spatiotemporal setting, both multi-scaling by hybridization and hardcore distances. Our so-called hybrid Strauss hardcore point process model allows different types of interaction, at different spatial and/or temporal scales, that might be of interest in environmental and biological applications. The inference and simulation of the model are implemented using the logistic likelihood approach and the birth-death Metropolis-Hastings algorithm. Our model is used to describe forest fire occurrences in Spain.
The Promise, Problems, and Pitfalls of Including Pregnant Women in Lassa Fever Vaccine Clinical Trials: A Qualitative Analysis of Sub-Sahara Africa Investigators' Perception
Authors: Salami Kolawole A , Mandi Henshaw E , Imbault Nathalie , Tornieporth Nadia G 
Published: July 2021

Abstract
Background
Lassa fever run a uniquely severe course in pregnancy. There are plans for Lassa fever vaccine clinical trials in endemic West African countries. We tried to assess the perception of West African investigators to including pregnant women in these studies.
Methods
Interviews were conducted with eight investigators from sub-Saharan Africa. Six of them from West Africa. Data were analyzed thematically.
Results
Respondents had limited experience with pregnant women in clinical trials but desired a paradigm shift. They identified pregnant women's willingness, a robust community engagement strategy, and adequate safety data as enablers, while lack of safety data, persistent fears about potential harm to pregnant women and offspring, and inappropriate community engagement activities as potential barriers.
Conclusion
The inclusion of pregnant women in Lassa fever vaccine clinical trials should be a priority of vaccine developers. Investigators are willing to conduct these studies provided adequate measures to ensure safety is in place.
Kidney Damage After Sepsis: A Long-term Follow-up. An Experimental Study.
Authors: Liberatore Ana Maria Alvim , Obara Giovana C. , de Souza Rodrigo Barbosa , Cassiano Luara L. , Koh Ivan Hong Jun 
Published: July 2021

Abstract
Background: Acute kidney injury (AKI) in sepsis is a common event. This study aims to evaluate the long-term impact of sepsis on renal hemodynamics and morphology. Methods: Wistar rats underwent sepsis and survivors (n = 24) were followed for up to six months, monitoring macro, regional and micro hemodynamics of the kidney, serum creatinine, and renal histology. The naive animals were used as the control group (n= 6), and sepsis was induced by E. coli e.v. inoculation. Surviving animals were monitored for up to six months. Results: Overall, the findings show that sepsis survivors have long-term hemodynamic and morphological compromise, as well as a progressive worsening of renal functional unit components over time. Even after six months of recovery from sepsis, severe renal hypoxia, chronic inflammation, evidence of increased vascular resistance, and renal fibrosis were observed in surviving animals. These alterations were present in animals with a healthy appearance and normal MAP. Conclusion: Those findings may represent a state of severely impaired physiology and be a contributing factor to the higher susceptibility to renal failure in the face of a new infectious challenge or to other pathological stimuli in the post-sepsis periods.
The Structure of Blood–tumor Barrier and Distribution of Chemotherapeutic Drugs in Non-small Cell Lung Cancer Brain Metastases
Authors: Ye Ling-yun , Sun Li-xiang , Zhong Xiu-hua , Chen Xue-song , Hu Song , Xu Rong-rong , Zeng Xiao-ning , Xie Wei-ping , Kong Hui 
Published: July 2021

Abstract
Background: Brain metastasis is an important cause increasing the mortality of non-small cell lung cancer (NSCLC) patients. In brain metastasis, blood-brain barrier (BBB) is frequently impaired, while blood-tumor barrier (BTB) formed and leading to poor effects of chemotherapy. However, the characteristics of BTB and the impacts of BTB on chemotherapeutic drug delivery remain unclear. The present study investigated the structure of BTB, as well as the distribution of routine clinical chemotherapeutic drugs in both brain and peripheral tumors. Methods: Bioluminescent image was used to confirm the formation of brain metastases of transplanted lung cancer Lewis cells in mice. The permeability of BBB and BTB was measured by fluorescent tracers of evans blue and fluorescein sodium. Transmission electron microscopy (TEM), immunohistochemistry and immunofluorescence were performed to analyze structural differences between BBB and BTB. The content of chemotherapeutic drugs (gemcitabine, paclitaxel and pemetrexed) in tissues was assayed by liquid chromatography with tandem mass spectrometry (LC-MS/MS).Results: Brain metastasis exhibited increased BTB permeability compared with normal BBB detected by fluorescence tracers. TEM showed abnormal blood vessels, damaged endothelial cells, thick basement membranes, impaired intercellular endothelial tight junctions, as well as increased fenestrae and pinocytotic vesicles in metastatic lesions. Immunohistochemistry and immunofluorescence revealed that astrocytes were distributed surrounded the blood vessels both in normal brain and the tumor border, but no astrocytes were found in the inner metastatic lesions. By LC-MS/MS analysis, gemcitabine and paclitaxel showed higher permeability in brain metastatic lesions.Conclusions: Brain metastases of lung cancer disrupted the structure of BBB, and this disruption was heterogeneous. Chemotherapeutic drugs can cross the BTB of brain metastases of lung cancer but have difficulty crossing the normal BBB. The permeability of chemotherapeutic agents is related to their molecular weight and liposolubility.
Combined Indexes of Serum NLR, CRP, LDH, IL-6 and D-Dimer Levels are a Biomarker of Disease Severity and Prognostic Predictor in Patients with Coronavirus Disease 2019
Authors: Li Jing , Tang Mingyang , Liu Didi , Wang Fengchao , Yang Yanqing 
Published: July 2021

Abstract
Background: Coronavirus disease-2019 (COVID-19) has become a worldwide emergency and has had a severe impact on human health. Inflammatory factors have the potential to either enhance the efficiency of host immune responses or damage the host organs with immune overreaction in COVID-19. Therefore, there is an urgent need to investigate the functions of inflammatory factors and serum markers that participate in disease progression. Methods: In total, 54 COVID-19 patients were enrolled in this study. Disease severity was evaluated by clinical evaluation, laboratory tests, and computed tomography (CT) scans. Data were collected at: admission, 3–5 days after admission, when severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detection became negative, and composite endpoint. Results: We found that the positive rate in sputum was three times higher than that in throat swabs. Higher levels of C-reactive protein (CRP), lactate dehydrogenase (LDH), D-dimer (D-D), interleukin-6 (IL-6) and neutrophil-to-lymphocyte (NLR) or lower lymphocyte counts suggested more severe disease, and the levels of cytokines and serum markers were intrinsically correlated with disease progression. When SARS-CoV-2 RNA detection became negative, the receiver operating characteristic (ROC) curve demonstrated that LDH had the highest sensitivity independently, and four indicators (NLR, CRP, LDH, and D-D) when combined had the highest sensitivity in distinguishing critically ill patients from mild ones. Conclusions: Monitoring dynamic changes in NLR, CRP, LDH, IL-6, and D-D levels, combined with CT imaging and viral RNA detection in sputum, could aid in severity evaluation and prognosis prediction and facilitate COVID-19 treatment.
Hematological and Cytometrical Parameters of Japanese Quails Coturnix Coturnix Japonica, Temminck &amp; Schlegel, 1848 as Per Sex and Different Stages of Growth
Authors: Bhattacherjee Ananya , Mohanty Prafulla Kumar , Mallik Bandi Kumar 
Published: July 2021

Abstract
This study delineates influence of sex and age on haematological and cytometrical parameters in Japanese quail. Sixty birds were sampled, out of which 20 belong to each age-group (chicks, growers and adults). Haemoglobin, Total Erythrocyte Count, Packed Cell Volume, Erythrocyte indices, Total Leukocyte Count and Differential Leukocyte Count for all 3 age groups and cytometry of blood cells for chicks were analysed. Haemoglobin and packed cell volume of chicks differs significantly with other age-groups at p < 0.01. Significant differences at p = 0.01, p < 0.01 and p < 0.05 observed in lymphocytes, monocytes and Heterophil to Lymphocyte ratio between chicks and growers. Length, length to breadth, nuclear length, breadth, area and Nucleus to Cytoplasm of erythrocytes, length and area of lymphocytes, breadth and area of heterophils also vary significantly at p < 0.01 between Japanese quail chick male and female. Moreover, breadth of erythrocyte and length of heterophil differs significantly at p < 0.05 between two groups. Thus, age and sex influence physiology and hence haematology and may therefore affect egg and meat production.
The Perception of Medical Students Towards Virtual Learning During Corona Pandemic at Faculties of Medicine at Alzaiem Alazhari and Khartoum Universities, Khartoum, 2021
Authors: A'lamElhuda Daffalla , S.M Leenah Mohammed , M Alamin Mustafa .E. 
Published: July 2021

Abstract
Background: “Is COVID-19 pandemic the end of classical class room based education?” the most frequent question nowadays after the forced restrictions which included educational intuition lockdown، objectives, this paper aimed to study the perception of medical students towards virtual learning during COVID-19 pandemic at faculties of medicine at Alzaiem Alazhari and Khartoum universities in Sudan , 2021.Methods: This was a descriptive cross-sectional faculty -based study in which self-administered questionnaires were distributed to 357 medical students at faculties of medicine at Alzaiem Alazhari university and university of Khartoum. Respondents were selected using simple random sampling, and data was analyzed using SPSS 26. Results: This study revealed that the average number of hours that spent on virtual learning before and during the COVID-19 pandemic were statistically significant (p<0.05), with average of 1.9 hours per day before the pandemic and average of more than 3 hours per day during the pandemic (57.9%) .Moreover, the majority of the participants 77.9% (n=279) thought that virtual learning did not successfully replace the face to face classical teaching especially the clinical medical students 87.2% (n=312) who claimed that clinical skills cannot be taught virtually and they need the direct patient contact education in order to practice the clinical skills in a proper way.Conclusion: Virtual learning in these two medical faculties was found to be well perceived, because its pros outweighed its cons, as it was the most appropriate method to use in order to continue the education process during the pandemic.
Magnetically Guided Theranostics: Enhancing the Contrast of Magnetic Resonance Imaging With Multiple-Layer Montmorillonite-Based Iron/Platinum Nanoparticles for the Treatment of Orthotopic Hepatocellular Carcinoma
Authors: Chan Ming-Hsien , Lu Chi-Ning , Chung Yi-Lung , Chang Yu-Chan , Li Chien-Hsiu , Chen Chi-Long , Wei Da-Hua , Hsiao Michael 
Published: July 2021

Abstract
In Asia, including Taiwan, malignant tumors such as Hepatocellular carcinoma (HCC) one of the liver cancer is the most diagnosed subtype. Magnetic resonance imaging (MRI) has been a typical diagnostic method for accurately diagnosing HCC. When it is difficult to demonstrate non-enhanced MRI of tumors, radiologists can use contrast agents (such as Gd3+, Fe3O4, or FePt) for T1-weighted and T2-weighted imaging, which can remain in the liver for a long time to facilitate diagnosis via MRI. However, sometimes it is difficult for T2-weighted imaging to detect small tumor lesions because the liver tissue may actively absorb iron ions. This makes early cancer detection a challenging goal. To develop a method that can more efficiently diagnose and simultaneously treat HCC during MRI examination, we designed a functionalized montmorillonite (MMT) material with a porous structure to benefit related drugs, such as mitoxantrone (MIT) delivery or as a carrier for the FePt nanoparticles (FePt NPs) to introduce cancer therapy. Multifunctional FePt@MMT can simultaneously visualize and treat various diseases and can be used as an inducer of magnetic fluid hyperthermia (MFH). After loading the drug MIT, FePt@MMT-MIT provides both MFH treatment and chemotherapy in one nanosystem. These results ultimately prove that functionalized FePt@MMT-MIT could be integrated as a versatile drugs delivery system by combining with MRI, chemotherapeutic drugs, and magnetic guide targeting.
Novel Molecular Subgroups of Intrahepatic Cholangiocarcinoma Discovered by Single-Cell RNA Sequencing-Assisted Multi-Omics Analysis
Authors: Bao Xuanwen , Li Qiong , Chen Jinzhang , Chen Diyu , Ye Chanqi , Dai Xiaomeng , Wang Yanfang , Li Xin , Rong Xiaoxiang , Cheng Fei , Jiang Ming , Zhu Zheng , Ding Yongfeng , Sun Rui , Huang Lingling , Wu Wei , Guo Yixuan , Wu Jiangchao , Fu Wenguang , Tano Vincent , Fang Weijia , Guo Tiannan , Sheng Jianpeng , Zhao Peng , Ruan Jian 
Published: July 2021

Abstract
Intrahepatic cholangiocarcinoma (ICC) is a relatively rare but highly aggressive tumour type that responds poorly to chemotherapy and immunotherapy. Comprehensive molecular characterization of ICC is essential for the development of novel therapeutics. We performed a comprehensive multi-omics analysis of ICC via proteomic, whole-exon sequencing (WES) and single-cell RNA sequencing (scRNA-seq). We identified three molecular subtypes with deteriorating prognosis in ICC: chromatin remodelling, metabolism, and inflammation. The inflammation subtype was associated with a poor prognosis. Our random forest algorithm revealed that the mutation of KMT2D frequently occurred in the metabolism subtype and were associated with lower inflammatory activity. scRNA-seq further identified a novel APOE+C1QB+ macrophage subtype, which showed the capacity of promoting the inflammation subtype and contributing to a poor prognosis in ICC. Taking together, with a single-cell transcriptome-assisted multi-omics analysis, we identified novel molecular subtypes of ICC and valided APOE+C1QB+ TAMs as potential novel immunotherapy targets against ICC.
Clinical Outcomes of Ankle Distraction Arthroplasty Versus Supramalleolar Osteotomy
Authors: Yang Zongyu , Cui Liang , Tao Shiwu , Wang Li , Zhang Fengqi , Zhao Jianyong , Shao Xinzhong 
Published: July 2021

Abstract
BackgroundPost-traumatic ankle arthritis is increasing in young people and it is very important to preserve the ankle range of motion in young patients. This study aimed to compare ankle distraction arthroplasty versus supramalleolar osteotomy for post-traumatic ankle arthritis.MethodsThis retrospective study reviewed 32 consecutive patients who underwent surgery for post-traumatic ankle arthritis from January 2015 to December 2018 after failure of conservative treatment. Thirteen ankles that underwent ankle distraction arthroplasty were age-, sex-, and body mass index-matched with 19 ankles that underwent supramalleolar osteotomy. Patients returned for clinical and radiologic follow-up at an average of 32 (range, 24–48) months postoperatively. Outcomes were the comparison of the pre- and postoperative Visual Analog Scale (VAS) pain scores and American Orthopedic Foot & Ankle Society (AOFAS) ankle-hindfoot scores, complications, subjective patient-rated satisfaction, and ankle function.ResultsThe VAS and AOFAS scores of the two groups were significantly improved at final follow-up compared with preoperatively (p<0.05), but did not significantly differ between groups. The ankle distraction arthroplasty group had better postoperative ankle mobility than the supramalleolar osteotomy group. There was no significant difference between the two groups in the tibial anterior surface angle, talar tilt angle, tibial lateral surface angle, and other imaging parameters, but supramalleolar osteotomy was more effective in correcting the load-bearing line of the ankle and hindfoot. The complication rate was similar in both groupsConclusionsAnkle distraction arthroplasty and supramalleolar osteotomy both achieved good pain relief and improved function in patients with traumatic ankle arthritis.Level of evidence: Level III, retrospective comparative series.
Analysis of Spectral Transmission in Si Solar Cell With Pyramidal Texturization by Using PC3S Simulation
Authors: Rais Ahmad Rujhan Mohd , Sinin Nurul Aqidah Mohd , Sepeai Suhaila , Ibrahim Mohd Adib , Zaidi Saleem H. , Sopian Kamaruzzaman 
Published: July 2021

Abstract
Management of light is a crucial task in solar cell design and structure because it increases the path length of the light inside, which in turn increases the probability of electron-hole pair generation. This study addresses the impact of a pyramidal textured structure on spectral transmission in the morphology of silicon. The morphology of silicon wafers was investigated using PC3S spectral transmission software to study the spectral transmission, reflectance, collection probability, mobility, carriers, electric field, velocity, current and surface recombination. Spectral transmission on the front surface with pyramidal texture showed a better transmission percentage than the planar surface. The texture with a depth of 20 µm and base length of 20 µm exhibited good performance in front spectral transmission, spectral reflectance, electric field, velocity, current and surface recombination from the top to the bottom of the sample. The planar surface had more reflectance and lower collection probability than the other pyramidal textured samples due to its low mobility, carriers, electric field, velocity and current but high surface recombination.
The Externality of Negative Emotion
Authors: Zhou Weina , Wang Shun 
Published: July 2021

Abstract
To identify the causal impact of emotional contagion, recent studies mainly rely on online or lab experiments. This paper examines the causal impact of emotional contagion among middle school students, using a nationally representative school-based survey in China. We focus on schools that randomly assign students to classrooms and isolate the variations in classmates’ emotions based on a factor that originates outside the classroom: whether the classmate had a serious illness before primary school. We find that the effect of emotional contagion in a real-world setting is larger than previous findings from experimental studies have shown.
Intermediate Risk of Choledocolithiasis: Are We on the Right Path?
Authors: Giron Felipe , Rodríguez Lina M , Conde Danny , Vanegas Marco , Rey Carlos , Venegas David , Niño Laura , Gutierrez Fernando , Nassar Ricardo M , Jimenez Daniel , Rojas Susana 
Published: July 2021

Abstract
Background Choledocolithiasis is the presence of stones in the bile duct, commonly associated with cholelithiasis, with an incidence of 5-18%. Risk of choledocolithiasis should be assessed in every patient who must undergo cholecystectomy to define the next step, which can be either surgical or endoscopic. The American Gastroenterology Society (ASGE) proposed a predictor scale of choledocolithiasis based on ultrasound findings, liver function tests, and the presence of pancreatitis and/or cholangitis. Therefore we aim to describe our experience managing patients with intermediate risk of choledocolithiasis according to the ASGE guidelines and actual presence of bile duct stones in magnetic resonance cholangiopancreatography. MethodsA retrospective observational study with a prospective database was conducted. Patients over 18 years old who complied with inclusion criteria between January and December 2019, were registered. Descriptive statistics of all study parameters were provided. Analysis included socio demographic data, laboratory values ​​and imaging. Bivariate, multivariate and ROC analysis was performed. Results 327 patients with biliary disease were classified as having intermediate risk for choledocolithiasis. Half the patients were at least 65 years old (iqr 20). All patients underwent MRI cholangiography. 24.77% were diagnosed with choledocolithiasis. Bile duct dilation was documented in only 3.06% of cases. Diagnosis of choledocolithiasis is associated with age OR: 1.87 (p 0.02), alkaline phosphatase OR: 2.44 (p 0.02) and bile duct dilation < 6 mm OR: 14.65 (p 0.00). ConclusionsThere is a high proportion of patients classified as intermediate risk who did not have choledocolithiasis by colangioresonance. There is a persistently high variability in accuracy of imaging techniques in intermediate risk patients. Therefore, enhancing the criteria to define intermediate risk for patients in order to optimize resources is of paramount importance.