bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of blunt diaphragm injury in Australia
Authors: Cocco Annelise M , Ratnaraj Vignesh , Loveday Benjamin PT , Gumm Kellie , Antippa Phillip , McCormick Jacob J , Read David , Thomson Benjamin 
Published: August 2021

Introduction Blunt diaphragm injury (BDI) is an uncommon, potentially fatal consequence of blunt torso injury. While associations between BDI and other factors such as mechanism of injury or other injuries have been described elsewhere, little recent research has been done in Australia into BDI. The aims of this study were to determine the incidence rate of BDI in our centre, identify how it was diagnosed, determine rates of missed injury and identify predictive factors for BDI. The hypothesis was that patients with BDI would significantly differ to those without BDI. Methods All major trauma patients with blunt torso injuries at our Level 1 major trauma service from 2010 to 2018 were included. Data for patient demographics, other injuries, diagnosis and treatment of BDI were extracted. Patients with BDI were compared with patients without BDI in order to identify differences that could be used to predict BDI in future patients. Results Of 5190 patients with a blunt torso injury, 51 (0.98%) had a BDI at a mean age of 53 ± 19.6 years, and median Injury Severity Score (ISS) of 27(IQR 21–38.5) compared with 5139 patients with a mean age of 48.2 ± 20.7 years and median ISS of 21.9(IQR 14–26) who did not have a BDI. The diagnosis of BDI was made at CT ( n = 35), surgery ( n = 14) or autopsy ( n = 2). Blunt diaphragm injury was missed on index imaging for 11 of 43 patients (25.6%). On multivariate analysis, each point increase in ISS (OR 1.03, p = 0.02); rib fractures (OR 4.65, p = 0.004); splenic injury (OR 2.60, p = 0.004); and liver injury (OR 2.78, p = 0.003) were independently associated with BDI. Conclusion Injury Severity Score, rib fractures and solid abdominal organ injury increase the likelihood of BDI. In patients with these injuries, BDI should be considered even in the presence of normal CT findings.
Simulation of coupled transient heat and water vapor transfer in porous fiber membrane with different fiber orientations and porosity
Authors: Gu Haihong , Gao Li , Li Guoqing , Li Ni , Xiong Jie 
Published: August 2021

The transfer process of heat and water vapor in a porous fiber membrane was investigated through the simulation of a 3D model for optimizing the configuration design. 3D models with different fiber orientations and porosity were constructed by the parameter input method, and the accuracy of the model was validated by the coefficient of determination (R2) between the apparent velocity of the model and the air permeability of the membrane. The permeability of 3D model was used to reflect the discrepancy in fiber orientation of the model. The influences of fiber orientation and porosity on heat and water vapor transfer were surveyed by the coupled physics of heat transfer and dilute substance transfer. Since there was no temperature difference in the entire domain, heat conduction (10−9 W/m2) and moisture convection (10−14 mol·m−2·s−1) were faint in the model. With the diffusion of water vapor in the moisture, the heat convection flux and water vapor diffusion flux gradually decreased and reached equilibrium. When the permeability was increased by adjusting the fiber orientation (from 1.002 to 1.200 m2), the heat convection flux and water vapor diffusion flux followed a similar growth pattern due to the coupling effect of heat transfer and water vapor transfer. The R2 for the heat convection flux and water vapor transmission rate of the simulations and experiments with different porosity (44.87, 47.64 and 50.15%) were 0.999 and 0.923, respectively, which demonstrated the validation of the simulation in heat and water vapor transfer.
Low Expression of KAT6B May Affect Prognosis in Hepatocellular Carcinoma
Authors: Jiang Junjie , Wang Hui-Ju , Mou Xiao-Zhou , Zhang Huanqing , Chen YiZhen , Hu Zhi-Ming 
Published: August 2021

Aims: Lysine acetyltransferase 6B (KAT6B), is a histone acetyltransferase implicated to have a role in tumor suppression. However, the relationship between KAT6B and hepatocellular carcinoma (HCC) is unclear. The purpose of this study was to detect the expression of KAT6B in HCC tissues and analyze its connection with the clinicopathological features of HCC. Methods: First, we performed immunohistochemical staining on 250 HCC tissues and 222 non-tumor liver tissues to examine the expression of KAT6B.Then the relation between KAT6B expression and clinicopathological parameters was analyzed by chi-square test, and the overall survival analysis was conducted by Kaplan-Meier survival method. In addition, based on the Oncomine expression array online and the UALCAN database, we compared KAT6B expression differences between normal liver tissues and HCC tissues more broadly. Results: Compared with normal tissues, KAT6B expression was significantly lower in HCC tissues. Low KAT6B expression was found to be related to gender, AFP level, and tumor size. According to the online database, KAT6B expression was found to be decreased in HCC tissues and high in normal tissues. Conclusions: Lower expression of KAT6B is associated with poor prognosis of HCC, and KAT6B may be a potential tumor suppressor in liver cancer.
Machine learning prediction of diabetic foot ulcers in the inpatient population
Authors: Stefanopoulos Stavros , Ayoub Samar , Qiu Qiong , Ren Gang , Osman Mohamed , Nazzal Munier , Ahmed Ayman 
Published: August 2021

Background The objective of this study was to create an algorithm that could predict diabetic foot ulcer (DFU) incidence in the in-patient population. Materials and Methods The Nationwide Inpatient Sample datasets were examined from 2008 to 2014. The International Classification of Diseases 9th Edition Clinical Modification (ICD-9-CM) and the Agency for Healthcare Research and Quality comorbidity codes were used to assist in the data collection. Chi-square testing was conducted, using variables that positively correlated with DFUs. For descriptive statistics, the Student T-test, Wilcoxon rank sum test, and chi-square test were used. There were six predictive variables that were identified. A decision tree model CTREE was utilized to help develop an algorithm. Results 326,853 patients were noted to have DFU. The major variables that contributed to this diagnosis (both with p < 0.001) were cellulitis (OR 63.87, 95% CI [63.87–64.49]) and Charcot joint (OR 25.64, 95% CI [25.09–26.20]). The model performance of the six-variable testing data was 79.5% (80.6% sensitivity and 78.3% specificity). The area under the curve (AUC) for the 6-variable model was 0.88. Conclusion We developed an algorithm with a 79.8% accuracy that could predict the likelihood of developing a DFU.
Status of pulmonary fungal pathogens among individuals with clinical features of pulmonary tuberculosis at Mbarara University Teaching Hospital in Southwestern Uganda
Authors: Njovu Israel Kiiza , Musinguzi Benson , Mwesigye James , Kassaza Kennedy , Turigurwa Joseph , Nuwagira Edwin , Bazira Joel , Kabanda Taseera , Mpeirwe Moses , Ampaire Lucas , Mutekanga Andrew , Kiguli James , Achan Beatrice , Itabangi Herbert 
Published: August 2021

Background: Pulmonary mycoses are important diseases of the respiratory tract caused by pulmonary fungal pathogens. These pathogens are responsible for significant morbidity and mortality rates worldwide; however, less attention has been paid to them. In this study we determined the prevalence of pulmonary fungal pathogens among individuals with clinical features of pulmonary tuberculosis at Mbarara Regional Referral Hospital. Method: This was a hospital based cross sectional survey. Sputum samples were collected from each study participant. For each sample, the following tests were performed: Sabouraud dextrose agar for fungal culture, GeneXpert for Mycobacteria tuberculosis (MTB) and potassium hydroxide for fungal screening. Filamentous fungal growth and yeasts were further examined with lactophenol cotton blue staining and germ tube respectively. Results: Out of 113 study participants, 80 (70.7%) had pulmonary fungal pathogens whilst those with pulmonary tuberculosis numbered five (4.4%). Candida albicans [21 (22.58%)] and Aspergillus species [16 (17.20%)] were the pathogens most identified among others. Two (1.7%) TB GeneXpert positive participants had fungal pathogens isolated from their sputum samples. We established a prevalence of 57 (71.3%) for pulmonary fungal pathogen (PFP) isolates, three (60.0%) for MTB in HIV positive patients and 18 (22.5%) for PFP, and zero (0.0%) for MTB in HIV negative patients. On the other hand, two (100%) HIV positive patients had both PFP isolates and MTB. Conclusion: Our findings highlight the diversity of neglected pulmonary fungal pathogens whose known medical importance in causing pulmonary mycoses cannot be overemphasised. Therefore this presents a need for routine diagnosis for pulmonary mycoses among TB suspects and set-up of antimicrobial profile for pulmonary fungal isolates to support clinical management of these cases.
A novel hypokalaemic polymyopathy and subsequent unrelated nutritional thiamine deficiency in a young Burmese cat
Authors: Brough Abigail , Duchaussoy Anne-Claire 
Published: August 2021

Case summary An 8-month-old female spayed Burmese cat was referred for investigation of reduced appetite, reluctance to walk and jump and amaurosis. On serum biochemistry there was severe hypokalaemia and marked elevation of creatine kinase, suggestive of hypokalaemic polymyopathy. The neurological signs were consistent with thiamine deficiency. The cat was negative for the periodic hypokalaemic polymyopathy (PHP) of Burmese cats, and was ultimately diagnosed with a previously undescribed potassium wasting nephropathy requiring ongoing oral potassium supplementation. The response to treatment was excellent and the cat has remained clinically normal over a 12-month follow-up period. Relevance and novel information PHP in Burmese cats has been well described, but all cases to date have been shown to be secondary to a genetic mutation in WNK4, resulting in potassium wasting into the urine. This is the first case report of another potassium wasting nephropathy in a young Burmese cat, with subsequent development of nutritional thiamine deficiency.
Qualitative exploration of digital chatbot use in medical education: A pilot study
Authors: Kaur Anjuli , Singh Sid , Chandan Joht S , Robbins Tim , Patel Vinod 
Published: August 2021

Purpose During the coronavirus disease 2019 pandemic, face-to-face teaching has been severely disrupted and limited for medical students internationally. This study explores the views of medical students and academic medical staff regarding the suitability and limitations, of a bespoke chatbot tool to support medical education. Methods Five focus groups, with a total of 16 participants, were recruited using a convenience sample. The participants included medical students across all year groups and academic staff. The pre-determined focus group topic guide explored how chatbots can augment existing teaching practices. A thematic analysis was conducted using the transcripts to determine key themes. Results Thematic analysis identified five main themes: (1) chatbot use as a clinical simulation tool; (2) chatbot use as a revision tool; (3) differential usefulness by medical school year group; (4) standardisation of education and assessment; (5) challenges of use and implementation. Conclusions Both staff and students have clear benefits from using chatbots in medical education. However, they documented possible limitations to their use. The creation of chatbots to support the medical curriculum should be further explored and urgently evaluated to assess their impact on medical students training both during and after the global pandemic.
Minimally Invasive vs. Open Surgery for Lumbar Spinal Stenosis in Patients with Diabetes – A Canadian Spine Outcomes and Research Network Study
Authors: Hathi Kalpesh , Bigney Erin , Richardson Eden , Alugo Tolu , El-Mughayyar Dana , Vandewint Amanda , Manson Neil , Abraham Edward , Small Chris , Thomas Kenneth , Fisher Charles G. , Rampersaud Y. Raja , Hall Hamilton , McIntosh Greg , Johnson Michael G. , Bailey Christopher S. , Weber Michael H. , Paquet Jerome , Kingwell Stephen , Nataraj Andrew , Finkelstein Joel , Kelly Adrienne , Attabib Najmedden 
Published: August 2021

Study Design Retrospective cohort. Objectives To compare outcomes of minimally invasive surgery (MIS) vs open surgery (OPEN) for lumbar spinal stenosis (LSS) in patients with diabetes. Methods Patients with diabetes who underwent spinal decompression alone or with fusion for LSS within the Canadian Spine Outcomes and Research Network (CSORN) database were included. MIS vs OPEN outcomes were compared for 2 cohorts: (1) patients with diabetes who underwent decompression alone (N = 116; MIS n = 58 and OPEN n = 58), (2) patients with diabetes who underwent decompression with fusion (N = 108; MIS n = 54 and OPEN n = 54). Modified Oswestry Disability Index (mODI) and back and leg pain were compared at baseline, 6–18 weeks, and 1-year post-operation. The number of patients meeting minimum clinically important difference (MCID) or minimum pain/disability at 1-year was compared. Results MIS approaches had less blood loss (decompression alone difference 100 mL, P = .002; with fusion difference 244 mL, P < .001) and shorter length of stay (LOS) (decompression alone difference 1.2 days, P = .008; with fusion difference 1.2 days, P = .026). MIS compared to OPEN decompression with fusion had less patients experiencing adverse events (AEs) (difference 13 patients, P = .007). The MIS decompression with fusion group had lower 1-year mODI (difference 14.5, 95% CI [7.5, 21.0], P < .001) and back pain (difference 1.6, 95% CI [.6, 2.7], P = .002) compared to OPEN. More patients in the MIS decompression with fusion group exceeded MCID at 1-year for mODI (MIS 75.9% vs OPEN 53.7%, P = .028) and back pain (MIS 85.2% vs OPEN 70.4%, P = .017). Conclusions MIS approaches were associated with more favorable outcomes for patients with diabetes undergoing decompression with fusion for LSS.
Evaluation of Osseous Incorporation After Osteochondral Allograft Transplantation: Correlation of Computed Tomography Parameters With Patient-Reported Outcomes
Authors: Anderson Devon E. , Bogner Eric A. , Schiffman Scott R. , Rodeo Scott A. , Wiedrick Jack , Crawford Dennis C. 
Published: August 2021

Background: Studies have reported favorable clinical outcomes after osteochondral allograft (OCA) transplantation to treat osteochondral defects and have demonstrated that healing of the osseous component may be critical to outcomes. However, there is currently no consensus on the optimal modality to evaluate osseous healing. Purpose: To define parameters for OCA healing using computed tomography (CT) and to investigate whether osseous healing identified using CT is correlated with improved pain and function on patient-reported outcomes (PROs) collected closest in time to the postoperative CT scan and at final follow-up. Study Design: Case series; Level of evidence, 4. Methods: Of 118 patients who underwent OCA transplantation for articular cartilage defects of the knee over the 10-year study period, 60 were included in final analysis based on completion of CT scans at 5.8 ± 1.9 months postoperatively and PROs collected preoperatively and postoperatively. CT parameters, including osseous incorporation, bone density, subchondral bone congruency, and cystic changes, were summarized for each patient relative to the cohort. Parameters were assessed for inter- and intrarater reliability as well as for covariation with patient characteristics and surgical variables. Structural equation modeling was used to assess correlation of CT parameters with change in PROs from preoperatively to those collected closest in time to CT acquisition and at the final follow-up. Results: Bone incorporation was the most reliable CT parameter. The summarized scores for CT scans were normally distributed across the study population. Variance in CT parameters was independent of age, sex, body mass index, prior surgery, number of grafts, lesion size, and location. No significant correlation ( P > .12 across all comparisons) was identified for any combination of CT parameter and change in PROs from baseline for outcomes collected either closest to CT acquisition or at the final follow-up (mean, 38.2 ± 19.9 months; range, 11.6-84.9 months). There was a uniformly positive association between change in PROs and host bone density but not graft bone density, independent of patient characteristics and surgical factors. Conclusion: CT parameters were independent of clinical or patient variables within the study population, and osseous incorporation was the most reliable CT parameter. Metrics collected from a single postoperative CT scan was not correlated with clinical outcomes at ≥6-month longitudinal follow-up.
Estonian young stroke registry: High burden of risk factors and high prevalence of cardioembolic and large-artery stroke
Authors: Vibo Riina , Schneider Siim , Kõrv Liisa , Mallene Sandra , Torop Liisi-Anette , Kõrv Janika 
Published: August 2021

Background and aims The aim of the present study was to assess the risk factor burden and stroke etiology of young stroke patients in Estonia and to compare the results with similar cohorts from other countries. Methods This study includes ischemic stroke patients aged 18–54 years from the prospective Estonian Young Stroke Registry between 2013 and 2020. All patients were managed in a stroke unit following a prespecified detailed protocol. Data on stroke risk factors, etiology, and stroke severity were analyzed. Results A total of 437 patients (mean age 44.7 ± 8.3 years; 62% males) were included in the registry during the 8-year study period. A total of 50.2% of patients had ≥ 3 well-documented risk factors (higher for men: odds ratio (OR) 3.8; 95% confidence interval (CI) 1.8–8.3; p < .001) and 6.2% of patients had ≥ 3 less well-documented risk factors. While 42% of patients had undetermined cause of stroke (34% of them cryptogenic), the second most frequent etiologies were large-artery atherosclerosis and cardioembolism (both 19%). 60 percent of cardioembolic strokes were due to high-risk causes. Large-artery atherosclerosis was more prevalent in men (OR 1.8; 95% CI 1–3.3; p = .05) and among older patients (OR 6.2; 95% CI 1.8–21.4; p = .008). The median National Institutes of Health Stroke Scale score on admission was 3 (interquartile ranges 2–6), stroke was more severe in men ( p = .05). Conclusions Our study revealed that young patients with stroke in Estonia have higher burden of well-documented risk factors, higher prevalence of high-risk cardioembolic causes and higher prevalence of large-artery stroke compared to other young stroke cohorts.
Progress in Iron Oxides Based Nanostructures for Applications in Energy Storage
Authors: Lv Linfeng , Peng Mengdi , Wu Leixin , Dong Yixiao , You Gongchuan , Duan Yixue , Yang Wei , He Liang , Liu Xiaoyu 
Published: August 2021

AbstractThe demand for green and efficient energy storage devices in daily life is constantly rising, which is caused by the global environment and energy problems. Lithium-ion batteries (LIBs), an important kind of energy storage devices, are attracting much attention. Graphite is used as LIBs anode, however, its theoretical capacity is low, so it is necessary to develop LIBs anode with higher capacity. Application strategies and research progresses of novel iron oxides and their composites as LIBs anode in recent years are summarized in this review. Herein we enumerate several typical synthesis methods to obtain a variety of iron oxides based nanostructures, such as gas phase deposition, co-precipitation, electrochemical method, etc. For characterization of the iron oxides based nanostructures, especially the in-situ X-ray diffraction and 57Fe Mössbauer spectroscopy are elaborated. Furthermore, the electrochemical applications of iron oxides based nanostructures and their composites are discussed and summarized.Graphic Abstract
Levels and risks of antineoplastic drugs in households of oncology patients, hospices and retirement homes
Authors: Bláhová Lucie , Kuta Jan , Doležalová Lenka , Kozáková Šárka , Hojdarová Tereza , Bláha Luděk 
Published: August 2021

Abstract
Background
Contamination of the indoor environment by antineoplastic drugs (ADs) is known to pose health risks to the exposed staff in hospitals or pharmacies. ADs may also contaminate households of the patients receiving chemotherapy, but the exposure levels and potential risks to family members have not been studied. The objective was to provide an in-depth research of surface contamination by ADs inside homes focusing on the households of oncology patients, hospices, and retirement houses.

Methods
The study was carried out in 17 patient households, 2 hospices, and 3 retirement homes. Surfaces were sampled using a standardized approach and the wipe samples were analyzed by UPLC–MS for 11 organic ADs and by ICP-MS/MS for total Pt as a marker of Pt-based ADs.

Results
The main study included repeated samplings of surfaces (floors, desktops) in households of 17 ambulant oncology patients receiving different chemotherapies with cyclophosphamide (CP), platinum-based drugs (Pt), doxorubicin (DOX), 5-fluorouracil (FU) and others. Patients treated with chemotherapy were found to serve as a source of contamination for their households, representing thus a risk to sensitive family members such as children or elderly people. Carcinogenic CP was commonly found at relatively high concentrations, especially during the first 6 days after the chemotherapy (maximum 511 pg/cm2). Sweat seems to be a major medium for the spread of the contamination, and high and long-time persisting CP levels (traces still found after 6 months post-chemotherapy) were found on various desktops including kitchen dining tables. The pilot studies in hospices and retirement homes indicated rather lower exposure risks of the personnel but pointed to potential long-lasting contamination by Pt or some other persistent ADs such as ifosfamide (IF).

Conclusions
This is one of the first studies investigating the contamination by ADs in indoor environments outside of hospitals or pharmacies. Peak concentrations of the carcinogenic CP in households were comparable to those observed in hospitals, but the temporal exposures are likely to cause lower risks to family members and caregivers compared to the long-time occupationally exposed health care personnel. The information guidance flier with practical recommendations was prepared improving thus information as well as prevention of eventual risks for family members.
An alternative D. melanogaster 7SK snRNP
Authors: Nguyen Duy , Buisine Nicolas , Fayol Olivier , Michels Annemieke A. , Bensaude Olivier , Price David H. , Uguen Patricia 
Published: August 2021

Abstract
Background
The 7SK small nuclear RNA (snRNA) found in most metazoans is a key regulator of P-TEFb which in turn regulates RNA polymerase II elongation. Although its primary sequence varies in protostomes, its secondary structure and function are conserved across evolutionary distant taxa.

Results
Here, we describe a novel ncRNA sharing many features characteristic of 7SK RNAs, in D. melanogaster. We examined the structure of the corresponding gene and determined the expression profiles of the encoded RNA, called snRNA:7SK:94F, during development. It is probably produced from the transcription of a lncRNA which is processed into a mature snRNA. We also addressed its biological function and we show that, like dm7SK, this alternative 7SK interacts in vivo with the different partners of the P-TEFb complex, i.e. HEXIM, LARP7 and Cyclin T. This novel RNA is widely expressed across tissues.

Conclusion
We propose that two distinct 7SK genes might contribute to the formation of the 7SK snRNP complex in D. melanogaster.