bluuebunny/crossref_metadata_2025_split huggingface dataset:
Multifrequency magnetic resonance elastography-based tomoelastography of the parotid glands–feasibility and reference values
Authors: Elsholtz Fabian Henry Jürgen , Reiter Rolf , Marticorena Garcia Stephan Rodrigo , Braun Jürgen , Sack Ingolf , Hamm Bernd , Schaafs Lars-Arne 
Published: September 2021

Objectives:Accurate radiological differentiation of parotid tumors remains challenging despite recent technical advances in quantitative medical imaging. Multifrequency magnetic resonance elastography (MRE) could provide additional information on viscoelastic properties of normal and abnormal biological tissues. This study investigates the feasibility of MRE of the parotid glands in healthy participants and provides first reference values.Methods:20 healthy participants underwent multifrequency MRE of both parotid glands at 3 Tesla. Shear waves at frequencies of 25, 30, 40, and 50 Hz were introduced into the participants' heads through the occiput using pressurized-air actuators. Shear wave speed (SWS) and loss angle of the shear modulus (φ) were reconstructed by tomoelastography post-processing as surrogate parameters for tissue stiffness and viscosity or fluidity. 10 participants underwent repeated MRE to determine test–retest reliability based on intraclass correlation coefficients.Results:All MRE datasets acquired could be included in the analysis. Mean SWS was 0.97 ± 0.13 m/s, and mean φ was 0.59 ± 0.05 rad, each for both sides combined and without notable lateral difference (p = 0.88/0.87). Test–retest reliability was good for SWS (ICC = 0.84 for both sides/ICC = 0.77 for the right side/ICC = 0.79 for the left side) and good to excellent for φ(ICC = 0.94/0.86/0.90).Conclusions:Multifrequency MRE of the parotid glands is feasible and reliable. This technique, therefore, is a promising method for investigating the viscoelastic properties of salivary gland tumors in future studies.
Understanding service reorganisation in the Irish health & social care system from 1998 to 2020: lessons for reform and transformation
Authors: Barry Sarah , Stach Malgorzata , Thomas Steve , Burke Sara 
Published: September 2021

Background: Given policy drives for integrated care and other reforms requiring service reorganisation this study analyses service reorganisation in the Irish health and social care system from 1998 to 2020 with the aim of identifying lessons for reform implementation and system learning generally. Methods: A mixed-method, co-designed study of three distinct datasets through in a policy document analysis, a thematic analysis of interviews with elite respondents, and a formal review of the international literature, sets the Irish reorganisation story in the context of services and system reorganisation elsewhere. This approach is apt given the complexity involved. Results: We find repeated policy declarations for forms of integrated care from the early 1990s in Ireland. These have not resulted in effective change across the system due to political, organisational and implementation failures. We identify poor clarity and commitment to policy and process, weak change management and resourcing, and reluctance from within the system to change established ways of working, cultures and allegiances. Given its narrative approach and identification of key lessons, this study is of use to policy makers, researchers and practitioners, clinical and managerial. It forms part of a bigger project of evidence building for the implementation of Sláintecare, Ireland’s 10-year health system reform programme. Conclusions: The paper captures important lessons for regionalisation of services delivery and other reorganisations in service-based systems more generally. We find evidence of a negative policy/implementation/practice cycle repeatedly missing opportunities for reform. Learning to break this cycle is essential for implementing Sláintecare and other complex reorganisational health reforms generally.
Validation and clinical application of a method to quantify efavirenz in cervicovaginal secretions from flocked swabs using liquid chromatography tandem mass spectrometry
Authors: Olagunju Adeniyi , Nwogu Jacinta , Eniayewu Oluwasegun , Atoyebi Shakir , Amara Alieu , Kpamor John , Bolaji Oluseye , Adejuyigbe Ebunoluwa , Owen Andrew , Khoo Saye 
Published: September 2021

Background: A liquid chromatography tandem mass spectrometry method to quantify drugs in dried cervicovaginal secretions from flocked swabs was developed and validated using the antiretroviral efavirenz as an example. Methods: Cervicovaginal swabs (CVS) were prepared by submerging flocked swabs in efavirenz-spiked matrix. Time to full saturation, weight uniformity, recovery and room temperature stability were evaluated. Chromatographic separation was on a reverse-phase C18 column by gradient elution using 1mM ammonium acetate in water/acetonitrile at 400 µL/min. Detection and quantification were on a TSQ Quantum Access triple quadrupole mass spectrometer operated in negative ionisation mode. The method was used to quantify efavirenz in CVS samples from human immunodeficiency virus (HIV)-positive women in the VADICT study (NCT03284645). A total of 98 samples (35 paired intensive CVS and DBS samples, 14 paired sparse CVS and DBS samples) from 19 participants were available for this analysis. Results: Swabs were fully saturated within 15 seconds, absorbing 128 µL of matrix with coefficient of variation (%CV) below 1.3%. The method was linear with a weighting factor (1/X) in the range of 25-10000 ng/mL with inter- and intra-day precision (% CV) of 7.69-14.9%, and accuracy (% bias) of 99.1-105.3%. Mean recovery of efavirenz from CVS was 83.8% (%CV, 11.2) with no significant matrix effect. Efavirenz remained stable in swabs for at least 35 days after drying and storage at room temperature. Median (range) CVS efavirenz AUC0-24h was 16370 ng*h/mL (5803-22088), Cmax was 1618 ng/mL (610-2438) at a Tmax of 8.0 h (8.0-12), and Cmin was 399 ng/mL (110-981). Efavirenz CVS:plasma AUC0-24 ratio was 0.41 (0.20-0.59). Conclusions: Further application of this method will improve our understanding of the pharmacology of other therapeutics in the female genital tract, including in low- and middle-income countries.
Toward Robust Monitoring of Malicious Outbreaks
Authors: Tang Shaojie , Liu Siyuan , Han Xu , Qiao Yu 
Published: September 2021

Recently, diffusion processes in social networks have attracted increasing attention within computer science, marketing science, social sciences, and political science. Although the majority of existing works focus on maximizing the reach of desirable diffusion processes, we are interested in deploying a group of monitors to detect malicious diffusion processes such as the spread of computer worms. In this work, we introduce and study the [Formula: see text]-Monitoring Game} on networks. Our game is composed of two parties an attacker and a defender. The attacker can launch an attack by distributing a limited number of seeds (i.e., virus) to the network. Under our [Formula: see text]-Monitoring Game, we say an attack is successful if and only if the following two conditions are satisfied: (1) the outbreak/propagation reaches at least α individuals without intervention, and (2) it has not been detected before reaching β individuals. Typically, we require that β is no larger than α in order to compensate the reaction delays after the outbreak has been detected. On the other end, the defender’s ultimate goal is to deploy a set of monitors in the network that can minimize attacker’s success ratio in the worst-case. (We also extend the basic model by considering a noisy diffusion model, where the propagation probabilities on each edge could vary within an interval.) Our work is built upon recent work in security games, our adversarial setting provides robust solutions in practice. Summary of Contribution: Although the diffusion processes in social networks have been extensively studied, most existing works aim at maximizing the reach of desirable diffusion processes. We are interested in deploying a group of monitors to detect malicious diffusion processes, such as the spread of computer worms. To capture the impact of model uncertainty, we consider a noisy diffusion model in which the propagation probabilities on each edge could vary within an interval. Our work is built upon recent work in security games; our adversarial setting leads to robust solutions in practice.
Capsular ligaments provide a passive stabilizing force to protect the hip against edge loading
Authors: Karunaseelan Kabelan J. , Dandridge Oliver , Muirhead-Allwood Sarah K. , van Arkel Richard J. , Jeffers Jonathan R. T. 
Published: September 2021

Aims In the native hip, the hip capsular ligaments tighten at the limits of range of hip motion and may provide a passive stabilizing force to protect the hip against edge loading. In this study we quantified the stabilizing force vectors generated by capsular ligaments at extreme range of motion (ROM), and examined their ability to prevent edge loading. Methods Torque-rotation curves were obtained from nine cadaveric hips to define the rotational restraint contributions of the capsular ligaments in 36 positions. A ligament model was developed to determine the line-of-action and effective moment arms of the medial/lateral iliofemoral, ischiofemoral, and pubofemoral ligaments in all positions. The functioning ligament forces and stiffness were determined at 5 Nm rotational restraint. In each position, the contribution of engaged capsular ligaments to the joint reaction force was used to evaluate the net force vector generated by the capsule. Results The medial and lateral arms of the iliofemoral ligament generated the highest inbound force vector in positions combining extension and adduction providing anterior stability. The ischiofemoral ligament generated the highest inbound force in flexion with adduction and internal rotation (FADIR), reducing the risk of posterior dislocation. In this position the hip joint reaction force moved 0.8° inbound per Nm of internal capsular restraint, preventing edge loading. Conclusion The capsular ligaments contribute to keep the joint force vector inbound from the edge of the acetabulum at extreme ROM. Preservation and appropriate tensioning of these structures following any type of hip surgery may be crucial to minimizing complications related to joint instability. Cite this article: Bone Joint Res 2021;10(9):594–601.
An old drug and different ways to treat cutaneous leishmaniasis: Intralesional and intramuscular meglumine antimoniate in a reference center, Rio de Janeiro, Brazil
Authors: Oliveira-Ribeiro Carla , Pimentel Maria Inês Fernandes , Oliveira Liliane de Fátima Antonio , Vasconcellos Érica de Camargo Ferreira e , Conceição-Silva Fatima , Schubach Armando de Oliveira , Fagundes Aline , de Mello Cintia Xavier , Mouta-Confort Eliame , Miranda Luciana de Freitas Campos , Valete-Rosalino Claudia Maria , Martins Ana Cristina da Costa , Oliveira Raquel de Vasconcellos Carvalhaes de , Quintella Leonardo Pereira , Lyra Marcelo Rosandiski 
Published: September 2021

BackgroundTreatment of cutaneous leishmaniasis (CL) remains challenging since the drugs currently used are quite toxic, thus contributing to lethality unrelated to the disease itself but to adverse events (AE). The main objective was to evaluate different treatment regimens with meglumine antimoniate (MA), in a reference center in Rio de Janeiro, Brazil.MethodologyA historical cohort of 592 patients that underwent physical and laboratory examination were enrolled between 2000 and 2017. The outcome measures of effectiveness were epithelialization and complete healing of cutaneous lesions. AE were graded using a standardized scale. Three groups were evaluated: Standard regimen (SR): intramuscular (IM) MA 10–20 mg Sb5+/kg/day during 20 days (n = 46); Alternative regimen (AR): IM MA 5 mg Sb5+/kg/day during 30 days (n = 456); Intralesional route (IL): MA infiltration in the lesion(s) through subcutaneous injections (n = 90). Statistical analysis was performed through Fisher exact and Pearson Chi-square tests, Kruskal-Wallis, Kaplan-Meier and log-rank tests.ResultsSR, AR and IL showed efficacy of 95.3%, 84.3% and 75.9%, with abandonment rate of 6.5%, 2.4% and 3.4%, respectively. IL patients had more comorbidities (58.9%; p = 0.001), were mostly over 50 years of age (55.6%), and had an evolution time longer than 2 months (65.6%; p = 0.02). Time for epithelialization and complete healing were similar in IL and IM MA groups (p = 0.9 and p = 0.5; respectively). Total AE and moderate to severe AE that frequently led to treatment interruption were more common in SR group, while AR and IL showed less toxicity.Conclusions/SignificanceAR and IL showed less toxicity and may be good options especially in CL cases with comorbidities, although SR treatment was more effective. IL treatment was an effective and safe strategy, and it may be used as first therapy option as well as a rescue scheme in patients initially treated with other drugs.
Predictors of severity and development of critical illness of Egyptian COVID-19 patients: A multicenter study
Authors: Omran Dalia , Al Soda Mohamed , Bahbah Eshak , Esmat Gamal , Shousha Hend , Elgebaly Ahmed , Abdel Ghaffar Muhammad , Alsheikh Mohamed , El Sayed Enass , Afify Shimaa , Abdel Hafez Samah , Elkelany Khaled , Eltayar Ayman , Ali Omnia , Kamal Lamiaa , Heiba Ahmed 
Published: September 2021

Objectives
We conducted the present multicenter, retrospective study to assess the epidemiological, clinical, laboratory, and radiological characteristics associated with critical illness among patients with COVID-19 from Egypt.

Methods
The present study was a multicenter, retrospective study that retrieved the data of all Egyptian cases with confirmed COVID-19 admitted to hospitals affiliated to the General Organization for Teaching Hospitals and Institutes (GOTHI) through the period from March to July 2020. The diagnosis of COVID-19 was based on a positive reverse transcription-polymerase chain reaction (RT-PCR) laboratory test.

Results
This retrospective study included 2724 COVID-19 patients, of whom 423 (15.52%) were critically ill. Approximately 45.86% of the critical group aged above 60 years, compared to 39.59% in the non-critical group (p = 0.016). Multivariate analysis showed that many factors were predictors of critically illness, including age >60 years (OR = 1.30, 95% CI [1.05, 1.61], p = 0.014), low oxygen saturation (OR = 0.93, 95% CI [0.91, 0.95], p<0.001), low Glasgow coma scale (OR = 0.75, 95% CI [0.67, 0.84], p<0.001), diabetes (OR = 1.62, 95% CI [1.26, 2.08], p<0.001), cancer (OR = 2.47, 95% CI [1.41, 4.35], p = 0.002), and serum ferritin (OR = 1.004, 95% CI [1.0003, 1.008], p = 0.031).

Conclusion
In the present report, we demonstrated that many factors are associated with COVID-19 critical illness, including older age groups, fatigue, elevated temperature, increased pulse, lower oxygen saturation, the preexistence of diabetes, malignancies, cardiovascular disease, renal diseases, and pulmonary disease. Moreover, elevated serum levels of ALT, AST, and ferritin are associated with worse outcomes. Further studies are required to identify independent predictors of mortality for patients with COVID-19.
Predicting fracture outcomes from clinical registry data using artificial intelligence supplemented models for evidence-informed treatment (PRAISE) study protocol
Authors: Dipnall Joanna F. , Page Richard , Du Lan , Costa Matthew , Lyons Ronan A. , Cameron Peter , de Steiger Richard , Hau Raphael , Bucknill Andrew , Oppy Andrew , Edwards Elton , Varma Dinesh , Jung Myong Chol , Gabbe Belinda J. 
Published: September 2021

BackgroundDistal radius (wrist) fractures are the second most common fracture admitted to hospital. The anatomical pattern of these types of injuries is diverse, with variation in clinical management, guidelines for management remain inconclusive, and the uptake of findings from clinical trials into routine practice limited. Robust predictive modelling, which considers both the characteristics of the fracture and patient, provides the best opportunity to reduce variation in care and improve patient outcomes. This type of data is housed in unstructured data sources with no particular format or schema. The “Predicting fracture outcomes from clinical Registry data using Artificial Intelligence (AI) Supplemented models for Evidence-informed treatment (PRAISE)” study aims to use AI methods on unstructured data to describe the fracture characteristics and test if using this information improves identification of key fracture characteristics and prediction of patient-reported outcome measures and clinical outcomes following wrist fractures compared to prediction models based on standard registry data.Methods and designAdult (16+ years) patients presenting to the emergency department, treated in a short stay unit, or admitted to hospital for >24h for management of a wrist fracture in four Victorian hospitals will be included in this study. The study will use routine registry data from the Victorian Orthopaedic Trauma Outcomes Registry (VOTOR), and electronic medical record (EMR) information (e.g. X-rays, surgical reports, radiology reports, images). A multimodal deep learning fracture reasoning system (DLFRS) will be developed that reasons on EMR information. Machine learning prediction models will test the performance with/without output from the DLFRS.DiscussionThe PRAISE study will establish the use of AI techniques to provide enhanced information about fracture characteristics in people with wrist fractures. Prediction models using AI derived characteristics are expected to provide better prediction of clinical and patient-reported outcomes following distal radius fracture.
Infant and young child feeding practice among mothers of children age 6 to 23 months in Debrelibanos district, North Showa zone, Oromia region, Ethiopia
Authors: Mekonnen Mathewos , Kinati Tadele , Bekele Kumera , Tesfa Bikila , Hailu Dejene , Jemal Kemal 
Published: September 2021

Background
Inappropriate infant and young child feeding (IYCF) practice is the leading cause of malnutrition in children. Data is needed to identify children at risk of poor feeding practice and to target interventions to improve IYCF practices. Therefore, this study aimed to assess IYCF practice and associated factors among mothers of children age 6 to 23 months in Debrelibanos district, north Showa zone, Oromia region, Ethiopia.

Method
A community-based cross-sectional study design was conducted among 380 mothers of children age 6 to 23 months from March 1 to April 5, 2019. A simple random sampling technique was used to select the respondents. Data was collected using a structured interviewer-administered questionnaire that had been pretested. The data was entered into Epi-Data 3.1 and then transferred to SPSS 21 for analysis. Descriptive statistical analysis was done, and an association between an outcome variable and independent variables was examined in logistic regression models.

Result
Overall, 65.8% of mothers practiced appropriate IYCF practice. The study revealed that 70.5% of children started breastfeeding within one hour of birth, and 61.6% were breastfed exclusively for six months. Among studied mothers, 79.5% continued to breastfeed their children until 2 years, and 69.2% of the participants started complementary feeding timely at six months. Minimum dietary diversity was observed in 19.2% of children, while minimum meal frequency was found in 79.2%. The majority of mothers (77.6%) fed their babies with bottles. Mother’s educational status of primary school [AOR = 4.50, 95% CI: (1.38,14.61)], husband’s occupation being merchant [AOR = 6.45, 95% CI: (1.51, 27.59)]; antenatal care follows up [AOR = 3.15, % CI: (1.22, 8.12)], radio/television ownership [AOR = 7.41, 95% CI: (2.86, 19.20)], child’s sex being female [AOR = 4.78, 95% CI: (2.26, 10.064) and sufficient knowledge on child feeding [AOR = 2.82, 95% CI: (1.27, 26.26)] were independent predictors for appropriate IYCF practice.

Conclusion
The prevalence of appropriate infant and young child feeding practice indicators was found to be rather high among the mothers in this study. The use of a bottle to feed babies, in particular is very common among the mothers who were studied. To address child malnutrition, it is critical to educate families about proper IYCF practices. This study suggests that mothers be properly educated about IYCF recommendations at health care facilities during their visits, as well as the promotion of appropriate IYCF through various media.
Billy Higgins in the Zone: Brushwork, Breath, and Imagination
Authors: Williams James Gordon 
Published: September 2021

This Chapter presents an analysis of the late drummer and community leader Billy Higgins’s improvised brushwork and breathing strategies in his performance on Hoagy Carmichael’s “Georgia on My Mind” on his frequent collaborator’s Charles Lloyd’s recording The Water Is Wide (2000). Connecting with the book’s theme of political and cultural considerations of what it means to create Black musical space, Ashon Crawley’s “black pneuma” interpretive frame is used to help understand Higgins’s breathing strategies relative to his drumming as an orchestration of individual and community sound. Higgins’s breathing strategies during improvisation are theorized as a way to cross bar lines, accessing all colors of the human condition while creating a Black sense of musical place. Higgins’s values of musical place-making thrive through his ego-denying philosophy for the benefit of group sound throughout his career and within the social movement of Leimert Park.
Historia de un matrimonio
Authors: Pereira Domínguez Carmen , Rodríguez Hernández Juan Antonio 
Published: September 2021

Se aborda el proceso de divorcio de una pareja con un hijo que ejerce su carrera profesional en ciudades distantes entre sí (Los Ángeles y New York). La peculiaridad de esta familia es que pertenece al mundo escénico: Charlie, el padre, es director de teatro y Nicole, la madre, es actriz. Por lo demás, se evidencia un modelo de familia nuclear con un padre, una madre y un hijo; un contexto que sin duda ayudará a los espectadores a conectar con el argumento.
Se trata de la historia de un profundo desencuentro entre la pareja que termina en divorcio, a pesar de las variadas señales de cariño que apreciamos a lo largo de todo el metraje. Asimismo, se observan pequeños roces y acaloradas discusiones fuera de tono. No obstante, esta vivencia se aleja de cualquier acto violento y busca el equilibrio entre las voces de los personajes y la crudeza de la misma separación.
Henry es el hijo de ocho años del matrimonio que vivirá de cerca el proceso de divorcio de sus padres; poco a poco comprenderá que su relación con ellos cambiará para siempre y el amor que le profesan consolidará el respeto y la afectividad entre ambos.