bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of different thresholds for CT perfusion volumetric analysis on estimated ischemic core and penumbral volumes
Authors: Karhi Simo , Tähtinen Olli , Aherto Joona , Matikka Hanna , Manninen Hannu , Nerg Ossi , Taina Mikko , Jäkälä Pekka , Vanninen Ritva 
Published: April 2021

Purpose
This single-center study compared three threshold settings for automated analysis of the ischemic core (IC) and penumbral volumes using computed tomographic perfusion, and their accuracy for predicting final infarct volume (FIV) in patients with anterior circulation acute ischemic stroke (AIS).

Methods
Fifty-two consecutive AIS patients undergoing mechanical thrombectomy (November 2015–March 2018) were included. Perfusion images were retrospectively analyzed using a single CT Neuro perfusion application (syngo.via 4.1, Siemens Healthcare GmbH). Three threshold values (S1–S3) were derived from another commercial package (RAPID; iSchema View) (S1), up-to-date syngo.via default values (S2), and adapted values for syngo.via from a reference study (S3). The results were compared with FIV determined by non-contrast CT.

Results
The median IC volume (mL) was 24.6 (interquartile range: 13.7–58.1) with S1 and 30.1 (20.1–53.1) with S2/S3. After removing the contralateral hemisphere from the analysis, the median IC volume decreased by 1.33(0–3.14) with S1 versus 9.13 (6.24–14.82) with S2/S3. The median penumbral volume (mL) was 74.52 (49.64–131.91), 77.86 (46.56–99.23), and 173.23 (125.86–200.64) for S1, S2, and S3, respectively. Limiting analysis to the affected hemisphere, the penumbral volume decreased by 1.6 (0.13–9.02), 19.29 (12.59–26.52), and 58.33 mL (45.53–74.84) for S1, S2, and S3, respectively. The correlation between IC and FIV was highest in patients with successful recanalization (n = 34, r = 0.784 for S1; r = 0.797 for S2/S3).

Conclusion
Optimizing thresholds significantly improves the accuracy of estimated IC and penumbral volumes. Current recommended values produce diversified results. International guidelines based on larger multicenter studies should be established to support the standardization of volumetric analysis in clinical decision-making.
Late presentation for HIV remains a major health issue in Spain: Results from a multicenter cohort study, 2004–2018
Authors: Rava Marta , Domínguez-Domínguez Lourdes , Bisbal Otilia , López-Cortés Luis Fernando , Busca Carmen , Antela Antonio , González-Ruano Patricia , Hernández Cristina , Iribarren Josè-Antonio , Rubio Rafael , Moreno Santiago , Jarrín Inmaculada ,   Cohort of the Spanish HIV/AIDS Research Network (CoRIS)
Published: April 2021

Objectives
With the purpose of reducing the well-known negative impact of late presentation (LP) on people living with HIV (PLWH), guidelines on early HIV diagnosis were published in 2014 in Spain, but since then no data on LP prevalence have been published. To estimate prevalence and risk factors of LP and to evaluate their impact on the development of clinical outcomes in the Cohort of the Spanish HIV/AIDS Research Network (CoRIS) during 2004–2018.

Methods
CoRIS is an open prospective multicenter cohort of PLWH, adults, naive to ART at entry. LP was defined as HIV diagnosis with CD4 count ≤350 cells/μL or an AIDS defining event (ADE). Multivariable Poisson regression models were used to estimate both prevalence ratios (PR) for the association of potential risk factors with LP and Incidence rate ratios (IRRs) for its impact on the development of the composite endpoint (first ADE, first serious non-AIDS event [SNAE] or overall mortality).

Results
14,876 individuals were included. Overall, LP prevalence in 2004–2018 was 44.6%. Risk factors for LP included older age, having been infected through injection drug use or heterosexual intercourse, low educational level and originating from non-European countries. LP was associated with an increased risk of the composite endpoint (IRR: 1.34; 95%CI 1.20, 1.50), ADE (1.39; 1.18, 1.64), SNAE (1.22; 1.01, 1.47) and mortality (1.71; 1.41, 2.08).

Conclusions
LP remains a health problem in Spain, mainly among certain populations, and is associated with greater morbidity and mortality. Public policies should be implemented to expand screening and early diagnosis of HIV infection, for a focus on those at greatest risk of LP.
The Perme Mobility Index: A new concept to assess mobility level in patients with coronavirus (COVID-19) infection
Authors: Timenetsky Karina Tavares , Serpa Neto Ary , Lazarin Ana Carolina , Pardini Andreia , Moreira Carla Regina Sousa , Corrêa Thiago Domingos , Caserta Eid Raquel Afonso , Nawa Ricardo Kenji 
Published: April 2021

Introduction
The Coronavirus Disease 2019 (COVID-19) outbreak is evolving rapidly worldwide. Data on the mobility level of patients with COVID-19 in the intensive care unit (ICU) are needed.

Objective
To describe the mobility level of patients with COVID-19 admitted to the ICU and to address factors associated with mobility level at the time of ICU discharge.

Methods
Single center, retrospective cohort study. Consecutive patients admitted to the ICU with confirmed COVID-19 infection were analyzed. The mobility status was assessed by the Perme Score at admission and discharge from ICU with higher scores indicating higher mobility level. The Perme Mobility Index (PMI) was calculated [PMI = ΔPerme Score (ICU discharge–ICU admission)/ICU length of stay]. Based on the PMI, patients were divided into two groups: “Improved” (PMI > 0) and “Not improved” (PMI ≤ 0).

Results
A total of 136 patients were included in this analysis. The hospital mortality rate was 16.2%. The Perme Score improved significantly when comparing ICU discharge with ICU admission [20.0 (7–28) points versus 7.0 (0–16) points; P < 0.001]. A total of 88 patients (64.7%) improved their mobility level during ICU stay, and the median PMI of these patients was 1.5 (0.6–3.4). Patients in the improved group had a lower duration of mechanical ventilation [10 (5–14) days versus 15 (8–24) days; P = 0.021], lower hospital length of stay [25 (12–37) days versus 30 (11–48) days; P < 0.001], and lower ICU and hospital mortality rate. Independent predictors for mobility level were lower age, lower Charlson Comorbidity Index, and not having received renal replacement therapy.

Conclusion
Patients’ mobility level was low at ICU admission; however, most patients improved their mobility level during ICU stay. Risk factors associated with the mobility level were age, comorbidities, and use of renal replacement therapy.
What proportion of people have a follow-up biopsy in randomized trials of treatments for non-alcoholic steatohepatitis?: A systematic review and meta-analysis
Authors: Koutoukidis Dimitrios A. , Morris Elizabeth , Henry John A. , Shammoon Yusra , Zimmerman Matthew , Michalopoulou Moscho , Jebb Susan A. , Aveyard Paul 
Published: April 2021

Background and aim
Trials of treatments for non-alcoholic steatohepatitis require endpoint assessment with liver biopsies. Previous large-scale trials have calculated their sample size expecting high retention but on average did not achieve this. We aimed to quantify the proportion of participants with a valid follow-up biopsy.

Methods
We conducted a systematic review of MEDLINE and Embase until May 2020 and included randomized clinical trials of any intervention in non-alcoholic steatohepatitis with at least 1-year follow-up. We were guided by Cochrane methods to run a meta-analysis with generalized linear mixed models with random effects.

Results
Forty-one trials (n = 6,695) were included. The proportion of participants with a valid follow-up biopsy was 82% (95%CI: 78%-86%, I2 = 92%). There was no evidence of a difference by location, trial length, or by allocated treatment group. Reasons for missing follow-up biopsies were, in ranked order, related to participants (95 per 1,000 participants (95%CI: 69–129, I2 = 92%), medical factors, protocol, trial conduct, and other/unclear. Biopsy-related serious adverse events occurred in 16 per 1,000 participants (95% CI: 8–33, I2 = 54%). No biopsy-related deaths were reported.

Conclusions
The proportion of participants with a valid follow-up biopsy in therapeutic trials in non-alcoholic steatohepatitis is on average 82%, with around 1 in 10 participants declining a follow-up biopsy. These findings can inform adequately-powered trials.
Exploring the relationship between maternal prenatal stress and brain structure in premature neonates
Authors: Lautarescu Alexandra , Hadaya Laila , Craig Michael C. , Makropoulos Antonis , Batalle Dafnis , Nosarti Chiara , Edwards A. David , Counsell Serena J. , Victor Suresh 
Published: April 2021

Background
Exposure to maternal stress in utero is associated with a range of adverse outcomes. We previously observed an association between maternal stress and white matter microstructure in a sample of infants born prematurely. In this study, we aimed to investigate the relationship between maternal trait anxiety, stressful life events and brain volumes.

Methods
221 infants (114 males, 107 females) born prematurely (median gestational age = 30.43 weeks [range 23.57–32.86]) underwent magnetic resonance imaging around term-equivalent age (mean = 42.20 weeks, SD = 1.60). Brain volumes were extracted for the following regions of interest: frontal lobe, temporal lobe, amygdala, hippocampus, thalamus and normalized to total brain volume. Multiple linear regressions were conducted to investigate the relationship between maternal anxiety/stress and brain volumes, controlling for gestational age at birth, postmenstrual age at scan, socioeconomic status, sex, days on total parenteral nutrition. Additional exploratory Tensor Based Morphometry analyses were performed to obtain voxel-wise brain volume changes from Jacobian determinant maps.

Results and conclusion
In this large prospective study, we did not find evidence of a relationship between maternal prenatal stress or trait anxiety and brain volumes. This was the case for both the main analysis using a region-of-interest approach, and for the exploratory analysis using Jacobian determinant maps. We discuss these results in the context of conflicting evidence from previous studies and highlight the need for further research on premature infants, particularly including term-born controls.
Understanding the diagnostic delays and pathways for diabetes in eastern Uganda: A qualitative study
Authors: Kasujja Francis Xavier , Nuwaha Fred , Daivadanam Meena , Kiguli Juliet , Etajak Samuel , Mayega Roy William 
Published: April 2021

Background
Type 2 diabetes is rapidly becoming a significant challenge in Uganda and other low and middle-income countries. A large proportion of the population remains undiagnosed. To understand diagnostic delay, we explored the diagnostic pathways for diabetes among patients receiving care at a semi-urban district hospital in eastern Uganda.

Methods
Eligible participants were patients aged 35–70 years receiving care at the diabetes clinic of Iganga district hospital between April and May 2019 and their healthcare providers. Patients were interviewed using an interview guide to collect information on patients’ symptoms and their diagnostic experience. A separate interview guide was used to understand the organisation of the diabetes services and the diabetes diagnostic process at the hospital. Using maximum variation purposive sampling, we selected 17 diabetes patients aged 35–68 years, diagnosed within the previous three years, and the three health workers managing the diabetes clinic at Iganga hospital. The data was analysed using ATLAS.ti version 8 to code, organise and track the data segments. We conducted template analysis using a priori themes derived from the intervals of Walter’s model of Pathways to Treatment to identify the factors influencing diagnostic delay.

Results
We identified four typologies: a short diagnostic pathway, protracted appraisal pathway, protracted appraisal and diagnostic interval pathway, and delayed treatment pathway. The pathways of patients with protracted appraisal or diagnostic intervals demonstrated strong socio-cultural influences. There was a firm reliance on traditional healers both before and after diagnosis which deferred enrolment into care. Other health system barriers implicated in delayed diagnosis included stock-out of diagnostic supplies, misdiagnosis, and missed diagnosis. Denial of diagnosis was also found to lead to delayed initiation of care.

Conclusion
Reducing diagnostic delay requires addressing both negative socio-cultural influences and the adoption of system-wide interventions to address barriers to timely diagnosis.
Impact Behavior of Fiber-Reinforced Concrete with Polypropylene Fibers and Carbon Fiber–Reinforced Polymers
Authors: Kheyroddin Ali , Arshadi Hamed , Salehzade Jalil 
Published: April 2021

Abstract
In this study, the influences of bidirectional carbon fiber–reinforced polymer (CFRP) confinement along with polypropylene fibers on the impact resistance of concrete samples were experimentally studied. Forty-nine concrete cylindrical samples (with compressive strengths of 20, 30, and 40 MPa) with polypropylene fibers (with content ratios of 0 %, 1 %, 1.5 %, and 2 %) were subjected to weight (46.7 and 66.8 kg) dropping at a height of 1.6 m above the cross-section of the sample. Moreover, half of the samples were tested with CFRP confinement. The number of weight releases required to destroy the samples and the weights of the samples after each release were recorded. The results indicated that the concrete without fibers and fiber-reinforced polymers (with compressive strengths of 20, 30, and 40 MPa) did not have sufficient impact resistance and were swiftly destructed. However, as the content ratios of polypropylene fibers increased, the number of cracks and weight droppings (to reach 70 % of the initial sample weight) increased. Moreover, it was observed that the concrete samples wrapped with the CFRP sheets also withstood impact loading better than fiber-reinforced concrete samples without the confinements. Besides, it was indicated that the prevailing failure mode of the samples with CFRPs was CFRP rupturing. Finally, it was observed that the more the compressive strength of concrete, the more the impact resistance.
Review of Adrian Dunn's The Black Messiah
Authors: Johnson Kennedi A. 
Published: April 2021

The Black Messiah album is a sonic meditation on Black life that confronts the histories of anti-Black racism in the U.S. Showcasing a powerful group of Black artists, the album combines multiple genres including gospel, rap, jazz and opera. The Black Messiah offers a counter to George Handel’s Messiah and a timely response to the Black Lives Matter protests of summer 2020.
Accelerometery vs. video-derived stroke parameters in high-level swimmers
Authors: Courtney Musson  , Mark Kramer  
Published: April 2021

Background: Swimming is a multifaceted sport with nuanced performance parameters that tend to vary according to the swimmer’s stroke style. The extraction and analyses of swim parameters, such as lap time (LT), stroke length (SL), stroke rate (SR) and velocity are time-consuming. This may be eased and to some extent automated by the use of cost-effective tri- axial accelerometers.
Objectives: To determine the validity of tri-axial accelerometers across all four stroke styles, and to investigate kinematic differences in stroke styles using accelerometer- based data.
Methods: Twelve elite swimmers were recruited for the study. The group consisted of five male (age: 22.2 ± 2.6 years; height: 1.84 ± 0.08 m; weight: 76.2 ± 3.6 kg) and seven female (age: 20.7 ± 2.1 years; height: 1.68 ± 0.08 cm; weight: 62.0 ± 6.3 kg) swimmers.
Results: There was a small but significant bias for accelerometery data compared to video data across most parameters and stroke styles except for stroke length and stroke count (p > 0.05). However, accelerometery-derived SR, SL and velocity can be considered practically useful based on the training requirements of coaches. Parameters derived from video analysis compared to accelerometery were highly correlated (r > 0.91) and therefore consistent regardless of the method of analysis.
Conclusion: Although slight differences were present between the video and accelerometer data, these differences were not practically meaningful.
Measuring the oxygen consumption rate of some inactivated dry yeasts: comparison with other common wine antioxidants
Authors: Pons-Mercadé Pere , Anguela Sergi , Giménez Pol , Heras José M. , Sieczkowski Nathalie , Rozès Nicolas , Canals Joan Miquel , Zamora Fernando 
Published: April 2021

The aim of the study was to evaluate the oxygen consumption kinetics of some inactivated dry yeasts in comparison with those of sulfur dioxide, ascorbic acid and glutathione.The oxygen consumption rates of three inactivated dry yeasts, sulfur dioxide, ascorbic acid and glutathione at the usual doses in a model wine solution were determined by carrying out noninvasive fluorescence measurements. The results indicate that two of the studied inactivated dry yeasts consume oxygen more effectively than sulfur dioxide. These data suggest that some inactivated dry yeasts may be useful for protecting wine against oxidation.This study shows for the first time that inactivated dry yeasts can actually consume oxygen, therefore opening up an interesting area for future research.
Malignant Transformation of Giant Cell Tumor of Bone 7 years After Initial Surgery
Authors: Matsunobu Tomoya , Maekawa Akira , Jotatsu Mao , Makihara Kosuke , Hisaoka Masanori , Iwamoto Yukihide 
Published: April 2021

Case:
A 64-year-old man with a history of giant cell tumor of bone (GCTB) in the fibula 7 years earlier developed a recurrence with histologic features of osteosarcoma. Both the primary GCTB and the secondary osteosarcoma were found to have the H3F3A gene mutation. Despite immediate above-the-knee amputation, the patient died of respiratory failure because of lung metastases 3 months later.

Conclusion:
This is the first report of proven H3F3A mutation in both the primary GCTB and the secondary osteosarcoma in the same case. Clinicians should consider secondary malignancy in patients presenting with a lesion at the site of a previously treated GCTB after a long interval.
Bayesian Spatial Quantile Interval Model with Application to Childhood Malnutrition in Ethiopia
Authors: Shibeshi Abdu H , Asfaw Zeytu G 
Published: April 2021

Abstract
Background: The national prevalence of stunting and wasting in Ethiopia is still very high and it is the most common causes of morbidity and mortality among under five years old children. The aim of the current study was to investigate the determinant of stunting and wasting in Ethiopia. Methods: The available Demographic and Health Survey ( EDHS ) data-set in 2016 for Ethiopia was analyzed using fully Bayesian spatial quantile interval regression models using R- INLA package. Results: The study found that child sex, child age, mother's education, mother's age , source of drinking water, mother's BMI, wealth index, region, residence, cooking fuel and toilet facility were significantly associated with childhood malnutrition(stunting and wasting). Conclusions: Furthermore, these findings imply that a multisectorial and multidimensional approach is important to address malnutrition in Ethiopia. Finally, the education sector should promote reduction of gender barriers that contribute to childhood malnutrition; the health sector should encourage positive behaviors toward childcare and other feeding practices.
Gastric-type mucinous adenocarcinoma of the cervix in a woman with Peutz-Jeghers syndrome
Authors: Tong Tong , Fan Qiong , Shi Shu , Li Yuhong , Wang Yudong 
Published: April 2021

Abstract
Background: Peutz-Jeghers syndrome(PJS) is a very rare autosomal dominant disorder with predisposition to multiple neoplasms. Gastric-type adenocarcinoma (GAS) is a less common carcinoma of the cervix than squamous cell carcinoma, which is more aggressive and has lower 5 year survival rate than usual type endocervical adenocarcinoma (ECA), and unrelated to human papilloma virus(HPV) infection as well. We present a 32 year-old patient with Peutz-Jeghers syndrome who was found to have gastric-type adenocarcinoma of the cervix.Case presentation: A 32-year-old woman without sexual life ever who was diagnosed Peutz-Jeghers syndrome when she was two years old presented with watery discharge for more than 6 months. A tumor around 6cm was found on the cervix and she was diagnosed gastric-type mucinous adenocarcinoma of the cervix clinical stage IB3. She was treated with artery intervention chemotherapy for one course followed by radical surgery and then systematic chemotherapy.Conclusions: The case suggests more thorough cancer screening for patients with PJS as the disorder is rare and has high risk of malignancies. Young patients with Peutz-Jeghers syndrome, including those without sexual life, who have watery discharge or bleeding should be screened for cervical carcinoma even if cytologic results or human papilloma virus (HPV) is negative.
The Location Inventory Routing Optimization Model and Algorithm for the Islands Shipping Network
Authors: Wu Di , Wang Nuo 
Published: April 2021

Abstract
This paper studies a hub-and-spoke shipping network of islands and integrates a maritime location inventory routing problem (MLIRP) for the islands shipping network. By determining a series of decisions including the location of the hub islands, the number of shipping routes, the schedule of every route, the running mode of every route, the ship size, the wharf scale and the inventory capacity, the objective of the paper is to minimize the total cost of the islands shipping network. For solving the integrated MLIRP model, a hybrid genetic algorithm based on the stepwise configuration (SC-GA) is presented. Finally, instances are put forward to evaluate the performance of the algorithm. The results of sensitivity analysis show that the wharf construction cost affects the total costs the most, so more attention should be paid to it when making decisions. This paper can provide theoretical and practical information to design and optimize an islands shipping network.