bluuebunny/crossref_metadata_2025_split huggingface dataset:
Segmental Spinal Neurofibromatosis 1: A Novel Phenotype
Authors: Fatima Nida , Dine Anna La , Barnard Zachary R , Lekovic Gregory P 
Published: December 2021

Abstract
Segmental neurofibromatosis (SNF) is a rare subtype of neurofibromatosis (NF). The disease is characterized by features circumscribed to one or more body cutaneous and/or subcutaneous segments. This is a classic example of somatic mosaicism which occurs by postzygotic mutation of the NF1 gene late in the course of embryonic development affecting localized neural crest lines in the fetus. Our case series reported three novel patients who had segmental spinal expression of the disease classified as true mosaic/segmental NF1, along with their management plan treated at one of the largest NF1 center.
All-in-one Superparamagnetic and SERS-active Niosomes for Dual-targeted in Vitro Detection of Breast Cancer Cells
Authors: Maurer Viktor , Zarinwall Ajmal , Wang Zunhao , Wundrack Stefan , Wundrack Nicole , Seleci Didem Ag , Helm Vivien , Otenko Daniil , Frank Claudia , Schaper Fred , Stosch Rainer , Garnweitner Georg 
Published: December 2021

Abstract
BackgroundIn vitro and in vivo biosensing through surface-enhanced Raman scattering often suffer from signal contamination diminishing both the limit of detection and quantification. However, overcoming the lack of specificity requires excessive nanoparticle concentrations, which may lead to adverse side effects if applied to patients. ResultsWe propose encapsulation of iron oxide (FexOy) and gold (Au) nanoparticles (NPs) into the bilayer structure of transferrin-modified niosomes. This approach enables achieving greatly enhanced and contamination-free SERS-signals in vitro as well as a dual-targeting functionality towards MCF-7 breast cancer cells. An in-depth characterization of FexOyNPs- and AuNPs-loaded niosomes (AuNPs/FexOyNPs/NIO) after magnetic downstream processing reveals defined hybrid niosome structures, which show a long-term SERS-signal stability in various media such as MCF-7 cell culture medium. In vitro 2D-SERS imaging unveil a successful incorporation of a non-toxic dose of hybrid NPs into MCF-7 cells, which leads to strong and almost contamination-free SERS-signals. The measured signal-to-noise ratio of the in vitro signal exceeds the values required by DIN 32645 for the successful validation of a detection method. ConclusionsThe hybrid niosomes can be considered a promising and efficient agent for the establishment and commercialization of a highly sensitive detection kit for monitoring cancerous tissue.
Reading Difficulty Dynamics and Interventions Within Community Schools in Ghana; Evidence From Banka Community Senior High School Using the OARP Protocol
Authors: Hamenoo Simon Victory Quarcson , King Rudith , Baah-Ennumh Theresa Yaaba , Mengba Jennifer Dokbila , Gyamfi Stephen Boadi 
Published: December 2021

Abstract
This study was designed to assess reading difficulty dynamics and develop the corresponding interventions for students in the Banka Community Senior High School within the Asante Akyem South Municipality of Ghana. The study used multiple research designs and research methods in soliciting data for the analysis. Both semi-structured questionnaires and interview guides were used for data collection. A 100-worded paragraph was taken from the introductory page of the Integrated Science Textbook for Senior High Schools to assess the reading difficulty of students using the One-Minute Administration of Reading Passages (OARP) protocol. Three sessions of readings were done; the first without intervention, and the subsequent readings with teacher interventions. The results of the study show that majority of the respondents had text recognition accuracy (TRA), text pronunciation accuracy (TPA) and reading speed (RS) problems. Thus, TRA, TPA, and RS scores were below the 80% benchmark in the first reading (without intervention). Nevertheless, TRA, TPA, and RS scores increased above the 80% benchmark for the second and third readings (with teacher interventions). Four causative factors for the reading difficulties (RDs), three locational dynamics, four durational dynamics, four reading frequency dynamics and four periodic dynamics of RDs were identified. The study concludes that RD reduces with teacher interventions. The findings of this study is not a generalization of reading difficulty dynamics and intervention in all community schools in Ghana but rather presents contributions to an emerging academic problem which could have implications on SDG 4 in the near future within community schools. Hence, the need for setting up reading clubs in community schools towards reducing reading difficulties among students.
Eleven-year Retrospective Study Characterizing Patients With Severe Brain Damage and Poor Neurological Prognosis -Role of Physicians’ Attitude Toward Life-Sustaining Treatment
Authors: Wakatake Haruaki , Hayashi Koichi , Kitano Yuka , Hsu Hsiang-Chin , Yoshida Toru , Masui Yoshihiro , Taira Yasuhiko , Fujitani Shigeki 
Published: December 2021

Abstract
BackgroundSevere brain hemorrhage/infarction and cardiac arrest constitute the most critical situations leading to poor neurological prognosis. Characterization of these patients is required to offer successful end-of-life care, but actual practice is affected by multiple confounding factors, including ethicolegal issues, particular in Japan and Asia. The aim of this study is to evaluate the clinical courses of patients with severe brain damage and to assess the preference of end-of-life care for these patients in Japanese hospitals.MethodsA retrospective observational study was conducted between 2008 and 2018. All intracranial hemorrhage/infarction and cardiac arrest out-patients (n=510) who were admitted to our two affiliated hospitals and survived but with poor neurologic outcomes were included. Demographic characteristics as well as prognosis and treatment policies were also assessed. Results Patients were divided into two categories; cases with absent brainstem reflex (BSR) (BSR[-]) and those with preserved BSR (BSR[+]). The survival rate was higher and the length of hospitalization was longer in patients with BSR[+] than in those with BSR[-]. Among three life-sustaining policies (i.e., aggressive treatment, withdrawal of treatment, and withholding of treatment), withholding of treatment was adopted to most patients. In BSR[-], the proportion of three treatment policies performed at the final decision did not differ from that at the initial diagnosis on neurological status (p=0.432). In contrast, this proportion tended to be altered in BSR[+] (p=0.072), with a decreasing tendency of aggressive treatment and a modest increasing tendency of withdrawal of treatment. Furthermore, the requests from patients’ families to withdraw life-sustaining treatment, including discontinuation of mechanical ventilation, increased, but actual implementation of withdrawal by physicians was less than half of the requests. ConclusionsBSR constitutes a crucial determinant of mortality and length of hospitalization in comatose patients with severe brain damage. Although the number of withdrawal of life-sustaining treatment tends to increase over time in BSR[+] patients, there are many more requests from patients’ families for withdrawal. Since physicians has a tendency to desist from withdrawing life-sustaining treatment, more in-depth communication between medical staff and patients’ families will facilitate mutual understanding over ethicolegal and religious issues and may thus improve end-of-life care.
Smoking Cessation Behaviors and Reasons for use of Electronic Cigarettes (EC) and Heated Tobacco Products (HTP) Among Romanian Adults: Implications for Comprehensive Tobacco Control Policy
Authors: Hussain Sumaira , Sreeramare Chandrashekhar T 
Published: December 2021

Abstract
We report cessation behaviors, reasons for use of EC and HTP and association of their use with quit attempts and smoking intensity using Romania Global Adult Tobacco Survey 2018. Weighted estimates of EC and HTP by cigarette smoking (CS) status were assessed. ‘Quit attempts’, ‘intention to quit’, reasons for lack of intention to quit among current CS and reasons for current use of EC and HTP were estimated. Association of ‘ever use’ of EC and HTP with cigarette smoking intensity and quit attempts was explored using binary logistic regression. Of the total 4571 surveyed, 1243 (27.3%) were current CS, 300 (24.4%) made quit attempt in the past 12 months. Only 38 (12.5%) and 26 (8.6%) had used EC and HTP as an aid to quit. Among current CS, 512 (41.2%) had no intention to quit. Reasons for this were, ‘enjoy smoking’ (86.1%), ‘reduce stress’ (65.9%) and ‘staying alert’ (46.3%). Awareness and use of EC and HTP was significantly higher among current CS. ‘Dual use’ of EC and HTP with CS was manifolds higher than stand-alone use. Reasons for current use of EC and HTP were ‘enjoyment’, and ‘use in places where smoking was prohibited’.
Immune Combination Therapy With NK Cell and Pembrolizumab Showed Therapeutic Efficacy in Treating Advanced Solid Tumors
Authors: Jia Jiankun , Heng Gang , Wang Meiling , Wang Linling , Li Yunyan , Zhang Yingzi , Zhang Chengcheng , Yang Zhi , Ruan Zhihua , Qian Cheng 
Published: December 2021

Abstract
Background：Natural killer cells are innate cytotoxic lymphocytes that play an important role in the anti-tumor immune response. However, in the microenvironment of solid tumors, the effector functions of NK cells are often impaired by the induction of immune checkpoint inhibitors, including PD-1. Methods: In this study, we conducted a two-phase study treating advanced solid patients with NK cell therapy (phase 1) or NK and anti-PD-1 inhibitor, pembrolizumab (phase 2).Results: After treatment, only 3 of 9 patients achieved stable disease after accepting NK cell therapy in the phase 1 study. While in the phase 2 study, 4 patients achieved stable diseases and 1 patient achieved partial response. Remarkably, no severe adverse event was observed in patients treated by NK cell and pembrolizumab combination therapy.Conclusion: The results in our study indicated that immune combination therapy with NK cell and pembrolizumab might be a promising and safe approaches to treating advanced solid tumors.
Agro-Pastoralists’ Perception of Climate Change and Adaptation in the Qilian Mountains, China
Authors: Xie Shuntao , Ding Wenguang , Ye Weifeng , Deng Zhe 
Published: December 2021

Abstract
Global climate change affects all aspects of human society, especially agricultural and animal husbandry production. Northwest China has detrimentally affected by the climatic variations due to its high exposure to extreme climatic events. A number of studies have reported on agro-pastoralists' perceptions, adaptation and mitigation of climate change, but the current knowledge of agro-pastoralists' perceptions of climate change in China is insufficient. To fill this research gap, this study aims to investigate the cognition level of agro-pastoralists in Northwest China on climate change and related factors. Data were collected using a structured questionnaire based on household surveys of 554 study participants in four counties in Gansu Province, China. Raw data were collected using stratified random sampling. A probit model was used to analyze the respondents' understanding of climate change and its related socio-economic and demographic variables. Our results show that more than 70% of agro-pastoralists are perception of the changes of temperature and precipitation. Socioeconomic and demographic variables such as gender, farming experience, education level, cultivated land size, agricultural income, livestock, village cadre experience, access to weather information of agro-pastoralists are pertinently related to agro-pastoralists' awareness of climate change. Farming experience, education level, household size, grassland size, agricultural income, association membership, village cadre experience has a high impact on agro-pastoralists' adaptation to climate change. The results of this study will help guide government agencies and decision makers, and help arid and semi-arid areas to build sustainable adaptation measures under the framework of climate change.
Increased Rate of Enteric Bacteria As Cause of Periprosthetic Joint Infections In Patients With Liver Cirrhosis
Authors: Koepf Uta S. , Scheidt Sebastian , Strassburg Christian P. , Wirtz Dieter C. , Randau Thomas , Lutz Philipp 
Published: December 2021

Abstract
Introduction: Periprosthetic joint infections (PJI) are a major complication in joint-arthroplasty. While Rifampicin is one of the few antimicrobial agents, that penetrate the bacterial biofilm and therefore is often used as an additional agent to treat PJI, rifampicin-resistant pathogens are also known to be cross-resistant to other approved rifamycins (rifambutin, rifaximin and rifapentine). Moreover, rifaximin, a broad-spectrum antibiotic with poor intestinal absorption, is used to prevent episodes of hepatic encephalopathy. As transient resistances to rifampin may emerge in patients after taking rifaximin the aim of this study was to examine the microbial pattern of periprosthetic joint infections in cirrhotic patients and to test the hypothesis that intake of rifaximin increases the rate of resistance to rifampicin in periprosthetic joint infections. Methods: A cohort of cirrhotic patients and PJI (n=25) was analysed on the characteristics of bacterial isolates from sonication and tissue analysis. In a second step a subgroup analysis on the development of rifampicin resistant bacterial specimens, depending on the intake of rifaximin (8 rifaximin intake patients vs. 13 non rifaximin intake patients) was performed. Results: Gram-negative bacteria were found in nearly 30% of the specimens. By comparison of the single bacterial isolates, rifampicin resistance was detected in 69.2% (9/13) of the rifaximin-intake samples. In contrast, the non-rifaximin-intake isolates only were resistant to rifampicin in 22.2% (4/18) of the cases (p=0.01). The odds ratio for developing a rifampicin-resistance through rifaximin intake was calculated as OR=13.5.Conclusion: Periprosthetic joint infections have a high incidence of being caused by gram-negative bacteria in cirrhotic patients. Due to this change in microbial pattern and the innate resistance to rifampicin of most of gram-negative bacteria, the therapy with rifampicin should be carefully considered. The association between the use of rifaximin and developed resistance to rifampicin has a major impact on the treatment of PJI.
The Impact of The Government’s COVID-19 Restriction Policies On Human Mobility: Evidence From The United States
Authors: Zhou Yuxun , Mohammad Mafizur Rahman , Rasheda Khanam , Brad Robert Taylor 
Published: December 2021

Abstract
Purpose – In responding to COVID-19, governments around the world have imposed various restrictions with different levels of success. One important aspect of pandemic control is the willingness of individuals to stay home when possible. The purpose of this paper is to study the impact of government restrictions on human mobility in the United StatesMethodology/approach – Structural equation modelling is used to explore the issue. First, we use path regression analysis and factor analysis to identify the main factors that influence mobility. Second, we use total effect decomposition to investigate the deeper relationship between government restrictions and human mobility.Finding – Two important findings are revealed First, the economic environment is the fundamental and direct factor affecting human mobility. There is a significant negative relationship between economic environment and human mobility, meaning that where economic conditions are bad mobility is greater. Second, government restrictions and the scale of the pandemic do not directly affect human mobility. Government restriction indirectly influences human mobility through economic environment as a mediating variable. Therefore, the economic environment has a significant mediating effect.Originality/value – Existing literature lacks research on the mediating effect between government restrictions and human mobility. This paper provides new empirical evidence for the research topic by studying the mediating effect between government restrictions and human mobility. This provides policymakers with a more detailed picture of the processes through which policies operate.
A Retrospective Comparative Analysis of Factors Affecting the Decision and Outcome of Initial Intravenous Immunoglobulin Alone or Intravenous Immunoglobulin Plus Methylprednisolone Use in Children With the Multisystem Inflammatory Syndrome
Authors: Devrim İlker , Böncüoğlu Elif , Kıymet Elif , Şahinkaya Şahika , Çelebi Miray Yılmaz , Cem Ela , Düzgöl Mine , Arıkan Kamile Ötiken , Kara Aybüke Akaslan , Besin Dorukhan , Vuran Gamze , Seven Pınar , Meşe Timur , Ağın Hasan , Bayram Nuri 
Published: December 2021

Abstract
Background: Use of intravenous immunoglobulins (IVIG) with or without methylprednisolone is the most preferred therapeutic strategy for the multisystem inflammatory syndrome in children (MIS-C). This study aimed to compare the use of IVIG plus methylprednisolone vs IVIG alone in children with MIS-C. Methods: This retrospective cohort study was conducted during the period between April 1, 2020, and November 1, 2021. All children with MIS-C were included in the study. The patients were divided in two groups according to whether they were administered IVIG alone or IVIG plus methylprednisolone as an initial treatment for MIS-C. While the patients in group I were administered IVIG with a dosage of 2 gr/kg, the patients in group II were administered IVIG (dosage of 2 gr/kg) plus methylprednisolone (2 mg/kg/day). The re-occurrence of fever, duration of hospital stay, admission to pediatric intensive care unit were compared between these two groups. Results: A cohort of 91 patients under 18 years old and diagnosed as MIS-C was included in the study. Of these patients, 42 (46.2%) were in IVIG alone group. (group I) and 49 (53.8%) were in IVIG plus methylprednisolone (group II). The ratio of severe MIS-C was 36.7% for patients in the group II and significantly higher compared to the rate of severe MIS-C patients in the group I (9.5%) (p=0.01). The rate of hypotension was significantly higher in the group II (30.6 %) compared to the group I (9.5%) (p=0.014). Moreover, the mean serum levels of C-reactive protein were significantly higher for the patients in group II. The re-occurrence of fever was 26.5% in the group II and 33.3% in the group, however this difference was not statistically significant (p>0.05). Conclusions: The decision of the treatment choice of patients with MIS-C should be individually evaluated. In the clinically severe MIS-C patients who were with hypotension, and/or admitted to PICU should be treated with IVIG plus methylprednisolone. However, randomized double-blind studies are required for the treatment modalities of children with MIS-C.
Profile of The Judicialization In Pharmaceutical Assistance And Expenses With Antineoplastics: A Cross-Sectional, Descriptive Study Based On A Set of All The Lawsuits Filed Between The Years 2016 To 2018 In of A State In Northeastern Brazil
Authors: Oliveira Fábio Henrique Cavalcanti , Sobrinho José Eudes de Lorena , Mendes Antônio da Cruz Gouveia , Gutman Haynne Magalhães Santos , Filho Geraldo Jorge , Montarroyos Ulisses Ramos 
Published: December 2021

Abstract
Background: The judicialization of healthcare for acquiring medication is not an isolated occurrence in Brazil, it may also be observed in other Latin American countries, regardless of the existence of a universal health system, in Brazil, the Unified Health System. The search for justice, in terms of medications, has existed ever since the high demand for treating the Acquired Immunodeficiency Syndrome, while currently, the protagonist is cancer. Since pharmaceutical assistance is the area within Unified Health System, which is responsible for maintaining access to medications, the aim of this article is to describe the profile of judicialization in the pharmaceutical assistance of a state in Northeastern Brazil of economic significance, according to the characteristics of the lawsuits, regarding: the plaintiff filing the lawsuit; the medical and health information; the expenditure on acquiring the requested medications; and the relevance of spending on antineoplastic drugs. Methods: This was a cross-sectional, descriptive study based on a set of lawsuits filed between 2016-2018 at the Litigation Center in the State Health Department of Pernambuco.Results: A total of 2,947 lawsuits were analyzed that contained at least one requested medication, with a predominance of males (51.7%); and in which 49.8% of the requests originated in the Unified Health System, and were primarily from patients in the Metropolitan region of the state capital. The most frequent ICDs for cancer were C61, C71 and C50. The median overall expense of the lawsuits was U$1,734.94. Considering only antineoplastic drugs, expenditure exceeded U$7,500 per lawsuit over the three years, given that the median unit price of antineoplastic drugs is approximately U$65.00 compared to U$4.00 for non-antineoplastic drugs. Conclusion: The present study is of relevance as a matter of public health, and how the profile of judicialization behaves as a tool for managing and improving decision-making in times of economic austerity.
An Object-based Climatology of Precipitation Systems in Sydney, Australia
Authors: Ayat Hooman , Evans Jason P. , Sherwood Steven C. , Soderholm Joshua 
Published: December 2021

Abstract
The climate is warming and this is changing some aspects of storms, but we have relatively little knowledge of storm characteristics beyond intensity, which limits our understanding of storms overall. In this study, we apply a cell-tracking algorithm to 20 years of radar data at a mid-latitude coastal-site (Sydney, Australia), to establish a regional precipitation system climatology. The results show that extreme storms in terms of translation-speed, size and rainfall intensity usually occur in the warm season, and are slower and more intense over land between ~10am and ~8pm (AEST), peaking in the afternoon. Precipitation systems are more frequent in the cold season and often initiate over the ocean and move northward, leading to precipitation mostly over the ocean. Using clustering algorithms, we have found five precipitation system types with distinct properties, occurring throughout the year but peaking in different seasons. While overall rainfall statistics don't show any link to climate modes, links do appear for some system types using a multivariate approach. This climatology for a variety of precipitation system characteristics will allow future study of any changes in these characteristics due to climate change.
New Explicit and Exact Traveling Waves Solutions To The Modified Complex Ginzburg Landau Equation
Authors: Depelair Bienvenue , Houwe Alphonse , Rezazadeh Hadi , Bekir Ahmet , Nsangou Mama , Betchewe Gambo 
Published: December 2021

Abstract
This paper applies function transformation method to obtain under certain conditions bright, dark, kink and W-shaped dark solitons waves solutions to the modified complex Ginzburg Landau Equation (CGLE). These new obtained solutions can be useful in many applications such as communication, medicine, hydrodynamic, thermodynamic just to name a few and can allow to explain physical phenomena.