bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors and reasons for inappropriate hospitalization days for surgical patients in a tertiary hospital in Wuhan, China: a retrospective study
Authors: Li Hao , Tao Hongbing , Li Gang 
Published: September 2021

Abstract
Background
Inappropriate hospitalization day (IHD) is recognized as an important indication of the excessive demand for health-care services, especially for surgical patients. We aim to examine the degree of IHDs, predictors associated with higher incidences of IHDs, and reasons for each IHD in different periods of hospitalization.

Methods
A total of 4586 hospital days from 408 cases were evaluated by a cross-sectional and retrospective audit program carried out in a tertiary hospital with 5613 beds and 9623 faculty in Wuhan, China. This study used the revised Chinese version of the Appropriateness Evaluation Protocol (C-AEP) to assess IHDs, and the Delay Tool to ascertain each reason for IHDs. A binary logistic regression model was performed to examine the predictors of higher incidences of IHDs.

Results
The average frequency of IHDs was 23.24 %, and a total of 322 cases (78.92 %) were reported to have experienced at least one IHD. The multivariate analysis showed that patients at the age of 60–69 with respect to under 50, and with overlength of stay were predictors of higher incidences of preoperative IHDs, while admission from outpatient, multiple diagnosis, higher surgical incision level, and overlength of stay were predictors of higher incidence of postoperative IHDs. The most frequent reasons related to health providers for IHDs were doctor’s conservative views of patient management and delays in inspection, prescription, appointment, or result report. Patient factors gave rise to nearly a quarter of postoperative IHDs.

Conclusions
Findings from this study indicate that measures including paying more attention to the construction of MDT for diagnosis and treatment in general surgery, reducing laboratory turnaround time, dispelling distrust among health-care providers and patients, setting stricter discharge standards and, providing integrated out-of-hospital services could be adopted accordingly to improve the inappropriateness of hospital stays.
Prevalence and associated factors of hypertension among veterans of the Indian Gorkha regiments living in Pokhara Metropolitan City, Nepal
Authors: Sapkota Abhishek , Neupane Dinesh , Shrestha Aamod Dhoj , Adhikari Tara Ballav , McLachlan Craig Steven , Shrestha Naveen 
Published: September 2021

Abstract
Background
Hypertension is a major preventable risk factor for cardiovascular disease. Occupational factors such as having served or serving in armed forces may be associated with hypertension. This study aimed to assess the prevalence and factors associated with hypertension among veterans of the Indian Gorkha army living in western Nepal.

Methods
A community-based cross-sectional study was conducted among the veterans living in the Pokhara metropolitan city. Data on blood pressure (BP), anthropometric measurements, and behavioral factors were collected by face-to-face interviews using the World Health Organization's non-communicable disease risk factor surveillance (STEPS) tool. Hypertension was defined as systolic blood pressure (BP) ≥ 140 mm Hg and/or diastolic BP of ≥ 90 mm Hg or currently on antihypertensive medication.

Results
The age-adjusted prevalence of hypertension was 66.2 % among the study participants (317). Mean systolic and diastolic blood pressure was 144.5 mmHg (± 18.3) and 89.3mmHg (± 16.0), respectively. Among the hypertensive participants, 67 % were aware of their disease, 90 % of them were under treatment, and 14 % of the individuals who received treatment had their hypertension under control. The proportion of smokers was 12.9 % and alcohol drinker was 86.1 %. One-fourth (25.9 %) of the participants had a family history of hypertension. Veterans aged 55-64 years had higher odds (AOR: 5.3; 95 % CI: 1.8–15.9; p = 0.003) of being associated with hypertension as compared to 35–44 years. Being a current alcohol drinker (AOR: 2.5; 95 % CI: 1.4–4.5; p = 0.003), overweight (AOR: 1.9; 95 % CI: 1.0-3.5; p = 0.04), obese (AOR: 3.1; 95 % CI: 1.1–8.3; p = 0.03) and family history of hypertension (AOR: 2.9; 95 % CI: 1.5–5.8; p = 0.002) were independently associated with hypertension.

Conclusions
Hypertension was prevalent in retired Nepal veterans. Hypertension was associated with a number of modifiable lifestyle and behavioral factors. Our findings suggest the need for screening, education and management of Nepal veterans for hypertension.
How accurate is frozen section pathology compared to permanent pathology in detecting involved margins and lymph nodes in breast cancer?
Authors: Namdar Zahra Mehdipour , Omidifar Navid , Arasteh Peyman , Akrami Majid , Tahmasebi Sedigheh , Nobandegani Aida Salehi , Sedighi Sogol , Zangouri Vahid , Talei Abdolrasoul 
Published: September 2021

Abstract
Background
Frozen section (FS) pathology has multiple limitations, and different institutions report variable experiences with the use of FS for diagnosis of tumor involvement. We aimed to compare the FS accuracy with that of permanent pathology (gold standard) regarding marginal involvement and lymph node status using data from the largest breast cancer registry in Iran.

Methods
In this retrospective study, women who had both FS and permanent pathology reports were included. The two pathology reports were cross compared with regard to the involvement of tumor margins and sentinel lymph nodes.

Results
Overall, 2786 patients entered the study. Mean age of patients was 48.96±11.44 years. A total of 1742 margins were analyzed. Accordingly, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of FS pathology for detection of involvement of involved margins were 78.49%, 97.63%, 65.1%, and 98.7%, respectively. The accuracy and area under the curve (AUC) for FS pathology were 96.61% and 0.73 (95% CI: 0.64–0.831), respectively.
A total of 1702 sentinel lymph node biopsies were assessed. Sensitivity, specificity, PPV, and NPV, of FS pathology for detection of lymph node involvement, were 87.1%, 98%, 95.5%, and 93.3%, respectively. Accuracy and AUC of FS for diagnosis of involved lymph nodes were 94.1% and 0.926 (95% CI: 0.909–0.942), respectively.

Conclusion
Frozen pathology is a suitable method for identifying involved sentinel lymph nodes in patients with breast cancer, but this method has a less than optimum efficacy for detecting and confirming marginal involvement.
AMULET: a novel read count-based method for effective multiplet detection from single nucleus ATAC-seq data
Authors: Thibodeau Asa , Eroglu Alper , McGinnis Christopher S. , Lawlor Nathan , Nehar-Belaid Djamel , Kursawe Romy , Marches Radu , Conrad Daniel N. , Kuchel George A. , Gartner Zev J. , Banchereau Jacques , Stitzel Michael L. , Cicek A. Ercument , Ucar Duygu 
Published: September 2021

AbstractDetecting multiplets in single nucleus (sn)ATAC-seq data is challenging due to data sparsity and limited dynamic range. AMULET (ATAC-seq MULtiplet Estimation Tool) enumerates regions with greater than two uniquely aligned reads across the genome to effectively detect multiplets. We evaluate the method by generating snATAC-seq data in the human blood and pancreatic islet samples. AMULET has high precision, estimated via donor-based multiplexing, and high recall, estimated via simulated multiplets, compared to alternatives and identifies multiplets most effectively when a certain read depth of 25K median valid reads per nucleus is achieved.
H2A ubiquitination is essential for Polycomb Repressive Complex 1-mediated gene regulation in Marchantia polymorpha
Authors: Liu Shujing , Trejo-Arellano Minerva S. , Qiu Yichun , Eklund D. Magnus , Köhler Claudia , Hennig Lars 
Published: September 2021

Abstract
Background
Polycomb repressive complex 1 (PRC1) and PRC2 are chromatin regulators maintaining transcriptional repression. The deposition of H3 lysine 27 tri-methylation (H3K27me3) by PRC2 is known to be required for transcriptional repression, whereas the contribution of H2A ubiquitination (H2Aub) in the Polycomb repressive system remains unclear in plants.

Results
We directly test the requirement of H2Aub for gene regulation in Marchantia polymorpha by generating point mutations in H2A that prevent ubiquitination by PRC1. These mutants show reduced H3K27me3 levels on the same target sites as mutants defective in PRC1 subunits MpBMI1 and the homolog MpBMI1L, revealing that PRC1-catalyzed H2Aub is essential for Polycomb system function. Furthermore, by comparing transcriptome data between mutants in MpH2A and MpBMI1/1L, we demonstrate that H2Aub contributes to the PRC1-mediated transcriptional level of genes and transposable elements.

Conclusion
Together, our data demonstrates that H2Aub plays a direct role in H3K27me3 deposition and is required for PRC1-mediated transcriptional changes in both genes and transposable elements in Marchantia.
Intrathecal baclofen therapy for severe spasticity in an adult with tethered cord syndrome: a case report
Authors: Takagi Yasutaka , Yamada Hiroshi , Ebara Hidehumi , Hayashi Hiroyuki , Kidani Satoshi , Toyooka Kazu , Ishino Yuji , Kitano Yoshiyuki , Nakanami Aki , Kagechika Kenji , Yahata Tetsutaro , Tsuchiya Hiroyuki 
Published: September 2021

Abstract
Background
Patients with tethered cord syndrome often suffer severe spasticity. To the best of our knowledge, intrathecal baclofen (ITB) therapy in a patient with tethered cord syndrome has not been reported previously. We describe a case in which ITB therapy was useful for treating severe spasticity in an adult with tethered cord syndrome.

Case presentation
We present the case of a 50-year-old Japanese woman with tethered cord syndrome and related conditions suffering from severe spasticity and pain in the lower limbs. She was born with a lumbosacral myelomeningocele, which was closed in the neonatal period. For 4–5 years before this presentation, spasticity in the lower limbs had been exacerbated without any obvious cause. She received rehabilitation and pharmacotherapy from a local doctor, but symptoms were unimproved, and her previous doctor referred her to this department. A test with 50 μg of intrathecally delivered baclofen showed total relief of spasticity and pain, so a pump was implanted for continuous baclofen delivery. During 24 months of follow-up, spasticity has remained under excellent control with baclofen at 38.5–41.0 μg/day.

Conclusions
ITB therapy proved extremely effective in this adult with severe spasticity from tethered code syndrome.
Transcriptome-wide m6A methylome during osteogenic differentiation of human adipose-derived stem cells
Authors: Sun Wentian , Song Yidan , Xia Kai , Yu Liyuan , Huang Xinqi , Zhao Zhihe , Liu Jun 
Published: September 2021

Abstract
Objectives
Adipose-derived stem cells are frequently used for bone regeneration both in vitro and in vivo. N6-methyladenosine (m6A) is the most abundant post-transcriptional modification on eukaryotic RNAs and plays multifaceted roles in development and diseases. However, the regulatory mechanisms of m6A in osteogenic differentiation of human adipose-derived stem cells (hASCs) remain elusive. The present study aimed to build the transcriptome-wide m6A methylome during the osteogenic differentiation of hASCs.

Materials and methods
hASCs were harvested after being cultured in a basic or osteogenic medium for 7 days, and the osteogenic differentiation was validated by alkaline phosphatase (ALP) and Alizarin Red S staining, ALP activity assay, and qRT-PCR analysis of ALP, RUNX2, BGLAP, SPP1, SP7, and COL1A1 genes. The m6A level was colorimetrically measured, and the expression of m6A regulators was confirmed by qRT-PCR and western blot. Moreover, m6A MeRIP-seq and RNA-seq were performed to build the transcriptome and m6A methylome. Furthermore, bioinformatic analyses including volcano plots, Venn plots, clustering analysis, Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway, gene sets enrichment analysis, and protein-protein interaction analysis were conducted.

Results
In total, 1145 differentially methylated peaks, 2261 differentially expressed genes, and 671 differentially methylated and expressed genes (DMEGs) were identified. GO and KEGG pathway analyses conducted for these DMEGs revealed extensive and osteogenic biological functions. The “PI3K-Akt signaling pathway”; “MAPK signaling pathway”; “parathyroid hormone synthesis, secretion, and action”; and “p53 signaling pathway” were significantly enriched, and the DMEGs in these pathways were identified as m6A-specific key genes. A protein-protein interaction network based on DMEGs was built, and VEGFA, CD44, MMP2, HGF, and SPARC were speculated as the hub DMEGs.

Conclusions
The total m6A level was reduced with osteogenic differentiation of hASCs. The transcriptome-wide m6A methylome built in the present study indicated quite a few signaling pathways, and hub genes were influenced by m6A modification. Future studies based on these epigenetic clues could promote understanding of the mechanisms of osteogenic differentiation of hASCs.
Paleoceanography and dinoflagellate cyst stratigraphy across the Lower–Middle Pleistocene Subseries (Calabrian–Chibanian Stage) boundary at the Chiba composite section, Japan
Authors: Balota Eseroghene J. , Head Martin J. , Okada Makoto , Suganuma Yusuke , Haneda Yuki 
Published: September 2021

AbstractA dinoflagellate cyst record from the highly resolved Chiba composite section in Japan has been used to reconstruct sea-surface paleoceanographic changes across the Lower–Middle Pleistocene Subseries (Calabrian–Chibanian Stage) boundary at the global stratotype, constituting the first detailed study of this microfossil group from the Pleistocene of the Japanese Pacific margin. Cold, subarctic water masses from 794.2 ka gave way to warming and rapid retreat of the Subpolar Front at 789.3 ka, ~ 2000 years before the end of Marine Isotope Stage (MIS) 20. Throughout the fully interglacial conditions of MIS 19c, assemblages are consistent with warm sea surface temperatures but also reveal instability and latitudinal shifts in the Kuroshio Extension system. The abrupt dominance ofProtoceratium reticulatumcysts between 772.9 and 770.4 ka (MIS 19b) registers the influence of cooler, mixed, nutrient-rich waters of the Kuroshio–Oyashio Interfrontal Zone resulting from a southward shift of the Kuroshio Extension. Its onset at 772.9 ka serves as a local ecostratigraphic marker for the Chibanian Stage Global Boundary Stratotype Section and Point (GSSP) which occurs just 1.15 m (= 1300 years) below it. An interval from 770.1 ka to the top of the examined succession at 765.8 ka (MIS 19a) represents warm, presumably stratified but still nutrient-elevated surface waters, indicating a northward shift of the Kuroshio Extension ~ 5 kyrs after the termination of full interglacial conditions on land.
Sedimentary facies analysis of the fluvial environment in the Siwalik Group of eastern Nepal: deciphering its relation to contemporary Himalayan tectonics, climate and sea-level change
Authors: Rai Lalit Kumar , Yoshida Kohki 
Published: September 2021

AbstractThe Siwalik Group, ranging from the Early Miocene to Pleistocene, is believed to be deposited in the fluvial environment and controlled by contemporary Himalayan tectonics and climate. In this study, we established the fluvial environment and its controlling factors responsible for the deposition of the Siwalik succession along the Muksar Khola section in the eastern Nepal Himalaya. Five sedimentary facies associations are identified; these are interpreted as the deposits of flood plain-dominated fine-grained meandering river (FA1), flood-dominated overbank environment (FA2), sandy meandering river (FA3), anastomosing river (FA4), and debris flow-dominated gravelly braided river (FA5). These changes in the fluvial system occurred around 10.5 Ma, 10.0 Ma, 5.9 Ma and 3.5 Ma, defined by existing magnetostratigraphy constraints, due to the effects of hinterland tectonics, climate and sea-level change and continuous drifting of the foreland basin towards the hinterland concerning depositional age. The thick succession of an intraformational conglomerate reveals intensification of the monsoon started around 10.5 Ma in the eastern Nepal Himalaya. The present study also shows asynchronous exhumation of the Himalaya from east to west brought a significant difference in the fluvial environment of the Neogene foreland basin.
Impact of Althaea Officinalis extract in patients with atopic eczema: a double-blind randomized controlled trial
Authors: Khalighi Negar , Jabbari-Azad Farahzad , Barzegar-Amini Maral , Tavakkol-Afshari Jalil , Layegh Pouran , Salari Roshanak 
Published: September 2021

Abstract
Background
Althaea Officinalis introduced as an emerging anti-inflammatory agent with immunomodulatory effects that may suppress the symptoms of atopic eczema. In this study, we aimed to investigate the impact of liposomal formulation of Althaea Officinalis flower extract compared with steroids for atopic eczema treatment.

Methods
In this randomized, double-blind controlled trial phase II, forty patients with moderate to severe allergic atopic eczema confirmed by skin prick test were enrolled in the study from October 2018 to January 2019. Steroids on the lesions of the left side of the body and topical Althaea Officinalis extract (intervention) or eucerin as a topical placebo on the lesions of the right side of the body were tested. SCORAD (SCORing Atopic Dermatitis) was assessed at the baseline, and two, and four weeks after completing the trial. Data were analyzed by SPSS version 22.

Results
In the active treatment group, after two weeks, the SCORAD was significantly lower in the left side (recovery with steroid treatment) (p < 0.001), and after 4 weeks the SCORAD was lower on both sides, and there were no significant differences between two sides (similarity between Althaea Officinalis and steroid effects). In the control group, the SCORAD score was significantly lower on the left side (steroid) after two and four weeks (p < 0.001). There was no side effect and reaction to drugs.

Conclusions
Considering the potential side effects of steroids, and the similar efficacy of Althaea Officinalis flower extract, using this component may be accompanied by higher benefits in patients with atopic eczema.

Trial registration
IRCT2016102323235N5.
Exploring critical factors of the perceived usefulness of a learning analytics dashboard for distance university students
Authors: Rets Irina , Herodotou Christothea , Bayer Vaclav , Hlosta Martin , Rienties Bart 
Published: September 2021

AbstractLearning analytics dashboards (LADs) can provide learners with insights about their study progress through visualisations of the learner and learning data. Despite their potential usefulness to support learning, very few studies on LADs have considered learners’ needs and have engaged learners in the process of design and evaluation. Aligning with that, there is a limited understanding of what specific student cohorts, in particular distance and online learners, may seek from LADs to effectively support their studies. In this study, we present findings from 21 interviews with undergraduate distance learners, mainly high performers, that aimed to capture student perceptions about the usefulness of specific LAD features and the factors that explain these perceptions. Our findings revealed that amongst the LAD features favoured by students was the potential to receive study recommendations, whereas comparison with peers was amongst the least favoured elements, unless informed by qualitative information. Factors including information trust, attitudes, age, performance and academic self-confidence were found to explain these perceptions.
Metabolic Dysfunction-associated Fatty Liver Disease and Mortality Among Chinese Adults: a Prospective Cohort Study
Authors: Wang Xiaomo , Wu Shouling , Yuan Xiaojie , Chen Shuohua , Fu Qingjiang , Sun Yuanyuan , Lan Yanqi , Hu Shiqi , Wang Yanhong , Lu Ying , Qu Shunxi , Wang Li 
Published: September 2021

Abstract

Context
Nonalcoholic fatty liver disease (NAFLD) was renamed metabolic dysfunction associated with fatty liver disease (MAFLD) recently.

Objective
We aimed to explore the risk of all-cause deaths in MAFLD participants and compare it with NAFLD in Chinese adults.

Methods
We enrolled 152 139 participants with abdominal ultrasonography in the Kailuan Cohort from 2006 to 2012. We categorized the participants into MAFLD and non-MAFLD, NAFLD and non-NAFLD, and 4 groups of Neither FLD, MAFLD only, NAFLD only, and MAFLD-NAFLD, respectively. We used Cox regression models to estimate the hazard ratios (HRs) and 95% CI of death.

Results
The prevalence of MAFLD and NAFLD was 31.5% and 27.3%, respectively. After a median follow-up of 12.7 years, MAFLD and NAFLD both were associated with increased mortality, especially in men younger than 40 years, with HR (95% CI) of 1.51 (1.19-1.93) and 1.37 (1.06-1.78), respectively. The MAFLD-only group had higher mortality than the NAFLD-only in males 60 years or older (adjusted HR = 1.43; 95% CI, 1.00-2.03) and lower risk in males aged 40 to 59 years (adjusted HR = 0.65; 95% CI, 0.48-0.90). MAFLD with overweight/obesity-only decreased, but those with diabetes and/or metabolic dysregulation increased the risk of death. MAFLD with positive hepatitis B surface antigen and/or excessive alcohol consumption further increased the risk of death, especially in men younger than 40 years (HR = 9.86; 95% CI, 2.44-39.98).

Conclusion
MAFLD was associated with increased all-cause mortality among the Chinese population, which was different according to the status of overweight/obesity, diabetes, other metabolic indicators, and second causes. MAFLD patients should be managed by metabolic indicators and second causes to fulfill precise treatment and management.
Parasitic Infections of the Nervous System
Authors: Garcia Hector H. 
Published: September 2021

ABSTRACT

PURPOSE OF REVIEW
This article reviews how parasites affect the human nervous system, with a focus on four parasitic infections of major public health importance worldwide, two caused by protozoa (malaria and toxoplasmosis) and two by helminths (neurocysticercosis and schistosomiasis).

RECENT FINDINGS
Parasitic infections in humans are common, and many can affect the central nervous system where they may survive unnoticed or may cause significant pathology that can even lead to the death of the host. Neuroparasitoses should be considered in the differential diagnosis of neurologic lesions, particularly in individuals from endemic regions or those with a history of travel to endemic regions.

SUMMARY
Cerebral malaria is a significant cause of mortality, particularly in African children, in whom infected red blood cells affect the cerebral vessels, causing severe encephalopathy. Neurocysticercosis is the most common cause of acquired epilepsy worldwide and has varied clinical presentations, depending on the number, size, and location of the parasites in the nervous system as well as on the host’s inflammatory response. Toxoplasmosis is distributed worldwide, affecting a significant proportion of the population, and may reactivate in patients who are immunosuppressed, causing encephalitis and focal abscesses. Schistosomiasis causes granulomatous lesions in the brain or the spinal cord.