bluuebunny/crossref_metadata_2025_split huggingface dataset:
Flow cytometry of bone marrow aspirates from neuroblastoma patients is a highly sensitive technique for quantification of low-level neuroblastoma
Authors: Jain Neha , Sattar Shaista , Inglott Sarah , Burchill Susan , Fisher Jonathan , Serban Andreea-Madalina , Thomas Rebecca , Connor Chris , Ghara Niharendu , Chowdhury Tanzina , Duncan Catriona , Barone Giuseppe , Anderson John 
Published: September 2021

Background: Bone marrow involvement is an important aspect of determining staging of disease and treatment for childhood neuroblastoma. Current standard of care relies on microscopic examination of bone marrow trephine biopsies and aspirates respectively, to define involvement. Flow cytometric analysis of disaggregated tumour cells, when using a panel of neuroblastoma specific markers, allows for potentially less subjective determination of the presence of tumour cells. Methods: A retrospective review of sequential bone marrow trephine biopsies and aspirates, performed at Great Ormond Street Hospital, London, between the years 2015 and 2018, was performed to assess whether the addition of flow cytometric analysis to these standard of care methods provided concordant or additional information. Results: There was good concurrence between all three methods for negative results 216/302 (72%). Positive results had a concordance of 52/86 (61%), comparing samples positive by flow cytometry and positive by either or both cytology and histology. Of the remaining samples, 20/86 (23%) were positive by either or both cytology and histology, but negative by flow cytometry. Whereas 14/86 (16%) of samples were positive only by flow cytometry. Conclusions: Our review highlights the ongoing importance of expert cytological and histological assessment of bone marrow results. Flow cytometry is an objective, quantitative method to assess the level of bone marrow disease in aspirates. In this study, flow cytometry identified low-level residual disease that was not detected by cytology or histology. The clinical significance of this low-level disease warrants further investigation.
Case Report: Pseudomonas can take a toll on a patient
Authors: Buchbinder David K. , Singh Jasjit , Dao Tuan , Sassoon Aaron , Arrieta Antonio 
Published: September 2021

Pseudomonas aeruginosa (P. aeruginosa) is an aerobic Gram-negative bacterium that is implicated in the development of severe systemic infections among pediatric patients. It is identified in hospitalized chronically ill pediatric patients in association with genitourinary, respiratory tract, and skin or soft tissue infections as well as severe and life-threating infection including sepsis. A variety of immunologic mechanisms play a vital role in the host defense mechanisms against invasive infections with P. aeruginosa. Rarely, specific inborn errors of immune function are implicated in deficiencies that predispose to invasive infections with P. aeruginosa. Innate immune function including germ-line encoded pattern recognition receptors such as toll-like receptors (TLRs) and their downstream signaling is vital in the host defense against P. aeruginosa through the generation of antimicrobial peptides, cytokines/chemokines, and shaping of adaptive immune responses. Herein, we describe a previously healthy two-year-old female with an invasive skin, soft tissue, and central nervous system infection secondary to P. aeruginosa. The invasive nature of this infection prompted a careful evaluation for an inborn error of immunity. Decreased cytokine response to agonists of TLRs was documented. Targeted sequencing of interleukin-1 receptor-associated kinase (IRAK)-4 documented a homozygous deletion of exons 8-13 consistent with IRAK-4 deficiency. This report provides a vital educative message in the existing scientific literature by underscoring the importance of considering inborn errors of immunity in all patients with severe P. aeruginosa infections. Functional assessments of immune function often in combination with sequencing can accurately assign a diagnosis in a timely fashion allowing for definitive treatment and the use of necessary supportive care.
Risk factors and hematological profile associated with colic in Delman horses in Gresik, Indonesia
Authors: Purnama Muhammad Thohawi Elziyad , Hendrawan Dodit , Wicaksono Arya Pradana , Fikri Faisal , Purnomo Agus , Chhetri Shekhar 
Published: September 2021

Background: Horses are herd animals that have been domesticated in the last century. In several countries, an overview of risk factors and clinical evaluation in horses with colic has not been well‐described. This study aimed to evaluate risk factors and hematological profiles in horses associated with colic in Gresik, East Java, Indonesia. Methods: A cross-sectional study was performed during April - October 2019. A total of 115 horses were diagnosed based on physical examination, clinical symptoms, and rectal examination. A questionnaire was asked to the horse-owners to analyze the risk factors while the clinical examination was performed and blood samples were collected for pre-treatment and 14 days post-treatment. Hematological profile was evaluated from a whole blood sample. Serum cortisol, plasma epinephrine, and norepinephrine concentrations were also evaluated after separating the aliquots. Results: Of the 115 horses, 96 were diagnosed with colic. The horses with colic showed a significant association between cases with gender (p<0.021), breed (p<0.000), wheat bran feeding (p<0.015), concentrate feeding (p<0.003), anthelmintics administration (p<0.000), gastrointestinal parasites (p<0.000), dental diseases (p<0.024), previous exposure to colic (p<0.000), body condition score (p<0.000), and access to water per day (p<0.000). Based on whole blood and serum evaluation, there were ameliorated significantly on the hematological profile (p<0.01), serum cortisol (p<0.05), and plasma epinephrine (p<0.01) at 14 days post-treatment. Conclusion: This study has identified factors associated with colic in Delman horses. The study provides crucial information to investigate cases of colic and to contribute the development of healthcare strategies during treatment and clinical evaluation.
The Wessex Fit-4-Cancer Surgery Trial (WesFit): a protocol for a factorial-design, pragmatic randomised-controlled trial investigating the effects of a multi-modal prehabilitation programme in patients undergoing elective major intra–cavity cancer surgery
Authors: West Malcolm , Bates Andrew , Grimmett Chloe , Allen Cait , Green Richard , Hawkins Lesley , Moyses Helen , Leggett Samantha , Z H Levett Denny , Rickard Sally , Varkonyi-Sepp Judit , Williams Fran , Wootton Stephen , Hayes Matthew , P W Grocott Micheal , Jack Sandy 
Published: September 2021

Background: Surgical resection remains the primary curative treatment for intra-cavity cancer. Low physical fitness and psychological factors such as depression are predictive of post–operative morbidity, mortality and length of hospital stay. Prolonged post-operative morbidity is associated with persistently elevated risk of premature death. We aim to investigate whether a structured, responsive exercise training programme, a psychological support programme or combined exercise and psychological support, delivered between treatment decision and major intra-cavity surgery for cancer, can reduce length of hospital stay, compared with standard care. Methods: WesFit is a pragmatic, 2x2 factorial-design, multi-centre, randomised-controlled trial, with planned recruitment of N=1560. Participants will be randomised to one of four groups. Group 1 (control) will receive usual pre-operative care, Group 2 (exercise) patients will undergo 2/3 aerobic, high-intensity interval training sessions per week supervised by personal trainers. Group 3 (psychological support) patients are offered 1 session per week at a local cancer support centre. Group 4 will receive both exercise and psychological support. All patients undergo baseline and pre-operative cardiopulmonary exercise testing, complete self-report questionnaires and will be followed up at 30 days, 12 weeks and 12 months post-operatively. Primary outcome is post-operative length-of-stay. Secondary outcomes include disability-adjusted survival at 1-year postoperatively, post-operative morbidity, and health-related quality of life. Exploratory investigations include objectively measured changes in physical fitness assessed by cardiopulmonary exercise test, disease-free and overall mortality at 1-year postoperatively, longer-term physical activity behaviour change, pre-operative radiological tumour regression, pathological tumour regression, pre and post-operative body composition analysis, health economics analysis and nutritional characterisation and its relationship to post-operative outcome. Conclusions: The WesFit trial will be the first randomised controlled study investigating whether an exercise training programme +/- psychological intervention results in improvements in clinical and patient reported outcomes in patients undergoing major inter-cavity resection of cancer. ClinicalTrials.gov registration: NCT03509428 (26/04/2018)
The accuracy of Infrared sensor detection in a smart toilet
Authors: Lokman Amar , Rajendran Kirenraj , Ramasamy R Kanesaraj 
Published: September 2021

Background: Infrared (IR) sensors are useful tools for detecting distance and proximity. However, these sensors are not good at detecting edges of an area, therefore when used in a smart toilet it has difficulty in detecting the orientation and position of the user’s body. The aim of this study was to design an IR sensor for a smart toilet with a more accurate and consistent detection. Methods: A total of 12(six men and six women) participants with different body types were involved in this study. IR sensor detection was tested in the sitting and squatting toilets. For the best accuracy, the IR sensor's angle was measured. Red, blue, and red-blue plastic covers were used, as these colors improve precision. The microcontroller was set up to calculate the participant’s distance and presence in the cubicle. Results: Toilet positioning varied greatly depending on whether one is sitting or squatting. For sitting toilet, the red cover was close to the accurate distance at a 172˚ angle. IR detected a man but not a woman's body. The blue cover provided the same best angle of 172˚ with a higher sensor distance. When the red and blue cover combination was applied, the reading of 141cm detected both men and women, at 172˚ angle. The actual distance for squatting toilets was 158cm. The optimal angle for both red and blue covers was 176˚, however the sensor distance was greater for the blue cover. Finally, the red and blue cover combination gave a more accurate distance of up to 163cm from the actual reading, when detecting both genders at a normal angle of 76˚. Conclusion: The combination of red and blue cover gave the most accurate detection for the squatting and sitting toilets. The best angle for sitting was 172˚, and for squatting was 176˚.
Detection of the Fraunhofer band B (690  nm) in the absorption spectra of oxygen in aerated solvents
Authors: Benditkis A. S. , Kozlov A. S. , Goncharov S. E. , Krasnovsky A. A. 
Published: September 2021

IR phosphorescence (1270 nm) and chemical trapping of singlet

1

Δ
g

(

0

)

molecular oxygen have been studied in
aerated organic solvents under laser irradiation at 690 nm and 765 nm,
in order to reveal the Fraunhofer band B [

1

Σ

g

+

(

1

)
←

3

Σ

g

−

(

0

)

transition] in the absorption spectra
of dissolved oxygen molecules at normal conditions and compare its
parameters with those of the previously observed Fraunhofer band A [

1

Σ

g

+

(

0

)

←

3

Σ

g

−

(

0

)

transition]. Chemical trapping
experiments were found to be inappropriate for solution of this
problem because complexes of the traps with oxygen were revealed,
which were more photoactive under irradiation by red laser light than
oxygen molecules themselves. Phosphorescence of singlet oxygen was
reliably detected under laser irradiation of aerated solvents at
690 nm. It was about one order weaker than under excitation at 765 nm.
However, in both cases, phosphorescence linearly depended on
excitation power, equally increased after oxygen purging and built up
in the solvents containing heavy atoms (bromine and iodine). Similar
phosphorescence decay times were observed under pulsed laser
excitation at both 690 and 770 nm. The data provide compelling
evidence that phosphorescence arising under irradiation at 690 nm is
due to excitation of the Fraunhofer band B in the oxygen absorption
spectrum. The molar absorption coefficient at the peak of this band
was estimated to be

≈

5

×

10

−
5

M

−
1

c
m

−
1

in the aerated solvents lacking heavy
atoms. Thus, for the first time, absorption coefficients corresponding
to the Fraunhofer band B of dissolved oxygen were estimated in aerated
solvents under natural conditions. This information is important for
both spectroscopy of oxygen and mechanistic studies of biological and
therapeutic action of laser radiation.
Clinical characterization of Lassa fever: A systematic review of clinical reports and research to inform clinical trial design
Authors: Merson Laura , Bourner Josephine , Jalloh Sulaiman , Erber Astrid , Salam Alex Paddy , Flahault Antoine , Olliaro Piero L. 
Published: September 2021

Background
Research is urgently needed to reduce the morbidity and mortality of Lassa fever (LF), including clinical trials to test new therapies and to verify the efficacy and safety of the only current treatment recommendation, ribavirin, which has a weak clinical evidence base. To help establish a basis for the development of an adaptable, standardised clinical trial methodology, we conducted a systematic review to identify the clinical characteristics and outcomes of LF and describe how LF has historically been defined and assessed in the scientific literature.

Methodology
Primary clinical studies and reports of patients with suspected and confirmed diagnosis of LF published in the peer-reviewed literature before 15 April 2021 were included. Publications were selected following a two-stage screening of abstracts, then full-texts, by two independent reviewers at each stage. Data were extracted, verified, and summarised using descriptive statistics.

Results
147 publications were included, primarily case reports (36%), case series (28%), and cohort studies (20%); only 2 quasi-randomised studies (1%) were found. Data are mostly from Nigeria (52% of individuals, 41% of publications) and Sierra Leone (42% of individuals, 31% of publications).
The results corroborate the World Health Organisation characterisation of LF presentation. However, a broader spectrum of presenting symptoms is evident, such as gastrointestinal illness and other nervous system and musculoskeletal disorders that are not commonly included as indicators of LF.
The overall case fatality ratio was 30% in laboratory-confirmed cases (1896/6373 reported in 109 publications).

Conclusion
Systematic review is an important tool in the clinical characterisation of diseases with limited publications. The results herein provide a more complete understanding of the spectrum of disease which is relevant to clinical trial design. This review demonstrates the need for coordination across the LF research community to generate harmonised research methods that can contribute to building a strong evidence base for new treatments and foster confidence in their integration into clinical care.
How COVID-19 kick-started online learning in medical education—The DigiMed study
Authors: Stoehr Fabian , Müller Lukas , Brady Adrian , Trilla Antoni , Mähringer-Kunz Aline , Hahn Felix , Düber Christoph , Becker Nicole , Wörns Marcus-Alexander , Chapiro Julius , Hinrichs Jan Bernd , Akata Deniz , Ellmann Stephan , Huisman Merel , Koff David , Brinkmann Sebastian , Bamberg Fabian , Zimmermann Oscar , Traikova Nikoleta I. , Marquardt Jens U. , Chang D.-H. , Rengier Fabian , Auer Timo A. , Emrich Tilman , Muehler Felix , Schmidberger Heinz , Baeßler Bettina , dos Santos Daniel Pinto , Kloeckner Roman 
Published: September 2021

Background
The coronavirus disease 2019 (COVID-19) pandemic led to far-reaching restrictions of social and professional life, affecting societies all over the world. To contain the virus, medical schools had to restructure their curriculum by switching to online learning. However, only few medical schools had implemented such novel learning concepts. We aimed to evaluate students’ attitudes to online learning to provide a broad scientific basis to guide future development of medical education.

Methods
Overall, 3286 medical students from 12 different countries participated in this cross-sectional, web-based study investigating various aspects of online learning in medical education. On a 7-point Likert scale, participants rated the online learning situation during the pandemic at their medical schools, technical and social aspects, and the current and future role of online learning in medical education.

Results
The majority of medical schools managed the rapid switch to online learning (78%) and most students were satisfied with the quantity (67%) and quality (62%) of the courses. Online learning provided greater flexibility (84%) and led to unchanged or even higher attendance of courses (70%). Possible downsides included motivational problems (42%), insufficient possibilities for interaction with fellow students (67%) and thus the risk of social isolation (64%). The vast majority felt comfortable using the software solutions (80%). Most were convinced that medical education lags behind current capabilities regarding online learning (78%) and estimated the proportion of online learning before the pandemic at only 14%. In order to improve the current curriculum, they wish for a more balanced ratio with at least 40% of online teaching compared to on-site teaching.

Conclusion
This study demonstrates the positive attitude of medical students towards online learning. Furthermore, it reveals a considerable discrepancy between what students demand and what the curriculum offers. Thus, the COVID-19 pandemic might be the long-awaited catalyst for a new “online era” in medical education.
A national survey of hospital readiness during the COVID-19 pandemic in Nigeria
Authors: Ogoina Dimie , Mahmood Dalhat , Oyeyemi Abisoye Sunday , Okoye Ogochukwu Chinedum , Kwaghe Vivian , Habib Zayaid , Unigwe Uche , Iroezindu Michael Onyebuchi , Garbati Musa Abubakar , Rotifa Stella , Adekanmbi Olukemi , Garba Iliyasu , Dayyab Farouq Muhammad , Ibrahim Sanusi Mohammed , Kida Ibrahim Musa , Adamu Adamu , Alasia Datonye , Awang Sati Klein , Ohaju-Obodo John Oghenevwirhe , Usman Rabi , Mohammed Yahaya , Omololu Ayanfe , Tobin Ekaete Alice , Okogbenin Sylvanus , Asogun Danny , Kelly Iraoyah , Waziri Bala , Nauzo Aliyu Mamman , Jibrin Yusuf , Habib Abdulrazaq Garba 
Published: September 2021

Introduction
The COVID-19 pandemic continues to overwhelm health systems across the globe. We aimed to assess the readiness of hospitals in Nigeria to respond to the COVID-19 outbreak.

Method
Between April and October 2020, hospital representatives completed a modified World Health Organisation (WHO) COVID-19 hospital readiness checklist consisting of 13 components and 124 indicators. Readiness scores were classified as adequate (score ≥80%), moderate (score 50–79.9%) and not ready (score <50%).

Results
Among 20 (17 tertiary and three secondary) hospitals from all six geopolitical zones of Nigeria, readiness score ranged from 28.2% to 88.7% (median 68.4%), and only three (15%) hospitals had adequate readiness. There was a median of 15 isolation beds, four ICU beds and four ventilators per hospital, but over 45% of hospitals established isolation facilities and procured ventilators after the onset of COVID-19. Of the 13 readiness components, the lowest readiness scores were reported for surge capacity (61.1%), human resources (59.1%), staff welfare (50%) and availability of critical items (47.7%).

Conclusion
Most hospitals in Nigeria were not adequately prepared to respond to the COVID-19 outbreak. Current efforts to strengthen hospital preparedness should prioritize challenges related to surge capacity, critical care for COVID-19 patients, and staff welfare and protection.
Feasibility and Accuracy of Artificial Intelligence–Assisted Sponge Cytology for Community-Based Esophageal Squamous Cell Carcinoma Screening in China
Authors: Gao Ye , Xin Lei , Feng Ya-Dong , Yao Bin , Lin Han , Sun Chang , An Wei , Li Zhao-Shen , Shi Rui-Hua , Wang Luo-Wei 
Published: September 2021

INTRODUCTION:
Screening is the pivotal strategy to relieve the burden of esophageal squamous cell carcinoma (ESCC) in high-risk areas. The cost, invasiveness, and accessibility of esophagogastroduodenoscopy (EGD) necessitate the development of preliminary screening methods.

METHODS:
Residents aged 40–85 years were recruited in a high-risk area of ESCC. Esophageal cells were collected using an approved novel capsule sponge, and cytology slides were scanned by a trained artificial intelligence (AI) system before cytologists provided confirmation. Atypical squamous cell or more severe diagnosis was defined as positive cytology. AI-based abnormal cell counts were also reported. EGD was performed subsequently with biopsy as needed. Diagnostic accuracy, adverse events, and acceptability of cytology testing were assessed. Esophageal high-grade lesions (ESCC and high-grade intraepithelial neoplasia) were the primary target lesions.

RESULTS:
In total, 1,844 participants were enrolled, and 20 (1.1%) high-grade lesions were confirmed by endoscopic biopsy. The AI-assisted cytologist-confirmed cytology showed good diagnostic accuracy, with a sensitivity of 90.0% (95% confidence interval [CI], 76.9%–100.0%), specificity of 93.7% (95% CI, 92.6%–94.8%), and positive predictive value of 13.5% (95% CI, 7.70%–19.3%) for detecting high-grade lesions. The area under the receiver operation characteristics curve was 0.926 (95% CI, 0.850–1.000) and 0.949 (95% CI, 0.890–1.000) for AI-assisted cytologist-confirmed cytology and AI-based abnormal cell count, respectively. The numbers of EGD could be reduced by 92.5% (from 99.2 to 7.4 to detect 1 high-grade lesion) if only cytology-positive participants were referred to endoscopy. No serious adverse events were documented during the cell collection process, and 96.1% participants reported this process as acceptable.

DISCUSSION:
The AI-assisted sponge cytology is feasible, safe, and acceptable for ESCC screening in community, with high accuracy for detecting esophageal squamous high-grade lesions.