bluuebunny/crossref_metadata_2025_split huggingface dataset:
EXPLORATORY SPATIAL DATA ANALYSIS (ESDA) ON COVID-19 CASES IN MALAYSIA
Authors: Zakaria Syerrina , Zaini Nur Edayu , Abdul Malik Siti Madhihah , Wan Alwi Wan Saliha 
Published: October 2021

The Malaysian government implemented The Movement Control Order (MCO) on 18 March 2020 to control the spread of the COVID-19 outbreak. However, the third wave that started in September 2020 during the Recovery Movement Control Order (RMCO) phase saw a continuous increase in the number of cases. In this study, the exploratory spatial data analysis (ESDA) was used to analyse the existence of COVID-19 spatial clusters. Moran's index was used to map the spatial autocorrelation (cluster) to showcase the spreading patterns of the COVID-19 pandemic in Malaysia. The study results indicated significant changes in the COVID-19 hotspots over time. At the beginning of 2020, the state of Selangor and Sarawak were the first locality to become a significant COVID-19 hotspot. Furthermore, this research showed all affected areas during the study period. Overall, a non-random distribution of COVID-19 occurrences was detected, thus suggesting a positive spatial autocorrelation. Many parties are affected by the COVID-19 pandemic, especially those involved in healthcare provision, financial assistance allocation, and law enforcement. Other sectors such as the economy, education, and religion are also affected. Therefore, the findings from this study will provide useful information to all the related governmental and private agencies, as well as policymakers and researchers.
LIFE CYCLE ASSESSMENT ANALYZING WITH GABI SOFTWARE FOR FOOD WASTE MANAGEMENT USING WINDROW AND HYBRID COMPOSTING TECHNOLOGIES
Authors: Abu Rozieana , Ab Aziz Muhammad Arif , Che Hassan Che Hafizan , Noor Zainura Zainon , Abd Jalil Rohaya 
Published: October 2021

The use of composting technologies to treat food waste (FW) now represents an environmentally friendly form of waste treatment, in which organic matter can decompose biologically. However, the damaging emissions of composting technologies for FW treatment vary, thus a life cycle assessment (LCA) approach is often used to certify the quality of the decision-making process. This study quantifies and compares the environmental impact of two scenarios in Malaysia: windrow and hybrid composting (windrow integrated with a landfill) technologies. The scenario modeling was performed via GaBi v6.0 software using 1 ton of pre-treated FW as a functional unit, with the analysis based on the ReCiPe (H) v1.07 characterization method. The midpoint results revealed that windrow composting technology has a lower environmental impact and is an environmentally friendly option compared to hybrid technology. Treating FW in a windrow scenario has relatively low power requirements for operation with the added advantageous properties of compost production, and a substantial reduction in the distances transferred by the road. The hybrid scenario had the largest negative environmental impact in all categories, such as climate change (1.45E+03 kg CO2 eq), and ozone depletion (4.39E-09kg CFC-11 eq) because of the energy-intensive waste collection and treatment activities it needs, and with no landfill gas filtration. Finally, based on the single score synthesis, windrow is considered as an appropriate treatment with the avoidance of Resource Depletion (6.61E+02 Pt).
An Image-Driven Uncertainty Inverse Method for Sheet Metal Forming Problems
Authors: Li Yu , Wang Hu , Li Biyu , Wang Jiaquan , Li Enying 
Published: October 2021

Abstract
The purpose of this study is to obtain a margin of safety for material and process parameters in sheet metal forming. Commonly applied forming criteria are difficult to comprehensively evaluate the forming quality directly. Therefore, an image-driven criterion is suggested for uncertainty parameter identification of sheet metal forming. In this way, more useful characteristics, material flow, and distributions of safe and crack regions, can be considered. Moreover, to improve the efficiency for obtaining sufficient statistics of Approximate Bayesian Computation (ABC), a manifold learning-assisted ABC uncertainty inverse framework is proposed. Based on the framework, the design parameters of two sheet metal forming problems, an air conditioning cover and an engine inner hood, are identified.
Usefulness of the QuantiFERON test for the diagnosis of tubercular uveitis and the predictions of response to antituberculosis treatment
Authors: Danjou William , Pradat Pierre , Jamilloux Yvan , Gerfaud-Valentin Mathieu , Kodjikian Laurent , Trad Salim , Seve Pascal 
Published: October 2021

AimsFew studies have evaluated the contribution of QuantiFERON test for the diagnosis of tubercular uveitis in non-endemic countries for tuberculosis (TB). The objective of the present study was to evaluate the value of the QuantiFERON test in a large cohort of patients with uveitis for both the diagnosis of tubercular uveitis and antituberculosis treatment (ATT) response prediction.MethodsA single-centre retrospective study including consecutive adult patients with uveitis who were prescribed a QuantiFERON test between January 2003 and December 2019 was performed. Adjusted ORs (aORs) were calculated between patients with uveitis responding and not responding to ATT according to the Collaborative Ocular Tuberculosis Study (COTS) group diagnostic criteria. Sensitivity (SE), specificity (Sp), and positive and negative predictive values of the QuantiFERON test were calculated.ResultsA total of 1075 patients were included in the study; 178 (16.5%) were found positive using the QuantiFERON test. Among the 178 positive patients, 62 (35%) had a diagnosis of tubercular uveitis according to the updated COTS classification; all received ATT for 6 months; and 44/62 (71%) responded to ATT. A QuantiFERON test value of >2 IU/mL was associated with a greater chance of responding to ATT (aOR=36.7, 95% CI 7.2 to 185.9, p<0.001). The optimal threshold to maximise both Sp and SE for diagnosis of TB uveitis was 4 IU/mL.ConclusionOne-sixth of the patients diagnosed with uveitis had a positive QuantiFERON test. The QuantiFERON threshold with the optimal SE and Sp for the diagnosis of tubercular uveitis was 4 IU/mL.Trial registration numberNCT03863782.
‘Staying alive’ with antiretroviral therapy: a grounded theory study of people living with HIV in Peru
Authors: Leyva-Moral Juan Manuel , Palmieri Patrick Albert , Loayza-Enriquez Blanca Katiuzca , Vander Linden Kara Lynette , Elias-Bravo Ursula Elisa , Guevara-Vasquez Genesis Masiel , Davila-Olano Lucy Yonmey , Aguayo-Gonzalez Mariela Patricia 
Published: October 2021

BackgroundTo achieve an optimal quality of life through chronic disease management, people living with HIV (PLHIV) must adhere to antiretroviral therapy (ART). ART has been available throughout Peru since 2004 without cost in all regions; yet only 60% (43 200) of PLHIV receive ART and 32% are virally suppressed. Despite the low adherence, little is known about the experience of PLHIV with ART adherence in the context of Latin America.MethodsA constructivist grounded theory design was used to understand the ART adherence experiences of PLHIV in Northern Peru. Unstructured interviews were conducted with 18 participants resulting in theoretical saturation. All interviews were recorded, immediately transcribed and analysed concurrently with data collection using constant comparative analysis with Atlas.ti (V.8) software. Rigour was maintained through openness, reflexivity, audit trail, memo writing, debriefings, member checks and positionality.ResultsThe core category ‘staying alive’ emerged through the interaction of four categories, including: (1) overcoming barriers; (2) working with the healthcare team; (3) tailoring self-care strategies; and (4) appreciating antiretrovirals. Adherence is not a spontaneous outcome, instead, the surprise of HIV diagnosis transitions to living with HIV as a chronic disease. The healthcare team helps PLHIV realise ART is their life source by enhancing, supporting and facilitating self-care and overcoming barriers.ConclusionAdherence emerges from experiential learning as PLHIV recognised ART as their life source in balance with their desire to continue living a normal life. Social support and healthcare team interventions help PLHIV implement tailored self-care strategies to overcome personal, social, and structural barriers to adherence. Healthcare professionals need to recognise the challenges confronted by PLHIV as they learn how to continue living while trying to stay alive.
Natural language word embeddings as a glimpse into healthcare language and associated mortality surrounding end of life
Authors: Lau Ivan Shun , Kraljevic Zeljko , Al-Agil Mohammad , Charing Shelley , Quarterman Alan , Parkes Harold , Metaxa Victoria , Sleeman Katherine , Gao Wei , Dobson Richard J B , Teo James T , Hopkins Phil 
Published: October 2021

ObjectivesTo clarify real-world linguistic nuances around dying in hospital as well as inaccuracy in individual-level prognostication to support advance care planning and personalised discussions on limitation of life sustaining treatment (LST).DesignRetrospective cross-sectional study of real-world clinical data.SettingSecondary care, urban and suburban teaching hospitals.ParticipantsAll inpatients in 12-month period from 1 October 2018 to 30 September 2019.MethodsUsing unsupervised natural language processing, word embedding in latent space was used to generate phrase clusters with most similar semantic embeddings to ‘Ceiling of Treatment’ and their prognostication value.ResultsWord embeddings with most similarity to ‘Ceiling of Treatment’ clustered around phrases describing end-of-life care, ceiling of care and LST discussions. The phrases have differing prognostic profile with the highest 7-day mortality in the phrases most explicitly referring to end of life—‘Withdrawal of care’ (56.7%), ‘terminal care/end of life care’ (57.5%) and ‘un-survivable’ (57.6%).ConclusionVocabulary used at end-of-life discussions are diverse and has a range of associations to 7-day mortality. This highlights the importance of correct application of terminology during LST and end-of-life discussions.
Human pelvis injury risk curves from underbody blast impact
Authors: Yoganandan Narayan , Moore J , Humm J R , Baisden J L , Banerjee A , Pintar F A , Barnes D R , Loftis K L 
Published: October 2021

IntroductionUnderbody blast loading can result in injuries to the pelvis and the lumbosacral spine. The purpose of this study was to determine human tolerance in this region based on survival analysis.MethodsTwenty-six unembalmed postmortem human surrogate lumbopelvic complexes were procured and pretest medical images were obtained. They were fixed in polymethylmethacrylate at the cranial end and a six-axis load cell was attached. The specimens were aligned in a seated soldier posture. Impacts were applied to the pelvis using a custom vertical accelerator. The experimental design consisted of non-injury and injury tests. Pretest and post-test X-rays and palpation were done following non-injury test, and after injury test medical imaging and gross dissections were done. Injuries were scored using the Abbreviated Injury Scale (AIS). Axial and resultant forces were used to develop human injury probability curves (HIPCs) at AIS 3+ and AIS 4 severities using survival analysis. Then ±95% CI was computed using the delta method, normalised CI size was obtained, and the quality of the injury risk curves was assigned adjectival ratings.ResultsAt the 50% probability level, the resultant and axial forces at the AIS 3+ level were 6.6 kN and 5.9 kN, and at the AIS 4 level these were 8.4 kN and 7.5 kN, respectively. Individual injury risk curves along with ±95% CIs are presented in the paper. Increased injury severity increased the HIPC metrics. Curve qualities were in the good and fair ranges for axial and shear forces at all probability levels and for both injury severities.ConclusionsThis is the first study to develop axial and resultant force-based HIPCs defining human tolerance to injuries to the pelvis from vertical impacts using parametric survival analysis. Data can be used to advance military safety under vertical loading to the seated pelvis.
Surgical aortic valve replacement in the era of transcatheter aortic valve implantation: a review of the UK national database
Authors: Jahangiri Marjan , Bilkhu Rajdeep , Embleton-Thirsk Andrew , Dehbi Hakim-Moulay , Mani Krishna , Anderson Jon , Avlonitis Vassilios , Baghai Max , Birdi Inderpaul , Booth Karen , Bose Amal , Briffa Norman , Buchan Keith , Bhudia Sunil , Cale Alex , Deglurkar Indu , Farid Shakil , Hadjinikolaou Leonidas , Jarvis Martin , Javadpour Seyed Hossein , Jeganathan Reubendra , Kuduvalli Manoj , Lall Kulvinder , Mascaro Jorge , Mehta Dheeraj , Ohri Sunil , Punjabi Prakash , Venkateswaran Rajamiyer , Ridley Paul , Satur Christopher , Stoica Serban , Trivedi Uday , Zaidi Afzal , Yiu Patrick , Moorjani Narain , Kendall Simon , Freemantle Nick 
Published: October 2021

ObjectivesTo date the reported outcomes of surgical aortic valve replacement (SAVR) are mainly in the settings of trials comparing it with evolving transcatheter aortic valve implantation. We set out to examine characteristics and outcomes in people who underwent SAVR reflecting a national cohort and therefore ‘real-world’ practice.DesignRetrospective analysis of prospectively collected data of consecutive people who underwent SAVR with or without coronary artery bypass graft (CABG) surgery between April 2013 and March 2018 in the UK. This included elective, urgent and emergency operations. Participants’ demographics, preoperative risk factors, operative data, in-hospital mortality, postoperative complications and effect of the addition of CABG to SAVR were analysed.Setting27 (90%) tertiary cardiac surgical centres in the UK submitted their data for analysis.Participants31 277 people with AVR were identified. 19 670 (62.9%) had only SAVR and 11 607 (37.1%) had AVR+CABG.ResultsIn-hospital mortality for isolated SAVR was 1.9% (95% CI 1.6% to 2.1%) and was 2.4% for AVR+CABG. Mortality by age category for SAVR only were: <60 years=2.0%, 60–75 years=1.5%, >75 years=2.2%. For SAVR+CABG these were; 2.2%, 1.8% and 3.1%. For different categories of EuroSCORE, mortality for SAVR in low risk people was 1.3%, in intermediate risk 1% and for high risk 3.9%. 74.3% of the operations were elective, 24% urgent and 1.7% emergency/salvage. The incidences of resternotomy for bleeding and stroke were 3.9% and 1.1%, respectively. Multivariable analyses provided no evidence that concomitant CABG influenced outcome. However, urgency of the operation, poor ventricular function, higher EuroSCORE and longer cross clamp and cardiopulmonary bypass times adversely affected outcomes.ConclusionsSurgical SAVR±CABG has low mortality risk and a low level of complications in the UK in people of all ages and risk factors. These results should inform consideration of treatment options in people with aortic valve disease.
Correlation between neutrophil to lymphocyte ratio and overactive bladder in South Korean women: a community-based, cross-sectional study
Authors: Kim Soyeon , Park Jung Ha , Oh Yun Hwan , Kim Hyeon Ju , Kong Mi Hee , Moon Jihyun 
Published: October 2021

ObjectiveMany women with overactive bladder (OAB) do not seek medical care despite urinary symptoms. As the diagnosis and treatment of OAB are often late, there is a need to identify undiagnosed OAB patients and start effective treatment. Furthermore, an objective and appropriate screening biomarker for OAB is needed. This study aimed to investigate the relationship between serum neutrophil-to-lymphocyte ratio (NLR) and OAB in South Korean women.DesignCross-sectional, retrospective study.SettingJeju National University Hospital.ParticipantsThis study included a total of 4394 women (mean age=48.6 years) who underwent self-referred health screenings.InterventionsBlood tests were conducted and the NLR was calculated by dividing the number of neutrophils by the number of lymphocytes.Outcome measuresThe severity of OAB was evaluated using the OAB Symptom Score (OABSS).ResultsApproximately 9.8% of participants (n=432) were diagnosed with OAB. The association pattern between the NLR and urinary tract symptoms was variable; however, NLR was associated with OAB, by the OABSS and OAB severity (p<0.001). The NLR had a significant relationship with OAB after age, body mass index, homoeostatic model assessment for insulin resistance, 25-hydroxyvitamin D, stress status, and medication for hypertension (OR 1.19, 95% CI 1.06 to 1.32) were adjusted.ConclusionsElevated NLR is associated with OAB; hence, NLR may be a cost-effective and readily available biomarker of OAB in women.
Association between complement C3 and the prevalence of metabolic-associated fatty liver disease in a Chinese population: a cross-sectional study
Authors: Feng Limin , Zhao Ying , Wang Wei-Lin 
Published: October 2021

ObjectivesRecently studies demonstrated that adipose tissue can produce and release complement C3 and serum complement C3 levels were associated with diabetes mellitus, metabolic syndrome and non-alcoholic fatty liver disease (NAFLD). Thus, we plan to investigate the association of complement C3 levels and the presence of metabolic-associated fatty liver disease (MAFLD).DesignObservational study with a cross-sectional sample.SettingThis study surveyed 4729 participants in Zhejiang province, China.Participants55 participants were excluded for acute infection and 1001 participants were excluded for lack of ultrasonography diagnoses and complete or partial absence of laboratory tests. The final sample size was 3673 participants.Outcome measuresSpearman correlation analysis was used to examine the correlations between complement C3 levels and variables. Binary logistic regression was carried out to evaluate the association between complement C3 levels and the presence of MAFLD after adjustment for demographic and biochemical variables. Mediation effects were used to explore whether insulin resistance (IR), hyperlipidaemia and obesity mediated the association between complement C3 and MAFLD.ResultsParticipants with MAFLD had higher complement C3 levels and complement C3 levels were closely associated with body mass index, waist circumference, alanine aminotransferase, aspartate aminotransferase, γ-glutamyl transpeptidase and homoeostasis model assessment (HOMA)-IR. The presence of MAFLD increased with the increase of complement C3 levels and the presence of MAFLD were highest in the HOMA-IR ≥2.5 participants. We found the OR and Cl of standardised C3 for MAFLD was 1.333 (1.185–1.500), each 1 SD increase in C3 would increase the presence of MAFLD by 33.3%, and obesity partly mediated the effect of complement C3 on the presence of MAFLD.ConclusionsThe present results suggest that complement C3 can be used as a risk factor for the presence of MAFLD after adjustment for confounding variables and obesity may partly mediate the effect of complement C3 on the presence of MAFLD.
Protocol and statistical analysis plan for the Pragmatic Investigation of optimaL Oxygen Targets (PILOT) clinical trial
Authors: Semler Matthew W , Casey Jonathan D , Lloyd Bradley D. , Hastings Pamela G. , Hays Margaret , Roth Megan , Stollings Joanna , Brems John , Buell Kevin George , Wang Li , Lindsell Christopher J. , Freundlich Robert E. , Wanderer Jonathan P. , Bernard Gordon R. , Self Wesley H. , Rice Todd W. 
Published: October 2021

IntroductionMechanical ventilation of intensive care unit (ICU) patients universally involves titration of the fraction of inspired oxygen to maintain arterial oxygen saturation (SpO2). However, the optimal SpO2target remains unknown.Methods and analysisThe Pragmatic Investigation of optimaL Oxygen Targets (PILOT) trial is a prospective, unblinded, pragmatic, cluster-crossover trial being conducted in the emergency department (ED) and medical ICU at Vanderbilt University Medical Center in Nashville, Tennessee, USA. PILOT compares use of a lower SpO2target (target 90% and goal range: 88%–92%), an intermediate SpO2target (target 94% and goal range: 92%–96%) and a higher SpO2target (target 98% and goal range: 96%–100%). The study units are assigned to a single SpO2target (cluster-level allocation) for each 2-month study block, and the assigned SpO2target switches every 2 months in a randomly generated sequence (cluster-level crossover). The primary outcome is ventilator-free days (VFDs) to study day 28, defined as the number of days alive and free of invasive mechanical ventilation from the final receipt of invasive mechanical ventilation through 28 days after enrolment.Ethics and disseminationThe trial was approved by the Vanderbilt Institutional Review Board. The results will be submitted for publication in a peer-reviewed journal and presented at one or more scientific conferences.Trial registration numberThe trial protocol was registered with ClinicalTrials.gov on 25 May 2018 prior to initiation of patient enrolment (ClinicalTrials.gov identifier:NCT03537937).
Newly diagnosed cancer and the COVID-19 pandemic: tumour stage migration and higher early mortality
Authors: Guven Deniz Can , Sahin Taha Koray , Yildirim Hasan Cagri , Cesmeci Engin , Incesu Fatima Gul Gulbahce , Tahillioglu Yagmur , Ucgul Enes , Aksun Melek Seren , Gurbuz Suleyman Cagin , Aktepe Oktay Halit , Arik Zafer , Dizdar Omer , Yalcin Suayib , Aksoy Sercan , Kilickap Saadettin , Kertmen Neyran 
Published: October 2021

BackgroundWe compared the new outpatient clinic referrals during the first 10 months of the COVID-19 pandemic with the year before.MethodsWe compared baseline characteristics of the 2208 new referrals in 2020 (n=922) and 2019 (n=1286) with Χ2and Mann-Whitney U tests and calculated ORs with binary logistic regression. To evaluate the expected changes in the cancer survival secondary to stage migration, we used the 5-year survival data of Survival, Epidemiology and End Results (SEER) Program 2010–2016.ResultsThe percentage of patients with inoperable or metastatic disease was significantly increased during the pandemic (49.8% vs 39%, OR: 1.553, 95% CI: 1.309 to 1.843, p<0.001). We observed a significant decrease in the percentage of patients diagnosed via the screening methods (18.8% vs 28.7%, OR: 1.698, 95% CI: 1.240 to 2.325, p=0.001). The 90-day mortality after the cancer diagnosis was significantly higher during the pandemic (10.5% vs 6.6%, OR: 1.661, 95% CI: 1.225 to 2.252, p=0.001). Due to the increased advanced-stage disease rate at first referral, significant decreases in 5-year survival rates were expected for breast cancer (−8.9%), colorectal cancer (−11.1%), cervix cancer (−10.3%) and melanoma (−7%).ConclusionWe think that collaborative efforts are paramount to prevent the pandemic of late cancer diagnoses and ensure patient safety during the pandemic.