bluuebunny/crossref_metadata_2025_split huggingface dataset:
Critical Analysis on the Comparative Advantage of Presidentialism over Parliamentary System on Liberty and National Unity in Ethiopia
Authors: Temesgen Sisay A. 
Published: April 2021

Abstract
The Ethiopian Federal Democratic Republic (EFDR) Constitution is promulgated in 1994. Under Article (45) of the EFDR the country is restructured from presidential to parliamentary system of government. Since then, the country has been ravaged by the gross violation of the liberty of citizens and the crisis of national unity and consensus among the diversified ethnic groups. The impact of the parliamentary system in aggravating those critical challenges and the comparative advantage of presidantialism is the most ignored political research topic. In this Article, I investigated that the blurry separation of powers of the parliamentary structure of the country has created fusion of powers which has undermined the system of checks and balances. Thus, the executive organ of the government has enabled to concentrate unchecked and unaccountable power which has manifested in the gross violation of the liberty of citizens. Likewise, Article (73) of EFDR has declared that the prime minister and council of ministers of the country to be appointed by the legislators. This has deprived their boarder popular base and authenticity; and equivocally undermined their potency and decisiveness in addressing the existing crisis of national unity and consensus. Comparatively, the presidential structure of government is defined by the firm separation of powers and genuine system of checks and balances. The direct popular election of the president enables the president and council of ministers to secure broader popular base and authenticity. Thus, it is advantageous over parliamentarian structure in terms of protecting the liberty of citizens and addressing the crisis of national unity and consensus in Ethiopia.
The Judeo-Arabic Dialect of Yefren (Libya): Phonological and Morphological Notes
Authors: D’Anna Luca 
Published: April 2021

Abstract
The present article offers a preliminary description of the Judeo-Arabic variety spoken in Yefren (Libya), based on interviews collected from three elderly female informants. It analyzes the phonology and morphology of the dialect, attempting some sociolinguistic considerations on issues of dialect contact between Muslim and Jewish varieties of Libyan Arabic. In conclusion, the article discusses the position of Yefreni Judeo-Arabic within the context of Libyan and North African Judeo-Arabic as a whole. While belonging to the Eqa:l group of North-African Judeo-Arabic, a sufficient number of isoglosses allows us to posit the existence of two separate subgroups within Libyan Judeo-Arabic, here indicated as the Tripoli and Yefreni types.
Clinical effect of Brisson operation modified by Y-shaped incision for treatment of concealed penis in adolescents
Authors: Su Quanxin , Gao Shenglin , Lu Chao , Wu Xingyu , Zuo Li , Zhang Lifeng 
Published: April 2021

Objective To analyze the clinical effect of the Brisson operation modified by a Y-shaped incision in treating adolescent concealed penis. Methods We retrospectively analyzed clinical data of 27 adolescents with a concealed penis treated with the Brisson operation modified by a Y-shaped incision in our hospital from January 2017 to March 2020. Results The operation went smoothly in all 27 patients. Postoperative foreskin edema occurred in 12 patients and spontaneously resolved within 1 month postoperatively. Two patients developed postoperative retropubic infection. After administering antibiotics and symptomatic treatment, both patients’ conditions improved within 1 week. All operations obtained satisfactory results. Postoperatively, when the penis was in a non-erect state, it was clearly exposed without retraction or concealment; thus, demonstrating good surgical results. The prepuce was distributed naturally without obvious accumulation of redundant preputial tissue. The penile scar resembled that after circumcision. The postoperative follow-up period was 6 months, during which no patients developed recurrence. Conclusion The Brisson operation modified by a Y-shaped incision is effective for treating a concealed penis in adolescent patients. This technique may relieve the pathological abnormalities and retain the penile skin's integrity to the greatest extent with minimal scarring and a satisfactory appearance.
Polypharmacy, chemotherapy receipt, and medication-related out-of-pocket costs at end of life among commercially insured adults with advanced cancer
Authors: McDermott Cara L , Curtis J Randall , Sun Qin , Fedorenko Catherine , Kreizenbeck Karma , Ramsey Scott D 
Published: April 2021

Background Polypharmacy raises the risk of drug-drug interactions and adverse events among patients with cancer. Most polypharmacy research has focused on adults age 65 or older enrolled in Medicare insurance. To better inform pharmacy practice and cancer care delivery, data are needed on polypharmacy among commercially insured patients with cancer and those younger than 65. Methods We performed a retrospective analysis of insurance enrollment and claims files linked to the Puget Sound Cancer Surveillance System for adults age 18 and older who were commercially insured, diagnosed with stage IV cancer, survived 30+ days after diagnosis, and did not enroll in hospice. We describe the prevalence of polypharmacy, chemotherapy use, and medication-related out-of-pocket (OOP) costs in the last month of life. Results Of 606 patients, 390 (64%) experienced polypharmacy (i.e. 5+ medications) in the last 30 days of life. Almost half (n = 297, 49%) received chemotherapy or targeted agents; chemotherapy was associated with significantly higher odds of polypharmacy (odds ratio (OR) 2.93, 95% confidence interval (CI) 2.04–4.20). The most commonly prescribed medications at end of life were opioids, benzodiazepines and anti-emetics. Among 484 patients (80%) incurring medication-related costs in the last month of life, median total OOP cost was $82 (interquartile range $30–$200). Seven patients (1%) had total costs above $5,000. The median chemotherapy-related OOP cost was $446 (IQR $150–$1896); 32 patients (7%) had chemotherapy-related OOP costs between $1,000 and $5,000. Conclusion Most patients with advanced cancer experienced polypharmacy at end of life, although most medications observed herein are commonly used for supportive care. Patients receiving chemotherapy had higher medication-related OOP costs, and chemotherapy was significantly associated with polypharmacy at end of life. Evaluation of polypharmacy at end of life may represent an important opportunity to improve quality of life and reduce costs for patients and families.
Evaluation of Adjacent Segment With Pre-Existing Degeneration Using the Cerebrospinal Fluid Occlusion Sign on MRI Before Posterior Lumbar Fusion: A Multi-Center Observational Cohort Study
Authors: Sun Zhuoran , Li Zhuofu , Guo Yang , Li Weishi , Chen Xin , Li Shugang , Shen Jianxiong , Qi Longtao , Zhao Yao , Li Chunde , Zhu Di , Zhu Jichao , Liu Baoge 
Published: April 2021

Study Design: Prospective cohort study. Objective: To evaluate whether pre-existing adjacent spinal canal stenosis (SCS) is associated with short-term outcomes after lumbar fusion surgery. Methods: We included patients with lumbar spinal stenosis treated surgically between July 2015 and December 2017 at 4 centers. All patients had the same pathology, with L4-S1 as the culprit sections. Patients were divided into 2 groups based on the cerebrospinal fluid occlusion sign on MRI at the adjacent L3/4 level. Patients without SCS (grade 0) and with mild SCS (grade 1) were classified into the non-stenosis (NS) and mild stenosis (MS) groups, respectively. All patients underwent PLIF and completed at least 1-year follow-up. The incidence of adjacent segment degeneration (ASDeg) and clinical outcomes were compared between the 2 groups. Results: A total of 308 patients (NS, 156; MS, 152) met the inclusion criteria. The incidence of ASDeg in the NS group (n = 40, 25.6%) was significantly lower than that in the MS group (n = 74, 48.7%; P < .001). The most frequent type of ASDeg in the 2 groups was the SCS-aggravated type. No significant difference was observed in adjacent segment disease incidence between the 2 groups ( P = .243). The NS group had better outcomes according to the clinical function scores ( P < .05). Conclusions: The cerebrospinal fluid occlusion sign on MRI is valuable for evaluating the adjacent segment with pre-existing degeneration. Patients with mild SCS in adjacent segments were more likely to have ASDeg, and the most frequent type of ASDeg was the SCS-aggravated type at early follow-up.
Integrating spatial multi-criteria evaluation into the potential analysis of culture-led urban development – A case study of Tainan
Authors: Cheng Hsien-Hsin , Hsu Yi-Ya 
Published: April 2021

Post-1980s, early-developed historical cities attempted to reverse the dilemma of urban modern development and the preservation of historical textures. Culture-led urban development then emerged as a strategy to highlight the advantages of historical cities. However, study that propose practical evaluation framework that integrate culture, historical texture, and relevant resources is less. Furthermore, cultural resources, their characteristics, and their development potential are rarely considered under spatial scales. Therefore, we aim to conduct a spatial potential evaluation framework for culture-led urban development (CLUD), shedding light on the characteristics of the historical and cultural environment and their relevance to social and economic factors. Recent studies suggest that culture-led urban development should focus more on the balance between local cultural context and development planning content, to achieve long-term sustainable development. Consequently, we applied the concept of adaptive development, which emphasizes locally appropriate assess, particularly at a regional level. In this research, a spatial multi-criteria evaluation (SMCE) model was developed for the decision-making process, which can contain multiple aspects of the urban environment and related resources. We apply the established framework to Tainan City, due to its rich cultural resources, high cultural participation and intensive support from the government. The results were calculated in different spatial units in response to various purposes. The findings are divided into several zones performing various objectives that are appropriate for specific places. The outcome demonstrates the possibility of development cooperation within the study region. In the future, the framework and the processes can be applied to evaluate other regions to enable more comprehensive understanding before policy inputs.
Dual Antibacterial Effect of In Situ Electrospun Curcumin Composite Nanofibers to Sterilize Drug-Resistant Bacteria
Authors: Liu Chun-Li , Yang Jun , Bai Xiao-Han , Cao Zhi-Kai , Yang Chen , Ramakrishna Seeram , Yang Da-Peng , Zhang Jun , Long Yun-Ze 
Published: April 2021

AbstractBacterial infection especially caused by multidrug-resistant bacteria still endangers human life. Photodynamic therapy (PDT) can effectively kill bacteria, and nanofiber-based PDT can effectively reduce damage to normal tissues. However, current photosensitizers coated on the surfaces of fibers would release to the wound, causing some side effects. And nanofibers prepared by traditional method exhibit poor adhesion on the wound, which severely reduces the PDT effect due to its short-range effect. Herein, core–shell curcumin composite nanofibers are prepared by in situ electrospinning method via a self-made portable electrospinning device. The obtained composite nanofibers show superior adhesiveness on different biological surface than that of traditional preparation method. Upon 808-nm irradiation, these composite nanofibers effectively produced singlet oxygen (1O2) without curcumin falling off. After these composite nanofibers’ exposure to drug-resistant bacteria, they exhibit dual antibacterial behaviors and efficiently kill the drug-resistant bacteria. These dual antibacterial nanofiber membranes with excellent adhesiveness may benefit the application of wound infection as antibacterial dressing.
Ultrasound-guided prostate biopsy: indication, morbidity and outcome at Hopital General Idrissa Pouye
Authors: Ndiaye Modou , Jalloh Mouhamed , Ndoye Madina , Faye Samba Thiapato , Kouka Saint Charles Nabab , Ndour Ndiaga Seck , Mbodji Mouhamadou Moustapha , Diaw El Hadji Malick , Mane Ibrahima Louis , Labou Issa , Niang Lamine , Gueye Serigne Magueye 
Published: April 2021

Abstract
Background
Magnetic resonance imaging (MRI)-guided prostate biopsy has a higher sensitivity than the ultrasound-guided biopsy, but its realization requires a dedicated interventional MRI, specific material, which is not available in our context; hence, ultrasound-guided biopsy remains of great interest. Currently, ultrasound-guided biopsy outside of a clinical trial is the gold standard for the diagnosis of prostate cancer. The objective of our work is to evaluate our practice of transrectal ultrasound-guided prostate biopsy using an endorectal probe by describing the technique and evaluating the morbidity and results.

Methods
This is a descriptive study of ultrasound-guided prostatic biopsies performed over a 2-year period. The parameters studied were frequency of the procedure, age, rectal examination findings, total PSA level, prostate biopsy morbidities and results. Descriptive statistics were performed, and comparison of qualitative variables was made by the Chi-square test with statistical significance set for α < 5%

Results
Two hundred and thirty-one patients were included over a two-year period. The mean age of our patients was 65 ± 8.2 years. Rectal examination finding was suspicious in 36.9% and the median total PSA was 19.8 ng/ml (0.1-5936 ng/ml). Seventy-seven percent of patients reported their pathology results. Prostatic adenocarcinoma was the most common finding accounting for 53.7% of results. Complications were observed in 16 patients (6.9%) with a predominance of initial hematuria, voiding pain and fever.

Conclusion
In our series, the cancer detection rate was significant and the complications rate was acceptable at 6.9%.
Outcomes of voluntary medical male circumcision performed by medical doctors and non-doctor health workers in central Uganda
Authors: Matumaini Hope Kibansha , Batte Anthony , Otwombe Kennedy , Lebotsa Emily , Luboga Sam 
Published: April 2021

Abstract
Background
Voluntary medical male circumcision (VMMC) reduces the risk of HIV transmission. Task shifting of VMMCs to non-doctor health workers is recommended to enhance scale-up of VMMC programs. This study evaluated outcomes of circumcision conducted by doctors compared to non-doctors in central Uganda.

Methods
In this prospective observational study, we observed and followed 274 males at 3 health facilities in Kampala, Uganda. Each participant was observed during the circumcision procedure, monitored for 2 h post-surgery and assessed at 24 h, 3 days and after one week for adverse events.

Results
The median age of the circumcised men was 24.00(IQR, 20.00–28.00) years. Of the VMMCs, 19.3% (53/274) were carried out by doctors while 80.7% (221/274) by non-doctors. Following VMMC, 5.47% (15/274) men experienced adverse events and proportions of adverse events by cadre were similar; doctors (5.66% [3/53]) and non-doctor health workers (5.43% [12/221]), p = 0.99. Seven participants had pus discharge (all had been operated by non-doctors), 2 participants had bleeding at 2 h (one by doctor and one by non-doctor), and 4 participants had excessive skin removal (2 by doctors vs 2 by non-doctors). There was no reported urethral injury or glans amputation.

Conclusion
Our study found no statistically significant difference in the incidence of adverse events among VMMCs conducted by doctors compared to non-doctor health workers. Our study showed no incidence of serious adverse events such as death, urethral injury or glans amputation following VMMCs. Our results add to the existing literature to guide task shifting in the context of VMMCs.
Laparoscopic radical prostatectomy: a single surgeon’s experience in 80 cases after 2 years of formal training
Authors: Çelen Sinan , Özlülerden Yusuf , Mete Aslı , Başer Aykut , Tuncay Ömer Levent , Zümrütbaş Ali Ersin 
Published: April 2021

Abstract
Background
To assess the learning curve in laparoscopic radical prostatectomy (LRP) performed by a single surgeon who had a healthcare career as a surgical first assistant for 2 years in high-volume centers treating > 150 cases per year.

Methods
The records of 80 LRP cases performed between October 2017 and August 2018 by a single surgeon were consecutively divided into four groups (groups A = first 20 cases, B = second 20 cases, C = third 20 cases, and D = last 20 cases). The groups were compared in terms of surgical and functional outcomes with a minimum follow-up of 6 months.

Results
Clinical and surgical stages of the four groups were similar between groups. The operative time (126.8 ± 5.48 min; P = 0.001) and time of removal of the drain (1.65 ± 0.93 days; P = 0.029) were significantly lower in group D; however, hospitalization, catheterization time, and blood loss were similar between groups. The complication rate was low. No patient had a visceral injury, and there were no procedures needed to open conversion. The positive surgical margin (PSM) rates were similar between groups. In terms of continence and potency, all groups were similar at the 6th-month follow-up after surgery.

Conclusions
Our results showed that prior experience in laparoscopic surgery as a surgical first assistant in a high-volume center improves the learning curve and oncological and functional outcomes, and helps to minimize the complication rate
miR-122-5p regulates the tight junction of the blood-testis barrier of mice via occludin
Authors: Liu Limin , Zhu Maoying , Liu Xiaoli , Fei Lumin , Shen Jianyun , Chen Deyu 
Published: April 2021

AbstractBackgroundOccludin protein is the primary assembling protein of TJs and the structural basis for tight junction formation between Sertoli cells in the spermatogenic epithelium. The expression of miR-122-5p and occludin are negatively correlated. In order to investigate the regulation mechanism of miR-122-5p on occludin and TJ, the present study isolated primary Sertoli cells from C57BL/6 mice, identified a transcription factor of miR-122-5p in testicle, studied the modulating loci of miR-122-5p on occludin using a dual-luciferase reporter assay, analyzed the regulate of miR-122-5p on the expression of occludin with real-time RT-PCR and Western blot, and studied the effect of miR-122-5p on the tight junction using a Millicell Electrical Resistance System.ResultsThe relative luciferase activity in the pcDNA-Sp1 + pGL3-miR-122-5p promoter group was significantly higher than that in the pcDNA-Sp1 + pGL3-basic group, which suggests that transcript factor Sp1 promotes the transcription of miR-122-5p. The relative luciferase activity in the occludin 3′-UTR (wt) + miR-122-5p mimic group was significantly lower than that in the other groups (p < 0.01), which indicates that miR-122-5p modulates the expression of occludin via the ACACTCCA sequence of the occludin-3’UTR. The levels of occludin mRNA and protein in the miR-122-5p mimic group were significantly lower than that in the other groups (p < 0.05), which indicates that miR-122-5p reduces the expression of occludin. The trans-epithelial resistance of the miR-122-5p mimic group was significantly lower than that of the blank control group after day 4 (p < 0.05), which indicates that miR-122-5p inhibited the assembly of the inter-Sertoli TJ permeability barrier in vitro.ConclusionThese results displayed that miR-122-5p could regulate tight junctions via the Sp1-miR-122-5p-occludin-TJ axis.
Chemotherapy alone versus definitive concurrent chemoradiotherapy for cT4b esophageal squamous cell carcinoma: a population-based study
Authors: Li Chia-Chin , Chen Chih-Yi , Chou Ying-Hsiang , Huang Chih-Jen , Ku Hsiu-Ying , Chien Chun-Ru 
Published: April 2021

Abstract
Background
The role of radiotherapy for cT4bNanyM0 esophageal squamous cell carcinoma (ESqCC) is relatively unclear, with both chemotherapy (C/T) alone and definitive concurrent chemoradiotherapy (dCCRT) being treatment options in the current guidelines. We aimed to compare the survival of dCCRT versus C/T for these patients via a population-based approach.

Methods
Eligible cT4b ESqCC patients diagnosed between 2011 and 2017 were identified via the Taiwan Cancer Registry. We used propensity score (PS) weighting to balance the observable potential confounders between groups. The hazard ratio (HR) of death and incidence of esophageal cancer mortality (IECM) were compared between dCCRT and C/T. We also evaluated OS in subgroups of either low or standard radiotherapy doses.

Results
Our primary analysis consisted of 247 patients in whom covariates were well balanced after PS weighing. The HR for death when dCCRT was compared with C/T was 0.36 (95% confidence interval 0.24–0.53, P < 0.001). Similar results were found for IECM. Statistical significance was only observed in the standard RT dose but not in the low dose in subgroup analyses.

Conclusions
In this population-based nonrandomized study of cT4bNanyM0 ESqCC patients from Asia (Taiwan), we found that the use of radiotherapy with chemotherapy was associated with better overall survival than chemotherapy alone. Further studies (especially RCTs) are needed to confirm our findings.