bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dead space estimates may not be independently associated with 28-day mortality in COVID-19 ARDS
Authors:   the PRoVENT-COVID Study Group, Morales-Quinteros Luis , Neto Ary Serpa , Artigas Antonio , Blanch Lluis , Botta Michela , Kaufman David A. , Schultz Marcus J. , Tsonas Anissa M. , Paulus Frederique , Bos Lieuwe D. 
Published: May 2021

Abstract
Background
Estimates for dead space ventilation have been shown to be independently associated with an increased risk of mortality in the acute respiratory distress syndrome and small case series of COVID-19-related ARDS.

Methods
Secondary analysis from the PRoVENT-COVID study. The PRoVENT-COVID is a national, multicenter, retrospective observational study done at 22 intensive care units in the Netherlands. Consecutive patients aged at least 18 years were eligible for participation if they had received invasive ventilation for COVID-19 at a participating ICU during the first month of the national outbreak in the Netherlands. The aim was to quantify the dynamics and determine the prognostic value of surrogate markers of wasted ventilation in patients with COVID-19-related ARDS.

Results
A total of 927 consecutive patients admitted with COVID-19-related ARDS were included in this study. Estimations of wasted ventilation such as the estimated dead space fraction (by Harris–Benedict and direct method) and ventilatory ratio were significantly higher in non-survivors than survivors at baseline and during the following days of mechanical ventilation (p < 0.001). The end-tidal-to-arterial PCO2 ratio was lower in non-survivors than in survivors (p < 0.001). As ARDS severity increased, mortality increased with successive tertiles of dead space fraction by Harris–Benedict and by direct estimation, and with an increase in the VR. The same trend was observed with decreased levels in the tertiles for the end-tidal-to-arterial PCO2 ratio. After adjustment for a base risk model that included chronic comorbidities and ventilation- and oxygenation-parameters, none of the dead space estimates measured at the start of ventilation or the following days were significantly associated with 28-day mortality.

Conclusions
There is significant impairment of ventilation in the early course of COVID-19-related ARDS but quantification of this impairment does not add prognostic information when added to a baseline risk model.
Trial registration: ISRCTN04346342. Registered 15 April 2020. Retrospectively registered.
Study of Peri-Articular Anaesthetic for Replacement of the Knee (SPAARK): statistical analysis plan for a randomised controlled trial assessing the effectiveness of peri-articular liposomal bupivacaine plus bupivacaine hydrochloride compared with bupivacaine hydrochloride alone
Authors: Stokes Jamie R. , Wang Ariel , Poulton Lisa , Rombach Ines , Pandit Hemant , Knight Ruth 
Published: May 2021

Abstract
Background
Up to three quarters of surgical patients receive inadequate pain relief, with 40% of patients reporting severe pain following knee replacement, which may indicate the current pain relief strategies using opiate-based analgesia cannot achieve patient satisfaction. Liposomal bupivacaine is liposome-encapsulated bupivacaine which has been reported to be effective for up to 72 h. The study of Peri-Articular Anaesthetic for Replacement of the Knee (SPAARK) trial has been designed to assess the effectiveness of peri-articular liposomal bupivacaine and bupivacaine hydrochloride compared with peri-articular bupivacaine hydrochloride alone in the management of post-operative pain following knee replacement.

Methods/design
The SPAARK trial is a multi-centre, patient-blinded, randomised controlled trial. The co-primary outcomes are post-operative recovery assessed by global QoR-40 scores at 72 h and cumulative pain VAS score from 6 to 72 h following surgery. Longer-term measures of the co-primary outcomes are collected at 6 weeks and 6 and 12 months post randomisation, together with secondary outcomes, i.e. the Oxford Knee Score, and the American Knee Society Score. Cumulative opiate use and fitness for discharge are measured up to 72 h post-surgery. The analysis approaches for the primary and secondary outcomes are described here, as are the descriptive statistics which will be reported. The full SPAARK protocol has already been published.

Results
The co-primary outcomes will be analysed using multivariate linear regression adjusting for stratification factors and other important prognostic variables, including baseline scores in the case of the QoR-40. The adjusted mean difference between the two groups together with 97.5% confidence intervals will be reported for each of the primary outcomes. Other continuous variables will be assessed using the same method. Binary outcomes will be assessed using chi-squared tests.

Discussion
The paper provides details of the planned statistical analyses for the SPAARK trial and aims to reduce the risk of outcome reporting bias from prior data knowledge. Any changes or deviations from this statistical analysis plan will be described and justified in the final study report.

Trial registration
ISRCTN54191675. Registered on 13 November 2017.
Sports nutrition knowledge and perceptions among professional basketball athletes and coaches in Lebanon-a cross-sectional study
Authors: Boumosleh Jocelyne Matar , el Hage Catherine , Farhat Antoine 
Published: May 2021

AbstractBackgroundBasketball is the most popular sport in Lebanon. Adequate nutrition has been established to be a key component of optimal athletic performance, recovery from exercise and exercise-induced injury and documented to be associated with adequate nutrition knowledge (NK). In Lebanon, nutrition education is not incorporated into the basketball player training program and there is no established position for sports nutritionists in basketball clubs. To our knowledge, the present study is the first to evaluate the NK status of Division I Basketball (D1B) players /coaches in Lebanon. The objectives of this study are to assess the prevalence of inadequate NK; identify the gaps in NK, main sources of nutrition information, perceptions on sports nutrition and independent predictors of inadequate NK among D1B players and coaches in Lebanon.MethodsAll D1B players (n = 184) and coaches (n = 16) in Lebanon were invited to participate in the study. Study participants were asked to complete a questionnaire that included questions on NK, resources and perceptions. A percentage of ≥60% of NK questions answered correctly was used as indicative of having adequate NK. Descriptive statistics were used to summarize the sample characteristics. The T-test and chi square test were used for comparisons of means and proportions, respectively. Logistic regression was used to explore the predictors of inadequate NK in D1B players.ResultsThe sample consisted of 178 D1B players (nM = 126; nF = 52) and 11 male coaches, resulting in survey response rates of 97 and 69%, respectively. Inadequate NK was found among about 80 and 54% of D1B players and coaches, respectively. Inadequate NK was found to be independently associated with lack of nutrition education in D1B players.ConclusionsDespite widespread lack of adequate NK among D1B players and coaches in Lebanon, our sports clubs do not have dietitians. Basketball sports clubs in Lebanon should start to budget for hiring a dietitian or carrying out nutrition education campaigns that are based on analyses of incorrect responses of our study participants. Findings of this study are of tremendous significance to D1B players in Lebanon in terms of improving the athletes’ physical health and performance.
Radiological pattern in ARDS patients: partitioned respiratory mechanics, gas exchange and lung recruitability
Authors: Coppola Silvia , Pozzi Tommaso , Gurgitano Martina , Liguori Alessandro , Duka Ejona , Bichi Francesca , Ciabattoni Arianna , Chiumello Davide 
Published: May 2021

Abstract
Background
The ARDS is characterized by different degrees of impairment in oxygenation and distribution of the lung disease. Two radiological patterns have been described: a focal and a diffuse one. These two patterns could present significant differences both in gas exchange and in the response to a recruitment maneuver. At the present time, it is not known if the focal and the diffuse pattern could be characterized by a difference in the lung and chest wall mechanical characteristics. Our aims were to investigate, at two levels of PEEP, if focal vs. diffuse ARDS patterns could be characterized by different lung CT characteristics, partitioned respiratory mechanics and lung recruitability.

Methods
CT patterns were analyzed by two radiologists and were classified as focal or diffuse. The changes from 5 to 15 cmH2O in blood gas analysis and partitioned respiratory mechanics were analyzed. Lung CT scan was performed at 5 and 45 cmH2O of PEEP to evaluate lung recruitability.

Results
One-hundred and ten patients showed a diffuse pattern, while 58 showed a focal pattern. At 5 cmH2O of PEEP, the driving pressure and the elastance, both the respiratory system and of the lung, were significantly higher in the diffuse pattern compared to the focal (14 [11–16] vs 11 [9–15 cmH2O; 28 [23–34] vs 21 [17–27] cmH2O/L; 22 [17–28] vs 14 [12–19] cmH2O/L). By increasing PEEP, the driving pressure and the respiratory system elastance significantly decreased in diffuse pattern, while they increased or did not change in the focal pattern (Δ15-5: − 1 [− 2 to 1] vs 0 [− 1 to 2]; − 1 [− 4 to 2] vs 1 [− 2 to 5]). At 5 cmH2O of PEEP, the diffuse pattern had a lower lung gas (743 [537–984] vs 1222 [918–1974] mL) and higher lung weight (1618 [1388–2001] vs 1222 [1059–1394] g) compared to focal pattern. The lung recruitability was significantly higher in diffuse compared to focal pattern 21% [13–29] vs 11% [6–16]. Considering the median of lung recruitability of the whole population (16.1%), the recruiters were 65% and 22% in the diffuse and focal pattern, respectively.

Conclusions
An early identification of lung morphology can be useful to choose the ventilatory setting. A diffuse pattern has a better response to the increase of PEEP and to the recruitment maneuver.
Blockchain-based IoT device identification and management in 5G smart grid
Authors: Wang Dong , Wang Huanjuan , Fu Yuchen 
Published: May 2021

AbstractThis work investigates the unified coding and identification of smart grid IoT devices, as more and more IoT devices in smart grid need to be managed and controlled. We combine blockchain technology with 5G MEC to realize the connection of massive power IoT devices at the edge of 5G network. Due to blockchain’s distributed storage and credibility, it is used to identify and register IoT devices in smart grid, ensuring the reliability and accuracy of smart grid IoT devices management. In this paper, we propose a hybrid blockchain mechanism based on 5G MEC smart grid, where both public blockchain and private blockchain are deployed on the MEC gateway/server. To facilitate the data searching and extracting, we endeavor to build a blockchain explorer indexed by IoT device identifier. After that, we study the typical consensus algorithms in the blockchain such as PoW, PoS, DPoS, PDFT, and discuss their feasibility in the hybrid blockchain. Finally, we analyzed and compared the performance of different consensus algorithms from the perspective of average computing time and average time to agreement.
Approximate calculation of 8-point DCT for various scenarios of practical applications
Authors: Puchala Dariusz 
Published: May 2021

AbstractIn this paper, based on the parametric model of the matrix of discrete cosine transform (DCT), and using an exhaustive search of the parameters’ space, we seek for the best approximations of 8-point DCT at the given computational complexities by taking into account three different scenarios of practical usage. The possible parameter values are selected in such a way that the resulting transforms are only multiplierless approximations, i.e., only additions and bit-shift operations are required. The considered usage scenarios include such cases where approximation of DCT is used: (i) at the data compression stage, (ii) at the decompression stage, and (iii) both at the compression and decompression stages. The obtained results in effectiveness of generated approximations are compared with results of popular known approximations of 8-point DCT of the same class (i.e., multiplierless approximations). In addition, we perform a series of experiments in lossy compression of natural images using popular JPEG standard. The obtained results are presented and discussed. It should be noted, that in the overwhelming number of cases the generated approximations are better than the known ones, e.g., in asymmetric scenarios even by more than 3 dB starting from entropy of 2 bits per pixel. In the last part of the paper, we investigate the possibility of hardware implementation of generated approximations in Field-Programmable Gate Array (FPGA) circuits. The results in the form of resource and energy consumption are presented and commented. The experiment outcomes confirm the assumption that the considered class of transformations is characterized by low resource utilization.
A Neumann problem for a diffusion equation with n-dimensional fractional Laplacian
Authors: Arciga-Alejandre Martin P. , Sanchez-Ortiz Jorge , Ariza-Hernandez Francisco J. , Garcia-Murcia Eduard 
Published: May 2021

AbstractWe study an initial-boundary value problem for a n-dimensional stochastic diffusion equation with fractional Laplacian on $\mathbb{R}_{+}^{n}$

R
+
n

. In order to prove existence and uniqueness, we generalize the Fokas method to construct the Green function for the associated linear problem and then we apply a fixed point argument. Also, we present an example where the explicit solutions are given.
Differences in regional distribution and inequality in health-resource allocation on institutions, beds, and workforce: a longitudinal study in China
Authors: Dong Enhong , Xu Jie , Sun Xiaoting , Xu Ting , Zhang Lufa , Wang Tao 
Published: May 2021

AbstractBackgroundThe distribution of health-care resources is foundational to achieving fairness and having access to health service. China and its local Shanghai’s government have implemented measures to allocate health-care resources with the equity as one of the major goals since 2009-health-care reform. The aim of this study was to analyze differences in regional distribution and inequality in health-resource allocation on institutions, beds, and workforce in Shanghai over 7 years.MethodsThe study was conducted using 2010–2016 data to analyze health-resource allocation on institutions, beds, and workforce in Shanghai, China. The annual growth rate (AGR) was used to evaluate the time trends of health-care resource from 2010 to 2016, and Theil index was calculated to measure inequality of five indicators of health-care resource allocation during this study period.ResultsAll quantities of health-care resources per 1000 people increased across Shanghai districts from 2010 to 2016. Compared with suburban districts, the central districts had higher ratios on five health-care resource indicators, and faster average growth in the bed and nurse indicator. The Theil of the indicators, except for doctors in hospitals, all exhibited downward time trends.ConclusionsRegional difference between urban and rural areas and inequality between institution and workforce, especially for doctors, still existed. Some targeted measures including but not limited to income raising, facilitation of transportation conditions, investment of more fiscal funds, enhancement of health-care service provision for rural residents should be fully considered to narrow resource distribution gap between urban and rural districts and mitigate the inequality of health-care resource allocation.
Food security and environment conservation through sustainable use of wild and semi-wild edible plants: a case study in Berek Natural Forest, Oromia special zone, Ethiopia
Authors: Kidane Leul , Kejela Alemu 
Published: May 2021

Abstract
Background
Wild edible plants (WEPs) have an important role for rural communities in safeguarding food security, nutritive variation and continued earnings. Their significance, management and utilization are not fully documented. Objectives are to identify and document wild and semi-wild edible plants (WSWEPs) and their conservation status in Berek natural forest, Oromia special zone.

Methods
Various data collection tools were employed to gather data on WSWEPs. Ethnobotanical data were collected from 142 household representatives (77 men and 65 women) being at least 14 years old. Most of them (73.9%) had not received formal education. Data were analyzed using descriptive and inferential statistics, preference ranking, paired comparison, direct matrix ranking and informant consensus factor.

Results
A total of 34 useful WSWEP species belonging to 32 genera and 24 families were collected and identified. The family Rosaceae had the highest number of species (five species, 14.7%), followed by Anacardiaceae and Solanaceae with three species (8.8%) each. Growth form analysis showed that the majority of the species were trees (14 species; 41.2%), followed by herbs and shrubs (10 species each, 29.4%. These edible plants were available in different seasons; 15 (44%) of the plant species reached maturity in spring season while seven species (20.6%) were found in all seasons and eight (23.6%) species were able to reach maturity in autumn and winter. Although most of the local communities have an intimate relationship with their natural environment, there are common threats to WSWEPs and their habitat, particularly through overgrazing, fragmentation of the vegetation for agricultural expansion, introduction of exotic species, selective logging for construction purpose and charcoal making.

Conclusion
WSWEPs are valuable resources for improving the environment, food and nutritional security and income of households in rural areas. Moreover, to sustainably use edible plant species of the study area local communities and the Forest Administration should collaborate in managing these resources before becoming critically endangered.
Selenium deficiency induces spleen pathological changes in pigs by decreasing selenoprotein expression, evoking oxidative stress, and activating inflammation and apoptosis
Authors: Li Shuang , Sun Wenjuan , Zhang Kai , Zhu Jiawei , Jia Xueting , Guo Xiaoqing , Zhao Qingyu , Tang Chaohua , Yin Jingdong , Zhang Junmin 
Published: May 2021

Abstract
Background
The immune system is one aspect of health that is affected by dietary selenium (Se) levels and selenoprotein expression. Spleen is an important immune organ of the body, which is directly involved in cellular immunity. However, there are limited reports on Se levels and spleen health. Therefore, this study established a Se-deficient pig model to investigate the mechanism of Se deficiency-induced splenic pathogenesis.

Methods
Twenty-four pure line castrated male Yorkshire pigs (45 days old, 12.50 ± 1.32 kg, 12 full-sibling pairs) were divided into two equal groups and fed Se-deficient diet (0.007 mg Se/kg) or Se-adequate diet (0.3 mg Se/kg) for 16 weeks. At the end of the trial, blood and spleen were collected to assay for erythroid parameters, the osmotic fragility of erythrocytes, the spleen index, histology, terminal deoxynucleotidyl transferase nick-end labeling (TUNEL) staining, Se concentrations, the selenogenome, redox status, and signaling related inflammation and apoptosis.

Results
Dietary Se deficiency decreased the erythroid parameters and increased the number of osmotically fragile erythrocytes (P < 0.05). The spleen index did not change, but hematoxylin and eosin and TUNEL staining indicated that the white pulp decreased, the red pulp increased, and splenocyte apoptosis occurred in the Se deficient group. Se deficiency decreased the Se concentration and selenoprotein expression in the spleen (P < 0.05), blocked the glutathione and thioredoxin antioxidant systems, and led to redox imbalance. Se deficiency activated the NF-κB and HIF-1α transcription factors, thus increasing pro-inflammatory cytokines (IL-1β, IL-6, IL-8, IL-17, and TNF-α), decreasing anti-inflammatory cytokines (IL-10, IL-13, and TGF-β) and increasing expression of the downstream genes COX-2 and iNOS (P < 0.05), which in turn induced inflammation. In addition, Se-deficiency induced apoptosis through the mitochondrial pathway, upregulated apoptotic genes (Caspase3, Caspase8, and Bak), and downregulated antiapoptotic genes (Bcl-2) (P < 0.05) at the mRNA level, thus verifying the results of TUNEL staining.

Conclusions
These results indicated that Se deficiency induces spleen injury through the regulation of selenoproteins, oxidative stress, inflammation and apoptosis.
Initial study on TMPRSS2 p.Val160Met genetic variant in COVID-19 patients
Authors: Wulandari Laksmi , Hamidah Berliana , Pakpahan Cennikon , Damayanti Nevy Shinta , Kurniati Neneng Dewi , Adiatmaja Christophorus Oetama , Wigianita Monica Rizky , Soedarsono  , Husada Dominicus , Tinduh Damayanti , Prakoeswa Cita Rosita Sigit , Endaryanto Anang , Puspaningsih Ni Nyoman Tri , Mori Yasuko , Lusida Maria Inge , Shimizu Kazufumi , Oceandy Delvac 
Published: May 2021

Abstract
Background
Coronavirus disease 2019 (COVID-19) is a global health problem that causes millions of deaths worldwide. The clinical manifestation of COVID-19 widely varies from asymptomatic infection to severe pneumonia and systemic inflammatory disease. It is thought that host genetic variability may affect the host’s response to the virus infection and thus cause severity of the disease. The SARS-CoV-2 virus requires interaction with its receptor complex in the host cells before infection. The transmembrane protease serine 2 (TMPRSS2) has been identified as one of the key molecules involved in SARS-CoV-2 virus receptor binding and cell invasion. Therefore, in this study, we investigated the correlation between a genetic variant within the human TMPRSS2 gene and COVID-19 severity and viral load.

Results
We genotyped 95 patients with COVID-19 hospitalised in Dr Soetomo General Hospital and Indrapura Field Hospital (Surabaya, Indonesia) for the TMPRSS2 p.Val160Met polymorphism. Polymorphism was detected using a TaqMan assay. We then analysed the association between the presence of the genetic variant and disease severity and viral load. We did not observe any correlation between the presence of TMPRSS2 genetic variant and the severity of the disease. However, we identified a significant association between the p.Val160Met polymorphism and the SARS-CoV-2 viral load, as estimated by the Ct value of the diagnostic nucleic acid amplification test. Furthermore, we observed a trend of association between the presence of the C allele and the mortality rate in patients with severe COVID-19.

Conclusion
Our data indicate a possible association between TMPRSS2 p.Val160Met polymorphism and SARS-CoV-2 infectivity and the outcome of COVID-19.
The World Health Organization road map for neglected tropical diseases 2021–2030: implications for onchocerciasis elimination programs
Authors: Vieri Melissa Krizia , Logora Makoy Yibi , Rafiq Kamran , Colebunders Robert 
Published: May 2021

AbstractIn its new roadmap for neglected tropical diseases, the World Health Organization proposes three important strategic shifts: (i) Stronger accountability which shifting from process to impact indicators; (ii) Intensified cross-cutting approaches; and (iii) Stronger country ownership. In this paper we discuss the implementation of these three strategies in the setting of a high onchocerciasis disease burden in South Sudan.