bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of the Prevalence and Associated Risk Factors of Pediatric Hydrocephalus in Diagnostic Centers in Addis Ababa, Ethiopia
Authors: Mulugeta Blein , Seyoum Girma Gedion , Mekonnen Abebe , Ketema Elbet 
Published: May 2021

Abstract
Background: Hydrocephalus (HCP) is defined as pathophysiology with disturbed cerebrospinal fluid. Neither qualitatively nor quantitatively are there adequate data to determine the prevalence and incidence of HCP in the developing world. HCP is a treatable condition that when left untreated, has fatal consequences.Objective: The objective of this study was to assess the prevalence of pediatric HCP and associated risk factors in diagnostic centers in Addis Ababa.Methods: A cross-sectional facility-based study was conducted over a retrospective and prospective data collection periods. Children aged 5 years and below who came to the four diagnostic centers for MRI/CT examination were studied. The collected data were analyzed using binary logistic regression. Result: The retrospective study included 639(58%) males, 462 (42%) females, and 753 (68.4%) infants were aged younger than 24 months. The mean age calculated was 22.3 months. Children diagnosed with HCP were 245 (22.3%); of these HCP cases, 153(62.4%) were classified as non-communicating HCP. This study identified infants aged younger than 24 months to be significantly associated with HCP (P<0.05). Regarding the gender and age distribution of the prospective study, 57(57.6%) males, 42 (42.4%) females; a mean age of 24.9 months and 60 (60.6%) infants aged younger than 24 months were included. Children diagnosed with HCP were 23 (23.2%); of these HCP cases, 13(56.5%) were classified as non-communicating HCP. Inadequate consumption of folic acid and the familial association of HCP were found to be statistically significant (P<0.05). Conclusion: The results of this study suggest that the high prevalence of HCP was due to the high prevalence of aqueductal stenosis and neural tube defects; with a small contribution of post-infectious causes. The majority of infants who present with HCP were aged younger than 24months.
Nintedanib in Idiopathic and Secondary Pleuroparenchymal Fibroelastosis
Authors: Nasser Mouhamad , Si-mohamed Salim , Turquier Ségolène , Traclet Julie , Ahmad Kais , Philit Francois , Bonniaud Philippe , Chalabryesse Lara , Thivolet-Béjui Francoise , Cottin Vincent 
Published: May 2021

Abstract
Background: Pleuroparenchymal fibroelastosis (PPFE) has a variable disease course with dismal prognosis in the majority of patients with no validated drug therapy. This study is to evaluate the effect of nintedanib in patients with idiopathic and secondary PPFE. Patients admitted to a tertiary care center (2010-2019) were included into this retrospective analysis if they had a multidisciplinary diagnosis of PPFE, had been followed-up for 3 months or more, and had lung function tests and chest CTs available for review. Changes in pulmonary function tests were assessed using non-parametric tests and linear mixed effect model. Lung volumes were measured with lobar segmentation using chest CT.Results: Out of 21 patients with PPFE, nine had received nintedanib, six had received another treatment and another six patients were monitored without drug therapy. Annual FVC (% of predicted) relative decline was -13.6 ±13.4 %/year before nintedanib and -1.6 ±6.02 %/year during nintedanib treatment (p=0.014), whereas no significant change in FVC% relative decline was found in patients receiving another treatment (-13.25 ±34 before vs -16.61 ±36.2 %/yr during treatment; p=0.343). Using linear mixed effect model, the slope in FVC was -0.97 %/month (95% CI: -1.42; -0.52) before treatment and -0.50 %/month (95% CI: -0.88; 0.13) on nintedanib, with a difference between groups of + 0.47%/month (95% CI: 0.16; 0.78), p=0.004. The decline in the upper lung volumes measured by CT was -233 mL/yr ± 387 mL/yr before nintedanib and -149 mL/yr ± 173 mL/yr on nintedanib (p= 0.327). Nintedanib tolerability was unremarkable.Conclusion: In patients with PPFE, nintedanib treatment might be associated with slower decline in lung function, paving the way for prospective, controlled studies.
Multiple metabolic phenotypes as screening criteria are correlated with the plant growth-promoting ability of rhizobacterial isolates
Authors: Shi Peng , Zhang Jianli , Li Xingyue , Zhou Liyun , Luo Hui , Wang Li , Zhang Yafan , Chou Minxia , Wei Gehong 
Published: May 2021

Abstract
Aims
Most preliminary screening criteria for plant growth-promoting (PGP) rhizobacteria (PGPR) are based on traditional knowledge of PGP mechanisms and do not always work well due to complex plant–microbe interactions. The aim of this study was to analyze the correlation between the metabolic phenotypes of rhizobacterial isolates and their PGP ability. The feasibility of using these phenotypes as preliminary screening criteria for PGPR was also evaluated.
Methods
Twenty-one rhizobacterial isolates were screened for their PGP ability, traditional PGP traits, and multiple metabolic phenotypes that are not directly related to PGP mechanisms, but are possibly related to rhizosphere colonization. Correlations between the PGP traits or metabolic phenotypes and increases in plant agronomic parameters were analyzed to find the indicators that are most closely related to PGP ability.
Results
The utilization of 11 nutrient substrates commonly found in root exudates, such as D-salicin, β-methyl-D-glucoside, D-cellobiose, D-maltose, D-trehalose, and dextrin, was significantly positively correlated with the PGP ability of the rhizobacterial isolates. The utilization of one amino acid and two organic acids, namely L-aspartic acid, α-keto-glutaric acid, and formic acid, was negatively correlated with PGP ability. There were no significant correlations between four PGP traits tested in this study and the PGP ability.
Conclusion
The ability of rhizobacterial isolates to metabolize nutrient substrates that are identical or similar to root exudate components may act as better criteria than PGP traits for the primary screening of PGPR, because rhizosphere colonization is a prerequisite for PGPR to affect plants.
Thymoquinone loading into hydroxyapatite/alginate scaffolds accelerated the osteogenic differentiation of the mesenchymal stem cells
Authors: Rahmani-Moghadam Ebrahim , Talaei-Khozani Tahereh , Zarrin Vahideh , Vojdani Zahra 
Published: May 2021

Abstract
Background: Hydroxyapatite (HA) can be loaded by some osteogenic inducing agents such as thymoquinone (TQ) and alginate. This study was performed to investigate the effect of TQ loading into HA/alginate scaffolds on osteogenic differentiation capability of mesenchymal stem cells.Methods: HA scaffolds were fabricated by casting and sintering method and impregnated by TQ containing alginate. The stem cells were loaded onto the scaffolds and induced to differentiate into osteoblasts. Alkaline Phosphatase (ALP) activity, Alizarin Red S, Real-Time qRT-PCR, and MTT assessments were done. Finally, the cells were examined with a light microscope, confocal microscope, and SEM.Results: The results showed that the presence of the alginate decelerates the degradation rate and reinforces the mechanical strength. while the presence of TQ had no significant influence on physical and mechanical properties of the HA/alginate scaffolds, it led to a significant increase in ALP activity and expression of collagen, osteopontin, and osteocalcin at early phase of differentiation. Also, TQ administration had no impact on calcium deposition and proliferation as well as bone-marker expression at long term differentiation.Conclusion: TQ accelerates the differentiation of the stem cells into the osteoblasts without changing the properties of the scaffolds, and the HA/alginate/TQ scaffold can be used as a scaffold with osteogenic properties in bone tissue engineering applications.
Knowledge, attitude and practice of clinicians about antimicrobial stewardship and resistance among hospitals of Pakistan: A multicenter cross-sectional study
Authors: Ashraf Sohaib , Ashraf Shoaib , Ashraf Moneeb , Imran Muhammad Ahmad , Ahmad Zawar , Hafsa Hadiqa tul , Awais Abeer Bin , Kalsoom Larab , Akmal Rutaba , Farooq Iqra , Ashraf Sidra , Habib Zaighum , Ghufran Muhammad , Sherazi Syed Sami Hussain , Akram Muhammad Kiwan , Rafique Sundas , Nawaz Khawar , Safdar Zartasha , Ashraf Muhammad , Saboor Qazi Abdul , Humayun Ayesha , Izhar Mateen , Consortium ONE Health 
Published: May 2021

Abstract
Considering that antimicrobial resistance (AMR) is a global challenge, there is a dire need to gauge the knowledge, attitude, and practice (KAP) of clinicians in endemic countries. The aim of the current multicenter, cross-sectional study was to highlight the knowledge, aptitude and practice gaps in antimicrobial (AM) stewardship and AMR among practicing doctors working in public tertiary care teaching hospitals of Lahore, Pakistan. A KAP survey, based on a self-administered questionnaire containing 45 questions, was conducted among 336 clinicians practicing in 6 randomly selected hospitals of Lahore, Pakistan. Overall, 92% of the clinicians considered AMR as a worldwide problem but only 66% disagreed that cold and flu symptoms require antibiotics. Moreover, around 68% doctors felt confident about their practice in AM but still 96% felt need to get more knowledge about AM. Need to establish courses on rational antibiotic use was demanded by 84% of participants. The main contributing factors considered for AMR by the doctors included excessive AM usage in medical profession (87.1%) and multiple antibiotics per prescription (76.4%). Pharmacologically, AM spectrum was accurately chosen by 1.4% (ampicillin), 0.003% (erythromycin) and 0% (levofloxacin). Clinically, a more than 50% of clinicians used miscellaneous AM for empirical therapy of respiratory tract infection and cholecystitis. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 25. The knowledge of clinicians is relatively poor in AM spectrum and drugs of choice for certain infections. However, they know about their short comings with positive approach towards improvement.
Cooling Strategies for Thermal Comfort in Cities: A Review of Key Methods in Landscape Design
Authors: Zou Mo , Zhang Heng 
Published: May 2021

Abstract
Under the climate change scenario, the negative impacts of urban heat island (UHI) will exacerbate due to unsustainable urban planning and human activities. Thermal comfort has close relationships with UHI in urban areas. This paper is based on the studies of urban heat island, thermal comfort, microclimate and urban planning in cities in the recent decade, combined with cross-analysis research method. The key topics include vegetation and water conditions, the albedo of materials, urban morphology and more. By the comparative case studies in landscape projects, the results further reveal that the density of tree canopies, the natural structure and density of ground cover, the form of water features, the colour and texture of materials, and the scale of shading structures have different cooling effect and performance in outdoor thermal comfort improvement with specific features in the landscape design. It is also found that there are some external conditions that can influence design determinations in real practices. The purpose of this study is to provide theoretical research methods and evaluation of thermal comfort landscape design elements, and to provide guidance for future sustainable city research and landscape design.
Correlation of Preoperative Gd-EOB-DTPA-Contrast-Enhanced MRI With TGF-β1 Expression in Hepatocellular Carcinoma
Authors: Mo Zhiqing , Long Liling , Zhou Xiaojiao , Ding Hao 
Published: May 2021

Abstract
Purpose: To investigate the feasibility of preoperative gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) -enhanced magnetic resonance imaging (MRI) related signs in predicting transforming growth factor-β1(TGF-β1) gene expression in hepatocellular carcinoma (HCC).Materials and methods: Sixty patients with HCC (55 males, mean age 52.6±12 years) who underwent preoperative MRI enhancement were retrospectively analyzed. Qualitative and quantitative features of Gd-EOBDTPA-enhanced MRI in these pathologically confirmed HCC patients were analyzed. Reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry (IHC) were performed to determine the mRNA and protein levels of TGF-β1 in HCC. The relationship between these imaging features and TGF-β1 expression level in HCC was evaluated by rank sum test, correlation analysis and logistic regression analysis.Results: RT-PCR indicated that the expression level of TGF-β1 mRNA was statistically significant with the change of hepatobiliary signal (P=0.009). Immunohistochemical results indicated that the apparent diffusion coefficient (ADC) value of tumor was statistically significant at the protein level (P=0.038).There was no statistical significance in the distribution of other image features. Binary logistic regression analysis suggested that heterogeneous signals in hepatobiliary phase were independent risk factors for high TGF-β1 expression in HCC (P=0.012,OR=5.333,95%CI:1.437-19.801). Multivariate logistic regression analysis showed that ADC value was not an independent risk factor for TGF-β1 expression.Conclusions: heterogeneous signal performance in the hepatobiliary phase and/or ADC values of HCC are potential indicators of high expression of TGF-β1. Gd-EOB-DTPA-enhanced MRI may be useful in the selection of targeted therapies for patients with HCC.
Expression of Immune Checkpoint Regulators, Cytotoxic T Lymphocyte Antigen 4 (CTLA-4) and CD137 in Cervical Carcinomas
Authors: Kassardjian Ari , Moatamed Neda 
Published: May 2021

Abstract
Introduction: Immune checkpoint inhibitors in cancer therapy has a significant role in oncology. One of these immune checkpoint mediators is cytotoxic T-lymphocyte associated protein 4 (CTLA-4). Inhibition of the CTLA-4 pathway has already led to the FDA approval of Ipilimumab (anti-CTLA-4), a targeted therapy for melanoma and other malignancies. CD137 is an inducible, costimulatory receptor of the tissue necrosis factor receptor superfamily expressed on activated immune cells. Clinical trials had also been set for anti-CD137 in several malignancies. We investigated the expression of CTLA-4 and CD137 antibodies in benign and malignant uterine cervical tissues. Method: We assessed CTLA-4 and CD137 expression on a tissue microarray (TMA) comprising of 100 normal, non-neoplastic, and neoplastic cervical tissues. When detected as strong granular cytoplasmic reaction in the epithelial cells, CTLA-4 expression was scored as positive. For CD137, the results were recorded based on the presence or absence of staining reaction on the cell membranes of the lymphoplasmacytic infiltrate. Result: Overall, CTLA-4 was positive in 30% (30/100) of the cervical malignancies. Subcategorically, 20% of invasive endocervical adenocarcinomas, 62.5% of adenosquamous carcinomas, and 31% of squamous cell carcinomas were positive for CTLA-4 with a tendency toward lower grades SCCs. CD137 was positive in lymphoplasmacytic infiltrates of all endocervical adenocarcinomas, 90.5% of squamous cell carcinoma, and 87.5% cores of adenosquamous carcinomas. Conclusion: This study has found a significant expression of CTLA-4 in cervical cancer cells and CD137 positivity of lymphoplasmacytic infiltrates with potentials for future targeted immunotherapy.
Clinical and biomarker analyses of sintilimab versus chemotherapy as second-line therapy for advanced or metastatic esophageal squamous cell carcinoma: a randomized, open-label phase 2 trial (ORIENT-2)
Authors: Xu Jian Ming , Li Yi , Fan Qingxia , Shu Yongqian , Yang Lei , Cui Tongjian , Gu Kangsheng , Tao Min , Wang Xiuwen , Cui Chengxu , Xu Nong , Xiao Juxiang , Gao Quanli , Liu Yunpeng , Zhang Tao , Bai Yuxian , Li Wei , Zhang Yiping , Dai Guanghai , Ma Dong , Zhang Jingdong , Bai Chun-Mei , Huang Yun-Chao , Liao Wangjun , Wu Lin , Chen Xi , Yang Yan , Wang Junye , Ji Shoujian , Zhou Hui , Wang Yan , Ma Zhuo , Wang Yanqi , Peng Bo , Sun Jiya , Mancao Christoph 
Published: May 2021

Abstract
This randomized, open-label, multi-center phase 2 study (ClinicalTrials.gov, number NCT03116152) assessed sintilimab, a PD-1 inhibitor, versus chemo in patients with advanced esophageal squamous cell carcinoma (ESCC) refractory to first-line (1L) chemotherapy. The primary endpoint was overall survival (OS), while exploratory endpoint was the association of biomarkers with treatment efficacy. The median OS in the sintilimab group was significantly prolonged compared with that of the chemotherapy group, (objective response rates 12.6% and 6.3 %, respectively). Incidence of treatment-related adverse events of grade 3–5 was lower with sintilimab than with chemotherapy (20.2 vs. 39.1 %). Patients with high TCR clonality and low mTBI showed the longest median OS (15.0 mo), while patients with low NLR at 6 wk post-treatment had a significantly prolonged median OS compared with those with high NLR. High expression of T-follicular helper cells or activated B-cell signature was significantly associated with longer progression-free survival in the sintilimab group.
Navigating the COVID-19 Data Landscape: Automated Hypothesis Generation using Topological Data Analysis
Authors: Kamruzzaman Methun , Bielskas Matthew , Krishnamoorthy Bala , Marathe Achla , Vullikanti Anil , Kalyanaraman Ananth 
Published: May 2021

Abstract
Background: There have been significant spatio-temporal variations in how the COVID-19 pandemic has unfolded in different parts of the country. While a huge amount of data related to the COVID-19 pandemic has become available including data on disease outcomes, different kinds of behaviors and diverse interventions, along with a number of co-variates, analyzing this data to characterize the spatio-temporal variations and gleaning actionable insights and hypotheses on different factors driving the pandemic remains a big challenge. The objective of this study is to identify in an unsupervised fashion the key spatio-temporal patterns, anomalies, and associated factors in the spread of COVID-19 in different regions that can be used in the development of models and the planning of public health policies. Methods: We present a topological data analysis (TDA) framework for exploring COVID-19 data that supports two types of analytical functions: i) discover disease epochs in the trajectories that reveal spatio-temporal events of interest; and ii) modeland better elucidate interactions between variables of different disease outcomes (e.g., number of cases, hospitalizations , deaths) and intervention mechanisms (e.g., social distancing, contract tracing). Results: Our TDA framework reveals several insights in an automated manner by identifying co-evolving and divergent cohorts of states with respect to various disease outcomes (e.g., number of new cases) and measures of behavior or interventions (e.g. social distancing, COVID exposure, hospital bed utilization). Our framework also identifies the branching points at which the different cohorts start evolving separately. Conclusions: The illustrative case studies show that our TDA-based analytical framework can help navigate the epidemic data landscape in an automated and guided manner, and can provide insights to formulate hypotheses and devise sound, data-aided public health policies.
Challenges of Emergency Medical Services utilization by the older adults in Tabriz, Iran
Authors: Azizi-Zeinalhajlou Akbar , Ghafouri Rouzbeh Rajaei , Sahebihagh Mohammad Hasan , Mohammadpoorasl Asghar , Parsian Zahra , Yousefi Mahmood 
Published: May 2021

Abstract
Background: As the number of older adults is increasing, the health care services such as Emergency Medical Services (EMS) should be promoted. One of the preconditions for the use of health services is awareness of these services and their terms of use. This study is conducted to evaluate the awareness of the older adults in Tabriz about EMS and the terms of services. Methods: This cross-sectional survey was conducted in a representative sample of over 60 years old noninstitutionalized population in Tabriz (Iran). It included 1062 participants (514 males and 548 females) who were selected using Probability Proportional to Size (PPS) sampling method. Service awareness is considered as being informed about the existence of the EMS. Knowledge about EMS is defined as knowing the EMS phone number and knowledge about its free and 24-hour service. After completing the informed consent, data collection was conducted in the households of the participants. Data analysis was conducted using logistic regression. Results: The findings showed that 47% of the older adults were not familiar with the EMS system. Awareness of EMS in males (63.4%) was higher than females (44.2%) and also it was higher among those born in cities (61.2%) than rural areas (46.1%). Holding primary, secondary, and higher education compared with illiteracy had higher chance of awareness of EMS by more than 2, 4, and 12 times respectively (OR= 2.53, OR= 4.69, and OR= 12.09). Conclusion: Due to high rate of illiteracy and low public awareness, older adults do not have appropriate knowledge about the facilities, conditions, and terms of using EMS and may not be able to demand some of their essential services; therefore, notifying and increasing awareness about the available services to older adults are necessary.
Analyzing the Impact of ATF3 in Tumorigenesis and Immune Cell Infiltration of Ovarian Tumor: A Bioinformatics Study
Authors: wu Xiujuan 
Published: May 2021

Abstract
ATF3 is an essential transcription activator in regulating cancer-related genetic expression. To identify the role of ATF3 in ovarian, we investigated the correlation between ATF3 expression and the clinicopathological properties using multiple database. The cBioPortal and GEPIA database displayed the clinical information of ovarian patients harboring or without harboring ATF3 mutation. Furthermore, we assessed the relationship between survival and ATF3 expression level using Kaplan-Meier plotter, which reveals that the ovarian patients with higher expression of ATF3 suffered the worse overall survival and progression-free survival. The differentially expressed genes were analyzed using Gene Ontology, protein-protein interaction network and gene set enrichment analysis to identify the hub gene and critical pathways, significantly affecting the tumorigenesis of ovarian tumor. Finally, we assessed the correlation between ATF3 and immune cell infiltration using Tumor Immunoassay Resource (TIMER) database. The results demonstrated that higher expression is positive correlation with macrophage infiltration, expression for M1 and M2 type macrophages. Our study suggests that ATF3 can regulate the cell cycle and heme-related oxidative phosphorylation process, and it may be a critical factor to regulate the macrophage cell to be infiltrated into ovarian cancer. ATF3 can be as a biomarker for diagnosis and therapy of ovarian.