bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prospective meta-analysis protocol on randomised trials of renin–angiotensin system inhibitors in patients with COVID-19: an initiative of the International Society of Hypertension
Authors: Gnanenthiran Sonali Rukshana , Borghi Claudio , Burger Dylan , Charchar Fadi , Poulter Neil R , Schlaich Markus P , Steckelings Ulrike Muscha , Stergiou George , Tomaszewski Maciej , Unger Thomas , Wainford Richard D , Williams Bryan , Rodgers Anthony , Schutte Aletta E 
Published: February 2021

IntroductionWhether ACE inhibitors (ACEi) or angiotensin II receptor blocker (ARB) therapy should be continued, initiated or ceased in patients with COVID-19 is uncertain. Given the widespread use of ACEi/ARBs worldwide, guidance on the use of these drugs is urgently needed. This prospective meta-analysis aims to pool data from randomised controlled trials (RCTs) to assess the safety and efficacy of ACEi/ARB therapy in adults infected with SARS-CoV-2.Methods and analysisRCTs will be eligible if they compare patients with COVID-19 randomised to ACEi/ARB continuation or commencement versuss no ACEi/ARB therapy; study duration ≥14 days; recruitment completed between March 2020 and May 2021. The primary outcome will be all-cause mortality at ≤30 days. Secondary outcomes will include mechanical ventilation, admission to intensive care or cardiovascular events at short-term follow-up (≤30 days) and all-cause mortality at longer-term follow-up (>1 month). Prespecified subgroup analyses will assess the effect of sex; age; comorbidities; smoking status; ethnicity; country of origin on all-cause mortality. A search of ClinicalTrials.gov has been performed, which will be followed by a formal search of trial registers, preprint servers, MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials to identify RCTs that meet inclusion criteria. To date, a search of ClinicalTrials.gov identified 21 potentially eligible trials for this meta-analysis. We will request trial investigators/sponsors to contribute standardised grouped tabular outcome data.Ethics and disseminationEthics approval and informed consent will be the responsibility of the individual RCTs. Dissemination of results will occur by peer-reviewed publication. The results of our analysis can inform public health policy and clinical decision making regarding ACEi/ARB use in patients with COVID-19 on a global scale.
Prospective cohort study of mortality in very low birthweight infants in a single centre in the Eastern Cape province, South Africa
Authors: Michaelis Isabel A , Krägeloh-Mann Ingeborg , Manyisane Ncomeka , Mazinu Mikateko C , Jordaan Esme R 
Published: February 2021

BackgroundNeonatal mortality is a major contributor worldwide to the number of deaths in children under 5 years of age. The primary objective of this study was to assess the overall mortality rate of babies with a birth weight equal or below 1500 g in a neonatal unit at a tertiary hospital in the Eastern Cape Province, South Africa. Furthermore, different maternal-related and infant-related factors for higher mortality were analysed.MethodsThis is a prospective cohort study which included infants admitted to the neonatal wards of the hospital within their first 24 hours of life and with a birth weight equal to or below 1500 g. Mothers who consented answered a questionnaire to identify factors for mortality.Results173 very low birth weight (VLBW) infants were recruited in the neonatal department between November 2017 and December 2018, of whom 55 died (overall mortality rate 32.0%). Twenty-three of the 44 infants (53,5%) with a birth weight below 1000 g died during the admission. One hundred and sixty-one mothers completed the questionnaire and 45 of their babies died.Main factors associated with mortality were lower gestational age and lower birth weight. Need for ventilator support and sepsis were associated with higher mortality, as were maternal factors such as HIV infection and age below 20 years.ConclusionThis prospective study looked at survival of VLBW babies in an underprivileged part of the Eastern Cape of South Africa. Compared with other public urban hospitals in the country, the survival rate remains unacceptably low. Further research is required to find the associated causes and appropriate ways to address these.
Classification of brain arteriovenous malformations located in motor-related areas based on location and anterior choroidal artery feeding
Authors: Jiao Yuming , Li Hao , Fu Weilun , Weng Jiancong , Huo Ran , Wang Yinyan , Wang Shuo , Jiang Tao , Cao Yong , Zhao Ji Zong 
Published: February 2021

ObjectiveSurgical management of arteriovenous malformations (AVMs) involving motor cortex or fibre tracts (M-AVMs) is challenging. This study aimed to construct a classification system based on nidus locations and anterior choroidal artery (AChA) feeding to pre-surgically evaluate motor-related and seizure-related outcomes in patients undergoing resection of M-AVMs.Methods and materialsA total of 125 patients who underwent microsurgical resection of M-AVMs were retrospectively reviewed. Four subtypes were identified based on nidus location: (I) nidus involving the premotor area and/or supplementary motor areas; (II) nidus involving the precentral gyrus; (III) nidus involving the corticospinal tract (CST) and superior to the posterior limb of the internal capsule; (IV) nidus involving the CST at or inferior to the level of posterior limb of the internal capsule. In addition, we divided type IV into type IVa and type IVb according to the AChA feeding. Surgical-related motor deficit (MD) evaluations were performed 1 week (short-term) and 6 months (long-term) after surgery.ResultsThe type I patients exhibited the highest incidence (62.0%) of pre-surgical epilepsy among the four subtypes. Multivariate analysis showed that motor-related area subtypes (p=0.004) and diffuse nidus (p=0.014) were significantly associated with long-term MDs. Long-term MDs were significantly less frequent in type I than in the other types. Type IV patients acquired the highest proportion (four patients, 25.0%) of long-term poor outcomes (mRS >2). Type IVb patients showed a significantly higher incidence of post-surgical MDs than type IVa patients (p=0.041). The MDs of type III or IV patients required more recovery time. Of the 62 patients who had pre-surgical seizures, 90.3% (56/62) controlled their seizures well and reached Engel class I after surgery.ConclusionsCombining the consideration of location and AChA feeding, the classification for M-AVMs is a useful approach for predicting post-surgical motor function and decision-making.
COVID-19 and trauma: how social distancing orders altered the patient population using trauma services during the 2020 pandemic
Authors: Pelzl Casey E , Salottolo Kristin , Banton Kaysie , Madayag Robert M , Hamilton David , Duane Therese M , Carrick Matthew , Lieser Mark , Berg Gina , Bar-Or David 
Published: February 2021

BackgroundRecent studies have reported changes in trauma volumes resulting from the COVID-19 pandemic and social distancing orders (SDOs) implemented by federal and state governments. However, literature is lacking on demographic, injury and outcome patterns.MethodsThis retrospective, cross-sectional study included patients aged ≥18 years at six US level 1 trauma centers. Patients not discharged by the date of data acquisition were excluded. Demographic, injury and outcome variables were assessed across four time periods: period 1 (January 1, 2019–December 31, 2019); period 1b (March 16, 2019–June 30, 2019); period 2 (January 1, 2020–March 15, 2020); and period 3 (March 16, 2020–June 30, 2020). Patients admitted in period 3 were compared with patients presenting during all other periods. Categorical data were compared with χ2and Fisher’s exact tests, and continuous data were assessed with Student’s t-tests and Wilcoxon rank-sum tests.ResultsWe identified 18 567 patients: 12 797 patients in period 1 (including 3707 in period 1b), 2488 in period 2 and 3282 in period 3. Compared with period 1, period 3 had a statistically significant decrease in mean patient volume, increase in portion of penetrating injuries, increase in higher levels of trauma activation, change in emergency department discharge disposition locations, increase in in-hospital mortality and a shorter hospital length of stay. Comparison between period 1b and period 3 demonstrated a decrease in mean patient volume, increase in penetrating injuries, increase in high acuity trauma activations and increase in in-hospital mortality rate. From period 2 to period 3, the penetrating injuries rose from 6.7% to 9.4% (p=0.004), injury severity scale ≥25 increased from 5.9% to 7.7% (p=0.002), full trauma team activations increased from 13.7% to 16.4% (p<0.001), interhospital transfers decreased from 36.7% to 31.6% (p<0.001) and the in-hospital mortality rate increased from 3.3% to 4.2% (p=0.003).DiscussionBeyond altering social interactions among people, the federal SDO is associated with changes in trauma volumes, demographics and injury patterns among patients seeking care at six level 1 hospitals during the pandemic.Level of evidenceIV, prognostic and epidemiological.
Tree establishment and growth drive treeline advance and change treeline form on Pikes Peak (Colorado) in response to recent anthropogenic warming
Authors: Kummel Miroslav , McGarigal Alison , Kummel Michelle , Earnest Carol , Feiden Molly 
Published: February 2021

Treeline advance is a well-established response of treeline ecotones to climate change. However, the degree to which tree growth and establishment drives treeline movement is widely debated. We used geographic information system (GIS) analysis of aerial photographs and dendrochronological analysis of tree growth and age structure to examine treeline dynamics on Pikes Peak (Colorado). The rate of treeline advance at the site (1938–2017) was 0.235 m·year–1, and it accelerated through time. Several sites have transformed from abrupt to diffuse topology. Regional temperatures significantly increased after the 1890s, particularly in the last half-century. Tree growth was inhibited by late spring snow in the 1935–1985 window and enhanced by growing season temperature in the 1965–2009 window. Tree establishment above treeline appears to have transformed treeline topology and set up the potential for further treeline advance. We conclude that if current climatic trends and system relationships continue, treeline should continue to advance because (i) there are large numbers of seedlings and saplings above the treeline due to continuous significant seedling recruitment and (ii) growth of trees in the treeline ecotone is positively related to growing season temperatures, which are increasing. Other limits to the system, such as drought or topographic barriers, may arise in the future.
Embedding cosmology and gravity
Authors: Goswami Abhishek 
Published: February 2021

AbstractI start with a scenario where the universe is an abstract space $${\mathcal {M}}$$
M
having d dimensions. There is a two dimensional surface embedded in it. Embedding is a map from the embedded surface to $${\mathcal {M}}$$
M
that has a field theory described by Sigma model. I take d directions of $${\mathcal {M}}$$
M
to be the generators of a symmetry group SU(n) of the Lagrangian of the embedding. This means embedding has n flavors. Then I introduce spontaneous symmetry breaking in the theory and define the direction along which the symmetry breaking occurs as time. Next I write down the modified Einstein’s equation including the embedding. Then I discuss embedding’s relation to the expansion of the universe. After that I construct an inflationary scenario with embedding as inflaton and discuss its connection to Starobinsky $$R^{2}$$

R
2

model. Finally, I discuss the effect of inflation on the non-commutativity of the spacetime.
Nivolumab Immunotherapy Plus Hydrogen Inhalation for Treatment of KRAS-Mutant Pulmonary Sarcomatoid Carcinoma: A Case Report
Authors: Chen Bo , Zhai Heng , Hu Hongyuan , Zhou Ping , Zhang Fang , Li Liang , Wei Youzhen 
Published: February 2021

Background: Pulmonary sarcomatoid carcinoma (PSC) as a rare subtype of nonsmall cell lung cancer (NSCLC) is resistant to conventional chemotherapy and radiotherapy with poor prognosis. Nivolumab is a monoclonal antibody against PD-1 and might be a valuable therapy option for PSC, but limited case reports have shown good response. Case presentation: A 61-year-old man with PSC characterized with KRAS-G12C mutation and TP53 mutation received treatment of nivolumab synchronously combined with hydrogen inhalation. Clinical symptoms gradually relieved, and evaluation on imaging revealed a response after 1 year. Conclusion: This case suggests that immunotherapy combined with hydrogen inhalation may potentially be a promising strategy to treat PSC patients.
Synthesis of Hybrid Lead Iodide Perovskite Thin Film by Two-Step Method Modified with a Double Dipping Circle to Control Its Crystallization and Morphology to Improve Solar Cells’ Performance
Authors: Dinh Huy Anh , Nguyen Thuy Thanh Thi , Nguyen Le Thi , Nguyen Hai Tri , Trinh Dien Minh , Tran Vy Anh , Nguyen Phuong Tuyet 
Published: February 2021

Crystallization and morphology of perovskite film played an important role to obtain efficient performance of perovskite solar cells. This study is aimed at optimizing the fabrication of hybrid organic–inorganic lead iodide perovskite layer by a two-step method modified by a double dip coating process which enables to control the perovskite crystallization and morphology. The duration time of each circle for the step of dipping PbI2 film to methylammonium iodide solution was varied from 90 to 240 second. The obtained perovskite films were characterized by X-ray diffraction to evaluate the transformation of PbI2 reactant to the perovskite product and its crystallization, by scanning electron microscopy to observe its morphology. Then, the perovskite films were implemented in functional perovskite solar cell devices followed by current–voltage characterization. Results showed that the perovskite was formed via an equilibrium process which reached an optimum transformation of PbI2 to the product after

2
×
150

second circle dip coating, and its morphology was smooth with the least voids. The solar cell devices fabricated at the optimum conditions achieved a comparable performance of about 14%.
Characterizing Glycemic Control and Sleep in Adults with Long-Standing Type 1 Diabetes and Hypoglycemia Unawareness Initiating Hybrid Closed Loop Insulin Delivery
Authors: Malone Susan Kohl , Peleckis Amy J. , Grunin Laura , Yu Gary , Jang Sooyong , Weimer James , Lee Insup , Rickels Michael R. , Goel Namni 
Published: February 2021

Nocturnal hypoglycemia is life threatening for individuals with type 1 diabetes (T1D) due to loss of hypoglycemia symptom recognition (hypoglycemia unawareness) and impaired glucose counter regulation. These individuals also show disturbed sleep, which may result from glycemic dysregulation. Whether use of a hybrid closed loop (HCL) insulin delivery system with integrated continuous glucose monitoring (CGM) designed for improving glycemic control, relates to better sleep across time in this population remains unknown. The purpose of this study was to describe long-term changes in glycemic control and objective sleep after initiating hybrid closed loop (HCL) insulin delivery in adults with type 1 diabetes and hypoglycemia unawareness. To accomplish this, six adults (median

age
=
58

y

) participated in an 18-month ongoing trial assessing HCL effectiveness. Glycemic control and sleep were measured using continuous glucose monitoring and wrist accelerometers every 3 months. Paired sample

t

-tests and Cohen’s

d

effect sizes modeled glycemic and sleep changes and the magnitude of these changes from baseline to 9 months. Reduced hypoglycemia (

d
=
0.47
‐
0.79

), reduced basal insulin requirements (

d
=
0.48

), and a smaller glucose coefficient of variation (

d
=
0.47

) occurred with medium-large effect sizes from baseline to 9 months. Hypoglycemia awareness improved from baseline to 6 months with medium-large effect sizes (Clarke score (

d
=
0.60

), lability index (

d
=
0.50

), HYPO score (

d
=
1.06

)). Shorter sleep onset latency (

d
=
1.53

;

p
<
0.01

), shorter sleep duration (

d
=
0.79

), fewer total activity counts (

d
=
1.32

), shorter average awakening length (

d
=
0.46

), and delays in sleep onset (

d
=
1.06

) and sleep midpoint (

d
=
0.72

) occurred with medium-large effect sizes from baseline to 9 months. HCL led to clinically significant reductions in hypoglycemia and improved hypoglycemia awareness. Sleep showed a delayed onset, reduced awakening length and onset latency, and maintenance of high sleep efficiency after initiating HCL. Our findings add to the limited evidence on the relationships between diabetes therapeutic technologies and sleep health. This trial is registered with ClinicalTrials.gov (NCT03215914).
Legal Protection of Children in Non-International Armed Conflicts in Nigeria
Authors: Olusegun Olaitan Oluwaseyi 
Published: February 2021

Abstract
Armed conflicts are characterised by violence and human rights violations with various implications on the citizens, economy and development of nations. The impact is however more pronounced with life-long consequences on children, the most vulnerable members of the society. This article examines the impact of non-international armed conflicts on children in Nigeria and identifies the laws for the protection of children against armed conflicts, both in international law and Nigeria’s domestic law. It also addresses the challenges involved in the protection of children in armed conflict situations in Nigeria. The study found that legal efforts to protect children have not been given sufficient attention in Nigeria. This is mostly due to various challenges, including the fragmentation of legal framework and the refusal to domesticate relevant treaties. It is thus recommended that these challenges be addressed through the implementation of effective legal frameworks.
De Zuid-Afrikaanse Waarheids- En Verzoeningscommissie als Modelvoor Conflictverzoening
Authors: Verdoolaege Annelies 
Published: February 2021

The South African Truth and Reconciliation Commission as a model for conflict resolution
After the fall of apartheid in 1994, the new South African government got confronted with the necessity to deal with the crimes committed in the past. Apartheid had been a system of institutionalized discrimination by the white minority and this apartheid past could not be ignored when trying to build a unified and peaceful society. The question was how the apartheid atrocities could be dealt with in order for the majority of South Africans to be satisfied. A couple of possibilities were put forward, but the nation eventually opted for the establishment of the Truth and Reconciliation Commission (TRC). This paper will try to provide some background to this phenomenon. Possible alternatives and the coming into existence of the Commission will be highlighted. The concrete proceedings of the TRC will be described and finally the positive and the negative aspects of the Commission will be reflected upon. The final aim is to find out whether the TRC could be seen as a successful and praiseworthy institution and whether it could be regarded as a model for other countries confronted with traumatic conflicts.
Genetic disorders of the surfactant system: focus on adult disease
Authors: van Moorsel Coline H.M. , van der Vis Joanne J. , Grutters Jan C. 
Published: February 2021

Genes involved in the production of pulmonary surfactant are crucial for the development and maintenance of healthy lungs. Germline mutations in surfactant-related genes cause a spectrum of severe monogenic pulmonary diseases in patients of all ages. The majority of affected patients present at a very young age, however, a considerable portion of patients have adult-onset disease. Mutations in surfactant-related genes are present in up to 8% of adult patients with familial interstitial lung disease (ILD) and associate with the development of pulmonary fibrosis and lung cancer.High disease penetrance and variable expressivity underscore the potential value of genetic analysis for diagnostic purposes. However, scarce genotype–phenotype correlations and insufficient knowledge of mutation-specific pathogenic processes hamper the development of mutation-specific treatment options.This article describes the genetic origin of surfactant-related lung disease and presents spectra for gene, age, sex and pulmonary phenotype of adult carriers of germline mutations in surfactant-related genes.
Highlighting the gaps in hazard and risk assessment of unregulated Endocrine Active Substances in surface waters: retinoids as a European case study
Authors: Kubickova Barbara , Ramwell Carmel , Hilscherova Klara , Jacobs Miriam Naomi 
Published: February 2021

AbstractRegulatory hazard and risk assessment of endocrine-active substances currently specifies four modes of action: interference with sex hormone (oestrogen, androgen) pathways, steroidogenesis, and thyroid hormone signalling. This does not encompass the full complexity of the endocrine system and its extended interfaces with environmental pollutants that can potentially disrupt the carefully maintained balance. Here we take the retinoid signalling pathway as a European case study for both, under- and unregulated endocrine pathways and outline the different levels of interference, discuss their adversity, and indicate crosstalk to other signalling pathways. Retinoid compounds already exist in drinking water sources, occur naturally in cyanobacterial blooms and/or enter surface waters via wastewater discharge, where they pose a potential hazard to the environment and human health - a situation that can be expected to worsen due to water shortages induced by climate-change and population growth. We briefly review relevant aspects of current endocrine disruptor (ED) testing for regulatory purposes and then expand upon the needs for inclusion of disruption of retinoid signalling in (ED) regulatory safety assessment contributing to adverse health outcomes that include cognitive function and neurological disease. An overview of developmental effects of retinoid signalling disruption across species highlights critical processes and potential crosstalk with other signalling pathways. A focused weight of evidence-based evaluation of the biologically plausible associations between neurological disorders and altered retinoid signalling highlights the evidence gaps. We show that monitoring only a limited number of anthropogenic priority chemicals in water is insufficient to address the environmental risks of retinoid signalling disruption. To comprehensively assess impacts on the endpoints, processes, and pathways of the endocrine system that are most vulnerable to chemical interference we need further investigation of the true mixture composition in environmental matrices. On a weight of evidence-basis this information can then be integrated into a reliable, inclusive, quantitative approach that ultimately accommodates all the critical pathways. By focusing on the retinoid signalling pathway, we intend to improve the scope and relevance of an integrated approach for the risk assessment of endocrine disruptors.