bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health-Related Quality of Life in Children with Kaposiform Hemangioendothelioma : A Case Control Study
Authors: Dai Shiyi , Yang Kaiying , Qiu Tong , Zhou Jiangyuan , Zhang Xuepeng , Chen Siyuan , Li Li Zhi , Ji Yi 
Published: February 2021

Abstract
Background and objective: Kaposiform hemangioendothelioma (KHE) is a rare, aggressive and borderline vascular tumor mainly occurring in infants and children. The aim of this study was to determine the health-related quality of life (HRQOL) in children with KHE. Methods: A total of 91 children with KHE participated in this cross-sectional study. The HRQOL was assessed by the age-specific Pediatric Quality of Life Inventory Version 4.0 (PedsQL™ 4.0) Infant Scales, Family Information Form (FIF), Family Impact Module (FIM) and Generic Core Scales (GCS). For comparison, demographically matched healthy children were recruited as a control group. The main outcome measure of HRQOL was analyzed in the two groups. We determined related factors that influenced the HRQOL in children with KHE and their parents by using a stepwise multiple regression analysis. Results: Except for social and cognitive functioning, we found significant differences in the PedsQL™ 4.0 Infant Scales subscales between the patient group and healthy group (P<0.05). In the PedsQL™ 4.0 GCS, all the subscales were significantly different between the patient group and the healthy group (P<0.05). Additionally, in the ≤24 month age group, there were significant differences in the HRQOL between patients with and without Kasabach-Merritt phenomenon (KMP) in physical, physical symptoms, emotional and cognitive functioning (P<0.05). In the >24 month age group, physical, emotional and social functioning were significantly different between the patients with and without activity dysfunction (P<0.05). Conclusions: The findings presented here suggest that patients with KHE have a poor HRQOL. KMP and activity dysfunction are risk factors for poor HRQOL in patients with KHE. However, lesion size, lesion location and education level of the mother and father were not related to the HRQOL.
TFCrowd: A Blockchain-based Crowdsourcing Framework with Enhanced Trustworthiness and Fairness
Authors: Li Chunxiao , Qu Xidi , Guo Yu 
Published: February 2021

Abstract
Blockchain technology has attracted considerable attention due to the boom of cryptocurrencies and decentralized applications. Among them, the emerging blockchain-based crowdsourcing is a typical paradigm, which gets rid of centralized cloud-servers and leverages smart contracts to realize task recommendation and reward distribution. However, there are still two critical issues yet to be solved urgently. First, malicious evaluation from crowdsourcing requesters will result in honest workers not getting the rewards they deserve even providing valuable solutions. Second, unfair evaluation and reward distribution can lead to workers’ reluctance to work actively. Therefore, the above problems will seriously hinder the development of blockchain-based crowdsourcing platforms. In this paper, we propose a new blockchain-based crowdsourcing framework with enhanced trustworthiness and fairness, named TFCrowd. The core idea of TFCrowd is utilizing a smart contract of blockchain as a trusted authority to fairly evaluate contributions and allocate rewards. To this end, we devise a reputation-based evaluation mechanism to punish the requester who behaves as “false-reporting” and a Shapley value-based method to distribute rewards fairly. By using our proposed schemes, TFCrowd can prevent malicious requesters from making unfair comments and reward honest workers according to their contributions. Extensive simulations and the experiment results demonstrate that TFCrowd can protect the interests of workers and distribute rewards fairly.
WITHDRAWN: How Flushable Wet Wipes Are Causing Sewer Blockages – and An Approach to Prevent That
Authors: Harter Thomas , Bernt Ingo , Winkler Stefanie , Hirn Ulrich 
Published: February 2021

Abstract
Scientific publications and newsfeeds recently focused on flushable wet wipes and their role in sewage system blockages. It is stated that although products are marked as flushable, they do not disintegrate after being disposed of via the toilet. In this work it is shown that wetlaid hydroentangled wet wipes lose their initially good dispersive properties during their storage in wet condition. This behaviour is found for both, wet wipes from industrial production and wipes produced on pilot facilities. It is demonstrated that the deterioration of the wipe’s ability to disintegrate during wet storage is linked to the type of cellulosic fibres used. Only wipes made from a combination of band-shaped viscose fibres and unbleached softwood pulp fibres were preserving good disintegration during wet storage. The results are also suggesting to add tests after defined times of wet storage when assessing the flushability of wet wipes.
New Surgical Realities—Implementation of An Enhanced Recovery After Surgery Protocol for Gynecological Laparoscopy: A Prospective Study
Authors: Jimenez Jose Carlos Vilches , Serrano Beatriz Tripiana , Muñoz Emilia Villegas , Pérez Belinda Sanchez , Lopez Jesús S Jimenez 
Published: February 2021

Abstract
Background
Multimodal rehabilitation allows optimization of functional recovery in surgery patients by reducing the post-operative stress and hospital stay duration, without increasing the morbidity and mortality. It is reportedly successful in other surgical disciplines, and guidelines for its application to gynecological surgery are available; however, most evidence for these guidelines is derived from observational and/or retrospective studies. Therefore, this study aimed to investigate the applicability of an enhanced recovery after surgery (ERAS) protocol in laparoscopic gynecological surgery and its influence on the postoperative stay, morbidity, mortality and readmission, through a prospective approach.
Methods
This prospective cohort study was performed on 90 patients who underwent laparoscopic hysterectomy for benign causes from October 2017 to October 2019. Patients in whom the ERAS (ERAS group, n = 30) and traditional (control group, n = 60) protocols were implemented were compared. All patients were followed for six months.
Results
The groups were homogeneous and did not differ significantly with respect to the demographic characteristics (age, ASA score, body mass index), surgical indications, and surgery types. Adherence to the ERAS protocol was over 99%. The postoperative hospital-stay durations were 1.73 days (r = 1–3) and 2.97 days (r = 2–6) in the ERAS and control groups (p = 0.000). No significant intergroup differences were observed in the rates of complications and readmissions.
Conclusions
The ERAS protocol is applicable in laparoscopic gynecological surgery and can be implemented with good adherence. This can allow optimization of patient recovery by reducing the hospital stay duration, without increasing the rates of morbidity, mortality, or readmission.
Dexmedetomidine Attenuates Hemodynamic and Proinflammatory Responses During Craniotomy for Traumatic Brain Injury: A Randomized Controlled Trial Study
Authors: Hou Junde , Cheng Yanxin , Wei Hongfang , Wang Xiaowei , Chi Xiaohui , Zhao Guangping , Zhao Senming , Chen Yongxue 
Published: February 2021

Abstract
The authors have requested that this preprint be removed from Research Square.
Hundred Most Cited Articles in Perioperative Neurocognitive Disorder: A Bibliometric Analysis
Authors: Mi Xinning , Wang Xiaoxiao , Yang Ning , Han Yongzheng , Li Yue , Liu Taotao , Han Dengyang , Yuan Yi , Cao Yiyun , Shi Chengmei , Guo Xiangyang , Zhou Yang , Li Zhengqian 
Published: February 2021

Abstract
Background: In line with aging populations and increased application of anesthesia and surgery, perioperative neurocognitive disorder (PND) has received growing attention worldwide. Considerable research into PND is being conducted; however, the quantity and quality of such research have not been reported. Through a retrospective bibliometric analysis, this study aimed to identify and characterize the top 100 cited publications on PND. Methods: We searched the Web of Science database to find the top 100 cited articles focusing on PND. We collected bibliographic information, including year of publication, country of origin, article type, published journal, citation count, and authorship. To determine changes with time, we compared older and newer articles. Results: The top 100 cited articles were published between 1955 and 2016; the number of citations ranged from 111 to 1248. The United States had the most published papers; clinical trials were the most common article type. The specialty journals of Anesthesiology and Anesthesia & Analgesia were the two most cited journals. Newer papers had a comparable number of citations to older articles, but the former had higher citation rates, greater funding disclosures, more focus on basic research, and more open access publications. Conclusions: This study provides a comprehensive overview of the most cited articles and highlights the increasing attention on PND. High-quality clinical trials with a greater journal impact factor received more citations. However, there has been growth in the number of basic science studies as an area of research with respect to the pathogenesis of PND.
Allogeneic Red Blood Cell Transfusion Rate and Risk Factors in Elderly Patients with Femoral Neck Fracture After Hemiarthroplasty
Authors: Yue Rui , Yang Minghui , Deng Xiaohui , Zhang Ping 
Published: February 2021

Abstract
Objective: To determine the rate and risk factors of allogeneic red blood cell transfusions (ABT) in elderly patients with femoral neck fracture (FNF) after hemiarthroplasty (HA). Methods: We conducted a study on elderly patients (≥65 years old) who were admitted to the geriatric trauma orthopedics ward of Beijing Jishuitan Hospital for HA treatment from March 2018 to February 2019 due to FNF. The perioperative data were collected retrospectively, and univariate and multivariate stepwise logistic regression analysis were performed to determine the postoperative ABT rate and its risk factors. Results: 445 patients were included in the study, of which 177 (39.8%) received ABT after surgery. Multivariate stepwise logistic regression analysis showed that preoperative low hemoglobin (Hb), high intraoperative blood loss (IBL), advanced age, and low body mass index (BMI) are independent risk factors of ABT after HA in elderly FNF patients. Conclusion: ABT after HA is a common phenomenon in elderly patients with FNF. Their postoperative ABT needs are related to preoperative low Hb, high IBL, advanced age, and low BMI. Therefore, ABT can be reduced from the above aspects.
The General Relativistic Perspective
Authors: Taylor David 
Published: February 2021

Abstract
This paper formulates additional General Relativistic [GR] equations that do not contradict the originals. They rephrase Dr. Einstein's equations from a Relativistically distorted Perspective. The equations reason the distorted Escape velocity of a GR object, determining its real Escape velocity after the distortions of Relativity slow Bosons||Gravitons. In contrast to the variables in the Classical equations of Relativity, variables are more specific in their respect and relationship to Escape Velocity and Graviton distortion, not just the Time distortion.
Treatment and Pregnancy Outcomes of Pregnant Women Exposed to Second-line Anti-tuberculosis Drugs in South Africa
Authors: Mokhele Idah , Jinga Nelly , Berhanu Rebecca , Dlamini Thandi , Long Lawrence , Evans Denise 
Published: February 2021

Abstract
Background:Multi-drug resistant and rifampicin-resistant tuberculosis (MDR/RR-TB) in pregnant women is a cause for concern globally; few data have described the safety of second-line anti-TB medications during pregnancy. We characterize maternal, and pregnancy outcomes for pregnant women receiving second-line anti-tuberculosis treatment for MDR/RR-TB.Methods: We conducted a retrospective record review of pregnant women (≥18 years) who received treatment for MDR/RR-TB between 01/2010–08/2016 at three outpatient treatment sites in Johannesburg, South Africa. Demographic, treatment and pregnancy outcome data were collected from available medical records. Preterm birth (<37 weeks), and miscarriage were categorized as adverse pregnancy outcomes.Results: Out of 720 women of child-bearing age who received MDR/RR-TB treatment at the three study sites, 35 (4.4%) pregnancies were identified. Overall, 68.7% (24/35) were HIV infected, 83.3% were on ART. Most women (88.6%) were pregnant at the time of MDR/RR-TB diagnosis and four women became pregnant during treatment. Pregnancy outcomes were available for 20/35 (57.1%) women, which included 15 live births (11 occurred prior to 37 weeks), 1 neonatal death, 1 miscarriage and 3 pregnancy terminations. Overall, 13/17 (76.5%) had an adverse pregnancy outcome. Of the 28 women with known TB treatment outcomes 17 (60.7%) completed treatment successfully (4 were cured and 13 completed treatment), 3 (10.7%) died and 8 (28.6%) were lost-to-follow-up.Conclusions:Pregnant women with MDR/RR-TB suffer from high rates of adverse pregnancy outcomes and about 60% achieve a successful TB treatment outcome. These vulnerable patients require close monitoring and coordinated obstetric, HIV and TB care.
Diagnostic Reasoning by Master Clinicians: What Distinguishes Them From Their Peers?&nbsp;&nbsp;
Authors: Kumar Bharat , Ferguson Kristi , Swee Melissa L. , Suneja Manish 
Published: February 2021

Abstract
Introduction: Master clinicians are a group of physicians recognized in large part for their superior diagnostic reasoning abilities. However, their reasoning skills have not been rigorously and quantitatively compared to other clinicians using a validated instrument.Methods: We surveyed Internal Medicine physicians at the University of Iowa to identify the master clinicians. These master clinicians were administered the Diagnostic Thinking Inventory, along with an equivalent number of their peers in the general population of internists. Scores were tabulated for structure and thinking, as well as four previously identified elements of diagnostic reasoning (data acquisition, problem representation, hypothesis generation, and illness script search and selection). The 2-sample t-test was used to compare scores between the two groups.Results: 17 master clinicians were identified, of whom 17 (100%) completed the inventory. 19 out of 25 randomly-selected internists also completed the inventory (76%). Mean total scores were 187.2 and 175.8 for the Master Clinician (MC) and the Internist (IM) groups respectively. Thinking and structure subscores were 91.5 and 95.71 for MCs, compared to 85.5 and 90.3 for IMs (p-values: 0.0783 and 0.1199, respectively). The mean data acquisition, problem representation, hypothesis generation, and illness script selection subscores for MCs were 4.46, 4.57, 4.71, and 4.46, compared to 4.13, 4.38, 4.45, and 4.13 in the IM group (p-values: 0.2077, 0.4528, 0.095, and 0.029, respectively). Conclusions: Master Clinicians have greater proficiency in searching for and selecting illness scripts compared to their peers. There were no statistically significant differences between the other scores and subscores. These results will help to inform continuing medical education efforts to improve diagnostic reasoning.
Improved Trends in the Mortality-To-Incidence Ratios for Liver Cancer in Countries With High Development Index and Health Expenditures
Authors: Wang Chi-Chih , Chen Hsin-Hung , Sung Wen-Wei , Tsai Ming-Chang 
Published: February 2021

Abstract
Primary liver cancer is one of leading causes of death globally. Liver cancer has the uniqueness of geographical distribution as it predisposes viral infection etiologies and aging effects. We speculate if the human development index (HDI), current health expenditure (CHE) per capita, and current health expenditure on gross domestic product (CHE/GDP) can affect the incidence numbers, mortality numbers, or mortality-to-incidence ratios (MIRs) of liver cancer worldwide. Data was obtained from GLOBOCAN health data and statistics from the World Health Organization. MIRs and the changes in MIR over time (𝛿MIR) were used to evaluate the correlation of expenditures on healthcare and the HDI disparities via Spearman's rank correlation coefficient. The incidence and mortality of crude rate have significant associations with HDI, CHE per capita, and CHE/GDP. Specifically, there were significant associations between 𝛿MIR and HDI as well as between 𝛿MIR and CHE per capita. However, there were no significant associations between 𝛿MIR and CHE/GDP. We evidenced that favorable liver cancer 𝛿MIR was not associated with CHE/GDP, although it had significant association with HDI and CHE per capita. This result is worthy of the attention of the public health system all over the world.
The Effect of Paclitaxel on Apoptosis, Autophagy and Mitotic Catastrophe in AGS&nbsp;Cells
Authors: - Tin Myo Khing , Choi Won Seok , Kim Dong Min , - Wah Wah Po , - Wynn Thein , Shin Chang Yell , Sohn Uy Dong 
Published: February 2021

Abstract
Paclitaxel is an anti-microtubule agent that has been shown to induce cell death in gastric cancer. However, the detailed mechanism of action is unclear. In this study, we reveal that the paclitaxel-induced cell death mechanism involves mitotic catastrophe, autophagy and apoptosis in AGS cells. Paclitaxel induced intrinsic apoptosis by activating caspase-3, caspase-9 and PARP. In addition, the significant increase in autophagy marker LC3B-II, together with Atg5, class III PI3K and Beclin-1, and the down-regulation of p62 following paclitaxel treatment verified that paclitaxel induced autophagy. Further experiments showed that paclitaxel caused mitotic catastrophe, cell cycle arrest of the accumulated multinucleated giant cells at the G2/M phase and induction of cell death in 24 h. Within 48 h, the arrested multinucleated cells escaped mitosis by decreasing cell division regulatory proteins and triggered cell death. Cells treated with paclitaxel for 48 h were grown in fresh medium for 24 h and checked for CDC2, CDC25C and lamin B1 protein expressions. These proteins had decreased significantly, indicating that the remaining cells became senescent. In conclusion, it is suggested that paclitaxel-induced mitotic catastrophe is an integral part of the cell death mechanism, in addition to apoptosis and autophagy, in AGS cells.
Towards Safe Medication Use Among Geriatric Patients: A Combined Tool For Identification of Potential Drug-Related Problems
Authors: Bobrova Veera , Fialová Daniela , Desselle Shane , Heinämäki Jyrki , Volmer Daisy 
Published: February 2021

Abstract
Background: Drug-related problems (DRP), including potentially inappropriate medications (PIMs), are a common problem in older people with multi-morbidity and polypharmacy. It is important to identify appropriate tools, preferably adjusted to specific patient groups, to deal more effectively with potential or existing DRPs. Our hypothesis is that combining PIM identification tools enables to significantly enhance the determination of DRPs. The aim of this study was to develop a combined tool for identification of DRPs in geriatric multi-morbid and polypharmacy patients, using the EU(7)-PIM and EURO-FORTA lists, with a focus on high-risk medications. Methods: The combined PIM identification tool used the information on PIM active ingredients in both databases - the EU(7)-PIM and EURO-FORTA. PIMs were classified into four color groups based on risk profile: very significant PIMs (should be avoided in older patients) as red, significant PIMs (require dose and/or treatment duration adjustment) as yellow, non-significant PIMs/non-PIMs (low DRP risk) as green, and questionable PIMs (incomplete/missing information) as grey. Results: The summarized list of the red PIMs contains 34 active ingredients, including one combination of two medications and one medication class. According to the Anatomical Therapeutic Chemical classification, most of the red PIMs (n=27, 79.4%) belong to the A, C and N medication groups. Only 41.2% of the red PIMs have marketing authorization in Estonia. In 2019 more frequently used red PIMs in Estonia were sodium picosulfate, propafenone, ginkgo biloba, magnesium hydroxide, and dextromethorphan. The approximate number of the yellow and green PIMs is 248, but sub-classification of this category into one or another group depends mainly on an individual patient´s clinical characteristics. The complete list of the grey PIMs will be developed in the future Conclusions: The combined PIM tool based on the EU(7)-PIM and EURO-FORTA criteria was created to address the need for more efficient identification of DRP in geriatric multi-morbid patients. The combined PIM tool was developed with a focus on the high-risk medications for older adults and taking into consideration the availability of the PIMs in Estonia. The tool could potentially be applied as a screen to identify DRPs in different health care settings.
A Probability Formula Derived From Serum Indicators, Age and Comorbidities As An Early Predictor of Dementia For Elderly Chinese People
Authors: Gong Qing , Xie Lianhong , Bi Minghui , Yu Lina 
Published: February 2021

Abstract
Background: Blood-based indicators are potential economical and safe methods of population screening for dementia although their predictive values have not been confirmed. The present study proposes a dementia prediction formula based on serum indicators and patient characteristics.Methods: From Jan 2016 to Dec 2018 the data of elderly patients aged over 60 years admitted to the Department of Neurology and Geriatrics in our hospital were retrospectively reviewed. A multivariate logistic regression model was applied to verify the patients’ characteristics and serum indicators associated with the risk of dementia. After receiver operating characteristic curve (ROC) and area under the ROC curve (AUC) analysis, we propose a dementia prediction formula and cutoff values for predictive ability of early dementia.Results: 4,722 elderly patients were enrolled and the incidence of dementia was 12.0% (565). When patients had ≥ 8 comorbidities, their risk of developing dementia was 20 times higher than those without comorbidities. After multivariate regression analysis, age (OR: 1.086, P < 0.001) and homocysteine concentrations (HCY) (OR: 1.017, P = 0.003) were proven to be linked the risk of developing dementia, while total cholesterol (TC) (OR: 0.674, P = 0.005) was a protective factor for dementia. We developed a formula of age + LDL-C+ TC + HCY + number of comorbidities as a good predictor of dementia (AUC: 0.79), with a probability (cut-off) value of 0.112 (sensitivity 87.4%, specificity 55.8%, accuracy 60.5%).Conclusions: High serum HCY and low TC were risk factors for developing dementia. A cut-off value > 0.112 derived from the formula of age + LDL-C + TC + HCY + number of comorbidities was an excellent predictor for a high risk of dementia, which may be a potentially useful diagnostic tool for identifying at risk patients using this routine clinical test.