bluuebunny/crossref_metadata_2025_split huggingface dataset:
Consistency Analysis of Intraoperative Blood Loss Assessment Between Surgeons and Anesthesiologists
Authors: Liu Jian , Ma HongBao , Wang Faxuan , Wang Xuewei , Wang Chaoran , Wang Linan , Gao Yubo , Niu Ningkui 
Published: April 2021

Abstract
Objective: To explore the consistency between intraoperative blood loss recorded by surgeons, anesthesiologists and standard blood loss. Methods: The clinical data of 200 patients who underwent posterior lumbar interbody fusion (PLIF) from January 2019 to December 2020 in the Department of Spine Surgery of a Grade III Level A hospital were selected, including 109 males, aged 34-84 years, with an average of 56.40 ± 11.21 years, and 91 females, aged 27-78 years, with an average of 57.48 ± 11.40 years. The preoperative Hb, HCT, APTT, Pt, INR, intraoperative blood, and fluid infusion of patients were recorded. The standard blood loss of the patients was calculated by the formula and compared with the intraoperative blood loss recorded by the surgeons and the anesthesiologists separately for analysis. Results: 1. When the standard blood loss was less than 400ml, there was no statistical difference between the intraoperative blood loss recorded by surgeons and the standard blood loss (P > 0.05), which is considered to be consistent. 2. When the standard blood loss was between 400ml-800ml, the intraoperative blood loss recorded by surgeons and anesthesiologists was less than the standard blood loss,there was statistical difference between the intraoperative blood loss and the standard blood loss (P < 0.05), but the intraoperative blood loss recorded by surgeons was more accurate than that recorded by anesthesiologists; 3. When the standard blood loss was more than 800ml, the intraoperative blood loss recorded by surgeons and anesthesiologists was less than the standard blood loss,There was no consistency between the intraoperative blood loss recorded by anesthesiologists and the standard blood loss (P < 0.05), but the intraoperative blood loss recorded by anesthesiologists was more accurate than that recorded by surgeons. Conclusion: 1. There are differences between surgeons and anesthesiologists in recording intraoperative blood loss. 2. The accurate recording of intraoperative blood loss needs to be done jointly by surgeons and anesthesiologists, especially when the blood loss is more than 400ml, which is conducive to perioperative fluid management.
The Impact of Preoperative Biliary Drainage on Postoperative Outcomes of Patients with Malignant Obstructive Jaundice: A Retrospective Analysis of 290 Consecutive Cases at a Single Medical Center
Authors: Zhihui Gao , Jie Wang , Sheng Shen , Xiaobo Bo , Tao Suo , Xiaoling Ni , Han Liu , Yueqi Wang , Lihong Huang , Liu Houbao 
Published: April 2021

Abstract
BackgroundThe efficacy of preoperative biliary drainage (PBD) has been debated for several decades, and indications for PBD are still a controversial topic. The aim of this study was to compare the efficacy of PBD among patients with malignant obstructive jaundice in current clinical settings.MethodsAll consecutive patients with malignant obstructive jaundice who underwent radical resection from June 2017 to December 2019 at Zhongshan Hospital were analyzed retrospectively. The study population was divided into two groups: a PBD group (PG) and direct surgery group (DG). Subgroups were chosen by site of obstruction.ResultsA total of 290 patients were analyzed. Postoperative complications occurred in 134 patients (overall rate: 46.4%). Patients in group PG had a lower overall rate of postoperative complications as compared to group DG, with perioperative total bilirubin (TB) identified as an independent risk factor in multivariate analysis (hazard ratio = 1.004; 95% confidence interval 1.001–1.007; P = 0.017). Subgroup analysis showed that PBD reduced the complication rate in patients with proximal obstruction. In the proximal-obstruction subgroup, a preoperative TB level >162 μmol/L predicted postoperative complications.ConclusionsPBD may reduce the overall rate of postoperative complications among patients with proximal obstructive jaundice.Trial registrationClinicalTrials.gov, 2018ZSLC 24. Registered May 17, 2018, https://clinicaltrials.gov/.
Analysis of Elasto-plastic Thin-shell Structures using Layered Plastic Modeling and Absolute Nodal Coordinate Formulation
Authors: Li Jiachen , Liu Cheng , Hu Haiyan , Zhang Shixiong 
Published: April 2021

Abstract
A new elasto-plastic thin shell finite element of the absolute nodal coordinate formulation (ANCF) allowing for large deformation and finite rotation is proposed based on the Kirchhoff-Love theory and layered plastic model. The von Mises yield criterion of plane-stress with linear isotropic hardening is adopted in constitutive description of elasto-plastic material. Owing to the plane-stress constraint, special treatment should be given to the stress update algorithm for plasticity. To accommodate the plasticity formulation, the Gauss-point layered integration is inserted into the thickness of the element to produce the internal force. Then, the Jacobian of internal forces is deduced by deriving the consistent elasto-plastic tangent moduli. To accurately track the load-displacement equilibrium path in the buckling analysis of elasto-plastic thin shells, the arc-length method is used. The dynamics of the thin shells is also studied by using the generalized-alpha algorithm. Finally, several static and dynamic examples are presented to verify the accuracy of the proposed formulation.
Trend Analysis of Malaria Prevalence in Bati District, Northeastern Ethiopia (From 2015 to 2020): A Retrospective Study
Authors: daba chala , Kebede Edosa , Atamo Amanuel 
Published: April 2021

Abstract
Background: Malaria is the leading cause of morbidity and mortality in developing country including Ethiopia. Ethiopia is one of on ways to minimize the incidence of malaria by 40% as per its 2020 malaria reduction strategy since 2016. Thus, this study aimed to analyze six-year trend analysis of malaria prevalence in Bati district, Northeastern Ethiopia.Methods: Institutional based retrospective study was conducted to determine six-year trend analysis of malaria prevalence in Bati district. All malaria cases reported from 2015 to 2020 were carefully reviewed by trained laboratory technologist from the laboratory record books of Bati hospital and health center.Results: A total of 84,269 and 22,185 of malaria suspected patients were requested for blood films and Rapid diagnostic test (RDT) respectively. Of this, 12,032 (11.3%) malaria cases were microscopically confirmed. Plasmodium falciparum were the most dominant parasites detected, which accounted 57.6 %. Malaria has been reported from all age groups; however, age distribution showed that the majority of cases were adults’ age 15 years (57.2%). Even though there was fluctuation of malaria prevalence in the study area, the highest peak of malaria cases was reported during summer season which accounted 47.2%.Conclusion: Malaria is still a major public health problem in Bati district and the overall trend of total confirmed malaria cases were decreased in the past six years (2015–2020) with exception slightly increased cases from 2015 to 2016. Therefore, government, all healthcare workers and community should strengthen and scale up malaria prevention and control strategies in the study area
Performance Evaluation of RDT, Light Microscopy, and PET-PCR for Detecting P. Falciparum Malaria Infections in the 2018 Zambia National Malaria Indicator Survey
Authors: Mwenda Mulenga C. , Fola Abebe A. , Ciubotariu Ilinca I. , Mulube Conceptor , Mambwe Brenda , Kasaro Rachael , Hawela Moonga B. , Hamainza Busiku , Miller John M. , Carpi Giovanna , Bridges Daniel James 
Published: April 2021

Abstract
BackgroundZambia continues to advance on the path to elimination with significant reductions in malaria morbidity and mortality. Crucial components that have contributed to progress thus far and are necessary for achieving the national malaria elimination goals include properly identifying and treating all malaria cases through accurate diagnosis. This study sought to compare and assess the diagnostic performance of RDTs and LM with PET-PCR as the gold standard using 2018 MIS data across Zambia to better understand diagnostic accuracy metrics and how these vary across a transmission gradient. MethodsCross-sectional samples collected in a nationally representative survey from 7 provinces in Zambia were tested for the presence of malaria parasites by light microscopy (LM), rapid diagnostic test (RDT) and the gold standard PET-PCR. Diagnostic performance was assessed including sensitivity, specificity, negative- and positive-predictive values across a wide malaria transmission spectrum. Diagnostic accuracy metrics were measured, and statistically significant differences were calculated between test methods for different outcome variables. ResultsFrom the individuals included in the MIS, the overall prevalence of P. falciparum malaria was 32.9% by RDT, 19.4% by LM, and 23.2% by PET-PCR. Herein, we compared RDT and LM diagnostic performance against gold standard PET-PCR and found that LM had higher diagnostic accuracy than RDTs (91.3% vs 84.6% respectively) across the transmission spectrum in Zambia. However, we found that the performance of both diagnostics was significantly reduced in low parasitemia samples. Consistent with previous studies, RDT diagnostic accuracy was predominantly affected by a high rate of false positives.ConclusionWhile LM performance is overall superior to RDTs, the additional requirements for its implementation such as high-quality staining, microscopes, and additional manpower, means that its application will remain at the health facility level. In contrast, while RDTs overestimate prevalence as they have a higher false positive rate, their ability to be rapidly deployed makes them an excellent community level tool. Overall, we found that the performance of both diagnostics was acceptable, and their use should be continued.
Multiple Simultaneous Embolic Cerebral Infarctions 11 Months After COVID-19
Authors: Advani Rajiv , Strømsnes Torbjørn Austveg , Stjernstrøm Espen , Lugg Sebastian Thomas 
Published: April 2021

Abstract
BackgroundThe coronavirus disease (COVID-19) pandemic has led to an unprecedented worldwide burden of disease. However, little is known of the longer-term implications and consequences of COVID-19. One of these longer-term complications is a COVID-19 associated coagulopathy that can present as a venous thromboembolism (VTE) and, as yet unreported, multiple paradoxical cerebral emboli. Case PresentationA 51 year old man presented to the emergency department with multiple simultaneous embolic cerebral infarctions 11 months after mild COVID-19. In the subacute phase of the COVID-19 illness the patient developed increasing shortness of breath and was found to have an elevated D-dimer and multiple bilateral segmental pulmonary emboli. He was subsequently treated with 3 months of anticoagulation for a provoked VTE. The patient then presented 11 months after the initial COVID-19 diagnosis with multiple simultaneous cerebral infarctions where no traditional underlying stroke etiology was determined. A patent foramen ovale (PFO) and an elevated D-dimer were found indicating a paradoxical thromboembolic event due to an underlying coagulopathy. ConclusionsThis case report highlights the one of the potentially more serious complications of long-term COVID-19 where VTE due to a persistent coagulopathy is seen almost a year after the initial illness. Due to the highly prevalent nature of PFO in the general population, VTE due to COVID-19 associated coagulopathy could lead to ischemic stroke. This case report therefore highlights the challenge posed by the underlying COVID-19 associated coagulopathy which can persist for many months and beyond from the initial illness.
Quinolin-2-one-pyrimidine Hybrids Acting as Potent Reversal Agents on the P-gp-mediated Multidrug Resistance: Insights into Structure-activity Relationships and the Binding Mode
Authors: Laiolo Jerónimo , Lanza Priscila Ailin , Parravicini Oscar , Barbieri Cecilia , Insuasty Daniel , Cobo Justo , Vera D. Mariano Adolfo , Enriz Ricardo Daniel , Carpinella María Cecilia 
Published: April 2021

Abstract
P-gp-associated multidrug resistance (MDR) is a major impediment to the success of chemotherapy. With the aim of finding non-toxic and effective P-gp inhibitors, we investigated a panel of quinolin-2-one-pyrimidine hybrids. Among the active compounds, two of them significantly increased intracellular doxorubicin and rhodamine 123 accumulation by inhibiting the efflux mediated by P-gp and restored doxorubicin toxicity at nanomolar range. Structure-activity relationships showed that the number of methoxy groups, an optimal length of the molecule in its extended conformation, and at least one flexible methylene group bridging the quinolinone moiety favored the inhibitory potency of P-gp. The best compounds showed a similar binding pattern and interactions to those of doxorubicin and tariquidar, as revealed by MD and hybrid QM/MM simulations performed with the recent experimental structure of P-gp co-crystallized with paclitaxel. Analysis of the molecular interactions stabilizing the different molecular complexes determined by MD and QTAIM showed that binding to key residues from TMH 4–7 and 12 is required for inhibition.
Brain-Dead and Coma Patients Exhibit Different Serum Metabolic Profiles: A Novel Diagnostic Approach in Neurocritical Care
Authors: Dawiskiba Tomasz , Wojtowicz Wojciech , Qasem Badr , Łukaszewski Marceli , Mielko Karolina Anna , Dawiskiba Agnieszka , Banasik Mirosław , Skóra Jan Paweł , Janczak Dariusz , Młynarz Piotr 
Published: April 2021

Abstract
There is a clear difference between severe brain damage and brain death. However, in clinical practice, the differentiation of these states can be challenging. Currently, there are no laboratory tools that facilitate brain death diagnosis. The aim of our study was to evaluate the utility of serum metabolomic analysis in differentiating coma patients (CP) from individuals with brain death (BD). Serum samples were collected from 23 adult individuals with established diagnosis of brain death and 24 patients in coma with Glasgow Coma Scale 3 or 4, with no other clinical symptoms of brain death for at least 7 days after sample collection. Serum metabolomic profiles were investigated using proton nuclear magnetic resonance (NMR) spectroscopy. The results obtained were examined by univariate and multivariate data analysis (PCA, PLS-DA, and OPLS-DA). Metabolic profiling allowed us to quantify 43 resonance signals, of which 34 were identified. Multivariate statistical modeling revealed a highly significant separation between coma patients and brain-dead individuals, as well as strong predictive potential. The findings not only highlight the potential of the metabolomic approach for distinguishing patients in coma from those in the state of brain death but also may provide an understanding of the pathogenic mechanisms underlying these conditions.
High-sensitivity biosensor for simultaneous detection of cancer and diabetes using photonic crystal microstructure
Authors: Sani Mojtaba Hosseinzadeh , Ghanbari Ashkan , Saghaei Hamed 
Published: April 2021

Abstract
In this study, we propose a refractive index sensor for the simultaneous detection of cancer and diabetes based on photonic crystals (PhC). The proposed PhC composed of silicon rods in the air bed arranged in a hexagonal lattice forms the fundamental structure, and two tubes are used to place the cancerous or diabetic samples for measurement. The sensor's transmission characteristics are simulated and analyzed by solving Maxwell's electromagnetic equations using the finite-difference time-domain method for samples under study. The diagnosis of three types of cancer and diabetes is based on changing the samples' refractive index by applying the laser source centered at 1550 nm. Our results demonstrate that the proposed structure's quality factor and sensitivity can be adjusted by changing the sensor's geometry. They reveal that the transmission power is between 91% ~ 100%, depending on the sample. The sensitivity range is also between 1294 and 3080 nm/RIU. The maximum figure of merit is about 1550.11 RIU− 1 with a detection range of 31×10− 6 RIU. The small biosensor area of ​​ 61.56 µm2 makes it a suitable device for various applications in compact photonic integrated circuits.
Sarcopenia, Severe Anxiety and Increased C-Reactive Protein Are Associated with Severe Fatigue in Patients with Inflammatory Bowel Diseases
Authors: Tasson Laura , Zingone Fabiana , Barberio Brigida , Valentini Romina , Ballotta Pamela , Ford Alexander , Scarpa Marco , Angriman Imerio , Fassan Matteo , Savarino Edoardo 
Published: April 2021

Abstract
Background: Fatigue is defined as an overwhelming sense of tiredness not responsive to rest or sleep, and it affects every day occupations, social functioning, and work. Patients with inflammatory bowel disease (IBD) report fatigue more frequently than healthy population, but the precise mechanisms underlying its presence are unknown. This study aimed to evaluate the prevalence of fatigue in IBD and its relation with potential causative factors. Methods: A survey consisting of different questionnaires that aimed to evaluate fatigue, depression, anxiety, sleep disorders, and the presence of sarcopenia and malnutrition, was sent by email to 244 IBD outpatients of the Gastroenterology Unit of Academic Hospital of Padua . Demographics and clinical data, including the levels of fecal calprotectin (FC) and C-reactive protein (CRP), and current pharmacological treatments were obtained from patients’ medical records. Results: Ninety-nine (40.5%) subjects answered the survey. Ninety-two (92.9%) patients reported fatigue, with sixty-six having mild to moderate fatigue and twenty-six severe fatigue. After univariate analysis, subjects reporting severe fatigue were more likely to have abnormal values of CRP (OR 3.6) and to demonstrate scores suggesting the presence of sarcopenia, malnutrition, anxiety, depression, compromised sleep quality, and lower quality of life scores. Multivariate analysis showed that abnormal values of CRP (OR 5.1), severe anxiety (OR 3.7) and sarcopenia (OR 4.4) were the factors independently associated with severe fatigue. Conclusion: Fatigue has a high prevalence in subject affected by IBD. Subjects with altered CRP, sarcopenia and severe anxiety appear more at risk of severe fatigue.
Silver Coordination-Polymer based of 4,6-Diamino-2-pyrimidinethiol as Organic Ligand: a Highly Reusable Heterogeneous Nanocatalyst for the Asymmetric Hantzsch Synthesis of Polyhydroquinolines under Green Conditions
Authors: Hussain-Khil Noorullah , Ghorbani-Choghamarani Arash , Mohammadi Masoud 
Published: April 2021

Abstract
A highly efficient and stable heterogeneous coordination polymer (CP) was successfully prepared by hydrothermal combination of silver and 4,6-diamino-2-pyrimidinethiol. The prepared coordination polymer was characterized by FT-IR, XRD, TGA, SEM, EDX, X-ray mapping and Nitrogen adsorption-desorption analysis. The prepared Ag-CP exhibit excellent catalytic activity in multicomponent Hantzsch synthesis of polyhydroquinolines under mild reaction conditions in relatively short reaction times. The heterogeneity of the catalyst was confirmed by the hot filtration test; also, the catalyst was reused for at least four times under the optimized reaction conditions without any significant loss of its catalytic activity.
Association Between Epidural Analgesia and Cancer Recurrence or Survival After Surgery for Renal Cell Carcinoma: a Propensity Weighted Analysis
Authors: Yen Fang-Yu , Lin Shih-Pin , Lin Tzu-Ping , Chang Wen-Kuei , Tsou Mei-Yung , Chang Kuang-Yi 
Published: April 2021

Abstract
Whether epidural anesthesia and analgesia (EA) is beneficial for postoperative cancer outcomes remains controversial and we conducted this historical cohort study to evaluate the association between EA and long-term outcomes following surgery for renal cell carcinoma (RCC). We collected patients receiving RCC surgery from 2011 to 2017 and followed up them until February 2020. Patient attributes, surgical factors and pathological features were gathered through electronic medical chart review. The association between EA and recurrence-free and overall survival after surgery was evaluated using Cox regression models with inverse probability of treatment weighting (IPTW) to balance the observed covariates. The median follow-up time for the 725 included patients was 50 months (interquartile range: 25.3–66.5) and 145 of them (20%) received perioperative EA. We demonstrated EA use was associated with better recurrence-free survival (IPTW adjusted hazard ratio (HR): 0.64, 95% confidence interval (CI): 0.49–0.83, p < 0.001) and overall survival (IPTW adjusted HR: 0.66, 95% CI: 0.49–0.89, p = 0.006) in patients receiving surgical resection for RCC. More prospective studies are needed to verify this connection between EA and superior cancer outcomes after RCC surgery.
Iris Image Acquisition and Real-Time Detection System Using Convolutional Neural Network
Authors: Hu Yuan , Si Xiaoyong 
Published: April 2021

Abstract
The aim is to further improve the efficiency of iris detection and ensure real-time iris data acquisition. Here, the light field refocusing algorithm can collect the data in real-time based on the existing iris data acquisition and detection system, and the DL (Deep Learning) CNN (Convolutional Neural Network) is introduced. Consequently, an iris image acquisition and real-time detection system based on CNN is proposed, and the system for image acquisition, processing, and displaying is constructed based on FPGA (Field Programmable Gate Array). The spatial filtering algorithm can compare the performance of the proposed bilateral filters with common filters. The results indicate that the proposed bilateral filters can pick out qualified iris images in real-time, greatly improving the accuracy of the iris image recognition system. The average time for real-time quality assessment of each frame image is less than 0.05 seconds. The classification accuracy of the iris image quality assessment algorithm based on DL is 96.38%, higher than the other two algorithms, and the average classification error rate is 3.69%, lower than the average error rate of other algorithms. The results can provide a reference for real-time iris image detection and data acquisition.
Can global models provide insights into regional mitigation strategies? A diagnostic model comparison study of bioenergy in Brazil
Authors: Köberle Alexandre C , Daioglou Vassilis , Rochedo Pedro , Lucena André F. P. , Szklo Alexandre , Fujimori Shinichiro , Brunelle Thierry , Kato Etsushi , Kitous Alban , Vuuren Detlef P. van , Schaeffer Roberto 
Published: April 2021

Abstract
The usefulness of global integrated assessment model (IAM) results for policy recommendation in specific regions has not been fully assessed to date. This study presents the variation in results across models for a given region, and what might be behind this variation and how model assumptions and structures drive results. Understanding what drives the differences across model results is important for national policy relevance of global scenarios. We focus on the use of bioenergy in Brazil, a country expected to play an important role in future bioenergy production. We use results of the Stanford University Energy Modeling Forum’s 33rd Study (EMF-33) model comparison exercise to compare and assess projections of Brazil’s bioenergy pathways under climate mitigation scenarios to explore how 10 global IAMs compare to recent trends in the country. We find that, in their current form, global IAMs have limited potential to supply robust insights into regional mitigation strategies. Our results suggest fertile ground for a new research agenda to improve regional representation in global IAMs with improved spatial and technological resolutions.