bluuebunny/crossref_metadata_2025_split huggingface dataset:
Integrated hip fracture care pathway (IHFCP): reducing complications and improving outcomes
Authors: Heyzer Louise , Ramason Rani , Molina Joseph Antonio De Castro , Chan William Wai Lim , Loong Chen Yi , Kwek Ernest Beng Kee 
Published: April 2021

Abstract

Introduction:
Hip fractures in elderly people are increasing. A five-year Integrated Hip Fracture Care Pathway (IHFCP) was implemented at our hospital for seamlessly integrating care for these patients from admission to post discharge. We aimed to evaluate how IHFCP improved process and outcome measures in these patients.

Methods:
A study was conducted over a five-year period on patients with acute fragility hip fracture who were managed on IHFCP. The evaluation utilised a descriptive design, with outcomes analysed separately for each of the five years of the programme. First-year results were treated as baseline.

Results:
The main improvements in process and outcome measures over five years, when compared to baseline, were: (a) increase in surgeries performed within 48 hours of admission from 32.5% to 80.1%; (b) reduced non-operated patients from 19.6% to 11.9%; (c) reduced average length of stay at acute hospital among surgically (from 14.0 ± 12.3 days to 9.9 ± 1.0 days) and conservatively managed patients (from 19.1 ± 22.9 to 11.0 ± 2.5 days); (d) reduced 30-day readmission rate from 3.2% to 1.6%; and (e) improved Modified Functional Assessment Classification of VI to VII at six months from 48.0% to 78.2%.

Conclusion:
The IHFCP is a standardised care path that can reduce time to surgery, average length of stay and readmission rates. It is distinct from other orthogeriatric care models, with its ability to provide optimal care coordination, early transfer to community hospitals and post-discharge day rehabilitation services. Consequently, it helped to optimise patients’ functional status and improved their overall outcome.
Solsticial Hadley Cell ascending edge theory from supercriticality
Authors: Hill Spencer A. , Bordoni Simona , Mitchell Jonathan L. 
Published: April 2021

AbstractHow far the Hadley circulation’s ascending branch extends into the summer hemisphere is a fundamental but incompletely understood characteristic of Earth’s climate. Here, we present a predictive, analytical theory for this ascending edge latitude based on the extent of supercritical forcing. Supercriticality sets the minimum extent of a large-scale circulation based on the angular momentum and absolute vorticity distributions of the hypothetical state were the circulation absent. We explicitly simulate this latitude-by-latitude radiative-convective equilibrium (RCE) state. Its depth-averaged temperature profile is suitably captured by a simple analytical approximation that increases linearly with sinφ, where φ is latitude, from the winter to the summer pole. This, in turn, yields a one-third power-law scaling of the supercritical forcing extent with the thermal Rossby number. In moist and dry idealized GCM simulations under solsticial forcing performed with a wide range of planetary rotation rates, the ascending edge latitudes largely behave according to this scaling.
Observational estimates of turbulent mixing in the southeast Indian Ocean
Authors: Cyriac Ajitha , Phillips Helen E. , Bindoff Nathaniel L. , Mao Huabin , Feng Ming 
Published: April 2021

AbstractThis study investigates the spatio-temporal variability of turbulent mixing in the eastern South Indian Ocean using a collection of data from EM-APEX profiling floats, shipboard CTD and microstructure profilers. The floats collected 1566 profiles of temperature, salinity and horizontal velocity data down to 1200 m over a period of about four months. A fine-scale parameterization is applied to the float and CTD data to estimate turbulent mixing. Elevated mixing is observed in the upper ocean, over bottom topography and in mesoscale eddies. Mixing is enhanced in the anticyclonic eddies due to trapped near-inertial waves within the eddy. We found that cyclonic eddies contribute to turbulent mixing in the depth range of 500 – 1000 m, which is associated with downward propagating internal waves. The mean diapycnal diffusivity over 250 – 500 m depth is O(10−6) m2 s−1 and it increases to O(10−5) m2 s−1 in 500 – 1000 m in cyclonic eddies. The turbulent mixing in this region has implications for watermass transformation and large-scale circulation. Higher diffusivity (O(10−5) m2 s−1) is observed in the Antarctic Intermediate Water (AAIW) layer in cyclonic eddies whereas weak diffusivity is observed in the Subantarctic Mode Water (SAMW) layer (O(10−6) m2 s−1). Counter-intuitively, then, the SAMW watermass properties are strongly affected in cyclonic eddies whereas the AAIW layer is less affected. Comparatively high diffusivity at the location of the South Indian Countercurrent (SICC) jets suggests there are wave-mean flow interactions in addition to the wave-eddy interactions that warrant further investigation.
Trauma-Informed Parenting Education Support Groups for Mothers in Substance Abuse Recovery
Authors: Sperlich Mickey I. , Bascug Erin W. , Green Susan A. , Koury Samantha , Hales Travis , Nochajski Thomas H. 
Published: April 2021

Purpose: A trauma-informed educational support group pilot addressed traumatic stress, substance use disorders (SUDs), and child-rearing for clients who were pregnant and/or parenting young children. Methods: Seeking Safety was adapted with parenting content and delivered at two intensive residential rehabilitation facilities. An explanatory sequential mixed methods approach was used to evaluate the pilot. Forty-eight participants completed starting assessments (intention-to-treat) and 31 graduates completed postgroup surveys (per protocol). Focus group sessions were completed with 19 graduates. Results: Paired samples t tests of intention-to-treat data showed a statistically significant decrease in self-reported symptoms of stress and substance cravings and increases in positive behaviors and parenting self-efficacy. There were no statistically significant differences on lifestyle behaviors, parenting skill, and parenting confidence. Most participants found the intervention acceptable and felt supported to improve their parenting. Discussion: Trauma-informed parenting education support in inpatient rehabilitation settings may offer an important complement to existing SUD and parenting programming.
Disability in multiple sclerosis is related to thalamic connectivity and cortical network atrophy
Authors: Schoonheim Menno M , Pinter Daniela , Prouskas Stefanos E , Broeders Tommy AA , Pirpamer Lukas , Khalil Michael , Ropele Stefan , Uitdehaag Bernard MJ , Barkhof Frederik , Enzinger Christian , Geurts Jeroen JG 
Published: April 2021

Background: Thalamic atrophy is proposed to be a major predictor of disability progression in multiple sclerosis (MS), while thalamic function remains understudied. Objectives: To study how thalamic functional connectivity (FC) is related to disability and thalamic or cortical network atrophy in two large MS cohorts. Methods: Structural and resting-state functional magnetic resonance imaging (fMRI) was obtained in 673 subjects from Amsterdam (MS: N = 332, healthy controls (HC): N = 96) and Graz (MS: N = 180, HC: N = 65) with comparable protocols, including disability measurements in MS (Expanded Disability Status Scale, EDSS). Atrophy was measured for the thalamus and seven well-recognized resting-state networks. Static and dynamic thalamic FC with these networks was correlated with disability. Significant correlates were included in a backward multivariate regression model. Results: Disability was most strongly related (adjusted R2 = 0.57, p < 0.001) to higher age, a progressive phenotype, thalamic atrophy and increased static thalamic FC with the sensorimotor network (SMN). Static thalamus–SMN FC was significantly higher in patients with high disability (EDSS ⩾ 4) and related to network atrophy but not thalamic atrophy or lesion volumes. Conclusion: The severity of disability in MS was related to increased static thalamic FC with the SMN. Thalamic FC changes were only related to cortical network atrophy, but not to thalamic atrophy.
Current status of neuroprotective and neuroregenerative strategies in multiple sclerosis: A systematic review
Authors: Allanach Jessica R , Farrell John W. , Mésidor Miceline , Karimi-Abdolrezaee Soheila 
Published: April 2021

Background: Immune-mediated demyelination and consequent degeneration of oligodendrocytes and axons are hallmark features of multiple sclerosis (MS). Remyelination declines in progressive MS, causing permanent axonal loss and irreversible disabilities. Strategies aimed at enhancing remyelination are critical to attenuate disease progression. Objective: We systematically reviewed recent advances in neuroprotective and regenerative therapies for MS, covering preclinical and clinical studies. Methods: We searched three biomedical databases using defined keywords. Two authors independently reviewed articles for inclusion based on pre-specified criteria. The data were extracted from each study and assessed for risk of bias. Results: Our search identified 7351 studies from 2014 to 2020, of which 221 met the defined criteria. These studies reported 262 interventions, wherein 92% were evaluated in animal models. These interventions comprised protein, RNA, lipid and cellular biologics, small molecules, inorganic compounds, and dietary and physiological interventions. Small molecules were the most highly represented strategy, followed by antibody therapies and stem cell transplantation. Conclusion: While significant strides have been made to develop regenerative treatments for MS, the current evidence illustrates a skewed representation of the types of strategies that advance to clinical trials. Further examination is thus required to address current barriers to implementing experimental treatments in clinical settings.
Crystallographic orientation relationships between quartz and feldspar in myrmekite: a case study in monzodiorite from Meichuan pluton, China
Authors: Song Yueting , Zhao Shanrong , Xu Chang 
Published: April 2021

AbstractMyrmekites occurring in monzodiorite from the Meichuan pluton in the Dabie ultrahigh-pressure metamorphic belt were investigated. The petrographic evidence demonstrates a metasomatic origin for myrmekite formation at the scale of individual alkali feldspar grains, and that the myrmekitic quartz and plagioclase matrix are generated simultaneously replacing precursor feldspar. Energy-dispersive X-ray spectroscopy and electron microprobe analysis indicate a low anorthite content in the narrow rim of host plagioclase near the myrmekite–alkali-feldspar interface. The Ca2+, Na+proportion of hydrothermal fluids replacing precursor alkali feldspar is 1:5.4, calculated from the anorthite content of the inner part of the host plagioclase and the neighbouring alkali feldspar. Electron back-scattered diffraction was used to identify the crystallographic orientation of the myrmekitic quartz, plagioclase matrix and the precursor alkali feldspar. The crystallographic orientation relationships (110)Kfs//(11$\bar{2}\bar{1}$)Qtz, (20$\bar{1}$)Kfs//(11$\bar{2}$1)Qtzand [11$\bar{2}3]$Qtz//[001]Kfsbetween myrmekitic quartz and adjacent alkali feldspar were obtained from statistical analysis. No clear crystallographic orientation relationship between quartz and plagioclase was found. The growth of myrmekitic quartz is constrained by the precursor alkali feldspar rather than the simultaneously crystallised plagioclase. This research is helpful for understanding the intergrowth mechanism during metasomatism.
Eye-color and Type-2 diabetes phenotype prediction from genotype data using deep learning methods
Authors: Muneeb Muhammad , Henschel Andreas 
Published: April 2021

Abstract
Background
Genotype–phenotype predictions are of great importance in genetics. These predictions can help to find genetic mutations causing variations in human beings. There are many approaches for finding the association which can be broadly categorized into two classes, statistical techniques, and machine learning. Statistical techniques are good for finding the actual SNPs causing variation where Machine Learning techniques are good where we just want to classify the people into different categories. In this article, we examined the Eye-color and Type-2 diabetes phenotype. The proposed technique is a hybrid approach consisting of some parts from statistical techniques and remaining from Machine learning.

Results
The main dataset for Eye-color phenotype consists of 806 people. 404 people have Blue-Green eyes where 402 people have Brown eyes. After preprocessing we generated 8 different datasets, containing different numbers of SNPs, using the mutation difference and thresholding at individual SNP. We calculated three types of mutation at each SNP no mutation, partial mutation, and full mutation. After that data is transformed for machine learning algorithms. We used about 9 classifiers, RandomForest, Extreme Gradient boosting, ANN, LSTM, GRU, BILSTM, 1DCNN, ensembles of ANN, and ensembles of LSTM which gave the best accuracy of 0.91, 0.9286, 0.945, 0.94, 0.94, 0.92, 0.95, and 0.96% respectively. Stacked ensembles of LSTM outperformed other algorithms for 1560 SNPs with an overall accuracy of 0.96, AUC = 0.98 for brown eyes, and AUC = 0.97 for Blue-Green eyes. The main dataset for Type-2 diabetes consists of 107 people where 30 people are classified as cases and 74 people as controls. We used different linear threshold to find the optimal number of SNPs for classification. The final model gave an accuracy of 0.97%.

Conclusion
Genotype–phenotype predictions are very useful especially in forensic. These predictions can help to identify SNP variant association with traits and diseases. Given more datasets, machine learning model predictions can be increased. Moreover, the non-linearity in the Machine learning model and the combination of SNPs Mutations while training the model increases the prediction. We considered binary classification problems but the proposed approach can be extended to multi-class classification.
Genome-wide analysis of SET-domain group histone methyltransferases in apple reveals their role in development and stress responses
Authors: Li Wenjie , Yan Jinjiao , Wang Shicong , Wang Qianying , Wang Caixia , Li Zhongxing , Zhang Dehui , Ma Fengwang , Guan Qingmei , Xu Jidi 
Published: April 2021

Abstract
Background
Histone lysine methylation plays an important role in plant development and stress responses by activating or repressing gene expression. Histone lysine methylation is catalyzed by a class of SET-domain group proteins (SDGs). Although an increasing number of studies have shown that SDGs play important regulatory roles in development and stress responses, the functions of SDGs in apple remain unclear.

Results
A total of 67 SDG members were identified in the Malus×domestica genome. Syntenic analysis revealed that most of the MdSDG duplicated gene pairs were associated with a recent genome-wide duplication event of the apple genome. These 67 MdSDG members were grouped into six classes based on sequence similarity and the findings of previous studies. The domain organization of each MdSDG class was characterized by specific patterns, which was consistent with the classification results. The tissue-specific expression patterns of MdSDGs among the 72 apple tissues in the different apple developmental stages were characterized to provide insight into their potential functions in development. The expression profiles of MdSDGs were also investigated in fruit development, the breaking of bud dormancy, and responses to abiotic and biotic stress; the results indicated that MdSDGs might play a regulatory role in development and stress responses. The subcellular localization and putative interaction network of MdSDG proteins were also analyzed.

Conclusions
This work presents a fundamental comprehensive analysis of SDG histone methyltransferases in apple and provides a basis for future studies of MdSDGs involved in apple development and stress responses.
Evaluation of early postoperative intravenous opioid rescue as a novel quality measure in patients who receive thoracic epidural analgesia: a retrospective cohort analysis and prospective performance improvement intervention
Authors: Levy Nadav , Santer Peter , Zucco Liana , Nabel Sarah , Korsunsky Galina , Ramachandran Satya Krishna 
Published: April 2021

Abstract
Background
In this study, we explored the utility of intravenous opioid rescue analgesia in the post anesthesia care unit (PACU-OpResc) as a single marker of thoracic epidural analgesia (TEA) failure and evaluated the resource implications and quality improvement applications of this measure.

Methods
We performed a retrospective analysis of all TEA placements over a three-year period at a single academic medical center in Boston, Massachusetts. The study exposure was PACU-OpResc. Primary outcome was PACU length of stay (LOS). Secondary outcomes included reasons for delayed PACU discharge and intraoperative hypotension. The analyses were adjusted for confounding variables including patient comorbidities, surgical complexity, intraoperative intravenous opioids, chronic opioid use and local anesthetic bolus through TEA catheter. Post analysis chart review was conducted to determine the positive predictive value (PPV) of PACU-OpResc for inadequate TEA. As a first Plan-Do-Study-Act cycle, we then introduced a checkbox for documentation of a sensory level check after TEA placement. Post implementation data was collected for 7 months.

Results
PACU-OpResc was required by 211 (22.1%) patients who received preoperative TEA, was associated with longer PACU LOS (incidence rate ratio 1.20, 95% CI:1.07–1.34, p = 0.001) and delayed discharge due to inadequate pain control (odds ratio 5.15, 95% CI 3.51–7.57, p <  0.001). PACU-OpResc had a PPV of 76.3 and 60.4% for re-evaluation and manipulation of the TEA catheter in PACU, respectively. Following implementation of a checkbox, average monthly compliance with documented sensory level check after TEA placement was noted to be 39.7%. During this time, a reduction of 8.2% in the rate of PACU-OpResc was observed.

Conclusions
This study demonstrates that PACU-OpResc can be used as a quality assurance measure or surrogate for TEA efficacy, to track performance and monitor innovation efforts aimed at improving analgesia, such as our intervention to facilitate sensory level checks and reduced PACU-OpResc.

Trial registration
not applicable.
Association of body mass index and waist circumference with high blood pressure in older adults
Authors: Zhang Wenli , He Kun , Zhao Hao , Hu Xueqi , Yin Chunyu , Zhao Xiaoyan , Shi Songhe 
Published: April 2021

Abstract
Background
The relationship between obesity and prevalent high blood pressure in older adults has predominantly been estimated using categorical measures of body mass index (BMI) and waist circumference (WC), masking the shape of the dose-response relationship. We aimed to examine the precise relationship of BMI, WC with high blood pressure and to assess the appropriate level of BMI and WC for high blood pressure.

Methods
We examined data for 126,123 individuals in Xinzheng city aged ≥60 years from a population based study from January to December 2019. Logistic regression and restricted cubic spline models were applied to assess the relationship and the appropriate level of BMI and WC for high blood pressure. An additive interaction analysis was used to test synergistic effects between a higher BMI and WC for high blood pressure.

Results
The full-adjusted odds ratios (ORs) with 95% confidence intervals (CIs) of an increase of 1 kg/m2 in BMI and 1 cm in WC for high blood pressure were 1.084 (1.080–1.087) and 1.026(1.024–1.027), respectively. Multivariable adjusted restricted cubic spline analyses showed the nonlinear relationships of BMI and WC with high blood pressure in both men and women (all P < 0.001). The risk of high blood pressure increased steeply with increasing BMI from ≥25 kg/m2 and WC ≥ 88 cm or 86 cm for males and females, respectively. And we observed a significant additive interaction between a higher BMI and WC such that the prevalence of high blood pressure was significantly enhanced.

Conclusion
These findings suggest increased high blood pressure prevalence in the older adults with increased BMI and WC. BMI ≤ 25 kg/m2 and WC ≤ 88 cm or 86 cm for males and females may be the best suggestion with regard to primary prevention of high blood pressure in older adults.
COVID-19 in Northeast Bosnia and Herzegovina and patient’s length of hospitalization
Authors: Trnacevic Alma , Mujkanovic Amer , Al-Salloum Noura , Sakusic Amra , Trnacevic Emir , Jusufovic Emir , Hukic Fatima , Jahic Rahima , Stratton Richard 
Published: April 2021

AbstractBackgroundSince the outbreak of COVID-19 pandemic, clinical data from various parts of the world have been reported. Up till now, there has been no clinical data with regards to COVID-19 from Bosnia and Herzegovina (B&H). The aim was to report on the first cohort of patients from B&H and to analyze factors that influence COVID-19 patient’s length of hospitalization (LOH).MethodsThis retrospective cohort study was conducted at Tuzla University Clinical Center (UKC), B&H. It involved 25 COVID-19 positive patients that needed hospitalisation between March 28th and April 27th 2020. The LOH was measured from the time of admission to discharge. Factors analyzed induced age, BMI, presence of known comorbidities, serum creatinine and O2saturation upon admission.ResultsThe mean age was 52.92 ± 19.15 years and BMI 28.80 ± 4.22.LOH for patients with BMI < 25 was 9 ± SE2.646 days (CI 95% 3.814–14.816) vs 14.182 ± SE .937 (CI 95% 12.346–16.018p < 0.05; HR 5.148 CI95% 1.217 to 21.772p = 0.026) for ≥25 BMI. The mean LOH of patients with normal levels of O2 ≥ 95% was 11.667 ± SE1.202 (CI95% 8.261 to 13.739;p = 0.046), while LOH for patients with < 95% was 14.625 ± SE 1.231 CI95% 12.184 to 16.757p = 0.042; HR 3.732 CI95%1.137–12.251p = 0.03). Patients without known comorbidities had a mean LOH of 11.700 ± SE1.075 (CI 95% 9.592–13.808), while those with comorbidities had a mean of 14.8 ± 1.303 (CI 95% 12.247–17.353;p = 0.029) with HR2.552.ConclusionLOH varied among COVID-19 patients and was prolonged when analyzed for BMI ≥25, comorbidities, elevated creatinine, and O2 saturation < 95%. Furthermore, risk factors for COVID-19 patients in B&H do not deviate from those reported in other countries.