bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nesting Effects of Climate and Local Drivers on Long-Term Subalpine Fires in the Alps
Authors: Carcaillet Christopher , Boulley Benjamin , Carcaillet Frédérique 
Published: October 2021

Abstract
Background: The present article questions the relative importance of local- and large-scale processes on the long-term dynamics of fire in the subalpine belt in the western Alps. The study is based on soil charcoal dating and identification, several study sites in contrasting environmental conditions, and sampling of soil charcoal along the elevation gradient of each site. Based on local differences in biomass combustion, we hypothesize that local-scale processes have driven the fire history, while combustion homogeneity supports the hypothesis of the importance of large-scale processes, especially the climate. Results: The results show that biomass burning during the Holocene resulted from the nesting effects of climate, land use, and altitude, but was little influenced by topography (slope exposure: north versus south), soil (dryness, pH, depth), and vegetation. The mid-Holocene (6500–2700 cal BP) was an important period for climatic biomass burning in the subalpine ecosystems of the western Alps, while fires from about 2500 years ago appear much more episodic, prompting us to speculate that human society has played a vital role in their occurrence. Conclusion: Our working hypothesis assuming that the strength of mountain natural and local drivers should offset the effects of regional climate is not validated. The homogeneity of the fire regime between sites thus underscore that climate was the main driver during the Holocene of the western Alps. Long-term subalpine fires are controlled by climate at millennial scale. Local conditions count for little in determining variability at the century scale. The mid-Holocene was a chief period for climatic biomass burning in the subalpine zone, while fires during the late Holocene appear much more episodic, prompting the assumption that societal drivers has exercised key roles on their control.
Establishment of a Prognostic Prediction System Based on Tumor Microenvironment of Pancreatic Cancer
Authors: Liu Bo , Fu Tingting , He Ping , Xu Ke 
Published: October 2021

Abstract
Purpose: Pancreatic cancer (PC) is an inflammatory tumor. Tumor microenvironment (TME) plays an important role in the development of PC. This study aims to explore hub genes of TME and establish a prognostic prediction system for PC.Methods: High throughput RNA-sequencing and clinical data of PC were downloaded from TCGA and ICGC database, respectively. PC Patients were divided into High- and low-score group by using stromal, immune scores system based on ESTIMATE. Differentially expressed genes (DEGs) between High- and low-score patients were screened and survival related DEGs were identified as candidate genes by univariate COX regression analysis. Final variables for establishment of the prognostic prediction system were determined by LASSO analysis and multivariate COX regression analysis. The predictive power of the prognostic system was evaluated by internal and external validation. Results: A total of 210 candidate genes were identified by stromal, immune scores system and survival analyses. Finally, the prognostic risk score system was constructed by the following genes: FAM57B, HTRA3, CXCL10, GABRP, SPRR1B, FAM83A, LY6D. In process of internal validation, Harrell's C-index of this prognostic risk score system was 0.73, and the area under the receiver operating characteristic curve (AUC) value of 1-year, 2-year and 3-year OS period was 0.67, 0.76 and 0.86, respectively. In the external validation set, the survival prediction C-index was 0.71, and the AUC was 0.81, 0.72, 0.78 at 1-year, 2-year and 3-year, respectively.Conclusion: This prognostic risk score system based on TME demonstrated a good predictive capacity to the prognosis of PC.
The Analgesic Efficacy of Ultrasound-guided Bilateral Transversus Thoracic MusclePlane Block after Open-Heart Surgeries: A Randomized Controlled Study
Authors: Hamed Mohamed Ahmed , Boules Maged Labib , Sobhy Mina Mahrous , Abdelhady Mahdy Ahmed 
Published: October 2021

Abstract
Background: We aimed to evaluate the analgesic efficacy of ultrasound-guided bilateral Transversus Thoracic Muscle Plane Block after Open-Heart Surgeries. Methods: 70 patients aged above 18 years and scheduled for valve replacement or adult congenital via median sternotomy were enrolled in this study. Patients were divided into two groups, randomized by computer-generated random numbers: the block group, which had the ultrasound-guided bilateral transversus thoracic muscle plane block, and the control group, which had a sham block. The primary outcome was total fentanyl consumption in the first 24-hours. The secondary outcomes were pain score, time to the first analgesic request, time to extubation , ICU stays, and hospital stay. Results: The total fentanyl consumption in the first 24 hours was significantly lower in the block group, with a mean difference of -158.286 (95% CI = (-179.271 to -137.300; p=<0.0001). The time to the first analgesic request was statistically significantly shorter in the non-block group (median 3 hours) than the block group (median 14 hours). During the postoperative period (0.5-24 hours), at-rest pain scores were 1.86 units lower in the block group (the estimate was -1.80, 95% CI = -2.14 to -1.45, t = -10.323 with p <0.0001). Likewise, pain scores with cough were 3.29 units lower in the block group (the estimate was -3.29, 95% CI = -3.80 to -2.77, t = -12.703, p <0.0001).Conclusion: Bilateral Transversus Thoracic Muscle Plane Block is a promising and effective technique in reducing opioid consumption and controlling post-sternotomy pain after open-heart surgery via median sternotomy.Trial Registration: This study is registered on ClinicalTrials.gov (NCT04116554; principal investigator: Mohamed Ahmed Hamed; date of registration: October 4, 2019).
Effect of Surya Namaskara on Mental Health, Self-control and Mindfulness of Adolescent School Children.
Authors: Parajuli Niranjan , Shindhe Mutturaj , Pradhan Balaram 
Published: October 2021

Abstract
BackgroundA big portion of adolescent school children suffers from mental health problems. Low self-control and mindfulness are positively associated with poor mental health. Therefore, the present study was designed to assess the effect of Surya Namaskara (SN) on mental health, self-control, and mindfulness among school children.Method63(39 female and 24 male) students (mean age = 14.24 years and SD = 0.42 years) studying at 9th grade in a private school in Karnataka, India were recruited as participants of the study. The design of the present study was a non-randomized two arms design. Students in grade 9 section ‘A’ (N= 33) were selected as the intervention group. Whereas, students in grade 9 section ‘B’ (N = 30) were considered as a control group. Students in the intervention group were given SN for 15 days. The participants were administrated the Brief Self-control Scale (BSCS), Mindfulness, Attention and Awareness Scale for Adolescents (MAAS-A), and General Health Questionnaire-12 (GHQ-12) questionnaires on the baseline and after 15 days of intervention. ResultsFindings of the present study showed a significant difference in MAAS-A scores [F (1, 54) = 18.47, p < 0.001, ηp2 = 0.26] in within group comparison. There was also a significant interaction (Times*Groups) for BSCS [F (1, 54) = 4.89, p = 0.031, ηp2 = 0.08] and MAAS-A [F (1, 54) = 6.63, p = 0.013, ηp2 = 0.12] scores. Post-hoc analysis showed SN group has significantly high post BSCS score (p = 0.005) and MAAS-A score (p = 0.005) compared to control group. Similarly, there was a significant high BSCS score (p = 0.003) and MAAS-A score (p < 0.001) after SN intervention compare to their respective pre scores. There was no significant change in the GHQ-12 scores in both groups in pre-post comparison.ConclusionThe finding of the present study showed that SN improves self-control and mindfulness in adolescent school children. However, the results of the current study should be confirmed by future studies with robust research design, a large sample size, and advanced tools.
Photothermal Conversion of Biodegradable Fluids And Carbon Black Nanofluids
Authors: Kosinska Anna , Balakin Boris V. , Kosinski Pawel 
Published: October 2021

Abstract
The paper is devoted to the topic of direct absorption solar collectors (DASCs). The main focus is on comparing two kinds of working fluids that can be used in DASCs, namely carbon black nanofluids and biodegradable coffee colloids. At first, the fluids were tested by exposing them to artificial light (indoor experiments) and real solar irradiation (field experiments). The indoor experiments used a system of relatively large geometry, so most of the heat absorption occurred close to the irradiated surface. This resulted in a similar performance by both fluids. The field experiments involved a smaller system, and the light was concentrated by a solar collector. Here the nanofluid outperformed the coffee colloids. Next, the process was analysed using a theoretical analysis that gave good correspondence with the experiments. Finally, we extended the theoretical analysis to a DASC with a flowing fluid. The model was validated against results from the literature, but it also supported our experimental findings.
Symptom Burden and Quality of Life After Successful Ablation in Patients With Low Burden of Symptomatic Premature Ventricular Complexes
Authors: Amir Muzakkir , Kabo Peter , Tandean Pendrik , Patellongi Ilham Jaya , Siregar Muchtar Nora Ismail , Zam Sitti Multa 
Published: October 2021

Abstract
Background: It is essential to enhance life quality in patients with premature ventricular complexes (PVCs) with the use of radiofrequency ablation (RFA). The aim of the study was to assess symptom burden and life quality in patients with a low PVC burden following RFA. Methods: 31 individuals with a low PVC burden in whom RFA was indicated were included in the study. At baseline and after a year following RFA, the Arrhythmia-Specific questionnaire in Tachycardia and Arrhythmia (ASTA) scale was used for appraisal. A 24-hour Holter electrocardiogram was used to detect recurrent PVCs 12 months after the RFA intervention.Results: ASTA scores related to symptom burden, including the near-syncope score, healthrelated quality of life (HRQOL) scales pertaining to physical and mental health, and consequently the total HRQOL score, were all diminished a year after RFA (p<0.001). The ASTA score for syncope symptoms was also reduced (p<0.05). A fall in mean PVC burden was seen from 8.0% to 0.8% (p<0.001). Conclusion: The long-term clinical endpoint in individuals with a low PVC burden following RFA is reported. Symptom load, life quality and ultimate PVC burden were all enhanced. Additional studies incorporating longer follow-up and monitoring periods, respectively, would be beneficial.
Case Report About Extraperitoneal Metastasis of Cervical Adenocarcinoma In Situ
Authors: Le Aiwen , Han Lirong , Wang Peng , Kang Kai 
Published: October 2021

Abstract
Background: adenocarcinoma in situ(AIS) cells are often misdiagnosed, and recognizing AIS in cervical cytology is challenging. Here, we present a case of extraperitoneal metastasis 5 years after a missed diagnosis of AIS.Case presentation: We report a 49-year-old Chinese woman who presented with a retroperitoneal mass 5 years after cervical conization for AIS. The retroperitoneal mass was composed of glands lined by malignant mucinous epithelium; these tumors were metastases from her previous AIS which were misdiagonised cervical intraepithelial neoplasia(CIN) III in 2013. The patient is alive and well 2 years after resection of the tumors.Conclusions: An experienced pathologist or multiple pathologists should take part in endocervical AIS diagnosis. We should follow these patients for over 15 years. When Cancer Antigen 125(CA125) or Carcinoembryonic antigen(CEA) levels are elevated, the occurrence of metastases should be strictly monitored.
Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy in Younger Patients with Peritoneal Metastasis from Colorectal Cancer
Authors: Chen Haipeng , Zhou Sicheng , Jiang Yujuan , Zheng Zhaoxu , Liu Zheng , Liu Qian , Xu Jianping , Pei Wei , Liang Jianwei , Wang Xishan 
Published: October 2021

Abstract
Background Currently, few studies have evaluated effectiveness of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in young patients with peritoneal metastasis (PM) of colorectal cancer (CRC) origin.Method Clinicopathological characteristics, perioperative data and survival outcomes in young patients, defined as being 50 years or less (n=23), performing CRS+HIPEC between June 2017 to June 2019 were reviewed and compared with older patients, defined as aged over 50 years (n=47).Results Compared with older patients, young patients were more likely to present with PM at the time of diagnosis (78.3% vs 51.1%, P=0.029) and exhibit a mucinous and signet-ring histology (60.9% vs 29.8%, P=0.013). The cancer-specific survival (CSS) after CRS+HIPEC in two groups are similar. On multivariate Cox regression, rectal origin (HR, 2.51, 95%CI, 1.11-5.67; P=0.027) and mucinous/signet adenocarcinoma (HR, 2.20, 95%CI, 1.02-4.74; P=0.044) were independent risk factors for poor CSS.Conclusion Younger patients (aged ≤50 years) with PM of CRC origin presented more often with synchronous PM than older patients. Although tend to exhibit a aggressive nature, they derive similar benefit from CRS+HIPEC as older patients.
“Why them, why me, why us?” The Experiences of Parents of Children with Lysomal Acid Lipase Deficiency: An Interpretative Phenomenological Analysis Study
Authors: Hassell Sadie , Smith Debbie M , Rust Stewart , Jones Simon , Wittkowski Anja 
Published: October 2021

Abstract
BackgroundLysosomal acid lipase deficiency (LALD) is an ultra-rare, inherited metabolic disease within the category of lysosomal storage disorders, affecting an infant’s ability to metabolise cholesterol. Developments in treatment, including Enzyme Replacement Therapy, have proven successful, with some children living for a number of years post-diagnosis, although the future still remains unknown. The aim of this study was to explore the lived experiences of parents of children with LALD. Main textParticipants were recruited from across the United Kingdom between 2020-2021. Eight parents (five mothers and three fathers) whose child had a confirmed diagnosis of LALD were interviewed. Data collected from the semi-structured interviews were audio-record, transcribed and analysed using Interpretative Phenomenological Analysis (IPA). Three superordinate and nine subordinate themes emerged from the data: 1) Uncertainty - a double-edged sword (plunged into an uncertain world, living life with worry and walking the tightrope of stability), 2) Powerless against a shared battle (a helpless parent, a joint battle, protection against distress and a vulnerable parent needing to be held) and 3) Accepting a life with LALD - the camouflage of a “normal” child (trying to make sense of ‘why’ and a condition disguised by normality). ConclusionsThe findings of this study highlighted that the diagnosis of LALD proves to be a very vulnerable time in parents’ lives, eliciting strong emotional reactions against an unknown future. This study signified the importance of clinical pathways and service provisions to support parents and their children through this period, raising important issues around diagnosis.
Diagnostic Efficacy of CCTA And CT-FFR Based On Risk Factors For Myocardial Ischemia
Authors: Gao Yongguang , Shi Yibing , Xia Ping , Zhang Jinyao , Fu Yufei , Huang Yayong , Xu Yuanshun , Li Gutao 
Published: October 2021

Abstract
Background: Coronary artery CCTA can observe the degree of coronary artery stenosis and FFR can evaluate the physiological function of coronary artery. However, noninvasive imaging examination that can both observe the above two methods at the same time has not yet been elucidated.Objective: To investigate the diagnostic efficacy of coronary computed tomography angiography (CCTA) and computed tomography-derived fractional flow reserve (CT-FFR) based on different risk factors for myocardial ischemia.Methods: Patients undergoing CCTA in our hospital from August 18, 2020 to April 28, 2021 were randomly selected, and the data were subjected to CT-FFR analysis. Vascular characteristics were measured, including total plaque volume, calcified plaque volume, non-calcified plaque volume, plaque length, and lumen stenosis, and the patients were categorized into a non-ischemia group (FFR>0.8) and an ischemia group (FFR≤0.8). Plaque characteristics were compared between the two groups, and logistic regression analysis was employed to explore the correlations between plaque characteristics and ischemic lesions.Results: From a total of 122 patients enrolled in the study, there were 218 vascular branches with FFR>0.8 and 174 vascular branches with FFR≤0.8. There were significant group differences in total plaque volume, calcified plaque volume, plaque length, and lumen stenosis >50% (n). The obtained data were as follows: non-ischemic group 10.57 (4.80, 259.65), ischemic group 14.87 (3.39, 424.45), Z=9.772, p=0.002, non-ischemic group 10.57 (0, 168.77), ischemic group 14.87 (0, 191.00), Z=2.503，p≤0.001), non-ischemic group 8.17 (37.05, 40.53), ischemic group 8.38 (56.66, 86.47), Z=5.923, p=0.016, and lumen stenosis >50%, non-ischemic group 46, ischemic group 90, x2=14.77，p≤0.001. The regression analysis results indicated that total plaque volume, calcified plaque volume, plaque length and lumen stenosis >50% were risk factors for myocardial ischemia, with ORs and p values of (2.311, p=0.002), (1.021, p=0.004), (2.159, p<0.001), and (0.181, p<0.001), respectively.Conclusion: Total plaque volume, calcified plaque volume, plaque length and lumen stenosis >50% are predictors for myocardial ischemia. Coronary artery CCTA combined with CT-FFR could simultaneously observe the anatomical stenosis and evaluate myocardial blood supply at the functional level. Thus, myocardial ischemia could be better diagnosed.
Association of Long Sleep and Physical Inactivity with Incident Disability in Community-Dwelling Older Adults: A 5-Year Longitudinal Study
Authors: Nakakubo Sho , Doi Takehiko , Tsutsumimoto Kota , Kurita Satoshi , Ishii Hideaki , Kiuchi Yuto , Shimada Hiroyuki 
Published: October 2021

Abstract
Background
Good sleep durations and physical activity are essential factor for maintaining good health. This study examined whether sleep duration and physical inactivity were associated with incident disability among community-dwelling older adults.
Methods
A total of 4,372 adults aged ≥ 70 years participated in a baseline assessment. We also assessed self-reported sleep duration and physical activity using the International Physical Activity Questionnaire – Short Form at baseline assessment. We measured monthly incident disability, defined as the onset of being certified for personal support or care as required by Japanese public long-term care insurance over 5 years. The Cox proportional hazard regression analysis estimated hazard ratios (HRs) and 95% confidence intervals (CIs) for incident disability according to long sleep duration (≥ 9 h) and physical inactivity.
Results
Long sleep duration (HR 1.32, CI 95% 1.05–1.67) and physical inactivity (HR 1.33, CI 95% 1.13–1.57) were associated with incident disability in multivariate analyses. These results were also sustained in the model where both long sleep duration and physical inactivity were simultaneously submitted as independent variables. Furthermore, coexistence of long sleep duration and physical inactivity had higher risk of incident disability than each factor individually (HR 1.69, CI 95% 1.11–2.58), even though the synergistic interaction was mildly effective.
Conclusions
This study revealed that long sleep duration and physical inactivity were independently associated with the risk of incident disability among older adults. More attention should be paid to both sleep duration and physical activity in order to prevent incident disability.
Using the Problem Tree and Results Chain to Improve Uptake of Intermittent Preventive Treatment in Pregnancy Services—Case Study of the Malaria Action Program for Districts in Uganda
Authors: Ngabirano Thomson , Kigozi Ruth , Lugemwa Myers , Gudoi Sam , Tetteh Gladys , Nabakooza Jane , Opigo Jimmy , Tibenderana James 
Published: October 2021

Abstract
Malaria in pregnancy contributes considerably to poor pregnancy outcomes. The U.S. Agency for International Development’s Malaria Action Program for Districts project in Uganda used the Problem Tree and Results Chain tool to identify demand and supply barriers responsible for the low uptake of intermittent preventive treatment of malaria in pregnancy (IPTp) in 52 districts of Uganda. The key supply-side barriers identified were related to leadership/governance, health financing, medicines and technologies, health information systems, human resources, service delivery, and users. The project used the results to plan and implement interventions targeting the barriers. As a result, from October 2018 to September 2019, the project reported an apparent improvement in uptake of three or more doses of IPTp (49–67%). Malaria in pregnancy cases and stock out of sulfadoxine-pyrimethamine (SP) did not change considerably. The Problem Tree and Results Chain tool is a useful and complementary project management tool to identify root causes and their solutions during planning and implementation. Projects using this tool should periodically re-assess performance of IPTp policy implementation and develop appropriate solutions to address the key bottlenecks identified to increase the likelihood of sustained improvement. Further evaluation of the utility of the tool in other settings is recommended.
Clinical Efficacy of Different Approaches for Laparoscopic Intersphincteric Resection of Low Rectal Cancer: A Comparison Study
Authors: Ou Wenquan , Wu Xiaohua , Zhuang Jinfu , Yang Yuanfeng , Zhang Yiyi , Liu Xing , Guan Guoxian 
Published: October 2021

Abstract
Background: The operative results of different approaches for the laparoscopic intersphincteric resection (LAISR) of low rectal cancer vary, and the patient characteristics associated with the best outcomes for each procedure have not been reported. We compared the efficacy of different approaches for LAISR of low rectal cancer and discussed the surgical indications for each approach.Methods: We retrospectively reviewed data from 235 patients with low rectal cancer treated via LAISR from October 2010 to September 2016. Patients underwent either the transabdominal approach for ISR (TAISR, n=142), the transabdominal perineal approach for ISR (TPAISR, n=57), or the transanal pull-through approach for ISR (PAISR, n=36).Results: The PAISR and TAISR groups exhibited shorter operation times and less intraoperative blood loss than the TPAISR group. The anastomotic distance was shorter in the PAISR and TPAISR groups than in the TAISR group. No differences in the ability to perform radical resection, overall complications, postoperative recovery, Wexner score recorded 12 months after ostomy closure, three-year disease-free survival, local recurrence-free survival, distant metastasis-free survival, or overall survival (OS) were observed among the three groups.Conclusions: TAISR, TPAISR, and PAISR have unique advantages and do not differ in terms of operation safety, patient outcomes, or anal function. TPAISR requires a longer time to complete and is associated with more bleeding and a slower recovery of anal function. PAISR should be considered when TAISR cannot ensure a negative distal margin and the tumor and BMI are relatively small; otherwise, TPAISR is required.