bluuebunny/crossref_metadata_2025_split huggingface dataset:
“The red flags” in clinical approach to acute ataxia – the experience in cohort of 76 children
Authors: Kravljanac Ruzica , Golubovic Aleksa , Tadic Biljana Vucetic , Ostojic Slavica , Cerovic Ivana , Savkic Jana 
Published: April 2023

Abstract

Objectives: The aim of our study is to define the most frequent etiology, clinical presentation, and predictive factors of outcome in children with acute ataxia (AA) and to determine “the red flags” in the diagnostic approach to children with AA.
Methods: The retrospective study included the patients with AA treated in Institute from 2015 - 2021. The inclusion criteria were: children aged 1 - 18 years; evolution time of ataxia within 72 hours, diagnosis made by a physician. The exclusion criteria were: anamnestic data about ataxia without confirmation by any physician; chronic/persistent ataxia; psychogenic or postictal ataxia. Clinical presentation was divided into two categories: 1. isolated cerebellar signs (CS): ataxic gait, dysmetria, dysdiadochokinesia, intention tremor, dysarthria, and nystagmus; 2. CS-plus symptoms which included CS associated with any of other symptoms such as encephalopathy (GCS <15), awareness disturbances, vomiting, headache, a new onset limb or facial paresis, torticollis, hypotonia, and opsoclonus. The outcome was assessed at the end of hospitalization and was defined as complete or incomplete recovery. Evaluated parameters in patients are demographic features, etiology, the age of ataxia onset, clinical presentation and symptoms associated with ataxia, neuroimaging, comorbidities, treatment, and the outcome. The predictive value of different outcomes was analyzed using univariate and multivariate logistic regression analyses.
Results: The study included 76 children, with a mean age of 5.7 years (IQR 2.1-8.3). The most frequent causes of AA were immune-mediated/infective cerebellar ataxia in 27 (35.5%), and intoxication in 24 (31.6%) cases, followed by vestibular ataxia, opsoclonus-myoclonus-ataxia syndrome, and intracranial expansive process. Forty-two (56%) cases experienced isolated CS and 35 (46%) cases had CS-plus. Complete recovery was experienced by 62 (81,6%) patients. Univariate analysis showed that the presence of CS-plus symptoms (p=0.007) and structural abnormalities (p=0.001) were related to poor outcomes. In multivariate logistic regression analysis of these factors, statistical significance remained (p=0.021 and p=0.002) respectively.
Conclusions: Most of the children with AA have “benign” etiology with favorable outcomes such as intoxication and post/parainfectious cerebellar ataxia. On the other hand, AA might be the first manifestation of CNS neoplasm or paraneoplastic phenomena. “The red flags” associated with cerebellar signs are limbs or facial palsy, hypotonia, GCS<15, vomiting, opsoclonus, headache, myoclonus, visual impairment, torticollis, and vertigo. The presence of those signs and/or structural brain abnormalities was related to poor outcomes in children with AA.
Apolipoprotein B/Apolipoprotein A ratio: a novel prognostic factor for pancreatic cancer
Authors: Li Chenxi , yang xuhui , Zhong Yan , Wang Wenying , Jin Xin , Bian Lihua , wang xiaona 
Published: April 2023

Abstract
Objective: The relationship between serum lipids and prognosis of pancreatic cancer has not been confirmed. Our purpose in the study was to investigate the associations between serum lipids level and prognosis in patients with pancreatic cancer.
Methods: A retrospective study was performed on 286 pancreatic cancer patients who admitted to our hospital from January 1, 2017 to December 31, 2021. Serum lipids level were recorded. Clinical-pathological characteristics, oncologic outcomes, progression free survival (PFS) and overall survival (OS) were collected. The prognostic significance was determined by Kaplan-Meier analysis and Cox proportional hazards regression model.
Results: Regarding serum lipids level, compared to normal apolipoprotein B/ apolipoprotein A (ApoB/ApoA), high ApoB/ApoA level indicated a shorter OS (HR:2.028, 95% CI: 1.174-2.504, P = 0.011) and a shorter PFS (HR:1.800, 95% CI: 1.076-3.009, P = 0.025). Other serum lipid molecules were not associated with PFS and OS.
Conclusion: ApoB/ApoA might be an independent prognostic factor of pancreatic cancer.
High-resolution nanoscale NMR for arbitrary magnetic fields
Authors: Vorobyov Vadim , Meinel Jonas , Maier Rouven , Sumiya Hitoshi , Onoda Shinobu , Isoya Junichi , Wrachtrup Jörg , Dasari Durga , Kwon Minsik 
Published: April 2023

Abstract
Nitrogen vacancy (NV) centers are a major platform for the detection of nuclear magnetic resonance (NMR) signals on the nanoscale.
To overcome the intrinsic electron spin lifetime limit in spectral resolution a heterodyne detection approach is widely used.
However, application of this technique at high magnetic fields (> 0.1 T) is yet an unsolved problem.
Here we introduce a heterodyne detection method utilizing a series of phase coherent electron nuclear double resonance sensing blocks, thus eliminating the need for the application of numerous Rabi microwave pulses in the detection scheme.
As a result our detection protocol can be extended to high magnetic fields, which allow chemical shift resolution in NMR experiments.
We demonstrate this principle on a weakly coupled 13C nuclear spin in the bath surrounding single NV centers, while comparing the results to existing heterodyne protocols.
This work paves the way towards high field nanoscale heterodyne NMR protocols with chemical resolution.
Nurses' job burnout after the first peak of COVID-19 in Northeast China: a descriptive study
Authors: Zhao Xinyang , Sun YAjun , Ye Jingjing , Wang Yali , Sun Shanwen , Zhang Xiaochun 
Published: April 2023

Abstract
Background: Since November 2022, China has continuously optimized and adjusted its prevention and control measures to achieve a smooth transition in the prevention and control of the epidemic in a relatively short period of time, and successfully passed the first wave of the COVID-19 epidemic. The purpose of this study was to investigate nurses' job burnout and its influencing factors after the first peak of COVID-19 in Northeast China.
Methods: 1350 frontline nurses in Northeast China were surveyed online through a questionnaire, including a general information questionnaire,Maslach Burnout Inventory-General Survey(MBI-GS), Simplified Coping Style Scale(SCSQ), and Perceived Social Support Scale(PSSS). The final effective response was 1328, with an effective response rate of 98.37%.
Results: 47.44% of nurses in Northeast China experienced job burnout after the first peak of COVID-19. The risk factors for job burnout are persistence in work and night shifts during self infection (OR: 1.342,95% CI: 1.002-1.798). The protective factors are that there are no elderly people in the family who need to take care of themselves (OR: 0.669,95% CI: 0.510-0.878), no patients who need to be cared for every day (OR: 0.574,95% CI: 0.363-0.908), or 3-5 patients who need to be cared for (OR: 0.560,95% CI: 0.381-0.823), financial support (OR: 0.766,95% CI: 0.604-0.971), psychological support (OR: 0.550,95% CI: 0.409-0.742), and family assistance (OR: 0.427,95% CI: 0.324-0.564). Job burnout is negatively correlated with perceived social support, and positively correlated with coping styles.
Conclusions: Nurses in Northeast China experienced moderate job burnout after the first peak of COVID-19. Managers should make adequate preparations for the arrival of a new COVID-19 peak according to the influencing factors of nurses' job burnout.
Distributed Denial of Service Attack Prediction over Software Defined Networks Using Federated Learning
Authors: Mehta Nisarg , Shukla Madhu , Shah Pooja , Patel Samir , Shah Darshit , Makadiya Kishan 
Published: April 2023

Abstract
In today's digital age, Distributed Denial of Service (DDoS) attacks have emerged as a formidable threat to the availability of online services. The ability to predict these attacks in advance is a crucial element in ensuring uninterrupted access to these services. This is where our proposed methodology comes into play. We propose the use of Federated Learning in the prediction of DDoS attacks on Software Defined Networks (SDN). Federated Learning is a cutting-edge approach that allows multiple agents, such as network devices, to collaborate and learn a shared model without the need to share their raw data. Our proposed system leverages the collective intelligence of SDN-enabled network devices to construct a prediction model that can detect DDoS attacks in real time. The experimental results of our study demonstrate the efficacy of our approach in detecting DDoS attacks with a high degree of accuracy and minimal instances of false alarms. We believe that our proposed methodology can prove to be an invaluable tool for service providers in their efforts to prevent DDoS attacks and preserve the availability of online services.
Association between consumption of nonessential energy-dense food and body mass index among Mexican school-aged children: A prospective cohort study
Authors: Barrientos-Gutiérrez Tonatiuh , Illescas-Zárte Daniel , Batis Carolina , Singh Gitanjali , Mozaffarian Dariush , Ramirez Ivonne , Barraza-Villarreal Albino , Romieu Isabelle 
Published: April 2023

Abstract

BACKGROUND/OBJECTIVES: Obesity prevalence in Mexican children has increased rapidly and is among the highest in the world. We aimed to estimate the longitudinal association between nonessential energy-dense food (NEDF) consumption and body mass index (BMI) in school-aged children 5 to 11 years, using a cohort study with 6 years of follow-up.
SUBJECTS/METHODS: We studied the offspring of women in the Prenatal omega-3 fatty acid supplementation, child growth, and development (POSGRAD) cohort study. NEDF were classified into four main groups: chips and popcorn, sweet bakery products, non-cereal based sweets, and ready-to-eat cereals. We fitted fixed effects models to assess the association between change in 418.6 kJ (100 kcal) of NEDF consumption and changes in BMI.
RESULTS: Between 5 and 11 years, children increased their consumption of NEDF by 225 kJ/day (53.9 kcal/day). In fully adjusted models, we found that change in total NEDF was not associated with change in children’s BMI (0.033 kg/m2, [p=0.246]). However, BMI increased 0.078 kg/m2 for every 418.6 kJ/day (100 kcal/day) of sweet bakery products (p=0.035) in fully adjusted models. For chips and popcorn, BMI increased 0.208 kg/m2 (p=0.035), yet, the association was attenuated after adjustment (p=0.303).
CONCLUSIONS: Changes in total NEDF consumption were not associated with changes in BMI in children. However, increases in the consumption of sweet bakery products were associated with BMI gain. NEDF are widely recognized as providing poor nutrition yet, their impact in Mexican children BMI seems to be heterogeneous.
First report on the Sero-molecular prevalence of Brucella melitensis in local small ruminants in Khyber Pakhtunkhwa, Pakistan
Authors: Hassan Sohaib Ul , Khan Farhan Anwar , Saddique Umer , Shahid Muhammad , Shah Said Sajjad Ali , Ullah Naveed 
Published: April 2023

Abstract
Background Globally, ruminant production contributes immensely to the supply of the highest quality and quantity of proteins for human consumption, sustenance of livelihoods, and attainment of food security. It plays a staple role in the northern area. Brucellosis is an important infectious and zoonotic disease that affects a wide range of animals and is caused by different species of brucella, such as Brucella abortus, Brucella mellitensis, etc. Brucellosis is diagnosed in humans and animals using a variety of serological and molecular assays, with varying degrees of effectiveness.Methods This study aimed to investigate the sero-molecular prevalence of brucellosis in small ruminants in two districts of Khyber Pakhtunkhwa-Pakistan, namely Mohmand, and Charsadda. For this study, 400 blood samples (n = 200 each from sheep and goats) were collected in gel tubes, along with a detailed history of the animals examined.Results The overall prevalence of brucellosis was 13, 9.75, and 6.5% through the Rose Bengal Plate test (RBPT), i-ELISA, and PCR, respectively. In sheep, the incidence rate of brucellosis was 13.5 and 7% through RBPT and i-ELISA while PCR confirmed 5% B. abortus and 2% B. melitensis. In goats, the incidence rate of brucellosis was 12.5 and 12.5% while PCR confirms 2% B. abortus and 4% B. melitensis.Conclusions Collectively, these results suggested that B. melitensis was found to be more prevalent in goats as compared to sheep whereas B. abortus was detected in higher numbers of sheep compared to goats through PCR. PCR is a more sensitive, efficacious, and time-saving test for the diagnosis of brucellosis.
Database derived from an electronic medical record-based surveillance network of US emergency department patients with acute respiratory illness 4-19-2023
Authors: Kline Jeffrey A. , Reed Brian , Alanis Naomi , Barshay Meylakh , Melzer Andrew , Galbraith James W. , Camargo Carlos A. , Budd Alicia , Pun Eugene , Winn Amber 
Published: April 2023

Abstract
Background:
For surveillance of episodic illness, the emergency department (ED) represents one of the largest interfaces for generalizable data about segments of the US public experiencing a need for unscheduled care. This protocol manuscript describes the development and operation of a national network linking symptom, clinical, laboratory and disposition data provides a public database dedicated to the surveillance of acute respiratory infections (ARIs) in EDs.
Methods:
The Respiratory Virus Laboratory Emergency Department Network Surveillance (RESP-LENS) network represents the collaboration between 24 investigators, representing 109 hospitals, and the Centers for Disease Control and Prevention (CDC) to survey viral infections. All data originate from electronic medical records (EMRs) accessed by standard query language (SQL) coding. Each Tuesday, data are imported into the standard data form for acute respiratory illness (ARI) visits that occurred the prior week (termed the index file); outcomes at 30 days and ED volume are also recorded. Up to 325 data fields can be populated for each case. Data are transferred from sites into an encrypted Google Cloud Platform, then programmatically checked for compliance, parsed, and aggregated into a central database a second cloud platform prior to transfer to CDC.
Results:
As of April, 2023, the network has reported index and 30-day data on over 560,000 ARI cases out of over 3.7 million ED encounters. Post-contracting challenges to network execution have included local shifts in testing policies and platforms, delays in ICD-10 coding to detect ARI cases, and site-level personnel turnover. The network is addressing these challenges and is poised to begin streaming weekly data for dissemination.
Conclusions:
The RESP-LENS network provides a living, weekly updated database that is a public health resource to survey the epidemiology, viral causes, and outcomes of ED patients with acute respiratory infections.
Self-Assessment Inclusion Scale (SAIS): A Tool for Measuring Inclusive Competence and Sensitivity
Authors: Argyriadis Alexandros , Paoullis Panagiotis , Samsari Eleni , Argyriadi Agathi 
Published: April 2023

Abstract
Recent studies highlight the fact that the establishment of an inclusive school is regarded as a requirement for the growth of a pluralistic, democratic society in which each form of diversity is welcomed and valued and the maintenance of social justice is a top priority. The aim of this research was to design and validate the Self-Assessment Inclusion Scale (SAIS) and test it in the population of teachers in Greece and Cyprus. The SAIS scale aims to self-assess the participants’ inclusive competence. Its ultimate goal is to help people to consider their skills, knowledge, and awareness of themselves in their interactions with others. The validation of the SAIS scale took place between October 2022 and February 2023 in 401 teachers in Greece and Cyprus using convenient sampling. The sample consisted of all school grades teachers. The findings imply that the participants were willing to consider their teaching methods and behavior and that they were aware of some of their own biases and stereotypes. In conclusion, the self-assessment scale used in this study to assess inclusive competence was found to be valid and useful in assessing participants' cultural awareness, knowledge, behaviors, and attitudes.
Regulating local molecular polarization of triazine-PDI based polymer for high-efficient photocatalytic coupling of benzylamine
Authors: Yan Rong , Song Meiyang , Chen Peng , Song Henghui , Fu Chengbing , Peng Haiyang , Yin Shuang-Feng F. 
Published: April 2023

Abstract
Designing a robust built-in electric field (BF) is a charming strategy for enhancing the separation and transportation of charges via introducing large π-conjugated molecules. However, it has flexible or semiflexible geometries, which significantly disorder the crystalline and deteriorated the built-in electric field. Here, a straightforward tactics for creating a cyano-functionalized smaller D (benzene) - A (triazine) units in PDI- triazine based polymer (PDIMB) to enhance intrinsic molecule dipole has been proposed. The density functional theory (DFT) calculation revealed that the modification of smaller D-A groups destroyed the π-localization of charges, which enhanced the molecular dipole and the BF for promoting the exciton dissociation and charge transfer. Moreover, it not only exposed number of active sites, but also enhanced the interfacial molecular interacting. Therefore, PDIMB-2 exhibits high activity (24.5 mmol g− 1 h− 1) and selectivity (> 99%) for the photooxidation of benzylamine to N-benzylidenebenzylamine under mild conditions. Our work offers a potential and simple synthetic option for enhancing the built-in electric field of polymer.
Dynamics of N Two-level moving atoms under the influence of the non-linear Kerr medium
Authors: Ibrahim M. , Anwar S. Jamal , Khan M. Khalid , Almalki S. , Alqannas Haifa S. , Abdel-Khalek S. 
Published: April 2023

Abstract
Dynamical evolution of global quantum discord (GQD) and von Neumann entropy (VNE) is studied for N two-level atomic system (TLS) (two, three and four TLS). The system interacts with the single mode Fock field and the cavity is filled with the non-linear Kerr medium (NLKM). It is seen that for large values of the Kerr parameter, the GQD and VNE show periodic behavior which leads to the sudden death and birth of the quantum entanglement (QE). It is found that the oscillations of the GQD is suppressed for the initial mixed state. The VNE has non-zero values of quantum interference throughout the dynamics of the system for initial mixed states. It is also found that the multipartite systems show sustained response to the QE during the time evolution. Moreover, the GQD and VNE are notably affected in the presence of the NLKM and affected for the entire range of Kerr values as we increase the number of photons in the cavity. Furthermore, for both initial pure and mixed states, the periodic behavior of the GQD and VNE is almost the same for the case of moving TLS. The sudden death and birth of QE is more prominent for moving TLS case. The atomic motion is favorable to sustain the QE in the atomic systems in a NLKM.
Prenatal Diagnosis Rate of Critical Congenital Heart Disease Remains Inadequate with Significant Racial/Ethnic and Socioeconomic Disparities and Technical Barriers
Authors: Davtyan Arpine , Ostler Heidi , Golding Ian Fraser , Sun Heather Y. 
Published: April 2023

Abstract
Background:Prenatal diagnosis (preDx) of critical congenital heart disease (CCHD) decreases neonatal morbidity and mortality. Obstetrical fetal cardiac imaging guidelines in 2013 aimed to increase preDx.
Objective: To determine the contemporary preDx rate of CCHD and identify maternal-fetal factors and variations in prenatal care that may be potential barriers.
Methods: This retrospective single center study evaluated maternal demographics and characteristics of infants with CCHD (requiring cardiac catheterization or surgical intervention before 6 months-old) between 2016 and 2019.
Results:58% of the 339 infants with CCHD had preDx. Infants with preDx were more likely to have mothers ≥ 35 years-old (p=0.028), family history of CHD (p=0.017), health insurance (p=0.002), or anatomic scan with perinatology (p<0.001). Hispanic infants were less likely to have preDx (45.6%, p=0.005). PreDx rates were higher in infants with extracardiac/genetic anomalies (p<0.001) and significantly different between CCHD subtypes (76% for single ventricle, 51% for biventricular, 59% for proximal outflow tract anomalies, and 48% for distal great artery anomalies; p=0.024). In infants without preDx, 25% of their mothers had indication for, but did not undergo, fetal echocardiography.
Conclusion:PreDx rates of CCHD remains inadequate across subtypes detectable by standard fetal cardiac screening views, particularly in uninsured and Hispanic communities.
Can Aspartame Induce Reversible Cerebellar Changes?
Authors: Youssef Ola Mohammed , Ahmed Ahmed S. , Eldken Zienab H. , Elsisy Rasha A. , Sakr Noha H. 
Published: April 2023

Abstract
Aspartame is a synthetic sweetener that is unlikely to have a negative impact on the cerebellar cortex. The current study was designed to evaluate the histopathological changes in the cerebellar cortex of aspartame-treated albino rats and the possibility of recovery from aspartame induced cerebellar injury. Three groups of six mature male albino rats, totaling 18, were allocated. Daily doses of distilled water were given to the control group. Group 2 (ASP group): received 250 mg/kg ASP by oral rote for 12 weeks. Group3 (Recovery) received 250 mg/kg/day aspartame for eight weeks, then a daily dosage of distilled water equal to the aspartame dose for the next 6 weeks. The rats were anesthetized, and their cerebella were dissected for immunohistochemical and histological studies. Studies in morphometry and statistics were carried out. Nitric oxide (NO), reduced glutathione (GSH), and malondialdehyde (MDA) levels were assessed in the cerebellum tissue. When compared to the control group, there was a very significant rise in MDA and NO levels and a reduction in GSH levels in the aspartame group. MDA and NO levels were decreased associated with a significant increase in GSH level compared to the aspartame group in the recovery group. Cerebellar cortex of aspartame group showed features of neurodegeneration, and apoptosis. The latter features were decreased in the recovery group. In conclusion, aspartame consumption has reversible deleterious effect on cerebellar cortex.