bluuebunny/crossref_metadata_2025_split huggingface dataset:
The changing malaria trend and control efforts in Oromia Special zone, Amhara Regional State, North-East Ethiopia
Authors: Tefera Selomon , Bekele Temesgen , Getahun Kefelegn , Negash Abiyot , Ketema Tsige 
Published: April 2022

Abstract
Background
Countries in malaria endemic regions are determinedly making an effort to achieve the global malaria elimination goals. In Ethiopia, too, all concerned bodies have given attention to this mission as one of their priority areas so that malaria would be eradicated from the country. Despite the success stories from some areas in the country, however, malaria is still a major public health concern in most parts of Ethiopia. Therefore, this study is aimed at analysing the changing malaria trend and assessing the impact of malaria control efforts in one of the malaria endemic regions of Ethiopia.

Methods
Five years data on clinical malaria cases diagnosed and treated at all health facilities (including 28 Health Centres, 105 Health Posts and 2 Hospitals) in Oromia Special zone, Amhara Regional State, Ethiopia, were reviewed for the period from June 2014 to June 2019. Data on different interventional activities undertaken in the zone during the specified period were obtained from the Regional Health Bureau.

Results
The cumulative malaria positivity rate documented in the zone was 12.5% (n = 65,463/524,722). Plasmodium falciparum infection was the dominant malaria aetiology and accounted for 78.9% (n = 51,679). The age group with the highest malaria burden was found to be those aged above 15 years (54.14%, n = 35,443/65,463). The malaria trend showed a sharp decreasing pattern from 19.33% (in 2015) to 5.65% (in 2018), although insignificant increment was recorded in 2019 (8.53%). Distribution of long-lasting insecticidal nets (LLIN) and indoor residual spraying (IRS) were undertaken in the zone once a year only for two years, specifically in 2014 and 2017. In 2014, a single LLIN was distributed per head of households, which was not sufficient for a family size of more than one family member. Number of houses sprayed with indoor residual spray in 2014 and 2017 were 33,314 and 32,184 houses, respectively, leading to the assumption that, 151,444 (25.9%) and 141,641 (24.2%) population were protected in year 2014 and 2017, respectively. The analysis has shown that P. falciparum positivity rate was significantly decreased following the interventional activities by 3.3% (p = 0.009), but interventional efforts did not appear to have significant effect on vivax malaria, as positivity rate of this parasite increased by 1.49% (p = 0.0218).

Conclusion
Malaria burden has shown a decreasing pattern in the study area, although the pattern was not consistent throughout all the years and across the districts in the study area. Therefore, unremitting surveillance along implementation of interventional efforts should be considered taking into account the unique features of Plasmodium species, population dynamics in the zone, seasonality, and malaria history at different districts of the zone should be in place to achieve the envisaged national malaria elimination goal by 2030.
The clinical outcomes of selective and spontaneous fetal reduction of twins to a singleton pregnancy in the first trimester: a retrospective study of 10 years
Authors: Wang Chao , Tang Fei , Song Bing , Li Guanjian , Xing Qiong , Cao Yunxia 
Published: April 2022

Abstract
Background
Singleton pregnancy is encouraged to reduce pregnancy complications. In addition to single embryo transfer (SET), selective and spontaneous fetal reduction (SEFR and SPFR) can also achieve singleton pregnancies. After SEFR or SPFR, an inanimate fetus remains in the uterus. It is unclear whether the inanimate fetus would adversely affect another fetus or the mother. Previous studies have focused on the differences between pre- and post-reduction. However, studies focusing on the influence of SEFR and SPFR on the remaining fetal development and maintenance of pregnancy are rare.

Methods
Materials from 5922 patients whose embryo transfer dates ranged from March 2011 to January 2021 were collected. Both the SEFR group (n = 390) and SPFR group (n = 865) had double embryos transferred (DET) and got twin pregnancies, but subsequent selective or spontaneous fetal reduction occurred. The SET group (n = 4667) had only one embryo transferred. All were singleton pregnancies on the 65th day after embryo transfer. Clinical outcomes, including pregnancy outcomes, pregnancy complications, and newborn outcomes, were compared among the three groups.

Results
After adjusting for age, infertility duration, types of infertility, states of embryos, body mass index, and factors affecting SET or DET decisions, multivariate regression analysis revealed that SEFR increased the risk of miscarriage (OR 2.368, 95% CI 1.423–3.939) and preterm birth (OR 1.515, 95% CI 1.114–2.060), and reduced the gestational age (βeta -0.342, 95% CI -0.544– -0.140). SPFR increased the risk of gestational diabetes mellitus (GDM) (OR 1.657, 95% CI 1.215–2.261), preterm premature rupture of membranes (PPROM) (OR 1.649, 95% CI 1.057–2.574), and abnormal amniotic fluid volume (OR 1.687, 95% CI 1.075–2.648). Both SEFR and SPFR were associated with reduced live birth rate (OR 0.522, 95% CI 0.330–0.825; OR 0.671, 95% CI 0.459–0.981), newborn birth weight (βeta -177.412, 95% CI -235.115–-119.709; βeta -42.165, 95% CI -83.104–-1.226) as well as an increased risk of low-birth-weight newborns (OR 2.222, 95% CI 1.490–3.313; OR 1.510, 95% CI 1.092–2.087).

Conclusions
DET with subsequent fetal reduction was related to poor clinical outcomes. We recommend that DET with subsequent fetal reduction should only be considered as a rescue method for multiple pregnancy patients with potential complications, and SET is more advisable.
International medical electives during and after the COVID-19 pandemic - current state and future scenarios: a narrative review
Authors: Storz Maximilian Andreas 
Published: April 2022

Abstract
Background
International medical electives are an important and popular component of the academic curriculum in many medical schools and universities worldwide. The purpose of abroad electives is to provide medical students with an opportunity to gain a better understanding of education and healthcare in an international context. The COVID-19 pandemic, however, has substantially changed the international elective landscape. Travel restrictions, closures of international elective programs and the expansion of virtual methods for education caused a widespread disruption to abroad electives. A comprehensive analysis with regard to other consequences for abroad electives, however, has not been done before. Thus, we sought to a) summarize the current transformation of the international medical elective and b) to address potential challenges for post-pandemic international medical electives.

Methods
The methodology employed is a multidisciplinary narrative review of the published and grey literature on international electives during the last two years of the COVID-19 pandemic.

Results
Students worldwide had electives postponed or canceled. Apart from evident immediate pandemic-related consequences (such as the substantial decline in global electives and impaired elective research opportunities for educators), there are other several problems that have received little attention during the last two years. These include challenges in the elective application process, poorly-understood consequences for host institutions, and growing global (ethical) disparities that are likely to increase once elective programs will gradually re-open. There is ample evidence that the post-pandemic elective landscape will be characterized by increasing elective fees, and a more competitive seat-to-applicant ratio. Ethical problems for international electives arising from an unequal global vaccine distribution will pose an additional challenge to students and elective coordinators alike.

Conclusion
The COVID-19 pandemic transformed the international medical elective landscape in an unprecedented way, and future generations of medical students will face a series of additional challenges when applying for global medical electives.
Ultrasound localization of central vein catheter tip by contrast-enhanced transthoracic ultrasonography: a comparison study with trans-esophageal echocardiography
Authors: Corradi Francesco , Guarracino Fabio , Santori Gregorio , Brusasco Claudia , Tavazzi Guido , Via Gabriele , Mongodi Silvia , Mojoli Francesco , Biagini Raffaello Umberto Dario , Isirdi Alessandro , Dazzi Federico , Robba Chiara , Vetrugno Luigi , Forfori Francesco ,   UCARE research group, Bologna Maria Lidia , Cardu Alessandro , Crocetti Laura , Cundari Francesco , Del Frate Elisa , Ferrari Samuele , Laffi Alberto , Marrucci Elena , Monfroni Marco , Piagnani Chiara , Taddei Erika , Tecchi Ludovica , Tempini Sara , Tognarelli Debora , Vullo Carmelo 
Published: April 2022

Abstract
Background
To assess the usefulness of pre-operative contrast-enhanced transthoracic echocardiography (CE-TTE) and post-operative chest-x-ray (CXR) for evaluating central venous catheter (CVC) tip placements, with trans-esophageal echocardiography (TEE) as gold standard.

Methods
A prospective single-center, observational study was performed in 111 patients requiring CVC positioning into the internal jugular vein for elective cardiac surgery. At the end of CVC insertion by landmark technique, a contrast-enhanced TTE was performed by both the apical four-chambers and epigastric bicaval acoustic view to assess catheter tip position; then, a TEE was performed and considered as a reference technique. A postoperative CXR was obtained for all patients.

Results
As per TEE, 74 (67%) catheter tips were correctly placed and 37 (33%) misplaced. Considering intravascular and intracardiac misplacements together, they were detected in 8 patients by CE-TTE via apical four-chamber view, 36 patients by CE-TTE via epigastric bicaval acoustic view, and 12 patients by CXR. For the detection of catheter tip misplacement, CE-TTE via epigastric bicaval acoustic view was the most accurate method providing 97% sensitivity, 90% specificity, and 92% diagnostic accuracy if compared with either CE-TTE via apical four-chamber view or CXR. Concordance with TEE was 79% (p < 0.001) for CE-TTE via epigastric bicaval acoustic view.

Conclusions
The concordance between CE-TTE via epigastric bicaval acoustic view and TEE suggests the use of the former as a standard technique to ensure the correct positioning of catheter tip after central venous cannulation to optimize the use of hospital resources and minimize radiation exposure.
Major adverse limb events in patients with femoro-popliteal and below-the-knee peripheral arterial disease treated with either sirolimus-coated balloon or standard uncoated balloon angioplasty: a structured protocol summary of the “SirPAD” randomized controlled trial
Authors: Barco Stefano , Sebastian Tim , Voci Davide , Engelberger Rolf Peter , Grigorean Alexandru , Holy Erik , Leeger Claudia , Münger Mario , Périard Daniel , Probst Eliane , Spescha Rebecca , Held Ulrike , Kucher Nils 
Published: April 2022

Abstract
Background
Peripheral arterial disease is a progressive atherosclerotic disease with symptoms ranging from an intermittent claudication to acute critical limb ischemia and amputations. Drug-coated balloons and stents were developed to prevent neo-intimal proliferation and restenosis after percutaneous transluminal angioplasty. Randomized controlled trials showed that drug-coated, notably paclitaxel-coated, devices reduce restenosis, late lumen loss, and the need for target lesion re-vascularization compared with uncoated ones. However, the size of these trials was too small to prove superiority for “hard” clinical outcomes. Moreover, available studies were characterized by too restrictive eligibility criteria. Finally, it remains unclear whether paclitaxel-coated balloons may impair long-term survival. Alternative drug-coated balloons, the so-called limus-based analogs, have been approved for clinical use in patients with peripheral arterial disease. By encapsulating sirolimus in phospholipid drug nanocarriers, they optimize adhesion properties of sirolimus and provide better bioavailability.

Methods
In this investigator-initiated all-comer open-label phase III randomized controlled trial, we will evaluate whether sirolimus-coated balloon angioplasty is non-inferior and eventually superior, according to a predefined hierarchical analysis, to uncoated balloon angioplasty in adults with infra-inguinal peripheral arterial disease requiring endovascular angioplasty. Key exclusion criteria are pregnancy or breastfeeding, known intolerance or allergy to sirolimus, and participation in a clinical trial during the previous 3 months. The primary efficacy outcome is the composite of two clinically relevant non-subjective “hard” outcomes: unplanned major amputation of the target limb and endovascular or surgical target lesion re-vascularization for critical limb ischemia occurring within 1 year of randomization. The primary safety outcome includes death from all causes.

Discussion
By focusing on clinically relevant outcomes, this study will provide useful information on the efficacy and safety of sirolimus-coated balloon catheters for infra-inguinal peripheral arterial disease in a representative (“all-comer”) population of unselected patients. As regulatory agencies had raised safety concerns in patients exposed to paclitaxel-coated devices (versus uncoated ones), collect mortality data up to 5 years after randomization will be collected.

Trial registration
ClinicalTrials.govNCT04238546
Development of a PET/CT molecular radiomics-clinical model to predict thoracic lymph node metastasis of invasive lung adenocarcinoma ≤ 3 cm in diameter
Authors: Chang Cheng , Ruan Maomei , Lei Bei , Yu Hong , Zhao Wenlu , Ge Yaqiong , Duan Shaofeng , Teng Wenjing , Wu Qianfu , Qian Xiaohua , Wang Lihua , Yan Hui , Liu Ciyi , Liu Liu , Feng Jian , Xie Wenhui 
Published: April 2022

Abstract
Background
To investigate the value of 18F-FDG PET/CT molecular radiomics combined with a clinical model in predicting thoracic lymph node metastasis (LNM) in invasive lung adenocarcinoma (≤ 3 cm).

Methods
A total of 528 lung adenocarcinoma patients were enrolled in this retrospective study. Five models were developed for the prediction of thoracic LNM, including PET radiomics, CT radiomics, PET/CT radiomics, clinical and integrated PET/CT radiomics-clinical models. Ten PET/CT radiomics features and two clinical characteristics were selected for the construction of the integrated PET/CT radiomics-clinical model. The predictive performance of all models was examined by receiver operating characteristic (ROC) curve analysis, and clinical utility was validated by nomogram analysis and decision curve analysis (DCA).

Results
According to ROC curve analysis, the integrated PET/CT molecular radiomics-clinical model outperformed the clinical model and the three other radiomics models, and the area under the curve (AUC) values of the integrated model were 0.95 (95% CI: 0.93–0.97) in the training group and 0.94 (95% CI: 0.89–0.97) in the test group. The nomogram analysis and DCA confirmed the clinical application value of this integrated model in predicting thoracic LNM.

Conclusions
The integrated PET/CT molecular radiomics-clinical model proposed in this study can ensure a higher level of accuracy in predicting the thoracic LNM of clinical invasive lung adenocarcinoma (≤ 3 cm) compared with the radiomics model or clinical model alone.
High resolution detectors for whole-body PET scanners by using dual-ended readout
Authors: Liu Zheng , Niu Ming , Kuang Zhonghua , Ren Ning , Wu San , Cong Longhan , Wang Xiaohui , Sang Ziru , Williams Crispin , Yang Yongfeng 
Published: April 2022

Abstract
Background
Most current whole-body positron emission tomography (PET) scanners use detectors with high timing resolution to measure the time-of-flight of two 511 keV photons, improving the signal-to-noise ratio of PET images. However, almost all current whole-body PET scanners use detectors without depth-encoding capability; therefore, their spatial resolution can be affected by the parallax effect.

Methods
In this work, four depth-encoding detectors consisting of LYSO arrays with crystals of 2.98 × 2.98 × 20 mm3, 2.98 × 2.98 × 30 mm3, 1.95 × 1.95 × 20 mm3, and 1.95 × 1.95 × 30 mm3, respectively, were read at both ends, with 6 × 6 mm2 silicon photomultiplier (SiPM) pixels in a 4 × 4 array being used. The timing signals of the detectors were processed individually using an ultrafast NINO application-specific integrated circuit (ASIC) to obtain good timing resolution. The 16 energy signals of the SiPM array were read using a row and column summing circuit to obtain four position-encoding energy signals.

Results
The four PET detectors provided good flood histograms in which all crystals could be clearly resolved, the crystal energy resolutions measured being 10.2, 12.1, 11.4 and 11.7% full width at half maximum (FWHM), at an average crystal depth of interaction (DOI) resolution of 3.5, 3.9, 2.7, and 3.0 mm, respectively. The depth dependence of the timing of each SiPM was measured and corrected, the timing of the two SiPMs being used as the timing of the dual-ended readout detector. The four detectors provided coincidence time resolutions of 180, 214, 239, and 263 ps, respectively.

Conclusions
The timing resolution of the dual-ended readout PET detector was approximately 20% better than that of the single-ended readout detector using the same LYSO array, SiPM array, and readout electronics. The detectors developed in this work used long crystals with small cross-sections and provided good flood histograms, DOI, energy, and timing resolutions, suggesting that they could be used to develop whole-body PET scanners with high sensitivity, uniform high spatial resolution, and high timing resolution.
Consumer lending efficiency: commercial banks versus a fintech lender
Authors: Hughes Joseph P. , Jagtiani Julapa , Moon Choon-Geol 
Published: April 2022

AbstractFintechs are believed to help expand credit access to underserved consumers without taking on additional risk. We compare the performance efficiency of LendingClub’s unsecured personal loans with similar loans originated by banks. Using stochastic frontier estimation, we decompose the observed nonperforming loan (NPL) ratio into three components: the best-practice minimum NPL ratio, the excess NPL ratio, and a statistical noise, the former two of which reflect the lender’sinherent credit riskandlending inefficiency, respectively. As of 2013 and 2016, we find that the higher NPL ratios at the largest banks are driven by inherent credit risk, rather than lending inefficiency. Smaller banks are less efficient. In addition, as of 2013, LendingClub’s observed NPL ratio and lending efficiency were in line with banks with similar lending volume. However, its lending efficiency improved significantly from 2013 to 2016. As of 2016, LendingClub’s performance resembled the largest banks – consistent with an argument that its increased use of alternative data and AI/ML may have improved its credit risk assessment capacity above and beyond its peers using traditional approaches. Furthermore, we also investigate capital market incentives for lenders to take credit risk. Market value regression using the NPL ratio suggests that market discipline provides incentives to make less risky consumer loans. However, the regression using twodecomposed components(inherent credit risk and lending inefficiency) tells a deeper underlying story: market value is significantly positively related to inherent credit risk at most banks, whereas it is significantly negatively related to lending inefficiency at most banks.Market discipline appears to reward exposure to inherent credit risk and punish inefficient lending.
Findings of uncertain significance by optical coherence tomography (OCT) as prognostic factors in neovascular age-related macular degeneration (nAMD) treated with ranibizumab
Authors: Hayashi-Mercado Ricardo , Pérez-Montaño Carla , Reyes-Sánchez Jaime , Ramírez-Estudillo Abel 
Published: April 2022

Abstract
Background
Biomarkers hold great promise for personalized medicine as information gained from diagnostic or progression markers can be used to tailor treatment to the individual for highly effective intervention in the disease process.

Methods
The aim of this retrospective study was to evaluate the association between visual outcome and the presence of findings of uncertain significance by optical coherence tomography (OCT) pre and post loading dose in patients with neovascular age-related macular degeneration (nAMD) treated with ranibizumab.

Results
Univariate analysis revealed a higher letter gain in those with presence of onion sign (+ 5.6 ETDRS letters, p = 0.04) absence of prechoroidal cleft (+ 3.7 ETDRS letters, p = 0.04), intraretinal pseudocysts (+4.8 ETDRS letters, p = 0.002), subretinal pseudocysts (+ 4.6 ETDRS letters, p = 0.005) and choroidal caverns (+ 4.4 ETDRS, letters p = 0.0065).

Conclusions
The presence of prechoroidal cleft, intraretinal and subretinal pseudocysts and choroidal caverns were associated with lower visual gains. Moreover, we found that the onion sign is related as a biomarker of good prognostics.
Trial registration Registration number: 2021R13B2. Date of registration: 01/05/2020
Obstructive shock due to tracheal perforation following long-term placement of a tracheostomy tube in a pediatric patient: a case report
Authors: Sakai Wataru , Nawa Yuko , Junichi Oba 
Published: April 2022

Abstract
Background
Tracheal perforation, although rare, is a known late complication of tracheostomy tube placement.

Case presentation
We present a 7-year-old boy with severe physical and mental disabilities under tracheostomy and long-term mechanical ventilation and steroid therapy who suddenly developed obstructive shock secondary to pneumomediastinum and pneumothorax. Prior bronchoscopy had shown the tip of the tracheostomy tube contacting the posterior tracheal wall, causing ulceration and subsequent tracheal perforation. The perforation was bridged using a cuffed tracheostomy tube, but the patient subsequently died of additional comorbidities.

Conclusions
Our experience suggests that tracheal perforation should be considered when pediatric patients with tracheostomy tubes suddenly develop hypotension.