bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating Dynamic Tor Onion Services for Privacy Preserving Distributed Digital Identity Systems
Authors: Höller Tobias , Roland Michael , Mayrhofer René 
Published: March 2022

Digital identity documents provide several key benefits over physical ones. They can be created more easily, incur less costs, improve usability and can be updated if necessary. However, the deployment of digital identity systems does come with several challenges regarding both security and privacy of personal information. In this paper, we highlight one challenge that digital identity systems face if they are set up in a distributed fashion: Network Unlinkability. We discuss why network unlinkability is so critical for a distributed digital identity system that wants to protect the privacy of its users and present a specific definition of unlinkability for our use-case. Based on this definition, we propose a scheme that utilizes the Tor network to achieve the required level of unlinkability by dynamically creating onion services and evaluate the feasibility of our approach by measuring the deployment times of onion services.
Perspectives of individuals with sickle cell disease on barriers to care
Authors: Phillips Shannon , Chen Yumei , Masese Rita , Noisette Laurence , Jordan Kasey , Jacobs Sara , Hsu Lewis L. , Melvin Cathy L. , Treadwell Marsha , Shah Nirmish , Tanabe Paula , Kanter Julie 
Published: March 2022

Introduction
Sickle cell disease (SCD) is an inherited hemoglobinopathy that predominantly affects African Americans in the United States. The disease is associated with complications leading to high healthcare utilization rates, including emergency department (ED) visits and hospitalizations. Optimal SCD care requires a multidisciplinary approach involving SCD specialists to ensure preventive care, minimize complications and prevent unnecessary ED visits and hospitalizations. However, most individuals with SCD receive sub-optimal care or are unaffiliated with care (have not seen an SCD specialist). We aimed to identify barriers to care from the perspective of individuals with SCD in a multi-state sample.

Methods
We performed a multiple methods study consisting of surveys and interviews in three comprehensive SCD centers from March to June 2018. Interviews were transcribed and coded, exploring themes around barriers to care. Survey questions on the specific themes identified in the interviews were analyzed using summary statistics.

Results
We administered surveys to 208 individuals and conducted 44 in-depth interviews. Barriers to care were identified and classified according to ecological level (i.e., individual, family/interpersonal, provider, and socio-environmental/organizational level). Individual-level barriers included lack of knowledge in self-management and disease severity. Family/interpersonal level barriers were inadequate caregiver support and competing life demands. Provider level barriers were limited provider knowledge, provider inexperience, poor provider-patient relationship, being treated differently, and the provider’s lack of appreciation of the patient’s SCD knowledge. Socio-environmental/organizational level barriers included limited transportation, lack of insurance, administrative barriers, poor care coordination, and reduced access to care due to limited clinic availability, services provided or clinic refusal to provide SCD care.

Conclusion
Participants reported several multilevel barriers to SCD care. Strategies tailored towards reducing these barriers are warranted. Our findings may also inform interventions aiming to locate and link unaffiliated individuals to care.
Brucellosis testing patterns at health facilities in Arusha region, northern Tanzania
Authors: Lukambagire AbdulHamid Settenda , Shirima Gabriel Mkulima , Shayo Damas Davis , Mathew Coletha , Yapi Richard B. , Kasanga Christopher Julius , Mmbaga Blandina Theophile , Kazwala Rudovick Reuben , Halliday Jo E. B. 
Published: March 2022

Background
Brucellosis is listed as one of six priority zoonoses in Tanzania’s One Health strategic plan which highlights gaps in data needed for the surveillance and estimation of human brucellosis burdens. This study collected data on current testing practices and test results for human brucellosis in Arusha region, northern Tanzania.

Methods
Retrospective data were extracted from records at 24 health facilities in Arusha region for the period January 2012 to May 2018. Data were captured on: the test reagents used for brucellosis, procurement and testing protocols, the monthly number of patients tested for brucellosis and the monthly number testing positive. Generalised linear mixed models were used to evaluate relationships between health facility characteristics and the probability that brucellosis testing was conducted in a given month, and the proportion of individuals testing positive.

Results
Four febrile Brucella agglutination tests were used widely. The probability of testing for brucellosis in a given month was significantly associated with an interaction between year of testing and facility ownership. Test probability increased over time with more pronounced increases in privately owned as compared to government facilities. The proportion of individuals testing positive for brucellosis was significantly associated with facility type and district, with individuals tested in hospitals in Meru, Monduli and Ngorongoro districts more likely to test positive.

Conclusions
Febrile Brucella agglutination tests, known for their poor performance, were the mainstay of brucellosis testing at health facilities in northern Tanzania. The study indicates that historical data on human brucellosis in Arusha and other regions are likely to provide an inaccurate measure of true disease burden due to poor performance of the tests used and variation in testing practices. Measures to address these identified shortcomings could greatly improve quality of testing and surveillance data on brucellosis and ultimately inform prevention and control of this priority disease.
The effects of others’ drinking on the harms to children in Thailand: Lessons from the WHO-ThaiHealth project
Authors: Preampruchcha Perawas , Suwanno Nattapong , Petchana Butpetch , Kuemee Tirada , Tanaree Athip , Nontarak Jiraluck , Balthip Karnsunaphat , Ratworawong Khemanat , Hayiyani Narisa , Oumudee Nurtasneam , Maneemai Ongart , Waleewong Orratai , Chotipanvithayakul Rassamee , Nasueb Sopit , Rungruang Supeecha , Chaiyasong Surasak , Saokaew Surasak , Intanont Tanomsri , Donraman Teerohah , Saengow Udomsak , Duangpaen Warangkhana , Bunyanukul Warintorn , Vichitkunakorn Polathep 
Published: March 2022

Background
Many knowledge gaps exist in the area of alcohol-related harms in children research such as the potential impact of other’s drinking and their social demography. Thus, this study aims to evaluate the effects of characteristics of household members and others’ alcohol drinking on harms to children in Thailand.

Data and methods
This study examined 952 parents caring for children and adolescents under 18 years of age, using the questionnaire (i.e., The Harm to Others from Drinking under the WHO/ThaiHealth International Collaboration Research Project). They were interviewed between September 2012 and March 2013.

Results
The study found that 15.89% of children and young people were affected by someone’s drinking in at least one category of harms. People over 60 years of age were less likely to cause alcohol-related harm to children than those aged 18 to 29 (adjusted odds ratio [AOR] 0.19, 95% confidence interval [Cl]: 0.06–0.58). Households with a binge drinker or regular drinker (≥1 time/week) were more likely to have children at higher risk of suffering alcohol-related harm in comparison to households without alcohol drinker (AOR 4.75 and 1.92, respectively).

Conclusion
This study found that children whose family members are young adult or consume alcohol (i.e., weekly drinker or binge drinker) were significantly adversely affected. The most common problems were domestic violence and verbal abuse. Most of the problems, affecting children, were caused mostly by their parents.
Performance of the Universal Vital Assessment (UVA) mortality risk score in hospitalized adults with infection in Rwanda: A retrospective external validation study
Authors: Hazard Riley , Bagenda Danstan , Patterson Andrew J. , Hoffman Julia T. , Lisco Steven J. , Urayeneza Olivier , Ntihinyurwa Polyphile , Moore Christopher C. 
Published: March 2022

Background
We previously derived a Universal Vital Assessment (UVA) score to better risk-stratify hospitalized patients in sub-Saharan Africa, including those with infection. Here, we aimed to externally validate the performance of the UVA score using previously collected data from patients hospitalized with acute infection in Rwanda.

Methods
We performed a secondary analysis of data collected from adults ≥18 years with acute infection admitted to Gitwe District Hospital in Rwanda from 2016 until 2017. We calculated the UVA score from the time of admission and at 72 hours after admission. We also calculated quick sepsis-related organ failure assessment (qSOFA) and modified early warning scores (MEWS). We calculated amalgamated qSOFA scores by inserting UVA cut-offs into the qSOFA score, and modified UVA scores by removing the HIV criterion. The performance of each score determined by the area under the receiver operator characteristic curve (AUC) was the primary outcome measure.

Results
We included 573 hospitalized adult patients with acute infection of whom 40 (7%) died in-hospital. The admission AUCs (95% confidence interval [CI]) for the prediction of mortality by the scores were: UVA, 0.77 (0.68–0.85); modified UVA, 0.77 (0.68–0.85); qSOFA, 0.66 (0.56–0.75), amalgamated qSOFA, 0.71 (0.61–0.80); and MEWS, 0.74 (0.64, 0.83). The positive predictive values (95% CI) of the scores at commonly used cut-offs were: UVA >4, 0.35 (0.15–0.59); modified UVA >4, 0.35 (0.15–0.59); qSOFA >1, 0.14 (0.07–0.24); amalgamated qSOFA >1, 0.44 (0.20–0.70); and MEWS >5, 0.14 (0.08–0.22). The 72 hour (N = 236) AUC (95% CI) for the prediction of mortality by UVA was 0.59 (0.43–0.74). The Chi-Square test for linear trend did not identify an association between mortality and delta UVA score at 72 hours (p = 0.82).

Conclusions
The admission UVA score and amalgamated qSOFA score had good predictive ability for mortality in adult patients admitted to hospital with acute infection in Rwanda. The UVA score could be used to assist with triage decisions and clinical interventions, for baseline risk stratification in clinical studies, and in a clinical definition of sepsis in Africa.
Incidence of Lyme disease in the United Kingdom and association with fatigue: A population-based, historical cohort study
Authors: Brellier Florence , Pujades-Rodriguez Mar , Powell Emma , Mudie Kathleen , Mattos Lacerda Eliana , Nacul Luis , Wing Kevin 
Published: March 2022

Background
Estimations of Lyme disease incidence rates in the United Kingdom vary. There is evidence that this disease is associated with fatigue in its early stage but reports are contradictory as far as long-term fatigue is concerned.

Methods and findings
A population-based historical cohort study was conducted on patients treated in general practices contributing to IQVIA Medical Research Data: 2,130 patients with a first diagnosis of Lyme disease between 2000 and 2018 and 8,510 randomly-sampled patients matched by age, sex, and general practice, followed-up for a median time of 3 years and 8 months. Main outcome measure was time to consultation for (1) any fatigue-related symptoms or diagnosis; or (2) myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). Adjusted hazard ratios (HRs) were estimated from Cox models. Average incidence rate for Lyme disease across the UK was 5.18 per 100,000 person-years, increasing from 2.55 in 2000 to 9.33 in 2018. In total, 929 events of any types of fatigue were observed, leading to an incidence rate of 307.90 per 10,000 person-years in the Lyme cohort (282 events) and 165.60 in the comparator cohort (647 events). Effect of Lyme disease on any subsequent fatigue varied by index season: adjusted HRs were the highest in autumn and winter with 3.14 (95%CI: 1.92–5.13) and 2.23 (1.21–4.11), respectively. For ME/CFS, 17 events were observed in total. Incidence rates were 11.76 per 10,000 person-years in Lyme patients (12 events) and 1.20 in comparators (5 events), corresponding to an adjusted HR of 16.95 (5.17–55.60). Effects were attenuated 6 months after diagnosis but still clearly visible.

Conclusions
UK primary care records provided strong evidence that Lyme disease was associated with subsequent fatigue and ME/CFS. Albeit weaker on the long-term, these effects persisted beyond 6 months, suggesting patients and healthcare providers should remain alert to fatigue symptoms months to years following Lyme disease diagnosis.
Galectin-1 and -3 in high amounts inhibit angiogenic properties of human retinal microvascular endothelial cells in vitro
Authors: Hillenmayer Anna , Wertheimer Christian M. , Geerlof Arie , Eibl Kirsten H. , Priglinger Siegfried , Priglinger Claudia , Ohlmann Andreas 
Published: March 2022

Purpose
Galectin-1 and -3 are β-galactoside binding lectins with varying effects on angiogenesis and apoptosis. Since in retinal pigment epithelial cells high amounts of human recombinant galectin (hr-GAL)1 and 3 inhibit cell adhesion, migration and proliferation, we investigated if hr-GAL1 and 3 have homologous effects on human retinal microvascular endothelial cells (HRMEC) in vitro.

Methods
To investigate the effect of galectin-1 and -3 on HRMEC, proliferation, apoptosis and viability were analyzed after incubation with 30, 60 and 120 μg/ml hr-GAL1 or 3 by BrdU-ELISA, histone-DNA complex ELISA, live/dead staining and the WST-1 assay, respectively. Further on, a cell adhesion as well as tube formation assay were performed on galectin-treated HRMEC. Migration was investigated by the scratch migration assay and time-lapse microscopy. In addition, immunohistochemical staining on HRMEC for β-catenin, galectin-1 and -3 were performed and β-catenin expression was investigated by western blot analysis.

Results
Incubation with hr-GAL1 or 3 lead to a decrease in proliferation, migration, adhesion and tube formation of HRMEC compared to the untreated controls. No toxic effects of hr-GAL1 and 3 on HRMEC were detected. Intriguingly, after treatment of HRMEC with hr-GAL1 or 3, an activation of the proangiogenic Wnt/β-catenin signaling pathway was observed. However, incubation of HRMEC with hr-GAL1 or 3 drew intracellular galectin-1 and -3 out of the cells, respectively.

Conclusion
Exogenously added hr-GAL1 or 3 inhibit angiogenic properties of HRMEC in vitro, an effect that might be mediated via a loss of intracellular endogenous galectins.
Knowledge of hepatitis C and awareness of reinfection risk among people who successfully completed direct acting antiviral therapy
Authors: Yazdani Kiana , Dolguikh Katerina , Zhang Wendy , Shayegi-Nik Sara , Ly Jessica , Cooper Shaughna , Trigg Jason , Bartlett Sophia , Barrios Rolando , Montaner Julio S. G. , Salters Kate 
Published: March 2022

Background
Hepatitis C virus (HCV) education may be changing following the simplification of HCV treatment and emergence of direct acting antiviral (DAA). We aimed to characterize HCV knowledge among people who recently completed DAA therapy.

Methods
The Per-SVR (Preservation of Sustained Virologic Response) is a prospective cohort of patients who achieved a sustained virologic response upon successful completion of DAA therapy. The per-SVR study provided the sampling frame of participants who completed a psychometrically validated 19-item HCV knowledge scale at cohort entry (n = 227). To score the questionnaire, for each correct response one point was awarded, with no point for incorrect response. We assessed mean HCV knowledge score in the overall sample and mutually exclusive populations: people who inject drug (PWID) (n = 71); people with co-occurring HIV (n = 23); PWID and co-occurring HIV (n = 29), and others (n = 104) Using a latent class analysis based on distal outcome, we identified unobserved subgroups and assessed HCV knowledge amongst them.

Results
Total mean (SD) percent of correct responses were 83 (11) in the overall sample; 83 (10) in PWID; 79 (12) in people with co-occurring HIV; 81 (10) in PWID and co-occurring HIV, and 84 (11) in rest of the sample Three latent groups were identified: baby boomers who ever experienced homelessness (n = 126); women sex workers who ever experienced homelessness (n = 68); men who inject drug, ever experienced homelessness and had ever diagnosis of mental health disorders (n = 18). Mean percent of correct responses were 85 (8), 82 (11), 85 (10), in latent class 1, 2, and 3, respectively.

Conclusion
Patients successfully treated with DAAs had a high HCV knowledge. High knowledge and awareness of reinfection among complex patient groups often facing barriers to HCV care is encouraging and emphasizes the positive outcomes of universal access to treatment.
Factors associated with community acquired severe pneumonia among under five children in Dhaka, Bangladesh: A case control analysis
Authors: Nasrin Sabiha , Tariqujjaman Md. , Sultana Marufa , Zaman Rifat A. , Ali Shahjahan , Chisti Mohammod J. , Faruque Abu S. G. , Ahmed Tahmeed , Fuchs George J. , Gyr Niklaus , Alam Nur H. 
Published: March 2022

Background
Pneumonia is the leading cause of death in children globally with the majority of these deaths observed in resource-limited settings. Globally, the annual incidence of clinical pneumonia in under-five children is approximately 152 million, mostly in the low- and middle-income countries. Of these, 8.7% progressed to severe pneumonia requiring hospitalization. However, data to predict children at the greatest risk to develop severe pneumonia from pneumonia are limited.

Method
Secondary data analysis was performed after extracting relevant data from a prospective cluster randomized controlled clinical trial; children of either sex, aged two months to five years with pneumonia or severe pneumonia acquired in the community were enrolled over a period of three years in 16 clusters in urban Dhaka city.

Results
The analysis comprised of 2,597 children aged 2–59 months. Of these, 904 and 1693 were categorized as pneumonia (controls) and severe pneumonia (cases), respectively based on WHO criteria. The median age of children was 9.2 months (inter quartile range, 5.1–17.1) and 1,576 (60%) were male. After adjustment for covariates, children with temperature ≥38°C, duration of illness ≥3 days, male sex, received prior medical care and severe stunting showed a significantly increased likelihood of developing severe pneumonia compared to those with pneumonia. Severe pneumonia in children occurred more often in older children who presented commonly from wealthy quintile families, and who often sought care from private facilities in urban settings.

Conclusion and recommendation
Male sex, longer duration of illness, fever, received prior medical care, and severe stunting were significantly associated with development of WHO-defined severe childhood pneumonia in our population. The results of this study may help to develop interventions target to reduce childhood morbidity and mortality of children suffering from severe pneumonia.
Chemotaxis-Stokes interaction with very weak diffusion enhancement: Blow-up exclusion via detection of absorption-induced entropy structures involving multiplicative couplings
Authors: Winkler Michael 
Published: March 2022

AbstractThe chemotaxis–Stokes systemnt+u⋅∇n=∇⋅(D(n)∇n)−∇⋅(nS(x,n,c)⋅∇c),ct+u⋅∇c=Δc−nc,ut=Δu+∇P+n∇Φ,∇⋅u=0,\left\{\begin{array}{l}{n}_{t}+u\cdot \nabla n=\nabla \cdot (D\left(n)\nabla n)-\nabla \cdot (nS\left(x,n,c)\cdot \nabla c),\\ {c}_{t}+u\cdot \nabla c=\Delta c-nc,\\ {u}_{t}=\Delta u+\nabla P+n\nabla \Phi ,\hspace{1.0em}\nabla \cdot u=0,\end{array}\right.is considered in a smoothly bounded convex domainΩ⊂R3\Omega \subset {{\mathbb{R}}}^{3}, with given suitably regular functionsD:[0,∞)→[0,∞)D:{[}0,\infty )\to {[}0,\infty ),S:Ω¯×[0,∞)×(0,∞)→R3×3S:\overline{\Omega }\times {[}0,\infty )\times \left(0,\infty )\to {{\mathbb{R}}}^{3\times 3}andΦ:Ω¯→R\Phi :\overline{\Omega }\to {\mathbb{R}}such thatD>0D\gt 0on(0,∞)\left(0,\infty ). It is shown that if with some nondecreasingS0:(0,∞)→(0,∞){S}_{0}:\left(0,\infty )\to \left(0,\infty )we have∣S(x,n,c)∣≤S0(c)c12for all(x,n,c)∈Ω¯×[0,∞)×(0,∞),| S\left(x,n,c)| \le \frac{{S}_{0}\left(c)}{{c}^{\tfrac{1}{2}}}\hspace{1.0em}\hspace{0.1em}\text{for all}\hspace{0.1em}\hspace{0.33em}\left(x,n,c)\in \overline{\Omega }\times {[}0,\infty )\times \left(0,\infty ),then for allM>0M\gt 0there existsL(M)>0L\left(M)\gt 0such that wheneverliminfn→∞D(n)>L(M)andliminfn↘0D(n)n>0,\mathop{\mathrm{liminf}}\limits_{n\to \infty }D\left(n)\gt L\left(M)\hspace{1.0em}\hspace{0.1em}\text{and}\hspace{0.1em}\hspace{1.0em}\mathop{\mathrm{liminf}}\limits_{n\searrow 0}\frac{D\left(n)}{n}\gt 0,for all sufficiently regular initial data(n0,c0,u0)\left({n}_{0},{c}_{0},{u}_{0})fulfilling‖c0‖L∞(Ω)≤M\Vert {c}_{0}{\Vert }_{{L}^{\infty }\left(\Omega )}\le Man associated no-flux/no-flux/Dirichlet initial-boundary value problem admits a global bounded weak solution, classical if additionallyD(0)>0D\left(0)\gt 0. When combined with previously known results, this particularly implies global existence of bounded solutions whenD(n)=nm−1D\left(n)={n}^{m-1},n≥0n\ge 0, with arbitrarym>1m\gt 1, but beyond this asserts global boundedness also in the presence of diffusivities which exhibit arbitrarily slow divergence to+∞+\inftyat large densities and of possibly singular chemotactic sensitivities.
Effect of the genetic mutant G71R in uridine diphosphate-glucuronosyltransferase 1A1 on the conjugation of bilirubin
Authors: Chen Hong , Zhong Danni , Gao Zongyan , Wu Xiaojing 
Published: March 2022

Abstract
We aimed to investigate the effect of the genetic mutant G71R (c. 211G > A) in uridine diphosphate (UDP)-glucuronosyltransferase 1A1 (UGT1A1) on the glucuronidation of unconjugated bilirubin. The UGT1A1 wild-type and mutant G71R gene sequences were inserted into the lentiviral vector GV358 plasmid and then transfected into COS-7 cells. Real-time polymerase chain reaction and western blot analyses were used to determine mRNA and protein expression levels of UGT1A1, respectively. High-performance liquid chromatography was used to quantitate the levels of conjugated bilirubin. The results showed no significant difference in the mRNA and protein expression levels between the UGT1A1 wild-type and G71R homozygous and heterozygous mutants. The level of conjugated bilirubin reached a maximum in wild-type UGT1A1-transfected COS-7 cells. However, relative to the UGT1A1 wild-type, conjugated bilirubin concentrations were 71 and 22% with G71R heterozygous- and G71R homozygous-transfected COS-7 cells, respectively. In conclusion, we successfully established in vitro cell models of the UGT1A1 wild-type and the G71R homozygous and heterozygous mutants using a lentiviral vector. Furthermore, the catalytic activity for unconjugated bilirubin was lower in the mutant G71R than the UGT1A1 wild-type enzyme, and a weaker effect was observed in the homozygote.