bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical and Sociodemographic Characteristics Associated with Emergency Peripartum Hysterectomy due to Puerperal Sepsis in Malawi
Authors: Stokes Mary , Olson Amber , Algeo Clare , Rajab Bakari , Mwalwanda Carolyn , Dongarwar Deepa , Pope Rachel 
Published: June 2022

Background and Objective: In Malawi, emergency peripartum hysterectomy continues to be routine for the management of puerperal sepsis. While the hysterectomy may be life-saving for the mother, it carries with it life-altering permanent sterility. The surgeon is left with a difficult dilemma: remove the infection source (uterus) to preserve the life of the patient at the cost of her fertility, or preserve the uterus and fertility but risk worsening infection and possible death for the patient. The objective of this study was to (1) identify characteristics associated with mortality post-laparotomy due to puerperal sepsis and (2) identify characteristics associated with emergency peripartum hysterectomy in the management of puerperal sepsis.
Methods: In this retrospective chart review, we obtained medical records of patients who underwent laparotomy secondary to puerperal sepsis at a tertiary hospital in Lilongwe, Malawi. Data collected included demographic information and clinical findings. These data were compared between women with and without adverse outcomes. Chi-squared tests were used to determine if there were significant relationships between variables and outcomes.
Results: Fifty-eight patient records met inclusion criteria. The following characteristics were significantly associated with mortality: age greater than 30, multiparity, vaginal delivery, and intensive care unit admission. Cesarean delivery and an intraoperative finding of necrosis were significantly associated with hysterectomy.
Conclusion and Global Health Implications: Emergency peripartum hysterectomy in the setting of puerperal sepsis is a significant source of maternal morbidity and mortality. To prevent emergency peripartum hysterectomy, it is important to have prompt recognition and treatment of puerperal sepsis, to have access to adequate antibiotics, and to have standards to guide the role of hysterectomy as the definitive and necessary treatment for puerperal sepsis.

Copyright © 2022 Stokes et al. Published by Global Health and Education Projects, Inc. This is an open-access article distributed under the terms of the Creative Commons Attribution License CC BY 4.0.
Performance evaluation of Fenton based processes in reducing COD of the petroleum effluents using the waste of steel slag
Authors: Etemadiasl Fatemeh , Tishehzan Parvaneh , Kashefipour Seyed Mahmood , Haaghighifard Nematolah Jaafarzadeh 
Published: June 2022

Abstract
Petroleum effluents pollution is an important challenge for many countries. The aim of this study was to investigate the efficiency of Fenton, Photo-Fenton (PF), Electro-Fenton (EF) and Photo-Electro-Fenton (PEF) processes in reducing chemical oxygen demand (COD) of desalination unit effluent using steel slag as catalyst, cathode and anode. For achieving this goal the experimental design by Taguchi method using Mintab18 software was used. The desired variables include pH (3, 5 and 7), hydrogen peroxide (5, 10 and 15 mmol/l), contact time (30, 60 and 90 min), catalyst (5, 7.5 and 10 g/L), radiant intensity (16, 24 and 32 W) and voltage (5, 15 and 30 V). In order to perform the experiments, the pilot was made using UV-C lamps (wavelengths of 200–280 nm) each with a power of 8 W and an AC power supply of 0–30 V in the range of 0–2 A. According to the results, PEF process under pH = 7, 10 mmol/l hydrogen peroxide, catalyst content of 5 g/L, radiant intensity of 24 W and voltage of 5 V for 90 min, provides the highest COD removal rate (98.7%). The present study showed that following the combined process of PEF, EF, PF and Fenton processes have a high potential in reducing COD using steel slag.
De novo full length transcriptome analysis and gene expression profiling reveal the regulation of phenylethanol glycosides biosynthesis in Cistanche tubulosa
Authors: Hou Lei , Li Guanghui , Chen Qingliang , Zhao JinJin , Pan Jiaowen , Lin Ruxia , Zhu Xiujin , Wang Pengfei , Wang Xingjun 
Published: June 2022

Abstract
Background
Cistanche as a famous tonic Chinese traditional medicine, is known as "desert ginseng". Its dried fleshy stem is a crucial tonic in Chinese traditional medicine, and the main active pharmacodynamic components are phenylethanol glycosides. Cistanche tubulosa is more suitable for cultivation and extracting active ingredients because it produces higher level of phenylethanol glycosides than C. deserticola. The molecular regulation of the phenylethanol glycosides is not clear, partially due to the lack of genomic and transcriptomic resources in C. tubulosa.
Results
In this study, we performed the full-length transcriptome sequencing and gene expression profiling of C. tubulosa using PacBio combined with BGISEQ-500 RNA-seq technology. Totally, 237,772 unique transcripts were obtained, the transcript lengths ranging from 199 bp to 31,857 bp, and the N50 length was 1,797 bp. Among the unique transcripts, 188,135 (79.12%) transcripts were annotated. Interestingly, 1080 transcripts were annotated as 22 enzymes related to PhGs biosynthesis. We measured the content of echinacoside, acteoside and total PhGs at two development stages, and found that the content of PhGs was 46.74% of dry matter in young fleshy stem (YS1) and then decreased to 31.22% at the harvest stage (HS2). To compare with YS1, 13,631 genes were up-regulated, and 15,521 genes were down regulated in HS2. Many differentially expressed genes (DEGs) were identified to be involved in phenylpropanoid biosynthesis pathway, phenylalanine metabolism pathway and tyrosine metabolism pathway between YS1 and HS2.
Conclusions
Based on these results, we proposed a potential model for phenylethanol biosynthesis regulation. This is the first report of transcriptome study of C. tubulosa which provided the foundation for understanding of PhGs biosynthesis regulation.
Improvement in Learning Efficiency of SARSA for Wireless Communication Network
Authors: Yadav Anil Kumar , Sharma Purushottam 
Published: June 2022

Abstract
State action reward state action (SARSA) is one of the important learning methods of reinforcement learning. It updates policy using optimal action taken over the environment and uses temporal difference (ʎ). Where the ʎ used for eligibility trace, it used to contain a temporary record of every node in state action pairs (s, a) under each episode. In this paper, we proposed a novel algorithm and developed the update target value applying the average of all possible successive action values along with eligibility trace to store every state action value within look up table. That improves reinforcement learning model convergence characteristics and learning efficiency. In the result section, represent that our proposed algorithm has better learning efficiency than Q learning. It can be used for solving complex wireless communication networks and other solutions for the development of other intelligent artificial communication networks.
A multi-centered trial investigating Gestational treatment with Ursodeoxycholic Acid compared to Metformin to Reduce effects of Diabetes mellitus (GUARD): a randomized controlled trial protocol
Authors: Lovell Holly , Mitchell Alice , Ovadia Caroline , Pitrelli Noelia , Briley Annette , Singh Claire , Marschall Hanns-Ulrich , Cruickshank Kennedy , Murphy Helen , Seed Paul , Williamson Catherine 
Published: June 2022

Abstract
BackgroundEach year in the UK, approximately 35,000 women develop gestational diabetes mellitus (GDM). The condition increases the risk of obstetric and neonatal complications for mother and child, including pre-eclampsia, preterm birth and large for gestational age babies. Biochemical consequences include maternal hyperglycemia, neonatal hypoglycemia and dyslipidemia. Metformin is the most commonly used first line pharmacological treatment. However, there are concerns about its widespread use during pregnancy, due to its limited efficacy and potential safety concerns. Therefore, there is a need for additional therapies that improve both maternal-fetal glucose and lipid metabolism.Ursodeoxycholic acid (UDCA) is not currently used for treatment for GDM. However, it can improve glucose control in type 2 diabetes, and it improves fetal lipid profiles in gestational cholestasis. Consequentially, it is hypothesized that treatment with UDCA for women with GDM may improve both maternal metabolism and neonatal outcomes. The primary outcome of this trial is to assess the efficacy of UDCA compared with metformin to improve glucose levels in women with GDM.Methods:The trial is a two-armed, open label, multi-center, randomized controlled trial. Women are eligible if they have been diagnosed with GDM by an oral glucose tolerance test between 24+0 to 30+6 weeks’ gestation, and if they require pharmacological intervention. 158 pregnant women will be recruited across seven NHS Trusts in England and Wales. Women who consent will be recruited and randomized to either metformin or UDCA, which will be taken daily until the birth of their baby. Maternal and neonatal blood samples will be taken to evaluate the impact of the treatments on maternal glucose control, and maternal and neonatal lipid metabolism. Maternal and fetal outcomes will be evaluated, and acceptability of UDCA compared with metformin will be assessed.Discussion:This trial has the potential to identify a potential new treatment for women with GDM. If successful, a future large multi-center trial will be designed to investigate where decisions can be personalized to identify which women will respond more effectively to UDCA than alternatives to improve maternal and baby outcomes. Trial registration:Clinicaltrials.gov – Registration number: NCT04407650
Probable human origin of the SARS-CoV-2 polybasic furin cleavage site
Authors: Romeu Antonio R. 
Published: June 2022

Abstract
The origin of the SARS-CoV-2 is still unclear. Simply said, its emergence was due to theacquisition of the polybasic furin cleavage site at the S protein in one of its closest relatives. Thediscovery in Laos of bat Rhinolophus coronaviruses that contain receptor binding domains almostidentical to that of SARS-CoV-2, and despite not having that polybasic furin cleavage site, they cantherefore infect human cells (1), is the cornerstone to identify the SARS-CoV-2 progenitor.However, it is not yet known where the furin site inserted at the S1/S2 junction in the S protein ofthe pandemic virus come from, nor the how and when of such acquisition. The CGG-CGG encodedarginine dimer is rare in coronaviruses (2), however, an arginine dimer with this code is present atthe SARS-CoV-2 acquired furin site: the PRRA four amino acid residue motif. Then, my questionwas if the SARS-CoV-2 S gene insert encoding the furin site would match to human transcripts.Here, I address this issue by using NCBI and GISAID databases, the NCBI Human GenomeResources, sequence analysis tools and in-house developed bioinformatic tools. I found that thepossible 12-nucleotide fragments which properly inserted in the S gene encode the SARS-CoV-2furin site 100% match to several NCBI RefSeq human transcripts. Taking this into account and theexpression patterns of these genes, together with further evidences found here, such as the codonoptimization of that SARS-CoV-2 furin site arginine dimer and other PRRA-like insertions in the Sprotein, results strongly suggest that recombination between the SARS-CoV-2 precursor genomeand human host cell mRNA produced the recombinant pandemic virus, along with the origin of theSARS-CoV-2 furin site, during undetected human-to-human virus transmission.
Treatment Outcomes of Applying External Fixator on Distal Radius Fractures: A Randomized Clinical Trial to Compare between Two Directions of Force Exertion in Parallel to Radius Shaft and Perpendicular to the Distal Radius Articular Surface
Authors: Jafari Davood , Birjandinejad Ali , B.O. Mahla Daliri , Emami Kimia , Moradi Ali 
Published: June 2022

Abstract
Background: External fixation has been one of the conventional managements of unstable distal radius fracture. The main aim of this paper is to compare two methods of applying distractive force along the radius shaft versus perpendicular to the distal radius articular surface.Design: Sixty patients with unstable distal radius fracture were included in present clinical trial and randomized in two groups, using block randomization method. In group A (first arm), distraction force was exerted parallel to the radius shaft. In group B (second arm), the external fixator was adjusted based on radial and palmar tilt of the mean population healthy wrist so that distraction was exerted perpendicular to the wrist articular surface.Methods: Radiological and clinical parameters were evaluated in both groups of patients pre-operatively, immediately after surgery, and 6 weeks post-operatively. We also followed up patients clinically at 12 weeks after surgery. PRWE, Mayo, and DASH questionnaires were used in order to assess patients’ clinical and functional states.Results: The method used in group B resulted in better improvement of palmar tilt both immediately (P = 0.007) and at 6 weeks follow up (P = 0.013) post-operatively in comparison with patients in group A. Radius height and radial inclination were also better restored when using the proposed modified method (P = 0.001 and <0.001, respectively). Clinical outcomes were not different between two groups. Conclusion: Applying distractive force perpendicular to the distal radius articular surface seems to improve some radiological outcomes, probably due to better reduction maintenance, when compared with the technique of applying distraction force along distal radius shaft axis.Level of Evidence: Level I (clinical trial study)
Study Protocol of Sirolimus-coated bAlloon Versus pAclitaxel-coated balloon angioplasty for the treatment of dysfunctional ArterioVenous Fistula (SAVE AVF)
Authors: Tan Chee Wooi , Tan Ru Yu , Pang Suh Chien , Tng Alvin Ren Kwang , Ng Nick Zhi Peng , Tan Alfred Bingchao , Patel Ankur , Gogna Apoorva , Chong Tze Tec , Tan Chieh Suai , Tang Tjun Yip 
Published: June 2022

Abstract
Background
Dysfunction of arteriovenous fistula (AVF) remains a significant morbidity for patients who are suffering from end-stage-kidney-disease (ESKD). The primary cause of dysfunction in AVF is due to stenosis from neointimal hyperplasia. Plain old balloon angioplasty (POBA) has been the standard of care for the treatment of AVF stenosis however the average patency rates remain poor. Drug-coated balloon (DCB) represents an emerging alternative to POBA in prolonging the patency of AV access. Paclitaxel-coated balloon (PCB) is currently the most widely studied DCB as compared to second generation DCB, sirolimus-coated balloon (SCB).
Methods
This is a single center, prospective and retrospective double arm registry study that is investigator driven to compare the efficacy and safety of the two DCBs in the real-world setting in Singapore. A total of 200 eligible participants will be recruited and followed-up for 12-months. The primary endpoint is the patency rates at 6-month while the secondary endpoints are the patency rates and the number of repeat interventions needed to maintain patency at 6-and 12-months.
Discussion
Drug-coated balloon is an emerging device in endovascular intervention of AV access. PCB was the most used DCB, until its safety concern was raised recently due to the findings of increasing risk of death following application of PCB in femoro-popliteal artery of the leg. Compared to paclitaxel, sirolimus is cytostatic in its action with a high safety margin and has anti-inflammatory effects. It has a high transfer rate to the vessel wall and effectively inhibits neointimal hyperplasia. There have not been head-to-head comparison of PCB and SCB in the treatment of dysfunctional AV access; hence through this study, we will be able to study the safety and efficacy of the two DCBs in the real-world setting.
Trial registration:
ClinicalTrials.gov Identifier: NCT05333640 on 19 April 2022
Primary stability of different implant macrodesigns in a sinus floor elevation simulated model: An Ex Vivo Study
Authors: Imai Mikio , Ogino Yoichiro , DDS Hideaki Tanaka , Koyano Kiyoshi , Ayukawa Yasunori , DDS Takeshi Toyoshima 
Published: June 2022

Abstract
Background
A novel type of implant (Straumann® BLX implant) has been developed for certain stability from the mechanical and biological aspects and is expected for the implant placement in atrophic maxilla with sinus floor elevation (SFE).
Purpose
The aim of this study was to evaluate the primary stability in the implants with different macrodesigns in a SFE simulated model. Primary stability defined as maximum insertion torque (MIT) and implant stability quotient (ISQ) were compared between this novel type of implant and other types.
Materials and Methods
Five types of Straumann® 10mm length implants (Standard Plus; SP, Tapered Effect; TE, Bone Level; BL, Bone Level Tapered; BLT and BLX) and two types of Straumann® 6mm length implants (SP short, BLX short) were used in this study. Each Implants were inserted through 5 mm–thick porcine iliac crest blocks (a SFE simulated model). Primary stability was evaluated by using MIT and ISQ.
Results
The mean values of MIT for BLX group showed significantly higher values than SP, BL (p < 0.01), and TE (p < 0.05) groups. The mean value of ISQ for BLX group was significantly higher than the other groups (p < 0.01). The mean value of MIT and ISQ for BLX and BLX short group were significantly higher than that for SP and SP short group (p < 0.01).
Conclusions
In a SFE simulated ex vivo model, BLX group showed the highest values. These results suggest that implant selection can play a crucial role in the achievement of primary stability during SFE and simultaneous implant placement.
Biochemical and Morphological screening of cotton (Gossypium hirsutum L.) hybrids for Jassid resistance (Amrasca devastans (Dist.))
Authors: S Subhashini , S Rajeswari , T Kalaimagal , M Muthuswami , P Jeyakumar 
Published: June 2022

Abstract
The cotton hybrids of seven lines (BSH 18, MCU 5, CO 14, TCH 1828, CO 17, TCH 11199 and Suraj) and five testers (KC2, KC3, GISV 323, GTHV 15–34 and RHC 1409) were raised in RBD for obtaining 35 hybrids. The hybrids along with their parents were studied for the traits viz., mean number of jassids per plant, injury grade, total phenol content, total reducing sugars, total soluble proteins, trichome length, trichome density and chlorophyll index along with the seed cotton yield per plant. Higher phenolic content, lower reducing sugar, lower soluble proteins, greater chlorophyll index and higher trichome density would result in fewer jassids per plant. MCU 5 X KC3 hybrid had the lowest injury grade (0.13), highest total phenol content (3.84 mg/g), lowest total reducing sugars (1.14 mg/g), highest chlorophyll index (58.33), lowest trichome length (0.43), highest trichome density (271.42 numbers per centimetre square) and highest yield of 150.74 g/plant. Hence this F1 hybrid confers resistance against jassids. Hence, higher phenolic content along with higher trichome density offers resistance to jassids in cotton plants. This cross could be further forwarded to F2 to identify the jassid segregants for further screening. Thus, knowledge into these biochemical analyses and trichome density of the cultivar might be used to breed for jassid resistance, which would assist minimise the usage of pesticides and pest loads from the fields, thereby increasing the population's productivity.
A taxonomic study on pollen morphology characteristics, chromosome karyotype characteristics, floral and fruit pigment compositions of 13 species and hybrids of Lonicera L.
Authors: Li Dalong , Zhai Xiaoou , Li Fang , Sun Liwei , Ji Xing , Zhang Sijia , Zhang Yujiao , Liu Huimin 
Published: June 2022

Abstract
In this paper, the pollen morphology characteristics, chromosome karyotype characteristics, floral and fruity pigment compositions of 13 species and hybrids of Lonicera L. were analyzed by means of scanning electron microscopy, root tip squash method, HPLC-MS and GC-MS, and then they were classified separately to discuss their genetic relationship and taxonomic relationship. According to the morphological taxonomy, Lonicera L. distributed in northern are divided into two categories by whether the branchlets are hollow or not. In this experiment, Lonicera chrysanthaTurcz. ex Ledeb., Lonicera maackii (Rupr.) Maxim., Lonicera ruprechtiana Regel., Lonicera tatarica Linn. and Lonicera korolkowi ‘Zabelii’. belongsto the category of hollow branchlets; and Lonicera edulisTurcz. and Lonicera tatarinowiiMaxim. belongs to the category of branchlets with solid white pith. Through the analysis of pollen morphology characteristics, chromosome karyotype characteristics, floral and fruit pigment compositions, and using the above four indexes for clustering, Lonicera ruprechtiana Regel. and Lonicera tatarica Linn. can always be clustered together. Five hybrids such as Lonicera korolkow‘Zabelii’.×Lonicera maackii (Rupr.) Maxim., Lonicera korolkow‘Zabelii’.×Lonicera tatarica Linn.No.8 etal. can basically clustered with their parents, which is conform to the morphological taxonomy. These results indicate that the analysis of pollen morphology characteristics, chromosome karyotype characteristics, floral and fruit pigment compositions, has certain value and significance for the study of system classification and genetic relationship of Lonicera L., and the conclusions of this study partially support morphological taxonomy. Among the four clusters, the clustering result of pollen morphology characteristics was in the highest agreement with morphological taxonomy.
Evaluation of Dynamic F Wave Parameters before and after Physical Activity in Normal Population
Authors: Khosrawi Saied , Haghighat Shila , Hamedfar Hadi 
Published: June 2022

Abstract
Objectives: F wave is one of the nerve conduction studies, mainly used to study the proximal pathway of peripheral nerves. One of its applications is dynamic assessment, i.e., before and after physical activity, when symptoms develop in some patients. Best to our knowledge, few studies evaluate normal dynamic F wave values in healthy individuals. This study aims to determine and compare normal values of several parameters of Compound Muscle Action Potential (CMAP) and F waves of tibial nerves dynamically before and after physical activity in the lower extremities of 34 normal subjects. These parameters were recorded before and after 15 minutes of continuous walking at intervals of one, five, and ten minutes after the end of physical activity.Results: Normal values of CMAP onset latency and amplitude, minimum, maximum, and mean latency of 10 F waves, F chronodispersion, and F persistence were dynamically collected before and during 10 minutes after physical activity in three phases. Some of the parameters showed significant changes (P<0.05). Although physical activity showed statistically significant effects on some CMAP and F wave parameters (especially F chronodispersion) in normal subjects, none of them exceeded the normal clinical values introduced in the literature.