bluuebunny/crossref_metadata_2025_split huggingface dataset:
Global burden and inequality of iron deficiency: findings from the Global Burden of Disease datasets 1990–2017
Authors: Wang Mengying , Gao He , Wang Jianing , Cao Chenliang , Ying Xiaoling , Wei Yingming , Yu Zhiying , Shao Jie , Dong Hengjin , Yang Min 
Published: March 2022

Abstract
Background
Iron deficiency (ID) impairs patient physical activity, recognition and life quality, which is difficult to perceive but should not be underestimated. Worldwide efforts have been made to lower ID burden, however, whether it decreased equally in different regions and sexes is unclear. This study is to examine regional and sex inequalities in global ID from 1990 to 2017.

Methods
We conducted a longitudinal, comparative burden-of-disease study. Disability-adjusted life-years (DALYs) of ID were obtained from Global Burden of Disease Report 2017. Human Development Index (HDI) data were obtained from Human Development Report 2017. Gini coefficient and the concentration index were calculated to assess the equities in global burden of ID.

Results
A downward trend of global ID burden (from 569.3 (95% Uncertainty Interval [UI]: 387.8–815.6) to 403.0 (95% UI: 272.4–586.6), p < 0.001), age-adjusted DALYs per 100,000 population) but an uptrend of its inequalities (from 0.366 to 0.431, p < 0.001, Gini coefficients) was observed between 1990 and 2017. ID burden was heavier in women than that in men ([age-adjusted DALYs per 100,000 population from 742.2 to 514.3] vs [from 398.5 to 291.9]), but its inequalities were higher in men since 1990. The between-sex gap of ID burden was narrowed with higher HDI (β =  − 364.11, p < 0.001). East Asia & Pacific and South Asia regions made a big stride for ID control in both sexes over decades [age-adjusted DALYs per 100,000 population from 378.7 (95% UI: 255.8–551.7) in 1990 to 138.9 (95%UI: 91.8–206.5) in 2017], while a heavy burden among Sub-Saharan African men was persistent[age-adjusted DALYs per 100,000 population, 572.5 (95% UI: 385.3–815) in 1990 and 562.6 (95% UI: 367.9–833.3) in 2017].

Conclusions
Redistributing attention and resources to help countries with low HDI, especially take care of women with low socioeconomic status (SES) and men under high ID burden may help hold back the expanding ID inequality.
Urokinase-type plasminogen activator receptor (uPAR) as a therapeutic target in cancer
Authors: Zhai Bing-Tao , Tian Huan , Sun Jing , Zou Jun-Bo , Zhang Xiao-Fei , Cheng Jiang-Xue , Shi Ya-Jun , Fan Yu , Guo Dong-Yan 
Published: March 2022

AbstractUrokinase-type plasminogen activator receptor (uPAR) is an attractive target for the treatment of cancer, because it is expressed at low levels in healthy tissues but at high levels in malignant tumours. uPAR is closely related to the invasion and metastasis of malignant tumours, plays important roles in the degradation of extracellular matrix (ECM), tumour angiogenesis, cell proliferation and apoptosis, and is associated with the multidrug resistance (MDR) of tumour cells, which has important guiding significance for the judgement of tumor malignancy and prognosis. Several uPAR-targeted antitumour therapeutic agents have been developed to suppress tumour growth, metastatic processes and drug resistance. Here, we review the recent advances in the development of uPAR-targeted antitumor therapeutic strategies, including nanoplatforms carrying therapeutic agents, photodynamic therapy (PDT)/photothermal therapy (PTT) platforms, oncolytic virotherapy, gene therapy technologies, monoclonal antibody therapy and tumour immunotherapy, to promote the translation of these therapeutic agents to clinical applications.
Obesity prevention practices in early care and education settings: an adaptive implementation trial
Authors: Swindle Taren , Rutledge Julie M. , Selig James P. , Painter Jacob , Zhang Dong , Martin Janna , Johnson Susan L. , Whiteside-Mansell Leanne , Almirall Daniel , Barnett-McElwee Tracey , Curran Geoff M. 
Published: March 2022

AbstractBackgroundDespite the potential for Early Care and Education (ECE) settings to promote healthy habits, a gap exists between current practices and evidence-based practices (EBPs) for obesity prevention in childhood.MethodsWe will use an enhanced non-responder trial design to determine the effectiveness and incremental cost-effectiveness of an adaptive implementation strategy for Together, We Inspire Smart Eating (WISE), while examining moderators and mediators of the strategy effect. WISE is a curriculum that aims to increase children’s intake of carotenoid-rich fruits and vegetables through four evidence-based practices in the early care and education setting. In this trial, we will randomize sites that do not respond to low-intensity strategies to either (a) continue receiving low-intensity strategies or (b) receive high-intensity strategies. This design will determine the effect of an adaptive implementation strategy that adds high-intensity versus one that continues with low-intensity among non-responder sites. We will also apply explanatory, sequential mixed methods to provide a nuanced understanding of implementation mechanisms, contextual factors, and characteristics of sites that respond to differing intensities of implementation strategies. Finally, we will conduct a cost effectiveness analysis to estimate the incremental effect of augmenting implementation with high-intensity strategies compared to continuing low-intensity strategies on costs, fidelity, and child health outcomes.DiscussionWe expect our study to contribute to an evidence base for structuring implementation support in real-world ECE contexts, ultimately providing a guide for applying the adaptive implementation strategy in ECE for WISE scale-up. Our work will also provide data to guide implementation decisions of other interventions in ECE. Finally, we will provide the first estimate of relative value for different implementation strategies in this setting.Trial registrationNCT05050539; 9/20/21.
Transtibial versus independent femoral tunnel drilling techniques for anterior cruciate ligament reconstruction: evaluation of femoral aperture positioning
Authors: Haroun Haitham K. , Abouelsoud Maged M. , Allam Mohamed R. , Abdelwahab Mahmoud M. 
Published: March 2022

Abstract
Background
Femoral tunnel can be drilled through tibial tunnel (TT), or independent of it (TI) by out-in (OI) technique or by anteromedial (AM) technique. No consensus has been reached on which technique achieves more proper femoral aperture position because there have been evolving concepts in the ideal place for femoral aperture placement. This meta-analysis was performed to analyze the current literature comparing femoral aperture placement by TI versus TT techniques in ACL reconstruction.

Methods
We performed a comprehensive systematic review and meta-analysis of English-language literature in PubMed, Cochrane, and Web of Science databases for articles comparing femoral aperture placement by TI versus TT techniques with aperture position assessed by direct measurement or by postoperative imaging, PXR and/or CT and/or MRI.

Results
We included 55 articles with study population of 2401 knees of whom 1252 underwent TI and 1149 underwent TT techniques. The relevant baseline characteristics, whenever compared, were comparable between both groups. There was nonsignificant difference between TI and TT techniques in the distance from aperture center to footprint center and both techniques were unable to accurately recreate the anatomic footprint position. TI technique significantly placed aperture at more posterior position than TT technique. TI technique significantly lowered position of placed aperture perpendicular to Blumensaat’s line (BL) than TT technique, and modifications to TT technique had significant effect on this intervention effect. Regarding sagittal plane aperture placement along both AP anatomical axis and BL, there was nonsignificant difference between both techniques.

Conclusion
Modifications to TT technique could overcome limitations in aperture placement perpendicular to BL. The more anterior placement of femoral aperture by TT technique might be considered, to some extent, a proper position according to recent concept of functional anatomical ACL reconstruction.
Immature instars of three species of Rhodnius Stål, 1859 (Hemiptera, Reduviidae, Triatominae): morphology, morphometry, and taxonomic implications
Authors: Lázari Cacini Gustavo , de Oliveira Jader , Belintani Tiago , dos Santos Souza Éder , Olaia Nicoly , Pinto Mara Cristina , da Rosa João Aristeu 
Published: March 2022

AbstractBackgroundAmong the 18 genera of the Triatominae subfamily, three stand out for their diversity and epidemiological importance:Triatoma,Panstrongylus, andRhodnius.Rhodniusincludes 21 species that can transmitTrypanosoma cruzi(the etiological agent of Chagas disease, also known as American trypanosomiasis) andTrypanosoma rangeli. TheRhodnius prolixuscomplex comprises seven species, includingRhodnius marabaensis,Rhodnius prolixus, andRhodnius robustus, which occur in the northern region of Brazil. Since both adults and immatures can carryT. cruzi, in this study the five nymphal instars of the three species mentioned were dorsally characterized.MethodsUsing microscopy, morphometrics, and geometric morphometrics, the present work measures and describes the morphological characters of the five nymphal instars ofR. marabaensis,R. prolixus, andR. robustus.ResultsThe study enabled the characterization of all five nymphal instars, as well as the distinction between the three species in each of their instars.ConclusionsThe morphological, morphometrics of the head, thorax, and abdomen and geometric morphometrics studies of the head enabled the specific distinction of these three species in all five instars.Graphical Abstract
Simulation-based education: deceiving learners with good intent
Authors: Alinier Guillaume , Oriot Denis 
Published: March 2022

AbstractThe level of performance of every clinician and of the overall multiprofessional team relies on the skills and expertise they have individually and collectively acquired through education, training, self-directed learning, and reflection. Simulation-based education (SBE) is playing an increasingly important role in that respect, and it is sometimes said that it is an art to facilitate. Many explanations can justify this assertion. Although there is generally an emphasis on making everything as realistic or “high-fidelity” as possible, it is often futile and this is where the art of simulation comes into play with an element of modulation of realism linked to the intended learning objectives. The atmosphere created by the educators; how the learners are made to engage and interact; how physical, technical, and contextual elements are simulated or represented; and what type of technology is used need to be appropriately adapted to contribute to the immersiveness of any SBE activity. Although it inevitably carries a negative connotation, some form of “deception” is more commonly used than one may think for the benefit of learners during SBE. High levels of realism are sometimes achieved by making learners believe something works or reacts as would be expected in real life, whereas it is achieved in a totally different manner. Learners do not need to know, see, or understand these “tricks of the trade”, shortcuts, or artistic or technological aspects, and this can be considered a form of benevolent deception. Similarly, information may be withheld to recreate a realistic situation and push learners to demonstrate specific learning outcomes, but it needs to be practised with caution and be justifiable. These forms of “positive” deception are part of most SBE activities and are used to help learners bridge the reality gap so they can suspend disbelief more easily, exercise critical thinking, and treat the simulation more realistically without damaging the trust they place in their educators. This article will discuss how aspects of SBE activities are often manipulated, modified, or hidden from learners to facilitate the learning experience and present a simulation fidelity model encompassing the environmental, patient, semantical, and phenomenal dimensions.
How do patients and physicians perceive immune thrombocytopenia (ITP) as a disease? Results from Indian analysis of ITP World Impact Survey (I-WISh)
Authors: Chakrabarti Prantar , George Biju , Shanmukhaiah Chandrakala , Sharma Lalit Mohan , Udupi Shashank , Ghanima Waleed 
Published: March 2022

AbstractPurposeImmune thrombocytopenia (ITP) is primarily considered a bleeding disorder; its impact on patients’ health-related quality of life (HRQoL) is under-recognized. We aimed to assess how aligned patient and physician perceptions are regarding ITP-associated symptoms, HRQoL, and disease management in India.MethodsPatients and physicians (hematologists/hemato-oncologists) from India who participated in the global ITP World Impact Survey (I-WISh) were included in this subgroup analysis (survey). Physicians were recruited via a local, third party recruiter in India. In addition to completing a survey themselves, physicians were asked to invite consulting patients on a consecutive basis to complete a survey. All surveys were completely independently by the respondents online in English. The respondents took 30 min to complete the questionnaire. Patients also completed the newly developed ITP Life Quality Index (ILQI) that included 10 questions on the impact of ITP on the following: work or studies, time taken off work or education, ability to concentrate, social life, sex life, energy levels, ability to undertake daily tasks, ability to provide support, hobbies, and capacity to exercise.ResultsA total of 65 patients and 21 physicians were included in this study. Average disease duration from diagnosis-to-survey-completion was 5.3 years. The most severe symptoms reported by patients at diagnosis were menorrhagia (15 of 19 patients [79%]), anxiety surrounding unstable platelet counts (17 of 28 patients [61%]), and fatigue (27 of 46 patients [59%]); these were also the key symptoms they wanted to be resolved. In contrast, physicians perceived petechiae (19 of 21 patients [90%]), bleeding-from-gums (8 of 21 patients [86%]), and purpura (16 of 21 patients [76%]) as the most common symptoms. While the important treatment goals for patients were healthy blood counts (42 of 65 patients [65%]), improved QoL (35 of 65 patients [54%]), and prevention of worsening of ITP (33 of 65 patients [51%]), physicians’ goals were reduction in spontaneous bleeding (17 of 21 physicians [81%]), better QoL (14 of 21 physicians [67%]), and symptom improvement (9 of 21 physicians [43%]). More than half the patients reported that ITP affected their work life/studies, social life, and energy levels, thereby negatively impacting their QoL. Patients were almost entirely dependent on family and friends for support.ConclusionsThis survey highlights the substantial discrepancy in patients’ and physicians’ perceptions regarding ITP-associated symptoms and treatment goals in India. Based on the identified gaps, educating physicians on aspects of ITP beyond bleeding, and highlighting patients’ under-recognized symptoms/needs through support-systems should be prioritized in the future.
The neurophysiologic basis of the human sleep–wake cycle and the physiopathology of the circadian clock: a narrative review
Authors: Okechukwu Chidiebere Emmanuel 
Published: March 2022

AbstractThe objectives of this review were to explain the neurologic processes that control the human sleep–wake cycle as well as the pathophysiology of the human circadian clock. Non-rapid eye movement and rapid eye movement sleep are the two main phases of sleep. When triggered by circadian input from the anterior hypothalamus and sleep–wake homeostatic information from endogenous chemical signals (example, adenosine), the ventrolateral preoptic nucleus initiates the onset of sleep. Arousal in which there is a conscious monitoring of the surroundings and the ability to respond to external stimuli is known as wakefulness. It contrasts the state of sleep, in which receptivity to external stimuli is reduced. The higher the synchronous firing rates of cerebral cortex neurons, the longer the brain has been awake. Sleep–wake disturbances induced by endogenous circadian system disruptions or desynchronization between internal and external sleep–wake cycles are known as circadian rhythm sleep–wake disorder (CRSWD). Patients with CRSWD usually report chronic daytime drowsiness and/or insomnia, which interferes with their activities. CRSWD is diagnosed based on the results of some functional evaluations, which include measuring the circadian phase using core body temperature, melatonin secretion timing, sleep diaries, actigraphy, and subjective experiences (example, using the Morningness–Eveningness Questionnaire). CRSWD is classified as a dyssomnia in the second edition of the International Classification of Sleep Disorders, with six subtypes: advanced sleep phase, delayed sleep phase, irregular sleep–wake, free running, jet lag, and shift work types. CRSWD can be temporary (due to jet lag, shift work, or illness) or chronic (due to delayed sleep–wake phase disorder, advanced sleep–wake phase disorder, non-24-h sleep–wake disorder, or irregular sleep–wake rhythm disorder). The inability to fall asleep and wake up at the desired time is a common symptom of all CRSWDs.
Anaesthetic management of a case of large ASD with severe pulmonary hypertension—case presentation
Authors: Madaan Vikram , Gupta Rekha 
Published: March 2022

Abstract
Background
Atrial septal defect is the most common acyanotic congenital cardiac anomaly in the adults after bicuspid aortic valve with high prevalence in females. Major challenges in the management of large ASD with severe pulmonary hypertension includes hypoxemia, hypercarbia, hypothermia leading to reversal of shunt (Eisenmenger syndrome), fatal arrhythmias and congestive heart failure.

Case presentation
We report the successful management of the case of 44-year-old female patient with large ASD and severe pulmonary arterial hypertension posted for total abdominal hysterectomy with salpingectomy. She had history of palpitations with exertional dyspnoea and history of abnormal uterine bleeding with failed medical treatment. Echocardiography showed large OS-ASD (24 mm) with left to right shunt, moderate TR, severe PAH with estimated RVSP 60 mmHg, LVEF 50% and grossly dilated RA/RV. She underwent total abdominal hysterectomy with salpingectomy under regional anaesthesia with prophylactic use of adrenaline infusion.

Conclusions
Cardiac patients for non-cardiac surgery can be managed under regional anaesthesia.
Evaluation of the protective effect of Clitoria ternatea L. against propionic acid induced autistic spectrum disorders in rat model
Authors: Jiji K. N. , Muralidharan P. 
Published: March 2022

Abstract
Background
As a result of aberrant neural development, autism spectrum disorder (ASD) is characterised by complicated behavioural and memory issues. The dearth of knowledge about the actual etiopathology of autism makes treatment extremely difficult. There is a collection of plants known as "Medhya drugs" in the Ayurvedic system of medicine because of their capacity to boost brain and neuron-related activities including learning and memory. Clitoria ternatea L. is a "Medhya drug" that has been shown to improve memory. In this study, the ethanolic root extract of Clitoria ternatea L. was evaluated for its neuroprotective effects against propionic acid induced neuroinflammation in autistic rat modells.

Method
Adult Wistar rats were segregated into 4 groups and administered the vehicle/extract for 28 days. Induction of autism was done by intra-cerebro-ventricular infusion of propionic acid between 22nd and 28th day of the study. During this infusion period, rats were subjected to various in vivo behaviour and memory evaluation methods by performing actophotometer test and Morris water maze test. On 29th day of the study, animals were sacrified to get the brain tissues. Extracted brain tissues were utilised for the estimation of various neuroinflammatory markers levels (TNF-α and IL-6), immunohistochemical analysis of neuroinflammation, and histopathological analysis.

Results
Pre-treatment of rats with extract at two dose levels (250 mg/kg and 500 mg/kg) significantly (p < 0.0001) reduced the neuroinflammation, memory and cognitive impairment produced by the propionic acid in a dose dependent manner.

Conclusion
Study results showed the potent neuroprotective effects of Clitoria ternatea L. roots against the propionc induced autistic neuroinflammation.
Methods for determination of plasticizer migration from polyvinyl chloride synthetic materials: a mini review
Authors: Chen Yi , Zhou Shuai , Pan Siyu , Zhao Dongfang , Wei Jianshe , Zhao Minzhong , Fan Haojun 
Published: March 2022

AbstractPlasticizer migration is responsible for premature coating failure in polyvinyl chloride (PVC) synthetic materials that continue to benefit our daily life as a reliable and cost-efficient simulant of genuine leather. In this context, the establishment of standard assays that measure the migration rate of plasticizers under varying scenarios plays a pivotal role in comparing durability of those PVC-derived leather-simulants. In this review, multiple methodologies developed over the last decade for determining plasticizer migration from PVC coating are compiled, with their operational principles, merits, and limitations being taken into consideration along with specific apparatus required for each. A concluding section discusses current challenges in this field, and highlights how nuclear magnetic resonance and computational simulation surpass conventional assays in yielding intercomparable results, and hence screening migration-resistant plasticizers in a labor- and time-saving way. Since migration resistance represents a decisive performance indicator of plasticizers, this systematic review may provide guidance to quite a few practitioners in PVC synthetic material industry, who are now engaged in validating various sustainable alternatives with performance allegedly equal to conventional but toxic di-(2-ethylhexyl) phthalate plasticizer.
Graphical abstract