bluuebunny/crossref_metadata_2025_split huggingface dataset:
An integrative review of adult patient-reported reasons for non-urgent use of the emergency department
Authors: McIntyre Amanda , Janzen Shannon , Shepherd Lisa , Kerr Mickey , Booth Richard 
Published: March 2022

Abstract
Aim
To conduct an integrative review of the scientific literature to explore adult patient-reported reasons for using the emergency department (ED) non-urgently.
Design:
Integrative review.
Data Sources:
A literature search of CINAHL, Cochrane, Embase, PsycINFO, and MEDLINE was conducted with filters for humans, published January 1, 1990-September 1, 2021, and English language.
Review Methods:
Methodological quality was assessed using Critical Appraisal Skills Programme Qualitative Checklist for qualitative and National Institutes Health (NIH) Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies for quantitative studies. Data was extracted on study and sample characteristics, and themes/reasons for ED use. Cited reasons were coded using thematic analysis.
Results
93 studies met inclusion criteria. Seven themes were found: need to be risk averse with respect to the health issue; knowledge and awareness of alternative sources of care; dissatisfaction with primary care provider; satisfaction with ED; ED accessibility and convenience resulting in low access burden; referred to the ED by others; and relationships between patients and health care providers.
Conclusion
For many ED patients, they have a very clear problem which needed to be addressed. Future studies should explore psychosocial factors driving decision-making (e.g., health literacy, health-related personal beliefs, stress and coping ability).
Impact:
This integrative review examined patient-reported reasons for attending the ED on a non-urgent basis. The findings suggest that ED patients are heterogenous and many factors influence their decision-making. Considering the complexity with which patients live, treating them as a single entity may be problematic. Limiting excessive non-urgent visits likely requires a multi-pronged approach.
Is Time of Ruptured Membranes A Risk Factor for Low Apgar? A Case-Control Study of Apgar Score Less Than Seven At Five Minutes in Term Pregnancy Accessing Many Variables
Authors: Junior Luis Carlos Machado , Pinto Camila Nazareth , Gerencer Caroline Sangalan , Prol Elisa Caroline Giacometti , Carvalho Heráclito Barbosa 
Published: March 2022

Abstract
PURPOSE To search for maternal, labor related and fetal variables associated with low Apgar in the fifth minute in term pregnancy. METHODS Retrospective case-control study with term births in a public teaching hospital from 2013 to 2020. Cases were term births with Apgar score less than seven in the fifth minute, and controls, the next one or two births following a case, with Apgar of seven or more. Were excluded non cephalic presentations, multiples and malformations. We accessed 100 cases and 190 controls. We considered significant values of p < 0.05. RESULTS Were accessed 27 variables which could be risk factors, from which 12 were associated with the outcome. We found a protective effect of prelabor cesarean for the outcome, odds ratio (OR) 0.37, p=0.011. Consequently, we conducted two sets of analyses: in the whole group and in the group of laboring women. The values OR were in general greater in the group of laboring women, compared with the whole group. We conducted multivariate analysis within the group of women in labor. The variables which fitted best in the model were nulliparity, male sex of the fetus, less than six prenatal visits and abnormal cardiotocography; all remained significant. It was found an association of rupture of membranes more than 360 minutes with the outcome, even after controlling for duration of labor; adjusted OR 2.45, p=0.023. CONCLUSION Twelve variables were associated with the outcome. Prelabor cesarean had a protective effect. Time of ruptured membranes was associated with low Apgar.
NNMT is a immune-related prognostic biomarker that modulates the tumor microenvironment in pan-cancer
Authors: Liu Wenxiu , Zhu Meng , Li Xiaoming , Er Limian , Li Shengmian 
Published: March 2022

Abstract
Background: Emerging evidence revealed the significant roles of Nicotinamide n-methyltransferase (NNMT) in cancer initiation, development, and progression, but there is no pan-cancer analysis of NNMT. Here, we aimed to analyze the expression and prognostic value of NNMT in pan-cancer and to gain insights into the association between NNMT and immune infiltration.Methods: We analyzed NNMT expression patterns and the association between NNMT expression levels and prognosis in pan-cancer via the Oncomine, Tumor Immune Estimation Resource (TIMER), Gene Expression Profiling Interactive Analysis (GEPIA), and Kaplan–Meier Plotter databases. After that, TIMER2 and Immune Cell Abundance Identifier (ImmuCellAI) databases were applied to investigate the relation between NNMT expression and immune infiltration across different cancer types. Signaling pathways related to NNMT expression were identified by gene set enrichment analysis (GSEA).Results: NNMT was significantly upregulated in various common cancers, and it was associated with prognosis. High expression of NNMT was associated with poor overall survival (OS) and relapse-free survival (RFS) in various common cancers, such as Cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC), head and neck squamous cell carcinoma (HNSC), Ovarian serous cystadenocarcinoma (OV) and stomach adenocarcinoma (STAD). NNMT remarkably correlated with the levels of cancer associated fibroblasts (CAFs) and Macrophage cells infiltration. Conclusion: NNMT may serve as a promising prognostic biomarker in pan-cancer andhas positive association with immune infiltrates.
Almond Shell as Coarse Aggregate Replacement in Concrete
Authors: Hama Mohammed Fadhil 
Published: March 2022

Abstract
The utilization of organic waste materials in concrete is an important beneficial factor for the environment. One of those organic wastes in the KRG Iraq are almond shells. Few studies have been conducted on the use of almond shells in concrete and have shown good potential. This study has investigated the properties and the mechanical behavior of almond shells partially replacing the conventional aggregates in concrete. The replacements were 5, 10, 25 and 75%. The almond shells show a uniform grading in its natural state when obtained from local farmers. Since the organic material is highly porous, it tends to absorb much of the water content in the mix which reduces the slump. Furthermore, with a 5% almond shells replacement, the specimens have shown a compressive strength of 17.03 MPa with a density of 1850 kg/m3 which is within the limits of the ACI and BS standards and identified as a structural lightweight concrete. Further recommendations for future studies have been identified based on the results of this study.
Ulinastatin alleviates rhabdomyolysis-induced acute kidney injury by suppressing inflammation and apoptosis via inhibiting TLR4/ NF-κB signaling pathway
Authors: Wang jinxiang , Xu Guowu , Jin Heng , Chai Yanfen , Yang xinyue , Liu Ziquan , Hou Shike , Fan Haojun 
Published: March 2022

Abstract
Acute kidney injury (AKI) is an important complication of rhabdomyolysis(RM),but there is lack of effective treatments.Ulinastatin (UTI) is a broad-spectrum serine protease inhibitor isolated and purified from human urine with strong anti-inflammatory and cytoprotective actions.The aim of this research was to investigate the effect and potential mechanism of UTI on RM-induced AKI(RM-AKI). We established RM-induced AKI model and myoglobin (Mb) stimulated- NRK-52E cells model.In vivo, twenty-four rats were randomly divided into three groups(n = 8):control, RM-AKI and RM-AKI + UTI. In vitro,the NRK-52E cells were divided into six groups according to the different treatment method.Mb stimulated- NRK-52E cells were treated with UTI or si-TLR4 transfection to characterize the mechanisms of UTI in RM-AKI. Indicators of the kidney injury, cell viability, cell cycle, oxidative stress, inflammation,apoptosis and TLR4/NF-κB signaling pathway were assessed.In vivo and in vitro,UTI significantly decreased the expression of TLR4 and p65.In vivo, UTI significantly improved renal function,reduced inflammatory reaction and kidney injury.In vitro,UTI protected NRK-52E cells from Mb stimulation by suppressing cells cytotoxicity, cell cycle inhibition, overproduction of ROS, inflammation and apoptosis. Additionally, UTI played a protective role by down regulating the TLR4 expression.The results indicate that UTI alleviates RM-AKI by suppressing the inflammatory response and apoptosis via inhibiting TLR4/NF-κB signaling pathway.Our study provides a new mechanism for the protective effect of UTI on RM-AKI.
Experiences of Academic and Professional Burn-out in Medical Students and Residents During First COVID-19 Lockdown in Belgium: a Cross-sectional Survey
Authors: Mouedden Issrae El , Hellemans Catherine , Anthierens Sibyl , Michels Nele Roos , DeSmet Ann 
Published: March 2022

Abstract
COVID-19 has presented a substantial burden on students and healthcare staff. This mixed-method, descriptive and correlational study aimed to : 1) describe academic; and 2) professional burnout levels; 3) their associations with working in COVID-19-related care; and 4) with perceived COVID-19 impact on studies and internships among medical students and residents. During first lockdown in Belgium, a cross-sectional survey assessed academic burnout (MBI-SS) and professional burnout in relation to internships and residency (MBI-HSS). Correlations and t-tests tested associations of burnout with involvement in COVID-19-related care and perceived impact of COVID-19 on studies and work (SPSS). Participants provided open-ended comments which were thematically analysed (NVivo). In total, 194 medical students and residents participated (79.5% female, M age = 24.9 ± 2.5). Emotional exhaustion and depersonalisation were high in professional burnout, but moderate in academic burnout. Those involved in COVID-19 related care perceived a higher impact of COVID-19 on their studies and internship/residency and have higher professional burnout, but do not show a higher academic burnout. Those who have a higher perceived impact of COVID-19 on their studies scored higher on academic burnout. Participants mentioned an increased workload, distress, fewer learning opportunities, lack of relatedness with patients and supervisors and cynicism towards remote care or non-medical tasks. Students and residents showed indications of professional and academic burnout in relation to the COVID-19 situation. Interventions are needed that can meet the needs of achieving learning outcomes, managing extreme situations and relatedness.
Are nutrients or salinity the drivers of macroinvertebrate community composition in wetlands of the desert Southwest?
Authors: Piña Anna Elisa , Lougheed Vanessa 
Published: March 2022

Abstract
The relatively rare freshwater ecosystems in the arid southwestern United States serve as biodiversity hotspots, yet they remain among the most threatened systems in the world due to human impacts and climate change. Water quality and macroinvertebrate data were collected over 2 years from 14 different wetland and riparian sites spanning across West Texas, New Mexico and Arizona. This project aims to shed light on the factors that drive macroinvertebrate community composition of wetlands of the US desert Southwest. Principal Component Analysis (PCA) indicated that salinity related variables such as chloride, sulfate and conductivity were the greatest drivers of environmental variance (32%) among sampled desert wetlands. Nutrients such as nitrate and phosphate described a second axis, with 22% of variation in environmental data explained, where we found a clear distinction between wastewater and non-wastewater wetlands. Subsequently, nutrients were shown to have the greatest impact on macroinvertebrate communities with wetlands of higher nutrient loads showing more uneven functional diversity and lower Simpson Index scores. Increased salinity levels were shown to correlate with lower Simpson Index scores and a higher abundance of tolerant macroinvertebrates such as coleopterans and amphipods. Overall, these data may be crucial in forecasting whether high nutrient levels lead to homogenization of macroinvertebrate communities within wastewater wetlands.
High-energy Charge Separation State for Photocatalytic Nonoxidative Methane Conversion
Authors: Wang Guangming , Mu Xiaowei , Li Jiayang , Pan Ziye , Zhan Qingyun , Tan Ruike , Fu Rong , Li Lu 
Published: March 2022

Abstract
The nonoxidative coupling of methane (NOCM) under mild conditions is a promising technique for low-cost H2 and carbon feedstock productions. Here, we fabricate a Ce-Zr solid solution photocatalyst containing nonstoichiometric CeO2 − x nano-islands with stepped surfaces and abundant oxygen vacancies, enabling unprecedented adsorption of methane and ideal for the photocatalytic NOCM at room temperature. It is revealed that the Ce-Zr photocatalyst can undergo a cooperative and reversible photo-induced transition from the initial resting state to the charge-separation state that stores sufficient energy to dissociate the inert methane C-H bond, thereby resulting in excellent photocatalytic activity with long-term stability (> 40 h, > 20 cycles) and high selectivity, exceeding that of traditional Ce-based photocatalysts by two orders of magnitude. This work not only provides fresh insight into the catalyst design for methane conversion but also extends the boundaries of conventional photocatalysts with the unique ability of storage and delayed release of solar energy.
Use of InSAR Data for the Measurement of Land Subsidence in Response to Groundwater Fluctuations and Climate Change (Case Study: Ardabil Plain, Iran)
Authors: Ghorbani Zahra , Khosravi Ali , Mojtahedi Farid Fazel , Javadnia Eslam , Nazari Ali , Fellow Yasser Maghsoudi Research 
Published: March 2022

Abstract
The Ardabil plain, with an approximate area of 1097.2 km² in northwestern Iran, has experienced land subsidence due to intensive groundwater withdrawal and long seasons of drought in recent years. Different techniques have been used to investigate and evaluate subsidence in this region including: Global Positioning Systems (GPS), Levelling, and Geotechnical methods. These methods are typically expensive, time-consuming, and identify only a small fraction of the areas prone to subsidence. This study employs an Interferometric Synthetic Aperture Radar (InSAR) technique to measure the long-term subsidence of the plain. An open-source SAR interferometry time series analysis package, LiCSBAS, that integrates with the automated Sentinel-1 InSAR processor (COMET-LiCSAR) is used to analyze Sentinel-1 satellite images from October 2014 to January 2021. Processing of Sentinel-1 images shows that the Ardabil plain has been facing rapid subsidence due to groundwater pumping and reduced rainfall, especially between May 2018 to January 2019. The maximum subsidence rate was 45 mm/yr, measured at the southeastern part of the plain. While providing significant advantages (less processing time and disk space) over other InSAR processing packages, implementation of the LiCSBAS processing package and its accuracy for land subsidence measurements at different scales needs further evaluation. This study provides a procedure for evaluating its efficiency and accuracy for land subsidence measurements by comparing its measurements with the results of the GMTSAR and geotechnical numerical modeling. The results of geotechnical numerical modeling showed land subsidence with an average annual rate of 3.8 cm between 2006 and 2020, which was close to measurements using the InSAR technique. Comparison of the subsidence measurements of the Ardabil plain using the LiCSBAS package with results obtained from other techniques shows that LiCSBAS is able to accurately detect land deformation at large scales (~ km). However, they may not be optimized for more local deformations such as infrastructure monitoring.
Effectiveness of a risk warning system: A driving simulation study
Authors: Fengxiang GUO , Yiwen ZHOU , Wenchen YANG , Huasen WAN 
Published: March 2022

Abstract
In order to improve the traffic safety condition of intersections, a real-time traffic conflict risk warning system (RTCRWS) is proposed for uncontrolled intersections. To evaluate the effectiveness of this system, a driving simulation experiment was designed and conducted. In this study, a virtual experimental scene including static road, traffic environment and dynamic traffic flow was constructed, and 45 drivers were recruited to complete the driving simulation experiment at 13 intersections. Three different data analysis methods were employed: (1) descriptive analysis of driving behavior characteristics; (2) descriptive analysis of physiological and psychological reactions of drivers; (3) Technique for Order Preference by Similarity to an Ideal Solution (TOPSIS) of RTCRWS. The results show that RTCRWS can effectively control the vehicle speed and reduce the driver's tension. In addition, the following conclusions are also drawn: (1) The early warning signs with better warning effect among the two types signs of RTCRWS were compared; (2) Among the elderly and young and middle-aged drivers, RTCRWS has a better warning effect on the elderly drivers. (3) Among the male and female drivers, RTCRWS has a better warning effect on female drivers.
Beta amyloid deposition and cognitive decline in Parkinson’s disease: a study of the PPMI cohort
Authors: Mihaescu Alexander , Valli Mikaeel , Uribe Carme , Diez-Cirarda Maria , Masellis Mario , Graff-Guerrero Ariel , Strafella Antonio P. 
Published: March 2022

Abstract
The accumulation of beta amyloid in the brain has a complex and poorly understood impact on the progression of Parkinson's disease pathology and much controversy remains regarding its role, specifically in cognitive decline symptoms. Some studies have found increased beta amyloid burden is associated with worsening cognitive impairment in Parkinson's disease, especially in cases where dementia occurs, while other studies failed to replicate this finding. To better understand this relationship, we examined a cohort of 25 idiopathic Parkinson's disease patients and 30 healthy controls from the Parkinson's Progression Marker Initiative database. These participants underwent [18F]Florbetaben positron emission tomography scans to quantify beta amyloid deposition in 20 cortical regions. We then analyzed this beta amyloid data alongside the longitudinal Montreal Cognitive Assessment scores across 3 years to see how participant’s baseline beta amyloid levels affected their cognitive scores prospectively. The first analysis we performed with these data was a hierarchical cluster analysis to help identify brain regions that shared similarity. We found that beta amyloid clusters differently in Parkinson’s disease patients compared to healthy controls. In the Parkinson’s disease group, increased beta amyloid burden in cluster 2 was associated with worse cognitive ability, compared to deposition in clusters 1 or 3. We also performed a stepwise linear regression where we found an adjusted R2 of 0.495 (49.5%) in a model explaining the Parkinson’s disease group’s Montreal Cognitive Assessment score one-year post-scan, encompassing the left gyrus rectus, the left anterior cingulate cortex, and the right parietal cortex. Taken together, these results suggest regional beta amyloid deposition alone has a moderate effect on predicting future cognitive decline in Parkinson’s disease patients. The patchwork effect of beta amyloid deposition on cognitive ability may be part of what separates cognitive impairment from cognitive sparing in Parkinson’s disease. Thus, we suggest it would be more useful to measure beta amyloid burden in specific brain regions rather than using a whole-brain global beta amyloid composite score and use this information as a tool for determining which Parkinson’s disease patients are most at risk for future cognitive decline.
Larger Lesion Volume in People with Multiple Sclerosis is Associated with Increased Transition Energies Between Brain States and Decreased Entropy of Brain Activity
Authors: Tozlu Ceren , Card Sophie , Jamison Keith , Gauthier Susan , Kuceyeski Amy 
Published: March 2022

Abstract
The mapping between severity or location of this brain tissue damage and an individual's impairment remains challenging in multiple sclerosis (MS). Network control theory (NCT) can be used to characterize the brain's energetic landscape using an individual's structural connectome and brain activity dynamics. We apply brain activity dynamics analysis and NCT to functional time series and structural connectomes in controls and MS patients with and without disability and compare the three groups' resulting metrics. We also assessed the entropy of the three groups' brain activity time series. NCT was used to compute the energy required to transition between each pair of recurring dynamic brain states which were identified with k-means approach applied on fMRI time series. Larger transition energies were associated with MS patient who had disability compared to controls. Entropy was negatively correlated with lesion volume as was transition energy in MS. Functional compensation of brain activity in MS patients without disability may result in decreased transition energies between states compared to controls, but, as this mechanism diminishes, transition energies increase and disability occurs. Larger volumes of MS-related lesions may result in greater energetic demands to transition between brain states which then leads to lower overall entropy of brain activity.
Forming characteristics of the novel robot tube bending process
Authors: Guo xunzhong , Sun zhenbiao , Liu chunmei , Huang zushu , Zheng shuo , Cheng cheng , Tao jie 
Published: March 2022

Abstract
Along with the development of “Industrial 4.0”, the application of industrial robot is becoming more and more extensive. Based on the industrial robot platform, a novel robot tube bending technology has been proposed. In order to provide guidance for the forming quality of tube bent by robot, using the plastic forming theory and simulation analysis method, compared with the rotary draw bending, the forming mechanism and characteristics of robot tube bending were analyzed. The Al6061 thin-walled tube with small diameter was taken as the research object. The results show that, in the novel robot tube bending process, since the bending die is feeding in the direction of the pipe axis while rotating, it will reduce to some extent the axial tensile stress T on the pipe during the bending process. Therefore, compared with the traditional rotary draw bending, the tensile stress and strain and thinning rate on the outer side of bent tube are both smaller, while the compressive stress and strain and thickening rate of the inner tube are instead larger in the robot tube bending process. With the increase of bending angle, the maximum cross-sectional distortion of bent tube in the robot tube bending process remains basically unchanged and is always smaller than that in the rotary draw bending process, and the greater the bending angle, the more obvious the difference. In summary, the robot tube bending technology plays a more positive role in reducing the thickness reduction and section distortion of the small diameter tube.