bluuebunny/crossref_metadata_2025_split huggingface dataset:
Virtual Curriculum Delivery in the COVID-19 era: The Pediatric Surgery Boot Camp v2.0
Authors: Baird Robert , Puligandla Pramod , Lopushinsky Steve , Blackmore Christopher , Krishnaswami Sanjay , Nwomeh Benedict , Downard Cynthia , Ponsky Todd , Ghani Muhammad O. , Lovvorn Harold N. 
Published: May 2022

Abstract
Purpose: We evaluated the impact of a virtual Pediatric Surgery Bootcamp curriculum on resource utilization, learner engagement, knowledge retention, and stakeholder satisfaction. Methods: A virtual curriculum was developed around Pediatric Surgery Milestones. GlobalCastMD delivered pre-recorded and live content over a single 10-hour day with a concluding social hour. Metrics of learner engagement, faculty interaction, knowledge retention, and satisfaction were collected and analyzed during and after the course. Results: Of 56 PS residencies, 31 registered (55.4%; 8/8 Canadian and 23/48 US; p=0.006), including 42 learners overall. The virtual BC budget was $15,500 (USD), 54% of the anticipated in-person course.. Pre- and post-tests were administered, revealing significant knowledge improvement (48.6% [286/589] vs 66.9% [89/133] p<0.0002). Learner surveys (n=14) suggested the virtual BC facilitated fellowship transition (85%) and strengthened peer-group camaraderie (69%), but in-person events were still favored (77%). Program Directors (PD) were surveyed, and respondents (n=22) also favored in-person events (61%). PDs not registering their learners (n=7) perceived insufficient value-added and concern for excessive participants. Conclusions: The virtual bootcamp format reduced overall expenses, interfered less with schedules, achieved more inclusive reach, and facilitated content archiving. Despite these advantages, learners and program directors still favored in-person education.
Effect of Redroot Pigweed Interference on Active Oxygen Species, Antioxidative Defence System and Oxidative Damage of Common bean (Phaseolus vulgaris L.)
Authors: Tabatabaiepour Seyede Zahra , Tahmasebi Zahra , Taab Alireza , Monfared Sajad Rashidi 
Published: May 2022

Abstract
Redroot Pigweed (Amaranthus retroflexus L.) is an important weed that is highly competitive with common bean. The aims of this study were to evaluate the relative expression of a number of antioxidant enzyme and light response genes and investigate the activity of antioxidant enzymes, anthocyanins and photosynthetic pigments of several red common bean cultivar/lines (Sayad, Derakhshan, and Line D81083) in third trifoliate leaf (V4) and pod formation (R7) stages under Redroot Pigweed free and infested conditions. At V4, enzymatic activity and gene expression decreased while with the increase of common bean competition with weeds, the expression of genes and enzymes activity increased. The activity of antioxidant enzymes increased in the R7 as compared to the V4, indicating the production of reactive oxygen species (ROS) upon competition with weed and increased enzymatic activity for the elimination of ROS. Sayad and D81083 exhibited the highest catalase contents under weed interference whereas demonstrated the lowest catalase enzyme amount under weed-free conditions. Thus, response of common bean to competition with weed depends on bean growth stage and genotype.
Improving access to palliative care for critically ill cancer patients in intensive care -A Quality Improvement initiative from a tertiary referral cancer centre in India.
Authors: BALAKRISHNAN KALPANA , .Ramasamy Thendral , Venketeswaran Meenakshi 
Published: May 2022

Abstract
Objectives/Background: Anaesthesiologists who were also working in palliative care (PC) wanted PC to be available for critically ill cancer patients in an exclusive oncology intensive care (ICU) with the aim of better communication and care giver comfort.Methods: A3 problem solving method with Plan Do check Act (PDCA) method of quality improvement was used. First a process map of patient movements into and out of ICU was made. Root cause assessment with the 5 whys were used to find the barriers for PC referral and included Lack of a protocol to assess PC needs, non-availability of PC data in intensive care electronic records and inadequate pathway for continuity of care after ICU discharge.Interventions: After consensus building, we introduced a PC referral trigger tool to initiate referral and ensured availability of list of PC centers for referral at discharge desk. Continued education of residents and nurses to use the tool helped in sustaining PC referral from ICU.Results/Outcomes: Patients continued access to PC both while in ICU and after discharge started increasing from baseline 0% to over 75% by mid-March 2020 .Conclusion: A structured QI process helped initiate access to PC for more than 50% of critically ill cancer patients.Lessons learned: Quality improvement process by its systematic methodology helps in attaining goals. Oncologists are not averse to initiation palliative care in ICU. However, for sustained results regular educational reinforcements of the support staff are needed.
Multiglandular Parathyroid Disease
Authors: Kowalski Grzegorz , Buła Grzegorz , Bednarczyk Adam , Gawrychowska Agata , Gawrychowski Jacek 
Published: May 2022

Abstract
BACKGROUND: Multiglandular parathyroid disease (MGD) is an uncommon cause of primary hyperparathyroidism (pHPT) and has been reported in the literature in 8–33 % of patients with pHPT. The aim of our study was to review the clinical characteristics and management of MGD and evaluation of surgical treatment failures.METHODS: We performed a retrospective study of 163 patients with pHPT undergoing parathyroidectomy (PTX) at the Department of General and Endocrine Surgery, between 1983 and 2018. All these patients were diagnosed with MGD. This group of patients was compared with the group of 856 patients with solitary disease operated for pHPT in the same period. RESULTS: Among 163 patients – 129 (79%) of them had two lesions, 26 (16%) had three and 8 (5%) four. They were prevalently women over the age of 50. The diagnosis was based on PTH and ionized calcium studies and used sestamibi technetium-99m scintigraphy (MIBI) scintigraphy as well for us. Treatment was surgical.CONCLUSIONS: Parathyroidectomy (PTX) for multiglandular parathyroid disease (MGD) is associated with a higher operative risk of failure compared to solitary disease. Preoperative diagnosis and localization of the parathyroid glands is an extremely important element of treatment. Mediastinal MGD is associated with increased surgical treatment failures.
Reconstruction of the medial patellofemoral ligament with autologous peroneal longus tendon versus semitendinosus tendon: a case control study
Authors: Han Mingzhan , Zhang Qianlong , Chen Wencao , Zhang Siping , Zhang Wenhao , Mou Limin , Yakufu Maihemuti , Liu Wei , Ma Pengcheng 
Published: May 2022

Abstract
Objective：In order to treat and improve recurrent patellar dislocation (RPD), autologous partial peroneal long tendon (PLT) or autologous partial semitendinosus tendon (ST) were taken to reconstruct the medial patellofemoral ligament (MPFL) respectively. The postoperative effects of the two methods were compared.Method:Patients with RPD in the Department of orthopedics of the Sixth Affiliated Hospital of Xinjiang Medical University were selected, and underwent MPFL reconstruction from February 2018 to February 2021. There were 65 cases, including 20 male patients and 45 female patients. The grafts were autologous PLT or ST, including 32 cases in PLT group and 33 cases in ST group. The evaluation indexes include: postoperative complications: patellar fracture, patellar subluxation, knee pain, knee stiffness, lower limb skin paresthesia, patellar tilt angle, patellar concentration angle, Kujala score and kofoed score of ankle. The functional improvement and complications of patella and knee joint before and after operation were compared, and the curative effect of PLT and ST reconstruction of MPFL was analyzed.Results：The follow-up time was 12-15 months. There were 7 cases of knee pain and 5 cases of knee stiffness in PLT group and 5 cases of knee pain and 3 cases of knee stiffness in ST group. There was no significant difference in postoperative pain and stiffness between the two groups (P > 0.05). There were 18 cases of infrapatellar branch of saphenous nerve (IPBSN) injury in ST group, but no IPBSN injury was found in PLT group (P < 0.05). The IPBSN injury in ST group was positively correlated with the incision length of tendon extraction (P < 0.05). In the last follow-up, there was no significant difference in patellar tilt angle, patellar convergence angle and Kujala score between the two groups (P > 0.05). The kofoed score of ankle joint in both groups was excellent.Conclusions：Autologous PLT and ST reconstruction of MPFL can effectively treat RPD, significantly improve patellar tilt angle and patellar concentration angle, improve Kujala score, improve knee function and clinical symptoms. Both are effective ways to treat RPD, but ST group will lead to IPBSN injury and sensory impairment of anterolateral skin of lower leg.
“We should be at the table together from the beginning”: sub-Saharan African perspectives on global health research partnerships
Authors: Voller Shirine , Chitalu Chama-Chiliba Miriam , Nyondo-Mipando Alinane Linda , Opobo Timothy , Bangirana Clare Ahabwe , Thorogood Nicki , Schellenberg Joanna , Chi Primus 
Published: May 2022

Abstract
Background: Global health research partnerships have been scrutinised for how they operate and criticised for perpetuating inequities. Guidance to inform fair partnership practice has proliferated and the movement to decolonise global health has added momentum for change. In light of this evolving context, in this study we sought to document contemporary experiences of partnership from the perspective of stakeholders in a sample of sub-Saharan African research institutions. Methods: We conducted qualitative interviews with 20 stakeholders at four research institutions in four countries in anglophone eastern and southern Africa. Interview questions were informed by published guidance on equitable research partnerships. Data was analysed through an iterative process of inductive and deductive coding, supported by NVivo software.Results: Early to mid-career and senior researchers and research administrators from four sub-Saharan African research institutions described wide-ranging experiences of partnership with high-income country collaborators. Existing guidelines for partnership provided good coverage of issues that participants described as being the key determinants of a healthy partnership, including mutual respect, role clarity and early involvement of all partners. However, there was almost no mention of guidelines being used to inform partnership practice. Participants considered the key benefits of partnership to be capacity strengthening and access to research funding. Meanwhile, participants continued to experience a range of well-documented inequities, including exclusion from agenda setting, study design, data analysis and authorship; and relationships that were exploitative and dominated by high-income country partners’ interests. Participants also reported emerging issues where their institution had been the prime recipient of funds. These included high-income country partners being unwilling to accept a subordinate role and failing to comply with reporting requirements. Conclusions: Contemporary global health research partnerships generate considerable benefits but continue to exhibit longstanding inequities and reveal emerging tensions. Long-term support targeted towards institutions and national research systems remains essential to fulfil the potential of research led from sub-Saharan Africa. High-income country stakeholders need to find new roles in partnerships and stakeholders from sub-Saharan Africa must continue to tackle challenges presented by the resource-constrained contexts in which they commonly operate.
Systemic lupus of pediatric onset: the experience of the French overseas departments of America
Authors: Felix Arthur , Delion Frederique , Suzon Benoit , Martin Elise , Ogrizek Anais , Sahnoun M'hamed Mohamed , Hospice Claudia , Armougon Aurelie , Cuadro Emma , Elenga Narcisse , Dramé Moustapha , Bader-Meunier Brigitte , Deligny Christophe , Hatchuel Yves 
Published: May 2022

Abstract
Introduction: Systemic diseases of pediatric onset are more frequent in the Afro-Caribbean population. We performed a study of patients followed in French overseas departments of America (FOAD) for pediatric systemic lupus (pSLE). The aims were to describe their clinical and biological specificities during childhood.Methods: A retrospective study was conducted between January 2000 and September 2021. Listings of patients with pediatric onset were obtained through multiple sources: computerized hospital archives, registry of referent pediatricians and adult specialists in internal medicine and French National Registry for rare diseases. The spectrum of diseases studied was systemic lupus according to international criteria with pediatric onset.Results: Overall, 2148 patients were identified, and 54 patients were included. The average follow-up was 8.3 years (range: 0.3 - 25 years). We found an increase in new diagnoses throughout the years. At onset, pSLE patients had a median of 10 SLICC criteria (range: 4-12), and the median EULAR/ACR 2019 score was 38 (12 - 54). At onset, one-third of patients had renal involvement, 15% neurolupus and 41% cardiac involvement. During childhood, 54% had renal involvement, and 26% suffered from neurolupus. Patients suffered a median of 3 flares during childhood and 26% from more than 5 flares. Younger patients at onset had worst outcomes; they had more flares (median at 5 p = 0,02) and needed an average of 4 background therapies (p = 0,04).Conclusion: The outcomes of Afro-Caribbean patients, where pSLE is more frequent, were similar to those in Western countries with worse disease activity at onset. Further studies should be performed to identify the genetic and environmental factors in this population.
MIS-C: Clinical profile, outcomes and predictors of severe disease
Authors: Subhash Swathy , Joji Prameela , Baby Greeshma , Nair Nisha , Kumar Shiju , Gupta Neetu 
Published: May 2022

Abstract
ObjectiveMIS-C is a novel disease entity. We aimed to outline the clinical features and laboratory parameters of children with moderate to severe MIS-C and to study predictors of more severe disease. MethodsIn this prospective longitudinal study, all children less than 15 years of age requiring admission to the Paediatric Intensive Care Unit (PICU) or High Dependency Unit (HDU) with three or more days of fever were screened for MIS-C according to the WHO case definition. Children with alternative diagnoses were excluded. Those included were tested for active or past infection with SARS-COV2 using RTPCR or antibody testing. Severe MIS-C was defined as presence of ventricular dysfunction, coronary dilatation, need for respiratory support, inotropes or invasive ventilation. Clinical features, laboratory parameters and risk factors for severe disease was studied.Results60 children were included in the study. Median age group was 5yrs(IQR 2.175,9)The median duration of PICU/HDU stay was 4 days(IQR 2,5.75). Two children died of the illness. Gastrointestinal symptoms were most common(73%) followed by muco-cutaneous(56%), respiratory(46%) and cardiovascular system(41%) involvement. Majority showed neutrophilia(73%), leucopenia(53%) and raised inflammatory markers including ESR,CRP, D-dimer, ferritin and NT-proBNP which showed significant association with need for respiratory support, inotropes, cardiac dysfunction and prolonged ICU stay. Gastrointestinal symptoms, respiratory distress, reduced urine output at admission, platelet counts less than 1.5 lakhs, D-dimer >2000ng/mL, CRP >70mg/L, NT-proBNP>500pg/mL, ferritin >250mcg/L were markers of severe MIS-C.ConclusionClinical features and laboratory parameters aid in early recognition of severe MIS-C resulting in greater probability of survival.
Hierarchical Reinforcement Learning for Efficient and Effective Automated Penetration Testing of Large Networks
Authors: Ghanem Mohamed Chahine , Chen Thomas , Nepomuceno Erivelton 
Published: May 2022

Abstract
Penetration testing (PT) is a method for assessing and evaluating the security of digital assets by planning, generating, and executing possible attacks that aim to discover and exploit vulnerabilities. In large networks, penetration testing becomes repetitive, complex and resource-consuming despite the use of automated tools.
This paper investigates reinforcement learning (RL) to make penetration testing more intelligent, targeted, and efficient. The proposed approach called Intelligent Automated Penetration Testing Framework (IAPTF) utilizes model-based RL to automate sequential decision making. Penetration testing tasks are treated as a partially observed Markov decision process (POMDP) which is solved with an external POMDP-solver using different algorithms to identify the most efficient options.
A major difficulty encountered was solving large POMDPs resulting from large networks. This was overcome by representing networks hierarchically as a group of clusters and treating each cluster separately.
This approach is tested through simulations of networks of various sizes. The results show that IAPTF with hierarchical network modeling outperforms previous approaches as well as human performance in terms of time, number of tested vectors and accuracy, especially in large networks. Another advantage of IAPTF is the ease of repetition for retesting similar networks, which is often encountered in real penetration testing. The results suggest that IAPTF is a promising approach to offload work from and ultimately replace human pen-testing.
Deterioration of vulcanized natural rubber sheets is associated with removal of calcium carbonate filler by wood-decay fungi Trichaptum abietinum and Trichaptum biforme
Authors: Sato Shin , Tien Hoan Kim , Inamori Wataru , Yoneyama Fuminori , Mase Akio 
Published: May 2022

Abstract
Wood-decay fungi may show potential in the degradation of rubber products in a natural and environmentally friendly process. Therefore, this study investigated the degradation of vulcanized natural rubber sheets by wood-decay fungi Trichaptum abietinum and Trichaptum biforme and the action of these fungi on the internal and external morphology, chemical composition, and physical properties of the rubber sheets. Scanning electron microscopy-energy dispersive X-ray spectroscopy analysis demonstrated that T. abietinum and T. biforme caused significant changes in the morphology of whole rubber. Crystals including calcium elements were formed on the rubber sheet after fungal treatment. Thermogravimetric analysis revealed a decrease in ash ingredient content corresponding to calcium carbonate in rubber treated with T. biforme for 3 months. These results suggest that the removal of the calcium carbonate filler from the rubber was associated with the deterioration of vulcanized natural rubber sheets by fungi. Furthermore, physical characteristics, durometer hardness, and tensile strength at the breakage point in rubber sheets were clearly altered after fungal treatment, although weight loss was not remarkable. We herein report for the first time that T. abietinum and T. biforme deteriorate vulcanized rubber sheets accompanied by transformation and translocation of calcium carbonate in vulcanized rubber.
Clinical implication of megestrol acetate in advanced cancer: A big data analysis from Health Insurance Review and Assessment (HIRA) database
Authors: Lee Chang Min , Kang Jung Hun , Go Se-Il 
Published: May 2022

Abstract
Purpose Megestrol acetate (MA) is used to manage anorexia and cachexia in patients with advanced cancer. This study investigated prescription patterns and impact on the survival and the venous thromboembolism (VTE) of MA in patients with advanced cancer.Methods In this study, a Health Insurance Review and Assessment (HIRA) service database was used to investigate differences in baseline characteristics, survival, and the incidence of VTE according to MA prescription patterns (i.e., prescription vs. no prescription) in patients diagnosed with metastatic gastric, colorectal, and pancreatobiliary cancers from July 2014 to December 2015.Results A total of 5,920 patients were included in this study. In total, 66.9% of the patients were prescribed MA. Pancreatobiliary cancer, older age, treatment in tertiary hospitals, and palliative chemotherapy were statistically significant predictive factors for MA prescription. Continuous prescription of MA was observed in 42.2% of patients. There was no statistically significant difference in survival between the MA and non-MA prescription groups. Among the 4,081 patients included in the analysis for VTE incidence, 5.4% and 2.9% were diagnosed with VTE during the follow-up period in the MA and non-MA prescription groups, respectively. However, there was no statistically significant difference in VTE diagnosis between the groups on multivariate analysis.Conclusions This study demonstrated that most patients with advanced gastrointestinal and pancreatobiliary cancer required MA prescription. The difference in the incidence of VTE was modest between the MA and non-MA prescription groups (not at the level of statistical significance on multivariate analyses).
Evaluation of the Performance of CMIP6 Model Simulations for the East Asia Region: Perspectives from Multiple Dimensions
Authors: Song Shuaifeng , Zhang Xuezhen , Gao Zhibo , Yan Xiaodong 
Published: May 2022

Abstract
A comprehensive model assessment on a 6-hourly scale from multiple dimensions is critical for model selection of dynamic downscaling to reduce uncertainties. In this study, we evaluated the performance of 13 models involved in the Coupled Model Intercomparison Project-6 (CMIP6) by comparing the simulated meteorological variables at the pressure levels of 850 hPa, 500 hPa, and 250 hPa, including 6-hourly air temperature, specific humidity, zonal wind, meridional wind, and geopotential height, to those from the ERA5 reanalysis data for the 1979-2014 period. The results indicated that the CMIP6 models could mostly reproduce the spatial pattern of the climatology. Most models underestimated air temperature and geopotential height while overestimating specific humidity and zonal and meridional wind speeds in the upper troposphere. Additionally, the interannual variability of zonal and meridional wind exhibits a relatively better performance but the limited ability for specific humidity at 850 hPa. Regarding the annual and diurnal cycles, CMIP6 models reasonably captured the annual cycle shape, while an overestimation was detected in simulating the diurnal amplitude, notably at 250 hPa. Based on a comprehensive rating index and overall rankings, our findings showed that no single model was identified as suitable for the simulation of any variables and regions. The models performed well for five variables, including MPI-ESM1-2-LR, MPI-ESM1-2-HR, TaiESM1 and UKESM1-0-LL, over East Asia. Then, according to the overall performance of the five variables and model accessibility, the optimal model varied by region and shared socioeconomic pathway (SSP) scenario. The MPI-ESM1-2-LR and MRI-ESM2-0 models were the two best models as lateral boundary conditions applied to seven climate scenarios over East Asia. This study provides valuable scientific references for selecting the optimal CMIP6 models for the projection of dynamic downscaling over East Asia and eight subregions.