bluuebunny/crossref_metadata_2025_split huggingface dataset:
Framework and Analysis of Key Performance Indicators in Cuban Higher Education
Authors: Vinajera-Zamora Andrey , Gaus Nurdiana , Rodríguez-Martínez Yohandra 
Published: February 2022

This article aims to examine how Cuban higher education has implemented and created frameworks for key performance indicators (KPIs) to enhance its higher education accountability and quality. Referring to the past 15 years of available data on the United Nations Educational, Scientific, and Cultural Organization’s website (2005–2020), this study shows that Cuba’s higher education system has improved, as indicated by the increasing rate of the gross graduation ratio (both sexes) as well as national and inbound student mobility. Resumen Este manuscrito examinó como la educación superior cubana ha implementado y creado marcos de referencia de Indicadores de Ejecución Clave para mejorar su responsabilidad y calidad de educación superior. Refiriéndose a los últimos 15 años de información disponible en la red mundial (2005–2020) de la página de las Naciones Unidas sobre Enseñanza, Organizaciones Científicas y Culturales, este estudio demuestra que el sistema de educación superior ha mejorado, indicado por el incremento en la tasa de graduación bruta (ambos géneros) nacional, y de movilidad estudiantil interna
Anemia Severity and the Risks of Postoperative Complications and Extended Length of Stay Following Primary Total Elbow Arthroplasty
Authors: Gordon Adam M. , Ashraf Asad M. , Sheth Bhavya K. , Magruder Matthew L. , Conway Charles A. , Choueka Jack 
Published: February 2022

Background: Anemia is a modifiable risk factor that may influence postoperative complications following orthopedic surgical procedures. The objective was to determine the influence of preoperative anemia severity on postoperative complications and length of stay (LOS) following total elbow arthroplasty (TEA). Methods: The American College of Surgeons National Surgical Quality Improvement Program registry was queried from 2006 to 2019 for patients undergoing primary TEA. Using the World Health Organization definitions of anemia, patients undergoing TEA were stratified into 3 cohorts: nonanemia (hematocrit >36% for women, >39% for men), mild anemia (hematocrit 33%-36% for women, 33%-39% for men), and moderate-to-severe anemia (hematocrit <33% for both women and men). Patient demographics, surgical time, LOS, and postoperative complications were compared between the groups. A P value <.004 was considered significant. Results: After exclusion, 589 patients, of whom 369 (62.6%) did not have anemia, 129 (21.9%) had mild anemia, and 91 (15.5%) had moderate/severe anemia, were included. Increasing severity of anemia was associated with an increased average hospital LOS (2.30 vs 2.81 vs 4.91 days, P < .001). There was a statistically significant increase in blood transfusions (1.08% vs 7.75% vs 17.58%, P < .001), major complications (9.21% vs 17.83% vs 34.07%, P < .001), any complications (11.11% vs 23.26% vs 36.26%, P < .001), and extended LOS ≥6 days (6.23% vs 6.98% vs 31.87%, P < .001) with increasing severity of anemia. Multivariate analysis identified moderate-to-severe anemia was significantly associated with major complications and extended LOS ( P < .001). Conclusions: Preoperative anemia is a modifiable risk factor for medical and surgical complications within 30 days of TEA.
Increased aortic repair in Germany correlates with reduction of death caused by aortic aneurysms but not aortic dissections
Authors: Santosa Frans , Beckerath Olga von , Cremer Svenja , Katoh Marcus , Juntermanns Benjamin , Kröger Knut , Gäbel Gabor 
Published: February 2022

Introduction We asked if there is a significant correlation between the increasing trend in aortic repair (AR) and decreasing aortic aneurysm (AA) and aortic dissection (AD) mortality? Therefore, we retrospectively analyzed all aortic repairs in patients with AA and AD and its correlation with disease-specific death rates and hospitalizations for ruptured AA and AD in Germany. Methods We retrieved the number of cases hospitalized for AA and AD as well as the procedures in these cases from the Federal Bureau of Statistics (DRG statistics) and death rates from the national mortality statistic published by the Federal Statistical Office in Germany for the years 2006–2017. Results From 2006 to 2017, the total number of hospitalized cases admitted with principal diagnosis of AA increased by 25.8% and that of AD by 56.7%. That of cases with the principal diagnosis of ruptured AA (rAA) remained unchanged (−2.5%) and that with rAD increased by 54.6%. The number of (open and endovascular) procedures in cases hospitalized for AA increased by 39.4% and for AD by 126.4%. The age-adjusted death rates in Germany for AA decreased from 4.0 to 2.9 per 100,000 inhabitants and that for AD increased from 1.0 to 1.4. The decrease in death attributed to AA cases can be described by linear regression as y = −0.0003*y + 6.7076 ( p < 0.0001). Accepting this association between increased elective procedures and reduced AA mortality, each/all 1000 procedures save 0.3 lives per 100,000 inhabitants. Conclusion Despite increasing numbers of AR for AA and AD, only the mortality rate for all AAs decreased, while we did not observe a decrease in overall mortality of AD in Germany.
Quality of antenatal care and associated factors among pregnant women in East Africa using Demographic and Health Surveys: A multilevel analysis
Authors: Raru Temam Beshir , Mamo Ayana Galana , Bahiru Nebiyu , Deressa Alemayehu , Alemu Addisu , Birhanu Abdi , Yuya Mohammed , Taye Merga Bedasa , Negash Belay , Letta Shiferaw 
Published: February 2022

Introduction: Antenatal care offers a forum for critical healthcare functions, including health education, screening, and disease prevention. Several pocket studies carried out in specific localities of East African countries were investigated. However, these were neither representative of the country nor specific to the recommended minimum of four antenatal care visits. Therefore, this study aimed to identify factors associated with quality of antenatal care among pregnant women in East Africa. Methods: A secondary data analysis was done using Demographic and Health Survey data of six East African Countries from 2008 to 2018. A total of 46,656 women who gave birth in the 5 years preceding the survey were included in this study. A multilevel mixed-effect logistic regression model was fitted. Variables with a p-value < 0.05 were declared as significant factors associated with the quality of antenatal care. Results: The magnitude of quality of antenatal care in East Africa was 11.16% (95% confidence interval: 10.87–11.45). Women of age 35–49 (adjusted odds ratio = 1.51; 95% confidence interval: 1.25–1.80), primary education (adjusted odds ratio = 1.35; 95% confidence interval: 1.18–1.55), richest wealth index (adjusted odds ratio = 2.35; 95% confidence interval: 2.02–2.74), and rural resident (adjusted odds ratio = 0.62; 95% confidence interval: 0.55–0.69) were among factors significantly associated with quality of antenatal care. Conclusion: The magnitude of antenatal care quality was low in East Africa. Age, level of education, wealth index, birth order, husband/partners’ level of education, residence, and living countries were among the factors associated with the quality of antenatal care. It would be useful to increase financial support strategies that enable mothers from poor households to use health services and enhance women’s understanding of the significance of antenatal care utilization through health education targeting both women and partners with no education is very crucial.
Intra-Articular Injection of Rebamipide-Loaded Nanoparticles Attenuate Disease Progression and Joint Destruction in Osteoarthritis Rat Model: A Pilot Study
Authors: Kim Sung Eun , Choi Sung Jae , Park Kyeongsoon , Kim Hak-Jun , Song Gwan Gyu , Jung Jae Hyun 
Published: February 2022

Objective Rebamipide has antioxidant effects and is a drug with a local rather than systemic mechanism of action. Oxidative stress and inflammation in chondrocytes are the major factors contributing to the development and progression of osteoarthritis (OA). Since OA is mainly developed in weight bearing or overused joints, the locally sustained therapy is effective for targeting inflammatory component of OA. We investigated the effects of intra-articular injection of rebamipide loaded nanoparticles (NPs) in OA rat model. Design We fabricated rebamipide-loaded methoxy poly(ethylene glycol)-b-poly(D,L-lactide) (mPEG-PDLLA) and poly(D, L-lactide- co-glycolide) (PLGA) NPs that allow the sustained release of rebamipide. In vitro, chondrocytes from rat were used to investigate the cytotoxicity and anti-inflammatory effect of rebamipide-loaded NPs. In vivo, monosodium iodoacetate (MIA)-induced OA rats were divided into 7 groups, consisting of healthy control rats and rats injected with MIA alone or in combination with NPs, rebamipide (1 mg)/NPs, rebamipide (10 mg)/NPs, rebamipide (10 mg) solution, or oral administration. Results In vitro, rebamipide/NPs dose-dependently suppressed the mRNA levels of pro-inflammatory mediators, including interleukin (IL)-1β, IL-6, tumor necrosis factor-α, matrix metalloproteinase (MMP)-3, MMP-13, and cyclo-oxygenase-2. In vivo, the mRNA levels of pro-inflammatory components most markedly decreased in the intra-articularly injected rebamipide (10 mg)/NP group compared to other groups. Macroscopic, radiographic, and histological evaluations showed that the intra-articular injection of rebamipide/NPs inhibited cartilage degeneration more than rebamipide solution or rebamipide administration. Conclusions Using a chemically induced rat model of OA, intra-articular delivery of rebamipide was associated with decreased local and systemic inflammatory response decreased joint degradation and arthritic progression.
Neural diffusion tensor imaging metrics correlate with clinical measures in people with relapsing-remitting MS
Authors: Alshehri Abdulaziz , Al-iedani Oun , Arm Jameen , Gholizadeh Neda , Billiet Thibo , Lea Rodney , Lechner-Scott Jeannette , Ramadan Saadallah 
Published: February 2022

Background and purpose Diffusion tensor imaging (DTI) can detect microstructural changes of white matter in multiple sclerosis (MS) and might clarify mechanisms responsible for disability. Thus, we aimed to compare DTI metrics in relapsing-remitting MS patients (RRMS) with healthy controls (HCs), and explore the correlations between DTI metrics, total brain white matter (TBWM) and white matter lesion (WML) with clinical parameters compared to volumetric measures. Material and methods 37 RRMS patients and 19 age/sex-matched HCs were included. All participants had clinical assessments, structural and diffusion scans on a 3T MRI. Volumetric and white matter DTI metrics; fractional anisotropy (FA), mean, radial and axial diffusivities (MD, RD and AD) were estimated and correlated with clinical parameters. The mean group differences were calculated using t-tests, and univariate correlations with Pearson correlation coefficients. Results Compared to HCs, statistically significant increases in MD (+3.6%), RD (+4.8%), AD (+2.7%) and a decrease in FA (−4.3%) for TBWM in RRMS was observed ( p < .01). MD and RD in TBWM and AD in WML correlated moderately with disability status. Volumetric segmentation indicated a decrease in the total brain volume, GM and WM(−5%) with a reciprocal increase in CSF(+26%) in RRMS( p < .01). Importantly, DTI parameters showed a medium correlation with cognitive domains in contrast to white matter-related volumetric measurements in RRMS(Pearson correlation, p < .05). Conclusions Our study shows a correlation of DTI metrics with clinical symptoms of MS, in particular cognition. More generally, these findings indicated that DTI is a useful and unique technique for evaluating the clinical features of white matter disease and warrants further investigation into its clinical role.
Social media-based intervention to promote HBV screening and liver cancer prevention among Korean Americans: Results of a pilot study
Authors: Hong Y. Alicia , Yee Soo , Bagchi Pramita , Juon Hee-soon , Kim Sojung Claire , Le Daisy 
Published: February 2022

ObjectiveIn United States, Asian Americans are 10 times more likely to have hepatitis B virus (HBV) infection than Whites. Asian immigrants with limited English proficiency face extra barriers to HBV screening and many are unaware of the infectious status. This study aimed to evaluate a social media-based intervention to promote HBV screening and liver cancer prevention among Korean Americans (KA) with limited English proficiency.MethodsOur community-academia partnership developed the “Lets talk about liver cancer” mHealth program by adapting a CDC media campaign. The program consisted of culturally tailored short video clips and pictorial messages and was delivered over 4 weeks to the participants via the popular Korean social media app, Kakao Talk. A total 100 KA living in greater Washington DC metropolitan were recruited via social media networks and completed this pre-post pilot study.ResultsOut of the 100 participants of KA, 56 were female, mean age was 60, and most have lived in the U.S. for more than 20 years, 84% had limited English proficiency, and 21% had a family history of HBV infection or liver cancer. After 4-week intervention, 95% completed the follow-up survey. Participants reported significant improvements in HBV-related knowledge, liver cancer prevention knowledge, perceived benefits of HBV testing, perceived risks of HBV infection, injunctive norms of HBV testing, and self-efficacy of HBV testing.ConclusionsThe Kakao Talk-based liver cancer prevention program for KAs was feasible and effective. We advocate for community-academia partnership to develop and implement culturally appropriate and social media-based interventions for underserved immigrants.
Donor-Site Morbidity After Autologous Fascia Lata Harvest for Arthroscopic Superior Capsular Reconstruction: A Midterm Follow-up Evaluation
Authors: Ângelo Ana Catarina Leiria Pires Gago , de Campos Azevedo Clara Isabel 
Published: February 2022

Background: Autologous fascia lata (AFL) graft use in arthroscopic superior capsular reconstruction (ASCR) is effective for the treatment of irreparable rotator cuff tears (RCTs). Although donor-site morbidity (DSM) is a recurrent argument against AFL graft use, scientific evidence for this argument is lacking. Purpose: To report the midterm clinical follow-up evaluation of DSM in ASCR using minimally invasively harvested AFL grafts and compare thigh function and patient satisfaction with those of an unharvested control group. Study Design: Cohort study; Level of evidence, 3. Methods: Of 66 consecutive patients who underwent ASCR using a minimally invasively harvested AFL graft, 39 patients with a minimum follow-up of 24 months were retrospectively evaluated (ASCR group) and compared with 39 randomly selected patients who underwent arthroscopic RCT repair by the same surgeons (control group). The functional outcomes of both thighs were evaluated using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Patient satisfaction was evaluated using the Patient Scar Assessment Questionnaire (PSAQ) and a subjective questionnaire. Pain was quantified using a visual analog scale (VAS). Results: The ASCR group had a mean age of 65 years (range, 51-77 years) and a mean follow-up of 47 months (range, 24-66 months). The WOMAC score in the harvested thigh differed by 0.8% from that in the contralateral thigh ( P = .002). The mean PSAQ score differed by 6 points from the minimum PSAQ score ( P < .001). Overall, 95% of the patients indicated that they would undergo the same surgery again and that the shoulder outcome compensated for the thigh symptoms. There was no significant association between the presence of residual thigh symptoms and the willingness to undergo the same surgery again ( P = .354). The mean VAS score in the harvested thigh was 0.6 (range, 0-5). There was no significant difference in the average WOMAC score or VAS score between groups ( P = .684 and P = .148, respectively). Conclusion: Despite the proportion of residual symptoms, the associated functional effects were small and not clinically significant, and the vast majority of patients were accepting of the harvest symptoms given the improvement in shoulder function.
Mechanical thrombectomy in stroke patients of working age: Real-world outcomes in Sweden
Authors: Roland Mihae , Markaki Ioanna , Andersson Tommy , Arnberg Fabian , Sjöstrand Christina 
Published: February 2022

Introduction Outcomes after mechanical thrombectomy (MT) in young stroke patients remain elusive due to small patient cohorts. We sought to determine outcomes after MT in stroke patients between ages 18 and 64 years and compare with outcomes in older patients in a large national stroke cohort. Patients and methods We used the Swedish National Stroke Registry and the Swedish National Endovascular Thrombectomy Registry to identify all patients treated with MT for anterior circulation occlusions. We examined outcome measures in terms of functional independence at 90 days (modified Rankin Scale score of 0–2), symptomatic intracerebral hemorrhage (sICH), and mortality at 90 days with multivariable logistic regression analysis. Results Of 2143 patients, 565 were between 18 and 64 years (26.4%) and 1179 (55.0%) were males. Analysis showed that patient aged 18–64 achieved higher rate of functional independence at 90 days (46.2% vs 28.4%, p < .001), had less often sICH (5.5% vs 6.8%, p = .008), and lower 90-day mortality rate (6.9% vs 17.7%, p < .001). Increasing age was associated with a lesser probability of functional independence at 90 days (adjusted odds ratio (aOR), 0.94; [95% confidence intervals (CIs) 0.93–0.95]), higher odds of mortality at 90 days (aOR, 1.05; [95% CIs 1.03–1.06]), and of sICH (aOR 1.03; [95% CIs 1.01–1.05]). Conclusion Patients aged 18–64 years demonstrated better outcome after thrombectomy regarding functional independence, sICH, and mortality at 90 days when compared to older ages.
Fuel cell drive for urban freight transport in comparison to diesel and battery electric drives: a case study of the food retailing industry in Berlin
Authors: Winkler John Kenneth , Grahle Alexander , Syré Anne Magdalene , Martins-Turner Kai , Göhlich Dietmar 
Published: February 2022

AbstractThe option of decarbonizing urban freight transport using battery electric vehicle (BEV) seems promising. However, there is currently a strong debate whether fuel cell electric vehicle (FCEV) might be the better solution. The question arises as to how a fleet of FCEV influences the operating cost, the greenhouse gas (GHG) emissions and primary energy demand in comparison to BEVs and to Internal Combustion Engine Vehicle (ICEV). To investigate this, we simulate the urban food retailing as a representative share of urban freight transport using a multi-agent transport simulation software. Synthetic routes as well as fleet size and composition are determined by solving a vehicle routing problem. We compute the operating costs using a total cost of ownership analysis and the use phase emissions as well as primary energy demand using the well to wheel approach. While a change to BEV results in 17–23% higher costs compared to ICEV, using FCEVs leads to 22–57% higher costs. Assuming today’s electricity mix, we show a GHG emission reduction of 25% compared to the ICEV base case when using BEV. Current hydrogen production leads to a GHG reduction of 33% when using FCEV which however cannot be scaled to larger fleets. Using current electricity in electrolysis will increase GHG emission by 60% compared to the base case. Assuming 100% renewable electricity for charging and hydrogen production, the reduction from FCEVs rises to 73% and from BEV to 92%. The primary energy requirement for BEV is in all cases lower and for higher compared to the base case. We conclude that while FCEV have a slightly higher GHG savings potential with current hydrogen, BEV are the favored technology for urban freight transport from an economic and ecological point of view, considering the increasing shares of renewable energies in the grid mix.
Complete genome sequence of the kiwifruit bacterial canker pathogen Pseudomonas savastanoi strain MHT1
Authors: Zhong Mingzhao , Sun Yunhao , Zhang Xianzhi , Liang Hong , Xiong Lina , Han Qunxin 
Published: February 2022

Abstract
Background
Pseudomonas savastanoi is an important plant pathogen that infects and causes symptoms in a variety of economically important crops, causing considerable loss of yield and quality. Because there has been no research reported to date on bacterial canker of kiwifruit (Actinidia chinensis) plants caused by P. savastanoi and, in particular, no in-depth studies of the complete genome sequence or pathogenic mechanism, long-lasting and environmentally friendly control measures against this pathogen in kiwifruit are lacking. This study therefore has both theoretical value and practical significance.

Results
We report the complete genome sequence of P. savastanoi strain MHT1, which was first reported as the pathogen causing bacterial canker in kiwifruit plants. The genome consists of a 6.00-Mb chromosome with 58.5% GC content and 5008 predicted genes. Comparative genome analysis of four sequenced genomes of representative P. savastanoi strains revealed that 230 genes are unique to the MHT1 strain and that these genes are enriched in antibiotic metabolic processes and metabolic pathways, which may be associated with the drug resistance and host range observed in this strain. MHT1 showed high syntenic relationships with different P. savastanoi strains. Furthermore, MHT1 has eight conserved effectors that are highly homologous to effectors from P. syringae, Pseudomonas amygdali, and Ralstonia solanacearum strains. The MHT1 genome contains six genomic islands and two prophage sequences. In addition, 380 genes were annotated as antibiotic resistance genes and another 734 as encoding carbohydrate-active enzymes.

Conclusion
The whole-genome sequence of this kiwifruit bacterial canker pathogen extends our knowledge of the P. savastanoi genome, sets the stage for further studies of the interaction between kiwifruit and P. savastanoi, and provides an important theoretical foundation for the prevention and control of bacterial canker.
Immunoglobulin G4-related constrictive pericarditis and the importance of a thorough workup: a case report
Authors: Maltês Sérgio , Cabral Margarida , Freitas Pedro , Albuquerque Catarina , Fernandes Carolina , Moura Diana , Santos Beatriz , Mendes Miguel , Neves José 
Published: February 2022

Abstract
Background
Constrictive pericarditis remains a problematic diagnosis and a thorough investigation is critical. Among possible aetiologies, immunoglobulin-G4 (IgG4)-related pericardial disease is an unusual cause of pericardial constriction. We report a challenging diagnostic case of pericardial constriction due to IgG4-related disease.

Case presentation
A 68-year old male with a history of inferior myocardial infarction with right ventricle (RV) involvement was thrice-hospitalized due to marked ascites and peripheral oedema. Systemic congestion was initially attributed to RV dysfunction due to previous infarction. Yet, at the final admission, a re-assessment echocardiogram followed by cardiac computed tomography, magnetic resonance and right heart catheterization raised a possible diagnosis of constrictive pericarditis with a finding of abnormal pulmonary venous return. Patient therefore underwent pericardiectomy and surgical correction of pulmonary venous return. Pericardium histology revealed an IgG4-related pericardial constriction. Patient was later discharged on corticosteroids with marked symptomatic improvement.

Conclusion
IgG4-related disease remains a rare cause of pericardium constriction while also presenting a challenging diagnosis in everyday clinical practice. This case exemplifies the difficulties faced by clinicians when reviewing a possible case of constrictive pericarditis, while highlighting the importance of a multimodality assessment.