bluuebunny/crossref_metadata_2025_split huggingface dataset:
The “whole ingredients extract” of Astragali Radix improves the symptoms of dextran sulfate sodium-induced ulcerative colitis in mice through systemic immunomodulation
Authors: Linghu Ke-Gang , Ma Qiushuo , Xiong Shi-Hang , Zhao Mingming , Chen Qiling , Xu Wen , Chen Meiwan , Zhang Jian-Ye , Hu Yuanjia , Xu Wei , Yu Hua 
Published: September 2022

Abstract
Background
Ulcerative colitis (UC) is a common inflammatory intestinal disease. Astragali Radix (AR) is one of the traditional Chinese medicines used in clinic for UC treatment. In our previous study, the whole ingredient extract (WIE) from AR have been proved to possess better immunomodulatory effects on immunosuppressed mice compared with the conventional water extraction (WAE). In the present study, we further evaluated the therapeutic effects of WIE against dextran sodium sulfate (DSS)-induced UC in mice through systemic immune regulation.

Methods
Gradient solvent extraction has been used to prepare the WIE of AR. The HPLC–MS analysis approach has been employed to analyze and compare the chemical differences between WAE and WIE. UC model was reproduced in 3% DSS-induced C57BL/6 mice for 6 days. Flow cytometric analysis for splenic lymphocyte subset. ELISA kits were used to determine the cytokines in the serum and colon tissues. The histopathological characteristics of colon were evaluated by hematoxylin–eosin staining and immunohistochemistry.

Results
The chemical compositions and the contents of main active ingredients were more abundant and higher in WIE than those in WAE. The WIE treatment altered a better action on reducing colitis disease activity index (DAI) and histological scores, as well as the recovered body weight and increased colon length in mice compared to the WAE group. Additionally, WIE showed better effects in recovering the levels of peripheral white blood cells in blood and cytokines (IL-2, IL-6 and MCP-1) in serum or colon tissues, improving the percentage of CD3+ and the ratio of CD4+/CD8+ in the spleen, and inhibiting the spleen enlargement in DSS-induced UC mice.

Conclusions
WIE has a more complete chemical composition than WAE. Meanwhile, WIE possesses better therapeutic effects on UC through resuming dysfunctional immunity in mice.
A scoping review of FGM in humanitarian settings: an overlooked phenomenon with lifelong consequences
Authors: Elnakib Shatha , Metzler Janna 
Published: September 2022

Abstract
Background
Female genital mutilation (FGM) is widely recognized as a human rights violation. Little is known about FGM rates and practices in humanitarian settings, and about the impact of crisis on the drivers and consequences of FGM. This scoping review set out to investigate the current research landscape on FGM in humanitarian settings.

Methods
We conducted a search of electronic databases and gray literature published between 1990 and 2021. This was coupled with backward citation tracking on eligible studies and reviews. We analyzed studies that met our eligibility criteria using thematic analysis.

Results
We found 13 peer-reviewed and four grey literature articles. Most studies were published in the last decade between 2010 and 2021, signaling growing attention to the issue. Five of the 17 articles provided estimates of incidence based on primary data collection amongst crisis-affected populations, ten focused on drivers, ten on consequences and five on interventions. The limited studies that have examined FGM in humanitarian settings indicate that the impact of crisis on FGM is multifaceted and context-specific, depending in part on interactions with host and other displaced communities and their social norms and practices. There is evidence that the acquisition and transfer of harmful social norms may take place during migration flows, but also that social norms underlying FGM may weaken in contexts of displacement, causing the practice to decrease. The incidence of FGM may also remain unchanged, but the type of FGM practiced may shift from more harmfully perceived forms to less radical forms. We found that drivers of FGM may be exacerbated, attenuated, or unchanged by crisis and displacement. Overall, there was predominant focus on medical consequences of FGM, and limited research on the social, economic, and psychological consequences of the practice. There was also a dearth of research into intervention effectiveness.

Conclusions
Despite an increase in research on FGM in humanitarian settings, there is still a notable dearth of studies investigating the impact of emergencies on FGM and the factors that propel it. More research and documentation of evidence are needed to inform interventions and policies.
Subcutaneous tunnelling versus conventional insertion of peripherally inserted central catheters in hospitalized patients (TUNNEL-PICC): a study protocol for a randomized controlled trial
Authors: Kwon Yohan , Kim Eung Tae , Cho Soo Buem , Lee Jae Hwan , Shim Dong Jae 
Published: September 2022

Abstract
Background
Peripherally inserted central catheters (PICCs) are now widely used in modern medicine, and associated complications have also increased. Central line-associated bloodstream infection (CLABSI) is the most serious complication because it can cause extended hospital stays and increase costs. Furthermore, it can contribute to dire consequences for critically ill patients. Subcutaneous tunnelling for central venous catheters is an accepted method to reduce the risk of CLABSI. However, it is not generally adopted for PICC placement in most hospitals because its safety and efficacy have not been thoroughly evaluated.

Methods
In this multi-institutional, prospective, non-blinded pragmatic randomized controlled trial, 1694 patients treated at five referral hospitals will be assigned to one of two parallel arms (conventional and tunnelled PICC groups) using computer-generated stratified randomization. The conventional group will undergo PICC placement by routine practice. In the tunnelled PICC (tPICC) group, additional subcutaneous tunnelling will be applied. Patients will be followed until PICC removal or the end of this study. The primary endpoint is whether subcutaneous tunnelling reduced the rate of CLABSI compared to the conventional method. The secondary endpoints are technical success rates, complications including exit-site bleeding or infection, and the procedure time between the groups.

Discussion
Subcutaneous tunnelling is a widely used method to reduce catheter-associated infection. However, it has not been thoroughly applied for PICC. A randomized trial is needed to objectively assess the effects of the subcutaneous tunnel in PICC placement. This TUNNEL-PICC trial will provide evidence for the effectiveness of subcutaneous tunnelling in decreasing the risk of CLABSI.

Trial registration
Clinical Research Information Service (CRiS) KCT0005521
A study protocol for a double-blind randomised placebo-controlled trial evaluating the efficacy of carrageenan nasal and throat spray for COVID-19 prophylaxis—ICE-COVID
Authors: Jessop Z. M. , Gibson J. , Lim J. Y. , Jovic T. H. , Combellack E. , Dobbs T. D. , Carter K. , Hiles S. , Islam S. , Healy B. , Humphreys I. , Eccles R. , Hutchings H. A. , Whitaker I. S. 
Published: September 2022

Abstract
Introduction
At present, vaccines form the only mode of prophylaxis against COVID-19. The time needed to achieve mass global vaccination and the emergence of new variants warrants continued research into other COVID-19 prevention strategies. The severity of COVID-19 infection is thought to be associated with the initial viral load, and for infection to occur, viruses including SARS-CoV-2 must first penetrate the respiratory mucus and attach to the host cell surface receptors. Carrageenan, a sulphated polysaccharide extracted from red edible seaweed, has shown efficacy against a wide range of viruses in clinical trials through the prevention of viral entry into respiratory host cells. Carrageenan has also demonstrated in vitro activity against SARS-CoV-2.

Methods and analysis
A single-centre, randomised, double-blinded, placebo-controlled phase III trial was designed. Participants randomised in a 1:1 allocation to either the treatment arm, verum Coldamaris plus (1.2 mg iota-carrageenan (Carragelose®), 0.4 mg kappa-carrageenan, 0.5% sodium chloride and purified water), or placebo arm, Coldamaris sine (0.5% sodium chloride) spray applied daily to their nose and throat for 8 weeks, while completing a daily symptom tracker questionnaire for a total of 10 weeks.

Primary outcome
Acquisition of COVID-19 infection as confirmed by a positive PCR swab taken at symptom onset or seroconversion during the study. Secondary outcomes include symptom type, severity and duration, subsequent familial/household COVID-19 infection and infection with non-COVID-19 upper respiratory tract infections. A within-trial economic evaluation will be undertaken, with effects expressed as quality-adjusted life years.

Discussion
This is a single-centre, phase III, double-blind, randomised placebo-controlled clinical trial to assess whether carrageenan nasal and throat spray reduces the risk of development and severity of COVID-19. If proven effective, the self-administered prophylactic spray would have wider utility for key workers and the general population.

Trial registration
NCT04590365; ClinicalTrials.gov NCT04590365. Registered on 19 October 2020.
Re-analysis on the statistical sampling biases of a mask promotion trial in Bangladesh: a statistical replication
Authors: Chikina Maria , Pegden Wesley , Recht Benjamin 
Published: September 2022

AbstractA recent randomized trial evaluated the impact of mask promotion on COVID-19-related outcomes. We find that staff behavior in both unblinded and supposedly blinded steps caused large and statistically significant imbalances in population sizes. These denominator differences constitute the rate differences observed in the trial, complicating inferences of causality.
Promoting the adoption of local governmental policy on the reimbursement of chronic disease medicines (PAPMed): study protocol of a field-based cluster randomized trial in rural Nantong, China
Authors: He Zhengting , Cao Xin , Zhao Duan , Tang Zemin , Zhao Jiayu , Beasley Mariel , Renne Angela , Liu Lei , Zhu Shengjie , Gao Yuexia , Yan Lijing L. 
Published: September 2022

Abstract
Background
Among rural Chinese patients with non-communicable diseases (NCDs), low socioeconomic status increases the risk of developing NCDs and associated financial burdens in paying for medicines and treatments. Despite the chronic disease medicine reimbursement policy of the local government in Nantong City, China, various barriers prevent patients from registering for and benefitting from the policy. This study aims to develop a behavior science-based intervention program for promoting the adoption of the policy and to evaluate the effectiveness of the program compared with usual practices.

Methods
Barriers and opportunities affecting stakeholders in adopting the policy were identified through contextual research and summarized through behavior mapping. The intervention is designed to target these barriers and opportunities through behavior science theories and will be evaluated through a 6-month cluster randomized controlled trial in Tongzhou District, Nantong, China. A total of 30 villages from two townships are randomized in a 1:1 ratio to either the intervention or the control arm (usual practices). Village doctors in the intervention arm (1) receive systematic training on policy details, registration procedures, and intervention protocol, (2) promote the policy and encourage registration, (3) follow up with patients in the first, third, and sixth months after the intervention, and (4) receive financial incentives based on performance. The primary outcome is policy registration rate and the secondary outcomes include the number of patients registering for the policy, medical costs saved, frequency of village doctor visits, and health measures such as blood pressure and glucose levels.

Discussion
This study is one of very few that aims to promote adoption of NCDs outpatient medication reimbursement policies, and the first study to evaluate the impact of these policies on patients’ financial and physical wellbeing in China. The simple, feasible, and scalable intervention is designed based on the theories of behavior science and is applicable to similar low-income regions nationwide where outpatient medical costs remain a financial burden for patients.

Trial registration
ClinicalTrials.govhttps://clinicaltrials.gov/ct2/show/NCT04731194?term=PAPMed&draw=2&rank=1, registered on 29 January 2021; Chinese Clinical Trial Registry http://www.chictr.org.cn/showproj.aspx?proj=65987, registered on 14 January 14 2021.
Effect of EARLY administration of DEXamethasone in patients with COVID-19 pneumonia without acute hypoxemic respiratory failure and risk of development of acute respiratory distress syndrome (EARLY-DEX COVID-19): study protocol for a randomized controlled trial
Authors: Franco-Moreno Anabel , Acedo-Gutiérrez María Soledad , Martín Nicolás Labrador-San , Hernández-Blanco Clara , Rodríguez-Olleros Celia , Ibáñez-Estéllez Fátima , Suárez-Simón Ana , Balado-Rico Mateo , Romero-Paternina Ana Rocío , Alonso-Menchén David , Escolano-Fernández Belén , Piniella-Ruiz Esther , Alonso-Monge Ester , Notario-Leo Helena , Bibiano-Guillén Carlos , Peña-Lillo Gabriela , Antiqueira-Pérez Armando , Romero-Pareja Rodolfo , Cabello-Clotet Noemí , Estrada-Pérez Vicente , Troya-García Jesús , de Carranza-López María , Escobar-Rodríguez Ismael , Vallejo-Maroto Nacho , Torres-Macho Juan 
Published: September 2022

Abstract
Background
Corticosteroids are one of the few drugs that have shown a reduction in mortality in coronavirus disease 2019 (COVID-19). In the RECOVERY trial, the use of dexamethasone reduced 28-day mortality compared to standard care in hospitalized patients with suspected or confirmed COVID-19 requiring supplemental oxygen or invasive mechanical ventilation. Evidence has shown that 30% of COVID-19 patients with mild symptoms at presentation will progress to acute respiratory distress syndrome (ARDS), particularly patients in whom laboratory inflammatory biomarkers associated with COVID-19 disease progression are detected. We postulated that dexamethasone treatment in hospitalized patients with COVID-19 pneumonia without additional oxygen requirements and at risk of progressing to severe disease might lead to a decrease in the development of ARDS and thereby reduce death.

Methods/design
This is a multicenter, randomized, controlled, parallel, open-label trial testing dexamethasone in 252 adult patients with COVID-19 pneumonia who do not require supplementary oxygen on admission but are at risk factors for the development of ARDS. Risk for the development of ARDS is defined as levels of lactate dehydrogenase > 245 U/L, C-reactive protein > 100 mg/L, and lymphocyte count of < 0.80 × 109/L. Eligible patients will be randomly assigned to receive either dexamethasone or standard of care. Patients in the dexamethasone group will receive a dose of 6 mg once daily during 7 days. The primary outcome is a composite of the development of moderate or more severe ARDS and all-cause mortality during the 30-day period following enrolment.

Discussion
If our hypothesis is correct, the results of this study will provide additional insights into the management and progression of this specific subpopulation of patients with COVID-19 pneumonia without additional oxygen requirements and at risk of progressing to severe disease.

Trial registration
ClinicalTrials.gov NCT04836780. Registered on 8 April 2021 as EARLY-DEX COVID-19.
Investigation of selected physico-chemical quality parameters in industrial wastewater by electrocoagulation process, Ethiopia
Authors: Tibebe Dessie , Negash Almaz , Mulugeta Marye , Kassa Yezbie , Moges Zerubabel , Yenealem Dereje 
Published: September 2022

AbstractNowadays, there are more than fourteen major state and private owned textile industries and garment factories in Ethiopia. However, these textile effluents are directly discharged without treatment to the surrounding environment, as a result, the pollutants bring serious problem to the surrounding community including health such as skin diseases, asthma, abortion, carcinogenic effect, biodiversity loss and mutagenic effect on the. The main objective of this study is characterization and treatment of the textile effluent using aluminum electrodes in the electrocoagulation process. EC experimental setups were designed and different parameters were optimized. Electrocoagulation treatment process eliminates physicochemical quality indicators such as pH, electrical conductivity (EC); turbidity, biological oxygen demand (BOD), ammonia; nitrate, nitrite, total nitrogen (TN) and phosphate were determined using standard procedures. From the result, the maximum removal efficiency of phosphate, ammonia, TN, electrical conductivity, turbidity and BOD were obtained 97, 87, 88, 89, 99 and 66%, respectively. Analyses of the electrochemically generated sludge by X-ray Diffraction, Scanning Electron Microscope (SEM), and Fourier Transform Infrared Spectroscopy (FTIR) revealed that the expected crystalline aluminum oxides (bayerite (Al(OH)3 diaspore (AlO(OH)) were found in the sludge. The amorphous phase was also found in the floc. Therefore, a treatment technology was good and encourages the community to apply the technique for the treatment of textile effluent before discharging into the environment.
The lymphatic vascular system: much more than just a sewer
Authors: Wilting Jörg , Becker Jürgen 
Published: September 2022

AbstractAlmost 400 years after the (re)discovery of the lymphatic vascular system (LVS) by Gaspare Aselli (Asellius G. De lactibus, sive lacteis venis, quarto vasorum mesaraicorum genere, novo invento Gasparis Asellii Cremo. Dissertatio. (MDCXXIIX), Milan; 1628.), structure, function, development and evolution of this so-called ‘second’ vascular system are still enigmatic. Interest in the LVS was low because it was (and is) hardly visible, and its diseases are not as life-threatening as those of the blood vascular system. It is not uncommon for patients with lymphedema to be told that yes, they can live with it. Usually, the functions of the LVS are discussed in terms of fluid homeostasis, uptake of chylomicrons from the gut, and immune cell circulation. However, the broad molecular equipment of lymphatic endothelial cells suggests that they possess many more functions, which are also reflected in the pathophysiology of the system. With some specific exceptions, lymphatics develop in all organs. Although basic structure and function are the same regardless their position in the body wall or the internal organs, there are important site-specific characteristics. We discuss common structure and function of lymphatics; and point to important functions for hyaluronan turn-over, salt balance, coagulation, extracellular matrix production, adipose tissue development and potential appetite regulation, and the influence of hypoxia on the regulation of these functions. Differences with respect to the embryonic origin and molecular equipment between somatic and splanchnic lymphatics are discussed with a side-view on the phylogeny of the LVS. The functions of the lymphatic vasculature are much broader than generally thought, and lymphatic research will have many interesting and surprising aspects to offer in the future.
A dark and stormy night: Reallocation storms in edge computing
Authors: Lovén Lauri , Peltonen Ella , Ruha Leena , Harjula Erkki , Pirttikangas Susanna 
Published: September 2022

AbstractEfficient resource usage in edge computing requires clever allocation of the workload of application components. In this paper, we show that under certain circumstances, the number of superfluous workload reallocations from one edge server to another may grow to a significant proportion of all user tasks—a phenomenon we present as a reallocation storm. We showcase this phenomenon on a city-scale edge server deployment by simulating the allocation of user task workloads in a number of scenarios capturing likely edge computing deployments and usage patterns. The simulations are based on a large real-world data set of city-wide Wi-Fi network connections, with more than 47M connections over ca. 560 access points. We study the occurrence of reallocation storms in three common edge-based reallocation strategies and compare the latency–workload trade-offs related to each strategy. As a result, we find that the superfluous reallocations vanish when the edge server capacity is increased above a certain threshold, unique for each reallocation strategy, peaking at ca. 35% of the peak ES workload. Further, while a reallocation strategy aiming to minimize latency consistently resulted in the worst reallocation storms, the two other strategies, namely a random reallocation strategy and a bottom-up strategy which always chooses the edge server with the lowest workload as a reallocation target, behave nearly identically in terms of latency as well as the reallocation storm in dense edge deployments. Since the random strategy requires much less coordination, we recommend it over the bottom-up one in dense ES deployments. Moreover, we study the conditions associated with reallocation storms. We discover that edge servers with the very highest workloads are best associated with reallocation storms, with other servers around the few busy nodes thus mirroring their workload. Further, we identify circumstances associated with an elevated risk of reallocation storms, such as summertime (ca. 4 times the risk than on average) and on weekends (ca. 1.5 times the risk). Furthermore, mass events such as popular sports games incurred a high risk (nearly 10 times that of the average) of a reallocation storm in a MEC-based scenario.
Improving datacenter utilization through containerized service-based architecture
Authors: Mulahuwaish Aos , Korbel Shane , Qolomany Basheer 
Published: September 2022

AbstractThe modern datacenter's computing capabilities have far outstripped the applications running within and have become a hidden cost of doing business due to how software is architected and deployed. Resources are over-allocated to monolithic applications that sit idle for large parts of the day. If applications were architected and deployed differently, shared services could be used for multiple applications as needed. When combined with powerful orchestration software, containerized microservices can both deploy and dynamically scale applications from very small to very large within moments—scaling the application not only across a single datacenter but across all datacenters where the application(s) are deployed.In this paper, we analyze data from an application(s) deployed both as a single monolithic codebase and as a containerized application using microservice-based architecture to calculate the performance and computing resource waste are both architected and deployed. A modern approach is offered as a solution as a path from how to go from a monolithic codebase to a more efficient, reliable, scalable, and less costly deployment model.