bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early Pleistocene complex cut-and-fill sequences in the Alps
Authors: Dieleman Catharina , Christl Marcus , Vockenhuber Christof , Gautschi Philip , Akçar Naki 
Published: March 2022

AbstractCut-and-fill sequences are the result of climatically or tectonically induced alternating aggradation and incision phases of a fluvial system. A recently established cosmogenic nuclide chronology of the Cover Gravels (Deckenschotter in German) in the northern Alpine Foreland, which are the oldest Quaternary glaciofluvial gravels and comprise evidence of early Pleistocene glaciations, suggests a cut-and-fill build-up. This suggested cut-and-fill architecture challenges the morphostratigraphy. The Deckenschotter deposits represent a suitable archive for reconstructing drainage patterns, base level changes, and the landscape evolution of the northern Alpine Foreland during the early Pleistocene. In this study, we focused on the highest morphostratigraphic Deckenschotter sites: three at Irchel and one in the area around Lake Constance. Sediment analyses were performed to determine their provenance and depositional environments. The geochronology was established using isochron-burial dating. The results indicate that the sediments were transported from the Central and eastern Central Alps, as well as from the Molasse, to the foreland and deposited in a proximal glaciofluvial environment. Based on these findings, we propose that the Deckenschotter are cut-and-fill sequences that accumulated in three stages during the early Pleistocene at ca. 2.5 Ma, ca. 1.5 Ma, and ca. 1 Ma. The presence of a cut-and-fill system implies that the regional base level was relatively constant during the early Pleistocene. In addition, the ca. 2.5 Ma glaciofluvial gravels document the first evidence of glaciers in the northern Alpine Foreland. This timing is synchronous with the onset of Quaternary glaciation in the northern hemisphere at ca. 2.7 Ma.
Deep hydrochemical section through the Central Alps: evolution of deep water in the continental upper crust and solute acquisition during water–rock-interaction along the Sedrun section of the Gotthard Base Tunnel
Authors: Stober Ingrid , Giovanoli Federico , Wiebe Victoria , Bucher Kurt 
Published: March 2022

AbstractDrilling of the Gotthard Rail Base Tunnel through the Central Alps from 2005 to 2010 opened up fractured basement units and frequent water inflows provided access to the major fluid-rock interactions processes in orogenic crystalline upper crust. Construction of the 57 km long tunnel was divided into five different sections. Here we report data and observations from the 10 km long central Sedrun section 211 water samples were collected at inflow points 900 to 2350 m below the surface. The exceptional samples and data provide a comprehension of the hydrochemical evolution and solute acquisition of deep groundwater in basement units. The investigated tunnel section drilled through steeply dipping rock units and vertical fracture systems at high angle. It cuts across granite, gneiss and schist of the pre-Alpine basement and across two narrow zones of meta-sediments. Rock temperature along the Sedrun section varies from 30 to 45 °C depending on the thickness of the overburden. The fracture water is of meteoric origin and acquires its composition exclusively by chemical interaction with the surrounding rocks along the flow path. Water from inflow points in the basement of the Gotthard Massif has typically a high pH of about 10 and total dissolved solids in the range of 100 to 300 mg L−1. Sodium is the prime cation of most waters. Although plentiful in the rocks, calcium, potassium and magnesium are low to very low in water. The anions associated with Na are carbonate/bicarbonate, sulfate, fluoride and chloride in widely varying proportions. High fluoride concentrations of up to 15.4 mg L−1are characteristic for most waters. As a result of the high pH dissolved silica (SiO2) reached concentrations of up to 58 mg L−1and represents 25—30 wt% of the solutes. The meteoric recharge provides dissolved O2and CO2to the fluid-rock interaction processes. The solutes derive from the dissolution of feldspar (Na+, SiO2aq), oxidation of sulfides to sulfate (SO42−), alteration of biotite (F−), and fluid inclusions opened by brittle deformation (Cl−). The solids formed during fluid-rock interaction, mainly zeolites, chlorite (and other clay minerals) and secondary Fe-minerals, remove Mg, Fe, and K almost quantitatively from the water. The high pH results from hydrolysis of silicates. The data distinctly show that within the depth interval of 1.0–2.5 km below surface deep water in continental basement evolves to a low TDS, high pH, sodium carbonate and silica solution by interaction of gneiss and granite with infiltrating pristine meteoric water, snow and rain.
Spinal epidural lipomatosis
Authors: Ramdani Hanae , Jidal Manal , Saouab Rachida , Sahri Imad-Eddine , En-Nouali Hassan , El Fenni Jamal 
Published: March 2022

AbstractSpinal epidural lipomatosis (SEL) is a rare pathologic growth of histologically normal nonencapsulated adipose tissue in the epidural space. It can cause myelopathy or radiculopathy. Etiologies include chronic exposure to endogenous or exogenous steroids and obesity. Idiopathic forms are much infrequent. We present a case of lumbar SEL compressing the thecal sac in a 50-year-old female patient.
Effect of appropriate dose, spectrum, and timing of antibiotics on 28-day mortality in patients with sepsis in the emergency department
Authors: Sanguanwit Pitsucha , Monthonn Chonpisit , Prachanukool Thidathit , Suttapanit Karn 
Published: March 2022

Abstract
Background
Appropriate antibiotics prescribing is key to treatment and to preventing mortality in patients with sepsis. The aim of this study was to determine the effect of the appropriate timing, spectrum, and dose of antibiotics on 28-day mortality in patients with sepsis.

Methods
We performed a retrospective cohort observational study. We enrolled patients with sepsis in the emergency department of a tertiary care hospital between 1 March and 31 July 2019. Patients were coded into an appropriate antibiotics group (time, spectrum, dose) and an inappropriate antibiotics group. We collected information of patient characteristics, comorbidities, vital signs, laboratory test results, and initial treatment. We followed patient outcomes, 28-day mortality, hospital deaths, 28-day ventilator-free days, and 28-day hospital-free days.

Results
A total of 593 patients were enrolled, with 323 (54.46%) in the appropriate antibiotics group. We used multivariate logistic analyses to assess factors for mortality. Primary outcomes of appropriate antibiotics (administration within 60 min of triage, appropriate spectrum and dose) did not affect 28-day mortality (adjusted odds ratio [OR], 0.57; 95% confidence interval [CI] 0.22–1.144; P=0.23). Subgroup analysis showed that appropriate spectrum alone influenced 28-day mortality (adjusted OR, 0.38; 95% CI, 0.15–0.99; P=0.047). Appropriate antibiotics was not associated with in-hospital mortality (adjusted OR, 0.62; 95% CI, 0.29–1.30; P=0.21).

Conclusion
Appropriate antibiotics included timing less than 60 min, spectrum and the dose was not significantly affected in 28-day mortality in emergency sepsis patients.

Trial registration
The trial was retrospectively registered in the Thai Clinical Trial Registry, identification number TCTR20211216003.
Defense response changes in roots of oil palm (Elaeis guineensis Jacq.) seedlings after internal symptoms of Ganoderma boninense Pat. infection
Authors: Faizah Rokhana , Putranto Riza Arief , Raharti Vivi Restu , Supena Nanang , Sukma Dewi , Budiani Asmini , Wening Sri , Sudarsono Sudarsono 
Published: March 2022

AbstractBackgroundThe development of basal stem rot (BSR) disease in oil palm is associated with lignin during vegetative growth and salicylic acid (SA) biosynthesis. The increase in the lignin content, SA accumulation, growth, and root biomass could indicate the resistance of oil palm seedlings to BSR disease. Therefore, although there are many studies on the interactions between theGanoderma boninenseand oil palm, research on evaluation of physiological processes, biochemistry, and molecules occurring during early internal symptoms of BSR in roots of oil palm (Elaeis guineensis Jacq.) are essential.ResultsGanoderma boninenseinoculation indicated that C01, C02, and C05 seedlings were susceptible, while the other three seedlings, C03, C07, and C08, were resistant based onGanodermaDisease Index (GDI). Infection by G. boninensein the most susceptible seedlings C05 reduced fresh weight of roots (FW) by 9.0%, and lignin content by 10.9%. The most resistant seedlings C08 were reduced by only 8.4%, and 0.2% regarding their fresh weight and lignin content, respectively. BSR disease induced SA accumulation in the most susceptible C08 and decreased peroxidase (PRX) enzyme (EC 1.11.1.7) activities in root tissues of oil palm seedlings except C07 and C08 where PRX activities remained high in the 4 months after planting. Infection with G. boninensealso increased glutathione S-transferase U19-like (EgGSTU19) gene expression in the root tissues of susceptible seedlings, while laccase-24 (EgLCC24) gene expression was associated with resistance against BSR disease. Based on the relative expression of twelve genes, two genes are categorized as receptors (EgWAKL5, EgMIK1), two genes as biosynthesis signal transduction compound (EgOPR5, EgACO1), five genes as defense responses (EgROMT, EgSOT12, EgLCC24, EgGLT3, EgGSTU19), and one gene as trans-resveratrol di-O-methyltransferase-like (EgRNaseIII) predicted related to BSR infection. While two other genes remain unknown (EgUnk1, EgUnk2).ConclusionsGanodermainfection-induced SA accumulation and lignification in resistant accessions promote the seedlings root biomass. Oil palm seedlings have a synergistic physical, biochemical, and molecular defense mechanism to the BSR disease. The utilization of nucleotide-based molecular markers using EgLCC24 gene is able to detect resistant oil palm seedlings toG. boninense.
Real-time ultrasound-guided stellate ganglion block for migraine: an observational study
Authors: Hou Jiawei , Pu Shaofeng , Xu Xingguo , Lu Zhiqiang , Wu Junzhen 
Published: March 2022

Abstract
Objective
To observe whether ultrasound-guided stellate ganglion block (SGB) can effectively relieve migraine pain and improve the quality of migraine patients’ life.

Methods
81 patients with migraines were enrolled in this study. The patients received SGB with 6 ml of 0.15% ropivacaine once every week for four times. Migraine was assessed with the Migraine Disability Assessment Scale (MIDAS) at baseline and three-months follow-up (Tm). The numerical rating scale (NRS) score at baseline, one day after treatment (Td) and Tm, the frequency of analgesic use in 3 months and the side effects were also recorded at the same time.

Results
The NRS score of migraine subjects decreased significantly from 7.0 (2.0) to 3.0 (1.0) at Td and 2.0 (2.0) at Tm (vs baseline, P < 0.01). The MIDAS total scores were 14.0 (10.5) at baseline and 7.0 (4.5) at Tm (P < 0.001). During the three months, the frequency of analgesic consumption was decreased from 6.2 ± 2.8 to 1.9 ± 1.8. There were no serious side effects.

Conclusions
This study confirmed that ultrasound-guided SGB is an effective method to treat migraines. This technique can reduce pain and disability and then improve the quality of life of patients with migraines.
Comparison of the outcomes of EMS vs. Non-EMS transport of patients with ST-segment elevation myocardial infarction (STEMI) in Southern Iran: a population-based study
Authors: Najafi Hjatolah , Bahramali Ehsan , Bijani Mostafa , Dehghan Azizallah , Amirkhani Mehdi , Balaghi inaloo Maryam 
Published: March 2022

Abstract
Background
In the medical management of acute myocardial infarction, the transport of patients and primary care provided by emergency medical technicians (EMTs) and paramedics are effective in reducing the mortality and disabilities. Therefore, the present study aimed to compare the outcomes of emergency medical services (EMS) vs. non-EMS transport of patients with ST-segment elevation myocardial infarction (STEMI) in southern Iran.

Methods
This is an analytical, cross-sectional study. The study population consisted of the individuals registered in Fasa Registry on Acute Myocardial Infarction (FaRMI) in the south of Iran. 2244 patients with STEMI were included in the study. Statistical analyses were performed using Chi-Square test and independent t-test at a significance level of P < 0.05 in SPSS 22.

Results
Out of the 2244 patients with STEMI, 1552 (69.16%) were male and 672 patients (29.94%) were female. 934(41.62%) patients used EMS transport to the hospital, while 1310 (58.37%) patients used non-EMS transport to the hospital. A total of 169 patients with STEMI (7.26%) expired (out-of-hospital cardiac arrest); of them, 113 (66.86%) patients did not use EMS transport to the hospital. Successful cardiopulmonary resuscitation (CPR) was performed on 52 patients who used EMS transport. 27 patients also received an effective DC shock due to ventricular fibrillation (VF). Of the total number of patients, 49 had a stroke; among them, 37(75.51%) patients did not use EMS transport.

Conclusion
In the present study, the death rate in patients with acute myocardial infarction who used EMS transport was lower than those who used non-EMS transport. The health system managers and policymakers in the healthcare systems are recommended to take the necessary measures to increase public health awareness and knowledge about the use of EMS and consequently reduce the death rate and complications of acute myocardial infarction.
“Decision tree analysis for assessing the risk of post-traumatic haemorrhage after mild traumatic brain injury in patients on oral anticoagulant therapy”
Authors: Turcato Gianni , Cipriano Alessandro , Park Naria , Zaboli Arian , Ricci Giorgio , Riccardi Alessandro , Barbieri Greta , Gianpaoli Sara , Guiddo Grazia , Santini Massimo , Pfeifer Norbert , Bonora Antonio , Paolillo Ciro , Lerza Roberto , Ghiadoni Lorenzo 
Published: March 2022

Abstract
Background
The presence of oral anticoagulant therapy (OAT) alone, regardless of patient condition, is an indication for CT imaging in patients with mild traumatic brain injury (MTBI). Currently, no specific clinical decision rules are available for OAT patients. The aim of the study was to identify which clinical risk factors easily identifiable at first ED evaluation may be associated with an increased risk of post-traumatic intracranial haemorrhage (ICH) in OAT patients who suffered an MTBI.

Methods
Three thousand fifty-four patients in OAT with MTBI from four Italian centers were retrospectively considered. A decision tree analysis using the classification and regression tree (CART) method was conducted to evaluate both the pre- and post-traumatic clinical risk factors most associated with the presence of post-traumatic ICH after MTBI and their possible role in determining the patient’s risk. The decision tree analysis used all clinical risk factors identified at the first ED evaluation as input predictor variables.

Results
ICH following MTBI was present in 9.5% of patients (290/3054). The CART model created a decision tree using 5 risk factors, post-traumatic amnesia, post-traumatic transitory loss of consciousness, greater trauma dynamic, GCS less than 15, evidence of trauma above the clavicles, capable of stratifying patients into different increasing levels of ICH risk (from 2.5 to 61.4%). The absence of concussion and neurological alteration at admission appears to significantly reduce the possible presence of ICH.

Conclusions
The machine-learning-based CART model identified distinct prognostic groups of patients with distinct outcomes according to on clinical risk factors. Decision trees can be useful as guidance in patient selection and risk stratification of patients in OAT with MTBI.
A unique case of coexisting intrauterine and abdominal pregnancy which progress to term with a positive birth outcome
Authors: Utalo Tadiwos , Getu Jenenu 
Published: March 2022

Abstract
Background
The term heterotopic pregnancy is defined as a uterine pregnancy coexisting with a second pregnancy in an extrauterine location. Spontaneous, full-term heterotopic pregnancy with alive birth is very rare. The diagnosis and management of such exceptionally unique case is difficult. When the patient presented with an advanced labor with no antenatal care follow up and with no risk factors is even more challenging for poorly equipped facilities like ours.

Case presentation
A 25 years old gravida 3, para 2 (both are alive) mother presented to the labor and delivery ward of Bele Primary Hospital, Southern Ethiopia with the complaint of pushing down pain of 18 h duration. Immediately after arrival, she gave birth to a 3300gm female neonate spontaneously. After delivery, an abdominal mass was recognized and manual exploration of the uterus was done to look for the presence of after coming second twin but the uterus was empty. On ultrasound examination, there was an alive fetus in transverse lie outside the uterus. With the impression of 2nd twin in a separate horn of bicornuate uterus and to rule out abdominal pregnancy, laparotomy was done. On laparotomy, there was abdominal pregnancy in the Pouch of Douglas with an intact amniotic sac. The sac was attached with the left broad ligament, left ovary, small bowel mesentery, and posterior wall of the uterus. The sac opened, a 1600gm alive female neonate with features of fetal growth restriction and left club foot was delivered. The placenta was detached spontaneously and removed without any complication.

Conclusions
The coexistence of spontaneous full-term intrauterine with advanced abdominal ectopic pregnancy is one of the rarest forms of heterotopic pregnancy. Every health professional should bear in mind that intrauterine and extrauterine pregnancy may happen simultaneously and it can progress to term without any symptoms. Ultrasound is the diagnostic method of choice but the existence of an intra-uterine pregnancy cannot rule out ectopic pregnancy. The life-threatening complication of abdominal ectopic pregnancy is bleeding from the detached placental site. Therefore, the decision to remove the placenta should be individualized.
Longitudinal changes of blood parameters and weight in inoperable stage III NSCLC patients treated with concurrent chemoradiotherapy followed by maintenance treatment with durvalumab
Authors: Guggenberger J. , Kenndoff S. , Taugner J. , Käsmann L. , Flörsch B. , Belka C. , Eze C. , Manapov F. 
Published: March 2022

Abstract
Background
Investigating dynamic changes in blood-parameters and weight in patients with locally advanced non-small cell lung cancer (NSCLC) receiving durvalumab maintenance therapy after chemoradiotherapy (cCRT). Laboratory outcomes were determined based on the number of durvalumab administrations received.

Methods
Twenty-two patients completed platinum-based cCRT followed by maintenance treatment with durvalumab. Different parameters such as hemoglobin (Hb), leukocytes, Lactate dehydrogenase (LDH), C-reactive protein (CRP), body weight and albumin were analyzed before cCRT, after cCRT, 3, 6, 9 and 12 months after starting durvalumab maintenance.

Results
Sixteen (72.7%) patients were male; twelve (54.5%) and fifteen (68.2%) patients had non-squamous histology and Union for International Cancer Control (UICC) stage IIIB-C disease, respectively. Median follow-up time was 24.4 months; 12- and 18-months- progression-free and overall-survival rates were 55.0% and 45.0 as well as 90.2 and 85.0%, respectively.
During maintenance treatment Hb increased by 1.93 mg/dl (17.53%) after 9 months (p < 0.001) and 2.02 mg/dl (18.46%) after 12 months compared to the start of durvalumab (p < 0.001). LDH decreased by 29.86 U/l (− 11.74%) after 3 months (p = 0.022). Receipt of at least 12 cycles of durvalumab was beneficial in terms of Hb-recovery (Hb 6 months: 12.64 vs. 10.86 [mg/dl]; Hb 9 months: 13.33 vs 11.74 [mg/dl]; (p = 0.03)). Median weight change [kilogram (kg)] was + 6.06% (range: − 8.89 − + 18.75%) after 12 months. The number of durvalumab cycles significantly correlated with total weight gain [kg] (Spearman-Rho-correlation: r = 0.502*).

Conclusion
In the investigated cohort, no severe hematologic toxicity occurred by laboratory blood tests within 1 year of durvalumab maintenance therapy after cCRT for unresectable stage III NSCLC. Receiving at least 12 cycles of durvalumab appears to have a significant effect on recovery of hemoglobin levels and body weight.
Expenditures on sugar-sweetened beverages in Jamaica and its association with household budget allocation
Authors: Paraje Guillermo , Gomes Fabio S. 
Published: March 2022

Abstract
Background
Sugar-sweetened beverages (SSB) consumption is associated with overweight and obesity, which are important drivers for the increasing healthcare and other social costs. If expenditures on SSB decrease expenditures on other goods and services, such as education and healthcare, this “crowding-out” may have a lasting effect. The main objectives of this article are, first, to estimate the statistical association between the decision of spending in SSB and several households’ sociodemographic characteristics; and second, to estimate the association between the decision of buying SSB and budget allocation across categories in Jamaica.

Methods
Using the Jamaican Household Expenditure Survey 2004–2005 a generalized ordered probit model was estimated to examine the association between socioeconomic variables and the decision to spend on SSB. Seemingly Unrelated Regression Equations (SURE) of all the expenditure groups (except the SSB group) were used to estimate the association between the decision of buying SSB and budget allocation on other goods and services.

Results
Expenditures on SSB are negatively affected by the size of the household and the area of residence (rural households spend more on SSB than urban ones), while having a larger proportion of children (15 or younger) and having a larger total budget is associated to more expenditures on SSB. Households with positive expenditure on SSB allocate significantly less budget to “Healthcare” and “Education”, when compared to those who did not buy SSB.

Conclusions
SSB expenditures may displace expenditures in necessary goods and services, which implies that decreasing the proportion of budget spent on SSB may have important present and future consequences on poorer households’ human capital accumulation and future incomes.