bluuebunny/crossref_metadata_2025_split huggingface dataset:
The application of the WSES classification system for open pelvic fractures—validation and supplement from a nationwide data bank
Authors: Li Pei-Hua , Hsu Ting-An , Kuo Yu-Chi , Fu Chih-Yuan , Bajani Francesco , Bokhari Marissa , Mis Justin , Poulakidas Stathis , Bokhari Faran 
Published: May 2022

Abstract
Background
Open pelvic fractures are rare but complex injuries. Concomitant external and internal hemorrhage and wound infection-related sepsis result in a high mortality rate and treatment challenges. Here, we validated the World Society Emergency Society (WSES) classification system for pelvic injuries in open pelvic fractures, which are quite different from closed fractures, using the National Trauma Data Bank (NTDB).

Methods
Open pelvic fracture patients in the NTDB 2015 dataset were retrospectively queried. The mortality rates associated with WSES minor, moderate and severe injuries were compared. A multivariate logistic regression model (MLR) was used to evaluate independent factors of mortality. Patients with and without sepsis were compared. The performance of the WSES classification in the prediction of mortality was evaluated by determining the discrimination and calibration.

Results
A total of 830 open pelvic fracture patients were studied. The mortality rates of the mild, moderate and severe WSES classes were 3.5%, 11.2% and 23.8%, respectively (p < 0.001). The MLR analysis showed that the presence of sepsis was an independent factor of mortality (odds of mortality 9.740, p < 0.001). Compared with patients without sepsis, those with sepsis had significantly higher mortality rates in all WSES classes (minor: 40.0% vs. 3.1%, p < 0.001; moderate: 50.0% vs. 9.1%, p < 0.001; severe: 66.7% vs. 22.2%, p < 0.001). The receiver operating characteristic (ROC) curve showed an acceptable discrimination of the WSES classification alone for evaluating the mortality of open pelvic fracture patients [area under curve (AUC) = 0.717]. Improved discrimination with an increased AUC was observed using the WSES classification plus sepsis (AUC = 0.767).

Conclusions
The WSES guidelines can be applied to evaluate patients with open pelvic fracture with accurate evaluation of outcomes. The presence of sepsis is recommended as a supplement to the WSES classification for open pelvic fractures.
Uncertainties of soil organic carbon stock estimation caused by paleoclimate and human footprint on the Qinghai Plateau
Authors: Liu Xia , Zhou Tao , Shi Peijun , Zhang Yajie , Luo Hui , Yu Peixin , Xu Yixin , Zhou Peifang , Zhang Jingzhou 
Published: May 2022

Abstract
Background
Quantifying the stock of soil organic carbon (SOC) and evaluating its potential impact factors is important to evaluating global climate change. Human disturbances and past climate are known to influence the rates of carbon fixation, soil physiochemical properties, soil microbial diversity and plant functional traits, which ultimately affect the current SOC storage. However, whether and how the paleoclimate and human disturbances affect the distribution of SOC storage on the high-altitude Tibetan Plateau remain largely unknown. Here, we took the Qinghai Plateau, the main component of the Tibetan Plateau, as our study region and applied three machine learning models (random forest, gradient boosting machine and support vector machine) to estimate the spatial and vertical distributions of the SOC stock and then evaluated the effects of the paleoclimate during the Last Glacial Maximum and the mid-Holocene periods as well as the human footprint on SOC stock at 0 to 200 cm depth by synthesizing 827 soil observations and 71 environmental factors.

Results
Our results indicate that the vegetation and modern climate are the determinant factors of SOC stocks, while paleoclimate (i.e., paleotemperature and paleoprecipitation) is more important than modern temperature, modern precipitation and the human footprint in shaping current SOC stock distributions. Specifically, the SOC stock was deeply underestimated in near natural ecosystems and overestimated in the strongly human disturbance ecosystems if the model did not consider the paleoclimate. Overall, the total SOC stock of the Qinghai Plateau was underestimated by 4.69%, 12.25% and 6.67% at depths of 0 to 100 cm, 100 to 200 cm and 0 to 200 cm, respectively. In addition, the human footprint had a weak influence on the distributions of the SOC stock. We finally estimated that the total and mean SOC stock at 200 cm depth by including the paleoclimate effects was 11.36 Pg C and 16.31 kg C m−2, respectively, and nearly 40% SOC was distributed in the top 30 cm.

Conclusion
The paleoclimate is relatively important for the accurate modeling of current SOC stocks. Overall, our study provides a benchmark for predicting SOC stock patterns at depth and emphasizes that terrestrial carbon cycle models should incorporate information on how the paleoclimate has influenced SOC stocks.
Poor education and urgent information need for emergency physicians about rare diseases in China
Authors: Zhou Lingli , Xu Jun , Yang Jing 
Published: May 2022

Abstract
Background
Rare diseases are serious and chronic diseases that affect no more than 1 person in 2000 (in European Union criteria). Patients suffering from RDs may come to the emergency department for life-threatening symptoms, such as acute aortic dissection, intracranial haemorrhage, and severe respiratory distress. Diagnostic delay of rare disease patients is common and often caused by low rare disease awareness among physicians. The main aim of this study was to investigate Chinese emergency physicians’ basic knowledge, information access and educational needs regarding rare diseases. An online questionnaire was completed by Chinese emergency physicians during January and March 2021.

Methods and results
A total of 539 emergency physicians, including 200 females and 339 males, responded to the questionnaire-based study. More than half of the respondents were from Tertiary A hospitals and had engaged in medical clinical work for more than 10 years. Only 4.27% of respondents correctly estimated the prevalence of rare diseases. A few respondents knew the exact number of RDs in the first official list of rare diseases in 2018. A total of 98.5% of respondents rated their knowledge about rare diseases as minimal or insufficient. Most emergency physicians preferred to obtain information through search engines instead of specialized websites on rare diseases. A lack of practice guidelines or consensus was considered the most important reason for the diagnostic delay of RD. Practice guidelines or consensus and professional websites on rare diseases are urgently needed for emergency physicians.

Conclusion
The investigation shows poor knowledge of rare diseases among emergency physicians. Practice guidelines and professional websites on rare diseases were the primary urgent needs for emergency physicians. Specialized RD courses should also be added to medical education.
Engineering the oleaginous yeast Candida tropicalis for α-humulene overproduction
Authors: Zhang Lihua , Yang Haiquan , Xia Yuanyuan , Shen Wei , Liu Liming , Li Qi , Chen Xianzhong 
Published: May 2022

Abstract
Background
α-Humulene is a plant-derived monocyclic sesquiterpenoid with multiple pharmacological activities, and far-reaching potential for the development of new drugs. Currently, the production of α-humulene is typically achieved via plant extraction, which is not sustainable and limited by low yields. The oleaginous yeast Candida tropicalis has recently emerged as a valuable host for producing high-value-added chemicals. However, the potential of C. tropicalis for terpenoid production has not been exploited.

Results
In this study, C. tropicalis was engineered for de novo synthesis of α-humulene from glucose. To improve α-humulene production, the codon-optimised α-humulene synthase gene and the entire endogenous farnesyl diphosphate synthesis pathway were co-overexpressed. Furthermore, bottlenecks in the α-humulene synthase pathway were identified and relieved by overexpressing α-humulene synthase, acetoacetyl-CoA thiolase and NADH-dependent HMG-CoA reductase. Combined with fermentation medium optimisation, the engineered strain produced 195.31 mg/L of α-humulene in shake flasks and 4115.42 mg/L in a bioreactor through fed-batch fermentation, a 253- and 5345-fold increase over the initial production, respectively.

Conclusions
This study demonstrates the potential of C. tropicalis for α-humulene production, and presents a platform for the biosynthesis of other terpenoids.
Allergological study in patients vaccinated against COVID-19 with suspected allergic reactions
Authors: Jover Cerdá Vicente , Rodríguez Pacheco Ramón , Doménech Witek Joan , Alonso Hernández Sonia , Durán García Rafael , Real Panisello Marina , Marco de la Calle Francisco Manuel 
Published: May 2022

Abstract
Background
One of the main barriers to vaccination against SARS-CoV-2 is the fear of developing hypersensitivity reactions to any of its components. Although these reactions are very rare, it is necessary to establish an effective protocol to detect patients at risk of developing them. The aim of this study was to evaluate hypersensitivity reactions in vaccinated patients in order to allow or not to complete the vaccination protocol.

Methods
Descriptive and cross-sectional study in which patients with suspected hypersensitivity to SARS-CoV-2 vaccines were evaluated. All patients underwent skin prick test (SPT) and/or intradermal test (IDT) with the vaccines and their excipients. In patients with positive IDT with the vaccine, a histopathological and immunohistochemical study was performed by skin biopsy. A basophil activation test (BAT) and a lymphoblastic transformation test (LTT) were also performed.

Results
Sixteen patients with suspected hypersensitivity to SARS-CoV-2 vaccine (12 received Comirnaty®, 3 received Vaxzevria®, and 1 received Spikevax®) were evaluated. Half had immediate hypersensitivity reactions and half had delayed reactions. All SPTs to excipients and vaccines were negative. IDTs with all excipients were negative. IDTs with vaccines were positive in 11 patients and negative in 5. The histological and immunohistochemical study of the two selected patients with positive IDT with vaccine showed T-lymphocyte involvement. BAT and LTT were negative in both cases. The vaccination protocol could be completed in 7 of 16 patients (44%) studied. The remaining 9 patients did not receive the second dose: 5 because vaccination was not required and 4 because they refused to be vaccinated.

Conclusions
Thanks to the allergological and immunohistochemical study, the vaccination protocol could be completed in about half of the patients who presented suspected hypersensitivity reactions to SARS-CoV-2 vaccines. IDTs with vaccines could be a valuable method for assessing the immunogenicity of the vaccines.
Increasing the publicness of riversides as public space development on Kebena River, Addis Ababa, Ethiopia
Authors: Getachew Abebe , Asnake Kalkidan , Desta Hayal 
Published: May 2022

Abstract
Introduction
Public space development is important for the socio-economic and ecological conditions of cities. This study evaluated the publicness of riversides as public space development on the Kebena River in Addis Ababa, Ethiopia. The study identified the potentials and challenges of open spaces for public space development along the riversides of the Kebena River to increase the publicness of the riversides.

Methods
A comparative analysis of the publicness level of three selected open spaces along the riversides of Kebena River, namely, Wisdom Park, Minister Meda, and Agoza Meda, were done using the star model. Quantitative data were collected using site observations, document reviews, and questionnaire surveys with 169 interviewees. The land use and land cover (LULC) change detections were done for the years 2002 and 2020. Data were analyzed using SPSS, ArcGIS (Geographic Information Systems) software, and the Star model of the publicness analysis tool. Both qualitative and quantitative data were used to examine the riversides of the Kebena River.

Result
The results from the star model revealed that the riversides of the Kebena River could not be considered public spaces in their present conditions. This could be attributable to the abuse by the illegal settlers and urban agriculture activities.

Conclusion
The study depicted that the publicness of the Kebena riverside areas is very low and has a very poor public life. Publicness-oriented public spaces should be established and developed to improve and enhance the publicness level of the riversides of the Kebena River. The study contributes to scientific communities and policymakers to enhance the development of open green spaces, which may contribute towards climate change mitigation and adaptation strategies.
VeriSIM: A model-based learning pedagogy for fostering software design evaluation skills in computer science undergraduates
Authors: Prasad Prajish , Iyer Sridhar 
Published: May 2022

AbstractEvaluating a software design is an important practice of expert software designers. They spend significant time evaluating their solution, by developing an integrated mental model of the software design and the requirements. However, sufficient emphasis has not been given on teaching and learning of evaluation practices in software design courses, and hence, graduating students find it difficult to critically analyse an existing design and improve upon it. In this paper, we describe a model-based learning pedagogy for teaching–learning of software design evaluation. Model-based learning has been extensively used in science education and entails helping students construct, refine, revise, evaluate, and validate scientific models. We argue that modelling practices in software design evaluation are analogous to these practices. We adapted the model-based learning paradigm and operationalised it into a technology-enhanced learning environment (TELE) for fostering software design evaluation skills in computer science undergraduates. We conducted a research study with 22 undergraduate students to explore how the TELE and its features help students effectively evaluate a given software design. Students attempted a pre-test and post-test which asked them to identify defects in the design. We used the content analysis method to identify categories of defects from student responses in the pre-test and post-test. We also analysed student interaction logs and conducted focus group interviews to identify how features in the TELE contributed towards student learning. Findings from the study showed that students’ understanding of evaluation improved, from merely adding new functionalities and requirements, to a process which involved identifying alternate scenarios in the design which violate the given requirements. Students perceived that pedagogical features of the TELE were useful in helping them effectively evaluate software designs. Findings from the study provide evidence for the model-based learning paradigm as an appropriate pedagogy for software design and also opens the space for researchers to investigate model-based learning in other aspects of software design, such as designs of different types and varying complexities.
Emotional intelligence and academic motivation in primary school students
Authors: Arias Julia , Soto-Carballo Jorge G. , Pino-Juste Margarita R. 
Published: May 2022

AbstractThe role of emotions in the educational context is one of the lines of research that has generated most interest in recent years. This study explores the level of emotional intelligence (EI) and motivation towards studying of primary school (PS) students, as well as the relationship between both variables. For this, a quasi-experimental design has been used with an accidental sample of 541 students from public centers in the province of Pontevedra (Spain). The instruments used were a School Motivation Scale and an EI questionnaire for primary school students, based on the five areas of Goleman EI. The results maintain a mid to high level of EI in all of the factors (self-conscience, self-control, emotional use, empathy and social skills) and a good level of academic motivation. Therefore, they show a positive and significant correlation of both variables. Girls have a higher emotional intelligence index and there is no difference in academic motivation in terms of gender. Based on these results, it is suggested to implement programs that consolidate emotional competences given their importance in the psychoevolutionary development of students and their relationship with academic motivation.
Fibronectin extra domain A as a drug delivery targeting epitope for rheumatoid arthritis
Authors: Sun Victor Z. , Melim Terry L. , Mitra Soumya , Erickson Jamie E. , Bryant Shaughn H. , Farnham Avery , Westmoreland Susan , Knight Heather , Zhang Liang , Ritacco Wendy , Homan Kristoff , Benatuil Lorenzo , Sterman Annette J. Schwartz , Goodearl Andrew D. 
Published: May 2022

Abstract
Objectives
To assess the ability of monoclonal antibodies (mAbs) specific for fibronectin extra-domain A (FnEDA) to target diseased tissues of mouse collagen induced arthritis (mCIA) models. To explore the parameters of the targeting exhibited by anti-FnEDA mAbs including timing and location.

Methods
Targeting capabilities of anti-FnEDA mAbs were demonstrated by biodistribution study where i.v. injected antibodies were detected by conjugated near-infrared (NIR) fluorophore, 125I label and immunohistochemistry (IHC) of the injected antibody. Location of FnEDA expression in both mCIA and human RA tissue were mapped by IHC. Quantification of anti-FnEDA mAbs targeted to disease tissue was measured by whole-body autoradiography (WBA). Timing of the targeting was interrogated with fluorescent and confocal microscopy using anti-FnEDA mAbs labeled with different fluorophores and injected at different times.

Results
Anti-FnEDA mAbs show specific targeting to diseased paws of mCIA animal. The targeting was focused on inflamed synovium which is consistent with FnEDA expression profile in both mCIA and human RA tissues. Anti-FnEDA mAbs accumulated in diseased tissue at pharmacologically relevant concentrations, the targeting was sustained for up to 14 days and FnEDA was able to support targeting of multiple doses of anti-FnEDA mAbs given 5 days apart.

Conclusion
FnEDA is specifically upregulated in the inflamed tissues of mCIA. Antibodies specific for FnEDA can be useful as molecular delivery vehicles for disease specific targeting of payloads to inflamed joint tissue.
Identifying drivers of breast cancer metastasis in progressively invasive subpopulations of zebrafish-xenografted MDA-MB-231
Authors: Xiao Jerry , McGill Joseph R. , Nasir Apsra , Lekan Alexander , Johnson Bailey , Wilkins Devan J. , Pearson Gray W. , Tanner Kandice , Goodarzi Hani , Glasgow Eric , Schlegel Richard , Agarwal Seema 
Published: May 2022

AbstractCancer metastasis is the primary cause of the high mortality rate among human cancers. Efforts to identify therapeutic agents targeting cancer metastasis frequently fail to demonstrate efficacy in clinical trials despite strong preclinical evidence. Until recently, most preclinical studies used mouse models to evaluate anti-metastatic agents. Mouse models are time-consuming and expensive. In addition, an important drawback is that mouse models inadequately model the early stages of metastasis which plausibly leads to the poor correlation with clinical outcomes.Here, we report an in vivo model based on xenografted zebrafish embryos where we select for progressively invasive subpopulations of MDA-MB-231 breast cancer cells. A subpopulation analogous to circulating tumor cells found in human cancers was selected by injection of MDA-MB-231 cells into the yolk sacs of 2 days post-fertilized zebrafish embryos and selecting cells that migrated to the tail. The selected subpopulation derived from MDA-MB-231 cells were increasingly invasive in zebrafish. Isolation of these subpopulations and propagation in vitro revealed morphological changes consistent with activation of an epithelial-mesenchymal transition program. Differential gene analysis and knockdown of genes identified gene-candidates (DDIT4, MT1X, CTSD, and SERPINE1) as potential targets for anti-metastasis therapeutics. Furthermore, RNA-splicing analysis reinforced the importance of BIRC5 splice variants in breast cancer metastasis. This is the first report using zebrafish to isolate and expand progressively invasive populations of human cancer cells. The model has potential applications in understanding the metastatic process, identification and/or development of therapeutics that specifically target metastatic cells and formulating personalized treatment strategies for individual cancer patients.
Toward Equitable Access to Tertiary Cancer Care in Rwanda: A Geospatial Analysis
Authors: Fadelu Temidayo , Nadella Pranay , Iyer Hari S. , Uwikindi Francois , Shyirambere Cyprien , Manirakiza Achille , Triedman Scott A. , Rebbeck Timothy R. , Shulman Lawrence N. 
Published: May 2022

PURPOSE Geographic access to care is an important measure of health equity. In this study, we describe geographic access to cancer care centers (CCCs) in Rwanda with the current facilities providing care and examine how access could change with expanded care infrastructure. METHODS Health facilities included are public hospitals administered by the Rwanda Ministry of Health. The WorldPop Project was used to estimate population distribution, and OpenStreetMap was used to determine travel routes. On the basis of geolocations of the facilities, AccessMod 5 was used to estimate the percentage of the population that live within 1 hour, 2 hours, and 4 hours of CCCs under the current (two facilities) and expanded care (seven facilities) scenarios. Variations in access by region, poverty, and level of urbanization were described. RESULTS Currently, 13%, 41%, and 85% of Rwandans can access CCCs within one, two, and 4 hours of travel, respectively. With expansion of CCCs to seven facilities, access increases to 37%, 84%, and 99%, respectively. There is a substantial variation in current geographic access by province, with 1-hour access in Kigali at 98%, whereas access in the Western Province is 0%; care expansion could increase 2-hour access in the Western Province from 1% to 71%. Variation in access is also seen across the level of urbanization, with current 1-hour access in urban versus rural areas of 45% and 8%, respectively. Expanded care results in improvement of 1-hour access to 67% and 33%, respectively. Similar trends were also noted across poverty levels. CONCLUSION Geographical access to CCCs varies substantially by province, level of urbanization, and poverty. These disparities can be alleviated by strategic care expansion to other tertiary care facilities across Rwanda.