bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of automated computed topography perfusion in prediction of hemorrhagic transformation after acute ischemic stroke
Authors: Elsaid Nada , Bigliardi Guido , Dell’Acqua Maria Luisa , Vandelli Laura , Ciolli Ludovico , Picchetto Livio , Borzì Giuseppe , Ricceri Riccardo , Pentore Roberta , Vallone Stefano , Meletti Stefano , Saied Ahmed 
Published: July 2022

Introduction The role of computed tomography perfusion (CTP) in prediction of hemorrhagic transformation (HT) has been evolving. We aimed to study the role of automated perfusion post-processing software in prediction of HT using the commercially available RAPID software. Methods Two hundred eighty-two patients with anterior circulation ischemic stroke, who underwent CTP with RAPID automated post-processing, were retrospectively enrolled and divided into HT ( n = 91) and non-HT groups ( n = 191). The automated RAPID-generated perfusion maps were reviewed. Mismatch volume and ratio, time to maximum (Tmax) > 4‐10s volumes, hypoperfusion index, cerebral blood flow (CBF) < 20–38% volumes, cerebral blood volume (CBV) < 34%–42% volumes, and CBV index were recorded and analyzed. Results The volumes of brain tissues suffering from reduction of cerebral blood flow (CBF < 20%–38%), reduction in cerebral blood volumes (CBV < 34–42%), and delayed contrast arrival times (Tmax > 4–10s) were significantly higher in the HT group. The mismatch volumes were also higher in the HT group ( p = .001). Among these parameters, the Tmax > 6s volume was the most reliable and sensitive predictor of HT ( p = .001, AUC = 0.667). However, the combination of the perfusion parameters can slightly improve the diagnostic efficiency (AUC = 0.703). There was no statistically significant difference between the non-HT group and either the parenchymal or the symptomatic subtypes. Conclusion The RAPID automated CTP parameters can provide a reliable predictor of HT overall but not the parenchymal or the symptomatic subtypes. The infarct area involving the penumbra and core represented by the Tmax > 6s threshold is the most sensitive predictor; however, the combination of the perfusion parameters can slightly improve the diagnostic efficiency.
Increased IL-31 expression in serum and tissue protein in prurigo nodularis
Authors: Chaowattanapanit Suteeraporn , Wongjirattikarn Rachot , Chaisuriya Nipon , Ungarreevittaya Piti , Poosekeaw Pirawan , Winaikosol Kengkart , Choonhakarn Charoen , Julanon Narachai , Salao Kanin 
Published: July 2022

Background: Prurigo nodularis (PN) is a chronic pruritic skin disease which can greatly impact patients’ quality of life. Moreover, the pathogenesis remains unclear, making it a difficult-to-treat condition. Aims: To investigate the expression of interleukin-31 (IL-31) in serum and skin biopsy specimens of PN patients and healthy subjects and identify its possible correlation to disease severity and itch intensity. Methods: Patients with PN and healthy volunteers were recruited for the study. Expression levels of IL-31 were measured by enzyme-linked immunosorbent assay and immunohistochemistry. Baseline characteristics, disease activity, itch intensity, and related laboratory results were collected. Results: Forty-three PN patients and 31 healthy subjects participated in our study. The PN patients had significantly higher mean serum IL-31 levels than the healthy subjects (52.9 ± 18.2 versus 36.3 ± 10.7 pg/ml, p < 0.001). Epidermal and dermal PN lesions also exhibited significantly higher IL-31 expression compared with the healthy skin ( p < 0.001 and p = 0.01, respectively). However, there was no significant difference in serum or lesional expression of IL-31 by disease severity or itch intensity. Conclusion: Increased IL-31 expression in serum and PN lesions suggests that IL-31 has a potential role in the pathogenesis of PN.
E-solutions in Estonian community pharmacies: A literature review
Authors: Tuula Anita , Sepp Kristiina , Volmer Daisy 
Published: July 2022

Objective Estonian innovative electronic solutions have long been leading the way in the healthcare sector. This article aims to give an overview of all e-solutions and their usability in community pharmacies in Estonia and how they compare and operate with the wider e-health system. Methods A comprehensive literature review was conducted on publicly accessible information regarding Estonian e-health and electronic community pharmacy solutions. Findings While Estonian e-health system, including the e-prescription system is developed and maintained by the nationally funded Health and Wellbeing Infosystem Center, community pharmacy owners have established many noteworthy systems such as the e-pharmacist decision-support system, commodities info systems, online pharmacies, a telehealth prescription reminder service, and an automated dosage dispense system. Some pharmacies are collaborating with private healthcare service providers to allow quick and easy prescription renewal through an electronic channel. Conclusion Different electronic systems have overall greatly improved Estonian pharmacy services, accuracy and flow of consultations, and accessibility of medicines. In some cases, more support and active involvement is still needed from government agencies for full implementation.
Complexity of the Contexts: Features of Private Tutoring and Units for Comparison in the GCC Countries of the Middle East
Authors: Bray Mark , Hajar (أنس حجّار) Anas 
Published: July 2022

Purpose Private supplementary tutoring—widely known as shadow education because of the ways in which it mimics regular schooling—is increasingly visible across the globe. The Middle East is no exception, though the phenomenon has received relatively little attention in the English-language literature. This article maps some key features of shadow education, identifying ways in which contextual forces have shaped it. Design/Approach/Methods The article focuses on patterns across and within the six members of the Gulf Cooperation Council (GCC), namely Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates. It draws on literature in both Arabic and English and shows the value of multiple units of comparison. Findings Private tutoring has a long history as a significant phenomenon in some GCC countries, but in others developed more recently. Some governments have had active policies to dampen the phenomenon, but with little success. Factors in the complex dynamics include social, economic and cultural forces. Originality/Value The article assembles literature from around the region, noting both commonalities and diversities among GCC members. It contributes to the global literature by providing the regional mapping from this specific part of the world and by showing comparisons with other world regions.
Prevalence of Social Determinants of Health Among Health System Employees
Authors: Seeholzer Eileen L. , Santiago Marielee , Thomas Charles , DeAngelis Monica , Scarl Francesca , Webb Anastasia , Woods Tangela , Sehgal Ashwini R. 
Published: July 2022

Introduction/Objectives: Many health systems screen patients for social determinants of health and refer patients with social needs to community service organizations for assistance. However, little is known about social determinants of health among health system employees. We sought to examine the prevalence of social determinants among employees of The MetroHealth System, a large safety-net health system in Cleveland, Ohio. Methods: We invited participants in an employee wellness program to answer the same screening questions that patients answer about 9 social determinants of health, including food insecurity, financial strain, transportation difficulty, inability to pay for housing or utilities, intimate partner violence, social isolation, infrequent physical activity, daily stress, and lack of internet access. We then determined the percentage of employees who met pre-defined criteria for being at risk for each social determinant. We also examined how these percentages varied across employee job categories. Results: Of 4191 full-time employees, 1932 (46%) completed the survey. The percentage of employees at risk for each social determinant were: food insecurity (11%), financial strain (12%), transportation difficulty (4%), inability to pay for housing or utilities (10%), intimate partner violence (4%), social isolation (48%), infrequent physical activity (10%), daily stress (58%), and lack of internet access (3%). Being at risk for specific social determinants was more common among support staff compared to staff physicians and nurses. For example, the survey participants included 436 administrative support staff, a job category that includes secretaries and patient service representatives. Among this group, 20% reported food insecurity, 20% financial strain, and 17% inability to pay for housing or utilities. Conclusions: Social determinants of health are common among health system employees, especially among workers in lower paid job categories. Health systems should routinely screen employees for social determinants and adjust salaries, benefits, and assistance programs to address their social needs.
Diabetic Kidney Disease Is Associated With Increased Complications Following Operative Management of Ankle Fractures
Authors: Polachek William S. , Baker Hayden P. , Dahm James S. , Strelzow Jason A. , Hynes Kelly K. 
Published: July 2022

Background: Diabetes mellitus and peripheral neuropathy are established risk factors for complications in operatively treated ankle fractures. Generally, the presence of peripheral neuropathy and diabetic nephropathy have been used as independent variables in studies of diabetic ankle fracture cohorts but are typically treated as binary risk factors. Our purpose was to quantify the effects of risk factors on complication rate specific to diabetic patients undergoing ankle fracture fixation. Methods: We identified 617 rotational ankle fractures treated operatively at a single academic medical center from 2010 to 2019, of which 160 were identified as diabetic. Of these, 91 ankle fractures in 90 diabetic patients met criteria for retrospective review of clinical and radiographic data. Criteria included perioperative laboratory studies, including glycated hemoglobin (HbA1c) and estimated glomerular filtration rate (eGFR), as well as follow-up radiographs in the electronic record. We defined complications in this surgical cohort as deep surgical site infection, unplanned return to the operating room, and failure of fixation. Logistic regression was performed and odds ratios (ORs) calculated. Results: The overall complication rate was 28.6% (26/91) in this cohort. Median follow-up was 29 weeks (range: 5-520 weeks). Mean perioperative HbA1c in patients who experienced postoperative complications was 7.6% (range: 5.1%-14.2%) compared with 7.8% (range: 5.6%-13.5%) who did not ( P = .69). Diabetic patients with chronic kidney disease (eGFR <60 mL/min per body surface area) (OR 5.29, P = .006) and peripheral neuropathy (OR 4.61, P = .003) were at significantly higher risk of all complications compared with diabetic patients without these comorbidities. Of note, we did not find an association between perioperative HbA1c or body mass index and complication rate. Conclusion: Patients with diabetes complicated by chronic kidney disease are at significantly higher risk of complications following operative management of ankle fractures. Our study also corroborated previous reports that within this high-risk cohort, the presence of peripheral neuropathy is a significant risk factor for complications. These sequalae of diabetic disease are manifestations of microvascular disease, glycosylation of soft tissues, and impaired metabolic pathways. Identifying these risk factors in diabetic patients allows for patient-specific risk stratification, education, and management decisions of ankle fractures. Level of Evidence: Level III, retrospective cohort study.
Easy Arthroscopic Transseptal Approach of the Knee
Authors: Gousopoulos Lampros , Hopper Graeme , Levy Yoann , Grob Charles , Vieira Thais Dutra , Sonnery-Cottet Bertrand 
Published: July 2022

Background: The arthroscopic approach to the posterior compartment of the knee is always challenging. This easy arthroscopic transseptal approach allows safe access to the posterior compartment of the knee, avoiding any potential neurovascular injury. Indications: Indications include arthroscopic posterior cruciate ligament (PCL) reconstruction, fixation of avulsion fractures of the tibial attachment of the PCL, arthroscopic posterolateral corner reconstruction, removal of loose bodies from the posterior compartment, PCL cyst removal, ramp repair, and arthroscopic arthrolysis of the posterior compartment. Technique Description: Using a posteromedial portal, a shaver is introduced with the tip in direct contact with the medial side of the septum facing anteriorly, away from the popliteal neurovascular bundle. The scope is then inserted into the posterolateral compartment to visualize the lateral side of the septum while the shaver remains in the posteromedial compartment. The septum is then released until the tip of the shaver is visible. The shaver is then removed and the scope can now be inserted from the posteromedial portal to the posterolateral compartment through the released septum. Results: The transseptal approach can be performed without any additional risk if the shaver remains centrally on the inferior aspect of the septum. Therefore, the risk of iatrogenic injury of the middle genicular artery is minimized. Likewise, with the knee flexed to 90°, there is no risk of damaging the popliteal neurovascular bundle. Having a precise knowledge of the anatomy of the posterior compartment of the knee minimizes any risks of the transseptal approach, avoiding any additional surgical time whilst facilitating the indicated operation. Conclusion: This easy arthroscopic transseptal approach allows safe access to the posterior compartment of the knee, avoiding any potential neurovascular injury.
The Role of Clinical Pharmacist in Pediatrics’ Adherence to Antiepileptic Drugs
Authors: Jarad Suha , Akour Amal , Khreisat Wael H. , Elshammari Afrah K. , Madae’en Saba 
Published: July 2022

Background: Rate of nonadherence to antiepileptic drugs (AEDs) in children is about 33%. Engaging clinical pharmacists in the management of patients has proved to increase adherence to medications which will improve the outcomes of treatment. Objectives: To investigate the effect of a clinical pharmacist-led education on the adherence to AEDs in pediatric patients with epilepsy. Secondary outcomes include effectiveness and safety of AEDs, satisfaction with information about AEDs provided to the caregivers, and patients quality of life (QoL). Methods: This was an interventional study where pediatric patients were randomly assigned to the intervention (n = 41) or the control (n = 40) group. A 30-minute clinical pharmacist-led educational interview to the parent/caregiver was provided to the first group as add-on to standard medical care received by latter. Outcomes were measured at baseline and after 8-week follow-up. Results: The intervention group had an increase in mean adherence score from 6 ± 1.09 at baseline to 7.6 ± 0.9 at follow-up ( P value < 0.001), while the control group had no significant change ( P value > 0.05), the difference between the 2 groups at follow-up was significant ( P value < 0.0001). No significant difference was observed between groups at follow-up with regard to effectiveness ( P value > 0.05), and safety ( P value = 0.08). While higher satisfaction with information ( P value < 0.0001), and higher QoL ( P value < 0.05) was observed in the intervention group. Conclusion and relevance: Clinical pharmacist-led education had a positive outcome on pediatric patients with epilepsy with regard to adherence, effectiveness, safety, satisfaction with information about AEDs, and QoL.
Targeting MDM2 enhances antileukemia immunity after allogeneic transplantation via MHC-II and TRAIL-R1/2 upregulation
Authors: Ho Jenny N. H. G. , Schmidt Dominik , Lowinus Theresa , Ryoo Jeongmin , Dopfer Elaine-Pashupati , Gonzalo Núñez Nicolás , Costa-Pereira Sara , Toffalori Cristina , Punta Marco , Fetsch Viktor , Wertheimer Tobias , Rittmann Marie-Claire , Braun Lukas M. , Follo Marie , Briere Christelle , Vinnakota Janaki Manoja , Langenbach Marlene , Koppers Felicitas , Shoumariyeh Khalid , Engel Helena , Rückert Tamina , Märklin Melanie , Holzmayer Samuel , Illert Anna L. , Magon Federica , Andrieux Geoffroy , Duquesne Sandra , Pfeifer Dietmar , Staniek Julian , Rizzi Marta , Miething Cornelius , Köhler Natalie , Duyster Justus , Menssen Hans D. , Boerries Melanie , Buescher Joerg M. , Cabezas-Wallscheid Nina , Blazar Bruce R. , Apostolova Petya , Vago Luca , Pearce Erika L. , Becher Burkhard , Zeiser Robert 
Published: July 2022

Abstract
Patients with acute myeloid leukemia (AML) often achieve remission after allogeneic hematopoietic cell transplantation (allo-HCT) but subsequently die of relapse driven by leukemia cells resistant to elimination by allogeneic T cells based on decreased major histocompatibility complex II (MHC-II) expression and apoptosis resistance. Here we demonstrate that mouse-double-minute-2 (MDM2) inhibition can counteract immune evasion of AML. MDM2 inhibition induced MHC class I and II expression in murine and human AML cells. Using xenografts of human AML and syngeneic mouse models of leukemia, we show that MDM2 inhibition enhanced cytotoxicity against leukemia cells and improved survival. MDM2 inhibition also led to increases in tumor necrosis factor-related apoptosis-inducing ligand receptor-1 and -2 (TRAIL-R1/2) on leukemia cells and higher frequencies of CD8+CD27lowPD-1lowTIM-3low T cells, with features of cytotoxicity (perforin+CD107a+TRAIL+) and longevity (bcl-2+IL-7R+). CD8+ T cells isolated from leukemia-bearing MDM2 inhibitor-treated allo-HCT recipients exhibited higher glycolytic activity and enrichment for nucleotides and their precursors compared with vehicle control subjects. T cells isolated from MDM2 inhibitor-treated AML-bearing mice eradicated leukemia in secondary AML-bearing recipients. Mechanistically, the MDM2 inhibitor-mediated effects were p53-dependent because p53 knockdown abolished TRAIL-R1/2 and MHC-II upregulation, whereas p53 binding to TRAILR1/2 promotors increased upon MDM2 inhibition. The observations in the mouse models were complemented by data from human individuals. Patient-derived AML cells exhibited increased TRAIL-R1/2 and MHC-II expression on MDM2 inhibition. In summary, we identified a targetable vulnerability of AML cells to allogeneic T-cell–mediated cytotoxicity through the restoration of p53-dependent TRAIL-R1/2 and MHC-II production via MDM2 inhibition.
Sputter-Deposited Binder-Free Nanopyramidal Cr/γ-Mo2N TFEs for High-Performance Supercapacitors
Authors: Govindarajan Durai , Palaniyandy Nithyadharseni , Chinnakutti Karthik Kumar , Nguyen Mai Thanh , Yonezawa Tetsu , Qin Jiaqian , Kheawhom Soorathep 
Published: July 2022

AbstractDue to their outstanding power density, long cycle life and low cost, supercapacitors have gained much interest. As for supercapacitor electrodes, molybdenum nitrides show promising potential. Molybdenum nitrides, however, are mainly prepared as nanopowders via a chemical route and require binders for the manufacture of electrodes. Such electrodes can impair the performance of supercapacitors. Herein, binder-free chromium (Cr)-doped molybdenum nitride (Mo2N) TFEs having different Cr concentrations are prepared via a reactive co-sputtering technique. The Cr-doped Mo2N films prepared have a cubic phase structure of γ-Mo2N with a minor shift in the (111) plane. While un-doped Mo2N films exhibit a spherical morphology, Cr-doped Mo2N films demonstrate a clear pyramid-like surface morphology. The developed Cr-doped Mo2N films contain 0–7.9 at.% of Cr in Mo2N lattice. A supercapacitor using a Cr-doped Mo2N electrode having the highest concentration of Cr reveals maximum areal capacity of 2780 mC/cm2, which is much higher than that of an un-doped Mo2N electrode (110 mC/cm2). Furthermore, the Cr-doped Mo2N electrode demonstrates excellent cycling stability, achieving ~ 94.6% capacity retention for about 2000 cycles. The reactive co-sputtering proves to be a suitable technique for fabrication of binder-free TFEs for high-performance energy storage device applications.

Graphical Abstract
Multi-head attention-based U-Nets for predicting protein domain boundaries using 1D sequence features and 2D distance maps
Authors: Mahmud Sajid , Guo Zhiye , Quadir Farhan , Liu Jian , Cheng Jianlin 
Published: July 2022

AbstractThe information about the domain architecture of proteins is useful for studying protein structure and function. However, accurate prediction of protein domain boundaries (i.e., sequence regions separating two domains) from sequence remains a significant challenge. In this work, we develop a deep learning method based on multi-head U-Nets (called DistDom) to predict protein domain boundaries utilizing 1D sequence features and predicted 2D inter-residue distance map as input. The 1D features contain the evolutionary and physicochemical information of protein sequences, whereas the 2D distance map includes the structural information of proteins that was rarely used in domain boundary prediction before. The 1D and 2D features are processed by the 1D and 2D U-Nets respectively to generate hidden features. The hidden features are then used by the multi-head attention to predict the probability of each residue of a protein being in a domain boundary, leveraging both local and global information in the features. The residue-level domain boundary predictions can be used to classify proteins as single-domain or multi-domain proteins. It classifies the CASP14 single-domain and multi-domain targets at the accuracy of 75.9%, 13.28% more accurate than the state-of-the-art method. Tested on the CASP14 multi-domain protein targets with expert annotated domain boundaries, the average per-target F1 measure score of the domain boundary prediction by DistDom is 0.263, 29.56% higher than the state-of-the-art method.