bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cervical End-Range Joint Motion Does Not Indicate Maximum Cervical Joint Motion In Healthy Adults. An Observational Study
Authors: Andersen Victoria Blogg , Wang Xu , Zee Mark De , Østergaard Lasse Riis , Plocharski Maciej , Lindstrom Renè 
Published: October 2020

Abstract
BackgroundIn clinical diagnosis, the largest motion associated with cervical range of motion is thought to be found at end-range and it is this perception that forms the basis for the interpretation of flexion/extension studies. There have however, been representative cases of joints producing their maximum motion before end-range, but this phenomenon is yet to be quantified. PurposeTo provide a quantitative assessment of the difference between maximum motion and end-range in healthy subjects. Secondarily to classify joints into type based on their motion and to assess the proportions of these joint types. Study designThis is an observational study. Subject sampleThirty three healthy subjects participated in the study. Outcome measuresMaximum motion, end-range motion and surplus motion in degrees were extracted from each cervical joint. MethodsThirty-three subjects performed one flexion and one extension motion excursion under video fluoroscopy. The motion excursions were divided into 10 percent epochs between the initial upright position and the end-range position, from which maximum motion, end-range and surplus motion were extracted. Surplus motion was then assessed in quartiles and joints were classified into type according to end-range. ResultsFor flexion 48.9% and for extension 47.2% of joints produced maximum motion before end-range (type Surplus). For flexion 45.9% and for extension 46.8% of joints produced maximum motion at end-range (type Classic) and 5.2% of joints in flexion and 6.1% of joints in extension concluded their motion anti-directionally (type Anti-directional). Mann-Whitney U tests produced significant results for C2/C3, C3/C4 and C4/C5 in flexion and C1/C2, C3/C4 and C6/C7 in extension when comparing end- range motion for type Classic and type Surplus. The average contributions to cervical range-of-motion (ROM) (C0 to C7) for flexion and extension were 60.23֯ and 67.86֯ for type Classic and 42.22֯ and 49.05֯ for type Surplus respectively. Thus, the average contribution to cervical ROM was larger for type Classic than for type Surplus. The average pro-directional surplus motion was 2.41֯ ± 2.12֯ with a range of range (0.07֯ -14.23֯) for flexion and 2.02֯ ± 1.70֯ with a range of 0.04°-6.97° for extension.ConclusionThis is the first study to categorise joints by type of motion. Type Surplus constituted approximately half of the joints analysed in this study. Therefore, end-range motion cannot be assumed to be a demonstration of a joint´s maximum motion.
Single-molecule switching via controlled tautomerization at room temperature
Authors: Hong Wenjing , Tang Chun , Stuyver Thijs , Ye Yiling , Liu Jun-yang , Shi Jia , Shaik Sason , Xia Haiping 
Published: October 2020

Abstract
The control of chemical reactivity at the single-molecule scale offers a unique opportunity for the design and fabrication of advanced nanodevices.1-3 As a prototypical reaction, tautomerization has been extensively explored as a promising tool for manipulating the single-molecule conductance of tetrapyrrole macrocycles absorbed on a surface.4-8 However, the resulting molecular devices were determined to undergo dynamic, spontaneous interconversions even under cryogenic conditions, so that control of tautomeric switching between well-defined and specific states remains challenging. Here, we report the design of a reversible single-molecule switch based on an enol-keto tautomerization reaction, which demonstrates controllable bistability and inhibits spontaneous interconversion even at room temperature. Such control is achieved by modulating the potential energy surface (PES) through a bias-triggered charge injection process. Our results reveal that the device operates through switching between two distinct redox-related PESs with opposite thermodynamic driving forces, i.e., one exhibits strong preference for the conducting enol form, while the other exhibits a preference for the insulating keto form. The described switching mechanism constitutes a promising approach to achieve robust switching devices at the single-molecule scale.
The Effect of the Physical Fitness and Breathing Training Program in COVID-19 patients in Wuhan, China: prospective study
Authors: Li Jianying , Zhao Ming , Lu Lu , Qi Mengyu , Li Zhiying , Zheng Ying , Huang Tianwen , Qiao Jinfang , Chen ZhiHao , Ma Yanzhao , Zhu Qingtang , Cheng Shouzhen 
Published: October 2020

Abstract
Background Corona Virus Disease 2019 (COVID-19) has adverse effects on patients’ respiratory system. Therefore the pulmonary rehabilitation is particularly necessary for COVID-19 patients. A recent qualitative study indicated that patients perceived the impact of fatigue on their daily lives to be a key factor in decreasing their quality of life. This study aimed to investigate the knowledge and needs of physical fitness and breathing training, and to explore the impact of physical fitness and breathing training on COVID-19 patients. Methods From Feb 16, 2020 to Apr 6, 2020, a self-designed questionnaire was used to investigate the knowledge and needs of physical fitness and breathing training in COVID-19 inpatients. And then the participants received an intervention about physical fitness and breathing training which lasted 2 weeks. The 9-item Functional Assessment of Chronic Illness Therapy-Fatigue scale (FACIT-F) was used to measure COVID-19 related fatigue before and after the intervention. Findings According to a 5-point Likert scale, the 133 COVID-19 patients had only an "not really" and "uncertain" knowledge of physical fitness and breathing training (2.47±1.17). 86.98% of the patients expected to receive guidance of physical fitness and breathing training through video teaching. Differences were observed in fatigue, General fatigue component (15.0(8.0) vs. 19.0(10.0), P<0.01); Functional ability component (4.0 (3.0) vs. 7.0(4.0), P<0.01); Psychological component (6.0(5.0) vs.7.0 (5.0), P<0.01), after the intervention, Moderate degree (36.09% vs. 28.57%) alleviated to mild degree (51.12% vs. 66.91%). SpO2-% 86 ((75, 89) vs. 92(89, 98), P<0.001), and Oxygen flow-L/min (2(0,4) vs. 8(3,9), P<0.001). In our study, 130 healthcare professionals took part in this program. None of the participants reported covid-19 related symptoms. When the participants returned home, they all tested negative for SARSCoV- 2 specific nucleic acids and IgM or IgG antibodies (95% confidence interval 0.0 to 0.7%).Interpretation COVID-19 patients had insufficient knowledge of physical fitness and breathing training for pulmonary rehabilitation. Patients should be guided to receive training, which can be benefit for patients.
The Residue of Tetracycline Antibiotics in Soil and Vegetable and Its Effect On The Diversity of Soil Bacterial Community
Authors: Xu Longshui , Wang Weizhong , Xu Weihong 
Published: October 2020

Abstract
[Background] Tetracycline antibiotics (TCs) are a broad-spectrum antibiotic, widely used in livestock and poultry breeding. The residue of tetracycline antibiotics in animal manure may cause changes of soil microbial community. [Methods] On the basis of the investigation and analysis of TCs pollution in the soil of main vegetable bases and the livestock manure of major large-scale farms in Chongqing, China, the effects of tetracycline antibiotics on the structure and diversity of soil microbial community were investigated by high-throughput sequencing. [Results] The TCs content in soil was increased by applying livestock manure. The contents of TC, OTC and CTC in the soil under pig manure treatment were 171.07-660.20 μg·kg-1, 25.38-345.78 μg·kg-1 and 170.77-707.47 μg·kg-1, respectively. The contents of TC, OTC and CTC in the soil under the treatment of chicken manure were 166.62-353.61 μg·kg-1, 122.25-251.23 μg·kg-1 and 15.12-80.91 μg·kg-1 respectively. The content of tetracycline antibiotics (TCs) in edible parts of Brassica juncea var. gemmifera was increased after livestock manure treatment, among which pig manure had the greatest influence on the increase of TCs content, and the larger the dosage of pig manure was, the more significant the increase of TCs content was. Proteobacteria, Acidobacteria, Actinobacteria, Chioroflexi and bacteroidetes under livestock manure treatment were the dominant phyla, accounting for 85.2%-92.4% of the total abundance of soil bacteria. [Conclusions] The soil OTUs under the treatment of pig manure was higher than that under the treatment of chicken manure. Biogas residue after fermentation treatment can effectively reduce the environmental and ecological risks caused by antibiotic residues.
Implementation of A Nurse Practitioner in Emergency Ambulance Care in The Netherlands: A Study Protocol for The IMPACT-Study
Authors: Ebben Remco , Vliet Risco van , Breedveld Lennert , Douwes Ilona , Hereijgers Juliette , Pas Harm van de , Vloet Lilian C.M. 
Published: October 2020

Abstract
Background Ambulance care professionals face an increasing demand for ambulance care, which is caused by a changing patient population with more complex healthcare problems and comorbidities, accessibility of emergency care, repeated requests for ambulance care and the request of ambulance care for primary care problems. These changes might require an ambulance care professional at master level, such as the nurse practitioner (NP). The objective is to (1) determine characteristics of patients and ambulance runs in situations where NP care was provided, and to evaluate the effect of implementing the NP in Dutch ambulance on (2) patient safety and (3) patient experience compared to non-NP care.Methods/design A prospective mixed-methods implementation design will be used. The intervention is the implementation of a NP as solo ambulance unit within this EMS, to (1) determine characteristics of the patients and ambulance runs, and the effects on (2) patient safety and (3) patient, compared to regular ambulance care. Within this pilot the NP can apply additional diagnostic and therapeutic interventions in addition to regular ambulance care. Data will be collected through databases, additional apps, and questionnaires.
Body Weight Perception and Quality of Life in Nurses of Nantong City, China: A Cross-Sectional Study
Authors: Wang Xu , Yang Xiaohua , Chu Hongmei , Ge Chunyan , Yin Jie 
Published: October 2020

Abstract
Background To explored associations of body weight perception with body mass index and quality of life among nurses.Methods A total of 456 nurses (18-55 years old） were surveyed in a cross-sectional study in a hospital of Nantong City, China. Data on social-demographic characteristics, body mass index, body weight perception and quality of life were collected. Results Our study showed that 40.6% of nurses misconception their weight status. Married nurses were more likely than unmarried to underestimate their weight. Significant disparity in mental health, vitality and mental component summary scores were found in nursers who underestimate their weight compared to those correctly perceived or over or who overestimate their weight. Conclusion Interventions should be designed to help nurse address body weight status misconception, thereby contributing to label themselves and patients as underweight, normal weight, overweight or obese correctly, and in turn, giving reasonable eating habits and physical activities health education.
Can The Arterial Clamping Method Be Used Safely Where The Tourniquet Cannot Be Used?
Authors: Erdogan Ozgur , Gurkan Volkan , Sonmez Cavide , Erden Tunay , Atasoy Sezen , Yildiz Fatih , Inan Bekir , Adilli Adile 
Published: October 2020

Abstract
Background: Vascular clamp application is widely used in visceral organ surgery to ensure bleeding control. This raises the question: why not use clamping in tumor resection or revision surgery where not suitable for tourniquet. This experimental animal study aimed to compare the arterial clamp and tourniquet applications regarding their histologic effect and also inflammatory response at molecular level, on the artery, vein, nerve and muscle tissues.Methods: Twenty-one rabbits were divided into three groups (group I: proximal femoral artery clamp; group II: proximal thigh tourniquet, and group III: control group). In the clamp group, the common femoral artery was clamped with a microvascular clamp for 2 hours. In the tourniquet group, a 12-inch cuff was applied to the proximal thigh for 2 hours with 200 mmHg. The common femoral artery and vein, femoral nerve, rectus femoris, and tibialis anterior muscles were excised and analysed in all groups. Results: Artery and vein total injury scores were higher in the clamp and tourniquet groups relative to the control group (p≤0.001 and p=0.007, respectively). No statistical difference was found between the clamp and tourniquet groups in terms of arterial, vein, muscle and nerve injury.Conclusions: This experimental study can give an idea that arterial clamp application can be performed with the help of a vascular surgeon in hemorrhagic limb surgeries where not suitable for tourniquet application, resulting in close to tourniquet vessel injury rates but without tourniquet related complications.
The Role of NLRP3 in The Prognosis and Immune Infiltrates of Skin Cutaneous Melanoma (SKCM)
Authors: Wu Shaobo , Zang Qijuan , Dai Bingling 
Published: October 2020

Abstract
BackgroundSkin cutaneous melanoma is one of most aggressive type of cancers worldwide, Therefore, the identification of SKCM biomarkers is of great importance. NLRP3 Inflammasome Complex Nodelike Receptor protein 3 (NLRP3) is one of the most characteristic inflammasomes belonging to the NLR protein family. This is the first time to use TCGA data to study NLRP3 expression in SKCM patients and its prognostic value, potential biological function, and impact on the immune system. MethodsThe expression of NLRP3 in SKCM was analyzed by GEPIA. We assessed the impact of NLRP3 on SKCM patient survival through the survival module. Then download the SKCM data set from TCGA. Logistic regression was used to analyze the correlation between clinical data and NLRP3 expression. Univariate survival rate and multivariate Cox analysis were used to compare several clinical features and survival rates. We also used CIBERSORT to investigate the association between NLRP3 and cancer immune infiltration. We used TIMER to investigate NLRP3 expression and collection of immune infiltration levels in SKCM, as well as cumulative survival in SKCM. Gene set enrichment analysis (GSEA) was performed using the TCGA dataset. In addition, data from the HPA was used to validate the results.ResultsUnivariate Logistic regression analysis showed that increased NLRP3 expression was significantly correlated with age, stage and tumor status. Specifically, NLRP3 expression level has significant positive correlations with infiltrating levels of B cell, CD4+ T cells, CD8+ T cells, Macrophages, Neutrophils and DCs in SKCM. GSEA revealed that NLRP3 is closely correlated with pathways in cancer. HPA showed that in tumor tissues, NLRP3 has higher levels of expression compared to normal tissues.ConclusionThe discovery of NLRP3 as a new biomarker of SKCM helps to elucidate how changes in the immune environment promote the occurrence of cutaneous melanoma. Further analysis suggested that NLRP3 might be a predictor of SKCM prognosis.
Design of Stirred Tank Reactor for Bioetanol Production From Banana Rod Using Cellulase Enzymes Cow's Liquid Rumen
Authors: Nisa Qurrotun Ayuni Khoirun , Paramita Vita 
Published: October 2020

Abstract
Due to pandemic, supply of alcohol as desinfectant really needed for nowadays. This research aims to determine the levels of bioethanol produced from banana rods by the hydrolysis process. The target to be achieved with the reactor design is to achieve high ethanol purity using a first order reaction kinetics approach. The study was carried out on various variables including fermentation time (6 - 30 hours), hydrolysis temperature (80 - 90 oC), and substrate enzyme ratio (1: 1 - 1: 3). While the parameters to be tested are glucose levels and bioethanol levels. The optimal effect of the variable on alcohol content is obtained when the \alcohol content value is more than 17.2% with an enzyme ratio of 3 - 3.5 at a temperature of 94 - 96 oC for 35 - 40 hours. From the research, it was found that it is possible to enlarge the reactor up to 10000 times by using a ratio ratio to obtain the ideal stirred tank reactor dimensions with a conversion of 97.15%.
Lactose Inducible Fermentation in Escherichia coli for Improved Production of Recombinant Urate Oxidase: Optimization by Statistical Experimental Designs
Authors: mohammadi Hamid shahbaz , Najjari Abbas , Omidinia Eskandar 
Published: October 2020

Abstract
The enzyme urate oxidase (UOX) is used as a drug for preventing and treatment of chemotherapy-induced hyperuricemia. This study deals with the statistical optimization of lactose inducible fermentation for production of soluble recombinant Aspergillus flavus UOX. 10 variables were investigated by Plackett–Burman design (PBD), and the most significant factors were further optimized by central composite design (CCD). PBD results indicated that glycerol, yeast extract, tryptone, and lactose affected UOX activity significantly. The CCD results showed that the maximum enzyme activity (19.34 U/ml) could be achieved under the optimum conditions of glycerol 0.87 g/L, yeast extract 9.11 g/L, tryptone 10.29 g/L, K2HPO4 1.81 g/L, and lactose 12.79 g/L. When the same induction strategy was tested at shake flask, 19.34 U/mL of UOX activity was obtained, which was 12.5 folds higher than IPTG induction protocol. Furthermore, the lower total cost (0.7 vs. 13.5 €) was additionally feature that confirmed the suitability of the lactose induction method. Collectively, our results showed that design of experiment methodology can be applied as a suitable tool for improved production of UOX using lactose as the inducer.
Clinician Roles in Symptoms and Signs Improvement among Advanced Cancer Patients
Authors: Chung Jae Ho , Kim Sun Hyun , Suh Sang-Yeon , Cheng Shao-Yi , Mori Masanori , Yamaguchi Takashi , Chen Ping-Jen , Morita Tatsuya , Tsuneto Satoru 
Published: October 2020

Abstract
Background: We, study and research how to improve terminally ill cancer patients’ symptoms and signs to ease their pain. Furthermore we also seek how the dedicated palliative care service effects on the cancer patients’ results.Methods: We analyzed 334 physician-diagnosed terminally ill cancer patients and categorized them into non-dedicated hospice care group of 234 and dedicated hospice care group of 100.Results: Symptoms improvement of dyspnea, fatigue, drowsiness, and dry mouth during the first week of admission were respectively 298 (89.2%), 25 (7.5%), 204 (61.1%), 76 (22.8%). Signs improvement of myoclonus, respiratory secretion, leg edema, and ascites between admission and a week after were 5 (1.5%), 41 (12.3%), 47 (14.1%), 12 (3.6%). Significant differences between dedicated hospice care physician group and non-dedicated hospice care physician group were shown in drowsiness (67.5% vs 46 %, p < 0.001) and respiratory secretion (15% vs 6%, p < 0.028).Conclusions:In conclusion, terminally ill cancer patients who received palliative or hospice service showed significant improvement in symptoms and illness signs. Moreover, family doctors (dedicated hospice physician group) performed better than oncologist (non-dedicated physician group).
Investigating Impacts of Therapeutic Strategies on Outcomes of Bactereamia Patients Captured by Varied Sepsis Definitions: Time for a Reappraisal of Sepsis-3 Criteria
Authors: Lee Ching-Chi , Chen Po-Lin , Huang Yi-Tzu , Hong Ming-Yuan , Hsieh Chih-Chia , Lin Chih-Hao , Ko Wen-Chien 
Published: October 2020

Abstract
Background: To early recognize septic patients, quick Sequential Organ Failure Assessment (qSOFA) was proposed by the Sepsis-3 guideline as the initial sepsis identification outside of intensive care units; however, the lack of consensus regarding the revised definition might impede efforts to treat septic patients. Our aim included validation of the new definition in patients with documented bactereamia, by means of the evaluation for the period of delayed treatment efforts and impacts of delayed treatment on prognosis of those categized by traditional or revised sepsis definitions. Methods: In the multicentre cohort of adults with community-onset bactereamia in the emergency department, clinical information was retrospectively analyzed and causative isolates were prospectively stored for susceptibility testes. Using the Cox-regression model, effects of delayed administration of appropriate antimicrobials and adequate source control on 30-day crude mortality in varied SIRS and qSOFA categories were examined after respective adjustment for independent determinants of 30-day mortality.Results: Of the total 3,898 adults, the time-to-appropriate antibiotic and time-to-source control in patients initially presented with SIRS scores of ≥ 2 remained significant shorter than those with qSOFA scores of ≥ 2. Effects of inappropriate EAT and inadequate source control on 30-day mortality were significant in patients who initially presented with SIRS scores of 2 (AOR, 3.06; P < 0.001 and AOR, 1.49; P = 0.04) and 3-4 (AOR, 1.63 and AOR, 2.39; all P < 0.001) but not in those with scores of 0-1 (AOR, 0.87; P = 0.88 and AOR, 1.57; P = 0.79). Notably, adverse impacts of inappropriate EAT and inadequate source control on 30-day mortality were significant in patients who initially experienced qSOFA scores of 0-1 (AOR, 2.05; P = 0.004 and AOR, 3.31; P = 0.003), who were recognised as non-septic patients according to Sepsis-3 guidelines.Conclusions: For patients with community-onset bacteraemia, definitions in the new Sepsis-3 guidelines might impede their treatment efforts in earlier stages and this delayed treatment consequently resulted in unfavourable outcomes. Accordingly, adopting a more restrictive sepsis definition that requires further progression along the sepsis pathway is necessary to avoid delayed interventions.