bluuebunny/crossref_metadata_2025_split huggingface dataset:
Four-component Meningococcal Serogroup B Vaccine Induces Antibodies With Bactericidal Activity Against Diverse Outbreak Strains in Adolescents
Authors: Biolchi Alessia , Tomei Sara , Santini Laura , La Gaetana Rita , Mori Elena , Novy Patricia , Rappuoli Rino , Bekkat-Berkani Rafik , Giuliani Marzia Monica , Pizza Mariagrazia 
Published: October 2020

Background:

Neisseria meningitidis serogroup B (MenB) causes most meningitis outbreaks worldwide. We evaluated the ability of the 4-component MenB vaccine (4CMenB) to induce bactericidal activity against outbreak strains in adolescents.

Methods:
Individual sera from 20 United States and 23 Chilean adolescents who received 2 doses of 4CMenB 2 months apart were assayed at prevaccination and 1 month after second dose using a human complement serum bactericidal antibody assay (hSBA) against a full or subset strain panel consisting of 14 MenB outbreak strains and 1 MenW hyperendemic strain collected between 2001 and 2017 in the United States, United Kingdom, and France. Bactericidal activity was determined as the percentage of adolescents with hSBA titer ≥1:4 or ≥1:8.

Results:
One month after the second 4CMenB dose, antibodies from 65% to 100% of the US adolescents were able to kill 12 of 15 strains at 1:4 dilution. The remaining 3 strains were killed by 45%, 25%, and 15% of US adolescent sera. Similar percentages exhibited hSBA titers of ≥1:8. Across a subset of 4 strains, point estimates for the percentages of Chilean and US adolescents with hSBA titers of ≥1:4 after the second 4CMenB dose were similar (100% for strain M27703, 74% vs. 80% for M26312, 52% vs. 45% for M08 0240745), except for strain M39090 (91% vs. 65%).

Conclusions:
This study was the first to evaluate bactericidal activity elicited by a MenB vaccine against 15 outbreak strains. Two doses of 4CMenB elicited bactericidal activity against MenB outbreak strains and a hyperendemic MenW strain.
Additional roles of diastolic parameters in the diagnosis of obstructive coronary artery disease
Authors: Kim Hyue Mee , Kim Hack-Lyoung , Kim Myung-A , Oh Sohee , Kim Mina , Park Sang Min , Yoon Hyun Ju , Byun Young Sup , Park Seong Mi , Shin Mi Seung , Hong Kyung-Soon , Shim Wan-Joo 
Published: October 2020

Background
A recent guideline emphasizes the role of four indicators, including annular e´ velocity, E/e´, left atrial (LA) size, and peak tricuspid regurgitation (TR) velocity, in the assessment of left ventricular (LV) diastolic dysfunction. This study was performed to determine the relationships among these four parameters and obstructive coronary artery disease (CAD).

Methods
The study data were obtained from a nation-wide registry, composed of 1307 patients (age, 60.4 ± 10.8 years; 964 women) with normal LV ejection fraction (LVEF) who underwent invasive coronary angiography in the suspicion of CAD. Septal e´, E/e´, LA dimension (LAd), and TR velocity were assessed by transthoracic echocardiography.

Results
Compared with patients without obstructive CAD, those with obstructive CAD showed changes in diastolic parameters indicating more progressed LV diastolic dysfunction in univariate analyses. In multiple logistic regression analysis, low septal e´ velocity (<7 cm/s) was identified as an independent risk factor associated with obstructive CAD (odd ratio, 1.91; 95% confidence interval, 1.08–3.36; P = 0.026). Receiver-operating characteristic curve analysis showed that septal e´ velocity had the most powerful value in the detection of obstructive CAD than the other three diastolic parameters (P < 0.01 for each comparison). Septal e´ velocity significantly increased diagnostic value of treadmill exercise test (TET) in the detection of obstructive CAD (P < 0.001 for integrated discrimination improvement index).

Conclusions
Among the four diastolic parameters, septal e´ velocity had the most powerful relationship with obstructive CAD in stable patients with normal LVEF. The addition of septal e´ velocity could improve the diagnostic value of TET.
Low Risk of Neoplasia and Intraprocedural Adverse Events in Gastric Hyperplastic Polypectomy
Authors: Bar Nir , Kinaani Fadi , Sperber Ami D. , Amir-Barak Hadar , Dekel Roy 
Published: October 2020

Goals:
Assess neoplasia and polypectomy-related adverse event (AE) rates in gastric hyperplastic polyps (GHPs).

Background:
GHPs carry a risk of neoplastic transformation. The rate of neoplastic transformation and the risk of polypectomy-related bleeding are unclear in the West, as data are derived from Asian or small studies. The authors aimed to determine the rate of dysplasia and intraprocedural AEs in GHP polypectomies in a western cohort.

Study:
A retrospective study of 591 GHPs >1 cm resected in 491 patients in a single referral center on the occurrence of neoplasia and intraprocedural AEs.

Results:
The mean age was 74.9±11.1 years, 57% female individuals. The mean polyp size was 2±0.8 cm. There were 11 neoplastic polyps (1.9%) with low-grade dysplasia, high-grade dysplasia, and cancer in 7 (1.3%), 2 (0.3%), and 2 (0.3%), respectively. Neoplasia was associated with age [9 (3.2%) for more than 75 years vs. 2 (0.7%) for less than 75 years; P=0.035], but not with polyp size or gender. Fifty patients (8.5%) had intraprocedural bleeding (IPB) requiring endoscopic intervention, with 3 hospitalizations. There were no perforations or procedure-related deaths. IPB was associated with polyp size and neoplasia. The adjusted odds ratio (95% confidence interval) for IPB was 1.63 (1.2-2.2) for a 1 cm increase in polyp size, and 7.4 (1.9-29.6) for the presence of neoplasia.

Conclusions:
The neoplasia rate in GHPs was 1.9%, lower than most previous reports, with no major intraprocedural AEs. Physicians may consider biopsy and follow-up in frail elderly patients, but the safety of this strategy needs further confirmation.
Combined PEG3350 Plus Lactulose Results in Early Resolution of Hepatic Encephalopathy and Improved 28-Day Survival in Acute-on-Chronic Liver Failure
Authors: Ahmed Syed , Premkumar Madhumita , Dhiman Radha K. , Kulkarni Anand V. , Imran Rather , Duseja Ajay , Kaur Prabhdeep , Taneja Sunil , Singh Virendra , Mishra Saurabh , Roy Akash , Mehtani Rohit 
Published: October 2020

Background and Aims:Acute-on-chronic liver failure (ACLF) is associated with high short-term mortality in those with hepatic encephalopathy (HE). Polyethylene glycol (PEG) 3350 electrolyte solution can ensure rapid gut catharsis, which may resolve HE more effectively than lactulose. In this open-label–randomized trial, we compared PEG+lactulose versus lactulose alone in ACLF with HE grade ≥2 for efficacy and outcome.Patients and Methods:Patients were randomized to receive PEG (2 L q12 h) followed by lactulose (30 mL q8 h) or standard medical treatment [SMT, lactulose (titrated 30 mL q8 h)]. Endpoints were HE grade improvement at 24 hours, 48 hours, and 7 days using hepatic encephalopathy scoring algorithm (HESA), ammonia reduction, HE resolution, and survival benefit.Results:Of 60 patients, 29 were randomized to PEG+lactulose arm and 31 to SMT. In the PEG arm, early reduction in HESA score was noted in more persons [18 (62.1%) vs. 10 (32.2%);P=0.021] with a shorter median time to HE resolution [4.5 (3 to 9) d vs. 9 (8 to 11) d;P=0.023]. On multivariate analysis, age [hazard ratio (HR),1.06 (1.00 to 1.13);P=0.03], HESA score [HR, 6.01 (1.27 to 28.5);P=0.024], and model for end-stage liver disease [HR, 1.26 (1.01 to 1.53);P=0.022] were predictors of mortality at 28 days. Ammonia level or reduction did not correlate with HE grades. Adverse events included excessive diarrhea (20.6% vs. 9.6%) in the PEG and SMT arms, albeit without dyselectrolytemia or worsened renal function. In the PEG versus SMT arm, survival at 28 days were 93.1% versus 67.7% (P=0.010) and at 90 days was 68.9% versus 48.3% (P=0.940), respectively, with fewer persons relapsing with HE in the PEG arm.Conclusions:PEG resulted in early and sustained HE resolution with improved short-term survival making, it a suitable and safe drug in patients with acute HE in ACLF.
Improving pediatric problem-based learning sessions in undergraduate and graduate medical education
Authors: Harriel Katherine L. , Parboosingh John T. 
Published: October 2020

Purpose of review
Problem-based learning (PBL) sessions have become common alternatives to traditional didactic-style sessions in medical education, including within pediatric education. The creation and execution of PBL sessions, however, can vary among institutions and even between educators at a given institution. Coupling the personal experiences of a recently-graduated medical student with that of a knowledgeable medical educator, the authors sought to analyze two PBL session experiences of the medical student during her second year with the goal of pinpointing specific elements that add value for both learners and facilitators.

Recent findings
Through this analysis, the authors propose enhancements to PBL sessions that may make them more optimal for developing knowledge in pediatric medicine. These include utilizing an interactive video of the clinical problem to more uniformly assess the learner's knowledge gaps, supporting the creation and evolution of peer-to-peer learning communities, and helping to educate facilitators in how to guide dialogue in this type of educational setting.

Summary
The PBL enhancements identified by the authors provide educators with innovative suggestions to better engage pediatric trainees in building social capital, acquiring knowledge, and helping learners retain that knowledge beyond their assessments.
Predicting Infection in Very Preterm Infants
Authors: Dail Robin B. , Everhart Kayla C. , Hardin James W. , Chang Weili , Kuehn Devon , Iskersky Victor , Fisher Kimberley , Murphy Heidi J. 
Published: October 2020

Background
Neonatal sepsis causes morbidity and mortality in preterm infants. Clinicians need a predictive tool for the onset of neonatal infection to expedite treatment and prevent morbidity. Abnormal thermal gradients, a central–peripheral temperature difference (CPtd) of >2°C or <0°C, and elevated heart rate characteristic (HRC) scores are associated with infection.

Objective
This article presents the protocol for the Predictive Analysis Using Temperature and Heart Rate Study.

Methods
This observational trial will enroll 440 very preterm infants to measure abdominal temperature and foot temperature every minute and HRC scores hourly for 28 days to compare infection data. Time with abnormal thermal gradients (Model 1) and elevated HRC scores (Model 2) will be compared to the onset of infections. For data analysis, CPtd (abdominal temperature − foot temperature) will be investigated as two derived variables, high CPtd (number/percentage of minutes with CPtd of >2°C) and low CPtd (number/percentage of minutes with CPtd of <0°C). In the infant-level model, the outcome yi
will be an indicator of whether the infant was diagnosed with an infection in the first 28 days of life, and the high CPtd and low CPtd variables will be the average over the entire observation period, logit(yi
) = β
0 + xiβ
1 + ziγ. For the day-level model, the outcome yit
will be an indicator of whether the ith infant was diagnosed with an infection on the tth day from t = 4 through t = 28 or the day that infection is diagnosed (25 possible repeated measures), logit(yit
) = β
0 + xitβ
1 + zitγ. It will be determined whether a model with only high CPtd or only low CPtd is superior in predicting infection. Also, the correlation of abnormal HRC scores with high CPtd and low CPtd values will be assessed.

Discussion
Study results will inform the design of an interventional study using temperatures and/or heart rate as a predictive tool to alert clinicians of cardiac and autonomic instability present with infection.
Assessing the Necessity for the “Joint Above and Below” Radiography Approach for Lower-extremity Long Bone Fractures in Children
Authors: Koetter Paige , Gallo Robert , Kasmire Kathryn E. 
Published: October 2020

Objectives
A common strategy for evaluation of extremity fractures is the “joint above and below” (JAB) radiograph approach, which includes dedicated imaging of the joint proximal and distal to a fracture independent of clinical suspicion for an injury involving the joint. The incidence of concomitant ipsilateral lower-extremity fractures or dislocations associated with lower-extremity long bone fractures in children has not been commonly reported and represents an evidential gap for determining a radiograph approach. Our purpose was to determine the frequency of and risk factors for concomitant ipsilateral lower-extremity fractures or dislocations.

Methods
A retrospective study of children aged 1 to 17 years treated at an academic medical center emergency department from 2015 to 2018 with any fracture involving the tibia, fibula, or femur. Children with pathologic fractures, transferred from another facility, and/or designated as a level I trauma were excluded. The primary outcome was the prevalence of a concomitant bony injury (fracture or dislocation) at a distinct site in the same extremity. Differences between the concomitant bony injury group and single injury group were characterized using Fisher exact tests. Regression analysis was used to determine predictors of concomitant bony injuries, including age, sex, and mechanism of injury (with injuries requiring level II or III trauma activation classified as high risk).

Results
During the study period, 241 patients with lower-extremity long bone fractures were included. Complete JAB radiographs, defined as dedicated orthogonal radiographs of the joint proximal to and distal to the fracture site, were taken in 85 (35.3%) of 241 patients. Concomitant bony injuries were found in 9 (3.73%) of 241 patients (95% confidence interval, 1.7–7.0%). No additional concomitant bony injuries were identified at follow-up. When comparing patients with and without concomitant bony injuries, there was no significant difference in age (P = 0.34) and sex (P = 0.73). However, patients with a high-risk injury were more likely to have a concomitant bony injury (P < 0.01; odds ratio, 21.9; 95% confidence interval, 3.6–131.5).

Conclusions
Concomitant ipsilateral lower-extremity fractures or dislocations are uncommon in children sustaining tibia, fibula, and/or femur fractures. Although the JAB approach to radiographs may be useful in identifying additional injuries in children with lower-extremity injuries resulting from a “high-risk” mechanisms, its overall yield is low. To provide safe, cost-effective care, providers should continue to value clinical suspicion, history, and physical examination findings to guide selection of radiographs in those with lower-extremity long bone fractures as significant fractures can typically be identified with limited imaging in patients with low-risk injury mechanisms.
Freeze-dried platelets promote clot formation, attenuate endothelial cell permeability, and decrease pulmonary vascular leak in a murine model of hemorrhagic shock
Authors: Trivedi Alpa , Potter Daniel R. , Miyazawa Byron Y. , Lin Maximillian , Vivona Lindsay R. , Khakoo Manisha A. , Antebi Ben , Lee Amber , Ishler Braden , Dickerson Matthew , Kozar Rosemary , Schreiber Martin A. , Holcomb John B. , Fitzpatrick Glen M. , Pati Shibani 
Published: October 2020

BACKGROUND
Hemorrhagic shock (HS) and trauma induce endothelial barrier compromise, inflammation, and aberrant clotting. We have shown that fresh human platelets (Plts) and Plt extracellular vesicles mitigate vascular leak in murine models of injury. Here, we investigate the potential of freeze-dried platelets (FDPlts) to attenuate pulmonary vascular permeability, decrease inflammation, and promote clotting in a murine model of HS.

METHODS
Human FDPlts were characterized using in vitro assays of Plt marker expression, aggregation, coagulation, and endothelial cell permeability. An intravital model of vascular injury in the mouse cremaster muscle was used to assess the ability of FDPlts to incorporate into clots. Mouse groups subjected to controlled hemorrhage for 90 minutes were (1) lactated Ringer solution (LR), (2) FDPlts, (3) fresh human Plts, (4) murine whole blood (WB), and (5) shams (only instrumented). Hemorrhagic shock mouse endpoints included coagulation, pulmonary vascular permeability, and lung injury.

RESULTS
Freeze-dried Plts expressed Plt-specific markers and retained functionality similar to fresh Plts. In in vitro assays of Plt aggregation, differences were noted. In vivo, FDPlts and Plts were found to incorporate into clots in postcapillary venules in the mouse cremaster muscle. Hemorrhagic shock mice resuscitated with LR displayed increased pulmonary vascular permeability compared with sham (sham, 686.6 ± 359.7; shock-LR, 2,637 ± 954.7; p = 0.001), and treatment with FDPlts or WB attenuated permeability compared with shock: shock-FDPlts, 1,328 ± 462.6 (p = 0.05), and shock-WB, 1,024 ± 370.5 (p = 0.0108). However, human Plts (Days 1–3) did not attenuate vascular leak in HS mice compared with shock-LR (shock-Plts, 3,601 ± 1,581; p = 0.33).

CONCLUSION
FDPlts contribute to clot formation similar to fresh human Plts. FDPlts also attenuated vascular permeability in vitro and in vivo. Mouse WB resuscitation but not fresh human Plts attenuated vascular permeability after HS. These data suggest that the effect of FDPlts may be a suitable alternative to fresh Plts in modulating hemostasis and the endotheliopathy associated with injury.
Thermal Effect On The Persistence Of SARS-CoV2 Egyptian Isolates As Measured By Quantitative RT-PCR
Authors: Seadawy M.G. , Gad A.F. , Elhoseny M.F. , ELharty B. , EL Desoky M.S. , Soliman Y.A. 
Published: October 2020

AbstractCoronavirus pandemic that caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) appeared in China in 2019 then spread all over the world .COVID-19 firstly appeared in Egypt in Feb 2020. Studies on the thermal stability of the virus is crucial proper specimens’ transportation for molecular study. Oropharyngeal swabs were taken from recently infected military people with COVID-19 from Egypt during April 2020. Samples were aliquoted and the thermal stability of the virus was measured using quantitative real Time RT-PCR for samples treated at different temperature ranges from 20 °C to 70 °C for 2,4and 6 hours. Results shown that inactivation of the virus and significant reduction in the ΔCq values begin at 40 °C/4h. Complete virus inactivation and loss of ΔCq values were seen at 50 °C/6h and 60 °C. Tested samples showed no significant difference in thermal stability at any temp/time combinations tested.
The viral protein NSP1 acts as a ribosome gatekeeper for shutting down host translation and fostering SARS-CoV-2 translation
Authors: Tidu Antonin , Janvier Aurélie , Schaeffer Laure , Sosnowski Piotr , Kuhn Lauriane , Hammann Philippe , Westhof Eric , Eriani Gilbert , Martin Franck 
Published: October 2020

AbstractSARS-CoV-2 coronavirus is responsible for Covid-19 pandemic. In the early phase of infection, the single-strand positive RNA genome is translated into non-structural proteins (NSP). One of the first proteins produced during viral infection, NSP1, binds to the host ribosome and blocks the mRNA entry channel. This triggers translation inhibition of cellular translation. In spite of the presence of NSP1 on the ribosome, viral translation proceeds however. The molecular mechanism of the so-called viral evasion to NSP1 inhibition remains elusive. Here, we confirm that viral translation is maintained in the presence of NSP1. The evasion to NSP1-inhibition is mediated by thecis-acting RNA hairpin SL1 in the 5’UTR of SARS-CoV-2. NSP1-evasion can be transferred on a reporter transcript by SL1 transplantation. The apical part of SL1 is only required for viral translation. We show that NSP1 remains bound on the ribosome during viral translation. We suggest that the interaction between NSP1 and SL1 frees the mRNA accommodation channel while maintaining NSP1 bound to the ribosome. Thus, NSP1 acts as a ribosome gatekeeper, shutting down host translation or fostering SARS-CoV-2 translation depending on the presence of the SL1 5’UTR hairpin. SL1 is also present and necessary for translation of sub-genomic RNAs in the late phase of the infectious program. Consequently, therapeutic strategies targeting SL1 should affect viral translation at early and late stages of infection. Therefore, SL1 might be seen as a genuine ‘Achille heel’ of the virus.
The impact of brand and social cause prominence dimensions of fit on consumer intentions to buy cause-related products
Authors: Dagyte-Kavoliune Gintare , Adomaviciute Karina , Urbonavicius Sigitas 
Published: October 2020

PurposeThe aim of this study is to assess the direct and indirect impact of the prominence dimensions of fit between a brand and a cause on consumer intentions to purchase cause-related products by considering cases with more versus less positive attitudes towards a brand and a higher versus lower social cause affinity.Design/methodology/approachThe study is based on data obtained via a survey of 403 respondents in Lithuania. A between-subjects study design with different brands and causes was used to identify the role of the differences in brand attitude and cause affinity on the message strength.FindingsThe data analysis has revealed that the specific prominence dimensions of fit (relationship visibility, relationship explicitness, visuals/colours, local attributes) have a direct and indirect impact, via the message strength, on consumer intentions to purchase cause-related products. Additionally, the mediation of the message strength was dependent on attitudes towards a brand but not on cause affinity.Originality/valueThis is the first attempt to contribute to filling the research gap regarding the impact of the prominence dimensions of fit on the intention to purchase a cause-related product. Paying special attention to message strength mediation allowed for the assessment of both the direct and indirect effects of the individual dimensions of fit.