bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Unfinished Business of Respect for Autonomy: Persons, Relationships, and Nonhuman Animals
Authors: Walker Rebecca L 
Published: May 2020

AbstractThis essay explores three issues in respect for autonomy that pose unfinished business for the concept. By this, I mean that the dialogue over them is ongoing and essentially unresolved. These are: (1) whether we ought to respect persons or their autonomous choices; (2) the role of relational autonomy; and (3) whether nonhuman animals can be autonomous. In attending to this particular set of unfinished business, I highlight some critical moral work left aside by the concept of respect for autonomy as understood in Beauchamp and Childress’ Principles of Biomedical Ethics. Specifically, while significant pragmatic traction is gained by the authors’ focus on autonomous choice, carving such a focus out from the broader questions of moral respect and the autonomy of the person leaves aside a number of questions that we might have thought a view about respect for autonomy in biomedicine ought to answer. These include: How should physicians respond when autonomous patients make decisions that appear nonautonomous? What is the impact of the view that autonomy is “relational” for cross-cultural differences in how autonomy is respected? If chimpanzees (and by extension young children) can be autonomous, what does that mean for how they should be treated?
Cell Therapies for Spinal Cord Injury: Trends and Challenges of Current Clinical Trials
Authors: Bartlett Richard D , Burley Sarah , Ip Mina , Phillips James B , Choi David 
Published: May 2020

Abstract
Cell therapies have the potential to revolutionize the treatment of spinal cord injury. Basic research has progressed significantly in recent years, with a plethora of cell types now reaching early-phase human clinical trials, offering new strategies to repair the spinal cord. However, despite initial enthusiasm for preclinical and early-phase clinical trials, there has been a notable hiatus in the translation of cell therapies to routine clinical practice. Here, we review cell therapies that have reached clinical trials for spinal cord injury, providing a snapshot of all registered human trials and a summary of all published studies. Of registered trials, the majority have used autologous cells and approximately a third have been government funded, a third industry sponsored, and a third funded by university or healthcare systems. A total of 37 cell therapy trials have been published, primarily using stem cells, although a smaller number have used Schwann cells or olfactory ensheathing cells. Significant challenges remain for cell therapy trials in this area, including achieving stringent regulatory standards, ensuring appropriately powered efficacy trials, and establishing sustainable long-term funding. However, cell therapies hold great promise for human spinal cord repair and future trials must continue to capitalize on the exciting developments emerging from preclinical studies.
USING DICENTRIC DOSE ESTIMATES AND EARLY RADIATION-INDUCED BLOOD CELL COUNT CHANGES OF REAL CASE HISTORIES FOR VALIDATION OF THE HEMODOSE BIODOSIMETRY TOOL
Authors: Haupt Julian , Ostheim Patrick , Port Matthias , Abend Michael 
Published: May 2020

Abstract
HemoDose is a software tool, which estimates absorbed doses based on blood cell counts (BCC). The aim of our study was to validate HemoDose for early dose estimates. Dose estimates generated by HemoDose were compared with dose estimates stored in SEARCH from radiation victims. Moreover, BCC from unirradiated donors and corresponding HemoDose dose estimates were analysed. We employed linear or logistic regression analysis. There was a significant correlation between calculated doses by HemoDose based on single and multiple lymphocyte counts when omitting lowest and highest dose estimates. Furthermore, there was a significant correlation between calculated doses by HemoDose based on lymphocyte counts and the estimated doses based on DIC. The dose estimates by HemoDose based on lymphocyte counts and DIC showed a comparable correlation with HARS degrees 0 and 4. In conclusion, HemoDose dose estimation based on early lymphocyte counts appears to be a promising biodosimetry tool under certain considerations.
14Popular Culture
Authors: Danesi Marcel 
Published: May 2020

Abstract
This review of three introductory textbooks in the field of popular culture published in 2018 and 2019 focuses on the different perspectives they provide on such culture, as a means for understanding its current state and future evolution. It is divided into six sections: 1. Introduction; 2. Pop Culture, People, and Politics; 3. A Pastiche Approach to Cinema; 4. Pop Culture Theories; 5. Pop Culture and the Internet; 6. Conclusion. Pop culture is changing radically today, breaking away from the historical flow that gained momentum in then 1920s, because its delivery through the Internet may be fragmenting its organic textuality. As a distinct form of culture, pop culture crystallized primarily in the US in the first decades of the twentieth century, arguably as a way for young people to contest and openly violate the restrictive social traditions of colonial America through new music, fashions, and overall lifestyles. It spread rapidly and broadly throughout American cities and other areas of the urbanized world—a diffusion made possible by new technologies, such as radio and cinema. From the outset, trends in pop culture influenced aesthetic tastes, politics, and even major musical and literary movements that were once considered to be part of ‘high culture’, gradually obliterating binary distinctions such as high-versus-low in cultural matters. In a phrase, what started out as a lifestyle reaction against puritanical colonial culture became a major source of new aesthetics (new music, new writing, and so on), remaining so ever since. But pop culture may have run its course with the rise of meme culture on the Internet. The books under review here are thus quite significant, not only because they present complementary views of pop culture to a broad audience, but also because we can draw from them a picture of how pop culture is evolving in the digital age and what this might imply for the future of this century-old cultural experiment.
Inpatient Unit Leaders' Perspectives on Parent Engagement in Neonatal and Pediatric Intensive Care
Authors: Vance Ashlee J. , Docherty Sharron , Brandon Debra H. 
Published: May 2020

Background:
Hospital unit leaders help set the unit's priorities and are responsible for guiding the unit mission and philosophy of care; however, the perspective of leaders in facilitating parent engagement within intensive care units is limited.

Purpose:
The purpose of this study was to explore how medical and nursing unit leaders facilitate parent engagement in intensive care settings.

Methods:
Qualitative secondary analysis of 16 semistructured interviews of unit leadership (medical directors and nurse managers). Directed content analysis explored themes within the interviews using systematic strategies to ensure rigor.

Findings:
Unit leadership described 3 main features of care delivery necessary for supporting parent engagement: (1) culture of care, (2) relationships in care, and (3) environment of care. Communication among providers and parents and timing of decision-making were key areas addressed, along with concerns about physical space limiting parent engagement. Unit leaders discussed how the 3 main features (unit culture, relationships, and physical space) of care delivery were interconnected to optimize parent engagement.

Implications for Practice:
Overall, unit leaders recognized the importance of each feature of care delivery in facilitating engagement. Parent engagement is ultimately influenced by the optimization of delivering inclusive care: the physical space, the policies surrounding medical and nursing care, and the overall culture of the unit.

Implications for Research:
Future research needs to explore best practices around relationship building and managing space limitations. Further clarification of the needs and expectations of both parents and providers surrounding parent engagement in intensive care settings is needed.
Can Procalcitonin Improve Antibiotic Stewardship for Late-Onset Sepsis Evaluations in Neonates?
Authors: Gareau-Terrell Jennifer , Branham Steven 
Published: May 2020

Background:
Procalcitonin (PCT) use is not widespread in the neonatal population during late-onset sepsis evaluations. Minimal data exist on appropriate PCT cutoff levels to treat with antibiotics for neonatal sepsis. New guidelines were implemented in select central Texas neonatal intensive care units for late-onset sepsis (infants older than 72 hours) with recommended PCT cutoff levels for antibiotic administration.

Purpose:
To evaluate antibiotic usage in a local neonatal population following late-onset sepsis workups pre-/postimplementation of a PCT guideline.

Methods:
A retrospective pre–/post–quality improvement project using chart review data was performed over 11 months in 2018. Inclusion criteria were infants older than 72 hours of life having a late-onset sepsis workup. The outcome measure is appropriate antibiotic administration, based on laboratory test results or cultures, for infants pre-/post-PCT guidelines.

Results:
The χ2 test indicated that the proportion of infants receiving appropriate antibiotics pre-/postinitiation of PCT guidelines did not significantly differ. There is, however, clinical significance with an improvement in the proportion of appropriate antibiotic administration and a decrease in variability.

Implications for Practice:
Using PCT may help the practitioner identify sepsis earlier and more effectively, thereby reducing morbidity and mortality among neonates while improving antibiotic stewardship.

Implications for Research:
The small sample size in this study and the limited number of neonatal intensive care units limit any inferences. Future research should evaluate the use of PCT in a larger sample across multiple settings.
Analyzing the Time From Discovery to Definitive Surgical Therapy for Lung Cancer Based on Referral Patterns
Authors: Napolitano Michael A. , Skancke Matthew D. , Mortman Keith D. 
Published: May 2020

Objective:
Surgery for early stage non–small cell lung cancer can be curative. A delay from diagnosis to surgery can lead to increased mortality. Our objective was to determine if referring patients to specialists before a thoracic surgeon caused a delay in definitive treatment.

Materials and Methods:
A retrospective review was conducted of patients who had surgery for non–small cell lung cancer by a single surgeon at our institution from 2013 to 2016. Patients were divided into 2 groups: those who saw a specialist before a thoracic surgeon and patients who were referred directly to a surgeon once the pulmonary nodule was identified on computed tomography (CT). The time from initial CT to resection was compared. Secondary analysis compared private insurance versus Medicare/Medicaid. Percentage of patients upstaged was compared.

Results:
There was no significant difference between groups when comparing time from CT to surgery (79.88 vs. 79.90 d; P=0.58). There was a significant decrease in time from CT to surgery for patients with private insurance compared with Medicare/Medicaid patients (66.05 vs. 86.99 d; P=0.03) and fewer private insurance patients were upstaged (22.9% vs. 31.8%; P=0.32). More patients who saw a different specialist first were upstaged compared with patients sent directly to thoracic surgery (32.6% vs. 22.2%; P=0.22).

Conclusions:
When comparing time from CT detection of a lung nodule to surgery, no significant difference was found between patients sent to nonthoracic specialists first and those referred directly to a thoracic surgeon. There was a significant decrease in time from CT to surgery for patients with private insurance compared with Medicare/Medicaid.
Management of Ocular Hypotony After Tube Surgery Using Bent Intraluminal Stents
Authors: Song Mi Yeon , Hwang Young Hoon 
Published: May 2020

Purpose:
We aimed to report a surgical technique for the management of ocular hypotony after tube surgery.

Methods:
We occluded the tube with ab interno insertion of 2 bent 5-0 polypropylene threads into the tube lumen. Bent stents were used to prevent stent displacement.

Results:
Our case series revealed that this procedure effectively resolved hypotony. Among the 3 cases, the stents were removed in 1 case and left in place in 2 cases. In all cases, the stent location remained stable without displacement.

Conclusion:
The insertion of bent intraluminal stents into the tube may be a useful method for the management of ocular hypotony after tube surgery.
Regressing SARS-CoV-2 sewage measurements onto COVID-19 burden in the population: a proof-of-concept for quantitative environmental surveillance
Authors: Bar-Or Itay , Yaniv Karin , Shagan Marilou , Ozer Eden , Erster Oran , Mendelson Ella , Mannasse Batya , Shirazi Rachel , Kramarsky-Winter Esti , Nir Oded , Abu-Ali Hala , Ronen Zeev , Rinott Ehud , Lewis Yair E. , Friedler Eran , Bitkover Eden , Paitan Yossi , Berchenko Yakir , Kushmaro Ariel 
Published: May 2020

AbstractSARS-CoV-2 is an RNA virus, a member of the coronavirus family of respiratory viruses that includes SARS-CoV-1 and MERS. COVID-19, the clinical syndrome caused by SARSCoV-2, has evolved into a global pandemic with more than 2,900,000 people infected. It has had an acute and dramatic impact on health care systems, economies, and societies of affected countries within these few months. Widespread testing and tracing efforts are employed in many countries in order to contain and mitigate this pandemic. Recent data has indicated that fecal shedding of SARS-CoV-2 is common, and that the virus can be detected in wastewater. This indicates that wastewater monitoring is a potentially efficient tool for epidemiological surveillance of SARS-CoV-2 infection in large populations at relevant scales. Collecting raw sewage data, representing specific districts, and crosslinking this data with the number of infected people from each location, will enable us to derive and provide quantitative surveillance tools. In particular, this will provide important means to (i) estimate the extent of outbreaks and their spatial distributions, based primarily on in-sewer measurements (ii) manage the early-warning system quantitatively and efficiently (and similarly, verify disease elimination). Here we report the development of a virus concentration method using PEG or alum, providing an important a tool for detection of SARS-CoV-2 RNA in sewage and relating it to the local populations and geographic information. This will provide a proof of concept for the use of sewage associated virus data as a reliable epidemiological tool.
Diagnosing SARS-CoV-2 infection: the danger of over-reliance on positive test results
Authors: Cohen Andrew N. , Kessel Bruce , Milgroom Michael G. 
Published: May 2020

AbstractContrary to the practice during previous epidemics, with COVID-19 health authorities have treated a single positive result from a PCR-based test as confirmation of infection, irrespective of signs, symptoms and exposure. This is based on a widespread belief that positive results in these tests are highly reliable. However, evidence from external quality assessments and real-world data indicate enough a high enough false positive rate to make positive results highly unreliable over a broad range of scenarios. This has clinical and case management implications, and affects an array of epidemiological statistics, including the asymptomatic ratio, prevalence, and hospitalization and death rates, as well as epidemiologic models. Steps should be taken to raise awareness of false positives and reduce their frequency. The most important immediate action is to check positive results with additional tests, at least when prevalence is low.Key messagesThe high specificities (usually 100%) reported in PCR-based tests for SARS-CoV-2 infection do not represent the real-world use of these tests, where contamination and human error produce significant rates of false positives.Widespread lack of awareness of the real-world false positive rates affects an array of clinical, case management and health policy decisions. Similarly, health authorities’ guidance on interpreting test results is often wrong.Steps should be taken immediately to reduce the frequency and impacts of false positive results, including checking positive results with additional tests at least when prevalence is low.
Mathematical model of COVID-19 intervention scenarios for São Paulo-Brazil
Authors: Neto Osmar Pinto , Reis José Clark , Brizzi Ana Carolina Brisola , Zambrano Gustavo José , de Souza Joabe Marcos , Pedroso Wellington Amorim , de Mello Pedreiro Rodrigo Cunha , de Matos Brizzi Bruno , Abinader Ellysson Oliveira , Kennedy Deanna M. , Zângaro Renato Amaro 
Published: May 2020

AbstractAn epidemiological compartmental model was used to simulate social distancing strategies to contain the COVID-19 pandemic and prevent a second wave in São Paulo, Brazil. Optimization using genetic algorithm was used to determine the optimal solutions. Our results suggest the best-case strategy for São Paulo is to maintain or increase the current magnitude of social distancing for at least 60 more days and increase the current levels of personal protection behaviors by a minimum of 10% (e.g., wearing facemasks, proper hand hygiene and avoid agglomeration). Followed by a long-term oscillatory level of social distancing with a stepping-down approach every 80 days over a period of two years with continued protective behavior.
Hydroxychloroquine application is associated with a decreased mortality in critically ill patients with COVID-19
Authors: Yu Bo , Li Chenze , Chen Peng , Zhou Ning , Wang Luyun , Li Jia , Jiang Hualiang , Wang Dao Wen 
Published: May 2020

AbstractImportanceCoronavirus disease 2019 (COVID-19) is a pandemic with no specific drugs and high mortality. The most urgent thing is to find effective treatments.ObjectiveTo determine whether hydroxychloroquine application may be associated with a decreased risk of death in critically ill COVID-19 patients and what is potential mechanism.Design, Setting and PatientsThis retrospective study included all 568 critically ill COVID-19 patients who were confirmed by pathogen laboratory tests despite antiviral treatment and had severe acute respiratory distress syndrome, PAO2/FIO2 <300 with need of mechanical ventilation in Tongji Hospital, Wuhan, between February 1 of 2020 to April 8 of 2020. All 568 patients received comparable basic treatments including antiviral drugs and antibiotics, and 48 of them additionally received oral hydroxychloroquine (HCQ) treatment (200 mg twice a day for 7-10 days). Primary endpoint is mortality of patients, and inflammatory cytokines levels were compared between hydroxychloroquine and non-hydroxychloroquine (NHCQ) treatments.MAIN OUTCOMES AND MEASURESIn-hospital death and hospital stay time (day) were obtained, level of inflammatory cytokine (IL-6) was measured and compared between HCQ and NHCQ treatments.RESULTSThe median age of 568 critically ill patients is 68 (57, 76) years old with 37.0% being female. Mortalities are 18.8% (9/48) in HCQ group and 45.8% (238/520) in NHCQ group (p<0.001). The time of hospital stay before patient death is 15 (10-21) days and 8 (4 - 14) days for the HCQ and NHCQ groups, respectively (p<0.05). The level of inflammatory cytokine IL-6 was significantly lowered from 22.2 (8.3-118.9) pg/mL at the beginning of the treatment to 5.2 (3.0-23.4) pg/ml (p<0.05) at the end of the treatment in the HCQ group but there is no change in the NHCQ group.CONCLUSIONS AND RELEVANCEHydroxychloroquine treatment is significantly associated with a decreased mortality in critically ill patients with COVID-19 through attenuation of inflammatory cytokine storm. Therefore, hydroxychloroquine should be prescribed for treatment of critically ill COVID-19 patients to save lives.Key PointsQuestionCould hydroxychloroquine administration be beneficial in the treatment of critically ill patients with COVID-19?FindingsIn this retrospective study, a total of 568 critically ill patients with COVID-19 all received basic therapy and additionally 48 of them received hydroxychloroquine for 7–10 days (200 mg twice per day). Hydroxychloroquine treatment is significantly associated with a decreased mortality in critically ill COVID-19 patients and attenuated inflammatory cytokine IL-6 level.MeaningOur data suggest that hydroxychloroquine could be used to treat critically ill patients with COVID-19 which may save a lot of lives.
Social Distancing Has Merely Stabilized COVID-19 in the US
Authors: Wagner Aaron B. , Hill Elaine L. , Ryan Sean E. , Sun Ziteng , Deng Grace , Bhadane Sourbh , Martinez Victor Hernandez , Wu Peter , Li Dongmei , Anand Ajay , Acharya Jayadev , Matteson David S. 
Published: May 2020

AbstractSocial distancing measures, with varying degrees of restriction, have been imposed around the world in order to stem the spread of COVID-19. In this work we analyze the effect of current social distancing measures in the United States. We quantify the reduction in doubling rate, by state, that is associated with social distancing. We find that social distancing is associated with a statistically-significant reduction in the doubling rate for all but three states. At the same time, we do not find significant evidence that social distancing has resulted in a reduction in the number of daily confirmed cases. Instead, social distancing has merely stabilized the spread of the disease. We provide an illustration of our findings for each state, including point estimates of the effective reproduction number, R, both with and without social distancing. We also discuss the policy implications of our findings.
Thiocyanate and organic carbon inputs drive convergent selection for specific autotrophicAfipiaandThiobacillusstrains within complex microbiomes
Authors: Huddy Robert J. , Sachdeva Rohan , Kadzinga Fadzai , Kantor Rose , Harrison Susan T.L. , Banfield Jillian F. 
Published: May 2020

AbstractThiocyanate (SCN-) contamination threatens aquatic ecosystems and pollutes vital fresh water supplies. SCN-degrading microbial consortia are commercially deployed for remediation, but the impact of organic amendments on selection within SCN-degrading microbial communities has not been investigated. Here, we tested whether specific strains capable of degrading SCN-could be reproducibly selected for based on SCN-loading and the presence or absence of added organic carbon. Complex microbial communities derived from those used to treat SCN-contaminated water were exposed to systematically increased input SCN concentrations in molasses-amended and -unamended reactors and in reactors switched to unamended conditions after establishing the active SCN-degrading consortium. Five experiments were conducted over 790 days and genome-resolved metagenomics was used to resolve community composition at the strain level. A singleThiobacillusstrain proliferated in all reactors at high loadings. Despite the presence of manyRhizobialesstrains, a singleAfipiavariant dominated the molasses-free reactor at moderately high loadings. This strain is predicted to breakdown SCN-using a novel thiocyanate dehydrogenase, oxidize resulting reduced sulfur, degrade product cyanate (OCN−) to ammonia and CO2via cyanase, and fix CO2via the Calvin-Benson-Bassham cycle. Removal of molasses from input feed solutions reproducibly led to dominance of this strain. Neither thisAfipiastrain nor the thiobacilli have the capacity to produce cobalamin, a function detected in low abundance community members. Although sustained by autotrophy, reactors without molasses did not stably degrade SCN-at high loading rates, perhaps due to loss of biofilm-associated niche diversity. Overall, convergence in environmental conditions led to convergence in the strain composition, although reactor history also impacted the trajectory of community compositional change.