bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome and prognostic factors of Pneumocystis jirovecii pneumonia in immunocompromised adults: a prospective observational study
Authors: Gaborit Benjamin Jean , Tessoulin Benoit , Lavergne Rose-Anne , Morio Florent , Sagan Christine , Canet Emmanuel , Lecomte Raphael , Leturnier Paul , Deschanvres Colin , Khatchatourian Lydie , Asseray Nathalie , Garret Charlotte , Vourch Michael , Marest Delphine , Raffi François , Boutoille David , Reignier Jean 
Published: November 2019

Abstract
Background
Pneumocystis jirovecii pneumonia (PJP) remains a severe disease associated with high rates of invasive mechanical ventilation (MV) and mortality. The objectives of this study were to assess early risk factors for severe PJP and 90-day mortality, including the broncho-alveolar lavage fluid cytology profiles at diagnosis.

Methods
We prospectively enrolled all patients meeting pre-defined diagnostic criteria for PJP admitted at Nantes university hospital, France, from January 2012 to January 2017. Diagnostic criteria for PJP were typical clinical features with microbiological confirmation of P. jirovecii cysts by direct examination or a positive specific quantitative real-time polymerase chain reaction (PCR) assay. Severe PJP was defined as hypoxemic acute respiratory failure requiring high-flow nasal oxygen with at least 50% FiO2, non-invasive ventilation, or MV.

Results
Of 2446 respiratory samples investigated during the study period, 514 from 430 patients were positive for P. jirovecii. Of these 430 patients, 107 met criteria for PJP and were included in the study, 53 (49.5%) patients had severe PJP, including 30 who required MV. All patients were immunocompromised with haematological malignancy ranking first (n = 37, 35%), followed by solid organ transplantation (n = 27, 25%), HIV-infection (n = 21, 20%), systemic diseases (n = 13, 12%), solid tumors (n = 12, 11%) and primary immunodeficiency (n = 6, 8%). By multivariate analysis, factors independently associated with severity were older age (OR, 3.36; 95% CI 1.4–8.5; p < 0.05), a P. jirovecii microscopy-positive result from bronchoalveolar lavage (BAL) (OR, 1.3; 95% CI 1.54–9.3; p < 0.05); and absence of a BAL fluid alveolitis profile (OR, 3.2; 95% CI 1.27–8.8; p < 0.04). The 90-day mortality rate was 27%, increasing to 50% in the severe PJP group. Factors independently associated with 90-day mortality were worse SOFA score on day 1 (OR, 1.05; 95% CI 1.02–1.09; p < 0.001) whereas alveolitis at BAL was protective (OR, 0.79; 95% CI 0.65–0.96; p < 0.05). In the subgroup of HIV-negative patients, similar findings were obtained, then viral co-infection were independently associated with higher 90-day mortality (OR, 1.25; 95% CI 1.02–1.55; p < 0.05).

Conclusions
Older age and P. jirovecii oocysts at microscopic examination of BAL were independently associated with severe PJP. Both initial PJP severity as evaluated by the SOFA score and viral co-infection predicted 90-day mortality. Alveolitis at BAL examination was associated with less severe PJP. The pathophysiological mechanism underlying this observation deserves further investigation.
Survey of non-resuscitation fluids administered during septic shock: a multicenter prospective observational study
Authors: Lindén-Søndersø Anja , Jungner Mårten , Spångfors Martin , Jan Mohammed , Oscarson Adam , Choi Sally , Kander Thomas , Undén Johan , Griesdale Donald , Boyd John , Bentzer Peter 
Published: November 2019

Abstract
Background
The indication, composition and timing of administration of non-resuscitation fluid in septic shock have so far received little attention and accordingly the potential to reduce this source of fluid is unknown. The objective of the study was to quantify and characterize non-resuscitation fluid administered to patients with septic shock.

Methods
This prospective observational study was performed in eight intensive care units in Sweden and Canada during 4 months in 2018. Adult patients with septic shock within 24 h of admission to the intensive care unit were eligible for inclusion. Non-resuscitation fluids were defined as fluids other than colloids, blood products and crystalloids at a rate ≥ 5 ml/kg/h. Indication, volume and type of fluid were recorded during the first 5 days after admission. A maximum of 30 patients could be included per centre. To estimate the potential to reduce administration of non-resuscitation fluid, a pragmatic “restrictive” protocol for administration of non-resuscitation fluids was devised based on the most restrictive practice already in place for non-resuscitation fluids at any of the participating centres. Data are presented as median (interquartile range [IQR]).

Results
A total of 200 patients were included in the study and the 30-day mortality was 35%. Patients received a total of 7870 (4060–12,340) ml of non-resuscitation fluids and 2820 (1430–4580) of resuscitation fluids during the observation period. Median volumes of non-resuscitation and resuscitation fluids were similar at day 1 (1620 [710–2320] and 1590 [520–3000]) ml, respectively) and non-resuscitation fluids represented the largest source of fluid from day 2 and onwards after admission to the ICU. Vehicles for drugs such as vasoactive drugs and antibiotics constituted the largest fraction of non-resuscitation fluids (2400 [1270–4030] ml) during the 5-day observation period. Modelling suggested that volume of non-resuscitation fluids could be reduced by 2840 (1270–4900) ml during the first 5 days of admission to the ICU, mainly through reducing maintenance fluids.

Conclusions
Non-resuscitation fluids constitute the major fraction of fluids administered in the ICU to patients suffering from septic shock and may represent the largest modifiable target to reduce fluid overload.
Selfish node detection based on hierarchical game theory in IoT
Authors: Nobahary Solmaz , Garakani Hossein Gharaee , Khademzadeh Ahmad , Rahmani Amir Masoud 
Published: November 2019

AbstractCooperation between nodes is an effective technology for network throughput in the Internet of Things. The nodes that do not cooperate with other nodes in the network are called selfish and malicious nodes. Selfish nodes use the facilities of other nodes of the network for raising their interests. But malicious nodes tend to damage the facilities of the network and abuse it. According to reviews of the previous studies, in this paper, a mechanism is proposed for detecting the selfish and malicious nodes based on reputation and game theory. The proposed method includes three phases of setup and clustering, sending data and playing the multi-person game, and update and detecting the selfish and malicious nodes. The process of setup and clustering algorithm are run in the first phase. In the second phase, the nodes of each cluster cooperate with each other in order to execute an infinite repeated game while forwarding their own or neighbor nodes’ data packets. In the third phase, each node monitors the operation of its neighbor nodes for sending the data packets, and the process of cooperation is analyzed for determining the selfish or malicious nodes which forwarded the data packets with delay or even not sent them. The other nodes reduce the reputation of the nodes which does not cooperate with them, and they do not cooperate with the selfish and malicious nodes, as punishment. So, selfish and malicious nodes are stimulated to cooperate. The results of simulation suggest that the detection accuracy of the selfish and malicious nodes has been increased by an average of 12% compared with the existing methods, and the false-positive rate has been decreased by 8%.
Sustainability governance of the Danish bioeconomy — the case of bioenergy and biomaterials from agriculture
Authors: Bentsen Niclas Scott , Larsen Søren , Stupak Inge 
Published: November 2019

Abstract
Background
The EU bioeconomy strategy aims to accelerate the European bioeconomy and its contributions to the United Nations Sustainable Development Goals and the Paris Agreement. National policies and strategies in many countries promote their bioeconomies. The importance of agricultural crops and residues as raw materials for the bioeconomy is increasingly recognised, but agricultural production also contributes to large impacts on nature and environment. With the aim of assessing the governance measures and their effectiveness in addressing the sustainability of bioenergy and biofuel production, the purpose of this study was to map the governance complex relevant to agricultural crop production in Denmark, and to identify the achievements, challenges and lessons learned.

Methods
The analysis is based on a review and assessment of publicly available databases, inventory reports and scientific literature on governance measures and their effectiveness. Governance here includes a variety of legislation, agreements, conventions and standardisation. Environmental sustainability is represented by greenhouse gas emissions from the agricultural sector, soil carbon, water quality and biodiversity.

Results
The agricultural sector has a significant impact on Danish climate performance and on landscapes in the form of soil carbon losses, leaching of nutrients to water bodies and pressures on biodiversity. The governance complex addressing these issues is made up of a variety of state regulation and co-regulation between state and firms, state and NGOs, or NGOs and firms. Much regulation is adopted from EU directives and implemented nationally.

Conclusions
The analysis found that greenhouse gas emission is a virtually unregulated field and additional regulation is required to live up to Denmark’s 2030 emission reduction targets. The regulatory framework for soil carbon is criticised for its complexity, its competing instruments and its recognition procedures of voluntary co-regulation. For water quality governance measures in place have improved water quality, but it is still difficult to achieve the goals of the Water Framework Directive. It remains a challenge to protect biodiversity in agriculture. Biodiversity is mainly governed by national and supranational regulation, but co-regulating between state and firms and NGOs and firms have been initiated in the framework of the Agricultural Agreement.
Risk factors of acute malnutrition among children aged 6–59 months enrolled in a community-based programme in Kurigram, Bangladesh: a mixed-method matched case-control study
Authors: Hoq Monsurul , Ali Masum , Islam Ashraful , Banerjee Charulatha 
Published: November 2019

Abstract
Background
Risk factors of acute malnutrition in Bangladesh are well documented. However, due to regional variations in prevalence of acute malnutrition, it is important to explore the risk factors specific to the region, for designing and implementing public health interventions.

Methods
A mixed-method matched case-control study was conducted in the Kurigram district of Bangladesh. Community perspectives on causes of acute malnutrition were collected from 75 purposively selected caregivers through interviews, focus group discussions and informal group discussions. The data was analysed manually by coding and sub-coding according to different themes. Caregivers of 52 malnourished and 95 well-nourished children matched in age group and sex with the malnourished children, were interviewed using a structured questionnaire. The conditional logistic regression analysis was performed to identify the risk factors of acute malnutrition.

Results
Caregivers perceived inappropriate feeding practice as a major cause of acute malnutrition whereas birth order (first child OR 0.3, 95% CI 0.09, 0.96), number of family members (OR 1.30, 95% CI 1.02, 1.65), illness in the last 2 weeks (OR 3.08, 95% CI 1.13, 8.42) and access to hygienic latrine (OR 0.25, 95% CI 0.07, 0.82) were also associated with acute malnutrition among children under five in Kurigram.

Conclusions
Community awareness on infant feeding practices and family planning, management of childhood illness and access to hygienic latrine facilities should be prioritised to prevent acute malnutrition in the northern districts.
Development of milk powder containing Lactobacillus plantarum NCIMB 8826 immobilized with prebiotic hi-maize starch and survival under simulated gastric and intestinal conditions
Authors: Bradford Ronamae , Reyes Vondel , Bonilla Franklin , Bueno Federico , Dzandu Bennett , Liu Chen , Chouljenko Alexander , Sathivel Subramaniam 
Published: November 2019

AbstractThe objectives of this study were to develop a probiotic milk powder containingLactobacillus plantarumNCIMB 8826 immobilized with prebiotic Hi-maize starch and to analyze cell viability after spray drying and exposure to simulated gastric and intestinal conditions. Milk powders containing freeL. plantarumand cells immobilized with Hi-maize starch were assessed. Powders were evaluated during storage at 4 °C for 15 days. After spray drying, at 0 and 15 days of storage both treatments had over 8 log CFU/g of viable cells and there were higher viable counts found for immobilized cells compared to free cells after 120 min in simulated gastric fluid. At 15 days of storage, immobilized cells had higher viable counts than free cells after exposure to simulated intestinal fluid for 120 min. The combined probiotic and prebiotic milk powder had stable viable cell counts at refrigerated storage conditions and under simulated gastric and intestinal transit.Graphical abstract
Parathyroid Hormone and Plasma Phosphate Are Predictors of Soluble α-Klotho Levels in Adults of European Descent
Authors: Dhayat Nasser A , Pruijm Menno , Ponte Belen , Ackermann Daniel , Leichtle Alexander Benedikt , Devuyst Olivier , Ehret Georg , Guessous Idris , Pechère-Bertschi Antoinette , Pastor Johanne , Martin Pierre-Yves , Burnier Michel , Fiedler Georg-Martin , Vogt Bruno , Moe Orson W , Bochud Murielle , Fuster Daniel G 
Published: November 2019

Abstract

Context
α-klotho is an integral membrane protein that serves as a coreceptor for fibroblast growth factor 23 (FGF23) in conjunction with cognate fibroblast growth factor receptors. Proteolytic cleavage sheds the ectodomain of α-klotho (soluble α-klotho) as an endocrine substance into blood, urine, and cerebrospinal fluid.

Objective
To study the relationship of soluble α-klotho to mineral metabolism in the general population with mainly preserved kidney function.

Design
Cross-sectional analysis of the associations between soluble α-klotho with laboratory markers of markers of mineral metabolism in a population-based cohort.

Setting
Three centers in Switzerland including 1128 participants.

Measures
Soluble full-length α-klotho levels by a specific immunoassay and markers of mineral metabolism.

Results
The median serum level of soluble α-klotho was 15.0 pmol/L. Multivariable analyses using α-klotho as the outcome variable revealed a sex-by-PTH interaction: In men, PTH was positively associated with α-klotho levels, whereas this association was negative in women. Plasma phosphate associated with soluble α-klotho levels in an age-dependent manner, changing from a positive association in young adults gradually to a negative association in the elderly. The decline of 1,25 (OH)2 vitamin D3 levels in parallel to the gradual impairment of kidney function was greatly attenuated in the setting of high circulating soluble α-klotho levels.

Conclusions
Soluble α-klotho level is associated with plasma phosphate in an age-dependent manner and with PTH in a sex-dependent manner. Furthermore, our data reveal soluble α-klotho as a modulator of 1,25 (OH)2 vitamin D3 levels in individuals with preserved renal function.
In Search of National Decoration
Authors: Ho Christine I. 
Published: November 2019

AbstractIn the late 1930s, design studies in China underwent a paradigmatic shift when the cosmopolitan idioms fashioned within treaty-port cities were rejected in favor of populist ethnonationalism, developed along the border regions of wartime China. This essay examines design compendia by Pang Xunqin and Lei Guiyuan, founding figures in modern design studies, as proposals that advocate for a reevaluation of folk and ethnic-minority traditions. Shaped by a signal moment in wartime modernism, the design proposals are located at the conjunction of two fields of knowledge that were discursively reframed by the heightened cultural nationalism of the Sino-Japanese War: the expansion of modern archaeology, and ethnographic study of minority cultures. In reclaiming folk-minority craft as a generative source of decoration, Pang Xunqin and Lei Guiyuan were also critically engaged with delimiting the design profession as a specialized realm of knowledge production.
Metal and Stone: An Analogy between the Story of David and Goliath (1 Sam 17) and the Story of Nebuchadnezzar’s Dream (Dan 2)
Authors: Golan Naama 
Published: November 2019

Abstract
The image that appears to Nebuchadnezzar in a dream, in which a colossal statue made from different metals is struck to the ground by a stone (Dan 2), creates an affinity between this story and that of David and Goliath (1 Sam 17). These two stories convey an identical message through the same symbols. While the stone signifies the divine, the man-made metal symbolizes human might. Though this is a broad analogy, which includes both thematic and linguistic parallels, it has not yet received sufficient scholarly attention. This paper unravels the analogy, shedding new light on Daniel 2, its meaning and its purpose.
Condiciones dignas de la labor docente del siglo XXI, un derecho inalienable, no una opción
Authors: Garbanzo Vargas Guiselle María 
Published: November 2019

Recibido 14 de abril de 2011 • Aceptado 26 de agosto de 2011 • Corregido 29 de agosto de 2011

Se desarrolla el tema de las condiciones dignas de la labor docente en el desafiante siglo XXI. El objetivo recae en realizar una contextualización de la sociedad emergente en el siglo XXI, en general; así como plantear una revisión, en América Latina, del contexto educativo y de las mismas condiciones laborales del profesional de la educación. Otro objetivo es revisar las condiciones laborales en que se encuentran los educadores en distintos sistemas educativos, incluyendo realidades de Europa y América Latina, entre otras. En las principales ideas que se abordan, se define el perfil del educador de siglo XXI en comparación con el educador de la sociedad tradicional y se desarrollan algunos indicadores de consenso en distintas realidades educativas, así como su integración en tres grandes dimensiones: cognitivas, operativas e institucionales. Sobresale, entre las principales conclusiones, la determinación de políticas públicas que respalden las condiciones laborales en las que se desempeñe el docente de manera digna, lo cual se considera fundamental para una educación inclusiva de calidad, en armonía con las exigencias de la desafiante sociedad emergente. Concluye la autora que este tema es inacabado y debe ser una constante en las agendas educativas de las distintas sociedades.
Rasgos del semblante docente y su impacto en el aprendizaje: Una mirada desde la subjetividad del alumno
Authors: Hernández Jacobo Verónica , Varela Nájera Carlos 
Published: November 2019

Recibido 13 de octubre de 2011 • Aceptado 23 de febrero 2012 • Corregido 23 de marzo de 2012

Este trabajo forma parte de una investigación más amplia que analiza aquellos rasgos del semblante docente que promueven o inhiben el deseo de aprendizaje de estudiante. Tiene como referente teórico el psicoanálisis y los datos empíricos de estudiantes del grupo 602, de la Facultad de Psicología de la Universidad Autónoma de Sinaloa (UAS), en México, del ciclo escolar 2009-2010. Se analizan solo las características o rasgos del semblante que promueven el deseo de aprender de los estudiantes. El objetivo es conocer si el deseo de los estudiantes y las estudiantes de Psicología por aprender los contenidos de una asignatura es despertado cuando estos se identifican con el semblante de su docente, desde la premisa de que este posee rasgos o cualidades que permiten al estudiante identificarse con el llamado semblante docente. Se utiliza el enfoque cualitativo y el método fenomenológico. Las técnicas de recolección de datos fueron el cuestionario y la entrevista en profundidad. La principal conclusión fue que un mismo docente no impacta de la misma manera a sus estudiantes.
Educando con medios alternativos
Authors: Rubí Barquero José Alberto 
Published: November 2019

Recibido 10 de noviembre de 2010 • Aceptado 09 de marzo de 2011 • Corregido 04 de mayo de 2011 Este artículo nace de mi interés por explorar caminos que hagan de la experiencia educativa que se vive diariamente en las aulas, una actividad más interesante y placentera; es por ello que exalto las posibilidades que como medio pedagógico tienen el cine y, en general, los medios audiovisuales, junto con la conveniencia de que los educadores recurran a ellos como alternativas enriquecedora de su desempeño profesional.
Diagnóstico sobre las actitudes hacia las Matemáticas del estudiantado que inicia sus estudios en tres posgrados en Administración de Empresas
Authors: Cardoso Espinosa Edgar Oliver , Vanegas López Eduardo Antonio , Cerecedo Mercado María Trinidad 
Published: November 2019

Recibido 05 de enero de 2012 • Corregido 19 de junio de 2012 • Aceptado 28 de junio de 2012

El objetivo de esta investigación fue diagnosticar las actitudes del estudiantado hacia la asignatura de Matemáticas, al comenzar sus estudios de posgrado en Administración de Empresas. El estudio fue exploratorio y no experimental, con un diseño transversal. Como instrumento para recopilar la información se utilizó un cuestionario organizado con las dimensiones de agrado, confianza, utilidad, motivación y ansiedad, el cual se diseñó con preguntas de tipo Likert. Las principales conclusiones de la investigación fueron que el estudiantado de posgrado presenta una actitud negativa hacia las Matemáticas, la cual percibe como una disciplina útil: pero difícil, por lo que manifiesta todavía desconfianza y ansiedad en las situaciones que involucran el empleo de los procedimientos matemáticos.
Integrating lattice materials science into the traditional processing-structure-properties paradigm
Authors: Zok Frank W. 
Published: November 2019

AbstractPeriodic lattice materials have been studied extensively in numerous science and engineering fields. Despite the vast knowledge that has emerged, the activities have been stove-piped within individual research communities, often in isolation from those in related fields. To bring this work into a holistic framework, the present article considers the elements needed to integrate the study of lattice materials into the processing–structure–properties paradigm that underpins materials science as an academic discipline. The emphasis is on concepts of structure involving topology, morphology, and defects of lattice materials, with illustrations of structure–property relations in the context of lattice strength.
The theatrical subject: Between aesthetic experience and academic reflection/El Sujeto teatral: entre la experiencia estética y la reflexión académica
Authors: Correa Páez Jesús Antonio 
Published: November 2019

En esta investigación se acoge la teoría sobre la enunciación en sentido extenso, es decir en que está implicado no sólo lo lingüístico, sino también lo semiótico, y bajo esta consideración se configuran planteamientos que permiten considerar la transfiguración del yo en la construcción del sujeto teatral, en ese sentido se focaliza la metáfora como herramienta que impele la semiotización en el orden simbólico. Para soportar teóricamente esta pretensión se recurre a los planteamientos de Husserl, Merleau-Ponty y Ricoeur; y además se toman consideraciones de Hernández Carmona en torno al tema. Se sustenta la presente teorización bajo los planteamientos de la semiótica de la subjetividad-afectividad u ontosemiótica, en el intento de explicar el sujeto teatral a manera de instancia sensible-reflexiva que surge de la confluencia de determinantes y disímiles factores.