bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sustainable workforce: South African Audiologists and Speech Therapists
Authors: Pillay Mershen , Tiwari Ritika , Kathard Harsha , Chikte Usuf 
Published: July 2020

Abstract
Background
Audiologists and Speech Therapists play a vital role in addressing sustainable development goals by supporting people who are marginalised due to communication challenges. The global burden of disease and poor social living conditions impact negatively on the development of healthy communication, therefore requiring the services of Audiologist and Speech therapists. Against this background, we examined the demographic profile and the supply, need and shortfall of Audiologists and Speech Therapists in South Africa.

Methods
The data set was drawn from the Health Professions Council of South Africa (HPCSA) registers (for 2002–2017) for the speech, language and hearing professions. This demographic profile of the professions was created based on the category of health personnel; category of practice, geographical location, population group (race) and sex. The annual supply was estimated from the HPCSA database while the service–target approach was used to estimate need. Additional need based on National Health Insurance Bill was also included. Supply–need gaps were forecast according to three scenarios, which varied according to the future intensity of policy intervention to increase occupancy of training places: ‘best guess’ (no intervention), ‘optimistic’ (feasible intervention), and ‘aspirational’ (significant intervention) scenarios up to 2030.

Results
Most (i.e. 1548, 47.4%) of the professionals are registered as Audiologists and Speech Therapists, followed by 33.5% registered as Speech Therapists and 19.1% registered as Audiologists. Around 88.5% professionals registered as Audiologists and Speech Therapists are practising independently, and 42.6% are practising in the Gauteng province. The profession is comprised majorly of women (94.6%), and in terms of the population groups (race), they are mainly classified as white (59.7%). In 2017, in best guess scenario, there is a supply–need gap of around 2800 professionals. In the absence of any intervention to increase supply capacity, this shortfall will remain same by the year 2030. By contrast, in aspirational scenario, i.e. supply is increased by 300%, the forecasted shortfall for 2030 reduces to 2300 from 2800 professionals.

Conclusions
It is clear that without significant interventions, South Africa is likely to have a critical shortfall of Audiologists and Speech Therapists in 2030. Policy-makers will have to carefully examine issues surrounding the current framework regulating training of these and associated professionals, in order to respond adequately to future requirements.
Is bed turnover rate a good metric for hospital scale efficiency? A measure of resource utilization rate for hospitals in Southeast Nigeria
Authors: Aloh Henry E. , Onwujekwe Obinna E. , Aloh Obianuju G. , Nweke Chijioke J. 
Published: July 2020

Abstract
Background
Nigeria health sector, like that of other sub-Saharan African countries, increasingly faces critical resource constraints. Thus, there is need to seek for ways of improving efficient use of scarce health resources. The aim of this study was to determine resource utilization rate of teaching hospitals in Southeast Nigeria as a means of estimating their efficiency.

Methods
The study is a longitudinal cross sectional study. It applied ratio indicators and Pabon Lasso model using data on the number of hospital bed, number of inpatients and total inpatient-days from purposefully selected teaching hospitals in Southeast Nigeria to measure efficiency over a period of 6 years (2011–2011).

Results
The hospitals’ mean bed occupancy rate was as low as 42.14%, far below standard benchmark of 80–85%. The mean average length of stay was as high as 8.15 days and observed mean bed turnover was 21.27 patients/bed/year. These findings portrayed high level of inefficiency in Nigeria teaching hospitals, which was further illustrated by Pabon Lasso graph, with only 10–20% of the hospital-years located within or near the efficient zone or quadrant.

Conclusion
The study was able to show that health ratio indicators such as hospital bed turnover rate (BTR) and bed occupancy rate (BOR), as well as patients’ average length of stay (ALS) can be used as tools for assessing hospital performance or its efficiency in resource utilization. Thus, in low and middle income countries where medical record keeping may be inadequate or poor, ratio indicators used alone or with Pabon Lasso graph/chart could be an optional metrics for hospital efficiency.
Comparable prevalence of distant metastasis and survival of different primary site for LN + pancreatic tumor
Authors: Lou Xin , Li Jun , Wei Ya-Qing , Jiang Zhi-Jia , Chen Ming , Sun Jin-Jin 
Published: July 2020

Abstract
Background
Few studies have delved into the prevalence of distant metastasis (DM +) and survival for patients with lymph node metastases (LN +) by primary site. We aimed to detect differences in distant metastasis and prognosis between pancreatic head and bodytail tumors for LN + patients.

Methods
Patients with chemotherapy, histologically diagnosed, primary site between 2004 and 2016 were included from the SEER (Surveillance, Epidemiology, and End Results) database. Pancreatic head tumors were compared with pancreatic bodytail tumors using the odds ratio (OR) for rates of distant metastasis, hazard ratios (HR) for overall survival (OS) and cancer-specific survival (CSS). The competing risk model and propensity score matching (PSM) were performed to further explore.

Results
Of 5726 LN + patients identified from the SEER database, pancreatic head tumors account for 85.2% (4877 of 5726) and 14.8% (849 of 5726) were pancreatic bodytail tumors. The incidence of DM was lower in pancreatic head than in pancreatic bodytail tumors (OR, 0.29; 95% CI 0.23–0.37; P < 0.001). The multivariate Cox regression show pancreatic head tumors have a significantly shorter survival rate relative to pancreatic bodytail (HR, 1.12; 95% CI 1.03–1.22; P = 0.008), but the primary site was not a significant independent risk factor for prognosis by log-rank test (P = 0.39) and multivariate competing risk model [subdistribution HR (SHR), 1.08; 95% CI 0.98–1.19; P = 0.087].We then examined our conclusion by 1:1 propensity score matching, and the result reflected pancreatic head tumors have a lower risk of DM compared with pancreatic bodytail tumors (OR, 0.22; 95% CI 0.15–0.34; P < 0.001), but the primary site of pancreatic tumors was not associated with LN + patient survival based on univariate Cox regression (HR, 1.04; 95% CI 0.93–1.17; P = 0.435) and competing risk analysis (SHR, 1.01; 95% CI 0.89–1.12; P = 0.947).

Conclusions
LN + pancreatic head tumors were significantly lower risk of DM relative to pancreatic bodytail tumors. Survival outcome in LN + pancreatic tumors didn’t exist significant differences split by primary site, which indicates that the prognosis of LN + patients with chemotherapy isn’t associated with the primary site of metastasis, but with the occurrence of metastasis.
A1 astrocytes contribute to murine depression-like behavior and cognitive dysfunction, which can be alleviated by IL-10 or fluorocitrate treatment
Authors: Zhang He-Yang , Wang Yan , He Youdi , Wang Ting , Huang Xiao-Hui , Zhao Chang-Ming , Zhang Lei , Li Si-Wei , Wang Changyong , Qu Yan-Nv , Jiang Xiao-Xia 
Published: July 2020

AbstractBackgroundAstrocytes are crucial regulators in the central nervous system. Abnormal activation of astrocytes contributes to some behavior deficits. However, mechanisms underlying the effects remain unclear. Here, we studied the activation of A1 astrocytes and their contribution to murine behavior deficits.MethodsA1 astrocytes were induced by treatment with lipopolysaccharide (LPS) in vitro. The functional phenotype of astrocytes was determined by quantitative RT-PCR, ELISA, and immunohistochemistry. To assess the role of A1 astrocytes in vivo, mice were injected intraperitoneally with LPS. Then, murine behaviors were tested, and the hippocampus and cortex were analyzed by quantitative RT-PCR, ELISA, and immunohistochemistry. The function of IL-10 and fluorocitrate on A1 astrocyte activation was also examined.ResultsOur results show that astrocytes isolated from B6.129S6-Il10tm1Flv/J homozygotes (IL-10tm1/tm1) were prone to characteristics of A1 reactive astrocytes. Compared with their wild-type counterparts, IL-10tm1/tm1astrocytes exhibited higher expression of glial fibrillary acidic protein (GFAP). Whether or not they were stimulated with LPS, IL-10tm1/tm1astrocytes exhibited enhanced expression of A1-specific transcripts and proinflammatory factors IL-1β, IL-6, and TNFα. In addition, IL-10tm1/tm1astrocytes demonstrated hyperphosphorylation of STAT3. Moreover, astrocytes from IL-10tm1/tm1mice showed attenuated phagocytic ability and were neurotoxic. IL-10tm1/tm1mice demonstrated increased immobility time in the forced swim test and defective learning and memory behavior in the Morris water maze test. Moreover, enhanced neuroinflammation was found in the hippocampus and cortex of IL-10tm1/tm1mice, accompanying with more GFAP-positive astrocytes and severe neuron loss in the hippocampus. Pretreatment IL-10tm1/tm1mice with IL-10 or fluorocitrate decreased the expression of proinflammatory factors and A1-specific transcripts in the hippocampus and cortex, and then alleviated LPS-induced depressive-like behavior.ConclusionThese results demonstrate that astrocytes isolated from B6.129S6-Il10tm1Flv/J homozygotes are prone to A1 phenotype and contribute to the depression-like behavior and memory deficits. Inhibiting A1 astrocyte activation may be an attractive therapeutic strategy in some neurodegenerative diseases.
Mitomycin, 5-fluorouracil, leflunomide, and mycophenolic acid directly promote hepatitis B virus replication and expression in vitro
Authors: Ruan Jie , Sun Shuo , Cheng Xin , Han Pengyu , Zhang Yinge , Sun Dianxing 
Published: July 2020

Abstract
Background
Reactivation of hepatitis B virus is a common complication that occurs in patients with hepatitis B virus (HBV) infection who have received cytotoxic chemotherapy or immunosuppressive therapy. This clinical phenomenon not only occurs in overt HBV infection patients but also occurs in patients with resolved HBV infection. Previous research has confirmed that epirubicin and dexamethasone can stimulate HBV replication and expression directly rather than indirectly through immunosuppression. Mitomycin and 5-fluorouracil are currently used as cytotoxic chemotherapy drugs for cancer patients. Leflunomide and mycophenolic acid are regarded as immunosuppressants for autoimmune diseases, and numerous clinical studies have reported that these drugs can reactivate HBV replication. In this study, we aimed to investigate whether mitomycin, 5-fluorouracil, leflunomide and mycophenolic acid induce HBV reactivation directly rather than indirectly through immunosuppression.

Methods
To observe the effect of mitomycin, 5-fluorouracil, leflunomide and mycophenolic acid on HBV replication and expression, we employed HepG2.2.15 and HBV-NLuc-35 cells as a cell model. Next, by native agarose gel electrophoresis (NAGE), quantitative PCR (qPCR), luciferase assay and HBV e antigen (HBeAg) enzyme-linked immunosorbent assay (ELISA) we detected changes in HBV replication and expression induced by these drugs. We also investigated whether lamivudine could inhibit the observed phenotype. SPSS 18.0 software was employed for statistical analysis, One-way ANOVA was used to compare multiple groups.

Results
Expression of HBV capsids and HBeAg in HepG2.2.15 cells was increased by increasing concentration of mitomycin, 5-fluorouracil, leflunomide, and mycophenolic acid. This phenomenon was also demonstrated in HBV-NLuc-35 cells, and the expression of capsids and luciferase activity increased in the same concentration-dependent manner. Replication levels of intracellular capsid DNA and extracellular HBV DNA in HepG2.2.15 cells gradually increased in a dose-dependent manner. In addition, although epirubicin, mitomycin, 5-fluorouracil, dexamethasone, leflunomide and mycophenolic acid enhanced HBV replication, lamivudine inhibited this process.

Conclusion
Our study confirmed that mitomycin, 5-fluorouracil, leflunomide and mycophenolic acid directly upregulated HBV replication and expression in vitro. This effect was investigated not only in HepG2.2.15 cells but also in the HBV-NLuc-35 replication system. Moreover, this effect could be prevented by nucleoside analogs, such as lamivudine (LAM). Thus, for patients with HBV infection, prophylactic antiviral therapy is necessary before receiving cytotoxic chemotherapy or immunosuppressive therapy.
Genomic prediction of yield and root development in wheat under changing water availability
Authors: Guo Xiangyu , Svane Simon F. , Füchtbauer Winnie S. , Andersen Jeppe R. , Jensen Just , Thorup-Kristensen Kristian 
Published: July 2020

Abstract
Background
Deeper roots help plants take up available resources in deep soil ensuring better growth and higher yields under conditions of drought. A large-scale semi-field root phenotyping facility was developed to allow a water availability gradient and detect potential interaction of genotype by water availability gradient. Genotyped winter wheat lines were grown as rows in four beds of this facility, where indirect genetic effects from neighbors could be important to trait variation. The objective was to explore the possibility of genomic prediction for grain-related traits and deep root traits collected via images taken in a minirhizotron tube under each row of winter wheat measured.

Results
The analysis comprised four grain-related traits: grain yield, thousand-kernel weight, protein concentration, and total nitrogen content measured on each half row that were harvested separately. Two root traits, total root length between 1.2 and 2 m depth and root length in four intervals on each tube were also analyzed. Two sets of models with or without the effects of neighbors from both sides of each row were applied. No interaction between genotypes and changing water availability were detected for any trait. Estimated genomic heritabilities ranged from 0.263 to 0.680 for grain-related traits and from 0.030 to 0.055 for root traits. The coefficients of genetic variation were similar for grain-related and root traits. The prediction accuracy of breeding values ranged from 0.440 to 0.598 for grain-related traits and from 0.264 to 0.334 for root traits. Including neighbor effects in the model generally increased the estimated genomic heritabilities and accuracy of predicted breeding values for grain yield and nitrogen content.

Conclusions
Similar relative amounts of additive genetic variance were found for both yield traits and root traits but no interaction between genotypes and water availability were detected. It is possible to obtain accurate genomic prediction of breeding values for grain-related traits and reasonably accurate predicted breeding values for deep root traits using records from the semi-field facility. Including neighbor effects increased the estimated additive genetic variance of grain-related traits and accuracy of predicting breeding values. High prediction accuracy can be obtained although heritability is low.
Laparoscopic transhiatal suture and gastric valve as a safe and feasible treatment for Boerhaave’s syndrome: an Italian single center case series study
Authors: Veltri A. , Weindelmayer J. , Alberti L. , De Pasqual C. A. , Bencivenga M. , Giacopuzzi S. 
Published: July 2020

Abstract
Background
Boerhaave’s syndrome (BS) is a rare life-threating condition with poor prognosis. Unfortunately, due to its very low incidence, no clear evidences or definitive guidelines are currently available: in detail, surgical strategy is still a matter of debate. Most of the case series reports thoracic approach as the most widely used; conversely, transhiatal abdominal management is just described in sporadic case reports. In our center, the laparoscopic approach has been adopted for years: in the present study, we aim to show his feasibility by reporting the outcomes of the largest clinical series available to date.

Methods
Clinical records of patients admitted for BS to the General and Upper GI Surgery Division of Verona from February 2014 to December 2019 were retrospectively collected. Clinico-pathological characteristics, preoperative workup, surgical management, and outcomes were analyzed.

Results
Seven patients were admitted; epigastric/thoracic pain and vomiting were the most frequent symptoms at diagnosis. Laboratory findings were not specific; conversely, radiological imaging always revealed abnormal findings: particularly, CT had excellent sensitivity in detecting signs of esophageal perforation. All but one case had diagnostic workup and received surgery within 24 h. Every patient had laparoscopic transhiatal direct suture and gastric valve; 2 patients (28.6%) also needed a thoracoscopic toilette. Postoperative complications occurred in 4 patients (57%), but in only two of them (29%), the complication was severe according to Clavien-Dindo classification (both received thoracentesis or thoracic drainage for pleural effusion). Of note, no cases of postoperative esophageal leak were recorded. Postoperative mortality was 14% due to one patient who died for cardiovascular complications. Most of the patients (71.4%) were admitted to ICU after surgery (average length, 8.8 days); mean hospital stay was 14.7 days. No patients had readmissions.

Conclusions
To our knowledge, this is the largest case series reporting laparoscopic management of BS. We show that laparoscopy is a safe and feasible approach associated with a shorter length of hospital stay when compared with clinical series in which thoracic approach had been chosen. Of note, laparoscopic management would be easily adopted by surgical centers treating benign gastro-esophageal junction entailing a proper management more widely.
The impact of age on outcomes of coronary artery bypass grafting
Authors: Lemaire Anthony , Soto Cassandra , Salgueiro Lauren , Ikegami Hirohisa , Russo Mark J. , Lee Leonard Y. 
Published: July 2020

Abstract
Objective
As the population ages, increasing number of older patients are undergoing adult cardiac surgery. The purpose of the study is to assess the impact of age on postoperative outcomes in patients that undergo coronary artery bypass grafting (CABG).

Methods
Patients that are ≥70 years old who underwent CABG were selected from the Nationwide/National Inpatient Sample from 2010 to 2015 using ICD-9-CM diagnosis and procedure codes. The patients who were 70–79 years old were compared to patients aged 80–89 years old to determine if the age difference of the patients had an impact on surgical outcomes. In addition, a secondary endpoint is to compare surgical outcomes between the 2 genders of the patients 80–89 years old. The rates of postoperative complications, and mortality were compared.

Results
A total of 67,568 patients were identified who were ≥ 70 years old and underwent CABG. Compared to the Septuagenarians, the Octogenarians were more likely to develop cardiac complications (OR [odds ratio] =1.20, 95% CI [confidence interval] 1.12–1.23. They were also more likely to develop renal complications (P < 0001), and respiratory complications (P < 0001). The Octogenarians were also more likely to bleed postoperatively (P < 0.0001) and have a higher mortality (P < 0001). Furthermore, the female Octogenarians had a higher mortality (OR 1.25 95% CI 1.07–1.46) compared to males in the same age group.

Conclusions
The patients who were ≥ 80–89 years old had worse postoperative outcomes. The Octogenarians who were females had a higher mortality compared to their male counterparts.
Time-resolved multi-omics analysis reveals the role of nutrient stress-induced resource reallocation for TAG accumulation in oleaginous fungus Mortierella alpina
Authors: Lu Hengqian , Chen Haiqin , Tang Xin , Yang Qin , Zhang Hao , Chen Yong Q. , Chen Wei 
Published: July 2020

Abstract
Background
Global resource reallocation is an established critical strategy through which organisms deal with environmental stress. The regulation of intracellular lipid storage or utilization is one of the most important strategies for maintaining energy homeostasis and optimizing growth. Oleaginous microorganisms respond to nitrogen deprivation by inducing lipid hyper accumulation; however, the associations between resource allocation and lipid accumulation are poorly understood.

Results
Here, the time-resolved metabolomics, lipidomics, and proteomics data were generated in response to nutrient availability to examine how metabolic alternations induced by nitrogen deprivation drive the triacylglycerols (TAG) accumulation in M. alpina. The subsequent accumulation of TAG under nitrogen deprivation was a consequence of the reallocation of carbon, nitrogen sources, and lipids, rather than an up-regulation of TAG biosynthesis genes. On one hand, nitrogen deprivation induced the down-regulation of isocitrate dehydrogenase level in TCA cycle and redirected glycolytic flux of carbon from amino acid biosynthesis into fatty acids’ synthesis; on the other hand, nitrogen deprivation induced the up-regulation of cell autophagy and ubiquitin-mediated protein proteolysis which resulted in a recycling of preformed protein nitrogen and carbon. Combining with the up-regulation of glutamate decarboxylase and succinic semialdehyde dehydrogenase in GABA shunt, and the phosphoenolpyruvate carboxykinase in the central hub involving pyruvate/phosphoenolpyruvate/oxaloacetate, the products from nitrogen-containing compounds degradation were recycled to be intermediates of TCA cycle and be shunted toward de novo biosynthesis of fatty acids. We found that nitrogen deprivation increased the protein level of phospholipase C/D that contributes to degradation of phosphatidylcholine and phosphatidylethanolamine, and supplied acyl chains for TAG biosynthesis pathway. In addition, ATP from substrate phosphorylation was presumed to be a critical factor regulation of the global resource allocation and fatty acids’ synthesis rate.

Conclusions
The present findings offer a panoramic view of resource allocation by M. alpina in response to nutrient stress and revealed a set of intriguing associations between resource reallocation and TAG accumulation. This system-level insight provides a rich resource with which to explore in-depth functional characterization and gain information about the strategic combination of strain development and process integration to achieve optimal lipid productivity under nutrient stress.