bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fluid-limiting treatment strategies among sepsis patients in the ICU: a retrospective causal analysis
Authors: Shahn Zach , Shapiro Nathan I. , Tyler Patrick D. , Talmor Daniel , Lehman Li-wei H. 
Published: February 2020

Abstract
Objective
In septic patients, multiple retrospective studies show an association between large volumes of fluids administered in the first 24 h and mortality, suggesting a benefit to fluid restrictive strategies. However, these studies do not directly estimate the causal effects of fluid-restrictive strategies, nor do their analyses properly adjust for time-varying confounding by indication. In this study, we used causal inference techniques to estimate mortality outcomes that would result from imposing a range of arbitrary limits (“caps”) on fluid volume administration during the first 24 h of intensive care unit (ICU) care.

Design
Retrospective cohort study

Setting
ICUs at the Beth Israel Deaconess Medical Center, 2008–2012

Patients
One thousand six hundred thirty-nine septic patients (defined by Sepsis-3 criteria) 18 years and older, admitted to the ICU from the emergency department (ED), who received less than 4 L fluids administered prior to ICU admission

Measurements and main results
Data were obtained from the Medical Information Mart for Intensive Care III (MIMIC-III). We employed a dynamic Marginal Structural Model fit by inverse probability of treatment weighting to obtain confounding adjusted estimates of mortality rates that would have been observed had fluid resuscitation volume caps between 4 L–12 L been imposed on the population. The 30-day mortality in our cohort was 17%. We estimated that caps between 6 and 10 L on 24 h fluid volume would have reduced 30-day mortality by − 0.6 to − 1.0%, with the greatest reduction at 8 L (− 1.0% mortality, 95% CI [− 1.6%, − 0.3%]).

Conclusions
We found that 30-day mortality would have likely decreased relative to observed mortality under current practice if these patients had been subject to “caps” on the total volume of fluid administered between 6 and 10 L, with the greatest reduction in mortality rate at 8 L.
What influenced people with chronic or refractory breathlessness and advanced disease to take part and remain in a drug trial? A qualitative study
Authors: Lovell N. , Etkind S. N. , Bajwah S. , Maddocks M. , Higginson I. J. 
Published: February 2020

Abstract
Background
Recruitment and retention in clinical trials remains an important challenge, particularly in the context of advanced disease. It is important to understand what affects retention to improve trial quality, minimise attrition and reduce missing data. We conducted a qualitative study embedded within a randomised feasibility trial and explored what influenced people to take part and remain in the trial.

Methods
We conducted a qualitative study embedded within a double-blind randomised trial (BETTER-B[Feasibility]: BETter TreatmEnts for Refractory Breathlessness) designed using a person-centred approach. Participants with cancer, chronic obstructive pulmonary disease (COPD), interstitial lung disease (ILD), or chronic heart failure (CHF), with a modified Medical Research Council dyspnoea scale grade of 3/4 were recruited from three UK sites. A convenience subsample completed qualitative interviews after the trial. Interviews were analysed using thematic analysis. Results were considered in relation to the core elements of person-centred care and our model of the person-centred trial.

Results
In the feasibility trial 409 people were screened for eligibility, and 64 were randomised. No participant was lost to follow-up. Twenty-two participants took part in a qualitative interview. Eleven had a diagnosis of COPD, 8 ILD, 2 CHF and 1 lung cancer. The participants’ median age was 71 years (range 56–84). Sixteen were male. Twenty had completed the trial, and two withdrew due to adverse effects. The relationship between patient and professional, potential for benefit, trial processes and the intervention all influenced the decision to participate in the trial. The relationship with the research team and continuity, perceived benefit, and aspects relating to trial processes and the intervention influenced the decision to remain in the trial.

Conclusions
In this feasibility trial recruitment targets were met, attrition levels were low, and aspects of the person-centred approach were viewed positively by trial participants. Prioritisation of the relationship between the patient and professional; person-centred processes, including home visits, assistance with questionnaires, and involvement of the carer; and enabling people to participate by having processes in line with individual capabilities appear to support recruitment and retention in clinical trials in advanced disease. We recommend the integration of a person-centred approach in all clinical trials.

Trial registration
ISRCTN Registry, ISRCTN32236160. Registered on 13 June 2016.
Comparison of the efficacy and safety of tacrolimus monotherapy and cyclophosphamide combined with glucocorticoid in the treatment of adult primary membranous nephropathy: protocol of a multicenter, randomized, controlled, open study
Authors: Chen Shasha , Ren Song , Wang Amanda Y. , Tran Hieu , Li Zheng , Cheng Xiaoyun , Liu Manli , Li Guisen , Wang Li , Hong Daqing 
Published: February 2020

AbstractBackgroundIdiopathic membranous nephropathy (IMN) remains the leading cause of adult nephrotic syndrome. Immunosuppressive therapy with cyclophosphamide (CTX) is often successful in reducing proteinuria, but its use is associated with severe side effects. Tacrolimus (TAC) is effective in achieving complete remission (CR) in patients with IMN. However, whether it is as effective as CTX in inducing and maintaining complete or partial remission in these patients is unknown. This trial aims to test TAC monotherapy for its non-inferiority to CTX in inducing long-term remission of proteinuria.MethodsPatients with biopsy-proven IMN with nephrotic syndrome will be randomized into a 12-month treatment period with oral TAC of 0.05–0.1 mg/kg/day for 6 months or with CTX + glucocorticoid. The efficacy of the treatment will be assessed by the remission status (based on changes in proteinuria) and relapse rate.DiscussionThis study will test whether treatment with TAC monotherapy is superior to CTX with glucocorticoid in inducing long-term remission of proteinuria in patients with adult IMN. The role of serum anti-PLA2R antibodies in the early assessment of the response to therapy using different therapeutic regimens will also be clarified.Trial registrationClinicalTrials.gov ChiCTR1800016140. Registered 12 June 2017.http://www.chictr.org.cn.
Hypoxia is regulating enzymatic wood decomposition and intracellular carbohydrate metabolism in filamentous white rot fungus
Authors: Mattila Hans Kristian , Mäkinen Mari , Lundell Taina 
Published: February 2020

Abstract
Background
Fungal decomposition of wood is considered as a strictly aerobic process. However, recent findings on wood-decaying fungi to produce ethanol from various lignocelluloses under oxygen-depleted conditions lead us to question this. We designed gene expression study of the white rot fungus Phlebia radiata (isolate FBCC0043) by adopting comparative transcriptomics and functional genomics on solid lignocellulose substrates under varying cultivation atmospheric conditions.

Results
Switch to fermentative conditions was a major regulator for intracellular metabolism and extracellular enzymatic degradation of wood polysaccharides. Changes in the expression profiles of CAZy (carbohydrate-active enzyme) encoding genes upon oxygen depletion, lead into an alternative wood decomposition strategy. Surprisingly, we noticed higher cellulolytic activity under fermentative conditions in comparison to aerobic cultivation. In addition, our results manifest how oxygen depletion affects over 200 genes of fungal primary metabolism including several transcription factors. We present new functions for acetate generating phosphoketolase pathway and its potential regulator, Adr1 transcription factor, in carbon catabolism under oxygen depletion.

Conclusions
Physiologically resilient wood-decomposing Basidiomycota species P. radiata is capable of thriving under respirative and fermentative conditions utilizing only untreated lignocellulose as carbon source. Hypoxia-response mechanism in the fungus is, however, divergent from the regulation described for Ascomycota fermenting yeasts or animal-pathogenic species of Basidiomycota.
Perception of prescribing factors and purchase statistics of non-steroidal anti-inflammatory drugs in an orthopedic clinic
Authors: Schjøtt Jan , Erdal Hilde , Opskar Sofie , Bjånes Tormod K. 
Published: February 2020

Abstract
Objectives
Nonsteroidal anti-inflammatory drugs (NSAIDS) are associated with concern of adverse drug reactions (ADRS) including gastrointestinal, cardiovascular, renal, and musculoskeletal. Non-selective and selective NSAIDS are proposed to differ with regard to their potential to cause ADRS. The aim of this pilot study was to compare perception of prescribing factors and purchase statistics of NSAIDS among physicians in a Norwegian orthopedic clinic.

Results
Forty-five (55%) of 82 invited physicians from the orthopedic clinic participated anonymous in a survey in February 2017. Effect and ADRS were rated as the most important factors for prescribing of NSAIDS. The participants were equally concerned about specific ADRS for prescription of non-selective and selective NSAIDS irrespective of type of ADR. They were generally more concerned about cardiovascular, gastrointestinal and renal ADRS than musculoskeletal. Purchase statistics from 2015 and 2016 showed that celecoxib, a selective NSAID, dominated in the orthopedic clinic. The discrepancy between perception of prescribing factors and purchase statistics of NSAIDS was possibly explained by a high degree of conformity to clinic guidelines. Our preliminary results indicate that perception of prescribing factors of NSAIDS among orthopedics should be surveyed in multicenter or multinational studies.
Porcine sialoadhesin suppresses type I interferon production to support porcine reproductive and respiratory syndrome virus infection
Authors: Liu Yingqi , Li Rui , Qiao Songlin , Chen Xin-xin , Deng Ruiguang , Zhang Gaiping 
Published: February 2020

AbstractPorcine reproductive and respiratory syndrome virus (PRRSV) is a significant threat to the global swine industry. Porcine sialoadhesin (poSn) has been previously shown to mediate PRRSV attachment and internalization. In the current study, we report its unidentified role in antagonism of type I interferon (IFN) production during PRRSV infection. We determined that poSn facilitated PRRSV infection via inhibition of type I IFN transcription. Mechanistically, poSn interacted with a 12 kDa DNAX-activation protein (DAP12), which was dependent on residues 51–57 within DAP12 transmembrane domain (TMD). PRRSV exploited the poSn-DAP12 pathway to attenuate activation of nuclear factor-kappa B (NF-κB). More importantly, the poSn-DAP12 pathway was involved in inhibiting poly (I:C)-triggered IFN production. All these results reveal a novel role of poSn in suppressing host antiviral responses, which deepens our understanding of PRRSV pathogenesis.
Architecture and experimental evaluation of context-aware adaptation in vehicular networks
Authors: Liu Hui , He Jialin , Wensowitch John , Rajan Dinesh , Camp Joseph 
Published: February 2020

AbstractIn vehicular networks, the propagation environment changes rapidly for mobile nodes. To achieve high throughput, wireless devices need to be highly adaptive to these environmental changes by altering their transmission parameters across different layers of the network stack. Sensors in mobile and vehicular nodes can be used to form an understanding of the surrounding context. Such contextual awareness is particularly important in vehicular networks as the frequent context switching and increased channel fluctuations can cause existing adaptation protocols to fail to converge to the optimal transmission parameters. In this paper, we leverage information about the environmental context to enable improved rate adaptation performance in vehicular networks. In particular, we propose a classification-based link-level adaptation framework, which can effectively learn the relationship between context information (such as velocity, SNR, and channel type) and the throughput of various transmission modes. We then quantify the throughput improvement using the proposed scheme and show that our proposed framework can significantly enhance the performance of rate adaptation. With experiments on emulated and in-field channels, we observe that the throughput increases by up to 245% over protocols which use SNR alone to make rate decisions. Based on an analysis of attribute importance, we identify channel type as a key parameter that affects classification performance. Since channel type often cannot be directly obtained, we propose a multi-dimensional channel inference method for use when knowledge about the channel type is not available. We demonstrate that the proposed channel inference achieves an accuracy of up to 94% in previously encountered channels and can quickly signal that a channel has not yet been encountered. The robustness of the proposed methods are demonstrated using experimental data from two different hardware platforms and three different carrier frequency bands. Lastly, we evaluate the most predominant Linux-based rate selection algorithm (Minstrel), study the relative rate selection accuracy of our approach, and analyze the key role that the retry mechanism in Minstrel plays on its performance.
Resistance Properties to Chloride Ingress of Standard-Cured Concrete Made with an Admixture Incorporating Rich SiO2 and Al2O3
Authors: Yamato Koichiro , Sasaki Akira , Ito Takayasu , Yoshitake Isamu 
Published: February 2020

AbstractIn regions where the concrete structures are exposed to a salty environment, the concrete requires high resistance to chloride-ion penetration. To achieve higher resistance against chloride ingress, a pozzolanic admixture incorporating a high volume of SiO2 and Al2O3 has been developed. The admixture is a fine mineral powder with a specific surface area of 13,000 m2/kg or higher. It is typically mixed with the concrete at a cement replacement level of 5–13 mass% (20–40 kg/m3). To demonstrate the applicability of the admixture to general ready-mix concretes, this study examined the fundamental properties of concrete cured under standard conditions regarding resistance against chloride ingress. Chloride immersion tests revealed high resistance against penetration of concrete produced with the admixture. Pore-size distribution analysis confirmed that the volume of pores less than 0.01 μm diameter increased whereas a decrease of large pores occurred (0.1 μm diameter or larger). The major contributor to the high resistance was found to be the immobilization of penetrating chloride ions by the formation of Friedel’s salt.
Are antibiotics substandard in Lebanon? Quantification of active pharmaceutical ingredients between brand and generics of selected antibiotics
Authors: Hobeika Eva , Farhat Joanna , Saab Joseph , Hleihel Walid , Azzi-Achkouty Samar , Sili Georges , Hallit Souheil , Salameh Pascale 
Published: February 2020

Abstract
Background
In developing countries, brand-generic substitution is not based on validated scientific evidence that confirm the therapeutic equivalence of the generic to the originator. Rather, decisions are made based on the availability of generic medications. Substitution by inappropriate preparations applies to antibiotics, which may increase the risk of resistance in case of underdosing. This analytical study aims to dose and assess for the accuracy of labeling three oral antibiotic preparations, namely ciprofloxacin hydrochloride, amoxicillin trihydrate and amoxicillin trihydrate-clavulanate potassium, the active pharmaceutical ingredients (APIs) found in brand and generic tablets available on the Lebanese market.

Methods
One brand and 4 generics of ciprofloxacin tablets, 3 generic amoxicillin tablets, and 1 brand and 4 generics of amoxicillin-clavulanic acid medications, were quantified, taking 2 batches of each. According to the United States Pharmacopeia (USP) guidelines, ultra-high pressure liquid chromatography was used to measure the APIs content within tablets. The USP required assay limit of the API was taken as the main comparison criteria.

Results
Out of the 5 ciprofloxacin medications tested, all 5 were out of the 2% required range, thus being substandard. For amoxicillin, all 3 medications were within the 20% range. As for amoxicillin-clavulanic acid medications, 4 out of 5 medications met the 30% required range of clavulanic acid and one exceeded the claimed amount of clavulanic acid, while all 5 met the assay limit for amoxicillin.

Conclusion
These findings raise safety and efficacy concerns, providing solid grounds for potential correlations of antibiotic resistance/substandard antibiotics.
A CT-based radiomics nomogram for differentiation of focal nodular hyperplasia from hepatocellular carcinoma in the non-cirrhotic liver
Authors: Nie Pei , Yang Guangjie , Guo Jian , Chen Jingjing , Li Xiaoli , Ji Qinglian , Wu Jie , Cui Jingjing , Xu Wenjian 
Published: February 2020

Abstract
Background
The purpose of this study was to develop and validate a radiomics nomogram for preoperative differentiating focal nodular hyperplasia (FNH) from hepatocellular carcinoma (HCC) in the non-cirrhotic liver.

Methods
A total of 156 patients with FNH (n = 55) and HCC (n = 101) were divided into a training set (n = 119) and a validation set (n = 37). Radiomics features were extracted from triphasic contrast CT images. A radiomics signature was constructed with the least absolute shrinkage and selection operator algorithm, and a radiomics score (Rad-score) was calculated. Clinical data and CT findings were assessed to build a clinical factors model. Combined with the Rad-score and independent clinical factors, a radiomics nomogram was constructed by multivariate logistic regression analysis. Nomogram performance was assessed with respect to discrimination and clinical usefulness.

Results
Four thousand two hundred twenty-seven features were extracted and reduced to 10 features as the most important discriminators to build the radiomics signature. The radiomics signature showed good discrimination in the training set (AUC [area under the curve], 0.964; 95% confidence interval [CI], 0.934–0.995) and the validation set (AUC, 0.865; 95% CI, 0.725–1.000). Age, Hepatitis B virus infection, and enhancement pattern were the independent clinical factors. The radiomics nomogram, which incorporated the Rad-score and clinical factors, showed good discrimination in the training set (AUC, 0.979; 95% CI, 0.959–0.998) and the validation set (AUC, 0.917; 95% CI, 0.800–1.000), and showed better discrimination capability (P < 0.001) compared with the clinical factors model (AUC, 0.799; 95% CI, 0.719–0.879) in the training set. Decision curve analysis showed the nomogram outperformed the clinical factors model in terms of clinical usefulness.

Conclusions
The CT-based radiomics nomogram, a noninvasive preoperative prediction tool that incorporates the Rad-score and clinical factors, shows favorable predictive efficacy for differentiating FNH from HCC in the non-cirrhotic liver, which might facilitate clinical decision-making process.
Individual and demographic responses of a marsh bird assemblage to habitat loss and subsequent restoration
Authors: Moreno-Opo Rubén 
Published: February 2020

AbstractBackgroundThe alteration and loss of habitats are two of the main threats that biodiversity conservation is currently facing up to. The present study describes the effects of a perturbation and restoration in a reedbed habitat on a bird assemblage. We studied the bird community of a wetland of central Spain between 1995 and 2009, during which time an anthropic perturbation altered the original structure of the habitat; subsequently, as a result of restoration works, the habitat returned to its original state.MethodsWe evaluated the effects on six population and physical parameters of the birds at three different phases of their life cycles (breeding, wintering and post-breeding migration seasons) before, during and after the habitat alteration. GLM was used to analyze the influence of three independent variables (year, perturbation phase and temperature).ResultsThe relative abundance and the species richness values decreased when habitat was altered, but then recovered as a result of the regeneration works. This pattern was the clearest amongst specialist species. Breeding success also declined during the perturbation phase and then increased; likewise, the sex ratio changed given that the proportion of male birds increased when habitat was altered. These results are discussed in relation to changes on availability of resources in altered habitats, to the adaptive mechanisms in the exploitation of ecological requirements and to the selection of optimum and sub-optimum habitats by generalist and specialist species.ConclusionsEcosystem restoration can favour the recovery of population indexes of specialist passerines, although it depends on the efficiency of the type of restoration activity performed and on the complexity of the habitat.
Advances in salt tolerance molecular mechanism in tobacco plants
Authors: Sun Haiji , Sun Xiaowen , Wang Hui , Ma Xiaoli 
Published: February 2020

AbstractTobacco, an economic crop and important model plant, has received more progress in salt tolerance with the aid of transgenic technique. Salt stress has become a key research field in abiotic stress. The study of tobacco promotes the understanding about the important adjustment for survival in high salinity environments, including cellular ion transport, osmotic regulation, antioxidation, signal transduction and expression regulation, and protection of cells from stress damage. Genes, which response to salt, have been studied using targeted transgenic technologies in tobacco plants to investigate the molecular mechanisms. The transgenic tobacco plants exhibited higher seed germination and survival rates, better root and shoot growth under salt stress treatments. Transgenic approach could be the promising option for enhancing tobacco production under saline condition. This review highlighted the salt tolerance molecular mechanisms of tobacco.
Epidemiology and mental illness in old age
Authors: Lilford Philippa , Hughes Julian C. 
Published: February 2020

SUMMARYThis is an overview of epidemiology relevant to mental health problems in old age. We start by reviewing some basic terminology: the definitions of prevalence and incidence; the difference between descriptive and analytical epidemiology; the differences between study designs, including cross-sectional, case–control and cohort studies. We then cover the main epidemiological features of the major psychiatric diseases that affect older people (dementia and its different types, depression, late-onset schizophrenia, bipolar affective disorder, delirium, anxiety-related disorders, eating disorders, alcohol and substance misuse, personality disorders) and suicide.We end with some descriptive statistics regarding quality of life in older people.
Crystal structure of diisobutyl 2,5-dihydroxycyclohexa-1,4-diene-1,4-dicarboxylate, C16H24O6
Authors: Li Zhuang-Yu , Liu E. , Liu Xiao-Jing , Jian Fang-Fang 
Published: February 2020

Abstract
C16H24O6, triclinic, P1̄ (no. 2), a = 6.3410(13) Å, b = 7.3430(15) Å, c = 10.241(2) Å, α = 94.06(3)°, β = 103.89(3)°, γ = 113.13(3)°, V = 418.3(8) Å3, Z = 1, R
gt(F) = 0.0546, wR
ref(F
2) = 0.1691, T = 295(3) K.