bluuebunny/crossref_metadata_2025_split huggingface dataset:
Risk factors for the development of neonatal sepsis in a neonatal intensive care unit of a tertiary care hospital of Nepal
Authors: Manandhar Sulochana , Amatya Puja , Ansari Imran , Joshi Niva , Maharjan Nhukesh , Dongol Sabina , Basnyat Buddha , Dixit Sameer , Baker Stephen , Karkey Abhilasha 
Published: December 2020

Abstract
Background: Sepsis is an overwhelming and life-threatening response to bacteria in bloodstream and a major cause of neonatal morbidity and mortality. Understanding the etiology and potential risk factors for neonatal sepsis is urgently required, particularly in low-income countries where burden of pathogens is high and epidemiology is poorly understood.Methods: A prospective observational cohort study was conducted between April 2016 and October 2017 in a level three NICU of a tertiary care hospital in Nepal to determine the bacterial etiology and potential risk factors for neonatal sepsis.Results: Among 142 NICU admitted neonates, 15% (21/142) and 32% (46/142) developed blood culture-positive and -negative neonatal sepsis respectively. Klebsiella pneumoniae (34%, 15/44) and Enterobacter spp. (25%, 11/44) were the most common isolates. The antimicrobial resistance of isolates to ampicillin (100%, 43/43), cefotaxime (74%, 31/42) and ampicillin-sulbactam (55%, 21/38) were the highest with blaTEM (53%, 18/34) and blaKPC (46%, 13/28) being the commonest ESBL and carbapenemase genes. In univariate logistic regression, various potential neonatal, maternal, environmental and laboratory parameters were tested. Of these, the odds of sepsis increased with each additional day of use of invasive procedures such as mechanical ventilation (OR 1.086, 95% CI 1.008–1.170), umbilical artery catheter (OR 1.375, 95% CI 1.049–1.803), intravenous cannula (OR 1.140, 95% CI 1.062–1.225); blood transfusion events (OR 3.084, 95% CI 1.407–6.760); NICU stay (OR 1.109, 95% CI 1.040–1.182); failure to breast feed (OR 1.130, 95% CI 1.060–1.205); leukopenia (OR 1.790, 95% CI 1.04–3.082),thrombocytopenia (OR 0.992, 95% CI 0.989–0.994) and increase in C-reactive protein (OR 1.028, 95% CI 1.016–1.040). In multivariate analysis, increase in IV cannula insertion days (OR 1.140, 95% CI 1.024–1.269) and CRP level (OR 1.021, 95% CI 1.003–1.040) increased the odds of sepsis.Conclusions: Our study indicated various nosocomial risk factors and underscored the need to improve local infection control measures so as to reduce the existing burden of sepsis. We have highlighted certain sepsis associated laboratory parameters along with identification of antimicrobial resistance genes, which can guide for early and better therapeutic management of sepsis. These findings could be extrapolated to other low-income settings within the region.
Linc00460/miR-641 promoted promotes proliferation and autophagy of breast cancer
Authors: Zhang Wei , Zhang Huimin , Wang Bin , Ren Yu , He Jianjun , Xu Jing 
Published: December 2020

Abstract
This manuscript aimed to investigate the oncogenic role of linc00460 in breast cancer both in vivo and in vitro and then specify its downstream microRNAs to build a ceRNA network. As for in vivo tests, we used subgroup analysis and nomogram for survival analysis. As for in vitro tests, qRT-PCR, CCK-8 and Dual luciferase reporter gene were used. Linc00460 expressed highly in breast cancer. The nomogram indicated that linc00460 was associated with worse prognosis. Linc00460 might negatively regulate miR-641 to promote the proliferation and autophagy of breast cancer cell. In conclusion, linc00460 could be a risk factor for breast cancer by regulating miR-641; and it has the potential to be a novel biomarker.
Cardiovascular Disease and Cumulative Incidence of Cognitive Impairment in The Health and Retirement Study
Authors: Covello Allyson , Horwitz Leora , Singhal Shreya , Blaum Caroline , Li Yi , Dodson John 
Published: December 2020

Abstract
Background: We sought to examine whether people with a diagnosis of cardiovascular disease (CVD) experienced a greater incidence of subsequent cognitive impairment (CI) compared to people without CVD, as suggested by prior studies, using a large longitudinal cohort. Methods: We employed Health and Retirement Study (HRS) data collected biennially from 1998-2014 in 1,305 U.S. adults age ≥65 newly diagnosed with CVD vs. 2,610 age- and gender-matched controls. Diagnosis of CVD was adjudicated with an established HRS methodology and included self-reported coronary heart disease, angina, heart failure, myocardial infarction, or other heart conditions. CI was defined as a score <11 on the 27-point modified Telephone Interview for Cognitive Status. We examined incidence of CI over an 8-year period using a cumulative incidence function accounting for the competing risk of death.Results: Mean age at study entry was 73 years, 55% were female, and 13% were non-white. Cognitive impairment developed in 1,029 participants over 8 years. The probability of death over the study period was greater in the CVD group (19.8% vs. 13.8%, p <.001). The cumulative incidence analysis, which adjusted for the competing risk of death, showed no significant difference in likelihood of cognitive impairment between the CVD and control groups (29.7% vs. 30.6%, p = 0.64). This finding did not change after adjusting for relevant demographic and clinical characteristics using a proportional subdistribution hazard regression model.Conclusions: Overall, we found no increased risk of subsequent CI among participants with CVD (compared with no CVD), despite previous studies indicating that incident CVD accelerates cognitive decline.
Analysis on the Efficiency of Health Care Service Delivery and Influencing Factors in China: A Study Based on DEA-Malmquist Index and Tobit Model
Authors: Chen Kui , Ye Jun 
Published: December 2020

Abstract
Objective: To evaluate the changeing trend and influencing factors of medical and health service supply efficiency in 31 provinces of China.Methods: According to the input-output relevant index data of medical and health service in China from 2009 to 2018, data envelopment analysis- Malmquist(DEA-Malmquist) was used to calculate the total factor productivity, technical efficiency, and technical change. Meanwhile, Tobit model to analyzed the main effective factors of medical and health service supply efficiency in ChinaResults: In 2018, 21 provinces including Beijing, Shanghai, Zhejiang and Guangdong were effective in DEA of China's medical and health supply efficiency. Jilin, Heilongjiang, Jiangsu and Shandong were weak DEA effective, while Shanxi, Inner Mongolia, Liaoning, Anhui, Fujian and Xinjiang were not DEA effective. From 2009 to 2018, the total factor productivity of China's medical and health service supply has been decreased steadily, which was mainly affected by technological changes. From the perspective of regions, the technical efficiency and pure technical efficiency of medical and health service supply was the highest in the east, followed by the central and the western region. Associate’s degree or above, gross regional domestic product, and health care expenditure were significantly associated with the increasing of medical and health service supply efficiency.Conclusions: According to their own conditions and constraints, all localities should take targeted measures to strengthen the allocation and management level of medical and health resources, promote technological progress, give full play to the role of education and economic development, increase the expenditure on medical and health care, improve the utilization rate of beds, shorten the average hospitalization days, effectively improve the efficiency of medical and health services supply, and better provide health care for people.
Characteristics of axial Length and Binocular axial Length Difference in Chinese Children and Teenagers
Authors: Mao Xiuyu , Chen Minjie , Dai Jinhui , Sun Xinghuai 
Published: December 2020

Abstract
Background: To investigate the characteristics of axial length and binocular axial length difference in Chinese children and teenagers. Methods: The axial length and binocular axial length difference of 4422 children were retrospectively reviewed in this school-based study, while duration of outdoor activities, total media exposure (including electronic devices usage and TV watching) and sleep were also analyzed. Results: The average axial length of all ages were 23.20±0.02mm in the right eyes and 23.18±0.02mm in the left eyes. The binocular axial difference was 0.16±0.24mm. There was a slow rising trend in axial length (AL) within age. Mean AL in boys was 0.49mm longer than that in girls. Those who wore frame glasses were generally having shorter AL in preschool children (mean AL: 22.29±0.69mm vs 21.84±1.06mms) and longer AL in elder children (mean AL: 24.11±1.34mm, 25.06±1.07mm, 25.39±1.02mm vs 23.07±0.83mm, 23.84±0.95mm, 24.05±0.98mm). No significant difference was found between age in AL and ALD since age 15 and age 12. Parental myopic background was related to AL in all age groups, and total media exposure was related to longer AL in junior and senior high school students. Longer outdoor activities, longer sleep duration were associated with a shorter AL in primary school students. ALD was only associated with age in primary school students. Conclusion Axial length and binocular axial length difference varied within age, and they did not show an increase since the age of 15 and 12, respectively. Male, longer sleep and longer outdoor durations were associating with shorter axial length in younger children; female, longer total media exposure and parental myopic background were associating with a longer axial length especially in adolescents.
Practical Aspects of the Application of Helical Tomotherapy for Craniospinal Irradiation
Authors: Lee Joongyo , Kim Euidam , Kim Nalee , Byun Hwa Kyung , Suh Chang-Ok , Chung Yoonsun , Yoon Hong In 
Published: December 2020

Abstract
We investigated the practical aspects of the application of craniospinal irradiation using helical tomotherapy (HT-CSI) by evaluating interfractional setup errors and intrafractional movement during each treatment in 83 patients undergoing HT-CSI between January 2014 and December 2018. Interfractional setup errors in each axis (mediolateral; ML, craniocaudal; CC, and anteroposterior; AP) were assessed as differences between pre-treatment megavoltage computed tomography (MVCT) images scanned (zygomatic arch to the C4 spine) and planning CT images. Intrafractional movements were evaluated as the difference between pre-treatment and post-treatment MVCT (T12–L4 spine) images at each fraction. Median interfractional setup error was acceptable in every axis (ML: 1.6 mm, CC: 1.9 mm, AP: 3.1 mm). Seven patients (8.4%) experienced significant intrafractional displacement from 1 to 10 fractions (0.35% for ML, 0.77% for CC, 1.26% for AP). Weight loss grade 1+ during treatment (p=0.016) was an independent risk factor for significant intrafractional displacement. The risk factor for significant intrafractional movement in pediatric patients was weight loss grade 1+ (p=0.020), while there was no factor in adults. HT-CSI could be a feasible treatment modality with acceptable setup verification. Inter- and intrafractional errors were acceptable; paying attention to weight loss during treatment is necessary, especially in pediatric patients.
Effect of Surface Treatments on Push-out Bond Strength of Calcium Silicate-based Cements to Fiber Posts
Authors: Elnaghy Amr , Mandorah Ayman , Hassan Ali , Elshazli Alaa , Elsaka Shaymaa 
Published: December 2020

Abstract
Background: To evaluate the effect of surface treatments on the push-out bond strength of Biodentine (BD) and white mineral trioxide aggregate (WMTA) to fiber posts. Methods: Two brands of fiber posts were used: Reblida post; RP and RelyX post; RX. Each type of post was divided into four groups and exposed to surface treatment as follows: Control (no treatment), sandblasting (SB), hydrofluoric acid (HF), and TiF4 4 wt/v%. Push-out bond strength of BD and WMTA to glass fiber posts was assessed. Data were statistically analyzed. Results: BD showed higher bond strength than WMTA (P < 0.001). The push-out bond strength for posts treated with TiF4 4 wt/v% showed greater bond strength than the other surface treatments (P < 0.05). The BD/RP-TiF4 4 wt/v% showed the greater characteristic bond strength (σ0) (15.93) compared with the other groups. Conclusions: The BD/RP-TiF4 4 wt/v% showed greater bond strength compared with the other groups. The TiF4 4 wt/v% surface treatment enhanced the bond strength of BD and WMTA to glass fiber posts than the other treatments. Surface treatment of fiber post with TiF4 4 wt/v% could be used to improve the bond strength with calcium silicate-based cements.
BLADE: Bayesian Log-normAl DEconvolution for enhanced in silico microdissection of bulk gene expression data
Authors: Barbosa Bárbara Andrade , Asten Saskia van , Oh Ji-won , Fariña-Sarasqueta Arantza , Verheij Joanne , Dijk Frederike , Laarhoven Hanneke van , Ylstra Bauke , Garcia-Vallejo Juan , de Wiel Mark van , Kim Yongsoo 
Published: December 2020

Abstract
High-resolution deconvolution of bulk gene expression profiles is pivotal to characterize the complex cellular make-up of tissues, such as tumor microenvironment. Single-cell RNA-seq provides reliable prior knowledge for deconvolution, however, a comprehensive statistical model is required for efficient utilization due to the inherently variable nature of gene expression. We introduce BLADE (Bayesian Log-normAl Deconvolution), a comprehensive probabilistic framework to estimate both cellular make-up and gene expression profiles of each cell type in each sample. Unlike previous comprehensive statistical approaches, BLADE can handle >20 cell types thanks to the efficient variational inference. Throughout an intensive evaluation using >700 datasets, BLADE showed enhanced robustness against gene expression variability and better completeness than conventional methods, in particular to reconstruct gene expression profiles of each cell type. All-in-all, BLADE is a powerful tool to unravel heterogeneous cellular activity in complex biological systems based on standard bulk gene expression data.
Direct observation of the particle exchange phase of photons
Authors: Tschernig Konrad , Müller Chris , Smoor Malte , Kroh Tim , Wolters Janik , Benson Oliver , Busch Kurt , Perez-Leija Armando 
Published: December 2020

Abstract
Quantum theory stipulates that if two particles are identical in all physical aspects, the allowed states of the system are either symmetric or antisymmetric with respect to permutations of the particle labels. Experimentally, the symmetry of the states can be inferred indirectly from the fact that neglecting the correct exchange symmetry in the theoretical analysis leads to dramatic discrepancies with the observations. The only way to directly unveil the symmetry of the states for, say, two identical particles is through the interference of the two-particle state and the physically permuted one, and measuring the phase associated with the permutation process, the so-called particle exchange phase. Following this idea, we have measured the exchange phase of indistinguishable photons, providing direct evidence of the bosonic character of photons.
How do gibbons solve social dilemmas?
Authors: Sanchez-Amaro Alejandro , Ball Robert , Rossano Federico 
Published: December 2020

Abstract
Social primates face conflicts of interest with other partners when their individual and collective interests collide. Despite living in small, primarily dyadic, groups compared to other social primates, gibbons are not exempt from these conflicts in their everyday lives. In the current task, we asked whether pairs of gibbons would solve a conflict of interest over food rewards. We presented pairs of gibbons with a situation in which one pair member, the actor, could release food rewards at a distance, giving the passive partner a chance to take an advantageous position to obtain the rewards. Gibbons participated in three conditions: A No Food control, an Altruistic situation in which the actor could not obtain a direct reward from the cooperative act and a Test condition in which the actor could secure a small fraction of the total rewards. We found that gibbons acted more often in the two conditions involving food rewards, and waited longer when no direct rewards were available for the actor, thus suggesting that they understood the mechanism and that they faced a social trade-off between making the rewards available and waiting for each other to act. However, we found that in a majority of pairs, acting individuals benefitted more than the passive partners in both altruistic and test conditions. Furthermore, in some occasions actors actively refused to approach the location where the food was released. These results suggest that while gibbons strategize to solve the social dilemmas, they often allowed their partners to obtain better rewards. Our results highlight the importance of social tolerance and motivation as drivers promoting cooperation in these pair-living species.
Duration of Lockdown and Mental Health
Authors: Chaudhuri Kausik , Uddin Moshfique , Ahmed Suman 
Published: December 2020

Abstract
The Covid-19 pandemic and associated lockdown has disrupted mental well-being of individual. A number of studies provide evidence that lockdown is associated with higher level of stress and anxiety that contribute to deteriorating mental wellbeing of individuals. The general conclusion of those studies is unidirectional meaning more lockdown days lead to more deterioration of mental health. However, resilience argument state that if people get more time with families and loved ones, their resilience level will improve and as a result mental wellbeing improves as well. As lockdown brings the opportunity to spend more time with families, this study hypothesise that mental health gets affected at the early days of lockdown but starts to improve at a later stage. Using data from UK household longitudinal data and adopting appropriate statistical tests, this study finds that the relationship between lockdown days and mental health is U-shaped, meaning that mental health becomes worse in the early days of lockdown but improves at a later stage. We have found that mental health starts improving after 54 days since the start of lockdown for the full sample. The results also indicate that females adopt much quicker that males. The average time females take to recover is 34.4 days whereas males take 75 days to recover.
Postoperative Pain After Cesarean Section at University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia, 2019; A Cross-Sectional Follow-up Study
Authors: Demelash Getamesay , Woldegerima Yophtahe , Hailekiros Amare , Birlie Wubie 
Published: December 2020

Abstract
Background: Cesarean section is one of the most common obstetric procedures worldwide. Following this, parturients experience moderate to severe pain in the acute postoperative period. Therefore, in resource-limited settings, for full utilization of basic analgesic modalities and to take appropriates interventions, it is vital to know about the magnitude of the problem and its factors.Objective: To assess the prevalence and factors associated with postoperative pain after cesarean section at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia, 2019.Methods: A hospital-based prospective follow-up study was conducted among parturients who undergo cesarean section in the University of Gondar Comprehensive Specialized Hospital, from mid-February to April 20, 2019, after approval of the ethical review committee. Consecutively, a total of 290 parturients were included with a response rate of 97%. To measure pain severity numerical rating scale was used. Data was entered into Epi-data version 4.2 and analyzed by SPSS version 20 (IBM Corporate). The association between independent factors and the outcome variable was determined at 95% CI with the chi-squared test, bivariate, and multivariate logistic regression. Hosmer-Lemeshow test was used to assess the goodness of fit. Variables with a p-value of < 0.05 were considered significant.Results: In this study, the incidence of moderate to severe post-operative pain after cesarean section was 85.5% (95% CI: 81.4%, 89.0%) within the first 24 postoperative hours. On the multi-variable analysis, preoperative anxiety (AOR: 2.3, 95% CI: 1.1, 4.9), history of previous cesarean section (AOR: 2.3, 95% CI: 1.1, 5.0), Pfannenstiel incision (AOR: 3.2, 95% CI: 1.3, 8.0) and absence of regional analgesia (AOR: 3.7, 95% CI: 1.7, 7.9) were significantly associated with moderate to severe postoperative pain after cesarean section.Conclusions: In this study, a large proportion of parturients had experienced moderate to severe post-cesarean pain in the first 24 postoperative hours. Preoperative anxiety, history of previous cesarean section, Pfannenstiel incision, and parturients with no regional analgesia were significantly associated with post-cesarean pain. Pain severity needs to be assessed and documented by using pain-rating scales and there should be an interdisciplinary approach to provide adequate pain management in our hospital.
Reducing carbon emissions of households through monetary incentives and behavioral interventions: a meta-analysis
Authors: Khanna Tarun , Baiocchi Giovanni , Callaghan Max , Creutzig Felix , Guias Horia Bogdan , Haddaway Neal , Hirth Lion , Javaid Aneeque , Koch Nicolas , Laukemper Sonja , Loeschel Andreas , Zamora Maria Del Mar , Minx Jan 
Published: December 2020

Abstract
Despite the importance of evaluating all mitigation options so as to inform policy decisions addressing climate change, a systematic analysis of household-scale interventions to reduce carbon emissions is missing. Here, we address this gap through a state-of-the-art machine-learning assisted meta-analysis to comparatively assess the effectiveness of a range of monetary and behavioral interventions in energy demand of residential buildings. We identify 122 studies and extract 360 effect sizes representing trials on 1.2 million households in 25 countries. We find that all the studied interventions reduce energy consumption of households. Our meta-regression evidences that monetary incentives are on an average more effective than behavioral interventions, but deploying the right combinations of interventions together can increase overall effectiveness. We estimate global cumulative emissions reduction of 8.64 Gt CO2 by 2040, though deploying the most effective packages and interventions could result in greater reduction. While modest, this potential should be viewed in conjunction with the need for de-risking mitigation with energy demand reductions and realizing substantial co-benefits.