bluuebunny/crossref_metadata_2025_split huggingface dataset:
Higher mortality in bacteremic sepsis - A propensity score matched study
Authors: Mellhammar Lisa , Kahn Fredrik , Whitlow Caroline , Kander Thomas , Christensson Bertil , Linder Adam 
Published: December 2020

Abstract
The aim of this study was to describe outcome for critically ill patients with either culture-positive or -negative sepsis.In a clinical chart review of patients with a sepsis diagnosis treated in an intensive Care Unit (ICU), those who fulfilled sepsis-3 criteria and at had least one blood culture sampled ±48h from ICU admission were included. In a propensity score analysis bacteremic and non-bacteremic patients were matched with regard to age, comorbidities, site of infection and antimicrobial therapy prior to blood cultures.Out of 784 patients treated in the ICU with a sepsis diagnosis, blood cultures were missing in 140 excluded patients and additionally 95 excluded patients did not fulfill a sepsis diagnosis. In total 549 patients were included, 295 (54%) with bacteremia, 90 (16%) were non-bacteremic but had relevant pathogens detected from another body location and in 164 (30%) no relevant pathogen was detected in microbial samples. After the propensity score analysis, 90-day mortality was higher in bacteremic patients, 47%, than in non-bacteremic patients, 36%, p =0.04. In conclusion, bacteremic patients had higher mortality than their non-bacteremic counter-parts and bacteremia is more common in sepsis when studied in a clinical review.
Higher Mortality in Bacteremic Sepsis - A Propensity Score Matched Study
Authors: Mellhammar Lisa , Kahn Fredrik , Whitlow Caroline , Kander Thomas , Christensson Bertil , Linder Adam 
Published: December 2020

Abstract
BackgroundSepsis is a highly heterogenous disease which needs to be thoroughly mapped. The aim of this study was to describe characteristics and outcome for critically ill patients with sepsis-3 with either culture-positive or -negative sepsis.Methods Patients with severe sepsis or septic shock were retrospectively identified in the local quality registry from a general mixed Intensive Care Unit (ICU) at a University Hospital in 2007-2014. Data were collected through manual review of medical charts. Patients were included if they fulfilled sepsis-3 criteria and at least one blood culture was sampled ±48h from ICU admission. In a propensity score analysis bacteremic and non-bacteremic patients were matched 1:1 with regard to age, comorbidities, site of infection and antimicrobial therapy prior to blood cultures. A Latent Class Analysis (LCA) was performed to identify unmeasured class membership.Results784 patients were identified as treated in the ICU with a sepsis diagnosis. Blood cultures were missing in 140 excluded patients and additionally 95 patients did not fulfill a sepsis diagnosis and were also excluded. In total 549 patients were included, 295 (54%) with bacteremia, 90 (16%) were non-bacteremic but had relevant pathogens detected from another body location and in 164 (30%) no relevant pathogen was detected in microbial samples. After the propensity score analysis (n=172 in each group) 90-day mortality was higher in bacteremic patients, 47%, than in non-bacteremic patients, 36%, p =0.04. Patients without antibiotic treatment before sample collection (n=352) were more often bacteremic, 63%. Non-bacteremic patients without prior antibiotic treatment had lower mortality, 31% (n=129), compared to non-bacteremic patients with prior antibiotic treatment, 51% (n=124), p <0.01.The LCA identified 8 classes, with different mortality rates, where pathogen detection in microbial sampleswere important factors for class distinction andoutcome.ConclusionsBacteremic patients had higher mortality than their non-bacteremic counter-parts. Bacteremia is more common in sepsis than previously reported, when studied in a clinical review. Clinical chart review should be considered gold standard since a significant proportion of the patients in the proposed sepsis cohort, did not have sepsis, but would have been included in ICD- or electronic health record (EHR) algorithm approaches.
The Impact of Trust in Public Institutions on Compliance With Epidemiological Measures to Slow Down the Spread of COVID-19
Authors: Caplanova Anetta , Sivak Rudolf , Szakadatova Estera 
Published: December 2020

Abstract
This paper investigates the causal relationship between the trust in institutions and compliance with measures introduced to slow down the spread of the novel coronavirus COVID-19 in Slovakia. We also analyse the impact of socio-economic characteristics on compliance with introduced measures. We use the data from a survey carried out by the Slovak Academy of Sciences on the representative sample of 1000 respondents. To derive the causal effect, we use a probit regression model. We find that trust in institutions helps to increase compliance with social distancing. We find that some socio-economic characteristics such as employment status, age or whether individuals feel to be in danger of COVID-19 have a positive and statistically significant effect on compliance with measures employed to slow the spread of the COVID-19 virus.
Lateral Advection Supports Nitrogen Export in the Oligotrophic Open-Ocean Gulf of Mexico
Authors: Kelly Thomas , Knapp Angela , Landry Michael , Selph Karen , Shropshire Taylor , Thomas Rachel , Stukel Michael 
Published: December 2020

Abstract
In contrast to its productive coastal margins, the open-ocean Gulf of Mexico (GoM) is notable for highly stratified surface waters with extremely low nutrient and chlorophyll concentrations. Field campaigns in 2017 and 2018 indicate low rates of turbulent mixing, which combined with oligotrophic nutrient conditions, give very low estimates of diffusive flux of nitrate into the euphotic zone (< 1 µmol N m-2 d-1). Estimates of local N2-fixation are similarly low. In comparison, measured export rates of sinking particulate organic nitrogen (PON) from the euphotic zone are 2-3 orders of magnitude higher (i.e. 462 – 1144 µmol N m-2 d-1). We reconcile these disparate findings with regional scale dynamics inferred independently from remote-sensing products and a regional biogeochemical model and find that laterally-sourced organic matter is sufficient to support >90% of open-ocean nitrogen export in the GoM. Results show that lateral transport needs to be closely considered in studies of biogeochemical balances, particularly for basins enclosed by productive coasts.
Value-Added Roles of Medical Students During COVID-19 Pandemic: Assessment of Medical Students’ Perception and Willingness in Sri Lanka
Authors: Wickramasinghe Nuwan , Jayarathne Shamalee , Pilapitiya Senaka 
Published: December 2020

Abstract
BackgroundCOVID-19 pandemic is an opportune time to identify the value-added roles of medical students to utilize the services of this potential workforce effectively in the health-care system. Hence, this study assessed medical students’ perception and willingness to assist in COVID-19 health sector preparedness and response via value-added roles in Sri Lanka. MethodsA cross-sectional online survey was conducted among all medical students studying in six batches of the Faculty of Medicine and Allied Sciences (FMAS), Rajarata University of Sri Lanka (RUSL). A Google form prepared in English with statements about individual perception of medical students’ role and their willingness to assist in the COVID-19 health sector response via value-added roles was used to collect data. ResultsOut of 856 (79.6%) study participants, the majority was females (n=601, 70.2%). The majority (n=804, 93.9%) reported that they have a responsibility to contribute to the COVID-19 health sector response in the country. There was a statistically significant difference in medical students’ perceived level of clinical knowledge and clinical skills to assist in COVID-19 health sector response with advancing academic year (p<0.001). The commonly identified value-added roles were developing (n=770, 89.9%) and disseminating (n=744, 86.9%) health education messages, and field contact tracing activities (n=653, 76.3%). Other value-added roles were assisting the curative health sector in COVID-19 patient management (n=380, 44.4%) and other non-COVID-19 patient management (n=463, 54.1%). ConclusionsMedical students are mostly willing to be engaged in the preventive health sector value-added roles and to a lesser extent in the curative health sector value-added roles during the COVID-19 outbreak. However, the medical educators need to clearly define the value-added roles and provide adequate training and supervision for medical students, from the first year to the final year, to combine learning with meaningful contributions to patient care and health-care system during the COVID-19 pandemic.
Facial emotion processing in young people with subjective memory complaints: an ERP study
Authors: Perez Vanesa , Garrido-Chaves Ruth , Perez-Alarcon Mario , Paiva Tiago O. , Pulopulos Matias M. , Hidalgo Vanesa , Salvador Alicia 
Published: December 2020

Abstract
Subjective memory complaints (SMCs) are commonly related to aging, but they are also presented by young adults. Their neurophysiological mechanisms are not thoroughly understood, although some aspects related to affective state have been mentioned. Here, we investigated whether facial emotion processing is different in young people with (n = 41) and without SMCs (n = 39) who were exposed to positive, negative, and neutral faces, by recording the event-related potential (ERP) activity. From the ERP activity, the N170 (an index of face processing) and the LPP (an index of motivated attention) components were extracted. Regarding N170, results showed less amplitude for positive and neutral faces in the participants with SMCs than in those without SMCs. Moreover, women with SMCs displayed longer latencies for neutral faces than women without SMCs. No significant differences were found between the groups in the LPP component. Together, our findings suggest deficits in an early stage of facial emotion processing in young people with SMCs, and they emphasize the importance of further examining affective dimensions.
RNA-Seq Reveals Allele-Specific Expression of Somatic Mutations in Neuroblastoma
Authors: Li Xiaoqing , Sun Lan , Liu Qian , Tu Lingli , Stucky Andres , Wang Jingyi , Wu Zhongjun , Zhang Xi , Wang Kai , Zhong Jiang F 
Published: December 2020

Abstract
Neuroblastoma (NB) is one of the most common solid tumors in children, accounting for approximately 8% of all pediatric malignancies and 15% of childhood cancer deaths. Somatic mutations in several genes such as ALK have been associated with neuroblastoma progression and can facilitate the discovery of novel therapeutic strategies. However, differential expression of mutated and wild-type alleles on the transcriptome level is not well studied. In this study, we analyzed 219 whole-exome sequencing datasets (with somatic mutations detected by MuTect from paired normal and tumor samples) and prioritized mutations in eight candidate genes as potential driver mutations. Meanwhile, we analyzed 127 RNA-seq samples (of which 85 also had DNA-seq data available) for allele-specific expression levels of each mutation. Our integrated analysis of somatic mutations and allele-specific expression levels confirmed the presence of allele-specific expression of somatic mutations in neuroblastoma including MYCN, ALK and PTPN22. The allele-specific expression of mutations suggests that the same somatic mutation may have different effects on clinical outcomes of tumors. Our study also suggests possible involvement of ZNF44 as a candidate driver gene for neuroblastoma. In summary, this study demonstrates the value of examining allele-specific expression levels of somatic mutations through the analysis of RNA-Seq data to assess the effects of somatic mutations in different patients. Improved understanding of allele-specific expression of somatic mutations can facilitate development of personalized treatment for neuroblastoma in precision medicine.
Magnification of Fear and Intention of Avoidance of Non-Experienced Dental Treatment
Authors: Lin Chia-Shu , Lee Chen-Yi , Chen Li-Ling , Wang Tze-Fang 
Published: December 2020

Abstract
Background. Dental fear is associated with the experience of prior dental treatment and avoidance of dental visits. It remains unclear if individuals show an intention of avoidance (IA) towards treatments that they have not received (i.e., non-experienced dental treatment). Methods. We investigated fear/IA of 12 common conditions of dental treatment of 402 adults. If subjects have experienced the condition, fear and IA were assessed based on subjects’ prior experience (i.e., ExpFear/ExpIA). If they have not experienced the condition, fear and IA were assessed based on their anticipation (i.e., NExpFear/NExpIA). Trait dental anxiety was assessed using the Index of Dental Anxiety and Fear (IDAF-4C+). Results. We found that (A) NExpFear and NExpIA were significantly higher than ExpFear and ExpIA, respectively. (B) The IDAF-4C+ scores are positively correlated with NExpFear/NExpIA and negatively correlated with the magnification of fear (i.e., the discrepancy in the fear/IA of non-experienced vs. experienced conditions). (C) The condition ‘extraction of a wisdom tooth’ and ‘root canal treatment’ showed the highest ratings on NExpFear. Conclusions. Individuals may develop a high degree of fear and IA of the treatment they have not received. Trait dental anxiety plays a key role in the magnification of the fear of non-experienced treatment.
Superpixel Image Segmentation of VISTA&nbsp;Expression in Colorectal Cancer: Implications for Immunotherapy
Authors: Wu Dongling , Hacking Sean , Vitkovski Taisia , Nasim Mansoor 
Published: December 2020

Abstract
Colorectal cancer is an overall bad player and accounts for 9% of all cancers. Today, advancements in immune checkpoint inhibition has provided therapeutics for many, but not all cancer patients. This issue is in part due to the tumoral microenvironment; which plays a significant role in determining response to immune check point therapeutics. This study serves as the first to evaluate a potent inhibitory checkpoint: V-domain immunoglobulin suppressor of T cell activation (VISTA) and its role in CRC. This was evaluated with both conventional light microscope and superpixel image segmentation. Here we found VISTA expression to be associated with low tumor budding, lower tumor stage, high tumor infiltrating lymphocytes, mature stromal differentiation, BRAF mutation status and better disease-free survival in colorectal cancer. When comparing methodologies; superpixel image segmentation better stratified patients into prognostic groups. Anti-VISTA clinical trials are now open and recruiting for patient enrollment for patients with certain advanced solid tumors. Considering raised VISTA expression is associated with improved survival for patients with colorectal cancer: careful, well-designed and robust clinical trials should be pursued in this cancer subtype.
Metaheuristics in the Decentralization of Emergency Care.
Authors: Cabral Eric Lucas dos Santos , Castro Wilkson Ricardo Silva , Florentino Davidson Rogério de Medeiros , Junior João Florêncio da Costa , Frazão Talita Dias Chagas , Francisco Claudia Aparecida Cavalheiro , Souza Ricardo Pires de , Rêgo Amália Cinthia Meneses , ARAÚJO-FILHO IRAMI , Cabral Marco Antônio Leandro 
Published: December 2020

Abstract
BackgroundThe growth of the urban population exerts considerable pressure on municipalities’ public managers to focus their attention on providing emergency medical care that meets the growing demand for emergency pre-hospital medical care. Currently, there are a significant number of traffic accidents and other serious occurrences, such as heart attacks, drownings, epidemics, fires and disasters (floods, landslides, earthquakes) that demand a prompt and seamless response from pre-hospital medical care. As a result of such scenario, the present article endeavours to apply a dual-coverage mathematical model (DSM-Double Standard Model) to define the optimal location of the Emergency Medical Service (SAMU) decentralized dispatch bases in Natal / RN and conduct a simulation study to evaluate the displacement of ambulances between such bases. Patients and methodsThe methodological course that was followed by this research constitute for 12 steps, so as to the location of decentralized bases for sending emergency ambulances was established using the DSM model and the simulation model was performed using the FlexSim software© version 2018 evaluating base coverage in relation to the total number of calls by demand points for different scenarios.ResultsThe results obtained throughout the research demonstrated the feasibility of redefining the decentralized bases of SAMU / Natal ambulances as a strategy to reduce response time and guarantee compliance with performance parameters established by international organizations (the World Health Organization, for instance, establishes the time of 8 minutes for emergency medical service calls response). The simulation study showed a significant reduction in response time, by up to 60% in some cases.Conclusion﻿The proposition of new locations for the decentralized dispatch bases of the SAMU/Natal can provide an overall significant reduction on the ambulance response time, so as to contributes to expedite the initiation of treatment of patients, if necessary, sent to hospitals.
Clinicopathological Characteristics and Prognostic Factors for Cervical Adenocarcinoma: A Population-Based Study
Authors: Wang Min , Zhou Zhen-huan , Han Wei-wei 
Published: December 2020

Abstract
Objective: We aimed to assess the clinicopathological features and determine prognostic factors of cervical adenocarcinoma (AC).Methods: Relevant data were extracted from Surveillance, Epidemiology and End Results (SEER) database from 2004 to 2015. The log-rank test and Cox proportional hazard analysis were utilized to identify independent prognostic factorsResults: A total of 3102 patients were identified. The higher proportion of patients with early FIGO stage (stage I: 69.4%; stage II: 14.1%), low pathological grade (grade I/II: 49.1%) and tumor size≤4cm (46.8%). The 5- and 10-year CSS rates were 74.47% and 70.00%. Meanwhile, the 5- and 10-year OS rates were 71.52% and 65.17%. Multivariate analysis found that married, surgery as well as chemotherapy were independent favorable prognostic indicators. Additionally, aged ˃45, grade III/IV, tumor size ˃4cm, advanced FIGO stage, pelvic lymph node metastasis (LNM) were unfavorable prognostic factors (all P<0.001). Stratified analysis found that patients without surgery could benefit significantly from chemotherapy and radiotherapy. In addition, chemotherapy could significantly improved survival in stage II-IV patients and radiothrapy only improved stage III patients (all P < 0.01).Conclusion: Marital status, age, grade, tumor size, FIGO stage, pelvic LNM, surgery and chemotherapy were significantly associated with prognosis of cervical AC.
Functional Characteristics of The Stelar K+ Outward Rectifying Channel (EeSKOR) Gene in Elytrigia Elongata
Authors: Zhou Yantong , Tian Xiaoxia , Zhang Yong , Mao Peichun , Zheng Mingli , Meng Lin 
Published: December 2020

Abstract
As an important nutrient, K+ plays a crucial role in plant stress resistance. It has been reported that the stelar K+ outward rectifying channel (SKOR) is involved in loading K+ into the xylem for its transport from roots to shoots. Elytrigia elongata is a perennial, sparsely distributed, rhizome-type herbaceous plant belonging to the wheatgrass family; it has high salt tolerance. Here, we isolated EeSKOR from decaploid E. elongata and investigated its function in transgenic tobacco. The results showed that EeSKOR was mainly expressed in the roots and was up-regulated with increasing salinity and drought intensity. Overexpression of EeSKOR in plants exposed to salt stress enhanced growth performance, increased SOD activity and chlorophyll content, significantly reduced H2O2 and MDA content, reduced Na+ concentration, and increased K+ concentration in transgenic tobacco plants compared with wild-type (WT) and null vector (Vector) plants. Our findings suggest that transgenic plants overexpressing EeSKOR could enhance K+ transport from the roots to the aboveground parts to maintain K+ steady-state in the aboveground under conditions of salt stress, thereby enhancing tobacco salt tolerance.
Effect of Ball Burnishing on HCF of Bilayer Composite for Support Wind Turbine Blades
Authors: Fouad Yasser , Marouani Haykel 
Published: December 2020

Abstract
The cyclic deformation behavior of two metal-matrix composites, namely aluminum-based composites reinforced with a steel wire and aluminum-based composites reinforced with an aluminum alloy 3030 wire, was investigated at room temperature for wind blades support. All materials were synthesized by sand casting and subjected to mechanical surface treatment by ball burnishing. High cycle fatigue was observed under reversed bending loading at 50 Hz. The composites reinforced with volume fraction (28% and 34%) of the wire shows excellent fatigue life and endurance limit under stress-controlled conditions. Moreover, the tensile and microstructural properties of these materials were examined. The alloyed aluminum-matrix-steel-wire-reinforced composite showed higher fatigue behavior than the wire reinforced using ball burnishing of as-cast alloys.
Molecular Mechanism by which Diosbulbin B Regulates the TP63 Gene in Triple-Negative Breast Cancer
Authors: LIU LIU , Lao Qiufeng , Li Shengle , Pang Weiyi 
Published: December 2020

Abstract
BackgroundDioscorea bulbifera L. is mainly used for antitumor therapy in clinical practice. Studies have shown that the drug-containing serum obtained from Dioscorea bulbifera L. induces the apoptosis and inhibits the proliferation of rat breast cancer cells. However, the main active compounds and the molecular mechanism in triple-negative breast cancer are still unclear.MethodsThe TCMSP, GeneCards, GEO and TCGA databases were used to identify genes that intersect the target genes of Dioscorea bulbifera L., active Dioscorea bulbifera L. components and triple-negative breast cancer targets, and Kaplan-Meier and GSEA methods were used to analyze the survival and pathway enrichment of the intersecting genes, respectively. Subsequently, in vitro experiments were performed for verification.ResultsA total of 14 active components were screened, and the targets of the active components were combined with triple-negative breast cancer-related targets and differentially expressed genes obtained from the GeneCards database. Three genes (CCNB1, PGR and TP63) are related to the anti-breast cancer effects of Dioscorea bulbifera L., and TP63 (P<0.05) is related to breast cancer survival. The GSEA showed that the TP63 gene is related to the apoptosis pathway, and TP63 gene analysis in the TCGA clinical database showed the greatest expression difference in triple-negative breast cancer. The in vitro experiments showed that diosbulbin B, the main antitumor compound in Dioscorea bulbifera L., may inhibit the proliferation and migration of MDA-MB-231 breast cancer cells and induce their apoptosis by promoting the expression of the TP63 gene.ConclusionThe present study fully elucidated the active components, potential targets and molecular mechanisms of Dioscorea bulbifera L. against triple-negative breast cancer and provided a new method for revealing the scientific basis and therapeutic mechanism of Chinese medicine in treating diseases.