bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of different geometric assumption of mitral annulus on the assessment of mitral regurgitation volume by Doppler method
Authors: Wang Wugang , Wang Zhibin , Li Junfang , Gong Kun , Zhao Liang , Tang Guozhang , Fu Xiuxiu 
Published: January 2020

Abstract
Background: Mitral regurgitation volume (MRvol) by quantitative pulsed Doppler (QPD) method previously recommended suffers from geometric assumption error because of circular geometric assumption of mitral annulus (MA). Therefore, the aim of this study was to evaluate the impact of different geometric assumption of MA on the assessment of MRvol by two-dimensional transthoracic echocardiographic QPD method. Methods: This study included 88 patients with varying degrees of mitral regurgitation (MR). The MRvol was evaluated by QPD method using circular or ellipse geometric assumption of MA. MRvol derived from effective regurgitant orifice area by real time three-dimensional echocardiography (RT3DE) multiplied by MR velocity-time integral was used as reference method. Results: Assumption of a circular geometry of MA, QPD-MAA4C and QPD-MAPLAX overestimated the MRvol by a mean difference of 10.4 ml (P ＜ 0.0001) and 22.5 ml (P ＜ 0.0001) compared with RT3DE. Assumption of a ellipse geometry of MA, there was no significant difference of MRvol (mean difference = 1.7 ml, P = 0.0844) between the QPD-MAA4C+A2C and the RT3DE. Conclusions: Assuming that the MA was circular geometry previously recommended, the MRvol by QPD-MAA4C was overestimated compared with the reference method. However, assuming that the MA was ellipse geometry, the MRvol by the QPD-MAA4C+A2C has no significant difference with the reference method.
Intestinal flora imbalance affects bile acid metabolism and is associated with gallstone formation.
Authors: Wang Qiang , Hao Chenjun , Yao Wenchao , Zhu Defu , Lu Haifeng , Li Long , Ma Biao , Sun Bei , Xue Dongbo , Zhang Weihui 
Published: January 2020

Abstract
Background: The gut microbiota participates in the metabolism of substances and energy, promotes the development and maturation of the immune system, forms the mucosal barrier, and protects the host from pathogen attacks. Although the pathogenesis of cholesterol gallstones is still not clear, studies have suggested that gut microbiota dysbiosis plays an important role in their formation.
Methods: Microbial DNA from faeces of normal control patients and those of patients with calculi was subjected to 16S rRNA gene sequencing to detect gene expression changes in intestinal microbes. ELISA kits were used to measure free bile acids, secondary bile acids and coprostanol according to the manufacturer’s instructions. The relationship between flora and their metabolites was then analysed.
Results: In the gallstone group, the diversity of intestinal bacteria and the abundances of certain phylogroups were significantly decreased (p<0.05), especially Firmicutes (p<0.05), the largest phylum represented by the gut microbiota. This study found an increase in free bile acids (p<0.001) and secondary bile acids (p<0.01) in the enterohepatic circulation. Bile salt hydrolase activity was not related to the abundances of BSH-active bacteria. 7a-dehydroxylating gut bacteria were significantly increased (p<0.01), whereas cholesterol-lowering bacteria were significantly reduced (p<0.05). The Ruminococcus gnavus group could be used as a biomarker to distinguish the gallstone group from the control group.
Conclusion: We conclude that intestinal flora imbalance affects bile acid and cholesterol metabolism and is associated with gallstone formation.
Keywords: Gut microbiota, Gallstone, Bile acid, BSH, 16S rRNA gene sequencing
A Simple Monochromatic Flow Cytometric Assay for Assessment of Intraerythrocytic Development of Plasmodium falciparum
Authors: Kulkeaw Kasem , Ketprasit Nutpakal , Tungtrongchitr Anchalee , Palasuwan Duangdao 
Published: January 2020

Abstract
Background: Gold standard microscopic examination of P. falciparum intraerythrocytic stage remains an important process for staging and enumerating parasitized erythrocytes in culture; however, microscopy is laborious and its accuracy is dependent upon the skill of the examiner. Methods: In this study, we used ViSafe Green (VSG), which is a nucleic acid-binding fluorescent dye, to assess in vitro development of P. falciparum using flow cytometry. Results: Fluorescence intensity of VSG was found to depend on the developmental stage of parasites. Specifically, multiple-nuclei-containing schizonts were observed in the VSGhigh population, and growing trophozoites and ring-shaped forms were observed in the VSGintermediate and VSGlow populations. The efficacy of our VSG-based assay was found to be comparable to the microscopic examination method, and it demonstrated an ability to detect as low as 0.001% of the parasitemia estimated by Giemsa staining. Moreover, when applying VSG for antimalarial drug test, we were able to observe the growth inhibitory effect of dihydroartemisinin, the front-line drug for malaria therapy. Conclusions: Taken together, the results of this study suggest the VSG-based flow cytometric assay to be a simple and reliable assay for assessing P. falciparum malaria development in vitro.
Association of acute kidney injury with readmissions after hospitalization for acute exacerbation of chronic obstructive pulmonary disease: A population-based study
Authors: Hirayama Atsushi , Goto Tadahiro , Hasegawa Kohei 
Published: January 2020

Abstract
Background and Aim: Little is known about the relationship between acute kidney injury (AKI) and outcomes after acute exacerbation of chronic obstructive pulmonary disease (AECOPD). We aimed to investigate associations between AKI and readmission risks after hospitalization for AECOPD.
Methods: A retrospective, population-based cohort study using State Inpatient Databases from seven U.S. states (Arkansas, California, Florida, Iowa, Nebraska, New York, and Utah) from 2010 through 2013. We identified all adults (aged ≥40 years) hospitalized for AECOPD during the study period. Among them, we further identified patients with a concurrent diagnosis of new AKI. The outcome measures were any-cause readmissions within 30 days and 90 days after hospitalization for AECOPD. To determine associations between AKI and readmission risk, we constructed Cox proportional hazards models examining the time-to-readmission. We also identified the primary reason of readmission.
Results: We identified 356,990 patients hospitalized for AECOPD. The median age was 71 years and 41.9% were male. Of these, 24,833 (7.0%) had a concurrent diagnosis of AKI. Overall, patients with AKI had significantly higher risk of 30-day all-cause readmission compared to those without AKI (hazard ratio 1.47; 95% CI 1.43-1.51; P<0.001). Likewise, patients with AKI had significantly higher risk of 90-day all-cause readmission (hazard ratio 1.35; 95% CI 1.32-1.38; P<0.001). These associations remained significant after adjustment for confounders (both P<0.05). Additionally, patients with AKI were likely to be readmitted for non-respiratory reasons including sepsis, acute renal failure, and congestive heart failure.
Conclusions: Among patients hospitalized for AECOPD, patients with AKI were at higher risk of 30-day and 90-day readmission, particularly with non-respiratory reasons.
Recovery and stable persistence of chloroquine sensitivity in Plasmodium falciparum parasites after its discontinued use in Northern Uganda.
Authors: Balikagala Betty , Yatsushiro Miki Sakurai , Tachibana Shin-Ichiro , Ikeda Mie , Yamauchi Masato , Katuro Osbert T. , Ntege Edward Hosea , Sekihara Makoto , Fukuda Naoyuki , Takahashi Nobuyuki , Yatsushiro Shouki , Mori Toshiyuki , Hirai Makoto , Opio Walter , Obwoya Paul S. , Anywar Denis Arony , Auma Mary Alai , Palacpac Nirianne Marie Querijero , Tsuboi Takafumi , Odongo-Aginya Emmanuel Igwaro , Kimura Eisaku , Ogwang Martin David , Horii Toshihiro , Mita Toshihiro 
Published: January 2020

Abstract
Background Usage of chloroquine was discontinued from the treatment of Plasmodium falciparum infection in almost all endemic regions because of global spread of resistant parasites. Since the first report in Malawi, numerous epidemiological studies have demonstrated that the discontinuance led to re-emergence of chloroquine-susceptible P. falciparum parasites, suggesting a possible role in future malaria control. However, most studies were cross-sectional, with few studies looking at the persistence of chloroquine recovery in long term. This study fills the gap by providing, for a period of at least 6 years, proof of persistent re-emergence/stable recovery of susceptible parasite populations using both molecular and phenotypic methods Methods Ex vivo drug-susceptibility assays to chloroquine (n = 319) and lumefantrine (n = 335) were performed from 2013 to 2018 in Gulu, Northern Uganda where chloroquine had been removed from the official malaria treatment regimen since 2006. Genotyping of pfcrt and pfmdr1 was also performed. Results Chloroquine resistance (100 nM) was observed in only 3 (1.3%) samples. Average IC 50 values for chloroquine were persistently low throughout the study period (17.4–24.9 nM). Parasites harboring p fcrt K76 alleles showed significantly lower IC 50 s to chloroquine than the parasites harboring K76T alleles (21.4 nM vs 43.1 nM, p-value= 3.9×10 -8 ). Prevalence of K76 alleles gradually increased from 71% in 2013 to 100% in 2018. Conclusion This study found evidence of stable persistence of chloroquine susceptibility with the fixation of pfcrt K76 in Northern Uganda after discontinuation of chloroquine in the region. Accumulation of similar evidence in other endemic areas in Uganda could open channels for possible future re-use of chloroquine as an option for malaria treatment or prevention.
The primary cilium dampens proliferative signaling and represses a G2/M transcriptional network in quiescent myoblasts
Authors: Venugopal Nisha , Ghosh Ananga , Gala Hardik , Aloysius Ajoy , Vyas Neha , Dhawan Jyotsna 
Published: January 2020

Abstract
Background Reversible cell cycle arrest (quiescence/G0) is characteristic of adult stem cells and is actively controlled at multiple levels. Quiescent cells also extend a primary cilium, which functions as a signaling hub. Primary cilia have been shown to be important in multiple developmental processes, and are implicated in numerous developmental disorders. Although the association of the cilium with G0 is established, the role of the cilium in the control of the quiescence program is still poorly understood. Results Primary cilia are dynamically regulated across different states of cell cycle exit in skeletal muscle myoblasts: quiescent myoblasts elaborate a primary cilium in vivo and in vitro , but terminally differentiated myofibers do not. Myoblasts where ciliogenesis is ablated using RNAi against a key ciliary assembly protein (IFT88) can exit the cell cycle but display an altered quiescence program and impaired self-renewal. Specifically, the G0 transcriptome in IFT88 knockdown cells is aberrantly enriched for G2/M regulators, suggesting a focused repression of this network by the cilium. Cilium-ablated cells also exhibit features of activation including enhanced activity of Wnt and mitogen signaling and elevated protein synthesis via inactivation of the translational repressor 4E-BP1. Conclusions Taken together, our results show that the primary cilium integrates and dampens proliferative signaling, represses translation and G2/M genes, and is integral to the establishment of the quiescence program.
Falciparum malaria from coastal Tanzania and Zanzibar remains highly connected despite effective control efforts on the archipelago
Authors: Morgan Andrew , Brazeau Nicholas , Ngasala Billy , Mhamilawa Lwidiko , Denton Madeline , Msellem Mwinyi , Morris Ulrika , Filer Dayne , Aydemir Ozkan , Bailey Jeffrey , Parr Jonathan , Mårtensson Andreas , Bjorkman Anders , Juliano Jonathan 
Published: January 2020

Abstract
Background
Tanzania’s Zanzibar archipelago has made significant gains in malaria control over the last decade and is a target for malaria elimination. Despite consistent implementation of effective tools since 2002, elimination has not been achieved. Importation of parasites from outside of the archipelago is thought to be an important cause of malaria’s persistence, but this paradigm has not been studied using modern genetic tools.
Methods
Whole-genome sequencing (WGS) was used to investigate the impact of importation, employing population genetic analyses of Plasmodium falciparum isolates from both the archipelago and mainland Tanzania. Ancestry, levels of genetic diversity and differentiation, patterns of relatedness, and patterns of selection between these two populations were assessed by leveraging recent advances in deconvolution of genomes from polyclonal malaria infections.
Results
Significant decreases in the effective population sizes were inferred in both populations that coincide with a period of decreasing malaria transmission in Tanzania. Identity by descent analysis showed that parasites in the two populations shared long segments of their genomes, on the order of 5 cM, suggesting shared ancestry within the last 10 generations. Even with limited sampling, two of isolates between the mainland and Zanzibar were identified that are related at the expected level of half-siblings, consistent with recent importation.
Conclusions
These findings suggest that importation plays an important role for malaria incidence on Zanzibar and demonstrate the value of genomic approaches for identifying corridors of parasite movement to the island.
Potential of Zymomonas mobilis as an electricity producer in ethanol production
Authors: Geng Bo-Yu , Cao Lian-Ying , Li Feng , Song Hao , Liu Chen-Guang , Zhao Xin-Qing , Bai Feng-Wu 
Published: January 2020

Abstract
Background: Microbial fuel cell (MFC) convokes microorganism to convert biomass into electricity. However, most well-known electrogenic strains can not directly use glucose to produce valuable products. Zymomonas mobilis, a promising bacterium for ethanol production, owns special Entner-Doudoroff pathway with less ATP and biomass produced and the low energy-coupling respiration, making Z. mobilis a potential exoelectrogen. Results: A glucose-consumed MFC is constructed by inoculating Z. mobilis. The electricity with power density 2.0 mW m-2 is derived from the difference of oxidation-reduction potential (ORP) between anode and cathode chambers. Besides, two-type electricity generation is observed as glucose-independent process and glucose-dependent process. For the sake of enhancing MFC efficiency, extracellular and intracellular strategies are implemented. Biofilm removal and addition of c-type cytochrome benefits electricity performance and Tween 80 accelerates the electricity generation. Perturbation of cellular redox balance compromises the electricity output, indicating that redox homeostasis is the principal requirement to reach ideal voltage. Conclusion: This study identifies potential feature of electricity activity for Z. mobilis and provides multiple strategies to enhance the electricity output. Therefore, additional electricity generation will benefit the techno-economic viability of the commercial bulk production for biochemicals or biofuels in an efficient and environmentally sustainable manner.
A nationwide survey on the use of Heated Humidified High Flow Oxygen therapy on the paediatric wards in the UK: current practice and research priorities
Authors: Hosheh Osama , Edwards Christopher T , Ramnarayan Padmanabhan 
Published: January 2020

Abstract
Background: Heated Humidified High Flow Nasal Cannula Oxygen Therapy (HHFNC) is increasingly used on the paediatric wards and High Dependency Units (HDU) for different types of pathologies and different age groups. Objective: We aimed to describe current practice related to the use of HHFNC on the paediatric wards and HDUs, weaning practices and preferred outcome measures for future research. Methods: We carried out a cross-sectional online survey of UK paediatric consultants or their delegates working on the paediatric wards. Proportions of the HHFNC users, their specialties, and their level of experience were surveyed. Reasons for HHFNC initiation, weaning criteria, patients’ characteristics and their primary pathologies were also analysed. Results: Participation of 218 paediatricians from 81 hospitals (Median: 2.7, Range: 1-11) was registered. HHFNC was provided in most of the surveyed hospitals (93%, 75/81). A High Dependency Unit (HDU) was available in 47 hospitals (58%); less than a third of those have a dedicated paediatrician. Decisions around HHFNC were made solely by paediatricians in (75%) of the cases, mostly at hospitals with no HDU compared to those with dedicated HDUs (70.3% VS 36.6%, 95%CI:22.6%-50.4%, P< .001). Most respondents (72%) agreed that HHFNC is either the same or superior to nasal Continuous Positive Airway Pressure therapy (nCPAP). Failure rate while on HHFNC was identified as the most important outcome measure in any future research followed by the length of need for HHFNC support (37.1%, and 28% respectively). Conclusion: This is the first and largest national survey to study HHFNC on the paediatric wards. Respondents showed support for developing a paediatric-specific national guidance on the use of HHFNC on the wards. Our list of defined research priorities may help guide further collaborative research efforts in this field.
Benefit of dosimetry distribution for patients with multiple brain metastases from non-small cell lung cancer by Cyberknife Stereotactic radiosurgery (SRS) system
Authors: YU Xuyao , Wang Yuwen , Yuan Zhiyong , Yu Hui , Song Yongchun , Zhao Lujun , Wang Ping 
Published: January 2020

Abstract
Background: To pursue high precision in tumor and steeper dose fall-off in healthy tissues of brain metastases stereotactic radiosurgery (SRS), this study investigated an opitimized planning by comparison only one multiple-lesions-plan (MLP) and multiple single-lesion-plans (SLP) in the treatment of brain metastases using Cyberknife (CK) Robotic Radiosurgery System. Methods : Fifty non-small cell lung cancer (NSCLC) patients (28 males and 22 females) with 2-4 multiple brain metastases were retrospectively replanned with 12 to 32 Gy prescription dose in 1 to 3 fractions. Two different clinical SRS plans (SLP and MLP) for the same patients were generated, under the same collimator and prescription isodose line (62-68%) by CK Multiplan System. Both the SLP and MLP were able to get ＞95% PTV volume covered prescription isodose and meet the Timmerman 2011 OAR (brainstem, optic nerve and pituitary) constraints. Resluts: Compared with the SLP, the maximum dose (Dmax) and mean dose (Dmean) of brainstem in the MLP decreased 0.22-3.13% (2.62%) and 2.71-12.56% (5.57%), over all P＜0.05. While the volumes of whole brain minus the tumors received a single dose equivalence of 8-16Gy (V8Gy-V16Gy) could effectively reduce in the MLP. And the treatment time parameters (the total number of beams and monitor units (MU)) of the MLP declined 3.31% and 1.47% (P＜0.05) respectively. Although there were a few differences of conformity index (CI) and homogeneity index (HI) between two treatment plans, it was no statistical significance (P = 2.94 and 1.08＞ 0.05). Conclusion: One multiple-lesions-plan for brain metastases could achieve higher precision in target and lower dose in healthy tissue, while shorten the treatment time and improve the treatment efficiency.
Program on high value cost-conscious education in Intensive Care: Educational program on prediction of outcome and cost awareness on Intensive Care admission
Authors: Wagenberg Linda van , Beurskens Charlotte J. P. , Stegeman Inge , Müller Marcella C. A. 
Published: January 2020

Abstract
Introduction: Intensive Care (ICU) involves extended and long lasting support of vital functions and organs. However, current training programs of ICU residents mainly focus on extended support of vital functions and barely involve training on cost-awareness and outcome. We incorporated an educational program on high-value cost-conscious care for residents and fellows on our ICU and measured the effect of education.
Methods: A cohort study with factorial survey design, in which residents and fellows ICU were asked to evaluate clinical vignettes, was performed on the mixed surgical-medical ICU of the Amsterdam University Medical Centre. Residents were offered an educational program focusing on outcome and costs of ICU care. Before and after the program they filled out a questionnaire, which consisted of 23 vignettes, in which known predictors of outcome of community acquired pneumonia (CAP), pancreatitis, acute respiratory distress syndrome (ARDS) and cardiac arrest were presented, together with varying patient factors (age, body mass index (BMI), acute kidney failure (AKI) and haemato-oncological malignancy). Participants were asked to either admit the patient or estimate mortality.
Results: BMI, haemato-oncological malignancy and severity of pancreatitis were discriminative for admission to ICU in clinical vignettes on pancreatitis and CAP. After education, only severity of pancreatitis was judged as discriminative. Before the intervention only location of cardiac arrest (in- vs out of hospital) was distinctive for mortality, afterwards this changed to presence of haemato-oncological malignancy.
Conclusion: We incorporated an educational program on high-value cost-conscious care in the training of ICU physicians. Based on our vignette study, we conclude that the improvement of knowledge of costs and prognosis after this program was limited.