bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is the effect of a decision aid in potentially vulnerable parents? Insights from the head CT choice randomized trial
Authors: Skains Rachel M. , Kuppermann Nathan , Homme James L. , Kharbanda Anupam B. , Tzimenatos Leah , Louie Jeffrey P. , Cohen Daniel M. , Nigrovic Lise E. , Westphal Jessica J. , Shah Nilay D. , Inselman Jonathan , Ferrara Michael J. , Herrin Jeph , Montori Victor M. , Hess Erik P. 
Published: November 2019

AbstractObjectiveTo test the hypotheses that use of the Head CT Choice decision aid would be similarly effective in all parent/patient dyads but parents with high (vs low) numeracy experience a greater increase in knowledge while those with low (vs high) health literacy experience a greater increase in trust.MethodsThis was a secondary analysis of a cluster randomized trial conducted at seven sites. One hundred seventy‐two clinicians caring for 971 children at intermediate risk for clinically important traumatic brain injuries were randomized to shared decision making facilitated by the DA (n = 493) or to usual care (n = 478). We assessed for subgroup effects based on patient and parent characteristics, including socioeconomic status (health literacy, numeracy and income). We tested for interactions using regression models with indicators for arm assignment and study site.ResultsThe decision aid did not increase knowledge more in parents with high numeracy (P for interaction [Pint] = 0.14) or physician trust more in parents with low health literacy (Pint = 0.34). The decision aid decreased decisional conflict more in non‐white parents (decisional conflict scale, −8.14, 95% CI: −12.33 to −3.95; Pint = 0.05) and increased physician trust more in socioeconomically disadvantaged parents (trust in physician scale, OR: 8.59, 95% CI: 2.35‐14.83; Pint = 0.04).ConclusionsUse of the Head CT Choice decision aid resulted in less decisional conflict in non‐white parents and greater physician trust in socioeconomically disadvantaged parents. Decision aids may be particularly effective in potentially vulnerable parents.
Ballistic evaluation and damage characterization of 3‐D printed, alumina‐based ceramics for light armor applications
Authors: Jones Tyrone L. , Vargas‐Gonzalez Lionel R. , Scott Brian , Goodman Bill , Becker Benjamin 
Published: November 2019

AbstractThe goal of this work was to present results of mechanical characterization and ballistic investigation of 3‐D printed alumina (Al2O3)‐based armor plates, manufactured using two additive manufacturing‐based methods: pressurized spray deposition (PSD) and direct ink write (DIW), to determine the maturity of these additive‐based processes against the industry standard process. The DIW plates exhibited superior hardness, flexural strength, and density compared to the PSD plates, and in many respects, even eclipsed some of the properties of the commercial isopressed (IP) material. Plates (90 mm × 90 mm × 8 mm) of these composition were manufactured for ballistic analysis in accordance with established ballistic characterization procedures, using a 50.8‐mm‐thick Aluminum 6061 plate as backing and witness plates in the case of penetration or deformation. Six alumina plates were examined ballisitically (one shot per plate) against the 12.7 mm APM2 projectile (45.9 g) at an impact velocity of 840 m/second. The plates that were manufactured using the DIW method provided a higher impact resistance than the PSD method, however, both did not perform as well as the traditionally processed IP material, due to the presence of defects introduced due to the printing processes.
Inactivation of bacterial endospores on surfaces by plasma processed air
Authors: Kramer B. , Hasse D. , Guist S. , Schmitt-John T. , Muranyi P. 
Published: November 2019

Abstract

Aims
In case of biological hazards and pandemics, personal protective equipment of rescue forces is currently manually decontaminated with harmful disinfectants, primarily peracetic acid. To overcome current drawbacks regarding supply, handling and disposal of chemicals, the use of plasma processed air (PPA) represents a promising alternative for surface decontamination on site. In this study, the sporicidal efficiency of a portable plasma system, designed for field applications, was evaluated.

Methods and Results
The developed plasma device is based on a dielectric barrier discharge (DBD) and operated with ambient air as process gas. PPA from the plasma nozzle was flushed into a treatment chamber (volume: 300 l) and bacterial endospores (Bacillus subtilis and Bacillus atrophaeus) dried on different surfaces were treated under variable conditions. Reductions in spores by more than 4 log10 were found within 3 min of PPA exposure. However, the presence of endospores in agglomerates or in an organic matrix as well as the complexity of the respective surface microstructure negatively affected the inactivation efficiency. When endospores were embedded in a dried protein matrix, mechanical wiping with swabs during exposure to PPA increased the inactivation effect significantly. Gaseous ozone alone did not provide a sporicidal effect. Significant spore inactivation was only obtained when water vapour was injected into the PPA stream.

Conclusion
The results show that endospores dried on surfaces can be reduced by several orders of magnitude within few minutes in a treatment chamber which is flushed with PPA from of a DBD plasma nozzle.

Significance and Impact of the Study
Plasma processed air generated on site by DBD plasma nozzles could be a suitable alternative for the disinfection of various surfaces in closed rooms.
Production of bioactive recombinant human myeloid‐derived growth factor in Escherichia coli and its mechanism on vascular endothelial cell proliferation
Authors: Zhao Longwei , Feng Shuang , Wang Shen , Fan Miaojuan , Jin Wei , Li Xianjing , Wang Chen , Yang Yong 
Published: November 2019

AbstractMyeloid‐derived growth factor (MYDGF) is a novel protein secreted by bone marrow cells that features important physiological functions. In recent years, MYDGF has gained considerable interest due to their extensive beneficial effect on cardiac repair and protects cardiomyocytes from cell death. However, its precise molecular mechanisms have not been well elucidated. The purpose of this study was to produce sufficient amount of biologically active recombinant human (rh) MYDGF more economically and effectively by using in vitro molecular cloning techniques to study its clinical application. The prokaryotic expression system of Escherichia coli was established for the preparation of rhMYDGF. Finally, a large amount of high biologically active and purified form of recombinant protein was obtained. Moreover, we investigated the potential mechanism of rhMYDGF‐mediated proliferation and survival in human coronary artery endothelial cells (HCAECs). Mechanistically, the results suggested that MAPK/STAT3 and the cyclin D1 signalling pathways are indispensable for rhMYDGF‐mediated HCAEC proliferation and survival. Therefore, this study successfully established a preparation protocol for biologically active rhMYDGF and it may be a most economical way to produce high‐quality active rhMYDGF for future clinical application.
CD8+ T cells exhaustion induced by myeloid‐derived suppressor cells in myelodysplastic syndromes patients might be through TIM3/Gal‐9 pathway
Authors: Tao Jinglian , Han Dong , Gao Shan , Zhang Wei , Yu Hong , Liu Pei , Fu Rong , Li Lijuan , Shao Zonghong 
Published: November 2019

AbstractCD8+ T cells play a central role in antitumour immunity, which often exhibit ‘exhaustion’ in the setting of malignancy and chronic viral infection due to T cell immunoglobulin and mucin domain 3 (TIM3) and myeloid‐derived suppressor cells (MDSCs). Our team previously found that overactive MDSCs and exhausted TIM3+CD8+ T cells were observed in myelodysplastic syndromes (MDS) patients. However, it is not obvious whether MDSCs suppress CD8+ T cells through TIM3/Gal‐9 pathway. Here, Gal‐9, as the ligand of TIM3, was overexpressed in MDSCs. The levels of Gal‐9 in bone marrow supernatants, serum and culture supernatants of MDSCs from MDS patients were elevated. CD8+ T cells from MDS or normal controls produced less perforin and granzyme B and exhibited increased early apoptosis after co‐culture with MDSCs from MDS. Meanwhile, the cytokines produced by CD8+ T cells could be partially restored by TIM3/Gal‐9 pathway inhibitors. Furthermore, CD8+ T cells produced less perforin and granzyme B after co‐culture with excess exogenous Gal‐9, and the function of CD8+ T cells was similarly restored by TIM3/Gal‐9 pathway inhibitors. Expression of Notch1, EOMES (associated with perforin and granzyme B secretion), p‐mTOR and p‐AKT (associated with cell proliferation) was decreased in CD8+ T cells from MDS after co‐culture with excess exogenous Gal‐9. These suggested that MDSCs might be the donor of Gal‐9, and TIM3/Gal‐9 pathway might be involved in CD8+ T cells exhaustion in MDS, and that TIM3/Gal‐9 pathway inhibitor might be the promising candidate for target therapy of MDS in the future.
Opportunistic invasive fungal disease in patients with type 2 diabetes mellitus from Southern China: Clinical features and associated factors
Authors: Lao Minxi , Li Chen , Li Jin , Chen Dubo , Ding Meilin , Gong Yingying 
Published: November 2019

AbstractAims/IntroductionA retrospective study was carried out to investigate the clinical characteristics and associated factors for invasive fungal disease in patients with type 2 diabetes mellitus.Materials and MethodsDemographic and clinical data were recorded. Associated factors were analyzed by logistic regression analysis.ResultsInvasive fungal disease was diagnosed in 120 patients with type 2 diabetes mellitus (prevalence, 0.4%). Yeast infection (56/120, 46.7%), including candidiasis (31/56, 55.4%) and cryptococcosis (25/56, 44.6%), was the most common. The urinary tract was mainly involved in candidiasis (12/31, 38.7%). More than half of the cryptococcosis (16/25, 64.0%) presented as pneumonia. Mold infection accounted for 40.8% of the cases, and predominantly involved the lung (34/49, 69.4%). A total of 15 (12.5%) patients had mixed fungal infection. Candida albicans (24/111, 21.6%), Cryptococcus neoformans (19/111, 17.1%) and Aspergillus fumigatus (14/111, 12.6%) were the leading agents. Co‐infection occurred in 58 (48.3%) patients, mainly presenting as pneumonia caused by Gram‐negative bacteria. The inpatient mortality rate of invasive fungal disease was 23.3% (28/120). Glycated hemoglobin levels were higher in non‐survivors than survivors (8.8 ± 2.5 vs 7.7 ± 2.1%, P = 0.02). Anemia (adjusted odds ratio, 3.50, 95% confidence interval 1.95–6.27, P < 0.001), hypoalbuminemia (adjusted odds ratio, 5.42, 95% confidence interval 3.14–9.36, P < 0.001) and elevated serum creatinine (adjusted odds ratio, 2.08, 95% confidence interval 1.07–4.04, P = 0.03) were associated with invasive fungal disease in type 2 diabetes mellitus patients.ConclusionsInvasive fungal disease is a life‐threatening complication in type 2 diabetes mellitus patients. C. a albicans, C. neoformans, and A. fumigatus are the leading agents. Prolonged hyperglycemia results in unfavorable outcomes. Correction of anemia and hypoalbuminemia might improve prognosis.
No evidence that Y‐chromosome differentiation affects male fitness in a Swiss population of common frogs
Authors: Veltsos Paris , Rodrigues Nicolas , Studer Tania , Ma Wen‐Juan , Sermier Roberto , Leuenberger Julien , Perrin Nicolas 
Published: November 2019

AbstractThe canonical model of sex‐chromosome evolution assigns a key role to sexually antagonistic (SA) genes on the arrest of recombination and ensuing degeneration of Y chromosomes. This assumption cannot be tested in organisms with highly differentiated sex chromosomes, such as mammals or birds, owing to the lack of polymorphism. Fixation of SA alleles, furthermore, might be the consequence rather than the cause of recombination arrest. Here we focus on a population of common frogs (Rana temporaria) where XY males with genetically differentiated Y chromosomes (nonrecombinant Y haplotypes) coexist with both XY° males with proto‐Y chromosomes (only differentiated from X chromosomes in the immediate vicinity of the candidate sex‐determining locus Dmrt1) and XX males with undifferentiated sex chromosomes (genetically identical to XX females). Our study finds no effect of sex‐chromosome differentiation on male phenotype, mating success or fathering success. Our conclusions rejoin genomic studies that found no differences in gene expression between XY, XY° and XX males. Sexual dimorphism in common frogs might result more from the differential expression of autosomal genes than from sex‐linked SA genes. Among‐male variance in sex‐chromosome differentiation seems better explained by a polymorphism in the penetrance of alleles at the sex locus, resulting in variable levels of sex reversal (and thus of X‐Y recombination in XY females), independent of sex‐linked SA genes.
Psychometric properties of the SCREESCO questionnaire used in a colorectal cancer screening programme—A Rasch analysis
Authors: Jervaeus Anna , Fritzell Kaisa , Hultcrantz Rolf , Wengström Yvonne , Kottorp Anders 
Published: November 2019

AbstractIntroductionColorectal cancer (CRC) is one of the most common cancer diagnoses among both sexes. Sweden has not yet implemented any CRC screening programme, but a study, Screening of Swedish Colons (SCREESCO), is ongoing. The movement within the health care sector towards a more participatory perspective has led to the increased importance of shared decision making (SDM), and this is suggestively applied when deciding upon screening participation. There is no Swedish questionnaire for assessing the level of SDM in relation to CRC screening. Therefore, the CRC screening module of the National Survey of Medical Decisions was translated and culturally adapted into a Swedish context: the SCREESCO questionnaire.AimThe SCREESCO questionnaire requires further evaluation, and therefore, the aim, by using the Rasch approach, was to evaluate the psychometric properties of the SCREESCO questionnaire.MethodsA Rasch partial credit model was chosen to investigate the psychometric properties. The sample consisted of individuals invited to the SCREESCO programme, who have answered the SCREESCO questionnaire.ResultsRating scale structures indicated stability for the response structure used. Satisfactory evidence for validity of internal structure was also shown for the whole questionnaire and two of three concepts/subscales, after deletion of a few items. Validity in response processes indicated acceptable, or close to acceptable, findings, while the results for unidimensionality and differential item functioning (DIF) were somewhat mixed. Separation index revealed less satisfactory results, both for the whole questionnaire and the concepts/subscales.ConclusionThis Rasch analysis of the SCREESCO questionnaire revealed that the questionnaire in its current form has difficulties to assess the level of SDM in relation to CRC screening. The achieved results will guide further evaluation and development with the long‐term goal of having a Swedish questionnaire, to be used in the health care sector, assessing the level of SDM in relation to CRC screening.
One‐step fiber post cementation and core build‐up in endodontically treated tooth: A clinical case report
Authors: Reis José Mauricio dos Santos Nunes , Oliveira Carlos R. de Moura , Reis Erica G. J. , Mascaro Bruno A. , Abi‐Rached Filipe de Oliveira 
Published: November 2019

AbstractObjectiveThis clinical case report addresses the step‐by‐step of the application of a core‐and‐post system that uses a single resin composite material to fiber post cementation and core build‐up in a maxillary left central incisor.Clinical considerationsThe literature reports several materials and methods for the restoration of endodontically treated teeth with coronal destruction that require an intra‐radicular fiber post for the core build‐up. The present case report describes a core‐and‐post or “monoblock” technique. A dual resin composite (Core‐X Flow; Dentsply DeTrey) highly filled material and cement was used for luting the fiber post (Blue X‐Post) and build‐up the core structure in an easy application.ConclusionsThe “core‐and‐post” technique that uses a single material system protocol minimizes the material interfaces, steps of procedures, and chair‐time in comparison to conventional techniques.Clinical SignificanceThe use of different materials for post cementation and core build‐up requires more steps, which increases the chair‐time and number of interfaces among the materials. Since the “monoblock” technique uses only one material, it can streamline the clinical procedures, thus, saving time and materials. Moreover, techniques based on core‐and‐post systems are easily applied, versatile, and esthetics, and can be applicable to posterior and anterior teeth.
Long‐term outcomes of thalidomide in pediatric Crohn's disease
Authors: Wang Lin , Xue Aijuan , Zheng Cuifang , Zhou Ying , Wang Yuhuan , Huang Ying 
Published: November 2019

AbstractBackground and AimIn this largest pediatric cohort to date in Asian population, we aimed to report our long‐term real‐life experience with thalidomide treatment in pediatric Crohn's disease (CD).MethodsA retrospective single‐center analysis of pediatric CD patients treated by thalidomide was conducted. The clinical characteristics and outcomes were extracted. Primary outcomes were clinical response and remission rate at different time points, especially comparing the difference between monogenic and non‐monogenic mutation patients. We also evaluated the long‐term safety of thalidomide.ResultsA total of 62 patients met the inclusion criteria. The median follow‐up period was 30.5 months. Among all, 19 patients (30.6%) were diagnosed with monogenic mutation during treatment. Clinical remission rate was 53.2% (33/62) at 6 months, 54.8% (34/62) at 12 months, and 33.9% (21/62) at the end of follow‐up. Clinical remission rates between non‐monogenic and monogenic groups at the end were statistically different (44.2% [19/43] vs 10.5% [2/19], P < 0.05). At 12 months, 66.7% (30/45) were with normalized C‐reactive protein level. Most patients (95.4%, 21/22) discontinued steroids with a median time of 4.4 months. Twelve patients relapsed, but no risk factor was identified to be significantly associated with relapse. A total of 45.2% (28/62) patients experienced an adverse event, in which 22 patients stopped thalidomide due to safety concern. Cumulative dose was not associated with abnormal electromyography but with the occurrence of adverse events.ConclusionsThalidomide was clinically efficacious and safe among pediatric CD. Our results suggest that it is an alternative therapy in monogenic mutation patients.
Progression of pancreatic cystic lesions without any risk features is associated with initial cyst size and obesity
Authors: Park Hye Won , Lee Jong Soo , Park Seo Young , Kim Tae Hyup , Lee Ji Young , Koo Ja Eun , Bae Suh Eun , Choe Jaewon , Chang Hye‐Sook , Park Do Hyun , Bae Inyoung , Park Sungwon 
Published: November 2019

AbstractBackground and AimThe clinical significance of incidental pancreatic cystic lesions (PCLs) remains unclear in those that are not accompanied by worrisome features or high‐risk stigmata. We aimed to investigate the natural course of PCLs without any risk features and examine the clinical factors associated with their progression.MethodsWe conducted a retrospective cohort study of 427 patients with PCLs, which were incidentally detected by computed tomography between January 2003 and December 2012. Progression of PCLs without any risk features and the clinical factors associated with their progression were investigated. The length of time to significant growth was also evaluated.ResultsNinety‐four (22.0%) of the 427 patients had asymptomatic PCLs that showed significant growth after a median surveillance period of 5.3 years; approximately 27.7% of the patients showed significant size changes in the first 5 years, while the remaining 72.3% showed significant changes after 5 years. The cumulative rate of patients with significant growth was associated with initial cyst size and high body mass index. In the growth group, additional treatments were required for 12 patients, one of whom developed malignancy. Four patients in the stable group underwent additional treatment and showed no malignant change.ConclusionsOne‐fifth of the asymptomatic PCLs significantly increased in size after a long‐term follow‐up period, which was associated with initial cyst size and obesity. The size of PCLs mostly increased after 5 years; although the malignancy risk of PCLs was low, it was still a concern.
Automatic detection of blood content in capsule endoscopy images based on a deep convolutional neural network
Authors: Aoki Tomonori , Yamada Atsuo , Kato Yusuke , Saito Hiroaki , Tsuboi Akiyoshi , Nakada Ayako , Niikura Ryota , Fujishiro Mitsuhiro , Oka Shiro , Ishihara Soichiro , Matsuda Tomoki , Nakahori Masato , Tanaka Shinji , Koike Kazuhiko , Tada Tomohiro 
Published: November 2019

AbstractBackground and AimDetecting blood content in the gastrointestinal tract is one of the crucial applications of capsule endoscopy (CE). The suspected blood indicator (SBI) is a conventional tool used to automatically tag images depicting possible bleeding in the reading system. We aim to develop a deep learning‐based system to detect blood content in images and compare its performance with that of the SBI.MethodsWe trained a deep convolutional neural network (CNN) system, using 27 847 CE images (6503 images depicting blood content from 29 patients and 21 344 images of normal mucosa from 12 patients). We assessed its performance by calculating the area under the receiver operating characteristic curve (ROC‐AUC) and its sensitivity, specificity, and accuracy, using an independent test set of 10 208 small‐bowel images (208 images depicting blood content and 10 000 images of normal mucosa). The performance of the CNN was compared with that of the SBI, in individual image analysis, using the same test set.ResultsThe AUC for the detection of blood content was 0.9998. The sensitivity, specificity, and accuracy of the CNN were 96.63%, 99.96%, and 99.89%, respectively, at a cut‐off value of 0.5 for the probability score, which were significantly higher than those of the SBI (76.92%, 99.82%, and 99.35%, respectively). The trained CNN required 250 s to evaluate 10 208 test images.ConclusionsWe developed and tested the CNN‐based detection system for blood content in CE images. This system has the potential to outperform the SBI system, and the patient‐level analyses on larger studies are required.