bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic stratification of pathological node-negative lung adenocarcinoma by carcinoembryonic antigen level
Authors: Batmunkh Khashchuluun , Cho Sukki , Yum Sungwon , Kim Kwhanmien , Jheon Sanghoon 
Published: February 2020

Abstract

OBJECTIVES
Carcinoembryonic antigen (CEA) is a well-known tumour marker for lung adenocarcinoma (AC). This study was conducted to evaluate the clinical characteristics and prognosis of patients with pathological node-negative lung AC who have a high preoperative level of CEA.

METHODS
Among 2124 patients with lung AC between 2003 and 2016, 858 patients were enrolled. CEA levels were dichotomized as normal (≤5 ng/ml) or high (&gt;5 ng/ml). According to the levels of CEA between 6 and 12 months after surgery, patients were divided into a normalized and a remained-high group. Propensity score matching was used to compare 80 patients without adjuvant chemotherapy (ACT) with 39 patients with ACT. Kaplan–Meier survival analysis with the log-rank test and Cox proportional hazards regression analysis were performed for recurrence-free survival (RFS) and overall survival (OS).

RESULTS
The multivariable analysis showed that high maximum standardized uptake value and T2 stage were more common in patients with high levels of CEA. The median follow-up period was 52.8 months (range 6–169 months). The 5-year RFS and OS rates were 89.3% and 68.9% and 92.8% and 77.2% in normal patients and patients with high levels of CEA, respectively, with a statistically significant difference. The 5-year RFS was 79.4% and 39.2% in the normalized and remained-high groups after surgery, respectively (P = 0.011). The 5-year RFS and OS rates were 68.9% and 62.2% and 80.1% and 82.9% in patients without and with ACT, respectively. After propensity score matching, RFS was not significantly different between patients without and with ACT (P = 0.500); however, OS was significantly better in patients with ACT than in those without ACT (P = 0.001).

CONCLUSIONS
The clinicopathological characteristics, RFS and OS of patients with lung AC might be well discriminated by preoperative CEA levels. In patients with node-negative disease and high CEA levels, those with normalized CEA levels had a significantly better prognosis than those with persistently high CEA levels.
Upregulation of TRPC6 Mediated by PAX6 Hypomethylation Is Involved in the Mechanical Allodynia Induced by Chemotherapeutics in Dorsal Root Ganglion
Authors: Zhang Xiang-Zhong , Luo De-Xing , Bai Xiao-Hui , Ding Huan-Huan , Liu Meng , Deng Jie , Mai Jing-Wen , Yang Yan-Ling , Zhang Su-Bo , Ruan Xiang-Cai , Zhang Xue-Qin , Xin Wen-Jun , Xu Ting 
Published: February 2020

AbstractBackgroundAlthough the action mechanism of antineoplastic agents is different, oxaliplatin, paclitaxel, or bortezomib as first-line antineoplastic drugs can induce painful neuropathy. In rodents, mechanical allodynia is a common phenotype of painful neuropathy for 3 chemotherapeutics. However, whether there is a common molecular involved in the different chemotherapeutics-induced painful peripheral neuropathy remains unclear.MethodsMechanical allodynia was tested by von Frey hairs following i.p. injection of vehicle, oxaliplatin, paclitaxel, or bortezomib in Sprague-Dawley rats. Reduced representation bisulfite sequencing and methylated DNA immunoprecipitation were used to detect the change of DNA methylation. Western blot, quantitative polymerase chain reaction, chromatin immunoprecipitation, and immunohistochemistry were employed to explore the molecular mechanisms.ResultsIn 3 chemotherapeutic models, oxaliplatin, paclitaxel, or bortezomib accordantly upregulated the expression of transient receptor potential cation channel, subfamily C6 (TRPC6) mRNA and protein without affecting the DNA methylation level of TRPC6 gene in DRG. Inhibition of TRPC6 by using TRPC6 siRNA (i.t., 10 consecutive days) relieved mechanical allodynia significantly following application of chemotherapeutics. Furthermore, the downregulated recruitment of DNA methyltransferase 3 beta (DNMT3b) at paired box protein 6 (PAX6) gene led to the hypomethylation of PAX6 gene and increased PAX6 expression. Finally, the increased PAX6 via binding to the TPRC6 promoter contributes to the TRPC6 increase and mechanical allodynia following chemotherapeutics treatment.ConclusionsThe TRPC6 upregulation through DNMT3b-mediated PAX6 gene hypomethylation participated in mechanical allodynia following application of different chemotherapeutic drugs.
Patient-reported outcome measures for inguinal hernia repair are insufficiently validated: a systematic review
Authors: Gram-Hanssen Anders , Tolstrup Anders , Zetner Dennis , Rosenberg Jacob 
Published: February 2020

Abstract

Purpose
To systematically assess the validity of patient-reported outcome measures (PROMs) for patients undergoing inguinal hernia repair.

Data sources
A systematic review was performed according to the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) guideline for systematic reviews of PROMs. PubMed, EMBASE and PsycINFO were consulted.

Study selection
Only studies explicitly aimed at validation of PROMs specific for patients with inguinal hernia were included.

Data extraction
Data regarding measurement properties of PROMs were extracted from the included studies. Each study was critically assessed for methodological quality and each PROM was evaluated for sufficient measurement properties.

Results of data synthesis
We included 15 studies, covering 11 different PROMs. The Carolinas Comfort Scale was the most frequently investigated PROM, being covered in five of the included publications. The included PROMs were evaluated according to nine different measurement properties, of which internal consistency and construct validity were the most frequently assessed. Evidence regarding content validity and structural validity was universally inadequate, according to the criteria for good measurement properties, as defined by the COSMIN.

Conclusion
Based on the current evidence, it is not possible to formulate recommendations for application of PROMs for patients undergoing inguinal hernia repair. Further validation of the included PROMs is necessary especially regarding content validity and structural validity.
Understanding unwarranted variation in clinical practice: a focus on network effects, reflective medicine and learning health systems
Authors: Atsma Femke , Elwyn Glyn , Westert Gert 
Published: February 2020

Abstract
In the past decades, extensive research has been performed on the phenomenon of unwarranted clinical variation in clinical practice. Many studies have been performed on signaling, describing and visualizing clinical variation. We argue that it is time for next steps in practice variation research. In addition to describing and signaling variation patterns, we argue that a better understanding of causes of variation should be gained. Moreover, target points for improving and decreasing clinical variation should be created. Key elements in this new focus should be research on the complex interaction of networks, reflective medicine, patient beliefs and objective criteria for treatment choices. By combining these different concepts, alternative research objectives and new targets for improving and reducing unwarranted variation may be defined. In this perspective, we reflect on these concepts and propose target points for future research.
In vitro synergy of ceftolozane/tazobactam in combination with fosfomycin or aztreonam against MDR Pseudomonas aeruginosa
Authors: Cuba Gabriel T , Rocha-Santos Gerlan , Cayô Rodrigo , Streling Ana Paula , Nodari Carolina S , Gales Ana C , Pignatari Antonio C C , Nicolau David P , Kiffer Carlos R V 
Published: February 2020

Abstract

Objectives
Carbapenem-resistant Pseudomonas aeruginosa (CR-PSA) imposes great limitations on empirical therapeutic choices, which are further complicated by metallo-β-lactamase production. This study evaluated in vitro antimicrobial synergy of ceftolozane/tazobactam in combination with aztreonam and fosfomycin against MDR PSA.

Methods
MICs were determined by broth microdilution and gradient strips. The effect of ceftolozane/tazobactam+aztreonam and ceftolozane/tazobactam+fosfomycin combinations were tested against 27 MDR PSA isolates carrying blaSPM-1 (n = 13), blaIMP (n = 4), blaVIM (n = 3), blaGES-1 (n = 2) and blaCTX-M-like (n = 2), and 3 isolates with no acquired β-lactamase production detected by gradient diffusion strip crossing (GDSC). Six genetically unrelated SPM-1-producing isolates were also evaluated by time–kill analysis (TKA).

Results
All CR-PSA isolates harbouring blaSPM-1, blaGES-1 and blaIMP-1 were categorized as resistant to ceftolozane/tazobactam, meropenem and fosfomycin, with 70% being susceptible to aztreonam. Synergism for ceftolozane/tazobactam+fosfomycin and ceftolozane/tazobactam+aztreonam combinations was observed for 88.9% (24/27) and 18.5% (5/27) of the isolates by GDSC, respectively. A 3- to 9-fold reduction in ceftolozane/tazobactam MICs was observed, depending on the combination. Ceftolozane/tazobactam+fosfomycin was synergistic by TKA against one of six SPM-1-producing isolates, with additional non-synergistic bacterial density reduction for another isolate. Aztreonam peak concentrations alone demonstrated a ≥3 log10 cfu/mL reduction against all six isolates, but all strains were within the susceptible range for the drug. No antagonism was observed.

Conclusions
In the context of increasing CR-PSA and the genetic diversity of resistance mechanisms, new combinations and stewardship strategies may need to be explored in the face of increasingly difficult to treat pathogens.
“How did you get to this number?” Stakeholder needs for implementing predictive analytics: a pre-implementation qualitative study
Authors: Benda Natalie C , Das Lala Tanmoy , Abramson Erika L , Blackburn Katherine , Thoman Amy , Kaushal Rainu , Zhang Yongkang , Ancker Jessica S 
Published: February 2020

AbstractObjectivePredictive analytics are potentially powerful tools, but to improve healthcare delivery, they must be carefully integrated into healthcare organizations. Our objective was to identify facilitators, challenges, and recommendations for implementing a novel predictive algorithm which aims to prospectively identify patients with high preventable utilization to proactively involve them in preventative interventions.Materials and MethodsIn preparation for implementing the predictive algorithm in 3 organizations, we interviewed 3 stakeholder groups: health systems operations (eg, chief medical officers, department chairs), informatics personnel, and potential end users (eg, physicians, nurses, social workers). We applied thematic analysis to derive key themes and categorize them into the dimensions of Sittig and Singh’s original sociotechnical model for studying health information technology in complex adaptive healthcare systems. Recruiting and analysis were conducted iteratively until thematic saturation was achieved.ResultsForty-nine interviews were conducted in 3 healthcare organizations. Technical components of the implementation (hardware and software) raised fewer concerns than alignment with sociotechnical factors. Stakeholders wanted decision support based on the algorithm to be clear and actionable and incorporated into current workflows. However, how to make this disease-independent classification tool actionable was perceived as a challenge, and appropriate patient interventions informed by the algorithm appeared likely to require substantial external and institutional resources. Stakeholders also described the criticality of trust, credibility, and interpretability of the predictive algorithm.ConclusionsAlthough predictive analytics can classify patients with high accuracy, they cannot advance healthcare processes and outcomes without careful implementation that takes into account the sociotechnical system. Key stakeholders have strong perceptions about facilitators and challenges to shape successful implementation.
A systematic review of the impact of health information technology on nurses’ time
Authors: Moore Esther C , Tolley Clare L , Bates David W , Slight Sarah P 
Published: February 2020

Abstract

Objective
Nursing time represents one of the highest costs for most health services. We conducted a systematic review of the literature on the impact of health information technology on nurses’ time.

Materials and Methods
We followed PRISMA guidelines and searched 6 large databases for relevant articles published between Jan 2004 and December 2019. Two authors reviewed the titles, abstracts, and full texts. We included articles that included a comparison group in the design, measured the time taken to carry out documentation or medication administration, documented the quantitative estimates of time differences between the 2, had nurses as subjects, and was conducted in either a care home, hospital, or community clinic.

Results
We identified a total of 1647 articles, of which 33 met our inclusion criteria. Twenty-one studies reported the impact of 12 different health information technology (HIT) implementations on nurses’ documentation time. Weighted averages were calculated for studies that implemented barcode medication administration (BCMA) and 2 weighted averages for those that implemented EHRs, as these studies used different sampling units; both showed an increase in the time spent in documentation (+22% and +46%). However, the time spent carrying out medication administration following BCMA implementation fell by 33% (P &lt; .05). HIT also caused a redistribution of nurses’ time which, in some cases, was spent in more “value-adding” activities, such as delivering direct patient care as well as inter-professional communication.

Discussion and Conclusions
Most of the HIT systems increased nursing documentation time, although time fell for medication administration following BCMA. Many HIT systems also resulted in nurses spending more time in direct care and “value-adding” activities.
Prediction of hydrocarbon reservoirs within coal-bearing formations
Authors: He Faqi , Rao Ying , Wang Weihong , Wang Yanghua 
Published: February 2020

Abstract
This paper presents a case study on the prediction of hydrocarbon reservoirs within coal-bearing formations of the Upper Palaeozoic. The target reservoirs are low-permeability low-pressure tight-sandstone reservoirs in the Daniudi Gas Field, Ordos Basin, China. The prime difficulty in reservoir prediction is caused by the interbedding coal seams within the formations, which generate low-frequency strong-amplitude reflections in seismic profiles. To tackle this difficulty, first, we undertook a careful analysis regarding the stratigraphy and lithology of these coal-bearing formations within the study area. Then, we conducted a geostatistical inversion using 3D seismic data and obtained reservoir parameters including seismic impedance, gamma ray, porosity and density. Finally, we carried out a reservoir prediction in the coal-bearing formations, based on the reservoir parameters obtained from geostatistical inversion and combined with petrophysical analysis results. The prediction result is accurately matched with the actual gas-test data for the targeted four segments of the coal-bearing formations.
Bureaucratic Competence and Procurement Outcomes
Authors: Decarolis Francesco , Giuffrida Leonardo M , Iossa Elisabetta , Mollisi Vincenzo , Spagnolo Giancarlo 
Published: February 2020

Abstract
To what extent does a more competent public bureaucracy contribute to better economic outcomes? We address this question in the context of the US federal procurement of services and works, by combining contract-level data on procurement performance and bureau-level data on competence and workforce characteristics. We use the death occurrences of specific types of employees as instruments and find that an increase in bureau competence causes a significant and economically important reduction in (a) time delays, (b) cost overruns, and (c) number of renegotiations. Cooperation within the office appears to be a key driver of the findings. (JEL D73, H11, H57, L26).
CD4/CD8 Ratio Recovery of Children and Adolescents Living With HIV With Virological Suppression: A Prospective Cohort Study
Authors: Han Win Min , Apornpong Tanakorn , Handoko Ryan , Jantarabenjakul Watsamon , Gatechompol Sivaporn , Ubolyam Sasiwimol , Kerr Stephen J , Avihingsanon Anchalee , Ruxrungtham Kiat , Phanuphak Praphan , Puthanakit Thanyawee 
Published: February 2020

Abstract

Background
There are limited data on immune restoration of young adults living with virologically suppressed human immunodeficiency virus (HIV). We investigated recovery rates of CD4/CD8 ratio among Thai children and adolescents after they initiated combination antiretroviral therapy (cART).

Methods
Children and adolescents who started cART at age of ≥ 5 years were eligible in this study if they achieved HIV RNA &lt; 50 copies/mL and had a CD4/CD8 ratio &lt; 0.8 at the time of virological suppression. Normalization of CD4/CD8 ratio was defined as 2 consecutive values ≥ 1. Using group-based trajectory analysis, low- and high-recovery groups were identified in terms of CD4/CD8 ratio recovery.

Results
One hundred thirty-eight children and adolescents (101 perinatally infected and 37 behaviorally infected) with median age of 10.6 years at cART treatment initiation were included. After 559 person-years of follow-up (PYFU), overall incidence rate of CD4/CD8 ratio normalization was 4.1 (95% confidence interval, 2.7–6.2) per 100 PYFU. The probabilities of normalization at 2, 5, and 10 years after HIV suppression were 5.2%, 22.6%, and 35.6%, respectively. The low-recovery group had lower median pre-cART CD4 count (146 vs 304 cells/μL, P = .01), pre-cART CD4/CD8 ratio (0.15 vs 0.23, P = .03) and at first viral suppression (0.38 vs 0.65, P = .0001), compared to the high-recovery group.

Conclusions
Less than half of children and adolescents living with HIV on cART with viral suppression had CD4/CD8 ratio normalization. Those with older age at cART initiation, lower pre-cART CD4 count, or CD4/CD8 ratio had slower ratio recovery. Long-term prognoses such as ongoing immune activation and clinical outcomes among children and adolescents on suppressive cART without CD4/CD8 ratio normalization need to be further investigated.
Misexpression of a transcriptional repressor candidate provides a molecular mechanism for the suppression of awns by Tipped 1 in wheat
Authors: Würschum Tobias , Jähne Felix , Phillips Andrew L , Langer Simon M , Longin C Friedrich H , Tucker Matthew R , Leiser Willmar L 
Published: February 2020

AbstractAwns are bristle-like structures formed at the tip of the lemma on the florets of some cereal grasses. Wild-type wheat is awned, but awnletted and awnless variants have been selected and nowadays all forms are cultivated. In this study, we dissected the genetic control underlying variation of this characteristic feature by association mapping in a large panel of 1110 winter wheat cultivars of worldwide origin. We identified the B1 (Tipped 1) locus on chromosome 5A as the major determinant of awnlessness globally. Using a combination of fine-mapping and expression analysis, we identified a putative C2H2 zinc finger protein with an EAR domain, characteristic of transcriptional repressors, as a likely candidate for Tipped 1. This gene was found to be up-regulated in awnless B1 compared with awned b1 plants, indicating that misexpression of this transcriptional regulator may contribute to the reduction of awn length in B1 plants. Taken together, our study provides an entry point towards a better molecular understanding of the evolution of morphological features in cereals through selection and breeding.
Crosstalk between heterotrimeric G protein-coupled signaling pathways and WRKY transcription factors modulating plant responses to suboptimal micronutrient conditions
Authors: Wu Ting-Ying , Krishnamoorthi Shalini , Goh Honzhen , Leong Richalynn , Sanson Amy Catherine , Urano Daisuke 
Published: February 2020

Abstract
Nutrient stresses induce foliar chlorosis and growth defects. Here we propose heterotrimeric G proteins as signaling mediators of various nutrient stresses, through meta-analyses of &gt;20 transcriptomic data sets associated with nutrient stresses or G protein mutations. Systematic comparison of transcriptomic data yielded 104 genes regulated by G protein subunits under common nutrient stresses: 69 genes under Gβ subunit (AGB1) control and 35 genes under Gα subunit (GPA1) control. Quantitative real-time PCR experiments validate that several transcription factors and metal transporters changed in expression level under suboptimal iron, zinc, and/or copper concentrations, while being misregulated in the Arabidopsis Gβ-null (agb1) mutant. The agb1 mutant had altered metal ion profiles and exhibited severe growth arrest under zinc stress, and aberrant root waving under iron and zinc stresses, while the Gα-null mutation attenuated leaf chlorosis under iron deficiency in both Arabidopsis and rice. Our transcriptional network analysis inferred computationally that WRKY-family transcription factors mediate the AGB1-dependent nutrient responses. As corroborating evidence of our inference, ectopic expression of WRKY25 or WRKY33 rescued the zinc stress phenotypes and the expression of zinc transporters in the agb1-2 background. These results, together with Gene Ontology analyses, suggest two contrasting roles for G protein-coupled signaling pathways in micronutrient stress responses: one enhancing general stress tolerance and the other modulating ion homeostasis through WRKY transcriptional regulatory networks. In addition, tolerance to iron stress in the rice Gα mutant provides an inroad to improve nutrient stress tolerance of agricultural crops by manipulating G protein signaling.
Research trends on big data domain using text mining algorithms
Authors: Jalali Seyed Mohammad Jafar , Park Han Woo , Vanani Iman Raeesi , Pho Kim-Hung 
Published: February 2020

Abstract
Most of the theories have considered big data as an interesting subject in the information technology domain. Big data is a term for describing huge databases that traditional methods in data processing suffer from analyzing them. Recognizing and clustering emerging topics in this area will help researchers whose aim is to work on this interesting subject. Text mining and social network analysis algorithms are utilized for identifying the emerging trends for big data domain. In this study, at first, we gathered the whole papers that are relevant to big data domain and then the word co-occurrence network was created based on the extracted keywords. Then the best clusters were identified and the relationship between keywords was recognized by the association rules technique. In conclusion, some suggestions were mentioned for future studies.