bluuebunny/crossref_metadata_2025_split huggingface dataset:
Managing COVID-19 within and across health systems: why we need performance intelligence to coordinate a global response
Authors: Kringos D. , Carinci F. , Barbazza E. , Bos V. , Gilmore K. , Groene O. , Gulácsi L. , Ivankovic D. , Jansen T. , Johnsen S. P. , de Lusignan S. , Mainz J. , Nuti S. , Klazinga N. ,   on behalf of the HealthPros Network, Baji P. , Brito Fernandes O. , Kara P. , Larrain N. , Meza B. , Murante A. , Pentek M. , Poldrugovac M. , Wang S. , Willmington C. , Yang Y. 
Published: July 2020

Abstract
Background
The COVID-19 pandemic is a complex global public health crisis presenting clinical, organisational and system-wide challenges. Different research perspectives on health are needed in order to manage and monitor this crisis. Performance intelligence is an approach that emphasises the need for different research perspectives in supporting health systems’ decision-makers to determine policies based on well-informed choices. In this paper, we present the viewpoint of the Innovative Training Network for Healthcare Performance Intelligence Professionals (HealthPros) on how performance intelligence can be used during and after the COVID-19 pandemic.

Discussion
A lack of standardised information, paired with limited discussion and alignment between countries contribute to uncertainty in decision-making in all countries. Consequently, a plethora of different non-data-driven and uncoordinated approaches to address the outbreak are noted worldwide. Comparative health system research is needed to help countries shape their response models in social care, public health, primary care, hospital care and long-term care through the different phases of the pandemic. There is a need in each phase to compare context-specific bundles of measures where the impact on health outcomes can be modelled using targeted data and advanced statistical methods. Performance intelligence can be pursued to compare data, construct indicators and identify optimal strategies. Embracing a system perspective will allow countries to take coordinated strategic decisions while mitigating the risk of system collapse.A framework for the development and implementation of performance intelligence has been outlined by the HealthPros Network and is of pertinence. Health systems need better and more timely data to govern through a pandemic-induced transition period where tensions between care needs, demand and capacity are exceptionally high worldwide. Health systems are challenged to ensure essential levels of healthcare towards all patients, including those who need routine assistance.

Conclusion
Performance intelligence plays an essential role as part of a broader public health strategy in guiding the decisions of health system actors on the implementation of contextualised measures to tackle COVID-19 or any future epidemic as well as their effect on the health system at large. This should be based on commonly agreed-upon standardised data and fit-for-purpose indicators, making optimal use of existing health information infrastructures. The HealthPros Network can make a meaningful contribution.
Microglia induce the transformation of A1/A2 reactive astrocytes via the CXCR7/PI3K/Akt pathway in chronic post-surgical pain
Authors: Li Ting , Liu Tongtong , Chen Xuhui , Li Li , Feng Miaomiao , Zhang Yue , Wan Li , Zhang Chuanhan , Yao Wenlong 
Published: July 2020

Abstract
Background
Activated astrocytes play important roles in chronic post-surgical pain (CPSP). Recent studies have shown reactive astrocytes are classified into A1 and A2 phenotypes, but their precise roles in CPSP remain unknown. In this study, we investigated the roles of spinal cord A1 and A2 astrocytes and related mechanisms in CPSP.

Methods
We used a skin/muscle incision and retraction (SMIR) model to establish a rat CPSP model. Microglia, CXCR7, and the phosphoinositide 3-kinase/Akt (PI3K/Akt) signaling pathways were regulated by intrathecal injections of minocycline (a non-specific microglial inhibitor), AMD3100 (a CXCR7 agonist), and LY294002 (a specific PI3K inhibitor), respectively. Mechanical allodynia was detected with von Frey filaments. The changes in microglia, A1 astrocytes, A2 astrocytes, CXCR7, and PI3K/Akt signaling pathways were examined by enzyme-linked immunosorbent assay (ELISA), western blot, and immunofluorescence.

Results
Microglia were found to be activated, with an increase in interleukin-1 alpha (IL-1α), tumor necrosis factor alpha (TNFα), and complement component 1q (C1q) in the spinal cord at an early stage after SMIR. On day 14 after SMIR, spinal cord astrocytes were also activated; these were mainly of the A1 phenotype and less of the A2 phenotype. Intrathecal injection of minocycline relieved SMIR-induced mechanical allodynia and reverted the ratio of A1/A2 reactive astrocytes. The expression of CXCR7 and PI3K/Akt signaling was decreased after SMIR, while they were increased after treatment with minocycline. Furthermore, intrathecal injection of AMD3100 also relieved SMIR-induced mechanical allodynia, reverted the ratio of A1/A2 reactive astrocytes, and activated the PI3K/Akt signaling pathway, similar to the effects produced by minocycline. However, intrathecal injection of AMD3100 did not increase the analgesic effect of minocycline. Last, LY294002 inhibited the analgesic effect and A1/A2 transformation induced by minocycline and AMD3100 after SMIR.

Conclusion
Our results indicated that microglia induce the transformation of astrocytes to the A1 phenotype in the spinal cord via downregulation of the CXCR7/PI3K/Akt signaling pathway during CPSP. Reverting A1 reactive astrocytes to A2 may represent a new strategy for preventing CPSP.
Vitamin D status affects the relationship between lipid profile and high-sensitivity C-reactive protein
Authors: Jin Dan , Zhu Dao-Min , Hu Hong-Lin , Yao Meng-Nan , Yin Wan-Jun , Tao Rui-Xue , Zhu Peng 
Published: July 2020

Abstract
Background
The biological pathways through which vitamin D is involved in the regulation of systemic inflammation remain largely unknown.

Objective
The objective of this study was to evaluate the role of vitamin D status on the relationship between lipid profile and high-sensitivity C-reactive protein (hs-CRP) in pregnant women.

Design
Serum 25-hydroxyvitamin D (25(OH)D), hs-CRP, and indicators of lipid profiles (total cholesterol, TC; triglyceride, TG; high-density lipoprotein cholesterol, HDL-C; low-density lipoprotein cholesterol, LDL-C), were measured in 2479 pregnant women during the second trimester. Potential confounding including maternal sociodemographic characteristics, perinatal health status, diet, and lifestyle was prospectively collected. Multiple regression models and cubic models were used to evaluate the associations.

Results
There was a significant non-linear relationship between lipid profile (TC, TG, HDL-C, LDL-C) and hs-CRP (P < 0.05). Increased serum 25(OH)D was significantly associated with decreasing TC, TG, HDL-C, LDL-C, and hs-CRP levels. Compared with medium levels of lipids group, pregnant women with higher levels of TC or TG have higher levels of hs-CRP, and pregnant women with lower levels of TC, HDL-C or LDL-C also have higher levels of hs-CRP in the vitamin D deficient group, and there was a significant correlation between low levels of TG and decreased hs-CRP (adjusted β for TG: -0.063, 95%CI: − 0.120,-0.007) in the non-vitamin D deficient group. Mediators that had appreciable shares of the associations between 25(OH)D and hs-CRP was TG (10.2% of the association; β = − 0.011; total indirect effect: 95% CI: − 0.019, − 0.002). The cubic model suggested that a steep increase in the adjusted regression coefficient of lipid with hs-CRP up to 50 nmol/L of 25(OH)D, and the highest adjusted regression coefficients were observed in pregnant women with 25(OH)D above 50 nmol/L.

Conclusion
Our findings suggest that high levels of vitamin D during pregnancy may improve lipid profile levels and inhibit elevated hs-CRP induced by high lipid metabolism.
Multicenter evaluation of a syndromic rapid multiplex PCR test for early adaptation of antimicrobial therapy in adult patients with pneumonia
Authors: Monard Céline , Pehlivan Jonathan , Auger Gabriel , Alviset Sophie , Tran Dinh Alexy , Duquaire Paul , Gastli Nabil , d’Humières Camille , Maamar Adel , Boibieux André , Baldeyrou Marion , Loubinoux Julien , Dauwalder Olivier , Cattoir Vincent , Armand-Lefèvre Laurence , Kernéis Solen ,   the ADAPT study group, Becker Agathe , Charpentier Julien , Textoris Julien , Gustave Claude-Alexandre , Destras Grégory , Vandenesch François , Lina Bruno , Casalegno Jean Sebastien , Lejeune Manon , Montravers Philippe , Poyart Claire , Tête Hugo , Timsit Jean-François , Uberti Thomas 
Published: July 2020

Abstract
Background
Improving timeliness of pathogen identification is crucial to allow early adaptation of antibiotic therapy and improve prognosis in patients with pneumonia. We evaluated the relevance of a new syndromic rapid multiplex PCR test (rm-PCR) on respiratory samples to guide empirical antimicrobial therapy in adult patients with community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), and ventilator-acquired pneumonia (VAP).

Methods
This retrospective multicenter study was conducted in four French university hospitals. Respiratory samples were obtained from patients with clinical and radiological signs of pneumonia and simultaneously tested using conventional microbiological methods and the rm-PCR. A committee composed of an intensivist, a microbiologist, and an infectious diseases specialist retrospectively assessed all medical files and agreed on the most appropriate antimicrobial therapy for each pneumonia episode, according to the results of rm-PCR and blinded to the culture results. The rm-PCR-guided antimicrobial regimen was compared to the empirical treatment routinely administered to the patient in standard care.

Results
We included 159 pneumonia episodes. Most patients were hospitalized in intensive care units (n = 129, 81%), and episodes were HAP (n = 68, 43%), CAP (n = 54, 34%), and VAP (n = 37, 23%). Conventional culture isolated ≥ 1 microorganism(s) at significant level in 95 (60%) patients. The syndromic rm-PCR detected at least one bacteria in 132 (83%) episodes. Based on the results of the rm-PCR, the multidisciplinary committee proposed a modification of the empirical therapy in 123 (77%) pneumonia episodes. The modification was a de-escalation in 63 (40%), an escalation in 35 (22%), and undetermined in 25 (16%) patients. In microbiologically documented episodes (n = 95), the rm-PCR increased appropriateness of the empirical therapy to 83 (87%), as compared to 73 (77%) in routine care.

Conclusions
Use of a syndromic rm-PCR test has the potential to reduce unnecessary antimicrobial exposure and increase the appropriateness of empirical antibiotic therapy in adult patients with pneumonia.
Impact of intracellular toxic advanced glycation end-products (TAGE) on murine myoblast cell death
Authors: Takata Takanobu , Sakasai-Sakai Akiko , Takeuchi Masayoshi 
Published: July 2020

AbstractBackgroundSarcopenia is a progressive condition that is characterized by decreases in skeletal muscle mass and function. Although sarcopenia is associated with lifestyle-related diseases (LSRD), the mechanisms underlying cell death in myoblasts, which differentiate to myotubes, remain unclear. We previously designated glyceraldehyde (an intermediate of glucose/fructose metabolism)-derived advanced glycation end-products (AGEs) as toxic AGEs (TAGE) because of their cytotoxicity and involvement in LSRD, and hypothesized that TAGE contribute to cell death in myoblasts.MethodsC2C12 cells, which are murine myoblasts, were treated with 0, 0.5, 1, 1.5, and 2 mM glyceraldehyde for 24 h. Cell viability and intracellular TAGE were then assessed using 5-[2,4,-bis(sodioxysulfonyl)phenyl]-3-(2-methoxy-4-nitrophenyl)-2-(4-nitrophenyl)-2H-tetrazole-3-ium (WST-8) and slot blot assays. Cells were pretreated with 8 mM aminoguanidine, an inhibitor of AGE production, for 2 h, followed by 0, 1.5, and 2 mM glyceraldehyde for 24 h. Cell viability and intracellular TAGE levels were then assessed. Serum TAGE levels in STAM mice, in which there were four stages (no steatosis, simple steatosis, steatohepatitis, and fibrosis), were measured using a competitive enzyme-linked immunosorbent assay. Results were expressed as TAGE units (U) per milliliter of serum, with 1 U corresponding to 1.0 μg of glyceraldehyde-derived AGE-bovine serum albumin (BSA) (TAGE-BSA). The viability of cells treated with 20, 50, and 100 μg/mL non-glycated BSA and TAGE-BSA for 24 h was assessed using the WST-8 assay.ResultsIn C2C12 cells treated with 1.5 and 2 mM glyceraldehyde, cell viability decreased to 47.7% (p = 0.0021) and 5.0% (p = 0.0001) and intracellular TAGE levels increased to 6.0 and 15.9 μg/mg protein, respectively. Changes in cell viability and TAGE production were completely inhibited by 8 mM aminoguanidine. Serum TAGE levels at the steatohepatitis and fibrosis stages were 10.51 ± 1.16 and 10.44 ± 0.95 U/mL, respectively, and were higher than those at the no steatosis stage (7.27 ± 0.18 U/mL). Cell death was not induced by 20 or 50 μg/mL TAGE-BSA. The viabilities of C2C12 cells treated with 100 μg/mL non-glycated BSA and TAGE-BSA were 105.0% (p = 0.2890) and 85.3% (p = 0.0217), respectively.ConclusionIntracellular TAGE strongly induced cell death in C2C12 cells and may also induce myoblast cell death in LSRD model mice.
Changes in excessive alcohol use among older women across the menopausal transition: a longitudinal analysis of the Study of Women’s Health Across the Nation
Authors: Peltier MacKenzie R. , Verplaetse Terril L. , Roberts Walter , Moore Kelly , Burke Catherine , Marotta Phillip L. , Phillips Sarah , Smith Philip H. , McKee Sherry A. 
Published: July 2020

Abstract
Background
Recent data suggest that excessive alcohol use is increasing among women and older adults. Such trends are concerning, as women are more vulnerable to alcohol-related health consequences, and such health problems may be exacerbated with age. Furthermore, there are sex-specific factors that may influence alcohol consumption among women, including the hormonal changes associated with the menopausal transition and negative affect. The present study sought to investigate transitions in excessive drinking among women across the menopausal transition and included exploration of sex hormones (estradiol; testosterone) and depression.

Methods
The present study utilized publicly available data from the Study of Women Across the Nation (SWAN) and included 3302 women (42–52 years old at baseline), who completed 10 years of annual assessments. National Institute on Alcohol Abuse and Alcoholism (NIAAA) criteria were used as guidance when defining excessive drinking within the present dataset. At year 1, 170 women were identified as drinking excessively. Random-effect logistic regressions were used to examine transitions in excessive drinking.

Results
Women identified as excessive drinkers were more likely to transition to non-excessive drinking across all menopausal transition stages (ORs range = 3.71–5.11), while women were more likely to transition from non-excessive to excessive drinking during the early peri- and postmenopausal stages (OR = 1.52 and 1.98, respectively). Higher testosterone levels were associated with a decreased likelihood of transitioning to non-excessive drinking (OR = 0.59). Depression and estradiol levels were not related to transitions in drinking.

Conclusions
The present study demonstrates that the menopausal transition marks a period of instability in alcohol use among women. Further research is warranted to understand factors related to transitioning in and out of excessive drinking.
Detection limit of 89Zr-labeled T cells for cellular tracking: an in vitro imaging approach using clinical PET/CT and PET/MRI
Authors: Lechermann Laura M. , Manavaki Roido , Attili Bala , Lau Doreen , Jarvis Lorna B. , Fryer Tim D. , Bird Nick , Aloj Luigi , Patel Neel , Basu Bristi , Cleveland Matthew , Aigbirhio Franklin I. , Jones Joanne L. , Gallagher Ferdia A. 
Published: July 2020

Abstract
Purpose
Tracking cells in vivo using imaging can provide non-invasive information to understand the pharmacology, efficacy, and safety of novel cell therapies. Zirconium-89 (t1/2 = 78.4 h) has recently been used to synthesize [89Zr]Zr(oxinate)4 for cell tracking using positron emission tomography (PET). This work presents an in vitro approach to estimate the detection limit for in vivo PET imaging of Jurkat T cells directly labeled with [89Zr]Zr(oxinate)4 utilizing clinical PET/CT and PET/MRI.

Methods
Jurkat T cells were labeled with varying concentrations of [89Zr]Zr(oxinate)4 to generate different cell-specific activities (0.43–31.91 kBq/106 cells). Different concentrations of labeled cell suspensions (104, 105, and 106 cells) were seeded on 6-well plates and into a 3 × 3 cubic-well plate with 1 cm3 cubic wells as a gel matrix. Plates were imaged on clinical PET/CT and PET/MRI scanners for 30 min. The total activity in each well was determined by drawing volumes of interest over each well on PET images. The total cell-associated activity was measured using a well counter and correlated with imaging data. Simulations for non-specific signal were performed to model the effect of non-specific radioactivity on detection.

Results
Using this in vitro model, the lowest cell number that could be visualized on 6-well plate images was 6.8 × 104, when the specific activity was 27.8 kBq/106 cells. For the 3 × 3 cubic-well, a plate of 3.3 × 104 cells could be detected on images with a specific activity of 15.4 kBq/106 cells.

Conclusion
The results show the feasibility of detecting [89Zr]Zr(oxinate)4-labeled Jurkat T cells on clinical PET systems. The results provide a best-case scenario, as in vivo detection using PET/CT or PET/MRI will be affected by cell number, specific activity per cell, the density of cells within the target volume, and non-specific signal. This work has important implications for cell labeling studies in patients, particularly when using radiosensitive cells (e.g., T cells), which require detection of low cell numbers while minimizing radiation dose per cell.
Securing communication by attribute-based authentication in HetNet used for medical applications
Authors: Lone Tufail A. , Rashid Aabid , Gupta Sumeet , Gupta Sachin Kumar , Rao Duggirala Srinivasa , Najim Mohd , Srivastava Ashutosh , Kumar Abhishek , Umrao Lokendra Singh , Singhal Achintya 
Published: July 2020

AbstractOne of the major applications of the Heterogeneous Network (HetNet) is in the healthcare system. Deploying HetNet in healthcare systems enables patients, physicians, and other stakeholders to communicate easily with each other. Due to the large growth in the network’s subscribers, the security of the stored health data became one of the major concerns because unauthorized access to this data may lead to very serious complications, and unreliable transmission of data may lead to fatal risks to the patient’s life. Therefore, taking data integrity into consideration, user authentication has become one of the main factors. However, significant research work has been performed at HetNet’s physical layer to secure communication, but the result of this leads to an increase in hardware components. The increasing hardware components not only costs money but also power consumption. Therefore, this paper presents an alternate way of securing communication in HetNet at the network layer. However, resolving security problems at the network layer increases computational complexity. Nevertheless, earlier, some encryption techniques like identity-based encryption (IBE), symmetric key encryption (SKE), and public-key encryption (PKE) have been utilized for securing data. Due to their own disadvantages, this paper utilizes an attribute-based encryption (ABE) authentication scheme for securing health data in medical applications. With the help of this method, access to the intruders is denied which results in reduced communication overhead. This authentication scheme helps protect the essential information against attacks by the intruders. It includes a third party server that helps to authenticate and store patient’s information. The whole security technique has been written in the form of HLPSL (high-level protocol specification language) codes, and the results are then validated with the help of AVISPA (automated validation of Internet security protocols and applications) tool.
Asymptotic behavior and threshold of a stochastic SIQS epidemic model with vertical transmission and Beddington–DeAngelis incidence
Authors: Chen Yang , Zhao Wencai 
Published: July 2020

AbstractThis paper investigates a deterministic and stochastic SIQS epidemic model with vertical transmission and Beddington–DeAngelis incidence. Firstly, for the corresponding deterministic system, the global asymptotic stability of disease-free equilibrium and the endemic equilibrium is proved through the stability theory. Secondly, for the stochastic system, the threshold conditions which decide the extinction or permanence of the disease are derived. By constructing suitable Lyapunov functions, we investigate the oscillation behavior of the stochastic system solution near the endemic equilibrium. The results of this paper show that there exists a great difference between the deterministic and stochastic systems, which implies that the large stochastic noise contributes to inhibiting the spread of disease. Finally, in order to validate the theoretical results, a series of numerical simulations are presented.
Modeling equatorial ionospheric vertical plasma drifts using machine learning
Authors: Shidler S. A. , Rodrigues F. S. 
Published: July 2020

AbstractWe present the results of an effort to model quiet-time vertical plasma drifts in the low-latitude F-region ionosphere using the random forest machine learning technique. The model is capable of describing the climatological variation of the drifts as a function of universal time, day of the year, solar flux, and altitude (200–600 km). The model has been trained using measurements of the vertical plasma drifts made by the incoherent scatter radar of the Jicamarca Radio Observatory ($$11.95^\circ \hbox { S}$$

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.

95
∘

S

, $$76.87^\circ$$

76
.

87
∘

W, $$\sim 1^\circ$$

∼

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∘

dip lat). In our analysis, we compare our machine learning model results with the Scherliess and Fejer (J Geophys Res 104:6829–6842, 1999) model (SF99 model), a widely used empirical model of the vertical drifts developed using a different set of Jicamarca measurements. We find that the machine learning model is able to capture the overall features of the diurnal variation of the equatorial drifts for different seasonal and solar flux conditions. The model is also capable of capturing the mean height variation of the drifts, particularly the height gradient enhancements that have been observed near sunrise and sunset. Finally, the model can easily be expanded and improved as more drift measurements are made and become available for training.