bluuebunny/crossref_metadata_2025_split huggingface dataset:
Penetrating injury to the cardiac box
Authors: Kim Jennie S. , Inaba Kenji , de Leon Luis Alejandro , Rais Cyrus , Holcomb John B. , David Jean-Stéphane , Starnes Vaughn A. , Demetriades Demetrios 
Published: May 2020

BACKGROUND
A penetrating injury to the “cardiac box” is thought to be predictive of an injury to the heart; however, there is very little evidence available to support this association. This study aims to evaluate the relationship between penetrating trauma to the cardiac box and a clinically significant injury.

METHODS
All patients presenting to a Level I trauma center from January 2009 to June 2015 who sustained a penetrating injury isolated to the thorax were retrospectively identified. Patients were categorized according to the location of injury: within or outside the historical cardiac box. Patients with concurrent injuries both inside and outside the cardiac box were excluded. Clinical demographics, injuries, procedures, and outcomes were compared.

RESULTS
During this 7-year period, 330 patients (92% male; median age, 28 years) sustained penetrating injuries isolated to the thorax: 138 (42%) within the cardiac box and 192 (58%) outside the cardiac box. By mechanism, 105 (76%) were stab wounds (SW) and 33 (24%) were gunshot wounds (GSW) inside the cardiac box, and 125 (65%) SW and 67 (35%) GSW outside the cardiac box. The overall rate of thoracotomy or sternotomy (35/138 [25.4%] vs. 15/192 [7.8%], p < 0.001) and the incidence of cardiac injury (18/138 [13%] vs. 5/192 [2.6%], p < 0.001) were significantly higher in patients with penetrating trauma within the cardiac box. This was, however, dependent on mechanism with SW demonstrating a higher incidence of cardiac injury (15/105 [14.3%] vs. 3/125 [2.4%], p = 0.001) and GSW showing no significant difference (3/33 [9.1%] vs. 2/67 [3%], p = 0.328]. There was no difference in overall mortality (9/138 [6.5%] vs. 6/192 [3.1%], p = 0.144).

CONCLUSION
The role of the cardiac box in the clinical evaluation of a patient with a penetrating injury to the thorax has remained unclear. In this analysis, mechanism is important. Stab wounds to the cardiac box were associated with a higher risk of cardiac injury. However, for GSW, injury to the cardiac box was not associated with a higher incidence of injury. The diagnostic interaction between clinical examination and ultrasound, for the diagnosis of clinically significant cardiac injuries, warrants further investigation.

LEVEL OF EVIDENCE
Prognostic study, Level IV, Therapeutic V.
Diaphragm pacing improves respiratory mechanics in acute cervical spinal cord injury
Authors: Kerwin Andrew J. , Zuniga Yohan Diaz , Yorkgitis Brian K. , Mull Jennifer , Hsu Albert T. , Madbak Firas G. , Ebler David J. , Skarupa David J. , Shiber Joseph R. , Crandall Marie L. 
Published: May 2020

BACKGROUND
Cervical spinal cord injury (CSCI) is devastating with ventilator-associated pneumonia being a main driver of morbidity and mortality. Laparoscopic diaphragm pacing implantation (DPS) has been used for earlier liberation from mechanical ventilation. We hypothesized that DPS would improve respiratory mechanics and facilitate liberation.

METHODS
We performed a retrospective review of acute CSCI patients between January 2005 and May 2017. Routine demographics were collected. Patients underwent propensity score matching based on age, Injury Severity Score, ventilator days, hospital length of stay, and need for tracheostomy. Patients with complete respiratory mechanics data were analyzed and compared. Those who did not have DPS (NO DPS) had spontaneous tidal volume (Vt) recorded at time of intensive care unit admission, at day 7, and at day 14, and patients who had DPS had spontaneous Vt recorded before and after DPS. Time to ventilator liberation and changes in size of spontaneous Vt for patients while on the ventilator were analyzed. Bivariate and multivariate logistic and linear regression statistics were performed using STATA v10.

RESULTS
Between July 2011 and May 2017, 37 patients that had DPS were matched to 34 who did not (NO DPS). Following DPS, there was a statistically significant increase in spontaneous Vt compared with NO DPS (+88 mL vs. −13 mL; 95% confidence interval, 46–131 mL vs. −78 to 51 mL, respectively; p = 0.004). Median time to liberation after DPS was significantly shorter (10 days vs. 29 days; 95% CI, 6.5–13.6 days vs. 23.1–35.3 days; p < 0.001). Liberation prior to hospital discharge was not different between the two groups. The DPS placement was found to be associated with a statistically significant decrease in days to liberation and an increase in spontaneous Vt in multivariate linear regression models.

CONCLUSION
The DPS implantation in acute CSCI patients produces significant improvements in spontaneous Vt and reduces time to liberation from mechanical ventilation. Prospective comparative studies are needed to define the clinical benefits and potential cost savings of DPS implantation.

LEVEL OF EVIDENCE
Therapeutic IV.
Impact of Postoperative Continuous Renal Replacement Therapy in Lung Transplant Recipients
Authors: Katahira Masato , Hirama Takashi , Eba Shunsuke , Suzuki Takaya , Notsuda Hirotsugu , Oishi Hisashi , Matsuda Yasushi , Sado Tetsu , Noda Masafumi , Sakurada Akira , Sidhu Aman , Okada Yoshinori 
Published: May 2020

Background.
Acute kidney injury (AKI) is a common complication after lung transplant (LTx), and continuous renal replacement therapy (CRRT) is increasingly of use to critically ill patients who have developed AKI. However, the optimal timing or threshold of kidney impairment for which to commence CRRT after LTx has been uncertain. There has also been limited information on the impact of CRRT among LTx recipients (LTRs) introduced in the early posttransplant period on survival, graft function, and renal function. We aimed to review LTRs who developed AKI requiring CRRT postoperatively and followed their long-term outcomes at Tohoku University Hospital (TUH).

Methods.
Medical records of consecutive patients who underwent LTx at TUH between 2000 and 2018 were reviewed, with follow-up to 2019 inclusive.

Results.
Although mortality in those who required CRRT (n = 21) was increased versus those who did not require CRRT (n = 85)(P = 0.024), conditional survival beyond 3-month posttransplant was not affected (P = 0.131). Additionally, the cumulative incidence of chronic lung allograft rejection (P = 0.160) and the development of chronic kidney disease (P = 0.757) were not significant between groups.

Conclusions.
The initiation of CRRT posttransplant may be a useful strategy to preserve cardiac and optimize volume management among critically ill patients.
Beyond the connectome: A map of a brain architecture derived from whole-brain volumetric reconstructions
Authors: Brittin Christopher A. , Cook Steven J. , Hall David H. , Emmons Scott W. , Cohen Netta 
Published: May 2020

ABSTRACTAnimal nervous system organization is crucial for all body functions and its disruption can manifest in severe cognitive and behavioral impairment. This organization relies on features across scales, from nano-level localization of synapses, through multiplicities of neuronal morphologies and their contribution to circuit organization, to the high level stereotyped connections between different regions of the brain. The sheer complexity of this organ means that to date, we have yet to reconstruct and model the structure of a complete nervous system that is integrated across all these scales. Here, we present a complete structure-function model of the nematodeC. elegansmain neuropil, the nerve ring, which we derive by integrating the volumetric reconstruction from two animals with corresponding synaptic and gap junctional connectomes. Whereas previously the nerve ring was considered a densely packed tract of axons, we uncover internal organization into 5 functional bundles and show how they spatially constrain and support the synaptic connectome. We find that theC. elegansconnectome is not invariant, but that a precisely wired core circuit is embedded in a background of variable connectivity, and propose a corresponding reference connectome for the core circuit. Using this reference, we show that the architecture of theC. elegansbrain can be viewed as a modular Residual Network that supports sensory computation and integration, sensory-motor convergence, and brain-wide coordination. These findings point to scalable and robust features of brain organization that are likely universal across phyla.
Real-space quantum-based refinement for cryo-EM: Q|R#3
Authors: Wang Lum , Kruse Holger , Sobolev Oleg V. , Moriarty Nigel W. , Waller Mark P. , Afonine Pavel V. , Biczysko Malgorzata 
Published: May 2020

AbstractElectron cryo-microscopy (cryo-EM) is fast becoming a major competitor to X-ray crystallography especially for large structures that are difficult or impossible to crystallize. While recent spectacular technology improvements are leading to significantly higher resolution of three-dimensional reconstructions, the average quality of cryo-EM maps is still on the low-resolution end of the range compared to crystallography. A long-standing challenge for atomic model refinement has been the production of stereochemically meaningful models for this resolution regime. Here we demonstrate how including accurate model geometry restraints derived fromab initioquantum-chemical calculations (HF-D3/6-31G) can improve the refinements of an example structure (chain A of 3j63). The robustness of the procedure is tested for additional structures with up to 7k atoms (3a5x, and chain C of 5fn5) by means of the less expensive semi-empirical (GFN1-xTB) model. Necessary algorithms enabling real-space quantum refinement are implemented in the latest version ofqr.refineand are described herein.SynopsisThe implementation of quantum-based real-space refinement inqr.refineis described.
Age- and Sex-Specific Fear Conditioning Deficits in Mice Lacking Pcdh10, an Autism Associated Gene
Authors: Ferri Sarah L. , Dow Holly C. , Schoch Hannah , Lee Ji Youn , Brodkin Edward S. , Abel Ted 
Published: May 2020

AbstractPCDH10is a gene associated with Autism Spectrum Disorder. It is involved in the growth of thalamocortical projections and dendritic spine elimination. Previously, we characterized micePcdh10haploinsufficient mice(Pcdh10+/−mice) and found male-specific social deficits that are rescued by N-methyl-D-aspartate receptor (NMDAR) partial agonist d-cycloserine, increased ultrasonic vocalizations in pups, and dark phase hypoactivity. In addition, we determined that the basolateral amygdala (BLA) of these mice exhibited increased dendritic spine density of immature morphology, decreased NMDAR expression, and decreased gamma synchronization. Here, we further characterizePcdh10+/−mice by testing for fear memory, which relies upon BLA function. We used both male and femalePcdh10+/−mice and their wild-type littermates at two ages, juvenile and adult, and in two learning paradigms, cued and contextual fear conditioning. We found that males at both ages and in both assays exhibited fear conditioning deficits, but females were only impaired as adults in the cued condition. These data are further evidence for male-specific alterations in BLA-related behaviors inPcdh10+/−mice, and suggest that these mice may be a useful model for dissecting male specific brain and behavioral phenotypes relevant to social and emotional behaviors.
Enantiomers of Chloroquine and Hydroxychloroquine Exhibit Different Activities Against SARS-CoV-2in vitro, EvidencingS-Hydroxychloroquine as a Potentially Superior Drug for COVID-19
Authors: Li Guanguan , Sun Jing , Huang Yi-You , Li Yingjun , Shi Yongjie , Li Zhe , Li Xiang , Yang Feng Hua , Zhao Jincun , Luo Hai-Bin , Zhang Tony Y. , Zhang Xumu 
Published: May 2020

ABSTRACTIn all of the clinical trials for COVID-19 conducted thus far and among those ongoing involving chloroquine or hydroxychloroquine, the drug substance used has invariably been chloroquine (CQ) diphosphate or hydroxychloroquine (HCQ) sulfate, i.e., the phosphoric or sulfuric acid salt of a racemic mixture ofR- andS-enantiomer (50/50), respectively. As a result, the clinical outcome from previous CQ or HCQ trials were, in fact, the collective manifestation of bothRandS-enantiomers with inherent different pharmacodynamic and pharmacokinetic properties, and toxicity liabilities. Our data for the first time demonstrated the stereoselective difference of CQ and HCQ against live SARS-CoV-2 virus in a Biosafety Level 3 laboratory.S-chloroquine (S-CQ) andS-hydroxychloroquine (S-HCQ) significantly more active against SARS-CoV-2, as compared toR-CQ andR-HCQ, respectively. In addition, Mpro, as one of the critical enzymes for viral transcription and replication, also exhibited an enantioselective binding affinity toward theS-enantiomers. The most significant finding from this study is the pronounced difference of the two enantiomers of CQ and HCQ observed in hERG inhibition assay. The IC50value ofS-HCQ was higher than 20 μM against hERG channel, which was much less active over all tested CQ and HCQ compounds. Moreover,S-HCQ alone did not prolong QT interval in guinea pigs after 3 days and 6 days of administration, indicating a much lower cardiac toxicity potential. With these and previous findings on the enantio-differentiated metabolism, we recommend that future clinical studies should employS-HCQ, substantially free of theR-enantiomer, to potentially improve the therapeutic index for the treatment of COVID-19 over the racemic CQ and HCQ.
mbkmeans: fast clustering for single cell data using mini-batchk-means
Authors: Hicks Stephanie C. , Liu Ruoxi , Ni Yuwei , Purdom Elizabeth , Risso Davide 
Published: May 2020

AbstractSingle-cell RNA-Sequencing (scRNA-seq) is the most widely used high-throughput technology to measure genome-wide gene expression at the single-cell level. One of the most common analyses of scRNA-seq data detects distinct subpopulations of cells through the use of unsupervised clustering algorithms. However, recent advances in scRNA-seq technologies result in current datasets ranging from thousands to millions of cells. Popular clustering algorithms, such ask-means, typically require the data to be loaded entirely into memory and therefore can be slow or impossible to run with large datasets. To address this problem, we developed thembkmeansR/Bioconductor package, an open-source implementation of the mini-batchk-means algorithm. Our package allows for on-disk data representations, such as the common HDF5 file format widely used for single-cell data, that do not require all the data to be loaded into memory at one time. We demonstrate the performance of thembkmeanspackage using large datasets, including one with 1.3 million cells. We also highlight and compare the computing performance ofmbkmeansagainst the standard implementation ofk- means. Our software package is available in Bioconductor athttps://bioconductor.org/packages/mbkmeans.
Dual thermal ecotypes co-exist within a nearly genetically-identical population of the unicellular marine cyanobacteriumSynechococcus
Authors: Kling Joshua D. , Lee Michael D. , Webb Eric A. , Coelho Jordan T. , Wilburn Paul , Anderson Stephanie I. , Zhou Qianqian , Wang Chunguang , Phan Megan D. , Fu Feixue , Kremer Colin T. , Litchman Elena , Rynearson Tatiana A. , Hutchins David A. 
Published: May 2020

AbstractThe extent and ecological significance of intraspecific diversity within marine microbial populations is still poorly understood, and it remains unclear if such strain-level microdiversity will affect fitness and persistence in a rapidly changing ocean environment. In this study, we cultured 11 sympatric strains of the ubiquitous marine picocyanobacteriumSynechococcusisolated from a Narragansett Bay (Rhode Island, USA) phytoplankton community thermal selection experiment. Despite all 11 isolates being highly similar (with average nucleotide identities of >99.9%, with 98.6-100% of the genome aligning), thermal performance curves revealed selection at warm and cool temperatures had subdivided the initial population into thermotypes with pronounced differences in maximum growth temperatures. Within the fine-scale genetic diversity that did exist within this population, the two divergent thermal ecotypes differed at a locus containing genes for the phycobilisome antenna complex. Our study demonstrates that present-day marine microbial populations can contain microdiversity in the form of cryptic but environmentally-relevant thermotypes that may increase their resilience to future rising temperatures.SignificanceNumerous studies exist comparing the responses of distinct taxonomic groups of marine microbes to a warming ocean (interspecific thermal diversity). For example,Synechococcus, a nearly globally distributed unicellular marine picocyanobacterium that makes significant contributions to oceanic primary productivity, contains numerous taxonomically distinct lineages with well documented temperature relationships. Little is known though about the diversity of functional responses to temperature within a given population where genetic similarity is high (intraspecific thermal diversity). This study suggests that understanding the extent of this functional intraspecific microdiversity is an essential prerequisite to predicting the resilience of biogeochemically essential microbial groups such as marineSynechococcusto a changing climate.
Fostering knowledge creation to improve performance: the mediation role of manufacturing flexibility
Authors: Pinheiro José , Silva Graça Miranda , Dias Álvaro Lopes , Lages Luis Filipe , Preto Miguel Torres 
Published: May 2020

PurposeThe purpose of this study is to examine the mediating role of manufacturing flexibility in the relationship between knowledge creation, technological turbulence and performance. In an increasingly competitive and changing environment, firms need to boost their technological and management know-how to adequately develop manufacturing flexibility.Design/methodology/approachThis study analyzes survey data collected from 370 manufacturing firms. Validity and reliability analyses were conducted using SPSS and Amos. The research hypotheses were tested using covariance-based structural equation modelling.FindingsThe main findings show that knowledge creation positively and significantly affects business and operational performances directly, and indirectly, through manufacturing flexibility. Moreover, technological turbulence has a positive and significant effect on it. This finding contributes to understanding why some firms get better outcomes from manufacturing flexibility than others, a disputed issue in the literature.Practical implicationsThis study highlights the need for manufacturing firms to foster cultures of knowledge creation, to better educate and train employees and to develop other instruments of knowledge creation.Originality/valueThis study makes several contributions to manufacturing flexibility literature: (1) establishing a link between technological turbulence and knowledge creation to develop manufacturing flexibility; (2) add empirical evidence on the relation between manufacturing flexibility and performance and (3) contributes to consolidating the mediation role of manufacturing flexibility in the relations between knowledge creation and business performance, as studies focussing on such a role are scarce in the literature.
Seismic performance assessments of school buildings in Taiwan using artificial intelligence theories
Authors: Chen Ching-Shan 
Published: May 2020

Purpose
Taiwan experiences frequent seismic activity. Major earthquakes in recent history have seriously damaged the school buildings. School buildings in Taiwan are intended to serve both as places of education and as temporary shelters in the aftermath of major earthquakes. Therefore, the seismic performance assessments of school buildings are critical issues that deserve investigation.

Design/methodology/approach
This paper develops a methodology that uses principal component analysis to generalize the seismic factors from the basic seismic parameters of school buildings, uses data mining to cluster different school building sizes and uses grey theory to analyze the relationship between seismic factors and the seismic performance of school buildings. Additionally, this paper employs the Artificial Neural Network (ANN) to deduce the seismic assessment model for school buildings. Finally, it adopts support vector machine to validate the ANN’s deductive results.

Findings
An empirical study was conducted on 326 school buildings in the central area of Taichung City, Taiwan, to illustrate the effectiveness of the proposed approach. Results show that thickness of wall and width of middle-row column relate significantly with school-building seismic performance.

Originality/value
This paper provides a model that structural engineers or architects may use to design school buildings that are adequately resistant to earthquakes as well as a reference for future academic research.
A contemporary perspective on the disaster management cycle
Authors: Sawalha Ihab Hanna 
Published: May 2020

PurposeThis study aims to examine the traditional disaster management cycle; discussing the significance of incorporating contemporary management concepts into the disaster management cycle; and proposing a conceptual model that reflects contemporary management insight for the disaster management cycle.Design/methodology/approachA literature review was made to discuss the significance of moving towards a more contemporary view to the disaster management cycle that brings more value to the final outcomes of the disaster management process. A conceptual model was then proposed to reflect a more contemporary view to the disaster management cycle. The current COVID-19 pandemic has also been addressed explicitly throughout the paper as a case that reflects the necessity of embracing contemporary insight and practise in the traditional disaster management cycle.FindingsThe literature indicates that people worldwide, as well as academics still rely heavily on the traditional disaster management lifecycle to manage disasters and major incidents which consists of four main stages; preparedness, mitigation, response and recovery unrecognizing that each and every disaster is a unique incident itself and that it should be treated differently. Contemporary management thought and insight is still lacking in the study of disaster and emergency management.Practical implicationsThis research offers a contemporary view to the traditional disaster management cycle in which recent concepts of management are used to better cope with the uniqueness of the different major incidents. This view fosters wider involvement of individuals and the general public in the disaster management process and highlights elements of creativity and modernity. The current COVID-19 pandemic, despite the many adverse consequences associated with it, has contributed constructively to the ways the traditional disaster management cycle is being implemented and practised worldwide.Originality/valueThis research is expected to be of a substantial value for those interested in improving performance during the various stages of the disaster management process, as well as those interested in improving organizational, social and national resilience. The traditional disaster management cycle tends to be procedural and therefore needs to embrace contemporary management thought and more value-based approaches.