bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is the Impact of the Rashomon Approach in Primary Care Education?: An Educational Care Report of Implementing Dialogue and Improvisation Into Medical Education
Authors: Takamura Akiteru , Imafuku Rintaro 
Published: August 2020

Abstract

Background:The excessive sub-divided or concrete pre-determined objectives found in the technological approach in contemporary medical education curricula may hinder the students’ spontaneous learning about diverse needs and values in care. However, medical professionals must learn the diversity for care or a variety of social factors of the patients influencing decision making in daily practice.Methods:We introduced a new method of curriculum development called the Rashomon approach. For testing the Rashomon approach, educational activities to teach the diversity in primary care were developed in four modules: 1) explication of the competency without specifying sub-objectives; 2) dialogue among multiple professional students; 3) visits and interviews of the patients; 4) dialogue with teachers' improvisation. The students’ outcomes and responses were quantitatively and qualitatively analyzed.Results:A total of 135 medical students joined this study in 2017. The descriptive data suggested that the key concepts of diversity in primary care were fully recognized and that the pre-determined general goals were achieved. Scores on the understanding of social factors in medicine, respect for other professionals, professional identity, and satisfaction with the course were very high.Conclusion:Instead of the technological approach, the Rashomon approach, in which only a general goal guides educational activities was used in this research. Improvisation and dialogue fit the approach and were potentially effective activities to learn the multifaceted practice of medicine. In an era of competency-based education, the Rashomon approach could be a very useful framework in primary care education.
Quantifying Carbon Monoxide Emissions on the Scale of Large Wildfires
Authors: Volkamer Rainer , Bela Megan , Kille Natalie , McKeen Stuart , Ahmadov Ravan , James Eric , Pereira Gabriel , Schmidt Chris , Pierce R , O'Neill Susan , Zhang Xiaoyang , Kondragunta Shobha , Wiedinmyer Christine 
Published: August 2020

Abstract
Anthropogenic factors, such as ignitions, climate, and land use changes, are the primary reason why the wildfire season today is three times longer than only twenty years ago, with fires now burning year-round in the continental United States1. The quantities of fuel that go up as smoke in the form of trace gases and aerosols affect public health2,3,4 and ecosystems5, but are highly uncertain6,7,8,9 due to a lack of measurement techniques to directly quantify wildfire emissions. Uncertain emissions contribute to errors in air quality models10,11 used to forecast smoke impacts on public health in affected communities, and to inform firefighting efforts. Here we show that destructive fires in northern California during October 2017 emitted 2040 ± 316 tonnes hr-1 carbon monoxide (CO), which is more than ten times larger than the emissions from all other anthropogenic CO pollution sources in the entire state of California combined. An assessment of satellite-based emission inventories reveals that the uncertainty in predicting pyrogenic CO emissions spans a factor of 83. Air quality impacts in the form of ozone and fine particulate matter range from insignificant to very severe (vary by two orders of magnitude), and scale with uncertain emissions caused primarily by the different ecosystem classification among emission inventories. This uncertainty is reduced to a factor of ~2 by our first CO mass flux measurements on the scale of actual wildfires. We derive the conversion factor of satellite fire radiative energy to CO emissions (α = 73 ± 11 to 149 ± 23 g CO MJ-1) for savannah and extratropical forest fuels of these fires, which is higher (+30 to +230%) than tabulated for these fuel types. Our results help to improve future model predictions, and suggest an additional organic soil contribution to emissions from wildfires in northern California.
HER-3 Expression and MEK Activation in Non-small Cell Lung Cancer
Authors: Manickavasagar Thubeena , Yuan Wei , Carreira Suzanne , Gurel Bora , Miranda Susana , Ferreira Ana , Crespo Mateus , Riisnaes Ruth , Baker Chloe , O’Brien Mary , Bhosle Jaishree , Popat Sanjay , Banerji Udai , Lopez Juanita , Bono Johann de , Minchom Anna 
Published: August 2020

Abstract
BackgroundHER-3 has a role in pathogenesis and development of resistance to targeted therapies in non-small cell lung cancer (NSCLC). MethodsWe analysed tumour samples from 45 patients with adenocarcinoma of the lung. HER-3 and HER-2 expression was identified using immunohistochemistry as well as bioinformatic interrogation of The Cancer Genome Atlas (TGCA). ResultsHER-3 was highly expressed in 42.2% of cases and observed more frequently than HER-2 overexpression. ERBB3 copy number alone did not account for HER-3 overexpression. Bioinformatic analysis of TCGA demonstrated that MEK activity score (a score of downstream pathway activity and surrogate of functional HER-3 signalling) did not correlate with HER-3 ligands. EGFR pathway signalling was predominant with a significantly positive correlation of EGFR and AREG expression with MEK activity score. In the ERBB3 expressed group, ERBB3 RNA expression levels were significantly correlated with MEK activity score. ERBB3 expression level remained highly positively correlated with MEK activity after adjusting for EGFR expression. ConclusionHER-3 expression is common and it is not associated with gene amplification nor is it ligand dependent. HER-3 is an alternative pathway to EGFR activating MEK. HER-3 is a potential therapeutic target in NSCLC by virtue of frequent overexpression and functional downstream signalling.
Risk of Esophageal Adenocarcinoma in Patients With Barrett's Esophagus Using Proton Pump Inhibitors: A Systematic Review With Meta-Analysis and Trial Sequential Analysis
Authors: Li Lunan , Gao Huiqin , Zhang Chenjing , Geng Xiaoge , Wang Jingya , Pan Wensheng , Jing Jiyong 
Published: August 2020

Abstract
Background: Proton pump inhibitors (PPIs) have been used to treat Barrett's esophagus (BE), but there seems to be insufficient evidence that PPIs can prevent esophageal adenocarcinoma (EAC) and high grade dysplasia (HGD). This study aimed to evaluate the effects of PPIs in BE patients. Methods: PubMed and EMBASE were systematically searched. Stata13 and trial sequential analysis (TSA) software were used to carried out related statistics. Pooled odds ratio (OR) with 95% confidence intervals (CIs) were calculated. Results: Using PPIs to reduce the incidence of EAC and HGD has not been confirmed (OR, 0.61; 95% CI, 0.29–1.26). The pooled results of three cohort studies reported that PPIs use was protective (OR 0.48; 95% CI 0.33 to 0.70). But the pooled results of five case-control study indicating PPIs use does not prove this protective effect (OR 0.73; 95% CI 0.21 to 2.48). On pooled analysis of 4 US studies 2 Netherlands, protective effect on development of EAC and HGD was noted (OR, 0.59; 95% CI, 0.43–0.80) and (OR, 0.16; 95% CI, 0.03–0.75). Conclusion: According to the Meta analysis and TSA of existing studies, the protective effect of PPIs on the progression of BE patients to OAC and / or HGD has not been confirmed. TSA shows that more patients are needed before a clear conclusion can be reached.
An Autophagy-Related Gene Signature Predicts Prognosis of Early Stage Colorectal Cancer
Authors: Zou Yi-feng , Wu Qiu-ning , Qin Si , Chen Xi Xi , Cai Jia-wei , Tan Ying-xin , Weng Jing-rong , Rong Yu-ming , Lin Xutao 
Published: August 2020

Abstract
Background and aimsA certain number of early-stage colorectal cancer (CRC) patients suffer tumor recurrence after initial curative resection. In this context, an effective prognostic biomarker model is constantly in need. Autophagy exhibits a dual role in tumorigenesis. Our study aims to develop an autophagy-related gene (ATG) signature based on high-throughput data analysis for disease-free survival (DFS) prognosis of patients with stage I/II CRC.MethodsGene expression profiles and clinical information of CRC patients extracted from four public datasets were divided into training cohort (GSE39582, n=566), validation cohort (TCGA CRC, n=624), and meta-validation cohort (GSE37892 and GSE14333, n=420). Autophagy genes significantly associated with prognosis were identified.ResultsAmong 655 autophagy-related genes, a 10 gene ATG signature, which was significantly associated with DFS in the training cohort (HR, 2.76[1.56–4.82]; P=2.06×10-4), was constructed. The ATG signature, stratifying patients into high and low autophagy risk groups, was validated in the validation (HR, 2.29[1.15–4.55]; P=1.5×10-2) and the meta-validation cohorts (HR, 2.5[1.03–6.06]; P=3.63×10-2), and proved to be prognostic in a multivariate analysis. Functional analysis revealed enrichment of several immune/ inflammatory processes in the high autophagy risk group, where significantly higher infiltration of T regulatory cells (Tregs) was observed.ConclusionsOur study established a prognostic ATG signature that effectively predicted DFS for early-stage CRC patients. Meanwhile, the study also revealed the possible correlation between autophagy and immune/ inflammatory processes and tumorigenesis.
Association between serum lactate levels and mortality in patients with cardiogenic shock receiving mechanical circulatory support: a multicenter retrospective cohort study
Authors: Scolari Fernando , Schneider Daniel , Fogazzi Débora Vacaro , Gus Miguel , Rover Marciane Maria , Bonatto Marcely Gimenes , de Araújo Gustavo Neves , Zimerman André , Sganzerla Daniel , Goldraich Lívia Adams , Teixeira Cassiano , Friedman Gilberto , Polanczyk Carisi Anne , Rohde Luis Eduardo , Rosa Regis Goulart , Wainstein Rodrigo Vugman 
Published: August 2020

Abstract
Background: To evaluate the prognostic value of peak serum lactate and lactate clearance at several time points in cardiogenic shock treated with temporary mechanical circulatory support (MCS) using veno-arterial extracorporeal membrane oxygenation (VA-ECMO) or Impella CP®.Methods: Serum lactate and clearance were measured before MCS and at 1h, 6h, 12h, and 24h post-MCS in 43 patients at four tertiary-care centers in Southern Brazil. Prognostic value was assessed by univariable and multivariable analysis and receiver operating characteristic (ROC) curves for 30-day mortality.Results: VA-ECMO was the most common MCS modality (58%). Serum lactate levels at all time points and lactate clearance after 6h were associated with mortality on unadjusted and adjusted analyses. Lactate levels were higher in non-survivors at 6h, 12h, and 24h after MCS. Serum lactate > 1.55 mmol/L at 24h was the best single prognostic marker of 30-day mortality [area under the ROC curve = 0.81 (0.67-0.94); positive predictive value = 86%). Failure to improve serum lactate after 24h was associated with 100% mortality.Conclusions: Serum lactate was an important prognostic biomarker in cardiogenic shock treated with temporary MCS. Serum lactate and lactate clearance at 24h were the strongest independent predictors of short-term survival.
Chemical and Morphological Characterization of Crinis Carbonisatus
Authors: Bhandari Tika Ram , Lamsal Bidit , Panta Prasamsha , Pradhan Nilam Shrestha , Liebscher Marco , Katuwal Tika Bahadur , Adhikari Rameshwar 
Published: August 2020

Abstract
BackgroundCrinis Carbonisatus, prepared by pyrolysis of human hair, is traditional Chinese medicine used for increasing blood clotting and wound healing. Its use is explored in literature but no detailed structural study is reported.ObjectiveThis work is aimed at studying the chemical and morphological variation of Crinis Carbonisatus under given heating condition.Materials and methodsCrinis Carbonisatus was obtained after pyrolysis of human hair at 300 °C in sealed ceramic pot. The obtained samples were characterized in terms of its physicochemical properties by scanning electron microscopy (SEM), Fourier Transform Infrared (FTIR) spectroscopy and X-ray Diffraction (XRD). ResultsDistinct morphology with nano-particulate structure was observed on SEM micrographs. FTIR spectroscopy of the samples revealed the presence of functional groups like –OH, -COO-­, -NH as well as methyl (-CH3) and methylene (-CH2­-) groups. Graphite interlayer spacing peak appeared in XRD pattern only after 24 h of pyrolysis.ConclusionPyrolysis converts the micron sized particles into the nanometric entities. Amorphous behavior of the materials decreases with the increase in pyrolysis time.
Preoperative Neutrophil-to-lymphocyte Ratio May Predict Postoperative Pneumonia in Stage I–III Gastric Cancer Patients After Curative Gastrectomy: A Retrospective Study
Authors: Mori Mikito , Shuto Kiyohiko , Hirano Atsushi , Narushima Kazuo , Kosugi Chihiro , Yamazaki Masato , Koda Keiji , Yoshida Masahiro 
Published: August 2020

Abstract
Background: Several studies have demonstrated that diverse systemic inflammatory-based prognostic parameters predict poor prognosis in patients with gastric cancer. However, few studies focused on the relationships between postoperative complications and systemic inflammatory-based prognostic parameters after curative gastrectomy. We investigated the relationships between postoperative complications and these parameters to identify parameter-specific postoperative complications, and assessed the clinical utility of the parameters as predictors of postoperative complications in stage I–III gastric cancer patients.Methods: We retrospectively reviewed 300 patients who underwent curative gastrectomy for stage I–III gastric cancer. A postoperative complication sensitive to the systemic inflammatory-based prognostic parameters was identified using a receiver operating characteristic curve, and we evaluated the relationships between the identified postoperative complication and other clinical factors.Results: In total, 101 patients (33.7%) had postoperative Clavien–Dindo grade II–IV complications, namely anastomotic complications, such as leak, stenosis, or hemorrhage (35 patients, 11.7%); pancreatic fistula (16 patients, 5.3%); and pneumonia (14 patients, 4.7%). Postoperative pneumonia had the most sensitive relationship to five systemic inflammatory-based prognostic parameters, and was associated with poor prognosis in stage I–III gastric cancer patients after curative gastrectomy. Multivariate analysis revealed that preoperative neutrophil-to-lymphocyte ratio (odds ratio: 5.228, 95% confidence interval: 1.269–21.541; P=0.022) was an independent predictor of postoperative pneumonia.Conclusions: Preoperative neutrophil-to-lymphocyte ratio may be a useful predictor of postoperative pneumonia in stage I–III gastric cancer patients after curative gastrectomy.
Prevalence of Chronic Hepatitis B and C in Malaysia- results from a community-based screening campaign.
Authors: ZZ Lim , JS Teo , Siam Tan Soek , Mohamed Rosmawati , KL Goh , Jaya Fauziah , K Senamjit , Aun Azlida Che' , Said Rosaida , EK Lim , Shahar Hamiza , AH Muhammad Radzi , Poh Tee Hoi , Seng Tan Soon , Menon Jayaram , Menon Rena , Lim Teck Onn 
Published: August 2020

Abstract
Introduction The epidemiology of hepatitis, which is apparently endemic in Asia, is still poorly documented in Malaysia. Available statistics are modelled estimates based on expert input or estimated from small studies on special populations. We therefore determined the prevalence of chronic hepatitis B and C in Malaysia based on a large sample data from a screening campaign. Methods A total of 10,914 subjects participated in the hepatitis screening campaign in 2018 and 2019. A low-cost Point-of-care test, which has previously been validated, was used to screen for HBsAg and anti-HCV. All screen positive subjects were recalled to undergo confirmatory serology tests and nucleic acid tests. Results We estimated 1.17% or 238,971 Malaysian adults aged 20 or older had chronic HBV, while only 0.74% or 151,144 adults had chronic HCV. Young adults below age 30 years had very low prevalence of HBV (0.09%). Women had lower prevalence of HBV and HCV, Chinese had the highest prevalence of HBV while Malay had the highest prevalence of HCV. Conclusion Young adults seems to be protected from HBV perhaps owing to the introduction of universal HBV vaccination since 1989. Chronic HBV however remains prevalent in older adults especially among the Chinese. Chronic HCV is uncommon in Malaysia.
Network Pharmacology Based Research into the Effect and Mechanism of Yinchenhao Decoction Against Cholangiocarcinoma
Authors: Chen Zhiqiang , Lin Tong , Liao Xiaozhong , Li Zeyun , Lin Ruiting , Qi Xiangjun , Chen Guoming , Sun Lingling , Lin Lizhu 
Published: August 2020

Abstract
Background: This study aimed to screen out the effective active components of Yinchenhao decoction (YCHD) using network pharmacology, estimate their potential targets, screen out the pathways, as well as delve into the potential mechanisms on treating cholangiocarcinoma. Methods: By the traditional Chinese medicine system pharmacology database and analysis platform (TCMSP) as well as literature review, the major active components and their corresponding targets were estimated and screened out. Using the software Cytoscape 3.6.0, a visual network was established using the active components of YCHD and the targets of cholangiocarcinoma. Based on STRING online database, the protein interaction network of vital targets was built and analyzed. With the Database for Annotation, Visualization, and Integrated Discovery (DAVID) server, the gene ontology (GO) biological processes and the Kyoto encyclopedia of genes and genomes (KEGG) signaling pathways of the targets enrichment were performed. The AutoDock Vina was used to perform molecular docking and calculate the binding affinity. The PyMOL software was utilized to visualize the docking results of active compounds and protein targets. In vivo experiment, the IC50 values and apoptosis rate in PI-A cells were detected using CCK-8 kit and Cell Cycle Detection Kit. The predicted targets were verified by the real-time PCR and western blot methods. Results: 32 effective active components with anti-tumor effects of YCHD were sifted in total, covering 209 targets, 96 of which were associated with cancer. Quercetin, kaempferol, beta-sitosterol, isorhamnetin, and stigmasterol were identified as the vital active compounds, and AKT1, IL6, MAPK1, TP53 as well as VEGFA were considered as the major targets. The molecular docking revealed that these active compounds and targets showed good binding interactions. These 96 putative targets exerted therapeutic effects on cancer by regulating signaling pathways (e.g., hepatitis B, the MAPK signaling pathway, the PI3K-Akt signaling pathway, and MicroRNAs in cancer). Our in vivo experimental results confirmed that YCHD showed therapeutic effects on cholangiocarcinoma by decreasing IC50 values, down-regulating apoptosis rate of cholangiocarcinoma cells, and lowering protein expressions. Conclusion: As predicted by network pharmacology strategy and validated by the experimental results, YCHD exerts anti-tumor effects through multiple components, targets, and pathways, thereby providing novel ideas and clues for the development of preparations and the treatment of cholangiocarcinoma.
Diagnostic value of neutrophil CD64, procalcitonin, and interleukin-6 in sepsis: A meta-analysis
Authors: Wang Ke , Cong Shan , Ma Tiangang , Di Xin , Tian Chang , Zhao Min 
Published: August 2020

Abstract
The aim of the study was to conduct a meta-analysis to evaluate the accuracy of neutrophil CD64, procalcitonin (PCT), and interleukin-6 (IL-6) for the diagnosis of sepsis. The sample articles were searched in various databases to collect published studies on the diagnosis of sepsis by neutrophil CD64, PCT, and IL-6. By using the Stata SE 15.0 software, forest plots and the area under the summary receiver operating characteristic curves were drawn. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve (AUC) were calculated. 54 articles were included in the study. The number of studies that evaluated the diagnostic value of neutrophil CD64, PCT, and interleukin-6 were 20, 39, and 15, respectively. The pooled sensitivity, specificity, and AUC of neutrophil CD64 for the diagnosis of sepsis were 0.88 [95% confidence interval (CI), 0.81–0.92], 0.88 (95% CI, 0.83–0.91), and 0.94 (95% CI, 0.91–0.96), respectively. The pooled sensitivity, specificity, and AUC of PCT for the diagnosis of sepsis were 0.82 (95% CI, 0.78–0.85), 0.78 (95% CI, 0.74–0.82), and 0.87 (95% CI, 0.83–0.89), respectively. Subgroup analysis showed that the AUC for PCT diagnosis of intensive care unit (ICU) sepsis was 0.86 (95% CI, 0.83–0.89) and the AUC for PCT diagnosis of non-ICU sepsis was 0.82 (95% CI, 0.78–0.85). The pooled sensitivity, specificity, and AUC of IL-6 for the diagnosis of sepsis were 0.72 (95% CI, 0.65–0.78), 0.70 (95% CI, 0.62–0.76), and 0.77 (95% CI, 0.73–0.80), respectively. Of the three biomarkers studied, neutrophil CD64 showed the highest diagnostic value for sepsis, followed by PCT, and IL-6. On the other hand, PCT showed a better diagnostic value for the diagnosis of sepsis in patients with severe conditions compared with that in patients with non-severe conditions.
A Preliminary Study on Various Types of 4-Aminoquinolines for Pre- or Post-Exposure Prophylaxis and for Treatment in Severe COVID-19
Authors: Bright Bisi , Ali Wael , Fajimi Niyi , Adesope Toyin , Tairu Suzanne , Sobande Patrick , Itodo Ewaoche Sunday 
Published: August 2020

Abstract
Background: LiveWell Initiative LWI is a self-funded nonprofit social enterprise that thrives on innovation.The organization has, for 5 years, supervised MPH and DrPH Practicums for the Harvard T. H. Chan School of Public Health, Harvard University, Boston USA. It also supervises the PhD thesis at the University of Helsinki, Finland. At the inception of COVID-19, LWI designed and compiled three (3) sets of study protocols in response to the COVID-19 response in Africa with a goal to arrive at a practical and affordable solution to the pandemic using 4-aminoquinolines. Method: A concurrent cohort/descriptive study of observation in patients exposed to HCQ/CQ prophylaxis and treatment with HCQ/CQ and quinine with categorization as specified as not critically ill, critically ill but not on a ventilator and critically ill on a ventilator. One hundred and twenty-three (123) subjects were categorized into shelter-in-place, self-quarantine and self-isolation (not critically ill, critically ill but not on a ventilator and critically ill on a ventilator). The 4-aminoquinolines were administered macrolide and zinc sulfate as appropriate for a defined duration and dose. Results: The preliminary study of the 123 subjects covering all categories listed above resulted in 100% positive outcomes: Nil death, Nil relapse in symptomatic persons and total recovery with no relapse after 6 weeks lockdown, and asymptomatic persons post-prophylaxis after 6 weeks lockdown. The results have been gathered principally from Clinician Reported Outcomes with a few Patient Reported Outcomes. Conclusion: These repurposed drugs with unique strengths—chloroquine and its analogue Hydroxychloroquine as well quinine—hold sway in the treatment of COVID-19.