bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outpatient Management of Oligosymptomatic Patients with Respiratory Infection in the Era of SARS-CoV-2. Experience from Rural German General Practitioners&nbsp;
Authors: Wernhart Simon , Förster Tim Henning , Weihe Eberhard 
Published: August 2020

Abstract
Background: Covid-19 is causing a pandemic and forces physicians to restructure their daily work. We want to share our experience in the outpatient management of potentially infected patients with colleagues from other countries with special consideration of altered national test strategies during the crisis.Methods: We analysed all patients with respiratory symptoms reporting to our three rural general practioner (GP) offices in North Rhine Westphalia, Germany, from 27.01-20.04.2020 (n=489 from a total of 6090 patients). Patients with respiratory symptoms were examined in a separated isolation area, while the others were allowed to enter the office. We applied the first recommended algorithm of the German Robert Koch Institute (RKI) to test suspected patients and compared our results to an adapted, more liberal version of the RKI, which is currently applied in Germany.Results: Eighty patients (16.36%, mean age: 47.03years+-18.08) were sent to a nasopharyngeal smear. five patients (6.25%) turned out to be positive, four of which had established risk factors for COVID-19. Overall, the most common symptoms were cough (83.75%), sore throat (71.25%), as well as myalgia and fatigue (66.25%). The most common diagnoses were rhinopharyngitis (37.22%) and acute bronchitis (30.27%). A sore throat was more common in positively tested patients (80% vs. 12%). Applying the first RKI test strategy yielded 6.25% of positive tests (n=80), while the more liberal later RKI recommendation would have achieved 1.36% of positive tests from 369 patients. No positive test was missed by applying the conservative strategy. None of our employees called in sick during this period, which emphasizes the efficacy and safety of our screening methods. Conclusion: A clinical distinction between ordinary respiratory infections and COVID-19 is not possible in a low-prevalence population. Our model to prevent unprotected physical contact, screen patients in front of the office with protective equipment, and to examine respiratory infections in separated areas works in the GP setting without overt health risks for employees. Thus, this approach should be used as a GP standard to uphold patient care without major health risks for the personnel. Large multicenter studies are necessary to work out the most suitable test strategy.
Targeting high risk forest goers for malaria elimination: A novel approach for investigating forest malaria to inform program intervention in Vietnam
Authors: Canavati Sara E. , Kelly Gerard C. , Quintero Cesia E. , Vo Thuan Huu , Tran Long Khanh , Ngo Thang Duc , Tran Duong Thanh , Edgel Kimberly A. , Martin Nicholas J. 
Published: August 2020

Abstract
Background Individuals that work and sleep in remote forest and farm locations in the Greater Mekong Subregion continue to remain at high risk of both acquiring and transmitting malaria. These difficult-to-access population groups largely fall outside the reach of traditional village-centered interventions, presenting operational challenges for malaria programs. In Vietnam, over 60% of malaria cases are thought to be individuals who sleep in forests or on farms. New malaria elimination strategies are needed in countries where mobile and migrant workers frequently sleep outside of their homes. Aims of this study were to apply targeted surveillance-response based investigative approaches to gather location-specific data on confirmed malaria cases and identify associated malaria prevention, treatment and risk behaviors of individuals sleeping in remote forest and farms sites in Vietnam. Methods A cross-sectional study using novel targeted reactive investigative approaches at remote area sleeping sites was conducted in three mountainous communes in Phu Yen province in 2016. Index cases were defined as individuals routinely sleeping in forests or farms who had tested positive for malaria. Index cases and non-infected neighbors from forest and farm huts within 500m of the established sleeping locations of index cases were interviewed in person at their remote-area sleeping sites. Results A total of 307 participants, 110 index cases and 197 neighbors, were enrolled. Among 93 participants who slept in the forest, index cases were more likely to make >5 trips to the forest per year (prevalence odds ratio (POR) 7.41, 95% confidence interval (CI) 2.66–20.63), sleep in huts without walls (POR 44.00, 95% CI 13.05–148.33), sleep without mosquito nets (POR 2.95, 95% CI 1.26–6.92), and work after dark (POR 5.48, 95% CI 1.84–16.35). Of the 204 farm-based respondents, a significantly higher proportion of index cases were involved in non-farming activities (logging) (POR 2.74, 95% CI 1.27–5.91). Conclusion Investigative approaches employed in this study allowed for the effective recruitment and characterization of high-priority individuals frequently sleeping in remote forest and farm locations, providing relevant population and site specific data that decision makers can use to design and implement targeted interventions to support malaria elimination.
The Universal Sample Holders of Microanalytical Instruments of FIB, TEM, NanoSIMS, and STXM-NEXAFS for the Coordinated Analysis of Extraterrestrial Materials
Authors: Ito Motoo , Tomioka Naotaka , Uesugi Kentaro , Uesugi Masayuki , Kodama Yu , Sakurai Ikuya , Okada Ikuo , Ohigashi Takuji , Yuzawa Hayato , Yamaguchi Akira , Imae Naoya , Karouji Yuzuru , Shirai Naoki , Yada Toru , Abe Masanao 
Published: August 2020

Abstract
We developed universal sample holders (the Kochi grid, Kochi clamp, and Okazaki cell) and a transfer vessel (facility-to-facility transfer container (FFTC)) to analyze sensitive and fragile samples, such as extremely small extraterrestrial materials. The holders and container prevent degradation, contamination due to the terrestrial atmosphere (water vapor and oxygen gas) and small particles, as well as mechanical sample damage. The FFTC can isolate the samples from the effects of the atmosphere for more than a week. The Kochi grid and clamp were made for a coordinated micro/nano-analysis that utilizes a focused-ion beam apparatus, transmission electron microscope, and nanoscale secondary ion mass spectrometry. The Okazaki cell was developed as an additional attachment for a scanning transmission X-ray microscope that uses near-edge X-ray absorption fine structure (NEXAFS). These new apparatuses help to minimize possible alterations from the exposure of the samples to air. The coordinated analysis involving these holders was successfully carried out without any sample damage or loss, thereby enabling us to obtain sufficient analytical datasets of textures, crystallography, elemental/isotopic abundances, and molecular functional groups for µm-sized minerals and organics in both the Antarctic micrometeorite and a carbonaceous chondrite. We will apply the coordinated analysis to acquire the complex characteristics in samples obtained by the future spacecraft sample return mission.
Protein cysteine S-nitrosylation provides reducing power by enhancing lactate dehydrogenase activity in Trichomonas vaginalis under iron deficiency
Authors: Cheng Wei-Hung , Huang Kuo-Yang , Ong Seow-Chin , Ku Fu-Man , Huang Po-Jung , Lee Chi-Ching , Yeh Yuan-Ming , Lin Rose , Chiu Cheng-Hsun , Tang Petrus 
Published: August 2020

Abstract
Background: Iron plays essential roles in the pathogenesis and proliferation of Trichomonas vaginalis, the causative agent of the most prevalent nonviral human sexually transmitted infection. We previously demonstrated that under iron deficiency, the endogenous nitric oxide (NO) is accumulated and capable of regulating the survival of T. vaginalis. Herein, we aim to explore the influence of NO on the activity of the pyruvate-reducing enzyme lactate dehydrogenase in T. vaginalis (TvLDH).Methods : Levels of lactate and pyruvate were detected for determining glycolysis activity in T. vaginalis under iron deficiency. Quantitative PCR was performed to determine the expression of TvLDH. S-nitrosylated (SNO) proteomics was conducted to identify the NO-modified proteins. The activities of glyceraldehyde-3-phosphate dehydrogenase (TvGAPDH) and TvLDH were measured after sodium nitrate treatment. The effects of protein nitrosylation on the production of cellular reducing power were examined by measuring the amount of nicotinamide adenine dinucleotide (NAD) and the ratio of the NAD redox pair (NAD+/NADH).Results: We found that although the glycolytic pathway was activated in cells under iron depletion, the level of pyruvate was decreased due to the increased level of TvLDH. By analyzing the SNO proteome of T. vaginalis upon iron deficiency, we found that TvLDH is one of the glycolytic enzymes modified by SNO. The production of pyruvate was significantly reduced after nitrate treatment, indicating that protein nitrosylation accelerated the consumption of pyruvate by increasing TvLDH activity. Nitrate treatment also induced NAD oxidation, suggesting that protein nitrosylation was the key posttranslational modification controlling cellular redox status. Conclusion: We demonstrated that NO-mediated protein nitrosylation plays pivotal roles in the regulation of glycolysis, pyruvate metabolism, and the activity of TvLDH. The recycling of oxidized NAD catalyzed by TvLDH provided the reducing power that allowed T. vaginalis to adapt to the iron-deficient environment.
Short-duration, submaximal intensity exercise stress combined with adenosine triphosphate decreases artifacts in myocardial perfusion single-photon emission computed tomography
Authors: Shinoda Yukinori , Tachibana Koichi , Minamisaka Tomoko , Fukuoka Hidetada , Inui Hirooki , Ueno Keisuke , Inoue Soki , Mine Kentaro , Ueda Kumpei , Hoshida Shiro 
Published: August 2020

Abstract
Background: Myocardial perfusion single-photon emission computed tomography (SPECT) imaging with stress is a useful examination for detecting coronary artery disease. Since the presence of artifacts is remaining challenges, we aimed to define the minimum intensity of low-grade exercise stress levels combined with drug stress to reduce undesired artifacts and their related factors. Methods: We divided patients with suspicious coronary artery disease into 4 groups as follows: group A, adenosine triphosphate (ATP) for 6 min; group A+25 W, ATP+25 W exercise for 6 min; group A+35 W, ATP+35 W exercise for 6 min; group A+45 W, ATP+45 W exercise for 6 min) and enrolled only those whose summed stress scores were <3. Undesired artifacts were evaluated on the basis of heart-to-liver activity ( H/L ) ratio and heart-to-10 pixels below the heart ( H /below the H ) ratio. Results: The logarithmic values of H/L and H /below the H ratios were significantly higher in groups A+35 W and A+45 W than in group A (p<0.05, each). In all the patients, the logarithmic values of H/L and H /below the H ratios positively correlated with the increment of rate pressure product (RPP, p=0.002 and p=0.005, respectively) after stress in the univariate analysis. The left ventricular end-diastolic volume (LVEDV) after stress (p=0.002) negatively correlated with the logarithmic value of H /below the H ratio, but not H/L ratio. Although the increment of RPP was independently associated with the logarithmic values of both H/L (p=0.001) and H /below the H ratios (p=0.005), LVEDV was also independently associated with the logarithmic value of H /below the H ratio (p<0.001) in multivariate regression analysis under adjusting with age and sex. Conclusion: ATP plus ≥35 W exercise stress for 6 min was useful for reducing undesired artifacts after stress in myocardial perfusion SPECT. LVEDV after stress in addition to the increment of RPP was independently associated with the H /below the H ratio, but not the H/L ratio.
Boosting toxic protein expressionbiosynthesis: transient in vivo inactivation of engineered bacterial alkaline phosphatase
Authors: Krawczun Natalia , Bielawa Marta , Szemiako Kasjan , Lubkowska Beata , Sobolewski Ireneusz , Zylicz-Stachula Agnieszka , Skowron Piotr M 
Published: August 2020

Abstract
Background The biotechnology production of enzymes is often troubled by the toxicity of the recombinant products of cloned and expressed genes, which interferes with the recombinant hosts’ metabolism. Various approaches have been taken to overcome these limitations, exemplified by tight control of recombinant genes or secretion of recombinant proteins. An industrial approach to protein production demands maximum possible yields of biosynthesized proteins, balanced with the recombinant host’s viability. Bacterial alkaline phosphatase (BAP) from Escherichia coli (E. coli) is a key enzyme used in protein/antibody detection and molecular cloning. As it removes terminal phosphate from DNA, RNA and deoxyribonucleoside triphosphates, it is used to lower self-ligated vectors’ background. The precursor enzyme contains a signal peptide at the N-terminus and is secreted to the E. coli periplasm. Then, the leader is clipped off and dimers are formed upon oxidation.Results We present a novel approach to phoA gene cloning, engineering, expression, purification and reactivation of the transiently inactivated enzyme. The recombinant bap gene was modified by replacing a secretion leader coding section with a N-terminal his6-tag, cloned and expressed in E. coli in a PBAD promoter expression vector. The gene expression was robust, resulting in accumulation of His6-BAP in the cytoplasm, exceeding 50% of total cellular proteins. The His6-BAP protein was harmless to the cells, as its natural toxicity was inhibited by the reducing environment within the E. coli cytoplasm, preventing formation of the active enzyme. A simple protocol based on precipitation and immobilized metal affinity chromatography (IMAC) purification yielded homogeneous protein, which was reactivated by dialysis into a redox buffer containing reduced and oxidized sulfhydryl group compounds, as well as the protein structure stabilizing cofactors Zn2+, Mg2+ and phosphate. The reconstituted His6-BAP exhibited high activity and was used to develop an efficient protocol for all types of DNA termini, including problematic ones (blunt, 3’-protruding).Conclusions The developed method appears well suited for the industrial production of ultrapure BAP. Further, the method of transient inactivation of secreted toxic enzymes by conducting their biosynthesis in an inactive state in the cytoplasm, followed by in vitro reactivation, can be generally applied to other problematic proteins.
New Onset Diabetes Mellitus and Cardiovascular Events in Korean Patients with Acute Myocardial Infarction Receiving High-Intensity Statins
Authors: Choi Jah Yeon , Choi Cheol Ung , Choi Byoung Geol , Park Yoonjee , Kang Dong Oh , Jang Won Young , Kim Woohyeun , Na Jin Oh , Kim Jin Won , Kim Eung Ju , Rha Seung-Woon , Park Chang Gyu , Seo Hong Seog , Jeong Myung Ho , Chae Sung-Chull , Seong In-Whan , Yoon Chang-Hwan , Cha Kwang Soo , Oh Seok Kyu 
Published: August 2020

Abstract
Background: High-intensity statin therapy is typically used in patients with acute myocardial infarction (AMI) for secondary prevention. However, there have been consistent concerns regarding its association with diabetes mellitus. We investigated the effect of high-intensity atorvastatin and rosuvastatin on new-onset diabetes mellitus (NODM) and cardiovascular outcomes over a 3-year follow-up period.

Methods: Data from the Korea Acute Myocardial Infarction Registry were collected from November 2011 to October 2015, and 13,104 patients with AMI were enrolled from major cardiovascular centers. Among them, 2,221 patients without diabetes who had been administered with high-intensity atorvastatin (40–80 mg) and rosuvastatin (20 mg) were investigated. The atorvastatin and rosuvastatin groups were evaluated for the incidence of NODM and major adverse cardiac events (MACE) including death, myocardial infarction, and revascularization cases in the following 3 years.

Results: Baseline characteristics were comparable between the two groups. Event-free survival rate of NODM and MACE was not significantly different between the atorvastatin and rosuvastatin groups (92.5% vs. 90.8%, respectively; Log-rank P-value = 0.550). The event-free survival rate of MACE was also not significantly different between atorvastatin and rosuvastatin groups (89.0% vs. 89.6%, respectively; Log rank P-value = 0.662). Multivariate Cox analysis revealed that statin type was not a prognostic factor in the development of NODM and MACE.

Conclusions: Administering high-intensity atorvastatin and rosuvastatin in patients with AMI produced comparable effects on NODM and clinical outcomes, suggesting their clinical equivalence in secondary prevention.
Comparison of BSGI , MRI, mammography, and ultrasound for the diagnosis of breast lesions and their correlations with specific molecular subtypes in Chinese women
Authors: liu hongbiao , Zhan Hongwei , Sun Da , Zhang Ying 
Published: August 2020

Abstract
Background: Breast cancer is a leading cause of cancer in females, and is the second leading cancer-related cause of death in this group. Early diagnosis is essential to breast cancer to be effectively treated, and ultrasound, mammography, and magnetic resonance imaging (MRI) represent three key technologies that are utilized for the diagnosis of breast lesions. Breast-specific gamma imaging (BSGI) is an approach to molecular breast imaging that allows for high-resolution radio-imaging that is not adversely impacted by breast tissue density. This study was therefore designed to assess the relative diagnostic efficacy of BSGI, MRI, mammography, and ultrasound in different molecular subtypes of breast cancer among Chinese women. Methods: Diagnostic findings from 390 patients that had undergone diagnosis and treatment in our breast surgery department were retrospectively reviewed. Patients had been diagnosed via BSGI, mammography, ultrasound, and MRI. The diagnostic efficacy of these different imaging modalities and their associated biological characteristics were compared in the present study. Results: A total of 229 of these 390 patients (58.7%) were diagnosed with malignant breast cancer, with the remaining 161 (41.3%) cases having been found to be benign. BSGI, MRI, mammography, and ultrasound yielded respective sensitivity values of 91.7%, 92.5%, 77.3%, and 82.1%, while the respective specificity values for these imaging modalities were 80.7%, 69.7%, 74.5%, and 70.8%. For lesions > 1 cm, BSGI offered a sensitivity of 92.5%. For mammographic breast density A, B, C, and D, BSGI offered a sensitivity of 93.3%, 94.0%, 91.5%, and 89.3%, respectively. BSGI also yielded a significantly higher lesion-to-normal lesion ratio (LNR) for malignant lesions relative to benign lesions (2.76±1.32 vs 1.46±0.49). Conclusions: These findings confirm that BSGI is highly sensitive and is superior to mammography in the detection and diagnosis of ductal carcinomas in situ (DCIS). Such diagnostic efficacy can be further improved by using BSGI as an auxiliary modality to mammography and ultrasound, potentially improving the reliability of breast lesion diagnosis, thereby ensuring that patients receive rapid and effective treatment without the risk of misdiagnosis or unnecessary surgical treatment.
Impact of daily versus weekly service of infectious diseases consultation on hospital antimicrobial consumption: a retrospective study
Authors: Cona Andrea , Gazzola Lidia , Viganò Ottavia , Bini Teresa , Marchetti Giulia Carla , Monforte Antonella d'Arminio 
Published: August 2020

Abstract
Background: To verify whether daily service of Infectious Diseases consultation (ID-cons) is more effective than weekly service in reducing antibiotic (ABT) consumption without worsening of clinical outcomes. Methods: Two-years observational analysis of all the ID-cons provided in a hospital in Milan. ID-cons resulted in: start-of-ABT; no-ABT; confirmation; modification-of-ABT. We evaluated the impact of weekly (09/2016-09/2017) versus daily (10/2017-10/2018) service of ID-cons on: time-from-admission-to-first-ID-cons, type of ABT-intervention and number-of-ID-cons per 100 bed days (bd). Primary outcomes: (i) reduction of overall hospital ABT consumption and (ii) reduction of ABT consumption by department and by ABT classes expressed as defined-daily-dose (DDD)/100bd (by Wilcoxon test for paired data). Secondary outcome: no significant increment of overall and sepsis-related in-hospital mortality (as death/patient’s admissions) from 2017 to 2018. Results: Overall 2552 ID-cons in 1111 patients (2.3 ID-cons/patient) were performed (18.6% weekly vs 81.4% daily). No differences in patient’s characteristics were observed. In daily-service, compared to weekly, patients were seen by the ID-consultant earlier (time-from-admission-to-ID-cons: 6 days (IQR 2-13) vs 10 days (IQR 6-19), p<0.0001) and ABT was more often started by the ID-consultant (Start-of-ABT: 11.6% vs 8%, p=0.02). After switch to daily service, the number-of-ID-cons increased from 0.4/100bd to 1.5/100bd (p=0.01), with the greatest increase in the emergency department (1.5/100bd vs 6.7/100bd, p<0.0001). Total ABT consumption decreased from 62.1 to 59.3 DDD/100bd, p=0.02. As for the number-of-cons, the consumption of ABT decreased mainly in the emergency area. According to ABT classes, glycopeptides consumption has been reduced from 3.1 to 2.1 DDD/100bd (p=0.02) while carbapenem use decreased from 3.7 to 3.1 DDD/100bd (p=0.07). No changes in overall-mortality (5.2% vs 5.2%) and sepsis-related mortality (19.3% vs 20.9%; p=0.7) were observed among the two time-period. Conclusions: Daily-ID-cons resulted in a more comprehensive taking charge of the infected patient by the ID-consultant, especially in the emergency area where we also observed the highest rate of reduction of ABT-usage. No change in mortality was observed.
COVID-19 Epidemic Prevention Plan: Reducing the Operational Risk in Pharmacy by the Isolation and Triage Mechanism
Authors: Wang Ya-Ling , Lu Ying-Hao , Lee Li-Yao , Kuo Chen-Chun , Shen Mei-Chiu , Chung Tang-Chia , Hsu Yu-Sheng , Lee Chun-Chen , Wang Jia-Hong , Hung Ching-Tzu 
Published: August 2020

Abstract
Background: Taiwan medical centers mainly use "Central Pharmacy" to carry out pharmaceutical operations and human resources management. The pharmacy is a 24-hour medication supply center for all units in the Hospital. Therefore, how to make the pharmacy run continuously in the potential impact of COVID-19 pandemic is an important issue in the epidemic prevention of the medical center. The purpose of this study is to design to reduce the incidence of cross or cluster infection in the event of nosocomial infection and to maintain the continuous operation of pharmaceutical service.Methods: The planning of "isolation and triage" of pharmaceutical operations is based on the epidemic level of COVID-19, the closing situation of outpatient service, the number of outpatients receiving medicine service and the number of inpatient beds.Results: After the overall planning, in the case of the low epidemic level (level A1), the emergency pharmacy took advance deployment, and fixed personnel was assigned to work in fixed location in the isolation, while other units started the isolation mode in the case of the moderate epidemic level (level B). Grouping mode was added for the severe epidemic level (level C). Different management measures should be planned according to the different level of risk area evaluated by the infection control center.Conclusions: In this study, the risk reduction management mechanism of "isolation and triage" was effectively used to make proper manpower allocation and work planning for all pharmaceutical service in Hospital.