bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neurological Presentation of Severe Dengue in Children From a Colombian Hyperendemic Area
Authors: Castellanos Jaime E. , Esteban Paula , Panqueba-Salgado Juanita , Benavides-del-Castillo Daniela , Pastrana Valentina , Acosta Gladys , Salgado Doris , Narvaez Carlos F. , Camacho-Ortega Sigrid , Calvo Eliana , Velandia-Romero Myriam L. 
Published: August 2020

Abstract
Objective: Dengue transmission is sustained in Colombia with increasing prevalence mainly in children. This work was aimed to describe a cases series of children diagnosed with dengue presenting neurological disease in the Huila province of Colombia. Eleven pediatric febrile patients confirmed to dengue disease and presenting neurological signs were studied in the University Hospital of Neiva, Huila province. Clinical and laboratory findings, CSF cytochemical analysis, neurology images, and serology and molecular studies were performed. Results. Viral RNA was detected in all patients’ sera by RT-PCR. Nine out of 11 were primary infections. Tonic-clonic seizures (73%), consciousness alterations (27%), irritability (27%) and ataxia (18%) were the most frequent neurological signs. None of the patients had plasma leakage, hypovolemic shock or liver disease, confirming the encephalitis diagnosis. Diagnostic images did not show abnormal findings neither bacterial or fungal infections were detected in CSF analysis. All patients survived without sequelae except in one patient that presented ataxia for months. In conclusion, we described a group of children with neurological signs during severe dengue disease as the main finding, indicating the importance of include dengue as a differential diagnosis in neurological patients from endemic areas.
Elucidation of tumor-stromal heterogeneity and the ligand-receptor interactome by single cell transcriptomics in real-world pancreatic cancer biopsies
Authors: Lee Jaewon , Bernard Vincent , Semaan Alexander , Monberg Maria , Huang Jonathan , Stephens Bret , Lin Daniel , Weston Brian , Bhutani Manoop , Haymaker Cara , Bernatchez Chantale , Taniguchi Cullen , Maitra Anirban , Guerrero Paola 
Published: August 2020

Abstract
Precision medicine approaches in pancreatic ductal adenocarcinoma (PDAC) are imperative for improving disease outcomes. However, the long-term fidelity of recently deployed ex vivo preclinical platforms, such as patient-derived organoids (PDOs), remains unknown. Through single-cell RNA sequencing (scRNA-seq), we identify substantial transcriptomic evolution of PDOs propagated from the parental tumor, which may alter predicted drug sensitivity. In contrast, scRNA-seq is readily applicable to limited biopsies from human primary and metastatic PDAC and identifies most cancers as being an admixture of previously described epithelial transcriptomic subtypes. Integrative analyses of our data provide an in-depth characterization of the heterogeneity within the tumor microenvironment, including cancer-associated fibroblast (CAF) subclasses, and predict a multitude of ligand-receptor interactions, revealing potential targets for immunotherapy approaches. While PDOs continue to enable prospective therapeutic prediction, our analysis also demonstrates the complementarity of using orthogonal de novo biopsies from PDAC patients paired with scRNA-seq to inform clinical decision-making.
“Z” Chest Drainage and Modified Incision and Closure Techniques for Uniportal VATS
Authors: Zhang Ruijie , Hao Zhipeng , Zhang Ni , Fu Xiangning 
Published: August 2020

Abstract
BACKGROUND: To research the application of “Z” chest drainage and modified incision and closure techniques for uniportal VATS.METHODS: The 422 patients by uniportal VATS were divided into three groups:282 in experimental group(“Z” Chest drainage with two 16 F chest tube),male 156,female 126, medianage is 55 years old;100 in control group1(traditional Chest drainage with two 16 F chest tube) , male 58,female 42, medianage is 53 years old;;40 in control group2(traditional Chest drainage with two 34 F chest tube), male 24,female 16, medianage is 52 years old. The age,sex and surgical method of the three groups has no statistical significance. To compare the incidence rate of Incision exudating、Poor healing of incision and debridement between the 3 groups.RESULTS: Incidence rate of Incision exudating of experimental group, control group1 and control group2: 5（1.8%,5/282），5（5%,5.0/100） and 6（15.0%，6/40）; Poor healing of incision of the three groups: 0，1（1%,1/100） and 3（7.5%,3/40）; debridement of the three groups: 0，0 and 3（7.5%,3/40）. For the healing of incision, control group1was better than control group2;and experimental group was better than control group1.CONCLUSIONS: “Z” Chest drainage and Modified Incision and Closure Techniques decreased the incidence rate of Incision exudating、Poor healing of incision and debridement,which would be useful to obtain a better cosmetic effect after uniportal VATS .
Clinical Impact of Interferon-γ in Anti-Citrullinated Protein Antibody-Positive Rheumatoid Arthritis
Authors: Lee Kijun , Min Hong Ki , Ko Seong-Hee , Lee Sang-Heon , Kim Hae-Rim , Ju Ji Hyeon , Kim Ho-Youn 
Published: August 2020

Abstract
Background: CD4+ T cells are crucial for the pathogenesis of rheumatoid arthritis (RA). The roles of gene overexpression in CD4+ T cells and the predictive roles of Th1- and Th17-related cytokines have not been clearly defined in patients with RA. Here, we investigated gene expression levels in CD4+ T cells in methotrexate (MTX)-naïve early RA (eRA) and evaluated changes in CD4+ T-cell-related cytokines during eRA. Methods: Patients with anti-citrullinated protein antibody (ACPA)-positive MTX-naïve eRA were recruited. Patients with osteoarthritis were evaluated as controls. Microarray analysis was used to identify overexpressed genes in CD4+ T cells, and reverse transcription quantitative polymerase chain reaction was used to validate the identified genes. Plasma cytokine levels were measured, and correlations with disease activity were assessed.Results: Thirty-four genes showed overexpression in CD4+ T cells from patients with ACPA-positive MTX-naïve eRA compared with controls. Nineteen were related to interferon (IFN)-γ, and nine were related to interleukin (IL)-17A; five were related to both IFN-γ and IL-17A. Plasma levels of five cytokines were elevated in the ACPA-positive MTX-naïve eRA group compared with those in the control group, and C-X-C motif chemokine ligand 10 was significantly elevated in the ACPA-positive MTX-naïve eRA group compared with that in the established active RA and OA groups. In established RA with low disease activity, the drug-free remission group/drug reduction group showed significantly lower IFN-γ and IL-17A levels than the drug maintenance group and relapse after drug reduction group. Conclusion: Our T2 research of IFN-γ emphasized that, not only the Th17 immune response, but the Th1 immune response is also very important for the RA pathogenesis. Concurrent increase in IFN-γ and IL-17 were observed in active stage of ACPA-positive MTX-naïve eRA, and the plasma levels of them could be useful for new clinical biomarkers before and/or after treatment of RA.
Non-conveyance of older adult patients and association with subsequent clinical and adverse events after initial assessment by ambulance clinicians: A cohort analysis
Authors: Lederman Jakob , Lindström Veronica , Elmqvist Carina , Löfvenmark Caroline , Ljunggren Gunnar , Djärv Therese 
Published: August 2020

Abstract
Background: Older adults (age ≥65 years) represent a significant proportion of all patients who are not transported to hospital after assessment by ambulance clinicians (non-conveyed patients). This study aimed to fill the knowledge gap in the understanding of the prevalence of older adult non-conveyed patients and investigate their characteristics and risk factors for subsequent and adverse events with those of younger non-conveyed patients comparatively.Methods: This population-based retrospective cohort study included all adult non-conveyed patients who availed the ambulance service of Region Stockholm, Sweden in 2015; they were age-stratified into two groups: 18–64 and ≥65 years. Inter-group differences in short-term outcomes (i.e. emergency department visits, hospitalisations, and mortality within 7 days following non-conveyance) were assessed using multivariate regression analyses.Results: Older adult patients comprised 48% of the 17,809 non-conveyed patients. Dispatch priority levels were generally lower among older non-conveyed patients than among younger patients. Non-conveyance among older patients occurred more often during daytime, and they were more frequently assessed by ambulance clinicians with nonspecific presenting symptoms. Approximately one in five older adults was hospitalised within 7 days following non-conveyance. Patients presenting with infectious symptoms had the highest mortality risk following non-conveyance. Oxygen saturation level <95% or systolic blood pressure >160 mmHg had significantly higher associations with hospitalisation within 7 days following non-conveyance in older adult patients.Conclusions: Older adult patients have an increased risk for adverse events following non-conveyance. In combination with a complex symptom presentation which proves difficult for dispatch operators and ambulance clinicians to identify, this risk raises questions on the patient safety of older adult non-conveyed patients.
Successes and Challenges of Implementing a Lung Cancer Screening Program in Federally Qualified Health Centers: A Qualitative Analysis Using the Consolidated Framework for Implementation Research
Authors: Allen Caitlin G. , Cotter Megan M. , Smith Robert A. , Watson Lesley 
Published: August 2020

Abstract
Background: The American Cancer Society (ACS) partnered with two federally qualified health centers (FQHCs) and American College of Radiology designated lung cancer screening facilities on a two-year pilot project to implement lung cancer screening. The project aimed to develop a referral program and care coordination practices to move patients through the screening continuum and identify critical facilitators and barriers to implementation. Methods: Evaluators conducted key informant interviews (N=46) with navigators, clinical staff, administrators from both sites, and ACS staff during annual site visits in 2017 and 2018 to capture data on implementation barriers and facilitators. Three evaluators conducted a thematic analysis using the Consolidated Framework for Implementation Research (CFIR) and assessed factors associated with effective implementation and improved screening outcomes.Results: One study site established a sustainable lung screening program, while the other encountered numerous implementation barriers which they failed to overcome. CFIR constructs highlighted critical barriers and factors associated with success and improved outcomes. Intervention Characteristics: Time spent with patients and disruption to normal workflows were challenges to implementation at both sites. Outer Setting: Both sites struggled with building patient trust and worked to gain trust by providing clear, consistent information about the screening process. One site was located in a state with Medicaid expansion that reimbursed screening but the other was not. Inner Setting: Engaged, supportive leaders who provided clear, consistent communication about implementation helped improve staff capacity, which was critical to building a successful program. Individual Characteristics: Knowledgeable, confident champions and intervention leaders were able to train, guide, and motivate staff throughout the intervention, whereas the absence of supportive leadership failed to produce staff champions and intervention leaders. Process: A slow, stepwise approach to implementation at one site allowed project champions to pilot-test the referral and reimbursement processes and resolve issues before scaling-up.Discussion: This pilot project provides insight into critical resources and steps for successful program implementation in underserved FQHC settings. Future efforts could build upon these findings by considering self-assessment and monitoring tools that incorporate CFIR constructs to help identify and address possible facilitators and barriers to implementation of LDCT.
Cell Banking of HEK293T Cell Line for Clinical-Grade Lentiviral Particles Manufacturing
Authors: Perpiña Unai , Herranz Cristina , Martin-Ibañez Raquel , Boronat Anna , Chiappe Felipe , Monforte Verónica , Orpella-Arecet Gemma , González Ester , Olive Myriam , Castella Maria , Suñe Guillermo , Urbano Alvaro , Delgado Julio , Juan Manel , Canals Josep M. 
Published: August 2020

Abstract
Background: Cell banks have been widely used to preserve cell properties as well as to record and control cell line access in research. However, the generation of cell banks involved in the manufacturing of Advanced therapy medicinal products such as cell or gene therapy products must comply with the current Good Manufacturing Practice regulation. Similarly, the quality of those cell lines used as starting materials in viral-vector manufacturing processes must be also evaluated.Methods: Three batches of both Master Cell Bank and Working Cell Bank of the HEK293T cell line were manufactured under the current Good Manufacturing Practices regulation. Quality control test were performed according to the product specifications. The process validation includes previous qualification of the manufacturing personnel by performing simulation tests as well as the continuous measure of environmental parameters during manufacturing such as air particles and microorganism. Cell number and viability of cryopreserved cells were periodically measured in order to define the stability of these cellular products.Results: All batches of Master Cell Bank and Working Cell Bank fulfilled the acceptance criteria of their specifications showing the robustness and homogeneity of the processes. In addition, both Master and Working cell bank maintain the defined viability and cell number 37 months after cryopreservation. Conclusions: Manufacturing cell banks under Good Manufacturing Practices regulation for its use as raw material or final cellular product is feasible. HEK293T cell banks have been used to manufacture clinical-grade lentiviral particles for Chimeric Antigen Receptor T-cell based clinical trials.
Pretreatments for Enhancing Sewage Sludge Reduction and Reuse in Lipid Production
Authors: Chen Jiaxin , Li Ji , Zhang Xiaolei , Wu Zhaoyang 
Published: August 2020

Abstract
Background: Converting wastewater sludge for lipid is considered as one of the best strategies of sludge management. The current problem of lipid production from sludge is the low yield due to the low availability of easily uptaken materials in sludge. Pretreatments are efficient methods to improve sludge bioavailability. Results: In this study, it was observed that the soluable chemical oxygen demand (SCOD) had significantly increased after different pretreatment.The SCOD in the supernatant was increased from 32.64±5.19 to 180±13 mg/L, 924±17 mg/L, 1030±6 mg/L and 3708±22 mg/L after acidic, alkaline, microwave irradiation and ultrasonication pretreatment, respectively. Pretreatments have also increased the release in total nitrogen (TN) and total phosphorus (TP) from solids. The sludge after different pretreatments were used as medium for lipid production, thighest lipid content (36.67% g/g) was obtained in the fermentation with ultrasonication pretreatment sludge, and the sludge reduction was 63.10%.Conclusion: It was found that ultrasonication pretreatment was the most efficient way to increase the sludge biodegradability (SCOD), to release TN and TP from solid phase to liquid phase. Pretreated sludge for lipid production achieved significant improvement lipid yield and sludge reduction. Lipids produced from pretreated sludge was transesterified to biodiesel and the analysis showed that the biodiesel had similar composition as commercial biodiesel. The study reveals that pretreatment on sludge is a promising method for enhancing biological sludge management efficiency.
Exploring the Association between Changes in Dialysis Reimbursement Policies and Care Outcomes of Peritoneal Dialysis
Authors: Chang Ray-E , Lin Shih-Pi , Yang Feng-Jung , Myrtle Robert C. 
Published: August 2020

Abstract
Background: Except for renal transplantation, peritoneal dialysis (PD) is considered to be relatively cost-effective option for end-stage renal disease (ESRD) patients. Less than 7% of ESRD patients receiving PD in Taiwan, and the promising benefits of PD treatment influenced health policy makers to seek ways to encourage PD utilization. The purpose of this study is to evaluate the effect of their policy initiatives.Methods: An observational longitudinal study using a before-and-after analysis was conducted. The propensity score matching technique was employed to match PD patients before and after the introduction of Taiwan’s efforts to encourage PD utilization in ESRD patients, and the change in PD technical failure was analyzed. HD patients were also matched as the control group to assess the impact of Taiwan’s PD utilization encouraging policies on mortality in PD patients. The competing risk regression approach for survival analysis was adopted in our study.Results: The results showed that while the PD encouraging policies had increased the PD utilization, the increase in PD utilization was accompanied by an increase in technique failure and an increase in mortality.Conclusions: The adoption of new treatments which may benefit patients and incentives to change physician practice behaviors require more disciplined and carefully managed implementation efforts. Care providers need to be equipped by adequate training and sufficient manpower as part of the policy package.
High obliquity, high angular momentum Earth as Moon’s origin revisited by Advanced Kinematic Model of Earth-Moon System
Authors: Sharma Bijay K 
Published: August 2020

Abstract
Matija Cuk et.al (2016) have proposed a new model for the birth and tidal evolution of our natural satellite Moon, born from lunar accretion of impact generated terrestrial debris in the equatorial plane of high obliquity, high angular momentum Earth. This paper examines their findings critically in the light of Advanced Kinematic Model (AKM) which includes Earth’s obliquity(ɸ), Moon’s orbital plane inclination (α), Moon’s obliquity (β) and lunar’s orbit eccentricity (e). It is shown that AKM’s valid range of application is from 45RE to 60.33RE. The evolution of α, β, e is in correspondence with the simulation results of Matija Cuk et.al (2016) but evolution of Earth’s obliquity has a break at 45RE. According to AKM, earlier than 45RE Earth should achieve 0° obliquity in order to achieve the modern value of eco-friendly 23.44° obliquity. Cuk et al (2016) silent on this point. AKM stands vindicated because using protocol exchange algorithm http://doi.org/10.1038/protex.2019.017, AKM has successfully given precise theoretical formalism of Observed LOD curve for the last 1.2 Gy time span opening the way for early warning and forecasting methods for Earth-quake and sudden Volcanic eruptions. This paper gives us an algorithm to determine the short term and long term changes in Earth’s obliquity which is related to Weather and Climate Extremes. Hence this paper gives us the mathematical tool for predicting the Earth’s climate extreme.
A multi-year retrospective quantitative implementation evaluation of Safer Opioid Prescribing, an opioid prescribing continuing education program for Canadian healthcare providers
Authors: Sud Abhimanyu , Doukas Kathleen , Hodgson Katherine , Hsu Justin , Miatello Amber , Moineddin Rahim , Paton Morag 
Published: August 2020

Abstract
Background: Continuing health professions education is considered an important policy intervention for the opioid epidemic. Besides examining effectiveness or impact, it is important to also study health policy implementation to understand how an intervention was delivered within complex policy and practice environments. Implementation outcomes can be used to help interpret continuing health profession education effects and impacts, help answer questions of “how” and “why” programs work, and inform transferability.Methods: We conducted a retrospective quantitative implementation evaluation of the 2014–2017 cohort of Safer Opioid Prescribing, a Canadian continuing health professions education program consisting of three synchronous webinars and in-person workshop. To measure reach and dose, we examined participation and completion data. We used Ontario physician demographic data, including regulatory status with respect to narcotics to examine relevant trends. To measure fidelity and participant responsiveness, we analyzed participant-provided evaluations of bias, active learning and relevance to practice. We used descriptive statistics and measures of association for both continuous and categorical variables. We used logistic regression to determine predictors of workshop participation and analysis of covariance to examine variation in satisfaction across different-sized sessions.Results: Eighty four percent of participants were family physicians with representative reach to non-major urban physicians. Webinar completion rate was 86.2% with no differences in completion based on rurality, gender or status with the regulatory college. Participants who had regulatory involvement with respect to opioids were more likely to be male, have been in practice for longer and participate in the workshop. Participants reported no significant bias and highly rated both active learning and relevance to practice regardless of their cohort size.Conclusions: This evaluation demonstrates that Safer Opioid Prescribing was implemented as intended. Over a short period and without any external funding, the program reached more than 1% of the Ontario physician workforce. This suggests that Safer Opioid Prescribing is a good model for using virtual continuing health professions education to reach a critical mass of prescribers to drive population level opioid utilization changes. This study represents a methodological advance of adapting evaluation methods from health policy and complex interventions for continuing health professions education.