bluuebunny/crossref_metadata_2025_split huggingface dataset:
The clinical value of passive leg raising plus ultrasound to predict fluid responsiveness in children after cardiac surgery
Authors: Luo Deqiang , Dai Wei , Lei Lei , cai xueying 
Published: August 2020

Abstract
Background: There are few non-invasive monitoring methods that can reliably predict fluid responsiveness (FR) in children. Here, we interrogate the value of doppler ultrasound evaluation of passive leg raising (PLR)-induced changes in stroke volume (SV) and cardiac output (CO) as a predictor of FR in children with mechanical ventilation after congenital cardiac surgery. Methods: A total of 40 children with mechanical ventilation following congenital cardiac surgery, who required volume expansion (VE) were included in this study. Hemodynamic parameters such as heart rate (HR), mean arterial pressure (MAP), SV, and central venous pressure (CVP) were monitored before and after PLR and VE. Besides, we assessed changes in SV and CO by bedside ultrasound. Patients showing >10% increase in SV in response to VE were considered to be responders (26 patients), while the rest (14 patients) were defined as non-responders. Results: Our data demonstrated that ΔSV-PLR and ΔCO- PLR were positively correlated with ΔSV-VE (r = 0.683, p <0.001 and r = 0.374, p = 0.017, respectively), and the area under the ROC curve (AUC) of ΔSV-PLR was 0.879 (95% CI [0.745 1.000], p < 0.001). The best cut-off value for ΔSV-PLR in predicting FR was 13%, with its sensitivity and specificity were 81.8% and 86.3%, respectively. ΔCVP, ΔHR, and ΔMAP were weak predictors of FR in the children. Conclusion: Our study demonstrated that SV changes, as evaluated by noninvasive ultrasound combined with PLR, could effectively evaluate FR in children under mechanical ventilation following congenital cardiac surgery.
Development and validation of a cancer stem cell-related signature for prognostic prediction in pancreatic ductal adenocarcinoma
Authors: Feng Zengyu , Shi Minmin , Li Kexian , Ma Yang , Jiang Lingxi , Chen Hao , Peng Chenghong 
Published: August 2020

Abstract
Background

Cancer stem cells (CSCs) are crucial to malignant behavior and poor prognosis of pancreatic ductal adenocarcinoma (PDAC). In recent years, CSC biology has been widely studied, but practical prognostic signatures based on CSC-related genes have not been established and reported in PDAC.

Methods

This signature was developed and validated in seven independent PDAC datasets. MTAB-6134 cohort was used as training set, while one Chinese local cohort and five other public cohorts were used for external validation. CSC-related genes with credible prognostic roles were selected to form the signature, and its predictive performance was evaluated by Kaplan-Meier survival, receiver operating characteristic (ROC), and calibration curves. Correlation analysis was employed to clarify the potential biological characteristics.

Results

A robust signature comprising DCBLD2, GSDMD, PMAIP1, and PLOD2 was developed. It could classify patients into high-risk and low-risk groups, and high risk patients had significantly shorter overall survival (OS) and disease-free survival (DFS) compared with low risk patients. Calibration curves and Cox regression analysis demonstrated the powerful predictive performance. ROC curves showed an improved survival prediction provided by this model. Functional analysis revealed positive association between risk score and CSC marker. These results had cross-dataset compatibility.

Conclusions

We established a novel four-gene signature based on CSC-related genes which could serve as a powerful prognostic tool in PDAC.

Impact

This signature can offer potential help for further improving current TNM staging system, and providing data for the development of novel personalized therapeutic strategies in the future.
Acting between guidelines and reality. Managers’ balancing between standardisation and adaptive behaviour in patient safety work- an interview study
Authors: Hedsköld Mats , Sachs Magna Andreen , Rosander Thorleif , von Knorring Mia , Harenstam Karin Pukk 
Published: August 2020

Abstract
Background: Safety culture can be described and understood through its manifestations in the organisation as artefacts, espoused values and basic underlying assumptions and is strongly related to leadership-yet it remains elusive as a concept. Even if the literature points to leadership as an important factor for creating and sustaining a mature safety culture, little is known about how the safety work of first line managers’ actually is done and how they balance the different and often conflicting organizational goals in everyday practice. The purpose of this study was to explore how health care first line managers perceive their role and how they promote patient safety and patient safety culture in their units. Methods: Interview study with first line managers in intensive care units in in eight different hospitals located in the middle of Sweden. An inductive qualitative content analysis approach was used. Results: We present how first line managers view their role in patient safety and exemplify concrete strategies by which managers promote safety culture by acting as role models, designing everyday work and promoting psychological safety and a learning environment. Conclusions: Our study shows the central role of front-line managers in designing the everyday work in the ICU. Although promoted widely in Swedish healthcare at the time for the interviews, the HSOPSC was not mentioned by the managers as a central source of information on the unit’s safety culture.
Barriers and Facilitators of Kangaroo Mother Care Adoption in Five Chinese Hospitals: a Qualitative Study
Authors: Yue Jieya , Liu Jun , Williams Sarah , Zhang Bo , Zhao Yingxi , Zhang Qiannan , Zhang Lin , Liu Xin , Wall Stephen , Wetzel Greta , Zhao Gengli , Bouey Jennifer 
Published: August 2020

Abstract
Background Kangaroo mother care (KMC) has been proved to be a safe and cost-effective standard of care for preterm babies. China hasn’t adopted the KMC practice widely until recently. We aim to assess barriers and facilitators of KMC adoption in neonatal intensive care units (NICUs) and postnatal wards in China. Methods We conducted clinical observations and semi-structured interviews with nurses, physicians, and parents who performed KMC in seven NICUs and postnatal wards housed in five hospitals in different provinces of China between August and September 2018. The interviews provided first-hand stakeholder perspectives on barriers and facilitators of KMC implementation and sustainability. We further explored health system’s readiness and families’ willingness to sustain KMC practice following its pilot introduction. We coded data for emerging themes related to financial barriers, parent- and hospital-level perceived barriers, and facilitators of KMC adoption, specifically those unique in the Chinese context. Results Five hospitals with KMC pilot programs were selected for clinical observations and 38 semi-structured interviews were conducted. Common cultural barriers included concerns with the conflict with traditional postpartum confinement (Zuo-yue-zi) practice and grandparents’ resistance, while a strong family support is a facilitator for KMC adoption. Some parents reported anxiety and guilt associated with having a preterm baby, which can be a parental-level barrier to KMC. Hospital-level factors such as fear of nosocomial infection and shortage of staff and spaces impeded the KMC implementation, and supportive community and peer group organized by the hospital contributed to KMC uptake. Financial barriers included lodging costs for caregivers and supply costs for hospitals. Conclusions We provided a comprehensive in-depth report on the multi-level KMC barriers and facilitators in China. We recommend policy interventions specifically addressing these barriers and facilitators and increase family and peer support to improve KMC adoption in China. We also recommend that well-designed local cultural and economic feasibility and acceptability studies should be conducted before the KMC uptake.
The role of TNFAIP8-mediated mTOR-Akt-ULK1 signaling pathway in gastric cancer
Authors: Chen Zheng , Zhang Jianguo , Dong Chenyang , Li Dongsheng , Yin Yuehan , Yu Wenhai , Chen Yuezhi 
Published: August 2020

Abstract
Background: The purpose of this article was to study the role of TNFAIP8 in gastric cancer. Methods: RT-PCR was used to detect the expression of TNFAIP8 mRNA and protein level in normal gastric mucosa cells and four gastric cancer cell lines. TNFAIP8 was silenced or overexpressed in two cell lines, CCK-8 cell viability was used, transwell experiment was used to detect cell invasion capability, and flow cytometry was used to detect cell apoptosis. TNFAIP was silenced or overexpressed in a cell line, and nude mice were inoculated to form transplanted tumors. HE staining and immunohistochemistry staining were used to detect the histopathological changes of tumors. Results: The mRNA and protein expression of TNFAIP8 was significantly up-regulated in GC patients and cells. After silencing and overexpressing TNFAIP8, gastric cancer cells with high expression increased, apoptosis decreased, and cell invasion increased. Expression of mTOR-Akt-ULK1 signal pathway was inhibited and autophagy signal was activated. Conclusions: Our findings indicate that TNFAIP8 inhibited gastric cancer cells by inhibiting mTOR-Akt-ULK1 signal pathway and activating autophagy signal.
Association between SNPs within MicroRNA Binding Sites and the Prognosis of Breast Cancer
Authors: Zhang Liwen , Han Lu , Huang Yubei , Feng Ziwei , Wang Xin , Li Haixin , Song Fangfang , Liu Luyang , Li Junxian , Zheng Hong , Wang Peishan , Song Fengju , Chen Kexin 
Published: August 2020

Abstract
Background: Single nucleotide polymorphisms (SNPs) within microRNA binding sites can affect the binding of microRNA to mRNA and regulate gene expression, thereby contributing to the prognosis of cancer. We performed this study to explore the association between SNPs within microRNA binding sites and the prognosis of breast cancer.Methods: We carried out a two-stage study including 2647 breast cancer patients, with a median follow-up of 68 months (range 0-159). In stage I, we genotyped 192 SNPs within microRNA binding sites using the Illumina Goldengate platform. In stage II, we validated SNPs significantly associated with breast cancer prognosis in another dataset using the TaqMan platform. Survival times was calculated, and Kaplan-Meier curves and Cox regression model were used to analyze survival of breast cancer patients with different genotypes.Results: We identified 8 SNPs significantly associated with breast cancer prognosis in stage I (P<0.05), and only rs10878441 was statistically significant in stage II (AA vs CC: adjusted HR=2.21, 95% CI: 1.11-4.42, P=0.024). We combined the data from stage I and stage II, and found that, compared with rs10878441 AA genotype, CC genotype was significantly associated with poor survival of breast cancer (HR=1.69, 95% CI: 1.18-2.42, P=0.004; adjusted HR=2.19, 95% CI: 1.30-3.70, P=0.003). Stratified analyses demonstrated that rs10878441 was related to breast cancer prognosis in grade II patients and lymph node-negative patients (P<0.05).Conclusions: The LRKK2 rs10878441 CC genotype is associated with poor prognosis of breast cancer in a Chinese population, and it could be used as a potential prognostic biomarker for breast cancer. Further studies are warranted.
Analysis of Bioavailable Toluene by Using Recombinant Luminescent Bacterial Biosensors with Different Promoters
Authors: Wang Guey-Horng , Tsai Teh-Hua , Kui Chun-Chi , Cheng Chiu-Yu , Huang Tzu-Ling , Chung Ying-Chien 
Published: August 2020

Abstract
In this study, we constructed recombinant luminescent Escherichia coli with T7, T3, and SP6 promoters inserted between tol and lux genes as toluene biosensors and evaluated their sensitivity, selectivity, and specificity for measuring bioavailable toluene in in groundwater and river water. The luminescence intensity of each biosensor depended on temperature, incubation time, ionic strength, and concentrations of toluene and coexisting organic compounds. Toluene induced the highest luminescence intensity in recombinant lux-expressing E. coli with the T7 promoter [T7-lux-E. coli, limit of detection (LOD) = 0.05 μM], followed by that in E. coli with the T3 promoter (T3-lux-E. coli, LOD = 0.2 μM) and SP6 promoter (SP6-lux-E. coli, LOD = 0.5 μM). Luminescence activities may have been synergistically or antagonistically affected by coexisting organic compounds other than toluene; nevertheless, low concentrations of benzoate and toluene analogs had no such effect. In reproducibility experiments, the biosensors had low relative standard deviation (4.3%–5.8%). SP6-lux-E. coli demonstrated high adaptability to environmental interference. T7-lux-E. coli biosensor—with low LOD, wide measurement range (0.05–500 μM), and acceptable deviation (−14.3% to 9.1%)—is an efficient toluene biosensor. This is the first study evaluating recombinant lux E. coli with different promoters for their potential application in toluene measurement in actual water bodies.
Molecular characteristics of the VP1 region of enterovirus 71 strains in China
Authors: Sun Haiyan , Gao Min , Cui Dawei 
Published: August 2020

Abstract
Background: Enterovirus 71 (EV71) is the most commonly implicated causative agent of severe outbreaks of paediatric hand, foot, and mouth disease (HFMD).VP1 protein, a capsid protein of EV71, is responsible for the genotype of the virus and is essential for vaccine development and effectiveness. However, the genotypes of EV71 isolates in China are still not completely clear.Methods: The VP1 gene sequences of 3712 EV71 virus strains from China,excluding repetitive sequences and 30 known EV71 genotypes as reference strains, between 1986 and 2019 were obtained from GenBank. Phylogenetic tree, amino acid homology, genetic variation and genotype analyses of the EV71VP1 protein were performed with MEGA 6.0 software.Results: The amino acid identity was found to be 88.33%~100% among the 3712 EV71 strains, 93.47%~100% compared with vaccine strain H07, and 93.04%~100% compared with vaccine strains FY7VP5 or FY-23K-B. Since 2000, the prevalent strains of EV71 were mainly of the C4 genotype. Among these, the C4a subgenotype was predominant, followed by the C4b subgenotype; other subgenotypes appeared sporadically between 2005 and 2018 in mainland China. The B4 genotype was the main genotype in Taiwan, and the epidemic strains were constantly changing. Some amino acid variations in VP1 of EV71 occurred with high frequencies, including A289T (20.99%), H22Q (16.49%), A293S (15.95%), S283T (15.11%), V249I (7.76%), N31D (7.25%), and E98K (6.65%).Conclusion: The C4 genotype of EV71 in China matches the vaccine and should effectively control EV71. However, the efficacy of the vaccine is partially affected by the continuous change in epidemic strains in Taiwan. These results suggest that the genetic characteristics of the EV71-VP1 region should be continuously monitored, which is critical for epidemic control and vaccine design to prevent EV71 infection in children.
Methods of analysis of Chloroplast Genomes of C3, Kranz type C4 and Single Cell C4 photosynthetic members of Chenopodiaceae
Authors: Sharpe Richard , Williamson-Benavides Bruce Andreas , Edwards Gerry , Dhingra Amit 
Published: August 2020

Abstract
Background Chloroplast genome information is critical to understanding forms of photosynthesis in the plant kingdom. During the evolutionary process, plants have developed different photosynthetic strategies that are accompanied by complementary biochemical and anatomical features. Members of family Chenopodiaceae have species with C 3 photosynthesis, and variations of C 4 photosynthesis in which photorespiration is reduced by concentrating CO 2 around Rubisco through dual coordinated functioning of dimorphic chloroplasts. Among dicots, the family has the largest number of C 4 species, and greatest structural and biochemical diversity in forms of C 4 including the canonical dual-cell Kranz anatomy, and the recently identified single cell C 4 with the presence of dimorphic chloroplasts separated by a vacuole. This is the first comparative analysis of chloroplast genomes in species representative of photosynthetic types in the family. Results Methodology with high throughput sequencing complemented with Sanger sequencing of selected loci provided high quality and complete chloroplast genomes of seven species in the family and one species in the closely related Amaranthaceae family, representing C 3 , Kranz type C 4 and single cell C 4 (SSC 4 ) photosynthesis Six of the eight chloroplast genomes are new, while two are improved versions of previously published genomes. The depth of coverage obtained using high-throughput sequencing complemented with targeted resequencing of certain loci enabled superior resolution of the border junctions, directionality and repeat region sequences. Comparison of the chloroplast genomes with previously sequenced plastid genomes revealed similar genome organization, gene order and content with a few revisions. High-quality complete chloroplast genome sequences resulted in correcting the orientation the LSC region of the published Bienertia sinuspersici chloroplast genome, identification of stop codons in the rpl23 gene in B. sinuspersici and B. cycloptera , and identifying an instance of IR expansion in the Haloxylon ammodendron inverted repeat sequence. The rare observation of a mitochondria-to-chloroplast inter-organellar gene transfer event was identified in family Chenopodiaceae. Conclusions This study reports complete chloroplast genomes from seven Chenopodiaceae and one Amaranthaceae species. The depth of coverage obtained using high-throughput sequencing complemented with targeted resequencing of certain loci enabled superior resolution of the border junctions, directionality, and repeat region sequences. Therefore, the use of high throughput and Sanger sequencing, in a hybrid method, reaffirms to be rapid, efficient, and reliable for chloroplast genome sequencing.
Serious non-fatal unintentional injuries among in-school adolescents in Sri Lanka: results from the 2016 Sri Lankan Global School-Based Health Survey
Authors: Wickramasinghe Sashimali , Gunawardena Nalika , Punyadasa Dhanusha , Gunawardena Shanthi , Wickramasinghe Champika , Lokubalasooriya Ayesha , Peiris Renuka , Senanayake Sameera 
Published: August 2020

Abstract
BackgroundUnintentional injuries among adolescents is a major public health problem world over. A great majority of the annual deaths among adolescents is due to unintentional injuries; being the leading cause of death among them throughout the world. The aim of this study was to estimate the incidence of injuries and their associated factors among school going adolescents aged 13-17 years using the data of the most recent Global School-Based Health Survey (GSHS) conducted in Sri Lanka.MethodsA cross-sectional survey was conducted, using a self-administered questionnaire, among 3,262 adolescents attending government schools. The sample was selected through a two-staged cluster sampling technique. In the first stage, 40 schools were selected, using probability proportional to school enrollment size, out of all schools that have 8-12 grades in the country. Then, from the selected schools, classes were selected using systematic equal probability sampling with a random start. Weighted prevalence was calculated, and logistic regression analysis was conducted in order to determine the correlates.ResultsDuring the 12 months before the survey, 35.8% (95% CI-30.7 - 41.1) of the students reported being seriously injured once or more times. The injuries were more common among males, but were equally common among different age groups (13-15 age group vs 16-17 age group). The most common type of injury was cut or stab wound (5.5%), followed by broken bone/dislocated joint (5.3%). Multivariable analysis revealed that only a few factors were associated with injury, such as male sex, being bullied, being physically attacked, and/or being in a physical fight.ConclusionThis study demonstrated that the prevalence of serious unintentional injuries among school going adolescents is a major public health problem in Sri Lanka. This timely and comprehensive survey would help the policy makers and researchers identify the unmet needs related to adolescent injuries. Furthermore, evidence generated form the study should be given due consideration while designing school-based interventions in order to prevent adolescent injuries.
Antimicrobial Resistance and Molecular Detection of Extended Spectrum β-Lactamase Producing Escherichia coli Isolates from Raw Meat in Greater Accra Region, Ghana
Authors: Dsani Esther , Afari Edwin Andrews , Danso-Appiah Anthony , Kenu Ernest , Kaburi Basil Benduri , Egyir Beverly 
Published: August 2020

Abstract
BackgroundTypically, raw meat can be contaminated with antibiotic resistant pathogens at unhygienic slaughter and sale points. Consumption of meat contaminated with antibiotic resistant E. coli is associated with grave health care consequences. The aim of this study was to determine the microbial quality of raw meat, the antimicrobial susceptibility and Extended Spectrum Beta Lactamase (ESBL) production in E. coli isolates from raw meat. ResultsTotal Plate Counts exceeded the acceptable limit of 5.0 log CFU/ cm2 in 60.5% (124/205) of raw meat samples. Total Coliform Counts in 70.7% (145/205) of samples were in excess of the acceptable limit of 2.5 log CFU/cm2. E. coli was detected in about half of raw meat samples (48%), ranging from 9.5% -79.0% among the slaughter sites. Isolates were susceptible to meropenem (100%), ceftriaxone (99%), cefotaxime (98%), chloramphenicol (97%), gentamycin (97%), ciprofloxacin (92%) and amikacin (92%), but resistant to ampicillin (57%), tetracycline (45%), sulfamethoxazole-trimethoprim (21%) and cefuroxime (17%). Multi-drug resistance (MDR) was identified in 22% of the isolates. The blaTEM gene was detected in 4% (4/98) of E. coli isolates in this study. ConclusionThe levels of microbial contamination of raw meat in this study were unacceptable. Meat handlers and consumers are at risk of foodborne infections from E. coli including ESBL producing E. coli that are resistant to most antibiotics in use. We recommend an enhanced surveillance for antibiotic resistance in food products for the early detection of emerging resistant bacteria species in the food chain.