bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expanding the 3 Wishes Project for compassionate end-of-life care: a qualitative evaluation of local adaptations
Authors: Vanstone Meredith , Neville Thanh H. , Swinton Marilyn E. , Sadik Marina , Clarke France J. , LeBlanc Allana , Tam Benjamin , Takaoka Alyson , Hoad Neala , Hancock Jennifer , McMullen Sarah , Reeve Brenda , Dechert William , Smith Orla M. , Sandhu Gyan , Lockington Julie , Cook Deborah J. 
Published: June 2020

Abstract
Background
The 3 Wishes Project (3WP) is an end-of-life program that honors the dignity of dying patients by fostering meaningful connections among patients, families, and clinicians. Since 2013, it has become embedded in the culture of end-of-life care in over 20 ICUs across North America. The purpose of the current study is to describe the variation in implementation of 3WP across sites, in order to ascertain which factors facilitated multicenter implementation, which factors remain consistent across sites, and which may be adapted to suit local needs.

Methods
Using the methodology of qualitative description, we collected interview and focus group data from 85 clinicians who participated in the successful initiation and sustainment of 3WP in 9 ICUs. We describe the transition between different models of 3WP implementation, from core clinical program to the incorporation of various research activities. We describe various sources of financial and in-kind resources accessed to support the program.

Results
Beyond sharing a common goal of improving end-of-life care, sites varied considerably in organizational context, staff complement, and resources. Despite these differences, the program was successfully implemented at each site and eventually evolved from a clinical or research intervention to a general approach to end-of-life care. Key to this success was flexibility and the empowerment of frontline staff to tailor the program to address identified needs with available resources. This adaptability was fueled by cross-pollination of ideas within and outside of each site, resulting in the establishment of a network of like-minded individuals with a shared purpose.

Conclusions
The successful initiation and sustainment of 3WP relied on local adaptations to suit organizational needs and resources. The semi-structured nature of the program facilitated these adaptations, encouraged creative and important ways of relating within local clinical cultures, and reinforced the main tenet of the program: meaningful human connection at the end of life. Local adaptations also encouraged a team approach to care, supplementing the typical patient-clinician dyad by explicitly empowering the healthcare team to collectively recognize and respond to the needs of dying patients, families, and each other.

Trial registration
NCT04147169, retrospectively registered with clinicaltrials.gov on October 31, 2019.
Evaluation of in-vivo antidiarrhoeal and in-vitro antibacterial activities of the root extract of Brucea antidysenterica J. F. Mill (Simaroubaceae)
Authors: Zewdie Kaleab Alemayehu , Bhoumik Dayananda , Wondafrash Dawit Zewdu , Tuem Kald Beshir 
Published: June 2020

Abstract
Background
Diarrhoea has been the major cause of death especially in children of developing countries. Brucea antidysenterica is one of the several medicinal plants used traditionally for the treatment of diarrhoea in Ethiopia. Hence, the present study was undertaken to investigate the antidiarrhoeal and antibacterial activities of the root extract of B. antidysenterica.

Methods
Plant material was extracted by maceration technique using 80% methanol. The antidiarrhoeal activity was tested using castor oil-induced diarrhoea, castor oil-induced charcoal meal test, and castor oil-induced enteropooling models in mice. Whilst, the antibacterial activity of the crude extract was evaluated using agar well diffusion and broth microdilution methods.

Results
The 80% methanolic crude extract significantly delayed the diarrhoeal onset at the two higher doses (p < 0.001) and it has also inhibited the number and weight of faecal output at all tested doses as compared with the negative control. Moreover, it showed a significant anti-motility effect (p < 0.001) at all tested doses. Whereas it displayed a significant reduction in the weight and volume of intestinal contents at the doses of 200 and 400 mg/kg (p < 0.01). The highest concentration (800 mg/mL) of test extract showed maximum zone of inhibition in all tested standard strains of bacteria (18.3 mm–22 mm). While MIC and MBC values (0.39 mg/mL and 1.56 mg/mL) showed that S. flexneri was the most susceptible pathogen for test extract.

Conclusion
The study revealed that the root extract of B. antidysenterica has antidiarrhoeal and antibacterial activities.
Hospital preparedness for mass critical care during SARS-CoV-2 pandemic
Authors: Wurmb Thomas , Scholtes Katja , Kolibay Felix , Schorscher Nora , Ertl Georg , Ernestus Ralf-Ingo , Vogel Ulrich , Franke Axel , Kowalzik Barbara 
Published: June 2020

AbstractMass critical care caused by the severe acute respiratory syndrome corona virus 2 pandemic poses an extreme challenge to hospitals. The primary goal of hospital disaster preparedness and response is to maintain conventional or contingency care for as long as possible. Crisis care must be delayed as long as possible by appropriate measures. Increasing the intensive care unit (ICU) capacities is essential. In order to adjust surge capacity, the reduction of planned, elective patient care is an adequate response. However, this involves numerous problems that must be solved with a sense of proportion. This paper summarises preparedness and response measures recommended to acute care hospitals.
Secreted breast tumor interstitial fluid microRNAs and their target genes are associated with triple-negative breast cancer, tumor grade, and immune infiltration
Authors: Terkelsen Thilde , Russo Francesco , Gromov Pavel , Haakensen Vilde Drageset , Brunak Søren , Gromova Irina , Krogh Anders , Papaleo Elena 
Published: June 2020

Abstract
Background
Studies on tumor-secreted microRNAs point to a functional role of these in cellular communication and reprogramming of the tumor microenvironment. Uptake of tumor-secreted microRNAs by neighboring cells may result in the silencing of mRNA targets and, in turn, modulation of the transcriptome. Studying miRNAs externalized from tumors could improve cancer patient diagnosis and disease monitoring and help to pinpoint which miRNA-gene interactions are central for tumor properties such as invasiveness and metastasis.

Methods
Using a bioinformatics approach, we analyzed the profiles of secreted tumor and normal interstitial fluid (IF) microRNAs, from women with breast cancer (BC). We carried out differential abundance analysis (DAA), to obtain miRNAs, which were enriched or depleted in IFs, from patients with different clinical traits. Subsequently, miRNA family enrichment analysis was performed to assess whether any families were over-represented in the specific sets. We identified dysregulated genes in tumor tissues from the same cohort of patients and constructed weighted gene co-expression networks, to extract sets of co-expressed genes and co-abundant miRNAs. Lastly, we integrated miRNAs and mRNAs to obtain interaction networks and supported our findings using prediction tools and cancer gene databases.

Results
Network analysis showed co-expressed genes and miRNA regulators, associated with tumor lymphocyte infiltration. All of the genes were involved in immune system processes, and many had previously been associated with cancer immunity. A subset of these, BTLA, CXCL13, IL7R, LAMP3, and LTB, was linked to the presence of tertiary lymphoid structures and high endothelial venules within tumors. Co-abundant tumor interstitial fluid miRNAs within this network, including miR-146a and miR-494, were annotated as negative regulators of immune-stimulatory responses. One co-expression network encompassed differences between BC subtypes. Genes differentially co-expressed between luminal B and triple-negative breast cancer (TNBC) were connected with sphingolipid metabolism and predicted to be co-regulated by miR-23a. Co-expressed genes and TIF miRNAs associated with tumor grade were BTRC, CHST1, miR-10a/b, miR-107, miR-301a, and miR-454.

Conclusion
Integration of IF miRNAs and mRNAs unveiled networks associated with patient clinicopathological traits, and underlined molecular mechanisms, specific to BC sub-groups. Our results highlight the benefits of an integrative approach to biomarker discovery, placing secreted miRNAs within a biological context.
Microbial succession during the transition from active to inactive stages of deep-sea hydrothermal vent sulfide chimneys
Authors: Hou Jialin , Sievert Stefan M. , Wang Yinzhao , Seewald Jeffrey S. , Natarajan Vengadesh Perumal , Wang Fengping , Xiao Xiang 
Published: June 2020

AbstractBackgroundDeep-sea hydrothermal vents are highly productive biodiversity hotspots in the deep ocean supported by chemosynthetic microorganisms. Prominent features of these systems are sulfide chimneys emanating high-temperature hydrothermal fluids. While several studies have investigated the microbial diversity in both active and inactive sulfide chimneys that have been extinct for up to thousands of years, little is known about chimneys that have ceased activity more recently, as well as the microbial succession occurring during the transition from active to inactive chimneys.ResultsGenome-resolved metagenomics was applied to an active and a recently extinct (~ 7 years) sulfide chimney from the 9–10° N hydrothermal vent field on the East Pacific Rise. Full-length 16S rRNA gene and a total of 173 high-quality metagenome assembled genomes (MAGs) were retrieved for comparative analysis. In the active chimney (L-vent), sulfide- and/or hydrogen-oxidizingCampylobacteriaandAquificaewith the potential for denitrification were identified as the dominant community members and primary producers, fixing carbon through the reductive tricarboxylic acid (rTCA) cycle. In contrast, the microbiome of the recently extinct chimney (M-vent) was largely composed of heterotrophs from various bacterial phyla, includingDelta-/Beta-/AlphaproteobacteriaandBacteroidetes.Gammaproteobacteriawere identified as the main primary producers, using the oxidation of metal sulfides and/or iron oxidation coupled to nitrate reduction to fix carbon through the Calvin-Benson-Bassham (CBB) cycle. Further analysis revealed a phylogenetically distinctNitrospiraecluster that has the potential to oxidize sulfide minerals coupled to oxygen and/or nitrite reduction, as well as for sulfate reduction, and that might serve as an indicator for the early stages of chimneys after venting has ceased.ConclusionsThis study sheds light on the composition, metabolic functions, and succession of microbial communities inhabiting deep-sea hydrothermal vent sulfide chimneys. Collectively, microbial succession during the life span of a chimney could be described to proceed from a “fluid-shaped” microbial community in newly formed and actively venting chimneys supported by the oxidation of reductants in the hydrothermal fluid to a “mineral-shaped” community supported by the oxidation of minerals after hydrothermal activity has ceased. Remarkably, the transition appears to occur within the first few years, after which the communities stay stable for thousands of years.
Symptoms of titanium and nickel allergic sensitization in orthodontic treatment
Authors: Zigante Martina , Rincic Mlinaric Marijana , Kastelan Marija , Perkovic Vjera , Trinajstic Zrinski Magda , Spalj Stjepan 
Published: June 2020

Abstract
Aim
The study aimed to evaluate to which extent self-reported symptomatology, age, and sex are predictors of titanium and nickel allergic sensitization in patients in treatment with fixed orthodontic appliances.

Methods
The study analyzed 228 subjects aged 11–45 years (median 18, interquartile range 16–22); 68% of them were females, and 52% were adolescents. The allergic sensitization testing included epicutaneous patch test to titanium, titanium dioxide, titanium oxalate, titanium nitride, and nickel sulfate. The questionnaire on symptoms potentially linked to titanium and nickel sensitization was used.

Results
Prevalence of the allergic sensitization to titanium in patients undergoing orthodontic treatment was 4% (2% only to titanium without nickel) while to nickel 14% (12% nickel without titanium). Hypersensitivity to both metals at the same time was present in 2% of subjects. Sensitization to nickel was more common in females than in males (17 vs. 8%) and much more common in adults than in adolescents with small effect size (20 vs. 8%; p = 0.013). Sensitization to titanium was more common in females than in males (6 vs. 1%) with no difference in age. Multiple logistic regression analysis revealed that adult age increases the odds for being sensitized to nickel for 2.4 × (95% CI 1.1–5.6; p = 0.044) while watery eyes for 3.7 × (95% CI 1.2–11.1; p = 0.022). None of the symptoms were significant predictors of titanium sensitization.

Conclusion
Allergic sensitization to titanium and nickel are not very frequent in orthodontic patients, and self-reported symptomatology is a weak predictor of those sensitizations.
Time to definitive care among severely injured farmers compared to other work-related injuries in a Midwestern state
Authors: Swanton Amanda , Peek-Asa Corinne , Torner James 
Published: June 2020

Abstract
Background
Farming is a high risk occupation that predisposes workers to injury, but may also lead to barriers in reaching trauma care. Little is known about emergency and trauma care for patients with farm-related injuries. The purpose of this study was to determine whether severely injured farmers presenting to a statewide trauma system faced delays in reaching definitive care compared to other severely injured workers.

Methods
A population-based observational study was performed using the Iowa State Trauma Registry from 2005 to 2011. The registry was used to identify a multiply imputed sample of severe occupational injuries. Time to definitive care for farm- and non-farm-related injuries was compared using Kaplan-Meier curves and an extended, stratified Cox model censoring at 4 h. An interaction with time was included in the Cox model to generate hazard ratios for each hour after injury.

Results
Seven-hundred forty-eight severe occupational injuries were identified; 21% of these were farm-related. The overall median time to definitive care was nearly an hour longer for farmers compared to other workers (2h46m vs. 1h48m, p < 0.05). When adjusted for confounders, farm status remained a significant predictor of delay in reaching definitive care, but only in the first hour after injury (HR = 0.44, 95%CI = 0.24–0.83).

Conclusions
Farm-related injuries accounted for more than 1 of every 5 severe occupational injuries entered into the Iowa trauma system. We found that severely injured farmers had delays in reaching definitive trauma care, even when adjusted for confounding variables such as rurality. This effect was most pronounced in the first hour.
A sensitive method for analyzing fluconazole in extremely small volumes of neonatal serum
Authors: Saito Jumpei , Tanzawa Ayano , Kojo Yuka , Maruyama Hidehiko , Isayama Tetsuya , Shoji Kensuke , Ito Yushi , Yamatani Akimasa 
Published: June 2020

Abstract
Background
The need for a large volume of serum sample significantly reduces the feasibility of neonatal pharmacokinetic studies in daily practice, which must often rely on scavenged or opportunistic sampling. This problem is most apparent in preterm newborns, where ethical and practical considerations prohibit the collection of large sample volumes. Most of the fluconazole analysis assays published thus far required a minimum serum sample of 50 to 100 μL for a single assay. The purpose of the present study was to develop and validate a sensitive method requiring a smaller sample volume (10 μL) to satisfy clinically relevant research requirements.

Methods
Following simple protein precipitation and centrifugation, the filtrated supernatant was injected into a liquid chromatography system and separated with a C18 reverse-phase column. Fluconazole and the internal standard (IS, fluconazole-d4) were detected and quantified using tandem mass spectrometry. The method was validated with reference to the Food and Drug Administration’s Guidance for Industry. Accuracy and precision were evaluated at six quality control concentration levels (ranging from 0.01 to 100 μg/mL).

Results
Investigated calibration curves were linear in the 0.01–100 μg/mL range. Intra- and inter-day accuracy (− 7.7 to 7.4%) and precision (0.3 to 6.0%) were below 15%. The calculated limit of detection and the lower limit of quantification (LLOQ) was 0.0019 μg/mL and 0.0031 μg/mL, respectively. Fluconazole in the prepared samples was stable for at least 4 months at − 20 °C and − 80 °C. This method was applied to analyze 234 serum samples from ten neonates who received fosfluconazole, a water-soluble phosphate prodrug of fluconazole which converts to fluconazole in the body, as part of a pharmacokinetic study using daily scavenged laboratory samples. The median (range) concentration up to 72 h after fosfluconazole administration was 2.9 (0.02 to 26.8 μg/mL) μg/mL, which was within the range of the calibration curve.

Conclusion
Fluconazole was able to be detected in an extremely small volume (10 μL) of serum from neonates receiving fosfluconazole. The method presented here can be used to quantify fluconazole concentrations for pharmacokinetic studies of the neonatal population by using scavenged samples.
Presentation, management, and outcomes of STEMI in Egypt: results from the European Society of Cardiology Registry on ST elevation myocardial infarction
Authors: Shaheen Sameh , Wafa Ahmad , Mokarab Mostafa , Zareef Basem , Bendary Ahmed , Abdelhameed Tarek , Rashwan Ahmad , Seleem Mohamad , Elmasry Magdy , Abdelhady Yaser , Abdelrazik Gomaa , Ibrahim Amr , Ghareeb Mohamad , Aly Khalid , Saraya Mahmoud , Wadie Moheb , Youssef Mahmoud 
Published: June 2020

Abstract
Background
Apart from few small single-center studies, there are limited data about STEMI patients in Egypt. Nineteen Egyptian centers (with and without PCI facilities) participated in this registry with 1356 patients who were compared to 7420 patients from other ESC countries. The aims of this study were to describe the characteristics of patients with STEMI, to assess STEMI management patterns particularly the current use of reperfusion therapies, to evaluate the organization of STEMI networks across Egypt, to evaluate in-hospital patient outcome, and to compare Egyptian patients with other ESC countries.

Results
Compared to other ESC countries, Egyptian patients were younger (mean age 55.4 ± 11.3 vs. 62.9 ± 12.4; p < 0.001 and 4.36% vs. 19.41%% were ≥ 75 years old; p < 0.001) with fewer females (18.44% vs. 25.63%; p < 0.001). Egypt had longer median time between symptoms onset and first medical contact: 120.0 (60.0; 240.0) vs.100.0 (50.0; 240.0) p < 0.001. Self-presentation rather than EMS presentation was the mode of admission in 86.06% in Egypt vs. 25.83% in EU countries (p < 0.001). On qualifying ECG, anterior STEMI was in 57.08% in Egypt vs. 45.98% in other countries (p < 0.001). Initial reperfusion therapy was 49.12%, 43.07%, and 7.26% for primary PCI, thrombolytic therapy and no reperfusion in Egypt vs. 85.42%, 7.26%, and 7.82% for EU countries, respectively. In-hospital mortality was 4.65% in Egypt vs. 3.50% in other countries p 0.040 and was 18.87% in no reperfusion vs. 2.10% in primary PCI vs. 4.97% in thrombolysis (p < 0.001) among Egyptians. Patients were discharged on aspirin in 98.61%, clopidogrel in 91.07%, ticagrelor in 7.31%, DAPT in 97.69%, beta blockers in 82.83%, ACE inhibitors in 84.76%, MRAs in 10.01%, and statins in 99.77%.

Conclusion
Compared to other ESC countries, Egyptian STEMI patients were younger, more frequently current smokers and diabetics, and had longer time between symptoms onset and first medical contact with more self-presentation rather than EMS presentation. Thrombolytic therapy is still a common reperfusion therapy in Egypt while primary PCI was offered to half of the patients. In-hospital mortality was significantly higher in Egypt and was highest among no reperfusion patients and lowest among PPCI patients.
Closer to Home: A Hanlin Academician Writes about Persons outside the Educated Class
Authors: Egan Ronald 
Published: June 2020

Abstract
Yijian zhi, the massive collection of supernatural tales compiled by Hong Mai (1123–1202) in the twelfth century, gives considerable attention to merchant figures and even members of more lowly walks of life (e.g., soldiers, butchers, waiters, and singing girls). This is unexpected since Hong Mai himself was not just an imperial official but a particularly eminent one, whose appointments included Hanlin academician and court historian. Appearing in the tales, sometimes even as protagonists, are members of society whom the superelite like Hong Mai seldom even mention in their conventional literary and scholarly writings. These Yijian zhi stories thus provide a glimpse of the ways that members of the socially and politically elite perceived persons of lowly social backgrounds. The fact that Hong Mai did not compose his stories from his own imagination but, rather, recorded tales told to him by informants, most of whom were also members of the elite, as well as his conviction that the tales narrate events that actually happened, however uncanny or “marvelous” they were, makes the collection even more valuable as a source for general upper-class perceptions. Once identified and examined, those perceptions by socially elite persons of contemporaries who did not have a classical education contain elements we might expect as well as those that may surprise us.
Translation as Method
Authors: Rojas Carlos 
Published: June 2020

Abstract
Taking Lu Xun's work as its starting point, this essay examines translation as a methodology for negotiating not between different languages or dialects but rather between different voices. To the extent that some fiction attempts to manifest the voices of socially marginalized figures, this translational approach offers a way of examining the possibilities and limits of this sort of negotiation. By extension, a similar translational framework may also be used to understand the attempts by critics to assess fiction's own attempts to render these marginalized voices.
Ragpicking as Method
Authors: Hillenbrand Margaret 
Published: June 2020

Abstract
This article explores the relationship between precarity, waste, and the ragpicker in contemporary Chinese visual culture. It asks first why precarity has come so little and so late to the theoretical scene in China, a society in which precarious experience is so rife as to be almost endemic. The essay then goes on to show how some of China's leading artists now work profusely with refuse—as a core theme of the precarious present—while noting the strange anomaly that their works offer up scant if any space for the figure of the waste picker. The artist, instead, has taken over her mantle as the sifter and sorter of garbage. This missing human figure matters, in part because waste is always about people—and their absence from aesthetic space suggests that art is responding to a felt sense that personhood is coming under assault as basic life sureties fray. But this essay also argues that the garbage takeover is part of a sustained practice of appropriation, effacement, even cruelty in the artistic representation of precarity in China. China's wasteworks are art forms born at the tense interface between different class actors, and they disclose fraught fears over where brittle life experience begins and ends in a society that has tried to eliminate class as a category of political action and analysis.