bluuebunny/crossref_metadata_2025_split huggingface dataset:
Predictors of Delirium Incidence, Time to Onset, and Recurrence in a Mixed Medical-surgical ICU Population: A Secondary Analysis Using Cox and CHIAD Decision Tree Modeling
Authors: Moghadam Keivan Gohari , Miller Andrew C , Rahimibashar Farshid , Salesi Mahmood , Ashtari Sara , Vahedian-Azimi Amir 
Published: August 2020

Abstract
Background: To address whether in intensive care unit (ICU) patients, which factors correlate with development of delirium (primary outcome), as well as more rapid delirium onset and recurrence (secondary outcomes).Methods: A retrospective secondary analysis of 4,200 patients was collected from two academic medical centers. Delirium was assessed with the Confusion Assessment Method for the Intensive Care Unit (CAM-ICU) in all patients. Univariate and multivariate Cox models, logistic regression analysis, and Chi-square Automatic Interaction Detector (CHAID) decision tree modeling were used to explore delirium risk factors.Results: Increased delirium risk as associated with exposed only to artificial light (AL) hazard ratio (HR) 1.84 (95% CI: 1.66-2.044, P<0.001), physical restraint application 1.11 (95% CI: 1.001-1.226, P=0.049), and high nursing care requirements (>8 hours per 8-hour shift) 1.18 (95% CI: 1.048-1.338, P=0.007). Delirium incidence was inversely associated with greater family engagement 0.092 (95% CI: 0.014-0.596, P=0.012), low staff burnout and anticipated turnover scores 0.093 (95% CI: 0.014-0.600, P=0.013), non-ICU length-of-stay (LOS)<15 days 0.725 (95% CI: 0.655-0.804, P<0.001), and ICU LOS ≤15 days 0.509 (95% CI: 0.456-0.567, P<0.001). CHAID modelling indicated that AL exposure and age <65 years conveyed a high risk of delirium incidence, whereas SOFA score ≤11, APACHE IV score >15 and natural light (NL) exposure were associated with moderate risk, and female sex were associated with low risk. More rapid time to delirium onset correlated with baseline sleep disturbance (P=0.049), high nursing care requirements (P=0.019), and prolonged ICU and non-ICU hospital LOS (P<0.001). Delirium recurrence correlated with age>65 years (HR 2.198; %95 CI: 1.101-4.388, P=0.026) and high nursing care requirements (HR 1.978, 95% CI: 1.096-3.569), with CHAID modeling identifying AL exposure (P<0.001) and age >65 years (P=0.032) as predictive variables.Conclusion: Development of ICU delirium correlated with application of physical restraints, high nursing care requirements, prolonged ICU and non-ICU LOS, exposure exclusively to AL (rather than natural), less family engagement, and greater staff burnout and anticipated turnover scores. ICU delirium occurred more rapidly in patients with baseline sleep disturbance, and recurrence correlated with presence of delirium on ICU admission, exclusive AL exposure, and high nursing care requirements.
Prevalence of Oral Human Papillomavirus Infection among Indian HIV-Positive Men Who Have Sex With Men: A Cross-Sectional Study
Authors: Hernandez Alexandra Lydia , Karthik Rajiv , Sivasubramanian Murugesan , Raghavendran Anantharam , Lensing Shelly , Lee Jeannette Y , Abraham Priya , Mathai Dilip , Palefsky Joel M 
Published: August 2020

Abstract
Background: Oral human papillomavirus (HPV) infection has been causally linked to a subset of oropharyngeal cancers in Western populations15-20, and both oropharyngeal cancer and oral HPV infection are increased among HIV-positive individuals24,41. India has high incidences of oral and oropharyngeal cancers, and Indian HIV-positive men who have sex with men (MSM) may be at increased risk of developing oropharyngeal cancers. However, there is little information available on the prevalence of oral HPV in this population.Methods: We tested 302 HIV-positive Indian MSM for oral HPV infection using L1 HPV DNA PCR with probes specific for 29 types and a mixture of 10 additional types. CD4+ level and plasma HIV viral load (VL) were measured. Participants completed an interviewer-administered questionnaire including a sexual history.Results: The prevalence of oral HPV was 23.7% (95% CI: 19-29%) and 2.4% of participants had oncogenic HPV types. No participants had oral HPV type 16 (HPV-16) and the prevalence of other anogenital HPV types was low. Participants with higher CD4+ levels had reduced odds of having any oral HPV infection (OR: 3.1 [1.4-6.9]) in multivariable analyses.Conclusions: This is the first report of oral HPV among Indian HIV-positive MSM. Our results show a high prevalence of oral HPV infection consistent with studies from Western populations. However, oncogenic anogenital HPV types were relatively uncommon in our study population. It is unknown what the impact of this distribution of oral HPV will be on oropharyngeal cancers. HIV-positive MSM in India should be monitored closely for oral and oropharyngeal pre-cancer and cancer.
Predicting the Willingness of Nurses to Work with COVID-19 Patients: The Impact of Knowledge and Attitude
Authors: Nashwan Abdulqadir J. , Abujaber Ahmad A. , Mohamed Ahmed S. , Villar Ralph C. , Al-Jabry Mahmood M. 
Published: August 2020

Abstract
Aim: This study aims to assess the impact of nurses’ knowledge and attitude toward Coronavirus Disease 2019 (COVID-19) as a predictor for their willingness to work with patients diagnosed with COVID-19 in Qatar. Design: A cross-sectional study.Methods: A self-administered, 35-item online survey was circulated to the registered nurses and midwives working in Hamad Medical Corporation; the principle healthcare provider in Qatar. Results: A total of 580 attempts to complete the survey. Of them, 377 completed surveys with a response rate of 65%. Logistic regression was used to predict nurses’ willingness to work with patients with COVID-19. Two main factors were found to be significant predictors for nurses’ willingness; knowledge level and the expected remuneration that is associated with the level of exposure to risk. The findings of this study may help nursing leaders design educational programs and remuneration models that may help boost nurses’ willingness to work with high-risk patient groups, especially during crisis situations.
What do Service Providers in Southern Ethiopia Think About Barriers to using Youth-Friendly Sexual and Reproductive Health Services for Adolescents?: Qualitative Study
Authors: Habtu Yitagesu , Kaba Mirgissa , Mekonnen Hussen 
Published: August 2020

Abstract
Background: In Ethiopia, lowest utilization of adolescent friendly sexual and reproductive health services (AFSRHs) is recorded among Sub-Saharan African countries. Little is known why adolescents were not accessing the existing services to the side of healthcare providers. Objective: The aim of this study is to explore contextual perceived and actual barriers to accessing AFSRHs by adolescents in Southern Ethiopia.Methods: Phenomenological study design supplemented with observation was used to explore perceived and actual barriers to accessing AFSRHs in 2020. Criterion sampling was used to select study participants. In-depth interviews with key healthcare providers and non-specialist sexual and reproductive health providers were conducted. Transcribed interviews and observation were imported to Open Code 4.02 for coding, categorizing codes, and creating themes. Finally, barriers to assessing the services were explained using thematic analysis. Results: The study explores contextual barriers to accessing sexual and reproductive health services in five emergent themes. According to providers’ view, barriers include ranging from providers (e.g poor providers’ competency), health facility (e.g. supply constraints and unsupportive environment), adolescents (e.g perceived lack of information and attitude towards SRHs), community (e.g. lack of parental and social support), and broader health system (e.g. poor implementation and multi-sectorial engagement). Conclusion: As to providers, adolescents face multiple barriers to accessing youth friendly sexual and reproductive health services. Healthcare facilities and the health systems should implement varieties of approaches to increase access to the services for adolescents. The existing strategies should be re-evaluated and new interventions at all levels of the healthcare system are needed. Moreover, implementation research is required at system level factors.
The recombinant subunit vaccine RBD-Fc, consisting of SARS-CoV-2 RBD and human IgG Fc as an immunopotentiator, elicits robust neutralizing antibody responses against SARS-CoV-2 infection
Authors: Liu Zezhong , Xu Wei , Xia Shuai , Gu Chenjian , Wang Xinling , Wang Qian , Zhou Jie , Wu Yanling , Cai Xia , Qu Di , Ying Tianlei , Xie Youhua , Lu Lu , Yuan Zhenghong , Jiang Shibo 
Published: August 2020

Abstract
The pandemic of COVID-19 caused by SARS-CoV-2 has posed serious threats to global health and economy, thus calling for the development of safe and effective vaccines. The receptor-binding domain (RBD) in the spike protein of SARS-CoV-2 is responsible for its binding to ACE2 receptor. It contains multiple dominant neutralizing epitopes and serves as an important antigen for the development of COVID-19 vaccines. Here, we showed that immunization of mice with a candidate subunit vaccine consisting of SARS-CoV-2 RBD and Fc fragment of human IgG, as an immunopotentiator, elicited high titer of RBD-specific antibodies with robust neutralizing activity against both pseudotyped and live SARS-CoV-2 infections. The mouse antisera could also effectively neutralize infection by pseudotyped SARS-CoV-2 with several natural mutations in RBD and the IgG extracted from the mouse antisera could also show neutralization against pseudotyped SARS-CoV and SARS-related coronavirus (SARSr-CoV). Vaccination of human ACE2 transgenic mice with RBD-Fc could effectively protect mice from the SARS-CoV-2 challenge. These results suggest that SARS-CoV-2 RBD-Fc has good potential to be further developed as an effective and broad-spectrum vaccine to prevent infection of the current SARS-CoV-2 and its mutants, as well as future emerging SARSr-CoVs and re-emerging SARS-CoV.
Expression of HYOU1 via reciprocal crosstalk between NSCLC cells and HUVECs control cancer progression and chemoresistance in multicellular tumor spheroids
Authors: Lee Minji , Song Yeonhwa , Choi Inhee , Lee Su-Yeon , Kim Sanghwa , Kim Se-Hyuk , Kim Jiho , Seo Haengran 
Published: August 2020

Abstract
Background

Among all cancer types, lung cancer ranks highest worldwide in terms of both incidence and mortality. The crosstalk between lung cancer cells and their tumor microenvironment (TME) has begun to emerge as the “Achilles heel” of the disease and thus constitutes an attractive target for anticancer therapy. We previously revealed that crosstalk between lung cancer cells and endothelial cells (ECs) induces chemoresistance in multicellular tumor spheroids (MCTSs).
Methods

In this study, we idientified that factors secreted in response to crosstalk between ECs and lung cancer cells play pivotal roles in the development of chemoresistance in lung cancer spheroids.
Results

We determined that the expression of hypoxia up-regulated protein 1 (HYOU1) in lung cancer spheroids was increased by factors secreted in response to crosstalk between ECs and lung cancer cells. Direct interaction between lung cancer cells and ECs also caused an elevation in the expression of HYOU1 in MCTSs. Inhibition of HYOU1 expression not only suppressed stemness and malignancy, but also facilitated apoptosis and chemosensitivity in lung cancer MCTSs. Inhibition of HYOU1 expression also significantly increased the expression of interferon signaling components in lung cancer cells. Moreover, the activation of the PI3K/AKT/mTOR pathway was involved in the HYOU1-induced aggression of lung cancer cells.
Conclusion

Taken together, our results identify HYOU1, which is induced in response to crosstalk between ECs and lung cancer cells within the TME, as a potential therapeutic target for combating the aggressive behavior of cancer cells.
miR-766-3p suppressed tumorigenesis, epithelial-mesenchymal transition, and metastasis by targeting BCL9L via β -catenin signaling pathway in osteosarcoma cells
Authors: Zhang Sheng , Chen Hongtao , Liu Wanshun , Fang Le , Qian Zhanyang , Kong Renyi , Zhang Qi , Li Juming , Cao Xiaojian 
Published: August 2020

Abstract
Background

Emerging evidence has indicated that abnormal microRNAs (miRNAs) play critical roles in carcinogenesis and progression of osteosarcoma (OS). The aim of this study was to clarify the relationship between miR-766-3p expression and osteosarcoma development and to explore its potential mechanism.
Methods

miR-766-3p was the most downregulated miRNA by analyzing GSE65071 from the GEO database. RT-PCR and western blot was performed to determine miR-766-3p expression and its specific target gene in human OS samples and cell lines. CCK-8 proliferation, colony formation, EdU, wound-healing, and transwell assays were used respectively to evaluate the influences of miR-766-3p depletion or ectopic expression on OS proliferation, migration and invasion in vitro. And a mouse tumorigenicity model was conducted to investigate effects of miR-766-3p in vivo. Moreover, we identified directly interactions between miR-766-3p and its specific target gene using luciferase reporter assays.
Results

miR-766-3p expression was overexpressed in OS tissues and cell lines, and ectopic miR-766-3p expression repressed the malignant level of OS, including cell proliferation, migration, invasion and epithelial to mesenchymal transition (EMT) in vitro and in vivo. B-Cell Lymphoma 9-Like Protein (BCL9L) was negatively correlated with miR-766-3p expression in human OS tissue, and was validated as a downstream target of miR-766-3p by the luciferase reporter assay and Western blotting. Rescue experiment indicated that BCL9L could restore the effects of miR-766-3p on OS migration and invasion. The β-Catenin signaling pathway was demonstrated as being implicated in the miR-766-3p/BCL9L axis.
Conclusions

In conclusion, miR-766-3p is a negative regulator of BCL9L and a risk factor for tumor metastasis in OS progression.
Modulation of RAS and PI3-AKT pathway by Stavudine (d4T) in PBMC of Alzheimer’s Disease Patients
Authors: Rosa Francesca La , Zoia Chiara Paola , Bazzini Chiara , Bolognini Alessandra , Saresella Marina , Conti Elisa , Ferrarese Carlo , Piancone Federica , Marventano Ivana , Galimberti Daniela , Fenoglio Chiara , Scarpini Elio , Clerici Mario 
Published: August 2020

Abstract
Background: Aβ42-deposition plays a pivotal role in AD-pathogenesis by inducing the activation of microglial cells and neuroinflammation. This process is antagonized by microglia-mediated clearance of Aβ plaques. Activation of the NLRP3 inflammasome is involved in neuroinflammation and in the impairments of Aβ-plaques clearance. Stavudine (d4T) on the other hand down-regulates the NLRP3 inflammasome and stimulates autophagy-mediated Aβ-clearing in a TPH-1 cell line model.We explored the effect of d4T on Aβ-autophagy using PBMC of AD patients that were primed with LPS and stimulated with Aβ in the absence/presence of d4T. We analyzed the NLRP3 activity by measuring NLRP3-ASC complexes formation by AMNIS Flow-sight and pro-inflammatory cytokines (IL-1β, IL-18 and Caspase-1) production by ELISA. Western blot analyses were used to measure phosphorylation and protein expression of p38, CREB, ERK and AKT, p70, LAMP 2A, Beclin-1 and Bax.Results: Data showed that d4T: 1) down regulates NLRP3 inflammasome activation and the production of down-stream proinflammatory cytokines even in PBMC; 2) stimulates the phosphorylation of AKT, ERK, p70 as well as LAMP2A production, but does modulate beclin-1, suggesting a selective effect of this compound on chaperone-mediated autophagy (CMA); 3) up regulates p-CREB and BAX, possibly diminishing Aβ-mediated cytotoxicity; and 4) reduces the phosphorylation of p-38, a protein involved in the production of pro-inflammatory cytokines.Conclusions: d4T reduces the activation of the NLRP3 inflammasome and stimulates CMA autophagy as well as molecular mechanisms that modulate cytotoxicity and reduce inflammation in cells of AD patients. It might be interesting to verify the possibly beneficial effects of d4T in the clinical scenario.
Involving People Affected by a Rare Condition in Shaping Future Genomic Research
Authors: Gwynne Kylie , Gray Sarah , Lacaze Paul , Nunn Jack S 
Published: August 2020

Abstract
Background There is evidence that involving potential participants and the public in co-designing research can improve the quality of the study design, recruitment and acceptability of the research, but appropriate methodologies for doing this are not always clear. In this study we co-designed a way of involving people affected by a rare genomic disease in shaping future genomic research about the condition. The aim was to report the process, experiences and outcomes of involving people in genomic research in a standardised way, in order to inform future methods of involvement in research co-production. Method Participants were recruited from an online community hosted by an Australian-based rare disease charity and were over the age 18 years. Once people gave consent, we shared learning resources with participants and invited them to complete an online survey before joining a two-week facilitated online discussion, followed by a second online survey. We used ‘Standardised Data on Initiatives (STARDIT)’ to map preferences, plan involvement and report any outcomes from the process, with quantitative data analysed descriptively and qualitative data thematically analysed. Results Of the 26 people who gave consent and completed the initial survey, 15 participated in the online discussion and 12 completed the follow-up survey. STARDIT was used to report six outcomes from the process, including 60% of participants’ responses showing a change towards ‘widening’ their view of who should be involved in research to include more people. Outcomes also included an improved understanding of research and how to be involved. Participants enjoyed online discussions, found learning resources useful and asked to stay involved in the research process. The partner organisation reported that a similar online discussion will be used in future research prioritisation processes. Conclusion Involving people in co-designing the process improved the study design, ensuring it met the needs of participants. Whilst the study includes participants from only one disease group, using STARDIT allowed us to map people’s preferences and report the methods and outcomes from involving people, providing a way for learning from this case study to inform future research studies beyond the discipline of public health genomics.
Bioinformatics analysis of single-cell mRNA-seq of SARS-CoV-1 and SARS-CoV-2 infection compared to MERS-CoV from Sequence Read Archive (SRA) database reveals novel targets for therapies
Authors: Wang Mengyao , Lu Peng 
Published: August 2020

Abstract
The global pandemic of COVID-19 caused by SARS-CoV-2 is still threatening the world. By May 13, 2020, more than 40 million people have been infected by SARS-CoV-2 and almost 300 thousand deaths were reported. The discovery and development of anti-viral drugs and vaccines are being conducted worldwide and the understanding of the molecular responses of a single cell to SARS-CoV-2 is in urgent need. The comparative analysis of gene expression in SARS-CoVs and MERS-CoV infected Calu-3 cells reveals that although the coronaviruses cause similar acute respiratory distress syndromes, the molecular responses of Calu-3 cells to SARS-CoVs infections showed a unique signature. A total of 64 correlated differentially expressed genes (DEGs) were identified in this study. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses indicated that the DEGs were significantly involved in biological process of ‘Response to interferon-γ’, ‘Viral life cycle’, ‘Phagosome’ and ‘Epstein-Barr virus infection’. STRING analysis showed that the DEGs that were up-regulated after SARS-CoVs infections but down-regulated after MERS-CoV infections showed a strong interaction network. Molecular Complex Detection (MCODE) analysis further refined a unique network consisted of eight hub genes out of 64 DEGs, which are involved in cytokine response (CXCL8, CCL20, and CSF2), ISGylation (ISG15), macrophage activation (ITGAM), complement system (C3), and NFκB signaling pathway (TRAF1 and NFκB2). The unique network identified here will be a potential fingerprint for distinguishing SARS-CoVs infections from MERS-CoV infection. The identification of the eight hub genes will lead to the discovery of new possible therapeutic targets for fighting COVID-19.
Upregulation of SIRT1 and FOXO3a Contributes to The Protective Role of Estrogen on HPH in Rats
Authors: Wang Li , Yuan Yadong , Gong Xiaowei , Mao Jianjun 
Published: August 2020

Abstract
Background: SIRT1 has anti-proliferation effects on cells through regulating the expression and activity of FOXOs. Estrogen (E2) has protective effects against hypoxic pulmonary hypertension (HPH), but the involvement of SIRT1 and FOXOs in the proliferation of pulmonary artery smooth muscle cells (PASMCs) and contribution to the effects of E2 on HPH are poorly understood. To use E2 to explore the roles of SIRT1 and FOXO3a in the pathogenesis and progression of HPH and pulmonary vascular remodeling (PVR) in vivo and in vitro.Methods: Female Sprague-Dawley rats with bilateral ovariectomy were randomized to normoxia, normoxia+E2, hypoxia, and hypoxia+E2. Serum E2 levels, hemodynamic, and pulmonary vascular pathomorphology were assessed. The anti-proliferation effect of E2 was determined in human PASMCs under hypoxia/normoxia. Immunohistochemistry, western blotting, and real-time PCR were used to assess SIRT1, FOXO3a, and PCNA in rat pulmonary artery and hPASMCs. SIRT1 activity was assayed.Results: Hypoxia increased mean pulmonary artery pressure (mPAP), medial width of pulmonary arterioles, right ventricular hypertrophy index (RVHI), decreased expression SIRT1 and FOXO3a and increased PCNA expression in rats; E2 alleviated these changes. In vitro, E2 significantly inhibited hypoxia-induced hPASMCs proliferation, associated with improvements in SIRT1 and FOXO3a expression, consistent with the in vivo results. SIRT1 inhibition attenuated the effects of E2 on hPASMCs proliferation and the expression of FOXO3a. A SIRT1 activator mimicked the effects of E2 on hPASMCs proliferation and the expression of FOXO3a.Conclusions: Upregulation of SIRT1 and FOXO3a contributes to the protective role of estrogen on HPH in rats, as supported by in vitro results using hPASMCs.
Performance of a reed bed system for faecal wastewater treatment: case study
Authors: Kabir Md Imran , Hoque Muhammad Azizul , Banik Bijit Kumar 
Published: August 2020

Abstract
Reed bed systems (RBS) have potential to treat wastewater, and being interested in such green wastewater infrastructures, an RBS has been installed for the first time in Bangladesh to treat faecal wastewater, which comes from a low-cost community latrine at a refugee camp in Cox's Bazar area. An anaerobic baffle reactor was set followed by the RBS, which was operated continuously for four months at five different retention times (3–7 days). The RBS was found to retain, on average, about 92% of 5-day biochemical oxygen demand (BOD5) and chemical oxygen demand (COD), 69% of and 52% of . Importantly, the effluent concentration met the national environmental standard for all except for . Thus the optimum hydraulic retention time in RBS has been selected to be 3 days when the ion has been reduced at maximum rate. High positive correlation () was observed between and concentrations in effluent water as well. The results of this study, thus, partly support the RBS as an effective green solution for faecal wastewater treatment.