bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antigen Processing and Presentation Mechanisms in Myeloid Cells
Authors: Roche Paul A. , Cresswell Peter 
Published: January 2020

ABSTRACTUnlike B cells, CD8-positive and CD4-positive T cells of the adaptive immune system do not recognize intact foreign proteins but instead recognize polypeptide fragments of potential antigens. These antigenic peptides are expressed on the surface of antigen presenting cells bound to MHC class I and MHC class II proteins. Here, we review the basics of antigen acquisition by antigen presenting cells, antigen proteolysis into polypeptide fragments, antigenic peptide binding to MHC proteins, and surface display of both MHC class I-peptide and MHC class II-peptide complexes.
What is the inter-rater agreement of injury classification using the WHO minimum data set for emergency medical teams?
Authors: Jafar Anisa Jabeen Nasir , Sergeant Jamie C , Lecky Fiona 
Published: January 2020

BackgroundIn 2017, the WHO produced its first minimum data set (MDS) for emergency medical team (EMT) daily reporting during the sudden-onset disasters (SODs), following expert consensus. The MDS was deliberately designed to be simple in order to improve the rate of data capture; however, it is new and untested. This study assesses the inter-rater agreement between practitioners when performing the injury aspect of coding within the WHO EMT MDS.Methods25 clinical case vignettes were developed, reflecting potential injuries encountered in an SOD. These were presented online from April to July 2018 to practitioners who have experience of/training in managing patients in SODs The practitioners were from UK-Med’s members, Australian Medical Assistance Team’s Northern Territory members and New Zealand Medical Assistance Team members. Practitioners were asked to code injuries according to WHO EMT MDS case classifications. Randolph’s kappa statistic for free-marginal multirater data was calculated for the whole dataset as well as subgroups to ascertain inter-rater agreement.Results86 practitioners responded (20.6% response rate), giving >2000 individual case responses. Overall agreement was moderate at 67.9% with a kappa of 0.59 (95% CI 0.49 to 0.69). Despite subgroups of paramedics (kappa 0.63, 95% CI 0.53 to 0.72), doctors (kappa 0.61, 95% CI 0.52 to 0.69) and those with disaster experience (kappa 0.62, 95% CI 0.52 to 0.71) suggesting slightly higher agreement, their CIs (and those of other subgroups) suggest overall similar and moderate levels of practitioner agreement in classifying injuries according to the MDS categories.ConclusionsAn inter-rater agreement of 0.59 is moderate, at best, however, it gives ministries of health some sense of how tightly they may interpret injury data derived from daily reports using WHO EMT MDS. Furthermore, this kappa is similar to established but more complex (thus more contextually impractical) injury scores. Similar studies, with weighting for injury likelihood using sample data from SODs would further refine the level of expected inter-rater agreement.
Using an interprofessional team to provide refugee healthcare in an academic medical centre
Authors: Elmore Catherine E , Tingen Jeffrey M , Fredgren Kelly , Dalrymple Sarah N , Compton Rebekah M , Carpenter Elizabeth L , Allen Claudia W , Hauck Fern R 
Published: January 2020

IntroductionThe International Family Medicine Clinic (IFMC) was established in 2002 by the University of Virginia Department of Family Medicine to provide comprehensive, timely, culturally sensitive and high-quality healthcare to the growing refugee and special immigrant population in Central Virginia, USA.MethodsThe purpose of this paper is to describe the IFMC, with a specific focus on interprofessional roles, interprofessional collaboration, community partnerships and the services and resources available to IFMC patients.ResultsThe clinic has served over 3100 refugees from 60 countries in its 16-year history. In 2019, the clinic staff now includes 4 attending physicians, 2 nurse practitioners and 14 residents who have dedicated clinic time to see refugees; a registered nurse care coordinator and a social worker dedicated to the IFMC refugee population; 2 clinical psychologists and doctoral students in clinical psychology; and a clinical pharmacist. The IFMC also provides onsite psychiatric care. A process flow map depicts the interconnectivity of interprofessional team members working together with other specialty care providers within the medical centre and with community partners on behalf of refugee patients through the resettlement process.ConclusionIndividuals who arrive in the USA as refugees are a particularly vulnerable patient group and often require an interprofessional team approach. The IFMC may serve as a model for other institutions interested in starting a similar interprofessional, refugee-centred medical home.
Glycaemic control, antidiabetic medications and influenza vaccination coverage among patients with diabetes in Udine, Italy
Authors: Valent Francesca , Tullio Annarita 
Published: January 2020

ObjectiveThe objectives of this study were to estimate influenza vaccination coverage among patients with diabetes mellitus in an Italian 250 000-inhabitant area in the 2017–2018 season and to assess whether glycaemic control and pharmacological treatment were associated with the likelihood of being vaccinated.DesignIn this cross-sectional study, we analysed anonymous health administrative databases, linked with each other at the individual patient level through a stochastic key: diabetes mellitus registry, vaccinations, drug prescriptions and laboratory database.SettingThe study was conducted in the catchment area of the University Hospital of Udine (‘the Udine area’), a 250 000-inhabitant area in the northeast of Italy.ParticipantsThe study included all subjects included in the regional registry of patients with diabetes mellitus, living in the Udine area as of 1 October 2017.Main outcome measuresVaccination coverage in the 2017–2018 influenza season was calculated. The association between patients’ characteristics and the likelihood of being vaccinated was assessed through multivariate log binomial regression.Result53.0% of 15 900 patients with diabetes living in the area were vaccinated. Coverage increased with age, approaching 75% at ≥85 years. Patients lacking recent glycated haemoglobin testing were less likely to be vaccinated (43.4% vaccination coverage), as were those not treated pharmacologically (44.4% vaccination coverage). Patients treated with both insulin, metformin and other antidiabetic medications were more likely to be vaccinated than those treated with metformin alone (58.1% vaccination coverage; adjusted relative risk=1.07, 95% CI 1.01 to 1.14).ConclusionInfluenza vaccination coverage was suboptimal in this Italian population of patients with diabetes. Strategies to improve diabetes management could in turn positively affect influenza coverage.
In SituDESI-MSI Lipidomic Profiles of Breast Cancer Molecular Subtypes and Precursor Lesions
Authors: Santoro Adriana Leandra , Drummond Rodrigo D. , Silva Israel Tojal , Ferreira Severino S. , Juliano Luiz , Vendramini Pedro H. , Lemos Monique Batista da Costa , Eberlin Marcos N. , Andrade Victor Piana 
Published: January 2020

AbstractClinically meaningful molecular subtypes for classification of breast cancers have been established, however, initiation and progression of these subtypes remain poorly understood. The recent development of desorption electrospray ionization-mass spectrometry imaging (DESI-MSI) facilitates the convergence of analytical chemistry and traditional pathology, allowing chemical profiling with minimal tissue pretreatment in frozen samples. Here, we characterized the chemical composition of molecular subtypes of breast cancer with DESI-MSI. Regions of interest were identified, including invasive breast cancer (IBC), ductal carcinoma in situ (DCIS), and adjacent benign tissue (ABT), and metabolomic profiles at 200 μm elaborated using Biomap software and the Lasso method. Top ions identified in IBC regions included polyunsaturated fatty acids, deprotonated glycerophospholipids, and sphingolipids. Highly saturated lipids, as well as antioxidant molecules [taurine (m/z 124.0068), uric acid (m/z 167.0210), ascorbic acid (m/z 175.0241), and glutathione (m/z 306.0765)], were able to distinguish IBC from ABT. Moreover, luminal B and triple-negative subtypes showed more complex lipid profiles compared with luminal A and HER2 subtypes. DCIS and IBC were distinguished on the basis of cell signaling and apoptosis-related ions [fatty acids (341.2100 and 382.3736 m/z) and glycerophospholipids (PE (P-16:0/22:6, m/z 746.5099, and PS (38:3), m/z 812.5440)]. In summary, DESI-MSI identified distinct lipid composition between DCIS and IBC and across molecular subtypes of breast cancer, with potential implications for breast cancer pathogenesis.Significance:These findings present the first in situ metabolomic findings of the four molecular subtypes of breast cancer, DCIS, and normal tissue, and add to the understanding of their pathogenesis.
Combined MEK and PI3K/p110β Inhibition as a Novel Targeted Therapy for Malignant Mesothelioma Displaying Sarcomatoid Features
Authors: Marqués Miriam , Tranchant Robin , Risa-Ebrí Blanca , Suárez-Solís María L. , Fernández Luis C. , Carrillo-de-Santa-Pau Enrique , del Pozo Natalia , Martínez de Villarreal Jaime , Meiller Clément , Allory Yves , Blum Yuna , Pirker Christine , Hegedus Balazs , Barry Simon T. , Carnero Amancio , Berger Walter , Jean Didier , Real Francisco X. 
Published: January 2020

Abstract

Among malignant mesotheliomas (MM), the sarcomatoid subtype is associated with higher chemoresistance and worst survival. Due to its low incidence, there has been little progress in the knowledge of the molecular mechanisms associated with sarcomatoid MM, which might help to define novel therapeutic targets. In this work, we show that loss of PTEN expression is frequent in human sarcomatoid MM and PTEN expression levels are lower in sarcomatoid MM than in the biphasic and epithelioid subtypes. Combined Pten and Trp53 deletion in mouse mesothelium led to nonepithelioid MM development. In Pten;Trp53-null mice developing MM, the Gαi2-coupled receptor subunit activated MEK/ERK and PI3K, resulting in aggressive, immune-suppressed tumors. Combined inhibition of MEK and p110β/PI3K reduced mouse tumor cell growth in vitro. Therapeutic inhibition of MEK and p110β/PI3K using selumetinib (AZD6244, ARRY-142886) and AZD8186, two drugs that are currently in clinical trials, increased the survival of Pten;Trp53-null mice without major toxicity. This drug combination effectively reduced the proliferation of primary cultures of human pleural (Pl) MM, implicating nonepithelioid histology and high vimentin, AKT1/2, and Gαi2 expression levels as predictive markers of response to combined MEK and p110β/PI3K inhibition. Our findings provide a rationale for the use of selumetinib and AZD8186 in patients with MM with sarcomatoid features. This constitutes a novel targeted therapy for a poor prognosis and frequently chemoresistant group of patients with MM, for whom therapeutic options are currently lacking.

Significance:
Mesothelioma is highly aggressive; its sarcomatoid variants have worse prognosis. Building on a genetic mouse model, a novel combination therapy is uncovered that is relevant to human tumors.
Comparative Effect of Proton-Pump Inhibitors on the Success of Triple and Quadruple Therapy for <b><i>Helicobacter pylori</i></b> Infection
Authors: Boltin Doron , Levi Zohar , Gingold-Belfer Rachel , Schmilovitz-Weiss Hemda , Shochat Tzippy , Dickman Ram , Perets Tsachi Tsadok , Dotan Iris , Niv Yaron 
Published: January 2020

<b><i>Introduction:</i></b> Suppression of gastric acid secretion with proton-pump inhibitors (PPI) is an integral part of the treatment of <i>Helicobacter pylori</i> infection. Esomeprazole has been shown to be superior to other PPIs when used in the context of triple therapy; however, comparative data for PPI efficacy in quadruple therapy are lacking. Current guidelines recommend <i>H. pylori</i> eradication with quadruple therapy in areas with high clarithromycin resistance. <b><i>Objective:</i></b> To determine whether esomeprazole is more effective than other PPIs in the context of quadruple therapy for <i>H. pylori</i> eradication. <b><i>Methods:</i></b> We retrospectively identified 25- to 60-year-old subjects with a positive <sup>13</sup>C-urea breath test and no prior laboratory or endoscopic test for <i>H. pylori</i> infection. Pharmacy dispensation data were retrieved. <b><i>Results:</i></b> A total of 7,896 subjects including 2,856 (36.2%) males, aged 40.4 ± 10.6 years, were identified. Of those, 78.1% received omeprazole, 20.1% received lansoprazole, 1.5% received esomeprazole, and 0.34% received pantoprazole together with antibiotics for <i>H. pylori</i> eradication. Esomeprazole was associated with a greater proportion of successful eradication (85.0 vs. 77.5%, esomeprazole vs. omeprazole, OR 1.64; 95% CI 0.99–2.72; <i>p</i> = 0.05). A nonsignificant trend favored esomeprazole over omeprazole among subjects receiving quadruple therapy (90.0 vs. 82.0%, respectively, OR 1.98; 95% CI 0.68–5.72; <i>p</i> = 0.16). Independent predictors of treatment success included older age and quadruple therapy. <b><i>Conclusion:</i></b> Esomeprazole is more beneficial than other PPIs for <i>H. pylori</i> eradication. Studies with larger subgroups are necessary to confirm our findings among subjects receiving quadruple therapy.
Survey of Hardware and Software Design Approaches for Mechatronic Chordophones
Authors: Placencia Juan Pablo Yepez , Murphy Jim , Carnegie Dale 
Published: January 2020

Abstract
Mechatronic instruments can create complex sounds that computers and digital instruments have yet to offer. As a specific example, we explore mechatronic chordophones, which use strings as a sound generator and offer a wide array of parametric affordances. The purpose of this work is to review recent approaches for chordophone design and construction, and present current, state-of-the-art devices. We explore multiple mechatronic frames and their components, and we analyze the challenges of building and interacting with these machines. Finally, we review software and hardware approaches that have been implemented to enhance these instruments and to bridge technical and creative restrictions.
Trends in Upper-Tropospheric Humidity: Expansion of the Subtropical Dry Zones?
Authors: Tivig Miriam , Grützun Verena , John Viju O. , Buehler Stefan A. 
Published: January 2020

AbstractSubtropical dry zones, located in the Hadley cells’ subsidence regions, strongly influence regional climate as well as outgoing longwave radiation. Changes in these dry zones could have significant impact on surface climate as well as on the atmospheric energy budget. This study investigates the behavior of upper-tropospheric dry zones in a changing climate, using the variable upper-tropospheric humidity (UTH), calculated from climate model experiment output as well as from radiances measured with satellite-based sensors. The global UTH distribution shows that dry zones form a belt in the subtropical winter hemisphere. In the summer hemisphere they concentrate over the eastern ocean basins, where the descent regions of the subtropical anticyclones are located. Recent studies with model and satellite data have found tendencies of increasing dryness at the poleward edges of the subtropical subsidence zones. However, UTH calculated from climate simulations with 25 models from phase 5 of the Coupled Model Intercomparison Project (CMIP5) shows these tendencies only for parts of the winter-hemispheric dry belts. In the summer hemisphere, even though differences exist between the simulations, UTH is increasing in most dry zones, particularly in the South and North Pacific Ocean. None of the summer dry zones is expanding in these simulations. Upper-tropospheric dry zones estimated from observational data do not show any robust signs of change since 1979. Apart from a weak drying tendency at the poleward edge of the southern winter-hemispheric dry belt in infrared measurements, nothing indicates that the subtropical dry belts have expanded poleward.
Near-Real-Time Forecast of Satellite-Based Soil Moisture Using Long Short-Term Memory with an Adaptive Data Integration Kernel
Authors: Fang Kuai , Shen Chaopeng 
Published: January 2020

AbstractNowcasts, or near-real-time (NRT) forecasts, of soil moisture based on the Soil Moisture Active and Passive (SMAP) mission could provide substantial value for a range of applications including hazards monitoring and agricultural planning. To provide such a NRT forecast with high fidelity, we enhanced a time series deep learning architecture, long short-term memory (LSTM), with a novel data integration (DI) kernel to assimilate the most recent SMAP observations as soon as they become available. The kernel is adaptive in that it can accommodate irregular observational schedules. Testing over the CONUS, this NRT forecast product showcases predictions with unprecedented accuracy when evaluated against subsequent SMAP retrievals. It showed smaller error than NRT forecasts reported in the literature, especially at longer forecast latency. The comparative advantage was due to LSTM’s structural improvements, as well as its ability to utilize more input variables and more training data. The DI-LSTM was compared to the original LSTM model that runs without data integration, referred to as the projection model here. We found that the DI procedure removed the autocorrelated effects of forcing errors and errors due to processes not represented in the inputs, for example, irrigation and floodplain/lake inundation, as well as mismatches due to unseen forcing conditions. The effects of this purely data-driven DI kernel are discussed for the first time in the geosciences. Furthermore, this work presents an upper-bound estimate for the random component of the SMAP retrieval error.
Global Burden of Head and Neck Cancer: Economic Consequences, Health, and the Role of Surgery
Authors: Patterson Rolvix H. , Fischman Victoria G. , Wasserman Isaac , Siu Jennifer , Shrime Mark G. , Fagan Johannes J. , Koch Wayne , Alkire Blake C. 
Published: January 2020

ObjectiveWe aimed to describe the mortality burden and macroeconomic effects of head and neck cancer as well as delineate the role of surgical workforce in improving head and neck cancer outcomes.Study DesignStatistical and economic analysis.SettingResearch group.Subjects and MethodsWe conducted a statistical analysis on data from the World Development Indicators and the 2016 Global Burden of Disease study to describe the relationship between surgical workforce and global head and neck cancer mortality‐to‐incidence ratios. A value of lost output model was used to project the global macroeconomic effects of head and neck cancer.ResultsSignificant differences in mortality‐to‐incidence ratios existed between Global Burden of Disease study superregions. An increase of surgical, anesthetic, and obstetric provider density by 10% significantly correlated with a reduction of 0.76% in mortality‐to‐incidence ratio (P <. 0001; adjusted R2 = 0.84). There will be a projected global cumulative loss of $535 billion US dollars (USD) in economic output due to head and neck cancer between 2018 and 2030. Southeast Asia, East Asia, and Oceania will suffer the greatest gross domestic product (GDP) losses at $180 billion USD, and South Asia will lose $133 billion USD.ConclusionThe mortality burden of head and neck cancer is increasing and disproportionately affects those in low‐ and middle‐income countries and regions with limited surgical workforces. This imbalance results in large and growing economic losses in countries that already face significant resource constraints. Urgent investment in the surgical workforce is necessary to ensure access to timely surgical services and reverse these negative trends.
A Critical Review of Chinese Theoretical Research on Moral Education Since 2000
Authors: Cheng Hongyan 
Published: January 2020

Purpose: The purpose of this article is to summarize and reflect Chinese theoretical research on moral education in the context of globalization and value pluralism since 2000 and to propose possible directions for the future research. Design/Approach/Methods: The research methods in this article are primarily literature review. Those papers which met the following criteria were selected and included in this review: (1) Papers published from 2000 to 2014 were included if they were cited by at least one other published article and (2) papers published from 2015 to 2017 were included if they were presented in a core research journal. Based on that, speculative thinking and critical thinking are also embodied in this research. Findings: Based on the features of “a man of virtue,” the article identifies the four dimensions that have influenced Chinese thinking about moral education: (1) Kantian and Enlightenment philosophy, (2) emotion and life experience, (3) social rights, and (4) the culture-value dimension. The four dimensions of moral education theory are related and complement, rather than contradict, each other. The author argues that the research scopes underlying current moral education theories are fairly narrow. A more comprehensive, interdisciplinary approach is needed to improve theoretical research and to enhance the effectiveness of moral education practice in schools and universities. Originality/Value: The article provides a latest overview and critical insights to consolidate the foundation of moral education in an era of societal transformation by comparing moral education research between China and the West and proposing realizing a deep integration between theory and practice.
A comparison of aspirin against rivaroxaban for venous thromboembolism prophylaxis after hip or knee arthroplasty: A meta-analysis
Authors: Xu Joshua , Kanagaratnam Aran , Cao Jacob Y , Chaggar Gurpreet S , Bruce Warwick 
Published: January 2020

Purpose: Total knee arthroplasty (TKA) and total hip arthroplasty (THA) patients are at an elevated risk of post-operative venous thromboembolism (VTE). Newer thromboprophylactic agents such as rivaroxaban are increasingly used and effective in preventing thromboembolic events but may worsen bleeding risk. Recent studies have suggested that the more cost-effective aspirin may also be effective in preventing VTE. This systematic review and meta-analysis aimed to compare the efficacy of aspirin against rivaroxaban for the prevention of VTE following TKA and THA. Methods: Electronic searches were performed using five databases from their date of inception to August 2018. Relevant studies were identified, with data extracted and meta-analyzed from the studies. Results: Five studies were included, which consisted of 2257 in the aspirin group and 2337 in the rivaroxaban group. There were no differences between aspirin and rivaroxaban for either VTE ( p = 0.48) or its components deep vein thrombosis ( p = 0.44) and pulmonary embolism ( p = 0.98). Also, there were no differences between groups for either major bleeding ( p = 0.17), any bleeding ( p = 0.62), readmissions ( p = 0.37) or wound complications ( p = 0.17). Conclusion: Aspirin was not significantly different to rivaroxaban for prevention of VTE or adverse events after TKA or THA. However, this study was limited by the significant heterogeneity of the included studies. More large randomized studies are needed to add to this body of evidence.