bluuebunny/crossref_metadata_2025_split huggingface dataset:
Deep-Learning Approaches to Identify Critically Ill Patients at Emergency Department Triage Using Limited Information
Authors: Joseph Joshua W. , Leventhal Evan L. , Grossestreuer Anne V. , Wong Matthew L. , Joseph Loren J. , Nathanson Larry A. , Donnino Michael W. , Elhadad Noémie , Sanchez Leon D. 
Published: May 2020

ImportanceTriage quickly identifies critically ill patients, helping to facilitate timely interventions. Many emergency departments use the emergency severity index (ESI) or abnormal vital sign thresholds to identify critically ill patients. However, both rely on fixed thresholds, and false activations detract from efficient care. Prior research suggests that machine-learning approaches may improve triage accuracy, but have relied on information that is often unavailable during the triage process.ObjectiveWe examined whether deep-learning approaches could identify critically ill patients using data immediately available at triage with greater discriminative power than ESI or abnormal vital sign thresholds.DesignRetrospective, cross-sectional study.SettingAn urban tertiary care hospital in the Northeastern United States.ParticipantsAdult patients presenting to the emergency department from 1/1/2012 - 1/1/2020 were included. Deidentified triage information included structured data (age, sex, initial vital signs, ESI score, and clinical trigger activation due to abnormal vital signs), and textual data (chief complaint) with critical illness (defined as mortality or ICU admission within 24 hours) as the outcome.InterventionsThree progressively complex deep-learning models were trained (logistic regression on structured data, neural network on structured data, and neural network on structured and textual data), and applied to triage information from all patients.Main Outcomes and MeasuresThe primary outcome was the accuracy of the model for predicting whether patients were critically ill using area under the receiver-operator curve (AUC), as compared to ESI, utilizing a 10-fold cross-validation.Results445,925 patients were included, with 60,901 (13.7%) critically ill. Vital sign thresholds identified critically ill patients with AUC 0.521 (95% CI 0.519 -- 0.522), and ESI less than 3 demonstrated AUC 0.672 (95% CI 0.671 -- 0.674), logistic regression classified patients with AUC 0.803 (95% CI 0.802 -- 0.804), neural network with structured data with 0.811 (95% CI 0.807 - 0.815), and the neural network model with textual data with AUC 0.851 (95% CI 0.849 -- 0.852).Conclusions and RelevanceDeep-learning techniques represent a promising method of enhancing the triage process, even when working from limited information. Further research is needed to determine if improved predictions can be translated into meaningful clinical and operational benefits.
A note on COVID-19 seroprevalence studies: a meta-analysis using hierarchical modelling
Authors: Levesque Jérôme , Maybury David W. 
Published: May 2020

AbstractIn recent weeks, several seroprevalence studies have appeared which attempt to determine the prevalence of antibodies against SARS-CoV-2 in the population of certain European and American locations. Many of these studies find an antibody prevalence comparable to the false positive rate of their respective serology tests and the relatively low statistical power associated with each study has invited criticism. To determine the strength of the signal, we perform a meta-analysis on the publicly available seroprevalence data based on Bayesian hierarchical modelling with Markov Chain Monte Carlo and Generalized Linear Mixed Modelling with prediction sampling. We examine studies with results from Santa Clara County (CA), Los Angeles County (CA), San Miguel County (CO), Chelsea (MA), the Comté de Genève (Switzerland), and Gangelt (Germany). Our results are in broad agreement with the conclusions of the studies; we find that there is evidence for non-trivial levels of antibody prevalence across all study locations. However, we also find that a significant probability mass exists for antibody prevalence at levels lower than the reported figures. The results of our meta-analysis on the recent seroprevalence studies point to an important and strongly suggestive signal.
Functional alteration of innate T cells in critically ill Covid-19 patients
Authors: Jouan Youenn , Guillon Antoine , Gonzalez Loïc , Perez Yonatan , Ehrmann Stephan , Ferreira Marion , Daix Thomas , Jeannet Robin , François Bruno , Dequin Pierre-François , Si-Tahar Mustapha , Baranek Thomas , Paget Christophe 
Published: May 2020

AbstractCovid-19 can induce lung infection ranging from mild pneumonia to life-threatening acute respiratory distress syndrome (ARDS). Dysregulated host immune response in the lung is a key feature in ARDS pathophysiology. However, cellular actors in Covid-19-driven ARDS are poorly understood. Here, we dynamically analyzed the biology of innate T cells, a heterogeneous class (MAIT, γδT and iNKT cells) of T lymphocytes, presenting potent anti-infective and regulatory functions. Patients presented a compartmentalized lung inflammation paralleled with a limited systemic inflammation. Circulating innate T cells of critically ill Covid-19 patients presented a profound and persistent phenotypic and functional alteration. Highly activated innate T cells were detected in airways of patients suggesting a recruitment to the inflamed site and a potential contribution in the regulation of the local inflammation. Finally, the expression of the CD69 activation marker on blood iNKT and MAIT cells at inclusion was predictive of disease severity. Thus, patients present an altered innate T cell biology that may account for the dysregulated immune response observed in Covid-19-related acute respiratory distress syndrome.
A systematic review and meta-analysis of published research data on COVID-19 infection-fatality rates
Authors: Meyerowitz-Katz Gideon , Merone Lea 
Published: May 2020

AbstractAn important unknown during the COVID-19 pandemic has been the infection-fatality rate (IFR). This differs from the case-fatality rate (CFR) as an estimate of the number of deaths as a proportion of the total number of cases, including those who are mild and asymptomatic. While the CFR is extremely valuable for experts, IFR is increasingly being called for by policy-makers and the lay public as an estimate of the overall mortality from COVID-19.MethodsPubmed, Medline, SSRN, and Medrxiv were searched using a set of terms and Boolean operators on 25/04/2020 and re-searched 14/05/2020, 21/05/2020, and 16/06/2020. Articles were screened for inclusion by both authors. Meta-analysis was performed in Stata 15.1 using the metan command, based on IFR and confidence intervals extracted from each study. Google/Google Scholar was used to assess the grey literature relating to government reports.ResultsAfter exclusions, there were 24 estimates of IFR included in the final meta-analysis, from a wide range of countries, published between February and June 2020.The meta-analysis demonstrated a point-estimate of IFR of 0.68% (0.53-0.82%) with high heterogeneity (p<0.001).ConclusionBased on a systematic review and meta-analysis of published evidence on COVID-19 until May, 2020, the IFR of the disease across populations is 0.68% (0.53-0.82%). However, due to very high heterogeneity in the meta-analysis, it is difficult to know if this represents the ‘true’ point estimate. It is likely that, due to age and perhaps underlying comorbidities in the population, different places will experience different IFRs due to the disease. Given issues with mortality recording, it is also likely that this represents an underestimate of the true IFR figure. More research looking at age-stratified IFR is urgently needed to inform policy-making on this front.Key messages–COVID-19 infection-fatality rate (IFR) is an important statistic for policy about the disease–Published estimates vary, with a ‘true’ fatality rate hard to calculate–Systematically reviewing the literature and meta-analyzing the results shows an IFR of 0.68% (0.53-0.82%)
Conformational maps of human 20S proteasomes reveal PA28- and immuno-dependent inter-ring crosstalks
Authors: Lesne Jean , Locard-Paulet Marie , Parra Julien , Zivković Dušan , Bousquet Marie-Pierre , Burlet-Schiltz Odile , Marcoux Julien 
Published: May 2020

AbstractHere, we used for the first time Hydrogen-Deuterium eXchange coupled to Mass Spectrometry (HDX-MS) to investigate conformational differences between the human standard 20S (std20S) and immuno 20S (i20s) proteasomes alone or in complex with PA28αβ or PA28γ activators. Their solvent accessibility was analyzed through a dedicated bioinformatic pipeline including stringent statistical analysis and 3D visualization. These data confirmed the existence of allosteric differences between the std20S and i20S at the surface of the α-ring triggered from inside the catalytic β-ring. Additionally, binding of the PA28 regulators to the 20S proteasomes modified solvent accessibility due to conformational changes of the β-rings. This work is not only a proof-of-concept that HDX-MS can be used to get structural insights on large multi-protein complexes in solution, it also demonstrates that the binding of the std20S or i20S subtype to any of its PA28 activator triggers allosteric changes that are specific to this 20S/PA28 pair.
Intravital imaging of islet Ca2+dynamics reveals enhanced β cell connectivity after bariatric surgery in mice
Authors: Akalestou Elina , Suba Kinga , Lopez-Noriega Livia , Georgiadou Eleni , Chabosseau Pauline , Leclerc Isabelle , Salem Victoria , Rutter Guy A. 
Published: May 2020

AbstractBariatric surgery improves both insulin sensitivity and secretion in type 2 diabetes. However, these changes are difficult to monitor directly and independently. In particular, the degree and the time course over which surgery impacts β cell function, versus mass, have been difficult to establish. In this study, we investigated the effect of bariatric surgery on β cell functionin vivoby imaging Ca2+dynamics prospectively and at the single cell level in islets engrafted into the anterior eye chamber. Islets expressing GCaMP6f selectively in the β cell were transplanted into obese male hyperglycaemic mice that were then subjected to either vertical sleeve gastrectomy (VSG) or sham surgery. Imagedin vivoin the eye, VSG improved coordinated Ca2+activity, with 90% of islets observed exhibiting enhanced Ca2+wave activity ten weeks post-surgery, while islet wave activity in sham animals fell to zero discernible coordinated islet Ca2+activity at the same time point. Correspondingly, VSG mice displayed significantly improved glucose tolerance and insulin secretion. Circulating fasting levels of GLP-1 were also increased after surgery, potentially contributing to improved β cell performance. We thus demonstrate that bariatric surgery leads to time-dependent increases in individual β cell function and intra-islet connectivity, together driving increased insulin secretion and diabetes remission, in a weight-loss independent fashion.Significance StatementUsed widely to treat obesity, bariatric surgery also relieves the symptoms of type 2 diabetes. The mechanisms involved in diabetes remission are still contested, with increased insulin sensitivity and elevated insulin secretion from pancreatic β cells both implicated. Whilst the speed of remission – usually within a few days – argues for improvements in β cell function rather than increases in mass, a direct demonstration of changes at the level of individual β cells or islets has been elusive. Here, we combine vertical sleeve gastrectomy with intravital imaging of islets engrafted into the mouse anterior eye chamber to reveal that surgery causes a time-dependent improvement in glucose-induced Ca2+dynamics and β cell - β cell connectivity, both of which likely underlie increased insulin release.
Expression and function of murine WFDC2 in the respiratory tract
Authors: Bingle L , Armes H , Williams DJ , Gianfrancesco O , Chowdhury Md M K , Drapkin R , Bingle C D 
Published: May 2020

AbstractWFDC2/HE4encodes a poorly characterised secretory protein that shares structural similarity with multifunctional host defence proteins through possession of two conserved Whey Acidic Protein/four disulphide-core (WFDC) domains. WFDC2 is expressed in multiple epithelia and although its’ function remains unresolved, it is also overexpressed in a number of human cancers and has an established role as a cancer marker. Currently, little is known about the distribution of WFDC2 in the mouse and thus we have systematically analysed the mousewfdc2gene, its’ expression and distribution. We have used recombinant WFDC2 for functional studies.Wfdc2is the most highly expressed family member in the lung and is enriched in the nasopharynx.Wfdc2is the most highly expressed family member in differentiated epithelial cells isolated from the trachea, nasal passages and middle ear.Wfdc2consists of 5 exons with exon 3 encoding an unstructured linker region that separates the two WFDC domains. This genomic organisation appears to be restricted to theMuridaeandCricetidaefamilies of rodents. Similar to the situation in man, mousewfdc2can be alternatively spliced to yield a number of distinct transcripts that have the potential to generate a repertoire of distinct protein isoforms. We used immunohistochemistry to localise the proteins to tissues of the respiratory tract and head and neck regions. Although the protein was limited to epithelial cells of the respiratory tract and nasal and oral cavities, it was expressed in different cells in different regions suggesting expression is governed by a unique regulatory mechanism. Recombinant WFDC2 did not possess antiproteinase activity against trypsin or elastase and had no clear antimicrobial activity.
Corrosion behavioral studies on AA7075 surface hybrid composites tailored through friction stir processing
Authors: Kandasamy Suganeswaran , Rathinasamy Parameshwaran , Nagarajan Nithyavathy , Arumugam Karthik , Rathanasamy Rajasekar , Velu Kaliyannan Gobinath 
Published: May 2020

Purpose
This paper aims to overcome the corrosion in AA7075 by incorporating the dual-reinforcements like Al2O3 and SiC through friction stir processing (FSP). In recent days, an automotive monocoque structure undergoes corrosion because of changes in environmental conditions.

Design/methodology/approach
Surface hybrid composites (SHCs) of AA7075 with different weight ratios of Al2O3 and SiC were fabricated at a rotating speed of 1000 rpm, traveling speed of 56 mm/min and tool tilt angle of 2º with two passes. Surface regions were observed using optical microscopy, and the potentiodynamic corrosion test was performed under a 3.5 per cent NaCl environment at room temperature. Then, the surface morphology analysis of corroded samples and their structural properties were also investigated through scanning electron microscopy (SEM), X-ray diffraction (XRD) and electron dispersive spectroscopy (EDS).

Findings
Through FSP, an improved interface between the reinforced particles and the AA7075 base matrix was observed because of the severe plastic deformation. Potentiodynamic polarization tests confirmed that the AA7075 matrix with a higher concentration of Al2O3 and a lower concentration of SiC (Al2O3 – 75 per cent and SiC – 25 per cent) possesses a lower corrosion rate than other specimens. This result is because of the combined effect of stable passive film formation and the resistance produced by hard SiC particles. In addition, the formation of a stronger interface between the reinforcements and the base matrix impedes the NaCl solution attack. The SEM micrograph depicts the film crystallinity variations with an increase in Al2O3 content. Debonding between the layers was observed on increasing the SiC content in the base matrix. XRD shows the peaks of reinforcing elements that influence the corrosion behavior. These observations suggest that the AA7075 reinforced with a higher concentration of Al2O3 and a lower concentration of SiC through FSP affords a suitable solution for automotive monocoque applications.

Originality/value
The corrosion rate has been identified for AA7075 SHCs with various concentrations of Al2O3 and SiC and has been compared with that of the base metal and the friction stir processed specimen without reinforcement.
Optimization of coal handling system performability for a thermal power plant using PSO algorithm
Authors: Malik Subhash , Tewari P.C. 
Published: May 2020

PurposeThis paper deals with the optimization of coal handling system performability for a thermal power plant.Design/methodology/approachCoal handling system comprises of five subsystems, namely Wagon Tippler, Crusher, Bunker, Feeder and Coal Mill. The partial differential equations are derived on the behalf of transition diagram by using the Markov approach. These partial differential equations are further solved to obtain the performance model with the help of normalization condition. Numerous performability levels are achieved by putting the appropriate combinations of failure and repair rates (FRRs) in performance model. Performability optimization for coal handling system is obtained by varying the population and generation size.FindingsHighest performability level, that is, 93.33 at population size of 40 and 93.31 at generation size of 70, is observed.Originality/valueThe findings of this paper highlight the optimum value of performability level and FRRs for numerous subsystems. These findings are highly beneficial for plant administration to decide about the maintenance planning.
Education for flourishing: an illustration of boundary object use, peer feedback and distance learning
Authors: Ostuzzi Francesca , Hoveskog Maya 
Published: May 2020

Purpose
Teaching sustainable development at the higher education level requires that existing curricula are supplemented with multi-disciplinary (and sometimes multi-national) collaboration and integrated thinking. The purpose of this paper is to increase the understanding of a particular framework for business model innovation for sustainability-as-flourishing that is used as a boundary object in the context of interdisciplinary, peer-assessed distance learning. This study is positioned in the broader picture of enlarging curricular content so as to reflect the systemic and interconnected nature of socio-technical and economic developments. The motivation behind this study is the authors’ wish to achieve a deeper understanding of how students engage with the complex concept of sustainable business modelling, while using the flourishing business canvas (FBC).

Design/methodology/approach
An experiment was conducted on the use of the FBC as a boundary object among 52 engineering students at two universities. Data were provided by the following: iterations of the FBC; oral and written peer feedback; and an online survey.

Findings
Based on an evaluation of the experiment, this study shows that the FBC supports the use of multi-disciplinary, multi-national peer and distance learning in sustainability education.

Research limitations/implications
This study used one test condition of multi-disciplinary, multi-national collaboration for peer and distance learning at one point in time. Additional tests, using the tools and approaches of this study, are needed.

Originality/value
Various tools and methods for use in education have been developed that support a new view of sustainability –sustainability-as-flourishing. Extant research focusses primarily on the development of tools and methods in this area. Not enough attention has been paid to the analysis of their implementation and use in higher education. This paper seeks to fill that research gap.
Dark data: the invisible resource that can drive performance now
Authors: Gimpel Gregory 
Published: May 2020

Purpose
This paper aims to provide guidance so firms can enter the Internet of Things (IoT) era today – and realize its data-driven benefits – by using IoT “dark data” already generated by their operations.

Design/methodology/approach
This study draws upon data from original expert interviews and an extensive study of over 1,200 research articles and white papers to provide managerial guidance for exploiting IoT dark data.

Findings
Many companies are held back from entering the IoT era today, not by technological issues, but by matters addressable by managerial and strategic leadership. Executives must build dark data awareness among their employees and use non-traditional measures to predict return on investment. The study shares expert advice for accomplishing both of these efforts.

Research limitations/implications
Only 3 out of 1,202 research articles addressed IoT dark data. This paper helps fill this gap in understanding.

Practical implications
This study provides normative guidelines for managers and executives to increase awareness of the dark IoT data that exist within their organizations and to motivate the investments needed to exploit this data to improve business performance.

Originality/value
This research provides guidance for companies to benefit from the IoT today. This study provides an alternate, pragmatic view of Industry 4.0 that focuses on current business reality rather than futurist visions.
Consumers’ reactions to unsubstantiated claims about ecological products
Authors: Söderlund Magnus , Mattsson Jan 
Published: May 2020

PurposeThe purpose of this study was to examine the impact of unsubstantiated claims that a product is “ecological.”Design/methodology/approachA between-subjects experimental design was used in which the absence versus the presence of an (unsubstantiated) ecological claim regarding a product was a manipulated factor. The design comprised four products, representing non-ingestible/ingestible products and familiar/unfamiliar brands. These two aspects were seen as potentially moderating factors with respect to the impact of ecological claims.FindingsThe results show that ecological product claims boosted beliefs that a product is indeed ecological. This influence was not moderated by non-ingestible/ingestible and familiar/unfamiliar product characteristics. Moreover, ecological product claims enhanced conceptually related product beliefs, namely, beliefs that the product is natural, environmentally friendly and healthy. Ecological claims also had a positive impact on the attitude toward the product.Practical implicationsThe results imply that influencers who want a receiver to believe that a product is ecological can expect to be successful by merely claiming that a product is ecological.Social implicationsFrom a societal point of view, however, and in an era in which “alternative facts” and “post-truths” are becoming the subject of increasing concern, the results are problematic, because they underline that customers can be made to believe in claims even though no supporting evidence is provided.Originality/valueThe results imply that influencers who want a receiver to believe that a product is ecological can expect to be successful by merely claiming that a product is ecological. From a societal point of view, however, and in an era in which “alternative facts” and “post-truths” are becoming the subject of increasing concern, the results are problematic, because they underline that customers can be made to believe in claims even though no supporting evidence is provided.