bluuebunny/crossref_metadata_2025_split huggingface dataset:
Preoperative X-ray C2C6AR is Applicable for Prediction of Difficult Laryngoscopy in Patients With Cervical Spondylosis
Authors: Zhou Yang , Han Yongzheng , Li Zhengqian , Zhao Yuqing , Yang Ning , Liu Taotao , Li Min , Wang Jun , Guo Xiangyang , Xu Mao 
Published: August 2020

Abstract
Background: Airway management is one of the most important techniques in clinical anesthesia practice, and inappropriate airway management is related with airway injury, brain hypoxia, and even death. The patients with cervical spondylosis are often confronted with difficult laryngoscopy and are more prone to appear unexpected difficult airway, so it is important to figure out the most valuable predictor of difficult laryngoscopy in these patients.Methods: We randomly enrolled 270 patients undergoing elective cervical spine surgery and analyzed the cervical mobility data in predicting difficult laryngoscopy. The preoperative X-ray radiological indicators were measured by an attending radiologist. Cormack–Lehane scales were assessed during intubation, and patients with a class III or IV view were assigned to the difficult laryngoscopy group.Results: Univariate analysis showed that the hyomental distance (HMD, the distance between the hyoid bone and the tip of the chin) and the hyomental distance ratio (HMDR, the ratio between HMD in the extension position and the one in the neutral position) might not be suitable indicators in patients with cervical spondylosis. Binary multivariate logistic regression (backward-Wald) analyses identified two independent risk factors from the cervical mobility indicators that correlated best as a predictor of difficult laryngoscopy: modified Mallampati test (MMT) and C2C6AR (the ratio of the angle between a line passing through the bottom of the second cervical vertebra and a line passing through the bottom of the sixth cervical vertebra in the extension position over the one in the neutral position). The odds ratio (OR) and 95% CI were 2.292(1.093-4.803) and 0.493 (0.306-0.793), respectively. C2C6AR exhibited the largest area under the curve (0.714; 95% CI 0.633–0.794).Conclusions: C2C6AR based on preoperative X-ray images may be the most accurate predictor of cervical mobility indicators for difficult laryngoscopy in patients with cervical spondylosis.Trial registration: The study was registered at the Chinese Clinical Trial Registry (http://www.chictr.org.cn; identifier: ChiCTR-ROC-16008598) on June 6, 2016.
Establishment of a prognostic model based on immune infiltration-related genes and clinical information in ovarian cancer
Authors: Kong Weikaixin , Zhang Xi , Gao Miaomiao , Jin Yuchen , Huang Zhuo , Guo Hongyan , Xie Zhengwei 
Published: August 2020

Abstract
Background Ovarian cancer is one of the most lethal gynecological cancers,and is in the top five cancer types associated with death in women. Immune infiltration of ovarian cancer is a critical factor in determining patient's prognosis. In addition to immune infiltration, key mutations also have a greater impact on the development and prognosis of OV.Methods Using data from TCGA and GTEx database combined with WGCNA and ESTIMATE methods, genes related to OV occurrence and immune infiltration were identified. Lasso and multivariate Cox regression were applied to define a prognostic score (IGCI score) based on immune genes and clinical information. The IGCI score has been verified by K-M curves, ROC curves, C-index on test set. Based on mutation data from TCGA, we identified key mutations related to immune infiltration by Chi-squared tests and we also did survival analysis of these mutations.Results In this section, we found 46 genes related to disease occurrence and immune infiltration, IGCI score was established based on six factors: Age, White, Pharmaceutical, FGF7, CCR1 and CD14. In test set, IGCI score (C-index = 0.630) is significantly better than AJCC stage (C-index = 0.541, P < 0.05) and CIN25 (C-index = 0.571, P < 0.05). Chi-squared tests revealed that 6 mutations are significantly (P < 0.05) related to immune infiltration : BRCA1, ZNF462, VWF, RBAK, RB1, and ADGRV1. According to mutation survival analysis, we found another 5 key mutations significantly related to patient prognosis (P < 0.05): CSMD3, FLG2, HMCN1, TOP2A, TRRAP. RB1 and CSMD3 mutations had small p-value (P < 0.1) in both Chi-squared tests and survival analysis. Then we conducted a drug sensitivity analysis of key mutation and found when RB1 mutation occurs, the efficacy of six anti-tumor drugs has changed significantly (P < 0.05).Conclusion Based on immune-related genes and clinical information, we have established an ovarian cancer prognosis score that is superior to other methods. At the same time, RB1 and CSMD3 gene mutations are considered to be closely related to ovarian cancer immunity and prognosis.
Large air pressure changes triggered by P-SV ground motion in a cave in northern Taiwan
Authors: Chen Chieh-Hung , Sun Yang-Yi , Lin Li-Ching , Han Peng , Yu Huai-Zhong , Zhang XueMin , Tang Chi-Chia , Chen Chun-Rong , Yen Horng-Yuan , Lin Cheng-Horng , Liu Jann-Yenq , Lin Ching-Ren 
Published: August 2020

Abstract
Barometers in the cave of the SBCB station observe a novel phenomenon of larger pressure changes inside than that at the Xinwu station (outside). Accordingly, the comparison between the observation data inside and outside the cave can drive investigations of potential sources of the novel phenomenon. Analysis of phase angle differences reveal that the air pressure outside the cave often lead air pressure changes inside. However, the larger pressure changes at frequencies > 2 × 10− 4 Hz inside the cave lead smaller changes outside. To expose causal mechanism of the novel phenomenon, continuous seismic waveforms recorded inside the cave are further conducted for examination. When the horizontal and vertical ground velocities of ground motion yield difference in the phase angle close to 90°, air pressure inside the cave increases accordingly. This suggests that the pressure-shear vertical ground motion can drive air pressure changes. Meanwhile, the results shed light on investigating the existence of acoustic waves near the Earth’s surface using a partially confined space underground due to that the assumptions of the waves can propagate upward in the atmosphere driving changes in the ionosphere.
Nutritional Predictors of Mortality after Discharge in Older Patients with type 2 Diabetes
Authors: Beretta Mileni Vanti , Silva Camila Nery da , Feldman Juliane Viero , Rodrigues Ticiana da Costa 
Published: August 2020

Abstract
Background: Older patient with type 2 diabetes (T2D) and malnutrition have a greater chance of negative events during hospitalization and a higher risk of mortality. The aim of this study was to investigate nutritional markers as mortality predictors following discharge hospitalized older patients with T2D. Methods: This is a prospective cohort study with follow-up of four years. All patients were subjected to Mini Assessment Nutrition, Subjective Global Assessment, calf circumference, arm circumference and adductor pollicis muscle thickness, obtained all within 48 h of admission. Mortality data were verified by medical registry and analyzed using Cox-proportional hazard models and survival curves. Results: 311 patients were included; the mean age was 71.35 years. There were 113 (36.3 %) deaths in the follow-up period. Nutritional status evaluated according to BMI identified 54.5% (n = 168) were overweight, for other hand the MAN identified 45.7% of patients were at risk of malnutrition and 37.7% malnutrition and the SGA identify 61.7% (n = 192) presented normal nutrition in admission. Malnutrition patients (OR=2.02), with low calf circumference (OR=1.43) or with APMT less than 5th percentile (2.33) were associated with post-discharge mortality. Conclusion: Malnutrition, reduced calf circumference and reduced APMT were nutritional predictors of mortality after hospital discharge in older patients with diabetes
Safety &amp; Cost-Effectiveness of Primary Neonatal Posterior Sagittal Ano-recto Plasty (PNPSARP)
Authors: Raboe Enaam , Owiwi Yazeed , Ghallab Alaa , Alsaggaf Ameen , Zidan Mazen , Alawi Ahmed , Shalaby Hanin 
Published: August 2020

Abstract
Background: Early repair of Anorectal malformation (ARM) within 6 months may be one of the factors that improve fecal continence. Delayed and multiple-stage repairs require dilatation, strict bowel preparation, fasting and total parenteral nutrition (TPN). PNPSARP requires neither bowel preparation nor parenteral nutrition. We believe it can be achieved within 72 hours of life.Aim: To evaluate the safety, feasibility and cost effectiveness of PNPSARP within 72 hours of life versus delayed or multiple-stage repair of vestibular and perineal fistula. Material & Methods: A retrospective study was carried out of all newborns with ARM at our institute between August 2016 and August 2019. PNPSARP within 72 hours of life was compared with delayed or multiple-stage repair. Neither bowel preparation nor parenteral nutrition was required in the PNPSRP group. Perioperative complications and costs were evaluated. Results: Eight PNPSARP were compared with 7 delayed or multiple stage repair over the study period. Four babies (50%) were operated at day 1 post delivery in the PNPSARP group. Mean operative time (MOT) was 109 minutes (68-155). Mean follow up period was 22 months (12-36). One girl with a vestibular fistula had wound infection. This group had a good outcome with no morbidity, high satisfaction rate and low costs in comparison to delayed or multiple-stage repair.Conclusions: PNPSARP for perineal and vestibular fistula with supportive ancillary services in the first few days of life appears to be safe and cost effective with minimal morbidity. PNPSARP is now the standard technique in our unit.
Effect of improved cookstove intervention on childhood acute lower respiratory infection in Northwest Ethiopia: Cluster randomized controlled trial
Authors: Adane Mesafint Molla , Alene Getu Degu , Mereta Seid Tiku , Wanyonyi Kristina L 
Published: August 2020

Abstract
Background: Household air pollution exposure is linked with over 3.5 million premature deaths every year, ranking highest among environmental risk factors globally. Children are uniquely vulnerable and sensitive to the damaging health effects of household air pollution which includes childhood acute lower respiratory infection (ALRI). The use of improved cookstoves has been widely encouraged to reduce these health burdens. It is, however, unclear as to whether it is possible to prevent household air pollution-related disease burdens with biomass-fuelled improved cookstove intervention and the evidence regarding its child health effect still attracts wide debate. Therefore, we investigated the child health effect of improved baking stove intervention compared with the continuation of the open burning traditional baking stove.Methods: A cluster randomized controlled trial was conducted to assess the health effect of improved baking stove intervention. A total of 100 clusters were randomly allocated to both arms at a 1:1 ratio, and a total of four follow-up visits were carried out within one year immediately after the delivery of the intervention to all households allocated into the intervention arm. Data were analyzed in SPSS-22, and the intervention effect was estimated using a Generalized Estimating Equations modeling approach among the intention-to-treat population.Results: A total of 5508 children were enrolled in the study across 100 randomly selected clusters in both arms, among which data were obtained from a total of 5333 participants for at least one follow-up visit which establishes the intention-to-treat population dataset. The intervention was not found to have a statistically significant effect on the longitudinal childhood ALRI with an estimated odds ratio of 0.95 (95% CI: 0.89-1.02). Nevertheless, the longitudinal change in childhood ALRI was significantly associated with age, baseline childhood ALRI, location of cooking quarter, secondary stove type and frequency of baking event measured at baseline.Conclusions: We found no evidence that an intervention comprising biomass-fuelled improved baking stove reduced the risk of childhood ALRI compared with the continuation of an open burning traditional baking stove. Therefore, effective cooking solutions are needed to avert the adverse health effect of household air pollution, particularly, childhood ALRI. Trial registration: The trial was registered on August 2, 2018 at clinical trials.gov registry database (registration identifier number: NCT03612362).
Early Enteral Permissive Underfeeding in Critically Ill Young Adults with Traumatic Brain Injury: A Single-Blind Randomized Controlled Pilot Trial
Authors: Kazemi Maryam , Nematy Mohsen , Malekahmadi Mahsa , Pahlavani Naseh , Samini Fariborz , Assadzadeh Hamid , Ehsaei Mohammad Reza , Barkhidarian Bahareh , Norouzy Abdolreza 
Published: August 2020

Abstract
Background and Objectives: There is no consensus on optimal initial energy requirements for critically ill patients. The present study aimed to compare the clinical outcomes of early enteral permissive underfeeding (EEPU) with those of early enteral standard feeding (EESF) in critically ill patients with traumatic brain injury (TBI). Materials and Methods: In this single-blind, randomized, controlled pilot trial, 60 young adults with TBI were randomly assigned to either EESF or EEPU groups (initiation energy goal: 100% vs. 30% of estimated energy requirements, respectively). Enteral feeding was administered during 24-48 hours of intensive care unit admission. Patients receiving EEPU were prescribed to achieve full energy requirements by day seven of the intervention. Results: The EEPU group demonstrated improved glycemic control (205.6±68 vs. 137.4±59 mg/dL, P=0.02), reduced duration of hospital stay (57.5±29 vs. 70.9±24 days, P=0.08) and shorter duration of mechanical ventilation (20.2±11 vs. 26.4±9 days, P=0.04). Gastrointestinal complications were more frequent in the EESF group (3.5±2 vs. 1.4±3 days, P=0.001). There were no differences between the EESF and EEPU groups in terms of 28-day mortality rate (3.8% vs. 10.7%, RR: 0.33; 95% CI: 0.03, 3.42; P=0.61).Conclusion: EEPU may be associated with beneficial effects on gastrointestinal toleration and glycemic control in young TBI patients, which might contribute to improved clinical outcomes in this population; however, further investigations are required on this issue. Trial registration: This trial was registered at Iranian Registry of Clinical Trials (www.irct.ir) as IRCT201201128709N1.
Arresting doubly excited electronic state mediating lightning speed ring-opening reaction of 1,3-cyclohexadiene
Authors: Karashima Shutaro , Uenishi Ryuta , Horio Takuya , Kanno Manabu , Humeniuk Alexander , Mitric Roland , Ohta Tetsuro , Nishitani Junichi , Suzuki Toshinori 
Published: August 2020

Abstract
The photoinduced ring-opening reaction of 1,3-cyclohexadiene to produce 1,3,5-hexatriene is a well-known example of the Woodward-Hoffmann rule for stereochemical reactions governed by molecular orbital symmetry, and it plays an essential role in photobiological synthesis of vitamin D3 in the skin. Since the photoexcited 11B state of 1,3-cyclohexadiene is not electronically correlated to the ground state of 1,3,5-hexatriene, the reaction is expected to proceed via non-adiabatic transitions through a doubly excited 21A electronic state. However, spectroscopic observation of this elusive state has been difficult. Here we present the results of a photoelectron spectroscopy study using table-top ultrafast deep and extreme UV lasers, based on filamentation four-wave mixing and high-harmonic generation, which enabled us to arrest the 21A state. It is shown that the ring-opening reaction takes only 60 fs to complete, which is a considerably shorter time than previous experimental and theoretical estimates. The ballistic reaction creates vibrational coherence in the reaction products.
Function-oriented Design of Robust Metal Cocatalyst for Photocatalytic Hydrogen Evolution on Metal/Titania Composites
Authors: Wang Dong , Gong Xue-Qing 
Published: August 2020

Abstract
To realize the rational design of improved catalysts is one of ultimate goals in catalysis, though practical strategies are generally in shortage, especially for the complicated photocatalytic processes. Here, we take the hydrogen evolution reaction (HER) as an example, and introduce a theoretical approach for designing robust metal cocatalysts supported on TiO2, using density functional theory calculations adopting on-site Coulomb correction and/or hybrid functionals. The approach starts with clarifying the individual function of each metal layer of metal/TiO2 composites in photocatalytic HER, covering both the electron transfer and surface catalysis aspects, followed by conducting a function-oriented optimization via exploring competent candidates. With this approach, we successfully determined and verified bimetallic Pt/Rh/TiO2 and Pt/Cu/TiO2 catalysts to be robust substitutes for conventional Pt/TiO2. The right metal type as well as the proper stacking sequence are demonstrated to be the key to boosting the performance. Moreover, we pioneeringly identified the tunneling barrier height as an effective electron transfer descriptor for photocatalytic reactions on metal/oxide catalysts. We believe that this study pushes forward the frontier of photocatalyst design towards higher water splitting efficiency.
Essential core competencies for health policy doctoral graduates
Authors: Doshmangir leila , Takian Amirhossein , Sakha Minoo Alipouri , Mostafavi Hakimeh 
Published: August 2020

Abstract
Background: In the health sector, competency-based education focuses on the desired performance characteristics of health professionals through designing and implementing the evidence-based standards, performance indicators and, quality outcomes. This paper aims to explore core competencies required for health policy graduates, aiming to prepare doctoral students for a spectrum of future roles, i.e. academic and non-academic.Methods: The databases including PubMed, Scopus, Google scholar, and SID were searched to identify the required competencies for health policy students worldwide. Students and well-known academics in the field of health policy (from Iran and other countries) were interviewed. This qualitative study was conducted in three phases: a critical review of literature; interviews; and validation of identified competencies through face to face consultations with experts complemented by a survey. We used three methods for data collection: 1) review of the literature; 2) 74 face to face and email-based semi-structured interviews and 3) validating the identified competencies through face to face consultations with qualified experts. Results: We identified five core competencies for health policy doctoral graduates without specific order including research, policy analysis, education, decision making, and communication.Conclusions: As countries are gearing up towards sustainable development goals (SDGs), the role of health policy graduates is crucial paving the pathway towards SDGs on health and well-being. Appropriate and contextually-tailored curriculum is pivotal, we envisage, to foster multi-dimensional competencies that are complementary to the specific disciplines of health policy scholars of future, those who can genuinely serve their health systems towards sustainable health development.
Recurrent Abdominal Pain, Vomiting, Velvet-Like Changes in the Small Intestine in a Patient with Multiple Acyl-CoA dehydrogenation Deficiency
Authors: Ye Ziqing , Shi Jieru , Lu Xiaolan , Meng Yingying , Lu Wei , Wu Bingbing , Huang Ying 
Published: August 2020

Abstract
BackgroundMultiple acyl-CoA dehydrogenation deficiency (MADD) is an inborn error of metabolism in fatty acid oxidation. We described an unusual case of recurrent vomiting and abdominal pain in a child with MADD, presenting with velvet-like changes in the small intestine. MethodsBecause of prominent gastrointestinal manifestations and small intestine ulcers, the patient was first diagnosed as Crohn’s disease. The patient was admitted to our institution because of recurrent symptoms despite treatment. Upper and lower endoscopy, computed tomography and trios exome sequencing were performed. ResultsThis patient underwent a repeated video endoscopy, which showed velvet-like changes in the small intestine rather than ulcers. Liver steatosis was identified by computed tomography. Serum tandem mass spectrometry showed elevated C8 and C10. Trios exome sequencing revealed compound heterozygous variants of c.250G>A, 524G>A in ETFDH. The diagnosis of multiple acyl-CoA dehydrogenation deficiency was made. Patient responded to oral riboflavin treatment. ConclusionWith this case, we aimed to highlight the importance of tandem mass spectrometry and genetic sequencing, especially when the endoscopic findings are not pathognomonic in pediatric cases with recurrent gastrointestinal complaints. We confirmed the diagnosis with next generation sequencing, and described unusual findings of velvet-like changes mimicking ulcers in the small intestine in this patient with MADD.
Non-Fermentative Gram-negative Bloodstream Infection in Northern Italy: a Multicenter Cohort Study.
Authors: Pascale Renato , Corcione Silvia , Bussini Linda , Pancaldi Livia , Giacobbe Daniele Roberto , Ambretti Simone , Lupia Tommaso , Costa Cristina , Marchese Anna , De Rosa Francesco Giuseppe , Bassetti Matteo , Viscoli Claudio , Bartoletti Michele , Giannella Maddalena , Viale Pierluigi 
Published: August 2020

Abstract
Background: The management of non-fermentative gram-negative bloodstream infection (NFGN-BSI) offers numerous challenges. In this study the aim is to analyse a large cohort of patients with NFGN-BSI recruited in the northern Italy to describe epidemiology, etiological and susceptibility pattern, therapeutic management and outcome.Methods: Multicentre retrospective cohort study of patients hospitalised at three large teaching hospitals in northern Italy in a fourth year period.Results: 355 BSI episodes were analyzed, due to P. aeruginosa (72.7%), A. baumannii (16.6%), and Stenotrophomonas maltophilia (10.7%). Overall, 21.4% of isolates were defined as DTR, highest rate among A. baumannii (64.4%). All-cause 30-day mortality rate was 17.5%. Rates of XDR or DTR A. baumannii isolation were significantly higher in non-surviving patients. Independent risk factors for 30-day mortality were: age (HR 1.03, 95%CI 1.00-1.04, p=0.003), septic shock (HR 2.84, 95%CI 1.67-4.82, p<0.001) and BSI due to Acinetobacter baumannii (HR 2.23, 95%CI 1.27-3.94, p=0.005). Conclusion: The overall prevalence of DTR was high in the NFGN BSI cohort analyzied, mainly among Acinetobacter baumannii episodes (64.4%). Acinetobacter baumannii is showed to be an independent predictor of mortality. These evidences marked the urgent need of new therapeutic options against this pathogen.Trial registration number: 79/2017/O/OssN. Approved: March14th, 2017.