bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a nomogram to predict 30-day mortality of patients with sepsis-associated encephalopathy: a retrospective cohort study
Authors: Yang Yang , Liang Shengru , Geng Jie , Wang Qiuhe , Wang Pan , Cao Yuan , Li Rong , Gao Guodong , Li Lihong 
Published: July 2020

Abstract
Background
Sepsis-associated encephalopathy (SAE) is related to increased short-term mortality in patients with sepsis. We aim to establish a user-friendly nomogram for individual prediction of 30-day risk of mortality in patients with SAE.

Methods
Data were retrospectively retrieved from the Medical Information Mart for Intensive Care (MIMIC III) open source clinical database. SAE was defined by Glasgow Coma Score (GCS) < 15 or delirium at the presence of sepsis. Prediction model with a nomogram was constructed in the training set by logistic regression analysis and then undergone internal validation and sensitivity analysis.

Results
SAE accounted for about 50% in patients with sepsis and was independently associated with the 30-day mortality of sepsis. Variables eligible for the nomogram included patient’s age and clinical parameters on the first day of ICU admission including the GCS score, lactate, bilirubin, red blood cell distribution width (RDW), mean value of respiratory rate and temperature, and the use of vasopressor. Compared with Sequential Organ Failure Assessment (SOFA) and Logistic Organ Dysfunction System (LODS), the nomogram exhibited better discrimination with an area under the receiver operating characteristic curve (AUROC) of 0.763 (95%CI 0.736–0.791, p < 0.001) and 0.753 (95%CI 0.713–0.794, p < 0.001) in the training and validation sets, respectively. The calibration plot revealed an adequate fit of the nomogram for predicting the risk of 30-day mortality in both sets. Regarding to clinical usefulness, the DCA of the nomogram exhibited greater net benefit than SOFA and LODS in both of the training and validation sets. Besides, the nomogram exhibited acceptable discrimination, calibration, and clinical usefulness in sensitivity analysis.

Conclusions
SAE is related to increased 30-day mortality of patients with sepsis. The nomogram presents excellent performance in predicting 30-day risk of mortality in SAE patients, which can be used to evaluate the prognosis of patients with SAE and may be more beneficial once specific treatments towards SAE are developed.
Processing of volcano infrasound using film sound audio post-production techniques to improve signal detection via array processing
Authors: Williams Ross Adrian , Perttu Anna , Taisne Benoit 
Published: July 2020

AbstractThe use of infrasound for the early detection of volcanic events has been shown to be effective over large distances, and unlike visual methods, is not weather dependent. Signals recorded via an infrasound array often have a poor signal to noise ratio, as other sources of infrasound are detected and recorded along with the volcano infrasound. Array processing software does not always detect known volcanic events, in part because of the amount of noise in the infrasound signal (Taisne et al., in: Pichon, Blanc, Hauchecorne (eds) Infrasound monitoring for atmospheric studies: challenges in middle atmosphere dynamics and societal benefits. Springer International Publishing, Cham, 2019). Resampling the infrasound into the audible range and then applying the acoustic noise reduction techniques of spectral subtraction prior to array processing is shown to improve signal detection of volcanic events. The discussed technique is applicable to any infrasound signal such as infrasound from anthropogenic sources like nuclear testing.
A simplification of rigorous atmospheric raytracing based on judicious rectilinear paths for near-surface GNSS reflectometry
Authors: Nikolaidou Thalia , Santos Marcelo , Williams Simon D. P. , Geremia-Nievinski Felipe 
Published: July 2020

AbstractAtmospheric delays are known to cause biases in Global Navigation Satellite System Reflectometry (GNSS-R) altimetry applications, such as for sea-level monitoring. The main quantity of interest is the reflection-minus-direct or interferometric atmospheric delay. Recently, we have presented a rigorous raytracing procedure to account for linear and angular refraction in conjunction with reflection as observed from near-surface platforms. Here, we demonstrate the feasibility of simplifying the ray trajectory by imposing a rectilinear wave propagation model. Two variants were assessed, based on the apparent or refracted satellite direction on the one hand and the geometric or vacuum conditions on the other hand. The former was shown to agree with rigorous results in terms of interferometric radio length while the latter agreed in terms of the interferometric vacuum distance. Upon a judicious combination of the best aspects of the two rectilinear cases, we have defined a mixed variant with excellent agreement with rigorous raytracing in terms of interferometric atmospheric delay. We further showed that mapping functions developed for GNSS positioning cannot be reused for GNSS-R purposes without adaptations. Otherwise, the total atmospheric delay may be underestimated by up to 50% at low elevation angles. The present work facilitates the adaptation of existing atmospheric raytracing software for GNSS-R purposes.
Playing well with others: a case study of collective impact in the early care and education policy arena
Authors: Zuckerman Sarah J. , Garrett Amanda L. , Sarver Susan , Huddleston-Casas Catherine 
Published: July 2020

AbstractThe quality and quantity of early childhood care and education services have risen as a key reform area for influencing educational and economic outcomes. However, changes in this policy arena are stymied by the fragmentation of this policy arena. Collaborative approaches have been proposed to create systems-level change. Collective impact is one such approach; however, few examples exist in the early childhood care and education literature, especially at the state level. This ethnographic case study conceptualizes collective impact as a policy network capable of change in a fractured policy arena and reports the results from the first year of a statewide collective impact effort examines stakeholder perceptions of mobilization and development of a common agenda, or shared understandings. The results illustrate the importance of relationship building, ongoing attention to common understandings through multiple processes and mechanisms, the importance of the backbone organization, and the need to attend to mindset shifts that accompany early collective impact work.
Impact of systemic steroid treatment on talc pleurodesis: a report of six cases
Authors: Ishii Soichiro , Sakurashita Hiroshi , Mashida Emiko , Saeki Yasuyuki , Matsuo Hiroaki 
Published: July 2020

Abstract
Background
Instillation of sterile graded talc in the pleural space is performed to prevent reaccumulation of malignant pleural effusion after drainage. Talc is thought to encourage pleural adhesions as part of the repair process by provoking inflammation, suggesting that adhesions are less likely to form in patients taking corticosteroids or other drugs with anti-inflammatory effects. However, the relationship between steroid therapy and pleurodesis efficacy remains unclear.

Case presentation
We report the outcomes of six patients who underwent pleurodesis at Hiroshima University Hospital while being treated with systemic steroid therapy for non-cancer-related illnesses. Talc pleurodesis was successful at the first attempt in five of the six patients. The five successful cases were receiving low-dose oral prednisolone or methyl prednisolone (range, 1–20 mg/day) at the time of pleurodesis and had serum albumin levels ranging from 2.2 to 3.0 g/dL. In contrast, the patient in whom pleurodesis was unsuccessful was receiving a higher dose of prednisolone (40 mg/day) intravenously and had a relatively low serum album level (1.7 g/dL).

Conclusions
The outcome of pleurodesis may be affected by the dose and/or route of systemic steroid therapy. Further analysis with more patients will be necessary to clarify the relationship between steroid dosage and talc pleurodesis success rate.
An assessment of mutagenicity of chemical substances by (quantitative) structure–activity relationship
Authors: Honma Masamitsu 
Published: July 2020

AbstractCurrently, there are more than 100,000 industrial chemicals substances produced and present in our living environments. Some of them may have adverse effects on human health. Given the rapid expansion in the number of industrial chemicals, international organizations and regulatory authorities have expressed the need for effective screening tools to promptly and accurately identify chemical substances with potential adverse effects without conducting actual toxicological studies. (Quantitative) Structure–Activity Relationship ((Q)SAR) is a promising approach to predict the potential adverse effects of a chemical on the basis of its chemical structure. Significant effort has been devoted to the development of (Q) SAR models for predicting Ames mutagenicity, among other toxicological endpoints, owing to the significant amount of the necessary Ames test data that have already been accumulated. The International Council for Harmonisation of Technical Requirements for Pharmaceuticals for Human Use (ICH) M7 guideline for the assessment and control of mutagenic impurities in pharmaceuticals was established in 2014. It is the first international guideline that addresses the use of (Q) SAR instead of actual toxicological studies for human health assessment. Therefore, (Q) SAR for Ames mutagenicity now require higher predictive power for identifying mutagenic chemicals. This review introduces the advantages and features of (Q)SAR. Several (Q) SAR tools for predicting Ames mutagenicity and approaches to improve (Q) SAR models are also reviewed. Finally, I mention the future of (Q) SAR and other advanced in silico technology in genetic toxicology.
The impact of patient-reported outcome data from clinical trials: perspectives from international stakeholders
Authors: Cruz Rivera Samantha , McMullan Christel , Jones Laura , Kyte Derek , Slade Anita , Calvert Melanie 
Published: July 2020

AbstractBackgroundPatient-reported outcomes (PROs) are increasingly collected in clinical trials as they provide unique information on the physical, functional and psychological impact of a treatment from the patient’s perspective. Recent research suggests that PRO trial data have the potential to inform shared decision-making, support pharmaceutical labelling claims and influence healthcare policy and practice. However, there remains limited evidence regarding the actual impact associated with PRO trial data and how to maximise PRO impact to benefit patients and society. Thus, our objective was to qualitatively explore international stakeholders’ perspectives surrounding:a)the impact of PRO trial data,b)impact measurement metrics, andc)barriers and facilitators to effectively maximise the impact of PRO trial data upon patients and society.MethodsSemi-structured interviews with 24 international stakeholders were conducted between May and October 2018. Data were coded and analysed using reflexive thematic analysis.ResultsInternational stakeholders emphasised the impact of PRO trial data to benefit patients and society. Influence on policy-impact, including changes to clinical healthcare practice and guidelines, drug approval and promotional labelling claims were common types of PRO impact reported by interviewees. Interviewees suggested impact measurement metrics including: number of pharmaceutical labelling claims and interviews with healthcare practitioners to determine whether PRO data were incorporated in clinical decision-making. Key facilitators to PRO impact highlighted by stakeholders included: standardisation of PRO tools; consideration of health utilities when selecting PRO measures; adequate funding to support PRO research; improved reporting and dissemination of PRO trial data by key opinion leaders and patients; and development of legal enforcement of the collection of PRO data.ConclusionsDetermining the impact of PRO trial data is essential to better allocate funds, minimise research waste and to help maximise the impact of these data for patients and society. However, measuring the impact of PRO trial data through metrics is a challenging task, as current measures do not capture the total impact of PRO research. Broader international multi-stakeholder engagement and collaboration is needed to standardise PRO assessment and maximise the impact of PRO trial data to benefit patients and society.
First-year drug therapy of new-onset rheumatoid and undifferentiated arthritis: a nationwide register-based study
Authors: Muilu Paula , Rantalaiho Vappu , Kautiainen Hannu , Virta Lauri J. , Eriksson Johan G. , Puolakka Kari 
Published: July 2020

Abstract
Background
In this retrospective cohort study, we evaluated the drug therapies used for early rheumatoid (RA) and undifferentiated (UA) arthritis patients.

Methods
From a nationwide register maintained by the Social Insurance Institution, information on sex, date of birth, and date of special medicine reimbursement decision for all new Finnish RA and UA patients between 2011 and 14 were collected, and their DMARD (Disease Modifying Antirheumatic Drug) purchases during the first year after the diagnosis were analyzed.

Results
A total of 7338 patients with early RA (67.3% female, 68.1% seropositive) and 2433 with early UA (67.8% female) were identified. DMARDs were initiated during the first month after the diagnosis to 92.0% of the patients with seropositive RA, 90.3% with seronegative RA and to 87.7% with UA (p < 0.001). Respectively, 72.1, 63.4, and 42.9% of the patients (p < 0.001) purchased methotrexate; 49.8, 35.9, and 16.0% (p < 0.001) as part of a DMARD combination during the first month. By the end of the first year after the diagnosis, self-injected biologics were purchased by 2.6, 5.3 and 3.1% (p < 0.001) of them. Only 1.4, 2.6 and 3.0% (p < 0.001) of the patients were not receiving any DMARDs. During the first year, 83.4% of the seropositive RA patients had purchased methotrexate, 50.4% sulfasalazine, 72.1% hydroxychloroquine, and 72.6% prednisolone.

Conclusions
Currently, combination therapy including methotrexate is a common treatment strategy for early seropositive RA in Finland. Despite an easy access to biologics, these drugs are seldom needed during the first year after diagnosis.
Optimization and immobilization of amylase produced by Aspergillus terreus using pomegranate peel waste
Authors: Ahmed Nehad E. , El Shamy Aliaa R. , Awad Hassan M. 
Published: July 2020

AbstractBackgroundAmylases are amongst the most important hydrolytic enzymes that are used in numerous industrial uses reaching for food to pharmaceuticals. Immobilization of enzymes can proposal several assistances as reusability and retrieval from their products improve strength under both operating and storing environments.ResultsMarine fungal isolate was recovered from red sea water at Sharm El-Sheikh Province and was tested for amylase activity using different agricultural wastes as substrate. It was found that pomegranate peel was the best substrate for amylase production (339 U/ml). Thus, it was subjected for identifying by 18S rDNA gene. The phylogenetic analysis results indicated that this fungal isolate belonged toAspergillusspecies with similarity of 99% and named asAspergillus terrusSS_RS-NE. Its nucleotide sequences were deposited in NCBI GenBank under accession no. of MN901491. Some parameters affecting amylase activity using pomegranate peel as substrate were studied. The results denoted that, the highest amylase activity of 340.69 U/ml using 1.5% pomegranate peel at 30 °C, pH 6.0 on 5 days incubation time byAspergillus terreus. The produced crude enzyme was partially purified with 80% ammonium sulfate followed by dialysis. The enzyme activity was 1246 U/ml and 2411 U/ml employing ammonium sulfate precipitation and dialysis respectively.The partially purified amylase was immobilized with 2% sodium alginate and the results showed the highest immobilized enzyme yield was 92.8%. The characterizations of immobilized amylase were studied and the results indicated that, the maximal immobilized amylase activity was 2522.5 U/ml with 2% starch as a substrate at optimum pH value of 6.5, temperature at 60 °C and 10 min reaction time in comparison to maximal free amylase enzyme at pH 5, 50 °C after 40 min. The results also indicated the immobilized amylase was stable at 60 °C for 20 min.ConclusionsAspergillus terrusSS_RS-NE (MN901491) was isolated and genetically identified. It has the ability to produce amylase enzyme using pomegranate peel waste with a yield of 339 U/ml. The crude enzyme was partially purified by ammonium sulfate followed by dialysis. The maximal immobilized amylase activity of 2522.5 U/ml was obtained under optimized some culture conditions and medium nutrient parameters.
Position and dimensions of the mental foramen and presence of the anterior loop in the Egyptian population: a retrospective CBCT study
Authors: Shalash M. , Khallaf Maram E. , Ali A. R. 
Published: July 2020

Abstract
Aim
Understanding the mental foramen (MF) position and prevalence and location of the anterior loop (AL) is important during clinical and surgical procedures close to the mental foramen to avoid damage to the neurovascular bundle. The current study was done to determine the location of the MF, its distance from the inferior border of the mandible, and prevalence of AL in Egyptian population using cone beam computed tomography (CBCT).

Methods
A retrospective analysis of CBCT images was done in this study. Images of Egyptian patients who have already been subjected to CBCT examination as part of their dental diagnosis and/or treatment planning were included according to the proposed eligibility criteria.

Results
This study showed that the most common location of the MF (43.8% on the left side and 67.9% on the right side) is located below the apex of the second premolar. The mean size of mental foramen showed a height of 3.32 mm in females, 3.60 mm in males, and a width of 3.41 mm in females and 3.59 mm in males. The mean value of distance from inferior border was 10.08 mm in females and 10.55 mm in males. Fifty-five percent of the cases showed presence of anterior loop.

Conclusion
These results are consistent with similar radiographic studies regarding size and location of MF and distances between MF and adjacent anatomic structures. The most common position of the MF is below the 2nd premolar. AL was found in more than half of the cases examined.
Differential Benefit of Adjuvant Docetaxel-Based Chemotherapy in Patients With Early Breast Cancer According to Baseline Body Mass Index
Authors: Desmedt Christine , Fornili Marco , Clatot Florian , Demicheli Romano , De Bortoli Davide , Di Leo Angelo , Viale Giuseppe , de Azambuja Evandro , Crown John , Francis Prudence A. , Sotiriou Christos , Piccart Martine , Biganzoli Elia 
Published: July 2020

PURPOSE Lipophilic drugs, such as taxanes, have a high affinity for adipose tissue and a resulting higher volume of distribution. Here, we reanalyzed clinical trial data to investigate whether the efficacy of docetaxel-based chemotherapy differs from non-docetaxel–based chemotherapy in patients with breast cancer according to their baseline body mass index (BMI). PATIENTS AND METHODS We retrospectively analyzed data from all of the patients in the adjuvant BIG 2-98 trial (ClinicalTrials.gov identifier: NCT00174655 ; N = 2,887) comparing non-docetaxel– to docetaxel-containing chemotherapy. BMI (kg/m2) was categorized as follows: 18.5 to < 25, lean; 25 to < 30, overweight; and ≥ 30, obese. Disease-free survival (DFS) was the primary endpoint, and overall survival (OS) was the secondary endpoint. A second-order interaction was assessed among treatment, BMI, and estrogen receptor (ER) status. RESULTS There was no difference in DFS or OS according to BMI in the non-docetaxel group, while reduced DFS and OS were observed with increasing BMI category in the docetaxel group. Adjusted hazard ratios for DFS and OS were, respectively, 1.12 (95% CI, 0.98 to 1.50; P = .21) and 1.27 (95% CI, 1.01 to 1.60; P = .04) for overweight versus lean groups and were 1.32 (95% CI, 1.08 to 1.62; P = .007) and 1.63 (95% CI, 1.27 to 2.09; P < .001), respectively, for obese versus lean groups. Similar results were obtained when considering ER-negative and ER-positive tumors separately and when considering only patients who received a relative dose intensity ≥ 85% for docetaxel. A joint modifying role of BMI and ER status on treatment effect was evident for DFS (adjusted P = .06) and OS (adjusted P = .04). CONCLUSION This retrospective analysis of a large adjuvant trial highlights a differential response to docetaxel according to BMI, which calls for a body composition–based re-evaluation of the risk-benefit ratio of the use of taxanes in breast cancer. These results now must be confirmed in additional series.
Teriparatide Promotes Bone Healing in Medication-Related Osteonecrosis of the Jaw: A Placebo-Controlled, Randomized Trial
Authors: Sim Ie-Wen , Borromeo Gelsomina L. , Tsao Claudine , Hardiman Rita , Hofman Michael S. , Papatziamos Hjelle Christian , Siddique Musib , Cook Gary J. R. , Seymour John F. , Ebeling Peter R. 
Published: July 2020

PURPOSE Medication-related osteonecrosis of the jaw (MRONJ) is an infrequent but morbid and potentially serious condition associated with antiresorptive and antiangiogenic therapies. Although MRONJ can be prevented by optimizing oral health, management of established cases is supportive and remains challenging. Teriparatide, an osteoanabolic agent that improves bone healing in preclinical studies and in chronic periodontitis, represents a potential treatment option. PATIENTS AND METHODS In a double-blind, randomized, controlled trial, 34 participants with established MRONJ, with a total of 47 distinct MRONJ lesions, were allocated to either 8 weeks of subcutaneous teriparatide (20 µg/day) or placebo injections, in addition to calcium and vitamin D supplementation and standard clinical care. Participants were observed for 12 months, with primary outcomes that included the clinical and radiologic resolution of MRONJ lesions. Secondary outcomes included osteoblastic responses as measured biochemically and radiologically and changes in quality of life. RESULTS Teriparatide was associated with a greater rate of resolution of MRONJ lesions (odds ratio [OR], 0.15 v 0.40; P = .013), and 45.4% of lesions resolved by 52 weeks compared with 33.3% in the placebo group. Teriparatide was also associated with reduced bony defects at week 52 (OR, 8.1; P = .017). The incidence of adverse events was balanced between groups, including nausea, anorexia, and musculoskeletal pain, most of mild severity. CONCLUSION Teriparatide improves the rate of resolution of MRONJ lesions and represents an efficacious and safe treatment for it.