bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nano-second protein dynamics of key residue at Position 38 in catechol-O-methyltransferase system: a time-resolved fluorescence study
Authors: Liu Fan , Zhang Jianyu 
Published: May 2020

AbstractHuman catechol-O-methyltransferase, a key enzyme related to neurotransmitter metabolism, catalyses a methyl transfer from S-adenosylmethionine to catechol. Although extensive studies aim to understand the enzyme mechanisms, the connection of protein dynamics and enzyme catalysis is still not clear. Here, W38in (Trp143Phe) and W38in/Y68A (Trp143Phe with Tyr68Ala) mutants were carried out to study the relationship of dynamics and catalysis in nano-second timescale using time-resolved fluorescence lifetimes and Stokes shifts in various solvents. The comprehensive data implied the mutant W38in/Y68A with lower activity is more rigid than the ‘WT’−W38in, suggesting the importance of flexibility at residue 38 to maintain the optimal catalysis.
Specialization versus competition: an anatomy of increasing returns to scale
Authors: Bucci Alberto , Ushchev Philip 
Published: May 2020

Abstract
We develop a model of monopolistic competition with a differentiated intermediate good and variable elasticity of technological substitution. The model allows to study the nature and origins of external increasing returns. We single out two sources of scale economies: specialization and competition. The former depends only on how total factor productivity (TFP) varies with input diversity, while the latter is fully captured by the behavior of the elasticity of substitution across inputs. This distinction gives rise to a full characterization of the rich array of competition regimes in our model. The necessary and sufficient conditions for each regime to occur are expressed in terms of the relationships between TFP and the elasticity of substitution as functions of the input diversity. Moreover, we demonstrate that, despite the folk wisdom resting on constant elasticity of substitution models, specialization economies are in general neither necessary nor sufficient for external increasing returns to emerge. This highlights the profound and nontrivial role of market competition in generating agglomeration economies and other phenomena driven by scale economies.
A functional structural model of grass development based on metabolic regulation and coordination rules
Authors: Gauthier Marion , Barillot Romain , Schneider Anne , Chambon Camille , Fournier Christian , Pradal Christophe , Robert Corinne , Andrieu Bruno 
Published: May 2020

Abstract
Shoot architecture is a key component of the interactions between plants and their environment. We present a novel model of grass, which fully integrates shoot morphogenesis and the metabolism of carbon (C) and nitrogen (N) at organ scale, within a three-dimensional representation of plant architecture. Plant morphogenesis is seen as a self-regulated system driven by two main mechanisms. First, the rate of organ extension and the establishment of architectural traits are regulated by concentrations of C and N metabolites in the growth zones and the temperature. Second, the timing of extension is regulated by rules coordinating successive phytomers instead of a thermal time schedule. Local concentrations are calculated from a model of C and N metabolism at organ scale. The three-dimensional representation allows the accurate calculation of light and temperature distribution within the architecture. The model was calibrated for wheat (Triticum aestivum) and evaluated for early vegetative stages. This approach allowed the simulation of realistic patterns of leaf dimensions, extension dynamics, and organ mass and composition. The model simulated, as emergent properties, plant and agronomic traits. Metabolic activities of growing leaves were investigated in relation to whole-plant functioning and environmental conditions. The current model is an important step towards a better understanding of the plasticity of plant phenotype in different environments.
Uncommon clinical presentation of a common bug: Group AStreptococcusmeningitis
Authors: Lee Jimin , Blackburn Julie , Pham-Huy Anne 
Published: May 2020

AbstractGroup A Streptococcus (GAS) is a common pathogen in paediatric infections. However, it is a rare etiologic agent of bacterial meningitis. We describe a case of Streptococcus pyogenes meningitis complicated by sensorineural hearing loss in an immunocompetent 7-year-old boy. Clinicians should be aware of GAS as a potential cause of paediatric meningitis, especially with prominent symptoms suggestive of frontal sinusitis. Meningitis caused by GAS has been shown to be associated with significant mortality and morbidity, including neurological complications. Early screening for sensorineural hearing loss in patients with GAS meningitis can facilitate timely cochlear implant.
Legal Power in Action: How Latinx Adult Children Mitigate the Effects of Parents’ Legal Status through Brokering
Authors: García Valdivia Isabel 
Published: May 2020

Abstract
Scholars have long demonstrated that Latinx children engage in cultural and linguistic brokering on behalf of their immigrant parents. This article adds to this literature by examining how the transition to adulthood enables adult children to deploy their legal power to assist their immigrant parents. This study identifies three types of brokering using legal power: securing loans or access to credit, sponsoring immigration petitions, and becoming a legal guardian for siblings. Using 37 in-depth interviews with adult children, parents, and extended family members with varying legal statuses in California, I show that citizen adult children have greater capacity than DACAmented adult children in mixed-status families to exercise legal power when brokering. In addition, adult children’s legal power may be enhanced or limited by incomplete paperwork, family tensions, and economic background. These findings provide an understanding of how the transition to legal adulthood affects the way adult children of immigrants help their undocumented parents access resources and information, negotiate the effects of immigration laws, and reduce some inequality suffered by their families.
Sleep Deprivation Etiologies Among Patients in the Intensive Care Unit
Authors: Al Mutair Abbas , Shamsan Abbas , Salih Samer , Al-Omari Awad 
Published: May 2020

Background
Sleep deprivation among patients is a common problem in the intensive care unit (ICU). Studies have tried to find the etiologies of sleep deprivation. Poor sleep quality in the ICU has effects such as delirium, weakening the wound healing, and anxiety. Researches have concluded that the etiologies for sleep deprivation are multifactorial.

Objectives
The aim of this review is to discuss the etiologies of sleep deprivation among ICU patients. This review also aims to discuss effects of sleep deprivations and provide implications for promoting sleep quality in the ICU.

Methods
For this literature review, ProQuest, MEDLINE, and Up To Date were used to find articles about sleep deprivation among ICU patients. The search was narrowed to articles between 2008 and 2019. A total of 23 articles were included that were found to match the inclusion criteria.

Results
Findings indicated that sleep deprivations etiologies among ICU patients can be environmental and nonenvironmental. Sensory overload, sensory deprivation, and patients' care activities are environmental etiologies for sleep deprivation. The nonenvironmental factors include pharmacological, physical, and psychological factors.

Discussion
Sleep deprivation etiologies are multifactorial and have several effects on ICU patients. Sleep protocol and staff training should be introduced to reduce unnecessary interventions by ICU staff. Tele-ICU monitoring can also be introduced to reduce unnecessary interventions where clinicians can monitor patients remotely and therefore enhance sleep in the ICU. During their stay in the ICU, patients can be instructed to wear earplugs and also have aromatherapy massage to reduce stress and enhance sleep quality. More research on the physical pain and the psychological factors using objective methods should be conducted in the future.
Implementing Cardiac Surgical Unit—Advanced Life Support Through Simulation-Based Learning
Authors: Marler Gregory S. , Molloy Margory A. , Engel Jill R. , Walters Gloria , Smitherman Melanie B. , Sabol Valerie K. 
Published: May 2020

Background
The European Association for Cardio Thoracic Surgery and the Society of Thoracic Surgeons endorse Cardiac Surgical Unit–Advanced Life Support, a protocol designed specifically for cardiothoracic surgical patients who suffer postoperative cardiac arrests. To enhance patient outcomes and to reduce death rates, cardiothoracic intensive care unit nurses must be able to perform the protocol with confidence, proficiency, and without delays. To this end, simulation-based learning (SBL) is a pedagogical method ideal for optimized learning.

Objectives
This quality improvement project was designed to implement a post–cardiac surgery resuscitation protocol in a nonacademic, community medical center to enhance nurse knowledge, confidence, and proficiency for optimal patient outcomes.

Methods
The Cardiac Surgical Unit–Advanced Life Support is an evidence-based resuscitation protocol that was implemented using didactic, hands-on training, and SBL. It was evaluated using knowledge surveys, comparisons in nurse confidence and performance measures, and patient outcomes data.

Results
Nurses' knowledge gains (ie, mean test scores) on our test were statistically significant between 3 time points (F2,60 = 81.204, P < .001). Knowledge significantly increased from pre-education to immediate post-education (P < .001), but declined from immediate post-education to 3-month post-education assessments (P < .001); however, the 3-month post knowledge mean was still higher than the pre-education knowledge mean (P < .001). Nurses were confident in their ability to apply the protocol, although results failed to show a correlation between confidence and performance ability. Statistical significance for delay in cardiopulmonary resuscitation was found between pre– and post–nursing education patient cardiac arrest events (P = .05).

Conclusions
Didactic and hands-on learning supported knowledge retention over time for cardiothoracic surgical intensive care unit nurses. Improving self-confidence and the application of an unfamiliar resuscitation protocol through SBL and any impact a training program has on patient outcomes will require ongoing practice and more evaluation.
Clinical outcomes after multiple self-expandable metallic stent placement using stent-in-stent technique for malignant gastric outlet obstruction
Authors: Mo Jin Won , Kim Young Min , Kim Jie-Hyun , Shin Seung Yong , Youn Young Hoon , Park Hyojin 
Published: May 2020

Abstract
Self-expandable metallic stent (SEMS) placement is widely used for relieving symptoms in malignant gastric outlet obstruction (MGOO). This study aimed to evaluate the efficacy and safety of multiple gastroduodenal stent placement using the stent-in-stent technique and to identify factors predictive of stent patency.
We retrospectively analyzed data from 170 patients with GOO receiving SEMS using the stent-in-stent technique between July 2006 and July 2018. Of these, 90 had been treated with SEMS placement for MGOO. Technical and clinical success rates were evaluated. Clinical outcomes and predictors of stent patency were also analyzed.
Second SEMS placement was used in 34.4% of cases and 9.7% were treated with third SEMS placement because of prior stent dysfunction. Median stent patency time was 15.7 weeks for the first SEMS, 10.4 weeks for the second, and 11.3 weeks for the third. The technical and clinical success rates were 100% and 97.8% for the first SEMS, 100% and 90.3% for the second, respectively, and both 100% for the third. Multivariable analysis showed that use of covered SEMS and chemotherapy after first and second SEMS placement was significant predictors of stent patency. Serious complications such as bleeding or perforation did not occur in any patient.
Second and third gastroduodenal SEMS placement using the stent-in-stent technique is safe and effective for management of first stent dysfunction in MGOO. Stent patency is significantly associated with the use of covered SEMS and chemotherapy after SEMS placement.
IDO, TDO, and AHR overexpression is associated with poor outcome in diffuse large B-cell lymphoma patients in the rituximab era
Authors: Chen Xiangli , Zang Yuzhu , Li Dujuan , Guo Jianmin , Wang Yacai , Lin Yuqi , Wei Zhenghong 
Published: May 2020

Abstract
Although Indoleamine 2,3-dioxygenase (IDO), tryptophan-2,3-dioxygenase (TDO), and aryl hydrocarbon receptor (AHR) are involved in cancer immune escape, their prognostic impact on diffuse large B-cell lymphoma (DLBCL) is unknown.
To examine the prognostic impact of IDO, TDO, and AHR on patients with DLBCL.
This was a retrospective study on treatment-naïve patients with newly diagnosed DLBCL at the Henan Province People's Hospital between 01/2012 and 06/2015. Patients with inflammatory reactive lymph nodes were included as controls. All cases were reviewed by 2 pathologists. IDO, TDO, and AHR positivity was determined through immunochemistry. Survival was examined using the Kaplan-Meier method and multivariable Cox analyses.
The positive expression of TDO (50.0% vs 16.7%, P = .005) and AHR (60.0% vs 8.3%, P < .001) were higher in DLBCL than in inflammatory control. The overall survival of IDO, TDO, and AHR positive expression in DLBCL patients was 34.6, 26.7, and 32.2 months, respectively, which is significantly shorter than that of the corresponding negative patients (49.0 months, P = .04; 58.2 months, P < .001; 58.0 months, P < .001; respectively). The multivariable analysis showed that TDO expression and Ann-Arbor stage were independently associated with PFS (TDO: HR = 8.347, 95%CI: 2.992–23.289, P < .001; stage: HR = 2.729, 95%CI: 1.571–4.739, P < .001) and OS (TDO: HR = 9.953, 95%CI: 3.228–30.686, P < .001; stage: HR = 2.681, 95%CI: 1.524–4.719, P = .001) in DLBCL patients.
Overexpression of IDO, TDO, and AHR is associated with poor survival of patients with DLBCL and could be involved in the immune escape of cancer cells. Further studies are necessary to determine whether these proteins can be targeted by treatment regimens.
The computation of case fatality rate for novel coronavirus (COVID-19) based on Bayes theorem
Authors: Chang Chi-Sheng , Yeh Yu-Tsen , Chien Tsair-Wei , Lin Jui-Chung John , Cheng Bor-Wen , Kuo Shu-Chun 
Published: May 2020

Abstract

Background:
When a new disease such starts to spread, the commonly asked questions are how deadly is it? and how many people are likely to die of this outbreak? The World Health Organization (WHO) announced in a press conference on January 29, 2020 that the death rate of COVID-19 was 2% on the case fatality rate (CFR). It was underestimated assuming no lag days from symptom onset to deaths while many CFR formulas have been proposed, the estimation on Bays theorem is worthy of interpretation. Hence, it is hypothesized that the over-loaded burdens of treating patients and capacities to contain the outbreak (LSBHRS) may increase the CFR.

Methods:
We downloaded COVID-19 outbreak numbers from January 21 to February 14, 2020, in countries/regions on a daily basis from Github that contains information on confirmed cases in >30 Chinese locations and other countries/regions. The pros and cons were compared among the 5 formula of CFR, including [A] deaths/confirmed; [B] deaths/(deaths + recovered); [C] deaths/(cases x days ago); [D] Bayes estimation based on [A] and the outbreak (LSBHRS) in each country/region; and [E] Bayes estimation based on [C] deaths/(cases x days ago). The coefficients of variance (CV = the ratio of the standard deviation to the mean) were applied to measure the relative variability for each CFR. A dashboard was developed for daily display of the CFR across each region.

Results:
The Bayes based on (A)[D] has the lowest CV (=0.10) followed by the deaths/confirmed (=0.11) [A], deaths/(deaths + recoveries) (=0.42) [B], Bayes based on (C) (=0.49) [E], and deaths/(cases x days ago) (=0.59) [C]. All final CFRs will be equal using the formula (from, A to E). A dashboard was developed for the daily reporting of the CFR. The CFR (3.7%) greater than the prior CFR of 2.2% was evident in LSBHRS, increasing the CFR. A dashboard was created to present the CFRs on COVID-19.

Conclusion:
We suggest examining both trends of the Bayes based on both deaths/(cases 7 days ago) and deaths/confirmed cases as a reference to the final CFR. An app developed for displaying the provisional CFR with the 2 CFR trends can improve the underestimated CFR reported by WHO and media.
Patient satisfaction in one-stage immediate breast reconstruction after mastectomy
Authors: Lei Chuqi , Xu Lijie , Xu Feng , Li Jie , Jiang Hongchuan , Guan Shan , Wang Xiang , Wen Bing , Li Jinfeng , Li Xiru , Geng Cuizhi , Yin Jian 
Published: May 2020

Abstract
To analyze patient satisfaction and the predictive factors characterizing three types of one-stage immediate breast reconstruction (IBR) after mastectomy, including prosthesis, latissimus dorsi myocutaneous flap (LDMF), transverse rectus abdominis myocutaneous (TRAM) flap techniques.
Data were collected via face-to-face or telephone interviews from eight breast centers in China from January 2012 to December 2016. A standardized questionnaire that evaluated the general satisfaction and aesthetic satisfaction was sent to patients who had undergone IBR. Logistic regression analysis was performed to identify risk factors associated with patient satisfaction among the three types of breast reconstruction.
A total of 412 questionnaires were sent out, and 309 copies were collected including 226 prosthesis, 46 LDMF, and 37 pedicle TRAM reconstruction. Logistic regression analysis showed that general satisfaction and aesthetic satisfaction were significantly correlated with radiotherapy (P < .001, P = .018), respectively. Besides, the aesthetic satisfaction was also associated with nipple-areola complex (NAC) preservation (P < .001).
Our multi-center study identified factors of higher patient satisfaction, like NAC preservation and absence of radiotherapy, in order to help breast surgeons make better decisions about individualized reconstruction plan.
Can cervical vascular ultrasound combined with transcranial Doppler ultrasound accurately diagnose cerebral infarction?
Authors: Qin Li-wei , Wang Chen , Feng Xiu-juan , Wang Xiao-hui , Qin Li-hong , Weeks Christina 
Published: May 2020

Abstract

Background:
The purpose of this study is to investigate the impact of cervical vascular ultrasound (CVU) combined transcranial Doppler ultrasound (TDU) in the diagnosis of cerebral infarction (CI).

Methods:
The following electronic databases will be sought from PUBMED, EMBASE, Cochrane Library, PSYCINFO, Web of Science, Allied and Complementary Medicine Database, WANGFANG, VIP database, and China National Knowledge Infrastructure. The search period will cover from the initial indexing to March 1, 2020 without restrictions of language and publication status. All case-controlled studies which identifying the impact of CVU combined TDU in the diagnosis of CI will be considered. Two authors will independently perform the whole process of study selection, data extraction, and quality assessment, respectively. If any disagreements occur between two authors, we will invite a third experienced author to help solve them through discussion. Quality Assessment of Diagnostic Accuracy Studies tool will be used to check study quality, and RevMan V.5.3 software and Stata V.12.0 software will be utilized to carry out statistical analysis.

Results:
This study will summarize the most recent evidence that focusing on the impact of CVU combined TDU in the diagnosis of CI.

Conclusion:
This study will provide helpful evidence to determine whether CVU combined TDU is an accurate diagnosis tool for CI or not.

Systematic review registration:
PROSPERO CRD42020171367.
The effect of Shexiang Tongxin Dropping Pills on coronary microvascular dysfunction (CMVD) among those with a mental disorder and non-obstructive coronary artery disease based on stress cardiac magnetic resonance images
Authors: Tian Jinfan , Zhang Lijun , Yang Xueyao , Zuo Huijuan , Zhao Xin , Yong Jingwen , He Yi , Song Xiantao 
Published: May 2020

Abstract

Introduction:
Coronary microvascular dysfunction (CMVD), highly prevalent among patients with a mental disorder (anxiety or depression), is closely related to adverse cardiac events, including hospitalization, sudden cardiac death, and myocardial infarction. Shexiang Tongxin Dropping Pills (STDP), a traditional Chinese medicine, exerts endothelial protective function by anti-inflammation, anti-oxidative stress, and promoting blood circulation. STDP protects against CMVD in previous fundamental studies. The present trial is aiming at evaluating the effect of STDP on CMVD among depressed or anxious patients with non-obstructive coronary artery disease (NOCAD).

Methods and analysis:
Seventy-two depressed or anxious patients diagnosed with NOCAD combined with CMVD utilizing coronary artery angiography and stress cardiac magnetic resonance (CMR) will be recruited in the present study. These patients will be randomized into two groups, namely, Nicorandil group (Nicorandil combined with routine medicine), and STDP groups (STDP combined with routine medicine). The change of CMVD status by assessing absolute myocardial blood flow and myocardial reperfusion using stress CMR 3-month after discharge is defined as the primary endpoint. Major adverse cardiac events (MACEs), quality of life (QOL), and metal disorder improvement are defined as the secondary endpoints. Seattle angina questionnaire (SAQ) which is used to assess angina pectoris and QOL will be recorded at 1-, 3-, 6-, 9-, 12-month of follow-up. Seven-item Generalized Anxiety Disorder Scale (GAD-7) and 9-item depression module from the Patient Health Questionnaire (PHQ9) which utilized to evaluate anxiety and depression, respectively, will be recorded at 1-, 3-, 6-, 9-, 12-month of follow-up. This study will first evaluate the efficacy of STDP on CMVD among patients with a mental disorder and NOCAD, and discuss the potential mechanisms, providing therapeutic evidence for the STDP for these patients.
Single-port endoscopic mastectomy via the lateral chest approach for the treatment of grade II gynecomastia
Authors: Jian Chenxing , Wu Limin , Lin Lisheng , Liu Wei , Zheng Zifang , Yang Chunkang 
Published: May 2020

Abstract
To investigate the feasibility of single-port endoscopic mastectomy via the lateral chest approach in the treatment of Simon grade II gynecomastia.
Data from 12 patients with grade II gynecomastia admitted from January 2017 to November 2018 were retrospectively analyzed, and related satisfaction surveys were conducted 6 months after the operation.
All surgeries were successfully performed under single-port endoscopy, and no patients were converted to open surgery. There were no serious complications related to the surgery, and all the patients were satisfied with the postoperative appearance.
The application of single-port endoscopy in the surgical treatment of grade II gynecomastia is safe and reliable.