bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Cost-Effectiveness Analysis of Screening Strategies involving Noninvasive Prenatal Testing for Trisomy 21
Authors: Wang Shuxian , Liu Kejun , Yang Huixia , Ma Jingmei 
Published: January 2020

Abstract
In the trends of increasing advanced maternal age (AMA) and decreasing cost of Noninvasive Prenatal Testing (NIPT), we investigated the benefits and cost effectiveness of NIPT as primary or contingent strategies for trisomy 21 (T21). A theoretical model involving 1,000,000 single pregnancies was established. We presented five screening scenarios, primary NIPT (Strategy 1), contingent NIPT after traditional triple serum screening higher than 1/300 or 1/1000 (Strategy 2-1 or Strategy 2-2) and age-based (Strategy 3). Strategy 3 was stratified, in which 1) for advanced maternal age (AMA) of 40 and more, prenatal diagnosis was offered, 2) for AMA of 35 to 39, NIPT was introduced, 3) if younger than 35, contingent strategy with screening risk higher than 1:300 (Strategy 3-1) or 1:1000 (Strategy 3-2) will be offered NIPT. Parameters were referred to publications or on-site verification. The primary outcome was incremental cost analysis for each strategy on baseline and alterative assumptions, which take aging society, reducing cost of NIPT and compliance into consideration. The second outcomes were total cost, cost-effect and cost-benefit analysis. If the incremental cost was less than 0.215 million US$, which was cost for raising one T21 child, or the benefit-to-cost ratio over 1, then the strategy was defined as “cost-effective”. The anticipated prenatal diagnosis was significantly reduced in Strategy 1 and 2, most notably in Strategy 2-1. For the incremental costs, strategy 2-1 was set as baseline. All other strategy costed more than raising one T21 except 3-1. In sensitivity analysis, strategy 1 costed the least when NIPT was lower than 47 US$. If NIPT less than 131 US$, the incremental cost of any strategy was less than 0.215 million US$. When the proportion of AMA accounted for more than 15% and 20% of population, incremental costs of strategy 3-1 and 3-2 were cost effective. In conclusion, contingent NIPT after traditional triple serum screening (risk higher than 1/300) was optimal in total cost (130 million US$), cost-effect (33.4 thousand US$) and cost-benefit (ratio=4.90) analysis of the model. Age-based strategy was optimal as AMA proportion and NIPT acceptance increased. The primary NIPT was most effective for certain price.
Anthropometric data before, during and after in-patient treatment of Anorexia Nervosa: Thigh circumference as reliable direct correlate to BMI and to prognosis.
Authors: Weber Dieter , Raimann Gustav , Wadlegger Silvia , Weber Waltraud , Smolle Josef , Egger Josef , Lahousen Theresa 
Published: January 2020

Abstract
Purpose The aim of the study was to determine the extent of changes in circumferential measurements taken at various localizations before, during and after in-patient treatment in patients with anorexia nervosa (AN) and their relation to BMI. Furthermore, we analyzed a possible impact of these values on long-term prognosis. Methods We retrospectively analyzed data of 269 patients (258 females, 11 males) with anorexia nervosa treated between 1999 and 2013 at a single institution by a 6-weeks quick refeeding therapy cycle. A complete set of data was available from 230 patients. BMI and 13 circumferential measuring points at the trunk and the extremities were monitored every day and at follow-up. Results 229 out of the total collective (85.13 %) had a favourable outcome with restored, stable weight after a mean observation time of 138 +- 52 months. All measuring parameters showed a highly significant increase from admission to end of treatment cycle (p < 0.0001 for each parameter. The highest gain expressed as percent of the value at admission was achieved in BMI, followed by girth of thigh. Measurements at the end of term of thorax, waist, upper arm and thigh correlated with a favourable prognosis. A thigh circumference >50 cm was significantly connected to BMI>18 and a beneficial outcome. Conclusions The highest gain in circumference during refeeding was found at the thigh. A thigh circumference greater than 50 if achieved after the first refeeding cycle was significantly linked to BMI >=18 and was a predictor of a favourable long-term course. Level of evidence Level II, comparative study
Identifying adults with sepsis, bedside tools versus administrative data: a cohort study
Authors: Bateson Meghan , Marwick Charis A , Patton Andrea , Stewart Elaine , Rooney Kevin D 
Published: January 2020

Abstract
Background Our objective was to calculate how well the bedside severity scores qSOFA, NEWS, and SIRS predict 30-day mortality from onset of infection compared to the Sepsis-3 recommended diagnostic criteria of an increase in SOFA score of ≥2 as a consequence of infection. We then assessed the ability of routinely collected administrative data (ICD-10 codes and blood culture sampling) to identify patients with clinical sepsis. The overall purpose is to inform development of a robust proxy measure for sepsis surveillance at scale.Methods This single centre retrospective case note review was set in a district general hospital in Scotland. Adult admissions between 1 st October 2015 and 31 st March 2016 with a blood culture were matched to admissions without a blood culture. The performance characteristics of SOFA, qSOFA, NEWS and SIRS were calculated to predict 30 day mortality. The ability of routinely collected administrative data to identify people with sepsis was assessed using receiver operating characteristic curves.Results This cohort of 958 admissions comprised 479 patients with a blood culture sampled and 479 without. There were 269 (28%) patients with sepsis as per the Sepsis-3 definition, and 361 (37.7%) with infection. 30-day mortality from onset of infection was 19.0% and 7.2% in the sepsis and infection groups respectively (p<0.001). NEWS ≥7 (AUROC 0.71) was a more accurate predictor of 30-day mortality from onset of infection compared to SOFA ≥2 (or Δ2) (AUROC 0.63), qSOFA ≥ 2 (AUROC 0.64) and SIRS≥2 (AUROC 0.65). ICD-10 sepsis codes (A40, A41 & R57.2) were recorded in only 26 (9.4%) sepsis admissions. Blood culture sampling performed better at identifying patients with sepsis (AUROC 0.63) compared to ICD-10 sepsis codes (AURO 0.54) or positive blood cultures (AUROC 0.53).Conclusions NEWS ≥7 was a better predictor of 30-day mortality in patients with infection than SIRS, qSOFA or SOFA. ICD-10 sepsis codes lack sensitivity for reliable sepsis surveillance. Blood culture sampling showed potential for inclusion as part of a clinically relevant proxy marker for sepsis surveillance.
Comparison of clinical characteristics and outcomes of bloodstream infections due to multidrug-resistant Acinetobacter baumannii and other Gram-negative bacteria in ICU patients
Authors: Qian Ying , Xie Yongpeng , Mao Haifeng , Li Jiguang , Gu Caihong , Liu Suxia , Liu Kexi 
Published: January 2020

Abstract
Background: Multidrug-resistant (MDR) bloodstream infection (BSI) by Gram-negative bacteria (GNB) is an important cause of mortality in the intensive care unit (ICU). The purpose of this study was to compare the clinical characteristics of some GNB BSIs and to analyze their drug resistance, with an emphasis on the analysis of prognostic risk factors related to MDR-Acinetobacter baumannii (A. baumannii) BSI.Methods: A retrospective study was conducted in the ICU of lianyungang hospital in China. Patients with BSIs due to MDR-A. baumannii, MDR-Klebsiella pneumoniae (K. pneumoniae), MDR-Pseudomonas aeruginosa (P. aeruginosa) and MDR-Escherichia coli (E. coli) were included.Results: The overall drug resistance rate to imipenem of A. baumannii and K. pneumoniae was significantly higher than that of P. aeruginosa and E. coli (95.8% and 75.5% vs 44.6% and 9.2% respectively). The mortality rates were 71.9%, 63.3%, 41.5% and 38.1%, respectively. The multivariate analysis of MDR-A. baumannii BSI, APACHE II score, hormone use, development of septic shock were associated with the 30-day mortality, while high albumin level with survival.Conclusion: The treatment of MDR-A. baumannii and MDR-K. pneumoniae infection resulted difficult due to their high drug resistance rate. However, the understanding of the clinical characteristics of different BSIs might be helpful to predict, to some extent, the pathogenic bacteria involved so as to proceed with an early sensitive antibiotic treatment. The high mortality rate due to BSI MDR-A. baumannii might be correlated with APACHE II score, nutritional status, and hormone therapy, while septic shock was a warning sign of poor prognosis.
Analysing the relationship between nutrition and the microbial composition of the oral biofilm - insights from the analysis of individual variability
Authors: Vach Kirstin , Al-Ahmad Ali , Anderson Annette , Woelber Johan Peter , Karygianni Lamprini , Wittmer Annette , Hellwig Elmar 
Published: January 2020

Abstract
Background : The influence of nutrition on the oral microbiota has been discussed in the literature, but usually only changes of the mean values are reported. This paper focuses on the variability of patients' reactions. Methods : Two types of inter-individual variability in such studies and statistical models to estimate them are introduced. Through smart presentation of the estimates from the studies, a better understanding of the data can be obtained. Random effects meta-analyses are used to analyse the heterogeneity in variability across different bacteria. Results : For the nutrition individually chosen by the participants, we observed an inter-individual variability of the bacterial concentration of three log steps. Given that we found no evidence of heterogeneity in variability across different bacteria, the results can be used to offer recommendations for future studies and compute the number of cases needed. Conclusions : For studies measuring the concentration change of bacteria as a reaction to nutrition change, the use of replications and analysis of the variability is recommended.
WITHDRAWN: A software tool for exploring the relation between diagnostic accuracy and measurement uncertainty
Authors: Chatzimichail Theodora , Hatjimihail Aristides T. 
Published: January 2020

Abstract
Background Screening and diagnostic tests are used to classify people with and without a disease. Diagnostic accuracy measures are used to evaluate the correctness of a classification in clinical research and practice. Although the correctness of a classification based on a measurand depends on the uncertainty of measurement, there has been limited research on their relation. The objective for this work is to develop an exploratory tool for the relation between diagnostic accuracy measures and measurement uncertainty, as diagnostic accuracy is fundamental to clinical decision making, while measurement uncertainty is critical to quality and risk management in laboratory medicine. Results For this reason, a freely available interactive program has been developed, written in Wolfram Language. The program provides four modules for calculating, optimizing, plotting and comparing various diagnostic accuracy measures and the corresponding risk of diagnostic or screening tests measuring a normally distributed measurand, applied at a single point in time in non-diseased and diseased populations. This is done for differing prevalence of the disease, mean and standard deviation of the measurand, diagnostic threshold, standard measurement uncertainty of the tests and expected loss. The application of the program is illustrated with a case study of glucose measurements in diabetic and non-diabetic populations, that demonstrates the relation between diagnostic accuracy measures and measurement uncertainty. Conclusion The presented interactive program is user-friendly and can be used as a flexible educational and research tool in medical decision making, to explore the relation between diagnostic accuracy measures and measurement uncertainty.
Family and peer effect on young and adolescent smoking in Bangladesh
Authors: Ahmed Moin Uddin , Hashmi Rubayyat , Pulok Mohammad Habibullah , Tannous Kathy , Alam Khorshed 
Published: January 2020

Abstract
Background: Cigarette smoking among youth has become a major public health problem in many developing countries like Bangladesh. Many smokers start smoking in their teens; then they become addicted and deepen the dependency during early adulthood, maintaining their smoking behaviour. Current literature from Bangladesh has not examined how peer effect, family influence and smoking-related knowledge impact smoking behaviour of the adolescent and young adults from the urban areas of the country. This study aims to fill this gap in the literature by investigating the smoking patterns of urban male adolescents and young adults in Bangladesh. The study aims to examine the family and peer influence on the behaviour of smoking of this population group. The study also explores how knowledge on harmful effects of smoking affects the participation decision of smoking by young adults and adolescents. Methods: This study is an educational institution-based cross-sectional study within the framework of the Global Youth Tobacco Survey (GYTS). Primary data has been collected from a sample of 995 urban male students aged between 10-24 years living in the seven divisional headquarters of Bangladesh. We use logistic regression and count data regression models to examine how smoking is associated with different factors. Results: Our results suggest that a person is 45% more prone to smoke a cigarette if any of the family members is a smoker. The likelihood of smoking is about six times higher if he is offered a cigarette by his friend, whereas the likelihood of being a smoker is 15-fold if he has a smoker friend, as the findings reveal. However, institutional and family awareness are not significantly related to smoking. Conclusion: Strong evidence of peer and family effect on smoking initiation indicates the need for effective smoking-prevention intervention at the national level, specifically targeted at family and educational institutions. The findings are also relevant for other countries which share the similar characteristics of Bangladesh in terms of adolescent smoking determinants.
The risk factors for linezolid-induced lactic acidosis in patients older than 85 years
Authors: Liu Tingting , Li Hongxia , Liu Miao , Wang Jiang , Fang Xiangqun 
Published: January 2020

Abstract
Background Lactate is considered a prognostic indicator in critically ill patients; however, studies on linezolid-induced lactic acidosis (LILA) are limited, and data from patients older than 85 are even more scarce, therefore we evaluated the risk factors for LILA in patients older than 85 years and established a risk prediction model. Methods In a retrospective cohort study, patients older than 85 years who were monitored for blood gas analysis and arterial lactate levels during the use of teicoplanin or linezolid were enrolled. After using propensity score-matched analyses we compared the incidence of lactic acidosis between teicoplanin or linezolid therapy and identified the risk factors of LILA. Results After propensity score-matched analyses, the incidence of lactic acidosis with teicoplanin therapy was significantly lower than that with linezolid therapy (0% vs 35.7%; p<0.0001). Duration of linezolid therapy ≥9 days (OR,3.541;95%CI,1.161-10.793; p=0.026), arterial blood glucose level ≥8 mmol/L (OR, 4.548; 95% CI, 1.507-13.725; p=0.007) and high sequential organ failure assessment (SOFA) score (OR, 1.429; 95% CI, 1.213-1.685; p<0.0001) were risk factors for LILA. A risk model is predictive of LILA (area under the curve, 0.849; specificity, 65.1%; sensitivity, 91.4%, with a negative predictive value of 93.2% and a positive predictive value of 59.3%) with high stability. Conclusions LILA can occur in patients older than 85 years with a relatively shorter duration of linezolid; hence, the close monitoring of blood gas and arterial lactate levels during the use of linezolid in the super-elderly population is necessary.
Purification of real car wash wastewater with complex coagulation/flocculation methods using polyaluminum chloride, polyelectrolyte, clay mineral and cationic surfactant
Authors: Veréb G. , Gayır V. E. , Santos E. N. , Fazekas Á. , Kertész Sz. , Hodúr C. , László Zs. 
Published: January 2020

Abstract
In the present study, real car wash wastewater was purified by different coagulation/flocculation methods. As coagulant, polyaluminum chloride (‘BOPAC’), conventional iron(III) chloride, iron(III) sulfate, and aluminum(III) chloride were used, while as flocculant non-ionic and anionic polyelectrolytes were investigated. The effects of added clay mineral (Na-bentonite) and cationic surfactant (hexadecyltrimethyl ammonium bromide – ‘HTABr’) were also investigated. The use of BOPAC was significantly more effective than conventional coagulants. Extra addition of clay mineral was also beneficial in relation to both the sediment volume and sedimentation speed, while polyelectrolyte addition enhanced further the sedimentation. Moreover, the simultaneous addition of HTABr significantly enhanced the color removal efficiency due to the successful in-situ generation of organophilic bentonite. In summary, the application of 100 mg L−1 Na-bentonite with 20 mg L−1 Al3+ (from BOPAC) and 0.5 mg L−1 anionic polyelectrolyte resulted in the efficient reduction of the turbidity (4–6 NTU), the COD (158 mg L−1) and the extractable oil content (4 mg L−1) with efficiencies of 98%, 59%, and 85%, respectively. By applying organophilic bentonite in high concentration (500 mg L−1) with identical concentrations of BOPAC and anionic polyelectrolyte, significant color removal (5 times lower absorbance at λ = 400 nm) and 27% lower sediment volume were achieved.
Protein Interaction Domains: Structural Features and Drug Discovery Applications (Part 2)
Authors: Vincenzi Marian , Mercurio Flavia Anna , Leone Marilisa 
Published: January 2020

Background:
Proteins present a modular organization made up of several domains. Apart
from the domains playing catalytic functions, many others are crucial to recruit interactors. The
latter domains can be defined as "PIDs" (Protein Interaction Domains) and are responsible for pivotal
outcomes in signal transduction and a certain array of normal physiological and disease-related
pathways. Targeting such PIDs with small molecules and peptides able to modulate their interaction
networks, may represent a valuable route to discover novel therapeutics.

Objective:
This work represents a continuation of a very recent review describing PIDs able to
recognize post-translationally modified peptide segments. On the contrary, the second part concerns
with PIDs that interact with simple peptide sequences provided with standard amino acids.

Methods:
Crucial structural information on different domain subfamilies and their interactomes was
gained by a wide search in different online available databases (including the PDB (Protein Data
Bank), the Pfam (Protein family), and the SMART (Simple Modular Architecture Research Tool)).
Pubmed was also searched to explore the most recent literature related to the topic.

Results and Conclusion:
PIDs are multifaceted: they have all diverse structural features and can
recognize several consensus sequences. PIDs can be linked to different diseases onset and progression,
like cancer or viral infections and find applications in the personalized medicine field. Many
efforts have been centered on peptide/peptidomimetic inhibitors of PIDs mediated interactions but
much more work needs to be conducted to improve drug-likeness and interaction affinities of identified
compounds.
Neuroprotective and Neurorestorative Effects of Epo and VEGF: Perspectives for New Therapeutic Approaches to Neurological Diseases
Authors: Ureña-Guerrero Mónica E. , Castañeda-Cabral José L. , Rivera-Cervantes Martha C. , Macias-Velez Rafael J. , Jarero-Basulto José J. , Gudiño-Cabrera Graciela , Beas-Zárate Carlos 
Published: January 2020

Background:Erythropoietin (Epo) and vascular endothelial growth factor (VEGF) are two vasoactive molecules with essential trophic effects for brain development. The expression and secretion of both molecules increase in response to neuronal damage and they exert protective and restorative effects, which may also be accompanied by adverse side effects.Objective:We review the most relevant evidence on the neuroprotective and neurorestorative effects of Epo and VEGF in three of the most frequent neurological disorders, namely, stroke, epilepsy and Alzheimer's disease, to develop new therapeutic approaches.Method:Several original scientific manuscripts and reviews that have discussed the evidence in critical way, considering both the beneficial and adverse effects of Epo and VEGF in the selected neurological disorders, were analysed. In addition, throughout this review, we propose several considerations to take into account in the design of therapeutic approaches based on Epo and VEGF signalling.Results:Although the three selected disorders are triggered by different mechanisms, they evolve through similar processes: excitotoxicity, oxidative stress, neuroinflammation, neuronal death, glial reactivity and vascular remodelling. Epo and VEGF exert neuroprotective and neurorestorative effects by acting on these processes due to their pleiotropism. In general, the evidence shows that both Epo and VEGF reduce neuronal death but that at the vascular level, their effects are contradictory.Conclusion:Because the Epo and VEGF signalling pathways are connected in several ways, we conclude that more experimental studies, primarily studies designed to thoroughly assess the functional interactions between Epo and VEGF in the brain under both physiological and pathophysiological conditions, are needed.
Blood-based Biomarkers of Alzheimer’s Disease: The Long and Winding Road
Authors: Manzine Patricia R. , Vatanabe Izabela P. , Peron Rafaela , Grigoli Marina M. , Pedroso Renata V. , Nascimento Carla M.C. , Cominetti Marcia R. 
Published: January 2020

Background:
Blood-based biomarkers can be very useful in formulating new diagnostic and treatment
proposals in the field of dementia, especially in Alzheimer’s disease (AD). However, due to the influence of
several factors on the reproducibility and reliability of these markers, their clinical use is still very uncertain.
Thus, up-to-date knowledge about the main blood biomarkers that are currently being studied is extremely important
in order to discover clinically useful and applicable tools, which could also be used as novel pharmacological
strategies for the AD treatment.

Objective:
The aim of this paper was to carry out a literature review on the major blood-based biomarkers for AD,
connecting them with the pathophysiology of the disease.

Methods:
A narrative review was performed based on the current candidates of blood-based biomarkers for AD
to show the main results from different studies, focusing on their clinical applicability and association with AD
pathogenesis.

Results:
Recent advances in the search of blood-based AD biomarkers were summarized in this review. The
biomarkers were classified according to the topics related to the main hallmarks of the disease such as inflammation,
amyloid, and tau deposition, synaptic degeneration and oxidative stress. Moreover, molecules involved in
the regulation of proteins related to these hallmarks were described, such as non-coding RNAs, neurotrophins,
growth factors and metabolites. Cells or cellular components with the potential to be considered as blood-based
AD biomarkers were described in a separate topic.

Conclusion:
A series of limitations undermine new discoveries on blood-based AD biomarkers. The lack of reproducibility
of findings due to the small size and heterogeneity of the study population, different analytical
methods and other assay conditions make longitudinal studies necessary in this field to validate these structures,
especially when considering a clinical evaluation that includes a broad panel of these potential and promising
blood-based biomarkers.