bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gastric Stump Cancer: Demanding a More Suitable Definition and TNM Staging System
Authors: Xu Jiannan , Liu Guangyao , Jin Xinghan , Wang Huijin , Zhu Lihua , Zhang Changhua , He Yu-long 
Published: December 2020

Abstract
BackgroundThe incidence of gastric stump cancer (GSC) following resection of gastric cancer has increase. However, the definition between GSC and recurrent gastric cancer (RGC) is still being debated. This study was conducted to compare the clinicopathological characteristics and outcome for this two groups.MethodsThe investigators retrospectively reviewed patients in the Surveillance Epidemiology and End Results (SEER) databases from 1975 to 2016 to identify patients who underwent resection of gastric cancer subsequently experienced metachronous gastric cancer. GSC was defined as cancer occurring in remnant stomach of ≥10 years after gastrectomy, while RGC was defined as <10 years after gastrectomy. T-test, Pearson χ2-test and Kaplan-Meier estimator method was used in the present study.ResultsAmong the 167,747 gastric cancer patients, 1,006 (0.6%) patients were diagnosed multiple gastric cancer, 93 patients met the GSC criterion, and 282 patients met the RGC criterion. The mean time interval between the initial cancer and second cancer for GSC was 13.34 years and 4.24 years for RGC. Male gender (P=0.003), younger age (60.1 years old vs. 65.9 years old, P<0.001) developed more frequently in GSC group. The median OS in GSC group was 20.0 months compared with 16.0 months for RGC group (p=0.302). Surgery treatment or not, the median OS have statistically significant (in RGC group, 64.0 months vs. 10.0 months, P＜0.001; 33 months vs. 13 months, P=0.014 in GSC group).ConclusionsIn our definition of GSC and RGC, the OS were not statistically significant and gastrectomy may be the appropriate treatment for this two groups. It may demand for a more suitable definition and TNM staging system for GSC.
Dzherelo (Immunoxel) as Adjunctive Therapy to Standard Antituberculosis Treatment in Patients with Pulmonary Tuberculosis: A Systematic Review and Meta-analysis of Clinical Trials
Authors: Kitenge Marcel , Phiri Bessie , Pheeha Sara M , Ogunrombi Modupe , Nyasulu Peter 
Published: December 2020

Abstract
BackgroundDzherelo (Immunoxel) is one of the few approved immunomodulators that has been shown to produce positive treatment outcomes in patients with tuberculosis (TB). The aim of this review was to assess the effectiveness of Immunoxel used as adjunct therapy with conventional anti-TB therapy for the treatment of pulmonary TB. MethodsComprehensive search was conducted in different major databases: Pubmed (MEDLINE), EMBASE (OVID), Cochrane Central Register of Controlled Trials (CENTRAL), SCOPUS (Elsevier). We also searched Google Scholar along with trial registries and hand-searched the reference list of identified original research as well as review articles. Conference proceedings of relevant TB and lung diseases annual conferences were also screened. Two independent authors extracted outcomes data using a standardized extraction form. Relative risk (RR), mean difference (MD) and standardised mean difference (SMD) with a 95% confidence interval (CI) were used as measures of effect. We assessed certainty of evidence using GRADE.ResultsSix clinical trials, which met the criteria for the review were identified and these provided data for the review. Overall results from the six trials that compared anti-tuberculosis treatment (ATT) alone versus ATT and Immunoxel, ATT and Placebo versus ATT and Immunoxel, showed an increased number of patients becoming sputum-negative in the Immunoxel group (RR 3.19; 95% CI 2.44 to 4.17; 488 participants). There was also great reduction in body temperature among patients receiving Immunoxel compared to ATT alone (MD -0.20, 95% CI -0.22 to -0.18, 345 participants). However, there were no differences in body weight changes across all the studies (MD 5.65; 95% CI: -0.80 to 12.11; 382 participants). ConclusionCurrent evidence indicates that the use of Immunoxel as an adjunctive treatment in patients with pulmonary tuberculosis has the potential to enhance the efficacy of anti-tuberculosis treatment. However, well-designed, conducted and adequately powered clinical trials are needed to establish the effectiveness of this adjunctive treatment. PROSPERO registration number: CRD42019127823
Genetic Composition and Evolution of the Prevalent Mycobacterium Tuberculosis Lineages 2 and 4 in the Chinese and Zhejiang Province Populations
Authors: Wu Beibei , Zhu Wenlong , Wang Yue , Wang Qi , Zhou Lin , Liu Zhengwei , Bi Lijun , Barun Mathema , Kreiswirth Barry N. , Chen Liang , Chen Songhua , Wang Xiaomeng , Wang Weibing 
Published: December 2020

Abstract
Background: There are seven human-adaptation lineages of Mycobacterium tuberculosis (Mtb). Tuberculosis (TB) dissemination is strongly influenced by human movements and host genetics. The detailed lineage distribution evolution of Mtb in Zhejiang Province is unknown. We aim to determine how different sub-lineages are transmitted and distributed within China and Zhejiang Province.Methods: We analyzed whole-genome sequencing data for a countrywide collection of 1154 isolates and a provincial collection of 1296 isolates, constructed the best-scoring maximum likelihood phylogenetic tree. Bayesian evolutionary analysis was used to calculate the latest common ancestor of lineages 2 and 4. The antigenic diversity of human T cell epitopes was evaluated by calculating the pairwise dN/dS ratios.Results: Of the Zhejiang isolates, 964 (74.38%) belonged to lineage 2 and 332 (25.62%) belonged to lineage 4. The distributions of the sub-lineages varied across the geographic regions of Zhejiang Province. L2.2 is the most ancient sub-lineage in Zhejiang, first appearing approximately 6897 years ago (95% HDI: 6513-7298). L4.4 is the most modern sub-lineage, first appearing approximately 2217 years ago (95% HDI: 1864-2581). The dN/dS ratios showed that the epitope and non-epitope regions of lineage 2 strains were significantly (P<0.001) more conserved than those of lineage 4.Conclusions: An increase in the frequency of lineage 4 may reflect its successful transmission over the last 20 years. The recent common ancestors of the sub-lineages and their transmission routes are relevant to the entry of humans into China and Zhejiang Province. Diversity in T cell epitopes may prevent Mycobacterium tuberculosis from being recognized by the immune system.
Smartphone Based Alerting of First Responders During The COVID-19 Pandemic
Authors: Ganter Julian , Damjanovic Domagoj , Trummer Georg , Busch Hans-Jörg , Baldas Klemens , Hänsel Mike , Mueller Michael Patrick 
Published: December 2020

Abstract
Background: Smartphone Alerting Systems (SAS) potentially reduce the resuscitation-free interval. Many of these systems invite lay persons, who a have been trained in Basic Life Support (BLS). The Freiburg alert system Region of Lifesavers (Region der Lebensretter, RDL) only registers first responders with a professional background (i.e. paramedics, nurses, physicians, medical students) and volunteers with at least 48 units training in emergency medicine. Here we describe the evolution of the RDL system during the pandemic.Methods: Due to a lack of personal protective equipment (PPE), the alert system had been stopped at the beginning of the COVID 19 pandemic on March 16th, 2020.The board of the charity organization operating RDL decided to design a concept for a safe restart. Following the raise of 34,000 Euros of private funds, 1,000 backpacks were equipped with FFP-2 mask, gloves, protective gown, safety glasses, mouth-nose protection, airway filter and ventilation bag/mask. Furthermore, the algorithm for first responders was adapted according to the ERC COVID guidelines. An online survey regarding volunteers’ willingness to help under different protective measures before, during and after the pandemic was conducted.Results: The system was restarted on May 26th, 2020. The number of volunteers newly registering for the system remained unchanged between 10 – 71 per month after restart of the system. The proportions of alarms with at least one first responder accepting among all activations of the system remained at approximately 50%, assuming that the volunteers being equipped with PPE felt safe during the COVID-19 pandemic. This was also confirmed by the results of the survey.Conclusions: During the ongoing pandemic, it is important to keep well-established first responder systems active, which can shorten the resuscitation-free interval. When PPE is provided for first responders, the readiness of the volunteers to remain active in the SAS is high.
Determinants of Gender Disparities in Scaling Up the First 90 Towards the UNAIDS&nbsp;90-90-90 Targets in South Africa: Findings From the 2017 Household-based National Cross-sectional Survey
Authors: Jooste Sean , Mabaso Musawenkosi , Taylor Myra , North Alicia , Shean Yolande , Simbayi Leickness Chisamu 
Published: December 2020

Abstract
Background: The first 90 of UNAIDS 90–90–90 targets to have 90% of the people living with HIV know their status is an important entry point to the HIV treatment cascade and care continuum, but evidence shows that there is a large gap between males and females in this regard. It is therefore important to understand barriers and facilitators of achieving the first 90 target. This study examined determinants of the first 90 target among females and males in order to inform strategies aimed at improving the HIV cascade in South Africa.Methods: The data used in the analysis were obtained from a 2017 household-based cross-sectional nationally representative survey conducted using a multi-stage stratified cluster random sampling design. A series of hierarchical multiple logistic regression models were fitted to identify the determinants of the first 90 target by gender.Results: Overall, 84.8% of HIV-positive individuals aged 15 years and older were aware of their HIV status. Females were significantly more aware of their HIV status compared to males (88.7% vs 78.2%, p<0.001). Both females aged 25 to 49 years [aOR=3.20 (95% CI: 1.35–7.57), p=0.008], and 50 years and older [aOR=3.19 (95% CI: 1.04–9.76), p=0.042] and males aged 25 to 49 years [aOR=3.00 (95% CI: 1.13–7.97), p=0.028], and 50 years and older [aOR=7.25 (95% CI: 2.07–25.36), p=0.002] were significantly more likely to know their HIV status compared to those aged 15 to 19 years. Males with tertiary education level were significantly more likely to be aware of their HIV positive status [aOR=75.24 (95% CI: 9.07–624.26), p<0.001] compared to those with no education or with primary level education. Females with secondary [aOR=3.28 (95% CI: 1.20–8.99), p=0.021] and matric [aOR=4.35 (95% CI: 1.54–12.37), p=0.006] educational levels were significantly more likely to be aware of their HIV positive status, compared to those with no education or with primary level education.Conclusion: Significant progress has been made with regards to reaching the UNAIDS first 90 target. In this context achieving the first 90 target is feasible but there is a need for additional interventions to reach the males especially youth including those with no education or low levels of education.
Severe Sepsis With Septic Shock as a Consequence of a Severe Hospital-Acquired Pneumonia Resulting From Legionella Pneumophila in Children: A Case Series and Literature Review
Authors: Ding Min , Yang Chunfeng , Li Yu-mei 
Published: December 2020

Abstract
BackgroundLegionella pneumophila is responsible for hospital or community-acquired pneumonia in adults. Immunocompromised patients with Legionella pneumophila infection are associated with rapidly severe clinical course and high mortality rates. Legionella pneumophila infection is rare in children, especially combined with extrapulmonary manifestations. In this report, we describe 2 children of severe hospital-acquired pneumonia and septic shock resulting from Legionella pneumophila. Standardized metagenomics next-generation sequencing allowed early diagnosis. Appropriate antibiotic therapy and timely extracorporeal life support were effective in achieving complete recovery. This is the first report of children with septic shock related to Legionella pneumophila infections diagnosed by metagenomics next-generation sequencing and recovered successfully.Case presentationThere were 2 cases about septic shock resulting from Legionella pneumophila. One was a six-month girl with congenital biliary atresia who underwent liver transplantation. She was suspected for rejecting the liver and admitted to hospital. The other one was a five-year-old boy with Burkitt lymphoma who was in the end of early chemotherapy. They both presented with fever, cough or shortness of breath during hospitalization. And they were transferred to PICU because of worsening dyspnea and decreased blood pressure. Patients were diagnosed by severe sepsis with septic shock likely resulting from hospital-acquired pneumonia. Metagenomics next-generation sequencing indicated L. pneumophila in blood and sputum. Aggressive intravenous fluids resuscitation and vasopressors were initiated on arrival to PICU, and they were placed on mechanical ventilation and continuous renal replacement therapy. Intravenous antibiotic therapy followed by azithromycin. Finally, the patients recovered without any long-term sequelae.ConclusionsThough sepsis or sepsis shock caused by Legionella pneumophila is rare in children, it can occur at high-risk population. Metagenomics next-generation sequencing is useful for conforming hard-to-culture pathogens and severely ill patients. The report remind pediatric physicians that we should be aware that Legionella pneumophila can cause severe sepsis or sepsis shock, especially in immunocompromised children. It is significant to select appropriate samples and pathogen detection methods in the early stage of disease.
Comparative Genomics and Physiological Investigation Supported Safety, Cold Adaptation, Efficient Hydrolytic and Plant Growth-promoting Potential of Psychrotrophic Glutamicibacter Arilaitensis LJH19, Isolated from Night-Soil Compost
Authors: Borker Shruti , Thakur Aman , Kumar Sanjeet , Kumari Sareeka , Kumar Rakshak , Kumar Sanjay 
Published: December 2020

Abstract
Background: Night-soil compost (NSC) has traditionally been conserving water and a source of organic manure in northwestern Himalaya. Lately, this traditional method is declining due to modernization, its unhygienic conditions, and social apprehensions. Reduction in the age-old traditional practice has led to excessive chemical fertilizers and water shortage in the eco-sensitive region. In the current study, a bacterium has been analysed for its safety, cold-adaptation, efficient degradation, and plant growth potential attributes for its possible application as a safe bioinoculant in psychrotrophic bacterial consortia for improved night-soil composting.Results: Glutamicibacter arilaitensis LJH19, a psychrotrophic bacterium, was isolated from the night-soil compost of Lahaul valley in northwestern Himalaya. The strain exhibited amylase (186.76 ± 19.28 U/mg), cellulase (21.85 ± 0.7 U/mg) and xylanase (11.31± 0.51 U/mg) activities at 10°C. Possessing efficient hydrolytic activities at low-temperature garners the capability of efficient composting to LJH19. Additionally, the strain possessed multiple plant growth-promoting (PGP) traits such as indole acetic acid production (166.11 ± 5.7 µg/ml), siderophore production (85.72 ±1.06 % psu), and phosphate solubilization (44.76 ± 1.5 µg/ml). Enhanced germination index and germination rate of pea seeds under the LJH19 inoculation further supported the bacterium's PGP potential. Whole-genome sequencing (3,602,821 bps) and genome mining endorsed the cold adaptation, degradation of polysaccharides and, plant growth-promoting traits of LJH19. Biosynthetic gene clusters for type III polyketide synthase (PKS), terpene, and siderophore supplemented the endorsement of LJH19 as a potential PGP bacterium. Comparative genomics within the genus revealed 217 unique genes specific to hydrolytic and PGP activity. Conclusion: The physiological and genomic evidence promotes LJH19 as a potentially safe bio-inoculant to formulate psychrotrophic bacterial consortia for accelerated degradation and improved night-soil compost.
Study of a New 5-DOF Parallel Mechanism for Multi-Directional 3D Printing
Authors: Wang Yesong , Lyu Changhuai , Liu Jiang , Zhang Jinguang , Jia Zhixin 
Published: December 2020

Abstract
This paper first designs a new 5-DOF parallel mechanism with 5PUS-UPU for multi-directional 3D printing, and then analyses its DOF by traditional Grubler-Kutzbach and motion spiral theory. It theoretically shows that the mechanism meets the requirement of 5 dimensions of freedoms including three-dimensional movement and two-dimensional rotation. Basing on this, the real mechanism is built, but unfortunately it is found unstable in some positions. Grassmann line geometry method is applied to analyze its unstable problem caused by singular posture, and then an improving method is put forward to solve it. With the improved mechanism, closed loop vector method is employed to establish the inverse position equation of the parallel mechanism, and kinematics analysis is carried out to get the mapping relationships between position, speed and acceleration of moving and fixed platform, Monte Carlo method is used to analyze the workspace of the mechanism, to explore the influencing factors of workspace, and then to get the better workspace. Finally an experiment is designed to verify the mechanism working performance to satisfy the spatial motion requirements of multi-directional 3D printing.
Sparse Autoencoder-Based Multi-Head Deep Neural Networks for Machinery Fault Diagnostics With Novelty Detection
Authors: Yang Zhe , Gjorgjevikj Dejan , Long Jian-Yu , Zi Yan-Yang , Zhang Shao-Hui , Li Chuan 
Published: December 2020

Abstract
Novelty detection is a challenging task for the machinery fault diagnosis. A novel fault diagnostic method is developed for dealing with not only diagnosing the known type of defect, but also detecting novelties, i.e. the occurrence of new types of defects which have never been recorded. To this end, a sparse autoencoder-based multi-head Deep Neural Network (DNN) is presented to jointly learn a shared encoding representation for both unsupervised reconstruction and supervised classification of the monitoring data. The detection of novelties is based on the reconstruction error. Moreover, the computational burden is reduced by directly training the multi-head DNN with rectified linear unit activation function, instead of performing the pre-training and fine-tuning phases required for classical DNNs. The addressed method is applied to a benchmark bearing case study and to experimental data acquired from a delta 3D printer. The results show that it is able to accurately diagnose known types of defects, as well as to detect unknown defects, outperforming other state-of-the-art methods.
Deep Learning Based Data Fusion for Sensor Fault Diagnosis and Tolerance in Autonomous Vehicles
Authors: Pan Huihui , Sun Weichao , Sun Qiming , Gao Huijun 
Published: December 2020

Abstract
Environmental perception is one of the key technologies to realize autonomous vehicles. Autonomous vehicles are often equipped with multiple sensors to form a multi-source environmental perception system. Those sensors are very sensitive to light or background conditions, which will introduce a variety of global and local fault signals that bring great safety risks to autonomous driving system during long-term running. In this paper, a real-time data fusion network with fault diagnosis and fault tolerance mechanism is designed. By introducing prior features to realize the lightweight of the backbone network, the features of the input data can be extracted in real time accurately. Through the temporal and spatial correlation between sensor data, the sensor redundancy is utilized to diagnose the local and global condence of sensor data in real time, eliminate the fault data, and ensure the accuracy and reliability of data fusion. Experiments show that the network achieves the state-of-the-art results in speed and accuracy, and can accurately detect the location of the target when some sensors are out of focus or out of order.
mTOR inhibitor Treats Autistic-like Behaviors in Tsc2+/- rats but not following Developmental Status Epilepticus
Authors: Petrasek Tomas , Vojtechova Iveta , Klovrza Ondrej , Tuckova Klara , Vejmola Cestmir , Rak Jakub , Sulakova Anna , Kaping Daniel , Bernhardt Nadine , de Vries Petrus , Otahal Jakub , Waltereit Robert 
Published: December 2020

Abstract
Background: Tuberous Sclerosis Complex (TSC), a multi-system genetic disorder often associated with Autism Spectrum Disorder (ASD), is caused by mutations of TSC1 or TSC2, which lead to constitutive overactivation of mammalian Target of Rapamycin (mTOR). In several Tsc1+/- and Tsc2+/- animal models, cognitive and social behavior deficits were reversed by mTOR inhibitors. However, phase II studies have not yet shown amelioration of ASD and cognitive deficits in individuals with TSC during mTOR inhibitor therapy. We asked here if developmental epilepsy, common in the majority of individuals with TSC, but absent in most animal models, could explain the discrepancy. Methods: At postnatal day P12, developmental status epilepticus (DSE) was induced in male Tsc2+/- (Eker) and wild-type rats, establishing four experimental groups including controls. In adult animals (n = 36), behavior was assessed in the paradigms of social interaction test, elevated plus-maze, light-dark test, Y-maze and novel object recognition. Electroencephalographic (EEG) activity was recorded in a separate set of animals (n = 18). The testing was carried out before medication (T1), during treatment with the mTOR inhibitor everolimus (T2) and after washing-out (T3). Results: Both Tsc2+/- mutation and DSE caused social behavior deficits and epileptiform EEG abnormalities (T1). Everolimus led to persistent improvement of the social deficit induced by Tsc2+/-, while deficits related to DSE did not respond to everolimus (T2, T3). Conclusions: These findings may contribute to an explanation why ASD symptoms in individuals with TSC, where comorbid early-onset epilepsy is common, were so far in clinical studies not reliably ameliorated by mTOR inhibitors.
Obesity Is Associated with Severe Disease and Mortality in Patients with Coronavirus Disease 2019 (COVID-19)
Authors: Cai Zixin , Yang Yan , Zhang Jingjing 
Published: December 2020

Abstract
Background: The coronavirus disease 2019 (COVID-19) pandemic has led to global research with the aim of predicting which people are at greatest risk of developing severe disease and dying. The aim of this meta-analysis was to determine the associations between obesity and the severity of and mortality due to COVID-19. Methods: We searched the PubMed, EMBASE, Cochrane Library and Web of Science databases for studies evaluating the associations of obesity with COVID-19 . Odd risks (ORs) and 95% confidence intervals (CIs) were calculated using random- or fixed-effects models. Results: Thirty-eight studies involving 621502 patients were included. Compared with nonobese patients, obese patients had a significantly increased risk of infection (OR 3.19, 95% CI 1.45-7.03; I2 = 98.3%), hospitalization (OR 1.77, 95% CI 1.61-1.95; I2 = 43.8%), clinically severe disease (OR 2.88, 95% CI 1.99-4.16; I2 = 49.9%), mechanical ventilation (OR 1.66, 95% CI1.42-1.94; I2 = 41.3%), intensive care unit (ICU) (OR 2.06, 95% CI1.49-2.85; I2 = 71.4%), and mortality (OR 1.48, 95% CI 1.18-1.85; I2 = 80.8%). Conclusion: Patients with obesity may have a greater risk of developing severe COVID-19 and dying. Therefore, it is important to increase awareness of these associations with obesity in COVID-19 patients.