bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association between collapse and serum creatinine and electrolyte concentrations in marathon runners: a 9-year retrospective study
Authors: Fitzpatrick Daniel , Walter Edward , Leckie Todd , Richardson Alan , Stacey Mike , Hunter Alex , Short Steve , Hill Neil , Woods David , Grimaldi Rachael , Galloway Rob , Hodgson Luke 
Published: September 2020

Objective
Abnormal biochemical measurements have previously been described in runners following marathons. The incidence of plasma sodium levels outside the normal range has been reported as 31%, and the incidence of raised creatinine at 30%. This study describes the changes seen in electrolytes and creatinine in collapsed (2010–2019 events) and noncollapsed (during the 2019 event) runners during a UK marathon.

Methods
Point-of-care sodium, potassium, urea and creatinine estimates were obtained from any collapsed runner treated by the medical team during the Brighton Marathons, as part of their clinical care, and laboratory measurements from control subjects.

Results
Results from 224 collapsed runners were available. Serum creatinine was greater than the normal range in 68.9%. About 6% of sodium results were below, and 3% above the normal range, with the lowest 132 mmol/l. Seventeen percent of potassium readings were above the normal range; the maximum result was 8.4 mmol/l, but 97% were below 6.0 mmol/l. In the control group, mean creatinine was significantly raised in both the collapse and control groups, with 55.4% meeting the criteria for acute kidney injury, but had resolved to baseline after 24 h. Sodium concentration but not the potassium was significantly raised after the race compared with baseline, but only 15% were outside the normal range.

Conclusion
In this study, incidence of a raised creatinine was higher than previously reported. However, the significance of such a rise remains unclear with a similar rise seen in collapsed and noncollapsed runners, and resolution noted within 24 h. Abnormal sodium concentrations were observed infrequently, and severely abnormal results were not seen, potentially reflecting current advice to drink enough fluid to quench thirst.
Influence of previous coronary artery bypass grafting in the difficulty of acute coronary syndrome diagnosis
Authors: Miró Òscar , Martínez-Nadal Gemma , Koechlin Luca , Coll-Vinent Blanca , Gil Víctor , Aguiló Sira , Galicia Miguel , García-Martínez Ana , Ortega Mar , Strebel Ivo , Ayala Pedro López , Gualandro Danielle M. , Boeddinghaus Jasper , Nestelberger Thomas , Bragulat Ernest , Sánchez Miquel , Müller Christian , López-Barbeito Beatriz 
Published: September 2020

Objectives
To investigate whether the diagnosis of acute coronary syndrome (ACS) in coronary artery bypass grafting (CABG) patients with chest pain (CP) is more difficult based on the initial clinical and electrocardiogram (ECG) findings.

Methods
We included consecutive CP patients attended at a single emergency department (ED) during a 10-year period. CABG status and the final diagnosis of ACS were considered as stated in the ED discharge report. We evaluated the frequency of 21 CP characteristics (CPC) and four ECG signatures, their individual and collective association with ACS, and ED length of stay (LOS) in CABG and non-CABG patients.

Results
We included 34 429 patients [median age: 61 years; female: 41.8%; CABG: 2204 patients (6.4%)], and ACS was diagnosed in 6727 (19.5%; CABG/non-CABG 37.2%/18.3%; P < 0.001). CABG patients more frequently had CPC and ECG findings typically associated with ACS, but their final association with ACS was weaker than in non-CABG patients (only significant after adjustment for attendant diaphoresis, throat irradiation, ST-segment elevation and T-wave inversion). The collective discriminative capacity was significantly lower in CABG patients (area under the curve 0.710 vs. 0.793; P < 0.001), even after adjustment (0.708 vs. 0.790; P < 0.001). ED LOS was longer for CABG patients, overall (P < 0.001) and for patients diagnosed with ACS (P = 0.008) and non-ACS (P < 0.001), but these differences disappeared after adjustment.

Conclusion
CABG substantially reduces the diagnostic performance of CPC and ECG findings to suggest ACS. A longer LOS in the ED in CABG patients is more related to their baseline characteristics than to CABG itself.
Prospective Exploratory Experience With Bivalirudin Anticoagulation in Pediatric Extracorporeal Membrane Oxygenation
Authors: Ryerson Lindsay M. , Balutis Kelsey R. , Granoski Donald A. , Nelson Lee-Ann R. , Massicotte M. Patricia , Lequier Laurance L. , Bauman Mary E. 
Published: September 2020

Objectives:Objective of this study was to determine if bivalirudin resulted in less circuit interventions than unfractionated heparin. A secondary objective was to examine associations between bivalirudin dose and partial thromboplastin time, international normalized ratio, and activated clotting time.Design:Prospective observational.Setting:Medical-surgical and cardiac PICUs.Patients:Neonatal and pediatric extracorporeal membrane oxygenation patients who received bivalirudin anticoagulation.Interventions:None.Measurements and Main Results:Twenty extracorporeal membrane oxygenation runs in 18 patients used bivalirudin; 90% were venoarterial. Median (interquartile range) age was 4.5 months (1.6–35 mo). Thirteen patients (72%) had an underlying cardiac diagnosis. Of the 20 runs using bivalirudin, 16 (80%) were initially started on unfractionated heparin and transitioned to bivalirudin due to ongoing circuit thrombosis despite therapeutic anti-Xa levels (n= 13), ongoing circuit thrombosis with unfractionated heparin greater than or equal to 40 U/kg/hr (n= 2), or absence of increase in ACT after bolus of 100 U/kg of unfractionated heparin and escalation of unfractionated heparin infusion (n= 1). Initial bivalirudin dose ranged from 0.2 to 0.5 mg/kg/hr; no bolus doses were used. Median (range) bivalirudin dose was 0.9 mg/kg/hr (0.15–1.6 mg/kg/hr). Median (interquartile range) time on extracorporeal membrane oxygenation was 226.5 hours (150.5–393.0 hr) including 84 hours (47–335 hr) on bivalirudin. Nonparametric results are as follows: the rate of circuit intervention was significantly lower in patients on bivalirudin than on unfractionated heparin (median [interquartile range]: 0 [0–1] and 1 [1–2], respectively; Wilcoxonp= 0.0126). Bivalirudin dose was correlated to PTT (rs= 0.4760;p< 0.0001), INR (rs= 0.6833;p< 0.0001), and ACT (rs= 0.6161;p< 0.0001). Four patients had a significant bleeding complication on bivalirudin. Survival to hospital discharge was 56%.Conclusions:Bivalirudin appears to be a viable option for systemic anticoagulation in pediatric extracorporeal membrane oxygenation patients who have failed unfractionated heparin, but questions remain namely its optimal monitoring strategy. This pilot study supports the need for larger prospective studies of bivalirudin in pediatric extracorporeal membrane oxygenation, particularly focusing on meaningful monitoring variables.
Significant Loss of Macronutrients During Passage Through Feeding Tube: An Observational Study
Authors: Moran-Lev Hadar , Azaiza Muhammad , Mangel Laurence , Mimouni Francis B. , Mandel Dror , Lubetzky Ronit 
Published: September 2020

Objective:
Feeding infants born before week 34 of gestation is based mainly on providing nutrition directly to the gastrointestinal tract through a nasogastric tube. Little is known about the impact of formulas passage through nasogastric tube on their macronutrient content. The aim of our study was to evaluate changes in macronutrient content of various formulas after transfer through a feeding tube.

Methods:
Eleven frequently used formulas were chosen. Ten consecutive measurements were performed for each formula. Simulated real-life practice tube feeding was performed by using an infusion pump connected to a feeding tube. A Human Milk Analyzer, using an infrared spectroscopy method, was used to compare the preinfusion and postinfusion macronutrient contents of the different formulas.

Results:
A total of 220 measurements were performed. Variations in at least one macronutrient were observed in 5 out of 10 formulas. Fat and energy content were modified in 1 preterm formula.

Conclusions:
Changes in the macronutrient content after tube feeding transfer were observed for some infant formulas, including those designed for very low birth weight infants. These alterations might relate to specific formulation of each formula. The biological significance of our results to the very low birth weight infants should be studied further.
Opportunities and challenges for physical rehabilitation with indigenous populations
Authors: Lin Ivan , Coffin Juli , Bullen Jonathan , Barnabe Cheryl 
Published: September 2020

Abstract
Indigenous peoples in colonised countries internationally experience a disproportionately high burden of disease and disability. The impact of many of these conditions, such as musculoskeletal pain, can be ameliorated by participating in physical rehabilitation. However, access by Indigenous peoples to physical rehabilitation is low. Overcoming barriers for Indigenous peoples to access high-quality, effective, culturally secure physical rehabilitation should be a priority. Physical rehabilitation outcomes for Indigenous peoples can be enhanced by addressing health system, health service, and individual clinician-level considerations. System-level changes include a greater commitment to cultural security, improving the funding of physical rehabilitation to Indigenous communities, building the Indigenous physical rehabilitation workforce, and developing and using Indigenous-identified indicators in quality improvement. At the health service level, physical rehabilitation should be based within Indigenous health services, Indigenous people should be employed as physical rehabilitation professionals or in allied roles, and cultural training and support provided to the existing physical rehabilitation workforce. For clinicians, a focus on cultural development and the quality of communication is needed. Indigenous ill-health is complex and includes societal and social influences. These recommendations offer practical guidance toward fair, reasonable, and equitable physical rehabilitation outcomes for Indigenous peoples.
Comparison of Efficiencies Between Shear Wave Elastography, Fine-Needle Aspiration Biopsy and American College of Radiology Thyroid Imaging Reporting and Data System Scoring System in Determining the Malignity Potential of Solid Thyroid Nodules
Authors: Yavuz Alpaslan , Akbudak İbrahim , Üçler Rifki , Özgökçe Mesut , Arslan Harun , Batur Abdussamed 
Published: September 2020

Abstract
We aimed to evaluate the efficiencies of quantitative shear-wave elastography, fine-needle aspiration (FNA) biopsy and American College of Radiology (ACR)-thyroid imaging reporting and data system (TIRADS) scoring system in determining the malignity potential of solid thyroid nodules. In period between September 2014 and January 2016, 191 solid thyroid nodules of 189 patients were enrolled in this study. The mean shear wave velocities of the nodules were recorded by acoustic radiation force impulse method. All nodules were classified according to ACR-TIRADS scoring system and underwent FNA procedure. The cytopathologic results (after FNA) were benign in nature, atypical-cytology/suspiciously malign and highly suspicious of malignity in 117, 28, and 21 nodules, respectively. The specimen from FNA was insufficient in 25 nodules. Thirty-four nodules of 33 enrolled patients were operated, and the efficiencies of shear wave elastography, FNA, and ACR-TIRADS procedures were statistically analyzed; relying on the histopathologic results, the shear-wave elastography had 83.3% sensitivity, 93.7% specificity (with a cutoff value of 2,74 m/s), the FNA had 94.4% sensitivity, 87.5% specificity, and ACR-TIRADS had 88.2% sensitivity, 94.1 specificity in determining malignant tyroid nodules (P < 0.005). Quantitative shear wave elastography is concluded to be an effective, noninvasive, and practical imaging modality with a lesser sensitivity and specificity values than TIRADS unless a lower sensitivity but a higher specificity values than FNA (93.7% vs 87.5%) in considering the malignity potential of solid thyroid nodules.
Correlation Between the Warrior/Worrier Gene on Post Burn Pruritus and Scarring: A Prospective Cohort Study
Authors: Oh Jamie , Fernando Amali , Muffley Lara , Honari Shari , Gibran Nicole S. 
Published: September 2020

Introduction:
Associations between genetic variation and clinical conditions suggest that single nucleotide polymorphisms (SNPs) might correlate with postburn outcomes. COMT modulates catecholamine metabolism, and polymorphisms within the rs4680 allele result in variable enzyme activity. Catechol-amines are known to modulate the inflammatory process and may affect scar formation. The aim of this study was to determine whether variants in the rs4680 SNP of the COMT gene are associated with post-burn pruritus and scarring.

Methods:
Adult burn patients, admitted between 2007 and 2017, with deep partial-thickness burns or delayed healing provided blood samples for genotyp-ing and self-reported itch scores within 1 year of injury. Scarring was measured using the Vancouver Scar Scale (VSS). Itch scores ≥ 4 and VSS scores >7 were considered severe. Genomic deoxyribonucleic acid was genotyped for the rs4680 SNP using realtime polymerase chain reaction (PCR).

Results:
Median itch and VSS scores were highest for GG homozygotes and lowest for AA homozygotes. This difference was statistically significant for VSS score (P < 0.0001) and approached significance for itch (P = 0.052). After accounting for confounding variables, including race/ethnicity, age, sex, and burn size, the GG homozygotes demonstrated worse scarring (odds ratio 1.88, P = 0.005) compared to AG heterozygotes whereas the AA homozygotes trended towards a protective effect against scarring (odds ratio 0.71, P = 0.10). itch did not demonstrate a statistically significant difference between rs4680 genotype.

Conclusions:
Our analysis identifies a trend between COMT genotype with scarring, with rs4680 genetic variation constituting an independent risk factor for VSS score.
Pro-IL-1β Is an Early Prognostic Indicator of Severe Donor Lung Injury During Ex Vivo Lung Perfusion
Authors: Major Triin , Ball Alexandra L. , Stone John P. , Edge Rebecca J. , Lopez-Castejon Gloria , Sjöberg Trygve , Andreasson Anders , Brough David , Steen Stig , Fisher Andrew J. , Fildes James E. 
Published: September 2020

Background.
Ex vivo lung perfusion (EVLP) is used to evaluate and recondition extended criteria donor lungs for transplantation. Interleukin-1β (IL-1β) has been identified as a prognostic indicator of nonrecovery during EVLP. This may be an effect of inflammasome activation or cellular necrosis following donation and graft preservation. Delineating the mechanism of IL-1β release is required.

Methods.
The inactive intracellular precursor molecule, pro-IL-1β, was characterized along with the pro-IL-1β processing enzyme, caspase-1, in the perfusate of n = 20 human lungs that had undergone EVLP (n = 10 lungs that failed to recover and were discarded versus n = 10 lungs that reconditioned and were transplanted). In an experimental porcine model, n = 8 lungs underwent EVLP and were randomized to receive either a specific NLRP3 inflammasome inhibitor or control.

Results.
Significant increases in pro-IL-1β and caspase-1 were observed in the perfusate from human lungs that did not recondition during EVLP compared with those that successfully reconditioned and were used for transplantation. Within the porcine EVLP, NLRP3 inflammasome inhibition reduced IL-1β within the perfusate compared with controls, but this had no impact on lung function, hemodynamics, or inflammation.

Conclusions.
Our data suggest that pro-IL-1β is passively released following cellular necrosis of the donor lung.
SCOAT-Net: A Novel Network for Segmenting COVID-19 Lung Opacification from CT Images
Authors: Zhao Shixuan , Li Zhidan , Chen Yang , Zhao Wei , Xie Xingzhi , Liu Jun , Zhao Di , Li Yongjie 
Published: September 2020

AbstractThe new coronavirus disease 2019 (COVID19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread worldwide at a rapid rate. There is no clinically automated tool to quantify the infection of COVID-19 patients. Automatic segmentation of lung opacification from computed tomography (CT) images provides excellent potential, which is of great significance for judging the disease development and treatment response of the patients. However, the segmentation of lung opacification from CT slices still faces some challenges, including the complexity and variability features of the opacity regions, the small difference between the infected and healthy tissues, and the noise of CT images. Besides, due to the limited medical resources, it is impractical to obtain a large amount of data in a short time, which further hinders the training of deep learning models. To answer these challenges, we proposed a novel spatial and channel-wise coarse-to-fine attention network (SCOAT-Net) inspired by the biological vision mechanism, which is for the segmentation of COVID-19 lung opacification from CT Images. SCOAT-Net has the spatial-wise attention module and the channel-wise attention module to attract the self-attention learning of the network, which serves to extract the practical features at the pixel and channel level successfully. Experiments show that our proposed SCOAT-Net achieves better results compared to state-of-the-art image segmentation networks.
Natrix: A Snakemake-based workflow for processing, clustering, and taxonomically assigning amplicon sequencing reads
Authors: Welzel Marius , Lange Anja , Heider Dominik , Schwarz Michael , Freisleben Bernd , Jensen Manfred , Boenigk Jens , Beisser Daniela 
Published: September 2020

AbstractSequencing of marker genes amplified from environmental samples, known as amplicon sequencing, allows us to resolve some of the hidden diversity and elucidate evolutionary relationships and ecological processes among complex microbial communities. The analysis of large numbers of samples at high sequencing depths generated by high throughput sequencing technologies requires effcient, flexible, and reproducible bioinformatics pipelines. Only a few existing workflows can be run in a user-friendly, scalable, and reproducible manner on different computing devices using an effcient workflow management system. We present Natrix, an open-source bioinformatics workflow for preprocessing raw amplicon sequencing data. The workflow contains all analysis steps from quality assessment, read assembly, dereplication, chimera detection, split-sample merging, sequence representative assignment (OTUs or ASVs) to the taxonomic assignment of sequence representatives. The workflow is written using Snakemake, a workflow management engine for developing data analysis workflows. In addition, Conda is used for version control. Thus, Snakemake ensures reproducibility and Conda offers version control of the utilized programs. The encapsulation of rules and their dependencies support hassle-free sharing of rules between workflows and easy adaptation and extension of existing workflows. Natrix is freely available on GitHub (https://github.com/MW55/Natrix).
Which waters hydrate best? A study using brine-shrimp cysts (Artemia franciscana)
Authors: Ye Tao , Pollack Gerald H. 
Published: September 2020

AbstractHydration plays a particularly important role in health maintenance and general well-being. A wide assortment of drinking waters are currently available on the market. However, their ability to hydrate may vary. For studying hydration, a useful organism may be the cysts of brine shrimp. Those cysts may remain dehydrated and functionless for years, but regain function once hydrated. In this study, we first determined the optimal factors for assessing hydration in the brine-shrimp model, including aeration method and flow rate, salinity, and temperature. Various kinds of water, including tap water, bottled water, and water containing health-promoting agents, were tested by using this new method to evaluate their ability to hydrate. Tap water showed weak hydration, while some bottled waters (e.g., Kirkland Signature Purified Water) hydrated more effectively. Mineral water, such as Fiji water, was found to be a desirable option to maintain adequate and lasting hydration.Graphic abstract
Evidence for and level of herd immunity against SARS-CoV-2 infection: the ten-community study
Authors: Jeremijenko Andrew , Chemaitelly Hiam , Ayoub Houssein H. , Hassan Abdulla Moza Abdellatif , Abou-Samra Abdul-Badi , Al Ajmi Jameela Ali A.A. , Al Ansari Nasser Ali Asad , Kanaani Zaina Al , Khal Abdullatif Al , Kuwari Einas Al , Al-Mohammed Ahmed , Al Molawi Naema Hassan Abdulla , Naomi Huda Mohamad Al , Butt Adeel A. , Coyle Peter , El Kahlout Reham Awni , Gillani Imtiaz , Kaleeckal Anvar Hassan , Masoodi Naseer Ahmad , Thomas Anil George , Nafady-Hego Hanaa , Latif Ali Nizar , Shaik Riyazuddin Mohammad , Younes Nourah B M , Abdul Rahim Hanan F. , Yassine Hadi M. , Al Kuwari Mohamed G. , Al Romaihi Hamad Eid , Al Thani Sheikh Mohammad , Bertollini Roberto , Abu-Raddad Laith J. 
Published: September 2020

ABSTRACTBackgroundQatar experienced a large severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) epidemic that disproportionately affected the craft and manual workers (CMWs) who constitute 60% of the population. This study aimed to investigate level of immunity in communities within this population as well as infection exposure required to achieve herd immunity.MethodsAnti-SARS-CoV-2 seropositivity was assessed in ten CMW communities between June 21 and September 9, 2020. PCR positivity, infection positivity (antibody and/or PCR positive), and infection severity rate were also estimated. Associations with anti-SARS-CoV-2 positivity were investigated using regression analyses.ResultsStudy included 4,970 CMWs who were mostly men (95.0%) and <40 years of age (71.5%). Seropositivity ranged from 54.9% (95% CI: 50.2-59.4%) to 83.8% (95% CI: 79.1-87.7%) in the different CMW communities. Pooled mean seropositivity across all communities was 66.1% (95% CI: 61.5-70.6%). PCR positivity ranged from 0.0% to 10.5% (95% CI: 7.4-14.8%) in the different CMW communities. Pooled mean PCR positivity was 3.9% (95% CI: 1.6-6.9%). Median cycle threshold (Ct) value was 34.0 (range: 15.8-37.4)—majority (79.5%) of PCR-positive individuals had Ct value >30 indicative of earlier rather than recent infection. Infection positivity (antibody and/or PCR positive) ranged from 62.5% (95% CI: 58.3-66.7%) to 83.8% (95% CI: 79.1-87.7%) in the different CMW communities. Pooled mean infection positivity was 69.5% (95% CI: 62.8-75.9%). Only five infections were ever severe and one was ever critical—an infection severity rate of 0.2% (95% CI: 0.1-0.4%).ConclusionsBased on an extended range of epidemiological measures, active infection is rare in these communities with limited if any sustainable infection transmission for clusters to occur. At least some CMW communities in Qatar have reached or nearly reached herd immunity for SARS-CoV-2 infection at a proportion of ever infection of 65-70%.