bluuebunny/crossref_metadata_2025_split huggingface dataset:
New Prediction Model for Cardiac Arrest Time of Palliative Care Patients in the Intensive Care Unit: A Single Center Retrospective Cohort Study
Authors: Takaki Shunsuke 
Published: September 2020

Abstract
Background: The trend of population ageing is a significant health issue in Japan and palliative care and end of life care are becoming key components of medical care. In the terminal care setting, the ability to accurately predict the time of death is an important research objective because it may allow family members to share valuable moments with the patient before death. Previous studies have investigated the time to death following withdrawal of therapy and several predictors of the time of death have been defined. The aim of this study was to determine an algorithm for the prediction of cardiac arrest time in the palliative care setting. Method: We retrospectively collected data of patients in the Yokohama City University Hospital between 2010 and 2016. Vital signs were collected until cardiac arrest, with continuous blood pressure recordings of <80 mmHg. We hypothesized that a breakdown of the autonomic nervous system was close to the time of cardiac arrest. We used the shock index (SI) defined as heart rate divided by systolic blood pressure (SBP) as the ratio variable for determination of the terminal phase. Results: A total of 4330 patients were admitted to the ICU. Of these, 19 patients were included to this study. We developed an exponential decay model using the SI and SBP: predicted Shock Index = 0.995 +(6.931-0.995) e -0.035 x SBP AUC 0.650 (0.512 to 0.788). The disparity between the real heart rate and predicted hear rate was -10 bpm (sensitivity, 49.9%; specificity, 75.8%; likelihood ratio, 2.06). In the validation data set, sensitivity was 52.7 %, specificity was 79.8 %, PPV was 35.7 %, and NPV was 88.8 %. LR was 2.61. Predicted residual time to cardiac arrest was calculated as follows: 12.3 + (0.18 x age) + (male: -6.0, female: 0) + (heart rate x 0.65) + (0.28 x Systolic Blood Pressure) + (0.34 x Heart Rate) + (-0.25 x Respiratory Rate). Conclusions: The new prediction model estimates the breakdown of the autonomic nervous system within 120 minutes of cardiac arrest. These algorithms might improve palliative care for last timing in the terminal situation.
Mutant Glucocorticoid Receptor Binding Elements on the Interleukin-6 Promoter Regulate Dexamethasone Effects
Authors: Chang Wen-Teng , Hong Ming-Yuan , Chen Chien-Liang , Hwang Chi-Yuan , Tsai Cheng-Chieh , Chuang Chia-Chang 
Published: September 2020

Abstract
BackgroundGlucocorticoids (GCs) have been extensively used as essential modulators in clinical infectious and inflammatory diseases. The GC receptor (GR) is a transcription factor belonging to the nuclear receptor family that regulates anti-inflammatory processes and releases pro-inflammatory cytokines. ResultsFive putative GR binding sites and other transcriptional factor binding sites were identified on the interleukin (IL)-6 promoter, and dexamethasone (DEX) was noted to reduce the lipopolysaccharide (LPS)-induced IL-6 production. Among mutant transcriptional factor binding sites, NF-κB, AP-1, and Sp1-2 sites reduced basal and LPS-induced IL-6 promoter activities through various responses. The first and third GR binding sites (GR2 and GR3) were noted to play a crucial role in both basal and inducible promoter activities in LPS-induced inflammation. ConclusionsWe concluded that selective GR2 and GR3 modulators might exert agonistic and antagonistic effects and could activate crucial signaling pathways during the LPS-stimulated inflammatory process.
Adaptation and Validation of the Portuguese Peabody Developmental Motor Scales - 2 edition: A Study With Children Aged 12 to 48 Months
Authors: Rebelo Miguel , Serrano João , Duarte-Mendes Pedro , Paulo Rui , Marinho Daniel Almeida 
Published: September 2020

Abstract
Background: The purpose of this study was to examine the psychometric properties of Peabody Developmental Motor Scales II (PDMS-2 - Folio & Fewell, 2000) using a Portuguese sample.Methods: The validation of the Portuguese version of the PDMS-2 was applied according to the manual, for 392 children, from two institutions, from 12 to 48 months, with an analysis of the internal consistency (α Cronbach), of Temporal Stability (ICC) and Construct validity (confirmatory factor analysis).Results: The results of the confirmatory factorial analysis (χ2 = 55.614; df=4; p=.06; χ2/df =13.904; SRMR=.065; CFI=.99, TLI=.99, RMSEA=.068) of two factors (Gross Motor and Fine Motor) as the original version. Most of the subtests had good internal consistency (α = .85) and good test-retest stability (ICC = .98 to .99).Conclusions: These results indicate that the Portuguese version of the PDMS-2 is an accurate and valid instrument to evaluate the gross and fine motor skills of children aged 12 to 48 months, can be used as a reference instrument by health and education professionals, as an indicator and support for the assessment of motor skills, thus having a assessment instrument that allows to detect maladjustments, deficiencies or precociousness, so that the child can later receive the appropriate intervention
A Comparison of Random Forest and Decision Tree for Suicide Ideation Classification
Authors: Mohammadian-Khoshnoud Mayam , Omidi Tahereh , Faradmal Javad , Poorolajal Jalal 
Published: September 2020

Abstract
Background: Suicide resulted from complex interaction factors. Most classical statistical methods were not efficiently enough to cover this complexity. With the new branch of statistics as statistical/machine learning, complex relationships between risk factors and responses can be modeled. Methods: We aimed to identify the high-risk groups for suicide using different classification methods including logistic regression(LR), decision tree(DT), and random forest(RF). Also, the prediction accuracy of the models is compared. This study used data obtained from a cross-sectional study conducted in in the Hamadan University of Medical Sciences from 2015-2016 to investigate the prevalence of suicidal ideation and related risk factors among university students. The LR, DT, and RF models were used to evaluate the high-risk group for suicide. Finally, the applied all three models were compared using sensitivity(SE), specificity(SP), and the area under receiver operating characteristics (ROC) curves. Results: In the training sample, the area under the ROC curve of the DT was greater than the LR and RF. But in the validation sample, the RF model has the best performance and the DT has the worst performance among these methods.Discussion: In this study, the risk factors for suicide were different for men and women. According to the results of the DT, substance abuse, average, general health score, faculty of education, depression were the risk factors on suicidal ideation in both genders. But despair about the future, residence (parents' house/dormitory) were among the factors contributing to the suicidal ideation of men. On the other hand, parents’ education, interested in the discipline and anxiety influence factors on suicidal ideation in women. The results of RF indicated that depression, general health score, average, anxiety and substance abuse were important risk factors for suicidal ideation in both genders. Also, the faculty of education and age are risk factors for suicide in women. Conclusions: In the training sample, the DT had better performance but in the validation sample, the RF model provided better results. The LR was the best model for diagnosis of the patient and the DT and RF are considered the best models to diagnosis a healthy individual.
Relationship Between Surgical R0 Resectability and Findings of Peripancreatic Vascular Invasion on CT Imaging After Neoadjuvant S-1 and Concurrent Radiotherapy in Patients with Borderline Resectable Pancreatic Cancer
Authors: Yasuta Sho , Kobayashi Tatsushi , Aizawa Hidetoshi , Takahashi Shinichiro , Ikeda Masafumi , Konishi Masaru , Kojima Motohiro , Kuno Hirofumi , Uesaka Katsuhiko , Morinaga Soichiro , Miyamoto Atsushi , Toyama Hirochika , Takakura Norihisa , Sugimachi Keishi , Takayama Wataru 
Published: September 2020

Abstract
BackgroundBorderline resectable pancreatic cancer (BRPC) is frequently associated with positive surgical margins and a poor prognosis because the tumor is in contact with major vessels. This study evaluated the relationship between the margin-negative (R0) resection rate and findings indicating peripancreatic vascular invasion on multidetector computed tomography (MDCT) imaging after neoadjuvant chemoradiotherapy (NACRT) in patients with BRPC.MethodsTwenty-nine BRPC patients who underwent laparotomy after neoadjuvant S-1 with concurrent radiotherapy were studied retrospectively. Peripancreatic major vessel invasion was evaluated based on the length of tumor-vessel contact on MDCT. The R0 resection rates were compared between the progression of vascular invasion (PVI) group and the non-progression of vascular invasion (NVI) group. ResultsThere were 3 patients with partial responses (10%), 25 with stable disease (86%), and 1 with progressive disease (3%) according to the RECISTv1.1 criteria. Regarding vascular invasion, 9 patients (31%) were classified as having PVI, and 20 patients (69%) were classified as having NVI. Of the 29 patients, 27 (93%) received an R0 resection, and all the PVI patients received an R0 resection (9/9; R0 resection rate = 100%). The R0 resection rates did not differ significantly between the PVI and NVI groups (P = 1.000, 100% vs. 90%).ConclusionsPatients with BRPC after NACRT achieved high R0 resection rates regardless of the vascular invasion status. BRPC patients can undergo R0 resections unless progressive disease is observed after NACRT.Trial registrationUMIN-CTR, UMIN000009172. Registered 23 October 2012, https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000010762
Expression Dominance and Homeolog Expression Bias Upon Chilling Stress in A Hybrid Weed Between the Invasive Sphagneticola Trilobata and the Native S. Calendulacea in South China and its Implications for Invasiveness
Authors: Wu Wei , Ni Guangyan , Wang Longyuan , Zhang Hui , Li yongquan , Chen Ping , Guo Wei 
Published: September 2020

Abstract
Background The role of hybridization or admixture in the biological invasion has been recognized in many invasive species. S ubgenome dominance was reported to occur instantly following the hybridization of divergent genomes, however, investigations on their consequences on physiological response were still scarce . For invasive species, thermotolerance was critical to their range expansions. In this study, a F1 weed between a chilling sensitive invasive S. trilobata and the tolerant native S. calendulacea were treated with consecutive chilling stress, Using physiological assay and RNA-sequencing, differential physiological response and transcriptome profile s were compared with a n emphasis on the patterns of the expression dominance and homeolog expression bias in the F1 hybrids. Results P hysiological assay including content of Malondialdehyde content, superoxide dismutase activity and et al. demonstrated these F1s resembled the chilling tolerant maternal parent S. calendulacea . For both parents and the F1, the numbers and categories of the enriched pathways or gene ontology terms showed extensive divergence, and an overall resemblance between F1s and S. calendulacea w as observed. For the homeologs with altered expression, expression level dominance was the most prominent pattern. With increased chilling stress, the increased magnitude of up-regulations and decreased magnitude of down-regulations of the Spc- homeologs in the F1s were jointly contributed to the ir resemblance to chilling tolerant parent S. calendulacea . Irrespective of the total homeolog expressive level, increased magnitude of homeolog expression bias toward the chilling tolerant parent S. calendulacea in the F1s also provided another line of evidence for their physiological resemblance. Conclusion The two Sphagneticola species showed significant differential response upon chilling stress. expression dominance and persistent S. calendulacea homeolog bias in the F1s were attributed to the overall resemblance to the tolerant native species S. calendulacea. Given their vigorous growth, it cations us that the F1 hybrid have great potential to expand northwards and become an awesome weed in the future.
The Landscape of Renal Replacement Therapy in Veterans Affairs Medical Center Intensive Care Units
Authors: Vangala Chandan , Shah Maulin , Dave Natasha N. , Attar Layth Al , Navaneethan Sankar D. , Ramanathan Venkat , Crowley Susan , Winkelmayer Wolfgang C. 
Published: September 2020

Abstract
Background Outpatient dialysis is standardized with several evidence-based measures of adequacy and quality that providers aim to meet while providing treatment. By contrast, in the intensive care unit (ICU) there are different types of continuous and prolonged renal replacement therapies with numerous and varied strategies for addressing patient care and a dearth of nationally accepted quality parameters. In order to eventually understand what quality measures are appropriate for ICU-related renal replacement therapy (RRT), we first aimed to capture the variety and prevalence of basic strategies and equipment utilized in the ICUs of Veteran Affairs (VA) medical facilities with inpatient hemodialysis capabilities.Methods Via email to the dialysis directors of all 87 VA facilities that provided inpatient hemodialysis during 2018, we requested participation in a survey regarding aspects of RRT in VA ICUs. Questions centered around mode of therapy, equipment, solutions, prescription authority, nursing, anticoagulation, antimicrobial dosing, and access.Results Seventy-six centers completed the questionnaire, achieving a response rate of 87.4%. Fifty-five centers or 72.4%, reported using some form of prolonged or continuous renal replacement therapy (CRRT) in addition to intermittent hemodialysis. Of these 55 centers, 42 reported being specifically CRRT-capable. Over half of the respondents had the capabilities to perform prolonged intermittent renal replacement therapy (PIRRT). Twelve centers (21.8%) were equipped to use slow low efficient dialysis (SLED) alone. Therapy was overwhelmingly prescribed by nephrologists (94.4% of centers).Conclusions Within the VA system, ICU-related RRT practice is quite varied. Variation in processes of care, prescription authority, RRT nursing care coordination, medication management, and safety practices present opportunities for developing cross cutting measures of quality of intensive care RRT that are agnostic of modality choice.
COVID-19 Induced Stress, Lifestyle Changes and Weight-gain in Youth during a 4-Month Lockdown: A Prospective Cohort Study
Authors: Liu Suixin , Dun Yaoshan , Jeffrey Ripley-Gonzalez , Zhou Nanjiang , You Baiyang , Li Qiuxia , Li Hui , Zhang Wenliang , Thomas Randal , Olson Thomas , Liu Jie , Dong Yuchen 
Published: September 2020

Abstract
The COVID-19 (coronavirus disease-19) has resulted in nationwide lockdowns, cessation of school and work, and social distancing. Reducing the negative impacts, such as weight-gain, has garnered global attention. In this dual-center prospective cohort study of 12,889 students, we assessed weight-gain in a youth during the 4-month COVID-19 lockdown, and examined the associations between weight-gain and COVID-19 induced stress, depression and self-reported physical activity, dietary habits and sedentary time. Participants gained an average of 2.6 kg (95% CI: 2.0 to 3.2 kg) for males and 2.1 kg (1.9 to 2.4 kg) for females. An increase in overweight and obese individuals as a demographic percentage by 4.5% and 2.7% and 4.8% and 3.4% in males and females respectively (P<0.001). Weight change was independently associated with severe COVID-19 induced stress, sedentary time, and depression score. Techniques to relieve COVID-19 induced stress, reduce sedentary time through increased physical activity, and improve dietary habits in youth may be warranted to help prevent and/or reverse weight-gain associated with the lockdown period of COVID-19.Registration: Registered with ChiCTR, registration no.: ChiCTR2000033514
Use and Impact of High Intensity Treatments in Patients with Traumatic Brain Injury Across Europe: A CENTER-TBI Analysis
Authors: Huijben Jilske , Dixit Abhishek , Stocchetti Nino , Maas Andrew , Lingsma Hester , Jagt Mathieu van der , Nelson David , Citerio Giuseppe , Wilson Lindsay , Menon David , Ercole Ari 
Published: September 2020

Abstract
Purpose: To study variation in, and clinical impact of high Therapy Intensity Level (TIL) treatments for elevated intracranial pressure (ICP) in patients with traumatic brain injury (TBI) across European Intensive Care Units (ICUs).Methods: We studied high TIL treatments (metabolic suppression, hypothermia (<35oC), intensive hyperventilation (PaCO2 <4 kPa), and secondary decompressive craniectomy) in patients receiving ICP monitoring in the ICU stratum of the CENTER-TBI study. A random effect logistic regression model was used to determine between-centre variation in their use. A propensity score-matched model was used to study the impact on outcome (6-months Glasgow Outcome Score-extended(GOSE)), whilst adjusting for case-mix severity, signs of brain herniation on imaging, and ICP.Results: 313 of 758 patients from 52 European centres (41%) received at least one high TIL treatment with significant variation between centres (median odds ratio = 2.4). Patients often transiently received high TIL therapies without escalation from lower tier treatments. 38% of patients with high TIL treatment had favourable outcomes (GOSE > 5). The use of high TIL treatment was not significantly associated with worse outcome (285 matched pairs, OR: 1.4, 95% CI [1.0 -2.0]). However, a sensitivity analysis excluding high TIL treatments at day 1 or use of metabolic suppression at any day did reveal a statistically significant association with worse outcome.Conclusion: Substantial between-centre variation in use of high TIL treatments for TBI was found and treatment escalation to higher TIL treatments were often not preceded by more conventional lower TIL treatments. The significant association between high TIL treatments after day 1 and worse outcomes may reflect aggressive use or unmeasured confounders or inappropriate escalation strategies.Take home message: Substantial variation was found in the use of highly intensive ICP-lowering treatments across European ICUs and a stepwise escalation strategy from lower to higher intensity level therapy is often lacking. Further research is necessary to study the impact of high therapy intensity treatments.Trial registration: The core study was registered with ClinicalTrials.gov, number NCT02210221, registered 08/06/2014, https://clinicaltrials.gov/ct2/show/NCT02210221?id=NCT02210221&draw=1&rank=1 and with Resource Identification Portal (RRID: SCR_015582).
Prediction of Mortality in a Patient With Acute Poisoning
Authors: Han Kap Su , Kim Su Jin , Lee Eui Jung , Shin Joong Ho , Lee Ji Sung , Lee Sung Woo 
Published: September 2020

Abstract
Objective: This study aimed to develop a scoring system for predicting the in-hospital mortality of acute poisoning patients at the emergency department (ED). Methods: This was a retrospective analysis of the Injury Surveillance Cohort generated by the Korea Center for Disease Control and Prevention (KCDC) from 2011–2018. We developed the new-Poisoning Mortality Scoring system (new-PMS) to generate a prediction model using the derivation group (2011–2017 KCDC cohort). Points were computed for each category of each variable. The sum of these points was the new-PMS. The validation group (2018 KCDC cohort) was subjected to external temporal validation. The performance of new-PMS in predicting mortality was evaluated using receiver operating characteristic (ROC) curves for both groups. For simple interpretation in clinical settings, risk groups were categorized as very low, low, intermediate, and high according to the new-PMS; we suggested the mortality curve according to new-PMS. Results: Of 57326 poisoning cases, 42568 were selected. Of these, 34352 (80.7%) and 8216 (19.3%) were enrolled in the derivation and validation groups, respectively. New-PMS was the sum of points for each category of 10 predictors. The range of new-PMS was -20 to 3420 points. The area under the ROC curve of new-PMS was 0.942 (95% CI: 0.934–0.949) and 0.946 (95% CI: 0.930–0.963) for the derivation and validation groups, respectively. The mean predicted mortality and the observed mortalities of the high-risk group (new-PMS ≥1048) were 9.7% (95% CI: 9.3 – 10.0) and 10.0% for the derivation group and 8.4% (95% CI: 7.7 – 9.1) and 7.4% for the validation groups, respectively. Conclusions: New-PMS showed good performance in predicting in-hospital mortality for both groups. As mortality sharply increased with the high risk-group of the new-PMS, early hemodynamic stabilization of acute poisoning patients at the ED may improve their clinical outcomes. New-PMS contributes to clinical decision-making for acute poisoning patients in clinical settings.
Identification of Key Genes in HCV-induced HCC at Early Stage on the Background of HCV-cirrhosis
Authors: Nie Jiao , Du Chao , Lu Lin , Gao Xiaozhong 
Published: September 2020

Abstract
Background: Hepatocellular carcinoma (HCC) is one of the most common and deadly malignant tumors worldwide. Hepatitis C virus (HCV)-induced cirrhosis (HCV-cirrhosis) is one of the leading causes of HCC occurrence. Due to the lack of effective biomarkers, most patients with HCV-induced HCC (HCV-HCC) are at advanced stages when they are first diagnosed. Our study aims to employ transcriptomic profiling dataset to identify potential biomarkers that can predict HCV-HCC at early stage on the background of HCV-cirrhosis. Methods: The dataset incorporating HCV-cirrhosis and HCV-HCC subjects at different stages from Gene Expression Omnibus was analyzed to identify gene signature-related to HCV-HCC on the background of HCV-cirrhosis. Multiple-genes based risk score-related prediction model was established to predict HCV-HCC samples at different stages, and receiver-operating characteristic (ROC) curve analysis was used to select the best cutoff value of risk scores for prediction and to evaluate the prediction model. Samples with risk scores higher than cutoff value were defined as high score group.Results: Highly clustered 20 genes were identified and were all gradually increased as HCV-HCC progressed from HCV-cirrhosis to very advanced HCC. Compared with HCV-cirrhosis, the prevalence of HCV-HCC at any of the stages in high score group was 100%. The risk score-related prediction model based on the 20 genes-biomarker got the accuracy of over 95.2 % with area under ROC (AUC) over 0.94. To implement the biomarker easily in real life and make it economical, we tried to limit the gene numbers. Interestingly, CDKN3 and FAM83D were significantly decreased in HCV-cirrhosis tissues as compared to normal tissues and then increased as HCV-HCC progressed. The results were attractive that the prediction model based on this 2 genes-biomarker indicated that prevalence of HCV-HCC in high score group was still 100% and got the predictive accuracy of over 95.2 % with AUC over 0.96, revealing even a better performance.Conclusion: Our study indicated a 2-genes-based biomarker that could identify HCV-HCC at earlier stages on the background of HCV-cirrhosis, which might be a promising biomarker for early diagnosis of HCV-HCC and potential novel treatment target.