bluuebunny/crossref_metadata_2025_split huggingface dataset:
Human embryonic stem cell-derived mesenchymal stem cells have potential of high differentiation into hepatocyte-like cells through increased level of hepatocyte growth factor
Authors: Lee Ji-Seon , Yoon Dajeong , Yoon Dogeon , Yeo Changhwan , Chun Wook 
Published: August 2020

Abstract
Background: As the aging society progresses, more patients are waiting for liver transplantation. However, the function of existing bio artificial liver is insufficient. Recently, research has been focused on stem cells to regenerate damaged liver. Most of all, the obstacle to the commercialization of widely used human adipose tissue-derived stem cells (hASCs) therapy is the limited supply of cells with consistent quality although most cell source of current stem cell therapy is hASCs. In this study, we attempt to differentiate human embryonic stem cell-derived mesenchymal stem cells (hESC-MSCs) into hepatocyte-like cells and tested whether hESC-MSCs have a potential of liver regeneration as a source of cell therapy, considering that they have characteristics of high differentiation rates, unlimited proliferation possibility from a single colony, and homogenicity.Methods: hESC-MSCs and hASCs were cultured under condition of hepatogenic differentiation in vitro. And then various experiments including quantitative real-time PCR, immunoblotting, ELISA, immunofluorescence, Periodic acid-Schiff staining and flow cytometry analysis were performed to evaluate expression level of HGF and the extent of differentiation into hepatocyte-like cells.Results: We found that hepatocyte growth factor (HGF), important for maintaining hepatocyte activity, is highly expressed in hESC-MSCs. Besides, it was confirmed that the expression of ALB, TDO2, and CYP2E1, which are the hepatocyte-specific genes when hepatogenic differentiation was performed under conditions even without HGF in hESC-MSCs, was higher than that when hASCs was differentiated into hepatocytes. Likewise, we concluded that hESC-MSCs could be well-differentiated into hepatocyte-like cells compared to hASCs through staining data.Conclusions: We propose that hESC-MSCs have a promising potential as a commercial cell therapy source to treat liver failure in view of the limited available cell sources for stem cell therapy.
An Iteration Model for Identifying Essential Proteins by Combining Comprehensive PPI Network With Biological Information
Authors: Li Shiyuan , Zhang Zhen , Li Xueyong , Tan Yihong , Wang Lei , Chen Zhiping 
Published: August 2020

Abstract
Background: Essential proteins have great impacts on cell survival and development, and played important roles in disease analysis and new drug design. However, since it is inefficient and costly to identify essential proteins by using biological experiments, then there is an urgent need for automated and accurate detection methods. In recent years, the recognition of essential proteins in protein interaction networks (PPI) has become a research hotspot, and many computational models for predicting essential proteins have been proposed successively.Results: In order to achieve higher prediction performance, in this paper, a new prediction model called TGSO is proposed. In TGSO, a protein aggregation degree network is constructed first by adopting the node density measurement method for complex networks. And simultaneously, a protein co-expression interactive network is constructed by combining the gene expression information with the network connectivity, and a protein co-localization interaction network is constructed based on the subcellular localization data. And then, through integrating these three kinds of newly constructed networks, a comprehensive protein-protein interaction network will be obtained. Finally, based on the homology information, scores can be calculated out iteratively for different proteins, which can be utilized to estimate the importance of proteins effectively. Moreover, in order to evaluate the identification performance of TGSO, we have compared TGSO with 13 different latest competitive methods based on three kinds of yeast databases. And experimental results show that TGSO can achieve identification accuracies of 94\%, 82\% and 72\% out of the top 1\%, 5\% and 10\% candidate proteins respectively, which are to some degree superior to these state-of-the-art competitive models. Conclusion: We constructed a comprehensive interactive network based on multi-source data to reduce the noise and errors in the initial PPI, and combined with iterative methods to improve the accuracy of necessary protein prediction, and means that TGSO may be conducive to the future development of essential protein recognition as well.
Effectiveness of a multidimensional intervention program in improving occupational musculoskeletal disorders among intensive care units nurses: a cluster controlled trial with follow-up at 3 and 6 months
Authors: Yang Shuai , Li Li , Wang Liqian , Zeng Jiaqi , Yan Bin , Li Yinglan 
Published: August 2020

Abstract
Background: Intensive care unit (ICU) nurses are at high risk for work-related musculoskeletal disorders (WRMDs). Data on occupational injuries indicate the significance of WRMDs among ICU nurses. Intervention programs have previously been developed to reduce WRMDs, but different intervention methods need to be adopted for different groups of people. This study aimed to evaluate the effectiveness of a multidimensional intervention program to prevent and reduce WRMDs in ICU nurses.Methods: The study was designed as a two-armed cluster controlled trial with an intervention group and a control group. The clusters were independent hospital ICUs, and the participants consisted of registered nurses. By cluster random sampling, 89 nurses from 2 ICUs were assigned to the intervention group, and 101 nurses from 2 other ICUs were assigned to the control group. A multidimensional intervention program based on previous studies was designed. This program combined improving risk perception, health behavior training, and promoting a safe working environment. The multidimensional intervention program was implemented in the intervention group, whereas the routine specialist training was implemented in the control group. Baseline and follow-up (3 and 6 months) data were collected using self-reported online questionnaires. The primary outcome was the report rate of WRMDs in the past 7 days. Secondary outcomes were risk perception, health behavior applied, and perception of a safe working environment. The data were statistically analyzed using SPSS 19.0. Results: A total of 190 nurses provided 3 recorded outcome measurement (intervention group N=89 (94.68%); control group N=101 (94.39%)). After 6 months, the intervention group experienced significant improvement relative to the control group in the report rate of WRMDs in the past 7 days (OR=0.512, p =0.038), risk perception (OR=0.517, p <0.001), health behavior training (OR=0.025, p <0.001), and perception of a safe working environment (OR=1.637, p =0.024). Conclusion: The multidimensional intervention program was superior to routine specialist training in preventing the occurrence of WRMDs in ICU nurses. WRMD training should include multifaceted approaches and pay increased attention to specific aspects of the departmental function.
Workforce Experience of the Implementation of An Advanced Clinical Practice Framework in England: A Mixed Methods Evaluation
Authors: Lawler Jessica , Maclaine Katrina , Leary Alison 
Published: August 2020

Abstract
Background This study aims to understand how the implementation of the Advanced Clinical Practice framework in England (2017) was experienced by the workforce to check assumptions for a national workforce modelling project. The Advanced Clinical Practice framework was introduced in England in 2017 by Health Education England to clarify the role of advanced practice in the National Health Service. Methods: As part of a large-scale workforce modelling project, a self-completed questionnaire was distributed via the Association of Advanced Practice Educators UK aimed at those studying to be an Advanced Clinical Practitioner or who are practicing at this level in order to check assumptions. Semi-structured phone interviews were carried out with this same group. Questionnaires were summarised using descriptive statistics in Excel for categorical responses and interviews and survey freetext were analysed using thematic analysis using NVivo 10. Results: The questionnaire received over 500 respondents (a response rate ten times that expected) and 15 interviews were carried out. Advanced Clinical Practice was considered by many the only viable clinical career progression. Respondents felt that employers were not clear about what practicing at this level involved or its future direction. 54% (287) thought that ACP was the right job title. 19% (98) of respondents wanted their origin registered profession to be included in their title. Balancing Advanced Clinical Practice education concurrently with a full-time role was challenging, participants underestimated the workload and expectations of employers training. There is an apparent dichotomy that has developed from the implementation of the 2017 framework, that of Advanced Clinical Practice as an advanced level of practice within a profession, and that of Advanced Clinical Practitioner as a new generic role in the medical model. Conclusions: Efforts to establish further clarity and structure around advanced clinical practice are needed for both the individuals practising at this level and their employers. A robust evaluation of the introduction of this role should take place.
Prone Positioning in Moderate to Severe Acute Respiratory Distress Syndrome due to COVID-19: A Cohort Study and Analysis of Physiology
Authors: Shelhamer Mehdi , Wesson Paul D. , Solari Ian L. , Jensen Deanna L. , Steele William Alex , Dimitrov Vihren G. , Kelly John Daniel , Aziz Shazia , Gutierrez Victor Perez , Vittinghoff Eric , Chung Kevin K. , Menon Vidya P. , Ambris Herman A. , Baxi Sanjiv M. 
Published: August 2020

Abstract
BACKGROUND: Coronavirus disease 2019 (COVID-19) can lead to acute respiratory distress syndrome (ARDS) but it is unknown whether prone positioning improves outcomes in mechanically ventilated patients with moderate to severe ARDS due to COVID-19.METHODS: A cohort study at a New York City hospital at the peak of the early pandemic in the United States, under crisis conditions. The aim was to determine the benefit of prone positioning in mechanically ventilated patients with ARDS due to COVID-19. The primary outcome was in-hospital death. Secondary outcomes included changes in physiologic parameters. Fine-Gray competing risks models with stabilized inverse probability treatment weighting (sIPTW) were used to determine the effect of prone positioning on outcomes. In addition, linear mixed effects models (LMM) were used to assess changes in physiology with prone positioning.RESULTS: Out of 335 participants who were intubated and mechanically ventilated, 62 underwent prone positioning, 199 met prone positioning criteria and served as controls and 74 were excluded. The intervention and control groups were similar at baseline. In multivariate-adjusted competing risks models with sIPTW, prone positioning was significantly associated with reduced mortality (SHR 0.61, 95% CI 0.46-0.80, P < 0.005). Using LMM to evaluate the impact of positioning maneuvers on physiological parameters, the oxygenation-saturation index was significantly improved during days 1-3 (P < 0.01) whereas oxygenation-saturation index (OSI), oxygenation-index (OI) and arterial oxygen partial pressure to fractional inspired oxygen (PaO2:FiO2) were significantly improved during days 4-7 (P < 0.05 for all). CONCLUSIONS: Prone positioning in patients with moderate to severe ARDS due to COVID-19 is associated with reduced mortality and improved physiologic parameters. One in-hospital death could be averted for every eight patients treated. Replicating results and scaling the intervention are important, but prone positioning may represented an additional therapeutic option in patients with ARDS due to COVID-19.
Development of an immunogenomics-based prognostic index model of laryngeal squamous cell carcinoma
Authors: Shen Yujie , Zhou Han , Dong Shikun , Lu Meiping , Dong Weida , Zhang Liqing 
Published: August 2020

Abstract
Background: The immune system greatly affects the prognosis of various malignancies. Studies on differentially expressed immune-related genes (IRGs) in the immune microenvironment of laryngeal squamous cell carcinoma (LSCC) have rarely been reported.Methods: In this paper, the prognostic potentials of IRGs in LSCC were explored. The RNAseq dataset containing differentially expressed IRGs and corresponding clinical information of LSCC patients was obtained from The Cancer Genome Atlas (TCGA). A total of 371 up-regulated and 61 down-regulated IRGs were identified. Subsequent functional enrichment analysis revealed that the pathway of IRGs was mainly enriched in the cytokine-cytokine receptor interaction. Then, 30 IRGs with prognostic potentials in LSCC were screened out, and the regulatory network induced by relevant transcription factors (TFs) were constructed.Results: Finally, multivariate Cox regression analysis was conducted to assess the prognostic potential of 15 IRGs after adjustment of clinical factors and LSCC patients were classified into 2 subgroups based on different outcomes. The gene expression of the model was verified by other independent databases. Nomogram including the 15 IRGs signature was established and shown some clinical net beneft. Intriguingly, B cells were significantly enriched in the low-risk group. Conclusion:These findings may contribute to the development of potential therapeutic targets and biomarkers for the new-immunotherapy of LSCC.
Vaginal microbiota and cytokine levels predict preterm delivery in Asian women
Authors: Kumar Manoj , Murugesan Selvasankar , Singh Parul , Saadaoui Marwa , Elhag Duaa Ahmed , Terranegra Annalisa , Kabeer Basirudeen Syed Ahamed , Marr Alexandra K , Kino Tomoshige , Brummaier Tobias , McGready Rose , Nosten François , Chaussabel Damien , Khodor Souhaila Al 
Published: August 2020

Abstract
Background: Preterm birth (PTB) is the most common cause of neonatal morbidity and mortality worldwide. Approximately half of PTBs are linked with microbial etiologies, including pathologic changes to the vaginal microbiota, which vary according to ethnicity. Globally more than 50% of PTBs occur in Asia, but studies of the vaginal microbiome and its association with pregnancy outcomes in Asian women are lacking. This study aimed to characterize the vaginal microbiome and cytokine environment of 18 Karen and Burman pregnant women who delivered preterm and 36 matched controls delivering at full term. Results: Using 16S ribosomal RNA gene sequencing we identified a predictive vaginal microbiota signature for PTB that was detectable as early as the first trimester of pregnancy, characterized by higher levels of Prevotella buccalis , and lower levels of Lactobacillus crispatus and Finegoldia , accompanied by decreased levels of cytokines including IFNγ, IL-4 and TNFα. Conclusion: Our findings highlight new opportunities to predict PTB in Asian women in low-resource settings who are at highest risk of adverse outcomes from unexpected PTB, as well as in Burman/Karen ethnic minority groups in high-resource regions.
Challenges and Reforms in Midwifery and Nursing Regulatory Systems in India: Implications for Education and Practice
Authors: Mayra Kaveri , Padmadas Sabu , Matthews Zoë 
Published: August 2020

Abstract
Background: Quality of maternal healthcare is determined by the strength of the regulatory framework in which health workers practice. Nursing regulation is poor and midwifery coexists with nursing in India, where 88% of midwifery and nursing education is provided by the private sector. The Indian health system faces major challenges for maternal health provision, with a 12% share of total maternal deaths globally, poor quality, indeterminate regulatory functions and lack of reforms. Methods: We undertake a qualitative investigation to understand the experiences and perceptions of nurse-midwife leaders on midwifery and nursing regulatory systems in India and further examine their influence on midwifery education and development. Thirty-four in-depth interviews were conducted with senior midwifery and nursing leaders representing administration, advocacy, education, regulation, research and service provision. Results: Our findings shows a lack of importance accorded to midwifery roles within the nursing system. The councils and statutes do not adequately reflect midwifery practice, and hence they are a barrier to good quality care provision. The lack of amendment of Acts and lack of representation of midwives and nurses in key governance positions in councils and committees have restrained or undermined leadership positions, which in turn has also impaired the growth of the profession. The regulatory framework standards for midwifery and nursing education in private institutions appeared imprudent with lack of opportunities for practice and unfair assessment practices. Discrimination against midwifery and nursing students was rampant in the education system in public and private institutions, with limited opportunities for clinical practice when compared to medical students. Conclusions: The study concludes with a reform measure including a recommendation for implementing direct-entry midwifery education, empowering midwives and nurses with autonomy, decision-making powers within health care and workforce governance.
Effectiveness of Mid-Regional Pro-Adrenomedullin (MR-proADM) as Prognostic Marker in COVID-19 Critically Ill Patients: an Observational Prospective Study
Authors: Montrucchio Giorgia , Sales Gabriele , Rumbolo Francesca , Palmesino Filippo , Fanelli Vito , Urbino Rosario , Filippini Claudia , Mengozzi Giulio , Brazzi Luca 
Published: August 2020

Abstract
Background Due to the lack of validated biomarkers to predict disease progression and mortality in COVID-19 ICU-patients, we tested the effectiveness of mid-regional pro-adrenomedullin (MR-proADM) in comparison to C-reactive protein (CRP), procalcitonin (PCT), D-dimer, lactate dehydrogenase (LDH) in predicting outcome.Methods All consecutive COVID-19 adult patients admitted between March and June 2020 to the ICU of the ‘Città della Salute e della Scienza’ hospital in Turin (Italy) were enrolled. MR-proADM, clinical and routine laboratory test were measured within 48 hours from ICU admission, on day 3, 7 and 14. Survival curves difference with MR-proADM cut-off set to 1.8 nmol/L were tested using log-rank test. Predictive ability was compared using area under the curve and 95% confidence interval of different receiver-operating characteristics curves. Potential confounding effects were tested using a logistic regression model. Results Fifty-seven patients were enrolled. ICU and overall mortality were 54.4%. Within the first 24 hours, lymphocytopenia was present in 86%; increased D-dimer and CRP levels were found in 84.2% and 87.7% respectively, while PCT values higher than 0.5 μg/L were observed in 47.4%. MR-proADM, CRP and LDH were significantly different between surviving and non-surviving patients and over time, while PCT, D-dimer and NT-pro-BNP did not show any difference between the groups and over time; lymphocytes count was different between surviving and non-surviving patients only.MR-proADM was higher in dying patients (2.65+2.33vs1.18+0.47, p=0.0001) and a higher mortality characterized patients with MR-proADM exceeding 1.8 nmol/L (p=0.0157). The logistic regression model adjusted for age, gender, cardiovascular disease, diabetes mellitus and PCT values confirmed an odds ratio equal to 10.274 (95%CI 1.970-53.578) (p=0.0057) for MR-proADM higher than 1.8 nmol/L and equal to 22.206 (95%CI 1.56-316.960) (p=0.0223) for cardiovascular disease. Overall, MR-proADM was found to have the best predictive ability (AUC=0.846 – 95%CI 0.779-0.899).Conclusions In COVID-19 ICU-patients, MR-proADM seems able to provide a more precise stratification of disease severity and mortality risk than other biomarkers. Repeated MR-proADM measurement may support a rapid and effective decision-making. Further studies are needed to better explain the mechanisms responsible of the increase in MR-proADM observed in COVID-19 patients.
Death in Hospital Following ICU Discharge: Insights from the LUNG SAFE Study
Authors: Madotto Fabiana , McNicholas Bairbre , Rezoagli Emanuele , Pham Tài , Laffey John , Bellani Giacomo 
Published: August 2020

Abstract
Background: To determine the frequency of, and factors associated with, death in hospital following ICU discharge.Methods: The Large observational study to UNderstand the Global impact of Severe Acute respiratory FailurE (LUNG SAFE) study was an international, multicenter, prospective cohort study of patients with severe respiratory failure, conducted across 459 ICUs from 50 countries globally. This current study aimed to understand the frequency and factors associated with death in hospital in patients who survived their ICU sta. We examined outcomes in the subpopulation discharged with no limitations of life sustaining treatments (‘treatment limitations’), and the subpopulations with treatment limitations.Results: 2,186 (94%) patients with no treatment limitations discharged from ICU survived, while 142 (6%) died in hospital. 118 (61%) of patients with treatment limitations survived while 77 (39%) patients died in hospital. Patients without treatment limitations that died in hospital after ICU discharge were older, more likely to have COPD, immunocompromise or chronic renal failure, less likely to have trauma as a risk factor for ARDS. Patients that died post ICU discharge were less likely to receive neuromuscular blockade, or to receive any adjunctive measure, and had a higher pre- ICU discharge non-pulmonary SOFA score. A similar pattern was seen in patients with treatment limitations that died in hospital following ICU discharge.Conclusions: A significant proportion of patients die in hospital following discharge from ICU, with higher mortality in patients with limitations of life-sustaining treatments in place. Non-survivors had higher systemic illness severity scores at ICU discharge than survivors. Trial Registration: ClinicalTrials.gov NCT02010073