bluuebunny/crossref_metadata_2025_split huggingface dataset:
The importance of temperature and lipid accumulation for initiation and duration of Calanus hyperboreus spawning
Authors: Schultz Mads , Nielsen Torkel Gissel , Møller Eva Friis 
Published: January 2020

AbstractLarge, lipid-storing copepods play a central role in marine Arctic ecosystems. Knowledge of the mechanisms that control their oogenesis is important for understanding their phenology and population dynamics. We investigated the impact of female lipid content on the timing and cumulative egg production (EP) of Calanus hyperboreus at 0, 3 and 6°C. The lipid content of females in early autumn was a good predictor of their EP potential. However, we saw no indication of a threshold in lipid content for initiation of spawning. Higher temperature resulted in 17 and 24 days earlier spawning at 3 and 6°C compared with 0°C, and the mean spawning duration was 8 and 30 days shorter, respectively. This illustrates that temperature affects the phenology of C. hyperboreus. When EP began, lipid metabolism increased 2–4 times. The females allocated 1.3 μg lipid per egg independent of temperature. However, the basic metabolism increased with increasing temperature; consequently, a smaller fraction of lipid was allocated for EP when the temperature increased.
Ultrasound-Guided Intercostal Peripheral Nerve Stimulator Implantation: Technique Report and Feasibility Study in a Cadaver
Authors: Gupta Sahil , Clendenen Steven , Ferreira-Dos-Santos Guilherme , Hurdle Mark Friedrich 
Published: January 2020

AbstractObjectiveThis study aimed to describe and validate a novel ultrasound-guided intercostal peripheral nerve stimulator implantation technique.MethodsThe fifth to tenth ribs on both sides of an unembalmed cadaveric specimen were localized using a 15–6-MHz linear array transducer, counting distally from T-1 bilaterally. A single interventionist then implanted 12 peripheral nerve stimulators on the fifth through tenth ribs, six MicroLeads on the left side and six StimRouters on the right side, using an in-plane lateral to medial approach to the inferior border of the corresponding rib. After all the stimulators were implanted, their location was confirmed using fluoroscopy. Gross anatomic dissection was later performed for each of the stimulators placed, and the distance of the lead from the intercostal nerve and pleura was noted.ResultsAll leads were noted in an accurate position in the plane between the inner and innermost intercostal muscle, without any intrapleural placement. The distance of the leads from the intercostal nerves was on average 2.3 mm and 1.1 mm for MicroLead and StimRouter, respectively.ConclusionsTo our knowledge, this study is the first to determine the feasibility of ultrasound-guided peripheral nerve stimulator placement in close proximity to the pleura. All the stimulator leads were accurately placed using our ultrasound-guided technique and were within 0.5–3 mm from the intercostal nerve. Although this technique might prove technically challenging, the use of ultrasound for intercostal peripheral nerve stimulator implantation appears feasible and warrants further investigation to establish this as an acceptable technique for patients.
Functional analysis of chimeric TrCel6A enzymes with different carbohydrate binding modules
Authors: Christensen Stefan Jarl , Badino Silke Flindt , Cavaleiro Ana Mafalda , Borch Kim , Westh Peter 
Published: January 2020

AbstractThe glycoside hydrolase (GH) family 6 is an important group of enzymes that constitute an essential part of industrial enzyme cocktails used to convert lignocellulose into fermentable sugars. In nature, enzymes from this family often have a carbohydrate binding module (CBM) from the CBM family 1. These modules are known to promote adsorption to the cellulose surface and influence enzymatic activity. Here, we have investigated the functional diversity of CBMs found within the GH6 family. This was done by constructing five chimeric enzymes based on the model enzyme, TrCel6A, from the soft-rot fungus Trichoderma reesei. The natural CBM of this enzyme was exchanged with CBMs from other GH6 enzymes originating from different cellulose degrading fungi. The chimeric enzymes were expressed in the same host and investigated in adsorption and quasi-steady-state kinetic experiments. Our results quantified functional differences of these phylogenetically distant binding modules. Thus, the partitioning coefficient for substrate binding varied 4-fold, while the maximal turnover (kcat) showed a 2-fold difference. The wild-type enzyme showed the highest cellulose affinity on all tested substrates and the highest catalytic turnover. The CBM from Serendipita indica strongly promoted the enzyme’s ability to form productive complexes with sites on the substrate surface but showed lower turnover of the complex. We conclude that the CBM plays an important role for the functional differences between GH6 wild-type enzymes.
SOIL–SOYBEAN TRANSFER FACTOR OF NATURAL RADIONUCLIDES IN DIFFERENT SOIL TEXTURES AND THE ASSESSMENT OF COMMITTED EFFECTIVE DOSE
Authors: Uosif M A M , Alrowaili Z A , Elsaman Reda , Mostafa A M A 
Published: January 2020

Abstract
From three different soil textures (clay, silt and sand), 36 soil and soybeans samples were accumulated from the agricultural area of EL-Mynia governorate in Upper Egypt, between (27°36′19.44″N; 30°30′14.14″ E) and (28°48′28.45″ N; 31°00′32.27″ E). Soil textures were prepared by particle size distribution through a pipette method. Its radioactivity measurements were performed with a NaI (Tl) and 3 × 3 inch crystal. The transfer factor (TF) of natural radionuclides from soil to soybeans was calculated. The value of the TF for 226Ra in clay soil ranges from 0.27 ± 0.03 to 0.42 ± 0.05, in sandy soil it ranges from 0.21 ± 0.02 to 0.57 ± 0.07 and in silt soil it ranges from 0.25 ± 0.03 to 0.53 ± 0.06. The TF for 232Th in clay soil ranges from 0.22 ± 0.03 to 0.90 ± 0.12, in sandy soil it ranges from 0.21 ± 0.03 to 1.00 ± 0.13, while in silt soil it ranges from 0.25 ± 0.03 to 0.88 ± 0.12. The TF for 40K in clay soil ranges from 0.95 ± 0.13 to 2.05 ± 0.29, in sandy soil it ranges from 1.21 ± 0.17 to 2.52 ± 0.35 and in silt soil it ranges and from 1.01 ± 0.14 to 1.46 ± 0.26.The results show that the committed effective dose from soybean consumption is between 54.5 and 103.4 μSv y−1 assuming consumption of 20 kg y−1.
Mathematical routines in transition: facilitating students’ defining and proving of sequence convergence
Authors: Schüler-Meyer Alexander 
Published: January 2020

Abstract
The transition to tertiary mathematics requires students to use definitions of mathematical objects instead of intuitions. However, routines of defining and of proving with definitions are difficult to engage in, as they are not familiar to students who come from secondary school mathematics. Defining is highly complex because of its underlying rules, which demand that a definition has to be minimal, formal, deductively ordered, operationalized and so forth. While students can learn these rules by the teacher making them explicit during defining, this paper illustrates a trajectory that aims to systematically build on students’ familiar secondary school routines of classifying, describing, symbolizing and proving as resources for learning defining and proving with definitions. This trajectory is informed by a five-session teaching–learning intervention in which upper-secondary students in Germany are engaged in defining and proving with definitions and which specifically focuses on systematically building on students’ prior experiences in secondary school mathematics.
Early Definitive Care Is as Effective as Staged Treatment Protocols for Open Ankle Fractures Caused by Rotational Mechanisms: A Retrospective Case–Control Study
Authors: Peterson Daniel L. , Schuurman Meg , Geamanu Andreea , Padela Muhammad T. , Kennedy Christopher J. , Wilkinson Joseph , Vaidya Rahul 
Published: January 2020

Objectives:
To compare immediate internal fixation with primary wound closure to temporary fixation/stabilization with delayed fixation and wound closure protocols for management of open ankle fractures.

Design:
Retrospective case–control study.

Setting:
Level 1 trauma center.

Patients:
Eighty-eight consecutive patients who presented with a Gustilo–Anderson type I, II, or IIIa open ankle fracture to a single center.

Intervention:
Patients were divided into 2 cohorts: either immediate internal fixation with primary wound closure (EARLY) or temporary fixation/stabilization with delayed fixation and wound closure (STAGED) due to practice differences of the attending surgeons.

Main Outcome Measures:
Infection, length of stay, number and type of operations, and clinical measures. We also assessed the 2 groups with regard to demographics and radiographic classification.

Results:
Overall, incidence of infection was 6 (6.8%) with no significant difference between patients treated with EARLY versus STAGED protocols. The EARLY cohort had a significantly shorter length of hospital stay, fewer number of reoperations but similar clinical outcomes for pain, ambulation, and radiographic evidence of osteoarthritis for patients followed for >12 months.

Conclusion:
Our study showed that early definitive treatment compared with a staged protocol for Gustilo–Anderson type I, II, and IIIa open ankle fractures has similar rates of infection, shorter hospital stay, fewer surgical interventions, and similar clinical outcomes.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Improved Outcomes After Regional Implementation of Sepsis Alert: A Novel Triage Model*
Authors: Rosenqvist Mari , Bengtsson-Toni Maria , Tham Johan , Lanbeck Peter , Melander Olle , Åkesson Per 
Published: January 2020

Objectives:
To assess whether the triage model Sepsis Alert for Emergency Departments results in improved initial care of patients with severe infections.

Design:
Interventional study comparing patient care before and after the start of a new triage model, including 90-day follow-up.

Setting:
Eight emergency departments in Skåne County, Sweden.

Subjects:
Patients with suspected severe infection.

Interventions:
Patients with severely deviating vital signs and suspected infection were triaged into a designated sepsis line called Sepsis Alert, for rapid evaluation supported by an infectious disease specialist. Also, all emergency department staff participated in a designated sepsis education before the model was introduced.

Measurements and Main Results:
Medical records were evaluated for a 3-month period 1 year before the triage system was started in 2016 and for a 3-month period 1 year after. Of 195,607 patients admitted to these emergency departments during two 3-month periods, a total of 5,321 patients presented severely abnormal vital signs. Of these, 1,066 patients who presented with fever greater thanor equal to 38°C or history of fever/chills were considered to be patients at risk of having severe sepsis. Among patients triaged according to Sepsis Alert, 89.3% received antibiotic treatment within 1 hour after arrival to the emergency department (median time to antibiotics, 26 min), which was significantly better than before the start of the new triage: 67.9% (median time to antibiotics, 37 min) (p < 0.001). Additionally, sepsis treatment quality markers were significantly improved after the introduction of Sepsis Alert, including number of blood cultures and lactate measurements taken, percentage of patients receiving IV fluids, and appropriate initial antibiotic treatment. There were no differences in 28- or 90-day mortality rates.

Conclusions:
The implementation of the new triage model Sepsis Alert with special attention to severe sepsis patients led to faster and more accurate antibiotic treatment and improved diagnostic procedures and supportive care.
Homocysteine and IgA nephropathy: observational and Mendelian randomization analyses
Authors: Zhang Yue-Miao , Zhou Xu-Jie , Shi Su-Fang , Liu Li-Jun , Lyu Ji-Cheng , Zhang Hong 
Published: January 2020

AbstractBackground:High levels of plasma homocysteine occur almost uniformly in patients with end-stage renal disease (ESRD). IgA nephropathy (IgAN) is the most common form of primary glomerulonephritis and a common cause of ESRD in young adults. Here, we aimed to detect whether homocysteine was elevated and associated with clinical-pathologic manifestations of IgAN patients and tested its causal effects using a two-sample Mendelian randomization (MR) approach.Methods:For observational analysis, 108 IgAN patients, 30 lupus nephritis (LN) patients, 50 minimal change disease (MCD) patients, and 206 healthy controls were recruited from April 2014 to April 2015. Their plasma homocysteine was measured and clinical-pathologic manifestations were collected from medical records. For MR analysis, we further included 1686 IgAN patients. The missense variant methylenetetrahydrofolate reductase C677T (rs1801133) was selected as an instrument, which was genotyped by TaqMan allele discrimination assays.Results:Majority of IgAN patients (93.52%, 101/108) showed elevated levels of plasma homocysteine (>10 μmol/L). Plasma homocysteine in IgAN patients was significantly higher than that in MCD patients (median: 18.32vs.11.15 μmol/L,Z = −5.29,P < 0.01) and in healthy controls (median: 18.32vs.10.00 μmol/L,Z = −8.76,P < 0.01), but comparable with those in LN patients (median: 18.32 Lvs.14.50 μmol/L,Z = −1.32,P = 0.19). Significant differences were observed in sub-groups of IgAN patients according to quartiles of plasma homocysteine for male ratio (22.22%vs.51.85%vs.70.37%vs.70.37%,χ2 = 14.29,P < 0.01), serum creatinine (median: 77.00vs.100.00vs.129.00vs.150.00 μmol/L,χ2 = 34.06,P < 0.01), estimated glomerular filtration rate (median: 100.52vs.74.23vs.52.68vs.42.67 mL·min−1·1.73 m−2,χ2 = 21.75,P < 0.01), systolic blood pressure (median: 120.00vs.120.00vs.125.00vs.130.00 mmHg,χ2 = 2.97,P = 0.05), diastolic blood pressure (median 80.00vs.75.00vs.80.00vs.81.00 mmHg,χ2 = 11.47,P < 0.01), and pathologic tubular atrophy and interstitial fibrosis (T) (T0/T1/T2: 62.96%/33.33%/3.70%vs.29.63%/40.74%/29.63%vs.24.00%/48.00%/28.00%vs.14.81%/37.04%/48.15%,χ2 = 17.66,P < 0.01). The coefficient of each rs1801133-T allele on homocysteine levels after controlling age and sex was 7.12 (P < 0.01). MR estimates showed causal positive effects of homocysteine on serum creatine (β = 0.76,P = 0.02), systolic blood pressure (β = 0.26,P = 0.02), diastolic blood pressure (β = 0.20,P = 0.01), and pathologic T lesion (β = 0.01,P = 0.01) in IgAN.Conclusions:By observational and MR analyses, consistent results were observed for associations of plasma homocysteine with serum creatinine, blood pressures, and pathologic T lesion in IgAN patients.
Long non-coding RNA HOTAIRM1 promotes proliferation and inhibits apoptosis of glioma cells by regulating the miR-873-5p/ZEB2 axis
Authors: Lin Yi-Hai , Guo Liang , Yan Feng , Dou Zhang-Qi , Yu Qian , Chen Gao 
Published: January 2020

Abstract

Background
Glioblastoma is one of the most common malignant brain tumors. Conventional clinical treatment of glioblastoma is not sufficient, and the molecular mechanism underlying the initiation and development of this disease remains unclear. Our study aimed to explore the expression and function of miR-873a-5p in glioblastoma and related molecular mechanism.

Methods
We analyzed the most dysregulated microRNAs from the Gene Expression Omnibus (GEO) database and examined the expression of miR-873-5p in 20 glioblastoma tissues compared with ten normal brain tissues collected in the Zhejiang Tongde Hospital. We then overexpressed or inhibited miR-873-5p expression in U87 glioblastoma cell lines and analyzed the phenotype using the cell counting kit-8 assay, wound healing assay, and apoptosis. In addition, we predicted upstream and downstream genes of miR-873-5p in glioblastoma using bioinformatics analysis and tested our hypothesis in U87 cells using the luciferase reporter gene assay and Western blotting assay. The differences between two groups were analyzed by Student's t test. The Kruskal-Wallis test was used for the comparison of multiple groups. A P < 0.05 was considered to be significant.

Results
The miR-873-5p was downregulated in glioblastoma tissues compared with that in normal brain tissues (normal vs. tumor, 0.762 ± 0.231 vs. 0.378 ± 0.114, t = 4.540, P < 0.01). Overexpression of miR-873-5p inhibited cell growth (t = 6.095, P < 0.01) and migration (t = 3.142, P < 0.01) and promoted cell apoptosis (t = 4.861, P < 0.01), while inhibition of miR-873-5p had the opposite effect. Mechanistically, the long non-coding RNA HOTAIRM1 was found to act as a sponge of miR-873-5p to activate ZEB2 expression in U87 cells.

Conclusions
We uncovered a novel HOTAIRM1/miR-873-5p/ZEB2 axis in glioblastoma cells, providing new insight into glioblastoma progression and a theoretical basis for the treatment of glioblastoma.
Artificial intelligence in gastrointestinal endoscopy: general overview
Authors: El Hajjar Ahmad , Rey Jean-François 
Published: January 2020

Abstract
Artificial intelligence (AI) is now a trendy subject in clinical medicine and especially in gastrointestinal (GI) endoscopy. AI has the potential to improve the quality of GI endoscopy at all levels. It will compensate for humans’ errors and limited capabilities by bringing more accuracy, consistency, and higher speed, making endoscopic procedures more efficient and of higher quality. AI showed great results in diagnostic and therapeutic endoscopy in all parts of the GI tract. More studies are still needed before the introduction of this new technology in our daily practice and clinical guidelines. Furthermore, ethical clearance and new legislations might be needed. In conclusion, the introduction of AI will be a big breakthrough in the field of GI endoscopy in the upcoming years. It has the potential to bring major improvements to GI endoscopy at all levels.
Use of Extranasal Bilobed Transposition Flaps in Cutaneous Reconstructive Surgery at 2 Institutions
Authors: Steele Robert B. , Jellinek Nathaniel J. , Foy Amanda , Lee Kachiu , Vij Alok , Knackstedt Thomas J. 
Published: January 2020

BACKGROUND
Bilobed transposition flaps are versatile random pattern flaps used in nasal and extranasal reconstruction as they preserve free margins, access distal tissue reservoirs, and reliably repair dynamic defects.

OBJECTIVE
We highlight the utility of extranasal bilobed flaps to encourage surgeons to consider these flaps for Mohs micrographic surgery defects.

METHODS
A two-institution retrospective chart review of patients reconstructed using an extranasal bilobed flap after Mohs micrographic surgery was performed. A validated scar scale was applied to postoperative photographs. Statistical analyses of the patient and surgery characteristics including patient co-morbidities, anatomic distribution, flap dimensions, and postprocedural events, including revisions, were conducted.

RESULTS
Forty-eight patients were identified. Site-specific flap dimensions were obtained with the cheek/lower eyelid requiring greater tissue mobilization with a higher final to primary defect ratio when compared with other sites. Postoperative events (complications, erythema, flap fullness, dehiscence, infection, etc.) were minimal. No major complications were noted. Nine cases of flap fullness or swelling were identified. Neither flap fullness nor dehiscence compromised flap integrity or cosmetic outcome. Independent flap cosmetic outcome review was good using a validated photographic scar scale.

CONCLUSION
Bilobed transposition flaps are versatile repairs for extranasal reconstruction with a favorable safety and outcome profile.
Performance and Impact of a CLIA-waived, Point-of-care Respiratory PCR Panel in a Pediatric Clinic
Authors: Beal Stacy G. , Posa Molly , Gaffar Maira , Reppucci Jennifer , Mack Jasmine A. , Gurka Matthew J. , Rand Kenneth , Houck Herbert , Kelly Maria N. 
Published: January 2020

Background:
Laboratory-based respiratory polymerase chain reaction (PCR) panels are rarely used in outpatient pediatric practice due to prolonged turn-around times and cost of medical equipment. The BioFire FilmArray Respiratory Panel EZ (RP EZ) is a Clinical Laboratory Improvement Amendments–waived respiratory pathogen PCR panel which rapidly tests for 14 common respiratory organisms. The aim of this study was to identify the distribution of organisms seen in pediatric clinics and to determine if utilization of this point-of-care test improved disease management, while exploring impact on clinic workflow.

Methods:
From January 2018 through January 2019, when clinically appropriate, patients were tested by the RP EZ and/or antigen tests (Clinic A) or antigen test only (Clinic B). Residual samples from Clinic B antigen tests were frozen and later tested on the RP EZ for definitive pathogen identification. Patient data and prescription records were extracted from the electronic health record.

Results:
A total of 430 patients had RP EZ tests performed, and at least 1 organism was detected in 70.4% of patients. The most common organisms identified were human rhinovirus/enterovirus, influenza, and respiratory syncytial virus. Appropriate treatment occurred for 93.6% of patients when the RP EZ was performed (Clinic A) versus 87.9% of patients who had only antigen tests performed (Clinic B, P = 0.0445). Utilization of RP EZ testing also significantly reduced appointment duration time (48.0 versus 54.9 minutes, P = 0.0009). Three false-positive influenza B results were identified by antigen testing.

Conclusions:
A point-of-care PCR panel improved patient care by providing an accurate diagnosis and shortened appointment duration.
Obstructive Sleep Apnea in Psychiatric Inpatients
Authors: Tanielian Maria , Doghramji Karl , Certa Kenneth 
Published: January 2020

AbstractThe aim of this study was to identify the prevalence of heightened risk for obstructive sleep apnea (OSA) and its clinical predictors in a heterogeneous diagnostic group of hospitalized psychiatric patients. Ninety-one consecutive psychiatric inpatients were administered the STOP-BANG and Epworth Sleepiness Scale (ESS) inventories. Medical and demographic information was gathered from inpatient clinical charts. Predictors of high OSA risk score were analyzed by a multivariate regression model. A total of 58.2% (53 patients) were determined to have a high risk for OSA. The predictors of high OSA risk were use of mood stabilizers, use of CNS depressants, use of CNS stimulants, and excessive daytime sleepiness measured by ESS. The risk of OSA was high in psychiatric inpatients, and particularly elevated in older patients and those taking commonly utilized psychiatric medications.
Anterior Tricuspid Leaflet Cleft in an Adult Male
Authors: Yamasaki Gentaro , Kondo Takeshi , Kuse Azumi , Sugimoto Marie , Takahashi Motonori , Morichika Mai , Nakagawa Kanako , Sakurada Makoto , Asano Migiwa , Ueno Yasuhiro 
Published: January 2020

AbstractThe deceased was a 44-year-old male who was treated for a suspected Ebstein's anomaly observed using transthoracic echocardiogram. He was found dead in his bed at home. Autopsy revealed that the septal tricuspid leaflet was intact; however, a large anterior tricuspid leaflet cleft and right atrioventricular cavity dilation were observed. Pathological examination revealed a normal tricuspid valve, except for the presence of a cleft with local fibrosis of the left ventricle papillary muscle and hemosiderin-containing macrophages at both lungs. There were no other abnormalities that may have led to death. It was concluded that he died a cardiac death based on the right heart overload associated with the anterior tricuspid leaflet cleft. This case indicates the possibility that the anterior tricuspid leaflet cleft can cause death and also highlights the necessity of a detailed autopsy to accurately diagnose the cause of death.