bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical and Cognitive Load Effects Due to a Powered Lower-Body Exoskeleton
Authors: Bequette Blake , Norton Adam , Jones Eric , Stirling Leia 
Published: March 2020

Objective The aim of this study is to determine the effects of a powered exoskeleton on measures of physical and cognitive performance. Background US warfighters carry heavy equipment into battle, and exoskeletons may reduce that burden. While exoskeletons are currently evaluated for their effects on physical performance, their cognitive effects are not currently considered. Method Twelve military members participated in a simulated patrol task under three conditions: wearing a powered exoskeleton (PWR), an unpowered exoskeleton (UNP), and without wearing an exoskeleton (OFF). While following a confederate over obstacles at a constant pace, participants performed additional audio and visual tasks. Dependent measures included visual misses, visual reaction time, audio misses, audio reaction time, incremental lag time, and NASA-TLX scores. Results The variability in the follow-task lag time was lowest with OFF and highest with UNP, highlighting reduced ability to maintain pace with the exoskeleton. Visual reaction time was significantly slower with PWR compared to OFF for 5 of 12 subjects. The NASA-TLX overall workload scores were lower for OFF compared to PWR and UNP. Conclusion Efforts to understand individual variability are warranted such that exoskeleton designs can be used for a wider set of the population. While not all subjects had measurable differences in the selected performance tasks, the perception of increased workload was present across subjects. It remains to be determined what difference in reaction time would be operationally relevant for task-specific settings. Application Findings draw attention to the need to consider “cognitive fit” and subject differences in the design and implementation of exoskeletons.
The Trach Safe Initiative: A Quality Improvement Initiative to Reduce Mortality among Pediatric Tracheostomy Patients
Authors: Ong Thida , Liu C. Carrie , Elder Leslie , Hill Leslee , Abts Matthew , Dahl John P. , Evans Kelly N. , Parikh Sanjay R. , Soares Jennifer J. , Striegl Amanda M. , Whitlock Kathryn B. , Johnson Kaalan E. 
Published: March 2020

ObjectiveTo describe the Trach Safe Initiative and assess its impact on unanticipated tracheostomy‐related mortality in outpatient tracheostomy‐dependent children (TDC).MethodsAn interdisciplinary team including parents and providers designed the initiative with quality improvement methods. Three practice changes were prioritized: (1) surveillance airway endoscopy prior to hospital discharge from tracheostomy placement, (2) education for community‐based nurses on TDC‐focused emergency airway management, and (3) routine assessment of airway events for TDC in clinic. The primary outcome was annual unanticipated mortality after hospital discharge from tracheostomy placement before and after the initiative.ResultsIn the 5 years before and after the initiative, 131 children and 155 children underwent tracheostomy placement, respectively. At the end of the study period, the institution sustained Trach Safe practices: (1) surveillance bronchoscopies increased from 104 to 429 bronchoscopies, (2) the course trained 209 community‐based nurses, and (3) the survey was used in 488 home ventilator clinic visits to identify near‐miss airway events. Prior to the initiative, 9 deaths were unanticipated. After Trach Safe implementation, 1 death was unanticipated. Control chart analysis demonstrates significant special‐cause variation in reduced unanticipated mortality.DiscussionWe describe a system shift in reduced unanticipated mortality for TDC through 3 major practice changes of the Trach Safe Initiative.Implication for PracticeDeath in a child with a tracheostomy tube at home may represent modifiable tracheostomy‐related airway events. Using Trach Safe practices, we address multiple facets to improve safety of TDC out of the hospital.
Cytokine Levels in Critically Ill Children With Severe Sepsis and Their Relation With the Severity of Illness and Mortality
Authors: Angurana Suresh Kumar , Bansal Arun , Muralidharan Jayashree , Aggarwal Ritu , Singhi Sunit 
Published: March 2020

Objective: To study the baseline cytokine levels and their relation with the severity of illness and mortality in critically ill children with severe sepsis. Design: Subgroup analysis of a randomized, double-blind, placebo-controlled trial. Setting: Pediatric intensive care unit of a tertiary level teaching hospital in India. Patients: Fifty children with severe sepsis aged 3 months to 12 years. Material and Methods: Blood was collected at admission for estimation of pro-inflammatory (interleukin 6 [IL-6], IL-12p70, IL-17, and tumor necrotic factor α [TNF-α]) and anti-inflammatory (IL-10 and transforming growth factor β1 [TGF-β1]) cytokines. Primary Outcome: To find out correlation between cytokine levels and severity of illness scores (Pediatric Risk of Mortality [PRISM] III score, Sequential Organ Failure Assessment [SOFA], and Vasoactive-Inotropic Score [VIS]). Secondary Outcomes: To compare cytokine levels among survivors and nonsurvivors. Results: Baseline pro-inflammatory cytokine levels (median [interquartile range]) were IL-6: 189 (35-285) pg/mL, IL-12p: 48 (28-98) pg/mL, IL-17: 240 (133-345) pg/mL, and TNF-α: 296 (198-430) pg/mL; anti-inflammatory cytokine levels were IL-10: 185 (62-395) pg/mL and TGF-β1: 204 (92-290) ng/mL. Pro-inflammatory cytokines showed positive correlation with PRISM III score: IL-6 (Spearman correlation coefficient, ρ = 0.273, P = .06), IL-12 (ρ = 0.367, P = .01), IL-17 (ρ = 0.197, P = .17), and TNF-α (ρ = 0.284, P = .05), and anti-inflammatory cytokines showed negative correlation: IL-10 (ρ = −0.257, P = .09) and TGF-β (ρ = −0.238, P = .11). Both SOFA and VIS also showed weak positive correlation with IL-12 (ρ = 0.32, P = .03 and ρ = 0.31, P = .03, respectively). Among nonsurvivors (n = 5), the levels of all the measured pro-inflammatory cytokines were significantly higher as compared to survivors, IL-6: 359 (251-499) pg/mL versus 157 (97-223) pg/mL, P < .0001, IL-12p70: 167 (133-196) pg/mL versus 66 (30-100) pg/mL, P < .0001, IL-17: 400 (333-563) pg/mL versus 237 (122-318) pg/mL, P = .009, and TNF-α: 409 (355-503) pg/mL versus 330 (198-415) pg/mL, P = .002, respectively. Conclusion: In critically ill children with severe sepsis, pro-inflammatory cytokines (especially IL-12p70) showed a weak positive correlation with severity of illness and were significantly higher among nonsurvivors.
Diffusion of RT Solar PV in Suburbs of Delhi/NCR, India: Triggers of Architect Recommendation Intent
Authors: Aggarwal Ashwini K. , Syed Asif Ali , Garg Sandeep 
Published: March 2020

Solar energy has shown considerable promise world over, and the sector has been growing with dramatic reduction in commercial pricing, improved efficiencies and improved deployments/usage conveniences. Rooftop solar in India has grown to 4.4 GW by the end March 2019—but it’s still underperforming versus National Solar Mission (NSM) target of 40 GW. Clearly, India has a significant need to improve the penetration of the rooftop solar. Recent studies in the Indian context have shown the role of social influence as a key enabler of the purchase intent for rooftop solar. Studies have also shown the relative prioritization between different opinion leader categories. A relevant question is to understand the triggers of pro-rooftop solar photovoltaic (RT SPV) recommendations from ecosystem players like architects. This article builds an empirical approach to model the factors of behaviour intent (to recommend RT SPV) of the architects. The field study is conducted in Delhi-National Capital Region (NCR) suburbs of Gurgaon and Faridabad. Policy implications are: To build focused penetration of communities, leveraging trusted peer networks, instead of a spray-and-pray approach. To build a solar champion branding (like green building certification) and a competence building programme to leverage natural position as a potential opinion leader while building one’s home. This research is part of the first Indian empirical study leveraging multi-city survey of architects and end-users to build a statistically verified consumer behaviour model using unified theory of acceptance and use of technology 2 (UTAUT2) theory for end-user purchase intent and recommendation intent by architects for RT SPV installation by their clients in the residential sector.
Increased Risk of Velopharyngeal Insufficiency in Patients Undergoing Staged Palate Repair
Authors: McCrary Hilary , Pollard Sarah Hatch , Torrecillas Vanessa , Khong Leon , Taylor Helene M. , Meier Jeremy , Muntz Harlan , Skirko Jonathan 
Published: March 2020

Objective: To evaluate the association of 2-stage cleft palate (CP) surgery on velopharyngeal insufficiency (VPI) incidence, speech surgeries, and cleft-related surgical burden. Design: Retrospective cohort with follow-up of 4 to 19 years. Setting: Academic, tertiary children’s hospital. Patients: Patients who underwent CP surgery between 2000 and 2017. Exclusions included submucous CP or age at last contact under 3.9. Interventions: Cleft palate surgery, completed in either a single-stage or 2-stage repair. Main Outcome Measure(s): Rates of VPI diagnosis and speech surgery and total cleft surgeries; t tests, tests of proportion, and linear and logistic regression were performed. Total cleft-related surgeries were examined in a subset (n = 418) of patients with chart reviews. Results: A total of 1047 patients were included; 59.6% had 2-stage CP repair, 40.4% had single-stage repair. Approximately 32% of children with 2-stage CP repair were diagnosed with VPI, as opposed to 22% of single-stage patients ( P < .001). Children with 2-stage CP repair were 1.8 times as likely to be diagnosed with VPI ( P < .001). Speech surgery rates were similar across groups. Patients who had 2-stage repair received an average of 2.3 more cleft-related procedures, when excluding prosthesis management procedures. Conclusion: Our data show an increased risk of VPI diagnosis and increased surgical burden among patients receiving 2-stage CP repair.
Regulatory T cells promote alloengraftment in a model of late-gestation in utero hematopoietic cell transplantation
Authors: Riley John S. , McClain Lauren E. , Stratigis John D. , Coons Barbara E. , Ahn Nicholas J. , Li Haiying , Loukogeorgakis Stavros P. , Fachin Camila G. , Dias Andre I. B. S. , Flake Alan W. , Peranteau William H. 
Published: March 2020

Abstract
In utero hematopoietic cell transplantation (IUHCT) has the potential to cure congenital hematologic disorders including sickle cell disease. However, the window of opportunity for IUHCT closes with the acquisition of T-cell immunity, beginning at approximately 14 weeks gestation, posing significant technical challenges and excluding from treatment fetuses evaluated after the first trimester. Here we report that regulatory T cells can promote alloengraftment and preserve allograft tolerance after the acquisition of T-cell immunity in a mouse model of late-gestation IUHCT. We show that allografts enriched with regulatory T cells harvested from either IUHCT-tolerant or naive mice engraft at 20 days post coitum (DPC) with equal frequency to unenriched allografts transplanted at 14 DPC. Long-term, multilineage donor cell chimerism was achieved in the absence of graft-versus-host disease or mortality. Decreased alloreactivity among recipient T cells was observed consistent with donor-specific tolerance. These findings suggest that donor graft enrichment with regulatory T cells could be used to successfully perform IUHCT later in gestation.
12-year adherence to inhaled corticosteroids in adult-onset asthma
Authors: Vähätalo Iida , Ilmarinen Pinja , Tuomisto Leena E. , Tommola Minna , Niemelä Onni , Lehtimäki Lauri , Nieminen Pentti , Kankaanranta Hannu 
Published: March 2020

Adherence to inhaled corticosteroids (ICS) has been suggested to be poor but long-term follow-ups are lacking. The objective of the present study was to assess adherence to ICS treatment in patients with adult-onset asthma during 12-year follow-up.A total of 181 patients with clinically confirmed, new-onset adult asthma were followed for 12 years as part of the Seinäjoki Adult Asthma Study. Adherence to ICS was assessed individually as the percentage of true dispensed ICS in micrograms per true prescribed daily ICS in micrograms over 12 years.Mean 12-year adherence to ICS was 69% (mean±sddispensed 2.5±1.8 g and prescribed 3.6±1.5 g budesonide equivalent per patient for 12 years), annual adherence varying between 81% (year 1) and 67% (year 12). Patients with good 12-year adherence (≥80%) used oral corticosteroids more often, and had add-on drugs in use and asthma-related visits to healthcare more often. In addition, they showed less reversibility in forced expiratory volume in 1 s and had higher peripheral blood neutrophil counts. However, lung function decline was steeper in patients with poorer adherence (<80%) and this association remained in multiple linear regression analysis. No difference was found in symptom scores, blood eosinophil counts, exhaled nitric oxide or immunoglobulin E between the patients with different levels of adherence.In patients with adult-onset asthma, adherence to ICS was moderate. Poorer adherence (<80%) to ICS was associated with more rapid decline in lung function but was not associated to symptoms or markers of inflammatory endotypes.
Polystyrene microplastics do not affect juvenile brown trout (Salmo trutta f. fario) or modulate effects of the pesticide methiocarb
Authors: Schmieg Hannah , Huppertsberg Sven , Knepper Thomas P. , Krais Stefanie , Reitter Katharina , Rezbach Felizitas , Ruhl Aki S. , Köhler Heinz-R. , Triebskorn Rita 
Published: March 2020

Abstract
Background
There has been a rising interest within the scientific community and the public about the environmental risk related to the abundance of microplastics in aquatic environments. Up to now, however, scientific knowledge in this context has been scarce and insufficient for a reliable risk assessment. To remedy this scarcity of data, we investigated possible adverse effects of polystyrene particles (104 particles/L) and the pesticide methiocarb (1 mg/L) in juvenile brown trout (Salmo trutta f. fario) both by themselves as well as in combination after a 96 h laboratory exposure. PS beads (density 1.05 g/mL) were cryogenically milled and fractionated resulting in irregular-shaped particles (< 50 µm). Besides body weight of the animals, biomarkers for proteotoxicity (stress protein family Hsp70), oxidative stress (superoxide dismutase, lipid peroxidation), and neurotoxicity (acetylcholinesterase, carboxylesterases) were analyzed. As an indicator of overall health, histopathological effects were studied in liver and gills of exposed fish.

Results
Polystyrene particles by themselves did not influence any of the investigated biomarkers. In contrast, the exposure to methiocarb led to a significant reduction of the activity of acetylcholinesterase and the two carboxylesterases. Moreover, the tissue integrity of liver and gills was impaired by the pesticide. Body weight, the oxidative stress and the stress protein levels were not influenced by methiocarb. Effects caused by co-exposure of polystyrene microplastics and methiocarb were the same as those caused by methiocarb alone.

Conclusions
Overall, methiocarb led to negative effects in juvenile brown trout. In contrast, polystyrene microplastics in the tested concentration did not affect the health of juvenile brown trout and did not modulate the toxicity of methiocarb in this fish species.
Identifying nucleic acid-associated proteins in Mycobacterium smegmatis by mass spectrometry-based proteomics
Authors: Kriel Nastassja L. , Heunis Tiaan , Sampson Samantha L. , Gey van Pittius Nico C. , Williams Monique J. , Warren Robin M. 
Published: March 2020

AbstractBackgroundTranscriptional responses required to maintain cellular homeostasis or to adapt to environmental stress, is in part mediated by several nucleic-acid associated proteins. In this study, we sought to establish an affinity purification-mass spectrometry (AP-MS) approach that would enable the collective identification of nucleic acid-associated proteins in mycobacteria. We hypothesized that targeting the RNA polymerase complex through affinity purification would allow for the identification of RNA- and DNA-associated proteins that not only maintain the bacterial chromosome but also enable transcription and translation.ResultsAP-MS analysis of the RNA polymerase β-subunit cross-linked to nucleic acids identified 275 putative nucleic acid-associated proteins in the model organismMycobacterium smegmatisunder standard culturing conditions. The AP-MS approach successfully identified proteins that are known to make up the RNA polymerase complex, as well as several other known RNA polymerase complex-associated proteins such as a DNA polymerase, sigma factors, transcriptional regulators, and helicases. Gene ontology enrichment analysis of the identified proteins revealed that this approach selected for proteins with GO terms associated with nucleic acids and cellular metabolism. Importantly, we identified several proteins of unknown function not previously known to be associated with nucleic acids. Validation of several candidate nucleic acid-associated proteins demonstrated for the first time DNA association of ectopically expressed MSMEG_1060, MSMEG_2695 and MSMEG_4306 through affinity purification.ConclusionsEffective identification of nucleic acid-associated proteins, which make up the RNA polymerase complex as well as other DNA- and RNA-associated proteins, was facilitated by affinity purification of the RNA polymerase β-subunit inM. smegmatis. The successful identification of several transcriptional regulators suggest that our approach could be sensitive enough to investigate the nucleic acid-associated proteins that maintain cellular functions and mediate transcriptional and translational change in response to environmental stress.
Type 2 diabetes induced microbiome dysbiosis is associated with therapy resistance in pancreatic adenocarcinoma
Authors: Kesh Kousik , Mendez Roberto , Abdelrahman Leila , Banerjee Santanu , Banerjee Sulagna 
Published: March 2020

AbstractResistance to therapy is one of the major factors that contribute to dismal survival statistics in pancreatic cancer. While there are many tumor intrinsic and tumor microenvironment driven factors that contribute to therapy resistance, whether pre-existing metabolic diseases like type 2 diabetes (T2D) contribute to this has remained understudied. It is well accepted that hyperglycemia associated with type 2 diabetes changes the gut microbiome. Further, hyperglycemia also enriches for a “stem-like” population within the tumor. In the current study, we observed that in a T2D mouse model, the microbiome changed significantly as the hyperglycemia developed in these animals. Our results further showed that, tumors implanted in the T2D mice responded poorly to gemcitabine/paclitaxel (Gem/Pac) standard of care compared to those in the control group. A metabolomic reconstruction of the WGS of the gut microbiota further revealed that an enrichment of bacterial population involved in drug metabolism in the T2D group. Additionally, we also observed an increase in the CD133+ tumor cells population in the T2D model. These observations indicated that in an animal model for T2D, microbial dysbiosis is associated with increased resistance to chemotherapeutic compounds.
Epigenetic modulations of noncoding RNA: a novel dimension of Cancer biology
Authors: Yang Xiao , Liu Ming , Li Mengmeng , Zhang Sen , Hiju Hong , Sun Jing , Mao Zhihai , Zheng Minhua , Feng Bo 
Published: March 2020

AbstractEmpowered by recent advances of sequencing techniques, transcriptome-wide studies have characterized over 150 different types of post-transcriptional chemical modifications of RNA, ranging from methylations of single base to complex installing reactions catalyzed by coordinated actions of multiple modification enzymes. These modifications have been shown to regulate the function and fate of RNAs and further affecting various cellular events. However, the current understanding of their biological functions in human diseases, especially in cancers, is still limited. Once regarded as “junk” or “noise” of the transcriptome, noncoding RNA (ncRNA) has been proved to be involved in a plethora of cellular signaling pathways especially those regulating cancer initiation and progression. Accumulating evidence has demonstrated that ncRNAs manipulate multiple phenotypes of cancer cells including proliferation, metastasis and chemoresistance and may become promising biomarkers and targets for diagnosis and treatment of cancer. Importantly, recent studies have mapped plenty of modified residues in ncRNA transcripts, indicating the existence of epigenetic modulation of ncRNAs and the potential effects of RNA modulation on cancer progression. In this review, we briefly introduced the characteristics of several main epigenetic marks on ncRNAs and summarized their consecutive effects on cancer cells. We found that ncRNAs could act both as regulators and targets of epigenetic enzymes, which indicated a cross-regulating network in cancer cells and unveil a novel dimension of cancer biology. Moreover, by epitomizing the knowledge of RNA epigenetics, our work may pave the way for the design of patient-tailored therapeutics of cancers.
Effects of endothelial progenitor cells transplantation on hyperlipidemia associated kidney damage in ApoE knockout mouse model
Authors: Gong Piyun , Zhang Zhongwen , Zhang Dongmei , Zou Zhiwei , Zhang Qian , Ma Huimei , Li Jingxiu , Liao Lin , Dong Jianjun 
Published: March 2020

AbstractBackgroundHyperlipidaemia causes kidney damage over the long term. We investigated the effect of the administration of endothelial progenitor cells (EPCs) on the progression of kidney damage in a mouse model of hyperlipidaemia.MethodsApolipoprotein E-knockout (ApoE−/−) mice were treated with a high-cholesterol diet after spleen resection. Twenty-four weeks later, the mice were divided into two groups and intravenously injected with PBS or EPCs. Six weeks later, the recruitment of EPCs to the kidney was monitored by immunofluorescence. The lipid, endothelial cell, and collagen contents in the kidney were evaluated by specific immunostaining. The protein expression levels of transforming growth factor-β (TGF-β), Smad2/3, and phospho-Smad3 (p-smad3) were detected by western blot analysis.ResultsApoE−/−mice treated with a high-fat diet demonstrated glomerular lipid deposition, enlargement of the glomerular mesangial matrix, endothelial cell enlargement accompanied by vacuolar degeneration and an area of interstitial collagen in the kidney. Six weeks after EPC treatment, only a few EPCs were detected in the kidney tissues of ApoE−/−mice, mainly in the kidney interstitial area. No significant differences in TGF-β, p-smad3 or smad2/3 expression were found between the PBS group and the EPC treatment group (TGF-β expression, PBS group: 1.06 ± 0.09, EPC treatment group: 1.09 ± 0.17,P = 0.787; p-smad3/smad2/3 expression: PBS group: 1.11 ± 0.41, EPC treatment group: 1.05 ± 0.33,P = 0.861).ConclusionsOur findings demonstrate that hyperlipidaemia causes basement membrane thickening, glomerulosclerosis and the vascular degeneration of endothelial cells. The long-term administration of EPCs substantially has limited effect in the progression of kidney damage in a mouse model of hyperlipidaemia.