bluuebunny/crossref_metadata_2025_split huggingface dataset:
Lymphocyte antigen 6 superfamily member D is a marker of urothelial and squamous differentiation: implications for risk stratification of bladder cancer
Authors: Andersson Nina , Ohlsson Johan , Wahlin Sara , Nodin Björn , Boman Karolina , Lundgren Sebastian , Jirström Karin 
Published: October 2020

Abstract
Background
Screening across a multitude of normal and malignant tissues revealed an enhanced expression of lymphocyte antigen 6 superfamily member D (LY6D) in squamous epithelium and urothelium, as well as in malignancies derived therefrom. The aim of this study was to further delineate the protein expression of LY6D in urothelial bladder cancer, with particular attention to its relationship with clinicopathological characteristics and patient outcome.

Methods
Immunohistochemical expression of LY6D was assessed in tissue microarrays with urothelial bladder cancer tumours from three independent patient cohorts; one with transurethral resection of the bladder (TURB) specimens of mixed tumour stages from 110 consecutive cases, one with tumours of mixed stages from 260 incident cases in a population-based cohort, and one with paired TURB specimens, resected tumours and a subset of lymph node metastases from 145 patients with muscle-invasive bladder cancer (MIBC). Chi-square and non-parametric tests were applied to examine associations of LY6D expression with clinicopathological characteristics. Kaplan-Meier and Cox regression analyses were applied to examine 5-year overall survival (OS) and recurrence free survival (RFS) in relation to LY6D expression.

Results
In the two cohorts with mixed stages, positive LY6D expression was denoted in 63 and 64% of the cases, respectively, and found to be significantly higher in low-grade and less invasive tumours. Negative LY6D expression was significantly associated with a reduced 5-year OS, although not independently of established prognostic factors. In the population-based cohort, LY6D expression was higher in tumours with squamous differentiation and lower in other variant histologies compared to pure urothelial tumours, and the association of LY6D expression with survival was somewhat enhanced after exclusion of the former. LY6D expression was generally lower in the MIBC cohort, and even more reduced in resected tumours compared to TURB specimens in patients who had not received neoadjuvant chemotherapy. There were no significant associations between LY6D expression and RFS, neither allover nor in relation to neoadjuvant chemotherapy.

Conclusion
LY6D is a marker of urothelial and squamous differentiation that may add useful diagnostic and prognostic information to better guide the clinical management of bladder cancer, given that the presence of variant histology is taken into account.
Comparative study of elastic properties and mode I fracture energy of carbon nanotube/epoxy and carbon fibre/epoxy laminated composites
Authors: Bora Jyotikalpa , Kirtania Sushen 
Published: October 2020

AbstractA comparative study of elastic properties and mode I fracture energy has been presented between conventional carbon fibre (CF)/epoxy and advanced carbon nanotube (CNT)/epoxy laminated composite materials. The volume fraction of CNT fibres has been considered as 15%, 30%, and 60% whereas; the volume fraction of CF has been kept constant at 60%. Three stacking sequences of the laminates viz.[0/0/0/0], [0/90/0/90] and [0/30/–30/90] have been considered in the present analysis. Periodic microstructure model has been used to calculate the elastic properties of the laminated composites. It has been observed analytically that the addition of only 15% CNT in epoxy will give almost the same value of longitudinal Young’s modulus as compared to the addition of 60% CF in epoxy. Finite element (FE) analysis of double cantilever beam specimens made from laminated composite has also been performed. It has been observed from FE analysis that the addition of 15% CNT in epoxy will also give almost the same value of mode I fracture energy as compared to the addition of 60% CF in epoxy. The value of mode I fracture energy for [0/0/0/0] laminated composite is two times higher than the other two types of laminated composites.
An antibiotic stewardship program in a surgical ICU of a resource-limited country: financial impact with improved clinical outcomes
Authors: Hussain Kashif , Khan Muhammad Faisal , Ambreen Gul , Raza Syed Shamim , Irfan Seema , Habib Kiren , Zafar Hasnain 
Published: October 2020

Abstract
Background
Antibiotic resistance (ABX-R) is alarming in lower/middle-income countries (LMICs). Nonadherence to antibiotic guidelines and inappropriate prescribing are significant contributing factors to ABX-R. This study determined the clinical and economic impacts of antibiotic stewardship program (ASP) in surgical intensive care units (SICU) of LMIC.

Method
We conducted this pre and post-test analysis in adult SICU of Aga Khan University Hospital, Pakistan, and compared pre-ASP (September–December 2017) and post-ASP data (April–July 2018). January–March 2018 as an implementation/training phase, for designing standard operating procedures and training the team. We enrolled all the patients admitted to adult SICU and prescribed any antibiotic. ASP-team daily reviewed antibiotics prescription for its appropriateness. Through prospective-audit and feedback-mechanism changes were made and recorded. Outcome measures included antibiotic defined daily dose (DDDs)/1000 patient-days, prescription appropriateness, antibiotic duration, readmission, mortality, and cost-effectiveness.

Result
123 and 125 patients were enrolled in pre-ASP and post-ASP periods. DDDs/1000 patient-days of all the antibiotics reduced in the post-ASP period, ceftriaxone, cefazolin, metronidazole, piperacillin/tazobactam, and vancomycin showed statistically significant (p < 0.01) reduction. The duration of all antibiotics use reduced significantly (p < 0.01). Length of SICU stays, mortality, and readmission reduced in the post-ASP period. ID-pharmacist interventions and source-control-documentation were observed in 62% and 50% cases respectively. Guidelines adherence improved significantly (p < 0.01). Net cost saving is 6360US$ yearly, mainly through reduced antibiotics consumption, around US$ 18,000 (PKR 2.8 million) yearly.

Conclusion
ASP implementation with supplemental efforts can improve the appropriateness of antibiotic prescriptions and the optimum duration of use. The approach is cost-effective mainly due to the reduced cost of antibiotics with rational use. Better source-control-documentation may further minimize the ABX-R in SICU.
Gastrointestinal stromal tumor in perforated Meckel’s diverticulum: a case report and literature review
Authors: Hashizume Naoki , Sakamoto Saki , Fukahori Suguru , Ishii Shinji , Saikusa Nobuyuki , Koga Yoshinori , Higashidate Naruki , Tsuruhisa Shiori , Nakahara Hirotomo , Tanaka Yoshiaki , Yagi Minoru 
Published: October 2020

Abstract
Introduction
Gastrointestinal stromal tumor (GIST) is rare neoplasms of the gastrointestinal tract associated with high rates of malignant transformation. GIST has been found largely in the stomach, small bowel, colon and rectum, and esophagus, but about 5% are found in other locations. We herein report a 56-year-old woman with a GIST in perforated Meckel's diverticulum. After encountering this patient, a review of the literature found reports of 18 similar patients.

Case presentation
A 56-year-old woman diagnosed with galactosialidosis (β-galactosidase-neuraminidase deficiency) presented with vomiting. On contrast-enhanced computed tomography, peritonitis due to perforation of the intestine was diagnosed based on the free air and dilated loop of the small bowel. Laparotomy revealed perforation of Meckel’s diverticulitis located 50 cm from the ileocecal valve. Partial resection of the ileum, including the diverticulum, and end-to-end anastomosis of the small intestine were performed. Regarding the pathological findings, the edge of the diverticulum wall consisted of a solid mass measuring 1.0 cm in size, and the tumor cells were spindle-shaped with 1 mitosis present per 50 high-power fields. The diagnosis was established as GIST of the Meckel's diverticulum. The postoperative period was uneventful. Follow-up at two years revealed no evidence of recurrence.

Conclusion
GIST in perforated Meckel's diverticulum is very rare. The potential for the coexistence of GIST or other tumor should be considered in the treatment of perforated Meckel's diverticulum.
Intrahepatic cholangiocarcinoma with clear cell type following laparoscopic curative surgery
Authors: Yamamoto Takuya , Abe Tomoyuki , Oshita Akihiko , Yonehara Shuji , Katamura Yoshio , Matsumoto Nozomu , Kobayashi Tsuyoshi , Nakahara Masahiro , Ohdan Hideki , Noriyuki Toshio 
Published: October 2020

AbstractBackgroundIntrahepatic cholangiocarcinoma (ICC) is the second most common malignancy of primary liver cancer. Among the several pathological types of ICC, only five cases of the clear cell type have been reported, including the one presented below. Here we report a unique case of clear cell type ICC following laparoscopic hepatectomy.Case presentationA 67-year-old woman had a history of hepatitis B virus. Computed tomography revealed a ring-like enhanced mass 35 mm in diameter at segment 7 in the early phase. The enhancement was prolonged to the late phase through the portal phase, while the shape was irregular. Ethoxybenzy magnetic resonance imaging revealed that the tumor had a low signal intensity on T1-weighted imaging and a high signal intensity on T2-weighted imaging. Diffusion-weighted images identified that the tumor had remarkably high signal intensity. Tumor enhancement was not detected throughout the tumor in the hepatocyte phase. Upon ICC diagnosis, a laparoscopic S7 subsegmentectomy was performed. The patient’s postoperative course was uneventful. An immunohistochemical examination revealed that the cells tested positive for cytokeratin 7 (CK7), CK19, and CD56 and negative for CK20, CD10, α-fetoprotein, thyroid transcription factor-1. At 2 years after surgery, the patient remains alive without recurrence.ConclusionsHere we presented a case of clear cell ICC that was treated by laparoscopic hepatectomy. Immunological analysis, especially by CD56 and several CK markers, is helpful for diagnosing this disease.
A terminal level analysis of service quality at Nigerian seaports
Authors: Sakyi Daniel , Appiah Christian Kwarteng , Ayesu Enock Kojo , Immurana Mustapha , Baidoo Samuel Tawiah 
Published: October 2020

AbstractSeaport terminals are major facilitators of international trade. One issue that is very crucial to the performance and survival of seaport terminals is the quality of service provided. However, in order to enhance the quality of service provided at these terminals, it is important to know customers’ expectations and perceptions about service quality. Notwithstanding, very little is known about customers’ expectations and perceptions on the service quality of seaport terminals in Africa. This paper therefore provides a comparative analysis of service quality of Nigerian seaport terminals with the aid of the gap score technique of the service quality (SERVQUAL) model. It is found that generally, all the selected terminals studied have low service quality. With regard to the average gap score per service quality dimension for all the selected terminals, transparency has the best service quality (least gap score) whiles responsiveness has the least service quality (highest gap score). The implication is that, in seaport terminals quest to enhance service quality, more attention should be paid towards enhancing responsiveness by providing prompt services, helping customers and informing them when exactly services will be performed.
Reliance on emotion promotes belief in fake news
Authors: Martel Cameron , Pennycook Gordon , Rand David G. 
Published: October 2020

AbstractWhat is the role of emotion in susceptibility to believing fake news? Prior work on the psychology of misinformation has focused primarily on the extent to which reason and deliberation hinder versus help the formation of accurate beliefs. Several studies have suggested that people who engage in more reasoning are less likely to fall for fake news. However, the role of reliance on emotion in belief in fake news remains unclear. To shed light on this issue, we explored the relationship between experiencing specific emotions and believing fake news (Study 1;N = 409). We found that across a wide range of specific emotions, heightened emotionality at the outset of the study was predictive of greater belief in fake (but not real) news posts. Then, in Study 2, we measured and manipulated reliance on emotion versus reason across four experiments (totalN = 3884). We found both correlational and causal evidence that reliance on emotion increases belief in fake news: self-reported use of emotion was positively associated with belief in fake (but not real) news, and inducing reliance on emotion resulted in greater belief in fake (but not real) news stories compared to a control or to inducing reliance on reason. These results shed light on the unique role that emotional processing may play in susceptibility to fake news.
Morphological, thermal, and thermomechanical properties of cellulose nanocrystals reinforced polylactide/poly [(butylene succinate)-co-adipate] blend composite foams
Authors: Motloung Mpho Phillip , Zungu Simphiwe , Ojijo Vincent , Bandyopadhyay Jayita , Ray Suprakas Sinha 
Published: October 2020

AbstractThis study examines the influence of cellulose nanocrystal (CN) particles on the morphological, thermal, and thermo-mechanical properties of polylactide (PLA)/poly [(butylene succinate)-co-adipate] (PBSA) blend foams prepared by casting and particulate leaching method using fructose as porogen particles. The morphological analysis showed an interconnected open-cell structure, with porosity above 80%. The crystallinity of the prepared foams was disrupted by the inclusion of CN particles as observed from XRD analyses, which showed a decrease in PLA crystal peak intensity. With regards to neat blend foam, the onset thermal degradation increased with the addition of CN particles, which also increased the thermal stability at 50% weight loss. Furthermore, CN acted as a reinforcing agent in improving the stiffness of the prepared blend foam. Overall, completely environmentally friendly foams were successfully prepared, as a potential material that can replace the current existing foam materials that pose many environmental concerns. However, there is a need to develop an environmentally friendly processing technique.
Anorectal diseases in patients with Antiphospholipid syndrome: a cross-sectional study
Authors: Cunha E. , Guzela V. , Balbi G. G. M. , Sobrado C. , Andrade D. 
Published: October 2020

Abstract
Background
Hemorrhoid disease (HD) is one of the most common gastrointestinal complaints worldwide, affecting 4.4% of the general population in the United States. Since antiphospholipid syndrome (APS) may lead to intra-abdominal thrombosis, one may expect that this condition can impact the risk for HD development. Additionally, as APS patients are more prone to thrombosis and treatment with anticoagulants may increase risk of bleeding, one may also infer that rates of HD complications may be higher in this scenario. Nevertheless, no data in these regards have been published until now. The objective of the present study is to evaluate frequency of HD and describe its complications rates in antiphospholipid syndrome APS patients.

Methods
We consecutively invited patients who fulfilled APS criteria to undergo proctological examination. After examination, patients were divided in two groups, based on the presence of HD, and compared regarding different clinical manifestations and antiphospholipid profile. We performed the analysis of the data, using chi-square and Mann Whitney U when applicable and considering a significance level of 0.05. Multivariate regression analysis included age and variables with p < 0.10 in the bivariate analysis.

Results
Forty-one APS patients agreed to undergo proctological examination. All were female and overall median age was 43 (36–49). Seventeen (41.4%) patients were diagnosed with HD, with the following frequency distribution: 7 internal (41.2%), 4 external (23.5%) and 5 mixed hemorrhoids (29.4%). Of the internal hemorrhoids, 5 patients were classified as grade I (71.4%), 1 grade II (14.3%), and 1 grade IV (14.3%). Prior gestation (p = 0.067) and constipation (p = 0.067) correlated with a higher frequency of HD. In multivariate analysis, constipation remained as an important risk factor (OR 3.92,CI95% 1.03–14.2,p = 0.037). Five out of 17 patients (29.4%) reported anal bleeding, but it did not correlate with warfarin dose (p = 0.949). Surgical treatment was indicated for 10 patients (58.8%). Other anorectal findings were anal fissure, plicoma, condyloma and one chlamydial retitis.

Conclusion
We found an unexpected high frequency of hemorrhoids in APS patients, with a great proportion requiring surgical treatment.
Microbiomes of a specialist caterpillar are consistent across different habitats but also resemble the local soil microbial communities
Authors: Gomes Sofia I. F. , Kielak Anna M. , Hannula S. Emilia , Heinen Robin , Jongen Renske , Keesmaat Ivor , De Long Jonathan R. , Bezemer T. Martijn 
Published: October 2020

Abstract
Background
Insect-associated microorganisms can provide a wide range of benefits to their host, but insect dependency on these microbes varies greatly. The origin and functionality of insect microbiomes is not well understood. Many caterpillars can harbor symbionts in their gut that impact host metabolism, nutrient uptake and pathogen protection. Despite our lack of knowledge on the ecological factors driving microbiome assemblages of wild caterpillars, they seem to be highly variable and influenced by diet and environment. Several recent studies have shown that shoot-feeding caterpillars acquire part of their microbiome from the soil. Here, we examine microbiomes of a monophagous caterpillar (Tyria jacobaeae) collected from their natural host plant (Jacobaea vulgaris) growing in three different environments: coastal dunes, natural inland grasslands and riverine grasslands, and compare the bacterial communities of the wild caterpillars to those of soil samples collected from underneath each of the host plants from which the caterpillars were collected.

Results
The microbiomes of the caterpillars were dominated by Proteobacteria, Actinobacteria, Firmicutes and Bacteroidetes. Only 5% of the total bacterial diversity represented 86.2% of the total caterpillar’s microbiome. Interestingly, we found a high consistency of dominant bacteria within the family Burkholderiaceae in all caterpillar samples across the three habitats. There was one amplicon sequence variant belonging to the genus Ralstonia that represented on average 53% of total community composition across all caterpillars. On average, one quarter of the caterpillar microbiome was shared with the soil.

Conclusions
We found that the monophagous caterpillars collected from fields located more than 100 km apart were all dominated by a single Ralstonia. The remainder of the bacterial communities that were present resembled the local microbial communities in the soil in which the host plant was growing. Our findings provide an example of a caterpillar that has just a few key associated bacteria, but that also contains a community of low abundant bacteria characteristic of soil communities.
Continuum modelling of structure formation of biosilica patterns in diatoms
Authors: Bobeth Manfred , Dianat Arezoo , Gutierrez Rafael , Werner David , Yang Hongliu , Eckert Hagen , Cuniberti Gianaurelio 
Published: October 2020

AbstractFormation of regularly structured silica valves of various diatom species is a particularly fascinating phenomenon in biomineralization. Intensive investigations have been devoted to elucidate the formation mechanisms of diatom valve structures. Phase-separation of species-specific organic molecules has been proposed to be involved in pattern formation, where the evolving organic molecule structures serve as template for silica formation. In the present work, using a continuum approach, we investigate the conditions under which silica structures of high regularity can develop within a phase separation model. In relation to previously reported in vitro experiments of silica formation, which revealed the important role of phosphate ions in the self-assembly of organic molecules, we propose a model where phase separation is coupled with a chemical reaction. We analyze the impact of the reaction of phosphate ions with organic molecules on the appearing morphology of the organic template. Two- and three-dimensional simulations of the development of regular stationary patterns are presented. The influence of a confined geometry and an interaction of organic molecules with the walls on pattern formation is also addressed. We expect that our approach will be relevant for experimental studies aiming at inducing structure formation under controlled in vitro conditions.
The early communicative skills among a sample of Egyptian infants and toddlers
Authors: Mohammed Hassnaa Othman , Mahmoud Nesreen Fathi 
Published: October 2020

AbstractBackgroundThe development of early communicative skills has always been an area of interest in the medical field. Although the assessment of early communicative skills and its relation to language development is important, it is a deficient field of research among Egyptian children. Therefore the current work is aiming to explore the early communicative skills among a sample of infants and toddlers in Egypt and to develop an Arabic assessment tool for early communicative abilities. A cross-sectional study was carried on in the period between January 2015 and January 2018. The study developed an assessment tool for assessment of early communicative skills (Early Communicative Skills Assessment Checklist in Arabic (ECSAC)) and then examined these communicative abilities among a sample of normally developed 151 Egyptian infants and toddler [83 (55%) males and 68 (45%) females] aged between 6 and 24 months. Then, the normative data of development of the early communicative skills were determined for the children in the period from 6 to 12 months, 13 to 18 months, and 19 to 24 months.ResultsECSAC was a valid and reliable tool for assessment of early communicative skills among Egyptian children. The normal age of development of different early communicative skills was determined. Both sexes performed equally on the checklist.ConclusionECSAC is a valid and reliable assessment tool among Egyptian infants and toddler.
Hedgehog produced by the Drosophila wing imaginal disc induces distinct responses in three target tissues
Authors: Hatori Ryo , Kornberg Thomas B. 
Published: October 2020

ABSTRACT
Hedgehog (Hh) is an evolutionarily conserved signaling protein that has essential roles in animal development and homeostasis. We investigated Hh signaling in the region of the Drosophila wing imaginal disc that produces Hh and is near the tracheal air sac primordium (ASP) and myoblasts. Hh distributes in concentration gradients in the anterior compartment of the wing disc, ASP and myoblasts, and activates genes in each tissue. Some targets of Hh signal transduction are common to the disc, ASP and myoblasts, whereas others are tissue-specific. Signaling in the three tissues is cytoneme-mediated and cytoneme-dependent. Some ASP cells project cytonemes that receive both Hh and Branchless (Bnl), and some targets regulated by Hh signaling in the ASP are also dependent on Bnl signal transduction. We conclude that the single source of Hh in the wing disc regulates cell type-specific responses in three discreet target tissues.