bluuebunny/crossref_metadata_2025_split huggingface dataset:
Importance of Respiratory Syncytial Virus as a Predictor of Hospital Length of Stay in Bronchiolitis
Authors: buendia jefferson , Guerrero Diana , Martinez Carlos Rodriguez 
Published: August 2020

Abstract
BackgroundBronchiolitis is the leading cause of hospitalization in children. Estimate potentially preventable variables that impact the length of hospital stay are a priority to reduce the costs associated with this disease.ObjectiveThis study aims to identify clinical variables associated with length of hospital stay of bronchiolitis in children in a tropical middle-income countryMethodsWe conducted a retrospective cohort study in 417 infants with bronchiolitis in tertiary centers in Colombia. All medical records of all patients admitted to the emergency department were reviewed. To identify factors independently associated we use negative binomial regression model, to estimate incidence rate ratios (IRR) and adjust for potential confounding variablesResultsThe median of the length of hospital stay was 3.68 days, with a range of 0.74 days to 29 days, 138 (33.17%) of patients have a hospital stay of 5 or more days. After modeling and controlling for potential confounders age < 6 months, comorbidities (CHD or neurological), BPD, chest indrawing, RSV isolation, and C-reactive protein were independent predictors of LOSConclusionsOur results show that in infants with bronchiolitis, RSV isolation, age < 6 months, comorbidities (CHD or neurological), BPD, chest indrawing, and C-reactive protein were independent predictors of LOS. As a potentially modifiable risk factor, efforts to reduce the probability of RSV infection can reduce the hight medical cost associates with prolonged LOS in bronchiolitis.
Spirulina Prevent Caspase-Independent Apoptosis in the Cochlea and Brainstem of Senescence-Accelerated Prone-8 Mice
Authors: Chan Yin-Ching , Lin Mei-Hsiao , Hwang Juen-Haur 
Published: August 2020

Abstract
Background: Spirulina platensis water extract (SP) could decrease hearing degeneration via reducing oxidative stress damages in the auditory system of senescence-accelerated prone-8 (SAMP8) mice. This study aimed to investigate the effects of SP on the caspase-independent apoptosis in the cochlea and brainstem of SAMP8 mice.Methods: Twelve 11-month-old SAMP8 mice were randomly divided into two groups: control group (SAMP8 mice was fed a normal diet) and spirulina group (SAMP8 mice was fed a normal diet with oral supplementation SP for 6 weeks. Auditory brainstem responses (ABRs) were measured in the beginning and at the end of the study. Cochlear histology and immunochemistry and Western blotting of brainstem were performed at the end of the study.Results: Compared with control group, spirulina group had significantly lower ABR thresholds using click sound stimulation at the end of this study. The spirulina group had significantly higher counts of outer hair cells (OHC) and spiral ganglion neuron (SGN) density in the middle turn of the cochlea. The spirulina group had significantly lower expressions of poly (ADP-ribose) polymerase-1 (PARP-1) and apoptosis-inducing factor (AIF) in the cochlea. Also, the spirulina group had significantly lower expression of PARP-1, but not the AIF, in the brainstem.Conclusions: SP could decrease hearing degeneration in SAMP8 mice possibly via reducing caspase-independent apoptosis signal pathway in the cochlea and brainstem.
Clinical Significance of Rapid and Sensitive Quantification of Pseudomonas aeruginosa by Quantitative Reverse Transcription PCR Targeting of rRNA Molecules
Authors: Niikura Mai , Atobe Satomi , Takahashi Akira , Kado Yukiko , Sugimoto Takuya , Tsuji Hirokazu , Shimizu Kentaro , Ogura Hiroshi , Asahara Takashi 
Published: August 2020

Abstract
Background: For Pseudomonas aeruginosa, nosocomial infection control and appropriate antimicrobial treatment have become important issues. Diagnosis is critical in managing P. aeruginosa infection, but conventional methods are not highly accurate or rapid. A novel P. aeruginosa quantification system based on 23S rRNA-targeted quantitative reverse transcription PCR (qRT-PCR) is a candidate diagnostic tool for managing P. aeruginosa infection. Here, we assessed the performance and potential impact of qRT-PCR on antibiotic therapy administered to ICU patients.Methods: We first evaluated specificity and detection sensitivity of the 23S rRNA-targeted qRT-PCR system in vitro and determined whether P. aeruginosa viable counts detected by this system reflect the inflammatory response of infected cells. Next, we utilized this system on fecal samples collected from 65 septic ICU patients and 44 healthy volunteers to identify the ICU infection status. Additionally, we monitored drug-resistant P. aeruginosa in 4 ICU patients. The trend was compared with trends in fecal microbiota composition, antibiotic use, and mechanical ventilator use.Results: The 23S rRNA-targeted qRT-PCR system quantified P. aeruginosa directly from clinical samples with high sensitivity (blood, 1 cell/mL; stool, 100 cells/g) without cross-reaction (within 6 h). Additionally, P. aeruginosa numbers detected under antibacterial treatment correlated well with the inflammatory response compared to other detection methods such as culturing and qPCR. Using this system, we confirmed that the P. aeruginosa detection ratio in ICU patients was significantly higher than that in healthy volunteers (49.2% vs. 13.6%, P<0.05). While some ICU patients had high P. aeruginosa numbers in feces (108 cells/g of feces), some patients had very low P. aeruginosa numbers (102 cells/g of feces) as observed in healthy volunteers. P. aeruginosa counts in feces of ICU patients monitored by this system correlated negatively with the proportion of total obligate anaerobes and positively with facultative anaerobes and aerobes. Additionally, trends in P. aeruginosa counts accurately reflected various treatment backgrounds of ICU patients.Conclusion: Our results suggest that this new 23S rRNA-targeted qRT-PCR system is beneficial for early diagnosis and evaluation of appropriate antibacterial treatment and may be a useful tool in combating P. aeruginosa infection.
Descriptive Evaluation of SBIRT Adoption, Implementation, and Delivery across a Health System
Authors: Keen Alyson , Thoele Kelli M , Oruche Ukamaka , Newhouse Robin 
Published: August 2020

Abstract
Background: Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an evidence-based intervention used to enhance reductions in alcohol and illicit drug use. SBIRT use has resulted in positive health and social outcomes. However, SBIRT implementation remains low. Research on implementation of evidence-based interventions, such as SBIRT, lacks information about challenges and successes related to implementation. The Expert Recommendations for Implementing Change (ERIC) provides a framework that improves the comprehension, clarity, and relevance of strategies available for implementation research. This framework was applied to structure findings from analyses of qualitative interview data gathered from local champions leading SBIRT implementation. The purpose of this study was to understand site coordinators’ (SCs) perceptions of SBIRT implementation and employed strategies. Study aims included (1) describe SCs’ perceptions of barriers, facilitators, and outcomes related to SBIRT implementation, and (2) describe strategies perceived as most effective to implement SBIRT. Methods: This was a descriptive study conducted with 14 SCs, representing 14 medical surgical units within a large healthcare system. A semi-structured interview guide was developed by the study team to capture barriers, facilitators, and outcomes related to SBIRT implementation. A follow-up survey, based on 14 commonly identified ERIC strategies during SC interviews, was administered to determine the SC’s perceptions of the most helpful (i.e. effective) implementation strategies on a scale of 1 (least helpful) to 5 (most helpful).Results: All site coordinators participated in the SBIRT implementation interview, and 11 of 14 (79%) responded to the follow-up survey. Within the categories of barriers, facilitators, and outcomes, 25 subthemes emerged. The most highly rated effective ERIC implementation strategies were purposely reexamining the implementation (M=4.38; n=8), providing ongoing consultation (M=4.13; n=8), auditing and providing feedback (M=4.1; n=10), developing education materials (M=4.1; n=10), identifying and preparing champions (M=4; n=7), and tailoring strategies (M=4; n=7). Conclusion: This study applied a common framework (ERIC) to implementation lessons within a large health system that can be replicated in other implementation studies and quality improvement efforts. Adapting and sustaining change are challenging in healthcare settings. However, understanding and using the most helpful implementations strategies may support healthcare teams to adopt and sustain interventions such as SBIRT.
Health Care Expert’s Readiness to Implement National Unified Medical Records (Numr) System in the United Arab Emirates; A Qualitative Study
Authors: Harbi Alya 
Published: August 2020

Abstract
Background
Electronic health records provide a valuable resource to improve health evaluation, surveillance and informs effective clinical decision making. Although electronic medical records (EMR) are introduced in many different settings, yet little is known about the readiness, effectiveness and progress of a centralized information system like NUMR across United Arab Emirates. This study aims to determine the readiness for national unified medical record (NUMR), barriers and challenges from the point of views of experts working in the field of health informatics on daily basis.
Methods
Semi-structured interviews were conducted with 10 experts using purposive sampling method from different healthcare organizations in the United Arab Emirates. Perceptions of interviewees regarding the readiness for national unified medical record were elicited. Thematic analysis was used to identify the different themes extracted from the interview transcripts.
Results
Overall, seven themes emerged after analyzing the transcripts obtained from the respondents. This study is expected to bring countless benefits for all countries that are moving forward toward nationwide and interoperable healthcare platforms. The support for NUMR will make a significant contribution to the health systems across UAE that will ultimately lead to safety, access to single shared records, improved care and coordination, better clinical and decision making, faster engagement, easy and secure access, safety and will save time for other tasks.
Conclusion
The future of implementation of NUMR in UAE is promising. Our findings offer beneficial guidelines for consideration in implementing NUMR system across UAE and also helps in the drive to improve healthcare systems nationally.
Anticancer activity of food grade nanoemulsions on hepatic cancer cells: a comparative study
Authors: Hassan Sayyeda Hira , Khan Muhammad Rehan 
Published: August 2020

Abstract
The current study was aimed to prepare stable NEs from plant oils to evaluate their cytotoxic effect on HepG2 cells. Oils form three different samples (flax seeds, cloves and olives) were extracted. NEs from these oils were prepared separately by ultrasonication method. After characterization of stable NEs, they were evaluated for their antioxidant and anticancer activities. Extracted oils and their NEs were applied separately to HepG2 cell line to construct a comparison and MTT assay was used for this purpose. Prepared NEs were found more effective against cancer cell line as compared to their respective oils. MTT assay showed efficacy of NEs in reducing cell viability with IC50 value of 10 µl (flax seed oil), 25 µl (clove oil NE) and 1 µl (olive oil NE), and was safe to normal cells. The results of the current study revealed that NEs prepared from flax seed, clove and olive oil have the potential for further development as anticancer agents.
WNT4, a potential biomarker in serum for colorectal cancer, promotes metastasis through WNT4/β-catenin pathway
Authors: Yang Dongmei , Li Qing , Shang Renduo , Yao Liwen , Wu Lianlian , Zhang Mengjiao , Zhang Lihui , Xu Ming , Lu Zihua , Zhou Jie , Huang Li , Huang Xiaodong , Cheng Du , Yang Yanning , Yu Honggang 
Published: August 2020

Abstract
Background
Wingless and Int-related protein (Wnt) ligands were aberrantly expressed in human diseases. However, the aberrant level of Wnt ligands have not been explored in serum. Here, we aimed to identify the WNT4 level in serum and explore its oncogenic role in colorectal cancer (CRC).
Methods
Serum samples from 40 CRC patients and 28 healthy donors were collected to measure the levels of WNT4. CRC tissue samples from patients were collected to explore the resource of WNT4. Further, we used CRC cells and xenograft mouse model to explore the oncogenic role of WNT4.
Results
WNT4 was significantly upregulated in serum of colorectal cancer (CRC) patients, and CRC tissues were identified as an important source of elevated WNT4 levels in CRC patients. Interestingly, the elevated WNT4 in serum was downregulated after tumor resection. Next, we found that WNT4 could contributed to epithelial-to-mesenchymal transition and activated fibroblasts by activating WNT4/β-catenin pathway in vitro and in vivo; besides, angiogenesis was also induced via WNT4/β-catenin/Ang2 pathway. Those effects could be reversed by ICG-001, a β-catenin/TCF inhibitor.
Conclusion
These data indicated that WNT4 may be a potential biomarker for CRC and provided evidence to support a critical role of WNT4 in promoting CRC cell metastasis by inducing epithelial-to-mesenchymal transition, activating fibroblasts and promoting angiogenesis in the colorectal tumor microenvironment.
Continuous Erector Spinae Plane Block versus Intercostal Nerve Block in Patients Undergoing Video-assisted Thoracoscopic Surgery: A Pilot Randomized Controlled Trial
Authors: Horth Dillon , Sanh William , Moisiuk Peter , O’Hare Turlough , Shargall Yaron , Finley Christian , Hanna Waël , Agzarian John , Forero Mauricio , Davis Kim , Vanniyasingam Thuva , Thabane Lehana , Shanthanna Harsha 
Published: August 2020

Abstract
Background: The optimal analgesia method in video-assisted thoracoscopic surgery (VATS) remains controversial. Intercostal nerve blockade (ICNB) is limited by its duration of action. The erector spinae plane (ESP) block has the potential to provide satisfactory analgesia for VATS; however, the effectiveness of continuous ESP versus surgeon-performed ICNB has not been investigated. The objectives of this study were to establish feasibility of patient recruitment and follow-up before undertaking a fully powered randomized controlled trial (RCT); and, secondarily, to compare opioid usage, pain control, and sensory blockade.Methods: This feasibility RCT was undertaken at St Joseph’s Hospital, Hamilton, Ontario, Canada, and included 24 patients (>18 years) having elective VATS with at least one overnight stay. Exclusion criteria were patient refusal; body mass index >40 kg/m2; contraindications to neuraxial analgesia techniques as per the American Society of Regional Anesthesia and Pain guidelines; known allergy to local anesthetics; language or comprehension barriers; procedures with a higher chance of open surgery; and regular opioid use for ≥3 months preoperatively. Patients underwent either continuous ESP (n=12) or surgeon-performed ICNB (n=12). All patients received routine intraoperative anesthesia care and multimodal analgesia. Feasibility criteria were recruitment rate of two patients/week and full follow-up in all patients in-hospital. We compared opioid consumption, postoperative pain scores (0–10 numerical rating scale), adverse events, patient satisfaction, and distribution of sensory blockade as clinical outcomes (secondary).Results: Feasibility of primary outcomes was successfully demonstrated. Five patients had an epidural in anticipation of open surgery. Mean opioid consumption was less in the ESP group over the first 48 h (mean difference, 1.63 [95% CI –1.20 to 4.45] morphine units). There were no differences in adverse effects. Conclusions: A fully powered RCT is feasible. Our results also suggest that continuous ESP is safe and can decrease opioid needs. However, it is important to consider procedures to improve compliance to protocol. Trial registration: Clinicaltrials.gov identifier: NCT03176667. Registered June 5, 2017, https://clinicaltrials.gov/ct2/show/NCT03176667
Sequential pretreatment to recover carbohydrates and phosphorus from Desmodesmus sp. cultivated in municipal wastewater
Authors: González-Balderas R. M. , Velásquez-Orta S. B. , Valdez-Vazquez I. , Orta Ledesma M. T. 
Published: August 2020

Abstract
This study focused on the simultaneous recovery of carbohydrates (CHO) and phosphorus (P) from Desmodesmus sp. biomass cultivated in municipal wastewater, through a sequential pretreatment. The pretreatment consisted first of ultrasound to trigger cell disruption followed by ozonation to recover CHO and P. For ozone pretreatment, three different parameters were considered: ozone concentration (9, 15, 21, 27, 36, and 45 mg O3/L), contact time (15, 25 and 35 min), and pH (8 and 11). The maximum simultaneous release of 84% of CHO and 58% of P was achieved at the experimental parameters of ozone concentration of 45 mg O3/L, contact time of 35 min, and pH of 11. Also, P was concentrated in solution by 8- to 14-fold with respect to municipal wastewater. The sequential pretreatment was conducted at alkaline pH of 11 and atmospheric conditions, which may considerably reduce energy demand and reagents, in comparison to a traditional hydrolysis pretreatment. The results found suggest that the sequential pretreatment could be feasible on a large scale.
Modified Microtensile Bond Strength of Glass Ionomer to Composite Resin Using Universal Adhesive in Self-etch and Total-etch Modes
Authors: Kermanshah Hamid , Omrani Ladan R. , Hemati Omid , Pedram Prham , Ahmadi Elham 
Published: August 2020

Background:
Glass Ionomer Cements (GICs) are frequently used as base or liner before the application of restorative materials. The success of this approach depends on the bond strength of GICs to composite resin.

Objectives:
This study to assess the modified microtensile bond strength of glass ionomer to composite resin using universal adhesive in self-etch and total-etch modes.

Methods:
Samples were fabricated of resin-modified GIC (RMGIC) and conventional GIC(CGIC) (6 x 1 x 1 mm), and were randomly divided into 8 groups. Clearfil SE Bond and G-Premio universal adhesive in self-etch and total-etch modes were used according to the manufacturers’ instructions. Z250 composite was applied over the GIC (12 x 1 x 1 mm), and light-cured. The microtensile bond strength was measured using a universal testing machine. The samples in each group were evaluated under an electron microscope to determine the mode of failure. Data were analyzed using one-way ANOVA and Tukey’s test.

Results:
The microtensile bond strength of RMGI used with Clearfil SE Bond was significantly higher than that of other groups (6.57±1.15 MPa) (P<0.05). The maximum and minimum microtensile bond strength values of CGIC after applying the bonding agents were recorded after using G-Premio total-etch mode (1.34±0.77 MPa) and SE Bond in total-etch mode(1.18±79 MPa), respectively.

Conclusion:
Application of of G-Premio in both modes did not show any significant different bond strength in both glass ionomers. The bond strength of RMGIC was higher than that of CGIC, and the maximum bond strength of RMGI was achieved by the use of SE Bond.
Corneal Indices Determined with Pentacam in Possible Candidates for Corneal Refractive Surgery
Authors: Alvarez Eduardo R. , Montesinos Giuseppe M. , Torres Piedra Diego M. , Palacios Nataly T. , Téllez Osvaldo F. 
Published: August 2020

Objective:
To describe the level of correlation of clinical refractive variables with corneal indices in Pentacam Scheimpflug tomography, demonstrate the usefulness of the study of corneal indices in the diagnosis of keratoconus (KC), and identify the corneal indexes with the greatest influence on the diagnosis of KC.

Methods:
A descriptive, retrospective, and cross-sectional study was conducted in 69 patients (138 eyes) with refractive disorders, possible candidates for corneal refractive surgery, at the Exilaser Ophthalmological Center, Cuenca, Ecuador, from March to August 2019. Corneal indices were studied using Pentacam. Statistical correlation methods, Levene’s test, Fisher’s exact test, Cramérs’ V coefficient, and multiple correspondence analyses were used.

Results:
The variables refractive cylinder and central keratometry had a direct correlation with the corneal indices (p<0.001). An inverse correlation was obtained between central pachymetry and corneal indices (p<0.001). A high level of dependence on central KC index (CKI) (Cramér V = 0.785) and KC index (KI) (Cramér V = 0.775) was obtained with the diagnosis of KC.

Conclusion:
Pentacam is a valuable tool in the analysis of corneal indices for the diagnosis of KC, given its high level of correlation with clinical refractive variables. The selection of candidates for refractive surgery, even when there is no diagnosis of KC, is strengthened with the analysis of the corneal indices. The indices with the most intense level of dependence with the diagnosis of KC are, in order, the following indices: CKI, KI, vertical asymmetry, minimum radius, and variation of the surface.
Impregnability and Performance of rCF-nonwovens with epoxy resin
Authors: Mankiewicz Jasmin , Cleve Ernst , Heber Michael , Gutmann Jochen Stefan 
Published: August 2020

Currently, the carbon fiber key market increases intensely. In consequence of production, 10–30 % of cost-intensive carbon fiber waste is accumulated by blending fabrics, prepregs which are out of specification and end-of-life products. Because of a landfill ban for carbon fibers, environmental aspects and a cost reduction potential, there is a stronger focus on carbon fiber recycling. Through new recycling methods, the carbon fiber is regained from polymer matrix, but looses its woven structure.One possibility to re-use chopped recycled fibers is through a fiber mat. Carbon fiber nonwovens can be fabricated by a wet-laid process, for example. For recycled fibers without a specific fiber length and sizing, a challenge lies in separating them in dispersion to get homogenous nonwovens and interlink the fibers in the nonwoven. For the first step, stirring and surfactants improve the separation, hydroxyethylcellulose ensures the bonding. Then the nonwoven can be impregnated with thermosets by resin transfer molding (RTM). The University of Applied Science Niederrhein is the first to investigate the whole process chain from handling recycled carbon fibers in order to attain the finished composite. Optical impregnability is inspected and material properties (tensile strength and Young’s modulus) are analyzed and compared to virgin fibers to get information on performance. A density range from 1.18 (5% CF) to 1.4 g/cm³ (40% CF) is very attractive for lightweight constructions as well.