bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sepsis related mortality of extremely low gestational age newborns after the introduction of colonization screening for multi-drug resistant organisms
Authors: Härtel Christoph , Faust Kirstin , Fortmann Ingmar , Humberg Alexander , Pagel Julia , Haug Clara , Kühl Reinhard , Bohnhorst Bettina , Pirr Sabine , Viemann Dorothee , Simon Arne , Zemlin Michael , Poralla Silvia , Müller Andreas , Köstlin-Gille Natascha , Gille Christian , Heckmann Matthias , Rupp Jan , Herting Egbert , Göpel Wolfgang 
Published: August 2020

Abstract
Background
In 2013 German infection surveillance guidelines recommended weekly colonization screening for multidrug-resistant (MDRO) or highly epidemic organisms for neonatal intensive care units (NICUs) and extended hygiene measures based on screening results. It remains a matter of debate whether screening is worth the effort. We therefore aimed to evaluate sepsis related outcomes before and after the guideline update.

Methods
The German Neonatal Network (GNN) is a prospective cohort study including data from extremely preterm infants between 22 + 0 and 28 + 6 gestational weeks born in 62 German level III NICUs.

Results
Infants treated after guideline update (n = 8.903) had a lower mortality (12.5% vs. 13.8%, p = 0.036), reduced rates for clinical sepsis (31.4 vs. 42.8%, p <  0.001) and culture-proven sepsis (14.4% vs. 16.5%, p = 0.003) as compared to infants treated before update (n = 3.920). In a multivariate logistic regression analysis, nine pathogens of culture-proven sepsis were associated with sepsis-related death, e.g. Pseudomonas aeruginosa [OR 59 (19–180), p <  0.001)]. However, the guideline update had no significant effect on pathogen-specific case fatality, total sepsis-related mortality and culture-proven sepsis rates with MDRO. While the exposure of GNN infants to cefotaxime declined over time (31.1 vs. 40.1%, p <  0.001), the treatment rate with meropenem was increased (31.6 vs. 26.3%, p <  0.001).

Conclusions
The introduction of weekly screening and extended hygiene measures is associated with reduced sepsis rates, but has no effects on sepsis-related mortality and sepsis with screening-relevant pathogens. The high exposure rate to meropenem should be a target of antibiotic stewardship programs.
Impact and returns on investment of mungbean research and development in Myanmar
Authors: Sequeros Teresa , Schreinemachers Pepijn , Depenbusch Lutz , Shwe Tun , Nair Ramakrishnan Madhavan 
Published: August 2020

Abstract
Background
There is a need for better evidence for the impact of plant breeding research on nutrient-rich crops such as pulses to guide policy-making and investment. Mungbean (Vigna radiata (L). Wilczek) is one of the major pulses of South and Southeast Asia and makes an important contribution to food security and agricultural sustainability. The objective of this study is to quantify impact of and returns on investment from international mungbean breeding research for Myanmar.

Methods
This study applies the economic surplus model, which is a widely applied method to quantify the economic impact of agricultural technology adoption at the aggregate level. Sensitivity analysis is used to test some of the key assumptions underlying the method. All data come from secondary sources. Estimates of economic impact are combined with investment costs to quantify returns on investment.

Results
Four mungbean varieties coming out of international agricultural research and released by the national agricultural system of Myanmar created aggregate economic gains of USD 1.4 billion from 1980 to 2016 and this is projected to increase to USD 3.7 billion by 2030. International donors and the Myanmar government invested about USD 5 million in the country’s mungbean research and development over this period. The average dollar invested generated USD 92 in economic gains up to 2016 and this is expected to increase to USD 181 by 2030. The internal rate of return is 27%. There is a 20-year time lag between start of investment and start of economic benefits.

Conclusions
International research into mungbean improvement led by the World Vegetable Center has created tremendous economic impact for Myanmar, most of it accruing to smallholder farm households and laborers contributing to the mungbean harvest. The unconditional sharing of plant genetic resources between national agricultural research systems in Asia was a key contributor to the success. It is important that this culture of sharing is maintained. The finding that agricultural research investment in mungbean gives high returns supports the case for diversifying investments into nutrient-rich crops to address Asia’s and the world’s nutritional and environmental challenges.
A five-compartment model of age-specific transmissibility of SARS-CoV-2
Authors: Zhao Ze-Yu , Zhu Yuan-Zhao , Xu Jing-Wen , Hu Shi-Xiong , Hu Qing-Qing , Lei Zhao , Rui Jia , Liu Xing-Chun , Wang Yao , Yang Meng , Luo Li , Yu Shan-Shan , Li Jia , Liu Ruo-Yun , Xie Fang , Su Ying-Ying , Chiang Yi-Chen , Zhao Ben-Hua , Cui Jing-An , Yin Ling , Su Yan-Hua , Zhao Qing-Long , Gao Li-Dong , Chen Tian-Mu 
Published: August 2020

Abstract
Background
The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, also called 2019-nCoV) causes different morbidity risks to individuals in different age groups. This study attempts to quantify the age-specific transmissibility using a mathematical model.

Methods
An epidemiological model with five compartments (susceptible–exposed–symptomatic–asymptomatic–recovered/removed [SEIAR]) was developed based on observed transmission features. Coronavirus disease 2019 (COVID-19) cases were divided into four age groups: group 1, those ≤ 14 years old; group 2, those 15 to 44 years old; group 3, those 45 to 64 years old; and group 4, those ≥ 65 years old. The model was initially based on cases (including imported cases and secondary cases) collected in Hunan Province from January 5 to February 19, 2020. Another dataset, from Jilin Province, was used to test the model.

Results
The age-specific SEIAR model fitted the data well in each age group (P < 0.001). In Hunan Province, the highest transmissibility was from age group 4 to 3 (median: β43 = 7.71 × 10− 9; SAR43 = 3.86 × 10− 8), followed by group 3 to 4 (median: β34 = 3.07 × 10− 9; SAR34 = 1.53 × 10− 8), group 2 to 2 (median: β22 = 1.24 × 10− 9; SAR22 = 6.21 × 10− 9), and group 3 to 1 (median: β31 = 4.10 × 10− 10; SAR31 = 2.08 × 10− 9). The lowest transmissibility was from age group 3 to 3 (median: β33 = 1.64 × 10− 19; SAR33 = 8.19 × 10− 19), followed by group 4 to 4 (median: β44 = 3.66 × 10− 17; SAR44 = 1.83 × 10− 16), group 3 to 2 (median: β32 = 1.21 × 10− 16; SAR32 = 6.06 × 10− 16), and group 1 to 4 (median: β14 = 7.20 × 10− 14; SAR14 = 3.60 × 10− 13). In Jilin Province, the highest transmissibility occurred from age group 4 to 4 (median: β43 = 4.27 × 10− 8; SAR43 = 2.13 × 10− 7), followed by group 3 to 4 (median: β34 = 1.81 × 10− 8; SAR34 = 9.03 × 10− 8).

Conclusions
SARS-CoV-2 exhibits high transmissibility between middle-aged (45 to 64 years old) and elderly (≥ 65 years old) people. Children (≤ 14 years old) have very low susceptibility to COVID-19. This study will improve our understanding of the transmission feature of SARS-CoV-2 in different age groups and suggest the most prevention measures should be applied to middle-aged and elderly people.
Differential diagnosis of coronavirus disease 2019 from community-acquired-pneumonia by computed tomography scan and follow-up
Authors: Liu Kai-Cai , Xu Ping , Lv Wei-Fu , Chen Lei , Qiu Xiao-Hui , Yao Jin-Long , Gu Jin-Feng , Hu Bo , Wei Wei 
Published: August 2020

Abstract
Objective
Coronavirus disease 2019 (COVID-19) is currently the most serious infectious disease in the world. An accurate diagnosis of this disease in the clinic is very important. This study aims to improve the differential ability of computed tomography (CT) to diagnose COVID-19 and other community-acquired pneumonias (CAPs) and evaluate the short-term prognosis of these patients.

Methods
The clinical and imaging data of 165 COVID-19 and 118 CAP patients diagnosed in seven hospitals in Anhui Province, China from January 21 to February 28, 2020 were retrospectively analysed. The CT manifestations of the two groups were recorded and compared. A correlation analysis was used to examine the relationship between COVID-19 and age, size of lung lesions, number of involved lobes, and CT findings of patients. The factors that were helpful in diagnosing the two groups of patients were identified based on specificity and sensitivity.

Results
The typical CT findings of COVID-19 are simple ground-glass opacities (GGO), GGO with consolidation or grid-like changes. The sensitivity and specificity of the combination of age, white blood cell count, and ground-glass opacity in the diagnosis of COVID-19 were 92.7 and 66.1%, respectively. Pulmonary consolidation, fibrous cords, and bronchial wall thickening were used as indicators to exclude COVID-19. The sensitivity and specificity of the combination of these findings were 78.0 and 63.6%, respectively. The follow-up results showed that 67.8% (112/165) of COVID-19 patients had abnormal changes in their lung parameters, and the severity of the pulmonary sequelae of patients over 60 years of age worsened with age.

Conclusions
Age, white blood cell count and ground-glass opacity have high accuracy in the early diagnosis of COVID-19 and the differential diagnosis from CAP. Patients aged over 60 years with COVID-19 have a poor prognosis. This result provides certain significant guidance for the diagnosis and treatment of new coronavirus pneumonia.
Nup133 and ERα mediate the differential effects of hyperoxia-induced damage in male and female OPCs
Authors: Sunny Donna Elizabeth , Hammer Elke , Strempel Sebastian , Joseph Christy , Manchanda Himanshu , Ittermann Till , Hübner Stephanie , Weiss Frank Ulrich , Völker Uwe , Heckmann Matthias 
Published: August 2020

Abstract
Background
Hyperoxia is a well-known cause of cerebral white matter injury in preterm infants with male sex being an independent and critical risk factor for poor neurodevelopmental outcome. Sex is therefore being widely considered as one of the major decisive factors for prognosis and treatment of these infants. But unfortunately, we still lack a clear view of the molecular mechanisms that lead to such a profound difference. Hence, using mouse-derived primary oligodendrocyte progenitor cells (OPCs), we investigated the molecular factors and underlying mechanisms behind the differential response of male and female cells towards oxidative stress.

Results
We demonstrate that oxidative stress severely affects cellular functions related to energy metabolism, stress response, and maturation in the male-derived OPCs, whereas the female cells remain largely unaffected. CNPase protein level was found to decline following hyperoxia in male but not in female cells. This impairment of maturation was accompanied by the downregulation of nucleoporin and nuclear lamina proteins in the male cells. We identify Nup133 as a novel target protein affected by hyperoxia, whose inverse regulation may mediate this differential response in the male and female cells. Nup133 protein level declined following hyperoxia in male but not in female cells. We show that nuclear respiratory factor 1 (Nrf1) is a direct downstream target of Nup133 and that Nrf1 mRNA declines following hyperoxia in male but not in female cells. The female cells may be rendered resistant due to synergistic protection via the estrogen receptor alpha (ERα) which was upregulated following hyperoxia in female but not in male cells. Both Nup133 and ERα regulate mitochondrial function and oxidative stress response by transcriptional regulation of Nrf1.

Conclusions
These findings from a basic cell culture model establish prominent sex-based differences and suggest a novel mechanism involved in the differential response of OPCs towards oxidative stress. It conveys a strong message supporting the need to study how complex cellular processes are regulated differently in male and female brains during development and for a better understanding of how the brain copes up with different forms of stress after preterm birth.
Resistance to PD-1/PD-L1 blockade cancer immunotherapy: mechanisms, predictive factors, and future perspectives
Authors: Sun Jin-Yu , Zhang Dengke , Wu Songquan , Xu Min , Zhou Xiao , Lu Xiao-Jie , Ji Jiansong 
Published: August 2020

AbstractPD-1/PD-L1 blockade therapy is a promising cancer treatment strategy, which has revolutionized the treatment landscape of malignancies. Over the last decade, PD-1/PD-L1 blockade therapy has been trialed in a broad range of malignancies and achieved clinical success. Despite the potentially cure-like survival benefit, only a minority of patients are estimated to experience a positive response to PD-1/PD-L1 blockade therapy, and the primary or acquired resistance might eventually lead to cancer progression in patients with clinical responses. Accordingly, the resistance to PD-1/PD-L1 blockade remains a significant challenge hindering its further application. To overcome the limitation in therapy resistance, substantial effort has been made to improve or develop novel anti-PD-1/PD-L1 based immunotherapy strategies with better clinical response and reduced immune-mediated toxicity. In this review, we provide an overview on the resistance to PD-1/PD-L1 blockade and briefly introduce the mechanisms underlying therapy resistance. Moreover, we summarize potential predictive factors for the resistance to PD-1/PD-L1 blockade. Furthermore, we give an insight into the possible solutions to improve efficacy and clinical response. In the following research, combined efforts of basic researchers and clinicians are required to address the limitation of therapy resistance.
Acute brain injuries trigger microglia as an additional source of the proteoglycan NG2
Authors: Huang Wenhui , Bai Xianshu , Meyer Erika , Scheller Anja 
Published: August 2020

AbstractNG2 is a type I transmembrane glycoprotein known as chondroitin sulfate proteoglycan 4 (CSPG4). In the healthy central nervous system, NG2 is exclusively expressed by oligodendrocyte progenitor cells and by vasculature pericytes. A large body of immunohistochemical studies showed that under pathological conditions such as acute brain injuries and experimental autoimmune encephalomyelitis (EAE), a number of activated microglia were NG2 immuno-positive, suggesting NG2 expression in these cells. Alternative explanations for the microglial NG2 labeling consider the biochemical properties of NG2 or the phagocytic activity of activated microglia. Reportedly, the transmembrane NG2 proteoglycan can be cleaved by a variety of proteases to deposit the NG2 ectodomain into the extracellular matrix. The ectodomain, however, could also stick to the microglial surface. Since microglia are phagocytic cells engulfing debris of dying cells, it is difficult to identify a genuine expression of NG2. Recent studies showing (1) pericytes giving rise to microglial after stroke, and (2) immune cells of NG2-EYFP knock-in mice lacking NG2 expression in an EAE model generated doubts for the de novo expression of NG2 in microglia after acute brain injuries. In the current study, we took advantage of three knock-in mouse lines (NG2-CreERT2, CX3CR1-EGFP and NG2-EYFP) to study NG2 expression indicated by transgenic fluorescent proteins in microglia after tMCAO (transient middle cerebral artery occlusion) or cortical stab wound injury (SWI). We provide strong evidence that NG2-expressing cells, including OPCs and pericytes, did not differentiate into microglia after acute brain injuries, whereas activated microglia did express NG2 in a disease-dependent manner. A subset of microglia continuously activated the NG2 gene at least within the first week after tMCAO, whereas within 3 days after SWI a limited number of microglia at the lesion site transiently expressed NG2. Immunohistochemical studies demonstrated that these microglia with NG2 gene activity also synthesized the NG2 protein, suggesting activated microglia as an additional source of the NG2 proteoglycan after acute brain injuries.
Combining phytate treatment and nanocellulose stabilization for mitigating iron gall ink damage in historic papers
Authors: Völkel L. , Prohaska T. , Potthast A. 
Published: August 2020

Abstract
Because of its acidic and oxidative nature, iron gall ink promotes the endogenous degradation of paper manuscripts. Mechanical damage in areas of concentrated ink application or along mechanically stressed edges or folds results in problems during storage and handling. So far, such strongly degraded areas have usually been stabilized locally with thin Japanese paper and adhesives. A new and innovative material—nanocellulose—is being evaluated as a stabilizer for manuscripts that have been degraded by iron gall ink. The aim of this study is to integrate the nanocellulose application into a multi-stage calcium phytate/calcium hydrogencarbonate treatment to combine deacidification and stabilization, thus avoiding an additional stabilization and drying step. Two different types of fibrillated nanocelluloses were applied on manuscripts damaged by iron gall inks in different treatment steps. The newly formed, interlinked network of nanocellulose and paper was characterised before and after accelerated degradation in closed vials. The effects on the paper cellulose were studied by size exclusion chromatography and light scattering with carbonyl group profiling to follow cellulose hydrolysis and oxidation pathways. In addition, the migration behavior of iron ions was examined by laser ablation coupled with metal analysis (ICP-MS). This paper discusses the applicability and stability of nanocellulose on paper damaged by iron gall ink with regard to its long-term performance. Advantages and limitations are covered in detail.
The impact of sanction and healthcare system reform on the healthcare performance and pharmaceutical market in Iran; 2001-2016
Authors: Zartab Saman , Koopaei Nasrin Nassiri , Abbasian Hadi , Koopaei Mansur Nassiri , Koopaei Nasser Nassiri 
Published: August 2020

Abstract
Background
Iranian government has introduced multiple healthcare system reforms during the last 30 years aiming at improving accessibility and affordability of care. Pharmaceutical products are one of the major sources of financial burden on the healthcare system. The healthcare system and pharmaceutical sector have been balanced out by the partially counteracting effects of the HSEP (Health sector evolution plan) and the imposed sanctions.

Methods
This research investigates the healthcare system performance as well as the pharmaceutical market trend mostly based on the financial criteria from 2001. The correlation between the two change patterns was studied to understand the underlying driving market forces.

Results
During 2001 to 2013, total health expenditure has grown 25.6% in average. THE (Total health expenditure) share of the GDP remains between 6-7%, while the out of pocket payment has dropped to 37% in 2015 from 57% in 2001, and most health services been directed to the inpatient facilities. Iranian pharmaceutical market has grown rapidly in recent years and grew 28.38% per year and drug consumption per capita reached 34.43$ from 2.28$. However, the import drove most of the market expansion. Noteworthy, the share of pharmaceuticals from THE has also increased.

Conclusions
It is concluded that the sanctions and HSEP have enforced partially counteracting forces on the pharmaceutical market to maintain its consistent growing trend.
Evaluation of aerosol iron solubility over Australian coastal regions based on inverse modeling: implications of bushfires on bioaccessible iron concentrations in the Southern Hemisphere
Authors: Ito Akinori , Perron Morgane M. G. , Proemse Bernadette C. , Strzelec Michal , Gault-Ringold Melanie , Boyd Philip W. , Bowie Andrew R. 
Published: August 2020

AbstractMineral dust is the major source of external micro-nutrients such as iron (Fe) to the open ocean. However, large uncertainties in model estimates of Fe emissions and aerosol-bearing Fe solubility (i.e., the ratio of labile Fe (LFe) to total Fe (TFe)) in the Southern Hemisphere (SH) hampered accurate estimates of atmospheric delivery of bioavailable Fe to the Southern Ocean. This study applied an inverse modeling technique to a global aerosol chemistry transport model (IMPACT) in order to optimize predictions of mineral aerosol Fe concentrations based on recent observational data over Australian coastal regions (110°E–160°E and 10°S–41°S). The optimized (a posteriori) model did not only better capture aerosol TFe concentrations downwind from Australian dust outbreak but also successfully reproduced enhanced Fe solubility (7.8 ± 8.4%) and resulted in much better agreement of LFe concentrations with the field measurements (1.4 ± 1.5 vs. 1.4 ± 2.3 ng Fe m–3). The a posteriori model estimates suggested that bushfires contributed a large fraction of LFe concentrations in aerosols, although substantial contribution from missing sources (e.g., coal mining activities, volcanic eruption, and secondary formation) was still inferred. These findings may have important implications for the projection of future micro-nutrient supply to the oceans as increasing frequency and intensity of open biomass burning are projected in the SH.
The Influence of Exercise-Induced Fatigue on Inter-Limb Asymmetries: a Systematic Review
Authors: Heil Jessica , Loffing Florian , Büsch Dirk 
Published: August 2020

Abstract
Background
Non-contact injuries such as anterior cruciate ligament ruptures often occur during physical load toward the end of a match. This is ascribed to emerging processes due to exercise-induced fatigue. Moreover, non-contact injuries often occur during dynamic actions such as landing or cutting movements. Inter-limb asymmetries are suggested as one possible cause for those injuries based on findings indicating that asymmetries between limbs are associated with a higher injury risk. Hence, assessing inter-limb asymmetry during physical load in the condition of exercise-induced fatigue is warranted to identify potentially relevant precursors for non-contact injuries.

Objective
The objective of this study was to overview the current state of evidence concerning the influence of exercise-induced fatigue on inter-limb asymmetries through a systematic review.

Methods
A systematic literature search was conducted using the databases Web of Science, Scopus, PubMed, SURF, and SPONET to identify studies that assessed inter-limb asymmetries of healthy people, calculated with an asymmetry equation, before and after, or during a loading protocol.

Results
Thirteen studies were included in the systematic review. The loading protocols involved running, race walking, jumping, squatting, soccer, rowing, and combinations of different exercises. Moreover, different tasks/procedures were used to assess inter-limb asymmetries, e.g., squats, single-leg countermovement jumps, gait analysis, or isokinetic strength testing. The results seem to depend on the implemented loading protocol, the tasks/procedures, and the measured parameters.

Conclusions
Future research needs more systematization and consistency, assessing the effect of exercise-induced fatigue on inter-limb asymmetries. Moreover, the emergence of inter-limb asymmetries should be regarded in the context of sport-specific movements/tasks. Testing before, after, and during a physical loading protocol is advisable to consider the influence of exercise-induced fatigue on sport-specific tasks and to identify the possible mechanisms underlying load-dependent inter-limb asymmetries with regard to risk of non-contact injury.