bluuebunny/crossref_metadata_2025_split huggingface dataset:
Seasonal effects of river flow on microbial community coalescence and diversity in a riverine network
Authors: Luo Xia , Xiang Xinyi , Yang Yuanhao , Huang Guoyi , Fu Kaidao , Che Rongxiao , Chen Liqiang 
Published: June 2020

ABSTRACTTerrestrial microbial communities may take advantage of running waters and runoff to enter rivers and mix with aquatic microorganisms. However, the environmental factors governing the interchange of the microbial community within a watercourse and its surrounding environment and the composition of the resulting community are often underestimated. The present study investigated the effect of flow rate on the mixing of water, soil, sediment and biofilm at four sites along the Lancang River and one branch of the river in winter and summer and, in turn, the resultant changes in the microbial community within each habitat. 16S rRNA gene-based Illumina high-throughput sequencing illustrated that bacterial communities were apparently distinct among biofilm, water, soil and sediment. Biofilms had the lowest richness, Shannon diversity and evenness indices compared with other habitats, and those three indices in all habitats increased significantly from winter to summer. SourceTracker analysis showed a significant coalescence between the bacterial communities of sediment, water and biofilm samples at lower flow rates. Additionally, the proportion of Betaproteobacteria in sediment and biofilms increased with a decrease in flow rate, suggesting the flow rate had a strong impact on microbial community composition and exchange among aquatic habitats. These results were further confirmed by a Mantel test and linear regression analysis. Microbial communities in all samples exhibited a significant but very weak distance–decay relationship (r = 0.093, P = 0.024). Turbidity played a much more important role on water bacterial community structure in summer (i.e. rainy season) (BIOENV, r = 0.92). Together, these results suggest that dispersal is an important factor affecting bacterial community structure in this system.
The tumor immune microenvironment transcriptomic subtypes of colorectal cancer for prognosis and development of precise immunotherapy
Authors: Tang Yun-Qiang , Chen Tu-Feng , Zhang Yan , Zhao Xiao-Chen , Zhang Yu-Zi , Wang Guo-Qiang , Huang Meng-Li , Cai Shang-Li , Zhao Jing , Wei Bo , Huang Jun 
Published: June 2020

AbstractBackgroundBiomarkers based on immune context may guide prognosis prediction. T-cell inactivation, exclusion, or dysfunction could cause unfavorable tumor microenvironments, which affect immunotherapy and prognosis. However, none of the immuno-biomarkers reported to date can differentiate colorectal-cancer (CRC) patients. Thus, we aimed to classify CRC patients according to the levels of T-cell activation, exclusion, and dysfunction in the tumor microenvironment.MethodsRNAseq data of 618 CRC patients from The Cancer Genome Atlas and microarray data of 316 CRC patients from Gene Expression Omnibus were analysed using the Tumor Immune Dysfunction and Exclusion algorithm. Unsupervised clustering was used to classify patients.ResultsBased on the expression signatures of myeloid-derived suppressor cells, cancer-associated fibroblasts, M2-like tumor-associated macrophages, cytotoxic T-lymphocytes, and PD-L1, all patients were clustered into four subtypes: cluster 1 had a high level of immune dysfunction, cluster 2 had a low level of immune activation, cluster 3 had intense immune exclusion, and cluster 4 had a high level of immune activation and a moderate level of both dysfunction and exclusion signatures. Compared with cluster 1, the hazard ratios and 95% confidential intervals for overall survival were 0.63 (0.35–1.13) for cluster 2, 0.55 (0.29–1.03) for cluster 3, and 0.30 (0.14–0.64) for cluster 4 in multivariate Cox regression. Similar immune clustering and prognosis patterns were obtained upon validation in the GSE39582 cohort. In subgroup analysis, immune clustering was significantly associated with overall survival among stage I/II patients, microsatellite stable/instability-low patients, and patients not treated with adjuvant therapy.ConclusionsOur findings demonstrated that classifying CRC patients into different immune subtypes serves as a reliable prognosis predictor and may help to refine patient selection for personalized cancer immunotherapy.
The New Philippine Innovation Laws: A Response to the Call of MSMEs and Start-Ups
Authors: Ilas-Panganiban Divina , Mitra-Ventanilla Reena 
Published: June 2020

Abstract
Innovation is essential to driving national progress. As such, it has to be fostered, safeguarded and incentivized. In order for innovation and technological growth to flourish, it is necessary to have a robust intellectual property regime coupled with effective government policies. Developing countries face many challenges when it comes to harnessing innovation and creating the right environment that will support and nourish it. Extra attention should be given to small and medium-sized enterprises, as they are more likely to be at risk due to financing, productivity and regulatory burdens.
Although the Philippines has lagged behind in the area of innovation, recent national policies have been adopted to improve the country's position. The recent legislations, namely, the Philippine Innovation Act, the Innovative Startup Act and the Personal Property Security Act, are all aimed to create an environment that creates opportunities towards sustaining and incentivizing innovation. The Philippines designed a ‘whole of government’ approach, which seeks to effectively drive innovation across all areas of government policy and to better facilitate engagement of businesses, R&D entities and other relevant sectors in the community. These laws, however, are but the first steps in the right direction. Proper implementation, constant monitoring and fine-tuning are essential for a national innovation policy to succeed.
Convergence of a finite-volume scheme for a degenerate-singular cross-diffusion system for biofilms
Authors: Daus Esther S , Jüngel Ansgar , Zurek Antoine 
Published: June 2020

AbstractAn implicit Euler finite-volume scheme for a cross-diffusion system modeling biofilm growth is analyzed by exploiting its formal gradient-flow structure. The numerical scheme is based on a two-point flux approximation that preserves the entropy structure of the continuous model. Assuming equal diffusivities the existence of non-negative and bounded solutions to the scheme and its convergence are proved. Finally, we supplement the study by numerical experiments in one and two space dimensions.
Definition and Risks of Cytokine Release Syndrome in 11 Critically Ill COVID-19 Patients With Pneumonia: Analysis of Disease Characteristics
Authors: Wang Wenjun , Liu Xiaoqing , Wu Sipei , Chen Sibei , Li Yimin , Nong Lingbo , Lie Puyi , Huang Liyan , Cheng Linling , Lin Yongping , He Jianxing 
Published: June 2020

Abstract
Corona virus disease 2019 (COVID-19) patients with severe immune abnormalities are at risk of cytokine release syndrome (CRS). The definition, prevention, and treatment of symptoms of CRS in critically ill patients with COVID-19 are important problems. We report a single-center case series of 11 COVID-19 patients with acute respiratory distress syndrome from The First Affiliated Hospital of Guangzhou Medical University in China from 26 January 2020 to 18 February 2020. The termination date of follow-up was 19 February 2020. Eight patients were determined to have characteristics of CRS, including pulmonary inflammation, fever, and dysfunction of nonpulmonary organs. An increase in interleukin-6 in peripheral blood was the highest risk factor and an early indicator of CRS in COVID-19.
Intelligent Liver Function Testing: Working Smarter to Improve Patient Outcomes in Liver Disease
Authors: Macpherson Iain , Nobes Jennifer H , Dow Eleanor , Furrie Elizabeth , Miller Michael H , Robinson Emma M , Dillon John F 
Published: June 2020

Abstract
Chronic liver disease (CLD) is a significant health problem affecting millions of people worldwide. In Scotland, CLD is a major cause of premature mortality. Liver function tests (LFTs) are a panel of frequently requested blood tests which may indicate liver disease. However, LFTs commonly contain at least one abnormal result, and abnormalities are rarely investigated to the extent recommended by national guidelines. The intelligent Liver Function Testing (iLFT) pathway is a novel, automated system designed to improve early diagnosis of liver disease. Initial abnormal LFT results trigger a cascade of reflexive testing to help identify the cause of any liver dysfunction. Algorithms combine these results with demographic and clinical data (such as patient age, body mass index, and alcohol intake) and fibrosis estimates to produce an electronic diagnosis and management plan. The pilot trial demonstrated that iLFT increased diagnosis of liver disease whilst remaining cost-effective. As such, iLFT has been fully operational across our region (NHS Tayside, Scotland) since August 2018. In the first year, iLFT generated over 2000 diagnoses from 1824 patient samples with an abnormality in the initial LFTs. The majority of these patients could be safely managed in primary care. iLFT allows maximal value to be obtained from liver blood tests across biochemistry, virology, immunology, and hematology with only minor changes to working practices. ‘Intelligent’, algorithm-led testing pathways break down the barrier between clinical and laboratory medicine and offer solutions to many of the challenges experienced in modern healthcare systems.
Building for the future: the creation of a residency training track to foster innovation through clinical informatics in psychiatry
Authors: Vitiello Evan , Kane Michael , Hutto Alissa , Hall Austin 
Published: June 2020

Abstract
Early clinical informatics (CI) education provides an introduction to CI methodologies for resident physicians to apply within their boarded specialties. A specialty notably absent from the effort to train residents in CI is psychiatry. We present a novel means of integrating CI exposure into a structured educational track within a psychiatry residency training program. The clinical informatics track at the University of North Carolina Department of Psychiatry is a 3-year, longitudinal experience open to residents starting in postgraduate year 2. To our knowledge, this is the first track of its kind within a psychiatry residency training program.
Stakeholder bias in best practice advisories: an ethical perspective
Authors: Baird Aaron , Kibbe Bryan , Lesandrini Jason 
Published: June 2020

Abstract
Clinicians are increasingly being asked to heed and follow the guidance provided by “best practice advisories.” Such advisories, often in the form of electronic reminders or alerts, are meant to increase the efficiency and effectiveness of evidence-based medical practice. However, we argue that best practice advisories can sometimes be infused with stakeholder bias, even if inadvertently. We specifically argue that best practice advisory biases can occur when an advisory is not oriented to benefit patients at least as much or more than other stakeholders. To address this issue, we put forth the perspective that ethical consideration of biases is especially important in best practice advisory design and revision processes.
ClinicNet: machine learning for personalized clinical order set recommendations
Authors: Wang Jonathan X , Sullivan Delaney K , Wells Alex C , Chen Jonathan H 
Published: June 2020

AbstractObjectiveThis study assesses whether neural networks trained on electronic health record (EHR) data can anticipate what individual clinical orders and existing institutional order set templates clinicians will use more accurately than existing decision support tools.Materials and MethodsWe process 57 624 patients worth of clinical event EHR data from 2008 to 2014. We train a feed-forward neural network (ClinicNet) and logistic regression applied to the traditional problem structure of predicting individual clinical items as well as our proposed workflow of predicting existing institutional order set template usage.ResultsClinicNet predicts individual clinical orders (precision = 0.32, recall = 0.47) better than existing institutional order sets (precision = 0.15, recall = 0.46). The ClinicNet model predicts clinician usage of existing institutional order sets (avg. precision = 0.31) with higher average precision than a baseline of order set usage frequencies (avg. precision = 0.20) or a logistic regression model (avg. precision = 0.12).DiscussionMachine learning methods can predict clinical decision-making patterns with greater accuracy and less manual effort than existing static order set templates. This can streamline existing clinical workflows, but may not fit if historical clinical ordering practices are incorrect. For this reason, manually authored content such as order set templates remain valuable for the purposeful design of care pathways. ClinicNet’s capability of predicting such personalized order set templates illustrates the potential of combining both top-down and bottom-up approaches to delivering clinical decision support content.ConclusionClinicNet illustrates the capability for machine learning methods applied to the EHR to anticipate both individual clinical orders and existing order set templates, which has the potential to improve upon current standards of practice in clinical order entry.
A Multicenter Evaluation of Outcomes Following the Use of Nebulized Heparin for Inhalation Injury (HIHI2 Study)
Authors: Cox Courtney L , McIntire Allyson M , Bolton Kimberly J , Foster David R , Fritschle Andrew C , Harris Serena A , Pape Kate O , Whitten Jessica A , Harman Brett C , Sood Rajiv , Walroth Todd A 
Published: June 2020

Abstract
Inhalation injury causes significant morbidity and mortality secondary to compromise of the respiratory system as well as systemic effects limiting perfusion and oxygenation. Nebulized heparin reduces fibrin cast formation and duration of mechanical ventilation in patients with inhalation injury. To date, no study has compared both dosing strategies of 5000 and 10,000 units to a matched control group. This multicenter, retrospective, case-control study included adult patients with bronchoscopy-confirmed inhalation injury. Each control patient, matched according to age and percent of total body surface area, was matched to a patient who received 5000 units and a patient who received 10,000 units of nebulized heparin. The primary endpoint of the study was duration of mechanical ventilation. Secondary endpoints included 28-day mortality, ventilator-free days in the first 28 days, difference in lung injury scores, length of hospitalization, incidence of ventilator-associated pneumonia, and rate of major bleeding. Thirty-five matched patient trios met inclusion criteria. Groups were well-matched for age (P = .975) and total body surface area (P = .855). Patients who received nebulized heparin, either 5000 or 10,000 units, had 8 to 11 less days on the ventilator compared to controls (P = .001). Mortality ranged from 3 to 14% overall and was not statistically significant between groups. No major bleeding events related to nebulized heparin were reported. Mechanical ventilation days were significantly decreased in patients who received 5000 or 10,000 units of nebulized heparin. Nebulized heparin, either 5000 units or 10,000 units, is a safe and effective treatment for inhalation injury.
Contact Hand Burns in Children: Still a Major Prevention Need
Authors: McBride Jaclyn M , Romanowski Kathleen S , Sen Soman , Palmieri Tina L , Greenhalgh David G 
Published: June 2020

Abstract
Since toddlers explore with their hands, contact burns continue to be a major pediatric problem. The purpose of this report is to review our 8-year experience with contact burns of the hand. After institutional review board approval, a review of pediatric contact hand burns that occurred between 2006 and 2014 was performed. In the 8-year span, 536 children had contact hand burns. The majority suffered burns from an oven or stove (120). The other etiologies included burns from a fireplace (76), clothing iron (65), curling or straightening iron (50), and firepit or campfire (46). The mean age was 2.62 years, with a range of 2 months to 18 years. Male children (339) burned their hands more than females (197). Most children burned the palmar aspect of their hand (384) compared to the dorsum (61). These burns typically cover small TBSAs (mean 1.08% TBSA), with only 2% of burns comprising &gt;5% TBSA. Approximately, 84% of these patients did not need surgery, but 86 (16%) had skin grafting (usually full thickness) and roughly 26% of those needed reconstructive surgery. Contact burns to the hand continue to be a major problem for toddlers. Children are most likely to burn themselves on an oven or stove, fireplace, clothing iron or curling/straightening iron. The palmar surface of the hand is the most likely site. While most children do not require surgery, approximately 16% require grafting. A significant number of those patients need reconstructive surgery. Clearly, current prevention efforts have failed to reduce these injuries.
Appearance Concerns, Psychosocial Outcomes, and the Feasibility of Implementing an Online Intervention for Adolescents Receiving Outpatient Burn Care
Authors: Riobueno-Naylor Alexa , Williamson Heidi , Canenguez Katia , Kogosov Ann , Drexler Alana , Sadeq Farzin , DePamphilis Matthew , Holcomb Juliana M , Stoddard Frederick J , Lydon Martha , Murphy J Michael , Sheridan Robert L 
Published: June 2020

AbstractThe current study assessed the prevalence of appearance concerns, psychosocial difficulty, and use of an appearance-focused social and psychological support resource (Young Person’s Face IT; YPF) within a population of teens (12–17 year-olds) receiving outpatient burn care with the goal to assess the feasibility of routine use of the resource in outpatient burn care. The study sample included 78 patients ages 12 to 17 receiving outpatient care for burns at one hospital. Appearance concerns were measured via the Burn Outcomes Questionnaire Appearance Subscale, the Appearance Subscale of the Body Esteem Scale for Adolescents, and a 2-part question which asked participants directly about appearance concerns related to the burn injury. A large majority (70.0%) of study participants reported appearance concerns on at least one appearance measure and girls reported more burn-related appearance concerns compared with boys. Psychosocial difficulty was measured via the Pediatric Symptom Checklist-17 (PSC-17) and measures of social functioning were collected and compared within the sample by burn size, burn location, sex, and appearance concerns. Internalizing symptoms were prevalent on the PSC-17 (18.6% risk) and decreased self-worth and increased social anxiety symptoms were significantly associated with having appearance concerns. Although interest in YPF was high (78.3%), actual use of the resource among those who signed up to pilot it (n = 46 participants) was low (19.4% use). Results indicate that there is a need for and interest in appearance-focused social anxiety resources for adolescents with burn injuries such as YPF, but more research is needed to understand its feasibility in clinical practice.
Single-Center North American Experience of Liver Transplantation in Autoimmune Hepatitis: Infrequent Indication but Good Outcomes for Patients
Authors: de Quadros Onofrio Fernanda , Neong Evon , Adebayo Danielle , Kollmann Dagmar , Adeyi Oyedele Adewale , Fischer Sandra , Hirschfield Gideon Morris , Hansen Bettina Elisabeth , Bhat Mamatha , Galvin Zita , Lilly Leslie Blake , Selzner Nazia 
Published: June 2020

Abstract

Background and Aims
A 40% risk of disease recurrence post-liver transplantation (LT) for autoimmune hepatitis (AIH) has been previously reported. Risk factors for recurrence and its impact on long-term patient outcome are poorly defined. We aimed to assess prevalence, time to disease recurrence, as well as patient and graft survival in patients with recurrent AIH (rAIH) versus those without recurrence.

Methods
Single-center retrospective study of adult recipients who underwent LT for AIH between January 2007 and December 2017. Patients with AIH overlap syndromes were excluded.

Results
A total of 1436 LTs were performed during the study period, of whom 46 (3%) for AIH. Eight patients had AIH overlap syndromes and were excluded. Patients were followed up for 4.4 ± 3.4 years and mean age at LT was 46.8 years. Average transplant MELD (Model for End-Stage Liver Disease) score was 24.9. About 21% of patients (8 of 38) were transplanted for acute onset of AIH; 66% of patients (n = 25) received a deceased donor liver graft, and 34% a living donor organ. rAIH occurred in 7.8% (n = 3/38) of recipients. Time to recurrence was 1.6, 12.2 and 60.7 months. Patient and graft survival in patients without recurrence was 88.6% and 82.8% in 5 years, whereas in those with rAIH, it was 66.7%, respectively.

Conclusion
Although AIH recurs post-LT, our data indicate a lower recurrence rate when compared to the literature and excellent patient and graft survival.
Does hip preservation surgery prevent arthroplasty? Quantifying the rate of conversion to arthroplasty following hip preservation surgery
Authors: Sohatee Mark Andrew , Ali Mohammed , Khanduja Vikas , Malviya Ajay 
Published: June 2020

AbstractHip arthroscopic surgery for femoroacetabular impingement and periacetabular osteotomy (PAO) for dysplasia is the most commonly used contemporary treatment for these conditions and has been shown to provide pain relief and restore function. What is less understood and perhaps of more interest to health economists, is the role of these procedures in preserving the hip joint and avoiding hip arthroplasty. The aim of this systematic review was to determine whether hip joint preservation surgery, indeed, preserves the hip joint by looking at conversion rates to total hip arthroplasty (THA). Two separate searches were undertaken, using PRISMA guidelines and utilizing PubMed and Open Athens search engines, identifying manuscripts that looked at conversion to THA following either hip arthroscopy (HA) or PAO. When considering HA, we found 64 eligible papers. Out of these studies, there were 59 430 hips with 5627 undergoing conversion to THA (9.47% [95% CI 9.23–9.71%]) with a mean conversion time of 24.42 months. Regarding PAO, there were 46 eligible papers including 4862 patients who underwent PAO with subsequent conversion to THA in 404 patients (8.31% [95% CI 7.54–9.12%]). with a mean conversion time of 70.11 months. Certain features were associated with increased conversion rates, including increasing age, worsening arthritis and joint space &lt;2 mm. This study demonstrates that the mean conversion rates to be &lt;10% for HA and PAO, during the mean follow-up periods of included manuscripts. Joint preserving surgery appears to defer or at least delay the need for THA.