bluuebunny/crossref_metadata_2025_split huggingface dataset:
Isotopic signatures reveal zinc cycling in the natural habitat of hyperaccumulator Dichapetalum gelonioides subspecies from Malaysian Borneo
Authors: van der Ent Antony , Nkrumah Philip Nti , Aarts Mark G. M. , Baker Alan J. M. , Degryse Fien , Wawryk Chris , Kirby Jason K. 
Published: September 2021

Abstract
Background
Some subspecies of Dichapetalum gelonioides are the only tropical woody zinc (Zn)-hyperaccumulator plants described so far and the first Zn hyperaccumulators identified to occur exclusively on non-Zn enriched 'normal' soils. The aim of this study was to investigate Zn cycling in the parent rock-soil-plant interface in the native habitats of hyperaccumulating Dichapetalum gelonioides subspecies (subsp. pilosum and subsp. sumatranum). We measured the Zn isotope ratios (δ66Zn) of Dichapetalum plant material, and associated soil and parent rock materials collected from Sabah (Malaysian Borneo).

Results
We found enrichment in heavy Zn isotopes in the topsoil (δ66Zn 0.13 ‰) relative to deep soil (δ66Zn -0.15 ‰) and bedrock (δ66Zn -0.90 ‰). This finding suggests that both weathering and organic matter influenced the Zn isotope pattern in the soil-plant system, with leaf litter cycling contributing significantly to enriched heavier Zn in topsoil. Within the plant, the roots were enriched in heavy Zn isotopes (δ66Zn ~ 0.60 ‰) compared to mature leaves (δ66Zn ~ 0.30 ‰), which suggests highly expressed membrane transporters in these Dichapetalum subspecies preferentially transporting lighter Zn isotopes during root-to-shoot translocation. The shoots, mature leaves and phloem tissues were enriched in heavy Zn isotopes (δ66Zn 0.34–0.70 ‰) relative to young leaves (δ66Zn 0.25 ‰). Thisindicates that phloem sources are enriched in heavy Zn isotopes relative to phloem sinks, likely because of apoplastic retention and compartmentalization in the Dichapetalum subspecies.

Conclusions
The findings of this study reveal Zn cycling in the rock-soil-plant continuum within the natural habitat of Zn hyperaccumulating subspecies of Dichapetalum gelonioides from Malaysian Borneo. This study broadens our understanding of the role of a tropical woody Zn hyperaccumulator plant in local Zn cycling, and highlights the important role of leaf litter recycling in the topsoil Zn budget. Within the plant, phloem plays key role in Zn accumulation and redistribution during growth and development. This study provides an improved understanding of the fate and behaviour of Zn in hyperaccumulator soil-plant systems, and these insights may be applied in the biofortification of crops with Zn.
Infective endocarditis in intravenous drug abusers: clinical challenges emerging from a single-centre experience
Authors: Scheggi Valentina , Del Pace Stefano , Ceschia Nicole , Vanni Francesco , Merilli Irene , Sottili Edoardo , Salcuni Leonardo , Zoppetti Nicola , Alterini Bruno , Cerillo Alfredo , Marchionni Niccolò , Stefàno Pier Luigi 
Published: September 2021

Abstract
Background
Intravenous drug abuse (IDA) is a known risk factor for infective endocarditis (IE) and is associated with frequent relapses, but its prognostic impact is still debated. The potential futility of surgery in this population is a further issue under discussion. We aimed to describe the clinical characteristics, the therapeutic strategy, and the prognosis associated with IDA in IE.

Methods
We retrospectively analysed 440 patients admitted to a single surgical centre for definite active IE from January 2012 to December 2020.

Results
Patients reporting IDA (N = 54; 12.2%) were significantly younger (p < 0.001) and presented fewer comorbidities (p < 0.001). IDA was associated with a higher proportion of relapses (27.8 vs. 3.3%, p < 0.001) and, at multivariable analysis, was an independent predictor of long-term mortality (HR 2.3, 95%CI 1.1–4.7, p = 0.015). We did not register multiple relapses in non-IDA patients. Among IDA patients, we observed 1 relapse after discharge in 9 patients, 2 relapses in 5 patients and 3 relapses in 1 patient. In IDA patients, neither clinical and laboratory variables nor the occurrence of even multiple relapses emerged as indicators of an adverse risk–benefit ratio of surgery in patients with surgical indication.

Conclusions
IE secondary to IDA affects younger patients than those with IE not associated with IDA. Probably due to this difference, IE secondary to IDA is not associated with significantly higher mortality, whereas the negative, long-term prognostic impact of IDA emerges in multivariate analysis. Considering the good prognosis of patients with uncomplicated IE treated medically, surgery should be reserved to patients with a strict- guidelines-based indication. However, since there are no clear predictors of an unfavourable risk–benefit ratio of surgery in patients with surgical indication, all patients with a complicated IE should be operated, irrespective of a history of IDA.
The effects of insulin therapy on maternal blood pressure and weight in women with gestational diabetes mellitus
Authors: Sun Tiange , Meng Fanhua , Zang Shufei , Li Yue , Zhang Rui , Yu Zhiyan , Huang Xinmei , Wang Fang , Zhang Liwen , Liu Jun 
Published: September 2021

Abstract
Background
Although insulin therapy achieves effective glycemic control, it may aggravate hyperinsulinemia. Nonetheless the benefits of insulin as first-line treatment for women with GDM are controversial. This work aimed to investigate the effect of insulin on maternal GDM.

Methods
This retrospective cohort study recruited 708 women with GDM of whom 616 underwent lifestyle intervention and 92 were prescribed insulin therapy. Differences in variables between the two groups were analyzed by univariate analysis and multivariate analysis. Propensity score matching was used to control for age, pre-pregnancy BMI, time and BP at GDM diagnosis, and family history of diabetes and hypertension. Paired sample test was applied to evaluate the changes in BP after intervention in the two groups of women.

Results
There was no significant difference in mode of delivery, newborn weight or incidence of macrosomia between women prescribed insulin and those who adopted lifestyle modifications. Insulin therapy was associated with a slight increase in maternal weight compared with the lifestyle intervention group and was attributed to short-term treatment (about 12 weeks). In addition, insulin therapy remarkably increased maternal blood pressure, an effect that persisted after matching age, pre-pregnancy BMI, time and BP at GDM diagnosis, and family history of diabetes and hypertension. Between commencing insulin therapy and delivery, systolic blood pressure significantly increased by 6mmHg (P = 0.015) and diastolic blood pressure by 9 mmHg (P < 0.001). Increase in BP was significantly higher in the insulin group compared with the lifestyle intervention group (P < 0.001). Logistic regression analysis with enter selection confirmed that insulin therapy was closely correlated with development of gestational hypertension (GH).

Conclusions
This work suggested that short-term insulin therapy for GDM was associated with a slight increase in maternal weight but a significant risk of increasing maternal blood pressure.
Neutrophil–lymphocyte ratio for the prediction of histological chorioamnionitis in cases of preterm premature rupture of membranes: a case-control study
Authors: Balciuniene Greta , Kvederaite-Budre Greta , Gulbiniene Violeta , Dumalakiene Irena , Viliene Rita , Pilypiene Ingrida , Drasutiene Grazina S. , Ramasauskaite Diana 
Published: September 2021

AbstractBackgroundThe neutrophil-lymphocyte ratio (NLR) is easily calculated blood test parameter, which can be used as marker to predict many inflammatory disorders. The aim of this study was to assess and compare the NLR in maternal blood with the white blood cell (WBC) count and C-reactive protein (CRP) concentration for the prediction of histological chorioamnionitis.MethodsThis was a case-control study of 137 woman with preterm premature rupture of membranes (PPROM) at a gestational age between 22+ 0and 34+ 6weeks. Blood samples, collected less than 48 h before delivery and at least 48 h after the administration of corticosteroids, were selected for the analysis. The NLR was calculated by dividing the number of neutrophils by the number of lymphocytes. Chorioamnionitis was diagnosed by the histopathological evaluation of placental membranes and chorionic plate.ResultsPatients with diagnosed histological chorioamnionitis (HCA) had significantly higher levels of WBC, CRP and NLR (p-value < 0.001). Levels of WBC, CRP and NLR predicted HCA with an area under the curve (AUC) of 0.81, 0.81 and 0.89, respectively. NLR had statistically significantly higher AUC than WBC, but no significant difference was found between AUCs of NLR and CRP. The cut-off level of NLR was found to be 5,97, which had a sensitivity of 77 % and a specificity of 95 %.ConclusionNLR has a good predictive value for HCA and could be used as an additional diagnostic marker for predicting histological chorioamnionitis in cases with preterm premature rupture of membranes before 34 weeks of gestation.
Comparison between the English and Bahasa Malaysia language versions of the Visual Functioning Questionnaire (VFQ-25) for use in patients with cataracts
Authors: Thevi Thanigasalam , Abas Adinegara Lutfi , Stephanie Yen Li Chang 
Published: September 2021

Abstract
Background
We conducted the study to compare the psychometric properties of the English version of the Questionnaire and the Bahasa Malaysia (Malay Language) version regarding the vision-related Quality of Life of patients with cataracts.

Methods
The Malay version was translated by two independent translators who were well versed in both languages. We carried out a cross-sectional study collecting data between June 2017 and March 2018 in the pre-operative Eye Clinic of Hospital Melaka with 224 respondents (mean age 66.8 years) and another 204 respondents (mean age 64.3 years) participating in the English version and Malay version of the Questionnaire respectively.
Methods used to validate the standard questionnaire included the use of construct validity via factor analysis and the deployment of reliability test through assessment of internal consistency via Cronbach’s alpha.

Results
We observed both English and Bahasa Malaysia versions to have high reliability with Cronbach’s alpha values of 0.90 and above in factors on difficulty with activities and responses to vision problems.
Exploratory factor analysis performed revealed that the three-factor model fits the data well for the English version of the questionnaire - difficulty with activities (23.81 % of variance), responses to vision problem (22.22 % of variance) and general health and vision (14.68 % of variance).
The Bahasa Malaysia version of the questionnaire produced three factors with two of the factors resembling the factors from the original version of the questionnaire - difficulty with activities (24.3 % of variance) and responses to vision problem (23.7 % of variance).
Item response theory analysis revealed that these factors for both English and Bahasa Malaysia versions comprised of adequately fitted items.

Conclusion
The present study observed that both the English and Bahasa Malaysia versions of the NEI VFQ-25 have comparable construct validity to the original American version. With high validity and reliability, the tool shall be able to provide health care providers the assessment of impact due to cataract and other ophthalmic conditions on the vision-related quality of life of ophthalmic patients.
Modeling the effect of age on quantiles of the incubation period distribution of COVID-19
Authors: Liu Xiaohui , Wang Lei , Ma Xiansi , Wang Jiewen , Wu Liwen 
Published: September 2021

Abstract
Background
The novel coronavirus SARS-CoV-2 (coronavirus disease 2019, COVID-19) has caused serious consequences on many aspects of social life throughout the world since the first case of pneumonia with unknown etiology was identified in Wuhan, Hubei province in China in December 2019. Note that the incubation period distribution is key to the prevention and control efforts of COVID-19. This study aimed to investigate the conditional distribution of the incubation period of COVID-19 given the age of infected cases and estimate its corresponding quantiles from the information of 2172 confirmed cases from 29 provinces outside Hubei in China.

Methods
We collected data on the infection dates, onset dates, and ages of the confirmed cases through February 16th, 2020. All the data were downloaded from the official websites of the health commission. As the epidemic was still ongoing at the time we collected data, the observations subject to biased sampling. To address this issue, we developed a new maximum likelihood method, which enables us to comprehensively study the effect of age on the incubation period.

Results
Based on the collected data, we found that the conditional quantiles of the incubation period distribution of COVID-19 vary by age. In detail, the high conditional quantiles of people in the middle age group are shorter than those of others while the low quantiles did not show the same differences. We estimated that the 0.95-th quantile related to people in the age group 23 ∼55 is less than 15 days.

Conclusions
Observing that the conditional quantiles vary across age, we may take more precise measures for people of different ages. For example, we may consider carrying out an age-dependent quarantine duration in practice, rather than a uniform 14-days quarantine period. Remarkably, we may need to extend the current quarantine duration for people aged 0 ∼22 and over 55 because the related 0.95-th quantiles are much greater than 14 days.
Effects of various walking intensities on leg muscle fatigue and plantar pressure distributions
Authors: Lung Chi-Wen , Liau Ben-Yi , Peters Joseph A. , He Li , Townsend Runnell , Jan Yih-Kuen 
Published: September 2021

Abstract
Background
Physical activity may benefit health and reduce risk for chronic complications in normal and people with diabetes and peripheral vascular diseases. However, it is unclear whether leg muscle fatigue after weight-bearing physical activities, such as brisk walking, may increase risk for plantar tissue injury. In the literature, there is no evidence on the effect of muscle fatigue on plantar pressure after various walking intensities. The objectives of this study were to investigate the effects of various walking intensities on leg muscle fatigue and plantar pressure patterns.

Methods
A 3 × 2 factorial design, including 3 walking speeds (1.8 (slow and normal walking), 3.6 (brisk walking), and 5.4 (slow running) mph) and 2 walking durations (10 and 20 min) for a total of 6 walking intensities, was tested in 12 healthy participants in 3 consecutive weeks. The median frequency and complexity of electromyographic (EMG) signals of tibialis anterior (TA) and gastrocnemius medialis (GM) were used to quantify muscle fatigue. Fourier transform was used to compute the median frequency and multiscale entropy was used to calculate complexity of EMG signals. Peak plantar pressure (PPP) values at the 4 plantar regions (big toe, first metatarsal head, second metatarsal head, and heel) were calculated.

Results
Two-way ANOVA showed that the walking speed (at 1.8, 3.6, 5.4 mph) significantly affected leg muscle fatigue, and the duration factor (at 10 and 20 min) did not. The one-way ANOVA showed that there were four significant pairwise differences of the median frequency of TA, including walking speed of 1.8 and 3.6 mph (185.7 ± 6.1 vs. 164.9 ± 3.0 Hz, P = 0.006) and 1.8 and 5.4 mph (185.7 ± 6.1 vs. 164.5 ± 5.5 Hz, P = 0.006) for the 10-min duration; and walking speed of 1.8 and 3.6 mph (180.0 ± 5.9 vs. 163.1 ± 4.4 Hz, P = 0.024) and 1.8 and 5.4 mph (180.0 ± 5.9 vs. 162.8 ± 4.9 Hz, P = 0.023) for the 20-min duration. The complexity of TA showed a similar trend with the median frequency of TA. The median frequency of TA has a significant negative correlation with PPP on the big toe ( r = -0.954, P = 0.003) and the first metatarsal head ( r = -0.896, P = 0.016).

Conclusions
This study demonstrated that brisk walking and slow running speeds (3.6 and 5.4 mph) cause an increase in muscle fatigue of TA compared to slow walking speed (1.8 mph); and the increased muscle fatigue is significantly related to a higher PPP.
Application of an index derived from the area under a neutrophil curve as a predictor of surgical site infection after spinal surgery
Authors: Inose Hiroyuki , Kobayashi Yutaka , Morishita Shingo , Matsukura Yu , Yuasa Masato , Hirai Takashi , Yoshii Toshitaka , Okawa Atsushi 
Published: September 2021

Abstract
Background
Patients with prolonged and intense neutrophilia after spinal surgery are at high risk of developing surgical site infection (SSI). To date, there is no standard method for the objective assessment of the intensity and duration of neutrophilia. Thus, this retrospective observational study aimed to test a new index (I-index), developed by combining the duration and intensity of neutrophilia, as a predictor of SSI.

Methods
I-index was calculated based on the postoperative neutrophil percentage. A total of 17 patients with SSI were enrolled as cases, and 51 patients without SSI were selected as controls. The groups were matched at a ratio of 1:3 by age, sex, and surgery type. The differences in the I-index were compared between the groups. Moreover, we checked the cumulative I-index (c-I-index), which we defined as the area under the neutrophil curve from postoperative day 1 until the first clinical manifestation of SSI in each case. Furthermore, a cutoff for SSI was defined using the receiver operating characteristic curve.

Results
The median I-index-7, I-index-14, and c-I-index were significantly higher in the SSI group than those in the control group. For a cutoff point of 42.1 of the I-index-7, the sensitivity and specificity were 0.706 and 0.882, respectively. For a cutoff point of 45.95 of the I-index-14, the sensitivity and specificity were 0.824 and 0.804, respectively. For a cutoff point of 45.95 of the c-I-index, the sensitivity and specificity were 0.824 and 0.804, respectively.

Conclusion
We devised a new indicator of infection, i.e., the I-Index and c-I-index, and confirmed its usefulness in predicting SSI.
Isolation and characterization of urine microvesicles from prostate cancer patients: different approaches, different visions
Authors: García-Flores María , Sánchez-López Christian M. , Ramírez-Calvo Marta , Fernández-Serra Antonio , Marcilla Antonio , López-Guerrero José Antonio 
Published: September 2021

Abstract
Background
Because of their specific and biologically relevant cargo, urine extracellular vesicles (EVs) constitute a valuable source of potential non-invasive biomarkers that could support the clinical decision-making to improve the management of prostate cancer (PCa) patients. Different EV isolation methods differ in terms of complexity and yield, conditioning, as consequence, the analytical result.

Methods
The aim of this study was to compare three different isolation methods for urine EVs: ultracentrifugation (UC), size exclusion chromatography (SEC), and a commercial kit (Exolute® Urine Kit). Urine samples were collected from 6 PCa patients and 4 healthy donors. After filtered through 0.22 µm filters, urine was divided in 3 equal volumes to perform EVs isolation with each of the three approaches. Isolated EVs were characterized by spectrophotometric protein quantification, nanoparticle tracking analysis, transmission electron microscopy, AlphaScreen Technology, and whole miRNA Transcriptome.

Results
Our results showed that UC and SEC provided better results in terms of EVs yield and purity than Exolute®, non-significant differences were observed in terms of EV-size. Interestingly, luminescent AlphaScreen assay demonstrated a significant enrichment of CD9 and CD63 positive microvesicles in SEC and UC methods compared with Exolute®. This heterogeneity was also demonstrated in terms of miRNA content indicating that the best correlation was observed between UC and SEC.

Conclusions
Our study highlights the importance of standardizing the urine EV isolation methods to guaranty the analytical reproducibility necessary for their implementation in a clinical setting.
Evaluation of a rapid one-step PSA test for primary prostate cancer screening
Authors: Ashida Shingo , Yamasaki Ichiro , Kawada Chiaki , Fukuhara Hideo , Fukata Satoshi , Tamura Kenji , Karashima Takashi , Inoue Keiji , Shuin Taro 
Published: September 2021

Abstract
Background
To enhance the convenience and reduce the cost of prostate cancer (PC) screening, a one-step prostate-specific antigen (PSA) test was evaluated in a large population. The PSA SPOT test kit enables rapid detection of human PSA in serum or plasma at or above a cutoff level of 4 ng/mL to aid in the diagnosis of PC.

Methods
PC screening using the PSA SPOT test was offered to male participants in educational public lectures that we conducted in various cities. Test results were reported to participants at the end of the lectures. Blood samples from 1429 men were evaluated. Two independent observers interpreted the tests at 15 and 30 min. The remaining serum samples were subsequently tested using a conventional quantitative assay.

Results
The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the test were 79.9, 93.0, 65.4, 96.6, and 91.2%, respectively. The sensitivity and specificity of the test changed with variations in the reading time. Quantitative assessment of the intensity of the band was correlated with the PSA value.

Conclusions
PSA testing using this kit can be easily performed. The low cost and speed of the test make it a useful and convenient tool for primary PC screening.