bluuebunny/crossref_metadata_2025_split huggingface dataset:
Randomised feasibility study of prehospital recognition and antibiotics for emergency patients with sepsis (PhRASe)
Authors: Jones Jenna , Allen Susan , Davies Jan , Driscoll Timothy , Ellis Gemma , Fegan Greg , Foster Theresa , Francis Nick , Islam Saiful , Morgan Matt , Nanayakkara Prabath W. B. , Perkins Gavin D. , Porter Alison , Rainer Timothy , Ricketts Samuel , Sewell Bernadette , Shanahan Tracy , Smith Fang Gao , Smyth Michael A. , Snooks Helen , Moore Chris 
Published: September 2021

AbstractSevere sepsis is a time critical condition which is known to have a high mortality rate. Evidence suggests that early diagnosis and early administration of antibiotics can reduce morbidity and mortality from sepsis. The prehospital phase of emergency medical care may provide the earliest opportunity for identification of sepsis and delivery of life-saving treatment for patients. We aimed to assess the feasibility of (1) paramedics recognising and screening patients for severe sepsis, collecting blood cultures and administering intravenous antibiotics; and (2) trial methods in order to decide whether a fully-powered trial should be undertaken to determine safety and effectiveness of this intervention. Paramedics were trained in using a sepsis screening tool, aseptic blood culture collection and administration of intravenous antibiotics. If sepsis was suspected, paramedics randomly allocated patients to intervention or usual care using scratchcards. Patients were followed up at 90 days using linked anonymised data to capture length of hospital admission and mortality. We collected self-reported health-related quality of life at 90 days. We pre-specified criteria for deciding whether to progress to a fully-powered trial based on: recruitment of paramedics and patients; delivery of the intervention; retrieval of outcome data; safety; acceptability; and success of anonymised follow-up. Seventy-four of the 104 (71.2%) eligible paramedics agreed to take part and 54 completed their training (51.9%). Of 159 eligible patients, 146 (92%) were recognised as eligible by study paramedics, and 118 were randomised (74% of eligible patients, or 81% of those recognised as eligible). Four patients subsequently dissented to be included in the trial (3%), leaving 114 patients recruited to follow-up. All recruited patients were matched to routine data outcomes in the Secure Anonymised Information Linkage Databank. Ninety of the 114 (79%) recruited patients had sepsis or a likely bacterial infection recorded in ED. There was no evidence of any difference between groups in patient satisfaction, and no adverse reactions reported. There were no statistically significant differences between intervention and control groups in Serious Adverse Events (ICU admissions; deaths). This feasibility study met its pre-determined progression criteria; an application will therefore be prepared and submitted for funding for a fully-powered multi-centre randomised trial.Trial registration: ISRCTN36856873 sought 16th May 2017; https://doi.org/10.1186/ISRCTN36856873
Degeneracy of light scattering and absorption by a single nanowire
Authors: Lee Jeng Yi , Chen Yi-Huan , Chen Pai-Yen 
Published: September 2021

AbstractWe theoretically and numerically prove that under an electromagnetic plane wave with linear polarization incident normally to a single nanowire, there exists a power diagram that could indicate scattering properties for any system configurations, material parameters, and operating wavelength. We demonstrate the distinct power distribution boundary in absorption, scattering, and extinction for a generalized nanowire with any partial wave modes dominant. In the boundary, each dominant scattering coefficients remain constant, and its energy performance would display superabsorbers or superscatterers. Interestingly, for a system with larger partial wave modes dominant, the occupied domain in the power diagram could completely cover that with lower ones. Hence, a system with different levels of partial wave modes can display the same power results, reflecting the degeneracy. This degenerate property could release more degrees of freedom in design of energy harvesting devices and sensors. We demonstrate several systems based on realistic materials to support our findings.
Dual function Li-reactive coating from residual lithium on Ni-rich NCM cathode material for Lithium-ion batteries
Authors: Sattar Tahir , Sim Seong-Ju , Jin Bong-Soo , Kim Hyun-Soo 
Published: September 2021

AbstractIn this study, lithium phosphate (Li3PO4) is coated on the surface of Ni-rich LiNi0.91Co0.06Mn0.03O2 cathode material to enhance its cyclability and rate performance. The process is carried-out by achieving dual benefits, reduction of residual lithium compounds by converting them into Li3PO4 coating material. The 0.1 mol.% Li3PO4 (LiP) sample exhibits a capacity retention of 82% while the pristine NCM shows only 68.1% after 100 cycles. In addition, the LiP-0.1 NCM delivers high discharge capacities (161.9 mAh g−1 at 3C, 144.3 mAh g−1 at 4C and 94.6 mAh g−1 at 5C) as compared to the pristine NCM (129.3 mAh g−1 at 3C, 67.4 mAh g−1 at 4C and 33.4 mAh g−1 at 5C) in the voltage range of 3.0–4.3 V. In addition, the irreversible phase transition has also suppressed in the coated sample which is confirmed by cyclic voltammetry. Our study suggests that Li3PO4 coating reduces the polarization and acts as protecting layer between the electrode and electrolyte that results in the superior electrochemical performance.
Flow cytometry method for absolute counting and single-cell phenotyping of mycobacteria
Authors: Barr David A. , Omollo Charles , Mason Mandy , Koch Anastasia , Wilkinson Robert J. , Lalloo David G. , Meintjes Graeme , Mizrahi Valerie , Warner Digby F. , Davies Gerry 
Published: September 2021

AbstractDetection and accurate quantitation of viable Mycobacterium tuberculosis is fundamental to understanding mycobacterial pathogenicity, tuberculosis (TB) disease progression and outcomes; TB transmission; drug action, efficacy and drug resistance. Despite this importance, methods for determining numbers of viable bacilli are limited in accuracy and precision owing to inherent characteristics of mycobacterial cell biology—including the tendency to clump, and “differential” culturability—and technical challenges consequent on handling an infectious pathogen under biosafe conditions. We developed an absolute counting method for mycobacteria in liquid cultures using a bench-top flow cytometer, and the low-cost fluorescent dyes Calcein-AM (CA) and SYBR-gold (SG). During exponential growth CA + cell counts are highly correlated with CFU counts and can be used as a real-time alternative to simplify the accurate standardisation of inocula for experiments. In contrast to CFU counting, this method can detect and enumerate cell aggregates in samples, which we show are a potential source of variance and bias when using established methods. We show that CFUs comprise a sub-population of intact, metabolically active mycobacterial cells in liquid cultures, with CFU-proportion varying by growth conditions. A pharmacodynamic application of the flow cytometry method, exploring kinetics of fluorescent probe defined subpopulations compared to CFU is demonstrated. Flow cytometry derived Mycobacterium bovis bacillus Calmette-Guérin (BCG) time-kill curves differ for rifampicin and kanamycin versus isoniazid and ethambutol, as do the relative dynamics of discrete morphologically-distinct subpopulations of bacilli revealed by this high-throughput single-cell technique.
Projections of northern hemisphere extratropical climate underestimate internal variability and associated uncertainty
Authors: O’Reilly Christopher H. , Befort Daniel J. , Weisheimer Antje , Woollings Tim , Ballinger Andrew , Hegerl Gabriele 
Published: September 2021

AbstractInternal climate variability will play a major role in determining change on regional scales under global warming. In the extratropics, large-scale atmospheric circulation is responsible for much of observed regional climate variability, from seasonal to multidecadal timescales. However, the extratropical circulation variability on multidecadal timescales is systematically weaker in coupled climate models. Here we show that projections of future extratropical climate from coupled model simulations significantly underestimate the projected uncertainty range originating from large-scale atmospheric circulation variability. Using observational datasets and large ensembles of coupled climate models, we produce synthetic ensemble projections constrained to have variability consistent with the large-scale atmospheric circulation in observations. Compared to the raw model projections, the synthetic observationally-constrained projections exhibit an increased uncertainty in projected 21st century temperature and precipitation changes across much of the Northern extratropics. This increased uncertainty is also associated with an increase of the projected occurrence of future extreme seasons.
Identification of potential genes related to breast cancer brain metastasis in breast cancer patients
Authors: Zhang Lijian , Wang Luxuan , Yang Hua , Li Chunhui , Fang Chuan 
Published: September 2021

Abstract
Brain metastases (BMs) usually develop in breast cancer (BC) patients. Thus, the molecular mechanisms of breast cancer brain metastasis (BCBM) are of great importance in designing therapeutic strategies to treat or prevent BCBM. The present study attempted to identify novel diagnostic and prognostic biomarkers of BCBM. Two datasets (GSE125989 and GSE100534) were obtained from the Gene Expression Omnibus (GEO) database to find differentially expressed genes (DEGs) in cases of BC with and without brain metastasis (BM). A total of 146 overlapping DEGs, including 103 up-regulated and 43 down-regulated genes, were identified. Functional enrichment analysis showed that these DEGs were mainly enriched for functions including extracellular matrix (ECM) organization and collagen catabolic fibril organization. Using protein–protein interaction (PPI) and principal component analysis (PCA) analysis, we identified ten key genes, including LAMA4, COL1A1, COL5A2, COL3A1, COL4A1, COL5A1, COL5A3, COL6A3, COL6A2, and COL6A1. Additionally, COL5A1, COL4A1, COL1A1, COL6A1, COL6A2, and COL6A3 were significantly associated with the overall survival of BC patients. Furthermore, COL6A3, COL5A1, and COL4A1 were potentially correlated with BCBM in human epidermal growth factor 2 (HER2) expression. Additionally, the miR-29 family might participate in the process of metastasis by modulating the cancer microenvironment. Based on datasets in the GEO database, several DEGs have been identified as playing potentially important roles in BCBM in BC patients.
Welche digitalen Angebote nutzen psychisch vorerkrankte Menschen
während der Corona-Pandemie und gibt es Zusammenhänge mit Angst
und depressiven Symptomen?
Authors: Dahmen Alina , Keller Franziska Maria , Derksen Christina , Kötting Lukas , Lippke Sonia 
Published: September 2021

Zusammenfassung
Ziel der Studie Die Corona-Pandemie erfordert zum Infektionsschutz
zahlreiche Maßnahmen wie Kontaktreduktion und Einhalten von Hygiene- und
Abstandsregeln. Ersteres kann durch eine soziale Isolation zu
(möglicherweise behandlungsbedürftigen) psychischen
Störungen führen, letztere erfordern Anpassungen in der
Durchführung medizinischer Therapien. Bei insgesamt begrenzten
Therapiekapazitäten kann der Nutzung digitaler (Gesundheits-)
Anwendungen in der Therapie insbesondere chronischer psychischer Erkrankungen
eine besondere Bedeutung zukommen. Die vorliegende Studie hat daher als Ziel, zu
untersuchen, welche Gesundheits-Apps von psychisch vorerkrankten Menschen
genutzt werden.
Methodik Es wurden 1.060 Versicherte in Vorbereitung auf eine
psychosomatische Rehabilitationsmaßnahme mittels eines
Online-Fragebogens befragt. Die Auswertung erfolgte mit deskriptiven Analysen,
Frequenzanalysen und Varianzanalysen mit Post-hoc Tests sowie
Korrelationsanalysen.
Ergebnisse Die Teilnehmenden nutzten im Durchschnitt drei Apps; die
häufigsten Themen waren „Ernährung“
(n=313), „Selbstdiagnose“ (n=244) und
„Entspannung“ (n=234). Weibliche Teilnehmende nutzten
Apps häufiger als männliche und jüngere Teilnehmende
häufiger als ältere. Eine Angstsymptomatik hing mit der Nutzung
von Apps zusammen, insbesondere zu Herzfrequenz/Blutdruck;
während eine depressive Symptomatik nicht mit der Nutzung digitaler
Anwendungen korrelierte.
Diskussion Einige Gesundheits-Apps werden häufig durch psychisch
vorerkrankte Menschen genutzt. Eine zunehmende Akzeptanz von digitalen
(Gesundheits-)Anwendungen bietet erhebliches Potenzial in der Behandlung
insbesondere psychisch erkrankter Menschen. Der Fokus sollte auf individuellen
Anwendungen mit Einbindung in den regulären Versorgungsprozess
liegen.
Schlussfolgerung Die zunehmende Digitalisierung auch im Gesundheitswesen
kann dazu genutzt werden, die Versorgung gerade in Zeiten der
Kontaktbeschränkungen und begrenzter personeller Ressourcen
sicherzustellen.
Importance of Hip-Spine Syndrome in Hip Arthroplasty: Influence on the Outcome and Therapeutic Consequences
Authors: Langer Severin , Stephan Maximilian , von Eisenhart-Rothe Rüdiger 
Published: September 2021

AbstractCorrect interaction between the spine, pelvis, and hip is an essential condition for successful progress after total hip replacement. Spinal pathologies, such as degeneration, fractures,
and spinopelvic imbalance with and without lumbar fusions, are closely associated with an increased risk of impingement or even dislocation of the prosthesis. To significantly reduce this
risk, various parameters are required to quantify the risk groups. Knowledge on the presence of stiffness of the spine (change in pelvic tilt between standing and sitting at < 10°) and
sagittal spinal deformity (pelvic incidence–lumbar lordosis mismatch > 10° or 20°) is essential in identifying patients with corresponding risk. The individual risk profile can be
assessed through a specific history and examination. Before total hip arthroplasty, a routine preoperative workup is recommended for high-risk patients: using information from standardised
preoperative radiographs while sitting and standing (pelvis, anteroposterior view, lying and standing; spine and pelvis, lateral view, standing and sitting). Important changes can be made
during the surgery. If the spine is stiff, attention should be paid to the position of the cup, with increased anteversion, sufficient offset, and larger head that is secure to dislocation –
to reduce the risk of dislocation. In the case of a sagittal spinal deformity, the functional coronary pelvic level must be carefully controlled so that it is better to use double mobility
cups. Digital systems, such as navigation and robotics, can optimise component positioning although, so far, there is little evidence that the complication rate decreased. Therefore, further
studies are warranted.
Post-Interventionelle subendokardiale “Tamponade“ bei
okkulter Koronarperforation während einer komplexen
PTCA
Authors: Eltarahony Mohamed , Finkenzeller Thomas , Schwinger Robert H. G. 
Published: September 2021

ZusammenfassungBei einem Patienten mit 3-Gefäß-Erkrankung und Zustand nach
aortokoronarer Bypassoperation vor 10 Jahren mit LIMA-Bypass auf LAD
und Venenbypass auf RCA wurde bei akuter Dyspnoesymptomatik mit
atemabhängigen Beschwerden und erhöhten D-Dimeren zum Ausschluss einer
Lungenarterienembolie (LAE) eine Computertomografie (CT 1)
durchgeführt und eine LAE ausgeschlossen. Bei fortbestehender
Beschwerdesymptomatik und bekannter KHK (koronarer Herzkrankheit)
wurde am Folgetag eine Koronarangiografie durchgeführt. Es wurde eine
PTCA und Stentimplantation mit sequenzieller Vordilatation der
proximalen und der mittleren RCA durchgeführt. Primär zeigte sich ein
gutes Ergebnis bei schwierigem PTCA-Verlauf bei ausgeprägter
Verkalkung und torquiertem Gefäßverlauf. Noch im Herzkatheterlabor
erfolgte das Loading mit Aspirin und Clopidogrel. Nach Beendigung der
Untersuchung wurde ein Perikarderguss echokardiografisch
ausgeschlossen. Im Rahmen einer Routine-Echokardiografie vor
Entlassung zeigte sich eine ausgeprägte echoarme Raumforderung im
rechten Ventrikel, die fast das gesamte Ventrikelvolumen ausfüllte,
mit Aussparung nur eines kleinen basalen Bereiches. Weder im ersten
TTE nach Intervention noch in der initialen CT-Untersuchung (CT 1) war
diese Raumforderung nachweisbar. Klinisch blieb der Patient
beschwerdefrei. Im dann durchgeführten Kardio-CT (CT 2) und im
Kardio-MRT sowie in der transösophagealen Echokardiografie bestätigte
sich diese Raumforderung im rechten Ventrikel, welche eine
subendokardiale und intramurale Ausbreitung zeigte. Zusammenfassend
(Vergleich CT 1 vs. CT 2) zeigte sich somit eine postinterventionelle
Tamponade ohne hämodynamische Relevanz am ehesten im Rahmen einer
Gefäßverletzung durch den Koronardraht mit aufgetretener okkulter
Koronarperforation. Somit können Mikrokoronarperforationen auch im
weiteren Verlauf über Tage zu intramuralen Einblutungen (gegenwärtiger
Fall) oder zur Ausbildung eines Perikardergusses führen.
Echokardiografische Kontrolluntersuchungen auch mehr als 24 Stunden
nach Koronarintervention bei komplexen Prozeduren können helfen, diese
rechtzeitig zu erkennen. Auch größere intramurale Einblutungen können
konservativ beherrschbar bleiben.
Prevalence of Anal Intraepithelial Lesions in Patients with Inflammatory Bowel Disease
Authors: Savio Mariane Christina , Baldin Rosimeri Kuhl Svoboda , Nóbrega Norton Luiz , Nicollelli Guilherme Mattioli , Brenner Antonio Sérgio , Rocha Pollyanna Borges da , Rossoni Marssoni Deconto , Sartor Maria Cristina , Baldin Antonio 
Published: September 2021

Abstract
Introduction Anal intraepithelial neoplasia (AIN) is a premalignant lesion of the anal canal associated with HPV, with a higher prevalence in immunosuppressed individuals. Patients with inflammatory bowel disease (IBD) are at potential risk for their development, due to the use of immunosuppressants and certain characteristics of the disease.
Method This is a prospective, cross-sectional, and interventional study that included 53 patients with IBD treated at a tertiary outpatient clinic, who underwent anal smear for cytology in order to assess the prevalence of AIN and associated risk factors.
Results Forty-eight samples were negative for dysplasia and 2 were positive (4%). Both positive samples occurred in women, with Crohn's disease (CD), who were immunosuppressed and had a history of receptive anal intercourse.
Discussion The prevalence of anal dysplasia in IBD patients in this study is similar to that described in low-risk populations. Literature data are scarce and conflicting and there is no evidence to recommend screening with routine anal cytology in patients with IBD. Female gender, history of receptive anal intercourse, immunosuppression and CD seem to be risk factors.
Anal Intraepithelial Neoplasia Associated with High-Grade Vulva Injury (Usual-Type Vulvar Intraepithelial Neoplasia): Surgical Treatment with Cutaneous Flap Advancement
Authors: Cunha-e-Silva José Antonio , Povedano Andrea , Vassalo Eduardo , Kneipp Angélica , Arbex Guilherme , do-Val Isabel Chulvis 
Published: September 2021

AbstractThe aim of the present article is to report the case of a young patient with bowenoid papulosis who was a carrier of other sexually-transmitted infections (STIs), such as HIV and high-grade vulva lesion (usual-type vulvar intraepithelial neoplasia, VIN), and to demonstrate the strategy used to manage the case, as well as to discuss important issues regarding the standardization of intraepithelial lesions.8
Tromboembolismo na artroplastia: Adesão à profilaxia
Authors: Viana Leandra Marla Aires Travassos , Nogueira Iara Antônia Lustosa , Fontenele Andréa Martins Melo , Oliveira Liszt Palmeira de 
Published: September 2021

Resumo
Objetivo Identificar o perfil de adesão à profilaxia medicamentosa de tromboembolismo em pacientes submetidos a cirurgias ortopédicas de artroplastia de joelho ou de quadril em hospital público.
Métodos Estudo de coorte prospectivo, realizado no período de agosto de 2017 a setembro de 2018, com pacientes adultos que foram acompanhados desde a internação até o pós-operatório. Para medir a adesão, aplicou-se a Escala de Adesão Terapêutica de Morisky de oito itens. A quantificação do grau de adesão foi determinada segundo o resultado da soma de todas as respostas corretas: alta adesão (8 pontos), média adesão (6 a < 8 pontos), e baixa adesão (< 6 pontos). No presente estudo, foram divididos em altamente aderentes aqueles que tiveram alta adesão e parcialmente aderentes os pacientes que tiveram média ou baixa adesão.
Resultados A análise da adesão mostrou que 73,0% dos pacientes foram altamente aderentes, enquanto 27,0% foram parcialmente aderentes à tromboprofilaxia. O anticoagulante prescrito na alta hospitalar foi o rivaroxabana, inibidor direto do fator Xa. Obtiveram maior adesão os pacientes que não necessitaram de reforço na orientação sobre a profilaxia durante o acompanhamento e, por conseguinte, relataram boa e ótima aceitação à profilaxia, embora estivessem polimedicados durante a alta hospitalar.
Conclusão A análise dos dados obtidos permitiu concluir que os fatores que mais influenciaram na adesão foram os níveis de compreensão e aceitação dos pacientes quanto à profilaxia, a quantidade de medicamentos usada por dia pelo paciente, o custo do anticoagulante e o seu potencial em desenvolver reações adversas.
Integrated Multiorgan Bedside Ultrasound for the Diagnosis and Management of Sepsis and Septic Shock
Authors: Sweeney Daniel A. , Wiley Brandon M. 
Published: September 2021

AbstractDespite decades of research, the mortality rate of sepsis and septic shock remains unacceptably high. Delays in diagnosis, identification of an infectious source, and the challenge of providing patient-tailored resuscitation measures routinely result in suboptimal patient outcomes. Bedside ultrasound improves a clinician's ability to both diagnose and manage the patient with sepsis. Indeed, multiple point-of-care ultrasound (POCUS) protocols have been developed to evaluate and treat various subsets of critically ill patients. These protocols mostly target patients with undifferentiated shock and have been shown to improve clinical outcomes. Other studies have shown that POCUS can improve a clinician's ability to identify a source of infection. Once a diagnosis of septic shock has been made, serial POCUS exams can be used to continuously guide resuscitative efforts. In this review, we advocate that the patient with suspected sepsis or septic shock undergo a comprehensive POCUS exam in which sonographic information across organ systems is synthesized and used in conjunction with traditional data gleaned from the patient's history, physical exam, and laboratory studies. This harmonization of information will hasten an accurate diagnosis and assist with hemodynamic management.