bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Plastic Packages for Food and Liquids in a prospective cohort of pregnant patients – Association analyses with birthweight and pregnancy duration
Authors: Stelzl Patrick , Pontones Constanza , Gass Paul , Emons Julius , Schwitulla Judith , Schneider Michael O. , Schwenke Eva , Haeberle Lothar , Ruebner Matthias , Faschingbauer Florian , Beckmann Matthias W. , Titzmann Adriana 
Published: May 2021

Abstract
Purpose: Exposure to endocrine disrupting chemicals (EDCs) is ubiquitous in modern civilization and their impact on hormonal regulation in vivid organisms is well established. These substances also seem to play a pivotal role during pregnancy as they might influence birth and pregnancy outcomes, such as fetal birthweight and pregnancy duration. The objective of this study is to investigate the associations of increased EDC exposure during pregnancy with changes of fetal birthweight and pregnancy duration.Methods: Individual use of plastic food and liquid packages was evaluated in 493 pregnant patients from the Clinical Gravidity Association Trial and Evaluation (CGATE) cohort using a three item lifestyle questionnaire concerning plastic consumption habits. To assess exposure to EDCs patients were further grouped into risk categories, and the associations with birthweight and pregnancy duration were investigated using a linear regression model.Results: For none of the investigated plastic consumption habits concerning drinking water, food from cans/plastic or beverage cartons (Tetra Pak) a statistically significant association with birthweight could be found. Moreover, no significant correlation between plastic consumption in regards of drinking water and food from cans/plastic with pregnancy duration could be detected. Interestingly, a statistically significant pregnancy prolongation of 0.4 weeks (p = 0.01, 95% CI: 0.1; 0.7) was observed with increasing consumption of Tetra Pak. Conclusion: The impact of plastic package consumption during pregnancy does not seem to have a major effect on birthweight or pregnancy duration, however the direction in which the statistically non-significant differences were seen were into the expected direction. Therefore larger studies are warranted to investigate this potentially important epidemiological factor.
Effectiveness of the Extension for Community Healthcare Outcomes (ECHO) Model of continuing tele-education and influence of key learning conditions on the development of competencies in healthcare professionals: Protocol for a mixed methods systematic review
Authors: Chicoine Gabrielle , Côté José , Pepin Jacinthe , Fontaine Guillaume , Maheu-Cadotte Marc-André , Hong Quan Nha , Rouleau Geneviève , Ziegler Daniela , Jutras-Aswad Didier 
Published: May 2021

Abstract
BackgroundThe Extension for Community Healthcare Outcomes (ECHO) Model of continuing tele-education is an innovative guided-practice model aiming at amplifying healthcare professionals’ competencies in the management of chronic and complex health conditions. While data on the effectiveness of the ECHO Model is increasingly available in the literature, the influence of key learning conditions on the model effectiveness remains unclear. Therefore, the overarching aim of this systematic review is to identify, appraise and synthesize the available quantitative (QUAN) and qualitative (QUAL) evidence regarding the effectiveness of the ECHO Model and the influence of key learning conditions on the development of competencies in healthcare professionals.MethodsThis proposed systematic review will be conducted in accordance with the Joanna Briggs Institute (JBI) methodology for Mixed Methods Systematic Reviews (MMSR) and will follow a convergent segregated approach. A systematic search will be undertaken using QUAN, QUAL and mixed methods (MM) studies of ECHO-affiliated programs identified in five databases. A publication date filter will be applied to find the articles published from 2003 onwards. Sources of unpublished studies and grey literature will be searched as well. Retrieved citations will be screened by two review authors independently. Disagreements will be resolved through discussion until a consensus is reached, or by including a third reviewer. Studies meeting the predefined inclusion criteria will be assessed on methodological quality and the data will be extracted using standardized data extraction forms. Separate QUAN and QUAL synthesis will be performed, and findings will be integrated using a matrix approach for the purpose of comparison and complementarity.DiscussionThis MMSR will fulfill important gaps in the current literature on the ECHO Model, as the first to provide estimates on its effectiveness and consider simultaneously the influence of key learning conditions on the development of competencies in healthcare professionals. As implementations of the ECHO Model greatly vary depending on the context, topic and targeted professional group, a better understanding of the conditions that contribute to competencies’ development in healthcare professionals is crucial to inform the design and implementation of the model.Systematic review registration:This MMSR protocol is pending registration in the International Prospective Register of Ongoing Systematic Reviews PROSPERO (submitted October 21, 2020; ID Number: 197579).
Ultrasound-guided navigation of a magnetic microrobot using acoustic phase analysis
Authors: Pane Stefano , Iacovacci Veronica , Ansari Mohammad Hasan Dad , Menciassi Arianna 
Published: May 2021

Abstract
Microrobots (MRs) have attracted significant interest for their potentialities in diagnosis and non-invasive intervention in hard-to-reach body areas. Fine control of biomedical MRs requires real-time feedback on their position and configuration. Ultrasound (US) imaging stands as a mature and advantageous technology for MRs tracking, but it suffers from disturbances due to low contrast resolution. To overcome these limitations and make US imaging suitable for closed-loop MR control, we propose a US contrast enhancement mechanism for MR visualization in heterogeneous and dynamic backgrounds (e.g., tissue). Our technique exploits the specific acoustic phase modulation produced by the MR characteristic motions. By applying this principle, we performed real-time visualization and position tracking of a magnetic MR rolling on a lumen boundary, both in static flow and opposing flow conditions, with an average error of 0.25 body-lengths. Overall, the reported results unveil countless possibilities to exploit the proposed approach as a robust feedback strategy for closed-loop control of medical MRs in-vivo.
Predictive Value of the Distress Thermometer Score for Risk of Suicide in Patients with Cancer
Authors: Chiang Yung-Chih , Couper Jeremy , Chen Jing-Wen , Lin Ke-Jui , Wu Han-Ping 
Published: May 2021

Abstract
Purpose: This study aimed to assess the association between the Distress Thermometer (DT) score and risk of suicide in patients with cancer. In addition, we aimed to determine the best cutoff score to predict patients at risk of suicide.Methods: From 2015 to 2016, we retrospectively collected data on patients with cancer. DT scores were collected, and the association between DT score and risk of suicide (suicide ideation or death ideation) was analyzed. Furthermore, receiver operating characteristic (ROC) analysis was performed to identify the appropriate cutoff score for predicting risk of suicide.Results: A total of 394 patients with cancer were included, and suicidal ideation was identified in 33 cases referred for psychological intervention. The DT scores of the patients with suicidal ideation were significantly higher than those of patients without suicidal ideation (6.30±2.11 vs. 4.29±1.72, p<0.05). In addition, the area under the ROC curve for predicting risk for suicide was 0.758. The cutoff DT score of 3 had the highest sensitivity of 1.00 to rule out suicidal ideation, while 9 had the highest specificity of 1.00 to rule in suicidal ideation. Moreover, the appropriate cutoff DT score to predict patients with suicidal ideation was 5, with a sensitivity of 0.52, specificity of .84, positive likelihood ratio of 3.24, and negative likelihood ratio of 0.58.Conclusion: The DT score may be a helpful clinical tool to evaluate emotional distress and risk of suicide in patients with cancer. Clinically, for DT scores greater than 5 in patients with cancer, the risk of suicide greatly increases. In view of the DT’s widespread use internationally by non-mental health clinicians in cancer to guide the need for specialist mental health interventions, it’s potential utility in also predicting suicide risk is of great interest.
Modified Device Key Generation Algorithm and A* Algorithm to Optimize the Security Measures Based on Trust Value in Device-to-Device Communications
Authors: VM Gayathri , p Supraja , A Razia Sulthana , P Mukunthan 
Published: May 2021

Abstract
Security plays a vital role in communication networks. Since the nodes are mobile in Mobile Ad-hoc Networks (MANET), they are vulnerable to different types of attacks. Because of its mobility nature any node can enter the network at any time based on the coverage of the network. No centralized mechanism is found to verify or authenticate the nodes that are arriving/leaving the network. An algorithm is proposed for secure communication between source and destination based on the QoS parameters is called Modified Device Key Generation Algorithm (MDKGA). This algorithm elects an agent node based on the QoS parameters. Agent node is responsible for secure key generation and distribution of keys among the nodes. The neighboring node selection is based on trust value which acts as a heuristic function to select the node using A* algorithm.Various performance metrics are also analyzed. Comparison study has been carried out between the protocols of MANET.
Molecular Characterization and Transcriptional Modulation of Stress-responsive Genes Under Heavy Metal Stress in Freshwater Ciliate, Euplotes Aediculatus
Authors: Somasundaram Sripoorna , Abraham Jeeva Susan , Maurya Swati , Toteja Ravi , Gupta Renu , Makhija Seema 
Published: May 2021

Abstract
The concentration of heavy metals in the environment is increasing predominantly due to anthropogenic activities such as mining and other industrial activities. Exposure to metals above a certain threshold level induces deleterious effects in the living organisms. To survive such harsh environment, microbes possess a range of tolerance mechanisms and express stress-responsive genes and/or antioxidant enzymes to detoxify the metal stress. Protozoans, especially ciliates, are highly sensitive to the environmental changes, thereby making them suitable model systems for ecotoxicological studies. Thus, in the present work, the effect of heavy metals such as cadmium and copper has been studied in the freshwater ciliate, Euplotes aediculatus. This study focuses on the activity of antioxidant enzymes namely catalase and glutathione peroxidase in E. aediculatus under the heavy metal stress. Also, the expression of stress-responsive genes; heat-shock protein 70 (hsp70) and catalase (cat), has been studied after metal exposure. It was observed that the enzyme activity and the expression of these genes increased with an increase in the metal concentration and with the duration of metal exposure. Besides, these genes have been characterized to understand their role in cell defense. These genes of fresh water ciliate, therefore, can be used as molecular biomarkers to evaluate heavy metal toxicity.
Noncanonical Nf-κB Activation by Icariin-Triggered CEBP-β/G-CSF Axis Confers Neuroprotection in Ischemic Optic Neuropathy
Authors: Desai Tushar Dnyaneshwar , Wen Yao-Tseng , Rayalu Jayasimha Daddam , Tsai Rong Kung 
Published: May 2021

Abstract
BackgroundAn ischemic insult at the optic nerve is followed by detrimental neuroinflammation that results in the loss of the retinal ganglion cells (RGCs) and vision. NF-κB is the key transcription factor of inflammatory cytokines in response to neuroinflammatory events. Icariin, an anti-inflammatory drug, is involved in the regulation of NF-κB activation. However, the protective mechanisms of icariin-induced NF-κB activation remain little known. Here, the protective mechanisms of icariin-induced NF-κB activation were investigated in experimental optic nerve ischemia. MethodsThe GOLD bio-informatics tool was used to select target drug based on CEBP-β binding affinity. The neuroprotective effects of target drug, Icariin, were assessed by measuring the flash visual electrode potentials, density of fluorogold-labeled cells, and TUNEL-positive cells in ganglion cell layer. The processes affecting RGC death were probed using optical coherence tomography, immunohistochemistry and immunoblotting techniques. ResultsThe simulation analysis and in vivo test demonstrated that the binding complex of icariin and CEBP-β significantly induced endogenous G-CSF expression. A single intravitreal injection of poly(lactic-co-glycolic acid) (PLGA)-icariin preserved visual function and RGC density after optic nerve infarct. The optic nerve edema, RGC apoptosis, and macrophage infiltration were inhibited by treatment with PLGA-icariin. The endogenous G-CSF expression switched the canonical NF-kB activation to the noncanonical NF-kB activation by promoting an alternative phosphorylation reaction of IKK-β. The noncanonical NF-κB activation further promoted the M2 microglia/macrophage polarization and AKT1 activation, which prevented the neuroinflammation and RGC apoptosis Granulocyte colony-stimulating factor. ConclusionOur study concluded that the protective mechanism of icariin is a G-CSF-induced non-canonical NF-kB activation, which may provide a potential therapeutic strategy for a patient with neuroinflammation diseases.
Degradable mesoporous semimetal antimony nanospheres for near-infrared II multimodal theranostics
Authors: Chen Yu , Yu Zhongzheng , Ren Yaguang , Zheng Kai , Wang Meng , Wu Qiang , Zhou Feifan , Liu Chengbo , Liu Liwei , Song Jun , Qu Junle 
Published: May 2021

Abstract
Metallic and semimetallic mesoporous frameworks are of great importance owing to their unique properties and broad applications. However, semimetallic mesoporous structures cannot be obtained by the traditional template-mediated strategies due to the inevitable hydrolytic reaction of semimetal compounds. Therefore, it is yet challenging to fabricate mesoporous semimetal nanostructures, not even mention controlling their pore sizes. Thus, we have developed a facile and robust selective etching route to synthesize monodispersed mesoporous antimony nanospheres (MSbNSs). This is the first report of semimetallic mesoporous structure to the best of our knowledge. The pore sizes of MSbNSs are tunable by carefully controlling the partial oxidation of Sb nuclei and the selective etching of the as-formed Sb2O3. MSbNSs showed a wide absorption from visible to second near-infrared (NIR-II) region. Moreover, PEGylated MSbNSs were degradable and the degradation mechanism was further explained. The NIR-II photothermal performance of MSbNSs was excellent with a high photothermal conversion efficiency of ~44% and intensive NIR-II photoacoustic signal. MSbNSs showed great potential as multifunctional nanomedicines for NIR-II photoacoustic imaging guided synergistic photothermal/chemo therapy in vivo. Our novel selective etching process would contribute to the development of various semimetallic mesoporous structures and efficient multimodal nanoplatforms for theranostics.
A Novel Prognostic Index for Sporadic Burkitt Lymphoma in Adult Patients: A Real-Word Multicenter Study
Authors: Chen Mei-ting , Pan Fei , Zhang Wei , Lv Hui-juan , Chen Yong-chang , Wang Zhao , Hong Huang-ming , Fang Xiao-jie , Wang Ya-wen , Pan Tao , Zou Li-qun , Guo Hong-qiang , Xie Ke , Chen Li-min , Li Xiao-qian , Yao Yu-yi , Chen Ze-geng , Weng Hua-wei , Li Xu-dong , Shen Yuan-yuan , Zhou Hui , Xue Hong-wei , Zhang Hui-lai , Huang He , Lin Tong-yu 
Published: May 2021

Abstract
Background: Adult sporadic Burkitt lymphoma (BL) is a rare but highly aggressive subtype of lymphoma which lacks its own unique prognostic model. Systemic inflammatory biomarkers have been confirmed as prognostic markers in several types of malignancy. Our objective was to explore the predictive value of pretreatment inflammatory biomarkers and establish a novel, clinically applicable prognostic index for adult patients with sporadic BL. Methods: We surveyed retrospectively 336 adult patients with newly diagnosed sporadic BL at 8 Chinese medical centers and divided into training cohort (n=229) and validation cohort (n=107). The pretreatment inflammatory biomarkers were calculated for optimal cut-off value. The association between serum biomarkers and overall survival (OS) was analyzed by Kaplan–Meier curves and Cox proportional models.Results and Conclusions: Univariate and multivariate analyses revealed that platelets<254×109/L, albumin<40g/L, lactate dehydrogenase≥334U/L independently predicted unfavorable OS. We used these data as the basis for the prognostic index, in which patients were stratified into Group 1 (no or one risk factor), Group 2 (two risk factors), or Group 3 (three risk factors), which were associated with 5-year OS rates of 88.1%, 72.4%, and 45%, respectively. In the subgroup analysis for high-risk patients, our prognostic model results showed that high-risk patients with no more than one adverse factor presented a 5-year survival rate of 85.9%, but patients with three adverse factors had a 5-year survival rate of 43.0%. Harrell’s concordance index (C-index) of the risk group score was 0.768. Therefore, the new prognostic model could be used to develop risk-adapted treatment approaches for adult sporadic BL.
Trends In Healthcare Visits And Antimicrobial Prescriptions For Acute Infectious Diarrhea In Individuals Aged 65 Years Or Younger In Japan From 2013 to 2018 Based On Administrative Claims Database: A Retrospective Observational Study
Authors: Ono Akane , Aoyagi Kensuke , Muraki Yuichi , Asai Yusuke , Tsuzuki Shinya , Koizumi Ryuji , Azuma Toshiaki , Kusama Yoshiki , Ohmagari Norio 
Published: May 2021

Abstract
Background: The inappropriate use of antimicrobials for acute infectious diarrhea is widespread and leads to the problem of antimicrobial resistance. To improve the use of antimicrobials, it is first necessary to understand the actual situation of diarrheal disease and to identify potential targets for intervention. This study aimed to investigate the recent epidemiological characteristics of and antimicrobial prescriptions for acute infectious diarrhea in Japan.Methods: This was a retrospective observational study of outpatients aged 0–65 years, separated into children (age 0–17 years) and adults (age 18–65 years), diagnosed with acute infectious diarrhea, using the administrative claims database of the Japan Medical Data Center from 2013 to 2018. We evaluated the number of eligible visits/number of database registrants (defined as the visit rate). The analysis of the antimicrobial prescription rate was restricted to otherwise healthy individuals diagnosed with acute infectious diarrhea alone by excluding patients with multiple disease diagnoses and with medical backgrounds of chronic bowel diseases or immunocompromised conditions. We further classified them by diagnosis of bacterial or nonbacterial acute infectious diarrhea.Results: The total number of eligible visits for acute infectious diarrhea was 2,600,065. The visit rate, calculated based on the number of eligible visits by database registrants, was higher in children (boys, 0.264; girls, 0.229) than in adults (men, 0.070; women, 0.079), with peaks in early summer and winter. The peaks for visits in adults lagged those of children. In total, 482,484 visits were analyzed to determine the antimicrobial prescription rate; 456,655 (94.6%) were diagnosed with nonbacterial acute infectious diarrhea. Compared with children (boys, 0.305; girls, 0.304), the antimicrobial prescription rate was higher in adults, and there were differences between sexes in adults (men, 0.465; women, 0.408). Fosfomycin and fluoroquinolone were most frequently used for nonbacterial acute infectious diarrhea in children (44.1%) and adults (50.3%), respectively.Conclusions: These results revealed overprescription of antimicrobials for acute infectious diarrhea in this administrative claims database in Japan and contribute to the development of antimicrobial stewardship strategies and the identification of targets for efficiently reducing inappropriate antimicrobial use.
The Positive Feedback Loop of NHE1-ERK Phosphorylation Mediated by BRAFV600E Mutation Contributes to Tumorigenesis and Development of Glioblastoma
Authors: Li Yuhui , Li Dan , Liu Yankun , Wang Shuqing , Sun Mingyang , Zhang Zhongyuan , Zheng Xuan , Li Jingwu , Li Yufeng 
Published: May 2021

Abstract
The occurrence rate of v-raf murine sarcoma viral oncogene homolog B1 (BRAF) activating mutation V600E (BRAFV600E) in glioblastoma multiforme (GBM) is more than 50%. Na/H exchanger 1 (NHE1), a main pH regulator affecting cell microenvironment, is hyper-expressed in GBM. However, the relationship between BRAFV600E signal pathway and NHE1 in GMB cells remains unclear. This study found that NHE1 was a downstream target of BRAFV600E and an upstream factor of extracellular signal-regulated kinase (ERK). In addition, there was a positive feedback loop between NHE1-ERK phosphorylation under regulation of BRAFV600E mutation contributing to the proliferation and invasion of GBM cells. Moreover, the proliferation and invasion abilities of BRAFV600E-mutant and BRAF wild type GBM cells were all suppressed by the NHE1 inhibitor, BRAFV600E inhibitor and combination of them. The inhibitory effect of combination of the two inhibitors was better than each single drug both in vitro and in vivo. Combination of BRAFV600E and NHE1 inhibitors could be considered as a new therapeutic regimen for GBM, especially for GBM with BRAFV600E.
How Costly is the First Prenatal Clinic Visit? Analysis of Out-of-Pocket Expenditure in Rural Sri Lanka - A Country With Free Maternal Health Care
Authors: Gunarathne Sajaan Praveena , Wickramasinghe Nuwan Darshana , Agampodi Thilini Chanchala , Prasanna Indika Ruwan , Agampodi Suneth Buddhika 
Published: May 2021

Abstract
Background: This study aimed to determine the magnitude of and factors associated with out-of-pocket expenditure (OOPE) during the first prenatal clinic visit among pregnant women in Anuradhapura district, Sri Lanka, which provides free maternal healthcare. Methods: The study design was a cross-sectional study, and the study setting was 22 Medical Officers of Health areas in Anuradhapura District, Sri Lanka. Data of 1,389 pregnant women were analyzed using descriptive statistics and non-parametric tests. Results: The mean OOPE of the first prenatal clinic visit was USD 8.12, which accounted for 2.9% and 4.5% of the household income and expenditure, respectively. Pregnant women who used only government-free health services had an OOPE of USD 3.49. A significant correlation was recorded between household expenditure (rs=0.095, p=0.002) and the number of pregnancies (rs=-0.155, p<0.001) with OOPE. Conclusion: Despite having free maternal services, the OOPE of the first prenatal clinic visit is high in rural Sri Lanka. One-fifth of pregnant women utilize private health services, and pregnant women who used only government-free maternal health services also spend a direct medical cost.