bluuebunny/crossref_metadata_2025_split huggingface dataset:
Artificial Intelligence-Assisted Reduction in Patients’ Waiting Time for Outpatient Procedures: A Retrospective Cohort Study
Authors: Li Xiaoqing , Tian Dan , Li Weihua , Dong Bin , Wang Hansong , Yuan Jiajun , Li Biru , Shi Lei , Lin Xulin , Zhao Liebin , Liu Shijian 
Published: January 2021

Abstract
Background: Many studies suggest that patient satisfaction is significantly negatively correlated with waiting time. A well-designed healthcare system should not keep patients waiting too long for appointment and consultation. However, in China, patients spend notable time waiting, and the actual time spent on diagnosis and treatment in the consulting room is comparatively less.Methods: We developed an artificial intelligence (AI)-assisted module and name it XIAO YI. It could help outpatients automatically order imaging examinations or laboratory tests based on their chief complaints. Thus, outpatients could get examined or tested before they went to see the doctor. People who saw a doctor in the traditional way were assigned to the conventional group, and those who used XIAO YI were assigned to the AI-assisted group. We conducted a retrospective cohort study that used data from HIS of Shanghai Children’s Medical Center for the period of August 1, 2019 to January 31, 2020. Propensity score matching was used to balance the confounding factor between the two groups. And waiting time was defined as the time from registration to preparation for laboratory tests or imaging examinations. The total cost included the registration fee, test fee, examination fee, and drug fee. We used Wilcoxon rank-sum test to compare the differences in time and cost between the AI-assisted group and the conventional group. The statistical significance level was set at 0.05 for two sides.Results: 12,342 visits were recruited, consisting of 6,171 visits in the conventional group and 6,171 visits in the AI-assisted group. The median waiting time was 0.38 (interquartile range: 0.20, 1.33) hours for the AI-assisted group compared with 1.97 (0.76, 3.48) hours for the conventional group (p < 0.05).Conclusions: Using XIAO YI can significantly reduce the waiting time of patients, and thus, improve the outpatient service process of hospitals.
Partnership Among Hospitals To Reduce Healthcare Associated Infections: A Quasi-Experimental Study In Brazilian ICUs
Authors: de Melo Ladjane Santos Wolmer , de Abreu Maria Verônica Monteiro , Santos Bernuarda Roberta de Oliveira , Carreteiro Maria das Graças Washington Casimiro , de Souza Maria Fernanda Aparecida Moura , de Albuquerque Maria Carolina Andrade Lins , Vidal Claudia Fernanda de Lacerda , Lacerda Heloisa Ramos 
Published: January 2021

Abstract
Background: Healthcare-associated infections (HAIs) are relevant in developing countries where frequencies can be at least 3 times higher than in developed countries. The purpose of this research was to describe the intervention implemented in intensive care units (ICUs) to reduce HAIs through collaborative project and analyze the variation over 18 months in the incidence density (ID) of the three main HAIs: ventilator associated pneumonia (VAP), central line-associated bloodstream infections (CLABSIs) and catheter-related urinary tract infections (CAUTIs) and also the length of stay and mortality in these ICUs. Methods: A quasi-experimental study in five public adult clinical-surgical ICUs, to reduce HAIs, through interventions using the BTS-IHI “Improvement Model”, during 18 months. In the project, promoted by the Ministry of Health, Brazilian philanthropic hospitals of excellence (HE), those mostly private, certified as excellence and exempt from security contributions, regularly trained and monitored public hospitals in diagnostics, data collection and in developing cycles to improve quality and to prevent HAIs (bundles). In the analysis regarding the length of stay, mortality, the IDs of VAP, CLABSIs and CAUTIs over time, a Generalized Estimating Equation (GEE) model was applied for continuous variables, using the constant correlation (exchangeable) between assessments over time. The model estimated the average difference (β coefficient of the model) of the measures analyzed during two periods: a period in the year 2017 (prior to implementing the project) and in the years 2018 and 2019 (during the project).Result: A mean monthly reduction of 0.427 in VAP ID (p = 0.002) with 33.8% decrease at the end of the period and 0.351 in CAUTI ID (p = 0.009) with 45% final decrease. The mean monthly reduction of 0.252 for CLABSIs was not significant (p = 0.068). Length of stay and mortality rates had no significant variation. Conclusions: Given the success in reducing VAP and CAUTIs in a few months of interventions, the achievement of the collaborative project is evident. This partnership among public hospitals/HE may be applied to other ICUs including countries with fewer resources.
Fine tuning the glycolytic flux ratio of EP-bifido pathway for mevalonate production by enhancing glucose-6-phosphate dehydrogenase (Zwf) and CRISPRi suppressing 6-phosphofructose kinase (PfkA) in Escherichia coli
Authors: Li Ying , Xian He , Xu Ya , Zhu Yuan , Sun Zhijie , Wang Qian , Qi Qingsheng 
Published: January 2021

Abstract
Background Natural glycolysis encounters the decarboxylation of glucose partial oxidation product pyruvate into acetyl-CoA, where one-third of the carbon is lost at CO2. We previously constructed a carbon saving pathway, EP-bifido pathway by combining Embden-Meyerhof-Parnas Pathway, Pentose Phosphate Pathway and “bifid shunt”, to generate high yield acetyl-CoA from glucose. However, the carbon conversion rate and reducing power of this pathway was not optimal, the flux ratio of EMP pathway and pentose phosphate pathway (PPP) needs to be precisely and dynamically adjusted to improve the production of mevalonate (MVA). Result Here, we finely tuned the glycolytic flux ratio in two ways. First, we enhanced PPP flux for NADPH supply by replacing the promoter of zwf on the genome with a set of different strength promoters. Compared with the previous EP-bifido strains, the zwf-modified strains showed obvious differences in NADPH, NADH, and ATP synthesis levels. Among them, strain BP10BF accumulated 11.2 g/L of MVA after 72 h of fermentation and the molar conversion rate from glucose reached 62.2%. Second, pfkA was finely down-regulated by the clustered regularly interspaced short palindromic repeats interference (CRISPRi) system. The MVA yield of the regulated strain BiB1F was 8.53 g/L, and the conversion rate from glucose reached 68.7%. Conclusion This is the highest MVA conversion rate reported in shaken flask fermentation. The CRISPRi and promoter fine-tuning provided an effective strategy for metabolic flux redistribution in many metabolic pathways and promotes the chemicals production.
Latency Optimization for D2D-Enabled Parallel Mobile Edge Computing in Cellular Networks
Authors: Cai Yan , Ran Liang , Zhang Jun , Zhu Hongbo 
Published: January 2021

Abstract
Edge offloading, including offloading to edge base stations (BS) via cellular links and to idle mobile users (MUs) via device-to-device (D2D) links, has played a vital role in achieving ultra-low latency characteristics in 5G wireless networks. This paper studies an offloading method of parallel communication and computation to minimize the delay in multi-user systems. Three different scenarios are explored, i.e., full offloading, partial offloading, and D2D-enabled partial offloading. In the full offloading scenario, we find a serving order for the MUs. Then, we jointly optimize the serving order and task segment in the partial offloading scenario. For the D2D-enabled partial offloading scenario, we decompose the problem into two subproblems and then find the optimal solution based on the results of the two subproblems. Finally, the simulation results demonstrate that the offloading method of parallel communication and computing can significantly reduce the system delay, and the D2D-enabled partial offloading can further reduce the latency.
The CYP19A1 (TTTA)n repeat polymorphism, but not Arg264Cys polymorphism, may affect the risk of prostate cancer: evidence from a meta-analysis
Authors: Guo Lei , Liu Yanan , Liu Lijun , Shao Shixiu , Cao Yanwei , Guo Jiaming , Haitao Niu 
Published: January 2021

Abstract
Background: Abnormal aromatase (CYP19A1) expression may participate in prostate cancer (PCa) carcinogenesis. However, results of studies on the CYP19A1 gene polymorphisms and PCa are conflicting.This meta-analysis aimed to systematically evaluate the association between the CYP19A1 Arg264Cys polymorphism and (TTTA)n repeat polymorphism and PCa.Methods: Electronic databases (PubMed, EmBase, ScienceDirect, and Cochrane Library) were comprehensively searched to identify eligible studies. The strength of association between the Arg264Cys polymorphism and PCa was assessed by pooled odds ratio (OR) and 95% confidence interval (95% CI) in allelic, dominant, recessive, homozygous, and heterozygous genetic models. To analyze the impact of the (TTTA)n repeat polymorphism, we took sequentially the N-repeat allele (where N equals 7,8,10,11,12, and 13) as the minor allele and the sum of all the other alleles as the major allele. The ORs and 95%CIs were calculated in the allelic model; this analysis was performed individually for each repeat number. Results: Pooled estimates of nine studies addressing the Arg264Cys polymorphism indicated that this polymorphism was not associated with PCa risk in the overall population and in the Caucasian and Asian subgroups. The 8-repeat allele in the (TTTA)n repeat polymorphism increased PCa risk in the overall population (OR=1.34, 95% CI=1.14–1.58, P=0.001) and in the subgroup with population-based (PB) controls (OR=1.41, 95% CI=1.13–1.74, P=0.002) as well as in the subgroup of studies using capillary electrophoresis to identify this polymorphism (OR=1.34, 95%CI=1.09-1.65, P=0.006). Conclusions: The meta-analysis indicated that the CYP19A1 (TTTA)n repeat polymorphism, but not Arg264Cys polymorphism may affect PCa risk.
Patients Age is a critical Factor in determining the Severity of Osteoarthritis of the Shoulder
Authors: Märtens Nicole , Maerz Vincent , Bertrand Jessica , Lohmann Christoph H , Berth Alexander 
Published: January 2021

Abstract
Background: Osteoarthritis (OA) is one of the most common musculoskeletal disorders in the aging population. The correlation of radiographic OA severity, disability and pain is variable and inconsistent for the different joints. This study aims to elucidate the relationship between histological and radiological signs of shoulder OA with pain sensation and functional impairment to potentially adapt the recommendation for surgical treatment for primary total shoulder arthroplasty (TSA). Methods: Forty-four patients with shoulder OA undergoing TSA using an anatomic stemless implant were included in this study. The radiological OA severity was scored preoperatively on true ap X-rays according to the Kellgren-Lawrence-Score (KL-Score). Acromial types according to Bigliani were defined by preoperative radiological images. The histological OA severity was determined according to the OARSI-Score using bone-cartilage sections from loaded areas of the humeral head. Pain was quantified using the Visual Analog Scale (VAS). The functional status was assessed by the items “mobility” and “strength” out of the Constant-Murley-Score (CS-Score). Demographic data including BMI, age, gender, diabetes mellitus and smoking were recorded. Results: There was no correlation between radiographic and histological severity in shoulder OA. However, a correlation of age and the severity of radiological changes was observed. Further, pain did not correlate with histological or radiological scores, whereas it correlated with age and the presence of diabetes mellitus. The functional shoulder status (mobility, strength) correlated with the severity of radiological changes, but not with the histologic scoring, which correlated with nicotine abuse. Conclusion: This study shows that increased age is the main determinant of radiological changes in shoulder OA, as well as pain. Therefore, age and pain sensation should be considered as important parameters for the recommendation for TSA.
Can a complex vocational rehabilitation intervention be delivered with fidelity? Fidelity assessment in the FRESH feasibility trial
Authors: Holmes Jain Anne , Fletcher-Smith Joanna Clare , Merchán-Baeza Jose Antionio , Phillips Julie , Radford Kathryn 
Published: January 2021

Abstract
Background:Determining whether complex rehabilitation interventions are delivered with fidelity is important as differences can occur between sites, therapists delivering the intervention and over time; threatening trial outcomes and increasing the risk of Type II and Type III errors. Aims: to (1) evaluate implementation fidelity of vocational rehabilitation delivered in Facilitating Return to work through Early Specialist Health-based interventions (FRESH), a multi-centre feasibility randomised controlled trial; and (2) understand factors affecting delivery. Methods:Mixed methods evaluation. Fidelity was measured quantitatively using intervention case report forms, fidelity checklists and clinical records. Qualitative data from mentoring records, interviews with the intervention therapists, participants and their employers and National Health Service (NHS) staff at each site explored moderators of implementation fidelity. The quantitative and qualitative data informed data collection tools and analysis. Data were examined against a logic model and benchmarked against an earlier cohort study. Results:Analysis of 38 clinical records (one per participant), 699 content clinical report form (CRF) (42-248 per therapist) and 12 fidelity checklists suggest intervention was delivered as intended. The core intervention process was followed in each case despite therapist variation. Qualitative data from clinical records, fidelity checklists, 183 mentoring records and 38 interviews (4 therapists, 15 trial participants, 6 employers and 13 NHS staff) explained factors affecting intervention fidelity. Fidelity moderators were similar across sites. Facilitators included therapists’ community rehabilitation experience, expert mentoring, and ability to individually tailor intervention. Barriers involved a lack of access to NHS systems no backfill and limited line-manager support. Factors that both helped or hindered intervention delivery were effective communication with participants, intervention acceptability, participants’ changing needs and interagency working. Different fidelity measures answered different questions. Fidelity checklists determined whether intervention processes were followed and explained moderators. Interviews provided insights into acceptability. Adherence was determined by content forms. Mentoring records described implementation barriers and how they were overcome.Conclusions:Mixed methods fidelity assessments enable trialists to identify factors likely to affect intervention fidelity in a definitive trial and longer-term clinical implementation. Mentoring provided insight into engagement and fidelity deviations that could be addressed in real-time, facilitating fidelity and offering a window on trial processes
Application of Ultrasound-guided Intranodal Lymphangiography and Embolization in Cancer Patients with Postoperative Lymphatic Leakage
Authors: Sun Xingwei , Zhou Feng , Bai Xuming , Yuan Qiang , Zhang Mingqing , Ma Liang , Jin Yong 
Published: January 2021

Abstract
Background: Traumatic lymphatic leakage is a rare but potentially life-threatening complication. The purpose of this study was to introduce ultrasound-guided intranodal lymphangiography and embolisation techniques for postoperative lymphatic leakage in patients with cancer.Methods: From January 2018 through June 2020, seven cancer patients (three males, four females, aged 59-75 years [mean 67.57 ± 6.11 years]) developed lymphatic leakage after abdominal or pelvic surgery, with drainage volumes ranging from 550 to 1200 mL per day. The procedure and follow-up of ultrasound-guided intranodal lymphangiography and embolisation were recorded. This study retrospectively analysed the technical success rate, operative time, length of hospital stay, clinical efficacy, and complications.Results: The operation was technically successful in all patients. Angiography revealed leakage and embolisation was performed in all seven patients (7/7, 100%). The operative time of angiography and embolisation was 41 to 68 minutes, with an average time of 53.29 ± 10.27 minutes. The mean length of stay was 3.51±1.13 days. Lymph node embolisation was clinically successful in five patients (5/7, 71.43%), who had a significant reduction in or disappearance of chylous ascites. The other two patients received surgical treatment two weeks later due to poor results after embolisation. All patients were followed for two weeks. No serious complications or only minor complications were found in all the patients.Conclusions: Ultrasound-guided intranodal lymphangiography and embolisation were well tolerated by the patients, who experienced a low incidence of complications. Early intervention is recommended for cancer patients with postoperative lymphatic leakage.
Synthesis of Chrysin, Quercetin and Naringin Nitroderivatives: Antiproliferative, Anti-inflammatory and Antioxidant Activity
Authors: Tavera-Hernández Rosario , Jiménez-Estrada Manuel , Alvarado-Sansininea Jesús J. , Nieto-Camacho Antonio , López-Muñoz Hugo , Sánchez-Sánchez Luis , Escobar María L. 
Published: January 2021

Background:
Flavonoids are an important group of natural products because they possess
various biological activities such as antioxidant, anti-inflammatory, and anti-cancer. The modification
of their structure could improve their biological activities. The nitro group is included in diverse
pharmaceuticals with various biological activities, such as anti-cancer and anti-inflammatory agents.

Objective:
The study aimed to introduce a nitro group into the structure of flavonoids in order to
observe how their anti-proliferative, antioxidant, and anti-inflammatory activities change.

Methods:
: In this investigation, we established diverse conditions of aromatic nitration of chrysin (1),
quercetin (2), and naringin (3) flavonoids using bismuth (III) nitrate, acetic acid or silica gel, and
NOx gases. The anti-proliferative activity in CaSki, MDA, and SK-LU-1 cancer cell lines and the
anti-inflammatory activity and antioxidant activity of flavonoids and nitro derivatives were evaluated
as well.

Results:
As a result, mild nitration conditions were established, and 8-nitrochrysin, 5’nitroquercetin,
and 3’nitronaringin were obtained. The number and hydroxyl group position in the flavonoid are
important to carry out the nitration reaction. Although chrysin showed higher anti-proliferative activity
than quercetin and naringin, the introduction of the nitro group at C-8 did not improve its antiproliferative,
antioxidant, and anti-inflammatory activities. On the other hand, the introduction of the
nitro group at C-5̍ in quercetin structure was important to improve its antioxidant and antiproliferative
activities on cancer cell lines. The introduction of the nitro group at C-3’ in naringin
improved its anti-inflammatory activity, but not its antioxidant and anti-proliferative activities. Chrysin,
8-nitrochrysin, quercetin, and 5’-nitroquercetin did not show necrotic activity.

Conclusion:
The introduction of a nitro group into flavonoids structure improved their antiproliferative,
antioxidant, and anti-inflammatory activities. These results promote future investigations
of structural modification on 2-phenylbenzopyran skeleton to optimize their biological activity.
A Short Review on the Synthesis of 1,2,4-Triazine Derivatives as Bioactive Compounds
Authors: Hashem Heba E. 
Published: January 2021

:
Triazines and their oxo derivatives are a representative class of heterocyclic compounds with a great interest in organic synthesis and medicinal chemistry as they have been associated with a broad range of pharmacological activities. 1,2,4-Triazines and their oxo derivatives are exhibiting a broad range of biological activities including antimicrobial, antifungal, anticancer, anti-inflammatory, besides their importance in the dyes and pesticides field. This review presents the different methods of the synthesis of triazine/one derivatives. Also, this literature surveys the different effects of these compounds in pharmaceuticals.
Sonoelastography for Pelvic Metastatic Malignant Pheochromocytoma: A Case Report
Authors: Song Minkyo , Park Sung Bin , Yoon Jin Woo , Park Hyun Jeong , Lee Eun Sun 
Published: January 2021

Introduction:
Pheochromocytoma are tumors arising from the chromaffin tissue located
in the adrenal medulla, associated with typical symptoms and signs.

Case Presentation:
Occasionally, metastasis, defined as the presence of tumor cells at sites other
than the original site, secondary to pheochromocytoma have been reported. Pelvic metastatic malignant
pheochromocytoma has rarely been reported in English literature.

Conclusion:
Here, we have reported a very rare case of pelvic metastatic malignant pheochromocytoma,
with a particular focus on sonoelastographic features.
COVID-19 and Clinical Trials: Current Challenges and Future Directions
Authors: Singh Vinay , Garg Sandeep , Klimek Monika , Sinha Rajeev Ranjan , Dhanwal Dinesh 
Published: January 2021

Background:The outbreak of coronavirus disease (COVID-19) has posed a major threat to people's lives across the globe. It has drastically changed the way we perceive this world. A paradigm shift was observed globally as the world’s emphasis shifted to testing, diagnosis, treatment, and developing a coronavirus cure. Clinical trials were also not untouched by this. The coronavirus pandemic has abhorrently affected the day-to-day clinical trial activities at sites.Methods:The status of various ongoing clinical trials was assessed through a literature search, which also includes clinical trial portals. Our evaluations were based on these observations.Results:Multiple challenges were present in clinical trials as recruitment, retention, the safety of trial subjects, protocol compliance, and this made the world to re-think to incorporate newer strategies and to cope with this untoward situation.Conclusion:Digitalization of clinical trials as virtual management of adverse events, remote monitoring visits, and web-based consulting with trial subjects are potential directions that can be applied to better manage clinical trials worldwide.