bluuebunny/crossref_metadata_2025_split huggingface dataset:
Severity-associated markers and assessment model for predicting the severity of COVID-19: a retrospective study in Hangzhou, China
Authors: Qi Jianjiang , He Di , Yang Dagan , Wang Mengyan , Ma Wenjun , Cui Huaizhong , Ye Fei , Wang Fei , Xu Jinjian , Li Zhijian , Liu Chuntao , Wu Jing , Qi Kexin , Wu Rui , Huang Jinsong , Liu Shourong , Zhu Yimin 
Published: August 2021

Abstract
Background
The severity of COVID-19 associates with the clinical decision making and the prognosis of COVID-19 patients, therefore, early identification of patients who are likely to develop severe or critical COVID-19 is critical in clinical practice. The aim of this study was to screen severity-associated markers and construct an assessment model for predicting the severity of COVID-19.

Methods
172 confirmed COVID-19 patients were enrolled from two designated hospitals in Hangzhou, China. Ordinal logistic regression was used to screen severity-associated markers. Least Absolute Shrinkage and Selection Operator (LASSO) regression was performed for further feature selection. Assessment models were constructed using logistic regression, ridge regression, support vector machine and random forest. The area under the receiver operator characteristic curve (AUROC) was used to evaluate the performance of different models. Internal validation was performed by using bootstrap with 500 re-sampling in the training set, and external validation was performed in the validation set for the four models, respectively.

Results
Age, comorbidity, fever, and 18 laboratory markers were associated with the severity of COVID-19 (all P values < 0.05). By LASSO regression, eight markers were included for the assessment model construction. The ridge regression model had the best performance with AUROCs of 0.930 (95% CI, 0.914–0.943) and 0.827 (95% CI, 0.716–0.921) in the internal and external validations, respectively. A risk score, established based on the ridge regression model, had good discrimination in all patients with an AUROC of 0.897 (95% CI 0.845–0.940), and a well-fitted calibration curve. Using the optimal cutoff value of 71, the sensitivity and specificity were 87.1% and 78.1%, respectively. A web-based assessment system was developed based on the risk score.

Conclusions
Eight clinical markers of lactate dehydrogenase, C-reactive protein, albumin, comorbidity, electrolyte disturbance, coagulation function, eosinophil and lymphocyte counts were associated with the severity of COVID-19. An assessment model constructed with these eight markers would help the clinician to evaluate the likelihood of developing severity of COVID-19 at admission and early take measures on clinical treatment.
Molecular study of metallo-β-lactamases and integrons in Acinetobacter baumannii isolates from burn patients
Authors: Nikibakhsh Mahnaz , Firoozeh Farzaneh , Badmasti Farzad , Kabir Kourosh , Zibaei Mohammad 
Published: August 2021

Abstract
Background
Productions of metallo-β-lactamases enzymes are the most common mechanism of antibiotic resistance to all beta-lactam classes (except monobactams) in Acinetobacter baumannii. MBLs are usually associated with gene cassettes of integrons and spread easily among bacteria. The current study was performed to detect the genes encoding MBLs and integron structures in A. baumannii isolates from burn patients.

Methods
This study was performed on 106 non-duplicate A. baumannii isolates from burn patients referred to Shahid Motahari Hospital in Tehran. Antibiotic susceptibility of A. baumannii isolates was performed using disk diffusion and broth microdilution method in accordance with the CLSI guidelines. The presence of class 1 integron and associated gene cassettes as well as MBLs-encoding genes including blaVIM, and blaIMP were investigated using PCR and sequencing techniques.

Results
In this cross-sectional study all (100%) of the A. baumannii isolates examined were multidrug resistant. All isolates were sensitive to colistin and simultaneously all were resistant to imipenem. PCR assays showed the presence of blaVIM and blaIMP genes in 102 (96.2%) and 62 (58.5%) isolates of A. baumannii respectively. In addition, 62 (58.5%) of the A. baumannii isolates carried integron class 1, of which 49 (79.0%) were identified with at least one gene cassette. Three types of integron class 1 gene cassettes were identified including: arr2, cmlA5, qacE1 (2300 bp); arr-2, ereC, aadA1, cmlA7, qacE1 (4800 bp); and aac(3)-Ic, cmlA5 (2250 bp).

Conclusion
A high prevalence of MBLs genes, especially blaVIM, was identified in the studied MDR A. baumannii isolates. In addition, most of the strains carried class 1 integrons. Furthermore, the gene cassettes arrays of integrons including cmlA5 and cmlA7 were detected, for the first time, in A. baumannii strains in Iran.
Characteristics of patients meeting the new definition of pre-capillary pulmonary hypertension (Nice 2018) in a single Japanese pulmonary hypertension center
Authors: Yamamoto Keiko , Tanabe Nobuhiro , Takahashi Yukiko , Naito Akira , Sekine Ayumi , Suda Rika , Jujo Sanada Takayuki , Sugiura Toshihiko , Shigeta Ayako , Sakao Seiichiro , Tatsumi Koichiro 
Published: August 2021

Abstract
Background
The 6th World Symposium on Pulmonary Hypertension (Nice 2018) proposed a new definition of pre-capillary pulmonary hypertension (PH) as a condition with mean pulmonary artery pressure (mPAP) > 20 mmHg, pulmonary artery wedge pressure  ≤ 15 mmHg, and pulmonary vascular resistance (PVR) ≥ 3 Wood units (WU). The characteristics and prognosis of patients with pre-capillary PH, according to this new definition, is unclear. Therefore, we determined the characteristics and survival of patients with borderline pre-capillary PH.

Methods
We retrospectively enrolled 683 patients who underwent their first right heart catheterization at Chiba University, Japan. Among them, 489 patients met the pre-capillary PH requirement with mPAP ≥ 25 mmHg (conventional pre-capillary PH group), while 22 patients met the borderline pre-capillary PH criteria (borderline pre-capillary PH group). Additionally, 16 patients with a mean PAP of 20–25 and PVR of 2–3 WU were also examined.

Results
The borderline pre-capillary PH group comprised 4.3% of the total patients with pre-capillary PH, and the majority was in Group 3 (40.9%) or 4 (45.5%). The survival of the borderline pre-capillary PH group tended to be better than that of the conventional pre-capillary PH group. The prognosis of Group3 PH was the worst among the patients with borderline precapillary PH. There was no significant difference in survival between the borderline pre-capillary PH group with PVR ≥ 3 WU and that with PVR of 2–3 2WU, although none of the patients in the latter group died due to right heart failure.

Conclusions
This is the first study conducted in a PH center in an Asian country to reveal the characteristics of patients with pre-capillary PH, according to the Nice 2018 definition. They comprised 4.3% of the total population with pre-capillary PH, and the majority of the pre-capillary PH cases were in either Group3 or 4. The prognosis may be affected by the patients’ underlying diseases. Further prospective studies are needed to determine whether the new definition, including the PVR cut-off, is beneficial in clinical practice.
Combined serum and synovial C-reactive protein tests: a valuable adjunct to the diagnosis of chronic prosthetic joint infection
Authors: Wang Hai , Qin Leilei , Wang Jiawei , Hu Ning , Huang Wei 
Published: August 2021

Abstract
Background
Diagnosis of periprosthetic joint infection (PJI), especially chronic PJI, is very confusing and challenging. The value of C-reactive protein (CRP) in infectious diseases has been recognized, but the diagnostic value of CRP in chronic PJI is unknown. Our aim was to investigate the diagnostic value of synovial CRP in chronic PJI and to explore the role of combined serum and synovial CRP in distinguishing chronic PJI from aseptic failure after knee and hip arthroplasties.

Methods
We prospectively enrolled patients scheduled to have a revision surgery for chronic PJI or aseptic loosening from January 2019 to December 2020, in which synovial CRP was additionally measured along with routine preoperative diagnostic serum ((ESR, CRP) and synovial (PMN%) biomarkers. The receiver operating characteristic (ROC) curves and area under the curve (AUC) were analyzed for each biomarker to determine diagnostic efficacy.

Results
There were no statistically significant differences between the infection (n = 39) and aseptic (n = 58) groups, including 61 hips and 36 knees. The synovial CRP levels were significantly higher in the infection group than in the aseptic group (median: 9.93 mg/l vs 3.58 mg/l; p < .001). The optimal cut-off value for detecting chronic PJI of Synovial fluid (SF) CRP was of 7.26 mg/l with a sensitivity of 84.62%, a specificity of 93.10%. The combined model I (Serum CRP > 10.2 mg/l OR SF CRP > 7.26 mg/l) had a negative predictive value (NPV) of 96.67%, and a sensitivity of 97.44%. The combined model II (Serum CRP > 10.2 mg/l AND Synovial CRP > 7.26 mg/l) led to a specificity of 1, and a positive predictive value (PPV) of 1.

Conclusions
The present study demonstrated that the combination of serum and synovial CRP can be used as an adjunct to the diagnosis of chronic PJI.
Silicate/zinc-substituted strontium apatite coating improves the osteoinductive properties of β-tricalcium phosphate bone graft substitute
Authors: Sugimoto Hironori , Inagaki Yusuke , Furukawa Akira , Kira Tsutomu , Kawasaki Sachiko , Uchihara Yoshinobu , Akahane Manabu , Tanaka Yasuhito 
Published: August 2021

AbstractBackgroundβ-Tricalcium phosphate (β-TCP) is a popular synthetic bone graft substitute with excellent osteoconductive properties and bioabsorbability. However, its osteoinductive properties are inferior to those of autologous or allogeneic bone. Trace elements such as strontium (Sr), silica (Si), and zinc (Zn) have been reported to promote osteogenesis in materials. In this study, we aimed to determine whether a Si/Zn-substituted Sr apatite coating of β-TCP could enhance osteoinductive properties.MethodsThe apatite-coated β-TCP disks were prepared using nanoparticle suspensions of silicate-substituted Sr apatite (SrSiP) or silicate- and Zn-co-substituted Sr apatite (SrZnSiP).Bone marrow mesenchymal cells (BMSCs) from rat femur were cultured and subsequently seeded at a density of 1.0 × 106/cm2onto apatite-coated and non-coated β-TCP disks.In vitro, the β-TCP disks were then placed in osteogenic medium, and lactate dehydrogenase (LDH) activity was measured from supernatants after culture for 2 days. Additionally, after culture for 14 days, the mRNA expression of genes encoding osteocalcin (OC), alkaline phosphatase (ALP), bone morphogenetic protein-2 (BMP-2), and vascular endothelial growth factor (VEGF) was evaluated by qRT-PCR.In vivo, the β-TCP disks were transplanted subcutaneously into rats that were sacrificed after 4 weeks. Then, the harvested disks were evaluated biochemically (ALP activity, OC content, mRNA expression of OC, ALP, BMP-2, and VEGF measured by qRT-PCR), radiologically, and histologically.ResultsSignificantly higher mRNA expression of almost all evaluated osteogenic and angiogenic genes was observed in the SrZnSiP and SrSiP groups than in the non-coated group, with no significant cytotoxicity elicited by the apatite coating in vitro. Moreover, in vivo, the SrZnSiP and SrSiP groups showed significantly higher osteogenic and angiogenic gene expression and higher ALP activity and OC content than the non-coated group (P < 0.05). Radiological and histopathological findings revealed abundant bone formation in the apatite-coated group.ConclusionsOur findings indicate that apatite coating of β-TCP improves osteoinductive properties without inducing significant cytotoxicity.
Prognostic value of preoperative body mass index for diabetic patients with non-metastasis gastric cancer: a single center experience
Authors: Ye Zaisheng , Wei Shenghong , Zeng Yi , Wang Yi , Lin Zhitao , Chen Shu , Xie Yunqing , Zheng Qiuhong , Chen Luchuan 
Published: August 2021

Abstract
Aim
This study was designed to investigate the prognostic effect of preoperative body mass index (BMI) for Type 2 diabetes mellitus (T2DM) patients with non-metastasis gastric cancer (GC) who underwent D2 gastrectomy.

Methods
T2DM patients with pT1–4bN0–3bM0 GC were retrospectively collected in Department of Gastrointestinal Surgical Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital from January, 2000 to December, 2010. These patients underwent D2 radical resection of the stomach combined with regional lymphadenectomy. Chi-square test was used to analyze unordered categorical variables and ranked data, followed by Kaplan–Meier analysis as well as Cox regression models to detect risk factors for survival outcomes. In addition, the cut-off point was determined by the X-tile program. All analyses were carried out using survival package of R and SPSS Software.

Results
A total of 302 T2DM patients with pT1–4bN0–3bM0 GC were collected and analyzed. The cut-off points of BMI, identified by the X-tile program, was 19 kg/m2. Patients with low BMI (< 19 kg/m2) had a higher percentage of advanced T stage (T4a and T4b), more advanced TNM stage (stage IIIA, IIIB and IIIC), and more elevated level of serum carcinoembryonic antigen (CEA), compared to those with high BMI (> 19 kg/m2) (all P < 0.05). In the low BMI subgroup, the 5-year overall survival rate was 39.02%, which was as high as 58.11% in the high BMI subgroup (P < 0.05). In the multivariate Cox regression model revealed that IIIC stage (OR = 3.101), N3b stage (OR = 3.113) were the most important prognostic indicators, followed by pretreatment BMI (OR = 2.136).

Conclusion
Low preoperative BMI (< 19 kg/m2) was a poor prognostic marker for T2DM patients with pT1–4bN0–3bM0 GC.
Learnings from the design and acceptance of the German COVID-19 tracing app for IS-driven crisis management: a design science research
Authors: Behne Alina , Krüger Nicolai , Beinke Jan Heinrich , Teuteberg Frank 
Published: August 2021

Abstract
Background
This article investigates the research problem of digital solutions to overcome the pandemic, more closely examining the limited effectiveness and scope of the governmental COVID-19 tracing apps, using the German COVID-19 tracing app (Corona-Warn-App) as an example. A well-designed and effective instrument in the technological toolbox is of utmost importance to overcome the pandemic.

Method
A multi-methodological design science research approach was applied. In three development and evaluation cycles, we presented, prototyped, and tested user-centered ideas of functional and design improvement. The applied procedure contains (1) a survey featuring 1993 participants from Germany for evaluating the current app, (2) a gathering of recommendations from epidemiologists and from a focus group discussion with IT and health experts identifying relevant functional requirements, and (3) an online survey combined with testing our prototype with 53 participants to evaluate the enhanced tracing app.

Results
This contribution presents 14 identified issues of the German COVID-19 tracing app, six meta-requirements, and three design principles for COVID-19 tracing apps and future pandemic apps (e.g., more user involvement and transparency). Using an interactive prototype, this study presents an extended pandemic app, containing 13 potential front-end (i.e., information on the regional infection situation, education and health literacy, crowd and event notification) and six potential back-end functional requirements (i.e., ongoing modification of risk score calculation, indoor versus outdoor). In addition, a user story approach for the COVID-19 tracing app was derived from the findings, supporting a holistic development approach.

Conclusion
Throughout this study, practical relevant findings can be directly transferred to the German and other international COVID-19 tracing applications. Moreover, we apply our findings to crisis management theory—particularly pandemic-related apps—and derive interdisciplinary learnings. It might be recommendable for the involved decision-makers and stakeholders to forego classic application management and switch to using an agile setup, which allows for a more flexible reaction to upcoming changes. It is even more important for governments to have a well-established, flexible, design-oriented process for creating and adapting technology to handle a crisis, as this pandemic will not be the last one.
Are male nurses sexually harassed? A cross-sectional study in the Greek Health System
Authors: Papantoniou Panagiotis 
Published: August 2021

Abstract
Background
The #MeToo and #Times Up movements have put a global spotlight on the phenomenon of sexual harassment in healthcare. Yet, most studies have explored sexual harassment among female professionals. This study departs from current research practices and investigates the frequency of sexual harassment in male nurses working in the Greek NHS and the reasons for not reporting their experiences.

Methods
A cross-sectional study was conducted using the Sexual Experiences Questionnaire (SEQ) to collect data from 507 male nurses working in Greece's various settings during October and February 2021. The electronic survey was sent to male nurses (n=3,091 registered with the Hellenic Association of Nurses. Survey items were consent form, demographics, three-dimensions of sexual harassment, silencing and negative consequences. Questions were measured using five-point Likert scales, binary scale and multiple-choice questions. ANOVA and T-tests were used to investigate whether specific groups more frequently dealt with sexual harassment. Multiple regression analyses were conducted to investigate the association between independent variables (sexually harassing behaviours) and the dependent variable (participants' negative physical, mental, and job-related outcomes).

Results
40% of male nurses have experienced sexual harassment at least once in their working lives, and the most common form of sexual harassment faced was gender harassment, followed by unwanted sexual attention. Male doctors and male nurses were the most common perpetrators. Private and younger male nurses with up to 5 years of experience experienced more frequent sexual harassment. 30% did not report sexual harassment due to the fear that no one would believe them, and because of beliefs, no action would be taken against the wrongdoer. Multiple regression analyses showed that unwanted sexual attention and sexual coercion were associated with physical and job-related outcomes. Cronbach Alpha was 0.91.

Conclusion
A high proportion of male nurses have experienced sexual harassment during their careers. Being younger with limited working experience and working in the private sector were positively associated with sexual harassment. Policymakers and health managers should focus on sexual harassment prevention strategies and report-enabling policies.
Peanut components measured by ISAC: comparison with ImmunoCap and clinical relevance in peanut allergic children
Authors: Brand H. K. , Schreurs M. W. J. , Emons J. A. M. , Gerth van Wijk R. , de Groot H. , Arends N. J. T. 
Published: August 2021

AbstractBackgroundSpecific IgE (sIgE) against the peanut component Arachis hypogaea (Ara h) 2 has been shown to be the most important allergen to discriminate between peanut allergy and peanut tolerance. Several studies determined sIgE cut off values for Ara h 2, determined by singleplex measurements. However, cut off values for Ara h 2 from multiplex arrays are less well defined. The aim of this study was to evaluate the correlation between Ara h 2 sIgE determined by singleplex versus multiplex measurements and to assess the diagnostic value of the different peanut components included in Immuno Solid-phase Allergen Chip (ISAC) multiplex analysis in children with a suspected peanut allergy.MethodsIn this retrospective study we analyzed Ara h 2 sIgE values with singleplex Fluorescence Enzyme Immunoassay (FEIA, ImmunoCap) and multiplex microarray (ISAC) measurements in 117 children with a suspected peanut allergy. Also, other peanut components measured by ISAC were analyzed. Double blinded placebo controlled oral food challenges were used as golden standard.ResultsAmong all studied peanut components FEIA Ara h 2 sIgE showed the highest area under the curve (AUC, 0.922), followed by ISAC Ara h 6 and Ara h 2 sIgE with AUCs of respectively 0.906 and 0.902. Best cut off values to diagnose peanut allergy were 4.40 kU/l for FEIA Ara h 2 sIgE and, 7.43 ISU and 8.13 ISU for respectively Ara h 2 and Ara h 6 sIgE in ISAC microarray. Ara h 2 sIgE determined in FEIA and ISAC showed a good correlation (r = 0.88; p < 0.01).ConclusionAra h 6 and Ara h 2 sIgE in multiplex ISAC are both good predictors of clinical peanut allergy in Dutch children, and their performance is comparable to the use of Ara h 2 in singleplex FEIA. The simultaneous measurement of different peanut components using ISAC is an advantage and clinically useful to detect peanut allergic children that are Ara h 2 negative but sensitized to other peanut proteins such as Ara h 6.
The impact of gender and the social determinants of health on the clinical course of people living with HIV in Myanmar: an observational study
Authors: Nyein Phyo Pyae , Aung Eithandee , Aung Ne Myo , Kyi Mar Mar , Boyd Mark , Lin Kyaw Swar , Hanson Josh 
Published: August 2021

Abstract
Background
There is a growing recognition of the impact of gender and the social determinants of health on the clinical course of people living with HIV (PLHIV). However, the relative contribution of these factors to clinical outcomes of PLHIV is incompletely defined in many countries. This study was performed to gain a greater understanding of the non-clinical determinants of prognosis of PLHIV in Myanmar.

Methods
Selected demographic, behavioural and socioeconomic characteristics of outpatients at two specialist HIV hospitals and one general hospital in Yangon, Myanmar were correlated with their subsequent clinical course; a poor outcome was defined as death, hospitalisation, loss to follow-up or a detectable viral load at 6 months of follow-up.

Results
221 consecutive individuals with advanced HIV commencing anti-retroviral therapy (ART) were enrolled in the study; their median CD4 T-cell count was 92 (44–158) cells/mm3, 138 (62.4%) were male. Socioeconomic disadvantage was common: the median (interquartile range (IQR) monthly per-capita income in the cohort was US$48 (31–77); 153 (69.9%) had not completed high school. However, in a multivariate analysis that considered demographic, behavioural, clinical factors and social determinants of health, male gender was the only predictor of a poor outcome: odds ratio (95% confidence interval): 2.33 (1.26–4.32, p = 0.007). All eight of the deaths and hospitalisations in the cohort occurred in males (p = 0.03).

Conclusions
Men starting ART in Myanmar have a poorer prognosis than women. Expanded implementation of gender-specific management strategies is likely to be necessary to improve outcomes.