bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expression of TIGAR and its correlation with clinicopathology, prognosis, and 18F-FDG PET/CT parameters in patients with resectable pancreatic ductal adenocarcinoma
Authors: Song Yang , Wang Peng-Yuan , Zheng Yang , Liu Chang , Wang Xiao-Ming 
Published: January 2021

Objective
The aim of this study was to investigate the expression of TP53-inducible glycolysis and apoptosis regulator (TIGAR) and its relationship with clinical pathology and prognosis; and to analyze the correlation between TIGAR expression and 18F-labeled fluoro-2-deoxyglucose (18F-FDG) PET/computed tomography (CT) parameters in patients with pancreatic ductal adenocarcinoma (PDAC).

Methods
We retrospectively analyzed the data of 23 patients who underwent preoperative 18F-FDG PET/CT examinations and were confirmed to have PDAC by postoperative pathology. TIGAR was detected using immunohistochemistry. The relationships between TIGAR expression and clinicopathology and its value in predicting the prognosis of patients with PDAC were analyzed. The correlations between TIGAR expression and 18F-FDG PET/CT parameters [standard uptake value (SUV) max, SUVmean, SUVpeak, metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] were analyzed.

Results
The expression of TIGAR was low in 34.8% of patients and high in 65.2% of patients. There was no correlation between TIGAR expression and clinicopathology. The overall survival of patients with high TIGAR expression was significantly shorter than that of patients with low TIGAR expression (11.2 vs. 35.4 months). The 18F-FDG PET/CT parameters: SUVmax, SUVmean, SUVpeak, MTV, and TLG were positively correlated with TIGAR expression, but only the MTV correlation with TIGAR expression was statistically significant.

Conclusion
TIGAR is highly expressed in PDAC. Its expression is independent of clinicopathological data and can be used as an independent prognostic factor. TIGAR expression was significantly positively correlated with the 18F-FDG PET/CT parameter MTV.
Situational Awareness in Acute Patient Deterioration
Authors: White Anne , Maguire Mary Beth R. , Brannan Jane , Brown Austin 
Published: January 2021

Background and Purpose
Prelicensure nursing students lack the situational awareness to promote timely intervention with a patient in septic shock. This study evaluated a multifaceted educational project that determined the impact on nursing students' knowledge retention and time to task (TTT).

Methods
A quasi-experimental, repeated-measures design was used to evaluate students' knowledge retention and TTT. Eighty-four prelicensure nursing students participated in groups of 4 students to participate in a high-fidelity simulation.

Results
Results show knowledge retention was significant between the pretest scores and 2 repeated assessment scores. The repeated-measures analysis of variance time effect P value was .02. The overall TTT group response suggested most (64/84, 76%) students responded within 5 minutes of patient deterioration.

Conclusions
A multifaceted approach was effective to influence knowledge of septic shock over time and demonstrate students' ability to intervene with a septic shock patient in a timely manner.
Development and validation of the Collaborative Health Outcomes Information Registry body map
Authors: Scherrer Kristen Hymel , Ziadni Maisa S. , Kong Jiang-Ti , Sturgeon John A. , Salmasi Vafi , Hong Juliette , Cramer Eric , Chen Abby L. , Pacht Teresa , Olson Garrick , Darnall Beth D. , Kao Ming-Chih , Mackey Sean 
Published: January 2021

Abstract

Introduction:
Critical for the diagnosis and treatment of chronic pain is the anatomical distribution of pain. Several body maps allow patients to indicate pain areas on paper; however, each has its limitations.

Objectives:
To provide a comprehensive body map that can be universally applied across pain conditions, we developed the electronic Collaborative Health Outcomes Information Registry (CHOIR) self-report body map by performing an environmental scan and assessing existing body maps.

Methods:
After initial validation using a Delphi technique, we compared (1) pain location questionnaire responses of 530 participants with chronic pain with (2) their pain endorsements on the CHOIR body map (CBM) graphic. A subset of participants (n = 278) repeated the survey 1 week later to assess test–retest reliability. Finally, we interviewed a patient cohort from a tertiary pain management clinic (n = 28) to identify reasons for endorsement discordances.

Results:
The intraclass correlation coefficient between the total number of body areas endorsed on the survey and those from the body map was 0.86 and improved to 0.93 at follow-up. The intraclass correlation coefficient of the 2 body map graphics separated by 1 week was 0.93. Further examination demonstrated high consistency between the questionnaire and CBM graphic (<10% discordance) in most body areas except for the back and shoulders (≈15–19% discordance). Participants attributed inconsistencies to misinterpretation of body regions and laterality, the latter of which was addressed by modifying the instructions.

Conclusions:
Our data suggest that the CBM is a valid and reliable instrument for assessing the distribution of pain.
Brief High Oxygen Concentration Induces Oxidative Stress in Leukocytes and Platelets: A Randomized Cross-over Pilot Study in Healthy Male Volunteers
Authors: Hafner Christina , Pramhas Sibylle , Schaubmayr Wolfgang , Assinger Alice , Gleiss Andreas , Tretter Eva Verena , Klein Klaus Ulrich , Scharbert Gisela 
Published: January 2021

ABSTRACT

Background:
Supplemental oxygen is administered routinely in the clinical setting to relieve or prevent tissue hypoxia, but excessive exposure may induce oxidative damage or disrupt essential homeostatic functions. It is speculated that oxidative stress in leukocytes and platelets may contribute to vascular diseases by promoting inflammation and cell aggregation.

Methods:
In this pilot study 30 healthy male volunteers (18–65 years) were exposed to high oxygen concentration (non-rebreather mask, 8 L/min, 100% O2) and synthetic air (non-rebreather mask, 8 L/min, 21% O2) in a cross-over design for 20 min at a 3-week interval. Venous blood samples were obtained at baseline and 1, 3, and 6 h postintervention. Primary outcome was generation of reactive oxygen species in leukocytes as measured by the redox-sensitive fluorescent dye dihydrorhodamine 123. Additional outcomes were oxidative stress in platelets and platelet aggregation as measured by thromboelastography (ROTEM) and Multiplate analyses.

Findings:
High oxygen exposure induced oxidative stress in leukocytes as evidenced by significantly higher mean fluorescence intensity (MFI) compared with synthetic air at 3 h postintervention (47% higher, P = 0.015) and 6 h postintervention (37% higher, P = 0.133). Oxidative stress was also detectable in platelets (33% higher MFI in comparison with synthetic air at 6 h, P = 0.024; MFI 20% above baseline at 3 h, P
= 0.036; 37% above baseline at 6 h, P = 0.002). ROTEM analyses demonstrated reduced mean clotting time 1 h postintervention compared with baseline (−4%, P = 0.049), whereas there were no significant effects on other surrogate coagulation parameters.

Conclusion:
Clinically relevant oxygen exposure induces oxidative stress in leukocytes and platelets, which may influence the immune and clotting functions of these cells.
A Novel Human Glucocorticoid Receptor Variant, G459V, is Hyperactive in Response to Steroids
Authors: Grigsby Melissa J. , Green Tajia L. , Lim Debora , Cho Kiho , Greenhalgh David G. 
Published: January 2021

ABSTRACT
A potential cause of the variable response to injury and sepsis is the variability of a patient's human glucocorticoid receptor (hGR) profile. To identify hGR variants, blood samples were collected on admission and biweekly thereafter from hospitalized patients who sustained at least a 20% total body surface area burn injury. A hyperactive G1376T single-nucleotide polymorphism (SNP) isoform was identified. This SNP led to a single amino acid change of glutamine to valine at site 459, “G459V,” in the DNA-binding domain. The isoform's activity was tested in a reporter assay after treatment with steroids, the hGR antagonist RU486 (mifepristone) alone, or RU486 followed by steroids. When treated with hydrocortisone, the hGR G459V isoform had a hyperactive response; its activity was over 30 times greater than the reference hGRα. Unexpectedly, G459V had significantly increased activity when treated with the hGR antagonist RU486. With the combination of both RU486 and hydrocortisone, G459V activity was repressed, but greater than that of RU486 alone. Finally, when hGRα was cotransfected with G459V to simulate isoform interaction, the activity was closer to that of the hGRα profile than the G459V isoform. The unique activity of the G459V isoform shows that some variants of hGR have the potential to alter a person's response to stress and steroid treatment and may be a factor as to why mitigating the clinical response to sepsis and other stressors has been so elusive.
Increased Intracranial Hemorrhage Amid Elevated Inflammatory Markers in Those With COVID-19 Supported With Extracorporeal Membrane Oxygenation
Authors: Bermea Rene S. , Raz Yuval , Sertic Federico , Rubin Jonah , Wolf Molly , Olia Salim , Richards Thomas , Crowley Jerome , Funamoto Masaki , Shelton Kenneth , Bermudez Christian 
Published: January 2021

ABSTRACT
COVID-19-related coagulopathy is a known complication of SARS-CoV-2 infection and can lead to intracranial hemorrhage (ICH), one of the most feared complications of extracorporeal membrane oxygenation (ECMO). We sought to evaluate the incidence and etiology of ICH in patients with COVID-19 requiring ECMO. Patients at two academic medical centers with COVID-19 who required venovenous-ECMO support for acute respiratory distress syndrome (ARDS) were evaluated retrospectively. During the study period, 33 patients required ECMO support; 16 (48.5%) were discharged alive, 13 died (39.4%), and 4 (12.1%) had ongoing care. Eleven patients had ICH (33.3%). All ICH events occurred in patients who received intravenous anticoagulation. The ICH group had higher C-reactive protein (P = 0.04), procalcitonin levels (P = 0.02), and IL-6 levels (P = 0.05), lower blood pH before and after ECMO (P < 0.01), and higher activated partial thromboplastin times throughout the hospital stay (P < 0.0001). ICH-free survival was lower in COVID-19 patients than in patients on ECMO for ARDS caused by other viruses (49% vs. 79%, P = 0.02). In conclusion, patients with COVID-19 can be successfully bridged to recovery using ECMO but may suffer higher rates of ICH compared to those with other viral respiratory infections.
Prognostic Value of Angiopoietin-like 4 in Patients with Acute Respiratory Distress Syndrome
Authors: Hu Jun , Liu Lian , Zeng Xianghu , Wang Ke , Wang Hao , Zeng Zijian , Cao Yufang , Gao Lijuan , Cheng Mengxin , Wang Tao , Wen Fuqiang 
Published: January 2021

ABSTRACT

Background:
Angiopoietin-like 4 (ANGPTL4) is a secreted glycoprotein that plays an important role in endothelial injury and the inflammatory response. Experimental models have implicated ANGPTL4 in acute respiratory distress syndrome (ARDS), but its impact on the progression of ARDS is unclear.

Methods:
Paired bronchoalveolar lavage fluid (BALF) and serum samples were obtained from patients with ARDS (n = 56) within 24 h of diagnosis and from control subjects (n = 32). ANGPTL4, angiopoietin-2, interleukin (IL)-6, and TNF-α levels were measured by magnetic Luminex assay. BALF albumin (BA) and serum albumin (SA) were evaluated by enzyme-linked immunosorbent assay.

Results:
BALF and serum ANGPTL4 concentrations were higher in patients with ARDS than in controls and were even higher in non-survivors than in survivors. The serum ANGPTL4 level was higher in indirect (extrapulmonary) ARDS than in direct (pulmonary) ARDS. Furthermore, BALF and serum ANGPTL4 levels correlated well with angiopoietin-2, IL-6, and TNF-α levels in BALF and serum. BALF ANGPTL4 was positively correlated with the BA/SA ratio (an indicator of pulmonary vascular permeability), and serum ANGPTL4 was associated with the severity of multiple organ dysfunction syndrome based on SOFA and APACHE II scores. Moreover, serum ANGPTL4 was better able to predict 28-day ARDS-related mortality (AUC 0.746, P < 0.01) than the APACHE II score or PaO2/FiO2 ratio. Serum ANGPTL4 was identified as an independent risk factor for mortality in a univariate Cox regression model (P < 0.001).

Conclusion:
ANGPTL4 levels were elevated in patients with ARDS and significantly correlated with disease severity and mortality. ANGPTL4 may be a novel prognostic biomarker in ARDS.
Clinical Significance of Pro-inflammatory Cytokines and Their Correlation with Disease Severity and Blood Coagulation in Septic Patients with Bacterial Co-infection
Authors: Wang Xin , Zhang Qi , Yan Yong , Yang Yang , Shang Xueyi , Li Yan 
Published: January 2021

ABSTRACT

Purpose:
To evaluate the clinical significance of pro-inflammatory cytokines for disease severity and coagulation in septic patients with bacterial co-infection.

Methods:
A total of 92 patients with sepsis admitted to intensive care unit (ICU) from January 2017 to August 2020 were enrolled and their clinical data were retrospectively analyzed. Forty-seven patients (51.1%) had a single infection by Klebsiella pneumoniae or Acinetobacter baumannii (single-infection group), and 45 patients (48.9%) were infected by both species (co-infection group). We compared the clinical characteristics and disease severity among the 92 patients. Disease severity was defined as ICU stay time and 30-day mortality. Plasma concentrations of pro-inflammatory cytokines and their correlation with disease severity and blood coagulation were analyzed.

Results:
The 30-day mortality in the co-infection group (35.5%) was significantly higher than in the single-infection group (19.1%). The levels of IL-6 and TNF-α in the co-infection group were higher than in the single-infection group. Moreover, high levels of IL-6, IL-8, and TNF-α were positively correlated with disease severity (Spearman P value < 0.05). High levels of IL-6 and TNF-α were negatively correlated with the platelet count (Spearman P value < 0.05) and positively correlated with prothrombin time, and plasma levels of fibrin degradation product and D-dimer levels (Spearman P value < 0.05 for all).

Conclusion:
Septic patients with bacterial co-infection had increased plasma levels of pro-inflammatory cytokines. Furthermore, a positive correlation between high levels of pro-inflammatory cytokines and increased disease severity and depressed blood coagulation function for septic patients with co-infection was identified.
Trap and kill of environmental microbes: Validation of a novel decontamination technology in Hospital ICU setting
Authors: Jose Sanju , Phadke Kruttika S. , Venkatraman Janani , Krishna Bhuvana , Sampath Sriram , Datta Santanu , Nagaraj Savitha , Ghatak Arindam 
Published: January 2021

AbstractNosocomial infections, also known as hospital-acquired infections (HAI), appear 48 hours or more after hospital admission and are independent of the original infirmity of the patient. To prevent or to reduce HAI, the central paradigm is to construct protective barriers between the large number of people who are sick and whose immune systems are compromised in the precincts of the hospital. Microbes that result in HAI do so by two routes of infection: touch and aerosol. We describe here ZeBox technology, a voltage induced synergistic killing of the microbe on designed surfaces, as a game-changer in this domain. Its kill rate is hitherto unmatched by any known chemical or non-chemical (viz; UV, ionisation) technology. In an enclosed test chamber, under challenge conditions, ZeBox technology can kill about a billion microbes in 10 minutes. When tested under clinical settings, the device could effectively reduce microbes, both from air and surfaces with more than 90% efficiency. The optimum requirement to reduce HAI would be to construct an online microbicidal device that operates in a continuous trap and kill mode in the background of people and patient movement, and decontaminates air and surfaces. We present unequivocal data to fortify our claims of online, continuous, safe, trap and kill mechanism of ZeBox technology.
Spatio-temporal analysis between the incidence of COVID-19 and human development in Mato Grosso do Sul, Brazil
Authors: de Souza Amaury , Abreu Marcel Carvalho , de Oliveira-Júnior José Francisco 
Published: January 2021

AbstractObjetiveTo analyze the spatial distribution of the Covid-19 incidence and its correlation with the municipal human development index (IDHM) in the state of Mato Grosso do Sul (MS), Brazil.MethodsThis is an ecological, exploratory and analytical study whose units of analysis were the 79 municipalities that make up the state of MS. Covid-19 incidence coefficients, death numbers, lethality rate, mortality rate and Human Development Index for municipalities (IDHM) in the period from March 2020 to December 31, 2020 were used. spatial correlations between the variables mentioned above.ResultsThe incidence of Covid-19 has spatial dependence with moderate positive correlation and formation of clusters located in the Metropolitan Region of Campo Grande (RMCG) and municipalities in the region.ConclusionThe uneven mapping of Covid-19 and its relationship with IDHM in the Ministry of Health can contribute to actions to address the regional pandemic.
SARS-CoV-2 B.1.1.7 lineage-related perceptions, COVID-19 vaccine acceptance and travel worry among healthcare workers
Authors: Temsah Mohamad-Hani , Barry Mazin , Aljamaan Fadi , Alhuzaimi Abdullah N , Al-Eyadhy Ayman , Saddik Basema , Alsohime Fahad , Alhaboob Ali , Alhasan Khalid , Alaraj Ali , Halwani Rabih , Jamal Amr , Alamro Nurah , Temsah Reem , Esmaeil Samia A. , Alanazi Shelaweeh , Alzamil Fahad , Alsomaily Ali , Al-Tawfiq Jafar A. 
Published: January 2021

AbstractBackgroundHealthcare workers’ (HCWs’) travel-related anxiety needs to be assessed in light of the emergence of SARS-CoV-2 mutations.MethodsAn online, cross-sectional questionnaire among HCWs between December 21, 2020 to January 7, 2021. The outcome variables were HCWs’ knowledge and awareness of the SARS-CoV-2 B.1.1.7 lineage, and its associated travel worry and Generalized Anxiety Disorder (GAD-7) score.ResultsA total of 1,058 HCWs completed the survey; 66.5% were female, 59.0% were nurses. 9.0% indicated they had been previously diagnosed with COVID-19. Regarding the B.1.1.7 lineage, almost all (97.3%) were aware of its emergence, 73.8% were aware that it is more infectious, 78.0% thought it causes more severe disease, and only 50.0% knew that current COVID-19 vaccines are effective in preventing it. Despite this, 66.7% of HCWs were not registered to receive the vaccine. HCWs’ most common source of information about the new variant was social media platforms (67%), and this subgroup was significantly more worried about traveling. Nurses were more worried than physicians (P=0.001).ConclusionsMost HCWs were aware of the emergence of SARS-CoV-2 B.1.1.7 variant and expressed substantial travel worries. Increased worry levels were found among HCWs who used social media as their main source of information, those with lower levels of COVID-19 vaccine uptake, and those with higher GAD-7 scores. The utilization of official social media platforms could improve accurate information dissemination among HCWs regarding the pandemic’s evolving mutations. Targeted vaccine campaigns are warranted to assure HCWs about the efficacy of COVID-19 vaccines toward SARS-CoV-2 variants.
Modeling the population effects of epitope specific escape mutations in SARS-CoV-2 to guide vaccination strategies
Authors: Koopman James S. , Simon Carl P. , Getz Wayne M. , Salter Richard 
Published: January 2021

AbstractEscape mutations (EM) to SARS-Cov-2 have been detected and are spreading. Vaccines may need adjustment to respond to these or future mutations. We designed a population level model integrating both waning immunity and EM. We also designed a set of criteria for elaborating and fitting this model to cross-neutralization and other data in a manner that minimizes vaccine decision errors. We formulated four model variations. These define criteria for which prior infections provide immunity that can be escaped. They also specify different sequences where one EM follows another. At all reasonable parameter values, these model variations led to patterns where: 1) EM were rare in the first epidemic, 2) rebound epidemics after the first epidemic were accelerated more by increasing drifting than by increasing waning (with some exceptions), 3) the long term endemic level of infection was determined mostly by waning rates with small effects of the drifting parameter, 4) EM caused loss of vaccine effectiveness and under some conditions, vaccines induced EM that caused higher levels of infection with vaccines than without them. The differences and similarities across the four models suggest paths for developing models specifying the epitopes where EM act. This model is a base on which to construct epitope specific evolutionary models using new high-throughput assay data from population samples to guide vaccine decisions.HighlightsThis model is the first to integrate both antigenic drifting from escape mutations and immunity waning in continuous time.Tiny amounts of only waning or only escape mutation drifting have small or no effects. Together, they have large effects.There are no or few escape mutations during the first epidemic peak and no effect of drifting parameters on the size of that wave.After the first epidemic peak, escape mutations accumulate rapidly. They increase with increases in waning rates and with increases in the drifting rate. Escape mutations then amplify other escape mutations since these raise the frequency of reinfections.Escape mutations can completely negate the effects of vaccines and even lead to more infections with vaccination than without, especially at very low waning rates.The model generates population level cross-neutralization patterns that enable the model to be fitted to population level serological data.The model can be modified to use laboratory data that determine the epitope specific effects of mutations on ACE2 attachment strength or escape from antibody effects.The model, although currently unable to predict the effects of escape mutations in the real world, opens up a path that can guide model incorporation of molecularly studied escape mutations and improve predictive value. We describe that path.Model analysis indicates that vaccine trials and serological surveys are needed now to detect the effects of epitope specific escape mutations that could cause the loss of vaccine efficacy.