bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of advance care planning practices among people with chronic diseases in hospital and community settings: a retrospective medical record audit
Authors: Jeong Sarah , Barrett Tomiko , Ohr Se Ok , Cleasby Peter , Davey Ryan , David Michael 
Published: April 2021

Abstract
Background
Advance Care Planning (ACP) enables healthcare professionals to embrace the important process where patients think about their values in life and goals for health care, and discuss their future health care preferences with family members for a time when they are not able to make health care decisions. Despite the promotion of ACP last two decades, and well-known benefits of ACP and a written Advance Care Directive (ACD), they are still underutilised in Australia and across the world. Previous studies have provided some insights, however, an uptake of ACP and prevalence of ACDs in community settings is rarely reported.

Methods
The aim of this study was to determine the uptake of ACP and prevalence of ACDs among people with chronic diseases in hospital and community settings. A retrospective medical record audit of eligible patients looking for evidence of ACP was conducted in 16 research sites in eight hospital and eight community care settings. Participants included those who were admitted to one of the research sites, and who were aged 18 years and over with at least one of nine nominated chronic diseases. The primary outcome measures included the number of patients with evidence of ACP through the following practices: completion of an ACD, appointment of an Enduring Guardian (EG), or completion of a resuscitation plan.

Results
The overall prevalence of ACD was 2.8% (n = 28) out of 1006 audited records, and only 10 (1%) of them were legally binding. The number of EGs appointed was 39 (3.9%) across the sites. A total of 151 (15.4%) resuscitation plans were found across the eight hospital sites. 95% (n = 144) of the resuscitation plans indicated ‘Not-for-resuscitation’.

Conclusions
The uptake of ACP is very low. Current medical recording system reveals the challenges in ACP lie in the process of storage, access and execution of the ACDs. Given that having an ACD or Enduring Guardian in place is only useful if the treating physician knows how and where to access the information, it has implications for policy, information system, and healthcare professionals’ education.

Trial registration
The study was retrospectively registered with the Australian New Zealand Clinical Trials Registry (Trial ID: ACTRN12618001627246). The URL of the trial registry record http://www.anzctr.org.au/trial/MyTrial.aspx
The role of CD38 in HIV infection
Authors: Lu Liqi , Wang Jie , Yang Qian , Xie Xiuqiao , Huang Yuanshuai 
Published: April 2021

AbstractThe widely-expressed molecule CD38 is a single-stranded type II transmembrane glycoprotein that is mainly involved in regulating the differentiation and activation state of the cell. CD38 has broad and complex functions, including enzymatic activity, intercellular signal transduction, cell activation, cytokine production, receptor function and adhesion activity, and it plays an important role in the physiological and pathological processes of many diseases. Many studies have shown that CD38 is related to the occurrence and development of HIV infection, and CD38 may regulate its progression through different mechanisms. Therefore, investigating the role of CD38 in HIV infection and the potential signaling pathways that are involved may provide a new perspective on potential treatments for HIV infection. In the present review, the current understanding of the roles CD38 plays in HIV infection are summarized. In addition, the specific role of CD38 in the process of HIV infection of human CD4+T lymphocytes is also discussed.
Pseudo-Wellens syndrome from sepsis-induced cardiomyopathy: a case report and review of the literature
Authors: Ju Teressa Reanne , Yeo Ilhwan , Pontone Gregory , Bhatt Reema 
Published: April 2021

Abstract
Background
Pseudo-Wellens syndrome is a rare entity characterized by the presence of electrocardiogram (ECG) changes of Wellens syndrome but without the stenosis of the left anterior descending (LAD) coronary artery. In previous reports, pseudo-Wellens syndrome most commonly resulted from recreational drug use or unidentified etiologies. We present a unique case of pseudo-Wellens syndrome due to sepsis-induced cardiomyopathy and a review of the literature.

Case presentation
A 62-year-old Caucasian woman was admitted for sepsis from left foot cellulitis. Laboratory data were notable for elevated lactate of 2.5 mmol/L and evidence of acute kidney injury. She developed chest pain on the third day of hospitalization. ECG showed symmetric T-wave inversion in leads V1–V4. Serial troponin I levels were within normal limits. Chest imaging showed no pulmonary embolism. Echocardiogram showed ejection fraction of 25%, left ventricular diastolic diameter of 4.6 cm, and multiple segmental wall motion abnormalities. Cardiac catheterization showed patent coronary arteries. The hospital course was complicated by transient sinus bradycardia and hypotension. She was hospitalized for a total of 17 days. ECG prior to discharge showed resolution of T-wave changes.

Conclusion
Pseudo-Wellens syndrome may result from myocardial ischemia due to vasospasm or myocardial edema from external insults. In our case, we suspect sepsis-related cytokine production resulting in cardiomyopathy and pseudo-Wellens syndrome. The clinical manifestations were indistinguishable between Wellens and pseudo-Wellens syndrome. Physicians should include the diagnosis of pseudo-Wellens syndrome when considering the presence of LAD coronary artery occlusion given risk stratifications.
Exosomes derived from miR-26a-modified MSCs promote axonal regeneration via the PTEN/AKT/mTOR pathway following spinal cord injury
Authors: Chen Yuyong , Tian Zhenming , He Lei , Liu Can , Wang Nangxiang , Rong Limin , Liu Bin 
Published: April 2021

Abstract
Background
Exosomes derived from the bone marrow mesenchymal stem cell (MSC) have shown great potential in spinal cord injury (SCI) treatment. This research was designed to investigate the therapeutic effects of miR-26a-modified MSC-derived exosomes (Exos-26a) following SCI.

Methods
Bioinformatics and data mining were performed to explore the role of miR-26a in SCI. Exosomes were isolated from miR-26a-modified MSC culture medium by ultracentrifugation. A series of experiments, including assessment of Basso, Beattie and Bresnahan scale, histological evaluation, motor-evoked potential recording, diffusion tensor imaging, and western blotting, were performed to determine the therapeutic influence and the underlying molecular mechanisms of Exos-26a in SCI rats.

Results
Exos-26a was shown to promote axonal regeneration. Furthermore, we found that exosomes derived from miR-26a-modified MSC could improve neurogenesis and attenuate glial scarring through PTEN/AKT/mTOR signaling cascades.

Conclusions
Exosomes derived from miR-26a-modified MSC could activate the PTEN-AKT-mTOR pathway to promote axonal regeneration and neurogenesis and attenuate glia scarring in SCI and thus present great potential for SCI treatment.

Graphical abstract
Can a deep learning model based on intraoperative time-series monitoring data predict post-hysterectomy quality of recovery?
Authors: Zhao Xu , Liao Ke , Wang Wei , Xu Junmei , Meng Lingzhong 
Published: April 2021

Abstract
Background
Intraoperative physiological monitoring generates a large quantity of time-series data that might be associated with postoperative outcomes. Using a deep learning model based on intraoperative time-series monitoring data to predict postoperative quality of recovery has not been previously reported.

Methods
Perioperative data from female patients having laparoscopic hysterectomy were prospectively collected. Deep learning, logistic regression, support vector machine, and random forest models were trained using different datasets and evaluated by 5-fold cross-validation. The quality of recovery on postoperative day 1 was assessed using the Quality of Recovery-15 scale. The quality of recovery was dichotomized into satisfactory if the score ≥122 and unsatisfactory if <122. Models’ discrimination was estimated using the area under the receiver operating characteristics curve (AUROC). Models’ calibration was visualized using the calibration plot and appraised by the Brier score. The SHapley Additive exPlanation (SHAP) approach was used to characterize different input features’ contributions.

Results
Data from 699 patients were used for modeling. When using preoperative data only, all four models exhibited poor performance (AUROC ranging from 0.65 to 0.68). The inclusion of the intraoperative intervention and/or monitoring data improved the performance of the deep leaning, logistic regression, and random forest models but not the support vector machine model. The AUROC of the deep learning model based on the intraoperative monitoring data only was 0.77 (95% CI, 0.72–0.81), which was indistinct from that based on the intraoperative intervention data only (AUROC, 0.79; 95% CI, 0.75–0.82) and from that based on the preoperative, intraoperative intervention, and monitoring data combined (AUROC, 0.81; 95% CI, 0.78–0.83). In contrast, when using the intraoperative monitoring data only, the logistic regression model had an AUROC of 0.72 (95% CI, 0.68–0.77), and the random forest model had an AUROC of 0.74 (95% CI, 0.73–0.76). The Brier score of the deep learning model based on the intraoperative monitoring data was 0.177, which was lower than that of other models.

Conclusions
Deep learning based on intraoperative time-series monitoring data can predict post-hysterectomy quality of recovery. The use of intraoperative monitoring data for outcome prediction warrants further investigation.

Trial registration
This trial (Identifier: NCT03641625) was registered at ClinicalTrials.gov by the principal investigator, Lingzhong Meng, on August 22, 2018.
Anesthetic management of a morbidly obese patient with endometrial cancer during robot-assisted laparoscopic surgery
Authors: Ishida Yusuke , Nakazawa Koichi , Okada Toshio , Tsuzuki Yumi , Kobayashi Takayuki , Yamada Rikako , Uchino Hiroyuki 
Published: April 2021

Abstract
Background
The number of robot-assisted surgeries being performed has increased in recent years, even in patients with risk factors, such as obesity, owing to advancements in medical technologies. We here report the anesthetic management of a morbidly obese woman who underwent robot-assisted surgery.

Case presentation
A 44-year-old woman (height, 165 cm; weight, 147 kg; body mass index, 54 kg/m2) was scheduled to undergo robot-assisted laparoscopic hysterectomy for endometrial cancer. Preoperative weight loss and rehearsal of positioning during induction of anesthesia and surgical procedures greatly contributed to the surgical success. Monitoring of oxygen reserve index in combination with SpO2 was useful for appropriate airway and respiratory management. During anesthesia induction, the ramp position using a special commercially available cushion facilitated manual mask ventilation and tracheal intubation. Lung-protective ventilation using a limited tidal volume with moderate PEEP was applied during the robot-assisted surgical procedure.

Conclusion
We successfully managed anesthesia without any complications.
Coating Lacticaseibacillus rhamnosus GG in Alginate Systems: an Emerging Strategy Towards Improved Viability in Orange Juice
Authors: Bonaccorso Angela , Russo Nunziatina , Romeo Alessia , Carbone Claudia , Grimaudo Maria Aurora , Alvarez-Lorenzo Carmen , Randazzo Cinzia , Musumeci Teresa , Caggia Cinzia 
Published: April 2021

AbstractFruit juices are successfully proposed as suitable probiotic vehicles, but researchers’ efforts should be developed to avoid effects of bacteria overgrowing on sensory and nutritional cues of final products and to preserve viability of probiotic bacteria during storage. In the present study, encapsulation of Lacticaseibacillus rhamnosus GG strain in alginate systems was performed through ionotropic gelation technology. The alginate systems were optimized by using Box-Behnken Design to investigate the influence of three independent variables at three different levels: particle mean size and polydispersity index. The optimized probiotic-loaded alginate particles were added to orange juice samples. The viability of the probiotic strain, both as free and microencapsulated, was evaluated in orange juice stored at 5°C for 35 days. Morphology and size of probiotic-loaded alginate particles were found suitable for incorporation into juice. TEM analysis revealed that unloaded systems were clustered as nanoparticles (CL_NP), while the loaded sample appeared as a coated system (Coated_LGG). Microbiological evaluation revealed that the encapsulation assured the survival of Coated_LGG, with a reduction of less than 1-unit log in cellular density after 35 days of refrigerated storage in orange juice. Results indicated that the encapsulated bacteria did not affect the macroscopic properties neither the microbiological characteristic of orange juice; thus, it can be proposed as functional food.
The Clinical Utility of DCISionRT® on Radiation Therapy Decision Making in Patients with Ductal Carcinoma In Situ Following Breast-Conserving Surgery
Authors: Shah Chirag , Bremer Troy , Cox Charles , Whitworth Pat , Patel Rakesh , Patel Anushka , Brown Eric , Gold Linsey , Rock David , Riley Lee , Kesslering Christy , Brown Sheree , Gabordi Robert , Pellicane James , Rabinovich Rachel , Khan Sadia , Templeton Sandra , Majithia Lonika , Willey Shawna C. , Wärnberg Fredrik , Gerber Naamit K. , Shivers Steve , Vicini Frank A. 
Published: April 2021

Abstract
Background
The role of radiation therapy (RT) following breast-conserving surgery (BCS) in ductal carcinoma in situ (DCIS) remains controversial. Trials have not identified a low-risk cohort, based on clinicopathologic features, who do not benefit from RT. A biosignature (DCISionRT®) that evaluates recurrence risk has been developed and validated. We evaluated the impact of DCISionRT on clinicians’ recommendations for adjuvant RT.

Methods
The PREDICT study is a prospective, multi-institutional, observational registry in which patients underwent DCISionRT testing. The primary endpoint was to identify the percentage of patients where testing led to a change in RT recommendations.

Results
Overall, 539 women were included in this study. Pre DCISionRT testing, RT was recommended to 69% of patients; however, post-testing, a change in the RT recommendation was made for 42% of patients compared with the pre-testing recommendation; the percentage of women who were recommended RT decreased by 20%. For women initially recommended not to receive an RT pre-test, 35% had their recommendation changed to add RT following testing, while post-test, 46% of patients had their recommendation changed to omit RT after an initial recommendation for RT. When considered in conjunction with other clinicopathologic factors, the elevated DCISionRT score risk group (DS > 3) had the strongest association with an RT recommendation (odds ratio 43.4) compared with age, grade, size, margin status, and other factors.

Conclusions
DCISionRT provided information that significantly changed the recommendations to add or omit RT. Compared with traditional clinicopathologic features used to determine recommendations for or against RT, the factor most strongly associated with RT recommendations was the DCISionRT result, with other factors of importance being patient preference, tumor size, and grade.
The Influence of Didactic Play on Reducing the Level of Anxiety in the Classroom
Authors: Volobueva E. 
Published: April 2021

The article highlights the issues of the teacher's use of didactic games as a form of teaching organization and an effective means of preventing and reducing anxiety among younger students in the process of educational activities in the classroom. The concept of "school anxiety" is characterized. The importance of didactic games for the development of children’s ability and desire to learn, increasing their intellectual activity, enriching the experience of communicative interaction with classmates, forming a sense of camaraderie and responsibility for the team result is considered.
The possibility of conducting educational games in the development of any subject content has been substantiated. Examples of didactic games for working in mathematics lessons with first-graders showing anxiety are given.
Linear Program-Based Approximation for Personalized Reserve Prices
Authors: Derakhshan Mahsa , Golrezaei Negin , Paes Leme Renato 
Published: April 2021

We study the problem of computing data-driven personalized reserve prices in eager second price auctions without having any assumption on valuation distributions. Here, the input is a data set that contains the submitted bids of n buyers in a set of auctions, and the problem is to return personalized reserve prices r that maximize the revenue earned on these auctions by running eager second price auctions with reserve r. For this problem, which is known to be NP complete, we present a novel linear program (LP) formulation and a rounding procedure, which achieves a 0.684 approximation. This improves over the [Formula: see text]-approximation algorithm from Roughgarden and Wang. We show that our analysis is tight for this rounding procedure. We also bound the integrality gap of the LP, which shows that it is impossible to design an algorithm that yields an approximation factor larger than 0.828 with respect to this LP. This paper was accepted by Chung Piaw Teo, Management Science Special Section on Data-Driven Prescriptive Analytics.
Microwave-photonic optical fiber interferometers for refractive index sensing with high sensitivity and a tunable dynamic range
Authors: Zhu Chen , Huang Jie 
Published: April 2021

We propose and demonstrate an extremely simple yet novel sensing strategy for measurements of a refractive index (RI) based on microwave-photonic optical fiber interferometry. A hybrid interferometric system based on an incoherent optical interferometer (i.e., a Michelson interferometer [MI]) and a coherent optical interferometer (i.e., a Fabry–Perot interferometer [FPI]) is constructed simply by using a low-cost off-the-shelf fiber coupler. The sensing arm of the MI is highly sensitive to a surrounding RI based on Fresnel reflection, where variations of the ambient RI cause changes in both the reflection magnitudes of the resonance frequencies and fringe visibility of the reflection spectra in the microwave domain. The coherent FPI is employed to tune the dynamic range of the MI by adjusting the effective reflectance of the reference arm of the MI. Essentially, other approaches that can vary the reflectance of the reference arm of the MI can also be used to tune the dynamic range of the system based on the proposed strategy. The experimental results are in good agreement with theoretical predictions. The prominent advantages of the sensor, including low cost, ease of fabrication, robustness, compactness, high sensitivity, and tunable dynamic range, make it a strong candidate in various chemical, biological, and environmental applications.
2  Gbps free-space ultraviolet-C communication based on a high-bandwidth micro-LED achieved with pre-equalization
Authors: Zhu Shijie , Qiu Pengjiang , Qian Zeyuan , Shan Xinyi , Wang Zhou , Jiang Ke , Sun Xiaojuan , Cui Xugao , Zhang Guoqi , Li Dabing , Tian Pengfei 
Published: April 2021

In this Letter, we experimentally achieve high-speed ultraviolet-C (UVC) communication based on a 276.8 nm UVC micro-LED. A record

−

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optical bandwidth of 452.53 MHz and light output power of 0.854 mW at a current density of

400

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2

are obtained with a chip size of 100 µm. A UVC link over 0.5 m with a data rate of 2 Gbps is achieved using 16-ary quadrature amplitude modulation orthogonal frequency division multiplexing and pre-equalization, and an extended distance over 3 m with a data rate of 0.82 Gbps is also presented. The demonstrated high-speed performance shows that micro-LEDs have great potential in the field of UVC communication.
Reusable snorkel masks adapted as particulate respirators
Authors: Seligman Henry , Zaman Sameer , Pitcher David S. , Shun-Shin Matthew J. , Hepworth Lloyd Freya , Androschuk Vitaliy , Sen Sayan , Al-Lamee Rasha , Miller David M. , Barnett Harry W. , Haji Gulam S. , Howard Luke S. , Nijjer Sukhjinder , Mayet Jamil , Francis Darrel P. , Ces Oscar , Linton Nicholas W. F. , Peters Nicholas S. , Petraco Ricardo 
Published: April 2021

Introduction
During viral pandemics, filtering facepiece (FFP) masks together with eye protection form the essential components of personal protective equipment (PPE) for healthcare workers. There remain concerns regarding insufficient global supply and imperfect protection offered by currently available PPE strategies. A range of full-face snorkel masks were adapted to accept high grade medical respiratory filters using bespoke-designed 3D-printed connectors. We compared the protection offered by the snorkel to that of standard PPE using a placebo-controlled respirator filtering test as well as a fluorescent droplet deposition experiment. Out of the 56 subjects tested, 42 (75%) passed filtering testing with the snorkel mask compared to 31 (55%) with a FFP3 respirator mask (p = 0.003). Amongst the 43 subjects who were not excluded following a placebo control, 85% passed filtering testing with the snorkel versus to 68% with a FFP3 mask (p = 0.008). Following front and lateral spray of fluorescence liquid particles, the snorkel mask also provided superior protection against droplet deposition within the subject’s face, when compared to a standard PPE combination of FFP3 masks and eye protection (3.19x108 versus 6.81x108 fluorescence units, p<0.001). The 3D printable adaptors are available for free download online at https://www.ImperialHackspace.com/COVID-19-Snorkel-Respirator-Project/.

Conclusion
Full-face snorkel masks adapted as particulate respirators performed better than a standard PPE combination of FFP3 mask and eye protection against aerosol inhalation and droplet deposition. This adaptation is therefore a promising PPE solution for healthcare workers during highly contagious viral outbreaks.
Timing of term elective cesarean section and adverse neonatal outcomes: A multi-center retrospective cohort study
Authors: Al Bizri Ayah , Boghossian Nansi S. , Nassar Anwar , Nakad Pascale , Jaber Dina , Chahine Rabih , Fallakha Gaby , Makhoul Ghaith , Yunis Khalid 
Published: April 2021

Background
Rate of cesarean section (CS), including elective CS has globally increased. Studies have found that term elective CS before 39 weeks of gestation is associated with increased risk of adverse respiratory outcomes.

Objective
To determine the rate of elective CS and examine the association between timing of elective term CS and adverse neonatal outcomes in a large population of Lebanese women.

Methods
A Multi-Center Study was conducted using data from the National Collaborative Perinatal Neonatal Network database. Simple and multivariable logistic regression models were used to examine the association between timing of term elective CS and adverse neonatal outcomes. Some of the neonatal adverse outcomes we examined included respiratory distress syndrome, admission to the NICU, and a composite of respiratory outcomes.

Results
A total of 28,997 low risk mothers who delivered through primary and repeat elective CS were included in the study. Uncomplicated elective planned term CS constituted 25% of all CS deliveries in Lebanon. Primary and repeat CS at 37 weeks of gestation increased the odds of most of the studied adverse neonatal outcomes. There were few associations between CS and adverse neonatal outcomes at 38 weeks of gestation.

Conclusions
Term primary and repeat cesarean delivery prior to 39 weeks of gestation is associated with respiratory and other adverse neonatal outcomes. Delaying birth 1–2 weeks till 39 weeks of gestation can prevent 64–77% of adverse respiratory outcomes.