bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Outcomes of Pediatric Catheter Ablation by Anesthesia Strategy: A Report From the NCDR IMPACT Registry
Authors: Janson Christopher M. , Shah Maully J. , Kennedy Kevin F. , Iyer V. Ramesh , Sweeten Tammy L. , Glatz Andrew C. , Steven James M. , O’Byrne Michael L. 
Published: June 2021

Background:
Anesthesia strategies for pediatric ablation procedures include general anesthesia (GA) and monitored anesthesia care (MAC). The effects of anesthesia strategy on arrhythmia inducibility and procedural outcomes have not been investigated.

Methods:
A multicenter retrospective study was performed, using data from the National Cardiovascular Data Registry’s Improving Pediatric and Adult Congenital Treatment Registry. Data from subjects 1 to 21 years undergoing elective first-time electrophysiology study (EPS) for evaluation of documented supraventricular tachycardia, ectopic atrial tachycardia, or premature ventricular contractions (PVC)/ventricular tachycardia (VT) from April 1, 2016, to December 31, 2019, were included, excluding cases with Wolff-Parkinson-White, congenital heart disease, and cardiomyopathy. The primary outcome was a negative EPS, defined as failure to induce the clinical tachyarrhythmia. Secondary outcomes included ablation success and adverse events.

Results:

Six thousand six hundred twenty-one subjects from 78 centers were evaluated: 49% male; mean age 13.3±3.8 years. GA was used in 5913 (89%), with MAC in 708 (11%). A negative EPS occurred in 9% of cases overall, with no difference by anesthesia strategy (9% GA versus 10% MAC,
P
=0.2). In supraventricular tachycardia and ectopic atrial tachycardia, there was no significant difference in likelihood of a negative EPS by anesthesia strategy. In PVC/VT, there was a higher rate of negative EPS under GA (28% GA versus 16% MAC,
P
=0.02), translating to a higher rate of nonablation (34% GA versus 14% MAC,
P
<0.001). In multivariable models, GA was associated with negative EPS in PVC/VT (odds ratio, 2.2 [95% CI, 1.1–4.4],
P
=0.03) but not in supraventricular tachycardia or ectopic atrial tachycardia. Acute ablation success was not different between strategies (94% GA versus 94% MAC,
P
=0.2). Major adverse events were rare, with no differences between GA and MAC.

Conclusions:
In this first report on pediatric ablation data in the Improving Pediatric and Adult Congenital Treatment Registry, there were no differences between GA and MAC in supraventricular tachycardia or ectopic atrial tachycardia inducibility, acute ablation success, or major adverse events. GA was associated with higher rates of noninducibility and nonablation in PVC/VT cases. A MAC strategy should be considered for PVC/VT ablation in the pediatric population.
Advancing the Use of Games as a Model for Scientific Practice
Authors: Queiroz Francisco , Spitz Rejane 
Published: June 2021

Abstract
Science is similar to a game, as both involve rules-based participation in search of optimal outcomes. Supported by key texts in history and philosophy of science, the authors propose a game-based model for understanding scientific inquiry and practice, particularly through computational resources. They conclude that this model creates space for more speculative and reflective approaches to scientific practice and can contribute to the design and development of better scientific software, simulation and visualization.
Bernard Stiegler, la technique, la culture et le temps: Une introduction à l’œuvre
Authors: Tron Colette 
Published: June 2021

Abstract
Décédé brutalement le 5 août 2020, le philosophe Bernard Stiegler aura eu une activité incessante et acharnée, une vie et une œuvre intenses et prolifiques, qu’il a transmises à ses contemporains et vers les générations futures. Soucieux d’un monde “non-inhumain,” de ses dits et écrits à ses actions et expérimentations, ses positions et propositions étaient étayées et son acuité en permanence vivace face à “la complexité de ce qui arrive”.
“People Want a Clean Environment”: Historical Roots of the Environmental Crisis and the Emergence of Eco-Resistances in Tunisia
Authors: Pepicelli Renata 
Published: June 2021

Abstract
In Tunisia since the 2010–11 revolution, the relationship between activism and territories has emerged as central in the redefinition of social conflicts. The present essay analyses the growing environmental protests, focusing on a series of movements in defence of urban and rural regions which, although different from each other, share the centrality of the local dimension in defining new forms of conflict and the environmentalist theme as the guiding thread of their struggles. Based on a historical analysis of the roots of the environmental crisis and inequalities in the country, on the one hand, and on the results of fieldwork on the ongoing environmental protests, on the other hand, the aim of this study is to give an enlarged image of the plural forms of eco-resistance that are taking place in Tunisia.
Simultaneous changes in anthocyanin, chlorophyll, and carotenoid contents produce green variegation in pink–leaved ornamental kale
Authors: Liu Yang , Feng Xin , Zhang Yuting , Zhou Fuhui , Zhu Pengfang 
Published: June 2021

Abstract
Background
Anthocyanin, chlorophyll, and carotenoid pigments are widely distributed in plants, producing various colors. Ornamental kale (Brassica oleracea var. acephala DC) which has colorful inner leaves is an ideal plant to explore how these three pigments contribute to leaf color. The molecular mechanisms of the coloration in ornamental kale could provide reference for exploring the mechanisms of pigmentation in other plants.

Results
In this study, we sequenced the transcriptome and determined the pigment contents of an unusual cultivar of ornamental kale with three different types of leaf coloration: pink (C3), light pink (C2), and variegated pink–green (C1). A total of 23,965 differentially expressed genes were detected in pairwise comparisons among the three types of leaves. The results indicate that Bo9g058630 coding dihydroflavonol 4–reductase (DFR) and Bo3g019080 coding shikimate O–hydroxycinnamoyltransferase (HCT) acted in anthocyanin biosynthesis in pink leaves. Bo1g053420 coding pheophorbidase (PPD) and Bo3g012430 coding 15–cis–phytoene synthase (crtB) were identified as candidate genes for chlorophyll metabolism and carotenoid biosynthesis, respectively. The transcription factors TT8, MYBL2, GATA21, GLK2, and RR1 might participate in triggering the leaf color change in ornamental kale. Anthocyanin content was highest in C3 and lowest in C1. Chlorophyll and carotenoid contents were lowest in C2 and highest in C1.

Conclusions
Based on these findings, we suspected that the decrease in anthocyanin biosynthesis and the increase in chlorophyll and carotenoid biosynthesis might be the reason for the leaf changing from pink to variegate pink–green in this unusual cultivar. Our research provides insight into the molecular mechanisms of leaf coloration in ornamental kale, contributing to a theoretical foundation for breeding new varieties.
The genomes of precision edited cloned calves show no evidence for off-target events or increased de novo mutagenesis
Authors: Jivanji Swati , Harland Chad , Cole Sally , Brophy Brigid , Garrick Dorian , Snell Russell , Littlejohn Mathew , Laible Götz 
Published: June 2021

Abstract
Background
Animal health and welfare are at the forefront of public concern and the agricultural sector is responding by prioritising the selection of welfare-relevant traits in their breeding schemes. In some cases, welfare-enhancing traits such as horn-status (i.e., polled) or diluted coat colour, which could enhance heat tolerance, may not segregate in breeds of primary interest, highlighting gene-editing tools such as the CRISPR-Cas9 technology as an approach to rapidly introduce variation into these populations. A major limitation preventing the acceptance of CRISPR-Cas9 mediated gene-editing, however, is the potential for off-target mutagenesis, which has raised concerns about the safety and ultimate applicability of this technology. Here, we present a clone-based study design that has allowed a detailed investigation of off-target and de novo mutagenesis in a cattle line bearing edits in the PMEL gene for diluted coat-colour.

Results
No off-target events were detected from high depth whole genome sequencing performed in precursor cell-lines and resultant calves cloned from those edited and non-edited cell lines. Long molecule sequencing at the edited site and plasmid-specific PCRs did not reveal structural variations and/or plasmid integration events in edited samples. Furthermore, an in-depth analysis of de novo mutations across the edited and non-edited cloned calves revealed that the mutation frequency and spectra were unaffected by editing status. Cells in culture, however, appeared to have a distinct mutation signature where de novo mutations were predominantly C > A mutations, and in cloned calves they were predominantly T > G mutations, deviating from the expected excess of C > T mutations.

Conclusions
We found no detectable CRISPR-Cas9 associated off-target mutations in the gene-edited cells or calves derived from the gene-edited cell line. Comparison of de novo mutation in two gene-edited calves and three non-edited control calves did not reveal a higher mutation load in any one group, gene-edited or control, beyond those anticipated from spontaneous mutagenesis. Cell culture and somatic cell nuclear transfer cloning processes contributed the major source of contrast in mutational profile between samples.
Hand hygiene during facility-based childbirth in Cambodia: a theory-driven, mixed-methods observational study
Authors: Nalule Yolisa , Buxton Helen , Ir Por , Leang Supheap , Macintyre Alison , Pors Ponnary , Samol Channa , Dreibelbis Robert 
Published: June 2021

Abstract
Background
Despite current efforts to improve hand hygiene in health care facilities, compliance among birth attendants remains low. Current improvement strategies are inadequate, largely focusing on a limited set of known behavioural determinants or addressing hand hygiene as part of a generalized set of hygiene behaviours. To inform the design of a facility –based hand hygiene behaviour change intervention in Kampong Chhnang, Cambodia, a theory-driven formative research study was conducted to investigate the context specific behaviours and determinants of handwashing during labour and delivery among birth attendants.

Methods
This formative mixed-methods research followed a sequential explanatory design and was conducted across eight healthcare facilities. The hand hygiene practices of all birth attendants present during the labour and delivery of 45 women were directly observed and compliance with hand hygiene protocols assessed in analysis. Semi-structured, interactive interviews were subsequently conducted with 20 key healthcare workers to explore the corresponding cognitive, emotional, and environmental drivers of hand hygiene behaviours.

Results
Birth attendants’ compliance with hand hygiene protocol was 18% prior to performing labour, delivery and newborn aftercare procedures. Hand hygiene compliance did not differ by facility type or attendants’ qualification, but differed by shift with adequate hand hygiene less likely to be observed during the night shift (p = 0.03). The midwives’ hand hygiene practices were influenced by cognitive, psychological, environmental and contextual factors including habits, gloving norms, time, workload, inadequate knowledge and infection risk perception.

Conclusion
The resulting insights from formative research suggest a multi-component improvement intervention that addresses the different key behaviour determinants to be designed for the labour and delivery room. A combination of disruption of the physical environment via nudges and cues, participatory education to the midwives and the promotion of new norms using social influence and affiliation may increase the birth attendants’ hand hygiene compliance in our study settings.
Epidemiological and clinical characteristics of respiratory viruses in 4403 pediatric patients from multiple hospitals in Guangdong, China
Authors: Zhang Yajie , Qiao Lin , Yao Jinxiu , Yu Nan , Mu Xiaoping , Huang Shengqi , Hu Bo , Li Weixuan , Qiu Feng , Zeng Fangyin , Chen Cong , Zhou Yuqiu , Zhang Bashan , Cai Tian , Wang Weijia , Wu Xianjin , Zhou Yiwen , Wang Guochang , Situ Bo , Lan Shuling , Li Na , Li Xiu , Li Zihua , Li Xin , Wang Congrong , Yang Chao , Feng Pingfeng , Wang Hongxia , Zhu Sijing , Xiong Yufeng , Luo Min , Shen Wenjuan , Hu Xiumei , Zheng Lei 
Published: June 2021

Abstract
Background
Acute respiratory infections (ARI) cause considerable morbidity and mortality worldwide, especially in children. Unfortunately, there are limited multi-center data on common viral respiratory infections in south China.

Methods
A total of 4403 nasal swabs were collected from children in 10 cities in Guangdong, China in 2019. Seven respiratory viruses, influenza A virus (IFA), influenza B virus (IFB), respiratory syncytial virus (RSV), adenoviruses (ADV) and parainfluenza virus types 1–3 (PIV1, PIV2 and PIV3), were detected by direct immunofluorescence antibody assay. The personal information and clinical characteristics were recorded and analyzed.

Results
The results showed that at least one virus was detected in 1099 (24.96 %) samples. The detection rates of RSV, IFA, ADV, PIV3, PIV1 and PIV2 were 7.13 % (314/4403), 5.31 % (234/4403), 4.02 % (177/4403), 3.04 % (134/4403), 1.70 % (75/4403) and 1.16 % (51/4403), respectively. The detection rate of RSV was highest in 0–6-month-old children at 18.18 % (106/583), while the detection rate of IFA was highest in 12–18-year-old children at 20.48 % (17/83). The total detection rates in winter and spring were 35.67 % (219/614) and 34.56 % (403/1166), higher than those in summer, 17.41 % (284/1631), and autumn, 19.46 % (193/992).

Conclusions
RSV and IFA were the main respiratory viruses in children. With increasing age the detection rate of RSV decreased in children, but the trends for the detection rates of IFA and IFB were the opposite. This study provided the viral etiology and epidemiology of pediatric patients with ARI in Guangdong, China.
Structural inequities in seasonal influenza vaccination rates
Authors: Brewer Lara I. , Ommerborn Mark J. , Nguyen Augustina Le , Clark Cheryl R. 
Published: June 2021

Abstract
Background
Influenza immunization is a highly effective method of reducing illness, hospitalization and mortality from this disease. However, influenza vaccination rates in the U.S. remain below public health targets and persistent structural inequities reduce the likelihood that Black, American Indian and Alaska Native, Latina/o, Asian groups, and populations of low socioeconomic status will receive the influenza vaccine.

Methods
We analyzed correlates of influenza vaccination rates using the 2019 Behavioral Risk Factor Surveillance System (BRFSS) in the year 2020. Our analysis compared influenza vaccination as the outcome of interest with the variables age, sex, race, education, income, geographic location, health insurance status, access to primary care, history of delaying care due to cost, and comorbidities such as: asthma, cardiovascular disease, hypertension, body mass index, cancer and diabetes.

Results
Non-Hispanic White (46.5%) and Asian (44.1%) participants are more likely to receive the influenza vaccine compared to Non-Hispanic Black (36.7%), Hispanic (33.9%), American Indian/Alaskan Native (36.6%), and Native Hawaiian/Other Pacific Islander (37.9%) participants. We found persistent structural inequities that predict influenza vaccination, within and across racial and ethnic groups, including not having health insurance [OR: 0.51 (0.47–0.55)], not having regular access to primary care [OR: 0.50 (0.48–0.52)], and the need to delay medical care due to cost [OR: 0.75 (0.71–0.79)].

Conclusion
As COVID-19 vaccination efforts evolve, it is important for physicians and policymakers to identify the structural impediments to equitable U.S. influenza vaccination so that future vaccination campaigns are not impeded by these barriers to immunization.
Mechanical power normalized to lung-thorax compliance predicts prolonged ventilation weaning failure: a prospective study
Authors: Ghiani Alessandro , Paderewska Joanna , Walcher Swenja , Neurohr Claus 
Published: June 2021

Abstract
Background
Mechanical power (MP) of artificial ventilation, the energy transferred to the respiratory system, is a chief determinant of adequate oxygenation and decarboxylation. Calculated MP, the product of applied airway pressure and minute ventilation, may serve as an estimate of respiratory muscle workload when switching to spontaneous breathing. The aim of the study was to assess MP’s discriminatory performance in predicting successful weaning from prolonged tracheostomy ventilation.

Methods
Prospective, observational study in 130 prolonged mechanically ventilated, tracheotomized patients in a specialized weaning center. Predictive weaning outcome ability of arterial blood gas analyses and indices derived from calculated MP at beginning and end of weaning was determined in terms of area under receiver operating characteristic curve (AUROC) and measures derived from k-fold cross-validation (likelihood ratios, diagnostic odds ratio, F1 score, and Matthews correlation coefficient [MCC]).

Results
Forty-four (33.8%) patients experienced weaning failure. Absolute MP showed poor discrimination in predicting outcome; whereas specific MP (MP normalized to dynamic lung-thorax compliance, LTCdyn-MP) had moderate diagnostic accuracy (MCC 0.38; AUROC 0.79, 95%CI [0.71‒0.86], p < 0.001), further improved by correction for corresponding mechanical ventilation PaCO2 (termed the power index of the respiratory system [PIrs]: MCC 0.52; AUROC 0.86 [0.79‒0.92], p < 0.001). Diagnostic performance of MP indices increased over the course of weaning, with maximum accuracy immediately before completion (LTCdyn-MP: MCC 0.49; AUROC 0.86 [0.78‒0.91], p < 0.001; PIrs: MCC 0.68; AUROC 0.92 [0.86‒0.96], p < 0.001).

Conclusions
MP normalized to dynamic lung-thorax compliance, a surrogate for applied power per unit of ventilated lung volume, accurately discriminated between low and high risk for weaning failure following prolonged mechanical ventilation.
Real-world effectiveness of early intervention with fixed-dose tiotropium/olodaterol vs tiotropium in Japanese patients with COPD: a high-dimensional propensity score–matched cohort analysis
Authors: Muro Shigeo , Suzuki Masaru , Nakamura Shuhei , Wang Jocelyn Ruoyi , Garry Elizabeth M. , Sakamoto Wataru , de Souza Sabrina 
Published: June 2021

Abstract
Background
Escalation to triple therapy (long-acting muscarinic antagonist/β2-agonist, inhaled corticosteroid [ICS]) in chronic obstructive pulmonary disorder (COPD) is recommended for patients on LAMA/LABA combinations with frequent exacerbations and severe symptoms. An extended time-to-escalation to triple therapy suggests patients are in a stable condition and is an indicator of treatment effectiveness. No studies in Japanese clinical practice have compared the effectiveness of LAMA/LABA fixed-dose combination therapies with LAMA monotherapy in terms of time-to-escalation to triple therapy. The primary objective of this real-world study in Japan was to compare time-to-escalation to triple therapy among new users of tiotropium/olodaterol or tiotropium monotherapy for COPD without asthma.

Methods
In this active-comparator cohort study, new users of tiotropium/olodaterol (n = 1436) and tiotropium monotherapy (n = 5352) were identified from a large Japanese hospital-based database (Medical Data Vision Co., Ltd., Tokyo; prespecified study period: 1 April 2015 to 31 March 2019); patients in each group were matched 1:1 using high-dimensional propensity scores (hdPS). The primary outcome was time-to-escalation to triple therapy.

Results
For the prespecified study period in the hdPS-matched cohort, escalation to triple therapy was infrequent among new users of tiotropium/olodaterol (n = 1302, 7 escalation events) and tiotropium monotherapy (n = 1302, 8 escalation events). The difference in time-to-escalation to triple therapy between groups was not statistically significant (median [interquartile range]: 28 days [15.0–139.2] for tiotropium monotherapy vs 193 days [94.5–302.0] for tiotropium/olodaterol; hazard ratio: 0.89; 95% CI: 0.32–2.46). Similar findings (hazard ratio: 0.71; 95% Cl: 0.36–1.40) were observed in a post hoc analysis, which extended the study period by 1 year to 31 March 2020. Risks of first moderate and/or severe COPD exacerbation were lower for tiotropium/olodaterol than tiotropium monotherapy (between-group differences not significant). There were no significant between-group differences for the risks of all-cause inpatient mortality, major adverse cardiovascular events, and first use of home oxygen therapy.

Conclusions
ICS monotherapy or ICS/LABA added to tiotropium or tiotropium/olodaterol is limited in Japanese clinical settings. The number of escalations to triple therapy was very limited in the dataset and there was insufficient power to detect differences between the treatment groups in the primary hdPS-matched cohort.
LIQA: long-read isoform quantification and analysis
Authors: Hu Yu , Fang Li , Chen Xuelian , Zhong Jiang F. , Li Mingyao , Wang Kai 
Published: June 2021

AbstractLong-read RNA sequencing (RNA-seq) technologies can sequence full-length transcripts, facilitating the exploration of isoform-specific gene expression over short-read RNA-seq. We present LIQA to quantify isoform expression and detect differential alternative splicing (DAS) events using long-read direct mRNA sequencing or cDNA sequencing data. LIQA incorporates base pair quality score and isoform-specific read length information in a survival model to assign different weights across reads, and uses an expectation-maximization algorithm for parameter estimation. We apply LIQA to long-read RNA-seq data from the Universal Human Reference, acute myeloid leukemia, and esophageal squamous epithelial cells and demonstrate its high accuracy in profiling alternative splicing events.
Development of a digital learning program for physiotherapists to enhance clinical implementation of aerobic exercise in stroke rehabilitation
Authors: Thornton Marianne , Harris Jennifer , Breithaupt Krista , Dyks Tracey , Finestone Hillel , MacKay-Lyons Marilyn 
Published: June 2021

Abstract
Background
This paper describes the initial development process of an eLearning continuing professional education program primarily for post-licensure physiotherapists –“Electronic Aerobic Exercise Recommendations to Optimize Best Practices in Care after Stroke” (eAEROBICS). Our objective was to develop an evidence-based, clinically relevant, user-friendly eLearning program for online delivery tailored to facilitate prescription of aerobic exercise post-stroke by physiotherapists. The Demand Driven Learning Model guided curriculum design, delivery, and evaluation. Based on previously identified gaps in physiotherapists’ knowledge of aerobic exercise, four learning modules were developed and delivered using an eLearning platform to maximize cost-effectiveness and flexibility. Five physiotherapists volunteered to pilot eAEROBICS, providing preliminary feedback on strengths and suggestions for improvement.

Results
Theoretical information and clinical applications addressed the learning objectives of each module in a logical manner. All technical or administrative issues encountered during program delivery were addressed. The feedback from the pilot end-users informed modifications to the eAEROBICS program.

Conclusions
Processes used in developing eAEROBICS have the potential to serve as a model of electronic continuing professional education for other areas of physiotherapy practice. Further investigation of end-user perspectives and clinical impact of the program is warranted to determine the overall effectiveness of the program.