bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinically contextualised ECG interpretation
Authors: Viljoen Charle André , Millar Rob Scott , Manning Kathryn , Hoevelmann Julian , Burch Vanessa Celeste 
Published: April 2021

Abstract
Background ECGs are often taught without clinical context. However, in the clinical setting, ECGs are rarely interpreted without knowing the clinical presentation.Methods We aimed to determine whether ECG diagnostic accuracy was influenced by knowledge of the clinical context and/or prior clinical exposure to the ECG diagnosis. Fourth- (junior) and sixth-year (senior) medical students as well as medical residents were invited to complete two multiple-choice question (MCQ) tests and a survey on the same day. Test 1 comprised 25 ECGs without case vignettes. Test 2, completed immediately after Test 1, comprised the same 25 ECGs and MCQs, but with case vignettes for each ECG. Subsequently, participants indicated in the survey when last, during prior clinical clerkships, they have seen each of the 25 conditions tested in Test 1 and 2.Results This study comprised 176 participants, of which 67 (38.1%) were junior students, 55 (31.3%) were senior students and 54 (30.7%) were medical residents. Prior ECG exposure depended on their level of training, i.e., junior students were exposed to 52% of the conditions tested, senior students 63.4% and residents 96.9%. Overall, all groups showed a marginal improvement in accuracy of ECG interpretation when the clinical context was known to them (Cohen’s d = 0.35, p < 0.001). The gains in accuracy were more pronounced amongst residents (Cohen’s d = 0.59, p < 0.001), than amongst senior (Cohen’s d = 0.38, p < 0.001) or junior students (Cohen’s d = 0.29, p < 0.001). All participants were more likely to make a correct ECG diagnosis if they reported having seen the condition during prior clinical training, whether they were provided with a case vignette (odds ratio [OR] 1.46, 95% confidence interval [CI] 1.24–1.71) or not (OR 1.58, 95% CI 1.35–1.84).Conclusion ECG interpretation using clinical vignettes devoid of real patient experiences does not appear to have as great an impact on ECG diagnostic accuracy as prior exposure during clinical training. However, exposure to ECGs during clinical training is largely opportunistic and haphazard. ECG training should therefore not rely on experiential learning alone for teaching electrocardiography, but instead be supplemented by other formal methods of instruction.
Feasibility and Efficacy of Text-Messaging to Promote Care Among Trauma Patients Screened for HIV at an Urban Tertiary Emergency Department in Tanzania
Authors: Hyuha Gimbo M , Sawe Hendry Robert , Kilindimo Said , Mussa Raya , Gulamhussein Masuma , Rwegoshora Shamila , Shayo Frida , Mdu Winnie , Mfinanga Juma , Weber Ellen J 
Published: April 2021

Abstract
BackgroundDue the high prevalence of Human Immune Virus (HIV), provider-initiated HIV testing for patients attending any health care setting is recommended. However, follow-up and linkage to care by those tested remains poor. We determined the feasibility and efficacy of text-messaging to promote follow-up among otherwise healthy trauma patients who underwent provider-initiated HIV testing and counseling at an Emergency Department (ED) in Tanzania. Material and methodsThis randomized controlled trial was conducted at Muhimbili National Hospital (MNH) ED between September 2019 to February 2020. Adult trauma patients consenting to HIV testing and follow-up text messaging were randomized to standard care (pre and post-test counseling) or standard care plus a series of 3 text-message reminders for follow-up in an HIV clinic, if positive, or retesting, if negative. Investigators blinded to study assignment called participants 2-months after the ED visit if HIV positive, or 4 months if HIV negative. We compared the proportion of people in the intervention and control groups completing recommended follow- up. Secondary outcomes were proportion accepting testing, agreeing to receive SMS and follow-up compliance by HIV status. ResultsOf 290 patients approached, 255 (87.9%) opted-in for testing and consented to the study. The median age of the study population was 29 [IQR 24-40] years. 127 (49.8%) were randomized to the intervention group and 128 (50.2%) to the control group. The short message service (SMS) system verified that 381 text messages in total were received. We traced 242 (94.9%) participants: 124 (51.2%) from intervention group and 118 (48.8%) controls. 100 (39.2%) subjects reported attending a follow-up visit, of which 77 (60.6%) were from the intervention group and 23 (17.9%) were controls. (RR = 3.4, 95%CI (2.3-5.0) resulting in number needed to treat (NNT) of 2.3. Of 246 HIV negative participants, 37% went for repeat-screening: 59% of those in the intervention group and 16% in the control group (RR= 3.7, P =<0.0001, NNT 2.3). Among 9 positive patients, all 5 in the intervention group and 3 of 4 controls had follow-up visits. ConclusionAutomated text message is a feasible and effective way to increase follow up in HIV tested individuals in a limited income country.
Targeting transforming growth factor-β2 by antisense oligodeoxynucleotide accelerates T cell-mediated tumor rejection in a humanized mouse model of triple-negative breast cancer
Authors: Lee Hong Kyu , Ji Hyeong-Jin , Shin Sang-Kyung , Koo Jihye , Kim Tae Hun , Kim Cho-Won , Seong Yeon Hee , Park Jun-Eui , Choi Kyung-Chul 
Published: April 2021

Abstract
Background: Transforming growth factor (TGF-β) pathway mediates suppression of anti-tumor immunity, and is associated with poor prognosis in triple-negative breast cancer (TNBC). Methods: In this study, we generated a humanized animal model by transplanting human peripheral blood mononuclear cells into immunodeficient mice followed by inoculation of MDA-MB-231 cells, and subsequently analyzed the role of TGF-β2 in the interaction between human T cells and human tumor cells. Results: Following reconstitution of the human immune system, inhibition of TGF-β signaling by TGF-β2 antisense oligodeoxynucleotide (TASO) resulted in accelerated tumor growth inhibition. TGF-β2 inhibition also resulted in downregulation of peripheral Foxp3+ regulatory T cells (Treg), whereas no effect was seen in the expression of CD8+ cytotoxic T cells. Analysis of the TASO-treated mice serum revealed elevated levels of human IFN-γ and reduced levels of human IL-10 and TGF-β2. Moreover, TGF-β2 inhibition resulted in increased CD8+ T cell infiltration, whereas the reduced infiltration of Tregs into the tumor partly resulted from decreased expression of CCL22. Decreased intra-tumoral Tregs facilitated the activation of cytotoxic T cells, associated with increased granzyme B expression. Conclusion: These results indicate that TASO potentiated T-cell mediated antitumor immunity, and it is proposed that TGF-β2 may be a promising target in the immunotherapeutic strategy of TNBC.
Resonant Interaction Of Relativistic Electrons with Realistic Electromagnetic Ion-Cyclotron Wave Packets
Authors: Grach Veronika , Demekhov Andrei , Larchenko Alexey 
Published: April 2021

Abstract
We study the influence of real structure of electromagnetic ion-cyclotron wave packets in the Earth’s radiation belts on precipitation of relativistic electrons. Automatic algorithm is used to distinguish isolated elements (wave packets) and obtain their amplitude and frequency profiles from satellite observations by Van Allen Probe B. We focus on rising-tone EMIC wave packets in the proton band, with a maximum amplitude of 1.2-1.6 nT.
The resonant interaction of the considered wave packets with relativistic electrons 1.5-9 MeV is studied by numerical simulations. The precipitating fluxes are formed as a result of both linear and nonlinear interaction; for energies 2-5 MeV precipitating fluxes are close to the strong diffusion limit. The evolution of precipitating fluxes is influenced by generation of higher-frequency waves at the packet trailing edge near the equator and dissipation of lower-frequency waves in the He+ cyclotron resonance region at the leading edge. The wave packet amplitude modulation leads to a significant change of precipitated particles energy spectrum during short intervals of less than 1 minute.
For short time intervals about 10-15 s, the approximation of each local amplitude maximum of the wave packet by a Gaussian amplitude profile and a linear frequency drift gives a satisfactory description of the resonant interaction.
Exotic Brittle Star Interactions With Native Octocoral Epizoites: An Endemic Benthic Ctenophore in Peril?
Authors: Glynn Peter , Coffman Brian , Detloff Kyle , Dominguez Joshua , Gilette Philip , Martinez Nicholas , Jones Nicolas , Riegl B. 
Published: April 2021

Abstract
Widespread and large populations of the exotic eastern Pacific ophiuroid brittle star Opthiothela mirabilis now occur in southeastern Florida, extending the range of this recently introduced species from southern Brazil northward to the eastern Caribbean Sea and Florida. The Florida brittle stars, representing two lineages, are epibionts on shallow (3-18 m depth), tropical/subtropical plexaurid (e.g., Eunicea spp., Muricea elongata) and gorgoniid (Antillogorgia spp.) octocorals. The scope of this study includes recent distributional records of O. mirabilis in south Florida, field abundances in relation to the cohabiting endemic ctenophore Coeloplana waltoni, behavioral observations of the ophiuroid, ctenophore and the predatory amphipod Caprella penantis, as well as a laboratory experiment testing the effects of the alien ophiuroid on the native ctenophore. Individuals of O. mirabilis have been collected near St. Lucie Inlet, extending its northern-most range by about 110 km since 2019. Two years of field sampling have demonstrated significant declines of the native, benthic ctenophore with increasing abundances of the exotic ophiuroid. Evidence suggests that the ophiuroid is negatively affecting the abundances of the ctenophore through interference competition, greatly aided by its abrasive armature of calcareous spines, plates and hooks. Sporadic and intense predation by a caprellid amphipod (Caprella penantis) also probably contributes to the ctenophore’s decline, but to a lesser extent than that caused by the ophiuroid. Adding to the risk of extinction of C. waltoni is its narrow requirement of living octocorals as hosts and restricted distribution in southeast Florida and the Bahamas.
Peste Des Petits Ruminants: A First Retrospective Investigation Among Susceptible Animal Species in Qatar
Authors: Haroun Mohamed , Abdulla Nawal M. , Habeb Mohammed , Farag Elmoubasher A. 
Published: April 2021

Abstract
A retrospective study was conducted to investigate the prevalence of peste des petits ruminants (PPR) in Qatar. Three hundred sixty-eight blood, swabs, and organ tissue samples collected between 2009 and 2016 were screened for PPR viral antibodies, antigens and nucleic acids using ELISA-Ab, ELISA-Ag and rRT-PCR, respectively. Fifteen PPR positive samples were subjected to virus isolation using Vero cell lines. 52% (n=192) of the samples were shown positive for PPR reporting first time infection of 52% (n=71) animal species including sheep, goat, deer, gazelle, addax, Oryx, blackbuck, deer, springbuck and waterbuck. Eight PPR virus (PPRV) field isolates demonstrated classical PPRV cytopathic effect (CPE) and shown positive for the virus antigens proving finally virus isolation. Sheep had the highest infection rate (55%) followed by wild ruminants (54%) and goats (47%). History wise, PPR might exist in Qatar before 2009. A systematic investigation is recommended to identify the risk factors associated with exposure of the susceptible animals to PPR infection, to test the susceptibility of the different species to PPR infection, and to describe the molecular entity and the replicative potentiality of the circulating field strains.
Estimation of Rainfall Threshold for Flood Warning for Small Urban Watersheds Based on the 1D-2D Drainage Model Simulation
Authors: Dao Duc Anh , Kim Dongkyun , Tran Dang Hai Ha 
Published: April 2021

Abstract
This study proposed an equation for Rainfall Threshold for Flood Warning (RTFW) for small urban watersheds based on computer simulations. First, a coupled 1D-2D dual-drainage model was developed for nine watersheds in Seoul, Korea. Next, the model simulation was repeated for a total of 540 combinations of the synthetic rainfall events and watershed imperviousness (9 watersheds x 4 NRCS Curve Number (CN) values x 15 rainfall events). Then, the results of the 101 simulations that caused the critical flooded depth (0.25m-0.35m) were used to develop the equation that relates the value of RTFW to the rainfall event temporal variability (represented as coefficient of variation or CV) and the watershed Curve Number. The results suggest that (1) RTFW exponentially decreases as the rainfall CV increases; (2) RTFW linearly decreases as the watershed CV increases; and that (3) RTFW is dominated by CV when the rainfall has low temporal variability (e.g., CV<0.2) while RTFW is dominated by CN when the rainfall has high temporal variability (e.g., CV>0.4). For validation, the proposed equation was applied for the flood warning system with two storm events occurred in 2010 and 2011 over 239 watersheds in Seoul. The system showed the the hit, false and missed alarm rates at 69% (48%), 31% (52%) and 6.7% (4.5%), respectively for the 2010 (2011) event.
Comparative Analysis of The Characteristics of The Chinese gCJD Patients With E196A and E196K Mutation in PRNP
Authors: Shi Qi , Xiao Kang , Chen Cao , Zhou Wei , Gao Li-Ping , Wu Yue-Zhang , Wang Yuan , Hu Chao , Gao Chen , Dong Xiao-Ping 
Published: April 2021

Abstract
Background: Genetic human prion diseases are a group of inherited encephalopathies caused by the different mutations in PrP-encoding gene PRNP. The clinical, neuropathological and laboratory features may differ largely according to the mutants at the different positions and with different amino acid. Here, we comparatively analyzed the features of 16 Chinese patients with E196A mutant and 5 patients with E196K mutant identified via Chinese National CJD Surveillance System (CNS-CJD). All genetic Creutzfeldt-Jacob disease (gCJD) with the mutations at codon 196 were Han-Chinese without blood kinship. Methods: Neurological examination, EEG and MRI test, western blot, gene sequence and RT-QuIC.Results: The onset-age of E196K gCJD cases (median of 61 y) was older than that of E196A ones (median of 67 y). Generally, these two subtypes of gCJD were more like sporadic CJD (sCJD) in clinical. The cases with E196A mutant showed more foremost symptoms, while those of E196K mutant restricted to dementia and mental problems. During the progression, more sCJD-associated symptoms and signs gradually appeared, but none of E196K cases showed cerebellum and visual disturbances. Typical PSWC on MRI was recorded in 20% E196A cases but not in all E196K cases. sCJD-associated abnormalities on MRI, positive CSF 14-3-3 and increased CSF total tau were observed frequently, ranging from 2/3 to 4/5 cases without difference between E196A and E196K cases. Family history was not reported in all cases. Positive of CSF RT-QuIC was detected in 37.5% (6/16) E196A cases and 60% (3/5) E196K cases. The duration of E196K cases (median of 4.5 m, from 2 to 5 m) were shorter than that of E196A cases (median of 6.5 m, from 2 to 28 m). Moreover, the female cases and the cases with young onset-age (<60 y) of E196A cases displayed much longer survival times than the male patients and the cases with older onset-age (>60 y).Conclusion: E196A gCJD is now the 5th most frequently observed genetic prion diseases in China. This is the largest comprehensive report of gCJD with the mutations at codon of 196 by now, which showing obvious diversity in clinical and laboratory tests between E196A and E196K mutants. Substitution of different amino acids at the same position induce the different clinical phenotype.
The Pitfalls and Strategies of Endoscopic Localization in Laparoscopic Colectomy: A Case Report
Authors: Wang Wei , Tao Feng , Lv Jieqing 
Published: April 2021

Abstract
Background: laparoscopic segmental colectomy is suitable for removing difficult polyps that are large, broad-based, or located in tortuous bowel segments. As we know, accurate segmental resection depends on precise localization. So far, intraoperative labeling of lesions by colonoscopy is increasingly performed for achieving appropriate resection margins, but a certain deviation is also found. There is no unified and standard endoscopic polyp localization method at present.Case presentation: A 63-year-old woman was admitted because she was diagnosed as a large and broad-based colonic polyp which was unsuitable for colonoscopic polypectomy. During endoscopy-assisted laparoscopic segmental colectomy, the irradiation angle of colonoscopy light on the polyp head was responsible for the localization errors. We proposed three-step measures of correct endoscopic polyp localization to ensure the accurate resection in laparoscopic segmental colectomy.Conclusions: Three-step measures of correct endoscopic polyp localization ensured the successful resection of colonic polyps in laparoscopic colectomy. Their advantages include simplicity, practicality and reliable localization.
Alternatively Spliced ANLN Isoforms Synergistically Contribute To The Progression of Head and Neck Squamous Cell Carcinoma
Authors: Guo Erliang , Mao Xionghui , Guo Lunhua , An Changming , Zhang Cong , Song Kaibin , Wang Guohui , Duan Chunbin , Zhang Xiwei , Yang Xianguang , Yuan Zhennan , Sun Ji , Li Xiaomei , Yang Weiwei , Meng Hongxue , Miao Susheng 
Published: April 2021

Abstract
Background: Head and neck squamous cell carcinoma (HNSCC) is a common cancer with high mortality. Anilin actin binding protein (ANLN) has been reported to be associated with carcinogenesis in multiple tumors. However, the expression pattern and functional effects of ANLN in HNSCC remains to be unclear.Methods: Expression of two major splice variants of ANLN was assessed in HNSCC tissues and cell lines. The functional effects and related mechanisms of ANLN isoforms were investigated in HNSCC in vitro and in vivo.Results: Our results showed that the two primary isoforms of ANLN transcripts ANLN-201 and ANLN-210 were highly expressed in HNSCC tissues and cell lines. Knockout of ANLN restrained cell proliferation, migration and invasion of SCC-9 cells. Mechanically, ANLN-201 could interact with c-Myc to keep its protein stability, thereby playing a oncogenic role in HNSCC. ANLN-210 could be transferred to macrophages via exosomes by binding to RNA binding protein hnRNPC. Exosomal ANLN-210 promoted macrophage polarization via PTEN/PI3K/Akt signaling pathway, thus stimulating tumor growth of HNSCC.Conclusions: Our findings demonstrate that alternatively spliced ANLN isoforms collaboratively promote HNSCC tumorigenesis in vitro and in vivo, which might provide the in-depth role and mechanism of ANLN in HNSCC development.
Left Renal Vein Thrombus and Pulmonary Thromboembolism Caused by Nutcracker Syndrome: a Case Report
Authors: Hori Kanta , Yamamoto Shota , Kosukegawa Maki , Yamashita Noboru , Shinno Yuichiro 
Published: April 2021

Abstract
Background: Nutcracker syndrome (NCS) refers to compression of the left renal vein (LRV) between the aorta and superior mesenteric artery (SMA), which results in renal venous hypertension and its resultant clinical manifestations. Left renal vein thrombus (LRVT) complicating NCS is relatively rare. To the best of our knowledge, there are only four case reports of LRVT complicating NCS. Furthermore, there are no reports of pulmonary thromboembolism (PTE) caused by NCS. Herein, we describe a rare case of NCS causing LRVT and PTE and its clinical management. Case Presentation: A 40-year-old man was admitted to our hospital with acute left flank pain. Computed tomography angiography (CTA) revealed compression of the LRV between the aorta and the SMA with an LRVT. Furthermore, CTA revealed bilateral PTE. Rivaroxaban was administered as an anticoagulant. Twenty days after initiation, CTA revealed complete resolution of PTE and LRVT, and repeat CTA at 3 and 6 months showed no recurrence. Conclusions: This case report demonstrates that NSC may be a possible cause of LRVT and PTE. We review the reported cases of NCS complicated by LRVT and discuss the imaging modalities for NCS.
Impact of Recurrent Urinary Infections on the Quality of Life of Women in Outpatient Care: a Case-control Study
Authors: Lourenção Luciano Garcia , Oliveira Jacqueline Flores de , Eduardo José Carlos Carraro , Homem Giovani Machado , Faria Carlos Augusto 
Published: April 2021

Abstract
Background: The repetitive urinary tract infections impact women's quality of life and represent an important problem for women's physical and mental health, causing relevant social impacts. This study aimed to evaluate the impact of recurrent urinary tract infections on the quality of life of women with recurrent infections.Methods: This is a case-control study with 49 women with recurrent urinary tract infections, confirmed by urine culture, without complications and 49 women without recurrent urinary tract infections, seen at an outpatient clinic of a public teaching hospital in the city of Niterói, Rio de Janeiro, Brazil. Quality of life was evaluated using the Brazilian version of the World Health Organization's shortened questionnaire, the WHOQOL-Bref.Results: Women with urinary tract infections showed greater impairment of quality of life in the physical (p = 0.007) and psychological (p = 0.038) domains, with lower quality of life score in their self-assessment (p = 0.002), when compared to the group control. Women with recurrent urinary infection had mean scores significantly lower than the control group in the Energy and fatigue (p = 0.003), Positive feelings (p = 0.014), Self-esteem (p = 0.040), Dependence on medication (p = 0.029), Negative feelings (p = 0.023) and Recreation and leisure (p = 0, 0.041).Conclusions: Recurrent urinary tract infections have an important impact on the quality of life of women, especially in the Physical and Psychological domains, representing a significant problem for women, health professionals, and the health system.
Studying the Effect of Alpha-Synuclein and Parkinson's Disease Linked Mutants on Inter Pathway Connectivities
Authors: Sen Sagnik , Dey Ashmita , Maulik Ujjwal 
Published: April 2021

Abstract
Parkinson's Disease is a common neurodegenerative disease. The differential expression of alpha-synuclein within Lewy Bodies leads to this disease. Some missense mutations of alpha-synuclein may resultant in functional aberrations. In this study, our objective is to verify the functional adaptation due to early and late-onset mutation which can trigger or control the rate of alpha-synuclein aggregation. In this regard, we have proposed a computational model to study the difference and/or similarities among the Wild type alpha-synuclein and two mutations G51D and E46K which are responsible for slow and fast aggregation respectively. Evolutionary sequence space analysis is also performed in this experiment. Subsequently, a comparative study has been performed between structural information and sequence space outcomes. The study shows the structural variability among the selected subtypes. This information assists inter pathway modeling due to mutational aberrations. Based on the structural variability, we have identified the protein-protein interaction partners for each protein that helps to increase the robustness of the inter-pathway connectivity. As per the inter-pathway networks, drug addiction has clear impacts on both the mutations i.e., G51D-slow, and E46K-fast and can be considered as the reason for early-onset Parkinson’s Disease. Finally, three top pathways associated with drug addiction viz., Amphetamine addiction, alcoholism, and Cocaine addiction show the higher influence in the mutated pathway networks based on the PageRank Algorithm where Dopaminergic Synapse system is also found within the same list in terms of Parkinson’s Disease pathogenicity.