bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interventions to control nosocomial transmission of SARS-CoV-2: a modelling study
Authors: Pham Thi Mui , Tahir Hannan , van de Wijgert Janneke H. H. M. , Van der Roest Bastiaan R. , Ellerbroek Pauline , Bonten Marc J. M. , Bootsma Martin C. J. , Kretzschmar Mirjam E. 
Published: August 2021

Abstract
Background
Emergence of more transmissible SARS-CoV-2 variants requires more efficient control measures to limit nosocomial transmission and maintain healthcare capacities during pandemic waves. Yet the relative importance of different strategies is unknown.

Methods
We developed an agent-based model and compared the impact of personal protective equipment (PPE), screening of healthcare workers (HCWs), contact tracing of symptomatic HCWs and restricting HCWs from working in multiple units (HCW cohorting) on nosocomial SARS-CoV-2 transmission. The model was fit on hospital data from the first wave in the Netherlands (February until August 2020) and assumed that HCWs used 90% effective PPE in COVID-19 wards and self-isolated at home for 7 days immediately upon symptom onset. Intervention effects on the effective reproduction number (RE), HCW absenteeism and the proportion of infected individuals among tested individuals (positivity rate) were estimated for a more transmissible variant.

Results
Introduction of a variant with 56% higher transmissibility increased — all other variables kept constant — RE from 0.4 to 0.65 (+ 63%) and nosocomial transmissions by 303%, mainly because of more transmissions caused by pre-symptomatic patients and HCWs. Compared to baseline, PPE use in all hospital wards (assuming 90% effectiveness) reduced RE by 85% and absenteeism by 57%. Screening HCWs every 3 days with perfect test sensitivity reduced RE by 67%, yielding a maximum test positivity rate of 5%. Screening HCWs every 3 or 7 days assuming time-varying test sensitivities reduced RE by 9% and 3%, respectively. Contact tracing reduced RE by at least 32% and achieved higher test positivity rates than screening interventions. HCW cohorting reduced RE by 5%. Sensitivity analyses show that our findings do not change significantly for 70% PPE effectiveness. For low PPE effectiveness of 50%, PPE use in all wards is less effective than screening every 3 days with perfect sensitivity but still more effective than all other interventions.

Conclusions
In response to the emergence of more transmissible SARS-CoV-2 variants, PPE use in all hospital wards might still be most effective in preventing nosocomial transmission. Regular screening and contact tracing of HCWs are also effective interventions but critically depend on the sensitivity of the diagnostic test used.
DDX56 modulates post-transcriptional Wnt signaling through miRNAs and is associated with early recurrence in squamous cell lung carcinoma
Authors: Wu Qingqing , Luo Xiaoyang , Terp Mikkel G. , Li Qingrun , Li Yuan , Shen Lei , Chen Ying , Jacobsen Kirstine , Bivona Trever G. , Chen Haiquan , Zeng Rong , Ditzel Henrik J. 
Published: August 2021

Abstract
Background
Early recurrence is a major obstacle to prolonged postoperative survival in squamous cell lung carcinoma (SqCLC). The molecular mechanisms underlying early SqCLC recurrence remain unclear, and effective prognostic biomarkers for predicting early recurrence are needed.

Methods
We analyzed primary tumor samples of 20 SqCLC patients using quantitative proteomics to identify differentially-expressed proteins in patients who experienced early versus late disease recurrence. The expression and prognostic significance of DDX56 was evaluated using a SqCLC tumor tissue microarray and further verified using different online databases. We performed in vitro and in vivo experiments to obtain detailed molecular insight into the functional role of DDX56 in SqCLC.

Results
We found that DDX56 exhibited increased expression in tumors of patients who experienced early versus late disease recurrence. Increased DDX56 expression in SqCLC tumors was subsequently confirmed as an independent prognostic factor of poor recurrence-free survival in independent SqCLC cohorts. Functionally, DDX56 promotes SqCLC cell growth and migration in vitro, and xenograft tumor progression in vivo. Mechanistically, DDX56 post-transcriptionally promotes expression of multiple Wnt signaling pathway-related genes, including CTNNB1, WNT2B, and represses a subset of miRNAs, including miR-378a-3p, a known suppressor of Wnt signaling. Detailed analysis revealed that DDX56 facilitated degradation of primary miR-378a, leading to down-regulation of mature miR-378a-3p and thus derepression of the target gene WNT2B.

Conclusion
We identified DDX56 as a novel independent prognostic biomarker that exerts its oncogenic effects through miRNA-mediated post-transcriptional regulation of Wnt signaling genes to promote early SqCLC recurrence. DDX56 may assist in identifying SqCLC patients at increased risk of early recurrence and who could benefit from Wnt signaling-targeted therapies.
Return to work in patients with lumbar disc herniation undergoing fusion
Authors: Protzer Lauren A. , Glassman Steven D. , Mummaneni Praveen V. , Bydon Mohamad , Bisson Erica F. , Djurasovic Mladen , Carreon Leah Y. 
Published: August 2021

Abstract
Background
Lumbar disc herniation (LDH) is a common problem. When surgical treatment is required, the intervention is typically decompression without fusion. Successful return-to-work (RTW) is a standard expectation with these limited procedures. Occasionally, the size or location of the disc herniation suggests the need for fusion, but the inability to RTW is a significant concern in these cases. The purpose of this study is to determine if the addition of lumbar fusion, as compared to decompression alone, will substantially diminish RTW in patients with lumbar disc herniation.

Methods
This is a longitudinal cohort study using prospectively collected data from the Quality and Outcomes Database (QOD). Patients with LDH, eligible to RTW (not retired, a student, or on disability) with complete 12-month follow-up data, were identified. Standard demographic and surgical variables, patient-reported outcomes (PROs), and RTW status at 3 and 12 months were collected.

Results
Of the 5062 patients identified, 4560 (90%) had decompression alone and 502 (10%) had a concurrent fusion. Age and gender were similar in the two groups. The fusion group had worse back pain (NRS 6.52 vs. 5.96) and less leg pain (6.31 vs. 7.01) at baseline compared to the no fusion group. Statistically significant improvement in all PROs was seen in both groups. RTW at 3 months post-op was seen in 85% of decompression cases and 66% of cases with supplemental fusion. At 12 months post-op, RTW increased to 93% and 82%, respectively.

Conclusion
The need for fusion in LDH cases is unusual, seen in only 10% of cases in this series. The addition of fusion decreased the RTW rate from 85 to 66% at 3 months and from 93 to 82% at 12 months post-op. While the difference is significant, the ultimate deterioration in RTW may be less than anticipated. A reasonable RTW rate can still be expected in the rare patient who requires fusion as part of their treatment for LDH.
Factors affecting the outcome of lower extremity osteomyelitis treated with microvascular free flaps: an analysis of 65 patients
Authors: Thai Duy Quang , Jung Yeon Kyo , Hahn Hyung Min , Lee Il Jae 
Published: August 2021

Abstract
Background
Free flaps have been a useful modality in the management of lower extremity osteomyelitis particularly in limb salvage. This study aimed to determine the factors affecting the outcome of free flap reconstruction in the treatment of osteomyelitis.

Methods
This retrospective study assessed 65 osteomyelitis patients treated with free flap transfer from 2015 to 2020. The treatment outcomes were evaluated in terms of the flap survival rate, recurrence rate of osteomyelitis, and amputation rate. The correlation between outcomes and comorbidities, causes of osteomyelitis, and treatment modalities was analyzed. The following factors were considered: smoking, peripheral artery occlusive disease, renal disease, diabetic foot ulcer, flap types, using antibiotic beads, and negative pressure wound therapy.

Result
Among the 65 patients, 21 had a severe peripheral arterial occlusive disease. Osteomyelitis developed from diabetic foot ulcers in 28 patients. Total flap failure was noted in six patients, and osteomyelitis recurrence was noted in eight patients, for which two patients underwent amputation surgery during the follow-up period. Only end-stage renal disease had a significant correlation with the recurrence rate (odds ratio = 16.5, p = 0.011). There was no significant relationship between outcomes and the other factors.

Conclusion
This study showed that free flaps could be safely used for the treatment of osteomyelitis in patients with comorbidities and those who had osteomyelitis developing from diabetic foot ulcers. However, care should be taken in patients diagnosed with end-stage renal disease.
Tracheostomy for COVID-19: evolving best practice
Authors: Williams Thomas , McGrath Brendan A. 
Published: August 2021

AbstractThis article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2021. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2021. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://link.springer.com/bookseries/8901.
To prone or not to prone ARDS patients on ECMO
Authors: Roca Oriol , Pacheco Andrés , García-de-Acilu Marina 
Published: August 2021

AbstractThis article is one of ten reviews selected from the Annual Update in Intensive Care and Emergency Medicine 2021. Other selected articles can be found online at https://www.biomedcentral.com/collections/annualupdate2021. Further information about the Annual Update in Intensive Care and Emergency Medicine is available from https://link.springer.com/bookseries/8901.
Spindle cell squamous cell carcinoma exhibiting prominent neutrophil phagocytosis: a case report
Authors: Yamazaki Manabu , Maruyama Satoshi , Abé Tatsuya , Sumita Yoshimasa , Katsumi Yuji , Nikkuni Yutaka , Hayashi Takafumi , Tanuma Jun-ichi 
Published: August 2021

Abstract
Background
Spindle cell squamous cell carcinoma is an uncommon variant of squamous cell carcinoma; its diagnosis is sometimes challenging because it histopathologically resembles neoplastic or reactive spindle cell lesions of mesenchymal origins. Here, we report a rare case of spindle cell squamous cell carcinoma exhibiting prominent neutrophil phagocytosis.

Case presentation
A 69-year-old Japanese man presented with pain and a polypoid mass on the lower left gingiva. He had received chemoradiotherapy for squamous cell carcinoma of the buccal mucosa 15 years prior to this consultation. In addition, he was treated for mandibular osteonecrosis 6 years after chemoradiotherapy without evidence of cancer recurrence. A biopsy revealed atypical spindle or pleomorphic cells scattered in the edematous and fibrin-rich stroma; however, no malignant squamous components were apparent. These atypical cells frequently contained neutrophils within their cytoplasm that formed cell-in-cell figures. Immunohistochemically, the atypical cells were negative for cytokeratins, epithelial membrane antigen, and E-cadherin, but positive for p63, vimentin, and p53. Although these findings suggested spindle cell squamous cell carcinoma, it was difficult to reach a definitive diagnosis. Based on a clinical diagnosis of a malignant tumor, the patient underwent a hemimandibulectomy. The surgically resected specimen had a typical spindle cell squamous cell carcinoma histology consisting of biphasic spindle cells and conventional squamous cell carcinoma components. Moreover, the surgical specimen also exhibited spindle tumor cells that frequently included neutrophils, around which intense staining for lysosomal-associated membrane protein 1 and cathepsin B was observed. This suggested that the cell-in-cell figures represent active neutrophil phagocytosis by tumor cells, and not emperipolesis.

Conclusion
The presence of neutrophil phagocytosis may be a potent indicator of malignancy.
A new competency ontology for learning environments personalization
Authors: Paquette Gilbert , Marino Olga , Bejaoui Rim 
Published: August 2021

AbstractCompetency is a central concept for human resource management, training and education. We define a competency as the capacity of a person to display a generic skill with a certain level of performance when applied to one or more knowledge entities. Competencies, and competency referentials grouping competencies, are essential elements for user models, e-Portfolios, adaptive learning, and personalization in Technology-based learning. But to be processed both by humans and by software tools, competencies should be represented in a formal, non-ambiguous model called an ontology. Moreover, this model should use a shared vocabulary to describe the generic skills and the knowledge entities. Defining and linking shared vocabularies is the purpose of ontologies in the semantic web. The goal of our research is to develop a competency ontology for the semantic web to be used as a shared referential in the description of competencies and competency profiles. We analysed five previous competency models and developed COMP2, a new competency ontology that integrates important elements of previous models and the richness of the semantic web vocabulary. COMP2 provides processing capabilities both to humans and computers. Its graphic model is highly readable by humans for design, evaluation and communication purposes. It also translates, together with its data sets, to standard semantic Web code for machine processing. The ontology is composed of five stages that are interlinked with other ontologies in use within the web of linked open data. We will present an example for the use of the ontology for competency-based personalization in learning environments.
Validation of the Mathematics Motivation Questionnaire (MMQ) for secondary school students
Authors: Fiorella Logan , Yoon So Yoon , Atit Kinnari , Power Jason R. , Panther Grace , Sorby Sheryl , Uttal David H. , Veurink Norma 
Published: August 2021

Abstract
Background
Motivation is critical for supporting persistence and achievement in science, technology, engineering, and mathematics (STEM) disciplines. In this study, we focus on the assessment of mathematics motivation among secondary school students. We provide validity and reliability evidence for the Mathematics Motivation Questionnaire (MMQ)—adapted from the Science Motivation Questionnaire designed for college students—using data from 2551 secondary students from seven states across the United States.

Results
Exploratory and confirmatory factor analyses confirmed five latent factors of the MMQ indicated by 19 items: intrinsic value, self-regulation, self-efficacy, utility value, and test anxiety. The nonlinear SEM reliability coefficients of the five constructs ranged from 0.76 to 0.91. To assess criterion validity, analyses using a subset of the data that included students’ mathematics standardized scores (n = 536) indicated that intrinsic value, self-regulation, and self-efficacy were significantly positively correlated with mathematics achievement, whereas test anxiety was significantly negatively correlated with mathematics achievement.

Conclusions
The MMQ provides a reliable, valid, and feasible measure of the specific factors underlying mathematics motivation among secondary students.
Methods of 3D printing models of pituitary tumors
Authors: Gillett Daniel , Bashari Waiel , Senanayake Russell , Marsden Daniel , Koulouri Olympia , MacFarlane James , van der Meulen Merel , Powlson Andrew S. , Mendichovszky Iosif A. , Cheow Heok , Bird Nick , Kolias Angelos , Mannion Richard , Gurnell Mark 
Published: August 2021

Abstract
Background
Pituitary adenomas can give rise to a variety of clinical disorders and surgery is often the primary treatment option. However, preoperative magnetic resonance imaging (MRI) does not always reliably identify the site of an adenoma. In this setting molecular (functional) imaging (e.g. 11C-methionine PET/CT) may help with tumor localisation, although interpretation of these 2D images can be challenging. 3D printing of anatomical models for other indications has been shown to aid surgical planning and improve patient understanding of the planned procedure. Here, we explore the potential utility of four types of 3D printing using PET/CT and co-registered MRI for visualising pituitary adenomas.

Methods
A 3D patient-specific model based on a challenging clinical case was created by segmenting the pituitary gland, pituitary adenoma, carotid arteries and bone using contemporary PET/CT and MR images. The 3D anatomical models were printed using VP, MEX, MJ and PBF 3D printing methods. Different anatomical structures were printed in color with the exception of the PBF anatomical model where a single color was used. The anatomical models were compared against the computer model to assess printing accuracy. Three groups of clinicians (endocrinologists, neurosurgeons and ENT surgeons) assessed the anatomical models for their potential clinical utility.

Results
All of the printing techniques produced anatomical models which were spatially accurate, with the commercial printing techniques (MJ and PBF) and the consumer printing techniques (VP and MEX) demonstrating comparable findings (all techniques had mean spatial differences from the computer model of < 0.6 mm). The MJ, VP and MEX printing techniques yielded multicolored anatomical models, which the clinicians unanimously agreed would be preferable to use when talking to a patient; in contrast, 50%, 40% and 0% of endocrinologists, neurosurgeons and ENT surgeons respectively would consider using the PBF model.

Conclusion
3D anatomical models of pituitary tumors were successfully created from PET/CT and MRI using four different 3D printing techniques. However, the expert reviewers unanimously preferred the multicolor prints. Importantly, the consumer printers performed comparably to the commercial MJ printing technique, opening the possibility that these methods can be adopted into routine clinical practice with only a modest investment.
The fishermen inhabiting the Xuande and Yongle Islands in Xisha Islands
Authors: Liu Li 
Published: August 2021

AbstractHainan Island fishermen have been engaged in fishing in Nanhai Zhudao (the Nanhai Islands) since ancient times. From sailing to the emergence of motorboats, the South China Sea fishermen have experienced different seafaring eras. Fishermen who work and live on the islands and reefs also have experienced living on islands seasonally to long-term. This article uses the inhabiting fishermen groups of the Xuande and Yongle Islands in Xisha Qundao (the Xisha Islands) as examples to demonstrate the unique livelihoods of the fishermen and reveal their role in the use of marine ecology to achieve sustainable development.
Multi-detector computed tomography in traumatic abdominal lesions: value and radiation control
Authors: Ahmed Hala Maher , Borg Mohamed , Saleem Abd El-Aal , Ragab Amira 
Published: August 2021

Abstract
Background, The context
A prospective study was conducted involving 81 patients (mean age, 20.79 years) with abdominal trauma who underwent ultrasonography and post-contrast CT on MDCT scanner. The total DLP for each patient was reviewed, and the effective dose was calculated. Purpose of the study to: explore the role of MDCT in assessing traumatic abdominal lesions, demonstrate radiation dose delivered by MDCT, and describe specific CT technical features to minimize radiation.

Results
The spleen was the most commonly injured organ (49.4%) followed by liver (39.5%) and kidney (24.7%). Pancreatic injury occurred in seven patients, whereas only two patients had intestinal injuries. One patient had adrenal injury. Minimal, mild and moderate free intra-peritoneal fluid collection was detected in 21 (25.9%), 47 (58%) and 10 (12.3%) patients, respectively. Only three (3.7%) patients had no collection. One patient had active uncontrolled bleeding and died. Radiation dose was below the detrimental level (calculated effective dose), with optimal image quality.

Conclusions
MDCT is sensitive to all types of traumatic abdominal lesions. Not only in determining the injury, but also in its grading. MDCT has affected the treatment directions, spotting a focus on conservative treatment by raising the diagnostic confidence.
FAST cannot be the sole imaging modality. The individual radiation risk is small but real. Advancements in medical imaging reduce radiation risk.
Effects of the first COVID-19 lockdown on quality and safety in mental healthcare transitions in England
Authors: Tyler Natasha , Daker-White Gavin , Grundy Andrew , Quinlivan Leah , Armitage Chris , Campbell Stephen , Panagioti Maria 
Published: August 2021

BackgroundThe COVID-19 pandemic forced the rapid implementation of changes to practice in mental health services, in particular transitions of care. Care transitions pose a particular threat to patient safety.AimsThis study aimed to understand the perspectives of different stakeholders about the impact of temporary changes in practice and policy of mental health transitions as a result of coronavirus disease 2019 (COVID-19) on perceived healthcare quality and safety.MethodThirty-four participants were interviewed about quality and safety in mental health transitions during May and June 2020 (the end of the first UK national lockdown). Semi-structured remote interviews were conducted to generate in-depth information pertaining to various stakeholders (patients, carers, healthcare professionals and key informants). Results were analysed thematically.ResultsThe qualitative data highlighted six overarching themes in relation to practice changes: (a) technology-enabled communication; (b) discharge planning and readiness; (c) community support and follow-up; (d) admissions; (e) adapting to new policy and guidelines; (f) health worker safety and well-being. The COVID-19 pandemic exacerbated some quality and safety concerns such as tensions between teams, reduced support in the community and increased threshold for admissions. Also, several improvement interventions previously recommended in the literature, were implemented locally.DiscussionThe practice of mental health transitions has transformed during the COVID-19 pandemic, affecting quality and safety. National policies concerning mental health transitions should concentrate on converting the mostly local and temporary positive changes into sustainable service quality improvements and applying systematic corrective policies to prevent exacerbations of previous quality and safety concerns.