bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding antimicrobial resistance from the perspective of public policy: a multinational knowledge, attitude, and practice survey to determine global awareness
Authors: Balleste-Delpierre Clara , Naing Soe Yu , Wijk Max van , Vila Jordi 
Published: July 2021

Abstract
Background

Minimizing the effect of antimicrobial resistance (AMR) requires an adequate policy response that relies on good governance and coordination. We have previously demonstrated a knowledge gap on infectious diseases within the general public, but equivalent data from a policy context are still lacking. The aim of this study is to have a better comprehension of how AMR is understood and perceived among policy makers and stakeholders in tackling AMR on a global level.
Methods

A digital survey was designed to capture the knowledge, attitude, and practices (KAP) towards AMR. A self-reporting questionnaire was distributed to politicians, policy advisors and relevant stakeholders, and survey responses were collected between November 2020 and March 2021.
Results

A total of 351 individuals participated in this study with 80% from high-income countries (HIC) and 20% from low- and middle-income countries (LMIC). Fifteen different countries were represented, and the majority of participants were from the Netherlands, Spain and Myanmar. Overall, participants had sufficient knowledge regarding AMR and reported the importance of political willingness in tackling AMR. More than half (65%) of participants from LMIC reported antibiotics misuse, and almost half (48%) claimed to be unaware of this health problem. Politicians and stakeholders from LMIC demonstrated a higher knowledge on AMR but showed poor perception and attitude toward antimicrobial use compared to those from HIC regions. HIC participants emphasized the role of the veterinary sector in particular, as well as the environmental dissemination of antibiotics and drug residues. The lack of funding resources was especially reported by participants from LMIC.
Conclusion

Inter-regional differences in KAP regarding AMR exist among politicians, policy advisors and relevant stakeholders. Overall, participants demonstrated to have a sufficient level of knowledge and awareness of AMR. This study characterizes a multi-national policymaker and stakeholder mapping that can be used to propose further policy implementation on various governance levels.
On the Dependency of GCM-based Regional Surface Climate Change Projections on Model Biases, Resolution and Climate Sensitivity
Authors: Giorgi Filippo , Raffaele Francesca 
Published: July 2021

Abstract
We investigate the dependency of projected regional changes in surface air temperature (SAT) and precipitation on the model biases, resolution and global temperature sensitivity in two global climate model (GCM) ensembles. End of 21st century changes under high end scenarios normalized in units of Per Degree of Global Warming (PDGW) are examined for CMIP5 (RCP8.5) and CMIP6 (SSP585) ensembles of comparable size over 26 sub-continental scale regions, for December-January-February (DJF) and June-July-August (JJA). We find that the average regional change patterns are very similar between the CMIP5 and CMIP6 ensembles, both for SAT and precipitation, with spatial correlations exceeding 0.84. Also similar are the regional bias patterns over most regions analyzed, suggesting that these two generations of models still share some common systematic errors. A statistically significant relationship between projected regional changes and biases is found in ~ 27% of regional cases for both SAT and precipitation; between regional changes and model resolution in 2% of cases for SAT and 12% of cases for precipitation; and between regional changes and global temperature sensitivity in 19% of cases for SAT and 14% of cases for precipitation. Therefore, we assess that the GCM resolution does not appear to be a significant factor in affecting the sub-continental scale projected changes, at least for the resolution range in the CMIP5 and CMIP6 models, while global temperature sensitivity and especially model biases play a more important role. These dependencies are not always consistent between the CMIP5 and CMIP6 ensembles. Overall, in our assessment the CMIP6 ensemble does not appear to provide substantially different, and presumably improved, regional surface climate change information compared to CMIP5 despite the use of more comprehensive models and somewhat higher resolution.
Epidemiological Profile and Detection of Resistance Genes in Bloodstream Infection in Cancer Patients: High Occurrence of Metallo-β-lactamases in Enterobacteriales
Authors: Soares Cynthia , Inácio Cicero Pinheiro , Silva Maria Jesuíta Bezerra , Leal Nilma Cintra , Xavier Danilo Elias , Magalhães Vera , Araújo Paulo Sérgio Ramos 
Published: July 2021

Abstract
Bloodstream infections remain one of the most common major complications in cancer patients. The aim of the study was to describe the etiology, phenotypic and molecular epidemiology of ICS isolates from cancer patients. Method: identification and the resistance profile were carried out using the automated biochemical method Vitek 2®. The presence and genes resistant to carbapenemases blaIMP, blaVIM, blaGIM, blaSIM, blaSPM, blaKPC, blaNDM, genes oxacilinase blaOXA-48, blaOXA-58, and the presence of ESBL genes blaSHV, blaCTX, blaTEM for Gram-negatives, as well as, mecA, vanA and vanB for Gram-positives were investigated in blood culture isolates. Result: Escherichia coli and Klebsiella pneumoniae were the most frequent pathogens. The serine-β-lactamase gene blaOXA-48 was the most frequent, followed by MβL blaSIM. blaTEM and blaCTX were the most common among ESBL. The mecA and vanA genes were found in Staphylococcus spp. and Enterococcus faecium, respectively. Candida spp showed high resistance to voriconazole and fluconazole. Conclusion: measures to prevent and control the spread of resistance genes are essential to reduce the risks of morbidity and mortality.
Low N use Efficiency in A Long-Term N-Fertilized Cunninghamia Lanceolata Plantation Ecosystem in Subtropical China: A 14-Year Case Study
Authors: shen fangfang , Liu Wenfei , Duan Honglang , Wu Chunsheng , Liao Yingchun , Wu Jianping , Yuan Yinghong , Fan Houbao 
Published: July 2021

Abstract
Background and aims

Forests host among the most important N pools of all terrestrial ecosystems. Influences of N application on forest N cycle have received increasing concern, which is particularly problematic given the increasing atmospheric N deposition in recent decades. However, accurate assessments of N storage and recovery rates in forest ecosystems remain elusive. We selected Chinese fir (Cunninghamia lanceolata (Lamb.) Hook) plantation ecosystem to explore how long-term N fertilization affected the N storage and recovery rate.
Methods

Plots in the field have been fertilized continuously for 14 years (2004–2017) with urea at rates of 0 (N0, control), 60 (N60, low-N), 120 (N120, medium-N) and 240 (N240, high-N) kg N hm− 2a− 1. Data collected in the field include N content and biomass on various plant organs (i.e., leaves, branches, stems, roots, and bark), understorey layer and litter in the ecosystem as well as soil N content and density at different depths (0–20, 20–40 and 40–60 cm).
Key results

The total N storage of ecosystem in the N-fertilized treatments was 1.1–1.4 times higher than that in the unfertilized treatment after 14 years of N fertilization. About 12.36% of the total ecosystem N was stored in vegetation (plant, litter, and understorey layer) and 87.64% was stored in soil (0–60 cm). N storage varied among ecosystem components and plant organs; and the plant organs, litter, and soil had higher N storage than that in understorey layer. Significantly higher Chinese fir N uptake was found in the medium-N (1.2 times) and high-N (1.4 times) treatments than that in the control. The N recovery rate of understorey layer in the N-fertilized treatments was negative, and less than that in the control.
Conclusions

Application of long-term N fertilizer to this stand led to a low N recovery rate (averagely 11.39%) while high loss of N (averagely 91.86%) which indicate low N use efficiency in the Chinese fir plantation ecosystem.
High Expression of Mitochondrial Autophagy-Related Gene FUNDC1 is Associated with Poor Prognosis of Colon Cancer and Defective Immune Cell Infiltration
Authors: Guo Yu , Shi Jian , Wang Shuang , Zhao Zeyun , Shang An , Li Donglin , Wang Min 
Published: July 2021

Abstract
Background: Mitochondrial dysfunction is related to the occurrence and development of many diseases. FUNDC1 has attracted attention as a receptor related to mitochondrial autophagy. Colorectal cancer is the fourth most commonly diagnosed cancer. This article uses bioinformatics analysis to study the relationship between FUNDC1 and immune cell infiltration and prognosis of colon cancer. Methods: The RNA sequencing data and detailed clinical prognostic information resources of 478 COAD samples in the TCGA database were included in the study. Two data sets (GSE37364, GSE110224) from the GEO database were selected for verification. Using Kaplan - Meier curves, univariate analysis and multivariate survival analysis to assess the relationship FUNDC1 level of expression and clinicopathological parameters and overall survival. The protein-protein interaction network of FUNDC1 was constructed by String and GeneMANIA databases. Screen the genes co-expressed with FUNDC1 in Oncomine and GEPIA. And use the TIMER database and GEPIA to explore the relationship between FUNDC1 and immune cell infiltration and surface markers. Results: FUNDC1 is obviously highly expressed in tumor samples and is related to the poor prognosis of patients. Univariate and multivariate analysis showed that FUNDC1 was related to advanced TNM staging. FUNDC1 mainly interacts with mitochondrial autophagy-related proteins. FUNDC1 is related to immune infiltration and mainly affects CD8+ T cells and macrophages. Conclusion: The research has proved that FUNDC1 is closely related to the infiltration of tumor microenvironment immune cells in COAD samples and to the poor prognosis of COAD patients, which may provide new treatment ideas and targets.
Prognostic Significance of Metastatic Lymph Node Ratio in Patients with Gastric Cancer After Curative Gastrectomy: A Large sample, Single center Retrospective Study
Authors: He Zhipeng , Li Dongchang , Liu Siyu , Song Endong , Lu Yida , Zhang Zhigong , Chen Ke 
Published: July 2021

Abstract
Background: The aim of this study was to examine the prognostic value of Metastatic lymph node ratio (MLNR) in patients with gastric cancer (GC) after curative gastrectomy and the potential for new indicators to strengthen the current guidelines.Methods:We retrospectively examined 3864 patients with GC who underwent curative gastrectomy between February 2011 and February 2016. Patients were classified into low-MLNR (L-MLNR), and high-MLNR (H-MLNR) groups according to adjusted X-tile cutoff-value of 0.25 for MLNR, and their clinicopathological characteristics and survival rates were compared.Results: Survival analysis indicated that MLNR was negatively associated with overall survival (OS) (P<0.001) and was an independent prognostic predictor in 3864 GC patients (P<0.001). Stratum analysis and univariate COX proportional hazards analysis were performed to validate the prognostic value of MLNR in various subgroups with clinicopathological characteristics (gender, age at surgery, tumor location, tumor size, type of gastrectomy, T stage, N stage, ELN, perineural invasion, vascular invasion, and TNM stage). MLNR is a prognostic indicator for patients with GC, regardless whether the number of lymph nodes examined is <16 or ≥16.Conclusions:The MLNR may become a new indicator for evaluating prognosis of patients with curative gastrectomy and complement the current guidelines.
Right Basal Ganglia Germinoma: Case Report and Literature Review
Authors: Tian Pu , Zhang Hongbo , Liang Yaqian , Bian Bingyang , Xu Shujia , Li Dan 
Published: July 2021

Abstract
Background: Among intracranial germinomas, germinoma of basal ganglia has been rarely reported. We discuss a new case of basal ganglia germinoma(BGG) and perform the literature review over the last two decades, with the aim of emphasizing the diagnosis and treatment in early-stage BGG.Case presentation: A seven years old Chinese boy presented with 4 months history of left limb movement disorder and oblique right mouth corner. The human chorionic gonadotropin(HCG) level in cerebrospinal fluid(CSF) was slightly increased. Magnetic resonance imaging(MRI) showed ipsilateral brain and brainstem atrophy. Susceptibility weighted imaging(SWI) revealed obvious hypointensity in right globus pallidus. Pathological diagnosis on biopsy was confirmed with germinoma. The patient had a favorable relief of symptoms after chemoradiotherapy.Conclusion: Intracranial germinoma, a potentially curable tumor, the early diagnosis is essential for the prognosis. An elevated HCG level of CSF or serum can be used as a reference indicator. MRI, especially SWI, plays an important role in early diagnosis. Patients should be treated with standardized chemoradiotherapy early rather than surgery.
Emotional Reactivity to Binge Food and Erotic Cues in Women With Bulimia Nervosa Symptoms
Authors: Hernández-Rivero Isabel , Blechert Jens , Miccoli Laura , Eichin Katharina Naomi , Fernández-Santaella M. Carmen , Rodríguez Rafael Delgado 
Published: July 2021

Abstract
Background: Studies on food cue reactivity have documented that altered responses to high-calorie food are associated with bulimic symptomatology, however, alterations in sexual motivations and behaviors are also associated clinical features for this population, which justify their inclusion as a research target. Here, we study responses to erotic cues – alongside neutral and aversive cues – to gain an understanding of specificity to food vs. a generalized sensitivity to primary reinforcers. Methods: We recorded peripheral psychophysiological indices –the startle reflex, zygomaticus, and corrugator responses– and self-reported emotional responses (valence, arousal, and dominance) in 75 women that were presented with the Spanish version of the Bulimia Test-Revised (BULIT-R). Multiple regression analysis tested whether BULIT-R symptoms were predicted by self-reported and psychophysiological responses to food vs. neutral and erotic vs. neutral images. Results: The results showed that individuals with higher bulimic symptoms were characterized by potentiated eye blink startle response during binge food (vs. neutral images) and more positive valence ratings during erotic (vs. neutral) cues. Conclusions: The results highlight the negative emotional reactivity of individuals with elevated bulimic symptoms toward food cues, which could be related to the risk of progression to full bulimia nervosa and thereby addressed in prevention efforts. Results also point to the potential role of reactivity to erotic content, at least on a subjective level. Theoretical models of eating disorders should widen their conceptual scope to consider reactivity to a broader spectrum of primary reinforcers, which would have implications for cue exposure-based treatments.
Marked Reductions in Pediatric Outpatient Antibiotic Prescribing in Portugal During the Pandemic
Authors: de Alarcão José Miguel Cunha , Gil Ana Teresa , Oliveiros Bárbara , Rodrigues Fernanda 
Published: July 2021

Abstract
The COVID-19 pandemic brought unexpected effects on healthcare systems access and usage. Some of the measures implemented by governments to try and contain it, such as confinement periods, social distancing, widespread use of masks and other hygiene practices led to unprecedented epidemiological changes in several common infectious diseases.We describe changes in antibiotic prescribing in pediatric outpatients before and during the pandemic in a dynamic population analysis context during a study period of three years in mainland Portugal.There was a marked reduction in antimicrobial prescribing in all regions, particularly in younger children and during the lockdown periods.This reduction was much sharper for those antimicrobials most commonly used to treat respiratory-tract infections, as Amoxicillin (with and without β-lactamase inhibitor) and Macrolides, and considerable less accentuated in other commonly prescribed antibiotics as Co-Trimoxazole and Fosfomycin, usually associated with the treatment of urinary tract infections.Conclusion: Our findings indicate that the COVID-19 pandemic has had profound effects on antibiotic use in ambulatory care in children in Portugal.Further monitoring is necessary to ascertain whether this reduction in antibiotic prescription will persist and whether these changes may impact antimicrobial resistance.
A Stepwise Laboratory Manual for the Dissection and Illustration of Major Limbic Structures. Evidence from the Klingler’s Technique.
Authors: Komaitis Spyridon , Kalamatianos Theodosis , Drosos Evangelos , Kalyvas Aristotelis , Piagkou Maria , Troupis Theodore , Mazarakis Nektarios , Stranjalis George , Koutsarnakis Christos 
Published: July 2021

Abstract
OBJECTIVE: To provide an educational, comprehensive, systematic and stepwise manual for the dissection and illustration of major limbic structures since there is a gap in the pertinent literature. Further, we aim to offer a thorough yet simplified roadmap for laboratory and intraoperative dissections.METHODS: Twenty (20) normal adult, formalin-fixed cerebral hemispheres were studied through the fiber dissection technique and under the microscope. Stepwise and in tandem medial to lateral and lateral to medial dissections were performed in all specimens aiming to reveal the morphology and spatial relationships of major limbic and paralimbic areas RESULTS: Twelve (12) consecutive, discrete and easily reproducible laboratory anatomical steps are systematically described to reveal the intricate anatomy of the structures of the limbic system.CONCLUSION: Surgical approaches for lesions or functional resections in and around limbic areas pose a challenging task for the neurosurgeon. By employing the fiber dissection technique, we were able to provide a stepwise and thorough laboratory guide for the gradual dissection and better comprehension of the morphology and spatial relationships of this specific system. Anatomical manuals like the present study raise interest and enrich anatomical knowledge on complex cerebral areas with the overarching goal to inform surgical practice.
Analysis of Clinical Characteristics and Prognosis of Patients With Stages I-III Colon Cancer Based on Seer Data
Authors: Zhao Fuqiang , Sun Ying , Ge Jie , Zheng Chunlei , Ning Kepeng , Zhao Jingying , Zhu Fangxu 
Published: July 2021

Abstract
Objective: This study analyzes the clinical features and prognosis of stages Ⅰ-Ⅲ colon cancer, and constructs a nomogram to predict the prognosis of patients. Methods: We included data from patients with stages Ⅰ-Ⅲ colon cancer confirmed by pathology after surgical treatment in the United States SEER (Surveillance, Epidemiology, and End Results) database from 2010-2015. The included patients are randomly divided into training cohorts and validation cohorts (ratio 1:1).The independent related factors of the prognosis of colon cancer patients were used to construct the nomogram and the web-based probability calculator.Concordance index (C-index) and calibration curve are used to evaluate the accuracy of the model. Results: After univariate and multivariate analysis, it was indicated that age, marital status, tumor grade, t-stage and n-stage were independent factors affecting prognosis of patients with stages Ⅰ-Ⅲ colon cancer. We built a nomogram and the web-based probability calculator based on this, and its C-index was 0.781 (95% CI: 0.77414–0.78786), and were superior to that of AJCC TNM Stage (C-index: 0.734, 95%CI: 0.72616–0.74184). The consistency test showed that the nomogram can effectively predict the prognosis of patients. The validation cohort confirms the reliability of the model. Conclusion: Age, marital status, tumor grade, t-stage and n-stage are independent factors affecting the prognosis of patients with stages Ⅰ-Ⅲ colon cancer. The nomogram we constructed in this way can better predict the prognosis of patients with stages Ⅰ-Ⅲ colon cancer.
Cancer-Secreted Exosomal HSPC111 Promotes Colorectal Cancer Liver Metastasis By Reprogramming Lipid Metabolism in Cancer-Associated Fibroblasts
Authors: Zhang Chong , Wang Xiang-Yu , Zhang Peng , He Tao-Chen , Han Jia-Hao , Zhang Rui , Lin Jing , Fan Jie , Lu Lu , Zhu Wen-Wei , Jia Hu-Liang , Zhang Ju-Bo , Chen Jin-Hong 
Published: July 2021

Abstract
Background: Metastasis and metabolic deregulation are two of the major hallmarks of cancer. Recent studies have revealed the critical driving role of metabolic reprogramming of tumor cells to promote colorectal cancer (CRC) metastasis. However, little is known about the metabolic alterations of cancer-associated fibroblasts (CAFs) in the pre-metastatic niche and how these changes facilitate CRC metastasis.Methods: Liquid chromatography-mass spectrometry (LC-MS) and Isobaric Tags for Relative and Absolute Quantitation (i-TRAQ) method were performed to identify the comparative metabolites and proteins expression in CAFs treated with exosomes derived from CRC cells, respectively. Tissue Microarray (TMA) was used to evaluate the level of HSPC111 in patient’s primary CRC tissues with or without liver metastasis. Co-immunoprecipitation (Co-IP), RNA-seq, chromatin immunoprecipitation (ChIP) migration and wound healing assay and immunofluorescence staining were employed to explore the expression regulation mechanism of exosomal HSPC111 in CAFs. Xenograft models were used to determine whether exosomal HSPC111 can remolding pre-metastatic niche of CAFs to promote CRC liver metastasis (CRLM) in vivo.Results: Here, we demonstrate that CRC cell-secreted exosomal HSPC111 induces a lipid metabolism reprogramming process in CAFs. Importantly, our results indicate that CRC patients with liver metastasis had significantly high level of HSPC111 in CRC tissues than CRC patients without liver metastasis. Mechanistically, HSPC111 upregulate the level of acetyl-CoA and histone acetylation by phosphorylating of ATP-citrate lyase (ACLY) in CAFs. This lipid metabolism reprogramming in CAFs facilitates CXCL5 secretion in vitro and pre-metastatic niche formation in the liver to promote CRLM in an exosomal HSPC111-dependent manner in vivo. In addition, conditioned medium (CM) from CAFs induce EMT of CRC cells by down-regulating E-cadherin levels and up-regulating Vimentin and Snail levels, which could be abolished by CXCL5-neutralizing antibody and CXCR2 inhibitor navarixin. Moreover, the HSPC111-ACLY association in CAFs was reinforced by CXCL5-CXCR2 axis, further promoting exosomal HSPC111 secretion from CRC cells to form a feedforward regulatory loop.Conclusion: Our present study reveals a novel insight into the pro-metastatic role of lipid metabolism reprogramming in CAFs and suggests the CXCL5-CXCR2 axis may be a promising target for halting CRLM.