bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of Continuous Positive Airway Pressure (CPAP) in Delaying or Avoiding Mechanical Ventilation in COVID-19 Respiratory Failure: A Retrospective Cohort Study
Authors: Cameron Allan , Fattah Sharif , Knox Laura , Grose Pauline 
Published: August 2021

Abstract
Background - During the winter of 2020-2021, the second wave of the COVID19 pandemic in the United Kingdom caused increased demand for intensive care unit (ICU) beds, and in particular, for invasive mechanical ventilation (IMV). To alleviate some of this pressure, some centres offered non-invasive continuous positive airway pressure (CPAP), delivered on specialised COVID high dependency units (cHDUs). However, this practice was based largely on anecdotal reports, and it is not clear from the literature how effective CPAP is at delaying or preventing IMV. Methods - This was a retrospective observational cohort study of consecutive patients admitted to a specialised cHDU at Glasgow Royal Infirmary between November 2020 and February 2021. Each patient had a continuous record of the level of respiratory support required, and was followed up to hospital discharge or death. We examined patient outcomes according to age, sex and maximum level of respiratory support, using logistic regression and time-to-event analysis. The number of patients who could not be oxygenated by standard oxygen facemask but could be oxygenated by CPAP was counted and compared to the number of patients admitted to ICU for IMV over the same period.Results - There were 152 admissions to cHDU over the study period. Of these, 125 received CPAP treatment. Of the patients who received support in cHDU, the overall mortality rate was 37.9% (95% CI 30.3% - 46.1%)). Odds of mortality were closely correlated with increasing age and oxygen requirement. Of the 152 patients, 44 patients (28.8%, 95% CI 22.0 – 36.9%) went on to require IMV in ICU. This represents 77.2% of the 57 COVID-19 admissions to ICU during the same period. However, there were also 41 patients who received levels of respiratory support on cHDU which would normally necessitate ICU admission but who never went to ICU, potentially reducing ICU admissions by 41.8% (95% CI 32.1 – 52.2%).Conclusion - Providing respiratory support in cHDU reduced the number of potential ICU admissions by 41.8%, as well as delaying IMV for over 75% of ICU admissions. This represents a significant sparing of ICU capacity at a time when IMV beds were in high demand.
Neutrophil Percentage to Albumin Ratio Was Associated with Clinical Outcomes in Coronary Care Unit Patients
Authors: Cai Chenghui , Sun Tienan , Zhao Fang , Ma Jun , Pei Xin , He Chen , Che Hao , Zhao Liyun 
Published: August 2021

Abstract
Background: Neutrophil percentage to albumin ratio (NPAR) was proved to be correlated with the prognosis of a variety of diseases. The purpose of this study was to explore the effect of NPAR on the prognosis of coronary care unit (CCU) dpatients.Method: All data of this study was extracted from Medical Information Mart for Intensive Care III (MIMIC-III, version1.4) database. All patients were divided into four groups according to NPAR quartiles. Primary outcome was in-hospital mortality and secondary outcomes were 30-day mortality, 365-day mortality, length of CCU stay, length of hospital stay, acute kidney injury, renal replacement therapy. Multivariable binary logistic regression analysis was performed to confirm the independent effect of NPAR. Subgroup analysis was used to determine the effect of NPAR on in-hospital mortality in different subgroups. Receiver-operating characteristic (ROC) curves were applied to evaluate the ability of NPAR to predict in-hospital mortality. Kaplan–Meier curves were built to compare cumulative survival of different groups.Result: 2364 CCU patients were enrolled in this study. In-hospital mortality rate increased significantly as NPAR quartiles increased (P < 0.001). In multivariable logistic regression, NPAR was proved to be independently associated with in-hospital mortality (Quartile 4 vs Quartile 1: OR, 95% CI: 1.80, 1.19-2.72, P=0.005, P for trend = 0.001). Moderate ability of NPAR to predict in-hospital mortality was demonstrated through ROC curves, the AUC of NPAR was 0.653 (P<0.001), which is better than PLR (P<0.001), neutrophil (P<0.001) but lower than SOFA(P=0.046) and SAPS II (P<0.001). Subgroup analysis did not find obvious interaction in most subgroups. Moreover, Kaplan-Meier curves showed that as NPAR quartiles increased, 30-day (Log rank, P<0.001) and 365-day (Log rank, P<0.001) cumulative survival decreased significantly. NPAR was also proved to be independently associated with acute kidney injury (Quartile 4 vs Quartile 1: OR, 95% CI: 1.57, 1.19-2.07, P=0.002, P for trend = 0.001). Length of CCU and hospital stay were prolonged significantly in higher NPAR quartiles.Conclusion: NPAR was an independent risk factor of in-hospital mortality in CCU patients and had a moderate ability to predict in-hospital mortality.
Climate Change will Increase Ozone Levels and Unravel Air Quality Regulations
Authors: Bento Antonio , Adler David , Miller Noah , Severnini Edson 
Published: August 2021

Abstract
Using daily data for the United States over the period 1980-2019, we estimate the impacts of temperature on ambient ozone concentrations, accounting for adaptation to climatic change. We find that even with adaptation, rises in temperature will steeply increase ozone levels by over 9 ppb on days above 25◦ C. By mid-century, we calculate that 189 additional counties 15 will be violating the air quality standards, with 33 million more residents exposed to unhealthy levels of ozone. Climate change will thus likely increase the costs of compliance with existing ambient ozone standards. In light of a recent EPA ruling that would effectively remove cobenefits of ozone precursor reductions from the cost-benefit analysis of those standards, they will be in peril, further threatening public health.
‘I know my place’- The hidden curriculum of professional hierarchy in a South African undergraduate medical program: A Qualitative Study
Authors: Sons Jacob , Gaede Bernhard 
Published: August 2021

Abstract
Background The hidden curriculum of professional hierarchy refers a tacitly acquired perception of a power differential between medical students and their clinical teachers. This power gradient is enforced and maintained by means of humiliation and race- and gender prejudices. The consequences of these pedagogical approaches include disillusionment, anxiety, depression and suicide among student populations. Little is known about this phenomenon in the post- colonial African setting.ObjectivesThe aim of this study was to explore the hidden curriculum of professional hierarchy as it is perceived by medical students. The objective was to define how it manifests and to describe the mechanism that enforce and maintain it.MethodsAn ethnographic study was conducted at a South African University. Through twelve in- depth interviews and 6 months’ participant observations in the clinical setting an understanding of the students’ experience was explored. NVivo software was used to perform a thematic analysis using an open coding method. The themes were then progressively refocussed as broader themes emerged and a deeper understanding of the hidden curriculum developed.ResultsFrom the interviews and the observations, we found that humiliation of students, racism and sexism was used to enforce the professional hierarchy between clinical teachers and students. Students felt discouraged and demotivated by such encounters.ConclusionsThe hidden curriculum of professional hierarchy plays a significant role in how students understand and find their place in the clinical setting. Humiliation continues to play a role despite institutional policies and guidelines and the transition to a democratic dispensation in 1994 in South Africa. Our findings resonated with the findings of international studies exploring the hidden curriculum. Using a historical perspective of the medical school where the study was conducted, the post-colonial lens offers a useful local analysis of the hidden curriculum in the local context of continued gender-based violence, racial, socio-political and economic inequalities in South Africa. It may allow for a more critical engagement with the students’ experience and hopefully assists in exploring institutional values in more profound ways.
CAR T cells targeting CD99 as an approach to eradicate T-cell Acute Lymphoblastic Leukemia without normal blood cells toxicity
Authors: Shi Jiangzhou , Zhang Zijian , Cen Hong , Wu Han , Zhang Shangkun , Liu Jiaxing , Leng Yingqi , Ren Anqi , Liu Xiyu , Zhang Zhijie , Tong Xiqin , Liang Jinjue , Li Zhe , Zhou Fuling , Huang Liang , Qin You , Yang Kunyu , Zhang Tong-cun , Zhu Haichuan 
Published: August 2021

Abstract
CAR T cell therapy has shown dramatic clinical success in relapsed or refractory (r/r) B-ALL and other haematological malignancies. However, the loss of specific antigens, cell fratricide, T cell aplasia, and normal T cell separation are challenges in treating T cell leukemia/lymphoma with CAR T therapy. CD99 is a promising antigen to target T-ALL and AML as it is expressed on the majority of T-ALL and AML. Here, we isolated a low-affinity CD99 (12E7) antibody, which specifically recognizes leukemia cells over normal bone marrow cells. T cells transduced with an anti-CD99-specific CAR that contained the 12E7 scFv expanded with minor fratricide, maintained their cytotoxic function and mediated powerful antitumour effects. Subsequently, we conducted a pilot clinical study to evaluate the safety and feasibility of therapy with anti-CD99 CAR T cells in 4 patients with r/r T-LBL (n=1), AML (n=2) or myeloid sarcoma (MS) (n=1). The clinical overall response rate (ORR) was 50% (2/4 patients), and 1 patients (25%) achieved complete remission (CR) for 2 month. Mild cytokine release syndrome (CRS) occurred in 2 patients and the CRS no more than grade 2. Together, our results demonstrate that anti-CD99 CAR T cells specifically recognize and efficiently eliminate CD99+ leukemia cells.
A Computational Study of Ivermectin and Doxycycline Combination Drug Against SARS-CoV-2 Infection
Authors: Rana Meenakshi , Yadav Pooja , Chowdhury Papia 
Published: August 2021

Abstract
In the present study, we have described how by using molecular docking and molecular dynamics (MD) simulation studies the combination drug of ivermectin and doxycycline can be used as a potential inhibitor for Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) virus. In lieu of unavailability of specific cure of coronavirus disease of 2019 (COVID-19) till now various possibilities for individual and combination drugs have been explored by the medical practitioners/scientists for the remedial purpose of CoV-2 infections. 3C-like protease (3CLpro) is the main protease of SARS-CoV-2 virus which plays an essential role in mediating viral replication in the human body. 3CLpro protein can serve as an attractive drug target. In this work, we have studied drug: 3CLpro interactions by in-silico molecular docking and MD simulation approaches. Common and easily available antiviral drugs ivermectin, doxycycline and their combination can regulate 3CLpro protein's function due to its easy inhibition.
Formic Acid Induces Hypertension-Related Hemorrhage in hSSAOTG in Mice and Stroke Patients
Authors: Di Yalan , yu yan , Zhao Shengjie , Huang Nayan , Fei Xuechao , Yao Dandan , Ai Li , lyu Jihui , He Rongqiao , Li Jianjun , Tong Zhiqian 
Published: August 2021

Abstract
Hypertension is a confirmed risk factor for cerebral hemorrhage in humans. Which endogenous factor directly induces hypertension-related stroke is unclear. In this study, 42 hemorrhagic stroke patients with hypertension and hyperlipidemia and 42 age-matched healthy controls were recruited. The contents of serum semicarbazide-sensitive amine oxidase (SSAO) and formic acid (FC, a final product of SSAO metabolism) were examined in the patients after stroke. Hemorrhagic areas were quantified by computer tomography. In the animal study, hemorrhagic degree was assessed by hemotoxylin & eosin or tissue hemoglobin kits. The relationship between FC and blood pressure/hemorrhagic degree was explored in wild-type mice and hSSAOTG mice fed with high-fat diets or high-fat and -salt diets. The results showed that the levels of serum FC were positively correlated with blood pressure and hemorrhagic areas in stroke patients. Transfection of microRNA-134 could enhance SSAO expression in human vascular smooth muscle cells. Consistently, after treatment with high-fat and -salt diets, hSSAOTG mice exhibited higher levels of miR134 and FC, higher blood pressure, and more severe hemorrhage than wild-type mice. Interestingly, folic acid reduced hypertension and hemorrhage in hSSAOTG mice fed with high-fat diets. These findings suggest that FC is a crucial endogenous factor for hypertension and hemorrhage.
Repetitive transcranial magnetic stimulation promotes neural functional recovery via upregulation of synaptic plasticity-related proteins in rats with traumatic brain injury
Authors: Qian Fangfang , He Youhua , Du Xiaohui , Lu Huaxiang , He Renhong , Fan Jianzhong 
Published: August 2021

Abstract
Background

Repetitive transcranial magnetic stimulation (rTMS) has become a popular approach for the treatment of traumatic brain injury (TBI). This study aimed to assess the efficacy and underlying mechanism of rTMS in TBI model rats.
Methods

Forty-five rats were randomized into SHAM, TBI, and rTMS (TBI and rTMS therapy) groups. Moderate TBI was established using Feeney's weight-dropping method. High-frequency rTMS (20 Hz) was administered to the damaged area in the rTMS group for two weeks. Neural function was assessed by modified neurological severity score (MNSS) at 3, 9, and 16 days after TBI. Synaptic ultrastructure was observed by transmission electron microscopy and levels of synaptic plasticity-related proteins (BDNF, TrkB, NMDAR1, P-CREB, and SYN) were assessed by immunohistochemistry, Western blotting, and real-time PCR.
Results

The rTMS group showed a lower MNSS than the TBI group at 16 days (P < 0.05). Compared to the TBI group, the postsynaptic density (PSD) was increased, the width of the synaptic cleft was decreased, and the synaptic active zone was lengthened in the rTMS group (all P < 0.05). Compared with the sham group, protein levels and mRNA expression of BDNF, TrkB, NMDAR1, and P-CREB were increased in the TBI group (P < 0.05) and further upregulated after rTMS treatment (P < 0.05). In addition, rTMS partially reversed downregulation of SYN (P < 0.05).
Conclusions

Taken together, these findings support that rTMS improves neural functional recovery in TBI rats. The possible mechanism is that rTMS modulates synaptic structural plasticity by reducing loss of SYN and alters synaptic functional plasticity by increasing cortical levels of BDNF, TrkB, NMDAR1, and P-CREB.
Surface Enhanced Raman Scattering (SERS) Spectroscopy Combined With Chemical Imaging Analysis For The Early Detection of Apple Valsa Canker
Authors: Fang Shiyan , Li Junmeng , Wang Yan , Zhao Yanru , Yu Keqiang 
Published: August 2021

Abstract
Background: Apple Valsa Canker (AVC) with early incubation characteristics is a severe apple tree disease. Therefore, early detection of the infected trees is necessary to prevent the rapid development of the disease. Surface enhanced Raman Scattering (SERS) spectroscopy is a promising technique that simplifies detection procedures and reduces detection time. Meanwhile, SERS enhance signals at low laser powers and suppress biological fluorescence. In this study, the early detection of the AVC disease was carried out by combining SERS spectroscopy with the chemometrics methods and machine learning algorithms, and then chemical distribution imaging was successfully applied to the analysis of disease dynamics.Results: Firstly, the microstructure, UV-Vis spectrum, and Raman spectrum of SERS metallic nano-substrates were proved to investigate the enhancement effects of the synthesized AgNPs. Secondly, the multiple spectral baseline correction (MSBC), the asymmetric least squares (AsLS), and the adaptive iterative reweighted penalized least squares (air-PLS) were adopted to eliminate the disturbances of the baseline offset. The correlation analysis method was employed to identify the best baseline correction algorithm, which was the air-PLS algorithm herein. Meanwhile, principal component analysis (PCA) was used to perform clustering analysis based on the healthy, early disease, and late disease sample datasets, demonstrating obvious clustering effects. After that, optimal spectral variables were selected to build machine learning models to detect AVC disease, incorporating the BP-ANN, ELM, RForest, and LS-SVM algorithms. The accuracy of these models was above 90%, showing excellent discriminant performance. Finally, SERS chemical imaging provided the spatiotemporal dynamic characteristics of changes in the cellulose and lignin of the phloem disease-health junction under AVC stress. The results suggested that cellulose and lignin in the cell walls of infected tissues reduced significantly.Conclusions: SERS spectroscopy combining with chemical imaging analysis for early detection of the AVC disease was considered feasible and promising. This study provided a practical method for the rapid diagnosis of apple orchard diseases.
Association Between Subtalar Articular Surface Typing and Flat Foot Deformity: Which Type is More Likely to Cause Flat Foot Deformity
Authors: Zhang Lei , Peng Xiaoyao , He Siyuan , Zhou Xin , Yi Gang , Tang Xiaogao , Li Bingkun , Wang Guoyou , Zhao Wanxue , Yang Yuening 
Published: August 2021

Abstract
Background
Previous studies have shown a wide range of anatomical classifications of the subtalar joint (STJ) in the population and this is related to the different force line structures of the foot. Different subtalar articular surface morphology may affect the occurrence and development of flat foot deformity, and there are fewer studies in this area. The main objective of our study was to determine the association of different subtalar articular surface with the occurrence and severity of flat foot deformity.
Methods
We analyzed the imaging data of 289 cases of STJ. The articular surface area, Gissane's angle and Bohler's angle of subtalar articular surface of different types were counted. The occurrence and severity of flat foot deformity in different subtalar articular surface were judged by measuring the Meary angle of foot.
Results
We classified 289 cases of subtalar articular surface into five types according to the morphology. According to Meary angle, the flat foot deformity of Type Ⅰ and Type Ⅳ are significantly severer than Type Ⅱ (P < 0.05). Type II (7.65 ± 1.38 cm2) was significantly smaller than Type I (8.40 ± 1.79 cm2) in the total joint facet area(P < 0.05). Type III (9.15 ± 1.92 cm2) was smaller than Type I (8.40 ± 1.79 cm2), II(7.65 ± 1.38 cm2) and Ⅳ(7.81 ± 1.74 cm2 ) (P < 0.05).Type II (28.81 ± 7.44∘) was significantly smaller than Type I (30.80 ± 4.61 degrees), and IV (32.25 ± 5.02 degrees) in the Bohler’s angle (P < 0.05). Type II (128.49 ± 6.74 degrees) was smaller than Type I (131.58 ± 7.32 degrees), and IV (131.94 ± 5.80 degrees) in the Gissane’s angle (P < 0.05).
Conclusions
After being compared and analyzed the measurement of morphological parameters, joint facet area and fusion of subtalar articular surface were closely related to the severity of flat foot deformity and Type I and IV were more likely to develop severer flat foot deformity.
Level of evidence:
Level III, retrospective comparative study.
Optimisation of the ratio of chitosan, tea polyphenols, and citric acid for avocado preservation and validation of the changes in quality
Authors: Luo Lina , Lu Jiaju , He Erqi , Wang Xiaomin , Han Shuquan 
Published: August 2021

Abstract
The effect of chitosan, tea polyphenols, and citric acid on avocado storage duration was investigated using a central composite design and response surface methodology by using Design-Expert software. A quadratic polynomial regression mathematical model was constructed with time as the response value to obtain the best concentration combination of chitosan, tea polyphenol, and citric acid for developing the basis of a low-cost, high-efficiency storage preservative for avocados. The results show that the analysis of variance of the regression model of the avocado storage duration has a p = 0.0003, indicating that the model reaches an extreme level of statistical significance, and the regression coefficient of R2 = 0.9629 indicates a good fit between the model and the equation (96.29%). The optimisation results show that the preservative effect on avocados was the best when chitosan, tea polyphenols, and citric acid were combined at a concentration of 1%, 2% and 2%, respectively, and when the storage duration was 19.2 days. Validation tests confirmed that this composite agent effectively delayed the decrease in hardness, the weight loss rate, the soluble solids, soluble protein and vitamin C（VC） content of avocados and decreased their browning index, similar to the predicted results. These results carry practical significance for guiding avocado storage and preservation technology development.
Research on Force Sensing and Zero Gravity Motion Simulation Technology of Industrial Robot
Authors: Hu Ruiqin , Meng Shaohua , Zhang Lijian , Dong Que , Zhang Chengli 
Published: August 2021

Abstract
Towards the zero-gravity simulation test requirements of spacecraft for on-orbit service missions, the zero-gravity motion simulation technology based on industrial robot was studied. In order to realize the accurate force sensing of load on robot, the BP neural network was used to establish the force prediction model. The model uses the robot pose, acceleration, angular velocity, and angular acceleration as input layer parameters, and uses the data from force/torque sensor on robot wrist as the output layer parameter. In order to realize the accurate force perception in whole working space of the robot, the orthogonal experiment design method was adopted to determine the path points of the robot for sample data collection. Based on the established force prediction model, the accurate force sensing of the end load of the robot under moving conditions is realized. In experiment, for the load with 100kg mass on robot, the maximum error of force sensing is 39.8N, and the root mean square error of force sensing is 9.3N. The maximum error of torque sensing is 18.7Nm, and the root mean square error of torque sensing is 4.4Nm. Furthermore, according to the real-time force sensing results of the robot load, the motion speed of the load in zero-gravity state is calculated by dynamics theory. Then the robot is driven to execute the corresponding motion of the load, and the zero gravity motion simulation of the load is realized.