bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pre-hospital suPAR, lactate and CRP measurements for decision-making: a prospective, observational study of patients presenting non-specific complaints
Authors: Jousi Milla , Mäkinen Marja , Kaartinen Johanna , Meriläinen Leena , Castrén Maaret 
Published: October 2021

Abstract
Background
In the pre-hospital setting, non-urgent patients with non-specific chief complaints pose assessment challenges for the emergency medical systems (EMS). Severely ill patients should be identified among these patients, and unnecessary transport to the emergency department (ED) should be avoided. Unnecessary admissions burden EDs, deplete EMS resources and can even be harmful to patients, especially elderly patients. Therefore, tools for facilitating pre-hospital decision-making are needed. They could be based on vital signs or point-of-care laboratory biomarkers. In this study, we examined whether the biomarker soluble urokinase plasminogen activator receptor (suPAR), either alone or combined with C-reactive protein (CRP) and/or lactate, could predict discharge from the ED and act as a pre-hospital support tool for non-conveyance decision-making.

Methods
This was a prospective, observational study of adult patients with normal or near-normal vital signs transported by an EMS to an ED with a code referring to deteriorated general condition. The levels of suPAR, CRP and lactate in the patients’ pre-hospital blood samples were analysed. The values of hospitalized patients were compared to those of discharged patients to determine whether these biomarkers could predict direct discharge from the ED.

Results
A total of 109 patients (median age: 81 years) were included in the study. Of those, 52% were hospitalized and 48% were discharged from the ED. No statistically significant association was found between suPAR and the ED discharge vs hospitalization outcome (OR: 1.04, 95% CI 0.97–1.13, AUROC: 0.58, 95% CI 0.47–0.69). Adding CRP (AUROC: 0.64, 95% CI 0.54–0.75) or lactate (AUROC: 0.60, 95% CI 0.49–0.71) to the regression models did not improve their diagnostic accuracy. None of the patients with a suPAR value of less than 2 ng/ml were admitted to hospital, while 64% of the patients with a suPAR value of more than 6 ng/ml were hospitalized.

Conclusion
Pre-hospital suPAR measurements alone or combined with CRP and/or lactate measurements could not predict the ED discharge or hospital admission of 109 non-urgent EMS patients with non-specific chief complaints and normal or near-normal vital signs.
The development of emergency medical services benefit score: a European Delphi study
Authors: Heino Anssi , Raatiniemi Lasse , Iirola Timo , Meriläinen Merja , Liisanantti Janne , Tommila Miretta ,   Collaboration Group, Krüger Andreas , Dami Fabrice , Moens Didier , Fevang Espen , Harve-Rytsälä Heini , Jäntti Helena , Nurmi Jouni , Tønsager Kristin , Rognås Leif , Rehn Marius , Schober Patrick , Bredmose Per P. , Hansen Peter Martin , Temesvari Peter , Mikkelsen Søren , Lindner Thomas W. , Hansen Troels Martin , Nikula Anna , Kantanen Anne-Mari , Lindgren Antti E. , Salmi Heli , Kirjasuo Karri , Varpula Marjut , Reinikainen Matti , Paalasmaa Nanneli , Peltoniemi Outi , Luoto Teemu , Lund Vesa , Jalkanen Ville 
Published: October 2021

Abstract
Background
The helicopter emergency services (HEMS) Benefit Score (HBS) is a nine-level scoring system developed to evaluate the benefits of HEMS missions. The HBS has been in clinical use for two decades in its original form. Advances in prehospital care, however, have produced demand for a revision of the HBS. Therefore, we developed the emergency medical services (EMS) Benefit Score (EBS) based on the former HBS. As reflected by its name, the aim of the EBS is to measure the benefits produced by the whole EMS systems to patients.

Methods
This is a four-round, web-based, international Delphi consensus study with a consensus definition made by experts from seven countries. Participants reviewed items of the revised HBS on a 5-point Likert scale. A content validity index (CVI) was calculated, and agreement was defined as a 70% CVI. Study included experts from seven European countries. Of these, 18 were prehospital expert panellists and 11 were in-hospital commentary board members.

Results
The first Delphi round resulted in 1248 intervention examples divided into ten diagnostic categories. After removing overlapping examples, 413 interventions were included in the second Delphi round, which resulted in 38 examples divided into HBS categories 3–8. In the third Delphi round, these resulted in 37 prehospital interventions, examples of which were given revised version of the score. In the fourth and final Delphi round, the expert panel was given an opportunity to accept or comment on the revised scoring system.

Conclusions
The former HBS was revised by a Delphi methodology and EBS developed to represent its structural purpose better. The EBS includes 37 exemplar prehospital interventions to guide its clinical use.
Trial registration The study permission was requested and granted by Turku University Hospital (decision number TP2/010/18).
“Left in limbo”: Exploring how patients with colorectal cancer interpret and respond to a suspected Lynch syndrome diagnosis
Authors: den Elzen Nicole , Joseland Sharelle L. , Saya Sibel , Jonnagadla Sowmya , Isbister Joanne , Winship Ingrid , Buchanan Daniel D. 
Published: October 2021

Abstract
Background
A diagnosis of suspected Lynch syndrome (SLS) is given when a tumour displays characteristics consistent with Lynch syndrome (LS), but no germline pathogenic variant is identified. This inconclusive diagnosis results in uncertainty around appropriate cancer risk management. This qualitative study explored how patients with CRC interpret and respond to an SLS diagnosis.

Methods
Semi-structured telephone interviews were conducted with 15 patients with CRC who received an SLS diagnosis, recruited from cancer genetics services across Australia. Interviews were transcribed verbatim and analysed using thematic analysis. Participant responses were compared with appointment summary letters from cancer genetics services.

Results
Participants’ interpretations of genetic test results were found to vary widely. While this variation often aligned with variation in interpretations by cancer genetics services, participants also had difficulties with the complexity and recall of genetic test results. Participants had a range of psychological responses to the uncertainty that their results presented, from relief to disappointment and doubt. Cancer risk perceptions also varied widely, with participants’ interpretations of their genetic test results just one of several influencing factors. Despite this variability, almost all participants adhered to cancer risk management advice, although different participants received different advice. All participants also communicated any cancer risk management advice to first-degree relatives, motivated by protecting them, but information communicated was not always consistent with advice received.

Conclusions
Our study findings highlight the variability in patients’ interpretations of their diagnosis, cancer risk management and family communication when a diagnosis of SLS is received, and provide novel insights into how healthcare professionals can better support patients with SLS.
Preparation of a new coating of graphene oxide/nickel complex on a nickelized metal surface for direct immersion solid phase microextraction of some polycyclic aromatic hydrocarbons
Authors: Pasandideh Yalda , Razmi Habib 
Published: October 2021

Abstract
Background
Solid-phase microextraction (SPME) is a versatile sampling and sample preparation technology that possess a significant application in the extraction and pre-concentration of a broad range of micro-pollutants from different kind of matrices. Selection and preparation of an appropriate fiber substrate and coating materials have always been the main challenges of the SPME procedure. This paper introduces a high-efficiency metal-based SPME fiber with a new chemical coating of nickel/graphene oxide/nickel tetraazamacrocyclic complex (Ni/GO/NiTAM).

Result
The Ni/GO/NiTAM sorbent was electroless deposited onto the surface of an aluchrom (Alu) wire, and then the prepared fiber was employed for the extraction and pre-concentration of some PAHs before their HPLC–UV analysis. The prepared fiber characterization data were assessed using FE-SEM, EDX, XRD, FT-IR, and BET techniques. The method validation parameters, including the linearity range (LRs: 0.10 to 200.0 µg L−1), the limit of detection (LODs: 0.03‒0.30 µg L−1), and the limit of quantification (LOQs: 0.10–1.00 µg L−1), under optimal conditions. The relative standard deviations (RSDs) of intra-day, inter-day, and single fiber repeatability (for the samples spiked at 25 µg L‒1) were in the range of 0.32–2.94, 1.20–4.09, and 1.42‒4.39%, respectively. In addition, the technique recoveries (RR %) and enrichment factors (EF) were in the range of 83.10‒107.80% and 83–164, respectively.

Conclusion
The fiber fabrication was simple, and the applied materials were also economical and easily accessible. Alu metal has high physicochemical and mechanical stability and thus can be a good alternative for the substrate of the fragile commercial SPME fibers. High rigidity and durability, long service life, and high extraction capability are some of the other advantages of the offered fiber.
Citrulline deiminase pathway provides ATP and boosts growth of Clostridium carboxidivorans P7
Authors: Li Xiangfei , Han Rumeng , Bao Teng , Osire Tolbert , Zhang Xian , Xu Meijuan , Yang Taowei , Rao Zhiming 
Published: October 2021

Abstract
Background
Clostridium carboxidivorans P7 is capable of producing ethanol and butanol from inexpensive and non-food feedstock, such as syngas. Achieving improved ethanol and butanol production in the strain for industrial application depends on the energetics and biomass, especially ATP availability.

Results
This study found that exogenous addition of citrulline promoted accumulation of ATP, increased specific growth rate, and reduced the doubling time of C. carboxidivorans P7. In heterotrophic fermentation experiments, the addition of citrulline increased intracellular ATP by 3.39-fold, significantly enhancing the production of total alcohol (ethanol + butanol) by 20%. Moreover, in the syngas fermentation experiments, the addition of citrulline improved the level of intracellular ATP and the biomass by 80.5% and 31.6%, respectively, resulting in an 18.6% and 60.3% increase in ethanol and the alcohol/acid production ratio, respectively.

Conclusions
This is the first report that citrulline could promote the growth of C. carboxidivorans P7 and increase the level of intracellular ATP, which is of great significance for the use of C. carboxidivorans P7 to synthesize biofuels.
Improvement of thermostability and catalytic efficiency of glucoamylase from Talaromyces leycettanus JCM12802 via site-directed mutagenesis to enhance industrial saccharification applications
Authors: Tong Lige , Zheng Jie , Wang Xiao , Wang Xiaolu , Huang Huoqing , Yang Haomeng , Tu Tao , Wang Yuan , Bai Yingguo , Yao Bin , Luo Huiying , Qin Xing 
Published: October 2021

Abstract
Background
Glucoamylase is an important industrial enzyme in the saccharification of starch into glucose. However, its poor thermostability and low catalytic efficiency limit its industrial saccharification applications. Therefore, improving these properties of glucoamylase is of great significance for saccharification in the starch industry.

Results
In this study, a novel glucoamylase-encoding gene TlGa15B from the thermophilic fungus Talaromyces leycettanus JCM12802 was cloned and expressed in Pichia pastoris. The optimal temperature and pH of recombinant TlGa15B were 65 ℃ and 4.5, respectively. TlGa15B exhibited excellent thermostability at 60 ℃. To further improve thermostability without losing catalytic efficiency, TlGa15B-GA1 and TlGa15B-GA2 were designed by introducing disulfide bonds and optimizing residual charge–charge interactions in a region distant from the catalytic center. Compared with TlGa15B, mutants showed improved optimal temperature, melting temperature, specific activity, and catalytic efficiency. The mechanism underlying these improvements was elucidated through molecular dynamics simulation and dynamics cross-correlation matrices analysis. Besides, the performance of TlGa15B-GA2 was the same as that of the commercial glucoamylase during saccharification.

Conclusions
We provide an effective strategy to simultaneously improve both thermostability and catalytic efficiency of glucoamylase. The excellent thermostability and high catalytic efficiency of TlGa15B-GA2 make it a good candidate for industrial saccharification applications.
Association of diabetes and obesity with sperm parameters and testosterone levels: a meta-analysis
Authors: Zhong Ou , Ji Lin , Wang Jinyuan , Lei Xiaocan , Huang Hua 
Published: October 2021

Abstract
Background
The present study performed two distinct meta-analyses with common outcomes (sperm parameters); one was performed in obese individuals (and non-obese controls) and the other in diabetic individuals (and non-diabetic controls).

Methods
PubMed, Embase, The Cochrane library, Web of Science, Scopus databases were searched to collect clinical studies related to the effects of obesity and diabetes on male sperm from inception to on 1st February 2021. Statistical meta-analyses were performed using the RevMan 5.4 software. Stata16 software was used to detect publication bias. The methodological quality of the included studies was assessed with the Ottawa–Newcastle scale using a star-based system.

Results
A total of 44 studies were finally included in the present study, which enrolled 20,367 obese patients and 1386 patients with diabetes. The meta-analysis results showed that both obesity and diabetes were associated with reduced semen volume (obese versus non-obese controls: mean difference (MD) = − 0.25, 95% CI = (− 0.33, − 0.16), p < 0.001; diabetes versus non-diabetic controls: MD = − 0.45, 95% CI = (− 0.63, − 0.27), p < 0.001), reduced sperm count (obese versus non-obese controls: MD = − 23.84, 95% CI = (− 30.36, − 17.33), p < 0.001; diabetes versus non-diabetic controls: MD = − 13.12, 95% CI = (− 18.43, − 7.82), p < 0.001), reduced sperm concentration (obese versus non-obese controls: MD = − 7.26, 95% CI = (− 10.07, − 4.46), p < 0.001; diabetes versus non-diabetic controls: MD = − 11.73, 95% CI = (− 21.44, − 2.01), p = 0.02), reduced progressive motility (obese versus non-obese controls: MD = − 5.68, 95% CI = (− 8.79, − 2.56), p < 0.001; diabetes versus non-diabetic controls: MD = − 14.37, 95% CI = (− 21.79, − 6.96), p = 0.001), and decreased testosterone levels (obese versus non-obese controls: MD = − 1.11, 95% CI = (− 1.92, − 0.30), p = 0.007; diabetes versus non-diabetic controls: MD = − 0.37, 95% CI = (− 0.63, − 0.12), p = 0.004).

Conclusions
Current evidence suggests that obesity and diabetes negatively affect sperm parameters in men and are associated with low testosterone levels. Due to the limitation of the number and quality of included studies, the above conclusions need to be verified by more high-quality studies.
Improved gut microbiota features after the resolution of SARS‑CoV‑2 infection
Authors: De Maio Flavio , Ianiro Gianluca , Coppola Gaetano , Santopaolo Francesco , Abbate Valeria , Bianco Delia Mercedes , Del Zompo Fabio , De Matteis Giuseppe , Leo Massimo , Nesci Antonio , Nicoletti Alberto , Pompili Maurizio , Cammarota Giovanni , Posteraro Brunella , Sanguinetti Maurizio , Gasbarrini Antonio , Ponziani Francesca Romana 
Published: October 2021

AbstractBackgroundThe severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) has a tropism for the gastrointestinal tract and several studies have shown an alteration of the gut microbiota in hospitalized infected patients. However, long-term data on microbiota changes after recovery are lacking.MethodsWe enrolled 30 patients hospitalized for SARS‑CoV‑2-related pneumonia. Their gut microbiota was analyzed within 48 h from the admission and compared with (1) that of other patients admitted for suspected bacterial pneumonia (control group) (2) that obtained from the same subject 6 months after nasopharyngeal swab negativization.ResultsGut microbiota alpha-diversity increased 6 months after the resolution of SARS-CoV-2 infection. Bacteroidetes relative abundance was higher (≈ 36.8%) in patients with SARS-CoV-2, and declined to 18.7% when SARS-CoV-2 infection resolved (p  =  0.004). Conversely, Firmicutes were prevalent (≈ 75%) in controls and in samples collected after SARS-CoV-2 infection resolution (p  =  0.001). Ruminococcaceae, Lachnospiraceae andBlautiaincreased after SARS-CoV-2 infection resolution, rebalancing the gut microbiota composition.ConclusionSARS-CoV-2 infection is associated with changes in the gut microbiome, which tend to be reversed in long-term period.
Effects of pre-exercise acupuncture stimulation on heart rate response during short-duration exercise
Authors: Nakahara Hidehiro , Ueda Shin-ya , Kawai Eriko , Higashiura Rui , Miyamoto Tadayoshi 
Published: October 2021

Abstract
Background
The purpose of the present study was to investigate the effects of bradycardia induced by pre-exercise acupuncture on heart rate responses during short-duration exercise.

Methods
A total of 29 healthy subjects underwent two protocols: protocol 1 assessed the effects of manual acupuncture on heart rate response during rest, and protocol 2 tested the hypothesis that the bradycardic effects induced by pre-exercise acupuncture continue during low- and high-intensity exercise. Their average age, height, weight, and body mass index were 21.2 ± 2.0 years, 167.2 ± 8.8 cm, 63.8 ± 12.8 kg, and 22.7 ± 3.5 kg/m2, respectively. In acupuncture stimulations for protocols 1 and 2, an acupuncture needle was inserted into the lower leg and manual acupuncture stimulation was performed at 1 Hz.

Results
In protocol 1 (resting condition), acupuncture stimulation induced a bradycardic response, which continued for 4 min after the cessation of acupuncture stimulation (p < 0.05). In protocol 2, the bradycardic response induced by pre-exercise acupuncture stimulation remained during low-intensity exercise and in the beginning of high-intensity exercise performed immediately after the cessation of acupuncture stimulation (p < 0.05). However, the effects disappeared when post-acupuncture exercise was performed when the heart rate was approximately 140 beats/min during high-intensity exercise. The rating of perceived exertion after exercise differed significantly between the acupuncture stimulation task (7.9 ± 1.6) and no-stimulation task (8.5 ± 2.0) (p = 0.03) only in the low intensity group.

Conclusion
This study may provide new insights into the effect of acupuncture stimulation on psycho-physiological conditions during exercise.
Micronodular basal cell carcinoma of the scrotum: a case report and review of the literature
Authors: Younes Mohammad , Kouba Lamia , Almsokar Hanaa , Badran Ayham 
Published: October 2021

Abstract
Introduction
Basal cell carcinoma is the most common nonmelanotic skin cancer. It has variable clinical and histological subtypes that vary in their aggressiveness and liability to recurrence and metastasis. Chronic ultraviolet radiation exposure is considered to be the main risk factor for developing basal cell carcinoma; therefore, it typically arises on sun-exposed skin, mainly the head and neck.

Case presentation
We present the case of a 55-year-old Caucasian male who presented with a lesion on the scrotum for 2 years. The lesion was clinically presumed benign and initially treated with curettage. Microscopic examination revealed an incompletely resected micronodular basal cell carcinoma with sebaceous differentiation. Therefore, a second excisional biopsy was performed to completely excise the incidentally discovered malignant tumor.

Conclusion
We report the first case of micronodular basal cell carcinoma arising on the scrotum. The goal of our article is to draw clinicians’ attention to the possible involvement of unexposed skin with basal cell carcinoma, and we highlight the importance of accurate diagnosis and prompt treatment due to the aggressive nature of micronodular basal cell carcinoma.
The impact of cross-docked poses on performance of machine learning classifier for protein–ligand binding pose prediction
Authors: Shen Chao , Hu Xueping , Gao Junbo , Zhang Xujun , Zhong Haiyang , Wang Zhe , Xu Lei , Kang Yu , Cao Dongsheng , Hou Tingjun 
Published: October 2021

AbstractStructure-based drug design depends on the detailed knowledge of the three-dimensional (3D) structures of protein–ligand binding complexes, but accurate prediction of ligand-binding poses is still a major challenge for molecular docking due to deficiency of scoring functions (SFs) and ignorance of protein flexibility upon ligand binding. In this study, based on a cross-docking dataset dedicatedly constructed from the PDBbind database, we developed several XGBoost-trained classifiers to discriminate the near-native binding poses from decoys, and systematically assessed their performance with/without the involvement of the cross-docked poses in the training/test sets. The calculation results illustrate that using Extended Connectivity Interaction Features (ECIF), Vina energy terms and docking pose ranks as the features can achieve the best performance, according to the validation through the random splitting or refined-core splitting and the testing on the re-docked or cross-docked poses. Besides, it is found that, despite the significant decrease of the performance for the threefold clustered cross-validation, the inclusion of the Vina energy terms can effectively ensure the lower limit of the performance of the models and thus improve their generalization capability. Furthermore, our calculation results also highlight the importance of the incorporation of the cross-docked poses into the training of the SFs with wide application domain and high robustness for binding pose prediction. The source code and the newly-developed cross-docking datasets can be freely available athttps://github.com/sc8668/ml_pose_predictionandhttps://zenodo.org/record/5525936, respectively, under an open-source license. We believe that our study may provide valuable guidance for the development and assessment of new machine learning-based SFs (MLSFs) for the predictions of protein–ligand binding poses.
Infinite Geraghty type extensions and their applications on integral equations
Authors: Bardhan R. , Ozel C. , Guran L. , Aydi H. , Park Choonkil 
Published: October 2021

AbstractIn this article, we discuss about a series of infinite dimensional extensions of some theorems given in (Shumrani et al. in SER Math. Inform. 33(2):197–202, 2018), (Fisher in Math. Mag. 48(4):223–225, 1975), and (Fogh, Behnamian and Pashaie in Int. J. Maps in Mathematics 2(41):1–13, 2019). We also prove a similar Geraghty type construction for Fisher (Math. Mag. 48(4):223–225, 1975) in an infinite dimension using similar techniques as in (Shumrani et al. in SER Math. Inform. 33(2):197–202, 2018) and (Fogh, Behnamian and Pashaie in Int. J. Maps in Mathematics 2(41):1–13, 2019). As an application, we ensure the existence of solutions for infinite dimensional Fredholm integral equation and Uryshon type integral equation.