bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intracolic ultrasound molecular imaging: a novel method for assessing colonic tumor necrosis factor-α expression in inflammatory bowel disease
Authors: Miao Xiaoyan , Mao Ren , You Yujia , Zhou Huichao , Qiu Chen , Li Xuehua , Chen Zhihui , Ren Jie , Chen Minhu , Wang Ping , Zheng Rongqin , Yin Tinghui 
Published: September 2021

Abstract
Background
While anti-tumor necrosis factor alpha (TNF-α) therapy has been proven effective in inflammatory bowel disease (IBD), approximately 40% of patients lose the response. Transmembrane TNF-α (mTNF-α) expression in the intestinal mucosa is correlated with therapeutic efficacy, and quantification of mTNF-α expression is significant for predicting response. However, conventional intravenous application of microbubbles is unable to assess mTNF-α expression in intestinal mucosa. Herein, we proposed intracolic ultrasound molecular imaging with TNF-α-targeted microbubbles (MBTNF-α) to quantitatively detect mTNF-α expression in the intestinal mucosa.

Methods
MBTNF-α was synthesized via a biotin–streptavidin bridging method. TNF-α-targeted ultrasound imaging was performed by intracolic application of MBTNF-α to detect mTNF-α expression in surgical specimens from a murine model and patients with IBD. Linear regression analyses were performed to confirm the accuracy of quantitative targeted ultrasound imaging.

Results
On quantitative TNF-α-targeted ultrasound images, a greater signal intensity was observed in the mouse colons with colitis ([1.96 ± 0.45] × 106 a.u.) compared to that of the controls ([0.56 ± 0.21] × 106 a.u., P < 0.001). Targeted US signal intensities and inflammatory lesions were topographically coupled in mouse colons. Linear regression analyses in specimens of mice and patients demonstrated significant correlations between the targeted ultrasound signal intensity and mTNF-α expression (both P < 0.001). Furthermore, TNF-α-targeted ultrasound imaging qualitatively distinguished the varying inflammatory severity in intestinal specimens from IBD patients.

Conclusion
Intracolic ultrasound molecular imaging with MBTNF-α enables quantitative assessment of mTNF-α expression. It may be a potential tool for facilitating the implementation of personalized medicine in IBD.
Mechanical performance of aluminum reinforced wood plastic composites under axial tension: an experimental and numerical investigation
Authors: Zhao Longlong , Xi Fei , Wang Xiaorui 
Published: September 2021

AbstractWood plastic composites (WPCs) are low-cost biomass composite materials with good mechanical stability and good weather resistance that are mainly used in the areas with low stress levels. Aimed at improving the mechanical properties of WPCs, this paper proposes a new WPC reinforced with aluminum. The WPC and aluminum were hot pressed to form an aluminum reinforced wood plastic composites (A-WPC). The axial tensile properties, stress–strain relationship, and failure mechanism of the composite were studied experimentally. The results show that the ultimate stress and strain, elastic modulus, and other mechanical parameters of A-WPCs are much higher than those of WPCs. The elongation at break is 10.13 times that of WPCs, which greatly improves the ductility. Based on the equivalent stiffness theory, two calculation models were proposed to predict the tensile stress–strain relationship of A-WPCs. The tensile rebound process of A-WPCs was analyzed in depth, and then the calculation formula of the residual curvature was deduced to compare with the test results. The experimental results are in good agreement with the calculation results.
Genetic and antimicrobial resistance profiles of non-O157 Shiga toxin-producing Escherichia coli from different sources in Egypt
Authors: Elsayed Mohamed Sabry Abd Elraheam , Eldsouky Samah Mahmoud , Roshdy Tamer , Bayoume Abeer Mohamed Ahmed , Nasr Ghada M. , Salama Ali S. A. , Akl Behiry A. , Hasan Al Shaimaa , Shahat Amany Kasem , Khashaba Rana Atef , Abdelhalim Walid Abdellatif , Nasr Hend E. , Mohammed Lina Abdelhady , Salah Ahmed 
Published: September 2021

AbstractBackgroundThe Shiga toxin-producingEscherichia coli(STEC) represented a great risk to public health. In this study, 60 STEC strains recovered from broiler and duck fecal samples, cow’s milk, cattle beef, human urine, and ear discharge were screened for 12 virulence genes, phenotypic and genotypic antimicrobial resistance, and multiple-locus variable-number tandem-repeat analysis (MLVA).ResultsThe majority of strains harbored Shiga toxin 1 (stx1) andstx1d,stx2andstx2e, andehxA genes, while a minority harboredstx2csubtype andeaeA. We identified 10stxgene combinations; most of strains 31/60 (51.7%) exhibited four copies ofstxgenes, namely thestx1,stx1d,stx2, andstx2e, and the strains exhibited a high range of multiple antimicrobial resistance indices. The resistance genesblaCTX-M-1 andblaTEM were detected. For the oxytetracycline resistance genes, most of strains containedtetA,tetB,tetE, andtetG while thetetC was present at low frequency. MLVA genotyping resolved 26 unique genotypes; genotype 21 was highly prevalent. The six highly discriminatory loci DI = 0.9138 are suitable for the preliminary genotyping of STEC from animals and humans.ConclusionsThe STEC isolated from animals are virulent, resistant to antimicrobials, and genetically diverse, thus demands greater attention for the potential risk to human.
Association between anion gap and mortality of aortic aneurysm in intensive care unit after open surgery
Authors: Gao Yijing , Hong Zilin , Shen Runnan , Zhang Shiran , You Guochang , Chen Jie , Guo Xushun , Peng Senyi , Huang Kai 
Published: September 2021

Abstract
Background
There has not been a well-accepted prognostic model to predict the mortality of aortic aneurysm patients in intensive care unit after open surgery repair. Otherwise, our previous study found that anion gap was a prognosis factor for aortic aneurysm patients. Therefore, we wanted to investigate the relationship between anion gap and mortality of aortic aneurysm patients in intensive care unit after open surgery repair.

Methods
From Medical Information Mart for Intensive Care III, data of aortic aneurysm patients in intensive care unit after open surgery were enrolled. The primary clinical outcome was defined as death in intensive care unit. Univariate analysis was conducted to compare the baseline data in different groups stratified by clinical outcome or by anion gap level. Restricted cubic spline was drawn to find out the association between anion gap level and mortality. Subgroup analysis was then conducted to show the association in different level and was presented as frost plot. Multivariate regression models were built based on anion gap and were adjusted by admission information, severity score, complication, operation and laboratory indicators. Receiver operating characteristic curves were drawn to compare the prognosis ability of anion gap and simplified acute physiology score II. Decision curve analysis was finally conducted to indicate the net benefit of the models.

Results
A total of 405 aortic aneurysm patients were enrolled in this study and the in-intensive-care-unit (in-ICU) mortality was 6.9%. Univariate analysis showed that elevated anion gap was associated with high mortality (P value < 0.001), and restricted cubic spline analysis showed the positive correlation between anion gap and mortality. Receiver operating characteristic curve showed that the mortality predictive ability of anion gap approached that of simplified acute physiology score II and even performed better in predicting in-hospital mortality (P value < 0.05). Moreover, models based on anion gap showed that 1 mEq/L increase of anion gap improved up to 42.3% (95% confidence interval 28.5–59.8%) risk of death.

Conclusions
The level of serum anion gap was an important prognosis factor for aortic aneurysm mortality in intensive care unit after open surgery.
Patient decision aid for trial of labor after cesarean (TOLAC) versus planned repeat cesarean delivery: a quasi-experimental pre-post study
Authors: Venkatesh Kartik K. , Brodney Suzanne , Barry Michael J. , Jackson Jamie , Lyons Kiira M. , Talati Asha N. , Ivester Thomas S. , Munoz Maria C. , Thorp John M. , Nicholson Wanda K. 
Published: September 2021

Abstract
Objective
To assess the impact of a web-based decision aid on patient-centered decision making outcomes among women considering a trial of labor after cesarean (TOLAC) versus planned repeat cesarean delivery.

Methods
The Birth Decision Aid Study (B-READY) was a quasi-experimental pre-post study of two sequential cohorts. From June 18, 2018 to July 31, 2019, 50 women were enrolled in routine care, followed by 50 women who were enrolled in the decision aid group. Inclusion criteria were singleton pregnancies between 19/0 to 36/6 weeks, ≤2 prior cesareans, and no contraindications to TOLAC. The decision aid group viewed the online Healthwise® “Pregnancy: Birth Options After Cesarean” program. Both groups received the same birth options counseling and completed the same online assessment. Primary patient-centered outcomes were knowledge about birth options and shared decision making at online assessment, and informed, patient-centered decision making about her preferred mode of delivery at delivery admission.

Results
Among 100 women participated in this study (50 per group), the mean gestational age at enrollment was 31 weeks, and 71% or 63/89 women who consented to delivery data abstraction had a cesarean delivery. Women in the patient decision aid group gained more knowledge (defined as score ≥ 75%) about birth options compared to those in the routine care group (72% vs. 32%; adjusted odds ratio, AOR: 6.15 [95% CI: 2.34 to 16.14]), and were more likely to make an informed, patient-centered decision (60% vs. 26%; AOR: 3.30 [95% CI: 1.20 to 9.04]. Women in both groups reported similar involvement in shared decision making, as well as satisfaction and values. More than 90% of decision aid users reported it was a useful tool and would recommend it to other TOLAC-eligible women.

Conclusions
A web-based birth options patient-centered decision aid for TOLAC eligible women can be integrated into prenatal Telehealth and may improve the quality of decision making about mode of delivery.

Trial registration
The study was registered with ClinincalTrials.gov and the ID# was NCT04053413. Registered 12 August 2019 – Retrospectively registered.
Comparison of nostril sizes of newborn infants with outer diameter of endotracheal tubes
Authors: Haase Bianca , Badinska Ana-Maria , Maiwald Christian A. , Poets Christian F. , Springer Laila 
Published: September 2021

Abstract
Background
Recommendations for endotracheal tube (ETT) size usually refer to the inner diameter (ID). Outer diameters (OD), however, vary greatly between manufacturers, which in some brands might cause difficulties in passing the ETT through the nostrils if choosing the nasal route for intubation. Even though the nostrils are dilatable by an ETT, it might be difficult to pass an ETT through the posterior naris (narrowest point of the nasal passage), if the OD is bigger than the nostrils. Therefore, nostril size may provide some guidance for the appropriate ETT size preventing unsuccessful intubation attempts. This study therefore compares nostril sizes of newborn infants with ODs of ETTs from several manufacturers.

Methods
This is a subgroup analysis of a prospective observational study, performed in a single tertiary perinatal centre in Germany. The diameter of the nostril of infants born between 34 and 41 weeks´ gestation was measured in 3D images using 3dMDvultus software and compared to the OD of ETT from five different manufacturers.

Results
Comparisons of nostril sizes with ODs of different ETTs were made for 99 infants with a mean (SD) birthweight of 3058g (559) [range: 1850-4100g]. Mean (SD) nostril size was 5.3mm (0.6). The OD of the 3.5mm ETT of different manufacturers ranged from 4.8-5.3mm and was thus larger than the nostril size of 20-46% of late preterm or term infants.
Some OD of a 3.0mm ETT were even bigger than the OD of a 3.5mm ETT (e.g. the 3.0mm ETT from Rüsch® has an OD of 5.0mm while the 3.5mm ETT from Portex® has an OD of 4.8mm).

Conclusions
Clinicians should be aware of the OD of ETTs to reduce unsuccessful intubation attempts caused by ETT sizes not fitting the nasal cavity. Generated data may help to adapt recommendations in future.

Trial registration
Subgroup analysis of the “Fitting of Commonly Available Face Masks for Late Preterm and Term Infants (CAFF)”-study: NCT03369028, www.ClinicalTrials.gov, December 11, 2017.
Financial, institutional, environmental, technical, and social (FIETS) aspects of water, sanitation, and hygiene conditions in indigenous - rural Indonesia
Authors: Daniel D. , Djohan Dennis , Machairas Ilias , Pande Saket , Arifin Arifin , Al Djono Trimo Pamudji , Rietveld Luuk 
Published: September 2021

Abstract
Background
There is increasing recognition of the complexity underlying WASH conditions in developing countries. This article explores the complexity by assessing the vulnerability of a specific area to poor WASH conditions using a qualitative approach.

Methods
We present our findings for the district of East Sumba in Indonesia. This area is known as one of the poorest regions in Indonesia with inadequate WASH services, indigenous belief that hinder the practice of WASH-related behaviours, and has a high rate of children malnutrition. All the factors that contribute to poor WASH conditions were discussed through the lens of the Financial, Institutional, Environmental, Technological, and Social (FIETS) framework. We then summarised the factors and visualized the “system” using a mind map which shows how factors are interconnected and helps to find the root causes of poor WASH conditions.

Results
There are three main challenges that inhibit the improvement of WASH conditions in this area: inadequate institutional capacity, water scarcity, and poor socio-economic conditions. We found that a village leader is the most important actor who influences the sustainability of WASH services in this area and healthcare workers are influential WASH promoters. This study also shows how culture shapes people’s daily lives and institution performance, and influences the current WASH conditions in East Sumba. The mind map shows there is an overlap and interconnection between FIEST aspects and WASH conditions in the study area.

Conclusion
WASH conditions are influenced by many factors and are often interconnected with each other. Understanding this complexity is necessary to improve WASH conditions and sustain adequate WASH services in developing countries. Finally, WASH interventions have to be considerate of the prevailing cultural practices and should involve multidisciplinary stakeholders.
Caught in the middle: a thematic analysis of the experiences of Korean-Canadian caregiver-employees in the greater Toronto and Hamilton area
Authors: Lyeo Joonsoo S. , Williams Allison 
Published: September 2021

Abstract
Background
The objective of this study was to investigate the experiences of caregiver-employees (CEs) from the Korean-Canadian community in the Greater Toronto and Hamilton Area.

Methods
Nine participants were recruited and invited to partake in data collection, which consisted of the completion of a sociodemographic questionnaire as well as a qualitative, semi-structured interview. The interview transcripts were thematically analyzed.

Result
The thematic analysis revealed four primary themes, each of which had three sub-themes. The four primary themes are:: (i) tensions, (ii) adaptations to the dual role of being a CE, (iii) coping mechanisms, and (iv) desired changes to the status quo.

Conclusion
The result of this study suggest that Korean-Canadian CEs, as a consequence of their position at the convergence of Korean and Western cultural values, would be best supported through the provision of culturally sensitive supports and greater workplace accommodation.
Renaming COPD exacerbations: the UK respiratory nursing perspective
Authors: Mwasuku Christine , King Joanne , Russell Richard E. K. , Bafadhel Mona 
Published: September 2021

Abstract
Background
Patients with COPD experience acute worsenings, termed ‘exacerbations’. While other terms to describe these events have been proposed there is no consensus on terminology which has led to multiple terms being used across the UK. Respiratory nurses are part of a multi-disciplinary team managing COPD patients, however, the nursing perspective on the term ‘exacerbation’ is unknown.

Methods
An anonymised survey of 17 questions was sent to respiratory nurses through an email invitation link. The survey link was open for one month. The aim was to understand the nurse perspective on ‘exacerbation’. Alternative terms used in the UK were compared versus the term 'exacerbation’.

Results
Responses were received from 113 nurses. The majority (88%) were female. There was no consensus on preference or meaning for the term ‘exacerbation’ between nurses. Less than 5% of nurses thought that patients with COPD would understand the term ‘exacerbation’. In ranked order, the nurses preferred the following terms: ‘flare-up’, ‘lung attack’, ‘crisis’, ‘exacerbation’ and ‘chest infection’. The term ‘crisis’, although new, was considered to be the term that most resonated with clinical practice.

Conclusion
Respiratory nurses in the UK report that the term ‘exacerbation’ is not fit for purpose for patients, and alternatives should be sought.
Are postoperative NLR and PLR associated with the magnitude of surgery-related trauma in young and middle-aged patients with bicondylar tibial plateau fractures? A retrospective study
Authors: Wang Zhongzheng , Wang Yanwei , Wang Yuchuan , Chen Wei , Zhang Yingze 
Published: September 2021

Abstract
Background
The invasiveness of different surgical procedures is variable. The purpose of this study was to investigate the value of the postoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) as biomarkers in assessing the magnitude of surgery-related trauma in young and middle-aged patients with bicondylar tibial plateau fractures (TPFs).

Methods
A total of 136 young and middle-aged patients with bicondylar TPFs who underwent surgical treatment between May 2016 and April 2020 were included. Details about demographic information, pre- and postoperative laboratory data, and surgical variables were obtained from the electronic database of our level I trauma center. According to the different surgery programs, all patients were divided into two groups: group 1, which represented minimally invasive reduction and internal fixation (MIRIF), and group 2, which represented open reduction and internal fixation (ORIF). Univariate and multivariate logistic regression and ROC curve analyses were used.

Results
The operative time, intraoperative tourniquet use, intraoperative blood loss, length of incision, postoperative NLR, PLR, RBC and HCRP were significantly different between the two groups (P < 0.05). In the multivariate analysis, postoperative PLR ≥ 223.9, surgical incision > 19.0 cm and operative time > 130 min were closely related to severe surgery-related trauma. The ROC curve analysis indicated that postoperative PLR could predict severe surgery-related trauma with a specificity of 76.0 % and a sensitivity of 55.7 %.

Conclusions
Postoperative PLR appears to be a useful biomarker that is closely associated with magnitude of surgery-related trauma in young and middle-aged patients with bicondylar TPFs.
Peripheral quantitative computed tomography in the assessment of bone mineral density in anti-TNF-treated rheumatoid arthritis and ankylosing spondylitis patients
Authors: Juhász Balázs , Gulyás Katalin , Horváth Ágnes , Végh Edit , Pusztai Anita , Szentpétery Ágnes , Pethő Zsófia , Bodnár Nóra , Hamar Attila , Bodoki Levente , Bhattoa Harjit Pal , Szekanecz Éva , Hodosi Katalin , Domján Andrea , Szamosi Szilvia , Horváth Csaba , Szántó Sándor , Szűcs Gabriella , Raterman Hennie G. , Lems Willem F. , FitzGerald Oliver , Szekanecz Zoltán 
Published: September 2021

AbstractIntroductionRheumatoid arthritis (RA) and ankylosing spondylitis (AS) are associated with osteoporosis. There have not been many peripheral quantitative computed tomography (QCT) studies in patients receiving biologics. We assessed volumetric and areal bone mineral density (BMD) by forearm QCT and dual-energy X-ray absorptiometry (DXA), respectively in addition to laboratory biomarkers in these arthritides.MethodsForty RA and AS patients treated with either etanercept (ETN) or certolizumab pegol (CZP) were undergoing follow-ups for one year. Volumetric and areal BMD, as well as parathyroid hormone (PTH), osteocalcin, RANKL, 25-hydroxyvitamin D (VITD), P1NP, CTX, sclerostin (SOST), Dickkopf 1 (DKK-1) and cathepsin K (CATHK) were determined.ResultsWe did not observe any further bone loss during the 12-month treatment period. Volumetric and areal BMD showed significant correlations with each other (p<0.017 after Bonferroni’s correction). Trabecular QCT BMD at baseline (p=0.015) and cortical QCT BMD after 12 months (p=0.005) were inversely determined by disease activity at baseline in the full cohort. Trabecular QCT BMD at baseline also correlated with CTX (p=0.011). In RA, CRP negatively (p=0.014), while SOST positively (p=0.013) correlated with different QCT parameters. In AS, RANKL at baseline (p=0.014) and after 12 months (p=0.007) correlated with cortical QCT BMD. In the full cohort, 12-month change in QTRABBMD was related to TNF inhibition together with elevated VITD-0 levels (p=0.031). Treatment and lower CATHK correlated with QCORTBMD changes (p=0.006). In RA, TNF inhibition together with VITD-0 (p<0.01) or CATHK-0 (p=0.002), while in AS, treatment and RANKL-0 (p<0.05) determined one-year changes in QCT BMD.ConclusionsBMD as determined by QCT did not change over one year of anti-TNF treatment. Disease activity, CATHK, RANKL and VITD may be associated with the effects of anti-TNF treatment on QCT BMD changes. RA and AS may differ in this respect.