bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sites of Blood Collection and Topical Disinfectants Associated with Contaminated Cultures: An Ambidirectional Cohort Study
Authors: Ota Koshi , Nishioka Daisuke , Ito Yuri , Hamada Emi , Ota Kanna , Shibata Yuriko , Takasu Akira 
Published: September 2021

Abstract
Background: We aimed to determine whether puncture sites for blood sampling and topical disinfectants are associated with rates of contaminated blood cultures in the emergency department (ED) of a single institution.Methods: This single-center, ambidirectional cohort study of 548 consecutive patients ≥ 20 years old was performed in the ED of a university hospital in Japan over a 13-month period. Pairs of blood samples were collected for aerobic and anaerobic cultures from patients in the ED. Physicians selected puncture sites and topical disinfectants according to their personal preference.Results: Potential contamination was identified in 110 of the 548 patients (20.1%). One hundred fourteen (20.8%) patients showed true-positive results for bacteremia and 324 (59.1%) patients showed true-negative results. Multivariate analysis revealed more frequent contamination when puncture sites were disinfected with povidone-iodine (PVI) than with alcohol/chlorhexidine (ACHX) (adjusted risk difference, 19.1%; 95% confidence interval [CI]), 15.7–22.6; P < 0.001). In terms of blood collection sites, femoral and central venous (CV) catheter with PVI disinfection showed more frequent contamination than venous sites with ACHX (adjusted risk differences: 26.6%, 95%CI 21.3–31.9, P < 0.001 and 41.1%, 95%CI 22.2–59.9, P < 0.001, respectively).Conclusions: Rates of contaminated blood cultures were significantly higher when blood was collected from CV catheter or femoral sites with PVI as the topical disinfectant.
Snail-Regulated Exosomal MicroRNA-21 Suppresses NLRP3 Inflammasome Activity to Enhance Chemoresistance
Authors: Cheng Han-Ying , Hsieh Chia-Hsin , Tai Shyh-Kuan , Chu Pen-Yuan , Lin Po-Han , Chen Yu-Tung , Hsu Dennis Shin-Shian , Yang Muh-Hwa 
Published: September 2021

Abstract
Compared to the precise targeting of drug-resistant mutant cancer cells, strategies for eliminating non-genetic adaptation-mediated resistance are limited. The pros and cons of the existence of inflammasomes in cancer have been reported. Nevertheless, the dynamic response of inflammasomes to therapies should be addressed. Here, we have demonstrated that in cancer cells undergoing Snail-induced epithelial-mesenchymal transition (EMT), tumor cells suppress NLRP3 inflammasome activities of tumor-associated macrophages (TAMs) in response to chemotherapy through the delivery of exosomal microRNA (miR)-21. Mechanistically, miR-21 represses PTEN and BRCC3 to facilitate NLRP3 phosphorylation and lysine-63 ubiquitination, inhibiting NLRP3 inflammasome assembly. Furthermore, the Snail-miR-21 axis shapes the post-chemotherapy tumor microenvironment (TME) by repopulating TAMs and by activating CD8+ T cells. In head and neck cancer patients, the Snail-high cases lacked post-chemotherapy IL-1β surge and were correlated with a worse response. This finding reveals the mechanism of EMT-mediated resistance beyond cancer stemness through modulation of post-treatment inflammasome activity. It also highlights the dynamic remodeling of the TME throughout metastatic evolution.
“Even Though They Insult Us, the Delivery They Give Us is the Greatest Thing”: A Qualitative Study Contextualizing Women’s Satisfaction with Facility-Based Maternal Health Care in Ethiopia
Authors: Hagaman Ashley , Rodriguez Humberto Gonzalez , Barrington Clare , Singh Kavita , Estifanos Abiy Seifu , Keraga Dorka Woldesenbet , Alemayehu Abiyou Kiflie , Magge Hema , Bitewulign Befikadu , Abate Mehiret , Barker Pierre 
Published: September 2021

Abstract
Background: Globally, amidst increased utilization of facility-based maternal care services, there is continued need to better understand women’s experience of care in places of birth. Quantitative surveys may not sufficiently characterize satisfaction with maternal healthcare (MHC) in local context, limiting their interpretation and applicability. The purpose of this study is to untangle how contextual and cultural expectations shape women’s care experience and what women mean by satisfaction in two Ethiopian regions. Methods: Health center and hospital childbirth care registries were used to identify and interview 41 women who had delivered a live newborn within a six-month period. We used a semi-structured interview guide informed by the Donabedian framework to elicit women’s experiences with MHC and delivery, any prior delivery experiences, and recommendations to improve MHC. We used an inductive analytical approach to compare and contrast MHC processes, experiences, and satisfaction. Results: Maternal and newborn survival and safety were central to women’s descriptions of their MHC experiences. Women nearly exclusively described healthy and safe deliveries with healthy outcomes as ‘satisfactory’. The texture behind this ‘satisfaction’, however, was shaped by what mothers bring to their delivery experiences, creating expectations from events including past births, experiences with antenatal care, and social and community influences. Secondary to the absence of adverse outcomes, health provider’s interpersonal behaviors (e.g., supportive communication and behavioral demonstrations of commitment to their births) and the facility’s amenities (e.g., bathing, cleaning, water, coffee, etc) enhanced women’s experiences. Finally, at the social and community levels, we found that family support and material resources may significantly buffer against negative experiences and facilitate women’s overall satisfaction, even in the context of poor-quality facilities and limited resources. Conclusion: Our findings highlight the importance of understanding contextual factors including past experiences, expectations, and social support that influence perceived quality of MHC and the agency a woman has to negotiate her care experience. Our finding that newborn and maternal survival primarily drove women’s satisfaction suggests that quantitative assessments conducted shortly following delivery may be overly influenced by these outcomes and not fully capture the complexity of women’s care experience.
Latissimus Dorsi Muscle Flap Transfer Through Endoscopic Approach Combined With the Implant After Tissue Expansion for Breast Reconstruction of Mastectomy Patients
Authors: Ma Jian-Xun , Li Bi , Xia You-Chen , You Wei-Tao , Zhang Jie , Sun Yi-Mou , Chang Xu , Lang Yue 
Published: September 2021

Abstract
Background: The increasing demand for breast reconstruction and good outcomes lead plastic surgeons to look for a new method to obtain more natural and aesthetically pleasing appearance of the reconstructed breasts.Methods: A retrospective review of thirty-one patients undergoing tissue expander (TE)/implant two-stage breast reconstruction with latissimus dorsi muscle flap (LDMF) transfer through endoscopic approach in Peking University Third Hospital from April 2016 to August 2020 was performed. The LDMF harvest time, drain time, and complications were reviewed. The 3D volume was obtained to assess the symmetry of bilateral breasts.Results: The mean endoscopic LDMF harvest time was 90.4 minutes (70.0~120.0 min). The average drain time after the final reconstruction was 10.1 days (6~19 days). In the mean follow-up of 11.2 months (6~28 months), there were no postoperative complications noted. The average post–reconstruction breasts asymmetry was 4.8%±2.4%, the reconstructed side achieved good volume symmetry to the contralateral side (P=0.256).Conclusions: The novel type of two-stage breast reconstruction protocol, which includes tissue expansion followed by implant insertion with endoscopy-assisted LDMF transfer, could effectively reduce visible scars, avoid the patch effect, shorten the LDMF harvest time and reduce the incidence of complications. It is a promising method for breast reconstruction because it achieves good outcomes in the mastectomy patients.
Comparison of Nitrogen Removal Efficiencies and Microbial Communities of Full-Scale Anaerobic, Anoxic and Aerobic Processes in Municipal Wastewater Treatment Plants having Low and High COD/TN Ratios
Authors: Phanwilai Supaporn , Noophan Pongsak , Li Chi-Wang , Choo Kwang-Ho 
Published: September 2021

Abstract
Full-scale anaerobic, anoxic and aerobic (A2O) process is used worldwide for biological nutrient removal (BNR). However, operation parameters for nitrogen removals and information of microbial communities related to nitrogen removal in full-scale A2O wastewater treatment plants (WWTPs) having low and high COD/TN ratios are not available. Based on the analysis of four full-scale A2O WWTPs, it is suggested that maintaining longer SRT of ≥ 30 day and DO of ≥ 0.9±0.2 mg-O2 L-1 is needed to improve nitrogen removal efficiency under low COD/TN ratio (≤ 3.7). On other hand, at high COD/TN ratio (≥ 4.2), DO level of ≥ 2.6 mg-O2 /L and typical SRT of 19‒ 25 days would be suggested. It was confirmed that phosphorus removal efficiency significantly improved under BOD/TP ratio of > 20 for A2O process in these full-scale WWTP. Microbial distribution analysis showed that ammonia-oxidizing archaea (AOA) was abundant under conditions of low DO level, longer SRT, high temperature and low COD/TN ratio (≤ 3.7). Nitrosomonas sp. are mostly found in aerobic tank of full-scale A2O WWTPs. However, abundances of Nitrosomonas sp. are proportional to DO and NH4+ concentrations for WWTPs with high COD/TN ratio. Nitrosospira sp. are only found under operating condition of longer SRT for WWTPs with low COD/TN ratio. Abundances of Nitrobacter sp. are proportional to DO concentration and temperature rather than abundance of Nitrospira sp. Predominance of nosZ-type denitrifiers were found at low COD/TN ratio. Abundance of denitrifiers by using nirS genes was over abundance of denitrifiers by using nirK genes at high COD/TN ratios WWTPs.
Long Non-Coding RNA SNHG12 Contributes to Cisplatin Resistance by Mediating WEE1 via miR-503-5p in Cervical Cancer
Authors: Dong Jing , Cong Qing , Xie Feng , Zhang Xiaojin 
Published: September 2021

Abstract
Background: Emerging evidences have indicated that the aberrant expression of long noncoding RNAs (lncRNAs) was responsible for drug resistance, which represents a major obstacle for chemotherapy failure. Our previous study has showed that small nuclear RNA host gene 12 (SNHG12) was increased and contributed to cell growth and invasion in cervical cancer. In the present study, we aimed to investigate the role of the lncRNA SNHG12 in cisplatin (DDP) resistance and elucidate its underlying mechanisms in cervical cancer.Methods: The expression and prognosis of SNHG12 in cervical cancer tissues were evaluated based on bioinformatics. MTT, colony formation assay and flow cytometer were performed to detect cell viability. Further, Molecular relationships among CTD-3252C9.4, IRF1 and IFI6 were investigated via luciferase reporter assay, western blot, and qRT-PCR. Finally, subcutaneous xenograft model was established to verify our findings.Results: In the present study, we evaluated the cell apoptosis and half maximal inhibitory concentration (IC50) of cervical cancer upon DDP treatment. Mechanically, we found that SNHG12 upregulated WEE1 expression to regulate cell and DDP resistance via sponging miR-503-5p. Moreover, SNHG12 silencing inhibited the growth of DDP-resistant cervical cancer tumors in vivo. Conclusions: Taken together, our findings suggested that a SNHG12/miR-503-5p/ WEE1 axis which modulated the chemoresistance of cervical cancer cell to DDP, and provided promising targets for dealing with the chemoresistance of cervical cancer.
Surgical Outcomes of Unilateral Lateral Rectus Recession Versus Recess-resect in Children With Small-to-medium Angle Convergence Insufficiency-type Intermittent Exotropia
Authors: Jang Yoon Kyung , Bae Seok Hyun , Choi Dong Gyu 
Published: September 2021

Abstract
To determine the efficacy of unilateral lateral rectus recession (ULR) for convergence insufficiency-type intermittent exotropia (CI-type IXT), we compared surgical outcomes following ULR and recess‒resect (RR) procedures for CI-type IXT. In this retrospective study, medical records of 57 children who underwent ULR (n = 30) or RR (n = 27) for CI-type IXT of less than 25 PD at distance with a postoperative follow-up of 6 months or more were reviewed. Surgical success was defined as an alignment between 10 PD exodeviation and 5 PD esodeviation at distance and near fixation. The postoperative exodeviation showed no significant difference between the two groups at the last follow-up. A significant reduction in the mean near-distance difference was achieved postoperatively in both groups: from 5.4 PD preoperatively to 2.5 at last follow-up after ULR, and from 8.2 to 2.4 after RR (both p = 0.001). However, this difference between ULR and RR was not statistically significant (p > 0.05). The success rate at the last follow-up was 63.3% for ULR and 70.4% for RR (p = 0.574). ULR was found to be an effective treatment for CI-type IXT, with similar surgical outcomes to RR.
Percutaneous Coronary Intervention Compared to Coronary Artery Bypass Grafting in Patients with Non-ST-Elevation Acute Coronary Syndrome – A Systematic Review and Meta-Analysis
Authors: Kirov Hristo , Caldonazo Tulio , Rahouma Mohamed , Robinson Bryce , Demetres Michelle , Serruys Patrick , Biondi-Zoccai Giuseppe , Gaudino Mario , Doenst Torsten 
Published: September 2021

Abstract
Objectives: Non-ST-elevation acute coronary syndrome (NSTE-ACS) affects millions of patients. Although an invasive strategy can improve survival, the optimal treatment (i.e., percutaneous coronary intervention [PCI] or coronary artery bypass grafting [CABG]) is not clear. We performed a meta-analysis of studies reporting outcomes between PCI and CABG in patients with NSTE-ACS.Methods: MEDLINE, EMBASE and Cochrane Library were assessed. The primary outcome was long-term mortality. Inverse variance method and random model were performed.Results: We identified 13 observational studies (48,891 patients). No significant difference was found in the primary endpoint (CABG vs. PCI, incidence rate ratio [IRR]= 0.93, 95% confidence interval [CI] 0.70; 1.23). CABG was associated with lower long-term major adverse cardiovascular events (MACE) (IRR= 0.64, 95% CI 0.54; 0.76) and lower long-term re-revascularization (IRR= 0.37, 95% CI 0.30; 0.47). There was no significant difference in long-term myocardial infarction (CABG vs. PCI, IRR= 0.96, 95% CI 0.50; 1.84) and peri-operative mortality (CABG vs. PCI, odds ratio [OR]= 1.36, 95% CI 0.94; 1.95).Conclusion: For the treatment of NSTE-ACS, CABG and PCI are associated with similar rates of long-term mortality and myocardial infarction. CABG is associated with lower rates of long-term MACE and re-revascularization. Randomized comparisons in this setting are necessary.
Evaluation of CMIP6 Models Toward Dynamical Downscaling Over Eight CORDEX Domains
Authors: Zhang Meng-Zhuo , Xu Zhongfeng , Han Ying , Guo Weidong 
Published: September 2021

Abstract
Both reliability and independence of global climate model (GCM) simulation are essential for model selection to generate a reasonable uncertainty range of dynamical downscaling simulations. In this study, we evaluate the performance and interdependency of 37 GCMs from the Coupled Model Intercomparison Project Phase 6 (CMIP6) in terms of seven key large-scale driving fields over eight CORDEX domains. A multivariable integrated evaluation method is used to evaluate and rank the models’ ability to simulate multiple variables in terms of their climatological mean and interannual variability. The results suggest that the model performance varies considerably with seasons, domains, and variables evaluated, and no model outperforms in all aspects. However, the multi-model ensemble mean performs much better than any individual model. Among 37 CMIP6 models, the MPI-ESM1-2-HR, FIO-ESM-2-0, and MPI-ESM1-2-LR rank top three due to their overall good performance across all domains. To measure the model interdependency in terms of multiple fields, we define the similarity of multivariate error fields between pairwise models. Our results indicate that the dependence exists between most of the CMIP6 models, and the models sharing the same idea or/and concept generally show less independence. Furthermore, we hierarchically cluster the top 15 models based on the similarity of multivariate error fields to facilitate the model selection. Our evaluation can provide useful guidance on the selection of CMIP6 models based on their performance and relative independence, which helps to generate a more reliable ensemble of dynamical downscaling simulations with reasonable inter-model spread.
A Study on Design, Development, Implementation, and Evaluation of Severe Drug-Drug Interaction Alert System in ICU
Authors: Karajizadeh mehrdad , Zand Farid , Sharifian Roxana , Vazin Afsaneh , Bayati Najmeh 
Published: September 2021

Abstract
Background and objective:
The overridden rate of Drug-Drug Interaction Alerts (DDIAs) in the Intensive Care Unit (ICU) is very high. Therefore, this study aimed to design, develop, implement, and evaluate a severe Drug-Drug Alert System (DDIAS) in ICU and measure the override rate of DDIAs.
Methods
This is a cross-sectional study for the design, development, implementation, and evaluation of severe DDIAs into a Computerized Provider Order Entry(CPOE) system in the ICUs of Nemazee general teaching hospitals in 2021. The patients exposed to the volume of DDIAs, acceptance and overridden of DDIAs, and usability of DDIAS have been collected.
Results
The knowledge base of DDIAS contains 9,809 severe DDIs. A total of 2672 medications were prescribed in the population study. The volume and acceptance rate for severe DDIAs were 81 and 97.5%, respectively. However, the override rate was 2.5%. The mean System Usability Scale (SUS) score of the DDIAS was 75.
Conclusion
This study demonstrated that the implementation of high-risk DDIAs at point of prescribing in ICU improved adherence to alerts. In addition, the usability of DDIAS was reasonable. Further studies are need to investigate the establishment of severe DDIAS and measure the physician's response to DDIAS on a larger scale.
Incidence and Risk Factors for Chronic Postsurgical Pain Following Video-assisted Thoracoscopic Surgery: a Retrospective Study
Authors: Zhang Yingying , Zhou Rong , Hou Bailing , Tang Suhong , Hao Jing , Gu Xiaoping , Ma Zhengliang , Zhang Juan 
Published: September 2021

Abstract
Backgroud: Video-assisted thoracoscopic surgery (VATS) has been widely used as an alternative for thoracotomy, but the reported incidence of chronic postsurgical pain (CPSP) following VATS varied widely. The purpose of this study was to investigate the incidence and risk factors for CPSP after VATS. Methods: We retrospectively collected preoperative demographic, anesthesiology, and surgical factors in a cohort of patients undergoing VATS between January 2018 and October 2020. Patients were interviewed via phone survey for pain intensity, and related medical treatment 3 months after VATS. Univariate and multivariate analysis were used to explore independent risk factors associated with CPSP.Results: 2,348 patients were included in our study. The incidence of CPSP after VATS were 43.99% (n = 1,033 of 2,348). Within those suffering CPSP, 14.71% (n = 152 of 1,033) patients reported moderate or severe chronic pain. Only 15.23% (n = 23 of 152) patients with moderate to severe chronic pain sought active analgesic therapies. According to multivariable analysis, age ＜ 65 years (OR 1.278, 95% CI 1.057-1.546, P = 0.011), female (OR 1.597, 95% CI 1.344-1.898, P < 0.001), education level less than junior school (OR 1.295, 95% CI 1.090-1.538, P = 0.003), preoperative pain (OR 2.564, 95% CI 1.696-3.877, P < 0.001), consumption of rescue analgesia postoperative (OR 1.248, 95% CI 1.047-1.486, P = 0.013), consumption of sedative hypnotic postoperative (OR 2.035, 95% CI 1.159-3.574, P = 0.013), subcutaneous emphysema of chest wall postoperative (OR 1.255, 95% CI 1.000-1.575, P = 0.050), and history of postoperative wound infection (OR 5.949, 95% CI 1.344-1.898, P < 0.001) were independent risk factors for CPSP development.Conclusions: CPSP remains a challenge in clinic because half of patients may develop CPSP after VATS. Trial registration: Chinese Clinical Trial Registry (ChiCTR2100045765), 2021/04/24
Micro-Fourier-Transform Infrared Reflectance Spectroscopy as Tool for Probing IgG Glycosylation in COVID-19 Patients
Authors: Bandeira Carla , Madureira Karen , Rossi Meire , Gallo Juliana , Silva Ana Paula da , Torres Vilanilse , de Lima Vinicius , Júnior Norival Kesper , Almeida Janete , Zerbinati Rodrigo , Braz-Silva Paulo , Lindoso Jose Angelo Lauletta , Martinho Herculano 
Published: September 2021

Abstract
It has been reported that patients diagnosed with COVID-19 become critically ill primarily around the time of activation of the adaptive immune response. However the role of antibodies in the worsening of disease is not obvious. Higher titers of anti-spike immunoglobulin IgG1 associated to low fucosylation of the antibody Fc tail have been associated to excessive inflammatory response. In contrast it has been also reported in literature that NP-, S-, RBD- specific IgA, IgG, IgM are not associated with SARS-CoV-2 viral load, indicating that there is no obvious correlation between antibody response and viral antigen detection. In the present work the micro-Fourier-Transform Infrared reflectance spectroscopy (micro-FTIR) was employed to investigate blood serum samples of healthy and COVID-19 (mild or oligosynthomatic) individuals (82 healthcare workers volunteers in “Instituto de Infectologia Emilio Ribas”, São Paulo, Brazil). The molecular-level-sensitive, multiplexing quantitative and qualitative FTIR data probed on 1 mL of dryed biofluidwas compared to Signal-to-Cutoff index of chemiluminescent immunoassays CLIA and ELISA (IgG antibodies against SARS-CoV-2). Our main result indicated that 1702-1785 cm-1 spectral window (carbonyl C=O vibration) appeared to be a spectral marker of the degree of IgG glycosylation, allowing to probe distinctive subpopulations of COVID-19 patients, depending on their degree of severity. The specificity was 87.5 % while the detection rate of true positive was 100%. The computed area under the receiver operating curve was equivalent to CLIA, ELISA and other ATR-FTIR methods (> 0.85). In summary, overall discrimination of healthy and COVID-19 individuals and severity prediction as well could also be potentially implemented using micro-FTIR reflectance spectroscopy on blood serum samples. Considering the minimal and reagent-free sample preparation procedures combined to fast (few minutes) outcome of FTIR we can state that this technology is very suitable for fast screening of immune response of individuals with COVID-19. It would be an important tool in prospective studies, helping investigate the physiology of the asymptomatic, oligosymptomatic, or severe individuals and measure the extension of infection dissemination in patients.