bluuebunny/crossref_metadata_2025_split huggingface dataset:
CCR2- and Flt3-Dependent Inflammatory Conventional Type 2 Dendritic Cells Are Necessary for the Induction of Adaptive Immunity by the Human Vaccine Adjuvant System AS01
Authors: Bosteels Cedric , Fierens Kaat , De Prijck Sofie , Van Moorleghem Justine , Vanheerswynghels Manon , De Wolf Caroline , Chalon Aurélie , Collignon Catherine , Hammad Hamida , Didierlaurent Arnaud M. , Lambrecht Bart N. 
Published: January 2021

The Adjuvant System AS01 contains monophosphoryl lipid A (MPL) and the saponin QS-21 in a liposomal formulation. AS01 is included in recently developed vaccines against malaria and varicella zoster virus. Like for many other adjuvants, induction of adaptive immunity by AS01 is highly dependent on the ability to recruit and activate dendritic cells (DCs) that migrate to the draining lymph node for T and B cell stimulation. The objective of this study was to more precisely address the contribution of the different conventional (cDC) and monocyte-derived DC (MC) subsets in the orchestration of the adaptive immune response after immunization with AS01 adjuvanted vaccine. The combination of MPL and QS-21 in AS01 induced strong recruitment of CD26+XCR1+ cDC1s, CD26+CD172+ cDC2s and a recently defined CCR2-dependent CD64-expressing inflammatory cDC2 (inf-cDC2) subset to the draining lymph node compared to antigen alone, while CD26-CD64+CD88+ MCs were barely detectable. At 24 h post-vaccination, cDC2s and inf-cDC2s were superior amongst the different subsets in priming antigen-specific CD4+ T cells, while simultaneously presenting antigen to CD8+ T cells. Diphtheria toxin (DT) mediated depletion of all DCs prior to vaccination completely abolished adaptive immune responses, while depletion 24 h after vaccination mainly affected CD8+ T cell responses. Vaccinated mice lacking Flt3 or the chemokine receptor CCR2 showed a marked deficit in inf-cDC2 recruitment and failed to raise proper antibody and T cell responses. Thus, the adjuvant activity of AS01 is associated with the potent activation of subsets of cDC2s, including the newly described inf-cDC2s.
Preparation of 304 Stainless Steel Powder for 3D Printing by Vacuum-Induced Multistage Atomization
Authors: Jiang Xueyu , Che Xin , Tian Chen , Zhu Xiaofei , Zhou Ge , Chen Lijia , Li Jianlin 
Published: January 2021

A vacuum-induced multistage atomization process was adopted to fabricate the high-performance 304 stainless steel powder for 3D printing, based on the flexible control of the droplet spheroidization and solidification process. The 36.7 μm-median diameter (D50) 304 stainless steel powder with high sphericity was successfully obtained, together with particle size proportion of 45–55 μm larger than 35% and the lower oxygen and nitrogen content increment below 0.04%.
Telemedicine Guidelines in South East Asia—A Scoping Review
Authors: Intan Sabrina Mohamad , Defi Irma Ruslina 
Published: January 2021

Background: Telemedicine is a useful tool to deliver healthcare to communities in low- to high-income countries, especially in the coronavirus disease 2019 pandemic era. Guidelines on telemedicine would assist healthcare providers in delivering healthcare services based on local circumstances.Objective: To explore and compare guidelines on telehealth and telemedicine in South East Asian countries.Methods: Electronic databases such as Google, PubMed, and Cochrane reviews were searched for articles using keywords such as “telemedicine” OR “telehealth” OR “eHealth” OR “telemedis” AND “guidelines” AND “South East Asia” OR “Malaysia” OR “Singapore” OR “Indonesia” OR “Thailand” OR “Vietnam” published up to 2020. Inclusion criteria were full articles and gray materials (i.e., policy statements, advisories, blueprints, executive summaries, and circulars) related to telemedicine guidelines. No language restrictions were imposed. Only the first 100 Google searches were included for eligibility based on its relevance to telemedicine guidelines. Exclusion criteria were abstracts, duplicate publications, blogs, news articles, promotional brochures, conference proceedings, and telemedicine projects unrelated to telemedicine guidelines.Results: A total of 62,300 articles were identified through the search engines (Google 62,203, PubMed 77, and Cochrane 20) and six articles from additional sources. Sixty-eight full-text articles fulfilled the inclusion criteria, but only 24 articles contained some form of guidelines on telemedicine: Indonesia (nine), Malaysia (seven), Singapore (five), Thailand (two), and Vietnam (one). There were six laws, six advisory guidelines, five policy statements, and two circulars (regulations) issued by either the Ministry of Communication and Multimedia, Ministry of Health, or Medical Councils from the respective countries. Issues addressed were clinical governance (100%); information and communication technology infrastructure (83.3%); privacy, storage, and record-keeping (77.8%, respectively); ethics and legal (77.8%); security and safety (72.2%); definitions and applications of telemedicine (72.2%); confidentiality (66.7%); licensing (66.7%); identification (55.6%); cost of information and communication technology infrastructure (55.6%); reimbursement (16.7%); mobile applications (11.1%); and feedback and choices (5.6%). The Singapore National Telemedicine Guidelines contained the most domains compared with other guidelines from South East Asia.Conclusions: Although there can be no “one-size-fits-all” telemedicine guideline, there should be a comprehensive and universal telemedicine guideline for any country to adapt based on the local context. Details on patient-identification, data ownership, back-up, and disposal; transregional cybersecurity laws and ways to overcome the limitations of telemedicine compared with face-to-face consultations should be outlined clearly to ensure uniformity of telemedicine service and patient safety.
Atypical Resting-State Functional Connectivity Dynamics Correlate With Early Cognitive Dysfunction in HIV Infection
Authors: Nguchu Benedictor Alexander , Zhao Jing , Wang Yanming , Li Yu , Wei Yarui , Uwisengeyimana Jean de Dieu , Wang Xiaoxiao , Qiu Bensheng , Li Hongjun 
Published: January 2021

Purpose: Previous studies have shown that HIV affects striato-cortical regions, leading to persisting cognitive impairment in 30–70% of the infected individuals despite combination antiretroviral therapy. This study aimed to investigate brain functional dynamics whose deficits might link to early cognitive decline or immunologic deterioration.Methods: We applied sliding windows and K-means clustering to fMRI data (HIV patients with asymptomatic neurocognitive impairment and controls) to construct dynamic resting-state functional connectivity (RSFC) maps and identify states of their reoccurrences. The average and variability of dynamic RSFC, and the dwelling time and state transitioning of each state were evaluated.Results: HIV patients demonstrated greater variability in RSFC between the left pallidum and regions of right pre-central and post-central gyri, and between the right supramarginal gyrus and regions of the right putamen and left pallidum. Greater variability was also found in the frontal RSFC of pars orbitalis of the left inferior frontal gyrus and right superior frontal gyrus (medial). While deficits in learning and memory recall of HIV patients related to greater striato-sensorimotor variability, deficits in attention and working memory were associated with greater frontal variability. Greater striato-parietal variability presented a strong link with immunologic function (CD4+/CD8+ ratio). Furthermore, HIV-infected patients exhibited longer time and reduced transitioning in states typified by weaker connectivity in specific networks. CD4+T-cell counts of the HIV-patients were related to reduced state transitioning.Conclusion: Our findings suggest that HIV alters brain functional connectivity dynamics, which may underlie early cognitive impairment. These findings provide novel insights into our understanding of HIV pathology, complementing the existing knowledge.
Two Symptoms Strongly Suggest Benign Paroxysmal Positional Vertigo in a Dizzy Patient
Authors: van Dam Victor S. , Maas Britta D. P. J. , Schermer Tjard R. , van Benthem Peter-Paul G. , Bruintjes Tjasse D. 
Published: January 2021

Introduction: This prospective cohort study determined which questions in patient history are most likely to identify symptoms that are independently associated with a diagnosis of benign paroxysmal positional dizziness (BPPV) in patients presenting with dizziness, and to evaluate whether the patient's age and type of BPPV are of influence.Methods: We included adult patients with dizziness referred to our dizziness center, Apeldoorn, the Netherlands, from December 2018 to November 2019. All patients completed a questionnaire, underwent vestibular testing and received a diagnosis. Symptoms strongly suggesting BPPV were tested with multivariable analysis to determine their independent associations with BPPV. Subgroup analysis was performed for patient age, and the type of BPPV.Results: We included a total of 885 patients, 113 of whom (13%) were diagnosed with BPPV. The duration of dizziness spells &lt;1 min (Q2) and dizziness provoked by rolling over in bed (Q4) were independently associated with the diagnosis BPPV. Q2 showed a sensitivity of 43%, and a specificity of 75%; Q4 scored 81% and 68%, respectively. Overall, the way patients perceived their dizziness (vertigo, light-headedness or instability) was not independently associated with the diagnosis BPPV. In younger patients, light-headedness and instability decreased the likelihood of BPPV compared to vertigo.Conclusion: The most reliable predictors for BPPV in patient history are a short duration of the dizziness spell and provocation of dizziness by rolling over in bed. Unlike younger patients, elderly patients with BPPV do not only perceive the dizziness as vertigo, but also as a feeling of instability.
Long-Term Oncologic Outcomes After Laparoscopic and Robotic Tumor Enucleation for Renal Cell Carcinoma
Authors: Dong Wen , Chen Xiong , Huang Ming , Chen Xu , Gao Ming , Ou Dehua , Li Kaiwen , Wang Chenyang , Wu Shaoxu , Liu Hao , Xie Weibin , Xie Wenlian , Campbell Steven C. , Lin Tianxin , Huang Jian 
Published: January 2021

ObjectivesTumor enucleation (TE) optimizes parenchymal preservation with promising short-term oncologic outcomes compared with standard partial nephrectomy (SPN). However, researches/literatures about long-term oncologic outcomes for TE after minimally invasive surgery are scarce. We aim to analyze long-term oncologic outcomes after laparoscopic and robotic tumor enucleation for renal cell carcinoma (RCC).Patients and MethodsWe retrospectively analyzed 146 patients who underwent TE with either laparoscopic or robotic approach for localized RCC in our center. Local recurrence, cancer specific survival (CSS), recurrence free survival (RFS), and overall survival (OS) were the main outcomes. Survival curves were generated using a Kaplan-Meier method. Perioperative outcomes and pathological outcomes were also analyzed.ResultsOverall, 98 male and 48 female patients were eligible for the study. The median tumor size was 3.4 cm with a median R.E.N.A.L. score of seven. Warm ischemia was used in 143 patients with a median ischemia time of 20 min and three patients had zero ischemia. Five patients (3.4%) had major complications (&gt; Clavien IIIa) and only two were related to urinary system. The median global glomerular filtration rate (GFR) preserved after surgery was 93%. Pseudocapsule invasion was reported in 50 tumors (34%) and positive surgical margins were found in 3/146 (2.1%) tumors. At a median follow-up of 66 months, local recurrence happened in two patients (1.4%), and systemic recurrence happened in six patients (4.2%). The 5-year CSS, RFS, OS were 95.7, 89.6, and 91.9%, and the 10-year CSS, RFS, OS were 93.8, 89.6, and 90.0%, respectively.ConclusionThis study indicates that tumor enucleation with laparoscopic or robotic approach in experienced hands for the treatment of RCC appears oncologically safe with a median follow-up of more than 5 years. Prospective studies with more patients and longer follow-up will be required to further evaluate oncologic safety after TE.
Machine Learning for Histologic Subtype Classification of Non-Small Cell Lung Cancer: A Retrospective Multicenter Radiomics Study
Authors: Yang Fengchang , Chen Wei , Wei Haifeng , Zhang Xianru , Yuan Shuanghu , Qiao Xu , Chen Yen-Wei 
Published: January 2021

BackgroundHistologic phenotype identification of Non-Small Cell Lung Cancer (NSCLC) is essential for treatment planning and prognostic prediction. The prediction model based on radiomics analysis has the potential to quantify tumor phenotypic characteristics non-invasively. However, most existing studies focus on relatively small datasets, which limits the performance and potential clinical applicability of their constructed models.MethodsTo fully explore the impact of different datasets on radiomics studies related to the classification of histological subtypes of NSCLC, we retrospectively collected three datasets from multi-centers and then performed extensive analysis. Each of the three datasets was used as the training dataset separately to build a model and was validated on the remaining two datasets. A model was then developed by merging all the datasets into a large dataset, which was randomly split into a training dataset and a testing dataset. For each model, a total of 788 radiomic features were extracted from the segmented tumor volumes. Then three widely used features selection methods, including minimum Redundancy Maximum Relevance Feature Selection (mRMR), Sequential Forward Selection (SFS), and Least Absolute Shrinkage and Selection Operator (LASSO) were used to select the most important features. Finally, three classification methods, including Logistics Regression (LR), Support Vector Machines (SVM), and Random Forest (RF) were independently evaluated on the selected features to investigate the prediction ability of the radiomics models.ResultsWhen using a single dataset for modeling, the results on the testing set were poor, with AUC values ranging from 0.54 to 0.64. When the merged dataset was used for modeling, the average AUC value in the testing set was 0.78, showing relatively good predictive performance.ConclusionsModels based on radiomics analysis have the potential to classify NSCLC subtypes, but their generalization capabilities should be carefully considered.
The Understanding of Peak Oxygen Uptake in Children Aged 8–16
Authors: Wong Simpson W. L. , Yu Clare C. W. , Li Albert M. 
Published: January 2021

Objective: To examine the understanding of the concept peak oxygen uptake (peak VO2) among children and adolescents at different ages from a developmental perspective.Methods: A total of 549 children and adolescents aged 8 to 16 were recruited and instructed to fill in a 20-item Peak VO2Understanding Inventory developed with reference to the research literature on peak VO2. We presented the participants with twenty scenarios and asked them to indicate whether peak VO2 would “remain unchanged,” “increase,” or “decrease,” or that there was “insufficient information for a definite answer.” The cross-sectional data was analyzed by employing a series of ANOVA analyses and chi-square association tests. Additional statistical analyses were performed to examine the error patterns and if there were gender differences.Results: Except for the 8-year-old group, the overall accuracy rate did not improve with age. Age-related differences in the choice of answers (“increase,” “decrease,” “unchanged,” and “uncertain”) for determining the resulting peak VO2 after a change of antecedent were observed. Error analysis by item showed that prefactual thinking that is important to understand the concept was emerging rather than fully developed in our child and adolescent samples.Conclusion: The mastery of peak VO2 is not subject to age-related maturation but might demand the acquisition of specific logical reasoning skill such as perfactual thinking. Early introduction of peak VO2 and related concepts is advocated and should be emphasized on the reasoning rather than providing model answers in physical literacy education.
Home Albumin Infusion Therapy, Another Alternative Treatment in Patients With Congenital Nephrotic Syndrome of the Finnish Type
Authors: Serramontmany Eugènia , Muñoz Marina , Fernández-Polo Aurora , Morillo María , Gómez-Ganda Laura , Cañete-Ramírez Carme , Ariceta Gema 
Published: January 2021

Background:Congenital nephrotic syndrome of the Finnish type (CNF) is a rare, severe glomerular disease caused by mutations in the NPHS1 gene, which codes for nephrin. It is characterised by massive proteinuria and severe edoema. Progression to end-stage kidney failure occurs during early childhood and the only curative treatment is kidney transplantation. Nowadays, patients need aggressive medical treatment, which includes daily albumin infusions (for months) until they get clinical stability to receive transplant.Objective:In our paediatric hospital, we implemented a multidisciplinary program for the home infusion of albumin with outpatient follow-up. The aim of the study was to assess the safety and efficacy of this program for the first four years of its implementation.Material and Methods:Retrospective observational study of CNF paediatric patients treated with home albumin infusion therapy from March 2014 to July 2018 at a tertiary care paediatric hospital. Information on albumin administration was obtained from the electronic prescription assistance program and details on clinical and care-related variables from the hospital's electronic information systems.Results:Four patients with CNF received albumin infusions for 18, 21, 22 months, and 3 years. The treatment was safe, and the complication rates were to be expected considering the severity of disease. Patients required a median of two hospital admissions a year (19 in total); 47% due to catheter-related complications, but there were just three catheter infections.Conclusions:In our experience, home albumin infusion therapy is safe and effective and helps to improve children health and quality of life.
SARS-CoV-2 Infections in Italian Schools: Preliminary Findings After 1 Month of School Opening During the Second Wave of the Pandemic
Authors: Buonsenso Danilo , De Rose Cristina , Moroni Rossana , Valentini Piero 
Published: January 2021

Introduction: The impact of school opening on the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic is still unknown. This study aims to provide preliminary information about the number of SARS-CoV-2 cases among students attending Italian schools.Methods: Data are extracted and analyzed from an open-access, online dataset that monitor, on a daily basis, media news about SARS-CoV-2 infections of students attending Italian schools.Results: As of October 5, 2020, a total of 1,350 cases of SARS-CoV-2 infections have been registered in the Italian territory schools (involving 1,059 students, 145 teachers, and 146 other school members), for a total of 1,212 out of 65,104 (1.8%) Italian schools involved. National schools reported only one case of SARS-CoV-2 infection in more than 90% of cases, and only in one high school a cluster of more than 10 cases has been described (P = 0.015). The detection of one or more SARS-CoV-2 infections led to the closure of 192 (15.8%) entire schools, more frequently nursery/kindergartens (P &lt; 0.0005).Discussion: Our preliminary data support low transmission of SARS-CoV-2 within schools, at least among younger students. However, entire schools are frequently closed in the fear of larger outbreaks. Continuous monitoring of school settings, hopefully through daily updated open-access datasets, is needed to better understand the impact of schools on the pandemic and provide guidelines that better consider different risks within different age groups.
Transcatheter Closure of Patent Ductus Arteriosus in Premature Infants With Very Low Birth Weight
Authors: Wang Jieh-Neng , Lin Yung-Chieh , Hsieh Min-Ling , Wei Yu-Jen , Ju Ying-Tzu , Wu Jing-Ming 
Published: January 2021

Background: The aim of this study was to describe our experience with transcatheter device closure of patent ductus arteriosus (PDA) in symptomatic low-birth-weight premature infants.Methods: We performed a retrospective study of infants born with a birth body weight of &lt; 2,000 g and admitted to National Cheng Kung University Hospital from September 2014 to December 2019. Basic demographic and clinical information as well as echocardiographic and angiographic data were recorded.Results: Twenty-five premature infants (11 boys and 14 girls) born at gestational ages ranging between 22 and 35 weeks (mean, 25 weeks) were identified. The mean age at procedure was 34.5 ± 5.5 days, and the mean weight was 1,209 ± 94 g (range, 478–1,980 g). The mean diameter of the PDA was 3.4 ± 0.2 mm (range, 2.0–5.4 mm). The following devices were used in this study: Amplatzer Ductal Occluder II additional size (n = 20), Amplatzer Vascular Plug I (n = 1), and Amplatzer Vascular Plug II (n = 4). Complete closure was achieved in all patients. The mean follow-up period was 30.1 ± 17.3 months (range, 6–68 months). In total, 3 patients had left pulmonary artery (LPA) stenosis and 1 patient had coarctation of the aorta during the follow-up period. Younger procedure age and smaller procedure body weight were significantly associated with these obstructions.Conclusions: Performing transcatheter PDA closure in symptomatic premature infants weighing more than 478 g is feasible using currently available devices; moreover, the procedure serves as an alternative to surgery.
Activation of Tripartite Motif Containing 63 Expression by Transcription Factor EB and Transcription Factor Binding to Immunoglobulin Heavy Chain Enhancer 3 Is Regulated by Protein Kinase D and Class IIa Histone Deacetylases
Authors: Pablo Tortola Cristina , Fielitz Britta , Li Yi , Rüdebusch Julia , Luft Friedrich C. , Fielitz Jens 
Published: January 2021

RationaleThe ubiquitin–proteasome system (UPS) is responsible for skeletal muscle atrophy. We showed earlier that the transcription factor EB (TFEB) plays a role by increasing E3 ubiquitin ligase muscle really interesting new gene-finger 1(MuRF1)/tripartite motif-containing 63 (TRIM63) expression. MuRF 1 ubiquitinates structural proteins and mediates their UPS-dependent degradation. We now investigated how TFEB-mediated TRIM63 expression is regulated.ObjectiveBecause protein kinase D1 (PKD1), histone deacetylase 5 (HDAC5), and TFEB belong to respective families with close structural, regulatory, and functional properties, we hypothesized that these families comprise a network regulating TRIM63 expression.Methods and ResultsWe found that TFEB and transcription factor for immunoglobulin heavy-chain enhancer 3 (TFE3) activate TRIM63 expression. The class IIa HDACs HDAC4, HDAC5, and HDAC7 inhibited this activity. Furthermore, we could map the HDAC5 and TFE3 physical interaction. PKD1, PKD2, and PKD3 reversed the inhibitory effect of all tested class IIa HDACs toward TFEB and TFE3. PKD1 mediated nuclear export of all HDACs and lifted TFEB and TFE3 repression. We also mapped the PKD2 and HDAC5 interaction. We found that the inhibitory effect of PKD1 and PKD2 toward HDAC4, HDAC5, and HDAC7 was mediated by their phosphorylation and 14-3-3 mediated nuclear export.ConclusionTFEB and TFE3 activate TRIM63 expression. Both transcription factors are controlled by HDAC4, HDAC5, HDAC7, and all PKD-family members. We propose that the multilevel PKD/HDAC/TFEB/TFE3 network tightly controls TRIM63 expression.