bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a large spontaneous pneumothorax after recovery from mild COVID-19 infection
Authors: Nunna Krishidhar , Braun Andrea Barbara 
Published: January 2021

A previously healthy 37-year-old man presented with fevers and myalgias for a week with a minimal dry cough. Initial SARS-CoV-2 nasopharyngeal testing was negative, but in light of high community prevalence, he was diagnosed with COVID-19, treated with supportive care and self-quarantined at home. Three days after resolution of all symptoms, he developed sudden onset chest pain. Chest imaging revealed a large right-sided pneumothorax and patchy subpleural ground glass opacities. IgM and IgG antibodies for SARS-CoV-2 were positive. His pneumothorax resolved after placement of a small-bore chest tube, which was removed after 2 days.This case demonstrates that patients with COVID-19 can develop a significant pulmonary complication, a large pneumothorax, despite only minimal lower respiratory tract symptoms and after resolution of the original illness. Medical professionals should consider development of a pneumothorax in patients who have recovered from COVID-19 and present with new respiratory symptoms.
Management of non-alcoholic fatty liver disease
Authors: Petroni Maria Letizia , Brodosi Lucia , Bugianesi Elisabetta , Marchesini Giulio 
Published: January 2021

ABSTRACT
Non-alcoholic fatty liver disease is a very common medical condition, driven by a combination of genetic and lifestyle factors, ultimately producing a severe chronic liver disease and increased cardiovascular risk. Most people are asymptomatic for a long time, and their daily life is unaffected, leading to difficulty in identifying and managing people who slowly progress to non-alcoholic steatohepatitis (NASH), NASH-cirrhosis, and eventually hepatocellular carcinoma. Despite advances in the understanding of pathogenic mechanisms and the identification of liver fibrosis as the strongest factor in predicting disease progression, no specific treatments have been approved by regulatory agencies. Outside controlled trials, treatment is generally limited to lifestyle intervention aimed at weight loss. Pioglitazone remains the drug of choice to reduce progression of fibrosis in people with diabetes, although it is often used off-label in the absence of diabetes. Vitamin E is mainly used in children and may be considered in adults without diabetes. Several drugs are under investigation according to the agreed targets of reduced NASH activity without worsening of fibrosis or improving fibrosis without worsening of NASH. Anti-inflammatory, anti-fibrotic agents and metabolism modulators have been tested in either phase III or phase IIb randomized controlled trials; a few failed, and others have produced marginally positive results, but only a few are being tested in extension studies. The development of non-invasive, easily repeatable surrogate biomarkers and/or imaging tools is crucial to facilitate clinical studies and limit liver biopsy.
Electronic health record alerts for acute kidney injury: multicenter, randomized clinical trial
Authors: Wilson F Perry , Martin Melissa , Yamamoto Yu , Partridge Caitlin , Moreira Erica , Arora Tanima , Biswas Aditya , Feldman Harold , Garg Amit X , Greenberg Jason H , Hinchcliff Monique , Latham Stephen , Li Fan , Lin Haiqun , Mansour Sherry G , Moledina Dennis G , Palevsky Paul M , Parikh Chirag R , Simonov Michael , Testani Jeffrey , Ugwuowo Ugochukwu 
Published: January 2021

Abstract

Objective
To determine whether electronic health record alerts for acute kidney injury would improve patient outcomes of mortality, dialysis, and progression of acute kidney injury.

Design
Double blinded, multicenter, parallel, randomized controlled trial.

Setting
Six hospitals (four teaching and two non-teaching) in the Yale New Haven Health System in Connecticut and Rhode Island, US, ranging from small community hospitals to large tertiary care centers.

Participants
6030 adult inpatients with acute kidney injury, as defined by the Kidney Disease: Improving Global Outcomes (KDIGO) creatinine criteria.

Interventions
An electronic health record based “pop-up” alert for acute kidney injury with an associated acute kidney injury order set upon provider opening of the patient’s medical record.

Main outcome measures
A composite of progression of acute kidney injury, receipt of dialysis, or death within 14 days of randomization. Prespecified secondary outcomes included outcomes at each hospital and frequency of various care practices for acute kidney injury.

Results

6030 patients were randomized over 22 months. The primary outcome occurred in 653 (21.3%) of 3059 patients with an alert and in 622 (20.9%) of 2971 patients receiving usual care (relative risk 1.02, 95% confidence interval 0.93 to 1.13, P=0.67). Analysis by each hospital showed worse outcomes in the two non-teaching hospitals (n=765, 13%), where alerts were associated with a higher risk of the primary outcome (relative risk 1.49, 95% confidence interval 1.12 to 1.98, P=0.006). More deaths occurred at these centers (15.6% in the alert group
v
8.6% in the usual care group, P=0.003). Certain acute kidney injury care practices were increased in the alert group but did not appear to mediate these outcomes.

Conclusions
Alerts did not reduce the risk of our primary outcome among patients in hospital with acute kidney injury. The heterogeneity of effect across clinical centers should lead to a re-evaluation of existing alerting systems for acute kidney injury.

Trial registration

ClinicalTrials.gov
NCT02753751
.
Neurovascular coupling alterations in type 2 diabetes: a 5-year longitudinal MRI study
Authors: Zhang Yang , Zhang Xiaolu , Ma Guangyang , Qin Wen , Yang Jiayang , Lin Jiahui , Zhang Quan 
Published: January 2021

IntroductionRespective alterations in resting-state brain neural activity and cerebral blood flow (CBF) in type 2 diabetes mellitus (T2DM) have been reported. However, their coupling alteration in T2DM remains largely unknown.Research design and methodsTwenty-seven patients with T2DM aged 40–67 years and 36 well-matched healthy controls (HCs) underwent resting-state functional MRI (rs-fMRI) and arterial spin labeling (ASL) scans at two time points with a 5-year interval. Regional homogeneity (ReHo) and CBF were calculated from rs-fMRI and ASL, respectively. The standardized ReHo:CBF ratio (mReHo:mCBF ratio), the spontaneous neuronal activity per unit CBF supply, was compared between the two time points. Relationships between the mReHo:mCBF ratio and memory performance were analyzed.ResultsOver 5 years, decreased mReHo:mCBF ratios in patients with T2DM were mainly distributed in four regions, among which the left insula exhibited more severely decreased mReHo:mCBF ratio in patients with T2DM than in HCs, while the left postcentral gyrus, the right Rolandic operculum, and the right precentral gyrus showed no significant intergroup difference. Correlations between the mReHo:mCBF ratio and memory performance were also found in patients with T2DM.ConclusionsThis study suggests that T2DM may accelerate neurovascular coupling impairment in specific brain regions (the left insula), contributing to memory decline. This study implies that the mReHo:mCBF ratio is a potential imaging marker for detecting neurovascular changes.
Workforce capacity for the care of patients with kidney failure across world countries and regions
Authors: Riaz Parnian , Caskey Fergus , McIsaac Mark , Davids Razeen , Htay Htay , Jha Vivekanand , Jindal Kailash , Jun Min , Khan Maryam , Levin Adera , Lunney Meaghan , Okpechi Ikechi , Pecoits-Filho Roberto , Osman Mohamed A , Vachharajani Tushar , Ye Feng , Harris David , Tonelli Marcello , Johnson David , Bello Aminu 
Published: January 2021

IntroductionAn effective workforce is essential for optimal care of all forms of chronic diseases. The objective of this study was to assess workforce capacity for kidney failure (KF) care across world countries and regions.MethodsData were collected from published online sources and a survey was administered online to key stakeholders. All country-level data were analysed by International Society of Nephrology region and World Bank income classification.ResultsThe general healthcare workforce varies by income level: high-income countries have more healthcare workers per 10 000 population (physicians: 30.3; nursing personnel: 79.2; pharmacists: 7.2; surgeons: 3.5) than low-income countries (physicians: 0.9; nursing personnel: 5.0; pharmacists: 0.1; surgeons: 0.03). A total of 160 countries responded to survey questions pertaining to the workforce for the management of patients with KF. The physicians primarily responsible for providing care to patients with KF are nephrologists in 92% of countries. Global nephrologist density is 10.0 per million population (pmp) and nephrology trainee density is 1.4 pmp. High-income countries reported the highest densities of nephrologists and nephrology trainees (23.2 pmp and 3.8 pmp, respectively), whereas low-income countries reported the lowest densities (0.2 pmp and 0.1 pmp, respectively). Low-income countries were most likely to report shortages of all types of healthcare providers, including nephrologists, surgeons, radiologists and nurses.ConclusionsResults from this global survey demonstrate critical shortages in workforce capacity to care for patients with KF across world countries and regions. National and international policies will be required to build a workforce capacity that can effectively address the growing burden of KF and deliver optimal care.
Towards biomarkers for outcomes after pancreatic ductal adenocarcinoma and ischaemic stroke, with focus on (co)-morbidity and ageing/cellular senescence (SASKit): protocol for a prospective cohort study
Authors: Henze Larissa , Walter Uwe , Murua Escobar Hugo , Junghanss Christian , Jaster Robert , Köhling Rüdiger , Lange Falko , Salehzadeh-Yazdi Ali , Wolkenhauer Olaf , Hamed Mohamed , Barrantes Israel , Palmer Daniel , Möller Steffen , Kowald Axel , Heussen Nicole , Fuellen Georg 
Published: January 2021

IntroductionAgeing-related processes such as cellular senescence are believed to underlie the accumulation of diseases in time, causing (co)morbidity, including cancer, thromboembolism and stroke. Interfering with these processes may delay, stop or reverse morbidity. The aim of this study is to investigate the link between (co)morbidity and ageing by exploring biomarkers and molecular mechanisms of disease-triggered deterioration in patients with pancreatic ductal adenocarcinoma (PDAC) and (thromboembolic) ischaemic stroke (IS).Methods and analysisWe will recruit 50 patients with PDAC, 50 patients with (thromboembolic) IS and 50 controls at Rostock University Medical Center, Germany. We will gather routine blood data, clinical performance measurements and patient-reported outcomes at up to seven points in time, alongside in-depth transcriptomics and proteomics at two of the early time points. Aiming for clinically relevant biomarkers, the primary outcome is a composite of probable sarcopenia, clinical performance (described by ECOG Performance Status for patients with PDAC and the Modified Rankin Scale for patients with stroke) and quality of life. Further outcomes cover other aspects of morbidity such as cognitive decline and of comorbidity such as vascular or cancerous events. The data analysis is comprehensive in that it includes biostatistics and machine learning, both following standard role models and additional explorative approaches. Prognostic and predictive biomarkers for interventions addressing senescence may become available if the biomarkers that we find are specifically related to ageing/cellular senescence. Similarly, diagnostic biomarkers will be explored. Our findings will require validation in independent studies, and our dataset shall be useful to validate the findings of other studies. In some of the explorative analyses, we shall include insights from systems biology modelling as well as insights from preclinical animal models. We anticipate that our detailed study protocol and data analysis plan may also guide other biomarker exploration trials.Ethics and disseminationThe study was approved by the local ethics committee (Ethikkommission an der Medizinischen Fakultät der Universität Rostock, A2019-0174), registered at the German Clinical Trials Register (DRKS00021184), and results will be published following standard guidelines.
Mutations inZP4are associated with abnormal zona pellucida and female infertility
Authors: Wei Xiaoli , Li Youzhu , Liu Qicai , Liu Wensheng , Yan Xiaohong , Zhu Xingshen , Zhou Dekun , Tian Yingpu , Zhang Fuxing , Li Na , Lu Zhongxian 
Published: January 2021

BackgroundThe zona pellucida (ZP) of human oocytes plays essential protective roles in sperm–egg interactions during fertilisation and embryo development.ZP4-null female rabbits exhibit a thin and irregular ZP, which severely impairs embryo development and fertility. However, the effects ofZP4defect on human female reproduction remain unknown.Methods and resultsWe performed whole-exome sequencing in 26 female patients with abnormal (thin and irregular) ZP and identified heterozygous variants inZP4(OMIM: 613514) from 3 patients (approximately 11%). NoZP4variant was found in the 30 control women with proven fertility. We constructedZP4-mutated plasmids and found that the variants reduced the secretion of ZP4 in vitro. Lower suction pressure facilitated egg retrieval, and intracytoplasmic sperm injection (ICSI) was a desirable treatment forZP4-mutated patients with abnormal ZP.ConclusionsWe identifiedZP4as a novel gene for human abnormal ZP and found that lower suction pressure and ICSI are efficient treatment strategies.
Apolipoprotein L1 risk genotypes in Ghanaian patients with systemic lupus erythematosus: a prospective cohort study
Authors: Blazer Ashira , Dey Ida Dzifa , Nwaukoni Janet , Reynolds Margaret , Ankrah Festus , Algasas Huda , Ahmed Tasneem , Divers Jasmin 
Published: January 2021

ObjectiveTwo apolipoprotein L1 (APOL1) risk variants (RV) are enriched in sub-Saharan African populations due to conferred resistance toTrypanosoma brucei. These variants associate with adverse renal outcomes by multiple causes including SLE. Despite emerging reports that SLE is common in Ghana, whereAPOL1variant allelic frequencies are high, the regional contribution to SLE outcomes has not been described. Accordingly, this prospective longitudinal cohort study tested the associations betweenAPOL1high-risk genotypes and kidney outcomes, organ damage accrual and death in 100 Ghanaian patients with SLE.MethodsThis was a prospective cohort study of 100 SLE outpatients who sought care at Korle bu Teaching Hospital in Accra, Ghana. Adult patients who met 4 American College of Rheumatology criteria for SLE were genotyped for APOL1 and followed longitudinally for SLE activity as measured by the Safety of Estrogens in Lupus National Assessment-Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) hybrid and organ injury as measured by the Systemic Lupus International Collaborating Clinics Damage Index (SDI) at baseline and every 6 months for 1 year. Outcomes of interest were kidney function, SDI and case fatality.ResultsAssuming a recessive inheritance, theAPOL1high-risk genotype (2RV) associated with end-stage renal disease (ESRD) at an OR of 14 (p=0.008). These patients accrued more SDI points particularly in renal and neurological domains. The SDI was 81.3% higher in 2RV patients compared with 0RV or 1RV patients despite no difference in SLE activity (p=0.01). After a 12-month period of observation, 3/12 (25%) of the 2RV patients died compared with 2/88 (2.3%) of the 0RV or 1RV carriers (OR=13.6, p=0.01). Deaths were due to end-stage kidney disease and heart failure.ConclusionAPOL1RVs were heritable risk factors for morbidity and mortality in this Ghanaian SLE cohort. Despite no appreciable differences in SLE activity,APOL1high-risk patients exhibited progressive renal disease, organ damage accrual and a 13-fold higher case fatality.
Elevated temperature and deposited sediment jointly affect early life history traits in southernmost Arctic char populations
Authors: Mari Lisandrina , Daufresne Martin , Guillard Jean , Evanno Guillaume , Lasne Emilien 
Published: January 2021

The combination of global warming and local stressors can have dramatic consequences on freshwater biota. Sediment deposition is an important pressure that can affect benthic species and benthic ontogenetic stages (eggs and larvae) habitat quality. However, knowledge on the effects of sediment in a warming context is lacking. We used a common garden approach to examine the effects of combined exposure to elevated temperature and deposited sediment on early life history traits in offspring of four wild Arctic char (Salvelinus alpinus) populations, originating from geographically isolated lakes at the southern edge of the species range. We report interactive effects of temperature and sediment, with higher temperature exacerbating the negative effects of sediments on the duration of the incubation period and on the body size – yolk expenditure trade-off during development. Our results highlight that reevaluating the impacts of sediment on organisms under the lens of global warming and at the scale of several wild populations is needed to improve our understanding of how vulnerable species can respond to environmental changes.
Fabrication, characterization and analysis of a prototype high purity germanium detector for $$^{76}$$Ge-based neutrinoless double beta decay experiments
Authors: Jany A. , Misiaszek M. , Mroz T. , Panas K. , Zuzel G. , Wojcik M. , Brudecki K. , Jurkowski J. , Mietelski J. W. , Misiak R. , Marszałek M. , Mitura-Nowak M. 
Published: January 2021

AbstractExperiments searching for the neutrinoless double beta decay in $$^{76}$$

76

Ge are currently achieving the lowest background level and, in connection with the excellent energy resolution of germanium detectors, they exhibit the best discovery potential for the decay. Expansion to a ton scale of the active target mass is presently considered – in this case on-site production of the detectors may be an option. In this paper we describe the fabrication and characterization procedures of a prototype detector with a small p+ contact, which enhances the abilities of the pulse shape discrimination – one of the most important tools for background reduction. Simulations of the shapes of pulses from the detector were carried out and tuned, taking the advantage of the fact that all the parameters of the Ge crystal, cryostat and of the spectroscopic chain were known. As a result, the pulse shape analyses performed on the simulated and measured data agree very well. The worked out method allows to optimize geometry and crystal parameters in terms of pulse shape analysis efficiency, before the actual production of the detectors.
Direct detection of dark matter: Precision predictions in a simplified model framework
Authors: Borschensky Christoph , Coniglio Gabriele , Jäger Barbara , Jochum Josef , Schipperges Vincent 
Published: January 2021

AbstractWe present a calculation of the next-to-leading order QCD corrections for the scattering of Dark Matter particles off nucleons in the framework of simplified models with s- and t-channel mediators. These results are matched to the Wilson coefficients and operators of an effective field theory that is generally used for the presentation of experimental results on spin-independent and spin-dependent direct detection rates. Detailed phenomenological studies illustrate the complementary reach of collider searches for Dark Matter and the direct detection experiments CRESST and XENON. In the case of cancellation effects in the tree-level contributions, one-loop corrections can have a particularly large impact on exclusion limits in the case of combined $$s + t$$

s
+
t

-channel models.
Radiative three-body D-meson decays in and beyond the standard model
Authors: Adolph Nico , Brod Joachim , Hiller Gudrun 
Published: January 2021

AbstractWe study radiative charm decays $$D \rightarrow P_1 P_2 \gamma $$

D
→

P
1

P
2

γ

, $$P_{1,2}=\pi ,K$$

P

1
,
2

=
π
,
K

in QCD factorization at leading order and within heavy hadron chiral perturbation theory. Branching ratios including resonance contributions are around $$\sim 10^{-3}$$

∼

10

-
3

for the Cabibbo-favored modes into $$K \pi \gamma $$

K
π
γ

and $$\sim 10^{-5}$$

∼

10

-
5

for the singly Cabibbo-suppressed modes into $$\pi ^+ \pi ^- \gamma , K^+ K^- \gamma $$

π
+

π
-

γ
,

K
+

K
-

γ

, and thus in reach of the flavor factories BES III and Belle II. Dalitz plots and forward–backward asymmetries reveal significant differences between the two QCD frameworks; such observables are therefore ideally suited for a data-driven identification of relevant decay mechanisms in the standard-model dominated $$D \rightarrow K \pi \gamma $$

D
→
K
π
γ

decays. This increases the potential to probe new physics with the $$D \rightarrow \pi ^+ \pi ^- \gamma $$

D
→

π
+

π
-

γ

and $$D \rightarrow K^+ K^- \gamma $$

D
→

K
+

K
-

γ

decays, which are sensitive to enhanced dipole operators. CP asymmetries are useful to test the SM and look for new physics in neutral $$|\Delta C|=1$$

|
Δ
C
|
=
1

transitions. Cuts in the Dalitz plot enhance the sensitivity to new physics due to the presence of both s- and t, u-channel intermediate resonances.
Note on shape moduli stabilization, string gas cosmology and the swampland criteria
Authors: Mitchell Gabrielle A. , Brandenberger Robert 
Published: January 2021

AbstractIn String Gas Cosmology, the simplest shape modulus fields are naturally stabilized by taking into account the presence of string winding and momentum modes. We determine the resulting effective potential for these fields and show that it obeys the de Sitter conjecture, one of the swampland criteria for effective field theories to be consistent with superstring theory.
Improved Precipitation Typing Using POSS Spectral Modal Analysis
Authors: Sheppard Brian E. , Thurai Merhala , Rodriguez Peter , Kennedy Patrick C. , Hudak David R. 
Published: January 2021

AbstractThe Precipitation Occurrence Sensor System (POSS) is a small X-band Doppler radar that measures the Doppler velocity spectra from precipitation falling in a small volume near the sensor. The sensor records a 2D frequency of occurrence matrix of the velocity and power at the mode of each spectrum measured over 1 min. The centroid of the distribution of these modes, along with other spectral parameters, defines a data vector input to a multiple discriminant analysis (MDA) for classification of the precipitation type. This requires the a priori determination of a training set for different types, particle size distributions (PSDs), and wind speed conditions. A software model combines POSS system parameters, a particle scattering cross section, and terminal velocity models, to simulate the real-time Doppler signal measured by the system for different PSDs and wind speeds. This is processed in the same manner as the system hardware to produce bootstrap samples of the modal centroid distributions for the MDA training set. MDA results are compared to images from the Multi-Angle Snowflake Camera (MASC) at the MASCRAD site near Easton, Colorado, and to the CSU–CHILL X-band radar observations from Greeley, Colorado. In the four case studies presented, POSS successfully identified precipitation transitions through a range of types (rain, graupel, rimed dendrites, aggregates, unrimed dendrites). Also two separate events of hail were reported and confirmed by the images.