bluuebunny/crossref_metadata_2025_split huggingface dataset:
Alterations in the human oral and gut microbiomes and lipidomics in COVID-19
Authors: Ren Zhigang , Wang Haiyu , Cui Guangying , Lu Haifeng , Wang Ling , Luo Hong , Chen Xinhua , Ren Hongyan , Sun Ranran , Liu Wenli , Liu Xiaorui , Liu Chao , Li Ang , Wang Xuemei , Rao Benchen , Yuan Chengyu , Zhang Hua , Sun Jiarui , Chen Xiaolong , Li Bingjie , Hu Chuansong , Wu Zhongwen , Yu Zujiang , Kan Quancheng , Li Lanjuan 
Published: March 2021

ObjectiveTo characterise the oral microbiome, gut microbiome and serum lipid profiles in patients with active COVID-19 and recovered patients; evaluate the potential of the microbiome as a non-invasive biomarker for COVID-19; and explore correlations between the microbiome and lipid profile.DesignWe collected and sequenced 392 tongue-coating samples, 172 faecal samples and 155 serum samples from Central China and East China. We characterised microbiome and lipid molecules, constructed microbial classifiers in discovery cohort and verified their diagnostic potential in 74 confirmed patients (CPs) from East China and 37 suspected patients (SPs) with IgG positivity.ResultsOral and faecal microbial diversity was significantly decreased in CPs versus healthy controls (HCs). Compared with HCs, butyric acid-producing bacteria were decreased and lipopolysaccharide-producing bacteria were increased in CPs in oral cavity. The classifiers based on 8 optimal oral microbial markers (7 faecal microbial markers) achieved good diagnostic efficiency in different cohorts. Importantly, diagnostic efficacy reached 87.24% in the cross-regional cohort. Moreover, the classifiers successfully diagnosed SPs with IgG antibody positivity as CPs, and diagnostic efficacy reached 92.11% (98.01% of faecal microbiome). Compared with CPs, 47 lipid molecules, including sphingomyelin (SM)(d40:4), SM(d38:5) and monoglyceride(33:5), were depleted, and 122 lipid molecules, including phosphatidylcholine(36:4p), phosphatidylethanolamine (PE)(16:0p/20:5) and diglyceride(20:1/18:2), were enriched in confirmed patients recovery.ConclusionThis study is the first to characterise the oral microbiome in COVID-19, and oral microbiomes and lipid alterations in recovered patients, to explore their correlations and to report the successful establishment and validation of a diagnostic model for COVID-19.
Organisational factors and under-reporting of occupational injuries in Sweden: a population-based study using capture–recapture methodology
Authors: Orellana Cecilia , Kreshpaj Bertina , Burstrom Bo , Davis Letitia , Frumento Paolo , Hemmingsson Tomas , Johansson Gun , Kjellberg Katarina , Wegman David H , Bodin Theo 
Published: March 2021

ObjectiveTo estimate the magnitude of under-reporting of non-fatal occupational injuries (OIs) by different organisational factors in Sweden for the year 2013.MethodsCapture–recapture methods were applied using two data sources: (1) the national OI register and (2) records from a labour market insurance company. To assure comparability of data sources, the analysis was restricted to the public sector and private companies with at least 50 employees. OIs were matched using personal identification number and reported injury dates (±7 days). Organisational factors were obtained from the national labour market register and injury severity (no healthcare/only outpatient/hospitalised) from the National Patient Register. Total number of OIs and ascertainment by data sources were estimated assuming data source independence.ResultsThere were an estimated 98 493 OIs in 2013. Completeness of reporting OIs to the national register and to the insurance company was estimated at 73% and 43%, respectively. No report to either source was estimated at 15 000 OIs (~15%). Under-reporting to the national register differed by selected organisational factors, being higher among organisations in the public sector, those with more females, with a younger workforce and with a higher proportion of immigrants. Overall under-reporting was more common in agriculture (19.7%), other services (19.3%), commerce and hospitality (19.1%), health (18.4%) and education (18.4%). Under-reporting decreased as injury severity increased, with little variations across sectors of economic activity.ConclusionsResults suggest considerable under-reporting of OIs in Sweden and differential under-reporting by organisational factors. Results are relevant for official estimates of burden and for setting priorities for workplace safety and prevention.
Improving metronidazole prescription practices in surgical patients: a full cycle audit
Authors: Sgrò Alessandro , Wu Diana A , Yalamarthi Satheesh 
Published: March 2021

ABSTRACT

Introduction
Metronidazole is commonly prescribed for intra-abdominal infections. Oral metronidazole has high bioavailability (&gt;95%) and intravenous metronidazole should be reserved for patients not suitable for oral preparations.

Methods and materials
This full cycle audit evaluated the type of metronidazole preparation prescribed in adult emergency surgical patients requiring first-line empirical antimicrobial therapy for intra-abdominal infections. The criterion for audit was the proportion of patients who were prescribed intravenous metronidazole when the oral route was available. The first cycle included all consecutive eligible patients between 20 April and 14 May 2020. After an intervention phase educating prescribers about the similar pharmacokinetic properties of oral and intravenous metronidazole, clinical practice was reaudited between 22 June and 16 July 2020. Data were collected by case note and drug chart review.

Results
A total of 54 patients were included in the first audit cycle. Of these, 11 (20.4%) were prescribed oral metronidazole and 43 (79.6%) were prescribed intravenous metronidazole. In the majority of cases (35/43, 81.4%), intravenous metronidazole was prescribed in the absence of clear contraindications to the oral preparation. Of the 61 patients included in the reaudit cycle, 23 (37.7%) were prescribed oral metronidazole and 38 (62.3%) were prescribed intravenous metronidazole. The proportion of patients prescribed intravenous metronidazole despite being suitable for oral preparation decreased from 81.4% in the first cycle to 34.2% (13/38) in the reaudit cycle (risk ratio 0.42, 95% CI: 0.26 to 0.67, p&lt;0.0001). Prescribing oral metronidazole when suitable saved up to £10.53/day per patient.

Conclusion
This full cycle audit led to a significant improvement in the use of oral metronidazole in suitable patients, as well as a considerable reduction in healthcare costs.
Midterm Prognosis of Patients With Pulmonary Embolism Receiving Catheter‐Directed Thrombolysis or Systemic Thrombolysis: A Nationwide Population‐Based Study
Authors: Lin Donna Shu‐Han , Lin Yu‐Sheng , Wu Cho‐Kai , Lin Heng‐Hsu , Lee Jen‐Kuang 
Published: March 2021

Background
This study compared the efficacy and safety between catheter‐directed thrombolysis (CDT) and systemic thrombolysis for patients with acute pulmonary embolism (PE) with midterm follow‐up.

Methods and Results
We conducted a prospective open cohort study by using data from the Taiwan National Health Insurance Research Database for 2001 to 2013. Patients who were first admitted for PE and were treated by either systemic thrombolysis or CDT were included and compared. Inverse probability of treatment weighting, based on the propensity score, was used to mitigate possible selection bias. A total of 145 CDT‐treated and 1158 systemic thrombolysis–treated patients with PE were included. The in‐hospital mortality rate was significantly lower in the CDT group (12.7% versus 21.4%; odds ratio, 0.49; 95% CI, 0.36–0.67) after inverse probability of treatment weighting. No significant differences between the groups were observed for the safety (bleeding) outcomes. In patients who survived the index PE admission, the 1‐year all‐cause mortality rate was significantly lower in the CDT group after inverse probability of treatment weighting (12.2% versus 13.2%; hazard ratio [HR], 0.73; 95% CI, 0.56–0.94). Treatment with CDT was also associated with lower risks of recurrent PE (9.3% versus 17.5%; subdistribution HR, 0.52; 95% CI, 0.41–0.66). The difference remained through the last follow‐up.

Conclusions
Among patients with PE requiring reperfusion therapy, those accepting CDT had lower all‐cause mortality and recurrent PE over both short‐term and midterm follow‐up periods than those receiving systemic thrombolysis. The bleeding risk was similar for both groups. These findings should be cautiously validated in future randomized trials.
Psychophysiological Markers of Performance and Learning during Simulated Marksmanship in Immersive Virtual Reality
Authors: Liu Sicong , Clements Jillian M. , Kirsch Elayna P. , Rao Hrishikesh M. , Zielinski David J. , Lu Yvonne , Mainsah Boyla O. , Potter Nicholas D. , Sommer Marc A. , Kopper Regis , Appelbaum Lawrence G. 
Published: March 2021

Abstract
The fusion of immersive virtual reality, kinematic movement tracking, and EEG offers a powerful test bed for naturalistic neuroscience research. Here, we combined these elements to investigate the neuro-behavioral mechanisms underlying precision visual–motor control as 20 participants completed a three-visit, visual–motor, coincidence-anticipation task, modeled after Olympic Trap Shooting and performed in immersive and interactive virtual reality. Analyses of the kinematic metrics demonstrated learning of more efficient movements with significantly faster hand RTs, earlier trigger response times, and higher spatial precision, leading to an average of 13% improvement in shot scores across the visits. As revealed through spectral and time-locked analyses of the EEG beta band (13–30 Hz), power measured prior to target launch and visual-evoked potential amplitudes measured immediately after the target launch correlated with subsequent reactive kinematic performance in the shooting task. Moreover, both launch-locked and shot/feedback-locked visual-evoked potentials became earlier and more negative with practice, pointing to neural mechanisms that may contribute to the development of visual–motor proficiency. Collectively, these findings illustrate EEG and kinematic biomarkers of precision motor control and changes in the neurophysiological substrates that may underlie motor learning.
Tracking the Contents of Spatial Working Memory during an Acute Bout of Aerobic Exercise
Authors: Garrett Jordan , Bullock Tom , Giesbrecht Barry 
Published: March 2021

Abstract
Recent studies have reported enhanced visual responses during acute bouts of physical exercise, suggesting that sensory systems may become more sensitive during active exploration of the environment. This raises the possibility that exercise may also modulate brain activity associated with other cognitive functions, like visual working memory, that rely on patterns of activity that persist beyond the initial sensory evoked response. Here, we investigated whether the neural coding of an object location held in memory is modulated by an acute bout of aerobic exercise. Participants performed a spatial change detection task while seated on a stationary bike at rest and during low-intensity cycling (∼50 watts/50 RPM). Brain activity was measured with EEG. An inverted encoding modeling technique was employed to estimate location-selective channel response functions from topographical patterns of alpha-band (8–12 Hz) activity. There was strong evidence of robust spatially selective responses during stimulus presentation and retention periods both at rest and during exercise. During retention, the spatial selectivity of these responses decreased in the exercise condition relative to rest. A temporal generalization analysis indicated that models trained on one time period could be used to reconstruct the remembered locations at other time periods, however, generalization was degraded during exercise. Together, these results demonstrate that it is possible to reconstruct the contents of working memory at rest and during exercise, but that exercise can result in degraded responses, which contrasts with the enhancements observed in early sensory processing.
Behavioral Induction of a High Beta State in Sensorimotor Cortex Leads to Movement Slowing
Authors: Muralidharan Vignesh , Aron Adam R. 
Published: March 2021

Abstract
The sensorimotor beta rhythm (∼13–30 Hz) is commonly seen in relation to movement. It is important to understand its functional/behavioral significance in both health and disease. Sorting out competing theories of sensorimotor beta is hampered by a paucity of experimental protocols in humans that manipulate/induce beta oscillations and test their putative effects on concurrent behavior. Here, we developed a novel behavioral paradigm to generate beta and then test its functional relevance. In two human experiments with scalp EEG (n = 11 and 15), we show that a movement instruction generates a high beta state (postmovement beta rebound), which then slows down subsequent movements required during that state. We also show that this high initial beta rebound related to reduced mu–beta desynchronization for the subsequent movement and, further, that the temporal features of the beta state, that is, the beta bursts, related to the degree of slowing. These results suggest that increased sensorimotor beta in the postmovement period corresponds to an inhibitory state—insofar as it retards subsequent movement. By demonstrating a behavioral method by which people can proactively create a high beta state, our paradigm provides opportunities to test the effect of this state on sensations and affordances. It also suggests related experiments using motor imagery rather than actual movement, and this could later be clinically relevant, for example, in tic disorder.
Aiming High, No Matter What?
Authors: Rudolphi Frida , Salikutluk Zerrin 
Published: March 2021

Abstract
The authors examine cross-national variation in the ethnic gradient in aspirations among 14-year-olds in England, Germany, the Netherlands and Sweden by using data from the Children of Immigrants Longitudinal Survey in Four European Countries, collected in 2009/2010. Results show that most ethnic minority groups are more likely to have university aspirations than ethnic majority youth. The most consistent minority advantage is found in England and Sweden, consistent with the interpretation that the ample scope for choice in progression through these school systems allows high ambitions of minorities to play out well. However, minority advantage of some groups is also present in the Netherlands and Germany, where transitions are more heavily conditional on previous performance. The pattern for immigrant generational status varies across countries and ethnic origins. There is no consistent empirical evidence indicating that aspiration differences between ethnic minority and majority youth will diminish due to assimilation processes across the generations.
The Point of Reality and the Circle of Appearance
Authors: Meisami Sayeh 
Published: March 2021

Abstract
This article explains three major Sufi themes of Maḥmūd Shabistarī’s Gulshan-i rāz as connected by the point-circle metaphor that captures the illusory state of a circle formed by the fast motion of a point. Inspired by Ibn ʿArabī, Shabistarī employs this metaphor in his poetic presentation of the unity of being, the existential state of the human soul, and the bifurcation of religious knowledge and practice into exoteric and esoteric with its implications for the relation between prophethood and sainthood. The article explains these themes mostly in light of Shams al-Dīn Lāhījī’s renowned commentary, Mafātīḥ al-iʿjāz. The analysis of some key verses on the above themes in Shabistarī’s Gulshan-i rāz and the corresponding comments from Lāhījī demonstrates the significance of Akbarian Sufi philosophy in the intellectual and literary life of Persians since late medieval times.
The Right to Freedom of Thought in the European Convention on Human Rights
Authors: O’Callaghan Patrick , Shiner Bethany 
Published: March 2021

Abstract
This paper examines the right to freedom of thought in the European Convention on Human Rights against the background of technological developments in neuroscience and algorithmic processes. Article 9 echr provides an absolute right to freedom of thought when the integrity of our inner life or forum internum is at stake. In all other cases, where thoughts have been manifested in some way in the forum externum, the right to freedom of thought is treated as a qualified right. While Article 9 echr is a core focus of this paper, we argue that freedom of thought is further supported by Articles 8, 10 and 11 echr. This complex of rights carves out breathing space for the individual’s personal development and therefore supports the enjoyment of freedom of thought in its fullest sense. Charged with ‘maintaining and promoting the ideals and values of a democratic society’ as well as ensuring that individual human rights are given ‘practical and effective protection’, this paper predicts that the European Court of Human Rights will make greater use of the right to freedom of thought in the face of the emerging challenges of the Fourth Industrial Revolution.
Transient Response of the Southern Ocean to Idealized Wind and Thermal Forcing across Different Model Resolutions
Authors: Li Qian , England Matthew H. , McC. Hogg Andrew 
Published: March 2021

AbstractThe Southern Ocean has undergone significant climate-related changes over recent decades, including intensified westerly winds and increased radiative heating. The interplay between wind-driven cooling and radiative warming of the ocean is complex and remains unresolved. In this study, idealized wind and thermal perturbations are analyzed in a global ocean–sea ice model at two horizontal resolutions: nominally, 1° and 0.1°. The sea surface temperature (SST) response shows a clear transition from a wind-driven cooling phase to a warming phase. This warming transition is largely attributed to meridional and vertical Ekman heat advection, which are both sensitive to model resolution due to the model-dependent components of temperature gradients. At higher model resolution, due to a more accurate representation of near-surface vertical temperature inversion and upward Ekman heat advection around Antarctica, the anomalous SST warming is stronger and develops earlier. The mixed layer depth at midlatitudes initially increases due to a wind-driven increase in Ekman transport of cold dense surface water northward, but then decreases when the thermal forcing drives enhanced surface stratification; both responses are more sensitive at lower model resolution. With the wind intensification, the residual overturning circulation increases less in the 0.1° case because of the adequately resolved eddy compensation. Ocean heat subduction penetrates along more tilted isopycnals in the 1° case, but it orients to follow isopycnal layers in the 0.1° case. These findings have implications for understanding the ocean response to the combined effects of Southern Hemisphere westerly wind changes and anthropogenic warming.
Risk factors of acute renal injury and in-hospital mortality in adult patients with postcardiotomy cardiogenic shock requiring veno-arterial extracorporeal membrane oxygenation: utility of MELD-XI score
Authors: Ding Xiaochen , Xie Haixiu , Yang Feng , Wang Liangshan , Hou Xiaotong 
Published: March 2021

Background: The suitability of model for end-stage liver disease excluding international normalized ratio (MELD-XI) score to predict the incidence of acute kidney injury (AKI) and in-hospital mortality in adult patients with postcardiotomy cardiogenic shock (PCS) requiring venoarterial extracorporeal membrane oxygenation (VA ECMO) remains uncertain. This study was performed to explore whether the MELD-XI score has the association with the incidence of AKI and in-hospital mortality in these patients. Methods: Adult patients with PCS requiring VA ECMO from January 2012 to December 2017 were enrolled and first classified into AKI group ( n = 151) versus no-AKI group ( n = 132), then classified into survival group ( n = 143) versus no-survival group ( n = 140). Multivariate logistic regressions were performed to identify factors independently associated with AKI and mortality. Baseline data were defined as the first measurement available. Results: Of 283 patients, the incidence of AKI was 53.36%. The in-hospital mortality rates were 63.58% and 33.33% in patients with and without AKI (p < 0.0001). Baseline MELD-XI score, baseline serum total bilirubin (T-Bil), baseline blood urea nitrogen (BUN), baseline left ventricular ejection fraction (LVEF), sequential organ failure assessment (SOFA) score, and lactate level at ECMO initiation were shown to be associated with the AKI. Vasoactive-inotropic score (VIS) and SOFA score at ECMO initiation as well as renal failure requiring renal replacement therapy (RRT) were shown to be associated with in-hospital mortality. Conclusions: The baseline MELD-XI score, baseline BUN, baseline T-Bil, baseline LVEF, SOFA score and lactate at the initiation of ECMO were associated with AKI. AKI, SOFA score, and VIS at the initiation of ECMO were associated with in-hospital mortality, whereas MELD-XI score was not found to be associated with in-hospital mortality. A specific MELD-XI score as a threshold, as well as its sensitivity and specificity, needs to be confirmed in further studies.
A qualitative study of bereaved relatives’ end of life experiences during the COVID-19 pandemic
Authors: Hanna Jeffrey R , Rapa Elizabeth , Dalton Louise J , Hughes Rosemary , McGlinchey Tamsin , Bennett Kate M , Donnellan Warren J , Mason Stephen R , Mayland Catriona R 
Published: March 2021

Background: Meeting the needs of relatives when a family member is dying can help facilitate better psychological adjustment in their grief. However, end of life experiences for families are likely to have been deleteriously impacted by the COVID-19 crisis. Understanding how families’ needs can be met during a global pandemic will have current/future relevance for clinical practice and policy. Aim: To explore relatives’ experiences and needs when a family member was dying during the COVID-19 pandemic. Design: Interpretative qualitative study using semi-structured interviews. Data were analysed thematically. Setting/participants: A total of 19 relatives whose family member died during the COVID-19 pandemic in the United Kingdom. Results: In the absence of direct physical contact, it was important for families to have a clear understanding of their family member’s condition and declining health, stay connected with them in the final weeks/days of life and have the opportunity for a final contact before they died. Health and social care professionals were instrumental to providing these aspects of care, but faced practical challenges in achieving these. Results are presented within three themes: (1) entering into the final weeks and days of life during a pandemic, (2) navigating the final weeks of life during a pandemic and (3) the importance of ‘saying goodbye’ in a pandemic. Conclusions: Health and social care professionals can have an important role in mitigating the absence of relatives’ visits at end of life during a pandemic. Strategies include prioritising virtual connectedness and creating alternative opportunities for relatives to ‘say goodbye’.