bluuebunny/crossref_metadata_2025_split huggingface dataset:
Can primary palliative care education change life-sustaining treatment intensity of older adults at the end of life? A retrospective study
Authors: Liu Qian , Qin Mingzhao , Zhou Jian , Zheng Hui , Liu Weiping , Shen Qi 
Published: June 2021

Abstract
Background
Palliative care education has been carried out in some hospitals and palliative care has gradually developed in mainland China. However, the clinical research is sparse and whether primary palliative care education influence treatment intensity of dying older adults is still unknown. This study aims to explore the changes to the intensity of end-of-life care in hospitalized older adults before and after the implementation of primary palliative care education.

Methods
A retrospective study was conducted. Two hundred three decedents were included from Beijing Tongren Hospital’s department of geriatrics between January 1, 2014 to December 31, 2019. Patients were split into two cohorts with regards to the start of palliative care education. Patient demographics and clinical characteristics as well as analgesia use, medical resources use and provision of life-sustaining treatments were compared. We used a chi-square test to compare categorical variables, a t test to compare continuous variables with normal distributions and a Mann–Whitney U test for continuous variables with skewed distributions.

Results
Of the total participants in the study, 157(77.3%) patients were male. The median age was 88 (interquartile range; Q1-Q3 83–93) and the majority of patients (N = 172, 84.7%) aged 80 years or older. The top 3 causes of death were malignant solid tumor (N = 74, 36.5%), infectious disease (N = 74, 36.5%), and cardiovascular disease (N = 23, 11.3%). Approximately two thirds died of non-cancer diseases. There was no significant difference in age, gender, cause of death and functional status between the two groups (p > 0.05). After primary palliative care education, pain controlling drugs were used more (p < 0.05), fewer patients received electric defibrillation, bag mask ventilation and vasopressors (p < 0.05). There was no change in the length of hospitalization, intensive care admissions, polypharmacy, use of broad-spectrum antibiotics, blood infusions, albumin infusions, nasogastric/nasoenteric tubes, parenteral nutrition, renal replacement and mechanical ventilation (p > 0.05).

Conclusions
Primary palliative care education may promotes pain controlling drug use and DNR implementation. More efforts should be put on education about symptom assessment, prognostication, advance care planning, code status discussion in order to reduce acute medical care resource use and apply life-sustaining treatment appropriately.
Outcomes of COVID-19 in a cohort of pediatric patients with rheumatic diseases
Authors: Villacis-Nunez D. Sofia , Rostad Christina A. , Rouster-Stevens Kelly , Khosroshahi Arezou , Chandrakasan Shanmuganathan , Prahalad Sampath 
Published: June 2021

Abstract
Background
There are few reports of COVID-19 in pediatric patients with rheumatic diseases. This study describes the clinical presentation and outcomes of COVID-19 in this population.

Methods
We analyzed a single-center case series of pediatric patients with rheumatic diseases and laboratory-confirmed COVID-19. Demographic, baseline and COVID-19 associated clinical features were compared between ambulatory and hospitalized patients using univariate analysis.

Results
Fifty-five cases were identified: 45 (81.8%) in the ambulatory group and 10 (18.2%) hospitalized. African American race (OR 7.78; 95% CI [1.46–55.38]; p = 0.006) and cardiovascular disease (OR 19.40; 95% CI 2.45–254.14; p = 0.001) predominated in hospitalized patients. Active rheumatic disease (OR 11.83; 95% CI 1.43–558.37; p = 0.01), medium/high-dose corticosteroid use (OR 14.12; 95% CI [2.31–106.04]; p = 0.001), mycophenolate use (OR 8.84; 95% CI [1.64–63.88]; p = 0.004), rituximab use (OR 19.40; 95% CI [2.45–254.14]; p = 0.001) and severe immunosuppression (OR 34.80; 95% CI [3.94–1704.26]; p = < 0.001) were associated with increased odds of hospitalization. Fever (OR 7.78; 95% CI [1.46–55.38]; p = 0.006), dyspnea (OR 26.28; 95% CI [2.17–1459.25]; p = 0.003), chest pain (OR 13.20; 95% CI [1.53–175.79]; p = 0.007), and rash (OR 26.28; 95% CI [2.17–1459.25]; p = 0.003) were more commonly observed in hospitalized patients. Rheumatic disease flares were almost exclusive to hospitalized patients (OR 55.95; 95% CI [5.16–3023.74]; p < 0.001).. One patient did not survive.

Conclusions
Medium/high-dose corticosteroid, mycophenolate and rituximab use, and severe immunosuppression were risk factors for hospitalization. Fever, dyspnea, chest pain, and rash were high-risk symptoms for hospitalization. Rheumatic disease activity and flare could contribute to the need for hospitalization.
Hyperactivation of monocytes and macrophages in MCI patients contributes to the progression of Alzheimer's disease
Authors: Munawara Usma , Catanzaro Michael , Xu Weili , Tan Crystal , Hirokawa Katsuiku , Bosco Nabil , Dumoulin David , Khalil Abdelouahed , Larbi Anis , Lévesque Simon , Ramassamy Charles , Barron Annelise E. , Cunnane Stephen , Beauregard Pascale B. , Bellenger Jean-Pierre , Rodrigues Serafim , Desroches Mathieu , Witkowski Jacek M. , Laurent Benoit , Frost Eric H. , Fulop Tamas 
Published: June 2021

Abstract
Background
Alzheimer’s disease (AD) is the most common neurodegenerative disease ultimately manifesting as clinical dementia. Despite considerable effort and ample experimental data, the role of neuroinflammation related to systemic inflammation is still unsettled. While the implication of microglia is well recognized, the exact contribution of peripheral monocytes/macrophages is still largely unknown, especially concerning their role in the various stages of AD.

Objectives
AD develops over decades and its clinical manifestation is preceded by subjective memory complaints (SMC) and mild cognitive impairment (MCI); thus, the question arises how the peripheral innate immune response changes with the progression of the disease. Therefore, to further investigate the roles of monocytes/macrophages in the progression of AD we assessed their phenotypes and functions in patients at SMC, MCI and AD stages and compared them with cognitively healthy controls. We also conceptualised an idealised mathematical model to explain the functionality of monocytes/macrophages along the progression of the disease.

Results
We show that there are distinct phenotypic and functional changes in monocyte and macrophage populations as the disease progresses. Higher free radical production upon stimulation could already be observed for the monocytes of SMC patients. The most striking results show that activation of peripheral monocytes (hyperactivation) is the strongest in the MCI group, at the prodromal stage of the disease. Monocytes exhibit significantly increased chemotaxis, free radical production, and cytokine production in response to TLR2 and TLR4 stimulation.

Conclusion
Our data suggest that the peripheral innate immune system is activated during the progression from SMC through MCI to AD, with the highest levels of activation being in MCI subjects and the lowest in AD patients. Some of these parameters may be used as biomarkers, but more holistic immune studies are needed to find the best period of the disease for clinical intervention.
Hemophagocytic lymphohistiocytosis during pregnancy: a review of the literature in epidemiology, pathogenesis, diagnosis and treatment
Authors: Liu Lidong , Cui Yutong , Zhou Qiongjie , Zhao Huanqiang , Li Xiaotian 
Published: June 2021

AbstractHemophagocytic lymphohistiocytosis during pregnancy is rare; it is often misdiagnosed, resulting in a high maternal and foetal mortality rate. Herein, based on limited case reports including antepartum and postpartum cases, we reviewed the current studies of pregnancy-related hemophagocytic lymphohistiocytosis, and compared the epidemiology, aetiology, diagnosis and treatment of pregnancy-related hemophagocytic lymphohistiocytosis with non-pregnancy, enriching the understanding of hemophagocytic lymphohistiocytosis and its treatment in obstetrics.
Lung distribution of gas and blood volume in critically ill COVID-19 patients: a quantitative dual-energy computed tomography study
Authors: Ball Lorenzo , Robba Chiara , Herrmann Jacob , Gerard Sarah E. , Xin Yi , Mandelli Maura , Battaglini Denise , Brunetti Iole , Minetti Giuseppe , Seitun Sara , Bovio Giulio , Vena Antonio , Giacobbe Daniele Roberto , Bassetti Matteo , Rocco Patricia R. M. , Cereda Maurizio , Rizi Rahim R. , Castellan Lucio , Patroniti Nicolò , Pelosi Paolo ,   Collaborators of the GECOVID Group, Bixio Mattia , Gratarola Angelo , Frisoni Paolo , Loconte Maurizio , Molin Alexandre , Orefice Giulia , Ciaravolo Elena , Costantino Federico , Battioni Dario , Buconte Gerolama , Casaleggio Alessandro , Cittadini Giuseppe , Dogliotti Luca , Giasotto Veronica , Perissi Sara , Pigati Maria , Santacroce Elena , Zaottini Federico , Dentone Chiara , Taramasso Lucia , Magnasco Laura , Bastianello Matilde 
Published: June 2021

Abstract
Background
Critically ill COVID-19 patients have pathophysiological lung features characterized by perfusion abnormalities. However, to date no study has evaluated whether the changes in the distribution of pulmonary gas and blood volume are associated with the severity of gas-exchange impairment and the type of respiratory support (non-invasive versus invasive) in patients with severe COVID-19 pneumonia.

Methods
This was a single-center, retrospective cohort study conducted in a tertiary care hospital in Northern Italy during the first pandemic wave. Pulmonary gas and blood distribution was assessed using a technique for quantitative analysis of dual-energy computed tomography. Lung aeration loss (reflected by percentage of normally aerated lung tissue) and the extent of gas:blood volume mismatch (percentage of non-aerated, perfused lung tissue—shunt; aerated, non-perfused dead space; and non-aerated/non-perfused regions) were evaluated in critically ill COVID-19 patients with different clinical severity as reflected by the need for non-invasive or invasive respiratory support.

Results
Thirty-five patients admitted to the intensive care unit between February 29th and May 30th, 2020 were included. Patients requiring invasive versus non-invasive mechanical ventilation had both a lower percentage of normally aerated lung tissue (median [interquartile range] 33% [24–49%] vs. 63% [44–68%], p < 0.001); and a larger extent of gas:blood volume mismatch (43% [30–49%] vs. 25% [14–28%], p = 0.001), due to higher shunt (23% [15–32%] vs. 5% [2–16%], p = 0.001) and non-aerated/non perfused regions (5% [3–10%] vs. 1% [0–2%], p = 0.001). The PaO2/FiO2 ratio correlated positively with normally aerated tissue (ρ = 0.730, p < 0.001) and negatively with the extent of gas-blood volume mismatch (ρ = − 0.633, p < 0.001).

Conclusions
In critically ill patients with severe COVID-19 pneumonia, the need for invasive mechanical ventilation and oxygenation impairment were associated with loss of aeration and the extent of gas:blood volume mismatch.

Graphic abstract
SPARK-X: non-parametric modeling enables scalable and robust detection of spatial expression patterns for large spatial transcriptomic studies
Authors: Zhu Jiaqiang , Sun Shiquan , Zhou Xiang 
Published: June 2021

AbstractSpatial transcriptomic studies are becoming increasingly common and large, posing important statistical and computational challenges for many analytic tasks. Here, we present SPARK-X, a non-parametric method for rapid and effective detection of spatially expressed genes in large spatial transcriptomic studies. SPARK-X not only produces effective type I error control and high power but also brings orders of magnitude computational savings. We apply SPARK-X to analyze three large datasets, one of which is only analyzable by SPARK-X. In these data, SPARK-X identifies many spatially expressed genes including those that are spatially expressed within the same cell type, revealing new biological insights.
Systems pharmacogenomics identifies novel targets and clinically actionable therapeutics for medulloblastoma
Authors: Genovesi Laura A. , Millar Amanda , Tolson Elissa , Singleton Matthew , Hassall Emily , Kojic Marija , Brighi Caterina , Girard Emily , Andradas Clara , Kuchibhotla Mani , Bhuva Dharmesh D. , Endersby Raelene , Gottardo Nicholas G. , Bernard Anne , Adolphe Christelle , Olson James M. , Taylor Michael D. , Davis Melissa J. , Wainwright Brandon J. 
Published: June 2021

Abstract
Background
Medulloblastoma (MB) is the most common malignant paediatric brain tumour and a leading cause of cancer-related mortality and morbidity. Existing treatment protocols are aggressive in nature resulting in significant neurological, intellectual and physical disabilities for the children undergoing treatment. Thus, there is an urgent need for improved, targeted therapies that minimize these harmful side effects.

Methods
We identified candidate drugs for MB using a network-based systems-pharmacogenomics approach: based on results from a functional genomics screen, we identified a network of interactions implicated in human MB growth regulation. We then integrated drugs and their known mechanisms of action, along with gene expression data from a large collection of medulloblastoma patients to identify drugs with potential to treat MB.

Results
Our analyses identified drugs targeting CDK4, CDK6 and AURKA as strong candidates for MB; all of these genes are well validated as drug targets in other tumour types. We also identified non-WNT MB as a novel indication for drugs targeting TUBB, CAD, SNRPA, SLC1A5, PTPRS, P4HB and CHEK2. Based upon these analyses, we subsequently demonstrated that one of these drugs, the new microtubule stabilizing agent, ixabepilone, blocked tumour growth in vivo in mice bearing patient-derived xenograft tumours of the Sonic Hedgehog and Group 3 subtype, providing the first demonstration of its efficacy in MB.

Conclusions
Our findings confirm that this data-driven systems pharmacogenomics strategy is a powerful approach for the discovery and validation of novel therapeutic candidates relevant to MB treatment, and along with data validating ixabepilone in PDX models of the two most aggressive subtypes of medulloblastoma, we present the network analysis framework as a resource for the field.
Biomechanical stress in the context of competitive sports training triggers enthesitis
Authors: Simon David , Kleyer Arnd , Bayat Sara , Knitza Johannes , Valor-Mendez Larissa , Schweiger Marina , Schett Georg , Tascilar Koray , Hueber Axel J. 
Published: June 2021

Abstract
Objective
To evaluate the influence of mechanical stress on the development of immediate enthesitis.

Methods
The BEAT study is an interventional study that assessed entheses in competitive badminton players before and immediately after a 60-min intensive training session. Power Doppler (PD) signal and Gray scale (GS) changes were assessed in the insertion sites of both Achilles tendon, patellar tendons, and lateral humeral epicondyles and quantified using a validated scoring system.

Results
Thirty-two badminton players were included. One hundred ninety-two entheseal sites were examined twice. The respective empirical total scores for PD examination were 0.1 (0.3) before and 0.5 (0.9) after training. Mean total GS scores were 2.9 (2.5) and 3.1 (2.5) before and after training, respectively. The mean total PD score difference of 0.4 between pre- and post-training was significant (p = 0.0014), whereas no significant difference for the mean total GS score was observed. Overall, seven participants (22%) showed an increased empirical total PD score. A mixed effects model showed a significant increase of PD scores after training, with a mean increase per site of 0.06 (95% CI 0.01 to 0.12, p = 0.017).

Conclusions
Mechanical stress leads to rapid inflammatory responses in the entheseal structures of humans. These data support the concept of mechanoinflammation in diseases associated with enthesitis.
A multi-OMIC characterisation of biodegradation and microbial community succession within the PET plastisphere
Authors: Wright Robyn J. , Bosch Rafael , Langille Morgan G. I. , Gibson Matthew I. , Christie-Oleza Joseph A. 
Published: June 2021

Abstract
Background
Plastics now pollute marine environments across the globe. On entering these environments, plastics are rapidly colonised by a diverse community of microorganisms termed the plastisphere. Members of the plastisphere have a myriad of diverse functions typically found in any biofilm but, additionally, a number of marine plastisphere studies have claimed the presence of plastic-biodegrading organisms, although with little mechanistic verification. Here, we obtained a microbial community from marine plastic debris and analysed the community succession across 6 weeks of incubation with different polyethylene terephthalate (PET) products as the sole carbon source, and further characterised the mechanisms involved in PET degradation by two bacterial isolates from the plastisphere.

Results
We found that all communities differed significantly from the inoculum and were dominated by Gammaproteobacteria, i.e. Alteromonadaceae and Thalassospiraceae at early time points, Alcanivoraceae at later time points and Vibrionaceae throughout. The large number of encoded enzymes involved in PET degradation found in predicted metagenomes and the observation of polymer oxidation by FTIR analyses both suggested PET degradation was occurring. However, we were unable to detect intermediates of PET hydrolysis with metabolomic analyses, which may be attributed to their rapid depletion by the complex community. To further confirm the PET biodegrading potential within the plastisphere of marine plastic debris, we used a combined proteogenomic and metabolomic approach to characterise amorphous PET degradation by two novel marine isolates, Thioclava sp. BHET1 and Bacillus sp. BHET2. The identification of PET hydrolytic intermediates by metabolomics confirmed that both isolates were able to degrade PET. High-throughput proteomics revealed that whilst Thioclava sp. BHET1 used the degradation pathway identified in terrestrial environment counterparts, these were absent in Bacillus sp. BHET2, indicating that either the enzymes used by this bacterium share little homology with those characterised previously, or that this bacterium uses a novel pathway for PET degradation.

Conclusions
Overall, the results of our multi-OMIC characterisation of PET degradation provide a significant step forwards in our understanding of marine plastic degradation by bacterial isolates and communities and evidences the biodegrading potential extant in the plastisphere of marine plastic debris.
Sociotechnical imaginaries of a secure future
Authors: Gerhold Lars , Brandes Edda 
Published: June 2021

AbstractThe article examines the increasingly important role played by technology in the domain of public security in Germany, illustrating its effects on social life. In order to illuminate developments that govern the adoption of security technologies and render them in their dependencies comprehensible, we present two plausible and consistent future scenarios for Germany 2035. Following Jasanoff and Kim, these scenarios are theoretically conceived as two competing “sociotechnical imaginaries” which implies different trajectories for shaping the future. In these imaginaries, security technologies condition social change, and vice versa, in a mutually interdependent process. On the basis of current literature in tandem with a structured scenario development process, we condensed the present sociotechnical imaginaries into two tangible future scenarios for the field of public security, illustrating its effects on how we live as a society. Our overarching goal is to identify key factors that will mediate future developments, and, by extension, to facilitate discussion on the type of future we find collectively desirable. The analysis of impact factors resulted in ten key factors that play a crucial role for the use of security technologies and serve as a leverage for shaping the future. Projections of these factors lead to two narrative scenarios “To Be Ahead” and “Turn Back The Clock”.
The effects of water temperature, acoustic tag type, size at tagging, and surgeon experience on juvenile Chinook salmon (Oncorhynchus tshawytscha) tag retention and growth
Authors: Robinson Rebecca R. , Notch Jeremy , McHuron Alex , Logston Renae , Pham Tom , Ammann Arnold J. 
Published: June 2021

Abstract
Background
Acoustic telemetry is a widely used tool to study the movement and survival of juvenile fish and often requires a surgical procedure to implant the transmitter, which may impact overall fitness and survival following release. This is an important consideration when implementing large-scale acoustic telemetry projects aimed at estimating outmigration survival. The objective of this study was to examine the effects of water temperature, tag type, size at tagging, and surgeon experience on tag retention and growth rate of juvenile Chinook salmon (Oncorhynchus tshawytscha). We tagged 128 spring-run Chinook salmon (81–97 mm fork length, 5.2–10.0 g, tag burden 2.4–6.0%) with one of two types of acoustic transmitters; a shorter, heavier model (‘standard’) and a longer, lighter model (‘injectable’). Fish were tagged by either a novice or experienced surgeon. An additional 64 untagged fish served as a control group and were split between temperature treatments. Fish were reared in either cool (mean 13.4 °C) or warm (mean 17.8 °C) water for 60 days, prior to being euthanized, weighed and measured.

Results
Tag retention was similar for both transmitter types, but varied with water temperature, with significantly higher tag loss in the warm treatment (21.9%, 14 tags expelled), compared to the cold treatment (7.8%, 5 tags expelled). In the warm treatment, fish growth in the injectable tag group was significantly lower compared to the control group, and lower than the standard tag group, but not significantly lower. There was no significant difference between the control and standard tag groups for the warm treatment. In the cool temperature treatment, fish growth was not significantly different among any of the factors tested. Surgery time differed between surgeons; however, surgeon experience did not significantly affect tag shedding or growth.

Conclusion
Total tag loss was 14.8% over the 60-day trial, with higher and earlier loss in the warmer treatment. Tag length may be a more important factor than tag weight in smaller size fish. This suggests that tag shedding is a significant factor to consider when estimating survival, as the actual survival rate may be higher than estimates based solely on receiver detections.