bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Framework for the Evaluation of Healthcare Data’s Value from the Perspective of Open Data
Authors: Xu Ting , Wu Danmai , Wang Shu , Wei Mingyue , Yu Guangjun 
Published: February 2021

Abstract
Background: This study is aimed at developing a framework for the evaluation of healthcare data’s value, so as to provide a tool for data managers in making decisions on data openness.Methods: In this study, the Delphi method was adopted. Firstly, a rudimentary framework was constructed following a literature review and focus group interviews, and an inquiry letter was designed. After handing out the inquiry letters to experts in related areas, the framework was modified according to the feedbacks. This process was repeated until a consensus was reached.Results: For this inquiry 15 experts were invited; whose levels of activeness and authority were relatively high. This research produced a framework for the evaluation of healthcare data with 2 primary criteria, 7 secondary criteria and 21 tertiary criteria, after two rounds in Delphi method.Conclusion: The framework established in this research lays a solid foundation for the identifying and evaluation of healthcare data’s value, and is expected to drive the process of opening of valuable healthcare data.
Timing for elective cesarean and maternal fetal outcome: a cohort in supplementary health care
Authors: Rosa Marcos Wengrover , Perez Amanda Vilaverde , Muller Gabriel Cardozo , Sbaraini Mariana , Hammes Luciano Serpa , Ghizzoni Flavia , Grossi Fernanda Santos , Ferreira Charles Francisco , Vettorazzi Janete 
Published: February 2021

Abstract
The increase in the number of cesarean sections (C-sections) has been reported in developed and under-developed countriesObjective: To assess the relationship between the timing of antepartum elective cesarean section (C-section) and neonatal outcomes in a Brazilian population.Design: Retrospective cohort study.Setting: large obstetric center in Porto Alegre, BrazilParticipants: women with single gestation submitted to elective C-section at a large obstetric from January 2013 to December 2016. Eligibility criteria included primiparous mothers and those who previously underwent a C-section, with gestational ages of 37–39 weeks (group I) or ≥ 39 weeks (group II), undergoing antepartum elective C-section without clinical indication. Participants under 18 years old, with fetal malformation diagnosis or dead fetus were excluded. Neonatal outcomes were compared between both gestational age groups.Exposure: elective C-section.Main Outcomes and Measures: adverse neonatal outcomes (NICU admission, Fetal trauma, respiratory distress, hypoglycemia, hiperbilirrubinemia, neonatal infection, thick meconium and meconium aspiration syndrome)Results: There were 17,184 live births at Hospital Moinhos de Vento during the study period. Of these, 13,457 were excluded (multiparous women, vaginal birth or C-section with medical indication), remaining 3,722 C-sections without medical indication in nulliparous women or in those with one previous C-section (both with no prior vaginal delivery). Of these, 1,460 were in group I and 2,262 were in group II. Most women were white (97.8%) and the median age was 33.0 (95%CI 33.1–33.5) years. Neonatal intensive care unit (NICU) hospitalization, respiratory distress and hyperbilirubinemia were positively associated with group I in relation to group II (p≤0.0001, p=0.001 and p=0.002, respectively). In logistic regression, overall higher gestational age was associated with reduction on odds of NICU admission (unadjusted OR 0.46, 95%CI 0.36-0.59), respiratory distress (unadjusted OR 0.52, 95%CI 0.33-0.78) and hyperbilirubinemia (unadjusted OR 0.35, 95%CI 0.20-0.61).Conclusion: Elective C-section based on maternal request should not be recommended; however, for women who require elective C-section, neonatal outcomes suggest that delivery between 39 and 39+7 weeks is the optimal timing.
The nasal symbiont Staphylococcus epidermidis shapes the cellular environment to decrease expression of SARS-CoV-2 entry factors in nasal epithelium
Authors: Ji Jeong Yeon , Jo Ara , Won Jina , Gil Chan Hee , Shin Haeun , Kim Sujin , Jeon Yung Jin , Kim Hyun Jik 
Published: February 2021

Abstract
Background

Emerging evidence indicates that severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2) targets the human nasal epithelium via the principal entry factors angiotensin-converting enzyme 2 (ACE2) and transmembrane serine protease 2 (TMPRSS2), which are highly expressed in the nasal epithelium. However, little is known about suppressive biologics against SARS-CoV-2 entry factors. Here, we report that the nasal commensal Staphylococcus epidermidis altered the host transcriptional response against SARS-CoV-2 in the nasal epithelium by reducing ACE2 and TMPRSS2 gene expression in concert with an increase in serine-peptidase inhibitors.
Results

Our data reveal that ACE2 was more abundantly expressed in nasal epithelial (NHNE) cells than bronchial epithelial cells, and inoculation with S. epidermidis reduced ACE2 transcription in NHNE cells. Our data also show that TMPRSS2 mRNA was significantly decreased in NHNE cells and that S. epidermidis colony number in human nasal mucus was inversely correlated with ACE2 and TMPRSS2 gene expression in the nasal mucosa. In addition, levels of the serine-peptidase inhibitors SERPINE1 and SERPINE2 were significantly increased by S. epidermidis, and this accompanied reduction of TMPRSS2 transcription in nasal epithelial cells.
Conclusion

These results characterize the S. epidermidis-regulated host transcriptional response restricting SARS-CoV-2 entry to the nasal epithelium via downregulation of receptors and host protease for SARS-CoV-2 cellular invasion coupled with SERPINE1 and SERPINE2 induction.
Computer-aided Diagnosis with a Convolutional Neural Network Algorithm for Automated Detection of Urinary Tract Stones on Plain X-ray
Authors: Kobayashi Masaki , Ishioka Junichiro , Matsuoka Yoh , Fukuda Yuichi , Kohno Yusuke , Kawano Keizo , Morimoto Shinji , Muta Rie , Fujiwara Motohiro , Kawamura Naoko , Okuno Tetsuo , Yoshida Soichiro , Yokoyama Minato , Suda Rumi , Saiki Ryota , Suzuki Kenji , Kumazawa Itsuo , Fujii Yasuhisa 
Published: February 2021

Abstract
Background: Recent increased use of medical images induces further burden of their interpretation for physicians. A plain X-ray is a low-cost examination that has low-dose radiation exposure and high availability, although diagnosing urolithiasis using this method is not always easy. Since the advent of a convolutional neural network via deep learning in the 2000s, computer-aided diagnosis (CAD) has had a great impact on automatic image analysis in the urological field. The objective of our study was to develop a CAD system with deep learning architecture to detect urinary tract stones on a plain X-ray and to evaluate the model’s accuracy. Methods: We collected plain X-ray images of 1017 patients with a radio-opaque urinary tract stone. X-ray images (n=827 and 190) were used as the training and test data, respectively. We used a 17-layer Residual Network as a convolutional neural network architecture for patch-wise training. The training data were repeatedly used until the best model accuracy was achieved within 300 runs. The F score, which is a harmonic mean of the sensitivity and positive predictive value (PPV) and represents the balance of the accuracy, was measured to evaluate the model’s accuracy. Results: Using deep learning, we developed a CAD model that needed 110 ms to provide an answer for each X-ray image. The best F score was 0.752, and the sensitivity and PPV were 0.872 and 0.662, respectively. When limited to a proximal ureter stone, the sensitivity and PPV were 0.925 and 0.876, respectively, and they were the lowest at mid-ureter. Conclusion: CAD of a plain X-ray may be a promising method to detect radio-opaque urinary tract stones with satisfactory sensitivity although the PPV could still be improved. The CAD model detects urinary tract stones quickly and automatically and has the potential to become a helpful screening modality especially for primary care physicians for diagnosing urolithiasis. Further study using a higher volume of data would improve the diagnostic performance of CAD models to detect urinary tract stones on a plain X-ray.
Direct Visualization of Grain Boundaries in Quartzites using Atomic Force Microscopy: Application to Study of Fluid Percolation in Continental Crust
Authors: Dobe Ritabrata , Das Anuja , Mukherjee Rabibrata , Gupta Saibal 
Published: February 2021

Abstract
Hydrous fluids play a vital role in the chemical and rheological evolution of ductile, quartz-bearing continental crust, where fluid percolation pathways are controlled by grain boundary domains. In this study, widths of grain boundary domains in seven quartzite samples metamorphosed under varying crustal conditions were investigated using Atomic Force Microscopy (AFM) which allows comparatively easy, high magnification imaging and precise width measurements. It is observed that dynamic recrystallization at higher metamorphic grades is much more efficient at reducing grain boundary widths than at lower temperature conditions. The concept of force-distance spectroscopy, applied to geological samples for the first time, allows qualitative estimation of variations in the strength of grain boundary domains. The strength of grain boundary domains is inferred to be higher in the high grade quartzites, which is supported by Kernel Average Misorientation (KAM) studies using Electron Backscatter Diffraction (EBSD). The results of the study show that quartzites deformed and metamorphosed at higher grades have narrower channels without pores and an abundance of periodically arranged bridges oriented at right angles to the length of the boundary. We conclude that grain boundary domains in quartz-rich rocks are more resistant to fluid percolation in the granulite rather than the greenschist facies.
Impact of Ciprofloxacin With Autophagy on Acute Kidney Injury
Authors: Park Woo Yeong , Lim Sun-Ha , Kim Yaerim , Paek Jin Hyuk , Jin Kyubok , Han Seungyeup , Ahn Ki Sung , Lee Jongwon 
Published: February 2021

Abstract
Renal tubular injury caused by oxidative stress and inflammation results in acute kidney injury. Recent research reported that antibiotics may restore deteriorated renal tubules, but the underlying mechanism remains unclear. Therefore, we investigated the efficacy and mechanism of action of antibiotics against renal tubular injury. We screened ciprofloxacin, ceftizoxime, minocycline, and netilmicin and selected ciprofloxacin to examine further because of its low toxicity towards renal tubular cells. We evaluated the effect of ciprofloxacin on cell survival by analyzing apoptosis and autophagy. TUNEL assay results showed that the ciprofloxacin group had less apoptotic cells than the control group. The ratio of cleaved caspase 3 to caspase 3, the final effector in the apoptosis process, was decreased, but the ratio of Bax to Bcl-2 located upstream of caspase 3 was not decreased in the ciprofloxacin group. Therefore, apoptosis inhibition does not occur via Bax/Bcl-2. Conversely, the levels of phosphorylated Bcl-2, and Beclin-1, an autophagy marker, were increased, and that of caspase-3 was decreased in the ciprofloxacin group. This indicates that ciprofloxacin enhanced autophagy, increasing the amount of free Beclin-1 via phosphorylated Bcl-2, and inhibited caspase activity. Therefore, ciprofloxacin might increase renal cell viability through the autophagy activation in acute kidney injury.
Eating Disorder Severity and Psychological Morbidity in Adolescents with Anorexia Nervosa or Atypical Anorexia Nervosa and Premorbid Overweight/Obesity
Authors: Matthews Abigail , Kramer Rachel A. , Mitan Laurie 
Published: February 2021

Abstract
PurposeA significant proportion of adolescents with anorexia nervosa (AN) or atypical anorexia nervosa (AAN) experience premorbid overweight/obesity, yet distinct characteristics among this subset of patients remain unclear. This study examined eating disorder (ED) symptom severity, psychological morbidity, and weight stigma in patients with premorbid overweight/obesity as compared to patients with premorbid normal weights.MethodsParticipants included adolescents with AN or AAN (aged 12-18) who received multidisciplinary treatment at a pediatric medical center in the United States. ED symptoms, anxiety, and depression were compared among patients with premorbid overweight/obesity (n = 43) and premorbid normal weights (n = 63). Associations between weight stigma, ED severity, and psychological morbidity were also examined. ResultsPatients with premorbid overweight/obesity reported greater ED severity (p = .04), anxiety (p < .003), depression (p = .02), and a higher frequency of weight-based teasing by peers (p = .003) and parent weight talk about their own weights (p < .001). Weight-based teasing was positively associated with ED symptoms, anxiety, and depression for all patients, regardless of premorbid weight status.ConclusionsAdolescents with AN or AAN and a history of overweight/obesity may present with greater ED symptom severity and psychological morbidity than patients with normal weight histories. Distinct prevention and treatment interventions for adolescents with AN or AAN and premorbid overweight/obesity may be warranted. Level of Evidence﻿Level III, case-control analytic study
Cerium Oxide Nanoparticles Improve Cotton Salt Tolerance by Enabling Better Ability to Maintain Cytosolic K+/Na+ Ratio
Authors: Liu Jiahao , Li Guangjing , Chen Linlin , Gu Jiangjiang , Wu Honghong , Li Zhaohu 
Published: February 2021

Abstract
BackgroundSalinity is a worldwide factor limiting the agricultural production. Cotton is an important cash crop; however, its yield and product quality are negatively affected by salinity. Using nanomaterials such as cerium oxide nanoparticles (nanoceria) to improve plant tolerance to stresses, e.g. salinity, is an emerged approach in agricultural production. Nevertheless, to date, our knowledge about the role of nanoceria in cotton salt response and the behind mechanisms is still rare. ResultsWe found that PNC (poly acrylic acid coated nanoceria) helped to improve cotton plant tolerance to salinity, showing the better phenotypic performance, the higher chlorophyll content and biomass, and the better photosynthetic performance in PNC treated cotton plants than the control group. Under salinity stress, in consistent to the results of the enhanced antioxidant enzyme activities, PNC treated cotton plants showed significant lower MDA content and ROS level than the control group, both in the first and second true leaf. Further experiments showed that under salinity stress, PNC treated cotton plants had significant higher cytosolic K+ and lower cytosolic Na+ fluorescent intensity in both the first and second true leaf than the control group. This is further confirmed by the leaf ion content analysis, showed that PNC treated cotton plants maintained significant higher leaf K+ and lower leaf Na+ content, and thus the higher K+/Na+ ratio than the control plants under salinity. Whereas no significant increase of vacuolar Na+ intensity was observed in PNC treated plants than the control under salinity, suggesting that PNC enhanced leaf K+ retention and leaf Na+ exclusion, but not leaf vacuolar Na+ sequestration are the main mechanisms behind the PNC improved cotton salt tolerance. qPCR results showed that under salinity stress, the modulation of HKT1 but not SOS1 refers more to the PNC improved cotton leaf Na+ exclusion than the control. ConclusionsNanoceria enhanced leaf K+ retention and Na+ exclusion, but not vacuolar Na+ sequestration are the main mechanisms behind the nanoceria improved cotton salt tolerance. Our results add more knowledge for better understanding the complexity of plant-nanoceria interaction in terms of nano-enabled plant stress tolerance.
Comparison of Culture-Negative and Culture-Positive Sepsis or Septic Shock: A Systematic Review and Meta-Analysis
Authors: Li Yuting , Guo Jianxing , Yang Hongmei , Li Hongxiang , Shen Yangyang , Zhang Dong 
Published: February 2021

Abstract
Background: Mortality and other clinical outcomes between culture-negative and culture-positive septic patients have been documented inconsistently and are very controversial. A systematic review and meta-analysis was performed to compare the clinical outcomes of culture-negative and culture-positive sepsis or septic shock.Methods: We searched the PubMed, Cochrane, and Embase databases for studies from inception to the 1st of January 2021. We included studies involving patients with sepsis or septic shock. All authors reported our primary outcome of all-cause mortality and clearly comparing culture-negative versus culture-positive patients with clinically relevant secondary outcomes (ICU length of stay, hospital length of stay, mechanical ventilation requirements, mechanical ventilation duration and renal replacement requirements). Results were expressed as odds ratio (OR) and mean difference (MD) with accompanying 95% confidence interval (CI).Results: Seven studies including 22655 patients were included. The primary outcome of this meta-analysis showed that there was no statistically significant difference in the all-cause mortality between two groups (OR=0.95; 95% CI, 0.88 to 1.01; P=0.12; Chi2=30.71; I2=80%) . Secondary outcomes demonstrated that there was no statistically significant difference in the ICU length of stay(MD=-0.19;95% CI, -0.42 to 0.04; P=0.10;Chi2=5.73; I2=48%), mechanical ventilation requirements(OR=1.05; 95% CI, 0.93 to 1.18; P=0.41; Chi2=5.89; I2=66%) and renal replacement requirements(OR=0.82; 95% CI, 0.67 to 1.01; P=0.06; Chi2=1.21; I2=0%) between two groups. The hospital length of stay of culture-positive group was longer than that of the culture-negative group(MD=-3.48;95% CI, -4.34 to -2.63; P<0.00001;Chi2=1.03; I2=0%). The mechanical ventilation duration of culture-positive group was longer than that of the culture-negative group(MD=-0.64;95% CI, -0.88 to -0.4; P<0.00001;Chi2=4.86; I2=38%).Conclusions: Culture positivity or negativity was not associated with mortality of sepsis or septic shock patients. Furthermore, culture-positive septic patients had similar ICU length of stay, mechanical ventilation requirements and renal replacement requirements as those culture-negative patients. The hospital length of stay and mechanical ventilation duration of culture-positive septic patients were both longer than that of the culture-negative patients. Further large-scale studies are still required to confirm these results.
Effects of Inappropriate Empirical Antimicrobial Therapy on the Outcomes of Patients with Community-Onset Bacteremia: Age Matters
Authors: Lin Chih-Hao , Chen Po-Lin , Ho Ching-Yu , Lee Chung-Hsun , Hsieh Chih-Chia , Ko Wen-Chien , LEE CHING-CHI 
Published: February 2021

Abstract
Background: Studies have reported the effects of delayed administration of appropriate empirical antimicrobial (AEA) on the prognosis of patients with bloodstream infections; however, whether there is an age-related difference in these effects remains debated. Methods: In this 4-year multicenter cohort study, patients with community-onset bacteremia were retrospectively included and categorized into “middle aged” (45–64 years), “old” (65–74 years), and “very old” (≥75 years) groups. To determine the timing of AEA administration for each patient, all causative microorganisms were prospectively obtained. For each age group, the effects of delayed AEA administration on 30-day mortality were investigated after adjustment for the independent predictors of 30-day mortality determined using a logistic regression model.Results: Significant differences were observed in the distribution of comorbidity types, comorbidity severity, bacteremia sources, bacteremia severity, and causative microorganisms among 968 (33.2%) middle-aged, 683 (23.4%) old, and 1,265 (43.4%) very old patients. Although significant effects (adjusted odds ratio [AOR], 1.002; P = 0.07) of delayed AEA administration on prognosis were not observed in middle-aged patients, each hour of AEA delay resulted in an average increase in the 30-day crude mortality of 0.036% (AOR, 1.0036; P < 0.001) and 0.38% (AOR, 1.0038; P < 0.001) in old and very old patients, respectively. Practically in critically ill patients, each hour of delayed AEA administration resulted in an average increase of 0.03% (AOR, 1.003; P = 0.04), 0.4% (AOR, 1.004; P < 0.001), and 0.5% (AOR, 1.005; P = 0.001) in 30-day crude mortality in middle-aged, old, and very old patients, respectively. Conclusions: Regardless of bacteremia severity, the adverse effects of delayed AEA administration on the survival of patients with community-onset bacteremia increased with patients’ age. To achieve favorable outcomes, rapid AEA administration is recommended in older patients.
Heterologous Expression of Cyanobacterial PCS Confers Augmented Arsenic And Cadmium Stress Tolerance and Higher Artemisinin In Artemisia Annua Hairy Roots.
Authors: Pandey Neha , Rai Krishna Kumar , Rai Sanjay Kumar , Pandey-Rai Shashi 
Published: February 2021

Abstract
The present study provides the first report of heterologous expression of phytochelatin synthase from Anabaena PCC 7120 (anaPCS) into the hairy roots of Artemisia annua. Transformed hairy roots of A. annua expressing anaPCS gene showed better tolerance to heavy metals viz., arsenic (As) and cadmium (Cd) owing to 143 and 191 % more As and Cd accumulation respectively as compared to normal roots with a bioconcentration factor (BCF) of 9.7 and 21.1 for As and Cd respectively. Under As and Cd stresses, transformed hairy roots possessed significantly higher amounts of phytochelatins and thiols probably due to the presence of both AaPCS (Artemisia annua PCS) and anaPCS. In addition, artemisinin synthesis was also induced in transformed hairy roots under heavy metals stresses. In-silico analysis revealed the presence of conserved motifs in both AaPCS and anaPCS sequences as well as structural modelling of PCS functional domain was conducted. Interaction of AaPCS and anaPCS proteins with CdCl2 and sodium arsenate gene ontology analysis gave insights to anaPCS functioning in transformed hairy roots of A. annua. The study provides transformed hairy roots of A. annua as an efficient tool for effective phytoremediation with added advantages of artemisinin extraction from hairy roots used for phytoremediation.