bluuebunny/crossref_metadata_2025_split huggingface dataset:
Non-HDL Cholesterol as a Predictor for Incident Type 2 Diabetes in Community-dwelling Adults: Longitudinal Findings Over 12 Years
Authors: Seo In-Ho , Son Da-Hye , Lee Hye Sun , Lee Yong-Jae 
Published: July 2021

Abstract
BackgroundNon-high-density lipoprotein cholesterol (non-HDL cholesterol) is a simple measure to analyze the total amount of proatherogenic lipoproteins in the blood and to predict development of cardiovascular disease. However, it is unclear whether non-HDL cholesterol has a relationship with incident type 2 diabetes. This study aimed to evaluate the association between non-HDL cholesterol and incident type 2 diabetes with a large-sample, community-based Korean cohort over a 12-year period.MethodsAmong the 10,038 total participants, 7,608 (3,662 men and 3,946 women) without diabetes were selected from the Korean Genome and Epidemiology Study (KoGES). Their non-HDL cholesterol level was calculated as [total cholesterol – HDL cholesterol] mg/dL and divided into quartiles. Newly developed type 2 diabetes was defined as any of the following: a fasting plasma glucose level ≥ 126 mg/dL; a plasma glucose level ≥ 200 mg/dL at two hours after a 75-g oral glucose tolerance test; a glycosylated hemoglobin level ≥ 6.5%; or current treatment with oral anti-diabetic medications or insulin therapy. The hazard ratios (HRs) with 95% confidence intervals (CIs) for incident type 2 diabetes were calculated using multivariate Cox proportional hazards regression models after adjusting for potentially confounding variables.ResultsIn total, 1,442 individuals (18.9%: 1442 of 7608) developed type 2 diabetes during the 12-year follow up period, with an incident rate of 3.0–5.0. Compared to the reference first quartile, the HRs (95% CIs) of incident type 2 diabetes for the second, third, and fourth quartiles increased in a dose-response manner after adjusting for potentially confounding variables, including the HOMA-IR insulin resistance marker.ConclusionNon-HDL cholesterol level at baseline can be a useful predictor of new-onset type 2 diabetes.
Comparative analysis of ChAdOx1 nCoV-19 and Ad26.COV2.S SARS-CoV-2 vector vaccines
Authors: Michalik Stephan , Siegerist Florian , Palankar Raghavendra , Franzke Kati , Schindler Maximilian , Reder Alexander , Seifert Ulrike , Cammann Clemens , Wesche Jan , Steil Leif , Hentschker Christian , Gesell-Salazar Manuela , Reisinger Emil , Beer Martin , Endlich Nicole , Greinacher Andreas , Völker Uwe 
Published: July 2021

Abstract
Vector-based SARS-CoV-2 vaccines have been associated with vaccine-induced thrombosis with thrombocytopenia syndrome (VITT/TTS), but the causative factors are still unresolved. We comprehensively analyzed ChAdOx1 nCov-19 (AstraZeneca) and Ad26.COV2.S (Johnson & Johnson). ChAdOx1 nCoV-19 contains significant amounts of host cell protein impurities, including functionally active proteasomes, and adenoviral proteins. In Ad26.COV2.S much less impurities were found. Platelet-factor 4 (PF4) formed complexes with ChAdOx1 nCoV-19 constituents, but not with purified virions from ChAdOx1 nCoV-19 or with Ad26.COV2.S. Vascular hyperpermeability was induced by ChAdOx nCoV-19 but not by Ad26.COV2.S.These differences in impurities together with EDTA-induced capillary leakage might contribute to the higher incidence rate of VITT associated with ChAdOx1 nCoV-19 compared to Ad26.COV2.S.
Carbapenem-resistant Acinetobacter Baumannii Ventilator-Associated Pneumonia in Critically Ill Patients: Potential Inference with Respiratory Tract Microbiota Dysbiosis
Authors: Xiao Tingting , Guo Qian , Zhou Yanzi , Shen Ping , Wang Yuan , Fang Qiang , Li Mo , Zhang Shuntian , Guo Lihua , Yu Xiao , Liao Yulin , Wang Chunhui , Chi Xiaohui , Kong Xiaoyang , Zhou Kai , Zheng Beiwen , Luo Qixia , Chen Yunbo , Zhu Huaiqiu , Xiao Yonghong 
Published: July 2021

Abstract
Background: Carbapenem-resistant Acinetobacter baumannii (CRAB) is a common cause of ventilator-associated pneumonia (VAP) in intensive care unit (ICU) patients, but infection and colonization are difficult to distinguish which aggravates the abuse of antimicrobial drugs and further accelerates the evolution of drug resistance. We sought to provide new clues for the diagnosis, pathogenesis and treatment of CRAB VAP based on lower respiratory tract (LRT) microbiota. Methods: A prospective study was conducted on patients with mechanical ventilation from July 2018 to December 2019 in a tertiary hospital. Multi-genomics studies (16S rRNA amplicon, metagenomics and whole-genome sequencing [WGS]) of endotracheal deep aspirate (ETA) were performed. Results: Fifty-two ICU patients were enrolled, including 24 with CRAB VAP (CRAB-I), 22 with CRAB colonization (CRAB-C), and six CRAB-negative patients (infection-free) (CRAB-N). Diversity of pulmonary microbiota was significantly lower in CRAB-I than in CRAB-C or CRAB-N (mean Shannon index, 1.79 vs. 2.73 vs. 4.81, P<0.05). Abundances of 11 key genera differed between the groups. Acinetobacter was most abundant in CRAB-I (76.19%), moderately abundant in CRAB-C (59.14%), and least abundant in CRAB-N (11.25%), but its interactions with other genera exhibited the opposite pattern. Metagenomics and WGS analysis showed that virulence genes were more abundant in CRAB-I than in CRAB-C. Multi-locus sequence typing (MLST) of 46 CRAB isolates revealed that the main types were ST208 (30.43%) and ST938 (15.22%), with no difference between CRAB-I and CRAB-C. Conclusions: LRT microbiota dysbiosis including elevated relative abundance of Acinetobacter and reduced bacterial interactions, and virulence enrichment may lead to CRAB VAP.
Features Derived From Blood Pressure Predict Elevated Intracranial Pressure in Critically Ill Children
Authors: Ackerman Kassi , Mohammed Akram , Chinthala Lokesh , Davis Robert L. , Kamaleswaran Rishikesan , Shafi Nadeem I. 
Published: July 2021

Abstract
Clinicians frequently observe hemodynamic changes preceding elevated intracranial pressure (ICP) events. We employed a machine learning approach to identify novel and differentially expressed features associated with elevated ICP (eICP) events in children with severe brain injuries. Statistical features from physiologic data streams were derived from non-overlapping 30-minute analysis windows prior to 21 eICP events; 200 records without eICP events were used as controls. Ten Monte Carlo simulations with training/testing splits provided performance benchmarks for 4 machine learning approaches. XGB yielded the best performing predictive models. SHAP analyses demonstrated that a majority of the top 20 contributing features from each simulation consistently derived from blood pressure data streams up to 240 minutes prior to eICP events, rivaling ICP-derived features at 0-60 minutes. Our AUROC benchmark at the 30-60 minutes analysis window using the XGB model bundle was 0.82 (95% CI 0.81-0.83); the AUPRC was 0.24 (95% CI 0.23-0.25), well-above the expected baseline. We conclude that physiomarkers discernable by machine learning are concentrated within blood pressure data up to 4 hours prior to eICP events and demonstrate robust benchmark performance. Future predictive modeling of elevated ICP events should leverage features contained within hemodynamic signals.
Evaluation of Staff Satisfaction After Implementation of a Routine Work Checklist in an Oral Outpatient Department and Its Effect on Work Efficiency
Authors: Zhang Wei , Ren Lizhi , Wang Xiaojing , Wang Qianqian , Zhang Xiaohong , Li Weili , Zhao Bin , Ren Xiuyun , Li Bing , Qin Haiyun , Ge Xuejun , Zhang Fang , Wang Xiangyu , Meng Xiaorui , Yu Feiyan 
Published: July 2021

Abstract
Objective: To evaluate the feasibility, effectiveness and sustainability of using a checklist in the routine work of a stomatological outpatient department and investigate the satisfaction of the nursing staff with the checklist.Methods: The study was divided into two stages: design and manufacture the checklist and apply the checklist. After the expert group performed stage one, an analysis of work efficiency and work omissions and a survey of staff satisfaction were carried out. The results of the groups either using the checklist (n = 14) or not (n = 14) were analysed and compared. Results: The average time of the checklist group was 14.14±0.81 min, and the average time of the nonchecklist group was 26.07±2.37 min, P < 0.001. The working efficiency of the checklist group was significantly higher than that of the nonchecklist group. The omission rate was 0% in the checklist group and 21.43% in the nonchecklist group. Staff satisfaction with the use of the checklist was high. Conclusion: The checklist can make routine work more efficient and convenient in a stomatological outpatient department. It is recommended for use in stomatological outpatient departments or hospitals.
A 3D primary human cell-based in vitro model of non-alcoholic steatohepatitis for efficacy testing of clinical drug candidates
Authors: Ströbel Simon , Kostadinova Radina , Fiaschetti-Egli Katia , Rupp Jana , Bieri Manuela , Pawlowska Agnieszka , Busler Donna , Hofstetter Thomas , Sanchez Katarzyna , Grepper Sue , Thoma Eva 
Published: July 2021

Abstract
Non-alcoholic steatohepatitis (NASH) is a progressive and severe liver disease, characterized by lipid accumulation, inflammation, and downstream fibrosis. Despite its increasing prevalence, there is no approved treatment yet available for patients. This has been at least partially due to the lack of predictive preclinical models for studying this complex disease. Here, we present a 3D in vitro microtissue model that uses spheroidal, scaffold free co-culture of primary human hepatocytes, Kupffer cells, liver endothelial cells and hepatic stellate cells. Upon exposure to defined and clinically relevant lipotoxic and inflammatory stimuli, these microtissues develop key pathophysiological features of NASH within 10 days, including an increase of intracellular triglyceride content and lipids, and release of pro-inflammatory cytokines. Furthermore, fibrosis was evident through release of procollagen type I, and increased deposition of extracellular collagen fibers. Whole transcriptome analysis revealed changes in the regulation of pathways associated with NASH, such as lipid metabolism, inflammation and collagen processing. Importantly, treatment with anti-NASH drug candidates (Selonsertib and Firsocostat) decreased the measured specific disease parameter, in accordance with clinical observations. These drug treatments also significantly changed the gene expression patterns of the microtissues, thus providing mechanisms of action and revealing therapeutic potential. In summary, this human NASH model represents a promising drug discovery tool for understanding the underlying complex mechanisms in NASH, evaluating efficacy of anti-NASH drug candidates and identifying new approaches for therapeutic interventions.
Insight Into the Causative Genes and Pathways Associated With Height, Length, Length to Height Ratio and Body Weight Traits of Korean Indigenous Breed, Jindo Dog Using Gene Set Enrichment and Pathway-based GWAS Analysis
Authors: Sheet Sunirmal , Kim Jong Seok , Ko Min Jeong , Kim Na Yeon , Lim Young Jo , Park Mi Rim , Lee Seung Jin , Kim Jeong Min , Oh Seok Il , Choi Bong-Hwan 
Published: July 2021

Abstract
As a companion and hunting dog, height, length, length to height ratio (LHR) and body-weight are the vital economic traits for Jindo dog. Artificial breeding has produced an extraordinary diversity in these traits. Therefore, the identification of causative markers, genes and pathways that led us to understand the genetic basis of this variability is essential for their selection purposes. Here, we performed a genome-wide association study (GWAS) combined with pathway-based analysis on 757 dogs using 118,879 SNPs. A higher heritability (h2) was detected for height (0.33) and weight (0.28) trait in Jindo. At a threshold of p-value < 5E-05, 10, 6, 13, and 11 SNPs on different chromosomes were significantly associated with height, length, LHR and body-weight traits, respectively. Based on our result, HHIP, LCORL, and NCAPG for height, IGFI and FGFR3 for length, DLK1 and EFEMP1 for LHR, and PTPN2, IGFI, and RASAL2 for weight can be the potential candidate genes because the significant SNPs located in their intronic or upstream regions. An additive and dominant mode of inheritance was noticed from the phenotype-genotype correlation plot for top variants. The gene-set enrichment analysis highlighted here 9 and 7 overlapping significant (p < 0.05) GO terms and pathways among traits. Interestingly, the highlighted pathways were related to hormone synthesis, secretion and signaling were generally involved in the metabolism, growth and development process. Our data provide an insight into the significant genes and pathways if verified further, which will have a significant effect on the breeding /management of the Jindo dog’s population.
Selection of the Gridded Temperature Dataset for Assessment of Thermal Bioclimatic Environment Changes in Amu Darya River Basin
Authors: Salehie Obaidullah , Ismail Tarmizi , Shahid Shamsuddin , Sammen Saad Sh , Malik Anurag , Wang Xiaojun 
Published: July 2021

Abstract
Assessment of the thermal bioclimatic environmental changes is important to understand ongoing climate change implications on agriculture, ecology, and human health. This is particularly important for the climatologically diverse transboundary Amy Darya River basin, a major source of water and livelihood for millions in Central Asia. However, the absence of longer period observed temperature data is a major obstacle for such analysis. This study employed a novel approach by integrating compromise programming (CP) and multicriteria group decision–making methods (MCGDM) to evaluate the efficiency of four global gridded temperature datasets based on observation data at 44 stations. The most reliable gridded data was used to assess the spatial distribution of global warming-induced unidirectional trends in thermal bioclimatic indicators (TBI) using a modified Mann-Kendall (MMK) test. Ranking of the products revealed Climate Prediction Center (CPC) temperature as most efficient in reconstruction observed temperature, followed by TerraClimate and Climate Research Unit (CRU). Assessment of TBI trends using CPC data revealed an increase in the minimum temperature in the coldest month over the whole basin at a rate of 0.03 to 0.08\(℃\) per decade, except in the east. Besides, an increase in diurnal temperature range and isothermally increased in the east up to 0.2\(℃\) and 0.6% per decade, respectively. The results revealed negative implications of thermal bioclimatic change on water, ecology, and public health in the eastern mountainous region and positive impacts on vegetation in the west and northwest.
Mental health assessment of healthcare workers in the Emergency Department of a low middle-income country during COVID 19 pandemic
Authors: Waheed Shahan , Kumar Nirdosh , Qureshi Bushra , Rahim Ahmed 
Published: July 2021

Abstract
Introduction:

Emergency department healthcare workers of Pakistan during COVID 19 pandemic are facing an acute rise of mental illnesses. In the present study, the authors aim to assess the frequency of anxiety and depression among healthcare workers in the emergency department.
Methods:

A cross-sectional online survey was conducted in the emergency department between July to August 2020 at Aga Khan University Hospital Karachi, Pakistan. The Hospital Anxiety and Depression (HAD) scale was used for mental illness assessment among emergency physicians and nurses. Descriptive analysis of grading as per Likert scale is done through frequencies, means and standard deviations. Categorical variables were expressed as frequency (%). Mann-Whitney U test was used to compare scores of various groups and sub-groups and Chi-square test was used to assess the association of depression and anxiety categories among the groups.
Results:

In the emergency department, 127 healthcare professionals (physicians and nurses) were included in this survey. Median depression score was 8 (IQR 6–10) with 21% (27) fall under depression and 39% (50) to borderline depression. Median anxiety score was 9 (IQR 7–12) with 33% (42) had abnormal, 38% (48) had borderline anxiety. Healthcare workers working for > 45 hours per week have odds of 3.62 [1.374–9.549] of developing depression compared to anxiety with a p-value of 0.009. Similarly, nurses and medical officers develop depression with odds of 2.18 [1.016–4.686] p-value 0.045 and 5.18 [0.197–1.02] p-value 0.002, respectively.
Conclusion:

In our study, we determined that healthcare workers working in the Emergency Department during COVID-19 pandemic suffered high levels of anxiety and depression, which is a matter of concern. Therefore, comprehensive support and training of emergency department healthcare providers are paramount to promote physical and mental wellbeing specifically through adequate provision and training on the use of personal protective equipment, strict infection control practices, shorter shift length, and provision of mental health and support services.
Proteome analysis of the Gram-positive fish pathogen Renibacterium salmoninarum reveals putative role of membrane vesicles in virulence
Authors: Kroniger Tobias , Flender Daniel , Schlüter Rabea , Köllner Bernd , Trautwein-Schult Anke , Becher Dörte 
Published: July 2021

Abstract
The bacterial kidney disease (BKD) is a chronic bacterial disease affecting both wild and farmed salmonids. The causative agent for BKD is the Gram-positive fish pathogen Renibacterium salmoninarum. As treatment and prevention of BKD has proven to be difficult, it is important to know and identify the key bacterial proteins that interact with the host. We used subcellular fractionation to report semi-quantitative data for the cytosolic, membrane, extracellular and membrane vesicle (MV) proteome of R. salmoninarum. These data can aid as a backbone for more targeted experiments regarding the development of new drugs for the treatment of BKD. Further analysis was focused on the MV proteome, where both major immunosuppressive proteins P57/Msa and P22 and proteins involved in bacterial adhesion were found in high abundance. Interestingly, the P22 protein was enriched only in the extracellular and MV fraction, implicating that MVs may play a role in host-pathogen interaction. Compared to the other subcellular fractions, the MVs were also enriched in lipoproteins and all four cell wall hydrolases belonging to the New Lipoprotein C/Protein of 60 kDa (NlpC/P60) family were detected, suggesting an involvement in the formation of the MVs.
Heart failure with reduced, mid-range and preserved left ventricular ejection fraction in Chinese with type 2 diabetes: risk factors and prognosis from time of first index hospitalization
Authors: Luk Andrea O.Y , Zhang Xinge , Fung Erik , Wu Hongjiang , Lau Eric S.H , Yang Aimin , Chow Elaine , Kong Alice P.S , Ma Ronald C.W , Chan Juliana C.N 
Published: July 2021

Abstract
BackgroundThe clinical predictors and prognosis of heart failure (HF) by categories of left ventricular ejection fraction (LVEF) have not been well studied in people with diabetes. In a retrospective cohort of Chinese with type 2 diabetes, we examined 1) clinical factors associated with incident decompensated HF, and 2) mortality post-HF, stratified by LVEF.MethodsWe conducted a retrospective analysis of the Hong Kong Diabetes Register comprising 23,348 people with type 2 diabetes without history of HF enrolled between 1993–2015, followed for incident decompensated HF until 2017. Heart failure subtypes were defined according to LVEF on echocardiography. Multivariate Cox proportional hazards models were used to identify clinical factors associated with incident HF versus no HF, stratified by HF subtypes. All-cause mortality rates were compared by HF subtypes.ResultsOver median follow-up of 7.1 years from enrolment, 1,195 (5.1%) people developed decompensated HF. Among 611 (51.1%) people with echocardiography, 24.1% had HF with reduced LVEF (HFrEF) (LVEF < 40%), 15.2% had HF with mid-range LVEF (HFmrEF) (LVEF 41–49%), and 60.7% had HF with preserved LVEF (HFpEF) (LVEF ≥ 50%). Old age, low GFR, albuminuria and coronary artery disease were associated with increased hazards for all HF subtypes. During median follow-up of 2.1 years post-HF, 760 (63.6%) people died. One-year mortality rate was lower in people with HFpEF (16.2%) than those with HFmrEF (vs 26.9%,p = 0.034) and HFrEF (vs 31.3%,p < 0.001). At 10 years, mortality rates in HFpEF group (58.0%) remained lower than HFmrEF group (vs 71.0%,p = 0.38), but similar to HFrEF group (vs 55.8%,p = 0.651).ConclusionsIn Chinese with type 2 diabetes, HFpEF was the predominant HF subtype. One-year mortality following decompensated HF was lowest in HFpEF group but 10-year mortality was similar between HFpEF and HFrEF.
Angioplasty for dysfunctional arteriovenous fistulas: a meta-analysis of recent randomized controlled trials compared paclitaxel-coated balloon versus conventional balloon angioplasty
Authors: Yang Qin , Zhou Yi , Cai Kui , Chen Yufang , Xia Congying 
Published: July 2021

Abstract
Background

Stenosis in arteriovenous fistulas (AVF) due to neointimal hyperplasia is one of the most common causes of hemodialysis vascular access dysfunction. Treating patients with dysfunctional AVF with drug-coated balloon (DCB) angioplasty may potentially improve outcomes. This systematic review aimed to compare the effectiveness and safety of DCB angioplasty versus conventional balloon angioplasty by pooling evidence from the most recent randomized controlled trials.
Methods

We conducted a comprehensive literature search in the Medline, Embase, and Cochrane central databases. Two independent researchers screened the article, extracted interest and evaluated included studies for risk of bias. Pooled estimation was conducted in terms of 6-month target-lesion primary patency (TLPP) and target-lesion reintervention (TLR), as well as other outcomes. Results were expressed with odds ratio (OR) and 95% confidence interval (CI).
Results

A total of 4 RCTs were identified and included in the meta-analyses, with 911 participants. There was no significant increase in rates of 6-month TLPP (OR 1.63, 95%CI 0.39–6.79, p = 0.35), or decrease in 6-month TLR (OR 0.45, 95%CI 0.17–1.19 p = 0.07) in patients who received DCB as compared to those who received conventional balloon angioplasty. Similarly, we found no difference in the 6-month access circuit primary patency and reinvention between the two groups.
Conclusion

There was no evidence supporting that DCB has a statistically significant higher rate of TLPP and lower rates of TLR in the treatment of dysfunctional AVF than conventional balloon angioplasty. However, DCB was non-inferior to conventional balloon angioplasty in terms of safety. Therefore, further study is needed to clarify whether DCB angioplasty can benefit hemodialysis patients with dysfunction AVF.