bluuebunny/crossref_metadata_2025_split huggingface dataset:
Applied business process management: An information systems approach to improve service delivery in public hospitals of low‐ and middle‐income countries
Authors: Seymour Lisa F. , Mwalemba Gwamaka , Weimann Edda 
Published: July 2019

AbstractSouth African public hospitals are faced with many challenges comprising inefficient processes, lack of digitalisation, severe austerity measures, and the rising burden of disease. Irrespective of the many existing initiatives in place, a critical challenge is the shortage of necessary resources required to fund, implement, and sustain new interventions. This deprives public hospitals from the efficiencies and quality of service experienced in private hospitals or other business entities. Through a case study strategy, this paper has abstracted two practice contributions. First, it describes and prescribes a low‐cost approach in which business process redesign was applied in a public hospital through a partnership between the hospital and a higher learning institution. The initiative involved third year students majoring in Information Systems performing, as part of their class project, process analysis at the hospital at no cost to the hospital other than their employees' time. The second contribution is a priority list of redesign and lean management principles that were abstracted from these initiatives. These include improving staff training, distributing and adhering to up‐to‐date standard operating procedures, performing tasks in parallel rather than in series, reducing handovers by avoiding certain tasks, incentivizing use of existing mobile software by doctors, developing low‐cost task automation solutions such as Microsoft Office applications, redesigning and standardizing forms, capturing data at source electronically rather than later, redesigning physical spaces, and improved key performance indicators and reporting. The study confirms the usefulness of this collaborative business process redesign approach for public hospitals as stakeholders got relevant information and practical, low‐cost, creative solutions with the potential to improve efficiencies and subsequently service delivery.
Health effects inflicted by chronic low‐level arsenic contamination in groundwater: A global public health challenge
Authors: Sinha Dona , Prasad Priyanka 
Published: July 2019

AbstractGroundwater arsenic (As) contamination is a global public health concern. The high level of As exposure (100‐1000 μg/L or even higher) through groundwater has been frequently associated with serious public health hazards, e.g., skin disorders, cardiovascular diseases, respiratory problems, complications of gastrointestinal tract, liver and splenic ailments, kidney and bladder disorders, reproductive failure, neurotoxicity and cancer. However, reviews on low‐level As exposure and the imperative health effects are far less documented. The World Health Organization (WHO) and the United States Environmental Protection Agency (USEPA) has set the permissible standard of As in drinking water at 10 μg/L. Considering the WHO and USEPA guidelines, most of the developed countries have established standards at or below this guideline. Worldwide many countries including India have millions of aquifers with low‐level As contamination (≤50 μg/L). The exposed population of these areas might not show any As‐related skin lesions (hallmark of As toxicity particularly in a population consuming As contaminated groundwater >300 μg/L) but might be subclinically affected. This review has attempted to encompass the wide range of health effects associated with chronic low‐level As exposure ≤50 μg/L and the probable mechanisms that might provide a better insight regarding the underlying cause of these clinical manifestations. Therefore, there is an urgent need to create mass awareness about the health effects of chronic low‐level As exposure and planning of proper mitigation strategies.
Mitochondrial dysfunction in endothelial cells induced by airborne fine particulate matter (<2.5 μm)
Authors: Miao Xiaoyan , Li Wenke , Niu Bingyu , Li Jiangshuai , Sun Jingjie , Qin Mengnan , Zhou Zhixiang 
Published: July 2019

AbstractExposure to ambient fine particulate matter (<2.5 μm; PM2.5) increases the risk of the physiopathology of vascular diseases. However, the underlying mechanism, particularly the mitochondrial damage mechanism, of PM2.5‐induced vascular dysfunction is still unclear. In this study, we examined PM2.5‐induced alterations of mitochondrial morphology, and further demonstrated the adverse effects on mitochondrial dynamics and function in vascular endothelial cells. Consequently, cultured EA.hy926 cells were subjected to PM2.5 collected from Beijing. A Cell Counting Assay Kit‐8 demonstrated that PM2.5 exposure decreased the proliferation of EA.hy926 cells in a dose‐dependent manner. The exposure caused an increment of abnormal mitochondria coupled with the decrease of fusion protein MFN2 and the increase of fission protein FIS1, suggesting that PM2.5 inhibits mitochondrial fusion. Further analyses revealed PM2.5 decreased the mitochondrial membrane potential (ΔΨm) and increased the mitochondrial permeability transport pore opening, eventually resulting in impairments in adenosine triphosphate synthesis. Therefore, it is clearly shown that PM2.5 triggered endothelial toxicity through mitochondria as the target, including the damage of mitochondrial homeostasis.
Denosumab Improves Glomerular Filtration Rate in Osteoporotic Patients With Normal Kidney Function by Lowering Serum Phosphorus
Authors: Miyaoka Daichi , Inaba Masaaki , Imanishi Yasuo , Hayashi Noriyuki , Ohara Masaya , Nagata Yuki , Kurajoh Masafumi , Yamada Shinsuke , Mori Katsuhito , Emoto Masanori 
Published: July 2019

ABSTRACT
Higher serum phosphorus (Pi) increases the risk for chronic kidney disease (CKD). It was reported that a single administration of denosumab or zoledronate significantly suppressed serum Pi levels as well as those of bone resorption markers in serum. Also, previous evidences suggest a link between bone anti-resorptive therapy and vasoprotective/renoprotective effects through mechanisms that remain unexplored. The aim of this study is to assess the renoprotective effect of denosumab and involvement of denosumab-induced reduction in serum Pi in osteoporotic patients. Osteoporotic patients (n = 73) without overt proteinuria in dipstick test results were treated with denosumab (60 mg) every 6 months during the study period (24 months). Estimated glomerular filtration rate based on serum cystatin C (eGFRcys) was used as a filtration marker and tartrate-resistant acid phosphatase-5b (TRACP-5b) as a bone resorption marker. For analysis of non-CKD patients (n = 56), those with eGFRcys &lt;60 mL/min/1.73 m2 were excluded. A single injection of denosumab suppressed serum Pi as well as TRACP-5b during the first 6 months, whereas age-related decline in eGFRcys was significantly reversed, with an increase of 2.75 ± 1.2 mL/min/1.73 m2 after 24 months noted. Multivariate analysis showed that serum Pi reduction following the initial denosumab injection was positively associated with serum TRACP-5b suppression during that same period (β = 0.241, p = 0.049). In addition, a positive association of serum Pi suppression, but not of corrected calcium or TRACP-5b, with eGFRcys increase after 24 months (β = 0.321, p = 0.014) was found after adjustments for gender, age, BMI, antihypertensive drug use, albumin, and eGFRcys. The same was observed in osteoporotic cases restricted to non-CKD patients. In conclusion, serum Pi reduction resulting from phosphorus load decrement from bone induced by denosumab is a determinant for eGFRcys increase. Early introduction of bone antiresorptive therapy can retain glomerular filtration in osteoporosis cases, including non-CKD patients. © 2019 American Society for Bone and Mineral Research.
Parathyroid hormone enhances the osteo/odontogenic differentiation of dental pulp stem cells via ERK and P38 MAPK pathways
Authors: Ge Xingyun , Li Zehan , Jing Shuanglin , Wang Yanqiu , Li Na , Lu Jiamin , Yu Jinhua 
Published: July 2019

AbstractObjectiveParathyroid hormone (PTH) is a main systemic mediator of calcium and phosphate homeostasis in the bone. Dental pulp stem cells (DPSCs) have been extensively studied in the regeneration of bone and tooth tissues. This paper aims to uncover the influences of PTH on the proliferative ability and osteo/odontogenic differentiation of DPSCs, as well as the underlying mechanisms.Materials and MethodsThe optimal concentration of PTH on DPSCs was determined by alkaline phosphatase (ALP) activity assay, ALP staining and western blot analysis. Proliferative ability and cell cycle distribution of DPSCs were analyzed by Cell counting kit‐8, 5‐ethynyl‐20‐deoxyuridine assay, and flow cytometry. Osteo/odontogenic capacity of DPSCs was evaluated and finally, the involvement of mitogen‐activated protein kinase (MAPK) pathway was assessed.ResultsPurified DPSCs were obtained by enzymatic digestion, which presented a typical fibroblast‐like morphology. 10−9 mol/L PTH was concerned as the optimal concentration for DPSCs induction. 10−9 mol/L PTH treatment did not change the proliferative rate of DPSCs (p > .05). Relative expressions of DSPP/DSPP, RUNX2/RUNX2, OSX/OSX, and ALP/ALP were upregulated in PTH‐treated DPSCs relative to control group. Particularly, their mRNA/protein levels at Day 7 were markedly higher relative to those at Day 3 (p < .05 or p < .01). Mineralized nodules were formed after PTH induction, and calcium content increased by cetylpyridinium chloride quantitative analysis. Mechanistically, the protein levels of p‐ERK and p‐P38 significantly increased after PTH treatment, and the inhibitors targeting MAPK were identified that weakened the effects of PTH on the committed differentiation of DPSCs.ConclusionsPTH enhances the osteo/odontogenic differentiation capacity of DPSCs via ERK and P38 signaling pathways.
Prolonged Pharmacokinetic Interaction Between Capecitabine and a CYP2C9 Substrate, Celecoxib
Authors: Ramírez Jacqueline , House Larry K. , Karrison Theodore G. , Janisch Linda A. , Turcich Michelle , Salgia Ravi , Ratain Mark J. , Sharma Manish R. 
Published: July 2019

AbstractThis study investigated the time course and magnitude of the pharmacokinetic interaction between capecitabine and the cytochrome P450 (CYP) 2C9 substrate celecoxib, with implications for coadministration of fluoropyrimidines with CYP2C9 substrates such as warfarin. Patients received celecoxib 200 mg orally twice daily continuously, with capecitabine (1000 mg/m2 orally twice daily for 14 days every 21 days) starting 7 days later. Assessment of the drug‐drug interaction (DDI) potential was performed using equivalence testing, which assumes that there is no clinically relevant DDI when the calculated 90% confidence intervals (CIs) of the drug exposure ratios fall within the range of 0.80 to 1.25. Comparison of steady‐state pharmacokinetic parameters of celecoxib between day 7 (cycle 0, celecoxib only) and day 14 (cycle 1, celecoxib + capecitabine) showed geometric mean ratios of 1.24 (90%CI, 1.04‐1.49), 1.30 (1.11‐1.53) and 1.28 (1.11‐1.47) for maximum plasma concentration, minimum plasma concentration, and area under the concentration‐time curve from time zero to 8 hours, respectively. Comparison of day 7 vs day 21 (cycle 1, after 1 week washout of capecitabine) showed a further increase in the geometric mean ratio of maximum plasma concentration (1.39; 90%CI, 1.16‐1.66), minimum plasma concentration (1.53; 1.10‐2.12) and area under the concentration‐time curve from time zero to 8 hours (1.41; 1.19‐1.68). Because the 90%CIs fell outside the prespecified equivalence margin, we conclude that coadministration results in a DDI (increased celecoxib exposure) that persists for at least 7 days after capecitabine discontinuation. Close monitoring should be undertaken when administering fluoropyrimidines with CYP2C9 substrates with narrow therapeutic indexes while also weighing the benefits and risks for individual patients.
Changes in knee extension peak torque and body composition and their relationship with change in gait speed
Authors: Osawa Yusuke , Chiles Shaffer Nancy , Shardell Michelle D. , Studenski Stephanie A. , Ferrucci Luigi 
Published: July 2019

AbstractBackgroundSlow gait speed is a powerful predictor of disability in activities of daily living and mortality. Muscle strength and body composition change over time, but their changes differ by sex. How these parameters jointly affect gait speed decline is unknown. Understanding this association could help develop and evaluate the sex‐specific effects of lifestyle interventions to delay gait speed decline in older adults. We assessed whether changes in strength (Δstrength), appendicular lean mass (ΔALM), and fat mass (Δfat) jointly relate to change in gait speed and whether the association differs by sex.MethodsThe analytic sample comprised 575 women and 539 men aged 22–95 years enrolled in the Baltimore Longitudinal Study of Aging. Mean follow‐up was 4.0 years. Measures included isometric knee extension strength, dual‐energy X‐ray absorptiometry‐assessed ALM and fat mass, and gait speed from the 400 m fast pace walk. Sex‐specific linear mixed models were adjusted for follow‐up time and baseline age, race, height, ALM, fat mass, peak torque, and gait speed. We also included second‐order interaction terms of the key predictive variables (e.g. Δstrength × ΔALM). To interpret the interactions, we estimated average gait declines using the 25th or 75th percentile of the two significant predictive variables and then assessed which condition relates to larger decline in gait speed.ResultsIn both sexes, independent of ΔALM and Δfat, larger decline in strength significantly related to larger decline in gait speed (P = 0.01 for both sexes). In men, interactions between Δstrength × ΔALM and Δfat by ΔALM were associated with change in gait speed; men with greater declines in both muscle strength and ALM or greater declines in both ALM and fat have steeper gait speed decline. In contrast, in women, the interaction between Δfat and ΔALM was associated with change in gait speed; women with an increase in fat mass combined with less decline in ALM have steeper gait speed decline.ConclusionsWhile change in strength affects change in gait speed in both sexes, the effects of body composition change differ by sex. Dual‐energy X‐ray absorptiometry‐based estimates of lean mass may be confounded by intramuscular fat. Future studies should examine sex‐specific combined effects of change in strength and body composition on mobility using multiple techniques to measure body composition. Intervention studies should consider testing sex‐specific interventions on body composition.
Deep semantic lung segmentation for tracking potential pulmonary perfusion biomarkers in chronic obstructive pulmonary disease (COPD): The multi‐ethnic study of atherosclerosis COPD study
Authors: Winther Hinrich B. , Gutberlet Marcel , Hundt Christian , Kaireit Till F. , Alsady Tawfik Moher , Schmidt Bertil , Wacker Frank , Sun Yanping , Dettmer Sabine , Maschke Sabine K. , Hinrichs Jan B. , Jambawalikar Sachin , Prince Martin R. , Barr R. Graham , Vogel‐Claussen Jens 
Published: July 2019

BackgroundChronic obstructive pulmonary disease (COPD) is associated with high morbidity and mortality. Identification of imaging biomarkers for phenotyping is necessary for future treatment and therapy monitoring. However, translation of visual analytic pipelines into clinics or their use in large‐scale studies is significantly slowed by time‐consuming postprocessing steps.PurposeTo implement an automated tool chain for regional quantification of pulmonary microvascular blood flow in order to reduce analysis time and user variability.Study TypeProspective.PopulationIn all, 90 MRI scans of 63 patients, of which 31 had a COPD with a mean Global Initiative for Chronic Obstructive Lung Disease status of 1.9 ± 0.64 (μ ± σ).Field Strength/Sequence1.5T dynamic gadolinium‐enhanced MRI measurement using 4D dynamic contrast material‐enhanced (DCE) time‐resolved angiography acquired in a single breath‐hold in inspiration. [Correction added on August 20, 2019, after first online publication: The field strength in the preceding sentence was corrected.]AssessmentWe built a 3D convolutional neural network for semantic segmentation using 29 manually segmented perfusion maps. All five lobes of the lung are denoted, including the middle lobe. Evaluation was performed on 61 independent cases from two sites of the Multi‐Ethnic Study of Arteriosclerosis (MESA)‐COPD study. We publish our implementation of a model‐free deconvolution filter according to Sourbron et al for 4D DCE MRI scans as open source.Statistical TestCross‐validation 29/61 (# training / # testing), intraclass correlation coefficient (ICC), Spearman ρ, Pearson r, Sørensen–Dice coefficient, and overlap.ResultsSegmentations and derived clinical parameters were processed in ~90 seconds per case on a Xeon E5‐2637v4 workstation with Tesla P40 GPUs. Clinical parameters and predicted segmentations exhibit high concordance with the ground truth regarding median perfusion for all lobes with an ICC of 0.99 and a Sørensen–Dice coefficient of 93.4 ± 2.8 (μ ± σ).Data ConclusionWe present a robust end‐to‐end pipeline that allows for the extraction of perfusion‐based biomarkers for all lung lobes in 4D DCE MRI scans by combining model‐free deconvolution with deep learning.Level of Evidence: 3Technical Efficacy: Stage 2J. Magn. Reson. Imaging 2020;51:571–579.
The hematite–goethite enhancement model of loess and an ‘irregular’ case from Paks, Hungary
Authors: Bradák B. , Seto Y. , Csonka D. , Végh T. , Szeberényi J. 
Published: July 2019

AbstractOn the basis of a key model of the appearance of hematite and goethite in some Chinese and European loess successions, paleosols generally contain higher proportions of hematite formed by pedogenic processes during warm and humid interglacials, while loess contains sedimentary goethite deposited during colder, glacial periods. Rock magnetic measurements were conducted on samples from Paks (Hungary) loess, revealing an anomalous case. Sediments were found to contain higher amounts of hematite and/or goethite, while the well‐developed paleosols were found to be lacking in hematite but had significant amounts of magnetite and maghemite. This observation demonstrates that the character of pedogenic magnetic mineral alteration and neoformation differs from the hematite/goethite model; the model is therefore not applicable to the Paks succession, possibly due to differences in the regional paleoclimate and pedogenic environment. The results indicate the existence of a further model, in which hematite formation is not significant in the course of pedogenesis.
Metabolic and transcriptional changes associated with the use ofAscophyllum nodosumextracts as tools to improve the quality of wine grapes (Vitis viniferacv. Sangiovese) and their tolerance to biotic stress
Authors: Frioni Tommaso , Tombesi Sergio , Quaglia Mara , Calderini Ornella , Moretti Chiaraluce , Poni Stefano , Gatti Matteo , Moncalvo Alessandro , Sabbatini Paolo , Berrìos Julian Garcìa , Palliotti Alberto 
Published: July 2019

ABSTRACTBACKGROUNDRecent studies report thatAscophyllum nodosumextracts, once applied on the canopy of different crops, deliver positive effects, increasing yield, inducing tolerance to biotic stress, and improving the quality of products. However, the mechanisms of action are still unclear. In this research, vines subjected to multiple foliar applications of anA. nodosumextract (ANE) at label doses were compared with untreated vines (NTV) in accordance with a comparative approach. The investigation coupled a field experiment with a second trial conducted under semi‐controlled conditions, to clarify the mechanisms of action involved.RESULTSThe biostimulant did not affect soluble solids or the acidity of grapes; instead, it improved their anthocyanin and phenolic concentrations and the respective profiles. At the time of harvest, anthocyanin, and phenolic concentration were increased by 10.4% and 14.5%, respectively, when compared to the NTV. These effects correlated with a specific modulation of genes involved in the flavonoid metabolic pathways. Moreover, grapes from ANE vines witnessed a significant reduction in the spreading of gray mold when they were either assessed in field conditions orin vitro, compared to the grapes of NTV vines. This was related to a significant upregulation of the defense‐related genes of the plant.CONCLUSIONSOverall, the results showed thatA. nodosumextracts can be valuable tools in viticulture considering the emergence of challenging environmental conditions; hence, the regulation of specific metabolic pathways is the mechanism of action that leads to an increased tolerance of biotic stress and of changes in the content of grape metabolites. © 2019 Society of Chemical Industry
Translocation of elements and sugars in wheat genotypes at vegetative and generative stages under continuous selenium exposure
Authors: Filek Maria , Sieprawska Apolonia , Telk Anna , Łabanowska Maria , Kurdziel Magdalena , Walas Stanisław , Hartikainen Helinä 
Published: July 2019

AbstractBACKGROUNDBiofortification with selenium (Se) elevates its concentration in feed and fodder plants and helps to prevent health problems in animals and humans. The aim of this study was to describe Se‐induced modifications in the accumulation of elements important for the proper functioning of wheat, one of the most popular cereals. The presence of Se correlated with carbohydrate synthesis and electron paramagnetic resonance (EPR). This explained the mechanisms of Se's antioxidant activity.RESULTSSelenium accumulation in vegetative and generative leaves, and in the grains of three wheat genotypes (cv. Parabola, cv. Raweta and cv. Manu), differing in their stress tolerance and grown hydroponically in the presence of 10 or 20 μM Na2SeO4,, was proportional to its content in the medium. Stronger Se accumulation was typical of a stress‐sensitive genotype. Selenium generally promoted the uptake of macronutrients and micronutrients but their distribution depended on tissue and genotype. Changes in the Se‐induced EPR signals of paramagnetic metals and organic radicals corresponded with stress tolerance of the tested genotypes.CONCLUSIONSSe application increased the accumulation of nutrients and carbohydrates that are vital for proper plant growth and development. Accelerated uptake of molybdenum (Mo), an element improving dietary properties of grains, may be an additional advantage of Se fertilization. The mechanisms of Se‐induced changes in removing Mn and iron (Fe) ions from macromolecules may be one of the factors that differentiate plant tolerance to oxidative stress. © 2019 Society of Chemical Industry