bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the first response unit on prehospital on-scene time among paramedic-suspected stroke patients: a retrospective before–after cohort study in Finland
Authors: Vaajanen Verna K.E. , Vuorinen Pauli E.T. , Setälä Piritta A. , Autio Reija , Hoppu Sanna E. 
Published: June 2023

Abstract
Background
Revascularization of an occluded artery by either thrombolysis or mechanical thrombectomy is a time-critical intervention in ischaemic stroke. Each link in the stroke chain of survival should minimize the delay to definitive treatment in every possible way. In this study, we investigated the effect of routine dispatch of a first response unit (FRU) on prehospital on-scene time (OST) on stroke missions.

Methods
Medical dispatch of FRU together with an emergency medical service (EMS) ambulance was a routine strategy in the Tampere University Hospital area before 3 October 2018, after which the FRU has only been dispatched to medical emergencies on the decision of an EMS field commander. This study presents a retrospective before–after analysis of 2,228 paramedic-suspected strokes transported by EMSs to Tampere University Hospital. We collected data from EMS medical records from April 2016 to March 2021, and used statistical tests and binary logistic regression to detect the associations between the variables and the shorter and longer half of OSTs.

Results
The median OST of stroke missions was 19 min, IQR [14–25] min. The OST decreased when the routine use of the FRU was discontinued (19 [14–26] min vs. 18 [13–24] min, p < 0.001). The median OST with the FRU being the first at the scene (n = 256, 11%) was shorter than in cases where the FRU arrived after the ambulance (16 [12–22] min vs. 19 [15–25] min, p < 0.001). The OST with a stroke dispatch code was shorter than with non-stroke dispatches (18 [13–23] min vs. 22 [15–30] min, p < 0.001). The OST for thrombectomy candidates was shorter than that for thrombolysis candidates (18 [13–23] min vs. 19 [14–25], p = 0.01). The shorter half of OSTs were associated with the FRU arriving first at the scene, stroke dispatch code, thrombectomy transportation and urban location.

Conclusion
The routine dispatch of the FRU to stroke missions did not decrease the OST unless the FRU was first to arrive at the scene. In addition, a correct stroke identification in the dispatch centre and thrombectomy candidate status decreased the OST.
Incidence and risk factors of warfarin therapy complications in community hospitals, central and eastern regions, Thailand: a retrospective, multicenter, cohort study
Authors: Sombat Benyapha , Tongkaew Sarisa , Nilwaranon Aticha , Mungthin Mathirut , Jongcherdchootrakul Kanlaya , Lertwanichwattana Teeraboon 
Published: June 2023

Abstract
Objectives
Warfarin, like many other anticoagulants, has been linked to an elevated risk of bleeding proportional to the amount of anticoagulation used. Not only was the incidence of bleeding raised by the dosage, but the subtherapeutic international normalized ratio (INR) was also associated with increased thrombotic events. This retrospective cohort and multi-center study evaluated the incidence and risk factors of warfarin therapy complications in community hospitals in Thailand’s central and eastern regions from 2016 to 2021.

Results
Among 335 patients (683.90 person-year of follow-up), The incidence rate of warfarin complications was 4.91 events per 100 person-year. The independent factor associated with warfarin therapy complications was propranolol prescription (Adjusted RR: 2.29, 95%CI: 1.12–4.71). The secondary analysis was divided according to the outcome of the major bleeding and thromboembolic event. Major bleeding events, hypertension (Adjusted RR: 0.40, 95%CI: 0.17–0.95), amiodarone prescription (Adjusted RR: 5.11, 95%CI: 1.08–24.15), and propranolol prescription (Adjusted RR: 2.86, 95%CI: 1.19–6.83) were the independent risk factors. While in the major thrombotic event, non-steroidal anti-inflammatory drugs (NSAIDs) prescription was an independent factor (Adjusted RR: 10.65, 95%CI: 1.26–90.35).
Association between polygenic risk for Alzheimer’s disease and brain structure in children and adults
Authors: He Xiao-Yu , Wu Bang-Sheng , Kuo Kevin , Zhang Wei , Ma Qing , Xiang Shi-Tong , Li Yu-Zhu , Wang Zi-yi , Dong Qiang , Feng Jian-Feng , Cheng Wei , Yu Jin-Tai 
Published: June 2023

Abstract
Background
The correlations between genetic risk for Alzheimer’s disease (AD) with comprehensive brain regions at a regional scale are still not well understood. We aim to explore whether these associations vary across different age stages.

Methods
This study used large existing genome-wide association datasets to calculate polygenic risk score (PRS) for AD in two populations from the UK Biobank (N ~ 23 000) and Adolescent Brain Cognitive Development Study (N ~ 4660) who had multimodal macrostructural and microstructural magnetic resonance imaging (MRI) metrics. We used linear mixed-effect models to assess the strength of the association between AD PRS and multiple MRI metrics of regional brain structures at different stages of life.

Results
Compared to those with lower PRSs, adolescents with higher PRSs had thinner cortex in the caudal anterior cingulate and supramarginal. In the middle-aged and elderly population, AD PRS had correlations with regional structure shrink primarily located in the cingulate, prefrontal cortex, hippocampus, thalamus, amygdala, and striatum, whereas the brain expansion was concentrated near the occipital lobe. Furthermore, both adults and adolescents with higher PRSs exhibited widespread white matter microstructural changes, indicated by decreased fractional anisotropy (FA) or increased mean diffusivity (MD).

Conclusions
In conclusion, our results suggest genetic loading for AD may influence brain structures in a highly dynamic manner, with dramatically different patterns at different ages. This age-specific change is consistent with the classical pattern of brain impairment observed in AD patients.
Frailty in randomised controlled trials for dementia or mild cognitive impairment measured via the frailty index: prevalence and prediction of serious adverse events and attrition
Authors: Wightman Heather , Quinn Terry J. , Mair Frances S. , Lewsey Jim , McAllister David A. , Hanlon Peter 
Published: June 2023

Abstract
Background
Frailty and dementia have a bidirectional relationship. However, frailty is rarely reported in clinical trials for dementia and mild cognitive impairment (MCI) which limits assessment of trial applicability. This study aimed to use a frailty index (FI)—a cumulative deficit model of frailty—to measure frailty using individual participant data (IPD) from clinical trials for MCI and dementia. Moreover, the study aimed to quantify the prevalence of frailty and its association with serious adverse events (SAEs) and trial attrition.

Methods
We analysed IPD from dementia (n = 1) and MCI (n = 2) trials. An FI comprising physical deficits was created for each trial using baseline IPD. Poisson and logistic regression were used to examine associations with SAEs and attrition, respectively. Estimates were pooled in random effects meta-analysis. Analyses were repeated using an FI incorporating cognitive as well as physical deficits, and results compared.

Results
Frailty could be estimated in all trial participants. The mean physical FI was 0.14 (SD 0.06) and 0.14 (SD 0.06) in the MCI trials and 0.24 (SD 0.08) in the dementia trial. Frailty prevalence (FI > 0.24) was 6.9%/7.6% in MCI trials and 48.6% in the dementia trial. After including cognitive deficits, the prevalence was similar in MCI (6.1% and 6.7%) but higher in dementia (75.4%). The 99th percentile of FI (0.31 and 0.30 in MCI, 0.44 in dementia) was lower than in most general population studies. Frailty was associated with SAEs: physical FI IRR = 1.60 [1.40, 1.82]; physical/cognitive FI IRR = 1.64 [1.42, 1.88]. In a meta-analysis of all three trials, the estimated association between frailty and trial attrition included the null (physical FI OR = 1.17 [0.92, 1.48]; physical/cognitive FI OR = 1.16 [0.92, 1.46]), although higher frailty index values were associated with attrition in the dementia trial.

Conclusion
Measuring frailty from baseline IPD in dementia and MCI trials is feasible. Those living with more severe frailty may be under-represented. Frailty is associated with SAEs. Including only physical deficits may underestimate frailty in dementia. Frailty can and should be measured in future and existing trials for dementia and MCI, and efforts should be made to facilitate inclusion of people living with frailty.
Comparative analysis of metaheuristic load balancing algorithms for efficient load balancing in cloud computing
Authors: Zhou Jincheng , Lilhore Umesh Kumar , M Poongodi , Hai Tao , Simaiya Sarita , Jawawi Dayang Norhayati Abang , Alsekait Deema Mohammed , Ahuja Sachin , Biamba Cresantus , Hamdi Mounir 
Published: June 2023

Abstract
Load balancing is a serious problem in cloud computing that makes it challenging to ensure the proper functioning of services contiguous to the Quality of Service, performance assessment, and compliance to the service contract as demanded from cloud service providers (CSP) to organizations. The primary objective of load balancing is to map workloads to use computing resources that significantly improve performance. Load balancing in cloud computing falls under the class of concerns defined as "NP-hard" issues due to vast solution space. Therefore it requires more time to predict the best possible solution. Few techniques can perhaps generate an ideal solution under a polynomial period to fix these issues. In previous research, Metaheuristic based strategies have been confirmed to accomplish accurate solutions under a decent period for those kinds of issues. This paper provides a comparative analysis of various metaheuristic load balancing algorithms for cloud computing based on performance factors i.e., Makespan time, degree of imbalance, response time, data center processing time, flow time, and resource utilization. The simulation results show the performance of various Meta-heuristic Load balancing methods, based on performance factors. The Particle swarm optimization method performs better in improving makespan, flow time, throughput time, response time, and degree of imbalance.
RNA-based amplicon sequencing is ineffective in measuring metabolic activity in environmental microbial communities
Authors: Wang Ya , Thompson Kelsey N. , Yan Yan , Short Meghan I. , Zhang Yancong , Franzosa Eric A. , Shen Jiaxian , Hartmann Erica M. , Huttenhower Curtis 
Published: June 2023

Abstract

Background
Characterization of microbial activity is essential to the understanding of the basic biology of microbial communities, as the function of a microbiome is defined by its biochemically active (“viable”) community members. Current sequence-based technologies can rarely differentiate microbial activity, due to their inability to distinguish live and dead sourced DNA. As a result, our understanding of microbial community structures and the potential mechanisms of transmission between humans and our surrounding environments remains incomplete. As a potential solution, 16S rRNA transcript-based amplicon sequencing (16S-RNA-seq) has been proposed as a reliable methodology to characterize the active components of a microbiome, but its efficacy has not been evaluated systematically. Here, we present our work to benchmark RNA-based amplicon sequencing for activity assessment in synthetic and environmentally sourced microbial communities.

Results
In synthetic mixtures of living and heat-killed Escherichia coli and Streptococcus sanguinis, 16S-RNA-seq successfully reconstructed the active compositions of the communities. However, in the realistic environmental samples, no significant compositional differences were observed in RNA (“actively transcribed — active”) vs. DNA (“whole” communities) spiked with E. coli controls, suggesting that this methodology is not appropriate for activity assessment in complex communities. The results were slightly different when validated in environmental samples of similar origins (i.e., from Boston subway systems), where samples were differentiated both by environment type as well as by library type, though compositional dissimilarities between DNA and RNA samples remained low (Bray–Curtis distance median: 0.34–0.49). To improve the interpretation of 16S-RNA-seq results, we compared our results with previous studies and found that 16S-RNA-seq suggests taxon-wise viability trends (i.e., specific taxa are universally more or less likely to be viable compared to others) in samples of similar origins.

Conclusions
This study provides a comprehensive evaluation of 16S-RNA-seq for viability assessment in synthetic and complex microbial communities. The results found that while 16S-RNA-seq was able to semi-quantify microbial viability in relatively simple communities, it only suggests a taxon-dependent “relative” viability in realistic communities.
ABCA1 transporter promotes the motility of human melanoma cells by modulating their plasma membrane organization
Authors: Wu Ambroise , Mazurkiewicz Ewa , Donizy Piotr , Kotowski Krzysztof , Pieniazek Małgorzata , Mazur Antonina J. , Czogalla Aleksander , Trombik Tomasz 
Published: June 2023

Abstract
Background
Melanoma is one of the most aggressive and deadliest skin tumor. Cholesterol content in melanoma cells is elevated, and a portion of it accumulates into lipid rafts. Therefore, the plasma membrane cholesterol and its lateral organization might be directly linked with tumor development. ATP Binding Cassette A1 (ABCA1) transporter modulates physico-chemical properties of the plasma membrane by modifying cholesterol distribution. Several studies linked the activity of the transporter with a different outcome of tumor progression depending on which type. However, no direct link between human melanoma progression and ABCA1 activity has been reported yet.

Methods
An immunohistochemical study on the ABCA1 level in 110 patients-derived melanoma tumors was performed to investigate the potential association of the transporter with melanoma stage of progression and prognosis. Furthermore, proliferation, migration and invasion assays, extracellular-matrix degradation assay, immunochemistry on proteins involved in migration processes and a combination of biophysical microscopy analysis of the plasma membrane organization of Hs294T human melanoma wild type, control (scrambled), ABCA1 Knockout (ABCA1 KO) and ABCA1 chemically inactivated cells were used to study the impact of ABCA1 activity on human melanoma metastasis processes.

Results
The immunohistochemical analysis of clinical samples showed that high level of ABCA1 transporter in human melanoma is associated with a poor prognosis. Depletion or inhibition of ABCA1 impacts invasion capacities of aggressive melanoma cells. Loss of ABCA1 activity partially prevented cellular motility by affecting active focal adhesions formation via blocking clustering of phosphorylated focal adhesion kinases and active integrin β3. Moreover, ABCA1 activity regulated the lateral organization of the plasma membrane in melanoma cells. Disrupting this organization, by increasing the content of cholesterol, also blocked active focal adhesion formation.

Conclusion
Human melanoma cells reorganize their plasma membrane cholesterol content and organization via ABCA1 activity to promote motility processes and aggressiveness potential. Therefore, ABCA1 may contribute to tumor progression and poor prognosis, suggesting ABCA1 to be a potential metastatic marker in melanoma.
Blinatumomab Conundrum in Low-Risk Relapsed B-Cell ALL
Authors: Maese Luke D. , Pulsipher Michael A. 
Published: June 2023

The Oncology Grand Rounds series is designed to place original reports published in the Journal into clinical context. A case presentation is followed by a description of diagnostic and management challenges, a review of the relevant literature, and a summary of the authors’ suggested management approaches. The goal of this series is to help readers better understand how to apply the results of key studies, including those published in Journal of Clinical Oncology , to patients seen in their own clinical practice. BACKGROUND The Children's Oncology Group (COG) AALL1331 trial demonstrated improved survival and less toxicity in children with high-/intermediate-risk relapsed ALL receiving blinatumomab compared with intensive chemotherapy before hematopoietic stem-cell transplant (HSCT). The low-risk arm of AALL1331 compared addition of three cycles of blinatumomab to chemotherapy alone, but a survival improvement was not noted. Secondary analyses showed improvement in disease-free survival (DFS) and overall survival (OS) of low-risk patients with bone marrow disease ± extramedullary (EM) involvement (4-year DFS 72.7% ± 5.8% v 53.7% ± 6.7%; 4-year OS 97.1% ± 2.1% v 84.8% ± 4.8%), but failed to show an advantage with blinatumomab for patients with isolated EM relapse. Of note, DFS of isolated CNS (iCNS) relapse was worse than previous studies at 24% on both arms, likely because of decreases in CNS-intensive therapy compared with previous approaches and inadequacy of blinatumomab for controlling CNS disease. CASE Our case of late isolated CNS B-cell ALL relapse outlines challenges for clinicians attempting to decrease toxicity and avoid HSCT: (1) defining of low risk appropriately, (2) attempting to reduce the treatment burden of past protocols, and (3) understanding approach and timing of cranial irradiation. APPROACH Although AALL1331 therapy without blinatumomab leads to excellent survival in patients with isolated testicular relapse, we recommend a modified AALL02P2 backbone of chemotherapy with 1,800 cGy cranial radiotherapy for patients with late iCNS relapse. Future studies integrating chimeric antigen receptor T cells, which have better CNS penetration, may help decrease the intensive treatment burden for patients with late iCNS recurrence.
Tracing the Bunny
Authors: Guo Shaohua 
Published: June 2023

Abstract
Since the 2010s, “we, the rabbit” has gained currency as an internet slang term referring to China, Chinese ethnicity, and the Chinese Communist Party. The recent popularity of the rabbit as a metonym for the nation is boosted by the varied multimedia forms of bunny characters appearing in historical narratives, web comics, games, and most important, the patriotic animated series Year Hare Affair. Juxtaposing commercial ambitions with a nationalist agenda, Year Hare Affair narrates historical events by personifying countries as anthropomorphic animals. Taking the viral rise of Year Hare Affair as a case study, this article delineates a genealogy of the bunny characters in Chinese popular culture. The transmedia forms of bunny characters, including those appearing in texts, comics, animated programs, and games, provide room for the construction of unstable meanings revolving around the bunny. Consequently, while such animated series align with official narratives of history, they also tone down the weight of those narratives by employing a variety of narrative devices, including parody, game-related motifs, and space-time manipulation. Through these diverse representations, the political message is sometimes enhanced and sometimes playfully challenged. Read in this light, the bunny's evolving trajectory in contemporary popular culture speaks volumes about the dynamics between digital aesthetics and politics, as well as the multiplicity of discourses generated as they meet.
Innovation in entrepreneurship during the time of COVID-19: a scoping review of the scientific evidence from Peru
Authors: Fernández-Bedoya Víctor Hugo , Meneses-La-Riva Monica Elisa , Suyo-Vega Josefina Amanda , Grijalva-Salazar Rosario Violeta , Gago-Chávez Johanna de Jesús Stephanie , Ocupa-Cabrera Hitler Giovanni , Alvarado-Suyo Sofía Almendra , Ocupa-Meneses Giovanni Di Deus 
Published: June 2023

Background: Entrepreneurship involves the actions of designing, launching and managing a business that initially starts small and grows along with the human structure that integrates it. The health crisis caused by coronavirus disease 2019 (COVID-19) had negative effects on health, but also on business; many ventures had to innovate in order to survive in this uncertain environment. Peru is a country located in Latin America, recognized for its high levels of entrepreneurial self-efficacy, so this scooping review sought to identify the experiences of innovation in entrepreneurship in times of COVID-19 in that country. Methods: We explored the Scopus and Scielo databases for records detailing innovation in entrepreneurship in both English and Spanish. Inclusion and exclusion criteria were: published between March 11, 2020, to May 5, 2023; English, Spanish, and Portuguese language; original articles that present both quantitative and qualitative results; within Peru; articles with an assigned issue and volume number. The search results identified 5 Peruvian experiences that met the research objectives. Results: The records identified deal with innovations in social entrepreneurship, women's entrepreneurship, entrepreneurship in the educational sector, and new business tools applied during the COVID-19 pandemic. The sources where these records were disclosed were South American journals (3 cases) and conference proceedings (2 cases). The language of the articles was recorded, identifying that most of them are written in Spanish (official language of Peru). Conclusions: We recommend the regional scientific community to disseminate the results of their research in scientific journals indexed in high-level databases in order to have greater visibility.
The high-speed revolution: a practical guide to friction grip burs
Authors: Bonsor Stephen J , Mackenzie Louis 
Published: June 2023

The practice of restorative dentistry frequently involves the preparation of the dental hard tissues and the use of restorative materials. Efficient armamentaria are required to facilitate this process with the friction grip bur used at high speed being the most commonly used operative instrument in contemporary clinical dentistry. This article describes the various friction grip burs that are available to the restorative dentist offering a practical guide as to their selection and usage. Furthermore, techniques are described to optimise outcomes while minimizing iatrogenic damage when working clinically. CPD/Clinical Relevance: Knowledge of different friction grip burs used in contemporary restorative dentistry should facilitate their optimum usage and minimize complications.
Iatrogenic perforation management using calcium silicate cement: a case report
Authors: Chopra Viresh 
Published: June 2023

The world today is literate enough about the basics of oral health conditions and available treatment options. Due to the availability of many resources on different platforms the urge to retain natural teeth rather than have extractions has increased. Dental catastrophes are sometimes unavoidable in everyday dental practice. The prime motive should be patient benefit while the general dental practitioner (GDP) identifies the risks associated with the case, availability of equipment and enhanced operator skill when deciding to the referral of the patient to a specialist. Most failed root canal treatment cases have one or more associated endodontic errors. This case report presents stepwise management of such a case of iatrogenic perforation that occurred during the initial endodontic management. It emphasizes the significance of evidence-based treatment planning, role of magnification, selection of the appropriate armamentarium for performing root canal treatment, use of bioactive materials that collectively demonstrate peri-apical healing following the repair of endodontic mishaps. It also emphasizes on the importance of recall in such cases where adequate healing can be tracked over a period. CPD/Clinical Relevance: Knowledge of management of iatrogenic perforations is useful information for clinicians.