bluuebunny/crossref_metadata_2025_split huggingface dataset:
Gut Microbiota and Metabolite Changes in Patients With Ulcerative Colitis and Clostridioides difficile Infection
Authors: Wan Jian , Zhang Yujie , He Wenfang , Tian Zuhong , Lin Junchao , Liu Zhenzhen , Li Yani , Chen Min , Han Shuang , Liang Jie , Shi Yongquan , Wang Xuan , Zhou Lei , Cao Ying , Liu Jiayun , Wu Kaichun 
Published: May 2022

BackgroundPatients with ulcerative colitis (UC) are at an increased risk of developing Clostridioides difficile infection (CDI), which in turn leads to poor outcomes. The gut microbial structure and metabolites in patients with UC and CDI have been scarcely studied. We hypothesized that CDI changes the gut microbiota and metabolites of patients with UC.Materials and MethodsThis study included 89 patients: 30 healthy controls (HC group), 29 with UC alone (UCN group), and 30 with UC and CDI (UCP group). None of the participants has been exposed to antibiotic treatments during the 3 months before stool collection. Stool samples were analyzed using 16S rRNA gene sequencing of the V3–V4 region and gas chromatography tandem time-of-flight mass spectrometry.ResultsThe UCN group displayed lower diversity and richness in gut microbiota and a higher relative abundance of the phylum Proteobacteria than the HC group. There were no significant differences between the UCN and UCP groups in the α-diversity indices. The UCP group contained a higher relative abundance of the genera Clostridium sensu stricto, Clostridium XI, Aggregatibacter, and Haemophilus, and a lower relative abundance of genera Clostridium XIVb and Citrobacter than the UCN group. In the UCP group, the increased metabolites included putrescine, maltose, 4-hydroxybenzoic acid, 4-hydroxybutyrate, and aminomalonic acid. Spearman’s correlation analysis revealed that these increased metabolites negatively correlated with Clostridium XlVb and positively correlated with the four enriched genera. However, the correlations between hemoglobin and metabolites were contrary to the correlations between erythrocyte sedimentation rate and high-sensitivity C-reactive protein and metabolites.ConclusionOur study identified 11 differential genera and 16 perturbed metabolites in patients with UC and CDI compared to those with UC alone. These findings may guide the design of research on potential mechanisms and specific treatments for CDI in patients with UC.
Sustainability of Diets in Mexico: Diet Quality, Environmental Footprint, Diet Cost, and Sociodemographic Factors
Authors: Curi-Quinto Katherine , Unar-Munguía Mishel , Rodríguez-Ramírez Sonia , Rivera Juan A. , Fanzo Jessica , Willett Walter , Röös Elin 
Published: May 2022

BackgroundLittle is known about the current intake of sustainable diets globally and specifically in middle-income countries, considering nutritional, environmental and economic factors.ObjectiveTo assess and characterize the sustainability of Mexican diets and their association with sociodemographic factors.DesignDietary data of 2,438 adults within the National Health and Nutrition Survey 2012 by integrating diet quality measured by the Healthy Eating Index (HEI-2015), diet cost, and four environmental indicators were analyzed: land use (LU), biodiversity loss (BDL), carbon footprint (CFP), and blue water footprint (BWFP). We defined healthier more sustainable diets (MSD) as those with HEI-2015 above the overall median, and diet cost and environmental indicators below the median. Logistic regression was used to evaluate the association of sociodemographic factors with MSD.ResultsMSD were consumed by 10.2% of adults (4% of urban and 22% of rural), who had lower intake of animal-source foods, unhealthy foods (refined grains, added sugar and fats, mixed processed dishes and sweetened beverages), fruits, and vegetables, and higher intake of whole grains than non-MSD subjects. Characteristics of MSD vs. non-MSD (urban; rural) were: HEI-2015 (62.6 vs. 51.9; 66.8 vs. 57.6), diet-cost (1.9 vs. 2.8; 1.9 vs. 2.5 USD), LU (3.3 vs. 6.6; 3.2 vs. 5.9 m2), BDL (105 vs. 780; 87 vs. 586 species × 10−10), BWFP (244 vs. 403; 244 vs. 391 L), and CFP (1.6 vs. 4.4; 1.6 vs. 3.7 kg CO2eq). Adults from rural vs. urban (OR 2.7; 95% CI: 1.7, 4.1), or from the South (OR 2.1; 95% CI: 1.1, 3.9), Center (OR 2.3; 95% CI: 1.3, 4.4) vs. the North were more likely to consume MSD, while adults with high vs. low socioeconomic status were less likely (OR 0.17; 95% CI: 0.09, 0.3).ConclusionsThe MSD is a realistic diet pattern mainly found in disadvantaged populations, but diet quality is still sub-optimal. Increased consumption of legumes, fruits, and vegetables, and a reduction in unhealthy foods, is required to improve nutritional quality of diets while ensuring their environmental sustainability.
Survival Is Worse in Patients Completing Immunotherapy Prior to SBRT/SRS Compared to Those Receiving It Concurrently or After
Authors: Woody Susan , Hegde Aparna , Arastu Hyder , Peach M. Sean , Sharma Nitika , Walker Paul , Ju Andrew W. 
Published: May 2022

Purpose/ObjectivesThe abscopal effect could theoretically be potentiated when combined with immunomodulating drugs through increased antigen production. The optimal dosing and schedule of radiotherapy with immunotherapy are unknown, although they are actively investigated in laboratory and clinical models. Clinical data in patients treated for metastatic disease with both modalities may guide future studies.Materials and MethodsThis is a single-institution retrospective review of all patients treated with stereotactic body radiotherapy (SBRT)/stereotactic radiosurgery (SRS) and immunomodulating therapy within 6 months before or after SBRT/SRS for metastatic cancer. Clinical and tumor characteristics were recorded, as well as SBRT/SRS details, immunotherapy details, and survival. Log-rank tests on Kaplan–Meier curves for overall survival (OS) that were calculated from the end of SBRT/SRS were used in univariate analysis and Cox proportional hazards regression for multivariate analysis.ResultsA total of 125 patients were identified who met the inclusion criteria; 70 received SBRT, and 57 received SRS. Eighty-three patients were treated for non-small cell lung cancer, 7 patients for small cell lung cancer, and 35 patients for other cancers, with the most common one being melanoma. Fifty-three percent of patients received nivolumab, 29% pembrolizumab, 13% atezolizumab, 5% other. Twenty percent received immunotherapy before SBRT/SRS, 39% during SBRT/SRS, 41% after. Eighty-six patients had died by the time of the analysis; the median OS for the whole cohort was 9.7 months. Patients who had completed immunotherapy prior to SBRT/SRS had worse OS than those who received concurrent therapy or immunotherapy after SBRT/SRS, with a difference in median OS of 3.6 months vs. 13.0 months (p = 0.010) that was retained on multivariate analysis (p = 0.011). There was no significant difference in OS between patients receiving SRS vs. SBRT (p = 0.20), sex (p = 0.53), age &gt;62 years (p = 0.76), or lung primary vs. others (p = 0.73) on univariate or multivariate analysis. When comparing before/concurrent to after/concurrent administration, there is a difference in survival with after/concurrent survival of 8.181 months and before survival of 13.010 months, but this was not significant (p = 0.25).ConclusionsOS appears to be worse in patients who complete immunotherapy prior to SBRT/SRS compared to those receiving it concurrently or after. The design of this retrospective review may be prone to lead time bias, although the difference in median survival is longer than the 6-month window before SBRT/SRS and could only account for part of this difference. Further analysis into causes of death and toxicity and prospective studies are needed to confirm the results of this analysis.
“Elastic Stretch Cavity Building” System in Endoscopic Thyroidectomy of Giant Thyroid Tumors
Authors: Chen Gaoxiang , Zhang Hai , Li Cheng , Wen Limu , Zhang Jianan , Wu Minhua , Teng Weifeng , Ji Xiaochun , Luo Yong , Wu Weizhu 
Published: May 2022

ObjectiveTo analyze the clinical characteristics of patients with large thyroid tumors underwent endoscopic thyroidectomy using the “elastic stretch cavity builder” system.MethodsThis retrospective case series study included thyroid tumor patients admitted to the Ningbo Medical Center Li Hui li Hospital between September 2017 and November 2021. The self-developed “elastic stretch cavity builder” was used to elastically lift the anterior cervical flap, combined with low-pressure (3 mmHg) high-flow CO2 inflation, and create a working cavity for endoscopic thyroidectomy.ResultsThis study included 13 patients for analysis. The endoscopic thyroidectomy duration was 92-170 min (mean, 123 ± 24min). The maximum transverse plane diameter of the glands was 5.0-6.2 cm (mean, 5.3 ± 0.3 cm). The maximum sagittal plane diameter was 6.8-10.0 cm (mean, 7.6 ± 0.9 cm). After the “elastic stretch cavity builder” lifted the cervical flap, the height of the subcutaneous region was increased by 1.3 ± 0.2cm without affecting cervical activity. There was no residual scar in the anterior cervical skin puncture hole. All patients were satisfied with the cosmetic with the cosmetic satisfaction score was 3.4 ± 0.5.ConclusionThe novel mixed cavity building model established by the “elastic stretch cavity builder” might provide the surgeon with additional longitudinal cervical operating space while improving the stability of the space and saving human effort.
Concordance of MRI-Guided Fusion and Systematic 12-Core Prostate Biopsy for the Detection of Prostate Cancer
Authors: Parsons Matthew , Sandhu Zoya , Foy Bridget , Chan Ernest , Crawford Bryan , Petersen Libby , Romney Benjamin , Sommers Daniel , Bishoff Jay , Lynch Steven , Mclean Logan , Gill David 
Published: May 2022

BackgroundMRI-guided fusion biopsy is increasingly utilized over systematic 12-core biopsy for men with MRI-visible prostate lesions.Patients and MethodsPatients with MRI visible lesions who underwent MRI-guided fusion and systematic 12-core biopsy from 2016-2020 in the Intermountain Healthcare (IHC) system were consecutively analyzed. This was in the setting of a continuous quality assurance initiative among the reading radiologists. Primary outcome was prostate cancer (PCa) detection defined by Gleason grade group (GGG) 1 or higher. Clinically significant cancer (CSC) was defined as GGG 2 or higher. Patients were stratified by biopsy date, 2016-2017 and 2018-2021, and lesions were stratified by PI-RADS v2 category.ResultsA total of 184 patients with 324 MRI-detectable lesions underwent both biopsy modalities in the IHC system from 2016 to 2021. CSC was detected in 23.5% of MRI-guided fusion biopsies. Comparing PI-RAD v2 categories 1-3 to categories 4-5, rate of CSC was 10% and 42% respectively. MRI-guided fusion and systematic 12-core biopsies were concordant for PCa in 77% of men and CSC in 83%. MRI-guided fusion biopsy detected PCa in 26/103 and CSC in 20/131 men in whom systematic 12-core biopsy was negative. Systematic 12-core biopsy detected PCa in 17/94 and CSC in 11/122 men in whom MRI-guided fusion was negative.ConclusionsOmitting MRI-guided fusion or systematic 12-core biopsy would have resulted in underdiagnosis of CSC in 11% or 6% of patients respectively. Combining biopsies increased detection rate of CSC. This was in the setting of a continuous quality assurance program at a large community-based hospital.
Individuals' Awareness of and Willingness to Accept Hospital-at-Home Services and Related Factors: A Cross-Sectional Study
Authors: Xu Siyu , Wang Jingjun , Wang Ya , Wang Mengmeng , Huang Xia , Huang Hao 
Published: May 2022

IntroductionHospital-at-home (HaH) services have become increasingly popular. However, the experience of HaH implementation in Asia is inadequate. Therefore, the purpose of this study was to investigate individuals' willingness to accept HaH services and the potential related factors.MethodsThe researchers visited households to select appropriate participants. An online questionnaire survey was conducted among the inhabitants of selected communities. An individual's awareness, willingness to accept HaH services, and demands such as ideal service providers and more detailed information to accept HaH care were investigated. The outcome measure was the willingness to accept HaH services. Chi-square tests and logistic regression models were used to analyze the factors.ResultsA total of 622 subjects participated in this study. The findings indicate that 55.9% of the participants were not aware of HaH services, while most of the subjects (88.4%) were willing to accept them. Regression models indicated that having health insurance (OR = 2.170, 95% CI: 1.003–4.697), an awareness of the necessity of HaH services (OR = 4.721, 95% CI: 2.471–9.019), very much hoping staff from central hospitals would be service providers (OR = 20.299, 95% CI: 5.718–72.068), and somewhat hoping that staff from central hospitals would be service providers (OR = 9.139, 95% CI: 2.714–30.775) were the factors associated with a greater willingness to accept HaH services.ConclusionThe study indicates that compared to the awareness of HaH care, residents had a greater willingness to accept such care. The willingness to utilize HaH services among individuals was associated with enabling factors, predisposing factors, and HaH-related demand factors.
Comparative Transcriptomics of Gonads Reveals the Molecular Mechanisms Underlying Gonadal Development in Giant Freshwater Prawns (Macrobrachium rosenbergii)
Authors: Yang Guang , Qin Zhendong , Lu Zhijie , Liang Rishen , Zhao Lijuan , Pan Gan , Lin Li , Zhang Kai 
Published: May 2022

The giant freshwater prawn, Macrobrachium rosenbergii, is a prawn that has economic significance throughout the world. It exhibits sex-related growth dimorphism, whereby the males grow significantly more rapidly than the females. Therefore, a study on the molecular regulatory mechanism, which underlies the sexual differentiation of M. rosenbergii, is of both scientific and commercial importance. However, a scarcity of genomic and transcriptomic resources severely limits our knowledge of the sexual differentiation mechanisms in M. rosenbergii. Here, transcriptome sequencing of several gonadic samples of males and females in M. rosenbergii was performed to investigate the molecular basis underlying gonadal development. Our results showed that 2149 unigenes presented as differentially expressed genes (DEGs) in the ovaries of females compared to the testes of males, which contained 484 down-regulated and 1665 up-regulated genes. Enrichment analysis of DEGs revealed many of these genes to be related to sexual differentiation and gonadal development. From our transcriptome analyses, and as confirmed by quantitative real-time PCR, male-related genes (Mrr, MRPINK, IR, IAGBP, TESK1, and dsx) in the testes were significantly up-regulated, and female-related genes (ERR, Sxl3, cyclinB, Dmrt99B, PPP2A, and ADCY9) in the ovaries were also significantly up-regulated. This indicates the potential role these genes play in the gonadal development of M. rosenbergii. Furthermore, multiple signal transduction pathways relating to gonadal maturation and spermatogenesis, including MAPK, were identified herein. Our data also supports previous ideas that IAG and IAGBP-IR signaling schemes could help in the regulation of testis’ development in M. rosenbergii and the ERR gene could regulate ovarian development by affecting the expression of cyclinB, PPP2A, and ADCY9. The data from this study provides incredibly usefully genomic resources for future research on the sexual differentiation and practical aquaculture of M. rosenbergii.
Two Dimensional and Stereo PIV Comparison for Port Applications
Authors: YELKEN Burak , SAVCİ İsmail Hakki , DÜLGER Zafer 
Published: May 2022

Fuel-air movements in-cylinder are one of the most critical diesel engine parameters to determine engine performance and emission. Swirling movement in the engine combustion chamber is investigated advanced experimental techniques to improve the air intake design.
Honeycomb measurement method and PIV (particle image velocimetry) method are used to measure the swirling airflow. The honeycomb measurement method can directly measure the swirl. However, it does not give detail information about the flow field. On the other hand, the PIV technique is one of the non-invasive measurement methods for swirl measurement. PIV can directly measure the velocity vector of the cylinder section.
In this study, the honeycomb measurement method was performed to measure the swirl ratio of 13L and 9L engines. The uncertainty analysis was determined for the reliability ratio of the measurement. In addition, PIV measurements are performed to understand the velocity field of the cylinder section. This velocity field gives detailed information about the center of the swirl and the velocity index of the velocity field.
Promotion of destinations through interactive digital marketing: collaborative model for smart cities
Authors: Cunha Carlos R. , Mendonça Vítor , Martins Márcio , Carneiro Manuela 
Published: May 2022

Smart cities are, by nature, spaces with a richness and diversity of technologies incorporated in their physical spaces, in such a way that they can be seen as a single intelligent and collaborative space. As technological pillars, two important layers arise – the sensory layer and the actuator layer, both of which are strongly interconnected with each other, emerging as a large Internet of Things network. This scenario reveals an enormous potential for marketing science and for the creation of innovative strategies to promote territories as touristic destinations. Within the multiple opportunities, there is space for the development of an interactive marketing experience, revolutionizing, through creative rethink, the way destinations interact with their visitors, and make known all their potential. Although in the context of tourism, there are three main moments in the visit process – the before, the during and the after, this work focuses on the moment of the destination visit – the during.
In order to understand how creative rethink can be carried out to create innovative strategies to promote touristic destinations, an introduction is carried out, substantiating the concepts of digital marketing, smart cities and Internet of Things.
Then, the methodology that governed the creation of a collaborative model for smart cities is clearly defined, being contextualized the importance of destinations-communication, the concept of a smart city and some of the major technology that support this concept.
After contextualization and methodological aspects, this article presents a conceptual model where its components are described and where it is discussed how the model can take advantage of the variety of technologies that exist in a smart city, in order to allow innovative digital marketing strategies and innovating in the interaction between the city and the visitant, and vice versa – the vision of interactive digital marketing. In the model discussion, some interaction-scenarios and their main benefits are highlighted, which serve as examples for validating the proposed model. Finally, we present the work limitations and mains conclusions.
The Future of Brand Awareness and Brand Loyalty on Travel Agencies
Authors: Santos Sara , Monteiro Joana , Espírito Santo Pedro , Augusto Luísa , Oliveira Adriana 
Published: May 2022

Tourism has emerged as one of the great activities of the 21st century; however, due to globalization and the development of the Internet, travel agencies see some of their business principles being changed by new technologies. Furthermore, the impacts of the pandemic crisis (SARS-COV2) have been highly negative.
In the field of tourism, travel agencies have been one of the parts that have undergone the most changes. Countless people have gone to a travel agency to book their trips in the past decade. However, this process is not always carried out in the same way. With the appearance and constant development of new technologies, the first online travel agencies emerged. In addition, the consumer becomes increasingly independent in their travel purchases, and the travel agent's work is limited.
Online travel agencies advertise more, offering more attractive prices and other conditions that attract customers to buy their trips without going to a travel agency in a physical space. The relationship between agency and tourist is essentially online.
Thus, it is essential to analyze the role of travel agents who have their physical spaces open and intend to increase their business by strengthening customer relationships. It is necessary to focus on consumer trust and loyalty while creating and establishing brand or company value.
Thus, the results obtained in this study, through a self-administered questionnaire, from a sample of 512 observations, demonstrate that the perceived quality of the relationship influences the brand's awareness and customer loyalty: consumer satisfaction and trust. In this context, this study highlights the importance of the human relationship in selling tourist products and the tourist's previous experience in loyalty to the travel agency.
Debt of Hotel Companies: The Impact of Company Characteristics and Crisis Periods
Authors: Alves Jorge 
Published: May 2022

This paper studies the financial determinants of debt of Portuguese hotel companies using the main indicators suggested by the Trade-Off and the Pecking Order theories. The main objective of this study was to analyse the determinants that most contribute to the debt of Portuguese companies in the hotel industry. The study also aimed to understand the impact of crisis periods on the debt. Since data collected refers to the period between 2005 and 2020 it also analyses the impact of the 2008 financial crisis and, more recently, the global pandemic COVID-19. The results show that debt is negatively associated with profitability and age, and is positively associated with size, growth opportunities and tangibility. These results are in line with the Pecking Order theory, ranking the choice of financing methods. We can also conclude that the way hotels finance their assets will affect their level of debt. We also evidence that debt of Portuguese hotels companies increases in periods of crisis.
Keywords: Debt; Hotels companies; Crisis; Capital Structure
Tourism and Big Data in a post-COVID-19 world: the utopian and dystopian rhetoric
Authors: Vaz Maria João , Machado Helena 
Published: May 2022

The tourism sector has been significantly impacted by the COVID-19 pandemic, making it one of the most affected economic areas worldwide. Simultaneously, the pandemic created contexts for the expansion and consolidation of trends already experienced in the recent past, namely the increasing adaptation of tourism to the digital society. One prominent example is the use of techniques known as “Big Data”, which carry out a massive mining of data from different sources, in order to define “profiles” of tourist consumption. This paper aims to map the social and ethical controversies associated with the use of Big Data by addressing the “technological optimism” that tends to surround the use of these techniques in the tourism sector.
Through a review of literature about Big Data in tourism, we conclude that the rhetoric surrounding the use of Big Data techniques is both utopian and dystopian. On the one hand, according to literature in disciplinary areas related to the development of technology, Big Data is considered an indispensable tool for improving competitiveness in the tourism sector and for helping to understand the tourist more effectively. On the other hand, however, social sciences tend to frame Big Data as an astute representation of Big Brother, challenging the protection of personal privacy in tourism consumption and highlighting the lack of awareness and legal regulations, as well as the possibility of decontextualisation and false correlations that may jeopardize the touristic experience. For this reason, it has become urgent to develop a critical reflection on the ethical challenges posed by the uses of Big Data in tourism and consider routes of an anticipatory governance of these technologies.