bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smart triage: Development of a rapid pediatric triage algorithm for use in low-and-middle income countries
Authors: Mawji Alishah , Li Edmond , Dunsmuir Dustin , Komugisha Clare , Novakowski Stefanie K. , Wiens Matthew O. , Vesuvius Tagoola Abner , Kissoon Niranjan , Ansermino J. Mark 
Published: November 2022

IntroductionEarly and accurate recognition of children at risk of progressing to critical illness could contribute to improved patient outcomes and resource allocation. In resource limited settings digital triage tools can support decision making and improve healthcare delivery. We developed a model for rapid identification of critically ill children at triage.MethodsThis was a prospective cohort study of acutely ill children presenting at Jinja Regional Referral Hospital in Eastern Uganda. Variables collected in the emergency department informed the development of a logistic model based on hospital admission using bootstrap stepwise regression. Low and high-risk thresholds for 90% minimum sensitivity and specificity, respectively generated three risk level categories. Performance was assessed using receiver operating characteristic curve analysis on a held-out test set generated by an 80:20 split with 10-fold cross validation. A risk stratification table informed clinical interpretation.ResultsThe model derivation cohort included 1,612 participants, with an admission rate of approximately 23%. The majority of admitted patients were under five years old and presenting with sepsis, malaria, or pneumonia. A 9-predictor triage model was derived: logit (p) = −32.888 + (0.252, square root of age) + (0.016, heart rate) + (0.819, temperature) + (−0.022, mid-upper arm circumference) + (0.048 transformed oxygen saturation) + (1.793, parent concern) + (1.012, difficulty breathing) + (1.814, oedema) + (1.506, pallor). The model afforded good discrimination, calibration, and risk stratification at the selected thresholds of 8% and 40%.ConclusionIn a low income, pediatric population, we developed a nine variable triage model with high sensitivity and specificity to predict who should be admitted. The triage model can be integrated into any digital platform and used with minimal training to guide rapid identification of critically ill children at first contact. External validation and clinical implementation are in progress.
LC–TOF-MS/MS and GC-MS based phytochemical profiling and evaluation of wound healing activity of Oroxylum Indicum (L.) Kurz (Beka)
Authors: Abdulhafiz Ferid , Reduan Mohd Farhan Hanif , Hisam Anwar Hazim , Mohammad Ibtihal , Abdul Wahab Ikarastika Rahayu , Abdul Hamid Fathin Faahimaah , Mohammed Arifullah , Nordin Muhammad Luqman , Shaari Rumaizi , Bakar Luqman Abu , Kari Zulhisyam Abdul , Wei Lee Seong , Goh Khang Wen , Ahmad Mohd Zain Muhammad Rajaei 
Published: November 2022

Background:Beka (Oroxylum indicum(L.) Kurz) has been used as a culinary herb and natural remedy by the local communities in Malaysia. The leaf ofO. indicumis traditionally used for the treatment of diarrhea, high blood pressure, and improving digestive health.Objectives:The present study was conducted to evaluate the phytochemical constituents and wound healing properties (in vitroandin vivomodels) of aqueous and ethanol extracts ofO. indicumleaves.Methods:The total phenolic (TPC) and total flavonoid (TFC) contents in the plant extracts were determined by the spectrophotometric methods. Further, the extract was characterized by Liquid Chromatography Time-of-Flight Mass Spectrometry (LC-TOF-MS/MS) and Gas Chromatography-Mass Spectrometry (GC-MS). The wound healing activity was assessed using thein vitroscratch wound-healing assay andin vivoexcisional wound model.Results:The results show the ethanol leaves extract had the higher TPC (164 mg GAE/g) when compared with the aqueous leaves extract (30 mg gallic acid equivalents/g). The ethanol leaves extract was also found to have higher TFC (101 mg Catechin equivalents/g) than the aqueous leaves extract (76 mg Catechin equivalents/g). The ethanol leaves extract was then used for further chemical analysis. The LC–TOF-MS/MS analysis showed that the leaves extracts ofO. indicumcontains many important compounds such as Orientin, Chrysin, Pinoquercetin, Cupressuflavone, Puerarin xyloside, Forsythiaside and Paederoside. In GC-MS analysis, 19 compounds were identified in ethanolic leaves extract. The wound healing studies shows thatO. indicumhas promising wound healing activity by increasing the rate of wound contraction significantly (p&lt; 0.05).Conclusion:In conclusion, the present study showed thatO. indicumleaf contains important phytochemicals and the wound healing potential of theO. indicumextract may probably be as a result of the presence of various phytoconstituents.
Rheological comparison between control and Dupuytren fibroblasts when plated in circular micropatterns using atomic force microscopy
Authors: Pérez-Domínguez Sandra , Werkmeister Elisabeth , Marini Maria Luisa , Dupres Vincent , Janel Sébastien , Lafont Frank , Radmacher Manfred 
Published: November 2022

In tissue, cells are obliged to confine and adapt to a specific geometric shape due to the surrounding environmental constraints. Under healthy conditions, fibroblasts present an elongated shape; however, changes in biochemical and physical properties of the extracellular matrix could distort the cell shape, inducing a pathological state. We have studied fibroblasts’ mechanical behavior under circular geometrical constraints. Circular micropatterns force fibroblasts to acquire a different shape from that of a healthy tissue, inducing a possible pathological condition. In total, three different fibroblast types from Dupuytren’s disorder, all obtained from the same patient, were confined in circular-shaped micropatterns of three different diameters (25, 35, and 45 µm), and mechanical properties were evaluated using an atomic force microscope (AFM). We found that control fibroblast mechanics (apparent Young’s modulus) increases with the increasing pattern diameter and comes together with a decrease in cell height and in loss tangent, translated into a more solid-like behavior. We hypothesize that these results resemble the transition toward the myofibroblast phenotype, ameliorating cytoskeleton formation and organization and enhancing cell contraction. Scar and Dupuytren fibroblasts did not display major changes in cell mechanics and cell height when changing the pattern diameter, suggesting that they are less affected by physical changes in the environment as they can adapt their shape to the geometrical dimensions. Therefore, our findings demonstrate that combining micropatterning and AFM measurements provides a powerful tool to study cell mechanics inducing constraints onto the cell, thus mimicking certain aspects of the tissue environment in both healthy and pathological states.
Rhizosphere microorganisms of Crocus sativus as antagonists against pathogenic Fusarium oxysporum
Authors: Zhang Jiahao , Lu Jiemiao , Zhu Yichun , Huang Qinger , Qin Luping , Zhu Bo 
Published: November 2022

IntroductionSeveral microorganisms in the plant root system, especially in the rhizosphere, have their own compositions and functions. Corm rot is the most severe disease of Crocus sativus, leading to more than 50% mortality in field production.MethodsIn this study, metagenomic sequencing was used to analyze microbial composition and function in the rhizosphere of C. sativus for possible microbial antagonists against pathogenic Fusarium oxysporum.ResultsThe microbial diversity and composition were different in the C. sativus rhizosphere from different habitats. The diversity index (Simpson index) was significantly lower in the C. sativus rhizospheric soil from Chongming (Rs_CM) and degenerative C. sativus rhizospheric soil from Chongming (RsD_CM) than in others. Linear discriminant analysis effect size results showed that differences among habitats were mainly at the order (Burkholderiales, Micrococcales, and Hypocreales) and genus (Oidiodendron and Marssonina) levels. Correlation analysis of the relative lesion area of corm rot showed that Asanoa was the most negatively correlated bacterial genus (ρ = −0.7934, p&lt; 0.001), whereas Moniliophthora was the most negatively correlated fungal genus (ρ = −0.7047, p&lt; 0.001). The relative lesion area result showed that C. sativus from Qiaocheng had the highest resistance, followed by Xiuzhou and Jiande. C. sativus groups with high disease resistance had abundant pathogen resistance genes, such as chitinase and β-1,3-glucanase genes, from rhizosphere microorganisms. Further, 13 bacteria and 19 fungi were isolated from C. sativus rhizosphere soils, and antagonistic activity against pathogenic F. oxysporum was observed on potato dextrose agar medium. In vivo corm experiments confirmed that Trichoderma yunnanense SR38, Talaromyces sp. SR55, Burkholderia gladioli SR379, and Enterobacter sp. SR343 displayed biocontrol activity against corm rot disease, with biocontrol efficiency of 20.26%, 31.37%, 39.22%, and 14.38%, respectively.DiscussionThis study uncovers the differences in the microbial community of rhizosphere soil of C. sativus with different corm rot disease resistance and reveals the role of four rhizospheric microorganisms in providing the host C. sativus with resistance against corm rot. The obtained biocontrol microorganisms can also be used for application research and field management.
The Arabidopsis thylakoid chloride channel ClCe regulates ATP availability for light-harvesting complex II protein phosphorylation
Authors: Dukic Emilija , Gollan Peter J. , Grebe Steffen , Paakkarinen Virpi , Herdean Andrei , Aro Eva-Mari , Spetea Cornelia 
Published: November 2022

Coping with changes in light intensity is challenging for plants, but well-designed mechanisms allow them to acclimate to most unpredicted situations. The thylakoid K+/H+ antiporter KEA3 and the voltage-dependent Cl− channel VCCN1 play important roles in light acclimation by fine-tuning electron transport and photoprotection. Good evidence exists that the thylakoid Cl− channel ClCe is involved in the regulation of photosynthesis and state transitions in conditions of low light. However, a detailed mechanistic understanding of this effect is lacking. Here we report that the ClCe loss-of-function in Arabidopsis thaliana results in lower levels of phosphorylated light-harvesting complex II (LHCII) proteins as well as lower levels of the photosystem I-LHCII complexes relative to wild type (WT) in low light conditions. The phosphorylation of the photosystem II core D1/D2 proteins was less affected either in low or high light conditions. In low light conditions, the steady-state levels of ATP synthase conductivity and of the total proton flux available for ATP synthesis were lower in ClCe loss-of-function mutants, but comparable to WT at standard and high light intensity. As a long-term acclimation strategy, expression of the ClCe gene was upregulated in WT plants grown in light-limiting conditions, but not in WT plants grown in standard light even when exposed for up to 8 h to low light. Taken together, these results suggest a role of ClCe in the regulation of the ATP synthase activity which under low light conditions impacts LHCII protein phosphorylation and state transitions.
Resilience and caregiving ability among caregivers of people with stroke: The mediating role of uncertainty in illness
Authors: Wang Jinyao , Cui Jun , Tu Shuangyan , Yang Rong , Zhao Lihong 
Published: November 2022

BackgroundIn China, stroke survivors are usually cared for by their family members. However, the caregiving ability of these informal caregivers remain inadequate during the hospitalization of their family members following a sudden onset of a stroke, and this sudden need for care overwhelms caregivers even after the hospital discharge. Therefore, research is required to identify predictors of caregiving ability that could be targeted in future interventions aimed at improving caregiving skills and reducing the burden on caregivers who care for stroke survivors.Materials and methodsFrom August 2019 to February 2020, stroke survivors were hospitalized for the first time, and their family caregivers were registered via convenience sampling. Caregiver demographic information, resilience status, uncertainty in illness, caregiving ability, and patients' severity of stroke were measured using standardized questionnaires. Structural equation modeling was used to test the proposed model, where caregiver resilience and stroke severity predicted caregiving ability directly, and uncertainty in illness mediated the association between caregiver resilience and caregiving ability.ResultsA total of 306 dyads were included in the study. The tested model fit the data well (χ2 = 118.2, df = 64, RMSEA = 0.053, CFI = 0.946, TLI = 0.923). Statistically significant pathways linked caregivers' resilience status to uncertainty in illness (β = −0.558, S.E. = 0.022, P &lt; 0.01), caregivers' resilience to the status of caregiving ability (β = −0.269, S.E. = 0.013, P &lt; 0.01) and caregivers' uncertainty about the illness to caregiving ability (β = 0.687, S.E. = 0.051, P &lt; 0.01). We also found that caregivers' uncertainty in illness mediated the association between caregivers' resilience and caregiving ability (β = −0.384, S.E. = 0.061, P &lt; 0.01).ConclusionsOur structural equation modeling result identified resilience and uncertainty about the illness as predictors of the caregiving ability of informal family caregivers who suffered from care burdens. Supporting family caregivers to build their resilience and reduce illness uncertainty may improve caregiving for stroke survivors.
Alterations in rat prefrontal cortex kynurenic acid levels are involved in the enduring cognitive dysfunctions induced by tetrahydrocannabinol exposure during the adolescence
Authors: Beggiato Sarah , Ieraci Alessandro , Zuccarini Mariachiara , Di Iorio Patrizia , Schwarcz Robert , Ferraro Luca 
Published: November 2022

IntroductionCannabis abuse during adolescence is a risk factor for cognitive impairments in psychiatric disorders later in life. To date, the possible causal relationship between cannabinoids, kynurenic acid (KYNA; i.e., a neuroactive metabolite of tryptophan degradation) and cognition has not been investigated in adolescence. Early exposure to delta 9-tetrahydrocannabinol (THC; i.e., the main psychotropic component of cannabis) causes enduring cognitive deficits, which critically involve impaired glutamatergic function in the prefrontal cortex (PFC). In addition, prenatal cannabis exposure results in enduring increases in PFC KYNA levels. Based on these findings, the effects of chronic THC exposure in rats, during another critical period of neurodevelopment particularly sensitive to perturbation by exogenous stimuli, such as adolescence, have been investigated.MethodsMale Wistar rats were chronically treated with vehicle or ascending intraperitoneal (i.p.) doses of THC starting on postnatal day (PND) 35 until PND 45. In adulthood (PND 75), cognitive assessment (Y-maze) and extracellular KYNA/glutamate levels were measured in the PFC by in vivo microdialysis, before and after a challenge with KYN (5 mg/kg i.p., the biological precursor of KYNA). By using the selective, brain-penetrable KAT II inhibitor PF-04859989, we then examined whether blockade of KYNA neosynthesis prevents the cognitive impairment.ResultsCompared to vehicle-treated controls, extracellular basal KYNA levels were higher in the PFC of adult rats chronically exposed to THC in adolescence (p &lt; 0.01). No changes were observed in extracellular glutamate levels. Following a challenge with KYN, extracellular KYNA levels similarly increased in both groups (i.e., vehicle- and THC-treated; p &lt; 0.001 and p &lt; 0.01, respectively). Chronic adolescent THC exposure negatively affected short-term memory (reduced spontaneous alternation), in adult animals (p &lt; 0.001), while PF-04859989 (30 mg/kg i.p.) restored the cognitive impairment (p &lt; 0.05).DiscussionWe propose that the observed alterations in PFC KYNA signaling might be involved in the cognitive dysfunction induced by the exposure to THC during the adolescence. In the translational realm, these experiments raise the prospect of prevention of KYNA neosynthesis as a possible novel approach to counteract some of the detrimental long-term effects of adolescence cannabis use.
Prevalence of refractive error among Chinese preschool children: The Changsha children eye study
Authors: You Yuxia , Fu Junxia , Xu Ming , Song Yali , Zhou Huanfen , Wei Shihui 
Published: November 2022

PurposeWe aimed to investigate the refractive status and prevalence of refractive error, as well as its characteristics in Chinese preschool children aged 1–6 years old.MethodsA population-based cross-sectional study—Changsha Children Eye Study (CCES) was conducted. The prevalence of refractive errors among children aged 1–6 years old from 18 community health service centers was surveyed. A handheld child vision screener, Suowei, was used for examination.ResultsA total of 43,105 preschool children were included. The mean spherical equivalent (SE) was 0.42 ± 1.05 D for the right eyes. The mean astigmatism (diopter of cylinder, DC) was −0.83 ± 1.02 D for the right eyes. The magnitude of refractive error was lower in older children, indicating the ongoing of the emmetropization during the 1–6-year-old children. The prevalence of myopia (SE ≤ −1.00 D), hyperopia (SE ≥ +2.00 D) and astigmatism (DC ≥1.50 D) was 2.94, 13.8 and 17.6%, respectively. The prevalence of myopia decreased with the increase of age between the six age groups (P&lt; 0.001). The prevalence of hyperopia was lower in 5–6 years old, whereas, the prevalence of myopia was slightly higher at this period of time. With-the-rule (WTR) astigmatism (+ cylinder axis 90° ± 15°) was the most prevalent type of astigmatism than against-the-rule (ATR) astigmatism (+ cylinder axis 180° ± 15°) and oblique (OBL) astigmatism (X2= 209.5,P&lt; 0.001). The binary logistic regression model showed that older age and suffering astigmatism were independently associated with the development of myopia. In addition, there was no significant gender difference in the prevalence of myopia, emmetropia, and hyperopia.ConclusionsOur population-based cross-sectional study investigated the prevalence of myopia, hyperopia, and astigmatism in preschool children aged 1–6 years old. The distribution of the refractive error was disperse in the younger group and gradually turned more centralized in older group. Similar to hyperopia, with age increased, the prevalence of myopia was lower in preschool children younger than 5 years old and then slightly increased at 5–6 years, which may indicate an early sign of myopia in school-age children. Therefore, we emphasize that more attention should be given to the children at this age.
Perceptions on a mobile health intervention to improve maternal child health for Syrian refugees in Turkey: Opportunities and challenges for end-user acceptability
Authors: Meyer Christina L. , Surmeli Aral , Hoeflin Hana Caitlyn , Narla Nirmala P. 
Published: November 2022

BackgroundMobile health (mhealth) technology presents an opportunity to address many unique challenges refugee populations face when accessing healthcare. A robust body of evidence supports the use of mobile phone-based reminder platforms to increase timely and comprehensive access to health services. Yet, there is a dearth of research in their development for displaced populations, as well as refugee perspectives in design processes to improve effective adoptions of mhealth interventions.ObjectiveThis study aimed to explore healthcare barriers faced by Syrian refugee women in Turkey, and their perceptions of a maternal-child health mobile application designed to provide antenatal care and vaccine services. These findings guided development of a framework for enhancing acceptability of mobile health applications specific to refugee end-users.MethodsSyrian refugee women who were pregnant or had at least one child under the age of 2 years old at the time of recruitment (n = 14) participated in semi-structured in-depth interviews. Participants had the opportunity to directly interact with an operational maternal-child health mobile application during the interview. Using a grounded theory approach, we identified critical factors and qualities mhealth developers should consider when developing user-friendly applications for refugees.ResultsIt was observed that a refugee's perception of the mobile health application's usability was heavily influenced by past healthcare experiences and the contextual challenges they face while accessing healthcare. The in-depth interviews with refugee end-users identified that data security, offline capability, clear-user directions, and data retrievability were critical qualities to build into mobile health applications. Among the features included in the maternal-child health application, participants most valued the childhood vaccination reminder and health information features. Furthermore, the application's multi-lingual modes (Arabic, Turkish, and English) strengthened the application's usability among Syrian refugee populations living in Turkey.ConclusionsThe inclusion of refugee perceptions in mhealth applications offers unique developer insights for building more inclusive and effective tools for vulnerable populations. Basic upfront discussions of the mobile application's health goals and its personal value to the user may improve their long-term use. Further prospective research is needed on retention and use of mobile health applications for refugee women and other displaced populations.
The design and application of an intensive care unit point-of-care nursing handover checklist based on the situation, background, assessment, and recommendation technique
Authors: Wang Lei , Ma Yu-Jie , Chen Xiao-Ting , Zhang Jie , Liu Tao 
Published: November 2022

ObjectiveThis study aims to analyze the effect of using an intensive care unit point-of-care nursing handover checklist based on the situation, background, assessment, and recommendation (SBAR) communication technique.MethodsAn intensive care unit point-of-care nursing handover checklist was designed based on the SBAR technique, and standard point-of-care nursing handover procedures and effect assessment indicators were established to compare the occurrence of adverse handover events and nursing risks with those previously observed.ResultsBefore and after the application of the intensive care unit point-of-care SBAR checklist, the occurrence of missed items during the handover was 7.26 and 2.02%, inadequate preparation for handover was 28.33 and 5%, and nursing risks were 5 and 1.67%, respectively.ConclusionBased on the SBAR technique, the application of an intensive care unit point-of-care nursing checklist reduced the occurrence of adverse handover events and nursing risks.